公开(公告)号：US07326178B1

公开(公告)日：2008-02-05

申请号：US10807368

申请日：2004-03-22

申请人： John P. Lunsford ,  Charles J. Adam ,  John W. Davis ,  Albert K. Chin

发明人： John P. Lunsford ,  Charles J. Adam ,  John W. Davis ,  Albert K. Chin

IPC分类号： A61B1/32

CPC分类号： A61B17/3421 ,  A61B1/3137 ,  A61B1/32 ,  A61B17/00008 ,  A61B17/0218 ,  A61B2017/00778 ,  A61B2017/320044 ,  A61B2017/3456

摘要： A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis that can be skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, a surgeon locates a vessel and side branch of interest and extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be deflected to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool. Removable, transparent tips are selectively positioned at the distal end of the cannula for performing dissection and transection via a single cannula. Additionally, the tips are configured to align the apices of the tips with the central axis of the endoscope to maximize the visual field through the tips via the endoscope. Wing-like protrusions on an alternate tip for the cannula facilitate tissue dissection in forming a tunnel in tissue along a target vessel. Swept back forward edges on the wing-like protrusions promote easy tissue dissection using reduced force to advance the cannula and alternate tip through tissue surrounding the target vessel.

摘要翻译： 牵开器和手术工具定位在套管内，并且牵开器的解剖支架位于套管的远端。 牵开器包括具有大致平行于套管轴线的轴线的第一部分和具有相对于套管轴线可偏斜的轴线的第二部分。 解剖支架位于牵开器的第二部分的远端，并且可以包括两个基本上平行的间隔开的腿，其中牵开器成形为相对于腿的轴线倾斜的平面之间的环中，并且与 环路远离手术工具。 因此，在操作中，外科医生定位感兴趣的血管和侧支，并且将牵开器延伸到支架中，以将解剖支架中的血管摇动。 一旦收起，收缩器可能被偏转以促使血管远离套管的轴线以隔离侧分支以暴露于外科手术工具。 可移除的透明尖端选择性地定位在套管的远端，以通过单个插管进行解剖和切断。 另外，尖端被配置成将尖端的顶点与内窥镜的中心轴线对准，以通过内窥镜通过尖端最大化视野。 用于插管的备选尖端上的翼状突起促进组织解剖，以沿着靶容器在组织中形成隧道。 在翼状突起上扫掠前部前缘，通过减小力促进组织夹层，从而使插管和交替的尖端通过围绕目标血管的组织。

公开(公告)号：US07033357B2

公开(公告)日：2006-04-25

申请号：US10718272

申请日：2003-11-18

申请人： Jeffrey W. Baxter ,  John Davis

发明人： Jeffrey W. Baxter ,  John Davis

IPC分类号： A61B18/12

CPC分类号： A61B17/320783 ,  A61B17/00008 ,  A61B17/32 ,  A61B17/320016 ,  A61B17/32002 ,  A61B18/1482 ,  A61B2017/320741 ,  A61B2018/00202 ,  A61B2018/00601 ,  A61B2018/126 ,  A61B2018/1861

摘要： An apparatus and method for minimally invasive surgery using a cutting tool with rotational cutting edges. The surgical instrument includes a tube having a distal end and a cutting edge at the distal end. A handle is attached to the proximal end of the tube. Within the tube is a shaft having a longitudinally extending blade at its distal end that is adjacent to the distal end of the tube. The blade is revolvable about the longitudinal axis of the instrument to provide rotational cutting action. One or both of the blade and the cutting edge on the tube can be electrically energized to provide for electrocauterization of the body tissue being cut.

公开(公告)号：US06890338B1

公开(公告)日：2005-05-10

申请号：US09794670

申请日：2001-02-27

申请人： John W. Davis ,  Geoffrey H. Willis

发明人： John W. Davis ,  Geoffrey H. Willis

IPC分类号： A61B17/064 ,  A61B17/11 ,  A61B17/08

CPC分类号： A61B17/0644 ,  A61B17/11 ,  A61B2017/00477 ,  A61B2017/0641 ,  A61B2017/1107 ,  A61B2017/1135 ,  A61B2017/1139

摘要： Anastomosis devices, methods and apparatus for installing the devices in the performance of an anastomosis. One example of a device includes a central ring portion from which malleable tines and optionally also fastener elements extend. Each tine may have a weakened section at which it preferentially folds or buckles when subjected to bending force. Each tine can grab and evert tissue around an orifice in which it is installed, as it is moved from an initial to a final configuration. To install a device, the tines are advanced against an anvil to cause them to grab tissue around the orifice and curl radially. The anvil is then retracted to fold the tines so their curled ends move radially outward.

摘要翻译： 吻合装置，用于在进行吻合时安装装置的方法和装置。 装置的一个实例包括中心环部分，可延展尖齿和任选地也可由紧固件元件延伸。 每个齿可能具有弱化部分，在受到弯曲力时它优先折叠或弯曲。 每个齿可以在从初始状态移动到最终配置时，围绕其安装的孔口抓住并转移组织。 为了安装一个装置，尖针先进抵​​靠砧座，使它们抓住孔周围的组织并且径向卷曲。 然后将砧座缩回以折叠尖齿，使得它们的卷曲端部径向向外移动。

公开(公告)号：US6162173A

公开(公告)日：2000-12-19

申请号：US200218

申请日：1998-11-25

申请人： Albert K. Chin ,  Edwin J. Hlavka ,  John P. Lunsford ,  Jeffrey W. Baxter

发明人： Albert K. Chin ,  Edwin J. Hlavka ,  John P. Lunsford ,  Jeffrey W. Baxter

IPC分类号： A61B1/012 ,  A61B1/015 ,  A61B1/018 ,  A61B1/12 ,  A61B17/00 ,  A61B17/02 ,  A61B17/28 ,  A61B17/32 ,  A61B17/12

CPC分类号： A61B1/313 ,  A61B17/00008 ,  A61B17/0218

摘要： A retractor and a surgical tool are positioned within a cannula, and a dissection cradle of the retractor is positioned at the distal end of the cannula. The retractor includes a first portion with an axis approximately parallel to the axis of the cannula and a second portion with an axis skewed relative to the axis of the cannula. The dissection cradle is located at the distal end of the second portion of the retractor, and may include two substantially parallel, spaced legs with the retractor shaped in a loop between and in a plane skewed relative to the axes of the legs, and with the loop directed away from the surgical tool. Thus, in operation, when the surgeon locates a vessel and side branch of interest, the surgeon extends the retractor to cradle the vessel in the dissection cradle. Once cradled, the retractor may be fully extended to urge the vessel away from the axis of the cannula to isolate the side branch for exposure to the surgical tool. The dissection cradle may include a forward shoulder for positioning a suture loop. A forwardly-projecting tensioner supports a length of suture from the loop to maintain the loop in tension for transport along the vein. During advancement, the suture loop is safely maintained in place due to the tension provided by the tension mount and the support provided by the shoulder. Upon reaching the surgical site of interest, the retractor is retracted, causing the suture loop to be displaced onto the vein at the desired position. In one embodiment, the loop is tightened by pulling on the length of suture near the proximal end of the cannula to constrict the suture loop about the vein near the distal end of the cannula.

公开(公告)号：US5941819A

公开(公告)日：1999-08-24

申请号：US869391

申请日：1997-06-05

申请人： Albert K. Chin

发明人： Albert K. Chin

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/22 ,  A61B17/32 ,  A61B17/34 ,  A61B19/00 ,  A61B19/02

CPC分类号： A61B17/0218 ,  A61B17/0281 ,  A61B17/22032 ,  A61B17/3417 ,  A61B90/50 ,  A61B17/3462 ,  A61B2017/00243 ,  A61B2017/00261 ,  A61B2017/00535 ,  A61B2017/00557 ,  A61B2017/320048 ,  A61B2090/306

摘要： A mechanical lifting retractor is provided which increases working space in the chest for cardiac surgery by temporarily expanding the space between the rib cage and the pericardium. The lifting device has a pair of parallel right-angled retractors. Distal portions of the retractors are insertable in side-by-side parallel relation between a pair of adjacent ribs in the rib cage and into the mediastinal space between the ribs and sternum and the pericardium beneath them. The distal portions are pivotable into a lifting position in which they are separated by a rotational angle of approximately 180.degree.. Following insertion of the distal portions into the mediastinal space, the distal portions are rotated into the lifting position and oriented in the sagittal plane such that each distal portion extends beneath one of the ribs. A lifting force is applied to the lifting retractor, causing the distal portions to engage the ribs and to lift the rib cage and thereby enlarging the mediastinal space. The lifting force is maintained for the duration of the surgical procedure.

摘要翻译： 提供了一种机械提升牵开器，其通过临时扩大肋骨和心包之间的空间来增加用于心脏手术的胸部中的工作空间。 提升装置具有一对平行的直角牵开器。 牵开器的远端部可以并排布置在肋骨笼中的一对相邻的肋之间并且在肋骨和胸骨之间的纵隔空间以及它们之下的心包中。 远端部分可转动到提升位置，在该提升位置，它们分开大约180°的旋转角度。 在将远端部分插入纵膈空间之后，远端部分转动到提升位置并且在矢状平面中定向，使得每个远端部分在一个肋下延伸。 提升力被施加到提升牵开器，使得远端部分接合肋并且提升肋骨架，从而扩大纵隔空间。 在外科手术期间维持提升力。

公开(公告)号：US5916233A

公开(公告)日：1999-06-29

申请号：US35704

申请日：1998-03-05

申请人： Albert K. Chin

发明人： Albert K. Chin

IPC分类号： A61B17/00 ,  A61B17/32 ,  A61B17/34 ,  A61M29/00

CPC分类号： A61B17/00008 ,  A61B17/3417 ,  A61B2017/00969 ,  A61B2017/320044 ,  A61B2017/3445

摘要： A blunt dissection cannula and method selectively isolate a vessel of interest within the body of a patient by dissecting connective tissue in and about the adventitial tissue plane. The procedure includes selectively advancing the cannula and transparent tapered tip along the vessel of interior to form an insufflated cavity along the course of the vessel while visualizing the vessel and side branches within the field of view of an endoscope through the transparent tip. An electrocautery electrode selectively extends through an access port at the distal end of the cannula, eccentrically relative to the transparent tip, to facilitate visualizing rotational and translational positioning of the electrode to contact and electrocauterize side branches within the field of view through the transparent tip. A hook-shaped end of the electrode in contact with a cauterized side branch exerts severing tension on the cauterized side branch to isolate the vessel of interest within the insufflated cavity for subsequent transection and removal from the body of the patient.

摘要翻译： 钝性解剖插管和方法通过解剖外膜组织平面内和周围的结缔组织来选择性地分离患者体内的感兴趣的血管。 该过程包括沿着内部容器选择性地推进插管和透明锥形尖端，以沿容器的过程形成吹入腔，同时通过透明尖端在内窥镜的视野内使容器和侧分支可视化。 电烙电极选择性地延伸穿过插管的远端处的入口端口，相对于透明尖端偏心，以便于使电极的旋转和平移定位可视化，以通过透明尖端在视场内接触和电烙化侧枝。 与烧灼侧分支接触的电极的钩形端在烧灼侧支上施加切断张力，以将感兴趣的血管隔离在吸入腔内，以便随后从患者体内切断和移除。

公开(公告)号：US5836871A

公开(公告)日：1998-11-17

申请号：US660728

申请日：1996-06-10

申请人： Daniel T. Wallace ,  Jeffery A. Smith ,  Richard Mueller ,  Joseph Mandato ,  Frederic H. Moll

发明人： Daniel T. Wallace ,  Jeffery A. Smith ,  Richard Mueller ,  Joseph Mandato ,  Frederic H. Moll

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/22 ,  A61B17/30 ,  A61B17/32 ,  A61B17/34 ,  A61B19/00 ,  A61B19/02 ,  A61M29/02

CPC分类号： A61B17/3417 ,  A61B17/0218 ,  A61B17/0281 ,  A61B17/22032 ,  A61B90/50 ,  A61B17/3462 ,  A61B2017/00261 ,  A61B2017/00535 ,  A61B2017/00557 ,  A61B2017/306 ,  A61B2017/320048 ,  A61B2017/3486 ,  A61B2090/306

摘要： An apparatus deployed through a laparoscopic incision in a body wall to apply an external lifting force over a large area of the body wall. The apparatus comprises a body wall engaging element and an elongate lifting member. The body wall engaging element is capable of passing in a packaged state through the laparoscopic incision, is inflatable to an inflated state, and includes, in the inflated state, a plane lifting surface. The elongate lifting member includes a distal portion connected to the plane lifting surface, and capable of passing through the laparoscopic incision. A proximal portion receives the external lifting force in a direction that moves the body wall engaging element into contact with the body wall. A method for lifting a body wall by applying an external lifting force to a large area of the body wall through a laparoscopic incision. The lifting device is provided that includes an body wall engaging element capable of passing through the laparoscopic incision in a packaged state. The lifting device also includes a lifting member including a distal portion to which the body wall engaging element is connected. The body wall engaging element and the distal portion of the lifting member are advanced through the laparoscopic incision. The body wall engaging element is inflated to an inflated state to provide a plane lifting surface. Finally, the external lifting force is applied to the proximal portion of the lifting member to move the lifting surface into contact with the body wall.

摘要翻译： 通过在体壁中的腹腔镜切口部署的装置，以将外部提升力施加在体壁的大面积上。 该装置包括主体壁接合元件和细长提升构件。 身体壁接合元件能够通过腹腔镜切口通过包装状态，可充气至充气状态，并且在膨胀状态下包括平面提升表面。 细长提升构件包括连接到平面提升表面的远端部分，并且能够穿过腹腔镜切口。 近端部分沿着使身体壁接合元件与身体壁接触的方向接收外部提升力。 一种用于通过腹腔镜切口将大体积的外部提升力施加到身体壁上的方法。 提供装置包括能够以包装状态通过腹腔镜切口的主体壁接合元件。 提升装置还包括提升构件，其包括远侧部分，身体壁接合元件连接到该远端部分。 提起构件的身体壁接合元件和远端部分通过腹腔镜切口前进。 体壁接合元件被充气到充气状态以提供平面提升表面。 最后，将外部提升力施加到提升构件的近端部分，以使提升表面与身体壁接触。

公开(公告)号：US5797946A

公开(公告)日：1998-08-25

申请号：US616206

申请日：1996-03-15

申请人： Albert K. Chin

发明人： Albert K. Chin

IPC分类号： A61B17/00 ,  A61B17/11 ,  A61B17/32 ,  A61B17/34 ,  A61B19/00

CPC分类号： A61B17/00008 ,  A61B17/11 ,  A61B17/320016 ,  A61B17/3417 ,  A61B2017/00243 ,  A61B2017/00473 ,  A61B2017/00969 ,  A61B2017/320044 ,  A61B2017/320048 ,  A61B90/36 ,  A61B90/361

摘要： A method of harvesting arterial conduits for coronary bypass grafting includes isolating the internal mammary artery and the superior and inferior epigastric arteries through a subcostal incision using a tapered tip balloon dissection cannula. A free end of the isolated artery may be anastomosed to the coronary artery, and a free graft harvested from the inferior epigastric artery may be anastomosed to the subclavian artery for an additional coronary bypass conduit.

摘要翻译： 收集用于冠状动脉旁路移植的动脉导管的方法包括通过使用锥形尖端气囊解剖插管的肋下切口分离内部乳腺动脉和上下动脉。 隔离动脉的自由端可以与冠状动脉吻合，从下腹部动脉收获的游离移植物可以与锁骨下动脉吻合用于另外的冠状动脉旁路导管。

公开(公告)号：US5704372A

公开(公告)日：1998-01-06

申请号：US282287

申请日：1994-07-29

申请人： Frederic H. Moll ,  Jeffrey A. Smith ,  John P. Lunsford ,  Albert K. Chin

发明人： Frederic H. Moll ,  Jeffrey A. Smith ,  John P. Lunsford ,  Albert K. Chin

IPC分类号： A61B17/00 ,  A61B17/02 ,  A61B17/22 ,  A61B17/30 ,  A61B17/32 ,  A61B17/34 ,  A61B19/00 ,  A61B19/02 ,  A61M29/00

CPC分类号： A61B17/3417 ,  A61B17/0218 ,  A61B17/0281 ,  A61B17/22032 ,  A61B90/50 ,  A61B17/3462 ,  A61B2017/00261 ,  A61B2017/00535 ,  A61B2017/00557 ,  A61B2017/306 ,  A61B2017/320048 ,  A61B2017/3486 ,  A61B2090/306

摘要： An apparatus for separating a first layer of tissue, such as the peritoneum, from a second layer of tissue, such as the properitoneal fascia. The apparatus includes a main envelope that defines a main inflatable chamber. The apparatus also includes an introducing device that introduces the main envelope in a collapsed state between the first layer of tissue and the second layer of tissue. The introducing device also inflates the main envelope into an expanded state to separate the first layer of tissue from the second layer of tissue, and to create a working space between the two layers of tissue. Finally, the apparatus includes an insufflating device that introduces insufflation gas into the working space between the two layers of tissue. A method for separating a first layer of tissue from a second layer of tissue provides a main envelope and insufflation gas. The main envelope defines a main inflatable chamber. The main envelope is introduced in a collapsed state between the first layer of tissue and the second layer of tissue. The main envelope is inflated into an expanded state to separate the first layer of tissue from the second layer of tissue, and to create a working space between the two layers of tissue. Insufflation gas is then introduced into the working space between the layers of tissue.

摘要翻译： 一种用于从第二层组织（例如腹膜筋膜）分离第一层组织（例如腹膜）的装置。 该装置包括限定主充气室的主外壳。 该装置还包括引入装置，该引入装置将第一层组织和第二组织层之间的折叠状态引入主包络体。 导入装置还使主外壳膨胀成展开状态，以将第一层组织与第二层组织分开，并在两层组织之间形成工作空间。 最后，该装置包括将吹入气体引入两层组织之间的工作空间中的吹入装置。 从第二层组织分离组织的第一层的方法提供主包膜和吹入气体。 主要信封定义了一个主要的可充气室。 在第一组织层和第二组织层之间的折叠状态下引入主信封。 主包膜膨胀成膨胀状态以将第一层组织与第二层组织分开，并在两层组织之间产生工作空间。 然后将吹入气体引入组织层之间的工作空间。

公开(公告)号：US5690607A

公开(公告)日：1997-11-25

申请号：US675694

申请日：1996-07-03

申请人： Albert K. Chin ,  Edmund K. M. Isoi

发明人： Albert K. Chin ,  Edmund K. M. Isoi

IPC分类号： A61B6/00 ,  A61B17/00 ,  A61B17/02 ,  A61B17/22 ,  A61B17/30 ,  A61B17/32 ,  A61B17/34 ,  A61B19/00 ,  A61B19/02

CPC分类号： A61B17/0218 ,  A61B17/0281 ,  A61B17/22032 ,  A61B17/3417 ,  A61B90/50 ,  A61B17/3462 ,  A61B2017/00261 ,  A61B2017/00535 ,  A61B2017/00557 ,  A61B2017/306 ,  A61B2017/320048 ,  A61B2090/306

摘要： An apparatus for allowing two retractors, preferably fan retractors, to be used to lift the abdominal wall to provide improved visualization and working space in the abdomen of obese patients, and in the lateral regions of the abdomen of normal patients. The apparatus connects a first retractor and a second retractor to a mechanical lifting arm, and comprises a bar, and first, second, and third connecting devices. The first and second connecting devices are each slidably mounted on the bar, are each lockable to the bar, and connect the first retractor and the second retractor, respectively, to the bar. The third connecting device is attached to the center of the bar and connects the bar to the mechanical lifting arm. The apparatus is used by making a first incision and a second incision in the abdominal wall at separated locations. The first retractor is inserted into the first incision, and the second retractor is inserted into the second incision. The first retractor and the second retractor are attached to the crossbar, anal a lifting force is applied to the crossbar.

摘要翻译： 一种用于允许两个收缩器（优选风扇牵引器）用于提升腹壁以在肥胖患者的腹部以及在正常患者的腹部的侧向区域中提供改善的可视化和工作空间的装置。 该装置将第一牵开器和第二牵开器连接到机械提升臂，并且包括杆，以及第一，第二和第三连接装置。 第一和第二连接装置各自可滑动地安装在杆上，分别被锁定到杆上，并将第一牵开器和第二牵开器分别连接到杆上。 第三连接装置连接到杆的中心并将杆连接到机械提升臂。 该装置通过在分开的位置处在腹壁中进行第一切口和第二切口来使用。 将第一牵开器插入第一切口，将第二牵开器插入第二切口。 第一牵开器和第二牵开器连接到横梁上，肛门将一个提升力施加到横梁上。