A surgical access system is disclosed. The surgical access system having a cannula may include a distal tip having one or more longitudinal channels distributed around a circumference of the distal tip, and one or more circumferential channels around the distal tip. The surgical access system also includes an obturator coaxially insertable within the cannula which may include a distal tip and a retractable cutting element having an actuator. The surgical access system also includes an articulation interface. The surgical access system may also include a distal tip of the cannula that may further include one or more bridges distributed circumferentially along the one or more circumferential channels of the distal tip. The obturator further may include an elongated tube and a slidable plunger element configured to control fluid flow inside the elongated tube of the obturator.

Technologies are generally provided for a tissue removal device for removing tissue protrusions extending from a wall of intestines. The tissue removal device may be a bell shaped tube configured to slide over an inflamed diverticulum that has been inverted to extend into interior space of the colon. The tissue removal device run be slid over the inverted diverticulum with a portion of the tissue removal device having a widest diameter oriented near the colon wall and a portion having a narrowest diameter oriented near a tip of the diverticulum. A pressure gradient may be induced along the walls of the tissue removal device such that the point of highest pressure at the narrowest opening may cause the walls of the diverticulum to be pinched together to induce necrosis and removal of the diverticulum, while promoting healing of the colon walls over the region of decreasing pressure.

An end effector including an anvil and a staple cartridge assembly is disclosed. The staple cartridge assembly comprises a deck having steps defined thereon for compressing tissue positioned between the anvil and the staple cartridge assembly to different pressures. The staple cartridge assembly further comprises staples having different unformed heights removably stored therein. The staples are deformed against the anvil to different formed heights.

Systems, devices, and methods for endoscopically retracting a target tissue. The device includes a first shaft and a second shaft slidably coupled thereto. An internal member extends in a transverse direction from the first shaft and is configured for advancement through a penetration in the target tissue to atraumatically engage a distal surface of the target tissue after being advanced therethrough. A pair of external members extend from the second shaft generally parallel to the transverse direction. The external members are spaced apart and are configured to atraumatically engage a proximal surface of the target tissue when the internal member is moved longitudinally relative to the external members. The internal member applies traction to the target tissue when retracted past the pair of external members, which apply counter-traction to the target tissue on opposing lateral sides of the internal member, to re-shape the target tissue and enable subsequent suture placement.

A surgical staple cartridge is disclosed comprising a plurality of staples removably stored within the surgical staple cartridge. The staples comprise staple legs which extend from a staple base portion. The staple legs comprise staple tips configured to pierce tissue and contact a corresponding forming pocket of an anvil of surgical stapling instrument. The staples further comprise zones having different hardnesses.

Embodiments of the present invention provide a cervical cerclage apparatus and a method for performing a cervical cerclage. In an embodiment of the invention, a cervical cerclage apparatus includes, a length of suture and at least two stitched regions formed by the length of suture around an exterior surface of a cervix. The cervical cerclage apparatus further includes at least two surgical buttons attached the length of suture, each surgical button comprising an inner face and an outer face, wherein the inner face of each surgical button are configured to be placed against the exterior surface of the cervix between the stitched regions, wherein at least one of the surgical buttons comprises Progesterone.

A device for reducing the volume of a hollow body organ includes a tissue port and a plurality of fasteners. The fasteners may be coupled to a flexible filament, such as a suture, which is tensioned to constrict the hollow body organ to achieve volume reduction.

A purse string suture instrument includes an end effector with first and second jaws disposed at a distal portion of an elongate tubular shaft. The first and second jaws are pivotably coupled to each other and to the elongate tubular shaft. The first and second jaws are spaced apart and define a gap therebetween. First and second pluralities of teeth extend perpendicularly from the first and second jaws respectively, and the first plurality of teeth is longitudinally offset from the second plurality of teeth. The first and second jaws are transitionable between open and approximated configurations. The approximated configuration is adapted to clamp tissue in the gap between the first and second jaws, thereby displacing sections of tissue outwardly between the first and second pluralities of teeth.

A therapeutic instrument for the ergonomic, effective and safe opening and closing of targeted remote tissue sites; includes a pistol grip style handle with a hand activated lever for needle deployment and, optionally, with features to control tissue cutting and guide wire installation; also incorporates a specialized elongated rigid or flexible instrument shaft, which enables vacuum assisted holding of tissue at a uniquely contoured distal tip, where placement of a suture in a purse string configures occurs along with, if desired, tissue cutting and guide wire passage.

Provided herein are medical apparatuses and methods and more particularly devices and methods for positioning and anchoring a lining to a hollow body organ, such as a stomach, intestine or gastrointestinal tract. For example, in one embodiment, an endoluminal applier includes a fastening assembly configured to receive tissue and lining, a suction device configured to acquire tissue and lining, and a stitching mechanism configured to stitch into the fastening cavity and to apply a running suture to the tissue portion and lining.