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1. 发明授权

US5389102A Apparatus and method for subcuticular stapling of body tissue 失效
标题翻译：身体组织皮下吻合装置及方法
公开(公告)号：US5389102A
公开(公告)日：1995-02-14
申请号：US959242
申请日：1992-10-09
申请人： David T. Green , Henry Bolanos , Maria Lopez-Isa , Marc J. Theroux , John C. Robertson , Joseph M. Paul , Stephen W. Gerry , Wayne P. Young
发明人： David T. Green , Henry Bolanos , Maria Lopez-Isa , Marc J. Theroux , John C. Robertson , Joseph M. Paul , Stephen W. Gerry , Wayne P. Young
IPC分类号： A61B17/04 , A61B17/064 , A61B17/068 , A61B17/28 , A61B17/68
CPC分类号： A61B17/04 , A61B17/064 , A61B17/068 , A61B17/282 , A61B17/68
摘要： A surgical apparatus for attaching two portions of cutaneous body tissue includes a pair of opposed elongated members having jaws which have tissue gripping members thereon at one end and which are movable toward each other to a closed position to engage two body tissue portions positioned within the members to move the body tissue portions into close approximation. Manually gripping systems of several alternative configurations are provided to actuate a mechanical transmission system to close the jaws. In a preferred embodiment, a fork is movable from a first position to a second position by manually operable devices to move the jaws toward each other. A pair of cam faces is located adjacent the opposite ends of the jaws. As the fork moves to its second position, the tines of the fork engage against the cam faces to move the opposed jaws to their closed position. A plurality of rod-like fasteners are carded in a stacked configuration proximally of the jaws such that when the jaws are in their closed position and the two body tissue portions are held in close approximation. Each rod-like fastener is movable to a position in ingress to penetrate the body tissue portions to attach the body tissue portions together. In another preferred embodiment, the elongated members are biased outwardly by a coil spring and a unique plate-like fastener drive member is provided to facilitate driving a fastener after the jaws are closed. A fastener cartridge is provided with fasteners stacked in a sloped fashion and having a coil spring to bias the fasteners toward the ejection position. Another embodiment includes a rack and gear teeth arrangement for approximating the jaws and for firing the fasteners. The rack and gear teeth function somewhat like a linear analog of a set of rotary gears. A method of attaching cutaneous body tissue portions is also disclosed.
摘要翻译：用于附接皮肤体组织的两部分的手术装置包括一对相对的细长构件，其具有在其一端具有组织夹持构件的钳口，并且可相对于彼此移动到关闭位置以接合位于构件内的两个身体组织部分将身体组织部分移动到近似。提供了几种替代配置的手动夹紧系统来致动机械传动系统以闭合钳口。在优选实施例中，叉可以通过手动操作的装置从第一位置移动到第二位置，以将夹爪朝向彼此移动。一对凸轮面邻近钳口的相对端定位。当叉移动到其第二位置时，叉的齿与凸轮面接合，以将相对的夹爪移动到其关闭位置。多个杆状紧固件被卡在卡爪的近侧的堆叠构造中，使得当夹爪处于其关闭位置并且两个身体组织部分保持紧密接近时。每个杆状紧固件可移动到入口位置以穿透身体组织部分以将身体组织部分附接在一起。在另一优选实施例中，细长构件被螺旋弹簧向外偏压，并且提供了独特的板状紧固件驱动构件，以便于在夹爪关闭之后驱动紧固件。紧固件卡盒设置有以倾斜方式堆叠的紧固件，并且具有螺旋弹簧以将紧固件偏压到喷射位置。另一个实施例包括用于近似钳口和用于击发紧固件的齿条和齿轮齿布置。齿条和齿轮齿有点像一组旋转齿轮的线性模拟。还公开了附着皮肤组织部分的方法。

2. 发明授权

US5253793A Apparatus for applying two-part surgical fasteners 失效
标题翻译：用于应用两部分手术紧固件的装置
公开(公告)号：US5253793A
公开(公告)日：1993-10-19
申请号：US651594
申请日：1991-02-06
申请人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
发明人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
IPC分类号： A61B17/00 , A61B17/072 , A61B19/00
CPC分类号： A61B17/07207 , A61B2017/00446 , A61B2017/00451 , A61B2017/07228 , A61B2090/08021
摘要： Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed. A locking mechanism can be provided in the form of a hook which engages the cam bar retainer after firing the staples to prevent forward movement of the cam bar retainer.

3. 发明授权

US5156614A Apparatus for applying two-part surgical fasteners 失效
标题翻译：用于应用两部分手术紧固件的装置
公开(公告)号：US5156614A
公开(公告)日：1992-10-20
申请号：US794596
申请日：1991-11-14
申请人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
发明人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
IPC分类号： A61B17/00 , A61B17/072 , A61B19/00
CPC分类号： A61B17/07207 , A61B2017/00446 , A61B2017/00451 , A61B2090/08021
摘要： Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed.
摘要翻译：用于将至少一排两部分手术紧固件施加到身体组织的装置，每个手术紧固件具有用于刺穿身体组织的带插脚的紧固件部分，以及孔保持器，所述孔保持器的尺寸和构造适于接合接合插入的紧固件部分，夹住其间的身体组织。该装置包括用于以大致对齐的关系保持多个紧固件部分的装置，与紧固件部分保持装置间隔开的装置，用于夹持其间的身体组织，并且用于可释放地将多个保持器以大致对齐的关系可释放地保持，身体组织位于它们之间。提供了用于将经插入的紧固件部分朝向有孔保持器顺序前进的装置，以使紧固件部分以接合的干涉关系刺穿身体组织并被容纳在保持器的孔内，以使紧固件部分和保持器成为在夹持其间的身体组织的同时接合。在优选实施例中，提供刀刃以在施加紧固件时在紧固件的相对的一对行之间的中间切割身体组织。还公开了一种在本发明的装置上将两个间隔开的紧固件对的行对施加到身体组织的方法。

4. 发明授权

US5653373A Arcuate apparatus for applying two-part surgical fasteners 失效
标题翻译：用于应用两部分手术紧固件的弧形装置
公开(公告)号：US5653373A
公开(公告)日：1997-08-05
申请号：US342323
申请日：1994-11-18
申请人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
发明人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
IPC分类号： A61B17/00 , A61B17/072 , A61B19/00 , A61B17/10
CPC分类号： A61B17/07207 , A61B2017/00446 , A61B2017/00451 , A61B2017/07221 , A61B2017/07278 , A61B2090/08021
摘要： Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes an arcuately shaped member for holding a plurality of the fastener portions in generally aligned relation, a correspondingly arcuately shaped member spaced from the fastener portion holding member for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. A fastener driver is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied.
摘要翻译：公开了用于沿弓形路径将外科紧固件应用于身体组织的装置。每个外科紧固件可以是两部分紧固件的形式，其具有用于刺穿身体组织的插入式紧固件部分，以及有孔保持器，该保持器的尺寸和构造用于接合接合夹紧的紧固件部分，以与其夹紧以夹持其间的身体组织。或者，紧固件可以是可变形钉钉的形式。该装置优选地包括用于以大致对齐的关系保持多个紧固件部分的弧形构件，与紧固件部分保持构件间隔开的用于夹持身体组织的相应的弧形构件，并且用于可释放地将多个保持器保持在大致对齐关系并且当身体组织位于其间时与紧固件相对定位。提供了一种紧固件驱动器，用于将经插入的紧固件部分朝向有孔保持器顺序前进，以使紧固件部分在其间刺穿身体组织。当施加紧固件时，可以设置刀来切割邻近紧固件的身体组织。

5. 发明授权

US5352238A Apparatus for applying two-part surgical fasteners 失效
标题翻译：用于应用两部分手术紧固件的装置
公开(公告)号：US5352238A
公开(公告)日：1994-10-04
申请号：US962279
申请日：1992-10-16
申请人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
发明人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
IPC分类号： A61B17/00 , A61B17/072 , A61B19/00
CPC分类号： A61B17/07207 , A61B2017/00446 , A61B2017/00451 , A61B2090/08021
摘要： Apparatus for applying at least one row of two-part surgical fasteners to body tissue, each surgical fastener having a pronged fastener portion for piercing body tissue, and an aperture retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. The apparatus includes means for holding a plurality of the fastener portions in generally aligned relation, means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. In the preferred embodiment a knife edge is provided to cut the body tissue midway between opposed pairs of rows of the fasteners as the fasteners are applied. A method for applying two spaced apart pairs of rows of the fasteners to body tissue on the apparatus of the invention is also disclosed.
摘要翻译：用于将至少一排两部分手术紧固件施加到身体组织的装置，每个手术紧固件具有用于刺穿身体组织的带插脚的紧固件部分，以及孔保持器，所述孔保持器的尺寸和构造适于接合接合插入的紧固件部分，夹住其间的身体组织。该装置包括用于以大致对齐的关系保持多个紧固件部分的装置，与紧固件部分保持装置间隔开的装置，用于夹持其间的身体组织，并且用于可释放地将多个保持器以大致对齐的关系可释放地保持，身体组织位于它们之间。提供了用于将经插入的紧固件部分朝向有孔保持器顺序前进的装置，以使紧固件部分以接合的干涉关系刺穿身体组织并被容纳在保持器的孔内，以使紧固件部分和保持器成为在夹持其间的身体组织的同时接合。在优选实施例中，提供刀刃以在施加紧固件时在紧固件的相对的一对行之间的中间切割身体组织。还公开了一种在本发明的装置上将两个间隔开的紧固件对的行对施加到身体组织的方法。

6. 发明授权

US5379933A Arcuate apparatus for applying two-part surgical fasteners 失效
公开(公告)号：US5379933A
公开(公告)日：1995-01-10
申请号：US898801
申请日：1993-06-15
申请人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
发明人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
IPC分类号： A61B17/00 , A61B17/064 , A61B17/072 , A61B19/00 , A61B17/04
CPC分类号： A61B17/07207 , A61B17/0643 , A61B2017/00446 , A61B2017/00451 , A61B2017/07221 , A61B2017/07228 , A61B2090/08021
摘要： Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes arcuately shaped means for holding a plurality of the fastener portions in generally aligned relation, correspondingly arcuately shaped means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied. A method for applying fasteners to body tissue on the apparatus of the invention along an arcuate path is also disclosed.

7. 发明授权

US5156315A Arcuate apparatus for applying two-part surgical fasteners 失效
标题翻译：用于应用两部分手术紧固件的弧形装置
公开(公告)号：US5156315A
公开(公告)日：1992-10-20
申请号：US692177
申请日：1991-04-26
申请人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
发明人： David T. Green , Henry Bolanos , Robert J. Geiste , Wayne P. Young , Stephen W. Gerry , Frank M. Rende, III
IPC分类号： A61B17/00 , A61B17/064 , A61B17/072 , A61B19/00
CPC分类号： A61B17/07207 , A61B17/0643 , A61B2017/00446 , A61B2017/00451 , A61B2017/07221 , A61B2017/07228 , A61B2090/08021
摘要： Apparatus is disclosed for applying surgical fasteners to body tissue along an arcuate path. Each surgical fastener may be in the form of a two-part fastener having a pronged fastener portion for piercing body tissue, and an apertured retainer dimensioned and configured for engaged reception of the pronged fastener portion in interference fit therewith for gripping the body tissue therebetween. Alternatively, the fasteners may be in the form of deformable staples. The apparatus preferably includes arcuately shaped means for holding a plurality of the fastener portions in generally aligned relation, correspondingly arcuately shaped means spaced from the fastener portion holding means for gripping body tissue therebetween and for releasably holding a plurality of the retainers in generally aligned relation and positioned opposite the fasteners when the body tissue is positioned therebetween. Means is provided for sequentially advancing the pronged fastener portions toward the apertured retainers to cause the fastener portions to pierce the body tissue and to be received within the apertures of the retainers in engaged interference relation so as to cause the fastener portions and the retainers to be engaged while gripping the body tissue therebetween. A knife may be provided to cut the body tissue adjacent the fasteners as the fasteners are applied. A method for applying fasteners to body tissue on the apparatus of the invention along an arcuate path is also disclosed.
摘要翻译：公开了用于沿弓形路径将外科紧固件应用于身体组织的装置。每个外科紧固件可以是两部分紧固件的形式，其具有用于刺穿身体组织的插入式紧固件部分，以及有孔保持器，该保持器的尺寸和构造用于接合接合夹紧的紧固件部分，以与其夹紧以夹持其间的身体组织。或者，紧固件可以是可变形钉钉的形式。该装置优选地包括弧形装置，用于以大致对齐的关系保持多个紧固件部分，相应的弧形装置与紧固件部分保持装置间隔开，用于夹持其间的身体组织，并且可释放地将多个保持器保持为大致对齐的关系，当身体组织位于其间时与紧固件相对定位。提供了用于将经插入的紧固件部分朝向有孔保持器顺序前进的装置，以使紧固件部分以接合的干涉关系刺穿身体组织并被容纳在保持器的孔内，以使紧固件部分和保持器成为在夹持其间的身体组织的同时接合。当施加紧固件时，可以设置刀来切割邻近紧固件的身体组织。还公开了一种沿着弓形路径将紧固件应用于本发明的装置上的身体组织的方法。

8. 发明授权

US5624431A Handle for manipulating a laparoscopic tool 失效
标题翻译：手术操作腹腔镜手术
公开(公告)号：US5624431A
公开(公告)日：1997-04-29
申请号：US417241
申请日：1995-04-05
申请人： Stephen W. Gerry , David T. Green , Henry Bolanos
发明人： Stephen W. Gerry , David T. Green , Henry Bolanos
IPC分类号： A61B17/28 , A61B19/00
CPC分类号： A61B17/2909 , A61B2017/292 , A61B2017/2929 , A61B2017/2946
摘要： A handle for a laparoscopic instrument is provided for manipulating a distal laparoscopic tool. The handle includes a casing, a pivot handle pivotally attached to the casing, and an actuating shaft mechanism extending outward from the casing. Attached at the distal end of the actuating shaft opposite the casing is the laparoscopic surgical tool. The actuating shaft mechanism is longitudinally movable in a first direction by a pivotal movement of the pivot handle for manipulating the laparoscopic tool. A detent carried by the casing allows movement of the shaft longitudinally in the first direction while restraining longitudinal movement of the shaft in a second opposite direction. A thumb wheel attached to the actuating shaft mechanism allows the actuating shaft mechanism to be rotated for further manipulating the laparoscopic tool.
摘要翻译：腹腔镜手术器具用于操纵远端腹腔镜手术器械。手柄包括壳体，可枢转地附接到壳体的枢转手柄以及从壳体向外延伸的致动轴机构。腹腔镜手术工具附着在与壳体相对的致动轴的远端。致动轴机构通过用于操纵腹腔镜工具的枢转手柄的枢转运动在第一方向上纵向移动。壳体承载的制动器允许轴沿第一方向纵向移动，同时限制轴沿第二相反方向的纵向移动。附接到致动轴机构的拇指轮允许致动轴机构旋转以进一步操纵腹腔镜工具。

9. 发明授权

US5409478A Handle for manipulating laparoscopic tool 失效
标题翻译：手术操作腹腔镜手术
公开(公告)号：US5409478A
公开(公告)日：1995-04-25
申请号：US039520
申请日：1993-03-29
申请人： Stephen W. Gerry , David T. Green , Henry Bolanos
发明人： Stephen W. Gerry , David T. Green , Henry Bolanos
IPC分类号： A61B17/28 , A61B17/00
CPC分类号： A61B17/2909 , A61B2017/292 , A61B2017/2929 , A61B2017/2946
摘要： A handle for a laparoscopic instrument is provided for manipulating a distal laparoscopic tool. The handle includes a casing, a pivot handle pivotally attached to the casing, and an actuating shaft mechanism extending outward from the casing. Attached at the distal end of the actuating shaft opposite the casing is the laparoscopic surgical tool. The actuating shaft mechanism is longitudinally movable in a first direction by a pivotal movement of the pivot handle for manipulating the laparoscopic tool. A detent carried by the casing allows movement of the shaft longitudinally in the first direction while restraining longitudinal movement of the shaft in a second opposite direction. A thumb wheel attached to the actuating shaft mechanism allows the actuating shaft mechanism to be rotated for further manipulating the laparoscopic tool.
摘要翻译：腹腔镜手术器具用于操纵远端腹腔镜手术器械。手柄包括壳体，可枢转地附接到壳体的枢转手柄以及从壳体向外延伸的致动轴机构。腹腔镜手术工具附着在与壳体相对的致动轴的远端。致动轴机构通过用于操纵腹腔镜工具的枢转手柄的枢转运动在第一方向上纵向移动。壳体承载的制动器允许轴沿第一方向纵向移动，同时限制轴沿第二相反方向的纵向移动。附接到致动轴机构的拇指轮允许致动轴机构旋转以进一步操纵腹腔镜工具。

10. 发明授权

US5376098A Fragmentable anastomosis ring applier 失效
标题翻译：可分段吻合环施加器
公开(公告)号：US5376098A
公开(公告)日：1994-12-27
申请号：US959152
申请日：1992-10-09
申请人： Diego Fontayne , Henry Bolanos , John C. Robertson , Timothy O. Van Leeuwen , Thomas A. Pelletier , Stephen W. Gerry
发明人： Diego Fontayne , Henry Bolanos , John C. Robertson , Timothy O. Van Leeuwen , Thomas A. Pelletier , Stephen W. Gerry
IPC分类号： A61B17/115 , A61B17/22 , A61B17/00
CPC分类号： A61B17/115 , A61B17/1155 , A61B2017/22072
摘要： A novel surgical instrument suitable for insertion and assembly of multi-ring compression devices for circular anastomosis of tubular tissue sections including a body having means to support and align the rings, means for clamping the rings around the free ends of the tissue sections, means for coring away excess clamped tissue and the centers of the rings, separate means for releasing the clamped rings from the instrument and dwell means to delay releasing the rings until after the coring operation is complete. The dwell means consists of an external cap containing separate and coaxial elements for the coring means and the releasing means which are provided with a series of recesses and a plurality of shifter keys to separate the operation of coring from the separate operation of releasing the assembled multi-ring compression device from the instrument. The instrument may additionally include means for detaching a portion of the support means to facilitate installation and alignment, and a safety to ensure safe operation and interchangeable knife blades.
摘要翻译：一种适于插入和组装用于管状组织切片的环形吻合的多环压缩装置的新型外科器械，包括具有支撑和对准环的装置的主体，用于将环围绕组织部分的自由端夹紧的装置，取出多余的夹紧组织和环的中心，用于将夹紧环从仪器释放的分离装置和驻留装置延迟释放环，直到取芯操作完成。停留装置包括外壳，其包含用于取芯装置的分离和同轴元件，以及释放装置，其具有一系列凹槽和多个移位键，用于将取芯操作与将组装的多个来自仪器的压缩装置。仪器还可以包括用于分离支撑装置的一部分以便于安装和对准的装置，以及确保安全操作和可互换刀片的安全性。

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