Abstract: A surgical stapling apparatus having an end effector capable of performing a surgical procedure. The surgical stapling apparatus may include a driving pawl that interfaces with a manually actuatable handle. The driving pawl may have a pawl body with a driving tooth thereon that is configured to interact with an actuation shaft such that, as the manually actuatable handle is actuated, the driving tooth interacts with the actuation shaft to cause the actuation shaft to apply the actuation motions to an elongated body operably coupled to the end effector. When the end effector experiences a firing load that exceeds a predetermined magnitude of firing load, the driving tooth moves relative to the pawl body to disengage from the actuation shaft to prevent further transfer of the actuation motions to the elongated body even though the manually actuatable handle continues to be actuated.

Abstract: Methods and devices regulate the activation of ghrelin hormones within a stomach in order to treat weight disorders, to promote learning and memory functions, to treat stress-induced depression, and to control sleep duration. In one embodiment, a method for regulating activation of ghrelin hormones within a stomach comprises a means for isolating non-activated ghrelin hormones from food content and dietary lipids within the stomach. These means for isolating may take any number of forms and may comprise one or more of a surgical procedure, an implanted device, or an ingestible substance.

Abstract: A staple cartridge assembly for use with a surgical stapler. The assembly has a cartridge body having a support portion with a plurality of staple cavities with openings. There is also a plurality of staples, wherein at least a portion of each the staple is removably stored within a the staple cavity. Each the staple is movable between an unfired position and a fired position, and is deformable between an unfired configuration and a fired configuration. The assembly also includes a compressible tissue thickness compensator configured to be captured within the staples. The compressible tissue thickness compensator at least partially covers the staple cavity openings. The compressed tissue thickness compensator is configured to assume different compressed heights within different the staples. The compressible tissue thickness compensator comprising a lyophilized foam having a hydrophillic agent embedded therein.

Abstract: Surgical stapling instruments are disclosed. At least one embodiment includes a first jaw that supports a plurality of surgical staples and a second jaw that is movable relative to the first jaw. Various arrangements include a tissue thickness compensator that is configured to be captured within the surgical staples and assume different compressed heights within different surgical staples upon application of a firing motion to the surgical staples. Various attachment protrusion arrangements are disclosed to mechanically removably attach the tissue thickness compensator to the first or second jaw.

Abstract: An apparatus for regulating the functioning of a patient's organ or duct includes an elongated member having a first end and a second end. A fastener is disposed on the first end of the elongated member. The fastener is configured to engage the second end of the elongated member so that the elongated member forms a loop around the organ or duct. A tension element is disposed for movement within the elongated member. A drive element is associated with and engages the tension element for causing the tension element to control the tension applied by the elongated member against a patient's body organ or duct. A load monitor ensures that excessive pressure is not applied to a patient's body organ or duct.

Abstract: Methods and devices for illuminating a body cavity or an internal region of a body are disclosed. In one aspect, a percutaneous illumination device for illuminating a body cavity includes an elongate member with an illumination source, and two support members disposed on the elongate member that are adapted to be positioned on opposite sides of a tissue surface for stabilizing the device. Variations on such an illumination device, kits that include such devices, and methods of utilizing such devices are all described within the present application.

Abstract: A surgical suturing apparatus includes a flexible member having a proximal end and a distal end. The proximal end has a handle attached thereto and the distal end has a suturing body attached thereto. The handle is operatively connected to the suturing body. The suturing body includes a suture housing in which a needle and drive assembly are housed for movement of the needle with a suture secured thereto about an arcuate path facilitating application of a suture to tissue. A mechanism is provided for accommodating and operating different sized needles and different sized sutures while maintaining the operative connection between the handle and the suturing body.

Abstract: Methods and devices are provided for providing surgical access into a body cavity. A surgical access port is provided that has an adjustable longitudinal length, such as by being formed from multiple segments configured to move relative to one another. An anchor can be coupled to a distal end of the surgical access port to help secure the surgical access port within a tissue opening by engaging a distal side of the tissue. Optionally, the anchor can be removably coupled to the distal end of the surgical access port, thereby allowing any one of a plurality of anchors to be selectively coupled thereto.

Abstract: Methods and devices are provided for providing access through tissue to a surgical site. Generally, the methods and devices allow adjustment of a surgical access port's longitudinal length. In one embodiment, a surgical access port is provided that includes a housing having a cannula distally extending therefrom. The housing can be configured to cut a proximal portion of the cannula to adjust a longitudinal length of the cannula and hence of the surgical access port. In another embodiment, a surgical access port is provided that includes a cannula formed of a plurality of modular segments removably coupled together. One or more of the segments can be configured to be removable from the cannula to change the cannula's longitudinal length.

Abstract: Various exemplary methods and devices are provided for tensioning suture. The methods and devices are particularly useful in surgical suturing applications in which it is desirable to maintain tension on suture being delivered, yet to allow the tension to be released as desired without retracting the suture. Thus, when tension is released, a length of suture extended from the device can remain extended without any tension being applied thereto. Tension is only applied to any additional length of suture that is extended from the device. The tension applied to the suture is proportional to the length of the suture extended from the device until the tension is released and reset.

Abstract: Methods and devices are provided for regulating a restriction system. In one exemplary embodiment, a restriction system is provided having a restriction device coupled to a port with a fluid disposed in the device, such that the restriction device is adapted to form a restriction in a pathway corresponding to an amount of fluid contained in the device, and a pressure adjustment unit in communication with the port and effective to maintain a substantially constant equilibrium pressure between the pressure adjustment unit and the restriction device. The pressure adjustment unit is configured to regulate an amount of fluid in the restriction device in response to a fluid pressure acting on the device.

Abstract: An inflatable medical instrument for tissue damage in gastric reduction surgery includes a main chamber composed of a biocompatible material capable of being selectively inflated. The medical instrument also includes a longitudinally extending tab member secured to an outer surface of the main chamber, a series of suction holes are formed along the tab member and an electrode is mounted on the tab member. The present invention also provides a method for forming a tissue junction used in defining a gastric pouch including damaging opposed tissue layers, apposing the tissue layers and fastening the tissue layers to allow the tissue layers to heal together.

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: Methods and devices are provided for diagnosing performance of a gastric restriction system. In general, the methods and devices can enable patients, health care providers, and others to use pressure data as a feedback mechanism to monitor efficacy of an implantable restriction device and to identify, train, and/or prescribe treatment plan options. Pressure data monitoring can be used locally and/or remotely to monitor a restriction in a patient and compare gathered pressure data with a typical pressure of the restriction. Based on the results of the comparison, possible problems related to the patient and the restriction can be identified and diagnosed with possible cause(s) and solution(s). Notice of any detected possible problems, causes, and/or solutions can be provided to a user.

Abstract: A surgical stapling apparatus having an end effector capable of performing a surgical procedure. The surgical stapling apparatus may include a driving pawl that interfaces with a manually actuatable handle. The driving pawl may have a pawl body with a driving tooth thereon that is configured to interact with an actuation shaft such that, as the manually actuatable handle is actuated, the driving tooth interacts with the actuation shaft to cause the actuation shaft to apply the actuation motions to an elongated body operably coupled to the end effector. When the end effector experiences a firing load that exceeds a predetermined magnitude of firing load, the driving tooth moves relative to the pawl body to disengage from the actuation shaft to prevent further transfer of the actuation motions to the elongated body even though the manually actuatable handle continues to be actuated.

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: Modular surgical instruments are disclosed. In various embodiments, a modular surgical instrument t is disclosed for use with a plurality of interchangeable surgical tool heads that are configured to perform different surgical actions. The instrument is configured to apply a plurality of different rotary drive motions and axial drive motions depending upon the type of surgical tool head attached thereto.

Abstract: Circular stapling instruments and anvil assemblies. The anvil assemblies may have collapsible anvil support members that may be inserted through an opening in a patient and then expanded to be attached to an anvil plate assembly that has a staple-forming surface thereon. The anvil support member is attachable to the anvil plate assembly in such a way that when the anvil assembly is coupled to the stapling head of a circular stapler, the staple-forming surface is in substantial registry with the staples supported in the stapling head. A variety of different anvil support members and anvil plate assemblies are disclosed.

Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: A gastric reduction apparatus endoscopically draws stomach walls into apposition. The apparatus includes an applicator body having a proximal end and a distal end. The applicator body also includes a suction slot shaped and dimensioned for housing a corkscrew anchor. A firing mechanism is associated with the corkscrew anchor for rotation of the corkscrew anchor in a manner causing the corkscrew anchor to penetrate and engage tissue brought adjacent the suction slot. A method for gastric reduction is achieved by introducing a gastric reduction apparatus as disclosed above within the stomach of an individual, applying the corkscrew anchor to a stomach wall and drawing stomach walls together to create a cavity within the stomach.