Abstract: A surgical device is disclosed along with methods of using the same. The surgical device may comprise an outer sheath and a collar assembly. The collar assembly may be coupled to the outer sheath and may comprise a first arm coupled to the outer sheath at a first hinge; a second arm coupled to the first arm at a second hinge; and a collar coupled to the second arm. The collar assembly may be movable from an un-deployed position where the first arm and the second arm extend the collar distally from the outer sheath to a deployed position where the collar is aligned with the first channel of the outer sheath. Also, the first arm, the second arm, and the collar may be positioned substantially within a cross-sectional area of a distal end of the outer sheath when the collar assembly is in the un-deployed position.

Abstract: Various embodiments are directed to a surgical device comprising an end effector. The end effector may comprise a first jaw member defining a first groove and a second jaw member defining a second groove. The first jaw member and the second jaw member may be selectively pivotable between an open position and a closed position. Also, the first groove and the second groove align to form a combined helical groove when the first jaw member and the second jaw member are in the closed position. In addition, the first jaw member may define a wire opening aligned with the first groove.

Abstract: A surgical device for use with an endoscope. The device includes an end cap removably affixable to a distal end of the endoscope such that at least a portion of the end cap distally extends beyond the distal end of the endoscope. The end cap defines a through bore for receiving the distal end of the endoscope, and the end cap includes an outer surface defining first and second tracks substantially perpendicular to a longitudinal axis of the through bore. The device further includes a first working channel having a distal end disposed in the first track and movable along a length of the first track between a first position and a second position. The device further includes a second working channel having a distal end disposed in the second track and movable along a length of the second track between a first position and a second position.

Abstract: A suture anchoring device includes a fastener body composed of a tube and a spool is mounted within the tube for rotation relative to the tube. Suture material is wrapped about the spool such that pulling of the suture material causes rotation of the spool within the tube. A one-way locking mechanism allows the spool to rotate freely in a first direction and prevents rotation in an opposite direction. A method for creating a tissue fold includes deploying a first suture anchoring device within the tissue with suture material extending proximally from the first suture anchoring device, deploying a second suture anchoring device within the tissue with a distal portion of the suture material extending between the first suture anchoring device and a proximal portion of the suture material extending proximally from the second suture anchoring device, and applying tension to the suture material to draw portions of the tissue together to form a tissue fold.

Abstract: A rolling instrument for rolling the outside surface of the stomach for reducing stomach volume in bariatric surgery includes an elongated tubular body that is sufficiently flexible to allow for access to the outside surface. The tubular body includes a proximal end and a distal end. The proximal end is shaped and dimensioned for use by the medical practitioner performing the medical procedure and includes a handle for manipulation of the rolling instrument. The distal end of the tubular body includes a mechanism allowing for gripping of the stomach in a manner permitting rolling thereof. A coiled retainer shaped and dimensioned is provided for application to the rolled portion of the stomach in a manner holding the rolled portion of the stomach in its rolled configuration. The coiled retainer includes a helically coiled body having a first end and a second end, the first end is pointed such that it may puncture tissue as the coiled body is rotated during its application to the stomach.

Abstract: Devices and methods are provided for penetrating tissue and/or effecting movement of devices relative to tissue. In general, a surgical instrument is provided having an at least partially fabric-covered distal tip that be used to at least partially penetrate tissue by contacting the tissue with the fabric and rotating the fabric to “drill” into the tissue. The surgical instrument can be configured for delivery proximate to tissue through a working channel of a delivery device and can include an elongate shaft having in its distal portion an end effector at least partially covered in fabric. The fabric, the end effector, and/or the shaft can rotate, thereby allowing at least the fabric to penetrate the tissue and, if sufficiently rotated, causing an opening to form in the tissue. The surgical instrument and/or the delivery device can be advanced through the opening.

Abstract: A surgical kit can be used to manipulate tissue within the body of a patient to create a working space within the body to allow a surgeon to easily access and work within the body using various surgical instruments. A surgical kit can include an implant comprised of a magnetic material which can be engaged with tissue within the body. The kit can further include a surgical instrument having a magnet which can be used to manipulate the implant and tissue engaged therewith. A surgical kit can include an anchor and a hanger configured to engage tissue at different locations within the body and a connection member engaged with the anchor and the hanger such that the connection member can be pulled to move the anchor toward the hanger. A surgical instrument which utilizes a vacuum provided to one or more movable members can also be used to manipulate tissue.

Abstract: Various embodiments of an elongate surgical device configured to travel along a tortuous body lumen to a surgical site are provided herein. In one embodiment, the device can include a tensioning element extending through a channel formed along a length of the device and the tensioning element can translate an articulation force to the working end of the device. During such articulation of the device, a portion of the channel can be configured to allow the tensioning element to exit the channel and move away from a longitudinal axis of the device thereby optimizing a mechanical advantage relative to the distal end of the device and thus maximizing the force capable of being delivered thereto. Additionally, various embodiments of a method for articulating a working end of an elongate surgical device are provided herein.

Abstract: A surgical instrument guide configured to be at least partially inserted into a natural orifice of a patient to allow a surgeon to access a tissue treatment region with multiple surgical instruments during the course of a minimally invasive surgical procedure. In various embodiments, the surgical instruments can be inserted at various angles with respect to the tissue treatment region to provide the surgeon with better access to the surgical site during an operation. In at least one embodiment, the surgical instrument guide may include a body portion having a first port and a second port defined therein. In such embodiments, the first and second ports may each be configured to receive a surgical instrument therethrough. Additionally, in various embodiments, at least one of the first and second ports can be configured to allow for pivotal movement of the surgical instrument within the body of the surgical instrument guide.

Abstract: A surgical instrument for being endoscopically or laparoscopically inserted into a surgical site for simultaneous stapling and severing of tissue includes force adjusted spacing between an upper jaw (anvil) and a lower jaw (staple cartridge engaged to an elongate staple channel) so that the height of staple formation corresponds to the thickness of the tissue, yet does not exceed the height range that may be accommodated by the length of the staples. In particular, resilient structures may be formed into one or more of the elongate channel that supports the staple cartridge, the anvil that is pivotally attached to the elongate channel, and/or a firing member that includes a cutting surface (knife) that severs tissue between a top pin that engages the anvil and a lower foot that engage the elongate channel. The resilience responds to the force exerted by clamped tissue to vary the spacing between the anvil and the staple cartridge supported within the elongate channel.

Abstract: Control devices and methods are provided for controlling tension applied to a tensioning element extending through a flexible shaft, such as on an endoscopic device. In one exemplary embodiment, the methods and devices are configured to allow free movement and optionally provide slack to a control mechanism on an endoscopic device during insertion to allow free flexion of the shaft of the device, and to tension the control mechanism when desired to actuate, articulate, or otherwise control the working end or other portion of the device disposed within a patient's body.

Abstract: Various exemplary methods and devices are provided for manipulating and/or anchoring devices and body parts during surgical procedures. In one embodiment, an anchor member is provided for anchoring a device or body part to tissue, such as an internal wall of a body cavity. The device can be, for example, an endoscopic device, an accessory channel coupled to an endoscopic device, or a support member adapted to support or manipulate an organ. The anchor member can include or form an opening through which the device can be inserted. The anchor member or device can thus be manipulated relative to the tissue to control movement of and/or provide support to the device, tools inserted through the device, and/or organs grasped by the device or tools.

Abstract: A suture anchor is provided which includes a hollow member having an outer surface defining an enclosure therein, the member having a longitudinal axis and a slot through a portion of the outer surface in a direction transverse to the longitudinal axis, the slot providing an opening into the enclosure. The suture anchor further includes a one-way valve positioned within the enclosure at the slot to allow entry of a suture through the slot into the enclosure and to prevent the exit of the suture from the enclosure. A device is provided for deploying the suture anchor. The deployment device includes an elongate hollow member having a suture anchor release zone positioned at the distal end thereof, a launch bar having at least a portion thereof positioned in the release zone, wherein the launch bar is movable within the release zone between a resting position and a launching position and is operatively connected to an actuation member positioned proximally to the elongate member.

Abstract: Devices and methods useful for manipulating tools at a surgical site are disclosed. In one exemplary embodiment, an accessory device is provided and can include an insertion member and a control wire. The insertion member can have a lumen for receiving a tool therethrough, such as an endoscope. The control wire can be coupled to the insertion member and have a distal portion extending distally from the insertion member and be adapted to receive and to manipulate a tool extending through the insertion member. The control wire can have a wide variety of configurations, and in certain exemplary embodiments the control wire can be slidably received in one or more control wire lumens formed through the insertion member. In use, the control wire can be manipulated, for example by axially sliding the control wire in one or more control wire lumens to control a tool.

Abstract: Devices and methods useful for delivering tools and/or materials to a surgical site are disclosed. In one embodiment, an accessory device for an endoscope is provided and can include an elongate sheath and an accessory channel. The elongate sheath can be adapted to receive an endoscope therein, and it can include a mating element extending longitudinally between proximal and distal ends thereof. The accessory channel can be adapted to receive a tool therethrough and it can also have a mating element extending between proximal and distal ends thereof and adapted to slidably mate to the mating element formed on the elongate sheath. In certain exemplary embodiments, a distal portion of the accessory channel can be adapted to derail from at least a distal portion of the elongate sheath while a proximal portion of the accessory channel remains mated to a proximal portion of the elongate sheath.

Abstract: A guidewire structure includes a medical guidewire and an overtube. The medical guidewire includes a first segment and a lengthwise-adjoining second segment. The overtube is adapted to slidably cover the first segment and to slidably expose the first segment. A minimum force required to slide the exposed first segment over patient tissue is greater than a minimum force required to slide the covered first segment over the patient tissue. A method for using a guidewire structure includes extending at least a portion of the second segment beyond a distal end of an insertion tube of an endoscope, extending at least a portion of the first segment beyond the distal end with the overtube covering the extended first segment, sliding the overtube off the extended first segment exposing the first segment, and advancing the insertion tube along the exposed and extended first segment further into a body lumen of a patient.

Abstract: A braided device for use with an endoscope having a selectively lockable braided flexible tube. The braided device may have cables disposed along side the braided flexible tube and capable, upon their retraction, of bending the braided device at a region along its length and holding it at a desired orientation. The braided device has a handle for controlling the steering and the locking of the flexible braided tube. A braided hollow member may be attached to an endoscope for providing space for the endoscope while it operates in an internal cavity or for holding tissue samples.

Abstract: Several medical drive systems each include a drive system assembly adapted to engage and move at least a portion of a medical apparatus. The medical drive system assemblies each are variously described in expressions such as an assembly adapted to engagingly slide onto a catheter, an assembly adapted to surroundingly attach to a catheter, an assembly adapted to engagingly slide onto a working channel entrance of an endoscope wherein the medical apparatus is insertable into the working channel entrance, an assembly including a spur gear and a nut gear wherein the nut gear includes external teeth engaged by the spur gear, an assembly insertable into a working channel of a flexible insertion tube of an endoscope, and/or an assembly including a drive shaft and a nut gear fixedly attached thereto wherein the drive shaft has at least a hollow portion and the medical apparatus is positionable in the hollow portion.