Abstract: A suturing assembly includes a suture passing member formed with a lumen in which are disposed a suture holding element and a first puncture element. Both the first puncture element and the suture holding element include suture receiving portions. A second puncture element includes a suture receiving portion. The first puncture element and the suture holding element have a retracted position and a deployed position. In the deployed position, the distal end of the first puncture element and/or suture holding element bends and passes over the distal end of the second puncture element, and a space is formed between the first puncture element and the suture holding element. During movement from the deployed position back to the retracted position, the suture receiving portion of the first puncture element and/or suture holding element moves adjacent the suture receiving portion of the second puncture element.

Abstract: A device to assist in securing a holding a portion of a suture during an intra-abdominal suturing procedure, the device including an elongated tubular body, a handle, an inner member element, and a push button. The inner member element may include at least one grasping element that expands as the at least one grasping element is extended beyond a distal end of the elongated tubular. The device may include a proximal spring disposed within the push button and abutting against a proximal end of the inner member element to allow the at least one grasping element to retract into the elongated tubular body in a proximal direction.

Abstract: A needle-suture combination includes a surgical needle having two ends and a suture connection location arranged between the two ends; a suture; and a connection part. A first end of the connection part is connected to the needle at the suture connection location and an opposite second end of the connection part is connected to the suture. The connection part includes a connection part cross section area and the suture includes a suture cross section area. The connection part cross section area is smaller than the suture cross section area. The connection part has a length which is larger than a longest distance from the suture connection location to each of the two ends of the needle.

Abstract: An apparatus includes a housing, a platform, a buttress assembly and a lockout feature. The housing defines a gap that is configured to receive a portion of an end effector of a surgical stapler. A portion of the platform is exposed in the gap defined by the housing. The buttress assembly is positioned on the platform. The buttress assembly is exposed in the gap defined by the housing. The lockout feature is configured to enable an end effector with an unspent staple cartridge to clamp onto the platform and thereby engage the first buttress assembly. The lockout feature is further configured to prevent an end effector with a spent staple cartridge from clamping onto the platform to thereby engage the first buttress assembly.

Abstract: A buttress is applied to an end effector of a surgical stapler. The buttress is loaded on a platform of a buttress applier cartridge. The end effector is closed upon the platform. An adhesive layer of the buttress secures the buttress to the end effector. The buttress is thus adhered to the end effector when the end effector is opened. The end effector is then actuated on tissue of a patient, thereby stapling the buttress to the tissue.

Abstract: An apparatus includes a housing, a platform, a buttress assembly, at least one retainer member, and a lockout alignment feature. A portion of the platform is exposed in a gap defined by the housing. The buttress assembly is positioned on the platform. The buttress assembly is exposed in the gap defined by the housing. The at least one retainer member is configured to selectively retain the buttress assembly against the platform. The at least one retainer member is further configured to release the buttress assembly from the platform in response to a clamping action of an end effector positioned in the gap defined by the housing. The lockout alignment feature is configured to prevent the at least one retainer member from releasing the buttress assembly form the platform unless the end effector is located at a predetermined position in relation to the buttress assembly during clamping of the end effector.

Abstract: A multicomponent suture comprising first and second substantially elongate suture portions with respective first and second cross-sectional profiles, and further including respective first and second materials, one of said materials being bioabsorbable and a second of said materials being non-bioabsorbable.

Abstract: Various exemplary matrix metalloproteinase (MMP) inhibiting adjuncts for surgical devices are provided. In general, an implantable adjunct can be configured to be applied to tissue by a surgical stapler in conjunction with staples. The adjunct can have at least one medicant releasably retained therein that is configured to reduce a length of the epithelialization process. In other words, the at least one medicant releasably retained in the adjunct can be configured to speed up an inflammation stage of wound healing and/or a proliferation stage of wound healing and, accordingly, reduce an amount of time before a remodeling stage of wound healing begins. The at least one medicant can be configured to be released along the staple line defined by the staples.

Abstract: Adjuncts for surgical devices including agonists and antagonists are provided. In general, an implantable adjunct can have two or more medicants releasably disposed therein that are each releasable from the adjunct. At least one of the medicants can include an agonist configured to encourage a physiological response, and at least one of the medicants can include an antagonist configured to discourage the physiological response encouraged by the agonist. The physiological response can include an aspect of wound healing such that the aspect of wound healing may be both encouraged by and discouraged by the adjunct. The adjunct having one or more agonists and one or more antagonists releasably disposed therein can be configured to be applied to tissue by a surgical stapler in conjunction with staples.

Abstract: Various exemplary devices and methods are provided for performing surgical procedures. In general, one or more adjuncts can be used in conjunction with surgical instruments. The adjunct(s) can have medicant(s) thereon and/or therein. The medicant(s) can vary depending on the desired effect of the medicant(s) on surrounding tissue. As a non-limiting example, medicant(s) can be provided to influence hemostasis, inflammation, macrophages, and/or fibroblasts. When used in conjunction with a surgical stapler, the adjunct(s) can be disposed between and/or on jaws of the stapler, incorporated into a staple cartridge disposed in the jaws, or otherwise placed in proximity to the staples. When staples are deployed, the adjunct(s) can remain at the treatment site with the staples.

Abstract: Adjunct materials for delivery to colon tissue are provided. In general, the adjunct materials can be configured to be delivered to colon tissue by deployment of staples from a cartridge body of a surgical stapler to form at least one line of deployed staples. The adjunct material can be formed of a fiber matrix and include an effective amount of one or more medicants for delivery to the colon tissue. The medicant is disposed within and releasable from the adjunct material, and effective to encourage a desired effect on blood vessels, such as angiogenesis and/or vasodilation, along the at least one line of deployed staples. Methods of using a staple cartridge assembly or an end effector to apply such adjunct materials to colon tissue are also provided.

Abstract: Adjunct material to provide controlled drug elution is provided. In general, an implantable adjunct formed from at least one bioabsorbable polymer can be configured to be applied to tissue by a surgical stapler in conjunction with staples. The adjunct can be made from a plurality of fibers and it can have one or more medicants releasably retained therein that are effective to provide a desired effect on tissue in-growth in a predetermined manner. Release of each of the at least one medicants from the adjunct material can be controlled by a degradation rate of the at least one bioabsorbable polymer.

Abstract: Tissue adhesions using surgical adjuncts and medicants are provided. In general, an implantable adjunct can have one or more medicants releasably retained therein that are configured to induce tissue adhesions. The adjunct can be configured to be applied to lung tissue in conjunction with surgical staples using a surgical stapler. Pleurodesis can be encouraged through delivery of the adjunct to the lung tissue.

Abstract: Adjunct materials for delivery to liver tissue are provided. In general, the adjunct materials can be configured to be delivered to tissue by deployment of staples from a cartridge body of a surgical stapler. The adjunct material is configured to transition from an unexpanded configuration to an expanded configuration after delivery thereof to the liver tissue. The adjunct material can include an effective amount of one or more medicants, such as a hemostatic agent or a tissue healing agent, disposed within and releasable from the adjunct material for delivery to the liver tissue. The adjunct material can expand to apply pressure to liver tissue to facilitate sealing of one or more fractures in the stapled liver tissue. Methods of using a staple cartridge assembly or an end effector to apply such adjunct materials to liver tissue are also provided.

Abstract: Disclosed is a surgical linear stapler comprising: a staple cartridge which is internally loaded with staples for stapling a surgical site; a cartridge accommodating channel which is formed with a cartridge accommodating groove to accommodate the staple cartridge therein; an anvil which corresponds to the staple cartridge and shapes the staple discharged from the staple cartridge; and a cutter which moves along a lengthwise direction of the staple cartridge by external force and cuts a surgical site arranged in between the staple cartridge and the anvil, in which distances from the cutting section of the surgical site to opposite stapling lines are different from each other, thereby stably and conveniently obtaining tissue for pathological examination, which is not damaged by a staple.

Abstract: Various exemplary surgical adjuncts with medicants affected by activator materials are provided. In general, an adjunct is provided with at least one medicant that is configured to be activated by an activator material. The adjunct can be delivered to a tissue of a patient, where the adjunct can be implanted. Various activator materials can be configured to activate the at least one medicant retained by the adjunct, the activation causing any one or more of a variety of actions. For example, the at least one medicant can be activated so as to yield at least one of a signal and/or an effect on the adjunct.

Abstract: Adjunct material to provide drug elution is a variety of different temporal and/or spatial patterns is provided. In general, a biocompatible adjunct having a plurality of distinct regions having a plurality of distinct regions is configured to be delivered to tissue by deployment of staples in a cartridge body of a surgical stapler. Each of the distinct regions can be disposed at a different location on the adjunct material and can have a different adjunct construction. At least two of the regions releasably retain at least one medicant and each of the at least one medicants is releasable from one of the regions in a non-homogeneous manner with respect to at least one of time of release and location of release.

Abstract: Tubular surgical constructs including adjunct material are provided. In general, a tubular construct can be configured to be applied to tissue of a patient. The tubular construct can be configured to be implantable and to be implanted within a tissue lumen. The tubular construct can be configured to radially expand and radially constrict. The tubular construct can have an adjunct material disposed thereon. The adjunct can have one or more medicants releasably retained therein. Each of the one or more medicants can be effective to provide a desired effect on tissue in a predetermined manner.

Abstract: Embodiments of a clamping instrument are disclosed. In some embodiments, a clamping device with calibrated parameters and a calibration process for the clamping device is presented. A method of calibrating a clamping instrument can include acquiring a data set of clamping torque as a function of tip deflection data for the clamping instrument; determining a torque limit from the data set; and storing the torque limit in the clamping instrument.

Abstract: A surgical staple cartridge is disclosed comprising a plurality of staples removably stored within the surgical staple cartridge. The staples comprise staple legs which extend from a staple base portion. The staple legs comprise staple tips configured to pierce tissue and contact a corresponding forming pocket of an anvil of surgical stapling instrument.

Abstract: A staple cartridge is disclosed. The staple cartridge is insertable into and removable from a jaw of surgical stapling instrument. The staple cartridge comprises a cartridge body including staple cavities and staples removably stored in the staple cavities. Each of the staple cavities includes a bottom opening and a top opening. The staples include features configured to inhibit the staples from falling out of the bottom openings of the staple cavities. The staple cartridge further comprises a firing member configured to eject the staples from the staple cavities through the top openings of the staple cavities. The firing member further comprises one or more features configured to inhibit the firing member from falling out of the bottom of the cartridge body. In various instances, as a result, a cover extending around the bottom of the cartridge body may not be required.

Abstract: A surgical staple cartridge is disclosed comprising a strip of staples removably stored within the surgical staple cartridge. The strip of staples comprises a plurality of staples, a base strip, and a plurality of connector portions joining the staples to the base strip.

Abstract: A staple cartridge is disclosed. The staple cartridge comprises a cartridge body including staple cavities and staples removably stored in the staple cavities. The staple cartridge further comprises a firing member configured to eject the staples from the staple cavities. The staples and staple cavities include features which reduce friction forces between the staples and the staple cavities when the firing member ejects the staples from the staple cavities. Each of the staples comprises a base including a drive portion and staple legs extending from the base and, in at least one instance, each of the staple cavities includes a proximal guide and a distal guide configured to guide the staple legs of the staple positioned therein as it is ejected from the staple cavity. In certain instances, each of the staple cavities further includes an intermediate guide offset from the proximal guide and the distal guide.

Abstract: Circular and curved surgical stapling instruments are disclosed comprising a circular and curved stapling configurations. A circular staple cartridge comprises a plurality of staples arranged in an inner row, an intermediate row, and an outer row. Staples in certain rows can vary in crown width to overlap gaps defined between staples in certain other rows which provide a stretch zone.

Abstract: A staple cartridge is disclosed which comprises a cartridge body, staples cavities defined in the cartridge body, and staples removably stored in the staple cavities. The staple cartridge comprises features for properly aligning and preventing the misalignment of the staples within the staple cavities.

Abstract: An end effector including an anvil and a staple cartridge assembly is disclosed. The staple cartridge assembly comprises a deck having steps defined thereon for compressing tissue positioned between the anvil and the staple cartridge assembly to different pressures. The staple cartridge assembly further comprises staples having different unformed heights removably stored therein. The staples are deformed against the anvil to different formed heights.

Abstract: A staple cartridge is disclosed. The staple cartridge comprises a cartridge body including staple cavities and staples removably stored in the staple cavities. The staple cartridge further comprises a firing member configured to eject the staples from the staple cavities. In various instances, each of the staples comprises a base including a drive portion and staple legs extending from the base and, in at least one such instance, each of the staple cavities includes a proximal guide and a distal guide configured to guide the staple legs of the staple positioned therein as it is ejected from the staple cavity by the firing member. In certain instances, the proximal guide and/or the distal guide is offset from the drive portion of the staple.

Abstract: A staple cartridge assembly is disclosed. The staple cartridge assembly comprises staples including a base, staple legs extending from the base, and a platform extending laterally from the base. The staple cartridge assembly further comprises an implantable layer. The platforms of the staples are configured to support the implantable layer when the staples are implanted into the tissue of a patient. Staples are also disclosed which included an implantable adjunct positioned over the platform of the staple. The implantable adjuncts can include one or more compressible pockets. One or more medicaments can be positioned in the compressible pockets.

Abstract: A surgical staple cartridge is disclosed comprising a plurality of staples removably stored within the surgical staple cartridge. The staples comprise staple legs which extend from a staple base portion in a parallel and offset plane with respect to a plane defined by the staple base portion. Each staple comprises a center of mass aligned with the staple base portion.

Abstract: A staple cartridge is disclosed. The staple cartridge comprises a cartridge body, staples removably stored in the cartridge body, and a firing member. The firing member is configured to directly engage the staples to eject the staples from the staple cavities. The firing member includes one or more channels and/or rails configured to orient the staples before, during, and/or after the staples contact an anvil positioned opposite the staple cartridge.

Abstract: A staple cartridge assembly including staples is disclosed herein. The staples comprise features which improve the biocompatibility and/or bioabsorption of the staples. The staples are comprised of a magnesium alloy, for example. The magnesium alloy can also include zinc. In certain instances, a bioabsorbable polymer is coated on part of, but not all of, the staple. Portions of the staple that are not coated by the bioabsorbable polymer will be absorbed at a first rate while portions of the staple that are coated by the bioabsorbable polymer will be absorbed at a slower rate. In various instances, the tips of the magnesium staples are coated with magnesium nitride and/or any other suitable material which can increase the hardness of the staples. In certain instances, the staples are coated in silver. In some instances, the staples include one or more apertures defined therein.

Abstract: A surgical staple cartridge is disclosed comprising a plurality of staples removably stored within the surgical staple cartridge. The staples comprise staple legs which extend from a staple base portion. The staple legs comprise staple tips configured to pierce tissue and contact a corresponding forming pocket of an anvil of surgical stapling instrument. The staples further comprise zones having different hardnesses.

Abstract: Various exemplary surgical adjuncts with medicants affected by activator materials are provided. In general, an adjunct is provided with at least one medicant that is configured to be activated by an activator material. The adjunct can be delivered to a tissue of a patient, where the adjunct can be implanted. Various activator materials can be configured to activate the at least one medicant retained by the adjunct, the activation causing any one or more of a variety of actions. For example, the at least one medicant can be activated so as to yield at least one of a signal and/or an effect on the adjunct.

Abstract: Adjunct material to promote tissue growth is provided. In general, an implantable adjunct can be configured to be applied to tissue by a surgical stapler in conjunction with staples. The adjunct can have one or more medicants releasably retained therein that are effective to provide a desired effect on tissue in-growth in a predetermined manner. One or more characteristics associated with the adjunct can be altered between various implementations to promote organized tissue remodeling in a desired manner during wound healing, such as by encouraging tissue growth to be in a certain direction and/or by discouraging tissue growth in a certain area and/or on a certain structure.

Abstract: A surgical staple driver array configured for operable use with a surgical staple cartridge. A distal staple driver is slidably supportable in the surgical staple cartridge and is configured to operably support a distal surgical staple thereon that is oriented in a distal direction. At least one intermediate staple driver is configured to be slidably supported in the surgical staple cartridge adjacent the distal staple driver. Each intermediate staple driver is configured to operably support a first surgical staple that is oriented in a first direction, a second surgical staple that is oriented in a second direction and a third surgical staple that is oriented in a third direction. A proximal staple driver is slidably supported adjacent a proximal most one of the intermediate staple drivers. The proximal staple driver is configured to operably support a proximal surgical staple thereon.

Abstract: A surgical staple driver array. The array comprises a distal staple driver configured to operably support at least two distal surgical staples thereon that are each oriented in a distal direction. At least one first intermediate staple driver is configured to operably support at least two first surgical staples oriented in a first direction and at least two second surgical staples oriented in a second direction that differs from the first direction. At least one second intermediate staple driver is configured to be slidably supported adjacent at least one of the distal staple driver and a corresponding one of the first intermediate staple drivers. Each of the second intermediate staple drivers is configured to operably support five surgical staples thereon.

Abstract: A surgical staple driver. A driver body is configured to be slidably supported in a surgical staple cartridge. The driver body comprises at least two staple support members. Each staple support member is configured to operably support a corresponding staple thereon. The driver body further comprises a first camming surface and a second camming surface that is spaced from the second camming surface. The driver body further comprises at least one aperture that is configured to slidably receive therein a corresponding driver guide formed in the staple cartridge.

Abstract: A surgical staple driver configured for use with a surgical staple cartridge that operably interfaces with a surgical instrument camming member that is axially movable along a first cam axis. A driver body is slidably supportable within the surgical staple cartridge. A camming surface is provided on the driver body that is oriented for camming engagement with the camming member along the first cam axis. The driver further includes a staple supporting portion that is configured to operably support at least one surgical staple thereon relative to the camming surface such that when the camming member engages the camming surface, the camming member passes transversely under a portion of a staple crown of at least one surgical staple supported on the staple supporting portion.

Abstract: A surgical staple driver array for operable use in a surgical staple cartridge. A plurality of first staple drivers is configured to be slidably supported in the surgical staple cartridge. Each first staple driver is configured to operably support at least two first surgical staples thereon that are parallel to each other. A plurality of second staple drivers is configured to be slidably supported in the surgical staple cartridge adjacent to at least one corresponding first staple driver. Each second staple driver supports a single, second surgical staple thereon. The second surgical staple extends in a second direction that is transverse to each of the first surgical staples supported on the at least one adjacent corresponding first staple driver.

Abstract: An apparatus includes a housing, a platform, a buttress assembly, a retainer member, and a release assembly. The housing defines a gap that is configured to receive a portion of an end effector of a surgical stapler. A portion of the platform is exposed in the gap defined by the housing. The buttress assembly is positioned on the platform and is exposed in the gap defined by the housing. The retainer member is configured to selectively retain the first buttress assembly against the platform. The release assembly is in communication with the retainer member. The release assembly is configured to store energy. The release assembly is further configured to release the stored energy to thereby cause the at least one retainer to release the first buttress assembly from the platform in response to a clamping action of an end effector positioned in the gap defined by the housing.

Abstract: An apparatus includes a housing, a platform, and a buttress assembly. The housing defines a gap configured to receive a portion of an end effector of a surgical stapler. A portion of the platform is exposed in the gap defined by the housing. The buttress assembly is positioned on the platform. The buttress assembly is exposed in the gap defined by the housing. The platform is configured to apply at least two different amounts of pressure against the first buttress assembly in response to a clamping action of an end effector positioned in the gap defined by the housing.

Abstract: An apparatus includes a housing, a platform, a buttress assembly, at least one retainer member, and an indicator. A portion of the platform is exposed in a gap defined by the housing. The buttress assembly is exposed in the gap defined by the housing. The retainer member is configured to selectively retain the buttress assembly against the platform. The retainer member is further configured to release the buttress assembly from the platform in response to a clamping action of an end effector positioned in the gap defined by the housing. The indicator is configured to provide indication of a state of one or both of the buttress assembly or the at least one retainer member. The indicator is further configured to change state in response to a change of state of one or both of the buttress assembly or the at least one retainer member.

Abstract: A medical shaft-type instrument includes an instrument head for applying clamps, the instrument head connectable via an instrument shaft to an instrument handle for actuating the instrument head. The instrument also includes a clip magazine having a housing, in which magazine a plurality of clamps are bunkered at a predetermined storage position spacing to each other according to the storage principle. All of the clamps can be moved forward by one storage position by a reciprocating transport and entraining rail within the scope of a single delivery stroke. The transport and entraining rail has one clamp entraining element per clamp. The relative distance of the individual clamp entraining elements differs from the respective storage position distances of the clamps in such a way that the entrainment of the bunkered clamps is carried out within the scope of one single delivery stroke in a clocked way.

Abstract: A surgical string applicator and method of use for anastomosis surgery are provided. The surgical string applicator includes an elongate shaft, a string applying assembly including a pair of opposing jaws connected to a distal end of the shaft, one or more jaws including one or more grooves along an inner surface of the jaw, each of the grooves configured to receive therein at least a portion of a surgical string, such as a zip-tie, and a string fastening mechanism adapted to engage and fasten the surgical string; and a handle portion connected to the proximal end of the shaft; the handle portion including control mechanisms adapted to open and close at least one of the jaws and to actuate the string fastening mechanism. Further provided is an intra-lumenal position guide to be used together with the surgical string applicator.

Abstract: An esophageal device is used to recognize, diagnose, characterize, or relieve an impact of an abnormal or defective UES anatomy, physiology, or functionality. In one implementation, the esophageal device measures a UES response to esophageal fluid infusion to detect or characterize an abnormality or defective UES anatomy, physiology, or functionality. An Upper Esophageal Sphincter compression device is used to increase intra-luminal pressure within the Upper Esophageal Sphincter of a patient in order relieve an impact of an abnormal or defective UES anatomy, physiology, or functionality.

Abstract: A computer assisted surgical system for guiding bone cutting operations of an arthroplasty surgery is provided. The computer assisted surgical system includes a cutting guide having a guiding surface for mounting to a bone and a computer. The computer is in communication with the cutting guide and configured to generate a bone model of the first bone without the use of pre-operative bone images, determine a position of an implant model having a bone interface surface on the bone model, determine a position of the cutting guide on the first bone based on the determined position of the implant model on the bone model, and position the guiding surface of the cutting guide to one of a plurality of predetermined cut configurations relative to the bone interface surface.

Abstract: In one embodiment, a cutting guide is disclosed for use in a surgical procedure to removed damaged tissue from a patient and form a recipient site configured and dimensioned to receive a donor graft. The cutting guide includes a first arm that abuts a section of the damaged tissue to be removed, and a second arm including a hole and a slot that receives a cutting implement, the first arm and the slot defining a distance therebetween corresponding to a desired dimension of the recipient site. In another embodiment, a cutting guide is disclosed for use in forming a donor graft from donor tissue. The cutting guide includes a body that receives the donor tissue, and a shaping member that is rotatably secured to the body. The shaping member includes at least one vane that shapes the donor tissue so as to form the donor graft.

Abstract: Various patient-specific tibial guide housings, patient-specific tibial guide boxes, and methods of resecting the tibial plateau are disclosed herein.

Abstract: Tibial resection systems and methods for use in a uni- or bi-cruciate retaining knee replacement procedure are disclosed. A tibial resection system can include a tibial block, an alignment guide, and a tibial implant template. The tibial block can be coupled to an anterior side of a tibia and longitudinally extend from a proximal end portion to a distal end portion. The alignment guide can be coupled to the proximal end portion of the tibial block and can include one or more drill guides and a drill guide adjustment mechanism. The tibial implant template can be engaged with the drill guide adjustment mechanism, such that rotational movement of the tibial implant template can adjust an axial direction of the one or more drill guides. An outer profile of the tibial implant template can be selected to substantially match an outer profile of a tibial prosthesis to be implanted.

Abstract: A surgical bur is disclosed having cutting and trailing edges and associated flutes and lands. Each flute includes a cutting edge. Each of the trailing edges relatives in a selected dimension to a preceding cutting edge.