公开(公告)号：US20100174312A1

公开(公告)日：2010-07-08

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: A61B17/08

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。

公开(公告)号：US07704264B2

公开(公告)日：2010-04-27

申请号：US10992306

申请日：2004-11-17

Applicant: Richard C. Ewers ,  Vahid C. Saadat ,  Kenneth J. Michlitsch ,  Chris Rothe ,  Rodney Brenneman ,  Cang C. Lam ,  Eugene C. Chen

Inventor： Richard C. Ewers ,  Vahid C. Saadat ,  Kenneth J. Michlitsch ,  Chris Rothe ,  Rodney Brenneman ,  Cang C. Lam ,  Eugene C. Chen

IPC: A61B17/10 ,  A61B17/08 ,  A61B17/15 ,  A61B17/128

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.

Abstract translation: 提供了设备和方法，用于通过在第一组织接触点处接合组织并使第一组织接触点从最初远端或与第二组织接触点一致的位置移动到位于第二组织接触点附近的位置来形成胃肠组织折叠 第二接触点，从而形成组织折叠，并且从第二组织接触点的附近延伸锚固组件穿过组织折叠。 可调锚固组件; 以及锚定递送系统，可锁定形状的导管和用于内窥镜执行医学程序的方法，例如胃减压，治疗胃食管反流疾病，切除病变和治疗出血部位; 也提供。

公开(公告)号：US20090131754A1

公开(公告)日：2009-05-21

申请号：US12360634

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.

公开(公告)号：US20090023985A1

公开(公告)日：2009-01-22

申请号：US12138348

申请日：2008-06-12

Applicant: Richard C. Ewers

Inventor： Richard C. Ewers

IPC: A61B1/00

CPC classification number: A61B1/0051 ,  A61B1/00147 ,  A61B1/00149 ,  A61B1/018 ,  A61B17/29 ,  A61B90/50 ,  A61B90/53 ,  A61B2017/003 ,  A61B2017/0409 ,  A61B2017/294 ,  A61B2017/3445 ,  A61B2017/3449

Abstract: Endoluminal instrument management systems are described herein which allow one or more operators to manage multiple different instruments utilized in endoluminal procedures. 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.

Abstract translation: 本文描述了腔内仪器管理系统，其允许一个或多个操作者管理腔内程序中使用的多种不同仪器。 可以配置一个或多个操作者之间的仪表管理的责任，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。

公开(公告)号：US07473221B2

公开(公告)日：2009-01-06

申请号：US10381220

申请日：2001-09-21

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 forming a seal with the body wall and providing an access channel into a body cavity. The valve has properties for creating a zero-seal in the absence of an instrument and an instrument seal with instruments. The valve can include a gel comprised of an elastomer and 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. A method for making the surgical access device includes combining a gelling agent with oil, preferably in a molding process. A method for using the device includes creating an opening with the instrument. 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.

Abstract translation: 手术进入装置包括单个阀，其与主体壁形成密封并且提供进入体腔的通道。 该阀具有在没有仪器和仪器密封的情况下产生零密封的特性。 阀可以包括由弹性体和油组成的凝胶，其提供大于1000％的伸长率和小于5肖氏A的硬度。单个阀可以用作手术口，其中仪器包括外科医生的手臂。 制造外科进入装置的方法包括将胶凝剂与油组合，优选在模制过程中。 使用该装置的方法包括用仪器创建开口。 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。

公开(公告)号：US20080262525A1

公开(公告)日：2008-10-23

申请号：US11736541

申请日：2007-04-17

Applicant: Arvin T. Chang ,  Richard C. Ewers

Inventor： Arvin T. Chang ,  Richard C. Ewers

IPC: A61B17/32

CPC classification number: A61B17/0218 ,  A61B2017/00278

Abstract: A tissue grasping apparatus includes a control member, an elongated shaft, and a tissue penetrating and 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 penetrating and grasping member. In an embodiment, the tissue penetrating and grasping member includes a rigid penetrating member that is rotatably attached to the distal end of the elongated shaft. 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穿透和抓持构件。 激活机构提供控制构件和组织穿透和抓持构件之间的用户可操作的连接。 在一个实施例中，组织穿透和抓握构件包括可旋转地附接到细长轴的远端的刚性穿透构件。 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：US07377898B2

公开(公告)日：2008-05-27

申请号：US11755305

申请日：2007-05-30

Applicant: Richard C Ewers ,  John R Brustad ,  Edward D Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V 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 V Taylor ,  Gary R Dulak ,  Michael J Dunn ,  Norman L Morales ,  Charles C Hart ,  Robert R Bowes

IPC: A61B1/32

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 means 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，缩回元件是可伸长的和不可扩张的，在环处有合适的附接装置，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。

公开(公告)号：US07361180B2

公开(公告)日：2008-04-22

申请号：US10954666

申请日：2004-09-29

Applicant: Vahid Saadat ,  Richard C. Ewers ,  Cang C. Lam ,  Robert A. Vaughan ,  Chris Rothe ,  Kenneth J. Michlitsch

Inventor： Vahid Saadat ,  Richard C. Ewers ,  Cang C. Lam ,  Robert A. Vaughan ,  Chris Rothe ,  Kenneth J. Michlitsch

IPC: A61B17/00 ,  A61B17/10 ,  A61B17/08

CPC classification number: A61F5/0086 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0482 ,  A61B17/0483 ,  A61B17/0487 ,  A61B17/06 ,  A61B17/06066 ,  A61B17/064 ,  A61B17/08 ,  A61B17/10 ,  A61B17/12013 ,  A61B17/1285 ,  A61B17/29 ,  A61B2017/00867 ,  A61B2017/0404 ,  A61B2017/0409 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/0445 ,  A61B2017/0446 ,  A61B2017/045 ,  A61B2017/0451 ,  A61B2017/0454 ,  A61B2017/0456 ,  A61B2017/0458 ,  A61B2017/0459 ,  A61B2017/0461 ,  A61B2017/0462 ,  A61B2017/0464 ,  A61B2017/0475 ,  A61B2017/0488 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/081 ,  A61B2017/3488

Abstract: Apparatus 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。 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，组织稳定构件 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。

公开(公告)号：US07041052B2

公开(公告)日：2006-05-09

申请号：US10888531

申请日：2004-07-08

Applicant: Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

Inventor： Vahid Saadat ,  Richard C. Ewers ,  Eugene G. Chen

IPC: A61B1/00

CPC classification number: A61B1/0052 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00105 ,  A61B1/00135 ,  A61B1/00154 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/0058 ,  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, 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 overtube may be selectively stiffened to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. 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：US06942613B2

公开(公告)日：2005-09-13

申请号：US10281461

申请日：2002-10-25

Applicant: Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

Inventor： Richard C. Ewers ,  Vahid Saadat ,  Boris Reydel

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.