Abstract: Instrumentation for transoral treatment of gastroesophageal reflux disease (GERD) are disclosed. In a preferred embodiment, an instrument includes a remotely operable invagination device for atraumatically approximating the lower esophagus and fundus of the stomach and for invaginating the gastroesophageal junction into the stomach thereby involuting the surrounding fundic wall. The same or a separate instrument includes a remotely operable surgical fastening instrument for fastening together the invaginated lower esophagus and fundic wall. A method of surgically treating GERD is also disclosed.

Abstract: A golf putter is disclosed which includes an elongate shaft defining a shaft axis, and opposed proximal and distal end portions, and a putter head associated with the distal end portion of the shaft. The putter head defines a body having a center of mass located therein, an external striking face spaced from the center of mass, and a center of effort located at the striking face. The center of effort is in axial alignment with the center of mass to define an axis of effort extending through the body. The distal end portion of the shaft extends substantially through the body such that the shaft axis intersects the axis of effort at a location forward of said center of mass and proximate the striking face, such that the putter head is equally balanced about the center of effort.

Abstract: An anvil is disclosed for utilization in conjunction with a surgical stapling instrument configured to apply rows of staples to body tissue. The anvil is provided with graduations to delineate the boundaries of the staple forming area defined thereby, as well as to delineate the range through which a fastener driving assembly and optional knife blade translate during a stapling operation.

Abstract: A surgical stapling or fastening instrument for applying surgical fasteners to tissue having an adjustable closure mechanism to linearly approximate the distance between the jaw members of the instrument. The adjustable closure mechanism consists of a retaining mechanism and a linkage structure which is actuable to linearly urge the jaw members towards each other. A coupling arrangement is also provided which permits firing of the staples or fasteners only when the jaw members are approximated a predetermined distance towards each other.

Abstract: A piercing tip for penetrating body tissue is provided which includes a conical body and a triangular cutting blade positioned within a slot formed in the conical body. The cutting blade includes a proximal mounting flange which extends outwardly from the conical body and is configured for mounting at the distal end of an obturator of a trocar assembly.

Abstract: A surgical stapler for placing lateral lines of staples and making an incision, all through an endoscopic tube, includes an anvil member which is mounted to the distal end of an elongated housing. A tubular collar disposed around the arm of the anvil member is movable to a distal position to bias the anvil member and a cartridge assembly into cooperative alignment, thereby clamping body tissue to be fastened between the anvil member and cartridge assembly.

Abstract: An endoscopic or laparoscopic surgical instrument for applying fasteners to bodily tissue is disclosed. The instrument includes a handle assembly, an endoscopic portion and a jaw portion. The instrument is configured and dimensioned to be insertable through a cannula, and is useful for applying a purse string to bodily tissue.

Abstract: An endoscopic ligating and dividing instrument includes an endoscopic portion and a non-endoscopic portion. The endoscopic portion includes clip closing jaws for applying at least two surgical clips to body tissue, pusher rods for loading clips into the jaws, a movable hook to catch and position the body tissue, and a knife for dividing the body tissue between the surgical clips. The non-endoscopic portion includes actuators responsive to manual actuation by a user.

Abstract: A surgical instrument is provided for use in endoscopic or laparoscopic procedures. The instrument includes a handle portion, an endoscopic portion extending from the handle portion, an articulating section pivotably connected to a distal end portion of the endoscopic portion, and a retractor assembly operatively associated with the articulating section. Structure is provided for manipulating the articulating section relative to the longitudinal axis of the endoscopic portion within an angular degree of rotation. An injection port may also be provided to deliver fluids through the endoscopic portion to the operative site.

Abstract: A surgical stapling or fastening instrument for applying surgical fasteners to tissue having an adjustable closure mechanism to linearly approximate the distance between the jaw members of the instrument. The adjustable closure mechanism consists of an advancing mechanism and a retaining mechanism which is actuable to urge the jaw members towards each other. A coupling arrangement is also provided which permits firing of the staples or fasteners only when the jaw members are approximated a predetermined distance from each other.

Abstract: An endoscopic surgical instrument having a handle assembly, a body portion, and a tool mechanism in which a pivoting handle pivots about a stationary handle to open and close the tool mechanism. The instrument includes a rotatable body portion, in which a rotation knob is provided on the instrument at the stationary handle so that the user may rotate the body portion, and consequently the tool mechanism, using a single hand. Furthermore, an electrocautery connection is provided which is positioned out of the line of sight of the surgeon, so that the surgeon may have an unobstructed view to the surgical site. The pivoting handle is provided with a rotatable connection point for connecting the slidable rod member to essentially eliminate radial deflection of the rod within the outer tube during opening and closing of the handles. The tool mechanism may include grasping jaws having rounded, interdigitating teeth for grasping and securely holding tissue or organs for removal through a cannula.

Abstract: The present invention relates to anvils for surgical fastener applicators having a fastener forming surface for forming surgical fasteners, an intermediate surface formed of a metallic alloy disposed on at least a portion of the fastener forming surface and a polytetrafluorethylene coating disposed on the intermediate surface. The polytetrafluorethylene coating is provided to reduce the force necessary to form the fasteners.

Abstract: An apparatus for stapling the plaque lining of an artery or vein to the wall of the artery or vein, which comprises first and second opposed cooperative elongated members pivotably associated with one another. The first and second elongated members have distal ends, and proximal ends forming handles. The first elongated member forms an anvil portion at its distal end which is configured for placement into an open end of a vein and/or an artery. A staple cartridge assembly is disposed on the distal end of the second elongated member and includes a staple magazine containing a multiplicity of staples longitudinally and sequentially aligned with the staple magazine. Actuating means are provided which are supported by the staple cartridge assembly for movement in a given direction therealong to drive the staples in the staple magazine toward a staple exit end.

Abstract: A surgical apparatus is disclosed for attaching adjacent end portions of cutaneous body tissue wherein a pair of opposed jaws have means for moving the jaws toward and away from each other. Body tissue engaging means in the form of sharp tip members extend from each jaw and toward the other so as to engage the opposed portions of cutaneous tissue when the jaws are positioned thereagainst and moved toward each other. The jaws and the tips are arranged to cause the cutaneous tissue to assume an irregular shape at the interface whereby an elongated rod-like member, preferably rectangular in cross section, may be directed generally medially of the interface of the tissue to attach the opposed portions to thereby permit healing. The elongated member may have indentations to improve retention within the tissue. A tapered distal end of the elongated member has a pointed tip to facilitate penetration into the tissue.

Abstract: An apparatus is disclosed for endoscopic application of surgical staples for fastening body tissue, especially vascular tissue. The apparatus includes a frame and an elongated endoscopic section connected to the frame and extending distally therefrom. A staple storage cartridge cooperates with the distal end of the endoscopic section and is selectively pivotal by the user. A staple firing mechanism advances an individual staple against an anvil for staple closure. Means are provided to prevent incomplete staple firing. Relative motion between the staple cartridge and the anvil clamps tissue to be stapled therebetween.The endoscopic section may be adapted for rotation about the longitudinal axis of the apparatus. Gaseous seal means located in the endoscopic section prevent escape of insufflating gas through the apparatus.

Abstract: A surgical stapler for placing lateral lines of staples and making an incision, all through an endoscopic tube, includes an anvil member which is mounted to the distal end of an elongated housing. A tubular collar disposed around the arm of the anvil member is movable to a distal position to bias the anvil member and a cartridge assembly into cooperative alignment, thereby clamping body tissue to be fastened between the anvil member and cartridge assembly.

Abstract: A self-contained powered surgical clip applier is provided which includes an elongate body defining a longitudinal axis and housing a plurality of surgical clips. The powered clip applier further includes a jaw assembly operatively associated with a distal end of the elongate body and actuable to move between an open position and a closed position, a motor assembly disposed within the elongate body, a power supply positioned within the elongate body for energizing the motor assembly, a clip pusher configured to individually advance surgical clips into the jaw assembly, and an actuation channel driven by the motor assembly and configured to translate through the elongate body to drive the clip pusher and actuate the jaw assembly.

Abstract: A surgical instrument for sizing the lumen of an organ is provided. The lumen sizer comprises a handle member with a projection at either end. Each projection has a substantially cylindrical sizing portion of different diameter, each diameter corresponding to the working range of a surgical instrument to be used on the organ or to the diameter of a prosthetic device to be attached to the organ. Tapered insertion regions having atraumatic tips extend from each of the substantially cylindrical sizing portions. The surgical instrument provides a fast and simple technique for measuring the lumen of an organ.

Abstract: An apparatus for applying a suture clip to a suture includes (a) an endoscopic portion having at least one slot to position a suture transversely to the longitudinal axis of the endoscopic portion, a camming surface for closing a clip onto a suture positioned within the suture receiving means, a pusher for advancing a suture clip into the camming surface, and a tubular housing; and (b) a handle portion including a handle portion housing, and an actuation mechanism for actuating the pusher.

Abstract: An umbilical cord clip and applicator is disclosed for clamping a maternal side of an umbilical cord, applying an umbilical cord clip to a fetal side of the umbilical cord and severing the cord intermediate the clamped maternal and fetal sides of the umbilical cord. The applicator includes a first arm having a first clamping surface, a second arm movably affixed to the first arm and having a second clamping surface and structure associated with at least one the first and second arms for mounting an umbilical cord clip thereon. The applicator also includes a recessed severing mechanism operatively associated with the first and second arms and disposed intermediate the first and second clamping surfaces and the mounting structure. The severing mechanism is automatically actuable upon closure of the first and second arms about an umbilical cord to sever the cord at a location between the first and second clamping surfaces and the clip.