Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems and ingestible pills. In one embodiment, a method of producing satiety comprising the steps of accessing a gastrointestinal tract of a patient and implanting an intraintestinal therapeutic substance eluting implant. The implant is capable of eluting a satiety inducing substance selected from at least one of a nutrient, a specific satiety inducing bio-active substance, pancreatic polypeptides, free fatty acids, cholecystokinin, amino acids, glutamine, lipids, linoleic acid, or a combination thereof, from the implant into the gastrointestinal tract.

Abstract: A surgical end effector is disclosed. The surgical end effector can comprise a shaft and a pair of jaws. The surgical end effector can further comprise a housing and a drive system, which can be positioned within the housing. The drive system can comprise a proximal assembly and a distal assembly, wherein the proximal assembly can be releasably coupled to the distal assembly by a pin.

Abstract: An apparatus includes an interface assembly and a shaft assembly. The interface assembly is configured for use with a robotic system and includes a first drive assembly and a mounting plate. The mounting plate includes an opening. The first drive assembly is positioned within the opening such that the first drive assembly is laterally translatable within the opening from a first position to a second position. The shaft assembly is removably coupled with the interface assembly. The shaft assembly comprises an end effector and a first coupling feature. The first drive assembly of the interface assembly actuates the end effector of the shaft assembly. The first coupling feature is longitudinally aligned with the first drive assembly. The first drive assembly engages the first coupling feature of the shaft assembly when the first drive assembly is laterally translated from the first position to the second position.

Abstract: An end effector comprises a first jaw, a second jaw, a firing beam, and a lockout feature. The second jaw pivots relative to the first jaw from an open position to a closed position. The firing beam has a sharp distal end and translates between the first and second jaws. The firing beam translates from a proximal position to a first distal position to pivot the second jaw to the closed position. The end effector applies bipolar RF energy when the firing beam is in the first distal position. The firing beam then translates to a second distal position to sever tissue captured between the first and second jaws. The lockout feature prevents the firing beam from advancing from the first distal position to the second distal position until the lockout feature is actuated.

Abstract: A cuff is used to provide a form for curing fluid about the exterior of an end-to-end anastomosis site. The cuff includes a port through which fluid may be injected to reach an interior space defined between the exterior of tissue at the anastomosis site and the inner surface of the cuff. A circular stapler may be used as a mandrel for the cuff and fluid. Alternatively, inflatable balloons may be used as a mandrel. The curing fluid may comprise a mixture of fibrin and thrombin.

Abstract: Methods and devices are provided for controlling movement of an end effector assembly, and in particular for causing mimicking motion between a handle and an end effector assembly. In an exemplary embodiment, a surgical device is provided having a handle or actuator, an elongate shaft, and an end effector assembly coupled to a distal end of the elongate shaft. The handle or actuator is configured such that movement of the handle is mimicked, not mirrored, by the end effector assembly. The mimicking motion can be achieved using various techniques, but in an exemplary embodiment the handle is located distal to an input joint, and motion is transferred to the end effector assembly through an output joint at a distal end of the elongate shaft. The motion is preferably transferred using a mechanical transmission coupled between the input and output joints.

Abstract: A method of deploying a surgical fastener using the steps of introducing a fastener into a body of a patient while the fastener is in a first shape forming a first loop. Moving end segments of the fastener away from each other substantially along an entire length thereof. And forming the fastener into a second loop having a width greater than a width of the first loop.

Abstract: Endoluminal sleeve device (1) for internally lining a section of the GI tract, comprising a sleeve (2) configured for deployment inside a GI tract, the sleeve (2) having walls of a flexible material defining a sleeve lumen (3), a proximal end (4) defining a proximal lumen opening (5), and a distal end (6) defining a distal lumen opening (7), a tubular anchoring portion (8) forming said proximal lumen end (4) and defining anchoring seats (9) delimited each one by an annular collar (11) forming an opening through which adjacent tissue portions (12) can be pulled into the anchoring seats (9), expansion means adapted to act on the tissue portions (12) arranged in the anchoring seats (9) such that the tissue portions (12) expand to a dimension greater than the opening of the annular collar (11).

Abstract: An endoscopic attachment apparatus for coupling an endoscope with an endoscopic instrument includes an attachment ring having a ring body with first and second apertures respectively shaped and dimensioned for the receipt of an endoscope and an endoscopic instrument. The attachment ring includes an annular body defining the first aperture and the annular body is provided with an endoscope release mechanism for facilitating release of the endoscope from the attachment ring.

Abstract: Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.

Abstract: An endoscopic apparatus shaped and dimensioned for passage through an orifice in the body includes a scope attachment member coupled to an endoscopic instrument, and a connection member attaching the scope attachment member to the endoscopic instrument. The connection member has an insertion orientation sized for passage through the orifice and a deployed orientation too large to pass though the orifice. When the connection member is in its insertion orientation the endoscopic instrument is positioned closely adjacent an exterior of an endoscope for low profile insertion of the endoscopic instrument through an orifice, and when the connection is in its deployed orientation the endoscopic instrument is spaced from the endoscope to improve visibility.

Abstract: Methods and devices reroute chyme to induce intestinal brake in order to improve the effectiveness of bariatric surgical procedures and to improve comorbidity resolution. A bowel is manipulated to provide a shortened path for chyme to travel to the ileum. These methods and devices of rerouting chyme to induce intestinal brake may include one or more of a surgical procedure, an implanted device, or a combination of an implant with an improved surgical procedure.

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 create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.

Abstract: A mechanism for feeding a fastener including a housing having a longitudinal axis and at least one fastener within the housing. The fastener has a crown and at least two legs extending therefrom. The fastener is disposed within the housing in a first plane parallel to the longitudinal axis. The mechanism includes an elongated actuator disposed within the housing. The actuator has a shaft substantially parallel to the longitudinal axis of the mechanism and rigidly spaced from the fastener in a second plane. The actuator has at least one radially extending advancer disposed along a length thereof, and a mechanism for rotating the actuator so that the advancer engages the fastener.

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 method for treating obesity by reducing the volume and/or alter the functioning of the gastric cavity to limit food consumption and induce early satiety. The method includes accessing the cavity endoscopically to visualize the interior of the cavity. The peritoneal cavity is accessed through a small incision in the abdominal wall. Using endoscopic visualization, suture anchoring devices are introduced into the peritoneal cavity through the incision and deployed from the exterior surface through the gastric cavity wall. Suture from pairs of the anchoring devices is drawn through the gastric cavity wall and tightened outside of the cavity to form a serosa to serosa plication. Any number of plications may be formed in the cavity wall and the contacting tissue within a plication may be treated to promote healing and a more durable bond.

Abstract: A surgical stapling device for deploying staples connected with suture to tissue includes a handle having a staple actuator mechanism, a tubular support shaft having a longitudinal axis and extending from the handle, and a staple cartridge mounted on the support shaft and connected to the staple actuator mechanism for applying one or more staples to the tissue. The cartridge has a cartridge housing adapted to receive a plurality of staples in a row for longitudinal movement therethrough and an anvil mounted on the housing. The cartridge further includes a mechanism for advancing the forwardmost staple in the row into engagement with the anvil, and a suture guide supporting a length of suture that extends in a loop for attachment to the staples as they are secured to the tissue.

Abstract: Several embodiments of medical ultrasound handpieces are described each including a medical ultrasound transducer assembly. An embodiment of a medical ultrasound system is described, wherein the medical ultrasound system includes a medical ultrasound handpiece having a medical ultrasound transducer assembly and includes an ultrasonically-vibratable medical-treatment instrument which is attachable to a distal end of the transducer assembly. An embodiment of a medical ultrasound system is described, wherein the medical ultrasound system has a handpiece including a medical ultrasound transducer assembly and including a housing or housing component surrounding the transducer assembly. A method for tuning a medical ultrasound handpiece includes machining at least a distal non-threaded portion of an instrument-attachment stud of the transducer assembly to match a measured fundamental frequency to a desired fundamental frequency to within a predetermined limit.