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公开(公告)号:US08206417B2
公开(公告)日:2012-06-26
申请号:US10865243
申请日:2004-06-09
IPC分类号: A61B17/04
CPC分类号: A61B17/0482 , A61B17/0401 , A61B17/0469 , A61B17/0644 , A61B2017/00867 , A61B2017/0454 , A61B2017/0464 , A61B2017/0496 , A61B2017/06052 , A61B2090/037
摘要: Apparatus and methods for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.
摘要翻译: 本文描述了用于优化锚固力的装置和方法。 在固定组织褶皱时,通过利用具有可扩张臂的组织锚来避免直接位于锚固件正下方的组织的过度压缩,所述组织锚构造成使锚和组织之间的接触面积最小化。 当锚固件处于其膨胀构型时,将负载施加到锚固件,直到其被最佳地构造成适应一定范围的偏转,同时锚固件本身对组织施加基本恒定的力。 可以使用各种装置,例如止动件,弹簧构件,保险丝,应变计等来指示锚固件何时被偏转到最佳范围内的预定水平。 此外,影响锚固特征的其他因素包括例如改变锚的臂或支柱的数量,臂的定位,臂的构型,套环的长度等。
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公开(公告)号:US07695493B2
公开(公告)日:2010-04-13
申请号:US10865736
申请日:2004-06-09
申请人: Vahid Saadat , Richard C. Ewers , Tracy D. Maahs , Alexander Khairkhahan , Kenneth J. Michlitsch
发明人: Vahid Saadat , Richard C. Ewers , Tracy D. Maahs , Alexander Khairkhahan , Kenneth J. Michlitsch
CPC分类号: A61B17/0401 , A61B17/0469 , A61B17/0482 , A61B17/0644 , A61B2017/00867 , A61B2017/0454 , A61B2017/0464 , A61B2017/0496 , A61B2017/06052 , A61B2090/037
摘要: Systems for optimizing anchoring force are described herein. In securing tissue folds, over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable arms configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue. Various devices, e.g., stops, spring members, fuses, strain gauges, etc., can be used to indicate when the anchor has been deflected to a predetermined level within the optimal range. Moreover, other factors to affect the anchor characteristics include, e.g., varying the number of arms or struts of the anchor, positioning of the arms, configuration of the arms, the length of the collars, etc.
摘要翻译: 这里描述了用于优化锚固力的系统。 在固定组织褶皱时,通过利用具有可扩张臂的组织锚来避免直接位于锚固件正下方的组织的过度压缩,所述组织锚构造成使锚和组织之间的接触面积最小化。 当锚固件处于其膨胀构型时,将负载施加到锚固件,直到其被最佳地构造成适应一定范围的偏转,同时锚固件本身对组织施加基本恒定的力。 可以使用各种装置,例如止动件,弹簧构件,保险丝,应变计等来指示锚固件何时被偏转到最佳范围内的预定水平。 此外,影响锚固特征的其他因素包括例如改变锚的臂或支柱的数量,臂的定位,臂的构型,套环的长度等。
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公开(公告)号:US08308765B2
公开(公告)日:2012-11-13
申请号:US10840950
申请日:2004-05-07
申请人: Vahid Saadat , Tracy D. Maahs , Richard C. Ewers , Marvin C. Elmers , Jesus Flores , Alex Khairkhahan , Ruey-Feng Peh , Cang C. Lam
发明人: Vahid Saadat , Tracy D. Maahs , Richard C. Ewers , Marvin C. Elmers , Jesus Flores , Alex Khairkhahan , Ruey-Feng Peh , Cang C. Lam
IPC分类号: A61B17/04
CPC分类号: A61B17/08 , A61B17/0401 , A61B17/0469 , A61B17/0487 , A61B17/06066 , A61B17/064 , A61B17/10 , A61B17/29 , A61B2017/00867 , A61B2017/0404 , A61B2017/0409 , A61B2017/0417 , A61B2017/0419 , A61B2017/0445 , A61B2017/0446 , A61B2017/045 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0459 , A61B2017/0461 , A61B2017/0462 , A61B2017/0464 , A61B2017/0475 , A61B2017/0488 , A61B2017/0496 , A61B2017/06052 , A61B2017/081 , A61B2017/3488 , Y10T24/39 , Y10T24/3936
摘要: Apparatus and methods for positioning and securing anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism either within the anchor itself of positioned proximally of the anchor may allow for the uni-directional translation while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This unidirectional anchor locking mechanism facilitates the cinching of the tissue plication between the anchors and it may be utilized in one or several anchors in cinching a tissue fold.
摘要翻译: 用于定位和固定锚固件的装置和方法适于被输送并植入到组织中,特别是患者胃肠系统内的组织中。 锚固件适于在缝合线上单向滑动,使得组织褶皱可以在锚固件之间束紧。 如果锚固件被拉动,推动或沿着缝合线沿相反方向被推动,锚固件本身内的定位器本身内的锁定机构可以允许单向平移,同时使锚固件能够锁定在缝合线上 。 这种单向锚定锁定机构有助于锚固件之间的组织褶皱的收紧,并且可以在一个或多个锚固件中使用紧固组织褶皱。
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公开(公告)号:US08057511B2
公开(公告)日:2011-11-15
申请号:US10841411
申请日:2004-05-07
申请人: Jesus Flores , Richard C. Ewers , Tracy D. Maahs , Alex Khairkhahan , Ruey-Feng Peh , Vahid Saadat
发明人: Jesus Flores , Richard C. Ewers , Tracy D. Maahs , Alex Khairkhahan , Ruey-Feng Peh , Vahid Saadat
IPC分类号: A61B17/04
CPC分类号: A61B17/0469 , A61B17/00234 , A61B17/0487 , A61B2017/00827 , A61B2017/00867 , A61B2017/0409 , A61B2017/0417 , A61B2017/0419 , A61B2017/0445 , A61B2017/0446 , A61B2017/045 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0459 , A61B2017/0461 , A61B2017/0464 , A61B2017/0475 , A61B2017/0477 , A61B2017/0488 , A61B2017/0496 , A61B2017/06028 , A61B2017/06052 , A61B2017/06176 , Y10T24/39 , Y10T24/3969
摘要: Apparatus and methods for positioning and securing anchors are disclosed herein. The anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism either within the anchor itself of positioned proximally of the anchor may allow for the uni-directional translation while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This uni-directional anchor locking mechanism facilitates the cinching of the tissue plication between the anchors and it may be utilized in one or several anchors in cinching a tissue fold.
摘要翻译: 本文公开了用于定位和固定锚固件的装置和方法。 锚固件适于被递送并植入到组织中,特别是患者胃肠系统内的组织中。 锚固件适于在缝合线上单向滑动,使得组织褶皱可以在锚固件之间束紧。 如果锚固件被拉动,推动或沿着缝合线沿相反方向被推动,锚固件本身内的定位器本身内的锁定机构可以允许单向平移,同时使锚固件能够锁定在缝合线上 。 这种单向锚定锁定机构有助于锚定器之间的组织褶皱收紧,并且可以在一个或多个锚定器中使用,以收紧组织褶皱。
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公开(公告)号:US07736378B2
公开(公告)日:2010-06-15
申请号:US10841245
申请日:2004-05-07
申请人: Tracy D. Maahs , Richard C. Ewers , Jesus Flores , Alexander Khairkhahan , Ruey-Feng Peh , Vahid Saadat , Cang C. Lam
发明人: Tracy D. Maahs , Richard C. Ewers , Jesus Flores , Alexander Khairkhahan , Ruey-Feng Peh , Vahid Saadat , Cang C. Lam
IPC分类号: A61B17/04
CPC分类号: A61B17/08 , A61B17/0401 , A61B17/0469 , A61B17/0487 , A61B17/06066 , A61B17/064 , A61B17/10 , A61B17/29 , A61B2017/00867 , A61B2017/0404 , A61B2017/0409 , A61B2017/0417 , A61B2017/0419 , A61B2017/0445 , A61B2017/0446 , A61B2017/045 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0459 , A61B2017/0461 , A61B2017/0462 , A61B2017/0464 , A61B2017/0475 , A61B2017/0488 , A61B2017/0496 , A61B2017/06052 , A61B2017/081 , A61B2017/3488 , Y10T24/39 , Y10T24/3936
摘要: Apparatus and methods for positioning and securing anchors are disclosed herein. The anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism either within the anchor itself of positioned proximally of the anchor may allow for the uni-directional translation while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This uni-directional anchor locking mechanism facilitates the cinching of the tissue plication between the anchors and it may be utilized in one or several anchors in cinching a tissue fold.
摘要翻译: 本文公开了用于定位和固定锚固件的装置和方法。 锚固件适于被递送并植入到组织中,特别是患者胃肠系统内的组织中。 锚固件适于在缝合线上单向滑动,使得组织褶皱可以在锚固件之间束紧。 如果锚固件被拉动,推动或沿着缝合线沿相反方向被推动,锚固件本身内的定位器本身内的锁定机构可以允许单向平移,同时使锚固件能够锁定在缝合线上 。 这种单向锚定锁定机构有助于锚定器之间的组织褶皱收紧,并且可以在一个或多个锚定器中用于收紧组织折叠。
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公开(公告)号:US07601159B2
公开(公告)日:2009-10-13
申请号:US10955244
申请日:2004-09-30
申请人: Richard C. Ewers , Tracy D. Maahs , Cang C. Lam , Vahid Saadat , Chris Rothe
发明人: Richard C. Ewers , Tracy D. Maahs , Cang C. Lam , Vahid Saadat , Chris Rothe
IPC分类号: A61B17/03
CPC分类号: A61B17/0401 , A61B17/0469 , A61B17/0487 , A61B17/06066 , A61B17/064 , A61B17/08 , A61B17/10 , A61B17/29 , A61B2017/00867 , A61B2017/0404 , A61B2017/0409 , A61B2017/0417 , A61B2017/0419 , A61B2017/0445 , A61B2017/0446 , A61B2017/045 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0459 , A61B2017/0461 , A61B2017/0462 , A61B2017/0464 , A61B2017/0475 , A61B2017/0488 , A61B2017/0496 , A61B2017/06052 , A61B2017/081 , A61B2017/3488
摘要: Interlocking tissue anchor apparatus and methods are described herein. In creating tissue folds within the body of a patient, a tissue manipulation assembly may generally have an elongate tubular member, an engagement member slidably disposed through the tubular member and a distal end adapted to engage tissue via a helical member, tissue stabilizing members positioned at the tubular member distal end which are adapted to stabilize tissue therebetween, and a delivery tube pivotable about the tissue stabilizer. Anchor assemblies can be delivered via the tissue manipulation assembly into or through the tissue. The anchors can incorporate various temporary interlocking features or spacing elements between one another to ensure that an anchor is not prematurely ejected from the needle assembly. This allows the anchor assembly to be advanced distally as well as withdrawn proximally within a deployment sheath while avoiding inadvertently ejecting an anchor.
摘要翻译: 本文描述了联锁组织锚装置和方法。 在组织折叠在患者体内产生时,组织操作组件通常可以具有细长的管状构件,可滑动地设置穿过管状构件的接合构件和适于通过螺旋构件接合组织的远端,组织稳定构件 所述管状构件远端适于在其间稳定组织,以及可围绕所述组织稳定器枢转的输送管。 锚固组件可以经由组织操纵组件输送到组织或穿过组织。 锚固件可以在彼此之间结合各种临时互锁特征或间隔元件,以确保锚不会从针组件过早地弹出。 这允许锚固组件在部署护套内远端地向远侧推进,同时避免无意中弹出锚固件。
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公开(公告)号:US07520884B2
公开(公告)日:2009-04-21
申请号:US10841233
申请日:2004-05-07
IPC分类号: A61B17/08
CPC分类号: A61B17/00234 , A61B17/0401 , A61B17/085 , A61B17/1114 , A61B2017/0496 , A61B2017/081 , A61F5/0086
摘要: Methods for performing gastroplasty include reducing the effective volume or cross-sectional area of the stomach via approximation of gastric tissue. Such reduction preferably is achieved endoluminally, either with or without laparoscopic ports. In one variation, a sleeve, pouch, Magenstrasse and Mill, Vertical Banded Gastroplasty (“VBG”), etc.,is formed within the stomach by approximating opposing anterior and posterior segments or ridges of the stomach wall at locations inferior to the gastroesophageal junction. In another variation, opposing walls of the stomach are approximated at a plurality of substantially random locations to reduce an effective volume of the stomach. In yet another variation, both a sleeve and random approximations are formed, the random approximations preferably disposed in a portion of the stomach excluded by the sleeve. In still another variation, opposing walls of the stomach are approximated over significant lengths at random or specified locations.
摘要翻译: 进行胃成形术的方法包括通过胃组织的近似来减小胃的有效体积或横截面积。 这种减少优选是在腹腔镜下或腹腔镜下进行的。 在一个变型中,通过在胃壁下方的胃壁的相邻的前部和后部区段或脊部近似形成在胃内形成套筒,袋,Magenstrasse和Mill,垂直带状胃成形术(“VBG”)等 。 在另一个变型中,胃的相对壁在多个基本上随机的位置近似,以减少胃的有效体积。 在另一个变型中,形成套筒和随机近似,随机近似优选地设置在由套筒排除的胃的一部分中。 在另一个变体中,胃的相对的壁在随机或指定的位置处以相当长的长度近似。
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公开(公告)号:US20130138151A1
公开(公告)日:2013-05-30
申请号:US13748302
申请日:2013-01-23
IPC分类号: A61B17/04
CPC分类号: A61B17/0401 , A61B17/0469 , A61B17/0482 , A61B17/0644 , A61B2017/00827 , A61B2017/00867 , A61B2017/0409 , A61B2017/0419 , A61B2017/0454 , A61B2017/0464 , A61B2017/0496 , A61B2017/06052 , A61B2090/037
摘要: Apparatus and methods optimize anchoring force in securing tissue folds. Over-compression of the tissue directly underlying the anchors is avoided by utilizing tissue anchors having expandable designs configured to minimize contact area between the anchor and tissue. When the anchor is in its expanded configuration, a load is applied to the anchor until it is optimally configured to accommodate a range of deflections while the anchor itself exerts a substantially constant force against the tissue.
摘要翻译: 装置和方法优化固定组织褶皱的锚固力。 通过使用具有可扩展设计的组织锚来避免直接位于锚固器下面的组织的过度压缩,所述组织锚定构造成使锚和组织之间的接触面积最小化。 当锚固件处于其膨胀构型时,将负载施加到锚固件,直到其被最佳地构造成适应一定范围的偏转,同时锚固件本身对组织施加基本恒定的力。
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公开(公告)号:US20130041214A1
公开(公告)日:2013-02-14
申请号:US13597072
申请日:2012-08-28
申请人: Tracy D. Maahs , Richard C. Ewers , Arvin T. Chang , Chris Rothe , Eugene C. Chen , Marvin C. Elmer , Gilbert Madrid , Kabir Gambhir
发明人: Tracy D. Maahs , Richard C. Ewers , Arvin T. Chang , Chris Rothe , Eugene C. Chen , Marvin C. Elmer , Gilbert Madrid , Kabir Gambhir
CPC分类号: A61B1/0051 , A61B1/00085 , A61B1/00089 , A61B1/00098 , A61B1/00179 , A61B1/00183 , A61B1/018 , A61B1/05
摘要: Methods and apparatus for off-axis visualization are described herein. An endoluminal tissue manipulation assembly is disclosed which provides for a stable endoluminal platform and which also provides for effective triangulation of tools. Such an apparatus may comprise an optionally shape-lockable elongate body defining a longitudinal axis and adapted for endoluminal advancement in a patient body, at least one articulatable visualization lumen disposed near or at a distal region of the elongate body, the at least one articulating visualization lumen being adapted to articulate off-axis relative to a longitudinal axis of the elongate body, and at least one articulatable tool arm member disposed near or at the distal region of the elongate body, the at least one articulatable tool arm member being adapted to articulate off-axis and manipulate a tissue region of interest.
摘要翻译: 本文描述了用于离轴可视化的方法和装置。 公开了一种腔内组织操作组件,其提供稳定的内腔平台,并且还提供工具的有效三角测量。 这种装置可以包括限定纵向轴线并且适于在患者体内进行腔内前进的可选形状可锁定细长体,至少一个可伸长的可视腔,其设置在细长体的远端区域附近或位于该远端区域处,该至少一个铰接可视化 内腔适于相对于细长主体的纵向轴线偏轴关节,以及设置在细长主体的远侧区域附近或其附近的至少一个可铰接工具臂构件,所述至少一个可铰接工具臂构件适于铰接 离轴并且操纵感兴趣的组织区域。
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10.
公开(公告)号:US20120238952A1
公开(公告)日:2012-09-20
申请号:US13483371
申请日:2012-05-30
申请人: Sean Mitchell , Richard C. Ewers , Tracy D. Maahs
发明人: Sean Mitchell , Richard C. Ewers , Tracy D. Maahs
IPC分类号: A61M25/092
CPC分类号: A61B1/0057 , A61B1/0052 , A61B1/0055 , A61B1/008 , A61B1/012 , A61M25/0147
摘要: An endoluminal surgical instrument has first and second steering controls on a handle. A flexible shaft attached to the handle has a distal steerable end including a first link and a second link separated by a plurality of intermediate links. First and second steering elements, such as pairs of steering wires, are linked to first and second steering controls and to the first and, second links. One or more of the links is pivotable through an angle of at least 30 degrees relative to an adjoining link. The set back position of the second steering elements from the first steering elements, and the pivoting capability of the links allows the steerable end to be steered into a small bend radius. This makes the instrument highly maneuverable for use in endoluminal surgery, such as incision-less surgery of the stomach.
摘要翻译: 腔内手术器械在手柄上具有第一和第二转向控制。 附接到手柄的柔性轴具有远端可操纵端,其包括由多个中间连杆分隔的第一连杆和第二连杆。 第一和第二转向元件,例如成对的转向线,被连接到第一和第二转向控制以及第一和第二连杆。 连接件中的一个或多个可相对于邻接连杆枢转至少30度的角度。 来自第一转向元件的第二转向元件的回退位置以及链节的枢转能力允许可转向端转向小的弯曲半径。 这使得仪器高度可操作地用于腔内手术,例如无切口的胃手术。
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