公开(公告)号：US08236009B2

公开(公告)日：2012-08-07

申请号：US12579295

申请日：2009-10-14

申请人： Vahid Saadat ,  Chris Rothe ,  Richard C. Ewers

发明人： Vahid Saadat ,  Chris Rothe ,  Richard C. Ewers

IPC分类号： A61B17/03

CPC分类号： A61B17/0401 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/06066 ,  A61B17/064 ,  A61B17/08 ,  A61B17/10 ,  A61B17/29 ,  A61B2017/00349 ,  A61B2017/00867 ,  A61B2017/0404 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/045 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0456 ,  A61B2017/0458 ,  A61B2017/0459 ,  A61B2017/0461 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/0475 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/081 ,  A61B2017/3488

摘要： Needle assemblies for tissue manipulation are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. A needle deployment assembly is deployable through the tissue manipulation assembly via a handle assembly, through the tubular member, and into or through tissue. An elongate pusher is translationally disposed within a sheath of the needle deployment assembly and can be urged distally for deploying an anchor assembly from the sheath distal end. The anchor assembly is positioned distally of the pusher within the sheath.

摘要翻译： 用于组织操作的针组件在本文中描述。 在组织折叠在患者体内产生时，组织操作组件通常可以具有细长的管状构件，可滑动地设置穿过管状构件的接合构件和适于通过螺旋构件接合组织的远端，位于 所述管状构件远端适于在其间稳定组织，以及可围绕所述组织稳定器枢转的输送管。 针部署组件可经由手柄组件穿过组织操纵组件展开，穿过管状构件，并且进入或穿过组织。 细长的推动器平移地设置在针展开组件的护套内，并且可以向远侧推动以从护套远端展开锚固组件。 锚固组件位于鞘内的推动器的远侧。

公开(公告)号：US07736372B2

公开(公告)日：2010-06-15

申请号：US10986461

申请日：2004-11-10

申请人： Boris Reydel ,  Cang Lam ,  Richard C. Ewers ,  Rodney Brenneman ,  Vahid Saadat

发明人： Boris Reydel ,  Cang Lam ,  Richard C. Ewers ,  Rodney Brenneman ,  Vahid Saadat

IPC分类号： A61B17/04

CPC分类号： A61B17/0469 ,  A61B17/0401 ,  A61B17/0482 ,  A61B17/0625 ,  A61B2017/00353 ,  A61B2017/0417 ,  A61B2017/2927 ,  A61B2090/3614

摘要： Apparatus & methods for endoscopic suturing are described herein. A distal tip of the endoscopic device engages the tissue and then approximates the engaged tissue to form a tissue fold. A needle body positioned within a flexible catheter is deployed into or through the newly created tissue fold where it is then detached or released from the endoscopic device. The needle body has a length of suture which depends therefrom and can be used to secure the tissue fold. The entire endoscopic device or its tissue engaging assembly can then be rotated relative to the tissue fold while maintaining engagement with the tissue to maneuver the flexible catheter to the opposing side of the penetrated tissue fold. This procedure can be repeated any number of times to create an interrupted, continuous, or running suture to secure the tissue fold.

摘要翻译： 本文描述了用于内窥镜缝合的装置和方法。 内窥镜装置的远侧末端接合组织，然后近似接合的组织以形成组织折叠。 定位在柔性导管内的针体部署在新产生的组织折叠中或穿过其中，然后将其从内窥镜装置分离或释放。 针体具有一定长度的缝合线，该缝合线依赖于其而可用于固定组织折叠。 然后，整个内窥镜装置或其组织接合组件可以相对于组织折叠旋转，同时保持与组织的接合，以将柔性导管操纵到穿透的组织折叠的相对侧。 该过程可以重复任意次数以产生中断的，连续的或运行的缝线来固定组织折叠。

公开(公告)号：US06960163B2

公开(公告)日：2005-11-01

申请号：US10281462

申请日：2002-10-25

申请人： Richard C. Ewers ,  Vahid Saadat

发明人： Richard C. Ewers ,  Vahid Saadat

IPC分类号： A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/31 ,  A61B1/32 ,  A61B1/00

CPC分类号： A61B1/00154 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/0058 ,  A61B1/008 ,  A61B1/31 ,  A61B1/32

摘要： 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：US09510817B2

公开(公告)日：2016-12-06

申请号：US13491273

申请日：2012-06-07

申请人： Vahid Saadat ,  Richard C. Ewers ,  Cang C. Laduca ,  Robert A. Vaughan ,  Chris Rothe ,  Kenneth J. Michlitsch

发明人： Vahid Saadat ,  Richard C. Ewers ,  Cang C. Laduca ,  Robert A. Vaughan ,  Chris Rothe ,  Kenneth J. Michlitsch

IPC分类号： A61B17/04 ,  A61B17/08 ,  A61B17/10 ,  A61B17/06 ,  A61B17/064 ,  A61B17/29 ,  A61B17/00 ,  A61B17/34

CPC分类号： A61F5/0086 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0483 ,  A61B17/0487 ,  A61B17/06 ,  A61B17/06066 ,  A61B17/064 ,  A61B17/08 ,  A61B17/10 ,  A61B17/12013 ,  A61B17/1285 ,  A61B17/29 ,  A61B2017/00867 ,  A61B2017/0404 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/045 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0456 ,  A61B2017/0458 ,  A61B2017/0459 ,  A61B2017/0461 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/0475 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/081 ,  A61B2017/3488

摘要： Apparatus for manipulating and securing tissue are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably dispose through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. The stabilizing members can be adapted to become angled relative to longitudinal axis of the elongate tubular member. Moreover, one or all the articulation controls and functions can be integrated into a singular handle assembly connectable to the tissue manipulation assembly via a rigid or flexible tubular body.

摘要翻译： 本文描述了用于操纵和固定组织的装置。 在组织折叠在患者身体内部时，组织操作组件通常可以具有细长的管状构件，可滑动地配置穿过管状构件的接合构件和适于经由螺旋构件接合组织的远端，组织稳定构件 所述管状构件远端适于在其间稳定组织，以及可围绕所述组织稳定器枢转的输送管。 稳定构件可以适于相对于细长管状构件的纵向轴线成角度。 此外，一个或所有关节运动控制和功能可以集成到通过刚性或柔性管状体连接到组织操作组件的单个手柄组件中。

公开(公告)号：US07041052B2

公开(公告)日：2006-05-09

申请号：US10888531

申请日：2004-07-08

申请人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

发明人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC分类号： A61B1/00

CPC分类号： A61B1/0052 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/00154 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/0058 ,  A61B1/31 ,  A61B1/32

摘要： 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.

公开(公告)号：US06942613B2

公开(公告)日：2005-09-13

申请号：US10281461

申请日：2002-10-25

申请人： Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

发明人： Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

IPC分类号： A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/31 ,  A61B1/32 ,  A61B1/00

CPC分类号： A61B1/00154 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/0058 ,  A61B1/008 ,  A61B1/31 ,  A61B1/32

摘要： 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

申请人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

发明人： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC分类号： A61B100

CPC分类号： A61B1/00154 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/0058 ,  A61B1/008 ,  A61B1/31 ,  A61B1/32

摘要： 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.

摘要翻译： 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

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

发明人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. 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： 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.

摘要翻译： 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

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

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

IPC分类号： A61B17/128

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

摘要： 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.

摘要翻译： 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：US08388526B2

公开(公告)日：2013-03-05

申请号：US12108400

申请日：2008-04-23

申请人： 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

发明人： 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分类号： A61B17/02

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。