Abstract: The present invention describes ultrasonic surgical instruments that include a mechanism for clamping tissue against an ultrasonic blade, including an arrangement for detachably mounting a clamp arm to the instrument. The ultrasonic surgical instrument comprises a waveguide adapted to be acoustically coupled to an ultrasonic transducer, and to transmit ultrasonic energy to an end-effector located at the distal end of the waveguide. A support tube extends from a handle assembly and surrounds at least a portion of the waveguide, terminating proximal to the end-effector. A clamp arm is detachably mounted to the distal end of the support tube. An actuation element is operatively coupled to the clamp arm. The ultrasonic surgical instrument may also include a clamp arm release.

Abstract: A method for establishing a surgical port for endoscopic or arthroscopic surgery is disclosed. A trocar is initially provided, and the obturator of the trocar includes a flat cutting blade, a shield that moves proximally and distally from a precock position to an extended position, a precock lever to move the shield proximally to expose the flat cutting blade, and a shield retaining assembly to constrain the shield in the proximal position. "Precocking" the trocar of the present invention moves the shield from the distal position wherein the flat blade is covered, to a proximal position wherein the flat blade is exposed, and the shield is constrained by the shield retaining assembly. Once the flat cutting blade is exposed, the skin of the patient is incised with the flat cutting blade of the obturator. The flat blade of the trocar is inserted into the incision and a penetrating force is applied so that the flat blade penetrates into the internal body cavity of the patient.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle having an opening therein and a flexible contact portion which is outwardly deflectable from the handle. The obturator assembly also includes an obturator having a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle and an obturator shaft. The obturator shaft has a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough. The protector also includes a flexible proximal end movable against the obturator handle to expose the penetrating tip when a proximal force is asserted against the protector.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle and an obturator shaft. The obturator shaft has a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough. The protector also includes a flexible proximal end movable against the obturator handle to expose the penetrating tip when a proximal force is asserted against the protector.

Abstract: A trocar which has an obturator assembly for establishment of a surgical port for endoscopic or arthroscopic surgery is disclosed. The obturator includes a flat cutting blade, a shield that moves proximally and distally, a precock lever to move the shield proximally to expose the flat cutting blade, and a shield retaining assembly to constrain the shield in the proximal position. "Precocking" the trocar moves the shield from the distal position wherein the flat blade is covered, to a proximal position wherein the flat blade is exposed, and the shield is constrained by the shield retaining assembly. The exposed flat cutting blade of the precocked trocar can be used to incise or pierce tissue, thus avoiding the need to use a separate surgical sharp.

Abstract: A surgical trocar has a cannula assembly including a sleeve having a proximal end, a distal end and a passageway therethrough. A housing having an opening is located at the proximal end of the sleeve and is aligned with the passageway of the sleeve. The trocar also includes an obturator assembly which is insertable in the cannula assembly. The obturator assembly includes a handle and an obturator shaft. The obturator shaft has a proximal end connected to the handle and a distal end opposite the proximal end. A penetrating tip is located at the shaft distal end for penetrating tissue. A protector having a distal end is slidably disposed around the obturator shaft for covering the penetrating tip. The protector has an aperture at its distal end for permitting the penetrating tip to pass therethrough. The protector also includes a flexible proximal end movable against the obturator handle to expose the penetrating tip when a proximal force is asserted against the protector.

Abstract: A safety-shielded trocar having an obturator with a linear cutting edge surface defining a base width substantially less than the diameter of the safety shield is disclosed. When the trocar is inserted through tissue, the tissue dilates from the width of the linear incision to accommodate the size of the safety shield of the trocar, thus making it possible to provide an access opening greater than the incisional width made by the linear cutting edge surface of the obturator. In a preferred embodiment, the safety shield has a shield tip region which is asymmetric to facilitate the dilation of the tissue as the trocar is inserted.

Abstract: A safety-shielded trocar having an obturator with a linear cutting edge surface defining a base width substantially less than the diameter of the safety shield is disclosed. When the trocar is inserted through tissue, the tissue dilates from the width of the linear incision to accommodate the size of the safety shield of the trocar, thus making it possible to provide an access opening greater than the incisional width made by the linear cutting edge surface of the obturator. In a preferred embodiment, the safety shield has a shield tip region which is asymmetric to facilitate the dilation of the tissue as the trocar is inserted.

Abstract: A trocar having an obturator with an obturator housing, a piercing tip and a rigid stem is disclosed. The piercing tip has a cutting edge surface and first and second spaced-apart legs generally parallel to each other extending away from the cutting edge surface. The stem is attached to the obturator housing at a first end of the obturator, and the legs of the piercing tip straddle the stem at an opposite end of the obturator. The straddling of the legs about the stem of the obturator fixes the piercing tip to the stem. The attachment of the piercing tip to the stem provides a secure attachment. The trocar is easy to manufacture and assemble, and the component parts can be readily disassembled. The piercing tip attachment is especially advantageous when the piercing tip is configured generally as a razor blade.

Abstract: A surgical instrument for penetrating bodily tissue including an imaging element providing the capability for simultaneous visualization during penetration is disclosed. A transparent portion of the imaging element extends from the distal end of an elongated, substantially hollow shaft. The imaging element is shaped to enlarge an opening as the instrument is advanced into bodily tissue, and an endoscope can be inserted through the shaft adjacent the imaging element to visualize the penetration of tissue as the instrument is advanced. The imaging element may be substantially hollow, and have an annular interior region inside the shaft distal end. The endoscope can then be positioned to rest on the annular region to prevent glare from the reflection of light traveling from the endoscope to the window surface. The imaging element may also have a blade for facilitating the advance of the instrument through tissue.

Abstract: A surgical instrument for penetrating or dissecting bodily tissue which provides for the capability for simultaneous visualization during penetration or dissection is disclosed. An endoscope can be inserted through the hollow shaft of the instrument to visualize the penetration or dissection. A locking assembly is featured which enables the user to initially slide the endoscope through the hollow shaft for proper positioning before the instrument is advanced into tissue, and then lock the endoscope in place to prevent substantial movement of the endoscope during advancement into tissue.

Abstract: A trocar and trocar obturator assembly having an obturator and a locking mechanism responsive to proximal, axial movement of the trocar obturator is disclosed. The trocar obturator has an elongated obturator shaft having a proximal end and a distal end with a piercing tip mounted thereto. The proximal end of the trocar obturator shaft is slidably mounted in a handle such that the obturator shaft is moveable axially. A protective safety shield having a distal end and a proximal end with a flange member mounted to the proximal end is slidably mounted on the trocar obturator. The safety shield is moveable, axially, between an extended distal position and a retracted proximal position. The protective safety shield is disposed concentrically about the obturator. A lockout arm for locking the safety shield in a locked extended position is mounted in the trocar obturator handle.

Abstract: Trocar assembly embodiments are disclosed that include a trocar tube and a housing defining a chamber adjoining a proximal end portion of the trocar tube. An elastomeric seal member is positioned within the chamber for sealing the chamber as an elongate instrument passes through an opening formed in the seal member. A seal/protector assembly is positioned in the chamber proximally of the seal member in facing relationship to the seal member. The protector assembly includes at least two axially aligned protector members, each of which has an annular collar portion and at least one leaf portion formed integrally with the collar portion so as to form a living hinge portion. The leaf portions define an opening therethrough in axial alignment with the opening in the seal member.

Abstract: A surgical stapler having a trigger attached to a ratcheting mechanism for preventing the refiring of the stapler trigger with a staple loaded within a forming mechanism. In addition, the mechanism contains driver buffering means to prevent the sharp reduction in opposing force driving formation of a staple. The staples are constantly maintained in proper orientation during transfer from a track to the forming site, and are self-centering on the former, and have an oversized crown so that cold-worked areas on each staple do not hinder forming.

Abstract: An electrosurgical device for laparoscopic use in tissue dissection and coagulation. The device includes a barrel member having a dissection tip at the distal end thereof that is connected to a source of electrical energy. An insulating sheath member surrounds the barrel member. The sheath member is movable between a first position wherein the distal end thereof extends distally beyond the dissection tip and a second position wherein the dissection tip extends distally beyond the distal end portion of the sheath member. The device includes means to flush and vacuum the surgical site. The device also includes pressure relief means to limit the internal pressure within the device.

Abstract: A surgical stapler having a trigger attached to a ratcheting mechanism for preventing the refiring of the stapler trigger with a staple loaded within a forming mechanism. In addition, the mechanism contains driver buffering means to prevent the sharp reduction in opposing force driving formation of a staple. The staples are constantly maintained in proper orientation during transfer from a track to the forming site, and are self-centering on the former, and have an oversized crown so that cold-worked areas on each staple do not hinder forming.

Abstract: A cartridge for housing a plurality of surgical clips that have opposed, hinged leg portions. The cartridge includes a base member having cavities formed therein and a retainer having openings formed therein that are in alignment with and configured to correspond to the configuration of the cavities. Retainer member is attached to the base member in a suitable manner such as a press fit connection.

Abstract: A surgical device and cooperating cartridge for applying surgical clips during endoscopic surgery. The surgical device incluces a jaw assembly, a barrel assembly, and a handle assembly. The jaw assembly has movable jaw members, each including a substantially transverse grooved portion and at least one angular side shield extending inwardly from an upper and a lower portion of the jaw member. The jaw members are oriented at an angle of approximately 22.degree. relative to the longitudinal axis of the barrel portion. The distal surface of each jaw member is oriented at an angle that extends distally and outwardly. The jaw members are insertable into a unique cooperating cartridge that retains the surgical clip.

Abstract: A surgical stapler having a trigger attached to a ratcheting mechanism for preventing the refiring of the stapler trigger with a staple loaded within a forming mechanism. In addition, the mechanism contains driver buffering means to prevent the sharp reduction in opposing force driving formation of a staple. The staples are constantly maintained in proper orientation during transfer from a track to the forming site, and are self-centering on the former, and have an oversized crown so that cold-worked areas on each staple do not hinder forming.