Abstract: An endoscopic instrument includes a tubular member having a proximal end and a distal end, a clevis at the distal end of the tubular member, and an end effector assembly mounted on the clevis. The clevis is rotatably coupled to the distal end of the tubular member using a bearing system. A control member extends through and is movable relative to the tubular member. The distal end of the control member is coupled to the end effector. The control member which actuates the end effectors is a composite structure that effectively transfers torque through a highly flexed instrument to rotate the clevis on the bearing.

Abstract: A stent includes a stent body having a circumference and struts disposed helically about the circumference. Each of the struts has a strut length and a ratio of a number of the struts around the circumference to the strut length is greater than 800 per inch, in particular, over 1000 per inch. A method for manufacturing a helical stent includes the steps of providing a stent body with struts disposed about the circumference thereof in turns and with bridges connecting the struts in adjacent turns. The stent body is expanded and, thereafter, some of the bridges, in particular, sacrificial bridges, are removed.

Abstract: A stent includes a stent body having a circumference, a diameter of between approximately 4 mm and approximately 12 mm, in particular, 8 mm, and a length of between approximately 10 mm and approximately 250 mm, in particular, 150 mm, and struts disposed helically about the circumference in turns. Substantially circumferentially oriented connecting bridges connect respectively adjacent ones of the turns. A method for manufacturing a helical stent includes the steps of providing a stent body with struts disposed about the circumference thereof in turns and with bridges connecting the struts in adjacent turns. The stent body is expanded and, thereafter, some of the bridges, in particular, sacrificial bridges, are removed.

Abstract: An endoscopic scissor instrument includes an elongate hollow member having a proximal end and a distal end, an actuator that moves axially through the hollow member, and first and second scissor blades with respective cutting surfaces. At least one of the first and second scissor blades are rotatably coupled to the hollow member adjacent its distal end. At least one of the first and second scissor blades includes a base supporting a resilient leaf-spring portion that includes a respective cutting edge. The resilient leaf-spring portion extends from the base in a cantilevered arrangement along the length of the leaf-spring portion.

Abstract: Methods of the invention include delivering a grasper, a clip applier, and an endoscope transorally to the site of fundoplication; grasping the fundus with the grasper (or similar device, e.g. corkscrew) and pulling it into the jaws of the clip applier; closing the jaws of the clip applier over the fundus and applying a clip to the fundus.

Abstract: Preferred embodiments of a stent with a high degree of flexibility are shown and described. The stent can include a continuous helical winding and at least one bridge. The continuous helical winding has a plurality of circumferential sections that circumscribe a longitudinal axis from a first end to a second end to define a tube. The circumferential sections are spaced apart along the axis. The at least one bridge is configured to connect one circumferential section to an axially-spaced adjacent circumferential section. The at least one bridge extends on a plane generally orthogonal with respect to the axis.

Abstract: Methods and apparatus for treating the interior of a blood vessel include a variety of improved catheter designs, methods and apparatus for accessing and occluding a blood vessel.

Abstract: The methods of the invention include examining a blood vessel to be treated, preferably with the aid of ultrasound, calculating a volume of the portion of the blood vessel, and treating the portion with a volume of treatment agent where the volume of treatment agent is a function of the volume of the portion of the blood vessel. Apparatus for implementing the methods are provided.

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: Radioactive therapeutic seeds include a carrier structure bearing a radioactive isotope and a radiopaque marker. According to several embodiments, the seeds include a central plug provided with an axial marker and a relatively transverse bore extending through the marker. A second marker may be positioned in the bore, thereby distinguishing a seed provided with the second marker relative to a seed not provided with the second marker. According to another embodiment, the isotope is deposited on the outer surface of a hollow radiolucent tube. A biologically-compatible, radiolucent, surface-sealing layer seals the external surface of the tube. A radiopaque marker wire of selected length is positioned in the hollow of the tube. Seeds may be distinguished from one another by providing seeds with marker wires of different lengths.

Abstract: A preferred apparatus for delivering an intravascular drug such as a sclerosing agent (or a microfoam sclerosing agent) to a varicose vein includes a catheter having three concentric tubes. The innermost tube has a guide wire lumen and an inflation lumen. The distal end of the innermost tube has an integral inflatable occlusion balloon in fluid communication with the inflation lumen. The intermediate tube has a lumen through which the innermost tube extends. The distal end of the intermediate tube has a self-expanding balloon with a plurality of fluid pores in fluid communication with the intermediate tube lumen. The outer tube has a lumen through which the intermediate tube extends. Sclerosing agent is dispensed through the intermediate tube to pores located at the distal end of the intermediate tube or in the self-expanding balloon. Veins are sclerosed as the self-expanding balloon is pulled through and ultimately out of the vein.

Abstract: A flexible clip applier includes a flat wire wound outer tubular coil, a pair of jaws at the end of the coil, end effector wires extending through the coil and coupled to the jaws, and a clip-advancing wire extending through the coil. A large pushing force to advance a clip is created by providing a compressive force to the outer tubular coil to increase its tensile limitation, and providing a force which is compressive to the clip-advancing wire and tensile to the tubular coil while maintaining the compressive force on the tubular coil.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an electrically conductive electrode, an electrically insulating material, and a metal shearing surface which is electrically insulated and physically spaced from the electrode by the insulating material which is disposed therebetween. In one embodiment, the electrode is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade, and the metal shearing surface which also provides the cutting edge is of a metal material which is fixed to the ceramic. In a second embodiment, the insulating material is a molded ceramic blade, with the electrode and the metal shearing surface layer metalized or otherwise fixed to the ceramic blade. In a third embodiment, the electrode is metalized on a thin layer insulating material which is fixed onto a metallic blade. In a fourth embodiment, metallic shearing and electrode layers are laminated to opposite sides of a fiberglass material.

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 flexible clip applier includes a flat wire wound tubular coil, a pair of jaws at the end of the coil, end effector wires extending through the coil and coupled to the jaws, and a clip-advancing wire extending through the coil. A clip chamber is defined in the distal end of the coil. A clip pusher is provided at a distal end of the clip-advancing wire, and advances a clip into the jaws when the clip-advancing wire is moved distally. The jaws include channels in which a distalmost clip rides when the jaws are closed and the pusher is advanced, thereby causing the distalmost clip to be pushed over the tissue, and a distal anvil which operate to bend a portion of the clip to facilitate its retention on the clamped tissue. The device can push a clip with a force in excess of 1500 grams.

Abstract: Radioactive therapeutic seeds include a carrier structure bearing a radioactive isotope and a radiopaque marker. According to several embodiments, the seeds include a central plug provided with an axial marker and a relatively transverse bore extending through the marker. A second marker may be positioned in the bore, thereby distinguishing a seed provided with the second marker relative to a seed not provided with the second marker. According to another embodiment, the isotope is deposited on the outer surface of a hollow radiolucent tube. A biologically-compatible, radiolucent, surface-sealing layer seals the external surface of the tube. A radiopaque marker wire of selected length is positioned in the hollow of the tube. Seeds may be distinguished from one another by providing seeds with marker wires of different lengths.

Abstract: Endoscopic bipolar scissor blades are formed in a laminate assembly of an electrically conductive electrode, an electrically insulating material, and a metal shearing surface which is electrically insulated and physically spaced from the electrode by the insulating material which is disposed therebetween. In one embodiment, the electrode is a metal blade, while the insulating material is a ceramic which is fixed to the metal blade, and the metal shearing surface which also provides the cutting edge is of a metal material which is fixed to the ceramic. In a second embodiment, the insulating material is a molded ceramic blade, with the electrode and the metal shearing surface layer metalized or otherwise fixed to the ceramic blade. In a third embodiment, the electrode is metalized on a thin layer insulating material which is fixed onto a metallic blade. In a fourth embodiment, metallic shearing and electrode layers are laminated to opposite sides of a fiberglass material.

Abstract: An implantable radiation therapy device includes a biocompatible radiotranslucent outer capsule containing a radiation shielding element and a radioactive isotope at least partially shielded by the shielding element. When the device is at or below body temperature, radiation is prevented or limited from being transmitted through the outer capsule by the shielding element. When non-ambient energy is applied to the device, the shielding element and radioactive isotope are reconfigured such that an increased level of radiation is transmitted through the outer capsule and emitted by the device.

Abstract: Radioactive therapeutic seeds include a carrier structure bearing a radioactive isotope and a radiopaque marker. According to several embodiments, the seeds include a central plug provided with an axial marker and a relatively transverse bore extending through the marker. A second marker may be positioned in the bore, thereby distinguishing a seed provided with the second marker relative to a seed not provided with the second marker. According to another embodiment, the isotope is deposited on the outer surface of a hollow radiolucent tube. A biologically-compatible, radiolucent, surface-sealing layer seals the external surface of the tube. A radiopaque marker wire of selected length is positioned in the hollow of the tube. Seeds may be distinguished from one another by providing seeds with marker wires of different lengths.

Abstract: A biological forceps device for the taking of tissue samples from a body, comprising a flexible main coil attached at its distal end to a pair of homologous cast jaws. The jaws have radially arranged teeth on their distalmost end. The jaws are opened and closed by attachment to a pair of pull wires which extend through the main coil, into a handle at its proximal end, the handle has a spool which slides about a central shaft attached to the main coil. The spool is attached to the pull wires, so that movement of the spool with respect to the central shaft, effectuates a force on the proximal ends of the levered jaws, to open and close them, appropriately.