摘要:
Apparatus and methods are provided for controlling pressurization of a body cavity by controlling the rate and magnitude of pressurization during insufflation and/or exsufflation. In one variation, a pump may be used to either draw suction or to pressurize a body cavity. The pump may be connected to a controller that controls one or more regulators and/or valves for regulating pressurization. The controller preferably is programmable to allow a medical practitioner to input and/or rapidly alter desired pressurization parameters. In another variation, one or more pumps may be provided to simultaneously and independently control pressurization of multiple body cavities, such as a patient's stomach and peritoneal cavity.
摘要:
Transgastric abdominal access methods and apparatus are described herein. A shape-lockable elongate body can be advanced endoluminally in a flexible state into the stomach, where an opening is created through the stomach wall. The opening can be created endoluminally or by incising instruments placed through the abdominal wall. The elongate body can be transitioned to a rigid state prior to, during, or after advancement into the patient and is passed through the opening into the peritoneal cavity. A dilation balloon can be positioned simultaneously within the elongate body and within the tissue opening such that the elongate body can be advanced through the tissue opening. A flexible needle catheter can also be delivered through the elongate body or an endoscope to provide for insufflation prior to cutting or piercing through the stomach wall. Also, tissue closure devices and methods to close the opening created through the stomach wall.
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:
Methods and apparatus for maintaining sterility during transluminal procedures are described. The sterility is achieved by making use of a membrane in either the form, e.g., of a sheath, cap or umbrella to keep the instruments (endoscopes, overtubes, etc.) sterile while being advanced through lumens in the body and into the various cavities. Methods, such as vacuum acquisition, mechanical tissue anchoring, etc., of the underlying tissue followed by incision of the tissue with, e.g., a needle knife, can be utilized to gain access to the various cavities. It is expected that this procedure will provide the desired level of sterility for transluminal procedures.
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:
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:
Apparatus and methods for conveying or transmitting force or energy to a medical end effector coupled to a flexible or rigid shaft are described herein. One variation of such apparatus may be used to manipulate tissue and create a tissue fold and may generally comprise an elongate tubular member having an end effector disposed thereon. The end effector may comprise a tissue engagement member adapted to engage tissue, a first stabilizing member and a second stabilizing member positioned at the tubular member distal end, and a launch tube adapted to pivot about the first stabilizing member. Elements of the end effector may be actuable via various force transmission elements and/or mechanisms. Such force transmission elements preferably are integrated into and/or are actuable via a handle. The force transmission mechanisms may be utilized to actuate and/or transmit force to alternative medical end effectors coupled to flexible or rigid shafts.
摘要:
Disposable shapelocking systems are disclosed herein. A shapelock assembly generally comprises an elongate body defining at least one lumen therethrough for advancement of an endoscope or other endoscopic instruments therethrough. A handle assembly can be actuated to compress nested links against one another to transition the elongate body from a flexible state to a rigid shape-locked state. One or more of the nested links can be made from a particular thermoplastic either alone or in combination with one or more reinforcing structures. Such structures can include a reinforcing ring integrated with the link on an inner, outer, or lower surface of the link. Alternatively, the link can be coated or layered to enhance its strength. Additionally, different portions of the shapelock body can be made from different types of links depending upon the loads imparted upon the various portions of the shapelock body.
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:
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.