Abstract: A surgical stapling instrument is disclosed, having upper and lower elongate jaws, one of which is adapted to receive a staple magazine, the other jaw being adapted to receive an anvil or to serve as one itself. A pusher bar and knife assembly including a pair of pusher bars and a central knife carrier moves along the jaws to eject staples from the magazine sequentially and to form laterally spaced staple rows in tissue gripped between the jaws while the knife cuts the tissue along a line between the staple rows. The instrument includes structure for locally supporting the jaws in the region of the forward ends of the pusher bars as these elements move along the jaws to resist forces which arise during staple ejection and shaping and which tend to vertically separate or laterally distort the jaws, or both. The magazine and the pusher bar and knife assembly may together constitute a unitary disposable cartridge. One jaw may have tabs or lugs for gripping the other jaw to provide additional lateral stability.

Abstract: An instrument, method and two-piece plastic-like fastener for surgically fastening tissue by:(A) placing the tissue between: (1) a retainer of an absorbable material, that is located distally of the tissue and that has a hole which extends longitudinally through it; (2) an elongated rigid piercing member that is located proximally of the tissue, that extends longitudinally, and that has means on its distal end for piercing the tissue; and (3) a fastener of an absorbable material, that is also located proximally of the tissue and that has a distally extending prong which, during distal movement of the fastener, can (a) move distally through an opening pierced in the tissue by the piercing member and (b) then move distally into the retainer hole to hold the retainer and fastener together;(B) then moving the piercing member distally so that its distal end pierces the tissue; and(C) then moving the fastener distally so that its prong moves through the opening pierced in the tissue and into the retainer hole to ho

Abstract: Surgical clip applying apparatus operable entirely by one hand for advancing clips one at a time into a pair of jaws which close the clip on body tissue. The clips are fed to the jaws in a line. The clips releasably intercouple with one another to form a train which is advanced by a clip pusher acting on the distal-most clip in the train. As the distal-most clip enters the jaws, it is uncoupled from the clip train, and the jaws then close the clip. The pusher is then retracted behind the next clip in the train to ready the apparatus for another cycle of operation.

Abstract: Apparatus for applying surgical clips to tissue includes a self-contained supply of clips and is constructed to apply those clips, one at a time, through movement of the thumb and fingers of one hand. The clips are stored inside a sleeve along the length of the instrument, are fed into jaws at the distal end of the instrument, and are closed about tissue by a camming action produced by moving the jaws relative to the sleeve and camming them shut. An actuating and sequencing section controls feeding and clip deformation, and guarantees that the instrument is operated only in the proper sequence so as to avoid jamming.

Abstract: Surgical fastener applying apparatus including an actuator and a removable surgical fastener container cartridge. The cartridge fits loosely into a cartridge holder part of the actuator which translates linearly toward or away from an anvil part of the actuator. As the cartridge holder translates toward the anvil, the cartridge is automatically brought into alignment and registration with the anvil.

Abstract: In apparatus for applying a two-part surgical fastener including a fastener part having at least one prong and a retainer part having an aperture for receiving and retaining the distal end of the prong, the retainer part is initially held securely to the apparatus by contact with a lug extending into the aperture. The lug is connected to the structure which supports the retainer part of the fastener by a frangible member. When the two parts of the fastener are forced together, the distal end of the prong pushes the lug out of the aperture, thereby breaking the frangible member and releasing the retainer part from the apparatus. The breaking of the frangible member preferably provides the operator of the apparatus with an indication that the two parts of the fastener have interlocked. This indication may be either tactile or audible or both.

Abstract: In apparatus for applying a two-part surgical fastener including a fastener part having at least one prong and a retainer part having an aperture for receiving and retaining the distal end of the prong, the retainer part is initially held securely to the apparatus by contact with a lug extending into the aperture. When the two parts of the fastener are forced together, the distal end of the prong pushes the lug out of the aperture, thereby releasing the retainer part from the apparatus.

Abstract: A blood pressure system which cycles through an inflation cycle and a deflation cycle during which systolic and diastolic blood pressure in a patient is automatically measured. The blood pressure system basically comprises an inflatable pressure cuff system for accomplishing occlusion and the subsequent opening of an artery in a patient being monitored, and an electrical system for increasing and decreasing the pressure in the cuff under servo loop control and for displaying the systolic and diastolic measurements. A pressure transducer produces an electrical signal indicative of the actual pressure in the cuff. A solenoid valve permits selective pressure decrease during the deflation cycle. A rotary vane compression pump provides pressure increase during the inflation cycle. During the inflation cycle, pressure increase in the cuff is accomplished by a servo control loop comprising the transducer, the pump, and an inflate/deflate controller.

Abstract: Surgical clip applying apparatus having a pair of laterally spaced fixed jaws with opposing clip forming surfaces which are inclined toward one another in the direction in which a clip is pushed into the jaws. Tissue to be clipped is positioned between the jaws. A clip is pushed into the jaws so that the free end of each arm of the clip contacts a respective one of the clip forming surfaces, and so that the clip forming surfaces cooperate to force the arms of the clip together on opposite sides of the tissue to produce hemostasis of the tissue. Various means can be included in the apparatus for feeding a plurality of clips to the jaws one at a time in succession. The clips can be made of metal or of plastic. Plastic clips can be either biologically absorbable or nonabsorbable.

Abstract: An improved, self-centering surgical staple is disclosed. Engaging members are located on the base portion of the staple. During forming (bending) of the staple on the anvil, the engaging members engage the forming mechanisms (i.e., the shoulders of the anvil or the twin heads of the pusher) to center the staple on the anvil so that the legs will be embedded in the tissue at the same depth.

Abstract: An apparatus for applying surgical fasteners to tissue is disclosed. The apparatus includes an actuator, an applicator section for applying the fasteners and a transversely flexible shaft connecting the applicator and the actuator. The actuator and applicator preferably each contain a hydraulic fluid chamber. The chambers communicate via a hydraulic line contained in the flexible shaft. Actuation of the instrument causes movement of a piston in the applicator fluid chamber, which causes application of the fasteners. A similar second hydraulic system is preferably provided for adjusting the axial position of an anvil used to clinch the fasteners. The two hydraulic control systems are operable wholly independently of each other, permitting precise control of the anvil pressure on the tissue.

Abstract: A surgical stapler comprising a stapling section, an actuator section remote from the stapling section, and a longitudinally flexible shaft connecting the stapling and actuating assemblies is disclosed. The stapling section generates a force to staple tissue responsive to a much smaller force transmitted hydraulically from the actuator section via the flexible shaft.

Abstract: A surgical stapler including a stapling assembly, an actuator assembly remote from the stapling assembly, and a longitudinal shaft assembly having a longitudinally flexible section for connecting the actuator assembly to the stapling assembly and for transmitting the forces and motions required to operate the stapling assembly from the actuator assembly to the stapling assembly.