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    Surgical access apparatus and method
    1.
    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：US08672839B2

    公开(公告)日：2014-03-18

    申请号：US13231348

    申请日：2011-09-13

    申请人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

    发明人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

    IPC分类号： A61B1/32

    CPC分类号： A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

    摘要： An access system comprises an access device. The access device is adapted to be disposed within an opening in a body wall. The access device has an external flange adapted to be disposed external to the body wall and an internal flange adapted to be disposed internal to the body wall. Holes extend through the access device between an external surface and an internal surface of the access device. The holes span the thickness of the body wall between a location external to the body wall and a location internal to the body wall. The access device is formed of an elastomeric material adapted to conform to surfaces of instruments inserted through the holes to form instrument seals along at least a portion of a length spanning the thickness of the body wall. The elastomeric material is compressible and adapted to form a seal with the body wall.

    摘要翻译： 访问系统包括访问设备。 进入装置适于设置在体壁的开口内。 进入装置具有适于设置在主体壁外部的外部凸缘和适于设置在主体壁内部的内部凸缘。 孔在进入装置的外表面和内表面之间延伸通过进入装置。 孔跨越体壁外部位置与体壁内部的位置之间的体壁厚度。 进入装置由弹性体材料形成，弹性体材料适于与穿过孔插入的仪器的表面一致，以沿跨越体壁厚度的至少一部分长度形成仪器密封。 弹性体材料是可压缩的并且适于与主体壁形成密封。

    Methods and apparatus for securing and deploying tissue anchors
    2.
    发明授权
    Methods and apparatus for securing and deploying tissue anchors 有权
    用于固定和部署组织锚的方法和装置

    公开(公告)号：US08628541B2

    公开(公告)日：2014-01-14

    申请号：US11238543

    申请日：2005-09-30

    申请人： Vahid Saadat ,  Richard C. Ewers ,  Cang C. Lam

    发明人： Vahid Saadat ,  Richard C. Ewers ,  Cang C. Lam

    IPC分类号： A61B17/10

    CPC分类号： A61B17/29 ,  A61B17/0401 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/0482 ,  A61B2017/003 ,  A61B2017/00349 ,  A61B2017/00827 ,  A61B2017/00867 ,  A61B2017/0419 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2017/2927

    摘要： Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which 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. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically by applying thermal energy through at least one suture cutting element disposed along the deployment assembly.

    摘要翻译： 本文描述了用于固定和展开组织锚的方法和装置。 组织操作组件可枢转地联接到管状构件的远端。 可重新配置的发射管也可枢转地联接到组织操作组件，组织操作组件可通过可形状锁定的内窥镜装置，常规内窥镜或直接自身进入患者。 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。 提供了一种展开组件，用于通过一个或多个组织锚固件固定所接合的组织，所述展开组件还被配置为通过沿着所述展开组件布置的至少一个缝合线切割元件施加热能而使所述锚定器在内部或腹腔镜下脱离。

    Wound retraction apparatus and method
    5.
    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：US08388526B2

    公开(公告)日：2013-03-05

    申请号：US12108400

    申请日：2008-04-23

    申请人： 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

    发明人： 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分类号： A61B17/02

    CPC分类号： A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

    摘要： 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.

    摘要翻译： 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，可扩张和不扩张两者都可以在环上使用适当的附接装置来设计，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。

    METHODS AND APPARATUS FOR OFF-AXIS VISUALIZATION
    6.
    发明申请
    METHODS AND APPARATUS FOR OFF-AXIS VISUALIZATION 有权
    用于非轴可视化的方法和装置

    公开(公告)号：US20130041214A1

    公开(公告)日：2013-02-14

    申请号：US13597072

    申请日：2012-08-28

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

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

    IPC分类号： A61B1/05 ,  A61B1/018

    CPC分类号： A61B1/0051 ,  A61B1/00085 ,  A61B1/00089 ,  A61B1/00098 ,  A61B1/00179 ,  A61B1/00183 ,  A61B1/018 ,  A61B1/05

    摘要： 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.

    摘要翻译： 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。

    ENDOLUMINAL SURGICAL TOOL WITH SMALL BEND RADIUS STEERING SECTION
    7.
    发明申请
    ENDOLUMINAL SURGICAL TOOL WITH SMALL BEND RADIUS STEERING SECTION 审中-公开
    具有小弯曲转向部的内镜手术工具

    公开(公告)号：US20120238952A1

    公开(公告)日：2012-09-20

    申请号：US13483371

    申请日：2012-05-30

    申请人： Sean Mitchell ,  Richard C. Ewers ,  Tracy D. Maahs

    发明人： Sean Mitchell ,  Richard C. Ewers ,  Tracy D. Maahs

    IPC分类号： A61M25/092

    CPC分类号： A61B1/0057 ,  A61B1/0052 ,  A61B1/0055 ,  A61B1/008 ,  A61B1/012 ,  A61M25/0147

    摘要： An endoluminal surgical instrument has first and second steering controls on a handle. A flexible shaft attached to the handle has a distal steerable end including a first link and a second link separated by a plurality of intermediate links. First and second steering elements, such as pairs of steering wires, are linked to first and second steering controls and to the first and, second links. One or more of the links is pivotable through an angle of at least 30 degrees relative to an adjoining link. The set back position of the second steering elements from the first steering elements, and the pivoting capability of the links allows the steerable end to be steered into a small bend radius. This makes the instrument highly maneuverable for use in endoluminal surgery, such as incision-less surgery of the stomach.

    摘要翻译： 腔内手术器械在手柄上具有第一和第二转向控制。 附接到手柄的柔性轴具有远端可操纵端，其包括由多个中间连杆分隔的第一连杆和第二连杆。 第一和第二转向元件，例如成对的转向线，被连接到第一和第二转向控制以及第一和第二连杆。 连接件中的一个或多个可相对于邻接连杆枢转至少30度的角度。 来自第一转向元件的第二转向元件的回退位置以及链节的枢转能力允许可转向端转向小的弯曲半径。 这使得仪器高度可操作地用于腔内手术，例如无切口的胃手术。

    SURGICAL ACCESS APPARATUS AND METHOD
    8.
    发明申请
    SURGICAL ACCESS APPARATUS AND METHOD 有权
    外科手术设备及方法

    公开(公告)号：US20120184821A1

    公开(公告)日：2012-07-19

    申请号：US13421730

    申请日：2012-03-15

    申请人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

    发明人： Richard C. Ewers ,  John R. Brustad ,  Edward D. Pingleton ,  Nabil Hilal ,  Gary R. Dulak ,  Payam Adlparvar ,  Robert R. Bowes

    IPC分类号： A61B1/32

    CPC分类号： A61B17/3423 ,  A61B17/0218 ,  A61B17/0293 ,  A61B17/3474 ,  A61B17/3498 ,  A61B2017/00265 ,  A61B2017/00526 ,  A61B2017/3419 ,  A61B2017/3445 ,  A61B2017/3492 ,  A61M13/003

    摘要： A device comprises an access port adapted to permit access of at least one surgical instrument into a patient. The access port comprises a proximal portion, a distal portion, and an intermediate portion monolithically formed of a flexible material. At least one opening extends through the access port. The proximal portion comprises a proximal flange. The distal portion comprises a distal flange. The intermediate portion comprises an outer surface and at least one inner surface. The access port is adapted to form a perimeter seal when the proximal flange is disposed exteriorly and the distal flange is disposed interiorly. The access port is adapted to form a seal with the at least one surgical instrument positioned through the access port. The intermediate portion conforms to the surface of the surgical instrument positioned through the at least one opening and forms the seal between the inner surface and the surgical instrument.

    摘要翻译： 一种装置包括适于允许至少一个外科器械进入患者的进入口。 进入口包括近端部分，远侧部分和由柔性材料整体形成的中间部分。 至少一个开口延伸穿过进入端口。 近端部分包括近侧凸缘。 远侧部分包括远端凸缘。 中间部分包括外表面和至少一个内表面。 当近侧凸缘设置在外部并且远侧凸缘位于内部时，进入口适于形成周边密封。 进入端口适于与通过进入端口定位的至少一个外科器械形成密封。 中间部分符合通过至少一个开口定位的外科器械的表面，并在内表面和外科器械之间形成密封。

    Apparatus and methods for optimizing anchoring force
    10.
    发明授权
    Apparatus and methods for optimizing anchoring force 有权
    用于优化锚固力的装置和方法

    公开(公告)号：US08206417B2

    公开(公告)日：2012-06-26

    申请号：US10865243

    申请日：2004-06-09

    申请人： Tracy D. Maahs ,  Richard C. Ewers ,  Vahid Saadat ,  Alex Khairkhahan ,  Kenneth J. Michlitsch

    发明人： Tracy D. Maahs ,  Richard C. Ewers ,  Vahid Saadat ,  Alex Khairkhahan ,  Kenneth J. Michlitsch

    IPC分类号： A61B17/04

    CPC分类号： A61B17/0482 ,  A61B17/0401 ,  A61B17/0469 ,  A61B17/0644 ,  A61B2017/00867 ,  A61B2017/0454 ,  A61B2017/0464 ,  A61B2017/0496 ,  A61B2017/06052 ,  A61B2090/037

    摘要： 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.

    摘要翻译： 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。