公开(公告)号：US20080265001A1

公开(公告)日：2008-10-30

申请号：US12147672

申请日：2008-06-27

申请人： David T. Green ,  Keith Ratcliff ,  Keith Milliman ,  Henry R. Sienkiewicz ,  Mitchell J. Palmer ,  Graham W. Bryan

发明人： David T. Green ,  Keith Ratcliff ,  Keith Milliman ,  Henry R. Sienkiewicz ,  Mitchell J. Palmer ,  Graham W. Bryan

IPC分类号： A61B17/068

CPC分类号： A61B17/07207 ,  A61B17/00234 ,  A61B2017/00535 ,  A61B2017/00544 ,  A61B2017/07214 ,  A61B2017/0725 ,  A61B2017/07271 ,  A61B2017/07285 ,  A61B2017/2926 ,  A61B2017/2927 ,  A61B2017/2929 ,  A61B2090/038 ,  A61B2090/0803

摘要： An endoscopic surgical apparatus is provided for placing lateral lines of surgical fasteners into body tissue. The apparatus includes a frame portion, an elongated portion extending from the frame portion, and an articulating fastener applying assembly associated with a distal end of the elongated portion. The fastener applying assembly includes a base portion, a staple cartridge housing, and an anvil member which has a forming surface thereon against which surgical fasteners are driven as they are ejected from the cartridge housing. A first mechanism is provided for effectuating the rotation of the fastener applying assembly about an axis defined by the body portion, a second mechanism is provided for effectuating the articulation of the fastener applying assembly, and a third mechanism is provided for independently rotating the cartridge housing and anvil member relative to a longitudinal axis defined by the base position to increase the range of operability of the apparatus.

摘要翻译： 提供内窥镜手术装置用于将外科紧固件的侧线放置在身体组织中。 该装置包括框架部分，从框架部分延伸的细长部分以及与细长部分的远端相关联的关节式紧固件施加组件。 紧固件施加组件包括基部，钉仓壳体和砧座构件，其具有成形表面，外科紧固件在从套筒壳体弹出时被驱动。 提供第一机构用于实现紧固件施加组件围绕由主体部分限定的轴线的旋转，提供第二机构用于实现紧固件施加组件的铰接，并且提供第三机构用于独立地旋转盒壳体 和砧构件相对于由基座位置限定的纵向轴线，以增加设备的可操作性的范围。

公开(公告)号：US07296724B2

公开(公告)日：2007-11-20

申请号：US11073454

申请日：2005-03-07

申请人： David T. Green ,  Keith Ratcliff ,  Keith Milliman ,  Henry R. Sienkiewicz ,  Mitchell J. Palmer ,  Graham W. Bryan

发明人： David T. Green ,  Keith Ratcliff ,  Keith Milliman ,  Henry R. Sienkiewicz ,  Mitchell J. Palmer ,  Graham W. Bryan

IPC分类号： A61B17/068

CPC分类号： A61B17/07207 ,  A61B17/00234 ,  A61B2017/00535 ,  A61B2017/00544 ,  A61B2017/07214 ,  A61B2017/0725 ,  A61B2017/07271 ,  A61B2017/07285 ,  A61B2017/2926 ,  A61B2017/2927 ,  A61B2017/2929 ,  A61B2090/038 ,  A61B2090/0803

摘要： An endoscopic surgical apparatus is provided for placing lateral lines of surgical fasteners into body tissue. The apparatus includes a frame portion, an elongated portion extending from the frame portion, and an articulating fastener applying assembly associated with a distal end of the elongated portion. The fastener applying assembly includes a base portion, a staple cartridge housing, and an anvil member which has a forming surface thereon against which surgical fasteners are driven as they are ejected from the cartridge housing. A first mechanism is provided for effectuating the rotation of the fastener applying assembly about an axis defined by the body portion, a second mechanism is provided for effectuating the articulation of the fastener applying assembly, and a third mechanism is provided for independently rotating the cartridge housing and anvil member relative to a longitudinal axis defined by the base position to increase the range of operability of the apparatus.

摘要翻译： 提供内窥镜手术装置用于将外科紧固件的侧线放置在身体组织中。 该装置包括框架部分，从框架部分延伸的细长部分以及与细长部分的远端相关联的关节式紧固件施加组件。 紧固件施加组件包括基部，钉仓壳体和砧座构件，其具有成形表面，外科紧固件在从套筒壳体弹出时被驱动。 提供第一机构用于实现紧固件施加组件围绕由主体部分限定的轴线的旋转，提供第二机构用于实现紧固件施加组件的铰接，并且提供第三机构用于独立地旋转盒壳体 和砧构件相对于由基座位置限定的纵向轴线，以增加设备的可操作性的范围。

公开(公告)号：US20070257082A1

公开(公告)日：2007-11-08

申请号：US11788671

申请日：2007-04-20

申请人： Keith Milliman

发明人： Keith Milliman

IPC分类号： A61B17/068

CPC分类号： A61B17/068 ,  A61B17/072 ,  A61B17/1155 ,  A61B17/32053 ,  A61B2017/00367 ,  A61B2017/00473 ,  A61B2017/07214 ,  A61B2017/0725 ,  A61B2017/07257 ,  A61B2090/0814

摘要： A surgical stapling device including a self-righting anvil assembly is disclosed. The anvil assembly includes an anvil center rod and a pivotable anvil head. The surgical stapling device includes an anvil retainer assembly having a locking member in the form of a trocar for moving the anvil head from its tilted position to its operative position upon attachment of the anvil assembly to the stapling device. A cam member is provided to retain the locking member in a first or locked position and, thus, the anvil head in the operative position until after the stapling device has been fired. In another embodiment, a tiltable anvil assembly for use with a surgical stapling device is disclosed. The anvil assembly includes a center rod and a head assembly which is pivotally secured to the center rod. The head assembly includes a housing, a post, an anvil plate and a backup member. The backup member is movably positioned about the post from a first position preventing pivotal movement of the head assembly to a second position permitting pivotal movement of the head assembly. A retainer member is positioned between the backup member and the housing to prevent movement of the backup member from its first position to its second position until a predetermined force has been applied to the backup member. In another embodiment, a passive lockout mechanism is disclosed which is operably associated with a trigger lock on the handle assembly of the surgical stapling device. The passive lockout mechanism is positioned to prevent movement of the anvil assembly in relation to the shell assembly of the device from an approximated position to an unapproximated position when the trigger lock is in an unlocked position.

摘要翻译： 公开了一种包括自立式砧座组件的外科缝合装置。 砧组件包括砧座中心杆和可枢转砧头。 外科缝合装置包括砧座保持器组件，其具有套管针形式的锁定构件，用于在将砧座组件附接到缝合装置时将砧座头从其倾斜位置移动到其操作位置。 凸轮构件被设置成将锁定构件保持在第一或锁定位置，并且因此将砧座头保持在操作位置，直到缝合装置被点火。 在另一个实施例中，公开了一种与外科缝合装置一起使用的可倾斜砧组件。 砧座组件包括中心杆和枢转地固定到中心杆的头部组件。 头组件包括壳体，柱，砧板和支撑构件。 支撑构件从第一位置围绕柱移动定位，从而防止头部组件的枢转运动到允许头部组件枢转运动的第二位置。 保持构件定位在支撑构件和壳体之间，以防止支撑构件从其第一位置移动到其第二位置，直到预定的力已经施加到支撑构件。 在另一个实施例中，公开了一种被动闭锁机构，其被可操作地与外科缝合装置的手柄组件上的触发器锁相关联。 被动锁定机构被定位成防止当触发器锁处于解锁位置时，砧座组件相对于装置的壳体组件从近似位置到未近似位置的移动。

公开(公告)号：US20070181632A1

公开(公告)日：2007-08-09

申请号：US11728698

申请日：2007-03-27

申请人： Keith Milliman

发明人： Keith Milliman

IPC分类号： A61B17/04

CPC分类号： A61B17/115 ,  A61B17/1114 ,  A61B17/32053 ,  A61B2017/07257 ,  A61B2017/2927

摘要： An anvil assembly for use with a surgical stapler is provided. The anvil assembly includes a cut ring assembly having a body and a cover. The cover has a first layer of material having a first hardness to allow penetration by a knife of a surgical stapler and at least one additional layer of material having a second hardness greater than the first hardness to minimize penetration of the cover by a knife of a surgical stapler.

摘要翻译： 提供了一种与外科缝合器一起使用的砧座组件。 砧组件包括具有主体和盖的切割环组件。 所述盖具有第一层材料，其具有第一硬度以允许手术吻合器的刀具穿透，以及具有大于第一硬度的第二硬度的至少一个另外的材料层，以最小化由所述第一硬度 手术吻合器

公开(公告)号：US07234624B2

公开(公告)日：2007-06-26

申请号：US11208667

申请日：2005-08-22

申请人： Richard D. Gresham ,  Scott E. Manzo ,  Ernest Aranyi ,  Robert J. Geiste ,  Bruce K. Jankowski ,  Keith Milliman

发明人： Richard D. Gresham ,  Scott E. Manzo ,  Ernest Aranyi ,  Robert J. Geiste ,  Bruce K. Jankowski ,  Keith Milliman

IPC分类号： A61B17/00 ,  A61B17/34

CPC分类号： A61B17/1155 ,  A61B17/115 ,  A61B17/34 ,  A61B2017/00128 ,  A61B2017/07257 ,  A61B2017/2905

摘要： This application is directed to a surgical stapling device for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The handle portion includes a rotatable approximation knob for approximating the anvil and shell assemblies and a firing trigger for actuating a firing mechanism for ejecting staples positioned within the shell assembly. The firing trigger forms one link of a two bar linkage provided to actuate the firing mechanism. The anvil assembly includes a tiltable anvil which will tilt automatically after firing of the device and unapproximating the anvil and shell assemblies. The head portion also includes a retractable trocar assembly which is slidably positioned within an anvil retainer and is automatically advanced and retracted upon attachment and detachment of the anvil assembly onto the anvil retainer. A lockout tube is provided and is positioned about an anvil retainer for releasably engaging an anvil assembly. The lockout tube prevents inadvertent detachment of the anvil assembly from the anvil retainer. The surgical stapling device also includes a firing lockout assembly which prevents actuation of the firing trigger until an anvil has been attached to the device and the anvil has been approximated. In one preferred embodiment, the firing lockout assembly includes a trigger lock and a safety bracket which prevents movement of the trigger lock from a locked to an unlocked position until an anvil has been attached to the device and approximated and returns the trigger lock to a locked position after the device has been fired. A tactile indication mechanism is also provided for notifying a surgeon that the device has been fired and for notifying a surgeon that the anvil head has been unapproximated a distance sufficient to permit the anvil head to tilt.

摘要翻译： 该应用涉及用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 手柄部分包括用于近似砧座和壳体组件的可旋转近似旋钮，以及用于致动用于排出位于壳体组件内的缝钉的击发机构的击发触发器。 击发触发器形成两个连杆的一个连杆，用于致动击发机构。 砧座组件包括可倾斜的砧座，该砧座将在装置点火之后自动倾斜并且使砧座和壳体组件不接近。 头部还包括可伸缩套管针组件，其可滑动地定位在砧座保持器内，并且在将砧组件附接和拆卸到砧座保持器上时自动前进和缩回。 锁定管被设置并且围绕砧座保持器定位以可释放地接合砧座组件。 锁定管防止砧组件从砧座保持器的意外脱离。 外科缝合装置还包括击发锁定组件，其防止触发触发器的致动，直到砧已经附接到装置并且砧已被近似。 在一个优选实施例中，击发锁定组件包括触发锁和安全支架，其防止触发锁从锁定位置移动到解锁位置，直到砧座已经附接到装置并近似并且将触发器锁定回锁定 设备启动后的位置。 还提供了一种触觉指示机构，用于通知外科医生该装置已经被点燃，并且通知外科医生砧座头未被近距离足以允许砧头倾斜的距离。

公开(公告)号：US07204843B2

公开(公告)日：2007-04-17

申请号：US10388969

申请日：2003-03-13

申请人： Keith Milliman ,  Kevin Sniffen ,  David A. Nicolas ,  Scott E. Manzo ,  Peter Hinchliffe

发明人： Keith Milliman ,  Kevin Sniffen ,  David A. Nicolas ,  Scott E. Manzo ,  Peter Hinchliffe

IPC分类号： A61B17/04

CPC分类号： A61B17/1285 ,  A61B17/0293 ,  A61B17/08 ,  A61B17/083 ,  A61B17/11 ,  A61B17/1152 ,  A61B17/122 ,  A61B2017/1107 ,  A61B2017/1135 ,  A61B2017/2916

摘要： A surgical instrument for anastomosis of first and second blood vessels includes a housing having distal and proximal ends, a handle and a disposable loading unit removably mounted to the distal end of the housing. The loading unit includes upper and lower fastener support members having a passage defined therethrough for receiving an end of the second blood vessel and configured to releasably support a plurality of surgical fasteners. The loading unit also includes a retractable anvil located at a distal end of the loading unit, the anvil being movable relative to the fastener support member in response to actuation of the handle to simultaneously deform the of surgical fasteners.

摘要翻译： 用于吻合第一和第二血管的手术器械包括具有远端和近端的壳体，手柄和可移除地安装到壳体的远端的一次性加载单元。 装载单元包括上和下紧固件支撑构件，其具有通过其限定的通道，用于接收第二血管的端部并且构造成可释放地支撑多个外科紧固件。 装载单元还包括位于加载单元的远端处的可伸缩砧座，砧座响应于手柄的致动而相对于紧固件支撑构件可移动，以同时使外科紧固件变形。

公开(公告)号：US20070078486A1

公开(公告)日：2007-04-05

申请号：US11602118

申请日：2006-11-20

申请人： Keith Milliman ,  Russell Heinrich

发明人： Keith Milliman ,  Russell Heinrich

IPC分类号： A61B17/08

CPC分类号： A61B17/1114 ,  A61B1/31 ,  A61B17/02 ,  A61B17/115 ,  A61B17/1155 ,  A61B2017/00469 ,  A61B2017/00473 ,  A61B2017/2927 ,  A61B2017/2931

摘要： A surgical stapling device is disclosed for the treatment of internal hemorrhoids. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The anvil assembly of the stapling device may include an approximation mechanism having an anvil retainer including an elongated distal extension dimensioned to be telescopingly received within a longitudinal bore of an anvil center rod of the anvil assembly. The elongated distal extension is of a length to provide telescopic engagement with the anvil center rod without obstructing visualization of the surgical site. A kit including a surgical instrument having a removable anvil assembly and an anvil assembly insertion handle is also disclosed. The kit may also include a speculum, an anal dialator and/or an obturator.

公开(公告)号：US20050205639A1

公开(公告)日：2005-09-22

申请号：US11081364

申请日：2005-03-16

申请人： Keith Milliman

发明人： Keith Milliman

IPC分类号： A61B17/04 ,  A61B17/11 ,  A61B17/115 ,  A61B17/28 ,  A61B17/32

CPC分类号： A61B17/115 ,  A61B17/1114 ,  A61B17/32053 ,  A61B2017/07257 ,  A61B2017/2927

摘要： An anvil assembly for use with a surgical stapler is provided. The anvil assembly includes a cut ring assembly having a body and a cover. The cover has a first layer of material having a first hardness to allow penetration by a knife of a surgical stapler and at least one additional layer of material having a second hardness greater than the first hardness to minimize penetration of the cover by a knife of a surgical stapler.

摘要翻译： 提供了一种与外科缝合器一起使用的砧座组件。 砧组件包括具有主体和盖的切割环组件。 所述盖具有第一层材料，其具有第一硬度以允许手术吻合器的刀具穿透，以及具有大于第一硬度的第二硬度的至少一个另外的材料层，以最小化由所述第一硬度 手术吻合器

公开(公告)号：US20050006433A1

公开(公告)日：2005-01-13

申请号：US10872747

申请日：2004-06-21

申请人： Keith Milliman ,  Russell Heinrich

发明人： Keith Milliman ,  Russell Heinrich

IPC分类号： A61B20060101 ,  A61B17/00 ,  A61B17/03 ,  A61B17/04 ,  A61B17/068 ,  A61B17/10 ,  A61B17/11 ,  A61B17/115 ,  A61B17/28 ,  B31B50/68

CPC分类号： A61B17/1114 ,  A61B1/31 ,  A61B17/02 ,  A61B17/115 ,  A61B17/1155 ,  A61B2017/00469 ,  A61B2017/00473 ,  A61B2017/2927 ,  A61B2017/2931

摘要： A surgical stapling device is disclosed for the treatment of internal hemorrhoids. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The anvil assembly of the stapling device may include an approximation mechanism having an anvil retainer including an elongated distal extension dimensioned to be telescopingly received within a longitudinal bore of an anvil center rod of the anvil assembly. The elongated distal extension is of a length to provide telescopic engagement with the anvil center rod without obstructing visualization of the surgical site. A kit including a surgical instrument having a removable anvil assembly and an anvil assembly insertion handle is also disclosed. The kit may also include a speculum, an anal dialator and/or an obturator.

摘要翻译： 公开了用于治疗内痔的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 头部包括砧座组件，该砧组件包括可倾斜的砧座，该砧座将在该装置被点火并且未被近似之后自动倾斜。 可倾斜的砧座提供减小的砧座轮廓，以在执行吻合过程之后减少在装置移除期间的创伤。 装订装置的砧座组件可以包括近似机构，其具有砧座保持器，该砧座保持器包括细长的远端延伸部，其尺寸可伸缩地容纳在砧座组件的砧座中心杆的纵向孔内。 细长的远端延伸部具有能够与砧座中心杆伸缩接合的长度，而不会妨碍手术部位的可视化。 还公开了一种包括具有可移除砧座组件和砧座组件插入手柄的手术器械的套件。 该套件还可以包括窥器，肛门拨号器和/或闭塞器。

公开(公告)号：US06644532B2

公开(公告)日：2003-11-11

申请号：US09852457

申请日：2001-05-09

申请人： David T. Green ,  Keith Ratcliff ,  Keith Milliman ,  Henry R. Sienkiewicz ,  Mitchell J. Palmer ,  Graham W. Bryan

发明人： David T. Green ,  Keith Ratcliff ,  Keith Milliman ,  Henry R. Sienkiewicz ,  Mitchell J. Palmer ,  Graham W. Bryan

IPC分类号： A61B17068

CPC分类号： A61B17/07207 ,  A61B17/00234 ,  A61B2017/00535 ,  A61B2017/00544 ,  A61B2017/07214 ,  A61B2017/0725 ,  A61B2017/07271 ,  A61B2017/07285 ,  A61B2017/2926 ,  A61B2017/2927 ,  A61B2017/2929 ,  A61B2090/038 ,  A61B2090/0803

摘要： An endoscopic surgical apparatus is provided for placing lateral lines of surgical fasteners into body tissue. The apparatus includes a frame portion, an elongated portion extending from the frame portion, and an articulating fastener applying assembly associated with a distal end of the elongated portion. The fastener applying assembly includes a base portion, a staple cartridge housing, and an anvil member which has a forming surface thereon against which surgical fasteners are driven as they are ejected from the cartridge housing. A first mechanism is provided for effectuating the rotation of the fastener applying assembly about an axis defined by the body portion, a second mechanism is provided for effectuating the articulation of the fastener applying assembly, and a third mechanism is provided for independently rotating the cartridge housing and anvil member relative to a longitudinal axis defined by the base position to increase the range of operability of the apparatus.