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Publication numberCN101980673 A
Publication typeApplication
Application numberCN 200980111663
PCT numberPCT/SE2009/000042
Publication date23 Feb 2011
Filing date29 Jan 2009
Priority date29 Jan 2008
Also published asCA2749778A1, CA2749782A1, CA2749792A1, CA2776479A1, CN101980673B, CN101980674A, CN102245133A, CN102245133B, CN104323877A, CN105361986A, CN105997315A, EP2240127A1, EP2240127A4, EP2240128A1, EP2240128A4, EP2240129A1, EP2240129A4, EP2240130A1, EP2240130A4, EP2240131A1, EP2240131A4, EP2240132A1, EP2240132A4, EP2240133A1, EP2240133A4, EP2240134A1, EP2240134A4, EP2240135A1, EP2240135A4, EP2240136A1, EP2240136A4, EP2240137A1, EP2240137A4, EP2240138A1, EP2240138A4, EP2240139A1, EP2240139A4, EP2240139B1, EP2240140A1, EP2240140A4, EP2249752A1, EP2249752A4, EP2249753A1, EP2249753A4, EP2349132A1, EP2349132A4, EP2349133A1, EP2349133A4, EP2349134A1, EP2349134A4, EP3072480A1, US8567409, US8636809, US8992629, US9060771, US9259223, US9277920, US9375213, US9445815, US9526649, US9561033, US9642733, US9681874, US9687335, US20100312047, US20100312048, US20100312049, US20100312050, US20100312356, US20100324360, US20100324361, US20100324362, US20100331614, US20100331615, US20100331616, US20100331617, US20100331945, US20100332000, US20110009894, US20110009896, US20110009897, US20110172693, US20110196197, US20110196391, US20110218394, US20120022561, US20120029550, US20120029551, US20140148645, US20140236212, US20140330075, US20150305851, US20160022462, US20160166418, US20160324673, US20160374843, US20170165092, US20170209292, WO2009096857A1, WO2009096858A1, WO2009096859A1, WO2009096860A1, WO2009096861A1, WO2009096862A1, WO2009096862A8, WO2009096863A1, WO2009096864A1, WO2009096865A1, WO2009096865A8, WO2009096866A1, WO2009096867A1, WO2009096868A1, WO2009096869A1, WO2009096870A1, WO2009096871A1, WO2009096872A1, WO2009096872A9, WO2009096873A1, WO2009096873A9, WO2009096874A1, WO2010042061A1, WO2010042062A1, WO2010042063A1
Publication number200980111663.8, CN 101980673 A, CN 101980673A, CN 200980111663, CN-A-101980673, CN101980673 A, CN101980673A, CN200980111663, CN200980111663.8, PCT/2009/42, PCT/SE/2009/000042, PCT/SE/2009/00042, PCT/SE/9/000042, PCT/SE/9/00042, PCT/SE2009/000042, PCT/SE2009/00042, PCT/SE2009000042, PCT/SE200900042, PCT/SE9/000042, PCT/SE9/00042, PCT/SE9000042, PCT/SE900042
Inventors彼得福塞尔
Applicant米卢克斯控股股份有限公司
Export CitationBiBTeX, EndNote, RefMan
External Links: SIPO, Espacenet
A device, system and method for treating obesity
CN 101980673 A
Abstract
An obesity treatment device is provided, the device comprising: at least one operable stretching device implantable in an obese patient and adapted to stretch a portion of the patient's stomach wall and an operation device for operating the stretching device when implanted to stretch the stomach wall portion such that satiety is created.
Claims(171)  translated from Chinese
  1. 一种肥胖症治疗装置,包括:至少一个可操作拉伸装置,其能植入在肥胖病人体中并适于拉伸所述病人的胃壁的一部分,以及操作装置,用于操作被植入时的所述拉伸装置,以拉伸所述胃壁部分,从而引起饱胀感。 At least one operable stretching device, which can be implanted in the obese patient and adapted to stretch a portion of the body of the stomach wall of the patient, and an operation means for operating to be implanted: one obesity treatment apparatus, comprising the stretching device to stretch the stomach wall portion, causing a feeling of fullness.
  2. 2.根据权利要求1所述的装置,其中所述拉伸装置包括第一接合构件和第二接合构件,所述第一接合构件适于接合所述胃壁的第一部分,所述第二接合构件适于接合所述胃壁的与所述第一胃部分接近但分隔开的第二部分。 2. The apparatus according to claim 1, wherein said stretching means includes a first member and a second engaging member engaging said first engaging member adapted to engage the first portion of the stomach wall, the second engagement member adapted to engage the stomach wall and the first portion of the stomach close to but spaced from the second portion.
  3. 3.根据权利要求2所述的装置,其中当所述接合构件接合所述第一和第二胃部分时, 所述操作装置适于操作所述第一和第二接合构件背离彼此,以拉伸所述胃的第一和第二部分之间的胃壁部分,从而引起饱胀感。 3. The apparatus according to claim 2, wherein when said engagement member engages said first and second time-sharing stomach, said operating means adapted to operate said first and second engaging members away from each other, in order to pull stretch the stomach stomach wall portion between the first and second parts, causing a feeling of fullness.
  4. 4.根据权利要求3所述的装置,其中所述第一和第二接合构件中的至少一个适于通过胃至胃的缝合线或订合线至少部分地被所述胃壁套叠,从而将所述接合构件保持在适当位置。 4. The apparatus according to claim 3, wherein said first and second engagement member is adapted to at least one of through the stomach to stomach sutures or staplers at least partly invaginated by the stomach wall, thereby The engaging member is held in place.
  5. 5.根据权利要求3所述的装置,其中所述第一和第二接合构件中的至少一个适于通过所述接合构件与所述胃壁之间的缝合线或订合线而保持在适当位置。 5. The apparatus according to claim 3 or claim, wherein said first and second engagement member and at least one is adapted to be held in place by the engaging member and the stomach sutures or staplers between .
  6. 6.根据权利要求5所述的装置,其中所述第一和第二接合构件中的至少一个包括组织生长促进结构,其适于与所述胃壁接触以保证所述拉伸装置长期附接到所述胃壁。 6. The apparatus according to claim 5, wherein said first and second engagement member comprises at least one tissue growth promoting structure adapted to contact with the stomach wall in order to ensure long stretching device attached to the the stomach wall.
  7. 7.根据权利要求6所述的装置,其中所述结构包括网状结构。 7. The apparatus according to claim 6, wherein said structure comprises a mesh structure.
  8. 8.根据权利要求1所述的装置,其中在所述拉伸装置能够拉伸所述胃壁的位置,所述拉伸装置适于通过胃至胃的缝合线或订合线而保持与所述胃壁接触。 8. The apparatus according to claim 1, wherein said device is capable of stretching the stomach wall in a stretched position, the stretching device is adapted to pass through the stomach to stomach sutures or staplers holding the lines stomach touch.
  9. 9.根据权利要求1所述的装置,其中所述拉伸装置适于通过胃至胃的缝合线或订合线被所述胃壁套叠。 9. The apparatus according to claim 1, wherein said stretching means is adapted to pass through the stomach to stomach sutures or staplers invaginated by the stomach wall.
  10. 10.根据权利要求1所述的装置,其中所述拉伸装置为大致非周界的胃或食管装置。 10. The apparatus according to claim 1, wherein said stretching means is substantially non-perimeter stomach or esophageal device.
  11. 11.根据权利要求1所述的装置,其中所述拉伸装置适于能够术后非侵入性地调节。 11. The apparatus according to claim 1, wherein after said stretching means is adapted to be able to non-invasively adjust.
  12. 12.根据权利要求1所述的装置,其中所述拉伸装置包括主体,其适于填充由所述胃的壁部分限定的容积。 12. The apparatus according to claim 1, wherein the stretching device comprises a body adapted to fill the portion of the wall defining the volume of the stomach.
  13. 13.根据权利要求12所述的装置,其中所述主体具有圆滑轮廓,而没有可能损坏所述病人的胃壁的太尖的边缘。 13. The apparatus according to claim 12, wherein the body has rounded contours without damage to the patient's stomach may be too sharp edges.
  14. 14.根据权利要求13所述的装置,其中所述主体具有各种周界,以更好地适于保持在被所述病人的胃壁部分套叠的位置。 14. The apparatus according to claim 13, wherein the body has a variety of perimeter to better adapted to maintain the position of the nested portion of the patient's stomach wall is.
  15. 15.根据权利要求13所述的装置,其中所述主体为类似蛋的形状。 15. The apparatus according to claim 13, wherein said body is a shape similar to the egg.
  16. 16.根据权利要求13所述的装置,其中所述主体为类似肾的形状。 16. The apparatus according to claim 13, wherein said body is a shape similar to the kidney.
  17. 17.根据权利要求1所述的装置,其中所述拉伸装置适于被放置在所述胃腔中。 17. The apparatus according to claim 1, wherein said stretching means is adapted to be placed in the stomach cavity.
  18. 18.根据权利要求17所述的装置,其中所述拉伸装置适于经由胃镜或入腔器械被插入所述胃腔中。 18. The apparatus according to claim 17, wherein said stretching means is adapted via endoscopy instrument is inserted into the cavity or into the stomach cavity.
  19. 19.根据权利要求1所述的装置,进一步包括至少两个可操作拉伸装置,其适于拉伸所述胃壁的至少两个不同部分。 19. The apparatus according to claim 1, further comprising at least two operable stretching devices adapted to stretch the stomach wall which at least two different portions.
  20. 20.根据权利要求19所述的装置,其中所述装置适于被术后且非侵入性地调整,并适于被时常地调整为使得在第一时间所述拉伸装置中的一个拉伸所述胃壁的一个部分,在第二时间,所述拉伸装置的另一个拉伸所述胃壁的另一部分。 20. The apparatus according to claim 19, wherein said means is adapted to be postoperatively and non-invasively adjust, and adapted to be adjusted from time to time for the first time such a stretching means stretching A portion of the stomach wall, at a second time, said stretching means stretching further another portion of the stomach wall.
  21. 21.根据权利要求1所述的装置,其中所述拉伸装置适于通过手术附接到所述胃壁。 21. The apparatus according to claim 1, wherein the stretching device is adapted to be surgically attached to the stomach wall.
  22. 22.根据权利要求1所述的装置,其中所述拉伸装置适于被放置在所述胃的外部。 22. The apparatus according to claim 1, wherein said stretching means is adapted to be placed on the outside of the stomach.
  23. 23.根据权利要求1所述的装置,其中所述操作装置包括适于通过手动按压所述开关以操作所述拉伸装置进行非侵入性操作的皮下开关。 23. The apparatus according to claim 1, wherein said operating means comprises a switch adapted by manually pressing the stretching means to operate the non-invasive subcutaneous switching operation.
  24. 24.根据权利要求1所述的装置,其中所述拉伸装置包括适于被所述病人的胃壁的一部分套叠的至少一个可膨胀主体,且所述操作装置包括流体贮存器,其与所述主体的室流体连通,所述操作装置能非侵入性地操作以将流体从所述流体贮存器分配到所述主体的室,以使所述主体膨胀,使得当所述主体套叠时,所述胃壁部分被拉伸。 24. The apparatus according to claim 1, wherein said stretching means comprises adapted to be a part of the patient's stomach wall invaginated at least one inflatable body, and said operating means comprises a fluid reservoir, with the The chamber in fluid communication with said body, said operating means capable of non-invasively operable to dispensing fluid from said fluid reservoir chamber to said main body, so that the expansion body, such that when said telescopic body, part of the stomach wall is stretched.
  25. 25.根据权利要求24所述的装置,其中所述流体贮存器通过手动按压所述流体贮存器进行操作。 25. The apparatus according to claim 24, wherein said fluid reservoir by manually pressing the fluid reservoir is operated.
  26. 26.根据权利要求25所述的装置,其中所述操作装置可包括回动伺服机构,且其中所述流体贮存器中的小容积的流体被较大的力压缩,且所述主体的室在每单位容积较小的力下造成较大总容积的运动。 26. The apparatus according to claim 25, wherein said operating means may include a reversed servo, wherein the fluid reservoir and the small volume of fluid to be compressed with a higher force and the chamber in the body caused by the volume per unit smaller force under the total volume of the larger movement.
  27. 27.根据权利要求1所述的装置,进一步包括与一个或多个较小的室接触的大室。 27. The apparatus according to claim 1, further comprising one or more of the smaller chamber of the large cell contact.
  28. 28.根据权利要求27所述的装置,其中所述室适于与分配在所述室之间的流体或空气连通。 28. The apparatus according to claim 27, wherein said chamber is adapted between the chamber and the dispensing of fluid or air communication.
  29. 29.根据权利要求27所述的装置,包括用于在所述室之间分配流体的回动伺服机构, 其中所述大室中的小容积的流体被较大的力压缩,且所述较小的室在每单位容积较小的力下造成较大总容积的运动。 29. The apparatus according to claim 27, comprising means for dispensing a fluid reversing mechanism between the servo chamber, wherein the fluid is a large volume of the small chamber is compressed large force, and the relatively small room caused a large movement in the total volume of less force per unit volume.
  30. 30.根据权利要求27所述的装置,其中所述大室适于被套叠在所述病人的基底胃壁中,以通过限制贲门切口朝向所述病人的隔膜肌的运动还治疗返流疾病,且其中所述小室适于用作用于治疗肥胖症的拉伸装置,其中所述大室适于将流体或空气分配到所述小室, 以致使所述小室膨胀并拉伸所述胃基底壁。 30. The apparatus according to claim 27, wherein the large chamber is adapted invaginated in the patient's stomach wall substrate, by limiting the cardiac notch towards the diaphragm muscle of the patient motion also treat reflux disease, and wherein the chamber is adapted to be used as stretching means for treating obesity, wherein the large chamber is adapted to distribute fluid or air into the chamber, to cause the chamber to expand and stretch the stomach fundus wall.
  31. 31.根据权利要求25所述的装置,其中所述贮存器适于被放置在皮下。 31. The apparatus according to claim 25, wherein said reservoir is adapted to be placed subcutaneously.
  32. 32.根据权利要求24所述的装置,其中所述贮存器适于被放置在腹部中。 32. The apparatus according to claim 24, wherein said reservoir is adapted to be placed in the abdomen.
  33. 33.根据权利要求24所述的装置,其中所述贮存器通过移动所述贮存器的壁来调整。 33. The apparatus according to claim 24, wherein the reservoir by moving the walls of the reservoir is adjusted.
  34. 34.根据权利要求33所述的装置,进一步包括适于移动所述贮存器的所述壁的马达。 34. The apparatus according to claim 33, further comprising a reservoir adapted to move the wall of the motor.
  35. 35.根据权利要求24所述的装置,进一步包括泵,其中通过由所述泵将流体或空气从所述贮存器泵浦到所述主体的室,来调整所述贮存器。 35. The apparatus according to claim 24, further comprising a pump, wherein the pump through the fluid or air is pumped from the reservoir to the chamber of the body, to adjust the reservoir.
  36. 36.根据权利要求24所述的装置,其中所述液压调整装置包括机械拉伸装置,其适于通过流体或空气的液压分配来调整。 36. The apparatus according to claim 24, wherein said hydraulic adjustment means comprises a mechanical stretching device, which is adapted to dispensing via a hydraulic fluid or air is adjusted.
  37. 37.根据权利要求1所述的装置,进一步包括机械调整拉伸装置。 37. The apparatus according to claim 1, further comprising adjusting a mechanical stretching device.
  38. 38.根据权利要求37所述的装置,进一步包括用于机械调整拉伸装置的马达。 38. The apparatus according to claim 37, further comprising means for mechanically regulating the stretching of the motor.
  39. 39.根据权利要求37所述的装置,其中所述拉伸装置包括适于接合所述胃壁的第一部分的第一接合构件和适于接合所述胃壁的与所述第一胃部分接近但分隔开的第二部分的第二接合构件,其中所述机械拉伸装置适于调整所述胃壁的所述第一和第二部分之间的距罔ο 39. The apparatus according to claim 37, wherein said stretching means includes a first portion adapted to engage the first engagement member adapted to engage the stomach wall and the stomach wall close to the first portion of the stomach, but points a second engagement member spaced from the second portion, wherein said mechanical means is adapted to adjust the stretching of the stomach wall indiscriminately ο distance between the first and second portions
  40. 40.根据权利要求37所述的装置,其中所述机械调整拉伸装置适于接合所述胃壁的第一部分和所述胃的第二部分。 40. The apparatus according to claim 37, wherein said mechanical adjustment means is adapted to draw a first portion engaging said second portion of the stomach wall and the stomach.
  41. 41.根据权利要求40所述的装置,其中所述机械调整拉伸装置包括适于被所述操作装置移动的关节机构。 41. The apparatus according to claim 40, wherein said stretching means includes mechanical adjustment means being adapted to move the joint operating mechanism.
  42. 42. 一种用于治疗病人的肥胖症的肥胖症治疗系统,包括根据权利要求1所述的用于治疗肥胖症的装置。 42. A method of treating obesity in a patient treatment system for obesity, comprising means for treating obesity according to claim 1.
  43. 43.根据权利要求42所述的系统,进一步包括开关,其适于手动且非侵入性地控制所述用于治疗肥胖症的装置的功能。 43. The system of claim 42, further comprising a switch adapted to manually and non-invasively treating obesity control function for the apparatus.
  44. 44.根据权利要求43所述的系统,其中所述开关为皮下开关。 44. The system of claim 43, wherein the switch is a subcutaneous switch.
  45. 45.根据权利要求43所述的系统,其中所述开关为电开关。 45. The system of claim 43, wherein the switch is an electrical switch.
  46. 46.根据权利要求42所述的系统,进一步包括具有液压贮存器的液压装置,其中所述用于治疗肥胖症的装置适于通过手动按压所述液压贮存器而被非侵入性地调整。 46. The system of claim 42, further comprising a hydraulic device having a hydraulic reservoir, wherein said apparatus is adapted for the treatment of obesity have been adjusted non-invasively by manually pressing the hydraulic reservoir.
  47. 47.根据权利要求42所述的系统,进一步包括用于控制所述装置的功能的无线远程控制器。 47. The system of claim 42, further comprising means for controlling the functions of the wireless remote control.
  48. 48.根据权利要求47所述的系统,其中所述无线远程控制器包括至少一个外部信号发射器,进一步包括能植入所述病人体中的内部信号接收器。 48. The system of claim 47, wherein the wireless remote control comprises at least one external signal transmitter, further comprising a patient can implant the internal signal receiver.
  49. 49.根据权利要求47所述的系统,其中所述无线远程控制器适于发射用于控制所述装置的至少一个无线控制信号。 49. The system of claim 47, wherein the wireless remote control adapted to transmit at least one wireless control signal for controlling the apparatus.
  50. 50.根据权利要求49所述的系统,其中所述无线控制信号包括频率调制信号、幅度调制信号或相位调制信号,或者其组合。 50. The system of claim 49, wherein the wireless control signal comprises a frequency modulated signal, or amplitude modulation signal phase-modulated signal, or a combination thereof.
  51. 51.根据权利要求49所述的系统,其中所述无线控制信号包括模拟或数字信号,或者模拟和数字信号的组合。 51. The system of claim 49, wherein the wireless control signal comprises a combination of analog or digital signals, or analog and digital signals.
  52. 52.根据权利要求49所述的系统,其中所述无线控制信号包括电场或磁场或者组合的电场和磁场。 52. The system of claim 49, wherein the wireless control signal comprises an electric or magnetic field or a combination of electric and magnetic fields.
  53. 53.根据权利要求49所述的系统,其中所述远程控制器发射用于承载无线控制信号的载波信号。 53. The system of claim 49, wherein the remote control transmits a carrier signal for carrying the wireless control signal.
  54. 54.根据权利要求53所述的系统,其中所述载波信号包括数字、模拟或数字和模拟信号的组合。 54. The system of claim 53, wherein said carrier comprises a combination of a digital signal, analog or digital and analog signals.
  55. 55.根据权利要求53所述的系统,其中所述远程控制器发射用于承载数字或模拟控制信号的电磁载波信号。 55. The system of claim 53, wherein said remote control transmitter for carrying the digital or analog control signal, an electromagnetic carrier signal.
  56. 56.根据权利要求42所述的系统,进一步包括用于非侵入性地用无线能量对所述装置提供能量的无线能量发射器。 56. The system of claim 42, further comprising means for non-invasively providing radio energy means the energy of a wireless energy transmitter.
  57. 57.根据权利要求56所述的系统,其中所述能量发射器通过至少一个无线能量信号发射能量。 57. The system of claim 56, wherein the energy emitter via at least one wireless energy signal emitted energy.
  58. 58.根据权利要求57所述的系统,其中无线能量信号包括波信号。 58. The system of claim 57, wherein the wireless energy signal comprises a wave signal.
  59. 59.根据权利要求58所述的系统,其中所述无线能量信号包括从以下选出的波信号: 声波信号、超声波信号、电磁波信号、红外光信号、可见光信号、超紫外光信号、激光信号、微波信号、无线电波信号、χ射线信号和伽马射线信号。 59. The system of claim 58, wherein the wireless energy signal comprises a wave signal of the following selected from: an acoustic signal, an ultrasonic signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, extreme ultraviolet signals, laser signals, microwave signal, a radio wave signal, χ and gamma ray signal signal.
  60. 60.根据权利要求58所述的系统,其中所述无线能量信号包括电场或磁场或者组合的电场和磁场。 60. The system of claim 58, wherein the wireless energy signal comprises an electric or magnetic field or a combination of electric and magnetic fields.
  61. 61.根据权利要求56所述的系统,其中所述无线能量发射器发射用于承载所述无线能量信号的载波信号。 61. The system of claim 56, wherein the wireless energy transmitter for transmitting wireless energy signal carrying the carrier signal.
  62. 62.根据权利要求61所述的系统,其中所述载波信号包括数字、模拟或数字和模拟信号的组合。 62. The system of claim 61, wherein said carrier comprises a combination of a digital signal, analog or digital and analog signals.
  63. 63.根据权利要求61所述的系统,其中所述远程控制器发射用于承载数字或模拟控制信号的电磁载波信号。 63. The system of claim 61, wherein said remote control transmitter for carrying the digital or analog control signal, an electromagnetic carrier signal.
  64. 64.根据权利要求61所述的系统,其中所述无线能量信号包括模拟或数字信号,或者模拟和数字信号的组合。 64. The system of claim 61, wherein the wireless energy signal comprises a combination of analog or digital signals, or analog and digital signals.
  65. 65.根据权利要求42所述的系统,进一步包括适于为所述装置提供动力的能量源。 65. The system of claim 42, further comprising means adapted to provide power to the energy source.
  66. 66.根据权利要求65所述的系统,其中所述能量源包括内部能量源。 66. The system of claim 65, wherein the energy source comprises an internal energy source.
  67. 67.根据权利要求65所述的系统,其中所述能量源为内部能量源,其适于接收来自以无线模式发射能量的外部能量源的能量。 67. The system of claim 65, wherein the energy source is an internal energy source adapted to receive energy from an external energy source transmitting energy in a wireless mode.
  68. 68.根据权利要求67所述的系统,其中所述内部能量源被无线模式的能量充填。 68. The system of claim 67, wherein the internal energy source of energy is filled wireless mode.
  69. 69.根据权利要求42所述的系统,进一步包括传感参数的传感器。 69. The system of claim 42, further comprising a sensor sensing parameters.
  70. 70.根据权利要求69所述的系统,其中所述传感器为传感该系统的功能参数的功能参数传感器。 70. The system of claim 69, wherein the sensor is sensing function parameters of the system function parameter sensor.
  71. 71.根据权利要求69所述的系统,其中该系统的所述功能参数与用于充填内部能量源的能量的传输相互关联。 71. The system of claim 69, wherein the functional parameters of the transmission system and for filling the internal energy source of the energy interrelated.
  72. 72.根据权利要求42所述的系统,进一步包括反馈装置,用于将信息从所述病人的身体内部发送到其外部,以给出与功能参数相关的反馈信息。 72. The system of claim 42, further comprising a feedback device for sending information from inside the patient's body to the outside, to give the functional parameters related feedback.
  73. 73.根据权利要求69所述的系统,进一步包括内部控制单元,用于响应传感功能参数的传感器来控制所述装置的所述操作装置。 73. The system of claim 69, further comprising an internal control unit, in response to a sensor for sensing function parameter controlling the operation means of the device.
  74. 74.根据权利要求69所述的系统,其中所述传感器为传感所述病人的物理参数的物理参数传感器。 74. The system of claim 69, wherein the sensor is a physical parameter sensor sensing a physical parameter of the patient.
  75. 75.根据权利要求74所述的系统,其中所述物理参数为身体温度、血压、血流量、心跳和呼吸中的一个。 75. The system of claim 74, wherein said physical parameter is body temperature, blood pressure, blood flow, heart rate and breathing one.
  76. 76.根据权利要求74所述的系统,其中所述物理参数传感器为压力或蠕动传感器,或者传感测量、弯曲、拉伸或食物摄入的传感器。 76. The system of claim 74, wherein the physical parameter sensor is a pressure or motility sensor, or a sensor measuring, bending, stretching or food intake sensor.
  77. 77.根据权利要求74所述的系统,进一步包括内部控制单元,用于响应传感器传感所述物理参数来控制所述操作装置。 77. The system of claim 74, further comprising an internal control unit, in response to the sensor sensing the physical parameter to control the operation of the apparatus.
  78. 78.根据权利要求42所述的系统,包括接收来自所述传感器的信息的内部控制单元。 78. The system of claim 42, comprising receiving information from the sensor inside the control unit.
  79. 79.根据权利要求1所述的系统,其中所述操作装置包括马达或泵。 79. The system of claim 1, wherein said operating means comprises a motor or a pump.
  80. 80.根据权利要求79所述的系统,其中所述操作装置包括电开关。 80. The system of claim 79, wherein said operating means comprises an electrical switch.
  81. 81.根据权利要求42所述的系统,其中所述操作装置为电动的。 81. The system of claim 42, wherein said operating means is electric.
  82. 82.根据权利要求42所述的系统,其中所述操作装置包括液压操作装置。 82. The system of claim 42, wherein said operating means comprises a hydraulic operation device.
  83. 83.根据权利要求42所述的系统,其中所述操作装置包括气动操作装置。 83. The system of claim 42, wherein said operating means comprises a pneumatic operation device.
  84. 84.根据权利要求56所述的系统,其中所述发射的能量直接以其无线形式影响所述操作装置,以形成动能,从而在能量传输期间操作所述装置的所述拉伸装置。 84. The system of claim 56, wherein said energy is emitted directly in its wireless form affect the operation device to form a kinetic energy, whereby the energy transfer during operation of the apparatus the stretching device.
  85. 85.根据权利要求42所述的系统,进一步包括外部数据通信器和与该外部数据通信器通信的可植入内部数据通信器,其中所述内部数据通信器适于将与所述用于治疗肥胖症的装置或所述病人相关的数据反馈回所述外部数据通信器,或者所述外部数据通信器将数据馈送到所述内部数据通信器。 85. The system of claim 42, further comprising an external data communicator and the data communication with the external communication implantable internal data communicator, wherein the internal data communicator is adapted to be used with the treatment The obesity means or data related to patient feedback back to the external data communicator or the external data communicator feeds data to the internal data communicator.
  86. 86.根据权利要求56所述的系统,进一步包括用于将无线能量从第一形式转换为第二形式的能量转换装置。 86. The system of claim 56, further comprising means for converting the wireless energy from a first form to a second form of energy conversion devices.
  87. 87.根据权利要求86所述的系统,其中所述能量转换装置直接在能量传输期间用所述第二形式的能量操作所述装置。 87. The system of claim 86, wherein said energy conversion device directly during energy transfer with the operation of the energy of the second form of apparatus.
  88. 88.根据权利要求86所述的系统,其中所述第二形式的能量包括直流或脉冲直流或者直流和脉冲直流的组合。 88. The system of claim 86, wherein the second form energy comprises a combination of a DC or pulsed DC and pulsed DC or DC.
  89. 89.根据权利要求86所述的系统,其中所述第二形式的能量包括交流或者直流和交流的组合。 89. The system of claim 86, wherein the second form of energy comprises a combination of AC or DC and AC.
  90. 90.根据权利要求86所述的系统,包括蓄能器,其中所述第二形式的能量至少部分地用于充填该蓄能器。 90. The system of claim 86, comprising an accumulator, wherein the second form of energy is used to at least partially fill the accumulator.
  91. 91.根据权利要求86所述的系统,其中所述第一或第二形式的能量包括磁能、动能、声能、化学能、辐射能、电磁能、光电能、核能或热能。 91. The system of claim 86, wherein said first or second form comprises magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, photo energy, nuclear energy or thermal energy.
  92. 92.根据权利要求86所述的系统,其中所述第一形式的能量和所述第二形式的能量中的一个为非磁、非动能、非化学、非声学、非核或非热的。 92. The system of claim 86, wherein the first form of energy and the energy of the second form in a non-magnetic, non-kinetic, non-chemical, non-acoustic, non-nuclear or non-thermal.
  93. 93.根据权利要求42所述的系统,进一步包括包含至少一个电压值防护罩的可植入电部件。 93. The system of claim 42, further comprising at least one voltage value comprising implantable electrical shield member.
  94. 94.根据权利要求42所述的系统,进一步包括包含至少一个恒电流防护罩的可植入电部件。 94. The system of claim 42, further comprising including at least one constant current guard implantable electrical components.
  95. 95. 一种用于通过手术治疗肥胖病人的方法,该方法包括步骤:在所述病人的腹壁中切割开口,切除所述胃周围的一区域,放置根据权利要求1的用于治疗肥胖症的装置,接合所述病人的所述胃壁,以及缝合所述胃壁。 95. A method for surgically treating obese patients, the method comprising the steps of: cutting the opening in the abdominal wall of the patient, the removal of an area around the stomach, placing according to claim 1 for the treatment of obesity means for engaging the stomach wall of the patient, and suturing the stomach wall.
  96. 96.根据权利要求95所述的方法,进一步包括另外的步骤:术后调整所述拉伸装置,以拉伸所述胃壁的一部分,从而影响所述病人的胃口。 96. The method according to claim 95, further comprising the additional steps of: adjusting the stretching device postoperatively to stretch a portion of the stomach wall to affect the appetite of the patient.
  97. 97.根据权利要求96所述的方法,其中调整所述拉伸装置的步骤从所述病人的身体外部控制。 97. The method according to claim 96, wherein the step of adjusting the stretching device from outside the patient's body control.
  98. 98.根据权利要求95所述的方法,进一步包括另外的步骤:放置另外的根据权利要求1所述的用于治疗肥胖症的装置,接合所述病人的所述胃壁,借助于所述用于治疗肥胖症的装置拉伸所述胃壁的第一部分,以及借助于所述另外的用于治疗肥胖症的装置拉伸所述胃壁的第二部分。 98. The method according to claim 95, further comprising the additional steps of: placing an additional device for treating obesity according to claim 1, wherein, engaging the stomach wall of the patient, said means for means for treating obesity stretching the first portion of the stomach wall, and by means of said further means for treating obesity stretching a second portion of the stomach wall.
  99. 99. 一种用于经由腹腔镜腹进路将用于治疗肥胖症的装置通过手术放置在病人体中的方法,该方法包括步骤:将针或管状器械插入所述病人的身体的腹部,利用所述针或管状器械向所述病人的腹部填充气体,由此使所述病人的腹腔膨胀, 在所述病人的身体中放置至少两个腹腔镜套针, 将照相机通过所述腹腔镜套针之一插入所述病人的腹部,将至少一个切除工具插入经过所述至少两个腹腔镜套针之一,并切除所述病人的意欲放置区域,以及放置根据权利要求1所述的用于治疗肥胖症的装置,接合所述胃壁。 99. A via a laparoscopic abdominal approach for treating obesity means surgically placed in a patient will be used in the method, the method comprising the steps of: inserting a needle or tubular instrument body of the patient's abdomen, the use of The needle or tube like instrument to fill the patient's abdominal gas, whereby the expansion of the patient's abdominal cavity, placing at least two laparoscopic trocars in the patient's body, the camera through the laparoscopic trocar inserting said one of the patient's abdomen, inserting at least one dissecting tool through one of said at least two laparoscopic trocars and dissecting an intended placement area of the patient, as well as the placement for the treatment according to claim 1 obesity means engaging the stomach wall.
  100. 100. 一种使用根据权利要求42所述的用于治疗肥胖症的系统的方法,包括步骤:术后调整所述拉伸装置,以拉伸所述胃壁的一部分,从而影响所述病人的胃口。 100. A method of using the system for treating obesity according to the method of 42, comprising the steps of claim: after adjusting the stretching means for stretching a portion of the stomach wall to affect the appetite of the patient .
  101. 101.根据权利要求100所述的方法,其中调整所述拉伸装置的步骤被非侵入性地执行。 101. The method according to claim 100, wherein the step of adjusting the stretching device is performed non-invasively.
  102. 102.根据权利要求100所述的方法,其中所述拉伸装置包括机械拉伸装置。 102. The method according to claim 100, wherein the stretching device comprises a mechanical stretching device.
  103. 103.根据权利要求100所述的方法,其中所述拉伸装置包括液压拉伸装置。 103. The method according to claim 100, wherein the stretching device comprises a hydraulic stretching device.
  104. 104.根据权利要求103所述的方法,其中所述液压拉伸装置包括贮存器,用于将凝胶或气体或流体移动到或移动离开所述拉伸装置。 104. The method according to claim 103, wherein the hydraulic stretching device comprises a reservoir, for moving gel or gas or fluid to or moving away from the stretching device.
  105. 105.根据权利要求104所述的方法,其中所述贮存器被放置在使所述病人的手够到的皮下,以手动将流体移动到或移动离开所述拉伸装置。 105. The method of claim 104, wherein said reservoir is placed so that the patient's hand reach subcutaneous, manually moving the fluid to move to or away from the stretching device.
  106. 106.根据权利要求100所述的方法,其中所述拉伸装置通过内部能量源提供动力以拉伸或释放所述拉伸装置,其中利用控制装置控制来自内部控制单元或来自所述病人身体外部的动力。 106. The method according to claim 100, wherein said stretching means providing an internal energy source for stretching or releasing to the stretching device, wherein the control device controls the internal control unit from the patient or from the outside of the body power.
  107. 107.根据权利要求100所述的方法,其中用于无线传输能量的无线能量发射器为所述操作装置提供动力,以使得所述拉伸装置直接在能量传输期间致使所述拉伸装置拉伸所述胃壁。 107. The method according to claim 100, wherein the wireless energy transmitter for wireless transmission of energy to provide power to said operating means, so that the stretching device directly during energy transfer cause the stretching device stretch the stomach wall.
  108. 108.根据权利要求100所述的方法,其中用于无线传输能量的无线能量发射器为所述内部能量源充电。 108. The method according to claim 100, wherein the wireless energy transmitter for wireless transmission of energy for charging the internal energy source.
  109. 109.根据权利要求100所述的方法,进一步包括将反馈信息从所述身体内部发送到其外部,以给出与所述装置的功能参数相关的反馈。 109. The method according to claim 100, further comprising sending feedback information from inside the body to the outside thereof, to give a functional parameter of the device with associated feedback.
  110. 110.根据权利要求100所述的方法,进一步包括将反馈信息从所述身体内部发送到其外部,以给出与所述病人的物理参数相关的反馈。 110. The method according to claim 100, further comprising sending feedback information from inside the body to the outside thereof, and to give the patient a physical parameter related to the feedback.
  111. 111.根据权利要求109所述的系统,其中所述装置的所述功能参数与用于对所述内部能量源充电的能量的传输相互关联。 111. The system of claim 109, wherein the functional parameter of said transmission means and for charging the internal energy source of energy interrelated.
  112. 112.根据权利要求100所述的系统,其中所述装置能从所述病人的身体外部编程。 112. The system of claim 100, wherein said means of the patient's body from external programming.
  113. 113.根据权利要求100所述的方法,进一步包括步骤: 发送所述病人的物理参数或所述装置的功能参数,以及将传感信息发送到适于调整所述拉伸装置的控制单元。 113. The method according to claim 100, further comprising the step of: sending the patient's physical function parameter or parameters of the device, and sending sensing information to a stretching device adapted to adjust the control unit.
  114. 114.根据权利要求100所述的方法,进一步包括步骤: 发送所述病人的物理参数或所述装置的功能参数,以及将传感信息发送到适于调整所述内部能量源的充电的控制单元。 114. The method according to claim 100, further comprising the step of: sending the patient's physical function parameter or parameters of the device, and sending sensing information to the internal energy source adapted to adjust the charging control unit .
  115. 115. 一种使用根据权利要求19所述的装置的方法,其中所述拉伸装置包括主体,其包括与适于拉伸所述胃壁的一个或多个较小的贮存器/室接触的大室。 115. A method of using the apparatus according to claim 19, wherein, wherein the stretching device comprises a body, which is adapted to stretch the stomach wall comprises one or more smaller reservoirs / chambers large contact room.
  116. 116.根据权利要求115所述的方法,其中所述室适于与在所述室之间移动的流体或空气连通。 116. The method according to claim 115, wherein the chamber between the chamber and is adapted to move the fluid or air communication.
  117. 117.根据权利要求103所述的方法,进一步包括皮下放置回动伺服机构,其具有小控制贮存器并用每单位面积较大的力从该控制贮存器移动小容积,从而用每单位面积较小的力弓I起所述拉伸装置的较大运动。 117. The method according to claim 103, further comprising subcutaneously placing a reversed servo having a small control reservoir with a large force per unit area to move from a small volume of the control reservoir, so that per unit area is small I bow from the force of the tension means a larger movement.
  118. 118. 一种使用根据权利要求19所述的装置的方法,其中所述大室适于利用其主容积而成为所述拉伸装置最重要的容积,且其中所述小室用作拉伸胃壁的拉伸装置以治疗肥胖症的拉伸装置,其中所述主室利用流体或凝胶连通至所述小室,从而在所述胃基底壁中引起拉伸效果,由此治疗肥胖症。 118. A method of using the apparatus according to claim 19, wherein, wherein the large chamber with its main volume adapted to become the most important means of the volume of the stretching, and wherein the stretching of the stomach wall as the chamber stretching means for stretching device for treating obesity, wherein said main chamber communication using a fluid or gel to the small chambers causing the stretching effect in the stomach fundus wall thereby treating obesity.
  119. 119.根据权利要求100所述的方法,包括回动伺服机构,其中在闭合式液压系统中移动少量流体,在第二较大闭合式液压系统中实现较大的流体运动,其中所述少量流体与大容积相比被每单位面积更大的力移动。 119. The method according to claim 100, including the reversed servo mechanism, which move a small amount of fluid in a closed hydraulic system to achieve greater fluid movement in a second larger closed hydraulic system, in which the small amount of fluid Compared to the large volume to be moved a greater force per unit area.
  120. 120.根据权利要求100所述的方法,其中在所述病人的所述基底胃壁中的套叠的拉伸装置适于可调节,其中被放置为套叠在所述胃基底壁中的所述拉伸装置适于被调节并拉伸所述胃基底壁由此引起饱胀感。 120. The method according to claim 100, wherein the stretching device set in the base of the patient's stomach wall is adapted to be adjusted in the stack, which is positioned in the invaginated in the stomach fundus wall stretching device is adapted to be adjusted and stretching the stomach fundus wall thereby causing a feeling of fullness.
  121. 121.根据权利要求100所述的方法,进一步包括通过手动按压皮下开关来执行所述非侵入性调整。 121. The method of claim 100, further comprising performing the noninvasive adjusted manually pressing the subcutaneous switch.
  122. 122.根据权利要求100所述的方法,进一步包括通过无线远程控制器来执行所述非侵入性调整。 122. The method according to claim 100, further comprising performing the wireless remote controller by non-invasive adjustments.
  123. 123.根据权利要求100所述的方法,进一步包括通过无线能量发射器来执行所述非侵入性调整。 123. The method according to claim 100, further comprising a wireless energy transmitter by performing the non-invasive adjustments.
  124. 124.根据权利要求100所述的方法,进一步包括通过能量源来为所述用于治疗肥胖症的装置提供动力。 124. The method according to claim 100, further comprising an energy source to provide power through the means for treating obesity.
  125. 125.根据权利要求124所述的系统,其中所述能量源包括内部能量源。 125. The system of claim 124, wherein the energy source comprises an internal energy source.
  126. 126.根据权利要求124所述的系统,其中所述能量源包括发射无线能量的外部能量源。 126. The system of claim 124, wherein the energy source comprises an external energy source transmitting wireless energy.
  127. 127.根据权利要求124所述的系统,进一步包括从外部能量源发射无线能量,以对可再充内部能量源充电。 127. The system of claim 124, further comprising transmitting wireless energy from the external source of energy, in order to be charged rechargeable internal energy source.
  128. 128. —种使用根据权利要求27所述的装置的方法,包括通过将所述大室采用主容积套叠在所述基底胃壁中由此限制所述胃切口朝向所述病人的隔膜肌的运动来治疗返流疾病,以及利用所述小室拉伸所述胃基底壁,利用流体或空气将所述大室与所述小室连通以在所述胃基底壁中引起拉伸效果由此治疗肥胖症。 Species motion apparatus using a method according to claim 27, comprising by the large volume of the main chamber using nested in the base of the stomach wall thereby restricting the patient's stomach notch towards the diaphragm muscle - 128. to treat reflux disease, as well as the use of the small chambers stretching the stomach fundus wall using the fluid or air to the large chamber in communication with said chamber to cause stretching effect in the stomach fundus wall thereby treating obesity . 表面结构套件 Surface structure kit
  129. 129. —种根据权利要求1所述的拉伸装置,适于术后被调节并包括至少一个可膨胀部分;其中所述拉伸装置适于能在第一塌缩状态与第二膨胀状态之间调节,在所述第一塌缩状态,所述可膨胀部分塌缩,在所述第二膨胀状态,所述可膨胀部分膨胀;以及其中所述可膨胀部分的外表面至少部分地包括表面结构,其具有与降低区域交替的升高区域;其中在所述第一塌缩和第二膨胀状态中的至少一种中,所述可膨胀部分适于具有: 相邻升高区域之间的第一距离,其充分延伸以在一定程度上防止纤维组织的生长直接互连相邻的升高区域从而削弱所述拉伸装置的第一塌缩与第二膨胀状态之间的可调节性, 并进一步包括在相邻的升高和降低区域之间的连接区域,在所述第一塌缩与第二膨胀状态中的至少一个中,进一步适于具有:相邻的连接区域之间的第二距离,其充分延伸以在一定程度上防止纤维组织的生长直接互连相邻的连接区域从而削弱所述拉伸装置的第一塌缩与第二膨胀状态之间的可调节性。 129. - Species stretching apparatus according to claim 1, wherein, after being adjusted and adapted to include at least one inflatable portion; wherein said stretching means can be adapted in a first collapsed state and the expanded state of the second between the adjustment in the first collapsed state, the expandable portion collapsed in the second expanded state, the expandable inflatable portion; and wherein the outer surface of the expandable portion at least partially comprises a surface structure having alternating raised and lowered areas area; wherein in said first collapsed and at least one second expanded state, the expandable portion is adapted to have: raised between adjacent regions a first distance, which extends sufficiently to a certain extent, prevent the growth of fibrous tissue directly interconnecting adjacent elevated areas thus weakening the adjustability of the first collapse contraction and stretching means between the second expanded state, and further comprising the raising and lowering of adjacent connection region between the region, in the first collapsed and a second expanded state of at least one, and further adapted to have: a first connection region between the adjacent second distance, which extends sufficiently to a certain extent, prevent the growth of fibrous tissue directly interconnecting adjacent connecting a first collapsed region thus weakening the stretching means between the expanded state and the second compression adjustability.
  130. 130.根据权利要求129所述的拉伸装置,其中至少所述可膨胀部分为中空的或包括中空主体。 130. A stretching device according to claim 129, wherein at least said expandable portion is hollow or comprises a hollow body.
  131. 131.根据权利要求129或130所述的拉伸装置,其中所述拉伸装置基本上完全中空,或包括沿所述拉伸装置的大致整个长度和/或整个容积延伸的中空主体。 129 or 131. The stretching device according to claim 130, wherein said stretching device is substantially completely hollow or comprises a stretching device along substantially the entire length and / or the entire volume of the hollow body extends.
  132. 132.根据权利要求1、2和5中任一项所述的装置,适于从所述腹部穿过所述胃壁中的孔。 132. The apparatus of 1, 2 and 5 according to any one of claims, adapted from the abdomen through the stomach wall of the hole.
  133. 133.根据权利要求132所述的装置,进一步包括从所述病人的身体外部控制所述拉伸装置的外部控制装置。 133. The apparatus according to claim 132, further comprising external control means from outside the patient's body for controlling said stretching means.
  134. 134.根据权利要求132所述的装置,其中所述可植入控制单元适于从所述病人的身体内部控制所述拉伸装置。 134. The apparatus according to claim 132, wherein the implantable control unit from inside the body of the patient is adapted to control the stretching device.
  135. 135.根据权利要求1、2和5中任一项所述的装置,进一步包括连接到所述拉伸装置、适于连接到注入端口的管。 And 135. The apparatus according to any one of claim 1, 2, 5, further comprising means connected to said drawing, the injection port adapted to be connected to the tube.
  136. 136.根据权利要求135所述的装置,其中所述装置适于接收通过所述管的流体。 136. The apparatus according to claim 135, wherein said means is adapted to receive a fluid through the tube.
  137. 137.根据权利要求136所述的装置,进一步包括适于连接到所述管的注入端口。 137. The apparatus according to claim 136, further comprising a tube adapted to be connected to the injection port.
  138. 138.根据权利要求1、2和5中任一项所述的装置,其中所述装置适于能术后且非侵入性地编程。 138. The apparatus of 1, 2 and 5 according to any one of claims, wherein the apparatus is adapted to be able to non-invasively and after programming.
  139. 139.根据权利要求1、2和5中任一项所述的装置,其中所述可植入控制器适于液压连接到所述拉伸装置。 139. The apparatus of 1, 2 and 5 according to any one of claims, wherein the implantable controller is adapted to be connected to the hydraulic stretching device.
  140. 140.根据权利要求1、2和5中任一项所述的装置,其中所述可植入控制器适于用电线连接到所述装置。 140. The apparatus of 1, 2 and 5 according to any one of claims, wherein the implantable controller is adapted to be connected to the wire means.
  141. 141.根据权利要求1所述的装置,包括第二或更多个装置,适于,利用胃至胃的缝合线或订合线放置在所述胃壁的外部而被套叠,适于术后拉伸套叠的胃壁部分。 141. The apparatus according to claim 1, comprising a second or more device, adapted, with stomach to stomach sutures or staplers placed on the outside of the invaginated stomach wall and adapted to pull after extending telescopic stomach wall portion.
  142. 142.根据权利要求141所述的装置,其中所述第一拉伸装置和所述第二或更多个拉伸装置适于拉伸所述胃壁的分立部分。 142. The apparatus according to claim 141, wherein said first stretching means and said second or more stretching device adapted to stretch a separate portion of the stomach wall.
  143. 143.根据权利要求1、2和5中任一项所述的装置,包括所述拉伸装置的第一部分,适于被放置在所述胃壁的外部、利用胃至胃的缝合线或订合线套叠;以及所述拉伸装置的第二部分,适于被放置在所述胃壁的外部、利用胃至胃的缝合线或订合线套叠在所述胃壁上的不同位置;并且所述装置进一步适于术后拉伸所述第一和第二部分之间的所述胃壁部分。 And 143. The apparatus according to any one of claim 1, 2, 5, comprising a first portion of said stretching means, adapted to be placed on the outside of the stomach wall, with stomach to stomach sutures or staplers line overlay; and the stretching of the second portion of the device adapted to be placed on the outside of the stomach wall with stomach to stomach sutures or staplers nesting in a different location on the stomach; and the said apparatus further adapted to postoperatively stretching the stomach wall portion of said first and second portions.
  144. 144.根据权利要求1、2和5中任一项所述的装置,进一步包括第二或更多个拉伸装置, 包括所述第二或更多个拉伸装置的第一部分,适于被放置在所述胃壁的外部上、利用胃至胃的缝合线或订合线套叠;以及所述第二或更多个拉伸装置的第二部分,适于被放置在所述胃壁的外部上、利用胃至胃的缝合线或订合线套叠在所述胃壁的不同位置;并且所述装置进一步适于术后拉伸所述第二或更多个装置的所述第一和第二部分之间的所述胃壁部分。 And 144. The apparatus according to any one of claim 1, 2, 5, further comprising a second or more stretching device, comprising a first portion of the second or more stretching device adapted to be placed on the outside of the stomach wall, stomach to stomach sutures or staplers overlay; and a second portion of the second or more stretching device adapted to be placed on the outside of the stomach wall on, with stomach to stomach sutures or staplers nested at different locations of the stomach wall; and the apparatus further adapted after stretching of the second or more device first and part of the stomach wall between the two parts.
  145. 145.根据权利要求111所述的装置,包括所述拉伸装置的第三或更多个部分,适于利用胃至胃的缝合线或订合线,被放置在所述胃壁的外部上,与所述第一或第二部分分离,并进一步适于术后拉伸所述第一和第二部分的组合与所述第三或更多个部分之间的胃壁部分。 145. The apparatus according to claim 111, said stretching means comprising a third or more portions adapted with stomach to stomach sutures or staplers, are placed on the outside of the stomach wall, separated from the first or second portion, and further adapted to postoperatively stretching the stomach wall portion combinations of the first and second portion of said third or more portion.
  146. 146.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置进一步包括:适于通过所述病人的胃壁部分至少基本套叠的至少一个容积填充装置;其中所述容积填充装置适于被放置在所述胃壁的外部上,使得食物腔的容积的尺寸通过显著超过所述容积填充装置的容积的容积而减小;其中所述容积填充装置的表面包含生物兼容性材料;其中所述容积填充装置的所述表面的绝大部分适于静靠所述胃壁的外部;以及其中所述容积填充装置在所述胃壁的外部具有至少30毫米的最大周界、至少0. OOOOlm3的容积,以减小所述胃的内部容积,由此进一步影响所述病人的胃口。 146. The apparatus of 1, 2 and 5 according to any one of claims, wherein said stretching means further comprises: adapted by the patient's stomach wall portion at least substantially nested at least one volume filling device; wherein It said volume filling device adapted to be placed on the outside of the stomach wall, so that the volume of food by the size of the cavity volume significantly exceeds the volume of the volume filling device decreases; wherein the surface of the volume filling device comprises a biocompatible material; wherein the majority of the surface of the volume filling device is adapted to the outside of the stomach wall against static; and wherein the volume filling device on the outside of the stomach wall having at least a maximum circumference of 30 mm, at least 0 . OOOOlm3 volume, in order to reduce the internal volume of the stomach, thereby further affect the patient's appetite.
  147. 147.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置进一步包括:至少一个可植入容积填充装置,形成容积并适于被肥胖病人的胃外部上的胃壁部分完全套叠,该装置适于被放置在所述病人的胃壁内部,使得胃腔本质上减小;其中所述食物摄入减小装置适于被所述胃壁部分套叠在与用于保留食物的所述剩余的胃分离的完全密封的容积中,由此当所述食物摄入减小装置被植入时,所述病人的胃口减小;其中所述装置的表面包含生物兼容性材料,所述表面的绝大部分适于静靠所述胃壁的内部;其中所述容积填充装置在所述胃壁的外部具有至少30毫米的最大周界、至少0. OOOOlm3的容积,以减小所述胃的内部容积,由此进一步影响所述病人的胃口。 147. The apparatus of 1, 2 and 5 according to any one of claims, wherein said stretching means further comprises: at least one implantable volume filling device, forming a volume and adapted to be obese patient on the exterior of the stomach completely invaginated stomach wall portion, the apparatus is adapted to be placed inside the patient's stomach wall, such that essentially reduced the gastric cavity; wherein said food intake reducing device is adapted to be invaginated in the stomach wall portion and for The retention volume of food remaining in the stomach is completely sealed separation, whereby when the food intake reducing device is implanted, the patient's appetite is reduced; wherein said surface means comprises a biocompatible material, most of the surface is adapted to the inside of the stomach wall against static; wherein the volume filling device on the outside of the stomach wall having at least a maximum circumference of 30 mm, a volume of at least 0. OOOOlm3 to reduce the said internal volume of the stomach, thereby further affecting the appetite of the patient.
  148. 148.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置进一步包括可植入运动限制装置,适于被所述病人的胃基底壁至少部分地套叠并具有包含生物兼容性材料的外表面,其中所述运动限制装置的外表面的绝大部分适于在所述病人的隔膜与所述套叠的胃基底壁的下部的至少一部分之间的位置,静靠所述胃壁,而不会伤害所述胃壁,使得当所述运动限制装置被套叠时,所述病人的胃的贲门切口朝向所述病人的隔膜的运动受到限制,由此防止贲门通过所述病人的隔膜开口滑到病人的胸腔中,以保持由所述病人的腹部施加在病人的贲门括约肌上的支撑压力,所述运动限制装置的尺寸为至少125mm3,周界为至少15mm。 148. The apparatus of 1, 2 and 5 according to any one of claims, wherein said stretching means further comprising an implantable movement restriction device adapted to be the patient's stomach fundus wall and at least partly invaginated having an outer surface comprising a biocompatible material, wherein the movement restriction device is adapted to the position of the majority of the outer surface of at least a portion of the patient between the diaphragm and the invaginated stomach fundus wall of the lower portion, Static against the stomach wall without damaging the stomach wall, so that when the movement restriction means invaginated when the patient's stomach cardia incision toward the patient's diaphragm movement is restricted, thereby preventing the cardia by said slide opening the patient's diaphragm in the patient's chest, to maintain the abdomen of the patient is applied to the patient's cardiac sphincter pressure support, the size of the movement restriction means is at least 125mm3, the perimeter of at least 15mm.
  149. 149.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置进一步包括:具有包含生物兼容性材料的外表面的可植入运动限制装置,其中所述运动限制装置适于利用其外表面的至少一部分静靠所述病人的胃基底壁,在所述病人的隔膜与所述基底壁之间的位置,使得当所述运动限制装置被植入在病人体中时,所述病人的胃的贲门切口朝向所述病人的隔膜的运动受到限制,由此防止贲门通过所述病人的隔膜开口滑到病人的胸腔中,以保持由所述病人的腹部施加在病人的贲门括约肌上的支撑压力,其中所述运动限制装置的尺寸为至少125mm3,周界为至少15mm;以及固定装置,其适于在所述运动限制装置被植入时将所述运动限制装置紧固到所述位置。 149. The apparatus of 1, 2 and 5 according to any one of claims, wherein said stretching means further comprises: an outer surface having a motion implantable biocompatible material comprising limiting means, wherein said movement restriction means adapted to use at least part of its outer surface against the patient's static stomach fundus wall, in a position between the patient and the base wall of the membrane, such that when the movement restriction device is implanted in the patient When the patient's stomach towards the patient's cardiac notch diaphragm movement is restricted, thereby preventing the patient's cardiac membrane by opening the patient's chest in the slide, to keep the patient from the patient's abdomen is applied cardia sphincter pressure on the support, wherein said movement limiting means is at least the size of 125mm3, the perimeter of at least 15mm; and a fixing means which is adapted to the movement restriction device is implanted when the movement restriction means tight Solid to the position.
  150. 150.根据权利要求148所述的装置,其中所述拉伸装置进一步包括可植入运动限制装置,适于被所述病人的胃基底壁至少部分地套叠并具有包含生物兼容性材料的外表面,其中所述运动限制装置的外表面的绝大部分适于在所述病人的隔膜与所述套叠的胃基底壁的下部的至少一部分之间的位置,静靠所述胃壁,而不会伤害所述胃壁,使得当所述运动限制装置被套叠时,所述病人的胃的贲门切口朝向所述病人的隔膜的运动受到限制,由此防止贲门通过所述病人的隔膜开口滑到病人的胸腔中,以保持由所述病人的腹部施加在病人的贲门括约肌上的支撑压力,所述运动限制装置的尺寸为至少125mm3,周界为至少15mm。 150. The apparatus according to claim 148, wherein said stretching means further comprising an implantable movement restriction device adapted to be the patient's stomach fundus wall is at least partially nested and having an outer biocompatible material comprising at least a portion between the position of the majority of the surface, wherein the movement restriction device is adapted to the outer surface of the lower portion of the patient's diaphragm and the invaginated stomach fundus wall of the static against the stomach wall without It will hurt the stomach wall, so that when the movement restriction means invaginated when the patient's stomach cardia incision toward the patient's diaphragm movement is restricted, thereby preventing cardiac patient through the patient's diaphragm opening slide chest in order to maintain the abdomen of the patient is applied to the patient's cardiac sphincter pressure support, the size of the movement restriction means is at least 125mm3, the perimeter of at least 15mm.
  151. 151.根据权利要求149所述的装置,其中所述拉伸装置进一步包括:具有包含生物兼容性材料的外表面的可植入运动限制装置,其中所述运动限制装置适于利用其外表面的至少一部分静靠所述病人的胃基底壁,在所述病人的隔膜与所述基底壁之间的位置,使得当所述运动限制装置被植入在病人体中时,所述病人的胃的贲门切口朝向所述病人的隔膜的运动受到限制,由此防止贲门通过所述病人的隔膜开口滑到病人的胸腔,以保持由所述病人的腹部施加在病人的贲门括约肌上的支撑压力,其中所述运动限制装置的尺寸为至少125mm3,周界为至少15mm;以及固定装置,其适于在所述运动限制装置被植入时将所述运动限制装置紧固到所述位置。 151. The apparatus according to claim 149, wherein said stretching means further comprises: an outer surface having a biocompatible material comprising an implantable movement restriction device, wherein the movement restriction device is adapted to use the outer surface at least a portion of the patient's stomach against the stationary base wall, between the position of the patient's diaphragm and the base wall such that when the movement restriction device is implanted in the patient, the patient's stomach cardiac notch of the patient toward the diaphragm movement is restricted, thereby preventing the patient's cardiac membrane by opening the patient's chest slide, in order to maintain the abdomen of the patient is applied to the patient's cardiac sphincter of the support pressure, wherein The size of the movement restriction means is at least 125mm3, the perimeter of at least 15mm; and a fixing means which is adapted when the movement restriction device is implanted to the motion limiting means secured to said position.
  152. 152.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置包括可膨胀结构, 当所述装置被套叠在所述胃壁时,适于膨胀和拉伸所述胃壁部分,其中所述结构包括专用手风琴状件,其适于考虑到围绕被植入的所述装置的纤维变性,使得所述手风琴状件的运动基本上不受所述纤维变性的影响。 152. The apparatus of 1, 2 and 5 according to any one of claims, wherein said stretching means comprises an expandable structure, when the apparatus when the invaginated stomach wall, adapted to expand and stretch the stomach wall portion, wherein said structure comprises a dedicated accordion-like member, which is adapted to take into account the device is implanted around fibrosis, such that movement of the accordion-like member is substantially free from the influence fibrosis.
  153. 153.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置包括三个或更多个机械部分,每个部分分别与所述胃壁的不同部分中的一个接合,其中所述接合包括缝合或订合到所述胃壁或者利用胃至胃的缝合线将所述机械部分套叠在所述胃壁部分中,其中所述三个或更多个机械部分适于相对于彼此移动以适于拉伸三个不同的壁部分,所述拉伸装置进一步适于使所述壁部分彼此独立拉伸,二者均针对;用于拉伸所述胃壁部分的力以及,施加所述拉伸的时间周期,以及何时施加所述拉伸。 153. The apparatus of 1, 2 and 5 according to any one of claims, wherein the stretching device comprising three or more mechanical parts engaged with different parts of each portion of the stomach wall, respectively, of a wherein the engagement includes suturing or stapling the stomach or the stomach to stomach sutures nested within the mechanical part of the stomach wall section, wherein the three or more mechanical portion adapted relatively in order to move each adapted to stretch three different wall portions, the stretching device is further adapted to enable said wall portions stretched independently from each other, both for; force for stretching the stomach wall portion as well, time periods the stretching is applied, and when the stretching is applied.
  154. 154.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置包括三个或更多个液压部分,每个部分分别与所述胃壁的不同部分中的一个接合,其中所述接合包括缝合或订合到所述胃壁或者利用胃至胃的缝合线将所述液压部分套叠在所述胃壁部分中,其中所述三个或更多个液压部分适于相对于彼此移动以适于拉伸三个不同的壁部分,所述拉伸装置进一步适于使所述壁部分彼此独立拉伸,二者均针对;用于拉伸所述胃壁部分的力,以及施加所述拉伸的时间周期,以及何时施加所述拉伸。 154. The apparatus of 1, 2 and 5 according to any one of claims, wherein the stretching device comprising three or more hydraulic parts engaged with different parts of each portion of the stomach wall, respectively, of a wherein said bond or close to the stomach wall with stomach to stomach sutures will be nested within the hydraulic part of the stomach wall section, wherein three or more hydraulic section comprises suturing or stapling adapted relatively in order to move each adapted to stretch three different wall portions, the stretching device is further adapted to enable said wall portions stretched independently from each other, both for; force for stretching the stomach wall portion, and time periods the stretching is applied, and when the stretching is applied.
  155. 155.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置包括三个或更多个液压部分,每个部分分别与所述胃壁的不同部分中的一个接合,其中所述接合包括缝合或订合到所述胃壁或者利用胃至胃的缝合线将所述液压部分套叠在所述胃壁部分中,其中所述三个或更多个液压部分适于独立于彼此拉伸三个不同的壁部分,所述拉伸装置进一步适于使所述壁部分彼此独立拉伸,二者均针对;用于拉伸所述胃壁部分的力,以及施加所述拉伸的时间周期,以及何时施加所述拉伸。 155. The apparatus of 1, 2 and 5 according to any one of claims, wherein the stretching device comprising three or more hydraulic parts engaged with different parts of each portion of the stomach wall, respectively, of a wherein the engagement includes suturing or stapling the stomach or the stomach to stomach sutures nested within the hydraulic part of the stomach wall section, wherein the three or more independent hydraulic portion adapted stretching to each other in three different wall portions, the stretching device is further adapted to enable said wall portions stretched independently from each other, both for; force for stretching the stomach wall portion, and applying said pull- extending time period, and when the stretching is applied.
  156. 156.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置与所述胃壁的一部分接合,包括将所述拉伸装置缝合或订合到所述胃壁或者利用胃至胃的缝合线将所述拉伸装置套叠在所述胃壁部分中,其中所述拉伸装置进一步适于拉伸胃壁部分,以控制;用于拉伸所述胃壁部分的力,以及施加所述拉伸的时间周期,以及何时施加所述拉伸。 156. The apparatus of 1, 2 and 5 according to any one of claims, wherein a portion of said stretching of the stomach wall with engaging means, said stretching device comprises suturing or stapling to the stomach wall or with force for stretching the stomach wall portion, and; stomach to stomach sutures the stretching device invaginated in the stomach wall portion, wherein said stretching means stretching the stomach wall portion is further adapted to control time periods the stretching is applied, and when the stretching is applied.
  157. 157.根据权利要求1、2和5中任一项所述的装置,其中所述拉伸装置包括两个部分,每个部分分别与所述胃壁的不同部分中的一个接合,其中所述接合包括将所述部分缝合或订合到所述胃壁或者利用胃至胃的缝合线将所述部分套叠在所述胃壁部分中,其中所述拉伸装置进一步适于使不同的壁部分彼此独立拉伸,以控制;用于拉伸所述胃壁部分的力,以及施加所述拉伸的时间周期,以及何时施加所述拉伸。 157. The apparatus of 1, 2 and 5 according to any one of claims, wherein said stretching device comprises two parts, each with a different portion of the engagement in the stomach wall, respectively, wherein said engagement including the portion suturing or stapling to the stomach wall or stomach to stomach sutures nested within the portion of the stomach wall section, wherein the stretching device is further adapted to different wall portions independently of each other stretching, in order to control; force for stretching the stomach wall portion, and applying the stretching time period, and when the stretching is applied.
  158. 158.根据权利要求1、2和5中任一项所述的装置,进一步包括从所述病人的身体外部控制所述拉伸装置的外部控制单元。 And 158. The apparatus according to any one of claim 1, 2, 5, further comprising the patient's body from the external control means of the external control unit stretching.
  159. 159.根据权利要求158所述的装置,其中所述外部控制单元包括适于从所述病人的身体外部控制所述拉伸装置的无线远程控制器。 159. The apparatus according to claim 158, wherein the external control unit is adapted to include a patient's body from the external control means of the wireless remote controller stretching.
  160. 160.根据权利要求158所述的装置,其中所述外部控制单元包括适于从所述病人的身体外部控制所述拉伸装置的皮下放置的开关或贮存器。 160. The apparatus according to claim 158, wherein the external control unit is adapted to comprise from outside the patient's body for controlling said stretching means subcutaneously placed switch or reservoir.
  161. 161.根据权利要求1、2和5中任一项所述的装置,包括适于被植入在所述病人身体中的传感器或传感装置,其中所述可植入控制单元适于利用来自适于直接或间接地传感所述病人的食物摄入的所述传感器或传感装置的信息从所述病人的身体内部控制所述拉伸装置。 And 161. The apparatus according to any one of claim 1, 2, 5, including adapted to be implanted in the patient's body in a sensor or sensing device, wherein the implantable control unit is adapted to use from adapted for directly or indirectly sensing the information of the patient's food intake sensor or from the sensing device inside the body of the patient to control the stretching device.
  162. 162.根据权利要求1所述的装置,其中所述拉伸装置设置有涂层或多层结构。 162. The apparatus according to claim 1, wherein the stretching device is provided with a coating or a multilayer structure.
  163. 163.根据权利要求162所述的装置,其中所述涂层为聚对二甲苯涂层。 163. The apparatus according to claim 162, wherein the coating is a parylene coating.
  164. 164.根据权利要求162所述的装置,其中所述涂层为聚四氟乙烯涂层。 164. The apparatus according to claim 162, wherein the coating is a polytetrafluoroethylene coating.
  165. 165.根据权利要求162所述的装置,其中所述涂层为聚氨酯涂层。 165. The apparatus according to claim 162, wherein the coating is a polyurethane coating.
  166. 166.根据权利要求162所述的装置,其中所述涂层为多层涂层。 166. The apparatus according to claim 162, wherein the coating is a multilayer coating.
  167. 167.根据权利要求162所述的装置,其中一层由聚氨酯制成。 167. The apparatus according to claim 162, wherein the layer is made of polyurethane.
  168. 168.根据权利要求162所述的装置,其中一层由硅制成。 168. The apparatus according to claim 162, wherein the layer made of silicon.
  169. 169.根据权利要求162所述的装置,其中一层由PTFE制成。 169. The apparatus according to claim 162, wherein the layer is made of PTFE.
  170. 170.根据权利要求162所述的装置,其中所述涂层为金属涂层。 170. The apparatus according to claim 162, wherein the coating is a metal coating.
  171. 171.根据权利要求162所述的装置,其中一层由金属制成。 171. The apparatus according to claim 162, wherein the layer is made of metal.
Description  translated from Chinese

用于治疗肥胖症的装置、系统和方法 It means the treatment of obesity, systems and methods for

技术领域 Technical Field

[0001] 本发明涉及一种用于治疗肥胖症的装置、系统和方法。 [0001] The present invention relates to an apparatus, system and method for the treatment of obesity. 背景技术 Background

[0002] 过去,肥胖病人通过胃减小手术来治疗,以限制病人的食物摄入。 [0002] In the past, obese patients by reducing the surgery to treat stomach to restrict the food intake of the patient. 目前,用于治疗肥胖症的两种胃间隔术过程,即:可调节胃束带手术(AGB)和胃垂直束带造形术(VBG),最经常执行。 Currently, two stomach surgery procedure intervals for the treatment of obesity, namely: adjustable gastric banding (AGB) and vertical banded gastroplasty arthroplasty (VBG), most often performed.

[0003] 在AGB中,束带被完全放置在肥胖病人的手术未损的胃周围接近其上端、在胃和食管的接合处的正下面,以限制病人的食物摄入。 [0003] In AGB, the band is placed completely in obese patients surgery intact stomach near its upper end around, being below the junction of the stomach and esophagus to limit the patient's food intake. 由于带束缚胃,因此一小胃囊被形成在带和胃中永久减小的气孔上面。 Since the band tied stomach, so a small stomach pouch is formed in the band and the stomach permanently reduce pores above. 少量食物填充小囊的想法导致病人感觉饱了,即,饱胀感。 A small amount of food to fill a small bag of ideas led to the patient feels full, that is, a sense of fullness. AGB 的示例公开在美国专利4,592,339和欧洲专利0611561中。 AGB example disclosed in U.S. Patent 4,592,339 and European Patent No. 0611561 in.

[0004] 在VBG中,典型地,胃被竖直地分为四行线性订合线,其将胃分隔为与食管相邻的细长的近侧较小隔间以及远侧较大隔间,使得较小隔间的容积为胃的容积的约10%。 [0004] In VBG, typically the stomach is vertically divided into four rows of linear staplers, which separates the stomach and esophagus to the proximal small adjacent elongate compartments and a distal larger compartment such that the volume of the smaller compartment is about 10% of the volume of the stomach. 一圆形孔被穿出在胃中在线性订合线行的下端,且若干圆形的订合线行被放置在胃上围绕所述圆形孔。 A circular hole is at the lower end of the stomach piercing linear staplers rows, and a number of circular staplers row is placed on the stomach around the circular aperture. 带被放置为通过圆形孔且被紧固在胃周围,由此带限定从胃的较小隔间到较大隔间的狭窄出口。 Band is placed through the circular hole and is fastened around the stomach, thereby defining a narrow band exit from the stomach into the small compartment large compartment. 一旦被紧固,则带防止胃在出口处拉伸,这引起出口经久保持其初始的小直径。 Once fastened, the belt tension at the exit to prevent the stomach, which causes prolonged keeping its initial export of small diameter. 病人摄入的食物被保存在较小隔间中,从而导致饱腹感。 Patient intake of food is stored in a small compartment, leading to satiety. 然后,食物缓慢通过出口流入较大隔间,消化在该较大隔间正常进行。 Then, through the export of food slowly flows into the larger compartment, normal digestion in the larger compartment. VBG的示例公开在美国专利5,345,949和5,549,621 中。 VBG examples are disclosed in U.S. Patents 5,345,949 and 5,549,621 in.

[0005] 存在很多与AGB和VBG相关联的并发症。 [0005] There are many AGB and VBG associated with complications. 然而,重要的是,病人在吞食食物之前非常仔细地完全咀嚼食物,从而聚集在胃的较小隔间中的食物碎渣能够穿过较小隔间的狭窄出口。 However, it is important that the patient very carefully before swallowing food completely chew food, which gathered in the narrow outlet of the stomach smaller compartment food debris to pass through the small compartment. 如果食物碎渣堵在出口,则其可能使病人呕吐和感觉不舒服。 If the food debris stuck in exports, it may make the patient vomit and feel uncomfortable. 在这种情况下,病人应该看医生或护士。 In this case, the patient should see a doctor or nurse. 与AGB和VBG相关联的另一并发症是:病人可能在晚上受胃酸返流的困扰。 Another complication associated with AGB and VBG are: patients may plagued by acid reflux at night.

[0006] 还使用胃壁的电刺激来使病人感觉饱胀。 [0006] also use electrical stimulation of the stomach to make the patient feel fullness. 发明内容 DISCLOSURE

[0007] 本发明的目的在于解决与存在的用于治疗肥胖症的胃减小手术(即AGB和VBG) 相关联的并发症。 Objective [0007] The present invention is to solve the presence of gastric surgery for the treatment of obesity is reduced (ie, AGB and VBG) associated complications.

[0008] 本发明的另一目的在于提供一种新的用于治疗肥胖症的装置。 [0008] It is another object of the present invention to provide a novel apparatus for treatment of obesity.

[0009] 这些和其他目的通过所附权利要求中描述的装置来实现。 [0009] These and other objects through the means described in the appended claims to achieve. 因此,通过提供一种如下装置而获得用于治疗肥胖症的装置,即该装置包括:至少一个可操作的拉伸装置,其能植入在肥胖病人体中并适于拉伸病人胃壁的一部分;以及操作装置,用于在所述拉伸装置被植入时操作该拉伸装置,以拉伸所述胃壁部分从而引起饱胀感。 Thus, by providing a means to obtain the following means for treating obesity, i.e., the apparatus comprising: at least one operable stretching device, which can be implanted in the body of the obese patient and adapted to stretch the stomach wall portion ; and an operation means for, when the operation of the stretching means stretching device is implanted, to stretch the stomach wall portion to cause satiety. 本发明基于以下认识:通过引起胃壁的拉伸效果而引起饱胀感。 The present invention is based on the following understanding: by causing stomach stretching effect satiety. 因此,不需要如AGB和VBG所需那样在胃中提供减小的永久气孔。 Therefore, no such AGB and VBG as required to provide a reduced permanent stoma in the stomach. 因此,与这种减小的气孔相关联的并发症通过本发明的新装置而消除,该新装 Thus, pores associated with complications such reduction by the new device of the present invention eliminated, the newly installed

14置是更简单、安全和长期工作的装置。 14 is set to be more simple, device security and long-term work.

[0010] 在拉伸装置能够拉伸胃壁的位置,拉伸装置可通过胃至胃的缝合线或订合线而保持与胃壁接触。 [0010] In the stretching apparatus capable of stretching the stomach wall position, the stretching device through the stomach to stomach sutures or staplers and held in contact with the stomach wall. 具体而言,拉伸装置可借助于胃至胃的缝合线或订合线而被胃套叠。 Specifically, the stretching device by means of the stomach to stomach sutures or staplers are stomach intussusception.

[0011] 拉伸装置可适于放置在胃腔中。 [0011] stretching device can be adapted to be placed in the stomach cavity. 为此,拉伸装置可适于经由胃镜或入腔器械插入胃腔,并适于通过手术附接到胃壁。 To this end, the stretching device can be adapted to insert into the stomach cavity or cavities via endoscopy instruments and adapted received a stomach surgically attached. 可替换地,拉伸装置可适于放置在胃的外侧。 Alternatively, the stretching device may be adapted to be placed on the outside of the stomach.

[0012] 在本发明的实施例中,拉伸装置包括第一接合构件和第二接合构件,所述第一接合构件适于接合胃壁的第一部分,所述第二接合构件适于接合胃壁的与第一胃部分接近但分隔开的第二部分。 [0012] In an embodiment of the present invention, the stretching device comprises a first member and a second engaging member engaging said first engaging member adapted to engage the first portion of the stomach wall, the second engagement member adapted to engage the stomach wall with the first portion of the stomach close to but spaced from the second portion. 操作装置适于操作第一和第二接合构件背离彼此移动,以拉伸胃的第一和第二部分之间的胃壁部分,从而引起饱胀感。 Operating means adapted to operate the first and second engagement member to move away from the one another to the stomach wall portion between the first and second parts stretching of the stomach, causing a feeling of fullness. 第一和第二接合构件中的至少一个可适于通过胃至胃的缝合线或订合线至少部分地被胃壁套叠,从而将接合构件保持在适当位置。 The first and second engagement member in at least one may be adapted through the stomach to stomach sutures or staplers at least partially stomach nesting, thereby engaging member is held in place. 另外,第一和第二接合构件中的至少一个可适于通过接合构件与胃壁之间的缝合线或订合线而保持在适当位置。 Further, the first and second engaging members may be adapted by the at least one engaging member and the stomach sutures or staplers between and held in place. 适当地,第一和第二接合构件中的至少一个包括组织生长促进结构,优选为网状结构,适于与胃壁接触以保证拉伸装置长期附接到胃壁。 Suitably, the first and second engagement member comprises at least one tissue growth promoting structure, preferably a mesh structure, in contact with the stomach wall is adapted to ensure long stretching device attached to the stomach wall.

[0013] 在本发明的另一实施例中,拉伸装置包括适于被病人胃壁的一部分套叠的至少一个可膨胀主体,且操作装置包括流体贮存器,其与所述主体的室流体连通。 [0013] In another embodiment of the present invention, the stretching means comprising a portion of the patient's stomach wall adapted to be nested at least one inflatable body, and the operation device comprises a fluid reservoir, in fluid communication with the chamber of the body . 操作装置可为非侵入性操作的,以将流体从流体贮存器分配到主体的室,从而使主体膨胀,使得当主体被套叠时,胃壁部分受到拉伸。 Operating device may be non-invasive procedures to the fluid dispensed from the fluid reservoir to the chamber body, so that the body swell, so that when the body invaginated stomach wall portion is stretched. 流体贮存器可通过手动按压其来操作。 Fluid reservoir which can be operated by pressing manually. 操作装置可包括回动伺服机构,其中流体贮存器中的小容积流体被较大的力压缩,且主体的室在每单位容积较小的力下引起较大总容积的运动。 Reversing the operation device may comprise a servo mechanism, wherein the fluid reservoir in a small volume of fluid is compressed large force, and the chamber body causes movement of the larger total volume per unit volume in the less force. 流体贮存器可被放置在皮下或腹腔中,并可通过例如利用马达移动贮存器的壁来调整。 Fluid reservoir may be placed subcutaneously or in the peritoneal cavity, and can be moved by a motor, for example by a wall of the reservoir is adjusted. 可替换地,泵可被提供为将流体或空气从贮存器泵浦到主体的室。 Alternatively, the pump may be provided as the pumping fluid or air from the reservoir to the chamber body.

[0014] 术语“回动伺服机构”包含如下含义:用较大的力和小冲程进行控制的装置,即,例如少量流体在较大的力下的运动控制由非常小的力移动的较大量的流体,但可替换地或另外地包含如下含义:将作用在具有短冲程的移动元件上的很大的力转变为作用在具有长冲程的另一移动元件上的很小的力的机构。 [0014] The term "reversed servo mechanism" includes the following meanings: a device for controlling a large force and small strokes, which, for example, a small amount of fluid movement in the larger force is controlled by a very small force to move a larger amount fluid, but may alternatively or additionally contain the following meanings: acting on a moving element having a short stroke into a strong force acting on another moving element having a long stroke of the small force mechanism. 当可以通过完整皮肤手动控制装置时,优选使用回动伺服机构。 When intact skin by manual control device, preferably using a reversed servo.

[0015] 在本发明的另一实施例中,该装置包括与一个或多个较小的室接触的大室。 [0015] In another embodiment of the present invention, the apparatus includes one or more smaller room contact large room. 所述室适于与分配在所述室之间的流体或空气连通。 The chamber is adapted to the chamber between dispensing and fluid or air communication. 用于在所述室之间分配流体的回动伺服机构可被提供,其中大室中的小容积流体被较大的力压缩,且较小的室在每单位容积较小的力下引起较大总容积的运动。 Reversed servo for distributing fluid between the chamber may be provided, of which a small volume of the fluid chamber is compressed by a large force, and smaller than in the chamber causing less force per unit volume large total volume of movement. 大室可适于被套叠在病人的基底胃壁中,从而也通过限制贲门切口朝向病人的隔膜肌的运动来治疗返流疾病,而小室用作拉伸装置以治疗肥胖症。 Large room can be adapted to the patient's base invaginated stomach wall, which also cut by limiting the cardiac muscle of the diaphragm toward the patient's movement to treat reflux disease, and the small room used as a stretching device for the treatment of obesity. 大室可将流体或空气分配到小室以使它们膨胀并拉伸胃基底壁。 Large room can be assigned to a small room fluid or air to make them swell and stretch the stomach fundus wall.

[0016] 在本发明的另一实施例中,拉伸装置包括机械拉伸装置,其中可提供用于机械调整拉伸装置的马达。 [0016] In another embodiment of the present invention, the stretching device comprises a mechanical stretching device, wherein the motor may be provided for mechanically regulating the stretching device. 机械调节的拉伸装置可适于接合胃壁的第一部分和胃的第二部分,其中该机械调节的拉伸装置包括适于被操作装置移动的关节机构。 Tensile mechanical adjustment means may be adapted to engage a second portion of the first portion of the stomach wall and the stomach, wherein the mechanically regulated stretching device comprises means adapted to be operated to move the joint mechanism. 可替换地,拉伸装置可包括适于接合胃壁的第一部分的第一接合构件和适于接合胃壁的与第一胃部分接近但分隔开的第二部分的第二接合构件,其中机械拉伸装置调节胃壁的第一和第二部分之间的距罔。 Alternatively, the stretching device may comprise a first portion adapted to engage the stomach wall and a first engaging member adapted to engage the second engagement member with the first portion of the stomach close to but spaced from the second portion of the stomach wall, wherein the mechanical pulling From indiscriminately stretch means adjusts the stomach wall between the first and second portions.

[0017] 作为可替代方案,以上描述的液压机构可用于通过液压分配流体或空气来调整这种机械拉伸装置。 [0017] As an alternative, the hydraulic mechanism described above can be used to adjust the allocation of such mechanical stretching device via a hydraulic fluid or air.

[0018] 拉伸装置可为术后非侵入性调节的。 [0018] The stretching device may be non-invasively adjusted after surgery.

[0019] 用于操作拉伸装置的操作装置可在其最简单的形式中包括适于通过手动按压开关以操作拉伸装置进行非侵入性操作的皮下开关。 [0019] Operating device for operating the stretching device may comprise a push switch adapted to operate by manually stretching operation means non-invasive subcutaneous switch in its simplest form.

[0020] 适于拉伸胃壁的至少两个不同部分的至少两个可操作拉伸装置可被提供,其中该装置适于被术后和非侵入性调整。 [0020] At least two operable stretching devices adapted to at least two different portions of the stretching of the stomach wall can be provided, wherein the apparatus is adapted to be postoperatively and non-invasively adjust. 具体而言,该装置可时常地调整,使得在第一时间,拉伸装置中的一个拉伸胃壁的一个部分,在第二时间,拉伸装置中的另一个拉伸胃壁的另一部分。 In particular, the device may be adjusted from time to time, so the first time, a stretching device stretch the stomach wall in a portion, at a second time, another portion of another stretching means stretching the stomach wall.

[0021] 在本发明的另一实施例中,拉伸装置包括主体,其适于填充由胃的壁部分限定的容积。 [0021] In another embodiment of the present invention, the stretching device comprises a body adapted to fill the stomach wall portion defined by the volume. 适当地,主体具有圆滑轮廓,而没有可能损坏病人胃壁的太尖的边缘。 Suitably, the body has a sleek profile, but no patient can damage the stomach wall too sharp edges. 在主体待被套叠的地方,其可具有变化的周界,以更好地保持在被病人的胃壁部分套叠的位置。 In the main place to be invaginated, which may have varying perimeter, in order to better maintain partially nested in the patient's stomach position. 主体可被成形为类似于蛋或类似于肾。 The body may be shaped like an egg or similar kidney.

[0022] 一般而言,可使用任何种类的机械结构。 [0022] In general, any type of mechanical structure. 可使用任何机械或液压驱动的机械机构或任何气动结构。 You can use any mechanical or hydraulic drive of mechanical mechanism or any aerodynamic structure. 在被提供动力时任何马达或任何泵或改变形式的移动材料可被用于实现如下简单目标:通过使胃壁的至少两个部分背离彼此移动来拉伸胃壁的一部分。 When power is supplied to any motor or any pump or moving material changing form may be used to achieve the following objectives simple: by reacting at least two portions of the stomach wall away from the moving part to each other to stretch the stomach wall.

[0023] 可使用任何种类的液压操作。 [0023] You can use any kind of hydraulic operation. 可以意识到,可使用气动操作来代替液压操作,其中代替液压流体的空气在贮存器与由拉伸装置形成的室之间移动。 As can be appreciated, pneumatic operation can be used instead of hydraulic operation, wherein the hydraulic fluid instead of air movement between the reservoir and the chamber formed by the stretching device. 优选地,贮存器具有锁定位置,从而如果该贮存器由病人处理,则将其保持在希望的位置。 Preferably, the reservoir has a locking position, so that if the reservoir by the patient treated, it is held in a desired position. 为了压缩贮存器,其优选保持压缩并在再次按压之后释放。 To compress the reservoir, which is preferably remain compressed and released again after pressing.

[0024] 任何种类的液压方案可用于拉伸装置。 [0024] Any kind of hydraulic solution may be used for the stretching device. 液压方案可通过机械和由任何马达或泵提供动力以及通过手动来驱动。 By mechanical and hydraulic solutions provided by any motor or pump power and manually driven.

[0025] 当然,仅仅使胃的套叠部分膨胀也拉离胃壁,这也可机械、液压、气动以及由马达或泵提供动力或手动力地实现。 [0025] Of course, only part of the stomach of nesting expansion also pulled away from the stomach, which may be mechanical, hydraulic, pneumatic, and power is provided by a motor or pump or hand power to achieve.

[0026] 根据一个实施例,提供一种用于治疗病人的肥胖症的装置,该装置包括至少一个可操作的拉伸装置,其能植入在病人体中并适于拉伸病人胃壁的一部分。 [0026] According to one embodiment of the part, there is provided an apparatus for the treatment of obesity in a patient, the apparatus comprising at least one operable stretching device, which can be implanted in the patient and adapted to stretch the stomach wall of the patient . 该装置进一步包括可植入控制单元,该可植入控制单元用于在控制单元和拉伸装置被植入时自动控制可操作拉伸装置,从而拉伸与病人吃饭关联的胃壁部分,从而引起饱胀感。 The apparatus further comprises an implantable control unit, the implantable control unit for, when the control unit and stretching device are implanted operable to automatically control the stretching device, thereby stretching the stomach wall portion associated with the patient to eat, causing a sense of fullness.

[0027] 根据另一实施例,该装置进一步包括至少两个拉伸装置,第一拉伸装置和第二拉伸装置,或三个或更多拉伸装置。 [0027] According to another embodiment, the apparatus further comprises at least two stretching devices, a first stretching means and second stretching device, or three or more stretching devices. 根据又一实施例,该装置进一步包括用于操作拉伸装置的操作装置,其中当控制单元和拉伸装置被植入时,控制单元控制操作装置拉伸胃壁部分。 According to yet another embodiment, the apparatus further includes an operating means for operating the stretching device, wherein when the control unit and stretching device are implanted, the control unit controls the operation means stretching the stomach wall portion.

[0028] 根据又一实施例,该装置进一步包括传感装置,其包括用于传感病人的物理参数或拉伸装置的功能参数的传感器,其中传感装置将与所述参数相关的信息发送到控制单元,且控制单元基于该信息控制拉伸装置。 [0028] According to a further embodiment, the apparatus further comprises sensing means, which comprises a functional parameter sensor sensing a physical parameter of the patient or the stretching device, wherein the sensing means associated with said parameter information sent to the control unit and the control unit controls the stretching device based on this information. 该装置可适于控制拉伸装置,以在控制单元和拉伸装置被植入时间歇地拉伸胃壁。 The apparatus may be adapted to control the stretching device to the control unit and stretching device are implanted intermittently stretch the stomach wall.

[0029] 根据一个实施例,可植入控制单元适于根据一个实施例通过随时间的变化、胃壁的拉伸量和/或在预定时间周期内对胃进行拉伸,控制由胃壁上的拉伸装置执行的拉伸量。 [0029] According to the control unit in accordance with one embodiment is adapted by varying over time, the amount of stretching of the stomach wall and / or within a predetermined period of time stretching of the stomach, the stomach is controlled by pulling on one embodiment, the implantable It means the amount of stretch elongation executed.

[0030] 根据一个实施例,可植入控制单元适于基于病人的食物摄入来控制拉伸装置,可植入控制单元可被编程为包括任意如下:拉伸装置被控制以拉伸胃壁的预定时间周期以及施加在胃壁上的拉伸量。 [0030] According to one embodiment, the implantable control unit based on the patient's food intake is adapted to control the stretching device, the implantable control unit may be programmed to include any of the following: the stretching device is controlled to stretch the stomach wall a predetermined time period and the amount of stretch applied to the stomach wall. 操作装置可为机械操作装置、液压操作装置、液压操作的机械操作装置或机械操作的液压操作装置。 Operating means for operating a mechanical device, hydraulic operation device, a mechanical operating device or mechanically operated hydraulic operation device hydraulically operated.

[0031] 根据一个实施例,传感装置的传感器直接或间接地传感病人的食物摄入,且可植入控制单元响应来自传感器的信号来控制操作装置以拉伸胃壁。 [0031] directly or indirectly sensing the patient's food intake sensor according to one embodiment, the sensing device embodiment, and implantable control unit in response to signals from the sensor to control the operation device to stretch the stomach wall.

[0032] 根据又一实施例,可植入控制单元适于控制操作装置以利用多于一个的拉伸装置来拉伸胃壁。 [0032] According to a further embodiment, the implantable control unit is adapted to control the operation means to take advantage of more than one stretching device to stretch the stomach wall. 这可通过可植入控制单元实现,该可植入控制单元适于在第一时间周期内控制第一拉伸装置以拉伸胃壁的第一部分,在第二时间周期内控制第二拉伸装置以拉伸胃壁的不同于该胃壁的第一部分的第二部分,从而允许胃壁在拉伸周期之间的较长放松。 This can be realized by an implantable control unit, the implantable control unit is adapted to control a first time period a first stretching means to stretch a first portion of the stomach wall, in a second time period a second control means stretching stretching of the stomach wall in a second portion of the first portion is different from the stomach, allowing the stomach to relax between the stretch longer period.

[0033] 根据一个实施例,传感装置的传感器适于传感与病人的食物摄入相关的参数,例如食管运动、食管弯曲、食管蠕动、食管拉伸、食管压力、穿过食管的食物、胃中的食物、神经活动、交感神经活动、肌肉活动、荷尔蒙活动、胃蠕动、胃拉伸、胃压力、胃弯曲、胃填充和/ 或胃中的酸度。 [0033] intake related parameter sensor according to one embodiment, the sensing device adapted to sense the implementation of patient food, such as esophageal motility, esophageal bent, esophageal motility, esophageal stretching, esophageal pressure through the esophagus of food, The food in the stomach, neural activity, sympathetic nerve activity, muscle activity, hormonal activity, stomach motility, stomach stretching, stomach pressure, stomach bending, stomach filling and / or stomach acidity. 传感装置也可适于传感蠕动、拉伸、弯曲、压力、运动、荷尔蒙、神经活动、PH 值、酸度、容积、电容、电阻、电压、安培、光吸收或视觉、超声反射或吸收、弯曲金属、双金属禾口PH0 Sensing device may also be adapted for sensing motility, stretching, bending, stress, exercise, hormones, neural activity, PH, acidity, volume, capacitors, resistors, voltage, amperage, or visual light absorption, reflection or absorption of ultrasound, bent metal, bimetal Hekou PH0

[0034] 根据一个实施例,该装置进一步包括可植入贮存器,其中操作装置受贮存器液压控制。 [0034] According to one embodiment, the apparatus further comprises an implantable reservoir, wherein the operation control means by hydraulic reservoir. 拉伸装置可适于利用病人控制而从病人身体外部得到控制,所述病人控制根据一个实施例可适于取代可植入单元的控制。 Stretching means may be adapted to control the use of the patient while the patient is controlled from outside the body, the patient may be adapted to control, according to one embodiment of the control unit replace implantable implemented. 可植入控制单元可适于由病人从病人身体外部来控制。 The implantable control unit may be adapted by the patient to control the patient's body from the outside.

[0035] 根据一个实施例,该装置进一步包括外部控制单元,其例如借助于可由病人操作的可植入开关来从病人身体外部控制可植入控制单元。 [0035] According to one embodiment, the apparatus further comprises an external control unit, for example, by means of which a patient can be used to operate an implantable switch implantable control unit from outside the patient's body control.

[0036] 根据一个实施例,该装置包括无线远程控制器,用于从病人身体外部控制和/或编程可植入控制单元。 [0036] According to one embodiment, the apparatus comprises a wireless remote control, from the patient's body for external control and / or programming the implantable control unit. 控制单元可包括力控制器,且机械操作装置可由该力控制器控制。 The control unit may comprise a force controller, and the mechanical operation of the apparatus by the force controller.

[0037] 根据一个实施例,可植入控制单元包括压力控制器,且液压操作装置由该压力控制器控制。 [0037] According to one embodiment, the implantable control unit comprises a pressure controller, and the hydraulic operation device is controlled by the pressure controller.

[0038] 拉伸装置 [0038] stretching device

[0039] 根据任意实施例的装置的拉伸装置可包括第一和第二接合部分,第一部分可适于接合到胃壁的第一区域,第二部分可适于接合到胃壁的第二区域。 [0039] drawing apparatus apparatus according to any of the embodiments may include first and second engaging portions, the first portion adapted to be bonded to the first region of the stomach wall, the second portion may be adapted to engage a second region of the stomach wall. 拉伸装置由此适于拉伸胃壁的在第一区域与第二区域之间的部分。 Thereby stretching means adapted to stretch the stomach wall portion between the first region and the second region. 拉伸装置可包括马达,例如可植入电动马达,其相应地可操作至少一个关节,以移动该关节从而拉伸胃壁部分。 Stretching means may comprise a motor, for example, an implantable electric motor, which in turn is operable at least one joint to move the joint portion thereby stretching the stomach wall.

[0040] 根据另一实施例,该装置可包括具有可变容积的室,所述室可适于接纳流体。 [0040] According to another embodiment, the apparatus may comprise a variable volume chamber, the chamber may be adapted to receive a fluid. 该装置可进一步包括贮存器,其适于保持流体并与所述室流体连接。 The apparatus may further comprise a reservoir adapted to maintain a fluid and connected to said fluid chamber. 拉伸装置可进一步包括泵浦装置,其可适于将流体从贮存器移动到室,并由此拉伸胃壁的一部分。 Stretching apparatus may further comprise a pumping device, which may be adapted to move the fluid from the reservoir to the chamber, and thereby stretching the portion of the stomach wall. 根据另一实施例, 该装置进一步包括第二流体连接部,其适于在预定时间周期内允许流体从室流回贮存器。 According to another embodiment, the apparatus further comprises a second fluid connection which is adapted for a predetermined time period to allow fluid to flow back from the reservoir chamber.

[0041] 液压 [0041] Hydraulic

[0042] 根据一个实施例,拉伸装置包括适于具有可变容积的室。 [0042] According to one embodiment, the stretching device comprises a chamber having a variable volume adapted. 所述室可包括至少一个可移动壁部,其可为弹性壁部。 The chamber may comprise at least one moveable wall portion, which may be an elastic wall portion. 所述室可具有大致圆形且可适于接纳流体。 The chamber may have a substantially circular and may be adapted to receive a fluid.

[0043] 根据另一实施例,拉伸装置进一步包括适于保持流体并与室流体连接的贮存器, 拉伸装置可进一步包括泵浦装置,其可适于经由将贮存器和室互连的第一流体连接部将流体从贮存器移动到室,由此拉伸胃壁的一部分。 [0043] According to another embodiment, the stretching device further comprises a chamber adapted to hold a fluid and fluidly connected with the reservoir, the stretching device may further comprise a pumping device, which can be adapted to the reservoir and the chamber via the first interconnection a fluid connection to the chamber to move the fluid from the reservoir, thereby stretching the stomach wall portion. 可以设想到,拉伸装置进一步包括第二流体连接部,其将室和贮存器互连并适于在预定时间周期内允许流体从室流回贮存器。 It is contemplated that the stretching means further comprises a second fluid connection unit which interconnects the chamber and the reservoir and adapted to allow fluid within a predetermined time period to flow back from the reservoir chamber.

[0044] 根据任意实施例的贮存器可适于被放置在皮下或腹部中,且贮存器可通过移动贮存器的壁来控制,这可利用合适的马达来实现。 [0044] According to any embodiment of the reservoir may be adapted to be placed subcutaneously or in the abdomen, and by moving the reservoir wall of the reservoir to control, which can be achieved using a suitable motor. 室也可包括适于膨胀室的容积的电动马达。 Chamber may also comprise a volume expansion chamber adapted electric motor.

[0045] 该装置可进一步包括回动伺服机构,其中贮存器中的小容积被较大的力压缩,且室利用每单位面积较小的力而引起较大总面积的运动。 [0045] The apparatus may further comprise a reversed servo, which in a small volume of the reservoir is compressed with a higher force, and room use less force per unit area caused a large movement of the total area.

[0046] 传感器 [0046] Sensors

[0047] 根据任意实施例的植入在病人体中的传感器可为功能参数传感器,其传感装置的功能参数,例如用于充填内部能量源的能量的传输。 [0047] Examples of energy transfer implanted in a patient sensor parameter sensor may be a function, which function parameter sensing means, e.g., for filling of internal energy source according to any of embodiments. 在其他实施例中,传感器为物理参数传感器,其传感病人的物理参数,例如病人的食物摄入。 In other embodiments, the sensor is a physical parameter sensor sensing a physical parameter which patients, e.g., the patient's food intake. 根据任意实施例的传感器可为如下中的至少一个:体温传感器、压力传感器、血压传感器、血流量传感器、心跳传感器、呼吸传感器、电导率传感器、PH传感器、光敏传感器、气体探测传感器以及传感机械应变的传感器,例如适于传感贲门的任意收缩和放松的传感器。 The sensor according to any of the embodiments may be at least one of the following: temperature sensors, pressure sensors, blood pressure sensors, blood flow sensors, heartbeat sensors, respiration sensors, conductivity sensors, PH sensors, light sensors, gas detection sensors and mechanical sensors strain sensors, for example, any suitable sensing cardiac contraction and relaxation of the sensor.

[0048] 根据一个实施例,该装置进一步包括反馈装置,用于将信息从病人身体内部发送到其外部,以给出与功能参数相关的反馈信息。 [0048] According to one embodiment, the apparatus further comprises a feedback device for sending information from inside the patient's body to the outside, to give the functional parameters related feedback.

[0049] 控制单元 [0049] The control unit

[0050] 根据一个实施例,该装置由适于控制拉伸装置的控制单元控制。 [0050] According to one embodiment, the device is controlled by a control unit adapted to control the stretching device. 控制单元可适于响应来自传感器的信号来控制拉伸装置或两个或更多个拉伸装置。 The control unit can be adapted to respond to signals from the sensor to control the stretching device or two or more stretching devices.

[0051] 根据一个实施例,控制单元时常地控制拉伸装置,使得拉伸装置中的一个在第一时间拉伸胃壁的第一部分,拉伸装置中的另一个在第二时间拉伸胃壁的第二部分。 [0051] According to one embodiment, the control unit controls the stretching devices from time to time, so that the stretching apparatus at a first time stretch a first portion of the stomach wall, stretching apparatus further stretching of the stomach wall in a second time The second part. 控制单元可适于从病人身体外部例如通过无线远程控制器来控制,所述无线远程控制器相应地可包括至少一个外部信号发射器,其可适于发射包括频率调制信号、幅度调制信号或相位调制信号或其组合的无线控制信号。 The control unit may be adapted, for example by means of a wireless remote controller to control the patient's body from the outside, the wireless remote controller may correspondingly comprise at least one external signal transmitter, which may be adapted to transmit a signal comprising a frequency modulation, amplitude modulation or phase signal modulated signal or a combination thereof wireless control signals. 根据一个实施例,所述至少一个发射器适于发射包括模拟或数字信号或者模拟和数字控制信号的组合的无线控制信号,或者发射包括电场或磁场或者组合的电场和磁场的无线控制信号。 According to one embodiment, the at least one transmitter adapted to transmit signals, including analog or digital or analog and digital control signals combined wireless control signal or emission including electric or magnetic field or a combination of electric and magnetic fields of the radio control signal.

[0052] 根据任意实施例的控制单元可适于植入病人皮下,且可适于控制液压系统。 [0052] The control unit according to any of the embodiments may be adapted to the patient subcutaneously implanted, and may be adapted to control the hydraulic system.

[0053] 该装置可进一步包括用于为控制单元提供动力的传输构件,该传输构件可包括流体传输构件和/或电引线。 [0053] The apparatus may further include means for providing power to the control unit transmission member, the transmission member may include a fluid transfer components and / or electrical leads.

[0054] 根据另一实施例,该装置进一步包括外部数据通信器以及与该外部数据通信器通信的可植入内部数据通信器。 [0054] According to another embodiment, the apparatus further comprising an external data communicator and an external data communicator communicating with the implantable internal data communicator. 内部通信器可适于将与该用于治疗肥胖症的装置相关的数据反馈回外部数据通信器,或者外部数据通信器将数据供给到内部数据通信器。 Internal communication can be adapted to the means for the treatment of obesity-related data is fed back to the external data communicator or the external data communicator supplied data to the internal data communicator.

[0055] 提供能量 [0055] provide energy

[0056] 为了对该装置提供能量,该装置可进一步包括通过诸如波信号等至少一个无线能量信号发射能量的无线能量发射器,所述波信号例如为声波信号、超声波信号、电磁波信号、红外光信号、可见光信号、超紫外光信号、激光信号、微波信号、无线电波信号、X射线信号和伽马射线信号。 [0056] In order to provide energy to the apparatus, the apparatus may further comprise wave signals, such as by at least one wireless energy signal transmitting wireless energy transmitter energy, said acoustic wave signal, for example, a signal, an ultrasonic signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, extreme ultraviolet signal, a laser signal, microwave signal, a radio wave signal, X-rays and gamma-ray signal signal. 无线能量信号可进一步包括电场或磁场或组合的电场和磁场。 Wireless energy signal may further include electric and magnetic fields, or a combination of electric or magnetic fields.

[0057] 根据又一实施例,该装置包括适于为该装置提供动力的能量源,其可包括内部能量源,该内部能量源相应地可适于接收来自以无线模式发射能量的外部能量源的能量。 [0057] According to a further embodiment, the apparatus comprises means adapted to provide power for the energy source, which may include an internal source of energy, the internal energy source can be appropriately adapted to receive from the external energy source transmitting energy in a wireless mode energy. 内部能量源可进一步包括蓄能器、至少一个电压值防护罩和/或至少一个恒流防护罩。 Internal energy source may further comprise an accumulator, at least one shield voltage value and / or at least one constant current guard.

[0058] 该装置可进一步包括适于将能量从第一形式转换为第二形式的能量转换装置。 [0058] The apparatus may further comprise adapted to convert energy from a first form to a second form of energy conversion devices.

18[0059] 固定 18 [0059] Fixed

[0060] 根据任意实施例的装置可包括固定构件,其可适于将拉伸装置固定到病人的胃壁。 [0060] The device according to any of the embodiments may include a fixing member, which can be adapted to the patient's stomach wall is secured to the stretching device. 固定构件可适于与缝合线或订合线接触,以将拉伸装置固定到病人的胃壁。 Contact with the fixing member may be adapted to sutures or staplers, to stretch the stomach wall is secured to the patient's device. 固定构件可包括网状结构,其可适于促进长期固定到胃壁的人体组织的生长。 Fixing member may include a net-like structure, which may be adapted to promote the growth of long-term fixed to the body tissue of the stomach wall.

[0061] 系统 [0061] System

[0062] 本发明还提供一种肥胖症治疗系统,包括如上所述的用于治疗肥胖症的装置。 [0062] The present invention also provides a obesity treatment system, comprising means for treating obesity as described above. 该系统可包括皮下电子开关,其适于手动且非侵入性地控制该用于治疗肥胖症的装置的功能。 The system may include subcutaneous electronic switch adapted to manually and non-invasively controlling the means for treating obesity function.

[0063] 该系统可包括具有液压贮存器的液压装置,其中该用于治疗肥胖症的装置适于通过手动按压液压贮存器而被非侵入性地调整。 [0063] The system may comprise a hydraulic device having a hydraulic reservoir, wherein the apparatus is adapted for the treatment of obesity by manually pressing the hydraulic reservoir is adjusted non-invasively.

[0064] 该系统可包括用于控制该装置的功能的无线远程控制器。 [0064] The system may include a wireless remote control for controlling the function of the apparatus. 无线远程控制器包括至少一个外部信号发射器,且内部信号接收器可被提供为植入在病人体中。 Wireless remote control comprises at least one external signal transmitter and an internal signal receiver may be provided to be implanted in the patient. 无线远程控制器适于发射用于控制该装置的至少一个无线控制信号。 Wireless remote controller is adapted to control the device emitting at least one wireless control signals. 无线控制信号可包括频率、幅度或相位调制信号或其组合,以及模拟或数字信号或模拟和数字信号的组合。 Wireless control signal may include a combination of frequency, amplitude or phase modulation signal or a combination thereof, as well as analog or digital signal or analog and digital signals. 可替换地,无线控制信号包括电场或磁场或者组合的电场和磁场。 Alternatively, the wireless control signal comprises an electric or magnetic field or a combination of electric and magnetic fields. 远程控制器可发射用于承载无线控制信号的载波信号。 Remote controller can transmit control signals for carrying wireless carrier signal. 载波信号可包括数字、模拟或数字和模拟信号的组合。 Carrier signal may include a combination of digital, analog or digital and analog signals. 远程控制器可发射用于承载数字或模拟控制信号的电磁载波信号。 Remote controller can be used to carry transmit digital or analog control signal electromagnetic carrier signal.

[0065] 该系统可包括用于非侵入性地用无线能量对该装置提供能量的无线能量发射器。 [0065] The system may include a non-invasive radio energy to provide energy to the apparatus of a wireless energy transmitter. 能量发射器通过至少一个无线能量信号发射能量。 Energy emitter via at least one wireless energy signal emitted energy. 无线能量信号可包括选自如下的波信号:声波信号、超声波信号、电磁波信号、红外光信号、可见光信号、超紫外光信号、激光信号、微波信号、无线电波信号、X射线信号和伽马射线信号。 Wireless energy signal may comprise a wave signal selected from the following: an acoustic signal, an ultrasonic signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, extreme ultraviolet signal, a laser signal, a microwave signal, a radio wave signal, X-rays and gamma rays signal signal. 可替换地,无线能量信号包括电场或磁场或者组合的电场和磁场。 Alternatively, the wireless energy signal comprises an electric or magnetic field or a combination of electric and magnetic fields. 无线能量发射器可发射用于承载无线能量信号的载波信号。 Wireless energy transmitter may transmit a carrier signal for carrying the wireless energy signal. 载波信号可包括数字、模拟或数字和模拟信号的组合。 Carrier signal may include a combination of digital, analog or digital and analog signals.

[0066] 该系统可包括用于将无线能量从第一形式转换为第二形式的能量转换装置。 [0066] The system may comprise means for converting the wireless energy from a first form to a second form of energy conversion devices. 能量转换装置可在能量传输期间用第二形式能量直接操作该装置。 Energy conversion device can be used during energy transfer with a second form of energy directly operate the device. 第二形式的能量可包括直流或脉冲直流或者直流和脉冲直流的组合。 The second form of energy may include a combination of a DC or pulsed DC or DC and pulsed DC. 第二形式的能量可包括交流或直流和交流的组合。 The second form of energy may include AC or a combination of DC and AC. 蓄能器可被提供,其中第二形式的能量至少部分地用于对该蓄能器充电。 The accumulator may be provided, wherein the second form of energy for at least partially charging the accumulator. 第一或第二形式的能量可包括磁能、动能、声能、化学能、辐射能、电磁能、光电能、核能或热能。 The first or second form may include magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, photo energy, nuclear energy or thermal energy. 第一形式的能量和第二形式的能量中的一个可为非磁、非动态、非化学、非声学、非核或非热的。 The first form of energy and the energy of the second form of a non-magnetic, non-dynamic, non-chemical, non-acoustic, non-nuclear or hot.

[0067] 该系统可包括适于为该装置提供动力的能量源。 [0067] The system may comprise means adapted to provide an energy source for power. 该能量源可包括内部能量源,其适于接收来自以无线模式发射能量的外部能量源的能量。 The energy source may include an internal energy source adapted to receive energy from an external energy source transmitting energy in a wireless mode. 内部能量源通过无线模式的能量充填。 Internal energy source through the charging mode wireless energy.

[0068] 该系统可包括反馈装置,用于将信息从病人身体内部发送到其外部,以给出与功能参数相关的反馈信息。 [0068] The system may include a feedback device for sending information from inside the patient's body to the outside, to give the functional parameters related feedback.

[0069] 该系统可包括传感诸如系统的功能参数等参数的传感器,其与用于充填内部能量源的能量的传输相互关联。 [0069] The system may include a sensor such as a functional parameter sensing system parameters such as transport and energy to fill its internal energy sources are interrelated. 内部控制单元可被提供用于响应传感功能参数的传感器来控制该装置的操作装置。 Internal control unit may be provided in response to the sensor sensing function parameter to control operation of the device. 可替换地,传感器传感病人的物理参数。 Alternatively, the sensor sensing the patient's physical parameters. 物理参数可为体温、血压、血流量、心跳和呼吸中的一个。 Physical parameters of temperature, blood pressure, blood flow, heart rate and breathing in one. 物理参数传感器可为压力或蠕动传感器,或者传感测量、弯曲、 拉伸或食物摄入的传感器。 Physical parameters of the sensor can be a pressure or a peristaltic sensor, or sensor measurement, bending, stretching or food intake sensor. 内部控制单元可响应传感物理参数的传感器来控制操作装置。 Internal control unit in response to the sensor sensing physical parameter to control the operation of devices. 内部控制单元可被提供为接收来自传感器的信息。 Internal control unit may be provided to receive the information from the sensors.

[0070] 该装置的操作装置可包括马达或泵。 [0070] Operation of the apparatus means may comprise a motor or a pump. 具体而言,操作装置可包括电动马达。 Specifically, the operation device may comprise an electric motor. 操作装置可为电动力的,可为液压操作装置,或者可为气动操作装置。 Operating device for electric power, hydraulic operation device may be, or may be a pneumatic operation device. 发射的能量可直接以其无线形式影响操作装置,以致使动能在能量传输期间操作该装置的拉伸装置。 Energy can be transmitted directly in its wireless form affect the operation means, to cause transmission of kinetic energy during operation of the apparatus the stretching device.

[0071] 该系统可包括反馈装置,用于将信息从病人身体内部发送到其外部,以给出与功能参数相关的反馈信息。 [0071] The system may include a feedback device for sending information from inside the patient's body to the outside, to give the functional parameters related feedback.

[0072] 该系统可包括外部数据通信器和与该外部数据通信器通信的可植入内部数据通信器,其中内部数据通信器适于将与用于治疗肥胖症的装置或病人相关的数据反馈回外部数据通信器,或者外部数据通信器将数据反馈到内部数据通信器。 [0072] The system may include an external data communicator and the data communication with the external communication implantable internal data communicator, wherein the internal data communicator is adapted to the patient associated with the device for treating obesity or the feedback data back to the external data communicator or the external data communicator data back to the internal data communicator.

[0073] 该系统可包括可植入电子部件,其包括至少一个电压值防护罩和/或至少一个恒流防护罩。 [0073] The system may comprise implantable electrical components including at least one voltage value shield and / or at least one constant current guard.

[0074] 方法 [0074] Method

[0075] 本发明还提供如下列出的方法: [0075] The present invention also provides methods listed below:

[0076] (a) 一种用于通过手术治疗肥胖病人的方法,该方法包括步骤: [0076] (a) a method for the surgical treatment of obese patients, the method comprising the steps of:

[0077] 在病人的腹壁中切割开口; [0077] In cutting an opening in the patient's abdominal wall;

[0078] 切除胃周围的一区域; [0078] removal of an area around the stomach;

[0079] 放置如上所述的用于治疗肥胖症的装置,接合病人的胃壁,并缝合胃壁。 [0079] placement device for treating obesity as described above, engaging the patient's stomach, and stomach stapling.

[0080] 该方法可进一步包括另外的步骤:术后调整拉伸装置,以拉伸胃壁的一部分,从而影响病人的胃口,其中调整拉伸装置的步骤从病人身体外部控制。 [0080] The method may further comprise the additional step: After adjusting the stretching device to stretch the portion of the stomach wall, thus affecting the appetite of the patient, wherein the step of adjusting the stretching device from outside the patient's body control.

[0081] 该方法可进一步包括另外的步骤:放置如上所述的另外的用于治疗肥胖症的装置,接合病人的胃壁,借助于所述用于治疗肥胖症的装置拉伸胃壁的第一部分,并借助于所述另外的用于治疗肥胖症的装置拉伸胃壁的第二部分。 [0081] The method may further comprise the additional step of: further means for treating obesity as described above placed, engaging the stomach wall of the patient, the treatment of obesity by means of said means for drawing the first portion of the stomach wall, and by means of said additional means for stretching the stomach wall to treat obesity second portion.

[0082] (b) 一种用于经由腹腔镜腹进路将用于治疗肥胖症的装置通过手术放置在病人体中的方法,该方法包括步骤: [0082] (b) via a laparoscopic abdominal approach for treating obesity device surgically placed in the patient's method, the method comprising the steps of:

[0083] 将针或管状器械插入病人身体的腹部; [0083] The needle or tube like instrument inserted into the patient's abdomen;

[0084] 利用该针或管状器械用气体填充病人的腹部,由此使病人的腹腔膨胀; [0084] The use of the needle or tube like instrument to fill the patient's abdomen with gas, whereby the patient's abdominal cavity expansion;

[0085] 在病人身体中放置至少两个腹腔镜套针; [0085] placing at least two laparoscopic trocars in the patient's body;

[0086] 将照相机通过腹腔镜套针之一插入病人腹部; [0086] The camera is inserted into the abdomen of the patient through one of the laparoscopic trocar;

[0087] 将至少一个切除工具通过至少两个腹腔镜套针之一插入并切除病人的意欲放置区域;以及 [0087] The at least one dissecting tool through one of at least two laparoscopic trocar insertion and removal of the patient's desire to place the region; and

[0088] 放置如上所述的用于治疗肥胖症的装置,接合胃壁。 [0088] means for treating obesity placement described above, engaging the stomach wall.

[0089] (c) 一种利用如上所述的用于治疗肥胖症的系统的方法,包括步骤:术后调整拉伸装置,以拉伸胃壁的一部分,从而影响病人的胃口,其中调整拉伸装置的步骤被非侵入性地执行。 [0089] (c) A method for treating obesity utilizing a system as described above, comprising the steps of: after adjusting the stretching device to stretch the portion of the stomach wall, which affect the patient's appetite, which adjust stretch Step device is performed non-invasively. 拉伸装置包括机械或液压拉伸装置。 Stretching device comprises a mechanical or hydraulic stretching device. 液压拉伸装置可包括贮存器,用于将凝胶或气体或流体移动到或移动离开拉伸装置。 Hydraulic stretching device may comprise a reservoir, for moving gel or gas or fluid to or moving away from the stretching device. 贮存器可被放置在使病人的手够到的皮下,以手动将流体移动到或移动离开拉伸装置。 The reservoir may be placed in the patient's hand reach subcutaneous, manually move the fluid to or moved away from the stretching device. 拉伸装置可由内部能量源提供动力,以拉伸或释放拉伸装置,其中借助于控制装置控制来自内部控制单元或病人身体外部的动力。 Stretching device is powered by an internal energy source, in order to stretch or release the stretching device, which by means of a control device controls the internal control unit or power from outside the patient's body. 用于无线传输能量的无线能量发射器为操作装置提供动力,以使得拉伸装置直接在能量传输期间致使拉伸装置拉伸胃壁。 Wireless energy transmitter for wireless transmission of energy for powering the operation device, so that the stretching device directly during energy transfer resulting in stretching means stretching the stomach wall. 用于无线传输能量的无线能量发射器对内部能量源进行充电。 Wireless energy transmitter for wireless transmission of energy for charging the internal energy source. 回动伺服机构可被提供,其中在闭合式液压系统中移动少量流体,在第二较大闭合式液压系统中实现较大的流体运动,其中所述少量流体与大容积相比被每单位面积较大的力移动。 Reversed servo mechanism can be provided, which move a small amount of fluid in a closed hydraulic system to achieve greater fluid movement in a second larger closed hydraulic system in which a small amount of fluid is said to be compared with the large volume per unit area than moving a large force. 在病人的基底胃壁中套叠的拉伸装置适于可调节,其中被放置为套叠在胃基底壁中的拉伸装置适于被调节并拉伸胃基底壁由此引起饱胀感。 In the patient's stomach wall base stretching device adapted telescopic adjustable, which is positioned to nesting in the stomach fundus wall stretching device is adapted to be adjusted and stretched stomach fundus wall thereby causing a feeling of fullness.

[0090] 该方法可进一步包括将反馈信息从身体内部发送到其外部,以给出与该装置的功能参数相关的反馈。 [0090] The method may further include sending feedback information from inside the body to the outside to give the device parameters and functions related to feedback. 可替换地,该方法可进一步包括将反馈信息从身体内部发送到其外部, 以给出与病人的物理参数相关的反馈。 Alternatively, the method may further comprise sending feedback information from inside the body to the outside to give the physical parameters of the patient-related feedback. 装置的功能参数可与用于对内部能量源充电的能量传输相互关联。 Function parameters of the device can be used with energy for charging the internal energy source interconnected transmission. 该装置可从病人身体外部编程。 The device can be programmed from a patient's body outside. [0091 ] 该方法可进一步包括步骤: [0091] The method may further comprise the steps of:

[0092] 传感病人的物理参数或装置的功能参数;以及 [0092] sensing the patient's functional parameters of the physical parameters or device; and

[0093] 将传感的信息发送到适于调整拉伸装置的控制单元。 [0093] transmits sensing information to the control means is adapted to adjust the stretching unit.

[0094] 该方法可进一步包括步骤: [0094] The method may further comprise the steps of:

[0095] 传感病人的物理参数或装置的功能参数;以及 [0095] sensing the patient's functional parameters of the physical parameters or device; and

[0096] 将传感的信息发送到适于调整内部能量源的充填的控制单元。 [0096] The sensor sends information to a control unit adapted to adjust the filling internal energy source.

[0097] 该方法可进一步包括皮下放置的回动伺服机构,其具有小控制贮存器并用每单位面积较大的力从该控制贮存器移动小容积,从而用每单位面积较小的力引起拉伸装置的较大运动。 [0097] The method may further comprise a reversed servo subcutaneous placement, which has a small control reservoir and with greater force per unit area moving from a small volume of the control reservoir, causing pull with less force per unit area large stretch motion device.

[0098] 该方法可进一步包括通过手动按压皮下开关执行非侵入性调整。 [0098] The method may further include performing non-invasive adjustment pressing the subcutaneous switch manually.

[0099] 该方法可进一步包括通过无线远程控制器执行非侵入性调整。 [0099] The method may further include performing non-invasive adjustment through the wireless remote controller.

[0100] 该方法可进一步包括通过无线能量发射器执行非侵入性调整。 [0100] The method may further include performing non-invasive adjustment through a wireless energy transmitter.

[0101] 该方法可进一步包括通过内部能量源为该用于治疗肥胖症的装置提供动力。 [0101] The method may further comprise treating obesity by an internal energy source means for providing power for.

[0102] 该方法可进一步包括通过发射无线能量的外部能量源为该用于治疗肥胖症的装置提供动力,其中所述能量源包括发射无线能量的外部能量源。 [0102] The method may further comprise transmitting wireless energy by external energy source for treating obesity means for supplying power, wherein said energy source comprises an external energy source transmitting wireless energy.

[0103] 该方法可进一步包括从外部能量源发射无线能量,以对可再充内部能量源充电。 [0103] The method may further comprise transmitting wireless energy from the external source of energy, in order to be charged rechargeable internal energy source.

[0104] (d) 一种利用如上所述的装置的方法,其中拉伸装置包括主体,其包括与适于拉伸胃壁的一个或多个较小贮存器/室接触的大室,其中所述室适于与在所述室之间运动的流体或空气连通。 [0104] (d) An apparatus using the method described above, wherein the stretching device comprises a body, which is adapted to stretch the stomach wall comprises one or more smaller reservoirs / chambers large contact chamber, wherein said chamber adapted to movement between the chamber fluid or air communication.

[0105] (e) 一种利用如上所述的装置的方法,其中大室的主容积适于成为拉伸装置最重要的容积,且其中小室用作拉伸胃壁的拉伸装置以治疗肥胖症,其中主室利用流体或凝胶与小室连通,从而在胃基底壁中引起拉伸效果,由此治疗肥胖症。 [0105] (e) a method of utilizing the apparatus as described above, wherein the main volume of the large chamber is adapted to be the most important volume of the stretching device, and wherein the chamber is used as stretching means stretching the stomach wall to treat obesity wherein the main chamber using a fluid or gel cell communication, causing the stretching effect in the stomach fundus wall, thereby treating obesity.

[0106] (f) 一种利用如上所述的装置的方法,包括通过将大室的主容积套叠在基底胃壁中由此限制胃切口朝向病人的隔膜肌的运动来治疗返流疾病,并利用小室拉伸胃基底壁, 利用流体或空气将大室与小室连通以在胃基底壁中引起拉伸效果由此治疗肥胖症。 [0106] (f) the use of a device as described above, comprising a large chamber through the main volume of nesting in the base stomach wall thereby limiting the patient's stomach and cut toward the diaphragm muscle exercise to treat reflux disease, and stretching the stomach with a small basement room wall, using a fluid or air to a large chamber in communication with the chamber to cause the stretching effect in the stomach fundus wall thereby treating obesity.

[0107] 提供一种利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的胃镜方法。 [0107] provide a suitable portion of the stomach wall stretching device utilizes the patient to treat the patient's obesity endoscopy methods. 该方法包括步骤:将所述装置通过食管插入病人的胃中,将所述装置放置为与胃壁接触,将所述装置固定到胃壁使得该装置能够拉伸胃壁的一部分。 The method comprises the steps of: said means inserted into the patient's stomach through the esophagus, placing the device in contact with the stomach wall, the stomach wall is secured to the device so that the device can stretch a part of the stomach wall.

[0108] 根据一个实施例,固定所述装置的步骤包括步骤:将所述装置的第一部分固定到胃壁的第一部分,以及将所述装置的第二部分固定到胃壁的第二部分。 [0108] According to one embodiment, the step of fixing said apparatus comprising: a first portion of the stomach wall is secured to a first portion of the device, and a second portion of the device to the stomach wall a second fixing portion. 固定所述装置的第一和第二部分的步骤包括步骤:利用胃至胃的缝合线或订合线来套叠第一和第二部分。 First step and the second portion of the fixing of the device comprising the steps of: with stomach to stomach sutures or staplers to telescoping first and second portions.

21[0109] 根据一个实施例,该方法包括另外的步骤:将适于拉伸胃壁的一部分的第二装置放置为与胃接触,将该第二装置固定到胃壁,利用第一装置拉伸胃壁的第一部分,并利用第二装置拉伸胃壁的第二部分。 21 [0109] According to one embodiment, the method comprises the additional steps of: a second device adapted to stretch a portion of the stomach wall placed in contact with the stomach, the second means is fixed to the stomach wall, stretching the stomach wall using the first device a first portion and a second portion using the second means stretch the stomach wall.

[0110] 根据一个实施例,第二部分的拉伸包括步骤:利用预定延时,延时拉伸第二部分。 [0110] According to one embodiment, the second portion of the drawing comprises the steps of: utilizing a predetermined delay, delay stretching the second portion.

[0111] 根据任意实施例的方法可进一步包括步骤:将胃镜插入病人的胃中,推动胃壁的一部分以在胃的外部制备囊,将所述装置插入该囊,放置在胃壁的内部,在将所述装置插入所述囊之前或之后缝合或订合以将该装置封闭在囊中。 [0111] The method according to any of the embodiments may further comprise the steps of: gastroscope into the patient's stomach to promote gastric wall in the external part of the preparation of the stomach pouch, inserting the device into the bladder, is placed inside of the stomach wall, in the The device is inserted into the bladder before or after suturing or stapling to the device enclosed in a bag.

[0112] 根据一个实施例,该方法进一步包括步骤:将胃镜插入病人的胃中,拉动胃壁的一部分以在胃的内部制备囊,在胃壁中形成到达所述囊的孔,将所述装置通过胃壁中的所述孔插入所述囊,在将所述装置通过所述孔插入之前或之后缝合或订合所述囊。 [0112] According to one embodiment, the method further comprising the steps of: gastroscope into the patient's stomach, pulling a portion of the interior of the stomach wall to the stomach balloon prepared in the capsule reaches the stomach wall hole is formed, the means by The hole in the stomach wall is inserted into the bladder, prior to insertion of the device through the hole or after suturing or stapling the pouch.

[0113] 该方法可进一步包括步骤:将传输构件从所述装置放置到控制单元,所述传输构件可为流体传输构件和/或适于传输电动力的构件。 [0113] The method may further comprise the steps of: placing the transfer member from the device to the control unit, the transmission member may be fluid transfer member and / or suitable for electric power transmission member is.

[0114] 该方法可进一步包括步骤:放置控制单元,该控制单元可被放置在病人皮下。 [0114] The method may further comprise the steps of: placing the control unit, the control unit can be placed in the patient skin.

[0115] 根据一个实施例,将传输构件从所述装置放置到控制单元的步骤包括步骤:在病人的腹部切割开口,将所述传输构件连接到所述控制单元,将所述控制单元插入病人皮肤中的开口,以及将所述控制单元固定在皮下。 [0115] According to one embodiment, the step of placing the transmission member from the device to the control unit comprises the steps of: cutting an opening in the patient's abdomen, the transfer member is connected to said control unit, said control unit into a patient an opening in the skin, and the control unit is fixed in the skin.

[0116] 根据一个实施例,该方法进一步包括将传输构件从所述装置放置到控制单元的步骤包括步骤:在病人的腹部切割开口,将所述传输构件连接到所述控制单元,将所述控制单元插入病人皮肤中的开口,以被放置在腹腔中。 [0116] one embodiment, the method further comprises placing the transfer member from the device to the control unit includes a step in accordance with the steps: the cutting opening in the patient's abdomen, the transfer member is connected to the control unit, the control unit is inserted in the skin of the patient opening to be placed in the abdominal cavity. 放置控制单元的步骤包括步骤:将所述控制单元固定到腹壁。 Step of placing the control unit comprises the steps of: the control unit is fixed to the abdominal wall.

[0117] 拉伸 [0117] stretch

[0118] 根据任意实施例的方法的一个实施例,该方法包括另外的步骤:术后且非侵入性地调整装置以拉伸胃壁的一部分,从而影响病人的胃口。 [0118] In accordance with one embodiment of the method of any of the embodiments, the method includes the additional step of: postoperatively and non-invasively regulating the device to stretch a part of the stomach wall, thus affecting the patient's appetite.

[0119] 术后且非侵入性地调整装置以拉伸胃壁的一部分的步骤包括步骤:增大胃壁的第一部分与胃壁的第二部分之间的距离。 [0119] postoperatively and non-invasively regulating the device to stretch the stomach wall portion step comprises the step of: increasing the distance between the second portion and the first portion of the stomach wall between the stomach wall.

[0120] 根据一个实施例,调整装置的步骤从病人身体外部执行,而根据其他实施例,该方法的调整装置的步骤包括通过可植入控制单元从病人内部调整装置。 [0120] According to one embodiment of the step, performed from the adjusting means outside the patient's body, whereas according to other embodiments, the steps of the method of adjusting means comprises an implantable control unit by adjusting means from inside the patient.

[0121] 根据一个实施例,调整装置的步骤包括时常地调整不同装置,以在第一时间拉伸胃壁的第一部分,在第二时间拉伸胃壁的第二部分。 [0121] According to one embodiment, the step of adjusting means comprises means different from time to time to adjust to the stomach wall at a first time stretch a first portion, a second time stretch a second portion of the stomach wall.

[0122] 根据一个实施例,该方法包括将两个或更多个装置放置为与胃接触,并时常地调整不同装置以拉伸胃壁的一部分。 [0122] According to one embodiment, the method comprises two or more devices placed in contact with the stomach, and often adjust different device to stretch a portion of the stomach wall.

[0123] 手动 [0123] Manual

[0124] 将装置放置为与胃接触的步骤可包括:将适于具有可变容积的装置放置为与胃接触,所述容积可通过至少一个可移动壁部分呢变化,所述至少一个可移动壁部分相应地可为至少一个弹性壁部分。 [0124] The device is placed in contact with the stomach step may comprise: with the variable volume means adapted to be placed in contact with the stomach, the volume through the at least one movable wall part of it changes, said at least one movable Accordingly, wall portions may be at least one elastic wall portion.

[0125] 根据任意实施例的装置可具有大致圆形或者蛋形。 [0125] The apparatus according to any of the embodiments may have a generally circular or oval.

[0126] 该装置可进一步包括皮下开关,且该方法可进一步包括按压所述开关并以便手动且非侵入性地调整该装置。 [0126] The apparatus may further include a subcutaneous switch, and the method may further comprise pressing the switch for manually and non-invasively and adjusting the apparatus.

[0127] 根据一个实施例,调整装置的步骤包括将流体从贮存器移动到装置的步骤。 [0127] According to one embodiment of the step, the adjustment means comprises a fluid moving from the reservoir means to the step. [0128] 根据一个实施例,该装置可包括泵,且该方法可包括步骤:将流体从贮存器泵浦到该装置以拉伸胃壁。 [0128] According to one embodiment, the apparatus may include a pump, and the method may include the steps of: pumping fluid from the reservoir to the device to stretch the stomach wall.

[0129] 将流体从贮存器移动到该装置的步骤包括移动贮存器的壁部分的步骤。 Step [0129] The moving fluid from the reservoir to the device comprises the step of moving a wall portion of the reservoir.

[0130] 调整装置的步骤可包括步骤:手动按压贮存器,其可被放置在皮下或腹部中。 [0130] Step adjusting means may comprise the steps of: manually pressing the reservoir, which may be placed subcutaneously or in the abdomen.

[0131] 机械 [0131] machinery

[0132] 根据一个实施例,增大胃壁的第一部分与胃壁的第二部分之间的距离包括将流体移动到具有可变容积的室中的步骤。 [0132] comprising a fluid chamber having a variable volume is moved to the step according to a distance between the second portion of one embodiment, a first portion of the stomach to increase the stomach wall.

[0133] 自动化 [0133] Automation

[0134] 根据一个实施例,将装置放置为与胃接触的步骤包括将适于具有可变容积的装置放置为与胃接触。 [0134] According to one embodiment, the step of placing the device in contact with the stomach comprises means adapted to have a variable volume is placed in contact with the stomach.

[0135] 该可适于具有可变容积的装置包括至少一个可移动壁部分,其可包括至少一个弹性壁部。 [0135] The apparatus may be adapted to have a variable volume comprising at least one movable wall part, which may comprise at least one elastic wall portion.

[0136] 该装置可具有大致圆形或大致蛋形形状。 [0136] The device may have a generally circular or substantially egg-shape.

[0137] 该装置可进一步包括皮下开关,且该方法可进一步包括按压所述开关以非侵入性地调整该装置。 [0137] The apparatus may further include a subcutaneous switch, and the method may further comprise pressing the switch for non-invasively regulating the device.

[0138] 调整装置的步骤可包括将流体从贮存器移动到该装置的步骤,这相应地可包括步骤:操作泵浦装置,该泵浦装置将流体从贮存器移动到所述装置,且所述装置容积膨胀并由此拉伸胃壁的一部分。 Step [0138] The adjustment means may include a fluid moving from the reservoir to the step of the apparatus, which in turn may comprise the steps of: operating a pumping device, the pumping device moving the fluid from the reservoir to the device, and the said means of volumetric expansion and thereby stretching the portion of the stomach wall.

[0139] 该方法可进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0139] The method may further comprise the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0140] 根据一个实施例,该方法可包括步骤:利用可植入传感器传感变量,解译该传感到的变量,并利用该解译的变量控制所述装置。 [0140] According to one embodiment, the method may include the steps of: sensing variable implantable sensor, interpreting the feeling of the variable transmission, and use of the interpretation of the variable control of the device.

[0141] 根据另一实施例,控制所述装置的步骤包括步骤:操作泵浦装置,以将流体从贮存器移动到所述装置,且所述装置容积膨胀并由此拉伸胃壁的一部分。 [0141] comprising the steps of another embodiment according to the procedure, the control means: operation of the pumping means to move the fluid from the reservoir to the device, and the expansion volume and thereby stretching means part of the stomach wall.

[0142] 根据一个实施例,该方法包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0142] According to one embodiment, the method comprises the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0143] 传感变量的步骤可包括步骤:传感与病人的食物摄入相关的变量,该步骤可包括步骤:传感与病人的食物摄入相关的变量造成胃部的拉伸增加,并由此使病人的饱胀感增加。 Step [0143] The sensor may include variables steps of: sensing the variables associated with the patient's food intake, this step may comprise the steps of: sensing the patient's food intake associated variables caused by increased stomach stretching, and thereby increasing the patient's sense of fullness.

[0144] 机械 [0144] machinery

[0145] 根据一个实施例,增大胃壁的第一部分与胃壁的第二部分之间的距离的步骤包括将流体移动到具有可变容积的室中的步骤。 [0145] According to step a distance between the second portion of the one embodiment, a first portion of the stomach to increase the stomach wall comprises the step of moving fluid into a chamber having a variable volume of.

[0146] 该方法可进一步包括步骤:将流体从贮存器移动到具有可变容积的室。 [0146] The method may further comprise the steps of: moving a fluid from a reservoir having a variable volume chamber. 将流体从贮存器移动到所述装置的步骤可包括步骤:操作泵浦装置,该泵浦装置将流体从贮存器移动到所述装置,且所述装置容积膨胀并由此拉伸胃壁的一部分。 The step of moving fluid from the reservoir to the device may comprise the steps of: operating a pumping device, the pumping device moving the fluid from the reservoir to the apparatus and the apparatus volume expansion and thereby stretching the stomach wall portion .

[0147] 根据一个实施例,操作泵浦装置的步骤包括利用无线远程控制器操作泵浦装置的步骤。 [0147] According to step one embodiment, the operation of the pump apparatus embodiment comprises the step pumping operation using a wireless remote control device.

[0148] 根据一个实施例,该方法进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0148] According to one embodiment, the method further comprising the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0149] 根据一个实施例,增大胃壁的第一部分与胃壁的第二部分之间的距离包括步骤:操作马达,该马达适于增大胃壁的第一部分与胃壁的第二部分之间的距离,由此拉伸胃壁的一部分。 The distance between the second part of the operation of the motor, the motor is adapted to increase the first portion of the stomach wall and the stomach wall: [0149] according to a distance between the second portion of one embodiment, a first portion of the stomach to increase the stomach wall comprises the step of thereby stretching the portion of the stomach wall. 操作马达可包括利用无线远程控制器操作马达的步骤。 Operating a motor may include a step using a wireless remote control operation of the motor.

[0150] 根据一个实施例,该方法进一步包括步骤:利用可植入传感器传感变量,解译该传感到的变量,并利用该解译的变量控制所述装置。 [0150] According to one embodiment, the method further comprises the steps of: the use of an implantable sensor sensing variable was variable interpret the transfer, and use of the interpretation of the variable control of the device.

[0151] 根据一个实施例,该方法包括步骤:操作泵浦装置,该泵浦装置将流体从贮存器移动到室,且所述室被流体填充以增大胃壁的第一部分与胃壁的第二部分之间的距离,由此拉伸胃壁的一部分。 [0151] According to one embodiment, the method comprises the steps of: operating a second pump means, the fluid pumping means is moved from the reservoir to the chamber, and the chamber is filled with fluid to increase the first portion of the stomach wall and the stomach wall the distance between the parts, thereby stretching the stomach wall portion.

[0152] 根据一个实施例,该方法进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0152] According to one embodiment, the method further comprising the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0153] 根据一个实施例,传感变量的步骤包括传感与病人的食物摄入相关的变量的步 [0153] intake related variables as step one embodiment, the sensor includes a sensing variable implementation of step with the patient's food

马聚ο Horse poly ο

[0154] 根据一个实施例,该方法进一步包括步骤:利用可植入传感器传感变量,解译该传感到的变量,并利用该解译的变量控制所述装置。 [0154] According to one embodiment, the method further comprises the steps of: the use of an implantable sensor sensing variable was variable interpret the transfer, and use of the interpretation of the variable control of the device. 传感变量的步骤可包括传感与病人的食物摄入相关的变量的步骤。 Sensing a variable step may include the step of sensing the variables associated with the patient's food intake.

[0155] 增大胃壁的第一部分与胃壁的第二部分之间的距离可包括步骤:操作机械装置, 该机械装置适于增大胃壁的第一部分与胃壁的第二部分之间的距离,由此拉伸胃壁的一部分。 From [0155] the second portion of the stomach wall increases between the first portion and the stomach wall may comprise the steps of: operating the mechanical means, the mechanical means is adapted to increase the distance between the second portion of the stomach wall and the stomach wall between the first portion by This part of the stomach wall stretch.

[0156] 根据一个实施例,该装置包括机械构件,其适于移动以拉伸位于胃壁的第一与第二部分之间的胃壁的部分。 [0156] According to one embodiment, the apparatus includes a mechanical member, which is adapted to move to stretch the stomach wall portion between the first and second portions of the stomach wall located. 该机械构件可利用马达移动以拉伸胃壁的一部分。 The mechanical member may be moved by a motor to draw a portion of the stomach wall.

[0157] 根据一个实施例,拉伸胃壁的一部分的步骤包括步骤:操作至少一个机械装置以拉伸胃壁的一部分。 [0157] According to one embodiment, the step of stretching the stomach wall portion comprising the steps of: operating at least one mechanical device for stretching a portion of the stomach wall.

[0158] 根据一个实施例,该方法包括步骤:利用胃至胃的缝合线将机械装置套叠在胃壁中。 [0158] According to one embodiment, the method comprises the steps of: with stomach to stomach sutures mechanism nested in the stomach wall.

[0159] 根据一个实施例,该方法包括步骤:使套叠的胃壁中的机械装置膨胀以拉伸胃壁。 [0159] According to one embodiment, the method comprises the steps of: making nested stomach mechanical means inflated to stretch the stomach wall.

[0160] 根据一个实施例,该方法包括使胃壁膨胀的马达,根据另一实施例,该方法包括使胃壁膨胀的记忆金属。 [0160] According to one embodiment, the method comprises a motor expanded stomach wall, according to another embodiment, the method comprises the stomach wall expanded memory metal.

[0161] 根据另一实施例,该方法包括使胃壁膨胀的液压控制的机械装置。 [0161] According to another embodiment, the method comprises expanding the stomach wall of the hydraulic control mechanism.

[0162] 放置 [0162] placement

[0163] 根据一个实施例,放置装置的步骤包括将装置放置为在胃壁的外部与胃壁相连, 这可包括将所述装置放置在病人的胃基底壁中的步骤。 [0163] According to one embodiment, the step of placing means comprises means positioned externally connected to the stomach wall with stomach, which may include the step of placing the device in the patient's stomach fundus wall.

[0164] 放置装置的步骤可包括将装置放置为在胃壁的内部与胃壁相连,这可包括将所述装置放置在病人的胃基底壁中的步骤。 Step [0164] placement apparatus may comprise means positioned in the stomach connected to the interior of the stomach, which may include placing the device in the patient's stomach fundus wall of the step.

[0165] 固定 [0165] Fixed

[0166] 固定至少一个装置的步骤包括将所述至少一个装置缝合或订合到胃壁。 [0166] the step of fixing at least one device comprises at least one means suturing or stapling the stomach wall.

[0167] 固定至少一个装置的步骤可包括利用胃至胃的缝合线或订合线套叠在胃壁中,在其他实施例中,固定至少一个装置的步骤包括借助于纤维组织放置适于被固定到胃壁的网。 [0167] step may include stomach to stomach sutures or staplers step line nested in the stomach wall, in other embodiments, the fixing device comprises at least one place fixed by means of fibrous tissue at least one device adapted to be fixed network to the stomach wall.

[0168] 该网可另外地由缝合线或订合线支撑,并可包括适于促进人体组织生长的结构, 例如网状结构。 [0168] The network may additionally by a suture or stapling line support, and may include adapted to facilitate the growth of human tissue structure, such as a mesh structure.

24[0169] 提供一种另外的方法,该方法包括步骤:在胃壁中形成孔;借助于器械将拉伸装置引入胃;移动所述装置通过所述孔并将其放置在胃壁的外部;在胃腔的内部形成胃壁的一部分的囊,其中所述装置被放置为抵靠胃壁的外部;将所述装置套叠在胃壁的囊中;以及优选利用缝合线或订合线密封所述孔。 24 [0169] to provide a further method, the method comprising the steps of: forming a hole in the stomach wall; means of the stretching device into the stomach instrument; mobile device through the hole and place it on the outside of the stomach wall; in gastric cavity formed inside the stomach of the balloon portion, wherein said apparatus is placed against the outside of the stomach wall; means invaginated in the stomach wall of the bag; and preferably with sutures or staplers seal the hole line.

[0170] 提供一种另外的方法,该方法包括步骤:在胃壁中形成孔;借助于器械在胃腔的内部形成胃壁的一部分的囊;借助于所述器械将所述装置引入胃;移动所述装置通过所述孔并将其放置在胃壁的外部;借助于所述器械将所述装置引入所述囊;将所述装置套叠到胃壁;以及优选利用缝合线或订合线密封所述孔。 [0170] provide a further method, the method comprising the steps of: forming a hole in the stomach wall; means devices inside the gastric cavity pouch forming part of the stomach wall; the instrument by means of the device into the stomach; movement said apparatus through the aperture and placed on the outside of the stomach wall; the instrument by means of the device into the bladder; the device to the stomach wall invaginated; and preferably with sutures or staplers seal the hole.

[0171] 根据一个实施例,该方法进一步包括提供用于从病人身体外部调整拉伸装置的装置;以及操作所述装置来调整所述装置。 [0171] According to one embodiment, the method further comprises providing means for adjusting from outside the patient's body stretching device; and means for adjusting the operation of said apparatus.

[0172] 根据另一实施例,该方法进一步包括步骤:切割病人的皮肤,将管插入病人的腹腔,将所述管连接到容积填充装置,用通过所述管注入的流体填充所述装置。 [0172] According to another embodiment, the method further comprising the steps of: cutting the skin of the patient, the tube is inserted into the patient's abdominal cavity, the volume of the tube is connected to a filling means for injecting a fluid through the tube of the filling means.

[0173] 根据另一实施例,该方法进一步包括步骤:皮下放置注入端口,并将所述管连接到所述注入端口。 [0173] According to another embodiment, the method further comprising the steps of: placing subcutaneous injection port, and the tube is connected to the injection port.

[0174] 根据另一实施例,该方法进一步包括步骤:提供通过所述孔连接到拉伸装置并进一步到达腹壁或穿过腹壁的管。 [0174] According to another embodiment, the method further comprising the steps of: providing connection to the stretching device through the hole and further reaches the abdominal wall or through the abdominal wall of the tube.

[0175] 根据另一实施例,该方法进一步包括步骤:切割病人的皮肤,从病人的连接到拉伸装置的腹腔接纳所述管,以及用通过所述管注入的流体填充所述装置。 [0175] According to another embodiment, the method further comprising the steps of: cutting the skin of the patient, the connection from the patient's peritoneal cavity to receive the tube stretching device, and filling the device with fluid injected through the tube.

[0176] 根据另一实施例,该方法进一步包括步骤:皮下放置注入端口,并将所述管连接到所述注入端口。 [0176] According to another embodiment, the method further comprising the steps of: placing subcutaneous injection port, and the tube is connected to the injection port.

[0177] 器械 [0177] Devices

[0178] 进一步提供一种用于将适于拉伸病人的胃壁的一部分的装置放置为与胃壁相连的器械。 [0178] Further there is provided a device for stretching a portion of the patient's stomach wall is adapted to be placed with the stomach wall is connected to the instrument. 该器械包括:适于可释放地保持所述装置的保持构件、适于将所述装置插入通过胃壁的插入构件以及适于帮助将所述装置固定到胃壁外部的固定构件。 The device comprises: adapted for releasably holding the holding member of the apparatus, the apparatus is adapted to insert the fixing member is fixed to the stomach wall outside the stomach wall by means of the insertion member and adapted to assist.

[0179] 所述器械可进一步包括用于在胃壁中切割孔的切割构件、用于观察胃的区域的光学构件。 [0179] The device may further comprise a cutting member for cutting a hole in the stomach wall, an optical member for observation of the stomach area. 固定装置可适于将所述装置缝合到胃壁在其内部,或者用于将所述装置订合到胃壁在其内部,或者用于利用胃至胃的缝合线将所述装置的至少一部分套叠在胃壁中在其内部,或者用于利用胃至胃的订合线将所述装置的至少一部分套叠在胃壁中在其内部,然而, 器械可适于从其外部执行所述方法。 Fixture means may be adapted to be sutured to the stomach wall inside thereof, or for stapling the device to the stomach wall inside thereof, or for the use of at least a portion of the stomach to stomach sutures sets said stack means The method is performed outside in the stomach wall in its interior, or for the use of the stomach-to-stomach stapling line at least a portion of the device nesting in the stomach wall in its interior, however, the instrument can be adapted from.

[0180] 器械可进一步包括专门的保持装置,其可包括适于利用真空或利用机械保持构件保持胃的专门的保持装置。 [0180] device may further comprise a special holding device, which may comprise a special holding device adapted to use a vacuum or using mechanical holding member holding the stomach.

[0181] 提供一种利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的手术或腹腔镜方法。 [0181] provide a suitable portion of the stomach wall of the patient drawing device utilized to treat patients for obesity surgery or laparoscopic methods. 该方法包括步骤:在病人的腹壁中切割孔,切除围绕所述胃的一区域,将所述装置放置为与所述胃接触,以及直接或间接通过所述胃壁的套叠将所述装置固定到所述胃壁,使得所述装置能够拉伸所述胃壁的一部分。 The method comprises the steps of: cutting a hole in the patient's abdominal wall, the removal of an area around the stomach, placing the device in contact with the stomach, and directly or indirectly through the invaginated stomach wall to the fixing means to the stomach wall, so that the device is capable of stretching a portion of the stomach wall.

[0182] 根据一个实施例,固定所述装置的步骤包括步骤:将所述装置的第一部分固定到所述胃壁的第一部分,以及将所述装置的第二部分固定到所述胃壁的第二部分,其中所述装置的第一和第二部分被固定,使得所述装置适于拉伸所述胃壁的在该胃壁的第一和第二部分之间的一部分。 [0182] According to step one embodiment, embodiment the fixing means comprises the steps of: stomach wall is secured to the first portion of the first portion of the device, and a second portion of the stomach wall means secured to said second portion, wherein said first and second portions of the means is fixed, such that said means adapted to stretch the stomach wall portion between the first and the second part of the stomach wall.

25[0183] 根据另一实施例,所述装置为第一装置,所述方法包括另外的步骤:通过所述胃壁的套叠直接或间接地固定与所述胃接触的适于拉伸所述胃壁的一部分的第二装置,将所述第二装置固定到所述胃壁,利用所述第一装置拉伸所述胃壁的第一部分,以及利用所述第二装置拉伸所述胃壁的第二部分。 25 [0183] According to another embodiment, the means for the first device, the method comprising the additional steps of: overlapping fixed directly or indirectly through the stomach wall of the sleeve and adapted to stretch the stomach in contact The second part of the stomach wall means, said second means secured to the stomach wall by means of the first stretch of the first portion of the stomach wall, and said second means utilizing a second stretching the stomach wall section.

[0184] 根据另一实施例,该方法包括另外的步骤:术后且非侵入性地调整装置,以拉伸胃壁的一部分,从而影响病人的胃口。 [0184] According to another embodiment, the method comprises the additional step of: postoperatively and non-invasively regulating the device to stretch a part of the stomach wall, thus affecting the patient's appetite.

[0185] 提供一种利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的手术或腹腔镜方法。 [0185] provide a suitable portion of the stomach wall of the patient drawing device utilized to treat patients for obesity surgery or laparoscopic methods.

[0186] 该方法包括步骤:将针或管状器械插入病人身体的腹部,利用所述针或管状器械向病人的身体填充气体,将至少两个腹腔镜套针放置在病人身体中,将照相机通过所述腹腔镜套针之一插入病人身体,将至少一个切除工具通过所述至少两个腹腔镜套针之一插入,切除所述胃的一区域,将装置引入腹腔,将所述装置放置在所述胃壁的外部,接合所述胃壁。 [0186] The method comprises the steps of: inserting a needle or tube like instrument body of a patient's abdomen, the use of a needle or tube like instrument to fill the gas into the patient's body, at least two laparoscopic trocars in the patient's body is placed in, through the camera one of the laparoscopic trocars into the patient body, at least one dissecting tool through one of the at least two laparoscopic trocar is inserted, the removal of a region of the stomach, the device into the abdominal cavity, placing the device in a outside of the stomach wall, engaging the stomach wall.

[0187] 根据另一实施例,该方法包括:术后且非侵入性地调整装置以拉伸胃壁的一部分的步骤包括增大胃壁的第一部分与胃壁的第二部分之间的距离的步骤。 [0187] According to another embodiment, the method comprising: non-invasively and after adjusting means for stretching the stomach wall portion step comprises the step of increasing the distance between the second portion and the first portion of the stomach wall between the stomach wall.

[0188] 根据另一实施例,调整装置的步骤从病人的身体外部执行。 [0188] executed from outside the patient's body according to another embodiment of the step, adjusting means.

[0189] 根据另一实施例,调整装置的步骤包括时常地调整不同装置,以在第一时间拉伸胃壁的第一部分,在第二时间拉伸胃壁的第二部分。 [0189] Oftentimes comprising adjusting means according to the different steps of another embodiment, adjusting means, to stretch the stomach wall at a first time a first portion, a second time stretch a second portion of the stomach wall.

[0190] 根据另一实施例,该方法包括将两个或更多个装置放置为与胃接触,并时常地调整不同装置以拉伸胃壁的一部分。 [0190] According to another embodiment, the method comprises two or more devices placed in contact with the stomach, and often adjust different device to stretch a portion of the stomach wall. 固定所述装置的第一和第二部分的步骤可进一步包括利用胃至胃的缝合线或订合线来套叠第一和第二部分的步骤。 First step and the second portion of the fixing of the device may further include stomach to stomach sutures or to overlay the first and second part of step staplers.

[0191] 根据另一实施例,该装置进一步包括可植入控制单元,其中调整装置的方法步骤包括通过所述可植入控制单元从身体内部调整装置。 [0191] According to another embodiment, the apparatus further comprises an implantable control unit, wherein the method step of adjusting means comprises an implantable control unit by the adjusting device from inside the body.

[0192] 根据另一实施例,第二部分的拉伸包括步骤:利用预定延时,延时拉伸第二部分。 [0192] According to another embodiment, the second portion of the drawing comprises the steps of: utilizing a predetermined delay, delay stretching the second portion.

[0193] 手动 [0193] Manual

[0194] 根据另一实施例,将装置放置为与胃接触的步骤包括:将适于具有可变容积的装置放置为与胃接触,其可利用至少一个可移动壁部分调整,至少一个可移动壁部分相应地可为弹性壁部分。 [0194] According to another embodiment, the device is placed in contact with the stomach steps comprising: means having a variable volume adapted to be placed in contact with the stomach, which can be used at least one movable wall part of the adjustment, the at least one movable Accordingly, wall portions may be elastic wall portion. 该装置可具有大致圆形或蛋形形状。 The device may have a generally circular or egg-shape.

[0195] 根据另一实施例,该装置可进一步包括皮下开关,且该方法可进一步包括按压所述开关以便手动并非侵入性地调整该装置。 [0195] According to another embodiment, the apparatus may further include a subcutaneous switch, and the method may further comprise pressing the switch for manually not invasively regulating the device. 调整装置可包括将流体从贮存器移动到所述装置的步骤。 Adjusting means may comprise a fluid moving from the reservoir means to said step.

[0196] 根据另一实施例,该装置可包括泵,且该方法可进一步包括将流体从贮存器泵浦到该装置以拉伸胃壁的步骤。 [0196] According to another embodiment, the apparatus may include a pump, and the method may further comprise pumping fluid from the reservoir to the device to stretch the stomach wall step.

[0197] 根据另一实施例,将流体从贮存器移动到该装置的步骤包括移动贮存器的壁部分的步骤,这可通过手动按压贮存器的步骤完成。 [0197] According to another embodiment, the fluid moving from the reservoir to the device step comprises the step of moving a wall portion of the reservoir, which can be done by manually pressing the reservoir steps.

[0198] 根据任意实施例,贮存器可被放置在皮下或腹部。 [0198] According to any embodiment, the reservoir may be placed subcutaneously or in the abdomen.

[0199] 机械 [0199] machinery

[0200] 根据另一实施例,增大胃壁的第一部分与胃壁的第二部分之间的距离的步骤包括将流体移动到具有可变容积的室中的步骤。 [0200] According to step a distance between the second portion of another embodiment, increasing the portion of the stomach wall and the stomach wall comprises a first fluid chamber having a variable volume is moved to the step. [0201] 自动化 [0201] Automation

[0202] 根据另一实施例,将装置放置为与胃接触的步骤包括将适于具有可变容积的装置放置为与胃接触。 [0202] According to another embodiment, the device is placed in contact with the stomach to step includes a variable volume means adapted to have placed in contact with the stomach.

[0203] 该适于具有可变容积的装置可包括至少一个可移动壁部分,其相应地可为弹性壁部分。 [0203] The apparatus is adapted to have a variable volume could comprise at least one movable wall part, which in turn may be elastic wall portion.

[0204] 根据任意实施例的装置可包括皮下开关,该方法可进一步包括按压所述开关以非侵入性地调整所述装置。 [0204] The device according to any of the embodiments may include a subcutaneous switch, the method may further comprise pressing the switch for non-invasively regulating the device.

[0205] 根据另一实施例,调整装置的步骤包括将流体从贮存器移动到装置的步骤。 [0205] According to another embodiment of the step, the adjustment means comprises a fluid moving from the reservoir means to the step. 将流体从贮存器移动到所述装置的步骤可包括步骤:操作泵浦装置,以将流体从贮存器移动到所述装置,且所述装置容积膨胀并由此拉伸胃壁的一部分。 Said step of moving fluid from the means to the reservoir may comprise the steps of: operating a pumping means to move the fluid from the reservoir to the device, and the expansion volume and thereby stretching means part of the stomach wall.

[0206] 根据另一实施例,该方法进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0206] According to another embodiment, the method further comprising the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0207] 根据另一实施例,该方法进一步包括步骤:利用可植入传感器传感变量,解译该传感到的变量,并利用该解译的变量控制所述装置。 [0207] According to another embodiment, the method further comprises the steps of: the use of an implantable sensor sensing variable was variable interpret the transfer, and use of the interpretation of the variable control of the device.

[0208] 根据另一实施例,控制所述装置的步骤包括步骤:操作泵浦装置,以将流体从贮存器移动到所述装置,且所述装置容积膨胀并由此拉伸胃壁的一部分。 [0208] comprising the steps of another embodiment according to the procedure, the control means: operation of the pumping means to move the fluid from the reservoir to the device, and the expansion volume and thereby stretching means part of the stomach wall.

[0209] 根据另一实施例,该方法进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0209] According to another embodiment, the method further comprising the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0210] 传感变量的步骤可包括传感与病人的食物摄入相关的变量的步骤,这可导致增加胃部的拉伸,并由此增加病人的饱胀感。 Step [0210] sensing variables may include sensing step with the patient's food intake related variables, which may lead to increased stretching of the stomach, and thereby increase the patient's sense of fullness.

[0211] 机械 [0211] machinery

[0212] 根据另一实施例,增大胃壁的第一部分与胃壁的第二部分之间的距离的步骤可包括将流体移动到具有可变容积的室中的步骤。 [0212] According to step a distance between the second portion of another embodiment, a first portion of the stomach is increased stomach wall may include a fluid chamber having a variable volume is moved to the step.

[0213] 根据另一实施例,将流体移动到室中的步骤包括将流体从贮存器移动到具有可变容积的室中的步骤。 [0213] According to another embodiment, the fluid moving into the chamber comprises moving the fluid from the reservoir to the chamber having a variable volume steps.

[0214] 根据另一实施例,将流体从贮存器移动到所述装置的步骤包括步骤:操作泵浦装置,该泵浦装置将流体从贮存器移动到所述装置,且所述装置容积膨胀并由此拉伸胃壁的一部分。 The step of the device [0214] According to another embodiment, the fluid moving from the reservoir to include the steps of: operating a pumping device, the pumping device moving the fluid from the reservoir to the device, and the volume expansion means and thereby stretching the portion of the stomach wall.

[0215] 根据另一实施例,操作泵浦装置的步骤包括利用无线远程控制器操作泵浦装置的步骤。 [0215] According to the procedure of Example, the operation of the pump apparatus according to another embodiment comprises using a wireless remote control of the operation of the pumping means step.

[0216] 根据另一实施例,该方法进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0216] According to another embodiment, the method further comprising the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0217] 根据另一实施例,增大胃壁的第一部分与胃壁的第二部分之间的距离的步骤包括步骤:操作适于增大胃壁的第一部分与胃壁的第二部分之间的距离的马达,由此拉伸胃壁的一部分。 [0217] According to a further embodiment, the step of increasing the distance between the first portion of the stomach wall and the stomach wall between the second portion comprises the steps of: operating a first portion adapted to increase the distance between the stomach wall and the stomach wall portion between the second motor, thereby stretching the stomach wall portion.

[0218] 操作马达的步骤可包括利用无线远程控制器操作马达的步骤。 Step [0218] operation of the motor may include a step using a wireless remote control operation of the motor.

[0219] 根据另一实施例,该方法可进一步包括步骤:利用可植入传感器传感变量,解译该传感到的变量,并利用该解译的变量控制所述装置。 [0219] According to another embodiment, the method may further comprise the steps of: the use of an implantable sensor sensing variable was variable interpret the transfer, and use of the interpretation of the variable control of the device.

[0220] 根据另一实施例,控制所述装置的步骤可包括步骤:操作泵浦装置,以将流体从 Step [0220] According to another embodiment, the control means may comprise the steps of: operating a pumping means for fluid from

27贮存器移动到室,且所述室被流体填充以增大胃壁的第一部分与胃壁的第二部分之间的距离,由此拉伸胃壁的一部分。 27 is moved to the reservoir chamber, and the chamber is filled with fluid to increase the distance between the second portion and the first portion of the stomach wall between the stomach wall, thereby stretching a portion of the stomach wall.

[0221] 根据另一实施例,该方法进一步包括步骤:流体从所述装置流回贮存器,由此释放胃壁的拉伸。 [0221] According to another embodiment, the method further comprising the steps of: flowing back fluid from said reservoir means, thereby releasing the stretching of the stomach wall.

[0222] 根据另一实施例,传感变量的步骤包括传感与病人的食物摄入相关的变量的步 [0222] According to another embodiment, the sensing step comprises sensing a variable with the patient's food intake step associated variables

马聚ο Horse poly ο

[0223] 根据另一实施例,该方法进一步包括步骤:利用可植入传感器传感变量,解译该传感到的变量,并利用该解译的变量控制所述装置。 [0223] According to another embodiment, the method further comprises the steps of: the use of an implantable sensor sensing variable was variable interpret the transfer, and use of the interpretation of the variable control of the device. 传感变量的步骤可包括传感与病人的食物摄入相关的变量的步骤。 Sensing a variable step may include the step of sensing the variables associated with the patient's food intake. 增大胃壁的第一部分与胃壁的第二部分之间的距离可包括步骤:操作机械装置,该机械装置适于增大胃壁的第一部分与胃壁的第二部分之间的距离,由此拉伸胃壁的一部分。 Increasing the distance between the second portion of the first portion of the stomach wall and the stomach wall may comprise the steps of: operating the mechanical means, the mechanical means is adapted to increase the distance between the second portion and the first portion of the stomach wall between the stomach wall, thereby stretching part of the stomach wall. 装置的第一和第二部分可包括机械构件,其适于移动以拉伸胃壁的在胃壁的第一和第二部分之间的部分。 The first and second part of the device may comprise a mechanical member, which is adapted to move to stretch the stomach wall portion between the first and second portions of the stomach wall.

[0224] 根据另一实施例,该方法包括马达,其中所述机械构件利用马达移动以拉伸胃壁的一部分。 [0224] According to another embodiment, the method comprises a motor, wherein the mechanical member is moved by a motor to draw a portion of the stomach wall.

[0225] 根据另一实施例,拉伸胃壁的一部分的步骤包括步骤:操作至少一个机械装置以拉伸胃壁的一部分。 [0225] According to another embodiment, the step of stretching the stomach wall portion comprising the steps of: operating the at least one part of the mechanical device to stretch the stomach wall.

[0226] 根据另一实施例,将机械装置套叠在胃壁中的步骤包括利用胃至胃的缝合线套叠。 [0226] According to another embodiment, the step of mechanical devices nested in the stomach wall, including with stomach to stomach sutures nesting.

[0227] 根据另一实施例,该方法进一步包括步骤:使套叠的胃壁中的机械装置膨胀以拉伸胃壁。 [0227] According to another embodiment, the method further comprises the steps of: telescopic mechanical device expansion of the stomach wall to stretch the stomach wall.

[0228] 根据另一实施例,套叠的机械装置包括使该套叠的机械装置膨胀的马达。 [0228] According to another embodiment, the mechanical device comprises telescopic expansion of the sleeve mechanism motor stack.

[0229] 该装置可进一步包括使胃壁膨胀的记忆金属或液压控制的机械装置。 [0229] The apparatus may further comprise a mechanical means so that the stomach wall expanded memory metal or hydraulically controlled.

[0230] 放置 [0230] placement

[0231] 根据另一实施例,放置装置的步骤包括将装置放置为在胃壁的外部或在胃基底壁中与胃壁相连,或者放置为在胃壁的内部与胃壁相连。 [0231] According to another embodiment, the step of placing means comprises means positioned outside of the stomach wall is connected to the stomach wall or in the stomach fundus wall, or placed in the stomach wall is connected to the interior of the stomach wall.

[0232] 根据另一实施例,将装置放置为在胃壁的内部与胃壁相连可包括步骤:在胃壁中切割孔,以及通过该胃壁中的孔插入所述装置。 [0232] According to another embodiment, the device is placed in the stomach wall can be connected to the interior of the stomach wall comprises the steps of: cutting a hole in the stomach wall and stomach wall through which the device is inserted in the hole.

[0233] 根据另一实施例,放置装置的步骤包括将装置放置在病人的胃基底壁中。 [0233] According to another embodiment, the step of placing means comprises means placed in the patient's stomach fundus wall.

[0234] 固定 [0234] Fixed

[0235] 根据另一实施例,固定至少一个装置的步骤包括:例如通过胃至胃的缝合线或订合线,将至少一个装置缝合或订合到胃壁。 [0235] According to another embodiment, the step of fixing at least one of the devices include: for example, through the stomach to stomach sutures or staplers, at least one device to the stomach wall suturing or stapling.

[0236] 固定至少一个装置的步骤可包括:利用纤维组织放置适于被固定到胃壁的网。 [0236] Step fixing means may comprise at least one of: the use of fibrous tissue adapted to be secured to the stomach wall to place the net. 该网可另外地由缝合线或订合线支撑,并适于促进人体组织生长,例如网状结构。 The network may additionally by a suture or stapling line support, and adapted to promote tissue growth, such as a mesh structure.

[0237] 控制单元 [0237] The control unit

[0238] 根据另一实施例,该方法可包括将传输构件从所述装置放置到控制单元的步骤。 [0238] step further embodiment, the method may include the transfer member is placed from the device to the control unit according to. 传输构件可包括流体传输构件,或者适于传输电力的传输构件。 Transmission member may include a fluid transfer member, or suitable for transmission of electric power transmission member.

[0239] 根据另一实施例,该方法进一步包括步骤:放置控制单元,该控制单元可被放置在病人皮下。 [0239] According to another embodiment, the method further comprising the steps of: placing the control unit, the control unit may be placed subcutaneously in the patient.

[0240] 根据另一实施例,将控制单元放置在皮下的步骤进一步包括步骤:将控制单元插入病人腹部中的孔,以及固定控制单元。 [0240] According to another embodiment, the control unit is placed in the subcutaneous step further comprises the steps of: the control unit into the hole in the abdomen of the patient, and the fixed control unit.

[0241] 还提供一种另外的方法,该方法包括步骤:在胃壁中形成孔;将拉伸装置引入腹部;移动所述装置通过所述孔并将其放置在胃壁的内部;在胃腔的外部形成胃壁的一部分的囊,其中所述装置被放置为抵靠胃壁的内部;将所述装置套叠在胃壁的囊中;以及优选利用缝合线或订合线密封所述孔。 [0241] A further method is also provided, the method comprising the steps of: forming a hole in the stomach wall; the stretching device into the abdomen; mobile device through the hole and place it on the inside of the stomach wall; in the stomach cavity sac formed outside part of the stomach wall, wherein the device is placed against the inside of the stomach wall; the unit nested within the stomach pouch; and preferably with sutures or staplers seal the hole line.

[0242] 根据另一实施例,根据任意实施例的方法可包括步骤:在胃壁中形成孔;移动所述装置通过所述孔并将其放置在胃壁的内部;利用器械将所述装置引入所述囊;以及优选利用缝合线或订合线密封所述孔。 [0242] According to another embodiment, the method according to any of the embodiments may include the steps of: forming a hole in the stomach wall; said moving means through said aperture and disposed in the interior of the stomach wall; the use of the device into the instrument said bag; and preferably with sutures or staplers seal the hole line.

[0243] 根据另一实施例,该方法进一步包括提供用于从病人身体外部调整拉伸装置的装置;以及操作所述装置来调整所述装置。 [0243] According to another embodiment, the method further comprises providing means for adjusting from outside the patient's body stretching device; and means for adjusting the operation of said apparatus.

[0244] 根据另一实施例,该装置包括可植入控制单元,该方法进一步包括步骤:提供用于从病人身体内部调整拉伸装置的可植入控制单元;以及操作所述装置来调整所述装置。 [0244] According to another embodiment, the apparatus comprises an implantable control unit, the method further comprising the steps of: providing adjustment of the stretching device from inside the patient's body for an implantable control unit; and operating the adjustment means said apparatus.

[0245] 该方法可进一步包括步骤:皮下放置注入端口,以及将与所述装置相连的管连接到该注入端口。 [0245] The method may further comprise the steps of: placing subcutaneous injection port, and means connected to said tube is connected to the injection port.

[0246] 根据另一实施例,该方法进一步包括步骤:提供通过所述孔连接到拉伸装置并进一步到达腹壁或穿过腹壁的管。 [0246] According to another embodiment, the method further comprising the steps of: providing connection to the stretching device through the hole and further reaches the abdominal wall or through the abdominal wall of the tube.

[0247] 根据另一实施例,该方法进一步包括步骤:从病人的连接到拉伸装置的腹腔接收所述管,以及用通过所述管注入的流体填充所述装置。 [0247] According to another embodiment, the method further comprises the steps of: connecting from the patient's peritoneal cavity to receive the tube stretching device, and filling the device with fluid injected through the tube.

[0248] 根据另一实施例,该方法可进一步包括步骤:皮下放置注入端口,并将所述管连接到所述注入端口。 [0248] According to another embodiment, the method may further comprise the steps of: placing subcutaneous injection port, and the tube is connected to the injection port.

[0249] 该方法可进一步包括另外的步骤:术后且非侵入性地调整装置,以拉伸胃壁的一部分,从而影响病人的胃口。 [0249] The method may further comprise the additional step of: after and non-invasively regulating the device to stretch the portion of the stomach wall, which affect the patient's appetite.

[0250] 根据另一实施例,该方法包括另外的用流体填充所述装置的步骤。 [0250] According to another embodiment, the method comprises the additional step of filling the device with fluid.

[0251] 根据另一实施例,该方法可包括另外的将内部控制单元放置在病人身体内的步 [0251] According to another embodiment, the method may further comprise the internal control unit is placed in the patient's body Step

马聚ο Horse poly ο

[0252] 根据一个实施例,该方法进一步包括另外的步骤:将内部控制单元连接到所述装置,这通过液压或利用电线来完成。 [0252] According to one embodiment, the method further comprises the additional steps of: the control unit is connected to the internal device, which is accomplished by utilizing a hydraulic or wires.

[0253] 提供一种利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的手术或腹腔镜方法。 [0253] provide a suitable portion of the stomach wall of the patient drawing device utilized to treat patients for obesity surgery or laparoscopic methods. 该方法包括步骤:将针或管状器械插入病人身体的腹部,利用所述针或管状器械向病人的身体填充气体,将至少两个腹腔镜套针放置在病人身体中,将照相机通过所述腹腔镜套针之一插入病人身体,将至少一个切除工具通过所述至少两个腹腔镜套针之一插入,切除所述胃的一区域,将装置引入腹腔,利用胃至胃的缝合线或订合线将所述装置套叠在所述胃壁的外部,以及通过操作装置术后拉伸套叠的胃壁部分。 The method comprises the steps of: inserting a needle or tube like instrument body of the patient's abdomen, using the needle or tube like instrument to fill the gas to the patient's body, at least two laparoscopic trocars in the patient's body is placed in the abdominal cavity through the camera One mirror trocars inserted into the patient's body, at least one dissecting tool through one of the at least two laparoscopic trocar insertion, removal of a region of the stomach, the device into the abdominal cavity, stomach to stomach sutures or staples bonding wire said telescoping means the outside of the stomach wall, and by operating the device after stretching invaginated stomach wall portion.

[0254] 根据另一实施例,该方法包括另外的步骤:将第二或更多个装置引入腹腔,利用胃至胃的缝合线或订合线将所述第二或更多个装置套叠在所述胃壁的外部,以及通过操作所述第二或更多个装置术后拉伸套叠的胃壁部分。 [0254] According to another embodiment, the method includes the additional steps of: a second or more means into the abdominal cavity, stomach to stomach sutures or staplers the second or more device telescoping on the outside of the stomach wall, and stomach stretching nested in part by a second or more after the operation of the device.

[0255] 根据另一实施例,该方法包括另外的步骤:在所述装置的彼此独立的第一或第二或更多个部分处术后拉伸套叠的胃壁部分。 [0255] According to another embodiment, the method includes the additional steps of: in a separate first or second or more portions of the device after each drawing invaginated stomach wall section.

[0256] 提供一种另外的利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的手术或腹腔镜方法。 [0256] An additional advantage of providing a device adapted to stretch a portion of the stomach wall of the patient to treat the patient's obesity surgery or laparoscopic methods. 该方法包括步骤:将针或管状器械插入病人身体的腹部,利用所述针或管状器械向病人的身体填充气体,将至少两个腹腔镜套针放置在病人身体中,将照相机通过所述腹腔镜套针之一插入病人身体,将至少一个切除工具通过所述至少两个腹腔镜套针之一插入,切除所述胃的一区域,将装置引入腹腔,利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述拉伸装置的第一部分套叠,以及利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述拉伸装置的与第一部分分离的第二部分套叠,以及通过操作所述装置术后拉伸所述第一和第二部分之间的胃壁部分。 The method comprises the steps of: inserting a needle or tube like instrument body of the patient's abdomen, using the needle or tube like instrument to fill the gas to the patient's body, at least two laparoscopic trocars in the patient's body is placed in the abdominal cavity through the camera One mirror trocars inserted into the patient's body, at least one dissecting tool through one of the at least two laparoscopic trocar insertion, removal of a region of the stomach, the device into the abdominal cavity, stomach to stomach sutures or staples The bonding wire is placed in the outside of the stomach wall portion of the first stretching device invaginated, and with stomach to stomach sutures or staplers placed on the outside of the stomach wall and the first portion of the stretching device The second part of the separation overlay, and after stretching the stomach wall portion between the first and second portions by operating the device.

[0257] 根据另一实施例,该方法包括另外的步骤:将第二或更多个装置引入腹腔,利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述第二或更多个拉伸装置的第一部分套叠,以及利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述第二或更多个拉伸装置的与第一部分分离的第二部分套叠,以及通过操作所述第二或更多个装置术后拉伸所述第一和第二部分之间的胃壁部分。 [0257] According to another embodiment, the method comprises the additional steps of: a second or more device into the abdominal cavity, with stomach to stomach sutures or staplers placed outside of the stomach wall in the second or more stretching device portion of the first overlay, and with stomach to stomach sutures or staplers will be placed in the first part of the stomach wall outside the second or more separate stretching device The second part of the overlay, and by a second or more device after operating the stretching of the stomach wall portion of the first and second portions.

[0258] 根据另一实施例,该方法包括另外的步骤:利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述拉伸装置的与第一或第二部分分离的第三或更多个部分套叠,以及通过操作所述装置术后拉伸所述第一和第二部分的任意组合与第三或更多个部分之间的胃壁部分。 [0258] According to another embodiment, the method comprises the additional step: with stomach to stomach sutures or staplers placed on the outside of the stomach wall stretching device separate from the first or second portion a third or more portions nested, and postoperatively stretching the stomach wall portion of said first and second portion with any combination of a third or more part by operating the device between.

[0259] 提供一种利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的手术方法,该方法包括步骤:切割人类病人的皮肤,切除胃的一区域,将装置引入腹腔,利用胃至胃的缝合线或订合线将所述胃壁外部的所述装置套叠,以及通过操作所述装置术后拉伸所述套叠的胃壁部分。 [0259] providing an apparatus adapted to use a portion of the stomach wall of the patient stretched surgical method of treating obesity in a patient, the method comprising the steps of: cutting the skin of the human patient, removal of an area of the stomach, the device into the abdominal cavity, the use of stomach to stomach sutures or staplers to the outside of the stomach wall telescopic device, and by operating the device after stretching the invaginated stomach wall portion.

[0260] 该方法可进一步包括另外的步骤:将第二或更多个装置引入腹腔,利用胃至胃的缝合线或订合线将所述胃壁外部的所述第二或更多个装置套叠,以及通过操作所述第二或更多个装置术后拉伸套叠的胃壁部分。 [0260] The method may further comprise the additional steps of: a second or more means into the abdominal cavity, stomach to stomach sutures or staplers to the stomach wall of the outer second or more device sets stacked, and by a second or more after the operation of the stretching device invaginated stomach wall section.

[0261] 根据另一实施例,该方法包括另外的步骤:在所述装置的彼此独立的第一或第二或更多个部分处术后拉伸套叠的胃壁部分。 [0261] According to another embodiment, the method includes the additional steps of: in a separate first or second or more portions of the device after each drawing invaginated stomach wall section.

[0262] 提供一种另外的利用适于拉伸病人胃壁的一部分的装置来治疗病人的肥胖症的手术方法。 [0262] An additional advantage of providing means adapted to stretch a portion of the stomach wall of a patient to treat obesity surgical patients. 该方法包括步骤:切割人类病人的皮肤,切除胃的一区域,将装置引入腹腔,利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述装置的第一部分套叠,利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述装置的与第一部分分离的第二部分套叠, 以及通过操作所述装置术后拉伸所述第一和第二部分之间的胃壁部分。 The method comprises the steps of: cutting the human patient's skin, removal of a region of the stomach, the device into the abdominal cavity, stomach to stomach sutures or staplers placed in the first part of the stomach wall outside cover of the device stack, said apparatus with stomach to stomach sutures or staplers be placed outside of the stomach wall separating the first portion of the second part telescopically, and by stretching the first and second operating means after the stomach wall portion between the two parts.

[0263] 根据另一实施例,该方法包括另外的步骤:将第二或更多个装置引入腹腔,利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述第二或更多个拉伸装置的第一部分套叠,以及利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述第二或更多个拉伸装置的与第一部分分离的第二部分套叠,以及通过操作所述第二或更多个装置术后拉伸所述第一和第二部分之间的胃壁部分。 [0263] According to another embodiment, the method comprises the additional steps of: a second or more device into the abdominal cavity, with stomach to stomach sutures or staplers placed outside of the stomach wall in the second or more stretching device portion of the first overlay, and with stomach to stomach sutures or staplers will be placed in the first part of the stomach wall outside the second or more separate stretching device The second part of the overlay, and by a second or more device after operating the stretching of the stomach wall portion of the first and second portions.

[0264] 根据另一实施例,该方法进一步包括步骤:利用胃至胃的缝合线或订合线将放置在所述胃壁外部的所述拉伸装置的与第一或第二部分分离的第三或更多个部分套叠,以及通过操作所述装置术后拉伸所述第一和第二部分的任意组合与第三或更多个部分之间的胃壁部分。 [0264] According to another embodiment, the method further comprising the steps of: with stomach to stomach sutures or staplers placed in a separate section from the first or second portion of the stomach wall outside the stretching apparatus three or more portions nested, and postoperatively stretching the first and second portion of any combination of the third portion of the stomach wall portion between more or by operating the device. [0265] 根据另一实施例,该方法包括另外的步骤:术后且非侵入性地调整装置,以拉伸胃壁的一部分,从而影响病人的胃口。 [0265] According to another embodiment, the method comprises the additional step of: postoperatively and non-invasively regulating the device to stretch a part of the stomach wall, thus affecting the patient's appetite.

[0266] 根据任意实施例的方法可进一步包括用流体填充所述装置的步骤。 [0266] Step method according to any embodiment may further comprise filling the device with fluid.

[0267] 根据另一实施例,该方法包括另外的步骤:将内部控制单元放置在病人的身体内, 以及将所述内部控制单元连接到所述装置,这可液压或利用电线来完成。 [0267] According to another embodiment, the method comprises the additional steps of: placing the internal control unit within the patient's body, and the internal control unit is connected to the device, which can utilize a hydraulic or wire to complete.

[0268] 器械 [0268] Devices

[0269] 进一步提供一种用于将适于拉伸病人的胃壁的一部分的装置放置为与胃壁相连的器械。 [0269] Further there is provided a device for stretching a portion of the patient's stomach wall is adapted to be placed with the stomach wall is connected to the instrument. 该器械包括:适于可释放地保持所述装置的保持构件,以及适于帮助将所述装置固定到胃壁在其外部的固定构件。 The device comprises: adapted for releasably holding the holding member means, and means adapted to assist to the stomach wall is secured to the fixing member at the outside thereof.

[0270] 器械可进一步包括用于观察胃的区域的光学构件。 [0270] The optical device may further comprise means for observing the stomach region.

[0271] 器械可包括适于将所述装置缝合到胃壁在其外部的固定构件。 [0271] The device may comprise means adapted to be sutured to the stomach wall at its outer fixing member.

[0272] 根据另一实施例,固定构件适于将装置订合到胃壁在其外部,在其他实施例中,固定构件适于利用胃至胃的缝合线将装置的至少一部分套叠在胃壁中在其外部。 [0272] According to another embodiment, the fixing member is adapted to stapling device to the stomach wall at its exterior, in other embodiments, the fixing member is adapted with stomach to stomach sutures least a portion of the device invaginated in the stomach wall In its exterior.

[0273] 根据另一实施例,固定构件可适于利用胃至胃的订合线将装置的至少一部分套叠在胃壁中在其外部。 [0273] According to another embodiment, the fixing member may be adapted with stomach-to-stomach staplers least a portion of the device invaginated in the stomach wall at the outside thereof.

[0274] 进一步提供一种用于将适于拉伸病人的胃壁的一部分的装置放置为与胃壁相连的器械。 [0274] Further there is provided a device for stretching a portion of the patient's stomach wall is adapted to be placed with the stomach wall is connected to the instrument. 该器械包括:适于可释放地保持所述装置的保持构件、适于将所述装置插入通过胃壁的插入构件以及适于帮助将所述装置固定到胃壁内部的固定构件。 The device comprises: adapted for releasably holding the holding member of the apparatus, the apparatus is adapted to be inserted into the inside of the stomach wall means secured to the fixing member is inserted through the stomach wall member and adapted to assist.

[0275] 所述器械可进一步包括用于在胃壁中切割孔的切割构件、用于观察胃的区域的光学构件。 [0275] The device may further comprise a cutting member for cutting a hole in the stomach wall, an optical member for observation of the stomach area. 固定构件可适于将所述装置缝合到胃壁在其内部,或者用于将所述装置订合到胃壁在其内部,或者用于利用胃至胃的缝合线将所述装置的至少一部分套叠在胃壁中在其内部,或者用于利用胃至胃的订合线将所述装置的至少一部分套叠在胃壁中在其内部。 The fixing member may be adapted to the stomach wall in the suturing device therein, or for stapling the device to the stomach wall at its interior, or for at least a portion with stomach to stomach sutures sets said stack means in the stomach wall in its interior, or for the use of the stomach-to-stomach stapling line at least a portion of the device in the stomach wall nested therein.

[0276] 器械可进一步包括专门的保持装置,其可包括适于利用真空或利用机械保持构件保持胃的专门的保持装置。 [0276] device may further comprise a special holding device, which may comprise a special holding device adapted to use a vacuum or using mechanical holding member holding the stomach.

[0277] 拉伸装置,适于术后可被调节且包括至少一个可膨胀部分,其中所述拉伸装置适于在第一塌缩状态与第二膨胀状态之间可调节。 [0277] stretching means can be adjusted and adapted to postoperative comprises at least one inflatable portion, wherein said stretching means is adapted between a first collapsed state and a second expanded state can be adjusted. 在第一塌缩状态,可膨胀部分塌缩,在第二膨胀状态,可膨胀部分膨胀。 In the first collapsed state, the expandable part collapsed in the second expanded state, the expandable portion expandable. 所述可膨胀部分的外表面至少部分地包括表面结构,其具有交替的降低区域和升高区域。 The outer surface of the expandable portion at least partially comprises a surface structure having alternating raised areas and lowered areas. 在所述第一塌缩和第二膨胀状态中的至少一个中,可膨胀部分适于具有在相邻升高区域之间的第一距离,其充分延伸以在一定程度上防止纤维组织的生长直接互连相邻的升高区域从而削弱所述拉伸装置的第一塌缩和第二膨胀状态之间的可调节性。 At least one of said first collapsed and a second expanded state, the expandable portion adapted to have a first distance between adjacent elevated region, which extends sufficiently to a certain extent, prevent the growth of fibrous tissue direct interconnection of adjacent raised area thus weakening the stretching device first collapsed and second expanded states adjustability. 所述可膨胀部分进一步包括在相邻的升高和降低区域之间的连接区域,在所述第一塌缩和第二膨胀状态中的至少一个中,进一步适于具有在相邻连接区域之间的第二距离,其充分延伸以在一定程度上防止纤维组织的生长直接互连相邻的连接区域从而削弱所述拉伸装置的第一塌缩和第二膨胀状态之间的可调节性。 The expandable portion further comprises a raising and lowering adjacent connection region between the region, in the first collapsed and a second expanded state of at least one, and further adapted to connect with the adjacent area second distance between its fully extended to a certain extent, prevent the growth of direct interconnection of fibrous tissue adjacent connection region thus weakening the stretching device of the first and second expansion state collapsed between adjustability .

[0278] 根据一个实施例,可膨胀部分为中空的或包括中空主体。 [0278] According to one embodiment, the expandable section is hollow or comprises a hollow body.

[0279] 根据另一实施例,拉伸装置基本上完全中空,或包括沿所述拉伸装置的大致整个长度和/或整个容积延伸的中空主体。 [0279] According to another embodiment, the stretching device is substantially completely hollow or comprises a stretching device along substantially the entire length and / or the entire volume of the hollow body extends.

[0280] 纤维组织可经常具有约0. 5mm至约1. 5mm的延伸长度或厚度,因此表面结构的元件的相关表面之间的距离适当地大于约3mm,因而大于约2 X 1. 5mm。 [0280] fibrous tissue can often have from about 0. 5mm to 1. 5mm extends about the length or thickness, distance-dependent surface element of the surface structure suitably between greater than about 3mm, and thus greater than about 2 X 1. 5mm. 但是根据情况,大于约 But in some cases, greater than about

311. Omm至约3mm的距离也可能是足够的。 311. Omm to about 3mm of distance may be sufficient. 在纤维组织可预期具有大于约1. 5mm的延伸长度或厚度的情况下,表面结构的元件的相关表面之间的距离以适当的方式适应。 In the case of fibrous tissue can be expected to have more than about 1. 5mm length or thickness extending from the surface of the element correlation between surface structure to adapt in an appropriate manner.

[0281] 表面结构可包括升高和降低区域,可能合适的是,升高和降低区域的不同平面之间的距离也大于特定阈值,以利于拉伸装置的可塌缩和/或可膨胀的功能性。 [0281] surface structure can include raising and lowering the area, it may be appropriate that the raising and lowering of the distance between the different planes of the area is also larger than a certain threshold, in order to facilitate the stretching device can be collapsed and / or expanded functionality. 如果所述距离太小,则拉伸装置的可塌缩和/或可膨胀功能可受到限制。 If the distance is too small, the stretching device collapsible and / or expandable functionality may be restricted. 所述距离的适当间隔为约0. 5 至10mm,更适当为约2至8mm,最适当为约3至7mm。 The appropriate spacing distance is from about 0.5 to 10mm, more suitably from about 2 to 8mm, most suitably about 3 to 7mm. 表面结构可包括不同的几何元件或形状以及这些元件或形状的组合,只要能够符合以上所述的该距离的条件即可。 The surface structure may comprise different shapes and combinations of these elements or components or geometric shape as long as possible to meet the above conditions according to the distance. 表面结构可例如包括不同形状的脊和槽。 Surface structure may include, for example ridges and grooves of different shapes. 脊和槽可分别具有截面,其为例如楔形、四边形、正方形、金字塔形、截断金字塔形。 Ridges and grooves may have a cross-section, respectively, which, for example, wedge-shaped, square, square, pyramid, truncated pyramid. 进一步可能的是,脊和槽具有不同形状的截面。 It is further possible that the ridges and grooves have different cross-sectional shapes. 表面结构也可大体上包括手风琴形结构,其中相同或其中不同种类的几何物体放置在表面上。 The surface structure may also include a generally accordion-shaped configuration, wherein the same or different types of geometric objects which is placed on a surface. 几何物体可被在实践中随机或根据一些方案放置在表面上。 Geometric objects can be random or based on some of the programs placed on the surface in practice.

[0282] 其中该类型的表面结构可以是合适的一种类型的拉伸装置为其中拉伸装置应该具有本质上改变形状和/或尺寸的拉伸装置。 [0282] wherein the surface structure of this type can be suitable for the type of stretching device where the stretching device should have to change the shape and / or size of essentially stretching device. 因此,这就是纤维组织的存在本质上可妨害或阻碍拉伸装置的功能的情况。 Thus, this is the stretching device may hinder or impede the function of the presence of the nature of the fibrous tissue. 但表面结构可被任何拉伸装置使用,其中表面结构的特征对于拉伸装置而言是有利的。 But the surface structure may be used any stretching device, wherein the surface structure characterized in terms of the stretching device is advantageous.

附图说明 Brief Description

[0283] 现在将通过非限制性示例并参照附图更为详细地描述本发明,在附图中: [0283] will now by way of non-limiting example and the present invention is described in more detail with reference to the accompanying drawings, in which:

[0284] 图1示出植入在病人的胃基底壁中在胃基底壁内部的拉伸装置。 [0284] Figure 1 shows a substrate implanted in the patient's stomach wall inside the stomach fundus wall stretching device.

[0285] 图2a示出植入在病人的胃基底壁中在胃基底壁外部的拉伸装置。 [0285] Figure 2a shows the implant in the patient's stomach fundus wall of the stomach fundus wall external stretching means.

[0286] 图2b示出植入在病人的胃基底壁中在胃基底壁外部的处于第二状态的拉伸装置。 [0286] Figure 2b shows a stretching device implanted in the patient's stomach fundus wall is in the second state in the stomach fundus wall outside.

[0287] 图3a示出根据第一实施例的实施例,其中拉伸装置包括两个拉伸装置。 [0287] Figure 3a shows an embodiment according to the first embodiment, wherein the stretching device comprises two stretching devices.

[0288] 图3b示出根据第二实施例的实施例,其中拉伸装置包括两个拉伸装置。 [0288] Figure 3b shows an embodiment according to the second embodiment, wherein the stretching device comprises two stretching devices.

[0289] 图4a至4i示出根据不同实施例的拉伸装置。 [0289] Figures 4a through 4i shows a different embodiment of the stretching device.

[0290] 图5a为拉伸装置10的表面结构700的截面图。 [0290] Figure 5a-sectional surface of the structure 700 of FIG. 10 stretching device.

[0291] 图5b为类似于图5a的截面图但带有稍微不同的表面结构700的截面图。 [0291] Figure 5b is a sectional view similar to FIG 5a, but with slightly different cross-sectional surface of the structure 700 of FIG.

[0292] 图5c至5e为示出本文所述的表面结构700的示例的截面的附图。 [0292] FIG. 5c to 5e illustrate the structure of the surface 700 of the example described herein, the cross-section.

[0293] 图5f示意性示出具有表面结构700的拉伸装置10的实施例。 [0293] Figure 5f schematically illustrates an embodiment 700 of the stretching device 10 has a surface structure.

[0294] 图5g和5h示出假体的不同截面的示例。 [0294] FIG. 5g and 5h shows an example of a different cross-section of the prosthesis.

[0295] 图5i至5k为示出不同表面结构的示例的附图。 [0295] Figure 5i to 5k accompanying drawings is a graph showing an example of a different surface structure.

[0296] 图6a至6c示出套叠在胃壁中的拉伸装置。 [0296] FIG. 6a to 6c show nested in the stomach wall stretching device.

[0297] 图7示出根据第一实施例的实施例,其中拉伸装置为机械拉伸装置。 [0297] FIG. 7 shows an embodiment according to the first embodiment, wherein the stretching device is a mechanical stretching device.

[0298] 图8示出根据第二实施例的实施例,其中拉伸装置为机械拉伸装置。 [0298] Figure 8 shows an embodiment according to the second embodiment, wherein the stretching device is a mechanical stretching device.

[0299] 图9a示出根据第三实施例的实施例,其中拉伸装置为机械拉伸装置。 [0299] Figure 9a shows an embodiment according to the third embodiment, in which the stretching device is a mechanical stretching device.

[0300] 图9b示出适于帮助固定拉伸装置的网。 [0300] Figure 9b shows the stretching device adapted to assist a fixed network.

[0301] 图9c示出根据第四实施例的实施例,其中拉伸装置为机械拉伸装置。 [0301] Figure 9c shows an embodiment according to the fourth embodiment, in which the stretching device is a mechanical stretching device.

[0302] 图IOa示出根据第五实施例的实施例,其中拉伸装置为机械拉伸装置。 [0302] FIG IOa shows an embodiment according to the fifth embodiment, wherein the stretching device is a mechanical stretching device.

[0303] 图IOb更为详细地示出根据第五实施例的处于第一状态下的实施例,其中拉伸装 [0303] FIG IOb shows in more detail a first embodiment according to the state in the fifth embodiment, wherein the tensile loading

32置为机械拉伸装置。 32 is set to a mechanical stretching device.

[0304] 图IOc更为详细地示出根据第五实施例的在第二状态下的实施例,其中拉伸装置为机械拉伸装置。 [0304] FIG IOc illustrated in more detail according to a fifth embodiment of the second embodiment in a state, in which the stretching device is a mechanical stretching device.

[0305] 图Ila示出根据第一实施例的实施例,其中拉伸装置与用于治疗返流疾病的装置组合。 [0305] FIG Ila shows an embodiment according to the first embodiment, wherein the stretching device in combination with a device for the treatment of reflux disease.

[0306] 图lib示出根据第二实施例的实施例,其中拉伸装置与用于治疗返流疾病的装置组合。 [0306] Figure lib shows an embodiment according to the second embodiment, wherein the stretching device in combination with a device for the treatment of reflux disease.

[0307] 图12a示出一实施例,其中拉伸装置与容积填充装置组合。 [0307] Figure 12a shows an embodiment wherein the stretching device in combination with a volume filling device.

[0308] 图12b示出手动类型的拉伸装置的又一实施例。 [0308] Figure 12b shows a type of manual stretching device further embodiment.

[0309] 图12b示出自动类型的拉伸装置的又一实施例。 [0309] Figure 12b shows a type of automatic stretching device further embodiment.

[0310] 图13至36示出描述拉伸装置的不同功能的示意图。 [0310] Figure 13-36 shows a schematic description of the different functions of the stretching device.

[0311] 图37a示出胃镜器械的控制单元。 [0311] Figure 37a shows the control unit endoscopy instruments.

[0312] 图37b示出放置在胃中的胃镜器械。 [0312] Figure 37b shows endoscopy instruments placed in the stomach.

[0313] 图37c示出刺穿胃壁时的胃镜器械。 [0313] Figure 37c shows a gastroscope equipment when pierced the stomach.

[0314] 图37d更为详细地示出刺穿胃壁时的胃镜器械。 [0314] Figure 37d shows in greater detail gastroscopic instrument when piercing the stomach wall.

[0315] 图37e示出根据一个实施例的胃镜或腹腔镜器械。 [0315] FIG. 37e shows an endoscopic or laparoscopic instrument according to an embodiment.

[0316] 图37f示出处于第二状态的根据一个实施例的胃镜或腹腔镜器械。 [0316] FIG. 37f shows a second state in accordance with an endoscopic or laparoscopic instrument embodiment.

[0317] 图37g示出处于第三状态的根据一个实施例的胃镜或腹腔镜器械。 [0317] Figure 37g illustrates a third state in endoscopic or laparoscopic instrument according to one embodiment.

[0318] 图37h示出处于第四状态的根据一个实施例的胃镜或腹腔镜器械。 [0318] FIG. 37h shows a fourth state in endoscopic or laparoscopic instrument according to one embodiment.

[0319] 图37i示出处于第五状态的根据一个实施例的胃镜或腹腔镜器械。 [0319] Figure 37i shows a fifth state in endoscopic or laparoscopic instrument according to one embodiment.

[0320] 图38a至38d更为详细地示出胃镜或腹腔镜器械。 [0320] Figure 38a to 38d is shown in more detail gastroscopic or laparoscopic instrument.

[0321] 图39a至39j示出胃镜或腹腔镜器械,其在胃壁中形成腔或袋,并插入拉伸装置。 [0321] FIG. 39a to 39j shown endoscopy or laparoscopy instruments, chamber or pouch which is formed in the stomach wall and insert the stretching device.

[0322] 图40a至40f示出胃镜或腹腔镜器械,其在胃壁中形成腔或袋,并插入拉伸装置。 [0322] FIG. 40a to 40f shown endoscopy or laparoscopy instruments, chamber or pouch which is formed in the stomach wall and insert the stretching device.

[0323] 图41a、41b示出插入导线的胃镜或腹腔镜器械。 [0323] FIG. 41a, 41b shows the insertion wire endoscopy or laparoscopic instrument.

[0324] 图42示出胃镜方法的流程图。 [0324] FIG. 42 shows a flowchart of a method of endoscopy.

[0325] 图43示出腹腔镜或手术方法的流程图。 [0325] FIG. 43 shows a flowchart or laparoscopic surgical procedures.

具体实施方式 DETAILED DESCRIPTION

[0326] 套叠在胃壁中可以被理解为物体被放置在由胃壁材料形成的腔的内侧。 [0326] nested in the stomach wall can be understood as an object is placed on the inside of the stomach wall material of the chamber. 套叠(invagination)允许胃至胃的缝合或订合,该缝合或订合允许物体利用人体组织自愈来封闭。 Intussusception (invagination) allows stomach to stomach suturing or stapling, suturing or stapling allows the object to the use of human tissue healing closed.

[0327] 在下文中,将给出各实施例的详细描述。 [0327] In the following, we will give a detailed description of the various embodiments. 在附图中,相同的附图标记在所有不同附图中表示相同或对应的元件。 In the drawings, like reference numerals designate identical or corresponding elements throughout the different figures. 可以意识到,这些附图仅用于例示,并不以任何方式来限制范围。 It will be appreciated that these drawings are only for illustration and do not in any way limit the scope. 因此,任何涉及到的方向,例如“上”或“下”,仅指附图中所示的方向。 Thus, in any direction involving, for example, "on" or "under", refers only to the direction shown in the drawings. 此外,附图中所示的任何尺寸等均出于例示的目的。 In addition, the purpose of illustration in the drawings shown for any size etc.

[0328] 图1示出肥胖症治疗装置的第一实施例。 [0328] Figure 1 shows a obesity treatment apparatus of the first embodiment. 该装置包括植入在人类病人体中的拉伸装置10。 The apparatus comprises implanting in the human body of a patient 10 in a stretching device. 在图1中,拉伸装置10套叠在病人的胃12的壁12中,拉伸装置10的主体成形为静靠胃12的壁12,并进一步具有适于静靠该壁12的外表面。 In Figure 1, drawn 10 nested in the patient's stomach wall 12 of the apparatus 12, the stretching apparatus body 10 is formed by the stationary wall 12 of the stomach 12, and further having an outer surface adapted by the stationary wall 12. 这意味着拉伸装置10优选具有大致圆形形状,以不损坏胃壁。 This means that the stretching means 10 preferably has a generally circular shape so as to not damage the stomach wall. 然而,胃壁12很强固,因此可以使用许多不同的形状和形 However, a strong stomach 12 solid, so you can use many different shapes and shape

33式。 33 ceremony.

[0329] 拉伸装置10可以多种不同方式固定到胃12的壁12a。 [0329] stretching apparatus 10 may be secured to a plurality of different gastric wall 12 12a. 在图1所示的实施例中,拉伸装置10套叠在胃壁12a中。 In the embodiment shown in Figure 1, the stretching device 10 is nested within the stomach wall 12a. 在套叠之后,施加多个胃至胃的缝合线或订合线14,以保持短期套叠。 After nesting, applying a plurality of stomach to stomach sutures or staplers 14, in order to maintain short-term intussusception. 这允许人体组织的生长,从而保持长期套叠。 This allows for the growth of human tissue, thereby maintaining long-term intussusception.

[0330] 通过扩大拉伸装置的尺寸,环绕拉伸装置10的胃壁12由于拉伸装置10的周界增大而被拉伸。 [0330] By expanding the size of the stretching device around the stomach wall stretching device 10 12 10 Due to the perimeter stretching device increases are stretched. 通过该拉伸,胃壁中的受体指示胃被充满,由此引起病人的饱胀感。 By this stretching the stomach wall receptors indicates stomach is full, thereby causing the patient's sense of fullness. 因此,当拉伸装置10收缩时,受体指示胃未被充满,由此恢复饥饿感。 Thus, when 10 contracts stretching device, Receptors instructions stomach is not full, thereby restoring a sense of hunger.

[0331] 拉伸装置10的膨胀和收缩可在病人的直接控制下执行。 Expansion and contraction [0331] stretching device 10 can be performed under the direct control of the patient. 可替换地,膨胀和收缩可根据预编程的安排执行。 Alternatively, expansion and contraction can be performed according to a pre-programmed arrangement.

[0332] 返回图1,该附图还示出流体操作装置,S卩,适于操作拉伸装置的液压或气动操作装置,其将在下文中详细描述。 [0332] Returning to Figure 1, this figure also shows a fluid operation device, S Jie, the stretching device is adapted to operate a hydraulic or pneumatic operating device, which will be described in detail hereinafter.

[0333] 拉伸装置10形成流体室,流体被允许在该流体室中流动。 [0333] stretching apparatus 10 forming a fluid chamber, the fluid is allowed to flow in the fluid chamber. 拉伸装置10因此形成可改变其在胃壁中所占据之容积的可膨胀室,由此形成液压或气动调整的拉伸装置10。 Stretching means 10 thus forming the volume change of the expansion chamber which can be occupied in the stomach wall, thereby stretching apparatus 10 forming a hydraulic or pneumatic adjustment.

[0334] 用于流体的调整贮存器16利用采用管的形式的管路18连接到拉伸装置10。 [0334] adjusted for the fluid reservoir 16 in the form of the use of the use of pipe line 18 is connected to the stretching device 10. 拉伸装置10由此适于通过使液体或空气从调整贮存器16移动到由拉伸装置形成的室而被优选非侵入性地调整。 Thereby stretching device 10 is adapted by adjustment of the liquid or air from the reservoir 16 is moved to the chamber formed by the stretching apparatus is preferably adjusted non-invasively.

[0335] 调整贮存器16可以多种方式调整。 [0335] regulation reservoir 16 can be adjusted in various ways. 在图1所示的实施例中,调整贮存器16通过手动按压调整贮存器16来调整。 In the embodiment shown in Figure 1, the regulation reservoir 16 by manually pressing the regulation reservoir 16 is adjusted. 换言之,调整贮存器16通过移动贮存器的壁来调整。 In other words, the regulation reservoir 16 by moving the walls of the reservoir is adjusted. 因而优选的是,调整贮存器16被放置在皮下,由此实现非侵入性的调整。 Thus it preferred that the regulation reservoir 16 is placed subcutaneously, thereby achieving non-invasive adjustments.

[0336] 当调整贮存器16被按压时,其容积减小,液压流体经由管路18从贮存器移动到由拉伸装置10形成的室,从而扩大或膨胀拉伸装置10。 [0336] When the regulation reservoir 16 is pressed, its volume decreases, the hydraulic fluid moving through the conduit 18 from the reservoir to the chamber formed by the stretching device 10, thereby expanding or stretching the expansion means 10. 为了填充和计算装置的流体水平,进一步提供注入端口1001。 In order to fill the fluid level and computing devices, further injection port 1001. 注入端口优选包括自密封隔膜,例如硅隔膜。 Injection port preferably comprises self sealing membrane, such as a silicon diaphragm.

[0337] 可以意识到,可使用气动操作来代替液压操作,其中代替液压流体的空气在贮存器16与由拉伸装置10形成的室之间移动。 [0337] As can be appreciated, pneumatic operation can be used instead of hydraulic operation, in which instead of air in the hydraulic fluid to move between the apparatus 16 and the chamber 10 formed by the stretching reservoir. 优选地,贮存器具有锁定位置,以将其保持在希望的位置。 Preferably, the reservoir has a locking position to keep it in a desired position. 如果病人压缩贮存器16,其优选保持压缩并在再次按压之后释放。 If the patient compression reservoir 16, which is preferably remain compressed and released again after pressing.

[0338] 任何种类的液压方案可用于拉伸装置。 [0338] Any kind of hydraulic solution may be used for the stretching device. 液压方案可通过机械或电力的任何马达或泵以及通过手动来驱动。 Hydraulic scheme may be driven by a motor or manually by any mechanical or electrical pump, and.

[0339] 图1进一步示出回动伺服系统,其包括调整贮存器16和伺服贮存器90。 [0339] Figure 1 further shows reversed servo system which comprises a regulation reservoir 16 and a servo reservoir 90. 伺服贮存器90通过管路18液压地控制拉伸装置10。 Servo reservoir 90 stretching device 10 through line 18 to control the hydraulic pressure. 回动伺服功能在图33至36中更为详细的描述。 Reversing servo functions are described in more detail in Figure 33-36. 图2a示出根据另一实施例的装置,在该装置中马达40适于移动调整贮存器16的壁。 Figure 2a shows an apparatus according to another embodiment, the motor 40 is adapted to move the adjustment of the reservoir wall 16 in the apparatus. 因而电力调整贮存器16优选被放置在病人的腹部中。 Thus the power adjustment reservoir 16 is preferably placed in the patient's abdomen. 在该实施例中,可被提供无线外部远程控制单元34b、c和外部能量发射装置34a以通过能量转换装置30执行马达的非侵入性调整,能量转换装置30适于向能量消耗操作装置(在本示例中的马达40)供应能量。 In this embodiment, may be provided wireless external remote control unit 34b, c and an external energy emitting means 34a by the energy converting means 30 performs non-invasive adjustment of the motor, the energy conversion means 30 is adapted to the energy consumption operation means (in In this example the motor 40) to supply energy.

[0340] 远程控制器可包括无线能量发射器34a,其也可用作用于非侵入性地调整拉伸装置的调整装置。 [0340] Remote controller may comprise a wireless energy transmitter 34a, which can also be used for non-invasively regulating the stretching device adjusting means. 当通过远程控制器34执行调整时,提供用于为调整装置提供动力的内部电源70。 When performing the adjustment by remote control 34 is provided for supplying power to the internal power adjustment means 70. 内部能量源70可例如为可再充电植入电池或电容器或者用于接收从病人身体外部发射的无线能量的电容器或装置。 Internal energy source 70 may be, for example, a rechargeable battery or capacitor or capacitors implantable device or receiving wireless energy emitted from outside the patient's body for. 以下将参照图13至29描述调整拉伸装置10的不同方式。 The following will be described with reference to FIG. 13 to 29 10 different ways to adjust the stretching device.

[0341] 如图2a所示的装置进一步包括传感器201,其传感优选与病人的食物摄入相关的病人或装置的参数。 The apparatus shown in Figure 2a [0341] 201 further includes a sensor, which sensor preferably with the patient's food intake related parameter of the patient or device. 传感器利用传感器信号传输构件202连接到控制组件42。 Sensors using the sensor signal transmission member 202 is connected to the control module 42. 传感器可用于以全自动方式调整所述装置,即,该装置响应与病人的食物摄入相关的传感器信号,由此影响控制组件来操作拉伸装置10拉伸胃壁12,并由此引起病人的饱胀感。 Automatic sensors can be used to adjust the said means, i.e., the device with the patient's response to a sensor signal related to food intake, thereby affecting the control assembly 10 to operate the stretching device stretch the stomach wall 12, and thereby cause the patient's a sense of fullness. 传感器可适于通过温度、血压、血流量、心跳、呼吸和压力中的任一个来测量病人的食物摄入,并可被放置在胃12、食管203中或与贲门204相连。 May be adapted by a temperature sensor, blood pressure, blood flow, heart rate, respiration, and the pressure is measured in any one of the patient's food intake, and can be placed in the stomach 12, esophagus 203 or 204 is connected to the cardia. 根据一个实施例,所述传感器为测量贲门204的收缩和/或放松的应变仪。 According to one embodiment, the sensor 204 to measure cardiac contraction and / or relaxation of the strain gauge.

[0342] 如图2a所示的装置进一步包括用于液压流体的回流的第二管路222。 The apparatus shown in Figure 2a [0342] further comprises a second hydraulic fluid reflux conduit 222. 回流适于形成希望的持续预定时间的饱胀感,之后,液压流体流回足够的量,以使拉伸装置不再拉伸胃壁,并由此使饥饿感返回给病人。 Reflux is adapted to form a sense of fullness of hope for a predetermined time after a sufficient amount of hydraulic fluid to flow back to the draw means no longer stretch the stomach, and thereby hunger returned to the patient. 该过程的适当时间为1到6小时之间。 This procedure is an appropriate time between 1-6 hours. 根据其他实施例, 利用连接到所述管路18的阀系统在主管路18中发生回流。 According to other embodiments, the use of reflux conduit connected to the valve system 18 takes place in the main conduit 18.

[0343] 为了填充和计算装置的流体水平,进一步提供注入端口1001。 [0343] In order to fill the fluid level and computing devices, further injection port 1001. 注入端口1001优选包括自密封隔膜,例如硅隔膜。 Injection port 1001 preferably comprises self sealing membrane, such as a silicon diaphragm.

[0344] 图2b示出处于第二状态下的根据图2a的实施例的装置,其中拉伸装置10膨胀并由此拉伸胃壁12。 [0344] Figure 2b shows the state in a second embodiment of the apparatus according to Figure 2a, wherein the stretching device 10 is expanded and thereby stretching the stomach wall 12.

[0345] 图3a示出一实施例,其中两个拉伸装置10”被提供。两个拉伸装置10”均根据以上参照图1所述的原理工作。 [0345] Figure 3a shows an embodiment, wherein two stretching means 10 'is provided. Two stretching means 10' are working according to the principles described above with reference to FIG. 1. 它们可适于术后且非侵入性地被调整,并适于时常地调整不同的拉伸装置,以在第一时间拉伸胃壁的第一部分并在第二时间拉伸胃壁的第二部分。 They can be adapted to postoperatively and non-invasively be adjusted from time to time and is adapted to adjust the different stretching means for stretching the stomach wall at a first time stretch a first portion and a second portion of the stomach wall at a second time.

[0346] 这种拉伸装置10可用于保持电子元件和/或能量源和/或液压流体。 [0346] This stretching means 10 can be used for holding the electronic component and / or an energy source and / or hydraulic fluid. 来自该装置的液压流体可被分配到若干较小的拉伸装置区域,以时常地改变拉伸区域,从而避免胃壁的任何可能的更为持久的拉伸效果。 The hydraulic fluid from the device can be assigned to several smaller stretching device areas to change from time to time stretch zones, thereby avoiding any possible more permanent stretching effect of the stomach wall. 甚至机械的若干拉伸区域可被使用。 Even mechanically several stretching areas may be used. 根据图3a的实施例进一步包括液压阀移位装置54,其被植入在病人体中,用于在操作第一和第二拉伸装置10”之间移位。该交替形成更具可持续性的装置,这是因为胃壁中的受体受到刺激在拉伸之间获得更长的恢复时间。 According to the embodiment of Figure 3a further comprises a hydraulic valve shifting device 54, which is implanted in the patient, for shifting between operating the first and second stretching device 10. "The more sustainable alternately formed of means, this is because the receptors are stimulated gastric wall in between stretching for longer recovery time.

[0347] 在图3a中,系统为如以上参照图1所述的由病人控制的手动系统,在图3b中,系统如上文参照图2a所述利用无线能量来获得能量。 [0347] Figure 3a, the system as described above with reference to FIG manual system controlled by the patient 1, in Figure 3b, the system as described above with reference to FIG. 2a the wireless energy to obtain the energy utilization.

[0348] 图4a至4e示出适于植入病人的拉伸装置10的不同实施例。 [0348] Figures 4a to 4e show different embodiments of the stretching device adapted for implantation in a patient 10. 拉伸装置10包括: 当装置套叠在胃壁中时适于与胃壁12接触的表面。 Stretching device 10 includes: a suitable surface 12 in contact with the stomach wall when the device is invaginated in the stomach wall. 图4b示出拉伸装置的实施例,其中拉伸装置包括固定构件206,用于将拉伸装置缝合或订合到胃壁。 Figure 4b shows an embodiment of the stretching device, wherein the stretching device comprises a fixing member 206 for suturing or stapling the stretching device to the stomach wall. 固定构件206可包括用于接收所述缝合线或订合线14的孔,或者固定装置206可被刺穿,使得缝合线或订合线可刺穿胃壁和固定装置206。 Fixing member 206 may include means for receiving the sutures or staplers hole 14, or fixing device 206 can be pierced, so that sutures or staplers can pierce the stomach wall and fixtures 206. 图4c示出根据一实施例的拉伸装置10,其中拉伸装置10包括用于向所述装置填充流体的入口构件207。 Figure 4c shows the stretching device 10 according to an embodiment wherein the stretching device 10 includes a means to fill the fluid inlet member 207. 所述入口构件优选连接到适于套叠在胃壁12中的液压管路18。 The inlet member is preferably connected to the hydraulic suitable nesting in the stomach wall 12 in line 18. 图4d示出根据一实施例的拉伸装置10,其中拉伸装置10包括保持构件208,当所述拉伸装置10插入胃壁12的套叠囊时,保持构件208适于连接到插入装置。 Figure 4d shows the stretching device 10 according to an embodiment, in which the stretching means 10 comprises a holding member 208, when the stretching device 10 is inserted into the stomach wall sleeve stack balloon 12, the holding member 208 is adapted to be connected to the insertion device. 图4e示出根据一实施例的拉伸装置10,其中拉伸装置具有稍微卵形或蛋形的形状。 Figure 4e shows a stretching apparatus according to an embodiment of embodiment 10, wherein the stretching device has a slightly oval or egg-shaped shape. 图4e进一步示出附接到所述拉伸装置10的液压管路18。 Figure 4e shows a further device 10 is attached to the hydraulic line 18 drawn. 图4f示出根据一实施例的拉伸装置10,其中拉伸装置可被通过管路18传送的流体充胀。 Figure 4f shows the stretching device 10 according to an embodiment wherein the stretching device can be transmitted through the fluid conduit 18 is inflated. 根据图4f所示的一个实施例,管路包括两个部分18a、18b,其中第一部分18a用于将拉伸装置10拉到适当位置并用合适的流体填充装置10,第二部分18b用于操作所述装置10。 According to one embodiment of the embodiment shown in Figure 4f, the pipe consists of two parts 18a, 18b, wherein the first portion 18a is used to pull the stretching device 10 in place and with a suitable fluid filling device 10, a second portion 18b for operating The apparatus 10. 图4g示出处于紧缩状态的根据图4f的实施例的拉伸装置10。 Figure 4g illustrates the embodiment of FIG. 4f stretching device 10 is in a state of contraction. 拉伸装置10以其紧缩状态被插入通过胃壁12中的孔,之后装置10被合适的 Stretching device 10 in its tightening state is inserted through the stomach wall 12 holes after the device 10 is suitable

35流体填充以进行操作。 35 is filled with operating fluid. 图4h示出根据一实施例的拉伸装置10,其中拉伸装置10包括两个可移动壁部223a、223b,其可利用由柔性材料制成的手风琴结构209移动。 Figure 4h shows the stretching device 10 according to an embodiment wherein the stretching device 10 comprises two movable wall portions 223a, 223b, which can be used accordion structure made of flexible material 209 to move. 图4i示出根据一实施例的拉伸装置,其中拉伸装置可利用四个可膨胀部分210膨胀,四个可膨胀部分210 沿拉伸装置的表面对称地放置在四个位置,如图4i的截面图所示。 Figure 4i shows the stretching device according to an embodiment, in which the stretching device may utilize four expandable portion 210 expands the four stretching means along the surface of the expandable portion 210 symmetrically disposed at four positions, as shown in Figure 4i The cross-section shown in FIG. 可膨胀部分210由柔性材料制成,从而当所述拉伸装置10被液压流体填充时,允许所述部分210膨胀。 Expandable portion 210 is made of a flexible material, so that when the stretching device 10 is filled with hydraulic fluid, the portion 210 allows the expansion.

[0349] 见图5a,两个升高区域701之间的第一距离708a长到足以防止直接连接两个相邻升高区域707的纤维组织的生长。 [0349] Figure 5a, both raised the first from the region between 701 708a long enough to prevent the growth of fibrous tissue in the raised area 707 is directly connected to the next. 也就是,可以使纤维组织在升高和降低区域701、702以及连接区域704的表面上生长。 That is, it can make the raising and lowering of the growth on the surface area of 701, 702 and 704 of fibrous tissue connecting area. 然而,由于第一距离708a的延伸长度,纤维组织被防止从一个升高区域701直接生长到另一相邻的升高区域701。 However, since the first distance 708a extending the length of fibrous tissue is prevented from a raised area 701 is grown directly adjacent to the raised area to another 701.

[0350] 关于表述“从一个升高区域701直接生长到另一相邻的升高区域701”,其例如意味着纤维组织从一个升高区域701生长到另一个,但没有生产在连接区域704或者仅在连接区域704上生长很小程度。 [0350] For the expression "from a raised area 701 is grown directly adjacent to another elevated area 701", which means, for example fibrous tissue growth from a raised area 701 to another, but there is no production in the connection area 704 or grow only to a small degree on the connection area 704. 如图5i的704a所示,第一距离708a可从升高区域701的水平在间隔704a内测量。 704a, the first distance as shown in the 708a 5i from the raised area 701 level in the measuring interval 704a. 表述“从一个升高区域701直接生长到另一相邻的升高区域701” 还包括如下情况:纤维组织生长在相邻的区域上,例如,两个相邻的连接区域704,该生长的厚度使得来自每个相邻区域的纤维组织交汇并桥接在两个升高区域701之间的距离或空间。 The expression "directly from one elevated area 701 to another adjacent elevated growing area 701" also include the following: the growth of fibrous tissue in the area adjacent to, e.g., two adjacent connection region 704, the growth of such that the thickness of fibrous tissue from each adjacent area and bridges between the intersection of the two raised regions 701 of the distance or space. 在这种情况下,两个升高区域701之间的空间可被纤维组织部分地或完全地填充。 In this case, the space area 701 between the two raised can be completely or partially filled with fibrous tissue.

[0351] 可能优选的是,对应于降低区域702的延伸长度的第二距离708b也延伸得足够大,以防止纤维组织从一个连接区域704直接生长到另一连接区域704。 [0351] It may be preferred that the second distance corresponding to the reduced region 702 extending the length of the extension 708b also large enough to prevent the growth of fibrous tissue from a connection region 704 to another connection region 704. 关于表述“从一个连接区域704直接生长到另一连接区域704”,其意味着纤维组织从一个连接区域704生长到另一个,但没有在降低区域702上生长或者仅在降低区域702上生长很小程度。 About the expression "from a connection region 704 is grown directly connected to another area 704", which means fibrous tissue growth from a connection area 704 to another, but not only in reducing the growth of, or reduce the area 702 is grown on the area 702 to a small extent.

[0352] 在图5中,包括升高和降低区域的表面结构被示出,但是除了升高和降低区域以外,也可使用许多其他几何结构,只要可以实现以上提及的防止纤维组织的生长。 [0352] In FIG. 5, the surface structure comprising elevated and lowered areas is shown, but in addition to elevated and lowered areas also many other geometrical structures may be used, as long as the above-mentioned can prevent the growth of fibrous tissue . 特别是, 以上提及的防止在升高区域之间和连接区域之间生长纤维组织。 In particular, the above-mentioned prevented between the raised area and the connecting area growth of fibrotic tissue.

[0353] 一些这种其他几何结构的示例示于图5i至5k中。 [0353] Some examples of such other geometrical structures are shown in Fig. 5i to 5k in. 在包括脊和槽的表面结构中, 脊和槽也可具有不同部分,一些示例适于图5a至5e中。 The surface structure comprising ridges and grooves, the ridges and grooves may also have different sections, some examples are adapted to Fig. 5e 5a.

[0354] 现在将主要参照图5a和5b阐释一些表述和方面。 [0354] Referring now primarily to Figures 5a and 5b explain some of the expressions and terms. 在该应用中,使用了相邻升高区域701、710之间的第一距离708a、718a的概念。 In this application, the use of the concept of 701, 710 a first distance between adjacent elevated regions 708a, 718a of. 关于该第一距离708a、718a,其意味着大致从升高区域701、710的边缘706、714到相邻升高区域701、710的边缘706、714测量的距离。 About the first distance 708a, 718a, which means roughly 701, 710 from the edge of the raised area adjacent to rise 706,714 to 706,714 measured from the edge of the area 701, 710. 大致从边缘测量意味着:测量可从升高区域701、710的水平在第一间隔704a内完成, 第一间隔704a从升高区域701、710的水平朝向相邻的降低区域702、712的水平延伸。 Level measurement can be done from elevated levels in the area of 701, 710 first interval 704a, 704a from elevated levels of the first spacer region 701, 710 toward the adjacent lower area 702, 712: The approximate measured from the edge means extension.

[0355] 在该应用中,还使用了相邻连接区域704、716之间的第二距离708b,718b的概念。 [0355] In this application, it is also used to connect the adjacent region of the second distance between 704,716 concepts 708b, 718b of. 关于该第二距离708b、718b,其意味着大致从在连接区域704、716与降低区域702、712之间的连接点到涉及相邻连接区域704、716的另一连接点所测量的距离。 About the second distance 708b, 718b, which means roughly 704,716 from the region in connection with the lower area of 702, 712 between the connection point to another connection point connection region adjacent 704,716 relates to the measured distance. 大致从连接点测量意味着:测量可从降低区域702、712的水平在第二间隔704b内完成,第二间隔704b从降低区域702的水平朝向相邻升高区域701、710的水平延伸。 Roughly from the connection point measurement means: measurements can be completed in the second interval 704b from the lower level area 702, 712, and the second interval 704b from the lower level of the adjacent area 702 toward elevated levels of 701, 710 extends the area.

[0356] 关于升高和降低区域,其意味着位于不同平面703、705、720、722中的区域,其中所述平面分隔开距离707、724、728。 [0356] For raising and lowering the area, which means that in a different plane 703,705,720,722 in the area where the plane separated from the 707,724,728. 所述平面可平行或大致平行,但也可不平行。 The plane may be parallel or substantially parallel to, but may not be parallel. 如果平面平行,则限定它们之间的距离不重要。 If the plane-parallel, the distance therebetween is defined unimportant. 如果平面不平行(如图5b),平面之间的距离可通过平面720、722之一的法线724、728限定,其中法线延伸到另一平面722、726中的区域上的一点,且平面之间的距离等于法线724、728的延伸长度。 If the plane is not parallel (Figure 5b), the distance between the plane through 720, 722, one of the 724,728 limited the normal plane, which extends to a point of another plane normal to 722,726 in the region, and equal to the distance between the plane normal to the length of the extension 724,728. 由图5b可见,法线724、728从平面720、722延伸到距区域的边缘近似相等距离的点。 5b shows that the normal map from the plane extending from 724,728 to 720, 722 from the edge of the area approximately equal point distance. 存在限定平面之间的法线或距离的两种可能方式。 There are two normal or the distance between the plane defining possible ways. 以法线728为例,可将法线限定为728a或728b。 In normal 728, for example, can be defined as normal 728a or 728b. 可适于将两个平面之间的距离限定为最长法线的延伸长度,因此平面720和722之间的距离可等于法线728a的延伸长度。 May be adapted to the distance between the two planes is defined as extending the length of the longest normal, so the distance between the plane 720 and 722 extend the length of the normal line 728a may be equal to the. 该限定将在下文中使用。 The restriction will be used hereinafter.

[0357] 升高和降低区域可具有不同形状,它们可为平面或大致平面,但它们也可具有某一种类的曲面形状。 [0357] curved shape of elevated and lowered areas may have different shapes, they may be planar or substantially planar, but they may also have some kind.

[0358] 升高区域701、710利用连接区域704、716连接到相邻的降低区域702、712。 [0358] raised area 701, 710 connected by the connection regions 704,716 to 702, 712 adjacent to the lower region. 在升高/降低区域与连接区域704、716之间的连接可包括不同尺寸的半径,较大或较小的半径。 In the up / down connections 704,716 connection between the region and the region may include a radius of different sizes, larger or smaller radius. 当半径非常小时,将大致存在对区域进行连接的边缘706、714。 When the radius is very small, it will generally exist to connect the edge of the area 706,714.

[0359] 表述“可膨胀部分”暗指所述部分也是可塌缩的。 [0359] The expression "expandable portion," alluding to the section is collapsible.

[0360] 适当地,拉伸装置10至少部分地包括具有高度生物兼容性的材料,这种材料可被称为生理惰性、生物惰性或生物兼容的。 [0360] Suitably, the stretching device 10 at least partially comprises a material having a high degree of biocompatibility, such materials may be called physiologically inert, biologically inert or biocompatible.

[0361] 具体参照图5a和5b,在表面结构700中,在相邻升高区域701、710之间可优选地存在特定第一距离708a、718a。 [0361] With particular reference to Figures 5a and 5b, the surface structure 700, adjacent elevated regions 701, 710 may preferably exist between a specific first distance 708a, 718a. 相邻升高区域701、710之间的距离被选定为纤维组织无法跨越相邻升高区域701、710之间的第一距离708a、718a。 The distance between adjacent elevated regions 701, 710 is selected as the fibrous tissue can not span adjacent elevated regions 701, 710 a first distance between 708a, 718a. 因此,相邻升高区域701、710之间的第一距离708a、718a优选足够大,以防止形成跨过相邻的升高区域701、710的纤维组织。 Thus, between adjacent elevated regions 701, 710 of the first distance 708a, 718a preferably large enough to prevent the formation across adjacent raised areas 701, 710 of fibrous tissue.

[0362] 如上所述,在相邻连接区域704、716之间可优选地存在特定第二距离708b、718b。 [0362] As described above, in the adjacent area may preferably be connected between 704,716 presence of a specific second distance 708b, 718b. 相邻连接区域704、716之间的第二距离708b、718b被选定为纤维组织无法跨过相邻连接区域704、716之间的第二距离708b、718b。 Connecting the adjacent region of the second distance between 704,716 708b, 718b is selected as the fibrous tissue can not cross a second distance between adjacent connection regions 704,716 708b, 718b. 因此,相邻连接区域704、716之间的第二距离708b,718b优选足够大,以防止形成跨过相邻的连接区域704、716的纤维组织。 Thus, the second connection region adjacent distance between 704,716 708b, 718b is preferably large enough to prevent the formation of cross connection region adjacent to the fibrous tissue 704,716.

[0363] 还可优选的是,升高和降低区域的不同平面703、705、720、722、726之间的第三距离707、724、728a比特定阈值大,以便于拉伸装置发挥可塌缩和/或可膨胀功能。 [0363] Preferably also, the raising and lowering of the third planar region 703,705,720,722,726 different distances between 707,724,728a greater than a specific threshold, in order to play the stretching device can be collapsed reduction and / or expandable functionality. 如果第三距离707、724、728a太小,则拉伸装置的可塌缩和/或可膨胀功能会受到限制。 If the third distance 707,724,728a too small, the stretching device can collapse and / or expandable functions are restricted. 第三距离707、724、728a的合适间隔为0. 5至10mm,更合适的为2_8mm,最合适的为3_7mm。 707,724,728a third distance is suitable interval 0.5 to 10mm, more suitable for the 2_8mm, most suitable for 3_7mm. 为使纤维组织不应阻碍拉伸装置的可塌缩/可膨胀功能,优选的是,距离707、724、728a不太小,但如前所述的间隔是合适的。 For the fibrous tissue stretching device should not impede the collapsible / expandable function, it is preferable that the distance 707,724,728a not too small, but the interval described above is appropriate.

[0364] 表面结构700可包括不同几何形状的物体或元件,例如不同形状的脊、不同形状的凸起以及能够允许本文所述的表面结构的其他形状。 [0364] surface of the structure 700 may include objects or elements of different geometric shapes, such as different shapes of ridges, protrusions of different shapes and other shapes capable of allowing the surface of the structure described herein. 升高区域701、710的面积可以非常小,但仍然形成具有希望功能的表面结构。 Area raised area 701, 710 can be very small, but still having a desired surface structure is formed functions. 升高区域701、710的面积可甚至几乎为零,如图5e中的例示。 701, 710 area raised area can even almost zero, 5e as shown in the illustration. 图5a和5b至5e示出表面结构700的示例的横截面,图5i至5k示出不同表面结构700的示例的立体图。 Figures 5a and 5b to 5e illustrates an example of a surface structure 700 of the cross-section, FIG. 5i to 5k perspective view showing a different example of a surface structure 700. 表面结构700中的物体或元件可成行放置,以一些其他方式编排,或者可以或多或少随意分配在拉伸装置的表面上。 The surface structure of an object or element 700 may be placed in rows, arranged in some other way, or may be more or less randomly distributed on the surface of the stretching device. 不同类型的物体也可一同使用在表面结构700中,例如金字塔形和圆柱形物体与一些形状的脊的组合。 Different types of objects can also be used together in the surface structure 700, such as a combination of pyramidal shape and a cylindrical object with a number of ridges.

[0365] 在图5f至5h中,拉伸装置10的实施例被示出,其中使用了表面结构700,未完全示出拉伸装置10。 [0365] In Figure 5f to 5h, the stretching apparatus in Example 10 is shown, in which the surface of the structure 700, is not fully shown stretching device 10. 图3示出拉伸装置10的纵向截面,其中740表示拉伸装置10的上侧的表面结构,742表示拉伸装置10的下侧的表面结构。 Figure 3 shows a longitudinal section of the stretching device 10, wherein the surface of the structure 740 shows the stretching device 10 side, 742 indicates the lower surface of the structure 10 of the stretching device. 如图5f所示,下侧的表面结构742具有的延伸长度可比阴茎假体的上侧的表面结构740的延伸长度大。 FIG. 5f, the surface structure of the upper surface of the lower structure 742 extending the length of the penile prosthesis having a comparable length 740 extending large. 当拉伸装置10膨胀时, 这为拉伸装置10赋予弯曲位置。 When the stretching device 10 is expanded, which is assigned to the stretching device 10 bent position. 表面结构140和142为弯曲部分的一个示例。 Surface structures 140 and 142 as an example of the bent portion. 图5g示出拉伸装置10的横截面,其中拉伸装置10包括腰部744,其中腰部包括腰表面结构746和748。 Figure 5g shows a cross-section of the stretching device 10, in which the stretching device 10 includes a waist 744, which includes a waist waist surface structures 746 and 748. 带有腰表面结构746和748的腰部使拉伸装置10也可沿径向膨胀。 Waist with waist surface structure 746 and 748 of the draw means 10 may also expand in the radial direction. 拉伸装置10也可具有如图10所示的横截面,其包括具有四个腰表面结构750、752、754、756的腰部744,从而进一步便于使拉伸装置10也能够沿径向膨胀。 Stretching device 10 may also have a cross-section 10 shown in FIG, comprising a surface structure having four waist waist 750,752,754,756 744, thereby further facilitates the stretching device 10 can be expanded radially. 图5g中的横截面沿图5f的线A1-A2截取。 Figure 5g in a cross-sectional view taken along line 5f A1-A2.

[0366] 图6a例示出设置有入口18b的拉伸装置10。 [0366] Figure 6a illustrates a stretching device 18b is provided with an inlet 10. 拉伸装置10套叠在胃壁12中,入口18b可以从病人的腹区域连接到管或类似形式。 Stretching device 10 nested within the stomach wall 12, the inlet 18b from the abdominal area of the patient may be connected to a tube or similar form. 管或管路18可优选地连接到控制单元42 或注入端口1001。 Tube or conduit 18 can preferably be connected to the control unit 42 or the injection port 1001.

[0367] 图6b例示出套叠的拉伸装置10,其中管路18或电引线代替入口延伸到病人的腹区域。 Stretching device nested [0367] Figure 6b illustrates 10, in which the lines or electrical wiring in place of the inlet 18 extends into the abdominal area of the patient.

[0368] 图6c示出拉伸装置10的一部分和拉伸装置被套叠所在的胃的部分。 [0368] Figure 6c shows a portion of the quilt stomach stretching device 10 where overlapping portions of the stretching device. 管路18或电引线利用胃至胃的缝合线或订合线14套叠在胃壁12中,缝合线或订合线14形成放置拉伸装置10的胃壁组织的整个密封囊。 Line 18 or electrical leads with stomach to stomach sutures or staplers 14 nested in the stomach wall 12, sutures or staplers 14 form the entire sealed bag placed stretching device 10 of the stomach tissue. 管路18或电引线由此在入口18b与填充装置10的容积之间掘进于胃壁12中。 Line 18 or electrical leads whereby the volume between the inlet 18b and filling device 10 heading in the stomach wall 12.

[0369] 已经示出拉伸装置10的形状可采取许多不同形式。 [0369] have shown the shape of the stretching device 10 can take many different forms. 可以意识到,拉伸装置10的材料也可改变。 As can be appreciated, device 10 stretchable material may also vary. 优选的是,拉伸装置10设置有涂层,例如聚对二甲苯、聚四氟乙烯(PTFE) 或聚氨酯涂层,或者这些涂层的组合,即,多层涂层。 Preferably, the stretching device 10 is provided with a coating, e.g., parylene, polytetrafluoroethylene (PTFE) or polyurethane coating, or a combination of these coatings, i.e., the multi-layer coating. 该涂层或多层涂层改善拉伸装置的性质,例如其抗磨损性。 The coating or a multilayer coating improved properties of the stretching device, such as its abrasion resistance.

[0370] 在图7所示的另一实施例中,拉伸装置10根据与以上参照图1至6所述的原理不同的原理工作。 [0370] In another embodiment shown in FIG. 7, the stretching apparatus 10 according to the principles described above with reference to Figures 1 to 6, wherein a different principle. 拉伸装置10在此包括第一固定部分IlOa和第二固定部分110b,第一固定部分IlOa适于在胃壁12上的第一位置具有第一固定,第二固定部分IlOb适于在胃壁12 上的第二位置具有第二固定。 In this stretching device 10 includes a first fixed portion IlOa and the second fixed portion 110b, a first fixing portion IlOa adapted to the stomach wall 12 has a first fixed first position, the second fixed portion IlOb adapted to the stomach wall 12 a second position having a second fixed. 优选具有大致圆形形状并优选适于套叠在胃壁12中的这些固定部分IlOaUlOb附接到各自腿部211的远端,腿部211接着在其各自的近端附接到操作装置,例如马达40。 Preferably having a substantially circular shape and preferably adapted invaginated in the stomach wall 12 of the fixed portion IlOaUlOb attached to the distal end of each leg 211, leg portion 211 is then at its proximal end attached to the respective operating means, such as a motor 40. 根据图7所示的实施例,马达为液压马达,包括液压活塞,其连接到先前参照图1所述的手动操作装置。 According to the embodiment shown in FIG. 7, the motor is a hydraulic motor, comprising a hydraulic piston, which is connected to the manually operable means described previously with reference to FIG. 1. 液压活塞通过其与放置在腿部的极限处的关节212的连接影响腿部。 Through its joint with hydraulic piston placed in the leg at the limit of 212 junctions of the legs. 拉伸装置110被封闭在壳体214中,以保护装置而避免纤维组织的生长,纤维组织可能损坏所述装置10的功能。 Stretching device 110 is enclosed in a housing 214 in order to protect the system and prevent the growth of fibrous tissue, fibrous tissue may damage the function of the device 10. 然而,同样可以设想到,马达为另一液压马达、气动马达或电动马达。 However, also conceivable that the motor is another hydraulic motor, a pneumatic motor or electric motor.

[0371] 拉伸装置10适于增大胃壁12上的第一位置与第二位置之间的距离,由此拉伸胃壁12。 [0371] stretching means 10 is adapted to increase the distance between the first position on the stomach wall 12 and the second position, thereby stretching the stomach wall 12. 第一和/或第二固定部分IlOaUlOb适于利用胃至胃的缝合线或订合线14至少部分地套叠在胃壁12中,从而将固定部分IlOaUlOb关于胃壁12悬浮地保持在适当位置。 The first and / or second fixed portion IlOaUlOb adapted with stomach to stomach sutures or staplers 14 is at least partially nested within the stomach wall 12, so that the fixed portion IlOaUlOb suspended on the stomach wall 12 held in place.

[0372] 当然,第一和第二位置可以多种可能的方式被缝合或固定到胃壁,本发明覆盖所有可能性,以通过使胃壁的两个部分背离彼此移动并由此首先将装置固定到胃壁上的至少两个位置来扩张胃壁。 [0372] Of course, the first and the second position can be a variety of possible ways sewn or fixed to the stomach wall, the present invention covers all possibilities to make the stomach wall by moving two portions to each other and thus away from the first means is fixed to the at least two positions to expand the stomach the stomach wall. 然而,优选软悬浮连接到胃壁12,其中纤维胃至胃的组织帮助给定长期稳定的位置。 Preferably, however, the soft suspension is connected to the stomach wall 12, in which the fibers of the stomach-to-stomach position given to organizations to help the long-term stability.

[0373] 当然,仅仅使胃的套叠部分膨胀也拉离胃壁12,这也可机械、液压、气动以及由马达或泵提供动力或手动力地实现。 [0373] Of course, only part of the stomach of nesting expansion also pulled away from the stomach wall 12, which may be mechanical, hydraulic, pneumatic, and power is provided by a motor or pump or hand power to achieve.

[0374] 任何种类的机械结构可被使用,公开的机械实施例为一个示例。 [0374] Any kind of mechanical construction may be used, the mechanical embodiment disclosed as an example. 可使用通过机械或液压或任何气动结构驱动的任何机械。 You can use any machine by any mechanical or hydraulic or pneumatic structure driven. 任何马达或任何泵或在被供应电力时改变形式的 Any motor or pump or any form of change, when the supply of electricity

38移动材料可被用于实现如下简单目标:通过使胃壁的至少两个部分背离彼此移动来拉伸胃壁的一部分。 38 may be used to move the materials to achieve the following objectives simple: by reacting at least two portions of the stomach wall away from the moving part to each other to stretch the stomach wall.

[0375] 图8示出根据一实施例的拉伸装置110,其中拉伸装置由可植入控制组件42控制, 如前所述,传感器输入被其接收。 [0375] Figure 8 shows the stretching device 110 according to an embodiment example, wherein the stretching device 42 is controlled by the implantable control unit, as described above, its sensor input is received. 拉伸装置因而利用泵44通过管路18调整,泵44连接到至少一个流体贮存器16、46并由连接到无线能量的接收器205、放置在皮肤36下面的能量转换构件30或者可植入能量源70 (例如,可再充电电池)提供动力。 Thus the stretching device 18 by a pump 44 through line adjustment, the pump 44 is connected to the at least one fluid reservoir 16,46 is connected to the wireless energy by the receiver 205, the skin 36 is placed below the energy conversion member 30 or the implantable energy source 70 (e.g., a rechargeable battery) powered.

[0376] 在图9a所示的变型中,第一和/或第二固定部分210a、210b分别展现出适于与胃壁12接触的结构,以促进人体组织的生长,从而确保附接到胃壁12的保拉伸装置10的长期放置。 [0376] In the variant shown in Figure 9a, the first and / or second fixing portions 210a, 210b, respectively, exhibit 12 is adapted to contact with the stomach wall structure, in order to promote the growth of human tissue, thereby ensuring attached to the stomach wall 12 Paul stretching device 10 long-term placement. 该结构优选包括网状结构213。 The structure preferably includes a mesh structure 213. 固定部分210a、210b可适于通过固定部分与胃壁12之间的缝合线或订合线来将拉伸装置10保持在适当位置,以确保拉伸装置10的短期放置。 Fixing portions 210a, 210b can be adapted to the fixed portion of the stomach wall via sutures or staplers 12 between the line 10 to the stretching device held in place, to ensure that the stretching device 10 is placed in the short term. 除机械操作之外,根据图9a所示的实施例的拉伸装置10根据参照图7所述的装置发挥作用。 In addition to the mechanical operation, according to FIG. 9a stretching apparatus shown in the embodiment of the apparatus 10 to play a role described with reference to FIG. 7 in accordance with. 图%示出固定装置213,其包括适于传播纤维组织的生长以将两个固定部分固定到胃壁12的网状结构。 Figure shows the fixture 213%, including the growth of fibrous tissue suitable for dissemination to the two fixed portion 12 is fixed to the mesh structure of the stomach wall.

[0377] 图9c示出根据图9a的实施例的处于第二状态的拉伸装置,其中两个固定部分已经彼此分离,且胃12已被拉伸。 [0377] Figure 9c shows the stretching device in the second state of the embodiment of the embodiment according to Figure 9a, which has two fixed portions separated from each other and the stomach 12 has been stretched.

[0378] 图IOa示出根据一实施例的拉伸装置,其中拉伸装置为通过电源线32'连接到控制组件42的电机械拉伸装置。 [0378] FIG IOa shows a stretching apparatus according to an embodiment wherein the stretching device through the power line 32 'is connected to the control unit 42 of the electrical mechanical stretching device. 电源线32连接到动力转换装置30,与无线能量的接收器205 (例如线圈)接触,接收器205从无线能量的发射器34a接收能量。 Power cord 32 is connected to the power conversion apparatus 30, 205 (e.g., coil) into contact with a receiver of wireless energy, the receiver 205 receives energy from the wireless energy transmitter 34a. 控制组件可进一步包括电池70,用于存储从无线能量发射装置34a接收的能量。 The control assembly may further include a battery 70, means 34a for storing the energy received from the wireless energy transmission. 控制组件接收来自传感器201 的输入,传感器201根据本实施例为测量贲门204的收缩和/或放松的应变仪。 Control module 201 receives input from sensors, sensor 201 according to this embodiment is a measurement of 204 cardiac contraction and / or relaxation of the strain gauge.

[0379] 图IOb进一步详细示出拉伸装置10。 [0379] FIG IOb further stretching device 10 is shown in detail. 拉伸装置10包括壳体,其具有由柔性材料制成的手风琴结构209,以使壁部分能够移动。 Stretching means 10 comprises a housing having accordion structure 209 made of flexible material, so that the wall portion can move. 电源线32连接到电动马达的定子217,所述马达进一步包括设有螺纹的转子218,转子218与包括对应螺纹的可移位构件219相互作用。 Power line 32 is connected to the electric motor stator 217, the motor further comprising a rotor provided with a thread 218, and the rotor 218 includes a corresponding threaded displaceable member 219 interaction. 移位构件可旋转地固定到壳体接触构件220,其推靠壳体以影响拉伸装置的容积并由此拉伸胃12。 Shift member rotatably secured to the housing member 220 contacts, which pushes against the housing to affect the volume of the stretching device and thereby stretching the stomach 12.

[0380] 图IOc示出处于第二状态下的根据图IOb的拉伸装置,其中拉伸装置10膨胀并由此拉伸胃壁12。 [0380] FIG IOc shown in a second state of the apparatus according to FIG. IOb stretching, wherein the stretching device 10 is expanded and thereby stretching the stomach wall 12.

[0381] 图Ila示出一实施例,其中适于治疗返流疾病的装置与根据以上任意实施例的拉伸装置组合。 [0381] FIG Ila illustrates an embodiment in which the apparatus is adapted to treat reflux disease and stretching means according to a combination of the above embodiment in any embodiment. 在装置410套叠在基底416中之后,由多个胃至胃的缝合线或订合线422a组成的固定被施加,以保持套叠短期不受损。 After the 410 sets of stacked substrate 416, by a number of stomach-to-stomach sutures or staplers 422a fixed composition is applied means to keep short-term intussusception is not damaged. 由多个胃至胃的缝合线或订合线422b组成的第二固定被设置为将装置410保持在贲门414上方的位置。 By a number of stomach-to-stomach sutures or staplers 422b composed of a second fixed device 410 is set to be held in position 414 above the cardia. 缝合线或订合线422b被施加在基底416的壁与食管424的壁之间。 Sutures or staplers 422b is applied between the substrate 416 and the wall of the esophagus wall 424. 另外,采用缝合线或订合线422c形式的第三固定可被提供在基底416的壁与隔膜418的壁之间,也用于将装置410保持在贲门414上方的位置。 In addition, the third fixed using sutures or staplers 422c form may be provided between the substrate 416 and the walls of the membrane wall 418, but also for the device 410 is maintained at a position 414 above the cardia.

[0382] 在图Ila所示的第四实施例中,返流疾病治疗装置410的尺寸在被植入时可被调整。 [0382] In the fourth embodiment shown in Figure Ila, the size of the reflux disease treatment apparatus 410, when the implant may be adjusted. 返流疾病治疗装置410与通过引线452b连接到返流疾病治疗装置410的皮下液压贮存器452关联,其中非侵入性调整可通过手动按压贮存器452执行。 Reflux disease treatment device 410 and 452b connected by wire to the reflux disease treatment device subcutaneously hydraulic reservoir 410 of 452 association, including non-invasive adjustment can be performed by manually pressing the reservoir 452. 按压贮存器452将液压流体经由引线452b从贮存器452移位到较小的室410b。 Pressing hydraulic fluid reservoir 452 via leads 452b displaced from the reservoir 452 to the smaller chambers 410b. 返流疾病治疗装置410接着连接到一个或多个较小的室410b。 Reflux disease treatment apparatus 410 is then connected to one or more smaller chambers 410b. 采用该方式,病人可以适于治疗的方式来调节流疾病治疗装置410的尺寸。 With this approach, the patient treatment may be adapted to adjust the size of the flow way disease treatment device 410.

39[0383] 而且,以上实施例可替换地也用于治疗肥胖症。 39 [0383] Further, the above embodiments may also alternatively be used in the treatment of obesity. 在该实施例中,通过利用返流疾病主体的容积来包含流体,并进一步利用连接到该装置主体的一个或多个较小的室40b被泵填充流体来膨胀并由此拉伸基底壁来制造饱胀感,该装置可适于治疗肥胖症。 In this embodiment, by using the volumetric reflux disease body to contain a fluid, and further use of the apparatus main body is connected to one or more of the smaller chamber 40b is filled with a fluid pump to draw swell and thereby to the base wall Manufacturing sense of fullness, the device can be adapted to treat obesity. 小室410b也适于被套叠在基底胃壁中,且当被填充流体时,发生胃的膨胀,这导致人体传感器反馈,从而造成饱胀感。 410b are also suitable for small room in the base invaginated stomach wall, and when the fluid is filled, the occurrence of stomach swelling, which causes the body sensor feedback, resulting in a feeling of fullness. 皮下液压贮存器/泵使病人能够方便地泵浦液压流体以填充小室410b,从而造成他或她希望的饱胀感。 Subcutaneous hydraulic reservoir / pump so that the patient can easily pump hydraulic fluid to fill the chamber 410b, thereby causing him a sense of fullness or she wishes.

[0384] 可替换实施例示于图lib中。 [0384] alternative embodiment shown in FIG. Lib. 该实施例基本类似于图Ila所示的实施例,不同之处在于如何控制返流治疗装置410和室410b。 This embodiment is substantially similar to the embodiment shown in FIG Ila, the difference lies in how to control the reflux treatment device 410 and the chamber 410b. 这里,室410b不由皮下的泵控制,而是由动力式内部控制单元456控制。 Here, the chamber 410b help subcutaneous pump control, but is controlled by the control unit 456 Powered Internal. 内部控制单元456包括如下机构,该机构用于使病人控制应该如何使用装置410来进行关于返流和/或肥胖症的治疗。 Internal control unit 456 includes the mechanism that should be used to control the patient how to use the device 410 for treatment on regurgitation and / or obesity. 其也可包括将动力供应到所述装置的机构。 It may also include the power supplied to the mechanism of the apparatus.

[0385] 内部控制单元456可包括电池470、电开关472、马达/泵444、贮存器452、注入端口1001。 [0385] The internal control unit 456 may include a battery 470, a power switch 472, the motor / pump 444, the reservoir 452, injection port 1001. 带有远程控制器的能量发射装置34适于控制装置并为该装置提供动力。 Energy-emitting device with a remote control device 34 is adapted to control and provide power for the devices. 例如,如果装置是电、液压、气动或机械操作的,则项目根据环境选择。 For example, if the device is an electrical, hydraulic, pneumatic or mechanical operations, the project selection according to the environment.

[0386] 装置10可用于保持电子元件和/或能量源和/或液压流体。 [0386] means 10 can be used to maintain electronic components and / or energy source and / or hydraulic fluid.

[0387] 图12a示出可调节容积填充装置810,其被套叠在病人的胃12的胃壁中。 [0387] Figure 12a shows an adjustable volume filling device 810, which invaginated in the stomach wall 12 of a patient's stomach. 容积填充装置810适于占据胃中的空间,并由此减小可放置食物的容积。 Volume filling device 810 is adapted to occupy space in the stomach, and thereby reducing the volume of the food can be placed. 另外,根据任意实施例的可调节拉伸装置10被套叠在病人的胃基底壁中。 Further, according to any of embodiments 10 adjustable stretching device invaginated in the stomach fundus wall of the patient. 优选的是,容积填充装置810显著大于拉伸装置10。 Preferably, the volume filling device 810 is significantly larger than the stretching device 10.

[0388] 容积填充装置810和拉伸装置10经由其中设置有泵54的第一流体管52彼此流体连通。 [0388] 810 and the volume filling device wherein the stretching device 10 via the first fluid pump 54 is provided with a tube 52 in fluid communication with each other. 泵54由能量转换装置30控制,能量转换装置30适于经由能量供应管线56向泵54供应能量。 54 by the pump means 30 controls the energy conversion, energy converting means 30 is adapted to supply line 56 to the pump 54 via a power supply energy. 能量转换装置30还连接到设置在病人食管中的传感器201,使得食物摄入可被检测。 Energy converting means 30 is also provided in the patient is connected to the sensor 201 in the esophagus, so that food intake can be detected.

[0389] 容积填充装置810和拉伸装置10还经由第二流体管58彼此流体连通,第二流体管58优选具有比第一流体管52小的截面面积。 [0389] 810 and the volume filling device 10 further stretching apparatus via a second fluid pipe 58 in fluid communication with each other, the second fluid tube 58 having a tube 52 is preferably smaller than the cross-sectional area of the first fluid.

[0390] 该设置结构的操作如下。 [0390] Operation of the set structure is as follows. 容积填充装置810用在上述实施例中,S卩,其减小病人的胃12的食物腔的尺寸。 Volume filling device 810 used in the above embodiments, S Jie, which reduces the size of the food cavity 12 of the patient's stomach. 另外,当通过利用泵54将流体从容积填充装置810泵浦到拉伸装置10而扩大拉伸装置10时,胃基底壁得到拉伸,从而造成病人的饱胀感。 In addition, by means of the pump 54 when fluid from the pumping volume filling device 810 to the stretching device 10 and expand stretching device 10, by stretching the stomach fundus wall, causing the patient's sense of fullness. 因此,例如当食物摄入被传感器201检测到时,流体自动泵浦到拉伸装置10,以增加饱胀感并由此限制食物摄入。 Thus, for example, when food intake is detected by sensor 201, fluid is automatically pumped into the stretching device 10, in order to increase the feeling of satiety and thereby limit the food intake.

[0391] 当流体已被注入拉伸装置10时,其中的内部压力高于容积填充装置810中的内部压力。 [0391] When fluid 10 is injected into the stretching device, wherein the internal pressure is higher than the volume of the filling device 810 in the internal pressure. 该压力差将引起第二、优选较窄的管58中的流体从拉伸装置10流动到容积填充装置810。 The pressure difference will cause the second, preferably narrower tube 58 from the fluid flow to the stretching apparatus 10 volume filling device 810. 流动率将首要通过压力差和第二管58的截面面积以及其他可能方法来确定。 The cross-sectional area of the flow rate by the pressure difference between the first and second tube 58 and other possible methods to determine. 优选的是,第二管的尺寸适于使得容积填充装置810和拉伸装置10中的压力将在流体已被注入拉伸装置10以引起饱胀感之后的3个小时之后恢复平衡。 Preferably, the second tube is sized such that the volume filling device 810 and the pressure stretching apparatus 10 which has been injected into the stretching device 10 to cause the fluid to restore equilibrium after 3 hours after fullness.

[0392] 在该实施例中,第二管58的功能是允许流体从拉伸装置10返回容积填充装置810。 [0392] In this embodiment, the function of the second tube 58 is to allow fluid return volume filling device 810 from the stretching apparatus 10. 可以意识到,该功能还可通过第一管52中的泵54执行,且因而第二管58可被省略。 As can be appreciated, the first tube 52 can also function in execution pump 54, and thus the second tube 58 may be omitted.

[0393] 现在将参照图12b描述用于治疗肥胖症的装置的又一可替换实施例,其示出被治疗肥胖症的病人的胃12。 [0393] will now be described with reference to FIG. 12b for treating obesity still another alternative embodiment of the apparatus, which is shown by the treatment of 12 patients with obesity stomach. 该装置包括采用可充胀装置10形式的容积填充装置810,其被套 The device includes a 10 in the form of an inflatable device volume filling device 810 quilt

40叠在病人的胃12的壁12a中。 40 stacked in the patient's stomach wall 12a 12's. 然而,在该情况下,套叠在基底(即,胃的上部,在该处胃壁中的受体的数量较大)执行,且可充胀装置用作针对胃基底壁一部分的拉伸装置。 However, in this case, nested in the base (ie, the upper part of the stomach, where the number of receptors in the stomach is larger) executed and the inflatable device is used as a base for the stomach wall portion stretching device.

[0394] 用于流体的调整贮存器利用采用管的形式的管路18连接到可充胀装置。 Adjustment reservoir [0394] using the tube for fluid use in the form of pipe 18 is connected to the inflatable devices. 可充胀装置810由此适于通过使液体或空气从调整贮存器移动到由可充胀装置810形成的室而被优选非侵入性地调整。 Inflatable means 810 thereby is adapted by adjustment of the liquid or air from the reservoir to the chamber to move the inflatable device 810 is formed is preferably adjusted non-invasively. 可充胀装置810的调整优选包括回动伺服机构,即,小容积例如通过病人的手指启动,且该小容积与较大容积(即,调整贮存器)相连。 Inflatable means 810 preferably comprises a reversed servo adjustment mechanism, i.e., a small volume such as through the patient's finger to start, and the small volume and large volume (i.e., the regulation reservoir) is connected.

[0395] 因此,可充胀装置810被放置在胃壁外部,并适于拉伸胃基底壁的一部分,由此影响病人的胃口。 [0395] Thus, the inflatable device 810 is placed in the stomach outside and adapted to stretch a base portion of the stomach wall, which affect the patient's appetite. 通过扩大拉伸装置的尺寸,由于可充胀拉伸装置810的周界增大,因此环绕可充胀拉伸装置810的胃基底壁被拉伸。 By expanding the size of the stretching device, since the inflatable stretching device 810 perimeter increases, so surround inflatable stretching device 810 gastric fundus wall is stretched. 通过该拉伸,胃壁中的受体指示胃被充满,由此引起病人的饱胀感。 By this stretching the stomach wall receptors indicates stomach is full, thereby causing the patient's sense of fullness. 因此,当拉伸装置810收缩时,受体指示胃没有满,由此恢复饥饿感。 Therefore, when the stretching device 810 contracts receptor indicates stomach is not full, thereby restoring a sense of hunger. 可以意识到,该实施例组合了减小胃食物腔的容积以及拉伸胃壁12的部分的效果,由此增加治疗效果。 It will be appreciated, this embodiment combines the reduced volume of the stomach food cavity and stretching effect of the stomach wall portion 12, thereby increasing the therapeutic effect.

[0396] 拉伸装置810的膨胀和收缩可在病人的直接控制下执行。 [0396] stretching device 810 expansion and contraction can be performed under the direct control of the patient. 可替换地,膨胀和收缩可根据预编程安排执行。 Alternatively, the expansion and contraction can be performed according to a pre-programmed schedule.

[0397] 在图12c所示的优选实施例,传感器201被设置在合适的位置,例如食管处。 [0397] In a preferred embodiment shown in Figure 12c example, the sensor 201 is provided at a suitable location, such as esophagus. 采用可充胀拉伸装置形式的容积填充装置810类似于图12b所示的容积填充装置810。 Using volume inflatable stretching device in the form of filling volume device 810 shown in Figure 12b is similar to filling device 810. 通过提供一个或多个传感器,用于治疗肥胖症的装置可被自动化,这是因为采用可充胀拉伸装置形式的容积填充装置810的尺寸根据进入胃的食物腔的食物量来调节。 By providing one or more sensors, a device for treating obesity can be automated, this is because the use of the volume of the inflatable stretching device in the form of a filling device 810 in accordance with the size of the food into the stomach cavity to adjust the amount of food. 流体由此移动在可充胀容积填充装置810与流体贮存器之间。 Whereby fluid is moved between the inflatable volume filling device 810 and the fluid reservoir.

[0398] 系统 [0398] System

[0399] 现在将参照图13至29描述大体上由附图标记28表示且包括如上所述的拉伸装置的肥胖症治疗系统。 [0399] will now be described with reference to FIG. 13 to 29 indicated generally by reference numeral 28 and includes a stretching device obesity treatment system as described above.

[0400] 图8的系统包括放置在病人腹部中的拉伸装置10。 System [0400] FIG. 8 is placed in the patient's abdomen comprises stretching means 10. 采用植入的能量转换装置30 形式的内部能量源适于经由动力供应管线32向肥胖症治疗系统的能量消耗部件供应能量。 Internal energy using implanted energy transforming means 30 forms the source is adapted to supply energy consuming member 32 via a power supply line of the power system to the treatment of obesity. 外部能量发射装置34包括发射由能量接收器接收的无线信号的无线远程控制器,能量接收器可并入植入的能量转换装置30或与其分立。 Energy of the external energy transmission device 34 comprises a radio signal transmitting energy received by a wireless remote control receiver, the receiver may be incorporated into the energy conversion means 30 or the implantable discrete thereto. 植入的能量转换装置30将能量从信号转换为经由动力供应管线32供应的电能。 Implanted energy transforming device 30 to the energy from the signal into electric power 32 supplied via the power supply line.

[0401] 图8的系统以更概括的框图形式示于图15中,其中大体上由竖直线示出的病人的皮肤36将线右侧的病人的内部与线左侧的外部分离。 [0401] In the system of Figure 8 is a more generalized block diagram form in FIG. 15, in which the patient is substantially outside the vertical line shown by the patient's skin 36 to the interior of the line on the right side to the left of the separation line.

[0402] 图13示出简化框图,其示出拉伸装置10、经由动力供应管线32为拉伸装置提供动力的能量转换装置30、以及外部能发射装置34。 [0402] Figure 13 shows a simplified block diagram showing the stretching device 10, switching means 30 via power supply line 32 to provide power for the stretching means energy, and the external device 34 can transmit.

[0403] 图14示出等同于图17的实施例的本发明的实施例,不同之处在于可由极化能操作的采用电开关38形式的回动装置也植入在病人体中,以使拉伸装置10回动。 [0403] FIG. 14 illustrates an embodiment of FIG. 17 is equivalent to the embodiment of the present invention, except that the reversing means 38 in the form of the use of electricity by the polarization switch can operate also implanted in the patient in order to make stretching means 10 move back. 外部能量发射装置34的无线远程控制器发射承载极化能的无线信号,植入的能量转换装置30将无线极化能转换为极化电流,以操作电开关38。 The external energy transmission device 34, wireless remote control transmitting a wireless signal carries polarized energy and the implanted energy transforming device 30 to the wireless polarized energy into polarization current to operate the electrical switch 38. 当电流的极性被植入的能量转换装置30移位时,电开关38使通过拉伸装置10执行的功能回动。 When the polarity of the current energy conversion device was implanted 30 shift, electrical switch 38 so that the function performed by stretching device 10 move back.

[0404] 图15示出等同于图13的实施例的本发明的实施例,不同之处在于植入在病人体中用于调整拉伸装置10的操作装置40被设置在植入的能量转换装置30与拉伸装置10之间。 [0404] FIG. 15 shows an embodiment of the present invention is equivalent to the embodiment of FIG. 13, except that the operation device implantable in the patient for regulating the stretching device 10 is provided at 40 implanted energy transforming 30 and 10 between the stretching device. 该操作装置可采用马达40的形式,例如电动伺服马达。 The operating device 40 may be in the form of a motor, such as an electric servo motor. 当外部能量发射装置34的远程控制器将无线信号发射到植入的量转换装置30的接收器时,马达40由植入的能量转换装置30的能量提供动力。 When the external energy transmission device 34 of the wireless remote controller signal is transmitted to the receiver 30 of the conversion amount of the implanted device, the motor 40 by the energy of the implanted device 30 to power the energy conversion.

[0405] 图16示出等同于图17的实施例的本发明的实施例,不同之处在于其也包括操作装置,该操作装置采用包括马达/泵单元78的组件42的形式且流体贮存器46植入在病人体中。 [0405] FIG. 16 shows an embodiment identical to Figure 17 of an embodiment of the present invention, except that it also includes an operation means, the operation means 78 adopts the form of assembly 42 comprises a motor / pump unit and the fluid reservoir 46 implanted in the patient. 在该情况下,拉伸装置10被液压操作,即液压流体通过马达/泵单元44从流体贮存器46通过管路48泵浦到拉伸装置10以操作该拉伸装置,液压流体通过马达/泵单元44从拉伸装置10泵浦回流体贮存器46,以使拉伸装置恢复起始位置。 In this case, the stretching device 10 is hydraulically operated, i.e. hydraulic fluid through the motor / pump unit 44 from the fluid reservoir 46 through line 48 to the pump 10 to operate the stretching means stretching device, the hydraulic fluid through the motor / pump unit 44 back from the stretching device 10 pumping fluid reservoir 46, so that the stretching means to restore the starting position. 植入的能量转换装置30 将无线能量转换为电流,例如极化电流,以经由电源供应管线50为马达/泵单元44提供动力。 Implanted energy transforming device 30 to the wireless energy into a current, for example, the polarization current to the power supply line 50 via the motor / pump unit 44 to power.

[0406] 还可以设想到,拉伸装置包括气动操作装置,以代替液压操作的拉伸装置10。 [0406] It is also contemplated that the stretching means comprises a pneumatic operating device, instead of a hydraulically operated stretching device 10. 在该情况下,加压空气可用于调整,流体贮存器由空气室代替,流体由空气代替。 In this case, pressurized air can be used to adjust the fluid reservoir is replaced by an air chamber, the fluid is replaced by air.

[0407] 在所有这些实施例中,能量转换装置30可包括可再充蓄能器(例如电池或电容器)以被无线能量充电,并将功能供应给装置的任何能量消耗部分。 [0407] In all of these embodiments, the energy converting device 30 may comprise a rechargeable accumulator (such as a battery or capacitor) is charged to a wireless energy supplied to the apparatus and the function of any part of the energy consumption.

[0408] 外部能量发射装置34优选是无线的,且可包括远程控制的控制装置,用于从人体外部控制装置。 [0408] the external energy transmission means 34 preferably are wireless, and may include a remotely controlled control device for the human body from the external control means.

[0409] 这种控制装置可包括无线远程控制器以及最可能间接地与病人的手接触的任何植入部分的手动控制器,例如放置在皮肤下面的用于按压的按钮。 [0409] The control means may include a wireless remote control as well as any portion of the implant may be indirectly in contact with the patient's hand manual controller, for example, is placed under the skin of the pressed button.

[0410] 图17示出本发明的实施例,其包括带有无线远程控制器的外部能量发射装置34、 在该情况下液压操作的拉伸装置10、以及植入能量转换装置30,并进一步包括液压流体贮存器52、马达/泵单元44和采用液压阀移位装置54形式的回动装置,所有均植入在病人体内。 [0410] FIG. 17 shows an embodiment of the present invention, comprising an external energy transmitter with a wireless remote control device 34, in this case 10, and a hydraulically operated stretching device implanted energy conversion means 30, and further 52, the motor / pump unit 44 and the reversing device uses a hydraulic valve shifting device 54 forms include a hydraulic fluid reservoir, all of which are implanted in the patient. 当然,液压操作可易于通过仅仅改变泵浦方向执行,液压阀因此可被省略。 Of course, the hydraulic operation can be easily executed by merely changing the direction of the pump, the hydraulic valve may therefore be omitted. 远程控制器可为与外部能量发射分离或包括在其内的装置。 Isolated or remote controller may include therein a means for the emission and external energy. 马达/泵单元44的马达为电动马达。 Motor / pump unit 44 of the motor is an electric motor. 响应来自外部能量发射装置34的无线远程控制器的控制信号,植入的能量转换装置30利用由控制信号承载的能量为马达/泵单元44提供能量,其中马达/泵单元44将液压流体分配在液压流体贮存器52与拉伸装置10之间。 In response to a control signal from the wireless remote control the external energy transmission device 34, the implanted energy transforming device 30 utilizing the energy carried by the control signal of the motor / pump unit 44 to provide energy, wherein the motor / pump unit 44 in the hydraulic fluid dispensing the hydraulic fluid between the reservoir 52 and the stretching means 10. 外部能量发射装置34的远程控制器控制液压阀移位装置54,以使液压流体流动方向在一个方向与另一相反方向之间改变,在所述一个方向上,流体由马达/泵单元44从液压流体贮存器52泵浦到拉伸装置10以操作拉伸装置,在所述另一相反方向上,流体由马达/泵单元44从拉伸装置10泵浦到液压流体贮存器52以将拉伸装置恢复到起始位置。 External energy transmission device 34 of the remote controller controls the hydraulic valve shifting device 54, so that the hydraulic fluid flow direction between one direction and the other in the opposite direction to change, in said one direction, fluid from the motor / pump unit 44 from pumping hydraulic fluid reservoir 52 to the stretching device 10 to operate the stretching device, on the other in the opposite direction, the fluid by the motor / pump unit 44 from the pumping device 10 to draw hydraulic fluid reservoir 52 to pull stretch means to return to the starting position.

[0411] 图18示出等同于图17的实施例的本发明的实施例,不同之处在于由外部能量发射装置34的无线远程控制器控制的内部控制单元56、蓄能器58和电容器60也被植入在病人体中。 [0411] FIG. 18 shows an embodiment identical to Figure 17 of an embodiment of the present invention, except that the internal control unit 34 of the radio remote control apparatus controlled by an external energy transmitter 56, an accumulator 58 and a capacitor 60 also it is implanted in the patient. 内部控制单元56将从植入的能量转换装置30接收的电能的存储布置在蓄能器58中,蓄能器58将能量供应到拉伸装置10。 Internal control unit 56 from the implanted energy transforming device 30 is arranged to receive the electrical energy stored in the accumulator 58, the accumulator 58 supplies energy to the stretching device 10. 响应来自外部能量发射装置34的无线远程控制器的控制信号,内部控制单元56或者释放来自蓄能器58的电能并将释放的电能经由动力线62和64转换,或者直接将来自植入的能量转换装置30的电能经由动力线66、稳定电流的电容60、动力线68和动力线64转换,用于操作拉伸装置10。 Energy response to control signals from the external energy transmission device 34 wireless remote control, the internal control unit 56 or the release of energy from the accumulator 58 and the release of 62 and 64 convert electrical energy via a power line, or directly from the implant electrical energy conversion means 30 via a power line 66, a constant current of the capacitor 60, the power line 68 and line 64 to convert power for operating the stretching device 10.

[0412] 内部控制单元优选可从病人身体外部编程。 [0412] The internal control unit is preferably programmable from outside the patient's body. 在优选实施例中,内部控制单元被编程为调整拉伸装置10,以根据预编程的时间或来自任意传感器的输入来安排拉伸胃,所述任意传感器传感病人的任何可能的物理参数或装置的任何功能参数。 In a preferred embodiment, the internal control unit is programmed to adjust the stretching device 10, in accordance with a pre-programmed time or to input from any sensor arrangement stretch the stomach, the patient any sensor sensing any possible physical parameter or any functional parameters of the device.

42[0413] 根据可替换方案,图18的实施例中的电容器60可被省略,根据另一可替换方案, 该实施例中的蓄能器58可被省略。 42 [0413] According to an alternative embodiment of Figure 18 in the capacitor 60 may be omitted, according to another alternative solution, for example, the embodiment of the accumulator 58 may be omitted.

[0414] 图19示出等同于图13的实施例的本发明的实施例,不同之处在于用于供应能量以操作拉伸装置10的电池70和用于切换拉伸装置10的操作的电开关72也被植入在病人体中。 [0414] FIG. 19 illustrates an embodiment of FIG. 13 is equivalent to the embodiment of the present invention, except that the operation of the operation for supplying energy to the battery 70 stretching device 10 and a switching device 10 electrically stretch switch 72 also is implanted in the patient. 电开关72通过由植入的能量转换装置30供应的能量操作,以从电池70未被使用的截止模式切换到电池70供应能量以操作拉伸装置10的导通模式。 Electrical energy generated by the switch 72 by the implanted energy transforming device 30 supplies the operation mode to turn off unused from the battery 70 is switched to the battery 70 supplies energy to operate the stretching device 10 is conducting mode.

[0415] 图20示出等同于图19的实施例的本发明的实施例,不同之处在于可由外部能量发射装置34的无线远程控制器控制的内部控制单元56也被植入在病人体中。 [0415] FIG. 20 illustrates an embodiment of FIG. 19 is equivalent to the embodiment of the present invention, except that the external energy emitted by the internal control unit 56 wireless remote control device 34 controls were also implanted in the patient . 在该情况下, 电开关72通过由植入的能量转换装置30供应的能量操作,以从防止无线远程控制器控制内部控制单元56且电池未被使用的截止模式切换到允许无线远程控制器控制内部控制单元56以从电池70释放电能从而操作拉伸装置10的待命模式。 In this case, the electrical energy generated by the switch 72 by the implanted energy transforming device 30 supplies the operation to prevent the radio from the remote controller to control the internal control unit 56 and the cut-off mode is switched to the battery is not in use allows the wireless remote controller Internal control unit 56 to release electric energy from the battery 70 so as to operate the stretching device 10 in standby mode.

[0416] 图21示出等同于图20的实施例的本发明的实施例,不同之处在于蓄能器58代替电池70,且植入的部件被不同地互连。 [0416] FIG. 21 shows an embodiment identical to Figure 20 of the embodiment of the present invention, except that an accumulator 58 instead of the battery 70 and the implanted components are interconnected differently. 在该情况下,蓄能器58存储来自植入的能量转换装置30的能量。 In this case, the accumulator 58 stores energy from the implanted energy conversion device 30. 响应来自外部能量发射装置34的无线远程控制器的控制信号,内部控制单元56控制电开关72,以从蓄能器58未被使用的截止模式切换到蓄能器58供应能量以操作拉伸装置10的导通模式。 In response to a control signal from the wireless remote control the external energy transmission device 34, the internal control unit 56 controls the electric switch 72, the accumulator 58 to switch from the OFF mode is not used to the accumulator 58 supplies energy to operate the stretching device conduction mode 10.

[0417] 图22示出等同于图21的实施例的本发明的实施例,不同之处在于电池70也被植入在病人体中,且植入的部件被不同地互连。 [0417] FIG. 22 shows an embodiment identical to the embodiment of FIG. 21 according to the present invention, except that a battery 70 also is implanted in the patient and the implanted components are interconnected differently. 响应来自外部能量发射装置34的无线远程控制器的控制信号,内部控制单元56控制蓄能器58输送能量来操作电开关72,以从电池70 未被使用的截止模式切换到电池70供应能量以操作拉伸装置10的导通模式。 In response to a control signal from the external energy transmission device 34 wireless remote control, the internal control unit 56 controls the accumulator 58 delivering energy to operate electrical switch 72 to off mode from the battery 70 is not being used to supply energy to switch to 70 batteries conduction mode operation stretching device 10.

[0418] 可替换地,电开关72可通过由蓄能器58供应的能量操作,以从防止无线远程控制器控制电池70供应电能且不被使用的截止模式切换到允许无线远程控制器控制电池70供应电能以操作拉伸装置10的待命模式。 [0418] Alternatively, the electrical switch 72 by the energy supplied by the accumulator 58 operates to prevent the cut-off mode from the wireless remote control controls the battery power supply 70 is not switched to allow the use of wireless remote controller battery 70 supply electrical power to operate the stretching device 10 is in standby mode.

[0419] 应该理解的是,开关应该被解释在其最宽泛的实施例中。 [0419] It should be understood that the switch should be interpreted in its broadest embodiment. 这意味着FPGA或DA转换器或任何其他电部件或电路可切换优选从身体外部或由内部控制单元控制的导通或截止。 This means that the FPGA or DA converter or any other electrical components or circuits can be switched preferably from outside the body or conducting internal control unit or a cutoff.

[0420] 图23示出等同于图19的实施例的本发明的实施例,不同之处在于马达40、采用齿轮箱74形式的机械回动装置、以及用于控制齿轮箱74的内部控制单元56也被植入在病人体中。 [0420] FIG. 23 illustrates an embodiment of FIG. 19 is equivalent to the embodiment of the present invention, except that the motor 40, the use of the gear box 74 in the form of a mechanical reversing device, as well as internal control unit for controlling the gear box 74 56 also is implanted in the patient. 内部控制单元56控制齿轮箱74回动由拉伸装置10(被机械操作)执行的功能。 Internal control unit 56 controls the gearbox 74 reversing 10 (to be mechanically operated) functions performed by a stretching device. 更简单的是电动切换马达的方向。 Easier to switch the direction of the electric motor.

[0421] 图24示出等同于图22的实施例的本发明的实施例,不同之处在于植入的部件被不同地互连。 [0421] FIG. 24 shows an equivalent embodiment of FIG. 22 in the present embodiment of the invention, except that the implanted components are interconnected differently. 因此,在该情况下,当蓄能器58(适当而言,电容器)启动电开关72以切换到导通模式时,内部控制单元56由电池70提供动力。 Therefore, in this case, when the accumulator 58 (appropriately, the capacitor) to start the electric switch 72 is switched to conduction mode, the internal control unit 56 is powered by a battery 70. 当电开关72处于其导通模式时,内部控制单元56被允许控制电池70供应或不供应用于操作拉伸装置10的能量。 When the power switch 72 is in its conduction mode, the internal control unit 56 is permitted to control the battery 70 to supply or not to supply energy for operating the stretching device 10.

[0422] 图25示意性示出用于实现各种连通选择的装置的植入部件的能设想到的组合。 [0422] FIG. 25 schematically shows a variety of communication means for implementing the selected implantation apparatus contemplated combinations can. 基本上,存在拉伸装置10、内部控制单元56、马达或泵单元44、和包括外部无线远程控制器的外部能量发射装置34。 Basically, there is a stretching apparatus 10, the internal control unit 56, motor or pump unit 44, and the external energy comprises an external wireless remote control transmitting device 34. 如上所述,无线远程控制器发射控制信号,该控制信号由内部控制单元56接收,内部控制单元56相应地控制装置的各种植入部件。 As described above, the wireless remote control transmits a control signal, the control signal reception by the internal control unit 56, unit 56 correspondingly controls the various implanted components of internal control.

[0423] 优选采用传感器76形式的反馈装置可被植入在病人体中,以传感病人的物理参数,例如食管203中的收缩波动,以告知病人正在吃饭。 [0423] Sensor 76 is preferably used in the form of a feedback device may be implanted in the patient for sensing a physical parameter of the patient, such as the esophagus 203 contraction fluctuations, to inform the patient is eating. 内部控制单元56、或者可替换地外部能量发射装置34的外部无线远程控制器可响应来自传感器76的信号控制拉伸装置10。 Internal control unit 56, or alternatively the external energy transmission device 34, an external wireless remote control may be responsive to the control signal from the sensor 76 of the stretching means 10. 收发器可与传感器76组合,以将关于传感到的物理参数的信息发送到外部无线远程控制器。 Transceiver 76 in combination with the sensor, to send information about the pass was a physical parameter to the external wireless remote control. 无线远程控制器可包括信号发射器或收发器,内部控制单元56可包括信号接收器或收发器。 Wireless remote control may comprise a signal transmitter or transceiver, the internal control unit 56 may include a signal receiver or transceiver. 可替换地,无线远程控制器可包括信号接收器或收发器,内部控制单元56可包括信号发射器或收发器。 Alternatively, the wireless remote control may comprise a signal receiver or transceiver, the internal control unit 56 may comprise a signal transmitter or transceiver. 以上收发器、发射器和接收器可用于将关于拉伸装置10的信息或数据从病人身体内部发送到其外部。 Above transceivers, transmitters and receivers can be used to draw on information or data device 10 is transmitted from inside the patient's body to the outside thereof.

[0424] 可替换地,传感器76可被布置为传感拉伸装置10的功能参数。 [0424] Alternatively, the sensor 76 may be arranged as a functional parameter sensing device 10 stretch.

[0425] 在马达/泵单元44和用于为马达/泵单元44提供动力的电池70被植入时,电池70可装备有收发器,以发送关于电池70的状况的信息。 [0425] when the motor / pump unit 44 and used for the motor / pump unit 44 of the battery 70 to provide power to be implanted, battery 70 may be equipped with a transceiver for sending information about the status of the battery 70. 更精确而言,当为电池或蓄能器进行能量充电时,与所述充电过程相关的反馈信息被发送,且能量供应相应地改变。 More precisely, when the battery or charging the energy accumulator, and the charging process related feedback information is transmitted, and the energy supply changes accordingly.

[0426] 图26示出可替换实施例,其中拉伸装置10从病人身体外部调整。 [0426] FIG. 26 shows an alternative embodiment wherein the stretching device 10 from the outside to adjust the patient's body. 肥胖治疗系统28包括经由皮下开关80连接到电池70的拉伸装置10。 Obesity treatment system 28 comprises a switch 80 via subcutaneous battery 70 is connected to the stretching device 10. 因此,拉伸装置10的调整通过手动按压皮下开关非侵入性地执行,由此拉伸装置10的操作被导通和截止。 Therefore, adjustment of the stretching device 10 pressing the subcutaneous switch performed non-invasively by manually operating the stretching device is thereby turned on and off 10. 可以意识到,所示实施例为简化版,其他部件(例如内部控制单元或本申请公开的任何其他部分)可被添加到该肥胖治疗系统。 As can be appreciated, the illustrated embodiment is a simplified version of other components (such as internal control unit or any other part disclosed herein) may be added to the obesity treatment system.

[0427] 图27示出可替换实施例,其中肥胖治疗系统28包括与液压流体贮存器52流体连接的拉伸装置10。 [0427] FIG. 27 shows an alternative embodiment in which the obesity treatment system 28 comprises a stretching device 52 and a hydraulic fluid reservoir 10 in fluid connection. 非侵入性调整通过手动按压连接到拉伸装置10的液压贮存器执行。 Non-invasive adjustment by manually pressing the hydraulic reservoir connected to the stretching device 10 execute.

[0428] 根据本发明的系统的另外的实施例包括反馈装置,用于将信息从病人身体内部发送到其外部,以给出与拉伸装置或系统的至少一个功能参数或病人的物理参数有关的反馈信息,由此最优化系统的性能。 [0428] includes a feedback device for sending information from inside the patient's body to the outside to give the stretching device or system with at least one function parameter or a physical parameter related to the patient in accordance with another embodiment of the system of the present invention. feedback, thus optimizing system performance.

[0429] 装置的一个优选功能参数可与用于对内部能量源充电的能量传输相互关联。 [0429] A preferred functional parameters of the device can be used with energy for charging the internal energy source interconnected transmission.

[0430] 在图28中,适应性示出一设置结构,用于将准确量的能量供应到植入在病人体中的肥胖治疗系统28,病人的皮肤36由竖直线表示。 [0430] In Fig. 28, showing the adaptability of a structure provided for the exact amount of energy supplied to the implant in the patient's obesity treatment system 28, the skin of the patient 36 is represented by a vertical line. 拉伸装置10连接到植入的能量转换装置30,例如位于病人体内,优选在病人皮肤36紧下面。 Stretching means 10 is connected to the implanted energy transforming means 30, for example, is located in the patient, preferably in the patient's skin 36 immediately below. 一般而言,植入的能量转换装置30 可被放置在腹部、胸腔、肌肉筋膜(例如,腹壁中)、皮下、或任何其他合适的位置。 Generally speaking, the implanted energy transforming device 30 can be placed in the abdomen, thorax, muscle fascia (e.g., the abdominal wall), subcutaneously, or any other suitable location. 植入的能量转换装置30适于接收从设置在外部能量发射装置34中的外部能量源34a发射的无限能量E,外部能量发射装置34位于病人皮肤36外部并处于植入的能量转换装置30邻近。 Implanted energy transforming means 30 adapted to receive an unlimited source of energy emitted from E 34a provided in the external energy transmission device 34 of the external energy, the external energy transmission device 34 is located outside the patient's skin 36 and is adjacent the implanted energy transforming means 30 .

[0431] 本领域众所周知,无线能量E可大体上利用任何合适的经皮肤能量传输(TET)装置传输,例如包括布置在外部能量源34a中的主线圈和布置在植入的能量转换装置30中的相邻的次线圈的装置。 [0431] known in the art, the wireless energy E may generally through the skin using any suitable energy transfer (TET) devices transmit, for example, comprise an external energy source 34a disposed in the main coil and arranged in the implanted energy transforming device 30 adjacent secondary coil unit. 当电流通过主线圈供给时,采用电压形式的能量被引入于次线圈中, 次线圈可用于操作拉伸装置,例如在将输入能量存储于能量存储装置或诸如电池或电容器等的蓄能器之后。 Then when the current through the primary coil supply voltage in the form of energy use was introduced in the primary coil, the secondary coil may be used to operate the stretching device, for example, the input energy is stored in the energy storage device such as a battery or a capacitor or accumulator . 然而,本发明大体上不限于任何特定的能量传输技术,TET装置或能量存储装置以及任何种类的无线能量可被使用。 However, the present invention is generally not limited to any particular energy transfer technique, TET devices or energy storage devices, and any kind of wireless energy may be used.

[0432] 身体内部对装置接收的能量值可与装置使用的能量相当。 [0432] the energy value within the body of the device is comparable with that received energy device used. 装置使用的术语因而被理解为也包括装置存储的能量。 The term thus means used is understood to include means for storing energy. 如上所述,传输的能量值可基于确定的能量平衡利用控制外部能量源34a的外部控制单元34b调整。 As described above, the energy value of the transmission can be balanced by the external energy source 34a by the control of the external control unit 34b based on the determined power adjustment. 为了传输正确的能量值,能量平衡和所需的能量值可利用与拉伸装置10相连的内部控制单元56确定。 In order to transfer the correct energy value, energy balance and energy values required by the internal control unit 10 is connected with the stretching device 56 is determined. 内部控制单元56因而可被布置为接收由合适的传感器或类似物获得的各种测量结果,所述传感器或类似物未被示出,从而测量拉伸装置10的特定特性,一定程度上反映正确操作拉伸装置10所需的能量值。 Internal control unit 56 may thus be arranged to receive various measurements by a suitable sensor, or the like obtained by the sensor, or the like is not shown, to measure a particular characteristic of the stretching device 10, to some extent, reflect the correct Operating stretching device 10 energy values required. And

44且,病人的当前状况也可利用合适的测量装置或传感器检测到,以提供反映病人状况的参数。 44 and the current condition of the patient may also be measured using suitable means or sensor detects, in order to provide parameters reflecting the patient's condition. 因此,这种特性和/或参数可与拉伸装置10的当前状态相关,例如功耗、操作模式和温度,以及由例如体温、血压、心跳和呼吸反映的病人状况。 Thus, the characteristics and / or parameters can be used with the current state of the stretching device 10 related, such as power consumption, operating mode and temperature, as well as by, for example temperature, blood pressure, heart rate and breathing to reflect the patient's condition.

[0433] 此外,能量存储装置或蓄能器58可选择性地连接到植入的能量转换装置30,以积蓄接收的能量,从而供拉伸装置10稍后使用。 Energy [0433] In addition, the energy storage device or accumulator 58 may be selectively connected to the conversion means 30 implanted in the received energy savings, thereby stretching device 10 for later use. 可替换地或可添加地,还可测量这种蓄能器的也反映所需的能量值的特性。 Alternatively or additively, also this measure reflects the characteristics of the accumulator is also required for the energy value. 蓄能器可由电池替代,测量的特性可与电池的当前状态相关,例如电压、温度等。 Accumulator battery can be replaced by the measured characteristics can be associated with the current state of the battery, such as voltage, temperature and the like. 为了向拉伸装置10提供充足的电压和电流,也避免过度加热,清楚理解的是,电池应最佳地通过接收来自植入的能量转换装置30的正确能量值(即不过少或过多)来充电。 Stretching means 10 in order to provide sufficient voltage and current, but also to avoid excessive heating, is clearly understood that the battery should be optimally correct energy value converting means (i.e., however little or too much) 30 by receiving energy from the implanted to recharge. 蓄能器也可为具有对应特性的电容器。 The accumulator may also be a capacitor having a corresponding characteristic.

[0434] 例如,电池特性可定期测量以确定电池的当前状态,然后该当前状态可在内部控制单元56中的合适的存储机构中被存储为状态信息。 [0434] For example, the battery characteristics can be measured periodically to determine the current state of the battery, then the current state of the internal control unit 56 in a suitable storage means is stored as state information. 因此,无论何时进行新的测量,存储的电池状态信息可相应地更新。 Thus, whenever a new measurement, battery status stored information can be updated accordingly. 采用该方式,电池的状态可通过传输正确的能量值来“计算”,以保持优化条件下的电池。 With this mode, battery status may value "calculated" by transmitting the right energy to keep the battery under optimized conditions.

[0435] 因此,基于由上述传感器或者拉伸装置10或病人的测量装置或者能量存储装置(如果使用的话)或者其任意组合所得出的测量结果,内部控制单元56适于确定能量平衡和/或当前所需的能量值(每单位时间的能量或积蓄的能量)。 [0435] Thus, based on the patient's measuring device 10 or the energy storage means or by said sensors or stretching means (if used) or any combination thereof measurements derived, the internal control unit 56 is adapted to determine the energy balance and / or currently required energy value (energy per unit time or energy savings). 内部控制单元56进一步连接到内部信号发射器82,其被布置为将反映确定的所需能量值的控制信号发射到与外部控制单元34b相连的外部信号接收器34c。 Internal control unit 56 is further connected to the internal signal transmitter 82, which is arranged to control the desired signal energy value determined will reflect emitted to the outside with an external control signal receiver unit 34b is connected to 34c. 从外部能量源34a发射的能量值因而可响应接收到的控制信号来调整。 Energy emitted from the external energy source 34a in response to the value thus received control signal to adjust.

[0436] 可替换地,传感器测量结果可被直接发射到外部控制单元34b,其中能量平衡和/ 或当前所需的能量值可通过外部控制单元34b确定,因而将内部控制单元56的上述功能集成在外部控制单元34b中。 [0436] Alternatively, sensor measurements can be transmitted directly to the external control unit 34b, wherein the energy balance and / or energy required current value can be determined by an external control unit 34b, so that the internal control unit 56 of the above-mentioned functions integrated external control unit (34b). 在该情况下,内部控制单元56可被省略,且传感器测量结果被直接供应到内部信号发射器82,其将所述测量结果发送到外部信号接收器34c和外部控制单元34b。 In this case, the internal control unit 56 may be omitted and the sensor measurements are supplied directly to the internal signal transmitter 82, which transmits the measurement result to the external signal receiver 34c and the external control unit 34b. 能量平衡和当前所需的能量值因而可基于这些传感器测量结果通过外部控制单元34b确定。 Energy balance and the current value thus the energy required by the external control unit 34b is determined based on the sensor measurements.

[0437] 因此,本方案采用反馈表示所需能量的信息,这比先前的方案更有效,因为其基于与接收的能量相比的实际使用的能量,例如关于与拉伸装置使用的能量率相比而言的能量值、能量差或能量接收率。 [0437] Thus, the program uses feedback indicates the energy needed, which is more efficient than the previous program, which is based on actual energy use as compared with the energy received, for example, on energy rate and stretching device for use with than the energy value terms, the energy difference or energy absorption rate. 拉伸装置可利用接收的能量消耗或存储在能量存储装置或类似物中的能量。 Stretching means can be used to receive the energy consumption or energy stored in the energy storage device or the like of. 因此,以上论述的不同参数如果相关或需要则可被使用,然后用作确定实际能量平衡的工具。 Therefore, different parameters discussed above can, if relevant, or need to be used, then used as a tool to determine the actual energy balance. 然而,这种参数本质上也可能对于内部采取的任何动作以特定地操作拉伸装置均是需要的。 However, such parameters may be essentially any actions taken internally to specifically operate the stretching device are needed.

[0438] 内部信号发射器82和外部信号接收器34c可被实施为分立的单元,利用合适的信号传输机构,例如无线电、红外(IR)或超声信号。 [0438] 82 and the external signal receiver 34c internal signal transmitter may be implemented as separate units using suitable signal transfer means, such as radio, infrared (IR) or ultrasound signals. 可替换地,内部信号发射器82和外部信号接收器34c可分别集成在植入的能量转换装置30和外部能量源34a中,以基本上利用相同的发射技术沿相对于能量传输相反的方向传递控制信号。 Alternatively, an external signal receiver 82 and the internal signal transmitter 34c, respectively, may be integrated in the implanted energy transforming device 30 and the external energy source 34a in order to take advantage of substantially the same direction with respect to the emission energy transfer technique in the opposite direction to pass control signal. 控制信号可在频率、相位或幅度方面进行调制。 Control signal can be modulated in frequency, phase or amplitude on.

[0439] 总之,图28中示出的能量供应设置结构可基本上以如下方式操作。 [0439] In summary, Figure 28 shows the structure of the energy supply may be disposed substantially in the following manner. 能量平衡首先由内部控制单元56确定。 First, the energy balance is determined by the internal control unit 56. 反映所需的能量值的控制信号也由内部控制单元56形成,且控制信号从内部信号发射器82发射到外部信号接收器34c。 Control signal values reflect the energy required is also formed by the internal control unit 56, and the control signal transmitted from the internal signal transmitter 82 to an external signal receiver 34c. 可替换地,能量平衡可通过取代植入的外部控制单元34b确定,如上所述。 Alternatively, the energy balance can be substituted by implantable external control unit 34b determines, as described above. 在该情况下,控制信号可承载由各种传感器形成的测量结果。 In this case, the control signal may carry measurement results from various sensors formed. 由外部能量源34a发射的能量值然后可例如响应接收到的控制信号基于确定的能量平衡通过外部控制单元34b来调整。 Emitted by the external energy source 34a may then be e.g. energy value in response to a control signal received via the external control unit 34b balance is adjusted based on the determined energy. 该过程可在正在进行的能量传输期间以特定间隔间歇地重复,或者可在能量传输期间或多或少连续地作用。 This process may be repeated intermittently at certain intervals during ongoing energy transfer, or may act more or less continuously during the energy transfer.

[0440] 传输的能量值可大体上通过调节外部能量源34a中的各种发射参数来调整,例如电压、电流、幅度、波动频率和脉冲特性。 [0440] The energy value of the transmission can be substantially adjusted by adjusting the transmission parameters in the external energy source 34a variety, such as voltage, current, amplitude, wave frequency and pulse characteristics.

[0441] 因此,提供一种方法,用于控制供应到植入在病人体中的电操作拉伸装置的无线能量的发射。 [0441] Thus, a method is provided for controlling the supply to the implant in the patient's electrically operated stretching device wireless energy transmission. 无线能量E从位于病人体外的外部能量源发射,并由位于病人体内的内部能量接收器接收,内部能量接收器连接到拉伸装置,以用于将接收的能量直接或间接地供应到拉伸装置。 Located in the wireless energy E from an external energy source outside the patient transmitter, located in the patient's internal energy received by the receiver, the internal energy receiver is connected to the stretching device, for the supply of energy received directly or indirectly to the stretch devices. 能量平衡在由内部能量接收器接收的能量与用于拉伸装置的能量之间确定。 Energy balance between the energy received by the internal energy receiver and the energy used for the stretching device is determined. 从内部能量源发射的无线能量E然后基于确定的能量平衡来控制。 Wireless energy emitted from an internal energy source E then determined based on the energy balance is controlled.

[0442] 还提供一种系统,用于控制供应到植入在病人体中的电操作拉伸装置的无线能量的发射。 [0442] further provided a system for controlling the supply to the implant in the patient's electrically operated stretching device wireless energy transmission. 该系统适于从位于病人体外的外部能量源发射无线能量E,无线能量E由位于病人体内的植入的能量转换装置接收,植入的能量转换装置连接到拉伸装置,以用于将接收的能量直接或间接地供应到拉伸装置。 The system is adapted to transmit located outside the patient from an external energy source wireless energy E, the wireless device receives energy from the energy E is located in the patient's implanted conversion, the implanted energy transforming means is connected to stretching means, for receiving the energy supply, directly or indirectly, to the stretching device. 该系统进一步适于确定由植入的能量转换装置接收的能量与用于拉伸装置的能量之间的能量平衡,并基于确定的能量平衡控制从外部能量源的无线能量E的发射。 The system is further adapted to determine the energy of the energy from the implanted energy transforming device for receiving and stretching means between the energy balance and energy balance from the wireless control of the external energy source E based on the determined transmission power.

[0443] 该装置的功能参数与用于对内部能量源充电的能量传输相互关联。 [0443] The function of the device parameters and the energy used to charge the internal energy source of transmission are interrelated.

[0444] 在又一可替换实施例中,外部能量源从病人身体外部控制以释放电磁无线能量, 释放的电磁无线能量用于操作拉伸装置。 [0444] In a further alternative embodiment, the external energy source from outside the patient's body to release electromagnetic wireless energy control, release electromagnetic wireless energy for operating the stretching device.

[0445] 在另一实施例中,外部能量源从病人身体外部控制以释放非磁无线能量,释放的非磁无线能量用于操作拉伸装置。 [0445] In another embodiment, the external energy source from outside the patient's body is controlled to release non-magnetic wireless energy non-magnetic wireless energy, for operation of the release of the stretching device.

[0446] 本领域技术人员将意识到,根据图17至29的以上各种实施例可以多种不同方式组合。 [0446] Those skilled in the art will recognize that many different ways may be combined according to the above various figures 17-29 embodiments. 例如,由极化能操作的电开关38可并入图11、18至24的任意实施例,液压阀移位装置54可并入图16的实施例,齿轮箱74可并入图15的实施例。 For example, the electrical switch 38 can be operated by the polarization may be incorporated into any of 11, 18 to FIG. 24 embodiment, a hydraulic valve shifting device 54 may be incorporated in the embodiment of FIG. 16, the gear box 74 may be incorporated into the embodiment of FIG. 15 Example. 请注意开关仅仅可以意味着任何电子电路或部件。 Please note that the switch can only mean any electronic circuit or component.

[0447] 用于操作拉伸装置的能量的无线传输被描述为允许非侵入性操作。 [0447] stretching device for operating a wireless energy transmission is described as allowing non-invasive procedures. 将意识到,拉伸装置也可用电线约束能量来操作。 It will be appreciated, the stretching device can also be used to operate the wire bound energy. 一个这种示例示于图29中,其中外部开关84利用动力线86和88互连在外部能量源34a与操作装置(例如调整拉伸装置10的电动马达)之间。 One such example is shown in Fig. 29, wherein an external switch 84 by the power lines 86 and 88 interconnecting the external energy source 34a and the operating means (e.g., an electric motor regulating the stretching device 10) between. 外部控制单元34b控制外部开关的操作,以实现拉伸装置10的正确操作。 The external control unit 34b controls the operation of an external switch, in order to achieve proper operation of the stretching device 10.

[0448] 液压或气动提供动力 [0448] a hydraulic or pneumatic powered

[0449] 图30至33更为详细地示出为根据本发明的用于治疗肥胖症的装置提供液压或气动动力的四种不同方式的框图。 [0449] FIG 30 to 33 in more detail a block diagram showing a different way of providing a hydraulic or pneumatic power means for obesity treatment according to the invention for four.

[0450] 图30示出以上参照任意图1至6所述的用于治疗肥胖症的装置。 [0450] Referring to FIG. 30 shows a means for treating obesity or more of any of the 1-6 in FIG. 该装置包括拉伸装置10以及另一个分立的调整贮存器16、单向泵44和供选阀54。 The apparatus includes a stretching device 10 and another separate regulation reservoir 16, pump 44 and the one-way valve 54 for the election.

[0451] 图31示出拉伸装置10和流体贮存器16。 [0451] FIG. 31 shows a stretching device 10 and a fluid reservoir 16. 通过以任何其他不同方式移动调整贮存器的壁或改变调整贮存器的尺寸,拉伸装置的调节可在没有任何阀、而只是流体畅通经过的情况下在任何时间通过移动贮存器壁来执行。 By moving in any other different ways to adjust the wall of the reservoir or changing the size of the adjustment reservoir, the stretching device may be adjusted without any valve, but only the case where the fluid flow through performed at any time by moving the reservoir wall.

[0452] 图32示出拉伸装置10、双向泵44和调整贮存器16。 [0452] FIG. 32 shows a stretching apparatus 10, a two-way pump 44 and the regulation reservoir 16. [0453] 图33示出回动伺服系统的框图,其中第一闭合式系统控制第二闭合式系统。 [0453] FIG. 33 illustrates a block diagram of a reversed servo system in which a first closed system controlling a second closed system. 伺服系统包括调整贮存器16和伺服贮存器90。 Servo system 16 comprises a regulation reservoir 90 and a servo reservoir. 伺服贮存器90通过机械互连器94机械地控制拉伸装置10,拉伸装置具有可膨胀/可接触腔。 90 servo reservoir 10, the stretching device having an expandable / contactable cavity 94 through the mechanical interconnection mechanically controlled stretching device. 该腔优选通过从与拉伸装置10流体连接的大型可调节贮存器92供应液压流体而膨胀或收缩。 The chamber 10 preferably by fluid from a device connected to the large stretch adjustable supply of hydraulic fluid reservoir 92 expands and contracts. 可替换地,腔包含可压缩气体,其可在伺服贮存器90的控制下被压缩和膨胀。 Alternatively, the cavity comprises a compressible gas, which can be compressed and expanded under the control of the servo reservoir 90.

[0454] 伺服贮存器90也可为拉伸装置自身的一部分。 [0454] The servo reservoir 90 may also be part of the self-stretching device.

[0455] 在一个实施例中,调整贮存器被放置在皮下在病人皮肤36下面,并通过用手指推动其外表面来操作。 [0455] In one embodiment, the regulation reservoir is placed subcutaneous under the patient's skin 36, and by pushing the outer surface thereof with a finger to operate. 该肥胖治疗系统例示于图34a至34c中。 The obesity treatment system is illustrated in Fig. 34a to 34c,. 在图34a中,柔性皮下调整贮存器16被示出为通过管路18连接到鼓起形的伺服贮存器90。 In FIG. 34a, a flexible subcutaneous regulation reservoir 16 is shown connected to a bulge shaped servo reservoir 90 through line 18. 该手风琴形状的伺服贮存器90被包含在柔性拉伸装置10中。 The accordion-shaped servo reservoir 90 is contained in the flexible stretching device 10. 在图34a所示的状态下,伺服贮存器90包含最少的流体,大部分流体被发现于调整贮存器16中。 In the state shown in FIG. 34a, the servo reservoir 90 contains a minimum of fluid, the fluid was found in the majority of the regulation reservoir 16. 由于伺服贮存器90与拉伸装置10之间的机械互连,拉伸装置10的外部形状收缩,即,其比其最大容积占据得更小。 10 due to the mechanical interconnection between the servo reservoir 90 and the stretching means, the stretching device 10, the external shape of the contraction, i.e., smaller than it occupies its maximum volume. 该最大容积在附图中用虚线示出。 The maximum volume shown by a dotted line in the drawing.

[0456] 图34b示出一状态,其中使用者(例如植入有拉伸装置的病人)按压调整贮存器16,以使其内包含的流体流动通过管路18并流进伺服贮存器90,其由于其手风琴形状而纵向膨胀。 [0456] Figure 34b shows a state in which a user (e.g., stretching device implanted in a patient) presses the regulation reservoir 16, so that it is contained within the fluid flow through the conduit 18 and flow into the servo reservoir 90, Due to its accordion shape its longitudinal expansion. 该膨胀相应地使拉伸装置10膨胀,使得其占据其最大容积,由此拉伸收缩的胃壁(未示出)。 Accordingly, to make the expansion of the stretching device 10 is expanded, so that it occupies its maximum volume, thereby stretching the stomach wall contractions (not shown).

[0457] 调整贮存器16优选设置有用于在压缩后保持其形状的机构。 [0457] regulation reservoir 16 is preferably provided with means for keeping its shape after compression mechanism. 因而,如图16a示意性所示,这意味着当使用者释放调整贮存器时,也将拉伸装置10保持在拉伸位置。 Thus, as shown schematically in FIG. 16a, this means that when the user releases the regulation reservoir, the stretching device 10 will remain in a stretched position. 通过该方式,调整贮存器本质上用作肥胖治疗系统的导通/截止开关。 In this way, the regulation reservoir essentially used as a treatment for obesity system ON / OFF switch.

[0458] 现在将参照图35和36a至36c描述液压或气动操作的可替换实施例。 [0458] Referring now to FIG. 35 and 36a to 36c described hydraulically or pneumatically operated alternative embodiment. 图35所示的框图包括控制第二闭合式系统的第一闭合式系统。 Block diagram shown in Fig. 35 comprises controlling a second closed system a first closed system. 第一系统包括调整贮存器16和伺服贮存器90。 The first system comprises a regulation reservoir 16 and a servo reservoir 90. 伺服贮存器90通过机械互连器94机械地控制大型可调节贮存器92。 Servo reservoir 90 large reservoir 92 can be adjusted by a mechanical interconnection 94 is mechanically controlled. 具有可膨胀/可收缩腔的拉伸装置10相应地通过从与拉伸装置10流体相连的大型可调节贮存器92供应液压流体而控制。 Having an expandable / contractible cavity stretching means 10 and 10 respectively by fluid drawn from the apparatus connected to a large reservoir 92 can be adjusted to control the supply of hydraulic fluid.

[0459] 现在将参照图36a至36c描述本实施例的示例。 [0459] Referring now to FIG. 36a to 36c of the present exemplary embodiment will be described. 类似于先前的实施例,调整贮存器被放置在皮下在病人皮肤下面,并通过用手指推动其外表面来操作。 Similar to the previous embodiment, the regulation reservoir is placed subcutaneous under the patient's skin, and by pushing the outer surface thereof with a finger to operate. 调整贮存器16通过管路18与手风琴形伺服贮存器90流体相连。 Regulation reservoir 16 is connected through line 18 with the accordion-shaped servo reservoir 90 of fluid. 在图34a所示的第一闭合式系统16、18、90 中,伺服贮存器90包含最少流体,大部分流体在调整贮存器16中。 In Fig 34a a first closed system shown 16,18,90, the servo reservoir 90 contains a minimum of fluid, most of the fluid in the reservoir 16 in adjustment.

[0460] 伺服贮存器90机械连接到大型可调节贮存器92,在该示例中也具有手风琴形状但比伺服贮存器90的直径大。 [0460] The servo reservoir 90 is mechanically connected to a larger adjustable reservoir 92, in this example also has the accordion shape but larger than the diameter 90 of the servo reservoir. 大型可调节贮存器92与拉伸装置10流体相连。 Large adjustable fluid reservoir 92 and the stretching device 10 is connected. 这意味着当使用者推动调整贮存器16由此将流体从调整贮存器16移位到伺服贮存器90时,伺服贮存器90的膨胀将使较大容积的流体从大型可调节贮存器92移位到拉伸装置10。 This means that when the user pushes the regulation reservoir 16 whereby the fluid from the reservoir 16 is shifted to adjust the servo reservoir 90, the servo reservoir 90 will swell larger volume of fluid from the reservoir 92 large adjustable shift stretching means 10 to the bit. 换言之, 在该回动伺服机构中,调整贮存器中的小容积被较大的力压缩,且这利用每单位面积较小的力而造成较大总面积的运动。 In other words, in this reversed servo, adjust the reservoir in a small volume is compressed with a higher force, and which use less force per unit area caused a large movement of the total area.

[0461] 类似于以上参照图34a至34c所述的先前实施例,调整贮存器16优选设置有用于在压缩后保持其形状的机构。 [0461] Similar to the above with reference to FIG. 34a to 34c according to the previous embodiment, the regulation reservoir 16 is preferably provided with means for maintaining its shape after compression mechanism. 因而,如图16a示意性所示,这意味着当使用者释放调整贮存器时,也将拉伸装置10保持在拉伸位置。 Thus, as shown schematically in FIG. 16a, this means that when the user releases the regulation reservoir, the stretching device 10 will remain in a stretched position. 通过该方式,调整贮存器本质上用作肥胖治疗系统的导通/截止开关。 In this way, the regulation reservoir essentially used as a treatment for obesity system ON / OFF switch. [0462] 方法 [0462] Method

[0463] 一种通过手术治疗肥胖病人的方法,该方法包括步骤:在病人的腹壁切割开口,切除胃周围的一区域,将用于治疗的装置放置到病人胃壁的一部分,以及缝合胃壁。 [0463] By a method of surgical treatment of obese patients, the method comprising the steps of: cutting an opening in the patient's abdominal wall, removal of an area around the stomach, will be used as part of the treatment device is placed into the stomach wall of the patient, and suturing the stomach wall.

[0464] 用于治疗肥胖症的装置优选经由腹腔镜腹肌路径放置在病人体中,包括步骤:将针或管状器械插入病人身体的腹部,利用所述针或管状器械向病人腹部填充气体,由此使病人的腹腔膨胀,将至少两个腹腔镜套针放置在病人身体中,将照相机通过所述腹腔镜套针之一插入病人腹部,将至少一个切除工具通过所述至少两个腹腔镜套针之一插入并切除病人的意欲放置区域,以及将用于治疗肥胖症的装置放置为与胃壁相连。 Device [0464] for the treatment of obesity through laparoscopic abdominal preferred route is placed in the patient, comprising the steps of: a needle or tube like instrument inserted into the patient's abdomen, using the needle or tube like instrument to fill the gas to the patient abdomen, whereby the patient's abdominal cavity expansion, at least two laparoscopic trocars placed in the patient's body, the camera through one of the laparoscopic trocars inserted into the abdomen of the patient, at least one cut by at least two laparoscopic tool One trocar insertion and removal of the patient's desire to drop zone, and means for treating obesity is linked with the stomach wall placement.

[0465] 该方法可进一步包括术后调整至少一个拉伸装置的步骤,从而:拉伸胃壁的一部分并从病人身体外部调整拉伸装置从而影响病人的胃口。 [0465] The method may further comprise adjusting at least one step after the stretching means, whereby: a portion of the stomach wall and adjust the tensile stretching device thus affecting the appetite of the patient from outside the patient's body.

[0466] 器械 [0466] Devices

[0467] 现在将参照图5a至5i描述一种将拉伸装置10套叠在胃壁12外部的入腔方法。 [0467] FIG. 5a to 5i now describes a stretched 10 nested within the stomach wall 12 outside the chamber method means reference. 起初,器械600 (优选是胃镜器械)插入病人的嘴,见图5a。 Initially, the instrument 600 (preferably a gastroscopic instrument) inserted into the patient's mouth, shown in Figure 5a. 该器械包括注入装置610、602, 用于将流体或装置注入病人的胃。 The device comprises an injection device 610,602, or means for fluid injection patient's stomach. 器械600进一步包括适于控制器械的操作的控制单元606。 Device 600 further includes a control unit 606 is adapted to control the operation of the instrument. 为此,控制单元606包括一个或多个操控装置,在该附图所示的实施例中采用两个摇杆603和两个控制按钮604的形式。 To this end, the control unit 606 comprises one or more control devices, in the form of two joysticks 603 and two control buttons 604 in the embodiment shown in the drawings. 显示器605被提供用于显示由观察胃内部的光学装置提供的图像,所述光学装置布置在细长构件607外端例如为照相机(未示出),见图5e至5i。 Display 605 is provided for displaying an image provided by the optical observation means inside the stomach, the optical device 607 is disposed at the outer end of the elongate member, for example, a camera (not shown), see FIG. 5e to 5i. 可包括沿细长构件延伸的连接电线的照相机可受到放置在细长构件上远端的光源(未示出)的帮助,以照射胃的内部。 The camera may comprise an elongate member extending along the connecting wires may be placed on the distal end of the elongate member, a light source (not shown) that help to illuminate the interior of the stomach. 光学装置也可包括沿细长构件放置并从病人身体引出的光导纤维,以从外部观察胃的内部。 The optical device may also include placing the patient's body and withdrawn from the optical fiber along the elongated member, in order to observe the interior from the exterior of the stomach.

[0468] 该器械进一步插入食管并至病人的胃中,见图37b。 [0468] The device is further inserted into the esophagus and stomach to the patient as shown in Figure 37b. 通过器械600,在胃12的壁中形成孔12b。 By instrument 600, a hole 12b in the wall of the stomach 12. 为此,该器械在其远端设置有一个或多个切割器615。 To this end, the device is provided with one or more cutters 615 at its distal end. 当然这些切割器可被设计为不同方式,例如围绕管状器械的中心轴线旋转的齿形辊式切割器。 Of course, these cutters may be designed in different ways, e.g., around the central axis of the tubular instrument toothed roller cutter.

[0469] 在胃壁中切割孔之后,器械600的远端插入并通过孔2b,使得其终止在胃壁12a 的外部。 [0469] After cutting a hole in the stomach wall, and the distal end of the instrument 600 is inserted through the hole 2b, so that it terminates at the outside of the stomach wall 12a. 这示于图37c以及图37d中,图37c示出胃12的侧视图,图37d为沿图37c的线Vd-Vd截取的胃的剖视图。 This is shown in FIG. 37c and FIG. 37d in FIG. 37c shows a side view of the stomach 12, and FIG. 37d is a cross-sectional view taken along line Vd-Vd 37c taken stomach.

[0470] 器械600适于围绕胃壁12中的孔12b在胃的外部形成“腔”或“囊”。 [0470] Devices 600 adapted to fit around the stomach wall 12 hole 12b is formed on the outside of the stomach, "cavity" or "bag." 现在将描述提供囊的这种器械和方法。 To provide such apparatus and method will now be described bladder.

[0471] 图37e至37i示出用于通过在放置有拉伸装置10的胃壁12材料中形成囊将拉伸装置10套叠在胃壁12中的腹腔镜器械或胃镜器械。 [0471] Figure 37e to 37i illustrate a balloon in the stomach wall 12 is formed by material stretching device 10 is placed in the stretching device invaginated in the stomach wall 10 of the laparoscopic instrument 12 or endoscopy equipment. 大体上由附图标记600表示且可包括以上参照图4a至4d描述的特征的器械包括具有近端和远端的细长构件607,细长构件607 具有比病人的食管小的直径且为柔性的,以允许将柔性细长构件607以其远端先入地引导通过病人的喉咙、食管并进入胃12到胃壁12a。 Generally indicated by reference numeral 600 and may include the above with reference to Figures 4a to 4d described wherein the instrument comprises an elongate member having a proximal end and a distal end 607, elongate member 607 having a smaller diameter than the patient's esophagus and flexible to allow the flexible elongate member 607 at its distal end first into the ground guided through the patient's throat and into the stomach and the esophagus 12 to the stomach wall 12a.

[0472] 胃刺穿装置或切割器615被设置在细长构件607上处于其远端处,以刺穿胃壁12a,从而在胃壁12a中形成孔,以允许将细长构件607引导通过孔。 [0472] stomach penetration device or cutter 615 is disposed on the elongated member 607 at its distal end for penetrating the stomach wall 12a, thereby forming a hole in the stomach wall 12a, to allow the elongate member 607 through the guide hole. 胃刺穿装置615可适于能操作以在胃基底壁12a被刺穿之后收缩所述胃刺穿装置5,而不进一步损坏主体内的组织。 Stomach penetration device 615 may be adapted for piercing means operable after the stomach fundus wall 12a is pierced shrink the stomach 5, without further damage to the tissue within the body. 器械进一步包括专用保持装置609,其被设置在细长构件607上在刺穿装置615的近侧。 Device 609 further comprises a special holding means, which is disposed on the elongated member 607 at a proximal piercing means 615.

[0473] 细长构件进一步包括可膨胀构件611,其适于在细长构件刺穿胃壁12a之后膨胀, [0473] the elongate member further comprises an expandable member 611, expanded after the elongated member is adapted to pierce the stomach wall 12a thereof,

48由此帮助形成适于保持容积填充装置610的腔或囊。 48 thus help shape adapted to hold the volume filling device 610 of cavity or pouch. 可膨胀构件611可包括可充胀圆形气球,其被设置在柔性细长构件607的远端部分周界周围。 The expandable member 611 may include a circular inflatable balloon, which is disposed around the flexible elongate member distal portion 607 perimeter.

[0474] 现在将详细描述当套叠容积填充装置时的方法步骤。 [0474] The method will now be described in detail when the volume filling step telescopic device when. 在器械600被插入胃12之后,胃刺穿装置615被放置为与胃壁12接触,见图37e。 After the instrument 600 is inserted into the stomach 12, the stomach penetration device 615 is placed in contact with the stomach wall 12, see Figure 37e. 胃刺穿装置或切割器615因而被引入以在胃壁中形成孔12b,之后至少可膨胀构件611被引导通过胃壁12中的孔12b。 Stomach penetration device or cutter 615 is thus introduced to the hole 12b formed in the stomach wall, after at least the expandable member 611 is guided through the stomach wall 12 in the hole 12b. 专用保持装置609在该步骤进入保持状态,其中其沿径向膨胀,以形成针对胃壁12的大致圆形的邻接表面,见图37f。 Special holding means 609 enters the step to maintain the state in which it expands radially to form a substantially circular abutment surface against the stomach wall 12, see FIG. 37f. 采用该方式,胃刺穿装置615和可膨胀构件611经过胃壁中的孔12 所进行的插入限于图37f所示的位置。 With this approach, stomach penetration device 615 and the expandable member 611 carried out through a hole in the stomach wall 12 into limited position shown in FIG. 37f.

[0475] 可膨胀构件611然后膨胀。 [0475] The expandable member 611 and then expanded. 在该情况下,可膨胀构件包括气球或类似物,空气或其他流体注入其中。 In this case, the expandable member comprises a balloon or the like, air or other fluid injected therein.

[0476] 细长构件607的包括可膨胀构件611的部分然后沿近端方向收缩,如图37g中的箭头所示,由此将胃壁612拉到由专用保持装置609形成的篮框或杯状结构中。 [0476] The elongate member 607 comprises an expandable portion of the member 611 in the proximal direction and contraction, as shown by the arrows in FIG. 37g, thereby pulling the stomach wall 612 by special basket or cup-shaped holding means 609 is formed structure.

[0477] 缝合或订合装置608被进一步设置为与细长构件607相连的装置或分立的器械。 [0477] suturing or stapling device 608 is further arranged to elongated member 607 is connected to a separate instrument or device. 缝合或订合构件包括缝合或订合端613,其适于利用胃至胃的缝合线或订合线14关闭腔或 Suturing or stapling member comprises suturing or stapling end 613, which is adapted with stomach to stomach sutures or staplers 14 is closed cavity or

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[0478] 在图37h所示的进一步的步骤中,可充胀拉伸装置10以其充胀状态被放置在杯状结构中。 [0478] In a further step shown in FIG. 37h, an inflatable stretching device 10 in its inflated state is placed in a cup-shaped structure. 拉伸装置10然后被充胀到其充胀或膨胀状态,见图37i。 Stretching means 10 is then inflated to its inflated or expanded state, shown in Figure 37i. 该拉伸装置10的充胀可通过将流体或凝胶注入充胀的拉伸装置中实现。 The inflatable device 10 may be stretched by stretching means fluid or gel injected inflated implemented. 其也可通过注入允许固化的材料由此形成固态装置10实现。 It may also be allowed to cure by injecting solid material thereby forming apparatus 10 realized. 因此,示于图37h和37i中的拉伸装置10可例示出气球状装置,其随后被流体或凝胶或可替换地被简单地注入由胃壁12形成的杯状结构的材料填充。 Thus, as shown in Fig. 37h and 37i of the stretching apparatus 10 may be exemplified spherical outlet means, which is then fluid or gel or alternatively be simply injected into the stomach wall 12 formed by the material of the cup-like structure is filled.

[0479] 用于填充拉伸装置10的流体可为适于填充拉伸装置10的任何合适的流体,例如盐溶液。 [0479] fluid is used to fill the stretching device 10 may be adapted to any suitable fluid 10 filled stretching device, such as a salt solution. 在另一实施例中,当该流体为适于转换为固体状态的流体时,该流体可为液型聚氨 In another embodiment, when the fluid is adapted to convert the solid state fluid, the fluid can be a liquid-type polyurethane

[0480] 为了最小化或全部消除泄漏,流体为等渗的,S卩,其具有与人类身体流体相同的渗透压度。 [0480] In order to minimize or completely eliminate the leak, the fluid is isotonic, S Jie, which has the same human body fluid osmolality. 防止扩散的另一方式是提供包括大分子(例如碘分子)的流体。 Another way to prevent the spread of the offer include macromolecules (such as iodine molecules) of fluid.

[0481] 胃至胃的缝合线或订合线14优选设置有固定部分,其呈现例如网状结构的结构, 适于与胃壁12接触以促进人类组织的生长,从而确保附接到胃壁的拉伸装置的长期放置。 [0481] stomach to stomach sutures or staplers 14 is preferably provided with a fixed portion, e.g., it exhibits the structure of the network structure, 12 in contact with the stomach wall is adapted to promote the growth of human tissue, thus ensuring the stomach wall attached to pull extension means long-term placement.

[0482] 由此,处于充胀或膨胀状态的可充胀装置10通过病人的在胃壁12外部的胃壁部分套叠。 [0482] Thus, in inflated or expanded state of the inflatable device 10 nested in the stomach wall 12 by an external part of the patient's stomach.

[0483] 在一个或多个上述步骤期间,胃可优选通过胃镜器械被气体充胀。 [0483] During one or more of the above steps, the stomach may be preferred by endoscopy instrument is gas inflated.

[0484] 以上参照图37a至37i描述的拉伸装置10被描述为可充胀拉伸装置。 Stretching means [0484] 37a to 37i above described with reference to FIG. 10 is described as an inflatable stretching device. 可以意识到,其也可为具有弹性的弹性拉伸装置,从而允许压缩以被插入胃镜器械,其在离开器械之后膨胀为膨胀状态。 As can be appreciated, it may also be an elastic stretching device having elasticity allowing compression so as to be inserted into the endoscopic instrument, its expansion after leaving the device to an expanded state.

[0485] 在一个实施例中,拉伸装置10包括可膨胀为膨胀状态的可充胀拉伸装置10。 [0485] In one embodiment, the stretching device 10 comprises an expanded state of the expandable inflatable stretching device 10. 在该情况下,可充胀拉伸装置10设置有流体的入口18b,并适于连接到胃镜器械。 In this case, the inflatable stretching device 10 is provided with a fluid inlet 18b, and adapted to be connected to the endoscopic instrument. 现在将参照图38a至38d详细描述该实施例。 Referring now to FIG. 38a to 38d in the embodiment described in detail.

[0486] 处于非膨胀状态的可充胀拉伸装置示于图38a中。 [0486] inflatable stretching device in a non-expanded state in Figure 38a is shown in. 大致气球状的充胀的拉伸装置10具有入口18b。 Stretching device substantially inflated balloon 10 has an inlet 18b. 在该状态下,可充胀拉伸装置10具有最多几毫米的直径,从而允许其利用胃镜管状器械600通过病人的食管插入胃,或者利用图38b所示的管状器械600通过腹 In this state, the inflatable stretching device 10 having a diameter of up to a few millimeters, allowing it to take advantage of the tubular endoscopic instrument 600 inserted through the patient's stomach and the esophagus, or the use of the instrument shown in FIG. 38b of the tubular 600 through the abdominal

49腔镜方法中的腹腔镜套针。 49 endoscopic methods laparoscopic trocar. 该器械包括外套筒600a和可相对于外套筒纵向移位的内套筒600b。 The device includes an outer sleeve 600a and longitudinal displacement relative to the outer sleeve inner sleeve 600b. 内套筒在其远端设置有切割器,其采用切割边缘615的形式。 The inner sleeve at its distal end provided with a cutter, which takes the form of a cutting edge 615. 该切割边缘可用于在胃壁中切割孔,如以下详细所述。 The cutting edge can be used for cutting a hole in the stomach wall, as described in detail below.

[0487] 当器械从其内部或外部到达胃壁(见图38c)时,内套筒从其外套筒的位置向前并与与胃壁12a接触。 [0487] When the device reaches the stomach (see Figure 38c) from internal or external, from contacting the inner sleeve and the outer sleeve forward position and with the stomach wall 12a. 内套筒的切割边缘615因而在胃壁中切割孔,以允许随后容积填充装置10插入通过该孔,见图38d。 The cutting edge of the inner sleeve 615 thereby cutting a hole in the stomach wall, in order to allow subsequent volume filling device 10 is inserted through the hole, see Figure 38d. 为了将拉伸装置推动通过该孔,活塞602可被设置在器械中。 In order to push the stretching device through the hole, the piston 602 may be disposed in the instrument. 因此,该器械进一步包括活塞602,其适于将充胀的拉伸装置10从示于图38b中的内套筒中的位置推出到示于图38d中的内套筒外部的位置。 Thus, the device further comprises a piston 602, which is adapted to the inflatable stretching device 10 from the introduction of the inner sleeve shown in FIG. 38b to the position shown in FIG. 38d in a position outside the inner sleeve.

[0488] 为了保护充胀的拉伸装置10免受内套筒的切割边缘615影响,另外的保护套筒(未示出)可被设置在拉伸装置周围。 [0488] In order to protect the inner inflatable stretching device 10 from the cutting edge 615 of the sleeve effects an additional protective sleeve (not shown) may be provided around the stretching device.

[0489] 图39a至39j示出在将拉伸装置10接合到病人的胃壁12的方法中所用的器械。 [0489] FIG 39a to 39j is shown in the process of stretching the stomach wall engaging means 10 to the patient 12 in the instrument used. 该器械适于被插入通过窄管形物体,例如,使用在入腔过程中的胃镜,或者使用在腹腔镜过程中的腹腔镜套针。 The instrument is adapted to be inserted through a narrow tube-shaped object, for example, in the chamber during endoscopy, or for use in laparoscopic procedure laparoscopic trocar. 该器械包括器械650,其适于通过包括多个环形构件的结构而为柔性的,然而,同样可以设想到,所述细长构件650适于通过由柔性或可调节材料制成的所述细长构件650而为柔性的。 The instrument includes a device 650, which comprises a plurality of annular members adapted to the structure of the flexible, however, also conceivable to, the elongate member 650 is adapted to the fine through a flexible or adjustable material the elongated member 650 and is flexible. 细长构件650被从其外部或内部插入主体并被放置为与病人的胃壁12接近。 The elongated member 650 is inserted into the body from the outside or inside of the stomach wall and placed near the patient 12. 细长构件650具有专用保持装置651,其适于通过机械抓取构件或真空来保持胃。 An elongated member 650 having a special holding means 651, which is adapted to hold the stomach by mechanical or vacuum gripping members. 专用保持装置651包括第一关节652和第二关节653,其使专用保持装置651可相对于细长构件650操作,并由此将保持装置651的包括机械抓取构件或真空元件的部分与病人的胃壁12接触。 Special holding device 651 includes first and second articulation joint 652 653, which makes special holding device 651 is movable relative to the elongate member 650 to operate, and thereby holding device 651 includes a mechanical gripping member or vacuum component part with the patient The stomach wall 12 contacts. 图39b示出被放置为与人类病人的胃壁12接触时的专用保持装置651,在此之后专用保持装置651连接到胃壁12,以保持胃壁12。 Figure 39b shows the contact 12 is placed in the patient's stomach wall with the human-specific holding means 651, after which the special holding means 651 is connected to the stomach wall 12 to maintain the stomach wall 12. 图39c示出当执行将推杆654从细长构件650推进的步骤时的器械。 Figure 39c shows the instrument when the plunger 654 steps from the elongated member 650 when advancing. 推杆654推动胃壁12以形成其腔或囊。 Pusher 654 pushing its stomach wall 12 to form a cavity or pouch. 图39d示出该器械相对于图39a至39c转动90度。 Figure 39d shows this instrument with respect to Figure 39a to 39c is rotated by 90 degrees. 该视图示出专用保持构件651a、651b,当推杆654 推动以形成腔或囊时,专用保持构件651a、651b可操作地附接到细长构件650的两侧并与胃壁12接触,从而保持胃壁12。 This view shows the special holding members 651a, 651b, when pushing the push rod 654 to form a cavity or pouch, special holding members 651a, 651b operably attached to both sides of the elongate member 650 and into contact with the stomach wall 12, thereby to keep the stomach wall 12. 当推杆654将胃壁12推到希望的位置时,专用保持装置651a、651b朝向推杆654移动,由此关闭腔或囊。 When the rod 654 will push the stomach wall 12 to a desired location, a dedicated holding means 651a, 651b move towards the push rod 654, thereby closing the cavity or pouch.

[0490] 在腔或囊被形成之后,其需要被密封。 [0490] After the cavity or pouch has been formed, which needs to be sealed. 图39f示出缝合或订合装置655从细长构件650的前移。 Figure 39f shows a suturing or stapling device 655 from the elongated member 650 forward. 缝合或订合装置655被定位为与胃壁相连,在此之后缝合或订合装置开始进行胃壁12的缝合和订合,从而形成胃至胃的缝合线或订合线14的密封。 Suturing or stapling device 655 is positioned connected to the stomach, after suturing or stapling device starts stitching and stapling the stomach wall 12, thereby forming a stomach-to-stomach sutures or staplers seal 14. 该器械沿病人的胃壁12移动,由此腔或囊利用该装置形成和密封,如图39g和39h所示。 The device 12 is moved along the patient's stomach wall, thereby cavity or pouch using the apparatus for forming and sealing, as shown in FIG. 39g and 39h. 当腔或囊或希望的尺寸已被形成和密封时,插入构件656从细长构件650前移。 When the desired size or bladder or cavity is formed and sealed insert member 656 from the elongated member 650 forward. 插入构件656适于插入可充胀的拉伸装置10,如本申请前文所述。 Insert member 656 is adapted to be inserted into the inflatable stretching device 10, as previously described in this application. 在插入构件656已被定位在腔或囊中之后,利用加压流体或气体或者将所述可充胀装置10推入腔或囊中的机械前移构件,拉伸装置10被插入通过插入构件656并至腔或囊中。 After the insert member 656 has been positioned in the cavity or pouch, using pressurized fluid or gas or the rechargeable 10 push cavity or pouch mechanical advance member expansion means stretching device 10 is inserted through the insertion member 656 and to the chamber or bag. 因而,插入构件用流体或气体充胀可充胀拉伸装置, 并利用胃至胃的缝合线或订合线14密封囊的最后部分。 Thus, the insertion member is inflated with fluid or gas inflatable stretching device, and with stomach to stomach sutures or staples last part of the bonding wire 14 sealed capsule. 所述实施例阐释了插入可充胀拉伸装置的过程,然而同样可以设想到,拉伸装置10通过由弹性材料制成的拉伸装置10而为可膨胀的。 The Example illustrates the process of inserting an inflatable stretching device, however, also conceivable that the stretching device 10 by stretching means 10 made of an elastic material and is expandable.

[0491] 图40a至40f示出使用在将拉伸装置10接合到病人的胃壁12的方法中的器械。 [0491] FIG. 40a to 40f shown using the procedure stomach stretching device 10 is bonded to the patient's 12 instruments. 该器械适于被插入通过窄管形物体,例如,使用在入腔过程中的胃镜,或者使用在腹腔镜过程中的腹腔镜套针。 The instrument is adapted to be inserted through a narrow tube-shaped object, for example, in the chamber during endoscopy, or for use in laparoscopic procedure laparoscopic trocar. 该器械包括细长构件660,其适于通过包括多个环形构件的结构而为柔 The instrument includes an elongated member 660, which comprises a plurality of annular members adapted to the structure of the flexible

50性的,然而,同样可以设想到,所述细长构件660适于通过由柔性或可调节材料制成的所述细长构件660而为柔性的。 Of 50, however, also conceivable to, the elongate member 660 is adapted to the elongate member by a flexible or adjustable material 660 and is flexible. 细长构件660被从其外部或内部插入主体并被放置为与病人的胃壁12接近。 The elongated member 660 is inserted into the body from the outside or inside of the stomach wall and placed near the patient 12. 细长构件660具有多个专用保持装置661,其适于通过机械抓取构件或真空来保持胃。 An elongate member having a plurality of special holding device 660 661, which is adapted to hold the stomach by a mechanical or vacuum gripping members. 专用保持装置661利用锁定环662被锁定在细长构件660旁边的位置。 Special holding unit 661 by the lock ring 662 is locked in position next to the elongated member 660. 专用保持装置由柔性材料制成并预弯曲以在所述锁定环662被移除时膨胀为漏斗形装置。 Special holding device consists of a flexible material and expansion of the pre-curved in a funnel-shaped device when said locking ring 662 is removed. 处于漏斗形膨胀状态的专用保持装置示于图40b中。 Dedicated in the funnel-shaped expanded state holding means is shown in Figure 40b,. 图40b进一步示出专用保持装置661,其被放置为与人类病人的胃壁12接触,在此之后专用保持装置661连接到胃壁12,以保持胃壁12。 Figure 40b further shows the special holding means 661, which is placed in the patient 12 in contact with the human stomach wall, after which the special holding means 661 is connected to the stomach wall 12 to maintain the stomach wall 12. 图40c示出当执行推杆665从细长构件660前移的步骤时的器械。 Figure 40c shows a putt when the instrument is 665 steps from the elongated member 660 when forward movement. 推杆665推动胃壁12以形成其腔或囊。 Pusher 665 pushing its stomach wall 12 to form a cavity or pouch. 当推杆664已将胃壁12推到希望的位置时,专用保持装置661朝向推杆664移动,由此关闭腔或囊。 When you have the stomach to push the plunger 664 to the desired position 12, the special holding unit 661 to move toward the push rod 664, thereby closing the cavity or pouch.

[0492] 在腔或囊已被形成之后,其需要被密封。 [0492] After the cavity or pouch has been formed, it needs to be sealed. 图40d示出缝合或订合装置665从细长构件660的前移。 Figure 40d shows a suturing or stapling device 665 from the elongated member 660 forward. 缝合或订合装置665被定位为与胃壁12相连,在此之后缝合或订合装置665开始进行胃壁12的缝合或订合,从而形成胃至胃的缝合线或订合线14的密封。 Suturing or stapling device 665 is positioned connected to the stomach wall 12, after suturing or stapling device 665 starts suturing or stapling the stomach 12, thereby forming a stomach to stomach sutures or staples seal bonding wire 14. 之后, 插入构件668从细长构件660前移,专用保持装置661收缩。 Thereafter, the insert member 668 from the elongated member 660 forward, the special holding unit 661 contracts. 插入构件666适于插入可充胀的拉伸装置10,如本申请前文所述。 Insert member 666 is adapted to be inserted into the inflatable stretching device 10, as previously described in this application. 在插入构件666已被定位在腔或囊中之后,利用加压流体或气体或者将所述可充胀装置10推入腔或囊中的机械前移构件,拉伸装置10被插入通过插入构件666并至腔或囊中。 After the insert member 666 has been positioned in the cavity or pouch, using pressurized fluid or gas or the rechargeable 10 push cavity or pouch mechanical advance member expansion means stretching device 10 is inserted through the insertion member 666 and to the chamber or bag. 因而,插入构件656用流体或气体充胀可充胀拉伸装置, 并利用胃至胃的缝合线或订合线14密封囊的最后部分。 Thus, the insert member 656 is inflated with fluid or gas inflatable stretching device, and with stomach to stomach sutures or staples last part of the bonding wire 14 sealed capsule. 所述实施例阐释了插入可充胀拉伸装置10的过程,然而同样可以设想到,拉伸装置10通过由弹性材料制成的拉伸装置10 而为可膨胀的。 The Example illustrates the process of inserting an inflatable stretching device 10, however, also conceivable that the stretching device 10 by stretching means 10 made of an elastic material and is expandable. 图40f示出拉伸装置10套叠在胃壁12中时在利用胃至胃的缝合线或订合线14密封的腔或囊中的拉伸装置10。 Figure 40f shows 10 nested in the stomach wall 12 when the stomach to stomach sutures or staplers 14 sealed cavity or capsule stretching device 10 out stretching device.

[0493] 图41a示出使用在将根据本申请的任意实施例的拉伸装置接合到胃壁12的方法中的器械。 [0493] Figure 41a shows a stretching apparatus used in the embodiment of the present application, according to any method of joining the stomach wall 12 in the instrument. 该器械包括细长构件670,其适于通过包括多个环形构件的结构而为柔性的,然而同样可以设想到,所述细长构件670适于通过由柔性或可调节材料制成的所述细长构件670而为柔性的。 The instrument includes an elongated member 670, which is adapted by including a plurality of annular members and flexible structure, but can also envisioned, wherein the elongate member 670 is adapted or adjustable by the flexible material the elongated member 670 and is flexible. 细长构件670被从其内部插入主体并被放置为与病人的胃壁12接近。 The elongated member 670 is as close to the stomach wall 12 from the patient's body and placed inside the insertion. 胃刺穿构件672被放置在细长构件670的远端,收缩地固定到保护套筒673,该保护套筒适于保护身体的组织在已执行切割操作之后免受尖锐刺穿构件672或切割器672的影响。 Stomach piercing member 672 is disposed at the distal end of the elongate member 670 is fixed to the protective sleeve shrink to 673, the protective sleeve is adapted to protect the body's tissues after the cutting operation has been performed against a sharp piercing or cutting member 672 672 in.

[0494] 图41b示出在切割操作已被执行且胃刺穿构件或切割器672已被收缩到保护套筒673中之后的包括细长构件670的器械。 [0494] Figure 41b shows the device comprising an elongate member 670 in the cutting operation has been performed and the stomach piercing member or cutter 672 has been retracted into the protective sleeve 673 after. 导线671被推动通过细长构件670、通过胃壁12中形成的孔并通出腹部,放置在病人皮肤的内部,皮肤从外部被刺穿以使导线671能够离开腹部。 Wire 671 is pushed through the elongated member 670, through the hole 12 formed in the stomach and through the abdomen, is placed inside the patient's skin, the skin is pierced from the outside to the wire 671 can be left abdomen. 导线671因而可用于引导附接到拉伸装置10的管路18或引线,从而从其内部放置在胃中。 Wire 671 can thus be used to guide the stretching device attached to the line 18 or lead 10, which is placed in the stomach from the inside. 带有管路18或电引线的拉伸装置10为根据本申请的任意实施例的拉伸装置10。 Electrical lead line 18 or 10 with a stretching device for the stretching apparatus 10 according to any embodiment of the present application. 管路18或电引线的引导使管路18或电引线能够附接到从腹部的外部放置在病人皮下的控制单元42。 Electrical wire line 18 or line 18 or guidance makes electrical leads can be attached to the abdomen from the outside skin of the patient is placed in the control unit 42.

[0495] 图42示出描述在插入用于拉伸胃壁的一部分的装置的入腔方法中所需的步骤的流程图,该方法包括步骤:将器械插入病人的食管203 (步骤la),利用器械将装置通过食管203插入病人的胃(步骤2a),将装置10放置为与胃壁12接触(步骤3a),将装置固定到胃壁12,使得该装置能够拉伸胃壁12的一部分。 [0495] FIG. 42 shows the steps required to describe the method of inserting the device into the lumen of the stomach wall to stretch a part of the flowchart, the method comprising the steps of: the instrument into the patient's esophagus 203 (step la), the use of The apparatus of instrument 203 inserted through the patient's stomach and the esophagus (step 2a), the device 10 is placed in contact with the stomach wall 12 (step 3a), the means 12 is secured to the stomach wall, so that the device is capable of stretching the stomach wall portion 12. 所述方法可进一步包括在完成放置装置之后非侵入性地调整装置的步骤。 The method may further comprise the step of placing apparatus after the completion of non-invasively regulating the device. [0496] 图43示出描述在插入用于拉伸胃壁的一部分的装置的腹方法中所需的步骤的流程图,该方法包括步骤:在所述病人的腹壁中切割孔(步骤lb),切除胃周围的一区域(步骤2b),将所述装置放置为与胃接触(步骤3b),以及通过胃壁的套叠将装置直接或间接地固定到胃壁,使得该装置能够拉伸所述胃壁的一部分(步骤4b)。 [0496] FIG. 43 shows a flowchart describing the method required in ventral insertion means for stretching the stomach wall portion of the step, the method comprising the steps of: cutting a hole in the abdominal wall of the patient (step lb), removal of an area around the stomach (step 2b), the device is placed in contact with the stomach (step 3b), and the stack is secured to the stomach wall means directly or indirectly through the stomach wall sleeve, so that the device is capable of stretching the stomach wall part (step 4b). 所述方法可进一步包括步骤:利用缝合线或订合线14关闭腹部中的孔,以及在完成放置装置之后非侵入性地调整该 The method may further comprise the steps of: the use of sutures or staplers 14 closes the hole in the abdomen, and after the completion of the deployment device non-invasively adjusted

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