Abstract: Methods and devices are provided for performing gastroplasties. In one embodiment, a method of performing a gastroplasty includes gaining access to a stomach of a patient through an opening formed in the patient's abdominal wall. A multiple port access device having two or more sealing ports through which surgical instruments can be inserted can be positioned in the abdominal opening. Various instruments can be inserted through the various sealing ports to perform certain steps, such as tensioning and cutting tissue, sizing and transecting the stomach, viewing the surgical site, etc. The methods and devices can be used to perform a Magenstrasse and Mill procedure in which only a portion of the stomach is transected.

Abstract: Methods and devices are provided for performing gastrectomies and gastroplasties. In one embodiment, a method includes gaining access to a stomach of a patient through an opening formed in the patient's abdominal wall and an opening formed in the patient's vaginal wall. Tissue attached to the stomach can be tensioned using a surgical instrument inserted through one of the abdominal and vaginal openings and can be separated from the stomach to free the stomach fundus using a dissecting surgical instrument inserted through another opening, e.g., through one of the abdominal and vaginal openings. The fundus can be at least partially transected using a surgical stapler inserted through one of the abdominal and vaginal openings, thereby forming a stomach “sleeve.” In another embodiment, the method is modified to form another opening in the patient's abdominal wall instead of forming an opening in the vaginal wall.

Abstract: Methods and devices are provided for performing gastrectomies and gastroplasties. In one embodiment, a method includes gaining access to a stomach of a patient through an opening formed in the patient's abdominal wall and an opening formed in the patient's vaginal wall. Tissue attached to the stomach can be tensioned using a surgical instrument inserted through one of the abdominal and vaginal openings and can be separated from the stomach to free the stomach fundus using a dissecting surgical instrument inserted through another opening, e.g., through one of the abdominal and vaginal openings. The fundus can be at least partially transected using a surgical stapler inserted through one of the abdominal and vaginal openings, thereby forming a stomach “sleeve.” In another embodiment, the method is modified to form another opening in the patient's abdominal wall instead of forming an opening in the vaginal wall.

Abstract: Methods and devices are provided for providing irrigation and/or suction to a surgical site and maintaining clear visibility through a lens of a scoping device during a surgical procedure. In general, the methods and devices can allow for a surgical instrument to maintain visibility during a surgical procedure using a fluid conduit coupled to the surgical instrument. A surgical device can include a sheath having at least one lumen extending therethrough configured to allow a surgical viewing instrument to be disposed therein. The sheath can also have a passageway extending therethrough configured to allow fluid to flow therethrough. The fluid conduit can be configured to be movable between positions that can allow alternative directions of fluid toward and/or away from a viewing element on the surgical instrument and fluid away from the viewing element and toward a surgical field in a body cavity.

Abstract: A first expression of apparatus for keeping clean a medical viewing scope's distal scope end includes a tube, an annular sheath, and a handpiece. The tube has a proximal end fluidly connectable to irrigation fluid and has a distal end fluidly connected to the handpiece. The sheath is surroundingly attachable to the scope and includes a lumen between the sheath's inside and outside diameters. The lumen has a substantially constant cross-sectional flow area which is substantially equal in area to the tube's cross-sectional flow area. The handpiece is in fluid communication with the proximal lumen end. The distal scope end is positioned proximate the attached sheath's distal lumen end. A second expression of the apparatus has the lumen with a substantially crescent shape without any limitation on its cross-sectional flow area. In an alternate embodiment, the lumen substantially continuously varies in cross-sectional flow area and/or irrigation flow path direction.

Abstract: A staple cartridge for use with a stapling device that has an actuator that is selectively actuatable in an axial direction and an anvil portion that is selectively movable between open and closed positions is disclosed. Various embodiments of the present invention include a cartridge body that movably supports first and second staple drivers. The staple drivers each support a staple thereon and serve to drive the staples into forming contact with the anvil upon actuation by the actuator. The various embodiments of the present invention enable the final formed heights of the staples to be varied so as to apply various clamping forces and pressures to soft tissue captured within the staples. In at least one embodiment, the staples can include crowns formed thereon which can be utilized to adjust or control the clamping force and/or pressure applied by the staples.

Abstract: A health care assessment system and associated methods are provided for providing increased access to individuals for assessing whether a need exists for health care and then also facilitating an individual's access to health care as needed. Embodiments of the system include a health care assessment system for receiving input from a patient and generating an output reflecting an indivdual's risk of one or more disease states. The health care assessment system is further capable of providing resources for health care and visual tools for collecting patient history.

Abstract: An apparatus and method for reducing post-operative ileus and/or gastric stasis is described. The method can include applying to the intestine a therapeutically effective amount of a composition comprising a drug that is effective in reducing post-operative ileus and/or gastric stasis, such as by introducing the composition through a surgical access device, such as a trocar or endoscope. The apparatus can include a sheet of material, a surgical fastener, or a buttress comprising the composition.

Abstract: An apparatus and method for reducing post-operative ileus and/or gastric stasis is described. The method can include applying to the intestine a therapeutically effective amount of a composition comprising a drug that is effective in reducing post-operative ileus and/or gastric stasis, such as by introducing the composition through a surgical access device, such as a trocar or endoscope. The apparatus can include a surgical fastener and a buttress comprising the composition.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle and an obturator shaft. The obturator shaft has a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough. The protector also includes a flexible proximal end movable against the obturator handle to expose the penetrating tip when a proximal force is asserted against the protector.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle and an obturator shaft. The obturator shaft has a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough. The protector also includes a flexible proximal end movable against the obturator handle to expose the penetrating tip when a proximal force is asserted against the protector.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle and an obturator shaft. The obturator shaft has a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough. The protector also includes a flexible proximal end movable against the obturator handle to expose the penetrating tip when a proximal force is asserted against the protector.

Abstract: An electrosurgical instrument is provided for cauterization and/or welding of tissue of varying impedance, thickness and vascularity especially in the performance of endoscopic procedures. The instrument compresses the tissue between one pole of a bipolar energy source located on one interfacing surface, and a second interfacing surface applying pressure in a predetermined range wherein one of the interfacing surfaces is positioned on an anvil with a specified preload and spring rate. A second pole is located one of the two interfacing surfaces. In a preferred embodiment, the second pole is located on the same interfacing surface as the first pole and an insulator electrically isolates the two poles. A preferred application of the invention is in a cutting instrument wherein a hemostatic line is formed along a cut line using RF energy.