EXHIBIT 4.1 FIRST AMENDMENT TO RIGHTS AGREEMENT This First Amendment to Rights Agreement dated as of August 23, 1999 (this "AMENDMENT"), to the Preferred Shares Rights Agreement dated as of May 9, 1997 (the "AGREEMENT"), is entered into by and between...Rights Agreement • September 2nd, 1999 • General Surgical Innovations Inc • Surgical & medical instruments & apparatus • California
