A surgical tack applier comprising a handle assembly, an inner tube, a plurality of fasteners and a solution is disclosed. The handle assembly includes an actuator associated therewith. The inner tube extends distally from the handle assembly and defines a longitudinal axis. The inner tube is rotatable about the longitudinal axis. The plurality of fasteners are disposed at least partially within the inner tube and are selectively ejectable therefrom. The solution is disposed within the inner tube and is dispensable through a distal opening of the inner tube.

A surgical instrument for applying tacks to tissue includes a handle assembly, an elongated portion, an outer tube, an end effector, a rotation assembly, and a rotation-limiting structure. The rotation assembly is configured to rotate at least a portion of the outer tube about a first longitudinal axis and with respect to the handle assembly. The rotation assembly includes a rotation knob rotationally fixed to a proximal portion of the outer tube. The rotation-limiting structure is disposed in mechanical cooperation with at least one of the rotation assembly and the handle assembly, and is configured to limit an amount of rotation of the outer tube with respect to the handle assembly.

A guide apparatus for facilitating formation of a stoma includes a guide having an outer flange segment arranged about a central longitudinal axis and an insert segment. The flange segment is configured for engaging end margins of a body vessel extending through an opening in skin of a subject, and defines a plurality of apertures. The insert segment extends from the outer flange segment along the longitudinal axis. The insert segment is configured for at least partial positioning within the body vessel to maintain the patency of the body vessel. The guide apparatus further includes a plurality of fasteners for insertion within respective apertures of the flange segment of the guide. The fasteners are configured for penetrating the end margins of the body vessel extending through the opening in the skin to attach the end margins to the skin to thereby create a stoma.

A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

A self-drilling bone fusion screw apparatus is disclosed which includes at least first and second sliding boxes. A first screw member having a tapered end and a threaded body is disposed within the first sliding box, and a second screw member having a tapered end and a threaded body disposed within the second sliding box. An adjuster adjusts the height of the sliding boxes. The screw members are screwed into vertebral bodies in order to fuse the vertebral bodies together. A plurality of the self-drilling bone fusion screw apparatuses may be attached together and/or integrated via a plate or cage. Also disclosed is a cervical facet staple that includes a curved staple base and at least two prongs attached to the bottom surface of the curved staple base.

An apparatus and method for joining members together using a self-drilling screw apparatus or stapling apparatus are disclosed. The screw apparatus includes a worm drive screw, a spur gear and superior and inferior screws which turn simultaneously in a bi-directional manner. A rotating mechanism drives the first and second screw members in opposite directions and causes the screw members to embed themselves in the members to be joined. The screw apparatus can be used to join members such as bones, portions of the spinal column, vertebral bodies, wood, building materials, metals, masonry, or plastics. A device employing two screws (two-in-one) can be combined with a capping horizontal mini-plate. A device employing three screws can be combined in enclosures (three-in-one). The stapling apparatus includes grip handles, transmission linkages, a drive rod a fulcrum and a cylinder. The staple has superior and inferior segments with serrated interfaces, a teethed unidirectional locking mechanism and four facet piercing elements. The staples can be also be used to join members such as bones, portions of the spinal column, or vertebral bodies.

Implementations described herein include a system that may include a deliver device, an annular anchor and an implant. The delivery device may include a distal end, a proximal and a lumen extending from the distal end to the proximal end. The annular anchor may be removably coupleable to the distal end of the delivery device. The annular anchor may be implantable at a target site in a patient via manipulation of the delivery device. The delivery device may be extendable outside the patient when the anchor is implanted at the target site. The implant may be deliverable through the delivery device to the target delivery site and implantable through the annular anchor. The delivery device may be coupled to the annular anchor to control a trajectory of the implant to the target site.

Thoracic/lumbar and cervical spinous process staples which staple/fuse adjacent spinous processes are disclosed. Thoracic/lumbar transverse process staples which staple/fuse adjacent transverse processes are also disclosed. Each embodiment has upper and lower claws connected by a ratchet spring mechanism, along with a multiplicity of bone fastener prongs attached to the upper and lower claws. Two sets of prongs on each staple claw are spaced by a distance approximately equal to the distance separating adjacent spinous or transverse processes so as to facilitate stapling/fusion of two adjacent processes. Also disclosed are staple prongs with multiple perforations which enable incorporation of bone fusion material thereby facilitating stapling/fusion of spinal elements.

A biodegradable scaffold for wound closure including a central rod and two spaced plates. The central rod may have an engagement block on top for stabilizing a implanting tool. The two spaced plates include an upper plate connected to the central rod and a lower plate connected to the central rod. Each of the upper and lower plates may include perforations which may be useful for detachably connecting an implanting tool and which encourage growth of the tissue. The biodegradable scaffold allows tension free anatomical alignment of tissue within the plates and facilitate wound healing. The upper and lower plate may have a helical, in which each plate may extend around the central rod greater than 360 degrees. The helical shape creates a camber feature that serves to draw or pull tissue around the wound defect into the scaffold during the course when deploying the scaffold.

Various articulating tools for endoscopic placement of fasteners are disclosed. The tool can comprise a multi-angle articulating screwdriver. The tool can have an elongate shaft with an articulating driver head at a distal end. The tool can rotate the articulating driver head to drive fasteners, such as screws, to a surgical site. The articulating driver head can articulate with respect to a longitudinal axis of the elongate shaft to enable the fastener to be driven at various angle. The tool can be coupled to a powered handpiece power and can transmit torque from the handpiece to the driver head.