A method for adjusting the operation of a surgical suturing instrument using machine learning in a surgical suite is disclosed. The method comprises gathering data during surgical procedures, wherein the surgical procedures include the use of a surgical suturing instrument comprising a suturing needle configured to be mechanically advanced through a suturing stroke, analyzing the gathered data to determine an appropriate operational adjustment of the surgical suturing instrument, and adjusting the operation of the surgical suturing instrument to improve the operation of the surgical suturing instrument.

A device for applying a hemostatic clip assembly includes a proximal delivery catheter having a handle assembly and an elongated catheter body defining a longitudinal axis extending distally from the handle assembly, and a distal clip assembly removably connected to a distal end of the catheter body. The distal clip assembly includes a distal clip housing, a jaw assembly and a jaw adapter yoke. The jaw assembly has a pair of jaw members fixed to the distal clip housing by a first pin oriented orthogonally relative to the longitudinal axis. The jaw adapter yoke is operatively connected to the jaw members. The proximal delivery catheter is configured to transmit linear motion along and torsion about the longitudinal axis to at least a portion of the distal clip assembly. At least one of the jaw members is configured to rotate about the first pin between an open and a closed configuration.

A proximal delivery catheter includes a proximal handle assembly, an elongated catheter body defining a longitudinal axis and extending distally from the proximal handle assembly, and a drive wire movably positioned within the elongated catheter body. A release pin assembly is coupled to a distal end of the drive wire. The release pin assembly including a release pin and a release pin housing positioned outward from the release pin. A shaft spring is positioned outward from the release pin housing. The shaft spring includes an annular portion wherein the release pin housing is configured and adapted to interfere with the annular portion of the shaft spring. A distal clip assembly is removably connected to the distal end of the elongated catheter body. The proximal delivery catheter is configured to transmit linear motion along and torsion about the longitudinal axis to at least a portion of the distal clip assembly.

A clipping system includes a cap, a clip and a control member. The cap includes a channel extending therethrough. A proximal portion of the cap is mounted over the endoscope such that a distal portion of the cap extends distally past a distal end of an endoscope. The distal portion of the channel includes opposing surfaces therealong defining a tapered portion tapering from the distal end of the cap toward a proximal end. The clip is mounted within the cap. The clip includes jaws movably connected via hinges. At least one of the hinges is biased to move the jaws away from one another. The clip is movable relative to the cap between open and closed configurations. The control member longitudinally movable relative to the cap to move the clip between the open and closed configurations.

A clipping system includes an adapter and a clip. The adapter is mounted over a distal end of an insertion device to a distal end and has a first annular groove formed in a distal face of the adapter. The clip has a body; a central body having a coupling portion and a ring; and jaws having outer arms coupled to the body at an outer arm proximal end and inner arms disposed radially inward of the outer arms and coupled to the ring at an inner arm proximal end. The body includes an annular protrusion extending proximally from a proximal surface of the body. The protrusion is inserted into the first groove of the adapter to couple the clip to the adapter. Movement of the central body along an axis of the clip causes movement of the jaws between an insertion configuration and a deployment configuration.

A laparoscopic staged hepatectomy using round-the-liver ligation is carried out includes: (1) a laparoscopic operation is performed with general anesthesia using round-the-liver ligation, the branches of the portal vein of the hemiliver are ligated, a tourniquet is used to tighten the connecting part between the right and left hemilivers to block the communicating blood flow between the hemiliver to be removed and the hemiliver to be reserved, a drainage tube is put into the peritoneal cavity, then close the peritoneal cavity; (2) the patient gradually resumes eating after the first operation, and recuperate to make the volume of the hemiliver increase to an expected volume; (3) after the hemiliver increases to the expected volume, a laparoscopic liver resection is carried out with general anesthesia to remove the diseased hemiliver, and then the patient is nursed to be completely recovered. An instrument for implementing the laparoscopic staged hepatectomy is also disclosed.

A tissue clipping apparatus, comprises a flexible, elongate member, a proximal end of which remains external to the body accessible to a user while a distal end of the flexible member is inserted into the body to a location adjacent to target tissue to be clipped and a control wire extending through the flexible member in combination with a capsule releasably coupled to a distal end of the flexible member and a clip a proximal portion of which is received within the capsule. A joint releasably coupling the clip to the control wire, includes a yoke extending around a proximal end of the clip and a frangible link which fails when subject to a predetermined force to separate the clip from the control wire.

A surgical clamp may have two elongated members with a bight portion that joins the two elongated members at a proximal end of the clamp and that may bias the two elongated members in an open position at a distal end. The bight portion may have one or more engagement features, such as a slotted aperture or other engagement or coupling feature. A clasp mechanism at the distal end of the clamp may have a male or first component disposed on or adjacent one of the two elongated members and a female or second component disposed on or adjacent the other of the two elongated members at the distal end of the clamp.

Improved methods and devices for performing an endoscopic surgery including a system for performing minimally invasive procedures including a flexible catheter having a working space expanding system positioned at a distal portion, the working space expanding system movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body lumen. A tissue retractor having an inner member positioned within an outer member has a plurality of closed loops at a distal portion forming a petal-like structure. The loops are positioned in a collapsed position within the outer member and are movable to an expanded position when exposed from the outer member.

A device includes an anoscope including an elongated hollow member with a longitudinal slot configured to receive tissue in an interior of the hollow member. The device also includes a clip applicator. The clip applicator includes a body slidably received in the slot and jaws at a distal end of the body configured to hold a ligation clip. The clip applicator further includes a plunger slidably coupled to the body configured to actuate the jaws. When the clip applicator is inserted into the slot and the plunger is moved relative to the body, the jaws close and deform the ligation clip from an open position into a closed position around tissue received in the slot.