Abstract: An applicator instrument for dispensing surgical fasteners includes a housing having a cartridge opening, an elongated shaft extending from the housing, and a cartridge insertable into the cartridge opening, the cartridge having a plurality of surgical fasteners pre-loaded into the cartridge. The applicator instrument has a firing system disposed within the housing, and an actuator for activating the firing system to commence a firing cycle for removing one of the surgical fasteners from the cartridge and driving the removed surgical fastener from the housing to a distal end of the elongated shaft. In one embodiment, the cartridge includes a cartridge body having an upper end and a lower end insertable into the cartridge opening. The surgical fasteners are arrayed in a stack that extends between the upper and lower ends of the cartridge body.

Abstract: A surgical fastener includes a first leg having a first distal barb and a first proximal barb that extend inwardly, and a second leg having a second distal barb and a second proximal barb that extend inwardly. A bridge interconnects proximal ends of the first and second legs. A first distance between opposing inner tips of the first and second distal barbs is greater than a second distance between opposing inner tips of the first and second proximal barbs. The first leg tapers inwardly between the proximal and distal ends thereof and has a cross-sectional area that is greater at the proximal end than at the distal end. The second leg tapers inwardly between the proximal and distal ends thereof and has a cross-sectional area that is greater at the proximal end than at the distal end. An insertion tool engages a crown on the proximal side of the bridge.

Abstract: Devices and methods for applying sealants to surgical instruments. In one embodiment, a surgical device is described that can include at least one nozzle formed at a proximal end of the device that is configured to receive a sealant, as well as an applicator formed at a distal end of the device that is configured to deliver the sealant received by the at least one nozzle. The applicator can be configured to interface with at least one of a first and second jaw of a surgical stapler such that the sealant delivered from the applicator can be deposited into a plurality of openings formed in the surgical stapler.

Abstract: An applicator instrument for dispensing surgical fasteners includes an elongated shaft having a proximal shaft section and a distal shaft section. The proximal shaft section includes an outer sheath and the distal shaft section includes a segmented member moveable between straight and articulated configurations. A handle is secured to the proximal shaft section, and an actuator is provided on the handle that is coupled with the outer sheath. An articulation band is disposed within the outer sheath and extends from the handle to the segmented member. The articulation band has a proximal end coupled with the actuator and a distal end attached to the segmented member. The actuator is moveable in a first direction for retracting the outer sheath, exposing the segmented member, and applying tension to the articulation band for moving the segmented member into the articulated configuration.

Abstract: Novel mesh implant positioning systems for use in laparoscopic body wall defect repairs, such as hernia defects, are disclosed. The systems utilize one or more bar members combined with surgical sutures and needles to position a mesh implant adjacent to a body wall defect without the need for stay sutures. Also disclosed are assemblies of the positioning systems with surgical mesh repair implants, and methods of repairing body wall defects such as hernias with the assemblies.

Abstract: A surgical fastener includes a first leg having a distal end, a proximal end, and a first insertion tip at the distal end of the first leg, the first insertion tip having a first distal piercing point, and a second leg having a distal end, a proximal end, and a second insertion tip at the distal end of the second leg, the second insertion tip having a second distal piercing point. A bridge connects the first and second legs. The first and second distal piercing points are located outside the respective first and second legs. The first and second legs extend along respective longitudinal axes, and the first and second insertion tips are asymmetrical and skewed outwardly relative to said respective longitudinal axes of the first and second legs.

Abstract: Novel stay suture devices and stay suture combinations with meshes are disclosed. The stay suture devices have a clip and a suture. The clip has leg members that are mounted to a hernia mesh implant such that the leg members are locked in a closed configuration. Also disclosed are novel methods of mounting stay sutures to a surgical mesh implant and repairing a body wall defect such as a hernia defect.

Abstract: An applicator instrument for dispensing surgical fasteners includes a handle and an articulating shaft extending from the distal end of the handle. The articulating shaft includes a proximal shaft section, a distal shaft section, and an articulating joint. An articulation control element is coupled with the proximal shaft section for articulating the distal shaft section relative to the proximal shaft section via the articulating joint. The applicator instrument includes an incompressible member interconnecting the proximal and distal shaft sections that maintains a fixed distance between the distal end face of the distal shaft section and the distal end of the handle as the articulating shaft moves between a straight configuration and an articulated configuration to ensure a consistent firing stroke.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing having an actuator and an elongated shaft extending from the housing. The applicator instrument includes a top stamping disposed within the elongated shaft, and a bottom stamping disposed within the elongated shaft that opposes the top stamping. The applicator instrument has a firing system for dispensing at least one surgical fastener from the distal end of the elongated shaft. An end cap is assembled with the distal ends of the top stamping, the bottom stamping, and the elongated shaft for stabilizing the distal end of the applicator instrument. The end cap has a distal end face with castling for engaging an opposing surface such as surgical mesh overlying tissue. The castling prevents the distal end of the applicator instrument from sliding or moving relative to the opposing surface.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing having an actuator, a shaft extending from the housing, and an end cap secured to a distal end of the shaft. The end cap has a bottom side, a top side, a lower distal edge adjacent the bottom side, and an end face that slopes upwardly and proximally from the lower distal edge to the top side of the end cap. A surgical fastener delivery window is formed in the sloping distal end face of the cap for dispensing surgical fasteners. The sloping distal end face extends continuously around the outer perimeter of the surgical fastener delivery window. The cap includes a plurality of gripping posts projecting distally from the sloping distal end face of the distal end cap. The posts are inserted into the pores of a surgical mesh for controlling movement of the mesh.

Abstract: A method of securing a prosthetic device to tissue includes providing an applicator instrument including a housing, a shaft, surgical fasteners, a firing rod for dispensing the surgical fasteners from the shaft, a trigger, and an energy storing element. The method includes positioning a prosthetic device over tissue, juxtaposing a distal end of the shaft with the prosthetic device, and compressing the trigger for piloting the firing rod toward the distal end of the elongated shaft at a first rate of speed. The method includes preventing the firing rod from moving distally while building up energy in the energy storing element, and further compressing the trigger for releasing the firing rod for distal movement and transferring the built up energy for moving the firing rod toward the distal end of the elongated shaft at a second rate of speed that is greater than the first rate of speed.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing, a firing system disposed in the housing, an actuator coupled with the housing for actuating the firing system, an elongated shaft extending from the housing, the elongated shaft having an outer diameter, and a cap secured to the distal end of the elongated shaft, whereby the cap has a lower distal edge that extends laterally beyond the outer diameter of the elongated shaft. The lower distal edge of the cap has a length that is greater than the outer diameter of the elongated shaft. The cap has a distal end face that slopes upwardly and proximally from the lower distal edge, and the cap has a surgical fastener delivery window formed in the distal end face for dispensing surgical fasteners. The delivery window has a lower end that is spaced from the lower distal edge.

Abstract: Novel stay suture devices and stay suture combinations with meshes are disclosed. The stay suture devices have a clip and a suture. The clip has leg members that are mounted to a hernia mesh implant such that the leg members are locked in a closed configuration. Also disclosed are novel methods of mounting stay sutures to a surgical mesh implant and repairing a body wall defect such as a hernia defect.

Abstract: Adjunct material and methods of using adjunct material to reinforce a staple line are provided herein. In general, adjunct material can be used to maintain a seal in tissue and prevent stapled tissue from tearing. This adjunct material can be coupled to a jaw of a surgical stapler, and can be deployed into tissue along with the staples. In some embodiments, the adjunct material can be sized and shaped so that a portion of the material extends laterally outside of the staple line and distributes strain to tissue outside of the staple line. In certain aspects, sealant can be applied to the staple line and to the adjunct material in various ways to further seal the tissue and/or prevent leaks from forming in the tissue.

Abstract: Devices and methods for applying sealants to surgical instruments are described herein. In one embodiment, a surgical device is described that can include at least one nozzle formed at a proximal end of the device that is configured to receive a sealant, as well as an applicator formed at a distal end of the device that is configured to deliver the sealant received by the at least one nozzle. The applicator can be configured to interface with at least one of a first and second jaw of a surgical stapler such that the sealant delivered from the applicator can be deposited into a plurality of openings formed in the surgical stapler.

Abstract: A clamping device for dispensing surgical fasteners includes a lower arm having a proximal end, a distal end, and a longitudinal axis extending between the proximal and distal ends, and an upper arm pivotally connected with the lower arm. An actuator is coupled with the upper and lower arms for moving the distal ends of the arms toward one another for closing the clamping device. A surgical fastener dispenser is secured to the distal end of the lower arm. The dispenser includes a cartridge body having a top surface with a surgical fastener dispenser opening. A pad is pivotally connected to the distal end of the upper arm. When the clamping device is closed, a bottom surface of the pad applies a clamping force upon the top surface of the cartridge body for dispensing one of the surgical fasteners at an angle that is perpendicular to the longitudinal axis.

Abstract: An applicator instrument for dispensing surgical fasteners includes a housing, a firing system disposed in the housing and being moveable in distal and proximal directions along a first axis, and an elongated shaft extending from the housing, the elongated shaft having a proximal section and a distal section that is oriented at an angle relative to the proximal section. A plurality of surgical fasteners are disposed in the elongated shaft. The applicator instrument has a handle that extends upwardly from the housing along a second axis that defines an acute angle with the first axis. A trigger is mounted on the handle, and a linkage couples the trigger with the handle and the firing system. When the trigger is squeezed, the linkage guides the trigger along a linear path of movement relative to the handle.