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    Surgical access apparatus and method
    62.
    发明授权
    Surgical access apparatus and method 有权
    手术进入装置及方法

    公开(公告)号：US08016755B2

    公开(公告)日：2011-09-13

    申请号：US12960458

    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: 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 an access seal adapted to be disposed within an incision within an abdominal wall. The access seal has an external flange adapted to be disposed external to the abdominal wall and an internal flange adapted to be disposed internal to the abdominal wall. The access seal with flanges is formed monolithically. There are access channels through the access seal. The access channels span the thickness of the abdominal wall and form working channels between a location external to the abdominal wall and a location internal to the abdominal wall. The access seal is formed of an elastomeric material adapted to conform to a surface of an instrument inserted through the working channel to form an instrument seal along a length spanning the thickness of the abdominal wall. The elastomeric material is adapted to form an abdominal seal within the abdominal wall.

    Abstract translation: 外科进入装置包括适于设置在腹壁内的切口内的进入密封件。 进入密封件具有适于设置在腹壁外部的外部凸缘和适于设置在腹壁内部的内部凸缘。 具有法兰的进入密封件整体形成。 有通道通过访问密封。 进入通道跨越腹壁的厚度，并在腹壁外部的位置与腹壁内部的位置之间形成工作通道。 进入密封件由适于与穿过工作通道插入的仪器的表面一致的弹性体材料形成，以沿跨越腹壁厚度的长度形成仪器密封。 弹性体材料适于在腹壁内形成腹部密封。

    Apparatus and methods for endoscopic suturing
    63.
    发明授权
    Apparatus and methods for endoscopic suturing 有权
    用于内窥镜缝合的装置和方法

    公开(公告)号：US07736372B2

    公开(公告)日：2010-06-15

    申请号：US10986461

    申请日：2004-11-10

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

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

    IPC: A61B17/04

    CPC classification number: A61B17/0469 ,  A61B17/0401 ,  A61B17/0482 ,  A61B17/0625 ,  A61B2017/00353 ,  A61B2017/0417 ,  A61B2017/2927 ,  A61B2090/3614

    Abstract: 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.

    Abstract translation: 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。

    ENDOSCOPIC INSTRUMENT MANAGEMENT SYSTEM
    64.
    发明申请
    ENDOSCOPIC INSTRUMENT MANAGEMENT SYSTEM 审中-公开
    内窥镜仪器管理系统

    公开(公告)号：US20100137681A1

    公开(公告)日：2010-06-03

    申请号：US12623224

    申请日：2009-11-20

    Applicant: Richard C. Ewers ,  Christopher James Earley ,  Barton P. Bandy ,  Haio Fauser

    Inventor： Richard C. Ewers ,  Christopher James Earley ,  Barton P. Bandy ,  Haio Fauser

    IPC: A61B1/01 ,  A61B1/018

    CPC classification number: A61B17/00234 ,  A61B17/2909 ,  A61B2017/003

    Abstract: Endoscopic instrument management systems are described herein which allow one or more operators to manage multiple different instruments utilized in endoscopic procedures. In one aspect, responsibility for instrumentation management between one or more operators may be configured such that a first set of instruments is controlled by a primary operator and a second set of instruments is controlled by a secondary operator. The division of instrumentation may be facilitated by the use of separated instrumentation platforms or a single platform which separates each instrument for use by the primary operator. Such platforms may be configured as trays, instrument support arms, multi-instrument channels, as well as rigidized portions of instruments to facilitate its handling, among others. In another aspect, one or more plastically deformable instrument manifolds are provided to guide flexible endoscopic instruments into and through an endoscopic access device.

    Abstract translation: 本文描述了内窥镜仪器管理系统，其允许一个或多个操作者管理在内窥镜程序中使用的多种不同的仪器。 一方面，可以配置一个或多个操作者之间的仪表管理责任，使得第一组仪器由主操作者控制，第二组仪器由次操作者控制。 可以通过使用分离的仪器平台或将每个仪器分离以供主要操作员使用的单个平台来促进仪器的划分。 这样的平台可以被配置为托盘，仪器支撑臂，多仪器通道，以及便于其操纵的仪器的刚性部分等。 在另一方面，提供一个或多个可塑性变形的仪器歧管以将柔性内窥镜器械引导入并通过内窥镜检查装置。

    SURGICAL ACCESS APPARATUS AND METHOD
    66.
    发明申请
    SURGICAL ACCESS APPARATUS AND METHOD 有权
    外科手术设备及方法

    公开(公告)号：US20090137879A1

    公开(公告)日：2009-05-28

    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.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。

    TISSUE GRASPING APPARATUS
    68.
    发明申请
    TISSUE GRASPING APPARATUS 有权
    组织砂光装置

    公开(公告)号：US20080262539A1

    公开(公告)日：2008-10-23

    申请号：US11736539

    申请日：2007-04-17

    Applicant: Richard C. Ewers ,  Eugene Chen ,  Arvin T. Chang ,  Robert A. Vaughan

    Inventor： Richard C. Ewers ,  Eugene Chen ,  Arvin T. Chang ,  Robert A. Vaughan

    IPC: A61B17/29

    CPC classification number: A61B17/29 ,  A61B2017/00278 ,  A61B2017/003 ,  A61B2017/2926 ,  A61B2017/2932 ,  A61B2017/2939 ,  A61B2017/320064

    Abstract: A tissue grasping apparatus includes a control member, an elongated shaft, and a tissue grasping member attached to the distal end of the elongated shaft. An activation mechanism provides an user-operable connection between the control member and the tissue grasping member. In an embodiment, the tissue grasping member includes a pair of jaws configured to open to an included angle between the jaws of 180 degrees or more. In an embodiment, the activation mechanism includes a flexible drive wire attached to the penetrating member.

    Abstract translation: 组织抓取装置包括控制构件，细长轴和附接到细长轴的远端的组织把持构件。 激活机构提供控制构件和组织把持构件之间的用户可操作的连接。 在一个实施例中，组织夹持构件包括一对夹爪，其被构造成以180度或更大的夹爪之间的夹角打开。 在一个实施例中，激活机构包括附接到穿透构件的柔性驱动线。

    Wound retraction apparatus and method
    69.
    发明授权
    Wound retraction apparatus and method 有权
    伤口收缩装置及方法

    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。

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