Systems, devices and methods related to various heart valve implants and for delivery of those heart valve implants are described. The implants may be used to re-size a native valve annulus or to replace a native heart valve. The implants include a re-sizable frame having angled struts. Anchors secure the implant to tissue and collars are used to decrease the angle between the struts and contract the frame. The implant thus expands from a first size inside of a delivery catheter, to a second and larger deployed size inside the heart to engage and anchor with the tissue, and then to a third and contracted size to re-size the annulus and/or provide a secure fit for a replacement heart valve. Various delivery systems including imaging capabilities for precise delivery, positioning and anchoring of the various implants are further described.

A circular stapling device includes an anvil assembly and an adaptor assembly including a shell assembly. The adaptor assembly includes an anvil retainer including an asymmetric tip. The anvil assembly has a center rod, an anvil head supported on the center rod, and an alignment member. The center rod has a proximal portion and a distal portion and defines a channel that extends from the proximal portion to the distal portion. The alignment member is positioned within the channel and is configured to engage the asymmetric trocar tip of the anvil retainer of the adaptor when the anvil assembly is attached to the anvil retainer to properly align the anvil assembly with the shell assembly.

A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

A circular stapling device includes an elongate body having a flexible outer tube that supports a reload assembly, a flexible inner cable that supports an anvil assembly, and a flexible central tube that is supported about the inner cable and within the outer tube. The stapling device is configured to access body cavities which cannot be easily accessed by a circular stapling device having a rigid shaft.

Systems and methods for tibial plateau leveling osteotomy (TPLO) are disclosed. According to some embodiments, an osteotomy method may include cutting a tibia with an arcuate cut to separate a tibial plateau of the tibia from a tibial base of the tibia, rotating the tibial plateau relative to the tibial base from a first orientation to a second orientation, and, with the tibial plateau in the second orientation relative to the tibial base, securing an implant to the tibia to secure the tibial plateau to the tibial base. Securing the implant to the tibia may include embedding a first leg of the implant into the tibial base, and embedding a second leg of the implant into the tibial plateau such that the first and second legs apply compression urging the tibial plateau toward the tibial base.

Devices and methods for gastrointestinal bypass are described. A gastrointestinal bypass device includes a gastrointestinal cuff and a gastrointestinal sleeve. The cuff may be configured to be attached in the esophagus, and may be sufficiently flexible to expand and collapse to conform with the inside of the esophagus to allow the esophagus to function substantially normally. The sleeve is configured to be coupled to the cuff, and may be made of a material that is floppy or flaccid but does not substantially expand radially.

Devices and methods are provided for stabilizing fasteners post-deployment. Devices and methods are also provided for facilitating ejection of surgical fasteners from a cartridge. Devices and methods are also provided for guiding surgical fasteners. Devices and methods are also provided for facilitating closing and clamping of an end effector of a surgical device. Devices and methods are also provided for securing fasteners and adjunct materials to tissue. Devices and methods are also provided for removably coupling a cartridge to an end effector of a surgical device. Devices and methods are also provided for locking a surgical device based on loading of a fastener cartridge in the surgical device. Devices and methods are provided for adjusting a tissue gap of an end effector of a surgical device. Devices and methods are also provided for manually retracting a drive shaft, drive beam, and associated components.

Methods of deploying and securing a heart valve prosthesis are disclosed. A heart valve prosthesis (100) having a plurality of anchor guides (212) is loaded within a catheter-based delivery device, wherein each of the anchor guides is releasably engaged by a respective elongate member (338) and wherein tensioning of the elongate members aids in collapsing the prosthesis during loading. The delivery device is advanced via a transcatheter procedure to position the heart valve prosthesis at an implantation site. The heart valve prosthesis undergoes controlled deployment by controlling the release of tension on the elongate members. After deployment of the heart valve prosthesis, an anchor tool (660) is advanced along a guide member to the anchor guide positioned at a securement site. When the securement site is reached, an anchor clip (662) is released from the anchor tool to secure the prosthesis to the heart.

Thoracic/lumbar and cervical spinous process staples which staple/fuse adjacent spinous processes are disclosed. Thoracic/lumbar transverse process staples which staple/fuse adjacent transverse processes are also disclosed. Each embodiment has upper and lower claws connected by a ratchet spring mechanism, along with a multiplicity of bone fastener prongs attached to the upper and lower claws. Two sets of prongs on each staple claw are spaced by a distance approximately equal to the distance separating adjacent spinous or transverse processes so as to facilitate stapling/fusion of two adjacent processes. Also disclosed are staple prongs with multiple perforations which enable incorporation of bone fusion material thereby facilitating stapling/fusion of spinal elements.

A surgical stapler can comprise an anvil comprising a staple pocket formed in a tissue contacting surface. The staple pocket can comprise a midline or centerline, a first forming cup, and a second forming cup. The first forming cup can comprise a first interior sidewall comprising a first vertical portion which is substantially perpendicular to the tissue contacting surface. The second forming cup can comprise a second interior sidewall comprising a second vertical portion which is substantially perpendicular to the tissue contacting surface. The first vertical portion and the second vertical portion can extend through the centerline, wherein the first interior sidewall and the second interior sidewall can comprise a trap for deforming a first staple leg of a staple to a first side of the centerline and for deforming a second staple leg of the staple to a second side of the centerline.