256 results about "Suturing instrument" patented technology

A fibrin injection mechanism for use in combination with an anastomosing and stapling attachment for an electromechanical device driver comprises a cylindrical dispensing chamber adjacent the cylindrical blade of the attachment and containing a sac filled with fibrin, a plurality of channels extending within the blade communicating between the dispensing chamber and the cutting edge of the blade, such that when the turning drive shaft is activated, the staple driver of the attachment moves forward to push a plurality of staples through corresponding staple ports and against the anvil of the attachment to pass through and staple together the target tissue, while the blade driver of the attachment moves forward to cut the unwanted residual tissue (post stapling), while a plunger (delivery) driver moves forward through the dispensing chamber to compress the sac to its break point, releasing the fluid medication into the dispensing chamber, and eventually pushing the medication though the channels to deliver the fibrin to the cutting edge of the blade and thus to the site of the newly stapled target tissue to accelerate the healing process.

A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to be movable relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. The system further includes a tissue suturing instrument and a suture securing instrument. Each of these instruments has a distal end coupled to a partially flexible shaft locatable through the accessory tube.

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.

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 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.

In various embodiments, a disposable loading unit for a surgical stapling instrument can include an anvil, a staple cartridge, a staple cartridge channel for operably supporting the staple cartridge, and a connector for removably attaching the disposable loading unit to the surgical instrument. In at least one embodiment, a first staple cartridge can be replaced with another staple cartridge after the first staple cartridge has been at least partially expended. In various embodiments, a staple cartridge can include a staple driver for deploying staples from the staple cartridge and a cutting member for incising tissue, wherein a new staple driver and a new cutting member can be provided with each new staple cartridge. The anvil can be removably attachable to the disposable loading unit such that a new anvil can be utilized with a new staple cartridge.

Circular stapling instruments for cutting and applying one or more surgical staples to tissue are disclosed. The instruments include various forms of feedback systems designed to provide at least one mode of feedback to the surgeon when the knife has cut through tissue clamped between a staple cartridge and an anvil portion.

An end effector for a surgical cutting and stapling instrument. In various embodiments, the end effector may include an elongate channel that is configured to support a staple cartridge therein and which is also operably coupled to a surgical cutting and stapling instrument. An anvil may be movably supported relative to the elongate channel for selective movement between an open position and a closed position wherein tissue is clamped between the anvil and a staple cartridge supported within the elongate channel in response to a closing motion applied thereto from the surgical cutting and stapling instrument. At least one light source may be provided on at least one of the staple cartridge and the elongate channel. The light sources may interface with the anvil to provide a visual indication viewable through a portion of the anvil to indicate a position of tissue clamped between the anvil and the staple cartridge.

A system for endoscopic suturing is provided having an endoscope, such as a gastroscope, with a distal end locatable in the body of a patient and a flexible shaft extending to the distal end, a flexible accessory tube coupled to the endoscope to be movable relative to the endoscope's shaft, and a tip coupled to the shaft of the endoscope having an opening through which one end of the accessory tube is received. A tissue suturing instrument is provided having a partially flexible shaft locatable through the accessory tube, and a tissue engaging end coupled to the shaft. The tissue engaging end has a vacuum sleeve enabling suction to be selectably applied at the tissue engaging end to capture tissue through an opening in the vacuum sleeve. Two needles are provided which extend through the shaft of the suturing instrument. Each needle is separately actuated into a gap in the instrument's tip, through tissue suctioned into the opening of the vacuum sleeve and into a ferrule at each end of a loop of suture. The system further includes a suture securing instrument having a partially flexible shaft locatable through the accessory tube, and a distal end coupled to the shaft. After removal of the suturing instrument from the accessory tube, a loop of suture extends through the tissue and the accessory tube, the suture securing instrument receives the free ends of the loop of suture at its distal end through a sleeve member, and the suture securing instrument is then inserted through the accessory tube to the location of the suture in the tissue. The suture securing instrument crimps the sleeve member and cuts the free ends of the suture to secure the suture closed. The suturing instrument and suture securing instrument are passed through the accessory tube without removal of the endoscope from the patient. The endoscope provides viewing by an operator of the engaging end of the suturing instrument for selecting placement of the suture through tissue, and of the distal end of the suture securing instrument to secure the suture closed.

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. Various embodiments are configured to be operably attached to a robotic system to receive actuation / control motions therefrom.

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. Various embodiments are configured to be operably attached to a robotic system to receive actuation / control motions therefrom.

A surgical stapling instrument. Various embodiments include an actuation system for selectively generating a plurality of control motions. A surgical end effector is operably coupled to the actuation system. The actuation system interfaces with an actuation member configured to operably engage rotatable camming members to fire staples within the end effector into forming contact with an anvil portion of the end effector.

The present invention provides a new family of ultrasonically powered medical devices and systems for powering such devices. Disclosed are methods for improving the overall power transfer efficiency of devices according to the present invention, as well as a wide variety of medical uses for such devices and systems. Devices of the present invention comprise a transducer that, during operation, converts electrical energy into high frequency, low amplitude mechanical vibrations that are transmitted to a driven-member, such as a wheel, that produces macroscopic rotary or linear output mechanical motions. Such motions may be further converted and modified by mechanical means to produce desirable output force and speed characteristics that are transmitted to at least one end-effector that performs useful mechanical work on soft tissue, bone, teeth and the like. Power systems of the present invention comprise one or more such handheld devices electrically connected to a power generator. Examples of powered medical tools enabled by the present invention include, but are not limited to, linear or circular staplers or cutters, biopsy instruments, suturing instruments, medical and dental drills, tissue compactors, tissue and bone debriders, clip appliers, grippers, extractors, and various types of orthopedic instruments. Devices of the present invention may be partly or wholly reusable, partly or wholly disposable, and may operate in forward or reverse directions, as well as combinations of the foregoing. The devices and systems of the present invention provide a safe, effective, and economically viable alternative source for mechanical energy, which is superior to AC or DC (battery) powered motors, compressed air or compressed gas, and hand powered systems.

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.

An instrument for surgical suturing includes a shaft, and a needle disposed slidably for longitudinal travel with respect to the shaft. A prong formed on one end of the shaft projects across a longitudinal axis of the needle and has an opening formed through the prong that provides a clearance through which a tip portion of the needle passes when it is advanced. Slots formed on a surface of the prong facing the shaft releasably hold suture across the opening. Advancing the needle through the clearance allows a hook formed on the tip of the needle to capture the suture. Once withdrawn, the needle draws the suture back through tissue pierced during advancement. The suture is released from the slots and drawn back through the tissue for further knot tying and suturing to effect the tissue repairs.

A surgical stapling instrument including an actuator knob which can be moved from one side of the stapling instrument to another side in order to reposition the actuator knob without having to reposition the stapling instrument within a surgical site. A stapling instrument can include a pusher bar, a housing having a first side and a second side, and an actuator knob rotatably mounted to the pusher bar wherein the actuator knob can be configured to be rotated between a first position in which the actuator knob can be moved along the first side of the housing and a second position where the actuator knob can be moved along a second side of the housing. Alternatively, a surgical stapling instrument can comprise one or more actuator knobs which can be operably engaged and disengaged with a pusher bar in order to selectively utilize the actuator knobs.

A surgical stapling instrument and, in addition, a staple cartridge comprising a cutting member positioned therein. The staple cartridge can comprise alignment features configured to align the cutting member of the staple cartridge with a distal end of a drive bar when the staple cartridge is assembled to the surgical stapling instrument.

A method and device for the placement of sutures and for the purpose of approximating tissue. The invention relates to devices for approximation, ligation and fixation of tissue using a suture, to various constituent parts comprising said devices, and particularly to the placement of sutures into certain difficult to access ligamental structures, to the approximation of tissue separated by means of an endosurgical trocar being inserted into a body cavity, and to approximation, ligation, and fixation of body tissue using both traditional open surgical and endosurgical techniques and instruments. The invention provides for the loading of suture material including needles into the device, introduction and placement of the device into the body cavity, with the distal end having deployable needle guides, extending the needle guides either simultaneously or individually to the periphery of the wound, engaging the wound with the needle guides, driving the needles and suture material through the tissue to be approximated into a catch mechanism, retracting the needle guides and withdrawing the device, leaving a loop of suture material in the margin of tissue. The suture may then be tied to approximate the wound and excess suture material cut off. The invention also provides for the placement of sutures for the endoscopic approximation, fixation, and ligation of tissues within a body cavity including the driving and retrieval of needle and suture combinations, and facilitating the tying of knots.

A device is disclosed for introducing a flexible elongated element through at least two portions of a subject. The device includes an advancement unit for advancing the flexible elongated element toward the end of the device such that the elongated element may exit from the device with sufficient force to pass through the subject. The device also includes a curved die for imparting a looping configuration to portions of the flexible elongated element exiting the device, and a curved guide for receiving the looped flexible elongated element as it returns to the end of the device. A cutting mechanism is provided to permit the looped flexible elongated element to be separated from the remainder of the flexible elongated element. The cutting mechanism is adapted to deform the trailing end of the looped flexible elongated element so that the trailing end is forced distally, toward the subject being sutured.

The invention relates to devices and methods for approximation, ligation, and fixation of tissue. The devices and methods are used with both traditional open surgical and endosurgical techniques.

A surgical stapling instrument including a staple sled which can be advanced and / or retracted relative to first and second jaw members, wherein the staple sled can be configured to deploy staples from a staple cartridge in one of the first and second jaw members. In at least one embodiment, the other of the first and second jaw members can include an anvil having at least one forming surface which can be configured to deform the staples as they are deployed from the staple cartridge. In at least one form of the invention, the anvil can be movably adjustable relative to the staple cartridge in order to adjust the distance in which the staples are deformed. In various embodiments, the anvil can be adjusted by a slidable adjusting plate and / or a rotatable cam.

A surgical stapling instrument including a first jaw member, a second jaw member, and a cutting member. In at least one form of the invention, the surgical stapling instrument can further include a housing which can at least partially extend over and / or around the cutting member. In various embodiments, the housing can at least partially cover the cutting member when the first and second jaw members are detached from one another, yet permit the cutting member to be moved relative to the first and second jaw members during use.

A surgical stapling instrument including first and second jaw members which can be pivotably connected to each other and secured in position relative to each other by a latch. The first and second jaw members can include first and second locking members which can allow the first and second jaw members to be rotated relative to one another but prevent, or at least inhibit, the first and second jaw members from being separated from one another. Such embodiments may be particularly useful in circumstances when the latch is in a partially-closed position and the first and second jaw members are being manipulated to position tissue therebetween. The first and second jaw members can be sufficiently connected together in order to prevent, or at least reduce the possibility of, the first and second jaw members from becoming detached from one another and exposing a cutting member.

A device is disclosed for passing a flexible elongated element through a portion of a subject. In an embodiment, the device includes structure for retaining said flexible elongated element; and advancement structure for longitudinally advancing the flexible elongated element from a proximal end of the device toward a distal end of the device with sufficient force to pass the flexible elongated element through the portion of the subject. The advancement structure includes at least one drive wheel for contacting the flexible elongated element, and further wherein the at least one drive wheel contains a peripheral groove therein for receiving the flexible elongated element so as to provide increased contact area between the at least one drive wheel and the flexible elongated element.

Circular stapling instruments for cutting and applying one or more surgical staples to tissue are disclosed. The instruments include various forms of feedback systems designed to provide at least one mode of feedback to the surgeon when the knife has cut through tissue clamped between a staple cartridge and an anvil portion.