Abstract: An endoscopic wire guide apparatus for insertion through an insertion tube of an endoscope having an accessory port, the endoscope being configured for advancement into a patient. The apparatus comprises a wire guide disposed through the insertion tube for delivery into the patient. The wire guide has a distal portion and a proximal portion. The distal portion has a first diameter and the proximal portion has a second diameter less than the first diameter. The first diameter is more rigid than the second diameter. The second diameter is configured to allow the proximal portion to collapse when proximally extending through the accessory port of the endoscope and the distal portion extends at least partially beyond the distal end of the insertion tube.

Abstract: A method of removing an obstruction in the biliary duct including the steps of providing a coaxial catheter device comprising an inner catheter having a proximal end and a distal end wherein at least two or more lumens are formed between the proximal end and distal end of the inner catheter. The method includes providing an outer catheter having a proximal end and a distal end and an opening wherein the inner catheter is coaxially engaged through the opening of the outer catheter thereby forming a coaxial space between the inner catheter and the outer catheter wherein at least one of the two or more lumens is configured for receiving a fluid for inflating a balloon, at least one of the first lumen and the second lumen is configured for receiving a wire guide and the coaxial space is configured for receiving a flushing fluid for the removal of an obstruction within the biliary duct.

Abstract: An intragastric device generally comprises a strip digestive-resistant mesh material that is operable between a first configuration and a second configuration. The first configuration is sufficiently small to permit introduction of the digestive-resistant mesh material into a gastric lumen of the mammal. The second configuration is sufficiently large to prevent the digestive-resistant mesh material from passing through the mammals pylorus, thereby permitting the mesh member to act as an artificial bezoar. Methods and devices for delivering the mesh member are also provided, including a pusher that is operable to engage and disengage the mesh member for delivery through the gastric lumen via a delivery sheath.

Abstract: An elongate catheter shaft is provided, having a side port aperture through a side wall of the catheter shaft between proximal and distal ends of the shaft. The side port aperture is open to a lumen. Embodiments of the present invention are directed to attached structures disposed in the side port aperture. The attached structures described herein are directed to biasing the catheter shaft in the region of a side port aperture in a straight or curved configuration that resists undesired flexure in the region of the side port aperture and to providing ease of wire guide passage.

Abstract: A feeding tube and method for introducing a feeding tube within the gastrointestinal tract of a patient, whereby the feeding tube is introduced over a wire guide of reduced length. The feeding tube comprises an elongate shaft having a distal end and proximal end. The feeding tube comprises a coupling region for coupling the feeding tube to a wire guide. The coupling region is disposed near the distal end of the elongate shaft and has a length that is substantially less than the length of the elongate shaft. The feeding tube is introduced within the patient by coupling the coupling region of feeding tube to a previously introduced wire guide, and then pushing the feeding tube distally along the wire guide.

Abstract: Luer assemblies are provided having first and second connectors operatively coupled and securing tails of a proximal end section of a catheter disposed therebetween. A method for cutting a proximal end section of a catheter having distal and proximal ends is provided, a slit in the proximal end section exposing a catheter lumen and forming first and second tails having inner, outer, and peripheral engaging surfaces. Another method secures catheter tails disposed between operatively coupled first and second connectors, the first connector having a distal insert inserted into the exposed catheter lumen and a catheter engaging body about which the catheter tails are disposed, and the second connector having a catheter engaging body disposed about the catheter tails, wherein the connectors are configured to be operatively coupled to each other and to operatively couple the catheter tails disposed between the catheter engaging bodies of the first and second connectors.

Abstract: A medical device for allowing a physician to unhand a scope or other instruments while maintaining control of the scope or other instruments during a medical procedure. The medical device includes at least one dock and a harness for attaching the dock to the physician's body. The harness can be adjustable, or sized to fit a specific physician. During a procedure, a physician outfitted with the medical device can place a scope and/or other instrument in the dock(s). Once the scope and/or other instrument is placed in the dock(s), the physicians hands are free to perform other procedures, while the physician continually controls the relative position of the scope with respect to the physician or the patient.

Abstract: The present invention is directed to medical catheters that may be modularly constructed to facilitate manufacture and provide properties that may be difficult to achieve with a catheter formed from a single extrusion or multiple materials that are fused together. The catheter may be constructed of one or more core elements that may be partially or fully surrounded by a jacket member in a variety of configurations. The core elements may comprise different properties with respect to the jacket member or one another, thereby permitting increased manufacturing flexibility. The modular catheter designs of the present invention further provide for a variety of lumen configurations, as well as providing for catheters that can change their shape by moving the core elements with respect to the jacket member or one another.

Abstract: A steerable wire guide comprises first and second members interconnected to form a unitary composite structure. The members slide relative to each other such that the leading portion of the composite structure bends in a first or second direction. The composite structure comprises a soft body portion at its distal end and a rigid body portion at its proximal end. Various cross-sections are disclosed. In an alternate embodiment, the wire guide comprises a first guiding wire section, a wire loop section and a second guiding wire section, the wire component being folded back on itself to form a generally central wire loop section; and a tubular sheath surrounding the first guiding wire section and the second guiding wire section. The first and second members or guiding wire sections can be connected to a removable handle to facilitate control and maneuverability of the wire guide.

Abstract: Over-the-scope stent introducers for detachably engaging at least a portion of the outside of an endoscope insert and for delivering a stent are provided. Embodiments include an inner member having a distal first end portion and a proximal second end portion and openings defining a channel. The inner member includes an outer surface, inner endoscope engaging surface, and stent abutting restraint disposed at the first end portion. Embodiments also include an outer member having a distal section and proximal section having openings defining a passageway sized to slideably receive at least a portion of the inner member, and a stent carrying inner chamber disposed at the distal section passageway and being configured to releasably contain a stent. In alternative embodiments, the inner and outer members are elongated to dispose substantially concentrically over a majority of an endoscope insert.

Abstract: A cautery catheter is described having an expandable and electrically conductive mesh that can cauterize treatment sites having large effective surface areas. The mesh is composed of interwoven filaments which are aligned with the cautery catheter in an unexpanded state. Reorientation of the filaments of the mesh enables expansion of the mesh.

Abstract: A feeding tube and method for introducing a feeding tube within the gastrointestinal tract of a patient, whereby the feeding tube is introduced by using a variation of the Ponsky “pull” method of feeding tube placement. The feeding tube comprises an elongate shaft having a distal end and proximal end. The feeding tube also comprises a coupling structure for coupling the feeding tube to a pull wire, the coupling structure be proximal of the distal end of the feeding tube shaft. The feeding tube further comprises a guiding structure for aligning the pull wire with the distal end of the shaft. The feeding tube is introduced within the patient by attaching the previously placed pull wire to the coupling and guiding structures of the feeding tube, and then pulling the pull wire so as to pull the feeding tube into and through the gastrointestinal tract of the patient.

Abstract: Steerable catheter devices are provided having a proximal first end portion, an elongate intermediate portion, and a distal flexible second end portion defining a longitudinal axis, and at least one channel having a proximal opening and terminating at an occluded distal end radially offset relative to the central longitudinal axis and positioned within the catheter flexible second end portion substantially straight in a relaxed position and bent when the occluded distal end is under a change in internal fluid pressure. Optionally, the catheter further has a dye injection lumen and a tool receiving passageway extending from the first end portion to the second end portion. The occluded distal end is axially elastically distensible under an internal fluid pressure to deflect (thereby to steer) the catheter second end portion through the tortuous path of a vessel passageway when used percutaneously or working channel of an endoscope or endoscope accessory device.

Abstract: A medical device connector for connecting the shafts of two or more catheters, the connector being disposed nearer to the distal end of the combined length of the two or more catheters.

Abstract: A medical device including an expandable member such as a balloon, which includes structure that provides for controlled incremental stepwise radial expansion of the expandable member.

Abstract: A stent introducer apparatus including a primary stent introducer device movably disposed within a secondary stent introducer device. The primary stent introducer device includes a first self-expanding stent mounted on an elongate pusher member. The primary stent introducer device further includes an inner introducer catheter slidably disposed about the pusher member and the first stent. The first stent is deployed by retracting the inner introducer catheter proximally relative to the pusher member to thereby expose the first stent from the distal end of the inner introducer catheter. The secondary stent introducer device includes a second self-expanding stent mounted within an outer introducer catheter. The primary stent introducer device is configured to engage and hold the second stent. The second stent is deployed by retracting the outer introducer catheter proximally relative to the primary stent introducer device to thereby expose the second stent from the distal end of the outer introducer catheter.

Abstract: A wire guide device includes an elongate wire guide having a proximal end and a distal end and a coating affixed to a portion of the wire guide. The coating includes at least two different diameters alternating between the proximal end and the distal end of the wire guide along the length of the wire guide. A wire guide device further includes an elongate wire guide comprising a first portion having a first diameter, a second portion having a second diameter, and a third portion having a third diameter alternating between a proximal end and a distal end of the wire guide along at least a portion of the wire guide.

Abstract: A device for directing a wire guide into a bodily passageway such as a branch of the biliary tree or other difficult to access bodily passageway. The device includes a member, such as an inflatable balloon or a self-expanding basket, for obstructing a first passage. Once the balloon is inflated, or the basket expanded, the wire guide can be reliably directed or deflected into a preferred adjacent passageway in order to cannulate the preferred adjacent passageway. A procedure for cannulating a preferred passageway by obstructing a passageway in the natural flow-path of a wire guide is also provided.

Abstract: Disclosed is a pressure sensitive prosthesis that includes a tubular member having a passageway extending therethrough and a sleeve attached about one end of the tubular member. The sleeve functions as a one-way valve to permit fluid flowing through the sleeve lumen in a first, distal direction and under a first pressure, while collapsing in response to fluid flowing in a second direction when the pressure thereof exceeds that of the first direction or pressure. One aspect of the invention includes an esophageal anti-reflux expandable prosthesis wherein the sleeve is adapted to invert out of the tubular stent frame to permit belching or vomiting (fluid or materials under a third, higher pressure).

Abstract: A wire guide torque device includes a handle member having a proximal end and a distal end wherein a groove extends between the proximal end and the distal end of the handle member for inserting a wire guide. A retaining ring is rotatably disposed on the proximal end of the handle member for securing the wire guide inside the groove along the proximal end of the handle member. A lever is slidably disposed in the distal end of the handle member for securing the wire guide inside the groove along the distal end of the handle member. The device further includes a pin having a first end and a second end, wherein the first end is engaged with the lever and the second end is engaged with the handle member.