Abstract: A suture clip with stop ribs and method for making same is provided. The clip includes a housing having an outer surface, and a pair of jaws extending longitudinally from the housing in an opposing relationship to each other. A resilient pad is carried by one of the jaws and defines with the outer surface of the housing a shutoff cavity. At least one rib extends longitudinally of the housing and across the cavity to inhibit any undesirable passage of the suture into the cavity.

Abstract: Embodiments of an access device system useful for single or limited port procedures comprises a retractor and a gel cap removably coupled to the retractor. The gel cap comprises a gel pad that acts as an artificial body wall, through which instruments may be inserted into a body cavity, either directly or through one or more trocars. The gel pad permits flexible instrument placement, as well as translational and angular degrees of freedom for the instruments while maintaining a gas tight seal.

Abstract: A trocar seal removably connected to a trocar cannula is provided that comprises an instrument seal and a zero seal with the zero seal connected to the instrument seal. A cover is connected to the instrument seal and a sleeve extends from the cover distally towards the end of the instrument seal.

Abstract: A balloon trocar includes a cannula assembly including a cannula and an outer sleeve fitting over the cannula. The distal end of the outer sleeve is proximal to the distal end of the cannula. A balloon is coupled to a distal portion of the sleeve and a distal portion of the cannula. The outer surface of the cannula includes a plurality of longitudinal channels for transmitting gas or fluid to the balloon. A bolster having a gel pad at its distal portion is slidably mounted to the cannula assembly and may be locked in a desired position. In use, the trocar is inserted into an incision through a body wall and into a body cavity. The balloon is inflated and the cannula assembly pulled proximally against the incision while the bolster is slid distally to the body wall and locked in place to seal the incision with the compressed balloon.

Abstract: A surgical instrument includes a shaft having a proximal end and a distal end with an operating device disposed at the distal end. A cable assembly is carried by the shaft and extends proximally to a terminus. A handle assembly coupled to the cable assembly concludes a first handle and a second handle. The first handle includes portions configured to receive the terminus and the proximal end of the shaft while portions of the second handle are configured to receive the terminus of the cable assembly. The proximal end of the shaft and the terminus are simultaneously rotatable to cover the proximal end of the shaft to the portions of the first handle and to couple the terminus to the portions of the second handle. The handle assembly can be made sterilizable with a minimum of non-bearing surfaces, while the shaft assembly can be made disposable and interchangeable with various operating devices. An associated method includes the step of releasably locking the shaft assembly to the handle assembly.

Abstract: A modulator clip applier includes a cartridge containing multiple surgical clips, and a handle assembly for operating the cartridge to crimp one of the clips onto body tissue of a patient. The handle assembly has a scissors configuration with a bayonet coupling, and flange pairs widely separated to provide a high degree of stability. The bayonet coupling enables the handles of the assembly to be fully separated for cleaning. Snap fittings between the cartridge and handle assembly are provided at the fulcrum and also at a spaced location where an operating pin of the cartridge engages intersecting slots in the flanges. Overdrive protection of three different types is contemplated along with a structure facilitating operation of the handle assembly by palming a pair of handle bars.

Abstract: A surgical instrument includes a shaft having a proximal end and a distal end with an operating device disposed at the distal end. A cable assembly is carried by the shaft and extends proximally to a terminus. A handle assembly coupled to the cable assembly concludes a first handle and a second handle. The first handle includes portions configured to receive the terminus and the proximal end of the shaft while portions of the second handle are configured to receive the terminus of the cable assembly. The proximal end of the shaft and the terminus are simultaneously rotatable to cover the proximal end of the shaft to the portions of the first handle and to couple the terminus to the portions of the second handle. The handle assembly can be made sterilizable with a minimum of non-bearing surfaces, while the shaft assembly can be made disposable and interchangeable with various operating devices. An associated method includes the step of releasably locking the shaft assembly to the handle assembly.

Abstract: A surgical instrument (10) is adapted to contact tissue of a patient, and to provide traction with the tissue in order to inhibit migration of the instrument relative to the tissue. The instrument may include a pair of opposing jaws (16, 18) with at least one of the jaws (16, 18) comprising a substrate having a particular surface facing the tissue, and a plurality of discrete elements (26, 28) disposed on the particular surface for increasing the traction of the instrument relative to the tissue. These discrete elements (26, 28) may include a multiplicity of granules, bristles, or projections, and may be formed of materials having various properties such as hydrophilic characteristics. The discrete elements in the form of bristles can be oriented too so that the column strength of each bristle provides increased traction in a predetermined direction.

Abstract: A surgical instrument is adapted to contact tissue of a patient and to provide traction with the tissue in order to inhibit migration of the instrument relative to the tissue. The instrument may include a pair of opposing jaws with at least one of the jaws comprising a substrate having a particular surface facing the tissue, and a plurality of discrete elements disposed on the particular surface for increasing the traction of the instrument relative to the tissue. These discrete elements may include a multiplicity of granules, bristles, or projections and may be formed of materials having various properties such as hydrophilic characteristics. The discrete elements in the form of bristles can be oriented too so that the column strength of each bristle provides increased traction in a predetermined direction.

Abstract: A surgical clamp includes opposing jaws and a covering enhancing traction between the jaws and a body conduit. A multiplicity of fibers oriented to extend longitudinally between the clamp and conduit may be composed of filaments and either woven or non-woven to form a fabric. A variety of weaves are contemplated to provide different textures, each having its own traction characteristics. The nature of the weave can control characteristics such as smoothness, absorption, and texture. The fibers or filaments may be formed from any solid or semi-solid material, adding its own characteristics to the resulting fabric insert or clamp.

Abstract: A surgical clamp includes a shaft having clamping jaws at a proximal end and an operative handle assembly at a distal end. The shaft has properties for being moved to a desired shape by the user prior to operation of the handle assembly and for holding the desired shape during operation of the handle assembly. The shaft may include a bendable element extending along an axis between the handle assembly and the jaws. A control element disposed relative to the bendable element is operable from the handle assembly at the proximal end of the shaft to move the jaws relative to each other at the distal end of the shaft. An associated method includes the step of bending the shaft to a desired shape prior to operation of the clamp and maintaining the shaft in substantially the desired shape during operation of the clamp.

Abstract: A surgical spring clip includes a first molded component having a first jaw and a first finger tab. A second component having a second jaw and a second finger tab comprises the only other molded component. The first component has a telescoping relationship with the second component and is moveable by operation of the finger tab between a first position wherein the jaws are generally closed and a second position wherein the jaws are generally open. A spring disposed between the tabs and the jaws biases the first and second components toward the first position. The clip has a telescoping barrel with the general shape of a polygon in radial cross-section. An increased guidance link provides the clip with a guidance ratio of about 1.5 ratio. Alignment of the components is further enhanced by the provision of ramped projections and the accommodation of tolerances only along one side of the telescoping barrel.

Abstract: An endoscopic clip applier for the temporary as well as permanent occlusion of vessels and the clipping of other tissues. The clip applier includes an elongated outer body having a proximal end attached to an actuating mechanism and a distal end. An elongated inner member is slidably positioned within the outer body and has a proximal end coupled to the actuating mechanism and a distal end coupled to a pair of generally opposing jaws. Movement of the inner member relative to the outer body pivots the jaws open and closed. The jaws are configured for receiving and supporting a malleable surgical clip which is insertable within an internal retention groove within each jaw. Each groove has an undercut portion at its distal end which is configured to mate with an outwardly tapering portion at the distal end of each clip. When forced distally in the grooves, the distal ends of the clip are moved into the undercut portion and the clip retained within the groove.

Abstract: A surgical clip applier for use in applying ligation as well as fixation surgical clips or fasteners to a vessel or other tissue at a surgical site. The clip applier includes an elongated hollow outer body having a proximal end attached to an actuating mechanism and a distal end. A pair of generally opposing jaws are coupled to the distal end of the outer body and are configured with guide slots for receiving a surgical clip. Means are provided for advancing a clip from within the outer body into the guide slots. Movement of the actuating mechanism moves the jaws between an open position, a first closed position and a second and fully closed position. The jaws are placed over a section of tissue and closed to the first closed position such that the tissue is compressed. The clip site is tested for proper ligation, and if acceptable, a clip is advanced into the jaw members.

Abstract: A trocar having a working channel extending between a distal end and a proximal end is adapted for disposition across a body wall. A valve is disposed in the working channel so that an instrument inserted into the working channel extends through the valve resulting in undesirable friction forces. The valve is provided with a first wall which intersects a second wall to define a contact surface with an area less than the combined area of the first wall and second wall. This surface provides a substantially reduced contact with the instrument thereby reducing the friction forces and facilitating movement of the instrument through the working channel. An associated method includes the step of orienting the first wall and the second wall to provide the contact surface with the configuration of a line.

Abstract: A parallel jaw clip comprises a barrel base and a barrel cap which when joined together forming an outer barrel, a hollow plunger which fits within the outer barrel, and a spring positioned within the hollow plunger. The outer barrel which permits the plunger to slidably move within the outer barrel and return to its original position, a clamping jaw on the barrel cap and the plunger which are parallel to each other and which face each other to grasp an object. Also disclosed is a method for assembling a parallel jaw clip comprising placing a spring within the barrel base, placing a plunger within the barrel base so that the spring is within the hollow interior of the plunger, placing the barrel cap over the plunger and the barrel base, attaching the barrel cap to the base, and positioning the plunger top so that it remains outside the aperture in the barrel cap.

Abstract: A method for performing a surgical operation on a body conduit includes the step of inserting into the conduit an apparatus having at its distal end an element the location of which is detectable from regions exterior of the body. The apparatus is moved within the conduit until the element is positioned relative to a predetermined location where the element functions as a target. Detecting the location of this target within the conduit facilitates insertion of a surgical instrument percutaneously of the body and toward the predetermined location. The targeting apparatus may be used with an endoscope and may include a variety of active and passive elements which form the target. The surgical instrument can be inserted percutaneously transverse to the axis of the conduit to perform a variety of surgical operations. Sidebranch occlusion in an insitu procedure is greatly facilitated by this method and apparatus.

Abstract: A trocar is adapted to provide a working channel across a body wall to accommodate a surgical instrument having a sharp or puncture prone configuration. The trocar includes a cannula and a housing which encloses at least one septum seal. A valve adjuster is movable by the instrument from a first position and a relaxed state, to a second position and an expanded state wherein the valve protector is disposed at least partially between the instrument and the valve. In this second position axial friction is reduced and the valve is protected from the sharp or puncture prone configuration of the instrument. A method includes the steps of engaging the valve adjuster with the instrument and moving the adjuster from the first position to the second position.

Abstract: A medical access device is adapted to receive an instrument and comprises a housing defining an inner channel and a valve disposed in the channel to form a seal with the housing. The valve includes an outer wall and a pair of inner walls extending in distally converging relationship to define a slot. At least one compression member extends between the outer wall and an associated one of the inner walls. The compression member is compressed in response to insertion of the instrument and exerts a force on the associated inner wall when compressed to reduce leakage of the valve when the instrument is inserted. A funnel is provided at the distal end of the valve to facilitate backloading of the instrument.

Abstract: Access devices to facilitate the introduction of various surgical instruments into vessels, conduits, cavities, and other interior regions of the body are disclosed, which include a "duck bill" valve having at least three flexible fold sections or leaflets subtending 360.degree. degrees of the cylindrical wall portion. The valve is configured to provide reduced friction forces when an instrument is inserted, as well as zero closure characteristics when the instrument is removed.