Abstract: A sternal closure device includes an insertion member, a receiver member and a joint locking mechanism. The joint locking mechanism includes a dual pawl assembly and a dual ratchet assembly. The dual pawl assembly includes a pair of pawl arms that include heads with outward facing teeth. The dual ratchet assembly includes a pair of ratchet arms with inward facing teeth that are configured for an intermeshed engagement with the teeth on the corresponding pawl arms. Alignment tabs on the ratchet arms are captured within guide channels on the receiver member. The configuration and number of the teeth contribute to the strength of the device. The locking mechanism contributes to efficiency, speed, and strength of the closure.

Abstract: A combined magnetic and bioabsorbable device for ventral hernia closure and/or tension distribution for maintenance of tissue apposition for healing, while avoiding a long-term footprint of foreign material and precluding materials spanning the interior layer of the abdominal closure where risk to visceral structures exists.

Abstract: A medical device and methods for hemostasis in a living body are disclosed. The medical device including a base configured to arranged on an upper surface of the tissue in the living body; a plurality of levers, each of the plurality of levers having a needle arranged on a lower surface thereof and configured to puncture the tissue in the living body, and wherein the plurality of lever are configured to be received with a slot or track of the base; and at least one tie, the at least one tie configured to hold together the plurality levers and needles upon compressing the tissue in the living body upon moving the plurality of levers inward in the slot or track of the base.

Abstract: The disclosure discloses a fastener tape, a slide fastener and a fastener tape manufacturing device. The fastener tape includes a fastener tape body and a fastener element fixed to a first side of the fastener tape body. A second side of the fastener tape body is folded toward a back side of the fastener tape body, and a bent part extending along a length direction of the fastener tape is formed after the folding. The bent part divides the fastener tape body into a first fastener tape part and a second fastener tape part respectively located on a front surface and a back surface of the fastener tape body. Moreover, a fixing holding part is further disposed between the first fastener tape part and the second fastener tape part for maintaining the folded state of the fastener tape body.

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: A reinforcement device [10] comprises a biocompatible material such as a mesh sheet [12] for closing and reinforcing the closure of a surgical incision, including an elongated abdominal incision. The biocompatible material may provide one or more of a column of hooks [16a, 16b] or a column of apertures [31a, 31b] or markings [51a, 51b] to indicate where puncturing/suturing is to occur and/or where the device [10] is to be positioned. A disclosed ratio of suture [22] length to incision length is 4:1. The reinforcement device [10], when implanted through surgery, may reduce the likelihood of and/or prevent incisional hernias. The reinforcement device [10] may be included in a surgical kit.

Abstract: A tissue closure device includes a first clip including a first longitudinal element extending along a longitudinal axis from a proximal end to a distal end and a first pair of arms extending laterally from the first longitudinal element, the first pair of arms movable between an open configuration in which free ends of the first pair of arms are separated from one another and a closed configuration in which the free ends of the first pair of arms extend toward one another, the first pair of arms being biased toward the closed configuration, and a sliding element extending from a proximal end to a distal end and longitudinally movable relative to the first clip so that when a portion of the sliding element is received between the first pair of arms, the first pair of arms is moved from the biased closed configuration to the open configuration.

Abstract: A skin frame or other skin straining device strains skin on each side of a wound where a wound has been closed to off load stresses at the wound site. A dressing may be applied to the strained skin. The dressing may be integral with one or more elements of the skin straining device.

Abstract: There is provided a surgical stapler having a staple formation recognition system incorporated into an anvil member of the surgical stapler. In one series of embodiments, a trace system and controller form an open electrical circuit and a surgical staple acts as an electrical connector to complete an electrical circuit and confirm the proper formation of the surgical staple. In another series of embodiments, a trace system and a controller form a complete electrical circuit which is broken by engagement of a surgical staple with a trace pad of the trace system to signal proper formation of the surgical staple. There is also provided a knife blade position indication system for tracking the progress of a knife blade through the anvil member and relative to staple crimping pockets formed in the anvil member.

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: A radiolucent fastening device for fastening a reference device to a body for computer-assisted surgery, wherein a part of the fastening device is made from an unsubstituted carbon fiber reinforced polyether compound, a monosubstituted carbon fiber reinforced polyether compound or a multisubstituted carbon fiber reinforced polyether compound.

Abstract: A device for treating a bone includes (a) an elongate body sized and shaped for insertion into a bone and extending longitudinally from a proximal end to a distal end, the elongate body including a channel extending therethrough and a coating along an outer surface thereof, the coating adapted to absorb a selected frequency of light such that, when the selected frequency of light is applied thereto, portions of the coating melt to form a mass; and (b) a first anchor member slidably mountable over the elongate body and movable therealong from a first position at the proximal end of the elongate body to a second position adjacent a bone into which the elongate body has been inserted to cooperate with the mass to fix the elongate body to the bone.

Abstract: An incision guide and wound closure device includes a surgical mesh having a top surface and a bottom surface, and first and second incision guides affixed to the top surface of the surgical mesh. The bottom surface of the mesh is adhered to tissue using clear or translucent adhesive. The first and second incision guides have opposing alignment surfaces that are adapted to guide a cutting instrument for making an incision through the mesh and into the tissue. The device has a closing element that is moveable along the length of the respective first and second incision guides for drawing the first and second alignment surfaces toward one another for closing the incision opening in the tissue.

Abstract: A surgical access device is disclosed which includes a housing, a collar, and a plurality of deformable members. The housing defines a proximal end and a distal end and has a plurality of lumens extending therethrough. The collar is repositionable between a first position and a second position with the second position being closer to the proximal end of the housing than the first position. Each of the plurality of deformable members defines a distal portion, is coupled to the collar and is transitionable through one of the plurality of lumens. The plurality of deformable members is in a retracted state when the collar is in the first position and a deployed state when the collar is in the second position. One or more of the plurality of deformable members may also include a barb attached to the distal portion.

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

Abstract: Surgical bolts are useful for solid visceral wound hemostasis. The devices utilize flexible, variable depth transfixing bolts that penetrate the viscera. These bolts bring the tissue into apposition and hold said tissue in apposition while the wound heals. These bolts, or soft tissue rivets, overcome the limitations of sutures that are currently used for the same purposes. The devices are flexible, bendable, and conformable in their wet or dry state. The bolts include pressure plates that are capable of exerting compressive pressure over broad areas of visceral wounds without causing tearing of the friable parenchyma. The bolts are placed and removed by open surgery or laparoscopic access. The bolts can be placed into tissue where both sides of the bolt are exposed, or they can be placed blindly into tissue where the bolt does not protrude out of the tissue at its distal end.

Abstract: Surgical bolts are useful for solid visceral wound hemostasis. The devices utilize flexible, variable depth transfixing bolts that penetrate the viscera. These bolts bring the tissue into apposition and hold said tissue in apposition while the wound heals. These bolts, or soft tissue rivets, overcome the limitations of sutures that are currently used for the same purposes. The devices are flexible, bendable, and conformable in their wet or dry state. The bolts include pressure plates that are capable of exerting compressive pressure over broad areas of visceral wounds without causing tearing of the friable parenchyma. The bolts are placed and removed by open surgery or laparoscopic access. The bolts can be placed into tissue where both sides of the bolt are exposed, or they can be placed blindly into tissue where the bolt does not protrude out of the tissue at its distal end.

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: 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: 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: 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: Disclosed is a flow control device for a bronchial passageway. The device can includes a valve member that regulates fluid flow through the flow control device, a frame coupled to the valve member, and a membrane attached to the frame. At least a portion of the flow control device forms a seal with the interior wall of the bronchial passageway when the flow control device is implanted in the bronchial passageway. The membrane forms a fluid pathway from the seal into the valve member to direct fluid flowing through the bronchial passageway into the valve member.

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

Abstract: Surgical bolts are useful for solid visceral wound hemostasis. The devices utilize flexible, variable depth transfixing bolts that penetrate the viscera. These bolts bring the tissue into apposition and hold said tissue in apposition while the wound heals. These bolts, or soft tissue rivets, overcome the limitations of sutures that are currently used for the same purposes. The devices are flexible, bendable, and conformable in their wet or dry state. The bolts include pressure plates that are capable of exerting compressive pressure over broad areas of visceral wounds without causing tearing of the friable parenchyma. The bolts are placed and removed by open surgery or laparoscopic access. The bolts can be placed into tissue where both sides of the bolt are exposed, or they can be placed blindly into tissue where the bolt does not protrude out of the tissue at its distal end.

Abstract: A zipper-type wound closer attachable to the skin around a skin opening and zipped closed to pull the skin opening closed. The wound closer includes two elongated connecting strips whose feet are pre-coated with adhesive and attached to the skin around the skin opening. The edges of the wound are trimmed flush with the interior sides of connecting strips, and the strips are then zipped together by moving a slider along the connecting strips to join the strips together like a familiar zipper. The wound zipper forms a continuous, toothless seam to prevent seepage of fluid through the seam. By holding the freshly trimmed edges of the skin opening together immobile in a clean, firm, closely aligned connection, the wound closer recreates the conditions under which scar-free healing of the skin can occur naturally; useful for repairing wounds and removing existing scars.

Abstract: An incision guide and wound closure device includes a surgical mesh having a top surface and a bottom surface, and first and second incision guides affixed to the top surface of the surgical mesh. The bottom surface of the mesh is adhered to tissue using clear or translucent adhesive. The first and second incision guides have opposing alignment surfaces that are adapted to guide a cutting instrument for making an incision through the mesh and into the tissue. The device has a closing element that is moveable along the length of the respective first and second incision guides for drawing the first and second alignment surfaces toward one another for closing the incision opening in the tissue.

Abstract: A catheter-based, annulus reduction device and system for cardiac valve repair and method of using the same. The system is usable for treating mitral valve regurgitation and comprises a catheter, a reduction ring carried within the catheter, the reduction ring including a plurality of exit ports formed in a side wall of the reduction ring and filament received in the reduction ring. The filament includes a plurality of radially extendible barbs corresponding to the sidewall openings. The reduction ring carrying the filament is deployed adjacent a mitral valve annulus and the filament is translated relative to the reduction ring to deploy the barbs through the exit ports and into the annulus and to further translate the reduction ring with deployed barbs to reshape the annulus.

Abstract: A zipper-type wound closer attachable to the skin around a skin opening and zipped closed to pull the skin opening closed. The wound closer includes two elongated connecting strips whose feet are pre-coated with adhesive and attached to the skin around the skin opening. The edges of the wound are trimmed flush with the interior sides of connecting strips, and the strips are then zipped together by moving a slider along the connecting strips to join the strips together like a familiar zipper. The wound zipper forms a continuous, toothless seam to prevent seepage of fluid through the seam. By holding the freshly trimmed edges of the skin opening together immobile in a clean, firm, closely aligned connection, the wound closer recreates the conditions under which scar-free healing of the skin can occur naturally; useful for repairing wounds and removing existing scars.

Abstract: Devices and methods for tissue approximation and distribution of tissue stresses and tension resulting therefrom. The devices comprise a shank having one or more structures thereon, an anchor button fixedly attached to one end of the shank with the opposite end of the shank being suitable for penetration of tissues or other structures. To secure the device, the shank engages with a locking button having a locking mechanism thereon. The locking button is engaged with the shank, preferably after a tissue approximation, so that the locking button can be advanced along the shank towards the anchor button compressing the approximated tissues between the anchor button and the locking button.

Abstract: Incision and closure surgical device designed to assist in operative surgery as a means of effecting and repairing skin wounds. A slide fastener is fitted to a self-adhesive sheet that is attached to the skin surface. The slider of the slide fastener contains a contact electrode for electrocoagulation fitted with a cutting edge. As the slide fastener is opened, the slider simultaneously effects the incision by means of the cutting edge of the electrode, severing both the flexible sheet and the skin beneath. For closing the incision, the stringer tapes of the slide fastener interlock by the action of the slider, thereby bringing both the edges of the flexible sheet and the wound beneath into apposition.

Abstract: A zipper-type wound closer attachable to the skin around a skin opening and zipped closed to pull the skin opening closed. The wound closer includes two elongated connecting strips whose feet are pre-coated with adhesive and attached to the skin around the skin opening. The edges of the wound are trimmed flush with the interior sides of connecting strips, and the strips are then zipped together by moving a slider along the connecting strips to join the strips together like a familiar zipper. The wound zipper forms a continuous, toothless seam to prevent seepage of fluid through the seam. By holding the freshly trimmed edges of the skin opening together immobile in a clean, firm, closely aligned connection, the wound closer recreates the conditions under which scar-free healing of the skin can occur naturally; useful for repairing wounds and removing existing scars.

Abstract: A zipper-type wound closer attachable to the skin around a skin opening and zipped closed to pull the skin opening closed. The wound closer includes two elongated connecting strips whose feet are pre-coated with adhesive and attached to the skin around the skin opening. The edges of the wound are trimmed flush with the interior sides of connecting strips, and the strips are then zipped together by moving a slider along the connecting strips to join the strips together like a familiar zipper. The wound zipper forms a continuous, toothless seam to prevent seepage of fluid through the seam. By holding the freshly trimmed edges of the skin opening together immobile in a clean, firm, closely aligned connection, the wound closer recreates the conditions under which scar-free healing of the skin can occur naturally; useful for repairing wounds and removing existing scars.

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. The loops of the device may be of various shapes, sizes, and configurations, and, in at least some embodiments, the loops have rounded peripheries. In some embodiments, at least one of the sides includes a tissue scaffold.

Abstract: A flexible medical closure screen for closing 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: 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: The present invention is directed to various systems for repairing tissue within the heart of a patient. The mitral valve repair system of the present invention comprises a guide catheter having a proximal end, a distal end, and at least one internal lumen formed therein, a therapy catheter capable of applying a suture to the tissue, and a fastener catheter capable of attaching a fastener to the suture. The therapy catheter and the fastener catheter are capable of traversing the internal lumen of the guide catheter. In addition, the present invention discloses various methods for repairing tissue within the heart of a patient.

Abstract: An improved device for closing an opening in a blood vessel includes a cannula holding a first wire group, a second wire group, and a wire fixation device. The positions of the first wire group and second wire group are independently adjustable. The first wire group is deployed from the cannula into an interior region of the blood vessel and retracted to a desired position in contact with an intimal surface of the blood vessel around the opening. The second wire group is deployed from the cannula and moved to a desired position in contact with an adventitial surface of the blood vessel around the opening. The fixation device is adapted to affix the first and second wire groups in their desired positions to thereby effectuate closure of the opening in the blood vessel.

Abstract: An anastomotic device for use in the joining of a first tubular structure and a second tubular structure is provided. The anastomotic device includes a cylindrical sleeve configured and dimensioned for placement at least partially within the first tubular structure, the cylindrical sleeve defining a bore therethrough; an inverting member configured and dimensioned for placement at least partially within the second tubular structure, the inverting member defining a bore therethrough which is configured and dimensioned to selectively receive the cylindrical sleeve therein; and a constricting member selectively positionable on the inverting member and movable onto the cylindrical sleeve when the cylindrical sleeve is at least partially positioned within the bore of the inverting member.

Abstract: A flow control device includes a sealing component that can be positioned within a bronchial lumen. The sealing component can comprise two or more overlapping segments that are movable relative to one another such that the segments collectively form a seal that can expand and contract in size to fit within and seal bronchial lumens of various sizes.

Abstract: A sternal closure device including impermanently joined sliding and receiving attachment structures which are adapted for intercostal positioning between at least two corresponding rib pairs and substantially surrounding a patient's sternum with each structure having a cross member, a plurality of integrated legs and foot members, a plurality of sternum engagement surfaces, and an end portion. The receiving structure further incorporates a resiliently tensioned catch member with angularly disposed teeth like structures positioned to receive and position a plurality of receiving structure projection members when inserted therein. The catch member further serves as a stabilizing structure with stabilization facilitated via an easily removed single screw like structure markedly facilitates quick release.

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.

Abstract: The invention discloses a device and technique for a sutureless wound closure, which limits the risks of rupture and scarring. The device comprises a two-part strap having short hooks or barbs on the ventral surface. The barbs are curved and flexible such that, when urged in one direction, the barbs do not engage while when urged in the opposite direction, the barbs are pushed downward and engage the tissue of the wound. By deploying one strap on each side of the wound, fastening the two straps in the middle of the wound and tightening the ends, the wound is closed. The tension required to close the wound is distributed along the length of the straps, thus resulting in a cleaner, safer closure.

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

Abstract: The present invention relates to a suture tightening wound closure device for use on mammals including humans. This device is comprising a smooth suture (to be sewn across an open wound through the skin and underlying tissue) and a suture loop tension means (for closing the wound). This tension means is by grasping one end of the suture, and pulling back its second end, forming a tensioned suture loop, enclosing the wound. Specifically, the device of the present invention is characterized by the tension means having a manual control mechanism (for pulling or releasing said second end). The smooth suture according to the preferred embodiment of the present invention is a suture band, which is flexible for bending along it's length and is resistant to bending along it's width. The device of the present invention also relates to embodiments having in addition a pair of suture supporting skin reinforcing means.

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

Abstract: An internal organ walls joining instrument for an endoscope is used for endoscopically joining two internal organ walls spaced apart from each other, and for endoscopically forming a fistula between the two internal organ walls. The instrument has at least a first stationary part, a second stationary part, a first line member, a second line member, and a stopper. Each of the first and the second line members is respectively coupled to the first stationary part, the second stationary part, and the stopper. The two internal organ walls are pinched between the first stationary part and the second stationary. The stopper keeps the two internal organ walls in the pinched state. In this state, the fistula is made by an electro-knife. The instrument remains for a certain time until fistula becomes strong, after which it is endoscopically removed.

Abstract: An external tissue expansion device applies constant continuous low grade force to skin to obtain additional tension free skin and subcutaneous tissue prior to a surgical procedure. The device consists of two suture plates each being laminated structure of steel and an adhesive attached foam cushion. On the each end of one suture plate is a housing that contains a constant force spring placed over a post. The ends of the constant force spring protrude from the housing and there is a hook attached to the end of the constant force spring. On each end of the other suture plate there is a housing, with a opening that can accept the hook of the opposite suture plate. These suture plates are constructed so that they can be manually shaped to conform to the topography of the body part to be corrected and are attached to skin near the defect to be corrected prior to a surgical procedure.

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

Abstract: An apparatus for closing wide skin defects may be used with two long interdermal needles configured for insertion underneath skin close to margins of a skin defect. The skin closing apparatus may include two retaining members (70, 71) configured as a flange connecting two legs (20) and forming a U-shaped profile. Each of the legs may include either a sharp book (23) or a blunt skin insertion element at the end of the leg adapted for percing the skin and engaging one of the long interdermal needles. Alternatively, the retaining members may include topical engagement elements for engaging portions of the interdermal needles which are located above the skin surface. A contracting mechanism such as a screw (82) may connect the retaining members and approximate the interdermal needles, while bringing the skin margins together until final closure of the skin defect results.

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.