Abstract: An optical fiber coupling system may include a first coupler half fixed to a first fiber optic element. The first coupler half may include a first magnetically energetic material. The first magnetically energetic material may include a first aperture extending through the first magnetically energetic material. The first fiber optic element may extend within the first aperture. The optical fiber coupling system may include a second coupler half fixed to a second fiber optic element. The second coupler half may include a second magnetically energetic material. The second magnetically energetic material may include a second aperture extending through the second magnetically energetic material. The second fiber optic element may extend within the second aperture. When the first magnetically energetic material is proximate the second magnetically energetic material, the first fiber optic element may be longitudinally aligned with the second fiber optic element.

Abstract: A method may comprise creating a first passage across a wall with a sharpened member at a first angle relative to a lumen; advancing an anchor assembly through the first passage such that a distal portion of the anchor assembly is placed within the blood vessel; applying a force to the anchor assembly to position an adjacent portion of the blood vessel wall into a desired contact configuration relative to the anchor assembly; and while maintaining the desired contact configuration, advancing a needle through a portion of the anchor assembly and through a portion of the wall of the blood vessel to form an expandable tract between overlapping tissue portions of the vessel wall, wherein a portion of the anchor assembly comprises a saddle-shaped needle receiving structure configured to receive and support the needle after it has been advanced across the portion of the wall to create the expandable tract.

Abstract: A method for sealing a tissue opening includes inserting a trocar tube including a folded sealing device disposed within the trocar, and guiding the trocar tube through an opening in a myocardium into a patient's ventricle, the sealing device can include an elongated elastic member having a distal and a proximal end, a proximal umbrella shaped braiding extending radially from the elongated elastic member, the proximal braiding being positioned at the proximal end of the elastic member, wherein the proximal braiding includes a proximal disc disposed therein having a proximal disc thread disposed therethrough such that a user can pull the proximal braiding, and a distal umbrella shaped braiding extending radially from the elongated elastic member and being positioned at the distal end of the elastic member opposite to the proximal braiding.

Abstract: A medical-device force transmission mechanism transmitting a force input at the proximal end of an elongated insertion portion inserted into a body and acting along the longitudinal direction of the insertion portion, to a rotation unit supported at the distal end of the insertion portion in a rotatable manner about the longitudinal axis of the insertion portion, the medical-device force transmission mechanism including: a first force transmitting part passing through the insertion portion and transmitting the force to the distal end of the insertion portion; a force converting part disposed at the distal end of the insertion portion and converting the force transmitted by the first force transmitting part into a rotational force; and a second force transmitting part transmitting the rotational force converted by the force converting part to the rotation unit at a different rotational speed.

Abstract: Embodiments of the invention may be directed to apparatuses for securing and sealing tissue and related methods of use.

Abstract: Devices and methods for placing an adjunct at a tissue treatment site prior to delivering staples through the tissue and adjunct are provided. In one embodiment, a flowable adjunct precursor can be deposited on the surface of the tissue at the tissue treatment site. The flowable adjunct precursor can be configured to solidify after deposition to form an adjunct. In another embodiment, an adjunct delivery device can include a non-stapling end effector configured to deliver an adjunct to a tissue treatment site. In either case, staples can be delivered through the adjunct and tissue after placement of the adjunct at the tissue treatment site.

Abstract: The device can include a first member connected to a second member via junctions. The members can be statically or pivotally connected at the junctions via arms extending from cross-beams of the members. The junctions can be configured to provide a biasing force. Methods of using the device may include collapsing the device and inserting it through an incision, allowing the biasing force to cause continuous traction and counter-traction adjacent to a leading dissection edge so that retraction of the skin from the tissue can be facilitated during a surgical procedure.

Abstract: Access devices including access ports and retractors, which enhance the working area and access to a surgical site. The access port includes a tubular body with at least one sidewall defining an interior path along the length of the tubular body. The sidewall includes a rigid portion and a flexible portion. The flexible portion is able to stretch or deform, for example, to accommodate an angled trajectory of a surgical implement. A surgical access device for retracting tissue includes a plurality of retractor blades. The outer surface of the retractor blades form a substantially circular cross-sectional configuration with a plurality of spiral ridges projecting therefrom such that advancement of the retractor into the surgical site may be improved.

Abstract: Surgical instrument subcomponent integration by additive manufacturing may include identifying at least two subcomponents of a multi-component assembly wherein a first subcomponent of the at least two subcomponents has a first functionality and wherein the first subcomponent of the at least two subcomponents is manufactured from a first material having a first set of material properties. Surgical instrument subcomponent integration by additive manufacturing may include modifying one or more properties of the first subcomponent of the at least two subcomponents to reproduce the first functionality when the first subcomponent is manufactured from a second material having a second set of material properties.

Abstract: A suture anchor and methods of use thereof are disclosed. The suture anchor comprises an anchor body having a slot formed in the body and a passage extending through the body in a first direction. The passage is sized to permit a suture to traverse the body through the passage. The suture anchor also has a shaft with a sharp portion, and the slot and the passage intersect within the anchor body. The shaft is movable relative to the anchor body within the slot from a first position in which the sharp portion and the passage do not intersect, to a second position in which the sharp portion and the passage intersect. The shaft can penetrate a suture or multiple suture strands to fix the suture or suture strands relative to the suture anchor.

Abstract: The present disclosure relates to a suture anchor. The suture anchor includes a body having a proximal end and a distal end, the body including threads along at least a partial length of the body and at least one through hole, the threads including a profile such that the threads located near the distal end of the body include a first shape and the threads located near the proximal end of the body include a second shape different from the first shape. Delivery devices and anchor dilators are also disclosed.

Abstract: A flexible anchor for coupling a suture to a bone is provided. The anchor is composed of non-woven electrospun fibers and has an elongate tubular body that extends from a first end to a second end. The anchor is configured to receive a suture that enters the anchor through a first aperture and exits the anchor through a second aperture. When free ends of the suture are pulled, the anchor transitions from a first configuration to a second anchoring configuration.

Abstract: A method for securing soft tissue to bone which does not require the surgeon to tie suture knots to secure the tissue to the bone. Suture is passed through the graft at desired points. A cannulated plug or screw is pre-loaded onto the distal end of a driver provided with an eyelet implant at its distal end. Suture attached to the graft is passed through the eyelet of the implant located at the distal end of the driver. The distal end of the driver together with the eyelet implant is inserted into the bone. Tension is applied to the suture to position the graft at the desired location relative to the bone. The screw or plug is advanced into the pilot hole by turning the interference screw or tapping the plug until the cannulated screw or plug securely engages and locks in the eyelet implant, so that the cannulated plug or screw with the engaged eyelet implant is flush with the bone.

Abstract: A method for securing soft tissue to bone which does not require the surgeon to tie suture knots to secure the tissue to the bone. Suture is passed through the graft at desired points. A cannulated plug or screw is pre-loaded onto the distal end of a driver provided with an eyelet implant at its distal end. Suture attached to the graft is passed through the eyelet of the implant located at the distal end of the driver. The distal end of the driver together with the eyelet implant is inserted into the bone. Tension is applied to the suture to position the graft at the desired location relative to the bone. The screw or plug is advanced into the pilot hole by turning the interference screw or tapping the plug until the cannulated screw or plug securely engages and locks in the eyelet implant, so that the cannulated plug or screw with the engaged eyelet implant is flush with the bone.

Abstract: A device for suture thread cutting, containing: a handle; a stationary external element having a channel at the distal end, and a proximal end connected to said handle, said channel is fitted and shaped for holding a suture thread; a movable cutter having a cutting edge, partially inserted into said handle, said cutting edge is configured to move between a first position and a second position in said channel; wherein in said first position the suture thread is retained within the channel and in said second position the suture thread is cut.

Abstract: A surgical suturing instrument includes a handle assembly, a shaft extending distally from the handle assembly, and an end effector. The end effector includes a body portion coupled to the shaft, a first jaw member pivotably coupled to the body portion, and a second jaw member pivotably coupled to the body portion. The first jaw member is rotatable about a longitudinal axis defined by the body portion and defines a hole configured for detachable receipt of a curved needle. The second jaw member defines a hole configured for detachable receipt of a curved needle such that the first and second jaw members transfer a curved needle therebetween upon rotation of the first jaw member about the longitudinal axis of the body portion toward the second jaw member.

Abstract: Disclosed are devices and methods for delivering several sutures accurately and simultaneously around the perimeter of an annular prosthetic device (prosthetic heart valve, annuloplasty ring, etc.) to secure the prosthetic device within a native heart valve region. Devices can comprise a proximal handle portion including an actuator and a distal suturing portion including several curved and straight needles arrayed around the shaft axis. The straight needles and the curved needles are configured to simultaneously guide a plurality of sutures through the native tissue and through the annular prosthetic device. The actuator can cause the straight needles to move axially relative to the curved needles and can also cause the curved needles to rotate, such that the motions are coordinated to simultaneously place all the sutures.

Abstract: A surgical instrument set includes capabilities to obtain access and close the fascial/peritoneal layer at the trocar wound site in a quick, consistent and reproducible manner at the end of a procedure. To facilitate closure of the wound, the system includes a scope guide, an obturator/adaptor, a suture passing needle used in combination with a closure guide apparatus which has suture capture features disposed at or near the distal tip.

Abstract: A suture device may include a suture translation assembly configured to be axially translatable within a lumen of a delivery system and a distal assembly configured to be securable to the distal end of the delivery system. The suture translation assembly and the distal assembly may cooperate to enable a user to pass a needle back and forth between the two in order to endoscopically suture a defect.

Abstract: The invention relates to tacking devices for use in minimally invasive surgery that have a quantity indicator on a distal end that can be seen through a scope and that show a number of fasteners remaining in the device. A surgeon can watch the delivery of fasteners while simultaneously seeing f a number of fasteners remaining. This allows a hernia mesh to be properly fixed into place without going astray during the delicate initial placement procedure and also for even spacing of the fasteners on the mesh. The patient's post-operative recovery progresses well, and excessive pain is avoided. Methods of the invention include viewing the surgical site via the scope while also viewing the indicator via the scope.

Abstract: The present invention provides novel medical devices for use in surgical procedures and methods for manufacturing novel medical devices. In some embodiments, the novel medical devices can include surgical needles that are capable of being repeatedly passed through tissue using minimal force. More particularly, the surgical needles can be manufactured with one or more coatings that provide the surgical needles with both durability and lubricity for ease of repeated and successive passes through tissue. Novel methods for manufacturing the surgical needles and for providing and applying coatings to the surgical needles are also provided.

Abstract: A method of implanting a penile prosthesis includes providing a tool including a needle having a locking groove formed in a shaft of the needle, where the locking groove has a ridge or a notch. The method includes accessing a penile implant having a length of suture coupled to a distal end of the penile implant, securing the length of suture into the locking groove of the needle; inserting the tool and the needle into a corpora cavernosum of a penis; passing the needle and the length of suture through a glans of the penis; disengaging the length of suture from the locking groove of the needle; and pulling the penile implant into the corpora cavernosum of the penis with the length of suture.

Abstract: A hemostatic clip assembly for mounting on a delivery device comprises a capsule and a clip slidably mounted within the capsule so that, when the clip is drawn proximally into the capsule, arms of the clip are drawn together to a closed position, an abutting surface of at least one of the arms contacting a corresponding surface of the capsule when the clip is drawn to a predetermined position within the capsule to provide a first user feedback indicating closure of the clip in combination with a tension member connected to the clip arms and biasing the clip arms toward an open, tissue receiving configuration and a yoke slidably received within the capsule and releasably coupled to the tension member, the yoke including a ball cavity for receiving a ball connector of a control element of the delivery device to maintain the clip assembly coupled to the delivery device, wherein the control element is frangible to detach the yoke from the delivery device and to provide a second user feedback and, wherein release

Abstract: A surgical instrument includes a body, a shaft, and an end effector that is operable to compress, staple, and cut tissue. The end effector includes an anvil and a cartridge. The anvil has a curved tip. The curved tip is elastically deformable from a biased curved position when the tip is subject to a force, such as the force exerted on the anvil when tissue is clamped between the anvil and cartridge. The curved and deformable features of anvil provide for an end effector with improved visualization and maneuverability, in particular during procedures involving marching.

Abstract: A surgical instrument includes a body, a shaft, and an end effector that is operable to compress, staple, and cut tissue. The end effector includes and anvil and a cartridge. The anvil has a body and a modular releasable curved tip that connects with the body. The curved tip is elastically deformable in response to force exerted on the curved tip when tissue is clamped between the anvil and cartridge. The curved and deformable features of anvil provide for an end effector with improved visualization and maneuverability, in particular during procedures involving marching. The modular nature of the curved anvil tip provides for an end effector that allows anvil tip replacement due to wear or interchangeability based on a user preference or procedure.

Abstract: A surgical instrument includes a body portion, a shaft, and an end effector that is operable to compress, staple, and cut tissue. The end effector includes and anvil and a staple cartridge. The anvil has a body and a modular releasable curved tip that connects with the body. The curved tip may be elastically deformable. The curved anvil tip and the tip of the cartridge include cooperating features that assist in gripping tissue during clamping. A separate cartridge may be provided that retains a replacement anvil tip and a replacement staple cartridge, where the replacement anvil tip and staple cartridge include the cooperating features. The separate cartridge may also include anvil tip and staple cartridge removal features to assist in removal of previously installed anvil tips and staple cartridges.

Abstract: An adjunct can be releasably retained on an end effector of a surgical tool, such as a surgical stapler, using a plurality of retaining elements. The retaining elements can be configured to retain the adjunct to the end effector with a mechanical force until a force is applied to the adjunct that overcomes the mechanical force, thereby allowing release of the adjunct from the end effector and into a patient's body.

Abstract: Various embodiments of a surgical end effector are provided. The end effector can include upper and lower jaws, and an anvil assembly configured to be releasably coupled to the upper and/or lower jaws. The anvil assembly can include an anvil plate that mates and aligns with the jaw, and staple pockets that align with staple cavities formed in the cartridge for formed staples fired from the cartridge. An adjunct material can be releasably secured to either the cartridge or anvil assembly, such as with one or more sutures.

Abstract: Various adjunct releasing mechanisms are provided herein that can be incorporated into surgical devices, such as an end effector of a surgical stapler. For example, an adjunct releasing mechanism can act to release an adjunct attached to an end effector of a surgical stapler upon deployment of staples retained within the end effector. The adjunct can be retained on the end effector through a variety of means, such as through use of adhesive or by having a portion of the adjunct partially received within cavities formed on a tissue-facing surface of the end effector. The releasing mechanisms can extend into the cavities formed on the tissue-facing surface of the end effector to cause the adjunct to detach from the end effector upon deployment of staples.

Abstract: Adjuncts for use with surgical instruments, such as staplers, are provided. In one embodiment, an adjunct can include a plurality of suction members configured to attach the adjunct to an end effector jaw of a surgical stapler using a suction force. The suction members can be configured to generate the suction force when compressed. The suction members can be further configured to release the suction force to decouple the adjunct from the end effector jaw, permitting deployment of the adjunct at a treatment site. In certain embodiments, the suction members can include a plurality of air pockets formed in the bulk of the adjunct or within protrusions extending outward from a surface of the adjunct. The air pockets can be in communication with corresponding openings allowing air to escape the air pockets when compressed.

Abstract: An adjunct material for use with an end effector in a surgical instrument is provided that has at least one projection configured to mate with a corresponding recess formed in at least one jaw, such as a cartridge or anvil, of the end effector. The at least one projection can be one or more discrete projections or longitudinal projection(s) extending between distal and proximal ends of the adjunct material. An applicator member can be used to apply force to the adjunct material to thus cause the adjunct material to mate with the jaw of the end effector. The applicator member can be configured told the adjunct material and can be clamped between the jaws of the end effector to release the adjunct material onto the jaw. Also, an applicator member can be used to push portions of an adjunct material into corresponding recesses in a jaw.

Abstract: Various buttress loaders are provided for cleaning and affixing one or more buttresses to an end effector of a surgical stapler. In an exemplary embodiment, a buttress loader can be configured to clean at least one tissue-engaging surface of an end effector on a surgical stapler, and the buttress loader can be configured to attach a buttress to the at least one tissue-engaging surface of the end effector. For example, a buttress loader can have two slots configured to receive the end effector therein. One slot can be configured to clean the end effector, and the other slot can be configured to attach the buttress to the end effector.

Abstract: A loading unit for engagement with a surgical instrument, and including double pushers and double retention cavities. At least one double pusher includes a first body portion having a first upper surface configured to engage a portion of a first fastener, a second body portion having a second upper surface configured to engage a portion of a second fastener, and a bridge interconnecting the first body portion and the second body portion. Each of the first upper surface and the second upper surface defining an acute angle with respect to a longitudinal axis. At least one double retention cavity includes a first retention guiding surface configured to engage a proximal pusher guiding surface of the first body portion of the double pusher retained therein, and a second retention guiding surface configured to engage a distal pusher guiding surface of the first body portion of the double pusher retained therein.

Abstract: A surgical instrument includes a body portion, a shaft, and an end effector that is operable to compress, staple, and cut tissue. The end effector includes an anvil and a staple cartridge. The anvil has a rigid bent tip configured to contact an angled surface of a nose portion of the staple cartridge. The staple cartridge includes gripping features along a staple deck that assist in gripping tissue during clamping. The staple deck of the cartridge may include multiple levels. The anvil further includes a slot with lateral portions having curved ends for receiving portions of a firing beam to guide the firing beam during a cutting and stapling action.

Abstract: Systems and methods for releasably coupling an adjunct material to an end effector for a surgical instrument are provided. The adjunct can be configured to be releasably retained on a jaw, such as a cartridge or anvil, using a contractible attachment feature configured to be transitioned from an original, non-contracted configuration to a contracted configuration under application of heat. The attachment feature, such as one or more strands of a shrinkable polymer, can be engaged with the adjunct, and contraction of the attachment feature is effective to couple the adjunct with retaining members formed on the jaw. Another type of an adjunct has at least one portion configured to be reversibly stretched using application of a force such that, when the force is removed, the portion transitions from a stretched configuration to a contracted configuration and thereby causes the adjunct to be engaged with retaining members formed on the jaw.

Abstract: An end effector for a surgical instrument is provided that has a first jaw, such as a cartridge body, having on a tissue-contacting surface thereof a plurality of staple cavities configured to seat staples therein, and a second jaw, such as an anvil, with a plurality of staple forming cavities formed on a tissue-contacting surface thereof. The first jaw has a generally rectangular nominal perimeter defining a regular perimeter around outer rows of the plurality of staple cavities. At least one of the first and second jaws has extension elements extending beyond the nominal perimeter of that jaw such that each of the extension elements has at least one attachment feature formed thereon. An adjunct material having a shape complementary to a shape of the jaw is configured to releasably mate with the attachment features formed on the jaw, via corresponding adjunct's mating features.

Abstract: Various embodiments of a frame for attaching an adjunct to an end effector of a surgical device are provided. In one embodiment, the end effector can include upper and lower jaws, and the frame can include features for releasably engaging one or the jaws. The frame can also include retaining features for coupling an adjunct to a tissue-facing surface of the frame, thereby releasably coupling the adjunct material to the jaw of the end effector. In some implementations, the frame can include a plurality of retaining features that are configured to engage the adjunct material to create a tension in the adjunct material, which can further assist with securing the frame to the jaw. In other embodiments, a removable applicator member is provided for retaining at least one adjunct material and for aligning and coupling the adjunct material to a frame.

Abstract: Systems and methods for separating an adjunct from a jaw of an end effector of a surgical stapling device are provided. The end effector, including first and second jaws configured to clamp tissue therebetween, include an adjunct material releasably retained on at least one of the jaws. The end effector also includes a firing bar configured to move between an unfired position at a proximal end of the end effector and a fired position at a distal end of the end effector. An adjunct removal assembly that can reside in the jaw is configured to couple to and move with the firing bar to separate the adjunct material from the surgical stapling device as the firing bar having the adjunct removal assembly coupled thereto is returned from the fired position to the unfired position.

Abstract: An adjunct loading system is provided that can include at least one adjunct material configured to be transferred from an adjunct loading member to first and second jaws of an end effector. The loading system can also include a supporting member configured to releasably retain the adjunct material. The loading system can further include an adhesive depot having an adhesive configured to transition from a non-flowable state to a flowable state upon application of heat when the adjunct material is released from the adjunct loading member and transferred to the jaw to retain the adjunct material on the jaw. The adjunct material is released from the adjunct loading member when load is applied thereto. The adhesive depot can be in the form of an adhesive feature formed on a polymer attachment layer or in the form of reservoirs in the supporting member.

Abstract: An end effector for a surgical instrument is provided that has different types of features for releasably retaining at least one adjunct material. The end effector has a first jaw having a cartridge and a second jaw having an anvil. The attachment feature includes a retaining filament having, an intermediate portion, and first and second ends disposed on opposed sides of the intermediate portion and having end features configured to mate with at least one jaw of the first and second jaws. The attachment feature is arranged to retain the adjunct material such that at least a part of the intermediate portion is disposed over the adjunct material and such that the first and second ends are spaced apart.

Abstract: Methods for applying one or more adjuncts to tissue are provided. In one embodiment, the method can include positioning an adjunct, e.g., using an adhesive, on one of first and second jaws of an end effector of a surgical stapler. In one embodiment, an attachment mechanism on the adjunct can prevent stretching of at least a portion of the adjunct. In other aspects, the adjunct can be maintained on the at least one jaw in a first state in which the adjunct is at least partially stretched over the at least one jaw, and actuation of the surgical stapler can cause the adjunct to transition from the first state to a second state such that the adjunct in the second state at least partially separates from the at least one jaw.

Abstract: A surgical stapler includes a body portion and a tool assembly. The body portion includes a large diameter portion and a small diameter portion extending distally from the large diameter portion. The large diameter portion supports larger internal components of the device including a lockout assembly adapted to prevent refiring of the stapler to allow the diameter of the small diameter portion of the device to be minimized to facilitate passage of the small diameter portion of the stapler and the tool assembly through an 8 mm trocar.

Abstract: The invention relates to a device for separating tissue parts, wherein the device has two parallel clamping plates, wherein at least one part of one clamping plate can be pivoted away from the other clamping plate in order to receive a tissue part and can be pivoted back in order to fix the tissue part, wherein the device has at least two interconnected blades arranged at an angle to each other or has one curved or kinked blade, wherein the blade or blades is/are insertable and displaceable in guide rails of the clamping plates, and wherein a cutting edge of the blade or blades extends between the clamping plates.

Abstract: An adjunct material for use with an end effector for a surgical instrument is provided that has different types of features for mating with the end effector. The adjunct is configured to be releasably retained on a jaw, such as a cartridge or anvil, using a plurality of female features formed thereon. Each female feature is configured to encompass a corresponding at least one of male features formed on the jaw in a clearance fit such that the adjunct is able to move with respect to the jaw at least in a first plane parallel to the tissue-facing surface. The male and female features mate such that the adjunct is not retained in a second plane that is perpendicular to the first plane. The adjunct also includes at least one attachment feature configured to releasably retain the adjunct on the jaw.

Abstract: A hybrid attachment mechanism is provided to attach an adjunct to an end effector jaw of a surgical instrument, such as a surgical stapler. The hybrid attachment mechanism can include at least two attachment mechanisms, each configured to inhibit at least one manner of detachment from the end effector jaw. A first attachment mechanism can be configured to inhibit vertical removal of the adjunct. A second attachment mechanism can be configured to inhibit sliding of the adjunct with respect to the jaw. A third attachment mechanism can be configured to inhibit curling of the adjunct upon itself. Each of the attachment mechanisms can operate in concert with the others, allowing the hybrid attachment mechanism to simultaneously inhibit multiple forms of adjunct detachment. The hybrid attachment mechanism can be further configured to decouple from the end effector jaw, permitting deployment of the adjunct at a treatment site.

Abstract: A surgical anchor device for being anchored on the mucous membrane of the inner wall of the intestine, the device having a temporary anchor element presenting anchoring that can be modified in a controlled manner and having a first substantially cylindrical multiply-perforated wall presenting properties of radial elasticity whereby the first wall presents an outer diameter that can be varied in controlled manner, wherein a portion of the inner surface of the first wall is lined with an independent leakproof inner sheath having only its longitudinal ends fastened to the anchor element to define a suction chamber between the inner sheath and the first wall, the temporary anchor element being coupled to a flexible or semi-rigid tube extending outside the anchor element, an open end of the injection-suction tube opening out into the suction chamber enabling air to be injected into or sucked out from the suction chamber.

Abstract: A surgical clip applier includes a housing, a channel assembly, jaw assembly, and a first insert. The channel assembly extends distally from the housing and the jaw assembly is disposed at the distal end of the channel assembly. The jaw assembly includes a first and second jaws constructed of a first material. Each of the jaws defines a recess extending longitudinally along opposing inner surfaces thereof. The first insert is disposed in the recess of at least one of the first or second jaws. The first insert is constructed of a second material different from the first material.

Abstract: An endoscopic surgical clip applier includes an endoscopic assembly and a handle assembly. The handle assembly includes a housing, a trigger, a drive bar, and a ratchet assembly. The ratchet assembly includes a first rack, a second rack, a pawl housing engageable with the first rack, and a second pawl engageable with the second rack. In a first position, the pawl housing is in registration with the first rack to prohibit reversal of a direction of movement of the trigger until the pawl housing is disposed beyond a proximal end or a distal end of the first rack. In a second position, the pawl housing is out of registration with the first rack to permit reversal of the movement of the trigger after the second pawl is disposed distally beyond a distal end of the second rack or proximally beyond a proximal end of the second rack.

Abstract: Luminal grafts and methods of making and using the same. An exemplary luminal graft of the present disclosure is configured as a generally tubular element configured for nerve cells to grow therethrough and comprises at least one sheet of biological tissue having elastin fibers and collagen fibers, with the elastin fibers being a dominant component thereof; and a plurality of microchannels formed on a surface of the at least one sheet of biological tissue, each of the microchannels extending longitudinally between a first end and a second end of the at least one sheet of biological tissue and configured to provide intraluminal structural guidance to nerve cells proliferating therethrough.

Abstract: A surgical stapler 101 comprises a proximal end and a distal end, wherein the proximal end is proximate to the user in use and the distal end is distal from the user in use and an anvil 120, 220, 320, 420, 520, 620, 720, 820, 920, 1020, 1120, 1220, 1320 at the distal end for providing resistance to staples during the stapling operation of the surgical stapler. The anvil 120, 220, 320, 420, 520, 620, 720, 820, 920, 1020, 1120, 1220, 1320 is configured to be actuated between a deployed state and a collapsed state. The anvil 120, 220, 320, 420, 520, 620, 720, 820, 920, 1020, 1120, 1220, 1320 comprises a plurality of segments 130, 230, 330, 430, 530, 630, 730, 830, 930 arranged end-to-end. The anvil 120, 220, 320, 420, 520, 620, 720, 820, 920, 1020, 1120, 1220, 1320 is elongated in the collapsed state, the anvil 120, 220, 320, 420, 520, 620, 720, 820, 920, 1020, 1120, 1220, 1320 being elongated generally in a first direction D1.