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: The method of the invention is to automatically activate an electromagnetic treating device as it is moved through a blood vessel so that an even amount of energy is dispensed per unit length of the blood vessel. Within reasonable limits, the EM device may be moved either slowly or quickly and still dispense the same amount of energy per unit length of blood vessel. An apparatus for performing the method includes an automatic switching apparatus for use with an EM device whereby activation of the EM device is automatically controlled as the EM device is moved through a blood vessel.

Abstract: A stent delivery system includes an inner tubular member on which a stent is loaded, an outer jacket extending over said inner tubular member, the retraction of which causes deployment of the stent, and a handle adapted to move the jacket relative to the inner tubular member. The constructions of the inner tubular member and outer jacket and the handle provide increased control of the relative movement of the outer jacket relative to the inner tubular member, and prevention of premature release of the stent from the deployment instrument, and greater control over stent deployment via visual and auditory feedback at the proximal end of the instrument, among other advantages.

Abstract: Methods and apparatus for delivering a medical instrument over the exterior of an endoscope while the endoscope is installed in the patient's body allow the use of instruments which are too large to fit through the lumena of an endoscope. Furthermore, the invention allows the elimination of working lumena in an endoscope thereby minimizing the likelihood of contamination.

Abstract: An endoscopic or laparoscopic biopsy forceps instrument is provided which includes a flexible tubular member having proximal and distal ends, a biopsy jaw assembly at the distal end of the tubular member, an actuation assembly to operate the jaw assembly between open and closed positions, and a control assembly to deflect the biopsy jaw assembly relative to a lumen through which the instrument extends and to rotate the jaw assembly about the longitudinal axis of the instrument.

Abstract: An endoscopic or laparoscopic biopsy forceps instrument is provided which includes a flexible tubular member having proximal and distal ends, a biopsy jaw assembly at the distal end of the tubular member, an actuation assembly to operate the jaw assembly between open and closed positions, and a control assembly to deflect the biopsy jaw assembly relative to a lumen through which the instrument extends and to rotate the jaw assembly about the longitudinal axis of the instrument.

Abstract: Methods and apparatus for delivering a medical instrument over the exterior of an endoscope while the endoscope is installed in the patient's body allow the use of instruments which are too large to fit through the lumena of an endoscope. Furthermore, the invention allows the elimination of working lumena in an endoscope thereby minimizing the likelihood of contamination.

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: An endoscopic multiple sample bioptome includes a hollow outer member and an axially displaceable inner member extending therethrough. The proximal ends of the outer and inner members are coupled to an actuator for axially displacing one relative to the other. The distal end of the outer member is coupled to one of a cylinder having a sharp distal edge and a jaw assembly, while the distal end of the inner member is coupled to the other. The jaw assembly includes a pair of opposed, preferably toothed jaw cups each of which is coupled by a resilient arm to a base member. The arms are bent to lie in planes which intersect the axis of the base member and to locate the jaws apart from each other. The base member is mounted inside the cylinder and axial movement of the jaw assembly and cylinder relative to each other draws the arms into the cylinder and brings the jaw cups together in a biting action.

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: Methods and apparatus for delivering a medical instrument over the exterior of an endoscope while the endoscope is installed in the patient's body allow the use of instruments which are too large to fit through the lumena of an endoscope. Furthermore, the invention allows the elimination of working lumena in an endoscope thereby minimizing the likelihood of contamination.

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: 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: 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: 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: 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: 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: 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: 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: The methods and devices of the invention include an encoder, an endoscopic robotic instrument, and an encoder/robotic instrument interface. A preferred embodiment of the encoder has a chest/shoulder plate provided with telescoping tubes and joints. Each joint is provided with a direct drive potentiometer to monitor movement and provide a corresponding signal. The chest plate is preferably adaptable to a large range of human-chest sizes and the telescopic segments are strapped to the arms of the practitioner at the elbows. A pistol grip is provided at the wrist end of the telescopic segments. According to the presently preferred embodiment, the encoder encodes flexion and rotation at the shoulder, elbow and wrist of each arm in addition to gripping at each hand. The encoding device is coupled to a circuit which operates a servo system. The servo system includes a series of servo motors. A series of pulleys corresponding to the number of servo motors are arranged in a housing.