Abstract: A treatment device has an arm member having a plurality of arms to have an open state and a closed state; a wire having a distal end connected to the arm member and the distal end is attachable and detachable to the arm member; a sheath through which the wire is inserted; an operator connected to a proximal end of the sheath; a slider connected to the wire and attached to the operator to be slidable toward a distal end or a proximal end of the operator, wherein the slider makes the plurality of arms to be in the closed state when the slider is disposed in a first range, and the slider makes the plurality of arms to be in the open state when the slider is disposed in a second range; and a slider restriction mechanism provided between the distal end of the operator and the slider.

Abstract: Surgical fasteners for use with articulating surgical instruments are disclosed. In one embodiment, a surgical fastener may include a head, a shaft extending distally from the head, and a through bore extending through the shaft from a proximal surface of the head to a distal end of the shaft. A fastener carrier of a surgical instrument may be slidably received in the through bore, and the through bore may be sized and shaped to have two or fewer contact points with the fastener carrier when the fastener carrier is in a fully articulated configuration. In another embodiment, a fastener may include a head, a shaft extending distally from the head and including a distal tip, a sloped surface sloping toward the distal tip, and a through bore passing through the head, shaft, and sloped surface. The sloped surface may terminate at two shoulders located on opposing sides of the through bore.

Abstract: A surgical instrument including an articulating region. An outer tube and an inner tube are axially fixed to one another distal to the articulating region and axially movable relative to one another proximal to the articulating region. Relative movement of the inner and outer tubes provides for articulation of the articulating tube assembly to a curved configuration. A working tool may be removably directed through a central cannula defined by the inner tube. The working tool may include a shaft having a flexible region configured to be arranged within the articulating region. The shaft may rotate within the inner tube with the articulating tube assembly in the curved configuration. The working tool may include a housing hub configured to be coupled with a handle to removably position the flexible region within the articulating region. Multiple working tools may be interchangeably directed through the central cannula.

Abstract: An apparatus for preventing deployment failure or damage of a movable portion of a treatment device via a force limiting element in the treatment device.

Abstract: Sutures with pre-tied knots for use in percutaneous surgical procedures and devices for easily and quickly tying complex suture knots are disclosed.

Abstract: The present invention relates to a reflux disease treatment apparatus, apparatus, comprising an implantable movement restriction device that maintains cardia in the correct position and an implantable stimulation device adapted to engage with the cardia sphincter of a patient. The invention further comprises a control device for controlling the stimulation device to stimulate the cardia sphincter. The invention can be combined with various methods for treating obesity, in particular methods that creates satiety by stretching the wall of the stomach or fills out a volume of the stomach.

Abstract: Conventional varicose vein techniques suffer from a number of disadvantages and potential complications, including, for example, a risk for the development of hematomas, swelling, and blood clots, post-surgical pain and nerve injury, a potential for spontaneous regeneration and undesired resumption of varicosity, a need for a highly skilled surgical professional, as well as, in certain instances, a prolonged recovery period, accompanied by severe limitations on post-surgical activity. The present invention overcomes the disadvantages and deficiencies of the prior art by providing a method for percutaneously occluding and dividing a varicose vein or other problematic vessel, a rapid, reliable, less invasive therapy that may be readily, reliably, and successfully performed by minimally skilled personnel around the world in a variety of medical settings.

Abstract: A guide wire holder includes a sheath having a lumen, an operation wire which is inserted through the lumen to be able to advance and retract, and a hook which is continuous with a distal end of the operation wire and protrudes from a distal end of the sheath, wherein the sheath has an inner wall surface which forms a groove configured to extend from the distal end of the sheath to a proximal end side of the sheath, the groove has an opening portion which opens to an outer peripheral surface of the sheath, the hook has a guide wire engagement surface which is engageable with a guide wire, and the guide wire is able to be held between the guide wire engagement surface and the inner wall surface.

Abstract: A slip knot suture construct system and method for securing multiple limbs of suture. The system includes a suture construct having a length of suture including a standing limb with a standing terminal end and a closing limb with a closing terminal end. The suture construct has three loops: a primary loop formed in the closing limb, the primary loop and closing limb extending to the standing limb, a secondary loop formed in the standing limb, and a locking loop formed in the length of suture between the primary loop and the secondary loop. A limb of suture extends through the primary loop. The limb of suture is secured in the suture construct by pulling the closing terminal end proximally, which pulls the primary loop holding the limb of suture through the locking loop and at least partially into the secondary loop.

Abstract: A bone anchor includes a flexible strand defining a first adjustable loop and a friction knot coupled to a proximal end of the first adjustable loop. The friction knot is configured to allow adjustment of the first adjustable loop in a first configuration and is configured to prevent adjustment of the first adjustable loop in a second configuration. A knot capsule includes a body defining an internal knot cavity. The friction knot and a portion of the first adjustable loop are positioned within the internal knot cavity. The internal knot cavity defines one or more impingement surfaces configured to maintain the friction knot in a fixed position within the internal knot cavity when the friction knot is in the second configuration.

Abstract: A clip dispensing system, clip dispenser, and method is described herein for dispensing and applying clips to tissue during minimally invasive surgery. The system may include a grasping surgical instrument having a shaft and a grasping tool, and a clip dispenser assembled to the shaft. The clip dispenser includes an inner tube surrounded by an outer tube and a plurality of clips housed between the inner tube and the outer tube. The clips include a first jaw, an opposing second jaw, and a cavity between the first jaw and the second jaw. The cavity permits the clip to slide along the length of the shaft and over the grasping tool of the grasping surgical instrument to be clamped onto a grasped piece of tissue with the aid of a second grasping instrument.

Abstract: A method for closing a wound in a tubular organ using a suture thread includes: a first step of connecting a first edge portion and a second edge portion with the suture thread; and a second step of connecting a third edge portion and a fourth edge portion with the suture thread. The first step includes passing the suture thread through a first position on a mucosal surface of at least one of the first edge portion and the second edge portion. The second step includes passing the suture thread through a third position on the mucosal surface of at least one of the third edge portion and the fourth edge portion. A shortest distance between the wound and the third position is larger than a shortest distance between the wound and the first position.

Abstract: A gastroplasty method involves a staple line that terminates prior to reaching the gastroesophageal junction such that the bypassed portion of the stomach does not require resection. Additionally, bougies are taught that assist a physician in following the improved staple line of the present invention.

Abstract: A tissue thickness compensator may generally comprise a first layer comprising a first biocompatible material sealingly enclosed in a water impermeable material and a second layer comprising a second biocompatible material comprising at least one encapsulation, wherein the first biocompatible material expands when contacted with a fluid. The tissue thickness compensator may comprise a haemostatic agent, an anti-inflammatory agent, an antibiotic agent, anti-microbial agent, an anti-adhesion agent, an anti-coagulant agent, a medicament, and/or pharmaceutically active agent. The encapsulation may comprise a biodegradable material to degrade in vivo and/or in situ. The tissue thickness compensator may comprise a hydrogel. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

Abstract: A clamp device for hemostasis or closure of tissue, including clamp housing and at least two clamp arms, wherein clamp arms can be coupled to distal end of control wire of medical instrument to stop bleeding of blood vessel, clamp device can be actuated to open and close clamp arms, which are coupled to each other or can be coupled at proximal ends, clamp arms is provided with guide groove, and guide grooves of clamp arms partially overlap each other, and guide pin attached to clamp housing, and extending in overlapping part of guide grooves and passing therethrough, so that by means of fitting of guide pin and guide grooves, movement of pivot axis is converted into closing movement of clamp arms or opening movement of clamp arms about pivot axis, holding hole being provided on each of clamp arm, holding hole extending from side thereof into guide groove.

Abstract: The present disclosure provides a system and method for controlling an articulating member including a tool. The method includes determining a first confidence indicator based on a manual control mode for the articulating member, determining a second confidence indicator based on an autonomous control mode for the articulating member, generating an allocation function based on the first confidence indicator and the second confidence indicator, and generating a control command for the articulating member based on the allocation function.

Abstract: A stapling assembly comprising a cartridge body, a plurality of staples, a plurality of first staple drivers, and a second staple driver is disclosed. The cartridge body comprises a longitudinal slot defining a longitudinal slot axis and a plurality of staple cavities defined in the cartridge body. The plurality of staples comprises a first row of staples, a second row of staples, and a third row of staples. Each first staple driver of the plurality of first staple drivers comprises a first staple support, a second staple support, and a third staple support configured to eject a staple from the first, second, and third rows of staples, respectively. The second staple driver is configured to eject only two staples of the plurality of staples and comprises a fourth staple support and a fifth staple support, each configured to eject a staple of the only two staples.

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: Locking assemblies for surgical clamping and cutting instruments include a locking member and a switch. A drive member may be configured to releasably engage a knife and/or a shuttle of the surgical instrument for translating the knife and/or shuttle in a distal direction through a firing stroke. The locking member is movable from a first position permitting distal translation of the drive member through the firing stroke, and a second position inhibiting distal translation of the drive member through the firing stroke. A switch, when proximally positioned, releasably engages the locking member to maintain the locking member in the first position. The switch disengages from the locking member when the switch is moved to a distal position.

Abstract: Devices including a capsule having an interior and a clamp assembly including a plurality of clamps. Each clamp includes a first arm having a first free end and a second arm having a second free end. The device includes a clamp assembly including a compacted state in which the plurality of clamps are compressed within the capsule and a deployed state in which at least the free ends of the plurality of clamps are positioned outside of the interior of the capsule. The first free end is closer to the second free end in the compacted state as compared to the deployed state. The device can further include a push rod releasably secured to the clamp assembly and a delivery rod releasably secured to the capsule. Methods of using the devices are also disclosed.

Abstract: The present disclosure pertains to medical devices. More particularly, the present disclosure pertains to devices, systems, and methods for closing a wound, such as a tissue defect resulting from an endoscopic mucosal resection or endoscopic submucosal dissection procedure. In one example, a device for closing a wound may include a closure element having a delivery configuration and a deployed configuration, the closure element configured to be disposed about an endcap of an endoscope in a delivery configuration. A release filament may have a distal end releasably coupled to the closure element and a proximal end extendable within the endcap. The closure element may be configured to substantially close about the wound in the deployed configuration.

Abstract: A surgical instrument for repairing a cartilage tear, of the present invention, can simply and safely fix a first fixing piece (501) and a second fixing piece (502) to a torn cartilage through a very simple method for sequentially discharging the first fixing piece (501) and the second fixing piece (502) provided to be connected to suture threads (10) through a needle (411) at the tip of a push rod guide (410) while selectively moving a push rod (200) a predetermined width forward in multiple stages by means of an operation of pressing and lowering a push button (300), which is inserted into a button coupling hole (120) of an instrument body (100) so as to receive the elastic repulsive force of a spring (310), or releasing and lifting the pressed button.

Abstract: Ligation bands are provided having improved compression and anti-slip properties. For example, a ligation band can be provide with a substantially ring-shaped elastic body that has a first tissue-contacting surface, a second tissue-contacting surface opposite the first tissue-contacting surface, and an aperture that extends therethrough. At least one of the tissue-contacting surfaces can have a plurality of protrusions that define an interlinking web-pattern with a plurality of recesses.

Abstract: The laboratory device includes an elongated handle with ergonomic grips. The device has a center recess for a rod to slide or rotate. The blade head attaches at the distal end of the elongated handle. The rod has geared teeth that interact and mesh with the gears on the blade head allowing the user to manipulate the angle of the blade head via rod. The rod in the proximal position of the handle is disposed at an acute angle relative to the longitudinal axis of the handle such that the blade head and handle are positioned for insertion into and removal of a tissue culture vessel. When the rod is moved distally or rotated the blade head position is disposed perpendicularly, acute or obtusely in relationship to the longitudinal axes of the handle such that the blade head provides optimal raking opportunities for the device to collect cell colonies.

Abstract: A fastener delivery tool configured to deliver a fastener into tissue of a patient including a shaft, a handle assembly connected to a proximal end of the shaft, one or more prongs connected to a distal end of the shaft, and a fastener push rod received at least partially within the shaft, wherein the fastener push rod is connected to the handle assembly, wherein the fastener push rod is moveable relative to the shaft, and wherein the fastener push rod includes one or more detents configured to be received within a passageway of a fastener and secure the fastener to the fastener push rod with friction.

Abstract: Medical device delivery system including a catheter, handle, lock line handle, and lock line. The catheter includes a proximal end portion and a distal end portion. The handle is coupled to the proximal end portion of the catheter. The lock line handle is releasably coupled to the handle and actuatable between a lock position and an unlock position. The lock line includes a first end portion fixedly coupled to the lock line handle, a second end portion releasably coupled to the lock line handle, and an intermediate portion configured to be releasably coupled to the medical implant disposed proximate the distal end portion of the catheter. Actuating the lock line handle from the lock position toward the unlock position increases tension on the lock line, and actuating the lock line handle from the unlock position toward the lock position decreases tension on the lock line.

Abstract: Disclosed is a medical instrument, comprising: a protective sheath device; a clamp device comprising a clamp shell arranged on a distal end of the protective sheath device and at least or just two clamp arms; and a control line extending and passing through the protective sheath device, wherein the clamp shell is directly connected to the protective sheath device by means of at least one connection element and is fixedly attached to the clamp shell, or, a portion thereof is releasably connected to the protective sheath device; and a release mechanism cooperating with each connection element is provided, and when the clamp arms have been closed, the release mechanism can be actuated by means of moving the control line in a proximal end direction so as to release each connection element from the protective sheath device and thus release the clamp shell.

Abstract: A medical device for tissue hemostasis or closure that is used by means of an endoscope, the medical device comprising: a handle (1); a sheath apparatus (2) attached to the handle (1); a clamping apparatus (3) comprising a clamping base (6) and at least or exactly two clamping arms (7a, 7b), the clamping base (6) specifically being a sleeve and being disposed on a distal end of the sheath apparatus (2); a control wire (4) that extends to pass through the sheath apparatus (2) and that can move reversibly in a distal direction and a proximal direction; and an actuator (5), the actuator (5) being coupled to a proximal end of the control wire (4) and being capable of actuating such that the control wire (4) moves reversibly in the distal direction and the proximal direction.

Abstract: A button inserter and system are disclosed that enable easily and effectively deploying a near bone suture button from the button inserter when implementing the suture button technique. To deploy the near bone button, with a far bone button deployed from the button inserter and against the far bone, the button inserter's handle may be translated away from the deployed far bone button. Translating the handle changes a position of a carriage body within a channel of the handle thereby compressing a spring. Protrusions on the carriage body may be forced through notches in the handle, which thereby alters an orientation of the carriage and releases the compressed spring, which applies force to the carriage body. The combination of force induces the carriage to rotate, which thereby releases the near bone button from the carriage. A free end of suture also releases from the carriage.

Abstract: A method for operating a medical device, comprising: (1) providing a surgical end effector at a distal end of an instrument shaft and a rotating actuator at a proximal end of the instrument shaft, and (2) operating the rotating actuator to perform at least one of actuating the surgical end effector by sliding the rotating actuator in a proximal direction and rotating the surgical end effector with respect to the instrument shaft and about a shaft axis.

Abstract: A surgical instrument comprising an end effector and a closure drive configured to close the end effector is disclosed. The surgical instrument further comprises a stowed lock deployable to hold a closure actuator of the closure drive in a partially-closed position. The surgical instrument further comprises an articulation drive operable to rotate the end effector about an articulation joint when the closure drive is in its partially-closed position.

Abstract: The present teachings provide a medical system for delivering and deploying a medical implant, and the method of using thereof. Specifically, one aspect of the present teachings provides a medical system having an implant with an engagement loop, and a delivery system having an engagement wire and an engagement mechanism. During implant delivery, the engagement wire engages the engagement loop of the implant. The engagement wire further interacts with the engagement mechanism in order to prevent unintended disengagement of the engagement loop from the engagement wire. The present teaching also provide an implant release mechanism that is configured to break away from the implant pusher shaft. Specially, one aspect of the present teaching provides that the implant release mechanism being of one unit with the implant pusher shaft. To release the implant, a clinician simply breaks away the implant release mechanism from the rest of the implant delivery system.

Abstract: The present disclosure relates generally to ligators, actuation devices, and methods for deploying ligation bands around a portion of tissue, utilizing an endoscope for suction, visualization, and support. In some embodiments, a ligator may include an elongate member having a lumen, and a ligating band dispenser extending from a distal end of the elongate member. The ligating band dispenser may include a cap and at least one ligating band on the cap. The ligator may further include an actuation device extending around the elongate member, wherein the actuation device includes a body, and a bobbin coupled to the body by support arms. A suture may be coupled between the bobbin and the at least one ligating band, wherein rotation of the bobbin draws the suture towards a proximal end of the elongate member to deploy the at least one ligating band from the cap.

Abstract: A clip applier may be configured to apply a surgical clip and have a pair of jaw members. Each of the jaw members may have an inner surface and a stabilizing member extending from the inner surface. Each of the jaw members may be configured to engage a distal portion of a leg member of the surgical clip. The stabilizing members may be configured to be positioned on opposite lateral sides of a proximal portion of the surgical clip to reduce lateral movement of the surgical clip. An inner portion of each of the stabilizing members may be spaced apart from the opposing jaw member in an open configuration, and each of the jaw members may have a channel on the inner surface to receive the opposing stabilizing member in a closed configuration.

Abstract: One embodiment relates to a medical instrument (1) with a hollow shaft (2), an actuating unit (4) arranged at the proximal end (3) of the shaft (2) and an instrument tip (6) with an instrument (7) arranged at the distal end (5) of the shaft (2), wherein the instrument (7) can be actuated via an actuating element (8) which is mounted in the shaft (2) in an axially displaceable manner, and wherein the actuating element (8) is operatively connected to the actuating unit (4) on the proximal side, and wherein the instrument tip (6) can be pivoted relative to the longitudinal axis (10) of the shaft (2) via a joint mechanism (9). According to one embodiment, the instrument tip (6) can be rotated endlessly, wherein a fixing device is provided on the instrument tip (6) with which the loose end (17, 23) of a sewing material (18, 24) can be fixed on the instrument tip (6).

Abstract: A medical device may include a handle including a fixed body and a movable body. The movable body may be movable relative to the fixed body. The medical device may include a shaft extending from the fixed body and an end effector at a distal end of the shaft. Rotation of the movable body relative to the fixed body may permit rotation of the end effector relative to the shaft, and rotation of the movable body with rotation of the fixed body may permit rotation of the end effector with the shaft. Deflection of the movable body relative to the fixed body may permit deflection of the end effector relative to the fixed body.

Abstract: An insertion device includes an elongate member and a stylet. The elongate member has a proximal end portion, a distal end portion, and defines a lumen therethrough. The stylet has a proximal end portion, a distal end portion, and is slidably coupled to the elongate member. The stylet is configured to move from a first position to a second position with respect to the elongate member. The proximal end portion of the stylet is configured to removably couple a mesh carrier thereto. A portion of the proximal end portion of the stylet is disposed outside of the lumen of the elongate member when the stylet is in its first position and is disposed within the lumen when the stylet is in its second position.

Abstract: A puncture visualization device can include a guidewire having a proximal section, a distal section, and a distal tip. The device can include a needle having a needle lumen configured to receive the guidewire. The device can include a lock, and the lock can engage with the guidewire. For instance, engagement of the lock with the guidewire can inhibit relative motion between the guidewire and the needle. The device can include an optical sensor, for example located at the distal tip of the guidewire. The optical sensor can be locked into a position, for instance by the lock. In an example, the device provides a distal field of view from a location within the needle and near a distal end of the needle for visualization to facilitate puncturing a target with the distal end of the needle.

Abstract: A method for use in a lung access procedure to aid in preventing pneumothorax includes providing a cannula having a pair of balloons, the pair of balloons including a first balloon longitudinally spaced from a second balloon along the cannula; inserting the cannula along an access opening and through pleural layers of a patient, with the first balloon and the second balloon of the pair of balloons respectively positioned on opposite sides of the pleural layers; inflating the pair of balloons with a first amount of a two-component sealant to compress the pleural layers together; and inflating the pair of balloons with a second amount of the two-component sealant that is sufficient to rupture the pair of balloons so as to comingle a first sealant component and a second sealant component of the two-component sealant at the site of the pleural layers so as to adhere the pleural layers together.

Abstract: The disclosure provides a dynamic vascular access and closure device for radial cinching of an access site. The device includes a tensioning tube, a resilient member disposed within the tensioning tube, and a plurality of sutures extending axially between a distal end of the tensioning tube and a proximal end of the tensioning tube. A proximal end of each of the plurality of sutures can be configured to attach to the resilient member such that movement of that suture causes compression or extension of the resilient member within the tensioning tube to provide cinching to the sutures.

Abstract: A releasable elongated assembly includes a release member having a length and an opening that extends along the length. The releasable elongated assembly includes a first elongated element having a first coupling member disposed in the opening and a second elongated element having a second coupling member disposed in the opening opposite the first coupling member along the length. The first and second elongated elements are interlaced with each other in the opening at a location between the first coupling member and the second coupling member such that the first and second elongated elements are attached to each other. The release member is moveable from a first position where the first and second coupling members are captured in the opening to a second position where the first and second coupling members are released from the opening so as to detach the first and second elongated elements from each other.

Abstract: A method and apparatus of adaptively controlling a surgical stapling instrument are disclose. The method includes identifying a staple cartridge type, configuring the surgical stapling instrument based on the identified staple cartridge, and adaptively controlling, by a control circuit, operation/functionality of the surgical stapling instrument based on the configuration of the surgical stapling instrument loaded with the identified staple cartridge type. The apparatus includes a control circuit including a microcontroller and a memory coupled to the microcontroller. The memory stores machine executable instructions that when executed by the microcontroller cause the microcontroller to execute the above method.

Abstract: An adjustable suture locking apparatus includes a lock pin, an outer tube, a handle, and an adjusting device. The lock pin is used to receive or fix a suture. The outer tube defines a receiving cavity. The lock pin is disposed at a distal end of the receiving cavity. The handle includes a fixing portion coupled to a proximal end of the outer tube. The adjusting device is disposed on the fixing portion. The adjusting device is coupled to a proximal end of the suture and operable to adjust tensioning or loosening of the suture.

Abstract: In one embodiment, a leaflet capture device for improving the coaptation of heart valve leaflets is provided. The leaflet capture device can include a clip having a coupling member and a leaflet engagement portion. The coupling member has a lumen extending therethrough. The leaflet engagement portion is moveable toward and away from the coupling member. The leaflet capture device can be delivered by a support catheter, an inner shaft, and an actuating connector. Extending an end of the inner shaft away from the coupling member of the clip pulls the actuating connector to move the leaflet engagement portion away from the coupling member.

Abstract: A retractable syringe device includes: a handle including a hollow body for receiving a syringe through an opening of the handle, the hollow body including a syringe actuator that moves the syringe between a distal position and a proximal position; and an instrument distally extending from the handle, the instrument including a channel extending through the instrument, the channel configured to receive a needle coupled to the syringe. When the syringe is in the distal position, a distal end of the needle distally extends from the instrument, and when the syringe is in the proximal position, the distal end of the needle is retracted into the channel. The handle of the device can include a fixed or removable structure for removably coupling to a proximal end of a shaft of an endoscope.

Abstract: Tissue ligation systems and methods are provides to mechanically strangulate abnormal or undesirable tissue. Tissue ligation systems include a multi-lumen catheter having an outer diameter smaller than the inner diameter of a standard endoscope channel such that the catheter can be inserted into the endoscope. Tissue ligation systems also include a ligation apparatus with an expandable hood disposed at the distal end of the catheter. A suture extends through a lumen of the catheter and has a distal loop portion that can strangulate tissue.

Abstract: A surgical instrument is disclosed herein. The surgical instrument can include an end effector that includes jaws configured to transition between an opened condition and a closed condition, a plurality of electrodes positioned within the jaws of the end effector, a control circuit, and a memory configured to store an algorithm configured to cause the control circuit to determine an impedance signal based on signals received from the plurality of electrodes, detect a media positioned between the jaws of the end effector based on the determined impedance signal, determine a position of the detected media based on the received signals, and generate an alert associated with the detected media and the determined position.

Abstract: Surgical fasteners for use with articulating surgical instruments are disclosed. In one embodiment, a surgical fastener may include a head, a shaft extending distally from the head, and a through bore extending through the shaft from a proximal surface of the head to a distal end of the shaft. A fastener carrier of a surgical instrument may be slidably received in the through bore, and the through bore may be sized and shaped to have two or fewer contact points with the fastener carrier when the fastener carrier is in a fully articulated configuration. In another embodiment, a fastener may include a head, a shaft extending distally from the head and including a distal tip, a sloped surface sloping toward the distal tip, and a through bore passing through the head, shaft, and sloped surface. The sloped surface may terminate at two shoulders located on opposing sides of the through bore.

Abstract: A gastrocutaneous closure device allows gastrocutaneous fistula closure from external abdominal access through the fistula site. Access through the fistula ensures accurate closure placement on the interior lumen wall of the stomach. A closure or clip has a plurality of prongs defined by a deformable material, such that the prongs extend radially from a central hub in an arcuate or curved, semicircular shape. The arcuate shape converges towards a central point or axis at a distal end, and the proximate end of the prongs attaches to the central hub such that the prongs radiate from the hub and the distal end curves back toward the axis through the hub. The deformable prongs may therefore radially compress or retract to define a larger or smaller diameter. The fistula lies on the axis such that the biased, inserted prongs pull the inner stomach wall closed around the healing fistula.

Abstract: A surgical instrument. The surgical instrument has a force delivery system which communicates a changing force to a user of the surgical instrument when a limit of a surgical function is reached. A sensor senses position of a moving element to communicate a signal to the force delivery system. In various embodiments, the system generates a vibratory force to signal the user.