Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: An integrated surgical staple retainer for use in the full thickness resectioning device is described. The integrated surgical staple retainer comprises a calibrating portion, a retaining portion, and a grasping portion. The calibrating portion defines a circular opening which has a diameter substantially equal to a diameter of a working channel of the full thickness resectioning device. The retaining portion has a lower surface adapted to limit movement of the surgical staples in the fill thickness resectioning device and is adjacent to the calibrating portion of the integrated surgical staple retainer.

Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: A substrate, such as a catheter or a guide wire, or a portion of the substrate is provided with a lubricous, hydrophilic abrasion-resistant coating by: (a) coating the substrate with a first aqueous coating composition having an aqueous dispersion or emulsion of a polymer having organic acid functional groups and a polyfunctional crosslinking agent having functional groups capable of reacting with organic acid groups, and drying the coating to obtain a substantially water-insoluble coating layer having excess polyfunctional including functional groups being reactive with organic acid groups remaining; and (b) contacting the dried water-insoluble coating layer with a second aqueous coating composition having an aqueous solution or dispersion of a hydrophilic polymer having organic acid functional groups, a polymer having organic acid functional groups and a polyfunctional crosslinking agent having functional groups capable of reacting with organic acid groups, and drying the combined coating to form an interme

Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: A full-thickness resection system comprises a flexible endoscope and a stapling mechanism, wherein the endoscope is slidably received through at least a portion of the stapling mechanism. The stapling mechanism comprises an anvil and a stapling head mounted to the anvil so that the anvil and the stapling head are moveable with respect to one another between a tissue receiving position and a stapling position and wherein a gap formed between the stapling head and the anvil is larger in the tissue receiving position than it is in the stapling position. A position adjusting mechanism is provided for moving the anvil and the stapling head between the tissue receiving and stapling positions and a staple firing mechanism sequentially fires a plurality of staples from the stapling head across the gap against the anvil and through any tissue received in the gap and a knife cuts a portion of tissue received within the gap.

Abstract: An endoscopic instrument includes a small diameter hollow tube, an axially displaceable wire extending through the tube, a manual actuator coupled to the proximal ends of the tube and wire for axially displacing the wire relative to the tube, a first end effector mechanically coupled to the distal end of the tube and having a proximal portion which is provided with a curved guiding channel which receives and guides a distal portion of the wire, and a second end effector mechanically coupled to the distal end of the displaceable wire and rotatably coupled to the first end effector. When arranged as a bipolar instrument, the tube and pull wire are conductive, the pull wire is covered with an electrically insulating sheath except at its very distal end, the first end effector is conductive and partially insulated and is electrically coupled to distal end of tube, and the second end effector is conductive and partially insulated and electrically coupled to the distal end of the pull wire.

Abstract: A hollow lumen coil for a surgical instrument is made from a continuous helically wound filament which is wound with different preload tension at different portions of the coil. When a relatively high preload tension is applied to the filament as the coil is wound, the coil will be relatively stiff. When a relatively low preload tension is applied to the filament as the coil is wound, the coil will be relatively flexible. By varying the preload tension applied to the filament while winding the coil, the coil is provided with areas of different stiffness and flexibility. The preload tension may be varied gradually or abruptly and may be varied several times along the length of the coil. Surgical instruments incorporating the coil are also disclosed. The coil is preferably made from stainless steel Type 304 wire having a diameter of approximately 0.021 inches and is wound with tensions ranging from nil to several pounds.

Abstract: A low friction sheath for endoscopic instruments is made from an extrusion grade of high density polyethylene (HDPE). The sheath is formed as an extruded polyethylene tube having an inner diameter slightly smaller than the outer diameter of the instrument it will cover. In order to place the sheath over the instrument, a containment sleeve is placed over the sheath and a source of pressurized gas is coupled to one end of the sheath. The endoscopic instrument tube is sealed and inserted into the other end of the sheath. The polyethylene sheath is filled with gas so that it expands against the containment sleeve and the endoscopic instrument tube is pushed into the expanded polyethylene sheath. The gas is released from the polyethylene sheath and it contracts against the outer surface of the endoscopic instrument tube. The sheath is preferably made from a HDPE having a microfractured surface with 10-20 micron fractures.

Abstract: An endoscopic instrument has a distal assembly removable from a proximal handle. The distal assembly includes a tube carrying an end effector and a push rod coupled to the end effector and slidable through the tube. The proximal handle includes a tube sleeve for receiving the tube, an actuator and a latch for coupling the push rod to the actuator. The tube sleeve is provided with a tube lock for holding the tube securely in place and the tube is provided with a circumferential groove for engaging the lock. The latch is spring loaded, hinged, and has an inclined surface for quick coupling with the push rod. The latch also has a mechanism for uncoupling the latch from the push rod. The push rod is provided with a mating tip which engages the latch so that the actuator causes reciprocal movement of the push rod within the tube to operate the end effector. An axially movable collar on the tube sleeve is used in unlatching, and in one arrangement is also used for rotating the distal assembly.

Abstract: An apparatus for counting the number of times a temperature cycle occurs includes an indicator having sequential indicia and a temperature responsive member for indicating a next one of the indicia. Mechanical, fluid mechanical and electronic versions of the invention are disclosed. In the mechanical version, the indicator can be a ratchet member having teeth, a pawl and a display surface containing indicia. A temperature responsive element such as a bimetallic member engages the teeth of the ratchet and advances the ratchet each time the apparatus is subjected to a preset temperature cycle. A housing with a window masks the display to indicate one of the indicia as advanced by the temperature responsive element. Preferred embodiments of the mechanical version include a ring-like ratchet member with interior teeth and an exterior display surface.

Abstract: An apparatus for counting the number of times a medical instrument has been sterilized includes an indicator having sequential indicia and a heat responsive member for indicating a next one of the indicia. Mechanical, fluid mechanical and electronic versions of the invention are disclosed. In the mechanical version, the indicator can be a ratchet member having teeth, a pawl and a display surface containing indicia. A heat responsive element such as a bimetallic member engages the teeth of the ratchet and advances the ratchet each time the apparatus is subjected to the heat of sterilization. A housing with a window masks the display to indicate one of the indicia as advanced by the heat responsive element. Preferred embodiments of the mechanical version include a ring-like ratchet member with interior teeth and an exterior display surface. The number of teeth is preferably one or more less than the number of indicia so that upon advancing the ratchet member to the last indicia, it can be advanced no further.

Abstract: An improved use counter for endoscopic instruments is mounted in the ferrule of the distal portion of an endoscopic instrument having separable proximal and distal portions. The counter includes a ratchet wheel having inner and outer teeth and a bimetallic coil having a fixed end and a free end. The fixed end of the bimetallic coil is attached to a hub portion of the ferrule and the free end of the bimetallic coil engages the inner teeth of the ratchet wheel. An inwardly extending tooth in the ferrule engages the outer teeth of the ratchet wheel to prevent backward movement of the ratchet wheel. The outer surface of the ratchet wheel is also provided with incremental indicia viewable through a window in the ferrule. As the bimetallic coil is heated and cooled when the instrument is sterilized, the free end of the coil engages and advances one tooth of the ratchet wheel. Movement of the free end is preferably limited by stops.