Abstract: An endoscopic scissor instrument includes an elongate hollow member, an actuator that moves axially through the hollow member, and first and second scissor blades with respective cutting surfaces. At least one of the scissor blades is rotatably coupled to the hollow member adjacent its distal end. At least one of the scissor blades includes a base supporting a resilient leaf-spring portion that includes a respective cutting edge. The resilient leaf-spring portion extends from the base in a cantilevered arrangement and generates a spring force acting on the respective cutting edge such that in a loaded state there is an automatic preload force imparted between the cutting edges of the scissor blades to maintain a consistent and continuous mating force between the two opposed sharpened cutting edges preferably over the complete range of rotational movement of the scissor blades.

Abstract: An endoscopic instrument includes a tubular member having a proximal end and a distal end, a clevis at the distal end of the tubular member, and an end effector assembly mounted on the clevis. A control member extends through the tubular member and includes a cam-pin coupled to the distal end thereof. The end effectors are controlled with a cam-pin and cam-slot arrangement, with the end effectors including the cam-slot and such cam-slot having a proximal end slot bilaterally widened to permit the cam-pin additional movement therein. When the cam-pin is retracted to move the end effectors into a closed positions and then further retracted into the bilaterally widened area, the end effectors can rotate together in the same direction to facilitate movement through a rigid bend in an endoscope.

Abstract: A stent includes a series of helical windings defining an outer circumference of a cylinder. The helical windings include a plurality of struts having straight portions connected by curved portions. The straight portions may be substantially aligned with a longitudinal axis of the stent when the stent is in a reduced state. A plurality of bridges connect adjacent windings. The bridges may be substantially orthogonal to the longitudinal axis of the stent in the reduced state. A plurality of radiopaque members extend from a terminal helical winding. The radiopaque members include an extension portion and an end portion. The extension portion may have a first width and the end portion may have a second width greater than the first width. The end portion may include an extreme end substantially orthogonal to the longitudinal axis of the stent.

Abstract: In an embodiment, a method for cutting tissue comprising inserting at least a portion of a medical instrument into a body; and cutting tissue of the body with first and second blades of the medical instrument, wherein the first blade includes: a first member having a shearing surface; an electrically insulative member supported by the first member; and a conductive member adjacent to the electrically insulative member and electrically insulated from the first member by the electrically insulative member.

Abstract: Preferred embodiments of a stent with a high degree of flexibility are shown and described. The stent can include a continuous helical winding having interconnected struts joined at vertices, and having bridges connecting sections of the helical winding to each other. An annular ring can be provided at one or both ends of the helical winding, and the annular ring can have five extensions extending to connect to the helical winding. One of the extensions can connect to a bridge and another extension can connect to a vertex. The struts at the ends of the helical winding can have strut lengths that differ from the strut lengths of the struts in a central portion of the winding between the ends of the winding.

Abstract: Preferred embodiments of a stent with a high degree of flexibility are shown and described. The stent can include a continuous helical winding having interconnected struts joined at vertices, and having bridges connecting sections of the helical winding to each other. An annular ring can be provided at one or both ends of the helical winding, and the annular ring can have extensions extending to connect to the helical winding. One of the extensions can connect to a bridge and another extension can connect to a vertex. The struts at the ends of the helical winding can have strut lengths that differ from the strut lengths of the struts in a central portion of the winding between the ends of the winding.

Abstract: An endoscopic scissor instrument includes an elongate hollow member, an actuator that moves axially through the hollow member, and first and second scissor blades with respective cutting surfaces. At least one of the scissor blades is rotatably coupled to the hollow member adjacent its distal end. At least one of the scissor blades includes a base supporting a resilient leaf-spring portion that includes a respective cutting edge. The resilient leaf-spring portion extends from the base in a cantilevered arrangement and generates a spring force acting on the respective cutting edge such that in a loaded state there is an automatic preload force imparted between the cutting edges of the scissor blades to maintain a consistent and continuous mating force between the two opposed sharpened cutting edges preferably over the complete range of rotational movement of the scissor blades.

Abstract: An endoscopic instrument includes a control wire having a push rod at its distal end and an end effector assembly having first and second effector elements such as scissors blades mounted on a clevis. The effector elements are operated by a cam-pin on the push rod riding in cam-slots defined in the effector elements. According to one aspect of the invention, the effector elements are symmetrically opened even when the push rod is canted relative to the clevis. According to another aspect of the invention, the effector elements can be rotated into a closed configuration that minimizes the distal dimension across the effector elements. In addition, the effector elements, when in the closed configuration, can rotate together to facilitate insertion of the end effector into an entry portion of an endoscope.

Abstract: An endoscopic scissor instrument includes an elongate hollow member, an actuator that moves axially through the hollow member, and first and second scissor blades with respective cutting surfaces. At least one of the scissor blades is rotatably coupled to the hollow member adjacent its distal end. At least one of the scissor blades includes a base supporting a resilient leaf-spring portion that includes a respective cutting edge. The resilient leaf-spring portion extends from the base in a cantilevered arrangement and generates a spring force acting on the respective cutting edge such that in a loaded state there is an automatic preload force imparted between the cutting edges of the scissor blades to maintain a consistent and continuous mating force between the two opposed sharpened cutting edges preferably over the complete range of rotational movement of the scissor blades.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an electrically conductive electrode, an electrically insulating material, and a metal shearing surface which is electrically insulated and physically spaced from the electrode by the insulating material which is disposed therebetween. In one embodiment, the electrode is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade, and the metal shearing surface which also provides the cutting edge is of a metal material which is fixed to the ceramic. In a second embodiment, the insulating material is a molded ceramic blade, with the electrode and the metal shearing surface layer metalized or otherwise fixed to the ceramic blade. In a third embodiment, the electrode is metalized on a thin layer insulating material which is fixed onto a metallic blade. In a fourth embodiment, metallic shearing and electrode layers are laminated to opposite sides of a fiberglass material.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an electrically conductive electrode, an electrically insulating material, and a metal shearing surface which is electrically insulated and physically spaced from the electrode by the insulating material which is disposed therebetween. In one embodiment, the electrode is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade, and the metal shearing surface which also provides the cutting edge is of a metal material which is fixed to the ceramic. In a second embodiment, the insulating material is a molded ceramic blade, with the electrode and the metal shearing surface layer metalized or otherwise fixed to the ceramic blade. In a third embodiment, the electrode is metalized on a thin layer insulating material which is fixed onto a metallic blade. In a fourth embodiment, metallic shearing and electrode layers are laminated to opposite sides of a fiberglass material.

Abstract: A preferred apparatus for delivering an intravascular drug such as a sclerosing agent (or a microfoam sclerosing agent) to a varicose vein includes a catheter having three concentric tubes. The innermost tube has a guide wire lumen and an inflation lumen. The distal end of the innermost tube has an integral inflatable occlusion balloon in fluid communication with the inflation lumen. The intermediate tube has a lumen through which the innermost tube extends. The distal end of the intermediate tube has a self-expanding balloon with a plurality of fluid pores in fluid communication with the intermediate tube lumen. The outer tube has a lumen through which the intermediate tube extends. Sclerosing agent is dispensed through the intermediate tube to pores located at the distal end of the intermediate tube or in the self-expanding balloon. Veins are sclerosed as the self-expanding balloon is pulled through and ultimately out of the vein.

Abstract: Preferred embodiments of a stent with a high degree of flexibility are shown and described. The stent can include a continuous helical winding having interconnected struts joined at vertices, and having bridges connecting sections of the helical winding to each other. An annular ring can be provided at one or both ends of the helical winding, and the annular ring can have extensions extending to connect to the helical winding. One of the extensions can connect to a bridge and another extension can connect to a vertex. The struts at the ends of the helical winding can have strut lengths that differ from the strut lengths of the struts Po. in a central portion of the winding between the ends of the winding.

Abstract: An endoscopic scissor instrument includes an elongate hollow member and first and second scissor blades each having longitudinally angled distal features. At least one scissor blade is rotatably mounted in a clevis adjacent the distal end of the hollow member. The clevis includes a pivot mechanism and spring bias means, disposed adjacent the pivot mechanism on at least one external side of the first and second scissor blades, for biasing transverse movement of the scissor blades toward one another. The spring bias means of the clevis and the angling of the distal features of the scissor blades serves to generate spring forces acting on the respective cutting edges such that there is an automatic preloading force imparted between the cutting edges of the scissors' blades.

Abstract: Surgical clips, which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus, and methods of applying the surgical clips to living tissue are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape, and which are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.

Abstract: Surgical clips, which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus, and methods of applying the surgical clips to living tissue are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape, and which are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.

Abstract: Preferred embodiments of a stent with a high degree of flexibility are shown and described. The stent can include a continuous helical winding having interconnected struts joined at vertices, and having bridges connecting sections of the helical winding to each other. An annular ring can be provided at one or both ends of the helical winding, and the annular ring can have five extensions extending to connect to the helical winding. One of the extensions can connect to a bridge and another extension can connect to a vertex. The struts at the ends of the helical winding can have strut lengths that differ from the strut lengths of the struts in a central portion of the winding between the ends of the winding.

Abstract: An endoscopic instrument includes an end effector assembly having first and second scissors blades mounted on the clevis. Laterally offset from the cutting edges a tissue stop is provided on each tissue receiving surface to hold and/or put traction on tissue. The tissue stop may include tenaculum or saw-like projections.

Abstract: An endoscopic instrument includes a tubular member having a proximal end and a distal end, a clevis rotatably mounted at the distal end of the tubular member, and an end effector assembly having first and second end effectors mounted on the clevis. A control member extends through the tubular and is coupled to the end effector assembly for moving at least one end effector relative to the other. The control member has decreasing torsional and flexural stiffness at different portions along its length from its proximal end to its distal end. The control member is a composite structure.

Abstract: An endoscopic instrument includes a tubular member having a proximal end and a distal end, a clevis at the distal end of the tubular member, and an end effector assembly mounted on the clevis. A control member extends through the tubular member and includes a cam-pin coupled to the distal end thereof. The end effectors are controlled with a cam-pin and cam-slot arrangement, with the end effectors including the cam-slot and such cam-slot having a proximal end slot bilaterally widened to permit the cam-pin additional movement therein. When the cam-pin is retracted to move the end effectors into a closed positions and then further retracted into the bilaterally widened area, the end effectors can rotate together in the same direction to facilitate movement through a rigid bend in an endoscope.