Abstract: A specimen container system and methods of use are described herein for capturing, storing and accessing fluids for lab testing. A cup is removably secured to a cap assembly. The cap assembly is comprised of cover and a lid which are connected by a hinge assembly having a biasing member for maintain the lid in an open position. An aperture in the cap has two sections that in combination with the lid decreases the contamination risk compared to prior art container system.

Abstract: A biopsy device may be used to obtain and store multiple tissue samples. The device permits the tissue samples to be stored in a sequenced fashion within a generally transparent tissue storage chamber disposed at a proximal end of the biopsy device. The tissue samples can be stored on flexible tissue sample strips arranged around the circumference of a rotating vacuum manifold disposed within the chamber.

Abstract: The present invention relates to a quick release apparatus configurable to drive a driven member. The driven member comprises a primary driver which provides or carries a driven member, and that is able to drive the driven member in a first direction to an operative position. The driven member further comprises an actuable secondary driver. The primary and secondary drivers are configurable between a first mode, wherein the secondary driver is able to drive the primary driver in the first direction, and in a second mode which allows the primary driver to be moved away from the operative position independent of the position of the secondary driver under the influence of a bias.

Abstract: A method of evaluating an image indicating a potential presence of a cancer lesion at a location within a prostate of a patient by transmitting light from an optical probe toward a location, receiving fluorescence spectra by the optical probe from the location, and generating a visual display of a diagnosis classification so as to confirm or contradict the existence of the cancer lesion at the location.

Abstract: A primary sample holder for imaging, gross pathology, or histological correlations of a biological sample includes an enclosure having a first side wall, a second side wall, and a bottom wall; a plurality of slots provided at predetermined intervals along the first and second side walls; and a grid recessed within the bottom wall. The grid includes a hole bisected by a central panel and at least one axial panel that intersects the central panel along a length thereof. The biological sample received by the primary sample holder is configured to be aligned with the central panel of the grid to align the biological sample along an accepted internal orientation line (e.g., the anterior-posterior commissure line in the brain). The slots are configured to receive a cutting device to cut the biological sample into slices of uniform thickness containing a region of interest based on histological and imaging findings.

Abstract: The present invention relates to a minimally invasive surgical instrument having an articulation immobilising structure. The present invention is a s minimally invasive surgical instrument and includes a shaft, an end effector connected towards one end of the shaft, a wire for controlling the articulated movement of the end effector, and an immobilising structure adapted to immobilise the state of articulated movement of the end effector. The immobilising structure includes a resilient member covering the wire, and the resilient member holds the wire when an internal space therein contracts.

Abstract: Methods and systems for closing an opening or defect in tissue, closing a lumen or tubular structure, cinching or remodeling a cavity or repairing a valve preferably utilizing a purse string or elastic device. The preferred devices and methods are directed toward catheter-based percutaneous, transvascular techniques used to facilitate placement of the devices within lumens, such as blood vessels, or on or within the heart to perform structural defect repair, such as valvular or ventricular remodeling. In some methods, the catheter is positioned within the right ventricle, wherein the myocardial wall or left ventricle may be accessed through the septal wall to position a device configured to permit reshaping of the ventricle. The device may include a line or a plurality of anchors interconnected by a line. In one arrangement, the line is a coiled member.

Abstract: The present invention relates to a vascular closure device for sealing a puncture site in a vascular wall comprising a sheath (10) having a distal end and at least one proximal end, wherein the sheath (10) comprises a tubular body (100). The vascular closure device (1) is characterized in that at least one distal balloon member (11) is firmly arranged at the distal end of the tubular body (100) of the sheath (10) and at least one expandable anchor member (12) is firmly arranged proximal to the distal balloon member (11) on the tubular body of the sheath (10), wherein at least the distal side of the distal balloon member (11) is a pressure area for applying pressure on the outside of the vascular wall. Furthermore a method of positioning of a vascular closure device (1) is described.

Abstract: A device for sealing an aperture in a tissue includes: a foot including a distal portion configured to be disposed distal to the tissue when the device is implanted in a position to seal the aperture; and a flexible wing positionable against a distal surface of the tissue adjacent the aperture such that the flexible wing is disposed between the distal portion of the foot and the distal surface adjacent the aperture.

Abstract: One exemplary aspect comprises an illuminated surgical retractor that comprises a blade portion having a top surface and a bottom surface, and having a proximal end and a distal end, the blade portion comprising an operative portion at the distal end, a saddle portion at the proximal end, and a barrel portion connecting the operative portion and the saddle portion; a handle portion connected to the saddle portion; and an illumination assembly. Other aspects will be apparent from the description, drawings, and claims.

Abstract: The various inventions relate to robotic surgical devices, consoles for operating such surgical devices, operating theaters in which the various devices can be used, insertion systems for inserting and using the surgical devices, and related methods.

Abstract: Improved methods and devices for performing an endoscopic surgery including a system for performing minimally invasive procedures including a flexible catheter having a working space expanding system positioned at a distal portion, the working space expanding system movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body lumen. A tissue retractor having an inner member positioned within an outer guide member has a plurality of closed loops at a distal portion forming a petal-like structure. The loops are positioned in a collapsed position within the outer guide member and are movable to an expanded position when exposed from the outer guide member.

Abstract: A dual-blade retractor comprising: a handle having a first end and a second end, a first blade extending from the first end of the handle, a second blade extending from the second end of the handle, and an illumination assembly including one or more first light sources provided on the first blade and one or more second light sources provided on the second blade, wherein the dual-blade retractor is configured to house therein an internal power source for supplying energy to the one or more first and second light sources.

Abstract: A method of anchoring soft tissue to a suitable bone site, using a soft suture anchor, includes steps of disposing the soft suture anchor on a shaft of an inserter, and securing a proximal end of a tensioning suture limb, extending proximally from the soft suture anchor, to structure in a handle of the inserter, so that it is maintained in place at a first level of holding tension (Thold). The inserter shaft is inserted into a bone hole at a desired procedural site, so that the soft suture anchor is positioned at a location where it is to be anchored. A further step involves actuating a control mechanism in the inserter handle to move the structure proximally to apply a second level of deployment tension (Tload) to the tensioning suture limb.

Abstract: Disclosed are systems and methods for performing soft tissue repair by delivering a suture through the soft tissue and underlying bone at two or more fixation points that can be spaced apart from each other and connected by the suture on the surface of the soft tissue. The two or more fixation points and the suture connected there between can be a continuous strand of suture, which can form a stitching assembly that can provide sufficient fixation in the bone and minimize disruption to the soft tissue and bone. In an example, the suture can be delivered into the bone using one or more implants that can catch the suture to drive the suture through the tissue and into the bone. The one or more implants can include structural features to aid in securing the suture to the implant. In an example, the suture can include structural features or be formed of a material to aid in fixation of the suture in the bone.

Abstract: A knotless tissue repair assembly for attachment of tissue to bone includes an anchoring implant with a length of suture threaded therethrough. The implant is preferably a soft flexible three-dimensional structure. The implant may be actuated from a first elongate low profile shape into a second short radially expanded shape having a larger diameter than the hole through which it was placed. The suture extends through the anchor, through a tissue to be secured, and back through a designated suture-binding region or passageway within the anchor enabling the suture to be secured therein and without the need for a physician to tie a knot. Further tension applied to a suture leg approximates the tissue to the anchor until a desired tension or distance between the tissue and anchor is achieved.

Abstract: A suture anchor assembly includes a suture anchor and a suture anchor inserter. The anchor includes a flexible distal tip and a rigid proximal anchor body. The distal tip includes a transverse suture eyelet and a cavity formed in a proximal end of the tip. The anchor body includes a lumen extending between proximal and distal ends of the body. The anchor inserter includes a tubular outer shaft and an inner inserter slidably received therein. The anchor assembly is actuatable to move the anchor tip and inner shaft proximally while the outer shaft and anchor body remain in place, urging the proximal end of the anchor tip against the distal end of the anchor body. The proximal end of the tip is deformable to accommodate at least a portion of the distal end of the anchor body within the anchor tip cavity.

Abstract: A wound closure device includes a shaft, a needle, and a housing. The needle includes a first leg portion coupled to a distal end of the shaft, a curved portion, and a second leg portion including a needled end portion terminating at a needle tip. The housing includes a first channel slidingly engaged with the elongated body of the shaft and a second channel slidingly engageable with the second leg portion of the needle. The second channel terminates at an opening defined within a notched section defined in a proximal portion of the housing. The needle is movable to a covered position in which the needle tip is disposed within the second channel of the housing, an advanced position in which the needle tip is disposed distal to the housing, and a retracted position in which the needle tip is disposed within the notched section of the housing.

Abstract: A stitching assembly includes upper and lower cradles, upper and lower needles, and first and second sutures supported by the upper and lower needles, respectively. The cradles move along a curved path in relation to the carriages between advanced and retracted positions. When each cradle is moved from the retracted position towards the advanced position, a stitch loop is formed when the respective needle is retracted. This process is repeated alternating between the first and second cradles with the upper and lower needles passing through the previous stitch loop formed by the other needle before passing through the tissue.

Abstract: Disclosed herein are minimally invasive systems and methods for intravascularly accessing the heart and performing a transcatheter repair of a heart valve by inserting a suture as an artificial chordae into a heart valve leaflet. In various embodiments, such systems and methods can be employed in other heart valve repair procedures such an edge to edge repair to coapt leaflets by inserting one or more sutures that retain the leaflets in a coapted positioned or inserting a suture to repair a tear in a leaflet, for example.

Abstract: Suture passer systems for tissue suspension and tissue compression, and more particularly for tongue suspension, are described. The system can include at least a first elongate tubular body or shaft, a needle having a lateral bias carried by the elongate body, and a retrieval element operably connected to the elongate tubular body. The needle can have a substantially straight configuration when located within the elongate tubular body, and be configured to exit an opening at or near a distal end of the elongate tubular body and assume a laterally biased or curved shape to form a path through tissue. The needle is configured to carry a suture. The retrieval element can be configured to retrieve the suture carried by the needle after the needle has formed a curved or otherwise angled path through tissue. The system can also include one or more bone anchors to secure the suture loops. Methods of placing one or more suture loops into tissue, such as the base of the tongue, are also described.

Abstract: Disclosed herein are suture clip delivery devices that can be loaded with several flat, disk-shaped suture clips and can deploy the suture clips one after another onto respective sutures without reloading the device with additional suture clips. An exemplary device includes a handle portion with an actuation mechanism that is coupled to a shaft portion that holds and deploys the suture clips. The shaft portion includes a mandrel on which the suture clips are mounted and a retainer that restricts the suture clips from moving proximally when the actuation mechanism pulls the mandrel proximally, which causes a distal-most suture clip to slide off the mandrel and be deployed onto one or more suture. The mandrel and remaining suture clips can them move distally to prepare to deploy the next suture clip.

Abstract: A system and method for affixing barbs on a suture are provided. In one embodiment, the system includes a suture supply mechanism for selectively retaining a length of suture and a barb supply mechanism for operably engaging a barb supply assembly including at least one barb. At least one of the suture supply mechanism and the barb supply mechanism are configured to approximate towards the other of the barb supply mechanism and suture supply mechanism to engage the at least one barb of the barb supply assembly with the suture of the suture supply assembly. Also provided are a barb for use in forming a barbed suture and a suture including at least one barb.

Abstract: Stapling assemblies for use with a surgical stapler and methods for manufacturing the same are provided. Three dimensional adjuncts for use with a surgical stapling assembly and methods for manufacturing the same are also provided.

Abstract: A surgical circular fastener apparatus includes an elongated body defining a longitudinal axis and having proximal and distal ends, a fastener cartridge disposed adjacent the distal end of the body, an anvil retainer releasably mounted relative to the fastener cartridge; and a manually operably release configured to move between a first position corresponding to a secured condition of the anvil retainer relative to the fastener cartridge and a second position corresponding to a release condition of the anvil retainer relative to the fastener cartridge.

Abstract: A surgical instrument is provided. The surgical instrument includes: a handle assembly; a jaw assembly comprising a staple cartridge containing a plurality of staples and an anvil to form the plurality of staples upon firing; a drive assembly at least partially located within the handle and connected to the jaw assembly and the lockout mechanism; a motor disposed within the handle assembly and operatively coupled to the drive assembly; and a controller operatively coupled to the motor, the controller configured to control supply of electrical current to the motor and to monitor a current draw of the motor, wherein the controller is further configured to terminate the supply of electrical current to the motor in response to a rate of change of the current draw indicative of a mechanical limit of at least one of the jaw assembly, the drive assembly, or the motor.

Abstract: The present disclosure is directed to an endoscopic surgical stapler having an articulation locking mechanism that functions to prevent straightening of a tool assembly of the surgical stapler when the surgical stapler is fired with the tool assembly in an articulated position. In embodiments, a mounting assembly supports a notched member on a proximal end of the tool assembly and the notched member defines a series of notches. An articulation member supported adjacent to the mounting assembly includes a locking member defining protrusions or teeth that are movable from a first unlocked position spaced from the notches of the mounting assembly to a second locked position received within the notches to lock the tool assembly in one of a plurality of articulated positions. In embodiments, the locking member is biased towards the unlocked position by a biasing member and is urged toward and retained in the locked position via engagement with a drive assembly of the surgical stapler.

Abstract: A surgical fastener apparatus includes a handle, a flexible elongate segment and an end effector having a fastener cartridge with a plurality of fasteners and an anvil, an approximator member movable relative to the longitudinal axis to cause relative movement of the fastener cartridge and the anvil between an open condition and an approximated condition, a fastener drive to deploy the fasteners from the fastener cartridge for crimping by the anvil, at least one tissue grasper at least partially extending along the end effector and movable to engage tissue and draw the tissue between the fastener cartridge and the anvil when in the open condition, and at least one manual actuator to actuate at least one of the approximator member, the fastener drive or the at least one tissue grasper.

Abstract: A dynamic clamping assembly for use with a surgical instrument including first and second jaws pivotally coupled together and movable between open and closed positions. The dynamic clamping assembly includes first jaw engagement features configured to slidably engage the first jaw and second jaw engagement features configured to slidably engage the second jaw to apply closing motions to the first and second jaws. The first jaw engagement features and/or the second jaw engagement features include a surface coating configured to increase a hardness thereof.

Abstract: A method for manipulating tissue of a patient includes a surgical instrument having a handle assembly, a shaft assembly, and an end effector. The method includes positioning a tissue within a gap between a cartridge and an anvil and against a guide pin to laterally position the tissue relative to the cartridge and the anvil. The method also includes moving a retaining pin from an open position to a closed position to capture the tissue and moving the cartridge toward the anvil in a closed configuration. Furthermore, the method includes inhibiting deflection of a distal end portion of the end effector wherein at least at least one of the guide pin or the retaining pin connects to the distal end portion. The method further includes forming a plurality of staples within the tissue and cutting the tissue with a knife.

Abstract: A surgical fastener applier including a housing containing a compartment, an elongated member extending distally from the housing, first and second jaws and a firing mechanism positioned within the housing. The firing mechanism is movable between a first position and a second position to effect firing of fasteners into the tissue clamped between the first and second jaws. A cover on the housing is openable to access the compartment. A power pack is removably loadable into the compartment, the power pack having a motor and an engagement member removably engageable with the firing mechanism within the compartment when the power pack is loaded into the compartment to effect movement of the firing mechanism from the first position to the second firing position.

Abstract: Embodiments include a method of stapling including providing an end effector having a first jaw with an anvil, a second jaw with a cartridge retaining a plurality of staples, a first coupling that couples a first end of the first jaw to a first end of the second jaw, a second coupling including a rigid link that movably couples a second end of the first jaw to a second end of the second jaw, and a knife; inserting the end effector through a trocar; positioning the cartridge face; positioning the anvil face; operating the end effector to move the rigid link such that the first jaw is urged towards the second jaw; operating the end effector to urge the plurality of staples from the cartridge; and actuating the knife.

Abstract: Surgical methods involving cutting and sealing tissue include affixing a first adjunct material to tissue at a treatment site, such as by stapling the adjunct to tissue. A second adjunct material is applied to at least a portion of the first adjunct material such that the second adjunct material interacts with the first adjunct material to form a seal in an area of the tissue covered by at least one of the first and the second adjunct material. The resulting tissue sealing structure, which includes a combination of the two adjuncts, is believed to be superior to the sealing properties of either adjunct alone.

Abstract: A surgical staple includes a backspan and a pair of deformable legs extending from the backspan and terminating in a penetrating end. The backspan and deformable legs are formed from a wire having a curvilinear cross-section defining a major axis and a minor axis with a portion of the wire above the major axis defining a first curved surface and a portion of the wire below the major axis defining a second curved surface, and a portion of the wire to the left of the minor axis defining a third curved surface and a portion to the right of the minor axis defining a fourth curved surface being different than the first, second, and third curved surfaces. One or more of the curved surfaces is different than the remaining curved surfaces.

Abstract: A surgical stapling assembly comprising a staple cartridge, a sled movable during a firing stroke between a proximal unfired position and a distal fired position, and a plurality of staples removably stored within the staple cartridge is disclosed. The staples are configured to be ejected from the staple cartridge by the sled. Each staple comprises a proximal staple leg comprising a proximal piercing tip, a distal staple leg comprising a distal piercing tip, and an integral staple driver base portion. The proximal staple leg and the distal staple leg extend from the integral staple driver base portion. The integral staple driver base portion comprises a body portion, a ramp surface configured to be contacted by the sled, and a starter guide feature configured to assist sled driving contact between the sled and the ramp surface.

Abstract: Described here are devices, systems and methods for closing the left atrial appendage. Some of the methods described here utilize one or more guide members having alignment members to aid in positioning of a closure device. In general, these methods include advancing a first guide having a first alignment member into the left atrial appendage, advancing a second guide, having a second alignment member, into the pericardial space, aligning the first and second alignment members, advancing a left atrial appendage closure device into the pericardial space and adjacent to the left atrial appendage, and closing the left atrial appendage with the closure device. In these variations, the closure device typically has an elongate body having a proximal end and a distal end, and a closure element at least partially housed within the elongate body. The closure element comprises a loop defining a continuous aperture therethrough.

Abstract: A balloon assist device is disclosed which includes an inner body, a balloon joined to the inner body, and a positioner. The inner body includes an open-ended closed tube extending along an axis from a proximal end to a distal end. The balloon assist device also includes an inflation tube in sealed communication with the balloon. The positioner allows a clinician to slide the balloon assist device along the catheter. The positioner may also include the inflation tube.

Abstract: A device for delivering an implant (e.g., an embolic micro-coil) to a vascular disorder of a patient includes a delivery pusher, a moveable element, and first and second elongate members. The delivery pusher defines a lumen between its proximal and distal ends. The moveable element (e.g., a floating tube or a floating coil) defines a passageway therethrough and is disposed within the lumen of the delivery pusher. The first and second elongate members (e.g., core wires) are also disposed within the lumen of the delivery pusher. A portion of each elongate member passes through the passageway of the moveable element. Movement of the first elongate member in a first direction (e.g., retraction of the first elongate member from a locked to an unlocked configuration) causes a time-delayed or lost motion movement of the second elongate member in the same (i.e., first) direction, which releases the implant from the delivery pusher.

Abstract: A non-occlusive device is provided that includes a coilable section and a docking section. The coilable section is configured to become coiled into a coil when deployed from a microcatheter within a vascular malformation. The coil is shaped so as to define a sequence of concentric loops. The coil is configured to bridge a neck of the vascular malformation so as to at least partially cover an orifice of the vascular malformation, when in use. The docking section is configured to be deployed from the microcatheter within the vascular malformation. The docking section is configured to, when in use, perform one or more functions selected from the group consisting of: anchoring the device within the vascular malformation, stabilizing the device within the vascular malformation, assisting with positioning of the device within the vascular malformation, and intertwining detachable coils delivered to the vascular malformation. Other embodiments are also described.

Abstract: A pneumatic physiotherapy apparatus with optimized compression, including a wrap and a controller. The wrap includes an outer wrap and an inner airbag set; the controller can be fixedly connected to, detachably connected to, or separately connected to the outer wrap; the inner airbag set includes the first airbag and the second airbag that are interconnected and overlapped; the controller contains an inflating motor and an integrated control board that are electrically connected. The inflating motor that is controlled by the integrated control board inflates the second airbag first and then the first airbag to achieve the overlapped compression between the second airbag and the first airbag. Therefore, the user can use the pneumatic physiotherapy apparatus with optimized compression to promote blood flow, improve blood circulation, prevent deep vein thrombosis and other diseases, and improve user experience in the treatment areas.

Abstract: A bone resection apparatus may comprise a roughly planar blade body that has a tip saw blade and that carries out cutting of bone with which the tip saw blade makes contact as a result of high-speed oscillation; and a guide plate which has a roughly planar tip guide portion, which is located at a top side of the blade body, and which is connected in such fashion as to permit sliding in a front-and-back direction relative to the blade body, the guide plate being capable of sliding between a protruding guide state in which the tip guide portion is made to protrude toward the tip to a point beyond the tip saw blade of the blade body to cover the tip saw blade and to guide a location in a thickness direction at which cutting by the tip saw blade occurs, and a retracted guide state in which the tip guide portion is retracted to a point behind the tip saw blade.

Abstract: A method of preparing a tibia to receive a tibial implant component includes performing a first set of cuts to prepare a floor interface surface on the tibia, wherein the floor interface surface includes a portion on each side of a tibial eminence extending above the floor interface surface on the tibia. The method further includes performing a second set of cuts to prepare a tibial eminence wall interface surface, wherein the wall interface surface extends substantially perpendicular to the floor interface surface between the floor interface surface and a top surface of the tibial eminence. The method further includes performing a third set of cuts to prepare a radiused intersection between the floor interface surface and the wall interface surface. The sets of cuts are performed subject to a cutting restraint guide. At least one set of cuts may be performed using a rotary cutter.

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

Abstract: A drill tool for implant surgery including a first drill part having a first, smaller diameter for drilling a recess for an implant post and a second drill part having a second, larger diameter for drilling a recess for an implant hat is disclosed. The second drill part has one or more shape cutting edges and one or more sharp pre-cutting edges extending beyond said one or more shape cutting edges.

Abstract: A surgical instrument includes a first member defining an axis and having a scraping surface configured to scrape tissue. A second member includes a cutting surface that is rotatable relative to the first member. The second member has a maximum length defined by opposite end surfaces of the second member. The end surfaces are each disposed within the first member. A third member includes an outer surface defining at least a portion of a passageway configured for disposal of the scraped tissue. The third member is fixed with the first member. The cutting surface is rotatable relative to the third member to transfer the scraped tissue along the axis. Systems and methods are disclosed.

Abstract: A surgical device and method for performing arthrodesis are disclosed. The device includes a bone fixation plate, a jig, and a guiding unit. The plate has several fastener-accommodating apertures. The jig has a base for engaging the plate with several bolt-accommodating apertures positioned to align with the plate apertures and a cannulated guide attached to the jig's arm. The cannulated guide has a bore. The arm is oriented at an oblique angle relative to the jig's base. The guiding unit has a first end with a wire guide tube and a drill guide tube affixed to its second end. The wire guide tube and the drill guide tube have an outer diameter with a diameter less than the inner diameter of the cannulated guide of the jig so as to enter into the cannulated guide for the fusion process.

Abstract: A surgical device has a shaft including a proximal portion and a distal portion being disposable with a surgical robot guide to engage vertebral tissue. The proximal portion defines a detectable marker and is connectable with at least one surgical instrument for manipulating the vertebral tissue. Systems, surgical instruments, spinal implants, constructs and methods are disclosed.

Abstract: Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.

Abstract: Devices, systems and methods for ocular ultrasound are provided having therapeutic and/or diagnostic applications. In one aspect, an ocular probe is disclosed that is uniquely configured for use in the eye on the basis of shape and frequency. The ocular probe may be multi-functional, providing sensor, optical or other functionality in additional to ultrasound energy.

Abstract: The application relates to a medical instrument with a hollow shaft, at the proximal end a handle is arranged, and at the distal end a tool with two jaw parts is arranged, of which at least one jaw part is pivotable, wherein the distal end is configured as a tool tip that can be deflected, and the tool tip is rotatable, wherein the rotation of the tool tip is effected via a first actuation element which is operatively connected at the proximal end to the handle, and wherein the deflection of the tool tip is effected via a second actuation element which is operatively connected to the handle, and wherein the at least one pivotable jaw part is adjustable between a closed position and an open position via a pull/push element. The pull/push element is mounted eccentrically in the tool tip and parallel to the longitudinal axis.