公开(公告)号：US20120184972A1

公开(公告)日：2012-07-19

申请号：US13348201

申请日：2012-01-11

申请人： Cang Lam ,  Richard C. Ewers ,  Christopher James Earley

发明人： Cang Lam ,  Richard C. Ewers ,  Christopher James Earley

IPC分类号： A61B17/04

CPC分类号： A61B17/0401 ,  A61B17/0487 ,  A61B17/29 ,  A61B2017/00353 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0464 ,  A61B2017/06052 ,  A61B2017/2905 ,  A61B2017/2916

摘要： An endoscopic tissue anchor deployment device includes a handle, an elongated shaft defining an internal lumen, and an end effector attached to the distal end of the elongated shaft. A tissue anchor catheter is removably inserted through the lumen of the elongated shaft, the catheter having a tissue anchor assembly that is deployable from its distal end. The handle may include a pin and track assembly that define a series of handle actuation steps corresponding to deployment steps for the deployment device end effector and the tissue anchor catheter. In some embodiments, the handle includes a catheter stop member that prevents movement of the tissue anchor catheter under certain circumstances, and a handle stop member that prevents actuation of the handle under certain circumstances.

摘要翻译： 内窥镜组织锚定部署装置包括手柄，限定内腔的细长轴和附接到细长轴的远端的端部执行器。 组织锚导管可移除地插入穿过细长轴的内腔，该导管具有可从其远端展开的组织锚组件。 手柄可以包括销和轨道组件，其限定对应于展开装置端部执行器和组织锚固导管的展开步骤的一系列手柄致动步骤。 在一些实施例中，手柄包括防止组织锚固导管在某些情况下移动的导管止动构件以及在某些情况下阻止手柄致动的手柄止动构件。

公开(公告)号：US08087413B2

公开(公告)日：2012-01-03

申请号：US11035702

申请日：2005-01-14

申请人： Vahid Saadat ,  Ruey-Feng Peh ,  Richard C. Ewers ,  Eugene G. Chen

发明人： Vahid Saadat ,  Ruey-Feng Peh ,  Richard C. Ewers ,  Eugene G. Chen

IPC分类号： A61B19/00 ,  A61B17/08 ,  A61B17/04 ,  A61F2/04 ,  A61L17/00

CPC分类号： A61B17/0469 ,  A61B17/00491 ,  A61B17/0401 ,  A61B17/0487 ,  A61B17/1114 ,  A61B2017/00349 ,  A61B2017/00495 ,  A61B2017/0406 ,  A61B2017/0454 ,  A61B2017/0464

摘要： The attenuation or isolation of environmental parameters on a gastric lumen is described herein. Once tissue plications are formed into a gastric lumen or sleeve within a stomach, the newly formed lumen is subjected to a multitude of fluctuating stresses or pressure from food or fluids passing therethrough, from naturally-occurring contractions, and/or from changes in pH levels from caustic stomach acids and hormones. The tissue interface between these plications can be isolated from such environmental fluctuations, or the fluctuations can be attenuated, by a number of methods. One example is to place a gastric stent or sleeve within the newly formed lumen. Another example is to utilize multiple rows of anchors, clips, or sutures along the interface. Alternatively, bio-adhesives can be dispensed to buttress the tissue interface. In another variation, the tissue can be approximated in different configurations which effectively reduce or isolate the adhered tissue region.

摘要翻译： 本文描述了在胃腔上的环境参数的衰减或分离。 一旦组织消融在胃内形成胃腔或套管，则新形成的内腔经受来自通过其的食物或液体的多种波动的应力或压力，从天然存在的收缩和/或pH水平的变化 从苛性胃酸和激素。 可以通过多种方法将这些斑点之间的组织界面与这种环境波动隔离，或者波动可以减弱。 一个例子是将胃支架或套管放置在新形成的内腔内。 另一个例子是沿着界面使用多行锚，剪辑或缝线。 或者，可以分配生物粘合剂以支撑组织界面。 在另一个实施方式中，可以以有效地减少或隔离粘附的组织区域的不同配置来近似组织。

公开(公告)号：US08070676B2

公开(公告)日：2011-12-06

申请号：US12960449

申请日：2010-12-03

申请人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

发明人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

IPC分类号： A61B1/32

CPC分类号： A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

摘要： A surgical access device includes an access seal comprising an ultra gel elastomeric material formed of a mixture comprising a triblock copolymer and an oil. The access seal is adapted to be disposed relative to the abdominal wall. At least one access channel is formed through the elastomeric material between a proximal portion and a distal portion of the access seal. The access channel when operatively disposed forms at least a portion of a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The elastomeric material of the access seal is adapted to conform to a surface of an instrument inserted through the working channel to provide instrument access to the abdominal cavity while maintaining insufflation pressure in the abdominal cavity. The access channel is configured to self seal in the absence of any instrument extending through the access channel.

摘要翻译： 外科进入装置包括进入密封件，其包括由包含三嵌段共聚物和油的混合物形成的超凝胶弹性体材料。 进入密封件适于相对于腹壁设置。 在进入密封件的近端部分和远端部分之间通过弹性体材料形成至少一个进入通道。 当操作性地设置时，进入通道形成在腹壁外部的位置与腹壁内部的位置之间的工作通道的至少一部分。 进入密封件的弹性体材料适于与通过工作通道插入的仪器的表面一致，以提供器械进入腹腔，同时保持腹腔内的注射压力。 访问通道被配置为在没有任何通过访问通道延伸的仪器的情况下自封。

公开(公告)号：US07704264B2

公开(公告)日：2010-04-27

申请号：US10992306

申请日：2004-11-17

申请人： Richard C. Ewers ,  Vahid C. Saadat ,  Kenneth J. Michlitsch ,  Chris Rothe ,  Rodney Brenneman ,  Cang C. Lam ,  Eugene C. Chen

发明人： Richard C. Ewers ,  Vahid C. Saadat ,  Kenneth J. Michlitsch ,  Chris Rothe ,  Rodney Brenneman ,  Cang C. Lam ,  Eugene C. Chen

IPC分类号： A61B17/10 ,  A61B17/08 ,  A61B17/15 ,  A61B17/128

CPC分类号： A61B1/0055 ,  A61B1/00135 ,  A61B1/018 ,  A61B1/2736 ,  A61B1/31 ,  A61B17/00234 ,  A61B17/0218 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0487 ,  A61B17/062 ,  A61B17/0625 ,  A61B17/0644 ,  A61B17/29 ,  A61B17/295 ,  A61B17/3421 ,  A61B17/3468 ,  A61B17/3478 ,  A61B2017/00269 ,  A61B2017/003 ,  A61B2017/00353 ,  A61B2017/00827 ,  A61B2017/0404 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0443 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0458 ,  A61B2017/0461 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/061 ,  A61B2017/06176 ,  A61B2017/0649 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2017/2943 ,  A61B2017/3445 ,  A61B2017/3488 ,  A61B2090/3614 ,  A61F5/0086

摘要： Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point and moving the first tissue contact point from a position initially distal to, or in line with, a second tissue contact point to a position proximal of the second contact point, thereby forming the tissue fold, and extending an anchor assembly through the tissue fold from a vicinity of the second tissue contact point. Adjustable anchor assemblies; as well as anchor delivery systems, shape-lockable guides and methods for endoluminally performing medical procedures, such as gastric reduction, treatment of gastroesophageal reflux disease, resection of lesions, and treatment of bleeding sites; are also provided.

摘要翻译： 提供了设备和方法，用于通过在第一组织接触点处接合组织并使第一组织接触点从最初远端或与第二组织接触点一致的位置移动到位于第二组织接触点附近的位置来形成胃肠组织折叠 第二接触点，从而形成组织折叠，并且从第二组织接触点的附近延伸锚固组件穿过组织折叠。 可调锚固组件; 以及锚定递送系统，可锁定形状的导管和用于内窥镜执行医学程序的方法，例如胃减压，治疗胃食管反流疾病，切除病变和治疗出血部位; 也提供。

公开(公告)号：US20090131754A1

公开(公告)日：2009-05-21

申请号：US12360634

申请日：2009-01-27

申请人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

发明人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

IPC分类号： A61B1/32

CPC分类号： A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

摘要： A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.A method for making the surgical access device includes the combining of a gelling agent with an oil, preferably in a molding process. A method for using the device includes steps for creating an opening with the instrument. In a particular process, an organ can be removed from the body cavity through the single valve to create an organ seal while the organ is addressed externally of the body cavity. The valve and method are particularly adapted for laparoscopic surgery wherein the abdominal cavity is insufflated with a gas thereby requiring the zero seal, the instrument seal, and the organ seal in various procedures.

公开(公告)号：US20090023985A1

公开(公告)日：2009-01-22

申请号：US12138348

申请日：2008-06-12

申请人： Richard C. Ewers

发明人： Richard C. Ewers

IPC分类号： A61B1/00

CPC分类号： A61B1/0051 ,  A61B1/00147 ,  A61B1/00149 ,  A61B1/018 ,  A61B17/29 ,  A61B90/50 ,  A61B90/53 ,  A61B2017/003 ,  A61B2017/0409 ,  A61B2017/294 ,  A61B2017/3445 ,  A61B2017/3449

摘要： Endoluminal instrument management systems are described herein which allow one or more operators to manage multiple different instruments utilized in endoluminal procedures. Responsibility for instrumentation management between one or more operators may be configured such that a first set of instruments is controlled by a primary operator and a second set of instruments is controlled by a secondary operator. The division of instrumentation may be facilitated by the use of separated instrumentation platforms or a single platform which separates each instrument for use by the primary operator. Such platforms may be configured as trays, instrument support arms, multi-instrument channels, as well as rigidized portions of instruments to facilitate its handling, among others.

摘要翻译： 本文描述了腔内仪器管理系统，其允许一个或多个操作者管理腔内程序中使用的多种不同仪器。 可以配置一个或多个操作者之间的仪表管理的责任，使得第一组仪器由主操作者控制，第二组仪器由次操作者控制。 可以通过使用分离的仪器平台或将每个仪器分离以供主要操作员使用的单个平台来促进仪器的划分。 这样的平台可以被配置为托盘，仪器支撑臂，多仪器通道，以及便于其操纵的仪器的刚性部分等。

公开(公告)号：US07473221B2

公开(公告)日：2009-01-06

申请号：US10381220

申请日：2001-09-21

申请人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

发明人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

IPC分类号： A61B1/32

CPC分类号： A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

摘要： A surgical access device includes a single valve forming a seal with the body wall and providing an access channel into a body cavity. The valve has properties for creating a zero-seal in the absence of an instrument and an instrument seal with instruments. The valve can include a gel comprised of an elastomer and oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon. A method for making the surgical access device includes combining a gelling agent with oil, preferably in a molding process. A method for using the device includes creating an opening with the instrument. An organ can be removed from the body cavity through the single valve to create an organ seal while the organ is addressed externally of the body cavity.

摘要翻译： 手术进入装置包括单个阀，其与主体壁形成密封并且提供进入体腔的通道。 该阀具有在没有仪器和仪器密封的情况下产生零密封的特性。 阀可以包括由弹性体和油组成的凝胶，其提供大于1000％的伸长率和小于5肖氏A的硬度。单个阀可以用作手术口，其中仪器包括外科医生的手臂。 制造外科进入装置的方法包括将胶凝剂与油组合，优选在模制过程中。 使用该装置的方法包括用仪器创建开口。 器官可以通过单个阀从体腔中移除，以在器官在体腔外部寻址时产生器官密封。

公开(公告)号：US07041052B2

公开(公告)日：2006-05-09

申请号：US10888531

申请日：2004-07-08

申请人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

发明人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC分类号： A61B1/00

CPC分类号： A61B1/0052 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/00154 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/0058 ,  A61B1/31 ,  A61B1/32

摘要： Apparatus and methods are provided for placing and advancing a diagnostic or therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube, a distal region having an atraumatic tip. The overtube may be removable from the handle, and have a longitudinal axis disposed at an angle relative to the handle. The overtube may be selectively stiffened to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The distal region permits passive steering of the overtube caused by deflection of the diagnostic or therapeutic instrument while the atraumatic tip prevents the wall of the organ from becoming caught or pinched during manipulation of the diagnostic or therapeutic instrument.

公开(公告)号：US06942613B2

公开(公告)日：2005-09-13

申请号：US10281461

申请日：2002-10-25

申请人： Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

发明人： Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

IPC分类号： A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/31 ,  A61B1/32 ,  A61B1/00

CPC分类号： A61B1/00154 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/0058 ,  A61B1/008 ,  A61B1/31 ,  A61B1/32

摘要： Apparatus and methods are provided for placing and advancing a diagnostic or therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube disposed within a hydrophilic sheath, and a distal region having an atraumatic tip. The overtube may be removable from the handle, and have a longitudinal axis disposed at an angle relative to the handle. The sheath may be disposable to permit reuse of the overtube. Fail-safe tensioning mechanisms may be provided to selectively stiffen the overtube to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The fail-safe tensioning mechanisms reduce the risk of reconfiguration of the overtube in the event that the tension system fails, and, in one embodiment, rigidizes the overtube without substantial proximal movement of the distal region. The distal region permits passive steering of the overtube caused by deflection of the diagnostic or therapeutic instrument, while the atraumatic tip prevents the wall of the organ from becoming caught or pinched during manipulation of the diagnostic or therapeutic instrument.

公开(公告)号：US06783491B2

公开(公告)日：2004-08-31

申请号：US10173220

申请日：2002-06-13

申请人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

发明人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC分类号： A61B100

CPC分类号： A61B1/00154 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/0058 ,  A61B1/008 ,  A61B1/31 ,  A61B1/32

摘要： Apparatus and methods are provided for placing and advancing a diagnostic or therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube, a distal region having an atraumatic tip. The overtube may be removable from the handle, and have a longitudinal axis disposed at an angle relative to the handle. The overtube may be selectively stiffened to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The distal region permits passive steering of the overtube caused by deflection of the diagnostic or therapeutic instrument while the atraumatic tip prevents the wall of the organ from becoming caught or pinched during manipulation of the diagnostic or therapeutic instrument.

摘要翻译： 提供了设备和方法，用于将诊断或治疗仪器放置并行进在曲折或无支撑的解剖结构的中空身体器官中，包括手柄，外套管，具有无创尖端的远侧区域。 外套管可以从手柄移除，并且具有相对于把手以一定角度设置的纵向轴线。 外套管可以选择性地加强，以减少由诊断或治疗仪器的前进引起的器官膨胀。 远端区域允许由诊断或治疗仪器的偏转引起的外套管的被动转向，而无创伤的尖端在操纵诊断或治疗仪器期间防止器官的壁被卡住或夹住。