19667 results about "Reoperative surgery" patented technology

A surgical device is described herein that can be used to fire different types and sizes of disposable loading units. In a preferred embodiment, the device applies parallel rows of surgical fasteners to body tissue and concomitantly forms an incision between the rows of staples during an endoscopic or laparoscopic surgical procedure. The device can be utilized with disposable loading units configured to apply linear rows of staples measuring from about 15 mm in length to about 60 mm in length and can be used to fire disposable loading units containing surgical clips and individual staples.

A surgical instrument is disclosed. According to various embodiments, the instrument includes a handle assembly and a drive system that is at least partially supported by the handle assembly. A surgical implement may be operably coupled to the handle assembly for receiving at least two independent drive motions from the drive system to cause the surgical implement to perform at least two surgical activities. The instrument may further include a timing indicator on at east one of the handle assembly and the surgical implement to provide an indication of an amount of time that has elapsed from an application of one of the control motions while maintaining an ability to selectively apply a second control motion after the first control motion has been applied.

A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

A heart valve can be replaced using minimally invasive methods which include a sutureless sewing cuff that and a fastener delivery tool that holds the cuff against the patient's tissue while delivering fasteners, two at a time to attach the cuff to the tissue from the inside out. The tool stores a plurality of fasteners. Drawstrings are operated from outside the patient's body and cinch the sewing cuff to the valve body. The cuff is releasably mounted on the tool and the tool holds the cuff against tissue and drives the fastener through the cuff and the tissue before folding over the legs of the fastener whereby secure securement between the cuff and the tissue is assured. At least two rows of staggered fasteners are formed whereby fasteners are located continuously throughout the entire circumference of the cuff. A minimally invasive surgical method is disclosed, and a method and tool are disclosed for repairing abdominal aortic aneurysms in a minimally invasive manner.

An intestinal intraluminal reconstruction and resection device includes a mechanism for intussusception of the bowel, a bowel anastomosis mechanism and a mechanism for severing the resected bowel. The surgical device allows the user to carry out intraluminally an anastomosis first, prior to resection of the intestine or any hollow viscus, therefore not exposing the dirty intraluminal content to the clean abdominal or thoracic cavities. The above is achieved by first intussuscepting the hollow viscus, then anastomosis and finally intraluminal resection.

Devices formed of or including biocompatible polyhydroxyalkanoates are provided with controlled degradation rates, preferably less than one year under physiological conditions. Preferred devices include sutures, suture fasteners, meniscus repair devices, rivets, tacks, staples, screws (including interference screws), bone plates and bone plating systems, surgical mesh, repair patches, slings, cardiovascular patches, orthopedic pins (including bone filling augmentation material), adhesion barriers, stents, guided tissue repair / regeneration devices, articular cartilage repair devices, nerve guides, tendon repair devices, atrial septal defect repair devices, pericardial patches, bulking and filling agents, vein valves, bone marrow scaffolds, meniscus regeneration devices, ligament and tendon grafts, ocular cell implants, spinal fusion cages, skin substitutes, dural substitutes, bone graft substitutes, bone dowels, wound dressings, and hemostats. The polyhydroxyalkanoates can contain additives, be formed of mixtures of monomers or include pendant groups or modifications in their backbones, or can be chemically modified, all to alter the degradation rates. The polyhydroxyalkanoate compositions also provide favorable mechanical properties, biocompatibility, and degradation times within desirable time frames under physiological conditions.

The present invention is directed to a circular anastomosis surgical stapler and methods of use. The circular anastomosis surgical stapler includes an operator control assembly, a tubular shaft having a distal end that is associated with a head portion, and an actuating head portion. The actuating head portion includes a detachable anvil portion with an axially extending stem portion. The anvil portion is engagable with the remainder of the head portion, which receives an array of staples. The head portion also includes an associated stapling portion with a stapling mechanism for firing an array of staples against the anvil portion. The anvil portion and the head portion matingly engage along a mating edge. The mating edge is defined by locations around the stem portion spaced from a particular position on the axis of the stem portion at axially and / or radially varying distances.

This invention provides surgical tools or instruments for use in minimally invasive telesurgical applications. The instruments typically include a base whereby the instrument is removably mountable on a robotically controlled articulated arm. An elongate shaft extends from the base. A working end of the shaft is disposed at an end of the shaft remote from the base. A wrist member is pivotally mounted on the working end. At least one end effector element mounting formation is pivotally mounted on an opposed end of the wrist member. A plurality of elongate elements, e.g., cables, extend from the end effector element mounting formation and the wrist member to cause selective angular displacement of the wrist member and end effector mounting formation in response to selective pulling of the elongate elements.

An apparatus is disclosed for endoscopic application of surgical staples adapted to attach surgical mesh to body tissue in laparoscopic hernia surgery. The apparatus includes a frame, and a generally elongated endoscopic section connected to the frame and extending distally therefrom. A staple storage cartridge is removably supported on a pivotal support system at the distal end portion of the endoscopic section with each staple being configured and adapted to attach the mesh to the body tissue. An elongated pusher system formed of several assembled components and extending from the frame to the endoscopic section is provided for individually advancing at least one staple at a time distally for positioning adjacent the surgical mesh and the body tissue. The pusher system also includes a trigger system to actuate the pusher. The trigger system is provided with perceptible tactile sensing means to indicate when the legs of the staple being advanced are exposed so as to be visible to the user for positioning and orientation purposes. Anvil means provides for individually closing each staple to encompass at least a portion of the surgical mesh and to penetrate the body tissue in a manner to attach the portion of the mesh to the body tissue. Projecting distally of the cartridge support system is a pair of legs which are dimensioned and configured to engage the staple during closure to prevent unwanted roll or deformation outside of the plane of the staple.

A robot system for use in surgical procedures has two movable arms each carried on a wheeled base with each arm having a six of degrees of freedom of movement and an end effector which can be rolled about its axis and an actuator which can slide along the axis for operating different tools adapted to be supported by the effector. Each end effector including optical force sensors for detecting forces applied to the tool by engagement with the part of the patient. A microscope is located at a position for viewing the part of the patient. The position of the tool tip can be digitized relative to fiducial markers visible in an MRI experiment. The workstation and control system has a pair of hand-controllers simultaneously manipulated by an operator to control movement of a respective one or both of the arms. The image from the microscope is displayed on a monitor in 2D and stereoscopically on a microscope viewer. A second MRI display shows an image of the part of the patient the real-time location of the tool. The robot is MRI compatible and can be configured to operate within a closed magnet bore. The arms are driven about vertical and horizontal axes by piezoelectric motors.

An apparatus for supplying surgical buttress material to a surgical stapler is provided. The apparatus has a pivotable area for attaching surgical buttress material. The apparatus may also have an adhesive and a release liner disposed over the buttress material.

A bipolar surgical device comprises a pair of actuable jaws. A first electrode member which optionally includes a line of electrically coupled tissue-penetrating elements is formed on one of the jaws, and a second electrode member which optionally includes a line of electrically coupled tissue-penetrating elements is formed on the same or the other jaw. The electrode members are laterally spaced-apart and arranged in a parallel, usually linear manner so that the lateral distance therebetween remains generally constant. In operation, tissue may be grasped between the jaws so that the electrode members contact and / or the tissue-penetrating elements enter into the tissue. By energizing the electrode members at opposite polarities using a high frequency energy source, tissue between the jaws will be heated, coagulated, and / or necrosed, while heating of tissue outside of the lines will be minimized.

A surgical device for manipulating tissue. The device includes an elongated shaft having a proximal end and a distal end extending therefrom. There is also an elongated end effector having a proximal end attached to the distal end of the shaft, a distal end extending therefrom. The end effector has first and second opposing jaws which are movable with respect to each other from an open position, wherein the jaws are spaced apart, to a closed position wherein the jaws are in close approximation to one another. At least one of the jaws has an expandable member disposed thereon for selectively increasing the size of the jaw in a direction perpendicular to the longitudinal axis so as to increase the rigidity of the end effector.

A delivery device for delivering a plurality of individual surgical anchors is disclosed. The delivery device includes a housing, a delivery tube, having a distal and a proximal end, an actuator, flexible anchor reaction members, a reciprocating anchor carrier, having a distal and a proximal end, the distal end terminating in a tissue penetrator. The device further includes at least one surgical anchor located in juxtaposition with the anchor carrier. Each of the surgical anchors has a penetration section and a head section. The surgical anchors are preferably made from an absorbable polymer. The actuator is connected to the anchor carrier and has at least two states. The first, or home state, is a position such that the surgical anchor is proximal the distal end of the tube. The second state is such that the penetrating section of the surgical anchor is exposed beyond the distal end of the delivery tube.

The present invention provides a micro-robot for use inside the body during minimally-invasive surgery. The micro-robot includes an imaging devices, a manipulator, and in some embodiments a sensor.

Apparatus for intratubular intussusception and anastomosis of a hollow organ portion including a cylindrical enclosure, coaxial intratubular intussusception device, for intussusception and clamping means. The apparatus also includes an intratubular anastomosis apparatus for joining organ portions after intussusception thereof with an anastomosis ring and crimping support element. The ring is formed of a shape memory alloy wire, for crimping adjacent organ portions against the crimping support element so as to cause anastomosis therebetween. The ring assumes a plastic or malleable state, at a lower temperature and an elastic state at a higher temperature. The apparatus further includes the crimping support element for intratubular insertion so as to provide a support for crimping the organ portions against the support element. The apparatus additionally includes a surgical excising means, for excising an intussuscepted organ portion, after crimping adjacent intussuscepted organ walls against the crimping support element with the anastomosis ring.

A suture and needle combination is disclosed for use during surgical and non-surgical procedures comprising a suture needle 16 with a breakaway tip 20, insertable tip 24 or reusable tip 32. Suture 10 passes freely through hollow needle 16 after a user removes needle tip (20,24, or 32) during use. This suture needle combination reduces the amount of room needed within a surgical site, reduces the length of needle 16 needed to exit tissue (for example) while suturing, and decreased trauma to at risk anatomical structures during a surgical procedure or other use.

For positioning a surgical instrument at a surgical site, an elongate tubular structure is coupled to the distal portion of a robotic arm. This structure is adapted to be inserted in the body cavity of a patient and is adapted to receive the surgical instrument and serve as a guide for the surgical instrument into the patient's body. The robotic arm may have a parallelogram center of motion linkage and actuators for driving various degrees of freedom of movement of the arm and the surgical instrument. The robotic arm may be remotely controlled by an operator manipulating an input device.

The invention provides surgical or diagnostic tools and associated methods that offer improved user control for operating remotely within regions of the body. These tools include a proximally-located actuator for the operation of a distal end effector, as well as proximally-located actuators for articulational and rotational movements of the end effector. Control mechanisms and methods refine operator control of end effector actuation and of these articulational and rotational movements. A rotation lock provides for enablement and disablement of rotatability of the end effector. The tool may also include other features. A multi-state ratchet for end effector actuation provides enablement-disablement options with tactile feedback. A force limiter mechanism protects the end effector and manipulated objects from the harm of potentially excessive force applied by the operator. An articulation lock allows the fixing and releasing of both neutral and articulated configurations of the tool and of consequent placement of the end effector.

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.

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.

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.

An apparatus for application of surgical clips to body tissue has a handle portion with a body extending distally from the handle portion defining a longitudinal axis and a plurality of surgical clips disposed within the body. The apparatus also has a jaw assembly mounted adjacent a distal end portion of the body with the jaw assembly including first and second jaw portions movable between a spaced-apart and an approximated position. The apparatus further has a wedge plate longitudinally movable between the first and the second jaw portions, and a clip pusher configured to individually distally advance a surgical clip to the jaw assembly while the jaw portions are in the spaced apart position with an actuator. The actuator is at least partially disposed within the body and longitudinally movable in response to actuation of the handle portion and has a cam link. The apparatus also has a jaw closure member positioned adjacent the first and second jaw portions to move the jaw portions to the approximated position. The cam link longitudinally moves wedge plate between the first and the second jaw portions.

An articulated surgical instrument for enhancing the performance of minimally invasive surgical procedures. The instrument has a high degree of dexterity, low friction, low inertia and good force reflection. A unique cable and pulley drive system operates to reduce friction and enhance force reflection. A unique wrist mechanism operates to enhance surgical dexterity compared to standard laparoscopic instruments. The system is optimized to reduce the number of actuators required and thus produce a fully functional articulated surgical instrument of minimum size.

A surgical system or assembly for performing cardiac surgery includes a surgical instrument; a servo-mechanical system engaged to the surgical instrument for operating the surgical instrument; and an attachment assembly for removing at least one degree of movement from a moving surgical cardiac worksite to produce a resultant surgical cardiac worksite. The surgical system or assembly also includes a motion tracking system for gathering movement information on a resultant surgical cardiac worksite. A control computer is engaged to the attachment assembly and to the motion tracking system and to the servo-mechanical system for controlling movement of the attachment assembly and for feeding gathered information to the servo-mechanical system for moving the surgical instrument in unison with the resultant surgical cardiac worksite such that a relative position of the moving surgical instrument with respect to the resultant surgical cardiac worksite is generally constant. A video monitor is coupled to the control computer; and an input system is coupled to the servo-mechanical system and to the control computer for providing a movement of the surgical instrument. The video monitor displays movement of the surgical instrument while the resultant surgical cardiac worksite appears substantially stationary, and while a relative position of the surgical instrument moving in unison with the resultant surgical cardiac worksite, as a result from the movement information gathered by the motion tracking system, remains generally constant. A method of performing cardiac surgery without cardioplegia comprising removing at least one degree of movement freedom from a moving surgical cardiac worksite to produce at least a partially stationary surgical cardiac worksite while allowing a residual heart section, generally separate from the at least partially stationary surgical cardiac worksite, to move as a residual moving heart part. Cardiac surgery is performed on the at least partially stationary cardiac worksite with a surgical instrument such as needle drivers, forceps, blades and scissors.

Surgical assemblies, instruments, and related methods are disclosed that control tissue gripping force. A surgical assembly includes an end effector including a jaw operable to grip a patient tissue and a spring assembly. The spring assembly includes an output link drivingly coupled with the jaw, an input link drivingly coupled to an articulation source, and a spring coupled with the input and output links to transfer an articulation force from the input link to the output link. The spring is preloaded to inhibit relative movement between the input link and the output link while the transferred articulation force is below a predetermined level and so as to allow relative movement between the input link and the output link when the transferred articulation force is above the predetermined level.