公开(公告)号：US20090248055A1

公开(公告)日：2009-10-01

申请号：US12060601

申请日：2008-04-01

申请人： James T. Spivey ,  David Stefanchik

发明人： James T. Spivey ,  David Stefanchik

IPC分类号： A61B17/14 ,  A61B19/00 ,  A61B1/00

CPC分类号： A61B17/320016 ,  A61B17/00234 ,  A61B17/320758 ,  A61B2017/00278 ,  A61B2017/00858 ,  A61B2017/320044 ,  A61B2217/005

摘要： Devices and methods are provided for penetrating tissue and/or effecting movement of devices relative to tissue. In general, a surgical instrument is provided having an at least partially fabric-covered distal tip that be used to at least partially penetrate tissue by contacting the tissue with the fabric and rotating the fabric to “drill” into the tissue. The surgical instrument can be configured for delivery proximate to tissue through a working channel of a delivery device and can include an elongate shaft having in its distal portion an end effector at least partially covered in fabric. The fabric, the end effector, and/or the shaft can rotate, thereby allowing at least the fabric to penetrate the tissue and, if sufficiently rotated, causing an opening to form in the tissue. The surgical instrument and/or the delivery device can be advanced through the opening.

摘要翻译： 提供了用于穿透组织和/或实现装置相对于组织的运动的装置和方法。 通常，提供具有至少部分织物覆盖的远侧末端的外科器械，其用于通过使织物与织物接触并将织物“钻”成组织至少部分地穿透组织。 手术器械可以被配置为通过输送装置的工作通道在组织附近输送，并且可以包括细长轴，其在其远端部分具有至少部分地覆盖在织物中的端部执行器。 织物，末端执行器和/或轴可以旋转，从而允许至少织物穿透组织，并且如果充分旋转，则在组织中形成开口。 手术器械和/或输送装置可以通过开口前进。

公开(公告)号：US20080021277A1

公开(公告)日：2008-01-24

申请号：US11458900

申请日：2006-07-20

申请人： David Stefanchik ,  Ragae M. Ghabrial

发明人： David Stefanchik ,  Ragae M. Ghabrial

IPC分类号： A61B1/04

CPC分类号： A61B1/00071 ,  A61B1/00085 ,  A61B1/00087 ,  A61B1/00154 ,  A61B1/0057 ,  A61B17/0218 ,  A61B17/0469 ,  A61B2017/22069 ,  A61B2017/3484 ,  A61B2017/3488

摘要： Methods for stabilizing and positioning an endoscope using various braided devices and suture techniques. Related endoscopic surgical procedures are also disclosed.

摘要翻译： 使用各种编织装置和缝合技术来稳定和定位内窥镜的方法。 还公开了相关的内窥镜外科手术。

公开(公告)号：US20060258910A1

公开(公告)日：2006-11-16

申请号：US11129592

申请日：2005-05-13

申请人： David Stefanchik ,  James Spivey ,  Omar Vakharia ,  Rick Applegate

发明人： David Stefanchik ,  James Spivey ,  Omar Vakharia ,  Rick Applegate

IPC分类号： A61B1/00

CPC分类号： A61B1/00135 ,  A61B1/00137 ,  A61B1/0014 ,  A61B1/012

摘要： A method for positioning a device, such as an endcap, on an endoscope is disclosed. The method can be used, for example, for facilitating pressing an endcap onto an endoscope, including in those applications where the endscope is disposed in a sheath and the endcap is positioned at the distal end of the sheath.

摘要翻译： 公开了一种用于将诸如端盖的装置定位在内窥镜上的方法。 该方法可以用于例如用于将端盖压入内窥镜，包括在内窥镜设置在护套中并且端盖位于护套的远端的那些应用中。

公开(公告)号：US5897563A

公开(公告)日：1999-04-27

申请号：US947115

申请日：1997-10-08

申请人： InBae Yoon ,  Ronald J. Brinkerhoff ,  David Stefanchik ,  Jeffrey S. Swayze ,  Bryan Knodel ,  Rudolph H. Nobis

发明人： InBae Yoon ,  Ronald J. Brinkerhoff ,  David Stefanchik ,  Jeffrey S. Swayze ,  Bryan Knodel ,  Rudolph H. Nobis

IPC分类号： A61B17/04

CPC分类号： A61B17/062 ,  A61B17/0469 ,  A61B17/0491

摘要： In accordance with the present invention there is provided a method for suturing tissue using a needle holder device, The device includes a handle for holding it, the handle has distal and proximal ends. The device also has right and left arms extending distally from the handle. The arms of the device have proximal ends attached to the handle and distal ends having grippers attached thereto for gripping and releasing a needle. The device includes at least one mechanism for moving the distal ends of the arms closely adjacent to one another and for passing the needle from one gripper to the other and thereafter for moving the distal ends of the arms further apart from one another. The right gripper is holding a needle having a suture attached thereto. The method first involves moving the distal ends of the arms apart from one another and manually inserting the needle into the tissue and back out again. Thereafter, the method involves actuating the mechanism so as to move the arms closely adjacent one another so that the left gripper holds the needle, the right gripper releases the needle. Then the method involves moving the distal ends of the arms further apart from one another. Lastly, the method involves removing the needle from the tissue.

摘要翻译： 根据本发明，提供了一种使用针保持器装置缝合组织的方法。该装置包括用于保持其的手柄，手柄具有远端和近端。 该装置还具有从手柄向远侧延伸的右臂和左臂。 装置的臂具有附接到手柄的近端，并且远端具有附接到其上的夹持器，用于夹紧和释放针。 该装置包括至少一个用于使臂的远端彼此靠近移动并将针从一个夹持器传递到另一个并且此后用于将臂的远端彼此远离移动的至少一个机构。 右夹具保持具有附着于其上的缝合线的针。 该方法首先涉及将臂的远端彼此分开移动并手动将针插入组织并再次退出。 此后，该方法包括致动该机构以使臂彼此靠近地移动，使得左夹具保持针，右夹具释放针。 然后，该方法包括使臂的远端彼此远离地移动。 最后，该方法包括从组织中去除针。

公开(公告)号：US5601573A

公开(公告)日：1997-02-11

申请号：US404662

申请日：1995-03-15

申请人： Mark Fogelberg ,  J. David Hughett ,  C. Kerwin Braddock ,  Michael E. Boehm ,  David Stefanchik ,  Michael A. Murray

发明人： Mark Fogelberg ,  J. David Hughett ,  C. Kerwin Braddock ,  Michael E. Boehm ,  David Stefanchik ,  Michael A. Murray

IPC分类号： A61B17/068 ,  A61B17/122 ,  A61B17/128 ,  A61B17/00

CPC分类号： A61B17/1227 ,  A61B17/1285 ,  Y10S227/901 ,  Y10S227/902

摘要： A clip, clip applier and method for ligating a tissue structure is provided. The applier has a two stage actuation. In the first stage, a tissue structure is positioned into the jaws of the clip applier The jaws close and lock to a preset force to compress and temporarily occlude the tissue structure. If satisfactorily positioned, the second stage is initiated in which a clip is advanced through the shaft of the clip applier in a closed position. At the distal end of the clip applier, the clip is opened slightly to capture the pre-compressed tissue structure, and is placed over the structure. The clip is then dissociated from the business end of the instrument. Preferably the clip comprises two leg members disposed in close proximity to one another joined from opposing directions by a connecting element. The connecting element restricts separation of the leg members with opposing spring members so as to provide substantially uniform parallel deflection of the leg members from each other.

摘要翻译： 提供了一种用于结扎组织结构的夹子，夹持器和方法。 施肥机具有两级致动。 在第一阶段中，组织结构被定位在夹具的夹爪中。夹爪闭合并锁定到预设的力以压缩并暂时闭塞组织结构。 如果令人满意地定位，则启动第二阶段，其中夹子在关闭位置通过夹具施加器的轴推进。 在施放器的远端处，夹子稍微打开以捕获预压缩的组织结构，并且被放置在结构上。 然后将剪辑从仪器的业务端解离。 优选地，夹子包括通过连接元件彼此紧密相邻地布置成由相反方向连接的两个腿部构件。 连接元件限制腿构件与相对的弹簧构件的分离，以便使腿构件彼此基本均匀地平行地偏转。

公开(公告)号：US08157727B2

公开(公告)日：2012-04-17

申请号：US11778142

申请日：2007-07-16

申请人： David Stefanchik

发明人： David Stefanchik

IPC分类号： A61B1/00 ,  A61B1/015

CPC分类号： A61B1/00073 ,  A61B1/00135 ,  A61B1/0014 ,  A61B1/00156 ,  A61B1/0058 ,  A61B1/015 ,  A61B1/31

摘要： An endoscopic device and method of use for facilitating movement of an elongate insertion element through a tortuous passageway includes a tissue engaging section having an outer wall with a plurality of openings that communicate with at least one of a source of vacuum and a source of irrigation, and a porous fabric extending over at least a portion of the tissue engaging section. The tissue engaging section can be appended to an accessory channel formed on an outer surface of the elongate insertion element, wherein the central longitudinal axis of the tissue engaging section is offset from a central longitudinal axis of the insertion element, or can be in the form of an elongate helical ribbon disposed around at least a portion of the insertion element. The movement of the device is effected by applying suction to draw tissue to the device, thus straightening the passageway. The suction can be removed or reduced and then the device can be further advanced along the passageway.

摘要翻译： 用于促进细长插入元件通过曲折通道的移动的内窥镜装置和方法包括具有外壁的组织接合部分，该外壁具有与真空源和冲洗源中的至少一个连通的多个开口， 以及在组织接合部分的至少一部分上延伸的多孔织物。 组织接合部分可以附着到形成在细长插入元件的外表面上的附件通道中，其中组织接合部分的中心纵向轴线偏离插入元件的中心纵向轴线，或者可以是形式 设置在所述插入元件的至少一部分周围的细长螺旋带。 装置的移动通过施加抽吸来将组织拉到装置来实现，从而矫正通道。 抽吸可以被去除或减少，然后装置可以沿通道进一步前进。

公开(公告)号：US08070759B2

公开(公告)日：2011-12-06

申请号：US12130023

申请日：2008-05-30

申请人： David Stefanchik ,  James T. Spivey

发明人： David Stefanchik ,  James T. Spivey

IPC分类号： A61B17/10

CPC分类号： A61B17/0057 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0491 ,  A61B17/12009 ,  A61B2017/0649

摘要： Various embodiments are directed to a surgical device including an end effector. The end effector may include a first jaw member defining a first groove and a second jaw member defining a second groove. The first jaw member and the second jaw member may be selectively pivotable between an open position and a closed position. Also, the first groove and the second groove may align to form a combined helical groove when the first jaw member and the second jaw member are in the closed position. In addition, the first jaw member may define a wire opening aligned with the first groove. Further, the first jaw member may define a beveled edge directed distally and substantially parallel to a distal portion of the wire opening.

摘要翻译： 各种实施例涉及包括端部执行器的手术装置。 端部执行器可以包括限定第一槽的第一钳口构件和限定第二槽的第二钳口构件。 第一钳口构件和第二钳口构件可以在打开位置和关闭位置之间选择性地枢转。 此外，当第一钳口构件和第二钳口构件处于关闭位置时，第一槽和第二槽可对准以形成组合的螺旋槽。 此外，第一钳口构件可以限定与第一凹槽对准的线开口。 此外，第一钳口构件可以限定朝向远侧并基本平行于线开口的远端部分的倾斜边缘。

公开(公告)号：US07976458B2

公开(公告)日：2011-07-12

申请号：US11566954

申请日：2006-12-05

申请人： David Stefanchik ,  James T. Spivey

发明人： David Stefanchik ,  James T. Spivey

IPC分类号： A61B1/00

CPC分类号： A61B1/018 ,  A61B1/00073 ,  A61B1/00135 ,  A61B1/0014 ,  A61B1/00154

摘要： Devices and methods useful for delivering tools and/or materials to a surgical site are disclosed. In one embodiment, an accessory device for an endoscope is provided and can include an elongate sheath and an accessory channel. The elongate sheath can be adapted to receive an endoscope therein, and it can include a mating element extending longitudinally between proximal and distal ends thereof. The accessory channel can be adapted to receive a tool therethrough and it can also have a mating element extending between proximal and distal ends thereof and adapted to slidably mate to the mating element formed on the elongate sheath. In certain exemplary embodiments, a distal portion of the accessory channel can be adapted to derail from at least a distal portion of the elongate sheath while a proximal portion of the accessory channel remains mated to a proximal portion of the elongate sheath. In use, the elongate sheath and the accessory channel can each provide a pathway for delivering tools and/or materials to a surgical site. The distal ends of elongate sheath and the accessory channel can be detached and positioned independently of one another to afford improved positioning or placement of the tools and/or materials received therethrough.

摘要翻译： 公开了用于将工具和/或材料递送到手术部位的装置和方法。 在一个实施例中，提供了一种用于内窥镜的附件装置，并且可以包括细长护套和附件通道。 细长护套可以适于在其中容纳内窥镜，并且其可以包括在其近端和远端之间纵向延伸的配合元件。 附件通道可以适于接收穿过其中的工具，并且其还可以具有在其近端和远端之间延伸并且适于滑动地配合到形成在细长护套上的配合元件的配合元件。 在某些示例性实施例中，附件通道的远侧部分可以适于从细长护套的至少远侧部分脱轨，而附件通道的近侧部分保持配合到细长护套的近端部分。 在使用中，细长护套和附件通道可以各自提供用于将工具和/或材料递送到手术部位的路径。 细长护套的远端和附件通道可以彼此独立地拆卸和定位，以提供通过其接收的工具和/或材料的改进的定位或放置。

公开(公告)号：US07815662B2

公开(公告)日：2010-10-19

申请号：US11715710

申请日：2007-03-08

申请人： James T. Spivey ,  David Stefanchik ,  Christopher Paul Swain

发明人： James T. Spivey ,  David Stefanchik ,  Christopher Paul Swain

IPC分类号： A61B17/04 ,  A61B17/08

CPC分类号： A61B17/0401 ,  A61B2017/0406 ,  A61B2017/0409 ,  A61B2017/0414 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/0488 ,  Y10T24/3916

摘要： A suture anchor is provided which includes a hollow member having an outer surface defining an enclosure, the member having a longitudinal axis and a slot through a portion of the outer surface in a direction transverse to the longitudinal axis, the slot providing an opening into the enclosure. The suture anchor further includes a one-way valve positioned within the enclosure at the slot to allow entry of a suture through the slot into the enclosure and to prevent the exit of the suture from the enclosure. A device is provided for deploying the suture anchor. The deployment device includes an elongate hollow member having a suture anchor release zone positioned at the distal end, a launch bar having at least a portion positioned in the release zone. The launch bar is movable within the release zone between a resting position and a launching position and is operatively connected to an actuation member positioned proximally to the elongate member. The hollow elongate member defines a housing for receiving a plurality of suture anchors in tandem.

摘要翻译： 提供了缝合锚，其包括具有限定外壳的外表面的中空构件，所述构件具有纵向轴线和穿过外表面的横向于纵向轴线的方向的一部分的狭槽，所述狭槽提供到 外壳。 缝合锚还包括位于外壳内的单向阀，该单向阀位于狭槽处，以允许缝线通过狭槽进入外壳并防止缝合线从外壳排出。 提供了用于展开缝线锚的装置。 展开装置包括细长的中空构件，其具有位于远端的缝合线锚释放区，发射杆具有至少一部分位于释放区中。 发射杆可在释放区域内在静止位置和发射位置之间移动，并且可操作地连接到定位在细长构件的近侧的致动构件。 中空细长构件限定用于串联接收多个缝合锚的壳体。

公开(公告)号：US07615003B2

公开(公告)日：2009-11-10

申请号：US11128733

申请日：2005-05-13

申请人： David Stefanchik ,  Rick D. Applegate

发明人： David Stefanchik ,  Rick D. Applegate

IPC分类号： A61B1/00

CPC分类号： A61B1/00073 ,  A61B1/00135 ,  A61B1/012 ,  A61B17/3415 ,  A61B17/3431 ,  A61B2017/00278

摘要： A medical apparatus and method useful for positioning one or more members within the gastro-intestinal tract is disclosed. The medical apparatus can include a track supported on a sheath sized to receive an endoscope, and a carrier slidable with respect to the track. A feeding tube accessory adapted to slidably engage the carrier is disclosed.

摘要翻译： 公开了一种用于将一个或多个构件定位在胃肠道内的医疗装置和方法。 医疗装置可以包括支撑在尺寸适于接收内窥镜的护套上的轨道和可相对于轨道滑动的托架。 公开了一种适于可滑动地接合载体的供给管附件。