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1. 发明申请

US20130085341A1 METHODS AND DEVICES FOR MANIPULATING TISSUE IN VIVO 审中-公开
标题翻译：用于在体液中操作组织的方法和装置
公开(公告)号：US20130085341A1
公开(公告)日：2013-04-04
申请号：US13249896
申请日：2011-09-30
申请人： Rudolph H. Nobis , Robert M. Trusty , James T. Spivey , Christopher J. Hess , Per O. Park , Omar J. Vakharia
发明人： Rudolph H. Nobis , Robert M. Trusty , James T. Spivey , Christopher J. Hess , Per O. Park , Omar J. Vakharia
IPC分类号： A61B1/32 , A61B17/34
CPC分类号： A61B17/29 , A61B17/07207 , A61B2017/00473 , A61B2017/00477
摘要： Methods and devices are provided for manipulating tissue in a body cavity, i.e., in vivo. In general, the methods and devices allow an end effector to engage tissue, be detached from a shaft used to control the end effector to engage the tissue, and then be moved to another location in the body cavity by a separate component, such as an external control unit. In some embodiments the end effector can include one or more deployable hooks that allow the end effector to remain at a surgical site independent of any shafts or external control units. Still further, in other embodiments the end effector can include a transverse bore to allow a second shaft to connect to the end effector to manipulate the tissue. Additional exemplary devices, kits, and methods related to manipulating tissue in vivo are also provided.
摘要翻译：提供了用于操作体腔中的组织，即体内的方法和装置。通常，方法和装置允许端部执行器接合组织，从用于控制末端执行器的轴分离以接合组织，然后通过单独的部件移动到体腔中的另一位置，例如外部控制单元。在一些实施例中，末端执行器可以包括一个或多个可展开的钩，其允许端部执行器独立于任何轴或外部控制单元而保持在手术位置。此外，在其他实施例中，端部执行器可以包括横向孔，以允许第二轴连接到末端执行器以操纵组织。还提供了与在体内操作组织相关的附加的示例性装置，试剂盒和方法。

2. 发明授权

US08388653B2 T-type suture anchoring devices and methods of using same 有权
标题翻译： T型缝合线锚固装置及其使用方法
公开(公告)号：US08388653B2
公开(公告)日：2013-03-05
申请号：US11127513
申请日：2005-05-12
申请人： Rudolph H. Nobis , Frank Jankoski , Omar J. Vakharia , John A. Faux , Gregory J. Bakos , Duane A. Linenkugel , Christopher Paul Swain
发明人： Rudolph H. Nobis , Frank Jankoski , Omar J. Vakharia , John A. Faux , Gregory J. Bakos , Duane A. Linenkugel , Christopher Paul Swain
IPC分类号： A61B17/04
CPC分类号： A61B17/0401 , A61B17/0467 , A61B17/0469 , A61B17/0487 , A61B17/06166 , A61B2017/0409 , A61B2017/0417 , A61B2017/0445 , A61B2017/045 , A61B2017/0451 , A61B2017/0454 , A61B2017/0458 , A61B2017/0464 , A61B2017/0488 , A61B2017/0496 , A61B2017/06052
摘要： Suture anchoring devices are disclosed, including a T-tag anchoring device that is suitably small enough to fit into the hollow tip of a needle and, furthermore, provide protection to the suture against being cut or otherwise damaged by the sharp edge of the needle tip. One disclosed device includes a slot for providing a pivot point between the suture and the body when deployed, which can be employed to form a T-tag.
摘要翻译：公开了缝合线锚定装置，其包括T形锚定装置，其适当地足够小以适合于针的中空尖端，并且此外，为缝合线提供保护以免被针尖的尖锐边缘切割或以其它方式损伤。一个公开的装置包括用于在展开时在缝合线和主体之间提供枢轴点的槽，其可用于形成T形标签。

3. 发明授权

US08211114B2 Medical instrument having a medical snare 有权
标题翻译：具有医疗圈套的医疗器械
公开(公告)号：US08211114B2
公开(公告)日：2012-07-03
申请号：US11409732
申请日：2006-04-24
申请人： Rudolph H. Nobis , Ifung Lu
发明人： Rudolph H. Nobis , Ifung Lu
IPC分类号： A61B17/24 , A61B17/26
CPC分类号： A61B17/32056 , A61B2017/00867 , A61B2018/1407
摘要： A medical instrument including a resiliently flexible first elongate member and a resiliently flexible second elongate member. The first elongate member has a first proximal end portion and a first distal portion. The second elongate member has a second proximal end portion and a second distal portion, wherein the second distal portion is attached to the first distal portion, and wherein the attached first and second distal portions define a distal-loop medical snare which is insertable within a patient. In a first example, the first proximal end portion is lengthwise translatable with respect to the second proximal end portion to articulate the medical snare. In the same or a second example, the first proximal end portion is rotatable about its centerline to articulate the medical snare.
摘要翻译：一种医疗器械，包括弹性柔性的第一细长构件和弹性柔性的第二细长构件。第一细长构件具有第一近端部分和第一远端部分。所述第二细长构件具有第二近端部分和第二远端部分，其中所述第二远端部分附接到所述第一远端部分，并且其中所述附接的第一远端部分和所述第二远端部分限定远端环形医疗圈套，患者。在第一示例中，第一近端部分可相对于第二近端部分纵向平移，以便铰接医疗圈套。在相同或第二示例中，第一近端部分可围绕其中心线旋转以铰接医疗圈套。

4. 发明申请

US20110295151A1 Enteroendocrine Manipulation for Metabolic Effect 审中-公开
标题翻译：肠内分泌操作代谢作用
公开(公告)号：US20110295151A1
公开(公告)日：2011-12-01
申请号：US13104282
申请日：2011-05-10
申请人： Gregory J. Bakos , Edward G. Chekan , Denzel Z. Herrera-Davis , Jason L. Harris , Gary L. Long , Rudolph H. Nobis , Mark S. Ortiz , Mark D. Overmyer , David N. Plescia , Randy J. Seeley , William B. Weisenburgh, II , Tamara S. Vetro Widenhouse , Mark S. Zeiner , Andrew M. Zwolinski
发明人： Gregory J. Bakos , Edward G. Chekan , Denzel Z. Herrera-Davis , Jason L. Harris , Gary L. Long , Rudolph H. Nobis , Mark S. Ortiz , Mark D. Overmyer , David N. Plescia , Randy J. Seeley , William B. Weisenburgh, II , Tamara S. Vetro Widenhouse , Mark S. Zeiner , Andrew M. Zwolinski
IPC分类号： A61M37/00 , A61P3/00 , A61K9/00 , A61F2/04 , A61K49/00 , A61P3/04 , A61B10/02 , A61M5/00 , A61K35/55 , A61K9/20
CPC分类号： C12N5/0679 , A61K35/12 , A61K35/38 , A61L27/14 , A61L27/3882 , A61L27/58 , A61L31/04 , A61L31/148 , A61L31/16 , A61L2300/64
摘要： L-cells may be introduced in the gastrointestinal tract. L-cells are used in the digestive process to produce a more efficient and lasting means of regulating feelings of satiation in a patient. Desired metabolic effects may be achieved by manipulating L-cells via delivery sites, frequency of delivery, or type of biological substance delivered.
摘要翻译： L细胞可能被引入胃肠道。 L细胞用于消化过程，以产生更有效和持久的调节患者饱腹感的手段。所需的代谢作用可以通过经由递送部位操纵L细胞，递送频率或递送的生物物质的类型来实现。

5. 发明申请

US20110087267A1 METHOD FOR EXCHANGING END EFFECTORS IN VIVO 有权
标题翻译：用于在体内交换终末效应的方法
公开(公告)号：US20110087267A1
公开(公告)日：2011-04-14
申请号：US12576578
申请日：2009-10-09
申请人： James T. Spivey , Kevin M. Huey , Rudolph H. Nobis , Sean P. Conlon
发明人： James T. Spivey , Kevin M. Huey , Rudolph H. Nobis , Sean P. Conlon
IPC分类号： A61B17/29 , A61B17/94
CPC分类号： A61B18/1442 , A61B17/29 , A61B2017/00296 , A61B2017/00473 , A61B2017/00477 , A61B2017/0053 , A61B2018/1495
摘要： A laparoscopic surgical method comprises obtaining a first instrument comprising an elongate shaft with a distal end and a proximal end connected to a first handle. The distal end of the first instrument is passed through a percutaneous incision. A surgical end effector is obtained having a distal end with operable jaws and a proximal end selectively attachable to and detachable from the distal end of the first instrument. A second instrument is obtained comprising a distal end and a proximal end connected to a second handle. The surgical end effector is loaded ex vivo on the distal end of the second instrument. The distal end of the second instrument with the loaded surgical end effector is passed through a second incision spaced from the percutaneous incision. The proximal end of the surgical end effector is attached in vivo to the distal end of the first instrument. Tissue is manipulated by actuating the handle of the first instrument to operate the jaws of the surgical end effector.
摘要翻译：腹腔镜手术方法包括获得包括细长轴的第一仪器，其具有远端和连接到第一手柄的近端。第一台仪器的远端通过一个经皮切口。获得外科末端执行器，其具有具有可操作的夹爪的远端和可选择性地附接到第一器械的远端并且可从第一器械的远端拆卸的近端。获得包括连接到第二手柄的远端和近端的第二器械。手术末端执行器离体装载在第二仪器的远端。具有装载的外科末端执行器的第二器械的远端通过与经皮切口间隔开的第二切口。手术末端执行器的近端在体内附着到第一器械的远端。组织通过致动第一仪器的手柄来操纵手术末端执行器的钳口来操纵。

6. 发明授权

US07833223B2 Tri-bending sphinctertome 有权
标题翻译：三弯括约肌切开术
公开(公告)号：US07833223B2
公开(公告)日：2010-11-16
申请号：US11381006
申请日：2006-05-01
申请人： Omar Vakharia , Ifung Lu , Rudolph H. Nobis , Christopher Paul Swain
发明人： Omar Vakharia , Ifung Lu , Rudolph H. Nobis , Christopher Paul Swain
IPC分类号： A61B18/14 , A61B17/32
CPC分类号： A61B18/1492 , A61B17/320016 , A61B2017/003 , A61B2018/00553 , A61B2018/00601 , A61B2018/144 , A61B2018/1467
摘要： Disclosed herein are devices and methods for forming multidirectional cuts in tissue. The tissue cutting devices disclosed herein generally include a flexible elongate member with at least first, second, and third wires that are at least partially constrained within or along a portion of the member. A distal portion of the wires is anchored on or within a portion of the elongate member. When tension is applied to at least one of the wires, such as by an actuator at a proximal end of the device, the elongate member bows while an unconstrained portion of the wire becomes exposed relative to the adjacent portion of the elongate member, assuming a tissue-cutting configuration.
摘要翻译：本文公开了用于在组织中形成多向切割的装置和方法。本文公开的组织切割装置通常包括柔性细长构件，其具有至少部分地限制在构件的一部分内或沿着构件的一部分的至少第一，第二和第三导线。电线的远端部分锚定在细长构件的一部分上或内部。当张紧被施加到至少一根电线时，例如通过设备近端处的致动器，细长构件弯曲，同时线的非约束部分相对于细长构件的相邻部分露出，假定组织切割配置。

7. 发明授权

US07824368B2 Method for endoscopic, transgastric access into the abdominal cavity 有权
标题翻译：内窥镜检查方法，经腹进入腹腔
公开(公告)号：US07824368B2
公开(公告)日：2010-11-02
申请号：US10465061
申请日：2003-06-19
申请人： Michael F. Clem , Gary W. Knight , Rudolph H. Nobis , Dale R. Schulze , Christopher J Hess , Elliott J. Fegelman
发明人： Michael F. Clem , Gary W. Knight , Rudolph H. Nobis , Dale R. Schulze , Christopher J Hess , Elliott J. Fegelman
IPC分类号： A61M29/00 , A61M5/00 , A61M5/32
CPC分类号： A61B1/00142 , A61B1/00154 , A61B1/01 , A61B1/313
摘要： The present invention is a method for accessing the abdominal cavity of a patient in order to perform a medical procedure therein. In one embodiment the method includes the step of inserting a guide wire into the upper gastrointestinal tract, via a gastric opening in the gastric wall and an abdominal opening in the abdominal wall of the patient, the guide wire having a first end that extends from the mouth of the patient, and a second end that extends from the abdominal opening of the patient. The method further includes providing an access device in the form of an elongated sheath having a lumen therethrough, attaching the first end of the guide wire to the distal end of the elongated sheath, and pulling the second end of the guide wire to position the access device into the upper gastrointestinal tract, wherein the distal end of the access device extends into the abdominal cavity while the proximal end of the access device extends out of the mouth of the patient.
摘要翻译：本发明是一种用于访问患者腹腔以便在其中执行医疗程序的方法。在一个实施例中，该方法包括通过胃壁中的胃开口和患者腹壁中的腹部开口将导丝插入上胃肠道的步骤，该导丝具有从并且从患者的腹部开口延伸的第二端。该方法还包括提供一种细长护套形式的进入装置，其具有穿过其中的内腔，将导丝的第一端附接到细长护套的远端，以及拉动导丝的第二端以定位通道装置进入上胃肠道，其中进入装置的远端延伸到腹腔中，而进入装置的近端延伸出患者口部。

8. 发明授权

US07819877B2 Method and apparatus for endoscopic minimally invasive orthopaedic plating procedures 有权
标题翻译：内镜微创矫形手术方法和装置
公开(公告)号：US07819877B2
公开(公告)日：2010-10-26
申请号：US10154558
申请日：2002-05-24
申请人： Pamela C. Guzmán , Michael A. Wack , Dale R. Schulze , Gary W. Knight , Christopher J. Hess , Rudolph H. Nobis , Michael F. Clem , Ronald J. Kolata
发明人： Pamela C. Guzmán , Michael A. Wack , Dale R. Schulze , Gary W. Knight , Christopher J. Hess , Rudolph H. Nobis , Michael F. Clem , Ronald J. Kolata
IPC分类号： A61B17/88
CPC分类号： A61B17/921 , A61B1/00154 , A61B1/0615 , A61B17/00234 , A61B17/0218 , A61B17/1604 , A61B17/1635 , A61B17/1655 , A61B17/1664 , A61B17/1703 , A61B17/1717 , A61B17/1725 , A61B17/1728 , A61B17/1735 , A61B17/1782 , A61B17/72 , A61B17/744 , A61B17/808 , A61B17/8685 , A61B17/8866 , A61B90/02 , A61B2090/08021 , A61F2/4644 , A61F2002/4635 , A61F2002/4649
摘要： A bone plating apparatus includes a handle having extending therefrom a tissue expander for insertion through a skin incision and through the subcutaneous tissue surrounding a fractured bone. A bone plate may be secured to the handle during advancement of the tissue expander so as to deliver the bone plate to a desired location proximate to the fractured bone. Both the tissue expander and the bone plate may be advanced to the desired location proximate to the fractured bone under the visualization of an endoscope. A screw alignment jig is secured to the handle and has a guide hole which aligns with an access hole of the tissue expander. The alignment of the guide hole and the access hole allow for percutaneous screw insertion into the delivered bone plate. A method for plating a fractured bone is also disclosed.
摘要翻译：骨电镀装置包括具有从其延伸的用于通过皮肤切口插入并通过围绕骨折骨的皮下组织的组织扩张器的手柄。在组织扩张器的前进过程中，骨板可以固定到手柄上，以将骨板输送到靠近骨折骨的期望位置。在内窥镜的可视化下，组织扩张器和骨板都可以前进到靠近骨折骨的期望位置。螺钉对准夹具固定到手柄上并具有与组织扩张器的进入孔对准的引导孔。引导孔和进入孔的对准允许经皮螺钉插入输送的骨板中。还公开了一种用于电镀骨折骨的方法。

9. 发明授权

US07658738B2 Medical devices for use with endoscope 有权
标题翻译：用于内窥镜的医疗设备
公开(公告)号：US07658738B2
公开(公告)日：2010-02-09
申请号：US11129601
申请日：2005-05-13
申请人： Rudolph H. Nobis , Christopher J. Hess , David Stefanchik , Michael Clem
发明人： Rudolph H. Nobis , Christopher J. Hess , David Stefanchik , Michael Clem
IPC分类号： A61B18/18
CPC分类号： A61B1/012 , A61B1/00073 , A61B1/00087 , A61B1/00135 , A61B1/0014 , A61B17/320783 , A61B18/1492 , A61B18/1815 , A61B2017/00269 , A61B2017/306 , A61B2018/00601 , A61B2018/00982 , A61B2018/144 , A61B2018/1495
摘要： A medical device is provided for use with an endoscope. The medical device can include a tissue resection device comprising an RF cutting wire. The tissue resection device can be supported for proximal and distal movement relative to the endoscope.
摘要翻译：提供用于内窥镜的医疗装置。医疗装置可以包括包括RF切割线的组织切除装置。组织切除装置可以被支撑用于相对于内窥镜的近端和远端运动。

10. 发明申请

US20080275297A1 ENDOSCOPIC GUIDE DEVICE 有权
标题翻译：内窥镜指导装置
公开(公告)号：US20080275297A1
公开(公告)日：2008-11-06
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
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。

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