公开(公告)号：US07390329B2

公开(公告)日：2008-06-24

申请号：US11036946

申请日：2005-01-14

Applicant: Hendrik S. Westra ,  Cang C. Lam ,  Richard C. Ewers ,  Vahid Saadat

Inventor： Hendrik S. Westra ,  Cang C. Lam ,  Richard C. Ewers ,  Vahid Saadat

IPC: A61B17/10 ,  A61B17/08

CPC classification number: A61B17/0469 ,  A61B17/00234 ,  A61B17/0401 ,  A61B17/0487 ,  A61B17/22031 ,  A61B17/29 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00407 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/0406 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0443 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/045 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0456 ,  A61B2017/0458 ,  A61B2017/0459 ,  A61B2017/0461 ,  A61B2017/0464 ,  A61B2017/0474 ,  A61B2017/0475 ,  A61B2017/0477 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06028 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/06171 ,  A61B2017/06176 ,  A61B2017/0649 ,  A61B2090/061

Abstract: Methods and apparatus for controlled grasping and cinching or locking of a tissue anchor are provided. In one variation, a tube is provided having a lumen and a resilient member that obstructs the lumen. A grasper may be advanced coaxially through the lumen, such that it reversibly displaces the resilient member and extends beyond the lumen's outlet to engage an element of the tissue anchor. The grasper then may be retracted within the tube, such that the resilient member again obstructs the lumen of the tube. Continued retraction of the grasper may act to cinch the anchor, for example, via interaction between the anchor and the obstructing resilient member. During cinching, a cinching mechanism of the anchor optionally may be positioned at least partially within the tube to enhance lateral stability. Furthermore, feedback indicative of a degree of cinching or locking may be provided during cinching.

Abstract translation: 提供了用于控制抓握和夹紧或锁定组织锚的方法和装置。 在一个实施例中，提供具有内腔和阻碍内腔的弹性构件的管。 夹持器可以同轴地穿过管腔前进，使得其可逆地移位弹性构件并且延伸超出管腔的出口以接合组织锚的元件。 然后，抓紧器可以缩回到管内，使得弹性构件再次阻塞管的内腔。 抓持器的继续缩回可以例如通过锚固件和阻碍弹性构件之间的相互作用而使锚固件收紧。 在收紧期间，锚固件的收紧机构任选地可以至少部分地定位在管内以增强横向稳定性。 此外，可以在收紧期间提供表示收紧或锁定程度的反馈。

公开(公告)号：US07347863B2

公开(公告)日：2008-03-25

申请号：US10955245

申请日：2004-09-29

Applicant: Chris Rothe ,  Richard C. Ewers ,  Cang C. Lam ,  Vahid Saadat ,  Kenneth J. Michlitsch

Inventor： Chris Rothe ,  Richard C. Ewers ,  Cang C. Lam ,  Vahid Saadat ,  Kenneth J. Michlitsch

IPC: A61B17/10 ,  A61B17/00 ,  A61B17/08

CPC classification number: A61B1/0014 ,  A61B17/0401 ,  A61B17/06066 ,  A61B17/29 ,  A61B17/295 ,  A61B2017/00867 ,  A61B2017/00876 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/3488 ,  A61B2090/037

Abstract: Apparatus and methods for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract translation: 本文描述了用于操纵和固定组织的装置和方法。 在组织折叠在患者体内产生时，组织操作组件通常可以具有细长的管状构件，可滑动地设置穿过管状构件的接合构件和适于通过螺旋构件接合组织的远端，位于 所述管状构件远端适于在其间稳定组织，以及可围绕所述组织稳定器枢转的输送管。 稳定构件可以适于相对于细长管状构件的纵向轴线成角度。 此外，一个或所有关节运动控制和功能可以集成到通过刚性或柔性管状体连接到组织操作组件的单个手柄组件中。

公开(公告)号：US09585651B2

公开(公告)日：2017-03-07

申请号：US11139920

申请日：2005-05-26

Applicant: Cang C. Lam ,  Richard C. Ewers ,  Robert A. Vaughan ,  Vahid Saadat

Inventor： Cang C. Lam ,  Richard C. Ewers ,  Robert A. Vaughan ,  Vahid Saadat

IPC: A61B17/04 ,  A61B17/29 ,  A61B17/00 ,  A61B17/06

CPC classification number: A61B17/0482 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/29 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/0419 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/2927

Abstract: Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically.

Abstract translation: 本文描述了用于固定和展开组织锚的方法和装置。 组织操作组件可枢转地联接到管状构件的远端。 可重新配置的发射管也可枢转地联接到组织操作组件，组织操作组件可通过可形状锁定的内窥镜装置，常规内窥镜或直接自身进入患者。 第二工具可以与组织操作组件组合使用以接合组织并且与组织操作组件一起操作组织。 提供了一种展开组件，用于通过一个或多个组织锚固件固定所接合的组织，所述展开组件还被配置为使得所述锚固体在内腔或腹腔镜下脱离。

公开(公告)号：US08926634B2

公开(公告)日：2015-01-06

申请号：US11951188

申请日：2007-12-05

Applicant: Chris A. Rothe ,  Richard C. Ewers ,  Cang C. Lam ,  Vahid Saadat ,  Kenneth J. Michlitsch

Inventor： Chris A. Rothe ,  Richard C. Ewers ,  Cang C. Lam ,  Vahid Saadat ,  Kenneth J. Michlitsch

IPC: A61B17/00 ,  A61B17/10 ,  A61B17/08 ,  A61B1/00 ,  A61B17/06 ,  A61B17/295 ,  A61B19/00 ,  A61B17/04 ,  A61B17/34 ,  A61B17/29

CPC classification number: A61B1/0014 ,  A61B17/0401 ,  A61B17/06066 ,  A61B17/29 ,  A61B17/295 ,  A61B2017/00867 ,  A61B2017/00876 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/3488 ,  A61B2090/037

Abstract: Apparatus and methods for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract translation: 本文描述了用于操纵和固定组织的装置和方法。 在组织折叠在患者体内产生时，组织操作组件通常可以具有细长的管状构件，可滑动地设置穿过管状构件的接合构件和适于通过螺旋构件接合组织的远端，位于 所述管状构件远端适于在其间稳定组织，以及可围绕所述组织稳定器枢转的输送管。 稳定构件可以适于相对于细长管状构件的纵向轴线成角度。 此外，一个或所有关节运动控制和功能可以集成到通过刚性或柔性管状体连接到组织操作组件的单个手柄组件中。

公开(公告)号：US08343175B2

公开(公告)日：2013-01-01

申请号：US12767731

申请日：2010-04-26

Applicant: Richard C. Ewers ,  Vahid Saadat ,  Kenneth J. Michlitsch ,  Chris A. Rothe ,  Rodney C. Brenneman ,  Cang C. Lam ,  Eugene G. Chen

Inventor： Richard C. Ewers ,  Vahid Saadat ,  Kenneth J. Michlitsch ,  Chris A. Rothe ,  Rodney C. Brenneman ,  Cang C. Lam ,  Eugene G. Chen

IPC: A61B17/08

CPC classification number: 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

Abstract: 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.

公开(公告)号：US07704264B2

公开(公告)日：2010-04-27

申请号：US10992306

申请日：2004-11-17

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

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

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

CPC classification number: 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

Abstract: 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.

Abstract translation: 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：US07361180B2

公开(公告)日：2008-04-22

申请号：US10954666

申请日：2004-09-29

Applicant: Vahid Saadat ,  Richard C. Ewers ,  Cang C. Lam ,  Robert A. Vaughan ,  Chris Rothe ,  Kenneth J. Michlitsch

Inventor： Vahid Saadat ,  Richard C. Ewers ,  Cang C. Lam ,  Robert A. Vaughan ,  Chris Rothe ,  Kenneth J. Michlitsch

IPC: A61B17/00 ,  A61B17/10 ,  A61B17/08

CPC classification number: A61F5/0086 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0483 ,  A61B17/0487 ,  A61B17/06 ,  A61B17/06066 ,  A61B17/064 ,  A61B17/08 ,  A61B17/10 ,  A61B17/12013 ,  A61B17/1285 ,  A61B17/29 ,  A61B2017/00867 ,  A61B2017/0404 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/045 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0456 ,  A61B2017/0458 ,  A61B2017/0459 ,  A61B2017/0461 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/0475 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/081 ,  A61B2017/3488

Abstract: Apparatus for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract translation: 本文描述了用于操纵和固定组织的装置。 在组织折叠在患者体内产生时，组织操作组件通常可以具有细长的管状构件，可滑动地设置穿过管状构件的接合构件和适于通过螺旋构件接合组织的远端，组织稳定构件 所述管状构件远端适于在其间稳定组织，以及可围绕所述组织稳定器枢转的输送管。 稳定构件可以适于相对于细长管状构件的纵向轴线成角度。 此外，一个或所有关节运动控制和功能可以集成到通过刚性或柔性管状体连接到组织操作组件的单个手柄组件中。

公开(公告)号：US08906038B2

公开(公告)日：2014-12-09

申请号：US13033485

申请日：2011-02-23

Applicant: Richard C. Ewers ,  Eugene G. Chen ,  Tracy D. Maahs ,  Stuart Moran ,  Cang C. Lam

Inventor： Richard C. Ewers ,  Eugene G. Chen ,  Tracy D. Maahs ,  Stuart Moran ,  Cang C. Lam

IPC: A61B17/10 ,  A61B17/08 ,  A61B17/04 ,  A61B17/42 ,  A61F5/00 ,  A61B17/00 ,  A61B17/06 ,  A61B17/29

CPC classification number: A61B17/04 ,  A61B17/0487 ,  A61B17/42 ,  A61B2017/00349 ,  A61B2017/00818 ,  A61B2017/00867 ,  A61B2017/0404 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0464 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/2926 ,  A61F5/0083

Abstract: Devices and methods for forming and securing tissue folds and elongated invaginations in gastric tissue are used as a treatment for obesity. In several embodiments, a plurality of tissue folds is formed along the greater curvature of the stomach using laparoscopic tissue anchor deployment devices. Additional embodiments include various combinations of tissue folds, elongated invaginations, and other reconfigurations of stomach tissue using laparoscopic devices or laparoscopic devices in combination with endoscopic devices.

Abstract translation: 用于在胃组织中形成和固定组织褶皱和细长凹陷的装置和方法用作肥胖症的治疗。 在几个实施例中，使用腹腔镜组织锚定部署装置沿着胃的较大曲率形成多个组织褶皱。 另外的实施例包括使用腹腔镜装置或腹腔镜装置与内窥镜装置组合的组织折叠，细长凹陷和胃组织的其它重新配置的各种组合。

公开(公告)号：US08298291B2

公开(公告)日：2012-10-30

申请号：US11412261

申请日：2006-04-26

Applicant: Richard C. Ewers ,  Cang C. Lam

Inventor： Richard C. Ewers ,  Cang C. Lam

IPC: A61F2/02

CPC classification number: A61B17/29 ,  A61B17/0401 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/0482 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00867 ,  A61B2017/0419 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/2927

Abstract: Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically by applying thermal energy through at least one suture cutting element disposed along the deployment assembly.

Abstract translation: 本文描述了用于固定和展开组织锚的方法和装置。 组织操作组件可枢转地联接到管状构件的远端。 可重新配置的发射管也可枢转地联接到组织操作组件，组织操作组件可通过可形状锁定的内窥镜装置，常规内窥镜或直接自身进入患者。 第二工具可以与组织操作组件组合使用以接合组织并且与组织操作组件一起操作组织。 提供了一种展开组件，用于通过一个或多个组织锚固件固定所接合的组织，所述展开组件还被配置为通过沿着所述展开组件布置的至少一个缝合线切割元件施加热能而使所述锚定器在内部或腹腔镜下脱离。

公开(公告)号：US08066719B2

公开(公告)日：2011-11-29

申请号：US10992912

申请日：2004-11-18

Applicant: Richard C. Ewers ,  Boris Reydel ,  Cang C. Lam ,  Eugene Chen ,  Brent D. Seybold ,  Rodney Brenneman ,  Vahid Saadat

Inventor： Richard C. Ewers ,  Boris Reydel ,  Cang C. Lam ,  Eugene Chen ,  Brent D. Seybold ,  Rodney Brenneman ,  Vahid Saadat

IPC: A61B17/10 ,  A61B17/32

CPC classification number: A61B17/00234 ,  A61B17/0401 ,  A61B17/0487 ,  A61B17/0644 ,  A61B17/29 ,  A61B17/3421 ,  A61B17/3468 ,  A61B17/3478 ,  A61B2017/0404 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/061 ,  A61B2017/3445 ,  A61B2017/3488

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point.

Abstract translation: 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来形成胃肠组织折叠，将第一组织接触点从最初远端到第二组织接触点的位置移动到第二接触点的近侧的位置，以形成 组织折叠，并且使锚固组件穿过第二组织接触点附近的组织褶皱延伸。