Endoscopic suturing system having external instrument channel

An endoscopic treatment system for use with an endoscope having a proximal end and a distal end, a longitudinal axis extending therebetween, and a circumference, comprising:

• a) a distal cap assembly having an end effector rotatable on an axis between open and closed positions, the end effector having a free end;
• b) a transmission assembly having proximal and distal ends, the distal end operably coupled to the end effector such that displacement of at least a portion of the transmission assembly rotates the end effector between the open and closed positions;
• c) a proximal handle assembly coupled to the transmission assembly and adapted to effect the displacement of at the least a portion of the transmission assembly to rotate the end effector;
• d) first and second lumen extending from the cap assembly to the proximal handle assembly for receiving instruments therethrough, the first lumen in alignment with the free end of the end effector, and the second lumen position between the first lumen and the axis on which the end effector rotates;
• and
• f) a plurality of clips spaced apart along the transmission assembly and first and second lumen, the clips each having a body adapted to extend greater than 180° about the circumference of the endoscope, the clips defining slots filled with a material having a higher coefficient of friction than the body.

An endoscopic treatment system for use with an endoscope having a proximal end and a distal end and a longitudinal axis extending therebetween, comprising:

• a) a distal cap assembly having an end effector rotatable on an axis between open and closed positions, the end effector having a free end;
• b) a transmission assembly having proximal and distal ends, the distal end operably coupled to the end effector such that displacement of at least a portion of the transmission assembly rotates the end effector between the open and closed positions;
• c) a proximal handle assembly coupled to the transmission assembly and adapted to effect the displacement of at the least a portion of the transmission assembly to rotate the end effector;
• d) first and second lumen extending from the cap assembly to the proximal handle assembly for receiving instruments therethrough, the first lumen in alignment with the free end of the end effector, and the second lumen position between the first lumen and the axis on which the end effector rotates;
• and
• e) a peripheral engagement structure adapted to be positioned about greater than 180° of a circumference of the distal end of the endoscope, the peripheral engagement structure integrated with the cap assembly.