Apparatus and methods are described allow the techniques of endoscopic and laparoscopic surgery to be combined into a minimally invasive hybrid surgical technique called NOTES-assisted laparoscopic surgery. Manual and robotic-controlled versions of a modular laparoscopic tool are described having a small diameter shaft that is delivered laparoscopically to a surgical site. Larger diameter working tips are delivered through a NOTES delivery tube inserted to the surgical site through a natural orifice and joined to the shaft of the modular laparoscopic tool. Larger diameter working tips improve the effectiveness of the modular laparoscopic tools and the number and size of laparoscopic ports used can also be reduced.

An end effector assembly for a surgical instrument includes first and second jaw members each including a jaw housing, an electrically-conductive tissue-treatment plate, and a longitudinally-extending channel. The first and/or second jaw member is movable relative to the other between a spaced-apart position and an approximated position. A cutting mechanism is disposed at least partially within the second jaw member. The cutting mechanism may include an inflatable bladder, a fluid line coupled to the inflatable bladder, and a knife coupled to the inflatable bladder. The cutting mechanism may alternatively include a fluid line, a knife, and a sealing member that defines a variable-volume sealed chamber within the longitudinally-extending channel of the second jaw member. The cutting mechanism may alternatively include at least one electromagnet, at least one electrical wire coupled to the at least one electromagnet, and a knife operably coupled to the at least one electromagnet.

Systems for the minimally invasive repair, stabilization and/or fixation of a fractured bone, such as a rib, are disclosed. The systems include one or more rods/support members that are designed to extend along a dimension of a bone being repaired and secure the fractured bone. The support members can be photodynamic and are formed using an expandable member that is filled with a light-sensitive liquid that is cured to form the rigid support member. Two or more clamps are used to secure the support member(s) to the rib or other bone. Minimally invasive surgical methods for securing the systems to a fractured bone are also disclosed.

A method of changing a bone angle includes creating an osteotomy between a first portion and a second portion of a tibia of a patient; creating a cavity in the tibia by removing bone material along an axis extending in a substantially longitudinal direction from a first point at the tibial plateau to a second point; placing a non-invasively adjustable implant into the cavity, the non-invasively adjustable implant comprising an adjustable actuator having an outer housing and an inner shaft, telescopically disposed in the outer housing, and a driving element configured to be remotely operable to telescopically displace the inner shaft in relation to the outer housing; coupling one of the outer housing or the inner shaft to the first portion of the tibia; coupling the other of the outer housing or the inner shaft to the second portion of the tibia; and remotely operating the driving element to telescopically displace the inner shaft in relation to the outer housing, thus changing an angle between the first portion and second portion of the tibia.

An endoscopic stapler is disclosed. The stapler includes a staple member and an anvil member. The staple member may include a staple housing and the staple holder may include one or more staples. The anvil member may be spaced apart from the staple member and may configured to relatively move towards one another. A controller may be fluidly coupled to the staple member through a plurality of conduits. The controller may be configured to (a) direct a pressurized fluid to the staple member through a first conduit of the plurality of conduits to relatively move the staple member and the anvil member towards one another, and (b) direct the pressurize fluid through a second conduit of the plurality of conduits to eject one or more staples from the staple holder.

Medical devices for delivering compositions or medical articles to a patient are disclosed. The medical plug delivery devices can include a fluid delivery device (e.g., a syringe), a frame, and a rotatable magazine. The rotatable magazine can include a plurality of chambers that each hold a composition or a medical article (e.g., a medical plug). By rotating the rotatable magazine relative to the frame, material within the chambers of the rotatable magazine can be sequentially deployed to a patient.

A biopsy device includes a hydraulic drive assembly, a drive mechanism, and a biopsy member. The hydraulic drive assembly includes a chamber housing, a drive piston, a driven piston, a cavity in the chamber housing between the drive piston and the driven piston, and a hydraulic fluid that fills the cavity and hydraulically connects the drive piston to the driven piston. The chamber housing defines a proximal chamber, a distal chamber, and a transition chamber, collectively forming a continuous passage. The drive mechanism includes a motor, a drive gear attached to the motor, a driven gear engaged with the drive gear, and a drive link member coupling the driven gear to the drive piston. The drive mechanism is drivably connected to the drive piston to move the drive piston in the proximal chamber. The driven piston moves in the distal chamber. The biopsy member is connected to the driven piston.

A shell assembly includes a shell housing defining a cavity, a plurality of staples, a staple cartridge supported on the shell housing, a pusher assembly positioned within the cavity of the shell housing, and a hydraulic piston configured to engage the pusher assembly to impart axial displacement to the pusher assembly and form a fluid tight seal against the shell housing. The staple cartridge defines slots that receive the plurality of staples. The pusher assembly includes a plurality of pushers arranged in an annular configuration to eject the plurality of staples from the staple cartridge. Supply of a fluid into the cavity of the shell housing advances the hydraulic piston, which, in turn, advances the pusher assembly to eject the plurality of staples from the staple cartridge.

A staple having a crown, a deformable leg extending from the crown, and a spring extending from the crown configured to compress tissue between the spring and the deformable member. Owing to the flexibility of the spring, the staple can accommodate a wide range of tissue thicknesses while still compressing the tissue captured therein. As a result, a single staple design can be used in a wide variety of surgical procedures thereby reducing the amount of staple designs that must be provided to the surgeon. In at least one embodiment, the staple includes a crushable member. This crushable member can include a plastically deformable first portion and an elastically deformable second portion. The present invention can also include, in various embodiments, a crown, a first deformable member extending from the crown, and means for compressing the tissue against the first deformable member.

Hydraulically expandable spinal rods and methods of use thereof are disclosed. The spinal rod may include a piston rod, a static rod, and a hydraulic pressure chamber for accepting hydraulic fluid and causing the piston rod to move in an expansion direction relative to the static rod. Upon connection of the piston and static rods to a patient's spinal column, the hydraulic spinal rod may be expanded to aid in correction of an underlying spinal deformity.