According to one aspect, a fastening device may include a coupling body having (1) a portion configured to couple to a distal end of a medical device, (2) a cartridge holder, and (3) an anvil pivotably coupled to the cartridge holder. The cartridge holder and the anvil may extend distally from the portion and may be configured to extend distally of a distalmost face of the medical device when the portion is coupled to the distal end of the medical device. A flexible member may be configured to extend through a channel of the medical device. A fastener cartridge may be coupled to a distal end of the flexible member, including at least one fastener, and may be configured for releasable coupling to the cartridge holder.

A surgical instrument includes a shaft assembly, an end effector, a firing system, and a firing lockout assembly. The end effector is operatively coupled with the shaft assembly. The end effector includes first and second jaws. The first jaw includes an anvil. The second jaw is configured to removably receive an unspent staple cartridge. The firing system extends through at least a portion of the shaft assembly and the end effector. The firing lockout assembly is selectively coupled with the firing system. The firing lockout assembly is disposed proximal to the end effector. The firing lockout assembly is configured to allow actuation of the firing system in an unlocked configuration in response to the unspent staple cartridge being coupled with the second jaw; and inhibit actuation of the firing system in a locked configuration in response to the unspent staple cartridge being absent from the second jaw.

Stapling assemblies for use with a surgical stapler are provided. In one exemplary embodiment, the stapling assembly includes a cartridge having a plurality of staples disposed therein and a non-fibrous adjunct formed of at least one fused bioabsorbable polymer and configured to be releasably retained on the cartridge. Adjunct systems for use with a surgical stapler are also provided. Surgical end effectors using the stapling assemblies are also provided. Methods for manufacturing stapling assemblies and using the same are also provided.

An anvil buttress loading system includes an anvil assembly, an anvil buttress loading tool, and an anvil buttress. The anvil buttress is retainable on each of the anvil buttress loading tool and the anvil buttress, and is transferrable from the anvil buttress loading tool to the anvil assembly.

A surgical stapling assembly is disclosed. The assembly can include a cartridge body having cavities defined therein forming a pattern of openings in the deck of the cartridge body. The pattern can include longitudinally-repeating clusters of cavity ends. The assembly can also include fasteners removably positioned in the cavities. The pattern of openings can comprise openings on a first side of the cartridge body comprising inner openings each defining an inner proximal-to-distal axis oriented parallel to the longitudinal axis, outer openings each defining an outer proximal-to-distal axis obliquely-oriented relative to the longitudinal axis at an outer angle, and intermediate openings each defining an intermediate proximal-to-distal axis obliquely-oriented relative to the longitudinal axis at an intermediate angle, wherein the intermediate angle is different than the outer angle. The assembly can include a sled having offset ramps and/or an anvil comprising an arrangement of forming pockets proximal to the tissue stop.

An apparatus includes a first jaw (16) and a second jaw (618, 718, 900) that cooperate to clamp and staple tissue (90). The second jaw includes a jaw body (620, 720, 902) and a distal tip (619, 719, 906) pivotable relative to the jaw body between a first discrete and a second discrete position. First and second openings (663, 784, 785, 932, 934) are both defined by one of the distal tip or a structure (621, 920) located proximal to the distal tip. A projection (637, 781, 918) is defined by the other of the distal tip or the structure. The projection is positionable within the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position, and within the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position.

Devices and methods for acquiring and fastening tissues folds within an internal organ, such as the stomach, and for applying the methods and devices to producing reductions in organ volume or repair of bariatric procedures, are disclosed. An exemplary method for forming a continuous laterally extending tissue fold involves forming a succession of laterally extending folds having adjacent overlapping fold portions. One exemplary tissue-acquisition device has an open-end roller-and-arm structure that allows individual tissue folds to be formed and fastened, then advanced to an adjacent region within the stomach, for capture of a new fold that will form an extension of the existing fold(s).

A staple cartridge has a plurality of staples, wherein each said staple comprises a base and a deformable leg extending from said base. The staple cartridge has a first region comprising a first hardness, a second region, and a third region comprising a hardness greater than said first hardness, wherein said third region is separable into a plurality of pieces.

A surgical stapling assembly is disclosed. The stapling instrument comprises a staple cartridge configured to staple the tissue of a patient and a cutting member configure to incise the tissue. The stapling instrument further comprises an anvil movable between an open position and a closed position to clamp tissue against the staple cartridge. The anvil is configured to deform the staples when the staples are ejected from the staple cartridge. In at least one embodiment, the stapling instrument comprises a lockout configured to prevent the cutting member from incising the tissue until after the staples have been formed. In at least one embodiment, the stapling instrument comprises a lockout configured to prevent the anvil from being opened while the cutting member is exposed.

A surgical device is disclosed which includes a handle assembly, an elongated member and a disposable loading unit. The handle assembly includes a mode selection mechanism configured to alternate the surgical device between a first grasping mode of operation and a second clamping mode of operation. The handle assembly includes a rotation control member and an articulation lever. The rotation control member is configured to facilitate rotation of the elongated member with respect to the handle assembly. The articulation lever is configured to facilitate articulation of the tool assembly about an axis substantially perpendicular to the longitudinal axis of elongated member. In one embodiment, the tool assembly includes a cartridge assembly having a plurality of staples and an anvil assembly configured to clamp and staple tissue in the second clamping mode of operation of the device.