A surgical stapling device includes an end effector configured to accommodate prolapsed tissue to perform an anastomosis externally of a body cavity. The surgical stapling device has an anvil assembly and a shell assembly. The anvil assembly includes an anvil plate and anvil rods that extend proximally from the anvil shaft and are positioned about the shell assembly. The anvil plate has a proximally facing surface that defines staple forming pockets. The shell assembly includes a shell housing that defines a cavity, an annular pusher that is movable within the cavity from a retracted position to an advanced position, an annular staple cartridge, and an annular knife blade. The staple cartridge includes staple receiving pockets that receive staples, and the knife blade is secured to the pusher radially outwardly of the staple receiving pockets.

An anastomotic coupler is provided. A ring can include a receiving portion. A fixation device includes a cartridge. The cartridge includes a plurality of fasteners. Upon actuation of the fixation device, the fasteners puncture the tubular structure. The fasteners are received by the receiving portions such that the tubular structure is coupled with the ring.

Systems and methods for treating tissue may include one or more delivery devices, a grasping element, a first ring for anchoring to a wall of a gastrointestinal tract, and a second ring operably couplable to a radially inward surface of the first ring. Other embodiments include methods of treating tissues, including tubular tracts of tissue, comprising coupling a first ring to first tissue of a wall of a tissue tract, relocating a target tissue proximally to a position proximal to the first ring, coupling a second ring to the first ring, and cutting tissue proximal to the interface of the first and second rings.

An apparatus is provided for stapling tissue. The apparatus includes an anvil and a trocar selectively coupled with the anvil. The anvil may have an inner opening and a plurality of staple pockets aligned around a surface of the anvil. The anvil may be inserted trans-orally through an esophagus prior to being coupled with the trocar. The trocar may include a shaft and a locking assembly. The locking assembly may secure the anvil in position relative to the trocar when the locking assembly is in the expanded position. The apparatus may also include an alignment assembly to align the staple pockets of the anvil relative to the apparatus. The apparatus may also include an introduction assembly to guide the anvil through the esophagus.

Methods, apparatuses, and systems are described for stent delivery and positioning for transluminal application. The method may include positioning the stent in an undeployed configuration through an access site in a wall of a first body lumen. In some cases, the method may include retracting an outer sheath proximally and past an anchoring component disposed at a distal portion of an inner tubular member based on positioning the stent. A distal portion of the stent may be disposed between the anchoring component and the outer sheath while the stent is in the undeployed configuration. The method may further include deploying the distal portion of the stent from the outer sheath and within the first body lumen and expanding a proximal portion of the stent from within the outer sheath such that upon fully exiting the outer sheath, the proximal portion expands to a deployed configuration within a second body lumen.

A system is configured to bring about anastomosis between two lumens in a patient or between two sections of a single lumen in a patient. The anastomosis system includes a first tissue-compressing element, a second tissue-compressing element, and an energy source. The energy source can be a thermal energy source or laser energy source. Tissue is interposed between the elements. Magnetic material incorporated into the tissue-compressing elements facilitates the alignment of the elements as well as compression of the interposed tissue. The energy source can deliver energy to tissue. This delivery of energy can cause local changes to the tissue that can help maintain positional stability of the implants, can bring about immediate patency of the anastomosis and can otherwise facilitate achieving desired outcomes for the patient.

A method is provided for operating a powered surgical stapler having a motor unit, a controller. and a stapling assembly having a closure member, a staple driver member, and a knife member. The controller receives a user input that indicates a tissue gap to be defined by the stapling assembly in a closed state. Based on the user input, the controller controls the motor unit to actuate the closure member to transition the stapling assembly to the closed state to define the tissue gap and clamp tissue therein. The controller then controls the motor unit to actuate the staple driver member to drive staples into the clamped tissue. In response to determining that the staple driver member has reached a predetermined longitudinal position, the controller controls the motor unit to initiate actuation of the knife member to cut the clamped tissue.

A stent with a selectively curved region. The stent includes a radially expandable tubular framework and a covering surrounding the tubular framework. A stent also includes a drawstring having a first end attached to the tubular framework at a first attachment location proximate the distal end of the tubular framework. The second end of the first drawstring is manipulatable proximate the proximal end of the tubular framework to deflect the tubular framework into a curved configuration.

A method for characterizing a state of an end effector of an ultrasonic device is disclosed. The ultrasonic device including an electromechanical ultrasonic system defined by a predetermined resonant frequency. The electromechanical ultrasonic system further including an ultrasonic transducer coupled to an ultrasonic blade. The method including applying, by an energy source, a power level to the ultrasonic transducer; measuring, by a control circuit coupled to a memory, an impedance value of the ultrasonic transducer; comparing, by the control circuit, the impedance value to a reference impedance value stored in the memory; classifying, by the control circuit, the impedance value based on the comparison; characterizing, by the control circuit, the state of the electromechanical ultrasonic system based on the classification of the impedance value; and adjusting, by the control circuit, the power level applied to the ultrasonic transducer based on the characterization of the state of the end effector.

The present invention relates to a system for bypassing stomach and creating a barrier for the proximal small bowel to include duodenum and jejunum so that food delivered is directly in the jejunum that results in weight loss. The technique involves placement and fixation of a gastric bypass device within the stomach to cover the small bowel. The present invention also provides a device and method which enables the suturing of the gastric bypass device. The duodeno-jejunal barrier remains unchanged and helps in bypassing the absorptive surface of the proximal small bowel.