Surgical instruments, such as distractors and methods of manufacture are provided for maintaining a displacement of bone determined to be necessary by a surgeon. For instance, a surgical distractor may include a first holder section, a second holder section, a first displacement element, a second displacement element, a positioning element, and a rotatable component having an opening. The second holder section may be coupled to the first holder section using one or more coupling elements coupled to both the first holder section and the second holder section. The first displacement element and the positioning element may be positioned on the first holder section and the second displacement element and the rotatable opening may be positioned on the second holder section configured to engage the first displacement element.

A disposable bidirectional ratchet, which has a tubular hollow handle with an interior surface having teeth thereon; a toggle mounted movably within the handle; a knob connected to an end of the toggle moves the toggle inside the handle; a plurality of pins on another end of the toggle; a plurality of actuators each comprising: fingers, levers, toes and a head, and having a post guide formed therein; a plurality of posts affixed to a clutch; and, wherein the actuators are movable affixed to the clutch via the posts, and the pin position selects the direction of engagement via adjustment of the actuator position via applying force to the levers, which moves the lateral edges of the actuator towards or away from the teeth.

A tibial alignment device includes an upper part for coupling with a tibial cutting guide and a lower part coupled to the upper part to be vertically slidable, wherein the upper part includes a cutting guide coupling part configured to mount the tibial cutting guide, and a connection part to connect the upper part and the lower part, and the lower part includes an ankle forceps part, wherein the cutting guide coupling part includes a fastening member for coupling to the tibial cutting guide, and a reception member to slidably receive the fastening member, wherein the fastening member includes a coupling part that protrudes to be coupled to the tibial cutting guide, the reception member includes a coupling part that protrudes to be coupled to the tibial cutting guide, and the coupling part of the fastening member is capable of adjusting a gap with respect to the coupling part of the reception member.

A surgical kit includes a stapling device and a securing ring. The stapling device includes a reload including a trocar member and an anvil assembly including an anvil and an anvil shaft detachably couplable to the trocar member of the reload for unitary movement. The securing ring is selectively securable about the anvil shaft. The securing ring has an annular profile defining an aperture. The securing ring includes first and second portions and an intermediate portion. The first and second portions adjustably overlap each other. The first portion includes a first tab. The second portion includes a hook. The intermediate portion includes a second tab and defines slots to receive the hook of the second portion. When the first and second tabs are displaced relative to each other, the aperture is transitionable from a first state having a first diameter to a second state having a second diameter.

A persuader instrument for advancing a fixation rod into a vertebral implant includes a housing and at least one arm. The at least one arm can include detents for detachable connection to the vertebral implant. The persuader instrument can also include a shaft coupled to an anchor. The anchor can include a fixation rod engagement surface. The shaft can be axially displaceable through the housing to axially displace the anchor and a rod engaged by the anchor. The persuader instrument can further include an auto-locking ratchet assembly in releasable engagement with the shaft. The auto-locking ratchet assembly can control axial displacement of the shaft through the longitudinal passage of the housing.

A surgical device is provided that includes a jaw portion with a first jaw and a second jaw moveable relative to the first jaw. The surgical device also includes a shaft portion coupled to a proximal end of the jaw portion. A driver is configured to cause relative movement of the jaw portion and the shaft portion. The driver may be configured to cause the jaw portion to pivot relative to the shaft portion about a pivot axis that is perpendicular to first and second longitudinal axes defined by the jaw portion and the shaft portion, respectively. The driver may also be configured to cause at least a portion of the jaw portion to rotate relative to the shaft portion about the first longitudinal axis. Advantageously, the surgical device includes a surgical member, e.g., a cutting element and/or a stapling element, disposed within the first jaw.

An endoscopic reposable surgical clip applier is provided and includes a handle assembly and an endoscopic assembly. The endoscopic assembly is selectively connectable to and in mechanical communication with the handle assembly and includes a shaft assembly. The shaft assembly includes a pair of jaws pivotably and fixedly supported in, and extending from a distal portion of the shaft assembly, a spindle assembly supported within the endoscopic assembly, and a lockout mechanism fixedly supported on the pair of jaws. A distal end of the spindle is operatively engaged with the pair of jaws to effectuate an opening and a closing of the pair of jaws upon an axial translation of the spindle. The lockout mechanism is in selective engagement with the spindle and includes a first position that enables distal advancement of the spindle and a second position that inhibits distal advancement of the spindle.

A tissue retrieval system including a tissue retrieval bag deployable from an introducer and suspended in an open configuration by support arms can include retention features to prevent inadvertent movement of the tissue retrieval bag relative to the support arms. The support arms can include protruding domes, folds, or curls to restrict sliding of the tissue retrieval bag relative to the support arms. Alternately, tension can be maintained in a cord loop coupled to an opening of the tissue retrieval bag to prevent the tissue retrieval bag from inadvertently sliding relative to the support arms.

A method is provided that includes implanting a first tissue-engaging element in a first portion of tissue in a vicinity of a heart valve. A second tissue-engaging element, which is connected to a third tissue-engaging element by a longitudinal sub-member, is implanted in a second portion of tissue of an annulus, and the third tissue-engaging element is implanted in a third portion of tissue of the annulus. A fourth tissue-engaging element is implanted in a portion of a blood vessel that is in contact with an atrium. While the longitudinal sub-member engages the longitudinal member at a junction therebetween, at least a first leaflet of the heart valve is drawn toward at least a second leaflet of the heart valve by adjusting a distance between the portion of the blood vessel and the first portion of tissue in the vicinity of the heart valve. Other embodiments are also described.

The present disclosure includes apparatuses for a surgical handle assembly. An example apparatus includes a toothed rack, a movable handle member, a driving pawl configured to engage the toothed rack and advance the toothed rack in a linear distal direction in response to a movable handle member advancing in a proximal direction and a latch configured to engage the toothed rack and advance the toothed rack in a linear proximal direction in response to the movable handle member advancing in a distal direction.