公开(公告)号：US07390329B2

公开(公告)日：2008-06-24

申请号：US11036946

申请日：2005-01-14

Applicant: Hendrik S. Westra ,  Cang C. Lam ,  Richard C. Ewers ,  Vahid Saadat

Inventor： Hendrik S. Westra ,  Cang C. Lam ,  Richard C. Ewers ,  Vahid Saadat

IPC: A61B17/10 ,  A61B17/08

CPC classification number: A61B17/0469 ,  A61B17/00234 ,  A61B17/0401 ,  A61B17/0487 ,  A61B17/22031 ,  A61B17/29 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00407 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/0406 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0443 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/045 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0456 ,  A61B2017/0458 ,  A61B2017/0459 ,  A61B2017/0461 ,  A61B2017/0464 ,  A61B2017/0474 ,  A61B2017/0475 ,  A61B2017/0477 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06028 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/06171 ,  A61B2017/06176 ,  A61B2017/0649 ,  A61B2090/061

Abstract: Methods and apparatus for controlled grasping and cinching or locking of a tissue anchor are provided. In one variation, a tube is provided having a lumen and a resilient member that obstructs the lumen. A grasper may be advanced coaxially through the lumen, such that it reversibly displaces the resilient member and extends beyond the lumen's outlet to engage an element of the tissue anchor. The grasper then may be retracted within the tube, such that the resilient member again obstructs the lumen of the tube. Continued retraction of the grasper may act to cinch the anchor, for example, via interaction between the anchor and the obstructing resilient member. During cinching, a cinching mechanism of the anchor optionally may be positioned at least partially within the tube to enhance lateral stability. Furthermore, feedback indicative of a degree of cinching or locking may be provided during cinching.

Abstract translation: 提供了用于控制抓握和夹紧或锁定组织锚的方法和装置。 在一个实施例中，提供具有内腔和阻碍内腔的弹性构件的管。 夹持器可以同轴地穿过管腔前进，使得其可逆地移位弹性构件并且延伸超出管腔的出口以接合组织锚的元件。 然后，抓紧器可以缩回到管内，使得弹性构件再次阻塞管的内腔。 抓持器的继续缩回可以例如通过锚固件和阻碍弹性构件之间的相互作用而使锚固件收紧。 在收紧期间，锚固件的收紧机构任选地可以至少部分地定位在管内以增强横向稳定性。 此外，可以在收紧期间提供表示收紧或锁定程度的反馈。

公开(公告)号：US07347863B2

公开(公告)日：2008-03-25

申请号：US10955245

申请日：2004-09-29

Applicant: Chris Rothe ,  Richard C. Ewers ,  Cang C. Lam ,  Vahid Saadat ,  Kenneth J. Michlitsch

Inventor： Chris Rothe ,  Richard C. Ewers ,  Cang C. Lam ,  Vahid Saadat ,  Kenneth J. Michlitsch

IPC: A61B17/10 ,  A61B17/00 ,  A61B17/08

CPC classification number: A61B1/0014 ,  A61B17/0401 ,  A61B17/06066 ,  A61B17/29 ,  A61B17/295 ,  A61B2017/00867 ,  A61B2017/00876 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/3488 ,  A61B2090/037

Abstract: Apparatus and methods for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to a longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

Abstract translation: 本文描述了用于操纵和固定组织的装置和方法。 在组织折叠在患者体内产生时，组织操作组件通常可以具有细长的管状构件，可滑动地设置穿过管状构件的接合构件和适于通过螺旋构件接合组织的远端，位于 所述管状构件远端适于在其间稳定组织，以及可围绕所述组织稳定器枢转的输送管。 稳定构件可以适于相对于细长管状构件的纵向轴线成角度。 此外，一个或所有关节运动控制和功能可以集成到通过刚性或柔性管状体连接到组织操作组件的单个手柄组件中。

公开(公告)号：US07128708B2

公开(公告)日：2006-10-31

申请号：US10173203

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: A61B1/00

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：US06958037B2

公开(公告)日：2005-10-25

申请号：US10399209

申请日：2001-10-20

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

IPC: A61B17/02 ,  A61B17/34

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 elements 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，既可扩张也不可扩张，可以考虑在环处的适当的附接元件，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：US06837847B2

公开(公告)日：2005-01-04

申请号：US10173238

申请日：2002-06-13

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

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

IPC: A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/31 ,  A61B1/32 ,  A61B1/04

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.

Abstract translation: 提供了设备和方法，用于将诊断或治疗仪器放置并行进在曲折或无支撑的解剖结构的中空身体器官中，包括手柄，外套管，具有无创尖端的远侧区域。 外套管可以从手柄移除，并且具有相对于把手以一定角度设置的纵向轴线。 外套管可以选择性地加强，以减少由诊断或治疗仪器的前进引起的器官膨胀。 远端区域允许由诊断或治疗仪器的偏转引起的外套管的被动转向，而无创伤的尖端在操纵诊断或治疗仪器期间防止器官的壁被卡住或夹住。

公开(公告)号：US06395021B1

公开(公告)日：2002-05-28

申请号：US09303113

申请日：1999-04-30

Applicant: Charles C. Hart ,  Ralph V. Clayman ,  John R. Brustad ,  Frans Vandenbroek ,  Richard C. Ewers

Inventor： Charles C. Hart ,  Ralph V. Clayman ,  John R. Brustad ,  Frans Vandenbroek ,  Richard C. Ewers

IPC: A61F206

CPC classification number: A61F2/04 ,  A61F2/042 ,  A61F2/82 ,  A61F2/848 ,  A61F2/90 ,  A61F2/95 ,  A61F2002/048 ,  A61F2250/0067 ,  A61M27/008

Abstract: A stent having an elongate tubular configuration is formed of a plurality of elongate elements interwoven or braided to form a tubular configuration. The elements may be relatively strong and rigid, but movable relative to each other within the weave or braid in order to provide the stent with generally soft characteristics. The elements may be formed of different materials, such as an absorbent material permitting the stent to be doped with materials such as drugs and chemicals. Even the absorbency can be controlled and varied to provide a predetermined time-release of the absorbent.

Abstract translation: 具有细长管状结构的支架由多个细长元件形成，交织或编织以形成管状构型。 这些元件可以是相对较强且刚性的，但是可以在编织物或编织物内相对于彼此移动，以便为支架提供通常柔软的特性。 元件可以由不同的材料形成，例如允许支架掺杂材料如药物和化学品的吸收材料。 甚至可以控制和改变吸光度以提供吸收剂的预定时间释放。

公开(公告)号：US09125555B2

公开(公告)日：2015-09-08

申请号：US13591958

申请日：2012-08-22

Applicant: Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

Inventor： Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

IPC: B29C65/00 ,  A61B1/00 ,  A61B1/307 ,  A61M39/06 ,  A61B17/34

CPC classification number: A61B1/00137 ,  A61B1/307 ,  A61B17/3462 ,  A61M39/0606 ,  A61M2039/0633 ,  A61M2039/066 ,  B29C65/00

Abstract: A surgical valve includes a housing with a proximal housing portion and a distal housing portion cooperating to define a gel cavity. A seal material is disposed in the gel cavity and includes a gel having flow characteristics and incompressible characteristics. A distal guide tube is provided to facilitate retrograde insertion of a surgical instrument into the seal material. During assembly, pressure is applied by the housing portions to the seal material in order to form a circumferential seal and to close an instrument channel. Manufacture can be facilitated by use of a mandrel for maintaining the structural elements in axial alignment. Complimentary screw threads disposed between the first and second housing portions can be used to pressurize the gel and thereby create a locking force on an inserted instrument. Detented tabs can be provided to facilitate control of this locking force.

Abstract translation: 手术阀包括具有近端壳体部分的壳体和协作以限定凝胶腔的远端壳体部分。 密封材料设置在凝胶腔中，并且包括具有流动特性和不可压缩特性的凝胶。 提供远端引导管以便于手术器械逆行插入到密封材料中。 在组装期间，通过壳体部分将压力施加到密封材料上，以形成周向密封并封闭仪器通道。 可以通过使用用于将结构元件保持轴向对准的心轴来促进制造。 设置在第一和第二壳体部分之间的免费螺纹螺纹可用于对凝胶加压，从而在插入的仪器上产生锁定力。 可以提供限位突片以便于该锁定力的控制。

公开(公告)号：US08777965B2

公开(公告)日：2014-07-15

申请号：US13103936

申请日：2011-05-09

Applicant: Eugene G. Chen ,  Tracy D. Maahs ,  Richard C. Ewers ,  Lee L. Swanstrom

Inventor： Eugene G. Chen ,  Tracy D. Maahs ,  Richard C. Ewers ,  Lee L. Swanstrom

IPC: A61B17/04 ,  A61B17/00

CPC classification number: A61B17/0401 ,  A61B17/0057 ,  A61B17/0469 ,  A61B17/0487 ,  A61B2017/00575 ,  A61B2017/00637 ,  A61B2017/00818 ,  A61B2017/00867 ,  A61B2017/0409 ,  A61B2017/0419 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/06052

Abstract: Devices and methods for laparoscopically repairing a hernia are described. In some embodiments, a laparoscopic instrument is used to deploy one or more tissue anchor assemblies into the edges of the fascia tissue surrounding or adjacent to the hernia defect. The tissue anchor assemblies are used to cause the fascia tissue to be approximated to facilitate the repair procedure, to improve healing, and to reduce the incidence of recurrence.

Abstract translation: 描述了用于腹腔镜修复疝气的装置和方法。 在一些实施例中，使用腹腔镜器械将一个或多个组织锚固组件部署到围绕或邻近疝缺损的筋膜组织的边缘。 组织锚固组件用于使筋膜组织近似以便于修复过程，以改善愈合并降低复发的发生率。

公开(公告)号：US08740940B2

公开(公告)日：2014-06-03

申请号：US13748302

申请日：2013-01-23

Applicant: Tracy D. Maahs ,  Marvin C. Elmer ,  Richard C. Ewers

Inventor： Tracy D. Maahs ,  Marvin C. Elmer ,  Richard C. Ewers

IPC: A61B17/04

CPC classification number: A61B17/0401 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0644 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/0409 ,  A61B2017/0419 ,  A61B2017/0454 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2090/037

Abstract: Apparatus and methods optimize anchoring force in securing tissue folds. Over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable designs 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.

Abstract translation: 装置和方法优化固定组织褶皱的锚固力。 通过使用具有可扩展设计的组织锚来避免直接位于锚固器下面的组织的过度压缩，所述组织锚定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。

公开(公告)号：US20120313325A1

公开(公告)日：2012-12-13

申请号：US13591958

申请日：2012-08-22

Applicant: Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

Inventor： Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

IPC: F16J15/14

CPC classification number: A61B1/00137 ,  A61B1/307 ,  A61B17/3462 ,  A61M39/0606 ,  A61M2039/0633 ,  A61M2039/066 ,  B29C65/00

Abstract: A surgical valve includes a housing with a proximal housing portion and a distal housing portion cooperating to define a gel cavity. A seal material is disposed in the gel cavity and includes a gel having flow characteristics and incompressible characteristics. A distal guide tube is provided to facilitate retrograde insertion of a surgical instrument into the seal material. During assembly, pressure is applied by the housing portions to the seal material in order to form a circumferential seal and to close an instrument channel. Manufacture can be facilitated by use of a mandrel for maintaining the structural elements in axial alignment. Complimentary screw threads disposed between the first and second housing portions can be used to pressurize the gel and thereby create a locking force on an inserted instrument. Detented tabs can be provided to facilitate control of this locking force.

Abstract translation: 手术阀包括具有近端壳体部分的壳体和协作以限定凝胶腔的远端壳体部分。 密封材料设置在凝胶腔中，并且包括具有流动特性和不可压缩特性的凝胶。 提供远端引导管以便于手术器械逆行插入到密封材料中。 在组装期间，通过壳体部分将压力施加到密封材料上，以形成周向密封并封闭仪器通道。 可以通过使用用于将结构元件保持轴向对准的心轴来促进制造。 设置在第一和第二壳体部分之间的免费螺纹螺纹可用于对凝胶加压，从而在插入的仪器上产生锁定力。 可以提供限位突片以便于该锁定力的控制。