Abstract: Methods and devices are provided for providing irrigation and/or suction to a surgical site and maintaining clear visibility through a lens of a scoping device during a surgical procedure. In general, the methods and devices can allow for a surgical instrument to maintain visibility during a surgical procedure using a fluid conduit coupled to the surgical instrument. A surgical device can include a sheath having at least one lumen extending therethrough configured to allow a surgical viewing instrument to be disposed therein. The sheath can also have a passageway extending therethrough configured to allow fluid to flow therethrough. The fluid conduit can be configured to be movable between positions that can allow alternative directions of fluid toward and/or away from a viewing element on the surgical instrument and fluid away from the viewing element and toward a surgical field in a body cavity.

Abstract: An end effector includes an anvil and a staple cartridge. The staple cartridge includes a first deck surface, a second deck surface, a plurality of first staple cavities arranged in a first row extending along the first deck surface, a plurality of second staple cavities arranged in a second row extending along the second deck surface, a plurality of third staple cavities arranged in a third row, a driven element, and a plurality of staples engaged with the driven element and simultaneously deployed into the tissue. The plurality of staples include a first staple removably stored in the first row, a second staple removably stored in the second row, and a third staple removably stored in the third row, the third staple at least partially distal to the second staple and the second staple at least partially distal to the first staple.

Abstract: A surgical stapler including an anvil, a staple cartridge, and a buttress material removably retained to the anvil and/or staple cartridge. In various embodiments, the staple cartridge can include at least one staple removably stored therein which can, when deployed, or fired, therefrom, contact the buttress material and remove the buttress material from the anvil and/or staple cartridge. In at least one embodiment, the anvil can include at least one lip and/or groove configured to removably retain the buttress material to the anvil until deformable members extending from the surgical staple are bent by the anvil and are directed toward and contact the buttress material.

Abstract: A surgical instrument includes a handle assembly having a trigger operable to fire a staple driver to staple tissue. The instrument includes a pointed rod to which an anvil may be coupled. An anvil detection feature is included to determine when the anvil is coupled to the rod. In some versions, the anvil detection feature comprises a translatable rod that inhibits a lockout feature from disengaging. In other versions, an anvil sensing tube is disposed about the pointed rod and interferes with actuation of the trigger in a first position. A recess in the tube permits trigger to actuate when the anvil sensing tube is in the second position. Alternatively, a resilient tab is coupled to the pointed rod and resists actuation of the staple driver. A trigger lockout assembly may include a spring-loaded button that “pops” out when a push rod is actuated, thereby freeing a pivotable lockout feature.

Abstract: A surgical instrument includes a body, a pivotable trigger, and a ratcheting assembly. The ratcheting assembly may include a rotary ratchet coupled to the trigger and a pawl coupled to the body. The rotary ratchet may further include a ramp that disengages the ratchet from the pawl. A release feature may be included to selectively disengage a second member of the ratcheting assembly from a first member. In some versions, the release feature may include a rotation knob or a slidable handle. In another configuration, the ratcheting assembly may have a first member coupled to an actuator and a second member coupled to the body. The assembly may include a lock member coupled to the body that selectively engages a plurality of teeth disposed on the actuator. Alternatively, the assembly may include a pivotable pawl coupled to the actuator that engages one or more notches formed in the body.

Abstract: A surgical stapling instrument for performing a circular anastomosis comprises a stapling head assembly, an actuator handle assembly, a shaft assembly, a safety latch, and a locking member. The stapling head assembly includes an anvil that moves relative to a staple holder and a staple driver to drive staples from the staple holder into tissue and against the anvil. The actuator handle assembly has a first actuator that controls motion of the anvil and a second actuator that controls motion of the staple driver. The shaft assembly couples the stapling head assembly to the actuator handle assembly. The safety latch prevents operation of the second actuator when the gap between the anvil and staple holder is outside a predetermined range. The locking member is configured to prevent adjustment of the anvil gap after the desired staple height has been set inside the predetermined range.

Abstract: A surgical instrument includes an anvil selectively coupleable to a stapling head assembly and a trigger operable to fire staples into tissue compressed between the anvil and the stapling head assembly. In some versions, a lockout member may engage a securing feature to prevent actuation of the anvil relative to the stapling head assembly. For instance, a tab may engage a slot on an actuator, a screen door lock may provide frictional resistance or engage teeth on the actuator, a door may actuate into engagement with one or more recesses, geared teeth may mesh with teeth on the actuator, the lockout member may include a ratcheting assembly to engage actuator, and/or a push button may actuate into a recess while disengaging the lockout member. Alternatively, in some versions, the trigger actuation assembly may be disengaged prior to firing. An anvil position indicator may restrict engagement of the trigger actuation assembly.

Abstract: Methods and devices are provided to allow the same component used to access a surgical site to assist in closing the surgical opening in which it was disposed. In one exemplary embodiment a flexible retractor is provided that includes proximal and distal ends and a lumen extending therethrough. A wound closure component is associated with the flexible retractor and is configured to engage tissue adjacent to a surgical incision in which the retractor is disposed and move tissue from one side of the surgical incision toward a second side of the surgical incision to assist in closing the surgical incision. In one embodiment the wound closure component includes strands of suture having hooks disposed on a distal end. In another embodiment the wound closure component includes a ring having hooks disposed around a circumference of the ring. Exemplary methods for closing a surgical opening are also provided.

Abstract: Methods and devices are provided for accessing a body cavity. In general, a surgical access device is provided that can include a retractor that forms a working channel through tissue, a seal housing for sealing the working channel and/or forming a seal around an instrument inserted therethrough, and a flexible suspension member that is configured to suspend the seal housing within the body cavity or allow the seal housing to extend beyond the distal end of the retractor.

Abstract: An apparatus is operable to secure suture fasteners to sutures to eliminate the need to tie knots in the sutures. The apparatus comprises a shaft, an end effector disposed at the distal end of the shaft, and a suture fastener removably secured to the end effector. The end effector may include a pivoting jaw or a suture cutter. The suture fastener may be secured to one, two, or more strands of suture. The apparatus may include several suture fasteners and may secure those fasteners to one or more sutures in a serial fashion without having to remove the apparatus from the patient for reloading. A plurality of fasteners may be arranged within the apparatus in an end-to-end configuration. The suture fastener may include an inner fastener member and an outer fastener member, and may capture one or more strands of suture between the inner and outer fastener members.

Abstract: A needle holder includes a shaft and a needle driver located at the distal end of the shaft. The needle driver is operable to rotate a needle such that the needle forms a non-perpendicular angle with a longitudinal axis of the shaft. In some versions, the needle driver includes a first arm and a rotatable assembly that is configured to longitudinally clamp about a portion of a needle. The rotatable assembly may include self-righting features to right the needle perpendicular to the first arm. The needle driver may further include a second arm that is pivotable relative to the first arm. The rotatable assembly may include a top member associated with the second arm and a bottom member associated with the first arm. In some versions, spring-loaded collets may secure the needle to a rotatable assembly. Alternatively, a pair of actuating arms may pivot the needle about a curved surface.

Abstract: Methods and devices are provided to allow for easy manipulation of a configuration and/or an orientation of seal elements of a surgical access device by an end user. In one exemplary embodiment a surgical access device is provided that includes a retractor configured to be positioned within a surgical incision to provide access to a body cavity, seal elements disposed within a lumen of the retractor, and adjustment mechanisms in communication with the seal elements and which are configured to manipulate an orientation of one or more of the seal elements. Types of adjustment mechanisms capable of manipulating the seal elements as desired include inflatable bladders and electroactive polymers. Exemplary methods for providing easy manipulation of the configuration and/or orientation of seal elements of a surgical access device on location are also provided.

Abstract: Various compositions, methods, and devices are provided that use fluorescent nanoparticles, which can function as markers, indicators, and light sources. The fluorescent nanoparticles can be formed from a fluorophore core surrounded by a biocompatible shell, such as a silica shell. In one embodiment, the fluorescent nanoparticles can be delivered to tissue to mark the tissue, enable identification and location of the tissue, and/or illuminate an area surrounding the tissue. In another embodiment, the fluorescent nanoparticles can be used on a device or implant to locate the device or implant in the body, indicate an orientation of the device or implant, and/or illuminate an area surrounding the device or implant. The fluorescent nanoparticles can also be used to provide a therapeutic effect.

Abstract: Various compositions, methods, and devices are provided that use fluorescent nanoparticles, which can function as markers, indicators, and light sources. The fluorescent nanoparticles can be formed from a fluorophore core surrounded by a biocompatible shell, such as a silica shell. In one embodiment, the fluorescent nanoparticles can be delivered to tissue to mark the tissue, enable identification and location of the tissue, and/or illuminate an area surrounding the tissue. In another embodiment, the fluorescent nanoparticles can be used on a device or implant to locate the device or implant in the body, indicate an orientation of the device or implant, and/or illuminate an area surrounding the device or implant. The fluorescent nanoparticles can also be used to provide a therapeutic effect.

Abstract: A trocar assembly including a sleeve assembly having a cannula connected to a housing and an obturator assembly including a handle connected to an obturator, wherein the obturator assembly is receivable in the sleeve assembly to define a gripping portion that includes the housing and the handle, the gripping portion having an axial length and a maximum width, and wherein a ratio of the axial length to the maximum width ranges from about 2.5 to about 3.5.

Abstract: A trocar assembly including a sleeve assembly defining a working channel extending axially therethrough and including an insufflation port in fluid communication with the working channel, and an insufflation valve assembly fluidly coupled to the insufflation port, the insufflation valve assembly including a valve member and a housing, wherein the valve member defines an inlet channel and is biased relative to the housing to a first position in which the inlet channel is in fluid communication with the working channel, and wherein the valve member is moveable relative to the housing from the first position to a second position in which the inlet channel is fluidly decoupled from the working channel.

Abstract: Methods and devices are provided to allow for easy manipulation of a configuration and/or an orientation of seal elements of a surgical access device by an end user. In one exemplary embodiment a surgical access device is provided that includes a retractor configured to be positioned within a surgical incision to provide access to a body cavity, seal elements disposed within a lumen of the retractor, and adjustment mechanisms in communication with the seal elements and which are configured to manipulate an orientation of one or more of the seal elements. Types of adjustment mechanisms capable of manipulating the seal elements as desired include inflatable bladders and electroactive polymers. Exemplary methods for providing easy manipulation of the configuration and/or orientation of seal elements of a surgical access device on location are also provided.

Abstract: Methods and devices are provided to allow the same component used to access a surgical site to assist in closing the surgical opening in which it was disposed. In one exemplary embodiment a flexible retractor is provided that includes proximal and distal ends and a lumen extending therethrough. A wound closure component is associated with the flexible retractor and is configured to engage tissue adjacent to a surgical incision in which the retractor is disposed and move tissue from one side of the surgical incision toward a second side of the surgical incision to assist in closing the surgical incision. In one embodiment the wound closure component includes strands of suture having hooks disposed on a distal end. In another embodiment the wound closure component includes a ring having hooks disposed around a circumference of the ring. Exemplary methods for closing a surgical opening are also provided.

Abstract: Methods and devices are provided for accessing a body cavity. In general, a surgical access device is provided that can include a retractor that forms a working channel through tissue, a seal housing for sealing the working channel and/or forming a seal around an instrument inserted therethrough, and a flexible suspension member that is configured to suspend the seal housing within the body cavity or allow the seal housing to extend beyond the distal end of the retractor.

Abstract: A surgical stapler including an anvil, a staple cartridge, and a buttress material removably retained to the anvil and/or staple cartridge. In various embodiments, the staple cartridge can include at least one staple removably stored therein which can, when deployed, or fired, therefrom, contact the buttress material and remove the buttress material from the anvil and/or staple cartridge. In at least one embodiment, the anvil can include at least one lip and/or groove configured to removably retain the buttress material to the anvil until deformable members extending from the surgical staple are bent by the anvil and are directed toward and contact the buttress material.