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31.发明授权Method of performing port off-pump beating heart coronary artery bypass surgery 有权执行端口跳动心脏冠状动脉旁路手术的方法公开(公告)号：US06503245B2
公开(公告)日：2003-01-07
申请号：US09733498
申请日：2000-12-08
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： A method for performing through-port off-pump beating heart coronary artery bypass surgery is provided. A port device is positioned in the chest wall and directed as necessary. A heart stabilizer is coupled to the port, and operated to apply a compressive force against the heart wall surrounding a location the required bypass such that the location is substantially immobilized. An instrument stabilizer includes a cannula which is inserted through a hole in the chest cavity, and the distal tip of the cannula is located adjacent the surgical site. The instrument stabilizer dampens movement of a surgical instrument, e.g., a scalpel or needle holder, extended therethrough. Once the bypass procedure is complete, the instruments, heart stabilizer, instrument stabilizers, and port are removed from the body of the patient.
摘要翻译： 提供了一种执行穿孔式抽动心脏冠状动脉旁路手术的方法。 端口装置定位在胸壁上，并根据需要定向。 心脏稳定器联接到端口，并且被操作以对围绕所需旁路的位置的心脏壁施加压缩力，使得该位置基本上被固定。 仪器稳定器包括穿过胸腔中的孔插入的套管，套管的远端位于手术部位附近。 仪器稳定器阻止手术器械的移动，例如从其延伸的手术刀或针保持器。 一旦旁路过程完成，仪器，心脏稳定器，仪器稳定器和端口从患者体内移除。
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32.发明授权公开(公告)号：US06464690B1
公开(公告)日：2002-10-15
申请号：US09686530
申请日：2000-10-11
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to provide a stabilized area sufficiently large to allow an accurate anastomosis to be performed. According to preferred aspects of the invention, the stabilizer is particularly adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also preferably adapted to be automatically deployed into its final configuration by release of a lock actuated at a proximal portion of stabilizer extending outside the port. In addition, the stabilizer is adapted to automatically fold when being pulled back through the port. According to various embodiments of the heart stabilizer, the feet of the stabilizer may be further adapted to facilitate immobilization of the heart wall between the feet.
摘要翻译： 心脏稳定器包括轴和联接到轴的远端的两个铰接臂。 在每个臂的末端是可旋转的脚，其适于相对于心脏壁轮廓成角度并且对心脏壁施加压力以有效地消除心脏壁在脚之间的运动。 稳定器适于提供足够大的稳定区域以允许进行精确的吻合。 根据本发明的优选方面，稳定器特别适于可折叠（可折叠）以插入通过端口装置并且相对于其纵向锁定。 稳定器还优选地适于通过释放在端口外部延伸的稳定器的近侧部分处致动的锁来自动地部署到其最终构造。 此外，稳定器适于在通过端口被拉回时自动折叠。 根据心脏稳定器的各种实施例，稳定器的脚可以进一步适于促进心脏壁在脚之间的固定。
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33.发明授权Stable port device for port off-pump beating heart coronary artery bypass surgery system 有权稳定的端口设备用于端口非泵跳动心脏冠状动脉旁路手术系统公开(公告)号：US06355028B2
公开(公告)日：2002-03-12
申请号：US09733503
申请日：2000-12-08
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： A port device includes tubular body with a distal swivel, a platform movable along the length of the port body, and preferably three legs movable relative to the platform. The tubular body is inserted through the chest wall, and the platform is then positioned over the proximal end of the tubular body and adjusted such that feet on the legs contact the chest wall and clamp the chest wall between the feet and the swivel. The legs may be individually adjusted to provide the tubular body at a desired angle relative to the chest wall. According to preferred aspects of the port device, the platform may be ratcheted relative to the port body and the feet may be ratcheted relative to the platform to permit rapid adjustment of the port relative to the patient.
摘要翻译： 端口装置包括具有远端旋转件的管状主体，可沿着端口主体的长度移动的平台，并且优选地相对于平台可移动的三个支柱。 管状体通过胸壁插入，然后将平台定位在管状体的近端上方，并被调节为使得腿上的脚接触胸壁并将胸壁夹在脚和旋转体之间。 可以单独地调整腿部以相对于胸壁以期望的角度提供管状体。 根据端口装置的优选方面，平台可以相对于端口主体棘爪，并且脚可以相对于平台棘齿，以允许端口相对于患者的快速调节。
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公开(公告)号：US06592573B2
公开(公告)日：2003-07-15
申请号：US09893099
申请日：2001-06-27
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： A heart stabilizer includes a shaft and two articulating arms coupled to a distal end of the shaft. At the end of each arm is a rotatable foot adapted to be angled relative to the heart wall contour and apply pressure against the wall of the heart to effectively eliminate motion of the heart wall between the feet. The stabilizer is adapted to be collapsible (foldable) to be inserted through the port device and locked longitudinally relative thereto. The stabilizer is also adapted to be deployed into an open configuration and then manipulated by actuation of a proximal control and actuation handle into a selected orientation.
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公开(公告)号：US06579281B2
公开(公告)日：2003-06-17
申请号：US09893141
申请日：2001-06-27
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： An instrument stabilizer minimizes unwanted motion at the distal end of a surgical instrument by applying a damping force to the instrument. According to one embodiment, the instrument stabilizer preferably includes a cannula through which an instrument can extend, and a distal bushing adapted to contact the instrument. The instrument stabilizer also includes a proximal housing which includes a mechanism which applies a stabilizing or damping force to the proximal portion of the cannula. The mechanism which applies the force may be, by way of example, one or more of elastic bands, springs, struts, etc. When a surgical instrument is extended through the cannula and contacts the bushing, movement of the cannula and consequently the surgical instrument is damped by the stabilization force on the proximal portion of the cannula. In addition, a swivel device for angularly orienting the instrument stabilizer relative to a body of patient is also provided.
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公开(公告)号：US06554823B2
公开(公告)日：2003-04-29
申请号：US09733493
申请日：2000-12-08
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： A system for performing through port off-pump coronary artery bypass surgery includes a port insertable between ribs into a chest wall of a patient, a heart stabilizer extendable through and stably couplable to the port, and an instrument stabilizer adapted to dampen extraneous movement to which a surgical instrument extending through the stabilizer is subject.
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37.发明授权Catch, stop and marker assembly for a medical instrument and medical instrument incorporating the same 有权用于医疗器械和包含该器械的医疗器械的捕捉，停止和标记组件公开(公告)号：US06544231B1
公开(公告)日：2003-04-08
申请号：US09575432
申请日：2000-05-22
IPC分类号： A61M5178
CPC分类号： A61B17/221 , A61B90/39 , A61B2017/00469 , A61B2017/347 , A61B2090/034 , A61B2090/062 , A61B2090/3908 , A61M25/09041 , A61M2025/0008 , A61M2025/09125
摘要： A medical instrument includes a shaft having an outer surface defining an outer diameter, a tube having an inner surface defining an inner diameter and extending over a portion of the shaft, at least one coil wound in a first rotational direction and provided between the shaft and the tube, the at least one coil having a first portion defining an inner surface interfering with an outer surface of the shaft such that the at least one coil grips the shaft, and a second portion coupled to the inner surface of the tube. The tube is movable longitudinally relative to the shaft in a first longitudinal direction when subject to force in the first longitudinal direction, and the tube is substantially immovable longitudinally relative to the shaft in a second longitudinal direction opposite the first longitudinal direction when subject to force in the second longitudinal direction only. When the tube is subject to rotational force in a second rotational direction opposite the first rotational direction, movement of the tube in the second longitudinal direction relative to the shaft is permitted. Other embodiments are also provided.
摘要翻译： 医疗器械包括具有限定外径的外表面的轴，具有限定内径并且在轴的一部分上延伸的内表面的管，至少一个缠绕在第一旋转方向上的线圈，并且设置在轴和 所述管，所述至少一个线圈具有限定与所述轴的外表面干涉的内表面的第一部分，使得所述至少一个线圈夹持所述轴，以及联接到所述管的内表面的第二部分。 当沿第一纵向方向受力时，该管能够在第一纵向方向上相对于该轴纵向运动，并且该管在相对于第一纵向方向的第二纵向方向上相对于该轴在纵向方向上基本上不可移动 仅第二纵向方向。 当管在与第一旋转方向相反的第二旋转方向上受到旋转力时，允许管相对于轴在第二纵向方向上的运动。 还提供了其他实施例。
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公开(公告)号：US20080154097A1
公开(公告)日：2008-06-26
申请号：US12045205
申请日：2008-03-10
IPC分类号： A61B1/32
CPC分类号： A61B17/0218 , A61B17/0281 , A61B2017/0237
摘要： A surgical retractor includes a “swivel” having a string extending from one end and a string extending from the midpoint between the two ends. The swivel is delivered by pushing it out of a tube which is inserted through a small incision between the ribs of the patient. After the swivel is deployed, the tube is removed and the string which is attached to the center of the swivel is pulled to lift the pericardium. When the procedure is complete, the swivel is removed from the patient by pulling the string attached to the end of the swivel. According to one embodiment, the swivel is a cylinder with a blunt conical end. According to another embodiment, the swivel has a sharp end which is covered by a spring loaded collar.
摘要翻译： 手术牵开器包括具有从一端延伸的绳和从两端之间的中点延伸的绳的“旋转”。 通过将其从穿过患者肋骨之间的小切口插入的管中推出来将其转运。 在旋转装置展开之后，将管子取出，并且将牵引到旋转中心的绳子被牵拉以提起心包。 当程序完成时，通过拉动附接到旋转端的连接器的绳索将患者的旋转体移除。 根据一个实施例，旋转件是具有钝锥形端的圆筒。 根据另一个实施例，旋转件具有由弹簧加载的套环覆盖的尖端。
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公开(公告)号：US07322935B2
公开(公告)日：2008-01-29
申请号：US10348845
申请日：2003-01-22
IPC分类号： A61B1/32
CPC分类号： A61B17/0218 , A61B2017/00867
摘要： An endoscopic retractor includes a tube having a proximal end and a distal end with a push rod extending therethrough. The proximal ends of the push rod is provided with a threaded portion. A rotatable handle is coupled to the proximal end of the tube and threadably engages the threaded portion of the push rod such that rotation of the handle causes a translation of the push rod. The distal end of the tube is provided with a clevis through which the distal end of the push rod extends. A multi-segment canopy is coupled to the clevis and the push rod via an articulate linkage. Translation of the push rod in the distal direction causes the canopy to be moved from a starting substantially cylindrical configuration with its axis nearly collinear with the axis of the tube to an opened quasi-planar configuration. Further translation of the push rod in the distal direction causes the quasi-planar canopy to be rotated in the clevis to an angle of approximately ninety degrees relative to the axis of the tube.
摘要翻译： 内窥镜牵开器包括具有近端和远端的管，其中延伸穿过其中的推杆。 推杆的近端设有螺纹部分。 可旋转手柄联接到管的近端并且可螺纹地接合推杆的螺纹部分，使得手柄的旋转引起推杆的平移。 管的远端设置有U形夹，推杆的远端延伸穿过该U形夹。 多段罩通过铰接连接件联接到U形夹和推杆。 推杆在远端方向的翻译使得顶盖从起始的大致圆柱形构型移动，其轴线与管的轴线几乎共线至打开的准平面构型。 推杆在远端方向上的进一步平移使得准平面罩能够在U形夹中相对于管的轴线旋转大约90度的角度。
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公开(公告)号：US06500170B2
公开(公告)日：2002-12-31
申请号：US09741387
申请日：2000-12-20
IPC分类号： A61B1700
CPC分类号： A61B17/3417 , A61B17/3421 , A61B17/3462 , A61B2017/00243 , A61B2017/00703 , A61B2017/0243 , A61B2017/3405 , A61B2017/3484 , A61B2017/3492
摘要： An instrument stabilizer minimizes unwanted motion at the distal end of a surgical instrument by applying a damping force to the instrument. According to one embodiment, the instrument stabilizer preferably includes a cannula through which an instrument can extend, and a distal bushing adapted to contact the instrument. The instrument stabilizer also includes a proximal housing which includes a mechanism which applies a stabilizing or damping force to the proximal portion of the cannula. The mechanism which applies the force may be, by way of example, one or more of elastic bands, springs, struts, etc. When a surgical instrument is extended through the cannula and contacts the bushing, movement of the cannula and consequently the surgical instrument is damped by the stabilization force on the proximal portion of the cannula. In addition, a swivel device for angularly orienting the instrument stabilizer relative to a body of patient is also provided.
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