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    TENDON-DRIVEN ENDOSCOPE AND METHODS OF USE
    31.
    发明申请
    TENDON-DRIVEN ENDOSCOPE AND METHODS OF USE 审中-公开
    TENDON驱动内窥镜及其使用方法

    公开(公告)号：US20100094088A1

    公开(公告)日：2010-04-15

    申请号：US12425272

    申请日：2009-04-16

    申请人： Robert M. Ohline ,  Joseph M. Tartaglia ,  Amir Belson ,  Alex T. Roth ,  Wade A. Keller ,  Scott C. Anderson ,  Christopher A. Julian

    发明人： Robert M. Ohline ,  Joseph M. Tartaglia ,  Amir Belson ,  Alex T. Roth ,  Wade A. Keller ,  Scott C. Anderson ,  Christopher A. Julian

    IPC分类号： A61B1/005

    CPC分类号： A61B1/00128 ,  A61B1/00006 ,  A61B1/00057 ,  A61B1/0016 ,  A61B1/0053 ,  A61B1/0057 ,  A61B1/0058 ,  A61B1/01 ,  A61B1/31 ,  A61B5/065 ,  A61B2034/301 ,  A61B2034/741 ,  A61B2034/742

    摘要： A steerable, tendon-driven endoscope is described herein. The endoscope has an elongated body with a manually or selectively steerable distal portion and an automatically controlled, segmented proximal portion. The steerable distal portion and the segment of the controllable portion are actuated by at least two tendons. As the endoscope is advanced, the user maneuvers the distal portion, and a motion controller actuates tendons in the segmented proximal portion so that the proximal portion assumes the selected curve of the selectively steerable distal portion. By this method the selected curves are propagated along the endoscope body so that the endoscope largely conforms to the pathway selected. When the endoscope is withdrawn proximally, the selected curves can propagate distally along the endoscope body. This allows the endoscope to negotiate tortuous curves along a desired path through or around and between organs within the body.

    摘要翻译： 这里描述了可操纵的肌腱驱动的内窥镜。 内窥镜具有细长主体，其具有手动或选择性可操纵的远侧部分和自动控制的分段近端部分。 可操纵的远端部分和可控部分的段由至少两个腱致动。 当内窥镜前进时，使用者操纵远侧部分，并且运动控制器致动分段近端部分中的肌腱，使得近端部分呈现选择性可操纵的远侧部分的选定曲线。 通过该方法，所选择的曲线沿着内窥镜主体传播，使得内窥镜大体上符合所选择的路径。 当内窥镜向近侧收回时，所选择的曲线可沿内窥镜体向远端传播。 这允许内窥镜沿着穿过体内器官之间或之间的所需途径协商曲折曲线。

    Device and method for isolating a surgical site
    33.
    发明授权
    Device and method for isolating a surgical site 失效
    用于隔离手术​​部位的装置和方法

    公开(公告)号：US06821247B2

    公开(公告)日：2004-11-23

    申请号：US10259146

    申请日：2002-09-27

    申请人： Mark A. Vierra ,  Alex T. Roth

    发明人： Mark A. Vierra ,  Alex T. Roth

    IPC分类号： A61B132

    CPC分类号： A61B17/0469 ,  A61B17/0483 ,  A61B17/062 ,  A61B17/11 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/1107

    摘要： The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration. An actuator, at the proximal end of the shaft, can be rotated to pivot the foot about a transverse axis so that the contact surfaces are oriented generally parallel to the surgical site to apply pressure to the tissue structure on both sides of the surgical site.

    摘要翻译： 本发明提供一种用于在体腔内执行较小侵入性外科手术的系统和方法。 在优选实施例中，本发明提供了用于在胸腔镜冠状动脉旁路移植手术中分离外科手术部位的系统和方法，例如内部乳房动脉和冠状动脉之间的吻合。 系统包括通过连杆（13）枢转地联接到轴（3）的远端的脚（11）。 脚具有第一和第二接合部分（15,17），其具有用于接合组织表面的接触表面。 接合部分可以在接触表面被间隙分开的打开位置和折叠位置之间移动，其中脚构造成通过经皮渗透进行输送。 在轴的近端处的致动器可以旋转以使脚围绕横向轴线枢转，使得接触表面大致平行于外科手术部位定向，以对手术部位两侧的组织结构施加压力。

    Method of performing a procedure on a coronary artery
    34.
    发明授权
    Method of performing a procedure on a coronary artery 有权
    在冠状动脉上执行手术的方法

    公开(公告)号：US06482151B1

    公开(公告)日：2002-11-19

    申请号：US09678763

    申请日：2000-10-03

    申请人： Mark A. Vierra ,  Alex T. Roth

    发明人： Mark A. Vierra ,  Alex T. Roth

    IPC分类号： A61B132

    CPC分类号： A61B17/0469 ,  A61B17/0483 ,  A61B17/062 ,  A61B17/11 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/1107

    摘要： The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration. An actuator, at the proximal end of the shaft, can be rotated to pivot the foot about a transverse axis so that the contact surfaces are oriented generally parallel to the surgical site to apply pressure to the tissue structure on both sides of the surgical site.

    摘要翻译： 本发明提供一种用于在体腔内执行较小侵入性外科手术的系统和方法。 在优选实施例中，本发明提供了用于在胸腔镜冠状动脉旁路移植手术中分离外科手术部位的系统和方法，例如内部乳房动脉和冠状动脉之间的吻合。 系统包括通过连杆（13）枢转地联接到轴（3）的远端的脚（11）。 脚具有第一和第二接合部分（15,17），其具有用于接合组织表面的接触表面。 接合部分可以在接触表面被间隙分开的打开位置和折叠位置之间移动，其中脚构造成通过经皮渗透进行输送。 在轴的近端处的致动器可以旋转以使脚围绕横向轴线枢转，使得接触表面大致平行于外科手术部位定向，以对手术部位两侧的组织结构施加压力。

    Device and method for isolating a surgical site
    35.
    发明授权
    Device and method for isolating a surgical site 有权

    公开(公告)号：US6149583A

    公开(公告)日：2000-11-21

    申请号：US306687

    申请日：1999-05-06

    申请人： Mark A. Vierra ,  Alex T. Roth

    发明人： Mark A. Vierra ,  Alex T. Roth

    IPC分类号： A61B1/32 ,  A61B17/00 ,  A61B17/02 ,  A61B17/04 ,  A61B17/11

    CPC分类号： A61B17/0469 ,  A61B17/0483 ,  A61B17/062 ,  A61B17/11 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/1107

    摘要： The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration. An actuator, at the proximal end of the shaft, can be rotated to pivot the foot about a transverse axis so that the contact surfaces are oriented generally parallel to the surgical site to apply pressure to the tissue structure on both sides of the surgical site.

    Device and method for isolating a surgical site
    37.
    发明授权
    Device and method for isolating a surgical site 失效

    公开(公告)号：US6017304A

    公开(公告)日：2000-01-25

    申请号：US62911

    申请日：1998-04-20

    申请人： Mark A. Vierra ,  Alex T. Roth

    发明人： Mark A. Vierra ,  Alex T. Roth

    IPC分类号： A61B1/32 ,  A61B17/00 ,  A61B17/02 ,  A61B17/04 ,  A61B17/11

    CPC分类号： A61B17/0469 ,  A61B17/0483 ,  A61B17/062 ,  A61B17/11 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/1107

    摘要： The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration. An actuator, at the proximal end of the shaft, can be rotated to pivot the foot about a transverse axis so that the contact surfaces are oriented generally parallel to the surgical site to apply pressure to the tissue structure on both sides of the surgical site.

    Endoscopic microsurgical instruments and methods
    38.
    发明授权
    Endoscopic microsurgical instruments and methods 失效
    内窥镜显微外科手术和方法

    公开(公告)号：US5810877A

    公开(公告)日：1998-09-22

    申请号：US744208

    申请日：1996-11-05

    申请人： Alex T. Roth ,  Scott H. Miller

    发明人： Alex T. Roth ,  Scott H. Miller

    IPC分类号： A61B17/00 ,  A61B17/04 ,  A61B17/12 ,  A61B17/128 ,  A61B17/28

    CPC分类号： A61B17/2909 ,  A61B17/1285 ,  A61B17/0469 ,  A61B2017/00243 ,  A61B2017/2845 ,  A61B2017/2912 ,  A61B2017/2919 ,  A61B2017/2926 ,  A61B2017/2946 ,  A61B2017/305

    摘要： The invention provides devices and method for performing extremely small-scale, minimally-invasive microsurgery such as thoracoscopic coronary artery bypass grafting. The instruments of the invention utilize a symmetrical, forcep-like actuator which provides extremely precise actuation and control of the instrument and which mimics the feel of instruments used in conventional open surgical procedures. The instruments generally include a pair of coaxially arranged shafts, an end-effect at the distal ends of the shafts, and an actuator at the proximal ends of the shafts. The actuator includes a pair of arms pivotally coupled to one of either the outer or inner shaft, and a pair of links pivotally coupled at one end to the arms, and at a second end to the other of the shafts. The links are coupled to a proximal portion of the arms to maximize mechanical advantage and reduce interference. The actuator may be easily adapted for either pull-type or push-type actuation, and for either outer shaft or inner shaft translation. The end-effectors may have a variety of configurations, including needle drivers, forceps, scissors, and clip appliers.

    摘要翻译： 本发明提供了用于进行极小规模，微创显微外科手术如胸腔镜冠状动脉旁路移植术的装置和方法。 本发明的仪器使用对称的强力致动器，其提供了对仪器的非常精确的致动和控制，并且模拟了常规开放式外科手术中使用的仪器的感觉。 仪器通常包括一对同轴布置的轴，在轴的远端处的端部效应以及在轴的近端处的致动器。 致动器包括可枢转地联接到外轴或内轴中的一个的一对臂和在一端枢转地联接到臂的一对连杆，并且在另一端处连接到另一个轴。 连杆联接到臂的近端部分以最大化机械优点并减少干扰。 致动器可以容易地适用于拉式或推式致动，以及用于外轴或内轴平移。 末端执行器可以具有各种配置，包括针驱动器，镊子，剪刀和夹具装置。

    Device for isolating a surgical site
    39.
    发明授权
    Device for isolating a surgical site 失效
    用于隔离手术​​部位的装置

    公开(公告)号：US5749892A

    公开(公告)日：1998-05-12

    申请号：US686073

    申请日：1996-07-24

    申请人： Mark A. Vierra ,  Alex T. Roth

    发明人： Mark A. Vierra ,  Alex T. Roth

    IPC分类号： A61B1/32 ,  A61B17/00 ,  A61B17/02 ,  A61B17/04 ,  A61B17/11

    CPC分类号： A61B17/0469 ,  A61B17/0483 ,  A61B17/062 ,  A61B17/11 ,  A61B2017/00243 ,  A61B2017/0243 ,  A61B2017/1107

    摘要： The invention provides a system and method for performing less-invasive surgical procedures within a body cavity. In a preferred embodiment, the invention provides a system and method for isolating a surgical site such as an anastomosis between an internal mammary artery and a coronary artery in a thoracoscopic coronary artery bypass grafting procedure. The system comprises a foot (11) pivotally coupled to the distal end of a shaft (3) by a linkage (13). The foot has first and second engaging portions (15, 17) with contact surfaces for engaging a tissue surface. The engaging portions are movable between an open position, where the contact surfaces are separated by a gap, and a collapsed position, where the foot is configured for delivery through the percutaneous penetration. An actuator, at the proximal end of the shaft, can be rotated to pivot the foot about a transverse axis so that the contact surfaces are oriented generally parallel to the surgical site to apply pressure to the tissue structure on both sides of the surgical site.

    摘要翻译： 本发明提供一种用于在体腔内执行较小侵入性外科手术的系统和方法。 在优选实施例中，本发明提供了用于在胸腔镜冠状动脉旁路移植手术中分离外科手术部位的系统和方法，例如内部乳房动脉和冠状动脉之间的吻合。 系统包括通过连杆（13）枢转地联接到轴（3）的远端的脚（11）。 脚具有第一和第二接合部分（15,17），其具有用于接合组织表面的接触表面。 接合部分可以在接触表面被间隙分开的打开位置和折叠位置之间移动，其中脚构造成通过经皮渗透进行输送。 在轴的近端处的致动器可以旋转以使脚围绕横向轴线枢转，使得接触表面大致平行于外科手术部位定向，以对手术部位两侧的组织结构施加压力。