公开(公告)号：US07404792B2

公开(公告)日：2008-07-29

申请号：US10745781

申请日：2003-12-24

申请人： Paul A. Spence ,  Warren P. Williamson, IV

发明人： Paul A. Spence ,  Warren P. Williamson, IV

IPC分类号： A61F2/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/0243 ,  A61B2017/308

摘要： A system for manipulating and supporting a beating heart during cardiac surgery, including a gross support element for engaging and supporting the heart (the gross support element preferably including a head which is sized and shaped to cradle the myocardium of the left ventricle”), a suspension head configured to exert lifting force on the heart when positioned near the apical region of the heart at a position at least partially overlying the right ventricle, and a releasable attachment element for releasably attaching at least one of the gross support element and the suspension head to the heart. The releasable attachment element can be a mechanical element (such as one or more staples or sutures') or an adhesive such as glue. Alternatively, the system includes a suspension head and a releasable attachment element for releasably attaching it to the heart, but does not include a gross support element.

摘要翻译： 一种用于在心脏手术期间操纵和支撑跳动心脏的系统，包括用于接合和支撑心脏的总体支撑元件（总体支撑元件优选地包括头部，其尺寸和形状适于摇动左心室的心肌），悬架 头部构造成当至少部分地覆盖右心室的位置处定位在心脏的顶部区域附近时在心脏上施加提升力;以及可释放的附接元件，用于将大体支撑元件和悬架头部中的至少一个可释放地附接到 心脏 可释放的附接元件可以是机械元件（例如一个或多个缝钉或缝线）或诸如胶的粘合剂。 或者，该系统包括悬挂头和可释放的附接元件，用于可释放地将其附接到心脏，但不包括总支撑元件。

公开(公告)号：USRE40377E1

公开(公告)日：2008-06-10

申请号：US10863862

申请日：2004-06-07

申请人： Warren P. Williamson, IV ,  Paul A. Spence ,  George T. Christakis ,  Mark Ortiz

发明人： Warren P. Williamson, IV ,  Paul A. Spence ,  George T. Christakis ,  Mark Ortiz

IPC分类号： A61F2/24

摘要： A heart valve can be replaced using minimally invasive methods which include a sutureless sewing cuff that and a fastener delivery tool that holds the cuff against the patient's tissue while delivering fasteners to attach the cuff to the tissue from the inside out. The tool stores a plurality of fasteners and is self-contained whereby a fastener is delivered and placed all from inside a vessel. The fasteners are self-forming whereby they do not need an anvil to be formed. Anchor elements are operated from outside the patient's body to cinch a prosthesis to an anchoring cuff of the valve body. The cuff is releasably mounted on the tool and the tool holds the cuff against tissue and drives the fastener through the cuff and the tissue before folding over the legs of the fastener whereby secure securement between the cuff and the tissue is assured. Fasteners are placed and formed whereby fasteners are located continuously throughout the entire circumference of the cuff. A minimally invasive surgical method is disclosed, and a method and tool are disclosed for repairing abdominal aortic aneurysms in a minimally invasive manner. Fasteners that are permanently deformed during the process of attaching the cuff are disclosed as are fasteners that are not permanently deformed during the attaching process.

摘要翻译： 可以使用微创方法来替换心脏瓣膜，所述方法包括无缝线缝合套，以及紧固件递送工具，其将袖带保持抵靠患者组织，同时递送紧固件以将袖带从内向外附接到组织。 该工具存储多个紧固件并且是独立的，由此紧固件全部从容器内部输送和放置。 紧固件是自成型的，由此它们不需要形成砧座。 锚杆元件从患者身体外部操作，将假体固定到阀体的锚定箍。 袖带可释放地安装在工具上，并且工具将袖带保持抵靠组织，并且在折叠紧固件的腿部之前通过袖口和组织驱动紧固件，从而确保袖带和组织之间的牢固固定。 紧固件被放置和形成，由此紧固件连续地位于袖带的整个圆周上。 公开了一种微创手术方法，并且公开了一种以微创方式修复腹主动脉瘤的方法和工具。 在附接袖带的过程中永久变形的紧固件公开为在附接过程中不会永久变形的紧固件。

公开(公告)号：US06884251B2

公开(公告)日：2005-04-26

申请号：US10384250

申请日：2003-03-06

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  George Christakis ,  Mark Ortiz ,  Craig B. Berky ,  Douglas P. Allen ,  Matthew J. Huddleston ,  Delbert Ted Leimbach ,  Cecil R. Robinson ,  E. Dale VanHoose ,  Thomas J. Ward ,  Marty J. Warnecke

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  George Christakis ,  Mark Ortiz ,  Craig B. Berky ,  Douglas P. Allen ,  Matthew J. Huddleston ,  Delbert Ted Leimbach ,  Cecil R. Robinson ,  E. Dale VanHoose ,  Thomas J. Ward ,  Marty J. Warnecke

IPC分类号： A61B17/11 ,  A61B17/115 ,  A61B17/08

CPC分类号： A61B17/11 ,  A61B17/1152 ,  A61B2017/1135 ,  A61B2017/1139

摘要： An anastomosis is performed using a flexible mounting structure mounted on the outside of at least one vessel. Fasteners extend through the vessel and are bent towards the incision to attach the flexible mounting structure to the vessel in a manner that controls the edge of the vessel adjacent to the incision. The mounting structures are oriented on each vessel so fasteners on one mounting structure interdigitate with fasteners on the other mounting structure at the location of contact between the vessels when the two vessels are brought together. This creates two complementary sinusoidal-shaped vessel edges with peaks of one edge being accommodated in the valleys of the other edge. The peak-to-valley orientation forms a sinusoidal-shaped joint which is leak free. The fasteners are spaced so proper pressure is applied to the tissue to promote healing without leaking. Furthermore, the fasteners are sized and shaped to properly engage the tissue and bend in a desired manner. Methods and tools for carrying out the anastomosis according to the invention are also disclosed. Methods for forming the fastener and the tines having the proper characteristics are disclosed. An absorbable ring-shaped stent is also disclosed.

摘要翻译： 使用安装在至少一个容器的外部的柔性安装结构进行吻合。 紧固件延伸穿过容器并朝向切口弯曲，以将控制与切口相邻的容器边缘的方式将柔性安装结构附接到容器。 安装结构被定向在每个容器上，因此当两个容器被接合在一起时，在一个安装结构上的紧固件与另一个安装结构上的紧固件在容器之间的接触位置处相互交错。 这产生两个互补的正弦形容器边缘，其中一个边缘的峰值被容纳在另一个边缘的谷部中。 峰 - 谷取向形成无泄漏的正弦形接头。 紧固件间隔开，以便适当的压力施加到组织以促进愈合而不泄漏。 此外，紧固件的尺寸和形状适于适当地接合组织并以期望的方式弯曲。 还公开了用于进行根据本发明的吻合的方法和工具。 公开了用于形成紧固件和具有适当特性的尖齿的方法。 还公开了可吸收的环形支架。

公开(公告)号：US06254617B1

公开(公告)日：2001-07-03

申请号：US09200796

申请日：1998-11-27

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  George Christakis

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  George Christakis

IPC分类号： A61B1704

CPC分类号： A61B17/1152 ,  A61B17/11 ,  A61B2017/1135 ,  A61B2017/1139 ,  Y10S623/903

摘要： An anastomosis is performed using a mounting structure mounted on the outside of at least one vessel. The mounting structure includes a flexible mounting structure that is attached to the vessel by a special instrument. A graft vessel is attached to the mounting structure either directly or by means of another mounting structure attached to the graft vessel. Tools for attaching a mounting structure to a vessel are disclosed, and a tool for attaching two mounting structures together is also disclosed. Methods for carrying out the anastomosis according to the invention are also disclosed.

摘要翻译： 使用安装在至少一个容器的外部的安装结构进行吻合。 安装结构包括通过专用仪器附接到容器的柔性安装结构。 移植物容器直接或通过附接到移植血管的另一安装结构附接到安装结构。 公开了用于将安装结构附接到容器的工具，并且还公开了用于将两个安装结构连接在一起的工具。 还公开了根据本发明的用于进行吻合的方法。

公开(公告)号：US6080173A

公开(公告)日：2000-06-27

申请号：US318866

申请日：1999-05-26

申请人： Warren P. Williamson, IV ,  Craig B. Berky ,  Paul A. Spence ,  Mark Ortiz

发明人： Warren P. Williamson, IV ,  Craig B. Berky ,  Paul A. Spence ,  Mark Ortiz

IPC分类号： A61B17/11 ,  A61B17/32

CPC分类号： A61B17/32053 ,  A61B2017/1107

摘要： A surgical punch prevents tissue debris associated with punching a hole in a patient's tissue, such as an aorta during an anastomosis procedure, from reentering the patient's bloodstream. The punch includes elements that move the debris away from the cutting site and then capture that debris inside the instrument. The punch also includes means for aligning the punch with the selected site and for atraumatically holding the tissue prior to cutting. Various means for moving the tissue debris and for trapping the tissue debris in the instrument are also disclosed.

摘要翻译： 外科手术冲击器防止在吻合过程期间冲击患者组织（例如主动脉）中的孔而与患者血流重新进入相​​关联的组织碎片。 冲头包括将碎屑从切割部位移开的元件，然后捕获仪器内的碎屑。 冲头还包括用于将冲头与选定部位对准的装置，并且用于在切割之前无创地保持组织。 还公开了用于移动组织碎片和捕获器械中的组织碎片的各种手段。

公开(公告)号：US07722642B2

公开(公告)日：2010-05-25

申请号：US10786657

申请日：2004-02-25

申请人： Warren P. Williamson, IV ,  Paul A. Spence ,  George A. Keller ,  Cecil R. Robinson ,  Thomas J. Ward

发明人： Warren P. Williamson, IV ,  Paul A. Spence ,  George A. Keller ,  Cecil R. Robinson ,  Thomas J. Ward

IPC分类号： A61B17/08 ,  A61B17/10

CPC分类号： A61F2/2427 ,  A61B17/0401 ,  A61B17/0467 ,  A61B17/0469 ,  A61B17/0487 ,  A61B17/064 ,  A61B17/0644 ,  A61B17/0684 ,  A61B17/072 ,  A61B17/115 ,  A61B2017/00243 ,  A61B2017/0406 ,  A61B2017/0458 ,  A61B2017/0464 ,  A61B2017/047 ,  A61B2017/0641 ,  A61B2017/0725 ,  A61B2017/07271 ,  A61B2017/3486 ,  A61B2090/061 ,  A61B2090/395 ,  A61F2/2409

摘要： Wire fasteners having legs with lengths that can be one hundred times the width of the fastener are used to secure items, such as prosthesis valves to a patient during minimally invasive surgery. The fasteners are manipulated into position and then are immobilized by means of the legs thereof for tensioning, cutting and forming in situ. The fasteners are manipulated, tensioned and formed from the leg end of the fasteners. Tools for initially placing the fasteners and for immobilizing, tensioning, cutting and bending the fastener legs are disclosed. Once the fasteners are initially placed, the prosthesis is placed on the long legs of the placed fasteners and is guided into position on the legs. Once the prosthesis is in position, the legs of the fasteners are immobilized, tensioned, cut and bent into staple-like shapes to secure the prosthesis to the patient. A method for carrying out the procedure using the long fastener is also disclosed. Using the teaching of the present disclosure, a surgeon can customize a fastener to the particular surgery or even to the particular portion of surgery being performed during the surgery.

摘要翻译： 具有长度为紧固件宽度的一百倍的腿的电线紧固件用于在微创手术期间将物品（例如假体瓣膜）固定到患者。 紧固件被操纵到位，然后通过其腿部固定，用于原位张紧，切割和成形。 紧固件由紧固件的腿端被操纵，张紧和形成。 公开了用于初始放置紧固件并固定，张紧，切割和弯曲紧固件腿的工具。 一旦紧固件被初始放置，假体被放置在所放置的紧固件的长腿上并且被引导到腿上的位置。 一旦假体就位，紧固件的腿被固定，张紧，切割并弯曲成钉状形状以将假体固定到患者身上。 还公开了一种使用该长紧固件执行该过程的方法。 使用本公开的教导，外科医生可以定制针对特定手术的紧固件，或甚至可以在手术期间执行手术的特定部分。

公开(公告)号：US07476196B2

公开(公告)日：2009-01-13

申请号：US10863409

申请日：2004-06-08

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61B19/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A suction cup adapted to engage a surface of a beating heart with sufficient force to move the beating heart to an unnatural position upon moving the suction cup, while the suction cup maintains engagement with the surface of the heart and the heart continues to beat. Various suction cups are described each including at least a first chamber having a flexible rim and configured to engage the surface of the beating heart and a second chamber smaller than the first chamber and fluidly connected therewith. A suspension device configured to engage a beating heart and maintain engagement via suction while moving the suspension device to move the beating heart to an unnatural position and maintain the beating heart in the unnatural position to perform a surgical procedure, while the heart continues to beat, includes a suction cup and a support arm connected thereto. The suction cup has a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected therewith. The second chamber is adapted to fluidly connect the first chamber with a source of suction. The support arm is movable with the suction cup to effect movement of the beating heart after engagement of the suction cup to a surface of the beating heart. A method of manipulating a beating heart to orient the beating heart in a desired position for performing a surgical procedure includes providing a suction cup having a first chamber configured to engage the surface of the beating heart, and a second chamber smaller than the first chamber and fluidly connected with the first chamber, the second chamber being further fluidly connected to a source of suction; contacting a surface of the beating heart with the first chamber; applying suction between the first chamber and the surface of the beating heart, thereby engaging the suction member with the surface of the beating heart; and moving the suction member while maintaining engagement with the surface of the beating heart, thereby moving the beating heart.

公开(公告)号：US07377895B2

公开(公告)日：2008-05-27

申请号：US10698798

申请日：2003-10-31

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61F2/00

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A system for use in conducting coronary surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. The system includes a first device for engaging and repositioning the beating heart to a displaced position, and is capable of maintaining the heart in the displaced position to perform a surgical procedures. The system includes a second device adapted to engage a portion of the heart to immobilize that portion for conducting a surgical procedure in the immobilized location, while the remainder of the heart continues to beat. Both first and second devices may be adapted to be fixed to a relatively stationary object, such as a frame, which may be a sternal retractor.

摘要翻译： 用于进行冠状动脉手术的系统允许在跳动的心脏上进行冠状动脉手术，同时保持心输出量不变且不间断。 Circumflex冠状动脉手术可以使用系统进行。 该系统包括用于将跳动心脏接合并重新定位到移位位置的第一装置，并且能够将心脏保持在移位位置以执行外科手术。 该系统包括适于接合一部分心脏以将该部分固定在固定位置进行外科手术的第二装置，同时心脏的其余部分继续击打。 第一和第二装置可以适于固定到相对静止的物体，例如框架，其可以是胸骨牵开器。

公开(公告)号：US06659270B2

公开(公告)日：2003-12-09

申请号：US10200398

申请日：2002-07-22

申请人： Warren P. Williamson, IV ,  Craig B. Berky ,  Paul A. Spence ,  Mark Ortiz

发明人： Warren P. Williamson, IV ,  Craig B. Berky ,  Paul A. Spence ,  Mark Ortiz

IPC分类号： A61B1706

CPC分类号： A61B17/06138 ,  A61B2017/06142 ,  A61B2017/06157

摘要： A suture package (30) including a panel having a series of superimposed subpanels (32a). A suture (20) loops back and forth on the subpanels (32a) such that adjacent loops are retained on adjacent subpanels (32a) and the adjacent subpanels separate the adjacent loops from one another. In the preferred embodiment, an accordion style panel (32) is utilized and the series of subpanels (32a) are folded into a superimposed relationship. Various features are incorporated to reduce the instances or likelihood of kinking and tangling of the suture (20) when pulled from the package (30) by a user.

公开(公告)号：US08317695B2

公开(公告)日：2012-11-27

申请号：US12336290

申请日：2008-12-16

申请人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

发明人： Paul A. Spence ,  Warren P. Williamson, IV ,  Mark Ortiz

IPC分类号： A61B1/32

CPC分类号： A61B17/0218 ,  A61B17/00491 ,  A61B17/02 ,  A61B17/0206 ,  A61B17/0293 ,  A61B17/04 ,  A61B17/064 ,  A61B17/068 ,  A61B17/29 ,  A61B2017/00305 ,  A61B2017/00309 ,  A61B2017/0243 ,  A61B2017/308

摘要： A system for manipulating a heart during cardiac surgery permits coronary surgery on a beating heart while maintaining cardiac output unabated and uninterrupted. Circumflex coronary artery surgery can be performed using the system. A component of the system engages the heart with a heart positioning device, repositions the heart into a displaced position and maintains it in the displaced position while the heart continues to beat with substantially unabated and uninterrupted cardiac output. One form of the system can be used in minimally invasive surgery.

摘要翻译： 在心脏手术期间操作心脏的系统允许在跳动心脏上进行冠状动脉手术，同时保持心输出量不变且不间断。 Circumflex冠状动脉手术可以使用系统进行。 该系统的一个组件与心脏定位装置的心脏接合，将心脏重新定位到位移位置，并将其保持在位移位置，同时心脏继续以基本上不间断的和不间断的心输出量搏动。 该系统的一种形式可用于微创手术。