Abstract: The invention provides an actuator handle useful in connection with a variety of surgical instruments, in particular, least invasive surgical instruments having an elongate shaft and an axial passage in the shaft in which a linkage is slidably disposed. In a preferred embodiment, the actuator handle comprises a tubular housing axially aligned with the shaft having an axially-aligned elongate opening on a lateral side thereof. A lever is disposed in the elongate opening and is pivotally coupled to the housing at a first end and coupled to the linkage of the surgical instrument at a second end. The second end of the lever is coupled to the linkage wherein the linkage is translated axially by pivoting the lever relative to the housing. The actuator handle further includes a locking lever to lock the lever in an inward position, as well as a pigtail connector for connecting the linkage to an electrosurgical generator.

Abstract: A trocar system comprises an obturator and a trocar cannula. The obturator includes an elongate shaft having a tapered distal end and a proximal end. At least one port is provided near the distal tip of the tapered distal end and open to an axial lumen within the obturator. A mechanism for producing an audible signal in response to superatmospheric pressure at the port, typically a whistle structure, is provided near the proximal end of the trocar. In this way, when the trocar system is introduced to an insufflated region during laparoscopic surgery, an audible whistle will be provided to alert the treating surgeon.

Abstract: The invention provides an apparatus and method for tissue ligation and transection. In a preferred embodiment, the apparatus comprises a shaft with a slot at the distal end in which a tissue structure may be positioned. A suture is mounted about the periphery of the slot with a free end of the suture on a first side of the slot and a knotted loop on a second side of the slot. The free end of the suture is retrieved and threaded through knotted loop so as to form a ligature surrounding the tissue structure. The free end is drawn proximally to tighten the ligature, and the knotted loops are cinched tight to lock the ligature in position. A blade slidably mounted in the shaft may be advanced to transect the tissue structure adjacent or between ligatures. A sleeve for compressing tissue within the slot during ligation, as well as electrodes for cauterizing the tissue, are also disclosed.

Abstract: A suture applier comprises a shaft having proximal and distal ends and carrying a length of suture along its axis. The suture has a surgical needle at its distal end and a knotted loop formed proximally of the needle. The knotted loop is carried at the distal end of the shaft, and a slidable handle is provided at the proximal end for applying axial tension on the suture. In this way, the needle may be used to suture a wound in tissue and may be tied by passing the needle through the knotted loop and closing the loop by pulling on the slidable handle.

Abstract: The invention provides a tissue manipulation system including a tethered clamp and a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity. In a further embodiment, the tissue manipulation system includes a introducer through which the tether can be withdrawn from the abdominal cavity and a clamp attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.

Abstract: A suture applying device comprises an elongate shaft having a length of suture therein. A pre-tied loop suture is held at the distal end of the shaft with a free end of the suture being attached within a handle secured to the proximal end of the shaft. In a first embodiment, a pulley and puller assembly is provided for closing the pre-tied suture loop, where the pulley permits a greater length of suture to be taken in than is traveled by the puller. In a second embodiment, a pair of opposed jaws are slidably mounted within the handle for selectively engaging and gripping the free end of the suture. In this way, an arbitrarily large length of suture may be taken in by pulling on the free end of the suture in successive strokes. The device further includes a sheath slidably disposed on the shaft for protecting the suture during introduction. The sheath automatically retracts when the device is introduced through a trocar sleeve or cannula, thereby exposing the suture loop.

Abstract: A suture applying device comprises an elongate shaft having a slidably mounted cutting member. A pre-tied suture loop is held at the distal end of the shaft with a free end of the suture being attached to a body member which is slidably received over the shaft. The cutting member is secured to the shaft by a link which collapses under a predetermined compressive force, causing the cutting member to move distally forward relative to the shaft to sever the free end of the suture. In this way, the suture loop can be initially tightened and subsequently severed by simply retracting the body member relative to the shaft in a single motion.

Abstract: A suturing device includes a shaft with a pair of axial passages extending through the shaft. A length of suture passes through the first axial passage, the suture having a surgical needle attached to its distal end, and a preformed knotted loop disposed at a distal end of the first axial passage. The second axial passage includes a gaseous seal and is configured to receive a surgical instrument for manipulating tissue to facilitate application of the suture. In the method of the invention, the suturing device is inserted through a cannula and a surgical instrument is introduced through the second axial passage. Tissue is manipulated using the surgical instrument to facilitate application of the suture. A needle holder introduced through a separate cannula is used to pass the needle through the wound and through the knotted loop. Tension is then applied to the suture to close the knot and bind the wound.

Abstract: A suture applier comprises a shaft having proximal and distal ends and carrying a length of suture along its axis. The suture has a surgical needle at its distal end and a knotted loop formed proximally of the needle. The knotted loop is carried at the distal end of the shaft, and a slidable handle is provided at the proximal end for applying axial tension on the suture. In this way, the needle may be used to suture a wound in tissue and may be tied by passing the needle through the knotted loop and closing the loop by pulling on the slidable handle.

Abstract: A device for introducing fluids into the lumen of a body duct comprises an elongate shaft having a mechanism at its distal end for capturing the duct. A needle is disposed within an axial passage in the shaft, and a mechanism for reciprocating the needle is located at the proximal end of the shaft. In this way, the duct can be captured with the capture mechanism and pierced with the needle. The fluid is then provided to the lumen of the duct through a perfusion port located at or near the distal end of the needle. Optionally, a mechanism for applying a vacuum externally to the duct within the capture mechanism is provided to help hold the duct and open the interior to facilitate introduction of the fluid.