A laparoscopic staged hepatectomy using round-the-liver ligation is carried out includes: (1) a laparoscopic operation is performed with general anesthesia using round-the-liver ligation, the branches of the portal vein of the hemiliver are ligated, a tourniquet is used to tighten the connecting part between the right and left hemilivers to block the communicating blood flow between the hemiliver to be removed and the hemiliver to be reserved, a drainage tube is put into the peritoneal cavity, then close the peritoneal cavity; (2) the patient gradually resumes eating after the first operation, and recuperate to make the volume of the hemiliver increase to an expected volume; (3) after the hemiliver increases to the expected volume, a laparoscopic liver resection is carried out with general anesthesia to remove the diseased hemiliver, and then the patient is nursed to be completely recovered. An instrument for implementing the laparoscopic staged hepatectomy is also disclosed.

A system for closing a blood vessel includes a housing having a proximal end and a distal end and configured to be held in the hand of a user, an elongate body extending from the distal end of the housing, a distal housing having a proximal end coupled to a distal end of the elongate body and having a cavity including an opening on a side of the distal housing, a lumen passing through the elongate body and terminating at the cavity of the distal housing and configured to couple to a vacuum source, a sensor carried by the distal housing adjacent the cavity and configured for identifying a blood vessel, wherein the lumen is configured to maintain a vacuum within the cavity when a probe having a vessel closure module is inserted within the lumen and the vessel closure module is within the cavity.

A method for closure of the left atrial appendage (LAA), including: placing an LAA reshaper in contact with an LAA wall or near the LAA wall; invaginating at least a portion of the LAA into the left atrium (LA); reshaping by the LAA reshaper the LAA during the invagination; fastening the invaginated at least a portion of said LAA; and retracting the LAA reshaper from the LAA

A medical device may include an implantable device for treating a body tissue structure. The implantable device may include a plurality of bodies spaced from adjacent bodies and arranged so as to be configured to extend around an exterior surface of a body tissue structure. The bodies may be configured to apply a static force to the body tissue in a relaxed state and may adjust or move in response to a radially outward force above a threshold level that is acting on one or more of the bodies. The bodies may be pliable and/or made with a pliable material. The bodies may be interconnected via interconnecting regions. One or more of the bodies may be configured to articulate so as to conform to movement of a body tissue structure. A skeletal component may or may not extend through one or more of the plurality of bodies.

A system for closing a blood vessel includes a housing having a proximal end and a distal end and configured to be held in the hand of a user, an elongate body extending from the distal end of the housing, a distal housing having a proximal end coupled to a distal end of the elongate body and having a cavity including an opening on a side of the distal housing, a lumen passing through the elongate body and terminating at the cavity of the distal housing and configured to couple to a vacuum source, a sensor carried by the distal housing adjacent the cavity and configured for identifying a blood vessel, wherein the lumen is configured to maintain a vacuum within the cavity when a probe having a vessel closure module is inserted within the lumen and the vessel closure module is within the cavity.

Disclosed are embodiments of a method for occluding a left atrial appendage (LAA) and other cavities or openings within a body. Some embodiments of the method can include an implant configured to be deployed within the LAA or other cavity, configured to be expanded or moved against a wall portion of the LAA or other cavity, and configured to twist at least a portion of the LAA or other cavity when the implant is rotated. Thereafter, one or more securing elements, staples, sutures, or other fasteners can be implanted in the gathered tissue to hold the tissue in the gathered state, thereby occluding the opening of the LAA or other cavity. In some embodiments, the opening of the LAA or other cavity can be occluded by elongating or otherwise reshaping the opening using an implant device, and securing the opening in the occluded state.

Disclosed are apparatus and method for forming passage extending along a plane crossing an organ's volumetric region from an entry point to an opposing exit point at a surface of the organ, and for passing a tension member around the volumetric region by pulling the tension member from the exit point to the entry point through the passage. The apparatus can include a rigid outer tube with a tip for penetrating the organ and reach a penetration depth; an inner needle with elastic body configured to pass straightened through outer tube lumen and to partially protrude and voluntarily flex to a curved form greater than the diameter of the volumetric region; and a tension member passer with a pulling portion for engaging with portion of tension member and for pulling the tension member when withdrawn.

A device includes a housing having a first opening for receiving tissue therein and a distal head disposed at least partly within the housing. The distal head is configured to rotate about a longitudinal axis of the distal head. The device also includes a first holding member coupled to the housing and a second holding member coupled to the distal head. The first and second holding members are configured so that rotating the distal head stretches a first ligation band coupled to the first and second holding members, permitting tissue drawn into the first opening to pass through an opening of the first ligation band.

Apparatus and methods are provided for occluding blood vessels and other anatomical structures. Occlusion devices are delivered percutaneously and extraluminally through a small gauge needle and include expandable elements that are deployable on opposite sides of a target vessel to be occluded. When positioned about the vessel the elements are expanded and brought together to compress and occlude the vessel. Embodiments include those adapted for temporary as well as permanent use.

Methods are disclosed for dissecting a mucosa and a submucosa from a muscularis propria from a region of an esophagus of a subject. These methods include injecting submucosally into the esophagus of the subject a pharmaceutical composition comprising an extracellular matrix (ECM) hydrogel to form a cushion between the submucosa and the underlying muscularis propria at the region of the esophagus, wherein the ECM hydrogel has the following characteristics: a) a time to 50% gelation of less than 30 minutes at a temperature of about 37° C.; b) a flow viscosity suitable for infusion into the esophagus; and c) a stiffness of about 10 to about 400 Pascal (Pa). The ECM hydrogel is not a urinary bladder ECM hydrogel.