Abstract: A pair of partitioning elements located in a duodenum, sealably isolates a first portion of the duodenum, in which a minimally invasive procedure is to be carried out from a proximal second portion and a distal third portion of the duodenum to allow insufflating of the first portion only. The first partitioning element located between the first and second portions of the duodenum comprises a tubular carrier element and an isolating membrane secured to the carrier element. The carrier element is radially expandable from a compressed first state to a second state with the isolating membrane sealably isolating the first portion from the second portion. A communicating opening through the isolating membrane accommodates an endoscope therethrough into the first portion. The communicating opening is omitted from the second partitioning element.

Abstract: An attachment (1) for a trocar cannula (3) having an access valve (12) located in a proximal end (5) thereof comprises a housing (20) defining an instrument passageway (29). An operating member (43) having an instrument bore (46) is slideable in the instrument passageway (29) from a disengaged state disengaged from the access valve (12) to an engagement state extending through the access valve (12) with the access valve (12) in the open state and shielded from an instrument passing therethrough. A pair of detecting probes (55) carried on a carrier (50) and extending into the instrument bore (46) are urgeable distally from a first state to a second state by a distal end of an instrument being urged distally in the instrument bore (46) for in turn urging the operating member (43) from the disengaged state to the engagement state.

Abstract: A clip assembly (42) for securing a tubular member (5) to an endoscope (3) comprises a plurality of clips (40) tethered together by a looped tether (41). Each clip (40) comprises a first channel (48) for engaging the endoscope (3) and a second channel (50) for engaging the tubular member (5). Each clip comprises a carrier element (45) and an adapter element (47) secured to the carrier element (45). The carrier element (45) comprises a body member (52) having a pair of first side members (54) extending therefrom defining the first channel (48), and a pair of engagement side members (67) defining an engagement channel (69). The adapter element comprises an arcuate element (80) engaged in the engagement channel (69) for defining the second channel (50). A covering element (95) comprising a pair of end panels (91) extending from the arcuate element (80) cover ends (61) of the carrier element (45).

Abstract: A valve mechanism (3) for attaching to a proximal end (4) of a trocar cannula (2) for minimising leakage of insufflating and other gases proximally from the trocar cannula (2), comprises a housing (7) adapted for securing to the trocar cannula (2) adjacent the proximal end (4) thereof. The housing (7) defines an instrument bore (22) extending from a proximal end (23) to a distal end (21). A distal valve (28) is located adjacent the distal end (21) of the instrument bore (22) and is pivotal from an open state to a closed state. A proximal valve (40) is located towards the proximal end (23) of the instrument bore (22), and comprises first and second valve members (41) and (42) which are urgeable from a withdrawn state clear of the instrument bore (22) to an engagement state sealably engaging an instrument in the instrument bore (22) for sealing the instrument bore (22).

Abstract: A suture instrument comprising an elongated outer sleeve (3) and a cannula (9) terminating in a distal piercing tip (12) is slideable within a cannula bore (7) extending through the outer sleeve (3). A plurality of sutures (15), are located in a suture bore (14) extending longitudinally through the cannula (9). Each suture (15) comprises a suture thread extending between a pair of anchor bars (20), and a cinch clip (24), which is located on a loop (22) of the suture thread (7) formed between the anchor bars (20), and is slideable along the loop (22) for reducing the effective length of the suture thread (17) between the anchor bars (20). The anchor bars (20) and the cinch clips (24) of the sutures (15) are aligned end-to-end sequentially along the suture bore (14) of the cannula (9) with the cinch clip (24) of each suture (15) located between the anchor bars (20) thereof.

Abstract: A collection device (1) for minimising dispersal of pathogens into the environment during insufflating of the peritoneal cavity (12) of a subject (3), and which are entrained in insufflating gases and other gases escaping through an incision (8) in the abdominal wall (9) of the subject (3), through which a trocar is entered into the peritoneal cavity (12) comprises a patch (5) supported on a support framework (30). The patch (5) terminates in an outer peripheral portion (20) with a pressure sensitive adhesive (21) coated thereon for sealably securing the outer peripheral portion (20) to the abdominal wall (9). A central access opening (24) formed in the patch (5) tightly and sealably engages the trocar (10).

Abstract: A suturing device (1) for suturing parts (5,6) together of a lumen (8) with one or more sutures (3) comprises an actuator (34) having a handle (33) and first and second operating elements (60,68) slideable longitudinally on the handle (33). A tubular shield (35) extends from the handle (33), and a cannula (40) slideable in the tubular shield (35) is connected to the first operating element (60) for urging the cannula (40) between a withdrawn state within the tubular shield (35) to an extended state extending from the tubular shield (35). An elongated push rod (52) slideable in the cannula (40) terminating in a distal hook (55) is coupled to and operated by the second operating element (68). Anchor elements (22) of the suture (3) are located in the cannula (40), and are sequentially urged therefrom by the push rod (52), as the cannula (40) sequentially pierces through the parts (5,6).

Abstract: A suturing apparatus comprises an invaginating device secured to a distal end of an endoscope for invaginating two parts of the interior of a wall of a vessel, for example, a stomach to be sutured together to form a gastric sleeve. The invaginating device includes a suction chamber for forming invaginated parts of the interior of the wall of the vessel. A suturing instrument extending through an instrument channel of the endoscope extends into the invaginating device, and is urged into or adjacent the suction chamber for inserting a suture into the invaginated part in the suction chamber. The next invaginated part is then formed, and the suture is inserted into it. The suture is then tightened to draw the two invaginated parts together.

Abstract: A face mask (90) comprises an instrument shielding apparatus (91) which comprises an instrument shielding device (92) which is connected to the face mask (90) by an adapter (89). The adapter (89) comprises an instrument accommodating housing (15) through which an instrument bore (25) extends therethrough. The instrument accommodating housing (15) terminates at one end in a first main port (20) engageable with an instrument port (7) of the face mask (90), and in the other end in a second main port (23). The instrument shielding device (92) comprises a shielding sleeve (95) a first end (96) of which is secured by a coupling ring (98) to the second main port (23) of the adapter (89), and a second end (97) of which is secured in a storage chamber (94) of a sleeve storing housing (93) of the instrument shielding device (92).

Abstract: An insufflator for insufflating a body cavity includes a compressed air vessel and a flow control valve for delivering insufflating air to the cavity through a first trocar. A discharge control valve at an outlet port of a second trocar exhausts insufflating air from the cavity. A pressure sensor on the first trocar monitors cavity pressure, and a microcontroller operates the flow control valve for maintaining a predefined working pressure in the cavity. A foot operated switch is operable by a surgeon for opening and closing the discharge control valve. When the pressure in the cavity drops below the predefined working pressure, the flow control valve increases the insufflating air to the cavity, thereby increasing the insufflating air flow through the cavity for removing undesirable gases. The apparatus and insufflator may also be adapted for removing smoke, nitrogen or other undesirable gases during both cauterisation and cryogenic procedures.

Abstract: An insufflator for insufflating a body cavity includes a compressed air vessel and a flow control valve for delivering insufflating air to the cavity through a first trocar. A discharge control valve at an outlet port of a second trocar exhausts insufflating air from the cavity. A pressure sensor on the first trocar monitors cavity pressure, and a microcontroller operates the flow control valve for maintaining a predefined working pressure in the cavity. A foot operated switch is operable by a surgeon for opening and closing the discharge control valve. When the pressure in the cavity drops below the predefined working pressure, the flow control valve increases the insufflating air to the cavity, thereby increasing the insufflating air flow through the cavity for removing undesirable gases. The apparatus and insufflator may also be adapted for removing smoke, nitrogen or other undesirable gases during both cauterisation and cryogenic procedures.

Abstract: A microneedle device for delivering a therapeutic fluid to a fistula comprises a carrier element (5) formed by a pair of shells (9). The shells (9) are of semi-circular cross-section and are urged together by resilient bands (10) to define a main bore (14) extending therethrough. A plurality of microneedles (17) extend from the respective shells (9). An operating member (30) of circular transverse cross-section of external diameter greater than the diameter of the main bore (14) is urgeable into the main bore (14) for urging the shells (9) and in turn the microneedles (17) radially outwardly from a rest state to an engagement state, and into the tissue within the fistula (3).

Abstract: A valve mechanism (1) for coupling to a trocar (3) comprises a housing (15) having an instrument bore (16) extending therethrough from an upstream end (17) to a downstream end (18) and alignable with an instrument bore (9) of the trocar (3). A gate valve (20) comprising a pair of gate elements (22) located in the housing (15) is operable between a closed state closing the instrument bore (16) and an open state clear of the instrument bore (16). First compression springs (31) urge the gate elements (22) into the closed state. A pair of engagement members (33), which are engageable with an instrument (10), for example, a laparoscope in the instrument bore (16), and which extend into the instrument bore (16) from respective carrier elements (35) through guide slots (38).

Abstract: A leak detecting apparatus (1) for detecting a leak and determining the size of the leak in a suture repaired site (5) of a hollow organ (3), for example, a stomach, in a cavity (7), for example, the peritoneal cavity of a subject comprises a first insufflator (12) for insufflating the hollow organ (3) with a first gas, and a second insufflator (14) for insufflating the cavity (7) with a second gas. A gas detector (18) is provided for detecting the concentration of the first gas in gases exhausted from the cavity (7) through a communicating conduit (35). A flow meter (25) monitors the flow rate of the first gas to the hollow organ (3). First and second pressure sensors (15) and (16) monitor the static pressure of the first and second gases in the hollow organ (3) and the cavity (7), respectively. The apparatus (1) is operable in a first mode and a second mode.

Abstract: A system for insufflating a vessel in a human or animal body, such as the rectum comprises a first pressure sensor located adjacent a leading end of an endoscope for monitoring pressure in the rectum. A second pressure sensor located on a carrier element which is urgeable through the endoscope into the colon monitors pressure therein. Insufflating air which may leak into the abdominal cavity is exhausted therefrom by a needle. A third pressure sensor monitors pressure in the abdominal cavity. A microcontroller controls the supply of insufflating air to the rectum for maintaining pressure in the rectum at a first predefined pressure, for preventing pressure in the colon exceeding a second predefined pressure, and for controlling a vacuum pump for drawing insufflating air from the abdominal cavity to prevent pressure therein exceeding a third predefined pressure.

Abstract: Apparatus for rupturing muscle fibres in a lower oesophageal sphincter comprises a balloon catheter. A multi-electrode impedance planimetry measuring system comprising a pair of stimulating electrodes and sensing electrodes is located on the catheter within the balloon for monitoring the diameter of the balloon when the balloon is inflated with a liquid saline solution from a reservoir through a flowmeter under the control of a microprocessor. The microprocessor computes the minimum diameter value from signals read from the sensing electrodes each time the cumulative volume of the liquid saline solution in the balloon increases by a predefined unit volume. The microprocessor computes a curve of a plot of the minimum diameter values against the corresponding cumulative volume values and determines the slope at each computed minimum diameter value. Rupture of the muscle fibres of the sphincter is determined at the point of inflection of the curve.

Abstract: Systems, methods, and apparatus for esophageal panometry are provided. An example method includes capturing measurement data including an area and a pressure of an esophageal body via a measurement device positioned with respect to the esophageal body; generating representations of the exported measurement data; analyzing the measurement data to determine esophageal reactivity based on the area and pressure; assessing esophageal function based on the determined esophageal reactivity; and outputting an indication of esophageal function.

Abstract: An insufflator for insufflating a body cavity includes a compressed air vessel and a flow control valve for delivering insufflating air to the cavity through a first trocar. A discharge control valve at an outlet port of a second trocar exhausts insufflating air from the cavity. A pressure sensor on the first trocar monitors cavity pressure, and a microcontroller operates the flow control valve for maintaining a predefined working pressure in the cavity. A foot operated switch is operable by a surgeon for opening and closing the discharge control valve. When the pressure in the cavity drops below the predefined working pressure, the flow control valve increases the insufflating air to the cavity, thereby increasing the insufflating air flow through the cavity for removing undesirable gases. The apparatus and insufflator may also be adapted for removing smoke, nitrogen or other undesirable gases during both cauterisation and cryogenic procedures.