Abstract: The present invention concerns a flexible stapling device (1). More particularly, this invention concerns a flexible endovascular stapling device (1) for an intavascular procedure such as patent foramen ovale closure, which is designed to avoid open heart surgery by permitting the closure of the defect utilizing a stapling means (26) which is positioned by using a flexible shaft/guidewire system.

Abstract: The present disclosure provides absorbable surgical fasteners.

Abstract: A method of, and device for, slowing the passage of food through a digestive tract of a patient and thereby treating obesity. The device is an obesity tube comprising (A) an upper ring of a size corresponding to a point under a patient's esophagus and above the patient's diaphragm muscle, and (B) a lower tube having a length and a distal opening. The method comprises stapling the upper ring under the patient's esophagus, above the patient's diaphragm muscle, and placing the lower tube distal to the upper ring. The length of the lower tube depends on whether the tube is to terminate distally in the stomach or terminate past the pylorus, in which case a section can be provided which is thick enough to resist collapsing under pylorus pressure. The lower tube can be entirely or partially non-permeable or semi-permeable. Semi-permeable tubes or sections thereof have walls which permit the passage of gastric hydrochloric acid but not food.

Abstract: This disclosure relates to surgical stapling apparatus for enhancing one or more properties of body tissue that is or is to be repaired or joined. The apparatus includes a staple anvil, a staple cartridge, a driving member for driving the surgical staples from individual staple slots in the staple cartridge and against the staple anvil, and a wound closure material applicator assembly. The applicator assembly includes at least one conduit extending along at least a length of the driving member, anvil and/or cartridge and at least one reservoir in fluid communication with the at least one conduit, the reservoir containing a wound closure material therein. The staples can be coated with a wound closure material.

Abstract: A surgical instrument for use in connection with a pneumatically powered tool having a firing mechanism operably supported therein that is movable between an unactuated position and an actuated position. In various embodiments, a drive system is supported by at least one of a handle assembly and an elongate shaft assembly and is configured to selectively apply a firing motion to the firing mechanism of the pneumatically powered tool to cause the firing mechanism to move from the unactuated position to the actuated position in response to a flow of gas from a source of gas fluidically coupled to the drive system. A travel monitoring member is operably supported by the handle assembly and is linked to the drive system to provide an indication of progress of the firing mechanism of the pneumatically powered tool as the firing mechanism moves from the unactuated position to the actuated position.

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: To close a translumenal hole made in the stomach (or colon, etc.) pursuant to natural orifice surgical treatment of tissue in the peritoneal cavity, one or more guides are engaged with the hole, and the guides can be pulled to purse together tissue on opposite sides of the hole. A closure device is then advanced along the guides over the pursed tissue to adhere the tissue together using heat, staples, sutures, etc.

Abstract: A method for surgically stapling tissue may include providing staples in a first configuration, plastically deforming at least one staple to a second configuration different from the first configuration; and then plastically deforming at least one staple to a third configuration different from the first configuration and the second configuration. The deformation of a staple from the first configuration to the second configuration may be performed by splaying the staple. The staple may be splayed by a splay arm or other suitable structure or mechanism.

Abstract: Apparatus and methods are provided for use in sealing a vascular puncture site. The invention comprises an integrated vascular device having a sheath with a closure component and puncture sealant. The closure component is disposed on and advanceable over the exterior of the sheath and may comprise any of a variety of apparatus suited for closing a vascular puncture. Once the closure component has been actuated to close the puncture, sealant is introduced to seal the puncture. The sheath and closure component are then removed from the patient.

Abstract: A surgical instrument for creating an anastomosis includes a housing, a handle extending from the housing and a fastener support member extending distally from the housing. The fastener support member is configured and dimensioned to releasably support a plurality of surgical fasteners. The instrument further includes a tissue retaining mechanism which is selectively movable from a first position relative to the fastener support member to a second position in closer proximity with the fastener support member such that tissue disposed adjacent to the fastener support member is retained thereagainst. Upon actuation of the handle, a fastener firing mechanism simultaneously deforms the plurality of surgical fasteners to complete the anastomosis.

Abstract: The kit (1) comprises a needle (3) for placing the fixing element (2), and the fixing element (2) comprises at least one stop part (5) and a threaded deformable part (7) joined to said stop part (5).

Abstract: Fastening devices are provided that are designed to effectively close tissue as well as instruments for applying the inventive fastening devices. The devices are useful for closing tissue such as mucosa in the oral cavity, oropharynx, hypopharynx, laryngeal surfaces, oronasopharynx, or other mucosal tissues. In particular, uvulopalatopharyngoplasty (UPPP), uvulopalatal flap (UPF) technique, and tonsillectomy can be assisted using the inventive system. Embodiments also provide methods of using the fastening devices and/or instruments, and kits including the fastening devices.

Abstract: A medical device includes a surgical end effector, an end effector control handle, and a control shaft having a longitudinal axis and a handle portion connecting the control shaft to the control handle rotatably about the longitudinal axis. A passive articulation joint connects the end effector to the control shaft. An articulation joint release unlocks the articulation joint when actuated and locks the articulation joint when unactuated. An end effector control device is rotationally fixedly connected to at least a portion of the control shaft to correspondingly rotate the control shaft about the longitudinal axis when the control device is rotated and is longitudinally connected to the joint release to selectively unlock the articulation joint when actuated.

Abstract: A needle biopsy system for marking a sampling site is described.

Abstract: In a method of stapling layers of tissue within a body cavity, an engaging instrument is passed between a stapler cartridge and anvil and used to engage a region of tissue. The engaging instrument is retracted to move the engaged tissue into the stapling position, and driving staples from the cartridge through at least two layers of the engaged tissue. The method and associated system may be used to form plications in body tissue, such as stomach wall tissue. Staples simultaneously driven through tissue may simultaneously capture a reinforcing elements positioned adjacent the cartridge and/or anvil prior to stapling.

Abstract: Surgical coils for marking, anchoring, stapling and suturing that can be implanted in the body by deforming it to a small cross section profile and then sliding it through a low profile delivery device then deploying from an embodiment of a delivery device at a targeted site. Embodiments of surgical coils when deployed revert back to a coiled configuration and circle tissue at the target site. Can be deployed about attachment members, such as suture lines, marker lines and the like for anchoring same.

Abstract: Methods and devices are provided for actuating and/or articulating a circular stapler. In one exemplary embodiment, a circular stapler is provided having an elongate shaft with a stapling apparatus coupled thereto. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to pivotally or angularly adjust a position of the stapling apparatus relative to the elongate shaft by delivering energy to the electroactive polymer actuator. In another embodiment, an electroactive polymer actuator can be used to actuate the stapling apparatus, thereby driving one or more staples, preferably in a substantially curved pattern, into tissue. The actuator can alternatively or additionally drive a blade distally to cut tissue being stapled.

Abstract: Methods and devices are provided for effecting movement of one or more components of a multifire device, such as a clip applier, hernia tacker, or skin stapler. In one exemplary embodiment, a surgical fastening instrument is provided having an elongate shaft with an end effector coupled thereto and adapted to apply one or more surgical fasteners to tissue. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to drive a fastener advancing or forming assembly through the elongate shaft, thereby driving a surgical fastener into tissue. In another embodiment, an electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to effect movement of an articulation joint formed between the elongate shaft and the end effector.

Abstract: Methods and devices are provided for actuating and/or articulating a surgical stapler. In one embodiment, a surgical stapler is provided having a stapling mechanism or end effector that is movably coupled to a distal end of an elongate shaft. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to pivotally or angularly adjust a position of the stapling mechanism relative to the elongate shaft by delivering energy to the electroactive polymer actuator. In another embodiment, an electroactive polymer actuator can be used to actuate the staple applying assembly, thereby driving one or more staples, and preferably at least two linear rows of staples, into tissue. The actuator can alternatively or additionally drive a blade distally to cut tissue being stapled.

Abstract: A device for reducing the volume of a hollow body organ includes a tissue port and a plurality of fasteners. The fasteners may be coupled to a flexible filament, such as a suture, which is tensioned to constrict the hollow body organ to achieve volume reduction.

Abstract: Methods and devices are provided for actuating and/or articulating a surgical stapler. In one embodiment, a surgical stapler is provided having a stapling mechanism or end effector that is movably coupled to a distal end of an elongate shaft. An electrically expandable and contractible actuator, such as an electroactive polymer actuator, can be used to pivotally or angularly adjust a position of the stapling mechanism relative to the elongate shaft by delivering energy to the electroactive polymer actuator. In another embodiment, an electroactive polymer actuator can be used to actuate the staple applying assembly, thereby driving one or more staples, and preferably at least two linear rows of staples, into tissue. The actuator can alternatively or additionally drive a blade distally to cut tissue being stapled.

Abstract: A medical device includes a control handle, an end effector, and a passive articulating joint connecting the end effector to the handle. The handle has a stapling actuator, an articulation joint actuator different from the stapling actuator, and a body through which the stapling and articulation joint actuators traverse. The end effector has an anvil, a stapler cartridge with staples, and an anvil-cartridge control device connected thereto and to the stapling actuator and staples when the stapling actuator is actuated. The stapling actuator passes through the articulating joint and flexes correspondingly to articulation of the articulating joint. The articulation joint actuator, when unactuated, holds the articulation joint and, thereby, the end effector, in a substantially fixed articulation position, and, when actuated, releases the articulation joint into its freely articulating state to permit free articulation of the end effector dependent upon external forces acting upon the end effector.

Abstract: A closure device for an arteriotomy includes an elongate hollow shaft and an elongate driver slidably disposed therein. The elongate hollow shaft includes a pair of a pair of opposing actuation tips disposed at a distal end thereof defining a staple chamber there between. An anvil extends into the staple chamber from one of the actuation tips. The closure device includes a release mechanism for spreading apart the pair of opposing actuation tips to provide a gap associated with the anvil, the gap dimensioned such that the staple may pass there through. A method of using the closure device is also disclosed.

Abstract: A dual staple disposable surgical gun, wherein the gun fires two staples in a staggered formation simultaneously to close an incision in the skin to prevent the skin overlapping. The dual staple disposable surgical gun comprises a frame structure, adapted to be held by a hand with a grip having a handle. A first staple track and a second staple track each with an advancing blade and a spring mechanism is incorporated to aid in the injection of the staples. A translatable driver manually actuates both staple tracks to eject a single pair of staples simultaneously when the dual staple disposable surgical gun is squeezed. The dual staple disposable surgical gun additionally includes a biasing means for returning the translatable driver from a staple ejecting position to a staple reloading position.

Abstract: A compression-self-adjusting staple includes a substantially U-shaped staple body and a compression device. The staple body has a bridge and two legs extending from the bridge at an angle thereto. Each of the legs has a base end integral with the bridge and a deformable distal end defining a stapling point shaped to pierce material to be stapled. The compression device is at least partly disposed between the legs and has a bias portion with a compression surface movably disposed between the legs and a compression resistor connected to the bridge and to the compression surface and formed to resist movement of the compression surface towards the bridge with a force.

Abstract: A circular stapling device particularly suited for surgical treatment of internal hemorrhoids is provided. The stapling device includes a distal head portion having an anvil and a shell assembly. A tissue tensioner device including a tissue engagement member is movably positioned between the anvil and the shell assembly and is operable via a tensioner trigger to position tissue within a bore defined within the shell assembly.

Abstract: An endovascular stapler for securing an endograft to a vessel is disclosed. The stapler includes a staple housing adapted for storing at least one staple therein. The staple housing having an exit area for discharge of the at least one staple therethrough. The stapler also includes an actuating assembly adapted for discharging the at least one staple through the exit area and a displacement mechanism in operative association with the staple housing near the exit area. The displacement member is operative for pushing the exit area against the endograft when discharging the at least one staple therethrough. The displacement mechanism may comprise a balloon adapted to be inflated and deflated positioned near the exit area. The unbent staples may be shaped as elongate W shapes, or may alternatively be straight wire segments. The staples may be bent upon discharge.

Abstract: The present disclosure relates to support structures for surgical staplers comprising at least on hydrophilic polymer and methods for preparing such structures.

Abstract: Provided herein are implantable or insertable biomedical devices comprising a substrate and a collagen inhibitor on or in said substrate, and methods of treatment using the same. In some embodiments, the device is a urethral, ureteral, or nephroureteral catheter or stent. In some embodiments, the device is an absorbable esophageal or tracheal stent. Wound closure devices are also provided herein, including a substrate and a collagen inhibitor on or in the substrate. Also provided are surgical packings, including a substrate and a collagen inhibitor on or in the substrate. A barrier material for preventing adhesions in a subject is further provided, including a preformed or in situ formable barrier substrate and a collagen inhibitor on or in the substrate. Kits comprising the coated substrates are also provided.

Abstract: An apparatus and method for reducing post-operative ileus and/or gastric stasis is described. The method can include applying to the intestine a therapeutically effective amount of a composition comprising a drug that is effective in reducing post-operative ileus and/or gastric stasis, such as by introducing the composition through a surgical access device, such as a trocar or endoscope. The apparatus can include a surgical fastener and a buttress comprising the composition.

Abstract: A disposable loading unit. The disposable loading unit includes a housing assembly, a knife assembly connected to the housing assembly, and an agent cartridge connected to the housing assembly. The agent cartridge houses a medical agent. The disposable loading unit is configured to deliver the medical agent proximate a cutting surface of the knife assembly.

Abstract: A staple having a crown, a deformable leg extending from the crown, and a spring extending from the crown configured to compress tissue between the spring and the deformable member. Owing to the flexibility of the spring, the staple can accommodate a wide range of tissue thicknesses while still compressing the tissue captured therein. As a result, a single staple design can be used in a wide variety of surgical procedures thereby reducing the amount of staple designs that must be provided to the surgeon. In at least one embodiment, the staple includes a crushable member. This crushable member can include a plastically deformable first portion and an elastically deformable second portion. The present invention can also include, in various embodiments, a crown, a first deformable member extending from the crown, and means for compressing the tissue against the first deformable member.

Abstract: A surgical staple including at least one deformable member which can be bent upon contacting an anvil of a surgical stapler. In various embodiments, at least a portion of the deformable member can include a non-circular cross-section which can dictate the direction and manner in which the deformable member is bent. In at least one various embodiment, the non-circular cross-section can include a flat portion which can cause the deformable member to bend in the direction of the flat portion. In various embodiments, the non-circular portion of the cross-section can be configured to abut soft tissue of a patient and apply a compressive force or pressure thereto. In various embodiments, a crown formed on the surgical staple can dissolve as the soft tissue heals and can, depending on the cross-sectional geometry of the deformable member, reduce the force or pressure applied to the soft tissue by the deformable member.

Abstract: An electrosurgical stapling instrument includes an end effector capable of applying bipolar RF energy into tissue. The end effector has a first pole electrode and a second pole electrode for forming an RF contact circuit with tissue. At least one of the electrodes may have a dielectric coating thereon to create a RF circuit with tissue. The dielectric coating can cover one of the electrodes to create a capacitive coupling circuit with tissue, or can have at least one open passageway extending through the dielectric coating to enable tissue contact with the electrode and the passage of RF energy therethrough. The dielectric coating on the electrode can be masked to create passageways through the dielectric, or the dielectric coating can be locally removed with a variety of techniques to form passageways. The dielectric coating may provide a barrier to prevent shorting between the dielectrically coated electrode and a conductive fastener embedded within tissue.

Abstract: Systems, including apparatus and methods, for repairing injured connective tissue. These systems may include, among others, a surgical stapler and staples for repairing partially or completely severed tendons and/or ligaments.

Abstract: A surgical staple is disclosed and can include a base and at least one tine that can extend from the base. The at least one tine includes an enlarged portion to provide a greater surface area to engage tissue when installed in a patient.

Abstract: A surgical staple is disclosed and can include a base and at least one tine that can extend from the base. Further, at least one tissue engagement structure can be incorporated into the at least one tine. The at least one tissue engagement structure can be moved between a retracted configuration and an extended configuration.

Abstract: The present disclosure is directed to staple-gap adjustment members for use in surgical stapling apparatus and methods. A gap adjustment member includes one or more bearing portions sharing a common rotational axis and one or more cam surface portions having a periphery with at least two different points along the periphery, with each point along the periphery having a different radius from the rotational axis. The one or more cam surface portions can have a central axis parallel to and spaced a distance from the rotational axis of the one or more bearing portions.

Abstract: A device is provided for piercing a graft and artery wall in order to retain the graft on the artery. The device has a central section with an abutment surface for contacting the inner wall of the graft and two elongate members with distal ends for contacting the outer wall of the artery when the device is pierced through the graft and artery. The elongate members are biased so as to urge the abutment surface into the graft and retain the graft on the artery.

Abstract: A multi-nail hemorrhage occluder pin is disclosed for effectively securing to the presacral bleeding defect to stop the bleeding during a proctectomy by means of the application of a metal hemorrhage occluder pin applicator. The multi-nail hemorrhage occluder pin has a head, and nails respectively formed of a series of barbed portions and perpendicularly extended from one side of the head for holding a bone or spongiahaemostic. The metal hemorrhage occluder pin applicator has a holder block with a recessed portion for receiving the multi-nail hemorrhage occluder pin for installation.

Abstract: The present disclosure relates generally to devices, systems, and methods for use with tissue, more particularly the present disclosure relates to a device including a frame with a surface defining a pinch point region with a predefined shape. The device also includes a tab with an opening defining an anchor attachment on the frame. The frame can elastically deform under a stress to alter the predefined shape of the pinch point region.

Abstract: An anastomosis tool may include a connector holder connected to an anvil. The connector holder may be bifurcated and configured to straddle the graft vessel. The connector holder may be generally U-shaped. The connector holder may be shaped to extend around more than half of the circumference of the graft vessel.

Abstract: A surgical staple assembly is disclosed and can include a surgical staple. The surgical staple assembly can be moved between a first configuration and a second configuration. In the first configuration, the surgical staple can be in an original shape. Moreover, in the second configuration, the surgical staple can be in a deformed configuration.

Abstract: A surgical device 20 for attaching staples 40 to a portion of a body comprising an anvil 23; a smart memory material (SMM) 50, 75 capable of going from one physical state to another physical state; a supply of staples in communication with the smart memory material and placed near the anvil; and an activating apparatus 21 which is in communication with the smart memory material and which can cause the change in the physical state of the smart memory material, which change in state causes the movement of the staples against the anvil thereby securing the staples 40 to the desired body portion. The device utilizes a source of electricity which when activated causes the SMM to expand in volume thereby moving an individual staple from the supply of staples. The device may also contain a surgical knife 62 to cut a body portion wherein a SMM is in communication with the knife whereby when the SMM expands it engages the knife causing the knife to cut the desired body portion.

Abstract: An anastomosis system for connecting a graft vessel to a target vessel includes an elongated anvil arm for insertion into the target vessel. The anvil arm includes a contact surface that contacts the inner surface of the wall of the target vessel. The anvil arm includes a channel through which a cutting element translates, and a opening that extends between the channel and the contact surface of the anvil arm. The cutting element is translated along the channel, and is controlled to extend through the opening and make an incision in the wall of the target vessel at a selected location. The incision is made at a location spaced apart from the penetration site at which the anvil arm is inserted into the target vessel, resulting in a tissue bridge between the incision and the penetration site.

Abstract: A self-closing tissue fastener for use in wound closure and surgery has, in an annular configuration, a central ring; tissue-piercing spines projecting from a first side of the ring; and stabilizing members projecting from a second side of the ring. The fastener can be carried on the inside of a tube, where it is stable without additional restraint, as well as on the outside of a tube or mandrel. The device can be compressed from a planar state, as fabricated, to the annular state by compressing the stabilizers (or, if they are on the outside in the planar form, the barbs). Unlike present devices, which are not as stable in the annular state, the inventive device and an applicator therefore provide an open channel to a site of surgery, for passage of endoscopes or various endoscopic and similar instruments. In particular, the fastener can be delivered under endoscopic monitoring.

Abstract: A barbed staple having a therapeutic agent.

Abstract: An anastomosis staple has a base from which multiple deformable tines extend. At least one tine may be offset from at least one other tine. The tines are moveable from a first configuration to a second configuration. The staple optionally includes at least one alignment guide.

Abstract: A surgical instrument (e.g., endocutter, grasper, cutter, staplers, clip applier, access device, drug/gene therapy delivery device, and energy device using ultrasound, RF, laser, etc.) may benefit from having a plurality of hydraulically actuated subsystems (e.g., severing, stapling, articulation, locking/unlocking, lockout enabling/disabling, grasping, etc.) supplied with hydraulic power from a trigger actuated rotary pump (e.g., lobe pump, rotary gear pump, internal rotating gear pump, flexible vane rotor pump, rotary vane pump). Thereby, an available amount of mechanical advantage available at a firing trigger may be optimally distributed to various end effector components, perhaps sequenced by an electroactive polymer or piezoelelectrically actuated function switch block.

Abstract: A surgical stapling apparatus includes a staple anvil and a staple cartridge having a working surface, one or more rows of individual staple slots formed in the working surface, a knife track formed along a length of the working surface, and a plurality of surgical staples individually disposed within the individual staple slots. The apparatus further includes an actuation sled having a knife and being configured and adapted to movably position the knife axially within the knife track. The apparatus also includes a wound closure material applicator assembly having a needle secured to the knife to dispense a quantity of wound closure material along a length of the knife track as the actuation sled and knife are moved therealong.