Abstract: A surgical clip has a base portion and two generally parallel, spaced arms extending from the base portion and defining an opening therebetween. The arms terminate distally in fingers which are of reduced width and thickness relative to the arms and which are adapted to be bent towards and past each other. A transition section from each arm to the finger provides curved structures which extending away from each other and providing a wider mouth for the opening between the arms. The arms also have a proximal section with an undercut which helps in flexure of the arms. The base is an extended structure having a rounded proximal end with outwardly extending shoulders which are arranged to be engaged by the curved structures of the mouth of another clip.

Abstract: Methods of the invention include delivering a grasper, a clip applier, and an endoscope transorally to the site of fundoplication; grasping the fundus with the grasper (or similar device, e.g. corkscrew) and pulling it into the jaws of the clip applier; closing the jaws of the clip applier over the fundus and applying a clip to the fundus.

Abstract: A low profile bone screw system includes a retainable washer and a low profile bone screw having a smooth conical head for insertion into the washer. The washer has an axial bore with a conical portion for fully seating the screw head and a smooth outer surface shaped like the head of a conventional compression bone screw head. Washer dispensing units are also provided.

Abstract: A method of performing a treatment for gastroesophagheal reflux disease (GERD) includes providing a distal end of a shaft of a medical instrument with a proximally facing end effector having a laterally offset clevis defining a shaft-clevis plane and opposing mutually rotatable jaws proximally directed and laterally displaced relative to a longitudinal axis of the shaft. The jaws hold parts of a two-part fastener, respectively, and are offset and separated from the shaft. Significantly, the jaws operate in a plane at an angle to the shaft-clevis plane. The shaft is inserted with the proximally facing end effector through the esophagus in a first direction. The shaft is retracted in a second direction substantially opposite the first. The end effector contacts a stomach wall at a location near the esophagus and the stomach wall is manipulated with the end effector.

Abstract: A flexible clip applier includes a flat wire wound tubular coil, a pair of jaws at the end of the coil, end effector wires extending through the coil and coupled to the jaws, and a clip-advancing wire extending through the coil. A clip chamber is defined in the distal end of the coil. A clip pusher is provided at a distal end of the clip-advancing wire, and advances a clip into the jaws when the clip-advancing wire is moved distally. The jaws include channels in which a distalmost clip rides when the jaws are closed and the pusher is advanced, thereby causing the distalmost clip to be pushed over the tissue, and a distal anvil which operate to deform a portion of the clip to enhance its retention on the clamped tissue.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A system for the internal fixation of a fractured bone of an elbow joint of a patient includes at least one bone plate, each bone plate having a plurality of holes and generally configured to fit an anatomical surface of the fractured bone. The at least one plate is adapted to be customized to the shape of a patient's bone. The system also includes a plurality of fasteners including at least one locking fastener for attaching the bone plate to the bone. At least one of the holes is a threaded hole. Guides for plate benders, drills, and/or K-wires can be pre-assembled to the threaded holes, and the locking fastener can lock into any of the threaded holes after the guides are removed.

Abstract: A polyaxial locking screw system includes a bone plate defining a plate hole with an inner spherical surface and a relatively harder split polyaxial bushing with a outer spherical surface provided within the plate hole for receiving a bone screw. In one embodiment, the plate is formed from titanium alloy, while the bushing is formed from a cobalt chrome alloy. The outer surface of the polyaxial bushing includes a plurality of spikes. When the screw is inserted into the bushing, since the bushing material is considerably harder than the plate material, the forceful expansion of the bushing during screw insertion causes the spikes to penetrate into the inner spherical surface of the hole, thereby increasing the frictional engagement of the bushing to the plate to lock the screw at a desired angle.

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: An electrosurgical device includes an elongated body including a proximal end and a distal end and defining a longitudinal axis, at least one arm coupled to the distal end of the elongated body and an electrode coupled to at least one arm. The electrode includes an upper surface and a lower surface. The lower surface is substantially convex and defines a radius of curvature relative to an axis substantially perpendicular to the longitudinal axis.

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 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 an 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 tissue-piercing posts, and the second part includes a second base defining apertures receiving the posts and a portion movable relative thereto between first and second orientations. When the posts are inserted into the apertures, the movable portion can be moved from the first unlocked orientation into the second configuration to lock the fastener parts together in an implanting position determined by various alignment measures, including markings or flags on the jaws or at the housing. The instrument is adapted to move the second part into the second configuration.

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: A flexible endoscopic dip 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.

Abstract: A flexible endoscopic clip applier includes a flexible coil, a manual actuator coupled to one end and a jaw assembly coupled to the other. A store of clips is arranged adjacent to the jaw assembly and a clip pusher 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 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 portion. The threaded portion engages a threaded member near the pusher such that rotation of the second control member by the crank causes the pusher to be moved distally.

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.

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.