Abstract: A flexible or elastic brachytherapy strand that includes an imaging marker and/or a therapeutic, diagnostic or prophylactic agent such as a drug in a biocompatible carrier that can be delivered to a subject upon implantation into the subject through the bore of a brachytherapy implantation needle has been developed. Strands can be formed as chains or continuous arrays of seeds up to 50 centimeters or more, with or without spacer material, flaccid, rigid, or flexible.

Abstract: A surgical stapling apparatus is provided. The surgical stapling apparatus includes an actuating device including an elongated shaft. A tool assembly is disposed on a distal end of the shaft. The tool assembly includes a first jaw member supporting a cartridge assembly having a plurality of surgical fasteners, and a second jaw member supporting an anvil. The first jaw member is movable in relation to the second jaw member between a spaced position and an approximated position. One of the first and second jaw members includes a cantilever at a proximal end thereof. A firing cam bar assembly is slidably disposed within the tool assembly and includes a cam surface configured to engage the cantilever to move the first and second jaw member towards the approximated position and a distal end configured to deploy the plurality of surgical fasteners from the cartridge assembly.

Abstract: An apparatus comprises a body, a shaft, and an end effector that is operable to compress, staple, and cut tissue. The end effector comprises and anvil and a cartridge. A longitudinal axis intersects the distal tip of the anvil when the anvil is in a closed position. The cartridge defines a sight line extending along a distal surface of the cartridge from a first side of the cartridge toward the anvil. The first side of the cartridge is opposite to the anvil. The distal surface of the cartridge is neither parallel to nor perpendicular to the longitudinal axis. The sight line intersects the longitudinal axis near the distal tip when the anvil is in the closed position. A segment of the sight line and a segment the longitudinal axis define an angle ?. The angle ? is larger than 90°.

Abstract: A device 10 for gathering tissue in a patient includes an elongated catheter 14 and a capture assembly 13 at a distal portion of the catheter. The capture assembly has a closed side 18 and a door 20 rotatable between an open condition and a closed condition. The closed side 18 of the capture assembly 13 and the door 20 in the closed condition may collectively define a tissue capturing compartment 19. Movement of the door 20 from the open condition to the closed condition adjacent the tissue may capture a portion 44 of the tissue in the tissue capturing compartment 19. A clip may then be applied from the capture assembly 13 to the captured tissue 44 to hold the tissue substantially in a gathered configuration.

Abstract: In various embodiments, an end effector for use with a surgical instrument is disclosed. The end effector comprises a first jaw and a second jaw moveable relative to the first jaw, wherein one of the first jaw and the second jaw comprises a plurality of staple cavities arranged in a plurality of curved staple cavity rows, and wherein at least one curved staple cavity row extends along a path. The path comprises a first curved portion comprising a first longitudinal vector component and a second curved portion comprising a second longitudinal vector component, wherein the second longitudinal vector component is opposite of the first longitudinal vector component. The end effector further comprises a firing member comprising a laterally-offset cutting edge, a first camming surface configured to engage the first jaw, and a second camming surface configured to engage the second jaw.

Abstract: A clip unit includes: a clip body having a pair of arm parts; and a fastening ring arranged in the outside of the clip body and configured to maintain the arm parts in the closed state, in which the clip body includes a connection base section connecting the base end side of the pair of arm parts, and a connection tail section provided on the connection base section to extend opposite to the arm parts and connected to the front end of a transmission member, and the connection base section has a flat part perpendicular to the axial direction of the fastening ring, and the arm parts and the connection tail section are connected on a side of the flat part.

Abstract: The present invention relates to a medical clip, a clip unit, and a clip device by which accuracy in access to a target (a site to be treated) can be secured and also which can be employed to suture or remove a site involving widespread tissue injury. As one example to achieve this, the present invention provides a medical clip including: a first arm and a second arm between which a target is placed and which together squeeze the target; a ring configured to connect one end of the first arm with one end of the second arm; a first ancillary arm articulated with the other end of the first arm; and a second ancillary arm articulated with the other end of the second arm.

Abstract: An anvil assembly includes a retaining member having a body portion and a frangible portion connected to the body portion, where the frangible portion is positioned to engage a backup member and separates from the body portion during movement of the backup member from a first, proximal position to a second, distal position. The retaining member keeps the backup plate in the proximal position prior to firing of the stapling assembly, and upon separation of the frangible portion allows the backup plate to move to the distal position during firing of the stapling assembly. Proximal force on the backup plate after firing of the stapling assembly is avoided, thereby helping to ensure titling of the anvil assembly.

Abstract: Embodiments of the present invention provide methods and apparatus for imaging a tissue specimen excised during surgery with a combined positron emission tomography (PET) and micro computed tomography (micro CT) scanner. The specimen is scanned with a CT imaging system of the combined PET and micro CT scanner. The specimen is also scanned with a PET imaging system of the combined PET and micro CT scanner. A PET image is constructed based on data acquired by the PET imaging system. A micro CT image is constructed based on data acquired by the micro CT imaging system. The micro CT image includes at least one visualization of a lesion marker.

Abstract: Described, in certain embodiments, are methods and apparatuses for delivering anchoring devices such as T-anchors into body passage walls. Some inventive methods involve inserting one or more anchoring devices into a wall of an organ in a direction from a luminal surface to an abluminal surface of the wall. In some instances, inserting a device in this manner, while providing at least part of the device implanted between the luminal surface and the abluminal surface of the wall, is conducted without the device exiting the wall's abluminal surface. In these and other inventive methods, delivering an anchoring device into a body passage wall may involve manipulating the wall in some manner before, during and/or after placing the device in the wall. Various forms of manipulation are described in this regard.

Abstract: In various embodiments, a cordless instrument for cutting and coagulating tissue is provided. The cordless instrument comprises a handle comprising a power supply system, wherein the power supply system comprises a battery, an oscillator, and an amplifier. The cordless instrument further comprises an end effector comprising a battery-powered electrode and a moveable cutting member. The cordless instrument further comprises a conductor extending between the power supply system and the battery-powered electrode.

Abstract: The present disclosure is directed to a surgical apparatus, comprising an anvil jaw configured to form at least one surgical staple, a cartridge jaw configured to deploy one or more surgical staples against the anvil jaw, and a pressure distribution device attached to at least one of the anvil jaw and the cartridge jaw, wherein the pressure distribution device is configured to distribute a clamping pressure to a target tissue during a clamping and a stapling of the target tissue.

Abstract: A surgical instrument is disclosed. The surgical instrument comprises a handle, a shaft comprising a proximal portion extending from the handle and a distal portion, and a firing member. The surgical instrument further comprises a motor, wherein the motor is configured to be operated in a first direction to advance the firing member toward the distal portion during a firing stroke, wherein the firing stroke comprises a firing stroke end, and wherein the motor is configured to be operated in a second direction to retract the firing member away from the distal portion. The surgical instrument further comprises a switch configured to detect when the firing member has reached the firing stroke end, wherein the motor is configured to be automatically operated in the second direction when the switch detects the firing stroke end.

Abstract: Provided is a surgical instrument including an external tube (2) and two elongated members (4) positioned in the tube (2), each of which includes a distal end (10a) for capturing one of the two tissue zones (M1, M2) to be attached. The instrument (1) may further include a catching member (22, 25) for each tissue (M1, M2) to be attached; a rod (15, 16) linked to each catching member (22, 25) enabling tension to move axially, the rod (15, 16) being separable from said catching member (22, 25) when a tension is exerted on it beyond a certain threshold; and a member (17a) forming a stop for locking axially each catching member (22, 25) during the tensioning.

Abstract: A transcatheter method of gathering tissue of a heart valve leaflet may include inserting an elongated catheter assembly to a position adjacent the heart valve leaflet, the catheter assembly including a capture tool moveable between a retracted position and an extended position, a tissue support, and a clamping member moveable between an open position and a closed position. The capture tool may be partially retracted to gather tissue of the heart valve leaflet between the tissue support and the clamping member. The clamping member may then be moved from the open position toward the closed position so as to clamp a substantial portion of the gathered tissue of the heart valve leaflet between the tissue support and the clamping member. Subsequently, a clip may be applied from the catheter assembly to the clamped tissue so as to hold the clamped tissue substantially in a gathered configuration.

Abstract: A surgical instrument includes an end effector assembly having first and second jaw members moveable relative to one another between a spaced-apart position and an approximated position for grasping tissue therebetween. In the approximated position, the jaw members cooperate to define a cavity that is configured to house tissue grasped between the jaw members. An injectable material configured for injection into the cavity defined by the jaw members is also provided. The injectable material is configured to substantially surround tissue housed within the cavity. The injectable material is transitionable from a first state, facilitating injection of the injectable material into the cavity, to a second state, wherein the injectable material forms about tissue housed within the cavity to occlude tissue.

Abstract: A clipping device includes (a) a shaft defining a lumen therethrough from a proximal end which, during a procedure remains outside the body accessible to a user and a distal end including a distal opening which, during a procedure is inserted into the body to a position adjacent to target tissue; (b) a flexible clip deployable from the distal opening, when in an unconstrained state, the clip assuming a shape selected to clip tissue and prevent a flow of fluid therethrough wherein, while residing within the lumen the clip is held substantially straight by an inner diameter of the lumen; (c) a control wire extending through the lumen from the proximal end to the distal end thereof; and (d) a release mechanism connecting the control wire to the clip during deployment of the clip and disconnecting the control wire from the clip after deployment thereof.

Abstract: A device for inserting a medical apparatus into a living body includes a handle and an elongated sheath extending from the handle to a distal end configured for insertion to a target location in the living body in combination with a clasp positioned within a distal portion of the elongated sheath and configured to temporarily attach to an endoscopic device and a spring retention mechanism movable from a first resting configuration maintaining a first closed position of the clasp to a second compressed configuration moving the clasp to an open position. A withdrawal mechanism is movable from a first resting configuration in which the distal end of the elongated sheath extends distally over a distal end of the endoscopic device to a second retracted configuration in which the distal end of the elongated sheath is moved proximally of the distal end of the endoscopic device.

Abstract: A surgical instrument is provided including a handle portion and a body portion extending distally from the handle portion and defining a longitudinal axis. The surgical instrument also includes a grasper disposed at a distal end of the body portion, the grasper including an ultraviolet (UV) light mechanism for performing UV tacking of an implant. The implant is positioned between the first and second jaw members of the grasper: (i) to be placed at a surgical site and (ii) to be exposed by a UV light emitted from the UV light mechanism such that the UV tacking of the implant to the surgical site is performed.

Abstract: To economically manufacture a surgical clip applicator for U-shaped or V-shaped clips, which allows secure closure of the clips when applied to tissue structures, in particular, also in the case of double-shank or multiple clips, it is proposed that the applicator comprise a handle portion, a shaft adjoining the handle portion, a clip applying tool arranged at the free end of the shaft, and a clip magazine, the applying tool comprising a mouthpiece with tool jaws for holding a clip during the application and a closing device for transferring the tool jaws from an open, idle position to a closed position, and the mouthpiece being made of a plastic material and being held separately from the closing device on the clip applicator.

Abstract: This invention provides hermetically-sealed handle assembly with a rotating trigger for use with disposable components, such as surgical clip appliers. The rotating trigger reduces the gripping force necessary to fully control the internal actuator mechanism to operate a disposable surgical clip applier to fully ligate a vessel or other tissue. The hermetic seal on the handle assembly prevents any patient fluids and other bioburden from entering the internal structures. This reduces the possibility of cross-contamination and the costs of sterilization.

Abstract: A ligation clip applier is provided. The clip applier includes: a pair of jaws; a distal clevis tube to which the jaws are pivotally mounted; a proximal clevis tube located behind the distal clevis tube, wherein the distal clevis tube and the proximal clevis tubes move axially with respect to each other; a clip lock actuator fixed to one of the proximal and distal clevis tubes; and a distal pushrod extending through the distal and proximal clevis tubes and forming a camming connection with the jaws configured to close and move the jaws toward a proximal direction toward the clip lock actuator when the distal pushrod is moved in the proximal direction. A method for applying a clip on a vessel is disclosed.

Abstract: Embodiments of the disclosure may include a medical device comprising a flexible elongate member including a longitudinal axis and a tool connected to the elongate member at a pivot axis, wherein the tool may be configured to conduct electricity and deliver a fluid, and wherein the tool may be configured to pivot towards either side of the longitudinal axis relative to the elongate member at the pivot axis.

Abstract: A system for stapling tissue comprises a flexible endoscope and an operative head including a pair of opposed, curved tissue clamping jaws sized to pass through an esophagus, the jaws being moveable with respect to one another between an open tissue receiving configuration and a closed tissue clamping configuration, a first one of the curved jaws including a stapling mechanism and a second one of the jaws including a staple forming anvil surface, the stapling mechanism including staple slots through which staples are fired arranged in a row extending from a proximal end of the first jaw to a distal end thereof in combination with a control handle which, when the operative head is in an operative position within one of a patient's stomach and esophagus, remains outside the patient, the control handle including a first actuator for moving the jaws relative to one another and a second actuator for operating the stapling mechanism.

Abstract: An apparatus for the repair of a cardiovascular valve has leaflets comprising a grasper capable of grabbing and co-apting the leaflets of the valve. In a preferred embodiment, the grasper has jaws that grasp and immobilize the leaflets, and then a fastener is inserted to co-apt the leaflets. The apparatus is particularly useful for repairing mitral valves to cure mitral regurgitation.

Abstract: An electromechanical surgical device includes an end effector configured to perform at least one function, the end effector including an input drive axle projecting therefrom; and a shaft assembly. The shaft assembly includes a rotatable drive shaft; a proximal neck housing supported at a distal end of an outer tube; a distal neck housing pivotally connected to the proximal neck housing; a pivot pin interconnecting the proximal neck housing and the distal neck housing; and a gear train supported in the proximal neck housing, on the pivot pin, and in the distal neck housing. The gear train includes a proximal gear; an intermediate gear; a distal gear; and a pair of output gears, wherein each output gear defines a coupling socket each configured to selectively receive the drive axle of the end effector.

Abstract: A self-retaining neural retraction clip, preferably having controlled retraction level and an off-set retraction means. This device can reduce operative site clutter to enhance disc access while providing consistent and stable dural retraction.

Abstract: A surgical cutting instrument includes a first jaw member, a second jaw member movably supported relative to the first jaw member for selective movement between an open position and a closed position to clamp tissue therebetween upon application of a closing motion thereto, and a cutting member comprising a tissue cutting edge to cut the tissue clamped between the first jaw member and the second jaw member upon application of a retraction motion to the cutting member.

Abstract: Each of the clip units 13 includes a clip body 35 having a pair of arm parts 41 that can ligate the biological tissue and a fastening ring 37 that accommodates the clip body 35, and the plurality of clip units 13 are disposed in series within the distal end of the outer sheath member 19. Each of the fastening rings 37 includes a connecting mechanism 85 consisted by a locking member 87 that connects the adjacent fastening rings 37 each other and a fitting support 101, the manipulation wire 23 engaged with the locking member 87 is pulled to release the connection of the fastening rings 37 by the connecting mechanism 87.

Abstract: The x-ray stick marker includes a shaft having a proximal end, a distal end, and a lumen extending through the shaft between the proximal end and the distal end. A handle is disposed at the proximal end of the shaft and a marking tip is disposed at the distal end of the shaft. The handle includes an actuating button configured to control the release of the marking tip. The marking tip is configured for marking the skin of the patient. To avoid exposure to radiation, a user may maintain a suitable distance from the patient when positioning the marking tip on a designated location of the patient's skin for drawing a mark thereon.

Abstract: A tissue constriction device comprises a tissue-surrounding part defining a central, tissue-receiving opening which, when in a tissue-receiving configuration, has a first diameter and which, when in a tissue-constriction configuration, has a second diameter less than the first diameter, at least a shape memory portion of the tissue-surrounding part being formed of a shape memory material with the tissue-constriction configuration corresponding to a memorized shape of the shape memory portion.

Abstract: Devices and methods for the repair of the functioning of heart valves are provided. A device may comprise a first section having a generally spiral shape and a second section connected to the first section. A method involves positioning the device such that chords associated with the heart valve are positioned within the path of the generally spiral shape of the first section and positioning the second section on an opposite side of the heart valve. The first section may be turned in a manner such that the chords move closer to the center of the first section. The first section draws the chords closer together, thereby pulling the valve leaflets closer together in order to facilitate their coaptation and proper closing.

Abstract: A surgical fastener applier is disclosed and includes a handle portion, a tubular member extending from the handle portion and defining a longitudinal axis, a drive member rotatably supported in the tubular member and in the handle portion, and a plurality of fasteners. The drive member is configured to rotate while in a deflected condition with respect to the longitudinal axis. The drive member includes a proximal portion, a central portion, and a distal portion, the central portion being relatively more flexible configuration as compared to at least one of the proximal portion and the distal portion. The plurality of fasteners is disposed within the tubular member and is configured to engage a portion of the drive member such that rotational motion of the drive member causes distal advancement of at least one fastener of the plurality of fasteners through the tubular member.

Abstract: A surgical instrument with a tissue-clamping end effector, where actuation of the instrument is locked out when the thickness of the tissue clamped in the end effector is not within a specified thickness range. The end effector may comprise a tissue thickness module that senses the thickness of the tissue clamped in the end effector. The surgical instrument also comprises a control circuit in communication with the tissue thickness module. The control circuit prevents actuation of a working portion of the end effector when the thickness of the tissue clamped in the end effector is not within the specified thickness range.

Abstract: An apparatus for delivering a closure element can include a splittable carrier tube and a splitter to split the tube. The carrier tube can have an outer surface retaining a closure element in a tubular configuration and can be split into radially-expandable flaps. A closure element can have a shape-memory body having a relaxed configuration with a planar-annular body defining a lumen with tines directed inwardly from the body. The clip can be held in a retaining configuration having a substantially asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile and a proximal end having the tines being longitudinally directed with a first tine being more distally oriented compared to a substantially opposite second tine being more proximal, and retracting to a deploying configuration having a tubular shape with a rectangular longitudinal cross-sectional profile with the first tine being even with the second tine when being delivered.

Abstract: A surgical endoscopic instrument with detachable end tool as a clamp is provided. The instrument comprises a clamp, removably connected by a coupling to an elongated shaft, this comprising two concentric tubes, which can rotate about each other, connected to a rotating element, that is attached to a housing, inside which a push-pull rod, driven by a handle, transmits the surgeon's commands, leading to the actuating of the end tool's jaws, as well as the clamp detachment/retrieving, from/to the elongated shaft, by operating the coupling, given by the rotation of the concentric tubes about each other, thus resulting in the detachment/attachment of clamp with its jaws blocked in its given position at the time of detachment.

Abstract: The present invention relates to a retraction system for laparoscopic surgery. According to one embodiment of the present invention, the retraction system includes: a retraction part for holding an object or tissue to be retracted; a retraction fiber control part for retracting the retraction part at the area to be retracted by means of a retraction fiber to fix the retraction part; and an abdominal wall fixer coupled to the retraction fiber control part, wherein the abdominal wall fixer is fixed to the abdominal wall. The retraction fiber control part includes: a retraction fiber control part body having a retraction hole through which the retraction fiber connected to the retraction part passes in the lower portion thereof; and a retraction fiber fixing part disposed outside the retraction fiber control part body so as to retract the retraction fiber or fix the retraction fiber such that the retraction fiber is immovable.

Abstract: A surgical device and method for the retracting, maneuvering, and re-positioning of tissue and/or a body organ during endoscopic and laparoscopic procedures. The surgical apparatus comprises at least one separable grasping device with a detachable head, and an exteriorly-operated handle mechanism, or puppet handle. The disclosed device enables a physician, using a plurality of lengths of sutures simultaneously connected to (a) stems of the exteriorly exposed puppet handle and (b) the detachable head, positioned at clasping points on the organ, to rearrange the orientation of tissue or the organ for better accessibility, analysis, and/or exposure to accompanying surgical instruments in situ. The method presented minimizes the number of bodily incisions required to perform surgery by means of endoscope or laparoscopic equipment.

Abstract: A surgical cutting tool including a first jaw and a second jaw operably associate with the first jaw such that the first jaw and the second jaw are movable relative to one another between an opened position and a closed position. A cutting member is movably attached to the first jaw so that the cutting member extends from the first jaw towards the second jaw, and an actuating mechanism is operably associated with the cutting member so as to cause the cutting member to move relative to the first jaw.

Abstract: The present disclosure relates to an apparatus for endoscopic application of surgical clips to body tissue. The apparatus includes a handle portion, an elongated tubular member, one or more surgical clips, a jaw assembly and a locking cam driver. The elongated tubular member extends distally from the handle portion and defines a longitudinal axis. The surgical clips are disposed within the tubular member. The locking cam driver includes a bifurcated distal end portion that has a pair of angled camming surfaces to facilitate closure of the jaw assembly.

Abstract: Described herein are devices, methods and kits for assessing and/or enhancing the accessibility of a subvalvular space of a heart, accessing the subvalvular space of the heart (e.g., to provide access for one or more other devices), and/or positioning one or more devices in the subvalvular space of the heart. The devices described herein may, for example, comprise catheters that may be used to manipulate one or more chordae tendineae, diagnostic catheters having different sizes and/or shapes (e.g., different curvatures), guide catheters having different sizes and/or shapes (e.g., different curvatures), and visualization catheters. In some variations, the devices, methods, and/or kits may be used to visualize a target site, such as a subannular groove of a heart valve. In certain variations, the devices, methods, and/or kits may be used to manipulate chordae tendineae to provide additional space in a ventricle of a heart (e.g., enhancing the accessibility of the ventricle).

Abstract: An instrument for use in a medical procedure that includes a proximal end, a distal end, a handle adjacent to the proximal end of the instrument, a flexible elongated neck extending distally from a distal end of the handle, a jaw power screw extending from a distal end of the neck, a pair of moveable jaws operatively connected to the jaw power screw, and a handle power screw assembly operatively connected to a proximal end of the flexible neck within the handle, wherein manipulation of the handle will control movement of the jaws.

Abstract: A repair technique utilizing an elastic loop that is inserted on each side of an annular tear or annular incision following discectomy. The loop is initially an opened linear strand with the open ends inserted on each side of the annular tear with guiding arms in curvilinear fashion. The ends are joined together in the substance of the annulus where the ends are locked under tension. The insertion device is then removed and the elastic loop, which has been under tension, will tighten causing the annular tear to pull together thereby diminishing or eliminating any gap. One or more annular elastic sutures can be used for each annular tear to insure proper closure. The insertion device has guiding arms that push the open ends of the annular suture loop through the substance of the annulus and then forces them together engaging a locking mechanism inside the substance of the annulus. This technique allows for relatively easy and quick repair of the annular defect or tear.

Abstract: A surgical instrument may include an end effector, an input drive shaft, a closure drive, and/or a firing drive. The end effector may comprise a jaw assembly including a first jaw member and a second jaw member. The end effector may comprise an I-beam member axially translated between a proximal position and a distal position within the end effector. In one embodiment, the input drive shaft may selectively engage the firing drive and/or the closure drive. In one configuration, the closure drive is threadedly engaged with the firing drive allowing the input drive shaft, during a firing stroke, to simultaneously move the closure drive and the firing drive until the closure drive is disengaged from the firing drive. On a reverse stroke, the closure drive may be reengaged with the firing drive.

Abstract: Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a tissue acquisition and fixation system is disclosed that includes an elongate shaft, a staple applying assembly having a proximal end coupled to the distal end of the elongate shaft and having first and second jaws, and a tissue acquisition member coupled to the staple applying assembly by a linkage mechanism. The linkage mechanism is configured to move the tissue acquisition member between a first position that is longitudinally offset and proximal to the staple applying assembly, and a second position that is longitudinally adjacent to the staple applying assembly.

Abstract: A method and device for controlling the compression of tissue include clamping tissue between a first clamping member and a second clamping member by driving at least one of the clamping members with an electric motor toward a predetermined tissue gap between the clamping members and, during the clamping, monitoring a parameter of the electric motor indicative of a clamping force exerted to the tissue by the clamping members. The method and device include, during the clamping, controlling the electric motor, based on the monitored parameter, to limit the clamping force to a predetermined maximum limit.

Abstract: Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a tissue acquisition and fixation system is disclosed including a stapling member having first and second jaws that are effective to apply at least one staple to tissue engaged between the jaws, a tissue acquisition member coupled to at least one of the first and second jaws, and a secondary tissue acquirer coupled to the tissue acquisition member. The secondary tissue acquirer is configured to engage tissue and maintain the tissue in position relative to the tissue acquisition member.

Abstract: A surgical clip applier is provided and includes a ratchet mechanism having a rack member connected to a drive channel such that axial translation of the drive channel results in axial translation of the rack member, the rack member defining a first set of teeth along a first side thereof and a second set of teeth along a second side thereof. The ratchet mechanism including a first pawl and a second pawl each tiltably supported in the housing and disposed on respective opposed sides of the rack member; and a buckling spring interposed between the first pawl and the second pawl and constrained in a slot formed in the rack member, wherein the buckling spring is dimensioned so as to bow in one of a proximal direction and a distal direction.

Abstract: An apparatus comprises an end effector, an elongate shaft, and a handle assembly. The end effector is operable to grasp tissue. The elongate shaft extends between the end effector and the handle assembly. The handle assembly comprises a body portion, a trigger, and a trigger return lever. The trigger is movable relative to the body portion from a home position to an actuated position, and is thereby operable to control the end effector to selectively grasp tissue. The trigger includes a cam feature. The trigger return lever is positioned to engage the cam feature of the trigger. The trigger return lever is configured to bias the trigger toward the home position during at least part of a range of motion of the trigger from the home position to the actuated position.

Abstract: A clip unit for ligating a biological body includes: a clip body having a pair of arm parts; and a fastening ring arranged in an outside of the clip body, and configured to fasten the arm parts, in which: the fastening ring includes a flap part configured to expand diametrically outward from the fastening ring, and a flap retaining unit configured to retaining an expansion extent of the flap part at a given extent.