A surgical applicator is utilized in forming a purse string suture used to, e.g., close internal anal structure or to narrow a passage for performing transanal dissection to create total mesorectal excision. The surgical applicator includes an actuation assembly and a reload operatively coupled with the actuation assembly. The reload includes a sleeve defining a lumen extending therethrough, a drive rod rotatably supported within the sleeve, a surgical fastener including a coil body portion rotatably supported on the drive rod such that rotation of the drive rod advances the surgical fastener, and a suture extending through the drive rod.

A surgical applicator is useful in forming a purse string suture and may be used to, e.g., close internal anal structure or to narrow a passage for performing transanal dissection to create total mesorectal excision. The surgical applicator includes an actuation assembly and a reload operatively coupled with the actuation assembly.

An anvil introduction system is operable to provide smooth insertion of an anvil of a surgical stapling device through a bodily lumen such as the esophagus. The anvil introduction system is coupled to the anvil and includes a dilation feature. The dilation feature has a collapsed position and an expanded position. The dilation feature may cover staple pockets and an outer edge of the anvil with the dilation feature is in the expanded position. The anvil may be inserted through the bodily lumen with the dilation feature in the expanded position. The dilation feature may then be collapsed in order to complete an end-to-end anastomosis of the bodily lumen.

A vascular closure system for sealing an opening in a blood vessel may include an introducer sheath extending through the opening, the introducer sheath having a lumen extending through the introducer sheath, wherein partial withdrawal of the introducer sheath from the opening everts tissue of the blood vessel at the opening, and a shaping sheath slidably disposed over the introducer sheath, the shaping sheath having a split distal portion configured to engage the everted tissue.

A distal tip for a suture securing tube is disclosed. The distal tip has a flared distal end and a distal opening in the flared distal end. The distal tip also has a tube interface opening in a proximal end. The distal tip further has a channel coupling the distal opening to the tube interface opening. The distal tip also has one or more crimp windows.

A surgical suturing apparatus includes an end effector including a jaw assembly and a needle assembly. The jaw assembly includes first and second jaws movable between open and closed positions. Each of the first and second jaws includes a tissue facing surface having an elongated rail and a longitudinal row of teeth. Each tooth of the longitudinal rows of teeth of the first and second jaws includes a needle channel extending therethrough. The elongated rails and the longitudinal rows of teeth of the first and second jaws are disposed in opposed relation relative to each other. The needle assembly includes a first needle, a second needle, and a suture coupled to the first and second needles. The first needle is slidable through the needle channels of the first jaw and the second needle is slidable through the needle channels of the second jaw.

An apparatus includes an end effector including an anvil and lower jaw. The anvil is pivotable toward the lower jaw to capture tissue. The apparatus further includes a stapling and severing assembly configured to sever and staple tissue clamped between the anvil and the lower jaw. A staple cartridge is coupled with the lower jaw. The staple cartridge includes a deck facing the anvil, a plurality of staples positioned in a plurality of staple openings formed through the deck, and a cinching feature positioned on the deck. At least a portion of the cinching feature is configured to be captured by the staples as the staples are driven out of the staple openings in response to activation of the stapling and severing mechanism. The cinching feature is configured to cinch severed and stapled tissue.

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.

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 surgical stapler comprising a handle assembly, an elongated body portion extending distally from the handle assembly, and a head portion disposed adjacent a distal portion of the elongated body portion and including an anvil assembly and a shell assembly. The anvil assembly is movable in relation to the shell assembly between spaced and approximated positions. The anvil assembly has an anvil head and a plurality of projections extending proximally of the anvil head, the projections engageable with a portion of the shell assembly.