Abstract: A retractor for manipulating an object includes a body having proximal and distal ends and a retraction device with a head connected to the distal end of the body, a connector movably disposed in the body, and flexible needles of a shape memory material having a memory shape. The needles are connected to the connector and each have a distal tip. The memory shape of the needles include a portion with an arcuate shape biasing the needles in a memory direction out and away from the head and toward the body to position the distal tip of each of the needles closer to the body when the needles are fully extended out of the head than when the needles are only partially extended out of the head. An actuation device is connected to the proximal end of the body and operatively connected to the connector through the body, the actuation device, upon actuation thereof, moves the connector to selectively extend the needles out of the head in different directions and withdraw the needles into the head.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.

Abstract: A tissue retractor includes a body having proximal and distal ends. The retractor also includes a retraction device having a head connected to the distal end of the body and defining two opposing openings, a connector movably disposed in the body, and two flexible needles of a shape memory material having a memory shape. The needles are fixedly connected to the connector for traveling through a respective one of the openings. The memory shape of the needles includes a portion with an arcuate shape. A one-handed actuation device is connected to the proximal end of the body and is operatively connected to the connector through the body. Upon actuation of the actuation device, the connector can be moved to selectively extend the needles out of the head and withdraw the needles into the head. Methods for using the tissue retractor, in particular for the treatment of Gastroesophageal Reflux Disease, are also provided.

Abstract: A method of performing a treatment for gastroesophagheal reflux disease (GERD) includes providing a distal end of a shaft of a medical instrument with a proximally facing end effector having a laterally offset clevis defining a shaft-clevis plane and opposing mutually rotatable jaws proximally directed and laterally displaced relative to a longitudinal axis of the shaft. The jaws hold parts of a two-part fastener, respectively, and are offset and separated from the shaft. Significantly, the jaws operate in a plane at an angle to the shaft-clevis plane. The shaft is inserted with the proximally facing end effector through the esophagus in a first direction. The shaft is retracted in a second direction substantially opposite the first. The end effector contacts a stomach wall at a location near the esophagus and the stomach wall is manipulated with the end effector.

Abstract: An apparatus for the transoral invagination and fundoplication of the stomach to the esophagus includes a clip applier having sharp toothed jaws for grasping and damaging the fundus prior to applying the clip. The clip applier has an overall diameter of less than 7 mm. The clip applier jaws are coupled to a pull wire via a linkage which increases the mechanical advantage and thus permits greater grasping force. A plurality of clip designs are also provided.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.