Abstract: Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.

Abstract: A high-flow low-pressure irrigation system (10) for directing a fluid to and recovering the fluid from an area within a body, the irrigation system (10) comprising a sheath (37) and a flexible catheter (20) disposed in the sheath (37). The catheter (20) comprises a plurality of apertures (26) at a distal pigtail portion (28). The fluid is directed through the apertures (26) and recovered through the sheath (37). Renal applications include alkaline irrigation for dissolution or uric acid stones, chemo-dissolution of cystine stones, irrigation with chemotherapy drugs after ureteroscopic tumor management, antibiotic irrigation for severe infection (e.g. fungal and bacterial), and irrigation of thrombotic agents (Alum Or direct delivery of Amicar for renal bleeding).

Abstract: A surgical valve includes a housing with a proximal housing portion and a distal housing portion cooperating to define a gel cavity. A seal material is disposed in the gel cavity and includes a gel having flow characteristics and incompressible characteristics. A distal guide tube is provided to facilitate retrograde insertion of a surgical instrument into the seal material. During assembly, pressure is applied by the housing portions to the seal material in order to form a circumferential seal and to close an instrument channel. Manufacture can be facilitated by use of a mandrel for maintaining the structural elements in axial alignment. Complimentary screw threads disposed between the first and second housing portions can be used to pressurize the gel and thereby create a locking force on an inserted instrument. Detented tabs can be provided to facilitate control of this locking force.

Abstract: Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.

Abstract: Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point.

Abstract: A plurality of semiconductor die, which may be of diverse size and diverse junction pattern, are fixed to a common lead frame and within a common package. The semiconductor die are mounted on respective main pad areas that are laterally spaced from one another and which have respective heat sinks. The heat sinks extend from the boundary of the device package and form external pins that are available for external connection at the same or at different potentials. Isolated pins are also provided. The device package may be used for high and low side chopper circuits, synchronous regulator circuits, single-mode bridges, and the like.

Abstract: A surface-mount semiconductor package comprises a semiconductor which is embedded within a plastic material body. Electrical control connections to the semiconductor package include first and second pads which are spaced apart from each other, making it easier to couple the devices in parallel. Power output is provided by metal pads. The pads may be partially sheared, to step them, thereby allowing a single thickness lead frame to be used in the manufacture of the device. On the lower face of the body there are channels which increase the electrical tracking distance and allow improved washing of residues after the device has been secured to a substrate.

Abstract: A surface-mount semiconductor package comprises a semiconductor which is embedded within a plastics material body (10). Electrical control connections to the semiconductor comprise first and second upstanding legs (12,14) which are offset from each other, making it easier to couple the devices in parallel. Power output is provided by metal pads (16,18). The pads may be partially sheared, to step them, thereby allowing a single thickness leadframe to be used in the manufacture of the device. On the lower face of the body (10) there are channels (22,24) which increase the electrical tracking distance and allow improved washing of residues after the device has been secured to a substrate.