公开(公告)号：US07736374B2

公开(公告)日：2010-06-15

申请号：US11070846

申请日：2005-03-01

Applicant: Robert A. Vaughan ,  Cang C. Lam ,  Richard C. Ewers ,  Vahid Saadat

Inventor： Robert A. Vaughan ,  Cang C. Lam ,  Richard C. Ewers ,  Vahid Saadat

IPC: A61B17/08 ,  A61B17/12 ,  A61B17/00

CPC classification number: A61B17/10 ,  A61B1/0051 ,  A61B17/0401 ,  A61B17/0487 ,  A61B17/06066 ,  A61B17/29 ,  A61B2017/00349 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/00876 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/06076 ,  A61B2017/3488 ,  A61B2090/037

Abstract: Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly.

Abstract translation: 本文描述了组织操纵和固定系统。 组织操作组件可枢转地联接到管状构件的远端，并且具有下颚构件和可枢转地联接到下颚构件的上颚构件。 可重构的发射管也可枢转地联接到上钳口构件，并且用于将钳口构件从小轮廓构造推动到用于接收组织的打开构型。 组织操作组件可以通过形状可锁定内窥镜装置，常规内窥镜，或者直接自身进入患者。 第二工具可以与组织操作组件组合使用以接合组织并且与组织操作组件一起操作组织。

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。

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。

公开(公告)号：US07703459B2

公开(公告)日：2010-04-27

申请号：US10954658

申请日：2004-09-29

Applicant: Vahid Saadat ,  Chris Rothe ,  Ruey-Feng Peh ,  Richard C. Ewers

Inventor： Vahid Saadat ,  Chris Rothe ,  Ruey-Feng Peh ,  Richard C. Ewers

IPC: A61B17/00

CPC classification number: A61B17/0401 ,  A61B17/0469 ,  A61B17/12013 ,  A61B17/320016 ,  A61B17/32053 ,  A61B17/32075 ,  A61B17/3211 ,  A61B17/3478 ,  A61B18/14 ,  A61B18/1482 ,  A61B18/1492 ,  A61B90/39 ,  A61B2017/00269 ,  A61B2017/00349 ,  A61B2017/00818 ,  A61B2017/00986 ,  A61B2017/0411 ,  A61B2017/0419 ,  A61B2017/06052 ,  A61B2017/306 ,  A61B2017/308 ,  A61B2017/320044 ,  A61B2018/00029 ,  A61B2018/00244 ,  A61B2018/00291 ,  A61B2018/00494 ,  A61B2018/00577 ,  A61B2018/00595 ,  A61B2018/00982 ,  A61B2018/124 ,  A61B2018/1415 ,  A61B2018/144 ,  A61B2018/1467 ,  A61B2090/036 ,  A61B2090/3908 ,  A61B2090/3912 ,  A61B2090/3937 ,  A61B2090/395 ,  A61B2090/3987 ,  A61B2090/3991 ,  A61B2218/002 ,  A61B2218/007 ,  A61F5/0013

Abstract: Apparatus and methods are provided for mapping out endoluminal gastrointestinal surgery, including endoluminal gastric reduction. Mapping is achieved by locally marking the interior of the gastrointestinal lumen at specified locations. In some variations, mucosectomy and/or mucosal ablation are performed to map out endoluminal GI surgery, to facilitate direct endoluminal engagement of underlying muscularis tissue and/or to initiate a wound healing response. Specialized apparatus may be provided to achieve desired spacing and/or positioning of tissue markings, as well as to actually form the markings. Methods of using apparatus of the present invention are provided.

Abstract translation: 提供装置和方法用于映射腔内胃肠手术，包括腔内胃减少。 通过在指定位置局部标记胃肠腔的内部来实现测绘。 在一些变型中，进行粘膜切除术和/或粘膜消融以绘出腔内GI手术，以促进下面的肌层组织的直接腔内接合和/或引发伤口愈合反应。 可以提供专用设备以实现组织标记的期望的间隔和/或定位，以及实际形成标记。 提供了使用本发明装置的方法。

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。

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。

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。