公开(公告)号：US08157831B2

公开(公告)日：2012-04-17

申请号：US11313175

申请日：2005-12-20

Applicant: Maciej J. Kieturakis ,  Helmut Kayan ,  Jan M. Echeverry ,  Thomas A. Howell ,  Kenneth H. Mollenauer ,  James E. Jervis

Inventor： Maciej J. Kieturakis ,  Helmut Kayan ,  Jan M. Echeverry ,  Thomas A. Howell ,  Kenneth H. Mollenauer ,  James E. Jervis

IPC: A61B17/00

CPC classification number: A61B17/0218 ,  A61B17/320016 ,  A61B17/3421 ,  A61B17/3439 ,  A61B18/08 ,  A61B90/361 ,  A61B2017/00557 ,  A61B2017/0212 ,  A61B2017/320044 ,  A61B2017/320048 ,  A61B2090/0813 ,  A61F2/0063 ,  A61F2002/0072 ,  A61M25/0668 ,  A61M25/1002 ,  A61M29/02

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layer to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creature of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdrawn through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.

Abstract translation: 一种用于隧道解剖的腹腔镜装置，包括中空隧道构件和设置在隧道构件的远端处的可膨胀气囊，以一起形成钝头填塞物。 隧道构件具有允许在其中插入常规腹腔镜的孔径以在外科手术期间提供观察。 腹腔镜可以通过隧道构件的开放远端直接观察解剖。 当设备用于在组织层与患者体内的感兴趣区域之间隧穿时，以及在随后的球囊充气期间，当组织层被解剖以引起组织层和解剖学的生物分离时， 工作空间。 解剖空间创建完毕后，通过切口取出装置和腹腔镜。 如果需要，可以将套针针插入切口中以提供对先前创建的外科手术进行空间的访问。 如果特定程序需要，解剖工作空间可以用吹入气体吹入。 通过将穿透构件插入形成球囊的球囊的内部，穿过隧道构件的通常为圆柱形的辊，并且优选地通过使用整体气囊盖将隧道构件插入到隧道构件 以形成半刚性钝头封闭器。

公开(公告)号：US08282665B2

公开(公告)日：2012-10-09

申请号：US11975901

申请日：2007-10-22

Applicant: Maciej J. Kieturakis ,  Kenneth H. Mollenauer ,  Jan M. Echeverry ,  Thomas A. Howell ,  James E. Jervis ,  Helmut Kayan ,  Janine C. Robinson

Inventor： Maciej J. Kieturakis ,  Kenneth H. Mollenauer ,  Jan M. Echeverry ,  Thomas A. Howell ,  James E. Jervis ,  Helmut Kayan ,  Janine C. Robinson

IPC: A61M29/02

CPC classification number: A61M25/1002 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/0218 ,  A61B17/320016 ,  A61B17/3421 ,  A61B17/3439 ,  A61B18/08 ,  A61B90/02 ,  A61B90/361 ,  A61B2017/00557 ,  A61B2017/00902 ,  A61B2017/0225 ,  A61B2017/320044 ,  A61B2017/320048 ,  A61B2017/320056 ,  A61B2090/0813 ,  A61F2/0063 ,  A61F2002/0072 ,  A61F2250/0003 ,  A61M25/0668 ,  A61M25/1027 ,  A61M29/02 ,  A61M2025/1004

Abstract: An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various apparatus permitting observation during tunneling and balloon dissection are disclosed. In one embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope inserted into the tubular member to permit observation of the procedure during tunneling to a desired location and balloon inflation. An elongated neck of the balloon is secured to the tunneling member, and permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation. After the balloon has been advanced to the desired location in the body it is inflated to dissect tissue and create an operating space. Various balloon constructions and a reusable design are also disclosed.

Abstract translation: 一种可扩展的隧道装置和相关联的方法，用于创建外科手术的解剖工作空间。 公开了在隧道掘进和气球解剖期间允许观察的各种装置。 在一个实施例中，管状构件具有延伸穿过其中的孔和敞开的远端。 在管状构件的远端形成唇缘以捕获插入到管状构件中的腹腔镜的远侧末端，以允许在隧穿期间观察手术到期望的位置和球囊膨胀。 气囊的细长的颈部被固定到隧道构件上，并且允许管状构件在充气之后从气囊中略微抽出以便于观察。 气囊已经进入身体所需的位置后，它被充气以解剖组织并创建一个操作空间。 还公开了各种气球结构和可重复使用的设计。

公开(公告)号：US08137368B2

公开(公告)日：2012-03-20

申请号：US12271103

申请日：2008-11-14

Applicant: Helmut Kayan ,  James E. Jervis

Inventor： Helmut Kayan ,  James E. Jervis

IPC: A61B17/08

CPC classification number: A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B2017/0042 ,  A61B2017/00429

Abstract: A blood vessel clip applicator includes two twist pins at one end, between which a blood vessel is placed before occlusion. A magazine in the blood vessel clip applicator holds a plurality of blood vessel clips and can be rotated independently from a grip assembly, whereby the twist pins can be rotated to compress a blood vessel held between them. The blood vessel clip is placed on the blood vessel after it has been flattened. The blood vessel clip includes spring quality material, and has a head connected to a first leg and a second leg. The magazine has a constricted region adjacent to an exit aperture. As the head enters the constricted region, the compressive force exerted on the head by the constricted region opens the blood vessel clip to an open position.

Abstract translation: 血管夹施加器在一端包括两个扭转销，在闭塞之前放置血管。 血管夹施加器中的杂志夹持多个血管夹，并且可以独立于手柄组件旋转，由此扭转销可以旋转以压缩保持在它们之间的血管。 血管夹被平坦化后放置在血管上。 血管夹包括弹簧质量材料，并且具有连接到第一腿部和第二腿部的头部。 杂志具有邻近出口孔的收缩区域。 当头进入收缩区域时，由收缩区域施加在头部上的压缩力将血管夹打开到打开位置。

公开(公告)号：US06695854B1

公开(公告)日：2004-02-24

申请号：US09450921

申请日：1999-11-29

Applicant: Helmut Kayan ,  James E. Jervis

Inventor： Helmut Kayan ,  James E. Jervis

IPC: A61B1704

CPC classification number: A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B2017/0042 ,  A61B2017/00429

Abstract: A blood vessel clip applicator preferably includes two twist pins at one end, between which a blood vessel is placed before occlusion. A magazine in the blood vessel clip applicator preferably holds a plurality of blood vessel clips and can be rotated independently from a grip assembly, whereby the twist pins can be rotated to compress a blood vessel held between them. A blood vessel clip is preferably placed on the blood vessel after it has been flattened. A blood vessel clip preferably comprises spring quality material, and preferably has a head connected to a first leg and a second leg. The magazine preferably has a constricted region adjacent to an exit aperture. As the head enters the constricted region, the compressive force exerted on the head by the constricted region opens the blood vessel clip to an open position. In an alternate embodiment, a plunger applies a blood vessel clip with a direct stroke. The plunger has a plurality of stepwise indentations used to restrain the blood vessel clips before application and for pushing them all forward substantially simultaneously during application. In an alternate embodiment, a variety of blood vessel clips having different shapes, cross-sections and grooves are suitable for use with the blood vessel clip applicator. The alternate blood vessel clip preferably have two legs in a “V” configuration and a head connecting the two legs. The constricted region compresses the head of the blood vessel clip as it passes through the constricted region, thereby closing the clip onto the blood vessel. These alternate embodiments may comprise substantially annealed metal.

Abstract translation: 优选地，血管夹施加器在一端包括两个扭转销，在闭塞之前放置血管。 血管夹施加器中的杂志优选地保持多个血管夹，并且可以独立于手柄组件旋转，由此扭转销可以旋转以压缩保持在它们之间的血管。 血管夹在平坦化之后优选放置在血管上。血管夹优选地包括弹簧质量材料，并且优选地具有连接到第一腿部和第二腿部的头部。 该盒优选地具有与出口孔相邻的收缩区域。 当头进入收缩区域时，通过收缩区域施加在头部上的压缩力将血管夹打开至打开位置。在替代实施例中，柱塞施加直接行程的血管夹。 柱塞具有多个逐步的压痕，用于在施用之前约束血管夹，并且在施用期间基本上同时推动它们。在替代实施例中，具有不同形状，横截面和凹槽的各种血管夹适合 用于血管夹施加器。 替代血管夹优选地具有“V”构型的两条腿和连接两条腿的头部。 收缩区域在通过收缩区域时压缩血管夹的头部，从而将夹子封闭在血管上。 这些替代实施例可以包括基本退火的金属。

公开(公告)号：US06632234B2

公开(公告)日：2003-10-14

申请号：US09873886

申请日：2001-06-04

Applicant: Maciej J. Kieturakis ,  Helmut Kayan ,  Jan M. Echeverry ,  Thomas A. Howell ,  Kenneth H. Mollenauer ,  James E. Jervis

Inventor： Maciej J. Kieturakis ,  Helmut Kayan ,  Jan M. Echeverry ,  Thomas A. Howell ,  Kenneth H. Mollenauer ,  James E. Jervis

IPC: A61B1700

CPC classification number: A61B17/0218 ,  A61B17/320016 ,  A61B17/3421 ,  A61B17/3439 ,  A61B18/08 ,  A61B90/361 ,  A61B2017/00557 ,  A61B2017/0212 ,  A61B2017/320044 ,  A61B2017/320048 ,  A61B2090/0813 ,  A61F2/0063 ,  A61F2002/0072 ,  A61M25/0668 ,  A61M25/1002 ,  A61M29/02

Abstract: A laparoscopic apparatus for tunneling dissection including a hollow tunneling member and an inflatable balloon disposed at the distal end of the tunneling member to form together a blunt tipped obturator. The tunneling member has a bore sized allow the insertion of a conventional laparoscope therein to provide observation during surgical procedures. The laparoscope provides direct observation of dissection through the open distal end of the tunneling member. Observation is provided both when the device is used to tunnel between tissue layers to a region of interest within the body of a patient, and during subsequent balloon inflation when the tissue layers are dissected to cause separation of the tissue layers and the creation of an anatomical working space. After the anatomic space has been created, the device and laparoscope are withdraw through the incision. If needed, a trocar can be inserted into the incision to provide access back to the previously created space where the surgical procedure is to be performed. The anatomic working space may be insufflated with an insufflation gas if required for the particular procedure. The apparatus is prepared for use by inserting the tunneling member into the interior of the balloon, forming the balloon into a generally cylindrical roll about the tunneling member, and preferably, through the use of an integral balloon cover, securing the balloon roll to the tunneling member to form a semi-rigid blunt tipped obturator.

Abstract translation: 一种用于隧道解剖的腹腔镜装置，包括中空隧道构件和设置在隧道构件的远端处的可膨胀气囊，以一起形成钝头填塞物。 隧道构件具有允许在其中插入常规腹腔镜的孔径以在外科手术期间提供观察。 腹腔镜可以通过隧道构件的开放远端直接观察解剖。 当设备用于在组织层之间隧穿到患者身体内的感兴趣区域时，以及在随后的球囊充气期间，当组织层被解剖以引起组织层的分离和创建解剖学 工作空间。 解剖空间创建完毕后，装置和腹腔镜通过切口退出。 如果需要，可以将套针针插入切口中以提供对先前创建的外科手术进行空间的访问。 如果特定程序需要，解剖工作空间可以用吹入气体吹入。 通过将隧道构件插入球囊的内部来准备该装置，将球囊形成围绕隧道构件的大致圆柱形的辊，并且优选地，通过使用整体气囊盖，将球囊固定到隧道 成员形成一个半刚性钝头封闭器。

公开(公告)号：US06537289B1

公开(公告)日：2003-03-25

申请号：US09689220

申请日：2000-10-11

Applicant: Helmut Kayan ,  James E. Jervis

Inventor： Helmut Kayan ,  James E. Jervis

IPC: A61B1704

CPC classification number: A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B2017/0042 ,  A61B2017/00429

Abstract: A blood vessel clip, preferably comprising spring quality material, has a head connected to a first leg and a second leg. Preferably, the two legs of the blood vessel clip are in a “V” configuration so that a blood vessel can be located therebetween. The blood vessel clip is adapted so that, when forced axially through a constricted region of a clip applicator, a compressive force is exerted on the head by the constricted region. This compressive force causes the legs of the clip to move closer relative to one another, thereby closing the clip and occluding a blood vessel located between the two legs. A variety of blood vessel clips having different shapes, cross-sections and grooves suitable for occluding a blood vessel are described.

Abstract translation: 优选地包括弹簧质量材料的血管夹具有连接到第一腿部和第二腿部的头部。 优选地，血管夹的两条腿处于“V”形状，使得血管位于它们之间。 血管夹被适配成使得当被迫轴向穿过夹子施加器的收缩区域时，压缩力由收缩区域施加在头部上。 该压缩力使得夹子的腿相对于彼此移动更靠近，从而闭合夹子并阻塞位于两个腿之间的血管。 描述了具有不同形状，各种适合于阻塞血管的截面和凹槽的血管夹。

公开(公告)号：US6004337A

公开(公告)日：1999-12-21

申请号：US990385

申请日：1997-12-15

Applicant: Maciej K. Kieturakis ,  Helmut Kayan ,  Jan M. Echeverry ,  Thomas A. Howell ,  Kenneth H. Mollenauer ,  James E. Jervis

Inventor： Maciej K. Kieturakis ,  Helmut Kayan ,  Jan M. Echeverry ,  Thomas A. Howell ,  Kenneth H. Mollenauer ,  James E. Jervis

IPC: A61B17/32 ,  A61B17/00

CPC classification number: A61B17/32 ,  A61B2017/320048

Abstract: Apparatus for creating an anatomic space in tissue in a body of a patient using a cannula with proximal and distal extremities and a bore extending therethrough to provide an open end. A balloon having an inflated space is provided. The balloon is capable of assuming collapsed and inflated conditions. A retainer is carried by the balloon for forming the balloon when in a collapsed condition into a generally cylindrical roll to aid in inserting the balloon into the tissue. An obturator shaft having a rounded distal end is sized so that it extends through the cannula and into the roll. A laparoscope can be introduced into the obturator shaft to permit viewing through the obturator shaft and the balloon. An inflation tube is provided for inflating the balloon after it is disposed in the tissue to cause the balloon to progressively expand to create separation forces in the tissue to create the anatomic space.

Abstract translation: 用于使用具有近端和远端四肢的套管以及穿过其延伸以提供开放端的孔来在患者身体中的组织中产生解剖空间的装置。 提供具有充气空间的气球。 气球能够承担塌缩和膨胀的状况。 保持器由气囊承载，以在塌缩状态下形成气囊以形成大致圆柱形的辊以有助于将气囊插入组织中。 具有圆形远端的闭孔轴的尺寸设计成使得其延伸穿过套管并进入辊中。 腹腔镜可以被引入到闭孔轴中以允许通过闭孔轴和气囊观察。 提供充气管，用于在将气囊放置在组织中之后对气囊进行充气，以使气囊逐渐膨胀以在组织中产生分离力以产生解剖空间。

公开(公告)号：US20090076533A1

公开(公告)日：2009-03-19

申请号：US12271103

申请日：2008-11-14

Applicant: Helmut Kayan ,  James E. Jervis

Inventor： Helmut Kayan ,  James E. Jervis

IPC: A61B17/122

CPC classification number: A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B2017/0042 ,  A61B2017/00429

Abstract: A blood vessel clip applicator preferably includes two twist pins at one end, between which a blood vessel is placed before occlusion. A magazine in the blood vessel clip applicator preferably holds a plurality of blood vessel clips and can be rotated independently from a grip assembly, whereby the twist pins can be rotated to compress a blood vessel held between them. A blood vessel clip is preferably placed on the blood vessel after it has been flattened.A blood vessel clip preferably comprises spring quality material, and preferably has a head connected to a first leg and a second leg. The magazine preferably has a constricted region adjacent to an exit aperture. As the head enters the constricted region, the compressive force exerted on the head by the constricted region opens the blood vessel clip to an open position.In an alternate embodiment, a plunger applies a blood vessel clip with a direct stroke. The plunger has a plurality of stepwise indentations used to restrain the blood vessel clips before application and for pushing them all forward substantially simultaneously during application.In an alternate embodiment, a variety of blood vessel clips having different shapes, cross-sections and grooves are suitable for use with the blood vessel clip applicator. The alternate blood vessel clip preferably have two legs in a “V” configuration and a head connecting the two legs. The constricted region compresses the head of the blood vessel clip as it passes through the constricted region, thereby closing the clip onto the blood vessel. These alternate embodiments may comprise substantially annealed metal.

Abstract translation: 优选地，血管夹施加器在一端包括两个扭转销，在闭塞之前放置血管。 血管夹施加器中的杂志优选地保持多个血管夹，并且可以独立于手柄组件旋转，由此扭转销可以旋转以压缩保持在它们之间的血管。 血管夹在平坦化之后优选放置在血管上。 血管夹优选地包括弹簧质量材料，并且优选地具有连接到第一腿部和第二腿部的头部。 该盒优选地具有与出口孔相邻的收缩区域。 当头进入收缩区域时，由收缩区域施加在头部上的压缩力将血管夹打开到打开位置。 在替代实施例中，柱塞施加具有直接冲程的血管夹。 柱塞具有多个阶梯式压痕，用于在施用之前约束血管夹，并且在施用期间基本上同时推动它们。 在替代实施例中，具有不同形状，横截面和凹槽的各种血管夹适用于血管夹施加器。 替代血管夹优选地具有“V”构型的两条腿和连接两条腿的头部。 收缩区域在通过收缩区域时压缩血管夹的头部，从而将夹子封闭在血管上。 这些替代实施例可以包括基本退火的金属。

公开(公告)号：US06673083B1

公开(公告)日：2004-01-06

申请号：US09689208

申请日：2000-10-11

Applicant: Helmut Kayan ,  James E. Jervis

Inventor： Helmut Kayan ,  James E. Jervis

IPC: A61B1704

CPC classification number: A61B17/122 ,  A61B17/1227 ,  A61B17/1285 ,  A61B2017/0042 ,  A61B2017/00429

Abstract: A blood vessel clip applicator comprises a magazine adapted to hold a plurality of blood vessel clips therein and two twist pins at one end, whereby the twist pins can be rotated to compress a blood vessel held between them. A blood vessel clip, having a head connected to first and second legs in a “V” configuration, is placed on the blood vessel after it has been flattened. The magazine has a constricted region adjacent to an exit aperture. As the head of a blood vessel clip passes through the constricted region, the compressive force exerted on the head by the constricted region opens or closes the legs of the blood vessel clip. A variety of blood vessel clips having different shapes, cross-sections and grooves are suitable for use with the blood vessel clip applicator.

Abstract translation: 血管夹施加器包括适于在其中容纳多个血管夹的盒，在一端保持两个捻针，由此扭转销可以旋转以压缩保持在它们之间的血管。 具有以“V”形式连接到第一和第二腿的头部的血管夹在其被平坦化之后放置在血管上。 杂志具有邻近出口孔的收缩区域。 当血管夹的头部通过收缩区域时，由收缩区域施加在头部上的压缩力打开或关闭血管夹的腿部。 具有不同形状，横截面和凹槽的各种血管夹适用于血管夹施加器。

公开(公告)号：US6129736A

公开(公告)日：2000-10-10

申请号：US250969

申请日：1999-02-16

Applicant: James E. Jervis ,  Helmut Kayan

Inventor： James E. Jervis ,  Helmut Kayan

IPC: A61B17/00 ,  A61B17/02 ,  A61B17/32 ,  A61B17/34 ,  A61F2/00 ,  A61M25/00 ,  A61B19/00

CPC classification number: A61B17/0218 ,  A61B2017/00557 ,  A61B2017/320044 ,  A61B90/02 ,  A61F2/0063 ,  A61F2002/0072

Abstract: The present invention relates to an expansible tunneling apparatus suitable for tissue dissection. The apparatus is provided with a cannula-loading shaft at its proximal end such that a cannula chosen from a range of different cannulas may be loaded over the cannula-loading shaft and installed in an anatomic space created by the expansible tunneling apparatus. The apparatus is also provided with an inflatable member such as a balloon to accomplish the dissection and a sleeve covering the balloon which are removed from the apparatus before the cannula is loaded on the cannula-loading shaft.

Abstract translation: 本发明涉及适用于组织剥离的可扩展隧道装置。 该设备在其近端处设置有插管加载轴，使得从一定范围的不同插管中选择的插管可以被加载在套管装载轴上并且安装在由可膨胀隧道装置产生的解剖空间中。 该装置还设置有可充气构件，例如气囊，以完成解剖，以及覆盖气囊的套筒，其在将套管装载到套管装载轴之前从装置移除。