Abstract: Disclosed herein are devices and methods for forming multidirectional cuts in tissue. The tissue cutting devices disclosed herein generally include a flexible elongate member with at least first and second wires that are at least partially constrained within or along a portion of the member. A distal portion of the wires is anchored on or within a portion of the elongate member. When tension is applied to one of the wires, such as by an actuator at a proximal end of the device, the elongate member bows while an unconstrained portion of the wire becomes exposed relative to the adjacent portion of the elongate member, assuming a tissue-cutting configuration.

Abstract: Devices and methods useful for manipulating tools at a surgical site are disclosed. In one exemplary embodiment, an accessory device is provided and can include an insertion member and a control wire. The insertion member can have a lumen for receiving a tool therethrough, such as an endoscope. The control wire can be coupled to the insertion member and have a distal portion extending distally from the insertion member and be adapted to receive and to manipulate a tool extending through the insertion member. The control wire can have a wide variety of configurations, and in certain exemplary embodiments the control wire can be slidably received in one or more control wire lumens formed through the insertion member. In use, the control wire can be manipulated, for example by axially sliding the control wire in one or more control wire lumens to control a tool.

Abstract: In various embodiments, a surgical instrument for operation in an aqueous environment is provided. In at least one embodiment, the surgical instrument may include a hollow sheath and a blade disposed at least partially within the sheath. Coupled to the blade may be at least one ultrasonic transducer, which, in turn, may be coupled to a drive system. The drive system may be configured to deliver gross axial motions to the blade such that the blade translates with respect to the hollow sheath when the drive system is activated. Accordingly, tissue may be cut by the blade with gross axial movement of the blade and/or ultrasonic vibrational motion provided by the ultrasonic transducer(s). In alternative embodiments, the blade may be rotated axially instead of translated with respect to the hollow sheath.

Abstract: A surgical instrument can comprise a first electrode, a second electrode positioned about the first electrode, and a third electrode positioned about the second electrode. In various embodiments, a surgical instrument can comprise a biopsy punch shaft and one or more electrodes mounted to the outside of the shaft. In certain embodiments, a surgical instrument can comprise a cylinder configured to be rolled over a tissue surface wherein electrodes extending from the cylinder can contact and/or penetrate the tissue. In various embodiments, a surgical instrument can comprise at least one rotatable electrode wherein the electrode can be rotated to grasp and pull tissue.

Abstract: An interface system for interfacing between at least one endoscopic surgical instrument and a cable-controlled guide tube system. Various embodiments may include a tool docking assembly that is supportable relative to the cable-controlled guide system. The tool docking assembly may comprise one or more tool docking stations for retainingly supporting at least one endoscopic surgical instrument for selective pivotal travel about transverse axes. The system may further include cable attachment arrangements for coupling steering cables from the guide tube assembly to the various tool docking stations.

Abstract: Interface systems for interfacing between at least one endoscopic surgical instrument and a cable-controlled guide tube system. Various embodiments include at least one surgical tool docking assembly that is supportable relative to the cable-controlled guide tube system. The surgical tool docking assembly may comprise a cable drive assembly that is operably couplable to the cable-controlled guide system for applying control motions thereto. The surgical tool docking assembly may further comprise at least one tool docking station that is configured to support an endoscopic surgical instrument therein for selective pivotal travel about a first axis and a second axis. The tool docking stations cooperate with corresponding drive shafts for imparting rotary drive motions to the cable drive assembly. Various docking arrangements are disclosed for coupling the cable drive assembly to the cable-controlled guide tube assembly.

Abstract: An intralumenal accessory tip for use with an inner sheath assembly during initial insertion of the inner sheath into a patient. The intralumenal accessory tip is removably attachable to the distal end of the inner sheath assembly and has passages therein to accommodate access tubes and endoscopic tools protruding from the inner sheath assembly. The intralumenal accessory tip may be attached to the distal end of the inner sheath assembly and both assemblies may be inserted into an overtube to permit the inner sheath assembly to be inserted into the patient. The inner sheath assembly may then be withdrawn out of the overtube and the intralumenal tip accessory removed therefrom.

Abstract: A selectively positionable camera assembly for use in connection with a guide tube assembly that has a guide tube handle portion and at least one guide tube protruding therefrom. In various embodiments, the camera includes an elongated flexible camera portion that is sized to operably extend through at least one of the guide tubes of the guide tube assembly. A camera handle is operably coupled to the elongated flexible camera portion such that the handle is movably supported by at least a portion of the guide tube handle portion. At least one retainer is provided on the guide tube handle and/or the camera handle for releasably retaining the camera handle in any one of a plurality of orientations relative to the portion of the guide tube handle.

Abstract: Various surgical devices, kits, and/or methods are provided herein that may be useful in performing a surgical procedure through a natural orifice. Such a surgical procedure may utilize one or more devices, kits, and/or methods to create an access port to a body cavity of a patient, to perform a specific surgical procedure, and to close the access port. In various embodiments, the specific surgical procedure may comprise a sleeve gastrectomy, a ventral hernia repair, a hybrid transgastric cholecystectomy, and/or a hybrid transgastric appendectomy.

Abstract: An electrical ablation apparatus comprises first and second electrodes. Each electrode comprises a first end configured to couple an energy source and a second end configured to couple to a tissue treatment region. An energy source is coupled to the first and second electrodes. At least one electrode is movable between a first position and a second position. A first necrotic zone having a first shape is created when the electrodes are energized in the first position and a second necrotic zone having a second shape is created when the electrodes are energized in the second position. At least one electrode may be pre-formed with a radius.

Abstract: A medical instrument includes a flexible catheter, a medical guidewire, and a mechanized guidewire drive assembly. The catheter has a distal end insertable into a body lumen of a patient. The mechanized guidewire drive assembly is adapted for operable engagement with the medical guidewire. The mechanized guidewire drive assembly includes a motor and includes a controller which drives the motor with a driving force. The driving force has a predetermined upper limit.

Abstract: An implantable restriction device includes a belt and a balloon secured to the belt for engagement with tissue when the implantable restriction device is positioned about the stomach. A spacer is associated with the belt for maintaining the restriction device in a spaced relation with a staple line employed during gastric reduction surgery.

Abstract: A medical apparatus and method useful for positioning a device, such as an endcap, on an end of an endoscope, is disclosed. The apparatus can exert a pulling force on the endoscope through the endcap while a pushing force is applied to the endcap. The apparatus can be used to press an endcap onto the distal end of an endoscope without grasping by hand a sheath in those applications where the endoscope is disposed in a sheath.

Abstract: A guide system for accommodating an endoscopic tool. The guide system comprises a flexible inner sheath and a handle coupled to the inner sheath adjacent a proximal end of the inner sheath. The inner sheath includes a plurality of working channels. The working channels are bundled over a common portion of their respective lengths, and the working channels collectively define a substantially honeycombed cross-sectional area.

Abstract: A first medical instrument includes a flexible catheter and a medical guidewire extendable beyond a distal end of the catheter. The catheter has an articulated section. The medical guidewire has first and second segments, wherein the bending moment of inertia of the first segment is less than the bending moment of inertia of the second segment. A second medical instrument includes a flexible catheter, a mechanized guidewire assembly, and a medical guidewire extendable beyond a distal end of the catheter. The catheter has an articulated section. The medical guidewire has an exterior surface including a repetitive series of spaced-apart surface elevation features. One example of surface elevation features is external threads. The spaced-apart surface elevation features are adapted for operable engagement with the mechanized guidewire drive assembly.

Abstract: A guide system for use with an endoscope, and a method of use is disclosed. The guide system can include a track, in the form of a rail, and a mating member for engaging the rail. The guide system can also include an accessory, such as an accessory guide tube through which a medical instrument can be carried external of the endoscope. An end cap can be provided to support the track relative to the distal end of the endoscope.

Abstract: A first medical instrument includes a flexible catheter and a medical guidewire extendable beyond a distal end of the catheter. The catheter is adapted to slidably receive a rail-coupling portion of an adjunct medical device. The medical guidewire has first and second segments, wherein the bending moment of inertia of the first segment is less than the bending moment of inertia of the second segment. A second medical instrument includes a flexible catheter, a mechanized guidewire assembly, and a medical guidewire extendable beyond a distal end of the catheter. The catheter is adapted to slidably receive a rail-coupling portion of an adjunct medical device. The medical guidewire has an exterior surface including a repetitive series of spaced-apart surface elevation features. One example of surface elevation features is external threads. The spaced-apart surface elevation features are adapted for operable engagement with the mechanized guidewire drive assembly.

Abstract: Devices and methods are provided which may be used for suturing, including performing a totally transoral surgical procedure, such as a posterior gastropexy procedure. A suture lock and cut assembly is provided to lock and cut one or more sutures in one motion, which motion can be a non-curved, non rotational linear motion. The suture lock and cut assembly with one or more sutures threaded therethrough may be pushed through, for example, a patient's esophagus and into the stomach by the tip of an endoscope, or alternatively, sized to be fed through the working channel of the endoscope.

Abstract: Control devices and methods are provided for controlling tension applied to a tensioning element extending through a flexible shaft, such as on an endoscopic device. In one exemplary embodiment, the methods and devices are configured to allow free movement and optionally provide slack to a control mechanism on an endoscopic device during insertion to allow free flexion of the shaft of the device, and to tension the control mechanism when desired to actuate, articulate, or otherwise control the working end or other portion of the device disposed within a patient's body.

Abstract: Various embodiments are directed to a curved-jaw dissector device for use in endoscopic surgical procedures. The device may comprise an end effector, a flexible shaft extending proximally from the end effector; a handle coupled to the proximal portion of the flexible shaft; and a translating member extending from the handle, through the flexible shaft, to the end effector, wherein the translating member is coupled to the handle at an actuator having a first and a second position such that placing the actuator in the first position causes the end effector to be in the closed position and placing the actuator in the second position causes the end effector to be in the open position.