Abstract: A hydraulically actuated medical instrument includes an elongated shaft having proximal and distal ends, a hydraulically actuated end effector at the distal end of the shaft and a fluid flow path extending through the shaft to the end effector. The shaft may be capable of an angled configuration where at least a portion of the shaft is manually movable to a direction in which it extends at an angle to another portion of the shaft. The end effector is not limited to a linear configuration and at least a portion of an elongated end effector extends at an angle relative to another portion of the end effector as is needed or desirable for the particular procedure to be performed.

Abstract: An exemplary surgical method of treating tissue may include possessing a surgical tool that has at least one movable feeder belt that includes staples frangibly connected thereto, where at least one staple is oriented relative to the feeder belt in a direction angled relative to the transverse direction; placing the surgical tool adjacent to tissue; deforming at least one staple into tissue; frangibly separating at least one deformed staple from the feeder belt; advancing the feeder belt; and repeating the placing, deploying and separating. Another exemplary surgical method of treating tissue of a patient may include holding a cartridgeless surgical tool that includes staples; stapling tissue with staples in response to a single actuation of the surgical tool; and repeating the stapling at least once.

Abstract: A surgical endocutter may include an end effector, at least one feeder belt that extends at least partially into the end effector; and two or more staples, where each staple has a first end frangibly connected to a corresponding feeder belt and a second, free end, and where the staples form at least one row. The endocutter may be used to treat a patient by inserting the end effector into the body of a patient through an opening such as a trocar port, engaging tissue with the end effector, stapling tissue along two staple lines with the end effector; cutting tissue between the staple lines with the end effector, releasing the tissue from the end effector, and repeating the holding, stapling and engaging on tissue at a different location within the body of the patient without removing the end effector from within the body of the patient.

Abstract: A hydraulically actuated medical instrument includes an elongated shaft having proximal and distal ends, a hydraulically actuated end effector at the distal end of the shaft and a fluid flow path extending through the shaft to the end effector. The end effector may be directly manually operated by way of a handle located at the proximal end of the shaft or remotely, for example, via robotic controller. Articulation joints may be provided along the shaft, between the shaft and end effector or handle, or elsewhere. The hydraulic actuation of the present invention permits multiple axis instrument articulation, miniaturization and simplified instrument fabrication.

Abstract: An exemplary driverless surgical stapler may include a staple holder; staples positioned within that staple holder; and at least one wedge, where each wedge is slidable to directly contact at least one staple, where that contact causes deployment of each contacted staple. An exemplary surgical method may include providing a driverless surgical stapler that has a staple holder, staples positioned within the staple holder, and at least one wedge; and sliding at least one wedge relative to the staples to directly contact at least one staple.

Abstract: A surgical apparatus may include a feeder belt having two lateral edges, and a number of staples, where each staple includes a first end frangibly connected to the feeder belt and a second free end, where at least one staple is oriented relative to the feeder belt in a direction angled relative to the transverse direction, and where the staples form at least one row, each row including at least two staples. The feeder belt may be held by a surgical stapler. The surgical stapler may be utilized by placing that surgical stapler adjacent to tissue, deforming at least one staple into tissue, separating at least one deformed staple from the feeder belt, advancing the feeder belt, and repeating the placing, deploying and separating.

Abstract: An exemplary surgical stapler may include a staple holder, staples positioned within the staple holder, and at least one structure slidable within the staple holder to contact directly at least one staple, where that direct contact deploys at least one staple from the staple holder. Another exemplary surgical stapler may include a staple holder, an anvil movably connected to the staple holder, staples positioned within the staple holder; and a sled slidable within the staple holder to contact directly at least one staple, where that direct contact urges at least one staple out of the staple holder and against the anvil.

Abstract: A hydraulically actuated medical instrument includes an elongated shaft having proximal and distal ends, a hydraulically actuated end effector at the distal end of the shaft and a fluid flow path extending through the shaft to the end effector. The end effector may be directly manually operated by way of a handle located at the proximal end of the shaft or remotely, for example, via robotic controller. Articulation joints may be provided along the shaft, between the shaft and end effector or handle, or elsewhere. The hydraulic actuation of the present invention permits multiple axis instrument articulation, miniaturization and simplified instrument fabrication.

Abstract: One example of a surgical instrument may include a handle, an end effector, and a shaft that connects the handle to the end effector, where the shaft includes an articulated region. At least one feeder belt may extend through the lumen of the shaft into the end effector, where at least one feeder belt may include at least one staple frangibly connected thereto.

Abstract: A method for closing a patent foramen ovale in the heart tissue of a patient may include percutaneously advancing a connector applicator to the patent foramen ovale, registering the connector applicator with the patent foramen ovale, deploying connectors into heart tissue to close the patent foramen ovale; and percutaneously removing the connector applicator from the heart. One or more anchors may be used to register the connector applicator with the patent foramen ovale. The connector applicator may include a driver having a longitudinal passage therein, where at least part of at least one connector is positioned within the passage.

Abstract: An anastomosis system for connecting a graft vessel to a target vessel includes spaced-apart arms, and an anvil connected to those arms, where that anvil has a blunt distal end. The anvil is insertable into the target vessel. One or more connectors, such as staples, may be deployed from each arm to connect the graft vessel to the target vessel.

Abstract: An exemplary driverless surgical stapler may include a staple holder; staples positioned within that staple holder; and at least one wedge, where each wedge is slidable to directly contact at least one staple, where that contact causes deployment of each contacted staple. An exemplary surgical method may include providing a driverless surgical stapler that has a staple holder, staples positioned within the staple holder, and at least one wedge; and sliding at least one wedge relative to the staples to directly contact at least one staple.

Abstract: An integrated anastomosis tool may include an effector that both makes an opening in the wall of a target vessel and connects a graft vessel to the target vessel. The connection between the graft vessel and the target vessel may be compliant, and may be achieved by deploying a plurality of connectors such as staples into tissue. The effector may include a cutter assembly and a connection module that are independently actuatable. The cutter assembly and/or the connection module may be cable-actuated.

Abstract: An example of a surgical clip applier may include a housing with a passage defined therein, the passage having a longitudinal centerline; a plurality of clips held within the passage, each clip lying in a plane angled relative to the longitudinal centerline of the passage; a pusher slot defined in the housing; and a pusher slidable along the pusher slot, wherein distal motion of the pusher urges the distalmost clip in the passage out of the passage in a direction angled relative to the longitudinal centerline of the passage. Another example of a surgical clip applier may include a first jaw having a control slot defined therein; a second jaw having a control slot defined therein; and a control arm extending into the control slot of each jaw; wherein the control arm is movable along the control slots in a first direction to close the jaws and is movable along the control slots in a second direction to open the jaws.

Abstract: An anastomosis tool includes a handle connected to a tissue effector that may be capable of being oriented in two or more positions relative to the handle. The tissue effector holds a graft vessel having at least one flap defined in at least one end thereof against the side of a target vessel. Actuation of a trigger or other mechanism on the handle causes the tissue effector to deploy one or more connectors into the flaps of the graft vessel and the side of the target vessel, thereby connecting the graft vessel to the target vessel.

Abstract: One example of a surgical stapler may include a pusher, at least one generally planar staple, where the pusher holds at least one staple, and a splay arm that includes spaced-apart splay fingers extending generally distally, where at least one splay finger includes a splay tip extending therefrom, and where relative motion of said pusher and said splay fingers causes said at least one said splay tip to engage and then splay at least one said staple. Another example of a surgical stapler may include a plurality of staples positioned out of contact with one another; a pusher that engages each staple; and at least one splay tip, each splay tip configured to contact a distal surface of the distalmost staple.

Abstract: A surgical tool may include a staple holding strip, and surgical staples frangibly connected to an edge of that staple holding strip.

Abstract: An apparatus and method for ejecting fluid from a fluid delivery system. The fluid delivery system has a pneumatic assembly that when triggered injects gas into a hydraulic assembly, which in turn ejects fluid through an external interface. An electronic interface displays various measurements, for example, how much fluid has been ejected and if the hydraulic system is closed the pressure of the system. The pneumatic assembly can also be depressurized such that fluid can reenter the hydraulic assembly through the external interface.

Abstract: One method for closing an opening in tissue may include providing a substantially continuous solid staple having a plurality of tines and a longitudinal centerline, plastically deforming the staple to a splayed configuration; penetrating at least one tine into tissue in proximity to the opening; and plastically deforming the staple to a closed configuration. Another method for closing an opening in tissue may include providing a staple having a plurality of tines; plastically deforming the staple to a splayed configuration by applying force in the distal direction against a proximal surface of the staple; penetrating at least one tine into tissue in proximity to the opening; and plastically deforming the staple from the splayed configuration to a closed configuration by applying force in the distal direction against a proximal surface of the staple.

Abstract: A method for anastomosing a first vessel to a second vessel may include connecting an end of the first vessel to the side of the second vessel and creating an opening in the wall of the second vessel from within the lumen of the second vessel, where that opening allows fluid communication between the lumen of the first vessel and the lumen of the second vessel.