The problem of positioning one or more nerve ends inside a sheathing implant is solved by the use of a pulley and cinching systems that pull a nerve end into an implant and that can adjust the diameter of an implant to conform the implant to the diameter of the nerve, respectively. The pulley system utilizes a suture that traverses the wall of an implant leaving one end outside the implant wall and another end that can be attached to a nerve. Pulling the suture end outside the wall pulls the nerve attached to the other end of the suture into the bore of the implant. A cinching system utilizes specially arranged sutures within the wall of an implant to tighten or cinch up the wall after a nerve is placed therein, so as to conform at least part of the implant to the diameter of the nerve. Methods are also disclosed by which such pulley systems can be formed during an intraoperative procedure.

The present invention provides a tissue closure device, comprising: a first clamping base and a second clamping base which may be opened/closed relatively and form an accommodation cavity after being closed; and a pouch assembly which may be driven to move in the accommodation cavity, wherein: the pouch assembly comprises a staple pusher, a pair of needle heads movably connected to the staple pusher, and a connection portion connected to the proximal ends of the pair of needle heads; and when the staple pusher moves from the proximal end to the distal end, the pair of needle heads pushes a tubular tissue located in the accommodation cavity to the distal end until the distal ends of the pair of needle heads are closed to close the tubular tissue into a purse string. A bundled purse string with a gathered center may be formed through the tissue closure device.

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 in a parallel and offset plane with respect to a plane defined by the staple base portion. Each staple comprises a center of mass aligned with the staple base portion.

A surgical device, or a portion of a surgical device, that places purse string sutures in tissue within a body (e.g., intra-peritoneal space). The surgical device includes, or an end effector for a surgical device includes, a jaw assembly, staple cartridges, and a suture.

A suturing device is provided that includes a suture positioning assembly that is slidably attachable to a sheath, a housing of the assembly includes a nose, a primary suture with connectors, an end effector, and an end effector actuator, an intravascular tip with a blood contact indicator on the nose, a slide limiter, and a fascia receiving surface, the intravascular tip is configured for insertion into the artery when disposed beneath a fascial layer, the fascia receiving surface is configured for accepting a perimeter edge of a dilated hole of the fascial layer, the housing nose further includes an intermediary suture having intermediary suture connectors, the primary suture connecters are configured for connection to the intermediary suture connectors, the end effector actuator is disposed to operate the end effector to condition the facial layer hole in a position for suturing by the intermediary suture connected to the primary suture.

Circular and curved surgical stapling instruments are disclosed comprising a circular and curved stapling configurations. A circular staple cartridge comprises a plurality of staples arranged in an inner row, an intermediate row, and an outer row. Staples in certain rows can vary in crown width to overlap gaps defined between staples in certain other rows which provide a stretch zone.

A surgical stapling assembly comprising a staple cartridge, a sled movable during a firing stroke between a proximal unfired position and a distal fired position, and a plurality of staples removably stored within the staple cartridge is disclosed. The staples are configured to be ejected from the staple cartridge by the sled. Each staple comprises a proximal staple leg comprising a proximal piercing tip, a distal staple leg comprising a distal piercing tip, and an integral staple driver base portion. The proximal staple leg and the distal staple leg extend from the integral staple driver base portion. The integral staple driver base portion comprises a body portion, a ramp surface configured to be contacted by the sled, and a starter guide feature configured to assist sled driving contact between the sled and the ramp surface.

A wound closure system and a method of closing a wound are disclosed. The wound closure system includes a plurality of skin anchors mechanically attached to external skin tissue around a periphery of a wound, a line extending between the skin anchors, the line slidably engaged with each skin anchor, a biasing member that provides tension on the line to draw all of the skin anchors toward the wound and a negative pressure wound dressing apparatus adapted to be used in conjunction with the wound closure system. The method of closing a wound includes the steps of attaching a plurality of skin anchors to external skin around a periphery of a wound, extending a line between the skin anchors around substantially the entire periphery of the wound, providing tension to the line to draw the skin anchors toward the wound, and applying a negative pressure to the wound.

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.

The problem of positioning one or more nerve ends inside a sheathing implant is solved by the use of a pulley and cinching systems that pull a nerve end into an implant and that can adjust the diameter of an implant to conform the implant to the diameter of the nerve, respectively. The pulley system utilizes a suture that traverses the wall of an implant leaving one end outside the implant wall and another end that can be attached to a nerve. Pulling the suture end outside the wall pulls the nerve attached to the other end of the suture into the bore of the implant. A cinching system utilizes specially arranged sutures within the wall of an implant to tighten or cinch up the wall after a nerve is placed therein, so as to conform at least part of the implant to the diameter of the nerve. Methods are also disclosed by which such pulley systems can be formed during an intraoperative procedure.