Abstract: An electro-surgical device for performing tissue resection and cauterization includes an elongated body, a pair of arms extending from a distal end of the elongated body, and an electrode in communication with the pair of arms. The elongated body is adapted to be coupled to a source of energy at a proximal end. The electrode has a first region coated with an insulative coating and a second region for focusing energy emission. The coating can be a diamond-like carbon coating or other coating exhibiting resistance to cracking at high temperatures and high voltages. The coating can be deposited on a base section of a loop electrode while the end sections remain free of the coating. Alternatively, the coating can be unevenly deposited on the electrode. In other embodiments, the electrode can comprise a rollerball and the insulative coating can be deposited on selected or random portions of the rollerball.

Abstract: Surgical clips which are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus. are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape, and which are provided with a first structure adapted to prevent a movement of the clip in a direction perpendicular to a longitudinal axis of the clip after the clip is applied to tissue. In addition, the clips preferably also include a second structure adapted to prevent rotation of the clip about the longitudinal axis of the clip after the clip is applied to tissue.

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: Surgical clipswhich are particularly useful in the transoral invagination and fundoplication of the stomach to the esophagus are disclosed. The clips include first and second arms joined by a bridge to form a substantially U-shape. According to one embodiment, a barb is provided on one of the arms. According to another embodiment, at least one of the arms has a bendable retainer which is long enough to bend in a complete circle. According to another embodiment, the bendable retainer is removable.

Abstract: An apparatus for the transoral invagination and fundoplication of the stomach to the esophagus includes a clip applier having sharp toothed jaws for grasping and damaging the fundus prior to applying the clip. The clip applier has an overall diameter of less than 7 mm. The clip applier jaws are coupled to a pull wire via a linkage which increases the mechanical advantage and thus permits greater grasping force. A plurality of clip designs are also provided.

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 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.

Abstract: An automatic suturing instrument generally includes a proximal actuation handle assembly, a flexible tubular member, a control wire, and an end effector assembly. The control wire extends through the tubular member and the end effector-assembly is coupled to the distal end of each of the tubular member and the control wire, while the handle is coupled to the proximal end of each of the tubular member and the control wire. Actuation of the handle moves the control wire relative to the tubular member and thereby moves the end effector assembly from an open to a closed position. The end effector assembly generally includes two end effectors, a needle engaged by one of the end effectors (but which can be engaged by either end effector alternately), and a suture material. The end effector assembly further includes a needle passing mechanism that automatically alternates which end effector engages the needle each time the end effectors are moved into a closed position.

Abstract: A vacuum powered pump includes a spring biased piston or diaphragm in a vacuum chamber coupled to a source of vacuum. When vacuum is applied to the vacuum chamber, the piston or diaphragm is moved in a first direction against the spring. A delayed action valve is coupled to the vacuum chamber to allow ambient air to enter the chamber only after the piston or diaphragm has been moved a substantial distance in the first direction. When the delayed action valve opens, air enters the vacuum chamber and the force of the entering air together with the bias of the spring propels the piston or diaphragm in a second direction opposite the first direction. The delayed action valve automatically closes and the process repeats so long as a vacuum source is coupled to the vacuum chamber. The reciprocal movement of the piston or diaphragm effects a pulsatile pumping of fluid through a fluid chamber having at least one check valve.