Abstract: A conductive cannula assembly is disclosed to dissipate possible, accumulated electrical charges through body tissue. The cannula assembly includes cannula housing means and cannula means formed of a material having an electrical conductivity value which is at least fifty percent the conductivity value of silver. The invention also includes cannula assembly accessories formed of a material having an electrical conductivity value which is at least fifty percent the conductivity value of silver. The invention further provides a method for guiding endoscopic instruments into body tissue utilizing the cannula assembly and the cannula assembly accessories of the present invention.

Abstract: A safety device is provided for use with endoscopic instrumentation, particularly and endoscopic clip applier. The device includes a collar which is adapted to be disposed on the elongated shaft of the endoscopic instrument. A release means is provided as part of the trocar guide sleeve which is adapted to contact the collar and release it from engagement with the elongated shaft.

Abstract: Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes arcuately shaped means for holding a plurality of the fastener portions in generally aligned relation, correspondingly arcuately shaped means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween.

Abstract: A suture holding clip including legs each having a suture contacting surface. The legs can be closed to define an interface for holding a suture in a serpentine configuration. In another embodiment the suture holding clip is initially in a spider leg configuration with a spine and legs projecting from the spine and alternately angled to one or the other of two directions so as to define therebetween a lengthwise extending passage for the reception therethrough of a suture.

Abstract: A detachable anvil rod for use with an apparatus for circular fastening of hollow organs is provided. An elongated rod member has a proximal end portion, a distal end portion and an irregular surface portion intermediate the proximal and distal end portions. The irregular surface portion includes a plurality of grooves which define a plurality of raised ridges. The ridges are adapted to engage grasping surfaces of a grasping tool so as to minimize potential of slippage, thus enhancing the maneuvering procedure of the anvil rod about the operative site. The anvil rod also includes a narrowly configured mounting portion which enables the rod to be applied to and mounted within the distal end of the stapling apparatus from a variety of angular positions. An apparatus which incorporates the improved detachable anvil rod is also described.

Abstract: An apparatus for simultaneously applying to body tissue at least one surgical suture in conjunction with a plurality of surgical fasteners arranged end to end in rows. The apparatus preferably includes a knife for making an incision in the body tissue sealed in each side by at least one row of fasteners. The fasteners are two-part fasteners fabricated from bioabsorbable material. The incision is closed by pulling the ends of the suture(s).

Abstract: An apparatus and surgical staple are disclosed for endoscope application of the surgical staples for attaching surgical mesh to body tissue in laparoscopic hernia surgery. The surgical staple is formed of a length of wire having a central portion having a middle portion and end portions extending therefrom in a first direction. Wire leg members extend in a direction generally perpendicular to the middle portion. Bridge portions are provided to connect each leg member to the end portions of the central portion. The bridge portions each have a straight portion substantially parallel to the middle portion and extending away from the end portions of the central portion. A first generally arcuate portion connected to the straight portions has a concave surface portion facing in a direction generally inwardly toward the opposing leg member.

Abstract: A surgical fastening apparatus comprises first and second handles with an anvil jaw pivotally connected to at least one of the handles for movement from an open to a closed position in response to a first movement of a handle to clamp body tissue. Fastener pushing means are provided for advancing an individual fastener into contact with the anvil jaw in response to a subsequent movement of a handle. An indicator is provided to alert the user to the termination of the first movement; in a preferred embodiment this indicator is a second movement dwell period of the apparatus in which handle movement continues but the anvil jaw remains stationary and the fastener pushing means is not yet actuated. The apparatus further comprises means for preventing incomplete actuation of the fastener pushing means during the subsequent handle movement.

Abstract: An apparatus is disclosed for endoscopic application of surgical staples adapted to attach surgical mesh to body tissue in laparoscopic hernia surgery. The apparatus includes a frame, and a generally elongated endoscopic section connected to the frame and extending distally therefrom. A staple storage cartridge is removably supported on a pivotal support system at the distal end portion of the endoscopic section with each staple being configured and adapted to attach the mesh to the body tissue. An elongated pusher system formed of several assembled components and extending from the frame to the endoscopic section is provided for individually advancing at least one staple at a time distally for positioning adjacent the surgical mesh and the body tissue. The pusher system also includes a trigger system to actuate the pusher.

Abstract: An end-to-end anastomosis stapling apparatus is provided with a shroud for creating a partial anastomosis. The shroud is provided with a collar, portion for mounting the shroud onto the distal end of the stapling apparatus, and a tissue shield for shielding a predetermined portion of tissue from entering between an anvil and a staple cartridge on the stapling apparatus.

Abstract: Approximating apparatus for surgical jaw structure is provided which effects substantially parallel approximation of first and second surgical jaw structure to permit substantially parallel working interaction therebetween. The approximating apparatus includes camming structure for engaging at least one movable jaw of the surgical jaw structure to bias that jaw toward or away from a second jaw structure in a substantially parallel manner. A tissue stop may be provided to more easily guide and protect tissue captured by the jaw structure.

Abstract: An apparatus is disclosed for endoscopic application of surgical staples adapted to attach surgical mesh to body tissue in laparoscopic hernia surgery. The apparatus includes a frame, and a generally elongated endoscopic section connected to the frame and extending distally therefrom. A staple storage cartridge is removably supported on a pivotal support system at the distal end portion of the endoscopic section with each staple being configured and adapted to attach the mesh to the body tissue. An elongated pusher system formed of several assembled components and extending from the frame to the endoscopic section is provided for individually advancing at least one staple at a time distally for positioning adjacent the surgical mesh and the body tissue. The pusher system also includes a trigger system to actuate the pusher.

Abstract: A surgical apparatus for tightening a strap loop to a predetermined tension about split tissue portions includes a frame, an advancing mechanism for tightening the strap loop, a linkage mechanism which severs excess strap material not used in securing the tissue portions together and a control mechanism for controlling operation of the apparatus. The advancing mechanism includes a tensioning lever and a gear mechanism. The gear mechanism includes a tensioning hub and a clutch which releases when the tension in the strap loop exceeds a predetermined value. The control mechanism includes a safety feature for preventing inadvertent activation of the linkage mechanism. A buckle and a method for use with the surgical apparatus is also disclosed. The invention is particularly contemplated for repair of the human sternum when the sternum has been split during surgical procedures.

Abstract: Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween.

Abstract: A detachable anvil assembly for use with an apparatus for performing circular anastomosis of tubular organs includes an elongated anvil rod having proximal and distal end portions and an anvil head mounted to the distal end portion of the anvil rod. The distal end portion is pivotally mounted and is adapted to pivot approximately plus or minus ninety degrees relative to a longitudinal axis defined by the rod. An elongated delivery member detachably receives the anvil assembly and facilitates delivery of the anvil assembly to the operative site. The pivoting feature of the distal end reduces the transverse profile of the assembly which consequently facilitates introduction and advancement of the anvil assembly within the tubular organ.

Abstract: An apparatus for applying a buckle assembly about split portions of tissue is provided. The apparatus is particularly contemplated for use with a buckle of the type having a base member with an opening extending generally transversely therethrough for reception of a first strap end portion and a clamp member slidably housed within a channel formed in the base member. The apparatus includes a frame member, a mechanism disposed in a lower surface of the frame member for releasably supporting the buckle member and a mechanism associated with the frame member for advancing the clamp member within the channel of the buckle to a strap securing position wherein the strap member is secured within the buckle member in a looped configuration about the tissue portions.In an alternate embodiment, a surgical system for repair of split portions of tissue includes a flexible strap member having a buckle member attached thereto.

Abstract: A surgical stapling apparatus comprising an anvil jaw pivotally connected to a first handle for movement from an open position to a closed position to clamp body tissue, staple advancing means for advancing an individual staple into contact with the anvil jaw for deformation of the staple legs and means for closing the anvil and for actuating the staple advancing means in a three phase movement of the handles. In the first movement of the handle the anvil jaw pivots to a closed position; in a second subsequent movement of the handles the anvil jaw remains stationary and the staple advancing means is not yet actuated; and in a third movement of the handle the staple advancing means is actuated. This second movement constitutes a dwell period of the apparatus.

Abstract: Approximating apparatus for surgical jaw structure is provided which effects substantially parallel approximation of first and second surgical jaw structure to permit substantially parallel working interaction therebetween. The approximating apparatus includes camming structure for engaging at least one movable jaw of the surgical jaw structure to bias that jaw toward or away from a second jaw structure in a substantially parallel manner.

Abstract: A suture holding clip including legs each having a suture contacting surface. The legs can be closed to define an interface for holding a suture in a serpentine configuration. In another embodiment the suture holding clip is initially in a spider leg configuration with a spine and legs projecting from the spine and alternately angled to one or the other of two directions so as to define therebetween a lengthwise extending passage for the reception therethrough of a suture.