A system to facilitate sealing a puncture of a vessel includes an implant having first and second expandable sections, and a delivery device that includes an inner tube and a circumscribing outer tube. The outer tube defines a first lumen configured to retain the implant, and a second lumen configured to channel fluid from the vessel through a distal opening proximal to the implant. A pusher circumscribed at least partially by the outer tube is configured to compress the implant to selectively expand the first and second expandable sections. The outer tube is selectively retractable relative to the inner tube such that the first expandable section remains substantially within the first lumen and the second expandable section is positioned outside of the first lumen. The outer tube is further selectively retractable relative to the inner tube such that the first expandable section is positioned outside of the first lumen.

A surgical stapling device includes an alignment pin pusher, an approximation assembly, and a linkage assembly. The linkage assembly includes a bell crank assembly including a bell crank and a bell crank pin. The bell crank pin is movable from an activated position to a deactivated position. In the activated position, the bell crank pin couples the alignment pin pusher to the approximation mechanism such that movement of the approximation mechanism causes movement of the alignment pin pusher from a retracted position to an advanced position. In the deactivated position, the bell crank pin is moved to a position to uncouple alignment pin assembly from the approximation mechanism.

A surgical stapling attachment is disclosed. The surgical stapling attachment comprises an attachment portion, a shaft assembly, an articulation joint, and an end effector assembly. The end effector assembly comprises a drive system comprising a main drive and a lockout drive driven by a single rotary input. The main drive is configured to capture, clamp, and staple tissue. The lockout drive is configured to prevent the main drive from being driven in the event a staple cartridge is not installed within the end effector assembly. Another lockout is provided to prevent the drive system from being actuated when a spent staple cartridge is installed within the end effector assembly.

The present disclosure relates to electromechanical surgical systems configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue. A force transmitting assembly of surgical instrument transmits a rotation of a rotatable drive member of the surgical instrument to the rotation receiving member of the end effector. A distal neck assembly of the surgical instrument includes at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces to the end effector; and an articulating neck assembly interconnecting the tubular body and the distal neck housing. The articulating neck assembly is configured to enable off-axis articulation of the distal neck assembly. The rotatable drive member extends through the articulating neck assembly.

A system to facilitate sealing a puncture of a vessel includes an implant having first and second expandable sections, and a delivery device that includes an inner tube and a circumscribing outer tube. The outer tube defines a first lumen configured to retain the implant, and a second lumen configured to channel fluid from the vessel through a distal opening proximal to the implant. A pusher circumscribed at least partially by the outer tube is configured to compress the implant to selectively expand the first and second expandable sections. The outer tube is selectively retractable relative to the inner tube such that the first expandable section remains substantially within the first lumen and the second expandable section is positioned outside of the first lumen. The outer tube is further selectively retractable relative to the inner tube such that the first expandable section is positioned outside of the first lumen.

Circular and curved surgical stapling instruments are disclosed comprising 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 have different unformed heights. Some arrangements include deck features that protrude from the staple cartridge deck. Various anvil arrangements are also disclosed to attain staples having different formed heights.

The present disclosure relates to electromechanical surgical systems configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue. A force transmitting assembly of surgical instrument transmits a rotation of a rotatable drive member of the surgical instrument to the rotation receiving member of the end effector. A distal neck assembly of the surgical instrument includes at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces to the end effector; and an articulating neck assembly interconnecting the tubular body and the distal neck housing. The articulating neck assembly is configured to enable off-axis articulation of the distal neck assembly. The rotatable drive member extends through the articulating neck assembly.

A system, for use with a leaflet of a valve of a subject's heart, comprises a catheter, a cutting device, a helical needle, and a suture. The catheter is transluminally advanceable toward the heart. The cutting device is advanceable distally out of the catheter, and is adapted to cut through tissue of the leaflet to form cut tissue and cut edges at the cardiac valve. The helical needle defines a helical lumen, the helical needle configured to be advanced distally out of the catheter and to rotationally extend through, and secure together, two tissue segments of the leaflet. The suture extends through the helical lumen of the helical needle. The helical needle and the suture are configured to extend along the two tissue segments of the leaflet to suture the two tissue segments to each other. Other embodiments are also described.

A surgical system includes an anvil that has, one, an elongate slot extending longitudinally along a length of the anvil and, two, a plurality of first staple-forming pockets. The surgical system further includes an anvil modification member releasably attachable to the anvil, wherein the anvil modification member comprises a plurality of second staple-forming pockets. In addition, the surgical system also includes a staple cartridge that has a plurality of staples formable by the plurality of first staple-forming pockets when the anvil modification member is not attached to the anvil, and wherein the staples are formable by the plurality of second staple-forming pockets when the anvil modification member is attached to the anvil.

An apparatus comprises an end effector, an elongate shaft, and a handle assembly. The shaft includes an articulation section that is operable to deflect the end effector away from the longitudinal axis of the shaft. The handle assembly includes a rotary member positioned within an intermediate section of the handle assembly. The rotary member is rotatable about an axis that is parallel to the longitudinal axis of the shaft. The rotary member is operable to control the articulation section of the shaft. The rotary member may include opposing thread sections that simultaneously drive lead screws in opposite longitudinal directions, to thereby control the articulation section. The shaft may be rotatable relative to the handle assembly, and the apparatus may selectively lock or resist such rotation based on the articulation state of the articulation section.