Abstract: A deployment system includes a sheath, a torque able shaft having a handle positioned at its proximal end, a detachable helical first suture anchor positioned at the shafts distal end and an elongate suture fixedly coupled to the suture anchor. The deployment system can be positioned at a first tissue, and the shaft rotated to advance the helical first suture anchor into engagement with the first tissue. The shaft is detached from the first suture anchor thereby deploying it at the first tissue location. Then, the deployment system is removed from the patient, and a second suture anchor is coupled to the distal end of the shaft. The deployment system is re-inserted into the patient and the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second suture anchor at the second tissue location.

Abstract: An anchor and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The anchor assembly includes an anchor tip and an anchor body. The anchor tip has a blunt end that may be rounded or beaded, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The anchor body has first and second ends, tip tabs, retainers for removably retaining the anchor body relative to the needle holder arm, and a suture opening. The anchor tip is fixed relative to the anchor body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the anchor body and is fixed therein.

Abstract: A deployment system includes a sheath, a torque able shaft having a handle positioned at its proximal end, a detachable helical first suture anchor positioned at the shafts distal end and an elongate suture fixedly coupled to the suture anchor. The deployment system can be positioned at a first tissue, and the shaft rotated to advance the helical first suture anchor into engagement with the first tissue. The shaft is detached from the first suture anchor thereby deploying it at the first tissue location. Then, the deployment system is removed from the patient, and a second suture anchor is coupled to the distal end of the shaft. The deployment system is re-inserted into the patient and the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second suture anchor at the second tissue location.

Abstract: Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.

Abstract: An anchor and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The anchor assembly includes an anchor tip and an anchor body. The anchor tip has a blunt end that may be rounded or beaded, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The anchor body has first and second ends, tip tabs, retainers for removably retaining the anchor body relative to the needle holder arm, and a suture opening. The anchor tip is fixed relative to the anchor body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the anchor body and is fixed therein.

Abstract: A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

Abstract: A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end. The needle body is tubular and has first and second ends and flexible tab retainers adjacent the second end for retaining the needle body relative to the needle holder arm. The tab retainers elastically deform to allow the needle body to be released from the needle holder arm upon application of force therebetween. The needle body has a suture opening located between the first end and the retainers. A suture extends into the suture opening of the needle body and is fixed therein.

Abstract: A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

Abstract: Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A needle and suture assembly is provided for use with an endoscopic suturing device with a needle holder arm. The needle assembly includes a needle tip and a needle body. The needle tip has a sharp end, a capture groove, a tab groove and a plug portion positioned between the capture groove and the tab groove. The needle body has first and second ends, tip tabs, retainers for removably retaining the needle body relative to the needle holder arm, and a suture opening. The needle tip is fixed relative to the needle body by plastic deformation of the tip tabs into the tab groove. A suture extends into the suture opening of the needle body and is fixed therein.

Abstract: An endoscopic tissue grasper device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, and a distal helical coil having a sharpened end for engaging tissue. The tissue grasper is advanced through a working channel of an endoscope, engaged relative to tissue, and retracted to pull tissue into a path of a movable needle coupled at a distal end of the endoscope so that the needle can be passed through the tissue. The needle is preferably provided with a suture so that as the needle is passed through the tissue a stitch is formed.

Abstract: A system includes a first tube, a sharp coil at a distal end of the first tube, a second tube displaceable within the first tube, and a sharp housing at a distal of the second tube for storing fasteners. The housing can be positioned at a first tissue, and the coil rotated to advance the coil into engagement with the first tissue. The first tube is retracted to retract the first tissue, and then a first fastener is deployed at the first tissue location. Then, without removing the system from the patient, the distal end of the system is moved adjacent a second tissue location, and the process is repeated for a second fastener at the second tissue location. A suture extends between the first and second fasteners, and tension is applied to the suture to draw the first and second tissues toward each other to reconfigure the tissue.

Abstract: A deployment system includes a sheath, a shaft having a handle positioned at its proximal end, a micro motor having a motor shaft at the shafts distal end, a detachable helical first suture anchor positioned at the motor shafts distal end and an elongate suture fixedly coupled to the suture anchor. The deployment system can be positioned at a first tissue, and the motor shaft rotated to advance the helical first suture anchor into engagement with the first tissue. The motor shaft is detached from the first suture anchor thereby deploying it at the first tissue location. The deployment system can be reloaded with multiple suture anchors to deploy at multiple tissue locations. The suture extending between the anchors can then be drawn together to reconfigure the coupled tissue.

Abstract: A cinch deployment system includes a delivery system and a releasable cinch including an inner tubular, a compressible gripper having a suture passage, the gripper positioned within the inner tubular housing, and a resilient structure biased to compress the gripper to reduce the size of the suture passage. The resilient structure has a first configuration in which the resilient structure is constrained from applying sufficient compression to the gripper to prevent movement of the gripper on the suture, and a second configuration in which sufficient compression is applied to secure the gripper on the suture. The resilient structure is moved from the first to the second configuration by movement of the retainer moved by the deployment system.

Abstract: An endoscopic tissue grasper device includes a flexible tubular member, a flexible shaft extending through the tubular member, a proximal handle for moving the shaft and tubular member relative to each other, and a distal helical coil having a sharpened end for engaging tissue. The tissue grasper is advanced through a working channel of an endoscope, engaged relative to tissue, and retracted to pull tissue into a path of a movable needle coupled at a distal end of the endoscope so that the needle can be passed through the tissue. The needle is preferably provided with a suture so that as the needle is passed through the tissue a stitch is formed.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

Abstract: A suture needle system includes a first needle and at least one second needle. Each of the first and second needles preferably has a common needle body construct. The first needle includes an elongate suture having a length sufficient to extend at least the length of an instrument channel of an endoscope. The second needle includes an opening formed by a loop of suture at which the second needle can be advanced over the elongate suture. In use, the first needle is secured to a first tissue location using an endoscopic suturing system. A second needle is advanced at its opening over the elongate suture and secured to a second tissue location. Additional second needles may be advanced over the elongate suture to respective tissue locations. The elongate suture is pulled taut, drawing the second needles into proximity, and secured.

Abstract: A gastric implant includes a distal sleeve portion configured to be disposed in a duodenum of a patient, and a pyloric restriction portion connected to a proximal end of the distal sleeve portion. The pyloric restriction portion is configured to be disposed in a pylorus of a patient. Also, the implant includes a proximal anchor portion connected to a proximal end of the pyloric restriction portion. The proximal anchor portion is configured to be disposed in a lower stomach of the patient. The proximal anchor portion has at least one eyelet for fastening to the stomach to secure the implant to the gastrointestinal tract.