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    Methods and apparaus for off-axis visualization
    51.
    发明申请
    Methods and apparaus for off-axis visualization 有权
    离轴可视化的方法和应用

    公开(公告)号：US20060189845A1

    公开(公告)日：2006-08-24

    申请号：US11365088

    申请日：2006-02-28

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

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

    IPC分类号： A61B1/00

    CPC分类号： A61B1/00179 ,  A61B1/0008 ,  A61B1/00183 ,  A61B1/0051 ,  A61B1/018 ,  A61B1/04

    摘要： 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.

    摘要翻译： 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。

    HIGH FLOW STONE BASKET SYSTEM
    52.
    发明申请
    HIGH FLOW STONE BASKET SYSTEM 审中-公开
    高流动石盆系统

    公开(公告)号：US20080039684A1

    公开(公告)日：2008-02-14

    申请号：US11875085

    申请日：2007-10-19

    申请人： Ralph Clayman ,  Nabil Hilal ,  Edward Pingleton ,  Richard Ewers

    发明人： Ralph Clayman ,  Nabil Hilal ,  Edward Pingleton ,  Richard Ewers

    IPC分类号： A61B1/005 ,  A61B17/221

    CPC分类号： A61B1/018 ,  A61B17/221 ,  A61B2017/22072 ,  A61B2017/2212

    摘要： A medical device for viewing inside a body and for retrieving an object from a location within the body, the medical device comprising an endoscope having a tube defining a working channel and a basket engageable with the object. In one embodiment of the invention, the basket does not require a sheath and is disposed through the working channel such that the endoscope operates to contain or activate the sheathless basket. In another embodiment of the invention, a single push wire with a collar at its end is used in place of a sheath to control the opening and closing of the basket. In another embodiment of the invention, a tapered and funnel-shaped sheath surrounding the basket is used to contain or activate the basket. The invention minimizes the basket crossing profile so as to improve fluid flow in the working channel.

    摘要翻译： 一种用于在体内观察并用于从体内的位置检索物体的医疗装置，所述医疗装置包括具有限定工作通道的管和可与所述物体接合的篮的内窥镜。 在本发明的一个实施例中，篮子不需要护套并且通过工作通道设置，使得内窥镜操作以容纳或激活无鞘篮。 在本发明的另一个实施例中，使用在其端部具有套环的单个推动线代替护套来控制筐的打开和关闭。 在本发明的另一个实施例中，围绕篮子的锥形和漏斗形护套用于容纳或激活筐。 本发明使筐横向轮廓最小化，以便改善工作通道中的流体流动。

    Wound retraction apparatus and method
    54.
    发明申请
    Wound retraction apparatus and method 有权
    伤口收缩装置及方法

    公开(公告)号：US20050288558A1

    公开(公告)日：2005-12-29

    申请号：US11218412

    申请日：2005-09-01

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

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

    IPC分类号： A61B17/02 ,  A61B17/34 ,  A61B1/32

    CPC分类号： A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

    摘要： 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.

    摘要翻译： 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。

    WOUND RETRACTION APPARATUS AND METHOD
    56.
    发明申请
    WOUND RETRACTION APPARATUS AND METHOD 有权
    回绕装置和方法

    公开(公告)号：US20070225569A1

    公开(公告)日：2007-09-27

    申请号：US11755305

    申请日：2007-05-30

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

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

    IPC分类号： A61B1/32

    CPC分类号： A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

    摘要： 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.

    摘要翻译： 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。

    Surgical access apparatus and method
    57.
    发明申请
    Surgical access apparatus and method 有权
    手术进入装置及方法

    公开(公告)号：US20060030755A1

    公开(公告)日：2006-02-09

    申请号：US11244647

    申请日：2005-10-05

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

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

    IPC分类号： A61B1/32

    CPC分类号： A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

    摘要： 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.

    摘要翻译： 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。

    Surgical gel seal
    58.
    发明申请
    Surgical gel seal 有权
    手术凝胶密封

    公开(公告)号：US20050090713A1

    公开(公告)日：2005-04-28

    申请号：US10695295

    申请日：2003-10-28

    申请人： Joseph Gonzales ,  Boun Pravong ,  Richard Ewers ,  Richard Myers

    发明人： Joseph Gonzales ,  Boun Pravong ,  Richard Ewers ,  Richard Myers

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

    CPC分类号： A61B1/00137 ,  A61B1/307 ,  A61B17/3462 ,  A61M39/0606 ,  A61M2039/0633 ,  A61M2039/066 ,  B29C65/00

    摘要： 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.

    摘要翻译： 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。

    Helical tissue manipulation instruments and methods of use
    60.
    发明申请
    Helical tissue manipulation instruments and methods of use 审中-公开
    螺旋组织操作仪器和使用方法

    公开(公告)号：US20070142849A1

    公开(公告)日：2007-06-21

    申请号：US11303521

    申请日：2005-12-16

    申请人： Richard Ewers ,  Arvin Chang ,  John Cox

    发明人： Richard Ewers ,  Arvin Chang ,  John Cox

    IPC分类号： A61B17/08

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

    摘要： 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.

    摘要翻译： 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。