A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity is adapted to articulate instruments inserted therein. The surgical apparatus includes an anchor member configured to form a sealing relation with a tissue, a balloon member and a plurality of articulating arms extending distally from the anchor member. Inflating and/or deflating the balloon member effectuate articulation of the articulating arms.

The disclosure relates to an actuation unit (16) for a medical instrument (10) and to a medical instrument (10) with a shaft (12) which extends between a proximal end (20) and a distal end (22), wherein the instrument (10) is designed at the distal end (22) to receive an end effector (14), an actuation unit (16, 216) which is assigned to the proximal end of the shaft (12), and which has a plurality of drives (50, 52, 54, 56), and with at least two control trains (100, 102, 104, 106, 108, 110, 112, 114) which extend through the shaft (12), wherein the at least two control trains (100, 102, 104, 106, 108, 110, 112, 114) can be used for controlling at least one degree of freedom of the instrument, in particular for deflecting the end effector (14), wherein the at least two control trains (100, 102, 104, 106, 108, 110, 112, 114) comprise a first control train (100, 104, 108, 112) and a second control train (102, 106, 110, 114), and wherein the first control train (100, 104, 108, 112) is coupled to a first carrier (70, 74, 78, 82) and the second control train (102, 106, 110, 114) is coupled to a second carrier (72, 76, 80, 84), on which a drive (50, 52, 54, 56) acts for generating a pushing movement or pulling movement of the carrier (70, 72, 74, 76, 78, 80, 82, 84).

A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

A robotic surgical instrument includes a housing and a shaft extending distally from the housing and including proximal and distal segments and an articulating portion interconnecting the segments. An end effector assembly is coupled to the distal segment and a plurality of actuation components extends through at least a portion of the shaft to enable selective actuation of the end effector assembly. A seal configuration is operably associated with a proximal body portion of a proximal link of the articulating portion of the shaft to establish seals against an interior annular surface of the shaft, about each actuation component of the plurality of actuation components, and within a distal end portion of the proximal segment of the shaft to inhibit fluid communication proximally into the proximal segment of the shaft.

An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable.

A forceps having at least a first jaw with a longitudinal axis is disclosed. The first jaw can include a body portion, a first flange, a second flange and a cam pin. The first flange can define a first cam slot with a longitudinal extent along the longitudinal axis. The second flange can be spaced from the first flange a distance transverse to the longitudinal axis of the first jaw and can have a second cam slot. The cam pin, with a longitudinal axis, can be moveably secured within the first cam slot and the second cam slot. A diameter of the cam pin can be less than a width between a first longitudinal edge that defines a first side of each of the first cam slot and the second cam slot and a second longitudinal edge that defines a second opposing side of each of the first cam slot and the second cam slot so that the cam pin is moveably received by both the first cam slot and the second cam slot. With the first jaw pivoted to at least a first position, the cam pin and first flange can be configured such that the first longitudinal edge is contacted by the cam pin but the second longitudinal edge is spaced from the cam pin. The cam pin and second flange can be configured such that the first longitudinal edge is spaced from the cam pin but the second longitudinal edge is contacted by the cam pin.

A stapling assembly for use with a surgical stapler is disclosed. The stapling assembly comprises a first jaw, a second jaw, an elongate channel configured to receive a staple cartridge, a firing member, and a lockout. The staple cartridge comprises a sled configured to eject staples. The firing member is configured to move distally in response to a rotary motion. The firing member is configured to advance the sled during a firing stroke. The lockout is configured to selectively prevent said firing member from performing said firing stroke.

A surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient is disclosed and includes an elongate manipulator having a distal end for receiving an end effector and including a plurality of control links extending through the manipulator operable to cause movement of the distal end in response to movement of the control links in a longitudinal direction. An actuator chassis is disposed at a proximal end of the manipulator and includes a plurality of actuators slidingly mounted within the actuator chassis for linear movement in the longitudinal direction. Each actuator is coupled to a control link and adjacently disposed about a curved periphery of the actuator chassis. An outwardly oriented portion couples a drive force to the actuator to cause movement of the control link.

An adjustable trocar assembly includes a housing configured to facilitate insertion of one or more surgical tools into a patient's body, and an elongated tubular member extending distally from the housing and defining a longitudinal axis. The elongated tubular member includes a channel configured to facilitate passage of surgical instruments through the elongated tubular member, an adjustable portion configured to facilitate axial movement of the elongated tubular member, a collar of fixed diameter; and a rim of fixed diameter equal to the diameter of the collar.

Articulating surgical instruments are disclosed. In one embodiment, a surgical instrument may include an elongated shaft assembly including an articulable portion moveable between a non-articulated configuration and an articulated configuration. First and second articulating shafts of the elongated shaft assembly may be coaxially arranged and axially fixed at an attachment point located distally from the articulable portion. Proximal portions of the first and second articulating shafts may be displaceable in opposing directions to articulate the articulable portion from the non-articulated configuration to the articulated configuration. In another embodiment, an articulation control may be movable from a first position to a second position to move an articulation lock from a locked configuration to an unlocked configuration to selectively permit articulation of a surgical instrument. The articulation lock also may be movable from the second position to a third position to articulate the surgical instrument.