Abstract: An endoscopic treatment tool is provided which includes: a grasping portion that has a first shoulder portion and second shoulder portion; a current-carrying portion that protrudes out from a distal end of each of the first and second shoulder portions; a pivot portion that is disposed in the distal end of the first shoulder portion so as to protrude in substantially the same direction as the longitudinal direction of the first shoulder portion, the distal end of the pivot portion being provided with an insulating portion; a wire that is connected to the grasping portion; a sheath which has a tubular shape, and into which the wire and grasping portion are inserted; a main body to which the sheath is fixed; and a sliding portion which is disposed to move in the longitudinal direction of the main body in a sliding manner, and to which the wire is connected.

Abstract: A medical device is provided for use with an endoscope. The medical device can include a tissue resection device comprising an RF cutting wire. The tissue resection device can be supported for proximal and distal movement relative to the endoscope.

Abstract: A system and method for controlling electrosurgical snares are disclosed. The system includes an electrosurgical instrument having an elongate tubular sheath having proximal and distal ends, the sheath having a longitudinal axis defined therethrough and a shaft having proximal and distal ends. The shaft extends through and is axially movable relative to the sheath. A snare loop is provided at the distal end of the shaft and is configured for encircling tissue. Movement of the shaft relative to the tubular sheath changes the diameter of the exposed snare loop. A feedback sensor operatively connected to the elongated tubular sheath which determines at least one condition of the snare loop, and an electrosurgical generator provides electrosurgical energy to the electrosurgical snare instrument. The generator is configured to receive feedback measurements from the electrosurgical snare instrument and to adjust electrosurgical energy as a function of the measurements.

Abstract: A method for resecting tissue from an organ of a patient, the organ being comprised of at least a first layer, a second layer and a third layer, the method including the steps of providing an EMR device with access to the organ, the EMR device including at least one deployable cutting element disposed on at least one moveable arm, identifying a target tissue area for resection, forming an incision through the first and second layers without penetrating the third layer, positioning the EMR device through the incision such that the device is positioned between the first third layers, advancing the moveable arm between the first and third layers, deploying the cutting element such that the cutting element is advanced in the direction of the first layer and away from the third layer and, while the EMR device is positioned between the first and third layers, cutting through the first layer.

Abstract: A low profile, short, tapered distal tip catheter and methods for its manufacture are provided. The catheter tip is configured to have a taper over a relatively short length resulting in a low profile that is useful when navigating the catheter tip into tight passages such as the Papilla of Vater. The configuration of the tip and process for making it can be employed in any medical catheter but are found to be most useful in a multilumen papillotome catheter used in biliary procedures.

Abstract: The present invention provides an apparatus for, and a method of, accurate positioning of endoscopic instruments. Accurate positioning of the instruments is accomplished through the inclusion of a steering ability within the device. After the endoscopic instrument is properly positioned the present invention may use rapid exchange technology, soft locks, and mechanical locks to maintain the position of the endoscopic instrument. Rapid exchange technology is used to minimize displacement forces present on the guidewire or catheters. Soft locks and mechanical locks resist movements caused by displacement forces.

Abstract: Efficient ablation with multiple prong electrodes is obtained by electrically isolating the prongs from each other and rapidly switching electric power between the prongs, between a prong and a ground pad, or both. In this way, power distribution to a tumor can be controlled efficiently without the need to change probe geometry.

Abstract: A loop section has a bending portion at the distal end. The bending portion bends in a direction that intersects the plane formed by the loop section. A diathermic snare is used in combination with an endoscope. When the loop section expands along the inner circumference of an engagement projection of a cap section, the bending portion of the loop section conforms to the corner of the bending portion of the projection.

Abstract: A high-frequency snare for an endoscope includes an electrically insulating sheath, an operation wire slidably inserted through the sheath, a plurality of resilient twisted wires. Proximal ends of the plurality of twisted wires are connected to the distal end of the operation wire. Distal ends of the plurality of twisted wires are deposited with each other within an atmosphere of inactive gas. A proximal end side of the deposited ends of the plurality of wires being connected together with a metallic connecting member. When the operation wire is operated to withdraw at least proximal side portions of the plurality of twisted wires, the twisted wires are tucked. The plurality of twisted wires are expanded to form a loop with resilience thereof when the plurality of twisted wires are protruded from the sheath.

Abstract: An atrial ablation catheter and methods for its use. The endocardial catheter includes an electrode array particularly adapted to locate and ablate foci of arrhythmia which are required for sustained atrial fibrillation is provided. The array is easily deployed and retracted from the catheter, and presents a distally oriented electrode array that can be pressed against the wall of the atrium.

Abstract: This relates to a device for treating lung disease, and more particularly, relates to a device for exchanging energy with airway tissue such as that found in the airways of human lungs. The exchange of energy with this airway tissue in the airways reduces the ability of the airways to constrict and/or reduces the resistance within the airway to the flow of air through the airway.

Abstract: A high-frequency incision device includes a high-frequency treating wire 9, which forms a curved portion 11 so that a wire loop 10 formed by the wire 9 may be laterally tilted in a plane parallel to the center axis 7a of an actuating wire 7 when the wire 9 extends from the forward end of a flexible sheath 2.

Abstract: A snare for an endoscope includes a flexible sheath, a control wire movable within the flexible sheath, and a snare loop connected to an end of the control wire, wherein when the control wire is axially advanced, the snare loop projects from the flexible sheath and expands into a loop shape, whereas when the control wire is axially retracted, the snare loop retracts into the flexible sheath and is folded into a closed shape. A resilient wire which forms the snare loop includes a hook portion protruding in a lateral direction of the snare loop. The resilient wire includes a biasing portion which biases the distal end of the resilient wire from a tip end to a base end of the hook portion to press the distal end of the resilient wire against an inner surface of the flexible sheath when the resilient wire is retracted.

Abstract: A treatment tool for an endoscope includes a flexible sheath, with a transparent portion near a distal end thereof, which is inserted into and ejected from a treatment tool insertion channel of the endoscope, a rod-shaped treatment piece arranged into the flexible sheath, an operation wire arranged inside the flexible sheath with a distal end thereof being connected with the rod-shaped treatment piece such that the rod-shaped treatment piece is projected back and forth from the distal end of the flexible sheath by operating the operation wire, and a mobile indicator formed at the rod-shaped treatment piece or a portion of the operation wire near the distal end thereof to move along with movement of the rod-shaped treatment piece and to be visually recognized through the transparent portion of the flexible sheath from an outside of the flexible sheath.

Abstract: The present invention relates to methods and devices for performing endoscopic cannulation, papillotomy and sphincterotomy and similar procedures. According to the present state of the art, endoscopic cannulation of the common bile duct and papillotomy and similar procedures are accomplished by advancing the device into an endoscope/duodenoscope so that the distal tip of the device exits the endoscope adjacent the sphincter muscles at the Papilla of Vater. The endoscope mechanisms are then manipulated to orient the distal tip of the device to the desired position for proper cannulation of the duct. Due to inconsistencies in, for example, the sphincterotome, anatomy, and endoscope manipulation, it is difficult to accurately and consistently position the sphincterotome for proper cannulation.

Abstract: A device and method for treatment of a tissue specimen disposed in surrounding tissue has a tissue specimen isolating tool and a tissue specimen damager. The tissue specimen isolating tool isolates the tissue specimen from the surrounding tissue. The tissue specimen damager damages the tissue, with a possible end result being necrosis. The severing tool may have a cutting member that is extendable to an outwardly radially bowed position about device. The tissue specimen is isolated by rotating the cutting member about the tissue specimen. The cutting member may be functionally connected to a cutting member radio frequency generation source. The tissue specimen damager may damage the tissue specimen using ionizing radiation, cutting devices, thermal treatment devices, chemical treatment devices, or sealing an outer boundary of the tissue specimen.

Abstract: A tissue separator assembly has an elongate tubular member and a tissue separator device located at a distal end of the elongate tubular member. An elongate coupler extends through the lumen of the elongate tubular member and has a distal coupler end. A tissue localization assembly has an elongate member and a localization device located at the distal end of the elongate member. The localization device may be movable from a first, radially-contracted state to a second, radially-expandable state. The distal coupler end of the elongate coupler and the proximal end of the elongate tubular member of the localization assembly are joinable to one another to permit docking of the tissue localization assembly to the tissue separator assembly. Methods of use of this device are also described.

Abstract: Method, system and apparatus for carrying out accurate electrosurgical cutting. A thin resilient electrode is utilized at the forward end region of an instrument which is deployable from a longitudinally disposed slot positioned rearwardly of the tip of the instrument. Lateral sides of the slot extend between a forward location adjacent the tip and a rearward location. The electrode is deployed by urging it forwardly in compression to form an arch profile supported by the abutting slot sides adjacent the forward and rearward locations. Electrosurgically excitable with a cutting output, the electrode may carry out a cutting action both during its deployment and retraction into the noted slot. This permits a pivoting maneuver effective for circumscribing a volume of targeted tissue.

Abstract: A wire section (1) inserted into a patient includes a wire (4) connected with a snare (3) at the front end thereof, and an outer tube (8) which retractably passes the wire (4) and the snare (3) therein. A remote control section (2) not inserted into the patient's body includes a bar-like main body (9) with a hollow inside; an operating member (11) connected to the main body (9) so as to be slidable in L and R direction and sled to enter or exit the snare (3) into and from the outer tube (8); and a pinching mechanism (15) built in the main body (9) and connected to the operating member (11) for detachably pinching the pipe (6) connected to the rear end of the wire (4). The wire section (1) and the remote control section (2) are connected when the pipe (6) is pinched by the pinching mechanism (15), and the wire section (1) and the remote control section (2) are separated when the pipe (6) is released from the pinching mechanism (15).

Abstract: A multifilar flexible rotary shaft includes a plurality of individual filaments which are not wound around each other or around a central core, a loose ensemble of filaments. The input ends of each filament are coupled to each other and the output ends of each filament are coupled to each other. Preferably all of the filaments are identical. A loose ensemble of N filaments can transmit N times the torque of a single filament, and will have N times the torsional stiffness of a single filament, while retaining the minimum radius of operation of a single filament. Since a loose ensemble of filaments does not have any appreciable contact forces among the filaments (because they are not forcibly twisted together), there is no appreciable internal friction or hysteresis. In order to appreciably eliminate all the hysteresis in such an ensemble of filaments, the filaments should be no more than loosely twisted together, if at all.

Abstract: A medical treatment instrument for an endoscope includes: an insulated sheath; a treatment member that is provided at a distal end of the sheath; and a wire loop that surround the treatment member and is capable of expansion and contraction by an operation at a proximal side of the sheath.

Abstract: A medical cauterization snare includes a tubular member such as a catheter, a rod or wire disposed at least partially inside the tubular member, and a resilient loop of a first size attached to a distal end of the rod or wire. The loop includes a nose on a side of the loop opposite the wire. The loop further includes two loop sections each extending between the wire and the nose. The loop sections are each formed with a respective notch or dent for enabling a use of the loop in a second size smaller than the first size. Positioning the loop relative to the tubular member so that the notches or dents are disposed at a mouth opening of the tubular member generates this secondary deployment configuration.

Abstract: A medical procedure carried out via a natural opening, comprising: fastening the distal end of thread members to a tissue in a body cavity in proximity to a targeted incision site via a first introduction member that is inserted into a body cavity through a natural opening of an examination subject; inserting a second introduction member having a cutting instrument attached to the distal end thereof into a body cavity through a natural opening of an examination subject and disposing the cutting instrument in proximity to the targeted incision site; and cutting the tissue by pressing the cutting instrument against the tissue while pulling the proximal end sides of the thread members.

Abstract: The present disclosure is directed to electrosurgical pencils having variable controls. In one aspect, the electrosurgical pencil, includes an elongated housing, an electrocautery blade supported within the housing and extending distally from the housing, the electrocautery blade being connected to a source of electrosurgical energy, an activation button supported on the housing, the activation button being movable from a first position to at least a subsequent position, and a transducer electrically connected between the activation button and the source of electrosurgical energy. The transducer is configured to transmit an electrical output signal to the electrosurgical energy source correlating to the movement of the activation button. The source of electrosurgical energy correspondingly supplies an amount of electrosurgical energy to the electrocautery blade dependant upon the electrical output signal.

Abstract: Devices and methods for a minimally invasive procedure for cutting tissue are disclosed. The device generally includes a probe with a distal exit at an exit angle relative to the probe, a cutting loop with shape memory having a preconfigured shape, and a loop securing mechanism to secure the cutting loop in a penetrating configuration and to release the cutting loop into a cutting configuration. The cutting loop is generally within a profile of the probe in the penetrating configuration. In the cutting configuration, the cutting loop extends through the cutting loop exit and generally returns to the preconfigured shape at a cutting angle generally defined by the exit angle. The cutting loop securing mechanism may be, for example, a cover slidable over the probe, a slidable member extending from a distal tip of the probe, or a groove defined in the probe proximal to the cutting loop exit.

Abstract: An ablation device includes a cannula having a distal end and a lumen, an array of electrodes deployable from within the lumen, each of the electrodes having a first configuration when inside the lumen, and a second configuration when unconfined outside the lumen, the electrodes having respective distal ends that point at least partially towards a distal direction when deployed, and an operative electrode secured to the distal end of the cannula. In one embodiment, the operative electrode has a shape that is different from the array of electrodes. In another embodiment, the operative electrode is not retractable within the lumen.

Abstract: An electrically activated surgical device includes a probe body, an active element and a structure for selectively electrically insulating and/or physically isolating the active element from the patient's tissue when the device is in use. The probe body defines an outer surface, a proximal end, a distal end and a window defined within the outer surface near or at the distal end. The active element is electrically connected to a power source and is configured to selectively assume a non-deployed configuration and a variable deployed configuration in which the active element at least partially emerges from the window out of the probe body. The insulating structure selectively insulates the active element from the patient's tissue when the device is inserted therein.

Abstract: Large tissue regions are treated using pairs of electrode arrays. The electrode arrays may be concave and disposed in tissue so that their concave portions are opposed to each other. Axial conductors may be provided extending from the arrays and toward each other in order to increase the heating of tissues lying along the axis between the deployed electrode arrays. By properly spacing the electrode arrays apart and selecting the diameters of the arrays, desired volumes of tissue may be treated, typically with a bipolar, radiofrequency current.

Abstract: An electrosurgical electrode assembly having a cutting device including a catheter with a proximal and distal end, and an electrode carried on the distal end of the catheter. A controller is connected to the cutting device. A data acquisition system is connected to the controller and is capable of monitoring voltage and current output. A microprocessor may also be connected to the data acquisition system for processing voltage and current data from the data acquisition system. A generator is also connected to the data acquisition system. The controller initiates movement of the electrode upon arc initiation at the electrode. Methods of using the devices herein are also disclosed.

Abstract: A medical probe assembly and method are provided for ablating tissue. The probe assembly comprises an elongated shaft and an electrode array mechanically coupled to the distal end of the shaft. The electrode array is configured to assume an outwardly curved shape, when exposed to a first temperature, and assume a pointed tip when exposed to a second temperature less than the first temperature. The first temperature is preferably greater than body temperature, e.g., equal to the tissue ablation temperature, and the second temperature is preferably less than a tissue ablation temperature, e.g., body temperature. In this manner, the pointed tip assumed by the electrode array facilitates introduction of the probe assembly through the tissue prior to the ablation process, while the outwardly curved shape assumed by the electrode array facilitates deployment of the electrode array within the tissue during the ablation process.

Abstract: A physician access system comprising a catheter for use with an endoscope, the catheter including a wire guide lumen having a plurality of access ports disposed along an intermediate portion thereof to permit the insertion of a wire guide at different locations. The location of each access port corresponds to a specific length of the catheter exiting from the distal end of the endoscope. The access ports are located so that at least one of the access ports will be positioned near the endoscope handle when the distal end of the catheter, and any operational tool attached thereto, has been extended a short distance past the distal end of the endoscope. A physician may select the access port which best allows simultaneous control of the wire guide and the endoscope depending on the length of the catheter that the physician desires to have extend from the end of the endoscope.

Abstract: A tissue ablation system is described. The tissue ablation system can include a plurality of electrodes, a viewing window between adjacent electrodes, illuminating elements, and an image sensor. The image sensor can be a CMOS device.

Abstract: An electrosurgical instrument and method is provided for transecting an organ. The electrosurgical instrument includes an introducer having a channel therein, and a conductive wire positioned in and deployable from the channel. A deployment device on the introducer is capable of moving the conductive wire between an undeployed position wherein it is substantially positioned within the channel, and a deployed position wherein a portion is deployed from and positioned outside of the channel and has a substantially looped configuration. A capture element at the distal end of the introducer can secure the distal end of the wire to the introducer, and the deployment device can subsequently move the wire toward the undeployed position to thereby cinch the conductive wire.

Abstract: An endoscope hood comprises a cap section which has A cap section which has a nail section inside of an inner surface of a tip margin, an attaching section which is disposed to a base terminal of the cap section to be attached to a tip of an inserting section of the endoscope, a soft tube 16 of which tip aperture connects to an inside of the cap section so as to insert the snare sheath therethrough, a snare wire which is inserted in the cap section via the soft tube 16, and a snare wire feeding section which is formed by making a notch section in a part of the soft tube in the nail section in a corresponding position to the tip aperture, such that the snare wire can be spread in the cap section so as to be disposed inside of the nail section, and the center axis of the soft tube is disposed so as to pass through a range of the snare wire feeding section.

Abstract: A medical cauterization snare assembly with a tubular member, an electrically conductive cauterization loop ejectable from a distal end of the tubular member, and a capture pouch also ejectable from the distal end of the tubular member. The pouch is attached to an auxiliary loop which has a size larger than that of the cauterization loop. Alternatively, the tubular member is formed at its distal end with a first port or opening and in a distal end portion with a second port or opening spaced from the first port or opening. The two ports or openings both face in a distal direction (i.e., away from the user). The cauterization loop is alternately ejectable from and retractable into the first port or opening, while the capture pouch is separately ejectable from the second port or opening. Alternatively, the capture pouch is attached to the cauterization loop, to only a proximal portion of the loop to divide the loop's area into a proximal section covered by the pouch and an open or uncovered distal section.

Abstract: The present invention relates to a method and a device for transporting a molecule through a mammalian barrier membrane of at least one layer of cells comprising the steps of: ablating the membrane with an electric current from a treatment electrode; and utilizing a driving force to move the molecule through the perforated membrane.

Abstract: A sensing and ablation electrode includes bifurcated sensing limbs separated by an ablation web. The electrode is disposed on the distal end of a catheter. The sensing limbs each support an array of sensors that are individually wired for mapping and post ablation efficacy testing. The web includes a pair of pliable membranes that define a lumen and are adapted to collapse the cross-section of the electrode. One membrane defines a plurality of apertures for dispersing a conductive fluid medium as a virtual electrode. The sensors and the apertures all lie within substantially the same plane.

Abstract: One of a first endoscopic treatment instrument setting state and a second endoscopic treatment instrument setting state is selectable. In the former state, when a first diathermic snare is removably inserted in a flexible tube, a loop portion is circumferentially broadened and disposed along a first projection portion. In the latter state, when a second diathermic snare is removably inserted in the flexible tube, a loop portion is circumferentially broadened and disposed along a second projection portion.

Abstract: A catheter for diagnosis of sphincter motility by measuring pressure exerted by the sphincter and, when necessary, ablating the sphincter immediately after diagnosis of a dysfunction. The catheter is in the form of an elongate sheath that has a proximal end, a distal end, and a longitudinal portion therebetween, with a manometry data collecting portion and a sphincterotome portion located at the distal end, and a handle assembly located at the proximal end. Embodiments are shown wherein the distal end can be aimed in a direction that facilitates cannulating the sphincter by moving the handle assembly. The catheter is used by maneuvering the distal end of the catheter into a sphincter. The manometry data collecting portion is first aligned with the sphincter and pressure measurements are taken. If it is determined that the sphincter is dysfunctional, the sphincterotome portion is aligned with and used to ablate the dysfunctional sphincter.

Abstract: A surgical snare instrument according to several embodiments includes a first handle capable of controlling the rotational position of the snare, and a second handle adapted to control the opening and closing of the snare and cauterization. The first handle serves as a grippable element on the sheath and contains a system which rotates the shaft, and consequently the snare, so that when the physician grips the first handle, the physician is capable of steering the snare by operating the first handle. In addition, the physician is also capable of positioning the entire sheath relative to the endoscope by sliding the sheath into and out of the working channel of the endoscope. The proximal handle is operable by an assistant and permits longitudinal movement of the shaft and cautery application. According to other embodiments, the snare instrument is provided with a mount which enables the snare instrument to be adjustably fixed relative to an endoscope handle.

Abstract: Systems and methods employ a guide element that carries a region of energy emitting material. The systems and methods electronically couple the region to a source of energy that, when emitted by the region, ablates tissue. The systems and methods are responsive to user commands for changing the physical characteristics of the lesions being created by electronically altering the energy emitting characteristics of the region itself.

Abstract: Method, system and apparatus for carrying out electrosurgical procedures interstitially. Elevated temperature fluid such as steam generated by an instrument born electrosurgical cutting arc is evacuated through an intake port located adjacent the cutting electrode. Instrument cannula surface heating caused by transport of the heated fluid is isolated. Such thermal isolation is provided by a thermal shield which may be configured as an enveloping sheath.

Abstract: A surgical instrument and method for facilitating the capture of objects during surgery are provided. The surgical instrument includes a flexible tube defining a cable passageway and being configured for insertion of at least portion of the flexible tube into a body cavity of a patient. The surgical instrument further includes flexible cable slidably disposed in the cable passageway. A snare loop is attached to the cable end and both are adapted so that the snare loop can be selectively retracted or extended within the cable passageway by sliding the cable proximally or distally within the cable passageway. The loop member is adapted for selectively encircling and engaging at least a portion of an object in the body cavity. The system also comprises a tether, the tether attached to the loop member at one end and to the flexible tube at the other, so that extension of the flexible cable causes the snare loop to deform in a predetermined manner.

Abstract: The high frequency surgical instrument includes the electrical connection portion configured to detachably connect the connection cord designed for an external high frequency power source, to the slider, and the instrument has such a structure in which the contact pin configured to lead the connection cord backward in substantially parallel with the advancing and retreating direction of the slider is provided in substantially parallel with the advancing and retreating direction of the slider while the connection cord is connected to the electric connection portion.

Abstract: The ablation catheter is comprised of a guiding catheter and an inner catheter. The guiding catheter is comprised of a shaft section which is attached to an articulating section at its distal end and a first handle at its proximal end. The inner catheter is comprised of an elongated central shaft, an electrode assembly attached to the distal end of the central shaft, and a second handle attached to the proximal end of the central shaft. The electrode assembly is comprised of a flexible plastic catheter tube having an outer surface, a porous tip electrode, and at least one linear electrode carried on the outer surface of the catheter tube. The electrode assembly is articulated to better align the electrode assembly to the generally arcuate shape of the inner chambers of the heart.

Abstract: This invention relates broadly to surgical instruments. More particularly, this invention relates to a surgical snare instrument for excising polyps. Preferably, the instrument includes a coupling member that may increase ability to actuate the snare. According to a preferred embodiment, the present invention comprises a surgical instrument for insertion through an endoscope having a handle and a working channel, said surgical instrument including an elongate flexible tubular sheath having proximal and distal ends; a flexible shaft extending through and axially movable relative to the sheath, said shaft having proximal and distal ends; an end effector coupled to or formed at said distal end of said shaft; and a coupling member disposed at said distal end of said shaft.

Abstract: A medical device and method are provided for positioning and supporting a therapeutic tool within the heart or other body cavity. The device has a tubular member through which a cage can be extended. The cage supports the positioning and delivery of a tool to a targeted treatment or diagnosis area within the heart or other body cavity. Markers on the device facilitate accurate positioning and delivery of the tool.

Abstract: A device for ablating tissue is provided. The device comprises a conductive element with a channel for irrigating fluid formed therein, which is in contact with a non-conductive microporous interface. All or a portion of the interface may be removable. When the interface is removed, a portion of the conductive element is exposed for use in ablating tissue. Methods of using the device and of removing the interface are also provided.

Abstract: An irrigation probe useful for ablation during open heart surgery is provided. The irrigation probe comprises a generally rigid probe body and a handle mounted to the proximal end of the probe body. The generally rigid probe body has an electrode at its distal end having at least one irrigation opening through which fluid can pass. An infusion tube extends through the probe body for introducing fluid to the electrode.

Abstract: An integrated catheter assembly for enabling diverse endoscopic in situ therapies. The assembly includes a catheter with an irrigation fluid lumen, a distal electrode tip portion that acts as a hemostat, and a cutting wire for making incisions in or ablating tissue. A cutting wire hub provides a sealing entrance for a cutting wire. An operator enables the physician to displace the cutting wire between extended and retracted positions. The cutting wire and electrode are electrically isolated. In addition, the catheter assembly may include a planar tip which, when extended outside the distal end of the assembly, assumes a substantially flat unbiased configuration for use. The apparatus of the present invention allows the physician to make incisions in or ablate tissue using electrosurgery, irrigate tissue, and cauterize or coagulate tissue without having to remove the apparatus from the working channel of the endoscope.