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A surgical instrument for laparoscopic and endoscopic clinical procedures simultaneously severs and staples tissue clamped in an end effector comprising an elongate channel, which holds a staple cartridge, and a pivotally attached anvil. An E-beam firing bar engages the channel and selectively engages the anvil during distal firing movements, wherein the tissue is severed and stapled driven upward from the staple cartridge to form against the anvil. In particular, a wedge integral to the staple cartridge is driven distally by a middle pin of the firing bar to effect stapling. A lockout mechanism of the staple cartridge responds to the presence of the wedge sled in its unfired position to allow the firing bar to fire. Otherwise, the lockout mechanism prevents firing when the staple cartridge is spent.

A surgical instrument for laparoscopic and endoscopic clinical procedures simultaneously severs and staples tissue clamped in an end effector comprising an elongate channel, which holds a staple cartridge, and a pivotally attached anvil. An E-beam firing bar engages the channel and selectively engages the anvil during distal firing movements, wherein the tissue is severed and stapled driven upward from the staple cartridge to form against the anvil. In particular, a wedge integral to the staple cartridge is driven distally by a middle pin of the firing bar to effect stapling. A single lockout of the elongate channel responds to the presence of the wedge sled in its unfired position to allow the firing bar to fire. Otherwise, the single lockout prevent firing when the staple cartridge is missing or spent.

A surgical instrument for performing surgery includes a housing defining an axial bore. A lock is slidably disposed in the transverse bore to engage and disengage a tube adaptor. A latch extends from the lock to move the latch into and out of the axial bore. The lock and latch allow for interchangeability of tip assemblies inserted into the surgical instrument. A first and second handle are pivotally attached to the housing. A first ratchet member is rotatably attached to the first handle and includes serrated teeth. A second ratchet member extends from the second handle. The second ratchet member including a finger for engagement with the serrated tooth to prevent movement of said first handle relative to the second handle. The first ratchet member is rotatable about the rotational axis to disengage from the second ratchet member and allow the first handle to move relative to the second handle.

The invention relates to a surgical stapler for applying at least two rows of staples, said surgical stapler comprising a cartridge housing said rows of staples and having a slot extending along the cartridge between two rows of staples, said surgical stapler further comprising a cutting means movable along said slot and a lockout mechanism for preventing movement of said cutting means, wherein said lockout mechanism comprises a blocking member movable between a first position, in which the blocking member blocks movement of said cutting means, and a second position, in which the blocking member permits movement of said cutting means, and a biasing member for biasing said blocking member towards said first position and wherein said cartridge comprises a release member for moving said blocking member towards said second position upon insertion of said cartridge into said surgical stapler.

The present invention relates to apparatus for methods for endovascularly replacing a patient's heart valve. The apparatus includes an expandable anchor with leaflet engagement elements on the proximal end of the anchor and a replacement valve. The leaflet engagement elements can be used to prevent distal migration and insure proper positioning of the apparatus.

Several embodiments of the present invention are generally directed to medical visualization systems that comprise combinations of disposable and resuable components, such as catheters, functional handles, hubs, optical devices, etc. Other embodiments of the present invention are generally directed to features and aspects of an in-vivo visualization system that comprises an endoscope having a working channel through which a catheter having viewing capabilities is routed. the catheter may obtain viewing capabilities by being constructed as a vision catheter or by having a fiberscope or other viewing device selectively routed through one of its channels. The catheter is preferably of the steerable type so that the distal end of the catheter may be steered from its proximal end as it is advanced with the body. A suitable use for the in-vivo visualization system includes but is not limited to diagnosis and/or treatment of the duodenum, and particularly the biliary tree.

A surgical instrument for laparoscopic and endoscopic clinical procedures simultaneously severs and staples tissue clamped in an end effector comprising an elongate channel, which holds a staple cartridge, and a pivotally attached anvil. An E-beam firing bar engages the channel and selectively engages the anvil during distal firing movements, wherein the tissue is severed and stapled driven upward from the staple cartridge to form against the anvil. In particular, a wedge integral to the staple cartridge is driven distally by a middle pin of the firing bar to effect stapling. A single lockout of the elongate channel responds to the presence of the wedge sled in its unfired position to allow the firing bar to fire. Otherwise, the single lockout prevents firing when the staple cartridge is missing or spent.

Apparatus and methods provide distal protection while accessing blood vessels within a patient's vasculature. A flexible sheath and distal protection element, e.g., a balloon or filter, are carried by a stiffening member. The sheath is lubricious and has a relatively thin wall, thereby providing a collapsible/expandable guide for delivering fluids and/or instruments. The sheath is advanced into a blood vessel in a contracted condition, expanded to an enlarged condition to define a lumen, and the distal protection element is deployed within the vessel beyond the sheath. Fluids and/or instruments are introduced into the vessel via the sheath lumen, the distal protection element retaining the fluids and/or capturing emboli released by the instruments. Upon completing the procedure, the sheath, distal protection element, and stiffening member are removed from the vessel.

A suture anchor (e.g. 100) for knotlessly securing nearby tissue to bone is formed from an anchor body (e.g. 101/102) that includes a mechanism for being securely anchored to the bone, an elongated suture puller (e.g. 122) extending through the anchor body with a proximal end for being pulled in a proximal direction by a surgeon and a distal end (e.g. 125) with a suitable mechanism for engaging suture (e.g. 127), suture (e.g. 132) carried by the engaging mechanism (e.g. 127) at the distal end (e.g. 125) of the elongated suture puller (e.g. 122), and a suture locking mechanism (e.g. 110) that substantially prevents the suture (e.g. 122) from moving in at least a first direction after being pulled into and through the anchor body (e.g. 101/102) by the elongated suture puller (e.g. 122).

An intervertebral implant comprising a spacer for engaging between two spinous processes of two vertebrae of the spine. The spacer has two elements each presenting a first part suitable for being connected to a spinous process and bearing second parts opposite from the first part, the bearing second parts being situated facing each other. An elastically-compressible member is disposed between the bearing second parts. Links are provided which are distinct from the elastically-compressible member for linking together the two elements, the link member being suitable for blocking translation movement of the two elements relative to each other when the two elements are driven apart from each other.

The present disclosure is directed to a surgical stapling device (10) for performing circular anastomoses. The surgical stapling device includes a handle portion (12), an elongated body portion (14) and a head portion (16) including an anvil assembly (30) and a shell assembly (31). The handle portion (12) includes a rotatable approximation knob (22) for approximating the anvil and shell assemblies (30,31) and a firing trigger (20) for actuating a firing mechanism for ejecting staples positioned within the shell assembly (31). The firing trigger (20) forms one link of a two bar linkage provided to actuate the firing mechanism. The anvil assembly (30) includes a tiltable anvil which will tilt automatically after firing of the device and unapproximating the anvil and shell assemblies (30,31). The head portion (16) also includes a retractable trocar assembly (240) which is slidably positioned within an anvil retainer (38) and is automatically advanced and retracted upon attachment and detachment of the anvil assembly (30) onto the anvil retainer (38). A lockout tube (270) is provided and is positioned about the anvil retainer (38) for releasably engaging an anvil assembly (30). The lockout tube (270) prevents inadvertent detachment of the anvil assembly (30) from the anvil retainer (38). The surgical stapling device (10) also includes a firing lockout assembly which prevents actuation of the firing trigger (20) until an anvil has been attached to the device and the anvil (129) has been approximated. A tactile indication mechanism is also provided for notifying a surgeon that the device has been fired and for notifying a surgeon that the anvil head has been unapproximated a distance sufficient to permit the anvil head to tilt.