2000results about "Excision instruments" patented technology

Articulation joints for use in connection with a surgical instrument that has a portion that must be passed through a trocar or similar structure and then articulated relative to another portion of the instrument received within the trocar. Various embodiments of the articulation joint include at least one fluid-actuated cylinder or flexible driven member to articulate the surgical implement relative to the handle assembly of the instrument.

In various embodiments, a surgical stapling instrument can include a handle, a shaft extending from the handle, wherein the shaft defines an axis, and a disposable loading unit which is assembled to the shaft in a direction which is transverse to the shaft axis. Such a connection between the disposable loading unit and the shaft can prevent, or at least inhibit, the disposable loading unit from being unintentionally displaced proximally and/or distally relative to the shaft of the surgical instrument. The surgical stapling instrument and/or disposable loading unit can further include a threaded collar and/or detent assembly configured to hold the disposable loading unit in place. In various embodiments, a disposable loading unit can include a lockout feature which can prevent, or at least inhibit, an expended disposable loading unit from being reassembled to the elongated body of the surgical instrument.

A stapling unit for use with an endoscopic stapling system adapted to be advanced along an endoscope to a predetermined location within a body lumen to staple the portion of tissue, as part of an occlusal or full thickness resectioning procedure. The stapling unit comprises a first casing having a distal end, a proximal end and a stapling device mounted thereto adjacent to a first window extending through a periphery of the first casing. The invention includes methods for the stapling, severing and removal of tissue by using the device.

A surgical instrument for anastomosis of first and second blood vessels includes a housing having distal and proximal ends and an actuator disposed therebetween. The actuator includes a handle and a link assembly, the link assembly being movable through a firing stroke in response to movement of the handle. The instrument also includes a disposable loading unit releasably attached to the distal end of the housing in mechanical cooperation with the actuator. The disposable loading unit supports a plurality of surgical fasteners, which deform upon movement of the actuator and the link assembly through the firing stroke.

A method of accessing a blood vessel, comprising: forming a hole in the blood vessel; mounting a hole closure device onto the blood vessel; accessing the blood vessel through the hole, while the hole closure device is mounted on the blood vessel; and closing the hole by the hole closure device, after accessing the blood vessel through the hole.

A surgical stapling instrument (1) comprises a staple fastening assembly (4) in the distal region of said instrument, the staple fastening assembly (4) including a cartridge device (8) which comprises at least one closed row (17, 18) of staples and defines a wavy distal end surface (14), and an anvil (9) which defines a wavy proximal staple forming surface (20) substantially matching the distal end surface (14) and which is adapted to cooperate with the cartridge device (8) for forming the ends of the staples exiting from the cartridge device (8), wherein the distal end surface (14) and the staple forming surface (20) have a globally wavy shape including two opposite peaks (21) and two opposite valleys (22) angularly spaced at about 90° from the adjacent peaks (21) and in that said two-peaks-two-valleys wavy shape is formed by a stepped configuration of said surfaces (14, 20).

An apparatus for withdrawing a tissue specimen being held by a grasping instrument through an endoscope includes an endoscope having an endoscopic shaft with proximal and distal ends and a lumen extending therebetween. The apparatus also includes first and second hoop-like support members which are selectively slideable within the lumen from a first position to at least one second position. Each of the hoop members includes a diameter which is variable from a first diameter to at least one different diameter. The apparatus also includes a pouch having first and second ends which attach to respective first and second hoop members. The pouch defines a container therein for retaining the tissue specimen. A pair of drawstrings are attached to the first and second ends of the pouch, respectively, and are remotely operable to close the ends about the tissue specimen.

A two piece anastomosis device for attaching two organs together and creating a passage between the organs is disclosed. The anastomosis device has a first tissue clamping ring and a second tissue clamping ring that are brought together to clamp tissue therebetween and cut off the flow of blood to the tissue. The tissue clamping rings are locked together with an adhesive, and over time, causes the clamped tissue to necrose and slough off. The sloughed tissue creates a passageway through the anastomosis device. A method of using the fastener to create a bypass passageway between the stomach and small intestine is disclosed.

Disclosed is a tissue removal device having an outer tube with a resection window and an inner tube disposed within the outer tube. The inner tube is slidable and rotatable relative to the outer tube so that the distal end of the inner tube moves back and forth across the resection window to sever tissue extending therethrough. The inner tube may be driven to rotate at a speed of at least about 1100 rpm, to axially translate at a rate of at least about 1.5 cps, and with an advance ratio of no more than about 0.25. The drive system for controlling axial reciprocation and rotation of the inner tube may be totally mechanical.

According to embodiments of the invention, an apparatus for moving a diseased portion of an anatomical structure with respect to a healthy portion of an anatomical structure includes a first vacuum section adapted to apply vacuum force to and hold the healthy portion, and a second vacuum section adapted to apply vacuum force to and hold the diseased portion, wherein the second vacuum section is adapted to withdraw within the first vacuum section.

Endoscopic apparatus is provided, having a distal end (102) for insertion into a body of a patient and a proximal end that is held outside the body of the patient. The apparatus includes a proximal cylinder (404), disposed in a vicinity of the proximal end of the endoscopic apparatus. A proximal piston (406) is slidably contained within the proximal cylinder. A distal cylinder (328) is disposed in a vicinity of the distal end of the endoscopic apparatus, and a distal piston (310) is slidably contained within the distal cylinder. A tube (402) for containing a liquid is coupled between the proximal and distal cylinders. A tool (e.g., biopsy tool 115) is coupled to be actuated by displacement of the distal piston, so as to perform a mechanical action on tissue of the body or contents of the body, responsive to displacement of the distal piston.

Endovascular fastener applicator for endoluminally fastening prosthetic grafts to vessels, are provided. The endovascular fastener applicator includes a delivery assembly configured for positioning within a vessel, and a control assembly mounted to a proximal end of the outer sheath for extracorporeal control of the delivery assembly. The delivery assembly includes an expandable portion disposed adjacent a distal end of an outer sheath and being expandable to support a prosthetic in contact with an inner surface of a vessel; a yoke assembly disposed within the expandable portion; an applicator head assembly pivotably mounted to the yoke assembly and movable between a loading position longitudinally aligned with the yoke assembly, and a firing position oriented substantially perpendicular to the yoke assembly; and a fastener assembly connectable to a distal end of the expandable portion, the fastener assembly retaining at least one fastener therein.

Surgical accessories are presented in vivo and used by surgical tools in the surgical site to perform additional tasks without the need to remove the tools from the surgical site for tool change or instrument loading. Examples of in vivo accessories include fastening accessories such as surgical clips for use with a clip applier, single working member accessories such as a blade which can be grasped and manipulated by a grasping tool for cutting, sheath accessories that fit over working members of a tool, flow tubes for providing suction or introducing a fluid into the surgical site, and a retraction member resiliently biased to retract a tissue to expose an area in the surgical site for treatment. The accessories can be introduced into the surgical site by a dedicated accessory introducer, or can be supported on the body of a surgical tool inserted into the surgical site and be manipulated using another surgical tool in the surgical site. The accessory introducer can be resiliently biased to bias the accessories toward a predetermined position in the surgical site.

A method for forming an anastomosis between first and second organs in a patient using a hollow receptacle that is inflatable with magnetic material. The method may include forming openings through the first and second organs utilizing a hole-forming instrument inserted into the organs through a natural orifice in the patient. The hollow receptacle may be supported on a catheter assembly that is also inserted through the patient's natural orifice and through the openings in the first and second organs and is positioned within the second organ. The hollow receptacle is then inflated with magnetic material and magnetic force is applied within the force organ to draw the inflated receptacle toward the first organ such that the inflated receptacle retains the second organ in sealing contact with the first organ while maintaining the alignment between the first and second openings to create an anastomosis between the first and second organs.

A surgical stapling apparatus includes a staple cartridge and an anvil member. The staple cartridge includes a plurality of surgical fasteners disposed in rows of retention slots. The staple cartridge may have an annular or linear configuration of retention slots. The tissue contacting surface of the staple cartridge may be tapered or stepped. The anvil member has a tissue contacting surface that includes a number of pockets arranged for substantially aligning with the retention slots. In addition, the tissue contacting surface of the anvil member may complement the tissue contacting surface of the staple cartridge.

Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities/nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

Embodiments of the invention provide a system and method for resecting a tissue mass. The system for resecting a tissue mass includes a surgical instrument and a first sensor for measuring a signal corresponding to the position and orientation of the tissue mass. The first sensor is dimensioned to fit insider or next to the tissue mass. The system also includes a second sensor attached to the surgical instrument configured to measure the position and orientation of the surgical instrument. The second sensor is configured to receive the signal from the first sensor. A controller is in communication with the first sensor and/or the second sensor, and the controller executes a stored program to calculate a distance between the first sensor and the second sensor. Accordingly, visual, auditory, haptic or other feedback is provided to the clinician to guide the surgical instrument to the surgical margin.

Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.

A surgical stapler comprising a handle assembly, an elongated body portion extending distally from the handle assembly, and a head portion disposed adjacent a distal portion of the elongated body portion and including an anvil assembly and a shell assembly. The anvil assembly is movable in relation to the shell assembly between spaced and approximated positions. The anvil assembly has an anvil head and a plurality of projections extending proximally of the anvil head, the projections engageable with a portion of the shell assembly.

Methods and apparatus are provided for valve repair or replacement. In one embodiment, the method comprises providing an apparatus having a valve prosthesis, a valve leaflet support and a valve excisor, the apparatus having a first configuration and a second configuration; accessing the aortic root without placing the patient on a heart-lung machine; advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus; expanding the apparatus into a second configuration so that the support will engage the valve; and moving the valve leaflet support and valve excisor together to remove leaflets of the valve. Penetrating members may be advanced into the tissue wherein the penetrating members may act as fasteners to hold the prosthesis in place.

Devices, systems and methods for performing image guided interventional and surgical procedures, including various procedures to treat sinusitis and other disorders of the paranasal sinuses, ears, nose or throat.

A surgical fastening apparatus having a fastener retaining frame including a first annular portion having a plurality of retainers circumferentially disposed thereon and a second annular portion having a plurality of circumferentially arranged perforations. The fastener retaining frame is detachably secured to a supporting structure. After the plurality of surgical fasteners have been mated with the plurality of retainers, an annular blade severs the perforations.

Sinusitis, mucocysts, tumors, infections, hearing disorders, choanal atresia, fractures and other disorders of the paranasal sinuses, Eustachian tubes, Lachrymal ducts and other ear, nose, throat and mouth structures are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies and endoscopic studies. Access and occluding devices may be used to facilitate insertion of working devices such asendoscopes, wires, probes, needles, catheters, balloon catheters, dilation catheters, dilators, balloons, tissue cutting or remodeling devices, suction or irrigation devices, imaging devices, sizing devices, biopsy devices, image-guided devices containing sensors or transmitters, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting or delivering devices and implants, etc.

Devices, methods, kits, and methods remove obstructive material from the vasculature and other body lumens. Expansible baskets may be used as cooperating radially expansible shearing members. Helically oriented struts of each basket may wind in a uniform circumferential direction. The struts can be independently flexible, allowing the shearing members to flex axially together. The inner basket may be rotatably driven and may use an axial pump extending proximally from the shearing members and/or a distal penetrator for advancing into an occlusion which inhibits guidewire access. The struts may slide substantially continuously across each other, and may be sufficiently aggressive for highly effective thrombectomy. A rotationally static and axially flexible outer basket may provide a safe, limited atherectomy treatment.

A method and device for tissue removal. The device may be used to remove uterine fibroids and other abnormal gynecological tissue. According to one embodiment, the device includes a housing, an outer tube, and an inner tube. The outer tube is fixed to the housing and includes a side window proximate to its distal end. The side window may have sloped proximal and distal ends. The inner tube has a distal end positioned within the outer tube, the distal end being adapted to rotate and, at the same time, to move back and forth past the side window, with the rotational and translational movement of the inner tube being independently controllable. The distal end of the inner tube may have an external bevel. Suction is applied to the proximal end of the inner tube to draw tissue into the side window and to remove resected tissue through the inner tube.

Implantable devices and methods for delivering drugs and other substances to locations within the body of a human or animal subject to treat or diagnose sinusitis and a variety of other disorders. The invention includes implantable substance delivery devices that comprise reservoirs and barriers that control the rate at which substances pass out of the reservoirs. The delivery devices may be advanced into the body using guidewires, catheters, ports, introducers and other access apparatus. In some embodiments the delivery devices may be loaded with one or more desired substance before their introduction into the body. In other embodiments the delivery devices are loaded and/or reloaded with a desired substance after the delivery device has been introduced into the body.

Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire through the body from a first location, around a curved pathway, and out of the body through a second location, so that the distal and proximal ends of the guidewire extend from the body, then pulling a device into position using the guidewire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to the device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body. Devices to modify tissue may also be positioned or manipulated so that a target tissue within the body is modified.

A ligation device includes a cannula having first and second extendable members and a Doppler wand. The Doppler wand permits an anatomical vessel, such as a blood vessel, to be located in close proximity to the distal end of the cannula. The extendable members are extendable on two opposite sides of the vessel. A length of ligation material, such as suture material, extends through the first extendable member, and is attached to a detachable element mounted to the distalmost end of the extendable member. The second extendable member includes a snare. The first extendable member includes curved portions which, when the member is extended distally, extend the detachable element into position for the snare so that the snare can grab the loop. Once ensnared, the detachable element is released from the first extendable member, which pulls the ligation material around the vessel. The ligation device does not require prior visualization or dissection of the area around the vessel.

According to an aspect of the present invention, a medical device is provided, which comprises the following: (a) a hollow elongate body (e.g., a elongate cylinder, such as a needle) having distal and proximal ends; and (b) a rotatable member comprising a tissue morselizer and an elongate shaft (e.g., an auger-like tissue-drilling bit). In the devices of the present invention, the elongate shaft is disposed within the hollow elongate body and cooperates with the hollow elongate body to (i) advance material (e.g., morselated tissue) toward the proximal end of the hollow elongate body when the shaft is rotated in a first direction, and (ii) advance material (e.g., a therapeutic agent and/or a bulking agent) toward the distal end of the hollow elongate body when the shaft is rotated in a second direction that is opposite the first direction. According to another aspect of the invention a method of treatment is provided that comprises: (a) inserting the a medical device like that above into the tissue of a patient; (b) morselizing and removing tissue from within the patient while rotating the shaft in a first direction, thereby creating a void within the patient; and (c) introducing a therapeutic agent and/or a bulking agent into the void.

An excisional biopsy system includes a tubular member that has a proximal end and a distal end in which one or more windows are defined. A first removable probe has a proximal portion that includes a cutting tool extender and a distal portion that includes a cutting tool. The first removable probe may be configured to fit at least partially within the tubular member to enable the cutting tool to selectively bow out of and to retract within one of the windows when the cutting tool extender is activated. A second removable probe has a proximal section that includes a tissue collection device extender and a distal section that includes a tissue collection device. The second removable probe may also be configured to fit at least partially within the tubular member to enable the tissue collection device to extend out of and to retract within one of the windows when the tissue collection device extender is activated. A third removable probe may also be provided. The third removable probe may also be configured to fit at least partially within the tubular member and may include an imaging device, such as an ultrasound transducer, mounted therein. By selectively activating the cutting tool and the tissue collection device while rotating the excisional device, a tissue specimen may be cut from the surrounding tissue and collected for later analysis.