A guidewire including a thin elongated structure and an outer shell around at least a portion of the thin elongated structure. The outer shell includes a first portion and a second portion. The first portion and the second portion of the outer shell are each coupled to the thin elongated structure. The first portion is spaced from the second portion by a gap. The guidewire is configured to move between a flexible state and a rigid state. The gap has a first distance when the guidewire is in the flexible state and the gap has a second distance greater than the first distance when the guidewire is in the rigid state.

A system a guidewire and a tensioning mechanism. The guidewire includes a thin elongated structure and an outer shell around a first portion of the thin elongated structure. A second portion of the thin elongated structure is exposed outside the thin elongated structure. The tensioning mechanism is configured to engage the second portion of the thin elongated structure to move the guidewire between a flexible state and a rigid state.

Apparatus for performing a minimally-invasive procedure, the apparatus comprising: a shaft having a distal end and a proximal end; a handle attached to the proximal end of the shaft; and an end effector attached to the distal end of the shaft; wherein the shaft comprises a flexible portion, a first articulating portion and a second articulating portion, wherein the flexible portion extends distally from the handle, the first articulating portion extends distally from the flexible portion, and the second articulating portion extends distally from the first articulating portion; wherein at least one articulation cable extends from the handle to the first articulating portion, such that when tension is applied to the at least one articulation cable, the first articulating portion deflects; wherein a plurality of articulation cables extend from the handle to the second articulating portion, such that when tension is applied to at least one of the plurality of articulation cables, the second articulating portion deflects.

A deflectable medical device (1) includes a shape memory alloy wire (15) integrated into a flexible elongated body (11). The shape memory alloy wire (15) is arranged to shorten upon receiving energy from an energy supply (2,4), thereby deflecting the medical device (1). A rod (18) positioned in a lumen (14) of the flexible elongated body (11) and compressed between a fixture (16) in the proximal end (12) of the elongated body (11) and the distal end (13) of the elongated body (11) is responsible for the shape memory alloy wire (15) recovering its initial length upon discontinuation of energy supply.

An apparatus can include: (1) a steerable tube, having a proximal section, a distal section, and a central longitudinal axis, the tube defining a primary lumen and two secondary lumens; (2) two wires, each extending from the distal section proximally through a respective secondary lumen; (3) a handle, coupled to the proximal section, and including a steering knob that is coupled to the wires such that rotation of the knob adjusts a degree of tension in the wires; (4) a pull ring coupled to the distal section of the tube such that the pull ring circumscribes the longitudinal axis at the distal section of the tube, and defining two recesses, a distal end portion of each wire being disposed in a respective one of the recesses; and (5) at least one cap, bridging the recesses and the distal end portion of the wires. Other embodiments are also described.

A surgical stapling instrument is disclosed. The stapling instrument comprises an end effector including a staple cartridge comprising a circular array of staple cavities and staples removably stored in the staple cavities and, in addition, an anvil configured to deform the staples which is movable toward the staple cartridge to clamp tissue therebetween. The anvil is movable away from the staple cartridge to release the tissue after the tissue has been stapled. The stapling instrument further comprises a lockout configured to prevent the anvil from being moved toward the staple cartridge once again until the staple cartridge has been replaced with an unfired staple cartridge.

An instrument having a flexible and elongated body includes at least a lumen and a flex member disposed within the lumen. The flex member may be capable of providing steering control to a first portion of the elongate body while providing load bearing support to a second portion of the elongate body. A pull wire may be disposed within the flex member, and at least a distal portion of the pull wire may be coupled to the elongate body and a proximal portion of the pull wire may be operatively coupled to a control unit. The control unit may be coupled to a proximal portion of the elongate body. In addition, a control member may be operatively coupled to the control unit such that a distal portion of the control member may be positioned near a proximal portion of the flex member. The control member may be configured to support the flex member and control the movement or displacement of the flex member. Furthermore, the flex member may be configured to selectively decouple articulation or steering forces of a first portion of the elongate body away from a second portion of the elongate body; thereby, preventing compression of the second portion of the elongate body while maintaining elasticity or flexibility of the second portion of the elongate body.

A simplified placement system and method for a tissue graft anchor by which a surgeon may introduce one or more sutures into a socket in a boney tissue, apply a precise amount of tension to the sutures to advance a soft tissue graft to a desired location, and then advance the anchor into the socket, preferably while maintaining the requisite pre-determined suture tension and without introducing spin to the suture is disclosed. Alternate embodiments of the anchor placement system and method of the present invention may forego tensioned sutures in favor of direct engagement with the soft tissue graft, whereby an end or a portion of the graft is trapped between an outer surface of the anchor and the boney surface of the wall of the socket such that friction force between the inserted portions of graft and socket maintains the position of graft relative to socket and bone. In either case, particularly preferred embodiments allow for the one-handed operation. Particularly preferred embodiments allow relative axial movement between the inner tensioning device and outer driver device to be optionally physically constrained, for example by means of cooperating and/or compressive elements disposed in the respective hub and handle portions.

An esophageal deflection device includes an elongate outer tube that has a natural curved deflection at a position that corresponds to a targeted esophagus region for deflection. The outer diameter of the outer tube is substantially matched to an inner diameter of the esophagus to closely contact the esophagus wall, or is at least half of the inner diameter, or is smaller and includes suction ports for drawing the esophagus wall inward. An insertion rod or tube includes a portion that is stiffer than the curved deflection, and slides into the elongate outer tube to straighten the tube and can serve to guide the deflection device into an esophagus. Subsequent withdrawal of the insertion tube or rod will allow the curved deflection to return to its natural shape and deflect the targeted region of the esophagus. A three-dimensional array of temperature sensors can be disposed near an outer surface of the elongate outer tube.

A surgical stapling instrument is disclosed. The stapling instrument comprises a staple cartridge including a circular array of staple cavities defined therein and an anvil configured to deform the staples. The stapling instrument further comprises a closure drive configured to position the anvil relative to the staple cartridge and a firing drive configured to eject the staples from the staple cartridge. The closure drive includes a shaft which is extendable above the staple cartridge to permit the anvil to be attached to the shaft. In various instances, the stapling instrument is configured and arranged such that the anvil cannot be attached to the shaft unless the shaft is moved into a fully-extended position above the staple cartridge.