Abstract: The present invention provides a method and device for preventing cerebral embolization during endovascular procedures in the carotid arteries. The invention comprises a guide catheter and balloon, which may selectively occlude the common carotid artery, and further comprises a wire and balloon, which may selectively occlude the internal carotid artery. Occlusion of the common carotid artery will induce retrograde flow at the site, redirecting emboli to the external carotid artery. Occlusion of the internal carotid artery reduces the risk of emboli migrating to the brain, and allows clearance of the site by antegrade blood flow from the common carotid artery. Occlusion of both the common and internal carotid arteries induces a quiescent state at the site during the procedure. Control of blood flow by selective inflation and deflation of either or both balloons, in concert with the procedures, will reduce the risk of emboli migrating to the brain.

Abstract: Paired vascular clamps simplify laparoscopic vascular reconstruction surgery by providing an instrument for bringing vessel ends together to a reasonable working distance under a controlled fashion. A first clamp, with a pivoted connecting arm, and a second clamp with a lock/release device for attaching the second clamp to the connecting arm, can be inserted through an trocar or other port into a surgical field and then positioned on with the first clam and the second clamp in side-by-side and substantially parallel relationship, so that said first clamp and said second clamp can hold and position one or more vessels or elongated tissues. A laparoscopic approximator-everter has extendable blades for gripping blood vessel edges or other tissue to be anamosted, and an extendable sheath that can be advanced to surround the blades.

Abstract: A medical device for placing a very small embolic coil at a preselected location within a vessel comprising a positioning catheter having a distal tip for retaining a headpiece with an attached embolic coil such that when the catheter is pressurized with a fluid the distal tip of the catheter expands outwardly to release the headpiece and coil at the preselected position.

Abstract: An endovascular stent for vascular vessels which can be used to occlude the vessel or which can be used to bridge damaged areas in the vessel. The endovascular stent comprising a stent that can be permanently expanded from a first diameter to a larger second diameter. The stent can be a helically wound wire stent, each wire comprising at least two strands. The two strands being twisted. The twisted strands securing fibers to form a fabric pile extending outwardly from stent, and optionally extending inwardly into the stent. In a second embodiment, the stent is enclosed with a tubular-like expandable graft. The graft having an exterior fabric pile made up of individual fibers. In both embodiments, the fibers or the pile are optionally coated with a hydrophilic polymeric gel which expands upon being wetted.

Abstract: There is disclosed a ligating apparatus comprising an introducing tube which can be inserted in a living body cavity, a manipulating wire inserted in the introducing tube in such a manner that the manipulating wire can freely advance or retreat, a clip which is directly joined to a tip end of the manipulating wire, which has a holding portion formed in a tip end of an arm portion extending from the base end, and which has an extending/opening property, and engaging means disposed in at least one of the base end of the clip and the tip end of the manipulating wire, wherein at least one of the engaging means is deformed and releases engaging of the clip and the manipulating wire, when the clip engages with the tip end of the introducing tube, and a force for detaching the base end of the clip from the tip end of the manipulating wire is applied.

Abstract: A releasable, surgical clamp (10) for insertion through a surgical introducer sheath (11) and into a cavity (12) of a patient (13) during a minimally invasive surgical procedure. The releasable clamp comprises a continuous wire (39) that is shaped for insertion through the surgical sheath and into opposing jaws (14, 15). The jaws have a plurality of open and closed positions. One of the jaws has a retainer (16) that maintains the lateral displacement (17) between the opposing jaws and prevents the clamp from twisting off a vessel. A resilient assembly (18) including a torsion spring (19) and first and second resilient arms (20, 21) extending to the opposing jaws urges the jaws to a closed position. Each of the resilient arms includes a distal portion which cross each other urging the opposing jaws to a closed position.

Abstract: Disclosed are implants for use in biomedical treatment thermally, including thermo-coil, thermo-guide wire and thermostent. Thermally heated, magnetic material selected from among duplex stainless steel, nickel-copper alloy, iron-nickel alloy, palladium-cobalt alloy, and palladium-nickel alloy is fabricated into coils or tubular forms which can be inserted into the lumen. The material is treated at 200-1,500° C. After being inserted into the body, the implants can generate heat by themselves in response to the application of an external magnetic field, without a separate electrical connection to the exterior, thereby inducing necrosis or physiological changes at the target site and neighboring tissues to improve therapeutic effects at the target site.

Abstract: A clamp configured and constructed for use in clamping a saphenous vein for use in coronary bypass surgery comprising a pair of pivotally connected clamping members, each constructed and configured to define a vein engaging clamping structure and a handle element for actuating the clamp means pivotally connecting the clamping members biasing means for biasing the clamping structures toward each other and ratchet means for adjusting the biasing element to apply a variable desired clamping force to the clamping structures is disclosed.

Abstract: In order to simplify the structure and production in the case of a surgical clip with two clamping arms, which may be swivelled relative to one another around a rotational axis and in one clamping position have a clamping region where they essentially abut one another, said clamping arms respectively having a free end and an end provided with a bearing, wherein a joint shaft defining the rotational axis is disposed in the two bearings, and with a tension element assigned to the two clamping arms and holding these under prestress in the clamping position, it is proposed that the shaft is formed by the tension element.

Abstract: A method and devices for protecting kidneys from irreversible damage. The method is based on controlling or restricting blood flow through renal arteries in order to prevent kidney failure. The devices are delivered to a renal artery for restricting the flow of blood through the artery to the kidney. The devices may take the form of internal restrictors, such as an orifice, a venturi, a tapered coil, or a perforated sleeve that is inserted in a renal artery, or external devices such as an inflatable cuff or balloon, or a clamp that is placed around a renal artery. The improved method of the present invention includes means for delivering the internal devices to renal arteries by a percutaneous catheter system, or external devices by endoscopic devices or surgery.

Abstract: A method for delivering a plurality of individual surgical fasteners includes the steps of providing a surgical fastener delivery device. The delivery device has a drive mechanism having a distal and a proximal end, and a first and a second opposing member. The members are moveable proximally and distally with respect to the delivery device, and individually with respect to each other. The delivery device further includes a plurality of surgical fasteners located between the first and the second members. Next, the surgical fastener delivery device penetrates tissue by moving the drive mechanism distally. A distal end of one of the fasteners is partially deployed by moving the first member proximally. Finally, the distal end of the fastener is fully deployed by moving the second member proximally.

Abstract: A device 10 and method for replacing or restoring competence to incompetent valves. The device 10 is inserted percutaneously or surgically and is preferably constructed of a material capable of promoting cellular ingrowth such that, eventually, native biologic tissue completely covers the device 10 insulating the blood flow therefrom. The material is preferably bioabsorbable over time, allowing the device to harbor the regeneration of a valve structure and to later become absorbed by the body. The device is sized and arranged to mimic the valve it is replacing or repairing.

Abstract: A sealing device for a puncture in a blood vessel, the device being slidingly receivable over a guide tube and comprising a tubular, resilient sealing member formed with a sealing portion spontaneously sealable upon deployment of the device into an activated state, an engaging portion for bearing against an external surface of the blood vessel and a plurality of anchors fitted at their fore end with fasteners for engaging an internal surface of the blood vessel. The anchors are displaceable between a constricted position in which they blend with the tubular sealing member, and an operative position in which the fasteners are laterally deployed to engage the internal surface of the blood vessel.

Abstract: An intravenous surgical instrument comprises an inner shaft or post and an outer sheath. At a distal end of the inner post a spring-tail or whip-like electrode is disposed substantially in a sagittal plane, or one perpendicular to a longitudinal axis of the shaft. Following an insertion into a human vein or other circulatory vessel the distal end of the shaft is protruded from the sheath; thereafter sheath, post and electrode are simultaneously withdrawn from the vein, with a relative rotatory motion being imparted to the electrode. A current flow is preferably simultaneously imposed across the electrode into an inner surface of the surrounding vessel, facilitating a damaging of the vessel inner surface and a collapse of the vessel.

Abstract: A device (1) for closing a canal-shaped anastomosis (2), between the aorta (3) and the pulmonary artery (4), which remained open after the birth of a person (6). It is formed by a closing element (8) that can be inserted using a catheter (7) and that has two seals (10) and (11) spaced apart from each other and connected via an elastic tension element (9). The two seals have a certain elasticity and in the usage position, cover or fill up the two mouths or ends of the anastomosis (2), located between the aorta (3) and the pulmonary artery (4). The seals (10) and (11) can be folded, so that they on the one hand fit into the catheter (7) and on the other hand, can be introduced through the anastomosis (2) and brought to the respective application position.

Abstract: An aorta cross clamp assembly includes a clamp having movable jaws and a removable actuator having movable handles. Initially, the actuator is connected to the clamp with the jaws in an open position. When the actuator handles are closed, the jaws also will be closed. The clamp is provided with a toothed retainer that prevents the jaws from being opened accidently. The actuator can be detached from the clamp and removed from the operative site, leaving the locked clamp in place. When it is desired to remove the clamp, the actuator can be reattached to the clamp and used to disengage the toothed retainer. The actuator then can be used to spread the jaws in order to permit the clamp to be removed. The clamp and the actuator are provided in two forms. In one form, the toothed retainer is engaged and disengaged by movement toward and away from the jaws (“horizontal” movement).

Abstract: A delivery device for delivering an implantable endoprosthesis with an occlusion region for occluding fluid flow to a desired location in a body lumen. The delivery device includes an outer sleeve and an inner tube terminating at a distal tip. The distal tip is made of one of a dissolvable, bioabsorbable, or deformable material. Upon deployment of the endoprosthesis at the desired location, the shape of the distal tip is altered to a different shape and withdrawn through the constricted region of the endoprosthesis.

Abstract: The surgical instrument for stapling and cutting a blood vessel or other organic structure utilizes surgical staple clips. The surgical instrument includes an elongated tube or rod having a longitudinally movable rod disposed therein. A handle is mounted on the proximal end of the tube. The handle has a movable member which causes the movable rod to longitudinally shift positions in the tube. In one version, a pair of surgical staple clip-carrying jaw sets are pivotally mounted on a common lateral axis located at the distal end of the elongated tube. A scissor jaw set may also be included in the system. When the rod longitudinally moves with respect to the elongated tube or rod, the clip jaw sets clip the surgical staple clips onto the blood vessel or other organic structure. The handle for the surgical instrument includes a movable member coupled to a movable rod and a stationary grip member mounted to the elongated tube, within which moves the longitudinally movable rod.

Abstract: Replaceable pads are provided for jaw-type surgical clamps, clips and other occluding devices. The pads include elastomer impregated mesh embedded in and extending from an elastomeric cushion. When engaged with a vessel, the mesh partially penetrates the adventitial layers of the vessel, securing outer adventitial layers against inner vessel layers to resist relative movement of the layers, thereby minimizing slippage of the device along the clamped vessel. The embedded mesh also functions to stabilize the cushion, especially against lateral movement.

Abstract: A clamp for clamping a body structure in a patient. The clamp includes a flexible cable housed within a sheath. The cable and sheath extend between a clamp and a handle. The cable actuator. The cable extends through a sheath which is anchored at the clamp and the actuator for actuating jaws from a proximal end of the clamp. A malleable positioner is provided for positioning the clamp about the body structure.

Abstract: A filter is provided that is convertible from a filter configuration to an open, stent-like configuration. The filter includes a plurality of intraluminal filter elements (filter legs) that may be formed into a single cone or dual cone filter structure. A retainer secures the filter legs in the filter configuration upon initial deployment within a vessel. The retainer is then either self-releasing or removable to permit the filter legs to expand from the filter configuration into what may generally be described as an open or stent-like configuration.

Abstract: Medical forceps for vascular surgery are presented. The forceps serve as vascular clamps, allowing a vascular surgeon to close torn or ruptured veins, both laterally and transversely, and to allow the clamp to remain in place without damaging the veins. The forceps are constructed of flexible stainless steel stems, having a two clamps defined at one end thereof in the form of interengaging rows of teeth. At an opposite end of the stems, a pair of grips are presented for use by the surgeon. Maintained in close proximity to the grips are a pair of locking tabs, one associated with each of the stems, the locking tabs being configured to allow for selective locking engagement of either of the clamps defined at the opposite end of the forceps. The forceps are preferably manufactured of 420 stainless steel, appropriately heat treated such that the flexibility of the stems dissipates much of the force imparted through the grips, such that a clamped vein is not damaged thereby.

Abstract: The invention includes a composite tube for forming an arteriovenous fistula with at least two conjoined segments or sections. The first section includes an elongated tubing formed from PTFE or another catheter material that is similarly amenable for convenient arterioveneous access. The second section includes an elongated tubing formed from silicone or another suitable long term catheter material. An intermediate connection couples the first section to the second section. The diameter of the first segment is between 2 mm. to 10 mm. while the second segment is between 4 to 8 millimeters at the coupling site and tapers to approximately 3 to 4 mm. distally. The second segment includes outlet ports proximate a beveled tip permitting outward blood flow. Several intermediate connections may be employed including single composite tubing, flanged segments and male and female tabbed collars, as long as the connection allows uninterrupted laminar flow across the entire length of the arteriovenous fistula.

Abstract: An endoscopic clip applier for the temporary as well as permanent occlusion of vessels and the clipping of other tissues. The clip applier includes an elongated outer body having a proximal end attached to an actuating mechanism and a distal end. An elongated inner member is slidably positioned within the outer body and has a proximal end coupled to the actuating mechanism and a distal end coupled to a pair of generally opposing jaws. Movement of the inner member relative to the outer body pivots the jaws open and closed. The jaws are configured for receiving and supporting a malleable surgical clip which is insertable within an internal retention groove within each jaw. Each groove has an undercut portion at its distal end which is configured to mate with an outwardly tapering portion at the distal end of each clip. When forced distally in the grooves, the distal ends of the clip are moved into the undercut portion and the clip retained within the groove.

Abstract: In order to provide better guidance for the two branches in the region of a cross-over point of a vascular clip having a first and a second branch which are pivotal resiliently into a closed position whereby, in the region of the cross-over point, the first branch passes through a longitudinal slot in the second branch formed between two parallel webs, it is proposed that a bridge piece be arranged laterally of the first branch which passes through the second branch, and that the bridge piece extends in parallel with the section passing through the longitudinal slot in the second branch and, together with the section passing through the longitudinal slot in the second branch, forms a longitudinal slot which is closed at each side and into which a web of the second branch is guided.

Abstract: The present invention relates to new and useful apparatus for use with an intraluminally directed anvil apparatus for intraluminally directed vascular anastomosis of an end of a graft vessel to the wall of a receiving blood vessel that is performed according to a minimally invasive procedure. The intraluminally directed vascular anastomosis does not require the interruption of blood flow in the receiving blood vessel and it is versatile enough to suitably combine a variety of cutting, welding, soldering, sealing, and joining techniques such as stapling. The intraluminally directed anvil apparatus comprises an anvil and a wire used for signaling the optimal anastomosis site; this signaling can be performed when the initial exploration is performed. The intraluminally directed anvil apparatus is typically used with a catheter.

Abstract: A surgical instrument for stapling and cutting a blood vessel or other organic structure utilizes at least two surgical staple clips. The surgical instrument in one embodiment includes an elongated tube with a longitudinally movable rod disposed therein. A handle, mounted on a proximal end of the tube, includes a movable member which causes the movable rod to move longitudinally. In one embodiment, a pair of surgical staple clip carrying jaw sets are pivotally mounted on a common lateral axis located at the distal end of the elongated tube, each clip jaw set includes at least two jaw members, and each jaw member defines a clip action cam following channel. In a further embodiment, jaw members are ganged together and move as a unit based upon a cam follower surface motivated by a cam actuator member.

Abstract: An instrument for use in endoscopic surgery in human or animal bodies, said instrument, in particular, being insertable into said body through a channel of an insertion instrument. The invented instrument is distinguished by the instrument comprising at least one operating element disposed at the distal end thereof and one oblong introduction and control component connecting in the operating element to the proximal region, and the operating element and the introduction and control component being joined in such a manner via a connecting mechanism that the operating element can be disconnected intracorporally from the introduction and control component and can be reconnected thereto.

Abstract: A U-shaped surgical clip having two arms is provided. The arms are connected to one another via a deformable web. In order firstly to increase the application safety and secondly to simplify application, it is proposed that, via the junction point of the arms with the web, the arms comprise rearwardly projecting extensions. Interacting catches are disposed at these extensions and/or at the deformable web. The catches fix the extensions to one another and/or fix the web to these extensions when the web is deformed upon the compression of the arms and is forced against the extensions.

Abstract: A surgical device having a latching mechanism comprising a latch member; and a retaining member having at least one aperture adapted to receive and retain said latch member in a locked position, said latch member and said retaining member being of contrasting colors so that when the latch member is locked in place by the retaining member that the latch member's presence in the locked position is externally visible.

Abstract: An improved surgical clip and clip applicator for placing a surgical clip over a target structure. The surgical clip generally has a pair of opposing clamp arms, each having an associated clamping surface, and a connecting portion joining the clamp arms and biasing them to a normally closed position. The surgical clip may be opened and locked into the open position prior to being loaded into a clip applicator or the surgical clip may be opened by a clip applicator itself. The surgical clip and clip applicators require reduced actuation forces and simplified applicator mechanisms.

Abstract: An apparatus for modulating flow in biological conduits has a valve mechanism which has an open state and a closed state. The valve is applied and secured to a particular biological conduit while being maintained in an open state. An actuating mechanism is provided which actuates a change of state of the valve from an open state to a closed state in response to leakage from the biological conduit. In one embodiment, actuation is automatic and in another it is manual but remote. A preferred embodiment is a pinch valve such as that used in temporary micro vascular surgery to which is added an effectively resilient element interposed between opposing members of said clip. The interposed element is configured such that it is unable to maintain the clip in an open position unless the clip opening is augmented by manual or other means, and it is able to maintain the clip in an open position if a blood vessel is placed within the clip and has an adequate flow.

Abstract: The present invention relates to a vascular clamp assembly. The vascular clamp assembly includes at least one bendable elongated shaft with a proximal part and distal part. A pair of clamping members are located at the distal part of the shaft. The clamp includes means for moving the clamping members between an open position and a clamping position.

Abstract: Medical devices or components for medical devices formed from bioabsorbable elastomers comprising a segmented copolymer are disclosed. The segmented copolymer is a copolymer of from about 30 to about 40 mole percent of lactide and the balance being substantially p-dioxanone. The segmented copolymers surprisingly exhibit elastomeric properties, and the copolymers are bioabsorbable. The combination of physical and biological properties of these elastomeric copolymers are particularly well suited for numerous medical and surgical applications.

Abstract: This invention is an occlusive device for inserting into body cavities or vesicles. More particularly, it is a vasoocclusive device which, as used, is in the approximate shape of an anatomical cavity. It may be ultimately deployed as a substantially spherical shape in the operable configuration. The device is a self-forming shape made from a pre-formed occlusive strand of flexible material. The occlusive strand may be helically coiled or braided and may be adapted with various polymeric fibers. The device is typically introduced through a catheter in the substantially linear inoperable configuration. The invention provides a plurality of such substantially spherical strand portions which nest concentrically with each other in the operable configuration. The invention also includes methods of producing and using the substantially spherical occlusive devices.

Abstract: A manually operable clip operable as a hemostasis valve for use with intravenously inserted catheters. The valve preferably comprises a unitary piece of wire formed to have first and second jaw portions defining front and back ends that preferably include transversely extending arms formed thereon. The valve is further formed such that a spring portion is provided interconnecting the first and second jaw portions that extends intermediate the front and back ends thereof and between said transversely extending arms which is operable to bias the front ends towards each other such that when positioned upon the catheter, such biasing force causes the lumen thereof to assume a closed state. The back ends of the first and second jaw portions may be manually actuated to release the clip from the catheter.

Abstract: Methods and apparatus for passing attachment apparatus (e.g., connector devices, staples, etc.) or connector material (e.g., suture thread, wire, cord, filament, monofilament, etc.) into or through the wall of a luminal anatomical structure (e.g., a blood vessel or other anatomical conduit) for the purpose of; i) closing the lumen of the anatomical structure, ii) forming an anastomotic junction between separate anatomical structures (or between approximated segments of the same anatomical structure), and/or iii) attaching an article (e.g., an endoluminal, extraluminal or transluminal graft) or other apparatus to the wall of the anatomical structure.

Abstract: An apparatus for application of surgical clips to body tissue is disclosed having a handle assembly and an elongated body portion extending distally from the handle assembly. A jaw assembly is mounted at a distal end portion of the elongated body portion and includes first and second jaws movable between an open position and a closed position. An actuator is disclosed which is slidable within the elongated body portion in response to actuation of the handle assembly. The actuator has camming structure at a distal portion thereof for moving the first and second jaws between the open position and the closed position. A loading unit is releasably mounted to the elongated body portion and stores a plurality of surgical clips therein. The loading unit includes a clip advancer having a portion engageable with the actuator and movable therewith for advancing a distalmost surgical clip and a ratchet assembly associated with the clip advancer to index progressive movement thereof.

Abstract: The present invention relates to a vascular clamp assembly. The vascular clamp assembly includes at least one bendable elongated shaft with a proximal part and distal part. A pair of clamping members are located at the distal part of the shaft. The clamp includes means for moving the clamping members between an open position and a clamping position.

Abstract: In accordance with the present invention, there is provided a surgical device for attaching a first hollow organ to a second hollow organ and creating a passageway therebetween. The device includes a first member comprising a first prong for entering a wall of the first hollow organ and a second prong for entering a wall of the second hollow organ. The prongs each have a proximal end which attaches to the first member and a distal end extending therefrom. The device further includes a second member having a plow for incising at least one of the hollow organs so as to create a passageway between the hollow organs. The second member further includes a plurality of needle paths on either side of the plow for guiding a needle through the walls of the hollow organ on either side of the passageway. The device further includes a means for driving a needle, having a suture attached thereto, so as to attach the hollow organs together.

Abstract: A device for occluding abnormal vessel communications is of the type comprised by a wire which, being pre-formed as a means of endo-luminal blocking and being stretchable in the direction of its longitudinal axis, has heat-sensitive resilient memory; said wire, which is to be introduced into an abnormal vessel communication, such as that produced between arteries and veins, or between systemic arterial circulation and pulmonary circulation, is characterized in that the wire is shaped as a conical spiral, the apex of which is followed by a terminal portion of the same wire, bent as a hook; such that the loops of said wire define portions of different diameter, which may be adapted to the vessel gap or passage, while the end as a hook is a means for anchoring the occluding device, emerging through the smaller end of the lumen.

Abstract: A low profile unobtrusive occluder device is disclosed which is particularly applicable for occluding blood vessels in minimally invasive beating heart CABG surgical procedures, wherein relatively small surgical openings are provided. At least one flexible member is provided on the occluder, which is placed against the vessel. A suture thread is passed under the vessel to encompass the vessel between the occluder and suture thread. The suture thread is selectively attached to the occluder such that the flexible member, when deformed, applies continuous selected tension on the suture thread to apply a corresponding compression on the vessel which occludes the flow of blood. An applicator is attached to the occluder to enable installation thereof, but is detachable after installation such that only the low profile occluder remains on the heart surface during surgery. The applicator is re-attached to the occluder to facilitate removal of the latter.

Abstract: Clips having pseudoelastic properties at body temperature are used to cause hemostatis of blood vessels located along the gastrointestinal tract. Methods for causing the hemostasis of blood vessels and ulcer beds using the clips of the present invention are also disclosed.

Abstract: A surgical clip includes a first jaw and a second jaw relatively movable in a first direction between a first relatively proximate position and a second relatively spaced position. The jaws in the second position have a predetermined dimension in the first direction. The clip has an overall maximum dimension in the first direction which is not greater than about the predetermined dimension of the jaws in the second position. A spring under tension is housed in a telescoping barrel and coupled between the first and second jaws for biasing the jaws to the first position.

Abstract: An improved elastic band for ligating tissue within a living body comprises a central opening defining an axis. A first curved edge is formed between a first surface extending substantially parallel to the axis and a second surface extending substantially perpendicular to the axis. A method of ligating tissue within a living body using such a ligating band comprises the steps of positioning the elastic band, which has been stretched to increase the size of a central opening extending therethrough, adjacent to a portion of tissue to be ligated. The tissue to be ligated is then drawn through the central opening of the elastic band and the elastic band is released so that the size of the central opening decreases to grip the tissue received therein.

Abstract: The present invention provides a device and method for creating a seal around the inner wall of an incision in a blood vessel. The device is particularly adapted to create an anastomosis site for coronary artery bypass grafts to a patient's aorta without obstructing the flow of blood in the aorta. The device comprises an extruded tube with a translatable shaft positioned therein. One end of the shaft is coupled to a handle of the device which allows a practitioner to advance and withdraw the shaft relative to the tube. The other end of the shaft is connected to a flexible inverting member which is attached to the distal end of the tube. By manipulating the handle, the practitioner can remotely deform the inverting member between two configurations: an elongated, narrow configuration in which the inverting member is adapted to be inserted through a small incision, and an inverted configuration in which the inverting member forms an expanded, inward-facing cup.

Abstract: An attachment assembly and repair graft are disclosed for securing a graft to repair a vessel having an aneurysm therein. The attachment assembly comprises an attachment cuff such that the graft is not dimensionally dependent upon the size of the vessel. A visualization apparatus is also disclosed for real time direct viewing of an interior of a vessel. A penetration apparatus is disclosed for use in forming treatment specific holes in a potentially calcified vessel wall which facilitates thereafter the securing of the graft and attachment assembly to the vessel wall. An introducer sheath device is also disclosed that comprises a sealing assembly for preventing the loss of blood from the vessel during the insertion and subsequent removal of surgical components during the surgical procedure.

Abstract: The present invention provides umbilical cord clamps that comprise two or more different colors at the distal end of each of the elongated arms of the clamps. The colors are complementary to each other so that, when combined, they create a third color.

Abstract: A clip, clip applier and method for ligating a tissue structure is provided. The applier has a two stage actuation. In the first stage, a tissue structure is positioned into the jaws of the clip applier. The jaws close and lock to a preset force to compress and temporarily occlude the tissue structure. If satisfactorily positioned, the second stage is initiated in which a clip is advanced through the shaft of the clip applier in a closed position. At the distal end of the clip applier, the clip is opened slightly to capture the pre-compressed tissue structure, and is placed over the structure. The clip is then dissociated from the business end of the instrument. Preferably the clip comprises two leg members disposed in close proximity to one another joined from opposing directions by a connecting element. The connecting element restricts separation of the leg members with opposing spring members so as to provide substantially uniform parallel deflection of the leg members from each other.

Abstract: A flexible implant (1) with a cylinder-like basic form has near its first end (2) an eye-like opening (3), the axis (4) of which runs transversely to the cylinder axis. The implant (1) can be closed to a ring form by guiding the second end (6) through the opening (3), and is thus suitable in particular for the treatment of reflux oesophagitis and/or axial hiatus hernia.