An injector apparatus comprises an elongate structure having one or more openings positionable near a penetrable barrier of an implantable device so as to receive fluid of the implantable device. The apparatus comprises a needle and a sheath extending over at least a portion of the needle. The elongate structure may comprise a distal tip to penetrate tissue and the penetrable barrier, and a distal opening near the tip to release therapeutic fluid into the implantable chamber. In many embodiments the distal tip, the distal opening, and the plurality of openings are separated from a stop that engages a tissue of the patient and limit penetration depth such that the distal opening and the plurality of openings are located along an axis of the implantable device to increase an efficiency of the exchange.

A barrier system is provided for use in reducing infections associated with post-operative surgical incision and/or a percutaneous medical device, such as a catheter, that is disposed within the surgical incision. Such a barrier system may include: a barrier device having a skin-contacting surface and a catheter-receiving surface; and an adhesive composition configured for adhering to skin, the barrier device, and/or the catheter so as to form a barrier at or adjacent to an incision in the skin where the catheter is percutaneously inserted through the skin. A tensioning anchor and associated system of two or more tensioning anchors is provided for post-operative wound closure. A method for applying and removing the barrier device and tensioning anchors is also provided.

Embodiments provide apparatus and methods for delivering liquid form medication within the body wherein the medication is stored in solid form and then mixed with a liquid in an apparatus implanted within the body. One embodiment provides an implantable apparatus for in vivo delivery of medication comprising a housing including a reservoir, a store of solid form medication (SSM) and a pump. An SSM element is added to the reservoir along with fluid to form a medication solution comprising at least one drug. The medication solution is then delivered to a delivery site using a pumping means to pump solution from the reservoir through a delivery member such as catheter to a delivery site. Embodiments of the invention are particularly useful for delivering medication to a patient to treat a medical condition over an extended period of time without requiring the patient to take external medication.

Embodiments provide apparatus and methods for delivering liquid form medication within the body wherein the medication is stored in solid form and then mixed with a liquid in an apparatus implanted within the body. One embodiment provides an implantable apparatus for in vivo delivery of medication comprising a housing including a reservoir, a store of solid form medication (SSM) and a pump. An SSM element is added to the reservoir along with fluid to form a medication solution comprising at least one drug. The medication solution is then delivered to a delivery site using a pumping means to pump solution from the reservoir through a delivery member such as catheter to a delivery site. Embodiments of the invention are particularly useful for delivering medication to a patient to treat a medical condition over an extended period of time without requiring the patient to take external medication.

An in-dwelling port for providing repeated entry to a body during and/or after an operation is described. The port may include an external portion secured to a body outside an incision and a collapsible insertion portion that is inserted through the incision. The collapsible portion collapses when no instrument or lumen is present to permit the body to return to substantially a normal profile around the incision.

A medical blood access system used for hemodialysis treatment to enable blood withdrawal for processing of blood by an external apparatus and return the same blood to a patient, comprising an interfacial fluid conduit between the machine and patient's blood supply which is repeatedly connectable along a guided pathway passing through epidermis and subcutaneous tissue via a naturally formed tissue tract to enter blood space, providing improved patient safely, convenience, effective prophylaxis, without bleeding or tissue trauma or pain, and is executable by the patient to precisely connect and disconnect with minimal disfigurement or life restrictions, and is useable on virtually all patients soon after placement and is robust and safe to high blood flow.

Various implementations include a system for coupling a needle to a port. The system includes a port and a needle. The port includes a reservoir and a lock box disposed within the cavity and defining a lock opening. The reservoir includes a membrane and a base coupled to the membrane, which together define a cavity. The reservoir is configured to be implanted under the skin of a person. The needle defines a lumen extending along a needle longitudinal axis. The needle includes a key disposed within the lumen. The key is movable from a first position to a second position. A portion of the key extends further in a radially outward direction in the second position than in the first position. A distal end of the needle is disposable within the lock opening such that the key is couplable to the lock box when in the second position.

An implantable device includes a low-profile housing having a cavity defined in a side thereof, and an element insertably removable with respect to the housing in a direction substantially parallel to a surgical plane of the implantable device. The element has a first portion adapted to be received in the housing cavity. The element further includes a second portion adapted to protrude from the housing upon insertion of the element into the housing cavity. The second portion includes at least one surface adapted for engagement with a surgical instrument for insertion and removal of the element with respect to the housing. A method for servicing the implantable device includes, at an incision proximate an implant location of the implantable device, insertably and removably accessing the element in a direction substantially parallel to a surgical plane of the implantable device.

An instrument advancement device may include a housing and an extension tube extending through the housing. A wedge may be disposed within the housing. The wedge may include an arc-shaped channel. A pair of opposing pinch members configured to pinch the extension tube may be disposed within the housing and configured to move along the extension tube. An instrument may extend through the arc-shaped channel. A first end of the instrument may be fixed. In response to moving the housing distally along the extension tube, the pair of opposing pinch members may push the wedge distally. In response to movement of the wedge distally a first distance, a second end of the instrument may be configured to advance distally a second distance. A support element or compressible element may be disposed within a lumen of the extension tube to support the instrument.

An implantable device includes a low-profile housing having a cavity defined in a side thereof, and an element insertably removable with respect to the housing in a direction substantially parallel to a surgical plane of the implantable device. The element has a first portion adapted to be received in the housing cavity. The element further includes a second portion adapted to protrude from the housing upon insertion of the element into the housing cavity. The second portion includes at least one surface adapted for engagement with a surgical instrument for insertion and removal of the element with respect to the housing. A method for servicing the implantable device includes, at an incision proximate an implant location of the implantable device, insertably and removably accessing the element in a direction substantially parallel to a surgical plane of the implantable device.