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    Methods for performing gastroplasty
    23.
    发明申请
    Methods for performing gastroplasty 有权
    进行胃成形术的方法

    公开(公告)号：US20050250980A1

    公开(公告)日：2005-11-10

    申请号：US10841233

    申请日：2004-05-07

    Applicant: Lee Swanstrom ,  Richard Ewers ,  Tracy Maahs ,  Eugene Chen ,  Vahid Saadat

    Inventor： Lee Swanstrom ,  Richard Ewers ,  Tracy Maahs ,  Eugene Chen ,  Vahid Saadat

    IPC: A61B17/00 ,  A61B17/04 ,  A61B17/08 ,  A61B17/11 ,  A61F2/04 ,  A61F5/00

    CPC classification number: A61B17/00234 ,  A61B17/0401 ,  A61B17/085 ,  A61B17/1114 ,  A61B2017/0496 ,  A61B2017/081 ,  A61F5/0086

    Abstract: The present invention provides methods for performing gastroplasty by reducing the effective volume or cross-sectional area of the stomach via approximation of gastric tissue. Such reduction preferably is achieved endoluminally, either with or without laparoscopic ports. In one variation, a sleeve, pouch, Magenstrasse and Mill, Vertical Banded Gastroplasty (“VBG”), etc., is formed within the stomach by approximating opposing anterior and posterior segments or ridges of the stomach wall at locations inferior to the gastroesophageal junction. In another variation, opposing walls of the stomach are approximated at a plurality of substantially random locations to reduce an effective volume of the stomach. In yet another variation, both a sleeve and random approximations are formed, the random approximations preferably disposed in a portion of the stomach excluded by the sleeve. In still another variation, opposing walls of the stomach are approximated over significant lengths at random or specified locations.

    Abstract translation: 本发明提供了通过胃组织近似来减小胃的有效体积或横截面面积来进行胃成形术的方法。 这种减少优选是在腹腔镜下或腹腔镜下进行的。 在一个变型中，通过在胃壁下方的胃壁的相邻的前部和后部区段或脊部近似形成在胃内形成套筒，袋，Magenstrasse和Mill，垂直带状胃成形术（“VBG”）等 。 在另一个变型中，胃的相对壁在多个基本上随机的位置近似，以减少胃的有效体积。 在另一个变型中，形成套筒和随机近似，随机近似优选地设置在由套筒排除的胃的一部分中。 在另一个变体中，胃的相对的壁在随机或指定的位置处以相当长的长度近似。

    Apparatus and methods for endoscopic suturing
    24.
    发明申请
    Apparatus and methods for endoscopic suturing 有权
    用于内窥镜缝合的装置和方法

    公开(公告)号：US20050119671A1

    公开(公告)日：2005-06-02

    申请号：US10986461

    申请日：2004-11-10

    Applicant: Boris Reydel ,  Cang Lam ,  Richard Ewers ,  Rodney Brenneman ,  Vahid Saadat

    Inventor： Boris Reydel ,  Cang Lam ,  Richard Ewers ,  Rodney Brenneman ,  Vahid Saadat

    IPC: A61B20060101 ,  A61B17/00 ,  A61B17/04 ,  A61B17/08 ,  A61B17/28 ,  A61B19/00

    CPC classification number: A61B17/0469 ,  A61B17/0401 ,  A61B17/0482 ,  A61B17/0625 ,  A61B2017/00353 ,  A61B2017/0417 ,  A61B2017/2927 ,  A61B2090/3614

    Abstract: Apparatus & methods for endoscopic suturing are described herein. A distal tip of the endoscopic device engages the tissue and then approximates the engaged tissue to form a tissue fold. A needle body positioned within a flexible catheter is deployed into or through the newly created tissue fold where it is then detached or released from the endoscopic device. The needle body has a length of suture which depends therefrom and can be used to secure the tissue fold. The entire endoscopic device or its tissue engaging assembly can then be rotated relative to the tissue fold while maintaining engagement with the tissue to maneuver the flexible catheter to the opposing side of the penetrated tissue fold. This procedure can be repeated any number of times to create an interrupted, continuous, or running suture to secure the tissue fold.

    Abstract translation: 本文描述了用于内窥镜缝合的装置和方法。 内窥镜装置的远侧末端接合组织，然后近似接合的组织以形成组织折叠。 定位在柔性导管内的针体部署在新产生的组织折叠中或穿过其中，然后将其从内窥镜装置分离或释放。 针体具有一定长度的缝合线，该缝合线依赖于其而可用于固定组织折叠。 然后，整个内窥镜装置或其组织接合组件可以相对于组织折叠旋转，同时保持与组织的接合，以将柔性导管操纵到穿透的组织折叠的相对侧。 该过程可以重复任意次数以产生中断的，连续的或运行的缝线来固定组织折叠。

    WOUND RETRACTION APPARATUS AND METHOD
    27.
    发明申请
    WOUND RETRACTION APPARATUS AND METHOD 有权
    回绕装置和方法

    公开(公告)号：US20070225569A1

    公开(公告)日：2007-09-27

    申请号：US11755305

    申请日：2007-05-30

    Applicant: Richard Ewers ,  John Brustad ,  Edward Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott Taylor ,  Gary Dulak ,  Michael Dunn ,  Norman Morales ,  Charles Hart ,  Robert Bowes

    Inventor： Richard Ewers ,  John Brustad ,  Edward Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott Taylor ,  Gary Dulak ,  Michael Dunn ,  Norman Morales ,  Charles Hart ,  Robert Bowes

    IPC: A61B1/32

    CPC classification number: A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

    Abstract: A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter, the retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound. A second ring has a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound. A plurality of retraction elements are disposed in a generally cylindrical relationship to each other, between the first ring and the second ring. These elements extend through the wound to exert a radial retraction force on the wound which is dependent on the distance separating the first ring and the second ring Retraction elements, both distensible and non-distensible are contemplated with appropriate attachment means at the rings to provide for variations in the retraction force. With a suitable retraction sleeve, a third ring can be provided to form a circumferential retainer to vary the retraction force. Rings can also be made inflatable or self-expanding to vary the retraction force An associated method includes the step of rolling the second ring circumferentially of the third ring to form the circumferential retainer.

    Abstract translation: 外科伤口牵开器适于将可拉伸至期望直径的伤口扩张，牵开器包括直径大于伤口所需直径的第一环，并适于在伤口内部配置。 第二环的直径大于伤口所需的直径，并且适于在伤口的外部配置。 多个退回元件在第一环和第二环之间以大致圆柱形的关系设置。 这些元件延伸穿过伤口以在伤口上施加径向缩回力，这取决于分离第一环和第二环的距离，缩回元件是可伸长的和不可扩张的，在环处有合适的附接装置，以提供 收缩力的变化。 利用合适的缩回套筒，可以提供第三环以形成圆周保持器以改变收回力。 环也可以制成充气或自膨胀以改变收缩力。相关联的方法包括在第三环周向滚动第二环以形成圆周保持器的步骤。

    Surgical access apparatus and method
    29.
    发明申请
    Surgical access apparatus and method 有权
    手术进入装置及方法

    公开(公告)号：US20060030755A1

    公开(公告)日：2006-02-09

    申请号：US11244647

    申请日：2005-10-05

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

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

    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。 用于制造外科进入装置的方法包括胶凝剂与油的组合，优选在模制过程中。 一种使用该装置的方法包括用该仪器产生开口的步骤。 在特定的过程中，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。 该阀和方法特别适用于腹腔镜手术，其中腹腔用气体吹入，因此需要零密封，器械密封和器官密封。

    Apparatus and methods for optimizing anchoring force
    30.
    发明申请
    Apparatus and methods for optimizing anchoring force 有权
    用于优化锚固力的装置和方法

    公开(公告)号：US20050277981A1

    公开(公告)日：2005-12-15

    申请号：US10865243

    申请日：2004-06-09

    Applicant: Tracy Maahs ,  Richard Ewers ,  Vahid Saadat ,  Alex Khairkhahan ,  Kenneth Michlitsch

    Inventor： Tracy Maahs ,  Richard Ewers ,  Vahid Saadat ,  Alex Khairkhahan ,  Kenneth Michlitsch

    IPC: A61B17/00 ,  A61B17/04 ,  A61B17/06 ,  A61B17/064 ,  A61B17/08 ,  A61B19/00

    CPC classification number: A61B17/0482 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0644 ,  A61B2017/00867 ,  A61B2017/0454 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2090/037

    Abstract: Apparatus and methods for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.

    Abstract translation: 本文描述了用于优化锚固力的装置和方法。 在固定组织褶皱时，通过利用具有可扩张臂的组织锚来避免直接位于锚固件正下方的组织的过度压缩，所述组织锚构造成使锚和组织之间的接触面积最小化。 当锚固件处于其膨胀构型时，将负载施加到锚固件，直到其被最佳地构造成适应一定范围的偏转，同时锚固件本身对组织施加基本恒定的力。 可以使用各种装置，例如止动件，弹簧构件，保险丝，应变计等来指示锚固件何时被偏转到最佳范围内的预定水平。 此外，影响锚固特征的其他因素包括例如改变锚的臂或支柱的数量，臂的定位，臂的构型，套环的长度等。

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