116 results about "Bypass surgery" patented technology

Surgical instrumentation and methods for performing a bypass procedure in a digestive system incorporate laparoscopic techniques to minimize surgical trauma to the patient. The instrumentation includes an outer guide member dimensioned for insertion and passage through an esophagus of a patient and defining an opening therein extending at least along a portion of the length of the outer guide member, an elongate anvil delivery member at least partially disposed within the opening of the outer guide member and being adapted for longitudinal movement within the outer guide member between an initial position and an actuated position and an anvil operatively engageable with the delivery member. The anvil includes an anvil rod defining a longitudinal axis and an anvil head connected to the anvil rod. The anvil head is at least partially disposed within the opening of the outer guide member when in the initial position of the delivery member and is fully exposed from the distal end of the outer guide member upon movement of the delivery member to the actuated position.

A heart retractor links lifting of the heart and regional immobilization which stops one part of the heart from moving to allow expeditious suturing while permitting other parts of the heart to continue to function whereby coronary surgery can be performed on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the heart retractor of the present invention. The retractor includes a plurality of flexible arms and a plurality of rigid arms as well as a surgery target immobilizing element. One form of the retractor can be used in minimally invasive surgery, while other forms of the retractor can accommodate variations in heart size and paracardial spacing.

Devices and methods for tissue acquisition and fixation, or gastroplasty, are described. Generally, the devices of the system may be advanced in a minimally invasive manner within a patient's body, e.g., transorally, endoscopically, percutaneously, etc., to create one or several divisions or plications within the hollow body organ. Such divisions or plications can form restrictive barriers within a organ, or can be placed to form a pouch, or gastric lumen, smaller than the remaining stomach volume to essentially act as the active stomach such as the pouch resulting from a surgical Roux-En-Y gastric bypass procedure. Moreover, the system is configured such that once acquisition of the tissue by the gastroplasty device is accomplished, any manipulation of the acquired tissue is unnecessary as the device is able to automatically configure the acquired tissue into a desired configuration.

Polymeric delivery devices have been developed which combine high loading / high density of molecules to be delivered with the option of targeting. As used herein, “high density” refers to microparticles having a high density of ligands or coupling agents, which is in the range of 1000-10,000,000, more preferably between 10,000 and 1,000,000 ligands per square micron of microparticle surface area. A general method for incorporating molecules into the surface of biocompatible polymers using materials with an HLB of less than 10, more preferably less than 5, such as fatty acids, has been developed. Because of its ease, generality and flexibility, this method has widespread utility in modifying the surface of polymeric materials for applications in drug delivery and tissue engineering, as well other other fields. Targeted polymeric microparticles have also been developed which encapsulate therapeutic compounds such as drugs, cellular materials or components, and antigens, and have targeting ligands directly bound to the microparticle surface. Preferred applications include use in tissue engineering matrices, wound dressings, bone repair or regeneration materials, and other applications where the microparticles are retained at the site of application or implantation. Another preferred application is in the use of microparticles to deliver anti-proliferative agents to the lining of blood vessels following angioplasty, transplantation or bypass surgery to prevent or decrease restenosis, and in cancer therapy. In still another application, the microparticles are used to treat or prevent macular degeneration when administered to the eye, where agents such as complement inhibitors are administered.

The present invention provides systems, apparatus and methods for selectively applying electrical energy to body tissue in order to incise, dissect, harvest or transect tissues or an organ of a patient. The electrosurgical systems and methods are useful, inter alia, for accessing, dissecting, and transecting a graft blood vessel, such as the internal mammary arteries (IMA) or the saphenous vein, for use in a by-pass procedure. A method of the present invention comprises positioning an electrosurgical probe adjacent the target tissue so that one or more active electrode(s) are brought into at least partial contact or close proximity with a target site in the presence of an electrically conductive fluid. A high frequency voltage is then applied between the active electrode and one or more return electrode(s). During application of the high frequency voltage, the electrosurgical probe may be translated, reciprocated, or otherwise manipulated such that the active electrode is moved with respect to the tissue. The present invention volumetrically removes the tissue at the point of incision, dissection, or transection in a cool ablation process that minimizes thermal damage to surrounding, non-target tissue.

A system for manipulating and supporting a beating heart during cardiac surgery, including a gross support element for engaging and supporting the heart (the gross support element preferably including a head which is sized and shaped to cradle the myocardium of the left ventricle), a suspension head configured to exert lifting force on the heart when positioned near the apical region of the heart at a position at least partially overlying the right ventricle, and a releasable attachment element for releasably attaching at least one of the gross support element and the suspension head to the heart. The releasable attachment element can be a mechanical element (such as one or more staples or sutures) or an adhesive such as glue. Alternatively, the system includes a suspension head and a releasable attachment element for releasably attaching it to the heart, but does not include a gross support element.

Restenosis or neointimal formation may occur following angioplasty or other trauma to an artery such as by-pass surgery. This presents a major clinical problem which narrows the artery. The invention provides a device and a method whereby vascular cells in the area of the artery subjected to the trauma are subjected to irreversible electroporation which is a non-thermal, non-pharmaceutical method of applying electrical pulses to the cells so that substantially all of the cells in the area are ablated while leaving the structure of the vessel in place and substantially unharmed due to the non-thermal nature of the procedure.

Polymeric microparticles have been developed which encapsulate therapeutic compounds such as drugs, cellular materials or components, and antigens, and can have targeting ligands directly bound to the microparticle surface. Preferred applications include use in tissue engineering matrices, wound dressings, bone repair or regeneration materials, and other applications where the microparticles are retained at the site of application or implantation. Another preferred application is in the use of microparticles to deliver anti-proliferative agents to the lining of blood vessels following angioplasty, transplantation or bypass surgery to prevent or decrease restenosis, and in cancer therapy. In still another application, the microparticles are used to treat or prevent macular degeneration when administered to the eye, where agents such as complement inhibitors are administered.

Surgical methods and related medical devices for treating glaucoma are disclosed. The method comprises trabecular bypass surgery, which involves bypassing diseased trabecular meshwork with the use of a stent implant. The stent implant is inserted into an opening created in the trabecular meshwork by a piercing member that is slidably advanceable through the lumen of the stent implant for supporting the implant insertion. The stent implant is positioned through the trabecular meshwork so that an inlet end of the stent implant is exposed to the anterior chamber of the eye and an outlet end is positioned into fluid collection channels at about an exterior surface of the trabecular meshwork or up to the level of aqueous veins.

Controlled cessation of heart beat during coronary bypass surgery and other cardiac surgeries on a beating heart improves surgical technique, and is achieved typically by electrical stimulation of the vagus nerve and administration of a combination of drugs.

Surgical methods and related medical devices for treating glaucoma are disclosed. The method comprises trabecular bypass surgery, which involve bypassing diseased trabecular meshwork with the use of a seton implant. The seton implant is used to prevent a healing process known as filling in, which has a tendency to close surgically created openings in the trabecular meshwork. The surgical method and novel implant are addressed to the trabecular meshwork, which is a major site of resistance to outflow in glaucoma. In addition to bypassing the diseased trabecular meshwork at the level of the trabecular meshwork, existing outflow pathways are also used or restored. The seton implant is positioned through the trabecular meshwork so that an inlet end of the seton implant is exposed to the anterior chamber of the eye and an outlet end is positioned into fluid collection channels at about an exterior surface of the trabecular meshwork or up to the level of aqueous veins.

A device and method for improving flow through a native blood vessel valve, such as the aortic valve, are provided. The present invention allows a miniature valve to be implanted into affected leaflets percutaneously, obviating the need for coronary bypass surgery. The method includes the cutting of small holes, on the order of 4 mm, in the leaflets of a targeted valve, thereby allowing blood to flow through the newly formed holes. The holes are used as attachment sites for the miniature valves of the present invention.

The present invention concerns the use of oxygen antagonists and other active compounds for inducing stasis or pre-stasis in cells, tissues, and / or organs in vivo or in an organism overall, in addition to enhancing their survivability. It includes compositions, methods, articles of manufacture and apparatuses for enhancing survivability and for achieving stasis or pre-stasis in any of these biological materials, so as to preserve and / or protect them. In specific embodiments, there are also therapeutic methods and apparatuses for organ transplantation, hyperthermia, wound healing, hemorrhagic shock, cardioplegia for bypass surgery, neurodegeneration, hypothermia, and cancer using the active compounds described.

Disclosed is an ostial stent positioner that has the form of a wire for most of its length and having a short cylinder with a longitudinal slit and expandable legs situated at the positioner's distal end. The slit cylinder with its attached wire acts as an introducer sheath to introduce a stent delivery system with a stent into the artery that is to be stented. A second aspect of the present invention is a method for accurately placing a stent at the ostium of an artery that would have an ostial stenosis. Examples of such arteries that have ostial stenoses are the right and left main coronary arteries, a saphenous vein graft as used in coronary bypass surgery and the renal arteries. Also disclosed are designs for the slit cylinder that provides a variable diameter so as to fit snugly within guiding catheters having different inside diameters.

The invention is directed to a laser catheter (1) for bypass surgery, wherein the distal part (2) of the catheter (1) is provided with: a tubular arrangement (3) of optical fibres (4) having distal ends (5) defining a ring-shaped light emergence surface (6) for emitting a tubular bundle of light beams in the distal direction (D) of the catheter (1); and a stop surface (7) extending around the tubular arrangement (3) of optical fibres (4) and facing in the distal direction (D), the stop surface (7) being arranged at a distance (A) proximally from the light emergence surface (6). The light emergence surface (6) slants at a slanting angle (α) in the range of [20°, 60°] with respect to the longitudinal axis (8) of the catheter (1). The invention further relates to an assembly comprising such a catheter.

The present invention concerns the use of oxygen antagonists for inducing stasis in cells, tissues, and / or organs in vivo or in an organism overall. It includes methods and apparatuses for achieving stasis in any of these biological materials, so as to preserve and / or protect them. In specific embodiments, therapeutic methods and apparatuses for organ transplantation, hyperthermia, wound healing, hemorrhagic shock, cardioplegia for bypass surgery, neurodegeneration, hypothermia, and cancer is provided.

An anastomotic ring device for forming a hollow rivet (ring) attachment between tissue lumens facilitates laparoscopic or endoscopic implantation by including features that facilitate actuation from a stressed, generally cylindrical shape. Economical manufacturer is achieved by weaving open ended strands into a generally cylindrical stent shape that is imparted with a Shape Memory Effect (SME) to actuate to a hollow rivet (ring) shape. Alternatively or in addition to SME inherent in the woven strands, an actuating force may be received from a helical spring element incorporated into the ring. Self-actuating ring devices are enhanced by forming woven strands into petals that diverge from opposing petals such that the strands encounter less friction when actuating. Each of these features alone or in combination enhance clinical use of anastomotic ring devices, such as a bariatric gastric bypass procedure.

Described are equipment, a system, a kit and a method for the performance of a minimally-intensive body access, such as cardiac access. Epicardial Access Surgery (EAS) is disclosed. EAS does not need general anesthesia or extracorporeal circulation nor does it need a chest opening, which is very advantageous for various aspects. For instance an operation of a coronary artery bypass is created by creating a direct path of flow from one body artery into a coronary artery with the aid of catheter-based minimally-invasive EAS based bypass surgery. In addition, various medical devices are used, such as a special partially flexible needle, a special partially covered stent, and a special partially flexible port.

A suture-less graft coupling system for anastamosis and bypass procedures comprising a first stent for insertion into a radially transected vessel being treated, a graft member overlapping the stented area of the transected vessel, and a second stent overlapping the graft and vessel in an area of the first stent wherein sealing pressure from the second stent can be applied to seal the vessel and graft in a leak-free arrangement.

Restenosis or neointimal formation may occur following angioplasty or other trauma to an artery such as by-pass surgery. This presents a major clinical problem which narrows the artery. The invention provides a device and a method whereby vascular cells in the area of the artery subjected to the trauma are subjected to irreversible electroporation which is a non-thermal, non-pharmaceutical method of applying electrical pulses to the cells so that substantially all of the cells in the area are ablated while leaving the structure of the vessel in place and substantially unharmed due to the non-thermal nature of the procedure.

The invention discloses an artificial nerve conduit of double layer and the method for preparing same. The said nerve conduit comprises an inner conduit and an outer layer, which are made from degradable and adsorptive material in living body. The slit between said inner conduit and outer conduit is filled with fiber albumen glue (used for regeneration of nervous tissue and blood vessel). The artificial nerve conduit of double layer can be used for bypass surgery for damaged round nerve and spinal marrow, and it will be degraded and adsorbed in living body after nerve regeneration. The said artificial nerve conduit possesses good elasticity and strength, and the degradation time is adaptive to growing speed of nervous fiber (about 1-6 months).