Endoluminal surgical delivery system

1. A system for delivering a staple to a locus of an artery comprising

a. a delivery conduit insertable within the lumen of an artery, through which delivery conduit a staple can be delivered to the locus, wherein the delivery conduit has a distal end flexibly connected to a proximal section of the delivery conduit, whereby the distal end of the delivery conduit may be oriented at an angle with respect to the proximal section of the delivery conduit;

b. an elongated insertion element insertable within the lumen of an artery alongside the delivery conduit, the insertion element:

(1) having an at least substantially inexpandable diameter, and

(2) having an insertion element joinder location pivotally coupled to the delivery conduit at a delivery conduit joinder location at or adjacent the distal end of the delivery conduit, the pivotal coupling:

(a) fixing the insertion element joinder location and the delivery conduit joinder location at an at least substantially constant distance between each other, and

(b) being defined by a flexible tether extending between the insertion element joinder location and the delivery conduit joinder location, the flexible tether extending about and/or into one or both of the insertion element and the delivery conduit,

wherein:

i. the insertion element has an outer circumference extending alongside and exterior to an outer circumference of the delivery conduit at the pivotal coupling, and for lengths extending proximally and distally therefrom, and

ii. the outer circumference of the delivery conduit extends alongside and exterior to the outer circumference of the insertion element at the pivotal coupling;

whereby advancing the proximal section of the delivery conduit toward the distal end of the delivery conduit causes bending of the delivery conduit such that the angle of the distal end of the delivery conduit changes.

2. The system of claim 1 wherein the insertion element is defined by:

a. a guide wire, or

b. a catheter through which a guide wire extends.

3. The system of claim 1 wherein the insertion element includes an inflatable balloon thereon.

4. The system of claim 3 wherein the inflatable balloon is situated between the insertion element and the delivery conduit.

5. The system of claim 4 wherein the distal end of the delivery conduit is situated closer to the insertion element than the balloon when the balloon is inflated.

6. The system of claim 4 wherein:

a. the insertion element has:

(1) a balloon side, the balloon side being adjacent the balloon, and

(2) a stapling side,

along the length of the insertion element;

b. the distal end of the delivery conduit is axially directed toward the stapling side when the balloon is inflated.

7. The system of claim 1 wherein:

a. the insertion element is a catheter mounted on a guide wire, and

b. the insertion element bears an inflatable balloon.

8. The system of claim 1 wherein a distal end of the insertion element extends longitudinally beyond the distal end of the delivery conduit.

9. A system for delivering a staple to a locus of an artery, the system including:

a. a delivery conduit insertable within the lumen of an artery, wherein the delivery conduit includes:

(1) a proximal delivery conduit section,

(2) a distal delivery conduit section terminating in a distal delivery conduit end, the distal delivery conduit section being flexibly joined to the proximal delivery conduit section such that the distal delivery conduit end may be oriented at an angle with respect to the proximal delivery conduit section,

(3) an outer delivery conduit surface extending along the proximal and distal delivery conduit sections, and

(4) an inner passage through which a staple can be delivered to the locus;

b. an elongated insertion element having an outer insertion element surface extending alongside the outer delivery conduit surface and being joined thereto at a joinder location at or adjacent the distal end of the delivery conduit, with:

(1) the outer insertion element surface and the outer delivery conduit surface being pivotally fixed together by a flexible filament at the joinder location, and

(2) a distal end of the elongated insertion element:

(a) extending longitudinally beyond the distal end of the delivery conduit, and

(b) having an at least substantially inexpandable diameter,

whereby advancing the proximal section of the delivery conduit toward the distal end of the delivery conduit causes bending of the delivery conduit such that the angle of the distal end of the delivery conduit changes.

10. The system of claim 9 wherein the flexible filament extends about and/or into one or both of the insertion element and the delivery conduit.

11. The system of claim 9 wherein the delivery conduit and insertion element extend alongside and exterior to each other at the joinder location, and for a length extending proximally thereto.

12. The system of claim 9 wherein the insertion element is defined by:

a. a guide wire, or

b. a catheter through which a guide wire extends.

13. The system of claim 9 wherein the insertion element includes an inflatable balloon thereon.

14. The system of claim 13 wherein the inflatable balloon is situated between the insertion element and the delivery conduit.

15. The system of claim 14 wherein the distal end of the delivery conduit is situated closer to the insertion element than the balloon when the balloon is inflated.

16. The system of claim 14 wherein:

a. the insertion element has:

(1) a balloon side, the balloon side being adjacent the balloon, and

(2) a stapling side,

along the length of the insertion element;

b. the distal end of the delivery conduit is axially directed toward the stapling side when the balloon is inflated.

17. The system of claim 9 wherein:

a. the insertion element is a catheter mounted on a guide wire, and

b. the insertion element bears an inflatable balloon.

18. A system for delivering a staple to a locus of an artery, the system including:

a. a delivery conduit insertable within the lumen of an artery, wherein the delivery conduit includes:

(1) a proximal delivery conduit section,

(2) a distal delivery conduit section terminating in a distal delivery conduit end, the distal delivery conduit section being flexibly joined to the proximal delivery conduit such that the distal delivery conduit end may be oriented at an angle with respect to the proximal delivery conduit section,

(3) an outer delivery conduit surface extending along the proximal and distal delivery conduit sections, and

(4) an inner passage through which a staple can be delivered to the locus;

b. an elongated insertion element having an outer insertion element surface extending alongside the outer delivery conduit surface and being joined thereto by a flexible tether at a joinder location at or adjacent the distal end of the delivery conduit, with:

(1) the outer insertion element surface and the outer delivery conduit surface being pivotally fixed together at the joinder location, and

(2) a distal end of the elongated insertion element:

(a) extending longitudinally beyond the distal end of the delivery conduit, and

(b) having an at least substantially inexpandable diameter,

wherein:

i. the insertion element has an outer circumference extending alongside and exterior to an outer circumference of the delivery conduit at the pivotal coupling, and

ii. the outer circumference of the delivery conduit extends alongside and exterior to the outer circumference of the insertion element at the pivotal coupling;

whereby advancing the proximal section of the delivery conduit toward the distal end of the delivery conduit causes bending of the delivery conduit such that the angle of the distal end of the delivery conduit changes.

19. The system of claim 18 wherein the flexible tether extends about and/or into one or both of the insertion element and the delivery conduit.

20. The system of claim 18 wherein the insertion element is defined by:

a. a guide wire, or

b. a catheter through which a guide wire extends.

21. The system of claim 18 wherein the insertion element includes an inflatable balloon thereon.

22. The system of claim 21 wherein the inflatable balloon is situated between the insertion element and the delivery conduit.

23. The system of claim 21 wherein the distal end of the delivery conduit is situated closer to the insertion element than the balloon when the balloon is inflated.

24. The system of claim 21 wherein:

a. the insertion element has:

(1) a balloon side, the balloon side being adjacent the balloon, and

(2) a stapling side,

along the length of the insertion element;

b. the distal end of the delivery conduit is axially directed toward the stapling side when the balloon is inflated.

25. The system of claim 18 wherein:

a. the insertion element is a catheter mounted on a guide wire, and

b. the insertion element bears an inflatable balloon.