Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

Abstract: The invention in certain aspects relates to a surgical fastener for fastening tissue segments having tissue surfaces. The fastener includes a first fastener member having a base and a piercing element connected to the base for piercing the tissue segments to be fastened, a second fastener member having an opening for receiving and retaining the piercing element of the first fastener member such that the tissue segments to be fastened are retained between the first and second fastening members, and means for promoting adhesion between the tissue surfaces. The invention also relates to related methods and devices for promoting adhesion of tissue segments and preventing fastener migration, especially in an endoscopic procedure for the treatment of GERD.

Abstract: A double acting bipolar endoscopic scissors includes a hollow tube with an integral clevis and a bipolar push rod extending therethrough. The tube is rotatably mounted in a handle member which is provided with a manual actuation lever. The bipolar push rod includes a pair of spaced apart rods which are insulated along substantially their entire lengths by polypropylene sheaths, and which are insert molded in a distal insulating collar near their distal ends, in a proximal insulating collar near their proximal ends, and in a plurality of non-conductive cylinders therebetween. The distal collar includes a flattened distal portion and the distal ends of the rods are bent approximately 90 degrees and exit the flattened portion. A pair of scissor blades are mounted in the clevis with an axle screw and a nut and are insulated from the clevis and the axle screw. One of the scissor blades has a ceramic coating on its face to insulate it from the other scissor blade.

Abstract: An endoscopic bipolar electrocautery instrument includes a proximal actuator coupled by a tube and push rod to a pair of distal graspers. The tube is covered with an insulating shrink wrap from its distal end up to an uncovered proximal portion. A stationary jaw with an integral clevis is mounted inside the distal end of the tube and electrically contacts the inner surface thereof. The clevis holds a pair of ceramic insulators between which a movable jaw is mounted on an insulated bushing with an axle pin. The movable jaw is electrically and mechanically coupled to the push rod which is covered with an insulating shrink wrap from a point just proximal of its connection with the movable jaw to a point near its proximal end. The uninsulated proximal end of the tube is mounted in a conductive bushing which rotates within a nonconductive handle. The proximal end of the push rod extends beyond the conductive bushing and a rubber insulator is fitted between the bushing and the push rod.

Abstract: An endoscopic multiple sample bioptome includes a hollow outer member and an axially displaceable inner member extending therethrough. The proximal ends of the outer and inner members are coupled to an actuator for axially displacing one relative to the other. The distal end of the outer member is coupled to one of a cylinder having a sharp distal edge and a jaw assembly, while the distal end of the inner member is coupled to the other. The jaw assembly includes a pair of opposed, preferably toothed jaw cups each of which is coupled by a resilient arm to a base member. The arms are bent to urge the jaws away from each other. The base member is mounted inside the cylinder and axial movement of the jaw assembly and cylinder relative to each other draws the arms into the cylinder and brings the jaw cups together in a biting action.

Abstract: Elastomeric fluid seals for endoscopic instruments include a single piece of molded elastomer surrounding a pushrod and placed with the outer tube or clevis of the instrument, thereby sealing the annular space between the pushrod and the outer tube. The dimensions of the seals are chosen such that they fit snugly inside the tube or clevis of the endoscopic instrument and the push rod of the endoscopic instrument fits snugly through the seal. When placed within the tube, the seal is preferably formed as a cylinder with a radially inward extending toroidal ring. As the push rod is moved through the fluid seal, the toroidal ring is pressed in an axial direction and thereby exerts a radially outward force on the seal which keeps the seal from moving inside the tube. When placed within the clevis, the seal is preferably formed as an adjacent cylinder and semi-cylinder which is inserted in a radial bore overlapping the proximal portion of the U-shaped cut-out of the clevis.

Abstract: An endoscopic bipolar electrocautery instrument includes a proximal actuator coupled by a tube and push rod to a pair of distal graspers. The tube is covered with an insulating shrink wrap from its distal end up to an uncovered proximal portion. A stationary jaw with an integral clevis is mounted inside the distal end of the tube and electrically contacts the inner surface thereof. The clevis holds a pair of ceramic insulators between which a movable jaw is mounted on an insulated bushing with an axle pin. The movable jaw is electrically and mechanically coupled to the push rod which is covered with an insulating shrink wrap from a point just proximal of its connection with the movable jaw to a point near its proximal end. The uninsulated proximal end of the tube is mounted in a conductive bushing which rotates within a nonconductive handle. The proximal end of the push rod extends beyond the conductive bushing and a rubber insulator is fitted between the bushing and the push rod.

Abstract: An endoscopic surgical instrument includes a proximal handle with a distally extending lever actuator. The handle and lever actuator are coupled by a tube and push rod to a pair of distal end effectors. The proximal end of the tube is mounted in a bushing having a flange which is freely rotatable within a flange receiving recess in the handle. The proximal end of the push rod extends proximally beyond the bushing and is coupled to the lever actuator by a ball and set screw coupling. The lever actuator preferably extends at least four inches distally from the proximal end of the handle and includes a finger ring near its distal end. The tube is preferably provided with a ferrule immediately distal of the handle for rotating the tube and push rod about the longitudinal axis of the instrument. The ferrule is preferably provided with a distal extension having an annular notch for locking engagement inside another endoscopic instrument.