Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.

Abstract: An apparatus for the transoral invagination and fundoplication of the stomach to the esophagus includes a clip applier having sharp toothed jaws for grasping and damaging the fundus prior to applying the clip. The clip applier has an overall diameter of less than 7 mm. The clip applier jaws are coupled to a pull wire via a linkage which increases the mechanical advantage and thus permits greater grasping force. A plurality of clip designs are also provided.

Abstract: A medical method includes sliding two substantially straight unconnected arms over a fold of body tissue such that a first arm contacts a first portion of the fold and a second arm contacts a second portion. Then, each arm is bent completely through the fold such that both of the arms compress the portions of the fold into contact with each other. Another method includes releasably coupling first and second substantially linear arms to a bridge, each of the arms having a substantially straight sliding portion and a bendable piercing portion. The arms are slid over opposing sides of two body tissue layers, the first arm sliding over the first layer and the second over the second layer. While the sliding portions of the arms remain substantially straight, each piercing portion is bent completely through the adjacent layer and halfway through the other layer to compress the two layers together.

Abstract: A pair of plate benders are provided for bending a bone plate. Each bender includes a lever arm having a first end and a second end. The first end includes a fulcrum for placement on the upper surface of the plate, and a foot insertable through the oblong screw hole to contact the lower surface of the plate. The second end includes a cut-out with a central divider. The cut-out has a length dimensioned to extend widthwise about the plate at the location of the oblong screw hole with the divider extending into the oblong screw hole for stability. The second end may also be provided with a deep slot that accommodates the thickness of the plate. In use, plate benders with such structure can be used in pairs to longitudinal bend the plate; bend the plate in plane; or twist the plate along its axis.

Abstract: A torque-limiting fastener driver for driving a bone fastener into bone includes a handle supporting a driver shaft. The driver shaft includes limited components which are designed to provide feedback to a user regarding the applied torsional force. In addition, the driver shaft is designed to controllably fail before any potential uncontrolled failure of the distal driving tip. This prevents application of too much torque and controlled design of the shape and size of the failed components.

Abstract: A surgical clip includes a U-shaped configuration with first and second arms, and a bridge portion therebetween. The first arm is provided with a tip preferably having a catch, and the second arm extends into a deformable retainer having a tissue-piercing end and preferably also a hook. During application, tissue is clamped, and the clip is forced over the clamped tissue and the retainer of the second arm is bent and may be pierced through the tissue. The retainer is toward and around or adjacent the tip of the first arm preferably until the hook is engaged about the catch to secure the clip to the tissue and prevent the clip and tissue from separating. The clip is provided with structure that facilitates the stacking of a plurality of clips in a clip chamber of a clip applier.

Abstract: A surgical fastener with a safety position includes a lower base having piercing posts each having fixed and coupling ends, first and second base portions respectively attached to the posts, a hinge coupling the base portions, and a bias device imparting force on at least one base portion toward the other and at an angle to the hinge axis. Also provided is an upper fastening portion receiving and selectively coupling the posts. The lower base has a piercing position for coupling with the upper fastener portion where the posts are substantially parallel and a folded position where a distance between a coupling end of the first piercing post and the coupling end of the second piercing post is less than a distance between the fixed end of the first piercing post and the fixed end of the second piercing post.

Abstract: Removable guide tips are pre-assembled into threaded holes of a fracture fixation plate. The guide tips may be used with or without drill guides to guide a drill along the axes of threaded holes defined in the plate. In addition, the tips may be used with bending tools to contour the plate laterally, longitudinally and with twist. More particularly, such plate contouring can be performed while the plate is located on the bone.

Abstract: A medical method includes sliding two substantially straight unconnected arms over a fold of body tissue such that a first arm contacts a first portion of the fold and a second arm contacts a second portion. Then, each arm is bent completely through the fold such that both of the arms compress the portions of the fold into contact with each other. Another method includes releasably coupling first and second substantially linear arms to a bridge, each of the arms having a substantially straight sliding portion and a bendable piercing portion. The arms are slid over opposing sides of two body tissue layers, the first arm sliding over the first layer and the second over the second layer. While the sliding portions of the arms remain substantially straight, each piercing portion is bent completely through the adjacent layer and halfway through the other layer to compress the two layers together.

Abstract: A surgical clip applier includes a clip chamber defined at the distal end of the instrument. A clip chain of at least two clips is provided in the clip chamber. The clip chain is coupled such that both relatively distal and proximal movement of the proximalmost clip of the clip chain within the chamber results in longitudinal translation of clips within the chamber.

Abstract: Removable guide tips are pre-assembled into threaded holes of a fracture fixation plate. The guide tips may be used with or without drill guides to guide a drill along the axes of threaded holes defined in the plate. In addition, the tips may be used with bending tools to contour the plate laterally, longitudinally and with twist. More particularly, such plate contouring can be performed while the plate is located on the bone.

Abstract: A disposable single indication orthopedic trauma surgical kit has no bone plates other than a single bone plate precountoured and sized to match an anatomic shape of a portion of a bone of a patient's extremity. The single bone plate has a plurality of fastener apertures. The surgical kit also has a plurality of fasteners with heads that are dimensioned to mate with the fastener apertures. The surgical kit also has a disposable torque driver adapted to engage the fastener heads. The foregoing components are contained in a sterile sealed container.

Abstract: A bone plate system for the internal fixation of a fractured bone of a patient has a bone plate with one or more threaded bone fastener apertures and one or more non-threaded bone fastener apertures. The system also has a plurality of bone fasteners, each with a shaft and a head. The heads are dimensioned and configured to threadedly engage the threaded bone fastener apertures to provide a fixed angle locking construct. The heads also are dimensioned and configured to directly engage the non-threaded bone fastener apertures to provide a polyaxial non-locking compressive construct.

Abstract: Surgical clips, which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus, and methods of applying the surgical clips to living tissue are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape, and which are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.

Abstract: Surgical clips, which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus, and methods of applying the surgical clips to living tissue are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape, and which are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.

Abstract: Surgical clips, which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus, are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape. The arms are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.

Abstract: A retractor for manipulating an object includes a body having proximal and distal ends and a retraction device with a head connected to the distal end of the body, a connector movably disposed in the body, and flexible needles of a shape memory material having a memory shape. The needles are connected to the connector and each have a distal tip. The memory shape of the needles include a portion with an arcuate shape biasing the needles in a memory direction out and away from the head and toward the body to position the distal tip of each of the needles closer to the body when the needles are fully extended out of the head than when the needles are only partially extended out of the head. An actuation device is connected to the proximal end of the body and operatively connected to the connector through the body, the actuation device, upon actuation thereof, moves the connector to selectively extend the needles out of the head in different directions and withdraw the needles into the head.

Abstract: The invention in certain aspects relates to a one-piece coil-shaped surgical fastener for fastening tissue segments, especially suitable for fastening segments of the lower esophageal sphincter and fundus in an endoscopic procedure for the treatment of GERD. The invention also relates to related methods and devices for insertion of such a fastener, especially along a juncture of the surfaces of such tissue segments.

Abstract: A flexible endoscopic clip applier includes a flexible coil with a manual actuator coupled to one end and a jaw assembly coupled to the other end. A store of clips is arranged adjacent to the jaw assembly and a clip pusher is arranged adjacent to the store of clips. The actuator includes a lever for opening and closing the jaws, a knob for rotating the jaw assembly, and a crank for dispensing clips. The knob and the lever are coupled to a single control member which extends through the coil to a joiner where it is joined to a pair of pull wires coupled to the jaws. The crank is coupled to a second control member which is threaded along a distal portion. The threaded portion engages a threaded member near the pusher and is coupled to the pusher such that rotation of the threaded control member by the crank causes the pusher to be moved distally.