Abstract: A cleaning head is provided having a support structure having a front edge. A foldable portion is coupled to the support structure at least partially along the front edge. A receptacle is connected to the foldable portion and defining a chamber therein. A suction inlet is arranged within the foldable portion for allowing debris to flow into the chamber. A cleaning pad is positioned underneath the support structure. An attachment tab extends from a rear edge of the cleaning pad.

Abstract: An air handling assembly and a cleaning apparatus having same are provided. The air handling assembly includes: a cyclonic chamber, a cyclonic cone, a dust collection chamber and an exhaust chamber. The cyclonic chamber has a dirty air inlet, a clean air outlet and a dust fall opening. The cyclonic cone is arranged inside the cyclonic chamber, an air exit of the cyclonic cone is arranged away from the dust fall opening, and an end of the cyclonic cone close to the dust fall opening is spaced apart from an end of the cyclonic chamber at which the dust fall opening is arranged.

Abstract: A cyclonic separation device and a vacuum cleaner including the cyclonic separation device are disclosed. The cyclonic separation device includes a housing and a cyclonic separation device. The cyclonic separation device is provided in the housing to allow dirt in a dust-containing airflow to be separated. The cyclonic separation device includes a first-stage cyclone separator and second-stage cyclone separators located downstream of the first-stage cyclone separator in a flow direction of the airflow. The second-stage cyclone separators surround the first-stage cyclone separator. The first-stage cyclone separator includes an air guide channel and a first-stage cyclone channel surrounding a part of the air guide channel. The dust-containing airflow enters, from the air guide channel, the first-stage cyclone channel for cyclonic separation and then enters the second-stage cyclone separators again through the air guide channel.

Abstract: Disclosed are an air duct assembly and a cleaning device. The air duct assembly includes a dirt collecting box, a filter, a cyclone separator and a fan. The dirt collecting box is provided with a dirt collecting cavity and the dirt collecting box is also provided with a dirt inlet and an air outlet communicated with the dirt collecting cavity. The dirt collecting cavity is provided with an air guiding structure, the filter is arranged in the air outlet, the cyclone separator is connected with the air outlet, and the fan is connected with the cyclone separator. The fan drives an air flow to enter into the dirt collecting cavity from the dirt inlet, and enter the cyclone separator from the air outlet after being guided by the air guiding structure, and then enter the fan from the cyclone separator.

Abstract: A cleaner is provided. The cleaner includes a suction head, a dust collector connected to the suction head, and a fan motor provided to generate a suction force inside the dust collector, wherein the dust collector comprises a housing having an inlet and an outlet, a fixed body arranged inside the housing, and a rotating body rotatably provided between the housing and the fixed body.

Abstract: The present invention aims to provide a medical image processing apparatus, a medical image processing method, a program, and an endoscope system that report a region of interest without interrupting observation of a medical image. The above problem is solved by a medical image processing apparatus including: an emphasis processing unit that emphasizes a position of a region of interest included in a plurality of medical images sequentially displayed on a display unit; and a transition time setting unit that sets a transition time in accordance with a feature quantity of the region of interest, in which the emphasis processing unit emphasizes the position of the region of interest at a first emphasis level and, after the transition time has elapsed from emphasis at the first emphasis level, emphasizes the position of the region of interest at a second emphasis level relatively lower than the first emphasis level.

Abstract: A surgical hub is disclosed. The surgical hub includes a processor and a memory coupled to the processor. The memory stores instructions executable by the processor to receive first image data from a first image sensor, the first image data represents a first field of view, receive second image data from a second image sensor, wherein the second image data represents a second field of view, and display, on a display coupled to the processor, a first image rendered from the first image data corresponding to the first field of view and a second image rendered from the second image data corresponding to the second field of view.

Abstract: Systems and methods may display and/or provide analysis of a number of selected images of a patients gastrointestinal tract collected in-vivo by a swallowable capsule. Images may be displayed for review (e.g., as a study) and/or for further analysis by a user. A subset of images representing the stream of images and automatically selected according to a first selection method may be displayed. On user input, additional images corresponding to a currently displayed image may be displayed, where the additional images are automatically selected according to a second selection method. The second selection method may be based on a relation between images of the stream of in-vivo images and the currently displayed image.

Abstract: An endoscope system capable of easily measuring a size of a subject is provided. In the endoscope system, since an index figure indicating an actual size of a specific region of a test object is displayed together with an image of the subject, a user can measure the specific region easily by comparing the specific region with a marker. Since the size of the index figure is set in accordance with a spot position, there is no need for distance measurement, a device configuration is simple, and measurement can be quickly and easily performed. In addition, a specific value of the “actual size” can be set in accordance with conditions, such as the type of test object and the purposes of measurement. Additionally, an affected region can be the specific region in a case where the test object is a living body.

Abstract: Embodiments of the disclosure include an endoscope tip assembly for use on an endoscope, during procedures. The endoscope tip assembly may include a base configured to receive an endoscope tip configured to not disengage from the endoscope tip during a procedure. The endoscope tip assembly may also include a plurality of struts which is connected by a webbing, may fold flat during insertion, and may assume a balloon-like shape during withdrawal.

Abstract: A device for distending a body lumen for enhanced visualization with a capsule endoscope includes a plurality of struts configured to extend from the capsule endoscope, a retention mechanism configured to attach the plurality of struts to the capsule endoscope, and a trigger configured to release the retention mechanism.

Abstract: Systems, apparatuses, and methods are discussed herein for an endoscope. The endoscope has a distal tip with an oblique portion and a flat portion, the oblique portion defines a plane that forms an angle between and including 20 and 40 degrees to a central axis of the endoscope. A related sheath may have similar features at the distal tip.

Abstract: Tools and systems are provided for the delivery of accessory devices to endoscopes. A device delivery system for delivering an endoscopic device to an endoscope, comprises an insertion instrument having a pair of pivotable arms. The arms extend from a device delivery portion of the insertion instrument at a first end, into a handle portion at an opposed, second end, and are connected together at a pivotable connection. A bracket is connected to a back plate for placement of a device to be delivered thereagainst. An extension shaft extends from the back plate for placement through a working channel of the endoscopic device to be delivered. The system further comprises a removable spacer for enclosing the device delivery end of the insertion instrument.

Abstract: The present invention provides a robotic locomotive device (1) that is capable of driving itself forwards and backwards, anchoring and steering itself whilst inside a tubular structure (200), for example, the human colon, or any structure comprising two opposing walls (202, 204). In this respect, the device is made up of two or three segments (102, 104, 106) covered in an elastic material and driven by an internal actuating mechanism. All of the segments (102, 104, 106) have a concertina configuration that enable a shortening and lengthening motion. As well as contracting and extending in length, at least one of the end segments (102, 106) is capable of bending at an angle away from the longitudinal axis such that it becomes wedged or jammed between the walls (202, 204) of the tubular structure (200). That is, the end segments (102, 106) are capable of both a bending action and a contracting and extending action.

Abstract: A camera head with multiple image sensors that may be detachably connected to an endoscope is presented. Each sensor capturing a portion of the image by the attached endoscope. One sensor receives two portions of the image light at opposing sides of the central image area, and another sensor receives the central image area. The output from the multiple sensors is combined and manipulated into a single higher resolution image which can then be displayed to the user. A virtual horizon rotation feature is also provided which can rotate a displayed image within a combined field of view including data from the multiple image sensors. Various light directing element designs are provided to direct image light to the multiple sensors.

Abstract: A light source apparatus, a medical observation system, an adjustment apparatus, an illumination method, an adjustment method, and a program that enable performing light modulation on a semiconductor light source through PWM control and current control without the necessary of a complicated work are provided. A light source apparatus 3 includes a first light source section 31 that emits a first light, a second light source section 32 that emits a second light, and a light source control section 33 that controls each of a pulse emission time and a pulse emission intensity of the first light and performs a control that changes one of a pulse emission time and a pulse emission intensity of the second light with the other one of the pulse emission time and the pulse emission intensity of the second light fixed.

Abstract: Introduced here is an ingestible device that can comprise a capsule, an intervention tool, and a processor configured to controllably employ the intervention tool to manipulate structures in a living body. The ingestible device may further comprise a camera that is configured to generate images of various in vivo environments as the ingestible device traverses the living body. These images may be wirelessly transmitted to an electronic device located outside of the living body to enable greater control over the intervention tool.

Abstract: A system for performing a surgical procedure includes a bronchoscope, monitoring equipment coupled to the bronchoscope, a tracking system, a positioning assembly, and a biopsy tool. The biopsy tool includes an elongated flexible body extending from a proximal end to a distal end and a biopsy member formed on the distal end of the elongated flexible body. The biopsy member includes a tissue-receiving portion defining an opening including sharpened edges. The sharpened edges are disposed on the interior perimeter of the opening and are capable of cutting tissue. A biopsy tool is also provided.

Abstract: The disclosure includes a connection method to fluidly connect a fluid pathway in a handle is formed co-linearly or axially and connects to a lumen through a tool and shaft. The body and movable latch may be an integral single molded plastic part connected by a flexible. In operation actuating the movable latch to raise or lower a latching beak within a corresponding open guide in the plastic body. The shaft fits into a shaft guide in the body which intersects the beak guide to temporarily latch the shaft to the body via a mounting fixture the shaft with the beak; and, wherein the body has a face end and a tail end.

Abstract: A surgical instrument includes a shaft, a force transmission mechanism disposed at a first end of the shaft, an end effector disposed at a second end of the shaft, an actuation element that extends along the shaft from the force transmission mechanism to the end effector, and an actuation element guide extending along the shaft. The actuation element guide defines a lumen in which the actuation element guide is received. The actuation element guide is compressed into a pre-compressed state along at least a portion of an axial length of the shaft. The actuation element guide can be compressed between first and second blocks of the instrument. The instrument can include a flush tube configured to receive a cleaning fluid, with the actuation element guide being in flow communication with the flush tube to receive the cleaning fluid in the lumen of the actuation element guide.

Abstract: A system for performing minimally invasive procedures in a working space within a body lumen of a patient including a flexible catheter configured to receive a working instrument therethrough. The flexible catheter has a working space expanding system positioned at the distal portion, the working space expanding system including first and second flexible elements movable from a non-expanded insertion position to an expanded position forming an expanded region to expand the working space within the body. The first and second flexible elements are connected at a distal region by a coupling structure. A stabilizing member stabilizes the distal portion of the flexible catheter.

Abstract: The invention regards a device for reconstituting a bioactive agent and forming a paste, the device comprising:—a container (2) containing the bioactive agent,—a first syringe (4) containing a liquid,—a second syringe (5) containing a paste forming material,—a connector element (6) configured for establishing sequential fluid connections between 1) the first syringe and the container, 2) the container and the second syringe, and 3) the first and second syringes, such that the liquid can be transferred from the first syringe to the container to reconstitute the bioactive agent, whereupon the reconstituted bioactive agent can be transferred from the container into the second syringe to form a paste, and the paste can be transferred to the first syringe.

Abstract: In one aspect, the present invention provides a device for occluding an aperture in a body, for example, a patent foramen ovale (PFO), including a first side adapted to be disposed on one side of the septum and a second side adapted to be disposed on the opposite side of the septum. The device has an elongated, low-profile delivery configuration and a shortened, radially expanded deployment configuration. The first and second sides are adapted to occlude the aperture upon deployment of the device at its intended delivery location. The device also includes a radially expandable center portion. In some embodiments, the center portion includes a plurality of ribs provided by slits in device. The ribs expand radially when the device is deployed. The expandable center portion facilitates the positioning of the device in the aperture. The device can be secured in the deployed configuration using a catch system.

Abstract: Systems, methods and compositions relating to delivering synthetic polymer formulations to the body are described, which can be used by a range of medical personnel including those with minimal experience and training. Under some embodiments, the present invention relates to systems and devices for delivering polymer formulations to a body cavity (e.g. peritoneal cavity) to reduce or stop bleeding. Under some embodiments, an initial percutaneous access pathway is first formed using a delivery device with a probe and needle mechanism that automatically stops the advance of the device upon insertion into a body cavity or space, thus minimizing user error and improving patient safety. The hollow probe then allows transmission of polymer, mixed with gas and/or additional substances, from a holding chamber or canister to flow through the device and hollow probe into the patient's anatomic cavity or space of interest, stopping expansion when the device senses the appropriate pressure.

Abstract: The present disclosure is directed to embodiments of an occlusive medical device including a frame and at least one closure coupled to the frame. The frame includes a distal annular flange having a radially outer surface and a radially inner surface, a proximal annular flange having a radially outer surface and a radially inner surface, and a waist portion extending between and connecting the distal annular flange to the proximal annular flange. The radially inner surface of the distal annular flange, the waist member, and the radially inner surface of the proximal annular flange define an unobstructed passageway through the frame. The at least one closure is configured to close the passageway to: (i) provide an occlusive effect, and (ii) enable subsequent access through the passageway.

Abstract: A surgical protective equipment includes: a first boundary surface having a horseshoe shape in a plan view; a second boundary surface disposed face-to-face with the first boundary surface and having a horseshoe shape in a plan view; an inner surface disposed between the first boundary surface and the second boundary surface, and forming a groove by connecting an inner end of the first boundary surface and an inner end of the second boundary surface to each other; and an outer surface connecting an outer end of the first boundary surface and an outer end of the second boundary surface, wherein a surgical incision area is inserted in the groove.

Abstract: A delicate tissue retraction system for use with a navigation probe having a probe shaft and a probe tip at a distal end of the probe shaft. The delicate tissue retraction system includes a retractor and an introducer that is removably installed within the retractor. The introducer has a wall forming a hollow channel extending from a proximal introducer end to a distal introducer end. A mount is integrally formed with the introducer and extends from the distal introducer end into the channel. The mount is positioned to surround the probe tip when the navigation probe is at a fully inserted position within the introducer with the probe tip at the distal introducer end.

Abstract: The present disclosure is directed to a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing an intravascular device having a distal portion and a longitudinal axis and inserting the intravascular device into the vascular lumen. The method may further include positioning the distal portion in the vascular wall, rotating the intravascular device about the longitudinal axis, and advancing the intravascular device within the vascular wall.

Abstract: A toggle-type suture anchor that incorporates individual suture tensioning and locking without knot tying. The anchor includes an elongate toggle body having a working suture pre-threaded into a first passage and back up and out a second passage with a length running longitudinally adjacent the side of the anchor. A locking suture loop is pre-threaded into a third passage between the first and second passage and includes a collapsible loop that encircles a portion of the length of suture running longitudinally adjacent the side of the anchor. With the loop open, the working suture can slide through the anchor, however, when the loop is closed the working suture is locked in position to retain tension on the working suture. The anchor can be utilized in a pre-strung connected array of anchors.

Abstract: A toggle-type suture anchor for transtendinous implantation in bone to secure soft tissue thereto during repair of a tear, especially a rotator cuff repair. The anchor can include an elongate body with side surfaces defining a maximum diameter of the body. The body can also include proximal, middle and distal bores extending from the top surface to the bottom surface, each bore located at spaced intervals along the elongate body with a single suture passing into the proximal bore top surface and out the bottom surface, then back up through the distal bore bottom surface out the top surface leaving a length of suture extending past the middle bore bottom surface. To assure toggling in transtendinous delivery into bone, the elongate body can include a pair of fins extending both proximally and radially outward from the elongate body to prevent back out once placed in a bone hole.

Abstract: A suture suspension system including a flexible backstop extending along a longitudinal axis and having two ends positioned in a first direction in an undeployed configuration. A length of suture can be positioned through the flexible backstop and forms a bridge connecting and creating suspension between a first body to a second body. In a deployed configuration, the two ends of the flexible backstop are positioned in a second direction different from the first direction. The system may also include an anchoring body having the length of suture woven therethrough. A portion of the anchoring body is positioned on a distal surface of a second body and a portion of the flexible backstop is positioned on a proximal surface of the first body.

Abstract: A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.

Abstract: A method for operating a medical device, comprising: (1) providing a surgical end effector at a distal end of an instrument shaft and a rotating actuator at a proximal end of the instrument shaft, and (2) operating the rotating actuator to perform at least one of actuating the surgical end effector by sliding the rotating actuator in a proximal direction and rotating the surgical end effector with respect to the instrument shaft and about a shaft axis.

Abstract: A method is used to manufacture a knife of an end effector of a surgical instrument. The method includes forming the knife using metal injection molding. The knife has at least one feature having a molded shape. The method also includes machining the at least one feature of the knife to have a machined shape without machining the entire knife. The method also includes incorporating the knife into the end effector of the surgical instrument.

Abstract: In some embodiments, torque compensation in a clamping instrument includes control electronics obtaining an initial torque limit for the clamping instrument, adjusting the initial torque limit based on a temperature of a motor assembly used to operate the clamping instrument, and clamping the clamping instrument according to the adjusted torque limit. The adjusted torque limit corresponds to a maximum torque that may be applied by the clamping instrument to perform the clamping. In some embodiments, torque compensation in a stapling instrument includes control electronics obtaining an initial torque limit for the stapling instrument, adjusting the initial torque limit based on a number of times the stapling instrument has been fired, and firing the stapling instrument according to the adjusted torque limit. The adjusted torque limit corresponds to a maximum torque that may be applied by the stapling instrument to perform the firing.

Abstract: A compressible adjunct kit for use with a staple cartridge is provided and includes a biocompatible adjunct material and a pretreatment fluid. The biocompatible adjunct material is configured to be releasably retained on a staple cartridge and is configured to be delivered to tissue by deployment of staples in the staple cartridge. The adjunct material can be in the form of a porous polymer body. The pretreatment fluid is configured to be applied to the adjunct material to change the adjunct material from an untreated state to a treated state. The adjunct material in the untreated state is configured to exhibit a first degradation profile when delivered to tissue. The adjunct material in the treated state is configured to exhibit a second degradation profile, different from the first degradation profile, when delivered to tissue.

Abstract: A surgical stapling instrument. Various embodiments include an actuation system for selectively generating a plurality of control motions. A surgical end effector is operably coupled to the actuation system. The actuation system interfaces with an actuation member configured to operably engage rotatable camming members to fire staples within the end effector into forming contact with an anvil portion of the end effector.

Abstract: A surgical stapling instrument includes an anvil defining a plurality of staple forming pockets and a stapling head assembly. The stapling head assembly includes a body, a coupling member capable of actuating the anvil relative to the body, a staple deck defining a plurality of staple openings, and a firing assembly capable of driving a plurality of staples against the staple forming pockets of the anvil. The firing assembly includes a proximal driving body and an array of discrete staple driving segments positioned distal to the proximal driving body. The proximal driving body is slidably housed within the body. The staple driving segments each have a free proximal end. The proximal driving body is capable of simultaneously actuating the array of staple driving segments to drive the plurality of staples against the staple forming pockets of the anvil.

Abstract: An apparatus is provided for treating a vascular malformation. The apparatus includes an orifice section, an intra-vascular-malformation docking section, and a connecting section. The apparatus is configured such that, when unconstrained the orifice section is shaped so as to define an orifice-section curve that winds at least 2.5 turns around an orifice-section central axis at a changing distance from the orifice-section central axis, the intra-vascular-malformation docking section is shaped so as to define a docking-section curve that winds between 0.5 and 2 turns around a docking-section central axis at a changing or constant distance from the docking-section central axis, and the connecting section connects the orifice-section curve with the docking-section curve, and has an average radius of curvature that is different from an average radius of curvature of an outermost loop of the orifice-section curve. Other embodiments are also described.

Abstract: Devices for occluding an aneurysm are provided. In particular, the device include an upper member that sits against the dome of the aneurysm, a lower member that sits in the neck of the aneurysm, and a means of adjusting the overall dimensions of the device. Also provided are methods of making and using these devices.

Abstract: In some examples, a medical assembly includes a catheter and a delivery-assist tool. The catheter includes an elongated body comprising a proximal body portion and a distal body portion and defining a body inner lumen; and an expandable member located at the distal body portion, the expandable member defining an expandable member inner lumen. The delivery-assist tool includes a support structure configured to extend through the body inner lumen and the expandable member inner lumen of the catheter; and a flexible cover coupled to a distal portion of the support structure, wherein the flexible cover is configured to facilitate compression and retention of the expandable member in a delivery configuration while being advanced through a delivery sheath and while the support structure extends through the body inner lumen and the expandable member inner lumen.

Abstract: A medical device for treating hip joint osteoarthritis in a human patient by providing at least one artificial hip joint surface. The medical de ice comprises a prosthetic part or a bone plug adapted to be placed in a hole in the pelvic bone and a supporting member connected to said prosthetic part or bone plug, wherein the prosthetic part or the bone plug is adapted to be inserted into said hole from the abdominal side of the acetabulum and oriented, during the insertion, such that the concave interior surface is facing in the direction towards the caput femur. Wherein the medical device comprises an artificial caput femur surface or artificial acetabulum surface, and wherein a largest cross-sectional distance of said artificial caput femur or acetabulum surface is smaller than said bole, such that said artificial caput femur surface can pass through said hole.

Abstract: Devices, systems, and methods for bone stabilization, especially proximal humeral stabilization. The stabilization system may include a bone plate having an elongated portion extending along a longitudinal axis and an enlarged head portion extending from the elongated portion. The stabilization system may include an intramedullary nail having an upper portion and a lower portion extending from the upper portion, the upper portion and the lower portion including a plurality of holes. A plurality of fasteners may be configured to extend through one or more of the plurality of through holes in the bone plate and/or one or more of the plurality of holes in the intramedullary nail and into the bone. The plate and nail may each be used alone or in combination together to stabilize a fracture in a long bone, such as a humerus.

Abstract: A clot removal system comprises a catheter, a vacuum source, and a controller. The catheter comprises a proximal end, a distal end, and controller operating parameters and defines a lumen configured to be filled with a liquid column having a proximal portion. The vacuum source is configured to supply vacuum. The controller is configured to carry out a control pattern of turning on and off the vacuum based upon the controller operating parameters and is configured to receive the controller operating parameters in an automatic response to the catheter being operatively connected to at least one of the vacuum source and the controller and, responsive to the connection, to carry out the control pattern to change a level of vacuum at the distal end of the catheter.

Abstract: An elongate endovascular element for crossing through an obstruction in a blood vessel comprises: a proximal section; a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections; wherein the tapered intermediate section has a length that is substantially ?/2 or a multiple of ?/2, where ? is a wavelength of a driving frequency that will produce longitudinal resonance in the element.

Abstract: A clot removal device has an expandable treatment member having a distal tip and a proximal end, a delivery wire having a distal end coupled to the proximal end of the expandable treatment member, and a flow restrictor carried along the delivery wire at a location that is separate and proximal from the expandable treatment member. The flow restrictor has a body with a distal section and a proximal section, the distal section being covered and the proximal section being uncovered. The expandable treatment member is moveable relative to the flow restrictor, and can be retracted into the distal section.

Abstract: A clot retrieval device that includes a proximal scaffolding section with a closed proximal end and an open distal end; an inner elongate member; and a distal scaffolding section with a closed proximal end and an open distal end element.

Abstract: Mechanical thrombectomy apparatuses including an inverting, rolling conveyor region (“tractor”) at the distal end that are configured to grab and remove thrombus material. In particular, described herein are mechanical thrombectomy apparatuses that are adapted to prevent premature deployment of the tractor, e.g., by including a tractor hold (e.g., a housing, a lock, a clamp, etc.) or the like to secure the outer end of the tractor against and/or relative to the elongate inversion support.

Abstract: A surgical instrument includes an elongated shaft having a distal portion and a proximal portion coupled to a housing. An inner shaft member extends at least partially through the elongated shaft and is selectively movable in a longitudinal direction. An end effector is supported by the distal portion of the elongated shaft. The end effector includes upper and lower jaw members pivotally coupled to the distal portion of the elongated shaft about a pivot axis and including a pair of laterally spaced flanges. The pairs of flanges of the jaw members are arranged in an offset configuration such that one flange of the upper jaw member is positioned on a laterally exterior side of a corresponding flange of the lower jaw member, and the other flange of the upper jaw member is positioned on a laterally interior side of the other flange of the lower jaw member.

Abstract: A method for producing a medical hand-held instrument having two grip elements, pivotable relative to each other, and a spring element, with the method steps to be performed in the following sequence: providing the two grip elements each with a pivot-pin receiver eyelet formed thereon, at their one end portion and an articulation eyelet for the spring element formed thereon, providing the spring element with pivot pins arranged at or formed integrally with each spring end, inserting the pivot pins of the spring element into the articulation eyelets of the grip elements not yet pivotally coupled to each other, and bringing together the grip elements in the region of their pivot pin receiver eyelets and pivotally coupling the grip elements by inserting a pivot pin into the overlapping pivot pin receiver eyelets.