Abstract: A modular, reduced-pressure, wound-closure system for generating a closing force on a surface wound on a patient includes a sealed contracting member, a plurality of attachment base members, and a plurality of connecting members. The combination of the plurality of attachment base members and plurality of connecting members forms a circumferential wall around the surface wound. The sealed contracting member is operable to be disposed within an interior space defined by the circumferential wall and coupled to at least of portion of the circumferential wall. When reduced pressure is provided to the sealed contracting member, the sealed contracting member contracts and the circumferential wall delivers a closing force. Other systems and methods are presented.

Abstract: An epidermal positioning mechanism for use with an application to a predetermined epidermal surface. The epidermal positioning mechanism comprises a strip of material having a first end portion of a predetermined shape, a second end portion of a predetermined shape, and middle portion coupling the first end portion to the second end portion. The first end portion and the second end portion each may include a side including an adhesive layer. An overlaying, non-adhesive barrier layer may be located between a portion of the adhesive layer and an end portion.

Abstract: Viscerotomy closure devices and methods of use close a hole in a bodily organ, such as one created during a natural orifice transgastric surgery procedure. A mesh with a hole in its center and an attached loop of suture having a Roeder knot is mounted on the protruding rod of an end-to-end anastomosis stapler between the anvil and the staple carrying member. The mesh covers the staple receiving slots. When rotated when in contact with tissue, an augur-shaped blade attached to the anvil's exterior self-feeds the tissue through a notch in the anvil's base into the space between the anvil and the staple carrying member. After the stapler is fired to staple the mesh to the tissue and create a viscerotomy, a knot pusher cinches the loop of suture and subsequently tightens the Roeder knot to maintain the cinch.

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 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: An internal and external medical closure system 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: Viscerotomy closure devices and methods of use close a hole in a bodily organ, such as one created during a natural orifice transgastric surgery procedure. A mesh with a hole in its center and an attached loop of suture having a Roeder knot is mounted on the protruding rod of an end-to-end anastomosis stapler between the anvil and the staple carrying member. The mesh covers the staple receiving slots. When rotated when in contact with tissue, an augur-shaped blade attached to the anvil's exterior self-feeds the tissue through a notch in the anvil's base into the space between the anvil and the staple carrying member. After the stapler is fired to staple the mesh to the tissue and create a viscerotomy, a knot pusher cinches the loop of suture and subsequently tightens the Roeder knot to maintain the cinch.

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: Devices and methods for sealing a passageway formed by a patent foramen ovale (PFO track) in the heart are provided. One method includes providing an abrading device to the PFO track and abrading the tissue within the PFO track. The abraded tissue forming the PFO track is then held together under pressure, either via lowering right atrial pressure or via applying suction to the septum primum to pull it into apposition against the septum secundum. After a sufficient period of time, the pressure is released and the abraded tissue heals to form a robust seal over the PFO track. Additionally, several devices are provided which can be placed into the PFO track to apply adhesive to the walls of the PFO track. The devices may or may not be left within the PFO track. If the devices are not left within the PFO track, the walls of the PFO track, covered with adhesive, are brought into apposition with one another and adhered together.

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: An occlusion device includes a center assembly having a flexible section formed by a spring connector and a safety tether. The flexible spring connector gives the center assembly improved torque and flexure characteristics, which allows the occlusion device to better conform to the contours of the heart. The safety tether serves to further ensure the structural integrity of the center assembly.

Abstract: Apparatus is provided for sealing a vascular puncture by causing a reduction in the circumference of the puncture tract through delivery of a closure agent into tissue surrounding the puncture tract. A resultant inflammatory response and volumetric increase cause the tissue to swell into the puncture tract, thereby sealing it.

Abstract: Methods and apparatus for treatment of layered tissue defects such as a patent foramen ovale provide for applying energy to tissues adjacent to the PFO with a closure device that substantially closes the PFO. Apparatus generally includes an elongate flexible member having a proximal end and a distal end and an energy transmission member deployable from the elongate flexible member. The energy transmission member applies energy to the layered tissue defect at a first position and a second position adjacent to the first position so as to substantially close the layered tissue defect along at least a portion of the defect. Applied energy may be monopolar or bipolar radiofrequency energy or any other suitable energy, such as laser, microwave, ultrasound, resistive heating, direct heat energy, cryogenic or the like. PFO closure via energy-based approaches of the invention may help prevent stroke, treat migraine headache, and possibly treat or prevent other medical conditions.

Abstract: A device and method for closing a percutaneous vascular puncture with anchors at the distal ends of wires temporarily implanted in extravascular tissue adjacent the puncture. The wires are tensioned to draw the tissue together to approximate the edges of the puncture. The wires are retained in that position while the blood in the region of the arteriotomy clots. When hemostasis has been achieved, the anchoring wires then can be removed.

Abstract: A traction device includes an advancing member equipped with a zone through which a member is forcibly advanced, a pair of cooperating flexible members, wherein each flexible member has at least one side thereof at least partially coated with an adhesive material, wherein the adhesive material of each the member is connected to opposing skin surrounding a wound such that a remaining portion of each member extends over and above the wound and wherein the remaining portions are connected through the zone of the advancing member in a manner to advance the remaining portions and draw the opposing surrounding skin toward each other in a manner to aid in closure of the wound.

Abstract: A surgical instrument for closing an otomy includes a handle portion, an outer tube, an inner tube, and at least one deployable/retractable tissue engaging hook. The handle portion may comprise an actuator configured to move the inner tube and the at least one deployable/retractable tissue engaging hook. The outer tube may comprise a distal end and a proximal end, and the inner tube may also comprise a distal end and a proximal end. The inner tube may be configured to be movably retained in the outer tube and may be configured to be coupled to the actuator. The deployable/retractable tissue engaging hook may comprise a distal end and a proximal end. The deployable/retractable tissue engaging hook may be configured to be movably retained in the inner tube. The distal end of the deployable/retractable tissue engaging hook may be configured to engage to a portion of tissue.

Abstract: An occlusion device includes a flexible section formed by a wire connector. The flexible wire connector gives the occlusion device improved torque and flexure characteristics, which allows the device to better conform to the contours of the heart.

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 system for gaining access to an interventional site within vasculature through a vessel wall or other structure such as that of a medical device. An apparatus is provided to accomplish a sealed worksite as are sensor delivery systems including sealable sensor devices that are adapted to be placed at the interventional site.

Abstract: The invention generally relates to systems and methods for closing an aperture in a patient, such as an aperture in a vessel wall of a patient. In certain embodiments, the invention provides a system for closing an aperture in a patient including a delivery device that is removably attachable to a medical device, and a clip releasably disposed within the delivery device. The clip includes tissue engaging members configured to engage bodily tissue of the patient. The clip includes a body portion biased towards a first configuration to facilitate closure of the aperture when the tissue engaging members are engaged with the bodily tissue.

Abstract: A lip closure device (105) for use with human remains includes a shaft (201) having a first end (205) that is substantially pointed and a second end (213) that is substantially blunt. One or more hooking notches (207, 215) are used for engaging with tissue inside the mouth of the human remains in order to maintain the lips into a substantially closed position.

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 said plate-like bodies. One tensioning device is arranged on at least one of said plate-like bodies and being connected to said pulling thread for applying a tensile force to said pulling thread. A guidance serves for guiding said at least one pulling thread during a movement of said at least two plate-like bodies towards one to another.

Abstract: A wound (50) is closed using a first adhesive shoe (10) adhesively affixed adjacent to a first edge (51) of the wound, a second adhesive shoe (20) adhesively affixed adjacent to a second opposite edge (52) of the wound, a forceps device (100) comprising a first leg (101 ) adapted to couple with the first adhesive shoe and a second leg (102) adapted to couple with the second adhesive shoe; and a locking mechanism (150) adapted to draw the first and second forcep legs together and hold legs in the desired closed position after they are drawn together.

Abstract: A sternal closure device for securing and retaining longitudinally divided halves of a sternum, the device having two sets of anterior and posterior longitudinally extended brace members with brace joining mechanisms extending through the sternal halves to join the anterior brace members to the posterior brace members, such that the sternal halves are compressed between the anterior and posterior brace members, and transverse bridging members that laterally connect the two sets of brace members, with securing mechanisms to retain the two sets of brace members in a contracted configuration with the sternal halves in abutting relation.

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: A method for threading a suture in a patient's body. The method includes the steps of providing a suture, providing a threading device comprising an elongated rod having a suture tie-off location and first and second ends, tying the suture to the suture tie-off location, inserting the first end of the elongated rod through a first opening in the patient's skin, passing the first end of the elongated rod subcutaneously to a second opening in the patient's skin, pulling the first end of the elongated rod and a portion of the suture through the second opening, without turning the elongated rod around, and passing the second end of the elongated rod subcutaneously to an opening in the patient's skin. At least one point during the performance of the method the first end of the elongated rod extends out of the first opening and the second end of the elongated rod extends through the second opening.

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 changing the shape of the dressing after application of the dressing to the skin wherein the changed shape applies pressure to the skin. The changing can include releasing a member from the dressing to allow the dressing to change the shape of the dressing; deforming at least a portion of the dressing to change the shape of the dressing or allowing the dressing to heat to above a transition temperature at which the dressing changes shape.

Abstract: Device, system and method for drawing together patient tissue. A central hub has an axis. Several tines are coupled to the central hub. Each of the tines has a tip and is resiliently biased to for a coil. Each tip points radially outward from the axis, with an approximately common angle between adjacent ones of the tines.

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: A barbed bodily tissue connector for insertion into tissue comprises an elongated body having a substantially polygonal periphery in cross-section including at least three sides. Each side meets an adjacent side at an edge of the elongated body. A plurality of barbs project from the edges of the body. The barbs are configured such that they are yieldable in a direction toward the body and resist retraction from tissue in an opposite direction.

Abstract: A patent foramen ovale closure device, method of delivering and a delivery system are provided. The device may include a closure device releasably connectable to an actuator. The device may include a proximal segment, an intermediate segment and a distal segment. When delivered, the proximal segment and intermediate segment form a first clip-shaped portion sized and configured to be positioned over a septum secundum of the patent foramen ovale, and the intermediate segment and distal segment form a second clip-shaped portion sized and configured to be positioned over a septum primum of the patent foramen ovale.

Abstract: A perianal support device is provided that is configured to inhibit the formation and/or progression of tissue damage in the perianal region of the body. A method is provided to apply the perianal support device to patients during childbirth to inhibit the formation and/or progression of tissue damage in the perianal region of the body.

Abstract: An introducer comprises a sheath, a guide rod, at least one wire stabilization guide, and a loop actuation wire for securing and centering a wound opening during a medical procedure (e.g., wherein a transluminal device is utilized) and during closure of the wound. The guide rod is sized to fit within the inside diameter of the sheath. The guide rod has at least one slot along its length for releasably holding the loop actuation wire. One or more wire stabilization guides or elongated members are coupled to the sheath. In one exemplary embodiment, the elongated members may be actuated to form a loop, so that when the sheath is approximated to a wound site, the loop portion is approximated to tissue surrounding the wound site to hold the sheath approximately centered on the wound site.

Abstract: A closure device configured for closing an opening in a body lumen. The closure device may include a delivery sheath, a cleat, and one or more anchors. The cleat may be disposed within and move longitudinally with respect to the delivery sheath. The one or more anchors may be configured to engage tissue surrounding the body lumen opening and selectively couple to the cleat to obstruct and/or close the body lumen opening.

Abstract: A fastening device for clamping and fastening tissue together with fasteners formed from an adhesive is disclosed. An embodiment of the adhesive fastening device can clamp a first and a second portion of tissue together between a first and a second jaw, and can place a fluid polymer adhesive into tissue and form it into a polymerized surgical fastener within the tissue. The adhesive fastener can be formed as a polymerized shank or shaft extending through the tissue, and can have one or more heads formed on the shank. The shank can be formed solely from the polymerizable adhesive, or can be formed from another material such as nitinol, titanium, stainless steel, suture, or a plastic. Shanks of other material can be combined with the adhesive. Alternately, an adhesive fastener can be formed extending distally from a distal end of the surgical device. And, an adhesive fastener can be formed around a luminal tissue or within luminal tissue.

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 & methods for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.

Abstract: Devices for treating wounds and methods of treating wounds are described. In use, the devices allow both mechanical force and negative pressure therapy.

Abstract: A device and method for obliterating or occluding a body cavity or passageway, in particular, the left atrial appendage of a patient's heart. The procedure can be carried out intraoperatively, but is preferably carried out percutaneously by use of a delivery catheter to position an occluding device adjacent a patient's left atrial appendage. The occluding device may prevent the passage of embolic or other material to or from the left atrial appendage by volumetrically filling the appendage, closing the opening of the appendage with an occluding member, or pulling the tissue around the opening of the appendage together and fixing it in a closed state.

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 modular, reduced-pressure, wound-closure system for generating a closing force on a surface wound on a patient includes a sealed contracting member, a plurality of attachment base members, and a plurality of connecting members. The combination of the plurality of attachment base members and plurality of connecting members forms a circumferential wall around the surface wound. The sealed contracting member is operable to be disposed within an interior space defined by the circumferential wall and coupled to at least of portion of the circumferential wall. When reduced pressure is provided to the sealed contracting member, the sealed contracting member contracts and the circumferential wall delivers a closing force. Other systems and methods are presented.

Abstract: A modular, reduced-pressure, wound-closure system for providing a closing force on a surface would includes a flexible strap operable to be formed into a closed loop inbound and around the surface wound and a plurality of modular closing members coupled to the flexible strap. A reduced-pressure source is fluidly coupled to the plurality of modular closing members. The modular closing members are operable to generate a closing force on the surface wound. A portion of the modular closing members are releasably attached to the patient's epidermis proximate the surface wound and another portion are attached to the flexible strap. A reduced pressure from the reduced-pressure source is delivered to each modular closing member to generate the closing force on the surface wound. Methods and other systems are presented.

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: A sutureless biopsy closure that includes an adhesive member adapted to be disposed over a biopsy region prior to the performance of the biopsy; at least one adhesive strip including one end supported on the adhesive member and a second free end forming a tab. The tab is adapted to extend over the biopsy region to seal the wound.

Abstract: Devices and methods for sealing a passageway formed by a patent foramen ovale (PFO track) in the heart are provided. One method includes providing an abrading device to the PFO track and abrading the tissue within the PFO track. The abraded tissue forming the PFO track is then held together under pressure, either via lowering right atrial pressure or via applying suction to the septum primum to pull it into apposition against the septum secundum. After a sufficient period of time, the pressure is released and the abraded tissue heals to form a robust seal over the PFO track. Additionally, several devices are provided which can be placed into the PFO track to apply adhesive to the walls of the PFO track. The devices may or may not be left within the PFO track. If the devices are not left within the PFO track, the walls of the PFO track, covered with adhesive, are brought into apposition with one another and adhered together.

Abstract: A wound closure system and a method of closing a wound are disclosed. The disclosure is directed to a wound closure system comprising a skin anchor mechanically attached to external skin tissue on a first side of a generally linear wound, an anchorable tensioning apparatus mechanically attached to external skin tissue on an opposite side of the wound, and a line extending between the skin anchor and the tensioning apparatus to movably connect the anchor to the tensioning apparatus. The line is fixedly engaged with an anchor on one side of the wound while the tensioning apparatus provides tension on the line to draw the skin anchor and the tensioning apparatus toward each other and toward the wound.

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 and methods for biological tissue closure are disclosed. Arteriotomy closure and hemostasis devices and methods are disclosed. A device that can provide a lateral tension across an opening in the tissue and apply energy to seal the tissue is disclosed. Methods for using the device are also disclosed.

Abstract: Apparatus & methods for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.