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1. 发明授权

US08603078B2 Methods and devices for guiding and supporting surgical instruments 有权
标题翻译：引导和支持手术器械的方法和装置
公开(公告)号：US08603078B2
公开(公告)日：2013-12-10
申请号：US12903330
申请日：2010-10-13
申请人： David Stefanchik , James T. Spivey , Robert M. Trusty , Peter K. Shires , Michael J. Stokes
发明人： David Stefanchik , James T. Spivey , Robert M. Trusty , Peter K. Shires , Michael J. Stokes
IPC分类号： A61B17/00
CPC分类号： A61B17/0218 , A61B90/11 , A61B2017/3407
摘要： Methods and devices are provided for allowing a surgical instrument to be supported by a surgical support system configured to controllably guide the instrument to a desired position at surgical site. A surgical support system is provided that includes a guide port defining a pivot point about which a surgical instrument advance therethrough can pivot. The guide port, and hence the pivot point, can be located a distance above a tissue surface through which the instrument is advanced. Methods and devices are also provided for allowing insufflation of a body cavity without introduction of an insufflation fluid therein. A mechanical insufflation device is provided that includes an expandable distal member configured to selectively expand and unexpand to mechanically insufflate a body cavity. The mechanical insufflation device can optionally be used with the surgical support system.
摘要翻译：提供的方法和装置用于允许外科手术器械由外科支撑系统支撑，所述手术支撑系统构造成可手动地将器械引导到手术部位的期望位置。提供了一种手术支撑系统，其包括限定枢轴点的引导端口，手术器械可以通过该枢转点枢转。引导端口以及枢轴点可以位于仪器前进的组织表面上方的距离处。还提供了用于允许体腔内注射而不在其中引入注射液的方法和装置。提供了一种机械吹气装置，其包括可膨胀的远端构件，其构造成选择性地膨胀和展开以机械地灌注体腔。机械吹气装置可以可选地与外科支架系统一起使用。

2. 发明申请

US20120199632A1 ROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR 有权
标题翻译：具有可选择性终止效应的机器人控制的手术仪器
公开(公告)号：US20120199632A1
公开(公告)日：2012-08-09
申请号：US13369594
申请日：2012-02-09
申请人： James T. Spivey , Mark S. Ortiz , Frederick E. Shelton, IV , Jerome R. Morgan
发明人： James T. Spivey , Mark S. Ortiz , Frederick E. Shelton, IV , Jerome R. Morgan
IPC分类号： A61B17/068 , A61B19/00
CPC分类号： A61B34/30 , A61B1/0052 , A61B1/0058 , A61B17/068 , A61B17/072 , A61B17/07207 , A61B17/115 , A61B17/320016 , A61B17/32053 , A61B34/71 , A61B50/30 , A61B50/36 , A61B90/37 , A61B2017/00057 , A61B2017/00199 , A61B2017/0023 , A61B2017/003 , A61B2017/00309 , A61B2017/00314 , A61B2017/00323 , A61B2017/00327 , A61B2017/00367 , A61B2017/0042 , A61B2017/00473 , A61B2017/00477 , A61B2017/00685 , A61B2017/00734 , A61B2017/0688 , A61B2017/07235 , A61B2017/07242 , A61B2017/07264 , A61B2017/07271 , A61B2017/07278 , A61B2017/2905 , A61B2017/291 , A61B2017/2919 , A61B2017/2923 , A61B2017/2927 , A61B2017/2933 , A61B2017/2937 , A61B2017/2946 , A61B2017/2947 , A61B2017/320052 , A61B2034/306 , A61B2090/0811 , A61B2090/372
摘要： Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting.
摘要翻译：提供了用于通过机器人系统来控制手术装置的工作端的移动的装置和系统。在一个实施例中，系统和装置被提供用于移动外科紧固装置的远端上的末端执行器。运动可以包括端部执行器围绕轴的轴线的旋转运动，端部执行器相对于轴的铰接，以及端部执行器的致动，例如闭合，点火和/或切割。

3. 发明申请

US20120095449A1 METHODS AND DEVICES FOR GUIDING AND SUPPORTING SURGICAL INSTRUMENTS 有权
标题翻译：用于指导和支持手术仪器的方法和装置
公开(公告)号：US20120095449A1
公开(公告)日：2012-04-19
申请号：US12903330
申请日：2010-10-13
申请人： David Stefanchik , James T. Spivey , Robert M. Trusty , Peter K. Shires , Michael J. Stokes
发明人： David Stefanchik , James T. Spivey , Robert M. Trusty , Peter K. Shires , Michael J. Stokes
IPC分类号： A61B17/00
CPC分类号： A61B17/0218 , A61B90/11 , A61B2017/3407
摘要： Methods and devices are provided for allowing a surgical instrument to be supported by a surgical support system configured to controllably guide the instrument to a desired position at surgical site. A surgical support system is provided that includes a guide port defining a pivot point about which a surgical instrument advance therethrough can pivot. The guide port, and hence the pivot point, can be located a distance above a tissue surface through which the instrument is advanced. Methods and devices are also provided for allowing insufflation of a body cavity without introduction of an insufflation fluid therein. A mechanical insufflation device is provided that includes an expandable distal member configured to selectively expand and unexpand to mechanically insufflate a body cavity. The mechanical insufflation device can optionally be used with the surgical support system.
摘要翻译：提供的方法和装置用于允许外科手术器械由外科支撑系统支撑，所述手术支撑系统构造成可手动地将器械引导到手术部位的期望位置。提供了一种手术支撑系统，其包括限定枢轴点的引导端口，手术器械可以通过该枢转点枢转。引导端口以及枢轴点可以位于仪器前进的组织表面上方的距离处。还提供了用于允许体腔内注射而不在其中引入注射液的方法和装置。提供了一种机械吹气装置，其包括可膨胀的远端构件，其构造成选择性地膨胀和展开以机械地灌注体腔。机械吹气装置可以可选地与外科支架系统一起使用。

4. 发明申请

US20110295074A1 Methods and Devices for Providing Multiple Devices Access to a Surgical Site Through a Single Port 审中-公开
公开(公告)号：US20110295074A1
公开(公告)日：2011-12-01
申请号：US12790360
申请日：2010-05-28
申请人： David Stefanchik , William B. Weisenburgh, II , James T. Spivey
发明人： David Stefanchik , William B. Weisenburgh, II , James T. Spivey
IPC分类号： A61B1/32
CPC分类号： A61B1/32 , A61B17/3423 , A61B2017/3445 , A61B2017/3466
摘要： Methods and devices are provided to assist in providing multiple devices access to a surgical site through a single port. In one exemplary embodiment an access device includes a body having a plurality of ports. The ports can include at least one primary instrument port and at least one secondary instrument port. A self-sealing passageway can be disposed between the primary and secondary instrument ports to allow communication between the two ports. As a result, a surgical instrument can be repositioned from one port to another without removing the instrument from the access device. In one embodiment a combined end effector nominal width of surgical instruments disposed in the ports can be greater than a diameter of the primary instrument port and/or a diameter of the body of the access device. Exemplary systems and methods for performing procedures using multiple devices in a single surgical opening are also provided.

5. 发明授权

US07967741B2 Endoscopic guide device 有权
标题翻译：内镜引导装置
公开(公告)号：US07967741B2
公开(公告)日：2011-06-28
申请号：US11742948
申请日：2007-05-01
申请人： Gregory J. Bakos , Christie M. Cunningham , David Stefanchik , James W. Voegele , Michael J. Stokes , Christopher J. Hess , James T. Spivey , Gary L. Long , Kurt R. Bally , Ragae M. Ghabrial , Rudolph H. Nobis
发明人： Gregory J. Bakos , Christie M. Cunningham , David Stefanchik , James W. Voegele , Michael J. Stokes , Christopher J. Hess , James T. Spivey , Gary L. Long , Kurt R. Bally , Ragae M. Ghabrial , Rudolph H. Nobis
IPC分类号： A61B1/00 , A61F2/00 , A61F13/00 , A61M5/32
CPC分类号： A61B1/01 , A61B1/00147 , A61B5/6882 , A61B17/0401 , A61B2017/00292 , A61B2017/00336
摘要： Various exemplary methods and devices are provided for manipulating and/or anchoring devices and body parts during surgical procedures. In one embodiment, an anchor member is provided for anchoring a device or body part to tissue, such as an internal wall of a body cavity. The device can be, for example, an endoscopic device, an accessory channel coupled to an endoscopic device, or a support member adapted to support or manipulate an organ. The anchor member can include or form an opening through which the device can be inserted. The anchor member or device can thus be manipulated relative to the tissue to control movement of and/or provide support to the device, tools inserted through the device, and/or organs grasped by the device or tools.
摘要翻译：提供各种示例性的方法和装置用于在外科手术过程中操纵和/或锚定装置和身体部位。在一个实施例中，提供锚定构件用于将装置或身体部分锚定到组织，例如体腔的内壁。该装置可以是例如内窥镜装置，耦合到内窥镜装置的附件通道或适于支撑或操纵器官的支撑构件。锚定构件可以包括或形成开口，通过该开口可以插入装置。锚定构件或装置因此可以相对于组织被操纵以控制装置的移动和/或提供对装置的插入，通过装置插入的工具和/或由装置或工具抓住的器官。

6. 发明申请

US20110087265A1 LAPAROSCOPIC INSTRUMENT WITH ATTACHABLE END EFFECTOR 审中-公开
标题翻译：具有附加功能的LAPAROSCOPIC仪器
公开(公告)号：US20110087265A1
公开(公告)日：2011-04-14
申请号：US12576546
申请日：2009-10-09
申请人： Rudolph H. Nobis , James T. Spivey , Kevin M. Huey , Christopher J. Hess
发明人： Rudolph H. Nobis , James T. Spivey , Kevin M. Huey , Christopher J. Hess
IPC分类号： A61B17/28
CPC分类号： A61B17/29 , A61B17/320016 , A61B2017/00362 , A61B2017/00473 , A61B2017/00477 , A61B2017/0053 , A61B2017/2931 , A61B2017/320093 , A61B2017/320095
摘要： A laparoscopic surgical device comprises an elongate shaft defining a longitudinal axis, the shaft comprising a distal end and a proximal end. A plurality of arms project distally from the distal end of the elongate shaft, the arms each comprising a lateral notch. The arms are axially slideable relative the elongate shaft and are medially deflectable. An elongate pin is positioned medially relative the arms. The elongate pin is axially slideable relative the arms between a locked position preventing medial deflection of the arms and an unlocked position allowing medial deflection of the arms. A surgical end effector is selectively attachable in vivo and detachable in vivo to the mating feature of the arms, the surgical end effector comprising jaws that open and close in response to the axial movement of the two arms when attached to the surgical end effector.
摘要翻译：腹腔镜手术装置包括限定纵向轴线的细长轴，该轴包括远端和近端。多个臂从细长轴的远端向远侧突出，所述臂各自包括侧向凹口。臂相对于细长轴可轴向滑动并且可内向偏转。细长销相对于臂中间定位。细长销相对于臂在可防止臂的内侧偏转的锁定位置和允许臂的内侧偏转的解锁位置之间轴向滑动。手术末端执行器可选择性地附接到体内并且能够在体内可拆卸到臂的配合特征，所述外科末端执行器包括当连接到手术端部执行器时响应于两个臂的轴向运动而打开和关闭的钳口。

7. 发明授权

US07857754B2 Apparatus useful for positioning a device on an endoscope 有权
标题翻译：用于将装置定位在内窥镜上的装置
公开(公告)号：US07857754B2
公开(公告)日：2010-12-28
申请号：US11128704
申请日：2005-05-13
申请人： James T. Spivey , David Stefanchik , Omar J. Vakharia , Rick D. Applegate
发明人： James T. Spivey , David Stefanchik , Omar J. Vakharia , Rick D. Applegate
IPC分类号： A61B1/00
CPC分类号： A61B1/005 , A61B1/00073 , A61B1/00135 , A61B1/0014 , A61B1/012 , A61B2017/00296
摘要： A medical apparatus and method useful for positioning a device, such as an endcap, on an end of an endoscope, is disclosed. The apparatus can exert a pulling force on the endoscope through the endcap while a pushing force is applied to the endcap. The apparatus can be used to press an endcap onto the distal end of an endoscope without grasping by hand a sheath in those applications where the endoscope is disposed in a sheath.
摘要翻译：公开了一种用于将诸如端盖的装置定位在内窥镜的端部上的医疗装置和方法。该装置可以通过端盖在内窥镜上施加拉力，同时向端盖施加推力。该装置可用于在将内窥镜设置在护套中的那些应用中用手将护套按压到内窥镜的远端而不用手抓住。

8. 发明申请

US20100057108A1 SUTURING DEVICE 有权
标题翻译：装备装置
公开(公告)号：US20100057108A1
公开(公告)日：2010-03-04
申请号：US12202740
申请日：2008-09-02
申请人： James T. Spivey , Kempton K. Carroll, II , David B. Griffith
发明人： James T. Spivey , Kempton K. Carroll, II , David B. Griffith
IPC分类号： A61B17/04
CPC分类号： A61B17/06066 , A61B17/0625 , A61B2017/00867
摘要： Methods of using a surgical suturing device are disclosed. The methods may contemplate a surgical suturing device comprising a grasper device that is translatable within an outer lumen. The methods may comprise grasping a first end of a needle with the grasper device. The needle may be resilient to a curved resting state. The methods may also comprise translating the grasper device proximally relative to the outer lumen such that the needle is translated into the outer lumen, wherein the outer lumen tends to straighten the needle from the curved resting state and moving the outer lumen distally towards tissue. The grasper device may be translated distally relative to the outer lumen such that a second end of the needle extends distally from the outer lumen and pierces the tissue. The needle may return to the curved resting state as it exits the outer lumen. The methods may also comprise releasing the first end of the needle from the grasper device. When a second end of the needle emerges from the tissue, the second end of the needle may be grasped with the grasper device.
摘要翻译：公开了使用外科缝合装置的方法。该方法可以考虑一种外科缝合装置，其包括可在外腔内平移的抓紧装置。该方法可以包括用抓紧装置抓住针的第一端。针可能是弯曲的静止状态的弹性。所述方法还可以包括相对于外腔向近侧平移抓紧装置，使得针被平移到外腔中，其中外腔倾向于使针从弯曲的静止状态伸直并且使外腔向组织移动。抓紧装置可以相对于外腔向远侧平移，使得针的第二端从外腔向远侧延伸并刺穿组织。当针头离开外腔时，针可能返回到弯曲的静止状态。所述方法还可以包括从抓取装置释放针头的第一端。当针的第二端从组织出来时，针的第二端可以用抓紧装置抓住。

9. 发明申请

US20090326561A1 SURGICAL SUTURE ARRANGEMENT 有权
标题翻译：手术方案
公开(公告)号：US20090326561A1
公开(公告)日：2009-12-31
申请号：US12163255
申请日：2008-06-27
申请人： Kempton K. Carroll, II , James T. Spivey , Duane A. Linenkugel
发明人： Kempton K. Carroll, II , James T. Spivey , Duane A. Linenkugel
IPC分类号： A61B17/04
CPC分类号： A61B17/0401 , A61B2017/0034 , A61B2017/00818 , A61B2017/0409 , A61B2017/0417 , A61B2017/0464 , A61B2017/06052
摘要： A surgical instrument may comprise a shaft having proximal and distal ends defining an axis therebetween. The shaft may be flexible and sized for insertion into the working channel of a flexible endoscope. The shaft may be configured to be used in conjunction with various suture anchor applicators. One suture anchor applicator may have a first tube with a first channel and a tissue penetrating tip. The first channel may be adapted to retain a second tube. The second tube may have a second channel and a blunt tip. The second channel may be adapted to retain at least one suture anchor and may include an exit port adapted for ejecting suture anchors. An alternative suture anchor applicator may comprise a first tube and a second tube with a tissue penetrating tip. The second channel is adapted to retain at least one suture anchor.
摘要翻译：外科器械可以包括具有限定其间的轴线的近端和远端的轴。轴可以是柔性的并且尺寸适于插入到柔性内窥镜的工作通道中。轴可以被配置为与各种缝合锚固施加器结合使用。一个缝合锚定施加器可以具有带有第一通道和组织穿透尖端的第一管。第一通道可适于保持第二管。第二管可以具有第二通道和钝头。第二通道可以适于保持至少一个缝合锚，并且可以包括适于弹出缝线锚的出口。替代的缝合锚定施加器可以包括第一管和具有组织穿透尖端的第二管。第二通道适于保持至少一个缝合锚。

10. 发明申请

US20090248055A1 TISSUE PENETRATING SURGICAL DEVICE 有权
标题翻译：组织穿刺手术装置
公开(公告)号：US20090248055A1
公开(公告)日：2009-10-01
申请号：US12060601
申请日：2008-04-01
申请人： James T. Spivey , David Stefanchik
发明人： James T. Spivey , David Stefanchik
IPC分类号： A61B17/14 , A61B19/00 , A61B1/00
CPC分类号： A61B17/320016 , A61B17/00234 , A61B17/320758 , A61B2017/00278 , A61B2017/00858 , A61B2017/320044 , A61B2217/005
摘要： Devices and methods are provided for penetrating tissue and/or effecting movement of devices relative to tissue. In general, a surgical instrument is provided having an at least partially fabric-covered distal tip that be used to at least partially penetrate tissue by contacting the tissue with the fabric and rotating the fabric to “drill” into the tissue. The surgical instrument can be configured for delivery proximate to tissue through a working channel of a delivery device and can include an elongate shaft having in its distal portion an end effector at least partially covered in fabric. The fabric, the end effector, and/or the shaft can rotate, thereby allowing at least the fabric to penetrate the tissue and, if sufficiently rotated, causing an opening to form in the tissue. The surgical instrument and/or the delivery device can be advanced through the opening.
摘要翻译：提供了用于穿透组织和/或实现装置相对于组织的运动的装置和方法。通常，提供具有至少部分织物覆盖的远侧末端的外科器械，其用于通过使织物与织物接触并将织物“钻”成组织至少部分地穿透组织。手术器械可以被配置为通过输送装置的工作通道在组织附近输送，并且可以包括细长轴，其在其远端部分具有至少部分地覆盖在织物中的端部执行器。织物，末端执行器和/或轴可以旋转，从而允许至少织物穿透组织，并且如果充分旋转，则在组织中形成开口。手术器械和/或输送装置可以通过开口前进。

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