4652results 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.

The present invention, in accordance with various embodiments thereof, relates to a surgical device for at least one of cutting and stapling a section of tissue. The surgical device includes a housing including at least two drivers. The surgical device also includes an anvil mechanically attachable to the housing and moveable relative to the housing between an open position and a closed position. The first driver operates to move the anvil relative to the housing to an intermediate position between the open position and the closed position. The second driver operates to move at least a portion of the housing relative to the anvil between the intermediate position and the closed position.

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 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.

Circular stapling instruments for cutting and applying one or more surgical staples to tissue are disclosed. The instruments include various forms of anvil locking systems designed to selectively prevent the anvil from moving axially relative to the stapling head of the stapling instrument. One embodiment employs an elongated gear rack that is selectively engagable with locking gears to prevent axial motion of the elongated gear rack and an adjustment shaft used to axially position the anvil. Other embodiments employ a gear assembly that cooperates with the elongated gear rack. A locking member is movably supported by a handle assembly that houses the gear assembly and elongated gear rack. The locking member is configured for selective meshing engagement with the gear assembly to ultimately prevent axial movement of the gear rack and adjustment shaft.

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 flexible driven member to articulate the surgical implement relative to the handle assembly of the instrument.

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.

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 material comprising a matrix or a buttress is impregnated with an adhesive initiator and is used with a surgical stapling device and an adhesive. The tissue and material are stapled together, and a knife in the surgical stapling device cuts the tissue and the material. The adhesive is applied across the cut and sets up or polymerizes to seals the cut when the adhesive contacts the adhesive initiator. The surgical stapling device can place the staples in a linear, arcuate, or circular array, and can anastomose luminal tissue. The methods of use can include stapling luminal tissue end to end, stapling two portions of material onto ether side of tissue, and stapling two portions of tissue onto a portion of material. Additionally, a portion of adhesive filed material can be stapled onto one side of portion of tissue and the adhesive initiator impregnated material can be stapled onto the other. Cutting the material and tissue provides a path for the adhesive across the cut, and catalyzes the adhesive from contact with the adhesive initiator.

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

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.

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).

A surgical fastening apparatus including a fastener receiving frame including a plurality of spaced apart openings formed therein and a fastener supporting member containing a plurality of surgical fasteners extending therefrom. The surgical fasteners are engagable with the plurality of openings to mate with the fastener receiving frame to fasten tissue therebetween. The fasteners are engageable with the openings in a plurality of positions dependent on a tissue thickness between the fastener receiving frame and the fastener supporting member.

An endoscopic accessory medical device is provided. The device can include a handle, a flexible shaft, and an end effector. The handle can include an actuator for operating the end effector through a wire or cable pulling member that extends through the flexible shaft. The handle and actuator can be operable with a single hand, such that the operation of the end effector can be accomplished with the same hand that is used to hold the handle and advance the end effector through an endoscope. The handle can include an actuation mechanism that is decoupled from operation of the end effector when the actuator is in a first open position, which becomes operatively coupled to the end effector when the actuator is moved to a second position, such as by squeezing the actuator, and which operates the end effector when the actuator is moved further to a third position.

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.

In an embodiment, the invention provides a catheter suitable for use in performing a procedure within a vessel, lumen or organ of a living having a distal end which is steerable, such as upon the application of compression. The catheter may be of the over the wire type, or alternatively may be a rapid exchange catheter. The catheter may provide for a rotating element which may be used to open a clogged vessel, or alternatively to provide information about adjacent tissues, such as may be generated by imaging or guiding arrangements using tissue detection systems known in the art, e.g., ultrasound, optical coherence reflectometry, etc. For rapid exchange catheters having a rotating element, there is provided an offset drive assembly to allow the rotary force to be directed from alongside the guidewire to a location coaxial to and over the guidewire.

A device for morcellating tissue within a body cavity of a patient comprises a stationary tube having a distal end portion, and a bipolar electrosurgical electrode assembly located at the distal end of the tube. The electrosurgical electrode assembly comprises first and second electrodes separated by an insulation member, the bipolar electrosurgical electrode assembly extending around the circumference of the distal edge of the tube. When an electrosurgical cutting voltage is applied to the electrode assembly, and relative movement is initiated between the tube and the tissue, a core of severed tissue is formed within the tube such that it can be removed from the body cavity of the patient. A tissue-pulling device such as a jaw assembly can be employed to pull tissue against the distal end of the tube.

Guidewire exchange systems, devices and methods, for positioning and actuating surgical devices in a desired position between two tissues in a patient's body are described. A guidewire may be coupled to a surgical device for positioning and actuating (e.g., urging against a target tissue). The guidewire may be exchanged between different surgical devices during the same procedure, and the guidewire and surgical devices may be releaseably or permanently coupled. The surgical device generally includes one or more guidewire coupling members. A system may include a guidewire and a surgical device having a guidewire coupling member. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures.

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.

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.

Methods and devices described herein facilitate improved access of locations within the body by providing a variety of dissection modes on a single access device.

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.