Abstract: Methods for advancing a device through a gastrointestinal tract. These methods may include inserting a device into the gastrointestinal tract, advancing a first portion of the device having a first vacuum port distally through the gastrointestinal tract away from a second portion of the device having a second vacuum port, sliding the second vacuum port towards the first vacuum port while the first vacuum port is applying suction, preventing tissue from moving distally past the first vacuum port by radially expanding a blocker that is positioned proximal to the first vacuum port, activating vacuum through the second vacuum port to suction tissue of the gastrointestinal tract to the second vacuum port, and releasing vacuum on the first vacuum port and advancing the first vacuum port distally through the gastrointestinal tract a desired distance while the vacuum is activated through the second vacuum port.

Abstract: A device, system, and method for ligating the left atrial appendage without creating pro-arrhythmic tissue. The device may generally include a snare including a thermally transmissive distal portion and a suture including a distal portion, both distal portions having a lasso-shaped configuration that may be positioned proximate the base of the left atrial appendage. Once the distal portions of the snare and the suture are tightened around the base of the left atrial appendage, the thermally transmissive distal portion of the snare may be activated to create an ablation lesion in adjacent left atrial appendage tissue. The lesion may be created with radiofrequency energy or through cryoablation by the circulation of refrigerant within the thermally transmissive distal portion of the snare.

Abstract: A flexible sensor configured for use in a bladder is flexible and moveable from a first position in which it is configured to not be discharged from the bladder to a second position in which it is configured to be inserted into the bladder. A sensor insertion tool includes an over sheath, a push rod configured to be inserted into a first lumen of the over sheath. The flexible sensor is positioned in the first lumen of the over sheath, the push rod is then inserted partially into the over sheath behind the flexible sensor. The sensor insertion tool is then positioned at a location, such as the opening to the bladder, in which the sensor is to be deployed.

Abstract: A tissue resection device comprises inner and outer coaxial sleeves. The outer sleeve has a cutting window formed therein, and the inner sleeve has a distal cutting end that can be reciprocated past the cutting window. The sleeves comprise electrodes to provide electrosurgical cutting, and an edge portion of the window includes a dielectric material.

Abstract: The disclosure provides various embodiments of catheters that can be used for various procedures. Embodiments of methods are also provided that can be performed with catheters in accordance with the present disclosure.

Abstract: A ureteral catheter includes a drainage lumen including a proximal portion configured to be positioned in at least a portion of a patient's urethra and/or bladder and a distal portion configured to be positioned in a patient's kidney, renal pelvis, and/or in the ureter adjacent to the renal pelvis, the distal portion including a retention portion for maintaining positioning of the distal portion of the drainage lumen, the retention portion including two or more openings on a sidewall of the retention portion for permitting fluid flow into the drainage lumen, wherein a number of the openings nearer to a distal end of the retention portion is greater than a number of the opening(s) nearer to a proximal end of the retention portion.

Abstract: Catheters for ablation and removal of occlusions from blood vessels are provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Catheters include expandable distal ends to facilitate, in some cases, relatively high bodily material removal rates compared to other devices.

Abstract: A catheter is provided which includes an outer catheter and an extendable inner catheter. A sealing feature is positioned between the inner catheter and the outer catheter to seal the annular gap between the two while allowing axial translation. The seal may be a compliant protrusion surrounding the inner catheter and may have a chevron-shape for facilitating axial translation. The seal may be a one-way valve configured to allow antegrade flushing but prevent retrograde flow. The seal may be squeegee-like flange on the distal tip of the outer catheter. The seal may be an expandable bulge, which may be mechanically expandable or inflatable or which may be a photosensitive or electrosensitive hydrogel. The seal may include a spring that is radially compressed upon translation or rotation of the inner catheter to transiently break the seal. Also provided is a seal for sealing between the catheter and the vasculature.

Abstract: A method for treating tissue of at least one of an internal carotid artery, an ophthalmic artery, or an ostium between the internal carotid artery and the ophthalmic artery of a subject may include expanding a first expandable device of a first device in the internal carotid artery. The method also may include delivering a second device in the ophthalmic artery via the first device and expanding a second expandable device of the second device in the ophthalmic artery. Further, the method may include adjusting a radial position of the second expandable device relative to the first expandable device.

Abstract: A novel catheter-based system that ligates the left atrial appendage (LAA) on the outside of the heart, preferably using a combination of catheters and/or instruments, e.g., a guide catheter inserted into the interior of the left atrial appendage that may assist in locating the left atrial appendage and/or assist in the optimal placement of a ligature or constricting element on the outside of the appendage, and a ligating catheter and/or instrument outside the heart in the pericardial space to set the ligature or constricting element at the neck of the left atrial appendage.

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 surgical retrieval apparatus includes an elongate tubular member having a drive rod slidably disposed therein. A support member is operably coupled to a distal end of the drive rod. A pouch is attached to the support member and has a closed end and an open end. The pouch is securely coupled to the support member.

Abstract: An endoscope for removing tissue at a surgical site includes an elongated tubular body insertable within a mammalian cavity of a patient. An instrument channel extends between a first opening at a distal end and a second opening at a proximal end of the tubular body and is sized and configured to receive a surgical cutting assembly that includes an aspiration channel configured to remove material entering the endoscope via a distal end of the surgical cutting assembly. A torque generation component configured to generate torque is positioned within the distal end and configured to provide the generated torque to a coupling component. The coupling component is positioned at the distal end of the elongated tubular member and configured to actuate a cutting component of the surgical cutting assembly responsive to actuation of the torque generation component.

Abstract: A cyst extractor allows a medical practitioner to retract, aspirate, ligate and amputate a cyst or cystic mass within a patient under regional anaesthesia and minimally invasive incision. A cyst extractor may include a transparent tubular member with a cap coupled to one end. The cap may have at least one view port that has a magnifying lens. The cap may also have a needle port through which a needle is inserted to puncture the cyst. A trap may be in fluid communication with the transparent tubular member. A suction post is in communication with the trap in order to pull the contents of an aspirated cyst into the trap. A light post containing a light source may be connected to the transparent tubular member in order to illuminate the interior of the extractor. A ligature deployer and a cutting wire may also be coupled to the tubular member.

Abstract: A medical instrument includes a tubular cutter extending along an axis and having a windowed outer sleeve and a moveable inner cutting sleeve. An ultrasound transducer is operatively coupled to the inner cutting sleeve in order to induce motion in the inner cutting sleeve to enhance cutting or resection of tissue by the inner cutting sleeve as it is reciprocated or otherwise moved past the cutting window. The instrument typically will include a motor drive configured to reciprocate and/or rotate the inner cutting sleeve relative to the windowed outer sleeve, usually at a reciprocation rate between 1 and 10 Hz.

Abstract: A medical device for managing tissue in an organ, such as the stomach, for retracting or positioning tissue and related organs to allow certain regions of the stomach to be acquired for a gastroplasty procedure. The medical device includes an elongated body having a proximal end and a distal end, and a tissue treatment device attached to the distal end of the elongated body. The tissue treatment device includes a first jaw opposite a second jaw, and each jaw is adapted to acquire tissue. A retractor is disposed along the tissue treatment device and adapted to be moveable from a delivery position to a retraction position to move or manage the tissue of the stomach. The medical device also includes a collapsible barrier disposed between the first and second jaws of the tissue treatment device to direct tissue into the first and second jaws separately.

Abstract: An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.

Abstract: Methods of providing suction may include providing suction patterns having varying intensity levels, such as a “crescendo suction” pattern. Cycles of crescendo suction patterns may comprise variable intensities of negative suction in a crescendo pattern (such as a small intensity negative suction pressure, a medium intensity negative suction pressure, and a large intensity negative suction pressure). The suction patterns may include pauses or temporary stops to the negative suction pressure.

Abstract: The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

Abstract: An arterial device, system and method are provided for use with a patient undergoing a cardiac procedure. The system is configured for enabling one or more arterial devices to be accommodated in the aorta of the patient in use of the system, and a perfusion lumen arrangement provides therethrough a target perfusion flow into the aorta having a target perfusion flow rate that is significantly greater than a nominal perfusion flow rate, by an excess perfusion flow rate. A suction lumen arrangement provides therethrough a suction flow out of the aorta at a suction flow rate. The target perfusion flow rate and the suction flow rate may be concurrently and selectively controlled to cause embolic debris that may be present in the aorta to be diverted to the suction inlet, while providing the nominal flow rate to the body circulation of the patient.

Abstract: The present disclosure relates to a tissue collection apparatus. The tissue collection apparatus comprises a housing defining an inlet and an outlet, a first filter disposed within the housing, a second filter disposed within the housing, the second filter configured to isolate tissue particles of a desired size that pass through the first filter under the application of an aspiration force applied through the housing. A method of harvesting tissue is also disclosed.

Abstract: The present disclosure relates to a tissue collection apparatus. The tissue collection apparatus comprises a housing defining an inlet and an outlet, a first filter disposed within the housing, a second filter disposed within the housing, the second filter configured to isolate tissue particles of a desired size that pass through the first filter under the application of an aspiration force applied through the housing. A method of harvesting tissue is also disclosed.

Abstract: A kit for surgically removing stones comprising: a double barreled sheath including a first barrel and a second barrel joined side-by-side; a first connector which is engaged at the proximal end of the first barrel; a second connector which is engaged at the proximal end of the second barrel; a first rigid tube interconnecting the first barrel with the first connector with the first connector being releasably engaged to the first rigid tube and the first rigid tube, first barrel and first connector being co-axial; a second rigid tube interconnecting the second barrel with the second connector with the second connector being releasably engaged to the second rigid tube and the second rigid tube, second barrel and second connector being co-axial; and a wire basket retriever adapted for insertion into one of the barrels and being releasably engaged with a connector or an actuation device.

Abstract: A fluid management system for use in a tissue resection procedure includes a controller. An inflow pump is operated by the controller and configured to provide fluid inflow through a flow path to a site in patient's body. An outflow pump is operated by the controller and configured to provide fluid outflow through a flow path from the site in patient's body. A motor driven resecting device may be provided for resecting tissue at the site. The controller is configured to actuate an inflow pump and an outflow pump in response to various signals and various algorithms are provided to provide malfunction warnings and assure safe operation.

Abstract: The present invention provides an endoscopic abrasion device and methods of use thereof. The device includes a catheter having an inflation balloon including one or more elements disposed on the balloon for abrasion of tissue when the balloon is rotated about the longitudinal axis of the catheter. The device may be used to treat and diagnose diseases of the esophageal passage, such as Barrett's disease.

Abstract: A cutting device includes an elongated shaft that extends between a proximal end and a distal end. A distal arm extends from the distal end of the elongated shaft. The distal arm includes an inner surface defining a cavity and an outer surface defining a blunt tip. At least one proximal arm extends from the distal end of the elongated shaft at a position proximal to the distal arm. The at least one proximal arm having an inner surface defines a cavity including a cutting portion configured to cut tissue.

Abstract: A cutting device includes an elongated shaft that extends between a proximal end and a distal end. A distal arm extends from the distal end of the elongated shaft. The distal arm includes an inner surface defining a cavity and an outer surface defining a blunt tip. At least one proximal arm extends from the distal end of the elongated shaft at a position proximal to the distal arm. The at least one proximal arm has an inner surface defining a cavity including a cutting portion configured to cut tissue.

Abstract: A cutting device includes an elongated shaft extending between a proximal end and a distal end. A lower portion extends from the distal end of the elongated shaft and includes an outer surface and an inner surface spaced apart from the outer surface which together form a blunt end configured as a stop so as to protect adjacent tissue. An upper portion extends from the distal end of the elongated shaft and including an inner surface. The upper portion is configured so as to be disposed opposite the lower portion. A cutting element is disposed between the lower portion and the upper portion and is configured for retractable extension beyond the distal end of the elongated shaft so as to contact tissue.

Abstract: An apparatus has an elongate element with a proximal end and a distal end. A connection element is disposed at the proximal end of the elongate element. A morcellator is disposed proximate the distal end. The morcellator has a shank with a base and a leading surface. The base is operably connected to the distal end of the elongate element. The shank at least partially defines a flute disposed substantially helically about an outer surface of the shaft. At least one cutting edge is disposed on the leading surface and proximate the at least one flute.

Abstract: A grabbing device includes a transparent flexible cup that can be placed adjacent to a selected region of an inner surface of a body cavity. The flexible cup is visually put in place by the surgeon, and a vacuum is applied to draw a selected amount of tissue into the flexible cup, so that it may, e.g., be excised. The device may also retrieve the tissue excised from the body cavity.

Abstract: An apparatus and method to suppress vacuum surges in a surgical aspiration system is disclosed and claimed. A vacuum surge suppressor includes a first fluid path for coupling to a surgical instrument, and a filter attached to the first fluid path. A flow restrictor is coupled to the filter with the filter disposed upstream of the flow restrictor. The filter defines a filter longitudinal axis that may be oriented vertically with respect to gravity, so that a downstream direction at the filter is upwards. The vacuum surge suppressor also includes a second fluid path for coupling to a vacuum pump. The second fluid path is connected to the flow restrictor and disposed downstream of the flow restrictor. A third fluid path is coupled to the filter and is connected to the second fluid path, bypassing the flow restrictor. A valve in the third fluid path selectively obstructs or permits flow in the third fluid path.

Abstract: The various embodiments of the present invention provide a tonsillar suction dissector for performing the functions of dissecting a tonsil and suctioning blood simultaneously. The tonsillar suction dissector includes a handle, a suction tube connected to one end of the handle, a proximal part coupled to a proximal end, a serrated distal end connected to the proximal part through the suction tube, a rolling part interconnected to the proximal part and the proximal end, and a tip assembly. The opening suctioning channels placed adjacent to the serrated distal end provide an opening to communicate with the handle and allows the suction tube to suction to clear a dissection surface thereby performing the functions of dissecting a tonsil and suctioning the dissection surface simultaneously.

Abstract: A system and associated method for altering or destroying tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders. In one aspect, the system includes a device configured to deploy devices for altering the lobes of a prostate.

Abstract: An ultrasonically pulsating high-pressure fluid jet coupled with a suction system serve as a tissue harvesting device. The pulsated fluid jet disrupts tissue, permitting both harvesting of cells for therapeutic delivery, and as a surgical dissector and aspirator, for liposuction, soft tissue dissection, etc. The jet is delivered to the target tissue through a cannula, coupled to an aspiration system. An ultrasonically actuated rod vibrates within the cannula engaging a nozzle, disrupting the fluid jet into droplets, permitting tuning of the jet to the resonant frequencies and impact pressures necessary to dissociate the target tissue. A suction recovery system may be separated or integrally formed with the fluid jet cannula, and is linked by a closed tubing system appropriate for sterilization and subsequent delivery of the harvested cells/tissues with or without growth factor or matrix addition for human re-implantation or for in vitro expansion for later re-implantation.

Abstract: Compressed air dissector is a surgical dissector which is used in tumor dissection and excision phases in surgical branches and especially in neurosurgery and microsurgery. The problem at this point is removal of the tumoral tissue without damaging the adjacent normal tissue and the blood vessels feeding the normal tissue. Moreover, serious difficulties may be encounter in the dissection phase of the arachnoid matter in brain surgery. The occurring adhesions can easily be opened with the aid of the air dissector. This provides great convenience in aneurism surgery. The operation principle of the compressed air dissector is direction of the controlled, sterile compressed air (gas) to the brain parenchyma and removal of the dissected particles from the location with an aspirator system. In said system, the particles in the air are cleaned with a filter system. When the compressed air is directed to the tumor tissue it easily dissects and removes the tumor.

Abstract: Various medical devices and methods for cutting, evacuating and/or performing work on tissue are provided. The devices and methods may utilize a reciprocating mechanism or motor powered by suction from a vacuum source. The medical devices and methods may be used on tissue in various regions of a patient's body and for treating various conditions, e.g., for performing a polypectomy.

Abstract: Sinusitis, enlarged nasal turbinates, tumors, infections, hearing disorders, allergic conditions, facial fractures and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches and, in many cases, flexible catheters as opposed to instruments having rigid shafts. Various diagnostic procedures and devices are used to perform imaging studies, mucus flow studies, air/gas flow studies, anatomic dimension studies, endoscopic studies and transillumination studies. Access and occluder devices may be used to establish fluid tight seals in the anterior or posterior nasal cavities/nasopharynx and to facilitate insertion of working devices (e.g., scopes, guidewires, catheters, tissue cutting or remodeling devices, electrosurgical devices, energy emitting devices, devices for injecting diagnostic or therapeutic agents, devices for implanting devices such as stents, substance eluting devices, substance delivery implants, etc.

Abstract: A specimen retrieval apparatus includes an elongated tubular member defining a lumen therethrough and having an end effector disposed at a distal end thereof. The end effector includes a shaft defining a longitudinal axis, the shaft including a lumen extending therethrough. The lumen of the shaft communicates with the lumen of the elongated tubular member. A suction member is disposed at a distal end of the shaft in communication with the lumen of the shaft. The suction member is configured to retain a tissue specimen thereon. A sleeve is disposed about the shaft and is movable with respect to the shaft from a proximal to a distal position. A specimen retrieval bag is coupled to the sleeve. The bag is deployable from an undeployed position wherein the bag is disposed about the sleeve to an extended position wherein the bag is deployed over the tissue specimen.

Abstract: The present devices and methods relate generally to medical devices and methods for cutting, resecting, excising and/or evacuating tissue from various regions of a patient's body. In particular, devices and methods for cutting and/or removing various tissues, e.g., polyps or endometrium, from a uterus or uterine space are provided. Devices and methods for cutting and/or removing various tissues from the human body, such as during laparoscopic or thoracoscopic surgery, are also provided.

Abstract: The various embodiments of the present invention provide a tonsillar suction dissector for performing the functions of dissecting a tonsil and suctioning blood simultaneously. The tonsillar suction dissector includes a handle, a suction tube connected to one end of the handle, a proximal part coupled to a proximal end, a serrated distal end connected to the proximal part through the suction tube, a rolling part interconnected to the proximal part and the proximal end, and a tip assembly. The opening suctioning channels placed adjacent to the serrated distal end provide an opening to communicate with the handle and allows the suction tube to suction to clear a dissection surface thereby performing the functions of dissecting a tonsil and suctioning the dissection surface simultaneously.

Abstract: A probe for resecting and coagulating tissue comprises an outer sleeve having a tissue cutting window and an inner sleeve having a tissue cutting distal end. And RF cutting region is formed at the distal end of the inner member and an RF coagulation region is formed on an exterior surface of the inner member immediately proximal to the cutting surface. A single power supply providing a single RF energy mode can be connected to both RF applicator regions to simultaneously cut and coagulate tissue.

Abstract: A medical retrieval device has a multi-prong retrieval assembly. The multi-prong retrieval assembly has a first position, in which the retrieval assembly extends from the distal end of the sheath to form an open ended grasping device, and a second position, in which the retrieval assembly extends from the distal end of the sheath to form a substantially close ended basket-type retrieval device. When the retrieval assembly is used as a basket-type retrieval device, the distal ends of the prongs of the retrieval assembly that form the basket are not connected to each other. Thus, captured objects may be released by the operator, or by applying sufficient force to separate one or more of the prongs.

Abstract: A grabbing device includes a transparent flexible cup that can be placed adjacent to a selected region of an inner surface of a body cavity. The flexible cup is visually put in place by the surgeon, and a vacuum is applied to draw a selected amount of tissue into the flexible cup, so that it may, e.g., be excised. The device may also retrieve the tissue excised from the body cavity.

Abstract: Devices and methods for manipulating and restraining non-target tissue during a surgical procedure are disclosed. In various forms, the device includes a body member that is configurable from a collapsed position wherein the device may be inserted into the body through a small opening to an expanded position wherein the device may be used to retaining engage the non-target tissue upon the application of suction thereto. Some embodiments have at least one ferromagnetic insert therein to enable the device to be magnetically manipulated and restrained by a controlled unit located outside of the patient's body.

Abstract: A tissue removal device includes an outer tubular member coupled to a housing and a having a tissue resection window, an inner tubular member slidably disposed within the outer tubular member, a tissue trap having a sealed interior in fluid communication with a vacuum chamber, an open proximal end of the inner tubular member being disposed within the tissue trap interior, and an actuator moveably coupled to the housing and operatively connected to a movable piston in the vacuum chamber, such that movement of the actuator relative to the housing generates a vacuum in the tissue trap.

Abstract: A grabbing device includes a transparent flexible cup that can be placed adjacent to a selected region of an inner surface of a body cavity. The flexible cup is visually put in place by the surgeon, and a vacuum is applied to draw a selected amount of tissue into the flexible cup, so that it may, e.g., be excised. The device may also retrieve the tissue excised from the body cavity.

Abstract: Various medical devices and methods for cutting and/or evacuating tissue are provided. The devices and methods may utilize a reciprocating mechanism or motor powered by suction from a vacuum source. The medical devices and methods may be used on tissue in various regions of a patient's body and for treating various conditions, e.g., for performing a polypectomy or discectomy.

Abstract: In the endoscope system 1, a tissue recovery device 3 that recovers tissue is directly mounted on an endoscope 2. The tissue recovery device 3 has a filter portion, and the filter portion is inserted so as to traverse the conduit of the suction conduit 20 that passes inside the endoscope operation portion 10. The suction conduit 20 opens to the distal end portion of the endoscope insertion portion 11, and the working channel 23 branches off from the branch portion 22 that is provided further on the distal end side than the insertion location of the tissue recovery device 3. With this endoscope system, it is possible to reduce operational burden of the operator with regard to the endoscope system that includes the tissue recovery device that recovers tissue.

Abstract: A surgical instrument can be used to capture and retrieve tissue, or other specimens, from within the body of a patient through a single trocar port. The surgical instrument can include a grasper, wherein the grasper can be configured to capture a specimen, and a specimen retrieval bag, wherein the specimen retrieval bag can be configured to at least partially surround, or encapsulate, the captured specimen when the specimen retrieval bag is in a deployed position. In certain embodiments, the retrieval bag can be inverted as it is moved between undeployed and deployed positions. In various embodiments, the surgical instrument can further include a snare operably engaged with the specimen retrieval bag, wherein the snare can be configured to at least partially close the bag. A vacuum can be placed in communication with the bag to reduce the size of the bag before it is removed from the surgical site.

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.