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: Methods and devices are provided for controlling movement of a working end of a surgical device, and in particular for performing various surgical procedures using an instrument having an end effector that can be articulated relative to an elongate shaft of the device. In certain embodiments, the end effector can also optionally rotate relative to the elongate shaft of the device, and/or the shaft can rotate relative to a handle of the device.

Abstract: Devices and related methods are provided that generally involve a specimen retrieval pouch coupled to and/or disposed within a surgical access device. Once a specimen is positioned within the pouch, the pouch can be closed and/or contracted to contain the specimen therein, for example by actuating one or more drawstrings configured to contract an open end of the specimen retrieval pouch.

Abstract: A dicing device dices tissue harvested from a patient. The dicing device comprises a grid cutting element and a tray to receive diced tissue. The dicing device may be integrated into an otherwise conventional biopsy device. The diced tissue specimens may be further processed, such as by being introduced into a self-expanding fistula plug creation and delivery system. The self-expanding fistula plug creation and delivery system comprises a sheet and a reinforcement tube. A scaffold material may be placed in the sheet, which may then be folded and reinforced, with the scaffold material being compressed in the sheet. The scaffold material may then be pushed into a catheter end. The catheter end may be inserted in a fistula. The scaffold material may then be flushed with a cell matrix that is based on the diced tissue to create a fistula plug, which may be left in the fistula.

Abstract: Methods and devices are provided for controlling movement of a working end of a surgical device, and in particular for performing various surgical procedures using an instrument having an end effector that can be articulated relative to an elongate shaft of the device. In certain embodiments, the end effector can also optionally rotate relative to the elongate shaft of the device, and/or the shaft can rotate relative to a handle of the device.

Abstract: Methods and devices are provided for performing minimally invasive surgical procedures. In one embodiment, a surgical device is provided that include an elongate shaft having a distal portion configured to be movable between a first configuration in which the distal portion of the shaft is substantially straight or linear and a second configuration in which the distal portion of the shaft is articulated at a compound angle. The shaft's distal portion can include two articulation joints to facilitate formation of the compound angle.

Abstract: An attachment mechanism for a surgically implantable medical device includes one or more fasteners which may be simultaneously moved from an undeployed position to a deployed position by operation of an integral actuator. The attachment mechanism may be configured to be deactuated, and the fasteners simultaneously moved from a deployed position to an undeployed position, allowing removal or repositioning of the medical device. An applier includes a locator for detachably holding the implantable medical device, locating it at the desired position, and actuating the attachment mechanism. The applier is configured to undeploy the attachment mechanism the implantable medical device can be detached from the body tissue.

Abstract: An attachment mechanism for a surgically implantable medical device includes one or more fasteners which may be simultaneously moved from an undeployed position to a deployed position by operation of an integral actuator. The attachment mechanism may be configured to be deactuated, and the fasteners simultaneously moved from a deployed position to an undeployed position, allowing removal or repositioning of the medical device. An applier includes a locator for detachably holding the implantable medical device, locating it at the desired position, and actuating the attachment mechanism. The applier is configured to undeploy the attachment mechanism the implantable medical device can be detached from the body tissue.

Abstract: In one general aspect, various embodiments are directed to methods for treating tissue within an aqueous environment. Various methods may include introducing a cutting implement of a surgical instrument into the aqueous environment. The cutting implement may have at least one cutting surface thereon and at least one ultrasonic portion thereon and be selectively rotatable within a hollow sheath. The methods may include rotating or rotatably oscillating the cutting implement within the hollow sheath for tissue cutting purposes. The cutting implement may also be retained in a position wherein the ultrasonic portion of the cutting implement may be applied to tissue and then have ultrasonic motion applied thereto.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that has an ultrasonic blade that protrudes from an ultrasonic transducer assembly. In some embodiments, the ultrasonic blade coaxially extends through a rotatable tissue cutting blade that is rotatably supported by a housing that supports the ultrasonic transducer assembly. In other embodiments, the ultrasonic blade and the tissue cutting blade are both selectively rotatable relative to the housing. In yet other embodiments, the tissue cutting blade and the ultrasonic blade are supported relative to each other in separate sheaths attached to the housing.

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 and a blade disposed at least partially within the sheath. Coupled to the blade may be at least one ultrasonic transducer, which, in turn, may be coupled to a drive system. The drive system may be configured to deliver gross axial motions to the blade such that the blade translates with respect to the hollow sheath when the drive system is activated. Accordingly, tissue may be cut by the blade with gross axial movement of the blade and/or ultrasonic vibrational motion provided by the ultrasonic transducer(s). In alternative embodiments, the blade may be rotated axially instead of translated with respect to the hollow sheath.

Abstract: In one general aspect, various embodiments are directed to an ultrasonic surgical instrument that comprises a handpiece housing that rotatably supports an ultrasonic transducer assembly therein that may be selectively rotated by various motor configurations. Various slip ring arrangements are disclosed for supplying ultrasonic electrical signals and motor drive signals from a control system. Various forms of blade and cutting implements are disclosed for attachment to the ultrasonic transducer assembly such that such implements may be selectively rotatable within a hollow outer sheath. Vacuum may be applied to the cutting implement or through the outer sheath to draw tissue through an opening in the sheath and into contact with the cutting implement.

Abstract: A specimen retrieval instrument comprises a handle assembly, an actuating rod, an introducer tube, and a retrieval bag. In some versions the specimen retrieval instrument further comprises a modular cartridge containing the retrieval bag. Upon translation of the actuating rod within the tube, the cartridge opens, releasing and opening the retrieval bag for receiving a specimen. A center spindle may be included where the spindle includes a slot for inserting a portion of the retrieval bag and wrapping the retrieval bag about the spindle. Some versions of the specimen retrieval instrument further comprise a rotating cam actuator that opens and closes a pair of support arms attached to the retrieval bag. Some versions of the specimen retrieval instrument further comprise rotating curved support arms operable to open and close the retrieval bag. Pins registered to helical grooves may provide rotation of the support arms as the support arms translate.

Abstract: A tissue retrieval device includes an introducer tube and a tissue retrieval bag. The introducer tube is insertable into a patient through a trocar. The bag may be selectively exposed at the distal end of the introducer tube, receive a tissue specimen, and be withdrawn from the patient. The bag includes a plurality of folds allowing the bag to transition from a folded configuration to an unfolded configuration. The folds may extend along a length of the bag transverse to the introducer tube; or along a length of the bag parallel to the introducer tube. The folds may extend about a perimeter of the bag, such as a circumference of the bag, and may be spaced apart along a length of the bag transverse to the introducer tube. The folds may be formed by petals that provide the bag with a generally spherical configuration when the bag is unfolded.

Abstract: A method for implanting an injection port within a patient. The method involves providing a port having a housing with a closed distal end, a open proximal end, a fluid reservoir therebetween, a needle penetrable septum attached to the housing about the opening, and at least one attachment mechanism mounted to the housing at a pivot point along an outer periphery of the housing. The attachment mechanism is an arcuate hook pivotable with respect to the housing, the arcuate hook having a length extending substantially at least 180° about the pivot point. The method further involves placing the distal end of the port adjacent tissue, and rotating the arcuate hook at least 180 degrees so that a free end of the hook extends into tissue and back out again.

Abstract: A laparoscopic surgical method comprises obtaining a first instrument comprising an elongate shaft with a distal end and a proximal end connected to a first handle. The distal end of the first instrument is passed through a percutaneous incision. A surgical end effector is obtained having a distal end with operable jaws and a proximal end selectively attachable to and detachable from the distal end of the first instrument. A second instrument is obtained comprising a distal end and a proximal end connected to a second handle. The surgical end effector is loaded ex vivo on the distal end of the second instrument. The distal end of the second instrument with the loaded surgical end effector is passed through a second incision spaced from the percutaneous incision. The proximal end of the surgical end effector is attached in vivo to the distal end of the first instrument. Tissue is manipulated by actuating the handle of the first instrument to operate the jaws of the surgical end effector.

Abstract: A surgical device for use in combination with a percutaneous elongate shaft defining a longitudinal axis. The shaft comprises a distal end and a proximal end, the distal end comprising an attachment mechanism. A surgical end effector is selectively attachable in vivo and detachable in vivo to the attachment mechanism of the percutaneous elongate shaft. A percutaneous elongate loader comprises an articulating distal end. The distal end comprises a tube with an opening at the distal tip, the tube being dimensioned to receive the surgical end effector. The distal end further comprises an engagement feature capable of frictionally holding the surgical end effector in the tube during in vivo attachment to and in vivo detachment from the percutaneous elongate shaft.

Abstract: A medical device comprises a handle comprises an actuator. A shaft extends distally from the handle. A first shaft segment extends proximally from the handle and has a proximal end and a distal end. A second shaft segment has a proximal end and a distal end and is pivotably supported with respect to the distal end of the first shaft segment at a position offset from a longitudinal axis of the shaft in a first offset direction. A third shaft segment has a proximal end and a distal end and is pivotably supported with respect to the distal end of the second shaft segment at a position offset from the longitudinal axis of the shaft in a second offset direction different from the first offset direction. A first member extends through at least a portion of the first shaft segment and is operatively associated with the actuator. A second member extends through at least a portion of the second shaft segment.

Abstract: A self attaching injection port has integral moveable fasteners which are moveable from a undeployed state to a deployed state engaging tissue. The fasteners may be disposed radially or tangentially, and rotated to pierce the fascia. The fasteners may be rigid or elastically deformable.

Abstract: An attachment mechanism for a surgically implantable medical device includes one or more fasteners which may be simultaneously moved from an undeployed position to a deployed position by operation of an integral actuator. The attachment mechanism may be configured to be deactuated, and the fasteners simultaneously moved from a deployed position to an undeployed position, allowing removal or repositioning of the medical device. An applier includes a locator for detachably holding the implantable medical device, locating it at the desired position, and actuating the attachment mechanism. The applier is configured to undeploy the attachment mechanism the implantable medical device can be detached from the body tissue.