Abstract: Methods and devices are provided for manipulating tissue in a body cavity, i.e., in vivo. In general, the methods and devices allow an end effector to engage tissue, be detached from a shaft used to control the end effector to engage the tissue, and then be moved to another location in the body cavity by a separate component, such as an external control unit. In some embodiments the end effector can include one or more deployable hooks that allow the end effector to remain at a surgical site independent of any shafts or external control units. Still further, in other embodiments the end effector can include a transverse bore to allow a second shaft to connect to the end effector to manipulate the tissue. Additional exemplary devices, kits, and methods related to manipulating tissue in vivo are also provided.

Abstract: A surgical device comprising a clevis defining a longitudinal axis and a jaw comprising a first member and a second member. A slider is slidably engaged to the clevis, the slider comprising a pin. The pin is receiveably engaged in the first slot and the jaw is selectively moveable between a first position and a second position through longitudinal movement of the slider. In various embodiments, the first and second members are movable between an angular open position, a parallel open position, and a parallel closed position.

Abstract: Methods and devices are provided for controlling an endoscope in a body cavity. In one exemplary embodiment, a stiffening element for an endoscopic surgical system includes an elongate member having a diameter configured for insertion and use in a channel of an endoscope. The elongate member can be movable between an unlocked position in which the elongate member is freely movable to assume a desired configuration, and a locked position in which the elongate member is maintained in a desired configuration. In one embodiment, the elongate member is formed from a plurality of links that are pivotally coupled to one another. Methods for controlling a surgical device in a body cavity, as well as systems for use in endoscopic surgeries, are also provided herein.

Abstract: A surgical instrument may comprise a shaft having proximal and distal ends defining an axis therebetween. The shaft may be flexible and sized for insertion into the working channel of a flexible endoscope. The shaft may be configured to be used in conjunction with various suture anchor applicators. One suture anchor applicator may have a first tube with a first channel and a tissue penetrating tip. The first channel may be adapted to retain a second tube. The second tube may have a second channel and a blunt tip. The second channel may be adapted to retain at least one suture anchor and may include an exit port adapted for ejecting suture anchors. An alternative suture anchor applicator may comprise a first tube and a second tube with a tissue penetrating tip. The second channel is adapted to retain at least one suture anchor.

Abstract: Methods and devices are provided for controlling movement of a working end of a surgical device. In one embodiment, methods and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting. In other embodiments, a single cable actuator is provided and is movable between a first position, in which it is effective to rotate an end effector without actuating (i.e., closing and firing) the end effector, and a second position, in which it is effective to actuate the end effector without rotating the end effector. In other aspects, methods and devices are provided for moving a flexible neck formed on a distal end of an accessory channel for use with an endoscope.

Abstract: Various embodiments of an elongate surgical device configured to travel along a tortuous body lumen to a surgical site are provided herein. In one embodiment, the device can include a tensioning element extending through a channel formed along a length of the device and the tensioning element can translate an articulation force to the working end of the device. During such articulation of the device, a portion of the channel can be configured to allow the tensioning element to exit the channel and move away from a longitudinal axis of the device thereby optimizing a mechanical advantage relative to the distal end of the device and thus maximizing the force capable of being delivered thereto. Additionally, various embodiments of a method for articulating a working end of an elongate surgical device are provided herein.

Abstract: An apparatus having an elongate hollow metal body extending along a longitudinal axis is disclosed. The hollow body defines a central opening and has a predetermined wall thickness. A pattern of laser cut slits is formed into the body. The slits define a plurality of articulatable elements. The plurality of articulatable elements enable active articulation of the body in a first plane and passive deflection in planes orthogonal to the first plane.

Abstract: Various embodiments of a surgical device and methods of using the surgical device are disclosed. The surgical device may comprise a collar configured to fit over a distal face of an endoscope and rotate about a longitudinal axis of the endoscope. The surgical device may also comprise a flexible, elongate translating mechanism coupled to the collar and extending proximally from the collar. Applying a linear force to the translating mechanism may cause the translating mechanism to exert a rotational force on the collar. In addition, the surgical device may comprise a hollow cap coupled to a distal end of the collar. The cap may be pivotable relative to the collar in a plane parallel to the axis. In addition, the cap may have a first open end configured to face the endoscope and a second open end configured to face distally.

Abstract: Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.

Abstract: A surgical device comprising a container and a tether used for delivering a sterile appliance into a body cavity during endoscopic procedures. Once positioned in the body cavity, a force is applied to the container through the tether. The force opens the container and releases the sterile appliance into the body cavity. In various embodiments, gas or liquid may be used to open the container.

Abstract: Devices and related methods are provided for the controlled delivery of a therapeutic to a targeted location within a body. More particularly, methods and devices are provided for controlling the rate of passage of an orally administered pill through a body, as well as for controlling the delivery of a therapeutic within the pill at a specific location within the body. Various types of devices, generally referred to herein as “catchers,” are provided that can actively catch a pill as it passes through a body. The catcher can hold the pill at a specific location within the body until a predetermined event occurs, such as partial or complete administration of a therapeutic within the pill. The catcher can then release the pill upon command and/or upon the occurrence of the predetermined event to allow the pill to pass out of the body. In other embodiments, various types of pills are provided that can actively engage a catcher and remain engaged with the catcher until a predetermined event occurs.

Abstract: Devices and related methods arc provided for the controlled delivery of a therapeutic to a targeted location within a body. More particularly, methods and devices are provided for controlling the rate of passage of an orally administered pill through a body, as well as for controlling the delivery of a therapeutic within the pill at a specific location within the body. Various types of devices, generally referred to herein as “catchers,” are provided that can actively catch a pill as it passes through a body. The catcher can hold the pill at a specific location within the body until a predetermined event occurs, such as partial or complete. administration of a therapeutic within the pill. The catcher can then release the pill upon command and/or upon the occurrence of the predetermined event to allow the pill to pass out of the body. In other embodiments, various types of pills are provided that can actively engage a catcher and remain engaged with the catcher until a predetermined event occurs.

Abstract: A surgical instrument can be used to capture and retrieve tissue, or other specimens, from within the body of a patient through a single trocar port. The surgical instrument can include a grasper, wherein the grasper can be configured to capture a specimen, and a specimen retrieval bag, wherein the specimen retrieval bag can be configured to at least partially surround, or encapsulate, the captured specimen when the specimen retrieval bag is in a deployed position. In certain embodiments, the retrieval bag can be inverted as it is moved between undeployed and deployed positions. In various embodiments, the surgical instrument can further include a snare operably engaged with the specimen retrieval bag, wherein the snare can be configured to at least partially close the bag. A vacuum can be placed in communication with the bag to reduce the size of the bag before it is removed from the surgical site.

Abstract: Devices and methods are provided for reducing the effect of frictional forces on the operation of a surgical instrument, particularly when inserted within a tortuous body lumen. A vibratory mechanism coupled to the surgical instrument can be activated to vibrate the shaft and/or the actuator of the surgical instrument to reduce the effect of frictional forces generated between the shaft and the actuator of the surgical instrument, thereby reducing the force necessary to actuate the end effector.

Abstract: Methods and devices are provided for allowing a surgical instrument to be supported by a surgical support system configured to controllably guide the instrument to a desired position at surgical site. A surgical support system is provided that includes a guide port defining a pivot point about which a surgical instrument advance therethrough can pivot. The guide port, and hence the pivot point, can be located a distance above a tissue surface through which the instrument is advanced. Methods and devices are also provided for allowing insufflation of a body cavity without introduction of an insufflation fluid therein. A mechanical insufflation device is provided that includes an expandable distal member configured to selectively expand and unexpand to mechanically insufflate a body cavity. The mechanical insufflation device can optionally be used with the surgical support system.

Abstract: Methods and devices are provided for allowing a surgical instrument to be supported by a surgical support system configured to controllably guide the instrument to a desired position at surgical site. A surgical support system is provided that includes a guide port defining a pivot point about which a surgical instrument advance therethrough can pivot. The guide port, and hence the pivot point, can be located a distance above a tissue surface through which the instrument is advanced. Methods and devices are also provided for allowing insufflation of a body cavity without introduction of an insufflation fluid therein. A mechanical insufflation device is provided that includes an expandable distal member configured to selectively expand and unexpand to mechanically insufflate a body cavity. The mechanical insufflation device can optionally be used with the surgical support system.

Abstract: A laparoscopic surgical device comprises an elongate shaft defining a longitudinal axis, the shaft comprising a distal end and a proximal end. A plurality of arms project distally from the distal end of the elongate shaft, the arms each comprising a lateral notch. The arms are axially slideable relative the elongate shaft and are medially deflectable. An elongate pin is positioned medially relative the arms. The elongate pin is axially slideable relative the arms between a locked position preventing medial deflection of the arms and an unlocked position allowing medial deflection of the arms. A surgical end effector is selectively attachable in vivo and detachable in vivo to the mating feature of the arms, the surgical end effector comprising a torque transfer means and tissue contact apparatus that open and close in response to the axial movement of the two arms when attached to the surgical end effector.

Abstract: A laparoscopic surgical device comprises an elongate shaft defining a longitudinal axis, the shaft comprising a distal end and a proximal end. A plurality of arms project distally from the distal end of the elongate shaft, the arms each comprising a lateral notch. The arms are axially slideable relative the elongate shaft and are medially deflectable. An elongate pin is positioned medially relative the arms. The elongate pin is axially slideable relative the arms between a locked position preventing medial deflection of the arms and an unlocked position allowing medial deflection of the arms. A surgical end effector is selectively attachable in vivo and detachable in vivo to the mating feature of the arms, the surgical end effector comprising a torque transfer means and tissue contact apparatus that open and close in response to the axial movement of the two arms when attached to the surgical end effector.

Abstract: A surgical device comprises an ex vivo magnet and an in vivo sled magnetically attracted to the ex vivo magnet. The sled can be positioned and anchored within a patient by moving the ex vivo magnet. The sled defines a longitudinal axis. An arm extends from the sled. The arm is moveable relative the sled between a retracted position and an extended position. The arm comprises an end effector. A locking mechanism operatively connected to the arm to lock the arm in the retracted and extended positions. The mechanism may include a rack that both rotates about a pinion and translates tangentially about the pinion.

Abstract: A surgical kit comprises two percutaneous instruments each having an elongate shaft with a distal end and a proximal end connected to a handle; at least two end effectors attachable and detachable to the distal ends of the percutaneous instruments; a laparoscopic loader adapted to receive the end effectors; a trocar; and a laparoscopic surgical stapler. The surgical kit may further comprise laparoscopic energy based clamping and coagulating device and/or a laparoscopic suture device. Optionally, the surgical kit may further comprised a third percutaneous instrument having an elongate shaft with a distal end and a proximal end connected to a handle, and at least three end effectors attachable and detachable to the distal ends of the percutaneous instruments. The surgical kit may further comprise a magnetic camera and/or a magnetic external control unit adapted to anchor a magnetic camera. The components of the surgical kit may be contained in a sterile sealed package.