Abstract: Use of one or more saccharides, for example one or more non-toxic mono-, di-, tri-, oligo- or polysaccharides, in the manufacture of a biocompatible glue for adhering a first structure to a surface of a second structure. The biocompatible glue can be adapted to act as a temporary glue. In this case the glue may be used to enable a medical structure to be transferred from a medical instrument onto the surface of a structure of a human or animal body, for example as in the transfer of a buffer material from the fork of a surgical stapler to a diseased lung after one or more rows of staples have been fired through the buffer material into the lung during lung volume reduction surgery for treating emphysema. The biocompatible glue can also to advantage be used to adhere or secure medical structures to a structure of a human or animal body direct, such as in the case of a patch being applied to the skin of a mammal.

Abstract: A hemostatic device formed of collagen particles and methods for producing and using the hemostatic device to control bleeding are provided. The collagen particles of the hemostatic device have a hemostatic activity that is equivalent to the hemostatic activity of the collagen particles from which the hemostatic device is formed. More preferably, the hemostatic devices are formed of Avitene® flour and the collagen particles of the hemostatic devices of the invention have a hemostatic activity equivalent to the hemostatic activity of Avitene® flour. The hemostatic devices optionally include hemostatic agents and/or therapeutic agents, to further promote hemostasis and wound healing.

Abstract: Novel methods and devices which provide enhanced mixing and application of two liquid components to form a biomaterial with minimized aerosols is achieved using air flow rates below about 1.25 liters/minute in combination with a ratio of air flow to total liquid flow of from about 150:1 up to about 1500:1. Preferably the air flow is below about 1 liter/minute and the ratio of air flow to total liquid flow is from about 200:1 to about 1200:1. The parameters are ideally suited for the spray application of components which form a surgical sealant, e.g., a fibrin sealant. Also a part of the present invention are novel application methods for biomaterial, e.g., surgical sealant, components at liquid flows below 1.9 ml/minute, novel methods involving the mixing of such components on the exit surface of a spray tip or nozzle, novel spray tips and biomaterial applicators and methods for making such applicators.

Abstract: A process and apparatus for one-step preparation of fibrinogen adhesive by polyethylene glycol-mediated precipitation from plasma are disclosed. The methods and apparatus of the invention permit preparation of autologous fibrinogen adhesive composition from the patient during surgery, and can be applied generally to provide such compositions. Also disclosed are an apparatus and method for application of sealant comprising this fibrinogen adhesive composition.

Abstract: A system including an implantable fastener for fastening layers of tissue is disclosed. In one embodiment, the fastener includes a proximal anchor member and a distal anchor member each being movable from a reduced profile position to a deployed position. The anchor members are mesh structures capable of moving to the deployed position by reducing the axial spacing between opposite ends of the anchor members. Methods of treating gastroesophageal reflux disease (GERD) are also disclosed. One of the methods includes placing the distal anchor member through a hole formed in the wall of the esophagus and through a hole formed in the gastric wall. The distal anchor member and the proximal anchor member are then placed in their deployed positions to fasten the wall of the esophagus and the gastric wall together between the anchor members.

Abstract: The invention provides composition and methods for repairing a ruptured anterior cruciate ligament.

Abstract: The present invention is directed to bioabsorbable adhesive/hemostatic formulations of a 2-alkoxyalkylcyanoacrylate and liquid or solid polymeric modifiers and adjuvant. The present adhesive formulations are useful as tissue adhesive/sealants, hemostatic agents, and as a means for patching or anastomic coupling of damaged organs.

Abstract: Use of one or more saccharides, for example one or more non-toxic mono-, di-, tri-, oligo- or polysaccharides, in the manufacture of a biocompatible glue for adhering a first structure to a surface of a second structure. The biocompatible glue can be adapted to act as a temporary glue. In this case the glue may be used to enable a medical structure to be transferred from a medical instrument onto the surface of a structure of a human or animal body, for example as in the transfer of a buffer material from the fork of a surgical stapler to a diseased lung after one or more rows of staples have been fired through the buffer material into the lung during lung volume reduction surgery for treating emphysema. The biocompatible glue can also to advantage be used to adhere or secure medical structures to a structure of a human or animal body direct, such as in the case of a patch being applied to the skin of a mammal.

Abstract: A collagen fiber and methods for producing and using the collagen fiber of the inventions to prepare hemostatic fabrics to control bleeding are provided. The collagen particles (e.g., fibrils) of the fiber, preferably, have a hemostatic activity that is equivalent to the hemostatic activity of the collagen particles from which the fiber is formed. The collagen fibers of the invention and hemostatic fabrics formed thereof optionally include hemostatic agents and/or other therapeutic agents, to further promote hemostasis and wound healing.

Abstract: An applicator gun for spraying a medically useful multiple component fluid to an area of interest. The handheld applicator gun functionally receives a commercially available or standardized multi-syringe applicator, and dispenses fluid from the multi-syringe applicator in a controllable manner. The handheld applicator gun further includes a return stop and a dispensing stop to limit the force exerted on the multi-syringe applicator.

Abstract: A composition and method for a light activated composition for improved wound closure, is disclosed. The composition includes a biodegradable polymer that is impregnated with a solder that is biologically compatible and a chromophoric dye. The chromophoric dye enhances the amount of light energy that the composition absorbs.

Abstract: A method for repairing a defect in living mammalian tissue comprising: covering a tissue defect and surrounding tissue with a prosthetic by placing the prosthetic over the defect and against the surrounding tissue. The method includes applying a surgical adhesive to the prosthetic on the surrounding tissue on at least one location on the prosthetic and the surrounding tissue so that surrounding tissue and the prosthetic adhere to each other.

Abstract: Use of one or more saccharides, for example one or more non-toxic mono-, di-, tri-, oligo- or polysaccharides, in the manufacture of a biocompatible glue for adhering a first structure to a surface of a second structure. The biocompatible glue can be adapted to act as a temporary glue. In this case the glue may be used to enable a medical structure to be transferred from a medical instrument onto the surface of a structure of a human or animal body, for example as in the transfer of a buffer material from the fork of a surgical stapler to a diseased lung after one or more rows of staples have been fired through the buffer material into the lung during lung volume reduction surgery for treating emphysema. The biocompatible glue can also to advantage be used to adhere or secure medical structures to a structure of a human or animal body direct, such as in the case of a patch being applied to the skin of a mammal.

Abstract: A biocompatible and biodegradable barrier material is applied to a tissue region, e.g., to seal a vascular puncture site. The barrier material comprises a compound, which is chemically cross-linked without use of an enzyme to form a non-liquid mechanical matrix. The compound preferably includes a protein comprising recombinant or natural serum albumin, which is mixed with a polymer that comprises poly(ethylene) glycol (PEG), and, most preferably, a multi-armed PEG polymer.

Abstract: A collagen fiber and methods for producing and using the collagen fiber of the inventions to prepare hemostatic fabrics to control bleeding are provided. The collagen particles (e.g., fibrils) of the fiber, preferably, have a hemostatic activity that is equivalent to the hemostatic activity of the collagen particles from which the fiber is formed. The collagen fibers of the invention and hemostatic fabrics formed thereof optionally include hemostatic agents and/or other therapeutic agents, to further promote hemostasis and wound healing.

Abstract: A biocompatible and biodegradable hydrogel compound, which is free of a hemostatic agent, is applied to arrest the flow of blood or fluid from body tissue. The compound preferably includes a protein comprising recombinant or natural serum albumin, which is mixed with a polymer that comprises poly(ethylene) glycol (PEG), and, most preferably, a multi-armed PEG polymer.

Abstract: The invention relates to the use of an anoxemia preventing compound for the manufacture of a medicament for preventing adhesion formation. . The invention further relates to an endoscopic insufflation system comprising gas supplying means for an insufflation line, wherein the supplying means are designed to supply gas mixtures comprising 0 2. The invention also relates to a method for preventing adhesion formation by preventing anoxemia by or during, CO 2 pneumoperitoneum.

Abstract: A closure device is provided for sealing a puncture in a body vessel. The closure device includes an energy delivery device for delivering energy to tissue adjacent the vessel puncture which enhances an adhesiveness of the tissue to a closure composition precursor.

Abstract: The present invention is directed to bioabsorbable adhesive/hemostatic formulations of a 2-alkoxyalkylcyanoacrylate and liquid or solid polymeric modifiers and adjuvant. The present adhesive formulations are useful as tissue adhesive/sealants, hemostatic agents, and as a means for patching or anastomic coupling of damaged organs.

Abstract: Disclosed is a device for delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a perforation in a lumen, cavity or organ, or potential lumen or cavity, within a human or other animal. Also disclosed is a method of delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity. The method is particularly suited to sealing perforations in vascular walls, such as after arterial access for Percutaneous Transluminal Coronary Angioplasty (PTCA), Percutaneous Coronary Angiography and Percutaneous Coronary Atherectomy and other diagnostic and therapeutic procedures.

Abstract: A biocompatible and biodegradable barrier material is applied to a tissue region, e.g., to seal a vascular puncture site. The barrier material comprises a compound, which is chemically cross-linked without use of an enzyme to form a non-liquid mechanical matrix. The compound preferably includes a protein comprising recombinant or natural serum albumin, which is mixed with a polymer that comprises poly(ethylene) glycol (PEG), and, most preferably, a multi-armed PEG polymer.

Abstract: A method and system for performing anastomosis uses an anvil to control and support a tissue site during an anastomosis procedure involving tissue bonding techniques such as tissue welding and adhesive tissue bonding. The anvil is particularly useful for supporting a wall of a coronary artery during attachment of a graft vessel in a coronary artery bypass graft procedure. The anvil is inserted into a pressurized or unpressurized target vessel and is pulled against an inner wall of the target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the anastomosis site and an end of the graft vessel is positioned adjacent an exterior of the target vessel. When tissue welding is used, a graft vessel fixture is positioned over the tissue surfaces to be welded in order to clamp the graft and target vessel tissue together. The tissue contacting surfaces of the anvil and/or graft vessel fixture are provided with one or more energy applying surfaces.

Abstract: Wound closure methods and apparatus are provided which utilize blood fluid by activating the clotting cascade of the blood fluid outside the body within a substantially enclosed sterile container then introducing the blood fluid to the wound site to complete clotting. Methods and apparatus for providing ways of inhibiting anticoagulants and slowing fibrin clot degradation are also disclosed. Kits for practicing the invention singularly or in combination with and/or associated with preferred procedures are also disclosed.

Abstract: Bioabsorbable cyanoacrylate-based tissue adhesives containing bioabsorbable copolymers are disclosed. The copolymers are preferably derived from &egr;-caprolactone, lactide and glycolide monomers or from butyl 2-cyanoacrylate, glycolide, lactide, &egr;-caprolactone monomers. The adhesives are characterized by increased biodegradability, increased viscosity and increased flexibility. The adhesives are useful for wound and incision closure, and for medical devices, including implants.

Abstract: A method of joining together in vivo living tissue surfaces includes (a) holding together at least two tissue surfaces to form abutted tissue surfaces, (b) applying across the abutted tissue surfaces an excessive amount of an adhesive composition comprising at least one monomer that forms a medically acceptable polymer with an applicator having a porous applicator tip; and (c) maintaining the tissue surfaces in contact in vivo until the composition polymerizes to form a thick film of polymerized composition on the abutted tissue surface.

Abstract: A method for joining tissue comprising aligning and abutting edges of the tissue to be joined applying biodegradable, biological solder or an analogue thereof, across the edges and exposing the solder to an energy source under conditions which provide transfer of energy from the source to the solder to cause the solder to bond to the tissue surface adjacent the edges to provide a weld holding the edges together.

Abstract: Novel methods and devices which provide enhanced mixing and application of two liquid components to form a biomaterial with minimized aerosols is achieved using air flow rates below about 1.25 liters/minute in combination with a ratio of air flow to total liquid flow of from about 150:1 up to about 1500:1. Preferably the air flow is below about 1 liter/minute and the ratio of air flow to total liquid flow is from about 200:1 to about 1200:1. The parameters are ideally suited for the spray application of components which form a surgical sealant, e.g., a fibrin sealant. Also a part of the present invention are novel application methods for biomaterial, e.g., surgical sealant, components at liquid flows below 1.9 ml/minute, novel methods involving the mixing of such components on the exit surface of a spray tip or nozzle, novel spray tips and biomaterial applicators and methods for making such applicators.

Abstract: Methods and products for rapidly sealing a fluid leak in a tissue are provided. A polymerizable protein is applied to a tissue having an opening which creates a fluid leak in the tissue, in order to seal the opening. The tissue area and opening coated with the polymerizable protein are exposed to an initiator in order to polymerize the covering in situ, and create a seal over the opening that prevents fluid leakage. The methods and products to the invention may be used, for example, to seal airholes in lung injuries and to seal anastomoses and suture lines for blood vessels.

Abstract: Methods and apparatus of forming in situ tissue adherent barriers are provided using a sprayer capable of applying two or more viscous crosslinkable components to tissue. The sprayer comprises separate spray nozzles for each of two or more crosslinkable solutions, with each nozzle surrounded by an annular gas flow outlet. Crosslinkable solutions are stored in separate compartments and communicated under pressure to the spray nozzles. In the presence of gas flow through the annular gas flow outlets, the crosslinkable solutions are atomized and mixed in the gas flow to form a spray. Multi-component hydrogel systems suitable for use with the inventive methods and apparatus are also described.

Abstract: Methods and apparatus of forming in situ tissue adherent barriers are provided using a sprayer capable of applying two or more viscous crosslinkable solutions to tissue. The sprayer comprises separate spray nozzles for each of two or more crosslinkable solutions, wherein each nozzle is either surrounded by an annular gas flow outlet or in communication with a gas-pressurized chamber, and also may include valves that prevent backflow through the supply lines carrying the crosslinkable solutions, and a venting system for venting excess pressure for laparoscopic applications In the presence of gas flow, the crosslinkable solutions are atomized and mixed to form a spray. Multi-component hydrogel systems suitable for use with the inventive methods and apparatus are also described.

Abstract: A method of controlling hemostasis by applying a hemostatic agent in a tissue sealant composition. The tissue sealant is a biodegradable, biocompatible synthetic polymer that may not intrinsically possess strong hemostatic properties. Inclusion of a hemostatic material in the tissue sealant can control bleeding at the site and may also provide improved adherence of the sealant to tissue and provide shorter healing times.

Abstract: Wound closure methods and apparatus are provided which utilize blood fluid by activating the clotting cascade of the blood fluid outside the body within a substantially enclosed sterile container then introducing the blood fluid to the wound site to complete clotting. Methods and apparatus for providing ways of inhibiting anticoagulants and slowing fibrin clot degradation are also disclosed. Kits for practicing the invention singularly or in combination with and/or associated with preferred procedures are also disclosed.

Abstract: Chitosan/alginate post-surgical anti-adhesion barriers, methods of preventing post-surgical adhesions, and methods and devices for forming post-surgical anti-adhesion barriers are provided. An aqueous solution of chitosan and a complexing agent, and an aqueous solution of alginate are combined to form an anti-adhesion barrier at a site of surgical intervention. A medicinal agent may optionally be incorporated.

Abstract: A method for occluding aneurysms or peripheral blood vessels is provided which allows for isovolumetric, isobaric delivery of occluding agents to aneurysms or peripheral blood vessels, wherein the aneurysms or peripheral blood vessels are isolated from the general circulation until the occluding agent has stabilized or until occlusion is effected. In particular, a double balloon method for occluding aneurysms or peripheral blood vessels is disclosed wherein a first balloon is inserted into the aneurysm or peripheral blood vessel to deliver an occluding agent, and a second balloon is placed such that it substantially covers the neck of the aneurysm or peripheral blood vessel to substantially seal the aneurysm or peripheral blood vessel from the general circulation. Additionally, an aneurysm or peripheral blood vessel comprising a double balloon configuration useful for occluding aneurysms or peripheral blood vessels is disclosed.

Abstract: Disclosed are kits of parts comprising a first container comprising a cyanoacrylate composition and a second container comprising a compatible antimicrobial agent and, in particular, a compatible iodine containing antimicrobial agent. Mixture of these compositions provide for in situ formation of an antimicrobial polymeric cyanoacrylate film on mammalian skin.

Abstract: It is a general object of the invention to provide a method of effecting tissue repair or replacement using a biomaterial. It is a specific object of the invention to provide a biomaterial suitable for use as a stent, for example, a vascular stent, or as a conduit replacement, as an artery, vein or a ureter replacement. The biomaterial can also be used as a stent or conduit covering or lining. The present invention relates to a method of repairing, replacing or supporting a section of a body tissue. The method comprises positioning a biomaterial at the site of the section and bonding the biomaterial to the site or to the tissue surrounding the site. The bonding is effected by contacting the biomaterial and the site, or tissue surrounding the site, at the point at which said bonding is to be effected, with an energy absorbing agent. The agent is then exposed to an amount of energy absorbable by the agent sufficient to bond the biomaterial to the site or to the tissue surrounding the site.

Abstract: A device for promoting hemostasis in a blood vessel puncture is employed with an introducer that accesses the puncture through an incision. The introducer has an open distal end positionable at the puncture, an external portion with an open proximal end, and an axial channel therebetween. The device includes a hollow catheter, dimensioned to pass through the introducer channel, having a distal end to which is attached an expansible compression element, which may be an inflatable balloon, a collapsible prong assembly, or a resilient foam pad. The compression element is collapsed when the distal end of the catheter is enclosed within the introducer. When the catheter and the introducer are located the desired distance from the puncture, the introducer is displaced axially relative to the catheter to expose the compression element to the subcutaneous tissue, whereupon the compression element is expanded.

Abstract: A biological sealant comprising a gelatin slurry. The slurry contains gelatin, saline or water and thrombin.

Abstract: A device and method are provided for sealing a puncture in a body vessel. The device has an elongated body having a proximal end and a distal end sized to be positioned within a lumen of the body vessel; at least one closure composition precursor lumen within the elongated body having a entrance port adjacent the proximal end of the elongated body through which one or more fluent closure composition precursors can be delivered into the closure composition precursor lumen and an exit port adjacent the distal end of the elongated body through which the one or more fluent closure composition precursors can be delivered outside the vessel adjacent the vessel puncture; and a microwave antenna for delivering microwave energy adjacent the distal end of the elongated body to the fluent closure compound precursor. The microwave antenna according to this embodiment is preferably incorporated onto the elongated body adjacent the body distal end.

Abstract: The present invention relates to a device for percutaneously sealing of an internal puncture site comprising a tissue portion having a puncture formed therethrough. A locating device is mounted for longitudinal movement relative to a guide wire towards and away from the puncture site. Delivery structure has a distal end portion and is mounted for longitudinal movement relative to the guide wire. A tubular puncture site engaging member has a distal end portion and is mounted exteriorly of the delivery structure for longitudinal movement relative to the guide wire. A supply of fluid thrombogenic material which will be capable of promoting clotting when delivered to the puncture site is provided. The delivery structure has a fluid passageway open to the distal end portion thereof and communicated to the supply of fluid thrombogenic material. The locating device and the puncture site engaging member are positioned with respect to one another such that they can be moved together towards the puncture site.

Abstract: Method for the effective transplantation of chondrocytes/cartilage to an articular joint surface defect is taught, as well as a description of certain instruments and kit for practicing the invention.

Abstract: A process and apparatus for one-step preparation of fibrinogen adhesive by polyethylene glycol-mediated precipitation from plasma are disclosed. The methods and apparatus of the invention permit preparation of autologous fibrinogen adhesive composition from the patient during surgery, and can be applied generally to provide such compositions. Also disclosed are an apparatus and method for application of sealant comprising this fibrinogen adhesive composition.

Abstract: An apparatus and method for applying a particulate hemostatic agent to living tissue are disclosed. The apparatus includes a particulate hemostatic agent source (22) and a continuous gas source (14). A continuous gas stream from the continuous gas source is turbulently combined with the particulate hemostatic agent within the hemostatic agent source from a finely dispersed fluid stream of the particulate hemostatic agent in the continuous gas stream. An outlet conduit (34) extends from where the gas and particulate hemostatic agent are combined through an outlet (36) of the conduit, whereby the fluid stream is conducted through the outlet conduit and is discharged from the outlet conduit onto proximate living tissue, thereby applying the particulate hemostatic agent o the living tissue.

Abstract: The present invention provides a composition comprising a protein solder, a bioactive compound, and a vehicle for delivering the bioactive compound into a target cell having a genome. The present invention also provides a method for delivering a bioactive compound into a target cell having a genome comprising (a) contacting a tissue with a composition comprising the protein solder, a bioactive compound, and a vehicle for delivering the bioactive compound into the target cell, and (b) exciting the protein solder to effect delivery of the bioactive compound into the target cell.

Abstract: An apparatus and method for effecting and enhancing wound closure in tissue is disclosed. Wounds and tissue are sealed by heating a sealant material, such as collagen, in an applicator (10) to a temperature sufficient to melt the sealant. The melted sealant is then extruded through a distal tip of an elongate shaft (22) and applied to the target site, where it cools and sets to form bonds with the underlying tissue. The heated sealant flows over the wound to create an effective barrier against further blood leakage and, upon cooling, it readily adheres to the tissue to seal the wound. In addition, since high intensity energy is not applied directly to the wound, damage or destruction of neighboring tissue is minimized.

Abstract: A process and apparatus for one-step preparation of fibrinogen adhesive by polyethylene glycol-mediated precipitation from plasma are disclosed. The methods and apparatus of the invention permit preparation of autologous fibrinogen adhesive composition from the patient during surgery, and can be applied generally to provide such compositions. Also disclosed are an apparatus and method for application of sealant comprising this fibrinogen adhesive composition.

Abstract: Disclosed is a device for delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a perforation in a lumen, cavity or organ, or potential lumen or cavity, within a human or other animal. Also disclosed is a method of delivering tissue adhesives and/or sealant patches to a surface which covers or surrounds a lumen, cavity or organ, or potential lumen or cavity. The method is particularly suited to sealing perforations in vascular walls, such as after arterial access for Percutaneous Transluminal Coronary Angioplasty (PTCA), Percutaneous Coronary Angiography and Percutaneous Coronary Atherectomy and other diagnostic and therapeutic procedures.

Abstract: A method for joining or reconstructing biological tissue comprises providing a solid filler material in the form of a preformed sheet, where the sheet comprises collagen, gelatin or a mixture thereof. The filler material is placed over tissue. Radiofrequency energy or optical energy is thereafter applied to the filler material in an amount sufficient to melt or denature the filler material.

Abstract: Post catheterization arterial bleeding is reduced by introduction of a fibrin sealant, prepared from fibrinogen and thrombin, into the periarterial tissue surround the arteriotomy through which the catheter was inserted. The fibrin sealant is introduced as the catheter is withdrawn, which introduction may be accompanied by local pressure. The fibrin sealant, prepared from fibrinogen and thrombin, clots or "sets" to form a fibrin seal, reducing arterial bleeding and post catheterization difficulties.

Abstract: Tissue adhesions are inhibited by applying and immobilizing a solid preformed matrix material over a target region, such as a surgical site, in a first tissue surface. The matrix material may be any continuous solid material, such as a sheet or film. After applying the material to the target region, the material is immobilized by applying energy over at least a portion of the surface of the matrix material which causes the material to fuse to the underlying tissue. The matrix material is preferably bioabsorbable so that it is resorbed by the body over time. Suitable matrix materials include proteins, polysaccharrides, and synthetic polymers.