公开(公告)号：US07238154B2

公开(公告)日：2007-07-03

申请号：US11218412

申请日：2005-09-01

Applicant: Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott 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 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 to a desired diameter. The retractor includes first and second rings, each having a diameter greater than that desired for the wound. The first and second rings are adapted for disposition interiorly and exteriorly of the wound, respectively. A plurality of retraction elements is disposed in a generally cylindrical relationship between the first and second rings and extends through the wound to exert a radial retraction force on the wound that is dependent on the distance separating the first and second rings. Retraction elements, both distensible and non-distensible, are contemplated with appropriate attachment elements 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.

Abstract translation: 外科伤口牵开器适于将伤口扩张到期望的直径。 牵开器包括第一和第二环，每个环的直径大于伤口所需的直径。 第一和第二环分别适于在伤口的内部和外部设置。 多个退回元件以第一和第二环之间的大致圆柱形的关系设置，并且延伸穿过伤口，以在伤口上施加径向缩回力，这取决于分隔第一和第二环的距离。 可伸缩和不扩张的回缩元件可以考虑在环处的合适的附接元件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。

公开(公告)号：US06960163B2

公开(公告)日：2005-11-01

申请号：US10281462

申请日：2002-10-25

Applicant: Richard C. Ewers ,  Vahid Saadat

Inventor： Richard C. Ewers ,  Vahid Saadat

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：US06939296B2

公开(公告)日：2005-09-06

申请号：US10436522

申请日：2003-05-13

Applicant: Richard C. Ewers ,  Gary R. Dulak ,  Nabil Hilal

Inventor： Richard C. Ewers ,  Gary R. Dulak ,  Nabil Hilal

IPC: A61B1/313 ,  A61B1/32 ,  A61B17/34 ,  A61B19/00

CPC classification number: A61B1/06 ,  A61B1/3132 ,  A61B1/32 ,  A61B17/3423 ,  A61B17/3498 ,  A61B90/30 ,  A61B2017/00902

Abstract: An access device particularly adapted for use in laparoscopic surgery facilitates access with instruments, such as the hand of the surgeon, across a body wall and into a body cavity. The device can be formed of a gel material having properties for forming a zero seal, or an instrument seal with a wide range of instrument diameters. The gel material can be translucent facilitating illumination and visualization of the surgical site through the access device.

Abstract translation: 特别适用于腹腔镜手术的进入装置便于使用诸如外科医生的手的器械穿过体壁进入体腔。 该装置可以由具有用于形成零密封的性质的凝胶材料或具有宽范围的仪器直径的仪器密封件形成。 凝胶材料可以是半透明的，便于通过进入装置对外科手术部位的照明和可视化。

公开(公告)号：US09125555B2

公开(公告)日：2015-09-08

申请号：US13591958

申请日：2012-08-22

Applicant: Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

Inventor： Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

IPC: B29C65/00 ,  A61B1/00 ,  A61B1/307 ,  A61M39/06 ,  A61B17/34

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：US08777965B2

公开(公告)日：2014-07-15

申请号：US13103936

申请日：2011-05-09

Applicant: Eugene G. Chen ,  Tracy D. Maahs ,  Richard C. Ewers ,  Lee L. Swanstrom

Inventor： Eugene G. Chen ,  Tracy D. Maahs ,  Richard C. Ewers ,  Lee L. Swanstrom

IPC: A61B17/04 ,  A61B17/00

CPC classification number: A61B17/0401 ,  A61B17/0057 ,  A61B17/0469 ,  A61B17/0487 ,  A61B2017/00575 ,  A61B2017/00637 ,  A61B2017/00818 ,  A61B2017/00867 ,  A61B2017/0409 ,  A61B2017/0419 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/06052

Abstract: Devices and methods for laparoscopically repairing a hernia are described. In some embodiments, a laparoscopic instrument is used to deploy one or more tissue anchor assemblies into the edges of the fascia tissue surrounding or adjacent to the hernia defect. The tissue anchor assemblies are used to cause the fascia tissue to be approximated to facilitate the repair procedure, to improve healing, and to reduce the incidence of recurrence.

Abstract translation: 描述了用于腹腔镜修复疝气的装置和方法。 在一些实施例中，使用腹腔镜器械将一个或多个组织锚固组件部署到围绕或邻近疝缺损的筋膜组织的边缘。 组织锚固组件用于使筋膜组织近似以便于修复过程，以改善愈合并降低复发的发生率。

公开(公告)号：US08740940B2

公开(公告)日：2014-06-03

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：US20120313325A1

公开(公告)日：2012-12-13

申请号：US13591958

申请日：2012-08-22

Applicant: Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

Inventor： Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

IPC: F16J15/14

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：US20120296348A1

公开(公告)日：2012-11-22

申请号：US13491273

申请日：2012-06-07

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

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

IPC: A61B17/04

CPC classification number: 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

Abstract: 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.

Abstract translation: 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：US08262622B2

公开(公告)日：2012-09-11

申请号：US10695295

申请日：2003-10-28

Applicant: Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

Inventor： Joseph A. Gonzales ,  Boun Pravong ,  Richard C. Ewers ,  Richard L. Myers

IPC: A61M5/178 ,  A61B1/307

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，以便形成周向密封并封闭器械通道。 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：US20120226105A1

公开(公告)日：2012-09-06

申请号：US13312393

申请日：2011-12-06

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 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 comprises an access seal. 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 conforms 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。 手术进入装置包括进入密封件。 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。 进入密封件的材料符合通过工作通道插入的仪器的表面。