公开(公告)号：US09492086B2

公开(公告)日：2016-11-15

申请号：US14930284

申请日：2015-11-02

Applicant: Richard Ewers ,  Kevin Chen ,  Andrew Dominguez

Inventor： Richard Ewers ,  Kevin Chen ,  Andrew Dominguez

IPC: A61M16/06 ,  A61M16/20 ,  A61B5/00 ,  A61M16/00 ,  A61M16/08

CPC classification number: A61B5/0002 ,  A61B5/01 ,  A61B5/02405 ,  A61B5/02438 ,  A61B5/0533 ,  A61B5/0816 ,  A61B5/1118 ,  A61B5/4809 ,  A61B5/4812 ,  A61M16/0057 ,  A61M16/0069 ,  A61M16/024 ,  A61M16/06 ,  A61M16/0666 ,  A61M16/0816 ,  A61M16/0875 ,  A61M16/206 ,  A61M16/208 ,  A61M2016/003 ,  A61M2205/128 ,  A61M2205/3569 ,  A61M2205/3592 ,  A61M2205/50 ,  A61M2230/005 ,  A61M2230/205 ,  A61M2230/63

Abstract: Apparatus, systems, and methods are provided for treating obstructive sleep apnea. A unitary valve assembly removably located inside the exterior profile of a nasal pillow mask uses positive airway pressure from a low-flow hose to automatically create an on-demand therapeutic air splint in the pharynx. During inspiration the mask's valving system allows room air to be inspired. During exhalation another valve governs therapeutic backpressure equal to the prescribed pressure setting of the CPAP blower machine. The mask may be worn when the CPAP blower machine is off, and systems are provided for turning the CPAP blower machine on only when needed.

Abstract translation: 提供了用于治疗阻塞性睡眠呼吸暂停的装置，系统和方法。 可拆卸地位于鼻枕罩的外部轮廓内的单一阀组件使用来自低流量软管的正气道压力来自动地在咽部产生按需治疗空气夹板。 在灵感的过程中，面罩的阀门系统允许室内空气受到启发。 在呼气期间，另一个阀控制等于CPAP鼓风机的规定压力设定的治疗背压。 当CPAP鼓风机关闭时，面罩可能磨损，仅在需要时提供用于转动CPAP鼓风机的系统。

公开(公告)号：US20070225569A1

公开(公告)日：2007-09-27

申请号：US11755305

申请日：2007-05-30

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

Inventor： Richard Ewers ,  John Brustad ,  Edward Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott Taylor ,  Gary Dulak ,  Michael Dunn ,  Norman Morales ,  Charles Hart ,  Robert 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，缩回元件是可伸长的和不可扩张的，在环处有合适的附接装置，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圆周保持器的步骤。

公开(公告)号：US20060030755A1

公开(公告)日：2006-02-09

申请号：US11244647

申请日：2005-10-05

Applicant: Richard Ewers ,  John Brustad ,  Edward Pingleton ,  Nabil Hilal ,  Gary Dulak ,  Payam Adlparvar ,  Robert Bowes

Inventor： Richard Ewers ,  John Brustad ,  Edward Pingleton ,  Nabil Hilal ,  Gary Dulak ,  Payam Adlparvar ,  Robert 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. A method for making the surgical access device includes the combining of a gelling agent with an oil, preferably in a molding process. A method for using the device includes steps for creating an opening with the instrument. In a particular process, an organ can be removed from the body cavity through the single valve to create an organ seal while the organ is addressed externally of the body cavity. The valve and method are particularly adapted for laparoscopic surgery wherein the abdominal cavity is insufflated with a gas thereby requiring the zero seal, the instrument seal, and the organ seal in various procedures.

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。 用于制造外科进入装置的方法包括胶凝剂与油的组合，优选在模制过程中。 一种使用该装置的方法包括用该仪器产生开口的步骤。 在特定的过程中，器官可以通过单个阀从体腔中移除，以在器官在体腔外部寻址时产生器官密封。 该阀和方法特别适用于腹腔镜手术，其中腹腔用气体吹入，因此需要零密封，器械密封和器官密封。

公开(公告)号：US20050090713A1

公开(公告)日：2005-04-28

申请号：US10695295

申请日：2003-10-28

Applicant: Joseph Gonzales ,  Boun Pravong ,  Richard Ewers ,  Richard Myers

Inventor： Joseph Gonzales ,  Boun Pravong ,  Richard Ewers ,  Richard Myers

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

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：US20060217762A1

公开(公告)日：2006-09-28

申请号：US11404423

申请日：2006-04-14

Applicant: Tracy Maahs ,  Marvin Elmer ,  Richard Ewers

Inventor： Tracy Maahs ,  Marvin Elmer ,  Richard Ewers

IPC: A61B17/08

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 & methods for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms 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. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.

Abstract translation: 本文描述了用于优化锚固力的装置和方法。 在固定组织褶皱时，通过利用具有可扩张臂的组织锚来避免直接位于锚固件正下方的组织的过度压缩，所述组织锚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。 可以使用各种装置，例如止动件，弹簧构件，保险丝，应变计等来指示锚固件何时被偏转到最佳范围内的预定水平。 此外，影响锚固特征的其他因素包括例如改变锚的臂或支柱的数量，臂的定位，臂的构型，套环的长度等。

公开(公告)号：US20060184161A1

公开(公告)日：2006-08-17

申请号：US11060231

申请日：2005-02-16

Applicant: Tracy Maahs ,  Richard Ewers

Inventor： Tracy Maahs ,  Richard Ewers

IPC: A61B18/18 ,  A61B18/04

CPC classification number: A61B18/1492 ,  A61B18/1445 ,  A61B18/1477 ,  A61B2017/0046 ,  A61B2017/2931 ,  A61B2018/1425 ,  A61B2018/1495

Abstract: Flexible shaft systems having interchangeable end effectors are described herein. A shaft with a flexibility sufficient to allow advancement through a lumen of an endoscopic device has an interface at its distal end for engaging a removable end effector tool. The shaft and end effector tool are configured to enable endoluminal deployment through a patient, e.g., through the esophagus and into the stomach. The removable end effector tool may comprise any number of different tools, such as graspers, forceps, scissors, snares, needles, etc., each being interchangeable upon the flexible shaft distal end. Once a procedure is done within the patient, the flexible shaft may be withdrawn and another distal end effector tool may be interchanged. The new end effector tool and flexible shaft can then be reintroduced into the patient.

Abstract translation: 这里描述了具有可互换的端部执行器的柔性轴系统。 具有足以允许通过内窥镜装置的内腔前进的轴具有在其远端处的接口用于接合可移除的末端执行器工具的界面。 轴和末端执行器工具被配置为使得能够通过患者进行腔内展开，例如通过食道并进入胃。 可移除的末端执行器工具可以包括任何数量的不同的工具，例如抓紧器，镊子，剪刀，圈套，针等，它们可在柔性轴远端上互换。 一旦在患者体内完成了一个程序，则可以撤回柔性轴，另一个远端执行器工具可以互换。 然后可以将新的末端执行器工具和柔性轴重新引入患者体内。

公开(公告)号：US20160051791A1

公开(公告)日：2016-02-25

申请号：US14930284

申请日：2015-11-02

Applicant: Richard Ewers ,  Kevin Chen ,  Andrew Dominguez

Inventor： Richard Ewers ,  Kevin Chen ,  Andrew Dominguez

IPC: A61M16/20 ,  A61B5/00 ,  A61M16/08 ,  A61M16/06 ,  A61M16/00

CPC classification number: A61B5/0002 ,  A61B5/01 ,  A61B5/02405 ,  A61B5/02438 ,  A61B5/0533 ,  A61B5/0816 ,  A61B5/1118 ,  A61B5/4809 ,  A61B5/4812 ,  A61M16/0057 ,  A61M16/0069 ,  A61M16/024 ,  A61M16/06 ,  A61M16/0666 ,  A61M16/0816 ,  A61M16/0875 ,  A61M16/206 ,  A61M16/208 ,  A61M2016/003 ,  A61M2205/128 ,  A61M2205/3569 ,  A61M2205/3592 ,  A61M2205/50 ,  A61M2230/005 ,  A61M2230/205 ,  A61M2230/63

Abstract: Apparatus, systems, and methods are provided for treating obstructive sleep apnea. A unitary valve assembly removably located inside the exterior profile of a nasal pillow mask uses positive airway pressure from a low-flow hose to automatically create an on-demand therapeutic air splint in the pharynx. During inspiration the mask's valving system allows room air to be inspired. During exhalation another valve governs therapeutic backpressure equal to the prescribed pressure setting of the CPAP blower machine. The mask may be worn when the CPAP blower machine is off, and systems are provided for turning the CPAP blower machine on only when needed.

Abstract translation: 提供了用于治疗阻塞性睡眠呼吸暂停的装置，系统和方法。 可拆卸地位于鼻枕罩的外部轮廓内的单一阀组件使用来自低流量软管的正气道压力来自动地在咽部产生按需治疗空气夹板。 在灵感的过程中，面罩的阀门系统允许室内空气受到启发。 在呼气期间，另一个阀控制等于CPAP鼓风机的规定压力设定的治疗背压。 当CPAP鼓风机关闭时，面罩可能磨损，仅在需要时提供用于转动CPAP鼓风机的系统。

公开(公告)号：US20070175488A1

公开(公告)日：2007-08-02

申请号：US11342288

申请日：2006-01-27

Applicant: John Cox ,  Tracy Maahs ,  Richard Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

Inventor： John Cox ,  Tracy Maahs ,  Richard Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

IPC: A61B17/138

CPC classification number: A61B17/1114 ,  A61B17/29 ,  A61B2017/00278 ,  A61B2017/00349 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/1103 ,  A61B2017/1125 ,  A61B2017/1142 ,  A61B2017/2905 ,  A61F5/0083 ,  A61F5/0086

Abstract: Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alterative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.

Abstract translation: 描述了先前进行的失败的肥胖程序的腔内修复的方法和装置。 一个或多个腔内器械可以每次口服进入先前形成的失败的小袋，其中可以执行许多不同的程序。 可以形成和固定一个或多个组织折叠以减小小袋的尺寸，或者使用内腔部署的组织锚固件将小袋连接到肠道的造口减小。 这些程序可以完全从袋内腔或袋的外表面通过仪器经腹进入患者的腹膜腔进行。 或者，袋内的内部组织可以被损伤或硬化以收缩袋腔。 在另一个替代方案中，Roux肢体的长度可以被内在缩短以产生吸收不良的区域。

公开(公告)号：US20070142849A1

公开(公告)日：2007-06-21

申请号：US11303521

申请日：2005-12-16

Applicant: Richard Ewers ,  Arvin Chang ,  John Cox

Inventor： Richard Ewers ,  Arvin Chang ,  John Cox

IPC: A61B17/08

CPC classification number: A61B17/30 ,  A61B17/22031 ,  A61B17/29 ,  A61B2017/00349 ,  A61B2017/3488 ,  A61B2090/034 ,  A61B2090/062 ,  A61B2090/0811 ,  A61B2090/3614

Abstract: Helical tissue manipulation instruments and methods of their use are described herein. A helical tissue engager is adapted to reversibly engage tissue and is positioned upon a flexible shaft which is advanceable through a rigidizable endoscopic assembly. The flexible shaft defines a marked section proximal to the tissue engager which can include any number of markings, designs, patterns, projections, textures, etc., which acts to provide a visual indication to the user as to the translational movement, rotation, direction of rotation, etc., of the tissue engager and the shaft. An optional guidewire can be advanced through the tissue engager. Additionally, the tissue engager and shaft can be advanced through an optional tubular sheath which may be used for dilating tissue openings prior to passage of the helical engager through the tissue opening.

Abstract translation: 本文描述了螺旋组织操作仪器及其使用方法。 螺旋组织接合器适于可逆地接合组织并且被定位在柔性轴上，柔性轴可前进通过可硬化的内窥镜组件。 柔性轴限定靠近组织接合器的标记部分，其可以包括任何数量的标记，设计，图案，投影，纹理等，其用于向使用者提供关于平移运动，旋转，方向 旋转等组织接合器和轴。 可选的导丝可以穿过组织夹持器。 此外，组织收集器和轴可以通过可选的管状护套前进，可选的管状护套可用于在螺旋装置通过组织开口之前扩张组织开口。

公开(公告)号：US20060189845A1

公开(公告)日：2006-08-24

申请号：US11365088

申请日：2006-02-28

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

Inventor： Tracy Maahs ,  Richard Ewers ,  Arvin Chang ,  Chris Rothe ,  Eugene Chen ,  Marvin 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。