公开(公告)号：US06059800A

公开(公告)日：2000-05-09

申请号：US974724

申请日：1997-11-19

申请人： Charles C. Hart ,  Nabil Hilal

发明人： Charles C. Hart ,  Nabil Hilal

IPC分类号： A61B17/06 ,  A61B17/00 ,  A61B17/04

CPC分类号： A61B17/0625 ,  A61B17/0469 ,  A61B17/0483 ,  A61B17/0057 ,  A61B17/0482 ,  A61B2017/00637 ,  A61B2017/00663 ,  A61B2017/0472

摘要： A suturing apparatus is adapted for joining two objects which define a near side and a far side. The apparatus includes an elongate support structure having a working channel and an axis extending between a proximal end and a distal end. The structural support is adapted to be positioned over a guidewire extending between the two objects, in an operative position wherein the proximal end is disposed on the near side and the distal end as disposed on the far side. Removal of the guidewire permits use of a stylet for positioning a suture to extend within the working channel from the proximal end to the distal end. A pair of hooks are movable from a proximal position at the proximal end of the support structure through the objects and a pair of slots in the support structure, to a distal position wherein the hooks engage the suture within the working channel at the distal end of the support structure. The actuator is then operable to move the hooks and the engaged suture from the distal position to the proximal position in order to facilitate tying of the suture and joining of the two objects. Alternatively, suture loops can be carried through the objects by unidirectional hooks and into the working channel. The hooks can then be withdrawn leaving the suture loops in the working channel where they can be engaged by a snare and withdrawn proximally between the two objects. Suturing pledgets can be added to the suturing apparatus prior to operative disposition, and a backing member can be provided to support at least the pledgets when the hook passes through the object.

摘要翻译： 缝合装置适于接合限定近侧和远侧的两个物体。 该装置包括具有工作通道和在近端和远端之间延伸的轴线的细长支撑结构。 结构支撑件适于定位在在两个物体之间延伸的导丝线上，处于操作位置，其中近端设置在远侧并且远端设置在远侧。 导线的移除允许使用探针针定位缝合线在工作通道内从近端到远端延伸。 一对钩可以从支撑结构的近端处的近端位置移动通过物体和支撑结构中的一对狭槽，到达远侧位置，其中钩在工作通道内与缝合线接合在工作通道的远端 支撑结构。 然后致动器可操作以将钩和接合的缝合线从远侧位置移动到近侧位置，以便于缝合缝合和两个物体的接合。 或者，缝合线环可以通过单向钩并进入工作通道而被传送通过物体。 然后可以将钩子撤回离开工作通道中的缝线环，在那里它们可以被圈套接合并且在两个物体之间向近侧撤回。 可以在手术处理之前将缝合物料加入到缝合装置中，并且当钩子穿过物体时，可以提供支撑构件以支撑至少该物品。

公开(公告)号：US6030394A

公开(公告)日：2000-02-29

申请号：US31327

申请日：1998-02-26

申请人： Charles C. Hart

发明人： Charles C. Hart

IPC分类号： A61B17/12 ,  A61B17/08

CPC分类号： A61B17/12009

摘要： A vessel loop adapted to frictionally engage a vessel of a patient includes an elongate elastomeric member having an outer surface which is adapted to be brought into contact with the vessel. A friction-enhancing structure is disposed relative to this outer surface to increase the frictional relationship between the elongate member and the vessel. The friction-enhancing structure may take the form of a woven or non-woven mesh, various projections, bristles, or granules, for example. A woven mesh sleeve is disposed over the elongate member and bonded to the member in a preferred embodiment.

摘要翻译： 适于与患者的血管摩擦接合的容器回路包括细长的弹性构件，其具有适于与容器接触的外表面。 相对于该外表面设置摩擦增强结构以增加细长构件和容器之间的摩擦关系。 摩擦增强结构可以采用例如编织或非织造网，各种突起，刷毛或颗粒的形式。 在优选实施例中，编织网套筒设置在细长构件上并结合到构件。

公开(公告)号：US5853374A

公开(公告)日：1998-12-29

申请号：US540795

申请日：1995-10-11

申请人： Charles C. Hart ,  Desmond H. Birkett

发明人： Charles C. Hart ,  Desmond H. Birkett

IPC分类号： A61B17/00 ,  A61B10/00

CPC分类号： A61B17/00234 ,  A61B2017/00287

摘要： A tissue collection apparatus is adapted for use in capturing and removing tissue through a hole in a body wall defining a body cavity. The apparatus includes an elongate flexible enclosure sized and configured to extend through the hole with a first end of the enclosure positioned within the body cavity and a second end of the enclosure positioned outside the body cavity. Portions of the distal end define opposing first and second edges which define an opening into the enclosure. A flap extends through the opening and distally of the apparatus to form a lip facilitating placement of tissue through the opening and into the enclosure. The coupling attaches a tension member to the enclosure along at least a point disposed not more distally than the flap. The tension member can be pulled proximally through the hole in the body wall to invert the apparatus without inverting the flap so that the flap covers the second edge of the opening in order to substantially close the opening with the tissue disposed within the enclosure. A method of use includes the steps of pulling the tension member to invert the enclosure and during the pulling step covering the opening with the flap.

摘要翻译： 组织收集装置适用于通过限定体腔的体壁中的孔捕获和去除组织。 该装置包括细长的柔性外壳，其大小和构造成延伸穿过孔，外壳的第一端定位在体腔内，外壳的第二端位于体腔外部。 远端的部分限定相对的第一和第二边缘，其限定到外壳中的开口。 翼片延伸穿过开口并且远离装置以形成唇缘，促进组织穿过开口并进入外壳中。 联接器将张紧构件沿着不比翼片更远端设置的至少一个点附接到外壳。 张紧构件可以被向近侧拉动穿过体壁中的孔，以反转设备而不翻转翼片，使得翼片覆盖开口的第二边缘，以便基本上用布置在外壳内的组织封闭开口。 一种使用方法包括以下步骤：拉动张紧构件以反转外壳，并且在用翼片覆盖开口的拉伸步骤期间。

公开(公告)号：US5846251A

公开(公告)日：1998-12-08

申请号：US686175

申请日：1996-07-22

申请人： Charles C. Hart

发明人： Charles C. Hart

IPC分类号： A61B17/22

CPC分类号： A61B17/22031

摘要： An access device having a single sheath is inserted into a body passage puncture, with an expandable member of the access device held to a minimum diameter. The expandable member is held to the minimum diameter using structure that does not increase the diameter of the access device, rather than a large-diameter external sheath. The structure for holding the expandable member to a minimum diameter can subsequently be removed from the lumen of the access device, once the expandable member has been expanded.

摘要翻译： 具有单个护套的进入装置被插入到主体通道穿刺中，其中可访问装置的可扩展构件保持最小直径。 使用不增加进入装置的直径而不是大直径外部护套的结构将可扩展构件保持在最小直径。 一旦可膨胀构件已经膨胀，用于将可扩张构件保持在最小直径的结构可以随后从进入装置的内腔移除。

公开(公告)号：US5658299A

公开(公告)日：1997-08-19

申请号：US504912

申请日：1995-07-20

申请人： Charles C. Hart

发明人： Charles C. Hart

IPC分类号： A61B17/12 ,  A61B17/10

CPC分类号： A61B17/12013

摘要： A ligating device includes an elongate tube having an interior channel and an axis extending between a proximal end and a distal end. A handle is disposed at the proximal end of the tube. Distal portions of the tube define a recess extending into the channel transversely of the axis. A suture extending through the channel includes first portions disposed proximally of the recess and second portions disposed distally of the recess. An engagement apparatus movable by operation of the handle engages the suture distally of the recess and is operable to draw the suture (loop) into the tube. In this manner, the suture substantially encircles the conduit permitting ligation of the conduit. An associated method includes the steps of moving the engagement apparatus to engage the suture and withdraw the suture ends from the body after substantially encircling the body conduit.

摘要翻译： 结扎装置包括具有内部通道和在近端和远端之间延伸的轴线的细长管。 把手设置在管的近端。 管的远端部分限定了沿轴线横向延伸到通道中的凹槽。 延伸穿过通道的缝线包括设置在凹部的近侧的第一部分和设置在凹部的远侧的第二部分。 通过手柄的操作可移动的接合装置与缝隙的远端接合缝合线并可操作以将缝合线（环）拉入管中。 以这种方式，缝合线基本上环绕导管，允许导管连接。 相关联的方法包括以下步骤：移动接合装置以接合缝合线并且在基本上环绕身体导管之后将缝合线端部从主体中取出。

公开(公告)号：US5584850A

公开(公告)日：1996-12-17

申请号：US451022

申请日：1995-05-25

申请人： Charles C. Hart ,  Vincent C. Tangherlini

发明人： Charles C. Hart ,  Vincent C. Tangherlini

IPC分类号： A61B17/34

CPC分类号： A61B17/3498

摘要： A trocar is adapted to form a seal around a surgical instrument and includes a cannula having an axis extending between a proximal end and a distal end. A seal housing disposed at the proximal end has a proximal wall with a hole extending into the housing. A septum valve disposed within the housing has a normal state when the instrument is absent from the trocar, and a stretched state when the instrument is being withdrawn from the trocar. A spacer extending between the proximal wall and the septum valve, engages the valve at a particular position which separates the valve into an inner portion, which is adapted to form a seal with the instrument and an outer portion, which is adapted to form a seal with the housing. The spacer has an axial length sufficient to space the particular position of the septum wall from the hole in the proximal wall a distance greater than the radial length of the inner portions of the valve in the stretched state. The septum valve can be configured to provide an instrument insertion force less than an instrument withdrawal force.

摘要翻译： 套管针适于在外科器械周围形成密封，并且包括具有在近端和远端之间延伸的轴线的套管。 设置在近端的密封壳体具有近端壁，该近端壁具有延伸到壳体中的孔。 设置在壳体内的隔膜阀当仪器不存在于套针针时具有正常状态，并且当仪器从套管针抽出时具有拉伸状态。 在近端壁和隔膜阀之间延伸的间隔件在将阀分离成内部的特定位置处接合阀，该内部适于与仪器形成密封件，外部部分适于形成密封件 与房屋。 间隔件具有足够的轴向长度，用于将隔膜壁的特定位置从邻近壁中的孔延伸到比拉伸状态下阀的内部部分的径向长度的距离。 隔膜阀可以配置为提供小于仪器拔出力的仪器插入力。

公开(公告)号：US5569205A

公开(公告)日：1996-10-29

申请号：US275620

申请日：1994-07-14

申请人： Charles C. Hart ,  Vincent C. Tangherlini

发明人： Charles C. Hart ,  Vincent C. Tangherlini

IPC分类号： A61B17/34 ,  A61M39/22 ,  A61M39/26

CPC分类号： A61B17/3498 ,  A61B17/3462 ,  A61B2017/3445 ,  A61B2017/3449 ,  A61B2017/3466 ,  Y10S128/26

摘要： A trocar adapted to extend across the body wall into a body cavity, and to form a seal around an instrument inserted through the trocar comprises a cannula having a first axis extending between a proximal end and a distal end. A valve housing attached to the proximal end of the cannula forms a working channel with the cannula and includes a rigid housing portion and a flexible housing portion. First and second septum valves are formed in an end wall of the flexible housing portion and form separate valve sets with associated zero closure valves disposed within the valve housing. The valve sets are sized and configured to accommodate different ranges of instrument diameters. The first and second septum valves are offset from the axis of the cannula in their natural positions but are movable to positions more aligned with the axis of the cannula, due to elastomeric characteristics of the flexible housing portions. With multiple valve sets, the trocar can accommodate the simultaneous insertion of two instruments, as well as a full range of instrument diameters.

摘要翻译： 套管针适于延伸穿过体壁进入体腔，并且围绕穿过套管针插入的器械形成密封件，其包括具有在近端和远端之间延伸的第一轴线的套管。 附接到套管的近端的阀壳体与套管形成工作通道，并且包括刚性壳体部分和柔性壳体部分。 第一和第二隔膜阀形成在柔性壳体部分的端壁中并且形成分离的阀组，其具有设置在阀壳体内的相关联的零关闭阀。 阀组的尺寸和构造适合不同范围的仪器直径。 由于柔性壳体部分的弹性特性，第一和第二隔膜阀在其自然位置处偏离插管的轴线，而是可移动到与插管的轴线更为对准的位置。 使用多个阀组，套管针可以同时插入两个仪器，以及全套仪器直径。

公开(公告)号：US20120283518A1

公开(公告)日：2012-11-08

申请号：US13462330

申请日：2012-05-02

申请人： Charles C. Hart

发明人： Charles C. Hart

IPC分类号： A61B1/32

CPC分类号： A61B17/3498 ,  A61B17/3421 ,  A61B17/3462

摘要： A surgical access device includes an elongate cannula having a side wall at the proximal end that is coaxial with and movable relative to a seal-housing. A seal assembly that includes at least one seal is disposed within the seal-housing. An inflation port is formed in on the seal housing and configured to align with an opening in the side wall at the proximal end of the cannula. The seal housing is movable relative to the side wall between an open and closed configuration. In an open configuration, the inflation port is aligned with the opening in the side wall permitting fluid to flow across the cannula side wall. In a closed configuration, the inflation fort is offset from the opening in the side wall preventing fluid flow across the cannula side wall. In one variation, a resilient retention member is disposed inside the seal housing to bias the seal.

摘要翻译： 外科进入装置包括细长插管，该套管具有在近端处的侧壁，其与密封壳体同轴并且可相对于密封壳体移动。 包括至少一个密封件的密封组件设置在密封壳体内。 充气端口形成在密封壳体上并且构造成与套管近端处的侧壁中的开口对准。 密封壳体可以在打开和关闭构型之间相对于侧壁移动。 在打开构造中，充气口与侧壁中的开口对准，允许流体流过套管侧壁。 在闭合构型中，充气堡垒偏离侧壁中的开口，防止流体流过套管侧壁。 在一个变型中，弹性保持构件设置在密封壳体的内部以偏置密封。

公开(公告)号：US20110282157A1

公开(公告)日：2011-11-17

申请号：US13105179

申请日：2011-05-11

申请人： Charles C. Hart ,  Edward D. Pingleton

发明人： Charles C. Hart ,  Edward D. Pingleton

IPC分类号： A61B1/32

CPC分类号： A61B17/0293 ,  A61B17/3423 ,  A61B17/3498 ,  A61B2017/00265

摘要： The invention is directed to a surgical access system that provides access to a surgical area while maintaining pneumoperitoneum during laparoscopic surgery. The access system comprises a sheath retractor adapted to dilate a wound stretchable to a desired diameter and a detachable seal adapted to be removable from the sheath retractor. In another aspect, the detachable seal comprising a valve including a plurality of overlapping sheets defining an access channel that extends into communication with the incision in the patient. Each of the overlapping sheets includes a portion of the perimeter that is not fixed to the inner diameter of the ring, which provide open edges defining the access channel.

摘要翻译： 本发明涉及一种在腹腔镜手术期间保持气腹的外科手术区域的外科进入系统。 所述进入系统包括套管牵开器，所述护套牵开器适于将可拉伸到期望直径的伤口扩张，并且适于可从所述鞘收缩器移除的可拆卸密封件。 在另一方面，所述可拆卸密封件包括阀，所述阀包括多个重叠片材，所述多个重叠片材限定了与所述患者体内的切口连通的进入通道。 每个重叠片材包括未固定到环的内径的周边的一部分，其提供限定接入通道的开口边缘。

公开(公告)号：US07867254B2

公开(公告)日：2011-01-11

申请号：US11954457

申请日：2007-12-12

申请人： Charles C. Hart ,  Said S. Hilal

发明人： Charles C. Hart ,  Said S. Hilal

IPC分类号： A61B17/04

CPC分类号： A61B17/0469 ,  A61B17/0467 ,  A61B17/0487 ,  A61B2017/0454 ,  A61B2017/0464 ,  A61B2017/0488

摘要： A surgical clip having a sliding state and a crimped state is adapted for use in a surgical procedure initially to slide along suture ends to an operative position and ultimately to crimp the suture ends at the operative position. A substrate, bendable between the sliding state and the crimped state carries at least one coating having either lubricious or traction enhancing properties. A second coating can be added to form a coating laminate with the outer coating having lubricious properties facilitating the sliding state and the inner coating having traction enhancing properties facilitating the crimped state.

摘要翻译： 具有滑动状态和卷曲状态的手术夹具适于在外科手术过程中用于最初沿着缝合线端部滑动到操作位置，并且最终将缝线端部压缩在操作位置。 在滑动状态和卷曲状态之间可弯曲的基底携带至少一种具有光滑或牵引增强特性的涂层。 可以添加第二涂层以形成涂层层压体，其中外涂层具有促进滑动状态的润滑性质，并且内涂层具有促进卷曲状态的牵引增强性质。