Abstract: A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

Abstract: A drill guide assembly configured to engage a drill bit, including: a drill guide including: a drill guide tube including a ring and a flared end at a proximal end of the drill guide tube; a drill guide body with a central opening configured to receive the drill guide tube and a tube stop configured to engage the flared end; and a spring configured to engage the ring and distal end of the drill guide body; and a drill guide sleeve with a central opening configured to receive the drill guide including a ring stop configured to engage the ring and a sleeve distal end configured to engage a plate hole on a bone plate, wherein the spring is configured to bias the drill guide tube in a distal direction so that a distal end of the drill guide tube extends from the sleeve distal end.

Abstract: A method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.

Abstract: A method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.

Abstract: A surgical instrument includes an ultrasonic waveguide extending through a body assembly. An ultrasonic blade connects to the ultrasonic waveguide. A clamp arm assembly of the surgical instrument is able to move from an opened position for receiving a tissue toward a closed position for clamping the tissue. The clamp arm assembly includes a clamp body and a clamp pad facing the ultrasonic blade. A clamp arm actuator of the surgical instrument is able to move from a first position toward a second position to direct the clamp arm assembly from the opened position toward the closed position. A modular coupling of the surgical instrument connects to the clamp pad such that at least the clamp pad can be disconnected relative to the ultrasonic blade for replacement thereof.

Abstract: A packaging assembly is designed for an applicator that contains a buttress assembly that is used with a surgical stapler to reinforce a cut and stapled tissue site. The packaging assembly protects the buttress assembly from damage due to physical contact as well as exposure to adverse environmental factors like excess moisture, etc. In one example the packaging assembly includes a dual tray design with an inner tray that holds the applicator. The combined inner tray and applicator are hermetically sealed within a foil assembly or foil pouch. The foil pouch with the inner tray and applicator within is placed within the outer tray to protect the foil from damage.

Abstract: A method of suturing a trocar path incision in a tissue of a patient with an obturator includes inserting the obturator through the tissue such that a shaft of the obturator extends through a tissue opening about the trocar path incision and a distal tip of the obturator is positioned within a cavity of the patient. The method also includes directing the suture via a suturing feature with the obturator inserted through the tissue in order to direct the suture relative to the tissue. Furthermore, the method includes closing the tissue opening about the trocar path incision with the suture.

Abstract: A device includes an outer sleeve of flexible material forming an outer conduit extending longitudinally therethrough for the insertion of a bone treatment device (“BTD”) to target sites within a living body. A distal opening of the outer conduit is open so that, when the outer sleeve is in a desired position within the body, BTD is inserted through the outer conduit exits the outer sleeve adjacent to a target portion of a bone. The device also includes an inner sleeve received within the outer sleeve and defining an inner conduit within the outer conduit to form a protective covering. The inner sleeve is split longitudinally. Portions of the inner sleeve on opposite sides of the split are coupled to one another so that a diameter of the inner conduit is adjustable in response to forces exerted thereon by one of BTD and tissues surrounding the outer sleeve.

Abstract: A packaging assembly is designed for an applicator that contains a buttress assembly that is used with a surgical stapler to reinforce a cut and stapled tissue site. The packaging assembly protects the buttress assembly from damage due to physical contact as well as exposure to adverse environmental factors like excess moisture, etc. In one example the packaging assembly includes a dual tray design with an inner tray that holds the applicator. The combined inner tray and applicator are hermetically sealed within a foil assembly or foil pouch. The foil pouch with the inner tray and applicator within is placed within the outer tray to protect the foil from damage.

Abstract: A method of suturing a trocar path incision in a tissue of a patient with an obturator includes inserting the obturator through the tissue such that a shaft of the obturator extends through a tissue opening about the trocar path incision and a distal tip of the obturator is positioned within a cavity of the patient. The method also includes directing the suture via a suturing feature with the obturator inserted through the tissue in order to direct the suture relative to the tissue. Furthermore, the method includes closing the tissue opening about the trocar path incision with the suture.

Abstract: In one example, a system has an insertion handle that can be coupled to an intramedullary nail and includes a first coupler that defines one of a recess and a projection, and one of a latch and an abutment surface. The system has an aiming guide that includes a guide body that defines at least one alignment aperture therethrough. The aiming guide includes a second coupler that can couple the guide body to the first coupler such that the at least one alignment aperture is positioned to guide an instrument towards at least one bone-anchor fixation hole of the intramedullary nail. The second coupler defines another of the recess and the projection, and another of the latch and the abutment surface. The first and second couplers can couple to one another by receiving the projection in the recess and by engaging the latch with the abutment surface.

Abstract: A method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.

Abstract: A method is used to reduce a volume of a stomach of a patient. The method includes inverting a portion of a stomach wall to thereby create an inverted portion. An expandable member is positioned adjacent to the outer surface of the inverted portion. The expandable member is expanded to thereby expand the inverted portion. The expanded expandable member has a first outer diameter. A base region of the inverted portion is cinched to thereby capture the expanded expandable member in the expanded inverted portion. The expanded expandable member has a first outer diameter. Expanding and cinching provide a cinch diameter to first outer diameter ratio from approximately 0.5:1 to approximately 0.9:1.

Abstract: An apparatus includes an anvil, a closure assembly, a firing assembly, and a casing assembly. The firing assembly includes a staple driver and an annular array of staples. The casing assembly includes a first section and a second section. The first section includes a first handle portion, a first shaft portion, and a tubular casing. The tubular casing slidably houses the staple driver. The first section defines a homogenous continuum of material along the length of the first handle portion, the first shaft portion, and the tubular casing. The second section includes a second handle portion and a second shaft portion. The second handle portion is laterally coupled with the first handle portion. The second shaft portion is laterally coupled with the first shaft portion. The second section defines a homogenous continuum of material along the length of the second handle portion and the second shaft portion.

Abstract: A method of applying a buttress to a surgically cut and stapled site uses an end effector with a buttress applier cartridge assembly to load one or more buttress assemblies to the end effector. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The adhesive of the buttress assemblies can include a pattern to assist in both attachment to the end effector and release from the end effector after cutting and stapling a tissue site. The buttress applier cartridge can include features that accommodate end effectors having various tip configurations, including straight tips and curved or bent tips.