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:
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 When the endoscope is withdrawn proximally, the selected curves can propagate distally along the endoscope body.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:
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:
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:
The present invention relates, generally, to the reduction or elimination of permanent and catastrophic herniations in Bowden cables or coil pipes in articulating devices or snake-like robots. More particularly, the present invention relates managing the coil pipes in a spiral pattern along the articulating device or snake-like robot to reduce or eliminate the necessity of the Bowden cables or coil pipes to slide along the length of the articulating device or snake-like robot. Reduction or elimination of the necessity for the Bowden cables or coil pipes to slide reduces or eliminates catastrophic herniations in articulating devices or snake-like robots undergoing one or more articulations.
摘要:
The present invention relates, generally, to the reduction or elimination of permanent and catastrophic herniations in Bowden cables or coil pipes in articulating devices or snake-like robots. More particularly, the present invention relates managing the coil pipes in a spiral pattern along the articulating device or snake-like robot to reduce or eliminate the necessity of the Bowden cables or coil pipes to slide along the length of the articulating device or snake-like robot. Reduction or elimination of the necessity for the Bowden cables or coil pipes to slide reduces or eliminates catastrophic herniations in articulating devices or snake-like robots undergoing one or more articulations.
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:
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.