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: An anastomosis staple has a base from which multiple deformable tines extend. At least one tine may be offset from at least one other tine. The tines are moveable from a first configuration to a second configuration. The staple optionally includes at least one alignment guide.

Abstract: An endoscopic staple and related stapling device that can be used in conjunction with flexible or rigid endoscopy. The staple can also be used for other surgical procedures. The invention relates to performing a stapling operation on internal body tissues as part of a surgical procedure, diagnostic procedure or therapeutic procedure. This invention includes a surgical staple, an associated staple holder, and an associated staple delivery and deployment device. The staple holder and delivery system have a design iteration whereby the holder can be reloaded with additional staples to be used on the same patient. There is another design iteration whereby the staple holder and stapler are reusable after appropriate cleaning and sterilization.

Abstract: A fastener including at least an element to be anchored in an anatomical support, at least a stop element relative to a planar prosthetic component to be fixed, and a linking rod is characterised in that the linking rod is rectilinear and the junction zones of the anchoring element and the stop element with the linking rod enable the fastener to adopt: a non-stressed stripping configuration; a maximum stress configuration, doubled up on itself, for example in a tubular configuration by complete insertion of the fastener into a tube, and a minimum stress configuration, wherein the respective directions of the stop element and the anchoring element form between them, for example in the same plane, an angle not greater than 90°.

Abstract: Surgical devices such as implants or suture fastenings are assembled from a plurality of discrete components, one of which components includes a heat bondable plastic material for bonding the components together. At least two components are bonded to each other by the applying heat to the heat bondable plastic material of one component. The heat bondable plastic material is preferably a polymeric or composite material suitable for surgical applications and implantation in humans, and may be a biodegradable material. A laser may be used as the heat source. The present invention is advantageously embodied in heat bonded fastenings for sutures or K-wires, in which a variety of different suture anchors are usable, including expandable distal suture anchors.

Abstract: A fastener for insertion into pierced openings of a tissue wound has a body formed of a generally bioabsorbable polymer defining an initial capture area internal to the body. The body includes a pair of arms, each with an inwardly projecting cleat operably joined at an elbow portion defining an internal elbow angle. The arms are operably joined to a backspan at a shoulder portion defining an internal shoulder angle. A durable tissue retention zone is defined between the cleat and the arm. The elbow portion and the internal elbow angle define an insertion width greater than a width of the pierced openings resulting in the pierced openings stretching over the cleat and being elastically retained within the durable tissue retention zone. The fastener initially captures wound tissue in the initial capture area and then dynamically reforms in response to lateral stresses applied by the wound tissue without a fracture failure of the fastener until a minimum degradation period.

Abstract: A surgical fastening system for attaching one piece of tissue to another piece of tissue. The system comprises a surgical fastener, an installation tool for deploying the surgical fastener in tissue, and a method for using the same.

Abstract: An endoscopic surgical instrument for deploying a two part fastener having a male fastener part and a female fastener part, includes a tube having a proximal end and a distal end. An end effector is coupled to said distal end of said tube and is configured to hold the male fastener part and the female fastener part in opposed relation. An actuator is coupled to said proximal end of said tube and is configured to actuate the end effector. A shearing device may be positioned proximate the end effector to shear off a tip of the male fastener part after the male and female fastener parts are moved into locking relation. In addition, the surgical instrument may include a male fastener part having a shaft with a plurality of detent positions. Further, the male fastener part may include a base and a shaft pivotally connected to the base.

Abstract: A holding member has an opening portion which opens to an distal end. The opening portion, the distal end of an endoscope and a holding member define a treatment space. A clamping member can project and retreat from and into the opening portion through the treatment space. The puncture member can move in the treatment space, in a direction that intersects with the longitudinal direction of the endoscope.

Abstract: Systems for anastomosing a first hollow tissue structure to a second hollow tissue structure are disclosed. In an exemplary embodiment, such a system comprises at least one tissue securing member adapted to secure the first and second hollow tissue structures together, and a device for applying the tissue securing member to the tissue structures. The tissue securing member is preferably configured to pass through only one of the tissue structures, and is movable from a first configuration to a second configuration which results in a compressive force being applied to the tissue structures. The systems are particularly useful for performing anastomosis of blood vessels in heart surgery.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.

Abstract: A mechanical stapling device for fastening deep tissue during the closing of peritoneal side of a stab wound, which is associated with a laparoscopic surgical procedure, is provided. Also provided is a unique staple for use with the stapling device of the present invention. A method of using the device and staple of the present invention is also provided.

Abstract: A surgical stapling device is provided having an elongate housing and a surgical staple slidable longitudinally within the housing towards a free forward end thereof, the staple having a back and two forwardly pointing legs. The housing contains a staple-firing mechanism for driving the staple towards the free end of the housing, bending the staple to bring the free ends of the legs towards one another to close the staple, and releasing the closed staple. A cap is located at the free end of the housing at a position where, in operation of the staple-firing mechanism, the cap becomes trapped between the back of the closed staple and human or animal tissue being stapled so as to provide a greater area of pressure on the tissue than in the absence of the cap.

Abstract: A method and soft tissue cleat device for improving the repair of soft tissue damage. A disc having projections pierces soft tissue and securely joins with a second disc to coapt the interposed soft tissue. This provides an increased pull-out strength of the suture and resistance to shear stresses, improving the quality of the repair. The present invention may be used with any bone fixation devices to reattach soft tissue to bone, and may also be used to rejoin soft tissues after a tear in the tissue.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.

Abstract: Systems for anastomosing a first hollow tissue structure to a second hollow tissue structure are disclosed. In an exemplary embodiment, such a system comprises at least one tissue securing member adapted to secure the first and second hollow tissue structures together, and a device for applying the tissue securing member to the tissue structures. The tissue securing member is preferably configured to pass through only one of the tissue structures, and is movable from a first configuration to a second configuration which results in a compressive force being applied to the tissue structures. The systems are particularly useful for performing anastomosis of blood vessels in heart surgery.

Abstract: A transmyocardial revascularization system including a plurality of inserts formed of a material to elicit a healing response in tissue of the myocardium and deployment instruments and associated components for deploying the inserts into the wall of the myocardium. The inserts are arranged to be disposed within respective lumens or channels in the wall of the myocardium. The inserts can take various forms, e.g., be solid members, tubular members, or porous members, and may be resorbable, partially resorbable or non-resorbable. In some embodiments the inserts are arranged to be left in place within the channels in the wall of the myocardium to result in plural lumens which enable blood to flow therethrough and into contiguous capillaries. The deployment instruments are arranged to pierce the tissue of the myocardium from either the endocardium or the epicardium to insert the inserts into the myocardium, depending on the particular deployment instrument used.

Abstract: An apparatus and method used to apply a self-adherent strip of bio-compatible, staple line reinforcement material onto a working surface of a surgical stapler. The apparatus effectively contains and supports reinforcement material during sterilization and shipment. At the point of use, the apparatus provides a simple method for applying the reinforcement material to a variety of staplers. Once the reinforcement material is applied, no excess material remains attached to the stapler thus post-attachment removal of excess material is avoided. The apparatus is simple to manufacture, accommodates a wide variety of reinforcement material shapes and configurations, allows for accurate sizing of the reinforcement material to a variety of stapler jaws, and provides a very low profile package to reduce packaging, shipping, and storage costs.

Abstract: A surgical staple for use in creating an everted anastomosis of at least two anatomical structures includes a bendable staple body. At least two evening elements protrude from the staple body. Spacing elements and a penetrating element also are provided. In use, the evening elements and spacing elements are apposed, and inner layers of the anatomical structures are held together to form an evened anastomosis. The evening platforms are disposed on an outer radius of the closed staple, and the penetrating element is disposed on a different, inner radius, to ensure that the penetrating element is excluded from the lumen of the anastomosis. Embodiments of the invention substantially ensure intima-to-intima approximation completely circumferentially at the anastomotic site, with no portion of cut tissue edges, suture or staple exposed to the lumen of the anastomosis. Cut tissue edges, as well as the staple, are completely extra-lumenal. Related methods provide similar advantages.

Abstract: Methods and devices are provided for reconfiguring a tissue within a hollow body organ using an entirely endoscopic approach in order to effectively reduce flow of fluid contents into a second hollow body organ in fluid communication with the first.

Abstract: A tissue staple that includes a pair of legs arranged generally parallel to one another connected by a pair of tabs. The tabs define an arc that extends distally from the proximal ends of the legs, and further define a slot between the tabs. The distal end of the leg may include a forked portion that defines two or more tissue piercing prongs. The location of the fork also may define a tissue stop. The legs may also include an indent that bends inwardly toward an indent formed on the other leg.

Abstract: A method and device for performing endoluminal fundoplication are described. A device is inserted in the patient's stomach through the esophagus, including an unit adapted to grasp and pull a portion of the gastroesophageal junction into the stomach, and an unit adapted to move a portion of the fundus towards the esophagus. The device also can place fasteners to hold the gastric wall and the esophageal wall secured together, thus forming a valve between esophagus and stomach. An adhesive compound can be used to stabilize the juncture of the two walls.

Abstract: The present invention relates to devices and methods for the repair of hernia. One method for repairing a hernia the steps of making an incision through a skin layer of a patient near the hernia, creating an entrance into the preperitoneal space above the peritoneum at a location above the hernia, identifying and freeing a hernia sac, creating a pocket in the preperitoneal space, directing a surgical patch down through the incision and into the preperitoneal space, and expanding the surgical patch in the preperitoneal space.

Abstract: A compression suture device for the surgical treatment of hemorrhoids, comprising two mutually opposite sections, each of which has a portion for mutual irreversible connection and a clamping portion for at least two flaps of organic tissue which are arranged in contact.

Abstract: An impermanent biocompatible fastener comprises a male portion and a female portion. The male portion includes a base member and a pair of male members. The male members extend downwardly from the base member, each male member comprising a post and a head disposed at the bottom end of the post. The female portion includes a base member and a pair of sleeves. The sleeves extend upwardly from the base member, each sleeve defining a bore adapted to receive a head from a corresponding male member and having an inner flange. The flange extends into the bore and is engageable with the head once the head has been inserted past the flange to inhibit withdrawal of the head from the bore. Except for a biodegradable outer coating on each of the two heads, the fastener is made entirely of a non-bioabsorbable material.

Abstract: Various methods and devices for treating a patient who has lost, or is at risk of losing cardiac function by cardiac ischemia are disclosed. Treatment includes first imaging a patient's heart, or a portion thereof, to identify underperfused regions of cardiac muscle, and a source of oxygenated blood that is proximate to the underperfused region. Between the underperfused regions and the oxygenated blood source, a target area is selected where thermal or mechanical injury is introduced, and optionally reintroduced, to convert initial capillary blush, resulting from the injury.

Abstract: An endoscopic surgical instrument includes a flexible tube, a grasping and fastening end effector coupled to the distal end of the tube, and a manual actuator coupled to the proximal end of the tube. The manual actuator is coupled to the end effector by a plurality of flexible cables which extend through the tube. The tube contains a lumen for receiving a manipulable endoscope and the end effector includes a passage for the distal end of the endoscope. The end effector has a store for a plurality of male fastener parts, a store for a plurality of female fastener parts, a rotatable grasper, a rotatable fastener head for aligning a female fastener part and a male fastener part with tissues therebetween, and a firing member for pressing a male fastener part through tissues grasped by the grasper and into a female fastener part.

Abstract: An assembly for releasably attaching a buttress material onto a tissue clamping member of a surgical stapling device is disclosed. The assembly has a substantially rigid frame for connecting to a top surface of a tissue clamping member of a surgical stapling device when the assembly is disposed thereon. A buttress material is attached to first and second sides of the frame for abutting against a bottom surface of a tissue clamping member of a surgical stapling device when the assembly is disposed thereon.

Abstract: A method for delivering a plurality of individual surgical fasteners. The method includes the step of providing a surgical fastener delivery device having a drive mechanism with distal and proximal ends, the drive mechanism comprising moving and fixed opposing members, the moving member being moveable proximally and distally with respect to the delivery device, and the fixed member being fixed with respect to the delivery device, the device having the plurality of surgical fasteners located between the moving and the fixed members. The method further involves the step of penetrating tissue and placing a distal end one of the surgical fasteners within tissue, by moving the moving member distally. The method further involves the step of deploying a distal end of one of the surgical fasteners by moving the moving member proximally.

Abstract: A transmyocardial revascularization system including a plurality of inserts formed of a material to elicit a healing response in tissue of the myocardium and deployment instruments and associated components for deploying the inserts into the wall of the myocardium. The inserts are arranged to be disposed within respective lumens or channels in the wall of the myocardium. The inserts can take various forms, e.g., be solid members, tubular members, or porous members, and may be resorbable, partially resorbable or non-resorbable. In some embodiments the inserts are arranged to be left in place within the channels in the wall of the myocardium to result in plural lumens which enable blood to flow therethrough and into contiguous capillaries. The deployment instruments are arranged to pierce the tissue of the myocardium from either the endocardium or the epicardium to insert the inserts into the myocardium, depending on the particular deployment instrument used.

Abstract: A surgical fastening system includes a fastener having a plurality of individual fastener pairs each having a piercing element with a pin that pierces the tissue to be repaired and a receiver portion that interlocks with the pin of a corresponding piercing element. A fastener dispenser holds the piercing elements and receiver elements in relative juxtaposition and in a predetermined geometric configuration, such as a circle. After the tissues to be joined are positioned between the piercing and receiving elements held in the dispenser, the dispenser is adjusted to draw the elements together capturing the tissue therebetween. The dispenser then pushes the piercing elements through the tissue and into the receiving elements causing the elements to interlock. Because the anastomosed junction is formed by a plurality of independent pairs, the junction retains flexibility. When used to anastomose a tubular organ, the fastener allows radial expansion of the organ permitting peristalsis.

Abstract: An instrument for inserting graft fixation device. The fixation device is useful for affixing a tissue graft to a bone or other body surface. The graft fixation device comprises two implantation members connected by a connecting member. The fixation device can be combined with insertion members. The implantation members have longitudinal passageways therethrough. The instrument has an elongated member with a distal end. Removably mounted to the distal end is an end housing. A pair of insertion prongs for receiving a fixation device and insertion members are removably mounted in the end housing.

Abstract: An implantable marker for implantation in tissue of a surgical patient is disclosed. The marker has a base and an elevated bridge. A pair of legs descend from first and second transitions of the bridge. Each leg has a distal tip, a generally straight leg arm adjacent the tip, a camming marker surface between the transitions of the base and the straight leg arm, and a camming marker surface notch. The camming marker surfaces extend outwardly from the straight leg arms of the legs. In its pre-formed configuration, the first and second straight leg arms of the legs of the marker are generally parallel to each other. In its open form configuration, the first and second straight leg arms initially converge towards each other, then diverge into an open form generally taking the shape of the letter “W”. The marker is particularly adapted for fixation in tissue to mark the site of a lesion or other abnormal tissue which may be removed during a biopsy procedure, for example a breast biopsy procedure.

Abstract: The suture delivery system utilizes two sutures. Each suture has a filament body and a toggle bar. The delivery system includes an elongated central tube with two needle retainer guides and a cam distally disposed on the central tube. The needles have piercing needle ends and each needle end carries a respective toggle bar for a suture disposed thereon. A longitudinally movable member is coupled to the needles. The needles are movably disposed in respective needle retainer guides. An actuator is coupled to the movable member such that when the actuator moves, the needles extend outward such that the needle ends move over the cam. In a further embodiment, the actuator includes a first user actuation surface coupled to the movable member and the central tube includes a second user actuation surface which is generally static. In a further embodiment, a locking member is disposed on the second user actuation surface. The cam may take one of a variety of shapes.

Abstract: Medical devices and methods used to cause hemostasis of blood vessels located along the gastrointestinal tract. The medical devices include a clip having a stem, an anchor at a first end of the stem and a bolster at or near a second end of the stem. Methods of deploying the medical devices are disclosed.

Abstract: A method of affixing a graft to bone using a the combination of a graft fixation device and an insertion member. The fixation device is useful for affixing a tissue graft to a bone or other body surface. The graft fixation device comprises two implantation members connected by a connecting member. The implantation members have longitudinal passageways therethrough. The insertion device member similarly has a longitudinal passage.

Abstract: The self securing suture includes a suture having at least one terminal end and a toggle, formed of suture material, at the suture's terminal end. In one embodiment, the suture toggle is a bar. In another embodiment the suture is a wire and the toggle is a wire element toggle. The wire element toggle is a double strand segment or an open loop segment. The suture delivery system includes a slotted needle configured such that a protruding tab or leg of the toggle bar fits within slot of the needle. For wire sutures, the open loop wire element toggle fits within the slotted needle. In another embodiment, a depending wire tip, from the wire element toggle, fits within the slot in the needle.

Abstract: Medical devices and methods used to cause hemostasis of blood vessels located along the gastrointestinal tract. The medical devices include a clip having a stem, an anchor at a first end of the stem and a bolster at or near a second end of the stem. Methods of deploying the medical devices are disclosed.

Abstract: A meniscus repair anchor. The anchor includes an anchor body and a retaining head intercoupled by a flexible member. The anchor is lodged within a hollow needle. The needle is advanced into the meniscus and across the tear in an inner-to-outer direction, thereby preventing contact between the anchor body and meniscal tissue during deployment. Once the needle tip has penetrated the outer edge of the meniscus and protrudes therefrom, a stylus is used to deploy the flexibly tethered retaining head against the outer edge. The hollow needle is then retracted, causing the barbs along the anchor body to deploy internally within the meniscus. Excess length of the anchor body is cut off at the inner edge entry point of the meniscus.

Abstract: Surgical devices such as implants or suture fastenings are assembled from a plurality of discrete components, one of which components includes a heat bondable plastic material for bonding the components together. At least two components are bonded to each other by the applying heat to the heat bondable plastic material of one component. The heat bondable plastic material is preferably a polymeric or composite material suitable for surgical applications and implantation in humans, and may be a biodegradable material. A laser may be used as the heat source. The present invention is advantageously embodied in heat bonded fastenings for sutures or K-wires, in which a variety of different suture anchors are usable, including expandable distal suture anchors.

Abstract: Medical devices and methods used to cause hemostasis of blood vessels located along the gastrointestinal tract. The medical devices include a clip having a stem, an anchor at a first end of the stem and a bolster at or near a second end of the stem. Methods of deploying the medical devices are disclosed.

Abstract: The self securing suture includes a suture having at least one terminal end and a toggle, formed of suture material, at the suture's terminal end. In one embodiment, the suture toggle is a bar. In another embodiment the suture is a wire and the toggle is a wire element toggle. The wire element toggle is a double strand segment or an open loop segment. The suture delivery system includes a slotted needle configured such that a protruding tab or leg of the toggle bar fits within slot of the needle. For wire sutures, the open loop wire element toggle fits within the slotted needle. In another embodiment, a depending wire tip, from the wire element toggle, fits within the slot in the needle.

Abstract: A surgical device having a latching mechanism comprising a latch member; and a retaining member having at least one aperture adapted to receive and retain said latch member in a locked position, said latch member and said retaining member being of contrasting colors so that when the latch member is locked in place by the retaining member that the latch member's presence in the locked position is externally visible.

Abstract: A transmyocardial revascularization system including a plurality of inserts formed of a material to elicit a healing response in tissue of the myocardium and deployment instruments and associated components for deploying the inserts into the wall of the myocardium. The inserts are arranged to be disposed within respective lumens or channels in the wall of the myocardium. The inserts can take various forms, e.g., be solid members, tubular members, or porous members, and may be resorbable, partially resorbable or non-resorbable. In some embodiments the inserts are arranged to be left in place within the channels in the wall of the myocardium to result in plural lumens which enable blood to flow therethrough and into contiguous capillaries. The deployment instruments are arranged to pierce the tissue of the myocardium from either the endocardium or the epicardium to insert the inserts into the myocardium, depending on the particular deployment instrument used.

Abstract: Surgical devices such as implants or suture fastenings are assembled from a plurality of discrete components, one of which components includes a heat bondable plastic material for bonding the components together. At least two components are bonded to each other by the applying heat to the heat bondable plastic material of one component. The heat bondable plastic material is preferably a polymeric or composite material suitable for surgical applications and implantation in humans, and may be a biodegradable material. A laser may be used as the heat source. The present invention is advantageously embodied in heat bonded fastenings for sutures or K-wires, in which a variety of different suture anchors are usable, including expandable distal suture anchors.

Abstract: Systems for anastomosing a first hollow tissue structure to a second hollow tissue structure are disclosed. In an exemplary embodiment, such a system comprises at least one tissue securing member adapted to secure the first and second hollow tissue structures together, and a device for applying the tissue securing member to the tissue structures. The tissue securing member is preferably configured to pass through only one of the tissue structures, and is movable from a first configuration to a second configuration which results in a compressive force being applied to the tissue structures. The systems are particularly useful for performing anastomosis of blood vessels in heart surgery.

Abstract: A graft fixation device. The device is useful for affixing a tissue graft to a bone or other body surface. The graft fixation device comprises two implantation members connected by a connecting member. The implantation members have longitudinal passageways therethrough.

Abstract: Medical devices or components for medical devices formed from bioabsorbable elastomers comprising a segmented copolymer are disclosed. The segmented copolymer is a copolymer of from about 30 to about 40 mole percent of lactide and the balance being substantially p-dioxanone. The segmented copolymers surprisingly exhibit elastomeric properties, and the copolymers are bioabsorbable. The combination of physical and biological properties of these elastomeric copolymers are particularly well suited for numerous medical and surgical applications.

Abstract: Medical devices and methods used to cause hemostasis of blood vessels located along the gastrointestinal tract. The medical devices include a clip having a stem, an anchor at a first end of the stem and a bolster at or near a second end of the stem. Methods of deploying the medical devices are disclosed.

Abstract: An endoscopic surgical instrument includes a flexible tube, a grasping and fastening end effector coupled to the distal end of the tube, and a manual actuator coupled to the proximal end of the tube. The manual actuator is coupled to the end effector by a plurality of flexible cables which extend through the tube. The tube contains a lumen for receiving a manipulable endoscope and the end effector includes a passage for the distal end of the endoscope. The end effector has a store for a plurality of male fastener parts, a store for a plurality of female fastener parts, a rotatable grasper, a rotatable fastener head for aligning a female fastener part and a male fastener part with tissues therebetween, and a firing member for pressing a male fastener part through tissues grasped by the grasper and into a female fastener part.