摘要:
An apparatus is operable to secure suture fasteners to sutures to eliminate the need to tie knots in the sutures. The apparatus comprises a shaft, an end effector disposed at the distal end of the shaft, and a suture fastener removably secured to the end effector. The end effector may include a pivoting jaw or a suture cutter. The suture fastener may be secured to one, two, or more strands of suture. The apparatus may include several suture fasteners and may secure those fasteners to one or more sutures in a serial fashion without having to remove the apparatus from the patient for reloading. A plurality of fasteners may be arranged within the apparatus in an end-to-end configuration. The suture fastener may include an inner fastener member and an outer fastener member, and may capture one or more strands of suture between the inner and outer fastener members.
摘要:
A needle holder includes a shaft and a needle driver located at the distal end of the shaft. The needle driver is operable to rotate a needle such that the needle forms a non-perpendicular angle with a longitudinal axis of the shaft. In some versions, the needle driver includes a first arm and a rotatable assembly that is configured to longitudinally clamp about a portion of a needle. The rotatable assembly may include self-righting features to right the needle perpendicular to the first arm. The needle driver may further include a second arm that is pivotable relative to the first arm. The rotatable assembly may include a top member associated with the second arm and a bottom member associated with the first arm. In some versions, spring-loaded collets may secure the needle to a rotatable assembly. Alternatively, a pair of actuating arms may pivot the needle about a curved surface.
摘要:
A suture needle driving instrument comprises a shaft assembly, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft assembly and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The shaft assembly includes two pairs of parallel concentric shafts, which form part of the actuation assembly. Each shaft pair is operable to drive a respective internal drive shaft having separate threaded regions with opposing pitch. The instrument may be used through a trocar during minimally invasive surgery.
摘要:
An apparatus comprises an end effector, a shaft assembly, and a drive assembly. The end effector comprises needle receiving arms operable to grasp a needle. The drive assembly comprises drive members that are rotatable about respective drive axes that are perpendicular to the axis of the shaft assembly. The drive assembly is operable to drive the needle receiving arms to selectively engage and disengage the needle; and to selectively pass the needle from one needle receiving arm to the other needle receiving arm. The drive assembly provides an interface to a controller that is operable via a remote user interface. The drive assembly may include helical gears, clutch assemblies, a rack and pinion, or other components to convert motion of the drive members into motion at the end effector.
摘要:
A suture needle driving instrument comprises a shaft and an end effector. The end effector is located at the distal end of the shaft and includes a pair of needle grasping arms. Each grasping arm extends along a respective arm axis. The grasping arms are operable to drive a suture needle along a rotational path about an axis, such as one of the arm axes, that is offset from the central longitudinal axis of the shaft. The rotational path may be perpendicular to the axis of the shaft. A needle driven by the end effector may have an arc radius that is greater than the radius of the shaft. At least one of the needle grasping arms may include a dogleg feature positioning a distal portion of the grasping arm outside the radius of the shaft. The instrument may be used through a trocar during minimally invasive surgery.
摘要:
A surgical needle includes a pair of ends, a mid-region extending between the ends, and at least one grasping feature configured for grasping by a suturing instrument. An end of a suture is secured to the mid-region of the needle in a manner such that the end of the suture defines an oblique angle with at least part of the centerline defined by the mid-region of the needle. The end of the suture may be disposed in a hollow portion of the needle. The grasping feature may include a notch such as a scallop. The suture may be pivotally coupled with the needle via a ball or pin. The needle may have one or more sharp points. The sharp point may include three converging cutting edges, at least two planar surfaces bounded by the three cutting edges, and a rounded surface bounded by two of the three cutting edges.
摘要:
A surgical instrument includes a handle portion, a shaft housing a firing bar, an end effector comprising an anvil, a lower jaw, and a stapling and severing assembly responsive to a longitudinal closing motion produced by the handle portion and the shaft. The lower jaw is configured to receive a removable cartridge. The cartridge includes a housing, a plurality of staples disposed in the housing, and a deck disposed over the plurality of staples. The deck defines apertures, with each aperture being substantially disposed over each staple. The cartridge further receives a buttress material stored in one or both of the anvil or cartridge. The material is releasable onto severed tissue via a firing bar severing the buttress material in response to the longitudinal closing motion.
摘要:
Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices are accomplished via stabilized implantable systems, and ingestible pills. In one embodiment, the implantable system comprises a device delivering a therapeutic substance to a target location within the gastrointestinal tract of a patient in order to initiate an intestinal braking effect which would promote sensations of satiety and stimulate excess weight loss for the patient.
摘要:
A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.
摘要:
Methods and devices create an intestinal braking effect, are non-invasive or minimally invasive, and may be reversible. These methods and devices may be accomplished via stabilized implantable systems and ingestible pills. In one aspect, a method of inducing satiety includes implanting an implant within a lumen of a gastrointestinal tract and retaining a portion of chyme that flows by the implant within a body of the implant. The method further involves re-releasing the retained chyme from the implant into the gastrointestinal tract at a predetermined rate slower than a rate caused by natural peristalsis.