公开(公告)号：US06790173B2

公开(公告)日：2004-09-14

申请号：US10173227

申请日：2002-06-13

Applicant: Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

Inventor： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC: A61B104

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

Abstract: 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：US06589208B2

公开(公告)日：2003-07-08

申请号：US09870255

申请日：2001-05-30

Applicant: Richard C. Ewers ,  Boun Pravong ,  Gary R. Dulak

Inventor： Richard C. Ewers ,  Boun Pravong ,  Gary R. Dulak

IPC: A61M2900

CPC classification number: A61M25/04 ,  A61M25/0017 ,  A61M25/10 ,  A61M2025/0213

Abstract: A self-deploying catheter assembly comprises an anchoring device mounted to a tube. A distal end of the anchoring device is held in a fixed position by a releasable suture while a proximal end is freely movable between a proximal position and a distal position defined by a stop on the tube. During insertion into a body cavity, the anchor automatically maintains a low-profile state with the ends spaced apart. Once fully inserted, the anchor self converts into a high-profile state when the tube is slightly withdrawn, bringing the ends closer together. The suture is disengaged to release the distal end of the anchor in order to facilitate a low-profile state for withdrawal of the assembly.

Abstract translation: 自我展开的导管组件包括安装到管的锚定装置。 锚固装置的远端通过可释放的缝合线保持在固定位置，而近端可在由管上的止挡限定的近端位置和远端位置之间自由移动。 在插入体腔内时，锚定器自动保持两端间隔开的低轮廓状态。 一旦完全插入，当管稍微抽出时，锚自身转换成高轮廓状态，使端部更靠近在一起。 缝合线脱离以释放锚固件的远端，以便于用于抽出组件的低调状态。

公开(公告)号：US06231572B1

公开(公告)日：2001-05-15

申请号：US09087361

申请日：1998-05-29

Applicant: Charles C. Hart ,  Nabil Hilal ,  Richard C. Ewers ,  Bounsavanh Pravongviengkham

Inventor： Charles C. Hart ,  Nabil Hilal ,  Richard C. Ewers ,  Bounsavanh Pravongviengkham

IPC: A61B1814

CPC classification number: A61B18/1492 ,  A61B2017/22038 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00285 ,  A61B2018/0041 ,  A61B2018/00505 ,  A61B2018/162

Abstract: A catheter adapted to increase the patency of a body conduit includes an elongate tube having an axis extending between a proximal end and a distal end, and a balloon disposed at the distal end of the tube and having properties for being expanded to a high-profile state and for being contracted to a low-profile state. A sleeve disposed over the balloon has a pair of ends disposed on opposing sides of a central section, the ends having a floating relationship relative to the tube with the central section disposed circumferentially of the balloon. An electrode disposed outwardly of the sleeve has properties for being electrosurgically energized to incise materials defining the body conduit when the balloon is in the high-profile state. The electrode can be formed of a plurality of elements stranded to increase the surface area of the electrode. The catheter can be inserted relative to a guide member having a conductor which carries the electrosurgical energy from the proximal end of the tube to the electrode at the distal end of the tube. An associated method includes the step of introducing electrosurgical energy into the conductor of the guide member to energize the electrode of the catheter.

Abstract translation: 适于增加身体导管的通畅的导管包括具有在近端和远端之间延伸的轴线的细长管和设置在管的远端处的球囊，并且具有用于扩展到高轮廓的性质 并且被缩小到低调的状态。 设置在气囊上方的套筒具有设置在中心部分的相对侧上的一对端部，所述端部相对于管具有浮动关系，其中心部分设置在气囊的周向。 设置在套筒外侧的电极具有电气通电的特性，以便当球囊处于高轮廓状态时切割限定体导管的材料。 电极可以由多个元件形成，以增加电极的表面积。 导管可以相对于具有导体的引导构件插入，该导体将电外科能量从管的近端延伸到管的远端处的电极。 相关联的方法包括将电外科能量引入导向构件的导体以激励导管的电极的步骤。

公开(公告)号：US08870916B2

公开(公告)日：2014-10-28

申请号：US11773933

申请日：2007-07-05

Applicant: Richard C. Ewers ,  Tracy D. Maahs ,  Shirley Vong

Inventor： Richard C. Ewers ,  Tracy D. Maahs ,  Shirley Vong

IPC: A61B17/04 ,  A61B17/00 ,  A61B17/28 ,  A61B17/29 ,  A61B17/06 ,  A61B17/22

CPC classification number: A61B17/0401 ,  A61B17/0487 ,  A61B17/06166 ,  A61B17/22031 ,  A61B17/282 ,  A61B17/29 ,  A61B2017/00004 ,  A61B2017/00526 ,  A61B2017/00862 ,  A61B2017/00986 ,  A61B2017/0403 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0451 ,  A61B2017/0458 ,  A61B2017/048 ,  A61B2017/0496 ,  A61B2017/061

Abstract: Tissue anchors include a flat, broad, and large contact surface for engagement with a portion of tissue. Several embodiments of composite tissue anchors include a support element and an overlay element. Tissue anchor assemblies include two or more tissue anchors, a connector, and a cinching mechanism. In some embodiments, the tissue anchors included in the tissue anchor assemblies are of different types, sizes, and/or shapes.

Abstract translation: 组织锚固件包括平坦的，宽的和大的接触表面，用于与一部分组织接合。 复合组织锚的几个实施例包括支撑元件和覆盖元件。 组织锚组件包括两个或多个组织锚，连接器和收紧机构。 在一些实施例中，包括在组织锚组件中的组织锚固件具有不同类型，尺寸和/或形状。

公开(公告)号：US08828027B2

公开(公告)日：2014-09-09

申请号：US12815335

申请日：2010-06-14

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

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

IPC: A61B17/08

CPC classification number: A61B17/10 ,  A61B1/0051 ,  A61B17/0401 ,  A61B17/0487 ,  A61B17/06066 ,  A61B17/29 ,  A61B2017/00349 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/00876 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/3488 ,  A61B2090/037

Abstract: Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly 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.

Abstract translation: 本文描述了组织操纵和固定系统。 组织操作组件可枢转地联接到管状构件的远端，并且具有下颚构件和可枢转地联接到下颚构件的上颚构件。 可重构的发射管也可枢转地联接到上钳口构件，并且用于将钳口构件从小轮廓构造推动到用于接收组织的打开构型。 组织操作组件可以通过形状可锁定内窥镜装置，常规内窥镜，或者直接自身进入患者。 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。

公开(公告)号：US08496581B2

公开(公告)日：2013-07-30

申请号：US13421730

申请日：2012-03-15

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

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

IPC: A61B1/32

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

Abstract: A device includes an access port adapted to permit access of at least one surgical instrument into a patient. The access port includes a proximal portion, a distal portion, and an intermediate portion monolithically formed of a flexible material. At least one opening extends through the access port. The proximal portion includes a proximal flange. The distal portion includes a distal flange. The intermediate portion includes an outer surface and at least one inner surface. The access port is adapted to form a perimeter seal when the proximal flange is disposed exteriorly and the distal flange is disposed interiorly. The access port is adapted to form a seal with the at least one surgical instrument positioned through the access port. The intermediate portion conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal between the inner surface and the surgical instrument.

Abstract translation: 一种装置包括适于允许至少一个手术器械进入患者的进入口。 进入口包括近端部分，远端部分和由柔性材料整体形成的中间部分。 至少一个开口延伸穿过进入端口。 近端部分包括近侧凸缘。 远侧部分包括远端凸缘。 中间部分包括外表面和至少一个内表面。 当近侧凸缘设置在外部并且远侧凸缘位于内部时，进入口适于形成周边密封。 进入端口适于与通过进入端口定位的至少一个外科器械形成密封。 中间部分符合通过至少一个开口定位的外科器械的表面，并在内表面和外科器械之间形成密封。

公开(公告)号：US08308765B2

公开(公告)日：2012-11-13

申请号：US10840950

申请日：2004-05-07

Applicant: Vahid Saadat ,  Tracy D. Maahs ,  Richard C. Ewers ,  Marvin C. Elmers ,  Jesus Flores ,  Alex Khairkhahan ,  Ruey-Feng Peh ,  Cang C. Lam

Inventor： Vahid Saadat ,  Tracy D. Maahs ,  Richard C. Ewers ,  Marvin C. Elmers ,  Jesus Flores ,  Alex Khairkhahan ,  Ruey-Feng Peh ,  Cang C. Lam

IPC: A61B17/04

CPC classification number: A61B17/08 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/06066 ,  A61B17/064 ,  A61B17/10 ,  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 ,  Y10T24/39 ,  Y10T24/3936

Abstract: Apparatus and methods for positioning and securing anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism either within the anchor itself of positioned proximally of the anchor may allow for the uni-directional translation while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This unidirectional anchor locking mechanism facilitates the cinching of the tissue plication between the anchors and it may be utilized in one or several anchors in cinching a tissue fold.

Abstract translation: 用于定位和固定锚固件的装置和方法适于被输送并植入到组织中，特别是患者胃肠系统内的组织中。 锚固件适于在缝合线上单向滑动，使得组织褶皱可以在锚固件之间束紧。 如果锚固件被拉动，推动或​​沿着缝合线沿相反方向被推动，锚固件本身内的定位器本身内的锁定机构可以允许单向平移，同时使锚固件能够锁定在缝合线上 。 这种单向锚定锁定机构有助于锚固件之间的组织褶皱的收紧，并且可以在一个或多个锚固件中使用紧固组织褶皱。

公开(公告)号：US08277373B2

公开(公告)日：2012-10-02

申请号：US11365088

申请日：2006-02-28

Applicant: Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

Inventor： Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

IPC: A61B1/00

CPC classification number: A61B1/00179 ,  A61B1/0008 ,  A61B1/00183 ,  A61B1/0051 ,  A61B1/018 ,  A61B1/04

Abstract: Methods and apparatus for off-axis visualization are described herein. An endoluminal tissue manipulation assembly is disclosed which provides for a stable endoluminal platform and which also provides for effective triangulation of tools. Such an apparatus may comprise an optionally shape-lockable elongate body defining a longitudinal axis and adapted for endoluminal advancement in a patient body, at least one articulatable visualization lumen disposed near or at a distal region of the elongate body, the at least one articulating visualization lumen being adapted to articulate off-axis relative to a longitudinal axis of the elongate body, and at least one articulatable tool arm member disposed near or at the distal region of the elongate body, the at least one articulatable tool arm member being adapted to articulate off-axis and manipulate a tissue region of interest.

Abstract translation: 本文描述了用于离轴可视化的方法和装置。 公开了一种腔内组织操作组件，其提供稳定的内腔平台，并且还提供工具的有效三角测量。 这种装置可以包括限定纵向轴线并且适于在患者体内进行腔内前进的可选形状可锁定细长体，至少一个可伸长的可视腔，其设置在细长体的远端区域附近或位于该远端区域处，该至少一个铰接可视化 内腔适于相对于细长主体的纵向轴线偏轴关节，以及设置在细长主体的远侧区域附近或其附近的至少一个可铰接工具臂构件，所述至少一个可铰接工具臂构件适于铰接 离轴并且操纵感兴趣的组织区域。

公开(公告)号：US08216253B2

公开(公告)日：2012-07-10

申请号：US12107701

申请日：2008-04-22

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

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，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：US08105234B2

公开(公告)日：2012-01-31

申请号：US12360710

申请日：2009-01-27

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

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

IPC: A61B1/32

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

Abstract: 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.

Abstract translation: 外科进入装置包括与主体壁形成密封并且将进入通道提供到体腔中的单个阀。 该阀具有在没有仪器的情况下产生零密封的特性，以及具有仪器直径范围的仪器的仪器密封。 该阀可以包括凝胶，优选地包括由弹性体和提供大于1000％的伸长率和小于5肖氏A的硬度的油的超细颗粒。单个阀可用作手动口，其中仪器包括外科医生的手臂 ，从而提供手进入空腔。