Abstract: A surgical device is disclosed which includes a handle portion, a central body portion and a single use loading unit, or “SULU”. The SULU includes a proximal body portion, an intermediate pivot member and a tool assembly. The intermediate pivot member is pivotally secured to the proximal body portion about a first pivot axis and the tool assembly is pivotally secured to the intermediate pivot member about a second pivot axis which is orthogonal to the first pivot axis. The SULU includes a plurality of articulation links which are operably connected to the tool assembly by non-rigid links. The articulation links are adapted to releasably engage articulation links positioned in the central body portion. The body portion articulation links are connected to an articulation actuator which is supported for omni-directional movement to effect articulation of the tool assembly about the first and second axes.

Abstract: A multiple coil staple is provided which includes a backspan and a pair of spaced legs. The backspan includes one or more pockets configured to induce coiling of the legs of the staple. A multiple coil staple applier is also provided which includes a pusher having a distal face defining a staple engagement surface and one or more staple deforming pockets. Each staple deforming pocket is configured to induce coiling of the legs of a staple. The multiple coil staple and staple applier facilitate joining of tissues having wider ranges of thicknesses using a single size staple.

Abstract: A surgical instrument is disclosed. The surgical instrument includes a control unit and a staple cartridge including a transponder. The control unit is configured to transmit a first wireless signal to the transponder and to receive a second wireless signal from the transponder to determine one of a first electronic state and a second electronic state of the transponder based on the second wireless signal.

Abstract: According to an aspect of the present disclosure, a surgical instrument for operating on tissue is provided. The surgical instrument includes an end effector including a first tissue engaging member and a second tissue engaging member in juxtaposed relation to the first tissue engaging member; a gap determination element operatively associated with each of the first tissue engaging member and the second tissue engaging member for measuring a gap distance between the first tissue engaging member and the second tissue engaging member; and a tissue contact determining element operatively associated with a respective tissue contacting surface of at least one of the first tissue engaging member and the second tissue engaging member. The present disclosure also relates to methods of using the surgical instrument.

Abstract: A tissue closure apparatus having a collar, a pair of elastically deformable legs, and a flexible adjustment member is provided. The collar includes a collar wall defining a passage therethrough, along which are disposed a plurality of teeth extending outward into the passage. A pair of elastically deformable legs is connected to the collar, and each leg includes a lateral portion adjacent the collar and an engagement portion connected to the lateral portion. A flexible adjustment member is connected to the engagement portion of at least one of the elastically deformable legs. The flexible adjustment member is disposed within the passage of the collar and includes a plurality of teeth to engage the plurality of teeth of the collar.

Abstract: A surgical instrument with articulated jaw structure includes a frame and two jaws. The jaws have proximal portions that are mounted to each other for movement in a substantially parallel relation between a fully open position wherein the jaws are separated for receiving tissue therebetween and an approximated position wherein the jaws are closer together. Preferably, the jaws are in the fully open position when the distal portion of at least of the jaws is located in an extended position and are in the approximated position when the distal portion of the extended jaw or jaws is located in a retracted position. The surgical instrument may further include a detachable knife assembly and knife actuating mechanism.

Abstract: Described herein are endoscopic staplers used to apply one or more fasteners to body tissue. In one embodiment, a fastener-applying device, which is preferably a stapler, is passed transorally into the stomach and used to plicate stomach tissue by engaging tissue from inside of the stomach and drawing it inwardly. In the disclosed embodiments, the tissue is drawn inwardly into a vacuum chamber, causing sections of serosal tissue on the exterior of the stomach to be positioned facing one another. The disclosed staplers allow the opposed sections of tissue to be moved into contact with one another, and preferably deliver staples for maintaining contact between the tissue sections at least until serosal bonds form between them. Each of these steps may be performed wholly from the inside of the stomach and thus can eliminate the need for any surgical or laparoscopic intervention.

Abstract: A surgical instrument for applying a fastener to tissue. The fastener includes a male component including a base having a hole, a needle receivable in the hole, and a female component including a base and a recess for receiving the needle. The instrument includes a shaft, a first jaw pivotally mounted on the shaft including a receiver for holding the base one component, and a second jaw statically mounted on the shaft including a receiver for releasably holding the base the other component. The first jaw is moveable between an open position and a closed position. The first and/or second jaw includes a channel for slideably receiving a needle. The instrument includes a mechanism for moving the first jaw between the open and closed positions and an ejector for driving the needle through the hole in the male component, through tissue and into the recess of the female component.

Abstract: The present disclosure describes an anvil assembly for a circular stapling apparatus. The anvil assembly includes an anvil head configured to support an anvil plate thereon; a shaft extending from the anvil head and configured to selectively engage a connection member of the circular stapling apparatus; an anvil plate operatively connected to the anvil head, the anvil plate defining a plurality of staple forming pockets therein; and a wound treatment material disposed in each staple forming pocket of the anvil plate. The wound treatment material is at least one of an adhesive, a sealant, a hemostat and a medicament.

Abstract: Novel silver-triclosan salts are provided which have antimicrobial properties and may be used as pharmaceutical compositions or to treat articles such as medical devices, packaging materials, and textiles.

Abstract: Articles are provided having no orientation or a multi-directional orientation. Such articles may be in the form of films, ribbons, sheets, and/or tapes and may be utilized as buttresses with a surgical stapling apparatus or as reinforcing means for suture lines. The articles may be produced with etchings on at least a part of a surface of the article.

Abstract: Methods and devices are provided for performing gastrectomies and gastroplasties. In one embodiment, a method includes gaining access to a stomach of a patient through an opening formed in the patient's abdominal wall and an opening formed in the patient's vaginal wall. Tissue attached to the stomach can be tensioned using a surgical instrument inserted through one of the abdominal and vaginal openings and can be separated from the stomach to free the stomach fundus using a dissecting surgical instrument inserted through another opening, e.g., through one of the abdominal and vaginal openings. The fundus can be at least partially transected using a surgical stapler inserted through one of the abdominal and vaginal openings, thereby forming a stomach “sleeve.” In another embodiment, the method is modified to form another opening in the patient's abdominal wall instead of forming an opening in the vaginal wall.

Abstract: Methods and devices are provided for performing gastrectomies and gastroplasties. In one embodiment, a method includes gaining access to a stomach of a patient through an opening formed in the patient's abdominal wall and an opening formed in the patient's vaginal wall. Tissue attached to the stomach can be tensioned using a surgical instrument inserted through one of the abdominal and vaginal openings and can be separated from the stomach to free the stomach fundus using a dissecting surgical instrument inserted through another opening, e.g., through one of the abdominal and vaginal openings. The fundus can be at least partially transected using a surgical stapler inserted through one of the abdominal and vaginal openings, thereby forming a stomach “sleeve.” In another embodiment, the method is modified to form another opening in the patient's abdominal wall instead of forming an opening in the vaginal wall.

Abstract: A surgical instrument used in an endoscopic fundoplication is disclosed. The instrument may include an elongated tube having a proximal end and a distal end, a distal member coupled proximate the distal end of the tube and configured to fold a fundus of a stomach toward an esophageal wall, and a grasper configured to grasp at least a portion of the fundus or the esophageal wall. The grasper may be coupled to one of the elongated tube and the distal member.

Abstract: A surgical stapler including an anvil, a staple cartridge, and a buttress material removably retained to the anvil and/or staple cartridge. In various embodiments, the staple cartridge can include at least one staple removably stored therein which can, when deployed, or fired, therefrom, contact the buttress material and remove the buttress material from the anvil and/or staple cartridge. In at least one embodiment, the anvil can include at least one lip and/or groove configured to removably retain the buttress material to the anvil until deformable members extending from the surgical staple are bent by the anvil and are directed toward and contact the buttress material.

Abstract: A surgical stapler including a “breakaway” washer that is inserted into an anvil. The washer can include a circular inner portion and a circular outer portion. The outer portion may include a number of staple guide sections that define openings through which staple ends of surgical staples are driven when the surgical stapler is fired and are thereafter bent, or turned, by the anvil. The staple ends may then contact and be retained by the staple guide sections so that the staple ends do not re-penetrate or otherwise re-puncture stapled tissue. The washer can be dissolvable or bioabsorbable.

Abstract: A cutting and stapling device for use as an attachment to an electromechanical device driver comprises an upper jaw and a lower jaw which separate and close against one another in a continuously parallel alignment. The upper jaw includes a series of staple guides corresponding to one or more staples in a removable staple tray disposed within a lower jaw, whereby a blade and wedge having a threaded bore travel upon a matching threaded shaft in a channel disposed in the lower jaw below the staple tray, such that rotation of the threaded shaft causes movement of the wedge through the channel while a sloped surface of the wedge contacts the staples to push the staples against the staples guides, closing the staples.

Abstract: A catheter-based, annulus reduction device and system for cardiac valve repair and method of using the same. The system is usable for treating mitral valve regurgitation and comprises a catheter, a reduction ring carried within the catheter, the reduction ring including a plurality of exit ports formed in a side wall of the reduction ring and filament received in the reduction ring. The filament includes a plurality of radially extendible barbs corresponding to the sidewall openings. The reduction ring carrying the filament is deployed adjacent a mitral valve annulus and the filament is translated relative to the reduction ring to deploy the barbs through the exit ports and into the annulus and to further translate the reduction ring with deployed barbs to reshape the annulus.

Abstract: A surgical instrument particularly suited to endoscopic use articulates an end effector by including a laterally sliding member in a proximal portion of a shaft that pivots the end effector to a selected side. Differentially opposing actuating forces (e.g., hydraulic, fluidic, mechanical) act against the laterally sliding member without binding by incorporating guidance mechanisms between the laterally sliding member and a frame of the shaft.

Abstract: A staple having a backspan and a first and second leg extending distally from the backspan. Each of the first and second legs includes a bend zone dividing each leg into a traversing leg portion and a linear clenching leg portion. When formed through tissue, each of the clenching leg portions of the first and second legs are formed substantially parallel to the backspan. A staple assembly is also provided including a substantially box staple having a backspan and a first and a second leg extending distally from the backspan. The staple assembly includes a staple plate positionable over the first and second legs.

Abstract: Systems for anastomosing a first hollow tissue structure to a second hollow tissue structure are disclosed. In an exemplary embodiment, such a system comprises at least one tissue securing member adapted to secure the first and second hollow tissue structures together, and a device for applying the tissue securing member to the tissue structures. The tissue securing member is preferably configured to pass through only one of the tissue structures, and is movable from a first configuration to a second configuration which results in a compressive force being applied to the tissue structures. The systems are particularly useful for performing anastomosis of blood vessels in heart surgery.

Abstract: A surgical stapler having a selectively bendable end effector is provided. A staple holding jaw of the end effector is coupled to another jaw for grasping tissue to be stapled. The stapler can adapted to drive staples into tissue having a pattern conforming with the selected shape of the end effector. In particular, the end effector can be adapted to drive staples in a linear pattern when the end effector orients staples in a substantially linear configuration. The end effector can also be adapted to drive staples in a non linear pattern when the end effector orients staples in a non linear configuration. Methods of stapling tissue with a stapler having a bendable end effector are also discussed.

Abstract: A gasket for use with a surgical stapling apparatus is disclosed. The gasket comprises a diisocyanate end-capped poly(ether ester). The diisocyanate is selected from the following: aromatic, aliphatic and acyclic isocyanates. The poly(ether ester) can further comprise at least one polyol and at least one poly acid. The gasket is desirably bioabsorbable.

Abstract: The surgical stapling apparatus includes a handle assembly, an elongated body extending distally from the handle assembly, and an articulation mechanism for articulating a tool assembly. The articulation mechanism includes a first gear rotatably mounted on a transmission shaft and configured to engage a second gear, a clutch interconnecting the second gear and a main shaft; and a yoke shaft coupled to the main shaft and adapted to linearly advance a J-channel, the J-channel operatively connected to an articulation link. A motor assembly may rotate the transmission shaft of the articulation mechanism. Alternatively, the articulation mechanism may include an articulation knob. Users may manually rotate the articulation knob to articulate the tool assembly of the surgical stapling apparatus.

Abstract: A tacker for applying a rotary tack, including a drive shaft coupled to a trigger, wherein operating the trigger causes rotation of the drive shaft, a magazine that holds a rotary tack rotatingly connected to the drive shaft, and an articulated applicator arm including a rotatable output shaft rotatingly connected to the magazine, wherein the magazine is proximal to the articulated applicator arm, the articulated applicator arm including one or more pivoting links, each pivoting link including a link shaft, wherein operation of the trigger causes the driver shaft and the one or more link shafts to rotate so as to distally advance the rotary tack from the magazine past the one or more pivoting links.

Abstract: An articulating surgical instrument is provided including a handle, an articulating portion extending distally of the handle and an end effector positioned on a distal end of the articulating portion. A flexible drive band is provided for movement through the articulating portion and end effector. The flexible drive band includes a first portion having a first height and the second portion having a second height greater than the first height. The difference in heights being sufficient to eject staples from a body portion of the end effector into an anvil member of the end effector. An actuation mechanism is provided for drawing the flexible drive band through the articulating surgical instrument.

Abstract: A fluidthight surgical staple for a surgical stapling device comprises a deformable back that comprises two parts that are hinged with respect to each other and at least four rows of anchoring pins. The back remains substantially flat when the staple is in place, so that it does not protrude from the wall of the organ; when the back is in the open position, the axes of the pins of the two central rows tend to align parallel to each other and the tips of the pins are separated by a gap larger than in the closed position. At least a second row of converging second anchoring pins is placed towards the outer side of each hinged part of the back. The staple is provided with gripping points for keeping the staple in open or closed position.

Abstract: A staple having an expandable backspan and a pair of spaced legs is described. The expandable backspan is configured to expand or deform to accommodate tissues of varying thicknesses. In one embodiment, the backspan is non-linear and defines a recess. In another embodiment, the backspan includes a deformable pad or spacer. The amount of deformation of the backspan is proportional to the thickness of the tissue, i.e., the greater the thickness of tissue, the greater the deformation of the backspan.

Abstract: The present disclosure relates to surgical instruments including a staple anvil formed in a distal end of the surgical stapler and a staple cartridge selectively receivable in a distal end of the surgical stapler and in juxtaposition relative to the staple anvil, the staple cartridge including one or more laterally spaced apart rows of staple slots formed in an upper surface thereof, a plurality of surgical staples disposed, one each, within the staple slots, and a staple line reinforcing system configured and adapted to augment the strength of the staple line formed by the firing of the surgical staples into body tissue, wherein the surgical stapler concomitantly drives the plurality of surgical staples through the adjacent layers of body tissue to mechanically secure the body tissue and activates the reinforcing system to non-mechanically secure the adjacent layers of body tissue to one another.

Abstract: A surgical instrument including a frame, an elongate portion, a drive beam and an end effector is disclosed. The elongate portion extends distally from the frame. The drive beam is disposed at least partially within the elongate portion and is translatable with respect to the elongate portion. The end effector is disposed adjacent a distal end of the elongate portion and includes first and second jaw members. The first jaw member is movable with respect to the second jaw member. The first jaw member includes a proximal camming surface and a distal camming surface thereon. A surgical fastener cartridge is disposed in the first jaw member. an actuation portion of the drive beam has an upper member arranged to contact the distal camming surface causing approximation of the jaw members. Proximal translation of the drive beam causes the actuation portion of the drive beam to contact the proximal camming surface effecting opening of the jaw members.

Abstract: A closure device for an arteriotomy includes an elongate tube having a distal opening, a staple disposed within the tube, and a frangible cap mounted across the distal opening to guard the staple tips against contact with the tissue track. The frangible cap is pierced, fractured or torn when the staple is advanced through the distal opening. A portion of the torn frangible cap may be implanted with the staple as a pledget. The staple may be carried within the elongate tube by a stapler comprising an elongate hollow shaft and an elongate driver slidably disposed therein. A pair of opposing actuation tips is disposed at a distal end of the hollow shaft to define an open-sided staple chamber there between. An anvil is fixedly disposed within the staple chamber, which holds at least a proximal portion of the staple.

Abstract: A biomaterial for suturing comprising a physiologically compatible support material coated with a cellular population with proliferative and/or differentiation capacity, characteristics which facilitate the regeneration of the sutured tissue. This biomaterial for suturing not only brings together the two edges of an open wound, but also contributes actively to the healing process, thereby accelerating the tissue repair process. Also disclosed are methods for making the biomaterial and methods for using the biomaterials in therapy.

Abstract: A system for tissue apposition includes a delivery assembly having a tissue clip selectively secured thereto for the deployment and application of the tissue clip. The tissue clip is shaped and dimensioned for engaging spaced locations along a span of tissue and upon rotation thereof drawing the spaced locations together into apposition to thereby create a fold of tissue.

Abstract: A repair system including a closure prosthesis and deployment device, and associated methods for repairing any imperfection including a flaw, hole, tear, bulge, or, in some cases, a deliberate cut or incision in any tissue including an intervertebral disc is disclosed. The prosthesis has first and second side portions with a connecting central portion, and is designed to span an imperfection with opposite ends positioned on opposite sides of the imperfection or the same side of the imperfection. The prosthesis may include anchoring features including barbs and/or members that extend transversely or at different angles. The deployment device can include a cannula for positioning the prosthesis near the imperfection, and, in some cases, a mechanism that may cause the two sides of the prosthesis to be deployed in a specific order.

Abstract: A dermal punch for extracting skin or tissue samples. The dermal punch has a blade having a pair of walls. Each wall is convex and opens towards each other. The walls are connected to each other at a pair of mating edges. Each wall has a cutting edge. In a preferred embodiment, the ratio of the minor axis to the major axis of the opening created by the walls is between 1 to 3 and 1 to 4, wherein the major axis extends through the mating edges. The cutting edge is formed of a plurality of teeth and the teeth have a sawtooth shape. The cutting edge has a projecting edge for each wall, and the projecting edge is concave. The cutting length is greater than twice the length of the projecting edge.

Abstract: A stapling system includes a tissue staple, a mandrel, and a pusher. The staple includes a crown at the proximal end and a plurality of prongs extending distally therefrom about a central axis of the staple. Each prong of the staple includes a tab extending towards the central axis. The mandrel receives the staple along an outer surface thereof. The mandrel includes a proximal groove adapted to receive the tab of the corresponding prong. The proximal groove includes a ramp from a proximal portion of the proximal groove to a distal portion of the proximal groove. The mandrel further includes a distal groove adapted to receive the tabs of the prongs and a distal anvil disposed distally of the distal groove. The pusher is disposed around the mandrel abutting and proximal to crown of the staple.

Abstract: A stapling system for closing an arteriotomy includes a staple having four legs and a stapler that accommodates a non-orthogonal angle formed between a percutaneous tissue track and an arteriotomy. The staple is formed from a resilient material and is biased towards a static configuration in which a proximal portion of the staple is generally orthogonal to an imaginary axis of the stapling system. The stapler deforms the staple into a delivery configuration in which the pointed tips of the staple are staggered with respect to the axis of the stapling system. Once the staple is engaged in vessel tissue as desired about the arteriotomy, the staple is released from the stapler and tends to revert back to the static configuration in order to hold the arteriotomy closed. Methods of using the stapling system are also disclosed.

Abstract: A material-fastening device and related fastener and methods for use, and more particularly, a device with segments of the fastener capable of being independently attached to different sides of a gap in the material.

Abstract: A medical device for closing an opening in tissue may include a staple including a plurality of tines, where the staple is deformable from an initial configuration to a splayed configuration and then a closed configuration and a shuttle fixed to the staple, where the shuttle includes a weakened area proximal to the shuttle. A method for closing an opening in tissue of a patient with that medical device may include moving the staple to a location in proximity to the opening; plastically deforming the staple to a splayed configuration; penetrating at least one of the tines into tissue in proximity to the opening; plastically deforming the staple to a closed configuration; and fracturing said shuttle at the weakened area, whereby the staple and a fragment of the shuttle fixed to the staple remain in the patient.

Abstract: A tissue staple that includes a pair of legs arranged generally parallel to one another connected by a pair of tabs. The tabs define an arc that extends distally from the proximal ends of the legs, and further define a slot between the tabs. The distal end of the leg may include a forked portion that defines two or more tissue piercing prongs. The location of the fork also may define a tissue stop. The legs may also include an indent that bends inwardly toward an indent formed on the other leg.

Abstract: A surgical device is disclosed which includes a handle portion, a central body portion and a SULU. The SULU includes a proximal body portion, an intermediate pivot member and a tool assembly. The intermediate pivot member is pivotally secured to the proximal body portion about a first pivot axis and the tool assembly is pivotally secured to the intermediate pivot member about a second pivot axis which is orthogonal to the first pivot axis. The SULU includes a plurality of articulation links which are operably connected to the tool assembly by non-rigid links. The articulation links are adapted to releasably engage articulation links positioned in the central body portion. The body portion articulation links are connected to an articulation actuator which is supported for omni-directional movement to effect articulation of the tool assembly about the first and second axes.

Abstract: Devices and methods for closing an arteriotomy include a percutaneously placeable central tube deployable about the arteriotomy by which an array of radially expandable fingers having suction ports can be engaged with the surface of tissue about the arteriotomy enabling the fingers to grip the tissue without piercing it. A delivery tube can advance a closure element along the outside surface of the central tube, thereby radially contracting the fingers and puckering the gripped tissue to approximate the edges of the arteriotomy. The closure element is further advanced until it is forced off of the distal tips of the fingers such that the closure element surrounds the puckered tissue and secures permanent closure of the arteriotomy.

Abstract: A tissue fastener includes a bridge section and two cannulated leg sections. The tissue fastener is a single piece of material, and the material can be a bioabsorbable material. Each of the two leg sections can include at least one barb for resisting dislodgement from tissue after the fastener is inserted into tissue. The bridge can be flexible, and the leg sections can receive needles to allow insertion of the fastener into tissue from above a surface of the tissue. Various insertion devices and mechanisms are possible to deploy the fastener into a wound in a patient's skin from above the surface of and generally perpendicular to the skin.

Abstract: Methods and devices are provided for reconfiguring a tissue within a hollow body organ using an entirely endoscopic approach in order to effectively reduce flow of fluid contents into a second hollow body organ in fluid communication with the first.

Abstract: Methods, systems, and apparatuses for nanomaterial-enhanced hemostatic medical devices are provided. Hemostatic materials and structures are provided that induce coagulation of blood at a wound/opening caused by trauma, a surgical procedure, ulceration, or other cause. The hemostatic materials and structures may incorporate nanostructures and/or further hemostatic elements such as polymers and/or glass beads. The hemostatic materials and structures may be resorbable. Example embodiments include hemostatic bandages, hemostatic plugs, and hemostatic formulations.

Abstract: A surgical stapling device particularly suited for endoscopic procedures is described. The device includes a handle assembly and an elongated body extending distally from the handle assembly. The distal end of the elongated body is adapted to engage a disposable loading unit. A control rod having a proximal end operatively connected to the handle assembly includes a distal end extending through the elongated body. A control rod locking member is provided to prevent movement of the control rod until the disposable loading unit is fully secured to the elongated body of the stapling device.

Abstract: An antimicrobial coating is provided for use on textiles, medical devices, packaging materials, and the like. The antimicrobial coating includes a halogenated furanone.

Abstract: A surgical staple for approximating tissue margins. The staple comprises a male portion which includes a first body, a first attachment portion, a male arm and a projection and a female portion separate from the male portion which includes a second attachment portion and a second body arranged to form an opening therein. The projection and the opening are configured to engage with each other and close a wound opening. The staple can be engaged to hold the tissue at varying tensions.

Abstract: A surgical fastener apparatus is provided with a reinforcement material holder, where the holder positions a sheet of reinforcement material adjacent body tissue that is sutured by a plurality of surgical staples dispensed by the apparatus.

Abstract: A drive mechanism for use with a surgical instrument includes a rotatable drive member, a crank operatively coupled to the drive member; a clutch operatively coupled to the crank, wherein rotational motion of the drive member causes oscillating movement of the clutch; and a gear rotatably coupled to the clutch, wherein the oscillating movement of the clutch causes rotation of the gear. The drive mechanism may further include a gear configured to engage a linear member. The crank may include a pin extending distally therefrom. The clutch may include a slot dimensioned and configured to receive a pin of the crank.