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.

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.

4 There are provided an adhesion promotion device and a medical device which are capable of effectively reducing risk factors of an anastomotic leakage. The adhesion promotion device has a main body portion formed of a biodegradable sheet having a plurality of through-holes and promoting adhesion of biological tissues, and an assistance unit provided in the main body portion and assisting the main body portion to hold a biological organ serving as an object to be joined.

A method for forming a staple against an anvil of a surgical stapling instrument is disclosed. The staple comprises a base defining a drive plane, a first leg, and a second leg. The first leg and the second leg are in a forming plane. The method comprises deploying the first leg from a staple cavity defined in a staple cartridge positioned in the surgical stapling instrument into a first forming pocket of the anvil, supporting the first leg by a first cavity extension, forming the first leg in the first forming pocket along a first path which is outside of the drive plane, deploying the second leg from the staple cavity into a second forming pocket of the anvil, supporting the second leg by a second cavity extension, and forming the second leg in the second forming pocket along a second path which is outside of the drive plane.

An endoluminal pursestring device is provided and includes a handle assembly, a shaft, an elongated fork, a plurality of surgical fasteners disposed with the shaft, and a suture engaged with the surgical fasteners. The suture is secured to a head of each of the surgical fasteners, and extends proximally through the handle assembly. In use, a distal end of the endoluminal pursestring device is positioned adjacent tissue surrounding a lumen, and the handle assembly is rotated to cause the distal-most surgical fastener to be rotated into the tissue. The following surgical fasteners are also rotated into other portions of the tissue surrounding a lumen. The suture connecting each of the surgical fasteners is then pulled such that the surgical fasteners are pulled together, thereby closing the lumen.

A soft anchor assembly according to an exemplary aspect of the present disclosure includes, among other things, a sheath and a flexible strand at least partially surrounded by the sheath.

A suture device is configured to form a purse string suture in procedures such as, e.g., transanal total mesorectal excision (TaTME), for removal of low rectal and ultra-low rectal tumors and preservation of anal sphincters to avoid permanent stomas. The suture device may provide uniform needle rotation, tissue penetration, and/or suture advancement independent of the skill of the clinician. The suture device includes a plurality of needles operatively associated with a needle driver such that rotation of the needle driver transitions the plurality of needles between a retracted position, in which, the plurality of needles extends radially inward, and an extended position, in which, the plurality of needles rotates to extend radially outward to engage and pierce through tissue to form a purse string suture.

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 suture device is utilized in forming a purse string suture during, e.g., laparoscopic end to end anastomosis procedure, to effect joining of two opposing intestinal sections. The suture device is utilized in other procedures such as, e.g., transanal total mesorectal excision (TaTME) for removal of low rectal and ultra-low rectal tumors and preservation of anal sphincters to avoid permanent stomas. In particular, the suture device is utilized in forming surgical stitches used to close an internal anal structure or to narrow a passage for performing further transanal dissection to create total mesorectal excision.

A soft anchor assembly according to an exemplary aspect of the present disclosure includes, among other things, a sheath and a flexible strand at least partially surrounded by the sheath.