Abstract: Methods and devices for controlling motorized surgical devices are provided. In general, the methods and devices can allow a surgical device to grasp and cut tissue. In some embodiments, the device's motor can begin providing power for grasping and/or cutting tissue in response to an output from the device's sensor, the device can adjust power provided by the motor based on whether the device is clamping tissue or is being fired, the device can adjust an amount of power provided by the motor based on an amount of user-applied force to the device's actuator and/or can control drive direction of the motor based on the amount of the force, the device can maintain a force applied to the device, the device can self-shift the motor, and/or the device can adjust an amount of power provided to the device's end effector based on a degree of the end effector's closure.

Abstract: A diagnostic device (10) for pathologies of tubular anatomical structures comprises a tubular elongated structure (12, 28) developing between a proximal end and a distal end and is suitable to be inserted in the tubular anatomical structure, means (22, 32) for locally dilating the walls of the tubular anatomical structure that are associated with the distal end of said elongated structure, said means for locally dilating being movable between a closed position for introducing the device and at least one open position for viewing and evaluating the pathology, and control means being associated with the proximal end of the elongated structure, said control means being operatively connected to said means for locally dilating, in order to move them between the closed position and the open position, and vice versa.

Abstract: A surgical instrument for laparoscopic and endoscopic clinical procedures simultaneously severs and staples tissue clamped in an end effector comprising an elongate channel, which holds a staple cartridge, and a pivotally attached anvil. An E-beam firing bar engages the channel and selectively engages the anvil during distal firing movements, wherein the tissue is severed and stapled driven upward from the staple cartridge to form against the anvil. In particular an upper pin of the firing bar is disengaged from the anvil before firing. A ramped transition from an anvil to an anvil slot avoids misfiring when the end effector has clamped too much tissue, yet assists in successfully clamping a slightly excess amount of tissue.

Abstract: A tissue suspension device has an elongated spanning element with a first and a second end. A suspending element is attachable to the spanning element. A first supporting element is attached to the first end of the spanning element, and a second supporting element is attached to the second end of the spanning element. The tissue suspension device substantially spans the transverse width of the body cavity and suspends tissue within the body cavity. The first and second supporting elements are attachable to the body wall, which supports the weight of the suspended tissue.

Abstract: A surgical access device provides surgical access through an incision in the body wall to the inside of a body cavity of a patient. The surgical access device has a subassembly with an opening around a center axis and is adjustable between a closed configuration and an open configuration. The surgical access device has a sleeve attached to the subassembly and positionable in the incision. The sleeve defines a passageway through the body wall between the opening in the valve subassembly and the body cavity. The surgical access device also has at least one access channel extending from the subassembly. The access channel is outside the opening and the passageway and provides an access to the body cavity.

Abstract: A surgical access device includes a base having two or more ports or apertures that provide for the insertion of surgical instruments. The multi-port insert may be used with a laparoscopic access device. The multi-port insert may also include one or more instrument supports that are attached to the base to fix the position of one or more surgical instruments inserted through the multi-port insert.

Abstract: A surgical instrument system and method is provided for a hand-assisted, laparoscopic procedure. The system has a laparoscopic disc and a surgical instrument. The surgical instrument has at least one end effector that is removably attachable to the distal end of the surgical instrument. The surgeon may pass his/her hand into the body cavity via the laparoscopic disc and may removably attach the end effector to the distal end of the surgical instrument while the distal end of the surgical instrument is inside of the body cavity of the patient.

Abstract: A method is provided for planning a surgical procedure on a patient. The method includes surgically accessing a body cavity of the patient, identifying a key, anatomical structure within the body cavity; and marking the key, anatomical structure. The key, anatomical structure may be a distal or proximal end point of tissue to be resected, a vessel that supplies arterial blood to tissue to be resected, or the cutting line for the tissue to be resected. A tissue marker is also provided for marking soft, internal tissue during a surgical procedure. The tissue marker may be mechanically attachable to tissue, or the tissue marker may comprise a marking fluid.

Abstract: Disclosed is an instrument and method for use in a procedure to effect anastomosis of a patient's bladder and urethra following a prostatectomy. The instrument comprises a tube assembly, and an end effector assembly operably supported thereby, where the end effector assembly includes a positioner assembly and an anchor driver assembly in operable mechanical communication with a handle, for use in performing anastomotic procedures.

Abstract: Disclosed is an instrument, assembly, and method for use in a procedure to effect anastomosis of a patient's bladder and urethra following a prostatectomy. The instrument comprises a tube assembly having an end effector assembly operably supported thereby, where the end effector assembly includes a harness adapted to receive a balloon portion of a balloon catheter assembly.

Abstract: Disclosed is an instrument for use in a procedure to effect anastomosis of a patient's bladder and urethra following a prostatectomy having a tube assembly, and an end effector assembly operably supported by the tube assembly. The end effector assembly includes a positioner assembly and an anchor driver assembly in operable mechanical communication with first and second rods of the tube assembly, so as to be actuable by movement of the first and the second rods with respect to a spine member.

Abstract: Disclosed is an instrument for use in a procedure to effect anastomosis of a patient's bladder and urethra following a prostatectomy having a tube assembly, and an end effector assembly operably supported by the tube assembly, where the end effector assembly includes an anchor for insertion into and through the patient's bladder wall and pelvic floor and an anchor guide associated therewith.

Abstract: A system and method to be used in ultrasonic lithotripsy of a stone in a ureter, the system including a catheter having a probe tip capable of transmitting and receiving ultrasonic energy. The catheter can include an inflatable balloon adjacent to the probe tip, the balloon capable of pooling some urine in the ureter to be used as an ultrasonic transmission media. The ultrasonic probe is connected to a source of energy capable of driving the probe tip to deliver ultrasonic energy of a high frequency and relatively low energy to image a stone. Then the probe can be connected to a source of energy capable of driving the probe to deliver a low frequency, high energy ultrasonic to disintegrate the stone.

Abstract: A surgical severing and stapling instrument clamps, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel clot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing.

Abstract: A system and method to be used in ultrasonic or other types of lithotripsy of a stone in a ureter, the system including a catheter having a stone probe tip capable of transmitting stone reducing energy. The catheter can include an expandable funnel section adjacent to the probe tip, such that expansion of the expandable funnel section can dislodge a stone by pushing back on the ureter wall expanding it slightly. The funnel section also being capable of pooling some urine in the ureter to be used as an ultrasonic transmission media. The stone probe can be connected to a source of energy capable of driving the probe tip to deliver energy to break apart the stone.

Abstract: The method disclosed may be used following a prostatectomy may comprise inserting an instrument having an end effector into the bladder lumen via the urethra; using the end effector to urge the bladder wall to the pelvic floor and drive an anchor through the bladder wall into the pelvic floor, thereby connecting a balloon harness within the bladder to the pelvic floor; withdrawing the end effector; inserting and inflating a balloon catheter within the balloon harness, thereby pressing the bladder wall surrounding the bladder opening against the pelvic floor; maintaining the balloon catheter in place and draining the bladder during the time required for the tissues to effectively knit; and then deflating and withdrawing the balloon catheter and disconnecting and withdrawing the balloon harness. The instrument may comprise one or more tubes that support an end effector comprising a positioner and an anchor driver.

Abstract: Embodiments for an anchor for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy are disclosed. The anchor may comprise a shaft with a lodging structure. Alternative embodiments may include a penetration limiting structure, a driver interface proximate to a rearward end, a forward end with a penetration facilitating shape that may comprise a point defined by three flat intersecting faces, a bioabsorbable portion of one or more bioabsorbable materials, and a metal portion of one alloy, or a plurality of alloys which may have differing expansion properties.

Abstract: The instrument disclosed may comprise a tube assembly further comprising substantially coaxially situated and relatively longitudinally movable tubes, supporting and operating an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In alternative embodiments the tube assembly may comprise a rod and two tubes, three tubes, a rod and three tubes, or four tubes. The method disclosed may comprise inserting an instrument having an end effector into the bladder lumen, and using the end effector to urge the bladder wall to the pelvic floor and drive an anchor through the bladder wall and into the pelvic floor.

Abstract: The instrument disclosed may comprise a tube assembly supporting an end effector that may be adapted for insertion into and through the urethra, and adapted for use in effecting the anastomosis of a patient's bladder and urethra following a prostatectomy. In one embodiment the end effector may comprise a positioner having an extendable and retractable petal operably connected to a tube, an anchor driver, and an anchor releasably held by the anchor driver. In another embodiment the end effector may comprise a positioner and an anchor driver having a driver pin operably connected to a tube.

Abstract: The method disclosed may be used following a prostatectomy, and may comprise inserting an instrument into the bladder lumen through incisions in the abdomen and bladder wall; using an end effector thereon to urge the bladder wall to the pelvic floor and align the openings of the bladder and urethra, and drive an anchor through the bladder wall into the pelvic floor, thereby connecting a balloon harness to the pelvic floor; inflating a balloon within the harness, which holds the bladder wall surrounding the bladder opening against the pelvic floor; maintaining the balloon in place and draining the bladder via a catheter during the time required for the tissues to effectively knit; and then deflating the balloon, disconnecting the harness, and withdrawing the instrument. The instrument may comprise one or more tubes that support an end effector comprising a positioner, an anchor driver, a harness, a balloon and a catheter.