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    Apparatus and method for subcuticular stapling of body tissue
    31.
    发明授权
    Apparatus and method for subcuticular stapling of body tissue 失效
    身体组织皮下吻合装置及方法

    公开(公告)号：US5389102A

    公开(公告)日：1995-02-14

    申请号：US959242

    申请日：1992-10-09

    申请人： David T. Green ,  Henry Bolanos ,  Maria Lopez-Isa ,  Marc J. Theroux ,  John C. Robertson ,  Joseph M. Paul ,  Stephen W. Gerry ,  Wayne P. Young

    发明人： David T. Green ,  Henry Bolanos ,  Maria Lopez-Isa ,  Marc J. Theroux ,  John C. Robertson ,  Joseph M. Paul ,  Stephen W. Gerry ,  Wayne P. Young

    IPC分类号： A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/28 ,  A61B17/68

    CPC分类号： A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/282 ,  A61B17/68

    摘要： A surgical apparatus for attaching two portions of cutaneous body tissue includes a pair of opposed elongated members having jaws which have tissue gripping members thereon at one end and which are movable toward each other to a closed position to engage two body tissue portions positioned within the members to move the body tissue portions into close approximation. Manually gripping systems of several alternative configurations are provided to actuate a mechanical transmission system to close the jaws. In a preferred embodiment, a fork is movable from a first position to a second position by manually operable devices to move the jaws toward each other. A pair of cam faces is located adjacent the opposite ends of the jaws. As the fork moves to its second position, the tines of the fork engage against the cam faces to move the opposed jaws to their closed position. A plurality of rod-like fasteners are carded in a stacked configuration proximally of the jaws such that when the jaws are in their closed position and the two body tissue portions are held in close approximation. Each rod-like fastener is movable to a position in ingress to penetrate the body tissue portions to attach the body tissue portions together. In another preferred embodiment, the elongated members are biased outwardly by a coil spring and a unique plate-like fastener drive member is provided to facilitate driving a fastener after the jaws are closed. A fastener cartridge is provided with fasteners stacked in a sloped fashion and having a coil spring to bias the fasteners toward the ejection position. Another embodiment includes a rack and gear teeth arrangement for approximating the jaws and for firing the fasteners. The rack and gear teeth function somewhat like a linear analog of a set of rotary gears. A method of attaching cutaneous body tissue portions is also disclosed.

    摘要翻译： 用于附接皮肤体组织的两部分的手术装置包括一对相对的细长构件，其具有在其一端具有组织夹持构件的钳口，并且可相对于彼此移动到关闭位置以接合位于构件内的两个身体组织部分 将身体组织部分移动到近似。 提供了几种替代配置的手动夹紧系统来致动机械传动系统以闭合钳口。 在优选实施例中，叉可以通过手动操作的装置从第一位置移动到第二位置，以将夹爪朝向彼此移动。 一对凸轮面邻近钳口的相对端定位。 当叉移动到其第二位置时，叉的齿与凸轮面接合，以将相对的夹爪移动到其关闭位置。 多个杆状紧固件被卡在卡爪的近侧的堆叠构造中，使得当夹爪处于其关闭位置并且两个身体组织部分保持紧密接近时。 每个杆状紧固件可移动到入口位置以穿透身体组织部分以将身体组织部分附接在一起。 在另一优选实施例中，细长构件被螺旋弹簧向外偏压，并且提供了独特的板状紧固件驱动构件，以便于在夹爪关闭之后驱动紧固件。 紧固件卡盒设置有​​以倾斜方式堆叠的紧固件，并且具有螺旋弹簧以将紧固件偏压到喷射位置。 另一个实施例包括用于近似钳口和用于击发紧固件的齿条和齿轮齿布置。 齿条和齿轮齿有点像一组旋转齿轮的线性模拟。 还公开了附着皮肤组织部分的方法。

    Surgical stapler apparatus
    34.
    发明授权
    Surgical stapler apparatus 失效
    手术吻合器装置

    公开(公告)号：US5158222A

    公开(公告)日：1992-10-27

    申请号：US702630

    申请日：1991-05-17

    申请人： David T. Green ,  Keith Ratcliff ,  Henry Bolanos

    发明人： David T. Green ,  Keith Ratcliff ,  Henry Bolanos

    IPC分类号： A61B17/115 ,  A61B17/32 ,  A61B17/34 ,  A61B19/00

    CPC分类号： A61B17/115 ,  A61B17/1155 ,  A61B17/32053 ,  A61B17/34 ,  A61B90/39

    摘要： The end-to-end anastomosis apparatus is provided with a mounting means which can receive a trocar for making holes in tissue and, subsequently, an anvil shaft for the mounting of an anvil assembly for stapling purposes. The anvil shaft is provided with splines which cooperate with splines on a shell liner within the housing of the apparatus to align the buckets on the anvil assembly with the staples in a cartridge secured in the apparatus. In addition, the anvil assembly is provided with a spring for locking of the anvil housing on the anvil shaft.

    摘要翻译： 端对端吻合装置设置有可以容纳用于在组织中形成孔的套针针的安装装置，以及随后用于安装用于装订目的的砧座组件的砧座轴。 砧座轴设置有花键，其与设备壳体内的外壳衬里上的花键配合，以使砧座组件上的铲斗与装在该装置中的钉仓中的钉对准。 此外，砧组件设置有用于将砧壳体锁定在砧座轴上的弹簧。

    Skin fastener
    35.
    发明授权
    Skin fastener 失效
    皮肤紧固件

    公开(公告)号：US5108422A

    公开(公告)日：1992-04-28

    申请号：US601335

    申请日：1990-10-22

    申请人： David T. Green ,  Henry Bolanos ,  Wayne Person

    发明人： David T. Green ,  Henry Bolanos ,  Wayne Person

    IPC分类号： A61B17/00 ,  A61B17/064

    CPC分类号： A61B17/064 ,  A61B2017/00004

    摘要： A fastener for securing adjacent layers of body tissue to each other and being configured and composed of a material so as to emerge from the body tissue after a limited period of time. The fastener includes a backspan and at least two prongs extending from the backspan. Each prong has a tapered tip culminating in a sharp point. The prongs each include a shaft having a cylindrical portion of uniform diameter. In one embodiment the prong includes a serrated portion having a plurality of notches spaced apart so as to define ridge portions therebetween.

    Apparatus for applying surgical fasteners to body tissue
    36.
    发明申请
    Apparatus for applying surgical fasteners to body tissue 失效
    用于将外科紧固件应用于身体组织的装置

    公开(公告)号：US20090105535A1

    公开(公告)日：2009-04-23

    申请号：US11978852

    申请日：2007-10-30

    申请人： David T. Green ,  Henry Bolanos ,  Wayne Young ,  Stephan A. DeFonzo ,  Richard A. McGarry ,  Dominick L. Mastri

    发明人： David T. Green ,  Henry Bolanos ,  Wayne Young ,  Stephan A. DeFonzo ,  Richard A. McGarry ,  Dominick L. Mastri

    IPC分类号： A61B17/10 ,  A61B1/018

    CPC分类号： A61B17/0686 ,  A61B17/00234 ,  A61B17/0684 ,  A61B2017/2837 ,  A61B2017/2927 ,  A61B2017/2929 ,  A61B2090/0811 ,  A61F2/0063 ,  Y10S227/902

    摘要： An apparatus is disclosed for endoscopic application of surgical staples adapted to attach surgical mesh to body tissue in laparoscopic hernia surgery. The apparatus includes a frame, and a generally elongated endoscopic section connected to the frame and extending distally therefrom. A staple storage cartridge is removably supported on a pivotal support system at the distal end portion of the endoscopic section with each staple being configured and adapted to attach the mesh to the body tissue. An elongated pusher system formed of several assembled components and extending from the frame to the endoscopic section is provided for individually advancing at least one staple at a time distally for positioning adjacent the surgical mesh and the body tissue. The pusher system also includes a trigger system to actuate the pusher. The trigger system is provided with perceptible tactile sensing means to indicate when the legs of the staple being advanced are exposed so as to be visible to the user for positioning and orientation purposes. Anvil means provides for individually closing each staple to encompass at least a portion of the surgical mesh and to penetrate the body tissue in a manner to attach the portion of the mesh to the body tissue. Projecting distally of the cartridge support system is a pair of legs which are dimensioned and configured to engage the staple during closure to prevent unwanted roll or deformation outside of the plane of the staple.

    摘要翻译： 公开了一种用于内窥镜施加适于在腹腔镜疝手术中将手术网连接到身体组织的装置。 该装置包括框架，以及连接到框架并从其向远端延伸的大致细长的内窥镜部分。 钉仓存储盒可移除地支撑在内窥镜部分的远端部分处的枢转支撑系统上，每个钉被构造并适于将网状物附接到身体组织。 提供由几个组装部件形成并从框架延伸到内窥镜部分的细长推动器系统，用于在远端单独推进至少一个钉，用于邻近外科手术网和身体组织定位。 推动器系统还包括用于致动推动器的触发系统。 触发系统设置有可感知的触觉感测装置，用于指示订书钉的前进的腿部何时被暴露以使用户可见以便定位和定向。 砧座装置提供单独地封闭每个钉以包围外科手术网的至少一部分并且以以将网的该部分附接到身体组织的方式穿透身体组织。 墨盒支撑系统的远端突出是一对腿，其尺寸和构造在关闭期间接合钉，以防止在钉的平面外部不期望的滚动或变形。

    Anvil for surgical stapler
    37.
    发明授权
    Anvil for surgical stapler 有权
    砧座用于外科缝合器

    公开(公告)号：US6053390A

    公开(公告)日：2000-04-25

    申请号：US309027

    申请日：1999-05-10

    申请人： David T. Green ,  Henry Bolanos ,  Henry R. Sienkiewicz ,  Patrick Leahy

    发明人： David T. Green ,  Henry Bolanos ,  Henry R. Sienkiewicz ,  Patrick Leahy

    IPC分类号： A61B17/00 ,  A61B17/11 ,  A61B17/115 ,  A61B17/12 ,  A61B17/28

    CPC分类号： A61B17/115 ,  A61B17/1155 ,  A61B2017/00473 ,  A61B2017/07257 ,  A61B2017/1125 ,  A61B2017/2927 ,  A61B2017/2931

    摘要： A detachable anvil assembly for use with an apparatus for performing circular anastomosis of tubular organs includes an elongated anvil rod having proximal and distal end portions and an anvil head mounted to the distal end portion of the anvil rod. The distal end portion is pivotally mounted and is adapted to pivot approximately plus or minus ninety degrees relative to a longitudinal axis defined by the rod. An elongated delivery member detachably receives the anvil assembly and facilitates delivery of the anvil assembly to the operative site. The pivoting feature of the distal end reduces the transverse profile of the assembly which consequently facilitates introduction and advancement of the anvil assembly within the tubular organ.

    摘要翻译： 与用于执行管状器官的圆形吻合的装置一起使用的可拆卸的砧组件包括具有近端部分和远端部分的细长砧杆，以及安装到砧座杆的远端部分的砧座头部。 远端部分枢转地安装并且适于相对于由杆限定的纵向轴线大约正负90度旋转。 延长的传送构件可拆卸地接收砧座组件并且便于将砧组件传送到操作部位。 远端的枢转特征减小了组件的横向轮廓，因此有助于砧座组件在管状器官内的引入和推进。

    Method of anastomosing a vessel using a surgical clip applier
    39.
    发明授权
    Method of anastomosing a vessel using a surgical clip applier 失效
    使用外科夹具施放器吻合血管的方法

    公开(公告)号：US5779718A

    公开(公告)日：1998-07-14

    申请号：US714790

    申请日：1996-09-13

    申请人： David T. Green ,  Henry Bolanos ,  Kenneth E. Toso ,  Daniel E. Alesi ,  Robert Geiste ,  Frank C. Maffei

    发明人： David T. Green ,  Henry Bolanos ,  Kenneth E. Toso ,  Daniel E. Alesi ,  Robert Geiste ,  Frank C. Maffei

    IPC分类号： A61B17/08 ,  A61B17/11 ,  A61B17/128 ,  A61B17/28 ,  A61B17/04

    CPC分类号： A61B17/1285 ,  A61B17/08 ,  A61B17/083 ,  A61B17/2909 ,  A61B2017/1107 ,  A61B2017/2913 ,  A61B2017/2916 ,  A61B2017/2929 ,  Y10S227/901

    摘要： A surgical clip applicator comprising a housing, a pair of handles pivotally connected to opposite sides of said housing, and a jaw blade assembly fixedly connected to the housing. The jaw blade assembly includes a pair of jaws for receiving and deforming a clip therebetween and a clip carrier for supplying a series of clips to said jaws. A channel assembly is slidably mounted in the housing and envelops said jaw blade assembly. A forming cam is connected between and to said handles and said channel assembly for sliding said channel assembly in a distal direction in response to closing of said handles together to move said jaws towards each other. A feed cam bar slidably mounted in said channel assembly in overlying relation to said clip carrier, said bar having a nose at its distal end. A pusher bar sidably mounted in said channel assembly for advancing clips along said clip carrier. A first spring member connected between said cam bar and said forming cam for sliding said cam bar in a proximal direction in response to closing of said handles together and further biasing said channel assembly in a proximal direction. Second spring member biasing said pusher bar in a distal direction to push a foremost clip in said clip carrier between said jaws in response to opening of said handles from each other. A clip retainer for preventing movement of said spring biased pusher bar is also provided.

    摘要翻译： 一种手术夹施加器，其包括壳体，可枢转地连接到所述壳体的相对侧的一对手柄，以及固定地连接到所述壳体的钳口刀片组件。 颚板组件包括一对夹爪，用于接收和变形夹子，夹子支架用于将一系列夹子供给到所述夹爪。 通道组件可滑动地安装在壳体中并且包围所述钳口叶片组件。 成形凸轮连接在所述手柄和所述通道组件之间，用于响应于所述把手的关闭而在远侧方向上滑动所述通道组件以将所述钳口朝向彼此移动。 一种进给凸轮杆，其可滑动地安装在所述通道组件中，与所述夹子托架相重叠，所述杆在其远端具有鼻部。 一个推杆可倾斜地安装在所述通道组件中，用于沿着夹子承载件推进夹子。 连接在所述凸轮杆和所述成形凸轮之间的第一弹簧构件，用于响应于所述把手的关闭而沿近端方向滑动所述凸轮杆，并且进一步沿近侧方向偏置所述通道组件。 第二弹簧构件在远侧方向上偏压所述推杆，以响应于所述把手彼此打开而在所述夹爪之间推动所述夹子承载件中的最前面的夹子。 还提供了用于防止所述弹簧偏压推杆的移动的夹持器。

    Handle for manipulating a laparoscopic tool
    40.
    发明授权
    Handle for manipulating a laparoscopic tool 失效
    手术操作腹腔镜手术

    公开(公告)号：US5624431A

    公开(公告)日：1997-04-29

    申请号：US417241

    申请日：1995-04-05

    申请人： Stephen W. Gerry ,  David T. Green ,  Henry Bolanos

    发明人： Stephen W. Gerry ,  David T. Green ,  Henry Bolanos

    IPC分类号： A61B17/28 ,  A61B19/00

    CPC分类号： A61B17/2909 ,  A61B2017/292 ,  A61B2017/2929 ,  A61B2017/2946

    摘要： A handle for a laparoscopic instrument is provided for manipulating a distal laparoscopic tool. The handle includes a casing, a pivot handle pivotally attached to the casing, and an actuating shaft mechanism extending outward from the casing. Attached at the distal end of the actuating shaft opposite the casing is the laparoscopic surgical tool. The actuating shaft mechanism is longitudinally movable in a first direction by a pivotal movement of the pivot handle for manipulating the laparoscopic tool. A detent carried by the casing allows movement of the shaft longitudinally in the first direction while restraining longitudinal movement of the shaft in a second opposite direction. A thumb wheel attached to the actuating shaft mechanism allows the actuating shaft mechanism to be rotated for further manipulating the laparoscopic tool.

    摘要翻译： 腹腔镜手术器具用于操纵远端腹腔镜手术器械。 手柄包括壳体，可枢转地附接到壳体的枢转手柄以及从壳体向外延伸的致动轴机构。 腹腔镜手术工具附着在与壳体相对的致动轴的远端。 致动轴机构通过用于操纵腹腔镜工具的枢转手柄的枢转运动在第一方向上纵向移动。 壳体承载的制动器允许轴沿第一方向纵向移动，同时限制轴沿第二相反方向的纵向移动。 附接到致动轴机构的拇指轮允许致动轴机构旋转以进一步操纵腹腔镜工具。