公开(公告)号：US20120004510A1

公开(公告)日：2012-01-05

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：US20110071462A1

公开(公告)日：2011-03-24

申请号：US12960449

申请日：2010-12-03

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: A61M13/00

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 surgical access device is adapted for performing laparoscopic surgical procedures with at least one instrument passing through the surgical access device and through an incision in the abdominal wall of a patient with the abdominal cavity pressurized with an insufflation gas. The surgical access device is adapted to provide instrument access to the abdominal cavity for surgical procedures while generally maintaining insufflation pressure in the abdominal cavity. The surgical access device comprises an access seal. The access seal comprises a material formed of a mixture comprising a triblock copolymer and an oil. The access seal is adapted to be disposed relative to the abdominal wall in an operative position. The material of the access seal is adapted to form a seal to generally maintain insufflation pressure within the abdominal cavity. At least one opening is formed through the material of the access seal between a proximal portion and a distal portion of the access seal. The at least one opening when operatively disposed is in communication with the incision and forms a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The material of the access seal is adapted to conform to a surface of an instrument inserted through the working channel.

Abstract translation: 外科进入装置适于执行腹腔镜外科手术，其中至少一个器械通过外科进入装置，并通过患有腹部腔的切口在腹腔内用吹入气体加压。 外科进入装置适于提供仪器进入腹腔以进行外科手术，同时通常维持腹腔内的注射压力。 手术进入装置包括进入密封件。 进入密封件包括由包含三嵌段共聚物和油的混合物形成的材料。 进入密封件适于在操作位置相对于腹壁布置。 进入密封件的材料适于形成密封件，以通常维持腹腔内的注入压力。 通过进入密封件的近端部分和远端部分之间的进入密封件的材料形成至少一个开口。 当操作性地设置时，所述至少一个开口与所述切口连通并且在所述腹壁外部的位置与所述腹壁内部的位置之间形成工作通道。 进入密封件的材料适于符合通过工作通道插入的仪器的表面。

公开(公告)号：US20080200767A1

公开(公告)日：2008-08-21

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: A61B1/32

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：US06589208B2

公开(公告)日：2003-07-08

申请号：US09870255

申请日：2001-05-30

Applicant: Richard C. Ewers ,  Boun Pravong ,  Gary R. Dulak

Inventor： Richard C. Ewers ,  Boun Pravong ,  Gary R. Dulak

IPC: A61M2900

CPC classification number: A61M25/04 ,  A61M25/0017 ,  A61M25/10 ,  A61M2025/0213

Abstract: A self-deploying catheter assembly comprises an anchoring device mounted to a tube. A distal end of the anchoring device is held in a fixed position by a releasable suture while a proximal end is freely movable between a proximal position and a distal position defined by a stop on the tube. During insertion into a body cavity, the anchor automatically maintains a low-profile state with the ends spaced apart. Once fully inserted, the anchor self converts into a high-profile state when the tube is slightly withdrawn, bringing the ends closer together. The suture is disengaged to release the distal end of the anchor in order to facilitate a low-profile state for withdrawal of the assembly.

Abstract translation: 自我展开的导管组件包括安装到管的锚定装置。 锚固装置的远端通过可释放的缝合线保持在固定位置，而近端可在由管上的止挡限定的近端位置和远端位置之间自由移动。 在插入体腔内时，锚定器自动保持两端间隔开的低轮廓状态。 一旦完全插入，当管稍微抽出时，锚自身转换成高轮廓状态，使端部更靠近在一起。 缝合线脱离以释放锚固件的远端，以便于用于抽出组件的低调状态。

公开(公告)号：US06231572B1

公开(公告)日：2001-05-15

申请号：US09087361

申请日：1998-05-29

Applicant: Charles C. Hart ,  Nabil Hilal ,  Richard C. Ewers ,  Bounsavanh Pravongviengkham

Inventor： Charles C. Hart ,  Nabil Hilal ,  Richard C. Ewers ,  Bounsavanh Pravongviengkham

IPC: A61B1814

CPC classification number: A61B18/1492 ,  A61B2017/22038 ,  A61B2018/00077 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00285 ,  A61B2018/0041 ,  A61B2018/00505 ,  A61B2018/162

Abstract: A catheter adapted to increase the patency of a body conduit includes an elongate tube having an axis extending between a proximal end and a distal end, and a balloon disposed at the distal end of the tube and having properties for being expanded to a high-profile state and for being contracted to a low-profile state. A sleeve disposed over the balloon has a pair of ends disposed on opposing sides of a central section, the ends having a floating relationship relative to the tube with the central section disposed circumferentially of the balloon. An electrode disposed outwardly of the sleeve has properties for being electrosurgically energized to incise materials defining the body conduit when the balloon is in the high-profile state. The electrode can be formed of a plurality of elements stranded to increase the surface area of the electrode. The catheter can be inserted relative to a guide member having a conductor which carries the electrosurgical energy from the proximal end of the tube to the electrode at the distal end of the tube. An associated method includes the step of introducing electrosurgical energy into the conductor of the guide member to energize the electrode of the catheter.

Abstract translation: 适于增加身体导管的通畅的导管包括具有在近端和远端之间延伸的轴线的细长管和设置在管的远端处的球囊，并且具有用于扩展到高轮廓的性质 并且被缩小到低调的状态。 设置在气囊上方的套筒具有设置在中心部分的相对侧上的一对端部，所述端部相对于管具有浮动关系，其中心部分设置在气囊的周向。 设置在套筒外侧的电极具有电气通电的特性，以便当球囊处于高轮廓状态时切割限定体导管的材料。 电极可以由多个元件形成，以增加电极的表面积。 导管可以相对于具有导体的引导构件插入，该导体将电外科能量从管的近端延伸到管的远端处的电极。 相关联的方法包括将电外科能量引入导向构件的导体以激励导管的电极的步骤。

公开(公告)号：US08870916B2

公开(公告)日：2014-10-28

申请号：US11773933

申请日：2007-07-05

Applicant: Richard C. Ewers ,  Tracy D. Maahs ,  Shirley Vong

Inventor： Richard C. Ewers ,  Tracy D. Maahs ,  Shirley Vong

IPC: A61B17/04 ,  A61B17/00 ,  A61B17/28 ,  A61B17/29 ,  A61B17/06 ,  A61B17/22

CPC classification number: A61B17/0401 ,  A61B17/0487 ,  A61B17/06166 ,  A61B17/22031 ,  A61B17/282 ,  A61B17/29 ,  A61B2017/00004 ,  A61B2017/00526 ,  A61B2017/00862 ,  A61B2017/00986 ,  A61B2017/0403 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0451 ,  A61B2017/0458 ,  A61B2017/048 ,  A61B2017/0496 ,  A61B2017/061

Abstract: Tissue anchors include a flat, broad, and large contact surface for engagement with a portion of tissue. Several embodiments of composite tissue anchors include a support element and an overlay element. Tissue anchor assemblies include two or more tissue anchors, a connector, and a cinching mechanism. In some embodiments, the tissue anchors included in the tissue anchor assemblies are of different types, sizes, and/or shapes.

Abstract translation: 组织锚固件包括平坦的，宽的和大的接触表面，用于与一部分组织接合。 复合组织锚的几个实施例包括支撑元件和覆盖元件。 组织锚组件包括两个或多个组织锚，连接器和收紧机构。 在一些实施例中，包括在组织锚组件中的组织锚固件具有不同类型，尺寸和/或形状。

公开(公告)号：US08496581B2

公开(公告)日：2013-07-30

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 includes an access port adapted to permit access of at least one surgical instrument into a patient. The access port includes 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 includes a proximal flange. The distal portion includes a distal flange. The intermediate portion includes 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手术器械进入患者的进入口。 进入口包括近端部分，远端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：US08277373B2

公开(公告)日：2012-10-02

申请号：US11365088

申请日：2006-02-28

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: A61B1/00

CPC classification number: A61B1/00179 ,  A61B1/0008 ,  A61B1/00183 ,  A61B1/0051 ,  A61B1/018 ,  A61B1/04

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：US08105234B2

公开(公告)日：2012-01-31

申请号：US12360710

申请日：2009-01-27

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 surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.

Abstract translation: 外科进入装置包括与主体壁形成密封并且将进入通道提供到体腔中的单个阀。 该阀具有在没有仪器的情况下产生零密封的特性，以及具有仪器直径范围的仪器的仪器密封。 该阀可以包括凝胶，优选地包括由弹性体和提供大于1000％的伸长率和小于5肖氏A的硬度的油的超细颗粒。单个阀可用作手动口，其中仪器包括外科医生的手臂 ，从而提供手进入空腔。

公开(公告)号：US07955340B2

公开(公告)日：2011-06-07

申请号：US10734562

申请日：2003-12-12

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

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

IPC: A61B17/10 ,  A61B17/08 ,  A61B1/00

CPC classification number: A61B1/0055 ,  A61B1/00135 ,  A61B1/018 ,  A61B1/2736 ,  A61B1/31 ,  A61B17/00234 ,  A61B17/0218 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0487 ,  A61B17/062 ,  A61B17/0625 ,  A61B17/0644 ,  A61B17/29 ,  A61B17/3421 ,  A61B17/3468 ,  A61B17/3478 ,  A61B2017/00269 ,  A61B2017/003 ,  A61B2017/00353 ,  A61B2017/00827 ,  A61B2017/0404 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0443 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0458 ,  A61B2017/0461 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/061 ,  A61B2017/06176 ,  A61B2017/0649 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2017/2943 ,  A61B2017/3445 ,  A61B2017/3488 ,  A61B2090/3614 ,  A61F5/0086

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point and moving the first tissue contact point from a position initially distal to, or in line with, a second tissue contact point to a position proximal of the second contact point, thereby forming the tissue fold, and extending an anchor assembly through the tissue fold from a vicinity of the second tissue contact point. Adjustable anchor assemblies; as well as anchor delivery systems, shape-lockable guides and methods for endoluminally performing medical procedures, such as gastric reduction, treatment of gastroesophageal reflux disease, resection of lesions, and treatment of bleeding sites; are also provided.

Abstract translation: 提供了设备和方法，用于通过在第一组织接触点处接合组织并使第一组织接触点从最初远端或与第二组织接触点一致的位置移动到位于第二组织接触点附近的位置来形成胃肠组织折叠 第二接触点，从而形成组织折叠，并且从第二组织接触点的附近延伸锚固组件穿过组织折叠。 可调锚固组件; 以及锚定递送系统，可锁定形状的导管和用于内窥镜执行医学程序的方法，例如胃减压，治疗胃食管反流疾病，切除病变和治疗出血部位; 也提供。