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Methods, devices and systems for approximation and fastening of soft tissue

This invention provides minimally invasive mechanical instruments that are capable of laparoscopic or endoscopic approximation and fastening of soft tissues in a variety of interventional procedures. The devices of the present invention generally consist of a proximal handle assembly incorporating actuation means, an elongate tubular assembly (which may be flexible, rigid or combinations thereof) and a distal tool assembly incorporating mechanisms for engaging tissue at two or more spaced-apart locations on a tissue surface as well as mechanisms for deploying one or more tissue fasteners to securely hold the tissues in the approximated configuration. Typically the devices are provided in an initial collapsed (i.e. pre-deployed) configuration for insertion into the patient. After being deployed to an expanded configuration, tissue is contacted and engaged at two or more locations, and upon subsequent actuation by the user, at least one of the tissue engagement mechanisms, with tissue engaged, is repositioned by moving it toward another engaged tissue location, thereby approximating the engaged tissue locations near the distal end of the device. A variety of fasteners and fastener delivery mechanisms may be integrated into the devices of the present invention to securely and permanently hold the approximated tissues in the approximated configuration. Devices of the present invention provide surgeons the ability to carry out a variety of interventional procedures in which tissue approximation and fastening is required, in a safer and more efficient manner. Certain embodiments of the present invention enable entirely new minimally invasive tissue approximation and fastening procedures to be performed, such as closure of holes in the gastrointestinal lumen created to provide access to the abdominal cavity during natural orifice transluminal endoscopic surgery (NOTES) or laparoscopic plication gastroplasty procedures that reduce stomach volume from its external surface in the treatment of obesity.
Owner:LONGEVITY SURGICAL

Gas concentration sensor

A gas concentration sensor comprises an ultrasonic element 33 opposite a reflection surface 34. A depression 34a is formed on an edge portion of a reflection surface 34 which is in contact with a side wall of a measurement chamber 32 such that a bottom surface of the depression 34a is substantially in parallel with the reflection surface 34. The distance between the ultrasonic element 33 and the edge portion of the reflection surface 34 becomes greater than the distance between the ultrasonic element 33 and a central portion of the reflection surface 34. As a result, an indirect wave, which impinges obliquely on the side wall of the measurement chamber 32 and propagates along the side wall, is reflected from the bottom surface of the depression 34a and propagates. Thus, the propagation distance of this indirect wave becomes greater as compared to the case where the reflection surface 34 is flat, so that the indirect wave is not combined with a direct wave in the vicinity of a modulation point of the direct wave. That is, since the modulation point of the direct wave can be detected accurately, a time interval between a modulation point of a transmitted wave and that of a received wave can be measured as the propagation time of an ultrasonic wave, thereby enabling accurate determination of gas concentration.
Owner:NGK SPARK PLUG CO LTD
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