What is claimed is:
1. A system for endoscopic suturing of tissue comprising:
an endoscope locatable in the body of a patient having a flexible shaft;
an accessory tube having first and second ends, and coupled to said endoscope to flex in accordance with flexures of said shaft of said endoscope; and
at least one suturing instrument having a shaft locatable through said first and second ends of said tube, a distal tissue engaging end coupled to said shaft, a pair of needles extendible through said shaft to said tissue engaging end, in which said shaft has a first section and a second section, and a flexible needle carrying tube for each of said needles, in which said flexible needle carrying tube extends through at least part of said second section of said shaft, and said second section has sufficient flexibility for passing through said accessory tube have flexures in accordance with flexures of said endoscope.
2. The system according to claim 1 further comprising:
means for attaching said tube at a plurality of locations along said shaft of said endoscope to enable said tube to be substantially coaxial with said shaft of said endoscope while movable through said attaching means.
3. The system according to claim 1 further comprising:
a cannula attached to said first end of said accessory tube having a sealable opening in which said shaft of said suturing instrument passes through cannula to said tube.
4. The system according to claim 1 wherein said suturing instrument has a housing coupled to said shaft.
5. The system according to claim 1 wherein said tissue engaging end has a gap through which said needles are extendable through said gap, and said system further comprises means for providing suction through said shaft to said gap of said tissue engaging end to enable tissue to be pulled into said gap prior to extending said needles.
6. The system according to claim 5 wherein said tissue engaging end has channels for distributing said suction along said gap.
7. The system according to claim 5 wherein said suturing instrument further comprises a loop of suture having two ends, two ferrules each coupled to one of said ends of said loop of suture, means for selectably driving each of said needles forward through said suctioned tissue into a different one of said two ferrules, and retracting each of said needles through said suctioned tissue with said ferrule.
8. The system according to claim 7 wherein said suturing instrument further comprises a suture carrying tube extending through said shaft to said tissue engaging end for carrying said loop of suture.
9. The system according to claim 4 wherein said first section is rigid and extends from said housing, and said second section is flexible and extends from the first section to the tissue engaging end.
10. The system according to claim 9 wherein said first section of said shaft has a rigid tube and said second flexible section has a flexible tubular body, and a first coupler couples said rigid tube and said flexible tubular body, and the needle carrying tube for each of said needles is longitudinally fixed in said first coupler.
11. The system according to claim 10 wherein said flexible section of said shaft in said flexible tubular body further comprises a second coupler, a cable fixed to said second coupler extending to said tissue engaging end and attached to said tissue engaging end, and said second coupler couples the needle carrying tube for each of said needles to said cable.
12. The system according to claim 11 wherein said flexible section of said shaft in said flexible body further comprises a flexible guide member having three channels between said second coupler and said tissue engaging end for carrying said cable and needles, wherein said needles exit said needle carrying tubes prior to said flexible guide member.
13. The system according to claim 11 wherein said tissue engaging end further comprises a third coupler attached to said cable and said flexible body, and a sew tip attached to said third coupler having channels for said needles and a gap across which each of said needles are extendible.
14. The system according to claim 1 wherein said distal tissue engaging end comprises a frame and a plurality of sections which are integrated to said frame.
15. The system according to claim 12 wherein said second section of said shaft of said suturing instrument between said second and third couplers represents a part of said second section having the greatest flexibility.
16 The system according to claim 1 wherein said endoscope is a gastroscope.
17. The system according to claim 1 wherein said needles each have a first diameter and has a plurality of regions of a second diameter less than said first diameter which alternate with regions of said first diameter in at least a portion of said second section to enhance flexibility of said needles.
18. The system according to claim 1 wherein said suturing instrument is separate from said endoscope.
19. The system according to claim 1 further comprising a suture securing instrument having a flexible shaft locatable through said first and second ends of said accessory tube.
20. The system according to claim 19 wherein said suture securing instrument further comprises means for retaining in a sleeve member the two free ends of a loop of suture extending through tissue, and means for cutting the two free ends of the loop of suture near said sleeve member.
21. The system according to claim 19 wherein said suture securing instrument is separate from said endoscope.
22. The system according to claim 1 wherein said endoscope provides means for viewing the suturing instrument.
23. An accessory tube attachable to an endoscope having a flexible shaft with a distal end comprising:
a flexible tube having a first end and a second end;
a plurality of tube guides spaced along said flexible tube, each of said tube guides having an opening through which extends said flexible tube, each of said tube guides being attachable along the shaft of an endoscope to couple said flexible tube to said shaft such that said flexible tube follows flexures of said shaft;
a distal tip attached to the distal end of said shaft of said endoscope and having an opening receiving said second end of said flexible tube; and
a cannula attached to said first end of said flexible tube having a housing with a passageway to said flexible tube for enabling an instrument to pass into said flexible tube, a member in said housing disposed in said passageway having an opening which is normally closed to seal said passageway and a chamber with walls extending to said normally closed opening in which said walls of said chamber are deformable in response to an instrument passing through said passageway and said opening of said member into said flexible tube and through said opening of said distal tip, and said opening of said member closes to seal said passageway when the instrument is removed from said accessory tube.
24. A suturing instrument comprising:
a housing;
a shaft extending from said housing;
a tissue engaging end coupled to said shaft at the distal end of the instrument;
one or more needles which extend through said housing through said shaft to said tissue engaging end;
a suture tube extending through said housing and said shaft to said tissue engaging end;
said tissue engaging end having a sew tip with an opening through which said needles are extendable to each capture one end of suture extending through said suture channel to said sew tip;
said shaft representing an assembly having a first section and a second section coupled to said first section, said first section being rigid and extends from said housing, and said second section being flexible and extends from the first section to the tissue engaging end;
a flexible needle carrying tube for each of said needles, in which said flexible needle carrying tube extends through at least part of said first and second sections of said shaft; and
means for coupling said flexible needle carrying tube for each of said needles by a cable to said tissue engaging ends; and
a flexible guide member having channels for carrying said needles and cable to said tissue engaging end after each said needle exits their respective said needle carrying tube.
25. The suturing instrument of claim 24 further comprising means for providing suction to said opening of said sew tip through said shaft.
26. A suture securing instrument comprising:
a housing having a pivotally mounted actuator member;
a flexible tube extending from said housing;
a distal end coupled to said flexible tube having means for deforming a ferrule and cutting suture when loaded through said ferrule;
a wire coupled to said actuator member and extending through said flexible tube to actuate said deforming and cutting means at said distal end, said flexible tube being fixed to said housing and to said distal end, and said wire being extendable and retractable through said flexible tube in response to pivoting of said actuator member.
27. The instrument according to claim 26 wherein said flexible tube has successive regions of reduced diameter from said housing to said distal end to enhance flexibility of said tube.
28. The instrument according to claim 26 wherein an overtube is provided from said housing and said flexible tube extending through a portion of said overtube.
29. The instrument according to claim 28 further comprising a tip tube containing said deforming and cutting means and a distal coupler for attaching said flexible tube to said tip tube.
30. A system for endoscopic suturing of tissue comprising:
an endoscope locatable in the body of a patient having a flexible shaft;
an accessory tube having first and second ends, and coupled to said endoscope to flex with flexures of said shaft of said endoscope; and
at least one suturing instrument having a shaft locatable through said first and second ends of said tube, a distal tissue engaging end coupled to said shaft, a pair of needles extendible through said shaft to said tissue engaging end, in which each of said needles along a portion of the needle undulates between first diameter regions and second diameter regions larger than said first diameter regions to enhance flexibility of said needles.
31. A suturing instrument comprising:
a shaft locatable through said first and second ends of said tube;
a distal tissue engaging end coupled to said shaft;
one or more needles extendible through said shaft to said tissue engaging end;
said tissue engaging end further comprises a gap through which said needles are extendable; and
means for providing suction through said shaft to said gap of said tissue engaging end to enable tissue to be pulled into said gab prior to extending said needles, and said tissue engaging end has one or more channels for distributing said suction along said gap.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. A materials handling device, comprising:
(a) a chassis;
(b) an elongated handle shaft mounted to said chassis for use in maneuvering said device;
(c) at least one roller rotationally mounted to said chassis and in contact with a surface;
(d) at least one battery pack supported on said handle shaft and being configured so as to substantially surround a portion of said handle shaft;
(e) a drive unit spaced from said battery pack and mounted to said chassis so as to drivingly engage said roller; and
(f) means for electrically connecting said battery pack to said drive unit to supply electrical power to operate said drive unit to transmit a high torque driving output to said roller so that a rotary driving output can then be supplied by said roller to enable said device to thereby move across the surface and to manipulate and move a heavy load.
2. The device of claim 1 wherein said battery pack includes a plurality of individual battery cells.
3. The device of claim 2 wherein said battery cells are NiCad batteries.
4. The device of claim 2 wherein said battery cells are NiMH batteries.
5. The device of claim 2 wherein said battery cells are Lithium batteries.
6. The device of claim 2 wherein each of said battery cells has about a 1.2 volt rating.
7. The device of claim 6 wherein said battery pack includes forty of said battery cells such that said battery pack has about a 48 volt rating.
8. The device of claim 2 wherein said battery pack includes a housing of annular configuration supporting said battery cells in stacked end-to-end electrically contacting relationships and upper and lower electrical contacts electrically contacting end ones of said stacked battery cells.
9. The device of claim 8 wherein said housing has a central passage formed therethrough for receiving said handle shaft such that said housing supports a plurality of stacks of said battery cells spaced apart from one another about said handle shaft.
10. The device of claim 8 wherein said housing is includes a pair of holders being semi-cylindrical in configuration that fit and fasten together to provide said housing with said annular configuration and said passage therethrough.
11. A materials handling device, comprising:
(a) a chassis;
(b) at least one rechargeable battery pack removably and replaceably supported on said device;
(c) an electric motor and gearbox in a driving relation with a roller in contact with a surface; and
(d) a controller supported on said chassis and having a plurality of capacitors connected to said battery pack and charged by said battery pack so as to have available a store of electrical power, said capacitors of said controller being electrically connected between said battery pack and said electric motor such that said capacitors of said controller can supply said store of electrical power to said electric motor instantaneously when needed which via said gearbox can transmit a high torque driving output to said roller so that a rotary driving output can then be supplied by said roller to enable said device to thereby move across the surface and to manipulate and move a heavy load.
12. The device of claim 11 further comprising:
a switch connected to said controller and being activatable by an operator to cause said capacitors of said controller to discharge and supply instantaneously said store of electrical power to said electric motor.
13. The device of claim 11 wherein said electric motor is about a 48-volt electric motor.
14. The device of claim 11 further comprising:
an elongated handle shaft mounted to said chassis for use in maneuvering said device.
15. The device of claim 14 wherein said battery pack is supported on said handle shaft.
16. The device of claim 14 wherein said battery pack includes a plurality of individual battery cells.
17. The device of claim 16 wherein said battery cells are NiCad batteries.
18. The device of claim 16 wherein said battery cells are NiMH batteries.
19. The device of claim 16 wherein said battery cells are Lithium batteries.
20. The device of claim 16 wherein each of said battery cells has about a 1.2 volt rating.
21. The device of claim 20 wherein said battery pack includes forty of said battery cells such that said battery pack has about a 48 volt rating.
22. The device of claim 16 wherein said battery pack includes a housing of annular configuration supporting said battery cells in stacked end-to-end electrically contacting relationships and having upper and lower electrical contacts electrically contacting end ones of said stacked battery cells.
23. The device of claim 22 wherein said housing has a central passage formed therethrough for receiving a portion of said device such that said housing supports a plurality of stacks of said battery cells spaced apart from one another about said portion of said device.
24. The device of claim 22 wherein said housing is includes a pair of holders semi-cylindrical in configuration that fit and fasten together to provide said housing with said annular configuration and said passage therethrough.
25. A materials handling device, comprising:
(a) a chassis;
(b) an elongated handle shaft pivotally mounted to said chassis for use in maneuvering said device;
(c) at least one roller rotationally mounted to said chassis;
(d) a battery pack supported on said handle shaft;
(e) an electric motor and gearbox fitted within said roller in-line with a rotational axis of said roller; and
(f) a controller supported on said chassis and having a plurality of capacitors connected to said battery pack and charged by said battery pack so as to have available a store of electrical power, said capacitors of said controller being electrically connected between said battery pack and said electric motor such that said capacitors of said controller can supply said store of electrical power to said electric motor instantaneously when needed which via said gearbox can transmit a high torque driving output to said roller so that a rotary driving output can then be supplied by said roller to enable said device to thereby move across a surface and to manipulate and move a heavy load.
26. The device of claim 25 wherein said handle shaft has a switch mounted thereon and connected to said controller and being activatable by an operator to cause said capacitors of said controller to discharge and supply instantaneously said store of electrical power to said electric motor.
27. A materials handling system, comprising:
(a) a battery charger disposed at a location nearby an area of operation and operable to convert a rechargeable battery pack from a discharged condition to a charged condition; and
(b) a materials handling device displaced from said battery charger and being operable for moving a load at the area of operation, said materials handling device including
(i) a drive unit provided on the device;
(ii) a plurality of rechargeable battery packs, at least one of said rechargeable battery packs being removably and replaceably provided on said device for supplying electrical power to operate said drive unit, at least another of said rechargeable battery packs being provided at the location of said battery charger and maintained in a charged condition by said battery charger so that said another rechargeable battery pack is available to replace said at least one rechargeable battery pack on said device upon said at least one rechargeable battery pack on said device reaching the discharged condition, and
(iii) a controller provided on said device and having a plurality of capacitors connected to said at least one rechargeable battery pack on said device, said capacitors being charged by said at least one rechargeable battery pack on said device so as to have available a store of electrical power, said capacitors also being electrically connected between said at least one rechargeable battery pack and said drive unit such that said capacitors can supply said store of electrical power to said drive unit instantaneously when needed such that said drive unit can transmit a high torque driving output to enable said device to thereby move across a surface and to manipulate and move the load.
28. The system of claim 27 further comprising:
a switch provided on said device and connected to said controller and being activatable by an operator to cause said capacitors of said controller to discharge and supply instantaneously said store of electrical power to said drive unit.
29. The system of claim 27 wherein each of said battery packs includes a plurality of individual battery cells.
30. The system of claim 29 wherein said battery cells are NiCad batteries.
31. The system of claim 29 wherein said battery cells are NiMH batteries.
32. The system of claim 29 wherein said battery cells are Lithium batteries.
33. The system of claim 29 wherein each of said battery cells has about a 1.2 volt rating.
34. The system of claim 29 wherein each of said battery packs includes forty of said battery cells such that said battery pack has about a 48 volt rating.
35. The system of claim 27 wherein said drive unit includes an electric motor having about a 48-volt rating.
36. A materials handling system, comprising:
(a) a battery charger disposed at a location nearby an area of operation and operable to convert a rechargeable battery pack from a discharged condition to a charged condition; and
(b) a materials handling device displaced from said battery charger and being operable for moving a load at the area of operation, said materials handling device including
(i) a chassis,
(ii) at least one roller rotationally mounted to said chassis and in contact with a surface at the area of operation,
(iii) a drive unit mounted to said chassis so as to drivingly engage said roller,
(iv) a plurality of rechargeable battery packs, at least one of said rechargeable battery packs being removably and replaceably supported on said device for supplying electrical power to operate said drive unit, at least another of said rechargeable battery packs being disposed at the location of said battery charger and maintained in a charged condition by said battery charger so that said another rechargeable battery pack is available to replace said at least one rechargeable battery pack on said device upon said at least one rechargeable battery pack on said device reaching the discharged condition, and
(v) a controller supported on said chassis and having a plurality of capacitors connected to said at least one rechargeable battery pack on said device, said capacitors being charged by said at least one rechargeable battery pack on said device so as to have available a store of electrical power, said capacitors also being electrically connected between said at least one rechargeable battery pack and said drive unit such that said capacitors can supply said store of electrical power to said drive unit instantaneously when needed such that said drive unit can transmit a high torque driving output to said roller so that a rotary driving output can then be supplied by said roller to enable said device to thereby move across a surface and to manipulate and move the load.