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1. 发明授权

US06409739B1 Device and method for assisting end-to side anastomosis 失效
标题翻译：用于协助端对侧吻合的装置和方法
公开(公告)号：US06409739B1
公开(公告)日：2002-06-25
申请号：US09071462
申请日：1998-05-01
申请人： Anthony A. Nobles , Naoum A. Baladi
发明人： Anthony A. Nobles , Naoum A. Baladi
IPC分类号： A61B1708
CPC分类号： A61B17/11 , A61B2017/00243 , A61B2017/0243 , A61B2017/1107 , A61B2017/1135
摘要： The present invention provides a device and method for creating a seal around the inner wall of an incision in a blood vessel. The device is particularly adapted to create an anastomosis site for coronary artery bypass grafts to a patient's aorta without obstructing the flow of blood in the aorta. The device comprises an extruded tube with a translatable shaft positioned therein. One end of the shaft is coupled to a handle of the device which allows a practitioner to advance and withdraw the shaft relative to the tube or, in an alternative embodiment, to advance and withdraw the tube relative to the shaft. The other end of the shaft is connected to a flexible inverting member which is attached to the distal end of the tube. By manipulating the handle, the practitioner can remotely deform the inverting member between two configurations: an elongated, narrow configuration in which the inverting member is adapted to be inserted through a small incision, and an inverted configuration in which the inverting member forms an expanded, inward-facing cup. In operation, the medical practitioner inserts the inverting member into the blood vessel through an incision while the inverting member is maintained in its elongated, narrow configuration, and then manipulates the handle to cause the inverting member to assume its inverted configuration. A seal is then formed by applying a proximal force to the device to cause a rim of the cup to form a seal against an inner wall of the blood vessel. This prevents blood from flowing out of the incision and creates a working area for performing an end-to-side anastomosis. The working area is formed without interrupting the flow of blood through the vessel. The device preferably includes a hole punch device slidably mounted to the tube for allowing the practitioner to create an anastomosis hole once the seal has been formed.
摘要翻译：本发明提供一种用于在血管内的切口的内壁周围产生密封的装置和方法。该装置特别适于创建用于冠状动脉旁路移植物到患者主动脉的吻合部位，而不阻塞主动脉中的血液流动。该装置包括其中定位有可平移轴的挤压管。轴的一端联接到装置的手柄，其允许从业者相对于管推进和撤回轴，或者在替代实施例中，相对于轴推进和撤回管。轴的另一端连接到柔性反转构件，该柔性翻转构件附接到管的远端。通过操纵手柄，从业者可以在两种构型之间使反转构件远程变形：细长的窄结构，其中翻转构件适于通过小切口插入，以及倒置构造，其中翻转构件形成扩展的，向内的杯子在操作中，医生通过切口将反转构件插入血管，同时反转构件保持在其细长的狭窄构造中，然后操纵手柄以使翻转构件呈现其倒置构型。然后通过向装置施加近端力使杯的边缘与血管的内壁形成密封来形成密封。这样可以防止血液从切口流出，并创建一个进行端对侧吻合的工作区域。形成工作区域，而不会中断通过血管的血液流动。该装置优选地包括可滑动地安装到管的孔冲孔装置，以便一旦形成密封就允许从业者创建吻合孔。

2. 发明授权

US06171319B2 Anastomosis device with hole punch 有权
标题翻译：吻合装置带孔冲孔
公开(公告)号：US06171319B2
公开(公告)日：2001-01-09
申请号：US09300187
申请日：1999-04-27
申请人： Anthony A. Nobles , Naoum A. Baladi
发明人： Anthony A. Nobles , Naoum A. Baladi
IPC分类号： A61B1708
CPC分类号： A61B17/11 , A61B2017/00243 , A61B2017/0243 , A61B2017/1107 , A61B2017/1135
摘要： The present invention provides a device and method for creating a seal around the inner wall of an incision in a blood vessel. The device is particularly adapted to create an anastomosis site for coronary artery bypass grafts to a patient's aorta without obstructing the flow of blood in the aorta. The device comprises an extruded tube with a translatable shaft positioned therein. One end of the shaft is coupled to a handle of the device which allows a practitioner to advance and withdraw the shaft relative to the tube. The other end of the shaft is connected to a flexible inverting member which is attached to the distal end of the tube. By manipulating the handle, the practitioner can remotely deform the inverting member between two configurations: an elongated, narrow configuration in which the inverting member is adapted to be inserted through a small incision, and an inverted configuration in which the inverting member forms an expanded, inward-facing cup. In operation, the medical practitioner inserts the inverting member into the blood vessel through an incision while the inverting member is maintained in its elongated, narrow configuration, and then manipulates the handle to cause the inverting member to assume its inverted configuration. A seal is then formed by applying a proximal force to the device to cause a rim of the cup to form a seal against an inner wall of the blood vessel. This prevents blood from flowing out of the incision and creates a working area for performing an end-to-side anastomosis. The working area is formed without interrupting the flow of blood through the vessel. The device preferably includes a hole punch device slidably mounted to the tube for allowing the practitioner to create an anastomosis hole once the seal has been formed.
摘要翻译：本发明提供一种用于在血管内的切口的内壁周围产生密封的装置和方法。该装置特别适于创建用于冠状动脉旁路移植物到患者主动脉的吻合部位，而不阻塞主动脉中的血液流动。该装置包括其中定位有可平移轴的挤压管。轴的一端连接到装置的手柄上，该手柄允许从业者相对于管推进和撤回轴。轴的另一端连接到柔性反转构件，该柔性翻转构件附接到管的远端。通过操纵手柄，从业者可以在两种构型之间使反转构件远程变形：细长的窄结构，其中翻转构件适于通过小切口插入，以及倒置构造，其中翻转构件形成扩展的，向内的杯子在操作中，医生通过切口将反转构件插入血管，同时反转构件保持在其细长的狭窄构造中，然后操纵手柄以使翻转构件呈现其倒置构型。然后通过向装置施加近端力使杯的边缘与血管的内壁形成密封来形成密封。这样可以防止血液从切口流出，并创建一个进行端对侧吻合的工作区域。形成工作区域，而不会中断通过血管的血液流动。该装置优选地包括可滑动地安装到管的孔冲孔装置，以便一旦形成密封就允许从业者创建吻合孔。

3. 发明授权

US5944730A Device and method for assisting end-to-side anastomosis 失效
标题翻译：用于协助端对侧吻合的装置和方法
公开(公告)号：US5944730A
公开(公告)日：1999-08-31
申请号：US36125
申请日：1998-03-06
申请人： Anthony A. Nobles , Naoum A. Baladi
发明人： Anthony A. Nobles , Naoum A. Baladi
IPC分类号： A61B17/00 , A61B17/02 , A61B17/11 , A61B17/08
CPC分类号： A61B17/11 , A61B2017/00243 , A61B2017/0243 , A61B2017/1107 , A61B2017/1135
摘要： The present invention provides a device and method for creating a seal around the inner wall of an incision in a blood vessel. The device is particularly adapted to create an anastomosis site for coronary artery bypass grafts to a patient's aorta without obstructing the flow of blood in the aorta. The device comprises an extruded tube with a translatable shaft positioned therein. One end of the shaft is coupled to a handle of the device which allows a practitioner to advance and withdraw the shaft relative to the tube. The other end of the shaft is connected to a flexible inverting member which is attached to the distal end of the tube. By manipulating the handle, the practitioner can remotely deform the inverting member between two configurations: an elongated, narrow configuration in which the inverting member is adapted to be inserted through a small incision, and an inverted configuration in which the inverting member forms an expanded, inward-facing cup. In operation, the medical practitioner inserts the inverting member into the blood vessel through an incision while the inverting member is maintained in its elongated, narrow configuration, and then manipulates the handle to cause the inverting member to assume its inverted configuration. A seal is then formed by applying a proximal force to the device to cause a rim of the cup to form a seal against an inner wall of the blood vessel. This prevents blood from flowing out of the incision and creates a working area for performing an end-to-side anastomosis. The working area is formed without interrupting the flow of blood through the vessel. The device preferably includes a hole punch device slidably mounted to the tube for allowing the practitioner to create an anastomosis hole once the seal has been formed.
摘要翻译：本发明提供一种用于在血管内的切口的内壁周围产生密封的装置和方法。该装置特别适于创建用于冠状动脉旁路移植物到患者主动脉的吻合部位，而不阻塞主动脉中的血液流动。该装置包括其中定位有可平移轴的挤压管。轴的一端连接到装置的手柄上，该手柄允许从业者相对于管推进和撤回轴。轴的另一端连接到柔性反转构件，该柔性翻转构件附接到管的远端。通过操纵手柄，从业者可以在两种构型之间使反转构件远程变形：细长的窄结构，其中翻转构件适于通过小切口插入，以及倒置构造，其中翻转构件形成扩展的，向内的杯子在操作中，医生通过切口将反转构件插入血管，同时反转构件保持在其细长的狭窄构造中，然后操纵手柄以使翻转构件呈现其倒置构型。然后通过向装置施加近端力使杯的边缘与血管的内壁形成密封来形成密封。这样可以防止血液从切口流出，并创建一个进行端对侧吻合的工作区域。形成工作区域，而不会中断通过血管的血液流动。该装置优选地包括可滑动地安装到管的孔冲孔装置，以便一旦形成密封就允许从业者创建吻合孔。

4. 发明授权

US08709020B2 Suturing device and method for sealing an opening in a blood vessel or other biological structure 有权
标题翻译：用于密封血管或其他生物结构中的开口的缝合装置和方法
公开(公告)号：US08709020B2
公开(公告)日：2014-04-29
申请号：US11653083
申请日：2007-01-12
申请人： Anthony A. Nobles
发明人： Anthony A. Nobles
IPC分类号： A61B17/04 , A61B17/12
CPC分类号： A61B17/0057 , A61B17/0469 , A61B17/0482 , A61B17/0483 , A61B17/0491 , A61B2017/00637 , A61B2017/00663 , A61B2017/00672 , A61B2017/00867 , A61B2017/0472 , A61B2017/06042 , A61B2017/2911
摘要： A suturing device allows a physician to remotely seal an incision in a blood vessel or other biological tissue. The device comprises an elongated tubular body having a distal portion which is adapted to be inserted percutaneously through the incision and into the blood vessel. The distal portion has first and second retractable arms which extend from the distal portion of the body and releasably hold a suture within the blood vessel. First and second retractable needles, each of which is configured to catch the suture from a respective arm, are provided along the body proximal to the retractable arms. The arms and the needles are remotely movable by the physician using a handle or other control mechanism provided at a distal portion of the device. In operation, the arms are initially deployed within the blood vessel to hold the ends of the suture beyond the circumference of the tubular body. The needles are then deployed from and then retracted into the body, during which time the needles pierce the vessel wall on opposite sides of the incision, release the suture ends from the retractable arms, and pull the suture through the vessel wall. The device is particularly useful for closing an incision in an artery following a catheterization procedure. In one embodiment, the catheter sheath introducer (CSI) used to perform the catheterization procedure is left in place during the suturing procedure.
摘要翻译：缝合装置允许医生远程密封血管或其他生物组织中的切口。该装置包括细长的管状体，其具有远端部分，该远端部分适于经由切口经皮插入并进入血管。远侧部分具有从主体的远端部分延伸的第一和第二缩回臂，并将缝合线可释放地夹持在血管内。第一和第二伸缩针，每个可被构造成从相应的臂抓住缝合线，沿着靠近可伸缩臂的主体设置。臂和针可以由医师使用设置在装置的远端部分处的手柄或其他控制机构远程移动。在操作中，臂最初部署在血管内以将缝合线的端部保持超过管状体的圆周。然后将针展开，然后将其缩回到身体中，在此期间，针刺入切口相对侧上的血管壁，将缝合线端部从可伸缩臂释放，并将缝合线拉过血管壁。该装置特别可用于在导管插入术后闭合动脉中的切口。在一个实施例中，用于执行导管插入程序的导管鞘导管器（CSI）在缝合过程期间保留就位。

5. 发明授权

US08348962B2 Suturing device and method 有权
标题翻译：缝合装置和方法
公开(公告)号：US08348962B2
公开(公告)日：2013-01-08
申请号：US11503652
申请日：2006-08-14
申请人： Anthony A. Nobles , Steven E. Decker , Benjamin G. Brosch
发明人： Anthony A. Nobles , Steven E. Decker , Benjamin G. Brosch
IPC分类号： A61B17/04
CPC分类号： A61B17/0057 , A61B17/0469 , A61B17/0482 , A61B17/0491 , A61B17/06166 , A61B17/0625 , A61B2017/00637 , A61B2017/00659 , A61B2017/00663 , A61B2017/00672 , A61B2017/00867 , A61B2017/0472 , A61B2017/06042 , A61B2017/2911
摘要： A suturing device and method allows a physician to remotely suture biological tissue. The device includes an elongate body, first and second arms operably connected to the elongated body, whereby each arm mounts an end portion of a suture, and first and second needles, each needle having a distal end and being mounted such that the distal end of the needle is movable to engage respective end portions of suture. The suturing apparatus further includes an actuator which drives the needles to engage the suture. The suturing apparatus further includes an occluding device operably connected to the elongate body such that the occluding device may be advanced from the distal end of the elongate body to temporarily occlude the incision to be sutured.
摘要翻译：缝合装置和方法允许医生远程缝合生物组织。该装置包括细长主体，第一和第二臂可操作地连接到细长主体，由此每个臂安装缝合线的端部，以及第一和第二针，每个针具有远端并被安装成使得远端针可移动以接合缝合线的相应端部。缝合装置还包括致动器，其驱动针以接合缝合线。缝合装置还包括可操作地连接到细长主体的闭塞装置，使得闭塞装置可以从细长体的远端推进，以临时闭塞待缝合的切口。

6. 发明申请

US20110015655A1 Handle for Suturing Apparatus 有权
标题翻译：缝合器手柄
公开(公告)号：US20110015655A1
公开(公告)日：2011-01-20
申请号：US12890196
申请日：2010-09-24
申请人： Anthony A. Nobles , Steven E. Decker , Hung Tran , Benjamin G. Brosch
发明人： Anthony A. Nobles , Steven E. Decker , Hung Tran , Benjamin G. Brosch
IPC分类号： A61B17/062
CPC分类号： A61B17/0057 , A61B17/0469 , A61B17/0482 , A61B17/0625 , A61B2017/00367 , A61B2017/00637 , A61B2017/00663 , A61B2017/00672 , A61B2017/0472 , A61B2017/2911 , A61B2017/2912
摘要： Methods and apparatus are provided for closing incisions within biological tissue. In one embodiment, a device and method are provided for suturing biological tissue, such as, for example, an organ or blood vessel. The suturing apparatus is particularly well suited for suturing an incision made in an artery, such as the femoral artery, following a catheterization procedure. The device eliminates the need to apply pressure to a patient's thigh for an extended period of time, and eliminates many of the complications and costs associated with the creation of a thrombus patch. In addition, the device comprises an improved handle portion which enables the physician to quickly and easily apply suture. The handle portion is very reliable and easy to manipulate. The suturing may be used in combination with existing catheter sheath introducers.
摘要翻译：提供了用于闭合生物组织内的切口的方法和装置。在一个实施例中，提供了用于缝合生物组织的装置和方法，例如器官或血管。缝合装置特别适用于在导管插入术后缝合在动脉（例如股动脉）上制成的切口。该装置不需要长时间地向患者的大腿施加压力，并且消除了与创建血栓贴片相关的许多并发症和成本。此外，该装置包括改进的手柄部分，其使医师能够快速且容易地应用缝线。手柄部分非常可靠，易于操作。缝合可以与现有的导管鞘引入器结合使用。

7. 发明授权

US06911034B2 Suturing method and apparatus 有权
标题翻译：缝合方法和装置
公开(公告)号：US06911034B2
公开(公告)日：2005-06-28
申请号：US09882821
申请日：2001-06-14
申请人： Anthony A. Nobles , Steven E. Decker , Rod T. Peterson , Chad W. Trembath
发明人： Anthony A. Nobles , Steven E. Decker , Rod T. Peterson , Chad W. Trembath
IPC分类号： A61B17/00 , A61B17/04 , A61B17/12
CPC分类号： A61B17/0057 , A61B17/0469 , A61B17/0482 , A61B17/12022 , A61B2017/00637 , A61B2017/00641 , A61B2017/00663 , A61B2017/00672 , A61B2017/0472 , A61B2017/0496
摘要： A suturing apparatus comprises an elongated body, at least one arms movable relative to the elongated body and at least one needle movable relative to the elongated body. The arm releasably holds an end portion of a length of suture. The arm has a sharp end portion adapted to pierce an inner surface of a wall of a biological structure and pass an end portion of the suture through the inner surface. The needle is adapted to pierce the inner surface of such biological structure at a location proximal to the location where the end portion of the suture was inserted. The needle captures an end portion of the suture from the arm and draws the end portion of the suture back through the inner surface. The end of the suture is then drawn out of the biological structure by removing the elongated body.
摘要翻译：缝合装置包括细长主体，至少一个相对于细长主体可移动的臂和可相对于细长主体移动的至少一个针。臂可释放地保持一段缝合线的端部。臂具有适于刺穿生物结构的壁的内表面的尖端部分，并使缝合线的端部通过内表面。该针适于在靠近缝合线端部插入位置的位置刺穿这种生物结构的内表面。针从臂捕获缝合线的端部并且将缝合线的端部部分通过内表面拉回。然后通过移除细长的主体将缝线的末端从生物结构中拉出。

8. 发明授权

US5562696A Visualization trocar 失效
标题翻译：可视化套管针
公开(公告)号：US5562696A
公开(公告)日：1996-10-08
申请号：US376759
申请日：1995-01-20
申请人： Anthony A. Nobles , Arthur Lancaster , Ben G. Brosch, Jr.
发明人： Anthony A. Nobles , Arthur Lancaster , Ben G. Brosch, Jr.
IPC分类号： A61B1/04 , A61B1/05 , A61B1/313 , A61B17/34 , A61B19/00
CPC分类号： A61B17/3417 , A61B1/042 , A61B1/313 , A61B1/05 , A61B2017/3454 , A61B2017/3456 , A61B2017/346 , A61B90/30 , A61B90/37
摘要： A trocar has an elongated shaft, and a puncturing head is attached to a distal end of the shaft. The puncturing head can have three blades with sharpened cutting edges. A pathway for light communication is established through three apertures in the puncturing head to a longitudinal bore within the shaft. An endoscope can be positioned in the bore to collect light from the distal end of the shaft. A video monitor is connected to the endoscope for displaying an image of the path of advancement of the trocar.
摘要翻译：套针针具有细长轴，并且穿刺头附接到轴的远端。穿刺头可以具有三个锋利切割刃的刀片。通过穿刺头中的三个孔到轴内的纵向孔建立用于光通信的路径。内窥镜可以定位在孔中以收集来自轴的远端的光。视频监视器连接到内窥镜，用于显示套管针的前进路径的图像。

9. 发明授权

US5263956A Ball joint for neurosurgery 失效
标题翻译：球形关节神经外科
公开(公告)号：US5263956A
公开(公告)日：1993-11-23
申请号：US846000
申请日：1992-03-04
申请人： Anthony A. Nobles
发明人： Anthony A. Nobles
IPC分类号： A61B19/00 , A61B17/00
CPC分类号： A61B90/11
摘要： A ball joint for holding a neurosurgery tool in a predetermined orientation relative to a patient's skull has a plate that fits onto the skull. The plate is formed with a socket, and a ball is rotatably positioned in the socket. The ball, in turn, is formed with a bore, and the neurosurgery tool can be positioned in the bore to extend through the bore of the ball into the patient's brain. The ball can accordingly be rotated as appropriate to establish a predetermined orientation of the neurosurgery tool relative to the patient's skull. Set screws are provided to hold the neurosurgery tool stationary relative to the bore of the ball, and to hold the ball stationary relative to the plate. A retainer ring holds the ball against the plate.
摘要翻译：用于以相对于患者头骨的预定取向保持神经外科工具的球形接头具有适合于颅骨的板。板形成有插座，并且球可旋转地定位在插座中。球体又形成有孔，并且神经外科手术工具可以定位在孔中以延伸穿过球的孔进入患者的大脑。因此，球可以适当地旋转以建立神经外科手段相对于患者头骨的预定取向。提供固定螺钉以将神经外科工具相对于球的孔固定，并将球保持相对于板固定。保持环将球保持在板上。

10. 发明授权

US09649106B2 Suturing devices and methods for suturing an anatomic valve 有权
公开(公告)号：US09649106B2
公开(公告)日：2017-05-16
申请号：US14111534
申请日：2012-04-12
申请人： Anthony A. Nobles , Benjamin G. Brosch , William Ettlinger Cohn
发明人： Anthony A. Nobles , Benjamin G. Brosch , William Ettlinger Cohn
IPC分类号： A61B17/04 , A61B17/12 , A61B17/06 , A61B17/00
CPC分类号： A61B17/0483 , A61B17/0057 , A61B17/0469 , A61B17/0482 , A61B17/06004 , A61B17/06066 , A61B2017/00243 , A61B2017/00575 , A61B2017/00663 , A61B2017/00783 , A61B2017/0406 , A61B2017/047 , A61B2017/0472 , A61B2017/0496 , A61B2017/06085 , A61B2017/061
摘要： Suturing apparatuses configured to suture biological tissue, such as an anatomical valve, can include an elongate member having a proximal end, a distal end, one or more arms, and one or more needles. A protective member may be used to inhibit contact between a distal end of a needle and surrounding tissue. Methods for suturing bodily tissue such as an anatomical valve may be performed with the suturing apparatuses. The suturing apparatuses may be used to suture adjacent valve leaflets or the base of a valve in order to treat or repair the valve.

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