Abstract: Jaw assemblies for a surgical stapler are provided. The jaw assemblies comprise a first jaw having a first clamping surface and a plurality of staples disposed therein and second jaw assembly having a second clamping surface. The jaw assemblies can be actuated from a closed configuration in which the first clamping surface contacts or is adjacent to the second clamping surface to an open configuration in which the second jaw is pivoted away from the first jaw to a stapling position in which the second clamping surface is parallel to the first clamping surface and spaced apart from the first clamping surface. A pivoting link or sliding pivot joint can couple the second jaw to the first jaw to facilitate motion between the closed position, the open position, and the stapling position.

Abstract: A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; a flexible outer ring; an inner ring; a flexible sheath extending between the outer ring and the inner ring; and at least one rigid segment adapted to attach to the flexible outer ring to thereby increase the rigidity of the outer ring. Embodiments of the retractor/protector are described that have interlocking and non-interlocking rigid segments. Embodiments are also described that have bases that insert into or under the flexible outer ring in addition to or in lieu of rigid segments to increase rigidity and/or provide support for a detachable cap.

Abstract: A surgical instrument is provided having an actuator mechanism with an integrated extension element. The surgical instrument comprises a handle assembly, an elongate shaft, and an end effector. The end effector comprises a jaw assembly having atraumatic pads to reduce force on grasped tissue. An actuator is movable within the elongate shaft to actuate jaws of the jaw assembly responsive to a movable handle of the handle assembly. The actuator can have an integrated extension element that allows the actuator to translate within the elongate shaft upon application of a relatively low force and translate and extend upon application of a relatively higher force to the actuator to limit the force applied by the jaw assembly. The actuator also utilizes forces stored with the integrated extension element to provide a dynamic amount of force used to grasp the tissue when the tissue volume decreases while in the jaws.

Abstract: A renal hilum surgical simulation system is provided. The renal hilum surgical simulation system includes simulated tissue layers and simulated renal organs and/or vasculatures. The renal hilum surgical simulation system is adapted for but not limited to laparoscopic donor nephrectomy surgical procedures.

Abstract: A simulated tissue structure for surgical training is provided. The simulated tissue structure includes a first layer made of silicone and a second layer made of silicone interconnected by a third layer made of polyester fiber that is embedded in part in the first layer and in part in the second layer to create a mechanical linkage between the first layer and the second layer. Part of the third layer that is adjacent to the first layer and part of the third layer that is adjacent to the second layer includes fiber strands coated in silicone. An inclusion that mimics an anatomical structure is located between the first layer and the second layer. The third layer of polyester fibers provides a realistic dissection plane for the practice of the surgical excision of the inclusion.

Abstract: Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; and various stabilizing mechanisms surrounding the tubular body, sized and configured to stabilize and retain the retractor within the orifice. The stabilizing embodiments described herein are useful in all natural orifices and are of particular use in the vaginal surgery.

Abstract: Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.

Abstract: A tissue retrieval system including a tissue retrieval bag deployable by an actuator from an introducer and suspended in an open configuration by support arms can be serially redeployed between a partially or fully stowed configuration and a first deployed configuration to be used in procedures to collect multiple samples. The system can include defeasible proximal and distal stop mechanisms to limit movement of the actuator for serial redeployment. The tissue retrieval system can include a retention latch to couple a bead of the tissue retrieval bag to the actuator with the retrieval bag in the first deployed position and a user-selectable deployment release to allow deployment of the retrieval bag to a fully deployed position where it is released from the actuator. A bead stop is positioned to engage the introducer to prevent reintroduction of the bead and bag into the introducer once the bag has been fully deployed.

Abstract: An electrosurgical instrument is provided that captures, compresses, fuses and cuts tissue between upper and lower jaws connected to pivotably movable handles. The instrument includes a force and over compression regulation mechanism that is configured such that in a clamped configuration, the jaws delivers a gripping force between the first jaw and the second jaw between a predetermined minimum force and a predetermined maximum force.

Abstract: A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include a rotational mechanism arranged to discretely position the rotatable actuation shaft in one of the rotational orientations. The rotational mechanism can be arranged for single handed operation such as by including a slidable switch or selector to rotate the actuation shaft.

Abstract: A surgical stapler is provided that includes a spring loaded lift that automatically adjusts a staple cartridge and/or staple formation between a range of sizes. The lift is automatically released as the staple firing mechanism begins its forward translation of the firing sequence. The automatic one-way adjustment also adjusts the staple cartridge while maintaining the cartridge parallel to the anvil to provide consistent staple formations.

Abstract: A surgical training model that includes a simulated tissue having a tubular shape that is connected to a tissue holder is provided. A portion of the simulated tissue overhangs the distal end of the tissue holder to simulate a cuff-like entry to the vaginal vault or resected intestine suitable for practicing laparoscopic closure of the vaginal vault, intestine or other organ via suturing or stapling. Two concentric tubular structures are also arranged over the same tissue holder. A second model includes two portions of simulated tissue that are held by two holders such that the simulated tissues are adjacent making the model suitable for practicing different types of anastomosis procedures. A third model includes two holders with a single or double tubular simulated tissue structure connected to and spanning a gap between the holders. The model isolates the step of closing a cylindrical opening for the purpose of repeated practice.

Abstract: A tissue retractor comprising an outer ring, an inner ring, and a flexible, metal sheath extending therebetween is described. Embodiments of the inner ring comprise a flat or wedge-shaped conformation useful for insertion between muscle layers. Other embodiments of the inner ring include variable diameter inner rings, where the diameter can be adjusted as required and optionally locked into place, and reshapeable inner rings that permit a user to conform the inner ring to the anatomy of the patient when placing the inner ring.

Abstract: A surgical access port or trocar is provided. The trocar has a trocar seal housing and a trocar cannula with an optical obturator insertable through the trocar seal housing and the trocar cannula. The trocar is configured to access a body cavity, to maintain positive pressure and to prevent loss of surgical insufflation gas used in laparoscopic procedures. The trocar seal housing can be releasably attached to the trocar cannula. The trocar seal housing may also have a shield and/or alignment channel that provide protection or assist in operation of instrument and zero seals housed in the trocar seal housing.

Abstract: A surgical training model can have features for training surgical suturing techniques. The training model can be formed as a sheet of simulated tissue having at least one cut with markings arranged on either side of the cut. The markings can be formed of a first layer of resilient simulated tissue material having a color that contrasts with a color of the remainder of the sheet of simulated tissue material. The sheet of simulated tissue material can have several cuts having different configurations and orientations to facilitate suturing training for a variety of tissue orientations. The sheet of simulated tissue material can further include holes positioned to be mounted to a base of a surgical training system. The sheet of simulated tissue material can be manufactured by molding a marking layer and casting a tissue layer over the marking layer.

Abstract: A mechanical cap ring/gel pad assembly useful in surgical access devices and methods for making the same, wherein the cap ring and the gel pad are formed separately and then mechanically attached to form a strong seal without the need for heating, solvents or adhesives.

Abstract: The present invention provides a surgical training device for training laparoscopic first entry surgical techniques. The training device includes a simulated abdominal wall that is penetrable with an optical trocar. A receptacle containing a tissue simulation is located inside the receptacle. The tissue simulation is observable via scope placed inside the optical trocar. Upon penetration of the one or more of the simulated abdominal wall and receptacle, the tissue simulation appears to translate distally relative to the simulated abdominal wall. The distal translation is effected by a variety of ways including the release of negative pressure inside the receptacle upon penetration and the expansion of an elastic wall of the receptacle with the introduction of fluid under pressure into the receptacle.

Abstract: A system for training surgical camera navigation skills is provided. A plurality of two-dimensional targets is printed on an upper surface of a flat sheet of material. The sheet is easily transportable and placed onto a base of a typical box trainer that defines a simulated abdominal cavity between the base and a top. A scope is inserted through a port in the top and the targets are viewed on a live video feed displayed to a trainee on a screen with the targets being otherwise obscured from view by the box trainer. The trainee can move the scope back and forth, roll and angulate the scope about the port in order to view the targets on the sheet at different angles and distances. The trainee is instructed to follow a sequence of targets marked on the sheet and manipulate the scope to align consecutively each target with the edges of the screen in the sequence provided.

Abstract: A laparoscopic suturing device is provided. The suturing device can pass a suturing needle back and forth between jaws of a jaw assembly to suture tissue at a surgical site in a minimally invasive procedure. The jaw assembly can have a pivotable jaw member in each jaw to position the jaw assembly and needle in a low-profile stowed configuration for insertion through a low diameter surgical port. The jaw assembly can be actuated by a handle assembly that provides simultaneous needle passing from a driving jaw to a receiving jaw and latching the needle within the receiving jaw in a single trigger cycle.

Abstract: A system for training a clinician in energy-based surgical techniques that advantageously does not require the simulated tissue to be electrically conductive is provided. The simulated tissue comprises one or more materials. A heat generator is configured in the shape of a medical instrument typically encountered in energy-based surgical procedures such as electrosurgery or electrocautery. The instrument delivers sufficient heat to melt at least one of the materials in order to simulate energy-based surgical techniques such as excising target material. The one or more materials are configured in the simulated tissue such that their relative thermoplasticity defines a predetermined surgical pathway of a desired clinical outcome.