Abstract: Surgical clip appliers are provided and include a housing; at least one handle pivotably connected to the housing; a channel assembly extending distally from the housing; a clip carrier disposed within the channel assembly and defining a channel and a plurality of windows therein; and a plurality of clips slidably disposed within the channel of the clip carrier. The surgical clip appliers further include a drive channel reciprocally disposed within at least one of the housing and the channel assembly; a wedge plate reciprocally disposed within the channel assembly; a pusher bar reciprocally positioned within the housing and the channel assembly; and a motion multiplier system having a plurality of linkage members configured to distally move the pusher bar by an incremental amount upon an initial actuation of the handles, and configured to proximally move the pusher bar and the wedge plate subsequent to the initial actuation of the handles.

Abstract: A surgical clip applicator includes a universal handgrip and an individual clip magazine having an integrated crimping head, which individual clip magazine can be detachably fastened to the universal handgrip. The universal handgrip and the individual clip magazine fastened thereto interact to form a feed path for the clip transport of individual clips from a clip receiving portion of the clip magazine toward the crimping head, which feed path is defined or individually available for actuation. The individual clip magazine can be selected from a plurality of clip magazines for different clip types as needed. The clip magazine can include an integrated coding mechanism designed depending on the clip type to be applied, which coding mechanism defines in interaction with the universal handgrip at least the feed path adapted to the respective clip type.

Abstract: A reposable surgical clip applier (10) is provided and includes a handle assembly (100), an endoscopic assembly (200) selectively connectable to a housing (102) of the handle assembly (100), and a cartridge assembly (300) selectively loadable in and connectable to the endoscopic assembly (200).

Abstract: A surgical clip applier is provided including a channel assembly and overlying a clip carrier having a clip counter plate slidably supported in the channel assembly, wherein the clip counter plate is configured and adapted to display a change in status of the clip applier upon actuation of the handle.

Abstract: A device for treating a tissue includes a capsule extending longitudinally from a proximal end to a distal end and including a channel extending therethrough, the capsule releasably coupled to a proximal portion of the device and clip arms, proximal ends of which are slidably received within the channel of the capsule so that the clip arms are movable between an open configuration, and a closed configuration. A core member is coupled to the clip arms, the core member including a proximal portion and a distal portion releasably connected to one another so that, when the core member is subjected to a predetermined load, the proximal and distal portions are separated from one another. An electrically conductive control member is connected to the core member, a proximal end of the connected member connected to a power source for delivering an electrical current to the clip arms.

Abstract: Tools for installing a clip having a depressible engagement member are disclosed. In one embodiment, the tool includes a pin and a head both configured to engage the depressible engagement member. A trigger assembly is mechanically coupled to both the pin and the head. The pin is configured to actuate the trigger assembly so as to release the hear, wherein the head may actuate a counting unit so as to register a count when the pin engages the depressible engagement member, informing the installer when a clip is properly installed.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly and a shaft assembly. The handle assembly includes a drive assembly; and a trigger operatively connected to the drive assembly. The shaft assembly extends from the handle assembly and includes an articulating neck assembly; and an end effector assembly supported on a distal end of the articulating neck assembly and being configured to form a surgical clip in place on the body tissue.

Abstract: A mechanical driver comprising a wedge shaped member operatively coupled to a shape memory alloy such that the shape memory alloy is able to displace the wedge shaped member in an essentially linear direction. The wedge shaped member is in constant contact with a lever arranged so that it can rotate about a fixed pivot point. A piston is arranged such that it is constant contact with the lever at a point between the pivot point of the lever and the contact point between the lever and the wedge shaped member. Activation of the shape memory alloy displaces the wedge shaped member along its linear direction and this causes the lever to be deflected about its pivot point and the piston to be deflected in an essentially linear direction that is perpendicular to the linear direction of travel of the wedge shaped member.

Abstract: A tool for driving a helical anchor into a target location, the tool including a proximal portion and a distal portion, the proximal portion having a handle and an actuator, and a shaft extending distally from the proximal portion, the shaft comprising an outer shaft and an inner rotating shaft that is at least partially concentrically positioned within the outer shaft, the shaft having a length that facilitates accessing a location of a posterior pelvic region, wherein the inner rotating shaft is actuated by movement of the actuator in a predetermined motion.

Abstract: The present invention relates to devices, and methods for using the devices, to create and secure a tissue fold during an endoluminal medical procedure. The devices and methods may be used for folding and securing, for example, a fundus wall onto an esophagus wall or esophageal tissue in the region of the lower esophageal sphincter (LES) to reduce the diameter of the esophagus opening in that region. One aspect of the invention includes forming the tissue fold by closing a grasping arm that is pivotably connected to an overtube that has been positioned at the juncture of the fundus wall and esophagus wall. A further aspect of the invention includes tissue clips configured to be inserted and positioned through an endoluminal device.

Abstract: A tacker for applying a rotary tack, including a tacker for applying a rotary tack, including a handle with a first trigger assembly and a second trigger assembly, the trigger assemblies being coupled to an articulated applicator arm which is disposed through a drive shaft connected to the handle, the first trigger assembly operative to apply a rotary tack from a distal end of the applicator arm and the second trigger assembly operative to bend the distal end of the applicator arm, wherein a longitudinal axis of the handle is tilted with respect to the drive shaft.

Abstract: A neuromonitoring needle electrode placement gun which includes a housing, at least a first needle electrode and housing assembly, an elongated channel dimensioned and configured for accommodating axial movement of the at least a first needle electrode and housing assembly within the channel and for directing movement of the at least a first needle electrode and housing assembly and a pusher dimensioned and configured for engaging the at least a first needle electrode and housing assembly and for axially displacing the at least a first needle electrode and housing assembly.

Abstract: A surgical instrument includes an active electrode coupled to a source of electrosurgical energy. The active electrode includes a tissue-contacting surface on an exterior surface of the instrument such that the tissue-contacting surface of the active electrode may intimately engage tissue. A replacement electrode includes a tissue-contacting surface, and is located in an interior cavity of the instrument. A seal is formed between the active electrode and the interior cavity of the instrument such that the tissue-contacting-surface of the replacement electrode is isolated from contamination exposed to the exterior of the instrument. The active electrode is removable from the instrument to expose the tissue-contacting surface of the replacement electrode, and the replacement electrode is connectable to the source of electrosurgical energy when the active electrode is removed.

Abstract: A clip applier adapted for use with a surgical robot is disclosed. The clip applier comprises a shaft having clips stored therein and jaws adapted for receiving a clip from the shaft. The shaft is in mechanical communication with a robotic mounting portion. The robotic mounting portion contains a gear drive assembly for rotating the shaft, feeding clips into the jaws and forming clips in the jaws.

Abstract: A surgical clip applier with scissor-type operating handle and clip applying cartridge in which handle has housing of upper and lower shells that defines socket for receiving cartridge, includes a lever arm actuated linear translator for linear reciprocating movement delivered to the cartridge, and an anti-backup mechanism for full forward and release strokes of the handle, and in which cartridge includes jaws for applying clips, safety means to ensure opening of jaws for each cycle, a puller bar for receiving motion from handle and timing of jaw operation to clip feed, a magazine for feeding clips to jaws in proper sequence, and a lockout mechanism to render applier inoperative after using last clip.

Abstract: Apparatus and methods are disclosed for occluding an anatomical structure including an occlusion apparatus having first and second beams and at least one connector for connecting the respective ends of the beams together. The occlusion apparatus may be adapted for use in a deployment device having a pair of jaws and optionally having a respective pair of shuttle bodies for releasably connecting an occlusion apparatus to the jaws while in an open position and for releasing the occlusion device from the jaws while in a closed position. A system for occluding an anatomical structure is also disclosed that includes an occlusion apparatus and a deployment device for holding the occlusion apparatus in an open position for locating the occlusion device adjacent the anatomical structure to be occluded and then moving the occlusion apparatus to a closed position and locking the occlusion apparatus in the closed position.

Abstract: A method is provided for attaching a hair extension to a recipient's hair. The method comprises defining an anchoring structure for receiving attachment of the hair extension; positioning the hair extension adjacent to the anchoring structure; employing a hair extension attachment apparatus to attach the hair extension to the anchoring structure; wherein the employment includes manipulating a user manipulable hand member of the apparatus to position a shield mechanism between the recipient's scalp and the fastener as the fastener is being crimped; and to crimp a fastener to attach the hair extension to the anchoring structure. An apparatus is provided for attaching a hair extension to the recipient's hair. The apparatus comprises a mechanism for crimping a fastener to attach the hair extension; and a shield mechanism for preventing the fastener from contacting the recipient's scalp as the fastener is being crimped.

Abstract: A surgical clip applier includes a jaw assembly having first and second jaws. Each jaw defines an opposed surface configured to receive a portion of a surgical clip. The jaws are moveable between a spaced-apart position and an approximated position for forming the surgical clip about tissue. Each jaw includes a relief element disposed on a surface adjacent to and substantially transverse relative to the opposed surface thereof. The relief elements are cooperable to define a relief recess upon movement of the jaws to the approximated position. The relief recess is configured to receive at least a portion of a previously formed surgical clip during formation of a subsequent surgical clip about tissue adjacent to the previously formed surgical clip.

Abstract: An apparatus for application of surgical clips to body tissue includes a jaw assembly mounted adjacent a distal end portion of a body, the jaw assembly including first and second jaw portions movable between a spaced-apart and an approximated position; a yoke slidably supported at least partially in a handle portion and being connected to at least one trigger; a drive link slidably supported at least partially in the handle portion and the body, the drive link having a proximal end connected to the yoke; a spindle supported in the body and rotatably connected to the drive link; and a jaw closure member connected to a distal end of the spindle and being positioned adjacent the first and second jaw portions to move the jaw portions to the approximated position upon a squeezing of the at least one trigger which results in distal advancement of the jaw closure member.

Abstract: A synchronized gripping mechanism is provided which includes coupled slider-crank mechanisms. The coupled mechanisms each include a sliding grip and an intermediate link connected by a pivotal connector. A coupler link is provided on a stationary pivot and which couples and synchronizes the two slider-crank mechanisms. Overload protection structure is provided to prevent damaging the links if one of the sliding grips encounters an off-center specimen.

Abstract: In order to provide a surgical clip device with which the closure of vessels is successfully achieved even more safely, particularly in neurosurgery, it is proposed that the surgical clip device be provided with at least two electrically conductive clip parts that are electrically isolated from each other (by an element) and are arranged at a predetermined distance opposite each other.

Abstract: Spring clips are arranged end to end in a cavity of an inner shaft. Such shaft slides within an outer shaft, and a pusher member slides in the cavity behind the clips. The clips have jaws biased together, but which are wedged apart by an opener as the pusher is moved distally. An opened clip is ejected by relative movement of the inner and outer shafts to clamp body tissue at a desired site.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.

Abstract: An implant placement device includes a longitudinal axis member having a lumen extending along a longitudinal axis of the longitudinal axis member such that the implant is disposed in a stretched state and an opening formed by communicating with the lumen, a stylet provided in the lumen, a sheath into which the longitudinal axis member is inserted,—an operating part operating the sheath so as to be rotatable around the longitudinal axis, and having a contact surface that is in contact with a part of the implant, which is pushed out of the opening of the longitudinal axis member by the stylet, in a rotational direction around the longitudinal axis in a state where the opening of the longitudinal axis member is located inside the sheath.

Abstract: A surgical device for clipping tissue can include a replaceable cartridge comprising a stack of clips contained therein and a firing drive configured to reciprocatingly eject, or deploy, the clips from the cartridge. The cartridge and/or the surgical device can include a firing chamber wherein the clips can be sequentially pushed into the firing chamber along a supply axis. The firing drive can include a firing member which is moved along a firing axis to deploy a clip positioned in the firing chamber wherein the supply axis can be transverse to the firing axis.

Abstract: An insertion device includes an insertion needle holder and a drive mechanism for linearly moving the insertion needle holder in a puncturing direction. The insertion needle holder also includes at least one actuating element for actuating a drive mechanism. The drive mechanism converts a driving motion of the actuating element, which extends transversely or opposite to the puncturing direction, into a puncturing motion of the insertion needle holder.

Abstract: Apparatus is provided, including a tissue-adjusting member selected from the group consisting of: one or more artificial chordae tendineae and at least a portion of an annuloplasty ring structure. The tissue-adjusting member includes an adjusting mechanism that is configured to adjust a tension of the tissue-adjusting member. The adjusting mechanism includes a locking mechanism configured to restrict adjusting of the tissue-adjusting member by the adjusting mechanism. An elongate member is configured to maintain the locking mechanism in an unlocked state during adjusting of the tension of the tissue-adjusting member by the adjusting mechanism, and facilitate locking of the adjusting mechanism by the locking mechanism. A tool is configured to facilitate actuation of the adjusting mechanism to adjust the tension of the tissue-adjusting mechanism. The elongate member and the tool are slidably coupled with respect to each other. Other applications are also described.

Abstract: A surgical buttress for use in a surgical stapling apparatus is provided. The surgical buttress includes an elongate rectangular body portion defining a width; a nose portion integrally formed with and extending from a distal end of the body portion, the nose portion defining a width that is less than the width of the body portion; a neck portion integrally formed with and extending from a distal end of the body portion, the neck portion defining a width; a head portion integrally formed with and connected to a distal end of the neck portion, the head portion defining a width; and a tail portion integrally formed with and extending from a proximal end of the body portion, the tail portion defining a width that is less than the width of the body portion. The surgical buttress is formed from a material having filaments.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: A deployment device and an associated surgical fastener as well as their methods of use are disclosed. In one embodiment, the deployment device includes a restraining mechanism constructed and arranged to temporarily limiting movement of a surgical fastener back span. The surgical fastener includes two legs extending in a distal direction from opposing ends of the back span. The legs are in a first closed position with a first shape. The deployment device also includes a spreader configured and arranged to engage the legs of the surgical fastener in the first closed position. When the spreader is moved in a distal direction relative to the back span, the spreader spreads the legs of the surgical fastener from the first closed position to a second open position as the back span is limited from distally moving by the restraining mechanism.

Abstract: The present disclosure is directed to an implantable repository including a housing comprising at least one bioactive agent and at least one attachment member coupled to the housing, the at least one attachment member configured to couple the implantable repository to at least one of a medical device and a tissue surface.

Abstract: A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device and a plurality of anchor assemblies. The delivery system is configured to deliver a first anchor using loaded energy and reload the energy required to deliver an addition anchor.

Abstract: A hand-operable surgical clip applicator (10) including a barrel (12) having a first end (14) and a second end (16), the second end formed to accommodate a surgical clip, a crimping lever (20) pivotally connected at the second end of the barrel, and a trigger (28) co-located with the barrel, the trigger being operable to pivot the crimping lever, the pivoting movement of the crimping lever causing the surgical clip to be urged from an open position to a closed position, wherein the trigger has an operating portion on either side of the barrel.

Abstract: Surgical instruments and their methods of use are disclosed. In some embodiments, the surgical instrument may include a handle and an elongated shaft assembly extending distally from the handle. The surgical instrument may also include a fastener deployment system for deploying fasteners from the elongated shaft assembly including a reciprocating driveshaft disposed within the elongated shaft assembly. The driveshaft may include an internal channel and at least one guide surface shaped and arranged to maintain an orientation of at least one fastener in the channel of the driveshaft. In other embodiments, the fastener deployment system may include a follower disposed within the elongated shaft assembly for displacing one or more fasteners within the elongated shaft assembly towards a distal fastener deployment position.

Abstract: An end effector of a forceps includes first and second jaw members movable between spaced-apart and approximated positions for grasping tissue. Each jaw member includes a tissue sealing plate that is selectively energizable. The tissue sealing plates are configured to conduct energy therebetween and though tissue to seal tissue. A knife includes a distal surface and an upper surface. The knife is selectively translatable between a retracted position and an extended position wherein the knife extends between the jaw members. The distal surface is configured for dynamic tissue cutting upon translation of the knife from the retracted to the extended position. The upper surface is configured for static tissue cutting with the knife in the extended position. The knife is selectively energizable and is configured to conduct energy between the knife and one or both of the tissue sealing plates and through tissue to electrically cut tissue.

Abstract: An apparatus for application of surgical clips to body tissue has a handle portion; a body extending distally from the handle portion; a plurality of surgical clips disposed within the body; and a jaw assembly mounted adjacent a distal end portion of the body. The jaw assembly includes first and second jaw portions movable between a spaced-apart and an approximated position. The apparatus also has a wedge plate longitudinally movable between the first and the second jaw portions, a clip pusher configured to individually distally advance a surgical clip to the jaw assembly while the jaw portions are in the spaced apart position; an actuator at least partially disposed within the body and longitudinally movable in response to actuation of the handle portion; and a jaw closure member positioned adjacent the first and second jaw portions to move the jaw portions to the approximated position.

Abstract: A surgical clip applier is provided including a channel assembly and overlying a clip carrier having a clip counter plate slidably supported in the channel assembly, wherein the clip counter plate is configured and adapted to display a change in status of the clip applier upon actuation of the handle.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: A surgical fastener applier includes a variable drive mechanism disposed within a housing and operably coupled between an input member and an output member, the variable drive mechanism being transitionable between at least a first condition, wherein rotation of the input member by a fixed amount effects rotation of the output member a first amount, and a second condition, wherein rotation of the input member by the fixed amount effects rotation of the output member a second amount different from the first amount.

Abstract: A surgical clip applier is provided having a cartridge carrying multiple surgical clips with a manual graspable actuator configured to sequentially deliver clips to the jaws of the clip applier. Both the cartridge and the jaws are connectable to a scissors-like handle assembly arranged to translate motion from finger loops to the jaws to open and close the jaws and thus close or crimp a delivered clip between the jaws.

Abstract: Method and apparatus for implanting radially expandable prostheses in the body lumens rely on tacking or anchoring of the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable. After initial placement, a fastener applier system is introduced within the expanded prostheses to deploy a plurality of fasteners at least one prosthesis end, usually as each end of the prosthesis. The fasteners are usually helical fasteners which are delivered from a helical track in the fastener applier by rotation with a rotator wire. The fasteners will be applied singly, typically in circumferentially spaced-apart patterns about the interior of each end of the prosthesis.

Abstract: A gas operated surgical instrument is provided. The instrument includes a pressurized gas connection for connection to a source of pressurized gas, a working piston adapted to be acted upon by a pressurized gas, an actuating element for actuating the instrument, and a regulating device coupled to the actuating element and to the working piston for regulating a feed force of the working piston. The regulating device is configured such that, for feed forces below a predetermined limit force, it defines a first work area in which the working piston is movable in the distal direction solely owing to a feed force applied with the actuating element, and that above the limit force the regulating device defines a second work area in which the working piston is movable in the distal direction by being acted upon by pressurized gas.

Abstract: A surgical clip applier includes a train of clips disposed in a plane with a single clip removed from the train of clips and disposed in a staging position. A pair of jaws are adapted to receive the single clip from the staging position by operation of a jaw loader moveable outside the plane of the train of clips. In an associate method, a handle assembly is provided which is moveable in an open stroke and a closed stroke. A source of surgical clips are provided along with a pair of jaws which are adapted to receive one of the clips as the handle assembly is moved in an open stroke, the jaws are open to receive the clip. Following the opening of the jaws, a jaw loader is extended to a position between the jaws to move the clip into the jaws. The handle assembly is moveable in a closed stroke during which the jaws are closed to crimp the clip. Prior to this closing of the jaws, the jaw loader is retracted from the position between the jaws leaving the clip in the jaws.

Abstract: A device for deploying a tissue fixation apparatus of the type including first and second tissue anchors coupled together by an adjustable suture assembly. The device comprises a handle mechanism and a needle cartridge assembly releasably coupled to the handle mechanism. The needle cartridge assembly includes a needle cannula with a side opening through which a tissue anchor can be loaded into an internal chamber of the needle cannula. A push rod is disposed in the needle cannula and is operable between an extended position in which the push rod prevents the tissue anchor from entering the chamber through the side opening, and a retracted configuration in which the tissue anchor can be pushed into the chamber under the action of a resilient band positioned over the side opening.

Abstract: An applier for ligation clip is provided. The applier includes: an outer tube having mounting bosses; a pair of jaws pivotally connected to the mounting bosses, the jaws having actuating projections; a feed tube located in the outer tube and configured to move axially within the outer tube, the feed tube having actuating slots in which the actuating projections are located; a clip lock arm located in the outer tube and configured to move axially within the outer tube; and a clip advance arm located in the outer tube and configured to move axially within the outer tube, the clip advance arm having flexible pinchers at one end of the clip advance arm. A method of applying a ligation clip is also disclosed.

Abstract: Systems and methods for delivering multiple ocular implants to reduce intraocular pressure are disclosed. The ocular implants can be implanted at multiple sites within a single human eye without requiring removal of the delivery apparatus from the eye. A system for delivering multiple ocular implants can include at least two implants preloaded within a delivery device and configured to be implanted within the eye, a metering device configured to transfer energy to the implants for delivery at selected locations within the eye, wherein the metering device is configured to meter a variable amount of energy for each implant delivery event in the eye. The system can further include an injector mechanism configured to serially engage and drive each of the implants.

Abstract: Surgical tools that can be used in single port laparoscopic procedures can include a low-profile handle assembly to minimize tool interference adjacent the incision site. For example, a handle assembly for a surgical instrument can have a generally in-line configuration extending linearly along a central longitudinal axis of an elongate shaft of the instrument. A linkage mechanism including a trigger, an actuation link, and an actuation shaft can be positioned within the in-line handle. The linkage mechanism can be pivoted between an open position in which end effectors of the instrument are open and a toggle position in which the end effectors are locked closed. A locking mechanism such as a ratchet mechanism can also be used to lock the end effectors. A surgical dissector can include gripping jaws having a curved profile or an angled elongate shaft to minimize tool interference and maximize visibility within a procedure site.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: An elongate inserter has a distal end releasably connected to an expandable interbody fusion device and a proximal end including a trigger actuator. The interbody fusion device comprises a superior endplate and an inferior endplate that are movable in an expansion direction relative to each other in the intradiscal space. The inserter includes a lifting platform comprising ramps surfaces that upon operation of the trigger actuator cooperatively engage complementary surfaces of expansion structure within the device to cause the superior and inferior endplates to move relatively away from each other. A driver is supported by the inserter for pushing an insert between the superior and inferior endplates after expansion of the device.