Abstract: Modular systems comprising a cannula and at least one access port adjacent to a distal end of the cannula provide insertion of one or more therapeutic or diagnostic devices into a vessel or cardiac tissue through a single incision site. Other embodiments include a vessel introducer or multi-port introducer. The devices can be operated in combination or independently. The systems can be employed to provide multiple therapies, including blood perfusion, filtration, aspiration, vessel occlusion, atherectomy, and endoscopic devices. Methods of using the system for vessel cannulation are also disclosed herein.

Abstract: A hysteroscope for carrying out endoscopic operations in the uterus by way of an auxiliary instrument, consists of an inner shank and an outer shank surrounding the inner shank whilst forming a longitudinal channel, of a first fitting for supplying rinsing fluid to be supplied through the inner shank into the uterus and of a second fitting for removing rinsing fluid from the uterus via the longitudinal channel. Furthermore there are provided a third fitting on which the auxiliary instrument is introducable into the hysteroscope and is further distally movable through a working channel, and deflection means with which the distal end region of the auxiliary instrument is elastically laterally deflectable.

Abstract: A continuously rinsing double-sheath endoscope, which includes an inner sheath and an outer sheath. The inner sheath includes a feed duct and receives an optics. The outer sheath surrounds the inner sheath and cooperates with the inner sheath to subtend a return flow duct. The outer sheath is fitted at its distal end zone with at least one aperture to establish fluid communication between the return duct and the ambience of the outer sheath. Cross-sectional geometric centers of gravity of the inner and outer sheaths are mutually shifted along most of the length of the return-flow duct subtended between them.

Abstract: An enhanced endotracheal tube utilizing a fiber optic bundle positioned in its wall section to transmit light and a reflectively coated bore to transmit images is disclosed. Additional passages formed in the wall of the endotracheal tube are adapted to receive a stylette and to act as an air passage for inflating an inflatable cuff formed on the inner end of the endotracheal tube. The light transmitted through the fiber optic bundle aids in illuminating the patient's laryngeal area and the image is reflected along the reflectively coated bore to aid the physician in intubating the patient. Alternative embodiments using a bore with a sleeve having a different refractive index from that of the tube material and an enhanced endotracheal tube for use with children are shown.

Abstract: A fluid management assembly for use in an endoscopic procedure is provided. The assembly comprises a first line for fluid to flow therethrough from an endoscope to a Y-connector and a second line for fluid to flow therethrough from a drape to the Y-connector. The Y-connector is also in fluid communication with a third line which connects the Y-connector to a suction source which supplies a suction force and receives the fluid. According to the present invention the Y-connector is located in close proximate relation with respect to the suction source and the first and second lines are preferably co-joined along a portion of their lengths. The first and second lines define scope and drape legs, respectively, which are elongated in comparison to more conventional designs. These features of the present invention serve to optimize distention and eliminate pressure fluctuations in the operative organ during the surgical procedure.

Abstract: An apparatus and method for providing a biopsy device at the distal end of a medical device, such as an endoscope, are disclosed. The apparatus can include a device attached to an endoscope to guide the position of the end of the instrument, such as by constraining the instrument to bend in a predetermined manner, or otherwise guide the distal end of the instrument extending from the distal end of the instrument channel.

Abstract: The invention relates to an endoscope shaft comprising a hose body which forms a central working conduit and a number of functional conduits. According to the invention, the hose body is manufactured of an extruded synthetic material surrounded by a silicone clothing or cover which forms the outer layer of the endoscope shaft.

Abstract: An endoscope has a removable suction tube to facilitate cleaning and reduce the risk of patient infection. The endoscope includes an elongated flexible probe with a housing at its proximal end to control the direction and operation of the probe and for viewing images carried by optical fibers from the distal end of the probe. A recess or slot extending along either the suction tube or probe enables the suction tube to be removably secured to the probe. A suction tube connector at the proximal end of the suction tube allows the suction tube to be removably secured to the housing and also provides a connector for removable attachment to an external suction line. In the preferred embodiment, the suction tube connector includes means for regulating suction through the suction tube, such as a vent opening that can be manually sealed by a healthcare provider.

Abstract: An EEG electrode system for establishing positive electrical contact with the scalp, uses absorptive electrode wrap material in contact with metallic electrodes, with saturated electrode wrap material placed in contact with the scalp. Saturation of the electrode warp material with a conductive solution such as saline provides mechanically and electrically stable contact at multiple scalp electrode sites. An electrode wrap holder assembly holds the electrode wrap and an exposed portion of the electrode wrap in contact with the scalp, while providing access to the electrode wrap for re-wetting with the conductive solution if required. The electrode wrap holders are mounted in straps, hard caps or other headgear. Adjustment of the electrode wrap holders within the mounts further compresses the flexible, absorptive electrode wrap, causing flow of the conductive solution therein and enhancement of the electrical contact.

Abstract: A flexible tube having a laminated multi-layer structure including an outer layer composed of a main tube body layer formed of thermoplastic synthetic resin in a predetermined thickness and a reinforcing layer provided on the inner side of the main tube body layer, and an inner layer formed of a thin film sheet of air tight and low friction material. The inner layer is formed by rolling an elongated strip of a thin film sheet into a tubular form such that opposite lateral sides of the thin film sheet are overlapped one on the other to provide a thick wall portion extending longitudinally of and at one angular position of the inner layer.

Abstract: A medical endoscope with a sealed housing that defines a shaft. A working passage, which is open at its ends, extends through the shaft in a sealed manner in the longitudinal direction. The passage projects proximally beyond the housing and has a lateral branch passage for connection of a flow line. The branch passage is arranged on the housing so as to pass through the housing wall and a wall defining the working passage.

Abstract: An endoscope which has small bending resistance and is hard to be damaged or broken even when it is repeatedly used is disclosed. The endoscope includes a flexible insertion section 2 and an operation section 7 provided on the proximal end of the insertion section 2. The insertion section 2 has a sheath constructed from an outer layer 382 and the like, and elongated members such as an image guide 31 and light guides 32, 32 and the like are housed in lumens in the sheath. Further, each light guide 32 has an optical fiber bundle and a protective sheath 321 for protecting the optical fiber bundle. In the interior space of the protective sheath 321, a lubricant 5 containing a silicone oil and a solid lubricant is provided. The solid lubricant contains at least one of boron nitride, poly tetrafluoroethylene, and molybdenum disulfide. The solid lubricant is preferably formed into powder having an average grain size of 0.1 to 15 &mgr;m.

Abstract: An endoscopic instrument has a portion having an outer surface with a non-circular cross-sectional shape. The non-circular cross-sectional shape may be provided to the instrument by providing peripheral projections or fins along the length of the portion or by providing the periphery of the portion with a polygonal shape. Where fins are used, the fins are preferably quite small and only have a minimal effect on the fluid flow cross sectional area between the interior of the working channel and the endoscopic instrument. The resulting instrument has significantly reduced backlash while maintaining adequate fluid flow in the working channel. According to a second embodiment of the invention, a portion of the interior of the working channel of the endoscope has an interior surface having a non-circular cross sectional shape by the inclusion of a plurality of radially spaced and inwardly directed ribs or by being polygonally shaped.

Abstract: An electronic endoscope includes a solid imaging device with a rectangular effective imaging plane built into the tip of an inserting portion; and an endoscope channel through which endoscope fixing pieces are inserted; wherein the opening of the endoscope channel is positioned to the long side of the effective imaging plane of the solid imaging device at the tip of the inserting portion.

Abstract: An endoscope of the present invention includes a flexible tube section having an outer sheath layer composed of resin for constituting an endoscope insertion section and a slender tube member inserted into the endoscope insertion section, wherein the amount of shrink of the tube member after the completion of a high temperature/high pressure steam sterilization process is set as much as or greater than the amount of shrink of the flexible tube section after the completion of the high temperature/high pressure steam sterilization process.

Abstract: In an endoscope for ultrasonic examination, an optical examination mechanism is provided on a distal end of an insertion portion of the endoscope for endoscopic examination forwardly of the insertion portion. A probe insertion channel is disposed along the insertion portion so that a ultrasonic probe is passed therethrough. A probe guiding mechanism is disposed in the insertion portion to guide a distal end of the ultrasonic probe to project from the distal end of the insertion portion laterally of the distal end of the insertion portion.

Abstract: An endoscopic instrument has a portion having an outer surface with a non-circular cross-sectional shape. The non-circular cross-sectional shape may be provided to the instrument by providing peripheral projections or fins along the length of the portion or by providing the periphery of the portion with a polygonal shape. Where fins are used, the fins are preferably quite small and only have a minimal effect on the fluid flow cross sectional area between the interior of the working channel and the endoscopic instrument. The resulting instrument has significantly reduced backlash while maintaining adequate fluid flow in the working channel. According to a second embodiment of the invention, a portion of the interior of the working channel of the endoscope has an interior surface having a non-circular cross sectional shape by the inclusion of a plurality of radially spaced and inwardly directed ribs or by being polygonally shaped.

Abstract: A radially non-deformable surgical access catheter with a central lumen surrounded by plural peripheral lumens, the lumens being rigidly connected to each other to provide axial stiffness for the catheter as well as rotational stiffness for the catheter so that the catheter may be rotated about its longitudinal axis to place the instruments in any of the peripheral lumens into operational proximity to preselected tissue. Methods are also disclosed.

Abstract: A hysteroscope for carrying out endoscopic operations in the uterus by way of an auxiliary instrument, consists of an inner shank and an outer shank surrounding the inner shank whilst forming a longitudinal channel, of a first fitting for supplying rinsing fluid to be led through the inner shank into the uterus and of a second fitting for removing rinsing fluid from the uterus via the longitudinal channel. Furthermore there are provided a third fitting on which the auxiliary instrument is introducable into the hysteroscope and is further distally movable through a working channel, and deflection means with which the distal end region of the auxiliary instrument is elastically laterally deflectable.

Abstract: Surgical techniques and instruments are provided for preparing a disc space for implantation of a vertebral fusion device or implant. In accordance with one embodiment of the technique, a surgical instrument assembly is provided having an outer sleeve with distraction fingers at one end to maintain distraction of a disc space. A switching sleeve having a pair of rotatable distractors is coupled within the outer sleeve, and the sleeves are placed over a dilator until the distractor heads are placed within the disc space. The dilator is withdrawn and the disc space distracted by rotating the distractors of the switching sleeve. The switching sleeve is uncoupled from the outer sleeve and the fingers of the outer sleeve are then inserted into the disc space. The switching sleeve and dilator are then removed and the outer sleeve defines a channel therethrough that allows insertion of implants at bilateral locations within the disc space without movement or manipulation of the outer sleeve.

Abstract: An endoscopic instrument for the therapy of the heart muscle forming channels in the heart muscle tissue by way of laser energy and including a shank tube and at least one instrumentation channel for a laser fiber disposed in axial direction within the shank tube as well as central optics parallel to the laser fiber for observing the locus of treatment. The distal end of the shank tube may be connected to a vacuum source and is designed such that the heart muscle can be restrained by partially suctioning the same against the shank end.

Abstract: An endoscope comprises a hollow shank, optic viewing means positioned in the hollow shank for observing a body cavity, and a separate adjustable instrument channel which is axially, slidably arranged in an internal guiding region of the hollow shank. The instrument channel has a flexible curvature section and a laterally running end section with an end portion that is pivotably and articulably mounted in a radial passage in the distal circumferential wall region of the hollow shank. Sliding the instrument channel axially in the hollow shank results in flexing of the curvature section and pivoting of the end portion, such that an auxiliary instrument provided in the instrument channel is laterally deflected when guided through the hollow shank.

Abstract: An endoscope includes a housing having a working channel extending therethrough; an elongated insertion section mounted to the housing and having a distal end to be attached on the housing so as to cover a portion of the elongated insertion section. The sheath creates and maintains a working space at the surgical site.

Abstract: The present invention provides an endoscope having an opening of a channel tube retracted from a distal end face having an observation window of the insert therein toward a proximal end side. When a plurality of polyps are removed, a picked-up polyp is moved back from the distal end face of the insert toward the proximal side of the insert in order for the picked-up polyp not to interfere with observation by the endoscope and operation by a cutting tool extending through the endoscope channel.

Abstract: A biopsy forceps device is provided for obtaining tissue samples at a site within the body, while maintaining access to the site through an access lumen of the biopsy forceps. The device includes an elongate tubular body for introduction into the body and navigation to an area of interest. An inner tubular member having a lumen, or a plurality of lumens, extends through or adjacent the outer tubular member, from the proximal end to the distal end, where cutting jaws are provided. The cutting jaws are rotatably mounted at the distal end of the device and are controlled by movement of the inner tubular member. The inner tubular member is coupled with a handle portion allowing control of the cutting jaws at the proximal end. Access to the lumen of the inner tubular member is gained at the proximal end, where a luer fitting is provided.

Abstract: In the method of treating internal body tissue, the steps that include providing an endoscope having a viewing channel, with an elongated optical stem, associated with the channel, and defining a longitudinal axis; providing a longitudinally elongated sheath received on a stem and supported for controlled rotation about an axis and into selected angular position relative to a support, to gain access to the selected urethral tissue zone to be treated; providing means to be rotated with the sheath to be targeted toward and to eject flowable treatment material onto or into tissue at a zone; and rotating the sheath and ejecting treatment material at a selected zone.

Abstract: The disposable endoscope sheath includes a low-profile sleeve member that cooperates with the endoscope shaft to establish a relatively narrow irrigation space between the sleeve member and the endoscope shaft. The sleeve member is intentionally shorter than the endoscope shaft to accommodate a variety of different endoscope lengths that are longer than the sleeve. In various embodiments of the invention the sleeve member can be positioned to establish a predetermined distal gap between the terminal end of the sleeve member and the viewing end of the endoscope shaft, to establish a flush alignment between the respective ends, or to have the endoscope shaft project slightly beyond the terminal end of the sleeve member. Irrigation fluid can thus flow across the viewing end of the endoscope flushing away surgical debris from the viewing end. The sleeve member can be a rigid or flexible structure.

Abstract: A device utilizable with an endoscope to promote cleanliness comprises a substantially thin-walled elongate tubular sheath made of a flexible material, the sheath having a use configuration with an inner diameter larger than an outer diameter of an insertion member of the endoscope, whereby the sheath may be removably disposed about such insertion member to substantially surround same prior to insertion of the insertion member into a patient. A liner element extends parallel to the sheath and inside the sheath at least along a distal end portion of the liner element. The liner element is insertable into a biopsy channel of the insertion member of the endoscope. The sheath and the liner element are attached at their distal ends by a transparent cap member to form a germ-tight seal. Biopsy channels expandable from a collapsed configuration to receive endoscopic surgical instruments during an operation are provided in or on the sheath.

Abstract: An apparatus for surgically manipulating tissue without causing irreparable damage to the tissue during retention and manipulation is disclosed. The tissue manipulator apparatus includes a shaft having proximal and distal ends, a rod member with proximal and distal ends circumferentially contained within the shaft, a contact member having at least one tissue contact surface area comprising a plurality of projections connected to the distal end of the rod member, and a handle member attached near the proximal end of the shaft. The plurality of projections preferably point in the direction of retraction of the targeted tissue. The apparatus is designed to distribute the interdentating contact over the tissue micro surface area in an effort to reduce reliance on pressure induced friction alone.

Abstract: An endoscope system of the present invention makes it possible to pass a cleaning brush through all conduits, simplify cleaning, and perform disinfection such as sterilization by an autoclave. The system is an endoscope for controlling the opening/closing of various conduits by an solenoid valve unit, in which a conduit unit is removably set to the joint at the rear end of an operating portion and a conduit to be connected to various conduits at the main frame side is set to the conduit unit. Moreover, a second cable which is used separately from a first cable in which an electric-signal transmission line is set is provided for the conduit unit to lead said conduit to the solenoid-valve unit. Thereby, it is possible to separately clean the conduit unit by removing it from the main frame. Therefore, cleaning is simplified and the conduit unit can be sterilized by an autoclave or the like.

Abstract: A mechanically expandable retractor for use in arthroscopic surgery. The retractor has an expanding portion at its distal end for expanding against sub-surface tissues when the retractor is in use. The expanding portion includes a plurality of radially expanding arms. The radially outermost surface of each arm when expanded is longitudinally disposed approximately at the distal end of the retractor. The expanding arms can be disposed irregularly circumferentially around the retractor to expand the tissues to provide a working space between adjacent arms. The retractor is inserted through a small percutaneous opening, expanded in sub-surface tissues without significantly damaging the tissue, then collapsed after use for removal. The retractor has a projecting portion at a proximal end of the retractor for manipulating the retractor, to allow the surgeon to push or pull or lever on tissue.

Abstract: A polytetrafluoroethylene (PTFE) or expanded polytetrafluoroethylene (ePTFE) flexible and bendable working channel section which is circumferentially reinforced against kinking and which is adapted to be insertable, in-line, with the rigid section of the endoscopic working channel.

Abstract: In an endoscope system including an endoscope having an insertion section and an operation section and a disposable protection cover having an insertion section cover having formed therein a forceps channel and a forceps inlet opening through which a forceps can be inserted into the forceps channel, the forceps inlet opening is selectively closed by a forceps plug which is made of resilient material and separately formed from the insertion section cover. The forceps plug is preferably formed such that it can be detachably secured to a forceps inlet opening of an ordinary coverless (without-cover} endoscope.

Abstract: An endoscope viewing system including an orotracheal introducing guide (10) having channels (60) therethrough to support endoscope imaging end components (70,72) and, if desired, medical implements (120).

Abstract: An apparatus for controlling a suction passage in an endoscope includes a cylinder connected between an insertion pipe, on an insertion side of the endoscope, and a suction pipe, on a suction side of the endoscope. A piston is provided in the cylinder to move in an axial direction thereof to selectively connect or disconnect the insertion and suction pipes. The suction pipe, attached to the cylinder, is open at a position opposed to an outer periphery of the piston. A communication passage, provided in the piston, connects the insertion and suction pipes when the piston is in an operative position. An opening in the communication passage at the outer periphery of the piston is surrounded by an annular seal member to establish a water-tight connection between the open end of the communication passage and an open end of the suction pipe.

Abstract: A method and apparatus for ultrasonically cleaning the interior of a flexible, elongate, tubular medical instrument, such as an endoscope, laparoscope, or the like involves the generation of both longitudinal and transverse ultrasonic waves in a fluid medium within the interior channel or lumen of the instrument. The ultrasonic waves are generated within the instrument by a flexible wire resonator coupled to and responsive to an ultrasonic transducer and generator.

Abstract: An endoscope unit includes an endoscope having an insertion portion and a fluid supply instrument mounted on the insertion portion. The fluid supply instrument comprises a thin resilient tube. This resilient tube is intimately attached to an outer periphery of the insertion portion of the endoscope and radially expansible. A supply member is connected to a basal end of the resilient tube. When fluid from this supply member is supplied to the basal end of the resilient tube, the resilient tube is radially expanded and a fluid passage is formed between the resilient tube and the insertion portion of the endoscope. The fluid is discharged from a distal end of the resilient tube.

Abstract: An endoscope sheath assembly usable within an elongated flexible endoscope to isolate a portion of the endoscope from an external environment during a therapeutic or diagnostic endoscopic procedure. The sheath assembly has a sheath with an elongated flexible endoscope tube, a plurality of working channels extending the endoscope tube, and a low-friction, fabric isolating sleeve positioned within the endoscope tube and surrounding portions of the working channels. The isolating sleeve includes first and second sleeve lumens formed therein through which respective working channels extend. The coefficient of friction between the isolating sleeve and the working channels is less than the coefficient of friction between the working channels themselves so that working channels are frictionally isolated from each other, from the endoscope tube, and from the insertion tube to reduce resistance to articulation of the endoscope.

Abstract: A guiding device for treatment accessories of an endoscope includes a guiding tube and a fixing device. The guiding tube is long enough to extend from a forceps channel of the endoscope and is provided with a bent portion at a distal end thereof. The fixing device positions the guiding tube to having a predetermined positional relationship with respect to the entrance of the forceps channel such that the bent portion bends in a predetermined direction with respect to the exit of the forceps channel.

Abstract: A coupler structure for tube units of endoscopes functions to prevent a liquid, etc. remaining in aspiration tubes from adhering or penetrating to or into other tubes, and avoid increasing surplus cleaning and sterilizing works. Aspiration tubes have protruding lengths longer than those of air feeding tubes and water feeding tubes in couplers of an endoscope which is configured to couple a tube unit with a control section by way of a faucet joint and control rings. All these tubes are arranged so as to protrude from wall surfaces. When a positioning key and a key groove which also serve for restricting rotation are to be disposed, this key is configured longer than the aspiration tubes. This coupler structure allows the air feeding tube and the water feeding tube to have been already pulled out when the aspiration tube is pulled out, thereby preventing soiled water, etc. flowing out of the aspiration tubes from adhering to or penetrating into the air feeding tubes and water feeding tubes.

Abstract: The disposable endoscope sheath includes a low-profile sleeve member that cooperates with the endoscope shaft to establish a relatively narrow irrigation space between the sleeve member and the endoscope shaft. The sleeve member is intentionally shorter than the endoscope shaft to accommodate a variety of different endoscope lengths that are longer than the sleeve. In various embodiments of the invention the sleeve member can be positioned to establish a predetermined distal gap between the terminal end of the sleeve member and the viewing end of the endoscope shaft, to establish a flush alignment between the respective ends, or to have the endoscope shaft project slightly beyond the terminal end of the sleeve member. Irrigation fluid can thus flow across the viewing end of the endoscope flushing away surgical debris from the viewing end. The sleeve member can be a rigid or flexible structure.

Abstract: A surgical access device and method are provided for endoscopic surgeries comprising biopsies or other surgical cutting procedures. The device generally comprises a substantially rigid first channel associated with a first port and a second channel associated with a second port of a proximal housing. The first or main channel extends to a curved distal end of the device, and the second channel is connected to a guide channel extending tangential to the main channel. The guide channel comprises substantially noncompliant material and has a pre-insertion position such that a cross-section of an inserted portion of the device is substantially the same as a cross-section of the main channel. A preferred method of the present invention includes the use of an open-loop device formed at a distal tip of an introducer and an aspiration tube during the location, excision and removal of one or more tissue specimens.

Abstract: An endoscope system in accordance with the present invention comprises: an endoscope having an insertional part, operation unit, and connector unit set in array, and including channels that communicate with an opening formed in the distal section of the insertional part and an opening formed in the operation unit or connector unit; and at least one cleaning instrument having a flexible tube that can be connected to the opening formed in the operation unit or connector unit of the endoscope and that has the overall length thereof set to 30 cm or larger.

Abstract: A device utilizable with an endoscope to promote cleanliness comprises a substantially thin-walled elongate tubular sheath made of a flexible material, the sheath having a use configuration with an inner diameter larger than an outer diameter of an insertion member of the endoscope, whereby the sheath may be removably disposed about such insertion member to substantially surround same prior to insertion of the insertion member into a patient. A liner element extends parallel to the sheath and inside the sheath at least along a distal end portion of the liner element. The liner element is insertable into a biopsy channel of the insertion member of the endoscope. The sheath and the liner element are attached at their distal ends by a transparent cap member to form a germ-tight seal. Biopsy channels expandable from a collapsed configuration to receive endoscopic surgical instruments during an operation are provided in or on the sheath.

Abstract: An endoscope system including an endoscope having an insertion section which extends from a proximal end to a distal end and is inserted into a cavity under inspection and an operation section connected to the proximal end of the insertion section, and a protection cover including an insertion section inserting channel which extends from a proximal end to a distal end and into which said insertion section of the endoscope is insertable and a conduit channel which extends from the proximal end to the distal end, the improvement being characterized in that a distal end portion of the insertion section has a non-circular cross section such as a semicircular or oval cross section and a proximal end portion of the insertion section has a substantially circular cross section. A distal end member of the insertion section inserting channel has an accommodating portion which is a corresponding non-circular cross section.

Abstract: An endoscope having a conduit-providing flexible tube and a device for connecting said flexible tube, said device comprising a coupling member that is provided on the outer circumference with a first tapered portion the outside diameter of which decreases toward at least one end of said coupling member and that has a conduit in the interior, an annular retaining member that is fitted over the outer circumference of one end portion of said flexible tube which is to be fitted over said first tapered portion and that has on the inner circumference a second tapered portion the inside diameter of which decreases toward said at least one end in such a way as to provide engagement with said first tapered portion, and a clamp member that depresses said retaining member in the axial direction in which said first tapered portion flares, thereby depressing said flexible tube to be secured to said coupling member, characterized by further having an urging and covering member that not only covers the outer circumferential

Abstract: A cover system endoscope apparatus in which an insert part cover sheath for isolating the insert part of a cover endoscope is airtightly connected to a distal end constructive part of a tip part of an insert part cover. The insert part cover sheath is composed of a soft resin such as polyurethane exhibiting an excellent chemical resistance and a relatively high flexibility. The tip side of the cover sheath is connectively covered on an outer peripheral edge of the rear end of the distal end constructive part. The insert part cover sheath is formed with a forceps inlet on its near-at-hand side. Connected airtightly thereto is an endoscope manipulation part fixing mouth part having an expansion tube mouth for connecting an expansion tube and further a connecting part connected to a cover holding tool. An opening of an endoscope insert channel provided in an interior of the insert part cover sheath is formed on the near-at-hand side of the endoscope manipulation part fixing mouth part.

Abstract: An endoscope which is capable of appropriately sucking air in the stomach in endoscopic retrograde cholangiopancreatography, and which is capable of feeding and sucking a liquid and air at a portion other than the end portion. The endoscope comprises: an end portion which is also used as a suction hole and which is provided with a forceps insertion; a bendable flexible portion; and an auxiliary hole disposed in an outer peripheral groove formed in the middle of the flexible portion separately from the forceps insertion hole. An auxiliary receiving portion at the operating portion is connected to the auxiliary portion through a supply pipe. It is possible to feed or suck water or air from the flexible portion by mounting a syringe or the like in the auxiliary receiving hole. Since the auxiliary hole is disposed in the outer peripheral groove, sucking or feeding is not obstructed by a wall or the like in the body under observation.

Abstract: A retractor for use in arthroscopic surgery. The retractor has a mechanical expanding portion for expanding against sub-surface tissues when the retractor is in use. The retractor also has a fluid-operated expanding portion, which may be independently controllable, for expanding against sub-surface tissues when the retractor is in use. The retractor is inserted through a small percutaneous opening, expanded in sub-surface tissues without significantly damaging the tissue, then collapsed after use for removal. The retractor can be manipulated to allow the surgeon to push or pull or lever on tissue. The retractor can be hollow like a cannula to permit the passage of one or more surgical devices through the retractor, with a side portal into the center of the retractor.

Abstract: An endoscopic accessory comprising a catheter with axial walls defining an interior area, an elongated tool shaft slidably positioned within the interior area of the catheter, an endoscopic tool attached to the distal end of the tool shaft, and a retaining member connected to the catheter to prevent the tool from inadvertently deploying. The tool is slidable relative to the catheter between a withdrawn position and an advanced position, with the tool being positioned proximal to the distal end of the catheter when in the withdrawn position and extending beyond the distal end of the catheter when in the advanced position. The retaining member is connected to the catheter proximal to the distal end of the catheter and is movable between a closed position and an open position. In the closed position, the retaining member prevents the tool from being prematurely deployed. In the open position, the retaining member allows the endoscopic tool to be deployed without interference.