摘要:
A suturing apparatus adapted to close an incision and an anterior tissue wall includes an elongate support structure having an axis extending between a proximal end and distal end. A receiver disposed at the distal end is insertable through the incision in a low-profile state and expanded to a high-profile state on the far side of the tissue wall. Needles carried by the support structure are operable to extend through the support wall on either side of the incision and into the expanded receiver. Sutures advanced through the needles are captured by the receiver after the needles are removed and the receiver is returned to its low-profile state. Removal of the suturing apparatus from the incision draws the captured suture ends outwardly through the incision. A novel suture knot can be tied in the four suture ends and moved into proximity with the tissue wall to close the incision.
摘要:
A drainage catheter is adapted to drain fluid from the body cavity through a body conduit and includes an elongate tube having a distal end and a retention member disposed at the distal end and adapted for movement between the low-profile state facilitating insertion of the catheter and a high-profile state facilitating the tension of the catheter in its operative position. A woven mesh forms at least a portion of one of the tube and the retention member, and can be made permeable or impermeable in various regions of the catheter. The woven mesh can be formed of filaments heat-settable so that the catheter automatically moves to the high-profile state. Insertion of the catheter can be facilitated using an obturator and a guidewire in an associated method, an obturator facilitating insertion of the catheter can be removed to permit the catheter to automatically return to a normal, high-profile state.
摘要:
A catheter includes an introducer and a flow isolator adapted for disposition in a primary conduit to facilitate flow in the primary conduit while inhibiting flow and intersecting secondary conduits. The flow isolator may include a tubular mesh and surrounding balloon structure. Alternatively, a sleeve can be provided with a primary opening and a secondary opening which are sized to inflate the sleeve with the body fluid. Structures for deploying the sleeve between a low-profile state and high-profile state may include expandable fingers, or pneumatic chambers inflatable from an external source. In operation the sleeve can be forced by the body fluid against the intersection with the secondary conduits to achieve isolation. Alternatively, the pneumatic chambers can be inflated to form seals with the primary conduit. A blood filter or snare is contemplated to filter any blood clots which may develop around the flow isolator.
摘要:
A multi-seal trocar system includes a plurality of co-axial sealing elements adapted for forming a seal with either a large or small instrument. Small and large sealing elements are disposed in an in-line arrangement such that a-single port is provided for instrument insertion. A zero seal is disposed distally of the sealing elements to seal a working channel of the system and to prevent backflow when no instruments are inserted. The small sealing element is configured such that insertion of a large instrument automatically moves the small sealing element out of its path, thereby avoiding contact with the large instrument.
摘要:
A suture system for closing a wound defined by tissue portions includes an elongate suture having a pair of ends adapted for threading relative to the tissue portions leaving the suture ends free. A securing mechanism has a first position for capturing the suture ends and a second position for permanently holding the suture ends in a fixed relationship, with the suture tensioned to maintain the tissue portions in close proximity. In a third position, the securing mechanism frictionally engages the suture ends in a sliding relationship. In an associated method, continuous tension is placed on the suture ends during operation of the securing mechanism.
摘要:
The invention primarily is directed to a medical tubing adapted for insertion into a body tissue or cavity and method of manufacturing different variations of the tubing along a length of the tubing. The tubing comprises a plurality of individual, discrete, generally ring-shaped elements arranged in series and fused or bonded together forming a continuous tubular structure. The ring-shaped elements may be formed of a thermoplastic or a thermoset material. The ring-shaped elements may include plastic rings, metallic rings, un-reinforced plastic rings and/or metal reinforced plastic rings assembled along the length of the tubular structure to provide variable flexibility and kink-resistance. The tubular structure may have a cross-section of any geometric shape and it may be bent, twisted or curved without kinking. The ring-shaped elements may have different flexural modulus. The ring-shaped elements may include a combination of flexible and rigid ring-shaped elements assembled along different portions or sections of the tubular structure. The ring-shaped elements may be metallic and may be bonded with a resilient, flexible elastomeric adhesive, wherein the ring-shaped elements may have different lengths and may be fused closer or further apart to one another depending on the characteristics of a portion or section of the tubing. In another aspect of the invention, the medical tubing may further comprise a secondary lumen and a pull wire to control the tubular structure. The ring-shaped elements may be truncated to provide a bending bias. In another aspect of the invention, the ring-shaped elements may vary in diameter and/or composition in different portions or sections of the tubular structure. In yet another aspect of the invention, some of the ring-shaped elements may be radiopaque, or the ring-shaped elements may comprise of different colors to operate as indicators along the tubular structure.
摘要:
A multi-seal trocar system (10) includes a plurality of co-axial sealing elements (30 60,80) adapted for forming a seal with either a large or small instrument. Small and large scaling elements (45,62) are disposed in an in-line arrangement such that a single port is provided for instrument insertion. A zero seal (80) is disposed distally of the sealing elements to seal a working channel of the system and to prevent backflow when no instruments are inserted The small sealing element (45) is configured such that insertion of a large instrument automatically moves the small sealing element (45) out of its path, thereby avoiding contact with the large instrument
摘要:
A surgical clip having a sliding state and a crimped state is adapted for use in a surgical procedure initially to slide along suture ends to an operative position and ultimately to crimp the suture ends at the operative position. a sub straight, bendable between the sliding state and the crimped state carries at least one coating having either lubricious or traction enhancing properties. A second coating can be added to form a coating laminate with the outer coating having lubricious properties facilitating the sliding state and the inner coating having traction enhancing properties facilitating thee crimped state.
摘要:
A stent is adapted for disposition in a body conduit of a patient and comprises a mesh formed in the configuration of a tube and having an axis and axial convolutions, which facilitate movement between a low-profile state and a high-profile state. The tube in the low-profile state has an elongate configuration and a wall with a first thickness and first tube strength. The tube in the high-profile state has a compressed configuration and a wall with a second thickness greater than the first thickness and a second hoop strength greater than the first hoop strength. An associated method of use includes the steps of mounting the step on a catheter between first and second enlargement members, increasing the size of the enlargement members, and moving the enlargement members to axially compress the stent to the high-profile state. An associated method of manufacture includes the steps of corrugating the mesh on a mandrel by moving the ends of the mesh toward each other. The mesh can then be heat-set in the high-profile state.
摘要:
A surgical device is disclosed for treating and removing obstructing material from within a vascular conduit or other body passageway. The device comprises a catheter device having an expandable and collapsible outer mesh sleeve disposed at a distal end. The outer mesh sleeve is configured such that when expanded in the obstructed conduit or passageway, a portion of the obstructing material is forced through a plurality of openings in its outer surface and thus, into the outer mesh sleeve. An inflatable and deflatable balloon may be coupled to the catheter and used to radially expand the outer mesh sleeve into the obstructing material. A treatment element disposed within the catheter device is moved against the inner surface of the outer mesh sleeve to treat and remove any obstructing material with which it contacts. The treatment element may be configured as a blade for physically removing the obstructing material, or as an electrode for electrosurgical treatment. After treatment or removal of the obstructing material, the outer mesh sleeve is collapsed and the catheter device removed from the body conduit.