Abstract: A steerable multi-linked device. The device includes a first multi-linked mechanism and a second multi-linked mechanism. At least one of the first and second multi-linked mechanisms is steerable and includes a modular link assembly at an end thereof. The modular link assembly includes a base, and a tip removably connected to the base.

Abstract: Systems and method are disclosed whereby elongate medical instruments may be registered to adjacent tissue structures and other structures, and may be navigated and operated in a coordinated fashion to maximize ranges of motion, ease of use, and other factors. A method for registering an instrument relative to nearby structures may comprise moving a portion of the instrument between two in situ positions, tracking movement during this movement with both a kinematic model and also a localization sensor based configuration, determining the orientation of the tracked portion relative to both the instrument coordinate system used in the kinematic modeling and also a localization coordinate reference frame, and adjusting the orientation of the instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors. Methods and configurations for navigating coupled and registered instrument sets are also disclosed.

Abstract: A medical robotic system includes an entry guide with articulatable instruments extending out of its distal end, an entry guide manipulator providing controllable four degrees-of-freedom movement of the entry guide, and a controller configured to limit joint velocities in the entry guide manipulator so as to prevent movement of tips of the articulatable instruments from exceeding a maximum allowable linear velocity when the entry guide manipulator is being used to move the entry guide.

Abstract: An arrangement for surgery including a hub and a cannula assembly connected thereto. The cannula assembly defines a first fully enclosed chamber extending substantially along a length of the cannula assembly, with the first fully enclosed chamber being coextensive with a head central passage of the hub such that a first tool is configured to extend through the hub and the first fully enclosed chamber. The cannula assembly defining a second fully enclosed chamber that extends along only a portion of the length of the cannula assembly and spaced from the hub. The second fully enclosed chamber having an entrance and an exit being spaced from the hub for allowing a second surgical tool to extend through the second fully enclosed chamber without also passing through the hub or the first fully enclosed chamber. The first fully enclosed chamber and the second fully enclosed chamber being substantially parallel.

Abstract: A self-propelling device includes a drive unit and a toroid unit supported thereabout. The toroid unit includes a track structure of a toroid shape and a roller support sleeve inside the track structure. Three belt portions are provided in the track structure with high rigidity. The drive unit includes an inner sleeve for mounting on an introducer of an endoscope, and an outer sleeve supported around the inner sleeve. An inner surface of the roller support sleeve and an outer surface of the outer sleeve extend triangularly. Drive wheels are disposed upstream and downstream of respectively flat portions of the outer sleeve. Two follower rollers are disposed on respectively each of flat portions of the roller support sleeve. The drive wheels and follower rollers nip the belt portions of the track structure to move the track structure endlessly.

Abstract: Provided is a guide sheath that is maintained in a desired shape and at a desired position even after a dilator has been pulled out therefrom so that the guide sheath can guide an insertion section to an appropriate position. A cylindrical guide sheath that guides an insertion section of a medical device to be inserted into a body cavity includes a base-end opening that is provided at a base end of a guide sheath body and into which the insertion section is inserted; a distal-end opening that is provided at a distal end of the guide sheath body and from which the insertion section extends out; and a shape maintainer that extends in an axial direction at an inner surface of the guide sheath body and has photo-curable resin that is cured by light.

Abstract: Systems and methods for treating spinal stenosis include endoscopic access devices and bone removal devices used to perform a foraminotomy or other bone removal procedures. A bone removal device includes a cannulotome with an endoscopic imaging lumen. Optionally, an endoscope retaining device can be used to facilitate advancement of the endoscope through the cannulotome.

Abstract: A body cavity access tube assembly includes a body cavity access tube having an external surface. A collapsible protective sleeve is positioned over the external surface and has a proximal end attached to the body cavity access tube and a distal end attached to a repositioning device The repositioning device is supported on the external surface of the body cavity access tube and has a released configuration wherein the repositioning device and the distal end of the collapsible protective sleeve are movable relative to a longitudinal axis of the body cavity access tube. The repositioning device also has an engaged configuration wherein the repositioning device and the distal end of the collapsible protective sleeve have a fixed position relative to the longitudinal axis of the body cavity access tube.

Abstract: The invention relates to an image apparatus for endoscopes, which makes sure easier viewing especially at a peripheral portion of a screen while taking care of the observing angle of view and size of an optical system. The image apparatus comprises an optical system adapted to form an optical image of an object, an image pickup device adapted to convert the formed optical image into electric signals to obtain image data, and an image processing means adapted to move and transform a position of the optical image acquired by the image pickup device. A radiation direction magnification is transformable by the image processing means independently from a concentric direction magnification, and a magnification for a conformal object is higher at a peripheral portion than at a central portion of a screen.

Abstract: An endoscopic bite block, with teeth position defining regions which guide the subject's teeth to grip the bite block in their natural position, with the teeth of the upper jaw positioned further out than the lower jaw teeth. These teeth position defining regions are also preferably curved to match the curved shape of the jaw. The upper and lower parts of the front plate of the bite block may also be positioned at different distances out, so that upper and lower lip regions both contact the front plate snuggly. The bite block may be used with separate oral/nasal cannulae, or may incorporate breath sampling or gas supply cannulae. A flexible flapped curtain at the outer end of the bite block may be provided to largely enclose the inner volume of the bite block to enable more accurate capnographic sampling under conditions of wide-open mouth breathing.

Abstract: A steerable endoscope has an elongated body with a selectively steerable distal portion and an automatically controlled proximal portion. The endoscope body is inserted into a patient and the selectively steerable distal portion is used to select a desired path within the patient's body. When the endoscope body is advanced, an electronic motion controller operates the automatically controlled proximal portion to assume the selected curve of the selectively steerable distal portion. Another desired path is selected with the selectively steerable distal portion and the endoscope body is advanced again. As the endoscope body is further advanced, the selected curves propagate proximally along the endoscope body, and when the endoscope body is withdrawn proximally, the selected curves propagate distally along the endoscope body. This creates a serpentine motion in the endoscope body that allows it to negotiate tortuous curves along a desired path through, around, and between organs within the body.

Abstract: A new, quick, simple, efficient, safe, and reproducible surgical technique for the treatment of female urinary incontinence, in which the posterior urethra is suspended using a tape passed through the obturator orifices from inside (underneath the urethra) to outside (thigh folds). A variety of specifically designed surgical instruments are utilized to perform this operative procedure.

Abstract: Operability in inserting an insertion part of an endoscope into a body cavity using an insertion assisting tool is improved. In an insertion assisting tool, a sidewall portion of a tube main body through which an insertion part of an endoscope is passed is provided with a sidewall opening part having a size in which the insertion part can pass through. A distal end side of the sidewall opening part is provided with a guiding valve, and the insertion part is guided by the guiding valve to be easily fed from the sidewall opening part. The guiding valve is swingably supported, and when the insertion part is fed from a distal end opening part of the tube main body, allowing the parallel state of being substantially parallel to an axial direction of the insertion part and passing the insertion part to a distal end opening part side are enabled.

Abstract: An endoscope overtube includes a flexible tubular member and a hub assembly provided at the proximal end of the tubular member. The hub assembly includes an elastic sleeve seal cuff extending about the inner surface of a body member of the hub. The ends of seal cuff are coupled to the body member. An inflation line extends into the body member in communication with the outer surface of the seal cuff. When fluid is pressurized through the inflation line, the cuff is distended inward to reduce the size of the opening through the port such that the cuff forms a seal about an endoscope received through the hub. The body member is preferably coupled to each of the flexible tubular member and to the elastic seal cuff using a snap-fit engagement of parts such that no fasteners, welds, glues, etc. are necessary for securing the hub assembly together.

Abstract: An access system includes a proximal handle, an overtube coupled to the handle, and an endoscope port extending through handle and overtube sized for receiving an endoscope therethrough. The overtube includes anatomic wall securing system that secures a distal portion of the overtube within a hole in the anatomic wall. The overtube is provided with a shaped distal portion or a controllably shapeable distal portion that aids in directing an endoscope inserted through the port to a particular location within the peritoneal cavity. The access system includes a system for insufflating/deflating the peritoneal space separately from the body cavity accessible via a natural orifice. The access system includes a closure system to cinch closed the hole made in the anatomical wall after the access system has been removed from the hole. Methods are provided for inserting the access system through the anatomical wall to perform intra-abdominal surgery.

Abstract: A surgical apparatus for introduction of laparoscopic instruments into an anatomical cavity through tissue at an entry site. The apparatus includes a body with a frustoconical-shaped wall. The body defines an interior cavity, an open bottom, and a substantially closed top wall with openings from which a plurality of ports extend upward therefrom. The ports are adapted to receive the laparoscopic instruments for introduction through the interior cavity and open bottom of the body into the anatomical cavity. In the preferred embodiment, the frustoconical-shaped wall of the body is placed through an incision in the umbilicus. In one aspect of the invention, the body is a unitary one-piece molded structure. A reinforcing belt or plate formed from a relatively hard material can be integral to the body.

Abstract: A self-propelling device includes a turning unit and a supporter. The supporter includes a first support sleeve, a second support sleeve and a cover formed respectively cylindrically. A drive wheel is secured to the first support sleeve in a rotatable manner. A pair of follower rollers are secured to the second support sleeve together. The cover is fitted on an outer surface of the second support sleeve externally, and disposed in the turning unit together with the second support sleeve. The turning unit is pressed by the follower rollers to the drive wheel. When the drive wheel rotates, the turning unit is circulated around the second support sleeve in a longitudinal direction of the first support sleeve. An inner wall of a body cavity will not be damaged, as the follower rollers are covered by the cover and do not appear externally even if the turning unit breaks.

Abstract: The biological introduction apparatus includes a drive force generation and input mechanism, a drive force transmission mechanism, a helical rotation member, a holding member and a positioning mechanism. The positioning mechanism positions a proximal end portion of a main body portion which is arranged in the helical rotation member to an intermediate portion arranged between a distal end portion of an insertion unit and a proximal end portion of the insertion unit.

Abstract: Endoscopic cannulas and methods of their use are disclosed. In some embodiments, an endoscopic cannula may include an elongated body having a proximal end and a distal end. A viewing channel and a working channel may extend through the elongated body. The viewing channel can be configured for passing therethrough an endoscope to the distal end of the elongated body for viewing outside the elongated body, while the working channel can be configured for passing therethrough an injection needle distally of the elongated body. The cannula may also include a suction pod disposed on a bottom surface of the elongated member, the suction pod being in communication with a suction channel extending through the elongated body to create suction between the suction pod and a tissue surface to temporary attach the elongated body to the tissue surface.

Abstract: A torque-transmitting, variably-flexible device, comprising a hollow body having a proximal end and a distal end, a torque-transmitting element operable to transmit torque from the proximal end towards the distal end of the hollow body, and a steering element operable to steer the distal end of the hollow body.

Abstract: The present embodiments provide an endoscopic access system comprising a handle including a proximal handle segment and a distal handle segment. A sheath extends distally from the distal handle segment. A flexible cannula having proximal and distal ends and lumen extending therebetween is sized to be advanced through a lumen of the sheath. The handle has a coupled state in which the proximal handle segment is engaged to the distal handle segment, and where the flexible cannula is disposed through at least a portion of both the proximal and distal handle segments. The handle further has an uncoupled state in which the proximal handle segment is disengaged from the distal handle segment, and where the flexible cannula is disposed only through the distal handle segment.

Abstract: The apparatus of one embodiment of the present invention is comprised of a flexible sheath instrument, a flexible guide instrument, and a tool. The flexible sheath instrument comprises a first instrument base removably coupleable to an instrument driver and defines a sheath instrument working lumen. The flexible guide instrument comprises a second instrument base removably coupleable to the instrument driver and is threaded through the sheath instrument working lumen. The guide instrument also defines a guide instrument working lumen. The tool is threaded through the guide instrument working lumen. For this embodiment of the apparatus, the sheath instrument and guide instrument are independently controllable relative to each other.

Abstract: An optical obturator for penetrating tissue and being at least partially positionable within a cannula assembly. The obturator may include an obturator housing at a proximal end of the obturator and may configured to be grasped by a user. The obturator housing may define an opening for receiving an endoscope, the obturator housing including an endoscope retention mechanism adapted for securing and stabilizing an endoscope inserted therethrough. The obturator housing may also include at least one attachment mechanism for enabling selective attachment and detachment of the obturator housing to the cannula assembly. The obturator may also include an obturator shaft integrally formed with the obturator housing. The obturator shaft may define a hollow interior configured to receive the endoscope inserted through the opening. A penetrating member is disposed at the distal end of the obturator shaft. The obturator may be formed as a single component, preferably from transparent material.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: An endoscope shaft made of a composite tube comprises an external tube and an internal tube which is softer and more resilient compared to the external tube as well as a helical spring for stiffening the composite tube. According to the invention, the helical spring in the relaxed state has an outer diameter which is larger than the inner diameter of the internal tube. Furthermore the helical spring is inserted in the internal tube preferably loosely at a spring bias, whereby it is radially pressed against the internal tube.

Abstract: A catheter introducer system for endoscopy includes a steering section and a propulsion section located near the end of the catheter that is introduced in a body cavity. The propulsion section is designed to pull the rest of the catheter inside the body cavity, so there is no need to push the catheter along. The propulsion section includes a distal and proximal gripper portion, each of which includes a suction ring extending circumferentially around the catheter. Each suction ring can include a plurality of suction holes disposed either on a recessed portion of the suction ring or on a portion surrounded by a peripheral ridge extending above the outer surface of the suction ring. The suction ring can also include an inflatable member for urging tissue against the perimeter of the suction holes.

Abstract: Dilators with a threaded distal portion and direct visualization capability may be used for penetrating and dilating stiff tissues and bones. The threaded portion of a dilator engages the tissue between the insertion site and the target site, and may be rotated for advancing through the target tissue in a more controlled fashion. The direct visualization capability may be used to visualize the ligament as the threaded distal portion passes through the ligamentum flavum. The devices and methods described may be used in procedures, for example, where ligaments surrounding the epidural space need to be dilated in order to deliver one or more surgical instruments into the epidural space.

Abstract: An optical access apparatus for receiving an endoscope to permit visualization during passage through tissue includes an access member dimensioned for insertion through body tissue. The access member defines a longitudinal axis and has a longitudinal opening for receiving an endoscope. The access member has a closed penetrating end adapted to pass through tissue. The closed penetrating end is transparent to permit visualization of tissue with the endoscope. The optical access apparatus further includes a locking collet coaxially mounted relative to the longitudinal axis of the access member and a manual member mounted adjacent the locking collet and operatively engageable therewith. The locking collet has internal surfaces defining an internal passage to permit passage of the surgical instrument.

Abstract: A method of transluminal surgery is provided, which utilizes an endoscopic surgery apparatus having pivotable arms attached by hinges on its distal end. The arms are interchangeable with arms of various configurations. The method includes the steps of inserting an endoscopic surgery apparatus into a body cavity of a patient, making an incision in the body cavity wall to allow access to the patient's abdominal cavity, and further inserting the apparatus through the incision. Surgery is performed at the desired surgical site and the apparatus is withdrawn into the body cavity where the incision is closed. Finally, the apparatus is withdrawn from the patient's body.

Abstract: An auxiliary thrust device includes a membrane, a carrier tube, and a drive cylinder. First and second insertion holes into which first and second torque wires are inserted are formed in a wire sheath. First and second gears are fixed to tip portions of the torque wires, which protrudes from a tip of the wire sheath, respectively. The first gear fixed to the first torque wire meshes with a spur gear portion of the drive cylinder, and the second gear connected to the second torque wire meshes with the first gear. Since the respective torque wires are inserted into one wire sheath and are bent in the same shape, a frictional force generated between the first torque wire and the inner surface of the wire sheath is substantially the same as that generated between the second torque wire and the inner surface of the wire sheath.

Abstract: A cannula assembly including a seal for an endoscopic internal magnetic camera tether. The seal may include stacked compliant membranes with an aperture in each membrane through which a camera tether may pass. The apertures may overlap. The at least one aperture may be arranged as a slit. Each of the apertures may comprise a wedge-shaped gap. The membranes may include engagement members that couple to engagement members on the cannula assembly. The cannula assembly may provide separate ports for the camera tethers and for a trocar or other endoscopic instrument passing through the cannula assembly. The cannula assembly also may include a rotating housing with two openings and a seal arranged in each opening. The cannula assembly may include a sleeve that encases a cannula tube. The sleeve may include a seal on its end and a channel on its periphery through which a camera tether may pass.

Abstract: An apparatus includes a flexible elongate member that defines a lumen and is configured to be inserted within a body passageway of a patient. The flexible elongate member includes a proximal portion, a distal portion, and a medial portion disposed between the proximal portion and the distal portion. The distal portion is movable between a substantially linear configuration and a curved configuration. A stiffening member is coupled to the flexible elongate member. The stiffening member is movable to a selected location along a length of the flexible elongate member to provide modified flexibility to the selected location of the flexible elongate member. The stiffening member may include a first portion and a second portion, the first portion having a first stiffness and the second portion having a second stiffness different than the first stiffness. The stiffening member may be disposed within a lumen or at an exterior portion of the flexible elongate member.

Abstract: An endoscopic screening system uses an apparatus has an endoscope with an upper/lower wheel and a right/left wheel for controlling bending of an endoscope tip within an organ being imaged; an intelligent mouthpiece adapted to precisely measure inclination of the endoscope using marks in degrees in both the novel mouth piece and in the new shaft; an endoscope shaft having both cross and longitudinal marks along a longitudinal length for digitalization of output to precisely obtain the length of insertion from a reference point to a tip of the endoscope; and an angulation device for measuring rotation of the upper/lower and right/left wheels. Every portion/part/side located within an organ is already assigned an alphanumeric code as part of the new nomenclature. The endoscopic screening system allows for imaging sequentially of an entire interior surface of a portion of the patient's gastrointestinal tract and image reconstruction of the surface with overlapping redundant pictures without image gaps.

Abstract: Systems for use in assisted respiration can permit insertion of one or more elongated medical instruments into the proximal and/or distal airway of a patient during administration of assisted respiration, which may, in some instances, proceed with a patient awake or only minimally sedated. In some systems, a bite block is coupled with a mask and is movable relative to the mask such that the system is capable of accommodating differing patient anatomies.

Abstract: Propellable apparatus, assemblies and related methods including a self-enclosed member are disclosed. The self-enclosed member can include an inner surface at least partially defining an enclosed region, and an outer surface that turns outwardly to engage a cavity or lumen wall in addition to turning inward to at least partially encompass a central region defining a longitudinal path. The apparatus can include an internal drive mechanism engageable with the outer surface of the self-enclosed member to provide relative movement between the self-enclosed member and the cavity or lumen wall. A tapered member, positioned on the apparatus adjacent an end of the self-enclosed member, can provide a size transition between an outer surface portion of the self-enclosed member and an outer surface of a payload insertable within the central region. In some examples, one or more reinforcing members can be integrated within the self-enclosed member for increased durability and rotational use.

Abstract: Propellable apparatus, assemblies and related methods including a self-enclosed member are disclosed. The self-enclosed member can include an inner surface at least partially defining an enclosed region, and an outer surface that turns outwardly to engage a cavity or lumen wall in addition to turning inward to at least partially encompass a central region defining a longitudinal path. The apparatus can include an internal drive mechanism engageable with the outer surface of the self-enclosed member to provide relative movement between the self-enclosed member and the cavity or lumen wall. A tapered member, positioned on the apparatus adjacent an end of the self-enclosed member, can provide a size transition between an outer surface portion of the self-enclosed member and an outer surface of a payload insertable within the central region. In some examples, one or more reinforcing members can be integrated within the self-enclosed member for increased durability and rotational use.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: A lubricant supplying device of an endoscope everting tube drive comprises a drive tube everted at least once to thus form an outer and an inner tube portion. Inside the inner tube portion an endoscope shaft is mounted in an axially displaceable manner. In addition a drive device is provided which encompasses the drive tube everted at least once or the inner tube portion thereof so as to apply a driving force for an advancing movement of the endoscope shaft onto the inner tube portion, the drive means being in fluid connection with a lubricant supplying line and a lubricant discharge line for introducing a lubricant via the drive device into the drive tube everted at least once and/or for discharging it. The lubricant supply line and the lubricant discharge are connected to the drive device in two locations thereof diametrically opposite with respect to the endoscope shaft.

Abstract: A guide tube having a tube; a ciliary portion including many cilia inclined in a longitudinal direction of the tube, provided in an outer peripheral portion of the tube; and a vibration portion provided on the tube for vibrating the ciliary portion so as to move the tube in the longitudinal direction.

Abstract: An apparatus includes an endoscope and a surgical instrument guide device. An elongated surgical instrument is allowed to insert through a working channel of the endoscope to cooperate with a processor module of the endoscope. The surgical instrument guide device includes a base member, an adjustment member, a catch, a cap member, fasteners, and a tubing. Pegs of the catch are fitted in positioning holes of the base member. A tube of the endoscope is inserted through the tubing of the surgical instrument guide device so as to dispose in close proximity to a target.

Abstract: An insertion auxiliary implement of the present invention includes: a tubular part into which a flexible endoscope insertion part which is insertable into a body cavity, and one of a treatment tool and a channel into which the treatment tool is insertable, are insertable; and a sealing member which has through holes for supporting the endoscope insertion part and one of the treatment tool and the channel in the tubular part, and which airtightly and movably contacts each of a periphery of the endoscope insertion part, a periphery of the treatment tool or a periphery of the channel, and an inner surface of the tubular part, and thereby maintains airtightness between a distal end and a proximal end inside the tubular part.

Abstract: There is provided a flexibility/rigidity adjustable apparatus which can change over its state between a flexible state in which such apparatus is freely bendable and a rigid state in which such bending is restricted when in use. A flexible closing cover 18 which can expand/shrink is provided on an outer circumference 2 of a flexible tube 1. A latching member 7 which moves together with the closing cover 18 is provided, and a latching-member receiving part 11 with which the latching member 7 can engage is provided at the outer circumference 2 of the tube 1. A closed space 21 formed between the closing cover 18 and the tube 1 is connected to an air inlet/outlet part 22. As the air is evacuated through the inlet/outlet part 22 to change the pressurized condition of the closed space 21 from an atmospheric pressure condition to a negative pressure condition, the closing cover 18 reduces its diameter around an axis 4, and the latching member 7 is caused to engage with the latching-member receiving part 11.

Abstract: A propellable apparatus comprises one or more rotatable membranes. The rotatable membranes include an inner surface at least partially defining an encircled region and a continuous outer surface that turns outward to engage a cavity or lumen wall, for example, and turns inward to at least partially encompass a central region defining a longitudinal path. The membranes are powerable to provide movement relative to the cavity or lumen wall. The apparatus further comprises an inflatable and deflatable support structure, configured to bias the outer surface of the membranes outward to engage the cavity or lumen wall at a first outer diameter, and be deformable inward in response to a compressive force or operator command to provide a second outer diameter that is less than the first outer diameter. In some examples, the rotatable membranes include belt-like membranes, and the inflatable and deflatable support structure includes at least one impermeable bladder.

Abstract: An endoscopic system including an accessory that fits over an endoscopic device, the accessory including at least one collapsible tube which has a collapsed state and an expanded state, wherein in the collapsed state, the accessory increases an outer perimeter of the endoscopic device by not more than 10%, and in the expanded state, the at least one collapsible tube has fluid that flows therethrough and the accessory increases the outer perimeter of the endoscopic device by at least 10%.

Abstract: A propulsion assembly for mounting on a tip device of an endoscope includes a barrel sleeve having inner and outer surfaces. A flexible endless track device is disposed to extend along the inner and outer surfaces of the barrel sleeve, for endlessly moving in an axial direction, for propulsion by contacting a wall of a body cavity. A drive gear is engaged with the endless track device, for moving the same. A driving mechanism rotates the drive gear. Engaging teeth are formed on the endless track device at a predetermined pitch, arranged serially, moved by the drive gear in mesh therewith. A peripheral surface of the engaging teeth is curved without a sharp form. Furthermore, a support sleeve is disposed between the driving mechanism and the endless track device, for supporting the drive gear in a rotatable manner.

Abstract: A selective cannulation method for a lumenal tissue's branch section includes: a first step for guiding an endoscope having a channel to an aperture section of the lumenal tissue; a second step for inserting a distal end of an endoscopic treatment instrument through the channel into the aperture section of the lumenal tissue; a third step for having the distal end of the endoscopic treatment instrument make contact with a pipe wall extending from the aperture section of the lumenal tissue to the branch section at two opposed points on the pipe wall by deforming the distal end of the endoscopic treatment instrument; a fourth step for sliding and moving the distal end of the endoscopic treatment instrument to the branch section while having the distal end of the endoscopic treatment instrument make contact with the pipe wall; and a fifth step for inserting the distal end of the endoscopic treatment instrument into a predetermined branch lumen divided from the branch section.

Abstract: An endoscopically inserting surgical tool is composed of an elongated flexible cord to be passed through a tool guide channel on an endoscope, and a tool action mechanism mounted on a fore distal end of the flexible cord to be projected out of the tool guide channel. The flexible cord has such a length that, when the tool action mechanism is projected out of a tool exit opening at the end of the tool guide channel, a proximal end portion of the flexible cord still remains outside and rearward of a tool entrance way which is provided on a manipulating head grip of the endoscope as an approach to the tool guide channel. A proximal end portion of the flexible cord is gripped in a rotary tool adjustor which is manipulable to turn the tool action mechanism clockwise or counterclockwise together with the flexible cord in the tool guide channel of the endoscope.

Abstract: Devices and methods are provided for manipulating scoping devices, surgical tools, and/or tissue. An exemplary system for manipulating a scoping device can include a scoping device having a working channel, a tether extending through the working channel, and an internal coupling member attached to the tether and positioned adjacent to a distal end of the scoping device. The internal coupling member can be magnetically coupled to an external coupling member. An exemplary method for manipulating a scoping device can include inserting at least a portion of a scoping device into a body cavity and positioning an external coupling member proximate to an external surface of tissue such that the external coupling member magnetically couples through the tissue to an internal coupling member disposed within the body cavity and attached to a tether passed through at least one working channel of the scoping device.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: A flexible conduit for insertion into a body lumen comprises a plurality of elements coupled end to end to define a conduit lumen. A first one of the elements includes a male portion and a female portion. A second element includes a female portion having an inner surface configured to engage a male portion of an outer surface of the first element to form a first ball joint. A third element includes a male portion, an outer surface of the male portion of the third element configured to engage an inner surface of the female portion of the first element to form a second ball joint. The male and female portions of the first element are adapted to fictionally engage the female portion of the second element and the male portion of the third element to establish a rigid connection therebetween.