Abstract: A suture needle driving instrument comprises a shaft and an end effector. The end effector is located at the distal end of the shaft and includes a pair of needle grasping arms. Each grasping arm extends along a respective arm axis. The grasping arms are operable to drive a suture needle along a rotational path about an axis, such as one of the arm axes, that is offset from the central longitudinal axis of the shaft. The rotational path may be perpendicular to the axis of the shaft. A needle driven by the end effector may have an arc radius that is greater than the radius of the shaft. At least one of the needle grasping arms may include a dogleg feature positioning a distal portion of the grasping arm outside the radius of the shaft. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: An apparatus comprises an end effector, a shaft assembly, and a drive assembly. The end effector comprises needle receiving arms operable to grasp a needle. The drive assembly comprises drive members that are rotatable about respective drive axes that are perpendicular to the axis of the shaft assembly. The drive assembly is operable to drive the needle receiving arms to selectively engage and disengage the needle; and to selectively pass the needle from one needle receiving arm to the other needle receiving arm. The drive assembly provides an interface to a controller that is operable via a remote user interface. The drive assembly may include helical gears, clutch assemblies, a rack and pinion, or other components to convert motion of the drive members into motion at the end effector.

Abstract: An assembly for fastening tissue is disclosed. The assembly may comprise a first jaw comprising a cartridge, wherein the cartridge comprises a plurality of fasteners. The plurality of fasteners comprises a first fastener comprising a first height and a second fastener comprising a second height, wherein the second height is different than the first height. The assembly further comprises a second jaw, wherein at least one of the first jaw and the second jaw is movable relative to the other. The second jaw comprises a plurality of fastener-engaging portions. The plurality of fastener-engaging portions comprises a first fastener-engaging portion and a second fastener-engaging portion. The assembly further comprises a compressible layer intermediate the first jaw and the second jaw.

Abstract: An apparatus includes a housing, a drive gear assembly, and a drive arm. The housing defines a channel that receives a needle such that the needle is movable within the channel. The drive gear assembly is positioned within the housing and includes a first gear, a second gear, and a rack. The rack is translatable relative to the housing and is coupled with the first and second gears to rotate the first and second gears. The drive arm is coupled with the drive gear assembly and engages the needle to move the needle within the channel of the housing.

Abstract: An apparatus comprises a body, a shaft assembly, an end effector assembly, and a drive assembly. The body may include a handpiece with an integral motor. The shaft assembly may include two pairs of concentric shafts. The end effector assembly may include arms that selectively grasp and release a suturing needle. The drive assembly is operable to drive the end effector assembly via the shaft assembly. The drive assembly is operable to convert a single rotary input into at least two rotary outputs. In some versions, the drive assembly comprises a plurality of shaft assemblies that include an input shaft, a first output shaft, a second output shaft, and a third output shaft. The drive assembly is operable to selectively rotate and hold the shaft assemblies in accordance with a predetermined sequence, such as to perform tissue suturing through a trocar in a minimally invasive surgical procedure.

Abstract: A surgical suturing device comprises an arced needle track, an arced needle positioned in the needle track, and a length of suture connected to the needle. A reciprocating needle driver is operative to engage and move the needle in the needle track. A rotary input rotates about an axis. A link has a proximal end connected to the rotary input and a distal end connected to the needle driver. Rotation of the rotary input in a first angular direction translates the needle driver in a second angular direction opposite of the first angular direction.

Abstract: A suture needle driving instrument comprises a shaft assembly, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft assembly and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The shaft assembly includes two pairs of parallel concentric shafts, which form part of the actuation assembly. Each shaft pair is operable to drive a respective internal drive shaft having separate threaded regions with opposing pitch. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: An apparatus is provided for operating on tissue. The apparatus includes an end effector having an upper jaw and lower jaw. The upper and lower jaws each include an electrode surface. The apparatus also includes a tissue tacking cartridge coupled to one of either the upper jaw or the lower jaw. The tissue tacking cartridge includes at least one fastener positioned outside of the electrode surfaces. The fastener is operable to be deployed from the tissue tacking cartridge. A tack loading cartridge may also be operable to load the end effector with at least one fastener.

Abstract: A surgical suturing system comprises a reusable shaft having a proximal end and a distal end, the distal end has a receiver and a rotary drive. A reusable actuator is connected to the proximal end of the shaft. A disposable cartridge is adapted to be attached to and detached from the receiver. The cartridge comprises an arced track, an arced needle positioned in the track having a leading end and a trailing end, a length of suture connected to the trailing end, a reciprocating needle driver operative to engage and move the needle in the arced circular track, and a transmission operatively connected to the needle driver having a rotary input adapted to couple to the rotary drive. The reusable shaft and actuator may be autoclavable.

Abstract: A surgical suturing device has an elongate shaft has a proximal end, a distal end, and a longitudinal axis between the proximal and distal ends. An actuator is connected to the proximal end of the elongate shaft. A circular needle applier is on the distal end of the elongate shaft. The circular needle applier has an arced needle and a needle driver operatively connected to the actuator to rotate the arced needle in a circular path. A joint is positioned between the proximal and distal ends of the elongate shaft. The joint is operatively connected to the actuator to selectively articulate the shaft. A bearing is on the shaft positioned distally of the joint. The bearing is operatively connected to the actuator to selectively rotate the circular needle applier about the longitudinal axis.

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 surgical needle includes a pair of ends, a mid-region extending between the ends, and at least one grasping feature configured for grasping by a suturing instrument. An end of a suture is secured to the mid-region of the needle in a manner such that the end of the suture defines an oblique angle with at least part of the centerline defined by the mid-region of the needle. The end of the suture may be disposed in a hollow portion of the needle. The grasping feature may include a notch such as a scallop. The suture may be pivotally coupled with the needle via a ball or pin. The needle may have one or more sharp points. The sharp point may include three converging cutting edges, at least two planar surfaces bounded by the three cutting edges, and a rounded surface bounded by two of the three cutting edges.

Abstract: An apparatus comprises a shaft, a needle throwing arm, and a needle receiving arm. The arms are movable asynchronously along planes that are substantially parallel to a longitudinal axis defined by the shaft. The arms selectively engage a surgical needle, such that the throwing arm may pass the surgical needle through tissue for receipt by the receiving arm, and the receiving arm may then pass the surgical needle back to the throwing arm for additional stitching. The arms may pivot about a common pivot. Such versions may include a single actuator for both arms or separate actuators for the arms. The arms may also pivot about their own respective axles, which may facilitate a forward reset motion for a needle, allowing the needle to continue travelling along a circular path in a single direction to create several stitches. The apparatus may also convert reciprocating movement of actuators into rotational motion.

Abstract: A fistula cleaning and repairing device comprises a device for cleaning a fistula and a device for repairing a fistula. Some versions of the device for cleaning a fistula comprise a rotary device with ah head configured to debride a fistula. Some versions of the device for cleaning comprise an abrasive catheter. Some versions of the device for cleaning comprise a plurality of abrasive beads. Some versions of the device for repairing a fistula comprise an implantable stent. Some versions of the device for repairing a fistula comprise an implantable mesh. Some versions of the device for repairing a fistula comprise a swab configured to deliver a medical fluid.

Abstract: An apparatus includes a housing, a drive gear assembly, and a drive arm. The housing defines a channel that receives a needle such that the needle is movable within the channel. The drive gear assembly is positioned within the housing and includes a first gear, a second gear, and a rack. The rack is translatable relative to the housing and is coupled with the first and second gears to rotate the first and second gears. The drive arm is coupled with the drive gear assembly and engages the needle to move the needle within the channel of the housing.

Abstract: A surgical needle includes a pair of ends, a mid-region extending between the ends, and at least one grasping feature configured for grasping by a suturing instrument. An end of a suture is secured to the mid-region of the needle in a manner such that the end of the suture defines an oblique angle with at least part of the centerline defined by the mid-region of the needle. The end of the suture may be disposed in a hollow portion of the needle. The grasping feature may include a notch such as a scallop. The suture may be pivotally coupled with the needle via a ball or pin. The needle may have one or more sharp points. The sharp point may include three converging cutting edges, at least two planar surfaces bounded by the three cutting edges, and a rounded surface bounded by two of the three cutting edges.

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: A surgical fastening instrument can comprise a handle and an end effector, wherein the end effector can comprise a first jaw comprising a first cartridge attachment portion and a second jaw comprising a second cartridge attachment portion, and wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw and the second jaw. The surgical fastening instrument can further comprise a first cartridge that is insertable into the first jaw and attachable to the first cartridge attachment portion and, in addition, a second cartridge that is insertable into the second jaw and attachable to the second cartridge attachment portion. In various embodiments, the first cartridge can comprise first fastener portions which are engageable with second fastener portions in the second cartridge.

Abstract: A suture needle driving instrument comprises a shaft and an end effector. The end effector is located at the distal end of the shaft and includes a pair of needle grasping arms. Each grasping arm extends along a respective arm axis. The grasping arms are operable to drive a suture needle along a rotational path about an axis, such as one of the arm axes, that is offset from the central longitudinal axis of the shaft. The rotational path may be perpendicular to the axis of the shaft. A needle driven by the end effector may have an arc radius that is greater than the radius of the shaft. At least one of the needle grasping arms may include a dogleg feature positioning a distal portion of the grasping arm outside the radius of the shaft. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A surgical stapling instrument can comprise, one, a handle comprising an actuator and, two, an end effector comprising a proximal end, a distal end, and a longitudinal axis extending between the proximal end and the distal end. The end effector can further comprise a first jaw configured to support staples comprising staple legs and, in addition, a second jaw supporting a matrix element opposite the staples, wherein one of the jaws is movable toward the other in order to engage the matrix element with the staple legs. The stapling instrument can further comprise a cam operably coupled with the actuator, wherein the cam is movable along the longitudinal axis to deform the staple legs.