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 septal defect occluder is provided having first and second occluder panels. Each occluder panel includes a fabric support structure and fabric suspended therefrom. The occluder panels are conjoined at a plurality of discrete points which are located within an area bounded by each perimeter of the fabric support structures, as well as on the fabric, to thereby form a defect conforming region for the occluder.

Abstract: Devices and methods for performing a temporary tarsorrhaphy are provided. One device comprises two shafts mounted in parallel on the upper and lower eyelids of an eye. The shafts are then fastened together in a reversible manner to complete the temporary tarsorrhaphy. Each device further comprises a tube which is partially implanted in a linear fashion under the eyelid such that the tube is at a subcutaneous center portion and each end of the tube projects from the eyelid. The end portions of the tube that lie outside of the eyelid are each attached to the terminal portion of a shaft having first and second ends. The procedure is repeated on the lower eyelid. The shafts are then joined together with one or removable fasteners to complete the temporary tarsorrhaphy.

Abstract: An occlusion device with stranded wire support arms for the closure of atrial or ventricular septal defects, for the closure of patent ductus arteriosus, patent foramen ovale, or other vascular defects. The occlusion device comprises a center section extending in an axial direction, with upper and lower stranded wire fixation devices emanating from the center section. The stranded wire fixation devices have been heat treated and formed with a shape memory. The stranded wire fixation devices are formed of multiple wire strands and have atraumatic tips. Attached to the fixation devices are sheets, which serve to occlude the opening.

Abstract: A healing device applied to wounds, fistulas, pancreatitis, varicose ulcers, and other medical or veterinary pathologies includes a compacting chamber for covering the wound over the affected or diseased zone of the patient. The compacting chamber is defined by a self adhesive polymeric material laminar sheet, made out of a waterproof material. The compacting chamber has a replaceable mass of aerated polymer fiber flock therewithin, as a wound-stabilizing dressing. The compacting chamber uses a vacuum for deforming and compacting a mass of polymer fiber flock into effective healing contact with the wound. The vacuum means is terminated upon achieving compaction of the mass of polymer fiber flock and upon effective healing contact of the mass of polymer fiber flock with the wound.

Abstract: Surgical devices such as implants or suture fastenings are assembled from a plurality of discrete components, one of which components includes a heat bondable plastic material for bonding the components together. At least two components are bonded to each other by the applying heat to the heat bondable plastic material of one component. The heat bondable plastic material is preferably a polymeric or composite material suitable for surgical applications and implantation in humans, and may be a biodegradable material. A laser may be used as the heat source. The present invention is advantageously embodied in heat bonded fastenings for sutures or K-wires, in which a variety of different suture anchors are usable, including expandable distal suture anchors.

Abstract: A percutaneously insertable system for sealing punctures in blood vessels includes an element that is percutaneously insertable into and deplorable within a blood vessel, a thread-like member attached to the element that passes through the wall of the blood vessel and arresting element moveable on the thread and into engagement with the other surface of the blood vessel thereby to seal the opening.

Abstract: A system, a closure, and method of use for sealing a percutaneous puncture in a blood vessel. The puncture includes an opening in the vessel wall and a tract leading to the opening. The system includes an introducer sheath and associated positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device enables the introducer sheath to be positioned at a desired position within the vessel. The deployment instrument includes a tubular carrier storing the closure. The closure comprises a rigid, e.g., radio-opaque, anchor, a compressed collagen plug, and a thin filament connecting the two in a pulley-like arrangement. The instrument and introducer are used to introduce the closure into the puncture, with the anchor located within the artery and with the collagen plug within the puncture tract. A locking member is provided to hold the closure in place at its operative position, whereupon hemostasis occurs rapidly, thereby sealing the puncture.

Abstract: The invention relates to a device for closing the open edges of a wound in the skin of a mammal, characterized in that it comprises: a) at least one first elongated element comprising a first and a second end, said first end being intended to come into abutment on the skin near the first open edge of the wound, said second end being connected to first traction means which are provided, opposite the wound, to exert a traction to turn the first end towards the wound; b) at least one second elongated element comprising a first and a second end, said first end being intended to come into abutment on the skin near the second open edge of the wound, and the second end being connected to second traction means which are provided, opposite the wound, to exert a traction to turn the first end towards the wound; and c) at least one connecting means is provided between said first and second elements to join the two elements together, said connecting means being disposed between said first and second ends of each first

Abstract: A skin biopsy system covers all aspects of the biopsy procedure from initial incision to final closure. The system includes a flexible closure consisting of 4 elongated rigid members interconnected by flexible hinges. The opening within the closure is initially diamond-shaped, approximating an ellipse, which is then deformed or pinched to a narrow linear opening when the wound is closed. Included with the system is a knife which interacts with the closure to yield a guided incision of constant depth. The path of the knife is guided by interference between the blade and the inside faces of the closure while the depth is limited by interference of the handle proximal the blade and the top faces of the closure.

Abstract: A catheter delivered device to close a septal defect, the device comprising a cylindrical shaft of metal or polymeric material with concentric parallel cuts through the wall of the device which create flattened support struts. The center of the support struts move radially away from the axis in a hinge like fashion in response to the movement of the device's proximal and distal ends toward the center of the device. This movement is reversibly effected through mechanical means. The device can be coated with growth factors, mitogenic factors or other determinants which can improve tissue growth such that tissue ingrowth can occur over a period of time. The catheter itself may be an ultrasonic imaging catheter.

Abstract: An anchor connected with a suture is moved through a passage between opposite sides of a bone. The anchor is then pivoted to change its orientation. A second anchor is connected with the suture. While tension is maintained in the suture, the suture is secured against movement relative to the anchors. This may be done by tying the suture or by using a suture retainer to hold the suture. A suture retainer may be used in place of the second anchor. The passage may extend across a fracture in the bone. The passage may have either a nonlinear or linear configuration. The passage may be formed by first moving a thin elongated member through the bone. The thin elongated member is then used as a guide for a drill. The thin elongated member is withdrawn from the drill and the suture anchor is moved through a passage in the drill.

Abstract: A fabric prosthetic unit for repairing an incissional hernia including a joining strip is intended to be positioned in a space created by a tear or collapse of an aponeurosis. Two substantially planer sheets of colonisable flexible prosthetic fabric material extend substantially parallel to each other and are linked together by the joining strip. Each of the planer sheets includes flap extensions lying opposite to each other and are on either side of an edge part of a corresponding face on the joining strip.

Abstract: The present invention relates to a device for closing cutaneous wounds without sutures, which comprises a pair of three-dimensionally flexible strips adopted to be positioned on each side of a wound and formed of a plurality of laterally spaced apart elongated anchoring members extending side-by-side in succession and transversely of the wound and being interconnected in a three-dimensionally flexible manner to follow the lips of an open wound.

Abstract: The present invention relates to a self-expanding device for sealing a defect in a wall, such as a septal defect. The device of the present invention has a fluoropolymer membrane that is supported by an embedded wire structure having elastic properties which is capable of being compressed and inserted in the defect by a catheter and thereafter returning to its memory induced configuration. The device of the present invention can be employed in a variety of applications where a small hole needs to be sealed.

Abstract: A sternal closure device comprising first and second clamps. The first and second clamps have a generally tubular portion and the second clamp has a portion that is slidably receivable in the tubular portion, and a lock configured to retain said second clamp within said first clamp. A surgical instrument for laterally moving opposed sternal clamps toward one another is also disclosed. The instrument comprises first and second grasping members generally linearly slidably coupled to one another.

Abstract: Apparatus and a method for hemostasis of an artery having a puncture after arterial catheterization, the apparatus comprising a catheter introducer having a forward and and a balloon adjacent said forward end, wherein the catheter introducer is constructed such that inflation of the balloon adjacent the forward end of the catheter introducer in engagement with an outer wall surface of the artery causes the forward end of the catheter introducer to be withdrawn completely from the wall of the artery and spaced therefrom.

Abstract: An anchor connected with a suture is moved through a passage between opposite sides of a bone. The anchor is then pivoted to change its orientation. A second anchor is connected with the suture. While tension is maintained in the suture, the suture is secured against movement relative to the anchors. This may be done by tying the suture or by using a suture retainer to hold the suture. A suture retainer may be used in place of the second anchor. The passage may extend across a fracture in the bone. The passage may have either a nonlinear or linear configuration. A tubular member may be positioned in the passage with the tubular member extending into portions of the passage on opposite sides of the fracture. Opposite end portions of the tubular member may be disposed in a compact outer layer of the bone. If desired, a member other than a suture may be used as a force transmitting member between the two anchors. The tubular member may be formed of bone.

Abstract: A surgical stapling apparatus having tissue bolstering material releasably attached thereto for application of the material and staples to body tisuse is disclosed. The tissue bolstering material is preferably releasably held to surfaces of the stapling apparatus through pins, clips or similar securing structures. The tissue bolstering material can be either planar or tubular in configuration. Preferably, both the anvil portion and the fastener ejecting portion of the stapler are at least partially covered with the tissue bolstering material. In use, tissue is disposed between the anvil portion and the stapling portion of the instrument and the instrument is fired. The tissue bolstering material is thereby secured to the tissue and releasably detaches from the stapler upon withdrawal of the stapler from the surgical site.

Abstract: This is a device for bridging the necks of wide-necked or narrow-necked aneurysms in the vasculature. It is a device which may be used by itself to bridge the neck of an aneurysm or used to stabilize the presence of other vaso-occlusive devices such as helically wound coils in that aneurysm. The included vaso-occlusive devices may be delivered to the aneurysm in a variety of different ways, e.g., by a core wire which is linked to the coils by an electrolytically severable or mechanically detachable joint. The vaso-occlusive devices may also be simply pushed into the aneurysm. The aneurysm neck bridge may also be delivered in a variety of ways, but preferably is attached to an electrolytically severable joint for its deployment. The inventive neck bridge may contain one or two sections: a first or inner section to be placed within the aneurysm and an optional second or outer section suitably placed outside the aneurysm.

Abstract: A catheter delivered device to close a septal defect, the device comprising a cylindrical shaft of metal or polymeric material with concentric parallel cuts through the wall of the device which create flattened support struts. The center of the support struts move radially away from the axis in a hinge like fashion in response to the movement of the device's proximal and distal ends toward the center of the device. This movement is reversibly effected through mechanical means. The device can be coated with growth factors, mitogenic factors or other determinants which can improve tissue growth such that tissue ingrowth can occur over a period of time. The catheter itself may be an ultrasonic imaging catheter.

Abstract: In order to stimulate the formation of new tissues in extensive and deep wounds, the tissues are eased by exerting a traction force on the tissue with a vertical force component in relation to the plane of the wound. If the wound is vacuum sealed by a plastic foil (F), traction may be exerted through the foil (F). If a distractor that acts in the plane of the wound is set at the wound edges, the vertical traction component may be exerted on the edges of the wound by this distractor. The vertical traction component is generated through turnbuckles (70).

Abstract: A medical device for causing the hemostasis of a blood vessel located along the gastrointestinal tract. The medical device comprises a tissue-penetrating device having a pair of hollow jaws, and a clip that is insertable into the tissue-penetrating device. Methods for causing the hemostasis of a blood vessel located along the gastrointestinal tract by using the medical device of the present invention are also provided.

Abstract: A surgical attachment device. The device has an elastomeric member which may be bioabsorbable. A tissue engagement means such as a hook is mounted to the elastomeric member. The tissue engagement means may also be bioabsorbable. The device provides tensioned fastening.

Abstract: A device for extending living tissue includes at least two rigid supports that respectively have a plurality of hook-like barbs on one end thereof for attachment to the skin, each point of attachment corresponding to a respective edge of the areas of tissue to be treated, while the other end of each support includes at least one guide for receiving a flexible extendable elastic belt thereabout, the belt having a portion extending parallel along at least one of the rigid supports.

Abstract: A prothesis is provided for repairing a defect in a muscle or tissue wall. The prothesis has a preformed shape that conforms to the wall to facilitate placement and minimize shifting of the prothesis when positioned on the wall. The prosthesis may include a body formed of a sheet of surgical mesh fabric having a flexible inner portion surrounded by a stiffer periphery that is capable of resuming the preformed shape after being temporarily deformed to allow for implantation. The body may include a tapered end to facilitate insertion of the prothesis between the parietal peritoneum and the abdominopelvic wall during hernia repairs. The body may also include a curved end to permit repositioning of the bladder after implantation. In one embodiment, the prothesis includes a conical portion at the tapered end and a spherical portion at the curved end.

Abstract: Disclosed are wound closure strips which have an uniaxially oriented, silica filled, polyolefin substrate, a medical grade pressure sensitive adhesive, and a release sheet covering the pressure sensitive adhesive. Such strips are breathable, tearable to size, and may be removed from the skin with an alcohol wipe. Multiple wound closure strips are mounted on the upper surface of a backing sheet and pressure sensitive adhesive patch coated on the lower surface of the backing sheet, thereby making it possible to adhere the backing sheet to a surface near the intended point of use and, then, easily remove and handle the wound closure strips with a gloved hand. The wound closure strips may be color-coded and used not only for incisions and wounds but also for attaching catheters, and other medically related uses. Sterile packages of multiple wound closure strips make them useable in a sterile operation room arena.

Abstract: A medical apparatus includes a trocar assembly including a cannula and a trocar, wherein (1) the cannula has a lumen defined therein, (2) the trocar is positionable between a first trocar position and a second trocar position, (3) the trocar is positioned within the lumen of the cannula when the trocar is positioned at the first trocar position, and (4) the trocar is completely removed from the lumen of the cannula when the trocar is positioned at the second trocar position. The medical apparatus also includes a sleeve having a passageway extending therethrough, and a number of sealing members extending therefrom, wherein (1) the cannula is positionable between a first cannula position and a second cannula position, (2) the cannula is positioned within the passageway of the sleeve when the cannula is positioned at the first cannula position, and (3) the cannula is completely removed from the passageway of the sleeve when the cannula is positioned at the second cannula position.

Abstract: Methods are disclosed for binding together human or animal tissue using one-way sutures having barbs on their exterior surfaces, allowing passage of a needle-drawn suture in one direction through tissue, but not in the opposite direction. In closing a wound, the sutures are passed through tissue at each of the opposed sides of the wound, forming suture pairs in which trailing ends of the sutures are juxtaposed in the wound. The number of suture pairs is selected in accordance with the size of the wound. The wound is closed and ends of the sutures of each suture pair are secured together, which may be by heat bonding or surgical knots. In a variation of this procedure double-armed sutures are used. In another variation detachable needles are used to leave the barbed sutures below the skin. The invention avoids loop stitching, minimizing scarring.

Abstract: Surgical devices such as implants or suture fastenings are assembled from a plurality of discrete components, one of which components includes a heat bondable plastic material for bonding the components together. At least two components are bonded to each other by the applying heat to the heat bondable plastic material of one component. The heat bondable plastic material is preferably a polymeric or composite material suitable for surgical applications and implantation in humans, and may be a biodegradable material. A laser may be used as the heat source. The present invention is advantageously embodied in heat bonded fastenings for sutures or K-wires, in which a variety of different suture anchors are usable, including expandable distal suture anchors.

Abstract: An anchor connected with a suture is moved through a passage between opposite sides of a bone. The anchor is then pivoted to change its orientation. A second anchor is connected with the suture. While tension is maintained in the suture, the suture is secured against movement relative to the anchors. This may be done by tying the suture or by using a suture retainer to hold the suture. A suture retainer may be used in place of the second anchor. The passage may extend across a fracture in the bone. The passage may have either a nonlinear or linear configuration. The passage may be formed by first moving a thin elongated member through the bone. The thin elongated member is then used as a guide for a drill. The thin elongated member is withdrawn from the drill and the suture anchor is moved through a passage in the drill.

Abstract: Occlusion assembly for sealing openings in blood vessels, consisting of an occlusion element and fixing element to be fitted through the openings in the blood vessel. The fixing element is firmly connected to a retaining element. A locking element engages on the retaining element. This locking element is fitted horizontally against the outside of the blood vessel.

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: An apparatus and a method for occluding an aperture within a body surface, including an occlusion bag having a proximal sac and a distal sac, a delivery catheter, a guide catheter, a super-elastic wire, a release mechanism and a delivery sheath. The method of the invention includes affixing the delivery catheter to the proximal sac and then inserting the guide catheter into the delivery catheter. The super-elastic wire is attached to the release mechanism and the wire, release mechanism, occlusion bag, guide catheter and delivery catheter are inserted into a delivery sheath for transport to the aperture. After delivery, the occlusion bag is placed within the aperture and the wire is deployed within the bag. The bag and wire are repositioned if necessary, and the release mechanism is activated to release the wire. The guide catheter, delivery catheter, release mechanism and delivery sheath are then withdrawn.

Abstract: An insertion guide wire with an anchor formed in the distal end for precisely locating a subcutaneous arterial wound and inserting a guide sheath adjacent to said arterial wound. The hemostatic material can then be placed outside the wound. When the guide sheath is properly placed, the anchor can be released and the guide wire removed. The hemostatic material can then be placed outside the wound, leaving no foreign object in the lumen of the artery.

Abstract: A catheter delivered device to close a septal defect, the device comprising a cylindrical shaft of metal or polymeric material with concentric parallel cuts through the wall of the device which create flattened support struts. The center of the support struts move radially away from the axis in a hinge like fashion in response to the movement of the device's proximal and distal ends toward the center of the device. This movement is reversibly effected through mechanical means. The device can be coated with growth factors, mitogenic factors or other determinants which can improve tissue growth such that tissue ingrowth can occur over a period of time. The catheter itself may be an ultrasonic imaging catheter.

Abstract: A surgical instrument for gripping and applying tension to and closing separated skin edges as needed to suture a wound.

Abstract: The present invention relates to a device for closing cutaneous wounds without sutures, which comprises a pair of three-dimensionally flexible strips adopted to be positioned on each side of a wound and formed of a plurality of laterally spaced apart elongated anchoring members extending side-by-side in succession and transversely of the wound and being interconnected in a three-dimensionally flexible manner to follow the lips of an open wound.

Abstract: A medical suturing material which is loaded into an automatic suturing device having a staple line when used. The medical suturing material according to the present invention is formed into a bag shape having a closed leading end by sewing a sheet shape suturing material by using a suturing thread. The main material of the suturing material is unwoven fabric such as felt, woven fabric or a knit cloth having somewhat flexibility and stretchability. In particular, bioabsorbable polymer, such as polyglycolic acid or a portion of a tissue of an organism is employed. Since the suturing material according to the present invention is formed into the bag shape having a closed leading end by sewing, displacement taking place attributable to shrinkage in the insertion direction can be prevented when the automatic suturing device is inserted.

Abstract: Devices and methods for performing a temporary tarsorrhaphy are provided. One device comprises two clips mounted in parallel on the upper and lower eyelids of an eye. The clips are then fastened together in a reversible manner to complete the temporary tarsorrhaphy. Each clip comprises a tube which is partially implanted in a linear fashion under the eyelid such that the tube is at a subcutaneous center portion and each end of the tube projects from the eyelid. The end portions of the tube that lie outside of the eyelid are joined together by a connecting means having first and second ends. The procedure is repeated on the lower eyelid. The connecting means are then joined together with one or more removable fasteners to complete the temporary tarsorrhaphy.

Abstract: An improved surgical apparatus for hand-assisted minimum invasive surgery with isolation at the site of a wound from ambient conditions. A sleeve of gas-impermeable material includes entry and exit openings for access to the wound, and ports for introducing surgical instruments into the sleeve within easy reach of a surgeon's hand.

Abstract: The present invention provides unique apparatus, systems and methods for an aligned closing and stabilized sealing of a vascular perforation in a chosen blood vessel after percutaneous puncture and completion of a catheterization procedure. The invention is an adaptation of the conventionally known modified Seldinger technique in which the means for guidance, closing and stabilized sealing are deployed and positioned during the manipulations performed during the percutaneous puncture of the blood vessel itself.

Abstract: Devices, systems, and methods are provided for accessing the interior of the heart and performing procedures therein while the heart is beating. In one embodiment, a tubular access device having an inner lumen is provided for positioning through a penetration in a muscular wall of the heart, the access device having a means for sealing within the penetration to inhibit leakage of blood through the penetration. The sealing means may comprise a balloon or flange on the access device, or a suture placed in the heart wall to gather the heart tissue against the access device. An obturator is removably positionable in the inner lumen of the access device, the obturator having a cutting means at its distal end for penetrating the muscular wall of the heart. The access device is preferably positioned through an intercostal space and through the muscular wall of the heart.

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.

Abstract: This is an intravascular prothesis deliverable percutaneously with several cardiac applications including but not limited to heart valves, intravascular narrowings and cardiac defect occlusion. The device has a detachable sac connected through a thread or wire outside the body where it is immobilized. The device can remain inside the heart for as long as it is clinically useful in non permanent applications (valve, throttle); at any point it can be retrieved by pulling it outside the body by the holding wire/thread. In permanent applications (defect occlusion) the wire/thread can be withdrawn allowing the sac to endothelialize.

Abstract: An anchor 9 for a surgical dressing includes a sheet 12 with eyelets 13 therein, said sheet attached to a layer of elastic and flexible polymeric foam 20 having an adhesive layer 30, such as a hydrocolloid or polyisobutylene adhesive. The foam is at least 10 mils thick and preferably in the range of 70 mils to 90 mils thick. The eyelets may have reinforcements 18, 24.

Abstract: A vascular hemostasis device comprises a shaft coaxially received within a hollow tube, and having a distal end formed with an opposed pair of resilient grasping prongs. The tube has an open distal end that may be situated percutaneously adjacent a vascular puncture site. The shaft and the tube are axially movable with respect to one another, so that the distal end of the shaft may be selectively extended from and partially retracted into the distal end of the tube by means of an actuation member attached to the shaft. When the distal shaft end is in its extended position, the prongs are exposed from the distal end of the tube, and they resiliently expand to an open position. When the distal shaft end is moved to its retracted position, the prongs are partially retracted into the distal end of the tube, radially contracting them to a closed position. In contracting, the prongs grasp and gather tissue adjacent the puncture site to obstruct bleeding therefrom.

Abstract: A system for anchoring tissue to bone includes a suture anchor, a first loop of suture thread attached to the suture anchor, a suture needle and a second loop of suture thread which is attached to the suture needle, the first and second suture loops are interlocked with one another. The suture needle can be of a conventional type useful in open surgical procedures, or a type useful in closed surgical procedures that is formed on the end off an elongate tool. A method for anchoring soft tissue to bone using the system is also provided.

Abstract: Autologous fibrinogen and chitosan containing hemostatic adhesive agents having strong hemostatic properties when applied to a bleeding wound or vessel. Fibrinogen is isolated and purified using ammonium sulphate precipitation in slow incremental portions.

Abstract: An endoscopic instrument comprising an elongate body having a proximal end and a distal end. Actuating mechanism is located at the proximal end and operating mechanism at the distal end. The operating mechanism comprises a pair of V-shaped jaw members, a cautery wire associated with jaw members to incise tissue gripped by the jaws and a mucosa-protecting balloon attached to and movable with one of the jaw members.