Abstract: The present invention relates to methodology of and apparatus for accurately positioning devices for performing endoscopic cannulation, papillotomy and sphincterotomy and similar procedures. The sphincterotome with a steerable or adjustable distal segment of the present invention allows the physician to control the position of the distal tip of the device independently of the endoscope and adjust for inconsistencies in the device and the anatomy. According to one embodiment of the present invention, a threaded portion of a cable assembly cooperates with a torque transmission element and a cog to enable the operator to rotate a cutting wire into a desired position relative to the catheter. Alternate embodiments allow the operator to fix the depth of a needle knife while allowing, if desired, accurate rotational positioning of the associated catheter. Threaded stabilizing elements, pivot elements and a steering wire may be used together or individually to accomplish these features.

Abstract: Endoscopic devices and methods used for fastening multiple tissue layers, such as, for example, an endoscopic fundoplication procedure, are disclosed. The device may include, for example, an elongated tubular member having a proximal end for extending outside of the body and a distal end for positioning proximate the multiple tissue layers, a grasper configured for positioning proximate the distal end of the tubular member and for grasping at least one of the multiple tissue layers, a device coupled to the distal end of the tubular member for folding the multiple tissue layers together, a tissue fastener configured to be inserted into the tissue layers to hold the tissue layers together, and a fastener head for inserting the tissue fastener into the tissue layers.

Abstract: The present invention relates to methodology of and apparatus for accurately positioning devices for performing endoscopic cannulation, papillotomy and sphincterotomy and similar procedures. The sphincterotome with a steerable or adjustable distal segment of the present invention allows the physician to control the position of the distal tip of the device independently of the endoscope and adjust for inconsistencies in the device and the anatomy. According to one embodiment of the present invention, a threaded portion of a cable assembly cooperates with a torque transmission element and a cog to enable the operator to rotate a cutting wire into a desired position relative to the catheter. Alternate embodiments allow the operator to fix the depth of a needle knife while allowing, if desired, accurate rotational positioning of the associated catheter. Threaded stabilizing elements, pivot elements and a steering wire may be used together or individually to accomplish these features.

Abstract: Various embodiments of a medical device having a deflecting shaft and related methods of manufacture and use are disclosed. For example, the device may include a proximal handle, a distal assembly for performing a medical procedure and a wire-coil connecting the proximal handle to the distal assembly, wherein actuation of the proximal handle may cause the distal assembly to perform the medical procedure. The wire coil may have a proximal portion comprised of a first wire and a distal portion comprised of a second wire. The second wire may have a diameter less than a diameter of the first wire so that the distal portion of the wire coil may have a flexibility greater than a flexibility of the proximal portion.

Abstract: Endoscopic devices and methods used for fastening multiple tissue layers, such as, for example, an endoscopic fundoplication procedure, are disclosed. The device may include, for example, an elongated tubular member having a proximal end for extending outside of the body and a distal end for positioning proximate the multiple tissue layers, a grasper configured for positioning proximate the distal end of the tubular member and for grasping at least one of the multiple tissue layers, a device coupled to the distal end of the tubular member for folding the multiple tissue layers together, a tissue fastener configured to be inserted into the tissue layers to hold the tissue layers together, and a fastener head for inserting the tissue fastener into the tissue layers.

Abstract: An apparatus for deployment of multiple hemostatic clips, comprises a shaft connected to a handle and a control linkage operatively connected to the handle in combination with a magazine disposed at a distal end of the shaft, the magazine containing a plurality of clips arranged in a chain rotatable within the magazine, wherein a proximal-most one of the clips is coupled to the control linkage, a distal portion of the magazine being contoured to permit opening of a distal-most one of the clips during a distal stroke of the control linkage, and to assist closing and locking of the distal-most clip during a proximal stroke of the control linkage, the magazine including an expanded chamber sized to allow opening in any rotational orientation of a next clip located immediately proximal to the distal-most clip to a degree sufficient to disengage the distal-most clip.

Abstract: Various embodiments of a medical device having a deflecting shaft and related methods of manufacture and use are disclosed. For example, the device may include a proximal handle, a distal assembly for performing a medical procedure, and a wire coil connecting the proximal handle to the distal assembly, wherein actuation of the proximal handle may cause the distal assembly to perform the medical procedure. The wire coil may have a proximal portion comprised of a first wire and a distal portion comprised of a second wire. The second wire may have a diameter less than a diameter of the first wire so that the distal portion of the wire coil may have a flexibility greater than a flexibility of the proximal portion.

Abstract: Embodiments of the invention include a medical device including a handle portion, an end effector assembly, an elongate member connecting the handle portion and the end effector assembly, and one or more treatment devices extendable through the elongate member and end effector assembly. The end effector assembly includes an electrode assembly configured to cauterize tissue. The treatment devices may include an elongate cutting member with a safety tip. The treatment devices may include a multi-lumen catheter with a lumen configured to deliver fluid and another lumen configured to accommodate an injection needle, a cutting member, or other therapeutic or diagnostic devices.

Abstract: Various embodiments of a measurement device used to measure a size of a lumen and related methods of use are disclosed. For example, the device may include a proximal handle, a distal member including a radially expandable portion, a control member connecting the proximal handle to the distal member, and a measurement indication member for displaying a value indicative of a size of the expandable portion. The radially expandable portion may be configured to expand from a contracted state to an expanded state to measure the size of a lumen.

Abstract: A delivery catheter for delivering material(s) into the body of a mammal can include a first elongated member and a second elongated member. At least a portion of the second elongated member can be slidably disposed within a lumen of the first elongated member. The delivery catheter can mix two materials and then introduce the mixed materials into the body of a mammal.

Abstract: An intravascular catheter that exhibits the combined features of superior flexibility, softness, radiopacity and oval/kink resistance. The catheter includes an elongate shaft having a proximal region, a distal region and a lumen extending therethrough. The proximal region of the shaft includes an inner lubricious polymer layer, a reinforcement layer and an outer layer. The reinforcement layer comprises a braid having one or more metallic members and a plurality of polymer members wherein each polymer member comprises a plurality of monofilaments, preferably formed of LCP. The polymer members of the braid provide improved flexibility and softness in addition to high burst pressure. The metallic member(s) of the braid provide improved radiopacity and oval/kink resistance. The catheter may also include a longitudinal member extending along the reinforcement layer.

Abstract: Various embodiments of a medical device having a deflecting shaft and related methods of manufacture and use are disclosed. For example, the device may include a proximal handle, a distal assembly for performing a medical procedure, and a wire coil connecting the proximal handle to the distal assembly, wherein actuation of the proximal handle may cause the distal assembly to perform the medical procedure. The wire coil may have a proximal portion comprised of a first wire and a distal portion comprised of a second wire. The second wire may have a diameter less than a diameter of the first wire so that the distal portion of the wire coil may have a flexibility greater than a flexibility of the proximal portion.

Abstract: A snare device and methods of making and using the same. The snare device may include a sheath having a proximal end region, a distal end region, and a shaft slidably disposed therein. A handle may be coupled to the shaft and disposed adjacent the proximal end region. The snare device may also include a swivel disposed adjacent the distal end region of the sheath and coupled to the shaft and to a snare loop.

Abstract: A low profile emboli capture device is provided for use in angioplasty and other intravascular procedures. A standard guidewire is utilized having a reduced cross-sectional area formed near its distal end. A filter and self-expanding stent are packaged on the reduced cross-sectional area of the guidewire. A movable sleeve extends over the guidewire and holds the self-expanding stent and filter in their retracted positions while the device is being positioned in the artery. The sheath is moved relative to the self-expanding stent and filter, whereupon the self-expanding stent and filter become deployed.

Abstract: A deflecting method and deflecting apparatus allows the distal end of device, for example an endoscopic medical device, to be remotely and adjustably deflected from a straight configuration to a deflected configuration. Manipulating a proximal handle causes the deflection, controls actuation of an end effector assembly on the distal end, and straightens the deflecting apparatus back to its original configuration.

Abstract: An intravascular catheter that exhibits the combined features of superior flexibility, softness, radiopacity and oval/kink resistance. The catheter includes an elongate shaft having a proximal region, a distal region and a lumen extending therethrough. The proximal region of the shaft includes an inner lubricious polymer layer, a reinforcement layer and an outer layer. The reinforcement layer comprises a braid having one or more metallic members and a plurality of polymer members wherein each polymer member comprises a plurality of monofilaments, preferably formed of LCP. The polymer members of the braid provide improved flexibility and softness in addition to high burst pressure. The metallic member(s) of the braid provide improved radiopacity and oval/kink resistance. The catheter may also include a longitudinal member extending along the reinforcement layer.

Abstract: A low profile emboli capture device is provided for use in angioplasty and other intravascular procedures. A standard guidewire is utilized having a reduced cross-sectional area formed near its distal end. A filter and self-expanding stent are packaged on the reduced cross-sectional area of the guidewire. A movable sleeve extends over the guidewire and holds the self-expanding stent and filter in their retracted positions while the device is being positioned in the artery. The sheath is moved relative to the self-expanding stent and filter, whereupon the self-expanding stent and filter become deployed.

Abstract: A medical instrument such as a guidewire that is designed to have controlled torque transmission along its length. Specially treated areas are placed in selected and equal areas along the entire length of the elongated shaft of the medical instrument, and are separated from one another by untreated areas. This process ensures that any torque is transmitted distally, in a smooth manner, regardless of the guidewire position, thus resulting in a substantial reduction in whipping. In one embodiment, a stainless steel guidewire is utilized, and is subjected to annealing heat treatment in selected areas. This annealing process creates a mandrel that has repeated temper properties along its length. Torque applied at one end of this mandrel is transmitted to the opposite end in an even and controlled manner, even when the mandrel is formed into a loop.

Abstract: Endoscopic devices and methods used for fastening multiple tissue layers, such as, for example, an endoscopic fundoplication procedure, are disclosed. The device may include, for example, an elongated tubular member having a proximal end for extending outside of the body and a distal end for positioning proximate the multiple tissue layers, a grasper configured for positioning proximate the distal end of the tubular member and for grasping at least one of the multiple tissue layers, a device coupled to the distal end of the tubular member for folding the multiple tissue layers together, a tissue fastener configured to be inserted into the tissue layers to hold the tissue layers together, and a fastener head for inserting the tissue fastener into the tissue layers.

Abstract: A medical instrument converts linear movement of a shaft at a proximal end of the instrument to a rotational movement of an end effector of the instrument. According to one embodiment, the medical instrument includes an end effector formed of a snare loop connected to a shaft that is located within a sleeve. Once the sleeve is located near a desired location within a patient, the snare loop may be rotationally positioned with linear movement of the shaft by the operator. The shaft is formed with a threaded portion that matches threads formed in a torque transmitter element fixed within the sleeve. Linear movement of the shaft through the torque transmitter element causes the shaft to rotate. The medical instrument may also include a pivot connector for reducing torque build-up of the shaft and/or a clutch assembly for restricting controlled rotation of the snare loop to only one direction.