The General Hospital Corporation d/b/a Massachusetts General Hospital (USA)
Inventeur(s)
Kaplan, Lee M.
Hatoum, Ida
Harris, Jason L.
Abrégé
Methods and compositions are generally provided for treating metabolic disorders, e.g., obesity. One aspect discloses methods and compositions for obtaining a biological sample from the subject, evaluating the sample for the presence or absence of a genetic indicator, wherein the genetic indicator is selected from a single nucleotide polymorphism and a level of gene expression, and performing a first metabolic procedure if the genetic indicator is present, or performing an alternative second metabolic procedure if the genetic indicator is absent. One aspect discloses methods and compositions for obtaining a sample including deoxyribonucleic acids (DNA) from the subject, evaluating the DNA for an absence or presence of one or more genetic indicators and performing a first metabolic procedure or an alternative second metabolic procedure based on the absence or presence of the genetic indicator(s). Other aspects are also disclosed.
C12Q 1/6883 - Produits d’acides nucléiques utilisés dans l’analyse d’acides nucléiques, p.ex. amorces ou sondes pour les maladies provoquées par des altérations du matériel génétique
2.
DEVICES AND METHODS FOR THE TREATMENT OF METABOLIC DISORDERS
A system for stimulating the release of satiety hormone in a subject comprises a stimulus device which is implantable in the subject and adapted to apply an electrical stimulus to a tissue of a gastrointestinal system of said subject, and a detection device which is implantable in the subject and adapted to continuously monitoring at least one of a mechanical characteristic and an electrical characteristic of the subject to detect an ingestion of food by said subject, wherein the detection device cooperates with the stimulus device such that the stimulus device applies said electrical stimulus in response to a detected ingestion of food.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.
A method of adjusting a switch of a device, which comprises using a biasing force-adjusting element, adjusting a magnitude of a biasing force imparted to a switching element of the switch by a biasing element disposed about the switching element, wherein the switching element is movably disposed within an interior cavity of a hollow body of the switch and the biasing force places the switching element in one of a first position and a second position. The first position corresponds to a first electrical state and the second position corresponds to a second electrical state.
H01H 9/06 - Enveloppes d'un interrupteur constitué par un manche servant à un autre but que d'actionner l'interrupteur, p.ex. par le manche d'un aspirateur
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
H01H 11/00 - Appareillages ou procédés spécialement adaptés à la fabrication d'interrupteurs électriques
H01H 13/18 - Organes d'actionnement, p.ex. bouton-poussoir adaptés pour être actionnés dans une position limite ou autre position prédéterminée dans le trajet d'un corps, le mouvement relatif de l'interrupteur et du corps ayant principalement un autre but que d'actionner l'interrupteur, p.ex. interrupteur de
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an interior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
Various systems and methods for predicting metabolic and bariatric surgery outcomes are provided. The systems and methods can also provide predictions for non-surgical metabolic and bariatric treatments. In general, a user can receive predictive outcomes of multiple bariatric procedures that could be performed on a patient. In one embodiment, a user can electronically access a metabolic and bariatric surgery outcome prediction system, e.g., using one or more web pages. The system can provide predictive outcomes of one or more different bariatric surgeries for the patient based on data gathered from the user and on historical data regarding outcomes of the different bariatric surgeries. The system can additionally provide predictive outcomes for not having any treatment and/or a comparison of the predictive outcomes of the one or more different bariatric surgeries to the predictive outcomes for not having any treatment.
G16H 50/20 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicales; TIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour le diagnostic assisté par ordinateur, p.ex. basé sur des systèmes experts médicaux
G06N 5/04 - Modèles d’inférence ou de raisonnement
An apparatus comprises a sleeve, a seal, and an anchor assembly. The sleeve is flexible and non-permeable and is configured to fit in a duodenum. The seal is positioned at the proximal end of the sleeve and is configured to seal the proximal end of the sleeve against the stomach mucosa, the pylorus, or the duodenum mucosa. The anchor assembly comprises a pair of atraumatic anchor ends and a resilient member positioned between the anchor ends. At least a portion of the resilient member extends along at least a portion of the length of the sleeve. The resilient member is configured to bias the anchor ends generally toward each other, to thereby substantially anchor the sleeve in the duodenum. The sleeve is configured to prevent chyme from contacting the mucosa of the duodenum; and to prevent enzymes excreted in the duodenum from mixing with chyme in the duodenum.
A system for stimulating the release of satiety hormone in a subject comprises a stimulus device which is implantable in the subject and adapted to apply an electrical stimulus to a tissue of a gastrointestinal system of said subject, and a detection device which is implantable in the subject and adapted to continuously monitoring at least one of a mechanical characteristic and an electrical characteristic of the subject to detect an ingestion of food by said subject, wherein the detection device cooperates with the stimulus device such that the stimulus device applies said electrical stimulus in response to a detected ingestion of food.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
A method of creating a switch, comprising disposing a switching element movably within an interior cavity of the switch to define switch-making and switch-breaking positions along a switching axis of the switching element, disposing a biasing element about the switching element to impart a biasing force to the switching element to place the switching element in one of the switch-making and switch-breaking positions until an external force imparted to the switching element exceeds the biasing force to cause the switching element to change to the other position, disposing a biasing force-adjusting element in cooperative engagement with the biasing element such that a magnitude of the biasing force is adjustable, and coupling a conductive contact to the switching element to define a switch-making state when the switching element is in the switch-making position and a switch-breaking state when the switching element is in the switch-breaking position.
H01H 13/18 - Organes d'actionnement, p.ex. bouton-poussoir adaptés pour être actionnés dans une position limite ou autre position prédéterminée dans le trajet d'un corps, le mouvement relatif de l'interrupteur et du corps ayant principalement un autre but que d'actionner l'interrupteur, p.ex. interrupteur de
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
H01H 11/00 - Appareillages ou procédés spécialement adaptés à la fabrication d'interrupteurs électriques
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
11.
Clip applier adapted for use with a surgical robot
A clip applier adapted for use with a surgical robot is disclosed. The clip applier comprises a shaft having clips stored therein and jaws adapted for receiving a clip from the shaft. The shaft is in mechanical communication with a robotic mounting portion. The robotic mounting portion contains a gear drive assembly for rotating the shaft, feeding clips into the jaws and forming clips in the jaws.
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A method of creating a switch, comprising disposing a switching element movably within an interior cavity of the switch to define first and second positions along a switching axis of the switching element, disposing a biasing element about the switching element to impart a biasing force to the switching element to place the switching element in one of the first and second positions until an external force imparted to the switching element exceeds the biasing force to cause the switching element to move to the other position, disposing a biasing force-adjusting element in cooperative engagement with the biasing element such that a magnitude of the biasing force is adjustable, and coupling a conductive contact to the switching element to define a first switching state when the switching element is in the first position and a second switching state when the switching element is in the second position.
H01H 13/18 - Organes d'actionnement, p.ex. bouton-poussoir adaptés pour être actionnés dans une position limite ou autre position prédéterminée dans le trajet d'un corps, le mouvement relatif de l'interrupteur et du corps ayant principalement un autre but que d'actionner l'interrupteur, p.ex. interrupteur de
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
13.
Devices and methods for the treatment of metabolic disorders
A system for stimulating the release of satiety hormone in a subject comprises a stimulus device which is implantable in the subject and adapted to apply an electrical stimulus to a tissue of a gastrointestinal system of said subject, and a detection device which is implantable in the subject and adapted to continuously monitoring at least one of a mechanical characteristic and an electrical characteristic of the subject to detect an ingestion of food by said subject, wherein the detection device cooperates with the stimulus device such that the stimulus device applies said electrical stimulus in response to a detected ingestion of food.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
The General Hospital Corporation General Hospital (USA)
Inventeur(s)
Kaplan, Lee M.
Hatoum, Ida
Harris, Jason L.
Abrégé
Methods and compositions are generally provided for treating metabolic disorders, e.g., obesity. One aspect discloses methods and compositions for obtaining a biological sample from the subject, evaluating the sample for the presence or absence of a genetic indicator, wherein the genetic indicator is selected from a single nucleotide polymorphism and a level of gene expression, and performing a first metabolic procedure if the genetic indicator is present, or performing an alternative second metabolic procedure if the genetic indicator is absent. One aspect discloses methods and compositions for obtaining a sample including deoxyribonucleic acids (DNA) from the subject, evaluating the DNA for an absence or presence of one or more genetic indicators and performing a first metabolic procedure or an alternative second metabolic procedure based on the absence or presence of the genetic indicator(s). Other aspects are also disclosed.
C12Q 1/6883 - Produits d’acides nucléiques utilisés dans l’analyse d’acides nucléiques, p.ex. amorces ou sondes pour les maladies provoquées par des altérations du matériel génétique
15.
Systems and methods for predicting metabolic and bariatric surgery outcomes
Various systems and methods for predicting metabolic and bariatric surgery outcomes are provided. The systems and methods can also provide predictions for non-surgical metabolic and bariatric treatments. In general, a user can receive predictive outcomes of multiple bariatric procedures that could be performed on a patient. In one embodiment, a user can electronically access a metabolic and bariatric surgery outcome prediction system, e.g., using one or more web pages. The system can provide predictive outcomes of one or more different bariatric surgeries for the patient based on data gathered from the user and on historical data regarding outcomes of the different bariatric surgeries. The system can additionally provide predictive outcomes for not having any treatment and/or a comparison of the predictive outcomes of the one or more different bariatric surgeries to the predictive outcomes for not having any treatment.
G16H 50/20 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicales; TIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour le diagnostic assisté par ordinateur, p.ex. basé sur des systèmes experts médicaux
G06N 5/04 - Modèles d’inférence ou de raisonnement
G06F 19/00 - Équipement ou méthodes de traitement de données ou de calcul numérique, spécialement adaptés à des applications spécifiques (spécialement adaptés à des fonctions spécifiques G06F 17/00;systèmes ou méthodes de traitement de données spécialement adaptés à des fins administratives, commerciales, financières, de gestion, de surveillance ou de prévision G06Q;informatique médicale G16H)
A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.
Methods and devices are provided for performing various procedures using interchangeable end effectors. In general, the methods and devices allow a surgeon to remotely and selectively attach various interchangeable surgical end effectors to a shaft located within a patient's body, thus allowing the surgeon to perform various procedures without the need to remove the shaft from the patient's body. In an exemplary embodiment, multiple end effectors can be introduced into a body cavity. The end effectors can be disassociated or separate from one another such that they float within the body cavity. A distal end of a shaft can be positioned within the body cavity and it can be used to selectively engage one of the end effectors. In particular, the device can be configured to allow each end effector to be remotely attached and detached from the distal end of the shaft.
Methods and devices are provided for activating brown adipose tissue (BAT). Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss. In one embodiment, a medical device is provided that activates BAT by electrically stimulating nerves that activate the BAT and/or electrically stimulating brown adipocytes directly, thereby increasing thermogenesis in the BAT and inducing weight loss through energy expenditure.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A switch comprising an interior cavity and a switching element movably disposed within the interior cavity to define a first position and a second position, the second position being different from the first position. A biasing element imparts a biasing force to the switching element to place the switching element in either the first or the second position until an external force imparted to the switching element exceeds the biasing force, thereby causing the switching element to move to the other one of the first or the second position. A biasing force-adjusting element is cooperatively engaged with the biasing element, wherein a magnitude of the biasing force is adjustable using the biasing force-adjusting element. An electrically-conductive contact, coupled to the switching element, defines a first switching state when the switching element is in the first position and a second switching state when the switching element is in the second position.
Methods and devices are provided for activating brown adipose tissue with targeted substance delivery. Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss and/or improved metabolic function. In one embodiment, a chemical configured to stimulate nerves that activate the BAT and/or to stimulate brown adipocytes directly can be delivered to a patient, thereby increasing thermogenesis in the BAT and inducing weight loss and/or improved metabolic function through energy expenditure. The chemical can be delivered to the patient locally and/or systemically to stimulate the nerves and/or the brown adipocytes.
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaire; Accessoires à cet effet, p.ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
A61M 5/142 - Perfusion sous pression, p.ex. utilisant des pompes
A61M 5/14 - Dispositifs de perfusion, p.ex. perfusion par gravité; Perfusion sanguine; Accessoires à cet effet
A61M 35/00 - Dispositifs pour appliquer des agents, p.ex. des remèdes, sur le corps humain
A61K 9/00 - Préparations médicinales caractérisées par un aspect particulier
A61M 37/00 - Autres appareils pour introduire des agents dans le corps; Percutanisation, c. à d. introduction de médicaments dans le corps par diffusion à travers la peau
A61M 5/172 - Moyens pour commander l'écoulement des agents vers le corps ou pour doser les agents à introduire dans le corps, p.ex. compteurs de goutte-à-goutte électriques ou électroniques
A switch comprising a switching element, a hollow body defining an interior cavity in which the switching element is movably disposed along a longitudinal device axis to define a first and second positions along the longitudinal device axis, the second position being different from the first position, a biasing element imparting an adjustable biasing force to the switching element to place the switching element in one of the first position and the second position until an external force imparted to the switching element along the longitudinal device axis exceeds the biasing force thereby causing the switching element to move to the other one of the first position and the second position, and an electrically-conductive contact coupled to the switching element and defining a first switching state when the switching element is in the first position and a second switching state when the switching element is in the second position.
H01H 35/14 - Interrupteurs actionnés par changement de l'accélération, p.ex. par choc ou vibration, interrupteur à inertie
H01H 13/18 - Organes d'actionnement, p.ex. bouton-poussoir adaptés pour être actionnés dans une position limite ou autre position prédéterminée dans le trajet d'un corps, le mouvement relatif de l'interrupteur et du corps ayant principalement un autre but que d'actionner l'interrupteur, p.ex. interrupteur de
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
22.
Methods for partial diversion of the intestinal tract
Devices and methods are used to modify a metabolic pathway of a digestive system by creating a pathway within the intestinal tract through an anastomosis between a proximal location within the intestinal tract and a distal location within the intestinal tract. In some examples, the small intestine has a first initial length and the created pathway defines a second length of the intestinal tract that is approximately ten to seventy percent of the first initial length of the small intestine.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
Methods and therapeutics are provided for treating metabolic disorders by increasing activation of brown adipose tissue. Generally, the methods and therapeutics can increase activation of brown adipose tissue to increase energy expenditure and induce weight loss. In one embodiment, a method for increasing activation of brown adipose tissue includes modifying brown adipocytes to express a gene that activates brown adipocytes, such as uncoupling protein 1. In another embodiment, a method for increasing brown adipose tissue activation includes increasing the number of brown adipocytes. This can be accomplished by inducing proliferation of adipocytes in vivo or expanding adipocytes ex vivo, transplanting adipocytes into brown adipose tissue depots or elsewhere and inducing differentiation of adipocyte progenitor cells, such as MSCs, adipocyte progenitor cells, pre-adipocytes and adipocyte precursor cells.
A61K 48/00 - Préparations médicinales contenant du matériel génétique qui est introduit dans des cellules du corps vivant pour traiter des maladies génétiques; Thérapie génique
C07K 14/705 - Récepteurs; Antigènes de surface cellulaire; Déterminants de surface cellulaire
C07K 14/47 - Peptides ayant plus de 20 amino-acides; Gastrines; Somatostatines; Mélanotropines; Leurs dérivés provenant d'humains provenant de vertébrés provenant de mammifères
C12N 15/85 - Vecteurs ou systèmes d'expression spécialement adaptés aux hôtes eucaryotes pour cellules animales
A duodenal sleeve assembly comprises a sleeve, an expandable sealing member, a tether, and an expandable anchor. The sleeve is secured to the sealing member. The tether couples the anchor with the sealing member. A deployment instrument comprises a shaft assembly, a first retention member, and a second retention member. The first retention member selectively secures the sealing member to the shaft assembly. The second retention member selectively secures the anchor to the shaft assembly. When the first retention member is released, the sealing member expands outwardly to seal the proximal end of the sleeve against the mucosa of the patient's duodenum. When the second retention member is released, the anchor expands outwardly within the stomach to anchor the sleeve assembly relative to the stomach. The tether traverses the pylorus. The sleeve isolates chyme from enzymes in the duodenum; and the mucosa of the duodenum from nutrients in the chyme.
A system for stimulating the release of satiety hormone in a subject comprises a stimulus device which is implantable in the subject and adapted to apply an electrical stimulus to a tissue of a gastrointestinal system of said subject, and a detection device which is implantable in the subject and adapted to continuously monitoring at least one of a mechanical characteristic and an electrical characteristic of the subject to detect an ingestion of food by said subject, wherein the detection device cooperates with the stimulus device such that the stimulus device applies said electrical stimulus in response to a detected ingestion of food.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
26.
Methods and devices for remotely controlling movement of surgical tools
Methods and devices are provided for controlling movement of a distal end of a surgical instrument. In general, the methods and devices can allow for controlling movement of surgical tools, and in particular for causing mimicked motion between an external control unit and a surgical tool positioned within a patient's body. In one embodiment, a surgical system is provided having a master assembly including an input tool and a slave assembly including a surgical instrument. The master assembly and the slave assembly can be configured to be electronically coupled together such that movement of the master assembly can be electronically communicated to the slave assembly to cause mimicked movement of the slave assembly.
Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an interior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
Methods and devices are provided for activating brown adipose tissue (BAT). Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss. In one embodiment, a medical device is provided that activates BAT by electrically stimulating nerves that activate the BAT and/or electrically stimulating brown adipocytes directly, thereby increasing thermogenesis in the BAT and inducing weight loss through energy expenditure.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
Various systems and methods for predicting metabolic and bariatric surgery outcomes are provided. The systems and methods can also provide predictions for non-surgical metabolic and bariatric treatments. In general, a user can receive predictive outcomes of multiple bariatric procedures that could be performed on a patient. In one embodiment, a user can electronically access a metabolic and bariatric surgery outcome prediction system, e.g., using one or more web pages. The system can provide predictive outcomes of one or more different bariatric surgeries for the patient based on data gathered from the user and on historical data regarding outcomes of the different bariatric surgeries. The system can additionally provide predictive outcomes for not having any treatment and/or a comparison of the predictive outcomes of the one or more different bariatric surgeries to the predictive outcomes for not having any treatment.
G06F 19/00 - Équipement ou méthodes de traitement de données ou de calcul numérique, spécialement adaptés à des applications spécifiques (spécialement adaptés à des fonctions spécifiques G06F 17/00;systèmes ou méthodes de traitement de données spécialement adaptés à des fins administratives, commerciales, financières, de gestion, de surveillance ou de prévision G06Q;informatique médicale G16H)
G01N 5/04 - Analyse des matériaux par pesage, p.ex. pesage des fines particules séparées d'un gaz ou d'un liquide en éliminant un constituant, p.ex. par évaporation, et en pesant le reste
A surgical stapling instrument (1) comprises a staple fastening assembly (4) in the distal region of said instrument, the staple fastening assembly (4) including a cartridge device (8) which comprises at least one closed row (17, 18) of staples and defines a wavy distal end surface (14), and an anvil (9) which defines a wavy proximal staple forming surface (20) substantially matching the distal end surface (14) and which is adapted to cooperate with the cartridge device (8) for forming the ends of the staples exiting from the cartridge device (8), wherein the distal end surface (14) and the staple forming surface (20) have a globally wavy shape including two opposite peaks (21) and two opposite valleys (22) angularly spaced at about 90° from the adjacent peaks (21) and in that said two-peaks-two-valleys wavy shape is formed by a stepped configuration of said surfaces (14, 20).
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
Methods and devices are provided for activating brown adipose tissue (BAT) with cooling. Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss and/or improved metabolic function. In one embodiment, a medical device is provided that activates BAT by cooling tissue having a high density of cold sensitive thermoreceptors and/or by cooling BAT depots directly, thereby increasing thermogenesis in the BAT and inducing weight loss and/or improved metabolic function through energy expenditure.
A surgical clip is provided for ligating or transecting tissue, such as vessels, other tubular ducts, and the like and a surgical clip applier device for delivering and applying the surgical clip to the tissue. The surgical clip can include a spine and opposed arms extending from the spine where the arms can define a clamping length. In a resting state, the clip can be biased to a closed position such that the ends of each opposed arm are disposed in proximity to each other. With such biasing, when applied to a tissue, such as with a surgical clip applier, the clip can exert a positive clamping pressure to the tissue along the clamping length to seal the tissue and limit passage of fluids, such as blood, from the tissue.
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A duodenal sleeve assembly comprises a sleeve, an expandable sealing member, a tether, and an expandable anchor. The sleeve is secured to the sealing member. The tether couples the anchor with the sealing member. A deployment instrument comprises a shaft assembly, a first retention member, and a second retention member. The first retention member selectively secures the sealing member to the shaft assembly. The second retention member selectively secures the anchor to the shaft assembly. When the first retention member is released, the sealing member expands outwardly to seal the proximal end of the sleeve against the mucosa of the patient's duodenum. When the second retention member is released, the anchor expands outwardly within the stomach to anchor the sleeve assembly relative to the stomach. The tether traverses the pylorus. The sleeve isolates chyme from enzymes in the duodenum; and the mucosa of the duodenum from nutrients in the chyme.
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaire; Accessoires à cet effet, p.ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
A61F 2/04 - Prothèses implantables dans le corps Éléments ou organes creux ou tubulaires, p.ex. vessies, trachées, bronches ou voies biliaires
An apparatus comprises a sleeve, a seal, and an anchor assembly. The sleeve is flexible and non-permeable and is configured to fit in a duodenum. The seal is positioned at the proximal end of the sleeve and is configured to seal the proximal end of the sleeve against the stomach mucosa, the pylorus, or the duodenum mucosa. The anchor assembly comprises a pair of atraumatic anchor ends and a resilient member positioned between the anchor ends. At least a portion of the resilient member extends along at least a portion of the length of the sleeve. The resilient member is configured to bias the anchor ends generally toward each other, to thereby substantially anchor the sleeve in the duodenum. The sleeve is configured to prevent chyme from contacting the mucosa of the duodenum; and to prevent enzymes excreted in the duodenum from mixing with chyme in the duodenum.
An implantable system for stimulating the release of satiety hormone in a subject comprises a stimulus device which is implantable in the subject and adapted to apply an electrical stimulus to a tissue of a gastrointestinal system of said subject, and a detection device which is implantable in the subject and adapted to continuously monitoring at least one of a mechanical characteristic and an electrical characteristic of the subject to detect an ingestion of food by said subject, wherein the detection device cooperates with the stimulus device such that the stimulus device applies said electrical stimulus in response to a detected ingestion of food.
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61N 1/05 - Electrodes à implanter ou à introduire dans le corps, p.ex. électrode cardiaque
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
Provided herein are medical apparatuses and methods and more particularly devices and methods for positioning and anchoring a lining to a hollow body organ, such as a stomach, intestine or gastrointestinal tract. For example, in one embodiment, an endoluminal applier includes a fastening assembly configured to receive tissue and lining, a suction device configured to acquire tissue and lining, and a stitching mechanism configured to stitch into the fastening cavity and to apply a running suture to the tissue portion and lining.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A system for stimulating the release of satiety hormone in a subject comprises a stimulus device (1) having a tissue engaging portion (2) intended to be placed in contact with a target tissue (3) of a gastrointestinal system of the subject, a movement device (15) linked with the tissue engaging portion (2) and operable to move the tissue engaging portion (2), thereby mechanically stimulating the target tissue (3), and an anchoring device for permanently fastening the stimulus device (1) in a target location at the gastrointestinal system such that the tissue engaging portion (2) engages the target tissue (3).
A61H 23/00 - Massage par percussion ou vibration, p.ex. en utilisant une vibration ultrasonique; Massage par succion-vibration; Massage avec des membranes mobiles
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
Methods and devices are provided for performing various procedures using interchangeable end effectors. In general, the methods and devices allow a surgeon to remotely and selectively attach various interchangeable surgical end effectors to a shaft located within a patient's body, thus allowing the surgeon to perform various procedures without the need to remove the shaft from the patient's body. In an exemplary embodiment, multiple end effectors can be introduced into a body cavity. The end effectors can be disassociated or separate from one another such that they float within the body cavity. A distal end of a shaft can be positioned within the body cavity and it can be used to selectively engage one of the end effectors. In particular, the device can be configured to allow each end effector to be remotely attached and detached from the distal end of the shaft.
An apparatus is operable to provide an anastomosis coupling two hollow organs, such as a duodenum and ileum. The apparatus includes a first component that is inserted through an enterotomy in a first hollow organ and a second component that is inserted through an enterotomy in a second hollow organ. The first and second components are brought together to o align the enterotomies and compress apposed layers of tissue adjacent to the enterotomies. The compressed tissue eventually necroses and the apparatus may be removed or simply pass through the hollow organ. Each component may include a set of pivoting links and a resilient member that is configured to both bias the links to an expanded configuration and grip the tissue adjacent to the enterotomy. The components may include magnets that secure the positioning of the components relative to each other and provide a compressive force on the apposed tissue.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
40.
Device for providing transdermal electrical stimulation at an adjustable position on a head
A device for providing transdermal electrical stimulation at an adjustable position on a head. The device including a supporting member economically shaped and configured to be fixedly supported about an anatomical body part; the supporting member being adjustably positionable in only two directions substantially perpendicular to one another. No electrical stimulation is provided by the supporting member. Alternatively, the device includes at least one pair of electrodes for producing the transdermal electrical stimulation to the head. The electrodes are mounted to a securing member shaped and configured to be releasably securable only about a plurality of strands of hair at a predetermined fixed orientation without being secured about any anatomical body part.
Methods and therapeutics are provided for treating metabolic disorders by increasing activation of brown adipose tissue. Generally, the methods and therapeutics can increase activation of brown adipose tissue to increase energy expenditure and induce weight loss. In one embodiment, a method for increasing activation of brown adipose tissue includes modifying brown adipocytes to express a gene that activates brown adipocytes, such as uncoupling protein 1. In another embodiment, a method for increasing brown adipose tissue activation includes increasing the number of brown adipocytes. This can be accomplished by inducing proliferation of adipocytes in vivo or expanding adipocytes ex vivo, transplanting adipocytes into brown adipose tissue depots or elsewhere and inducing differentiation of adipocyte progenitor cells, such as MSCs, adipocyte progenitor cells, pre-adipocytes and adipocyte precursor cells.
A61K 35/12 - Substances provenant de mammifères; Compositions comprenant des tissus ou des cellules non spécifiés; Compositions comprenant des cellules souches non embryonnaires; Cellules génétiquement modifiées
C12N 15/85 - Vecteurs ou systèmes d'expression spécialement adaptés aux hôtes eucaryotes pour cellules animales
A61K 48/00 - Préparations médicinales contenant du matériel génétique qui est introduit dans des cellules du corps vivant pour traiter des maladies génétiques; Thérapie génique
C07K 14/47 - Peptides ayant plus de 20 amino-acides; Gastrines; Somatostatines; Mélanotropines; Leurs dérivés provenant d'humains provenant de vertébrés provenant de mammifères
42.
Device for anchoring an endoluminal sleeve in the GI tract
Endoluminal sleeve device (1) for internally lining a section of the GI tract, comprising a sleeve (2) configured for deployment inside a GI tract, the sleeve (2) having walls of a flexible material defining a sleeve lumen (3), a proximal end (4) defining a proximal lumen opening (5), and a distal end (6) defining a distal lumen opening (7), a tubular anchoring portion (8) forming said proximal lumen end (4) and defining anchoring seats (9) delimited each one by an annular collar (11) forming an opening through which adjacent tissue portions (12) can be pulled into the anchoring seats (9), expansion means adapted to act on the tissue portions (12) arranged in the anchoring seats (9) such that the tissue portions (12) expand to a dimension greater than the opening of the annular collar (11).
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaire; Accessoires à cet effet, p.ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.
Methods and devices are provided for activating brown adipose tissue (BAT) with light. Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss and/or improved metabolic function. In one embodiment, a medical device is provided that activates BAT by using light to stimulate nerves that activate the BAT and/or to stimulate brown adipocytes directly, thereby increasing thermogenesis in the BAT and inducing weight loss and/or improved metabolic function through energy expenditure. The light can be configured to directly or indirectly stimulate the nerves and/or the brown adipocytes. The light can be configured to indirectly stimulate the nerves and/or the brown adipocytes by activating a light activatable medium administered to a patient and configured to respond to the light to cause activation of the brown adipose tissue.
A surgical instrument, such as an electrical ablation device, includes an elongate member having therealong disposed a first electrode extending along an axis. A first expandable portion extends along the axis and defines a first perimeter of the first electrode and has an associated first diameter with respect to the axis. The first expandable portion includes a first framework selectively expandable to transition the first expandable portion from a contracted state to an expanded state. The first framework is selectively contractible to transition the first expandable portion from the expanded state to the contracted state. When the first framework is expanded, the first diameter is expanded and the first expandable portion is transitioned from the contracted state to the expanded state. When the first framework is contracted, the first diameter is contracted and the first expandable portion is transitioned from the expanded state to the contracted state.
A61B 18/18 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p.ex. de micro-ondes
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A surgical instrument, such as an electrical ablation device, including a first elongate body having an insert and a second elongate body having an electrically insulative sheath that defines a bore. A mating element mates the elongate bodies when at least a portion of the insert is received within the bore. The second elongate body is configured to receive electrical energy from the first elongate body and transmit the electrical energy to an electrode. In certain embodiments, the electrical ablation device may include first and second elongate bodies. The first includes an electrically conductive insert configured to electrically couple to an energy source and apply the electrical energy to tissue, and the second includes an electrically insulative sheath defining a bore configured to receive the insert therethrough and move proximally or distally relative to the insert.
A61B 18/18 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p.ex. de micro-ondes
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Methods and devices are provided for performing minimally invasive surgical procedures. In one embodiment, a surgical device is provided that include an elongate shaft having a distal portion configured to be movable between a first configuration in which the distal portion of the shaft is substantially straight or linear and a second configuration in which the distal portion of the shaft is articulated at a compound angle. The shaft's distal portion can include two articulation joints to facilitate formation of the compound angle.
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A method of creating a switch to be disposed along a longitudinal axis of a device, comprising providing a hollow body defining an interior cavity, disposing a switching element movably within the interior cavity, the switching element defining a switch-making position and a switch-breaking position and having a biasing element, coupling an electrically-conductive contact to the switching element to define a switch-making state when the switching element is in the switch-making position and a switch-braking state when the switching element is in the switch-braking position, and imparting a variable longitudinal bias to the switching element with the biasing element to place the switching element in one of the switch-making position and the switch-braking position until an external force imparted to the switching element along the switching axis exceeds the longitudinal bias thereby causing the switching element to move to the other one of the switch-making position and the switch-braking position.
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A device for guiding electrodes relative to a tissue treatment region. The device can comprise a body have a plurality of passages therethrough. Each passage can axially restrain an electrode positioned therein. When each electrode is axially restrained in a passage, the distal ends of the electrodes can be spaced a predetermined distance apart. Further, the electrodes can be held in a parallel or substantially parallel alignment when axially retained in the passages. The predetermined distance between the electrodes can correspond to a treatment distance in a tissue treatment region and the distal ends of the electrodes can be operably structured to conduct current therebetween when at least one of electrodes is energized by an energy source.
A61B 90/11 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures pour la chirurgie stéréotaxique, p.ex. système stéréotaxique à cadre avec des guides pour aiguilles ou instruments, p.ex. des glissières courbes ou des articulations à rotule
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Methods and devices are provided for activating brown adipose tissue with targeted substance delivery. Generally, the methods and devices can activate BAT to increase thermogenesis, e.g., increase heat production in the patient, which over time can lead to weight loss and/or improved metabolic function. In one embodiment, a chemical configured to stimulate nerves that activate the BAT and/or to stimulate brown adipocytes directly can be delivered to a patient, thereby increasing thermogenesis in the BAT and inducing weight loss and/or improved metabolic function through energy expenditure. The chemical can be delivered to the patient locally and/or systemically to stimulate the nerves and/or the brown adipocytes.
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaire; Accessoires à cet effet, p.ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A61M 35/00 - Dispositifs pour appliquer des agents, p.ex. des remèdes, sur le corps humain
A61M 5/142 - Perfusion sous pression, p.ex. utilisant des pompes
A61M 5/14 - Dispositifs de perfusion, p.ex. perfusion par gravité; Perfusion sanguine; Accessoires à cet effet
A61M 5/172 - Moyens pour commander l'écoulement des agents vers le corps ou pour doser les agents à introduire dans le corps, p.ex. compteurs de goutte-à-goutte électriques ou électroniques
51.
Device and method for self-positioning of a stimulation device to activate brown adipose tissue depot in a supraclavicular fossa region
Self-positioning of at least a portion of a transdermal electrical stimulation patch within a target area (e.g., supraclavicular fossa region) of a human body to activate a depot of brown adipose tissue therein. An electric field is generated using the electrical stimulation patch to activate the brown adipose tissue within the supraclavicular fossa region of the body. The patch is self-positioned using one or more anatomical points (e.g., anatomical landmarks and/or anatomical features) or markings on the body. Brown adipose tissue may also be activated by applying an electrical signal to a body piercing partially implanted proximate a target area in which the tissue is disposed.
A61N 1/00 - SCIENCES MÉDICALE OU VÉTÉRINAIRE; HYGIÈNE ÉLECTROTHÉRAPIE; MAGNÉTOTHÉRAPIE; THÉRAPIE PAR RADIATIONS; THÉRAPIE PAR ULTRASONS Électrothérapie; Circuits à cet effet
A medical patch having a multi-piece bottom liner including a central liner sequentially removable independently of two outer perimeter liners. The multi-piece liner covering two adhesives of different peel force. Removal of the central liner exposes a first temporary/repositionable adhesive. Once properly positioned, the outer perimeter liners are removed to expose a second stronger adhesive. A foam cushioning layer is disposed beneath and extends beyond a footprint of every printed circuit board to prevent skin irritation. The medical patch may be designed specifically for stimulation of the sacral (S3 foramen) spinal nerve without the use of a separate mechanical placement tool or assistance by another.
A61N 1/30 - Appareils d'ionothérapie ou d'électrophorèse
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
53.
Clip applier adapted for use with a surgical robot
A clip applier adapted for use with a surgical robot. The clip applier includes a shaft having clips stored therein and jaws adapted for receiving a clip from the shaft. The shaft is in mechanical communication with a robotic mounting portion that is adapted for mounting to a surgical robot. The robotic mounting portion contains a gear drive assembly for independently rotating the shaft, feeding clips into the jaws and forming clips in the jaws.
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
54.
Active braking electrical surgical instrument and method for braking such an instrument
An electrically powered surgical instrument includes a surgical end effector having a surgical procedure effecting actuation assembly. A handle is coupled with the end effector. An electric motor is disposed within a shell of the handle and has power terminals and a drive train actuating the assembly when the motor is supplied with power. A break-before-make power supply switch at the handle selectively controls supply of power to the motor. A post-termination braking circuit electrically short-circuits the power terminals when the switch does not supply power to the motor. A method for post-termination braking of an electrical motor utilizes the permanent magnetic field of the motor to counteract an inertia-induced over-stroke characteristic of the motor, drive train, and/or actuation assembly after powered operation by short-circuiting the still-spinning motor to create an electrically generated magnetic field in opposition to the permanent magnetic field upon ceasing supply of power to the motor.
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
55.
Apparatus and methods for cleaning the lens of an endoscope
An apparatus for cleaning a lens, or one or more lenses, of an endoscopic camera while the endoscope is deployed in a patient during a medical procedure, such as a minimally invasive procedure, or a therapeutic or diagnostic procedure, is disclosed. The cleaning apparatus generally includes a conduit having a fluid delivery port, an alignment system, and a flexible supply tube to fluidly connect the conduit to one or both of a source of a fluid and a suction device.
A61B 1/12 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments avec système de refroidissement ou de rinçage
A61B 1/00 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments
56.
Adhesive structure with stiff protrusions on adhesive surface
AGENCY FOR SCIENCE, TECHNOLOGY AND RESEARCH (Singapour)
Inventeur(s)
Natarajan, Sriram
Hammer, Joseph
Cooper, Kevin
Vyakarnam, Murty
Low, Hong Yee
Rodriguez, Isabel
Lim, Chee Tiong
Ho, Audrey Yoke Yee
Abrégé
A laminate and process of making the laminate is disclosed comprising: a surgical mesh having first and second surfaces; and an adhesive structure having adhesive and non-adhesive surfaces, wherein the non-adhesive surface of the adhesive structure is laminated to at least one of said first and second surfaces of said surgical mesh, and the adhesive surface of said adhesive structure has protrusions extending therefrom comprising a resin having a Young's modulus of greater than 17 MPa, which protrusions are of sufficiently low diameter to promote adhesion by increasing physical attractive forces between the adhesive structure and a target surface, as measured by shear adhesion.
A61F 2/00 - Filtres implantables dans les vaisseaux sanguins; Prothèses, c.-à-d. éléments de substitution ou de remplacement pour des parties du corps; Appareils pour les assujettir au corps; Dispositifs maintenant le passage ou évitant l'affaissement de structures corporelles tubulaires, p.ex. stents
A61L 31/06 - Matériaux macromoléculaires obtenus autrement que par des réactions faisant intervenir uniquement des liaisons non saturées carbone-carbone
B29C 33/52 - Moules ou noyaux; Leurs détails ou accessoires comportant des moyens ou conçus spécialement pour faciliter le démoulage d'objets, p.ex. des objets à contre-dépouille solubles ou fusibles
C09J 7/04 - sur papier ou tissus (garnitures absorbantes, bandages ou pansements adhésifs A61L 15/16)
Devices and methods are provided for forming and securing a tissue plication. More particularly, the devices and methods of the present invention can be used to create multiple tissue folds on an anterior and posterior wall of a stomach cavity to reduce the volume thereof. In one aspect, a method of gastric volume reduction is disclosed that includes advancing a tissue acquisition and fixation device endoscopically into a stomach, manipulating the device to form a first fold of tissue on an interior surface of an anterior wall of the stomach, and manipulating the device to form a second fold of tissue on an interior surface of a posterior wall of the stomach, where the second fold is not attached to the first fold.
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
Surgical devices are disclosed herein that generally include an intracorporeal elbow joint to facilitate translational movement of an end effector while allowing a body portion of the surgical device and a trocar or working channel through which the device is inserted to be maintained in a fixed angular orientation relative to the patient. This allows a plurality of such devices to be used effectively with a single incision or access device. Such devices also generally provide end effector movement with six degrees of freedom, while maintaining a mechanical linkage between the user and the end effector and while mimicking and/or mirroring natural user movement. Various methods related to such devices are also disclosed.
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
Surgical devices are disclosed herein that generally include an intracorporeal elbow joint to facilitate translational movement of an end effector while allowing a body portion of the surgical device and a trocar or working channel through which the device is inserted to be maintained in a fixed angular orientation relative to the patient. This allows a plurality of such devices to be used effectively with a single incision or access device. Such devices also generally provide end effector movement with six degrees of freedom, while maintaining a mechanical linkage between the user and the end effector and while mimicking and/or mirroring natural user movement. Various methods related to such devices are also disclosed.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
Surgical devices are disclosed herein that generally include an intracorporeal elbow joint to facilitate translational movement of an end effector while allowing a body portion of the surgical device and a trocar or working channel through which the device is inserted to be maintained in a fixed angular orientation relative to the patient. This allows a plurality of such devices to be used effectively with a single incision or access device. Such devices also generally provide end effector movement with six degrees of freedom, while maintaining a mechanical linkage between the user and the end effector and while mimicking and/or mirroring natural user movement. Various methods related to such devices are also disclosed.
Methods and devices are provided for performing various procedures using interchangeable end effectors. In general, the methods and devices allow a surgeon to remotely and selectively attach various interchangeable surgical end effectors to a shaft located within a patient's body, thus allowing the surgeon to perform various procedures without the need to remove the shaft from the patient's body. In an exemplary embodiment, multiple end effectors can be introduced into a body cavity. The end effectors can be disassociated or separate from one another such that they float within the body cavity. A distal end of a shaft can be positioned within the body cavity and it can be used to selectively engage one of the end effectors. In particular, the device can be configured to allow each end effector to be remotely attached and detached from the distal end of the shaft.
Methods and compositions are provided for treating metabolic disorders by modulating bile acid levels. Generally, the methods and compositions can modulate bile acid levels, such as serum bile acid levels, to treat a metabolic disorder. In one embodiment, a method of modulating a bile acid level includes measuring a bile acid level and delivering a composition effective to modulate the bile acid level. A method for modulating a bile acid profile includes comparing a bile acid profile to a target profile and delivering a bile acid cocktail to increase bile acid levels. In another embodiment, a pharmaceutical composition for increasing bile acid levels includes a bile acid cocktail effective to increase bile acid levels. The composition is further useful as part of an implantable system.
A patient-referenced surgical support frame and method of use are provided. In one embodiment, a surgical support frame can have at least three support members coupled by adjustable linkages. Each support member can have a lumen extending therethrough for receiving a cannula, and each support member can be configured such that the at least three support members (or the cannulas extending therethrough) are angularly adjustable relative to one another, and such that a distance between each of the at least three support members is adjustable. In use, the surgical support frame can be positioned on a skin surface of a patient and used to retain one or more instruments extending through the support members in a fixed orientation or position with respect to the patient, thereby allowing more than two instruments to be used simultaneously.
A61B 1/32 - Dispositifs pour ouvrir ou agrandir le champ de vision, p.ex. dans un conduit du corps
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
Methods and devices are provided utilizing an end effector having three jaws movably coupled thereto for grasping and/or dissecting tissue. In one embodiment, each of the three jaws are movable between an open position in which the distal ends of the three jaws are spaced apart from one another, and a closed position in which the distal ends directly contact one another. The jaws can define an opening therebetween when the jaws are in the closed position.
A61B 10/00 - Autres méthodes ou instruments pour le diagnostic, p.ex. pour le diagnostic de vaccination; Détermination du sexe; Détermination de la période d'ovulation; Instruments pour gratter la gorge
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 18/08 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage à l'aide de sondes chauffées électriquement
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/062 - Dispositifs pour manipuler les aiguilles
67.
Methods and devices for remotely controlling movement of surgical tools
Methods and devices are provided for controlling movement of a distal end of a surgical instrument. In general, the methods and devices can allow for controlling movement of surgical tools, and in particular for causing mimicked motion between an external control unit and a surgical tool positioned within a patient's body. In one embodiment, a surgical system is provided having a master assembly including an input tool and a slave assembly including a surgical instrument. The master assembly and the slave assembly can be configured to be electronically coupled together such that movement of the master assembly can be electronically communicated to the slave assembly to cause mimicked movement of the slave assembly.
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
68.
Devices and methods for providing suction and/or irrigation in a surgical procedure
Methods and devices are provided for providing suction and/or irrigation to locations within a body cavity. In general, the methods and devices can allow instruments within a body cavity to be cleaned during a surgical procedure without having to remove the instruments from the body cavity. In one embodiment, an end effector is provided that includes an elongate body having a cleaning base formed thereon. The end effector can be configured as a modular element configured to be removably and replaceably attachable to a distal end of an elongate shaft. The cleaning base can have one or more ports formed through a surface thereof. The cleaning base can be configured to provide suction and/or irrigation through the one or more ports to clean a face of a surgical instrument seated in the cleaning base or in close proximity to the cleaning base.
A61B 1/12 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments avec système de refroidissement ou de rinçage
A surgical instrument includes a handle portion, a shaft housing a firing bar, an end effector comprising an anvil, a lower jaw, and a stapling and severing assembly responsive to a longitudinal closing motion produced by the handle portion and the shaft. The lower jaw is configured to receive a removable cartridge. The cartridge includes a housing, a plurality of staples disposed in the housing, and a deck disposed over the plurality of staples. The deck defines apertures, with each aperture being substantially disposed over each staple. The instrument includes an anvil cartridge removably received in an anvil frame. The anvil cartridge is severed by the firing bar when the firing bar is advanced through tissue such that material from the anvil cartridge is released onto the severed tissue.
A surgical instrument includes a handle portion, a shaft housing a firing bar, an end effector comprising an anvil, a lower jaw, and a stapling and severing assembly responsive to a longitudinal closing motion produced by the handle portion and the shaft. The lower jaw is configured to receive a cartridge when in an open position. The cartridge includes a housing, a plurality of staples disposed in the housing, and a deck disposed over the plurality of staples. The deck defines apertures, with each aperture being substantially disposed over each staple. The cartridge further receives a matrix including glue beads suspended in the matrix. The staples are driven through the matrix to secure the matrix to tissue. The glue beads are activated when the matrix is secured to the tissue, such that the activated adhesive further secures the staple line in the tissue.
An apparatus for endosurgical use includes an instrument having an end effector and a staple cartridge insertable into the end effector. The staple cartridge includes staples, staple apertures, a resistive member, and a medical fluid. When coupled to a power source, the medical fluid is vaporized by the resistive member and expelled out the staple apertures onto the stapled tissue. The power source may be contained within the instrument. In one configuration, a resistive strip with strip contacts may electrically couple to a conductor in the end effector. The medical fluid may also be divided into a plurality of sealant pads corresponding to the staple apertures, and the medical fluid may be a depolymerizable cyanoacrylate, a sprayable thermoplastic urethane, or any vaporizable medicament or pharmaceutical. The staple drivers may include one or more apertures to permit the medical fluid to pass through or around the staple drivers.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
72.
Surgical staple cartridge with self-dispensing staple buttress
A surgical instrument includes a handle portion, a shaft housing a firing bar, an end effector comprising an anvil, a lower jaw, and a stapling and severing assembly responsive to a longitudinal closing motion produced by the handle portion and the shaft. The lower jaw is configured to receive a removable cartridge when in an open position. The cartridge includes a housing, a plurality of staples disposed in the housing, and a deck disposed over the plurality of staples. The deck defines apertures, with each aperture being substantially disposed over each staple. The instrument includes a movable buttress that is integral with the housing of the cartridge or integral with the lower jaw of the end effector. The buttress may attach to the anvil and include a portion to receive tissue. The receipt of tissue urges and moves the buttress proximally inwards to further encompass the tissue.
An apparatus comprises a surgical instrument and a buttress configured to hold a fluid adhesive. In some versions, the buttress contains a two-part fluid adhesive where two fluid materials form a fluid adhesive when combined. In some versions, the buttress is configured to be compressed by the surgical instrument thereby pressurizing a portion of the buttress. Thereafter, the buttress may be severed and the pressurized region may be operable to urge the fluid adhesive to a tissue site.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
74.
Firing member displacement system for a stapling instrument
A surgical stapling instrument can comprise a jaw configured to receive a staple cartridge, a firing member configured to eject staples from the staple cartridge, and a system for supplying a continuous number of staple cartridges to the jaw. The surgical stapling instrument can further comprise a system for displacing the firing member into a position in which a staple cartridge can be slid relative to the firing member. In at least one such embodiment, the surgical stapling instrument can comprise a shaft and a plurality of staple cartridges positioned within the shaft, wherein the firing member can be dropped downwardly within the shaft such that one or more staple cartridges can be slid by the firing member.
A surgical stapling instrument can comprise a jaw configured to receive a staple cartridge, a firing member configured to eject staples from the staple cartridge, and a system for supplying a continuous number of staple cartridges to the jaw.
A surgical stapling instrument can comprise an end effector configured to receive a staple cartridge, a shaft including a plurality of staple cartridges positioned therein, and a staple cartridge driver configured to sequentially advance the staple cartridges from the shaft into the end effector. In various embodiments, the staple cartridges can comprise different configurations which can be arranged within the shaft such that they are supplied in a specific predetermined order.
An instrument is configured to receive a staple cartridge to staple tissue and expel a fluid from within a container in the staple cartridge. The staple cartridge has an upper deck including staple apertures and orifices formed therein. The orifices are in fluid communication with the containers. The staple cartridge includes staple drivers having a driver body to translate a staple and a container protrusion to expel the fluid out the orifices. The fluid may be expelled while driving the staples out through the staple apertures. The container may be vertically compressible container or, in one alternative, may be a container having a channel and a sealant that is configured to be pierced as the fluid is expelled. Some configurations for the fluid include a hemostatic agent, thrombin, a gel, or a medicament. The containers may also be formed as reservoirs defined within the upper deck and/or cartridge body.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A switch of a device having a longitudinal axis, and comprising a switching element parallel to the longitudinal axis of the device, a hollow body defining an interior cavity in which the switching element is movably disposed to define a switch-making position at a first longitudinal position and a switch-breaking position at a second longitudinal position, a biasing element imparting a variable longitudinal bias to the switching element to place the switching element in one of the switch-making position and the switch-breaking position until an external force imparted to the switching element exceeds the longitudinal bias causing the switching element to move to the other of the switch-making position and the switch-breaking position, and an electrically-conductive contact coupled to the switching element and defining a switch-making state when the switching element is in the switch-making position and a switch-breaking state when the switching element is in the switch-breaking position.
A surgical stapling instrument comprises a cartridge device with a row of staples and a wavy first tissue interface, and an anvil having a wavy second tissue interface which cooperates with the first tissue interface for clamping tissue therebetween and forming the staples exiting from the cartridge device, a staple driving device adapted to drive the staples out of the cartridge device towards the anvil, wherein the staples are non-symmetrical U-shaped with two legs protruding toward the anvil and a transverse basis connecting the legs, wherein the basis is inclined with respect to the longitudinal direction of the legs and has a length greater than the staple projection on a plane perpendicular to the longitudinal direction of the legs.
An instrumentation for performing an endoluminal or transluminal anastomosis, comprises an anastomotic ring device including a proximal ring (5) having two guide wire seats (22) adapted to slidably receive two guide wires (1, 2) and a distal ring (6) having two guide wire seats (25) adapted to slidably receive the two guide wires (1, 2), the proximal ring 5 and the distal ring 6 being snap-connectable to each other, a surgical probe (7) comprising an elongate insertion shaft (30) and a probe head (32) adapted to be endoluminally advanced to a proximal tissue portion (3), the insertion shaft (30) defining guide wire canals (8, 9) extending into two guide wire exit openings (31) defined in the probe head (32) and adapted to deliver the distal ends (1″, 2″) of said guide wires (1, 2) to said proximal tissue portion (3). The distance between the two guide wire exit openings (31) of the probe (7) is substantially equal to the distance between the two guide wire seats (22) of the proximal ring (5) and to the distance between the two guide wire seats (25) of the distal ring (6).
A stapling cartridge assembly for a circular stapling instrument includes a casing, a staple driver, and a blade. The staple driver is receivable within the casing and configured to move within the casing from a pre-fired position to a fired position. The blade is attachable to the staple driver. The blade includes a cutting edge and a breakaway washer attachment member for fixedly attaching to a breakaway washer when the staple driver is moved from the pre-fired position to the fired position.
A circular stapling instrument includes a casing, an anvil assembly, a staple driver, and a locking mechanism. The anvil assembly is configured to move back and forth between an open position away from the casing and a closed position adjacent the casing. The staple driver is configured to move within the casing from a pre-fired position to a fired position. The locking mechanism is configured to, whenever the anvil assembly is in the open position, automatically lock the staple driver in the pre-fired position preventing the staple driver from being moved to the fired position. The locking mechanism is also configured to, whenever the anvil assembly is in the closed position, automatically unlock the staple driver from the pre-fired position to allow the staple driver to be moved to the fired position.
A circular stapling instrument is provided which includes a reciprocating drive shaft and a firing bar. The reciprocating drive shaft has a first engagement member at a tip of the reciprocating drive shaft and a threaded adjustment member at a base of the reciprocating drive shaft. The firing bar is movably connected at a first end with a firing trigger and movably connected at a second end with a stapling head assembly through a second engagement member. The firing bar forms a first engagement surface which faces a respective second engagement surface formed on the reciprocating drive shaft. The circular stapling instrument also includes a frictional reducing member located in between the first and second engagement surfaces in order to reduce friction between the reciprocating drive shaft and the firing bar.
An anvil assembly for a circular stapling instrument is provided. The anvil assembly includes a one-piece, polymer anvil and a staple-forming surface. The one-piece, polymer anvil comprises an anvil base surface and an anvil shaft extending from the anvil base surface. The staple-forming surface is attached to the anvil base surface.
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
86.
Anvil and cartridge alignment configuration for a circular stapler
A stapling reload assembly for a circular stapling instrument includes a casing, a staple holder, a staple driver, and an anvil assembly. The staple holder is attached to the casing. The staple driver includes a driver alignment surface. The staple driver is receivable within the casing and is configured to move within the casing from a pre-fired position to a fired position. The anvil assembly includes an anvil base surface, an anvil alignment surface, and a staple forming surface. The anvil base surface is configured to move from an open position away from the casing to a closed position adjacent the casing. The anvil alignment surface is configured to mate with the driver alignment surface, to rotationally align the staple forming surface with the staple holder, when the anvil base surface is in the closed position.
Surgical instruments and cartridges for cutting and fastening tissues and organs such as vessels are disclosed. In various non-limiting forms, the surgical instrument includes a first jaw that operably supports a substantially flexible elongated tissue closure assembly therein. A second jaw is movably supported relative to the first jaw and is selectively movable between open and closed positions in response to opening and closing motions applied thereto. A closure retraction assembly is configured to selectively apply cinching motions to the substantially flexible elongated tissue closure assembly.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p.ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
Surgical staple cartridges and methods for manipulating the severed ends of divided tissue. In various forms, the staple cartridge has at least one base material temporarily supported thereon that is oriented to be stapled to a corresponding end of the divided tissue. At least one elongated tether is non-removably affixed to each piece of base material. Once the base material is stapled to the corresponding piece of divided tissue, the clinician may manipulate that pieced of divided tissue by applying manipulation motions to the tether. Corresponding grooves or pockets may be provided on the cartridge body for temporarily supporting the tethers therein.
A method for monitoring the flow and usage of a plurality of medical devices (4) in a hospital (2) environment, in which before shipping the medical devices (4) to a hospital (2) identification tags (17) are connected to said medical devices (4) which are detectable at a distance and contain a medical device identification code and, upon receiving the medical devices (4) in the hospital (2) store (13; 14), they are scanned to detect and store the medical device identification codes of the received medical devices (4) as entrance codes in a data base (31;28) and, when medical devices (4) leave the hospital (2) store (13;14) towards an operation theater block (9) or clinical department, they are scanned to detect and store the medical device identification codes of the medical devices (4) which left the hospital store (13; 14) as exit codes in the data base (31;28) and a medical device stock level in the hospital store (13, 14) is calculated on the basis of the previously stored medical device identification entrance codes and medical device identification exit codes.
G06Q 10/06 - Ressources, gestion de tâches, des ressources humaines ou de projets; Planification d’entreprise ou d’organisation; Modélisation d’entreprise ou d’organisation
G06F 19/00 - Équipement ou méthodes de traitement de données ou de calcul numérique, spécialement adaptés à des applications spécifiques (spécialement adaptés à des fonctions spécifiques G06F 17/00;systèmes ou méthodes de traitement de données spécialement adaptés à des fins administratives, commerciales, financières, de gestion, de surveillance ou de prévision G06Q;informatique médicale G16H)
90.
Surgical instruments with lockable articulating end effector
Hand-held surgical instruments that have and end effector attached to an elongate shaft are disclosed. The end effector has at least a portion that is movable in response to opening and closing motions applied thereto by a closure member. An articulation control system is provided to articulate the end effector relative to the shaft. An articulation locking system is provided to lock the end effector in a desired articulated position. The locking system interfaces with the closure member and is activated upon application of a closure motion to the end effector.
Hand-held surgical instruments that have and end effector attached to an elongate shaft are disclosed. The end effector is articulatable and rotatable relative to the shaft by a nozzle arrangement supported by a handle from which the elongate shaft extends. In various embodiments, the nozzle is operable by the same hand that is used to support the handle.
An electrical ablation device may generally comprise first and second electrodes coupled to an energy source operative to generate and deliver a first sequence of electrical pulses and a second sequence of electrical pulses to tissue having a necrotic threshold, wherein the first sequence of electrical pulses delivers a first energy dose that is less than the necrotic threshold to induce thermal heating in the tissue and the second sequence of electrical pulses delivers a second energy dose equal to or greater than the necrotic threshold to induce cell necrosis in the tissue by irreversible electroporation. The first sequence of electrical pulses may each be independently characterized by a first amplitude, a first pulse width, and a first frequency. The second sequence of electrical pulses may be characterized by a second amplitude, a second pulse width, and a second frequency.
A61B 18/18 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p.ex. de micro-ondes
A61N 1/32 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p.ex. des courants à haute fréquence
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
94.
Surgical instrument with selectively rigidizable features
Mechanisms for altering the shape of a cell or chamber of a shaft or an actuation drive of an instrument are provided. The mechanisms may selectively rigidize the shaft of surgical or diagnostic instruments. The shaft assembly includes a shaft operatively connectable to a control member, at least one cell or a set of cells defined within the shaft, a shape altering material contained within the cell or cells, and, an activation link operatively connectable to a source of activation energy for delivering activation energy to each cell for activating the shape altering material to selectively rigidize or unrigidize the shaft. An actuator for producing work is also provided that includes an element within a housing that defines a cell or a set of cells. The shape altering material is contained within the cells, and a source of activation energy operatively connected to each cell for activating the shape altering material to expand or contract the cell. The element is operatively connectable to a driving member of an instrument such that the change in the cell is translated to the driving member to facilitate the production of work.
Methods and devices are provided for delivering obesity therapy to a patient. In general, the methods and devices allow for onset of a patient eating solid food, e.g., the patient beginning a meal, to trigger delivery of an obesity therapy to a patient. The obesity therapy can be delivered to the patient for a limited period of time such that the patient stops receiving the obesity therapy prior to a second onset of the patient eating solid food, e.g., the patient beginning a second meal, which can trigger a second delivery of the obesity therapy to the patient for a limited period of time.
A61M 37/00 - Autres appareils pour introduire des agents dans le corps; Percutanisation, c. à d. introduction de médicaments dans le corps par diffusion à travers la peau
A61N 1/00 - SCIENCES MÉDICALE OU VÉTÉRINAIRE; HYGIÈNE ÉLECTROTHÉRAPIE; MAGNÉTOTHÉRAPIE; THÉRAPIE PAR RADIATIONS; THÉRAPIE PAR ULTRASONS Électrothérapie; Circuits à cet effet
A61M 5/172 - Moyens pour commander l'écoulement des agents vers le corps ou pour doser les agents à introduire dans le corps, p.ex. compteurs de goutte-à-goutte électriques ou électroniques
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p.ex. stimulateurs cardiaques
A61B 5/024 - Mesure du pouls ou des pulsations cardiaques
A61B 5/0245 - Mesure du pouls ou des pulsations cardiaques utilisant des capteurs engendrant des signaux électriques
Methods are provided for biliary diversion. In one embodiment, a tubular member can be implanted within a patient by positioning a proximal end of the tubular member in the patient's gall bladder, positioning a distal end of the tubular member in the patient's intestine, and positioning a length of the tubular member extending between the proximal and ends thereof within the patient's stomach. Bile can therefore be allowed to pass from the gall bladder into the tubular member's proximal end, flow through the tubular member, and exit through the tubular member's distal end to enter the patient's gastrointestinal tract at the intestine.
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaire; Accessoires à cet effet, p.ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A61M 31/00 - Dispositifs pour l'introduction ou la rétention d'agents, p.ex. de remèdes, dans les cavités du corps
A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A system for tissue approximation and fixation is described herein. A device is advanced in a minimally invasive manner within a patient's body to create one or several divisions or plications within a hollow body organ. The system comprises a stapler assembly having a tissue acquisition member and a tissue fixation member. The stapler assembly approximates tissue from within the hollow body organ with the acquisition member and then affixes the approximated tissue with the fixation member. In one method, the system can be used as a secondary procedure to reduce the size of a stoma within the hollow body organ.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61F 5/00 - Procédés ou dispositifs d'orthopédie pour le traitement non chirurgical d'os ou articulations; Dispositifs pour donner des soins
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/11 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour réaliser l'anastomose; Boutons pour anastomose
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 1/313 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments pour l'introduction dans des incisions chirurgicales, p.ex. laparoscopes
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 19/00 - Instruments, outillage ou accessoires pour la chirurgie ou le diagnostic non couverts par l'un des groupes A61B 1/00-A61B 18/00, p.ex. pour stéréotaxie, opération aseptique, traitement de la luxation, protecteurs des bords des blessures(masques de protection du visage A41D 13/11; blouses de chirurgien ou vêtements pour malades A41D 13/12; dispositifs pour retirer, traiter ou transporter les liquides du corps A61M 1/00)
99.
Surgical fastener for applying a large staple through a small delivery port
A surgical fastener applying device having a handle with a trigger pivotably attached thereto and movable within a trigger plane. The trigger has a bottom portion extending from the handle and a top portion disposed within a housing of the handle. The device has a staple housing with a proximal end attached to the handle, a distal end extending therefrom and a longitudinal axis therebetween. The housing has a firing bar disposed within, and the trigger is coupled to the firing bar. The device has a link member with a first end pivotably attached to the top portion of trigger, the link member has a second end comprising a slidable pin. The pin engages a three dimensional cam path disposed within the housing. The link member follows distal and proximal movement of the top portion of the trigger, and the pin slides perpendicular to the trigger plane to follow the three dimensional cam path.
A fastener applying device including a staple housing having a proximal end attached to a handle, a distal end, and a longitudinal axis therebetween. There is at least one fastener within the housing. The device also includes an anvil movable within the staple housing. The anvil has a proximal position and a distal position, wherein when in the distal position a distal end of the anvil extends distal to the distal end of the staple housing by a distance. The device also includes an adjustment nut connecting the staple housing to the handle. Rotation of the adjustment nut changes the distance.
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