A system may comprise a first catheter having a first steerable segment and a second catheter disposed within the first catheter. The second catheter may have a second steerable segment. The system may also comprise an imaging element supported at a distal end of the second catheter, a coil reference sensor supported at a distal portion of the second catheter, and a processor in electrical communication with the coil reference sensor. The processor may be configured to determine a position of a distal portion of the first catheter with reference to the coil reference sensor.

Disclosed is an endoscopic device comprising an insertion tube, a distal tip, and at least one camera located at an initial location on or in the distal tip or the insertion tube. The endoscopic device is characterized in that it comprises a mechanical arrangement that is activated from the proximal end of the endoscopic device and is configured to do at least one of the following: (a) to move the at least one camera from the initial location to one or more different locations on, in or spaced away from the distal tip or the insertion tube; and (b) to change the direction of view of the at least one camera. Also disclosed are methods of performing endoscopic procedures using embodiments of the endoscopic device.

An endoscopic suturing system and method are disclosed as are devices for use with the system and method such as a suture dispenser, a cinch device, and a tissue grasper. In one embodiment the suturing system includes a cap assembly arranged at the distal end portion of an endoscope or guide member, with the cap assembly including a rotatable needle holder. The needle holder is actuated through a transmission element extending outside the endoscope or guide member. A needle capture device may be inserted through a channel of the endoscope or guide member in order to capture a needle held in the needle holder when the needle holder is rotated so that the needle punctures tissue.

A clipping system includes a cap configured to be mounted over a distal end of an endoscope. A clip mountable over the cap to move between an insertion configuration, in which first and second jaws extend over opposing portions of the cap so that the first and second jaws are separated from one another, a review configuration, in which the clip is moved distally relative to the cap so that a portion of the clip extends distally until at least a portion of the clip extends into a field of view of the optical system of an endoscope on which the cap is mounted, and a deployed configuration in which the clip is moved distally off of the clip so that the first and second jaws are drawn toward one another under the bias of the at least one hinge to close over tissue received therebetween.

The disclosure relates generally to devices and methods for treating a tissue defect, for example, by suturing. In some embodiments, a suturing device may include an elongate member having a working channel, a suture channel, and a suture arm extending from the elongate member. The suturing device may further include a needle passer located within the working channel, the needle passer operable to deliver a needle between the elongate member and a distal end of the suture arm for suturing a target tissue, and a suture extending through the suture channel, wherein the suture is coupled to the needle. The suturing device may further include a plurality of imaging devices, wherein a first imaging device is positioned along a distal face of the elongate member, and wherein a second imaging device is positioned along the suture arm.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

A guide wire gripping device is provided that includes: a sheath; an advanceable and retractable part extending along the longitudinal axis of the sheath; an operation control that moves the advanceable and retractable part along the longitudinal axis; a grasping portion having a contact surface having a peripheral edge surrounded by a distal end, a proximal end, and a pair of side ends; and a support part connected to the advanceable and retractable part and fixed to one of the pair of side ends.

A tissue traction device, system, and method presenting a grasping rail for coupling with a portion of a target tissue at a treatment site to apply a force, such as traction, to the grasped tissue, such as to facilitate performance of a procedure on the target tissue. A tissue traction device, system, and method having a distal support element, a proximal support element, and at least one expansion element extending therebetween. The at least one expansion element is extendable to define a working area for a procedure to be formed on target tissue at a treatment site. Two or more expansion elements may define a working area unimpeded by the expansion elements. The distal support element may be expandable to anchor the tissue traction device with respect to tissue.

A low profile surgical system includes a movable cart assembly, an endoscope, and a surgical instrument. The movable cart assembly includes a fluid source and a receptacle assembly that are in fluid communication with one another. The endoscope is operably coupled to the cart assembly and in fluid communication with the fluid source. The surgical instrument is operably coupled to the cart assembly. The surgical instrument and the endoscope are configured to dispense outflow fluid into the receptacle assembly.

A tissue displacing and fastening device is provided for manipulating and fastening tissue together. The device includes a tissue displacing elements, which displaces tissue. A fold is formed from the displaced tissue and the tissue is fastened together to secure the fold.