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71. 发明授权

US08992420B2 Methods and apparatus for off-axis visualization 有权
标题翻译：用于离轴可视化的方法和装置
公开(公告)号：US08992420B2
公开(公告)日：2015-03-31
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
IPC分类号： A61B1/00 , A61B1/005 , A61B1/018 , A61B1/05
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。

72. 发明授权

US08911366B2 Surgical access apparatus and method 有权
标题翻译：手术进入装置及方法
公开(公告)号：US08911366B2
公开(公告)日：2014-12-16
申请号：US13347897
申请日：2012-01-11
申请人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
发明人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
IPC分类号： A61B1/32 , A61B17/34 , A61B17/02 , A61B17/00
CPC分类号： A61B17/3423 , A61B17/0218 , A61B17/0293 , A61B17/3474 , A61B17/3498 , A61B2017/00265 , A61B2017/00526 , A61B2017/3419 , A61B2017/3445 , A61B2017/3492 , A61M13/003
摘要： A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.
摘要翻译：外科进入装置包括与主体壁形成密封并且将进入通道提供到体腔中的单个阀。该阀具有在没有仪器的情况下产生零密封的特性，以及具有仪器直径范围的仪器的仪器密封。该阀可以包括凝胶，优选地包括由弹性体和提供大于1000％的伸长率和小于5肖氏A的硬度的油的超细颗粒。单个阀可用作手动口，其中仪器包括外科医生的手臂，从而提供手进入空腔。

73. 发明授权

US08726909B2 Methods and apparatus for revision of obesity procedures 有权
标题翻译：肥胖程序修订方法和手段
公开(公告)号：US08726909B2
公开(公告)日：2014-05-20
申请号：US11342288
申请日：2006-01-27
申请人： John A. Cox , Tracy Maahs , Richard C. Ewers , Eugene Chen , Cang Lam , Lee Swanstrom
发明人： John A. Cox , Tracy Maahs , Richard C. Ewers , Eugene Chen , Cang Lam , Lee Swanstrom
IPC分类号： A61B19/00 , A61B17/10
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 alternative, 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缩缩以产生吸收不良区域。

74. 发明申请

US20130217973A1 WOUND RETRACTION APPARATUS AND METHOD 审中-公开
标题翻译：回绕装置和方法
公开(公告)号：US20130217973A1
公开(公告)日：2013-08-22
申请号：US13765278
申请日：2013-02-12
申请人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Payam Adlparvar , Scott V. Taylor , Gary R. Dulak , Michael J. Dunn , Norman L. Morales , Charles C. Hart , Robert R. Bowes
发明人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Payam Adlparvar , Scott V. Taylor , Gary R. Dulak , Michael J. Dunn , Norman L. Morales , Charles C. Hart , Robert R. Bowes
IPC分类号： A61B1/32
CPC分类号： A61B1/32 , A61B17/0293 , A61B17/3423 , A61B17/3431 , A61B2017/3484
摘要： A surgical wound retractor is adapted to dilate a wound stretchable to a desired diameter through body cavities of varying thicknesses. The retractor includes a first ring having a diameter greater than that desired for the wound and being adapted for disposition interiorly of the wound, a second ring having a diameter greater than that desired for the wound and is adapted for disposition exteriorly of the wound, and a sheath disposed between the two rings. Optionally, the second ring may be detachably attached to the sheath to adapt the retractor to body cavities of varying thickness. Additional rings may be disposed along the sheath to provide for adjustment of the distance between the first and second rings. The retractor may also include an expandable foam annulus that can adjust the distance between the first and second rings.
摘要翻译：外科伤口牵开器适于通过不同厚度的体腔将可伸展到期望直径的伤口扩张。牵开器包括第一环，其直径大于伤口所需的直径，并且适于在伤口内部配置，第二环的直径大于伤口所需的直径，并适于在伤口的外部进行配置;以及设置在两个环之间的护套。可选地，第二环可以可拆卸地附接到护套以使牵开器适应变化厚度的体腔。可以沿着护套设置附加的环以提供第一和第二环之间的距离的调整。牵开器还可以包括可调节第一和第二环之间距离的可膨胀泡沫环。

75. 发明申请

US20120283756A1 TREATMENT OF HYPERTENSION AND HEART DISEASE VIA SURGERY OF THE STOMACH 审中-公开
标题翻译：通过STOMACH手术治疗高血压和心脏疾病
公开(公告)号：US20120283756A1
公开(公告)日：2012-11-08
申请号：US13479991
申请日：2012-05-24
申请人： Scott Moonly , John Cox , Richard C. Ewers
发明人： Scott Moonly , John Cox , Richard C. Ewers
IPC分类号： A61B17/00 , A61B17/03
CPC分类号： A61B17/0401 , A61B17/0487 , A61B2017/003 , A61B2017/00349 , A61B2017/00818 , A61B2017/0409 , A61B2017/0417
摘要： Devices and methods for endolumenally manipulating stomach fundus tissue alter the function of nearby nerves. The altered function of the nerves interacts with the cardiopulmonary system to cause a substantially permanent reduction in blood pressure. The altered nerve function may also treat heart disease as well. This application also relates to devices and methods for endolumenally manipulating stomach tissue to alter hormone production from cells associated with stomach tissue, providing a therapeutic effect in treating hypertension and heart disease, not conventionally associated with the stomach.
摘要翻译：腔内操作胃底组织的装置和方法改变了附近神经的功能。神经的改变功能与心肺系统相互作用，导致血压基本上永久性降低。改变的神经功能也可以治疗心脏病。本申请还涉及用于腔内操作胃组织以改变与胃组织相关的细胞的激素产生的装置和方法，在治疗高血压和心脏病方面提供治疗效果，而不是常规地与胃相关。

76. 发明申请

US20120149989A1 SURGICAL ACCESS APARATUS AND METHOD 有权
标题翻译：外科手术APARATUS和方法
公开(公告)号：US20120149989A1
公开(公告)日：2012-06-14
申请号：US13347897
申请日：2012-01-11
申请人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
发明人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
IPC分类号： A61B1/32
CPC分类号： A61B17/3423 , A61B17/0218 , A61B17/0293 , A61B17/3474 , A61B17/3498 , A61B2017/00265 , A61B2017/00526 , A61B2017/3419 , A61B2017/3445 , A61B2017/3492 , A61M13/003
摘要： A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.
摘要翻译：外科进入装置包括与主体壁形成密封并且将进入通道提供到体腔中的单个阀。该阀具有在没有仪器的情况下产生零密封的特性，以及具有仪器直径范围的仪器的仪器密封。该阀可以包括凝胶，优选地包括由弹性体和提供大于1000％的伸长率和小于5肖氏A的硬度的油的超细颗粒。单个阀可用作手动口，其中仪器包括外科医生的手臂，从而提供手进入空腔。

77. 发明授权

US08016755B2 Surgical access apparatus and method 有权
标题翻译：手术进入装置及方法
公开(公告)号：US08016755B2
公开(公告)日：2011-09-13
申请号：US12960458
申请日：2010-12-03
申请人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
发明人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
IPC分类号： A61B1/32
CPC分类号： A61B17/3423 , A61B17/0218 , A61B17/0293 , A61B17/3474 , A61B17/3498 , A61B2017/00265 , A61B2017/00526 , A61B2017/3419 , A61B2017/3445 , A61B2017/3492 , A61M13/003
摘要： A surgical access device includes an access seal adapted to be disposed within an incision within an abdominal wall. The access seal has an external flange adapted to be disposed external to the abdominal wall and an internal flange adapted to be disposed internal to the abdominal wall. The access seal with flanges is formed monolithically. There are access channels through the access seal. The access channels span the thickness of the abdominal wall and form working channels between a location external to the abdominal wall and a location internal to the abdominal wall. The access seal is formed of an elastomeric material adapted to conform to a surface of an instrument inserted through the working channel to form an instrument seal along a length spanning the thickness of the abdominal wall. The elastomeric material is adapted to form an abdominal seal within the abdominal wall.
摘要翻译：外科进入装置包括适于设置在腹壁内的切口内的进入密封件。进入密封件具有适于设置在腹壁外部的外部凸缘和适于设置在腹壁内部的内部凸缘。具有法兰的进入密封件整体形成。有通道通过访问密封。进入通道跨越腹壁的厚度，并在腹壁外部的位置与腹壁内部的位置之间形成工作通道。进入密封件由适于与穿过工作通道插入的仪器的表面一致的弹性体材料形成，以沿跨越腹壁厚度的长度形成仪器密封。弹性体材料适于在腹壁内形成腹部密封。

78. 发明申请

US20100137681A1 ENDOSCOPIC INSTRUMENT MANAGEMENT SYSTEM 审中-公开
标题翻译：内窥镜仪器管理系统
公开(公告)号：US20100137681A1
公开(公告)日：2010-06-03
申请号：US12623224
申请日：2009-11-20
申请人： Richard C. Ewers , Christopher James Earley , Barton P. Bandy , Haio Fauser
发明人： Richard C. Ewers , Christopher James Earley , Barton P. Bandy , Haio Fauser
IPC分类号： A61B1/01 , A61B1/018
CPC分类号： A61B17/00234 , A61B17/2909 , A61B2017/003
摘要： Endoscopic instrument management systems are described herein which allow one or more operators to manage multiple different instruments utilized in endoscopic procedures. In one aspect, responsibility for instrumentation management between one or more operators may be configured such that a first set of instruments is controlled by a primary operator and a second set of instruments is controlled by a secondary operator. The division of instrumentation may be facilitated by the use of separated instrumentation platforms or a single platform which separates each instrument for use by the primary operator. Such platforms may be configured as trays, instrument support arms, multi-instrument channels, as well as rigidized portions of instruments to facilitate its handling, among others. In another aspect, one or more plastically deformable instrument manifolds are provided to guide flexible endoscopic instruments into and through an endoscopic access device.
摘要翻译：本文描述了内窥镜仪器管理系统，其允许一个或多个操作者管理在内窥镜程序中使用的多种不同的仪器。一方面，可以配置一个或多个操作者之间的仪表管理责任，使得第一组仪器由主操作者控制，第二组仪器由次操作者控制。可以通过使用分离的仪器平台或将每个仪器分离以供主要操作员使用的单个平台来促进仪器的划分。这样的平台可以被配置为托盘，仪器支撑臂，多仪器通道，以及便于其操纵的仪器的刚性部分等。在另一方面，提供一个或多个可塑性变形的仪器歧管以将柔性内窥镜器械引导入并通过内窥镜检查装置。

79. 发明申请

US20090137879A1 SURGICAL ACCESS APPARATUS AND METHOD 有权
标题翻译：外科手术设备及方法
公开(公告)号：US20090137879A1
公开(公告)日：2009-05-28
申请号：US12360710
申请日：2009-01-27
申请人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
发明人： Richard C. Ewers , John R. Brustad , Edward D. Pingleton , Nabil Hilal , Gary R. Dulak , Payam Adlparvar , Robert R. Bowes
IPC分类号： A61B1/32
CPC分类号： A61B17/3423 , A61B17/0218 , A61B17/0293 , A61B17/3474 , A61B17/3498 , A61B2017/00265 , A61B2017/00526 , A61B2017/3419 , A61B2017/3445 , A61B2017/3492 , A61M13/003
摘要： A surgical access device includes a single valve that forms a seal with the body wall and provides an access channel into a body cavity. The valve has properties for creating a zero seal in the absence of an instrument as well as an instrument seal with instruments having a full range of instrument diameter. The valve can include a gel and preferably an ultragel comprised of an elastomer and an oil providing elongation greater than 1000 percent and durometer less than 5 Shore A. The single valve can be used as a hand port where the instrument comprises the arm of a surgeon, thereby providing hand access into the cavity.A method for making the surgical access device includes the combining of a gelling agent with an oil, preferably in a molding process. A method for using the device includes steps for creating an opening with the instrument. In a particular process, an organ can be removed from the body cavity through the single valve to create an organ seal while the organ is addressed externally of the body cavity. The valve and method are particularly adapted for laparoscopic surgery wherein the abdominal cavity is insufflated with a gas thereby requiring the zero seal, the instrument seal, and the organ seal in various procedures.
摘要翻译：外科进入装置包括与主体壁形成密封并且将进入通道提供到体腔中的单个阀。该阀具有在没有仪器的情况下产生零密封的特性，以及具有仪器直径范围的仪器的仪器密封。该阀可以包括凝胶，优选地包括由弹性体和提供大于1000％的伸长率和小于5肖氏A的硬度的油的超细颗粒。单个阀可用作手动口，其中仪器包括外科医生的手臂，从而提供手进入空腔。用于制造外科进入装置的方法包括胶凝剂与油的组合，优选在模制过程中。一种使用该装置的方法包括用该仪器产生开口的步骤。在特定的过程中，器官可以通过单个阀从体腔中移除，以在器官在体腔外部寻址时产生器官密封。该阀和方法特别适用于腹腔镜手术，其中腹腔用气体吹入，因此需要零密封，器械密封和器官密封。

80. 发明申请

US20080262539A1 TISSUE GRASPING APPARATUS 有权
标题翻译：组织砂光装置
公开(公告)号：US20080262539A1
公开(公告)日：2008-10-23
申请号：US11736539
申请日：2007-04-17
申请人： Richard C. Ewers , Eugene Chen , Arvin T. Chang , Robert A. Vaughan
发明人： Richard C. Ewers , Eugene Chen , Arvin T. Chang , Robert A. Vaughan
IPC分类号： A61B17/29
CPC分类号： A61B17/29 , A61B2017/00278 , A61B2017/003 , A61B2017/2926 , A61B2017/2932 , A61B2017/2939 , A61B2017/320064
摘要： A tissue grasping apparatus includes a control member, an elongated shaft, and a tissue grasping member attached to the distal end of the elongated shaft. An activation mechanism provides an user-operable connection between the control member and the tissue grasping member. In an embodiment, the tissue grasping member includes a pair of jaws configured to open to an included angle between the jaws of 180 degrees or more. In an embodiment, the activation mechanism includes a flexible drive wire attached to the penetrating member.
摘要翻译：组织抓取装置包括控制构件，细长轴和附接到细长轴的远端的组织把持构件。激活机构提供控制构件和组织把持构件之间的用户可操作的连接。在一个实施例中，组织夹持构件包括一对夹爪，其被构造成以180度或更大的夹爪之间的夹角打开。在一个实施例中，激活机构包括附接到穿透构件的柔性驱动线。

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