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    Shape lockable apparatus and method for advancing an instrument through unsupported anatomy
    81.
    发明授权
    Shape lockable apparatus and method for advancing an instrument through unsupported anatomy 有权
    形状可锁定装置和方法，用于通过不支持的解剖结构推进器械

    公开(公告)号：US06960162B2

    公开(公告)日：2005-11-01

    申请号：US10281426

    申请日：2002-10-25

    Applicant: Vahid Saadat ,  Richard C. Ewers

    Inventor： Vahid Saadat ,  Richard C. Ewers

    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.

    Abstract translation: 提供了设备和方法，用于将诊断或治疗仪器放置在曲折或无支撑的解剖结构的空心体器官中，包括手柄，设置在亲水护套内的外套管，以及具有无创尖端的远侧区域。 外套管可以从手柄移除，并且具有相对于把手以一定角度设置的纵向轴线。 护套可以是一次性的，以允许外套管的再次使用。 可以提供故障安全的张紧机构以选择性地加固外套管，以减少由诊断或治疗仪器的前进引起的器官的膨胀。 在张力系统失效的情况下，故障安全张紧机构降低了外套管的重新配置的风险，并且在一个实施例中，使外套管刚性化，而远端区域没有实质的近端运动。 远侧区域允许由诊断或治疗仪器的偏转引起的外套管的被动转向，而无创伤尖端防止器官的壁在操纵诊断或治疗仪器期间被卡住或夹住。

    Endoscopic tissue anchor deployment
    85.
    发明授权
    Endoscopic tissue anchor deployment 有权
    内窥镜组织锚部署

    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

    IPC: A61B17/04 ,  A61B17/29 ,  A61B17/00 ,  A61B17/06

    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。

    Compressible tissue anchor assemblies
    86.
    发明授权
    Compressible tissue anchor assemblies 有权
    可压缩组织锚固组件

    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。

    ENDOSCOPIC TISSUE ANCHOR DEPLOYMENT
    88.
    发明申请
    ENDOSCOPIC TISSUE ANCHOR DEPLOYMENT 有权
    内窥镜组织锚固部分

    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。

    Attenuation of environmental parameters on a gastric lumen
    89.
    发明授权
    Attenuation of environmental parameters on a gastric lumen 有权
    胃管内环境参数的衰减

    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

    IPC: A61B19/00 ,  A61B17/08 ,  A61B17/04 ,  A61F2/04 ,  A61L17/00

    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。

    Surgical access apparatus and method
    90.
    发明授权
    Surgical access apparatus and method 有权
    手术进入装置及方法

    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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