An anastomosis device includes a stapler and an anvil. The stapler includes a clamp head with opposing first and second clamp jaws and a clamp actuator and clamp lock. Staple magazines are connected to the clamp jaws for retaining a plurality of staples in an array, and drivers are provided for moving the plurality of staples in the array out of the staple magazine. An anvil includes a clamp head with opposing first and second clamp jaws, a clamp actuator and a clamp lock. Anvil portions are connected to the clamp jaws. The stapler detachably engages to the anvil, and aligns the staple magazines with the anvils. The drivers are operated to move the staples from the staple magazines into contact with the anvil portions. A method for performing anastomosis is also disclosed.

A catheter-based device tracks over a guidewire which has been placed from a first blood vessel into a second blood vessel. The distal tip of the catheter is advanced into the second vessel while a proximal member remains in the first vessel. Matching blunt tapered surfaces on each of the distal tip and the proximal member are clamped together, with adjacent walls of each vessel between them, after which a known, controlled pressure is applied between the two surfaces. Heat energy is then applied to the blunt surfaces for approximately 1-30 seconds to weld the walls of the two vessels together. After coaptation of the vessel walls, the heat is increased to then cut through the vessel walls to create a fistula of the desired size.

Methods, devices, apparatus, assemblies, and kits for performing a vascular anastomosis are disclosed. A device for a vascular anastomosis includes tissue engaging portions that can move between at least two configurations. In some embodiments, the tissue engaging portions move without the aid of moving parts, while in other embodiments the tissue engaging portions extend from one or more movable wings. The tissue engaging portions may be separated by a first distance when in a pre-deployment configuration and by a second distance when in a deployed configuration. A method includes engaging a plurality of tissue engaging members of a coupling device against first end tissue. After selectively engaging the tissue engaging members and first end tissue, the first end tissue is stretched by at least moving the tissue engaging members. The stretched first end tissue is coupled to the second end tissue by mating the coupling device to a mating anastomosis device.

A surgical instrument that includes an elongated shaft that defines defining a central axis. The elongated shaft may have a distal end portion that is configured to operably support a circular staple cartridge therein. A tissue acquisition shaft may be axially movable within the elongated shaft such that a distal end portion of the tissue acquisition shaft may be distally advanced beyond the distal end portion of the elongated shaft. At least one tissue acquisition member may be pivotally attached to the distal end portion of the tissue acquisition shaft such that at least one tissue acquisition member is selectively pivotable about a corresponding acquisition axis that is substantially parallel to the central axis from a retracted position to deployed positions upon application of a deployment motion thereto. Various embodiments include an annular cutting member that is supported by the distal end of the elongated shaft for selective axial travel relative thereto.

In various embodiments, a surgical instrument is disclosed comprising a firing member, an anvil shaft assembly operably supported within an elongated shaft, and an anvil removably attachable to a distal connection portion of an anvil shaft assembly. The instrument further comprises a tissue acquisition shaft rotatably supported within the elongated shaft, tissue acquisition members pivotally attached to a distal end portion of the tissue acquisition shaft and being selectively pivotable between a retracted position to deployed positions, and at least one tissue acquisition pin corresponding to each one of the tissue acquisition members, each tissue acquisition pin radially protruding outward from the distal end portion of the tissue acquisition shaft to impale tissue drawn in towards the tissue acquisition shaft by the tissue acquisition members when the tissue acquisition members are moved from the deployed positions to the retracted position.

A surgical system for connecting body tissue is provided. The surgical system includes a surgical instrument having two tool elements movable relative to each other, each of which comprises a high-frequency electrode. The high-frequency electrodes, in an approach position of the tool elements, define a minimum distance from each other, lying opposite each other and facing each other. The instrument has a shaft at the distal end of which at least a first one of the tool elements is arranged or formed. A second tool element is movable from an operating position, in which it is adapted for movement into the approach position, into a removal position and/or vice versa. A surface area of a perpendicular projection of the second tool element onto a projection plane extending perpendicularly to a shaft direction in a region of the second tool element is smaller in the removal position than in the operating position.

A needle guard is used when suturing the cuff of an attachment ring to the heart. The needle guard is disposed in the attachment ring to prevent other parts of the attachment ring from being punctured by a suturing needle. The needle guard can include one or more grooves to inhibit relative movement between the needle guard and the attachment ring during suturing. The needle guard is removed upon completion of suturing and to allow insertion into attachment ring of an inflow conduit of a heart assist device. An articulated clamp is used to compress the attachment ring into engagement with the inflow conduit. The attachment include an annular rib that grabs the inflow conduit.

A method, system, or apparatus for stent delivery. Delivering one or more stents with a delivery tool that can include a kinetic transfer of energy to deliver one or more stents. The stents can include a modifiable stent that can change its overall shape and/or dimensions based on pre-configured design parameters. A coil stent that can engage with a vessel that surrounds the modifiable stent forming a dual stent configuration. The coil stent can also include anchor points that allow it to engage with a second vessel securing the first vessel and the second vessel together to aid in the healing process.

According to exemplary embodiments of the present disclosure, devices, systems, and methods for endoscopic procedures may include an end effector of a grasping system having a first arm and a second arm. The first and second arms may extend from a common proximal joint. The first and second arms may be formed of a self-expanding material and may have a spring force to set the arms in an unconstrained open position. The first and second arms may have an arc shape such that a distal tip of each first and second arm are configured to close as the first and second arms are actuated to a constrained closed position. A catheter may include a locating element at a distal end of a flexible tube. The locating element may be configured for locating the grasping system.

Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alternative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.