Abstract: A wound closure material applicator is provided which includes a handle assembly having a movable handle, a body portion extending distally from the handle assembly and a tip assembly supported adjacent the distal end of the body portion. The tip assembly includes a housing defining a bore, a tip member and a seal member. The tip assembly housing defines an inlet channel and a valve seat positioned adjacent the outlet of the inlet channel. The seal member is movable distally within the housing bore from a closed position in which the valve member abuts the valve seat to an open position in which the valve member is spaced from the valve seat. The tip assembly is configured such that movement of the seal member from the open to the closed position causes a reduction of pressure within a discharge channel of the tip assembly to minimize drippage of wound closure material from the applicator.

Abstract: A tilt top anvil assembly is provided for use with a surgical stapling device for performing end-to-end anastomosis of tissue. The tilt top anvil assembly included an anvil head, a center rod and a biasing member. The anvil head is pivotally secured to the center rod about a transverse axis which is offset from the longitudinal axis of the center rod. The biasing member is supported on the anvil assembly at a position to urge the anvil head to a tilted reduced profile position. The anvil assembly includes a first abutment surface which is operatively connected to the anvil head is movable into engagement with a second abutment surface formed on a surgical stapling device during approximation of the anvil assembly to move the anvil head from the tilted reduced profile position to an operative firing position. When the anvil assembly is moved to the unapproximated or spaced position, the biasing member is positioned to return the anvil assembly back to its tilted reduced profile position.

Abstract: There are disclosed various embodiments of surgical tacks for use in surgical procedures. The tacks generally include a head and a barrel portion extending distally from the head. Preferably the head and the barrel portion define a throughbore for receipt of a drive instrument. A thread on the head is provided to engage threads in the installation tool. A tissue thread is provided on the barrel, portion to engage tissue. Distal and proximal surfaces of the tissue thread may be oriented at various angles relative to the barrel portion. There is also disclosed an insertion instrument to insert one or more tacks as well as a method of use. There is further disclosed a model device for use in explaining the operation of the instrument.

Abstract: A tilt top anvil assembly is provided for use with a surgical stapling device for performing end-to-end anastomosis of tissue. The tilt top anvil assembly included an anvil head, a center rod and a biasing member. The anvil head is pivotally secured to the center rod about a transverse axis which is offset from the longitudinal axis of the center rod. The biasing member is supported on the anvil assembly at a position to urge the anvil head to a tilted reduced profile position. The anvil assembly includes a first abutment surface which is operatively connected to the anvil head is movable into engagement with a second abutment surface formed on a surgical stapling device during approximation of the anvil assembly to move the anvil head from the tilted reduced profile position to an operative firing position. When the anvil assembly is moved to the unapproximated or spaced position, the biasing member is positioned to return the anvil assembly back to its tilted reduced profile position.

Abstract: An applicator is provided for dispensing a first and a second component of a biological adhesive. The applicator includes a housing having a housing head for enclosing therein a first reservoir containing the first component, and a second reservoir containing the second component. The housing further includes an elongated body portion defining a longitudinal axis for enclosing therein a conduit assembly having a first and a second conduit in communication with the first and second reservoir, respectively. An activator assembly is provided which includes an activator and a rachet mechanism for compressing the reservoirs within the housing for dispensing the biological components into the conduits. An applicator tip having two separate channels in communication with the conduits may be provided on a distal end of the elongated body portion for dispensing the components on the application site. The first and second components are preferably fibrinogen and thrombin which intermix to form a fibrin sealant.

Abstract: A fibrin mixture and dispenser assembly is provided for mixing a first protein component with sterile water to form a first protein solution and for dispensing the first protein solution. The first protein solution forms a biological adhesive when intermixed with a second protein solution. The second protein solution is preferably mixed and dispensed by a similar fibrin mixture and dispenser assembly. The two fibrin mixture and dispenser assemblies can be housed within a single housing. The assembly includes a piercer and a first tubular extension having grooves for providing fluid communication between a reservoir and a mixing chamber or a vial. The reservoir is also in fluid communication with a dispensing needle through a second tubular extension. The reservoir is configured to contain water which is introduced to the mixing chamber. The mixing chamber is configured to contain the first protein component.

Abstract: Surgical instrumentation and methods for performing a bypass procedure in a digestive system incorporate laparoscopic techniques to minimize surgical trauma to the patient. The instrumentation includes an outer guide member dimensioned for insertion and passage through an esophagus of a patient and defining an opening therein extending at least along a portion of the length of the outer guide member, an elongate anvil delivery member at least partially disposed within the opening of the outer guide member and being adapted for longitudinal movement within the outer guide member between an initial position and an actuated position and an anvil operatively engageable with the delivery member. The anvil includes an anvil rod defining a longitudinal axis and an anvil head connected to the anvil rod.

Abstract: An applicator is provided for dispensing a first and a second protein solution to form a biological adhesive where the solutions can be deflected by a deflection assembly during dispensing for the adhesive to cover a broad or limited area. The applicator includes a housing having a housing head for enclosing therein a first reservoir containing a first component, and a second reservoir containing a second component. The first and second components are preferably fibrinogen and thrombin which intermix with water to form the first and second protein solutions, respectively. The housing further includes an elongated body portion defining a longitudinal axis for enclosing therein a conduit assembly having a first and a second conduit in communication with the first and second reservoir, respectively. The solutions intermix on an application site to form a fibrin sealant. In an alternate embodiment, the applicator includes two valves.

Abstract: An ultrasonic dissection and coagulation system for surgical use is provided. The system includes an ultrasonic instrument, a control module, and a pedal actuator. The ultrasonic actuator has a housing and an elongated body portion extending from the housing. An ultrasonic transducer supported within the housing is operatively connected to a cutting blade by a vibration coupler. The vibration coupler conducts high frequency vibration from the ultrasonic transducer to the cutting blade. The cutting blade has a cutting surface which is angled with respect to the longitudinal axis of the elongated body portion and, thus, with respect to the axis of vibration. A clamp member having a tissue contact surface is positioned adjacent to the blade member and is movable from an open position in which the tissue contact surface is spaced form the cutting surface to a clamped position in which the tissue contact surface is in close juxtaposed alignment with the cutting surface to clamp tissue therebetween.

Abstract: An applicator is provided for dispensing a first and a second component of a biological adhesive. The applicator includes a housing having a housing head for enclosing therein a first reservoir containing the first component, and a second reservoir containing the second component. The housing further includes an elongated body portion defining a longitudinal axis for enclosing therein a conduit assembly having a first and a second conduit in communication with the first and second reservoir, respectively. An activator assembly is provided which includes an activator and a rachet mechanism for compressing the reservoirs within the housing for dispensing the biological components into the conduits. An applicator tip having two separate channels in communication with the conduits may be provided on a distal end of the elongated body portion for dispensing the components on the application site. The first and second components are preferably fibrinogen and thrombin which intermix to form a fibrin sealant.

Abstract: A pneumatically powered trocar assembly includes a source of compressed gas which releases a metered amount of gas to a chamber. A piston slidably positioned within the chamber is driven forward by the compressed gas introduced therein, and an obturator with a tissue piercing tip are advanced thereby. Optionally, a sensor detects the presence of body tissue within the cutting path of the tip and blocks the passage of compressed gas to the chamber, or alternatively, opens an escape vent to release compressed gas therefrom if insufficient body tissue resistance is encountered. The powered trocar assembly is intended for use in conjunction with a cannula assembly to create a passage to the interior of a body cavity for conducting surgical procedures.

Abstract: An apparatus for application of surgical clips to body tissue is disclosed having a handle assembly and an elongated body portion extending distally from the handle assembly. A jaw assembly is mounted at a distal end portion of the elongated body portion and includes first and second jaws movable between an open position and a closed position. An actuator is disclosed which is slidable within the elongated body portion in response to actuation of the handle assembly. The actuator has camming structure at a distal portion thereof for moving the first and second jaws between the open position and the closed position. A loading unit is releasably mounted to the elongated body portion and stores a plurality of surgical clips therein. The loading unit includes a clip advancer having a portion engageable with the actuator and movable therewith for advancing a distalmost surgical clip and a ratchet assembly associated with the clip advancer to index progressive movement thereof.

Abstract: A surgical clip applier includes a housing, a pair of handles pivotably connected to opposite sides of the housing, a channel assembly which is anchored to the housing and a jaw assembly which is anchored to the channel assembly. The jaws are opened and closed by a cam plate which is slidably positioned in the channel assembly and is provided with cam slots at its distal end to engage drive rivets positioned on the jaw members. A pusher bar assembly is also provided to feed clips from a series of clips to the jaw mechanism, and the instrument operates such that all moving components move in the same direction during the closing stroke of the handle, and then move in the same direction opposite to the closing direction when the handles are in the opening stroke. A novel lockout mechanism is also provided to render the instrument inoperable after all the clips have been utilized from the instrument.

Abstract: An apparatus is provided for applying surgical clips which includes provisions for applying a partially closed clip to ducts or shunts during a surgical procedure. The apparatus includes a ratchet mechanism for permitting incremental closure of a pair of jaw members. A slide member is associated with the ratchet mechanism to prevent a movable handle from opening during a closing stroke until the closing stroke is completed.

Abstract: A surgical instrument is provided for use in endoscopic or laparoscopic procedures. The instrument includes a handle portion, an endoscopic portion extending from the handle portion, an articulating section pivotably connected to a distal end portion of the endoscopic portion, and a retractor assembly operatively associated with the articulating section. Structure is provided for manipulating the articulating section relative to the longitudinal axis of the endoscopic portion within an angular degree of rotation. An injection port may also be provided to deliver fluids through the endoscopic portion to the operative site.

Abstract: An apparatus for application of surgical clips to body tissue is disclosed having a handle assembly and an elongated body portion extending distally from the handle assembly. A jaw assembly is mounted at a distal end portion of the elongated body portion and includes first and second jaws movable between an open position and a closed position. An actuator is disclosed which is slidable within the elongated body portion in response to actuation of the handle assembly. The actuator has camming structure at a distal portion thereof for moving the first and second jaws between the open position and the closed position. A loading unit is releasably mounted to the elongated body portion and stores a plurality of surgical clips therein. The loading unit includes a clip advancer having a portion engageable with the actuator and movable therewith for advancing a distalmost surgical clip and a ratchet assembly associated with the clip advancer to index progressive movement thereof.

Abstract: An apparatus is provided for applying surgical clips which includes provisions for applying a partially closed clip to ducts or shunts during a surgical procedure such as cholecystectomy procedures. The apparatus includes means for effecting a partial closing stroke of the handle mechanism to correspond to a partial closure of the jaw members, and permits a partial opening stroke to release the partially closed clip in the jaw mechanism. Other features of the invention include means for preventing over advancement of a clip to the jaw mechanism, means for cradling the clip as it is advanced from the clip supply to the jaw mechanism, means for preventing splaying of the jaws in the event of a clip-over-clip application, and a novel rotation collar. The instrument of the present invention provides the surgeon with visual, audible, and tactile indication of the positioning of the jaw members to effect the application of a partially closed clip.

Abstract: A surgical clip applier includes a housing, a pair of handles pivotably connected to opposite sides of the housing, a channel assembly which is anchored to the housing and a jaw assembly which is anchored to the channel assembly. The jaws are opened and closed by a cam plate which is slidably positioned in the channel assembly and is provided with cam slots at its distal end to engage drive rivets positioned on the jaw members. A pusher bar assembly is also provided to feed clips from a series of clips to the jaw mechanism, and the instrument operates such that all moving components move in the same direction during the closing stroke of the handle, and then move in the same direction opposite to the closing direction when the handles are in the opening stroke. A novel lockout mechanism is also provided to render the instrument inoperable after all the clips have been utilized from the instrument.

Abstract: A surgical clip applying instrument is disclosed which includes a handle portion having a first handle and a second handle mounted for relative movement. The handles define a single closing stroke between an open position and a closed position. The closing stroke includes an initial throw, an intermediate throw, and a final throw. The clip applying instrument includes body portion extending distally from the handle portion and defining a longitudinal axis, and a plurality of surgical clips disposed within the body portion. A jaw assembly including first and second jaw portions is mounted at the distal end portion of the body portion and is movable between an approximated position and a spaced position. A jaw control mechanism is configured to move the jaw portions to the spaced position for reception of a distalmost clip in response to the initial throw of the handles. The jaw control mechanism is configured to maintain the jaw portions in the spaced position during the intermediate throw of the handles.

Abstract: A surgical instrument is provided for performing a variety of endoscopic or laproscopic procures. The instrument includes a handle assembly, a tubular body extending from the handle assembly and defining a longitudinal axis, a tool assembly associated with a distal end of the tubular body including a tool base and tool members, a first mechanism for effectuating remote articulation of the tool assembly with respect to the longitudinal axis of the tubular body, a second mechanism for effectuating remote rotation of the tool assembly about the longitudinal axis of the tubular body, and a third mechanism for effectuating remote rotation of the tool members relative to the tool base.