Abstract: The present disclosure relates generally to apparatus, devices, and methods for increasing force distribution at a suture-tissue interface. In some embodiments, a tissue suturing device may include a deployment device and a plurality of tissue supports deployable from the deployment device towards a target tissue. The plurality of tissue supports may each include a central opening for receiving a suture during deployment.

Abstract: Apparatus, systems, and methods are described for closing the base of a left atrial appendage or other tissue structure. A tissue closure device comprises a pair of legs having compliant surfaces for engaging against opposite sides of the tissue structure. A plurality of axially spaced-apart tissue-penetrating fasteners are delivered from one leg to the other to pierce the intervening tissue and hold the closure device in place on the tissue structure.

Abstract: A surgical stapling device includes a visualization device that extends through a body of the stapling device to facilitate visualization of tissue that surrounds an end effector of the stapling device. An anvil assembly of the surgical stapling device is adapted to facilitate passage of the visualization device through the anvil assembly.

Abstract: A brachytherapy source delivery device includes a first tissue-piercing leg having proximal and distal ends, a second tissue-piercing leg having proximal and distal ends, wherein the proximal ends of the first and second tissue-piercing legs are joined at a span section in a first angular orientation with respect to each other, and a carrier element formed at, or attached to, the span section, the carrier element configured to support a radioactive brachytherapy source. The distal ends of the first and second legs can be curved inward toward each other to pierce a tissue when engaged toward each other into a closed position. The first and second tissue-piercing legs can be formed of a wire having a circular cross-sectional or non-circular cross-sectional shape. The carrier element can be tangentially attached to the span section. Each of the legs have a length that is greater than the length of the span section.

Abstract: A tissue anchor system includes a fixation device and a tool. The fixation device includes a tab connected to a tissue anchor. The tool includes a shaft connected between a proximal handle portion and a distal tip. The distal tip is configured to limit movement of the fixation device during loading of the tissue anchor.

Abstract: Provided is an intraocular lens exchanger for moving a foldable intraocular lens (IOL), the intraocular lens exchanger including: an outer tube having a first passage formed in a forward/rearward direction; an inner tube disposed to be movable along the first passage and having a second passage formed in the forward/rearward direction; and a variable tube extending from a front end of the inner tube to form a variable passage connected to the second passage, in which the variable tube has an extension part having a width that increases forward in an unconstrained state in which the variable tube is not positioned in the first passage, and the extension part is provided to be elastically deformed when the unconstrained state changes to a constrained state in which at least a part of the extension part is received in the first passage.

Abstract: A compressible adjunct for use with a staple cartridge is provided and includes a biocompatible adjunct material configured to be releasably retained on a staple cartridge and configured to be delivered to tissue by deployment of staples in the staple cartridge. The adjunct material is formed from a porous polymer body and is configured to exhibit a first stiffness in compression that is approximately constant during a first time period from contact with the tissue. The adjunct material is further configured to exhibit a second stiffness in compression during a second time period following the first time period. The second stiffness is less than the first stiffness and is configured to decrease with time as a function of at least one of oxidation, enzyme-catalyzed hydrolysis, and change of pH resulting from interaction with at least one physiological element released from the tissue during healing progression of the tissue.

Abstract: A surgical implant comprising a receiver member and deployment member for clamping and sealing tissue of variable thickness, a corresponding applicator tool and surgical system for connecting, sealing, fastening and/or attaching tissue to itself, to other tissue and/or to non-tissue structures, and/or sealing the flow of fluid at and/or between structures such as tissue and vessel structures.

Abstract: An orthopedic fixation system includes an implant and an implant insertion device. The implant transitions between a natural shape and an insertion shape. The implant includes a bridge defining a slot with a first end and a second end and first and second anchoring members extending from the bridge. The implant insertion device moves between a loaded position and an unloaded position. The implant insertion device in its loaded position inserts through the slot of the bridge and engages the bridge at the first and second ends of the slot such that the implant insertion device constrains the implant in its insertion shape. The implant insertion device in its unloaded position releases the implant.

Abstract: A stent for anastomosis of different kinds of organs includes a main body, and at least one fixing unit provided in the main body. At least a portion of the main body is inserted into one of different kinds of organs to be anastomosed with each other, and the rest of the main body is inserted into the other of the different kinds of organs. A distance between the different kinds of organs under the anastomosis is maintained by the fixing units.

Abstract: Devices, systems and/or methods for repairing soft tissue adjacent a repair site. In one embodiment, a repair device includes a plate member and an anchor. The plate member having a periphery, the plate member configured to be positioned along an outer surface of the soft tissue. The anchor includes a base and six legs extending from the base, the six legs extending from the base being moveable to a curled configuration such that the six legs wrap around separate portions of the periphery of the plate member with the soft tissue therebetween. In this manner, the repair device may be anchored to the soft tissue.

Abstract: A surgical stapling device includes an elongate body and a tool assembly. The elongate body has a distal portion and a proximal portion. The tool assembly is supported on the distal portion of the elongate body and includes a stationary jaw, a top jaw positioned on one side of the stationary jaw, and a bottom jaw positioned on an opposite side of the stationary jaw. The top jaw is movable in relation to the stationary jaw independently of the bottom jaw between an open position and a clamped position to clamp tissue between the top jaw and the stationary jaw, and the bottom jaw is movable in relation to the stationary jaw independently of the top jaw between an open position and a clamped position to clamp tissue between the bottom jaw and the stationary jaw.

Abstract: Methods and devices are provided for anchoring a ligament or tendon to bone. In one embodiment, a surgical implant is provided having a sheath and an expander that is received within the sheath. Various delivery tools, including a sheath inserter and a driver, are also provided. In use, the sheath inserter can be used to position a tendon within a prepared bone hole, and it can be used to deliver the sheath with a guidewire coupled thereto into the bone hole. The driver can be provided for delivering the expander into the sheath. A loader can optionally be used to load the driver and expander onto the guidewire coupled to the implanted sheath.

Abstract: A sutureless ventral hernia meshing system and method of fixation is efficacious for fixating a surgical mesh panel to an abdominal wall for the purpose of hernia repair and prevention of hernia recurrence at the peripheral region of the mesh panel. The mesh panel comprises a hydrophilic face and a meshed face. A plurality of hollow anchors such as spikes or pins or hooks are disposed along the peripheral region of the mesh panel in a spaced apart relationship. A blunt quill or needle presses the hollow spikes or pins or hooks into the fascia around the hernia. The blunt quill or needle is removed after pressing the hollow pin into the fascia. In this manner, no sharp needle or suture is used. Tissue growth occurs in the cavity of the hollow spikes or pins or hooks to provide a sutureless anchor.

Abstract: An implant comprises an elongated plate having a first major face and at least one locking screw hole, to receive a locking fastener oriented normal to the major face. The elongated plate has a wall with a flat surface normal to the first major face. A non-locking screw hole is located between the locking screw hole and the wall. The non-locking screw hole is configured to receive a non-locking fastener oriented at an acute angle relative to the locking fastener.

Abstract: A surgical fastener includes a first leg having a first distal barb and a first proximal barb that extend inwardly, and a second leg having a second distal barb and a second proximal barb that extend inwardly. A bridge interconnects proximal ends of the first and second legs. A first distance between opposing inner tips of the first and second distal barbs is greater than a second distance between opposing inner tips of the first and second proximal barbs. The first leg tapers inwardly between the proximal and distal ends thereof and has a cross-sectional area that is greater at the proximal end than at the distal end. The second leg tapers inwardly between the proximal and distal ends thereof and has a cross-sectional area that is greater at the proximal end than at the distal end. An insertion tool engages a crown on the proximal side of the bridge.

Abstract: Some embodiments of the present disclosure are directed generally to systems and methods for delivering an implant to a body vessel of a patient. Such disclosed implants may be a monofilament implant, and disclosed systems for implanting the implant may be automatic. Some embodiments may enable retraction of said implant back into the delivery system following partial exteriorization of the implant from the delivery system. Some embodiments may be configured for retraction of said implant from the patient's body following complete exteriorization of the implant from the delivery system. Some of the embodiments are directed at delivering a monofilament implant for preventing embolic stroke. Other embodiments are directed at preventing pulmonary embolism, occluding a body vessel such as the left atrial appendage, occluding a body passageway such as a patent foramen ovalae, stenting a body vessel, or releasing a local therapeutic agent such as a drug or ionizing radiation.

Abstract: A surgical implant comprising a receiver member and deployment member for clamping and sealing tissue of variable thickness, a corresponding applicator tool and surgical system for connecting, sealing, fastening and/or attaching tissue to itself, to other tissue and/or to non-tissue structures, and/or sealing the flow of fluid at and/or between structures such as tissue and vessel structures.

Abstract: A staple cartridge for stapling the tissue of a patient is disclosed. The staple cartridge comprises a cartridge body, a plurality of staples, and a compressible tissue thickness compensator configured to adapt in thickness in response to the thickness of the tissue and adaptively apply different pressures to the tissue based on the thickness of the tissue captured within the staples. The compressible tissue thickness compensator comprises a plurality of fibers comprising a first matrix oriented in a first direction and a second matrix oriented in a second direction that is different than the first direction. A network of interstices is defined intermediate and among the first matrix and the second matrix. The network of interstices comprises a plurality of cavities that promote tissue and cellular ingrowth between the first and second matrices of fibers.

Abstract: A surgical system includes an anvil that has, one, an elongate slot extending longitudinally along a length of the anvil and, two, a plurality of first staple-forming pockets. The surgical system further includes an anvil modification member releasably attachable to the anvil, wherein the anvil modification member comprises a plurality of second staple-forming pockets. In addition, the surgical system also includes a staple cartridge that has a plurality of staples formable by the plurality of first staple-forming pockets when the anvil modification member is not attached to the anvil, and wherein the staples are formable by the plurality of second staple-forming pockets when the anvil modification member is attached to the anvil.

Abstract: A surgical staple cartridge is disclosed comprising a plurality of staples removably stored within the surgical staple cartridge. The staples comprise staple legs which extend from a staple base portion. The staple legs comprise staple tips configured to pierce tissue and contact a corresponding forming pocket of an anvil of surgical stapling instrument. The staples further comprise zones having different hardnesses.

Abstract: A surgical suturing instrument includes a handle assembly, an elongate member extending distally from the handle assembly, and an end effector attached to the distal end of the elongate member. The end effector may include a first jaw member movable relative to a second jaw member between an open position and an approximated position for grasping tissue. Each of the jaw members defines a knife slot, a first needle slot, and a second needle slot extending along a longitudinal axis of the end effector. The end effector also includes a knife assembly and an upper assembly pivotably coupled to an upper knife flange of the knife assembly. The upper assembly includes an upper bellcrank, a first needle, a first suture passing through a first aperture defined by the first needle, a second needle, and a second suture passing through a second aperture defined by the second needle.

Abstract: A layer of material for use with a surgical staple cartridge is disclosed. The layer can be releasably secured to the cartridge body of the surgical staple cartridge. The layer can comprise an array of discrete distressed regions arranged in a pattern that matches a pattern of staple cavities defined in the cartridge body.

Abstract: A staple cartridge for use with a stapling device that has an actuator that is selectively actuatable in an axial direction and an anvil portion that is selectively movable between open and closed positions is disclosed. Various embodiments of the present invention include a cartridge body that movably supports first and second staple drivers. The staple drivers each support a staple thereon and serve to drive the staples into forming contact with the anvil upon actuation by the actuator. The various embodiments of the present invention enable the final formed heights of the staples to be varied so as to apply various clamping forces and pressures to soft tissue captured within the staples. In at least one embodiment, the staples can include crowns formed thereon which can be utilized to adjust or control the clamping force and/or pressure applied by the staples.

Abstract: A flexible fixation assembly including a flexible main body and a suture engagement portion of the flexible main body. The suture engagement portion is configured to cooperate with a suture to mate the suture with the flexible main body. The flexible main body is configured to flex outward against walls of a bone hole when implanted therein to retain both the flexible main body and the suture mated therewith within the bone hole.

Abstract: In one embodiment, a medical device includes an elongate member, a first coupler, and a second coupler. The elongate member has a first end portion, a second end portion, and a side portion. The side portion of the elongate member has a first receiving portion and a second receiving portion. The first receiving portion is configured to receive a first support member. The second receiving portion is configured to receive a second support member. The first coupler is coupled to the elongate member and is configured to engage the first support member to help retain the first support member within the first receiving portion. The second coupler is coupled to the elongate member and is configured to engage the second support member to help retain the second support member within the second receiving portion.

Abstract: Devices and methods for sealing staples in tissue using a plurality of adjunct segments are described herein. In one embodiment, an end effector for a surgical instrument is described that can include first and second jaws, where the first jaw has a cartridge body removably attached thereto and the cartridge body has a plurality of staple cavities configured to seat staples therein. The second jaw can have an anvil with a plurality of staple forming openings formed therein, and at least one of the first and second jaws can be movable relative to the other jaw. The end effector can also include a plurality of sealing adjunct segments coupled to one another and at least one of the first and second jaws such that a staple ejected from the cartridge body passes through one of the plurality of sealing adjunct segments and tissue disposed between the first and second jaws.

Abstract: Systems and methods for fastening tissue include a hollow element and an elongate insertion element. The insertion element has a delivery device including a cone, suture, and needle at a delivery end, and an anchor at an opposite end. The hollow element includes an engagement structure in its interior surface that permits movement of the insertion element through the hollow element in a first direction, and prevents movement of the insertion element through the hollow element in a second direction opposite the first direction. The engagement structure may include a braid or mesh that operates on a finger-trap principle. The hollow element may include an elongate element with a cone, suture, and needle at a delivery end, and an anchor at an opposite end. Alternatively, the hollow element may include a button that incorporates the braid or mesh.

Abstract: The object of providing a device for reversibly attaching an implant to an eye, with which the implant can be attached in a simple way to the eye and can if necessary be detached or removed from the eye, is achieved according to the present invention by means of a device for attaching an implant by means of a pin that comprises a substantially elongated shaft, wherein the implant includes an implant film for contacting living tissue or nerves in the visual system of the eye and the implant film has an opening through which the shaft of the pin can be at least partially inserted, characterised in that the device includes a holding element that can be arranged on the shaft of the pin so that the holding element engages on the shaft of the pin and is fixed in an attachment position to the pin.

Abstract: Methods and devices for treating spinal deformities are provided. In one exemplary embodiment, a low-profile spinal anchoring device is provided for receiving a spinal fixation element, such as a tether, therethrough. The device generally includes a staple body that is adapted to seat a spinal fixation element, a fastening element for fixing the staple body to bone, and a locking assembly for coupling a spinal fixation element to the staple body. In one embodiment, the locking assembly includes a washer that is adapted to couple to the staple body such that the spinal fixation is disposed therebetween, and a locking nut that is adapted to engage the staple body to mate the washer to the staple body.

Abstract: Soft body tissue structure can be remodeled by shortening the distance between first and second portions of that tissue structure. First and second anchor structures are respectively implanted in the first and second portions of the tissue structure. These anchor structures are linked by a linking structure, the length of which between the anchor structures can be shortened to pull the tissue structure portions toward one another. Each of the anchor structures may include two screw structures that are driven into the associated tissue structure portion transverse to the linking structure and with a spacer between the two screws. The entire prosthesis can be implanted percutaneously if desired. An illustrative use of the prosthesis is to shorten the annulus of a patient's mitral valve, with at least a portion of the prosthesis implanted in the patient's coronary sinus.

Abstract: A graft anchor has first and second arms each having a leading end, a trailing end, an inner surface, and an outer bone contactable surface. The graft anchor also has a resilient bridge extending between the inner surface of the first arm and the inner surface of the second arm to space apart the first arm and the second arm. The resilient bridge defines a graft receiving pathway between the inner surfaces of the first and second arms. The resilient bridge also defines a deflection point about which a force acting upon the resilient bridge in a direction from the leading end to the trailing end causes the leading ends of the first and second arms to move toward one another and the trailing ends of the first and second arms to move away from one another.

Abstract: A clip applier adapted for use with a surgical robot. The clip applier includes a shaft having clips stored therein and jaws adapted for receiving a clip from the shaft. The shaft is in mechanical communication with a robotic mounting portion that is adapted for mounting to a surgical robot. The robotic mounting portion contains a gear drive assembly for independently rotating the shaft, feeding clips into the jaws and forming clips in the jaws.

Abstract: A surgical fastener for use with an anastomosis of two tissues includes a base leg and an upright leg. The base leg is selectively deformable and includes a traumatic tip for piecing tissue. The surgical fastener also includes at least one capillary disposed on the base leg which has a reservoir defined therein for retaining a liquid, e.g., bioadhesive, bonding agent, medicament, etc. Each of the capillaries is ruptureable upon deformation of the surgical fastener to dispense the liquid to the anastomosis site.

Abstract: A suturing system for receiving and retaining a suture is disclosed and includes a suture, at least one retainer, and at least one needle. Each needle is able to receive and removably retain the suture within a groove located in a tapered end. The retainer has a body that defines an aperture therethrough. The shape of the aperture is formed by a central passageway, and a pair of diametrically opposed slots extending radially outward from the central passageway. The central passageway is sized to allow passage of the needle therethrough. Each slot defines a tortured path section that permits passage of the suture in a first direction and inhibits passage of the suture in a second direction.

Abstract: A device for repairing tissue includes a first tubular anchor having a first central longitudinal axis and a first bore along the first central longitudinal axis, the first bore having a first curved surface and a first flat surface, and a first transverse bore perpendicular to the first central longitudinal axis and parallel to the first flat surface. The device includes a second tubular anchor having a second central longitudinal axis and a second longitudinal bore along the second central longitudinal axis, the second bore having a second curved surface and a second flat surface, and a second transverse bore perpendicular to the second central longitudinal axis and parallel to the second flat surface. A flexible strand couples the first and second tubular anchors and passes through the first and second transverse bores.

Abstract: An exemplary circular stapler may include an anvil; a staple holder connected to the anvil; and a feeder belt ring held within the staple holder, the feeder belt ring including staples frangibly affixed thereto. An exemplary surgical method for treating tissue may include possessing an anvil, a staple holder connected to the anvil, and a feeder belt ring held within the staple holder, the feeder belt ring including a plurality of staples frangibly affixed thereto; clamping tissue between the anvil and staple holder; and sequentially deforming and then breaking from the feeder belt ring at least two staples.

Abstract: To provide polyglycolic acid resin compositions having excellent moldability, and high barrier properties and transparency after molding, and molded articles therefrom. According to the present invention, a polylactic acid having a mass average molecular weight Mw of 100000 to 1000000 is added to a polyglycolic acid having a mass average molecular weight Mw of 100000 to 1000000 in a content of the polylactic acid of 5 to 30% by mass, and the mixture is melt-kneaded under, for example, a temperature condition of 230 to 270° C., thereby obtaining a resin composition having a temperature-lowering crystallization peak temperature Tc, measured by differential scanning calorimetry, of 3 to 18° C. lower than that of a polyglycolic acid only.

Abstract: A fastening device having a bellows made of a material that changes shape when activated by a catalyst, and having a pleated structure that contracts from an extended state to a contracted state upon activation. The shape changing material may be a shape memory metal alloy, shape memory polymer or elastic memory composite. A method of using this fastener provides apposition and compression of abutment surfaces to join together two pieces of material, and is suitable for joining apposing bone surfaces together to heal fractures via the use of orthopedic hardware.

Abstract: The present invention relates to a bioabsorbable osteosynthesis fixation device for the fixation of bone fractures or osteotomies. The fixation device comprises a tip, a shaft and a head. The periphery of the shaft comprises ridges which extend in a direction which forms an angle with the longitudinal axis of the shaft, the angle being between ?45° and 45°. The present invention also relates to a method for manufacturing the bioabsorbable osteosynthesis fixation device.

Abstract: The present invention provides, in certain aspects, medical systems that are useful for applying bolster material to patient tissue. One such system includes a surgical fastening apparatus that is comprised of a first arm having a first arm working surface; and a cutting element operable along a cutting path. This system also includes at least one piece of bolster material having a portion received in the cutting path, and a retaining element retaining the at least one piece of bolster material in association with the first arm working surface, wherein the retaining element has one or more segments received in the cutting path and includes portions residing between the first arm working surface and the at least one piece of bolster material. The invention also provides medical devices that are useful for applying bolster materials to surgical fastening apparatuses, as well as methods for preparing and using such devices.

Abstract: A fastener is provided for attaching body tissue to body tissue or another material to body tissue. The fastener includes a head portion, a body portion, and an anchoring element. The anchoring element is on the distal end of the fastener, and has one or more barbs or similar anchoring devices that are configured to prevent removal of the fastener once it is attached to the body tissue. The head is located on the proximal end of the fastener, and anchors the body tissue or other material when the fastener is attached to the body tissue. The disclosure also provides a driver apparatus for inserting the fasteners. The applicator device includes an indexer for sequentially indexing one or more fasteners, and a driver for applying an insertion force to a fastener that is sufficient to insert the fastener and attach it to body tissue. The disclosure also provides a method of using the fastener and applicator device.

Abstract: Devices for attaching a sheet-like implant to a target tissue include a sheath and a staple push rod. The sheath has a distal end configured to be pressed against the target tissue. The staple push rod is disposed within at least a portion of the sheath and is slidable relative thereto. The staple push rod includes a pair of stakes. Each stake is dimensioned to abut a surface of a staple to apply pushing forces thereto. The stakes are biased to assume a bow-like shape such that an intermediate portion of a staple extends tautly between the first stake and the second stake when the stakes are extending beyond the distal end of the tubular member. Methods for attaching a sheet-like implant to a target tissue are also disclosed.

Abstract: Devices, systems, and methods for delivery of therapeutics, in particular thrombolytic agents, in particular plasmin, are provided. The devices, systems, and methods also provide for occlusion of a vessel or graft distal and/or proximal to a treatment zone. Also provided are devices, systems, and methods that trap emboli.

Abstract: A surgical fastener for fastening tissue. The fastener includes a first piece of sheet material formed to have a generally planar base and an elongate needle portion extending upward from the base. The fastener includes a second piece of sheet material formed to have a generally planar base and an elongate needle portion extending upward from the base. The second piece of sheet material is pivotally connected to the first piece of sheet material.

Abstract: A surgical staple for connecting two tubular tissue structures may include a substantially rectangular base having a first edge and a second edge substantially parallel to one another, and a third edge substantially perpendicular to the first and said second edges; and may also include at least three deformable tines extending from the first and second edges of said base; where no tine that extends from the first edge may be positioned at substantially the same distance from the third edge as any said tine that extends from the second edge; and where deformation of the tines secures the tubular tissue structures together.

Abstract: Surgical fasteners, including tacks are disclosed for fastening a surgical mesh to underlying tissue during surgical procedures to repair body tissue, such as in hernia repair. Such tacks can include a head, a elongated body portion having a distal end and a proximal end, and an anchoring element on an outer surface of the body portion for inhibiting the removal of the tack from the mesh and body tissue.

Abstract: Provided is an anastomosis device including a first head holding a first anastomosis ring, a second head holding a second anastomosis ring, a first guide bar connected to the first head and switching a release position and a standby position to each other, wherein the first guide bar includes a first rotation groove, a second guide bar connected to the second head and switching the release position and the standby position to each other, wherein the second guide bar includes a second rotation groove, and a rotation driver moving approximately in a parallel direction to the first and second guide bars and including a first guide protrusion and a second guide protrusion, which move along the first and second rotation grooves, respectively.

Abstract: A ligation device is disclosed that is capable of containing a fluid, e.g., a biomechanical medium or an antimicrobial solution. The ligation device comprises an upper clip and a lower clip, each having a locking feature that enables the upper clip and the lower clip to be movably attached to each other.

Abstract: A fastener cartridge can comprise a compressible, collapsible, and/or crushable cartridge body and fasteners embedded within the cartridge body which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein the first jaw can be positioned opposite a second jaw, or anvil. The anvil can be engaged with the fastener cartridge to compress, collapse, and/or crush the cartridge body and deform, or otherwise deploy, the fasteners contained therein. As the fasteners are deformed or deployed, the fasteners can capture at least a portion of the cartridge body therein along with at least a portion of the tissue being fastened. In various embodiments, the cartridge body can comprise a plurality of bioabsorbable layers. These bioabsorbable layers can be comprised of materials which can be bioabsorbed at different rates.