Abstract: In various embodiments, a surgical instrument for operation in an aqueous environment is provided. In at least one embodiment, the surgical instrument may include a hollow sheath, a blade disposed at least partially within the hollow sheath and extending through an opening in the sheath, and at least one ultrasonic transducer operably coupled to the blade. The blade may include a polygonal cross-sectional shape and the tip may project away from the sheath's longitudinal axis. In another embodiment, the surgical instrument may include a blade with suction disposed therethrough and at least one ultrasonic transducer operably coupled to the blade. The blade may include a cutting edge that is positioned over a blade opening. Also, the cutting edge may project away from the blade's longitudinal axis.

Abstract: An ultrasonic surgical instrument including an ultrasonically actuated blade or end effector having a treatment portion. The blade can define a central axis and at least one axis which is transverse to the central axis, wherein the transverse axis can lie within a plane which is perpendicular, or normal, to the longitudinal axis and can define a cross-section of the treatment portion. Such a cross-section can include a central portion and a step extending from the central portion, wherein the central portion can comprise a width, and wherein the step can comprise a cutting edge. In at least one embodiment, the cutting edge can be defined by first and second surfaces which define an angle therebetween. In various embodiments, the position of the cutting edge and/or the angle between the cutting edge surfaces can be selected in order to balance the blade with respect to the transverse axis.

Abstract: Methods and devices reroute chyme to induce intestinal brake in order to improve the effectiveness of bariatric surgical procedures and to improve comorbidity resolution. A bowel is manipulated to provide a shortened path for chyme to travel to the ileum. These methods and devices of rerouting chyme to induce intestinal brake may include one or more of a surgical procedure, an implanted device, or a combination of an implant with an improved surgical procedure.

Abstract: A surgical instrument handle assembly includes a housing having a proximal end and a distal end. A proximal opening is formed at the proximal end of the housing. A distal opening is formed at the distal end of the housing. The proximal and the distal openings define a longitudinal axis. A handle extends downwardly from the longitudinal axis. The handle defines a proximal contact surface, a saddle surface, and a stabilization tail. A trigger is pivotally attached to the housing and is pivotally moveable relative to the handle.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that has an ultrasonic blade that protrudes from an ultrasonic transducer assembly. In some embodiments, the ultrasonic blade coaxially extends through a rotatable tissue cutting blade that is rotatably supported by a housing that supports the ultrasonic transducer assembly. In other embodiments, the ultrasonic blade and the tissue cutting blade are both selectively rotatable relative to the housing. In yet other embodiments, the tissue cutting blade and the ultrasonic blade are supported relative to each other in separate sheaths attached to the housing.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: An ultrasonic surgical instrument including an ultrasonically actuated blade or end effector having a treatment portion. The blade can define a central axis and at least one axis which is transverse to the central axis, wherein the transverse axis can lie within a plane which is perpendicular, or normal, to the longitudinal axis and can define a cross-section of the treatment portion. Such a cross-section can include a central portion and a step extending from the central portion, wherein the central portion can comprise a width, and wherein the step can comprise a cutting edge. In at least one embodiment, the cutting edge can be defined by first and second surfaces which define an angle therebetween. In various embodiments, the position of the cutting edge and/or the angle between the cutting edge surfaces can be selected in order to balance the blade with respect to the transverse axis.

Abstract: In various embodiments, a surgical instrument for operation in an aqueous environment is provided. In at least one embodiment, the surgical instrument may include a hollow sheath, a blade disposed at least partially within the hollow sheath and extending through an opening in the sheath, and at least one ultrasonic transducer operably coupled to the blade. The blade may include a polygonal cross-sectional shape and the tip may project away from the sheath's longitudinal axis. In another embodiment, the surgical instrument may include a blade with suction disposed therethrough and at least one ultrasonic transducer operably coupled to the blade. The blade may include a cutting edge that is positioned over a blade opening. Also, the cutting edge may project away from the blade's longitudinal axis.

Abstract: An ultrasonic surgical instrument includes a housing, an ultrasonic transducer assembly rotatably supported within said housing and communicating with a source of ultrasonic electrical signals, a motor within said housing and communicating with a source of motor drive signals, said motor coupled to said ultrasonic transducer assembly for applying rotational motion thereto, a horn coupled to said ultrasonic transducer assembly, an outer sheath coupled to said housing, said outer sheath including a distal portion, and a blade operably coupled to said horn, said blade rotatably supported relative to said outer sheath, wherein said blade includes an outer sheath contacting surface, wherein said distal portion of said outer sheath includes a blade contacting surface, and wherein at least one of said outer sheath contacting surface and said blade contacting surface includes a friction reducing material.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that comprises a handpiece housing that rotatably supports an ultrasonic transducer assembly therein that may be selectively rotated by various motor configurations. Various slip ring arrangements are disclosed for supplying ultrasonic electrical signals and motor drive signals from a control system. Various forms of blade and cutting implements are disclosed for attachment to the ultrasonic transducer assembly such that such implements may be selectively rotatable within a hollow outer sheath. Vacuum may be applied to the cutting implement or through the outer sheath to draw tissue through an opening in the sheath and into contact with the cutting implement.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that has an ultrasonic blade that protrudes from an ultrasonic transducer assembly. In some embodiments, the ultrasonic blade coaxially extends through a rotatable tissue cutting blade that is rotatably supported by a housing that supports the ultrasonic transducer assembly. In other embodiments, the ultrasonic blade and the tissue cutting blade are both selectively rotatable relative to the housing. In yet other embodiments, the tissue cutting blade and the ultrasonic blade are supported relative to each other in separate sheaths attached to the housing.

Abstract: Over the years, a variety of different types of non-ultrasonically powered cutters and shaving devices for performing surgical procedures have been developed. Some of these devices employ a rotary cutting instrument and other devices employ a reciprocating cutting member. For example, shavers are widely used in arthroscopic surgery. These devices generally consist of a power supply, a handpiece, and a single-use end effector. The end effector commonly has an inner and outer tube. The inner tube rotates relative to the outer tube and will cut tissue with its sharpened edges. The inner tube can rotate continuously or oscillate. In addition, such device may employ a suction channel that travels through the interior of the inner tube. For example, U.S. Pat. No. 4,850,354 to McGurk-Burleson, et al., discloses a non-ultrasonically powered surgical cutting instrument that comprises a rotary cutter for cutting material with a shearing action. It employs an inner cutting member which is rotatable within an outer tube.

Abstract: An ultrasonic assembly that is configured to permit selective cutting, coagulation, and fine dissection required in fine and delicate surgical procedures. The balanced blade provides a rounded distal end and concave edges to promote fine dissection and cutting in a variety of surgical procedures. The blade is curved for improved visibility at the blade tip and is designed to provide a multitude of tissue effects: coagulation, cutting, dissection, spot coagulation, tip penetration and tip scoring. The assembly features hand activation configured to provide an ergonomical grip and operation for the surgeon. The assembly further features user selectable blade rotation. A finger switch is placed in the range of the natural axial motion of the user's index finger, whether gripping the surgical instrument right-handed or left handed.

Abstract: An ultrasonic surgical instrument that supports an ultrasonically excited blade and an outer sheath that can be selectively rotated relative to each other to bring a distal cutting tip of the blade into contact with at least one cutting surface formed on a distal end of the outer sheath. In some embodiments, the distal cutting tip may contact two cutting surfaces located on opposing sides of an opening in the outer sheath through which the distal cutting tip protrudes. Tissue pads may be attached to the cutting surfaces. Various embodiments also include at least one suction lumen.

Abstract: In one general aspect, various embodiments are directed to methods for treating tissue within an aqueous environment. Various methods may include introducing a cutting implement of a surgical instrument into the aqueous environment. The cutting implement may have at least one cutting surface thereon and at least one ultrasonic portion thereon and be selectively rotatable within a hollow sheath. The methods may include rotating or rotatably oscillating the cutting implement within the hollow sheath for tissue cutting purposes. The cutting implement may also be retained in a position wherein the ultrasonic portion of the cutting implement may be applied to tissue and then have ultrasonic motion applied thereto.

Abstract: A surgical instrument comprising a trigger configured to be actuated by a proximally directed force and by a distally directed force. The trigger may comprise a proximal trigger portion having a first length and a distal trigger hook comprising a distal portion having a second length. The second length may be less than the first length. The distal trigger hook may be coupled to the proximal trigger portion.