Abstract: An end cap for an endoscope. The end cap is configured to allow the endoscope to be introduced into a patient body by a short-wire type of operation.

Abstract: A medical sphincterotome and a method of its use are described. The sphincterotome has structural elements that are capable of directing a wire guide through a selected body passageway. One structural element includes a distal port and deflection member that can deflect the wire guide into the desired passageway. Another structural element includes an offset nose-shaped end that can bend towards a passageway desired to be blocked. The wire guide is prevented from entering the blocked passageway, thereby enabling the wire guide to cannulate the desired passageway. The sphincterotome also includes a cutting wire to access a patient's sphincter and perform various other medical procedures.

Abstract: An endoscopic suction device of an endoscope for mucosectomy is disclosed. The device comprises a connecting base having an open end attachable to the distal end of the endoscope. The device further comprises a distal tip extending from the connecting base and having a closed distal end. The distal tip comprises a suction chamber formed therein and in fluid communication with the open end. The suction chamber has a suction opening formed laterally therethrough for suctioning lesions during mucosectomy.

Abstract: The present invention provides apparatus and methods suitable for removing at least one stone in a body passage. The apparatus comprises a balloon catheter having at least one working lumen adapted to receive an extraction basket. In use, the extraction basket may be used to capture and remove relatively large stones, and/or crush relatively large stones into smaller stone fragments. The balloon may then be inflated and maneuvered to engage the stone fragments and urge at least one of the stone fragments out of the body passage.

Abstract: A method and device for removing tissue from a patient during a biopsy procedure utilizing a biopsy collection device are provided. The biopsy collection device includes a body portion configured for attachment to an endoscope and a receptacle portion configured to retain a portion of tissue removed from a target site during the biopsy procedure. The biopsy collection device further includes a passageway configured to receive a biopsy sampling device, such as a pair of forceps, passing through the endoscope to the target site.

Abstract: The present invention provides apparatus and methods for performing endoscopic mucosal resection and endoscopic submucosal dissection of tissue. In a first embodiment, a hood member having a hood portion and a lever portion is provided. The hood portion is adapted to be disposed over a distal region of an endoscope. A portion of the lever portion is configured to be inserted beneath a section of mucosal tissue having a lesion, and the lever portion is configured to be rotated or otherwise maneuvered to lift the mucosal tissue in an upward direction, thereby facilitating removal of the tissue comprising the lesion. Optionally, a surgeon may advance a needle knife through the endoscope and lever portion to further incise submucosal tissue while the lever portion is disposed beneath the lesion. If desired, a flushing fluid may be provided to a target site during the procedure.

Abstract: A method and device for incising tissue from the gastrointestinal tract are described. The device is an electrosurgical cutting device. The electrosurgical cutting device includes a catheter and multiple electrically conductive cutting wires extending through a lumen of the catheter. The wires are movable between a retracted position and an extended cutting position. The wires form a divergent configuration in the extended cutting position. The electrosurgical cutting device may be loaded into an endoscope, which is then maneuvered to the target tissue site to be incised. Manipulating a handle assembly extends the wires into a divergent cutting configuration. Electrical current is applied causing the wires to incise tissue from the target site.

Abstract: A stent introducer apparatus includes a handle with a proximal end and a distal end and having a portion that is coaxially slidable from the distal end to the proximal end and vice versa. A catheter having a proximal end and a distal end is provided with a pair of open end slits each of which defines a tab that is connected to the slidable portion of the handle. A guide wire is disposed within the catheter and has a proximal end and a distal end such that when the slidable portion of the handle is moved from the distal end to the proximal end, the distal end of the guide wire is exposed. The guide wire has a stent carrying portion at its distal end to carry a stent that is deployed when the distal end of the guide wire is exposed.

Abstract: A clip device for hemostasis includes a clip having a proximal end portion and at least two arm portions extending from the proximal end portion and provided with a tendency to open. A sliding ring is provided for closing the arm portions of the clip. A first retainer is attached to the clip, and the first retainer is configured to be releasably secured to a second retainer that may be attached to an operating wire or a torque cable. In operation, the clip device is advanced to a target site in a body cavity. An outer sheath is retracted to expose the clip, causing the arms to open. An inner sheath is advanced distally, causing the sliding ring to advance distally to close the arms of the clip. Stop elements may be disposed on the clip to ensure that he sliding ring is not advanced distally over the clip. Then, the first retainer is disengaged from the second retainer. Various mechanisms are disclosed to permit the first and second retainers to disengage from one another.

Abstract: An apparatus and method comprising at least one intragastric member made of a digestive-resistant or substantially indigestible material that is introduced into a bag located in the gastric lumen of a mammal for the treatment of obesity. One or more intragastric members are loaded into a delivery tube in a partially compacted first configuration and delivered to an overtube. The overtube includes a proximal end, a distal end and a lumen configured to receive the intragastric members in the first configuration for delivery to the bag located in the gastric lumen wherein the intragastric member is expanded to a second configuration. The apparatus further comprises a constraining element engaged with the bag to secure the intragastric member upon delivery into the gastric lumen.

Abstract: The present invention provides a balloon cuff comprising an attachment structure adapted to be disposed around an exterior surface of an endoscope, and a balloon coupled to the attachment structure. An inflation means is in fluid communication with the balloon. The balloon has a deflated state suitable for insertion into a body passage and an inflated state suitable for urging stone fragments along the body passage. Optionally, an intraductal shock wave lithotripsy procedure may be performed through the working lumen of the first endoscope while the balloon cuff is disposed, either inflated or deflated, about the exterior surface of the first endoscope. The first endoscope and balloon cuff may be used alone to remove stone fragments, or alternatively, may be used in conjunction with a second endoscope, such as a duodenoscope, having a working lumen sized to received the first endoscope having the balloon cuff disposed thereon.

Abstract: The present invention provides apparatus and methods for performing endoscopic mucosal resection and endoscopic submucosal dissection of tissue. In a first embodiment, a catheter having proximal and distal ends and a balloon disposed near the distal end of the catheter is provided. A portion of the distal end of the catheter is configured to be inserted beneath a section of mucosal tissue having a lesion, and the balloon is configured to be inflated to lift the mucosal tissue in an upward direction, thereby facilitating removal of the tissue comprising the lesion. Optionally, a surgeon may advance a needle knife through the catheter to further incise submucosal tissue while the balloon is in the inflated state. If desired, a flushing fluid may be provided to a target site during the procedure.

Abstract: A medical device for performing lithotripsy on a foreign body within a patient. The medical device generally includes a wire basket constructed from distal portions of a plurality of multifilament wires. The distal portions of the plurality of multifilament wires each follow a generally helical path to give the wire basket a helical configuration. A method of performing lithotripsy is also provided using the medical device.

Abstract: A stent introducer apparatus including a primary stent introducer device movably disposed within a secondary stent introducer device. The primary stent introducer device includes a first self-expanding stent mounted on an elongate pusher member. The primary stent introducer device further includes an inner introducer catheter slidably disposed about the pusher member and the first stent. The first stent is deployed by retracting the inner introducer catheter proximally relative to the pusher member to thereby expose the first stent from the distal end of the inner introducer catheter. The secondary stent introducer device includes a second self-expanding stent mounted within an outer introducer catheter. The primary stent introducer device is configured to engage and hold the second stent. The second stent is deployed by retracting the outer introducer catheter proximally relative to the primary stent introducer device to thereby expose the second stent from the distal end of the outer introducer catheter.

Abstract: A stent introducer apparatus includes a handle having a housing and a rotatable reel. An inner stent carrier having a proximal end and a distal end is provided, with the proximal end being connected to the housing of the handle. An outer sheath movably disposed about the inner stent carrier and having a proximal end and a distal end is provided, with the proximal end being connected to the reel of the handle. Rotation of the reel relative to the housing peels the outer sheath away from the inner stent carrier so as to move the outer sheath proximally relative to the inner stent carrier, thereby exposing the distal end of the inner stent carrier. The inner stent carrier has a stent carrying portion at its distal end to carry a stent that is deployed when the distal end of the inner stent carrier is exposed.

Abstract: A method and apparatus for uncoupling a wire guide from and elongate medical device comprising a catheter shaft having a wire guide lumen extending there through, wherein the material surrounding the wire guide lumen is selected or adapted to facilitate splittability for removal of the wire guide. The catheter shaft is coextruded and comprises a plurality of materials. The portion of the shaft adjacent the wire guide lumen is formed from a first material and the balance of the shaft is formed from a second material. The first material is selected or adapted to facilitate splittability as compared to the second material. The first material may have a lower durometer than the second material. A peel tool for separating the wire guide from the catheter shaft is also provided.

Abstract: A wire guide holder having a body for securing an elongate medical wire or tube, such as a wire guide or catheter. The body is adapted to be attached to a scope or a bite block. The body can be provided with protrusions and/or grooves for holding a wire guide. The wire guide holder may be affixed to the medical scope by clamping. The wire guide holder can also be provided with a seal.

Abstract: A method and apparatus for introducing a first elongate medical device and short wire guide that are coupled together into a work site and remotely disconnecting them within the work site such that a secondary device comprising a catheter member can be introduced over the wire guide to the work site, and/or a second wire guide can be introduced to the work site via a passageway of the primary access device. A system of indicia, such as radiopaque or viewable markers, permit the operator to monitor the relative alignment of the devices within the work site to determine when uncoupling has occurred. In one example of the method, a wire guide and primary access device (e.g., a sphincterotome) is coupled to the wire guide and introduced via a duodenoscope into the biliary system. After performing a first medical operation, the devices are uncoupled with the wire guide being left within the biliary system such that a secondary access device, such as a balloon, biopsy device, stent delivery catheter, dilator, etc.

Abstract: Disclosed is a pressure sensitive prosthesis (10) that includes a tubular member (11) having a passageway (12) extending therethrough and a sleeve (13) attached about one end of the tubular member. The sleeve functions as a one-way valve to permit fluid flowing through the sleeve lumen (15) in a first direction (17) and under a first pressure, while collapsing in response to fluid flowing in a second direction 18 where the pressure that exceeds that of the first direction or pressure. One aspect of the invention includes an esophageal anti-reflux expandable prosthesis wherein the sleeve is adapted to invert back through the tubular stent frame to permit belching or vomiting (fluid or materials under a third, significantly higher pressure). Another aspect of the invention includes a tubular drainage stent (60), such as a biliary or urethral stent in which the sleeve opens to permit passage of fluids, then collapses to prevent retrograde flow.

Abstract: Disclosed is a pressure sensitive prosthesis (10) that includes a tubular member (11) having a passageway (12) extending therethrough and a sleeve (13) attached about one end of the tubular member. The sleeve functions as a one-way valve to permit fluid flowing through the sleeve lumen (15) in a first direction (17) and under a first pressure, while collapsing in response to fluid flowing in a second direction 18 where the pressure that exceeds that of the first direction or pressure. One aspect of the invention includes an esophageal anti-reflux expandable prosthesis wherein the sleeve is adapted to invert back through the tubular stent frame to permit belching or vomiting (fluid or materials under a third, significantly higher pressure). Another aspect of the invention includes a tubular drainage stent (60), such as a biliary or urethral stent in which the sleeve opens to permit passage of fluids, then collapses to prevent retrograde flow.