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    Apparatus and methods for endoluminal advancement
    1.
    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。

    Methods for performing gastroplasty
    2.
    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。

    Methods and apparaus for off-axis visualization
    3.
    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。

    Methods and apparatus for revision of obesity procedures
    4.
    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。

    Shape lockable apparatus and method for advancing an instrument through unsupported anatomy
    8.
    发明申请
    Shape lockable apparatus and method for advancing an instrument through unsupported anatomy 审中-公开
    形状可锁定装置和方法，用于通过不支持的解剖结构推进器械

    公开(公告)号：US20050137455A1

    公开(公告)日：2005-06-23

    申请号：US10888439

    申请日：2004-07-08

    申请人： Richard Ewers ,  Vahid Saadat ,  Eugene Chen

    发明人： Richard Ewers ,  Vahid Saadat ,  Eugene Chen

    IPC分类号： A61B1/005 ,  A61B1/01 ,  A61B1/31 ,  A61B1/32 ,  A61B1/00

    CPC分类号： A61B1/0052 ,  A61B1/00078 ,  A61B1/0008 ,  A61B1/00082 ,  A61B1/00135 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/31 ,  A61B1/32

    摘要： Apparatus and methods are provided for placing and advancing a diagnostic of therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube, a distal region having an atraumatic tip. The overtube may be removable from the handle, and have a longitudinal axis disposed at an angle relative to the handle. The overtube may be selectively stiffened to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The distal region permits passive steering of the overtube caused by deflection of the diagnostic or therapeutic instrument while the atraumatic tip prevents the wall of the organ from becoming caught or pinched during manipulation of the diagnostic or therapeutic instrument.

    摘要翻译： 提供了设备和方法，用于将治疗仪器的诊断放置并行进在曲折或无支撑的解剖结构的中空身体器官中，包括手柄，外套管，具有无创伤尖端的远侧区域。 外套管可以从手柄移除，并且具有相对于把手以一定角度设置的纵向轴线。 外套管可以选择性地加强，以减少由诊断或治疗仪器的前进引起的器官膨胀。 远端区域允许由诊断或治疗仪器的偏转引起的外套管的被动转向，而无创伤的尖端在操纵诊断或治疗仪器期间防止器官的壁被卡住或夹住。

    Endoluminal tool deployment system
    9.
    发明申请
    Endoluminal tool deployment system 审中-公开
    腔内工具部署系统

    公开(公告)号：US20050113640A1

    公开(公告)日：2005-05-26

    申请号：US10990559

    申请日：2004-11-16

    申请人： Vahid Saadat ,  Richard Ewers ,  Eugene Chen ,  David Miller

    发明人： Vahid Saadat ,  Richard Ewers ,  Eugene Chen ,  David Miller

    IPC分类号： A61B1/005 ,  A61B1/018 ,  A61B1/313 ,  A61B17/34

    CPC分类号： A61B17/00234 ,  A61B1/0055 ,  A61B1/0057 ,  A61B1/018 ,  A61B1/313 ,  A61B2017/003 ,  A61B2017/00323 ,  A61B2017/00349 ,  A61B2017/2906 ,  A61B2017/3445 ,  A61B2090/306 ,  A61B2090/508 ,  A61M25/0043 ,  A61M25/0105 ,  A61M25/0147 ,  A61M2025/0096

    摘要： Systems, devices and methods are provided for endoscopic procedures involving tissue manipulations beyond the capabilities of traditional endoscopic instruments. Embodiments of the systems include an elongated main body having a scope therethrough and at least one steerable tool arm which extends from the distal end of the main body. In preferred embodiments, the system includes two tool arms, each arm steerable to form a curve laterally outward which then bends laterally inward so that the arms form an angular shape. In addition, end effectors extend from the distal ends of each tool arm for use in manipulation of tissue. The angular shape brings the end effectors together in view of the scope for cooperative movements which are continuously visible by the surgeon. In addition, the tool arms may be steerable in any additional direction and may be rotateable to allow grasping, elevation and more complex manipulation of tissue.

    摘要翻译： 提供的系统，装置和方法用于内窥镜手术，其涉及组织操作超出传统内窥镜仪器的能力。 系统的实施例包括具有穿过其中的一个细长主体和从该主体的远端延伸的至少一个可操纵的工具臂。 在优选实施例中，系统包括两个工具臂，每个臂可转向以横向向外形成曲线，然后横向向内弯曲，使得臂形成角形。 另外，末端执行器从每个工具臂的远端延伸以用于组织的操作。 考虑到外科医生连续可见的协作运动的范围，角形状使末端执行器结合在一起。 此外，工具臂可以在任何附加方向上是可操纵的并且可以是可旋转的，以允许组织的抓握，升高和更复杂的操纵。