Abstract: An ultrasonic surgical instrument includes a reusable handle assembly and a removable and disposable transmission assembly. The handle assembly includes a trigger, a housing having a distal aperture formed in a distal end of the housing, a button disposed on a top surface of the housing, and a biasing member in communication with the button. The transmission assembly includes a proximal shaft, a rotator knob having a coupling feature, a distal shaft assembly extending distally from the proximal shaft, and an end effector at the distal end of the distal shaft assembly. The biasing member of the handle assembly is adjustably coupled to the coupling feature of the transmission assembly. Another version includes a movable yoke configured to engage an inner tube of the transmission assembly. Yet another version includes a waveguide of the transmission assembly non-threadably coupled to a transducer via a biasing force.

Abstract: A surgical stapling apparatus. Various embodiments include a rotatable elongated body that extends from a rotatable shroud on handle assembly and has a distal end configured for attachment to a disposable loading unit. The apparatus further includes a lockable rotation system for selectively locking the rotatable shroud to prevent rotation thereof about a 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 create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices may be accomplished via stabilized implantable systems and ingestible pills. In one aspect, a method of inducing satiety includes implanting an implant within a lumen of a gastrointestinal tract and retaining a portion of chyme that flows by the implant within a body of the implant. The method further involves re-releasing the retained chyme from the implant into the gastrointestinal tract at a predetermined rate slower than a rate caused by natural peristalsis.

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 comprise one or more of a surgical procedure, an implanted device, or a combination of an implant with an improved surgical procedure.

Abstract: Devices and methods for modifying stomach volume include the formation of intragastric slots for wrapping one or more portions of the fundus therethrough with minimal interference with nerves and vasculature flow. Intragastric space occupying devices expand with environmental changes brought about by natural conditions inherent to the digestive cycle such as with changes in pH. Extragastric volume occupying balloons are placed into folded stomach sections. The balloons are fluidly coupled to external gastric filling devices. In yet another set of embodiments, methods and devices provide adjustable gastric volume reduction fundal wraps. In one embodiment, a device is placed in the fundus for Nissen fundoplication and permits postoperative adjustment to reach desired weight loss. Intragastric and extragastric balloons are optionally incorporated.

Abstract: A method for regulating hormone production comprises placing at least one electrode in a gastrointestinal tract of a patient and recording an electrical signal during a preselected event produced by the gastrointestinal tract. The method further involves the steps of storing the electrical signal, and playing back the electrical signal by activating the electrode during the absence of the preselected event.

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, a method of producing satiety comprising the steps of accessing a gastrointestinal tract of a patient and implanting an intraintestinal therapeutic substance eluting implant. The implant is capable of eluting a satiety inducing substance selected from at least one of a nutrient, a specific satiety inducing bio-active substance, pancreatic polypeptides, free fatty acids, cholecystokinin, amino acids, glutamine, lipids, linoleic acid, or a combination thereof, from the implant into the gastrointestinal tract.

Abstract: Devices and methods for modifying stomach volume include the formation of intragastric slots for wrapping one or more portions of the fundus therethrough with minimal interference with nerves and vasculature flow. Intragastric space occupying devices expand with environmental changes brought about by natural conditions inherent to the digestive cycle such as with changes in pH. Extragastric volume occupying balloons are placed into folded stomach sections. The balloons are fluidly coupled to external gastric filling devices. In yet another set of embodiments, methods and devices provide adjustable gastric volume reduction fundal wraps. In one embodiment, a device is placed in the fundus for Nissen fundoplication and permits postoperative adjustment to reach desired weight loss. Intragastric and extragastric balloons are optionally incorporated.

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: A surgical device. The surgical device may comprise a transducer configured to provide vibrations along a longitudinal axis and an end effector coupled to the transducer and extending from the transducer along the longitudinal axis. The surgical device also may comprise a lower jaw extending parallel to the end effector. The lower jaw may comprise a clamp face extending toward the longitudinal axis. Also, the lower jaw may be slidable relative to the end effector to bring the clamp face toward a distal end of the end effector.

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 and a blade disposed at least partially within the sheath. Coupled to the blade may be at least one ultrasonic transducer, which, in turn, may be coupled to a drive system. The drive system may be configured to deliver gross axial motions to the blade such that the blade translates with respect to the hollow sheath when the drive system is activated. Accordingly, tissue may be cut by the blade with gross axial movement of the blade and/or ultrasonic vibrational motion provided by the ultrasonic transducer(s). In alternative embodiments, the blade may be rotated axially instead of translated with respect to the hollow sheath.

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 a motor housed therein. Various forms of blades and blade and sheath mounting arrangements are disclosed such that the blade may be selectively rotatable within a hollow outer sheath. The hollow outer sheath has at least one opening therein through which the blade tip may be exposed to tissue. Vacuum may be applied to the cutting implement or through the outer sheath to draw tissue through the opening(s) in the sheath and into contact with a portion of the blade.

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 a motor housed therein. Various forms of blades are disclosed for attachment to the ultrasonic transducer assembly such that the blade may be selectively rotatable within a hollow outer sheath. The hollow outer sheath has at least one opening therein through which the blade tip may be exposed to tissue. Vacuum may be applied to the cutting implement or through the outer sheath to draw tissue through the opening(s) in the sheath and into contact with a portion of the blade.

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: 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: 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: In one general aspect, various embodiments are directed to ultrasonic surgical instruments that may be used in aqueous environments. The instruments may include cutting a member that is supported within a hollow sheath. Various seal arrangements are disclosed for establishing a substantially fluid-tight seal between the cutting member and the sheath.

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.