Abstract: A flexible clip applier includes a ratchet mechanism adapted to locate a clip pusher to a known location after deployment of a distalmost clip. In addition, the clip applier includes a flexible housing into which a train of clips may be chambered. The flexible housing is constrained from elongation when subject to tensile forces. In accord with another aspect of the invention, the jaw assembly is adapted to have relatively high mechanical leverage which facilitates tissue compression prior to application of a clip.

Abstract: An endoscopic needle assembly has an inner tube formed from a close-wound coil of wire surrounded by a sheath, an outer tube surrounding the inner tube such that the inner tube can move longitudinally relative to the outer tube, a needle joined to a distal end of the inner tube, and a two piece handle having a first handle piece attaching to the inner tube and a second handle piece attaching to the outer tube. A safety shield, formed from a plurality of hinged petals, is built onto the distal end of the outer tube to protect an endoscope from inadvertent penetration by the needle.

Abstract: A surgical instrument includes an end effector having a clevis and first and second jaws mutually rotatable between open and closed positions. The jaws are proximally directed and laterally displaced relative to a longitudinal axis of a control shaft of the instrument. The jaws hold first and second parts of a fastener, respectively. The first part includes a base having upstanding tissue piercing posts, and the second part includes another base defining apertures for receiving the posts, as well as a portion movable relative to the second base. When the upstanding posts are inserted into the apertures, the movable portion can be moved into a second configuration to lock the parts of the fastener together. The instrument is adapted to move the second part into the second configuration. A method for using the apparatus and fastener are also provided.

Abstract: A surgical tool attaches to the distal end of an endoscope and provides a rotatable treating element. According to one embodiment of the invention, the treating element is a pair of jaws provided with cautery capability. According to an aspect of the invention, the treating element is capable of multiple movements from a first closed position, to an open position, to a second closed position and back to the first closed position via a single controller with a single linear movement.

Abstract: Methods and apparatus for delivering a medical instrument over the exterior of an endoscope while the endoscope is installed in the patient's body allow the use of instruments which are too large to fit through the lumena of an endoscope. Furthermore, the invention allows the elimination of working lumena in an endoscope thereby minimizing the likelihood of contamination.

Abstract: Methods and apparatus for delivering a medical instrument over the exterior of an endoscope while the endoscope is installed in the patient's body allow the use of instruments which are too large to fit through the lumena of an endoscope. Furthermore, the invention allows the elimination of working lumena in an endoscope thereby minimizing the likelihood of contamination.

Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: A surgical tool attaches to the distal end of an endoscope and provides a rotatable treating element. According to one embodiment of the invention, the treating element is a pair of jaws provided with cautery capability. According to an aspect of the invention, the treating element is capable of multiple movements from a first closed position, to an open position, to a second closed position and back to the first closed position via a single controller with a single linear movement.

Abstract: Methods and apparatus for delivering a medical instrument over the exterior of an endoscope while the endoscope is installed in the patient's body allow the use of instruments which are too large to fit through the lumena of an endoscope. Furthermore, the invention allows the elimination of working lumena in an endoscope thereby minimizing the likelihood of contamination.

Abstract: A surgical system includes an endoscope, a pair of end effectors provided on the outside of the distal end of a endoscope (“on-scope”), in which one end effector is rotatable or otherwise movable relative to the second end effector and in which such movement is effected via controls elements which do not extend through a lumen of the endoscope, and another instrument extending through the lumen of the endoscope (“through-scope”), and which preferably also has a pair of end effectors. The on-scope device may be clamping jaws, needle passers, clip appliers, cautery devices, staplers, and releasable hemoclips, among other end devices. The through-scope end effectors may be graspers and clip appliers, among other end effectors.

Abstract: Methods of the invention include delivering a grasper, a clip applier, and an endoscope transorally to the site of fundoplication; grasping the fundus with the grasper (or similar device, e.g. corkscrew) and pulling it into the jaws of the clip applier; closing the jaws of the clip applier over the fundus and applying a clip to the fundus.

Abstract: A surgical tool attaches to the distal end of an endoscope and provides a rotatable treating element. According to one embodiment of the invention, the treating element is a pair of jaws provided with cautery capability. According to an aspect of the invention, the treating element is capable of multiple movements from a first closed position, to an open position, to a second closed position and back to the first closed position via a single controller with a single linear movement.

Abstract: This invention relates to endoscopic electrocautery instruments for performing surgery on the tissue of a patient and passing current through the tissue to cause cauterization thereof. The instrument has a proximal end and a distal end and includes an elongated tube, a push rod located within the elongated tube, and a first and second end effector located adjacent a distal end of the elongated tube and controlled for relative movement by the push rod. Various arrangements are disclosed for creating a first and second cautery current path from the instrument proximal end to the first and second end effectors. In accordance with the invention, the end effectors are formed as scissor blade members having various conductive and non-conductive layer arrangements. The layer arrangements of the scissor blade members allow for different cauterization affects. Coupling arrangements between the blade members and the elongated tube are also disclosed.

Abstract: A biopsy forceps instrument is provided having a proximal actuation handle, a flexible multi-lumen tubular member, at least one control member extending through a lumen, an irrigation means, an aspiration means, and a distal assembly. The proximal actuation handle includes a shaft and a spool slidably mounted on the shaft. The actuation handle is coupled to the proximal ends of both the flexible tubular member and the control member. Lumens of the tubular member form irrigation and aspiration conduits. The distal assembly includes a hollow jaw cup coupled to the aspiration conduit and a hollow movable jaw coupled adjacent the irrigation conduit. The movable jaw is coupled to the control member, such that actuation of the actuation handle moves the movable jaw relative to the jaw cup. Moving the hollow jaws into a closed position provides a substantially fluidtight coupling between the irrigation and aspiration conduits.

Abstract: A surgical instrument for applying sutures to tissue includes a needle deployment mechanism and a catch mechanism. In some embodiments, the needle deployment mechanism employs a linear path. Alternatively, it can employ a curved needle. The surgical instrument may include a rotatable head, a bend, and/or a malleable elongated body member formable into various shapes.

Abstract: A bipolar endoscopic scissors is provided with scissor blades where at least one scissor blade is coated with an electrically non-conductive ceramic from its cutting edge along at least a contiguous portion of its shearing surface. The coated blade is provided with a cutting edge having an obtuse included angle which is preferably between approximately 95.degree.-140.degree., and more preferably between 110.degree. and 120.degree.. The blades according to the invention may be configured in several different ways with regard to the number of layers and types of material used, the extent of the ceramic coating, and whether one or both blades are configured in an identical manner. The blades according to the invention having cutting edges defined by obtuse angles cut well and provide a good cutting feel to the practitioner while preventing the ceramic coating from chipping at the cutting edge.

Abstract: A bipolar push rod assembly is disclosed in conjunction with an endoscopic bipolar cautery scissors instrument. The push rod assembly has two conductive push rods which are substantially covered and insulated from each other by a double lumen flexible sheath. The proximal ends of the push rods are stabilized by an overmolded plastic collar and the distal ends of the push rods are stabilized by a ceramic insulator. The plastic collar is provided with a snap retainer for coupling it to a plastic plug retainer having a pair of spaced apart passages. A pair of female plug adapters are press fit onto the proximal ends of the push rods and are maintained in place by the plug retainer with each adaptor residing in a respective one of the passages. The distal ends of the push rods are swaged approximately 90.degree. in opposite directions. A ceramic insulator is disclosed as a one-piece unit into which the distal ends of the push rods are inserted.

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: A biopsy forceps instrument is provided having a proximal actuation handle, a flexible multi-lumen tubular member, at least one control member extending through a lumen, an irrigation means, an aspiration means, and a distal assembly. The proximal actuation handle includes a shaft and a spool slidably mounted on the shaft. The actuation handle is coupled to the proximal ends of both the flexible tubular member and the control member. Lumens of the tubular member form irrigation and aspiration conduits. The distal assembly includes a hollow jaw cup coupled to the aspiration conduit and a hollow movable jaw coupled adjacent the irrigation conduit. The movable jaw is coupled to the control member, such that actuation of the actuation handle moves the movable jaw relative to the jaw cup. Moving the hollow jaws into a closed position provides a substantially fluidtight coupling between the irrigation and aspiration conduits.

Abstract: A process for providing an endoscopic scissors blade with the necessary roughness to receive a ceramic coating, without first requiring that the blade surfaces be roughened by gritblasting, includes obtaining an investment mold with an interior textured surface. The investment mold is textured by first texturing an injection mold cavity by etching, gritblasting, or electric-discharge machining the inside surface of the injection mold cavity to produce a desired roughness. A blade pattern (wax) is then formed in the injection mold with a resulting textured surface, and using the textured blade pattern, the investment mold with the textured interior cavity is generated. When metal is injected into the investment mold using a lost wax process, the resulting cast blades will have the necessary roughness for permitting a ceramic to be bonded thereto without the need for any additional roughening. Thus, the so-formed blades are coated with a ceramic material.