Abstract: Instruments, systems, implants, and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, and a mucosal resection device. A submucosal implant device for diagnosing and treating disorders of the body may be implanted. A passive submucosal implant device may take the form of a drug delivery depot in which a therapeutic agent within the depot elutes from the depot according to a predetermined elution profile. An active submucosal implant device may take the form of a drug delivery device that incorporates a self-contained diagnostic system to determine the appropriate delivery time and dosage of a therapeutic agent to be administered.

Abstract: A medical apparatus including: a projecting member; an introducing sheath; an extrusion member inside the introducing sheath, at a proximal side of the projecting member and movable in an axial direction with respect to the introducing sheath; a cover sheath outside the introducing sheath, the introducing sheath being movable between a first and second position with respect to the cover sheath; an introducing sheath manipulating section at a proximal side of the introducing sheath; an extrusion member manipulating section at a proximal side of the extrusion member; a cover sheath manipulating section at a proximal side of the cover sheath; and a release member on the cover sheath manipulating section and/or the introducing sheath manipulating section to release a fixation between the extrusion member manipulating section and the introducing sheath manipulating section when the introducing sheath is disposed on the first or second position.

Abstract: A method for forming an artificial valve includes inserting a sheath having proximal and distal sections and a lumen extending therethrough orally into a body cavity; inserting an endoscope orally into a body cavity, the endoscope being slidably positioned within the sheath; holding tissue in a vicinity of a junction of a stomach and an esophagus where the artificial valve is to be formed, using a holding device extending from the sheath; penetrating through tissue of the esophagus and then through tissue of the stomach at an oral side of the junction of the stomach and the esophagus with a needle provided outside of the endoscope which is not mechanically connected to the holding device and which is moveable outside of the endoscope relative to the endoscope; and passing a binding member through the tissue of the esophagus and the tissue of the stomach using the needle.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A transluminal approach through a natural body cavity to repair a ventral hernia is provided. In a transgastric approach, the abdominal cavity is accessed via an incision through a wall of the digestive tract. A system for the deployment of tissue anchors to anchor a tissue reinforcing mesh to repair the ventral hernia is provided. Particular tissue anchors are disclosed. In certain embodiments, the tissue anchors include a shaft and a head reconfigurably coupled to the shaft permitting the head and shaft to be in a substantially parallel loaded configuration and in a substantially transverse deployed configuration. In addition, tissue anchors may include biodegradable and non-biodegradable components, with the non-biodegradable component defining spaces for soft tissue ingrowth upon degradation of the biodegradable component.

Abstract: There is provided an endoscopic system. The system comprises a flexible endoscope insertable into a first tubular organ from a natural opening of a human body. The system further comprises an opening member which forms on a wall part of the first tubular organ an opening used to insert the endoscope into an abdominal cavity from the first tubular organ in the body, an anastomosing member which is able to anastomoses the first tubular organ with a second tubular organ in the abdominal cavity, and a cutting member with which the second tubular organ is able to be cut.

Abstract: Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include safe access needle injection instruments incorporating electrosurgical capability, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A tissue puncturing system used to suture tissues in a body cavity including: an endoscope; a flexible sheath having a distal portion provided with at least a side opening and a lumen, through which an endoscope may pass; at least one mechanism for puncturing tissue disposed in the flexible sheath, and having a pointed end, which is movable from a first position to a second position; and an operation mechanism for moving the mechanism for puncturing between the first and second positions.

Abstract: Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.

Abstract: In the case where the living tissues in the patient's body is resected as well, it is possible to suture the resected portion immediately without replacement with another treatment device after resection. Thus, prevention of bleeding from the resected portion or earlier repair of an ulcer that occurs with the resected portion can be carried out for the patent lowly invasively and easily.

Abstract: A transluminal approach through a natural body cavity to repair a ventral hernia is provided. In a transgastric approach, the abdominal cavity is accessed via an incision through a wall of the digestive tract. A system for the deployment of tissue anchors to anchor a tissue reinforcing mesh to repair the ventral hernia is provided. Particular tissue anchors are disclosed. In certain embodiments, the tissue anchors include a shaft and a head reconfigurably coupled to the shaft permitting the head and shaft to be in a substantially parallel loaded configuration and in a substantially transverse deployed configuration. In addition, tissue anchors may include biodegradable and non-biodegradable components, with the non-biodegradable component defining spaces for soft tissue ingrowth upon degradation of the biodegradable component.

Abstract: Instruments, systems, implants, and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, and a mucosal resection device. A submucosal implant device for diagnosing and treating disorders of the body may be implanted. A passive submucosal implant device may take the form of a drug delivery depot in which a therapeutic agent within the depot elutes from the depot according to a predetermined elution profile. An active submucosal implant device may take the form of a drug delivery device that incorporates a self-contained diagnostic system to determine the appropriate delivery time and dosage of a therapeutic agent to be administered.

Abstract: An endoscopic treatment device is used with an endoscope. This treatment device includes a transmission member with a flexible structure having a distal end portion to be inserted into a body and can be operated outside the body, a push rod coupled to the distal end portion, and first and second connecting members rotatably coupled to the push rod. The treatment device further includes first and second arm members rotatably coupled to the distal end portion of the connecting member, a holding member rotatably holding the respective arm at a predetermined interval therebetween, and first and second actuating members integrally formed with the arm members and can open/close when the transmission member actuates the first and second connecting members and the first and second arm members through the push rod. This device also includes a needle mounted on at least one of the first and second actuating members.

Abstract: An endoscopic treatment device is used with an endoscope. This treatment device includes a transmission member with a flexible structure having a distal end portion to be inserted into a body and can be operated outside the body, a push rod coupled to the distal end portion, and first and second connecting members rotatably coupled to the push rod. The treatment device further includes first and second arm members rotatably coupled to the distal end portion of the connecting member, a holding member rotatably holding the respective arm at a predetermined interval therebetween, and first and second actuating members integrally formed with the arm members and can open/close when the transmission member actuates the first and second connecting members and the first and second arm members through the push rod. This device also includes a needle mounted on at least one of the first and second actuating members.

Abstract: A translumenal approach through a natural body cavity to repair a ventral hernia is provided. In a transgastric approach, the abdominal cavity is accessed via an incision through a wall of the digestive tract. A system for the deployment of tissue anchors to anchor a tissue reinforcing mesh to repair the ventral hernia is provided. Particular tissue anchors are disclosed. In certain embodiments, the tissue anchors include a shaft and a head reconfigurably coupled to the shaft permitting the head and shaft to be in a substantially parallel loaded configuration and in a substantially transverse deployed configuration. In addition, tissue anchors may include biodegradable and non-biodegradable components, with the non-biodegradable component defining spaces for soft tissue ingrowth upon degradation of the biodegradable component.