Abstract: A clipper for cutting an end from a cigar preparatory to smoking the cigar includes a pair of relatively slidable body sections, each of which has an opening at an outer end dimensioned to permit a finger to pass thereinto and a pair of slide rails disposed along the sides. Two opposed cutouts at the inner ends form a body hole, into which extend a pair of opposed blade edges, which each also have opposed cutouts that form a cutting hole. The body sections are slidable between an admitting position for placing the cigar end into the cutting hole and a cutting position wherein the blade cutouts obscure the cutting hole, thereby clipping the end from the cigar.

Abstract: A locking mechanism for ensuring proper sequential usage of a surgical instrument is provided for an instrument utilizing a tissue treating energy, particularly a tissue heating energy, such as, for example, electrosurgical, ultrasonic, thermal, laser, infrared light, or other heating energies. One embodiment includes a cutting element to be used after heat treatment of tissue is completed to a desired degree. The instrument of the preferred embodiment includes a feedback monitor arranged to provide a signal indicating completion of tissue treatment. One embodiment includes an electro-mechanical locking mechanism responsive to the tissue treatment complete feedback signal and arranged to unlock when tissue treatment is complete.

Abstract: Wire fasteners having legs with lengths that can be one hundred times the width of the fastener are used to secure items, such as prosthesis valves to a patient during minimally invasive surgery. The fasteners are manipulated into position and then are immobilized by means of the legs thereof for tensioning, cutting and forming in situ. The fasteners are manipulated, tensioned and formed from the leg end of the fasteners. Tools for initially placing the fasteners and for immobilizing, tensioning, cutting and bending the fastener legs are disclosed. Once the fasteners are initially placed, the prosthesis is placed on the long legs of the placed fasteners and is guided into position on the legs. Once the prosthesis is in position, the legs of the fasteners are immobilized, tensioned, cut and bent into staple-like shapes to secure the prosthesis to the patient. A method for carrying out the procedure using the long fastener is also disclosed.

Abstract: A one-piece fastener or staple includes a base that contacts tissue and a prong that extends through the tissue. A suture lead is anchored to the base and a needle is attached to the suture lead. A tool positions the fastener adjacent to the tissue, and is operated to drive the prong and the suture needle through the tissue. The tool includes a needle grabber that is operated to grab the needle and pull the needle out of the patient. Since the suture lead is attached to the fastener, a prosthesis can be placed on the suture lead and pushed down to the tissue. A cassette is releasably mounted on the tool and contains the fastener, the suture lead and the suture needle. Alternative forms of the anchor have sutures attached to a base at locations that are spaced apart from each other, and sutures associated with each of two adjacent anchors can be tied together or sutures associated with a single anchor can be tied together. A suture threadably connected to an anchor can be used as a running suture.

Abstract: A surgical stapler comprising at least one cam having a cam surface, an arrangement for actuating the cam for a longitudinal firing movement of the cam surface, a cartridge having a plurality of staple drive members driven by the longitudinal movement of the cam surface, and a plurality of surgical staples respectively associated with the staple drive members for being fired by the longitudinal movement of the cam surface. In one embodiment of the present invention, the staple drive members include at least a pair of alternating first and second staple drive members, the first staple drive member including a laterally spaced pair of staple driving surfaces, the second staple drive member including a single staple driving surface. The first and second staple drive members are disposed such that the staple driving surfaces thereof are arranged in laterally spaced three rows.

Abstract: An anastomosis is performed using a mounting structure mounted on the outside of at least one vessel. The mounting structure includes a flexible mounting structure that is attached to the vessel by a special instrument. A graft vessel is attached to the mounting structure either directly or by means of another mounting structure attached to the graft vessel. Tools for attaching a mounting structure to a vessel are disclosed, and a tool for attaching two mounting structures together is also disclosed. Methods for carrying out the anastomosis according to the invention are also disclosed.

Abstract: Query electrodes are provided for monitoring the electrical impedance of tissue as it is treated with electrosurgical energy. In one embodiment, based on a predicted model of tissue impedance and a number of initial impedance readings, the impedance at which tissue treatment is completed is predicted. More particularly, a minimum impedance level is measured and a function of the minimum impedance is used to determine impedance at which coagulation is completed. A control device is provided for bringing the output of the generator within an optimum range based on a system load curve. In one embodiment the impedance monitoring device is used in conjunction with a bipolar electrosurgical instrument. Preferably, the instrument comprises electrically opposite therapeutic electrodes, each located on one or more tissue engaging surfaces for engaging tissue to be treated, and electrically opposite query electrodes, located on one or more tissue engaging surfaces.

Abstract: A tissue biopsy sample is placed on a tissue trapping and supporting material that can withstand tissue preparation procedures and which can be cut with a microtome. The tissue is immobilized on the material and the material and the tissue are subjected to a process for replacing tissue fluids with wax, and then the tissue and the supporting material are sliced for mounting on slides using a microtome. Harvesting devices and containers using the filter material are disclosed. An automated process is also disclosed. One form of the invention has the tissue trapping and supporting material porous and another form of the invention includes a tissue supporting material that is not easily microtomed.

Abstract: An improved electro surgical instrument is provided for cauterization and/or welding of tissue of varying impedances, thicknesses and vascularity especially in the performance of endoscopic procedures. The instrument compresses the tissue between one pole of a bipolar energy source located on one interfacing surface, and a second interfacing surface. A second pole is located on one of the two interfacing surfaces. In a preferred embodiment, the second pole is located on the same interfacing surface as the first pole and an insulator electrically isolates the two poles. A preferred application of the invention is in a cutting instrument wherein a hemostatic line is formed along a cut line using RF energy.

Abstract: A locking mechanism for ensuring proper sequential usage of a surgical instrument is provided for an instrument utilizing a tissue treating energy, particularly a tissue heating energy, such as, for example, electrosurgical, ultrasonic, thermal, laser, infrared light, or other heating energies. One embodiment includes a cutting element to be used after heat treatment of tissue is completed to a desired degree. The instrument of the preferred embodiment includes a feedback monitor arranged to provide a signal indicating completion of tissue treatment. One embodiment includes an electro-mechanical locking mechanism responsive to the tissue treatment complete feedback signal and arranged to unlock when tissue treatment is complete.

Abstract: An electrosurgical instrument is provided for cauterization and/or welding of tissue of varying impedances, thicknesses and vascularity especially in the performance of endoscopic procedures. The instrument compresses the tissue in the compression zone between first interfacing surface and second interfacing surfaces. The compression zone is formed by an insulator which forms a compression ridge in one of the interfacing surfaces and separates first and second electrically opposite electrodes. A preferred application of the invention is in a cutting instrument wherein a hemostatic line is formed using RF along a cut line.

Abstract: A device is provided for identifying certain characteristics of an end piece or end effector of a surgical instrument. A preferred embodiment provides a surgical stapling instrument having an electrical circuit contained on the stapling cartridge which is capable of indicating cartridge type and/or status (i.e., with or without staples) when a voltage or current is applied to the circuit. Other identification means are provided including an optical identification means.

Abstract: A centrifuge comprising a yoke element that rotates about a rotational axis and a processing chamber having an axis. The processing chamber includes a bowl element, a spool element, and a mechanism for joining the spool and bowl elements for relative movement between a mutually cooperating position for centrifugal processing and a mutually separated position for loading. A hinge attaches the processing chamber to the yoke element for pivotal movement between an operating position and an access position. In the operating position, the spool and bowl elements are in their mutually cooperating position and oriented for rotation with the yoke element about the rotational axis. In the access position, the processing chamber axis lies outside the axis of rotation and the spool and bowl elements are oriented for movement from their mutually cooperating position into their mutually separated position.

Abstract: A surgical stapler comprising at least one cam having a cam surface, an arrangement for actuating the cam for a longitudinal firing movement of the cam surface, a cartridge having a plurality of staple drive members driven by the longitudinal movement of the cam surface, and a plurality of surgical staples respectively associated with the staple drive members for being fired by the longitudinal movement of the cam surface. In one embodiment of the present invention, the staple drive members include at least a pair of alternating first and second staple drive members, the first staple drive member including a laterally spaced pair of staple driving surfaces, the second staple drive member including a single staple driving surface. The first and second staple drive members are disposed such that the staple driving surfaces thereof are arranged in laterally spaced three rows.

Abstract: A surgical stapler instrument is provided for applying lateral lines of staples to tissue while cutting the tissue between those staple lines. The instrument includes a handle portion, an implement portion, a reciprocating section, a drive member and a movable actuator. The implement portion includes a staple cartridge and an anvil. The reciprocating section is adapted to move back and forth along an axis of the implement portion. The movable actuator is associated with the handle portion and is engaged with the drive member such that motion of the actuator causes the drive member to move back and forth between first and second drive positions separated by a first distance. A multiplier is further provided and is associated with the reciprocating section and the drive member for causing the reciprocating section to move back and forth between first and second reciprocating positions in response to movement of the drive member.

Abstract: A jaw assembly is provided with a pair of jaws which are closed with a flexible, tension member that is pulled by the operator of the instrument. In a preferred embodiment, one of the jaws is pivotally mounted in a slot to the other jaw. A cord, having a loop configuration, is attached to the pivoting jaw and can be pulled to pivot the jaw closed. A second cord can be provided to initially hold the proximal end of the pivoting jaw away from the other jaw until the distal ends of the jaws are closer together. In another embodiment, jaws can be closed in a parallel orientation by rotating two pulleys with threaded shafts engaged with the jaws.

Abstract: A jaw assembly is provided with a pair of jaws which are closed with a flexible, tension member that is pulled by the operator of the instrument. In a preferred embodiment, one of the jaws is pivotally mounted in a slot to the other jaw. A cord, having a loop configuration, is attached to the pivoting jaw and can be pulled to pivot the jaw closed. A second cord can be provided to initially hold the proximal end of the pivoting jaw away from the other jaw until the distal ends of the jaws are closer together. In another embodiment, jaws can be closed in a parallel orientation by rotating two pulleys with threaded shafts engaged with the jaws.

Abstract: A device is provided for sensing the firing of a staple cartridge inserted into an end piece or end effector of a surgical instrument. The stapling instrument includes a magnetic sensing device arranged to sense the advancement of a knife or staple driver.

Abstract: A jaw assembly is provided with a pair of jaws which are closed with a flexible, tension member that is pulled by the operator of the instrument. In a preferred embodiment, one of the jaws is pivotally mounted in a slot to the other jaw. A cord, having a loop configuration, is attached to the pivoting jaw and can be pulled to pivot the jaw closed. A second cord can be provided to initially hold the proximal end of the pivoting jaw away from the other jaw until the distal ends of the jaws are closer together. In another embodiment, jaws can be closed in a parallel orientation by rotating two pulleys with threaded shafts engaged with the jaws.

Abstract: A centrifuge comprising a yoke element that rotates about a rotational axis and a processing chamber having an axis. The processing chamber includes a bowl element, a spool element, and a mechanism for joining the spool and bowl elements for relative movement between a mutually cooperating position for centrifugal processing and a mutually separated position for loading. A hinge attaches the processing chamber to the yoke element for pivotal movement between an operating position and an access position. In the operating position, the spool and bowl elements are in their mutually cooperating position and oriented for rotation with the yoke element about the rotational axis. In the access position, the processing chamber axis lies outside the axis of rotation and the spool and bowl elements are oriented for movement from their mutually cooperating position into their mutually separated position.