Abstract: A surgical stapler is provided having a cartridge arm for holding staples, an anvil pivotally connected thereto to deform fired staples from the cartridge arm, and a support for substantially preventing anvil deflection during staple firing to help insure proper staple formation. Some supports allow pivoting between the anvil and cartridge arm when in a first position, but prevent or hinder the pivoting action when in a second position. Supports can also be adapted to contact the anvil at a distal position relative to the pivot point between the anvil and cartridge arm. Exemplary structures of supports embodied as one or more links or as a sleeve are described. Methods of use are also discussed.

Abstract: An anchorable cannula adapted for positioning within an opening formed in tissue includes a cannula body having a proximal portion and distal portion. The proximal portion and the distal portion are linked by a circumferential ring positioned therebetween. The proximal portion includes a series of foldable arms extending upwardly from the circumferential ring and ending at a circumferential seal ring formed at a free end of the proximal portion. The distal portion includes a series of foldable arms extending downwardly from the circumferential ring and ending at a circumferential seal ring formed at a free end of the distal portion.

Abstract: An endoscopic gastric reduction apparatus adapted for applying a series of pledgets to anterior and posterior gastric walls for the creation of a mattress stitch suture within the stomach includes an applier having a distal end and a proximal end. The applier is secured at a distal end of a support shaft shaped and dimensioned for passage down the esophagus and into the stomach. The applier includes an applier body having a suction slot shaped and dimensioned for receiving tissue therein for the application of at least one pledget housed within the suction slot for selective coupling with tissue suctioned within the suction slot.

Abstract: A transgastric instrument provides a sterile and repeatable pathway to and through a gastric wall for the purpose of facilitating endoscopic transgastric procedures. The instrument includes at least one guide tube having a proximal end and a distal end, the distal end being shaped and dimensioned for positioning adjacent a desired location along the gastric wall. The instrument also includes a fixation mechanism at the distal end of the guide tube for selectively securing the distal end of the guide tube at a desired location along the gastric wall. An otomy creation device circumferentially smaller than the guide tube extends through the guide tube, the otomy creation device including a distal end shaped and dimensioned for cutting and dilating the gastric wall.

Abstract: A gastric reduction apparatus provides for the secure attachment of multiple fasteners into the gastric wall, the fasteners being linked with a flexible member in a manner permitting the reduction of the effective size of an individual's stomach. The apparatus includes an applicator head including a proximal end and a distal end. The applicator head of the gastric reduction apparatus includes a cavity shaped and dimensioned for receiving tissue. A fastener attachment mechanism is positioned within the cavity for access to tissue that is pulled within the cavity and the fastener attachment mechanism includes a plurality of fasteners.

Abstract: Methods and devices are disclosed for providing access through tissue to a surgical site, such as anatomical cavities ranging in size from the abdomen to small blood vessels, such as veins and arteries, epidural, pleural and subarachnoid spaces, heart ventricles, as well as spinal and synovial cavities. In one exemplary embodiment, an access port is provided having one or more electrically expandable and contractible actuators that are adapted to change an orientation of the access port.

Abstract: Methods and devices are provided for traversing a lumen of a tubular body part, such as the large or small intestine, the colon, the bladder, the stomach, etc. In an exemplary embodiment, the methods and devices utilize electroactive polymers that are selectively actuated to move a device through a lumen.

Abstract: Embodiments of the present invention generally provide methods and devices for providing percutaneous access to a tissue. In one exemplary embodiment, a PEG tube is provided having an elongate member with a proximal end adapted to be positioned adjacent to a tissue surface, a distal end adapted to be inserted through tissue, and an inner lumen extending between the proximal and distal ends and adapted to allow fluid flow there through. The PEG tube can also include an electrically actuatable element coupled to the distal end of the elongate member and configured to change dimensionally upon delivery of electrical energy thereto. In use, the electrically actuatable element can be adapted to expand to engage tissue and secure the distal end of the PEG tube to the tissue.

Abstract: A method for gastric reduction surgery includes the step of applying at least one clamp to the stomach in a manner forming a gastric pouch. The clamp includes a clamp body shaped and dimensioned to create a gastric pouch with a standard size from approximately 15 cc to approximately 30 cc.

Abstract: An articulating endoscopic instrument is adapted for properly orienting the stomach for cutting and stapling in an efficient manner. The instrument includes a body member having a first end and a second end, a plurality of suction holes along the body member in fluid communication with a suction inlet at the first end of the body member for the creation of suction along the body member and an articulating joint positioned along the body member. A method for gastric reduction surgery is achieved by inserting an articulating endoscopic instrument within the stomach and articulating the articulating endoscopic instrument to generally assume the shape of the relaxed stomach, applying suction through the articulating endoscopic instrument to draw the stomach tissue into contact with the articulating endoscopic instrument, articulating the articulating endoscopic instrument to a desired orientation and completing the gastric reduction surgery.

Abstract: A fastener is used during endoscopic procedures in which a suture is used in creating a predefined pouch through tissue apposition within the stomach. The fastener includes a fastener body having a tissue anchor for selectively securing the fastener body to tissue. The fastener body also includes a connection aperture shaped and dimensioned for passage of a suture therethrough.

Abstract: A gastric reduction apparatus endoscopically draws stomach walls into apposition. The apparatus includes an applicator body having a proximal end and a distal end. The applicator body also includes a suction slot shaped and dimensioned for housing a corkscrew anchor. A firing mechanism is associated with the corkscrew anchor for rotation of the corkscrew anchor in a manner causing the corkscrew anchor to penetrate and engage tissue brought adjacent the suction slot. A method for gastric reduction is achieved by introducing a gastric reduction apparatus as disclosed above within the stomach of an individual, applying the corkscrew anchor to a stomach wall and drawing stomach walls together to create a cavity within the stomach.

Abstract: A gastric reduction apparatus that facilitates the creation of a transoral linear passageway through the stomach includes an elongated body including a proximal end and a distal end. The elongated body is generally sinusoidal shaped with at least one tissue engaging surface oriented such that a needle will pass therethrough. The elongated body also includes at least one needle passing channel respectively formed adjacent the at least one tissue engaging surface. The at least one needle passing channel generally passes through the center of the sinusoidal waveforms defined by the at least one tissue engaging surface such that a needle will pass entirely through stomach tissue contacting the tissue engaging surface of the elongated body. The elongated body further includes a suture passing channel.

Abstract: Methods and devices are provided for remotely adjusting a size of a gastric band disposed around a patient's stomach. In one exemplary embodiment, a gastric band is provided having a first end and a second end that mate to one another to encircle a stomach. A latch mechanism can be formed on the band, and at least one actuator can be coupled to the latch mechanism and it can be adapted to expand and contract the latch mechanism when energy is applied thereto to adjust a diameter of the band. In one exemplary embodiment, the actuator(s) is an electroactive polymer actuator.

Abstract: Methods and devices for positioning tissues in apposition to each other are provided. In one exemplary embodiment, a tissue apposition device is provided having a flexible shaft with at least one expandable element coupled thereto, and a positioning element adapted to axially move the expandable element relative to the elongate shaft to move tissue engaged by the expandable element. In an exemplary embodiment, at least one of the positioning element and the expandable element(s) is formed from an electroactive polymer.

Abstract: Various methods and devices for deploying a stent a lumen are provided. In one exemplary embodiment, the stent deployment device can include an elongate shaft having at least one actuator coupled thereto and adapted to radially expand upon delivery of energy thereto. The device can also include a retractable sheath disposed therearound and adapted to maintain the stent on the actuator during deployment of the device.

Abstract: Methods and devices for pumping fluid are disclosed herein. In one exemplary embodiment, a pump is provided having a first member with a passageway formed therethrough, and a plurality of electrically expandable actuators in communication with the first member and adapted to change shape upon the application of energy thereto such that sequential activation of the activators can create a pumping action to move fluid through the first member.

Abstract: Various methods and devices for dilating strictures in a lumen are provided. In an exemplary embodiment, a stricture dilation device is provided having an elongate shaft with at least one electrically expandable actuator coupled thereto and adapted to radially expand to dilate a stricture in a lumen.

Abstract: A surgical tool or applier operable to deploy an anastomotic ring comprises a handle connected to an elongate shaft. The elongate shaft comprises an anastomotic ring deployment mechanism on a distal portion of the shaft. The ring deployment mechanism is moveable from an unactuated position to an actuated position. The elongate shaft comprises a rigid, curved member, thereby rendering the tool applicable for colorectal applications. In one embodiment, the tool comprises an actuating mechanism that is operable to transfer an actuating force to the ring deployment mechanism via a flexible connecting member.

Abstract: A surgical instrument for deploying an anastomotic ring device has a ring deployment mechanism, which is configured to receive and deploy an anastomotic ring. The instrument further comprises a flexible elongate shaft having one or more actuation cables extending therethrough. The shaft also has an imaging element, which is coupled to a camera with a lens located in the tip of the instrument. The instrument may be inserted through the esophagus of a patient to deploy an anastomotic ring device.