Abstract: An insufflator (1) operable in a set-up mode and a normal insufflating mode comprises a housing (10) for receiving pressurised insufflating gas from an external source (11) thereof. A microprocessor (13) controls a flow controller (16) in response to signals read from a pressure monitoring device (21) and a flow sensor (20) to maintain the peritoneal cavity (3) of a subject insufflated at a selectable working pressure. In the set-up mode, an optimum maximum pressure value is determined, beyond which the cavity (3) should ideally not be insufflated, since beyond the optimum maximum pressure there is minimal gain in working volume in the cavity (3), while the pressure in the cavity (3) increases significantly for each unit volume of insufflating gas delivered to the cavity (3).

Abstract: An insufflator (1) monitors the rate of insufflating of the peritoneal cavity (3) in the body (5) of a human subject by monitoring the increase in cavity pressure per unit time in order to avoid bradycardia (slow heart rate). A plurality of reference values of the maximum increases in cavity pressure per unit time is stored in a look-up table (23) for different body cavities for male and female subjects of different age ranges and different body mass index ranges. The particulars of the cavity (the peritoneal cavity 3) the sex, age and body mass index of the subject are inputted into the insufflator (1) through a touchscreen (30), and a microprocessor (20) determines the appropriate maximum increase in the cavity pressure per unit time from the look-up table (23).

Abstract: An endoscopic sleeve gastroplasty procedure comprises forming a gastric sleeve (5) through a stomach (1) by suturing a first portion (9) of a wall (3) of the stomach (1) to a second portion (11) of the wall (3). First and second rows (20, 22) of first and second mounds (18, 19) are formed in the first and second portions (9,11) by injecting a viscus bulking solution (25) into a submucosal layer (28) at sites (17) of the wall (3) to form pockets (27) therein to form the first and second mounds (18, 19). Sutures (15) are inserted into respective pairs (16) of the first and second mounds (18, 19) with anchor bars (38) of the sutures (15) located in the corresponding pockets (27). The sutures (15) are tightened for drawing the first and second mounds (18, 19) together to in turn draw the first and second portions (9, 11) of the wall (3) of the stomach (1) together to form the gastric sleeve (5).

Abstract: An insufflator (3) is operable to insufflate a cavity selectively and alternately at a first pressure and a second pressure lower than the first pressure. The insufflator (3) is responsive to a signal generated by a foot pedal operated switch (72) to change the pressure at which the insufflating gas is supplied from the one of the first and second pressures at which the insufflating gas is currently being supplied to the other one of the first and second pressures. The insufflator (3) comprises an output valve (47) having first and second output ports (49, 50) through which insufflating gas is selectively supplied. The first output port (49) is connectable to an instrument channel (10) of an endoscope (5), and the second output port (50) is connected to an insufflating channel (12) of the endoscope (5).

Abstract: A pair of partitioning elements located in a duodenum, sealably isolates a first portion of the duodenum, in which a minimally invasive procedure is to be carried out from a proximal second portion and a distal third portion of the duodenum to allow insufflating of the first portion only. The first partitioning element located between the first and second portions of the duodenum comprises a tubular carrier element and an isolating membrane secured to the carrier element. The carrier element is radially expandable from a compressed first state to a second state with the isolating membrane sealably isolating the first portion from the second portion. A communicating opening through the isolating membrane accommodates an endoscope therethrough into the first portion. The communicating opening is omitted from the second partitioning element.

Abstract: A collection device (1) for minimising dispersal of pathogens into the environment during insufflating of the peritoneal cavity (12) of a subject (3), and which are entrained in insufflating gases and other gases escaping through an incision (8) in the abdominal wall (9) of the subject (3), through which a trocar is entered into the peritoneal cavity (12) comprises a patch (5) supported on a support framework (30). The patch (5) terminates in an outer peripheral portion (20) with a pressure sensitive adhesive (21) coated thereon for sealably securing the outer peripheral portion (20) to the abdominal wall (9). A central access opening (24) formed in the patch (5) tightly and sealably engages the trocar (10).

Abstract: A suturing device (1) for suturing parts (5,6) together of a lumen (8) with one or more sutures (3) comprises an actuator (34) having a handle (33) and first and second operating elements (60,68) slideable longitudinally on the handle (33). A tubular shield (35) extends from the handle (33), and a cannula (40) slideable in the tubular shield (35) is connected to the first operating element (60) for urging the cannula (40) between a withdrawn state within the tubular shield (35) to an extended state extending from the tubular shield (35). An elongated push rod (52) slideable in the cannula (40) terminating in a distal hook (55) is coupled to and operated by the second operating element (68). Anchor elements (22) of the suture (3) are located in the cannula (40), and are sequentially urged therefrom by the push rod (52), as the cannula (40) sequentially pierces through the parts (5,6).

Abstract: A face mask (90) comprises an instrument shielding apparatus (91) which comprises an instrument shielding device (92) which is connected to the face mask (90) by an adapter (89). The adapter (89) comprises an instrument accommodating housing (15) through which an instrument bore (25) extends therethrough. The instrument accommodating housing (15) terminates at one end in a first main port (20) engageable with an instrument port (7) of the face mask (90), and in the other end in a second main port (23). The instrument shielding device (92) comprises a shielding sleeve (95) a first end (96) of which is secured by a coupling ring (98) to the second main port (23) of the adapter (89), and a second end (97) of which is secured in a storage chamber (94) of a sleeve storing housing (93) of the instrument shielding device (92).

Abstract: A suturing apparatus comprises an invaginating device secured to a distal end of an endoscope for invaginating two parts of the interior of a wall of a vessel, for example, a stomach to be sutured together to form a gastric sleeve. The invaginating device includes a suction chamber for forming invaginated parts of the interior of the wall of the vessel. A suturing instrument extending through an instrument channel of the endoscope extends into the invaginating device, and is urged into or adjacent the suction chamber for inserting a suture into the invaginated part in the suction chamber. The next invaginated part is then formed, and the suture is inserted into it. The suture is then tightened to draw the two invaginated parts together.

Abstract: An insufflator for insufflating a body cavity includes a compressed air vessel and a flow control valve for delivering insufflating air to the cavity through a first trocar. A discharge control valve at an outlet port of a second trocar exhausts insufflating air from the cavity. A pressure sensor on the first trocar monitors cavity pressure, and a microcontroller operates the flow control valve for maintaining a predefined working pressure in the cavity. A foot operated switch is operable by a surgeon for opening and closing the discharge control valve. When the pressure in the cavity drops below the predefined working pressure, the flow control valve increases the insufflating air to the cavity, thereby increasing the insufflating air flow through the cavity for removing undesirable gases. The apparatus and insufflator may also be adapted for removing smoke, nitrogen or other undesirable gases during both cauterisation and cryogenic procedures.

Abstract: A leak control system (26) for an evacuation system (12) of an insufflation system (1), for controlling leakage of insufflating gas from a vessel (5) of a subject being insufflated. An evacuation conduit (20) connects a Venturi vacuum creating device (14) to the vessel (5) through a pressure relief valve (27) operable from a closed state to an open state in response to a pressure drop across the pressure relief valve (27) in the direction of the arrow A exceeding a predefined pressure drop value. The vacuum creating device (14) is operable in response to a signal from a pressure sensor (10) detecting pressure in the cavity (5) exceeding a predefined pressure value for applying a vacuum to the evacuating conduit (20) to increase the pressure drop across the pressure relief valve (27) to the predefined pressure drop value, for in turn operating the pressure relief valve (27) into the open state.

Abstract: An insufflator for insufflating a body cavity includes a compressed air vessel and a flow control valve for delivering insufflating air to the cavity through a first trocar. A discharge control valve at an outlet port of a second trocar exhausts insufflating air from the cavity. A pressure sensor on the first trocar monitors cavity pressure, and a microcontroller operates the flow control valve for maintaining a predefined working pressure in the cavity. A foot operated switch is operable by a surgeon for opening and closing the discharge control valve. When the pressure in the cavity drops below the predefined working pressure, the flow control valve increases the insufflating air to the cavity, thereby increasing the insufflating air flow through the cavity for removing undesirable gases. The apparatus and insufflator may also be adapted for removing smoke, nitrogen or other undesirable gases during both cauterisation and cryogenic procedures.