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, second, and third 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 at least 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: Methods and devices are provided for controlling movement of a working end of a surgical device, and in particular for performing various surgical procedures using an instrument having an end effector that can be articulated relative to an elongate shaft of the device. In certain embodiments, the end effector can also optionally rotate relative to the elongate shaft of the device, and/or the shaft can rotate relative to a handle of the device.

Abstract: An endoscopic instrument having a lumen stabilizing feature, including a flexible shaft having a first distal end for insertion into the gastrointestinal tract of a patient, a plurality of arm housings disposed about the periphery of the distal end, a plurality of arms retained within the arm housings, wherein the arms may be extended from and retracted into the arm housings; and a finger connected to an arm, wherein the finger may be rotated with respect to a lateral axis of the arm. Lumen stabilizing accessories for flexible endoscopic instruments are also disclosed.

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: A medical device for use on a bodily organ includes a concave support element that is removably attachable to the surface of the bodily organ, thereby defining an enclosed space adjacent to the bodily organ. The enclosed space is fluidly connected to a fluid management system for circulating a fluid inside of the enclosed space. The medical device also has an energy transfer element mounted to the concave support element and electrically connected to a control unit. In some embodiments, the energy transfer element transmits intense ultrasound energy in a frequency range of 1–30 megahertz, and the fluid acoustically couples the energy transfer element to the bodily organ, and the fluid also cools the energy transfer element.

Abstract: A surgical instrument useful in harvesting blood vessels such as veins and arteries and for manipulating and grasping tissue. The instrument has a pair of jaws and a closing tube to open and close the jaws.

Abstract: A surgical device for applying radio frequency energy to a portion of a captured vessel is provided. The device including: a first tube having an internal lumen for passage of a viewing device therein, the first tube having a substantially transparent first window at a distal tip thereof; a second tube slidingly disposed over the first tube, the second tube having a substantially transparent second window at a distal tip thereof, the second tube further having a slot for capturing a portion of the vessel; an actuator for sliding the second tube relative to the first tube between open and closed positions, wherein in the closed position an inner surface of the second window is aligned with an outer surface of the first window and captures the portion of the vessel therebetween; and at least one electrode affixed to one of the inner or outer surfaces and facing the other of the inner or outer surfaces for applying radio frequency energy to the captured portion of the vessel.

Abstract: The present invention is a method for accessing the abdominal cavity of a patient in order to perform a medical procedure therein. In one embodiment the method includes the step of inserting a guide wire into the upper gastrointestinal tract, via a gastric opening in the gastric wall and an abdominal opening in the abdominal wall of the patient, the guide wire having a first end that extends from the mouth of the patient, and a second end that extends from the abdominal opening of the patient. The method further includes providing an access device in the form of an elongated sheath having a lumen therethrough, attaching the first end of the guide wire to the distal end of the elongated sheath, and pulling the second end of the guide wire to position the access device into the upper gastrointestinal tract, wherein the distal end of the access device extends into the abdominal cavity while the proximal end of the access device extends out of the mouth of the patient.

Abstract: A bipolar electrosurgical instrument useful in harvesting blood vessels such as veins and arteries. The instrument has a pair of jaws and a central cutting element displaceable distally and proximally to dissect tissue contained between the jaws. The instrument has offset electrodes.

Abstract: A portable endoscopic vessel harvesting system for use with a video display for retracting, viewing, and accessing tissue. An embodiment of the vessel harvesting system can include a first housing, an endoscope detachably mounted to the first housing, and a second housing detachably mounted to the endoscope, where the first housing configured to be disposable and the second portion configured to be reusable.

Abstract: A bipolar electrosurgical instrument useful in harvesting blood vessels such as veins and arteries. The instrument has a pair of jaws and a central cutting element displaceable distally and proximally to dissect tissue contained between the jaws. The instrument has offset electrodes.

Abstract: An endoscopic vessel harvesting device and a method of endoscopic harvesting of vessels from a patients body. The method comprises locating the vessel, and inserting the vessel harvesting device through an incision. Dissecting the vessel from the surrounding tissue, and capturing side branch vessels in a vessel capturing means. Ligating and transecting the side branch vessels using electrodes and a knife located in the vessel capturing means. Finally, ligating and transecting the vessel, and removing the vessel from the patients body. The vessel harvesting device comprises a head piece, a shaft having a lumen for receiving an endoscope, and a vessel capturing means located on the head piece for capturing the side branch vessels in the receiver.

Abstract: An endoscopic device including a shaft having a lumen for insertion of an endoscope therethrough, a transparent headpiece defining a workspace and disposed at a distal end of the shaft, a handle disposed at a proximal end of the shaft, a plunger disposed at the distal end of the shaft and movable between a retracted and extended position, wherein in the extended position the plunger interacts with at least a portion of the headpiece to capture a vessel therebetweeen, an actuator for moving the plunger between the retracted and extended positions, and a ligator for cauterizing the vessel captured between the plunger and the portion of the headpiece.

Abstract: An endoscopic vessel harvesting device and a method of endoscopic harvesting of vessels from a patients body. The method comprises locating the vessel, and inserting the vessel harvesting device through an incision. Dissecting the vessel from the surrounding tissue, and capturing side branch vessels in a vessel capturing device. Ligating and transecting the side branch vessels using electrodes and a knife located in the vessel capturing device. Finally, ligating and transecting the vessel, and removing the vessel from the patients body. The vessel harvesting device comprises a head piece, a shaft having a lumen for receiving an endoscope, and a vessel capturing device located on the head piece for capturing the side branch vessels in the receiver.

Abstract: A surgical instrument for dissecting a vessel in a patient. The surgical instrument includes a spoon retractor having a proximal end and a distal end, said spoon retractor defining a working space in the tissue of a patient, a dissecting element proximate to the spoon retractor for dissecting tissue from a vessel, and a handle for manipulating the spoon retractor near the vessel. Also provided is a method for dissecting a vessel including the steps of providing the surgical instrument for dissecting a vessel in a patient described above. Making an incision in a patient. Inserting the spoon retractor into the incision. Creating a working space in the tissue of the patient near the vessel being dissected, and manipulating the dissecting element to further dissect tissue surrounding the vessel being dissected.

Abstract: The present invention is a medical device for use on a bodily organ of a patient. The medical device includes a concave support element that is removably attachable to the surface of the bodily organ, thereby defining an enclosed space adjacent to the bodily organ. The enclosed space is fluidly connected to a fluid management system for circulating a fluid inside of the enclosed space. The medical device also has an energy transfer element mounted to the concave support element and electrically connected to a control unit. In some embodiments, the energy transfer element transmits intense ultrasound energy in a frequency range of 1-30 megahertz, and the fluid acoustically couples the energy transfer element to the bodily organ, and the fluid also cools the energy transfer element.

Abstract: A surgical device including: a punch slidingly disposed in a housing for forming a hole in a first vessel; a cartridge movably disposed in the housing between a cutting and deploying positions, the cartridge having a second vessel and a coupler for coupling the first and second vessel loaded therein; a punch actuator for sliding the punch between the cutting and deploying positions; a cartridge actuator for moving the cartridge between the cutting and deploying positions, wherein while in the cutting position, the punch and cartridge are in position to permit the punch to form the hole in the first vessel and while in the deploying position, they are in position to deploy the second vessel; and a deployment mechanism for deploying the second vessel and coupler into the hole of the first vessel while the punch and cartridge are in the deploying position to create an anastomosis.

Abstract: An endoscopic device including a shaft having a lumen for insertion of an endoscope therethrough, a transparent headpiece defining a workspace and disposed at a distal end of the shaft, a handle disposed at a proximal end of the shaft, a plunger disposed at the distal end of the shaft and movable between a retracted and extended position, wherein in the extended position the plunger interacts with at least a portion of the headpiece to capture a vessel therebetweeen, an actuator for moving the plunger between the retracted and extended positions, and a ligator for cauterizing the vessel captured between the plunger and the portion of the headpiece.

Abstract: A surgical instrument for dissecting a vessel in a patient. The surgical instrument includes a spoon retractor having a proximal end and a distal end, said spoon retractor defining a working space in the tissue of a patient, a dissecting element proximate to the spoon retractor for dissecting tissue from a vessel, and a handle for manipulating the spoon retractor near the vessel. Also provided is a method for dissecting a vessel including the steps of providing the surgical instrument for dissecting a vessel in a patient described above. Making an incision in a patient. Inserting the spoon retractor into the incision. Creating a working space in the tissue of the patient near the vessel being dissected, and manipulating the dissecting element to further dissect tissue surrounding the vessel being dissected.

Abstract: A surgical device for applying radio frequency energy to a portion of a captured vessel is provided. The device including: a first tube having an internal lumen for passage of a viewing device therein, the first tube having a substantially transparent first window at a distal tip thereof; a second tube slidingly disposed over the first tube, the second tube having a substantially transparent second window at a distal tip thereof, the second tube further having a slot for capturing a portion of the vessel; an actuator for sliding the second tube relative to the first tube between open and closed positions, wherein in the closed position an inner surface of the second window is aligned with an outer surface of the first window and captures the portion of the vessel therebetween; and at least one electrode affixed to one of the inner or outer surfaces and facing the other of the inner or outer surfaces for applying radio frequency energy to the captured portion of the vessel.