Abstract: A method for reconstructing at least a first and a second independently moving body from one 3D tomography scan includes performing a movement of the first body relative to the second body, obtaining the movement, obtaining a 3D tomography scan of the first body and the second body during the movement, and reconstructing a first 3D model of the first body and a second 3D model of the second body by applying the recorded movement to the 3D tomography scan. This has the effect that reconstruction of several 3D tomography scanned bodies is possible during motion of the scanned bodies.

Abstract: Methods and systems for x-ray and fluoroscopic image capture and, in particular, to a versatile, multimode imaging system incorporating a hand-held x-ray emitter operative to capture digital or thermal images of a target; a stage operative to capture static x-ray and dynamic fluoroscopic images of the target; a system for the tracking and positioning of the x-ray emission; a device to automatically limit the field of the x-ray emission; and methods of use. Automatic systems to determine the correct technique factors for fluoroscopic and radiographic capture, ex-ante.

Abstract: An esophageal stethoscope is disclosed. The esophageal stethoscope includes a cuff, a tube, one end of which is disposed in the interior of the cuff, and extending to a side that is opposite to the one end thereof, a mount member mounted on an opposite end of the tube, and a microphone disposed in the interior of the mount member, the tube includes at least one hole configured to allow sound waves that passes through the cuff to be provided into the tube, and the microphone absorbs cardiac sound and converts the cardiac sound to a cardiac sound electric signal, and is electrically connected to an external device to deliver the cardiac sound electric signal to the external device.

Abstract: Each conductor of a plurality of insulated conductors of a wiring harness extends between, and electrically connects, a corresponding terminal of a first electrical connector to either a corresponding terminal of an electrical connector jack of a plurality of electrical jacks located along the wiring harness, or to a corresponding terminal of a corresponding auscultatory sound-or-vibration sensor of the plurality of auscultatory sound-or-vibration sensors. The plurality of insulated conductors are organized in a plurality of distinct branches, each distinct branch originating either from the first electrical connector or from another portion of the wiring harness, and the locations of the plurality of distinct branches, in cooperation with the plurality of electrical jacks, if present, are implicitly suggestive of a corresponding location of the corresponding auscultatory sound-or-vibration sensor on a thorax of a test subject.

Abstract: An enhanced stethoscope device and method for operating the enhanced stethoscope are provided. The enhanced stethoscope device generally operates by providing stethoscope sensors, ultrasonic sensors, and other sensors to obtain a series of measurements about a subject. The series of measurements may be correlated, such as by machine learning, to extract clinically relevant information. Also described are systems and methods for ultrasonic beamsteering by interference of an audio signal with an ultrasonic signal.

Abstract: An electronic stethoscope system comprising a device to capture an acoustic heart signal from a patient and a neural network to classify the data into heart sound categories to provide time series sound category data comprising, for each of a succession of time intervals, category probability data representing a probability of the acoustic signal falling into each of the categories. The stethoscope also includes one or more heart state models each having a sequence of heart cardiac cycle states, a system to fit the time series sound category data to the models and determine timing data for the sequence of heart states and a confidence value for the model fit, and an output to output one or both of a model fit indication dependent upon the confidence value and an indication of the timing data.

Abstract: Disclosed herein are systems, devices, and methods for providing continuous, non-invasive blood pressure monitoring. A wearable monitoring device includes first and second transducer arrays separated by a fixed distance. Each of the transducer arrays includes a plurality of independent transducer elements for transmitting and receiving ultrasound energy. When a user wears the device, the transducers are positioned near the brachial artery. The device operates to measure the transit time of a cardiac pulse through the brachial artery and across the fixed distance between transducer arrays. The measured pulse transit time may then be used for determining pulse wave velocity and/or blood pressure.

Abstract: A monitoring system includes a wearable patch device configured to be secured to a body of a patient, the wearable patch device comprising a patch body, a first discrete transducer associated with a first position of the patch body, a second discrete transducer associated with a second portion of the patch body, and a wireless transmitter, and electronics including one or more processors and one or more memory devices and configured to receive signals based on transducer readings of the first and second discrete transducers and determine an amount of blood flow through one or more valves of a heart of the patient based on the signals.

Abstract: An intraluminal ultrasound imaging device includes a flexible elongate member configured to be inserted into a body lumen of a patient, the flexible elongate member comprising a proximal portion and a distal portion. The device also includes an ultrasound scanner assembly disposed at the distal portion of the flexible elongate member. The ultrasound scanner assembly includes a flexible substrate; a transducer region positioned on the flexible substrate; and a control region positioned on the flexible substrate, wherein the transducer region and the control region are radially arranged relative to one another. Associated devices, systems, and methods are also described.

Abstract: An intraluminal ultrasound imaging device includes a flexible elongate member configured to be inserted into a body lumen of a patient, the flexible elongate member comprising a proximal portion and a distal portion. The device includes an ultrasound scanner assembly disposed at the distal portion of the flexible elongate member. The ultrasound scanner assembly includes a flexible substrate comprising a longitudinal width extending from an inner edge to an outer edge; a control region embedded in the flexible substrate; a transducer region embedded in the flexible substrate; and a window region disposed between the outer edge of the flexible substrate and the transducer region, and wherein the window region, the transducer region, and the control region are radially arranged relative to one another. Associated devices, systems, and methods are also described.

Abstract: Aspects described herein disclose devices, systems, and methods for use in contexts such as minimally invasive surgery (MIS). A device is provided herein having a proximal portion and a distal portion, and an ultrasound transducer may be disposed within the distal portion and configured to scan tissue and identify certain portions of a patent's anatomy during the scanning process. The results of the detection may be presented to an operator of the device aurally and/or visually, such as in a 3-D volumetric image. By scanning the tissue, identifying the anatomy, and presenting the results to an operator, unnecessary damage to elements of the patients anatomy may be avoided or lessened. In some aspects, multiple transducers may be positioned on the device to increase the scanning range and/or scanning accuracy of the device. The device may provide an inner channel for the passage of surgical tools while scanning tissue.

Abstract: Intravascular systems, devices, and methods having a captively-held filling are provided. An intravascular imaging device can include a flexible elongate member including a lumen having a proximal portion and a distal portion; a drive cable disposed within the lumen such that an ultrasound transducer coupled to the drive cable is positioned within the distal portion of the lumen; and a filling captively held within at least the distal portion of the lumen and surrounding the ultrasound transducer, the filling facilitating transmission and receipt of ultrasound signals. A method of manufacturing an intravascular imaging device can include acquiring a flexible elongate member including a lumen; inserting a drive cable into the lumen, a rotational ultrasound transducer being coupled to the drive cable; inserting a filling that facilitates transmission and receipt of ultrasonic signals into the lumen such that the filling surrounds rotational ultrasound transducer; and sealing the filling within the lumen.

Abstract: A portable ultrasound probe is described having a mechanical transducer, rotating mirror, and mirror motor. The transducer can be used for diagnostic imaging and procedural guidance imaging.

Abstract: An ultrasonic generator includes an ultrasonic wave source and a converging portion. The converging portion includes a first reflecting portion which reflects the ultrasonic wave generated by the ultrasonic wave source on its first reflecting surface, a second reflecting portion which reflects the ultrasonic wave reflected by the first reflecting surface on its second reflecting surface, and a waveguide serving as a transmission path for the ultrasonic wave. The waveguide is disposed such that the ultrasonic wave reflected by the second reflecting surface is introduced through an introduction portion thereof. The focal point of the second reflecting surface and the focal point of the first reflecting surface are disposed such that the ultrasonic wave reflected by the second reflecting surface becomes a plane wave.

Abstract: The present invention provides an ultrasonic imaging device, comprising: an imaging assembly, the imaging assembly comprising an ultrasonic transducer for imaging tissue to be imaged; an adjustable arm, wherein one end of the adjustable arm is connected to the imaging assembly; a counterweight, the counterweight being connected to the other end of the adjustable arm through a cable; a frame, the frame being capable of guiding movement when the counterweight and/or adjustable arm moves; and a transmission assembly, the transmission assembly comprising a driving device and a transmission belt, wherein the driving device is connected to the transmission belt, and the transmission belt is connected to the counterweight; the driving device is capable of acting on the counterweight through the transmission belt, so as to adjust pressure applied by the imaging assembly onto the tissue to be imaged. The present invention further provides some imaging methods using the ultrasonic imaging device.

Abstract: A measuring system for measuring elasticity of biological tissue includes a mobile device and a measuring apparatus including a conducting seat and a measuring device. The conducting seat is for detachable mounting of the mobile device therein, and is adapted to abut against the biological tissue for conducting vibrations produced by the mobile device to the biological tissue to cause the biological tissue to vibrate. The measuring device includes an ultrasonic transducer to emit an ultrasound signal to the biological tissue and an elasticity analyzer to analyze an ultrasound echo signal that results from reflection of the ultrasound signal by the biological tissue which is vibrating to obtain an elasticity data of the biological tissue.

Abstract: A thermoacoustic system and method of use to receive an ultrasound system output from an ultrasound system, via an existing communication port on the ultrasound system. The thermoacoustic system includes a radio-frequency emitter, at least one thermoacoustic transducer, a processor, and a display that is integrated with the processor and configured to display an image that is a function of the ultrasound system output and data from the at least one thermoacoustic transducer. The thermoacoustic system is configured to perform an action, as a result of receiving the ultrasound system output.

Abstract: The purpose is to evaluate the condition of a muscle in a relatively simple constitution without accompanying exposure. An ultrasonic analysis apparatus comprises an interface configured to receive signals from a transmitter/receiver which receives ultrasonic waves transmitted from a plurality of mutually different positions on a surface of a body toward a muscle inside the body and reflected from inside the body, processing circuitry configured to generate ultrasonic images corresponding to the respective positions respectively based on the signals inputted from the interface, to stitch the ultrasonic images at the respective positions to generate a stitched image, to set a region of interest for at least the stitched image and the ultrasonic image, and to calculate an index related to the muscle from at least one of the respective images corresponding to the region of interest.

Abstract: Methods and systems are provided for improving image quality of ultrasound images by jointly selecting optimal scan parameter values. In one example, a method includes acquiring a plurality of ultrasound images of an anatomical region, each ultrasound image acquired at a different combination of parameter values for a first scan parameter and a second scan parameter, selecting a first parameter value for the first scan parameter and a second parameter value for the second scan parameter based on an image quality of each image, and acquiring one or more additional ultrasound images at the first parameter value and the second parameter value.

Abstract: An ultrasonic diagnosis and therapy apparatus according to an embodiment may include an ultrasound output unit including a plurality of ultrasound output elements, a circuit board that can be attached and detached through a connecting board connected to the ultrasound output unit to determine a function of the ultrasound output unit, and a control unit configured to control a setting value of each of the plurality of ultrasound output elements, wherein therapy and diagnosis functions are selectively or simultaneously implemented by changing the circuit board. With the ultrasonic diagnosis and therapy apparatus, it is possible to selectively or simultaneously implement the therapy and diagnosis functions by selectively mounting different types of circuit boards that determine the type and function of ultrasound outputted from the ultrasonic transducers.

Abstract: An instrument drive assembly for use with a surgical instrument includes a housing assembly supporting a drive assembly therein, a coupling tube supported at a distal end of the housing assembly and extending distally therefrom, a coupling assembly, and a retention mechanism. The coupling assembly is supported in the housing assembly and is configured to releasably couple to an instrument drive shaft of the surgical instrument, and the retention mechanism is configured to releasably couple to an instrument sleeve of the surgical instrument.

Abstract: An apparatus for sealing a puncture includes a cartridge, a pusher member, a sealant, and a tamping device on a proximal end of the cartridge. During use, the cartridge, sealant, and pusher member are advanced over a positioning member and into the puncture by advancing a cartridge hub carrying the tamping device. When further distal advancement of the cartridge is limited, the cartridge hub is further advanced, activating the tamping device, and causing the pusher member to advance relative to the sealant to compress the sealant within the puncture.

Abstract: Articulated instruments that include tools for disrupting and/or distracting tissue, and methods of using the same.

Abstract: The present disclosure describes a surgical retractor system and method. The surgical retractor includes an elongate element defining an operational axis, a first blade secured to the elongate element and comprising a blade face, a second blade moveably secured to the elongate element, wherein the second blade defines a reference point located thereon, and wherein a movement of the second blade moves the reference point in a linear direction parallel to the operational axis and orthogonal to the blade face. A guide element may be removably located within an opening located on either the first blade or the second blade.

Abstract: A method of forming an access opening through a psoas muscle to a patient's spine includes laterally inserting a stimulating dilator into the psoas muscle. The stimulating dilator has a stimulation channel formed in an outer surface thereof. An electrical pulse is transmitted into the stimulating dilator to locate a position of a nerve in the patient's psoas muscle. The stimulating dilator is laterally inserted through the psoas muscle and toward the patient's spine in a way that avoids the nerve. A stimulating probe is inserted into the stimulation channel along the outer surface of the stimulating dilator while transmitting an electrical pulse into the stimulating probe to verify the position of the nerve.

Abstract: A retractor system includes a retractor arm and a retractor blade attached to the retractor arm via a swivel gear of a retractor blade connector. The retractor blade includes an attachment post extending through a port of the swivel gear. The retractor blade connector further includes a swivel gear detent and a plunger. The swivel gear detent is positioned to selectively engage the swivel gear and prevent the swivel gear and attached retractor blade from rotating about the rotational axis. The plunger is movable among at least a locked position and an unlocked position. In the locked position, the plunger urges the swivel gear detent into engagement with the swivel gear and prevents rotation of the swivel gear and attached retractor blade about the rotational axis. In the unlocked position, the plunger permits the swivel gear and attached retractor blade to rotate past the swivel gear detent.

Abstract: A method of performing an operation, e.g. a spinal operation, on a patient using a retractor comprising a pair of blade assemblies which are adapted to open about a set of axes that are not parallel to a third spatial axis, and further comprising a pair of arms, which are adapted to move the pair of blade assemblies apart from one another in the third spatial axis. In the method, the blade assemblies are closed to assume a low profile, inserted into a relatively small incision, and stretched apart from each other, thereby stretching the skin about the incision to form an aperture longer than the incision. The blade assemblies are then opened by rotating the blades about the set of axes, stretching the skin around the incision in a second direction that is substantially perpendicular to the first direction (i.e. the direction of the incision.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to a tissue traction device, e.g., for endoscopic tissue dissection. For example, a tissue traction device may include a first clip comprising opposable jaws. The device may include a traction band having a first end, a second end, a length therebetween and extending along a longitudinal axis. The band may have a first aperture at the first end. A second aperture may be at the second end of the band. A first jaw of the opposable jaws of the first clip may be disposed through the first aperture.

Abstract: The present invention includes a suture adapted to be anchored into tissue, the suture comprising a length of an elongate flexible suture material and a plurality of barbed anchor articles slidingly disposed along a length of the suture material. The invention also includes a suture placement device designed to insert the anchors of the suture articles into opposing tissue surfaces and associated methods for approximating and/or affixing opposed tissue surfaces in surgical procedures and the like.

Abstract: A device having one or more adjustable loops or coils associated with an implant body for use in soft tissue reconstructions is provided. One exemplary embodiment of a device includes a body and a suture filament, with the filament being used to form a self-locking sliding knot disposed on a top side of the body and a plurality of adjustable coils that are substantially disposed on the body's bottom side. Terminal ends of the filament located above the body's top side can be passed through an opening of a Lark's Head knot from opposite sides, thus forming a self-locking sliding knot, and then the terminal ends can be tensioned to adjust a circumference of the coils. Changing a coil's circumference changes a location of a ligament graft disposed on the coil. Other configurations of devices and systems, as well as methods for performing ACL repairs, are also provided.

Abstract: Prosthetic heart valves and methods of use of prosthetic heart valves may be provided. In one implementation, a prosthetic heart valve may include an annular spacer configured for implantation with a native heart valve opening and a central valve section configured for disposal within the annular spacer. The central valve section may include at least one anchoring protrusion configured to anchor the central valve section against axial movement relative to the annular spacer. During deployment, the central valve section may be expanded radially within the heart into an at least partially-expanded configuration while at least a portion of the central valve section is situated outside of a space opening of the annular spacer, and moved upstream while remaining in the at least partially-expanded configuration until the anchoring protrusion engages the annular spacer.

Abstract: The present disclosure relates to devices, systems and methods for endoscopic suturing or stitching through an access tube or the like. An endoscopic stitching device is provided and includes a handle assembly; an elongate shaft supported by and extending from the handle assembly; and an end effector supported on a distal end of the elongate shaft. The end effector includes a neck assembly configured and adapted for articulation in one direction between a substantially linear configuration and an off-axis configuration, and a pair of juxtaposed jaws pivotally associated with one another. Each jaw defines a suture needle receiving recess formed in a tissue contacting surface thereof.

Abstract: The invention relates to an insert holding device (100) comprising a holding structure (110) configured to releasably hold an insert (300) for insertion into a bone, at least one first recess (120) for receiving a first suture (400), and at least one second recess (130) for receiving a looped second suture (500) and a suture holding device (200) comprising a first recess (210) and a holding structure (220) configured such that the first suture (400) can be laid around the second suture (500) and the insert (300), thereby connecting the second suture (500) to the insert (300) when the insert (300) is held by the holding structure (110). The invention further relates to a kit of parts and a method for connecting a suture (500) to an insert (300) for insertion into a bone.

Abstract: A suturing system including apparatus and methods for disposing stitches in a substrate comprising a thread carrier which inserts a thread in the substrate at a first location and withdraws the thread from the substrate at a second location.

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: Implantable materials for use with end effectors like surgical stapling devices, and methods for using the same, are generally provided. In some embodiments, adjunct materials for use with surgical staplers are provided. For example, a kit for stapling tissue is provided that can include a surgical stapler having an end effector. The end effector can have first and second jaws. The kit can include an adjunct material having hydrophobic surface regions and hydrophilic surface regions and the adjunct material can be configured to mate to at least one of the jaws of the end effector. Other implants, devices, and methods for surgical stapling are also provided.

Abstract: Inserters for dynamic implants include hooks that engage connecting means of the implants and rams that press against bridges of the implants when the inserters are actuated.

Abstract: A surgical stapling device includes an elongate member and a loading unit. The loading unit includes a tool portion and a body portion including a first portion having a first length, a second portion having a second length, and a third portion having a third length. The first portion is configured to be releasably secured with the elongate member. The second portion is distal of the first portion and dimensioned to be received in the elongate member. The third portion is distal of the second portion. At least the second or third portion is configured to engage the elongate member in a sealing relation. The second length is greater than the first and third lengths. The third portion of the body portion is dimensioned to be flush with the elongate member when the first and second portions are received in the elongate member.

Abstract: A surgical instrument, such as a surgical fastener applying apparatus, includes a tool assembly, an endoscopic body portion, and an articulation mechanism. The articulation mechanism articulates the tool assembly in relation to the endoscopic body portion over large arc segments while providing simple operating components. Thus, the range of operation of the surgical instrument and the types of surgical activities that can be performed by the surgeon can be expanded without at the same time requiring complex operating components.

Abstract: A handle assembly of a hand-held surgical instrument includes a handle housing, a rack supported in the handle housing and configured to operably couple to a driven member of a surgical end effector, an idler pinion gear operably coupled to the rack, and an output pinion gear drivingly coupled to a motor. The output pinion gear translates the rack via the idler pinion gear.

Abstract: An apparatus includes a body and a shaft assembly. The body includes a rotary drive output, a linear drive output, and a control module. The shaft assembly includes a distal end and a proximal end. The distal end includes a type of end effector configured to operate on tissue. The proximal end is configured to removably couple with the body assembly. The proximal end includes one or both of a rotary drive input configured to couple with the rotary drive output or a linear drive input configured to couple with the linear drive input. The shaft assembly is configured to actuate the end effector in response to movement of one or both of the rotary drive input or the linear drive input. The control module is configured to selectively actuate the rotary drive output or the linear drive output based on the type of end effector of the shaft assembly.

Abstract: A dissecting tip is provided for use with a surgical stapler or instrument. In one embodiment, the dissecting tip is secured to the end effector of the surgical instrument, e.g., to the cartridge assembly. The dissecting tip extends distally from the end effector and is configured to dissect or separate target tissue from certain tissue, e.g., adherent, connective, joined or other tissue.

Abstract: A surgical device comprising a first jaw member, a second jaw member, a clamping member and a clamp apparatus is disclosed. The clamping member is slidably positioned to translate at least partially through the first jaw member. The clamping member engages the first jaw member and the second jaw member, and has a knife blade for cutting tissue. A flange of the clamping member is configured to engage a cam surface to pivot the second jaw member with respect to the first jaw member from an open position toward an approximated position. The clamp apparatus is movable from a retracted position to an advanced position for preventing a gap between proximal portions of the first jaw member and the second jaw member from exceeding a predetermined distance. The clamping member and the clamp apparatus are separately movable.

Abstract: A surgical stapling apparatus includes a buttress retention assembly. The buttress retention assembly includes a sleeve configured to be detachably coupled with a first jaw member of a tool assembly of the surgical stapling apparatus, and a buttress material. The sleeve includes a proximal hook extending transversely outward from a lateral side of the sleeve, and a mouth including a hook configured to be received in a knife slot of the first jaw member. The mouth includes an inner surface having an inwardly extending boss. The buttress material includes a tab extending transversely outward from a lateral side thereof. The tab defines a proximal slot configured to receive the proximal hook of the sleeve. At least a portion of the distal end portion extends through the mouth of the sleeve. The distal end portion defines a distal slot dimensioned to receive the boss of the sleeve.

Abstract: A medical instrument comprising: (A) a first joint comprising a first member and a second member, the first member configured to be repositionable with respect to the second member in an X-Y plane; (B) a second joint operatively coupled to the first joint, the second joint comprising a third member and a fourth member, the third member configured to be repositionable with respect to the fourth member in a Y-Z plane perpendicular to the X-Y plane; and, (C) a controller operatively coupled to the first joint and the second joint, the controller including a first control configured to direct repositioning of at least one of the first member and the second member, and a second control configured to direct repositioning of at least one of the third member and the fourth member.

Abstract: A surgical clip applier includes a handle assembly and an elongated assembly configured to releasably engage the handle assembly. The handle assembly includes a trigger and a drive bar wherein pivoting of the trigger through a full actuation stroke translates the drive bar through a full drive distance. The drive bar has a magnetic distal end portion. The elongated assembly includes an inner drive assembly including a magnetic proximal end portion. Upon engagement of the elongated assembly with the handle assembly, the magnetic proximal end portion of the inner drive assembly is configured to attract the magnetic distal end portion of the drive bar to move the drive bar and pivot the trigger such that the trigger is pivotable through a reduced actuation stroke to translate the drive bar through a reduced drive distance.

Abstract: Jaws of a surgical clip applier with housings formed thereon and methods for manufacturing and use during a procedure to apply surgical clips to a vessel, duct, shunt, etc. are provided. In one exemplary embodiment, a surgical clip applier is provided having jaws on a distal end thereof with a rigid internal frame and an outer housing formed around the internal frame. The jaws of the surgical clip applier can include a variety of features to facilitate placement of surgical clips, including features to align a clip with the jaws and to prevent clip fallout during formation.

Abstract: A surgical stapling apparatus includes a handle, a tool assembly, and a staple cartridge. The handle includes an actuation trigger. The tool assembly is operatively coupled to the handle. In addition, the tool assembly includes a first jaw member and a second jaw member. The staple cartridge is releasably supported on the first jaw member. The staple cartridge includes first and second buttress materials and a spring member extending from the staple cartridge. The spring member is configured to support the second buttress material away from the first buttress material.

Abstract: The invention is an implantable magnetic anastomosis device having an exoskeleton that directs self-assembly. The design allows the device to be delivered in a linear configuration using a minimally-invasive technique, such as endoscopy or laparoscopy, whereupon the device self-assembles into, e.g., a polygon. A coupled set of polygons define a circumscribed tissue that can be perforated, or the tissue can be allowed to naturally necrose and perforate. The device can be used to create anastomoses in a variety of tissues, such as tissues found in the gastrointestinal, renal/urinary, and reproductive tracts. New procedures for using anastomoses, e.g., surgical bypass are also disclosed.

Abstract: A system for endoscopically forming an anastomosis between two naturally adjacent points in the digestive tract. The system utilizes elongate magnetic devices that, when connected across a tissue boundary, necrose tissue until an anastomosis forms and the devices are passed naturally. Despite the elongate shape of the devices, the resulting anastomosis is substantially round. As such, round anastomoses can be formed having increased diameters merely by increasing the lengths of the devices, obviating the need for wider endoscopes.