Abstract: Instrumentation for transoral treatment of gastroesophageal reflux disease (GERD) are disclosed. In a preferred embodiment, an instrument includes a remotely operable invagination device for atraumatically approximating the lower esophagus and fundus of the stomach and for invaginating the gastroesophageal junction into the stomach thereby involuting the surrounding fundic wall. The same or a separate instrument includes a remotely operable surgical fastening instrument for fastening together the invaginated lower esophagus and fundic wall. A method of surgically treating GERD is also disclosed.

Abstract: A fixed blade utility knife has a housing provided by a lower handle portion, an upper lever portion, and a nosepiece at one end thereof which seats one end of the handle and lever. The lever is pivotably supported on the nosepiece, and a blade holder in the nosepiece is pivotably supported on the handle. The blade is seated in the holder and extends outwardly of the nosepiece, and a blade guard of generally U-shaped cross section extends about the cutting edge and is slidable in the nosepiece to extend outwardly to sheathe the cutting edge and to be withdrawn into the nosepiece to expose the cutting edge. A manipulatable element slidably seated in the nosepiece is engaged with the blade guard to effect its sliding movement. Pivoting of the lever into an open position releases the blade from engagement in the holder so that it may be easily replaced.

Abstract: Instrumentation for transoral treatment of gastroesophageal reflux disease (GERD) are disclosed. In a preferred embodiment, an instrument includes a remotely operable invagination device for atraumatically approximating the lower esophagus and fundus of the stomach and for invaginating the gastroesophageal junction into the stomach thereby involuting the surrounding fundic wall. The same or a separate instrument includes a remotely operable surgical fastening instrument for fastening together the invaginated lower esophagus and fundic wall. A method of surgically treating GERD is also disclosed.

Abstract: A liquid light guide for surgical instrumentation, includes a flexible elongated tube having opposed tube portions, a transmissive member positioned within each tube end portion of the elongated tube to enclose an interior portion of the elongated tube and a light transmissive medium filling the interior portion of the elongated tube. A sealing mechanism forms a fluid tight seal between each tube end portion and the light transmissive plug to prevent leakage of the fluid from the tube. The liquid light guide is capable of providing excellent light transmission over the entire visible spectral range while substantially reducing undesired transmission of infrared and ultraviolet radiation. The light guide is contemplated to be used with an endoscope and is cost-effective to manufacture. Methods of making and using the disposable light guide also are disclosed.

Abstract: Instrumentation for transoral treatment of gastroesophageal reflux disease (GERD) are disclosed. In a preferred embodiment, an instrument includes a remotely operable invagination device for atraumatically approximating the lower esophagus and fundus of the stomach and for invaginating the gastroesophageal junction into the stomach thereby involuting the surrounding fundic wall. The same or a separate instrument includes a remotely operable surgical fastening instrument for fastening together the invaginated lower esophagus and fundic wall. A method of surgically treating GERD is also disclosed.

Abstract: An apparatus and system are disclosed for indicating relative positions of elements in a surgical apparatus. The indicating elements can include electrical circuitry that activates visual, audible or tactile indicators, thereby alerting the user that an event has occurred with respect to the instrument. In a circular anastomosis device, the indicator is preferably positioned at a proximal end of the device.

Abstract: A novel surgical instrument suitable for insertion and assembly of surgical fasteners, such as multi-ring compression devices, for circular anastomosis of tubular or hollow organ tissue sections, including a body having means to support and align the rings, means for clamping the rings around the free ends of the tissue sections, means for coring away excess clamped tissue and the centers of the rings, separate means for releasing the clamped rings from the instrument and dwell means to delay releasing the rings until after the coring operation is complete. The dwell means consists of an external cup containing separate and coaxial elements for the coring means and the releasing means which are provided with a series of recesses and a plurality of shifter keys to separate the operation of coring from the separate operation of releasing the assembled multi-ring compression device from the instrument.

Abstract: A surgical instrument for performing a circular anastomosis is disclosed. The instrument is provided with sealing means to permit use during endoscopic procedures. The first seal is fabricated from polyethylene foam, is disposed about an elongate member and is in at least partial contact with an inner surface of a compression member. The second seal is an O-ring seal configured and dimensioned to at least partially contact an outer portion of the compression member and an inner portion of an outer tube. The second seal is disposed intermediate of the compression member.

Abstract: A surgical instrument for performing a circular anastomosis is disclosed. The instrument is provided with sealing means to permit use during endoscopic procedures. The sealing means includes a first, O-ring seal disposed intermediate of a compression member, wherein the first seal is configured and dimensioned to at least partially contact an outer portion of the compression member and an inner portion of an outer tube. The second seal at least partially disposed proximal the first seal and has a first diameter portion, a second diameter portion and is disposed about the compression member. The compression member has at least one aperture which the second seal is adapted to engage.

Abstract: A novel surgical instrument suitable for insertion and assembly of multi-ring compression devices for circular anastomosis of tubular tissue sections including a body having means to support and align the rings, means for clamping the rings around the free ends of the tissue sections, means for coring away excess clamped tissue and the centers of the rings, separate means for releasing the clamped rings from the instrument and dwell means to delay releasing the rings until after the coring operation is complete. The dwell means consists of an external cap containing separate and coaxial elements for the coring means and the releasing means which are provided with a series of recesses and a plurality of shifter keys to separate the operation of coring from the separate operation of releasing the assembled multi-ring compression device from the instrument.

Abstract: A drive clutch mechanism for a pop-up oscillating irrigation sprinkler which serves to protect the internal components of the sprinkler against forceable rotation of the pop-up assembly by vandals, or others, and which when operated does not disturb the previous setting of the trip mechanism in the sprinkler.

Abstract: An irrigation sprinkler which may include a pop-up assembly driven by a water-flow powered motor. A nozzle is mounted on the upper end of the pop-up assembly and is rotated through an adjustable arc to irrigate a sector of a particular size, and it is automatically reversed at the end points of the selected irrigated sector to oscillate back and forth across the sector. The sprinkler is constructed so that if the pop-up assembly is rotated forceably beyond its preset arc of coverage, either by vandals or others, the sprinkler itself is not damaged, but it will automatically reset itself into its previously preset arc of coverage.

Abstract: An irrigation sprinkler with an internal assembly which is caused to turn back and forth through a preset arc so that a nozzle at the upper end of the assembly may irrigate a sector of land of a particular size, and in which the internal assembly arc of the internal assembly is adjustable by depressing a spring-loaded arc-adjust screw in the end of the assembly by a small standard screwdriver, or the like, and rotating the screw either clockwise or counterclockwise to decrease or increase the arc.