公开(公告)号：US20120004510A1

公开(公告)日：2012-01-05

申请号：US13231348

申请日：2011-09-13

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: An access system comprises an access device. The access device is adapted to be disposed within an opening in a body wall. The access device has an external flange adapted to be disposed external to the body wall and an internal flange adapted to be disposed internal to the body wall. Holes extend through the access device between an external surface and an internal surface of the access device. The holes span the thickness of the body wall between a location external to the body wall and a location internal to the body wall. The access device is formed of an elastomeric material adapted to conform to surfaces of instruments inserted through the holes to form instrument seals along at least a portion of a length spanning the thickness of the body wall. The elastomeric material is compressible and adapted to form a seal with the body wall.

Abstract translation: 访问系统包括访问设备。 进入装置适于设置在体壁的开口内。 进入装置具有适于设置在主体壁外部的外部凸缘和适于设置在主体壁内部的内部凸缘。 孔在进入装置的外表面和内表面之间延伸通过进入装置。 孔跨越体壁外部位置与体壁内部的位置之间的体壁厚度。 进入装置由弹性体材料形成，弹性体材料适于与穿过孔插入的仪器的表面一致，以沿跨越体壁厚度的至少一部分长度形成仪器密封。 弹性体材料是可压缩的并且适于与主体壁形成密封。

公开(公告)号：US07955253B2

公开(公告)日：2011-06-07

申请号：US11311999

申请日：2005-12-19

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

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

IPC: A61B1/00

CPC classification number: A61B1/00149 ,  A61B1/00082 ,  A61B1/00147 ,  A61B1/31

Abstract: The present invention provides methods and apparatus for pleating at least a portion of a patient's body lumen, such as the colon. Pleating is achieved via relative motion between an endoscope and a flexible conduit having an engagement element configured to reversibly engage the body lumen.

Abstract translation: 本发明提供了用于打褶患者体腔（如结肠）的至少一部分的方法和装置。 褶皱通过内窥镜和具有配置为可逆地接合体腔的接合元件的柔性导管之间的相对运动来实现。

公开(公告)号：US07918845B2

公开(公告)日：2011-04-05

申请号：US10991118

申请日：2004-11-16

Applicant: Vahid Saadat ,  Richard C. Ewers ,  Eugene Chen ,  David Miller

Inventor： Vahid Saadat ,  Richard C. Ewers ,  Eugene Chen ,  David Miller

IPC: A61B17/00 ,  A61B1/00

CPC classification number: A61B17/00234 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/018 ,  A61B1/313 ,  A61B2017/003 ,  A61B2017/00323 ,  A61B2017/00349 ,  A61B2017/2906 ,  A61B2017/3445 ,  A61B2090/306 ,  A61B2090/508 ,  A61M25/0043 ,  A61M25/0105 ,  A61M25/0147 ,  A61M2025/0096

Abstract: Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.

Abstract translation: 提供的系统，装置和方法用于内窥镜手术，其涉及组织操作超出传统内窥镜仪器的能力。 系统的实施例包括具有穿过其中的一个细长主体和从该主体的远端延伸的至少一个可操纵的工具臂。 在优选实施例中，系统包括两个工具臂，每个臂可转向以横向向外形成曲线，然后横向向内弯曲，使得臂形成角形。 另外，末端执行器从每个工具臂的远端延伸以用于组织的操作。 考虑到外科医生连续可见的协作运动的范围，角形状使末端执行器结合在一起。 此外，工具臂可以在任何附加方向上是可操纵的并且可以是可旋转的，以允许组织的抓握，升高和更复杂的操纵。

公开(公告)号：US20110071462A1

公开(公告)日：2011-03-24

申请号：US12960449

申请日：2010-12-03

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: A61M13/00

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 is adapted for performing laparoscopic surgical procedures with at least one instrument passing through the surgical access device and through an incision in the abdominal wall of a patient with the abdominal cavity pressurized with an insufflation gas. The surgical access device is adapted to provide instrument access to the abdominal cavity for surgical procedures while generally maintaining insufflation pressure in the abdominal cavity. The surgical access device comprises an access seal. The access seal comprises a material formed of a mixture comprising a triblock copolymer and an oil. The access seal is adapted to be disposed relative to the abdominal wall in an operative position. The material of the access seal is adapted to form a seal to generally maintain insufflation pressure within the abdominal cavity. At least one opening is formed through the material of the access seal between a proximal portion and a distal portion of the access seal. The at least one opening when operatively disposed is in communication with the incision and forms a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The material of the access seal is adapted to conform to a surface of an instrument inserted through the working channel.

Abstract translation: 外科进入装置适于执行腹腔镜外科手术，其中至少一个器械通过外科进入装置，并通过患有腹部腔的切口在腹腔内用吹入气体加压。 外科进入装置适于提供仪器进入腹腔以进行外科手术，同时通常维持腹腔内的注射压力。 手术进入装置包括进入密封件。 进入密封件包括由包含三嵌段共聚物和油的混合物形成的材料。 进入密封件适于在操作位置相对于腹壁布置。 进入密封件的材料适于形成密封件，以通常维持腹腔内的注入压力。 通过进入密封件的近端部分和远端部分之间的进入密封件的材料形成至少一个开口。 当操作性地设置时，所述至少一个开口与所述切口连通并且在所述腹壁外部的位置与所述腹壁内部的位置之间形成工作通道。 进入密封件的材料适于符合通过工作通道插入的仪器的表面。

公开(公告)号：US07637905B2

公开(公告)日：2009-12-29

申请号：US10346709

申请日：2003-01-15

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

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

IPC: A61B17/00 ,  A61B1/00

CPC classification number: A61B17/00234 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/018 ,  A61B1/313 ,  A61B2017/003 ,  A61B2017/00323 ,  A61B2017/00349 ,  A61B2017/2906 ,  A61B2017/3445 ,  A61B2090/306 ,  A61B2090/508 ,  A61M25/0043 ,  A61M25/0105 ,  A61M25/0147 ,  A61M2025/0096

Abstract: Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotatable to allow grasping, elevation and more complex manipulation of tissue.

Abstract translation: 提供的系统，装置和方法用于内窥镜手术，其涉及组织操作超出传统内窥镜仪器的能力。 系统的实施例包括具有穿过其中的一个细长主体和从该主体的远端延伸的至少一个可操纵的工具臂。 在优选实施例中，系统包括两个工具臂，每个臂可转向以横向向外形成曲线，然后横向向内弯曲，使得臂形成角形。 另外，末端执行器从每个工具臂的远端延伸以用于组织的操作。 考虑到外科医生连续可见的协作运动的范围，角形状使末端执行器结合在一起。 此外，工具臂可以在任何附加方向上是可操纵的并且可以是可旋转的，以允许组织的抓握，升高和更复杂的操纵。

公开(公告)号：US20080200767A1

公开(公告)日：2008-08-21

申请号：US12108400

申请日：2008-04-23

Applicant: Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V. Taylor ,  Gary R. Dulak ,  Michael J. Dunn ,  Norman L. Morales ,  Charles C. Hart ,  Robert R. Bowes

Inventor： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V. Taylor ,  Gary R. Dulak ,  Michael J. Dunn ,  Norman L. Morales ,  Charles C. Hart ,  Robert R. 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，可扩张和不扩张两者都可以在环上使用适当的附接装置来设计，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周向保持器的步骤。

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。