Abstract: Method and apparatus for limiting absorption of food products in specific parts of the digestive system is presented. A gastrointestinal implant device is anchored in the stomach and extends beyond the ligament of Treitz. All food exiting the stomach is funneled through the device. The gastrointestinal device includes an anchor for anchoring the device to the stomach and a flexible sleeve to limit absorption of nutrients in the duodenum. The anchor is collapsible for endoscopic delivery and removal.

Abstract: Method and apparatus for limiting absorption of food products in specific parts of the digestive system is presented. A gastrointestinal implant device is anchored in the stomach and extends beyond the ligament of Treitz. All food exiting the stomach is funneled through the device. The gastrointestinal device includes an anchor for anchoring the device to the stomach and a flexible sleeve to limit absorption of nutrients in the duodenum. The anchor is collapsible for endoscopic delivery and removal.

Abstract: A cooled electrosurgical system includes an electrosurgical device having at least one electrode for applying electrical energy to tissue. In one embodiment, the electrode includes an internal cavity in which a cooling medium such as water is contained. The internal cavity is closed at both ends of the device such that the cooling medium is contained within the electrode at the surgical site such that the cooling medium does not contact the tissue being treated. The electrosurgical device has an electrode and a heat pipe to conduct heat from the electrodes where substantially all heat conducted from the electrode through the heat pipe is dissipated along the length of the heat pipe. The heat pipe can have a thermal time constant less than 60 seconds and preferably less than 30 seconds.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

Abstract: An elongated tube is configured to carry digestive enzymes from the point at which they enter the duodenum, and deposit them downstream into a distal portion of the intestine, such as the distal jejunum, several feet down. This delays the breakdown and subsequent digestion of food. The proximal end of the tube can be secured to the hepatopancreatic ampulla, below the common bile duct using an anchor, such as a stent-like device. The tube can include an elongated flexible sleeve coupled at its proximal end to an anchor. The anchor is attached to the hepatopancreatic ampulla and the sleeve is then draped distally, through the intestines. Natural peristalsis carries the enzymes through the tube distally. The enzymes then exit the tube and mix with the chyme further down stream than is normal.

Abstract: A restrictive device implanted in the upper part of the stomach, selectively divides the stomach into two chambers, effectively reducing the size of the stomach immediately available for the uptake of food. The restrictive device also includes an aperture, limiting the rate at which food can pass from the esophagus portion of the stomach into the intestine. Being removable, the device permits a physician to change the size of the opening in a minimally invasive manner by replacing a removable member with another member having an aperture of a different size and/or shape. The restrictive device can also be combined with an elongated tube, or sleeve to selectively bypass the stomach, a portion of the intestine, or a combination of bypassing both the stomach and a portion of the intestine, allowing a physician to endoscopically create an equivalent to the Roux-en-y weight loss procedure.

Abstract: A cooled electrosurgical system includes an electrosurgical device having at least one electrode for applying electrical energy to tissue. In one embodiment, the electrode includes an internal cavity in which a cooling medium such as water is contained. The internal cavity is closed at both ends of the device such that the cooling medium is contained within the electrode at the surgical site such that the cooling medium does not contact the tissue being treated. The electrosurgical device has an electrode and a heat pipe to conduct heat from the electrodes where substantially all heat conducted from the electrode through the heat pipe is dissipated along the length of the heat pipe. The heat pipe can have a thermal time constant less than 60 seconds and preferably less than 30 seconds.

Abstract: A cooled electrosurgical system includes an electrosurgical device having at least one electrode for applying electrical energy to tissue. In one embodiment, the electrode includes an internal cavity in which a cooling medium such as water is contained. The internal cavity is closed at both ends of the device such that the cooling medium is contained within the electrode at the surgical site such that the cooling medium does not contact the tissue being treated. The electrosurgical device has an electrode and a heat pipe to conduct heat from the electrodes where substantially all heat conducted from the electrode through the heat pipe is dissipated along the length of the heat pipe. The heat pipe can have a thermal time constant less than 60 seconds and preferably less than 30 seconds.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

Abstract: The present invention relates to a clip feeder arrangement for supportive receipt in a handle of a medical clip stapling gun, for the advancement of a plurality of clips seriatim by a trigger mechanism in the handle to a location between a pair of pincher jaws. A distalmost clip of the plurality of clips is advanced to the jaws prior to advancement of the remaining plurality of clips. The feeder arrangement comprises a U-shaped cartridge having a proximal end and a distal end, the cartridge containing the plurality of clips, a frame for supporting the cartridge and an elongated, cyclically movable feeder bar or pusher mechanism arranged beneath and enagable with the cartridge, for first advancing the distalmost clip in the cartridge to a location between the jaws and then subsequently advancing the remaining plurality of clips distally by a ladder pushed thereadjacent, both of the advancement motions occurring in a single distal advance of the feeder bar mechanism.

Abstract: A cooled electrosurgical system includes an electrosurgical device having at least one electrode for applying electrical energy to tissue. In one embodiment, the electrode includes an internal cavity in which a cooling medium such as water is contained. The internal cavity is closed at the distal end of the device such that the cooling medium is contained within the electrode at the surgical site such that the cooling medium does not contact the tissue being treated.

Abstract: A cooled electrosurgical system includes an electrosurgical device having at least one electrode for applying electrical energy to tissue. In one embodiment, the electrode includes an internal cavity in which a cooling medium such as water is contained. The internal cavity is closed at the distal end of the device such that the cooling medium is contained within the electrode at the surgical site such that the cooling medium does not contact the tissue being treated.

Abstract: A reusable endoscopic surgical instrument includes a tool assembly and a detachable handle. The tool assembly consists of an outer sleeve to which a surgical jaw assembly such as scissors or graspers is mounted. An inner extension is mounted inside the sleeve and is longitudinally translatable with respect to the sleeve. When the distal end of the extension is in engagement with the jaws of the jaw assembly, translation of the extension causes the jaws to open and close. The extension can be translated out of engagement with the jaws to permit disassembly of the instrument for cleaning and changing jaw assemblies. The tool assembly is retained within the handle assembly. The sleeve is retained within the handle in a longitudinally stationary position with respect to the handle, while the extension is permitted to move longitudinally within the sleeve.

Abstract: An expanding polygonal surgical compressor has a first planar frame with at least three articulated frame members extendable from a compressed configuration to an extended configuration forming a polygon. A second planar frame has frame members corresponding to the frame members of the first frame. The first and second frames are pivoted relative to each other for movement from an open to a closed or tissue compressing position.

Abstract: A suture needle grasping and manipulating instrument includes first and second pivotally-connected arms each having a proximal end and a distal end, and first and second jaw assemblies or units pivotally mounted on the distal ends of the first and second arms respectively, said arms being disposed so as to permit relative pivotal movement thereof between a first closed jaw position wherein the jaw assemblies or units are adjacent one another and a second open position wherein the jaw assemblies or units are spaced from one another far enough to permit a needle to be inserted therebetween. The device further includes first selectively-operable means for causing said relative pivotal movement of said arms and second selectively-operable means for pivoting said jaw assemblies or jaw units relative to said arms.

Abstract: A universal port/seal device is provided for ocular surgery, notably for cataract surgery. The device is inserted into an ocular incision and is adapted to serve as (1) a port for inserting, manipulating and withdrawing a surgical instrument, e.g., the tip of a phacoemulsification handpiece, so as to protect the surrounding tissue from mechanical and thermal injury, and (2) a seal to prevent leakage of fluid from the eye. The device comprises (1) a housing having an internal passageway that permits it to function as a cannula or port for a surgical instrument, (2) at least two jaws that are movable toward and away from one another and are shaped so as to (a) serve as a seal to prevent leakage from a surgical eye incision and (b) accommodate a surgical instrument or tool that is inserted between them via the housing's internal passageway, and (3) sealing member for preventing leakage of fluid via the housing's internal passageway while allowing relative movement of an inserted surgical device.

Abstract: A reusable endoscopic surgical instrument includes a tool assembly and a detachable handle. The tool assembly consists of an outer sleeve to which a surgical jaw assembly such as scissors or graspers is mounted. An inner extension is mounted inside the sleeve and is longitudinally translatable with respect to the sleeve. When the distal end of the extension is in engagement with the jaws of the jaw assembly, translation of the extension causes the jaws to open and close. The extension can be translated out of engagement with the jaws to permit disassembly of the instrument for cleaning and changing jaw assemblies. The tool assembly is retained within the handle assembly. The sleeve is retained within the handle in a longitudinally stationary position with respect to the handle, while the extension is permitted to move longitudinally within the sleeve.

Abstract: A cooled electrosurgical system includes an electrosurgical device having at least one electrode for applying electrical energy to tissue. In one embodiment, the electrode includes an internal cavity in which a cooling medium such as water is contained. The internal cavity is closed at the distal end of the device such that the cooling medium is contained within the electrode at the surgical site such that the cooling medium does not contact the tissue being treated.

Abstract: A suturing instrument for suturing tissue comprises an elongated housing having opposite ends. A curved suturing needle having a pointed end and to which a suture is attached is supported at one end of the housing for rotational motion about an axis. A driver mechanism in the housing rotates said needle about said axis through successive revolutions. There may also be a suture tensioner in the housing which applies tension to the suture to draw the suture toward the other end of said housing following each revolution of said needle. In its operation, the instrument thus emulates the actions of a surgeon suturing manually.

Abstract: A reusable endoscopic surgical instrument includes a tool assembly and a detachable handle. The tool assembly consists of an outer sleeve to which a surgical jaw assembly such as scissors or graspers is mounted. An inner extension is mounted inside the sleeve and is longitudinally translatable with respect to the sleeve. When the distal end of the extension is in engagement with the jaws of the jaw assembly, translation of the extension causes the jaws to open and close. The extension can be translated out of engagement with the jaws to permit disassembly of the instrument for cleaning and changing jaw assemblies. The tool assembly is retained within the handle assembly. The sleeve is retained within the handle in a longitudinally stationary position with respect to the handle, while the extension is permitted to move longitudinally within the sleeve.