A surgical staple cartridge is disclosed comprising a plurality of staples removably stored within the surgical staple cartridge. The staples comprise staple legs which extend from a staple base portion. The staple legs comprise staple tips configured to pierce tissue and contact a corresponding forming pocket of an anvil of surgical stapling instrument. The staples further comprise zones having different hardnesses.

Vascular closure devices and methods for closing a blood vessel puncture site disposed at a distal end of a tissue tract are described. A combination of the body's own natural mechanism with chemical and/or biological agents is relied upon to accelerate the hemostatic process. Included are steps of introducing a closure device through the tissue tract and deploying an expansible member at a distal end of the device within the blood vessel to occlude the puncture site. A sealing member disposed proximal the expansible member is then displaced by retracting and tensioning a coil spring so as to expose a chemical and/or biological region or release region of the device. The retraction and tensioning of the coil spring is limited by a coupling member. Exposure of blood and tissue to the chemical and/or biological sealing member promotes the clotting processing to accelerate the occlusion process in the tract.

In various embodiments, a layer of material can comprise a body, a proximal end portion, and a distal end portion. The proximal end portion can be releasably secured to a staple cartridge of a surgical end effector, and the distal end portion can be releasably secured to an anvil of the surgical end effector. The layer of material can comprise a tissue thickness compensator.

A system for performing a minimally invasive percutaneous procedure comprises a medical device comprising a hydrogel delivery needle (4) with a tip and a hydrogel outlet (6), an injectable, shear-thinning, self-healing viscoelastic hydrogel that exhibits a storage modulus (G′) of at least 600 Pa, and a tan δ (G"/G′) from 0.1 to 0.6 in dynamic viscoelasticity measured by a rheometer at 1 Hz and 1% strain rate at 25° C. The system may also comprise a coaxial cannula (2) having a lumen configured for receipt of the hydrogel delivery needle (4), wherein the hydrogel delivery needle comprises an adjustable positioning mechanism (8) configured to limit the advancement depth of the hydrogel delivery needle through the coaxial cannula to a predetermined depth distal to a distal-most end of the coaxial cannula.

Described are medical devices useful for applying a bolster material to a surgical fastening device such as a stapler, and related methods of manufacture and use. The devices include an applicator element for receipt between arms of the stapler, and a bolster material, desirably a remodelable extracellular matrix material, coupled to the applicator element. In certain embodiments, the bolster material is held by the applicator element, for example having at least a portion looped around or received through or over a portion of the applicator element. Also described are unique implantable materials including coatings of dried, reversible adhesive.

A medical device that includes a body configured to store a first substance and a second substance, a shaft extending distally from the body and having a distal end, and a pressure source in fluid communication with the first substance, the second substance, and the shaft. Pressurized medium from the pressure source is configured to deliver the first substance through the shaft and out of the distal end, deliver the second substance through the shaft, separate from the first substance, and out of the distal end, and be delivered through the shaft separate from the first substance and the second substance, and out of the distal end. The pressurized medium mixes the first substance and the second substance externally of the shaft as the first and second substances exit the distal end.

A staple cartridge comprising a tissue thickness compensator is disclosed. The tissue thickness compensator comprises an external layer and tubular elements. The tubular elements are interconnected and positioned within the external layer. The tubular elements comprise apertures defined therein and the tubular elements are configured to collapse as pressure is applied to the tissue thickness compensator by tissue during the firing motion. The apertures enable fluids from the tissue to permeate the tissue thickness compensator.

Systems, devices, and methods for controlling cooperative surgical instruments with variable surgical site access trajectories are provided. Various aspects of the present disclosure provide for coordinated operation of surgical instruments accessing a common surgical site from different approach and/or separate body cavities to achieve a common surgical purpose. For example, various methods, devices, and systems disclosed herein can enable the coordinated treatment of tissue by disparate minimally invasive surgical systems that approach the tissue from varying anatomical spaces and must operate differently, but in concert with one another, to effect a desired surgical treatment.

Devices, systems and methods for applying a bioadhesive substance to an internal surface of the eye, such as the retina, can include an outer sleeve having a proximal end, a distal end, a passageway extending along a length of the elongate body and an opening at the distal end of the elongate body, an applicator tip including an elongate body having a proximal end and a distal end, an applicator portion coupled with the distal end of the elongate body, and a substance supply lumen extending along a length of the device through which a bioadhesive substance can pass so that the bioadhesive substance can be applied to at least the applicator portion of the applicator tip. Some embodiments of the device can also have a source of the bioadhesive substance in fluid communication with at least the substance supply lumen.

Devices and methods are described for occluding the left atrial appendage (LAA) to exclude the LAA from blood flow to prevent blood from clotting within the LAA and subsequently embolizing, particularly in patients with atrial fibrillation. An implant is delivered via transcatheter delivery into the LAA. The implant includes a conformable structure comprising a foam body and internal support. The support includes anchors that penetrate the foam body and anchor the implant to the walls of the LAA. The implant provides compliance such that it conforms to the native configuration of the LAA.