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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL SCHEDULE 13G
Under the Securities Exchange Act of 1934
General Surgical Innovations, Inc.
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(Name of Issuer)
Common Stock
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(Title of Class of Securities)
371013103
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(CUSIP Number)
Check here if a fee is being paid with this statement: . (A fee is not required
only if the filing person: (1) has a previous statement on file reporting
beneficial ownership of more than five percent of the class of securities
described in Item 1; and (2) has filed no amendment subsequent thereto reporting
beneficial ownership of five percent or less of such class.) (See Rule 13d-7).
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
PAGE 1 OF 9 PAGES
<PAGE>
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CUSIP No. 371013103 13G Page 2 of 9 Pages
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1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
John Hancock Mutual Life Insurance Company
I.R.S. No. 04-1414660
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
(b) |_|
N/A
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Commonwealth of Massachusetts
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5 SOLE VOTING POWER
Number of
Shares -0-
-------------------------------------------------------------
Beneficially 6 SHARED VOTING POWER
Owned by
Each -0-
-------------------------------------------------------------
Reporting 7 SOLE DISPOSITIVE POWER
Person
With -0-
-------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
-0-
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
None except through its indirect, wholly-owned subsidiary, Hancock
Venture Partners, Inc.
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
N/A
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
See line 9, above.
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12 TYPE OF REPORTING PERSON*
IC, BD, IA, HC
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
PAGE 2 OF 9 PAGES
<PAGE>
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CUSIP No. 371013103 13G Page 3 of 9 Pages
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1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
John Hancock Subsidiaries, Inc.
I.R.S. No. 04-2687223
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
(b) |_|
N/A
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware
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5 SOLE VOTING POWER
Number of
Shares -0-
-------------------------------------------------------------
Beneficially 6 SHARED VOTING POWER
Owned by
Each -0-
-------------------------------------------------------------
Reporting 7 SOLE DISPOSITIVE POWER
Person
With -0-
-------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
-0-
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
796,327 through its direct, wholly-owned subsidiary, Hancock Venture
Partners, Inc.
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
N/A
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11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
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12 TYPE OF REPORTING PERSON*
HC
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
PAGE 3 OF 9 PAGES
<PAGE>
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CUSIP No. 113809107 13G Page 4 of 9 Pages
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1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Hancock Venture Partners, Inc.
I.R.S. No. 04-2765223
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_|
(b) |_|
N/A
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3 SEC USE ONLY
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4 CITIZENSHIP OR PLACE OF ORGANIZATION
Delaware
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5 SOLE VOTING POWER
Number of
Shares 796,327
-------------------------------------------------------------
Beneficially 6 SHARED VOTING POWER
Owned by
Each -0-
-------------------------------------------------------------
Reporting 7 SOLE DISPOSITIVE POWER
Person
With 796,327
-------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
-0-
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9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
796,327
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10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
N/A
- --------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
6.0%
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12 TYPE OF REPORTING PERSON*
IA
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
PAGE 4 OF 9 PAGES
<PAGE>
The original statement shall be signed by each person on whose behalf the
statement is filed or his authorized representative. If the statement is signed
on behalf of a person by his authorized representative other than an executive
officer or general partner of the filing person, evidence of the
representative's authority to sign on behalf of such person shall be filed with
the statement, provided, however, that a power of attorney for this purpose
which is already on file with the Commission may be incorporated by reference.
The name and any title of each person who signs the statement shall be typed or
printed beneath his signature.
Note: Six copies of this statement, including all exhibits, should be filed with
the Commission.
Attention: Intentional misstatements or omissions of fact constitute
Federal criminal violations (See 18 U.S.C. 1001)
Item 1(a) Name of Issuer:
General Surgical Innovations, Inc.
Item 1(b) Address of Issuer's Principal Executive Offices:
3172 A Porter Drive
Palo Alto, CA 94304
Item 2(a) Name of Person Filing:
This filing is made on behalf of John Hancock Mutual Life
Insurance Company ("JHMLICO"), JHMLICO's direct,
wholly-owned subsidiary, John Hancock Subsidiaries, Inc.
("JHSI"), and JHSI's wholly-owned subsidiary, Hancock
Venture Partners, Inc. ("Venture").
Item 2(b) Address of the Principal Offices:
The principal business offices of JHMLICO and JHSI are
located at John Hancock Place, P.O. Box 111, Boston, MA
02117. The principal business office of Venture is One
Financial Center, Boston, Massachusetts 02111.
Item 2(c) Citizenship:
JHMLICO was organized and exists under the laws of the
Commonwealth of Massachusetts. JHSI and Venture were
organized and exist under the laws of the State of Delaware.
Item 2(d) Title of Class of Securities:
Common Stock
Item 2(e) CUSIP Number:
371013103
Item 3 If the Statement is being filed pursuant to Rule 13d-1(b),
or 13d-2(b), check whether the person filing is a:
JHMLICO: (a) (X) Broker or Dealer registered under ss.15
of the Act.
(c) (X) Insurance Company as defined in
ss.3(a)(19) of the Act.
(e) (X) Investment Adviser registered under
ss.203 of the Investment Advisers Act of
1940.
JHSI: (g) (X) Parent Holding Company, in accordance
with ss.240.13d-1(b)(ii)(G).
Venture: (e) (X) Investment Adviser registered under
ss.203 of the Investment Advisers Act of
1940.
PAGE 5 OF 9 PAGES
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Item 4 Ownership:
(a) Amount Beneficially Owned: Venture has beneficial
ownership of 796,327 shares of Common Stock. Venture
is a managing general partner of the general partner
of Hancock Venture Partners IV-Direct Fund L.P.
("Fund IV") which holds shares of the Issuer. Venture
has sole beneficial ownership of the shares held in
this partnership. Through their parent-subsidiary
relationship to Venture, JHMLICO and JHSI have
indirect beneficial ownership of the Venture shares.
(b) Percent of Class: 6.0%
(c) (i) sole power to vote or to direct the vote:
Venture has sole power to vote or direct the
vote of 796,327 shares of Common Stock.
(ii) shared power to vote or to direct the vote:
-0-
(iii) sole power to dispose or to direct the
disposition of:
Venture has sole power to dispose or to
direct the disposition of 796,327 shares of
Common Stock.
(iv) shared power to dispose or to direct the
disposition of: -0-
Item 5 Ownership of Five Percent or Less of a Class:
Not applicable.
Item 6 Ownership of More than Five Percent on Behalf of Another
Person:
See Item 4.
PAGE 6 OF 9 PAGES
<PAGE>
Item 7 Identification and Classification of the Subsidiary which
Acquired the Security Being Reported on by the Parent
Holding Company:
See Items 3 and 4 above.
Item 8 Identification and Classification of Members of the Group:
Not applicable.
Item 9 Notice of Dissolution of a Group:
Not applicable.
Item 10 Certification:
By signing below the undersigned certifies that, to the best
of its knowledge and belief, the securities referred to
above were acquired in the ordinary course of business and
were not acquired for the purpose of and do not have the
effect of changing or influencing the control of the issuer
of such securities and were not acquired in connection with
or as a participant in any transaction having such purpose
or effect.
PAGE 7 OF 9 PAGES
<PAGE>
SIGNATURE
After reasonable inquiry and to the best of its knowledge and belief, each
of the undersigned certifies that the information set forth in this statement is
true, complete and correct.
John Hancock Mutual Life Insurance Company
By: /s/ Marion L. Nierintz
Name: Marion L. Nierintz
Dated: January 27, 1997 Title: Second Vice President
John Hancock Subsidiaries, Inc.
By: /s/ Marion L. Nierintz
Name: Marion L. Nierintz
Dated: January 27, 1997 Title: Secretary
John Hancock Venture Partners, Inc.
By: /s/ Martha D. Vorlicek
Name: Martha D. Vorlicek
Dated: January 27, 1997 Title: Vice President & Treasurer
PAGE 8 OF 9 PAGES
<PAGE>
EXHIBIT A
JOINT FILING AGREEMENT
John Hancock Mutual Life Insurance Company, John Hancock Subsidiaries, Inc.
and Hancock Venture Partners, Inc. agree that the Initial Schedule 13G, to which
this Agreement is attached, relating to the Common Stock of General Surgical
Innovations, Inc. is filed on behalf of each of them.
John Hancock Mutual Life Insurance Company
By: /s/ Marion L. Nierintz
Name: Marion L. Nierintz
Dated: January 27, 1997 Title: Second Vice President
John Hancock Subsidiaries, Inc.
By: /s/ Marion L. Nierintz
Name: Marion L. Nierintz
Dated: January 27, 1997 Title: Secretary
John Hancock Venture Partners, Inc.
By: /s/ Martha D. Vorlicek
Name: Martha D. Vorlicek
Dated: January 27, 1997 Title: Vice President & Treasurer
PAGE 9 OF 9 PAGES
