Abstract: Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, is directed toward an occlusive device having a distal end, a proximal end, and a longitudinal axis extending therebetween. The occlusive device may comprise an elongated member wound about the longitudinal axis to form a series of loops, wherein along at least some of the loops, the elongated member includes a first peak and a second peak axially offset from the first peak, the first peak being axially between the second peak and the proximal end. The first peak may be convex towards the distal end, and the second peak may be convex towards the proximal end.

Abstract: The guidance and positioning device may be a system for creating a passage in tissue, positioning fasteners or other implants, and tensioning an elongated fastening member, like a suture, thread, wire, or pin. In some embodiments, the device may allow for the implantation of multiple sutures and fasteners in tissue. A fastener may be positioned at the distal end of a flexible pushrod. The fastener may be connected with the pushrod or may be loosely fitted with the distal end of the pushrod. A suture may be looped through or connected with the fastener such that one, two, or more sections, legs, strands, or portions of the suture extend from the fastener.

Abstract: Methods, apparatus, and systems used to deliver a prosthetic heart valve to a deficient valve. In one embodiment, for instance, a support member is positioned to at least partially surround the native leaflets of a valve. A locking member is used to couple both ends of the support member, forming a support band. An expandable prosthetic heart valve is delivered into the native heart valve and expanded while the expandable prosthetic valve is at least partially within the support band, thereby causing one or more of the native leaflets of the native heart valve to be frictionally secured between the support band and the expanded prosthetic heart valve.

Abstract: The guidance and positioning device may be a system for creating a passage in tissue, positioning fasteners or other implants, and tensioning an elongated fastening member, like a suture, thread, wire, or pin. In some embodiments, the device may allow for the implantation of multiple sutures and fasteners in tissue. A fastener may be positioned at the distal end of a flexible pushrod. The fastener may be connected with the pushrod or may be loosely fitted with the distal end of the pushrod. A suture may be looped through or connected with the fastener such that one, two, or more sections, legs, strands, or portions of the suture extend from the fastener.

Abstract: A surgical clip for a surgical clip applicator includes at least one pair of clip arms. Each clip arm has a distal end and a proximal end. The two clip arms are connected to each other at the proximal ends of the clip arms and form a clip throat. A tangent angle between a tangent to a neutral fiber of a clip arm and a perpendicular to a longitudinal axis of the clip increases over the entire length of the clip arm substantially continuously.

Abstract: A medical device configured for assistance with the cervical cerclage procedure is provided. The medical device includes a barrier structure with a finger and a therebetween. A hub is fixed to a distal end of the catheter and defines an extension with a second void between an end surface of the hub and the extension. The barrier structure and the hub are releaseably attached with the extension disposed within the first void and the finger within the second void. A wire guide withdrawably extends through coaxial holes within the hub, extension, finger, and a portion of the barrier structure to fix the hub and barrier structure together.

Abstract: A medical instrument comprising an end effector comprising a first jaw configured to be repositionable with respect to a second jaw, the first and second jaws removably mounted to an open-ended occlusion clip, the end effector configured to configured to be removably coupled to an open-ended occlusion clip with a pair of terminal ends and first and second robotic arms, and wherein the end effector includes at least one of a cavity and a projection configured to be engaged by at least one of the first and second robotic arms.

Abstract: The invention concerns lancets with a lancet needle, the tip of the lancet needle being embedded in an elastic material. Furthermore the invention concerns lancets where the tip of the lancet needle is surrounded by a hollow body which partially consists of an elastic material that can be pierced by the tip of the lancet needle during the lancing process and which reseals the tip of the lancet needle in the hollow body when it is retracted. In addition the invention concerns a lancet magazine in which the lancets are accommodated in individual chambers, each chamber having an opening through which the tip of the lancet needle can pass, which is sealed by an elastic material. Finally the invention concerns the use of an elastic material as a component of a lancet or a lancet magazine to maintain the sterility of at least the tip of a lancet needle in the unused state and to hygienically protect at least the tip of a lancet needle in the used state.

Abstract: A method and devices that endoscopically create an anastomosis between two sections of the digestive tract, thereby allowing at least some chyme to bypass a section of the digestive tract while, optionally, the remaining chyme passes through the entire tract.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and an elongated axially rigid gripping member extends diametrically across the through-opening. The gripping member can rest on a flange on the opposite side of the through-opening or engage with a second gripping member that extends diametrically across the through-opening from the opposite side of the ring. Or, a flexible cage structure can be disposed in the through-opening.

Abstract: Described are methods and systems for treating a patient to modify a body passage of the patient. The methods may involve removing tissue from a luminal surface of a body passage such as the esophagus or stomach, for the purpose of inducing a healing response that will result in a reshaping of the body passage.

Abstract: An articulate probe device includes a first mechanism, a second mechanism, and an overtube mechanism. The first mechanism includes a proximal link which is movable coupled to a first intermediate link, a plurality of intermediate links, and a distal link which is moveably coupled to a second one of the intermediate links. The second mechanism includes a proximal link which is movable coupled to a first intermediate link, a plurality of intermediate links, and a distal link which is moveably coupled to a second one of the intermediate links. The overtube mechanism includes a proximal link which is movable coupled to a first intermediate link, a plurality of intermediate links, and a proximal link which is moveably coupled to a second one of the intermediate links. Further, at least one of the first mechanism, second mechanism, and overtube mechanism is steerable and extendable beyond the other mechanisms.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

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: The hemorrhoid ligation apparatus (10) includes a main cylinder (12) to which an O-ring (50) for ligating the hemorrhoid is to be attached on an outer circumferential surface of a front end portion, a sub cylinder (14) air-tightly and slidably provided inside the main cylinder (12), so as to suck the hemorrhoid into the front end portion of the main cylinder (12) upon being drawn toward a rear end portion of the main cylinder (12), an operating fluid loaded inside the sub cylinder (14), and a plunger (16) air-tightly and slidably provided inside the sub cylinder (14), so as to pressurize the operating fluid upon being squeezed toward a front end portion of the sub cylinder (14), to thereby squeeze the O-ring (50) toward the front end portion of the main cylinder (12) with the pressurized operating fluid, thus detaching the O-ring (50) from the main cylinder (12).

Abstract: An endoscopic assembly for an endoscope is disclosed. The assembly comprises a ligator barrel having proximal and distal portions. The proximal portion has a seat and a receiving wall extending to a proximal end. The receiving wall has a first threaded portion formed thereon. The assembly further comprises a connector for connecting the ligator barrel about the endoscope. The connector has a scope portion and a tip portion. The scope portion has a receiving end through which the endoscope is disposed to engage the seat for connecting the ligator barrel about the endoscope. The tip portion has a second threaded portion formed thereon and are configured to cooperate with the first threaded portion to receive the receiving wall and attach the connector with the ligator barrel. The first and second threaded portions are configured to cooperate with each other to tighten the connection of the ligator barrel about the endoscope as the threads increase surface area contact therebetween.

Abstract: Systems, assemblies, and methods to treat pulmonary diseases are used to decrease nervous system input to distal regions of the bronchial tree within the lungs. Treatment systems damage nerve tissue to temporarily or permanently decrease nervous system input. The treatment systems are capable of heating nerve tissue, cooling the nerve tissue, delivering a flowable substance that cause trauma to the nerve tissue, puncturing the nerve tissue, tearing the nerve tissue, cutting the nerve tissue, applying pressure to the nerve tissue, applying ultrasound to the nerve tissue, applying ionizing radiation to the nerve tissue, disrupting cell membranes of nerve tissue with electrical energy, or delivering long acting nerve blocking chemicals to the nerve tissue.

Abstract: An easily operated castrating tool that allows placement of a continuous elastic band for ligation and removal of an appendage. The instant invention is also an improved adjustable spreading tool that allows for quick and easy placement of the improved elastic band about a body part to be ligated.

Abstract: An apparatus for delivering a closure element can include a splittable carrier tube and a splitter to split the tube. The carrier tube can have an outer surface retaining a closure element in a tubular configuration and can be split into radially-expandable flaps. A closure element has can have shape-memory body having a relaxed configuration with a planar-annular body defining a lumen with tines directed inwardly from the body. The clip can be held in a retaining configuration having a substantially asymmetrically-elongated tubular shape with a trapezoidal longitudinal cross-sectional profile and a proximal end having the tines being longitudinally directed with a first tine being more distally oriented compared to a substantially opposite second tine being more proximal, and retracting to a deploying configuration having a tubular shape with a rectangular longitudinal cross-sectional profile with the first tine being even with the second tine when being delivered.

Abstract: A radical prostatectomy anastomosis device including a cartridge having a plurality of anchors slidably disposed in a plurality of distally angled radial channels formed in the cartridge and a pusher assembly operatively coupled within the cartridge. The pusher assembly being configured and adapted to push each of the plurality of anchors out of the angled radial channels of the radial cartridge. The device further including a fitting removably coupled to a distal end of the cartridge. The fitting including a flange having a plurality of holes formed radially around the flange, wherein each of the plurality of holes includes suture locking means configured and adapted to permit a suture to be drawn distally through each of the plurality of holes and to prevent the sutures from being drawn proximally through each of the plurality of holes. The device further including a plurality of sutures secured to an inner surface of the cartridge.

Abstract: A variceal banding endoscope includes an elongated shaft having a distal end and a proximal end that is removably connected to a control unit. The endoscope includes a variceal banding apparatus fixedly attached to the distal end of the endoscope and capable of receiving a plurality of ligation bands. A trigger cable extends from the proximal end to the distal end of the shaft and is digitally actuated by an actuator in the control unit or handle of the scope in response to a user input device.

Abstract: A compression ring to grip and compress body structure such as diverticulum, hemorrhoids, and tissue adjacent a hole. A resilient ring-shaped body defines a compression channel, and one or more axially rigid elongated spikes extend from the body into the channel. The body defines a first axial segment surrounding the compression channel and a second axial segment surrounding the compression channel, with the spike being engaged only with the second axial segment. The first axial segment more tightly compresses the body structure than the second axial segment.

Abstract: Apparatus and methods are provided comprising an implantable non-hydraulic ring that encircles and provides a controllable degree of constriction to an organ or duct and an external control that powers and controls operation of the ring. The ring includes a rigid dorsal periphery that maintains a constant exterior diameter, and a compliant constriction system that reduces intolerance phenomena. A high precision, energy efficient mechanical actuator is employed that is telemetrically powered and controlled, and maintains the ring at a selected diameter when the device is unpowered, even for extended periods. The actuator provides a reversible degree of constriction of the organ or duct, which is readily ascertainable without the need for radiographic imaging. Methods of use and implantation also are provided.

Abstract: A system and associated method for manipulating tissues and anatomical or other structures in medical applications for the purpose of treating diseases or disorders or other purposes. In one aspect, the system includes a delivery device configured to deploy and implant devices for compressing, distracting and/or retracting the lobes of a prostate.

Abstract: An implantable sterilization device may include a ring having an inner diameter, a core slidable through the inner diameter of the ring, and a tissue securing element, at least part of which is positioned between the ring and the core. A method of closing a fallopian tube may include providing a closure system including a handle, a flexible shaft connected to the handle, and a sterilization device detachably connected to the flexible shaft, inserting the flexible shaft into the lumen of the fallopian tube and advancing the flexible shaft into the lumen; compressing a portion of the wall of the fallopian tube with the sterilization device to secure the sterilization device relative to the fallopian tube, blocking the lumen of the fallopian tube with the sterilization device; and separating the sterilization device from the tube.

Abstract: An easily operated castrating tool that allows placement of an improved continuous elastic band for ligation and removal of an appendage. The present invention includes a tool that allows such bands to be placed in a manner that is significantly more easy to use, and less fatiguing to the parties that utilize the device. The instant invention is also an improved elastic band which allows for better compressive ligation about a body part as well as a simple, but effective, spreading tool that allows for quicker and easier placement of the improved elastic band about a body part to be ligated.

Abstract: A surgical ring, designed to be implanted around biological organs comprising a pouch or a duct, so as, on the one hand, to form a closed loop between these two extremities (1, 2), thus forming a first (1) and a second (2) extremity and, on the other hand, to reduce the diameter of the opening of the organ when it is tightened by the ring, the ring including a system for reversibly controlling the variation in its diameter. The system also includes a flexible filiform element (4), inserted longitudinally with possibility of sliding into the material constituting the body of the ring between the first (1) and second (2) extremities, so as to define a fixed portion (5) connected to the first extremity (1) and a free portion (7) associated with an actuator (8) mounted on the ring near the second extremity (2).

Abstract: A supporting structure for a ligating band dispensing device adapted to be coupled to a distal end of an endoscope comprises a rigid substantially cylindrical, transparent outer support surface adapted to receive a plurality of ligating bands thereon, wherein the support surface includes a distal portion extending from a distal end thereof proximally to a distal-most ligating band receiving area. A channel extends axially through the support surface from the distal end to a proximal end thereof, wherein an abutting surface is formed along at least a portion of a circumference of the channel to define a distal-most point of penetration of an endoscope received therein. A gripping surface extending around at least a portion of a circumference of the proximal end of the channel is sized so that, when an endoscope extends into the proximal end of the channel, the gripping surface frictionally couples the support surface to the endoscope.

Abstract: The present invention provides a ligating band dispenser that is mounted on the distal end of an endoscope. The ligator is configured to deliver multiple ligating bands to a plurality of internal sites in a patient. The ligating bands are carried on a tubular band carrier member that is retractable relative to the distal end of the endoscope in order to preserve visibility through the endoscope during navigation, then extendable to define a suction chamber for tissue aspiration during band delivery. A tubular band driver member is slidable over the band carrier member and engages bands individually to push them off the distal end of the band carrier and onto a selected treatment site. A single-hand operated control handle for selectively operating the extension of the band carrier and movement of the band driver to release a band is also provided and is slidably and removably mounted to the endoscope shaft.

Abstract: A fitting hole portion of a shaft portion fitted to a mouth ring portion of an endoscope is provided to an attachment portion of a ligation band operation band, and an operation to switch between a flange portion insertion position at which the flange portion of the mouth ring is insertable and an engagement position at which a protrusion portion of the mouth ring portion is engagable is performed by a sliding member slidable with respect to the shaft portion.

Abstract: An improved distal end for a ligating band dispenser having a transverse groove or ridge profile that promotes rolling of the bands. In one embodiment, the ligating bands and the transverse grooves or ridges are dimensioned such that the width of the bands when stretched on the support surface is substantially the same as the pitch of the transverse grooves or ridges. In another embodiment, the ligating bands and the transverse grooves or ridges are dimensioned such that the width of the bands when stretched on the support surface is less than the pitch of the transverse grooves or ridges. Having the width of the bands when stretched on the support surface be substantially the same as or less than the pitch of the transverse grooves or ridges allows the bands to fit within the grooves, which helps insure that the bands are sufficiently held back by the ridge crests to induce a rolling action.

Abstract: A surgical device for performing internal ligation of a fallopian tube or other tubular anatomical structure, by application of one or more ligating bands to a folded portion of the wall of the tubular structure. Also the invention includes a method of using the device. The inventive method and device may be used for sterilization to prevent undesired pregnancies, or for other medical applications. The device includes an elongated tubular element that is inserted into the fallopian tube; a grasper that extends out of the tubular element, grasps the interior of the fallopian tube and retracts into the tubular element drawing in a folded bundle of the fallopian tube tissue; and a pusher balloon for pushing a ligating band from the tip of the tubular element onto the tissue bundle.

Abstract: According to the invention, the implant for treating rectocele and/or prolapsus of the vaginal fornix presents a structure that is thin and flexible and includes a support body from which there extend at least:

Abstract: An easily operated castrating tool that allows placement of an improved continuous elastic band for ligation and removal of an appendage. The present invention includes a tool that allows such bands to be placed in a manner that is significantly more easy to use, and less fatiguing to the parties that utilize the device. The instant invention is also an improved elastic band which allows for better compressive ligation about a body part as well as a simple, but effective, spreading tool that allows for quicker and easier placement of the improved elastic band about a body part to be ligated.

Abstract: A laparoscopic sterilization instrument comprises an excisor for excising a portion of a patient's oviduct and a receptacle for holding the excised oviduct portion until the instrument has been withdrawn from the patient's abdomen. The excised oviduct portion constitutes a full circumference biopsy that can be examined to confirm proper performance of the sterilization procedure, for the protection of patient and physician alike. The instrument includes first and second elongate parts attached to each other for relative movement parallel to their longitudinal axes to operate the excisor means. The first part is a rod and the second part is a sleeve within which the rod can move, the rod sliding longitudinally within the sleeve. The instrument is operable by a physician to work the excisor means and an applicator for applying a clip in a single action.

Abstract: A surgical device for performing internal ligation of a fallopian tube or other tubular anatomical structure, by application of one or more ligating bands to a folded portion of the wall of the tubular structure. A method of using the device is also disclosed. The inventive method and device may be used for sterilization to prevent undesired pregnancies, or for other medical applications. One embodiment of the device includes an elongated tubular element that is inserted into the fallopian tube, a grasper that extends out of the tubular element, grasps the interior of the fallopian tube and retracts into the tubular element in a folded bundle of the fallopian tube tissue; and a pusher balloon for pushing a ligating band from the tip of the tubular element onto the tissue bundle. A fold assist mechanism may be included to help evert a section of a fallopian, or other, tube.

Abstract: A ring applicator for applying elastic rings to anatomical tissue during surgical procedures includes an inner member with a forceps movably disposed within a middle tubular member having a distal end configured to hold a plurality of elastic rings in an expanded state and a proximal end with a plurality of longitudinally spaced steps. The middle tubular member is movably disposed in an outer tubular member, and an adjustable stop mechanism is mounted on the proximal end of the outer tubular member to limit axial movement of the outer tubular member relative to the middle tubular member to select which rings are to be ejected. A distal handle is connected with the inner member via slots in the outer and middle tubular members, and a proximal handle is pivotally connected to the middle tubular member via a slot in the outer tubular member.

Abstract: An apparatus and method for use in raising cattle, and in particular bulls, wherein bulls are: (a) fed a particularly nutritious liquid having a distinctive odor prior to weaning; (b) fed a combination of this liquid and conventional feed after weaning in a feedlot; (c) castrated using a ligation tool that provides a ligating tension to endless elastomeric ligation bands wherein the tool indicates the tension applied to such ligation bands; and (d) treated for infection prevention at least around the time of castration. Accordingly, cattle growth is accelerated due to enhanced nutrition, reduction in disease and a reduction in the stress upon the cattle. Furthermore, late castration of bulls (at approximately 5 to 14 months) is employed, wherein the tool of (c) provides a substantially stress-free ligation technique. Moreover, the meat produced from the cattle processed using the present invention has superior cutability characteristics.

Abstract: An apparatus and method for use in raising cattle, and in particular bulls, wherein bulls are: (a) fed a particularly nutritious liquid having a distinctive odor prior to weaning; (b) fed a combination of this liquid and conventional feed after weaning in a feedlot; (c) castrated using a ligation tool that provides a ligating tension to endless elastomeric ligation bands wherein the tool indicates the tension applied to such ligation bands; and (d) treated for infection prevention at least around the time of castration. Accordingly, cattle growth is accelerated due to enhanced nutrition, reduction in disease and a reduction in the stress upon the cattle. Furthermore, late castration of bulls (at approximately 5 to 14 months) is employed, wherein the tool of (c) provides a substantially stress-free ligation technique. Moreover, the meat produced from the cattle processed using the present invention has superior cutability characteristics.

Abstract: An operative laparoscopic instrument is equipped with proximal and distal loops closed by slip knots and tightenable from the proximal end of the instrument. A forceps extending from the distal end of the instrument grasps an anatomical tube to be both ligated and transected and pulls it into the instrument past both loops. The distal loop is first tightened to ligate the tube and the proximal loop is then tightened to transect the tube.

Abstract: An activating mechanism (20) for activating an endoscopic ligator is disclosed. The activating mechanism (20) includes a mounting component (21) and an activating component (22) coupled thereto. The mounting component (21) inserts directly into the proximal opening of an operating channel of an endoscope and is dimensioned to fit within the operating channel to mount the mechanism (20) to the endoscope. The mounting component (21) includes a channel receiving an activation line of the ligating device which is threaded through the operating channel and the channel in the mounting component, and onto the activating component (22) of the activating mechanism (20). The activation line attaches to a spool (50) of the activating component (22). The activating component (22) further provides a drive pin (40) and a roller clutch (70) for setting the activating component (22) in an engaged or disengaged position and a knob (60) for rotating the drive pin (40).

Abstract: A multi-ligator device that provides a signal to an operator indicating the release of a ligation ring from the ligator head. Thus, greatly simplifying the use of mechanically decoupled ligator-devices and relieving an operator from having to sense via transmitted vibrations when a ligation ring is detached from a ligator head. The multi-ligator device is constructed using a control unit to operate a ligator head that is connected to the control unit via a flexible shaft. The ligator head supports a plurality of ligation rings that are released by operating the control unit. When a ligation ring is released a signal is generated. The signal can be any one, or a combination, of a mechanical, acoustical, and a visual signal. Additionally, a kit for mounting a ligation ring on a ligator head uses a shaft having a cone-shaped portion to stretch the ligation ring. A lubricant is applied to both the ligation ring and shaft to facilitate the manipulation of the ligation ring.

Abstract: A self-disposing ligating band dispenser is formed of a member having predisposed windings, where the windings form a surface to support one or more expanded ligating bands. The wound member has a free portion which enables a properly oriented displacement of the free portion to effect the unwinding of the dispenser, and the dispensing of one or more stored ligating bands.

Abstract: An endoscopic ligating apparatus is provided that can be used percutaneuously to dispense multiple ligating bands or rings about several lesions. In one embodiment, a barrel supporting a plurality of bands stretched around its circumference is removably engaged to the insertion end of an endoscope. A trip wire extends through a working channel of the endoscope and includes a plurality of strands extending from the distal end of the barrel and wrapped around the end of the barrel. The ligating bands are situated over the strands, while the strands are provided with beads disposed adjacent the bands. As tension is applied to the trip wire by way of an activating mechanism, the strands retract within the barrel so that the beads draw the ligating bands successively to the end of the barrel. In one embodiment, the activating mechanism includes a mounting component that stably mounts the mechanism to a variety of endoscopes.

Abstract: An apparatus and method for use in raising cattle, and in particular bulls, wherein bulls are:(a) fed a particularly nutritious liquid having a distinctive odor prior to weaning;(b) fed a combination of this liquid and conventional feed after weaning in a feedlot;(c) castrated using a ligation tool that provides a ligating tension to endless elastomeric ligation bands wherein the tool indicates the tension applied to such ligation bands; and(d) treated for infection prevention at least around the time of castration.Accordingly, cattle growth is accelerated due to enhanced nutrition, reduction in disease and a reduction in the stress upon the cattle. Furthermore, late castration of bulls (at approximately 5 to 14 months) is employed, wherein the tool of (c) provides a substantially stress-free ligation technique. Moreover, the meat produced from the cattle processed using the present invention has superior cutability characteristics.

Abstract: A device which produces adequate local anesthesia for the purpose of infant male circumcision. The elastic form fitting body of the device is measured to fit over the infant male penis, and contains a coated inner surface that contacts the penile skin with an anesthetic gel, which upon contact, initiates anesthesia locally at the glans tip of the infant penis.

Abstract: A ligation device includes (1) a flexible outer tube which can be inserted through a channel of an insertion tube of the endoscope, (2) a flexible inner tube provided in the outer tube, (3) a ring which is made of an elastic material and is provided to a periphery of the inner tube, and (4) an manipulator which moves the outer tube with respect to the inner tube, so that the outer tube pushes the ring out of the inner tube.

Abstract: A medical instrument for ligation of tissue and anatomical structures, including fallopian tubes comprises at least two slideable shafts concentrically disposed relative to each other. A first shaft has a tissue receiving recess into which tissue is retracted by a grasper. The grasper is disposed on the end of a second shaft that is extendible from the first shaft. A ring retainer on the second or a third shaft can hold one or more elastic rings that are displaceable by the instrument around tissue extending from the tissue receiving recess. The rings are held on a tapered or necked down part of the instrument so that the rings contribute little or nothing to the largest outer diameter (OD) of the portion of the instrument that is inserted into a patient's body. Because the ring or rings do not contribute to the OD of the instrument, the instrument may be constructed to fit within insertion channels of 5 mm or less.

Abstract: A method of endoscopic tubal ligation includes the steps of introducing a distal end of an instrument assembly at an internal operative site through a small size port, visualizing the internal operative site with an endoscope from externally of the internal operative site, grasping an anatomical tubular structure at the internal operative site with a grasping member of the instrument assembly and drawing the anatomical tubular structure into a loop formation and contracting a ligature loop of filamentous ligature material of the instrument assembly around the loop formation to form a ligature without withdrawing the instrument assembly from the internal operative site.

Abstract: An apparatus and method for use in raising cattle, and in particular bulls, wherein bulls are:(a) fed a particularly nutritious liquid having a distinctive odor prior to weaning;(b) fed a combination of this liquid and conventional feed after weaning in a feedlot;(c) castrated using a ligation tool that provides a ligating tension to endless elastomeric ligation bands wherein the tool indicates the tension applied to such ligation bands; and(d) treated for infection prevention at least around the time of castration.Accordingly, cattle growth is accelerated due to enhanced nutrition, reduction in disease and a reduction in the stress upon the cattle. Furthermore, late castration of bulls (at approximately 5 to 14 months) is employed, wherein the tool of (c) provides a substantially stress-free ligation technique. Moreover, the meat produced from the cattle processed using the present invention has superior cutability characteristics.