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.

A powered surgical tack applier is configured to deploy a surgical tack through tissue or a surgical mesh. The surgical tack applier is articulatable to facilitate placement of the surgical tack to a desired surgical location. The powered surgical tack applier includes a power module that includes a battery, a motor, and a gear box. The power module provides a high-speed/low-toque output and a low-speed/high-torque output.

Some of the present apparatuses include a flexible vascular graft defining a lumen and a hub having a distal end configured to penetrate a blood vessel, a proximal end, and a wall extending between the distal end and the proximal end that defines an interior passageway. In some apparatuses, the vascular graft is non-removably coupled to the hub, and the lumen of the vascular graft is in communication with the interior passageway of the hub. Some apparatuses include one or more helical protrusions fixed in relation to the wall and configured to secure the hub relative to the blood vessel, each of the one or more helical protrusions extending away from the interior passageway. In some apparatuses, the wall has an outer surface defining an annular recess that extends around the wall, the recess configured to receive at least a portion of a wall of the blood vessel.

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.

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.

Shipping wedges for installing end effectors onto an endoscopic assembly of a surgical tack applier are provided. In aspects, a shipping wedge includes an elongate body extending along a longitudinal axis and defining a channel therethrough, and an arm disposed within a slot defined in a side wall of the elongate body. The arm includes a first end coupled to the side wall and a second end that is movable laterally with respect to the side wall. In aspects, a shipping wedge includes an elongate body extending along a longitudinal axis and defining a channel therethrough. A proximal portion of the elongate body includes a first arm extending proximally from a distal portion of the elongate body and a locking tab extending laterally into the channel of the elongate body.

A powered surgical tack applier is configured to deploy a surgical tack through tissue or a surgical mesh. The surgical tack applier is articulatable to facilitate placement of the surgical tack to a desired surgical location. The powered surgical tack applier includes a power module that includes a battery, a motor, and a gear box. The power module provides a high-speed/low-toque output and a low-speed/high-torque output.

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 implant comprises an anchor that comprises a helical tissue-coupling element. A tool is configured to advance the implant to a heart of a subject, and to position the anchor at tissue of the heart such that the implant extends from the anchor proximally away from the tissue. The tool comprises a tube having a distal end coupled to the implant, and a deployment manipulator. The deployment manipulator extends through the tube to the anchor disposed distally beyond the tube, and is configured to anchor the anchor to the tissue. Presence of the deployment manipulator through the distal end of the tube maintains the coupling between the distal end of the tube and the implant. Other embodiments are also described.

Shipping wedges for installing end effectors onto an endoscopic assembly of a surgical tack applier are provided. In aspects, a shipping wedge includes an elongate body extending along a longitudinal axis and defining a channel therethrough, and an arm disposed within a slot defined in a side wall of the elongate body. The arm includes a first end coupled to the side wall and a second end that is movable laterally with respect to the side wall. In aspects, a shipping wedge includes an elongate body extending along a longitudinal axis and defining a channel therethrough. A proximal portion of the elongate body includes a first arm extending proximally from a distal portion of the elongate body and a locking tab extending laterally into the channel of the elongate body.