公开(公告)号：US06942613B2

公开(公告)日：2005-09-13

申请号：US10281461

申请日：2002-10-25

Applicant: Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

Inventor： Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

IPC: A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/31 ,  A61B1/32 ,  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 disposed within a hydrophilic sheath, and 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 sheath may be disposable to permit reuse of the overtube. Fail-safe tensioning mechanisms may be provided to selectively stiffen the overtube to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The fail-safe tensioning mechanisms reduce the risk of reconfiguration of the overtube in the event that the tension system fails, and, in one embodiment, rigidizes the overtube without substantial proximal movement of the distal region. 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：US06783491B2

公开(公告)日：2004-08-31

申请号：US10173220

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: A61B100

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：US08672839B2

公开(公告)日：2014-03-18

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：US08512362B2

公开(公告)日：2013-08-20

申请号：US12265672

申请日：2008-11-05

Applicant: Richard C. Ewers ,  Christopher James Earley ,  Barton P. Bandy ,  Eugene G. Chen ,  Haio Fauser

Inventor： Richard C. Ewers ,  Christopher James Earley ,  Barton P. Bandy ,  Eugene G. Chen ,  Haio Fauser

IPC: A61B17/128

CPC classification number: A61B17/12013 ,  A61B17/0487 ,  A61B17/083 ,  A61B17/105 ,  A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B17/282 ,  A61B2017/00862 ,  A61B2017/06176 ,  A61B2017/12004 ,  A61B2017/2948

Abstract: A ligature delivery device includes a control member, an elongated shaft, and an end effector attached to the distal end of the elongated shaft. An activation mechanism provides an user-operable connection between the control member and the end effector. In several embodiments, the end effector includes a reverse grasping mechanism. Several embodiments of ligature devices are adapted to be deployed endoscopically and/or translumenally using the reverse-grasping delivery device.

Abstract translation: 结扎输送装置包括控制构件，细长轴和附接到细长轴的远端的端部执行器。 激活机构在控制构件和末端执行器之间提供用户可操作的连接。 在几个实施例中，末端执行器包括反向抓握机构。 连接装置的几个实施例适于使用反向抓取输送装置内窥镜和/或经腹进行部署。

公开(公告)号：US20130138151A1

公开(公告)日：2013-05-30

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：US08388526B2

公开(公告)日：2013-03-05

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: A61B17/02

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：US20130041214A1

公开(公告)日：2013-02-14

申请号：US13597072

申请日：2012-08-28

Applicant: Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

Inventor： Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

IPC: A61B1/05 ,  A61B1/018

CPC classification number: A61B1/0051 ,  A61B1/00085 ,  A61B1/00089 ,  A61B1/00098 ,  A61B1/00179 ,  A61B1/00183 ,  A61B1/018 ,  A61B1/05

Abstract: Methods and apparatus for off-axis visualization are described herein. An endoluminal tissue manipulation assembly is disclosed which provides for a stable endoluminal platform and which also provides for effective triangulation of tools. Such an apparatus may comprise an optionally shape-lockable elongate body defining a longitudinal axis and adapted for endoluminal advancement in a patient body, at least one articulatable visualization lumen disposed near or at a distal region of the elongate body, the at least one articulating visualization lumen being adapted to articulate off-axis relative to a longitudinal axis of the elongate body, and at least one articulatable tool arm member disposed near or at the distal region of the elongate body, the at least one articulatable tool arm member being adapted to articulate off-axis and manipulate a tissue region of interest.

Abstract translation: 本文描述了用于离轴可视化的方法和装置。 公开了一种腔内组织操作组件，其提供稳定的内腔平台，并且还提供工具的有效三角测量。 这种装置可以包括限定纵向轴线并且适于在患者体内进行腔内前进的可选形状可锁定细长体，至少一个可伸长的可视腔，其设置在细长体的远端区域附近或位于该远端区域处，该至少一个铰接可视化 内腔适于相对于细长主体的纵向轴线偏轴关节，以及设置在细长主体的远侧区域附近或其附近的至少一个可铰接工具臂构件，所述至少一个可铰接工具臂构件适于铰接 离轴并且操纵感兴趣的组织区域。

公开(公告)号：US20120238952A1

公开(公告)日：2012-09-20

申请号：US13483371

申请日：2012-05-30

Applicant: Sean Mitchell ,  Richard C. Ewers ,  Tracy D. Maahs

Inventor： Sean Mitchell ,  Richard C. Ewers ,  Tracy D. Maahs

IPC: A61M25/092

CPC classification number: A61B1/0057 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/008 ,  A61B1/012 ,  A61M25/0147

Abstract: An endoluminal surgical instrument has first and second steering controls on a handle. A flexible shaft attached to the handle has a distal steerable end including a first link and a second link separated by a plurality of intermediate links. First and second steering elements, such as pairs of steering wires, are linked to first and second steering controls and to the first and, second links. One or more of the links is pivotable through an angle of at least 30 degrees relative to an adjoining link. The set back position of the second steering elements from the first steering elements, and the pivoting capability of the links allows the steerable end to be steered into a small bend radius. This makes the instrument highly maneuverable for use in endoluminal surgery, such as incision-less surgery of the stomach.

Abstract translation: 腔内手术器械在手柄上具有第一和第二转向控制。 附接到手柄的柔性轴具有远端可操纵端，其包括由多个中间连杆分隔的第一连杆和第二连杆。 第一和第二转向元件，例如成对的转向线，被连接到第一和第二转向控制以及第一和第二连杆。 连接件中的一个或多个可相对于邻接连杆枢转至少30度的角度。 来自第一转向元件的第二转向元件的回退位置以及链节的枢转能力允许可转向端转向小的弯曲半径。 这使得仪器高度可操作地用于腔内手术，例如无切口的胃手术。

公开(公告)号：US20120184821A1

公开(公告)日：2012-07-19

申请号：US13421730

申请日：2012-03-15

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: A device comprises an access port adapted to permit access of at least one surgical instrument into a patient. The access port comprises a proximal portion, a distal portion, and an intermediate portion monolithically formed of a flexible material. At least one opening extends through the access port. The proximal portion comprises a proximal flange. The distal portion comprises a distal flange. The intermediate portion comprises an outer surface and at least one inner surface. The access port is adapted to form a perimeter seal when the proximal flange is disposed exteriorly and the distal flange is disposed interiorly. The access port is adapted to form a seal with the at least one surgical instrument positioned through the access port. The intermediate portion conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal between the inner surface and the surgical instrument.

Abstract translation: 一种装置包括适于允许至少一个外科器械进入患者的进入口。 进入口包括近端部分，远侧部分和由柔性材料整体形成的中间部分。 至少一个开口延伸穿过进入端口。 近端部分包括近侧凸缘。 远侧部分包括远端凸缘。 中间部分包括外表面和至少一个内表面。 当近侧凸缘设置在外部并且远侧凸缘位于内部时，进入口适于形成周边密封。 进入端口适于与通过进入端口定位的至少一个外科器械形成密封。 中间部分符合通过至少一个开口定位的外科器械的表面，并在内表面和外科器械之间形成密封。

公开(公告)号：US08092489B2

公开(公告)日：2012-01-10

申请号：US11736539

申请日：2007-04-17

Applicant: Richard C. Ewers ,  Eugene Chen ,  Arvin T. Chang ,  Robert A. Vaughan

Inventor： Richard C. Ewers ,  Eugene Chen ,  Arvin T. Chang ,  Robert A. Vaughan

IPC: A61B17/28

CPC classification number: A61B17/29 ,  A61B2017/00278 ,  A61B2017/003 ,  A61B2017/2926 ,  A61B2017/2932 ,  A61B2017/2939 ,  A61B2017/320064

Abstract: A tissue grasping apparatus includes a control member, an elongated shaft, and a tissue grasping member attached to the distal end of the elongated shaft. An activation mechanism provides an user-operable connection between the control member and the tissue grasping member. In an embodiment, the tissue grasping member includes a pair of jaws configured to open to an included angle between the jaws of 180 degrees or more. In an embodiment, the activation mechanism includes a flexible drive wire attached to the penetrating member.

Abstract translation: 组织抓取装置包括控制构件，细长轴和附接到细长轴的远端的组织把持构件。 激活机构提供控制构件和组织把持构件之间的用户可操作的连接。 在一个实施例中，组织夹持构件包括一对夹爪，其被构造成以180度或更大的夹爪之间的夹角打开。 在一个实施例中，激活机构包括附接到穿透构件的柔性驱动线。