Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

An end effector for use by a surgeon to staple an anatomical structure of a patient during a surgical procedure includes an anvil and a cartridge. Each of the anvil and the cartridge has a face that is positionable on the anatomical structure. The anvil is coupled to the cartridge at first and second ends. The anvil is movable relative to the cartridge to define a first gap between the faces at the first ends that is different from a second gap between the faces at the second ends.

An atraumatic microsurgical forceps may include an actuation structure, an actuation sleeve having an actuation sleeve distal end and an actuation sleeve proximal end, a surgical blank, and atraumatic forceps jaws of the surgical blank having atraumatic forceps jaws distal ends and atraumatic forceps jaws proximal ends. The surgical blank may be disposed within the actuation sleeve wherein at least a portion of the atraumatic forceps jaws extends from the actuation sleeve distal end. A compression of the actuation structure may be configured to gradually extend the actuation sleeve over the atraumatic forceps jaws proximal ends. An extension of the actuation sleeve over the atraumatic forceps jaws proximal ends may be configured to gradually close the atraumatic forceps jaws wherein the atraumatic forceps jaws initially contact at the atraumatic forceps jaws distal ends.

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.

An apparatus includes a shaft assembly and an end effector. The shaft assembly includes a first tube, a second tube, and a distally projecting tongue. The second tube is coaxially disposed within the first tube. One of the first tube or the second tube is configured to translate relative to the other of the first tube or the second tube. The tongue is fixed to either the first tube or the second tube. The end effector includes an ultrasonic blade and a clamp arm. The clamp arm is pivotally coupled to the tongue. The clamp arm is configured to pivot toward and away from the ultrasonic blade in response to relative translation between the first and second tubes. The tongue is configured to flex relative to the first tube and the second tube in response to the clamp arm grasping tissue.

An end effector for stapling and cutting an anatomical structure includes an anvil, a cartridge, and a blade. The anvil has an anvil face and a plurality of staple pockets positioned on the anvil face. The cartridge has a cartridge face defining a cartridge blade channel, the cartridge being configured to retain a plurality of staples. Each of the plurality of staples comprises a first staple leg, a second staple leg, and a crown connecting the first and second staple legs and having a midpoint. Each of the plurality of staples comprises an open staple configuration and a closed staple configuration where a first portion of the first staple leg and a second portion of the second staple leg are bent relative to the crown such that the first portion of the first staple leg and the second portion of the second staple leg cross the midpoint of the crown.

An end effector for a surgical clip applier includes a housing, jaws that include opposed first and second jaw members, each comprising an independent structure movable relative to the other, the first jaw member defining a first inner surface and the second jaw member defining a second inner surface opposite the first inner surface, and an actuation mechanism arranged within the housing and operable to move the jaws between open and closed positions. The actuation mechanism includes an actuation plate longitudinally movable within the housing, and a transition pin extending from the actuation plate and received within corresponding slots defined in each jaw member. Linear movement of the actuation plate drives the transition pin through the corresponding slots and thereby moves the jaws between the open and closed positions.

A surgical instrument is disclosed. The surgical instrument can include an end effector, comprising an anvil and a staple cartridge. The surgical instrument can further include a shaft defining a longitudinal axis. The surgical instrument can also include an articulation joint, wherein the end effector is rotatably connected to the shaft about the articulation joint between an unarticulated position and at least one articulated position. The surgical instrument can include means for adjusting the length of a firing stroke as a function of the degree in which the end effector is articulated relative to the longitudinal axis. The surgical instrument can include a sensor configured to defect shifting of lateral portions of a flexible firing bar that extends through the articulation joint. Additionally or alternatively, the surgical instrument can include a relief feature configured to accommodate shifting of lateral portions of a flexible firing bar.

A surgical instrument can include a shaft, an end effector, and an articulation joint configured to permit the end effector to rotate relative to the shaft about the articulation joint. The surgical instrument can further comprise a first articulation actuator for rotating the end effector in a first direction and a second articulation actuator for rotating the end effector in a second direction. The articulation actuators can be configured to push the end effector. The articulation actuators can assume different configurations depending on whether they are experiencing a compressive load or a tensile load. The articulation joint can comprise an articulation frame which forms a proximal joint with the shaft and a distal joint with the end effector. The joints can comprise fixed axis joints and/or ball-and-socket joints, for example. The articulation joint can comprise links having different sizes to facilitate the articulation of the articulation joint.

Disclosed herein is a percutaneous catheter apparatus, comprising two nested needles; and an inner plunger; which is guided as a catheter to the tissue surrounding a hard implant to actuate and deploy a pair of sharp-tip needle-forceps that perform two concentric cuts, circularly spaced 90-degree apart from each other, to complete a 360 degree bore around the implant before squeezing to arrest and extract the implant, together with its surrounding tissue.