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71.
公开(公告)号:US08926634B2
公开(公告)日:2015-01-06
申请号:US11951188
申请日:2007-12-05
Applicant: Chris A. Rothe , Richard C. Ewers , Cang C. Lam , Vahid Saadat , Kenneth J. Michlitsch
Inventor: Chris A. Rothe , Richard C. Ewers , Cang C. Lam , Vahid Saadat , Kenneth J. Michlitsch
IPC: A61B17/00 , A61B17/10 , A61B17/08 , A61B1/00 , A61B17/06 , A61B17/295 , A61B19/00 , A61B17/04 , A61B17/34 , A61B17/29
CPC classification number: A61B1/0014 , A61B17/0401 , A61B17/06066 , A61B17/29 , A61B17/295 , A61B2017/00867 , A61B2017/00876 , A61B2017/0409 , A61B2017/0417 , A61B2017/0419 , A61B2017/0496 , A61B2017/06052 , A61B2017/06076 , A61B2017/3488 , A61B2090/037
Abstract: Apparatus and methods 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 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. The stabilizing members can be adapted to become angled relative to a 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和方法。 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。 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。
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公开(公告)号:US08920436B2
公开(公告)日:2014-12-30
申请号:US13348201
申请日:2012-01-11
Applicant: Cang Lam , Richard C. Ewers , Christopher James Earley
Inventor: Cang Lam , Richard C. Ewers , Christopher James Earley
CPC classification number: A61B17/0401 , A61B17/0487 , A61B17/29 , A61B2017/00353 , A61B2017/0409 , A61B2017/0417 , A61B2017/0464 , A61B2017/06052 , A61B2017/2905 , A61B2017/2916
Abstract: An endoscopic tissue anchor deployment device includes a handle, an elongated shaft defining an internal lumen, and an end effector attached to the distal end of the elongated shaft. A tissue anchor catheter is removably inserted through the lumen of the elongated shaft, the catheter having a tissue anchor assembly that is deployable from its distal end. The handle may include a pin and track assembly that define a series of handle actuation steps corresponding to deployment steps for the deployment device end effector and the tissue anchor catheter. In some embodiments, the handle includes a catheter stop member that prevents movement of the tissue anchor catheter under certain circumstances, and a handle stop member that prevents actuation of the handle under certain circumstances.
Abstract translation: 内窥镜组织锚定部署装置包括手柄,限定内腔的细长轴和附接到细长轴的远端的端部执行器。 组织锚导管可移除地插入穿过细长轴的内腔,该导管具有可从其远端展开的组织锚组件。 手柄可以包括销和轨道组件,其限定对应于展开装置端部执行器和组织锚固导管的展开步骤的一系列手柄致动步骤。 在一些实施例中,手柄包括防止组织锚固导管在某些情况下移动的导管止动构件以及在某些情况下阻止手柄致动的手柄止动构件。
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公开(公告)号:US08382800B2
公开(公告)日:2013-02-26
申请号:US12724348
申请日:2010-03-15
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 for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms 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. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.
Abstract translation: 本文描述了用于优化锚固力的装置和方法。 在固定组织褶皱时,通过利用具有可扩张臂的组织锚来避免直接位于锚固件正下方的组织的过度压缩,所述组织锚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。 可以使用各种装置,例如止动件,弹簧构件,保险丝,应变计等来指示锚固件何时被偏转到最佳范围内的预定水平。 此外,影响锚固特征的其他因素包括例如改变锚的臂或支柱的数量,臂的定位,臂的构型,套环的长度等。
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公开(公告)号:US08343175B2
公开(公告)日:2013-01-01
申请号:US12767731
申请日:2010-04-26
Applicant: Richard C. Ewers , Vahid Saadat , Kenneth J. Michlitsch , Chris A. Rothe , Rodney C. Brenneman , Cang C. Lam , Eugene G. Chen
Inventor: Richard C. Ewers , Vahid Saadat , Kenneth J. Michlitsch , Chris A. Rothe , Rodney C. Brenneman , Cang C. Lam , Eugene G. Chen
IPC: A61B17/08
CPC classification number: A61B1/0055 , A61B1/00135 , A61B1/018 , A61B1/2736 , A61B1/31 , A61B17/00234 , A61B17/0218 , A61B17/0401 , A61B17/0469 , A61B17/0482 , A61B17/0487 , A61B17/062 , A61B17/0625 , A61B17/0644 , A61B17/29 , A61B17/295 , A61B17/3421 , A61B17/3468 , A61B17/3478 , A61B2017/00269 , A61B2017/003 , A61B2017/00353 , A61B2017/00827 , A61B2017/0404 , A61B2017/0417 , A61B2017/0419 , A61B2017/0443 , A61B2017/0451 , A61B2017/0454 , A61B2017/0458 , A61B2017/0461 , A61B2017/0462 , A61B2017/0464 , A61B2017/0488 , A61B2017/0496 , A61B2017/06052 , A61B2017/061 , A61B2017/06176 , A61B2017/0649 , A61B2017/2905 , A61B2017/2927 , A61B2017/2943 , A61B2017/3445 , A61B2017/3488 , A61B2090/3614 , A61F5/0086
Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point and moving the first tissue contact point from a position initially distal to, or in line with, a second tissue contact point to a position proximal of the second contact point, thereby forming the tissue fold, and extending an anchor assembly through the tissue fold from a vicinity of the second tissue contact point. Adjustable anchor assemblies; as well as anchor delivery systems, shape-lockable guides and methods for endoluminally performing medical procedures, such as gastric reduction, treatment of gastroesophageal reflux disease, resection of lesions, and treatment of bleeding sites; are also provided.
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公开(公告)号:US20120184972A1
公开(公告)日:2012-07-19
申请号:US13348201
申请日:2012-01-11
Applicant: Cang Lam , Richard C. Ewers , Christopher James Earley
Inventor: Cang Lam , Richard C. Ewers , Christopher James Earley
IPC: A61B17/04
CPC classification number: A61B17/0401 , A61B17/0487 , A61B17/29 , A61B2017/00353 , A61B2017/0409 , A61B2017/0417 , A61B2017/0464 , A61B2017/06052 , A61B2017/2905 , A61B2017/2916
Abstract: An endoscopic tissue anchor deployment device includes a handle, an elongated shaft defining an internal lumen, and an end effector attached to the distal end of the elongated shaft. A tissue anchor catheter is removably inserted through the lumen of the elongated shaft, the catheter having a tissue anchor assembly that is deployable from its distal end. The handle may include a pin and track assembly that define a series of handle actuation steps corresponding to deployment steps for the deployment device end effector and the tissue anchor catheter. In some embodiments, the handle includes a catheter stop member that prevents movement of the tissue anchor catheter under certain circumstances, and a handle stop member that prevents actuation of the handle under certain circumstances.
Abstract translation: 内窥镜组织锚定部署装置包括手柄,限定内腔的细长轴和附接到细长轴的远端的端部执行器。 组织锚导管可移除地插入穿过细长轴的内腔,该导管具有可从其远端展开的组织锚组件。 手柄可以包括销和轨道组件,其限定对应于展开装置端部执行器和组织锚固导管的展开步骤的一系列手柄致动步骤。 在一些实施例中,手柄包括防止组织锚固导管在某些情况下移动的导管止动构件以及在某些情况下阻止手柄致动的手柄止动构件。
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76.
公开(公告)号:US08087413B2
公开(公告)日:2012-01-03
申请号:US11035702
申请日:2005-01-14
Applicant: Vahid Saadat , Ruey-Feng Peh , Richard C. Ewers , Eugene G. Chen
Inventor: Vahid Saadat , Ruey-Feng Peh , Richard C. Ewers , Eugene G. Chen
CPC classification number: A61B17/0469 , A61B17/00491 , A61B17/0401 , A61B17/0487 , A61B17/1114 , A61B2017/00349 , A61B2017/00495 , A61B2017/0406 , A61B2017/0454 , A61B2017/0464
Abstract: The attenuation or isolation of environmental parameters on a gastric lumen is described herein. Once tissue plications are formed into a gastric lumen or sleeve within a stomach, the newly formed lumen is subjected to a multitude of fluctuating stresses or pressure from food or fluids passing therethrough, from naturally-occurring contractions, and/or from changes in pH levels from caustic stomach acids and hormones. The tissue interface between these plications can be isolated from such environmental fluctuations, or the fluctuations can be attenuated, by a number of methods. One example is to place a gastric stent or sleeve within the newly formed lumen. Another example is to utilize multiple rows of anchors, clips, or sutures along the interface. Alternatively, bio-adhesives can be dispensed to buttress the tissue interface. In another variation, the tissue can be approximated in different configurations which effectively reduce or isolate the adhered tissue region.
Abstract translation: 本文描述了在胃腔上的环境参数的衰减或分离。 一旦组织消融在胃内形成胃腔或套管,则新形成的内腔经受来自通过其的食物或液体的多种波动的应力或压力,从天然存在的收缩和/或pH水平的变化 从苛性胃酸和激素。 可以通过多种方法将这些斑点之间的组织界面与这种环境波动隔离,或者波动可以减弱。 一个例子是将胃支架或套管放置在新形成的内腔内。 另一个例子是沿着界面使用多行锚,剪辑或缝线。 或者,可以分配生物粘合剂以支撑组织界面。 在另一个实施方式中,可以以有效地减少或隔离粘附的组织区域的不同配置来近似组织。
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公开(公告)号:US08070676B2
公开(公告)日:2011-12-06
申请号:US12960449
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 comprising an ultra gel elastomeric material formed of a mixture comprising a triblock copolymer and an oil. The access seal is adapted to be disposed relative to the abdominal wall. At least one access channel is formed through the elastomeric material between a proximal portion and a distal portion of the access seal. The access channel when operatively disposed forms at least a portion of a working channel between a location external to the abdominal wall and a location internal to the abdominal wall. The elastomeric material of the access seal is adapted to conform to a surface of an instrument inserted through the working channel to provide instrument access to the abdominal cavity while maintaining insufflation pressure in the abdominal cavity. The access channel is configured to self seal in the absence of any instrument extending through the access channel.
Abstract translation: 外科进入装置包括进入密封件,其包括由包含三嵌段共聚物和油的混合物形成的超凝胶弹性体材料。 进入密封件适于相对于腹壁设置。 在进入密封件的近端部分和远端部分之间通过弹性体材料形成至少一个进入通道。 当操作性地设置时,进入通道形成在腹壁外部的位置与腹壁内部的位置之间的工作通道的至少一部分。 进入密封件的弹性体材料适于与通过工作通道插入的仪器的表面一致,以提供器械进入腹腔,同时保持腹腔内的注射压力。 访问通道被配置为在没有任何通过访问通道延伸的仪器的情况下自封。
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公开(公告)号:US20110213385A1
公开(公告)日:2011-09-01
申请号:US13108270
申请日:2011-05-16
Applicant: Richard C. EWERS , Vahid SAADAT , Eugene CHEN
Inventor: Richard C. EWERS , Vahid SAADAT , Eugene CHEN
IPC: A61B17/04
CPC classification number: A61B17/3478 , A61B17/00234 , A61B17/0401 , A61B17/0487 , A61B17/0644 , A61B17/3468 , A61B2017/0404 , A61B2017/0417 , A61B2017/0419 , A61B2017/0458 , A61B2017/0464 , A61B2017/0496 , A61B2017/061 , A61B2017/3488
Abstract: A delivery catheter for a gastric reduction system includes an elongate torqueable tube, a needle translatably disposed within the torqueable tube, an anchor translatably disposed within the needle and a stabilization device for holding a distal tip of the torqueable tube against a tissue wall.
Abstract translation: 用于胃减压系统的输送导管包括细长的可扭转管,可转动地设置在可扭转管内的针,可平移地设置在针内的锚固件和用于将可扭转管的远侧末端保持抵靠组织壁的稳定装置。
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公开(公告)号:US07942884B2
公开(公告)日:2011-05-17
申请号:US10612491
申请日:2003-07-01
Applicant: Saadat Vahid , Richard C. Ewers , Eugene Chen , Rodney Brenneman
Inventor: Saadat Vahid , Richard C. Ewers , Eugene Chen , Rodney Brenneman
IPC: A61B17/10
CPC classification number: A61B17/3478 , A61B17/00234 , A61B17/0401 , A61B17/0487 , A61B17/0644 , A61B17/3468 , A61B2017/0404 , A61B2017/0417 , A61B2017/0419 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0461 , A61B2017/0464 , A61B2017/0496 , A61B2017/061 , A61B2017/3445 , A61B2017/3488
Abstract: A method of reducing the cross-sectional area of a gastrointestinal lumen is provided wherein a delivery catheter having a needle, one or more anchors disposed within the needle and a suture coupled to each anchor is advanced into the gastrointestinal lumen, the needle extended through the tissue wall, and an anchor ejected from a distal tip of the needle through the tissue wall. The needle is then repositioned against an opposing tissue wall, another anchor deployed from the needle through the opposing tissue wall, and the tissue walls approximated by applying tension to the sutures.
Abstract translation: 提供了一种减少胃肠腔的横截面积的方法,其中具有针头,设置在针内的一个或多个锚定件和联接到每个锚固件的缝合线的输送导管进入胃肠腔,针穿过 组织壁和从针的远侧末端通过组织壁喷射的锚固体。 然后将针重新定位在相对的组织壁上,另一个锚从针穿过相对的组织壁展开,组织壁通过对缝线施加张力来近似。
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公开(公告)号:US20100249814A1
公开(公告)日:2010-09-30
申请号:US12815335
申请日:2010-06-14
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: A61B17/11
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。
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