Abstract: The invention provides a surgical clip applier particularly useful in laparoscopic and other least invasive surgical procedures. The clip applier includes a shaft having a distal end and a proximal end, the shaft defining an axial direction. Means are provided in the shaft for advancing a clip to the distal end. Hook means are fixed to the distal end of the shaft, the hook means having a distal portion disposed transverse to the shaft so as to define a surface facing in a proximal direction for engaging a tissue structure. A pair of movable jaws are mounted at the distal end of the shaft and are axially slidable relative to the hook means for closing a clip on a tissue structure engaged by the hook means. The movable jaws will define a U-shaped slot open in a generally distal direction. Means are further provided for advancing the jaws to a position adjacent the distal portion of the hook means, as well as means for closing the jaws.

Abstract: A clip unit for hernia repair surgery has first and second arms joined at a hinge joint. A latch or hook locks the arms together after they are closed. A mesh material extends around the outside edges of the clip. In use, the clip is placed over a portion of the elevated peritoneum and then closed and locked. The mesh is fixed to the surrounding peritoneum. The clip and surgical method expedites hernia repair surgery and reduces trauma and medical costs.

Abstract: A sterile one-piece suture clip having a first clamping member having a distal end, a first proximal end and a first clamping surface, a second clamping member having a second proximal end, a second clamping surface, and a locking surface and being pivotally connected at said second proximal end by a hinge to said first proximal end of the first clamping member, a plurality of leg members each having an inner surface, a side surface and an end, said legs being disposed in sets comprising U-shaped members in combination with the first clamping surface, the inner surface of each leg in the set facing the opposite leg thereof, said inner surface being beveled from the end of the leg toward the first clamping surface to form ears, said U-shaped members being attached to the first clamping member, said side surface of said legs being beveled from the end of the leg toward the first clamping member thereby forming a channel said first clamping member being adapted to be placed on a suture to be clipped, said channe

Abstract: An apparatus and surgical staple are disclosed for endoscope application of the surgical staples for attaching surgical mesh to body tissue in laparoscopic hernia surgery. The surgical staple is formed of a length of wire having a central portion having a middle portion and end portions extending therefrom in a first direction. Wire leg members extend in a direction generally perpendicular to the middle portion. Bridge portions are provided to connect each leg member to the end portions of the central portion. The bridge portions each have a straight portion substantially parallel to the middle portion and extending away from the end portions of the central portion. A first generally arcuate portion connected to the straight portions has a concave surface portion facing in a direction generally inwardly toward the opposing leg member.

Abstract: A malleable, bioabsorbable polymeric staple includes a back span with two legs depending perpendicularly therefrom that are deformed toward each other initially and then upwardly toward the back span such that end points on each leg extends to the side and past the back span. The staple has a noncircular cross-sectional shape. A surgical staple-deforming anvil for deforming the staples has a staple-receiving face formed with a pair of elongated, non-collinear pocket-like depressions each having an entry end lying on a longitudinal axis parallel to the back span of the staple, and an exit end. The respective exit ends of the pocket depressions are located on opposite sides of the longitudinal axis. Accordingly, the legs of a staple driven toward the anvil and received in the pocket depressions are initially bent toward each other and then steered upwardly toward opposite sides of the back span.

Abstract: A two-part surgical ligation clip includes a track having two substantially symmetrical arms and a clip for slidably receiving the track. The symmetrical arms are connected together at a proximal end to form an apex and have spaced-apart tips at a distal end with first complementary surface. The track also includes a connector connected to the apex and having a second complementary surface. The clip has an extended slot for slidably engaging the track and distal end tips for receiving the connector. A distal end of the clip has a first contour surface for engaging the first complementary surface on the track and locking it in a closed position and a second contour surface for engaging the second complementary surface on the track and locking it in an open position.

Abstract: The invention provides a tissue manipulation system including a tethered clamp and a clamp applicator for positioning the clamp through a trocar sleeve and applying the clamp to a tissue location in the abdominal cavity. In a further embodiment, the tissue manipulation system includes a introducer through which the tether can be withdrawn from the abdominal cavity and a clamp attached to the proximal end of the introducer for clamping the tether in position. The tissue manipulation system further includes an obturator for inserting the introducer into the abdomen, and a tether snare for retrieving the tether and withdrawing it through the introducer.

Abstract: A system is provided for fastening an implantable medical device, for example a defibrillator lead, to the heart. A lead electrode is placed in a desired position against the pericardium, pericardial tissue is grasped with a fastening tool, and the pericardial tissue is drawn away from epicardium and toward the fastening tool. A fastening member is applied to the pericardial tissue and to the lead electrode to secure the lead in the desired position. The application tool comprises a first pair of jaws for grasping membranous tissue and drawing the tissue away from other tissues and toward the tool. A second pair of jaws is provided for holding fastener members and delivering the fastener members to the membranous tissue.

Abstract: According to the present invention, a surgical clip applier includes means for preventing closure of the clip closing mechanism when no clips are left in the applier. The clip applier includes a shaft having distal and proximal ends, means in the shaft for advancing clips to the distal end, means at the distal end for closing clips and a jam clip carried by the advancing means proximally of the surgical clips, wherein the jam clip is positioned in the clip closing means and prevents closure thereof after all surgical clips have been applied.

Abstract: A surgical clamp for the temporary occlusion of a blood vessel during a surgical procedure and forceps-like instruments co-operative with the clamp for application and removal of the clamp in a coherent and rational surgical system is described.

Abstract: A two-part surgical fastener comprises a staple and a receiver which are adapted to secure body tissue together. The staple is generally U-shaped and includes at least two prongs with barbed distal ends which penetrate the tissue and are latched by the receiver. Each prong of the staple is configured as an elongated prism of hexagonal cross-section and includes a barbed tip with an enlarged hexagonal cross-section at its free end. Each aperture of the receiver is hexagonal in configuration and includes a pair of opposed ledges for engaging the barbed tip. The tip of each prong has a pointed distal end formed by a first pair of sloped surfaces which form the sharp angle and a second pair of sloped surfaces which form a blunt angle. The staple includes longitudinal ridges or grooves on the prongs which are engaged and guided by longitudinal channels or ribs provided in a staple cartridge. The staple and receiver consist of bioabsorbable material.

Abstract: A surgical staple for securing a purse string suture to human tissue comprises a staple body of deformable material formed into a loop through which the purse string suture is threaded. The staple body includes a pair of legs which are deformable into an overlapping configuration upon insertion into the tissue to secure the staple body and the purse string suture to the tissue. Alternatively, the staple body includes two or more legs including barbed ends for anchoring the legs to the tissue. To secure the purse string suture, a plurality of staples is positioned about the periphery of the tubular section of tissue, the purse string suture is threaded through the loops in the staples, and the staples are driven into the tissue to secure the purse string suture thereto. In addition, a surgical instrument is provided for applying the staples and the purse string suture to the tissue.

Abstract: A surgical fastener is comprised of a center span with two locking arms extending therefrom, each locking arm containing an indentation adapted to receive a locking point and an indentation adapted to receive a locking nub. An inner bendable member extends from the center span terminating in a staple point member, the staple point member terminating in a tissue piercing point. An outer bendable member extends from the staple point member parallel to the inner bendable member, terminating in a locking point and locking nub. In the closed position the locking point of the outer bendable member locks into the indentation in the locking arm, to lock the staple in the closed position. In the open position the locking nub of the outer bendable member locks into the locking nub indentation in the locking arm to hold the staple in the open position.

Abstract: An improved surgical clip of the type having first and second leg members joined at their proximal ends by a resilient hinge region and terminating at their distal ends in latch means. Each leg member has an outer surface and a clamping inner surface, and the outer surface of each leg member is configured to be accepted by the jaws of the clip applier. The improvement in the clip design specifically relates to a reduction in the mass of the clip in the hinge region. A reduced mass in the hinge region lessens the strain at the hinge region when the clip is in a clamped position, and therefore increases its strength retention.

Abstract: A bipolar electrosurgical clip is provided having two opposed prong members which are connected by a bridge member. The surface of the prong members are preferably coated with a conductive material while the bridge member is made of a highly resistive material which serves to electrically isolate the prong members from each other. One conductive prong member is adapted to serve as an active electrode through which electrosurgical energy is delivered to tissue while deploying the clip. The other conductive prong member serves as a return electrode, communicating through a conductor wire with an electrosurgical generator.

Abstract: A hemostatic clip to be applied to body structures such as veins, arteries, or the like. The hemostatic clip includes a plurality of preferably semicircular indentations arranged in staggered row configuration on the tissue contacting surface of the legs of the clip.

Abstract: A surgical fastening clip of a shape memory alloy which applies a first clamping force to a site when the alloy is in its martensitic condition and a second clamping force to the site when the alloy heats due to surrounding tissue such that the alloy transforms to its austenitic condition. The second clamping force is greater than the first clamping force and prevents the clip from slipping or falling off the clamped site due to shrinkage or movement of the site. For instance, the site could be a blood vessel which becomes thinner due to the compressive force of the clip and shrinks, but the clip maintains a clamping force on the blood vessel due to the shape memory effect of the alloy. A method of using a surgical fastening clip formed of a shape memory alloy by placing opposed legs of the clip around a site, deforming the legs to a closed configuration and heating the clip by the natural surroundings to cause further closing of the legs and thereby increasing the clamping force.

Abstract: A circumcision instrument includes a pair of body members displaceable toward each other to simultaneously cut the foreskin along a longitudinal or circumferential line of cut while simultaneously stapling together the skin and mucous layers of the foreskin along at least one stapling line generally parallel with the cut, thereby to reduce bleeding from a cut. In a first embodiment, a generally straight cutting blade is carried by a body member at one end of a pair of scissors-type arms for longitudinally cutting the foreskin, cooperating male and female staple members being removably mounted on opposed body members for simultaneously producing stapling lines on both sides of the cut. In a second embodiment, a pair of annular body members arranged concentrically about a penis are displaced together on opposite sides of the foreskin when folded concentrically back around one of the annular members, a circular stapling line being defined concentrically between a circular cut and the penis.

Abstract: An improved surgical clip having first and second leg members joined at their proximal ends by resilient hinge means and terminating at their distal ends in latch means. Each leg member has an outer surface and a clamping inner surface. The outer surface of each leg member is configured to be accepted by the jaws of a clip applier. The improvement in the clip design specifically relates to the design of the clamping inner surface of each leg member of the clip. The clamping inner surface of the first leg member has a convex radius of curvature extending transversely across at least a portion of the width of the first leg member, and the clamping inner surface of the second leg member has a concave radius of curvature extending transversely across at least a portion of the width of the second leg member. The radius of curvature of the clamping inner surface of the first leg member is smaller than, and complementary to, the radius of curvature of the clamping inner surface of the second leg member.

Abstract: The anvilless surgical stapler includes a pair of stapling assemblies which are mounted on the articulated handles of an applicator. Each stapling assembly includes a mounting block and a staple cartridge which is slidably mounted within the block. Further, each cartridge has a housing with a plurality of openings in which staples are slidably received along with a plurality of pushers. When the stapling assemblies are brought together, one or more ribs in the mounting blocks cause the pushers to fire the staples from the openings of the staple cartridge housings. A pair of deformable lips are also provided at the mouth of each opening for deforming the legs of each staple inwardly toward each other in order to embed into the tissue without penetrating into the tissue. The lips also permit passage of the deformed staples under the biasing force of the pushers.

Abstract: A surgical clip for closing the margins of a wound, is disclosed, which clip consists of a bridge and two legs having cutting edges at their ends and projecting from opposite ends of the bridge. Each leg has a part formed as an arc of a circle which adjoins the bridge, and a free ended straight section including the cutting edge of the leg, extending from the arcuate part of the leg. For reducing trama when the clip is implanted and for maintaining eversion of the wound margins after the clip has been implanted, the straight sections of the legs are set at an angle in the range of 2.5.degree. to 10.degree. with respect to the axis of symmetry of the clip.

Abstract: A hemostatic clip which permits selection of the clamping pressure applied by the clip to tissue is of single piece plastic construction and C-shaped configuration. A transversely extending region of reduced thickness at the center of the mid-portion of the clip defines the hinge axis of the clip. Cooperating latching members extend from the mid-portion on opposite sides of the reduced thickness region. A dispenser for the clips has a magazine for storing a series of clips, a dispensing mechanism for advancing clips from the magazine, and an applicator tip receiving the advanced clip and having adjustably spaced plates for determining the degree to which the clip is closed.

Abstract: A surgical staple has a base portion and a pair of leg portions respectively extending angularly from the opposite ends of the base portion. Each leg portion has at its distal end portion a first inclined surface and a second inclined surface extending from the first inclined surface to the distal end of said leg portion. The first and second inclined surfaces are inclined with respect to the axis of the leg portion. The angle between the first inclined surface and the axis of the leg portion is smaller than the angle between the second inclined surface and the axis of the leg portion. The second inclined surface terminates in a sharp edge at its distal end. For producing the surgical staple, a blade is moved toward each of the leg portions in inclined relation to the axis thereof to shear the leg portion, so that a smooth sheared surface and a coarse ruptured surface are formed on the distal end portion of the leg portion and arranged in this order toward the distal end of the leg portion.