Abstract: A self-articulating joint is disclosed for a minimally invasive surgical apparatus. The self-articulating joint has a first elbow component pivotably coupled to a second elbow component, wherein the first and second elbow components are biased to form a non-linear angle relative to each other. The self-articulating joint also has an elbow latch configured to releasably hold the first and second elbow components at a substantially fixed non-linear operating angle.

Abstract: A surgical snare assembly is disclosed. The surgical snare assembly has a suture fastener having an entrance and an exit. The surgical snare assembly also has a proximal suture engaging loop and a distal suture engaging loop. The surgical snare assembly further has a handle coupled to the proximal and distal suture engaging loops, and configured such that: 1) movement of the handle a first distance away from the suture fastener causes the proximal suture engaging loop to move through the suture fastener from the entrance to the exit; and 2) movement of the handle a second distance away from the suture fastener causes the distal suture engaging loop to move through the suture fastener from the entrance to the exit.

Abstract: A surgical suturing device has a guide tip defining cuff receiving and tissue bite areas. The guide tip has at least one needle guide configured to guide at least one needle through the cuff receiving area and the tissue bite area. Another surgical suturing device has a guide tip defining cuff receiving and tissue bite areas. The guide tip has at least one pair of needle guides configured to guide both the needles of at least one pair of needles through the cuff receiving area and the tissue bite area. The guide tip also has at least one pair of ferrule receiving apertures. The cuff receiving area and the tissue bite area are oriented to avoid cross-over of a suture passed by the at least one pair of needles through tissue in the tissue bite area and a replacement anatomical device sewing cuff in the cuff receiving area.

Abstract: A surgical clamp jaw is disclosed, having an inner profile and a deflection control profile opposite the inner profile. In one embodiment, the inner profile has a first substantially concave profile in an unclamped position and a second substantially flat profile in a clamped position. In one embodiment, the deflection control profile has one or more sets of corresponding abutment surfaces, at least one set of which is not contacting each other when the inner profile is in the unclamped position and which is contacting each other when the inner profile is in the clamped position. In one embodiment, the surgical clamp jaw defines one or more flexion assistance voids, wherein at least one of the one or more flexion assistance voids is in contact with a gap between one of the one or more sets of corresponding abutment surfaces.

Abstract: A surgical device has first and second clamp jaws, at least one of which is pivotable relative to the other. The surgical device also has first and second locking suture guides configured to receive at least one locking suture for knotting to hold the first and second clamp jaws in a clamped position.

Abstract: A minimally invasive surgical suturing device has a shaft; a needle slideably coupled to the shaft and having a ferrule engaging end; and a guide tip having a ferrule receiving aperture and moveably coupled to the shaft for selectable movement between a retracted position and an enabled position. In a related method, a distal shaft end, having a guide tip in a retracted position, is passed through a minimally invasive entry point and into a body cavity. The guide tip having a ferrule receiving aperture is actuated into an enabled position such that an insertion profile of the guide tip and shaft in the enabled position is larger than an access dimension of the minimally invasive entry point. A needle, slideably coupled to the shaft and having a ferrule engaging end, is advanced on a path substantially parallel to the shaft, toward and in alignment with the ferrule receiving aperture.

Abstract: A uterine manipulator includes a sound and a body. The sound has a selectively actuatable anchor disposed proximate a distal end and an operating mechanism spaced from the anchor for controlling actuation of the anchor. The body has a passage therethrough adapted to receive the sound passed proximally through the body to a position in which the operating mechanism is accessible proximally of the body and the anchor extends distally.

Abstract: A device for placing sutures through thick and/or moving tissue such as the wall of a beating heart. The device includes a tissue welting tip having a trough for forming a welt in a tissue section, an alignment guide having an opening receiving a guide wire and pivotally mounted in the distal end adjacent to the trough, and an elongated sleeve slidably engagable with the guide wire. The device also includes one or more expandable tissue engaging member(s) on the sleeve expandable from a collapsed configuration having a diameter small enough to pass through the opening in the tip to an expanded configuration having a diameter large enough to engage a tissue section and urge it into the trough to form a welt in the tissue section and a retractable needle extendable through at least two portions of a tissue section while the tissue section is engaged with the trough.

Abstract: An anatomic vaginal occluder is constructed of soft, relatively compliant materials for atraumatic insertion through the vaginal opening. This device integrates at its distal end a horizontally oriented, elliptically shaped, occlusive prominence coupled with a larger vertically oriented, elliptical occlusive prominence, located more proximally on the device's longitudinal axis. The vaginal wall tissue is compressed radially and put under longitudinal tension completely circumferentially around the occlusive features to create a seal against gas loss.

Abstract: A method and apparatus for securing separate loops of suture with a coaxial mechanical fastener. Separate loops of suture extend from opposite ends of the mechanical fastener. A wire snare facilitates pulling the suture through the fastener. A suturing instrument provides for the infusion of pressurized physiologic solutions into the left ventricle so that the proper replacement suture length can be demonstrated real time prior to crimping the fastener. The instrument incorporates a slotted release site so that the fastener and suture can be released from the device tip once the fastener is secured. A method of securing suture coming from cardiac valve leaflets and or other structures like papillary muscles permits a more atraumatic orientation of the fastener coaxial with the suture strands.

Abstract: A surgical pledget assembly includes a pledget body having first and second apertures extending through the body, one or more snares passing through the apertures in the pledget body and including first and second suture engaging loops disposed on a distal side of the pledget, an optional third folding loop disposed on a proximal side of the pledget, and a handle secured to the ends of the snare or snares proximal to the pledget.

Abstract: A method and apparatus for closing a punctured blood vessel is described. The apparatus includes a suturing instrument adapted to apply at least one suture to at least a portion of a blood vessel in order to close a puncture wound therein. In a preferred embodiment, the suture is secured by crimping a sleeve member over the free ends of the suture with a crimping instrument.

Abstract: A uterine manipulator includes a sound and a body. The sound has a selectively actuatable anchor disposed proximate a distal end and an operating mechanism spaced from the anchor for controlling actuation of the anchor. The body has a passage therethrough adapted to receive the sound passed proximally through the body to a position in which the operating mechanism is accessible proximally of the body and the anchor extends distally.

Abstract: A surgical suturing instrument has a needle which traverses at tissue receiving gap and picks up suture distal to the gap. This invention provides an automated mechanism enabling the suture to be removed from the needle after the needle is retracted proximal to the tissue gap. This mechanism provides enhanced device reloading and other potential uses.

Abstract: A crimpable magnesium sleeve for securing a suture within the body and for dissolving over time while introducing only compatible amounts of magnesium into the body. An instrument for placing such a sleeve on a suture crimping the sleeve and cutting the suture after placement. An alloy of magnesium, zinc, and aluminum may be used to form the sleeve.

Abstract: A uterine manipulator includes a sound and a body. The sound has a selectively actuatable anchor disposed proximate a distal end and an operating mechanism spaced from the anchor for controlling actuation of the anchor. The body has a passage therethrough adapted to receive the sound passed proximally through the body to a position in which the operating mechanism is accessible proximally of the body and the anchor extends distally.

Abstract: A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to flex relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. Tissue suturing and suture securing instruments are provided each having a sufficiently flexible shaft locatable through the accessory tube.

Abstract: A surgical pledget assembly includes a pledget body having first and second apertures extending through the body, one or more snares passing through the apertures in the pledget body and including first and second suture engaging loops disposed on a distal side of the pledget, an optional third folding loop disposed on a proximal side of the pledget, and a handle secured to the ends of the snare or snares proximal to the pledget.

Abstract: Abstract An instrument for cutting tissue to controlled dimensions for removal of tissue specimens from remote sites in the body of a patient. The instrument has a housing and a substantially flexible shaft extending from the housing to a distal end. Suction can be municated along the shaft to the distal end for distribution across a cavity utilizing a nifold to pull tissue into the cavity against a tissue engaging of the manifold. One or more needles are extendable into the cavity to enable infusion of fluid into the tissue. A blade in the distal end is extendable over the manifold to cui the tissue held by suction in the cavity. The shape and depth of the tissue removed by the cut is in accordance with the contour of the tissue engaging surface and the size and shape of the cavity at the distal end.