摘要:
A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.
摘要:
A catheter includes multiple primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes a resistive element located at the working end of the catheter. Separation is maintained between the leads such that each lead can individually receive power. The catheter can include a lumen to accommodate a guide wire or to allow fluid delivery. Energy is applied until the diameter of the hollow anatomical structure is reduced to the point where occlusion is achieved. In one embodiment, a balloon is inflated to place the resistive elements into apposition with a hollow anatomical structure and to occlude the structure before the application of energy. The inflated balloon impairs blood flow and facilitates the infusion of saline, or medication, to the hollow anatomical structure in order to reduce the occurrence of coagulation and to improve the heating of the structure by the catheter.
摘要:
One embodiment comprises an apparatus for applying energy to a hollow anatomical structure having an inner wall. The apparatus comprises an elongate shaft having a distal end and a proximal end opposite the distal end; and a capacitive treatment element located near the distal end. The capacitive treatment element is sized for insertion into the hollow anatomical structure and placement near the inner wall. The capacitive treatment element is configured to create an electric field that extends at least partially into the inner wall. Other devices and methods for treatment of hollow anatomical structures are disclosed as well.
摘要:
A catheter handle including a handle body defining a longitudinally extending handle aperture, a connector adapted to connect a steering wire to the handle body, a piston located at least partially within the handle aperture and slidable relative to the handle aperture, the piston being adapted to be operably connected to a catheter body, and a biasing element, operably connected to the piston, to bias the piston in the distal direction. As an alternative to the biasing element, or in addition, the catheter handle may also include a steering wire anchor associated with the handle body and including a movable portion operably connected to the proximal portion of the steering wire.
摘要:
Described herein are endoscopic plicators passed transorally into the stomach and used to plicate stomach tissue by engaging tissue from inside of the stomach and drawing it inwardly. In the disclosed embodiments, the tissue is drawn inwardly into a vacuum chamber, causing sections of serosal tissue on the exterior of the stomach to be positioned facing one another. The disclosed plicators allow the opposed sections of tissue to be moved into contact with one another, and preferably deliver sutures, staples or other means for maintaining contact between the tissue sections at least until serosal bonds form between them. Each of these steps may be performed wholly from the inside of the stomach and thus can eliminate the need for any surgical or laparoscopic intervention. After one or more plications is formed, medical devices may be coupled to the plication(s) for retention within the stomach.
摘要:
Described herein are devices for reversibly constraining an endoscope. Such devices may comprise: a base positionable proximate a patient; a column extending vertically from the base; an arm extending horizontally from the column; and a clamp coupled to the arm. In some embodiments, the clamp comprises a holder comprising an annular ring defining an endoscope receiving area or a first sidewall and a second sidewall together defining an endoscope receiving area. The holder is transitionable between a first configuration in which the annular ring or the first and second sidewall are configured to set apart from an endoscope in the endoscope receiving area and a second configuration in which the annular ring or the first and second sidewall are configured to clamp the endoscope in the endoscope receiving area.
摘要:
A guidewire has a guidewire body with a distal end and a proximal end. A balloon or other tissue anchor is disposed at or near the distal end of the guidewire, and the guidewire may be used to draw two layers of tissue into apposition by placing the guidewire through a tissue penetration, deploying the tissue anchor, and drawing proximally on the guidewire body. Optionally, the guidewire may include deployable blades for enlarging a tissue penetration as the guidewire is advanced therethrough.
摘要:
Described herein are endoscopic plicators passed transorally into the stomach and used to plicate stomach tissue by engaging tissue from inside of the stomach and drawing it inwardly. In the disclosed embodiments, the tissue is drawn inwardly into a vacuum chamber, causing sections of serosal tissue on the exterior of the stomach to be positioned facing one another. The disclosed plicators allow the opposed sections of tissue to be moved into contact with one another, and preferably deliver sutures, staples or other means for maintaining contact between the tissue sections at least until serosal bonds form between them. Each of these steps may be performed wholly from the inside of the stomach and thus can eliminate the need for any surgical or laparoscopic intervention. After one or more plications is formed, medical devices may be coupled to the plication(s) for retention within the stomach.
摘要:
Described herein are endoscopic plicators passed transorally into the stomach and used to plicate stomach tissue by engaging tissue from inside of the stomach and drawing it inwardly. In the disclosed embodiments, the tissue is drawn inwardly into a vacuum chamber, causing sections of serosal tissue on the exterior of the stomach to be positioned facing one another. The disclosed plicators allow the opposed sections of tissue to be moved into contact with one another, and preferably deliver sutures, staples or other means for maintaining contact between the tissue sections at least until serosal bonds form between them. Each of these steps may be performed wholly from the inside of the stomach and thus can eliminate the need for any surgical or laparoscopic intervention. After one or more plications is formed, medical devices may be coupled to the plication(s) for retention within the stomach.
摘要:
A trocar has an elongate body and a tissue-penetrating tip. One or more radially extending blade(s) are provided near the tissue-penetrating tip of the trocar body so that they automatically open as the trocar is advanced through tissue. The blades will enlarge the penetration which was formed by the tip of the trocar.