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    Tendon-driven endoscope and methods of insertion
    3.
    发明申请
    Tendon-driven endoscope and methods of insertion 审中-公开
    肌腱驱动内窥镜和插入方法

    公开(公告)号：US20050154261A1

    公开(公告)日：2005-07-14

    申请号：US11019963

    申请日：2004-12-20

    申请人： Robert Ohline ,  Joseph Tartaglia ,  Amir Belson ,  Alex Roth ,  Wade Keller ,  Scott Anderson ,  Chris Julian

    发明人： Robert Ohline ,  Joseph Tartaglia ,  Amir Belson ,  Alex Roth ,  Wade Keller ,  Scott Anderson ,  Chris Julian

    IPC分类号： G02B23/24 ,  A61B1/00 ,  A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/04 ,  A61B1/31 ,  G02B23/26

    CPC分类号： A61B1/00128 ,  A61B1/00006 ,  A61B1/00057 ,  A61B1/0016 ,  A61B1/0053 ,  A61B1/0057 ,  A61B1/0058 ,  A61B1/01 ,  A61B1/31 ,  A61B5/065 ,  A61B2034/301 ,  A61B2034/741 ,  A61B2034/742

    摘要： A steerable, tendon-driven endoscope is described herein. The endoscope has an elongated body with a manually or selectively steerable distal portion and an automatically controlled, segmented proximal portion. The steerable distal portion and the segment of the controllable portion are actuated by at least two tendons. As the endoscope is advanced, the user maneuvers the distal portion, and a motion controller actuates tendons in the segmented proximal portion so that the proximal portion assumes the selected curve of the selectively steerable distal portion. By this method the selected curves are propagated along the endoscope body so that the endoscope largely conforms to the pathway selected. When the endoscope is withdrawn proximally, the selected curves can propagate distally along the endoscope body. This allows the endoscope to negotiate tortuous curves along a desired path through or around and between organs within the body.

    摘要翻译： 这里描述了可操纵的肌腱驱动的内窥镜。 内窥镜具有细长主体，其具有手动或选择性可操纵的远侧部分和自动控制的分段近端部分。 可操纵的远端部分和可控部分的段由至少两个腱致动。 当内窥镜前进时，使用者操纵远侧部分，并且运动控制器致动分段近端部分中的腱，使得近端部分呈现选择性可操纵的远侧部分的选定曲线。 通过该方法，所选择的曲线沿着内窥镜主体传播，使得内窥镜大体上符合所选择的路径。 当内窥镜向近侧收回时，所选择的曲线可沿内窥镜体向远端传播。 这允许内窥镜沿着穿过体内器官之间或之间的所需途径协商曲折曲线。

    Method for reducing myocardial infarct by application of intravascular hypothermia
    4.
    发明申请
    Method for reducing myocardial infarct by application of intravascular hypothermia 有权
    通过应用血管内低温降低心肌梗塞的方法

    公开(公告)号：US20050027290A1

    公开(公告)日：2005-02-03

    申请号：US10933979

    申请日：2004-09-02

    申请人： Michael Dae ,  Wade Keller ,  Timothy Machold

    发明人： Michael Dae ,  Wade Keller ,  Timothy Machold

    IPC分类号： A61F2/958 ,  A61F7/00 ,  A61F7/12 ,  A61B18/04

    CPC分类号： A61F7/12 ,  A61F7/123 ,  A61F2007/0056 ,  A61F2007/0076 ,  A61F2007/126 ,  A61M25/1002

    摘要： Methods and apparatus for preventing myocardial infarction, or lessening the size/severity of an evolving myocardial infarction, by cooling at least the affected area of the myocardium using an intravascular heat exchange catheter. The heat exchange catheter may be inserted into the vasculature (e.g., a vein) and advanced to a position wherein a heat exchanger on the catheter is located in or near the heart (e.g., within the vena cava near the patient's heart). Thereafter, the heat exchange catheter is used to cool the myocardium (or the entire body of the patient) to a temperature that effectively lessens the metabolic rate and/or oxygen consumption of the ischemic myocardial cells or otherwise protects the ischemic myocardium from undergoing irreversible damage or infarction.

    摘要翻译： 通过使用血管内热交换导管至少冷却至少心肌的受影响区域来预防心肌梗死或减轻心肌梗死的大小/严重程度的方法和装置。 热交换导管可以插入脉管系统（例如静脉）中并且前进到导管上的热交换器位于心脏中或附近（例如在患者心脏附近的腔静脉内）的位置。 此后，热交换导管用于将心肌（或患者的整个身体）冷却到有效降低缺血心肌细胞的代谢率和/或氧消耗的温度，或以其它方式保护缺血心肌免受不可逆损伤 或梗死。

    Endoscope with adjacently positioned guiding apparatus
    5.
    发明申请
    Endoscope with adjacently positioned guiding apparatus 审中-公开
    内窥镜具有相邻定位的导向装置

    公开(公告)号：US20050154258A1

    公开(公告)日：2005-07-14

    申请号：US11019962

    申请日：2004-12-20

    申请人： Joseph Tartaglia ,  Wade Keller ,  Amir Belson ,  Arthur Ratchford

    发明人： Joseph Tartaglia ,  Wade Keller ,  Amir Belson ,  Arthur Ratchford

    IPC分类号： G02B23/24 ,  A61B20060101 ,  A61B1/00 ,  A61B1/005 ,  A61B1/008 ,  A61B1/01 ,  A61B1/04 ,  A61B1/31

    CPC分类号： A61B1/00073 ,  A61B1/0014 ,  A61B1/00147 ,  A61B1/0053 ,  A61B1/0055 ,  A61B1/008 ,  A61B1/01 ,  A61B1/07 ,  A61B1/31 ,  A61B5/065 ,  A61B2017/00323 ,  A61B2034/301 ,  A61B2034/741 ,  A61B2034/742

    摘要： An endoscope with guiding apparatus is provided. The endoscope has an elongate body with a steerable distal portion, an automatically controlled portion, a flexible and passively manipulated proximal portion, and an externally controlled and manipulatable guiding apparatus. The guiding apparatus may be positioned within the endoscope or may be positioned adjacent to the endoscope. An interlocking device is provided to slidably interlock the guiding apparatus and the endoscope. When the guide is in a flexible state, it can conform to a curve or path defined by the steerable distal portion and the automatically controlled portion. The guide can then be selectively rigidized to assume that curve or path. Once rigidized, the endoscope can be advanced along the guide in a monorail or “piggy-back” fashion so that the flexible proximal portion follows the curve held by the guide until the endoscope reaches a next point of curvature within a body lumen.

    摘要翻译： 提供具有引导装置的内窥镜。 内窥镜具有细长主体，其具有可转向的远端部分，自动控制部分，柔性和被动操纵的近端部分以及外部控制和可操纵的引导装置。 引导装置可以定位在内窥镜内，或者可以定位成与内窥镜相邻。 联锁装置设置成可滑动地联动引导装置和内窥镜。 当引导件处于柔性状态时，其可以符合由可转向远端部分和自动控制部分限定的曲线或路径。 然后，引导件可以选择性地刚性化以假定该曲线或路径。 一旦刚性化，内窥镜可以沿着导轨以单轨或“背部”方式前进，使得柔性近端部分遵循由引导件保持的曲线，直到内窥镜到达体腔内的下一个曲率点。

    Instrument and method for transection of a ligament
    6.
    发明授权
    Instrument and method for transection of a ligament 失效
    用于横断韧带的仪器和方法

    公开(公告)号：US5769865A

    公开(公告)日：1998-06-23

    申请号：US805464

    申请日：1997-02-25

    申请人： Jim Kermode ,  David Kermode ,  Mark Clifford ,  Wade Keller

    发明人： Jim Kermode ,  David Kermode ,  Mark Clifford ,  Wade Keller

    IPC分类号： A61B17/00 ,  A61B17/22 ,  A61B17/32

    CPC分类号： A61B17/320036 ,  A61B17/320783 ,  A61B2017/00557 ,  A61B2017/22054

    摘要： In a procedure for the treatment of carpal tunnel syndrome, the carpal ligament is spread by use of a cutting device passing through the interior of a cannula inserted into the carpal tunnel through an incision in the patient's wrist, the cannula containing an inflatable balloon at its distal end to secure the position of the cutting device against the carpal ligament, and the cutting device comprising a blade whose position is remotely controlled from the proximal end of the device. Other features of the procedure are the use of a blunt-tipped hypodermic needle and exchange wire to establish a path to the site under the carpal ligament, an endoscope or other visualization device to be inserted through the cannula with the cutting device, and a removable sheath over the cannula to contain the inflatable balloon until inflation is desired.

    摘要翻译： 在用于治疗腕管综合征的程序中，通过使用穿过患者腕部中的切口插入腕管的套管内的切割装置将腕韧带展开，套管内包含充气气球 远端以将切割装置的位置固定抵靠腕韧带，并且切割装置包括其位置从装置的近端远程控制的刀片。 该过程的其他特征是使用钝头皮下注射针和交换丝以建立通过腕管韧带下方的部位的路径，内窥镜或其它可切割装置，其通过插管插入切割装置，并且可移除 套在套管上以容纳可充气气球，直到需要充气。

    Method and system for control of a patient's body temperature by way of a transluminally insertable heat exchange catheter
    7.
    发明申请
    Method and system for control of a patient's body temperature by way of a transluminally insertable heat exchange catheter 有权
    通过可插入热交换导管来控制患者体温的方法和系统

    公开(公告)号：US20070191918A1

    公开(公告)日：2007-08-16

    申请号：US10645755

    申请日：2003-08-20

    申请人： Timothy MacHold ,  Wade Keller ,  Alex Roth ,  Nicole Bloom

    发明人： Timothy MacHold ,  Wade Keller ,  Alex Roth ,  Nicole Bloom

    IPC分类号： A61F7/00 ,  A61F7/12

    CPC分类号： A61F7/0085 ,  A61B2017/00092 ,  A61B2017/00119 ,  A61B2017/00123 ,  A61B2017/00199 ,  A61B2017/22051 ,  A61F7/0097 ,  A61F7/10 ,  A61F7/123 ,  A61F2007/0054 ,  A61F2007/0096 ,  A61F2007/126 ,  A61M25/10 ,  A61M25/1011 ,  A61M2025/1072 ,  A61M2025/1086 ,  A61M2205/12 ,  A61M2205/127

    摘要： Methods and apparatuses for temperature modification of a patient, or selected regions thereof, including an induced state of hypothermia. The temperature modification is accomplished using an in-dwelling heat exchange catheter within which a fluid heat exchange medium circulates. A heat exchange cassette of any one of several disclosed variations is attached to the circulatory flow lines of the catheter, the heat exchange cassette being sized to engage a cavity within one of various described re-usable control units. The control units include a heater/cooler device, a user input device, and a processor connected to receive input from various sensors around the body and the system. The heater/cooler device may be thermoelectric to enable both heating and cooling based on polarity. A temperature control scheme for ramping the body temperature up or down without overshoot is provided. The disposable heat exchange cassettes may include an integral pump head that engages with a pump drive mechanism within the re-usable control unit. More than one control unit may be provided to receive the same heat exchange cassette so that a large capacity control unit can be used initially, and a smaller, battery-powered unit can be substituted once the patient reaches the desired target temperature.

    摘要翻译： 包括诱导低温的状态的患者的温度改变方法和装置，或其选定区域。 使用在其中流体热交换介质循环的内部热交换导管来实现温度改变。 几个公开的变型中的任何一个的热交换盒附接到导管的循环流动管线，热交换盒的尺寸适于接合各种所描述的可重复使用的控制单元之一内的空腔。 控制单元包括加热器/冷却器装置，用户输入装置和连接以接收来自身体和系统周围的各种传感器的输入的处理器。 加热器/冷却器装置可以是热电，以使得能够基于极性进行加热和冷却。 提供了一种用于使体温上升或下降而没有过冲的温度控制方案。 一次性热交换盒可以包括与可再使用的控制单元内的泵驱动机构接合的整体泵头。 可以设置多个控制单元以接收相同的热交换盒，使得最初可以使用大容量控制单元，并且一旦患者达到期望的目标温度，可以取代较小的电池供电的单元。

    Inhibition of platelet activation, aggregation and/or adhesion by hypothermia
    8.
    发明申请
    Inhibition of platelet activation, aggregation and/or adhesion by hypothermia 有权
    通过低温抑制血小板活化，聚集和/或粘附

    公开(公告)号：US20070038277A1

    公开(公告)日：2007-02-15

    申请号：US11501442

    申请日：2006-08-08

    申请人： Michael Dae ,  Timothy Machold ,  Wade Keller

    发明人： Michael Dae ,  Timothy Machold ,  Wade Keller

    IPC分类号： A61F7/00 ,  A61F7/12

    CPC分类号： A61F7/12 ,  A61F7/123 ,  A61F2007/126

    摘要： A method for treating acute coronary syndromes (i.e., unstable angina or non-Q-wave MI) or transient ischemic attacks in a human or animal patient by placing a heat exchange apparatus in the patient's vasculature and using that heat exchange apparatus to cool the patient to a temperature (e.g. 30-36° C.) at which platelet inhibition (i.e., inhibition of platelet activation and/or aggregation and/or adhesion) occurs. Anti-shivering drugs or anesthesia may be administered to patients whose body temperature is cooled below that patient's shivering threshold (typically approximately 35.5 C). If it is determined that platelet inhibition is no longer desirable, such as when the patient is about to undergo a surgical or interventional procedure wherein bleeding could be problematic, the hypothermia-induced platelet inhibition may be rapidly reversed by using the intravascular heat exchange apparatus to re-warm the patient's body to normothermia or near normothermia.

    摘要翻译： 一种通过将热交换装置放置在患者的脉管系统中并使用该热交换装置来冷却患者来治疗人或动物患者的急性冠状动脉综合征（即不稳定型心绞痛或非Q波MI）或短暂性脑缺血发作的方法 达到血小板抑制（即，抑制血小板活化和/或聚集和/或粘附）的温度（例如30-36℃）。 可以向体温冷却到患者发抖阈值以下（通常约35.5℃）的患者施用抗发抖药物或麻醉。 如果确定不再需要血小板抑制，例如当患者即将进行其中出血可能有问题的手术或介入手术时，通过使用血管内热交换装置可以快速逆转低体温诱导的血小板抑制 将患者的身体重温为正常体温或接近正常体温。