公开(公告)号：US07722642B2

公开(公告)日：2010-05-25

申请号：US10786657

申请日：2004-02-25

申请人： Warren P. Williamson, IV ,  Paul A. Spence ,  George A. Keller ,  Cecil R. Robinson ,  Thomas J. Ward

发明人： Warren P. Williamson, IV ,  Paul A. Spence ,  George A. Keller ,  Cecil R. Robinson ,  Thomas J. Ward

IPC分类号： A61B17/08 ,  A61B17/10

CPC分类号： A61F2/2427 ,  A61B17/0401 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/064 ,  A61B17/0644 ,  A61B17/0684 ,  A61B17/072 ,  A61B17/115 ,  A61B2017/00243 ,  A61B2017/0406 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/047 ,  A61B2017/0641 ,  A61B2017/0725 ,  A61B2017/07271 ,  A61B2017/3486 ,  A61B2090/061 ,  A61B2090/395 ,  A61F2/2409

摘要： Wire fasteners having legs with lengths that can be one hundred times the width of the fastener are used to secure items, such as prosthesis valves to a patient during minimally invasive surgery. The fasteners are manipulated into position and then are immobilized by means of the legs thereof for tensioning, cutting and forming in situ. The fasteners are manipulated, tensioned and formed from the leg end of the fasteners. Tools for initially placing the fasteners and for immobilizing, tensioning, cutting and bending the fastener legs are disclosed. Once the fasteners are initially placed, the prosthesis is placed on the long legs of the placed fasteners and is guided into position on the legs. Once the prosthesis is in position, the legs of the fasteners are immobilized, tensioned, cut and bent into staple-like shapes to secure the prosthesis to the patient. A method for carrying out the procedure using the long fastener is also disclosed. Using the teaching of the present disclosure, a surgeon can customize a fastener to the particular surgery or even to the particular portion of surgery being performed during the surgery.

摘要翻译： 具有长度为紧固件宽度的一百倍的腿的电线紧固件用于在微创手术期间将物品（例如假体瓣膜）固定到患者。 紧固件被操纵到位，然后通过其腿部固定，用于原位张紧，切割和成形。 紧固件由紧固件的腿端被操纵，张紧和形成。 公开了用于初始放置紧固件并固定，张紧，切割和弯曲紧固件腿的工具。 一旦紧固件被初始放置，假体被放置在所放置的紧固件的长腿上并且被引导到腿上的位置。 一旦假体就位，紧固件的腿被固定，张紧，切割并弯曲成钉状形状以将假体固定到患者身上。 还公开了一种使用该长紧固件执行该过程的方法。 使用本公开的教导，外科医生可以定制针对特定手术的紧固件，或甚至可以在手术期间执行手术的特定部分。

公开(公告)号：US07476196B2

公开(公告)日：2009-01-13

申请号：US10863409

申请日：2004-06-08

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61B19/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to beat. Various suction cups are described each including at least a first chamber having a flexible rim and configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, includes a suction cup and a support arm connected thereto. The suction cup has a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected therewith. The second chamber is adapted to fluidly connect the first chamber with a source of suction. The support arm is movable with the suction cup to effect movement of the beating heart after engagement of the suction cup to a surface of the beating heart. A method of manipulating a beating heart to orient the beating heart in a desired position for performing a surgical procedure includes providing a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected with the first chamber, the second chamber being further fluidly connected to a source of suction; contacting a surface of the beating heart with the first chamber; applying suction between the first chamber and the surface of the beating heart, thereby engaging the suction member with the surface of the beating heart; and moving the suction member while maintaining engagement with the surface of the beating heart, thereby moving the beating heart.

公开(公告)号：US07377895B2

公开(公告)日：2008-05-27

申请号：US10698798

申请日：2003-10-31

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61F2/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A system for use in conducting coronary surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. The system includes a first device for engaging and repositioning the beating heart to a displaced position, and is capable of maintaining the heart in the displaced position to perform a surgical procedures. The system includes a second device adapted to engage a portion of the heart to immobilize that portion for conducting a surgical procedure in the immobilized location, while the remainder of the heart continues to beat. Both first and second devices may be adapted to be fixed to a relatively stationary object, such as a frame, which may be a sternal retractor.

摘要翻译： 用于进行冠状动脉手术的系统允许在跳动的心脏上进行冠状动脉手术，同时保持心输出量不变且不间断。 Circumflex冠状动脉手术可以使用系统进行。 该系统包括用于将跳动心脏接合并重新定位到移位位置的第一装置，并且能够将心脏保持在移位位置以执行外科手术。 该系统包括适于接合一部分心脏以将该部分固定在固定位置进行外科手术的第二装置，同时心脏的其余部分继续击打。 第一和第二装置可以适于固定到相对静止的物体，例如框架，其可以是胸骨牵开器。

公开(公告)号：US06659270B2

公开(公告)日：2003-12-09

申请号：US10200398

申请日：2002-07-22

申请人： Warren P. Williamson, IV ,  Craig B. Berky ,  Paul A. Spence ,  Mark Ortiz

发明人： Warren P. Williamson, IV ,  Craig B. Berky ,  Paul A. Spence ,  Mark Ortiz

IPC分类号： A61B1706

CPC分类号： A61B17/06138 ,  A61B2017/06142 ,  A61B2017/06157

摘要： A suture package (30) including a panel having a series of superimposed subpanels (32a). A suture (20) loops back and forth on the subpanels (32a) such that adjacent loops are retained on adjacent subpanels (32a) and the adjacent subpanels separate the adjacent loops from one another. In the preferred embodiment, an accordion style panel (32) is utilized and the series of subpanels (32a) are folded into a superimposed relationship. Various features are incorporated to reduce the instances or likelihood of kinking and tangling of the suture (20) when pulled from the package (30) by a user.

公开(公告)号：US08317695B2

公开(公告)日：2012-11-27

申请号：US12336290

申请日：2008-12-16

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61B1/32

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. A component of the system engages the heart with a heart positioning device, repositions the heart into a displaced position and maintains it in the displaced position while the heart continues to beat with substantially unabated and uninterrupted cardiac output. One form of the system can be used in minimally invasive surgery.

摘要翻译： 在心脏手术期间操作心脏的系统允许在跳动心脏上进行冠状动脉手术，同时保持心输出量不变且不间断。 Circumflex冠状动脉手术可以使用系统进行。 该系统的一个组件与心脏定位装置的心脏接合，将心脏重新定位到位移位置，并将其保持在位移位置，同时心脏继续以基本上不间断的和不间断的心输出量搏动。 该系统的一种形式可用于微创手术。

公开(公告)号：US5972004A

公开(公告)日：1999-10-26

申请号：US026671

申请日：1998-02-20

申请人： Warren P. Williamson, IV ,  Paul A. Spence ,  George A. Keller ,  Cecil R. Robinson ,  Thomas J. Ward

发明人： Warren P. Williamson, IV ,  Paul A. Spence ,  George A. Keller ,  Cecil R. Robinson ,  Thomas J. Ward

IPC分类号： A61B17/00 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/072 ,  A61B17/115 ,  A61B17/34 ,  A61B19/00 ,  A61F2/24

CPC分类号： A61B17/0469 ,  A61B17/0644 ,  A61B17/0684 ,  A61B17/072 ,  A61F2/2409 ,  A61F2/2427 ,  A61B17/0401 ,  A61B17/0467 ,  A61B17/0487 ,  A61B17/064 ,  A61B17/115 ,  A61B2017/00243 ,  A61B2017/0406 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/047 ,  A61B2017/0641 ,  A61B2017/3486 ,  A61B2090/061 ,  A61B2090/395

摘要： Wire fasteners having legs with lengths that can be one hundred times the width of the fastener are used to secure items, such as prosthesis valves to a patient during minimally invasive surgery. The fasteners are manipulated into position and then are immobilized by means of the legs thereof for tensioning, cutting and forming in situ. The fasteners are manipulated, tensioned and formed from the leg end of the fasteners. Tools for initially placing the fasteners and for immobilizing, tensioning, cutting and bending the fastener legs are disclosed. Once the fasteners are initially placed, the prosthesis is placed on the long legs of the placed fasteners and is guided into position on the legs. Once the prosthesis is in position, the legs of the fasteners are immobilized, tensioned, cut and bent into staple-like shapes to secure the prosthesis to the patient. A method for carrying out the procedure using the long fastener is also disclosed. Using the teaching of the present disclosure, a surgeon can customize a fastener to the particular surgery or even to the particular portion of surgery being performed during the surgery.

摘要翻译： 具有长度为紧固件宽度的一百倍的腿的电线紧固件用于在微创手术期间将物品（例如假体瓣膜）固定到患者。 紧固件被操纵到位，然后通过其腿部固定，用于原位张紧，切割和成形。 紧固件由紧固件的腿端被操纵，张紧和形成。 公开了用于初始放置紧固件并固定，张紧，切割和弯曲紧固件腿的工具。 一旦紧固件被初始放置，假体被放置在所放置的紧固件的长腿上并且被引导到腿上的位置。 一旦假体就位，紧固件的腿被固定，张紧，切割并弯曲成钉状形状以将假体固定到患者身上。 还公开了一种使用该长紧固件执行该过程的方法。 使用本公开的教导，外科医生可以定制针对特定手术的紧固件，或甚至可以在手术期间执行手术的特定部分。

公开(公告)号：US08162817B2

公开(公告)日：2012-04-24

申请号：US12331722

申请日：2008-12-10

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61F2/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to heat. Various suction cups are described each including at least a first chamber having a flexible rim and configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, includes a suction cup and a support arm connected thereto. The suction cup has a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected therewith. The second chamber is adapted to fluidly connect the first chamber with a source of suction. The support arm is movable with the suction cup to effect movement of the beating heart after engagement of the suction cup to a surface of the heating heart.

摘要翻译： 吸盘适于在跳动的吸盘上移动时将足够的力将跳动的心脏移动到不自然的位置，同时吸盘保持与心脏表面接合并且心脏继续加热。 描述了各种吸盘，每个吸盘至少包括具有柔性边缘的第一腔室，并且构造成与跳动心脏的表面接合，并且第二腔室小于第一腔室并与其流体连接。 一种悬挂装置，其构造成接合跳动的心脏并通过抽吸来保持接合，同时移动所述悬挂装置以使所述跳动的心脏移动到不自然的位置，并且将所述跳动的心脏保持在所述非自然位置以执行外科手术，同时所述心脏继续击打， 包括吸盘和与其连接的支撑臂。 吸盘具有构造成接合跳动心脏表面的第一腔室和小于第一腔室并与其流体连接的第二腔室。 第二室适于将第一室与吸入源流体连接。 支撑臂可随着吸盘移动以在吸盘与加热心脏的表面接合之后实现跳动心脏的运动。

公开(公告)号：US20090099412A1

公开(公告)日：2009-04-16

申请号：US12336290

申请日：2008-12-16

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61B17/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. A component of the system engages the heart with a heart positioning device, repositions the heart into a displaced position and maintains it in the displaced position while the heart continues to beat with substantially unabated and uninterrupted cardiac output. One form of the system can be used in minimally invasive surgery.

摘要翻译： 在心脏手术期间操作心脏的系统允许在跳动心脏上进行冠状动脉手术，同时保持心输出量不变且不间断。 Circumflex冠状动脉手术可以使用系统进行。 该系统的一个组件与心脏定位装置的心脏接合，将心脏重新定位到位移位置，并将其保持在位移位置，同时心脏继续以基本上不间断的和不间断的心输出量搏动。 该系统的一种形式可用于微创手术。

公开(公告)号：US20090099411A1

公开(公告)日：2009-04-16

申请号：US12331722

申请日：2008-12-10

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61B17/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to beat. Various suction cups are described each including at least a first chamber having a flexible rim and configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, includes a suction cup and a support arm connected thereto. The suction cup has a first chamber configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. The second chamber is adapted to fluidly connect the first chamber with a source of suction. The support arm is movable with the suction cup to effect movement of the beating heart after engagement of the suction cup to a surface of the beating heart. A method of manipulating a beating heart to orient the beating heart in a desired position for performing a surgical procedure includes providing a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected with the first chamber, the second chamber being further fluidly connected to a source of suction; contacting a surface of the beating heart with the first chamber; applying suction between the first chamber and the surface of the beating heart, thereby engaging the suction member with the surface of the beating heart; and moving the suction member while maintaining engagement with the surface of the beating heart, thereby moving the beating heart.

公开(公告)号：US07497865B2

公开(公告)日：2009-03-03

申请号：US10855604

申请日：2004-05-26

申请人： Geoffrey H. Willis ,  Thomas A. Kramer ,  Paul A. Spence ,  George T. Christakis ,  Timothy J. McCoy ,  John W. Davis ,  Bradley D. Blackwood ,  Peter Callas ,  Michael Francis Wei ,  Jonathan L. Podmore ,  Andrew Knight ,  Thomas J. Ward ,  Warren P. Williamson, IV

发明人： Geoffrey H. Willis ,  Thomas A. Kramer ,  Paul A. Spence ,  George T. Christakis ,  Timothy J. McCoy ,  John W. Davis ,  Bradley D. Blackwood ,  Peter Callas ,  Michael Francis Wei ,  Jonathan L. Podmore ,  Andrew Knight ,  Thomas J. Ward ,  Warren P. Williamson, IV

IPC分类号： A61B17/08 ,  A61B17/10 ,  A61B17/04

CPC分类号： A61B17/1152 ,  A61B17/11 ,  A61B17/115 ,  A61B2017/1107 ,  A61B2017/1132 ,  A61B2017/1135 ,  A61B2017/1139

摘要： A ring for use in anastomosis. Preferably, the ring is integrally formed from metal, and includes a ring portion and tines and docking members that extend from the ring portion. The ring portion and tines are malleable, and preferably also the docking members are malleable. The ring portion and tines are malleable in the sense that once deformed from a first shape into a second shape, they will not relax back into the first shape from the second. To install the ring in a vessel with the ring portion extending around an incision or other orifice, the tines pierce the tissue around the orifice and are curled against an anvil. The action of curling the tines inverts the tissue near the orifice edges to expose the inside surface of the vessel or organ. Other aspects of the invention are a method and apparatus for installing an anastomosis ring in an incision or other orifice in a vessel or other organ, a method and apparatus for precisely aligning two anastomosis rings (each installed in an incision or other orifice of a different organ) and fastening the aligned rings together. The clips can be crimped onto the aligned rings, or they can be spring clips which are sprung onto the aligned rings to clamp the rings together by spring force. Also within the scope of the invention are crimping and spring clips for use in listening together two aligned anastomosis rings. In other embodiments, the invention is a method for performing an anastomosis by installing an anastomosis ring in an orifice in an organ, installing another anastomosis ring in an orifice in another organ, precisely aligning the two installed anastomosis rings, and fastening the aligned rings together.

摘要翻译： 用于吻合的戒指。 优选地，环由金属一体地形成，并且包括从环部延伸的环部分和尖齿和对接构件。 环形部分和尖齿是可延展的，并且优选的是对接部件是可延展的。 环形部分和尖齿在从第一形状变形成第二形状的意义上是可延展的，它们将不会从第二形状放松回第一形状。 为了将环安装在具有围绕切口或其他孔口延伸的环部分的容器中，齿刺穿孔周围的组织并且卷绕在砧座上。 卷曲尖齿的作用使孔边缘附近的组织反转以暴露血管或器官的内表面。 本发明的其它方面是用于将吻合环安装在容器或其他器官中的切口或其它孔中的方法和装置，用于精确地对准两个吻合环（每个安装在切口或不同的其他孔中的其他孔中的方法和装置） 器官）并将对准的环固定在一起。 夹子可以压接在对准的环上，或者它们可以是弹簧夹，弹簧夹被弹簧上对准的环，以通过弹簧力将环夹在一起。 也在本发明的范围内的是压接和弹簧夹，用于一起收听两个对准的吻合环。 在其他实施例中，本发明是一种通过在器官中的孔中安装吻合环来进行吻合的方法，在另一个器官的孔中安装另一个吻合环，精确对准两个安装的吻合环，并将对准的环固定在一起 。