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公开(公告)号:US20080147084A1
公开(公告)日:2008-06-19
申请号:US11952934
申请日:2007-12-07
申请人: Jeffrey L. Bleich , Gregory Schmitz , Roy Leguidleguid , Ronald Leguidleguid , Nestor C. Cantorna , Michael P. Wallace
发明人: Jeffrey L. Bleich , Gregory Schmitz , Roy Leguidleguid , Ronald Leguidleguid , Nestor C. Cantorna , Michael P. Wallace
IPC分类号: A61B17/32
CPC分类号: A61B17/3207 , A61B17/149 , A61B17/320016 , A61B17/32002 , A61B2017/00261 , A61B2017/320004 , A61B2017/320008 , A61B2017/32006
摘要: A device for modifying tissue in a patient may include: an elongate body having a rigid proximal portion and a flexible distal portion having first and second major surfaces; a proximal handle coupled with the proximal portion of the body; one or more tissue modifying members disposed along the first major surface of the distal portion of the body; a guidewire coupled with and extending from the distal portion of the body; and a distal handle removably coupleable with the guidewire outside the patient.
摘要翻译: 用于修改患者组织的装置可以包括:细长体,其具有刚性近端部分和具有第一和第二主表面的柔性远侧部分; 与所述主体的近侧部分联接的近侧手柄; 沿着身体远端部分的第一主表面设置的一个或多个组织修改构件; 与所述主体的所述远端部分连接并从所述远端部分延伸的导丝; 以及远离手柄,其可拆卸地与患者外部的导丝连接。
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公开(公告)号:US20100274250A1
公开(公告)日:2010-10-28
申请号:US12773595
申请日:2010-05-04
申请人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
发明人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
IPC分类号: A61B17/16
CPC分类号: A61B17/025 , A61B5/4893 , A61B17/0218 , A61B17/7062 , A61B2017/0256 , A61B2017/32006 , A61M25/01 , A61M25/0105 , A61M25/0133 , A61M25/0136 , A61M25/09 , A61M29/02
摘要: Described herein are devices, systems and methods for cutting tissue in a patient. In some embodiments, a tissue modification region of a device includes a pair of flexible elongate cutting members extending along the length of the tissue modification region. Each elongate cutting member may be configured to cut a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. In some embodiments, the device includes a spacer. The spacer may be sized and configured to operate in one of two modes. A first mode, in which the spacer is coupled to the cutting members such that it holds a portion of each of the two cutting members a distance from one another, and a second mode, in which at least a portion of the spacer is moved away from a cutting member to allow the cutting members to cut further into tissue.
摘要翻译: 这里描述了用于切割患者组织的装置,系统和方法。 在一些实施例中,装置的组织修改区域包括沿着组织修改区域的长度延伸的一对柔性细长切割构件。 每个细长的切割构件可以被配置成将离散的槽切割成组织到比切割构件的厚度大的深度。 在一些实施例中,该装置包括间隔件。 间隔件的尺寸和构造可以以两种模式之一来操作。 第一模式,其中间隔件联接到切割构件,使得其将两个切割构件中的每一个的一部分保持彼此的距离,以及第二模式,其中至少一部分间隔件移开 从切割构件允许切割构件进一步切割成组织。
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公开(公告)号:US08409206B2
公开(公告)日:2013-04-02
申请号:US12773595
申请日:2010-05-04
申请人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
发明人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
IPC分类号: A61B17/00
CPC分类号: A61B17/025 , A61B5/4893 , A61B17/0218 , A61B17/7062 , A61B2017/0256 , A61B2017/32006 , A61M25/01 , A61M25/0105 , A61M25/0133 , A61M25/0136 , A61M25/09 , A61M29/02
摘要: Described herein are devices, systems and methods for cutting tissue in a patient. In some embodiments, a tissue modification region of a device includes a pair of flexible elongate cutting members extending along the length of the tissue modification region. Each elongate cutting member may be configured to cut a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. In some embodiments, the device includes a spacer. The spacer may be sized and configured to operate in one of two modes. A first mode, in which the spacer is coupled to the cutting members such that it holds a portion of each of the two cutting members a distance from one another, and a second mode, in which at least a portion of the spacer is moved away from a cutting member to allow the cutting members to cut further into tissue.
摘要翻译: 这里描述了用于切割患者组织的装置,系统和方法。 在一些实施例中,装置的组织修改区域包括沿着组织修改区域的长度延伸的一对柔性细长切割构件。 每个细长的切割构件可以被配置成将离散的槽切割成组织到比切割构件的厚度大的深度。 在一些实施例中,该装置包括间隔件。 间隔件的尺寸和构造可以以两种模式之一来操作。 第一模式,其中间隔件联接到切割构件,使得其将两个切割构件中的每一个的一部分保持彼此的距离,以及第二模式,其中至少一部分间隔件移开 从切割构件允许切割构件进一步切割成组织。
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公开(公告)号:US20120143206A1
公开(公告)日:2012-06-07
申请号:US13338134
申请日:2011-12-27
IPC分类号: A61B17/68
CPC分类号: A61B17/00234 , A61B17/1659 , A61B17/1671 , A61B2017/00469 , A61B2017/0256 , A61B2017/320044
摘要: Described herein are devices and methods for positioning a wire around a target tissue. In some embodiments, a probe device includes a rigid outer cannula having a curved distal region and a flexible inner cannula slideably disposed within the rigid outer cannula, wherein the inner cannula is configured to assume a curved shape when extended distally from the outer cannula. In some embodiments, the probe device further includes a distal tip at the distal end of the inner cannula and a safety retainer cable coupled to the distal tip and secured to the probe proximally from the distal end of the safety retainer; wherein the safety retainer cable extends proximally from the distal tip and is slack. In some embodiments, the inner cannula comprises an elongate body with a longitudinally extending support member and a longitudinally extending tubular body, configured to pass a wire, disposed inside the elongate body.
摘要翻译: 这里描述的是用于将线定位在靶组织周围的装置和方法。 在一些实施例中,探针装置包括刚性外套管,其具有弯曲的远侧区域和可滑动地设置在刚性外套管内的柔性内套管,其中,当从外插管向远侧延伸时,内套管构造成呈弯曲形状。 在一些实施例中,探针装置还包括在内套管的远端处的远侧末端和联接到远侧末端并从安全保持器的远端近侧固定到探头的安全保持器线缆; 其中所述安全保持器电缆从所述远侧末端向近侧延伸并且是松弛的。 在一些实施例中,内插管包括具有纵向延伸的支撑构件和纵向延伸的管状体的细长主体,该主体构造成通过设置在细长主体内部的导线。
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公开(公告)号:US20120095468A1
公开(公告)日:2012-04-19
申请号:US13338103
申请日:2011-12-27
申请人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
发明人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
IPC分类号: A61B17/16
CPC分类号: A61B17/025 , A61B5/4893 , A61B17/0218 , A61B17/1671 , A61B17/32 , A61B17/320016 , A61B17/7032 , A61B17/7062 , A61B17/864 , A61B2017/0256 , A61B2017/32006
摘要: Described herein are devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; at least two flexible elongate lengths of cable that extend substantially adjacent to each other proximally to distally; a plurality of rungs extending between the lengths of cable; and a pair of flexible elongate cutting members extending along the length of the tissue modification region of the device. Each elongate cutting member has a thickness cuts a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. The device may further include a substrate sized and configured to releasably hold the cutting members a distance from one another and a pair of couplers positioned toward an outer edge region of the substrate and configured to releasably secure a cutting member to the outer edge region of the substrate.
摘要翻译: 本文描述了用于在患者体内切割组织的装置和方法。 在一些实施例中,双手控制的装置可以包括组织修改区域; 至少两个柔性长度的电缆,其基本上彼此相邻地向远侧延伸延伸; 在电缆长度之间延伸的多个梯级; 以及沿设备的组织修改区域的长度延伸的一对柔性细长切割构件。 每个细长的切割构件具有将离散凹槽切割成组织的厚度,其厚度大于切割构件的厚度。 该装置还可以包括基板,其尺寸和构造为将切割构件可释放地保持彼此间隔一定距离;以及一对耦合器,其朝向基板的外边缘区域定位,并且构造成将切割构件可释放地固定到外部边缘区域 基质。
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公开(公告)号:US08845639B2
公开(公告)日:2014-09-30
申请号:US13007381
申请日:2011-01-14
申请人: Michael P. Wallace , Robert Garabedian , Gregory P. Schmitz , Jeffery L. Bleich , Nestor C. Cantorna , Ronald Leguidleguid , Roy Leguidleguid , Michael Sheinberg
发明人: Michael P. Wallace , Robert Garabedian , Gregory P. Schmitz , Jeffery L. Bleich , Nestor C. Cantorna , Ronald Leguidleguid , Roy Leguidleguid , Michael Sheinberg
CPC分类号: A61B17/1671 , A61B17/149 , A61B17/1659 , A61B17/320016 , A61B17/32002 , A61B17/3207 , A61B2017/00261 , A61B2017/320004 , A61B2017/320008 , A61B2017/32006 , A61B2017/32008 , A61B2090/3925 , A61B2090/3954 , A61B2090/3966
摘要: Described herein are elongate devices for modifying tissue having a plurality of flexibly connected and rungs or links, and methods of using them, including methods of using them to decompress stenotic spinal tissue. These devices may be included as part of a system for modifying tissue. In general, these devices include a plurality of blades positioned on for formed from) rungs that are flexibly connected and may be separated by one or more spacers. The rungs are typically wider than they are long (e.g., rectangular). The rungs may be arranged, ladder like, and may be connected by a flexible connector substrate or between two or more cables. Different sized rungs may be used, or rungs with different cutting properties. In some variations the tissue modification devices may have a non-linear axial shape, or may be converted from a first axial shape to a second axial shape.
摘要翻译: 本文描述的是用于修改具有多个柔性连接和梯级或链节的组织的细长装置,以及使用它们的方法,包括使用它们来减压狭窄的脊髓组织的方法。 可以将这些装置作为用于修改组织的系统的一部分。 通常,这些装置包括多个叶片,其位于用于形成的梯级上,所述多个叶片被柔性地连接并且可被一个或多个间隔件隔开。 梯级通常比它们长(例如,矩形)宽。 梯级可以布置成梯子,并且可以通过柔性连接器基板或两根或更多根电缆连接。 可以使用不同尺寸的梯级,或者具有不同切割性能的梯级。 在一些变型中,组织改变装置可以具有非线性轴向形状,或者可以从第一轴向形状转换成第二轴向形状。
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公开(公告)号:US08398641B2
公开(公告)日:2013-03-19
申请号:US13338103
申请日:2011-12-27
申请人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
发明人: Michael P. Wallace , Robert Garabedian , Nestor C. Cantorna , Jeffery L. Bleich , Roy Leguidleguid , Ronald Leguidleguid
IPC分类号: A61B17/00
CPC分类号: A61B17/025 , A61B5/4893 , A61B17/0218 , A61B17/1671 , A61B17/32 , A61B17/320016 , A61B17/7032 , A61B17/7062 , A61B17/864 , A61B2017/0256 , A61B2017/32006
摘要: Described herein are devices and methods for cutting tissue in a patient. In some embodiments, a bimanually controlled device may include a tissue modification region; at least two flexible elongate lengths of cable that extend substantially adjacent to each other proximally to distally; a plurality of rungs extending between the lengths of cable; and a pair of flexible elongate cutting members extending along the length of the tissue modification region of the device. Each elongate cutting member has a thickness cuts a discrete trough into tissue to a depth that is greater than the thickness of the cutting member. The device may further include a substrate sized and configured to releasably hold the cutting members a distance from one another and a pair of couplers positioned toward an outer edge region of the substrate and configured to releasably secure a cutting member to the outer edge region of the substrate.
摘要翻译: 本文描述了用于在患者体内切割组织的装置和方法。 在一些实施例中,双手控制的装置可以包括组织修改区域; 至少两个柔性长度的电缆,其基本上彼此相邻地向远侧延伸延伸; 在电缆长度之间延伸的多个梯级; 以及沿设备的组织修改区域的长度延伸的一对柔性细长切割构件。 每个细长的切割构件具有将离散凹槽切割成组织的厚度,其厚度大于切割构件的厚度。 该装置还可以包括基板,其尺寸和构造为将切割构件可释放地保持彼此间隔一定距离;以及一对耦合器,其朝向基板的外边缘区域定位,并且构造成将切割构件可释放地固定到外部边缘区域 基质。
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公开(公告)号:US20110004207A1
公开(公告)日:2011-01-06
申请号:US12724315
申请日:2010-03-15
申请人: Michael P. Wallace , Benjamin Kao-Shing Sun , Michael Sheinberg , Jeffrey L. Bleich , Gregory P. Schimitz , Roy Leguidleguid , Gary A. Schniederman
发明人: Michael P. Wallace , Benjamin Kao-Shing Sun , Michael Sheinberg , Jeffrey L. Bleich , Gregory P. Schimitz , Roy Leguidleguid , Gary A. Schniederman
CPC分类号: A61N1/0551 , A61B5/04001 , A61B5/0488 , A61B5/1107 , A61B5/4519 , A61B5/4893 , A61B5/6852 , A61B5/6855 , A61B17/149 , A61B17/1671 , A61B17/1757 , A61B17/7092 , A61B17/8897 , A61B2562/0261 , A61B2562/043 , A61B2562/046 , A61N1/0553
摘要: Described herein are devices, systems and methods for determining if a nerve is nearby a device or portion of a device. The neural stimulation tools described herein are configured to be flexible and low-profile, so that they can be used within body regions that may be tortuous or difficult to reach, such as within a compressed or partially occluded neural foramen. In most cases, these tools described herein are ribbon-shaped and adapted to be manipulated bimanually, for example, by applying force to the ends of the devices from separate locations outside of the patient's body. Thus, in some of the exemplary neural localization devices described herein, the distal end region of the device are configured to couple to the proximal end of a guidewire. One or more surfaces of the devices may include an electrode or multi-polar network of electrodes configured to stimulate only nerves within a predetermined distance of a particular face of the device.
摘要翻译: 本文描述了用于确定神经是否在设备或设备的一部分附近的装置,系统和方法。 本文所述的神经刺激工具被配置为柔性和低轮廓,使得它们可以在可能曲折或难以到达的身体区域内使用,例如在压缩或部分闭塞的神经孔内。 在大多数情况下,这里描述的这些工具是带状的并且适于双手操作,例如通过从患者身体外部的分离位置向装置的端部施加力。 因此,在本文所述的一些示例性神经定位装置中,装置的远端区域被配置为耦合到导丝的近端。 器件的一个或多个表面可以包括电极或多极电极网络,其被配置为仅在装置的特定面部的预定距离内刺激神经。
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公开(公告)号:US20100004654A1
公开(公告)日:2010-01-07
申请号:US12496094
申请日:2009-07-01
申请人: Gregory P. SCHMITZ , Michael P. Wallace , Winnie Chung , Amie R. Borgstrom , Jeffery L. Bleich , Gregory B. Arcenio , Ronald Leguidleguid , Roy Leguidleguid
发明人: Gregory P. SCHMITZ , Michael P. Wallace , Winnie Chung , Amie R. Borgstrom , Jeffery L. Bleich , Gregory B. Arcenio , Ronald Leguidleguid , Roy Leguidleguid
IPC分类号: A61B17/60
CPC分类号: A61B17/025 , A61B17/0218 , A61B17/7065 , A61B2017/0256 , A61B2017/32006 , A61M29/02
摘要: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire through the body from a first location, around a curved pathway, and out of the body through a second location, so that the distal and proximal ends of the guidewire extend from the body, then pulling a device into position using the guidewire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to the device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body. Devices to modify tissue may also be positioned or manipulated so that a target tissue within the body is modified.
摘要翻译: 这里描述的是通过首先将引导线或拉线从第一位置,绕弯曲的路径定位穿过身体,并通过第二位置离开身体来精确地放置和/或操纵身体内的装置的方法和系统,使得 导丝的远端和近端从主体延伸,然后使用导丝将装置拉入位置。 定位在主体内的装置与导丝的近端相连,并且通过拉动从身体延伸的导丝的远端将装置拉入身体。 该装置可以通过向远侧拉动导丝线以及向近端延伸的装置的附件进行双手操纵,从而允许近端和远端的控制。 以这种方式,可以在体内定位和/或操纵装置(并且特别是植入物,例如内侧牵引器,刺激引线和盘吊带)。 修改组织的装置也可以被定位或操纵,从而改变身体内的目标组织。
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公开(公告)号:US08568416B2
公开(公告)日:2013-10-29
申请号:US13588969
申请日:2012-08-17
申请人: Gregory P. Schmitz , Michael P. Wallace , Winnie Chung , Amie R. Borgstrom , Jeffery L. Bleich , Gregory B. Arcenio , Ronald Leguidleguid , Roy Leguidleguid , Jefferey Bleam
发明人: Gregory P. Schmitz , Michael P. Wallace , Winnie Chung , Amie R. Borgstrom , Jeffery L. Bleich , Gregory B. Arcenio , Ronald Leguidleguid , Roy Leguidleguid , Jefferey Bleam
IPC分类号: A61B17/00
CPC分类号: A61F2/4611 , A61B5/0488 , A61B5/1076 , A61B5/1101 , A61B5/407 , A61B5/7207 , A61B10/0275 , A61B10/0283 , A61B17/0218 , A61B17/06109 , A61B17/149 , A61B17/1604 , A61B17/1611 , A61B17/1626 , A61B17/1635 , A61B17/1659 , A61B17/1671 , A61B17/1757 , A61B17/29 , A61B17/320016 , A61B17/32002 , A61B17/320068 , A61B17/32053 , A61B17/3207 , A61B17/320708 , A61B17/320758 , A61B17/320783 , A61B17/3401 , A61B17/3403 , A61B17/3421 , A61B17/3468 , A61B17/3496 , A61B17/683 , A61B17/7065 , A61B17/7068 , A61B17/7092 , A61B17/842 , A61B17/8897 , A61B18/02 , A61B18/14 , A61B18/1477 , A61B18/1487 , A61B18/20 , A61B90/04 , A61B90/39 , A61B2017/00039 , A61B2017/00261 , A61B2017/00287 , A61B2017/003 , A61B2017/00349 , A61B2017/00469 , A61B2017/00477 , A61B2017/00557 , A61B2017/00867 , A61B2017/00986 , A61B2017/0225 , A61B2017/320004 , A61B2017/320008 , A61B2017/320044 , A61B2017/32006 , A61B2018/0044 , A61B2018/00565 , A61B2018/00577 , A61B2018/00595 , A61B2018/00601 , A61B2018/1407 , A61B2018/1412 , A61B2018/1425 , A61B2018/1465 , A61B2034/2048 , A61B2090/0427 , A61B2090/061 , A61B2090/064 , A61B2090/08021 , A61F2/0063 , A61M25/09041 , A61M25/0905 , A61N1/0551 , A61N1/08 , A61N2001/0578
摘要: Described herein are methods and systems for precisely placing and/or manipulating devices within the body by first positioning a guidewire or pullwire. The device to be positioned within the body is coupled to the proximal end of the guidewire, and the device is pulled into the body by pulling on the distal end of the guidewire that extends from the body. The device may be bimanually manipulated by pulling the guidewire distally, and an attachment to a device that extends proximally, allowing control of both the proximal and the distal ends. In this manner devices (and particularly implants such as innerspinous distracters, stimulating leads, and disc slings) may be positioned and/or manipulated within the body. Guidewire exchange systems, devices and methods are also described. A guidewire may be exchanged between different surgical devices and may be releaseably or permanently coupled.
摘要翻译: 这里描述的是通过首先定位导丝或拉线来精确地放置和/或操纵装置在体内的方法和系统。 定位在主体内的装置与导丝的近端相连,并且通过拉动从身体延伸的导丝的远端将装置拉入身体。 该装置可以通过将导丝线向远侧拉动和向近端延伸的装置的附件进行双手操作,从而允许近端和远端的控制。 以这种方式,可以在体内定位和/或操纵装置(并且特别是植入物,例如内侧牵引器,刺激引线和盘吊带)。 还将描述导丝交换系统,装置和方法。 导线可以在不同的手术装置之间交换,并且可以是可释放地或永久地耦合的。
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