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11. 发明授权

US08216252B2 Tissue manipulation and securement system 有权
标题翻译：组织操纵和固定系统
公开(公告)号：US08216252B2
公开(公告)日：2012-07-10
申请号：US11070863
申请日：2005-03-01
申请人： Robert A. Vaughan , Cang C. Lam , Richard C. Ewers , Vahid Saadat
发明人： Robert A. Vaughan , Cang C. Lam , Richard C. Ewers , Vahid Saadat
IPC分类号： A61B17/08
CPC分类号： A61B17/0401 , A61B17/0487 , A61B17/06066 , A61B17/29 , A61B2017/00278 , A61B2017/0409 , A61B2017/0419 , A61B2017/0464 , A61B2017/0496 , A61B2017/06052 , A61B2017/06076 , A61B2017/2923 , A61B2017/2927 , A61B2017/3488
摘要： Tissue manipulation and securement systems are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member and has a lower jaw member and an upper jaw member pivotably coupled to the lower jaw member. A reconfigurable launch tube is also pivotably coupled to the upper jaw member and is used to urge the jaw members from a low-profile configuration to an open configuration for receiving tissue. The tissue manipulation assembly may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly.
摘要翻译：本文描述了组织操纵和固定系统。组织操作组件可枢转地联接到管状构件的远端，并且具有下颚构件和可枢转地联接到下颚构件的上颚构件。可重构的发射管也可枢转地联接到上钳口构件，并且用于将钳口构件从小轮廓构造推动到用于接收组织的打开构型。组织操作组件可以通过形状可锁定内窥镜装置，常规内窥镜，或者直接自身进入患者。第二工具可以与组织操作组件组合使用以接合组织并且与组织操作组件一起操作组织。

12. 发明授权

US07736378B2 Apparatus and methods for positioning and securing anchors 有权
标题翻译：用于定位和固定锚固件的装置和方法
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。

13. 发明授权

US07695493B2 System for optimizing anchoring force 有权
标题翻译：优化锚固力的系统
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
IPC分类号： A61B17/08 , A61D1/00
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。

14. 发明授权

US07520884B2 Methods for performing gastroplasty 有权
标题翻译：进行胃成形术的方法
公开(公告)号：US07520884B2
公开(公告)日：2009-04-21
申请号：US10841233
申请日：2004-05-07
申请人： Lee L. Swanstrom , Richard C. Ewers , Tracy D. Maahs , Eugene G. Chen , Vahid Saadat
发明人： Lee L. Swanstrom , Richard C. Ewers , Tracy D. Maahs , Eugene G. Chen , Vahid Saadat
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。

15. 发明授权

US06960162B2 Shape lockable apparatus and method for advancing an instrument through unsupported anatomy 有权
标题翻译：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：US06960162B2
公开(公告)日：2005-11-01
申请号：US10281426
申请日：2002-10-25
申请人： Vahid Saadat , Richard C. Ewers
发明人： Vahid Saadat , Richard C. Ewers
IPC分类号： A61B1/005 , A61B1/008 , A61B1/01 , A61B1/31 , A61B1/32 , A61B1/00
CPC分类号： A61B1/00154 , A61B1/00078 , A61B1/0008 , A61B1/00082 , A61B1/00105 , A61B1/00135 , A61B1/0052 , A61B1/0055 , A61B1/0058 , A61B1/008 , A61B1/31 , A61B1/32
摘要： Apparatus and methods are provided for placing and advancing a diagnostic or therapeutic instrument in a hollow body organ of a tortuous or unsupported anatomy, comprising a handle, an overtube disposed within a hydrophilic sheath, and 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 sheath may be disposable to permit reuse of the overtube. Fail-safe tensioning mechanisms may be provided to selectively stiffen the overtube to reduce distension of the organ caused by advancement of the diagnostic or therapeutic instrument. The fail-safe tensioning mechanisms reduce the risk of reconfiguration of the overtube in the event that the tension system fails, and, in one embodiment, rigidizes the overtube without substantial proximal movement of the distal region. 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，用于将诊断或治疗仪器放置在曲折或无支撑的解剖结构的空心体器官中，包括手柄，设置在亲水护套内的外套管，以及具有无创尖端的远侧区域。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。护套可以是一次性的，以允许外套管的再次使用。可以提供故障安全的张紧机构以选择性地加固外套管，以减少由诊断或治疗仪器的前进引起的器官的膨胀。在张力系统失效的情况下，故障安全张紧机构降低了外套管的重新配置的风险，并且在一个实施例中，使外套管刚性化，而远端区域没有实质的近端运动。远侧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，而无创伤尖端防止器官的壁在操纵诊断或治疗仪器期间被卡住或夹住。

16. 发明授权

US08628541B2 Methods and apparatus for securing and deploying tissue anchors 有权
标题翻译：用于固定和部署组织锚的方法和装置
公开(公告)号：US08628541B2
公开(公告)日：2014-01-14
申请号：US11238543
申请日：2005-09-30
申请人： Vahid Saadat , Richard C. Ewers , Cang C. Lam
发明人： Vahid Saadat , Richard C. Ewers , Cang C. Lam
IPC分类号： A61B17/10
CPC分类号： A61B17/29 , A61B17/0401 , A61B17/0467 , A61B17/0469 , A61B17/0482 , A61B2017/003 , A61B2017/00349 , A61B2017/00827 , A61B2017/00867 , A61B2017/0419 , A61B2017/0458 , A61B2017/0464 , A61B2017/0496 , A61B2017/06052 , A61B2017/2927
摘要： Methods and apparatus for securing and deploying tissue anchors are described herein. A tissue manipulation assembly is pivotably coupled to the distal end of a tubular member. A reconfigurable launch tube is also pivotably coupled to the tissue manipulation assembly, which may be advanced through a shape-lockable endoscopic device, a conventional endoscope, or directly by itself into a patient. A second tool can be used in combination with the tissue manipulation assembly to engage tissue and manipulate the tissue in conjunction with the tissue manipulation assembly. A deployment assembly is provided for securing engaged tissue via one or more tissue anchors, the deployment assembly also being configured to disengage the anchors endoluminally or laparoscopically by applying thermal energy through at least one suture cutting element disposed along the deployment assembly.
摘要翻译：本文描述了用于固定和展开组织锚的方法和装置。组织操作组件可枢转地联接到管状构件的远端。可重新配置的发射管也可枢转地联接到组织操作组件，组织操作组件可通过可形状锁定的内窥镜装置，常规内窥镜或直接自身进入患者。第二工具可以与组织操作组件组合使用以接合组织并且与组织操作组件一起操作组织。提供了一种展开组件，用于通过一个或多个组织锚固件固定所接合的组织，所述展开组件还被配置为通过沿着所述展开组件布置的至少一个缝合线切割元件施加热能而使所述锚定器在内部或腹腔镜下脱离。

17. 发明授权

US08216260B2 Apparatus and methods for forming and securing gastrointestinal tissue folds 有权
标题翻译：用于形成和固定胃肠组织褶皱的装置和方法
公开(公告)号：US08216260B2
公开(公告)日：2012-07-10
申请号：US12198056
申请日：2008-08-25
申请人： Cang C. Lam , Richard C. Ewers , Alexander Khairkhanan , Vahid Saadat
发明人： Cang C. Lam , Richard C. Ewers , Alexander Khairkhanan , Vahid Saadat
IPC分类号： A61B17/08 , A61B17/04
CPC分类号： A61B17/00234 , A61B17/0401 , A61B17/0487 , A61B17/062 , A61B17/0644 , A61B17/29 , A61B17/3421 , A61B17/3468 , A61B17/3478 , A61B2017/0404 , A61B2017/0417 , A61B2017/0419 , A61B2017/0443 , A61B2017/0451 , A61B2017/0454 , A61B2017/0458 , A61B2017/0461 , A61B2017/0462 , A61B2017/0464 , A61B2017/0496 , A61B2017/061 , A61B2017/0649 , A61B2017/3445 , A61B2017/3488 , A61F5/0086
摘要： Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point. Adjustable anchor assemblies, as well as anchor delivery systems, are also provided.
摘要翻译：提供了设备和方法，用于通过在第一组织接触点处接合组织来形成胃肠组织折叠，将第一组织接触点从最初远端到第二组织接触点的位置移动到第二接触点的近侧的位置，以形成组织折叠，并且使锚固组件穿过第二组织接触点附近的组织褶皱延伸。还提供了可调节锚固组件以及锚固装置系统。

18. 发明授权

US08206417B2 Apparatus and methods for optimizing anchoring force 有权
标题翻译：用于优化锚固力的装置和方法
公开(公告)号：US08206417B2
公开(公告)日：2012-06-26
申请号：US10865243
申请日：2004-06-09
申请人： Tracy D. Maahs , Richard C. Ewers , Vahid Saadat , Alex Khairkhahan , Kenneth J. Michlitsch
发明人： Tracy D. Maahs , Richard C. Ewers , Vahid Saadat , Alex Khairkhahan , Kenneth J. Michlitsch
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。

19. 发明授权

US07955253B2 Apparatus and methods for achieving endoluminal access 有权
标题翻译：用于实现腔内通路的装置和方法
公开(公告)号：US07955253B2
公开(公告)日：2011-06-07
申请号：US11311999
申请日：2005-12-19
申请人： Richard C. Ewers , Boris Reydel , Eugene G. Chen , Vahid Saadat
发明人： Richard C. Ewers , Boris Reydel , Eugene G. Chen , Vahid Saadat
IPC分类号： A61B1/00
CPC分类号： A61B1/00149 , A61B1/00082 , A61B1/00147 , A61B1/31
摘要： The present invention provides methods and apparatus for pleating at least a portion of a patient's body lumen, such as the colon. Pleating is achieved via relative motion between an endoscope and a flexible conduit having an engagement element configured to reversibly engage the body lumen.
摘要翻译：本发明提供了用于打褶患者体腔（如结肠）的至少一部分的方法和装置。褶皱通过内窥镜和具有配置为可逆地接合体腔的接合元件的柔性导管之间的相对运动来实现。

20. 发明授权

US07918845B2 Endoluminal tool deployment system 有权
标题翻译：腔内工具部署系统
公开(公告)号：US07918845B2
公开(公告)日：2011-04-05
申请号：US10991118
申请日：2004-11-16
申请人： Vahid Saadat , Richard C. Ewers , Eugene Chen , David Miller
发明人： Vahid Saadat , Richard C. Ewers , Eugene Chen , David Miller
IPC分类号： A61B17/00 , A61B1/00
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。

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