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    Methods and apparaus for off-axis visualization
    1.
    发明申请
    Methods and apparaus for off-axis visualization 有权
    离轴可视化的方法和应用

    公开(公告)号：US20060189845A1

    公开(公告)日：2006-08-24

    申请号：US11365088

    申请日：2006-02-28

    申请人： Tracy Maahs ,  Richard Ewers ,  Arvin Chang ,  Chris Rothe ,  Eugene Chen ,  Marvin Elmer ,  Gilbert Madrid ,  Kabir Gambhir

    发明人： Tracy Maahs ,  Richard Ewers ,  Arvin Chang ,  Chris Rothe ,  Eugene Chen ,  Marvin Elmer ,  Gilbert Madrid ,  Kabir Gambhir

    IPC分类号： A61B1/00

    CPC分类号： A61B1/00179 ,  A61B1/0008 ,  A61B1/00183 ,  A61B1/0051 ,  A61B1/018 ,  A61B1/04

    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。

    Apparatus and methods for endoluminal advancement
    2.
    发明申请
    Apparatus and methods for endoluminal advancement 审中-公开
    用于腔内推进的装置和方法

    公开(公告)号：US20060287666A1

    公开(公告)日：2006-12-21

    申请号：US11154168

    申请日：2005-06-15

    申请人： Vahid Saadat ,  Eugene Chen ,  Tung Le ,  Tracy Maahs ,  Richard Ewers ,  John Cox ,  Chris Rothe

    发明人： Vahid Saadat ,  Eugene Chen ,  Tung Le ,  Tracy Maahs ,  Richard Ewers ,  John Cox ,  Chris Rothe

    IPC分类号： A61M29/00

    CPC分类号： A61M25/1011 ,  A61B2017/22068 ,  A61B2017/22069 ,  A61M2025/1015 ,  A61M2025/1052

    摘要： Apparatus and methods for endoluminal advancement are described herein. A shape-lockable tissue anchoring assembly generally has an elongate body, a handle assembly, and an anchoring assembly positioned at or proximal to a distal tip of the elongate body. A distal portion of the elongate body may optionally be steerable or curvable. The anchoring assembly may include various expandable or projecting anchoring features to contact and retain tissue relative to the elongate body such that pleated tissue is temporarily immobile relative to the elongate body. This anchoring can be actuated simultaneously with or independently from shape-locking of elongate body. The anchoring assembly can be actuated simultaneously with the shape-locking of the elongate body. Alternatively, the steerable distal portion of the elongate body can be angled against the pleated tissue to retain it while the endoscope is advanced relative to the pleated tissue.

    摘要翻译： 本文描述了腔内前进的装置和方法。 可锁定形状的组织锚固组件通常具有细长主体，手柄组件和定位在细长主体的远侧末端处或近侧的锚固组件。 细长主体的远端部分可以可选地是可操纵的或可调节的。 锚定组件可以包括各种可膨胀或突出的锚固特征，以相对于细长体接触和保持组织，使得褶皱组织相对于细长体临时固定不动。 这种锚固可以与细长体的形状锁定同时或独立地致动。 锚固组件可以与细长体的形状锁定同时致动。 或者，细长主体的可转向远端部分可以相对于打褶组织成角度，以在内窥镜相对于打褶组织前进时保持它。

    Compressible tissue anchor assemblies
    5.
    发明申请
    Compressible tissue anchor assemblies 有权
    可压缩组织锚固组件

    公开(公告)号：US20060217762A1

    公开(公告)日：2006-09-28

    申请号：US11404423

    申请日：2006-04-14

    申请人： Tracy Maahs ,  Marvin Elmer ,  Richard Ewers

    发明人： Tracy Maahs ,  Marvin Elmer ,  Richard Ewers

    IPC分类号： A61B17/08

    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 & 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。

    Methods and apparatus for performing endoluminal procedures
    6.
    发明申请
    Methods and apparatus for performing endoluminal procedures 审中-公开
    用于进行腔内手术的方法和装置

    公开(公告)号：US20050272977A1

    公开(公告)日：2005-12-08

    申请号：US11129513

    申请日：2005-05-13

    申请人： Vahid Saadat ,  Chris Rothe ,  Richard Ewers ,  Gilbert Madrid

    发明人： Vahid Saadat ,  Chris Rothe ,  Richard Ewers ,  Gilbert Madrid

    IPC分类号： A61B1/005 ,  A61B1/018 ,  A61B1/04

    CPC分类号： A61B1/0051 ,  A61B1/0008 ,  A61B1/00179 ,  A61B1/00183 ,  A61B1/018 ,  A61B1/04 ,  A61B17/29

    摘要： Methods and apparatus for performing endoluminal procedures 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： 本文描述了用于进行腔内手术的方法和装置。 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。

    Methods and apparatus for performing endoluminal procedures
    7.
    发明申请
    Methods and apparatus for performing endoluminal procedures 审中-公开
    用于进行腔内手术的方法和装置

    公开(公告)号：US20060183975A1

    公开(公告)日：2006-08-17

    申请号：US11400580

    申请日：2006-04-07

    申请人： Vahid Saadat ,  Chris Rothe ,  Richard Ewers ,  Gilbert Madrid

    发明人： Vahid Saadat ,  Chris Rothe ,  Richard Ewers ,  Gilbert Madrid

    IPC分类号： A61B1/00

    CPC分类号： A61B1/0051 ,  A61B1/0008 ,  A61B1/00179 ,  A61B1/00183 ,  A61B1/018 ,  A61B1/04 ,  A61B17/29

    摘要： Methods and apparatus for performing endoluminal procedures 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： 本文描述了用于进行腔内手术的方法和装置。 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。

    Methods and apparatus for revision of obesity procedures
    8.
    发明申请
    Methods and apparatus for revision of obesity procedures 有权
    肥胖程序修订方法和手段

    公开(公告)号：US20070175488A1

    公开(公告)日：2007-08-02

    申请号：US11342288

    申请日：2006-01-27

    申请人： John Cox ,  Tracy Maahs ,  Richard Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

    发明人： John Cox ,  Tracy Maahs ,  Richard Ewers ,  Eugene Chen ,  Cang Lam ,  Lee Swanstrom

    IPC分类号： A61B17/138

    CPC分类号： A61B17/1114 ,  A61B17/29 ,  A61B2017/00278 ,  A61B2017/00349 ,  A61B2017/0417 ,  A61B2017/0419 ,  A61B2017/1103 ,  A61B2017/1125 ,  A61B2017/1142 ,  A61B2017/2905 ,  A61F5/0083 ,  A61F5/0086

    摘要： Methods and apparatus for the endoluminal revision of previously performed obesity procedures which have failed are described. One or more endoluminal instruments may be advanced per-orally into the previously formed failed pouch where a number of different procedures can be performed. One or more tissue folds can be formed and secured to reduce the size of the pouch, or the stoma connecting the pouch to the intestinal tract can be reduced in size using endoluminally deployed tissue anchors. These procedures can be performed entirely from within the pouch lumen or upon the exterior surface of the pouch via transgastric entry of the instruments into the peritoneal cavity of a patient. Alternatively, the interior tissue within the pouch can be injured or sclerosed to shrink the pouch lumen. In another alterative, a length of the Roux limb can be shortened endoluminally to create a malabsorptive region.

    摘要翻译： 描述了先前进行的失败的肥胖程序的腔内修复的方法和装置。 一个或多个腔内器械可以每次口服进入先前形成的失败的小袋，其中可以执行许多不同的程序。 可以形成和固定一个或多个组织折叠以减小小袋的尺寸，或者使用内腔部署的组织锚固件将小袋连接到肠道的造口减小。 这些程序可以完全从袋内腔或袋的外表面通过仪器经腹进入患者的腹膜腔进行。 或者，袋内的内部组织可以被损伤或硬化以收缩袋腔。 在另一个替代方案中，Roux肢体的长度可以被内在缩短以产生吸收不良的区域。

    Methods for performing gastroplasty
    9.
    发明申请
    Methods for performing gastroplasty 有权
    进行胃成形术的方法

    公开(公告)号：US20050250980A1

    公开(公告)日：2005-11-10

    申请号：US10841233

    申请日：2004-05-07

    申请人： Lee Swanstrom ,  Richard Ewers ,  Tracy Maahs ,  Eugene Chen ,  Vahid Saadat

    发明人： Lee Swanstrom ,  Richard Ewers ,  Tracy Maahs ,  Eugene Chen ,  Vahid Saadat

    IPC分类号： A61B17/00 ,  A61B17/04 ,  A61B17/08 ,  A61B17/11 ,  A61F2/04 ,  A61F5/00

    CPC分类号： A61B17/00234 ,  A61B17/0401 ,  A61B17/085 ,  A61B17/1114 ,  A61B2017/0496 ,  A61B2017/081 ,  A61F5/0086

    摘要： The present invention provides methods for performing gastroplasty by 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： 本发明提供了通过胃组织近似来减小胃的有效体积或横截面面积来进行胃成形术的方法。 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。