Abstract: Methods and devices are provided for deploying and applying multiple suture anchors. In one embodiment, a surgical device is provided having a shaft configured to be introduced into a body, e.g., through a scoping device, and to deliver a plurality of suture anchors into tissue, preferably without the need to remove the shaft from the body. The shaft can have a plurality of channels, with each of the plurality of channels configured to seat at least one of a plurality of suture anchors. Each of the anchors can be removably seated in a channel such that the anchors can be removed from the device, such as by pulling on sutures attached to the respective anchors.

Abstract: Methods and devices are provided for providing suction and/or irrigation to locations within a body cavity. In general, the methods and devices can allow instruments within a body cavity to be cleaned during a surgical procedure without having to remove the instruments from the body cavity. In one embodiment, an end effector is provided that includes an elongate body having a cleaning base formed thereon. The end effector can be configured as a modular element configured to be removably and replaceably attachable to a distal end of an elongate shaft. The cleaning base can have one or more ports formed through a surface thereof. The cleaning base can be configured to provide suction and/or irrigation through the one or more ports to clean a face of a surgical instrument seated in the cleaning base or in close proximity to the cleaning base.

Abstract: Devices and methods are provided for manipulating scoping devices, surgical tools, and/or tissue. An exemplary system for manipulating a scoping device can include a scoping device having a working channel, a tether extending through the working channel, and an internal coupling member attached to the tether and positioned adjacent to a distal end of the scoping device. The internal coupling member can be magnetically coupled to an external coupling member. An exemplary method for manipulating a scoping device can include inserting at least a portion of a scoping device into a body cavity and positioning an external coupling member proximate to an external surface of tissue such that the external coupling member magnetically couples through the tissue to an internal coupling member disposed within the body cavity and attached to a tether passed through at least one working channel of the scoping device.

Abstract: Methods and devices are provided for deploying and applying a suture anchor. In one embodiment, a surgical device is provided having a shaft configured to be introduced into a body and to deliver a suture anchor with a coil of suture attached thereto to tissue. The shaft can be configured to deploy the suture anchor through tissue and to deliver the coil of suture into a body cavity such that the suture extending from the coil extends through the tissue to allow the anchor to engage the tissue. The coil can remain in the body cavity for subsequent use.

Abstract: Methods and devices are provided for providing suction and/or irrigation to locations within a body cavity. In general, the methods and devices can allow instruments within a body cavity to be cleaned during a surgical procedure without having to remove the instruments from the body cavity. In one embodiment, an end effector is provided that includes an elongate body having a cleaning base formed thereon. The end effector can be configured as a modular element configured to be removably and replaceably attachable to a distal end of an elongate shaft. The cleaning base can have one or more ports formed through a surface thereof. The cleaning base can be configured to provide suction and/or irrigation through the one or more ports to clean a face of a surgical instrument seated in the cleaning base or in close proximity to the cleaning base.

Abstract: Suture anchoring devices are disclosed, including a T-tag anchoring device that is suitably small enough to fit into the hollow tip of a needle and, furthermore, provide protection to the suture against being cut or otherwise damaged by the sharp edge of the needle tip. One disclosed device includes a slot for providing a pivot point between the suture and the body when deployed, which can be employed to form a T-tag.

Abstract: A surgical instrument may comprise a shaft having proximal and distal ends defining an axis therebetween. The shaft may be flexible and sized for insertion into the working channel of a flexible endoscope. The shaft may be configured to be used in conjunction with various suture anchor applicators. One suture anchor applicator may have a first tube with a first channel and a tissue penetrating tip. The first channel may be adapted to retain a second tube. The second tube may have a second channel and a blunt tip. The second channel may be adapted to retain at least one suture anchor and may include an exit port adapted for ejecting suture anchors. An alternative suture anchor applicator may comprise a first tube and a second tube with a tissue penetrating tip. The second channel is adapted to retain at least one suture anchor.

Abstract: Various methods and devices are provided for penetrating tissue. In one embodiment, a tissue-penetrating device is provided and includes a flexible hollow elongate shaft having a tissue-penetrating tip at a distal end thereof, and a plunger disposed within the tissue-penetrating tip. The plunger can be movable relative to the tissue-penetrating tip between a distal position in which the plunger is distal of the tissue-penetrating tip to prevent tissue penetration, and a proximal position in which the plunger is proximal of the tissue-penetrating tip to allow the tip to penetrate tissue. The plunger can be adapted to move from the distal position to the proximal position when the plunger is advanced into a tissue surface. The device can also include a biasing element coupled to the plunger that can be adapted to bias the plunger to the distal position. The biasing element can be coupled between a distal end of a stylet that extends through the hollow elongate shaft, and a proximal end of the plunger.

Abstract: Various surgical devices, kits, and/or methods are provided herein that may be useful in performing a surgical procedure through a natural orifice. Such a surgical procedure may utilize one or more devices, kits, and/or methods to create an access port to a body cavity of a patient, to perform a specific surgical procedure, and to close the access port. In various embodiments, the specific surgical procedure may comprise a sleeve gastrectomy, a ventral hernia repair, a hybrid transgastric cholecystectomy, and/or a hybrid transgastric appendectomy.

Abstract: A self-shielding suture anchor is provided and includes a body having a proximal end and a distal end, the distal end including a penetrating tip. The suture anchor also includes a shielding element movable relative to the distal end between a shielding position, wherein the shielding element is distal to the penetrating tip, and a retracted position, wherein the shielding element is proximal to the penetrating tip. The suture anchor also includes a spring element operatively connected to the shielding element to bias the shielding element to the shielding position.

Abstract: A guide system for use with an endoscope, and a method of use is disclosed. The guide system can include a track, in the form of a rail, and a mating member for engaging the rail. The guide system can also include an accessory, such as an accessory guide tube through which a medical instrument can be carried external of the endoscope. An end cap can be provided to support the track relative to the distal end of the endoscope.

Abstract: A first medical instrument includes a flexible catheter and a medical guidewire extendable beyond a distal end of the catheter. The catheter is adapted to slidably receive a rail-coupling portion of an adjunct medical device. The medical guidewire has first and second segments, wherein the bending moment of inertia of the first segment is less than the bending moment of inertia of the second segment. A second medical instrument includes a flexible catheter, a mechanized guidewire assembly, and a medical guidewire extendable beyond a distal end of the catheter. The catheter is adapted to slidably receive a rail-coupling portion of an adjunct medical device. The medical guidewire has an exterior surface including a repetitive series of spaced-apart surface elevation features. One example of surface elevation features is external threads. The spaced-apart surface elevation features are adapted for operable engagement with the mechanized guidewire drive assembly.

Abstract: Devices and methods are provided for manipulating scoping devices, surgical tools, and/or tissue. An exemplary system for manipulating a scoping device can include a scoping device having a working channel, a tether extending through the working channel, and an internal coupling member attached to the tether and positioned adjacent to a distal end of the scoping device. The internal coupling member can be magnetically coupled to an external coupling member. An exemplary method for manipulating a scoping device can include inserting at least a portion of a scoping device into a body cavity and positioning an external coupling member proximate to an external surface of tissue such that the external coupling member magnetically couples through the tissue to an internal coupling member disposed within the body cavity and attached to a tether passed through at least one working channel of the scoping device.

Abstract: Methods and devices are provided for deploying and applying multiple suture anchors. In one embodiment, a surgical device is provided having a shaft configured to be introduced into a body, e.g., through a scoping device, and to deliver a plurality of suture anchors into tissue, preferably without the need to remove the shaft from the body. The shaft can have a plurality of channels, with each of the plurality of channels configured to seat at least one of a plurality of suture anchors. Each of the anchors can be removably seated in a channel such that the anchors can be removed from the device, such as by pulling on sutures attached to the respective anchors.

Abstract: Methods and devices are provided for deploying and applying a suture anchor. In one embodiment, a surgical device is provided having a shaft configured to be introduced into a body and to deliver a suture anchor with a coil of suture attached thereto to tissue. The shaft can be configured to deploy the suture anchor through tissue and to deliver the coil of suture into a body cavity such that the suture extending from the coil extends through the tissue to allow the anchor to engage the tissue. The coil can remain in the body cavity for subsequent use.

Abstract: A surgical instrument may comprise a shaft having proximal and distal ends defining an axis therebetween. The shaft may be flexible and sized for insertion into the working channel of a flexible endoscope. The shaft may be configured to be used in conjunction with various suture anchor applicators. One suture anchor applicator may have a first tube with a first channel and a tissue penetrating tip. The first channel may be adapted to retain a second tube. The second tube may have a second channel and a blunt tip. The second channel may be adapted to retain at least one suture anchor and may include an exit port adapted for ejecting suture anchors. An alternative suture anchor applicator may comprise a first tube and a second tube with a tissue penetrating tip. The second channel is adapted to retain at least one suture anchor.

Abstract: A guide system for use with an endoscope, and a method of use is disclosed. The guide system can include a track, in the form of a rail, and a mating member for engaging the rail. The guide system can also include an accessory, such as an accessory guide tube through which a medical instrument can be carried external of the endoscope. An end cap can be provided to support the track relative to the distal end of the endoscope.

Abstract: A guide system for use with an endoscope, and a method of use is disclosed. The guide system can include a track, in the form of a rail, and a mating member for engaging the rail. The guide system can also include an accessory, such as an accessory guide tube through which a medical instrument can be carried external of the endoscope. An end cap can be provided to support the track relative to the distal end of the endoscope.

Abstract: An endoscopic instrument having a lumen stabilizing feature, including a flexible shaft having a first distal end for insertion into the gastrointestinal tract of a patient, a plurality of arm housings disposed about the periphery of the distal end, a plurality of arms retained within the arm housings, wherein the arms may be extended from and retracted into the arm housings; and a finger connected to an arm, wherein the finger may be rotated with respect to a lateral axis of the arm. Lumen stabilizing accessories for flexible endoscopic instruments are also disclosed.

Abstract: Various methods and devices are provided for penetrating tissue. In one embodiment, a tissue-penetrating device is provided and includes a flexible hollow elongate shaft having a tissue-penetrating tip at a distal end thereof, and a plunger disposed within the tissue-penetrating tip. The plunger can be movable relative to the tissue-penetrating tip between a distal position in which the plunger is distal of the tissue-penetrating tip to prevent tissue penetration, and a proximal position in which the plunger is proximal of the tissue-penetrating tip to allow the tip to penetrate tissue. The plunger can be adapted to move from the distal position to the proximal position when the plunger is advanced into a tissue surface. The device can also include a biasing element coupled to the plunger that can be adapted to bias the plunger to the distal position. The biasing element can be coupled between a distal end of a stylet that extends through the hollow elongate shaft, and a proximal end of the plunger.