公开(公告)号：US07377898B2

公开(公告)日：2008-05-27

申请号：US11755305

申请日：2007-05-30

申请人： Richard C Ewers ,  John R Brustad ,  Edward D Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V Taylor ,  Gary R Dulak ,  Michael J Dunn ,  Norman L Morales ,  Charles C Hart ,  Robert R Bowes

发明人： Richard C Ewers ,  John R Brustad ,  Edward D Pingleton ,  Nabil Hilal ,  Payam Adlparvar ,  Scott V Taylor ,  Gary R Dulak ,  Michael J Dunn ,  Norman L Morales ,  Charles C Hart ,  Robert R Bowes

IPC分类号： A61B1/32

CPC分类号： A61B1/32 ,  A61B17/0293 ,  A61B17/3423 ,  A61B17/3431 ,  A61B2017/3484

摘要： A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter, the retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound. A second ring has a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound. A plurality of retraction elements are disposed in a generally cylindrical relationship to each other, between the first ring and the second ring. These elements extend through the wound to exert a radial retraction force on the wound which is dependent on the distance separating the first ring and the second ring Retraction elements, both distensible and non-distensible are contemplated with appropriate attachment means at the rings to provide for variations in the retraction force. With a suitable retraction sleeve, a third ring can be provided to form a circumferential retainer to vary the retraction force. Rings can also be made inflatable or self-expanding to vary the retraction force. An associated method includes the step of rolling the second ring circumferentially of the third ring to form the circumferential retainer.

摘要翻译： 外科伤口牵开器适于将可拉伸至期望直径的伤口扩张，牵开器包括直径大于伤口所需直径的第一环，并适于在伤口内部配置。 第二环的直径大于伤口所需的直径，并且适于在伤口的外部配置。 多个退回元件在第一环和第二环之间以大致圆柱形的关系设置。 这些元件延伸穿过伤口以在伤口上施加径向缩回力，这取决于分离第一环和第二环的距离，缩回元件是可伸长的和不可扩张的，在环处有合适的附接装置，以提供 收缩力的变化。 利用合适的缩回套筒，可以提供第三环以形成圆周保持器以改变收回力。 环也可以制成充气或自膨胀以改变收缩力。 相关联的方法包括在第三环周向滚动第二环以形成周向保持器的步骤。

公开(公告)号：US07005026B2

公开(公告)日：2006-02-28

申请号：US10298116

申请日：2002-11-15

申请人： John R Brustad ,  Payam Adlparvar ,  Wassim R. Aliahmad ,  Canh T. Tran ,  Nabil Hilal ,  Boun Pravong ,  Raffi S. Pinedjian ,  Charles C Hart

发明人： John R Brustad ,  Payam Adlparvar ,  Wassim R. Aliahmad ,  Canh T. Tran ,  Nabil Hilal ,  Boun Pravong ,  Raffi S. Pinedjian ,  Charles C Hart

IPC分类号： B65H81/00

CPC分类号： A61M25/0012 ,  A61B17/3415 ,  A61B2017/00526 ,  A61M25/0045 ,  A61M25/005 ,  A61M25/0662 ,  B29C47/0023 ,  B29C47/004 ,  B29C47/0064 ,  B29C47/025 ,  B29C47/027 ,  B29C53/60 ,  B29C61/006 ,  B29L2023/00

摘要： A releasable mechanism such as a cap is adapted for use with an access sheath having an elongate tube and a handle structure disposed at a proximal end of the tube. The releasable mechanism is sized and configured to fit the handle structure, which is shaped like the bell of a horn, to further facilitate use with surgical instrumentation. The releasable mechanism may operate as a separate cap that snaps onto the handle structure to provide access pathways to the sheath. The releasable mechanism may also be disposed at a proximal end of a surgical instrument to be introduced into the access sheath such that it may be interlocked with the sheath. In a method of manufacturing a kink-resistant sheath, a wire is initially coated with a plastic material, the coated wire is then wrapped around a mandrel forming a plurality of windings, and the wound coated wire is heated until the plastic material melts and bonds the windings to form a wire-reinforced sheath. The plastic material is preferably polyurethane but may be a thermoplastic, a thermoset or any plastic material having hard and/or soft durometer. The wound coated wire may be heated by capturing the windings within a shrink tube or compressing the windings in a mold and heating the windings until the sheath is formed. In another aspect of the invention, a mandrel is used as part of an extrusion process. In another aspect of the invention, another coating or outside layer could be formed over the spring reinforcement by dipping in a solvent based solution. In yet another embodiment of the invention, a braid such as a polyester braid may be used instead of or in addition to the coil spring to form a kink-resistant sheath.

公开(公告)号：US08147458B2

公开(公告)日：2012-04-03

申请号：US12208000

申请日：2008-09-10

申请人： Charles C Hart ,  John R Brustad ,  Nabil Hilal ,  Said Hilal

发明人： Charles C Hart ,  John R Brustad ,  Nabil Hilal ,  Said Hilal

IPC分类号： A61M5/178

CPC分类号： A61B17/3462 ,  A61B2017/3464

摘要： A multi-seal trocar system includes a plurality of co-axial sealing elements adapted for forming a seal with either a large or small instrument. Small and large sealing elements are disposed in an in-line arrangement such that a-single port is provided for instrument insertion. A zero seal is disposed distally of the sealing elements to seal a working channel of the system and to prevent backflow when no instruments are inserted. The small sealing element is configured such that insertion of a large instrument automatically moves the small sealing element out of its path, thereby avoiding contact with the large instrument.

摘要翻译： 多密封套管针系统包括适于与大型或小型仪器形成密封件的多个同轴密封元件。 小型和大型密封元件以串联布置设置，使得提供用于仪器插入的单个端口。 零密封件被设置在密封元件的远侧以密封系统的工作通道，并且当没有插入仪器时防止回流。 小密封元件被构造成使得大型仪器的插入自动地将小密封元件移出其路径，从而避免与大型仪器接触。

公开(公告)号：US07878974B2

公开(公告)日：2011-02-01

申请号：US12815986

申请日：2010-06-15

申请人： John R Brustad ,  Jeremy J Albrecht ,  Nabil Hilal ,  Gary M Johnson ,  Charles C Hart

发明人： John R Brustad ,  Jeremy J Albrecht ,  Nabil Hilal ,  Gary M Johnson ,  Charles C Hart

IPC分类号： A61B1/32

CPC分类号： A61B17/0293 ,  A61B17/02 ,  A61B17/0218 ,  A61B17/3423 ,  A61B17/3431 ,  A61B17/3439 ,  A61B17/3462 ,  A61B17/3496 ,  A61B17/3498 ,  A61B90/40 ,  A61B2017/00477 ,  A61B2017/00526 ,  A61B2017/0225 ,  A61B2017/0287 ,  A61B2017/3419 ,  A61B2017/347 ,  A61B2050/005 ,  A61B2050/0051

摘要： The invention relates to a hand access laparoscopy device having a gelcap, a retainer, a sleeve and a retention ring. The gelcap includes gel that is bonded to a cap. The cap includes an inner cylindrical wall to which the gel in bonded, thereby providing a sealing area between the device and the wound in a body wall. By securing the gel to the inner cylindrical wall, the thickness of the gel and corresponding cap is minimized along with the overall footprint of the device. With the gel thickness reduced and able to be substantially flush, the “doming” phenomenon produced by insufflation of a patient's abdomen is reduced.

摘要翻译： 本发明涉及具有凝胶帽，保持器，套筒和保持环的手动腹腔镜装置。 凝胶帽包括结合到帽的凝胶。 该盖包括内部圆柱形壁，凝胶粘合到该内壁上，由此在该体壁中在该装置和该伤口之间提供密封区域。 通过将凝胶固定到内圆柱形壁上，凝胶和相应的盖的厚度与装置的总体占地面积最小化。 随着凝胶厚度降低并且能够基本上平齐，减少了通过吹入患者腹部产生的“穹隆”现象。

公开(公告)号：US07815567B2

公开(公告)日：2010-10-19

申请号：US11548765

申请日：2006-10-12

申请人： Jeremy J Albrecht ,  Charles C Hart ,  John R. Brustad ,  Gary M Johnson

发明人： Jeremy J Albrecht ,  Charles C Hart ,  John R. Brustad ,  Gary M Johnson

IPC分类号： A61B1/32

CPC分类号： A61B17/0293 ,  A61B17/02 ,  A61B17/0218 ,  A61B17/3423 ,  A61B17/3431 ,  A61B17/3439 ,  A61B17/3462 ,  A61B17/3496 ,  A61B17/3498 ,  A61B90/40 ,  A61B2017/00477 ,  A61B2017/00526 ,  A61B2017/0225 ,  A61B2017/0287 ,  A61B2017/3419 ,  A61B2017/347 ,  A61B2050/005 ,  A61B2050/0051

摘要： An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop placed therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

摘要翻译： 提供进入体腔的增量可调的伤口牵开器包括直径大于所述伤口切口所需直径的内环，具有环形轴线的外环和直径大于伤口切口的期望直径的内环 以及在内环和外环之间以大致圆柱形的形式设置的柔性套管。 外环包括轴向间隔开的第一和第二圆形管，每个包括内腔，其具有放置在其中的刚性，不一致的分割箍。 外环可以自身滚动并围绕环形轴线以足够的力使套筒缩回以将切口拉伸到期望的直径。 凝胶帽密封件可以联接到生物体外部的外环，以密封由卷绕牵开器在体腔和体腔外部产生的开口。

公开(公告)号：US07892172B2

公开(公告)日：2011-02-22

申请号：US12768328

申请日：2010-04-27

申请人： Jeremy J. Albrecht ,  Charles C Hart ,  John R. Brustad

发明人： Jeremy J. Albrecht ,  Charles C Hart ,  John R. Brustad

IPC分类号： A61B1/32

CPC分类号： A61B17/0293 ,  A61B17/02 ,  A61B17/0218 ,  A61B17/3423 ,  A61B17/3431 ,  A61B17/3439 ,  A61B17/3462 ,  A61B17/3496 ,  A61B17/3498 ,  A61B90/40 ,  A61B2017/00477 ,  A61B2017/00526 ,  A61B2017/0225 ,  A61B2017/0287 ,  A61B2017/3419 ,  A61B2017/347 ,  A61B2050/005 ,  A61B2050/0051

摘要： A wound retractor for retracting a surgical incision includes an inner ring, an outer ring and a distensible sleeve coupled to the inner and outer rings. The outer ring includes at least a pair of circular tubes coupled to each other. At least one of the circular tubes includes a lumen and a split that forms open ends. A noncompliant tubular hoop having a split therein is positioned in the lumen. The tubular hoop is oriented with its open ends positioned away from the split of the circular tubes. A core is positioned in the lumen of the tubular hoop. The core has a first end and a second end and is oriented with the ends positioned away from the split in the tubular hoop. The circular tubes may be parallel or may form a helical pattern similar to a Mobius strip.

摘要翻译： 用于缩回手术切口的缠绕牵开器包括联接到内环和外环的内环，外环和可扩张套管。 外环包括彼此耦合的至少一对圆形管。 圆形管中的至少一个包括形成开放端的管腔和裂口。 其中分开的不合适的管状环位于内腔中。 管状环被定向成其开口端定位成远离圆形管的分割。 核心位于管状箍的内腔中。 芯具有第一端和第二端，并且其端部定位成远离管状箍中的裂缝。 圆形管可以是平行的或可以形成类似于Mobius条的螺旋形图案。

公开(公告)号：US07727146B2

公开(公告)日：2010-06-01

申请号：US11548781

申请日：2006-10-12

申请人： Jeremy J Albrecht ,  Charles C Hart ,  John R. Brustad ,  Gary M. Johnson ,  Jennifer T. Ko ,  Donald L Gadberry

发明人： Jeremy J Albrecht ,  Charles C Hart ,  John R. Brustad ,  Gary M. Johnson ,  Jennifer T. Ko ,  Donald L Gadberry

IPC分类号： A61B1/32

CPC分类号： A61B17/0293 ,  A61B17/02 ,  A61B17/0218 ,  A61B17/3423 ,  A61B17/3431 ,  A61B17/3439 ,  A61B17/3462 ,  A61B17/3496 ,  A61B17/3498 ,  A61B90/40 ,  A61B2017/00477 ,  A61B2017/00526 ,  A61B2017/0225 ,  A61B2017/0287 ,  A61B2017/3419 ,  A61B2017/347 ,  A61B2050/005 ,  A61B2050/0051

摘要： An incrementally adjustable wound retractor, which provides access to a body cavity, includes an inner ring having a diameter greater than the desired diameter of the wound incision, an outer ring having an annular axis and a diameter greater than the desired diameter of the wound incision, and a flexible sleeve disposed in a generally cylindrical form between the inner and outer rings. The outer ring includes first and second circular tubes spaced apart axially with each including a lumen having a rigid, noncompliant split hoop positioned therein. The outer ring may be rolled over itself and around the annular axis to retract the sleeve with sufficient force to stretch the incision to the desired diameter. A gel cap seal may be coupled to the outer ring outside of the biological body to seal the opening produced by the wound retractor between the body cavity and outside the body cavity.

摘要翻译： 提供进入体腔的增量可调的伤口牵开器包括直径大于所述伤口切口所需直径的内环，具有环形轴线的外环和直径大于伤口切口的期望直径的内环 以及在内环和外环之间以大致圆柱形的形式设置的柔性套管。 外环包括轴向间隔开的第一和第二圆形管，其中每个包括具有定位在其中的刚性的，不一致的分割箍的内腔。 外环可以自身滚动并围绕环形轴线以足够的力使套筒缩回以将切口拉伸到期望的直径。 凝胶帽密封件可以联接到生物体外部的外环，以密封由卷绕牵开器在体腔和体腔外部产生的开口。

公开(公告)号：US07704207B2

公开(公告)日：2010-04-27

申请号：US11548767

申请日：2006-10-12

申请人： Jeremy J. Albrecht ,  Charles C Hart ,  John R. Brustad

发明人： Jeremy J. Albrecht ,  Charles C Hart ,  John R. Brustad

IPC分类号： A61B1/32

CPC分类号： A61B17/0293 ,  A61B17/02 ,  A61B17/0218 ,  A61B17/3423 ,  A61B17/3431 ,  A61B17/3439 ,  A61B17/3462 ,  A61B17/3496 ,  A61B17/3498 ,  A61B90/40 ,  A61B2017/00477 ,  A61B2017/00526 ,  A61B2017/0225 ,  A61B2017/0287 ,  A61B2017/3419 ,  A61B2017/347 ,  A61B2050/005 ,  A61B2050/0051

摘要： A wound retractor for retracting a surgical incision includes an inner ring, an outer ring and a distensible sleeve coupled to the inner and outer rings. The outer ring includes at least a pair of circular tubes coupled to each other. At least one of the circular tubes includes a lumen and a split that forms open ends. A noncompliant tubular hoop having a split therein is positioned in the lumen. The tubular hoop is oriented with its open ends positioned away from the split of the circular tubes. A core is positioned in the lumen of the tubular hoop. The core has a first end and a second end and is oriented with the ends positioned away from the split in the tubular hoop. The circular tubes may be parallel or may form a helical pattern similar to a Mobius strip.

摘要翻译： 用于缩回手术切口的缠绕牵开器包括联接到内环和外环的内环，外环和可扩张套管。 外环包括彼此耦合的至少一对圆形管。 圆形管中的至少一个包括形成开放端的管腔和裂口。 其中分开的不合适的管状环位于内腔中。 管状环被定向成其开口端定位成远离圆形管的分割。 核心位于管状箍的内腔中。 芯具有第一端和第二端，并且其端部定位成远离管状箍中的裂缝。 圆形管可以是平行的或可以形成类似于Mobius条的螺旋形图案。

公开(公告)号：US08998935B2

公开(公告)日：2015-04-07

申请号：US12200582

申请日：2008-08-28

申请人： Charles C Hart

发明人： Charles C Hart

IPC分类号： A61B17/08 ,  A61B17/064 ,  A61B17/122 ,  A61B17/068 ,  A61B17/128 ,  A61B17/00

CPC分类号： A61B17/0682 ,  A61B17/0643 ,  A61B17/0644 ,  A61B17/068 ,  A61B17/08 ,  A61B17/105 ,  A61B17/122 ,  A61B17/1285 ,  A61B2017/00858 ,  A61B2017/0641 ,  A61B2017/0649 ,  A61B2017/1225

摘要： A surgical staple-clip including a clip component and a securing member is used in a wide range of surgical procedures. The staple-clip may be introduced to a surgical site in an un-assembled condition through a small port or trocar. An applier for the staple-clip comprising a pair of opposed jaw-like channels is provided to position and apply the clip component and the securing member. The clip component is positioned around a target tissue and is compressed or clamped upon the tissue using only the force required for a specific surgical procedure such as occlusion, ligation or fixation. When the clip component is properly applied, the securing member is urged forward and over the clip component to secure the staple-clip. The clip component may include traction enhancement features such as surface interruptions, bumps, valleys and ridges. With the staple-clip of the invention, the force required to constrict or occlude the tissue is separate from the force required to secure and maintain the staple-clip in position and, as a result, the body tissue is not over-compressed and nourishment to the body tissue is maintained. Other aspects of the invention include thumb actuated clip appliers for use in hand assisted laparoscopy (HAL) In one embodiment, a clip applier includes a handle and a thumb actuated mechanism that is used to slidably release clips onto a body tissue or vessel by sliding the thumb actuated mechanism forward and backward using only one hand. In another aspect of the invention, a two-stage clip is disclosed having a clip component and a staple component for securing the clip after it has been properly positioned.

摘要翻译： 包括夹子组件和固定构件的外科手术夹夹用于广泛的手术过程。 钉夹可以通过小口或套管针以未装配的状态被引入外科手术部位。 用于包括一对相对的颚状通道的缝钉夹的施放器被设置以定位和施加夹子部件和固定部件。 夹子组件围绕目标组织定位，并且仅使用特定外科手术所需的力（例如闭塞，结扎或固定）压缩或夹紧在组织上。 当适当地施加夹子部件时，固定构件被推向夹持部件的上方并固定在钉夹上。 夹子组件可以包括牵引增强特征，例如表面中断，凸起，谷和脊。 利用本发明的钉夹，收缩或闭塞组织所需的力与将钉夹固定并保持在适当位置所需的力分离，因此，身体组织不被过度压缩和营养 维持身体组织。 本发明的其他方面包括用于手辅助腹腔镜（HAL）的拇指致动的施夹器。在一个实施例中，施夹器包括手柄和拇指致动机构，其用于通过滑动将夹子滑动到身体组织或容器上 拇指启动机构使用一只手向前和向后。 在本发明的另一方面，公开了一种具有夹子部件和用于在夹具被适当定位之后固定夹子的钉部件的两级夹子。