Abstract: A laparoscopic introducer and method of use comprise a laparoscopic channel and a guide channel for a secondary instrument. Upon initial insertion of the introducer, the guide channel closely conforms to the body of the introducer so as to only negligibly increase the cross-sectional profile thereof. Following insertion, the guide channel can be distended by means of a dilator. Thus, the guide channel allows a secondary instrument to be inserted into the body to perform laparoscopic procedures wherein the instrument is inserted and utilized along the same longitudinal axis as the laparoscope. Thus, the number of laparoscopic ports are reduced and visual distortions associated with triangulation are avoided. The guide channel is constructed from an extremely thin, but very strong and noncompliant membrane which may also be reinforced by means of a force distribution mechanism.

Abstract: A catheter comprising an elongated catheter body having a distal end and an elongated flexible guidewire having proximal and distal ends. The guidewire includes a rounded enlargement between the ends of the guidewire. The guidewire is mounted on the catheter body for movement longitudinally relative to the catheter body between a first position in which the rounded enlargement is adjacent the distal end of the catheter body and a second position in which the rounded enlargement is located distally of the position the rounded enlargement occupies in the first position.

Abstract: A surgical access device comprises an introducer with a main endoscopic channel and an auxiliary or secondary instrument channel. The introducer exhibits an extremely narrow cross-sectional profile in order to minimize the size of the portal or other entry point necessary to gain access into the patient's body, thereby minimizing pain and discomfort to the patient and allowing a wide variety of endoscopic procedures to be performed on an out-patient basis. The narrow profile of the introducer is maintained upon introduction by a guide channel which can be stored in a first position so as to closely conform to the profile of the introducer. The guide channel is provided with a set in order to maintain its stored position upon introduction; however, post introductively, the set in the guide channel can be readily released in order to deploy the guide channel and allow insertion of a secondary surgical instrument.

Abstract: A surgical access device and method are provided for endoscopic surgeries comprising biopsies or other surgical cutting procedures. The device generally comprises a substantially rigid first channel associated with a first port and a second channel associated with a second port of a proximal housing. The first or main channel extends to a curved distal end of the device, and the second channel is connected to a guide channel extending tangential to the main channel. The guide channel comprises substantially noncompliant material and has a pre-insertion position such that a cross-section of an inserted portion of the device is substantially the same as a cross-section of the main channel. A preferred method of the present invention includes the use of an open-loop device formed at a distal tip of an introducer and an aspiration tube during the location, excision and removal of one or more tissue specimens.

Abstract: An endoscope including an elongated endoscope body sized and adapted for insertion into a passage, such as a passage of the body of a patient. Optical components are carried by the endoscope body to enable viewing of the passage distally of the distal end of the endoscope body within a field of view of the endoscope. An elongated, resilient member is mounted on and carried by the endoscope body such that the endoscope body and the resilient member are a unitary assembly which can be inserted as a unit into the passage. The resilient member extends beyond the distal end of the endoscope body and is capable of contacting material within or forming the passage and relatively displacing the distal end of the endoscope body and such material within the field of view of the endoscope to enhance viewing of the passage with the endoscope.

Abstract: An everting catheter system comprising an elongated outer tubular body having an outer body lumen and an opening leading from the outer body lumen, an elongated inner tubular body movable longitudinally in the outer body lumen and having an inner body lumen and an everting element coupled to the outer body and the inner body so that with movement of the inner body longitudinally in the outer body lumen the everting element can be everted and inverted. The system also includes an elongated instrument, such as a transfer catheter, movable longitudinally in the inner body lumen relative to the inner body. A coupling releasably couples the instrument to the outer body in a substantially fixed longitudinal position with respect to the outer body.

Abstract: An endoscope comprising an elongated endoscope body having a distal end, an objective carried by the endoscope body adjacent the distal end and an elongated fiberoptic image guide in the endoscope body for transmitting an image proximally. The objective has a curved proximal surface and the image guide has a curved distal end surface which has a shape which generally conforms to the shape of the curved proximal surface of the objective. These surfaces are in close proximity to provide an interface and an index matching medium is in the interface. The objective provides a curved image plane substantially at the interface and the image plane has a shape which generally conforms to the shape of the curved proximal surface of the objective.

Abstract: An endoscope including an elongated endoscope body sized and adapted for insertion into a passage, such as a passage of the body of a patient. Optical components are carried by the endoscope body to enable viewing of the passage distally of the distal end of the endoscope body within a field of view of the endoscope. An elongated, resilient member is mounted on and carried by the endoscope body such that the endoscope body and the resilient member are a unitary assembly which can be inserted as a unit into the passage. The resilient member extends beyond the distal end of the endoscope body and is capable of contacting material within or forming the passage and relatively displacing the distal end of the endoscope body and such material within the field of view of the endoscope to enhance viewing of the passage with the endoscope.

Abstract: A method of depositing reproductive material into the reproductive tract of a female comprising inserting an elongated transfer catheter into the reproductive tract of a female. The transfer catheter includes an elongated catheter body having an elongated passage extending through the catheter body and terminating in a distal opening at a distal end of the catheter body. The distal opening opens both axially and laterally of the catheter body. The method also includes introducing the reproductive biological material through the passage and the distal opening of the catheter body into the reproductive tract.

Abstract: An everting catheter system which includes an elongated outer catheter having an outer catheter lumen and an opening, an elongated inner catheter movable in the outer catheter lumen and having the inner catheter lumen adapted to receive an elongated instrument and an everting element coupled to the outer catheter and the inner catheter. With movement of the inner catheter in the outer catheter lumen, the everting element can be everted through the opening of the outer catheter. A controller is coupled to the inner catheter for moving the inner catheter in the outer catheter lumen and for moving the instrument in the inner catheter lumen.

Abstract: A catheter for fallopian tube access comprising an elongated catheter body having a proximal region, a distal end and an elongated passage extending from the proximal region to the distal end. The elongated passage terminates in a distal opening at the distal end. The catheter body has an enlarged distal body portion and the distal opening is on the distal body portion. The distal body portion has a deflecting surface in the elongated passage adjacent the distal opening for directing a member or fluid passed through the elongated passage out of the distal opening along a path having a component which extends laterally of the catheter body.

Abstract: A catheter comprising an elongated, flexible catheter body having a distal end portion which is curved in an unstressed condition. The catheter body has a through lumen and a mandrel lumen. A mandrel is provided in the mandrel lumen, and the mandrel has a distal end portion configured to at least partially straighten the curve of the distal end portion of the catheter body. The mandrel is movable between an extended position in which the mandrel at least partially straightens the curve of the distal end portion of the catheter body and a retracted position in which the catheter body is more curved than in the extended position of the mandrel.

Abstract: A method of delivering a substance to a fallopian tube of a patient which includes obtaining transcervical access to a fallopian tube with an everting catheter. Access to the fallopian tube is obtained by everting an everting element of the everting catheter in the fallopian tube. A substance selected from the group consisting of biological material and cytotoxic agents is then delivered through the everting catheter to the fallopian tube to deposit the substance in the fallopian tube.

Abstract: A method of tubal recanalization comprising advancing an everting catheter adapted for dilatation and an endoscope to a position adjacent the site of a stenosis in an internal tubal passage of a patient. The everting catheter includes an endoscope lumen and the endoscope is within the endoscope lumen. The everting element is everted to a location within the stenosis and is then expanded to reduce the stenosis. When the tubal passage has been opened sufficiently, the everting element is retracted. The site of the stenosis is viewed using the endoscope and such viewing may be carried out prior to expansion of the everting element to locate the site as well as after the everting element has been retracted.

Abstract: A controller for moving an elongated medical instrument in a catheter comprising a supporting structure including a mounting section adapted to be coupled to a catheter and a drive section. The controller also includes a drive wheel and a secondary wheel with each of the wheels having a peripheral surface. Each of the peripheral surfaces has an instrument groove portion. One of the wheels has a circumferential recess in its peripheral surface and the other of the wheels provides a circumferential projection. The wheels are rotatably mounted on the drive section with the peripheral surfaces in generally confronting relationship and with the projection in the recess to align the wheels and to maintain the wheels in alignment as the wheels rotate. The instrument groove portions are in confronting relationship to provide an instrument groove which is sized and adapted to receive an elongated medical instrument.

Abstract: An inflator for use with a catheter having an inflatable component wherein the inflator includes a housing having an elongated plunger passage and an elongated gage passage. The housing includes a one piece main body which defines at least major lengths of both of the passages, and the passages extend in generally side- by-side relationship. The housing has a port which communicates with both of the passages and which can be coupled to the inflatable component of the catheter. A plunger is movable longitudinally in the plunger passage and is extendible out of a plunger opening in the plunger passage. A pressure responsive gage member is movable longitudinally in the gage passage and is responsive to pressure of the fluid adjacent the port. An indicator is responsive to the longitudinal position of the gage member to provide an indication of the pressure of the liquid adjacent the port. A releasable lock carried by the housing limits the plunger movement.

Abstract: A method of positioning an elongated instrument in an everting catheter is disclosed. The everting catheter includes an inflatable everting element which circumscribes a region of the instrument and which is inflated to grip the instrument. The everting catheter and instrument extend into a patient to a desired region within the body. Flush solution is introduced between the everting element and the instrument, and the instrument is moved relative to the everting element while the flush solution is between the everting element and the instrument.

Abstract: An endoscope comprising an elongated endoscope body having a proximal end and a distal end. The endoscope body is sized and adapted for insertion into an interior body region of a patient. Optical components are carried by the endoscope body to enable viewing of the interior body region of the patient. The endoscope body has an outer surface which defines a groove having a portion which extends distally of the endoscope body.

Abstract: A catheter comprising an elongated catheter body having a lumen with a distal opening, an elongated inner tube having a flexible distal end portion and a flexible everting element coupled to the catheter body and the inner tube so that the everting element can be inverted and everted to the distal opening. The inner tube has an inner tube lumen which extends through the distal end portion of the inner tube. The distal end portion of the inner tube includes a flexible tubular layer and a flexible reinforcing layer which reinforces the tubular layer and inhibits radial collapse of the inner tube lumen in the distal end portion of the inner tube.

Abstract: An everting catheter system comprising an outer tube having an outer catheter lumen and an opening leading from the outer catheter lumen, an inner catheter movable longitudinally in the outer catheter lumen and having an inner catheter lumen and an everting element coupled to the outer catheter and the inner catheter so that with movement of the inner catheter distally in the outer catheter lumen, the everting element can be everted through the opening. An elongated instrument is movable longitudinally in the inner catheter lumen relative to the inner catheter. Indicia are provided on the inner catheter and the instrument for indicating at least one longitudinal position of the instrument relative to the distal end of the everting element.