Abstract: Novel mesh implant positioning systems for use in laparoscopic body wall defect repairs, such as hernia defects, are disclosed. The systems utilize one or more bar members combined with surgical sutures and needles to position a mesh implant adjacent to a body wall defect without the need for stay sutures. Also disclosed are assemblies of the positioning systems with surgical mesh repair implants, and methods of repairing body wall defects such as hernias with the assemblies.

Abstract: An applicator instrument for dispensing surgical fasteners includes a handle and an articulating shaft extending from the handle including proximal and distal shaft sections and an articulating joint interconnecting the proximal and distal shaft sections. The proximal shaft section has a proximal outer tube and a proximal inner member, and the distal shaft section includes a distal outer tube and a distal inner member. An incompressible member interconnects the proximal and distal inner members to form an inner shaft member having a fixed length. Distal movement of the proximal outer tube relative to the proximal inner member articulates the distal shaft section relative to the proximal shaft section via the articulating joint. As the articulating shaft moves between a straight configuration and an articulated configuration the distance between a distal-most end of the distal outer tube and the handle changes while the length of the inner shaft member remains fixed.

Abstract: An adjunct material for use with an end effector in a surgical instrument is provided that has at least one projection configured to mate with a corresponding recess formed in at least one jaw, such as a cartridge or anvil, of the end effector. The at least one projection can be one or more discrete projections or longitudinal projection(s) extending between distal and proximal ends of the adjunct material. An applicator member can be used to apply force to the adjunct material to thus cause the adjunct material to mate with the jaw of the end effector. The applicator member can be configured told the adjunct material and can be clamped between the jaws of the end effector to release the adjunct material onto the jaw. Also, an applicator member can be used to push portions of an adjunct material into corresponding recesses in a jaw.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing having an actuator, a shaft extending from the housing, and an end cap secured to a distal end of the shaft. The end cap has a bottom side, a top side, a lower distal edge adjacent the bottom side, and an end face that slopes upwardly and proximally from the lower distal edge to the top side of the end cap. A surgical fastener delivery window is formed in the sloping distal end face of the cap for dispensing surgical fasteners. The sloping distal end face extends continuously around the outer perimeter of the surgical fastener delivery window. The cap includes a plurality of gripping posts projecting distally from the sloping distal end face of the distal end cap. The posts are inserted into the pores of a surgical mesh for controlling movement of the mesh.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing, an elongated shaft having a proximal shaft section and an articulating distal shaft section extending from the housing, a firing system disposed within the housing, an actuator that is engageable for commencing a firing cycle of the firing system, and an articulation lever provided on the housing for selectively articulating the articulating distal shaft section of the elongated shaft. The applicator instrument includes a cam plate disposed within the housing that is linked with the articulating distal shaft section and that coupled with the articulation lever for being rotated by the articulation lever between a first or horizontal position for straightening the articulating distal shaft section and a second or vertical position for articulating the articulating distal shaft section.

Abstract: An applicator instrument for dispensing surgical fasteners includes an elongated shaft, a housing connected with the elongated shaft, a trigger, a gear train, and a firing system disposed in the housing. The trigger is squeezed for commencing a firing cycle. The firing system includes a storage reel, a spool connected to the storage reel, a drive wheel located distal to the storage reel and the spool, a constant torque spring having a proximal end connected to the spool and a distal end connected to the drive wheel, and a flexible member in contact with the drive wheel. The flexible member has a proximal end connected to the storage reel and a length configured to be driven by the drive wheel toward the distal end of the elongated shaft.

Abstract: An applicator instrument having a reconfigurable handle for dispensing surgical fasteners includes a housing having a proximal end and a distal end, an elongated shaft extending from the housing, a handle coupled with the proximal end of the housing, and a trigger coupled with the handle. The applicator instrument has a firing system including an energy storing assembly that is disposed within the housing, and a gear train disposed within the handle and coupled with the trigger. The trigger is squeezed for commencing a firing cycle and storing energy in the energy storing assembly. The applicator instrument includes a handle reconfiguration actuator having a first position for locking the handle in place relative to the housing and a second position for enabling the handle to rotate relative to the housing between a pistol configuration and an in-line configuration.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing, an elongated shaft, and an elongated conduit extending through the elongated shaft. A firing system is disposed within the housing. The firing system has an insertion tool having a top surface that extends proximal and distal ends thereof and a stripper ramp that projects above the top surface. An actuator activates the firing system to commence a firing cycle. During the firing cycle, the firing system drives the insertion tool toward the distal end of the elongated shaft. The elongated conduit has a top wall with a top notch formed therein. The stripper ramp slides through the top notch for guiding movement of the insertion tool as the firing system drives the insertion tool toward the distal end of the elongated shaft.

Abstract: A surgical fastener includes a first leg having a first distal barb and a first proximal barb that extend inwardly, and a second leg having a second distal barb and a second proximal barb that extend inwardly. A bridge interconnects proximal ends of the first and second legs. A first distance between opposing inner tips of the first and second distal barbs is greater than a second distance between opposing inner tips of the first and second proximal barbs. The first leg tapers inwardly between the proximal and distal ends thereof and has a cross-sectional area that is greater at the proximal end than at the distal end. The second leg tapers inwardly between the proximal and distal ends thereof and has a cross-sectional area that is greater at the proximal end than at the distal end. An insertion tool engages a crown on the proximal side of the bridge.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing having a cartridge opening, an elongated shaft extending from the housing, and a cartridge insertable into the cartridge opening, the cartridge having a plurality of surgical fasteners pre-loaded into the cartridge. The applicator instrument has a firing system disposed within the housing, and an actuator for activating the firing system to commence a firing cycle for removing one of the surgical fasteners from the cartridge and driving the removed surgical fastener from the housing to a distal end of the elongated shaft. In one embodiment, the cartridge includes a cartridge body having an upper end and a lower end insertable into the cartridge opening. The surgical fasteners are arrayed in a stack that extends between the upper and lower ends of the cartridge body.

Abstract: A method of dispensing surgical fasteners includes providing an applicator instrument having a housing with a cartridge opening, an elongated shaft extending from the housing, a firing system disposed within the housing for dispensing surgical fasteners, and an actuator for activating the firing system. The method includes forming a surgical opening in tissue, inserting a distal end of the elongated shaft into the surgical opening, inserting a cartridge containing a plurality of first surgical fasteners into the cartridge opening, and engaging the actuator for dispensing one of the first surgical fasteners from the distal end of the elongated shaft.

Abstract: An applicator instrument for dispensing surgical fasteners includes an elongated shaft having a proximal shaft section and a distal shaft section. The proximal shaft section includes an outer sheath and the distal shaft section includes a segmented member moveable between straight and articulated configurations. A handle is secured to the proximal shaft section, and an actuator is provided on the handle that is coupled with the outer sheath. An articulation band is disposed within the outer sheath and extends from the handle to the segmented member. The articulation band has a proximal end coupled with the actuator and a distal end attached to the segmented member. The actuator is moveable in a first direction for retracting the outer sheath, exposing the segmented member, and applying tension to the articulation band for moving the segmented member into the articulated configuration.

Abstract: A novel single plane tissue repair patch is disclosed. The patch has a base member with an opening therethrough, and a closure member associated with the opening. The mesh may be used in open surgical procedures for hernia repairs and other repairs of body wall defects.

Abstract: Novel mesh implant positioning systems for use in laparoscopic body wall defect repairs, such as hernia defects, are disclosed. The systems utilize one or more bar members combined with surgical sutures and needles to position a mesh implant adjacent to a body wall defect without the need for stay sutures. Also disclosed are assemblies of the positioning systems with surgical mesh repair implants, and methods of repairing body wall defects such as hernias with the assemblies.

Abstract: A novel single plane tissue repair patch is disclosed. The patch has a base member with an opening therethrough, and a closure member associated with the opening. The mesh may be used in open surgical procedures for hernia repairs and other repairs of body wall defects.

Abstract: Novel deployment devices for use as adjuncts with tissue repair implants. The devices are removeably mounted to mesh tissue repair implant devices to manipulate the devices into position and provide for secure fixation about the periphery of such mesh implant devices by providing guide structures such as grooves for directing and positioning a surgical tacking instrument.

Abstract: A novel single plane tissue repair patch is disclosed. The patch has a base member with an opening therethrough, and a closure member associated with the opening. Mounted to the periphery of the bottom side of the base member is a locating structure. The mesh may be used in open surgical procedures for hernia repairs and other repairs of body wall defects.

Abstract: A novel single plane tissue repair device such as a patch is disclosed. The device has a base member with an opening therethrough, and a closure member associated with the opening. The mesh has a biaborbable polymeric adhesion barrier attached to the bottom side of the base member about its periphery to form a pocket that is accessible through the opening. The mesh may be used in open surgical procedures for hernia repairs and other repairs of body wall defects.

Abstract: Methods and apparatus related to executing an online multimedia game. Some implementations are directed to a method for determining a matchup of two players, receiving multimedia selections from the players of the matchup, providing the selections to other players, and determining a winner of the matchup based on ratings provided by the other players. Some implementations are directed to prompting one player of the matchup for a multimedia subject for the multimedia selections and receiving either a multimedia subject or a deferral to the other player of the matchup for selection of a multimedia subject.