Abstract: An end effector usable with a surgical instrument includes a first jaw pivotably coupled to a second jaw. The first jaw includes staple forming depressions. A staple cartridge is releasably attachable to a channel of the second jaw. A plurality of staples is disposed in the staple cartridge. A shipping wedge is releasably attached to the staple cartridge. The shipping wedge maintains the staples in their respective retention slots and is usable to separate the staple cartridge from the channel of the second jaw.

Abstract: The present disclosure relates to a medical device and methods of making the same. The medical device includes a porous substrate and at least one film. The film is formed within the pore of the substrate. The film is intra-porous and does not contact adjacent pores or films.

Abstract: A tissue thickness compensator may generally comprise a compressible core comprising a plurality of movable particles, and a wrap surrounding the compressible core. The plurality of movable particles may comprise at least one medicament. A tissue thickness compensator may generally comprise a compressible core comprising a plurality of crushable particles, and a wrap surrounding the compressible core. The plurality of crushable particles may comprise at least one medicament. The compressible core may comprise a material selected from a group consisting of a biocompatible material. The wrap may comprise a material selected from a group consisting of a biocompatible material. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

Abstract: A fibrous tissue repair device includes first and second tubular anchors having corresponding longitudinal passages. The tissue repair device includes corresponding first and second inserters. Each inserter has a shaft with a distal portion received in the longitudinal passage of the corresponding tubular anchor. A flexible strand couples the first and second anchors.

Abstract: A method for applying pressure to skin with a dressing. The method including: adhering at least a portion of the dressing to the skin; and subsequent to the adhering, changing the shape of the dressing by removing a restraint which restrains an elastic member associated with the dressing into a first shape. Where the removing of the restraint from restraining the elastic member moves the elastic member towards an unrestrained second shape to one or more of elongate or reduce a dimension of the dressing to apply a pressure to corresponding portions of the skin.

Abstract: An interventional medical closure device comprises a first engagement element for engagement with an external surface of a vessel on a first side of an opening through the vessel wall and a second engagement element for engagement with an external surface on a second side of the opening. A closure element extends from the first engagement element, into the vessel, and to the second engagement element to assist in closure of the opening. The device may include a foot element to engage the internal surface of the vessel on both sides of the opening. The foot element may provide a guide with a pathway for the closure element.

Abstract: A mechanical system for rotatably, sequentially securing opposing sides of a tissue wound with a fastener. An applicator apparatus is capable of imparting rotatable motion to a falcate tissue penetrator that sequentially pierces and carries a fastener into a first side and a second side of the tissue wound. The first side and second side of tissue can be simultaneously captured and positioned with respect to a tissue definition member or alternatively, the first tissue side and second tissue side can be individually, sequentially captured and positioned relative to the tissue definition member. The applicator apparatus can comprise a single fastener for small tissue wounds or resections or alternatively, the applicator can comprise a plurality of staged fasteners for use in closing a larger wounds or wounds with increased tension.

Abstract: In a human or animal patient, two bone portions separated by a cut or fracture are stabilized in a desired position relative to each other by bringing the two bone portions into this desired position, by pulling them against each other, by providing an opening having a mouth on a bone surface and reaching across the cut or fracture and walls in both bone portions, by inserting an implant into the opening and anchoring the implant in the walls of the opening with the aid of a material having thermoplastic properties and energy transmitted into the implant for in situ liquefaction of at least part of the material having thermoplastic properties. One exemplary application of the stabilizing procedure concerns the two tibial bone portions separated by tibial plateau leveling osteotomy in a canine patient suffering from cranial cruciate ligament damage or rupture in a stifle joint.

Abstract: A fibrous tissue repair device includes first and second tubular anchors having corresponding longitudinal passages. The tissue repair device includes corresponding first and second inserters. Each inserter has a shaft with a distal portion received in the longitudinal passage of the corresponding tubular anchor. A flexible strand couples the first and second anchors.

Abstract: The present invention resides in a sutureless wound closure device for external use. The device comprises a base layer for fixing the device to skin and an upper layer. The base layer includes an aperture therein. The upper layer has a first end anchored to the base layer and a second, opposite end that includes fixing means to attach the end to the base layer and close the aperture in the base layer.

Abstract: A surgical stapling apparatus includes a handle assembly and an elongate portion extending distally from the handle assembly. An end effector disposed adjacent a distal portion of the elongate portion includes an anvil assembly and a cartridge assembly, wherein at least one of the cartridge assembly and the anvil assembly is movable with respect to the other to move the end effector between an open configuration where the cartridge assembly and the anvil assembly are substantially spaced and a closed configuration where the cartridge assembly and the anvil assembly are closer together. The end effector also includes a clamping assembly including a first clamping surface deployable to extend laterally from the anvil assembly, and a second clamping surface deployable to extend laterally from the cartridge assembly such that, when deployed, the first and second clamping surfaces oppose one another when the cartridge assembly is in the closed position.

Abstract: A deployment device for bringing a sealing plug into position within a puncture tract or incision, and bringing an anchor into position adjacent a tissue puncture, is provided. The deployment device is designed to facilitate easier positioning of the sealing plug, wherein a separate tamping tool is not required. The sealing plug is held in place on the shaft of the anchor by a structure, for example, a knob or boss. The anchor, anchor shaft, and sealing plug may be made of various biocompatible resorbable materials such that the anchor may resorb very quickly, leaving the tissue or artery lumen clear, and the sealing plug may resorb more slowly, to assist in maintaining hemostasis. The deployment device may include a bypass device which maintains the anchor in either an extended or bent configuration. Further, the anchor may include at least one rib, to provide support to the anchor.

Abstract: A retainer for assembling tissue thickness compensators to a surgical stapler can comprise a grip, a first surface for supporting a first tissue thickness compensator, a second surface for supporting a second tissue thickness compensator, and clips for aligning and attaching the retainer to the surgical stapler. The clips may align and attach the retainer to a staple cartridge of the surgical instrument. The clips may align the retainer with an anvil of the surgical instrument. An insertion tool may be used in combination with the retainer to insert the retainer into the surgical stapler and to push the tissue thickness compensators against the anvil and/or the staple cartridge of the surgical instrument.

Abstract: A wound closure device for positioning within a wound gap defined between at least two tissue segments has an effect of drawing the at least two tissue segments to a state of proximity that closes the wound gap. The wound closure device includes a tubular collapsible member having an expanded configuration and a collapsed configuration. The wound closure device further includes tissue engaging structure for attaching the tissue segments to the tubular collapsible member.

Abstract: Devices and methods for treating an abdominal incision or hernia are described. An implant for the restoration or prophylactic treatment of an abdominal wall comprises an elongate element and at least one sheet connected to the elongate element along a longitudinal axis of the elongate element. The elongate element is positioned along the line of incision, and the at least one sheet is secured to the abdominal muscles surrounding the incision.

Abstract: A surgical stapling apparatus is provided including a cartridge assembly defining a tissue contacting surface; an anvil assembly defining a tissue contacting surface; and a surgical buttress releasably secured to at least one of the tissue contacting surface of the cartridge assembly and the tissue contacting surface of the anvil assembly by at least one anchor. A loading unit is provided including a surgical buttress releasably secured to an anvil assembly and/or a staple cartridge secured thereto by at least one anchor, and a drive assembly including a knife blade, wherein movement of the drive assembly from a proximal position to a distal position results in the knife blade cutting the at least one anchor and freeing each surgical buttress from the anvil assembly and/or cartridge assembly.

Abstract: The present invention includes a method and apparatus for adhering tissue to one another. In an embodiment of the present invention the two tissues to be joined, for example the lower esophagus and the fundus of the stomach, are first placed adjacent to one another. Next a first restraint is placed near the outside surface of one of the tissues and a second restraint is placed near the outside surface of the other tissue. An irritant is then placed between the two adjacent tissues. The restraints, and consequently the tissue surfaces, are then drawn together. As the touching irritated tissue surfaces heal they will become bonded to one another and their need for the mechanical fastening of the restraints, to secure them together, will be diminished.

Abstract: A loading unit for use with a surgical stapling apparatus is provided and includes a tool assembly having a cartridge assembly and an anvil assembly that are movable in relation to one another; a surgical buttress releasably secured to a tissue contacting surface of the anvil assembly and/or the cartridge assembly, wherein each surgical buttress is secured to the anvil assembly and/or the cartridge assembly by at least one anchor; a release assembly associated with the anvil assembly and/or the cartridge assembly; and a drive assembly slidably translatable through the tool assembly between proximal and distal positions, wherein the drive assembly actuates the release assembly to thereby release the anchor to free the surgical buttress from the anvil assembly and/or the cartridge assembly.

Abstract: The invention relates to novel internal fixation devices, such as bone plates, generally and novel craniomaxillofacial bone plates more specifically and systems for bonding the same. More specifically, the invention relates to bone plates made of a polymer blend of (poly)lactic acid and Ecoflex as well as a novel hot-melt adhesive polymer blend of the same material.

Abstract: The present disclosure relates to a medical device and methods of making the same. The medical device includes a porous substrate and at least one film. The film is formed within the pore of the substrate. The film is intra-porous and does not contact adjacent pores or films.

Abstract: The invention relates to a prosthesis that can be implanted in the center of wall wound scarring. The inventive prosthesis, which is intended for use in abdominal surgery, is provided with a geometric shape in the form of sheets that converge in dihedral angles. The sheets or planes are made from a synthetic biotolerated material in porous form with large pores. One of the planes is inserted into the center of the scarring between the two aponeurotic surfaces to be joined. The other plane(s) of the prosthesis, which is perpendicular to the aforementioned plane, is arranged so as to overlap the aponeurotic edges of the edge of the section. The proliferation obtained around the prosthesis, in the scarring center and close thereto, provides stress resistance greater than that obtained in standard closures, thereby greatly reducing the risk of hernias caused by a badly healed wound.

Abstract: An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

Abstract: An apparatus includes a flexible fixation member having a body with a longitudinal extent and a width, the body defining a plurality of openings through the body, each of the plurality of openings formed substantially cross wise through the width of the body, and a suture having two terminal ends, the suture being interwoven through each of the plurality of openings in the body of the fixation member such that multiple portions of the fixation member are slidably coupled to the suture and configurable to form a cluster within a surgical site.

Abstract: Implantable materials for use with end effectors like surgical stapling devices, and methods associated with the operation of such end effectors, are provided herein. In one exemplary embodiment, a tissue reinforcement material is releasably retained on a portion of a surgical stapler end effector for delivery to tissue upon deployment of staples. The tissue reinforcement material comprises a plurality of fibers having an arrangement configured to compress and seal around a fastener component inserted therethrough. Other implants, devices, and methods for surgical stapling are also provided.

Abstract: The present invention is directed to tissue closure devices for closing a tissue opening, including one or more closure components, each closure component having a first member and a second member, each of the first and second members having a first surface that adheres to a tissue surface proximate to the tissue opening, each of the first and second members having a second surface substantially orthogonal to the first surface, and each of the first and second members having a transitional region between the first surface and the second surface which is contoured to evert an edge of the tissue opening upon the drawing together of the first and second members. The present invention is also directed to systems and kits, dressing systems, and methods for tissue repair and closure.

Abstract: The present invention provides a device for occluding an anatomical aperture, such as a septal defect or patent foramen ovale (PFO). The occluder includes two sides connected by an intermediate joint. Each of the sides includes at least one elongate element, which is arranged to form non-overlapping loops. Each loop has at least one radially-extending segment that is adjacent to a radially-extending segment of another loop. In at least some embodiments, at least one pair of adjacent radially-extending segments is connected. In some embodiments, at least one of the sides includes a tissue scaffold. When the occluder is deployed in vivo, the two sides are disposed on opposite sides of the septal tissue surrounding the aperture, thereby exerting a compressive force on the septal tissue that is distributed along both the outer periphery of the occluder and the radially-extending segments.

Abstract: The present invention relates to a negative pressure wound closure system and methods for using such a system. Preferred embodiments of the invention facilitate closure of the wound by preferentially contracting to provide for movement of the tissue. Preferred embodiments can utilize tissue grasping elements to apply a wound closing force to the tissue.

Abstract: In one aspect, the present invention provides a device for occluding an aperture in a body, for example, a patent foramen ovale (PFO), including a first side adapted to be disposed on one side of the septum and a second side adapted to be disposed on the opposite side of the septum. The device has an elongated, low-profile delivery configuration and a shortened, radially expanded deployment configuration. The first and second sides are adapted to occlude the aperture upon deployment of the device at its intended delivery location. The device also includes a radially expandable center portion. In some embodiments, the center portion includes a plurality of ribs provided by slits in device. The ribs expand radially when the device is deployed. The expandable center portion facilitates the positioning of the device in the aperture. The device can be secured in the deployed configuration using a catch system.

Abstract: Multilayer structures including a porous layer and a non-porous layer are useful as buttresses when associated with a surgical stapling apparatus.

Abstract: A closure device for sealing a percutaneous puncture in a wall of a body passageway, the closure device including at least one of a toggle configured to engage an interior surface of the body passageway or a plug configured to engage an exterior surface of the body passageway and a guide wire configured to extend from an outside of the body to inside the body passageway, wherein at least one of the toggle and the plug is associated with the guide wire.

Abstract: A system and method for treating a defect. The system may comprise a first expandable barrier insertable into a defect interior space in a compact state and then expanded once positioned inside the defect. The first expandable barrier is expanded to be positioned against the inner surface of the defect. The system may also comprise a second barrier which may be expandable, positioned against the outer surface of the defect. Each of the first and second barriers may expand laterally to a greater extent than axially. The first and second barriers may be in communication through a connection member which couples the two barriers together. The barriers each obliterate the defect and can prevent subsequent CSF or other fluid leaks. Fibrin glue may be introduced into the defect to seal and secure the barriers to the defect. Each barrier may comprise a mesh, a basket, an umbrella or a balloon.

Abstract: An insertion device configured to provide access to a treatment site within a body cavity (e.g., an abdominal cavity) is provided herein. In general, the device includes any type of elongate sleeve (e.g., a trocar) having an inner lumen. Further, the device includes a tissue retraction mechanism configured to extend from a distal end of the sleeve wherein the tissue retraction mechanism is configured to securely engage a cavity wall such that in response to a retraction force the mechanism can pull the cavity wall over the distal end of the sleeve thereby positioning the sleeve across the cavity wall. Additionally, various embodiments of a method for providing access to a body cavity are also provided herein.

Abstract: Methods and systems for medializing a turbinate. Exemplary embodiments comprise methods and systems for repositioning a turbinate proximal to a septum. Certain embodiments comprise an implant and a flexible member coupled to the implant. Embodiments may also comprise an insertion device to install the implant in a desired location.

Abstract: The invention provides systems and methods for sternum repair. A sternum repair device may include a central body, which may include a plurality of bands and buckles, such that a band extends from the central body and is received by a buckle component. The band may wrap around the sternum and the device may be tightened to keep the separate sternum pieces together.

Abstract: A reduced-pressure, deep-tissue closure device for applying a closing force on a deep tissue includes a contractible matrix that is formed with a first plurality of apertures and which has a first side and a second, inward-facing side. The contractible matrix is for disposing proximate to the deep tissue. A reduced-pressure source is fluidly coupled to the contractible matrix and operable to deliver reduced pressure to the contractible matrix. When under reduced pressure, the contractible matrix grips the deep tissue adjacent the contractible matrix and provides a closing force on the deep tissue. A system and method are also presented.

Abstract: Described are medical devices useful for closing a percutaneous access site, as well as methods of using same.

Abstract: A closure system, assembly and attended method for closing and opening in the tissue of the patient includes first and second closure members each including a biased construction operative for disposition of the closure members into an out of retracted and expanded orientations. A connector is disposed in interconnecting relation with the closure members and structured to establish at least a partial spacing there between. The biased construction and the interconnection of the closure members facilitate con current disposition of the closure members with one another into and through an introductory instrument as well as independent and successive disposition of the first and second closure members into a closing relation to the tissue opening upon exiting the introductory instrument.

Abstract: Devices, systems and methods are described herein for sealing openings in an anatomical wall. A sealing system includes an elongate tubular support for delivery to an anatomical opening to be sealed, a cover of bio-compatible material covering a distal portion of the tubular support, and an anchor assembly, the anchor assembly being designed to secure the cover material to the opening. The anchor assembly can include a plurality of distal anchors and a plurality of proximal anchors, a button, ring or donut, and/or a C-clip. In some embodiments, the system further comprises a closure member for closing off an end of the cover material after removal of the tubular support.

Abstract: To provide a balloon catheter that enables a minimally invasive and effective pulmonary emphysema treatment. The balloon catheter includes: a first balloon that has at least a part of an external surface thereof come into contact with a biological tissue when expanded in living body; a second balloon expandable and contractible separately from the first balloon; a main body portion having a first lumen through which a fluid for expanding the first balloon can circulate and a second lumen through which a fluid for expanding the second balloon can circulate; and supply portions that supply the first balloon with an adhesive material for adhering the external surface of the first balloon to the biological tissue.

Abstract: Apparatus and methods for sealing a puncture through tissue or otherwise treating a body lumen of a patient. The carrier includes at least one, but not all, of the adherent layer components required to form a tacky or sticky adherent layer on the carrier. The remaining adherent layer precursor(s) are delivered to the carrier in situ to form a sticky and/or tacky adherent layer on the carrier that enhances the attachment and retention of the carrier to tissue surrounding a target treatment location in which the carrier is delivered. The carrier may include hydrogel and/or other porous material, e.g., for releasing one or more agents carried by the carrier at the treatment location.

Abstract: A wound closure system having first, second and third adhesive pads with a pair of strap members fixedly secured to the first and third adhesive pads. The pair of strap members are slidably received within the second adhesive pad. When the third adhesive pad is displaced, the first and second adhesive pads are displaced toward each other to close the wound.

Abstract: A device for sealing a single incision in a laparoscopic surgery, includes: an operating panel located on the top portion of the device, a sleeve located on the bottom portion of the device, a soft connecting portion; two symmetrical handles attached to the external surface of the sleeve; a blocking flange attached to the bottom end of the sleeve; and two clamping portions disposed on the blocking flange. The sleeve is inserted into the wound of the abdominal wall, the blocking flange is positioned inside the abdominal cavity and the soft connecting portion is positioned outside the abdominal cavity. The operating panel rotates around the axis of the soft connecting portion, and the operating holes with seals may avoid air leakage of the abdominal cavity. The device solves the defect that the use of a tubular anastomat in a laparoscopic surgery easily leads to air leakage and inconvenient operation.

Abstract: Apparatus and methods are provided for use with a hole closure device that is configured to be deployed by expanding inside a subject's body. An insertion device includes an outer tube and an inner pushing element. The outer tube constrains the hole closure device from expanding, during insertion of the hole closure device into the subject's body. The pushing element causes at least a portion of the hole closure device to self expand by pushing the portion out of a distal end of the outer tube, by the pushing element being advanced distally with respect to the outer tube. A safety element is couplable to the pushing element and is configured to prevent the hole closure device from expanding, by preventing distal advancement of the pushing element with respect to the outer tube, when the safety element is coupled to the pushing element. Other applications are also described.

Abstract: An asymmetric occlusion device for occluding an opening in a body tissue where part of the opening is defined by a partial inadequate rim. The asymmetric occlusion device includes a waist portion having a distal end extending to a proximal end. The waist portion is of non-woven material extending around a longitudinal axis opening. The occlusion device further includes a pair of asymmetric occluder disks attached to the waist. The asymmetric distal and proximal occluder disks are formed of shape memory material. The asymmetric occluder disks include a short arm extending from the waist and an extended arm extending from the waist. The extended arm exceeds the length of the first short arm. The density of the first short arm exceeds the density of the second extended arm.

Abstract: An endoluminal and intracorporeal negative pressure, wound care treatment, and prophylaxic system 10 and method includes a pressure distributor 40 for placement substantially within an internal organ or tissue abscess 34. A fluidic communication means 22 is provided between the pressure distributor 40 and a negative pressure source 20. A collection canister 24 is provided between the negative pressure source 20 and the pressure distributor 40 for collecting any effluents 36 that may be drawn from the abscess 34 during application of negative pressure. An introducing conduit 44 is provided for introducing the pressure distributor 40 into the abscess 34. A positioning conduit 46 is provided to properly position the pressure distributor 40 within the abscess 34. Negative pressure is applied to the pressure distributor 40 in order to provide negative pressure therapy within the abscess 34.

Abstract: A device for attaching, relocating or reinforcing tissue includes a first tissue anchoring portion having a support plate and a plurality of barbs extending from the support plate for engaging tissue at a first location, a second tissue anchoring portion having a support plate and a plurality of barbs extending from the support plate for engaging tissue at a second location which is different from the first location, and a connection element, such as a suture or a mesh structure, interposed between and interconnecting the first tissue anchoring portion and the second tissue anchoring portion. The support plate of at least one of the first tissue anchoring portion and the second tissue anchoring portion may have longitudinally axially formed therethrough a bore for receiving the connecting element so that the surgeon may pull on the end of the connecting element to adjust the distance between the first tissue anchoring portion and the second tissue anchoring portion.

Abstract: An occlusion device and method for occluding an undesirable passage through tissue, such as a septal defect, that provides an expandable cylinder or other structure that occludes the passage internally or by covering one or more openings to the passage. The occlusion device includes a wire lattice or mesh that expands from a contracted catheter-deliverable state to an expanded state that occludes the passage. The lattice or mesh has one or more layers, with layers that provide structural support to the device, and layers that provide a lattice braiding or pore sizes that promote further occlusion by a biological process, such as tissue ingrowth that further occludes the affected passage.

Abstract: Disclosed herein are trocar site closures, comprising a head with a plurality of arm receiving passages therethrough, an arm received by each of the passages, each passage having a discontinuity which allows each arm to be pulled inward but deters outward movement, and each arm having a grappling portion. The head and arms are inserted into a patient wound, such as a trocar site. The arms engage with tissue surrounding the wound. A pulling force is exerted on the arm proximal ends, drawing the distal ends of the arms toward the head and at least partially closing the wound. The head and at least a portion of the arms remain in the patient, and are preferably made of a biocompatible material. Also disclosed herein is an insertion device used to insert the closure into the wound and at least partially close the wound.

Abstract: This invention generally relates to devices and methods for repairing an aperture in biological tissue. In certain embodiments the invention provides as system for closing an aperture in a biological tissue including a handle, an elongate shaft connected to the handle, a deployment scaffold connected to the shaft, in which the scaffold is configured to releasably retain a surgical implant, and at least one adhesive dispensing system.

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.