618 results about "Abdominal wall" patented technology

The invention is directed to a remote center positioner used to support an instrument and provide a center of spherical rotation, remote from any bearings or mechanical supports, at a desired location of the instrument. The remote center positioner is particularly useful in laparoscopic surgery to constrain a surgical instrument to move around a fixed center of rotation remote from any bearings or mechanical supports and coincident with an entry incision in the abdominal wall.

A novel approach to diagnostic and therapeutic interventions in the peritoneal cavity is described. More specifically, a technique for accessing the peritoneal cavity via the wall of the digestive tract is provided so that examination of and/or a surgical procedure in the peritoneal cavity can be conducted via the wall of the digestive tract with the use of a flexible endoscope. As presently proposed, the technique is particularly adapted to transgastric peritoneoscopy. However, access in addition or in the alternative through the intestinal wall is contemplated and described as well. Transgastric and/or transintestinal peritoneoscopy will have an excellent cosmetic result as there are no incisions in the abdominal wall and no potential for visible post-surgical scars or hernias.

Methods and devices are provided for performing gastrectomies and gastroplasties. In one embodiment, a method includes gaining access to a stomach of a patient through an opening formed in the patient's abdominal wall and an opening formed in the patient's vaginal wall. Tissue attached to the stomach can be tensioned using a surgical instrument inserted through one of the abdominal and vaginal openings and can be separated from the stomach to free the stomach fundus using a dissecting surgical instrument inserted through another opening, e.g., through one of the abdominal and vaginal openings. The fundus can be at least partially transected using a surgical stapler inserted through one of the abdominal and vaginal openings, thereby forming a stomach “sleeve.” In another embodiment, the method is modified to form another opening in the patient's abdominal wall instead of forming an opening in the vaginal wall.

A sling for controlling urinary incontinence is disclosed. The sling is formed from a tube having substantially lengthwise inextensible end portions and an elastically lengthwise extensible intermediate portion between the end portions. The intermediate portion has a U-shape which cradles the urethra. The end portions extend through the abdominal tissue to anchor the intermediate portion in position. The sling places the urethra under a transverse compressive load to hold it closed and prevent inadvertent urination. The tube is formed from interlaced filamentary members. Interlacing may be by warp knitting, weaving using a leno weave or braiding using a tri-axial braid structure. The end portions have a rough texture to facilitate anchoring in the tissue of the abdominal wall. The intermediate portion is smooth and soft to prevent tissue erosion.

Instrument assisted abdominal access methods and apparatus are described herein. A shape-lockable elongate body can be advanced endoluminally in a flexible state into the stomach, where an opening is created through the stomach wall. The opening can be created endoluminally or by incising instruments placed through the abdominal wall. The elongate body can be transitioned to a rigid state prior to, during, or after advancement into the patient and is passed through the opening into the peritoneal cavity. To assist in the passage of the elongate body, a helical tissue engager can be advanced into the peritoneal cavity and temporarily anchored into a tissue wall. By pulling the helical tissue engager proximally and pushing the elongate body over a flexible length of the engager, the elongate body can be brought into the peritoneal cavity

A combination device for gastrostomy or jejunostomy usage having a retaining member, an elongated member having a gastrostomy lumen and a jejustomy lumen, and an inflatable balloon mounted on the elongated member. The retaining member is of a low profile and is arranged to be located on the skin adjacent a stoma in the abdominal wall through which the elongated member extends. The balloon seals the stoma about the elongated member. The retaining member includes at least one access port to communicate with respective ones of the lumens. The device, related compositions, and processes can prevent and/or treat granulomas.

An apparatus is provided for the laparoscopic deployment and positioning of surgical materials, such as mesh. The mesh is applied by at least one extension arm which radiates from a central shaft. Alternate embodiments employ simultaneously and/or individually extended rigid arms, and simultaneously deployed resilient arms. Various methods are also disclosed for attaching the mesh to the abdominal wall once it is deployed by the extension arms. Illustrative attaching methods include staples, low viscosity adhesives, and electro-cauterization.

A system for securing an implantable apparatus to a mammal includes a mount including a base portion having a plurality of holes dimensioned to receive rotationally-driven fasteners, each fastener comprising a helical portion having a tip configured for tissue penetration, the mount configured to secure the implantable apparatus relative to tissue of the mammal upon driving the fasteners into the tissue. The system further includes a fastening tool configured to rotationally drive the helical portion of the fasteners into the tissue. The mount may be secured to the fascia covering the sternum via a subcutaneous securement method, or it may be attached to the intra-abdominal wall, behind the sternum, or it may be attached to the sternum directly via bone screws or the like.

Tissue manipulation and retraction devices. In various forms, the manipulation devices include a cannula that is insertable through the abdominal wall. A plurality of independently controllable manipulation members extend through the cannula and are attachable to various forms of surgical tools. The surgical tools may be manipulated and controlled by a surgeon from a position outside of the patient.

The present invention provides systems and methods for applying RF energy to injured tissue, particularly the peritoneum, in order to prevent harmful post-surgical adhesions. One aspect of the invention is RF energy delivery systems employing trocars, which are designed for use in laparotomies and laparoscopies. Another aspect of the invention is an RF delivery system comprising a surgical sheet with one or more electrodes for delivering the RF energy to the injured tissue resulting from conventional surgical incisions into the abdominal wall. Additionally, another aspect of the invention provides methods for controlling the treatment dosage of RF heat to the injured tissue using parameters such as treatment time, change in tissue temperature, and change in tissue impedance.

A wound retractor system comprises a retractor having a distal ring 91 and a retracting sleeve 4 extending from the ring. An insertion tool 120 has a distal groove 122 to hold the ring for insertion of the ring through a small incision 90 in the abdominal wall 97. The retractor may be used for retracting an incision to receive an instrument therethrough. A seal or valve may be mounted to the retractor through which an instrument can pass.

Apparatus and methods enable insertion and tensioned deployment of a secondary material prosthetic device into a body cavity or other tissue of a patient, such as for example hernia repair mesh into the abdominopelvic cavity of a patient through the hernia site. The present invention establishes fixation sites for the prosthetic device and tensions it against the body tissue. It may also be used implant fixation devices within the body tissue so that the prosthetic device is tensioned into firm abutting contact with the body tissue. Instrument deployment and fixation struts may be advanced in retrograde fashion in order to reduce needed deployment volume within the patient's body cavity. The prosthetic device advantageously may be flexibly coupled to the instrument via fixation devices such as sutures, so as to increase orientation flexibility.

There is provided a surgical treatment instrument in which the mode can be easily switched between a treatment under a pneumoperitoneum condition and a treatment outside the peritoneal cavity, and forceps can be manipulated under the pneumoperitoneum condition, and when taking out a cancer-affected part, an incision in the abdominal wall is protected, and the incision is free from infection. The surgical treatment instrument includes a tubular portion which has a first fixing member provided at a near end-side open portion thereof, and also has a second fixing member provided at a remote end-side open portion thereof. At least two tension belts are mounted on the second fixing member, and fixing means for adjusting the length of the tension belts to position the first fixing member is provided at the first fixing member.

The present invention provides systems and methods for applying RF energy to injured tissue, particularly the peritoneum, in order to prevent harmful post-surgical adhesions. One aspect of the invention is RF energy delivery systems employing trocars, which are designed for use in laparotomies and laparoscopies. Another aspect of the invention is an RF delivery system comprising a surgical sheet with one or more electrodes for delivering the RF energy to the injured tissue resulting from conventional surgical incisions into the abdominal wall. Additionally, another aspect of the invention provides methods for controlling the treatment dosage of RF heat to the injured tissue using parameters such as treatment time, change in tissue temperature, and change in tissue impedance.

A laparoscopic insufflation device is provided in the configuration of a coil with a blunt tip. The device is capable of passing through the abdominal wall without cutting tissue, and exiting the abdominal wall substantially parallel to the inner surface. While rotation of the coiled device results in forward movement through the abdominal wall, a counter force can be applied to the device to create a safety space between the wall and the interior organs. With the blunt distal tip, parallel exit angle, and safety space, there is substantially no threat to the interior organs during placement of the device. Further space can be generated with the use of pressured gas to produce an abdominal cavity for the subsequent placement of trocars. By rotatably attaching the coiled insufflation device to a trocar, the advantage of a counter force can be used not only to establish the safety space but also to pull the trocar into the abdominal wall with a counterforce which resists tenting.

A surgical instrument, guide, and method capable of being used for closure of peritoneum fascia, occlusion of bleeding vessels such as inferior epigastric, and for all uses related to accurately passing suture material through a guide into tissue. A tip of a surgical instrument in a standard suture-/needle-driving position with a sharp tip that opens and closes with the surgeon grasping suture material with the sharp tip is provided. Insertion of the tip/suture through tissue until the tip is seen through the peritoneum by direct vision begins the wound-closing procedure. The suture is released by opening and withdrawing the tip from the guide. The suture is recovered by using the guide to redirect the tip and puncturing the tissue opposite the first point of insertion. The tip grasps the suture and pulls the suture through the guide. The suture is pulled outside the wound, providing for rapid closure of the surgical incision. The guide is insertable within the wound to be closed and guides the surgical instrument at a predetermined angle from the longitudinal axis of the guide for optimum wound closure. Alternative embodiments of the guide include providing a slot through which non-linear surgical instruments may pass through an open or enclosed passageway.

An implantable hernial prosthesis having top and bottom layers and a central sleeve to facilitate manual expansion and placement of the prosthesis within an incision in a patient. The top layer and a bottom layer are secured together with at least one seam at the perimeter of the prosthesis. The top layer is made of a synthetic mesh, preferably polypropylene mesh, to promote incorporation into the abdominal wall, and the bottom layer is made of the same material or in some cases of a mechanical barrier to prevent adhesions to the intestine. The top layer is provided with a central sleeve to introduce one or two fingers to expand the prosthesis in place, and also to introduce an articulated hernial stapler to secure the mesh into the abdominal wall.

A method for treating obesity by reducing the volume and/or alter the functioning of the gastric cavity to limit food consumption and induce early satiety. The method includes accessing the cavity endoscopically to visualize the interior of the cavity. The peritoneal cavity is accessed through a small incision in the abdominal wall. Using endoscopic visualization, suture anchoring devices are introduced into the peritoneal cavity through the incision and deployed from the exterior surface through the gastric cavity wall. Suture from pairs of the anchoring devices is drawn through the gastric cavity wall and tightened outside of the cavity to form a serosa to serosa plication. Any number of plications may be formed in the cavity wall and the contacting tissue within a plication may be treated to promote healing and a more durable bond.

Apparatus and methods for transgastric tissue manipulation are described herein. Procedures are performed transgastrically through a trocar or insert, e.g., to create tissue plications and approximating those plications towards one another for accomplishing gastroplasty procedures. The trocar is positioned through the abdominal wall of the patient and into the stomach. A multi-lumen insertion tool is positioned within the trocar and comprises one or several channels, e.g., two, three, or more channels as practicable, through the single insertion tool. Each of the channels is aligned and individually sealable with a reversible seal which allows for insertion or removal of a tool therethrough without comprising sealing of the entire trocar or port. A proximal section of the shafts comprise a flexible section to allow for the flexing of each respective control handle away from one another such that the surgeon can manipulate the tools without interference between the handles.

A suture tool for fixing the gastric wall to the abdominal wall comprises a first puncture needle for insertion, a suture thread, a second puncture needle for removing the suture thread, a linear grasping member and one or more anchor member. The tip end portion of the suture thread is inserted into the first puncture needle and a hook of the linear grasping member is inserted into the second puncture needle for removing the suture thread inserted into the first puncture needle for securing the gastric wall to the abdominal wall.

An apparatus and method for treating morbid obesity in mammals using a gastric reduction assembly that reduces the gastric volume of a stomach and induces early satiety. The gastric reduction assembly comprises at least two or more expandable devices, each able to be adjustably inflated with a fluid (e.g., a liquid or a gas) using a filling tube. In a preferred embodiment, the gastric reduction assembly is inserted through the abdominal wall and placed at a location exterior to the stomach body, avoiding an abdominal incision. Once positioned near the stomach body, the gastric reduction assembly allows for the external compression of the stomach body to limit food intake. The gastric reduction assembly also minimizes the potential for shifting of the expandable devices after insertion to the stomach body to revert to its pre-compressed state.