公开(公告)号：US20080058728A1

公开(公告)日：2008-03-06

申请号：US11880499

申请日：2007-07-23

申请人： Michael Soltz ,  Megan Prommersberger ,  Richard Gresham

发明人： Michael Soltz ,  Megan Prommersberger ,  Richard Gresham

IPC分类号： A61M25/04

CPC分类号： A61B17/3417 ,  A61B2017/00898 ,  A61B2017/00942 ,  A61B2017/3419 ,  A61B2017/3484

摘要： A stabilizer is provided to secure and fix the position of a cannula assembly relative to tissue. The stabilizer is a liquid swellable member which expands within an incision in tissue in response to the absorption of a liquid. The stabilizer includes an inner adhesive layer to secure the stabilizer relative to a cannula assembly. The stabilizer is formed of a polymeric gel or foam. In one embodiment, the stabilizer is fixedly secured to an elongate tubular member of a cannula assembly. In an alternative embodiment, the stabilizer is mounted for longitudinal movement along an elongate tubular member of a cannula assembly.

摘要翻译： 提供稳定器以固定和固定插管组件相对于组织的位置。 稳定剂是液体可膨胀的构件，其响应于液体的吸收而在组织内的切口内膨胀。 稳定器包括内部粘合剂层，以相对于插管组件固定稳定器。 稳定剂由聚合物凝胶或泡沫形成。 在一个实施例中，稳定器固定地固定到套管组件的细长管状构件上。 在替代实施例中，稳定器被安装成沿着套管组件的细长管状构件纵向移动。

公开(公告)号：US20070088258A1

公开(公告)日：2007-04-19

申请号：US11249830

申请日：2005-10-13

申请人： Thomas Wenchell ,  Richard Gresham

发明人： Thomas Wenchell ,  Richard Gresham

IPC分类号： A61M29/00

CPC分类号： A61B17/34 ,  A61B2017/3419 ,  A61B2017/3484 ,  A61B2017/3486

摘要： Apparatus and methods for providing access to a body cavity without substantial loss of inflation gas therein. The apparatus includes an access assembly that has a tubular member having a proximal end, a distal end, an elastic portion interposed the proximal end and the distal end, and a lumen therethrough. An anchor sleeve is disposed coaxially over the tubular member and has a radially expandable region. The anchor sleeve is moveable between an axially elongated configuration and an axially shortened configuration and is biased toward the axially shortened configuration by a force exerted by the elastic portion of the tubular member. The axially shortened configuration corresponds to the anchor sleeve being in the fully deployed position. Methods for providing anchored access to a cavity within a patient are also disclosed.

摘要翻译： 用于提供进入体腔的装置和方法，其中不会充分损失充气气体。 该装置包括一个入口组件，该入口组件具有管状构件，该管状构件具有近端，远端，插入近端和远端的弹性部分和穿过其中的内腔。 锚定套筒同轴地设置在管状构件上并且具有可径向扩张的区域。 锚定套筒可以在轴向细长构型和轴向缩短构型之间移动，并且通过由管状构件的弹性部分施加的力而被朝向轴向缩短构型偏压。 轴向缩短的配置对应于处于完全展开位置的锚定套筒。 还公开了用于提供对患者内的腔的锚定通路的方法。

公开(公告)号：US20050023325A1

公开(公告)日：2005-02-03

申请号：US10472402

申请日：2002-04-03

申请人： Richard Gresham ,  Scott Manzo ,  Ernest Aranyi ,  Robert Geiste ,  Bruce Jankowski ,  Keith Milliman

发明人： Richard Gresham ,  Scott Manzo ,  Ernest Aranyi ,  Robert Geiste ,  Bruce Jankowski ,  Keith Milliman

IPC分类号： A61B17/00 ,  A61B17/115 ,  A61B17/34 ,  A61B17/04

CPC分类号： A61B17/1155 ,  A61B17/115 ,  A61B17/34 ,  A61B2017/00128 ,  A61B2017/07257 ,  A61B2017/2905

摘要： The present disclosure is directed to a surgical stapling device (10) for performing circular anastomoses. The surgical stapling device includes a handle portion (12), an elongated body portion (14) and a head portion (16) including an anvil assembly (30) and a shell assembly (31). The handle portion (12) includes a rotatable approximation knob (22) for approximating the anvil and shell assemblies (30,31) and a firing trigger (20) for actuating a firing mechanism for ejecting staples positioned within the shell assembly (31). The firing trigger (20) forms one link of a two bar linkage provided to actuate the firing mechanism. The anvil assembly (30) includes a tiltable anvil which will tilt automatically after firing of the device and unapproximating the anvil and shell assemblies (30,31). The head portion (16) also includes a retractable trocar assembly (240) which is slidably positioned within an anvil retainer (38) and is automatically advanced and retracted upon attachment and detachment of the anvil assembly (30) onto the anvil retainer (38). A lockout tube (270) is provided and is positioned about the anvil retainer (38) for releasably engaging an anvil assembly (30). The lockout tube (270) prevents inadvertent detachment of the anvil assembly (30) from the anvil retainer (38). The surgical stapling device (10) also includes a firing lockout assembly which prevents actuation of the firing trigger (20) until an anvil has been attached to the device and the anvil (129) has been approximated. A tactile indication mechanism is also provided for notifying a surgeon that the device has been fired and for notifying a surgeon that the anvil head has been unapproximated a distance sufficient to permit the anvil head to tilt.

摘要翻译： 本公开涉及用于执行圆形吻合的外科缝合装置（10）。 外科缝合装置包括手柄部分（12），细长主体部分（14）和包括砧座组件（30）和壳体组件（31）的头部部分（16）。 手柄部分（12）包括用于近似砧和壳组件（30,31）的可旋转近似旋钮（22）和用于致动用于排出位于壳体组件（31）内的缝钉）的击发机构的击发触发器（20）。 击发触发器（20）形成设置成致动击发机构的两杆连杆的一个连杆。 砧座组件（30）包括可倾斜的砧座，该砧座将在该装置点火之后自动倾斜并且使该砧座和壳体组件（30,31）不接近。 所述头部部分（16）还包括可伸缩套管针组件（240），其可滑动地定位在砧座保持器（38）内，并且当所述砧座组件（30）附接和拆卸到所述砧座保持器（38）上时自动前进和缩回， 。 锁定管（270）被设置并且围绕砧座保持器（38）定位，以可释放地接合砧组件（30）。 锁定管（270）防止砧组件（30）从砧座保持器（38）的意外脱离。 外科缝合装置（10）还包括击发锁定组件，其防止击发触发器（20）的致动直到砧座已经附接到装置并且砧座（129）已被近似。 还提供了一种触觉指示机构，用于通知外科医生该装置已经被点燃，并且通知外科医生砧座头未被近距离足以允许砧头倾斜的距离。

公开(公告)号：US20070187456A1

公开(公告)日：2007-08-16

申请号：US11786198

申请日：2007-04-10

申请人： Frank Viola ,  David Racenet ,  Ernest Aranyi ,  Richard Gresham ,  Paul Scirica ,  David Farascioni ,  Kenneth Whitfield ,  Philip Roy ,  Earl Zergiebel

发明人： Frank Viola ,  David Racenet ,  Ernest Aranyi ,  Richard Gresham ,  Paul Scirica ,  David Farascioni ,  Kenneth Whitfield ,  Philip Roy ,  Earl Zergiebel

IPC分类号： A61B17/10

CPC分类号： A61B17/072 ,  A61B17/2816 ,  A61B2017/07214 ,  A61B2017/2904 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2017/2929 ,  A61B2017/2932

摘要： A surgical fastening apparatus includes a handle, an elongated member extending distally from the handle and a fastener applier and anvil head disposed at the distal end of the elongated member. The elongated member defines a distal offset end portion upon which the fastener applier and the anvil head are mounted. The offset end portion is angularly oriented with respect to the axis of the instrument at a predetermined fixed angle (e.g., either 45°, 60° and 75° relative to the axis of the instrument) thereby positioning the fastener applier and the anvil head at the fixed angle. This feature facilitates positioning of the tissue with respect to the instrument and enhances visual access to the tissue when appropriately disposed within the fastener applier and the anvil head. Various mechanisms for effectuating the clamping of the tissue between the fastener holder and anvil, and the firing of the instrument are disclosed.

摘要翻译： 手术紧固装置包括手柄，从手柄向远侧延伸的细长构件和设置在细长构件的远端处的紧固件敷贴器和砧头。 细长构件限定远端偏移端部，紧固件施加器和砧头安装在该远端上。 偏移端部以相对于仪器的轴线成一定角度地定向（例如，相对于仪器的轴线为45°，60°和75°），从而将紧固件施加器和砧座头定位在 固定角度。 该特征有助于组织相对于器械的定位，并且当适当地设置在紧固件施加器和砧座头部内时，增强了对组织的视觉访问。 公开了用于实现紧固件保持器和砧座之间的组织夹紧的各种机构以及仪器的点火。

公开(公告)号：US20070075117A1

公开(公告)日：2007-04-05

申请号：US11515660

申请日：2006-09-05

申请人： Keith Milliman ,  Bruce Jankowski ,  Douglas Cuny ,  Kevin Sniffin ,  Anthony Dato ,  Richard Gresham

发明人： Keith Milliman ,  Bruce Jankowski ,  Douglas Cuny ,  Kevin Sniffin ,  Anthony Dato ,  Richard Gresham

IPC分类号： A61B17/04

CPC分类号： A61B17/068 ,  A61B17/115 ,  A61B17/1155 ,  A61B17/32053 ,  A61B2017/00371 ,  A61B2017/07257 ,  A61B2017/2905 ,  A61B2090/0811 ,  A61B2090/3616

摘要： A surgical stapling device is disclosed for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The stapling device includes an approximation mechanism including a rotatable knob, a screw having a helical channel and an anvil retainer. The helical channel includes a dwell portion for providing a tactile indication to a surgeon that the anvil retainer has been advanced to a position wherein the anvil assembly can be removed from the anvil retainer. A removable trocar for attachment to the anvil assembly is also disclosed which includes a rib positioned proximally of a mounting projection. The rib is positioned to align the mounting projection with associated engagement structure of the anvil assembly.

摘要翻译： 公开了用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 头部包括砧座组件，该砧组件包括可倾斜的砧座，该砧座将在该装置被点火并且未被近似之后自动倾斜。 可倾斜的砧座提供减小的砧座轮廓，以在执行吻合过程之后减少在装置移除期间的创伤。 缝合装置包括近似机构，其包括可旋转旋钮，具有螺旋通道的螺钉和砧座保持器。 所述螺旋通道包括用于向外科医生提供触觉指示的停留部分，所述砧座保持器已经前进到其中所述砧座组件能够从所述砧座保持器移除的位置。 还公开了一种用于连接到砧组件的可拆卸的套针针，其包括位于安装突起的近侧的肋。 肋被定位成使安装突起与砧组件的相关接合结构对准。

公开(公告)号：US20070005086A1

公开(公告)日：2007-01-04

申请号：US11158155

申请日：2005-06-21

申请人： Richard Gresham

发明人： Richard Gresham

IPC分类号： A61B17/32

CPC分类号： A61B17/3417 ,  A61B17/3474 ,  A61B17/3496 ,  A61B2017/3486 ,  A61B2017/3492

摘要： An adjustable trocar washer is provided to facilitate sealing an incision in skin. The adjustable trocar washer is configured for use with a trocar or cannula assembly. The adjustable trocar washer generally includes a compressible collar and a skirt formed at the distal end of the compressible collar for sealing an incision in skin. The compressible collar is longitudinally movable along an elongate tubular member associated with the trocar or cannula assembly. A latch mechanism is provided on the compressible collar to secure the collar in a compressed condition about the elongate tubular member.

摘要翻译： 提供可调套管洗衣机以便于在皮肤中密封切口。 可调套管洗衣机被配置为与套管针或套管组件一起使用。 可调套管针垫圈通常包括可压缩套环和形成在可压缩套环的远端处的裙部，用于密封皮肤中的切口。 可压缩套环可以沿着与套管针或插管组件相关联的细长管状构件纵向移动。 在可压缩套环上设有一个锁定机构，以将套环固定在围绕细长管状构件的压缩状态。

公开(公告)号：US20060278679A1

公开(公告)日：2006-12-14

申请号：US11444664

申请日：2006-06-01

申请人： Frank Viola ,  Richard Gresham ,  Ken Blier ,  Paul Merten ,  Joseph Sapiente ,  Henry Holsten ,  Russell Heinrich

发明人： Frank Viola ,  Richard Gresham ,  Ken Blier ,  Paul Merten ,  Joseph Sapiente ,  Henry Holsten ,  Russell Heinrich

IPC分类号： B25C7/00

CPC分类号： A61B17/0644 ,  A61B17/0682 ,  A61B17/0684 ,  A61B17/0686 ,  A61B2017/0498 ,  A61B2017/0725 ,  A61B2017/07264 ,  B25C5/0257 ,  Y10S227/902

摘要： A multiple coil staple is provided which includes a backspan and a pair of spaced legs. The backspan includes one or more pockets configured to induce coiling of the legs of the staple. A multiple coil staple applier is also provided which includes a pusher having a distal face defining a staple engagement surface and one or more staple deforming pockets. Each staple deforming pocket is configured to induce coiling of the legs of a staple. The multiple coil staple and staple applier facilitate joining of tissues having wider ranges of thicknesses using a single size staple.

摘要翻译： 提供了多个线圈钉，其包括后跨和一对间隔开的腿。 反跨架包括构造成诱导订书钉的腿的卷绕的一个或多个口袋。 还提供了一种多线圈钉子施放器，其包括具有限定钉接合表面的远端面和一个或多个钉变形袋的推动器。 每个缝钉变形袋被构造成诱导订书钉的腿的卷绕。 多重线圈订书钉和订书钉装载器便于使用单一尺寸的订书钉连接具有更宽范围厚度的组织。

公开(公告)号：US20060163312A1

公开(公告)日：2006-07-27

申请号：US10528889

申请日：2003-10-06

申请人： Frank Viola ,  David Racenet ,  Ernest Aranyi ,  Richard Gresham ,  Paul Scirica ,  David Farascioni ,  Kenneth Whitfield ,  Philip Roy ,  Earl Zergiebel

发明人： Frank Viola ,  David Racenet ,  Ernest Aranyi ,  Richard Gresham ,  Paul Scirica ,  David Farascioni ,  Kenneth Whitfield ,  Philip Roy ,  Earl Zergiebel

IPC分类号： A61B17/10

CPC分类号： A61B17/072 ,  A61B17/2816 ,  A61B2017/07214 ,  A61B2017/2904 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2017/2929 ,  A61B2017/2932

摘要： A surgical fastening apparatus includes a handle, an elongated member extending distally from the handle and a fastener applier and anvil head disposed at the distal end of the elongated member. The elongated member defines a distal offset end portion upon which the fastener applier and the anvil head are mounted. The offset end portion is angularly oriented with respect to the axis of the instrument at a predetermined fixed angle (e.g., either 45°, 60° and 75° relative to the axis of the instrument) thereby positioning the fastener applier and the anvil head at the fixed angle. This feature facilitates positioning of the tissue with respect to the instrument and enhances visual access to the tissue when appropriately disposed within the fastener applier and the anvil head. Various mechanisms for effectuating the clamping of the tissue between the fastener holder and anvil, and the firing of the instrument are disclosed.

摘要翻译： 手术紧固装置包括手柄，从手柄向远侧延伸的细长构件和设置在细长构件的远端处的紧固件敷贴器和砧头。 细长构件限定远端偏移端部，紧固件施加器和砧头安装在该远端上。 偏移端部以相对于仪器的轴线成一定角度地定向（例如，相对于仪器的轴线为45°，60°和75°），从而将紧固件施加器和砧座头定位在 固定角度。 该特征有助于组织相对于器械的定位，并且当适当地设置在紧固件施加器和砧座头部内时，增强了对组织的视觉访问。 公开了用于实现紧固件保持器和砧座之间的组织夹紧的各种机构以及仪器的点火。

公开(公告)号：US20060047284A1

公开(公告)日：2006-03-02

申请号：US10925850

申请日：2004-08-25

申请人： Richard Gresham

发明人： Richard Gresham

IPC分类号： A61F11/00

CPC分类号： A61B17/3498 ,  A61B17/3415 ,  A61B17/3462

摘要： A seal assembly for use with an access device during a surgical procedure includes a housing having a passageway therethrough dimensioned to permit passage of a surgical instrument and being adapted for mounting to a trocar device, and a seal comprising a gel material and being mounted to the housing across the passageway. The seal includes inner seal portions defining an access channel dimensioned to form a substantial sealing relation with an object therethrough and substantially close in the absence of the surgical instrument. The seal preferably comprises a second material having a hardness greater than a hardness of the gel material. The gel material may be selected from the group consisting of urethane gel, silicon gel.

摘要翻译： 一种用于在外科手术过程中与进入装置一起使用的密封组件，包括具有通道的壳体，该通道的尺寸被设计成允许外科器械通过，并适于安装到套针针装置，以及包括凝胶材料并被安装到 住房通过通道。 密封件包括内部密封部分，其限定了进入通道，其尺寸被设计成与未经外科器械的物体通过其中的物体形成实质上的密封关系。 密封件优选地包括硬度大于凝胶材料的硬度的第二材料。 凝胶材料可以选自聚氨酯凝胶，硅胶。

公开(公告)号：US20080054045A1

公开(公告)日：2008-03-06

申请号：US11978345

申请日：2007-10-29

申请人： Keith Milliman ,  Bruce Jankowski ,  Douglas Cuny ,  Kevin Sniffin ,  Anthony Dato ,  Richard Gresham

发明人： Keith Milliman ,  Bruce Jankowski ,  Douglas Cuny ,  Kevin Sniffin ,  Anthony Dato ,  Richard Gresham

IPC分类号： A61B17/10

CPC分类号： A61B17/068 ,  A61B17/115 ,  A61B17/1155 ,  A61B17/32053 ,  A61B2017/00371 ,  A61B2017/07257 ,  A61B2017/2905 ,  A61B2090/0811 ,  A61B2090/3616

摘要： A surgical stapling device is disclosed for performing circular anastomoses. The surgical stapling device includes a handle portion, an elongated body portion and a head portion including an anvil assembly and a shell assembly. The head portion includes an anvil assembly including a tiltable anvil which will tilt automatically after the device has been fired and unapproximated. The tiltable anvil provides a reduced anvil profile to reduce trauma during removal of the device after the anastomoses procedure has been performed. The stapling device includes a bulbous indicator which preferably extends above a top surface of the handle assembly of the device. The indicator includes indicia to identify to a surgeon that the device has been approximated and is in a fire-ready position. Preferably, the indicator includes a cover which is formed of a magnification material to prominently display the indicia. The anvil assembly of the stapling device preferably includes a retainer clip positioned on the anvil head. The retainer clip preferably includes at least one resilient arm which is positioned to engage a cutting ring during unapproximation of the stapling device.

摘要翻译： 公开了用于执行圆形吻合的外科缝合装置。 外科缝合装置包括手柄部分，细长主体部分和包括砧座组件和壳体组件的头部部分。 头部包括砧座组件，该砧组件包括可倾斜的砧座，该砧座将在该装置被点火并且未被近似之后自动倾斜。 可倾斜的砧座提供减小的砧座轮廓，以在执行吻合过程之后减少在装置移除期间的创伤。 缝合装置包括球茎指示器，其优选地在装置的手柄组件的顶表面上方延伸。 指示器包括用于向外科医生识别装置已被近似并处于就绪位置的标记。 优选地，指示器包括由显着地显示标记的放大材料形成的盖。 装订装置的砧座组件优选地包括定位在砧头上的保持夹。 保持夹优选地包括至少一个弹性臂，其定位成在缝合装置的非近似期间接合切割环。