Abstract: A surgical tool for performing anastomosis may include a handle and a tissue effector connected by a shaft, at least party of which may be flexible. The tissue effector may include a staple holder connected to an anvil.

Abstract: A surgical staple for connecting two tubular tissue structures may include a substantially rectangular base having a first edge and a second edge substantially parallel to one another, and a third edge substantially perpendicular to the first and said second edges; and may also include at least three deformable tines extending from the first and second edges of said base; where no tine that extends from the first edge may be positioned at substantially the same distance from the third edge as any said tine that extends from the second edge; and where deformation of the tines secures the tubular tissue structures together.

Abstract: A surgical staple for connecting two tubular tissue structures may include a substantially rectangular base having a first edge and a second edge substantially parallel to one another, and a third edge substantially perpendicular to the first and said second edges; and may also include at least three deformable tines extending from the first and second edges of said base; where no tine that extends from the first edge may be positioned at substantially the same distance from the third edge as any said tine that extends from the second edge; and where deformation of the tines secures the tubular tissue structures together.

Abstract: A retractor and a surgical tool are posittioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a dissection cradle that is resiliently supported along an axis skewed relative to the axis of the cannula. The dissection cradle, in operation, is extended to cradle the target vessel, and the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate a side branch for exposure to a surgical tool. The retractor includes a hollow support and a spray nozzle disposed in the distal end of the retractor to form an irrigation system and lens washer that can be selectively positioned to direct the spray of irrigation fluid at a remote surgical site or at an endoscopic lens.

Abstract: An exemplary surgical stapler may include a staple holder, staples positioned within the staple holder, and at least one structure slidable within the staple holder to contact directly at least one staple, where that direct contact deploys at least one staple from the staple holder. Another exemplary surgical stapler may include a staple holder, an anvil movably connected to the staple holder, staples positioned within the staple holder; and a sled slidable within the staple holder to contact directly at least one staple, where that direct contact urges at least one staple out of the staple holder and against the anvil.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a dissection cradle that is resiliently supported along an axis skewed relative to the axis of the cannula. The dissection cradle, in operation, is extended to cradle the target vessel, and the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate a side branch for exposure to a surgical tool. The retractor includes a hollow support and a spray nozzle disposed in the distal end of the retractor to form an irrigation system and lens washer that can be selectively positioned to direct the spray of irrigation fluid at a remote surgical site or at an endoscopic lens.

Abstract: An integrated anastomosis tool may include an effector that both makes an opening in the wall of a target vessel and connects a graft vessel to the target vessel. The connection between the graft vessel and the target vessel may be compliant, and may be achieved by deploying a plurality of connectors such as staples into tissue. The effector may include a cutter assembly and a connection module that are independently actuatable. The cutter assembly and/or the connection module may be cable-actuated.

Abstract: An anastomosis tool includes a handle connected to a tissue effector that may be capable of being oriented in two or more positions relative to the handle. The tissue effector holds a graft vessel having at least one flap defined in at least one end thereof against the side of a target vessel. Actuation of a trigger or other mechanism on the handle causes the tissue effector to deploy one or more connectors into the flaps of the graft vessel and the side of the target vessel, thereby connecting the graft vessel to the target vessel.

Abstract: A method for anastomosing a first vessel to a second vessel may include connecting an end of the first vessel to the side of the second vessel and creating an opening in the wall of the second vessel from within the lumen of the second vessel, where that opening allows fluid communication between the lumen of the first vessel and the lumen of the second vessel.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a dissection cradle that is resiliently supported along an axis skewed relative to the axis of the cannula. The dissection cradle, in operation, is extended to cradle the target vessel, and the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate a side branch for exposure to a surgical tool. The retractor includes a hollow support and a spray nozzle disposed in the distal end of the retractor to form an irrigation system and lens washer that can be selectively positioned to direct the spray of irrigation fluid at a remote surgical site or at an endoscopic lens.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a dissection cradle that is resiliently supported along an axis skewed relative to the axis of the cannula. The dissection cradle, in operation, is extended to cradle the target vessel, and the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate a side branch for exposure to a surgical tool. The retractor includes a hollow support and a spray nozzle disposed in the distal end of the retractor to form an irrigation system and lens washer that can be selectively positioned to direct the spray of irrigation fluid at a remote surgical site or at an endoscopic lens.

Abstract: An anastomosis tool may include a connector holder connected to an anvil. The connector holder may be bifurcated and configured to straddle the graft vessel. The connector holder may be generally U-shaped. The connector holder may be shaped to extend around more than half of the circumference of the graft vessel.

Abstract: A surgical staple for connecting two tubular tissue structures may include a substantially rectangular base having a first edge and a second edge substantially parallel to one another, and a third edge substantially perpendicular to the first and said second edges; and may also include at least three deformable tines extending from the first and second edges of said base; where no tine that extends from the first edge may be positioned at substantially the same distance from the third edge as any said tine that extends from the second edge; and where deformation of the tines secures the tubular tissue structures together.

Abstract: An anastomosis staple has a base from which multiple deformable tines extend. At least one tine may be offset from at least one other tine. The tines are moveable from a first configuration to a second configuration. The staple optionally includes at least one alignment guide.

Abstract: A surgical tool for performing anastomosis may include a handle and a tissue effector connected by a shaft, at least party of which may be flexible. The tissue effector may include a staple holder connected to an anvil.

Abstract: A method and system for performing anastomosis may use an anvil to control and support a tissue site during an anastomosis procedure involving tissue bonding techniques such as adhesive tissue bonding. Adhesive may be applied to mating surfaces of the graft and/or target vessels either before or after the vessels are brought into contact. Adhesive may be applied via an applicator associated with the anvil.

Abstract: A method for tensioning incisions made in a target vessel during an anastomosis procedure is provided. After an incision is made in a target vessel, incision tensioners are placed within the incision in order to tension the incision. The incision is tensioned when the incision tensioners are pulled taut in order to stretch the incision to a predetermined length or a predetermined force. The tensioners allow for proper grafting of a graft vessel to the target vessel in an end to side anastomosis. In addition, the incision tensioners allow the incision to have a known geometry, thereby allowing precise grafting of the graft vessel to the target vessel during the anastomosis procedure. After the incision is tensioned, the graft vessel is grafted to the target vessel using clips, sutures, staples or other anastomosis devices. One example of anastomosis clips are configured to capture the graft vessel and the target vessel such that the graft vessel grafts with the target vessel.

Abstract: A method and system for performing anastomosis uses an anvil to control and support a tissue site during an anastomosis procedure involving tissue bonding techniques such as tissue welding and adhesive tissue bonding. The anvil is particularly useful for supporting a wall of a coronary artery during attachment of a graft vessel in a coronary artery bypass graft procedure. The anvil is inserted into a pressurized or unpressurized target vessel and is pulled against an inner wall of the target vessel causing tenting of the thin tissue of the vessel wall. A graft vessel is then advanced to the anastomosis site and an end of the graft vessel is positioned adjacent an exterior of the target vessel. When tissue welding is used, a graft vessel fixture is positioned over the tissue surfaces to be welded in order to clamp the graft and target vessel tissue together. The tissue contacting surfaces of the anvil and/or graft vessel fixture are provided with one or more energy applying surfaces.

Abstract: A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a dissection cradle that is resiliently supported along an axis skewed relative to the axis of the cannula. The dissection cradle, in operation, is extended to cradle the target vessel, and the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate a side branch for exposure to a surgical tool. The retractor includes a hollow support and a spray nozzle disposed in the distal end of the retractor to form an irrigation system and lens washer that can be selectively positioned to direct the spray of irrigation fluid at a remote surgical site or at an endoscopic lens.

Abstract: A method for connecting a graft vessel to a target vessel, each vessel having a wall surrounding a lumen, may include providing a connector holder, associating an end of the graft vessel with the connector holder, positioning the connector holder outside of the lumen of the target vessel, outside the lumen of the graft vessel, and in proximity to the outer surface of the wall of the target vessel, and actuating the connector holder to secure the end of the graft vessel to the side of the target vessel.