摘要:
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.
摘要:
Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.
摘要:
An apparatus for detecting leaks in a fluid-filled device used to treat a patient's tissue includes an catheter having an expandable device defining a fluid reservoir about the distal end of the catheter. An internal electrode is in electrical contact with a conductive fluid within the fluid reservoir. A grounding electrode is outside of the fluid reservoir, in electrical contact with the patient's tissue. Voltage is supplied to the internal electrode and the grounding electrode. Where a leak occurs in the expandable device, conductive fluid will contact the patient's tissue, thus creating an electrical current path between the internal electrode and the grounding electrode. This so-called "leak current" is used to generate a leak alarm signal.
摘要:
Apparatus and methods for intraoperatively performing surgery to create transmural channels in tissue, for example, as in transmyocardial revascularization, are provided using apparatus having an end region containing a mechanical cutting head and means for articulating the end-region to access hard-to-reach portions of the anatomy. The handpiece is coupled by a disposable cable to a controller that houses a vacuum pump and mechanisms for driving the cutting head. The cutting head is adapted to cooperate with the vacuum pump to evacuate tissue severed during the channel forming process.
摘要:
Apparatus for thermal coagulation having an improved circulation assembly and heating assembly. The apparatus includes a balloon catheter secured to and in fluid communication with a handle for inserting the apparatus into a human uterus. A distensible bladder is secured to the distal end of the catheter and encloses a heating assembly having a tubular core configured with a spiral groove which retains a heating filament. An impeller having at least two blades is positioned distal of the heating assembly and includes a cable having a distal end secured to the impeller. The impeller cable is partially disposed in the handle, in the elongate tubular member and in the core of the heating element, such that axial rotation of said cable rotates the blades of said impeller. During use of the apparatus, the distensible bladder is inflated with a fluid to a desired pressure and rotation of the impeller blades is initiated. The inflation fluid within the distensible bladder is heated to a desired temperature, which is maintained for a desired time interval. The inflation fluid within the distensible bladder is allowed to cool and rotation of the impeller blades is terminated. Thereafter, the inflation fluid is removed from the balloon catheter to deflate the distensible bladder.
摘要:
Apparatus and methods for intraoperatively performing surgery to create transmural channels in tissue, for example, as in transmyocardial revascularization, are provided using a device including a mechanical end effector and means for stabilizing the end effector in contact with the tissue. The end effector is adapted to cooperate with a source of suction to evacuate tissue severed during the channel forming process, and may optionally include an electrode for cauterizing the tissue surrounding the channel.
摘要:
A method of inhibiting tissue migration comprises positioning an open area of a hood against or adjacent to a tissue region. The method also comprises displacing an opaque fluid with a transparent fluid from the open area. The method includes engaging a portion of the tissue region within the open area via an end effector advanced through the open area and which grasps onto the portion. The end effector includes a tapered section, tapered along its entire length, through which a lumen extends. The tapered section includes threads extending from a surface of the tapered section in a direction orthogonal to the longitudinal axis. The tissue region is pierced while displacing the opaque fluid with the transparent fluid through the distal opening of the hood and while maintaining engagement of the portion of the tissue region such that distal movement of the tissue is inhibited.
摘要:
Apparatus and methods for ablation efficacy are described herein where a hood having a deployable elongated feature can extend beyond a distal face of the hood. The elongated feature can channel the energy to the deeper regions within the tissue (such as trabeculated regions or other tissue structures) such that the energy can be delivered to the target tissue despite small or large irregularities in the target tissue surface (or region) and/or changes in the relative distances between the hood and the target tissue.
摘要:
The delivery of biological compounds to ischemic and/or infarcted tissue are described herein where such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. Additionally, any number of therapeutic tools can also be passed through the deployment catheter and into the imaging hood for performing any number of procedures on the tissue for identifying, locating, and/or accessing ischemic and/or infarcted tissue.
摘要:
Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In some embodiments, a surgical tissue removal device includes a flexible elongate body that is adapted to conform with the target anatomy and a guidewire connector at the distal end region of the flexible elongate body configured to removably connect to the end of a guidewire so that the guidewire and flexible elongate body can be pulled distally. The body may have at least one blade edge, and the flexible elongate body may be a thin, flat, ribbon shaped flexible body that includes a profile having a width that is substantially greater than a height.