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    SURGICAL ACCESS APPARATUS AND METHOD
    61.
    发明申请
    SURGICAL ACCESS APPARATUS AND METHOD 有权

    公开(公告)号：US20110071463A1

    公开(公告)日：2011-03-24

    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: A61M13/00

    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 multiple instruments passing through the surgical access device and through a single incision in the abdominal wall of a patient with the abdominal cavity pressurized with an insufflation gas. The surgical access device is adapted to provide instrument access to the abdominal cavity for surgical procedures while generally maintaining insufflation pressure in the abdominal cavity. The surgical access device comprises an access pad. The access pad comprises a material formed of a mixture comprising a triblock copolymer, an oil, and a foaming agent. The access pad is adapted to be disposed within an incision within an abdominal wall. The access pad has an external flange and an internal flange integrally formed with the access pad. The external flange is adapted to be disposed external to the abdominal wall in an operative position and the internal flange adapted to be disposed internal to the abdominal wall in the operative position. The access pad is configured to be maintained in the operative position and adapted to form a seal with the abdominal wall. A plurality of openings are formed through the access pad between an external surface and an internal surface of the access pad. The plurality of openings when operatively disposed are in communication with the incision and form working channels between a location external to the abdominal wall and a location internal to the abdominal wall. The access pad is adapted to conform to a surface of an instrument inserted through the working channel. At least a portion of the access pad between the external flange and the internal flange and within the incision between an external surface of the abdominal wall and an internal surface of the abdominal wall is adapted to form an instrument seal with the instrument. Locating the access pad within the incision creates a radially compressive force to provide an axial seal between the access pad and the abdominal wall.

    Wound retraction apparatus and method
    63.
    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：US06958037B2

    公开(公告)日：2005-10-25

    申请号：US10399209

    申请日：2001-10-20

    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 ,  A61B17/34

    CPC classification number: A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

    Abstract: 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 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. An associated method includes the step of rolling the second ring circumferentially of the third ring to form the circumferential retainer.

    Abstract translation: 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，既可扩张也不可扩张，可以考虑在环处的适当的附接元件，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。 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。

    Ureteral stent system apparatus and method
    64.
    发明授权
    Ureteral stent system apparatus and method 失效
    输尿管支架系统装置及方法

    公开(公告)号：US06395021B1

    公开(公告)日：2002-05-28

    申请号：US09303113

    申请日：1999-04-30

    Applicant: Charles C. Hart ,  Ralph V. Clayman ,  John R. Brustad ,  Frans Vandenbroek ,  Richard C. Ewers

    Inventor： Charles C. Hart ,  Ralph V. Clayman ,  John R. Brustad ,  Frans Vandenbroek ,  Richard C. Ewers

    IPC: A61F206

    CPC classification number: A61F2/04 ,  A61F2/042 ,  A61F2/82 ,  A61F2/848 ,  A61F2/90 ,  A61F2/95 ,  A61F2002/048 ,  A61F2250/0067 ,  A61M27/008

    Abstract: A stent having an elongate tubular configuration is formed of a plurality of elongate elements interwoven or braided to form a tubular configuration. The elements may be relatively strong and rigid, but movable relative to each other within the weave or braid in order to provide the stent with generally soft characteristics. The elements may be formed of different materials, such as an absorbent material permitting the stent to be doped with materials such as drugs and chemicals. Even the absorbency can be controlled and varied to provide a predetermined time-release of the absorbent.

    Abstract translation: 具有细长管状结构的支架由多个细长元件形成，交织或编织以形成管状构型。 这些元件可以是相对较强且刚性的，但是可以在编织物或编织物内相对于彼此移动，以便为支架提供通常柔软的特性。 元件可以由不同的材料形成，例如允许支架掺杂材料如药物和化学品的吸收材料。 甚至可以控制和改变吸光度以提供吸收剂的预定时间释放。

    Methods and apparatus for off-axis visualization
    65.
    发明授权
    Methods and apparatus for off-axis visualization 有权
    用于离轴可视化的方法和装置

    公开(公告)号：US08992420B2

    公开(公告)日：2015-03-31

    申请号：US13597072

    申请日：2012-08-28

    Applicant: Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

    Inventor： Tracy D. Maahs ,  Richard C. Ewers ,  Arvin T. Chang ,  Chris Rothe ,  Eugene C. Chen ,  Marvin C. Elmer ,  Gilbert Madrid ,  Kabir Gambhir

    IPC: A61B1/00 ,  A61B1/005 ,  A61B1/018 ,  A61B1/05

    CPC classification number: A61B1/0051 ,  A61B1/00085 ,  A61B1/00089 ,  A61B1/00098 ,  A61B1/00179 ,  A61B1/00183 ,  A61B1/018 ,  A61B1/05

    Abstract: 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.

    Abstract translation: 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。

    Percutaneous hernia repair
    68.
    发明申请
    Percutaneous hernia repair 审中-公开
    经皮疝修补

    公开(公告)号：US20140214079A1

    公开(公告)日：2014-07-31

    申请号：US13815110

    申请日：2013-01-31

    Applicant: Richard C. Ewers ,  Eugene G. Chen

    Inventor： Richard C. Ewers ,  Eugene G. Chen

    IPC: A61B17/04

    CPC classification number: A61B17/0401 ,  A61B1/00183 ,  A61B1/008 ,  A61B17/0057 ,  A61B2017/00663 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0475 ,  A61B2017/0496 ,  A61B2017/06052

    Abstract: Methods for percutaneous hernia repair may include inserting a needle end of an anchor tool through a first tissue edge on a first side of a hernia defect opening. A first anchor is deployed with a first suture attached to the first anchor and running back through or along the anchor tool and outside of the patient's body. The needle end of the anchor tool is withdrawn from the first tissue edge. The first suture is separated from the anchor tool. The needle end of an anchor tool is inserted through a second tissue edge and a second anchor is deployed, with a second suture attached to the second anchor and running back through or along the anchor tool and outside of the patient's body. The sutures are tensioned and cinched or knotted.

    Abstract translation: 用于经皮疝修补的方法可以包括将锚固工具的针端插入到疝缺损开口的第一侧上的第一组织边缘。 部署第一锚固件，第一缝合线附接到第一锚固件并且沿着锚固工具并且沿着锚固工具向外延伸并且在患者身体外部延伸。 锚固工具的针端从第一组织边缘排出。 第一缝合线与锚固工具分离。 锚固工具的针端插入穿过第二组织边缘并且第二锚固件被展开，其中第二缝合线附接到第二锚固件并且通过锚固工具或者沿着锚固工具返回到患者身体的外部。 缝合线张紧，打结或打结。

    Methods and apparatus for revision of obesity procedures
    69.
    发明授权
    Methods and apparatus for revision of obesity procedures 有权
    肥胖程序修订方法和手段

    公开(公告)号：US08726909B2

    公开(公告)日：2014-05-20

    申请号：US11342288

    申请日：2006-01-27

    Applicant: John A. Cox ,  Tracy Maahs ,  Richard C. Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

    Inventor： John A. Cox ,  Tracy Maahs ,  Richard C. Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

    IPC: A61B19/00 ,  A61B17/10

    CPC classification number: A61B17/1114 ,  A61B17/29 ,  A61B2017/00278 ,  A61B2017/00349 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/1103 ,  A61B2017/1125 ,  A61B2017/1142 ,  A61B2017/2905 ,  A61F5/0083 ,  A61F5/0086

    Abstract: Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alternative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.

    Abstract translation: 描述了先前进行的失败的肥胖程序的腔内修复的方法和装置。 一个或多个腔内器械可以每次口服进入先前形成的失败的小袋，其中可以执行许多不同的程序。 可以形成和固定一个或多个组织折叠以减小小袋的尺寸，或者使用内腔部署的组织锚固件将小袋连接到肠道的造口减小。 这些程序可以完全从袋内腔或袋的外表面通过仪器经腹进入患者的腹膜腔进行。 或者，袋内的内部组织可以被损伤或硬化以收缩袋腔。 在另一个替代方案中，Roux肢体的长度可以被内缩缩以产生吸收不良区域。

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