A tourniquet with a twisting assembly including a base part having a plurality of teeth arranged in a circle; and a twisting part adapted for rotating relative to the base part and the twisting part having a windlass portion. A portion of a strap can be operatively connected to the windlass portion such that when the windlass portion is rotated, the portion of the strap is twisted. The twisting assembly is adapted to allow movement of the twisting part away from close engagement with the teeth of the base part to allow rotation of the twisting part in one rotational direction relative to the base part. The twisting assembly is adapted to cooperatively allow movement of the twisting part into close engagement with the teeth of the base part to prevent rotation of the twisting part in the opposite rotational direction.

An apparatus includes a body, a shaft, and a stapling head assembly. The shaft extends distally from the body and includes a coupling feature. The coupling feature includes threading or at least one barb. The stapling head assembly is configured to cut and staple tissue. The stapling head assembly is positioned at a distal end of the shaft. The stapling head assembly includes a knife member and a body member. The knife member includes a circular cutting edge configured to cut through tissue. The body member is configured to house the knife member. The body member includes a coupling feature that is configured to mechanically couple with the coupling feature of the shaft. The coupling feature of the body member includes threading or at least one barb.

An electronic system for a surgical instrument is disclosed. The electronic system comprises a main power supply circuit configured to supply electrical power to a primary circuit. A supplementary power supply circuit configured to supply electrical power to a secondary circuit. A short circuit protection circuit coupled between the main power supply circuit and the supplementary power supply circuit. The supplementary power supply circuit is configured to isolate itself from the main power supply circuit when the supplementary power supply circuit detects a short circuit condition at the secondary circuit. The supplementary power supply circuit is configured to rejoin the main power supply circuit and supply power to the secondary circuit, when the short circuit condition is remedied.

A surgical instrument includes a body assembly, a shaft assembly extending distally from the body assembly along a shaft axis, and an end effector at a distal end of the shaft assembly. The shaft assembly includes an outer tube configured to rotate relative to the body assembly about the shaft axis. The surgical instrument further includes a slip ring assembly configured to enable electrical communication between the shaft assembly and the body assembly while permitting relative rotation therebetween. The slip ring assembly includes a first electrical contact supported by the outer tube, and a second electrical contact electrically coupled with the first electrical contact and positioned radially outward of the outer tube. The first electrical contact is configured to rotate with the outer tube about the shaft axis relative to the second electrical contact while the first and second electrical contacts remain electrically coupled.

A medical device for approximating and securing tissue without requiring knots includes a lock-head, a strap section, distal protuberance, and a leader section. The device also includes a transition section between the leader and the strap section and a stiffening section proximal to the protuberance. The leader section is used to draw the strap section into the body through small apertures in tissue and the transition section provides a gradual transition in stiffness and size between the leader and the strap section. Tensioner and cutter and a threading tool configured to be slidably removed from a lumen of the tensioner and cutter is provided. A blade within the lumen of the tensioner and cutter is provided to cut excess leader and/or strap when the procedure is completed.

A surgical stapling device includes a tool assembly and a handle assembly. The tool assembly includes first and second jaw members. The handle assembly includes a rack and a retraction assembly. The rack is operatively coupled to the tool assembly and slidably supported in the handle assembly. The rack includes teeth extending along a length of the rack. The retraction assembly includes a shaft, a lever including a wheel and a lever handle extending from the wheel, and a pawl pivotably secured to the wheel. The lever is secured to the shaft for concomitant rotation therewith. The shaft is transitionable between a disengage state, in which, the pawl is disengaged from the teeth of the rack, and an engaged state, in which, the pawl engages the teeth of the rack such that when the lever handle is rotate about the shaft, the rack is retracted.

A laparoscopic staged hepatectomy using round-the-liver ligation is carried out includes: (1) a laparoscopic operation is performed with general anesthesia using round-the-liver ligation, the branches of the portal vein of the hemiliver are ligated, a tourniquet is used to tighten the connecting part between the right and left hemilivers to block the communicating blood flow between the hemiliver to be removed and the hemiliver to be reserved, a drainage tube is put into the peritoneal cavity, then close the peritoneal cavity; (2) the patient gradually resumes eating after the first operation, and recuperate to make the volume of the hemiliver increase to an expected volume; (3) after the hemiliver increases to the expected volume, a laparoscopic liver resection is carried out with general anesthesia to remove the diseased hemiliver, and then the patient is nursed to be completely recovered. An instrument for implementing the laparoscopic staged hepatectomy is also disclosed.

A bone graft delivery system can include an elongate tube, a handle having a trigger, and a tip. The trigger is actuated to deliver bone graft material through the tube. The tip has one or more openings to deliver the bone graft material to a desired location and includes a surface suitable to act as a rasp for decorticating bone. A method for delivering bone graft material to a desired surgical location includes providing a bone graft delivery device, positioning the device adjacent the surgical location, decorticating bone, and delivering bone graft material to the surgical location.

An endoscopic surgical clip applier includes an endoscopic assembly and a handle assembly. The handle assembly includes a housing, a trigger, a drive bar, and a ratchet assembly. The ratchet assembly includes a first rack, a second rack, a pawl housing engageable with the first rack, and a second pawl engageable with the second rack. In a first position, the pawl housing is in registration with the first rack to prohibit reversal of a direction of movement of the trigger until the pawl housing is disposed beyond a proximal end or a distal end of the first rack. In a second position, the pawl housing is out of registration with the first rack to permit reversal of the movement of the trigger after the second pawl is disposed distally beyond a distal end of the second rack or proximally beyond a proximal end of the second rack.

A system for closing a blood vessel includes a housing having a proximal end and a distal end and configured to be held in the hand of a user, an elongate body extending from the distal end of the housing, a distal housing having a proximal end coupled to a distal end of the elongate body and having a cavity including an opening on a side of the distal housing, a lumen passing through the elongate body and terminating at the cavity of the distal housing and configured to couple to a vacuum source, a sensor carried by the distal housing adjacent the cavity and configured for identifying a blood vessel, wherein the lumen is configured to maintain a vacuum within the cavity when a probe having a vessel closure module is inserted within the lumen and the vessel closure module is within the cavity.