Abstract: A device for stretching regions of tissue has at least one first plate-like body and at least one second plate-like body. At least one pulling thread joins the plate-like bodies. One tensioning device is arranged on at least one of the plate-like bodies and is connected to the pulling thread for applying a tensile force to the pulling thread. A guidance serves for guiding the at least one pulling thread during a movement of the at least two plate-like bodies towards one to another.

Abstract: Apparatus for closing a surgical incision comprise a base having left and right panels, a force distribution structure coupled to each panel, and a closure component which releasably attaches to the force distribution structure to draw the inner edges of the panels together in order to close adhered tissue edges. The force distribution structures allow the inner edges of the panels to expand while restraining expansion of the outer edges of the panels and limiting elongation of the lateral dimension of the panels. The incision closure appliance may be placed on skin or other tissue prior to forming the incision to be available to close said incision at the end of the surgical procedure.

Abstract: A PFO closing device for bringing the septum primum and the septum secundum into contact with each other and joining them together includes a clamping mechanism and energy supplying device. The clamping mechanism includes a needle part for puncturing the septum primum, and a clamping member for cooperating with the needle part in clamping therebetween tissue of the septum primum and the septum secundum. The energy supplying device supplies energy for joining the tissues clamped by the needle part and the clamping member. The clamping mechanism is mounted in a catheter so as to be protrudable from and retractable into the catheter.

Abstract: The disclosed elastic strip includes an elastic substrate and an overlying carrier. The elastic strip allows for controlled stretch of the elastic substrate. After stretching and applying to skin, the elastic strip can pull portions of the adhered skin. Therefore, the elastic strip can be used as a wound closure or as a nasal dilator, for example.

Abstract: A dehiscence preventive member is adapted to cover up a wound and surrounding tissues. A plurality of holding members are adapted to hold the dehiscence preventive member closely upon the wound and the surrounding tissues, and a contraction preventive member keeping the dehiscence preventive member suitably expanded in a dehiscence direction and of preventing the expanded dehiscence preventive member from contracting. The contraction distance of the dehiscence preventive member in the dehiscence direction is equal to or greater than a contraction distance of the holding member in the dehiscence direction. The dehiscence preventive is closely applied to the wound and surrounding tissues after expansion in the dehiscence direction such that the contraction distance of the dehiscence preventive member in the dehiscence direction is equal to or greater than the contraction distance of the dehiscence preventive member in a direction normal to the dehiscence direction.

Abstract: The invention generally relates to devices and methods for suturing tissue. The invention provides methods and devices for suturing by pushing two ends of a suture through tissue from a proximal side of the tissue and fastening the two ends together on a distal side of the tissue through one operation of a trigger.

Abstract: This invention provides, in certain aspects, unique devices and methods for treating fistulae. In one embodiment, an inventive device includes an elongate graft body having a proximal end and a distal end. The graft body is configurable to a first condition and a second condition, the second condition including the distal end deflected laterally relative to its position in the first condition of the body. The device also includes a tether, which is connected to the graft body, and is configured to traverse proximally along the body. The tether is manipulable to convert the graft body from the first condition to the second condition. Such a device may also include one or more additional tethers connected to the graft body. For instance, a second tether can be configured to extend distally from the distal end of the graft body, and may be effective in pulling the graft body along a fistula tract.

Abstract: A system and method of moving and stretching plastic tissue using dynamic force. An elastomeric driver is adjustably attachable to one or more anchors for securing the elastomer to the plastic tissue, providing a self adjusting system that is capable of exerting relatively constant tension over a certain distance.

Abstract: Methods for approximating and fastening tissue by application of one or more tissue fasteners are provided. In one embodiment, spaced apart tissue locations are engaged by tissue penetrating members of a deformable fastener, one of more of the engaged tissue locations is moved toward another engaged tissue location to approximate the spaced apart locations, and the deformable fastener is deployed to secure the approximated tissue locations. These methods may be used in laparoscopic plication gastroplasty procedures for forming an invaginated tissue fold, to close holes in the gastrointestinal lumen, and in a variety of interventional procedures.

Abstract: Disclosed herein are devices, systems and methods for using such devices and systems for treating incisions and wounds. In an aspect, disclosed is a device having a generally planar tension relief module and a flexible sealant structure sized to cover the tension relief module, the flexible sealant structure comprising a lower adhesive surface. The tension relief module includes a conduit structure having a plurality of support structures on an upper surface of the conduit structure and at least one opening extending through the conduit structure from a lower surface to the upper surface. At least a portion of the conduit structure is adapted to be aligned with a longitudinal axis of the incision. The tension relief module also includes opposing adhesive structures coupled to the conduit structure. The lower adhesive surface of the flexible sealant structure and the upper surface of the conduit structure form a flow pathway.

Abstract: An access apparatus is adapted and configured to access an underlying body cavity. The access apparatus includes a sleeve including a plurality of tubules. The tubules are configured and adapted to suction fascia of opposing tissue tracts to facilitate wound closure. A method of using the access apparatus is also provided.

Abstract: Disclosed are medical devices and methods for tendon, ligament, and soft tissue repair. A method includes introducing a first segment having a delivery assembly into a first soft tissue, and removing the delivery assembly to expose an opening of a hollow body of the first segment. The method also includes introducing a second segment having a second delivery assembly and a second body into a second soft tissue, guiding the second delivery assembly through the opening, and advancing the second body into the hollow body, thereby joining the first soft tissue and the second soft tissue.

Abstract: A wound closure system and a method of closing a wound are disclosed. The wound closure system includes a plurality of skin anchors mechanically attached to external skin tissue around a periphery of a wound, a line extending between the skin anchors, the line slidably engaged with each skin anchor, and a biasing member that provides tension on the line to draw all of the skin anchors toward the wound. The method of closing a wound includes the steps of attaching a plurality of skin anchors to external skin around a periphery of a wound, extending a line between the skin anchors around substantially the entire periphery of the wound, and providing tension to the line to draw the skin anchors toward the wound.

Abstract: A two-sheet fascial expander prosthesis for temporary use and method of using it to treat abdominal hypertension and associated organ system function impairment, in which each flat sheet is attached to the fascia only at opposite sides of an incision. One side of each sheet is armed with mating fastening elements that bond when united to bring about high tensile shear strength and low tensile peeling-off resistance permitting easy separation for diagnostic and therapeutic abdominal entry. The invention is useful because it expands the fascia and adds compliance to the envelope of the abdominal cavity by bridging the gap between free borders of the incised fascia containing intra-abdominal organs without strangulating their blood supply and retaining some tension on the fascia to prevent retraction and bringing the edges closer together as healing progresses, and permitting final removal of the patch and fascia-to-fascia closure.

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: Embodiments of invention are directed to tissue approximation instruments that may be delivered to the body of a patient during minimally invasive or other surgical procedures. In one group of embodiments, the instruments have an elongated configuration with two sets of expandable wings that each have spreadable wings that can be made to expand when located on opposite sides of a distal tissue region and a proximal tissue region and can then be made to move toward one another to bring the two tissue regions into a more proximate position. The instrument is delivered through a needle or catheter and is controlled by relative movement of a push tube and control wire wherein the control wire can be released from the instrument via rotation in a first direction and can cause release of the approximation device from tissue that it is holding by rotation in the opposite direction.

Abstract: A biopsy incision closure device includes a base having a frame incorporated therein. Together, the base and frame define an opening for performing a biopsy incision when the device is placed over a tissue surface. The base is typically composed of an elastomeric material, and the frame comprises resilient inelastic members which can be used to close the opening in a highly uniform manner with minimum distortion and stress introduced into the tissue edges being drawn together.

Abstract: Disclosed are medical devices and methods for tendon, ligament, and soft tissue repair. A method includes introducing a first segment having a delivery assembly into a first soft tissue, and removing the delivery assembly to expose an opening of a hollow body of the first segment. The method also includes introducing a second segment having a second delivery assembly and a second body into a second soft tissue, guiding the second delivery assembly through the opening, and advancing the second body into the hollow body, thereby joining the first soft tissue and the second soft tissue.

Abstract: Various exemplary methods and devices are provided for tensioning suture. The methods and devices are particularly useful in surgical suturing applications in which it is desirable to maintain tension on suture being delivered, yet to allow the tension to be released as desired without retracting the suture. Thus, when tension is released, a length of suture extended from the device can remain extended without any tension being applied thereto. Tension is only applied to any additional length of suture that is extended from the device. The tension applied to the suture is proportional to the length of the suture extended from the device until the tension is released and reset.

Abstract: An instrument for stretching tissue is provided. The instrument can include opposing hook jaws 10 movably coupled to a rod 12 and movable toward each other, and each hook jaw 10 can have a hook receptacle 18. A hook module 20, having at least one hook 22, can be seated in the hook receptacle 18. An adjustment cam 28 can be connected to each hook module 20 and an adjustment drive 26 can be coupled to the adjustment cams 28 where the adjustment drive 26 moves the adjustment cams 28 to cause a skin stretching force at one or more hook modules 20 and to cause a skin reperfusion force at one or more hook modules 20.

Abstract: The invention discloses a skin wound closure device capable of promoting skin wound healing and characterized by being capable of randomly adjusting stitching force for a wound. The skin wound closure device includes a support structure respectively arranged at both sides of a skin wound, at least one locking device is arranged above the support structure, the locking device includes a locking bar and a locking buckle arranged on the support structure, the locking bar is movably connected within the locking buckle, and a locking member is arranged on the locking buckle and can lock or loosely fit the locking bar in the locking buckle.

Abstract: A surgical or wound closure device utilizes a slide fastener for rapidly closing a surgical incision or wound with precise apposition of the sides of the incision. The surgical closure devices are configured for linear incisions, shaped incisions, such as used for wedge biopsy or excisional biopsy, and long incisions, such as used for laparotomy or surgical removal of redundant skin. The surgical closure device may be adhered to the patient's skin prior to making an incision and is subsequently used for closing the incision.

Abstract: Devices, kits and methods described herein may be for wound healing, including the treatment, amelioration, or prevention of scars and/or keloids by applying and/or maintaining a predetermined strain in an elastic skin treatment device that is then affixed to the skin surface using skin adhesives to transfer a generally planar force from the bandage to the skin surface. Applicators are used to apply and/or maintain the strains, and some of the applicators are further configured to provide at least some mechanical advantage to the user when exerting loads onto the skin treatment device.

Abstract: Devices, bandages, kits and methods are described that can control or regulate the mechanical environment of a wound to ameliorate scar and/or keloid formation. The mechanical environment of a wound includes stress, strain, and any combination of stress and strain. The control of a wound's mechanical environment can be active, passive, dynamic, or static. The devices are configured to be removably secured to a skin surface in proximity to the wound site and shield the wound from endogenous and/or exogenous stress.

Abstract: The present invention provides apparatus and methods of closing internal tissue punctures. The apparatus and method provide for an introducer sheath having at least one side port enabling aspiration of an internal tissue puncture site and injection of a sealant.

Abstract: A method for closing a fissure in a region of tissue having an inner surface and an outer surface, the method comprising: providing at least a pair of transverse anchor components, each transverse anchor component being coupled to at least one flexible longitudinal fixation component having a longitudinal axis; placing the transverse anchor components relative to the inner surface of the tissue on both sides of the fissure such that an exposed end of a flexible longitudinal fixation component extends through the tissue and past the outer surface of the tissue on both sides of the fissure; applying axial tension to the exposed ends; and anchoring the exposed ends.

Abstract: A welding element is provided for applying heat, chemicals, pressure, or any combination thereof to tissues inside a patient's body, e.g., a patent foramen ovale. In one aspect, the welding element is connected to a radio frequency energy source and includes an electrode and a locator. The locator facilitates positioning of the welding element and is capable of moving from an open position to a clamping position. In another aspect, a needle is provided for transseptal puncturing before the application of heat. In yet another aspect, the welding element is configured as a coil. The welding element can be made of Nitinol.

Abstract: A device for closing holes in tissue is delivered via a catheter to the inside of a body lumen such as a heart. An elastic barbed clip is expanded, pulled into the tissue and released, pulling the tissue with it. The operation is fully reversible.

Abstract: Apparatus for closing a surgical incision include a base having left and right panels, a force distribution structure coupled to each panel, and a closure component which releasably attaches to the force distribution structure to draw the inner edges of the panels together in order to close adhered tissue edges. The force distribution structures allow the inner edges of the panels to expand while restraining expansion of the outer edges of the panels and limiting elongation of the lateral dimension of the panels. The incision closure apparatus may be placed on skin or other tissue prior to forming the incision to be available to close said incision at the end of the surgical procedure.

Abstract: Devices and methods are disclosed herein for a closure device. A closure device includes a body movable from a pre-deployed configuration towards a deployed configuration, a plurality of tissue-engaging portions extending from the body. At least two of the tissue-engaging portions are separated by a first distance in the deployed configuration and a second distance in the pre-deployed configuration in which the first distance is smaller than the second distance. The closure device also includes a plurality of device-capture features secured to the body. The device-capture features are configured to move the tissue-engaging portions to a separation greater than the first distance.

Abstract: A biopsy incision closure device includes a base having a frame incorporated therein. Together, the base and frame define an opening for performing a biopsy incision when the device is placed over a tissue surface. The base is typically composed of an elastomeric material and the frame comprises resilient inelastic members which can be used to close the opening in a highly uniform manner with minimum distortion and stress introduced into the tissue edges being drawn together.

Abstract: Systems and methods for transeptal cardiac procedures are disclosed. A patient treatment device in accordance with a particular embodiment includes an elongated first intravenous guidewire that includes a first branch and a second branch fixably secured relative to the first branch at a first location. The device can further include an elongated second intravenous guidewire that is movable relative to at least one of the first and second branches between a first position in which the first and second branches are releasably secured relative to each other by the second guidewire at a second location, and a second position in which the first and second branches are separated from each other at the second location.

Abstract: A device is described for securing a cranial limb to the cranial top and for simultaneously closing craniotomy holes, comprising: a cortical support riser; first closing means operatively connected to the cortical riser; second closing means adapted to be secured to the cortical riser; and at least one handle removably connected to the cortical riser and adapted to drive the device to take it from its rest position to its operating securing position. A process for using such device is further described.

Abstract: A reduced-pressure, linear-wound closing bolster has a pivotable frame that moves from an extended position to a compressed position under the influence of reduced pressure. The closing bolster may have a first closing member, a second closing member, and an interior space. A manifold member is disposed within the interior space and may be coupled to the pivotable frame. When a reduced pressure is applied, the pivotable frame is urged from the extended position to the compressed position. A first gripping member for transmitting a closing force from the first closing member to a first edge of a linear wound may be attached. Likewise, a second gripping member for transmitting a closing force from the second closing member to a second edge of the linear wound may be attached. Systems and methods are also presented.

Abstract: A wound closure system comprises a forceps including first and second legs adapted to close into a proximate position in response to a squeezing force applied to the forceps. The forceps also includes a ratchet strip connected to the second leg and passing through an opening in the first leg. The lower edge of the opening is formed as a ratchet pawl for engaging the ratchet strip, thereby providing a ratchet mechanism. Engaging the ratchet mechanism maintains the proximate position of the forceps; rotation of the ratchet strip about the hinge causes it to move upward, thereby disengaging the ratchet mechanism. The forceps may also include a safety latch connected to the first leg by a hinge. Rotation of the safety latch about the hinge inserts a portion of the safety latch into the opening to contact the ratchet strip and thereby prevent disengaging of the ratchet mechanism.

Abstract: Systems and methods of applying dynamic force to tissues to promote healing. Systems of this invention may be applied to tissue to bolster the tissues, move the tissues, or expand the tissue. Systems of this invention may also include a tension indication feature, allowing measured application of dynamic force to the tissue.

Abstract: A tissue connector has a first pointed end, an anchor end, a body with a periphery and a plurality of barbs projecting from said periphery of said body. The plurality of barbs are yieldable in one direction, which direction is the direction of motion of the first pointed end through tissue, and are rigid in an opposite direction, which is in the direction of the anchor end. At axial locations of said body, said barbs are about equally located about the periphery of said body. At axial locations on a cylindrical periphery of the body barbs are locate at about 120 degree spacings. The barbs are conically shaped.

Abstract: An apparatus for delivering a closure element can include a splittable carrier tube and a splitter to split the tube. The carrier tube can have an outer surface retaining a closure element in a tubular configuration and can be split into radially-expandable flaps. A closure element has can have shape-memory body having a relaxed configuration with a planar-annular body defining a lumen with tines directed inwardly from the body. The clip can be held in a retaining configuration having a substantially asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile and a proximal end having the tines being longitudinally directed with a first tine being more distally oriented compared to a substantially opposite second tine being more proximal, and retracting to a deploying configuration having a tubular shape with a rectangular longitudinal cross-sectional profile with the first tine being even with the second tine when being delivered.

Abstract: The present embodiments provide methods for facilitating closure of a bodily opening. In one exemplary method, at least a portion of a first tacking device is disposed through at least a portion of tissue at a first location in a vicinity of an opening in the tissue. Then, at least a portion of a second tacking device is disposed through at least a portion of tissue at a second location in the vicinity of an opening in the tissue. A closure member having at least one loop portion is advanced towards the first and second tacking devices, and the loop portion is positioned around at least a portion of the first tacking device and at least a portion of the second tacking device. The closure member then is actuated to urge the first tacking device towards the second tacking device to provide a compressive force upon the opening.

Abstract: The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.

Abstract: Devices, bandages, kits and methods are described that can control or regulate the mechanical environment of a wound to ameliorate scar and/or keloid formation. The mechanical environment of a wound includes stress, strain, and any combination of stress and strain. The control of a wound's mechanical environment can be active, passive, dynamic, or static. The devices are configured to be removably secured to a skin surface in proximity to the wound site and shield the wound from endogenous and/or exogenous stress.

Abstract: Devices, bandages, kits and methods are described that can control or regulate the mechanical environment of a wound to ameliorate scar and/or keloid formation. The mechanical environment of a wound includes stress, strain, and any combination of stress and strain. The control of a wound's mechanical environment can be active, passive, dynamic, or static. The devices are configured to be removably secured to a skin surface in proximity to the wound site and shield the wound from endogenous and/or exogenous stress.

Abstract: An adjustable wound closure device includes at least one band or strip retaining element provided for attachment in the region of at least one edge of a wound. The retaining element has a multiplicity of hook elements on at least part of at least one of its two faces. The wound closure device further includes at least one gauze cover element which substantially completely covers the wound and the edge regions provided with the retaining element. The hook-like elements of the retaining element and the meshes of the cover element are designed and arranged such that the wound can be reversibly closed by a positive engagement of at least some of the hook-like elements in the meshes.

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: 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: An instrument for stretching tissue is provided. The instrument can include opposing hook jaws 10 movably coupled to a rod 12 and movable toward each other, and each hook jaw 10 can have a hook receptacle 18. A hook module 20, having at least one hook 22, can be seated in the hook receptacle 18. An adjustment cam 28 can be connected to each hook module 20 and an adjustment drive 26 can be coupled to the adjustment cams 28 where the adjustment drive 26 moves the adjustment cams 28 to cause a skin stretching force at one or more hook modules 20 and to cause a skin reperfusion force at one or more hook modules 20.

Abstract: A hypobaric wound space is provided for prophylactic and diagnostic purposes in surgical wounds of the abdomen deliberately left open. The hypobaric wound space provided is established by a combination of an impermeable folio sheet or thin flexible membrane, tissue fluid absorbing gauze or sponge, a drain tube, and a suction device to create hypobaric conditions and prevent wound contamination and infection, and to collect wound fluid to diagnose protein, fluid and other substrate losses on a quantity and quality basis.

Abstract: A medical closure screen device for a separation of first and second tissue portions is provided, which includes a mesh screen comprising tubular vertical risers, vertical strands with barbed filaments, and horizontal spacers connecting the risers and strands in a grid-like configuration. An optional perimeter member partly surrounds the screen and can comprise a perimeter tube fluidically coupled with the vertical risers to form a tubing assembly. Various input/output devices can optionally be connected to the perimeter tube ends for irrigating and/or draining the separation according to methodologies of the present invention. Separation closure, irrigation and drainage methodologies are disclosed utilizing various combinations of closure screens, tubing, sutures, fluid transfer elements and gradient force sources. The use of mechanical forces associated with barbed strands for repositionably securing separated tissues together is disclosed.

Abstract: Devices, bandages, kits and methods are described that can control or regulate the mechanical environment of a wound to ameliorate scar and/or keloid formation. The mechanical environment of a wound includes stress, strain, and any combination of stress and strain. The control of a wound's mechanical environment can be active, passive, dynamic, or static. The devices are configured to be removably secured to a skin surface in proximity to the wound site and shield the wound from endogenous and/or exogenous stress.

Abstract: A tool (101) is provided for inserting and mating two plug members (2, 3) of a sealing device (1) for closing a wound in the wall of a vessel by placing the distal plug member (2) of the sealing device inside the vessel and the proximal plug member (3) on the outside of the vessel. The distal plug member is provided with an elongated retracting means (6) extending from the distal plug member. The tool comprises a gear mechanism (32) coupled to the retracting means for converting a movement of the tool in a proximal direction away from the wound (22), when the distal plug member is anchored in the vessel (20), to a pushing movement for moving the proximal plug member in a direction towards the distal plug member in response to a stretching force in the retracting means.