Abstract: A medical device, such as a nasal-jejunal feeding tube, having an arrangement of flaps cut from the outer surface of the catheter and configured so as to not readily adhere to the catheter outer surface. The arrangement of flaps are configured to resist egress so as to permit peristaltic contractions of the body to propel the device forward, yet will allow the device to be removed from the body without the flaps causing significant trauma to the tissues of the body canal.

Abstract: A medical device including an inflation element, such as a syringe, and a balloon catheter in which the inflation element includes a series of indicia to which an operative portion of the inflation device can be aligned. The indicia directly correspond to a particular balloon diameter. A method of inflating a balloon to at least two desired diameters in a body lumen and determining the inflation diameter of the balloon within the body lumen. A method of calibrating the inflation device to allow a user to inflate a balloon to a desired diameter.

Abstract: A stent introducer apparatus includes a handle with a proximal end and a distal end and having a portion that is coaxially slidable from the distal end to the proximal end and vice versa. A catheter having a proximal end and a distal end is provided with a pair of open end slits each of which defines a tab that is connected to the slidable portion of the handle. A guide wire is disposed within the catheter and has a proximal end and a distal end such that when the slidable portion of the handle is moved from the distal end to the proximal end, the distal end of the guide wire is exposed. The guide wire has a stent carrying portion at its distal end to carry a stent that is deployed when the distal end of the guide wire is exposed.

Abstract: An activating mechanism for activating an endoscopic ligator is disclosed. The activating mechanism includes a mounting member, a spool, and a line. The mounting member has a passage and is adapted to be inserted into an endoscope channel. The spool is coupled to the mounting member and the line is coupled to the spool and extends through the passage of the mounting member and into the endoscope. Also disclosed is an activating mechanism with a mounting member coupled to a spool. The mounting member has a longitudinal axis for insertion into an endoscope channel, and the spool has an axis substantially perpendicular to the axis of the mounting member. Each device can be operated by rotating the spool to pull a line that is in turn operable coupled to an endoscopic ligator.

Abstract: A apparatus is disclosed that is adapted for delivery of a multiplicity of pre-loaded ligating bands within patient, such as to treat hemorrhoidal tissue. The apparatus comprises a delivery member that includes a tissue receiving chamber at the distal end that communicates with a passageway that represents part of the main suction pathway that connects with a suction means. The proximal portion of the apparatus includes an actuating mechanism that is operatively connected to one or more band carrier elements, such as strands with bead-like retainers, which receive and urge the ligating bands over the delivery member for deployment. The actuating mechanism and suction actuating interface are configured such that they can be controlled while the operator retains the other hand for another operation, such as to manipulate an anoscope. In one embodiment, the proximal portion includes a pistol-shaped grip portion, while the actuating mechanism comprises a knurled wheel.

Abstract: Disclosed is a medical apparatus assembly (10) comprising a medical device (11) that includes a side port assembly 13 adapted to combine a first pathway (37) for infusion of fluids with a second pathway (38) for wire guide (12) into a first passageway (26) while the second passageway (27) includes the third pathway (39), which comprises a control member (24), such as an electrical wire. The side port assembly is configured such that the first passageway communicates with both a first port (16), such as a fitting for connecting to a syringe, and a second port (15) which includes a sealing mechanism (32), such as a Tuohy-Borst fitting, thereby allowing the wire guide to be preloaded, instead of requiring it to be removed prior to infusing fluids. Optionally, a third port (43) may be included when external communication with the second passageway, is desired, such as balloons or baskets.

Abstract: An apparatus and method for coupling a gastroscope (30) to a gastrostomy feeding tube apparatus (10) such that both can be introduced together into the alimentary tract, thereby eliminating the need to separately introduce the gastroscope afterward in order to verify that the gastrostomy feeding tube (11) has been correctly placed within the stomach of the patient. The gastrostomy feeding tube includes a coupling member (12), such as an elongate tract or thread, that is accessible about the second end (26) thereof. The elongate tract is drawn through the working channel (31) of the gastroscope by an engagement member (29), such as snare, which then allows the distal end (33) of the gastroscope to be advanced into the end cap (18) of the feeding tube so that the two can be pulled together into the stomach. In another embodiment, the coupling member comprises an integrated attachment member (39), such as hook, to which the engaging member can attach.

Abstract: An apparatus and method are disclosed for measuring the compliance of the lower esophageal sphincter (LES), the apparatus comprises a catheter having a plurality of extendable members disposed therealong for both measuring the compliance of the LES and stimulating the esophagus which relaxes the LES to obtain a more clinically relevant measurement of LES compliance. In one embodiment, the plurality of extendable members include a first balloon which is located and inflated within the esophagus to trigger esophageal motility, a second, non-elastic balloon that is positioned within the LES, and a third balloon which is inflated within the stomach to help align the second balloon with LES. Incrementally increasing volumes of air are introduced into the second balloon, with the resulting pressures exerted by the LES calculated and compared to normative values to assess the condition of the LES.

Abstract: Disclosed is an introducer apparatus comprising an sleeve fixation mechanism or introducer member, such as a catheter, introducer, or ring-like structure, which is attached to a protective sleeve comprising a thin flexible material such a polymeric film. The sleeve is inverted into the passageway of a second member, such as a catheter, feeding tube, introducer, etc., that is advanced through the passageway of the introducer member and is introduced into a bodily passage of a patient, such as the bile duct, nasal passages, colon, etc. The sleeve everts from the passageway of the second member during its advancement to lay down a friction-reducing surface. The sleeve prevents frictional contact between the second member and delicate or sensitive tissues.

Abstract: An activating mechanism (20) for activating an endoscopic ligator is disclosed. The activating mechanism (20) includes a mounting component (21) and an activating component (22) coupled thereto. The mounting component (21) inserts directly into the proximal opening of an operating channel of an endoscope and is dimensioned to fit within the operating channel to mount the mechanism (20) to the endoscope. The mounting component (21) includes a channel receiving an activation line of the ligating device which is threaded through the operating channel and the channel in the mounting component, and onto the activating component (22) of the activating mechanism (20). The activation line attaches to a spool (50) of the activating component (22). The activating component (22) further provides a drive pin (40) and a roller clutch (70) for setting the activating component (22) in an engaged or disengaged position and a knob (60) for rotating the drive pin (40).

Abstract: An endoscopic ligating apparatus is provided that can be used percutaneuously to dispense multiple ligating bands or rings about several lesions. In one embodiment, a barrel supporting a plurality of bands stretched around its circumference is removably engaged to the insertion end of an endoscope. A trip wire extends through a working channel of the endoscope and includes a plurality of strands extending from the distal end of the barrel and wrapped around the end of the barrel. The ligating bands are situated over the strands, while the strands are provided with beads disposed adjacent the bands. As tension is applied to the trip wire by way of an activating mechanism, the strands retract within the barrel so that the beads draw the ligating bands successively to the end of the barrel. In one embodiment, the activating mechanism includes a mounting component that stably mounts the mechanism to a variety of endoscopes.

Abstract: A package 10 for maintaining the predetermined desired non-planar, three-dimensional shape of the distal tip 14 of a flexible catheter, cannula, sphincterotome or the like 12 includes a non-relaxing mounting tray 18 with a non-planar, three-dimensional structure 20 restricting movement of the distal tip 14, and a non-relaxing cover 26 detachably secured to the tray 18, trapping part and only part of the distal tip 14 against the three-dimensional structure 20 of the tray 18. The package 10 also includes a particularly configured non-relaxing insert 38 removably received in a bore 16 in the distal tip 14. The tray 18, cover 26 and insert 38 together support the distal tip 14 throughout its entire length. The structure 20 of the tray 18 includes a ramped, relatively tightly arced groove 24 on which the distal tip 14 lies. The cover 26 lies over at least the ramped, arced groove 24 and includes a pair of notches 30 receiving the distal tip 14 therethrough.

Abstract: An activating mechanism for activating an endoscopic ligator is disclosed. The activating mechanism includes a mounting component and an activating component coupled thereto. The mounting component inserts directly into the operating channel of an endoscope and is dimensioned to maintain a friction fit within the operating channel to mount the mechanism to the endoscope. The mounting component includes a channel for receiving an activation line of the ligating device which is threaded through the operating channel and the channel in the mounting component, and onto the activating component of the activating mechanism. The activation line attaches to a spool of the activating component. The activating component further provides a drive pin and a roller clutch for setting the activating component in an engaged or a disengaged position and a knob for rotating the drive pin. When the drive pin is engaged with the roller clutch, the knob can only rotate in one direction.

Abstract: Gastrostomy ports are disclosed for reliably providing enteral feeding to a patient over long periods of time. Gastrostomy ports shown herein provide one-way valves which include a resilient valve member which is compressively fitted within a receiving cavity defined by a rigid compression collar. The valve member has a diaphragm portion defining a slit. The compression collar presses inwardly against the outer peripheral edge of the diaphragm portion to apply laterally compressive forces which bias the slit toward a normally closed position. Gastrostomy ports are further shown for accessing the interior of a body cavity or organ which are self retaining and resist inadvertent pull-out but can be atraumatically implanted and removed.

Abstract: Gastrostomy feeding ports are disclosed which remain positively sealed after repeated and extensive use. In one embodiment, a valve housing defines an inner passageway to provide fluid communication into a long term indwelling catheter and includes a rigid compression collar portion which defines a valve member receiving cavity within the inner passageway. The resilient valve member has an outer peripheral edge which generally conforms in shape to the valve member receiving cavity but is larger in dimension than the cavity when uncompressed. The resilient valve member also includes an outer wall portion which extends away from the outer peripheral edge of the diaphragm portion and which generally conforms in shape to the cavity.

Abstract: A kink-resistant catheter, such as a balloon dilation catheter (10) useful in endoscopic or other surgical procedures, includes a flexible nitinol wire (24) having a transition temperature well above the temperature of the body. The catheter (10) remains essentially unkinked through acute bends and turns which would unacceptably kink comparable catheters having wires of stainless steel or other materials. The potential for patient injury from the catheter is thereby reduced. The catheter (10) includes a tubular catheter shaft (12) having a fluid flow lumen (14) defined therein, an expandable but nondistending balloon (18) connected to a distal end (16) of the shaft (12) in fluid communication with the lumen (14), and a flexible catheter tip (22) on the balloon (18) opposite the catheter shaft (12).

Abstract: A technique for removing an implanted stent and a device useful therefor. An endoscope is introduced into position at the proximal end of the implanted stent and a cannula is then introduced through the endoscope. A wire guide is then passed through the cannula and into the duct through the lumen of the stent which is to be removed. The cannula is then removed and a stent retrieval cable is advanced over the wire guide and into position at the proximal end of the stent. The stent retrieval cable is torqueable, and has a tapered thread at its distal end and a rotation dial at its proximal end. Once the retrieval cable has been placed into position, the rotation dial is turned to engage the threading into the lumen of the stent. After the stent has been attached to the retrieval cable in this manner, the stent and cable are removed together through the endoscope and out of the body, leaving the endoscope and wire guide in place for use in the implantation of the replacement stent.

Abstract: A flexible endoscopic instrument is provided with a plurality of elastic ligating rings mounted on one tube of a pair of tubular members which are affixed in coaxial relation to the insertion end of an endoscope. The rings are adapted to be dislodged therefrom in sequence at selectively controlled times for treating multiple lesions during a single insertion of the endoscope into a body organ. The endoscope is equipped with illumination and viewing [means] apparatus to facilitate orientation of the instrument in the body organ, and longitudinally extending tubular passages comprising a channel through which objects may be passed and suction applied for drawing the lesion tissue into the tubular end of the endoscope to facilitate ligation of a lesion, and a working channel through which a flexible actuating cable is inserted.

Abstract: A papillotome (10) including a multi-lumen inner member tube (11) with an outer member tube (16) positioned around the proximal portion thereof with a spacing therebetween for limiting the radial expansion of the inner member tube so that the elastic limit of the inner member tube is not exceeded. The material of and the spacing between the inner and outer member tubes is selected so as to longitudinally distribute the radial expansion of the inner member tube from a fixed or partial attachment of the inner and outer member tubes.

Abstract: An indwelling stent is disclosed which facilitates the drainage of fluids through a duct within the body, and which is easily removed when needed. The disclosed stent is a double wing stent and includes multiple flaps at each end for anchoring and has a continuously uninterrupted drainage tube therebetween. Constructed at the outflow end of the stent is a wick, which is made of an extended arcical section of the drainage tube of the stent and serves to enhance drainage by providing a "wicking" effect for fluid as it exits the stent's outflow end, while inhibiting reflux by allowing for the sphincter at the exit of the obstructed duct to function in a normal manner. The wick further serves to facilitate removal by providing a portion which is easily graspable by an instrument inserted into the body for retention and removal.