A surgical stapling apparatus (10) includes a tissue gap adjustment mechanism (260) having a stop member (250), an asymmetrical polygonal washer (264), and a set screw (262). The stop member (250) is supported on a drive screw (220), includes first and second flanges (255a, 255b), and defines a transverse slot (254) between the flanges (255a, 255b). The stop member (250) sets a minimum tissue gap. The washer (264) defines an eccentrically positioned aperture (268) and includes a plurality of pairs of opposed flat sides (269a-269h). The set screw (262) is configured to fix the stop member (250) relative to the drive screw (220). The washer (264) is selectively rotatable about the set screw (262) to position a selected pair of sides (269a-269h) between and in engagement with the flanges (255a, 255b) to set the position of the aperture (268) of the washer (264) relative to the transverse slot (254), thereby setting the stop member (250) relative to the drive screw (220) and defining the minimum tissue gap.

An apparatus includes a locking portion, a flexible pulling portion, a flexible body, and a plurality of barb features extending laterally from the body. The locking portion is configured to receive the pulling portion. The pulling portion is configured to engage and translate relative to the locking portion after the locking portion has received the pulling portion. The flexible body extends from the locking portion to the pulling portion. The flexible body is configured to form a loop when the pulling portion engages the locking portion. The loop is configured to decrease in size in response to pulling of the pulling portion relative to the locking portion. The barb features are configured to engage a tubular region of tissue and thereby form pleats in the tubular region of tissue.

An apparatus includes a staple cartridge including a plurality of staples and a deck defining a plurality of openings. Each opening of the plurality of openings is associated with a corresponding staple of the plurality of staples, such that each staple is configured to pass through a corresponding opening of the plurality of openings. The apparatus further includes a deformable feature configured to be coupled to tissue in response to actuation of the staple cartridge. The deformable feature is configured to retain at least one outer portion of stapled tissue in an inwardly directed position relative to an inner portion of stapled tissue.

A method of creating an anastomosis is provided using a stapling assembly including a body extending distally along a longitudinal axis and a deck member defining a deck surface. The deck surface includes a first array of staple openings comprising a herringbone pattern, and each staple opening of the first array of staple openings has a same size. The method includes positioning an anvil within a first lumen of a patient and positioning the stapling assembly within a second lumen of the patient. The method also includes releasably coupling the anvil with the stapling assembly and compressing tissue of the first and second lumens between the anvil and the deck member. The method further includes actuating a plurality of staple drivers to drive a first plurality of staples distally and parallel to the longitudinal axis from the first array of staple openings into the tissue to define the anastomosis.

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 circumcision tool having an outer jaw having front, rear, and medial blade passage channels; front and rear pluralities of skin fasteners; outer front and outer rear staple inserts releasably holding the front and rear pluralities of skin fasteners within the front and rear blade passage channels; front, rear, and medial blades, the medial blade having a cutting edge; slide tracks connecting the front, rear, and medial blades to the outer jaw; a cam connected operatively to the front, rear, and medial blades, for inwardly moving the front, rear, and medial blades toward the front, rear, and medial blade passage channels in alignments with the front and rear pluralities of skin fasteners, and in alignment of the medial blade with the medial blade passage channel; an inner jaw; and a vice grips actuator connected to the inner and outer jaws for alternatively retracting and splaying the inner and outer jaws.

An apparatus includes an elongate body and an end effector coupled to a distal end the elongate body. The end effector includes a first end effector element configured to hold a first coupler element, a second end effector element configured to hold a second coupler element of the, and first and second end effector elements coupling first and second end effector elements to the elongate body. The end effector is configured to move between a first configuration in which the first and second end effector elements are located in a first position in which axial end of first vessel is coupled to first coupler element, a second position in which axial end of second vessel is coupled to second coupler element, and a third configuration in which first and second end effectors close to coupler the coupler elements and anastomose the first and second vessel.

An anastomosis connector for being mounted to a flexible vessel, such as a blood vessel, comprises a non-expandable annular body having an inner wall surrounding an anastomotic orifice, an outer wall surrounding the inner wall, a front side and a back side which extend between the inner wall and the outer wall, and a plurality of staple pins configured to be bent permanently from a starting position to a final position and located at a distance from each other in circumferential direction of the annular body. The staple pins project from the annular body and point in a direction away from the back side. The distance between the front side and the back side at the inner wall of the annular body is smaller than the distance between the inner wall and the outer wall.

An anastomotic coupler is provided. A cartridge includes a plurality of fasteners. The fasteners are operable to engage with a ring such that the tubular structure is coupled with the ring.

An apparatus includes an elongate body and an end effector coupled to a distal end the elongate body. The end effector includes a first end effector element configured to hold a first coupler element, a second end effector element configured to hold a second coupler element of the, and first and second end effector elements coupling first and second end effector elements to the elongate body. The end effector is configured to move between a first configuration in which the first and second end effector elements are located in a first position in which axial end of first vessel is coupled to first coupler element, a second position in which axial end of second vessel is coupled to second coupler element, and a third configuration in which first and second end effectors close to coupler the coupler elements and anastomose the first and second vessel.