3934 results about "Hemostasis" patented technology

An electrosurgical stapling apparatus is provided which uses thermogenic energy as well as surgical fasteners or staples for strengthening tissue, providing hemostasis, tissue joining or welding. The thermogenic energy also strengthens tissue in proximity to a staple line and knife cut line and provides hemostasis along the staple and cut lines formed by the staples and a knife blade during surgical stapling. The use thermogenic energy provides short-term hemostasis and sealing, and reduces or prevents staple line and cut line bleeding, while the stapling features provide short and long-term tissue strength and hemostasis. The stapling apparatus further substantially reduces or prevents knife cut line bleeding by energizing a knife blade for cauterizing tissue while it is being cut. In one embodiment, energy is applied to the anvil to energize the staples as they make contact with the anvil.

The present disclosure relates to surgical fastener applying apparatus, and the application of variable compression to tissue. More specifically, the presently disclosed surgical fastener applying apparatus act to limit the flow of blood through tissue immediately adjacent a cut-line formed therein to effectuate hemostasis, while maximizing the flow of blood through tissue more removed from the cut-line to limit unnecessary necrosis. In one embodiment, a surgical fastener applying apparatus is disclosed having a tool assembly coupled to a distal end thereof with first and second jaws respectively including an anvil and a surgical fastener cartridge. The surgical fastener cartridge includes, among other things, a hemostasis member that is configured to apply at least two different compressive forces to tissue clamped between the first and second jaws of the tool assembly.

A bicomposite material based on collagen is prepared which has two closely bound layers and is biocompatible, non-toxic, hemostatic and biodegradable in less than a month, and can be used in surgery to achieve hemostasis and prevent post-surgical adhesion. To prepare the material, a solution of collagen or gelatin, which may contain glycerine and a hydrophilic additive such as polyethylene glycol or a polysaccharide, is poured onto an inert support to form a layer 30 .mu.m to less than 100 .mu.m thick. Then a polymeric porous fibrous layer is applied during gelling of the collagen or gelatin, and the resultant material is dried. The polymeric porous fibrous layer may be made of collagen or a polysaccharide, and have a density of not more than 75 mg / cm.sup.2, a pore size from 30 .mu.m to 300 .mu.m and a thickness of 0.2 cm to 1.5 cm.

A biopsy system having a lateral tissue access port includes an energy based tissue penetration system that can advantageously penetrate hard tumors, improve hemostasis, and provide greater tissue access. The energy based tissue penetration system has a vibrational member removeably disposed within the biopsy system, and a distal tip of the vibrational member extending from the biopsy system for tissue penetration. A sleeve is located between the vibrational member and the lateral access port to prevent tissue contact with the vibrational member through the lateral access port.

The present disclosure relates to surgical fastener applying apparatus and the application of variable compression to tissue. More specifically, the presently disclosed surgical fastener applying apparatus act to limit the flow of blood through tissue immediately adjacent a cut-line formed therein to effectuate hemostasis, while maximizing the flow of blood through tissue more removed from the cut-line to limit unnecessary necrosis. In one embodiment, a surgical fastener applying apparatus is disclosed having a tool assembly coupled to a distal end thereof with first and second jaws respectively including an anvil and a surgical fastener cartridge. The surgical fastener cartridge includes, among other things, angled pushers that engage surgical fasteners of varying lengths.

An apparatus for supporting tissue during compression prior to the insertion of a surgical element into the tissue has a substrate. The substrate is made from a predetermined material. The predetermined material has a thickness and a predetermined stress strain profile. The predetermined stress strain profile is complementary to a stress strain profile of the tissue and permits the substrate to support the tissue when the surgical element is delivered into the tissue. The substrate provides hemostasis control of the tissue when the surgical element is delivered into the tissue.

An apparatus for supporting tissue during compression prior to the insertion of a surgical element into the tissue has a substrate. The substrate is made from a predetermined material. The predetermined material has a thickness and a predetermined stress strain profile. The predetermined stress strain profile is complementary to a stress strain profile of the tissue and permits the substrate to support the tissue when the surgical element is delivered into the tissue. The substrate provides hemostasis control of the tissue when the surgical element is delivered into the tissue.

An electrosurgical stapling apparatus is provided which uses thermogenic energy as well as surgical fasteners or staples for strengthening tissue, providing hemostasis, tissue joining or welding. The thermogenic energy also strengthens tissue in proximity to a staple line and knife cut line and provides hemostasis along the staple and cut lines formed by the staples and a knife blade during surgical stapling. The use thermogenic energy provides short-term hemostasis and sealing, and reduces or prevents staple line and cut line bleeding, while the stapling features provide short and long-term tissue strength and hemostasis. The stapling apparatus further substantially reduces or prevents knife cut line bleeding by energizing a knife blade for cauterizing tissue while it is being cut. In one embodiment, energy is applied to the anvil to energize the staples as they make contact with the anvil.

A resection device includes an elongated probe shaft and a tissue resection member disposed at a distal end of the elongated probe shaft. The tissue resection member has a cutting surface configured for being placed in contact with tissue. In one aspect of the invention, at least one ejection port is located adjacent to the cutting surface of the tissue resection member, wherein the at least one ejection port is coupled to a source of a polymerizable hemostasis-promoting material that is delivered to the resection site of interest. In certain embodiments, polymerization of the hemostasis-promoting material may be accelerated by application of heat, radiofrequency energy, or ultra violet light.

A device for treating a tissue includes a capsule extending longitudinally from a proximal end to a distal end and including a channel extending therethrough, the capsule releasably coupled to a proximal portion of the device and clip arms, proximal ends of which are slidably received within the channel of the capsule so that the clip arms are movable between an open configuration, and a closed configuration. A core member is coupled to the clip arms, the core member including a proximal portion and a distal portion releasably connected to one another so that, when the core member is subjected to a predetermined load, the proximal and distal portions are separated from one another. An electrically conductive control member is connected to the core member, a proximal end of the connected member connected to a power source for delivering an electrical current to the clip arms.

A multiple clip applicator system for tissue clamping of hemostasis includes clip devices of a train and a flexible sheath. To load the flexible sheath with clip devices, a coupling device is used. A shaft head is positioned on an operating wire in the flexible sheath. A receiving opening is formed in the coupling device, for receiving insertion of the shaft head, for mating by press-fit with the fastening clip device. The shaft head is a selected one of plural shaft heads which are different in a shape according to the plural multiple clip assemblies. The receiving opening is a selected one of plural receiving openings having a shape according to corresponding shapes of the plural shaft heads, and adapted to preventing a second shaft head from entry in a first receiving opening and preventing a first shaft head from entry in a second receiving opening.

The present disclosure relates to surgical fastener applying apparatus and the application of variable compression to tissue. More specifically, the presently disclosed surgical fastener applying apparatus act to limit the flow of blood through tissue immediately adjacent a cut-line formed therein to effectuate hemostasis, while maximizing the flow of blood through tissue more removed from the cut-line to limit unnecessary necrosis. In one embodiment, a surgical fastener applying apparatus is disclosed having a tool assembly coupled to a distal end thereof with first and second jaws respectively including an anvil and a surgical fastener cartridge. The surgical fastener cartridge includes, among other things, angled pushers that engage surgical fasteners of varying lengths.

A method for treating obstructive sleep disorders includes accessing the interior of the tongue through an incision made in the skin in the vicinity of the jaw of a patient; advancing an instrument through the incision into the interior of the tongue; and removing an amount of tissue from the interior of the base of the tongue with the instrument. The present invention includes forming a cavity or plurality of channels in the tongue. The cavity may be collapsed using a suture, fastener or bioadhesive. An emplaced suture may be provided to hold the cavity in a collapsed position thereby reducing the degree of obstruction. Additionally, thermal energy may be applied to the tissue surface immediately surrounding the channels to cause thermal damage to the tissue surface, thereby creating hemostasis and stiffening the surrounding tissue structure.

Apparatus for sealing a puncture communicating with a blood vessel includes a porous carrier formed from lyophilized hydrogel or other material. The plug may include at least first and second hydrogel precursors and a pH adjusting agent carried by the porous carrier in an unreactive state prior to exposure to an aqueous physiological environment. Once exposed to bodily fluids, the carrier expands as the lyophilized material hydrates to enhance and facilitate rapid hemostasis of the puncture. When the plug is placed into the puncture, the natural wetting of the plug by bodily fluids (e.g., blood) causes the first and second precursors to react and cross-link into an adhesive or “sticky” hydrogel that aids in retaining the plug in place within the puncture.

A bipolar electrosurgical instrument having a pair of relatively moveable jaws, each of which includes a tissue contacting surface. The tissue contacting surfaces of the jaws are in face-to-face relation with one another, and adjacent each of the tissue contacting surfaces are first and second spaced-apart electrodes that are adapted for connection to the opposite terminals of a bipolar RF generator so as to generator a current flow between the electrodes. The first and second electrodes of one jaw are in offset opposed relation, respectively, with the first and second electrodes of the other jaw. A cutting portion is provided between the jaws. The cutting portion is moveable to provide the instrument with a scissors-like capability or a grasper-like capability, depending on the position of the cutting portion. A tissue dam is included on at least one jaw to help contain tissue within the desired coagulation area, and thereby help contain current density between the electrodes, thereby decreasing lateral tissue thermal damage and increasing hemostasis.

An apparatus for providing hemostasis within a puncture through tissue includes an elongate member having a lumen extending between proximal and distal ends thereof, an expandable member carried on the distal end and a housing on the proximal end, the housing including an interior communicating with the lumen, and further including a valve assembly with a one-way valve allowing access into the housing interior upon application of a pressure differential across the valve, and a movable plunger for overriding and opening the valve.

Devices and methods for achieving hemostasis and leakage control in hollow body vessels such as the small and large intestines, arteries and veins as well as ducts leading to the gall bladder and other organs. The devices and methods disclosed herein are especially useful in the emergency, trauma surgery or military setting, and most especially during damage control procedures. In such cases, the patient may have received trauma to the abdomen, extremities, neck or thoracic region. The devices utilize removable or permanently implanted, broad, soft, parallel jaw clips with minimal projections to maintain vessel contents without damage to the tissue comprising the vessel. These clips are applied using either standard instruments or custom devices that are subsequently removed leaving the clips implanted, on a temporary or permanent basis, to provide for hemostasis or leakage prevention, or both. These clips overcome the limitations of clips and sutures that are currently used for the same purposes. The clips come in a variety of shapes and sizes. The clips may be placed and removed by open surgery or laparoscopic access.

The present disclosure relates to surgical fastener applying apparatus, and the application of variable compression to tissue. More specifically, the presently disclosed surgical fastener applying apparatus act to limit the flow of blood through tissue immediately adjacent a cut-line formed therein to effectuate hemostasis, while maximizing the flow of blood through tissue more removed from the cut-line to limit unnecessary necrosis. In one embodiment, a surgical fastener applying apparatus is disclosed having a tool assembly coupled to a distal end thereof with first and second jaws respectively including an anvil and a surgical fastener cartridge. The surgical fastener cartridge includes, among other things, a hemostasis member that is configured to apply at least two different compressive forces to tissue clamped between the first and second jaws of the tool assembly.

An apparatus for delivering a closure element into an opening formed in a blood vessel or other body lumen and methods for manufacturing and using same. The apparatus is configured to retain the closure element such that the closure element is disposed substantially within the apparatus. The apparatus also can engage, and position the closure element substantially adjacent to, the blood vessel wall adjacent to the opening. During deployment of the closure element, the apparatus expands the closure element beyond a natural cross-section of the closure element such that the closure element, when deployed, is configured to engage a significant amount of the blood vessel wall and / or tissue. Engaging the blood vessel wall and / or tissue, the closure element is further configured to return to the natural cross-section, thereby drawing the engaged blood vessel wall and / or tissue substantially closed and / or sealed, such that hemostasis within the opening is enhanced.

Devices and methods for achieving hemostasis and leakage control in hollow body vessels such as the small and large intestines, arteries and veins as well as ducts leading to the gall bladder and other organs. The devices and methods disclosed herein are especially useful in the emergency, trauma surgery or military setting, and most especially during damage control procedures. In such cases, the patient may have received trauma to the abdomen, extremities, neck or thoracic region. The devices utilize removable or permanently implanted, broad, soft, parallel jaw clips with minimal projections to maintain vessel contents without damage to the tissue comprising the vessel. These clips are applied using either standard instruments or custom devices that are subsequently removed leaving the clips implanted, on a temporary or permanent basis, to provide for hemostasis or leakage prevention, or both. These clips overcome the limitations of clips and sutures that are currently used for the same purposes. The clips come in a variety of shapes and sizes. The clips may be placed and removed by open surgery or laparoscopic access.

Methods and apparatus for the remote coagulation of blood using high-intensity focused ultrasound (HIFU) are provided. A remote hemostasis method comprises identifying a site of internal bleeding and focusing therapeutic ultrasound energy on the site, the energy being focused through an intervening tissue. An apparatus for producing remote hemostasis comprises a focused therapeutic ultrasound radiating surface and a sensor for identifying a site of internal bleeding, with a registration means coupled to the radiating surface and the sensor to bring a focal target and the bleeding site into alignment. The sensor generally comprises a Doppler imaging display. Hemostasis enhancing agents may be introduced to the site for actuation by the ultrasound energy.

Apparatus for sealing a puncture communicating with a blood vessel includes a bioabsorbable sealing member secured to one end of a filament or other retaining member. The sealing member is delivered through the puncture into the vessel, and retracted against the wall of the vessel to provide temporary hemostasis. The sealing member is rapidly absorbed after exposure within the vessel, e.g., to an aqueous or heated physiological environment (e.g., exposure to blood or body temperature), immediately or shortly after completing a medical procedure via the puncture, e.g., within the time period that the patient is ambulatory optionally, extravascular sealing material is delivered into the puncture proximal to the sealing member. The retaining member and / or extravascular material may be bioabsorbable, being absorbed at a slower rate than the sealing member. Alternatively, the filament is removed from the puncture after hemostasis is established.

Disclosed herein are methods and systems for producing hemostasis, tissue closure, or vessel closure by inserting a thermal delivery probe into a passageway and emitting thermal energy from the probe to produce the hemostasis or tissue closure. These methods and systems may be used following a percutaneous medical procedure that creates a passageway in tissue of patient, such as is caused by introduction of an access device into the patient. The thermal delivery probe may have one or more ultrasound transducers positioned in an elongated shaft.

An apparatus for sealing a puncture extending through tissue to a blood vessel includes a guidewire including an expandable tamp, a retaining sheath for covering the tamp, and a delivery sheath including a primary lumen for receiving the guidewire therethrough and a secondary lumen for delivering sealing compound into the puncture. The guidewire is advanced into the puncture with the tamp in a contracted condition, the tamp is expanded within the vessel after retracting the retaining sheath, and the guidewire is retracted to seal the puncture from the vessel. The delivery sheath is advanced over the guidewire, and sealing compound is introduced into the puncture through the delivery sheath. After introducing the sealing compound, the delivery sheath is removed, and an introducer sheath is advanced over the guidewire to provide access to perform a medical procedure via the vessel after removing the guidewire.

A depth and puncture control system for a blood vessel hemostasis system includes a blood vessel puncture control tip which, when positioned in the lumen of a blood vessel, can inhibit the flow of blood out of the puncture site. When used together with a pledget delivery cannula and a pledget pusher, the control tip and the delivery catheter can both inhibit blood loss out the puncture site and inhibit the introduction of pledget material and tissue fragments into the blood vessel. The system also includes a handle which releasably connects together the control tip, pusher, and delivery cannula to permit limited longitudinal motion between the control tip and the delivery cannula, and between the pusher and the delivery cannula.

An apparatus to intervascularly promote hemostasis at a blood vessel puncture site with an inner lumen pressure and an outer lumen pressure has a flexible plug having a center, a top surface, and a bottom surface, and a release mechanism coupled to the center to position and release the flexible plug intervascularly at the blood vessel puncture site. The inner lumen pressure is greater than the outer lumen pressure to forceably secure the flexible plug around the blood vessel puncture site.

A clip device delivery apparatus for hemostasis has an introducer tube, such as an endoscope or sheath having a distal end portion and working channel receiving an operating wire detachably securing a clip device comprising tissue engaging arms and a sliding ring for closing the arms. A protective cap having a tube mounting section and a distal section having a receiving chamber define a passageway therebetween, the mounting section being mounted to the introducer tube distal end portion and the distal section receiving tissue and clip arms to close about tissue. The operating wire and clip device are inserted within the working channel. Methods of grasping tissue are provided using the introducer tube introduced endoscopically into a patient, tissue suctioned and clip arms deployed into tissue receiving chamber, sliding ring moved distally to close the clip arms about the tissue, and the clip detached from the operating wire.

A system and method for delivering a pledget of hemostasis promoting material to a blood vessel puncture to facilitate hemostasis, having an introducer sheath having an inner diameter and an outer diameter, a control tip coupled to the introducer sheath, and a self-expandable member disposed around a portion of the control tip to control blood flow at the blood vessel puncture.

A method of treating a perforator vein comprises applying ultrasound to the perforator vein and occluding the perforator vein with the ultrasound. An apparatus for treating blood vessels comprises an ultrasound emitter, wherein the ultrasound emitter is configured to emit ultrasound at multiple therapeutic ultrasound frequencies during a treatment cycle. The apparatus further comprises an acoustic coupler in sonic communication with the emitter, wherein the acoustic coupler has an acoustic coupling surface configured to contact a patient and facilitate delivery of ultrasound to the patient and wherein the acoustic coupler provides a conduction path for ultrasound from the emitter to the acoustic coupling surface. The apparatus further comprises an acoustic coupler containing a displaceable acoustic coupling material. The apparatus further comprises an acoustic coupler configured to vary the length of the conduction path in accordance with variation in the thickness of the acoustic coupling material disposed between the emitter and the acoustic coupling surface.

A hemostasis cannula unit including a valve housing, a cap, and a hemostasis valve, wherein the hemostasis valve includes a proximal valve gasket and a distal valve gasket compressed against the valve gasket by the valve housing, wherein the proximal valve gasket is the same shape as the distal valve gasket.