A medical apparatus includes an inflow tube having a first conduit having a first inner diameter. An outflow tube has a second conduit having a second inner diameter. An intermediate tube has a first end and a second end, the first end connected to the inflow tube and the second end connected to the outflow tube. The intermediate tube has a third inner diameter, the third inner diameter being larger than the first inner diameter and the second inner diameter. The intermediate tube defines a flow path. The flow path includes a first flow path configured to direct a liquid flowing along the flow path in a first direction, and a second flow path configured to direct the liquid flowing along the flow path in a second direction. The first direction is opposite to the second direction.

According to one aspect, a medical device may be configured for use with an endoscope and may include a tool. The tool may include an actuator, at least one extension at a distal portion of the actuator, and a distal end. The at least one extension may extend radially outward from the actuator and may have an edge configured to fragment debris within a body. The medical device may also include a cap configured for coupling to a distal end of the endoscope, and the cap may include a body defining an opening and a cavity. The opening may be configured to align with optics of the endoscope, and the at least one extension may be positioned within the cavity of the body.

The present 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.

A clipping device includes a clip including a capsule and a pair of clip arms, proximal ends of which are slidably received within the channel to move the clip arms between an open configuration and a closed configuration. Each of the pair of clip arms includes an elongated opening extending through the proximal ends thereof. A connector includes a central portion received between the proximal ends of the clip arms and a pin extending from the central portion receivable within the opening of each of the clip arms, the connector movable from an unlocked configuration, in which the pin is received within a distal portion of the elongated opening, to a locked configuration, in which the pin is received within a proximal portion of the elongated opening, when a predetermined force is applied thereto.

An apparatus for harvesting a vessel from a body, includes: a cannula having a dissector for advancing along the vessel to create a tunnel, the dissector having a transparent portion; and an energy tool moveably coupled to the cannula, wherein the energy tool is configured to separate a pediculated vessel having at least a segment of the vessel and a pedicle around the segment of the vessel from surrounding tissue, and wherein at least a part of the energy tool is visible through the transparent portion of the dissector during use of the energy tool.

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 traction tool for performing traction, of a suture thread under a flexible endoscope is provided. The traction toot includes a first holder configured to hold the suture thread or a suture needle attached to the suture thread; a second holder having an engaging surface configured to engage the suture, thread such that the suture thread is capable of advancing and retracting and configured to release an engagement with the suture thread; and a guide member holding the first holder and the second holder such that the first holder and the second holder are relatively movable.

A traction tool for performing traction of suture thread under a flexible endoscope is provided. The tool includes a shaft, a first holder which is provided at a distal end of the shaft and is configured to hold the suture thread or a suture needle attached to the suture thread, and second holder which is provided closer to a proximal end side of the shaft than the first holder and to which the suture thread is hooked. The second holder is expandable in a radial direction of the shaft.

A device for compressing body tissue includes a clip having a connection portion with first and second clip arms extending therefrom, the clip includes a recess formed on an inner surface of the connection portion, the recess being shaped and sized to slidably receive a mounting bar coupled to an outer surface of an endoscope on which the mounting bar is mounted with inner surfaces of the first and second clip arms maintained in an open position by contact between an endoscope on which the mounting bar is mounted and the inner surfaces of the first and second clip arms. The clip is slidable over the outer surface of an endoscope on which the mounting bar is mounted until the clip moves distally beyond the distal end of the endoscope so that the first and second clip arms spring closed to grip tissue therebetween.

Devices, methods, and systems are provided for consistent and effective delivery of ligating bands. In one embodiment, a crisscross orientation of pull cords along an exterior surface of a ligation barrel can be used to ensure consistent delivery of ligation bands to tissue, resulting in better results for patients and an easier, safer operation for users.