Abstract: The invention relates to a balloon catheter for treating enteroatmospheric fistulae in an open abdomen, consisting of an insertion tube that has a distal balloon arranged around the shaft and a proximal balloon arranged beneath this for sealing off the fistula, at least one injection line for filling said distal and proximal balloons with a filling medium, as well as a passage tube which is arranged transversely to said insertion tube at its base end and the lumen of which is connected to the lumen of the insertion tube and may be inserted into the intestinal tract.

Abstract: Entrapment and collection systems and method of entrapping and collecting biologic material produced on a patient are disclosed. The systems include a collection bag which formed of a flexible sheet material having a hollow interior, a first mouth and a second mouth. The first mouth is openable to enable the biological structure to be disposed in the hollow interior and to enable a removal instrument, e.g., a morcellator, to be introduced therethrough to engage the biologic structure to effect a procedure on it. The second mouth enables a viewing instrument to be extended through it for visualizing the procedure and is closeable by a drawstring to entrap biologic material produced by the procedure after the removal instrument and viewing instrument have been removed, whereupon the collection bag may be withdrawn from the body of the patient.

Abstract: During heart treatment performed via a port, the heart is moved without impeding the circulatory dynamics in the cardiac sac. Provided is a cardiac treatment apparatus including: an annular portion equipped with a wire that can be deformed between a contracted shape that allows insertion into the cardiac sac via a tubular port disposed passing from a body surface to the pericardium and an annular expanded shape in which the annular portion is expanded in the cardiac sac, is fitted onto the outer circumference of the heart from a ventricular apex side, and is located at a position for surrounding the outer circumference of the heart; and a pulling portion that exerts a pulling force on the annular portion such that the annular portion presses a sidewall of the heart, with the annular portion having been located at the position for surrounding the heart.

Abstract: A speculum drape for use in ophthalmic procedures. The speculum drape has at least a first sleeve made of surgical drape material and being is to envelop at least a first retaining portion of a speculum or retractor. The sleeve is an elongate hollow structure with first and second open ends through which at least the first retaining portion is insertable. The sleeve is adapted and arranged such that, with the first retaining portion of the speculum or retractor inserted into the sleeve and with the speculum or retractor in an operating position with the respective retaining portions of the speculum or retractor engaged with opposite edges of an eyelid of a patient, the sleeve (i) envelops the inserted first retaining portion (ii) is maintained in a disposition between the inserted retaining portion and the eyelid of the patient solely by compressive force and (iii) covers an eyelash of the patient.

Abstract: An assembly includes a flexible fixation member, a suture, and a delivery device. The fixation member includes a body with two terminal ends. A suture passes through the flexible fixation member at various points along a length of the body such that portions of the fixation member are slidable relative to the suture and configurable to form a cluster within a surgical site. The delivery device includes a tubular member, an elongated inserter, and a trigger. The elongated inserter is slidably disposed within the tubular member. The inserter has a forked distal end configured to receive a portion of the flexible fixation member and the suture. The trigger is finger-engagable and fixedly coupled to the proximal end of the inserter. It is configured to advance and retract the inserter relative to the tubular member. The trigger includes a retention member for retaining a proximal end portion of the suture.

Abstract: A method for impacting a suture anchor into bone comprises providing an implantable suture anchor and providing an impactor device for impacting the suture anchor into the bone. The suture anchor is coupled to a distal portion of the impactor device. Positioning the suture anchor engages the anchor with the bone at an implantation site, and powering the impactor device impacts the suture anchor thereby implanting the suture anchor into the bone. The frequency of impaction is less than 20 KHz. The impactor device is then decoupled from the suture anchor, and the impactor device may be removed from the implantation site.

Abstract: Devices and methods for securing prostheses such as heart valves or annuloplasty rings with sutures and without using knots are disclosed. The devices are particularly well suited for traditional surgery or minimally invasive surgery, and improve the ease of implantation by eliminating surgical knots a clinician would normally tie in the limited space in and around the implant site. The devices have opposed the clamp halves surrounded by a coil spring. Sutures pass between the clamp halves and the coil spring has an inner coil diameter sufficient to compress the sutures between the clamp. A retention member positioned between the clamp halves maintains a minimum space and therebetween to enable the locking device to be slid along the sutures into position, and to adjust the tension of the sutures therethrough. A delivery tool may be used to deliver and deploy the locking devices.

Abstract: The inventions disclosed herein relate to systems for securing medical devices to a blood vessel of a patient, including securing a vessel deforming component to a blood vessel. Certain embodiments relate to wraps configured to be secured around a blood vessel, including wraps configured to hold a vessel deformer adjacent a blood vessel, and further including, for example, a pulsatile balloon adjacent the aorta.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: A suture passer comprising: a hollow tube, the hollow tube comprising a distal end, a proximal end, and a lumen extending from the distal end to the proximal end; and a clamping rod slidably received in the lumen of the hollow tube, the clamping rod comprising a distal end and a proximal end, the distal end being bifurcated into a first arm and a second arm, one of the first and second arms extending distally of the other of the first and second arms and including a clamping surface; wherein at least one of the first arm and the second arm comprises a friction-enhancing surface for facilitating manipulation of a suture via engagement of the suture with the friction-enhancing surface.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: Systems, devices and methods to improve safety and efficiency in an operating room comprise providing a suture package that holds new suture needles and needle receptacles for storing used needles. The devices can be safely worn for the surgeon to self-dispense new suture needles in the near surgical field and to secure the used needles into a needle trap or a needle retainer located on his extremity, on his operative instruments or on the surgical drapes. The device may provide automated and/or simplified needle counting both during use and after removal from the surgical field. The device may be configured for ergonomic and efficient use so as to minimize the actions and motions of the surgeon to dispense and secure the needle.

Abstract: Interlock assemblies for attaching a loading unit to a surgical stapling instrument are provided. The interlock assemblies are formed on a proximal end of a shell member and on a distal end of an adapter assembly. The interlock assemblies may include a collar member for selectively securing the shell member to the adapter assembly. The collar member may be mounted on the shell member or on the adapter assembly.

Abstract: A surgical instrument including a handle assembly, an elongated portion, an end effector, and a stop member is disclosed. The end effector is disposed adjacent a distal portion of the elongated portion and includes a first jaw member and a second jaw member. At least one jaw member is movable with respect to the other jaw member between spaced and approximated positions. The first jaw member includes an upper tissue-contacting surface and a lower shelf portion. The shelf portion includes a groove disposed therein. The stop member is disposed adjacent a distal portion of the first jaw member and is pivotable with respect to the first jaw member between a first position, a significant portion of the stop member being positioned external to the first jaw member, and a second position where a lower portion of the stop member being positioned at least partially within the groove.

Abstract: A method and apparatus for closing a vascular wound includes a guidewire and/or other surgical implement extending from the wound. A hemostatic material is advanced over the surgical implement and into contact with an area of the blood vessel surrounding the wound. The surgical implement is removed. Blood soaks the hemostatic material, and blood clotting is facilitated by the hemostatic agent within the material. A sealing layer of adhesive can be applied to the hemostatic material, confining the blood flow to the material. Thus, the vascular puncture wound is sealed by natural blood clot formation.

Abstract: An end effector includes first and second jaws, a drive screw, a lead screw nut, and a drive beam. The drive screw is disposed within the first jaw. The lead screw nut defines a threaded bore that receives the drive screw. The lead screw nut is advanced along the drive screw as the drive screw is rotated in a first direction and is retracted along the drive screw as the drive screw rotates in a second direction. The drive beam is releasably coupled to the lead screw nut when the lead screw nut is in a retracted position. As the lead screw nut is advanced the drive beam is pulled by the lead screw nut. The drive beam is decoupled from the lead screw nut as the lead screw nut is advanced such that the lead screw nut is advanced relative to the drive beam.

Abstract: A size-variable Implantable device having a body including at least one attaching portion configured for securing the device to a surgical site of a patient; a size-controlling member configured for controlling at least one dimension of the device; and an actuator arranged to actuate the size-controlling member. The device may include a mounting portion for mounting one or more expandable conduits. The at least one attaching portion may be made from a deformable, e.g. an expandable and/or contractible, material, which may allow expansion and/or contraction of the size-variable implantable device. The device may include one or more sensors for detecting, measuring, collecting, storing, and/or communicating data in the region of deployment of the device, which may cause the actuator to actuate the size-controlling device when one or more of the detected parameters reach a predetermined value.

Abstract: The present invention relates to surgical instruments and a method for applying an adhesive or sealant to an anastomosis site immediately prior and/or during anastomotic surgical stapling. The present invention further relates to surgical instruments, devices, and methods for applying sealant to a target tissue of a surgical site being anastomotically joined so as to prevent leakage.

Abstract: A method of occluding an appendage of the heart with a clamp including at least first and second elongate clamping portions, the first and second elongate clamping portions including tissue engaging surfaces that promote tissue ingrowth. The method includes implanting the clamp by positioning the first and second elongate clamping portions on opposite sides of the appendage. At least one of the first or second elongate clamping portions is biased toward the other of the first and second elongate clamping portions to place the clamp into a clamping position on the appendage. Tissue ingrowth into the tissue engaging surfaces retains the clamp in place on the appendage.

Abstract: An apparatus (10) for removing bone material comprises a distal cutting instrument (12) and a proximal cutting instrument (14). The distal cutting instrument has at least one first cutting edge (30), a shoulder (20), and a shaft portion (22). The shaft portion (22) has an anti-rotation feature. The at least one first cutting edge (30) removes bone material when moved in a first direction. The proximal cutting instrument (14) is removably attached to the shaft portion (22). The proximal cutting instrument (14) has a first end portion (68) and a second end portion (66). The second end portion (66) contacts the shoulder (20) of the distal reamer (12) when the proximal reamer is mounted to the shaft portion (22). The proximal reamer (14) has at least one second cutting edge (32) and an aperture. The aperture is adapted to receive the anti-rotation feature of the shaft portion (22) of the distal reamer (12). The at least one second cutting edge (32) removes bone material when moved in a second direction.

Abstract: An acetabular reamer has a rotatable drive shaft extending along a first longitudinal central axis. A second housing surrounds at least a portion of the drive shaft, the first housing having a gripping arm. A drive motor in a first housing is coupled to a first end of the rotatable drive shaft for rotating the drive shaft. A reamer head is rotatably coupled to a second end of the rotatable drive shaft, the reamer head rotatable about a second axis extending at an acute angle with respect to the rotatable drive shaft first longitudinal. A releasable connector couples the first and second housing and prevent relative rotation between the first housing and the second housing.

Abstract: A patient-specific alignment guide includes a three-dimensional engagement surface customized in a pre-operating planning stage by computer imaging to closely mate and conform to a corresponding bone portion of a patient's elbow joint. The patient-specific alignment guide defines a first longitudinal guiding bore aligned with a reference axis associated with the elbow joint of patient when the alignment guide is mounted onto the corresponding bone portion.

Abstract: A humeral cut guide system for resectioning or resurfacing a humeral head. The humeral cut guide system includes a primary cut guide member configured to be removably coupled to the humeral head. The primary cut guide member includes a patient-specific bone-engaging surface, a primary elongate slot that defines a primary cutting plane, and a pair of cylindrical apertures configured to receive a pair of guide pins. A secondary cut guide member includes a pair of through-holes configured to mate with the pair of guide pins, and the secondary cut guide member includes a secondary elongate slot that defines a secondary cutting plane.

Abstract: A platform of devices for removing obstructions and other objects within a blood vessel or other interior lumen of an animal is provided. The system may be deployed in the lumen from a catheter(s) and the system includes a proximal hub, and a distal basket comprised of a plurality of cells. A number of different baskets designs are disclosed. Methods of manufacturing such baskets out of a single tube of a memory metal without the need for any welding or soldering, and methods of use are also disclosed.

Abstract: A guide wire, for use, for example, in guiding an elongated catheter through an artery or vein of a mammalian body having a stenosis and/or an occlusion therein, includes an elongated conductor having a longitudinal dimension, a proximal end and a distal end. The guide wire further includes an insulator overlying the elongated conductor. The insulator exposes a portion of the longitudinal dimension of the elongated conductor to form an electrode. The elongated conductor is arranged to be connected to a source of high voltage pulses to cause electrical arcs at the electrode that in turn form steam bubbles and shock waves to break the stenosis and/or open the occlusion and permit the guide wire to pass there through. Other embodiments are directed to a system including the guide wire and a method of using the guide wire.

Abstract: An apparatus is configured to deliver destructive energy to a stone. The apparatus includes a detector operative to obtain image data from the stone, a generator operating according to one or more producing parameters for producing the destructive energy, and a video processor unit receiving the image data from the detector. The video processor unit is operative to analyze the image data to determine a displacement of the stone relative to a previous location of the stone. A controller linked to the video processor unit and to the generator is operative to vary the one or more producing parameters of the generator responsively to the displacement of the stone. Methods carried out by the apparatus are further provided.

Abstract: A method and apparatus for disrupting material at a tissue site is described. A contact layer may be selected for use on the tissue site and positioned adjacent to the tissue site. The contact layer may include walls defining a plurality of through-holes. A sealing member may be positioned over the contact layer and sealed to tissue surrounding the tissue site to form a sealed space enclosing the contact layer. A negative-pressure source may be fluidly coupled to the sealed space. The negative-pressure source may supply negative pressure to the sealed space and the contact layer to draw tissue into the through-holes to form nodules. The negative pressure may be vented from the sealed space to release the nodules.

Abstract: An endoscopic surgical blade is disclosed. The blade is of a low-profile design, having a downward angled cutting surface that is radiused at its upper end. The blade is part of an endoscopic knife assembly which also contains a knife tube. The endoscopic knife assembly is for use in endoscopic surgery by insertion of the assembly through a slotted cannula. The knife tube is hollow and allows the insertion of an endoscope for viewing of the surgical procedure. A method for a performing an operative procedure on a target tissue in a subject using an endoscopic knife assembly having a low-profile, downward angled blade is also described.

Abstract: An apparatus and method for performing endoscopic carpal tunnel release (ECTR) surgery, thereby decreasing the pressure within the carpal tunnel that impairs median nerve function.

Abstract: An apparatus comprises a body assembly, a shaft, an acoustic waveguide, an articulation section, an end effector, and an articulation drive assembly. The shaft extends distally from the body assembly and defines a longitudinal axis. The acoustic waveguide comprises a flexible portion. The articulation section is coupled with the shaft. A portion of the articulation section encompasses the flexible portion of the waveguide. The articulation section comprises a plurality of body portions aligned along the longitudinal axis and a flexible locking member. The flexible locking member is operable to secure the body portions in relation to each other and in relation to the shaft. The end effector comprises an ultrasonic blade in acoustic communication with the waveguide. The articulation drive assembly is operable to drive articulation of the articulation section to thereby deflect the end effector from the longitudinal axis.

Abstract: An apparatus comprises a body assembly, a shaft, an acoustic waveguide, an articulation section, an end effector, and an articulation drive assembly. The shaft extends distally from the body assembly and defines a longitudinal axis. The acoustic waveguide comprises a flexible portion. The articulation section is coupled with the shaft. A portion of the articulation section encompasses the flexible portion of the waveguide. The articulation section comprises a plurality of body portions aligned along the longitudinal axis and a flexible locking member. The flexible locking member is operable to secure the body portions in relation to each other and in relation to the shaft. The end effector comprises an ultrasonic blade in acoustic communication with the waveguide. The articulation drive assembly is operable to drive articulation of the articulation section to thereby deflect the end effector from the longitudinal axis.

Abstract: An ultrasound system includes a 3D imaging probe and a needle guide which attaches to the probe for guidance of needle insertion into a volumetric region which can be scanned by the 3D imaging probe. The needle guide responds to the insertion of a needle through the guide by identifying a plane for scanning by the probe which is the insertion plane through which the needle will pass during insertion. The orientation of the insertion plane is communicated to the probe to cause the probe to scan the identified plane and produce images of the needle as it travels through the insertion plane.

Abstract: A needle access assembly and method for obtaining percutaneous needle access with little or no fluoroscopy. The method can include selecting a target for percutaneous access, directing a laser guide at a desired needle-insertion angle and in line with the selected target, aligning the needle access assembly with the laser, and inserting the needle into the target.

Abstract: A tissue retractor comprising an outer ring, an inner ring, and a flexible, metal sheath extending therebetween is described. Embodiments of the outer ring comprise an outer ring rotatable around an annular axis thereof, thereby rolling the sheath therearound when retracting an incision or opening in a body wall. Embodiments of the sheath comprise a plurality of linked loops, a plurality of loops joined by a wire extending through adjacent loops, a braided wire, and a plurality of chains. Also described are kits comprising outer rings, inner rings, and sheaths, some or all of varying dimensions, which may be selected and assembled by the user for their intended use. Some or all of the kit components may be resterilized for reuse.

Abstract: A delivery device for tissue anchor delivery is provided. The delivery device includes a first flexible tube having a rigid distal portion attachable to a tissue anchor, a second flexible tube coaxially disposed around the first tube and a tubular sheath covering the second flexible tube. Also provided is a system which includes an imaging device coupler reversibly attached to the delivery device through guides.

Abstract: An apparatus includes a substantially cylindrical body including an end portion having rounded edges and at least one opening. The apparatus further includes a nub extending from the end portion proximate to the at least one opening. The nub includes a substantially rounded end.

Abstract: An apparatus may include a plunger and a substantially cylindrical body. The substantially cylindrical body may include an end portion having rounded edges and may define a cavity sized to receive the plunger. The substantially cylindrical body may include at least one opening extending from the cavity to an external surface. The at least one opening may a substantially irregular shape. In some embodiments, the at least one opening may extend from the cavity through a nub to the external surface. The nub may have a rounded shape. In some embodiments, the substantially irregular shape may include one of a slit, an oval shape, an elliptical shape, an hourglass shape, a rectangular shape, and a diamond shape. In some embodiments, the opening may be part of a non-cylindrical fluid passage.

Abstract: This is an apparatus for pulling out ingrown hairs that cause razor bumps, with an application of hot water and soap lather or shaving foam. This opens the pores and loosens the ingrown hairs for extracting. The textured convex head with rounded corners, allows for a fluent motion on various contoured surfaces of the human body that is susceptible to ingrown hairs. The width of the textured head has enough surface area to capture the multiple ingrown hairs and extracting them in a minimal amount of time.

Abstract: A fixation clamp for use in an external fixation system for holding bone fragments adjacent to each other with the help of fixation elements has at least one clamping assembly having a pair of jaws with at least two different size grooves to accommodate a bone fixation element such as a pin or rod. An alternate clamping assembly has at least three grooves wherein at least two of the grooves have a different size adapted to accommodate a correspondingly sized bone fixation element such as a bone pin. The longitudinal axes of the grooves define a polygon. The jaw pairs can be rotated about a central longitudinal axis to present different size reception cavities towards the pins or rocks depending on their diameter.

Abstract: A prosthetic implant for restoring lamina after a laminectomy. The implant is generally a lamina-sized construct having a hollow interior. The lamina removed during the laminectomy may be converted to autologous bone that may then be placed inside the hollow interior of the implant. The implant may then be secured to the spine at the site of the laminectomy so that lamina restoration can occur as the hollow interior of the implant solidifies with bone growth.

Abstract: Device for fixing a bony structure to a support member, the device comprising a first connecting member which comprises: a main body provided with a first passage configured for receiving the support member, and with a first opening configured for passing a flexible member therethrough; and a rod fixed to and/or monobloc with the main body and protruding therefrom. The device further comprises a first flexible member passing through the first opening of the main body and extending beyond the main body for attachment to the bony structure.

Abstract: A hinged bone screw and tool set is used for implanting such bone screws in a human spine, followed by the implantation of a longitudinal connecting member into the bone screws. The hinged bone screw includes a shank with an upper portion and a receiver with integral arms forming a U-shaped channel. A lower curved seat partially defining the U-shaped channel cooperates with an upper portion of the bone screw shank for hinged movement of the shank with respect to the receiver. The tool set includes an insertion tool, a bone screw driver, a reduction tool and a closure starter. The insertion tool includes a bone screw attachment structure and a laterally opening channel. The insertion tool further includes a threaded portion for cooperation with the reduction tool to provide synchronized placement of a closure structure in the bone screw receiver while reducing and capturing a longitudinal connecting member within the receiver.

Abstract: Sacral fixation implants can include first and second implant segments. One of the first and second implant segments is received in the other of the first and second implant segments, and the first and segments can be fixed with respect to movement toward and away from each other, thereby stabilizing a sacral fracture.

Abstract: A sacral fixation implant can include at least one implant segment, a guide wire, and at least one locking member that is configured to fix the implant segment to the guide wire. The implant segment can be configured to be secured to an ilium bone, and the guide wire can be configured to be secured to the sacrum. The implant can include first and second implant segments that are configured to be secured to opposed ilium bones, such that a first locking member is configured to fix the first implant segment to the guide wire, and a second locking member is configured to fix the second implant segment to the guide wire.

Abstract: A spine stabilization system having a base plate having a plurality of screw holes and a plurality of corresponding screw locking mechanisms. The present invention also provides an extension plate having a plurality of screw holes and corresponding screw locking mechanisms. The extension plate is dimensioned and configured with an extension portion, the extension portion having a screw hole and a screw locking mechanism and a finger portion having a connection element and to contact and connect with the base plate. The base plate is provided a graft window having edges, wherein at least one of the edges being configured to receive and connect with the connection element.

Abstract: A spinal plate having an upper surface and a lower surface, the lower surface adapted to contact bone. A plurality of holes extend from the upper surface to the lower surface through the plate which is configured and adapted to receive bone fasteners for fixing the spinal plate to bone. The lower surface of the spinal plate comprises a ridge that protrudes from the underside of the plate and encloses the plurality of holes spaced inward from the perimeter of the spinal plate.

Abstract: An anterior cervical plate system is provided. The cervical plate includes a retention ring with a deflectable flange that is upwardly spaced from the top surface of the ring and configured to prevent an inserted bone fastener from backing out of the plate. The plate includes a locking pin having a camming surface and a blocking surface. When the camming surface is moved into position adjacent to the flange, the flange is free to flex out of the way of a bone screw being inserted into or removed from the plate. When the blocking surface is positioned adjacent to the flange, outward deflection of the flange is prevented to retain the bone screw inside the plate. The locking pin is rotated through a camming surface to bring a blocking surface against the flange deflecting the flange onto the head of the bone screw.

Abstract: Bone plates and bone plate systems are provided in which a bone plate includes a plurality of bone screw holes formed therein and positioned in laterally adjacent pairs. Positioned between the laterally adjacent pairs of bone screw holes are stabilizing strut. The bone plate system can additionally include windows positioned between longitudinally adjacent struts. Transverse bone screw planes can extend across the superior and inferior edges of the bone screw holes and define the minimum longitudinal boundaries of the windows. A guide device adapted for mating with the bone plate is also disclosed.

Abstract: Various embodiments described herein provide devices and associated methods for treating spinal disease by implanting one or more interspinous process spacing devices. In one embodiment, an interspinous process spacing device includes a first attachment side, a second attachment side, a spacer tray, and a securing means. The spacer tray extends from the first attachment side and is slideably insertable through a spacer tray slot formed in the second attachment side. The spacer tray is adapted to be positioned between a spinous process of a first vertebra and a spinous process of an adjacent second vertebra, and the spacer tray includes a trough formed in a top surface of the spacer tray. The securing means is configured to engage the trough of the spacer tray to secure the second attachment side relative to the first attachment side.

Abstract: Systems, devices, and methods suitable for use with procedures performed at least partially percutaneously are provided. In some procedures, two or more access devices for providing access to adjacent surgical locations within a patient are used. Certain embodiments of the access device comprise an elongate body having a distal end with one or more cutouts. The cutouts on adjacent access devices are generally aligned with each other to permit passage of a portion of a fixation element from one access device to the other access device. A fastener with an elongated removable head may be delivered to the surgical site through the access device. After a distal end of the fastener is secured to the surgical site, a portion of the elongated housing is detached from the remainder of the fastener and removed from the patient.