Abstract: A method for fastening a two-piece surgical fastener to bodily tissue whereby the surgical fastener has a safety position. The method comprises inserting first and second piercing posts through at least two layers of tissue and attaching a receiving portion to the coupling ends of the first and second piercing posts. Each of the first and second piercing posts have a fixed end and a coupling end, the first piercing post being fixedly-attached at its fixed end to a first base portion, the second piercing post being fixedly-attached at its fixed end to a second base portion, the first and second base portions being foldably coupled to one another by a hinge, where a bias device imparts a bias force on at least one of the first base portion and the second base portion in a direction toward the other and substantially perpendicular to a longitudinal axis of the hinge.

Abstract: A staple is provided having a backspan and a first and second legs extending distally from the backspan. Each of the first and second legs includes a bend dividing each leg into a traversing leg portion and a substantially linear clenching leg portion. A staple plate is positionable over the first and second legs between the backspan and the first and second clenching leg portions. An anvil assembly has first and second movable members which move toward to one another to engage outer surfaces of the first and second clenching leg portions. There is further disclosed a method of forming the staple through tissue.

Abstract: A skin closure clamping device includes: (a) a strip whose outer surface includes a front portion that has a number of cavities therein, (b) an assortment of pegs or male staples fabricated from a biodegradable material, each having distal and proximal ends, and wherein each of the pegs' distal ends is configured to pierce a patient's skin, and each of the pegs' proximal ends is configured to allow it to be detachably fitted into one of the cavities of the strip, and each peg's outer surface proximate its distal end having a ratcheting mechanism, and (c) a female member having an outer surface with a front portion that includes an opening configured to receive the pegs' distal ends in such a manner that the pegs' ratcheting mechanisms interact with the opening to adjustable lock together each of the pegs to the female member so as to apply a compressive force between them that aids in holding a patient's skin together while it heals.

Abstract: A device for attaching a sheet-like implant to a target tissue includes a pilot member and a staple push rod. In some embodiments, the pilot member has a distal end and at least a pair of prongs extending from the distal end. The prongs are configured to form pilot holes when the distal end of the pilot member is pressed against the target tissue. The staple push rod is disposed within at least a portion of the pilot member and slidable relative thereto. The staple push rod includes at least a pair of stakes. Each stake is dimensioned to engage a surface of a staple to apply pushing forces thereto. Each stake is positioned relative to a prong along an inner surface of the pilot member so that the stakes advance into the pilot holes when the stakes are moved in a distal direction.

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 multi-part surgical staple assembly is provided to provide uniform compression across stapled tissues. The staple assembly generally includes a staple, a staple plate positionable against a backspan of the staple for engagement with one side of a stapled tissue section and a platen for receipt of tissue penetrating tips of the staple and engageable with an opposite side of a stapled tissue section. The staple plate and platen are provided with holes to receive the legs of the staple. In one embodiment, the staple plate is provided with a biasing member to bias the staple plate away from the backspan of the staple and toward the stapled tissue.

Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

Abstract: A stapling apparatus for performing anastomosis on hollow organs. The apparatus consists of two combinable tools which are L-shaped, one tool for retaining staple retaining clips, and the other tool for retaining staples. The L-shaped tools are each provided with an elongated handle and a C-shaped jaw positioned at a distal bottom end of the handle in a plane substantially transverse to the handles of the tools. When the two tools are combined, the C-shaped jaw retaining a series of staple retaining clips is positioned below the C-shaped jaw retaining the arranged series of staples with the respective staples in registration with respective underlying clips for stapling. The C-shaped jaws provide gaps which permit ingress and egress of hollow organ ends to be stapled.

Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

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 has can have 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 method for fastening a two-piece surgical fastener to bodily tissue whereby the surgical fastener has a safety position. The method comprises inserting first and second piercing posts through at least two layers of tissue and attaching a receiving portion to the coupling ends of the first and second piercing posts. Each of the first and second piercing posts have a fixed end and a coupling end, the first piercing post being fixedly-attached at its fixed end to a first base portion, the second piercing post being fixedly-attached at its fixed end to a second base portion, the first and second base portions being foldably coupled to one another by a hinge, where a bias device imparts a bias force on at least one of the first base portion and the second base portion in a direction toward the other and substantially perpendicular to a longitudinal axis of the hinge.

Abstract: A surgical fastening system for attaching one piece of tissue to another piece of tissue. The system comprises a surgical fastener, an installation tool for deploying the surgical fastener in tissue, and a method for using the same.

Abstract: A surgical staple device which accommodates various tissue thicknesses by employing unique modified surfaces with increased friction is disclosed. The staple device includes a U-shaped staple body with modified surfaces on its legs, whereas the modified surfaces may be designed as ratchet teeth, barbs, hooks, grooves, and channels. The staple device further includes a footplate to receive and engage the legs.

Abstract: The present disclosure relates to surgical fasteners and more particularly to surgical fasteners coated with wound treatment materials. According to an aspect of the present disclosure, a surgical fastener for use in combination with a surgical fastener applying apparatus is provided. The surgical fastener includes a pair of legs; a crown interconnecting the pair of legs; and a wound treatment material coating at least a portion of the legs and crown.

Abstract: Methods and devices for fastening tissue are provided. In one exemplary embodiment, a tissue fastener is provided and includes a male fastening member having a base plate with at least one post extending therefrom and having a tissue-piercing tip. A protective member is coupled to the male fastening member and is movable between an open position in which the tissue-piercing tip is enclosed within the protective member such that the tissue-piercing tip is prevented from penetrating tissue, and a compressed position in which the tissue-piercing tip is exposed to penetrate tissue. A female fastening member is configured to mate to the male fastening member and to engage tissue therebetween.

Abstract: A surgical fastener applying apparatus comprising a fastener supporting portion and a retainer supporting portion. The fastener supporting portion includes a first row of first surgical fasteners and a second row of second surgical fasteners. The retainer supporting portion includes a first row of first retainers and a second row of second retainers, the first fasteners engagable with the first retainers and the second fasteners engagable with the second retainers. The fasteners and retainers are configured so when engaged a first distance between at least one of the first fastener backspans and respective first retainer backspan is different than a second distance between at least one of the second fastener backspans and respective second retainer backspan.

Abstract: An end-effector assembly is configured to be attached to a surgical instrument. The end-effector assembly comprises a first jaw comprising an electrode, a second jaw comprising a rivet cavity, and a rivet. At least one of the first jaw and the second jaw is movable relative to the other jaw. At least a portion of the rivet is removably positioned within the rivet cavity. The rivet comprises a tissue-engaging portion, an elongate portion extending from the tissue-engaging portion, and a meltable portion. The end-effector assembly comprises a driver configured to move the rivet between a first position in which the rivet is stored at least partially within the rivet cavity and a second position in which the rivet is at least partially deployed from the rivet cavity. The meltable portion of the rivet is positioned against or adjacent to the electrode when the rivet is in the second position.

Abstract: A fastener for insertion into pierced openings of a tissue wound has a body formed of a generally bioabsorbable polymer defining an initial capture area. The body includes a pair of arms, each with an inwardly projecting cleat operably joined at an elbow portion defining an internal elbow angle. The arms are operably joined to a backspan at a shoulder portion defining an internal shoulder angle. A durable tissue retention zone is defined between the cleat and the arm. The elbow portion and the internal elbow angle define an insertion width greater than a width of the pierced openings resulting in the pierced openings stretching over the cleat and being elastically retained within the durable tissue retention zone. The fastener captures wound tissue in the initial capture area and then dynamically reforms in response to lateral stresses without a fracture failure of the fastener until a minimum degradation period.

Abstract: A surgical instrument for applying a fastener to tissue. The instrument includes a shaft having a working end and a grip end, a first jaw pivotally mounted on the working end including a receiver for releasably holding a male component and a second jaw statically mounted on the working end including a receiver for releasably holding a female component. The first jaw is pivotally moveable between an open position in which the first jaw is sufficiently spaced from the second jaw so tissue can be received between a male component and a female component, and a closed position in which a protrusion of the male component is aligned with and received in a recess of the female component. The instrument includes a mechanism operatively connected to the first jaw for moving the first jaw between the open position and the closed position.

Abstract: An embodiment of the invention includes a method of fastening together two tissue portions. The method may include positioning a medical device adjacent a region of tissue having two tissue portions. The medical device may include a male member and a female member having a first bioabsorbable material overlying one of a non-bioabsorbable material and a second bioabsorbable material. The first bioabsorbable material may have a first degradation rate, and the second bioabsorbable material may have a second degradation rate slower than the first degradation rate. The method may also include inserting the male member inside the female member so as to inhibit withdrawal of the male member from the female member with the two tissue portions between the male member and the female member.

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 fastener with a safety position includes a lower base having piercing posts each having fixed and coupling ends, first and second base portions respectively attached to the posts, a hinge coupling the base portions, and a bias device imparting force on at least one base portion toward the other and at an angle to the hinge axis. Also provided is an upper fastening portion receiving and selectively coupling the posts. The lower base has a piercing position for coupling with the upper fastener portion where the posts are substantially parallel and a folded position where a distance between a coupling end of the first piercing post and the coupling end of the second piercing post is less than a distance between the fixed end of the first piercing post and the fixed end of the second piercing post.

Abstract: Provided herein are methods, devices and compositions to conductively or to inductively fix substrates, including tissues, using electromagnetic energy. Also provided is a method of controlling the fixing process via feedback monitoring of a property of the composition and/or of the electromagnetic energy used.

Abstract: The present invention provides a surgical implant which can be made of a metal that corrodes while implanted in tissue of a patient. The surgical implant has a preferential corrosion zone adapted to corrode at a different rate than the rest of the surgical implant. In one embodiment, the surgical implant is surgical staple that may be formed into a “B-shape” when deployed into tissue, although the invention also is applicable to many other kinds of staples, clips, and other metallic surgical implants. In one embodiment, the preferential corrosion zone comprises an indentation that provides a site for crevice corrosion.

Abstract: A fastener including at least an element to be anchored in an anatomical support, at least a stop element relative to a planar prosthetic component to be fixed, and a linking rod is characterised in that the linking rod is rectilinear and the junction zones of the anchoring element and the stop element with the linking rod enable the fastener to adopt: a non-stressed stripping configuration; a maximum stress configuration, doubled up on itself, for example in a tubular configuration by complete insertion of the fastener into a tube, and a minimum stress configuration, wherein the respective directions of the stop element and the anchoring element form between them, for example in the same plane, an angle not greater than 90°.

Abstract: A fastener system includes an open loop member and a receiving plate. The open loop member has first and second legs and a base. Each leg defines a longitudinal axis therethrough. The receiving plate has a body including a pair of spaced apart channels. The body defines a longitudinal axis therethrough. Each channel is positioned to receive a portion of one of the first or second legs.

Abstract: Provided is a two-piece anastomosis fastener that can be used to join two tissue sections together in accordance with Natural Orifice Transendoscopic Surgery (NOTES). The fastener may be releasably attached to a fastener applying instrument for delivery in accordance with such procedures. The fastener includes a first member and a second member, where the clamp members are operably configured to fasten together to clamp and hold tissue, such as gastric tissue, in juxtaposition to establish an anastomosis. The first clamp member and the second clamp member are coupled with an adhesive.

Abstract: A holding member has an opening portion which opens to an distal end. The opening portion, the distal end of an endoscope and a holding member define a treatment space. A clamping member can project and retreat from and into the opening portion through the treatment space. The puncture member can move in the treatment space, in a direction that intersects with the longitudinal direction of the endoscope.

Abstract: There is provided a variable size, uniform compression staple assembly for use in stapling differing thicknesses of tissues. The staple assembly includes a staple and a staple block for receipt of tissue penetrating tips of the staple. Upon assembly through tissue, the tissue penetrating tips of the staple lodge within the staple block to a depth inversely proportional to the thickness of the tissues being stapled. There is also disclosed an anvil configured for use with the staple assembly.

Abstract: A surgical fastening system for attaching one piece of tissue to another piece of tissue. The system comprises a surgical fastener, an installation tool for deploying the surgical fastener in tissue, and a method for using the same.

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 embodiments provide methods for facilitating closure of a bodily opening. In one exemplary method, at least a portion of a first tacking device is disposed through at least a portion of tissue at a first location in a vicinity of an opening in the tissue. Then, at least a portion of a second tacking device is disposed through at least a portion of tissue at a second location in the vicinity of an opening in the tissue. A closure member having at least one loop portion is advanced towards the first and second tacking devices, and the loop portion is positioned around at least a portion of the first tacking device and at least a portion of the second tacking device. The closure member then is actuated to urge the first tacking device towards the second tacking device to provide a compressive force upon the opening.

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: This invention provides minimally invasive mechanical instruments that are capable of laparoscopic or endoscopic approximation and fastening of soft tissues in a variety of interventional procedures. The devices of the present invention generally consist of a proximal handle assembly incorporating actuation means, an elongate tubular assembly (which may be flexible, rigid or combinations thereof) and a distal tool assembly incorporating mechanisms for engaging tissue at two or more spaced-apart locations on a tissue surface as well as mechanisms for deploying one or more tissue fasteners to securely hold the tissues in the approximated configuration. Typically the devices are provided in an initial collapsed (i.e. pre-deployed) configuration for insertion into the patient.

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. 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. The prosthesis may include anchoring features including barbs and/or members that extend transversely. 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 surgical stapler including a “breakaway” washer that is inserted into an anvil. In various embodiments, the washer can include a circular inner portion and a circular outer portion. In one various embodiment, 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. In various embodiments, 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. In one various embodiment, the washer can be dissolvable or bioabsorbable.

Abstract: A surgical staple including a deformable member and a crown, where the deformable member can slide relative to the crown. In various embodiments, a staple cartridge can include a cavity and a deck, where the cavity can be configured to receive at least a portion of the deformable member and the crown can be positioned within an opening in the deck. In one various embodiment, the crowns of two or more adjacent surgical staples can be connected. In various embodiments, the connected crowns can apply a uniform pressure to soft tissue and increase the stiffness of the soft tissue after the surgical staples have been deployed therein.

Abstract: Systems of releasably connecting staple line buttress material to the jaws of a surgical stapling instrument are provided. The systems include retainers configured to engage the buttress material and releasably retain the buttress material on the jaws of the surgical stapling instrument prior to stapling tissue. In certain embodiments, the retainers remain with the jaws of the instrument after stapling of tissue. In alternative embodiments, the retainers remain with the buttress material after being stapled to tissue.

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: Tissue holding implants which enable two or more layers of tissue to be held in approximation for an extended period. One and two-piece implants are described, made from materials that are biocompatible, and may also be biodegradable. Some embodiments include a portion which is deformed to capture the tissues to be held, and others are made from a super-elastic or shape memory material and hold the tissues in approximation when the implant is reverted to a known preformed shape.

Abstract: A system for holding surgical fasteners each having a first anchor, a second anchor and a connector extending therebetween upwardly from the first and second anchors, and a method for loading the same into an applicator. The system includes a shuttle having first and second channels dimensioned to slidably receive therein the first and second anchors, and having first and second grooves respectively forming openings into the channels along a portion of a length of the channels. When the first and second anchors are received within the first and second channels, the connector of the surgical fastener extends out of the shuttle through the first and second grooves. The system also includes a cartridge having at least a first channel dimensioned to slidably receive the shuttle therein, and having a first projection extending into the first channel.

Abstract: A surgical fastener for fastening tissue. The fastener includes a first piece of sheet material formed to have a generally planar base and an elongate needle portion extending upward from the base. The fastener includes a second piece of sheet material formed to have a generally planar base and an elongate needle portion extending upward from the base. The second piece of sheet material is pivotally connected to the first piece of sheet material.

Abstract: A biocompatible fastener particularly well-suited for use in fundoplication procedures. In a preferred embodiment, the fastener is designed to break within the span of approximately three to six months after implantation and comprises a male portion and a female portion. The male portion includes a first base member, the first base member being generally flat and oval. A pair of male members are mounted on the bottom surface of the first base member, each male member comprising a cylindrical post extending downwardly from the bottom surface of the first base member and a conical head disposed at the bottom end of the post. The female portion includes a second base member, the second base member being generally flat and oval. A pair of sleeves are mounted on the top surface of the second base member and extend upwardly therefrom. Each sleeve defines a bore adapted to receive a head from a corresponding male member and has an inner flange formed thereon.

Abstract: The present invention involves new interventional methods and devices for reducing gastric volume, and thereby treating obesity. The procedures are generally performed laparoscopically and may generally be described as laparoscopic plication gastroplasty (LPG) in which, after obtaining abdominal access, spaced apart sites on a gastric wall are engaged and approximated to create one or more tissue folds that are then secured to produce one or more plications projecting into the gastrointestinal space. The serosal tissue may optionally be treated during the procedure to promote the formation of a strong serosa-to-serosa bond that ensures the long-term stability of the tissue plication. These procedures are preferably carried out entirely extragastrically (i.e. without penetrating through the gastrointestinal wall), thereby minimizing the risks of serious complications. Methods for reversing the procedure are also disclosed.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to an axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having tissue-piercing posts, and the second part includes a second base defining apertures receiving the posts and a portion movable relative thereto between first and second orientations. When the posts are inserted into the apertures, the movable portion can be moved from the first unlocked orientation into the second configuration to lock the fastener parts together in an implanting position determined by various alignment measures, including markings or flags on the jaws or at the housing. The instrument is adapted to move the second part into the second configuration.

Abstract: A surgical fastener with a safety position includes a lower base having piercing posts each having fixed and coupling ends, first and second base portions respectively attached to the posts, a hinge coupling the base portions, and a bias device imparting force on at least one base portion toward the other and at an angle to the hinge axis. Also provided is an upper fastening portion receiving and selectively coupling the posts. The lower base has a piercing position for coupling with the upper fastener portion where the posts are substantially parallel and a folded position where a distance between a coupling end of the first piercing post and the coupling end of the second piercing post is less than a distance between the fixed end of the first piercing post and the fixed end of the second piercing post.

Abstract: An apparatus for use with a surgical stapler to provide a reinforced surgical staple line. The apparatus includes an applicator that carries a first and second bioimplantable material connected by a hinge. An applicator clip may be provided to releasably secure the first and second bioimplantable material onto the applicator.

Abstract: Provided are surgical fasteners coated with a material including an initiator configured for activation upon application of an initiator. The surgical fasteners may be configured for use in combination with a surgical fastener applying apparatus. In one version, the surgical fastener is a surgical staple including a pair of legs, a crown interconnecting the pair of legs, and a material including an initiator coating at least a portion of the legs and/or crown. Adhesive may be delivered into contact with the initiator associated with the surgical fasteners such that a desirable size, shape, and configuration of activated or polymerized adhesive is created.

Abstract: A surgical fastener for fastening tissue. The fastener includes a first piece having a curved needle, a second piece having an opening sized for receiving the needle, and a lock for holding the needle of the first piece in the opening of the second piece.

Abstract: A surgical fastener for fastening tissue. The fastener includes a first piece having a needle, a second piece having an opening sized for receiving the needle, and a lock for holding the needle of the first piece in the opening of the second piece. At least a portion of the first piece, the second piece and/or the lock comprises a bio-absorbable material so the fastener becomes unfastened from the tissue over time.