Abstract: A first medical instrument includes a flexible catheter having a distal end which has a substantially bullet-nose shape, which is insertable into a body lumen of a patient, and which has at least one guidewire passageway opening. The first medical instrument also includes a medical guidewire having a working portion extendable beyond the at-least-one guidewire passageway opening. A second medical instrument includes a flexible catheter, a medical guidewire having a working portion extendable beyond the distal end of the catheter, and at least one wire length counter which is operably connectable to the medical guidewire to measure a length of the working portion being extended beyond the distal end of the catheter. A third medical instrument includes a flexible catheter, a medical guidewire, and a force/torque-limiting clutch operatively connectable to the medical guidewire.

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. The energy source is configured to deliver a first series of electrical pulses sufficient to induce cell necrosis by irreversible electroporation and a second series of electrical pulses sufficient to induce cell necrosis by thermal heating, through at least one of the first and second electrodes. The first series of electrical pulses is characterized by a first amplitude, a first pulse length, and a first frequency. The second series of electrical pulses is characterized by a second amplitude, a second pulse length, and a second frequency.

Abstract: Methods and devices are provided for delivering a preloaded loop of suture extending from a knotting element to tissue to be ligated within a body. The knotting element can be threaded with a loop of suture and loaded onto a deployment device using a loading device. A protective sheath can be placed around the knotting element and the loop of suture to facilitate safe insertion of the loop of suture through a working channel of a minimally invasive device.

Abstract: A positionable imaging device includes a body defining a first end and a second end. The body is configured to be received within an internal body cavity. An imaging device is located at the first end of the body. A releasable fastener is coupled to the body to removably attach the imaging device to tissue within the internal body cavity. A release mechanism is coupled to the releasable fastener to detach the imaging device from the tissue.

Abstract: An endoscopic overtube with articulating fingers extending from the distal end. The articulating fingers form an opening that may be expanded by a balloon. When positioned in a puncture site in a tissue wall, the articulating fingers dilate and enlarge the puncture site to allow for the body of the overtube to pass through the puncture site. In various embodiments, the fingers may further comprise cutting elements to assist in the dilation of the puncture site.

Abstract: A surgical device comprising a clevis defining a longitudinal axis and a jaw comprising a first member and a second member. A slider is slidably engaged to the clevis, the slider comprising a pin. The pin is receiveably engaged in the first slot and the jaw is selectively moveable between a first position and a second position through longitudinal movement of the slider. In various embodiments, the first and second members are movable between an angular open position, a parallel open position, and a parallel closed position.

Abstract: A connector configured to receive electrical energy from an energy source. A fastener is coupled to the connector. The fastener is configured for attachment through a tissue wall. A first electrode includes at least one electrically conductive portion and is coupled to the connector by a first electrically conductive wire.

Abstract: A method for positioning a device, such as an endcap, on an endoscope is disclosed. The method can be used, for example, for facilitating pressing an endcap onto an endoscope, including in those applications where the endscope is disposed in a sheath and the endcap is positioned at the distal end of the sheath.

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 surgical kit can be used to manipulate tissue within the body of a patient to create a working space within the body to allow a surgeon to easily access and work within the body using various surgical instruments. A surgical kit can include an implant comprised of a magnetic material which can be engaged with tissue within the body. The kit can further include a surgical instrument having a magnet which can be used to manipulate the implant and tissue engaged therewith. A surgical kit can include an anchor and a hanger configured to engage tissue at different locations within the body and a connection member engaged with the anchor and the hanger such that the connection member can be pulled to move the anchor toward the hanger. A surgical instrument which utilizes a vacuum provided to one or more movable members can also be used to manipulate tissue.

Abstract: An electrosurgical apparatus, system, and method are disclosed. The apparatus, includes an elongate member defines a longitudinal opening. An elongate actuator member is slideably movable within the longitudinal opening. A proximal jaw member having a proximal portion is fixedly coupled to a distal end of the elongate flexible member. A distal jaw member has a proximal portion fixedly coupled to a distal end of the elongate actuator member. A first aperture is defined between the distal portion of the distal jaw member and the proximal portion of the distal jaw member. The distal jaw member is slideably movable relative to the proximal jaw member. The system includes a handle portion to receive a proximal end of the elongate actuator member of the apparatus. A method includes preparing the apparatus for surgery.

Abstract: In various surgical techniques, a bipolar forceps can be used to seal a vessel in two locations such that the vessel can be incised at a location positioned intermediate the two seal locations. The bipolar forceps can include a cutting element which can be configured to incise the vessel. In various embodiments, the cutting element can include a sharp edge which can be moved relative to the vessel. In at least one embodiment, the cutting element can be electrically connected to a source of energy. The bipolar forceps can include first and second electrodes positioned within first and second jaw members, respectively, wherein at least one of the jaw members can include a substantially tapered profile and can be configured to pull the vessel away from the surrounding soft tissue. Such jaw members can include ridges, teeth, and/or a textured outer surface configured to grip the soft tissue and/or vessel.

Abstract: A bipolar forceps including a first electrode, a second electrode, and a conductor operably connected to an electrical source, wherein the conductor can be selectively placed in electrical communication with the first electrode when the first electrode is moved between open and closed positions. The conductor can include a contact end which is not in contact with the first electrode when the first electrode is in its open position. In such an open position, the first electrode may not be in electrical communication with the electrical source and, as a result, current may not flow through the first electrode. The first electrode can be moved into its closed position such that the first electrode is in contact with the contact end of the wire. In such a closed position, the first electrode may be in electrical communication with the electrical source allowing current to flow through the first electrode.

Abstract: A first medical instrument includes a flexible catheter and a medical guidewire extendable beyond a distal end of the catheter. 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 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: An overtube for use with an endoscopic surgical instrument. In various embodiments, the overtube may comprise a substantially flexible helically wound continuous member forming a series of helical coils that define a hollow passage sized to receive a portion of the endoscopic surgical instrument therethrough. The coils may be configured to selectively interlock with each other to stiffen the overtube. An actuation system may be employed to steer the overtube and selectively stiffen it. Some embodiments include a second substantially flexible helically wound member that may be selectively wound between the first substantially flexible helically wound member or segments thereof.

Abstract: An electrical ablation device includes an elongated flexible member having a proximal end and a distal end. A clamp jaw portion is located at the distal end of the elongated flexible member. The clamp jaw portion is operatively movable from an open position to a closed position. A cutting blade is located in the clamp jaw portion. The clamp jaw portion is adapted to couple to an electrical waveform generator and to receive an electrical waveform.

Abstract: An electrical ablation device includes an elongated flexible member having a proximal end and a distal end. A clamp jaw portion is located at the distal end of the elongated flexible member. The clamp jaw portion is operatively movable from an open position to a closed position. A blunt dissection portion is formed on the clamp jaw portion. The clamp jaw portion is adapted to couple to an electrical waveform generator and to receive an electrical waveform.

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: 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: 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.