Abstract: Surgical instruments for use in mapping tissue defects include telescoping rulers and tubes. One of the instruments has a pointed anchoring tip for piercing tissue near the site of the defect. Another instrument has a hook for catching an anatomical landmark. Measuring portions of the rulers of both instruments include distance indicia so that a coordinate system can be established for mapping the location of the defect or of an implant at the defect site. The coordinate system can be re-established at a later time using the same fixation point for the anchoring tip and the same landmark for the hook to evaluate the clinical effects of the treatment selected. The method of using the instrument set is also described.

Abstract: A surgical instrument is disclosed. The surgical instrument can include an end effector, a shaft, and a handle. The handle can include a trigger assembly.

Abstract: In various embodiments, a surgical instrument is provided that may comprise an end effector for performing a surgical procedure on tissue, for example. The end effector may comprise at least one energy delivery surface and heat dissipation means for dissipating heat from at least a portion of the end effector. For example, in at least one embodiment, the end effector may comprise a first jaw, a second jaw, and a cutting member. The cutting member may comprise a cutting surface and a body, which may define a cavity and at least one opening communicating with the cavity. A fluid may be moved through the cavity to and/or from the opening(s). Additionally, in at least one embodiment, a surgical instrument's end effector may comprise a first jaw, a second jaw, a cutting member, and at least one heat pipe. Various other heat dissipation means are also disclosed.

Abstract: A nested trigger assembly for a surgical instrument may generally comprise a first trigger and a second trigger, wherein the first trigger and the second trigger are movable together on a first stroke of the nested trigger assembly, wherein the second trigger is configured to be biased away from the first trigger after the first stroke and before a second stroke, and wherein the second trigger is configured to be moved toward to the first trigger during the second stroke. A surgical instrument may generally comprise a shaft comprising a proximal end and a distal end, a handle extending from the proximal end, wherein the handle comprises a gripping portion, and a nested trigger assembly extending from the handle. The nested trigger assemble may comprise one of a separable trigger assembly and a divisible trigger assembly.

Abstract: One embodiment of the present invention is directed to compositions and methods for enhancing attachment of soft tissues to a metal prosthetic device. In one embodiment a construct is provided comprising a metal implant having a porous metal region, wherein the porous region exhibits a nano-textured surface, and a biocompatible polymer matrix coating the nano-textured surface. The polymer matrix coating comprises a naturally occurring extracellular matrix with biocompatible inorganic materials distributed within the matrix, or a biocompatible polymer and an osteo-inductive agent.

Abstract: In various embodiments, a surgical instrument is provided that may comprise an end effector for performing a surgical procedure on tissue, for example. The end effector may comprise at least one energy delivery surface and heat dissipation means for dissipating heat from at least a portion of the end effector. For example, in at least one embodiment, the end effector may comprise a first jaw, a second jaw, and a cutting member. The cutting member may comprise a cutting surface and a body, which may define a cavity and at least one opening communicating with the cavity. A fluid may be moved through the cavity to and/or from the opening(s). Additionally, in at least one embodiment, a surgical instrument's end effector may comprise a first jaw, a second jaw, a cutting member, and at least one heat pipe. Various other heat dissipation means are also disclosed.

Abstract: A surgical instrument that may include a housing, a transducer engaged with the housing which can produce vibrations, and an end-effector engaged with the transducer. The surgical instrument can further include an adjustable sheath extending from the housing where the sheath is movable relative to the distal tip of the end-effector and where the distance between the distal tip of the sheath and the distal tip of the end-effector can be set such that the sheath can act as a depth stop. The sheath can be adjusted such that, when the distal tip of the sheath contacts the tissue or bone being incised, the surgeon can determine that the appropriate depth of the incision has been reached. In other embodiments, the end-effector can be moved with respect to the sheath in order to adjust the distance between the distal tip of the end-effector and the distal tip of the sheath.

Abstract: One embodiment of the present invention is directed to compositions and methods for enhancing attachment of soft tissues to a metal prosthetic device. In one embodiment a construct is provided comprising a metal implant having a porous metal region, wherein the porous region exhibits a nano-textured surface, and a biocompatible polymer matrix coating the nano-textured surface. The polymer matrix coating comprises a naturally occurring extracellular matrix with biocompatible inorganic materials distributed within the matrix, or a biocompatible polymer and an osteo-inductive agent.

Abstract: A surgical instrument that may include a housing, a transducer engaged with the housing which can produce vibrations, and an end-effector engaged with the transducer. The surgical instrument can include an adjustable sheath extending from the housing where the sheath is movable relative to the distal tip of the end-effector and where the distance between the distal tip of the sheath and the distal tip of the end-effector can enable the sheath to act as a depth stop. The sheath can be adjusted such that, when the distal tip of the sheath contacts the tissue or bone being incised, the surgeon can determine that the appropriate depth of the incision has been reached. In other embodiments, the end-effector can be moved with respect to the sheath to adjust the distance between the distal tip of the end-effector and the distal tip of the sheath.

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 nested trigger assembly for a surgical instrument may generally comprise a first trigger and a second trigger, wherein the first trigger and the second trigger are movable together on a first stroke of the nested trigger assembly, wherein the second trigger is configured to be biased away from the first trigger after the first stroke and before a second stroke, and wherein the second trigger is configured to be moved toward to the first trigger during the second stroke. A surgical instrument may generally comprise a shaft comprising a proximal end and a distal end, a handle extending from the proximal end, wherein the handle comprises a gripping portion, and a nested trigger assembly extending from the handle. The nested trigger assemble may comprise one of a separable trigger assembly and a divisible trigger assembly.

Abstract: An electrosurgical surgical instrument can comprise a handle and an end effector, wherein the end effector can comprise first and second jaws which can be opened and closed to capture tissue therebetween. The second jaw can comprise a first electrode and a second electrode while the first jaw can comprise an opposing electrode positioned opposite the first electrode and the second electrode when the jaws are in their closed position. The first and second electrodes can be independently and/or sequentially operated in order to conduct current between the first and second electrodes and opposing electrode in order to draw the tissue positioned between the first and second jaws toward the center of the first and second jaws and weld the tissue. In various other embodiments, other firing sequences of the electrodes are contemplated. During and/or after such tissue welding processes, a cutting member can be advanced to cut the tissue.

Abstract: A surgical instrument can comprise a handle, a first conductor, a second conductor, and an end effector. The end effector can comprise a first jaw, a second jaw, wherein the first jaw is movable relative to the second jaw in order to capture tissue intermediate the first jaw and the second jaw, a first electrode electrically coupled with the first conductor, and a second electrode electrically coupled with the second conductor, wherein the second electrode is comprised of a material configured to have a first electrical resistance when a first pressure is applied to the material, and wherein the material is configured to have a second electrical resistance when a second pressure is applied to the material. In various circumstances, the material can be configured such that, once the applied pressure has exceeded a switching pressure, the resistance of the material can switch from the first resistance to the second resistance.

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: In various embodiments, a surgical instrument for operation in an aqueous environment is provided. In at least one embodiment, the surgical instrument may include a hollow sheath, a blade disposed at least partially within the hollow sheath and extending through an opening in the sheath, and at least one ultrasonic transducer operably coupled to the blade. The blade may include a polygonal cross-sectional shape and the tip may project away from the sheath's longitudinal axis. In another embodiment, the surgical instrument may include a blade with suction disposed therethrough and at least one ultrasonic transducer operably coupled to the blade. The blade may include a cutting edge that is positioned over a blade opening. Also, the cutting edge may project away from the blade's longitudinal axis.

Abstract: Biomarkers are collected and used to determine biological propensities of a patient, to determine the efficacy of medical devices, to select and administer therapeutic agents, to select medical devices, to make adjustments to medical devices, and/or to adjust surgical techniques. An apparatus includes a port to draw a biological fluid (e.g., a mist) from a surgical site. The apparatus includes a sensor having a cantilevered beam. The beam includes substances selected to attract certain biomarkers as the fluid is communicated across the beam. The same apparatus or another apparatus is used to administer a therapeutic agent based at least in part on collected biomarker data. The therapeutic agent delivery apparatus may include a device that is also used to create a wound at a surgical site. For instance, a harmonic surgical instrument may be used to both collect biomarkers and administer a therapeutic agent (e.g., gene therapy using sonoporation).

Abstract: A surgical stapler includes first and second tissue clamping members and a knife member. The first tissue clamping member is configured to receive a plurality of staples. The second tissue clamping member comprises an anvil configured to form the staples. A tissue treatment member is positionable between the first and second tissue clamping members. The tissue treatment member comprises a rupturable pouch or baffle that is configured to receive a medical fluid including at least one tissue cell. The tissue treatment member may have a spiral shape, an annular disc shape, or an elongate sleeve shape. The tissue treatment member may also include outwardly extending tabs. The tissue treatment member may also include an injection port. In use, the staples and/or the knife pierce the tissue treatment member to release at least a portion of the medical fluid held by the tissue treatment member.

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: A surgical stapling assembly is configured to be used to form a tissue seal having an arcuate portion. The surgical stapling assembly comprises an end-effector extending from the distal end of the shaft. The end-effector comprises a first portion and a second portion. The first portion comprises a first face at least partially surrounding the aperture, a staple cavity defined in the first face, a staple removably positioned within the staple cavity, and a first electrode positioned one of on and proximate to the first face. The second portion comprises a second face, an anvil pocket defined in the second face, and a second electrode positioned one of on and proximate to the second face, and a second electrode. The first electrode and the second electrode each comprise an arcuate portion. The first electrode has a different polarity than the second electrode.

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.