Abstract: The present invention generally provides methods and devices for controlling movement of an end effector, and in particular for causing mimicked motion between an input tool and an end effector during a surgical procedure. In an exemplary embodiment, a surgical system is provided having a master assembly with an input tool and a slave assembly with an end effector. The master assembly and the slave assembly can be coupled together by a mechanical assembly that is configured to mechanically transfer mimicked, rather than mirrored, motion from the input tool to the end effector. A floating frame is also provided and can be utilized with the surgical system. The floating frame can have a counterbalance that allows the surgical system to “float” above a patient and provide a weightless feel to movement of the surgical system. The floating frame can provides additional degrees of freedom for movement of the surgical system.

Abstract: A laparoscopic surgical method comprises obtaining a first instrument comprising an elongate shaft with a distal end and a proximal end connected to a first handle. The distal end of the first instrument is passed through a percutaneous incision. A surgical end effector is obtained having a distal end with operable jaws and a proximal end selectively attachable to and detachable from the distal end of the first instrument. A second instrument is obtained comprising a distal end and a proximal end connected to a second handle. The surgical end effector is loaded ex vivo on the distal end of the second instrument. The distal end of the second instrument with the loaded surgical end effector is passed through a second incision spaced from the percutaneous incision. The proximal end of the surgical end effector is attached in vivo to the distal end of the first instrument. Tissue is manipulated by actuating the handle of the first instrument to operate the jaws of the surgical end effector.

Abstract: A surgical instrument includes a handle assembly having a trigger operable to fire a staple driver to staple tissue. The instrument includes a pointed rod to which an anvil may be coupled. An anvil detection feature is included to determine when the anvil is coupled to the rod. In some versions, the anvil detection feature comprises a translatable rod that inhibits a lockout feature from disengaging. In other versions, an anvil sensing tube is disposed about the pointed rod and interferes with actuation of the trigger in a first position. A recess in the tube permits trigger to actuate when the anvil sensing tube is in the second position. Alternatively, a resilient tab is coupled to the pointed rod and resists actuation of the staple driver. A trigger lockout assembly may include a spring-loaded button that “pops” out when a push rod is actuated, thereby freeing a pivotable lockout feature.

Abstract: The present invention generally provides methods and devices for controlling movement of an end effector, and in particular for causing mimicked motion between an input tool and an end effector during a surgical procedure. In an exemplary embodiment, a surgical system is provided having a master assembly with an input tool and a slave assembly with an end effector. The master assembly and the slave assembly can be coupled together by a mechanical assembly that is configured to mechanically transfer mimicked, rather than mirrored, motion from the input tool to the end effector. A floating frame is also provided and can be utilized with the surgical system. The floating frame can have a counterbalance that allows the surgical system to “float” above a patient and provide a weightless feel to movement of the surgical system. The floating frame can provides additional degrees of freedom for movement of the surgical system.

Abstract: An apparatus comprises a body and a shaft assembly. The shaft assembly is in communication with the body and comprises an end effector, first cam gear, second cam gear, and a lock bar. The end effector has an articulation joint. The first cam gear is rotatably positioned within the shaft assembly. The second cam gear is in communication with the end effector at the articulation joint. The lock bar is distally biased to lock against the second cam gear. The first cam gear is rotatable through a first range of motion to unlock the lock bar relative to the second cam gear. The first cam gear is rotatable through a second range of motion to rotate the end effector at the articulation joint.

Abstract: A system for tissue approximation and fixation is described herein. A device is advanced in a minimally invasive manner within a patient's body to create one or several divisions or plications within a hollow body organ. The system comprises a stapler assembly having a tissue acquisition member and a tissue fixation member. The stapler assembly approximates tissue from within the hollow body organ with the acquisition member and then affixes the approximated tissue with the fixation member. In one method, the system can be used as a secondary procedure to reduce the size of a stoma within the hollow body organ.

Abstract: An end effector comprising a first jaw, a second jaw, and a firing member is disclose. The firing member, in various embodiments, further comprises a first portion configured to contact one of the first jaw and the second jaw, and a second portion configured to contact one of the first jaw and the second jaw. The first portion can be comprised of a first material. The firing member can further comprise an annex engaged with the first portion comprised of an annex material which is different than the first material. In various instances, the first portion and the second portion are configured to co-operatively set a tissue gap distance between the first jaw and the second jaw.

Abstract: Surgical devices are disclosed herein that generally include an intracorporeal elbow joint to facilitate translational movement of an end effector while allowing a body portion of the surgical device and a trocar or working channel through which the device is inserted to be maintained in a fixed angular orientation relative to the patient. This allows a plurality of such devices to be used effectively with a single incision or access device. Such devices also generally provide end effector movement with six degrees of freedom, while maintaining a mechanical linkage between the user and the end effector and while mimicking and/or mirroring natural user movement. Various methods related to such devices are also disclosed.

Abstract: A surgical cutting and fastening instrument. The instrument comprises an end effector that has a shaft coupled thereto that is coupled to a robotic system. A tool mounting portion includes an electric, DC motor connected to a drive train in the shaft for powering the drive train. A power pack that comprises at least one charge-accumulating device connected to the DC motor for powering the DC motor is provided.

Abstract: A surgical suturing device comprises a needle having a leading end, a trailing end, an arced body between the leading and trailing ends, and two steps located at antipodal positions on the body. A length of suture is connected to the needle. A needle driver reciprocates at least 180 degrees between a driven position and a returned position. The needle driver is adapted to engage the needle steps to rotate the needle in a circular path in first rotational direction. A pawl is positioned adjacent the driven position of the needle driver. The pawl is adapted to engage the needle steps to prevent the needle from rotating in a second rotational direction opposite of the first rotational direction.

Abstract: Methods and compositions are provided for treating weight related conditions and metabolic disorders by altering microbiota in a subject. One aspect provides methods and compositions to alter microbiota in a subject by administering to the subject a composition that includes a substantially purified microbiota from phyla such as Bacteroidetes, Proteobacteria, Firmicutes and Verrucomicrobia or orders such as Bacteroidales, Verrucomicrobiales, Clostridiales and Enterobacteriales or genera such as Alistipes, Clostridium, Escherichia, and Akkermansia. Another aspect includes a pharmaceutical composition for altering microbiota that includes a therapeutically effective amount of substantially purified microbiota and a pharmaceutically acceptable carrier. Yet another aspect includes methods for treating a disorder, such as obesity, in a subject in need of such treatment by changing relative abundance of microbiota in a gastrointestinal tract of the subject without or in addition to a surgical procedure.

Abstract: Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an interior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.

Abstract: A control circuit of a surgical device is disclosed. The control circuit includes a first circuit portion coupled to at least one switch operable between an open state and a closed state. The first circuit portion communicates with a surgical generator over a conductor pair to receive a control signal to determine a state of the at least one switch.

Abstract: An apparatus comprises a shaft, a needle throwing arm, and a needle receiving arm. The arms are movable asynchronously along planes that are substantially parallel to a longitudinal axis defined by the shaft. The arms selectively engage a surgical needle, such that the throwing arm may pass the surgical needle through tissue for receipt by the receiving arm, and the receiving arm may then pass the surgical needle back to the throwing arm for additional stitching. The arms may pivot about a common pivot. Such versions may include a single actuator for both arms or separate actuators for the arms. The arms may also pivot about their own respective axles, which may facilitate a forward reset motion for a needle, allowing the needle to continue travelling along a circular path in a single direction to create several stitches. The apparatus may also convert reciprocating movement of actuators into rotational motion.

Abstract: Methods and devices are provided utilizing an end effector having three jaws movably coupled thereto for grasping and/or dissecting tissue. In one embodiment, each of the three jaws are movable between an open position in which the distal ends of the three jaws are spaced apart from one another, and a closed position in which the distal ends directly contact one another. The jaws can define an opening therebetween when the jaws are in the closed position.

Abstract: An ultrasonic surgical shears includes an ultrasonic surgical blade, a clamping arm operable to open and close toward the blade, and a tissue pad attached to the clamping arm. A method for sealing a blood vessel of a patient includes obtaining an ultrasonic surgical shears and positioning the blood vessel between the blade and the tissue pad. The clamping arm is operated to exert an average coaptation pressure on the blood vessel between and including 60 psi and 210 psi. The blade is ultrasonically vibrated to transect and seal the blood vessel.

Abstract: An apparatus for operating on tissue includes an end effector, a first actuator, and a second actuator. The end effector includes a first jaw pivotable relative to a second jaw to a closed position. The first actuator is movable from a first position to a second position to pivot the first jaw to the closed position. The first actuator engages the second actuator in the second position to selectively provide RF energy to the end effector.

Abstract: Devices and methods for detecting meal intake are disclosed herein. In some embodiments, one or more sensors can be used to detect or monitor physiological parameters of a user (e.g., heart rate, body movements, temperature, pH, impedance, gastric stretch, sound emissions, and the like). The outputs of the sensors can be received by a computer system configured to analyze the sensor data and make a determination as to whether meal intake has occurred or is presently occurring. The computer system's determination can be used to trigger, modulate, or otherwise control one or more therapeutic devices. Other types of devices can also be controlled using this determination, such as monitoring or logging devices.

Abstract: A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

Abstract: A surgical instrument includes an end effector and a feedback system. The end effector includes a first jaw and a second jaw, wherein at least one of the first jaw and the second jaw is movable relative to the other one of the first jaw and the second jaw to transition the end effector during a closure stroke between an open configuration, a first approximated configuration, and a second approximated configuration. The feedback system includes an indicator, the indicator transitionable between a first indicator position, a second indicator position, and a third indicator position, wherein the indicator is in the first indicator position when the end effect is in the open configuration, wherein the indicator is in the second indicator position when the end effector is in the first approximated configuration, and wherein the indicator is in the third indicator position when the end effector is in the second approximated configuration.