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Publication numberCN102245133 A
Publication typeApplication
Application numberCN 200980149807
PCT numberPCT/SE2009/051155
Publication date16 Nov 2011
Filing date12 Oct 2009
Priority date10 Oct 2008
Also published asCA2749778A1, CA2749782A1, CA2749792A1, CA2776479A1, CN101980673A, CN101980673B, CN101980674A, 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 number200980149807.9, CN 102245133 A, CN 102245133A, CN 200980149807, CN-A-102245133, CN102245133 A, CN102245133A, CN200980149807, CN200980149807.9, PCT/2009/51155, PCT/SE/2009/051155, PCT/SE/2009/51155, PCT/SE/9/051155, PCT/SE/9/51155, PCT/SE2009/051155, PCT/SE2009/51155, PCT/SE2009051155, PCT/SE200951155, PCT/SE9/051155, PCT/SE9/51155, PCT/SE9051155, PCT/SE951155
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
An apparatus for treating gerd
CN 102245133 A
Abstract
The present invention relates to a reflux disease treatment apparatus, comprising an implantable movement restriction device with an elongated shape that maintains cardia in the correct position and an implantable stimulation device adapted to engage with the cardia sphincter of a patient. The movement has proximal and a distal end, wherein the distal end is adapted to stabilize and hold the distal end. The invention further comprises a control device for controlling the stimulation device to stimulate the cardia sphincter. The distal end can be further adaped to treat obesity, for example by stretching the wall of the stomach or filling out a volume of the stomach.
Claims(322)  translated from Chinese
1. 一种用于治疗人类或哺乳动物的反流疾病的装置,所述装置包括可植入的运动约束设备,所述运动约束设备具有构造成细长形的外表面,适于至少部分地被患者胃壁部分内陷,在植入患者体内时,所述设备具有近端部分和远端部分;其中所述运动约束设备适于至少部分地以其近端部分的外表面在患者横膈膜和胃底壁之间的位置抵靠患者胃底壁,以便在运动约束设备植入患者体内时,约束患者胃的心切迹朝向患者横膈膜的运动,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持由患者腹部施加在患者贲门括约肌上的支撑压力;并且其中所述运动约束设备的远端部分稳定并保持所述近端部分,所述远端部分适于基本上内陷在胃壁中。 1. A device for treatment of a human or a mammal for reflux disease, the implantable device includes a movement restraining device, the motion restraint device having an outer surface configured to elongate, adapted to at least partially Patients with stomach wall portion by retraction, when implanted in a patient, said device having a proximal portion and a distal portion; wherein said movement restraining device is adapted to at least partially in its outer surface at the proximal end portion of the diaphragm patients and between the gastric wall in patients with gastric position against the wall, in order to exercise restraint device implanted in a patient, the patient restraint toward the stomach in patients with heart notch diaphragm movement, thereby preventing cardiac patients through the diaphragm opening Slide patients chest, so as to maintain the patient's abdomen is applied to the cardiac sphincter of the patient support pressure; and wherein the distal end portion of the motion restraint device stable and holding said proximal portion, said distal portion adapted to substantially the stuck in the stomach wall.
2.根据权利要求1所述的装置,其特征在于,细长的运动约束设备的内陷的远端部分具有足够的长度以稳定所述细长的运动约束设备的近端部分,以防止贲门通过患者横膈膜开口滑入患者胸腔。 2. The apparatus according to claim 1, characterized in that the distal end portion of the elongated retraction motion restraint device having a length sufficient to stabilize the movement of the proximal end portion of the elongate restraint device to prevent the cardia Slide the patient through the patient diaphragm opening the chest.
3.根据权利要求1所述的装置,其特征在于,所述细长的运动约束设备的内陷的远端部分的周长足够稳定所述细长的运动约束设备的近端部分,以防止贲门通过患者横膈膜开口滑入患者胸腔。 3. The apparatus according to claim 1, characterized in that the circumference of the distal end portion of the elongated retraction motion restraint device of the proximal portion of the elongate sufficiently stable motion restraint device to prevent cardiac patient by patient chest diaphragm opening slide.
4.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分的尺寸至少为125mm3,周长至少为15mm。 4. The apparatus according to claim 1, characterized in that the size of said proximal portion of the motion restraint device of at least 125mm3, the perimeter of at least 15mm.
5.根据权利要求1所述的装置,包括固定设备,在所述运动约束设备植入时,所述固定设备适于将所述运动约束设备的近端部分固定在所述位置。 5. The apparatus according to claim 1, comprising fixing device, the movement restraining device when implanted, the device is adapted to be fixed to the proximal portion of the motion restraint device in the fixed position.
6.根据权利要求5所述的装置,其特征在于,所述固定设备包括可植入的第一固定设备,在植入患者体内时,该第一固定设备将所述运动约束设备的近端部分连接到胃底壁,从而将所述运动约束设备保持在所述位置。 6. The apparatus according to claim 5, wherein said fixing device comprises a first implantable fixation device, when implanted in a patient, the first fixing device to the proximal end of the motion restraint device fundic portion is connected to the wall, whereby the motion restraint device held in the position.
7.根据权利要求1所述的装置,其特征在于,在植入患者体内时,所述运动约束设备的近端部分是从患者体外不可调节的。 7. The apparatus according to claim 1, characterized in that, when implanted in a patient, the proximal portion of the motion restraint device from the patient's body is non-adjustable.
8.根据权利要求6所述的装置,其特征在于,所述第一固定设备包括组织生长促进结构,用于保持所述运动约束设备的近端部分长期连接到胃壁而不需要内陷。 8. The apparatus according to claim 6, characterized in that said first fixing device comprises a tissue growth promoting structure, for holding the proximal portion of the motion restraint device is connected to the stomach wall without the need for long-term retraction.
9.根据权利要求8所述的装置,其特征在于,所述组织生长促进结构包括网状结构。 9. The apparatus according to claim 8, wherein said tissue growth promoting structure comprises a mesh structure.
10.根据权利要求9所述的装置,其特征在于,所述组织生长促进结构进一步包括缝合线或卡钉,在植入患者体内时,所述缝合线或卡钉将所述网状结构连接到胃底壁。 10. The apparatus according to claim 9, characterized in that said structure further comprises a tissue growth promoting sutures or staples, when implanted in a patient, the sutures or staples to connect the mesh structure to the gastric wall.
11.根据权利要求5所述的装置,其特征在于,所述固定设备包括缝合线或卡钉,在植入患者体内时,所述缝合线或卡钉将包围所述运动约束设备的胃底壁部分连接在一起,从而将所述运动约束设备固定在所述位置。 11. The apparatus according to claim 5, wherein said fixing device comprises a suture or staple, when implanted in a patient, the sutures or staples to surround the motion restraint device fundus wall portions connected together, so that the apparatus is fixed at the position of the motion constraint.
12.根据权利要求11所述的装置,其特征在于,在植入患者体内从而将胃底壁部分连接在一起时,所述缝合线或卡钉将所述运动约束设备内陷在胃底壁中,从而保持所述运动约束设备就位。 12. The apparatus according to claim 11, characterized in that, in the implanted in the patient so that the gastric wall portions connected together, the suture or staple the motion restraint device in the gastric wall invaginations In order to maintain the motion restraint device in place.
13.根据权利要求11所述的装置,其特征在于,在连同所述运动约束设备一起植入患者体内之后,所述缝合线或卡钉将胃底壁部分连接在一起,从而使所述运动约束设备从患者胃壁内侧内陷。 13. The apparatus according to claim 11, characterized in that, in conjunction with the motion restraint device after implantation into a patient, together, the suture or staple the fundic wall portions connected together, so that the movement restraint device retraction from inside the stomach of patients.
14.根据权利要求11所述的装置,其特征在于,在连同所述运动约束设备的近端部分一起植入患者体内之后,所述缝合线或卡钉将胃底壁部分连接在一起,从而使所述运动约束设备从患者胃壁外侧内陷。 14. The apparatus according to claim 11, characterized in that, after the movement along with the proximal portion of the restraint device implanted in a patient together, the suture or staple the fundic wall portions connected together, whereby make the motion restraint device from the patient's stomach outside of the retraction.
15.根据权利要求6所述的装置,其特征在于,所述固定设备包括第二固定设备,在连同所述运动约束设备的近端部分一起植入患者体内之后,所述第二固定设备将所述运动约束设备间接或直接地固定到患者食管的希斯角附近。 15. The apparatus according to claim 6, wherein said fixing device comprises a second fixing device, together with the proximal portion of the movement after the restraint device implanted in a patient together, the second fixing device The motion constraints directly or indirectly secured to the patient's esophagus Heath corner near the equipment.
16.根据权利要求15所述的装置,其特征在于,所述第二固定设备由多个缝合线或卡钉构成,在连同所述运动约束设备一起植入患者体内之后,所述缝合线或卡钉连接胃底壁和患者食管壁,将所述运动约束设备保持在所述位置。 16. The apparatus according to claim 15, characterized in that said second fixing device by a plurality of suture or staples constituted, after together along with the motion restraint device implanted in a patient, said suture or staples connection gastric wall and patient esophageal wall, the movement restraining device is maintained at the position.
17.根据权利要求15所述的装置,其特征在于,所述固定设备第三固定设备,在连同所述运动约束设备的近端部分一起植入患者体内之后,所述第三固定设备将所述运动约束设备间接或直接地固定到患者横膈肌或者其他肌肉组织。 17. The apparatus according to claim 15, characterized in that said third fixation device fixing device, together with the proximal portion of the movement after the restraint device implanted in a patient together, said fixing device of the third said motion restraint devices directly or indirectly secured to the patient or other cross diaphragm muscle tissue.
18.根据权利要求17所述的装置,其特征在于,所述第三固定设备由多个缝合线或卡钉构成,在连同所述运动约束设备一起植入患者体内之后,所述缝合线或卡钉连接胃底壁和横膈肌或者其他肌肉组织,从而将所述运动约束设备保持在所述位置。 18. The apparatus according to claim 17, wherein said third fixation device by a plurality of sutures or staples constituted, after together along with the motion restraint device implanted in a patient, said suture or staples connection gastric wall and cross the diaphragm muscle or other tissue, so the motion restraint device remains in the position.
19.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分包括主体,该主体适于被患者胃底壁至少部分地内陷并且具有包括生物相容材料的外表面,所述主体的外表面的主要部分适于在患者横膈膜和内陷胃底壁下部的部分之间的所述位置抵靠胃壁。 19. The apparatus according to claim 1, characterized in that said movement device comprises a proximal portion bound by a body adapted to be at least partially gastric wall invaginations patient and having an outer surface including a biocompatible material, The position of the main portion of the outer surface of the body portion is adapted between the patient and the retraction of the diaphragm wall the lower portion of the fundus of the stomach wall against.
20.根据权利要求19所述的装置,其特征在于,所述主体基本上为卵形。 20. The apparatus according to claim 19, wherein said body is substantially oval.
21.根据权利要求19所述的装置,其特征在于,所述主体基本上构造成中部有凹陷的类卵形 21. The apparatus according to claim 19, wherein said body has a substantially central recess configured to class ovate
22.根据权利要求19所述的装置,其特征在于,所述主体基本上构造成类似于弯曲的卵形。 22. The apparatus according to claim 19, wherein said body is configured substantially similar to curved oval.
23.根据权利要求19所述的装置,其特征在于,所述主体具有圆形轮廓,不具有可能损伤患者胃壁的太尖锐的边缘。 23. The apparatus according to claim 19, characterized in that the body has a circular profile, with possible damage to the patient is not too sharp edges stomach.
24.根据权利要求19所述的装置,进一步包括:适于在植入患者体内时调节所述主体的尺寸的部件。 24. The apparatus according to claim 19, further comprising: when implanted in the patient adapted to the body size of the adjustment member.
25.根据权利要求19所述的装置,其特征在于,所述主体形成包含流体的腔室,在所述主体植入患者体内时,包含的流体量是可控制的以调节所述主体的尺寸。 25. The apparatus according to claim 19, wherein said body comprises a fluid chamber formed in the body when implanted in a patient, comprising an amount of fluid is to adjust the size of the body can be controlled .
26.根据权利要求19所述的装置,其特征在于,在植入患者体内时,所述主体的尺寸能非侵入式地调节。 26. The apparatus according to claim 19, characterized in that, when implanted in a patient, the size of the body can be adjusted non-invasively.
27.根据权利要求19所述的装置,其特征在于,所述主体适于借助胃镜或内部照明器械安置在患者胃壁内侧。 27. The apparatus according to claim 19, wherein said body is adapted by means of endoscopy or interior lighting device disposed on the inside of the stomach of patients.
28.根据权利要求19所述的装置,其特征在于,所述可植入的主体具有大致光滑的外表面,用于抵靠胃底壁。 28. The apparatus according to claim 19, characterized in that said implantable body having a generally smooth outer surface for abutment against gastric wall.
29.根据权利要求19所述的装置,其特征在于,所述主体能植入患者胃的内侧。 29. The apparatus according to claim 19, characterized in that the inner body can be implanted in the patient's stomach.
30.根据权利要求19所述的装置,其特征在于,所述主体适于通过手术连接到患者胃壁。 30. The apparatus according to claim 19, wherein said body is adapted to be connected to the stomach wall by surgery patient.
31.根据权利要求19所述的装置,其特征在于,所述主体适于安置在患者胃的外侧。 31. The apparatus according to claim 19, wherein said body is adapted to the outer disposed in the patient's stomach.
32.根据权利要求19所述的装置,其特征在于,所述主体是可变的,以呈现直径小于腹腔镜所用套管针的细长形式,由此在变成所述细长形式时,所述主体能够被推送或牵引经过所述套管针。 32. The apparatus according to claim 19, wherein said body is a variable, to present a diameter of less than laparoscopic trocar used in the form of an elongate, thereby into the elongated form, the body can be pushed or pull through the trocar.
33.根据权利要求19所述的装置,其特征在于,所述主体包括限定流体填充腔室的挠性外壁,允许所述主体经过腹腔镜所用的套管针。 33. The apparatus according to claim 19, characterized in that the body comprises a flexible outer wall defining a fluid-filled chamber, allowing the body through the laparoscopic trocar used.
34.根据权利要求25所述的装置,其特征在于,所述流体包括凝胶。 34. The apparatus according to claim 25, wherein said fluid comprises a gel.
35.根据权利要求19所述的装置,其特征在于,所述主体为中空形式,并且包括至少两个单独部件,这两个单独部件适于插入所述中空主体,并且进一步适于在所述主体内放在一起形成单一部件,由此允许所述主体经过腹腔镜所用的套管针。 35. The apparatus according to claim 19, wherein said body is a hollow form, and comprises at least two separate parts, these two separate members adapted to be inserted into the hollow body, and further adapted to the together forming a unitary member within the body, thereby allowing the body through the laparoscopic trocar used.
36.根据权利要求19所述的装置,其特征在于,所述主体包括外壁和中空的压缩内部部分,用于在插入患者身体之后用流体或凝胶填充。 36. The apparatus according to claim 19, wherein said body comprises a hollow inner portion and an outer wall of the compression, is filled with a fluid or gel used in the body of the patient after insertion.
37.根据权利要求19所述的装置,其特征在于,所述主体包括带有注入端口的腔室,其中所述主体的腔室通过所述注入端口填充流体。 37. The apparatus according to claim 19, wherein said body includes a chamber with the injection port, wherein the chamber of the body through the fill fluid injection port.
38.根据权利要求19所述的装置,其特征在于,所述主体包括弹性可压缩材料,允许所述主体通过腹腔镜所所用的套管针。 38. The apparatus according to claim 19, wherein said body comprises a resiliently compressible material, allowing the body through the laparoscopic trocar used.
39.根据权利要求19所述的装置,其特征在于,所述主体以软于25舒尔的材料制成。 39. The apparatus according to claim 19, characterized in that said body made of soft material 25 Shure.
40.根据权利要求19所述的装置,其特征在于,所述主体以软于15舒尔的材料制成。 40. The apparatus according to claim 19, characterized in that said body 15 Shure soft material.
41.根据权利要求19所述的装置,其特征在于,所述主体包括基本上呈现为球状的外壁。 41. The apparatus according to claim 19, wherein said body comprises a substantially spherical outer wall rendered.
42.根据权利要求19所述的装置,其特征在于,所述主体包括至少一个保持设备,所述保持设备适于用于推送或牵拉所述主体穿过腹腔镜所用的套管针。 42. The apparatus according to claim 19, wherein said body comprises at least one holding device, the holding device is adapted for pushing or pulling of the body through the laparoscopic trocar used.
43.根据权利要求42所述的装置,其特征在于,所述保持设备适于保持所述主体的适于由手术器械保持的延长部。 43. The apparatus according to claim 42, characterized in that said holding device adapted to hold said body portion adapted to extend from the surgical instrument held.
44.根据权利要求42所述的装置,其特征在于,所述保持设备适于保持穿过所述保持设备插入的线或带材。 44. The apparatus according to claim 42, characterized in that said holding device adapted to hold through the holding device into the line or strip.
45.根据权利要求42所述的装置,其特征在于,所述主体包括外壁,所述保持设备至少部分地安置在所述主体的外壁的内侧。 45. The apparatus according to claim 42, characterized in that said body comprises an outer wall, the holding device is at least partially disposed in the inner side of the outer wall of the body.
46.根据权利要求19所述的装置,其特征在于,所述主体的尺寸确定为大于胃的肠道出口。 46. The apparatus according to claim 19, characterized in that the size of the body is determined to be greater than the stomach intestinal outlet.
47.根据权利要求19所述的装置,其特征在于,所述主体的最小外径为30mm或更大。 47. The apparatus according to claim 19, wherein the minimum outer diameter of the main body is 30mm or more.
48.根据权利要求19所述的装置,其特征在于,所述主体的最小外径为40mm或更大。 48. The apparatus according to claim 19, wherein the minimum outer diameter of the main body is 40mm or more.
49.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为90mm。 49. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 90mm.
50.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为70mm。 50. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 70mm.
51.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为50mm。 51. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 50mm.
52.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为30mm。 52. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 30mm.
53.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为110mm。 53. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 110mm.
54.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为130mm。 54. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 130mm.
55.根据权利要求19所述的装置,其特征在于,所述主体的最小外周长为150mm。 55. The apparatus according to claim 19, characterized in that the outer circumference of the body of minimum 150mm.
56.根据权利要求1所述的装置,进一步包括:调节设备,所述调节设备用于至少调节所述运动约束设备的近端部分。 56. The apparatus according to claim 1, further comprising: adjusting device, the adjusting device for adjusting at least a proximal portion of the motion restraint device.
57.根据权利要求56所述的装置,其特征在于,所述运动约束设备的尺寸是液压可调的,并且所述调节设备包括液压流体容器,在植入患者体内时,所述液压流体容器连接到所述运动约束设备,并且其中所述运动约束设备的尺寸通过在所述液压流体容器和所述运动约束设备之间移动液压流体而被非侵入式地调节。 57. The apparatus according to claim according to claim 56, characterized in that the size of the motion restraint device is hydraulically adjustable, and the adjustment device comprises a hydraulic fluid reservoir, when implanted in a patient, the hydraulic fluid reservoir connected to the motion restraint device, and wherein the size of the motion restraint device through between the hydraulic fluid reservoir and said hydraulic fluid to move the motion restraint device is non-invasive adjusted.
58.根据权利要求57所述的装置,进一步包括:液压控制设备,所述液压控制设备包括至少一个腔室,在植入患者体内时,所述腔室与所述主体一起内陷在患者胃壁中并连接到所述主体,并且其中包含在所述主体中的液压流体量通过与所述液压容器和所述至少一个腔室之间分配流体而被非侵入式地调节。 58. The apparatus according to claim 57, further comprising: a hydraulic pressure control apparatus, the hydraulic control device comprises at least one chamber, when implanted in a patient, the chamber together with the retraction body in the stomach of patients the amount of the hydraulic fluid and connected to the body, and wherein said body comprises the dispensing by said hydraulic fluid between the container and the at least one chamber is non-invasive and adjusted.
59.根据权利要求58所述的装置,其特征在于,所述至少一个腔室在植入患者体内时, 利用所述容器中的泵被液压流体填充,从而牵拉胃底壁使患者产生饱足感。 59. The apparatus according to claim according to claim 58, characterized in that said at least one chamber when implanted in a patient using a pump of the container is filled with hydraulic fluid, thereby pulling gastric wall so that patients have full Foot feeling.
60.根据权利要求56所述的装置,包括:三个具有液压流体的可调容器,其中第一容器是包括第二容器的第一闭合系统的一部分,皮下安置的所述第一容器中的小体积流体以较高的每单位面积作用力被压缩,用于移动小体积的液压流体,并且其中第二容器影响第三容器中较大体积的液压流体,所述第三容器是第二闭合系统的一部分,体积大于所述第一容器,由此以较小的每单位面积作用力产生较大总体积的液压流体的运动。 60. The apparatus according to claim 56, comprising: three adjustable container having a hydraulic fluid, wherein the first portion of the second container is a container comprising a first closed system, the subcutaneous placement of the first container small volumes of fluid at a higher force per unit area is compressed, the hydraulic fluid used to move a small volume, and wherein the second hydraulic fluid container affect a larger volume of the third container, the third container is a second closed part of the system, is greater than the volume of the first container, whereby a smaller force per unit area generated a greater total volume of movement of hydraulic fluid.
61.根据权利要求19所述的装置,其特征在于,所述主体形成第一腔室,进一步包括至少一个额外主体,所述额外主体形成比第一腔室小的第二腔室,所述第一和第二腔室彼此接触。 61. The apparatus according to claim 19, characterized in that said body forming a first chamber, further comprising at least one additional body, the additional body is formed smaller than the first chamber of the second chamber, the contact each of the first and second chambers.
62.根据权利要求61所述的装置,其特征在于,所述第一和第二腔室彼此流体连通。 62. The apparatus according to claim 61, wherein said first and second chambers in fluid communication with each other.
63.根据权利要求57所述的装置,其特征在于,所述液压容器适于皮下安置在患者体内。 63. The apparatus according to claim 57, characterized in that said hydraulic container suitable for subcutaneous placement in the patient.
64.根据权利要求57所述的装置,其特征在于,所述液压容器适于安置在患者腹部中。 64. The apparatus according to claim 57, wherein said container is adapted to the hydraulic disposed in the patient's abdomen.
65.根据权利要求57所述的装置,其特征在于,所述液压容器具有限定其体积的壁,并且所述液压容器的体积通过移动所述液压容器的壁的部分壁来调节。 65. The apparatus according to claim 57, characterized in that the hydraulic container having a wall defining the volume, and the volume of the hydraulic part of the wall of the container by moving the hydraulic container wall is adjusted.
66.根据权利要求65所述的装置,进一步包括:用于移动所述部分壁的马达。 66. The apparatus according to claim 65, further comprising: means for moving said part of the wall of the motor.
67.根据权利要求58所述的装置,其特征在于,所述液压控制设备包括泵,并且所述液压容器利用泵在液压容器和所述至少一个腔室之间泵送流体来调节。 67. The apparatus according to claim 58, characterized in that said control device comprises a hydraulic pump and the hydraulic pressure between the hydraulic pressure in the container using a pump and the at least one container chamber to adjust the pump fluid.
68.根据权利要求58所述的装置,进一步包括:机械设备,所述机械设备可操作地连接到液压控制设备,由此随着所述液压控制设备操作而被移动。 68. The apparatus according to claim 58, further comprising: a mechanical device, said mechanical device is operatively connected to a hydraulic control device, whereby the operation with the hydraulic control device is moved.
69.根据权利要求1所述的装置,其特征在于,至少所述运动约束设备的近端部分被机械调节。 69. The apparatus according to claim 1, characterized in that at least the proximal portion of the motion restraint device is mechanically adjusted.
70.根据权利要求69所述的装置,进一步包括:用来机械地调节所述运动约束设备的马达。 70. The apparatus according to claim 69, further comprising: a motor for mechanically regulating the motion restraint device.
71.根据权利要求19所述的装置,进一步包括:第二主体,在与所述主体一起植入患者体内时,所述第二主体分别填充位于患者胃的两个不同部分的两个体积,由此影响患者反流。 71. The apparatus according to claim 19, further comprising: a second body, with the body when implanted in a patient together, the volume of the second body, respectively, located in two patients fill two different parts of the stomach, thereby affecting patients with reflux.
72.根据权利要求71所述的装置,其特征在于,所述反流疾病治疗设备适于被术后非侵入式地调节,并且适于不时地进行调节,以使在第一时刻,其中一个填充主体填充胃的一部分处的体积,而在第二时刻,另一个填充主体填充位于胃的另一部分处的体积。 72. The apparatus according to claim 71, characterized in that said reflux disease treatment apparatus is adapted to be adjusted after the non-invasive, and is adapted to be adjusted from time to time, so that at a first time, one filling the body portion of the volume of the stomach is filled, and in the second time, the other filling body filling volume located at another portion of the stomach.
73.根据权利要求1所述的装置,进一步包括:至少一个可调的牵拉设备,在植入患者体内时,所述牵拉设备牵拉患者胃壁的一部分,由此通过影响患者食欲来治疗肥胖。 73. The apparatus according to claim 1, further comprising: at least one adjustable traction device, when implanted in a patient, the patient pulling device pulling a portion of the stomach wall, whereby by influence appetite to treat patients obesity.
74.根据权利要求1所述的装置,其特征在于,至少所述运动约束设备的近端部分包括牵拉设备,在植入患者体内时,所述牵拉设备牵拉患者胃壁的一部分,由此通过影响患者食欲来治疗肥胖。 74. The apparatus according to claim 1, characterized in that at least the proximal portion of the motion restraint device comprises a pulling device, when implanted in a patient, the patient pulling device pulling a portion of the stomach wall, by the This appetite by affecting the patient to treat obesity.
75.根据权利要求74所述的装置,其特征在于,所述运动约束设备包括具有腔室的主体,并进一步包括与所述主体的腔室流体接触的第二腔室。 75. The apparatus according to claim 74, wherein said movement restraining device comprises a body having a chamber, and further comprising a second chamber in fluid contact with the chamber of the body.
76.根据权利要求75所述的装置,其特征在于,所述第二腔室小于小于所述主体。 76. The apparatus according to claim 75, wherein said second chamber is less than less than the body.
77.根据权利要求75所述的装置,其特征在于,在植入患者体内时,所述主体和所述第二腔室彼此连通,由此流体或空气在所述主体和所述第二腔室之间移动。 77. The apparatus according to claim 75, characterized in that, when implanted in a patient, said main body and said second chamber in communication with each other, whereby the fluid or air in the main body and the second chamber moving between rooms.
78.根据权利要求75所述的装置,其特征在于,所述主体的腔室是主腔室,而在植入患者体内时,所述第二腔室用作牵拉设备来治疗肥胖,在植入患者体内时,所述主腔室和所述第二腔室彼此连通,由此流体或空气在所述主腔室和所述第二腔室之间移动,由此对患者胃底壁产生牵拉作用,从而治疗肥胖。 78. The apparatus according to claim 75, wherein said main body chamber is the chamber, when implanted in a patient, the second chamber is used to treat obesity pulling apparatus, in When implanted in a patient, the main chamber and the second chamber communicate with each other, whereby the fluid or air to move between the main chamber and the second chamber, whereby the patient gastric wall generating traction effect, thereby treating obesity.
79.根据权利要求74所述的装置,其特征在于,所述运动约束设备的近端部分包括主体,在植入患者体内时,所述主体尺寸是可调的,并且内陷在患者胃底壁中,由此所述主体在尺寸增大时牵拉患者胃底壁,从而使患者产生饱足感。 79. The apparatus according to claim 74, characterized in that said movement device comprises a proximal portion bound body, when implanted in a patient, the body size is adjustable, and in patients with gastric invagination wall, thereby increasing the size of the body when pulling the gastric wall in patients, allowing patients to produce satiety.
80.根据权利要求1所述的装置,进一步包括:至少两个可植入的可调的牵拉设备,在植入患者体内时,所述牵拉设备牵拉患者胃壁的不同部分,由此通过影响患者食欲来治疗肥胖。 80. The apparatus according to claim 1, further comprising: at least two implantable adjustable traction device, when implanted in a patient, the patient pulling device pulling different parts of the stomach wall, thereby by affecting appetite to treat obesity in patients.
81.根据权利要求80所述的装置,其特征在于,在植入患者体内时,两个所述牵拉设备从患者体外进行调节,由此在第一时刻调节第一牵拉设备,以牵拉患者胃壁的第一部分,而在第二时刻调节第二牵拉设备,以牵拉患者胃壁的第二部分。 81. The apparatus according to claim 80, characterized in that, when implanted in a patient, both the traction device is adjustable from outside the patient, whereby the first stretch at a first time adjustment device, in order to pull The first part of the stomach wall of the patient to pull, and a second time adjusting the second pulling device to pull the second portion of the stomach wall of the patient.
82.根据权利要求74或80所述的装置,其特征在于,所述牵拉设备液压地调节,进一步包括连接到液压调节的牵拉设备的液压容器,由此在植入患者体内时,所述液压调节的牵拉设备适于利用来自所述液压容器的流体进行非侵入式地调节。 74 or 82. When the apparatus according to claim 80, characterized in that said traction hydraulic adjusting device further comprises a hydraulically adjustable connected to a hydraulic pulling device for containers, thereby implanted in the patient, the said hydraulically adjustable traction device adapted to utilize the hydraulic fluid from the container non-invasive adjustments.
83.根据权利要求82所述的装置,其特征在于,在植入患者体内时,所述液压容器被皮下植入,并且通过手动按压所述容器来非侵入式地调节。 83. The apparatus according to claim 82, characterized in that, when implanted in a patient, the hydraulic container is implanted subcutaneously, and by manually pressing the container to be adjusted non-invasively.
84.根据权利要求82所述的装置,其特征在于,所述运动约束设备包括可膨胀的主体, 进一步包括与所述主体流体连接的泵和腔室,其中在植入患者体内时,所述泵通过从所述主体向所述腔室泵送流体或空气而调节所述液压容器。 84. The apparatus according to claim 82, wherein said movement restraining device comprises an expandable body, and further comprising a pump chamber in fluid connection with the main body, wherein when implanted in a patient, the pump by pumping fluid or air from the body to the chamber and adjusting the hydraulic container.
85.根据权利要求74或80所述的装置,进一步包括:无线遥控器,在植入患者体内时, 利用所述无线遥控器非侵入式地调节所述牵拉设备。 74 or 85. The apparatus according to claim 80, further comprising: a wireless remote control, when implanted in a patient, the use of the wireless remote control to adjust the non-invasive traction device.
86.根据权利要求80所述的装置,进一步包括:能源,在植入患者体内时,所述能源为所述可调的牵拉设备提供动力。 86. The apparatus according to claim 80, further comprising: energy, when implanted in a patient, the energy to power the adjustable traction device.
87.根据权利要求86所述的装置,其特征在于,所述能源包括可植入患者体内的内部能源。 87. The apparatus according to claim 86, wherein said energy comprises an implantable internal energy of the patient.
88.根据权利要求86所述的装置,其特征在于,所述能源包括发射无线能量的外部能源。 88. The apparatus according to claim 86, characterized in that said energy source comprises an external energy source transmitting wireless energy.
89.根据权利要求88所述的装置,进一步包括:可植入患者体内的内部能源,在植入患者体内时,所述内部能源能利用所述外部能源发射的无线能量来充电。 89. The apparatus according to claim 88, further comprising: an implantable patient's internal energy, when implanted in a patient, can take advantage of the internal energy of the external energy source transmitting wireless energy to charge.
90.根据权利要求1所述的装置,进一步包括:可植入的第一固定设备,在植入患者体内时,所述第一固定设备将所述运动约束设备的近端部分固定在所述位置,使得所述运动约束设备的外表面基本上接触患者胃底壁;可植入的第二固定设备,在植入患者体内时,所述第二固定设备将所述运动约束设备的近端部分直接或间接固定到食管;和第三固定设备,在植入患者体内时,该第三固定设备将所述运动约束设备的近端部分固定到患者横膈肌或者其他肌肉组织。 90. The apparatus according to claim 1, further comprising: a first implantable fixing device, when implanted in a patient, the first fixing device of the motion restraint device fixed to the proximal portion position, such that the outer surface of the motion restraint device of substantially contact with gastric wall; a second implantable fixing device, when implanted in a patient, the second fixing device to the proximal end of the motion restraint device part directly or indirectly fixed to the esophagus; and a third fixed equipment, when implanted in a patient, the fixing device of the third motion restraint device proximal end portion secured to the patient or other cross-diaphragm muscle tissue.
91.根据权利要求90所述的装置,其特征在于,每一个固定设备包括多个缝合线或卡钉。 91. The apparatus according to claim 90, characterized in that each fixing device comprises a plurality of sutures or staples.
92.根据权利要求19所述的装置,其特征在于,在垂直于贯穿所述主体的轴线的平面上观察,所述主体具有最大周长,并且在比较沿着所述轴线移动的两个连续相连的平面时, 当从所述最大周长开始并在背离所述最大周长的一个或两个方向移动时,随着所述平面沿着所述轴线位移,所述周长减小或保持恒定。 92. The apparatus according to claim 19, characterized in that, in a plane through the axis of the body viewed in the vertical, said body having a maximum circumference, and two relatively movable continuously along the axis When connected to the plane, when starting from the largest circumference in one or both directions departing from the maximum circumference is moved, as the plane along the axis of displacement, decrease or maintain the circumference constant.
93.根据权利要求19所述的装置,其特征在于,所述主体的周长,其中在垂直于贯穿所述主体的至少一个轴线的平面上观察,所述主体具有周长,并且在比较沿着所述轴线移动的两个所述连续相连的平面时,所述轴线具有两个端点,随着所述平面沿着所述轴线位移, 所述周长增大至少两次或者减小至少两次或者在所述端点处具有较之所述端点之间的最小周长更大的周长。 93. The apparatus according to claim 19, characterized in that the circumference of the body, wherein the at least one axis in the plane perpendicular to the observation through the body, the body having a perimeter, and in comparison along When the axial plane of the continuous movement of the two connected, the axis has two endpoints, along with the plane along the axis of displacement, at least twice the circumference increase or decrease at least twice, or having a minimum circumference greater than the circumference of the end point between the endpoints.
94.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分适于基本上被患者胃底壁内陷。 94. The apparatus according to claim 1, characterized in that the movement of the proximal portion of the restraint device is adapted to substantially retraction patients gastric wall.
95.根据权利要求1所述的装置,进一步包括:固定设备,在所述运动约束设备植入时, 所述固定设备适于将所述运动约束设备的近端部分连接到胃底壁,以便将所述运动约束设备保持在所述位置。 95. The apparatus according to claim 1, further comprising: a fixing device, the movement restraining device when implanted, the device is adapted to be fixed to a proximal portion of the motion restraint device is connected to the gastric wall, in order to the motion restraint device remains in the position.
96.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分是可膨胀的,并适于充入凝胶或流体。 96. The apparatus according to claim 1, characterized in that said proximal portion of the motion restraint device is expandable, and adapted to the gel or fluid filled.
97.根据权利要求96所述的装置,进一步包括:用于接收流体以使所述运动约束设备膨胀的流体或凝胶接收构件。 97. The apparatus according to claim 96, further comprising: means for receiving fluid so that the motion restraint device expanded fluid or gel receiving member.
98.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分包括同质材料。 98. The apparatus according to claim 1, characterized in that said movement device comprises a proximal portion bound homogeneous material.
99.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分至少部分地包括实心体。 99. The apparatus according to claim 1, wherein said motion restraint device proximal portion at least partially comprises a solid body.
100.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分包括限定腔室的包围壁。 100. The apparatus according to claim 1, wherein said movement restraining device comprises a proximal end portion defining a chamber surrounded by a wall.
101.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分至少部分地具有刚性外壁。 101. The apparatus according to claim 1, characterized in that said motion restraint device having a proximal portion at least partially a rigid outer wall.
102.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分至少部分地具有弹性外壁。 102. The apparatus according to claim 1, wherein said motion restraint device proximal portion having at least partly an elastic outer wall.
103.根据权利要求1所述的装置,其特征在于,所述运动约束设备的近端部分至少部分地具有挠性外壁。 103. The apparatus according to claim 1, wherein said motion restraint device proximal portion having at least partially flexible outer wall.
104.根据权利要求101所述的装置,其特征在于,所述刚性外壁的刚性足以在承受胃运动产生的作用力时保持不会发生变形。 104. The apparatus according to claim 101, wherein said rigid outer wall rigid enough to withstand the force holding the deformation does not occur when the stomach Movement.
105.根据权利要求1所述的装置,其特征在于,所述运动约束设备适于穿过腹腔镜套管针或胃镜套管针或者器械。 105. The apparatus according to claim 1, wherein said movement restraining device is adapted to pass through the laparoscopic trocar or trocar or endoscopic instrument.
106.根据权利要求1所述的装置,其特征在于,所述运动约束设备能够改变形式,以便能穿过腹腔镜套管针或者胃镜套管针或者器械。 106. The apparatus according to claim 1, wherein said movement restraining device capable of changing the form, in order to pass through the laparoscopic trocar or trocar or endoscopic instrument.
107.根据权利要求1所述的装置,其特征在于,所述运动约束设备具有圆形轮廓,没有太尖锐的边缘,以使所述运动约束设备植入时不会损伤所述胃壁。 107. The apparatus according to claim 1, characterized in that the motion restraint device has a circular outline, not too sharp edges, so that the motion restraint device implantation without damaging the stomach wall.
108.根据权利要求1所述的装置,其特征在于,所述运动约束设备的体积能非侵入式地调节。 108. The apparatus according to claim 1, wherein the volume of said motion restraint device can be adjusted non-invasively.
109.根据权利要求1所述的装置,其特征在于,所述运动约束设备适于被患者胃底壁完全内陷。 109. The apparatus according to claim 1, wherein said movement restraining device is adapted to be gastric wall in patients with complete retraction.
110.根据权利要求1所述的装置,其特征在于,所述运动约束设备适于内陷,使得所述运动约束设备安置在胃底壁的内侧上。 110. The apparatus according to claim 1, characterized in that the motion restraint device adapted retraction, so that the motion restraint device mounted on the inside of the gastric wall.
111.根据权利要求1所述的装置,进一步包括:注入端口,所述注入端口适于连接到所述运动约束设备的可膨胀腔室,从而调节所述可膨胀腔室的体积。 111. The apparatus according to claim 1, further comprising: injection port, said injection port adapted to be connected to the motion restraint device expandable chamber, thereby adjusting the volume of the chamber can be inflated.
112.根据权利要求1所述的装置,进一步包括:保持设备,所述保持设备用于在所述运动约束设备植入过程中保持所述运动约束设备。 112. The apparatus according to claim 1, further comprising: a holding device, the holding device movement restraining device for the motion restraint device holding the implant procedure.
113.根据权利要求1所述的装置,其特征在于,所述运动约束设备至少一部分用能被胃酸破坏的材料制成。 113. The apparatus according to claim 1, characterized in that said at least a portion of the motion restraint device made with materials that can be damaged gastric acid.
114.根据权利要求1所述的装置,其特征在于,所述运动约束设备至少一部分用不能被胃酸破坏的材料制成。 114. The apparatus according to claim 1, characterized in that at least part of the motion restraint device is made of a material that can not be destroyed acid.
115.根据权利要求19所述的装置,其特征在于,在垂直于贯穿所述主体的轴线的平面上观察,所述主体具有周长,并且其中在沿着所述轴线从所述轴线第一端点到具有最大周长的中间点,所述周长持续增大或保持恒定,并且从所述中间点到所述轴线的第二端点移动时,所述周长持续减小或者而保持恒定。 115. The apparatus according to claim 19, characterized in that, in a plane through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along said axis from said first axis end to an intermediate point of maximum circumference, the circumference remains constant or increases continuously, and from the intermediate point to the second end of the axis is moved, while the circumference remains constant or decreases continuously .
116.根据权利要求19所述的装置,其特征在于,在垂直于贯穿所述主体的轴线的平面上观察,所述主体具有周长,并且其中在沿着所述轴线从所述轴线第一端点到具有第一最大周长的第一中间点,所述周长持续增大或保持恒定,并且从所述第一中间点到具有第一最小周长的第二中间点移动时,所述周长持续减小或者而保持恒定,在沿着所述轴线从所述第二中间点到具有第二最大周长的第三中间点移动时,所述周长持续增大或者而保持恒定,并且从所述第三中间点到所述轴线第二端点移动时,所述周长持续减小或者保持恒定。 116. The apparatus according to claim 19, characterized in that, in a plane through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along said axis from said first axis a first end having a first intermediate point of maximum circumference, the circumference remains constant or increases continuously, and from the first intermediate point to a second intermediate point having a smallest circumference of the first moves, the said perimeter and continues to decrease or remain constant along the axis from the second intermediate point to the third intermediate point with the second largest mobile perimeter, said perimeter continues to increase or remains constant , and from the point to the second end of said third intermediate axis moves, the circumference remains constant or decreases continuously.
117.根据权利要求1所述的装置,其特征在于,所述细长的运动约束设备的远端部分内陷在胃壁中,以使所述食物空腔体积减小,体积减小量基本上超过所述细长的运动约束设备的远端部分的体积。 117. The apparatus according to claim 1, characterized in that the distal end portion of the elongated retraction motion restraint device in the stomach wall, so that the volume of the food cavity is reduced, the volume reduction amount substantially Movement of the elongated confined volume than the distal end portion of the apparatus.
118.根据权利要求117所述的装置,进一步适于还通过减小所述食物空腔体积来治疗肥胖,体积减小量基本上超过所述细长的运动约束设备的远端部分的体积。 118. The apparatus according to claim 117, further adapted also by reducing the volume of the food cavity to treat obesity, reduce the amount substantially exceeds the volume of the volume of the distal end portion of the elongated motion restraint device.
119.根据权利要求118所述的装置,其特征在于,所述运动约束设备的远端部分的最大周长至少为30mm。 119. The apparatus according to claim 118, wherein said distal end portion of the motion restraint device of the maximum circumference of at least 30mm.
120.根据权利要求1所述的装置,其特征在于,所述运动约束设备的远端部分包括能扩张到扩张状态的可膨胀设备。 120. The apparatus according to claim 1, characterized in that said movement device comprises a distal end portion of restraint can expand to the expanded state of the expandable device.
121.根据权利要求120所述的装置,其特征在于,所述可膨胀设备具有用于流体或凝胶的进入端口,并且适于连接到胃镜器械后腹腔镜器械。 121. The apparatus according to claim 120, wherein the expandable device having an inlet port for fluid or gel and is connected to the endoscopic instrument adapted laparoscopic instrument.
122.根据权利要求122所述的装置,其特征在于,所述进入端口包括适于互联所述可膨胀设备与所述胃镜器械或腹腔镜器械的流体连接部。 122. The apparatus according to claim 122, wherein said access port comprises a suitable fluid connection interconnecting the inflatable portion of the endoscopic instrument or apparatus with laparoscopic instruments.
123.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分具有圆整形状。 123. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device having a rounded shape.
124.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分具有弯曲或曲线形状。 124. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device having a curved or curvilinear shape.
125.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分至少一部分包括弹性材料。 125. The apparatus according to claim 117, wherein at least a portion of said distal end portion of the motion restraint device comprises a resilient material.
126.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分至少一部分包括硅酮。 126. The apparatus according to claim 117, wherein at least a portion of the motion restraint device of the distal end portion including a silicone.
127.根据权利要求1所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一设置有至少一个料层。 127. The apparatus according to claim 1, characterized in that at least one of the motion restraint device distal portion and a proximal end portion is provided with at least one layer of material.
128.根据权利要求127所述的装置,其特征在于,所述至少一个料层包括聚对二甲苯层。 128. The apparatus according to claim 127, wherein said at least one material layer comprises parylene layer.
129.根据权利要求127所述的装置,其特征在于,所述至少一个料层包括聚四氟乙烯层。 129. The apparatus according to claim 127, wherein said at least one material layer comprises a layer of polytetrafluoroethylene.
130.根据权利要求127所述的装置,其特征在于,所述至少一个料层包括聚亚安酯。 130. The apparatus according to claim 127, wherein said at least one layer comprises a polyurethane material.
131.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括流体。 131. The apparatus according to claim 117, wherein said distal portion of the motion restraint device comprises a fluid.
132.根据权利要求131所述的装置,其特征在于,所述流体适于转化成固态或者固定形式。 132. The apparatus according to claim 131, wherein said fluid is adapted to be converted into solid or immobilized form.
133.根据权利要求131所述的装置,其特征在于,所述流体是液体聚亚安酯。 133. The apparatus according to claim 131, wherein said fluid is a liquid polyurethane.
134.根据权利要求131所述的装置,其特征在于,所述流体是等张流体。 134. The apparatus according to claim 131, wherein the fluid is isotonic fluid.
135.根据权利要求131所述的装置,其特征在于,所述流体包括大分子以防止扩散。 135. The apparatus according to claim 131, wherein the fluid comprises a macromolecule to prevent proliferation.
136.根据权利要求131所述的装置,其特征在于,所述流体包括碘分子。 136. The apparatus according to claim 131, wherein said fluid comprises an iodine molecule.
137.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分包括同质材料。 137. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of homogeneous material.
138.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分是实心体。 138. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device of at least a portion of the solid body.
139.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分包括限定腔室的包围壁。 139. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of a wall defining a chamber surrounded.
140.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分包括刚性外表面。 140. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of the rigid outer surface.
141.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分包括弹性外表面。 141. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of an outer surface of the elastic.
142.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分包括挠性外表面。 142. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of an outer surface of the flexible.
143.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的最大周长至少为50毫米。 143. The apparatus according to claim 117, wherein said maximum circumference of the distal end portion of the motion restraint device of at least 50 mm.
144.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的周长至少为80毫米。 144. The apparatus according to claim 117, wherein said distal end portion of the circumference of the motion restraint device of at least 80 mm.
145.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的体积介于0. 00001和0. OOlm3之间。 145. The apparatus according to claim 117, wherein the volume of said distal end portion of the motion restraint device is between 0.00001 and 0. OOlm3.
146.根据权利要求145所述的装置,其特征在于,所述运动约束设备的远端部分的体积介于0. 00001和0. 0002m3之间。 146. The apparatus according to claim 145, wherein the volume of said distal end portion of the motion restraint device is between 0.00001 and 0. 0002m3.
147.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分能变形到最大直径,以致插入腹腔镜套管针中。 147. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device can be deformed to the maximum diameter, so that the laparoscope trocar insertion.
148.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分适于利用胃到胃的缝合线或者卡钉保持就位,从而将所述设备内陷在胃壁中。 148. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device is adapted to use the stomach to stomach sutures or staples held in place, so that the retraction of the device in the stomach wall .
149.根据权利要求148所述的装置,其特征在于,所述胃到胃的缝合线或者卡钉设置有固定部分,所述固定部分表现为适于与胃壁接触的结构,以促使人体组织生长,从而长期固定连接到胃壁的所述运动约束设备的远端部分的位置。 149. The apparatus according to claim 148, wherein said stomach to stomach sutures or staples is provided with a fixed portion, the fixed portion is adapted to the performance of the structure in contact with the stomach wall, to promote tissue growth the position of the distal end portion, fixedly attached to the stomach wall so the long-term movement of the restraint device.
150.根据权利要求149所述的装置,其特征在于,所述结构包括网状结构。 150. The apparatus according to claim 149, wherein said structure comprises a mesh structure.
151.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分适于手术后非侵入式地调节。 151. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device after non-invasive surgery is adapted to be adjusted.
152.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分具有可变周长,以更好地适于保持内陷在患者胃壁中的位置。 152. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device having a variable circumference, adapted to better maintain the retraction position in the patient's stomach wall.
153.根据权利要求117所述的装置,包括:安置在胃壁外侧并适于牵拉一部分胃壁的牵拉设备,由此影响患者食欲,所述装置进一步包括互联所述牵拉设备和所述所述运动约束设备的远端部分的流体连接部。 153. The apparatus according to claim 117, comprising: disposed on the outside of the stomach wall and is adapted to stretch a portion of the stomach wall pulling device, thereby affecting appetite patient, said apparatus further comprising drawing the apparatus and the interconnection of the said motion constraints fluid connection portion of the distal end portion of the device.
154.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分适于经由胃镜器械安置在胃壁内侧。 154. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device via endoscopic instrument adapted disposed inside of the stomach wall.
155.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括至少两个可互联的部分,所述可互联的部分适于作为单独部分安置在胃壁内侧。 155. The apparatus according to claim 117, wherein the distal end portion of the apparatus comprises at least two interconnected parts of the motion constraints, said interconnecting portion is adapted as a separate part disposed on the inside of the stomach wall.
156.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括以下述材料至少一种制成的外表面层:聚亚安酯、特富龙、或者聚四氟乙烯、聚对二甲苯、 金、银、钛或者其他金属。 156. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising an outer surface layer is made of at least one of the following materials: polyurethane, Teflon , or poly tetrafluoroethylene, parylene, gold, silver, titanium, or other metals.
157.根据权利要求117所述的装置,其特征在于,至少所述运动约束设备的远端部分不会被酸破坏,优选不会被盐酸破坏。 157. The apparatus according to claim 117, wherein at least the distal portion of the motion restraint device is not destroyed by an acid, preferably hydrochloric acid will not be destroyed.
158.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括凝胶。 158. The apparatus according to claim 117, wherein said distal portion of the motion restraint device comprises a gel.
159.根据权利要求158所述的装置,其特征在于,所述凝胶的舒尔值小于15。 159. The apparatus according to claim 158, wherein said gel Shure value of less than 15.
160.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括适于与夹持器械协作的连接设备。 160. The apparatus according to claim 117, wherein said motion restraint device comprises a distal portion adapted to cooperate with a clamping device connected to the device.
161.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分适于被患者胃壁完全内陷。 161. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device adapted to be completely sunk patients stomach wall.
162.根据权利要求161所述的装置,包括:固定设备,在所述运动约束设备的近端部分被植入时,所述固定设备适于将所述运动约束设备的远端部分固定到胃壁,以保持所述运动约束设备的远端部分。 162. The apparatus according to claim 161, comprising: a fixing device, upon movement of the proximal end portion of said restraint device is implanted, the device is adapted to be fixed to the distal end portion of the motion restraint device is secured to the stomach wall to maintain the distal portion of the motion restraint device.
163.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的体积小于0. 0002m3。 163. The apparatus according to claim 117, wherein the volume of said distal end portion of the motion restraint device is less than 0. 0002m3.
164.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的体积介于0. 0001和0. OOlm3之间。 164. The apparatus according to claim 117, wherein the volume of said distal end portion of the motion restraint device is between 0.0001 and 0. OOlm3.
165.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的的周长至少为120mm。 165. The apparatus according to claim 117, wherein said distal end portion of the circumference of the motion restraint device of at least 120mm.
166.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的的周长至少为150mm。 166. The apparatus according to claim 117, wherein said distal end portion of the circumference of the motion restraint device of at least 150mm.
167.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的的周长至少为180mm。 167. The apparatus according to claim 117, wherein said distal end portion of the circumference of the motion restraint device of at least 180mm.
168.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的的周长至少为220mm。 168. The apparatus according to claim 117, wherein said distal end portion of the circumference of the motion restraint device of at least 220mm.
169.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分的至少一部分包括挠性但非弹性材料。 169. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of a flexible but non-elastic material.
170.根据权利要求117所述的装置,进一步包括:固定设备,所述固定设备适于参与将所述运动约束设备的远端部分固定到胃壁。 170. The apparatus according to claim 117, further comprising: a fixing device, the fixing device is adapted to participate in the distal end portion of the motion restraint device is secured to the stomach wall.
171.根据权利要求117所述的装置,进一步包括:两个或更多个固定设备,所述固定设备适于参与将所述运动约束设备的远端固定到胃壁。 171. The apparatus according to claim 117, further comprising: two or more fixtures, the fixture is adapted to participate in the distal end of the motion restraint device fixed to the stomach wall.
172.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括保持设备,所述保持设备适于利用器械保持以简化该设备的植入过程。 172. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprises a holding device, the holding device is adapted to maintain the use of instruments in order to simplify the process of implantation of the device.
173.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括两个或更多个保持设备,所述保持设备适于利用器械保持以简化该设备的植入过程。 173. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprises two or more holding device, the holding device is adapted to use the implant device to simplify the holding device process.
174.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括可膨胀腔室,进一步包括至少一个管件,所述管件连接到所述设备,用于向所述腔室供应流体。 174. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprises an expandable chamber, further comprising at least one tubular member, said tubular member is connected to the device for supplying the supplying the fluid chamber.
175.根据权利要求174所述的装置,进一步包括:能与所述管件连接的注入端口。 175. The apparatus according to claim 174, further comprising: injecting port can be connected to the tubular member.
176.根据权利要求117所述的装置,其特征在于,在垂直于贯穿所述设备轴线的平面上观察时,所述运动约束设备的远端部分具有最大周长,并且在垂直于贯穿所述设备轴线的其他平面上观察时,所述设备的周长等于所述最大周长或者沿着所述轴线从所述最大周长的方向看减小。 176. The apparatus according to claim 117, wherein, when viewed perpendicular to the plane through the axis of the apparatus, the motion restraint device of the distal end portion having a maximum circumference and perpendicular to said through Other devices on the plane when the axis of observation is equal to the circumference of the device or from the direction of the maximum circumference of the maximum circumference of view decreases along the axis.
177.根据权利要求117所述的装置,其特征在于,在垂直于贯穿所述设备轴线的平面上观察时,随着所述平面沿着所述轴线位移,所述运动约束设备的远端部分的周长增大和减小至少两次,或者随着所述平面沿着所述轴线位移,减小和增大至少一次。 177. The apparatus according to claim 117, wherein, when viewed perpendicular to the plane through the axis of the apparatus, with the plane along the displacement axis, the movement of the distal end portion of restraint devices The perimeter increases and decreases at least twice, or as the displacement along the axis of the plane, decrease and increase at least once.
178.根据权利要求127所述的装置,其特征在于,所述至少一个料层包括硅酮层。 178. The apparatus according to claim 127, wherein said at least one material layer comprises a silicone layer.
179.根据权利要求127所述的装置,其特征在于,所述至少一个料层包括金属层。 179. The apparatus according to claim 127, wherein said at least one material layer comprises a metal layer.
180.根据权利要求179所述的装置,其特征在于,所述金属层包括金、银、和钛中任一种或者它们的组合物。 180. The apparatus according to claim 179, wherein said metal layer comprises gold, silver, and titanium, or any combination thereof.
181.根据权利要求127所述的装置,其特征在于,所述至少一个料层包括特富龙层。 181. The apparatus according to claim 127, wherein said at least one layer of material comprises a layer of Teflon .
182.根据权利要求1所述的用于治疗反流疾病和肥胖的装置,其特征在于,所述运动约束设备包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁;和操作设备,所述操作设备用于操作植入后的所述牵拉设备,以牵拉所述一部分胃壁从而产生饱足感。 182. According to reflux for treating diseases and obesity apparatus 1, characterized in that the device comprises a pulling motion restraint device, the pulling apparatus comprises at least one drawing apparatus operable to claim the said traction device implanted in an obese patient can pull the patient and adapted part of the stomach; and operating the equipment, the operation of the traction device for operating the device after implantation to pull a portion of the stomach to produce full Foot feeling.
183.根据权利要求182所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一包括:a.至少一个可操作的牵拉设备,所述牵拉设备能植入患者体内并适于牵拉患者一部分胃壁;和b.可植入的控制单元,在所述控制单元和所述牵拉设备植入时,所述控制单元用于自动地控制所述可操作的牵拉设备,以牵拉正在进餐的患者的所述一部分胃壁从而产生饱足感。 183. The apparatus according to claim 182, wherein said motion restraint device distal portion and a proximal end portion comprising at least one of:. A stretch of at least one device operable, the pulling device can be implanted in a patient and adapted to stretch a portion of the stomach of patients; and b implantable control unit, when the control unit and the traction device implanted, the control unit for automatically controlling the traction device operable to pull the patient is eating part of the stomach to produce satiety.
184.根据权利要求117所述用于治疗反流疾病和肥胖的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,其中所述牵拉设备包括可扩张的牵拉容器;和操作设备,所述操作设备用于操作植入后的所述牵拉设备,以牵拉所述一部分胃壁,其中所述运动约束设备的远端部分可膨胀并且与所述牵拉容器流体连接,其中所述操作设备包括泵,用于在所述主容器和所述牵拉容器之间泵送流体,以牵拉所述一部分胃壁从而产生饱足感。 184. claim 117 for the treatment of obesity and reflux disease apparatus, wherein said motion restraint device distal portion and a proximal portion comprises at least one drawing device, the drawing device including at least one operable pulling device, the traction device implanted in an obese patient can pull the patient and adapted part of the stomach, where the traction device comprises an expandable container traction; and operating the equipment, the Operating device for operating the pulling device after implantation, in order to stretch the stomach wall portion, wherein the distal end portion of the motion restraint device may be expandable and connected with the traction fluid container, wherein the operating device It includes a pump for between the main container and the container pulled pumped fluid to pull a portion of the stomach to produce satiety.
185.根据权利要求184所述的装置,包括:控制设备,用于控制包括所述泵的所述牵拉设备。 185. The apparatus according to claim 184, comprising: a control device for controlling the pump including the drawing device.
186.根据权利要求185所述的装置,其特征在于,所述控制设备包括无线遥控器,所述无线遥控器适于从患者体外控制所述牵拉设备。 186. The apparatus according to claim 185, wherein said control device comprises a wireless remote control, wireless remote control adapted from the patient's body for controlling the traction device.
187.根据权利要求186所述的装置,其特征在于,所述控制设备包括皮下安置的开关或容器,所述开关或容器适于从患者体外控制所述牵拉设备。 187. The apparatus according to claim 186, wherein said control device comprises a switch placed subcutaneously or container, the container is adapted to switch from the patient's body or the traction control device.
188.根据权利要求186所述的装置,其特征在于,所述控制设备包括可植入的控制单元,用于控制所述牵拉设备。 188. The apparatus according to claim 186, wherein the control device comprises an implantable control unit for controlling the pulling device.
189.根据权利要求188所述的装置,包括:适于植入患者体内的传感器或传感设备,其中所述可植入的控制单元适于利用来自所述传感器或者传感设备的信息从患者体内控制所述牵拉设备,所述传感器或者传感设备适于直接或间接感测患者食物摄入。 189. The apparatus according to claim 188, comprising: a sensor adapted for implantation into a patient or sensing device, wherein the implantable control unit is adapted to use information from the sensor or the sensing device from the patient the body that controls the traction device, the sensors or sensing device is adapted to directly or indirectly sense the patient food intake.
190.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括主体积填充容器;牵拉设备,所述牵拉设备包括至少一个可操作地牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,其中所述牵拉设备包括可扩张的牵拉容器,适于内陷在胃上部处的胃壁中,在患者直立时高于所述可膨胀的主体积填充设备,其中所述运动约束设备的远端部分是可膨胀的并与所述牵拉容器流体连接,其中胃壁针对食物摄入的正常收缩导致流体从较低地安置在所述胃壁上的所述内陷的主体积填充容器流出, 适于导致所述牵拉容器牵拉所述胃壁部分从而产生饱足感。 190. The apparatus according to claim 117, wherein the distal end portion of the motion restraint device includes a main volume of the filled container; drawing apparatus, said drawing device comprising at least one operable stretching device, the said traction device implanted in an obese patient can pull the patient and adapted part of the stomach, where the traction device comprises an expandable pulling container suitable retraction in the stomach at the upper part of the stomach, the high when the patient is upright to the main inflatable volume filling device, wherein the distal end portion of the motion restraint device is expandable and connected to the pull fluid container, wherein the stomach for normal food intake causes contraction of the fluid from the lower ground placed in the main volume of the stomach wall filled container out of the retraction, suitable for lead to stretch the stomach wall portion of the container thereby pulling satiety.
191.根据权利要求190所述的装置,其特征在于,位于所述主体积填充容器和所述牵拉容器之间的流体连接部包括止回阀。 191. The apparatus according to claim 190, wherein the fluid connection portion located on the main container and the filling volume between the drawing comprises a container valve.
192.根据权利要求191所述的装置,其特征在于,位于所述主体积填充容器和所述牵拉容器之间的流体连接部包括释放功能,所述释放功能适于释放所述牵拉容器中的体积返回所述主体积填充容器。 192. The apparatus according to claim 191, wherein the fluid connection portion located on the main container and the filling volume between the container comprises stretch release function, the release function adapted to release said pulling container The volume is returned to the main volume of the container is filled.
193.根据权利要求191所述的装置,其特征在于,所述释放功能包括面积显著小于所述流体连接部的面积的流体返回连接部,以便从所述牵拉容器缓慢释放流体返回所述主体积填充设备容器,从而释放对胃壁部分的牵拉。 193. The apparatus according to claim 191, wherein said release feature comprises an area substantially smaller than the area of the portion of the fluid connection connecting the fluid return portion, the return to the slow release of fluid from the primary container drawing volume filling device container, thereby releasing part of the stomach wall stretch.
194.根据权利要求190所述的装置,包括:另外的手动控制设备,该手动控制设备包括皮下安置的容器,该皮下安置的容器适于从患者体外控制所述牵拉设备,以进一步影响牵拉设备牵拉所述胃壁部分。 194. The apparatus according to claim 190, comprising: an additional manual control device, the manual control device comprises a container subcutaneous placement, the container is adapted from the subcutaneous placed outside the patient controls the traction device to further influence the retractor pull device pull the stomach wall portion.
195.根据权利要求117所述的装置,包括:适于可膨胀的主体积填充容器,其中所述运动约束设备的远端部分进一步包括可扩张的结构,所述可扩张的结构适于在所述运动约束设备的远端部分植入胃壁之后扩张,其中所述结构包括波纹件,所述波纹件适于考虑所述设备植入后包围所述设备的纤维化情况,以使所述波纹件的运动基本上不受纤维化的影响。 195. The apparatus according to claim 117, comprising: an inflatable main volume adapted to fill the container, wherein the distal end portion of the motion restraint device further comprises an expandable structure, the expandable structure being adapted the distal end portion of said motion restraint device implanted in the stomach after the expansion, wherein the structure comprises a bellows, the bellows after implantation of the device is adapted to consider the situation surrounding the fibrosis of the device, so that the bellows member The campaign largely unaffected by fibrosis in.
196.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,并且其中所述牵拉设备包括可扩张的结构,所述可扩张的结构适于在所述设备内陷在胃壁之后扩张并牵拉所述胃壁部分,其中所述结构包括专用的波纹件,所述波纹件适于考虑所述设备植入后包围所述设备的纤维化情况,以使所述波纹件的运动基本上不受纤维化的影响。 196. The apparatus according to claim 117, wherein said distal motion restraint device comprises a drawing device portion, the pulling apparatus comprises at least one pulling device operable, the device can be pulled implanted in the patient and adapted to stretch in obese patients stomach wall portion, and wherein the drawing device comprises an expandable structure, the expandable structure is adapted to the retraction device after expansion and stretch the stomach wall in stomach wall portion, wherein said structure comprises a dedicated bellows, the bellows enclosing member is adapted to consider the device after implantation of the device fibrotic conditions, so that the movement of the bellows member is substantially free from fibrosis affected.
197.根据权利要求196所述的装置,进一步包括:用于在植入时操作所述牵拉设备的操作设备,以牵拉所述胃壁部分从而产生饱足感。 197. The apparatus according to claim 196, further comprising: means for operating the pulling device operating device when implanted to stretch the stomach wall portion thereby creating satiety.
198.根据权利要求196所述的装置,其特征在于,所述运动约束设备的远端部分包括可植入的控制单元,用于自动控制所述可操作的牵拉设备,以牵拉正在进餐的患者的胃壁部分从而产生饱足感。 198. The apparatus according to claim 196, wherein said distal end portion of the motion restraint device comprises an implantable control unit for automatically controlling the operable stretching device to stretch is dining part of the patient's stomach to produce satiety.
199.根据权利要求198所述的装置,进一步包括:无线遥控器,所述无线遥控器适于从患者体外由所述控制单元控制。 199. The apparatus according to claim 198, further comprising: a wireless remote control, wireless remote control adapted from the patient's body by the control unit.
200.根据权利要求198所述的装置,其特征在于,所述控制单元包括皮下安置的开关或容器,所述开关或容器适于从患者体外控制所述牵拉设备。 200. The apparatus according to claim 198, wherein said control means comprises a switch arranged subcutaneous or container, the container is adapted to switch from the patient's body or the traction control device.
201.根据权利要求198所述的装置,其特征在于,所述控制单元包括可植入的控制单元,用于控制所述牵拉设备。 201. The apparatus according to claim 198, wherein said control unit comprises an implantable control unit for controlling the pulling device.
202.根据权利要求201所述的装置,包括:适于植入患者体内的传感器或传感设备,其中所述可植入的控制单元适于利用来自所述传感器或者传感设备的信息从患者体内控制所述牵拉设备,所述传感器或者传感设备适于直接或间接感测患者食物摄入。 202. The apparatus according to claim 201, comprising: a sensor adapted for implantation into a patient or sensing device, wherein the implantable control unit is adapted to use information from the sensor or the sensing device from the patient the body that controls the traction device, the sensors or sensing device is adapted to directly or indirectly sense the patient food intake.
203.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一进一步包括牵拉设备,所述牵拉设备包括3个或更多个机械部件,所述机械部件与胃壁上的不同部位接合,一个机械部件接合一个不同部位,其中所述接合包括缝合或卡钉连接到胃壁、或者利用胃到胃的缝合线将所述机械部件内陷在所述胃壁部位中,其中所述3个或更多个机械部件适配成相对于彼此移动,适于牵拉3个不同的壁部分, 所述牵拉设备进一步适于让所述壁部分被彼此独立地牵拉,所述独立针对:用来牵拉胃壁部分的作用力以及施加牵拉的时间周期、还有施加牵拉的时刻。 203. The apparatus according to claim 117, wherein said motion restraint device distal portion and a proximal end portion further comprises at least one drawing device, the drawing device comprises three or more mechanical parts, mechanical parts and the different parts of the stomach wall engagement member engages a different one of mechanical parts, wherein said engagement includes suturing or stapling to the stomach wall is connected, or with stomach to stomach sutures within the mechanical member stuck in the stomach wall portion, and wherein said three or more mechanical members adapted to move relative to one another, adapted to stretch three different wall portions, the stretching device further adapted to let the wall portions are independently of one another drawing, for the independent: to pulling force applied to stretch the stomach wall portion as well as the period of time, there is always applied traction.
204.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一进一步包括牵拉设备,所述牵拉设备包括与胃壁的不同部位接合的两个或更多个液压部件,一个部件接合一个不同部位,其中所述接合包括将液压部件缝合或者卡钉接合到胃壁、或者利用胃到胃的缝合线将液压部件内陷在所述胃壁部位中,其中所述两个或更多个液压部件适配成相对于彼此移动,适于牵拉三个不同的壁部分,所述牵拉设备进一步适于让所述壁部分被彼此独立地牵拉,所述独立针对:用来牵拉胃壁部分的作用力以及施加牵拉的时间周期、还有施加牵拉的时刻。 204. The apparatus according to claim 117, wherein said at least one motion restraint distal portion and a proximal portion of the device further comprises a pulling device, said apparatus comprising pulling engagement with the different parts of the stomach wall two or more hydraulic components, a different member engaging a portion, wherein said engagement means comprises a hydraulic engaging suture or staples to the stomach wall, or with stomach to stomach sutures hydraulic retraction member in the stomach parts in which the two or more hydraulic parts are adapted to move relative to one another, adapted to stretch three different wall portions, the stretching device further adapted to let the wall portion being independent of each other pulling the independence for: pulling force to the stomach portion and applying a stretch of time period, and the time of applying traction.
205.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一进一步包括牵拉设备,所述牵拉设备与胃壁的部位接合,包括将所述牵拉设备缝合或卡钉连接到胃壁、或者利用胃到胃的缝合线将所述牵拉设备内陷在胃壁部位中,其中所述牵拉设备进一步适于牵拉胃壁部分,控制:用来牵拉胃壁部分的作用力、施加牵拉的时间周期以及施加牵拉的时刻。 205. The apparatus according to claim 117, wherein said motion restraint device distal portion and a proximal end portion further comprises at least one drawing device, the drawing device portion engaging with the stomach wall, comprising pull the suture or stapling device is connected to the stomach wall, or with stomach to stomach sutures retraction of the pulling device in the stomach wall portion, wherein the apparatus is further adapted to stretch the stomach wall portion traction control : pulling force to the stomach wall portion, the application time period and applying a pulling traction moment.
206.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一进一步包括与胃壁的不同部位接合的两个部件,一个部件接合一个不同部位,其中所述接合包括将部件缝合或者卡钉接合到胃壁、或者利用胃到胃的缝合线将部件内陷在胃壁部分中,其中所述牵拉设备进一步适于让不同的壁部分被彼此独立地牵拉,控制:用来牵拉胃壁部分的作用力、施加牵拉的时间周期以及施加牵拉的时刻。 206. The apparatus according to claim 117, wherein said motion restraint device distal portion and a proximal end portion further comprises at least one of two members and engaging different parts of the stomach wall, an engaging member of a different portion, wherein said engagement means comprises sutures or staples to the stomach wall joined, or with stomach to stomach sutures retraction member in the stomach wall portion, wherein the apparatus is further adapted to allow different stretching of the wall portions are each independently traction control: part of the force to pull the stomach, the application time period and the time of applying traction traction.
207.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一进一步包括控制设备,所述控制设备包括外部控制单元,用于从患者体外控制所述运动约束设备的远端部分。 207. The apparatus according to claim 117, wherein at least one of the motion restraint device distal portion and a proximal end portion further comprises a control device, the control device comprises an external control unit, for the patient Vitro controls the motion restraint device distal portion.
208.根据权利要求207所述的装置,其特征在于,所述外部控制单元包括无线遥控器, 所述无线遥控器适于从患者体外控制所述设备。 208. The apparatus according to claim 207, wherein the external control unit includes a wireless remote control, the wireless remote control adapted to control the device from the patient's body.
209.根据权利要求208所述的装置,其特征在于,所述控制设备包括皮下安置的开关或容器,所述开关或容器适于从患者体外控制所述运动约束设备的远端部分。 209. The apparatus according to claim 208, wherein said control device comprises a switch placed subcutaneously or container, or the container is adapted to switch the control from the distal end portion of the patient's body motion restraint device.
210.根据权利要求207所述的装置,进一步包括:适于植入患者体内的传感器或传感设备,其中所述控制设备适于利用来自所述传感器或者传感设备的信息从患者体内控制所述设备,所述传感器或者传感设备适于直接或间接感测患者食物摄入。 210. The apparatus according to claim 207, further comprising: a sensor adapted for implantation into a patient or sensing device, wherein the control device is adapted to use information from the sensor or the sensing device from the patient control said device, the sensor or sensing device adapted to sense the patient directly or indirectly food intake.
211.根据权利要求1所述的装置,其特征在于,所述运动约束设备的外表面包括生物相容材料。 211. The apparatus according to claim 1, characterized in that the outer surface of the motion restraint device comprises a biocompatible material.
212.根据权利要求1或117所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分两者适于借助胃镜器械安置在胃内侧。 212. The apparatus of claim 1 or according to claim 117, wherein said distal portion of both the motion restraint device and a proximal portion adapted to aid gastroscope disposed on the inside of the stomach instrument.
213.根据权利要求117所述的装置,其特征在于,所述胃壁的各部分连接在一起,从而使安置在患者胃壁内侧的所述运动约束设备内陷。 213. The apparatus according to claim 117, wherein the various parts of the stomach wall are connected together, so that the stomach wall of a patient positioned on the inside of the retraction motion restraint device.
214.根据权利要求117所述的装置,其特征在于,所述胃壁的各部分连接在一起,从而使安置在患者胃壁内侧的所述运动约束设备的至少远端部分内陷。 214. The apparatus according to claim 117, wherein the various parts of the stomach wall are connected together, so that the motion restraint device disposed at least partially sunk in the inner side of the distal end of the patient's stomach wall.
215.根据权利要求117所述的装置,其特征在于,至少所述运动约束设备的远端部分适于经由胃内侧被安置并被胃壁内陷在胃壁外侧。 215. The apparatus according to claim 117, wherein at least the distal portion of the motion restraint device adapted to be disposed through the inside of the stomach and the stomach wall outside the stomach wall invagination.
216.根据权利要求117所述的装置,其特征在于,至少所述运动约束设备的远端部分适于经由胃外侧被安置并被胃壁内陷在胃壁外侧。 216. The apparatus according to claim 117, wherein at least the distal portion of the motion restraint device adapted to be positioned outside of the stomach and the stomach via the outside of the stomach wall invagination.
217.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括至少两个可互联的部分,这两个可互联的部分适于作为单独的部分经由胃内侧被安置并被胃壁内陷在胃壁外侧。 217. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least two interconnected parts, the two parts adapted to be interconnected as a separate part of the inside of the stomach is via placed on the outside of the stomach and the stomach retraction.
218.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括至少两个可互联的部分,这两个可互联的部分适于作为单独的部分经由胃外侧被安置并被胃壁内陷在胃壁外侧。 218. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least two interconnected parts, the two parts adapted to be interconnected as a separate part of the outside of the stomach is via placed on the outside of the stomach and the stomach retraction.
219.根据权利要求117所述的装置,其特征在于,至少所述运动约束设备的远端部分适于经由胃内侧被安置并被胃壁内陷在胃壁内侧。 219. The apparatus according to claim 117, wherein at least the distal portion of the motion restraint device adapted to be positioned inside of the stomach and the stomach via the inside of the stomach wall invagination.
220.根据权利要求117所述的装置,其特征在于,至少所述运动约束设备的远端部分适于经由胃外侧被安置并被胃壁内陷在胃壁内侧。 220. The apparatus according to claim 117, wherein at least the distal portion of the motion restraint device adapted to be positioned outside of the stomach and the stomach via the inside of the stomach wall invagination.
221.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括至少两个可互联的部分,这两个可互联的部分适于作为单独的部分经由胃内侧被安置并被胃壁内陷在胃壁内侧。 221. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least two interconnected parts, the two parts adapted to be interconnected as a separate part of the inside of the stomach is via placed on the inside of the stomach and the stomach retraction.
222.根据权利要求117所述的装置,其特征在于,所述运动约束设备的远端部分包括至少两个可互联的部分,这两个可互联的部分适于作为单独的部分经由胃外侧被安置并被胃壁内陷在胃壁内侧。 222. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least two interconnected parts, the two parts adapted to be interconnected as a separate part of the outside of the stomach is via placed on the inside of the stomach and the stomach retraction.
223.根据权利要求1或117所述的装置,其特征在于,包括两个或更多个运动约束设备组件,适于组装成具有受控尺寸的可植入的组装运动约束设备,至少涉及运动约束设备的近端部分,所述组装运动约束设备适于以其至少一部分外表面在患者横膈膜和胃底壁之间的位置抵靠患者胃底壁,以使在运动约束设备植入患者体内时,患者胃的心切迹朝向患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔中,从而保持由患者腹部施加在患者贲门括约肌上的支撑压力。 223. The apparatus of claim 1 or according to claim 117, characterized in that it comprises two or more components of the motion restraint device, adapted to be assembled into the assembly motion restraint device having controlled dimensions implantable, at least related to the movement proximal portion restraint device, said assembly motion restraint device adapted to at least a portion of its outer surface at a position between the patient's diaphragm and gastric wall against the gastric wall in patients, so the motion restraint device implanted in a patient When the body of the stomach in patients with heart patients notch toward the diaphragm movement is constrained, thereby preventing cardiac patient by patient diaphragm opening slide into the thoracic cavity, thereby maintaining the support of patients with cardiac sphincter pressure is applied by the patient's abdomen.
224.根据权利要求223所述的装置,其特征在于,所述组装运动约束设备适于拆解成组件,如果它离开在横膈膜和胃底壁之间的位置至少部分地接触胃底壁的植入位置的话。 224. The apparatus according to claim 223, wherein said movement restraining device assembly adapted disassembled into components, if it is left between the diaphragm and the fundus wall position at least partially contacting gastric wall if the implant location.
225.根据权利要求223所述的装置,其特征在于,所述组装运动约束设备适于内陷在胃壁中,其中所述组装运动约束设备适于拆解成组件,如果它离开其植入胃位置,包括刺穿胃壁以保持胃内侧的位置。 225. The apparatus according to claim 223, wherein said assembly is adapted retraction motion restraint device in the stomach wall, wherein the motion restraint device assembly adapted disassembled into components, if it is left implanted in the stomach position, including piercing the stomach wall to maintain its position inside the stomach.
226.根据权利要求225所述的装置,其特征在于,所述组件适于单独通过食物通道,由此降低患者肠道阻塞/梗阻的风险。 226. The apparatus according to claim 225, wherein said assembly is adapted to individually through food channel, thereby reducing the risk of patients with intestinal blockage / obstruction.
227.根据权利要求223所述的装置,其特征在于,所述运动约束设备组件适于穿过套管针,用于将所述运动约束设备组装和植入腹腔中。 227. The apparatus according to claim 223, wherein said movement restraining device is adapted to pass through a trocar assembly, the motion restraint device for assembly and implanted in the abdominal cavity.
228.根据权利要求227所述的装置,其特征在于,所述运动约束设备组件具有适于穿过套管针的挠性外部形状。 228. The apparatus according to claim 227, wherein said movement restraining device adapted to pass through a trocar assembly having a flexible outer shape.
229.根据权利要求223所述的装置,其特征在于,所述运动约束设备组件适于具有允许它们在植入时组装成所述运动约束设备的形状。 229. The apparatus according to claim 223, wherein said movement assembly is adapted to have a restraint device upon implantation allows them assembled into the shape of the motion restraint device.
230.根据权利要求223所述的装置,其特征在于,所述运动约束设备组件为中空部件, 具有挠性外表面。 230. The apparatus according to claim 223, wherein said movement restraining device components as a hollow member having a flexible outer surface.
231.根据权利要求230所述的装置,其特征在于,所述运动约束设备组件适于以流体、 泡沫、凝胶或者硬化成固体材料的流体至少其中一种填充。 231. The apparatus according to claim 230, wherein said movement restraining device assembly is adapted to flow, foam, gel or harden into a solid material in which at least one fluid filled.
232.根据权利要求223所述的装置,其特征在于,所述运动约束设备组件为实心体。 232. The apparatus according to claim 223, wherein said movement restraining device assembly as a solid body.
233.根据权利要求223所述的装置,其特征在于,所述运动约束设备组件适于暂时保持它们的组装状态。 233. The apparatus according to claim 223, wherein said movement restraining device assembly which is adapted to hold temporarily assembled state.
234.根据权利要求233所述的装置,其特征在于,所述运动约束设备组件适于利用内陷的胃壁永久保持它们的组装状态。 234. The apparatus according to claim 233, wherein said assembly is adapted to use the motion restraint device invaginated stomach wall permanently maintain their assembled state.
235.根据权利要求233所述的装置,其特征在于,所述运动约束设备组件适于利用粘结剂暂时保持它们的组装状态。 235. The apparatus according to claim 233, wherein said movement restraining device is adapted to use a binder component temporarily held their assembled state.
236.根据权利要求223所述的装置,其特征在于,所述组件具有允许自由通过胃肠系统的尺寸。 236. The apparatus according to claim 223, wherein the assembly has to allow free passage through the gastrointestinal system size.
237.根据权利要求223所述的装置,其特征在于,每个组件置有至少一个装配元件,所述装配元件充分地配合另一个组件的至少一个装配元件,以使所述组件通过配合装配元件能被组装成可植入的运动约束设备。 237. The apparatus according to claim 223, characterized in that each component has at least one mounting element is set, the mounting member fully assembled with another component of the at least one element, so that the assembly by mating the mounting element It can be assembled into an implantable device motion constraints.
238.根据权利要求237所述的装置,其特征在于,所述组件包括芯部部件和多个外部部件。 238. The apparatus according to claim 237, wherein said assembly includes a core member and a plurality of external components.
239.根据权利要求237所述的装置,其特征在于,所述装配元件选择自充分配合的凸缘和狭槽。 239. The apparatus according to claim 237, wherein said mounting element choose from fully cooperate with the flange and slots.
240.根据权利要求238所述的装置,其特征在于,所述芯部部件适于接收所述外部元件并将其组装成可植入的运动约束设备。 240. The apparatus according to claim 238, wherein the core member is adapted to receive the outer member and assembled into an implantable motion restraint device.
241.根据权利要求239所述的装置,其特征在于,所述芯部部件具有装配狭槽,所述装配狭槽适于在组装所述运动约束设备时接收所述外部部件上的对应装配凸缘。 241. The apparatus according to claim 239, wherein the core member has a fitting slot, said slot adapted for fitting upon assembly of the motion restraint device receiving said corresponding mounting projections on the outer member edge.
242.根据权利要求241所述的装置,其特征在于,所述狭槽围绕所述芯部部件的外周边区域分布。 242. The apparatus according to claim 241, wherein the slot portion of the core member around the outer peripheral area of the distribution.
243.根据权利要求223至242任一项所述的装置,其特征在于,所述装置进一步包括引导设备,所述引导设备可操作用于将所述运动约束设备组件组装成可植入的运动约束设备。 243. The apparatus according to any one of 223 to 242 according to the preceding claims, characterized in that said apparatus further comprises a guide device, said guide device is operable to assemble components into the motion restraint device implantable movement restraint device.
244.根据权利要求243所述的装置,其特征在于,所述引导设备是可操作地连接到所述组件的操作导线。 244. The apparatus according to claim 243, characterized in that the guide device is operatively connected to the operating wire assembly.
245.根据权利要求244所述的装置,其特征在于,所述操作导线利用与腹腔中的体液接触时可发生生物降解的材料制成,从而有利于将所述运动约束设备拆解成组件。 245. The apparatus according to claim 244, wherein said operation wire use in contact with body fluids and peritoneal cavity can be made of biodegradable materials occur, thereby facilitating the motion restraint device disassembled into components.
246.根据权利要求243所述的装置,其特征在于,所述操作导线连接到所述芯部部件和所述外部部件,以使所述外部部件能依次组装到所述芯部部件,从而组装成所述运动约束设备。 246. The apparatus according to claim 243, wherein said operating wire is connected to the core member and the outer member, so that the outer member can be sequentially assembled to the core member, whereby the assembly to the motion restraint device.
247.根据权利要求246所述的装置,其特征在于,所述操作导线连接到所述外部部件的装配凸缘。 247. The apparatus according to claim 246, wherein said operating wire is connected to the mounting flange of the outer member.
248.根据权利要求246所述的装置,其特征在于,所述芯部部件设置有至少一条操作通道用来接收所述操作导线。 248. The apparatus according to claim 246, wherein the core member is provided with at least one working channel for receiving said operating wire.
249.根据权利要求248所述的装置,其特征在于,每个外部部件利用操作导线连接到两条操作通道。 249. The apparatus according to claim 248, characterized in that each outer conductor is connected with the operation to the operation of the two channels.
250.根据权利要求249所述的装置,其特征在于,第一操作通道具有位于芯部部件的端面中的第一开口和位于芯部部件的第一狭槽中的第二开口,以使在沿着远离所述端面的方向位移接收在所述第一操作通道中的操作导线时,第一外部部件被组装到所述芯部部件。 250. The apparatus according to claim 249, wherein the passage has a first operating member is located in the core portion of the first opening and the end face of the core member is located in a first slot of the second opening, so that the receiving at said first displacement operation of the operation wire passage along the direction away from the end face, the first outer member is assembled to the core member.
251.根据权利要求250所述的装置,其特征在于,第二操作通道在所述芯部部件的第二狭槽中具有两个开口,以便在沿着远离所述端面而来的方向移动连接到所述第一操作通道的操作导线时,第二外部部件被组装到所述芯部部件。 251. The apparatus according to claim 250, characterized in that the second working channel in the second slot of the core member has two openings, in order to move away from the end face of the connector along the direction from When the operation wire to operate the first channel, the second member is assembled to the outer portion of the core member.
252.根据权利要求251所述的装置,其特征在于,包括3个或更多个外部部件,外部部件利用穿过在所述芯部部件的每个指定狭槽中具有开口的操作通道的操作导线,所述外部部件被组装到所述芯部部件的指定狭槽中。 252. The apparatus according to claim 251, characterized in that it comprises three or more external members, through the use of the outer core member having a slot for each designated channel opening operation of the operation wire, said outer member being assembled to the designated slot of the core member.
253.根据权利要求251所述的装置,其特征在于,所述操作导线从所述第一通道开口伸出,以使其可以利用器械来操作从而移动所述操作导线和所述第一外部元件,以使其装配凸缘与所述芯部部件件上为该装配凸缘指定的第一装配狭槽配合,并且以预定的顺序通过相同的方式移动剩下的外部部件,从而组装所述可植入的运动约束设备。 253. The apparatus according to claim 251, wherein said operating wire extending from said first passage opening, so that it can be used to operate the instrument wire and the first outer member so as to move the operation , so the mounting flange of the core member element specified for the mounting flange with a first slot assembly, and in a predetermined order by the same manner as the rest of the exterior moving member, whereby the assembly can be exercise restraint device implanted.
254.根据权利要求223所述的装置,其特征在于,包括多于3个运动约束设备组件。 254. The apparatus according to claim 223, characterized in that it comprises more than three motion restraint device assembly.
255.根据权利要求1或223所述的装置,进一步包括:可植入的刺激设备,当植入患者体内时,所述刺激设备向贲门括约肌发出刺激脉冲,以刺激贲门括约肌并由此使贲门进一步闭合,以额外地防止反流疾病。 255. According to 1 or 223, further comprises: an implantable stimulation device, when implanted in a patient, the stimulation device sends a pulse to the cardiac sphincter stimulation to stimulate the cardiac sphincter and thereby the cardia further closed to prevent reflux disease additionally.
256.根据权利要求255所述的装置,其特征在于,所述刺激设备由至少一个导体和至少一个电极构成,在植入患者体内时,所述电极接收刺激脉冲并将其施加至贲门括约肌,从而刺激贲门括约肌。 256. The apparatus according to claim 255, wherein the stimulation device consists of at least one conductor and at least one electrode, when implanted in a patient, said electrode receiving and applying stimulation pulses to the cardiac sphincter, thereby stimulating the cardiac sphincter.
257.根据权利要求256所述的装置,其特征在于,所述刺激设备发出刺激脉冲作为脉冲串,其中所述脉冲串重复发送且每两个脉冲串之间具有时间间歇。 257. The apparatus according to claim 256, wherein the stimulation device stimulation pulse is emitted as a pulse train, wherein the transmission range of the burst repetition time interval between each two bursts.
258.根据权利要求257所述的装置,其特征在于,所述刺激设备成列地发出多个脉冲串,接着是比脉冲串之间的间歇更长的间歇,以允许肌肉休息,仍保持贲门括约肌闭合。 258. The apparatus according to claim 257, wherein the stimulation device to emit a plurality of columns to burst, followed by a longer interval than the interval between bursts to allow the muscles to rest, remains cardia sphincter closed.
259.根据权利要求257所述的装置,其特征在于,所述刺激设备发出刺激脉冲作为脉冲串,其中所述脉冲串重复发送且两个脉冲串之间具有时间间歇,所述间歇扩展所述脉冲串中每个脉冲之间的间歇。 259. The apparatus according to claim 257, wherein the stimulation device stimulation pulse is emitted as a pulse train, wherein the burst repetition transmission range of the time interval between two bursts, the intermittent extension of the burst interval between each pulse.
260.根据权利要求256所述的装置,其特征在于,所述刺激设备包括电子电路和能源。 260. The apparatus according to claim 256, wherein said device comprises an electronic circuit and a stimulation energy.
261.根据权利要求223所述的装置,其特征在于,所述运动约束设备的组件是可变的以呈现直径小于腹腔镜所用套管针的细长形式,由此在变成所述细长形式时,所述主体的组件能够被推送或牵弓I经过所述套管针。 261. The apparatus according to claim 223, wherein said motion restraint device assembly is variable in order to exhibit a diameter smaller than laparoscopic trocar used in the form of an elongate, thereby becomes the elongate When the form of assembly of the body can be pushed or led through the trocar I bow.
262.根据权利要求223所述的装置,其特征在于,所述主体包括限定流体或凝胶填充的腔室的挠性外壁,允许所述主体经过腹腔镜所用的套管针。 262. The apparatus according to claim 223, wherein said body includes a flexible outer wall defining a fluid or gel-filled chamber, allowing the body through the laparoscopic trocar used.
263.根据权利要求223所述的装置,其特征在于,至少一个组件为中空形式,包括带有注入端口的至少一个腔室,其中所述主体的腔室通过所述注入端口填充流体。 263. The apparatus according to claim 223, wherein the at least one component is a hollow form, comprising a chamber with at least one injection port, wherein the body cavity through the fill fluid injection port.
264.根据权利要求223所述的装置,其特征在于,所述组件包括弹性可压缩材料,允许所述主体穿过腹腔镜所用的套管针。 264. The apparatus according to claim 223, wherein said assembly comprises a resiliently compressible material, allowing the body through the laparoscopic trocar used.
265.根据权利要求223所述的装置,其特征在于,所述组件以软于25舒尔的材料制成。 265. The apparatus according to claim 223, wherein said assembly is made in a soft material 25 Shure.
266.根据权利要求223所述的装置,其特征在于,所述组件以软于15舒尔的材料制成。 266. The apparatus according to claim 223, wherein said assembly is made in a soft material 15 Shure.
267.根据权利要求223所述的装置,其特征在于,所述组件在组装时包括基本上呈现为球状的外壁。 267. The apparatus according to claim 223, wherein, when said assembly presents a substantially spherical assembly includes an outer wall.
268.根据权利要求223所述的装置,其特征在于,至少其中一个组件包括至少一个保持设备,所述保持设备适于用于推送或牵拉所述组件穿过腹腔镜所用的套管针组件。 268. The apparatus according to claim 223, wherein the at least one component which comprises at least one holding device, the holding device is adapted to push or pull the assembly through the trocar assembly used in laparoscopic .
269.根据权利要求268所述的装置,其特征在于,所述保持设备适于保持至少其中一个组件的延长部,该延长部适于被手术器械保持。 269. The apparatus according to claim 268, wherein said holding device adapted to hold at least one component of the extension portion, the extension portion being adapted to keep the surgical instrument.
270.根据权利要求268所述的装置,其特征在于,所述保持设备适于保持穿过所述保持设备插入的线或带材。 270. The apparatus according to claim 268, wherein said holding device adapted to hold through the holding device into the line or strip.
271.根据权利要求268所述的装置,其特征在于,所述组装运动约束设备包括外壁,所述保持设备至少部分地安置在所述主体的外壁的内侧。 271. The apparatus according to claim 268, wherein said assembly includes an outer wall motion restraint device, the inner holding device is at least partially disposed in the outer wall of the main body.
272.根据权利要求1或117或223所述的装置,进一步包括:调节设备,所述调节设备用于调节所述运动约束设备尺寸和/或形状。 1 or 117 or 272. The apparatus according to claim 223, further comprising: adjusting device, the adjusting device for adjusting the motion restraint device size and / or shape.
273.根据权利要求272所述的装置,其特征在于,所述运动约束设备的尺寸是液压可调的,并且所述调节设备包括液压流体容器,在植入患者体内时,所述液压流体容器连接到所述主体,并且通过移动液压流体来调节供应到所述主体的液压流体量从而非侵入式地调节所述主体的尺寸,由此调节所述主体的尺寸。 273. The apparatus according to claim 272, wherein the size of the motion restraint device is hydraulically adjustable, and the adjustment device comprises a hydraulic fluid reservoir, when implanted in a patient, the hydraulic fluid reservoir connected to the body, and is supplied to the body to regulate the amount of hydraulic fluid and thus non-invasive of the body to adjust the size by moving the hydraulic fluid, thereby adjusting the size of the body.
274.根据权利要求273所述的装置,进一步包括:液压控制设备,所述液压控制设备包括至少一个腔室,在植入患者体内时,所述腔室与所述主体一起内陷在患者胃壁中并连接到所述主体,并且其中包含在所述主体中的液压流体量通过在所述液压容器和所述至少一个腔室之间分配流体来被非侵入式地调节。 274. The apparatus according to claim 273, further comprising: a hydraulic pressure control apparatus, the hydraulic control device comprises at least one chamber, when implanted in a patient, the chamber together with the retraction body in the stomach of patients the amount of the hydraulic fluid and connected to the body, and wherein said main body is contained in the fluid to be allocated by the non-invasive adjustments between the container and the at least one hydraulic chamber.
275.根据权利要求272所述的装置,其特征在于,在植入患者体内时,所述至少一个腔室利用所述容器中的泵以液压流体填充,从而牵拉胃底壁,使患者产生饱足感。 275. The apparatus according to claim 272, characterized in that, when implanted in a patient, said at least one chamber with said container to pump the hydraulic fluid is filled, thereby pulling the gastric wall, so that patients have satiety.
276.根据权利要求272所述的装置,其特征在于,所述调节设备进一步包括反向伺服机构,该反向伺服机构包括三个具有液压流体的可调容器,其中第一容器是包括第二容器的第一闭合系统的一部分,皮下安置的所述第一容器中的小体积流体以较高的每单位面积作用力被压缩,用于移动小体积的液压流体,并且其中第二容器影响第三容器中较大体积的液压流体,所述第三容器是第二闭合系统的一部分,体积大于所述第一容器,由此以较小的每单位面积作用力产生较大总体积的液压流体的运动。 276. The apparatus according to claim 272, wherein said adjusting device further comprises a reverse servo, the reverse servo comprises hydraulic fluid having three adjustable containers, wherein a first container comprising a second The first part of the container closure system, the subcutaneous placement of the first container in a small volume of fluid at a higher force per unit area is compressed, the hydraulic fluid used to move a small volume, and wherein the second container Effect Three containers of larger volume of hydraulic fluid, the third part of the second container is a closed system, the volume is greater than the first container, whereby a smaller force per unit area of the hydraulic fluid to produce a greater total volume of movement.
277.根据权利要求272所述的装置,进一步包括:无线遥控器,在植入患者体内时,利用所述无线遥控器非侵入式地调节所述运动约束设备。 277. The apparatus according to claim 272, further comprising: a wireless remote control, when implanted in the patient, using the wireless remote control non-invasively adjust the motion restraint device.
278.根据权利要求272所述的装置,进一步包括:能源,在植入患者体内时,所述能源为所述可调的运动约束设备提供动力。 278. The apparatus according to claim 272, further comprising: energy, when implanted in a patient, the energy to power the movement of the adjustable restraint device.
279.根据权利要求278所述的装置,其特征在于,所述能源包括可植入患者体内的内部能源。 279. The apparatus according to claim 278, wherein said energy comprises an implantable internal energy of the patient.
280.根据权利要求278所述的装置,其特征在于,所述能源包括发射无线能量的外部能源。 280. The apparatus according to claim 278, wherein said energy source comprises an external energy source transmitting wireless energy.
281.根据权利要求280所述的装置,进一步包括:可植入患者体内的内部能源,在植入患者体内时,所述内部能源能利用所述外部能源发射的无线能量来充电。 281. The apparatus according to claim 280, further comprising: an implantable patient's internal energy, when implanted in a patient, can take advantage of the internal energy of the external energy source transmitting wireless energy to charge.
282.根据权利要求277所述的装置,其特征在于,所述无线遥控器包括至少一个外部信号发射器和接收器,进一步包括内部信号接收器和发射器,所述内部信号接收器和发射器可植入患者体内用于接收由所述外部信号发射器发射的信号并将反馈信号发回所述遥控器。 282. The apparatus according to claim 277, wherein the wireless remote control comprises at least one external signal transmitter and receiver further includes an internal signal receiver and transmitter, the internal signal receiver and transmitter can be implanted in a patient for receiving a signal from said external signal transmitter transmits the feedback signal and the remote control back.
283.根据权利要求277所述的装置,其特征在于,所述无线控制信号包括电场或磁场、 或者电场和磁场的组合。 283. The apparatus according to claim 277, wherein the wireless control signal comprises an electric or magnetic field, or a combination of electric and magnetic fields.
284.根据权利要求1或272所述的装置,进一步包括:无线能量发射器,用于在需要补充能量时,非侵入式地激励所述装置的任何部件。 284. 1 or 272, further comprises: a wireless energy transmitter for when you need to replenish their energy, non-invasive excite any part of the device.
285.根据权利要求284所述的装置,其特征在于,所述能量发射器通过至少一个无线能量信号发射能量。 285. The apparatus according to claim 284, wherein said energy emitter via at least one wireless energy signal emitted energy.
286.根据权利要求284所述的装置,其特征在于,所述无线能量包括波信号或场。 286. The apparatus according to claim 284, wherein the wireless energy comprises a wave signal or a field.
287.根据权利要求286所述的装置,其特征在于,所述波信号从以下信号中选择:声波信号、超声波信号,电磁波信号、红外光信号、可见光信号、紫外光信号、激光信号、微波信号、无线电波信号、χ射线辐射信号,或者伽马辐射信号。 287. The apparatus according to claim 286, wherein said wave signal from the following signals: an acoustic signal, an ultrasonic signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultraviolet light signal, a laser signal, a microwave signal , radio wave signals, χ-ray radiation signal, or a gamma radiation signal.
288.根据权利要求286所述的装置,其特征在于,所述无线能量信号包括电场或磁场、 或者电场和磁场的组合。 288. The apparatus according to claim 286, wherein the wireless energy signal comprises an electric or magnetic field, or a combination of electric and magnetic fields.
289.根据权利要求286所述的装置,进一步包括:可植入的蓄能器和能量转化设备, 所述能量转化设备将无线能量转化成电能,其中所述电能至少部分地用于给所述蓄能器充H1^ ο 289. The apparatus according to claim 286, further comprising: an implantable accumulator and the energy conversion device, said energy conversion device to the wireless energy into electrical energy, wherein said electrical energy to said at least partially for The accumulator charge H1 ^ ο
290.根据权利要求1或272所述的装置,进一步包括:感测参数的传感器。 290. The apparatus of claim 1 or claim 272 wherein, further comprising: a sensor sensing a parameter.
291.根据权利要求290所述的装置,其特征在于,所述参数是功能参数。 291. The apparatus according to claim 290, wherein said parameter is a function parameter.
292.根据权利要求291所述的装置,其特征在于,所述功能参数与用来给可植入患者体内的内部能源充电的能量的无线传输相关。 292. The apparatus according to claim 291, wherein said function parameter is used to be implanted in a patient's internal energy charging energy associated wireless transmission.
293.根据权利要求291或292所述的装置,进一步包括:反馈设备,在植入患者体内时,所述反馈设备从患者体内向患者体外发送反馈信息,所述反馈信息与所述功能参数相关。 293. According to the apparatus 291 or 292, and further comprises: a feedback device, when implanted in a patient, the feedback device to a patient from a patient in vitro send feedback information, the feedback information associated with the function parameter .
294.根据权利要求所述的装置,进一步包括:可植入的内部控制单元,所述内部控制单元用于响应传感器感测所述功能参数来控制所述运动约束设备。 294. The apparatus according to claim, further comprising: an implantable internal control unit, the internal control unit in response to a sensor for sensing a parameter to control the function of the motion restraint device.
295.根据权利要求290所述的装置,其特征在于,所述参数是患者身体参数。 295. The apparatus according to claim 290, wherein said parameter is the patient body parameter.
296.根据权利要求295所述的装置,其特征在于,用于感测身体参数的所述传感器是压力传感器。 296. The apparatus according to claim 295, wherein said sensor for sensing body parameter is a pressure sensor.
297.根据权利要求295所述的装置,其特征在于,用于感测身体参数的所述传感器是游动传感器。 297. The apparatus according to claim 295, wherein said sensor for sensing a physical parameter of the sensor is swimming.
298.根据权利要求295所述的装置,进一步包括:可植入的内部控制单元,所述内部控制单元用于响应传感器感测所述身体参数来控制所述运动约束设备。 298. The apparatus according to claim 295, further comprising: an implantable internal control unit, the internal control unit in response to the sensor sensing the physical parameter to control the motion restraint device.
299.根据权利要求1或272所述的装置,进一步包括:操作设备,所述操作设备用于操作所述运动约束设备,以控制其尺寸和/或形状。 299. According to 1 or 272, further comprises: operating the device, the operating device for operating the motion restraint device, to control its size and / or shape.
300.根据权利要求299所述的装置,其特征在于,所述操作设备包括马达或泵。 300. The apparatus according to claim 299, wherein said operation device comprises a motor or a pump.
301.根据权利要求1或272所述的装置,其特征在于,所述运动约束设备进一步适于接收无线能量,其中所述无线能量用于给所述操作设备提供动力,以产生动能用于所述运动约束设备的操作。 272 or 301. The apparatus according to claim, characterized in that the motion restraint device is further adapted to receive wireless energy, wherein the wireless energy for operation of the device to provide power to generate kinetic energy for the said kinematic constraints operate the equipment.
302.根据权利要求301所述的装置,其特征在于,当所述无线能量在由所述能量发射设备发射时,所述无线能量用于直接为所述操作设备提供动力,以产生动能用于所述运动约束设备的操作。 302. The apparatus according to claim 301, wherein, when the wireless energy transmitted by the energy when the transmitting apparatus, the wireless energy for directly powering the operation device, is used to generate kinetic energy The operation of the motion restraint device.
303.根据权利要求301所述的装置,其特征在于,所述无线能量包括波信号,所述波信号从以下信号中选择:声波信号、超声波信号,电磁波信号、红外光信号、可见光信号、紫外光信号、激光信号、微波信号、无线电波信号、χ射线辐射信号,或者伽马辐射信号。 303. The apparatus according to claim 301, wherein the wireless energy comprises a wave signal, said wave signal from the following signals: an acoustic signal, an ultrasonic signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultraviolet an optical signal, a laser signal, a microwave signal, a radio wave signal, χ-ray radiation signal, or a gamma radiation signal.
304.根据权利要求301所述的装置,其特征在于,所述无线能量信号包括电场或磁场、 或者电场和磁场的组合。 304. The apparatus according to claim 301, wherein the wireless energy signal comprises an electric or magnetic field, or a combination of electric and magnetic fields.
305.根据权利要求1或272所述的装置,进一步包括:可植入的电气部件,所述电气部件包括至少一个电压水平保护器。 272 or 305. The apparatus according to, claim further comprising: an implantable electrical components, the electrical component comprising at least one voltage level protection.
306.根据权利要求1或272所述的装置,进一步包括:可植入的电气部件,所述电气部件包括至少一个恒定电流保护器。 272 or 306. The apparatus according to, claim further comprising: an implantable electrical components, the electrical component comprising at least one constant current protector.
307.根据权利要求301所述的装置,进一步包括:能量转化设备,所述能量转化设备用于将无线能量转化成电能,其中当所述无线能量在由所述能量发射设备发射时,所述无线能量用于直接为所述操作设备提供动力,以产生动能用于所述体积填充设备的操作。 307. The apparatus according to claim 301, further comprising: energy conversion device, the energy transforming device for transforming wireless energy into electrical energy, wherein when the wireless energy transmitted by the energy when the device transmits, the wireless energy for directly powering the operation device to generate kinetic energy for operation of the volume filling device.
308.根据权利要求1所述的装置,其特征在于,在垂直于贯穿所述主体的轴线的平面上观察,所述主体具有周长,并且其中在沿着所述轴线从所述轴线第一端点到具有最大周长的中间点移动时,所述周长持续增大或保持恒定,并且从所述中间点到所述轴线的第二端点移动时,所述周长持续减小或者而保持恒定。 308. The apparatus according to claim 1, characterized in that, in a plane through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along said axis from said first axis end to an intermediate point having the maximum circumference is moved, the circumference remains constant or increases continuously, and point to the end point of the second axis when moving from said intermediate, or reduced while the circumference Length remains constant.
309.根据权利要求1所述的装置,其特征在于,在垂直于贯穿所述主体的轴线的平面上观察,所述主体具有周长,并且其中在沿着所述轴线从所述轴线第一端点到具有第一最大周长的第一中间点移动时,所述周长持续增大或保持恒定,并且从所述第一中间点到具有第一最小周长的第二中间点移动时,所述周长持续减小或者保持恒定,在沿着所述轴线从所述第二中间点到具有第二最大周长的第三中间点移动时,所述周长持续增大或者保持恒定,并且从所述第三中间点到所述轴线的第二端点移动时,所述周长持续减小或者保持恒定。 309. The apparatus according to claim 1, characterized in that, in a plane through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along said axis from said first axis a first end having a first intermediate point of the maximum circumference is moved, the circumference remains constant or increases continuously, and from the first intermediate point to a second intermediate point having the smallest first moving circumference the perimeter continues to decrease or remain constant along the axis from the second intermediate point to the third intermediate point with the second largest mobile perimeter, said perimeter continues to increase or remain constant and from the third intermediate point to a second end of the axis is moved, the perimeter continues to decrease or remain constant.
310.根据权利要求237至2M任一项所述的装置,其特征在于,至少一个装配元件沿着第一平面将每个所述运动约束设备的组件固定到所述芯部部件,并且所述运动约束设备的组件和所述芯部部件进一步包括第二装配元件,在所述组件和所述芯部部件组装后,所述第二装配元件沿着与所述第一平面成一角度的第二平面将每个组件和芯部部件固定。 237 310. The device according to any of claims 2M, characterized in that the at least one fitting member along the first plane of each of the motion restraint device assembly is secured to the core member, and the assembly and movement of the core member further comprises a second restraint device mounting member, and after the assembly of the core member assembly, said second mounting member along said first plane at an angle to the second plane of each component and the core component is fixed.
311.根据权利要求310所述的装置,其特征在于,所述第一平面和所述第二平面基本上垂直。 311. The apparatus according to claim 310, wherein said first plane and said second plane is substantially perpendicular.
312.根据权利要求310所述的装置,其特征在于,所述第二装配元件是配合元件,带有设置在运动约束设备组件和所述芯部部件上的匹配的凸起和凹部。 312. The apparatus according to claim 310, wherein said mounting element is a second mating member, with matching projections and recesses provided on the motion restraint device components and the core member.
313.根据权利要求312所述的装置,其特征在于,至少一个装配元件进一步包括凸起和凹部。 313. The apparatus according to claim 312, wherein the at least one fitting member further comprises a projection and recess.
314.根据权利要求313所述的装置,其特征在于,所述至少一个装配元件包括位于所述芯部部件中的装配狭槽、和位于所述组件中的装配凸缘,并且其中配合元件包括位于所述狭槽中的凸起和位于所述凸缘上凹部;或者所述至少一个装配元件包括位于所述芯部部件中的装配凸缘和位于所述组件中的装配狭槽,并且其中所述配合元件包括位于所述狭槽中的凸起和位于所述凸缘中的凹部。 314. The apparatus according to claim 313, wherein said mounting member comprises at least one portion of the core member in the fitting slot, and in said mounting flange assembly, and wherein the mating element comprises in said slot in said projection and recess on the flange; or the mounting element comprises at least one portion of the core member and the mounting flange assembly fitted in said slot, and wherein said engaging member comprises a slot in said protrusion and the flange portion is located in said recess.
315.根据权利要求127所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一设置有多个料层。 315. The apparatus according to claim 127, wherein at least one of the motion restraint device distal portion and a proximal end portion provided with a plurality of material layers.
316.根据权利要求315所述的装置,包括:以聚亚安酯、特富龙、或者聚四氟乙烯、聚对二甲苯、金属或者它们的组合物制成的外表面层。 316. The apparatus according to claim 315, comprising: polyurethane, Teflon, or polytetrafluoroethylene, poly-p-xylene outer surface layer, a metal, or combinations thereof made.
317.根据权利要求315所述的装置,包括:以聚亚安酯、特富龙、或者聚四氟乙烯、聚对二甲苯、金属或者它们的组合物制成的内表面层。 317. The apparatus according to claim 315, comprising: polyurethane, Teflon, or polytetrafluoroethylene, the inner surface layer of p-xylene, combinations thereof, or a metal formed.
318.根据权利要求315所述的装置,包括:聚四氟乙烯内表面层和硅酮外表面层。 318. The apparatus according to claim 315, comprising: an inner surface layer of polytetrafluoroethylene and a silicone outer surface layer.
319.根据权利要求315所述的装置,包括:聚四氟乙烯内表面层、硅酮中间层和聚对二甲苯外表面层。 319. The apparatus according to claim 315, comprising: an inner surface layer of polytetrafluoroethylene, a silicone intermediate layer and the outer surface of the parylene layer.
320.根据权利要求315所述的装置,包括:聚亚安酯内表面层和硅酮外层。 320. The apparatus according to claim 315, comprising: an inner surface layer of polyurethane and silicone outer layer.
321.根据权利要求315所述的装置,包括:聚亚安酯内表面层、硅酮中间层和和聚对二甲苯外层。 321. The apparatus according to claim 315, comprising: a polyurethane acrylate surface of the inner layer, the intermediate layer and the silicone and the outer layer of parylene.
322.根据权利要求127所述的装置,其特征在于,所述运动约束设备的远端部分和近端部分至少其中之一包括含有生物相容材料的外层。 322. The apparatus according to claim 127, wherein said at least one motion restraint distal portion and a proximal portion of the device comprises an outer layer comprising a biocompatible material.
Description  translated from Chinese

治疗胃食管反流疾病的装置 Means treatment of gastroesophageal reflux disease

技术领域 Technical Field

[0001] 本发明涉及治疗胃食管反流疾病(GERD)的装置。 [0001] The present invention relates to a device for treatment of gastroesophageal reflux disease (GERD) in.

[0002] 本发明涉及反流疾病治疗装置,该装置包括可植入的细长运动约束设备,该运动约束设备具有保持贲门处于正确位置的近端和稳定该近端并适于额外治疗肥胖的远端。 [0002] The present invention relates to the treatment of reflux disease apparatus includes an implantable elongated motion restraint device, the motion restraint device having a proximal end to keep the cardia in the correct position and stabilize the proximal end and adapted to additional treatment of obesity distal end. 所述装置可以进一步包括可植入的刺激设备,所述刺激设备适于接合患者贲门括约肌;和用来控制所述刺激设备来刺激贲门括约肌的控制设备。 The apparatus may further comprise an implantable stimulation device, the stimulation device is adapted to engage the patient cardiac sphincter; and means for controlling the stimulation device to stimulate cardiac sphincter control device. 本发明可以进一步与治疗肥胖的各种方法相结合,特别是与通过牵拉胃壁或者填充胃体积来产生饱足感的方法相结合。 The present invention may be further combined with various methods of treatment of obesity, especially in combination with or filled by pulling the stomach to produce satiety stomach volume method.

背景技术 Background

[0003] 胃食管反流疾病(GERD)或者反酸疾病是由食管反酸的反复发生而导致食管粘膜损伤的慢性病。 [0003] gastroesophageal reflux disease (GERD) or acid reflux disease is caused by recurrent esophageal acid reflux esophageal mucosal injury caused by chronic diseases. 这种病通常源于食管和胃之间的阻碍暂时或永久损伤。 This disease is often caused by obstruction of the esophagus and stomach between temporary or permanent damage. 这种情况可能源于下食管括约肌(LEQ失能、暂时性LES松弛、从胃部反流物从食管受损排出、或者食管梨形疝。 This situation may be due to the lower esophageal sphincter (LEQ disability, temporary LES relaxation, reflux from the stomach was removed from the damaged esophagus or esophageal hernia pear-shaped.

[0004] 胃食管反流疾病可以采用许多不同的方式进行治疗。 [0004] Gastroesophageal reflux disease can be treated in many different ways. 治疗方法包括但不限于药物和手术治疗。 Treatment methods include, but are not limited to drugs and surgery. 有时优于长期服用药物的标准手术治疗是尼森胃底折叠术,其中胃的上弯曲(胃底)围绕LES缠绕,以加强括约肌并防止反酸以及修复食管梨形疝。 Sometimes better than the long-term use standard surgical treatment is the Nissen fundoplication, in which the stomach is bent on (gastric) wrapped around the LES to strengthen the sphincter and prevent acid reflux and esophageal pear-shaped hernia repair. 该过程通常利用腹腔镜手术来完成。 The process usually use laparoscopic surgery to complete.

[0005] 已经开始使用的另一种手术治疗方法是Anglechik修复术,其中形成类似马蹄形的设备在贲门上方安置在食管周围。 [0005] Another surgical treatment has begun using Anglechik prosthetics, which form a horseshoe of similar equipment placed around the esophagus above the cardia. 期望的效果是防止贲门向上滑入胸腔。 The desired effect is to prevent cardiac chest upward slide. 但是,这种设备存在众多并发症,包括迁移和损伤食管。 However, there are many complications of such devices, including migration and damage the esophagus.

[0006] 根据医疗设备植入经验,已经知道植入设备和人体组织之间的缝合线无法长期保持。 [0006] The medical implant device experience, has been known implantable devices and human tissue suture between not long maintained. 对于长期植入设备来说,存在两种可能性来保持该设备就位。 For long-term implanted devices, there are two possibilities to keep the device in place. 第一种方案是将人体组织缝合到人体组织,由此将该设备保持就位。 The first option is sutured to the tissue of human tissue, thereby holding the device in place. 第二种方案是提供将设备短期保持就位的缝合线,并允许身体组织生长到该设备中,从而长期保持该设备就位。 The second scheme is to provide short-term to keep the device in place of sutures and allow the body tissue growth into the device, thereby maintaining the equipment in place long-term.

[0007] 提供与食管相关联的可植入设备的问题在于,食管外表面仅由食管肌肉组织构成,这种肌肉组织非常容易损伤或者迁移。 [0007] issues associated with esophageal implantable device that consists only of the outer surface of the esophagus esophageal muscle tissue, the muscle tissue is very easy to damage or migration. 这可能是上述Anglechik导致许多并发症诸如迁移的一个原因。 This may lead to many complications, such as the above-described migration Anglechik a reason.

[0008] 另一方面,胃外侧具有浆膜,由此为缝合提供更强韧的膜。 [0008] On the other hand, with the outside of the gastric serosa, thereby to provide a more robust film suture. 因此,将设备直接缝合到胃壁较之将植入式设备缝合到食管,获得了更好的效果。 Thus, the device directly sutured to the stomach than the implanted device is sutured to the esophagus, get better results.

[0009] 目前,存在长期治疗GERD的需求,这种治疗要比先前的治疗更有效,并且不会导致严重的并发症。 [0009] Currently, there is a demand for long-term treatment of GERD, this treatment is more effective than previous treatments, and does not lead to serious complications.

发明内容 DISCLOSURE

[0010] 本发明的目的是克服或者至少减轻现有的胃食管反流疾病(GERD)手术治疗中的一些问题。 [0010] The purpose of the present invention to overcome or at least alleviate existing gastroesophageal reflux disease (GERD) in the surgical treatment of a number of issues. 本发明的另一个目的是提供一种治疗胃食管反流疾病的装置。 Another object of the present invention is to provide a means for treatment of gastroesophageal reflux disease. 所述目的以及其他目的利用附带的权利要求书中所述的装置来实现。 The book means to achieve the aim and purpose of the use of the rights of other incidental requirements. [0011] 本发明的目的是提供长期特性改善的反流疾病治疗装置,这种装置还可以另外提供肥胖治疗功能。 [0011] The present invention is reflux disease treatment device provides improved long-term nature, such a device may additionally provide obesity treatment function.

[0012] 所述目的和其他目的利用附带的权利要求书中所述的装置来实现。 [0012] Said object and other objects of the appended claims the use of the device in the book to achieve. 一般来说,本发明涉及用来治疗人类或者哺乳动物患者的反流疾病,该装置包括可植入的运动约束设备,该运动约束设备形状细长并具有外表面,该设备适于利用患者胃壁部分至少部分地内陷。 Generally, the present invention relates to the treatment of human or mammalian patient reflux disease, the implantable device includes a motion restraint device, the motion restraint device having an elongated shape and an outer surface, the apparatus is adapted to use in patients with stomach part at least partially sunk. 所述运动约束设备在植入患者体内时,具有近端和远端,并且所述设备适于以其近端的外表面在患者横膈膜和胃底壁之间的位置至少部分地抵靠患者胃底壁,以便在运动约束设备植入患者体内时,约束患者胃的心切迹向着患者横膈膜的运动,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持患者腹部施加在患者贲门括约肌上的支撑压力。 The motion restraint device when implanted in a patient, having a proximal end and a distal end, and the outer surface of the proximal end of the device is adapted in its position between the diaphragm and the fundus wall of the patient at least partially against the Patients with gastric wall, so that when the motion restraint device implanted in a patient, the patient restraint toward the stomach in patients with heart notch diaphragm movement, thereby preventing cardiac patient by patient chest diaphragm opening slide, thereby maintaining the patient's abdomen is applied In support of the patient cardiac sphincter pressure. 所述设备还适于利用其远端稳定并保持所述近端,所述远端适于基本上内陷在胃壁中,以便阻止贲门通过患者横膈膜开口滑入患者胸腔。 The apparatus is further adapted to use and maintain the stability of its distal end a proximal end, said distal end adapted to substantially retraction in the stomach wall, in order to prevent the opening of the diaphragm slide through the patient cardiac patients chest. 术语“近端”和“远端”具有通常的解剖学含义。 The term "proximal" and "distal" has the usual meaning anatomy. 因此,近端作为解剖学位置,指的是最接近身体中心,或者位于结构的起点。 Thus, as the proximal anatomical position, referring to the center of the body closest to, or at the starting point of the structure. 在本发明的情景中,近端和远端指的是处于植入位置的运动约束设备的部分。 In the scenario of the present invention, the proximal and distal refers to the portion of the implant position in motion restraint device. 细长运动约束设备远端内陷部分的长度足够长,以便稳定细长运动约束设备的近端,以防止贲门通过患者横膈膜开口滑入患者胸腔。 The distal end of the elongated motion restraint device retraction length portion long enough to stabilize the proximal end of the elongate motion restraint device to prevent cardiac patient by patient chest diaphragm opening slide. 细长运动约束设备的远端内陷部分的周长使得其稳定该细长运动约束设备的近端部分,从而防止贲门通过患者横膈膜开口滑入患者胸腔。 Circumference of the distal end of the elongate portion retraction motion restraint device makes its stable motion constraints proximal portion of the elongated device, thereby preventing cardiac patient by patient chest diaphragm opening slide. 运动约束设备的近端部分具有至少125mm3的尺寸,周长至少为15mm。 Motion constraints proximal portion of the device having at least 125mm3 in size, girth at least 15mm.

[0013] 优选,所述装置包括可植入的第一固定设备,所述第一固定设备将所述运动约束设备的近端部分固定在约束胃的心切迹朝向患者横膈膜运动的位置,并且所述运动约束设备的外表面基本上接触患者的胃底壁。 [0013] Preferably, the apparatus comprises a first implantable fixation device, the first fixing device to the proximal portion of the motion restraint device fixed constraint stomach notch towards the center position of the patient's diaphragm movement, and the outer surface of the device is substantially the motion constraints contact with the gastric wall. 所述第一固定设备可以包括缝合线或卡钉,所述缝合线后卡钉将胃底部分连接在一起,以闭合运动约束设备的近端部分,从而将所述运动约束设备固定在所述位置,即运动约束设备至少部分地安置在内陷空间中。 The first fixation device may comprise a suture or staples, the staples after the gastric suture portion connected together to close the proximal portion of the motion restraint device, whereby the motion restraint device in the fixed position, that motion restraint device at least partially disposed in the retraction space. 因此,通过以这种方式将可植入的运动约束设备的近端部分间接附连,不需要在运动约束设备和组织之间进行缝合,反过来进一步减小了并发症的风险。 Thus, in this manner by the proximal portion of the motion restraint device implantable indirect attachment, it is not required between the motion restraint devices and suturing tissue, in turn, further reduce the risk of complications. 利用这种方式将运动约束设备的近端部分保持就位,带来了长期特性改善的弹性悬挂。 In this way the motion constraints proximal portion of the device is held in place, bringing the long-term characteristics improved elastic suspension.

[0014] 所述第一固定设备,诸如缝合线或卡钉,将胃底壁部分连接在一起,以便从患者胃壁内侧或外侧内陷所述运动约束设备的近端部分。 [0014] The first fixing device, such as sutures or staples, the gastric wall portions connected together, so that the stomach from the inside or outside of the patient motion constraints proximal portion of the retraction device.

[0015] 作为替代,组织生长促进结构可以缝合到胃壁,以相对较大的接触表面朝向胃。 [0015] Alternatively, tissue growth promoting structure can be sutured to the stomach, a relatively large contact surface towards the stomach. 该结构相对较大的表面,诸如网,将允许人体组织生长,用来长期保持运动约束设备的近端部分就位。 The relatively large surface structure, such as a network, will allow growth of human tissue for long-term movement of the proximal end portion of the restraint device in place. 所述组织生长促进结构可以包括将网状结构连接到胃底壁的缝合线或卡钉。 The tissue growth promoting structure may comprise a mesh structure is connected to the wall of the gastric sutures or staples.

[0016] 为了增加将运动约束设备的近端部分附连到胃底壁,可以采用第二固定设备。 [0016] In order to increase the motion restraint device attached to the proximal end portion connected to the gastric wall, you can use the second fixture. 第二固定设备可以用于将运动约束设备的近端部分相对于贲门附连。 Second fixed to the proximal portion of the device can be used with respect to the motion restraint device attached to the cardia. 例如,通过经由胃底壁第二次直接或间接附连运动约束设备的近端部分,运动约束设备的近端部分可以在贲门和横膈肌之间,附连在贲门上方的位置。 For example, the second via gastric wall attached directly or indirectly connected to the proximal portion of the motion restraint device, the proximal portion of the motion restraint device may be between cardia and horizontal diaphragm, attached to a position above the cardia. 第二固定设备可以将运动约束设备的近端部分直接或间接地固定到患者食管的希斯(His)角附近。 (His) second fixed angle near the proximal portion of the device can be fixed motion restraint device directly or indirectly to the patient's esophagus Heath. 第二固定设备适当地包括多个缝合线或卡钉,所述缝合线或卡钉连接到胃底壁和患者食管壁,以保持所述运动约束设备处于所述位置。 The second fixation device suitably comprises a plurality of sutures or staples, the staples or sutures to connect the patient to the esophageal wall and gastric wall, in order to maintain the motion restraint device is in the position.

[0017] 所述装置还可以包括第三固定设备,该第三固定设备将运动约束设备的近端部分直接或间接地固定到患者横膈肌或者其他肌肉组织。 [0017] The apparatus may further include a third fixation device, the third device the motion restraint device fixed proximal portion fixed directly or indirectly to the patient or other cross-diaphragm muscle tissue. 第三固定设备适当地包括多个缝合线或卡钉,所述缝合线或卡钉连接胃底壁和横膈肌或者其他肌肉组织,以保持运动约束设备处于所述位置。 Third fixture suitably comprises a plurality of sutures or staples, sutures or staples of the gastric wall and cross diaphragm connection or other muscle tissue in order to maintain motion constraint device is in the position.

[0018] 运动约束设备的近端部分可以适于基本上或者完全由患者胃底壁内陷,并且安置在胃底壁的内侧或外侧上。 [0018] The proximal portion of the motion restraint device may be adapted to substantially or completely sunk by the patient gastric wall and placed on the inside or outside of the gastric wall.

[0019] 运动约束设备的近端部分可以适于安置在患者胃壁的外侧上,以使胃空腔显著减小,减小的体积显著超过运动约束设备的体积。 [0019] a proximal portion of the motion restraint device can be adapted to the patient positioned on the outside of the stomach so that the stomach cavity is significantly reduced, the volume decreases significantly exceeds the volume of motion restraint device.

[0020] 运动约束设备的至少一部分可以用可以被胃酸破坏或者无法破坏的材料制成。 At least part of the acid can be damaged or can not destroy material [0020] The motion restraint device made.

[0021] 在实施方式中,运动约束设备的近端部分可以膨胀并适于利用凝胶或流体膨胀。 [0021] In an embodiment, the proximal portion of the motion restraint device can be expanded and adapted to use a gel or fluid expansion. 可以提供流体或凝胶接收构件用于接收流体来膨胀运动约束设备。 It can provide a fluid or gel receiving member for receiving fluid to inflate motion restraint device.

[0022] 运动约束设备的近端部分可以包括同质材料并且可以是实心体。 [0022] The proximal portion of the motion restraint device may comprise homogenous material and may be a solid body.

[0023] 运动约束设备的近端部分可以包括限定腔室的包围壁。 [0023] The proximal portion of the motion restraint device may comprise a wall defining a chamber surrounded.

[0024] 运动约束设备的近端部分可以具有刚性、弹性或挠性外壁。 [0024] The motion constraints proximal portion of the device may have a rigid, elastic or flexible outer wall. 如果外壁为刚性外壁, 则其刚性足够大,以保持在承受由胃运动产生的作用力时不发生变形。 If the outer rigid outer wall, its rigidity is large enough to keep the deformation does not occur in the stomach to withstand forces generated during movement.

[0025] 根据所述装置的优选实施方式,运动约束设备的近端部分包括主体,所述主体适于至少部分地被患者胃底壁内陷并具有包括生物相容材料的外表面。 [0025] According to a preferred embodiment of the apparatus, a proximal portion of the motion restraint device comprises a body adapted to at least partially sunk in patients with gastric wall and having an outer surface including a biocompatible material. 所述主体的外表面的主要部分适于在患者横膈膜和内陷胃底壁下部的部分之间抵靠胃底壁的所述位置。 The main portion of the outer surface of the body portion adapted to patients between the diaphragm and the retraction of the gastric wall of the lower position against the gastric wall. 适当的是,该主体以软于25或15舒尔(shure)的材料制成。 Suitably, the body soft to be made 25 or 15 Shure (shure) material.

[0026] 根据该主体的第一种一般设计,在垂直于贯穿该主体的轴线的平面上观察,所述主体具有最大周长。 [0026] According to a first general design of the body, on a plane perpendicular to the axis of the body observed through said body having a maximum circumference. 在垂直于所述轴线的其他平面上观察,所述主体的周长等于所述最大周长,或者沿着从所述轴线的方向观察,所述主体的直径从最大周长减小。 On the other plane perpendicular to the axis of the observation, the perimeter of the body is equal to the maximum circumference, or viewed from a direction along the axis, the diameter of the body decreases from the maximum circumference. 例如,所述主体可以基本上为卵形、球形,或者基本上构造成带有凹陷的中部组件的卵形,或者类似于弯曲的卵形。 For example, the body may be substantially ovoid, spherical, oval or substantially configured with a central recess of the assembly, or like curved oval.

[0027] 根据所述主体的第二种一般设计,在垂直于贯穿所述主体的轴线的平面上观察, 随着所述平面沿着所述轴线移动,所述主体的周长增加和减小至少两次,或者随着所述平面沿着所述轴线移动,减小和增大至少一次。 [0027] According to a second general design of the body, in a plane through the axis of the body viewed in the vertical, with the plane along the moving axis, the perimeter of the body increases and decreases at least twice, or with the plane along the moving axis, decrease and increase at least once. 例如,所述主体可以基本上构造成类似肾形。 For example, the body may be configured substantially similar to the kidney-shaped.

[0028] 优选,所述主体的尺寸确定为大于胃的肠道出口的尺寸。 [0028] Preferably the size of the body to determine the size of the stomach and intestines to be greater than exports. 所述主体可以的最小外径为30或40mm或者更大,并且最小外周长为150、110、90、70、50或30mm。 The body may be a minimum outer diameter of 40mm, or 30 or more, and a minimum outer circumference 150,110,90,70,50 or 30mm.

[0029] 适当的是,所述主体具有圆形轮廓,不具有可能损伤患者胃壁的太尖锐的边缘,并且具有用来抵靠胃底壁的大致光滑的外表面。 [0029] Suitably, the body has a circular profile, with possible damage to the patient is not too sharp edges of the stomach wall, and having against the gastric wall for substantially smooth outer surface.

[0030] 所述主体可以植入患者胃的内侧或外侧,并且适于通过手术连接到患者胃壁。 [0030] The implant body may be inside or outside the patient's stomach, the stomach wall and adapted to be connected to the patient by surgery. 所述主体可以变化,以呈现直径小于腹腔镜所用套管针的细长形式,由此在变成所述细长形式时,所述主体可以被推动或牵引经过所述套管针。 The body may be varied to exhibit a diameter smaller than laparoscopic trocar used in the form of an elongate, whereby when the elongate form into the body may be push or pull the needle through the cannula. 所述主体可以包括限定腔室的挠性外壁,该腔室以流体诸如凝胶填充,允许所述主体经过所述套管针。 The body may comprise a flexible outer wall defining a chamber, the chamber is filled with a fluid such as a gel, allowing the body through the trocar. 作为替代,所述主体可以包括弹性可压缩材料,允许所述主体经过所述套管针。 Alternatively, the body may comprise a resiliently compressible material, allowing the body through the trocar.

[0031] 所述主体可以为中空形式,并且包括至少两个单独部件,这两个单独部件适于插入所述中空主体,并且进一步适于在所述主体内放在一起形成单一部件,由此允许所述主体经过腹腔镜所用的套管针。 [0031] The body may be in the form of a hollow, and includes at least two separate parts, these two separate members adapted to be inserted into the hollow body, and further adapted to be placed within the main body together form a single member, whereby allowing the body through the use of laparoscopic trocar. 作为替代,所述主体可以包括外壁和中空的压缩内部部分,用于在插入患者身体之后利用流体或凝胶填充。 Alternatively, the body may include an inner portion and an outer wall of the hollow compression, for use in the body of the patient after insertion of fluid or gel-filled.

[0032] 所述主体可以包括带有注入端口的腔室,其中所述主体的腔室以流体通过所述注入端口填充。 [0032] The body may include a chamber with an injection port, a chamber wherein said body fluid is filled through the injection port.

[0033] 所述主体可以包括至少一个保持设备,所述保持设备适于用于通过腹腔镜所用的套管针推送或牵拉所述主体。 [0033] The body may comprise at least one holding device, the holding device is adapted for laparoscopic trocar used to push or pull the body. 所述保持设备适于保持所述主体的延长部,该延长部适于利用手术器械保持。 The holding device adapted to hold said extension body, the extension portion is adapted to maintain the use of surgical instruments. 更具体地说,所述保持设备适于保持通过所述保持设备插入的线或带材。 More specifically, the holding device is adapted to hold the holding device is inserted through the wire or strip. 如果所述主体包括外壁,则所述保持设备至少部分地安置在所述主体的外壁的内侧。 If the body comprises an outer wall, the holding device is at least partially disposed in the inner side of the outer wall of the body.

[0034] 在一种实施方式中,根据本发明的装置进一步包括调节设备(adjustment device),用于调节所述运动约束设备的至少近端部分。 [0034] In one embodiment, the apparatus according to the present invention further comprises a regulating device (adjustment device), the motion restraint device for adjusting at least a proximal portion. 为此,所述运动约束设备可以包括主体,该主体的尺寸可以液压地调节,并且所述调节设备可以包括液压流体容器,在植入患者体内时,所述液压流体容器连接到所述主体,并且其中所述主体的尺寸可以通过手动按压所述液压流体容器而非侵入式地调节,从而调节供应给所述主体的液压流体量,由此调节所述主体的尺寸。 To this end, the motion restraint device may include a body, the size of the body can be hydraulically adjusted, and the adjustment device may include a hydraulic fluid reservoir, when implanted in a patient, said hydraulic fluid reservoir is connected to the body, and wherein the size of the body may be manually pressed by the hydraulic fluid reservoir, not intrusive adjusted, thereby adjusting the amount of hydraulic fluid supplied to said main body, thereby adjusting the size of the body. 所述装置可以进一步包括液压控制设备(hydraulic regulation device),该设备包括至少一个腔室,在植入患者体内时,所述腔室与所述主体一起内陷在患者胃壁中并连接到所述主体,并且通过在液压容器和至少一个腔室之间分配流体来非侵入式地调节包含在所述主体内的液压流体量。 The apparatus may further comprise a hydraulic control device (hydraulic regulation device), the apparatus comprising at least one chamber, when implanted in a patient, the chamber together with the retraction body in the patient and connected to the stomach wall body, and by distribution of hydraulic fluid between the container and the at least one chamber to non-invasively adjust the amount of hydraulic fluid contained within said body. 优选,在植入患者体内时,所述至少一个腔室利用该容器内的泵而以液压流体填充,从而牵拉胃底壁,为患者产生饱足感。 Preferably, when implanted in a patient, said at least one chamber of the container using a pump and hydraulic fluid-filled, thereby pulling the gastric wall, patients produce satiety. 此外,所述调节设备进一步可以包括反向伺服机构,其中容器内小体积的流体被以较大的作用力压缩, 并且所述腔室以每单位体积上较小的作用力产生较大的总体积的运动。 Further, the regulating device may further comprise a reverse servo, wherein the container is a small volume of fluid to a greater compression force, and the chamber is a smaller force per unit volume greater total volume movement. 在一种实施方式中,所述主体形成第一腔室,进一步包括至少一个额外主体,所述额外主体形成比第一腔室小的第二腔室,所述第一和第二腔室彼此接触,优选彼此流体连通。 In one embodiment, the body forms a first chamber, further comprising at least one additional body, the additional body is formed smaller than the first chamber a second chamber, said first and second chambers with each other contacts, preferably in fluid communication with each other. 所述液压容器优选适于皮下安置在患者体内,并且所述液压容器优选适于安置在患者腹部内。 The hydraulic container is preferably suitable for subcutaneous placement in the patient, and the hydraulic container is preferably disposed within the patient's abdomen is adapted. 所述液压容器可以具有限定其体积的壁,并且所述液压容器的体积可以通过移动所述液压容器的壁的部分壁来调节。 The hydraulic container may have a wall defining the volume, the volume of the container and the hydraulic pressure can be adjusted by moving the hydraulic part of the wall of the container wall. 所述装置可以包括用来移动所述部分壁的马达。 The means for moving may include a portion of the wall of the motor. 所述液压控制设备可以包括泵, 并且所述液压容器利用泵在液压容器和所述至少一个腔室之间泵送流体来调节。 The hydraulic control device may comprise a pump, and the hydraulic pressure between the hydraulic pressure in the container using a pump and the at least one container chamber to adjust the pump fluid. 机械设备可操作地连接到液压控制设备,由此随着所述液压控制设备操作而移动。 Equipment operatively connected to a hydraulic control device, whereby the hydraulic control apparatus with a mobile operation. 在一种实施方式中,至少所述运动约束设备的近端能进行机械调节。 In one embodiment, at least the proximal end of the motion restraint device can be mechanically adjusted. 所述装置另外包括用来机械地调节所述运动约束设备的马达。 The apparatus additionally comprises a motor for mechanically regulating the motion restraint device.

[0035] 在一种实施方式中,根据本发明的装置进一步包括第二主体,在与所述主体一起植入患者体内时,所述第二主体分别填充位于患者胃的两个不同不问的两个体积,由此影响患者反流。 [0035] In one embodiment, the apparatus according to the present invention further comprises a second body, with the body when implanted in a patient together, are filled with the second body located in the stomach of patients do not ask for two different two volumes, thereby affecting patients with reflux. 所述反流疾病治疗设备适于手术后地并且非侵入式地调节,并且适于不时地进行调节,以使在第一时刻,其中一个填充主体填充胃的一部分处的体积,而在第二时刻, 另一个填充主体填充位于胃的另一部分处的体积。 The reflux disease treatment device to non-invasively and adapted to be adjusted after surgery, and is adapted to be adjusted from time to time, so that at a first time, wherein the volume of a filled body part at the filling of the stomach and in the second time, another filling body filling located at another part of the volume of the stomach.

[0036] 在一种实施方式中,根据本发明的装置包括调节设备,用于调节运动约束设备的尺寸和/或形状。 [0036] In one embodiment, the apparatus according to the invention comprises adjusting means for adjusting the size and / or shape of the motion restraint device. 运动约束设备的尺寸可以液压调节,并且所述调节设备可以包括液压流体容器,在植入患者体内时,所述液压流体容器连接到所述运动约束设备,并且所述运动约束设备的尺寸可以通过在所述液压流体容器和所述运动约束设备之间移动液压流体而非侵入式地调节。 Size of the motion restraint device may be hydraulic adjustment, and the adjustment device may include a hydraulic fluid reservoir, when implanted in a patient, said hydraulic fluid reservoir is connected to the motion restraint device, and the size of the motion restraint device may be prepared by between the hydraulic fluid reservoir and the motion restraint device mobile hydraulic fluid rather than invasive adjustments. 所述运动约束设备可以视为主体。 The movement can be seen as the main restraint device. 所述装置可以进一步包括液压控制设备,所述液压控制设备包括至少一个腔室,在植入患者体内时,所述腔室与所述主体一起内陷在患者胃壁中并连接到所述主体,并且其中包含在所述主体中的液压流体量通过在所述液压容器和所述至少一个腔室之间分配流体来非侵入式地调节。 The apparatus may further comprise a hydraulic control device, the hydraulic control device comprises at least one chamber, when implanted in a patient, the chamber together with the retraction body in the patient stomach wall and connected to the body, and wherein the amount of hydraulic fluid contained in the body by non-invasive dispensing fluid to adjust the hydraulic pressure between the container and the at least one chamber. 所述至少一个腔室在植入患者体内时,可以利用所述容器中的泵以液压流体填充,从而牵拉胃底壁,为患者产生饱足感。 Said at least one chamber when implanted in a patient, the container can be used to pump hydraulic fluid-filled, thereby pulling the gastric wall, patients produce satiety. 此外,所述调节设备可以包括反向伺服机构,该反向伺服机构包括三个具有液压流体的可调容器(adjustable reservoir),其中第一容器是包括第二容器的第一闭合系统的一部分,皮下安置的所述第一容器中的小体积流体以较高的每单位面积作用力压缩,用于移动小体积的液压流体,并且其中第二容器影响第三容器中较大体积的液压流体,第三容器第二闭合系统的一部分,体积大于所述第一容器,由此以较小的每单位面积作用力产生较大总体积的液压流体的运动。 Further, the adjusting device may comprise a reverse servo, the reverse servo comprises three adjustable container (adjustable reservoir) with hydraulic fluid, wherein the first container is a container comprising a first portion of the second closure system, The subcutaneous placement of the first container a small volume of fluid at a higher compression force per unit area, for a small volume of hydraulic fluid to move, and wherein the second hydraulic fluid container affect a larger volume of the third vessel, The second part of the third container closure system, is greater than the volume of the first container, whereby a smaller force per unit area generated a greater total volume of movement of hydraulic fluid.

[0037] 在特别的实施方式中,正如在前面段落中概括的运动约束设备包括两个或更多个运动约束设备组件,优选包括三个以上的组件,这些组件适配地组装成具有受控尺寸的可植入的组装运动约束设备,至少涉及运动约束设备的近端部分。 [0037] In a particular embodiment, as outlined in the previous paragraph motion restraint device comprises two or more components of the motion restraint device, preferably comprising three or more components, these components are adapted to be assembled with controlled sized implantable device assembly motion constraints, involving at least a proximal portion of the motion restraint device. 所述组装的运动约束设备适于以其至少一部分外表面在患者横膈膜和胃底壁之间的位置抵靠患者胃底壁,以使在运动约束设备植入患者体内时,患者胃的心切迹向着患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔中,从而保持患者腹部施加在患者贲门括约肌上的支撑压力。 The assembly motion restraint device adapted to at least a portion of its outer surface at a position between the diaphragm and gastric wall of the patient against the patient gastric wall, so that when the motion restraint device implanted in a patient, the patient's stomach Heart patients notch toward the diaphragm movement is constrained, thereby preventing cardiac patient by patient slides into the chest of the diaphragm opening, thereby maintaining the patient's abdomen is applied to the patient support cardiac sphincter pressure. 所述组装的运动约束设备优选适配地可拆解成组件,如果它离开在横膈膜和胃底壁之间的位置至少部分地接触胃底壁的植入位置的话。 The assembled device is preferably adapted to motion constraints may be broken down into components, if it is left in position between the diaphragm and the fundus wall in contact at least partially implantable gastric wall, then the location. 优选,所述组装的运动约束设备适于内陷在胃壁中,并拆解成组件,如果它离开其所植入的胃位置,包括刺穿胃壁以保持在胃内侧的位置。 Preferably, the assembly is suitable retraction motion restraint device in the stomach wall, and broken down into components, if it leaves its implantable gastric locations, including piercing the stomach to maintain its position on the inside of the stomach. 所述组件优选适于单独通过食物通道,由此降低患者肠道阻塞/梗阻的风险。 The assembly is preferably adapted individually through food channel, thereby reducing the risk of patients with intestinal blockage / obstruction. 所述运动约束设备组件可以适于通过套管针,用于将所述运动约束设备组装和植入腹腔中。 The motion restraint device may be adapted through a trocar assembly, the motion restraint device for assembly and implanted in the abdominal cavity. 所述运动约束设备组件可以具有适于穿过套管针的挠性外部形状。 The motion restraint device assembly may have adapted to pass through the trocar flexible outer shape. 所述运动约束设备组件可以适于具有允许它们在植入后组装成所述运动约束设备的形状。 The motion restraint device components can be adapted to allow them to have a restraint device assembled into the shape of the motion after implantation. 在一种实施方式中,所述运动约束设备组件为中空部件,具有挠性外表面。 In one embodiment, the motion restraint device components as a hollow member having a flexible outer surface. 所述运动约束设备组件可以适于以流体、泡沫、凝胶或者可以硬化成固体材料的流体至少其中一种填充。 The motion restraint device assembly may be adapted to a fluid, a foam, a gel or a solid material may harden into a fluid wherein the at least one filler. 在一种实施方式中,所述运动约束设备组件为实心体。 In one embodiment, the motion restraint device assembly as a solid body. 优选所述运动约束设备组件适于暂时保持它们的组装位置,优选利用内陷的胃壁保持,或者替代地利用粘结剂保持。 Preferably, the motion restraint device assembly is adapted to temporarily maintain their assembled position, the retraction is preferably used to maintain the stomach wall, or alternatively by an adhesive to maintain.

[0038] 为了组装,所述运动约束设备设置有至少一个装配元件,所述装配元件与另一个组件的至少一个装配元件充分配合,以使所述组件利用配合的装配元件可以组装成所述可植入的运动约束设备。 [0038] In order to assemble, the motion restraint device is provided with at least one mounting member, the mounting member and another component with at least one mounting element sufficiently to enable use of the assembly with the mounting element can be assembled into the exercise restraint device implanted. 优选,用于此目的的组件包括芯部部件和多个外部部件,并且优选所述至少一个装配元件在充分配合的凸缘和狭槽中选择。 Preferably, the components used for this purpose include a core member and a plurality of external components, and preferably at least one member in the flange and the slots cooperate fully with the selection assembly. 所述芯部部件适于接收所述外部元件并将其组装成可植入的运动约束设备,并且优选在组装所述运动约束设备时,所述芯部部件具有装配狭槽,所述装配狭槽适于接收所述外部部件上的对应装配凸缘。 The core member is adapted to receive the outer member and the movement assembled into an implantable restraint device, and preferably the motion restraint device when assembled, fitting the core member having a slot, the mounting slot slot adapted to receive the mounting flange corresponding to the outer member. 在一种实施方式中,所述狭槽围绕所述芯部部件的外周边区域分布。 In one embodiment, the slot around the core portion of the outer peripheral area of the distribution member. 所述外部部件则设置有充分配合所述狭槽的凸缘,以组装所述设备。 The outer member is provided with sufficient flange mating said slot, in order to assemble the device. 在另一种实施方式中,所述至少一个装配元件将每一个运动约束设备组件沿着第一平面固定到所述芯部部件,并且所述运动约束设备组件和所述芯部部件进一步包括第二装配元件,第二装配元件随着所述组件和所述芯部部件组装,而将每个组件和所述芯部部件沿着与所述第一平面成角度的第二平面固定。 In another embodiment, the at least one mounting element of each motion restraint device along a first plane assembly secured to the core member, and the movement restraining device and said core assembly further includes a first member two mounting member, the second member with the mounting assembly and the assembly of the core member, and each component of said core member and said first plane along a second plane angularly fixed. 例如,所述第一平面和所述第二平面可以基本上垂直。 For example, the first plane and the second plane may be substantially perpendicular. 所述第二装配元件包括配合元件,该配合元件优选具有设置在所述运动约束设备组件和所述芯部部件上的配合的凸起和凹部,而所述至少一个装配元件进一步包括凸起和凹部。 Said mounting member includes a second mating member, the mating member preferably has on the motion restraint device assembly and the core member and a projection provided with recesses, and said mounting member further comprises at least one projection and recess. 优选,所述至少一个装配元件包括位于所述芯部部件中的装配狭槽,和位于所述组件中的装配凸缘,并且所述配合元件包括位于所述狭槽中的 Preferably, the mounting element comprises at least one portion of the core member in the fitting slot, and in said mounting flange assembly, and said engaging member includes a slot in the

26凸起和位于所述凸缘上凹部,或者替代地,所述至少一个装配元件包括位于所述芯部部件上的装配凸缘和位于所述组件上的装配狭槽,并且所述配合元件包括位于所述狭槽中的凸起和位于所述凸缘上的凹部。 The projections 26 and recesses in said upper flange, or alternatively, the at least one mounting member includes a mounting flange of the core member and the mounting slots located on the assembly, and said engaging member including projections and recesses of the flange located in said slot in.

[0039] 在一种特定实施方式中,所述装置优选进一步包括引导设备,该引导设备可以操作,用来将所述运动约束设备组件组装成可植入的运动约束设备。 In one particular embodiment, the apparatus [0039] preferably further comprises a guide apparatus, the guide device can be operated, used to assemble the components of the motion restraint device implantable into motion restraint device. 优选,所述引导设备是可操作地连接到所述组件的操作导线。 Preferably, the guide device is operatively connected to the operating wire assembly.

[0040] 所述操作导线可以利用在与腹腔中的体液接触时可发生生物降解的材料制成,从而有利于将所述运动约束设备拆解成组件。 [0040] The operation wire can be used in contact with body fluids may occur in the abdominal cavity made of biodegradable materials, thereby facilitating the motion restraint device disassembled into components. 为了协助组装过程,每个组件可以设置有至少一个装配元件,所述装配元件充分地配合另一个组件的至少一个装配元件,以使所述组件利用配合的装配元件可以组装成可植入的运动约束设备。 In order to assist in the assembly process, each component may be provided with at least one mounting member, the mounting member substantially at least one other component with the mounting element, so that the use of mating mounting member assembly can be assembled into an implantable movement restraint device. 在一种实施方式中,所述组件包括芯部部件和多个外部部件,并且在一种实施方式中,所述装配元件从充分配合的凸缘和狭槽中选择。 In one embodiment, the assembly comprises a core member and a plurality of external components, and in one embodiment, the mounting element from the flange and the slot select fully fit.

[0041] 所述芯部部件适于接收所述外部元件并将其组装成可植入的运动约束设备。 [0041] The core member is adapted to receive the outer member and assembled into an implantable motion restraint device. 在一种实施方式中,所述芯部部件具有装配狭槽,所述装配狭槽适于在组装所述运动约束设备时,接收所述外部部件上的对应装配凸缘。 In one embodiment, the core member has a fitting slot, said slot adapted for fitting upon assembly of the motion restraint device, receiving said corresponding mounting flange on the outer member. 优选,所述狭槽围绕所述芯部部件的外周边区域分布。 Preferably, the slot around the core portion of the outer peripheral area of the distribution member. 所述狭槽和所述凸缘可以设计成松旷配合,这种松旷配合适于在运动约束设备处于其植入位置时,将所述组件保持在一起,但是如果所述运动约束设备不小心离开这种位置, 例如进入胃空腔,则有助于所述设备拆解。 The slot and the flange can be designed to fit Songkuang this Songkuang with suitable exercise restraint device implanted in their position, the assembly together, but if you are not careful the motion restraint device leave this position, for example into the stomach cavity, it helps to disassemble the device. 在这种情况下,所述引导设备降解也将有助于将所述运动约束设备拆解成组件,这些组件设计成不会导致任何阻塞或者对患者造成任何其他形式的损伤。 In this case, the guide device will also contribute to the degradation of the motion restraint device disassembled into components that are designed to not cause any obstruction to the patient, or any other form of damage.

[0042] 为了组装所述组件,所述操作导线连接到所述芯部部件和所述外部部件,以使所述外部部件能依次组装到所述芯部部件,从而组装所述运动约束设备。 [0042] In order to assemble the assembly, the operating wire is connected to the core member and the outer member, so that the outer member can be sequentially assembled to the core member, whereby the motion restraint device assembly. 为此,所述操作导线优选连接到所述外部部件的装配凸缘,并且优选所述芯部部件设置有至少一条操作通道用来接收所述操作导线。 To this end, said operating wire is preferably connected to the mounting flange of the outer member, and preferably the core member is provided with at least one working channel for receiving said operating wire. 优选,每个外部部件利用操作导线连接到两条操作通道。 Preferably, each of the outer conductor is connected with the operation to two working channel. 在一种实施方式中,第一操作通道具有位于芯部部件的端面上的第一开口和位于芯部部件的第一狭槽中的第二开口,以使在沿着远离所述端面的方向位移接收在所述第一操作通道中的操作导线时,第一外部部件组装到所述芯部部件。 In one embodiment, the first working channel has a second opening located in the end surface of the core member and the first opening is located in the core member of the first slot, so that in the direction away from the end face receiving at said first displacement operation of the operation wire passage, a first outer member assembled to the core member. 第二操作通道具有位于所述芯部部件的第二狭槽中的两个开口,以便在沿着远离所述端面的方向移动连接到所述第一操作通道的操作导线时,第二外部部件组装到所述芯部部件。 When two of the second working channel portion of said core member having a second slot opening in a direction to move away from the end face of the operating wire connected to the first operating channel, a second outer member assembled to the core member. 优选,所述牵引导线从所述第一通道开口伸出,以使其可以利用器械来操作,从而移动所述牵引导线和所述第一外部元件,以使其装配凸缘与芯部部件上为该装配凸缘指定的第一装配狭槽配合,并且以预定的顺序,通过相同的方式,移动剩下的外部部件,从而组装所述可植入的运动约束设备。 Preferably, the traction wire extends from said first channel opening, so that it can be used to operate the instrument, so as to move said first traction wire and the outer member, so mounting flange portion of the core member mounting a first mounting flange for the specified slot with, and in a predetermined sequence, in the same way, moving the rest of the outer member, thereby assembling the implantable motion restraint device. 所述组件可以包括3 个或更多个外部部件,利用牵引导线穿过在所述芯部部件的每个指定狭槽中具有开口的操作通道,这些外部部件组装到所述芯部部件的指定狭槽中。 The assembly may include three or more external components, the use of pulling wires through the slot in each of the specified portion of the core member has a passage opening operation of these external components are assembled to a specified portion of the core member slot. 在一种实施方式中,所述运动约束设备包括1个芯部部件和4个外部部件。 In one embodiment, the motion restraint device comprising a core member and the outer member 4. 但是,本领域技术人员容易想到在本发明的范围内设计所述组件的其他方式。 However, those skilled in the art will readily occur in other ways within the scope of the present invention is designed for the assembly. 如此组装的运动约束设备可以保持基本上球形形式,但是正如以下所述,其他形状和额外的功能元件也构成本发明的一部分。 Motion restraint device thus assembled can be maintained substantially spherical form, but as described below, other shapes and additional functional elements also form part of the invention.

[0043] 在以下的说明部分中,将描述运动约束设备的近端部分的其他特征。 [0043] In the following description section, we will describe other characteristics of the proximal portion of the motion restraint device. 这些特征可以与以下针对运动约束设备的远端部分所述的任何特征相结合。 These features can be any of the following characteristics for the distal end portion of the motion restraint device combination. [0044] 在所述装置的具有优势的实施方式中,所述装置现在适于也治疗肥胖,所述主体可以调节尺寸并且内陷在患者胃底壁中。 In the advantageous embodiment of the device, the device [0044] now also suitable for the treatment of obesity, the body can adjust the size and retraction in patients with gastric wall. 因此,所述主体在其尺寸增大时,牵拉患者胃底壁,由此为还罹患肥胖症的患者产生饱足感。 Therefore, the body in its size increases, pulling patient gastric wall, resulting satiety is also suffering from obesity patients. 至少两个可植入的可调牵拉设备可以用来牵拉患者胃壁的不同部分,由此通过有效地影响患者食欲来治疗肥胖。 At least two implantable adjustable traction device can be used to pull the different parts of a patient's stomach wall, thereby effectively influence by the patient to treat obesity appetite. 这两个牵拉设备从患者体外进行适当地调节,由此在第一时刻调节第一牵拉设备,以牵拉患者胃壁的第一部分, 而在第二时刻调节第二牵拉设备,以牵拉患者胃壁的第二部分。 Both traction device from outside the patient appropriately adjusted, thereby adjusting the first time in a first drawing device for drawing a first portion of the stomach wall of the patient, and a second time adjusting the second pulling device to pull Pull the second part of the stomach in patients.

[0045] 在先前段落中概括地表现为任何形式的本发明的所述装置可以进一步适于同时治疗肥胖和反流疾病,因为通常患者会同时罹患这两种并发症。 [0045] In the apparatus of the previous paragraph generally show any form of the present invention may be further adapted to simultaneously treat obesity and reflux disease, the patient typically will also suffer because of these two complications. 为此,所述运动约束设备的远端部分进一步适于治疗肥胖。 To this end, the distal end portion of the motion restraint device is further adapted to treat obesity. 所述远端部分具有体积填充设备的功能。 The distal end portion has a function of volume filling device.

[0046] 根据第一种可选方案,所述运动约束设备的远端部分适于安置在胃内侧,使得所述远端部分的外表面抵靠胃壁的内侧。 [0046] According to a first alternative, the motion restraint device disposed at the distal end portion is adapted to the inside of the stomach, such that the outer surface of the distal end portion abuts against the inside of the stomach wall.

[0047] 根据第二种可选方案,所述运动约束设备的远端部分适于安置在胃的外侧,使得该体积填充设备的外表面抵靠胃壁的外侧。 [0047] According to a second alternative, the motion restraint device is placed on the outside of the distal end portion adapted to the stomach, so that the outer surface of the volume filling device against the outside of the stomach wall.

[0048] 优选,所述运动约束设备的远端部分适于被患者胃壁完全内陷,并且经由胃镜器械安置在胃壁内侧或外侧。 [0048] Preferably, the distal portion of the motion restraint device adapted to be patient stomach totally sunk, and placed in the stomach via endoscopy equipment inside or outside. 为此,所述运动约束设备的远端部分可以包括连接设备,所述连接设备适于与夹持器械协作。 To this end, the motion restraint device in the distal portion may include a connection device, the connection device is adapted to collaborate with the holding device. 适当地是,所述运动约束设备的远端部分适于可以在手术后进行非侵入式地调节。 Suitably, the exercise restraint distal portion of the device can be adapted to non-invasively adjusted after surgery.

[0049] 所述装置可以包括固定设备,适当地包括两个或更多个固定设备,所述固定设备适于参与将所述运动约束设备的远端固定到胃壁。 Means [0049] may comprise fixed equipment, suitably comprising two or more fixtures, the fixture is adapted to participate in the distal end of the motion restraint device fixed to the stomach wall. 所述运动约束设备的远端部分可以包括保持设备,所述保持设备适于利用器械保持以简化该设备的植入过程,所述器械适当地为两个或更多个保持设备。 The distal portion of the motion restraint device may include a holding device, the holding device is adapted to maintain the use of instruments in order to simplify the process of implantation of the device, the device is suitably two or more holding devices.

[0050] 所述运动约束设备的远端部分的至少一部分可以用不会被胃酸破坏的材料制成。 [0050] movement of the distal end portion of restraint at least a portion of the apparatus can not be destroyed by stomach acid material is made. 所述运动约束设备的远端部分可以被酸破坏,例如被盐酸破坏。 The distal portion of the motion restraint device may be an acid damage, such as destruction of hydrochloric acid.

[0051] 在一种实施方式中,所述运动约束设备的远端部分可以膨胀到扩张状态,并包括限定腔室的包围壁,所述运动约束设备的远端部分利用供应到所述腔室的凝胶或流体而膨胀。 [0051] In one embodiment, the distal portion of the motion restraint device may be expanded to an expanded state, and including a wall defining a chamber enclosing the distal portion of the motion restraint device utilizing supplied to the chamber gel or fluid and swelling. 至少一个管件可以连接到所述运动约束设备的远端部分,用于向所述腔室供应凝胶或流体。 At least one tubular member may be connected to the distal end portion of the motion restraint device for supplying fluid to the gel or the chamber. 可以设置能与所述管件连接的注入端口。 You can set the port can be injected into the pipe connection. 作为替代,所述运动约束设备的远端部分可以设置有用于流体或凝胶的进入端口,该进入端口可以连接到胃镜器械,其中所述进入端口包括适于互联所述可膨胀的设备与所述胃镜器械的流体连接部。 Alternatively, the distal end portion of the motion restraint device may be provided with an access port for a fluid or gel, it may be connected to the inlet port gastroscope instrument, wherein the access port comprises an expandable adapted to interconnect the device with the said fluid connection endoscopy instruments.

[0052] 所述运动约束设备的远端部分可以包括同质材料,诸如舒尔值小于15的凝胶。 [0052] movement of the restraint device distal portion may include homogeneous material, such as Shure value less than 15 gels. 所述设备也可以是实心体。 The device may also be a solid body.

[0053] 所述运动约束设备远端部分和近端部分至少其中之一的至少一部分可以包括刚性、弹性或挠性外表面。 [0053] At least a portion of said at least one of the motion restraint device distal portion and a proximal portion may include an outer surface of the rigid, resilient or flexible. 在所述外表面具有刚性时,其刚性足够大,以便在承受胃运动产生的压力时,保持不会发生变形。 At the outer surface of a rigid, its rigidity is large enough to withstand the pressure generated when the gastric motility, deformation does not occur maintained. 所述运动约束设备的远端部分可以包括挠性的非弹性材料。 The distal portion of the motion restraint device may comprise a flexible non-elastic material.

[0054] 根据运动约束设备的远端部分的第一种一般设计,在垂直于贯穿所述设备轴线的平面上观察时,所述设备具有最大周长。 [0054] According to the first movement of the distal portion of the general design restraint device when viewed perpendicular to the plane through the axis of the device, the device has a maximum circumference. 在垂直于所述轴线的其他平面上观察时,所述设备的周长等于所述最大周长或者从来自所述最大周长的方向沿着所述轴线减小。 When viewed perpendicular to the plane of the other axis is equal to the circumference of the device from the direction of maximum circumference or decrease from the maximum circumference along the axis. 例如,所述设备可以基本上为卵形、球形或者基本上中部带有凹陷的类卵形或者类似弯曲的卵形。 For example, the device may be substantially ovoid, spherical or ovoid with a substantially curved central recess oval or similar type.

[0055] 根据所述设备的第二种一般设计,在垂直于贯穿所述设备的轴线的平面上观察,随着所述平面沿着所述轴线移动,所述设备的周长增加和减小至少两次,或者随着所述平面沿着所述轴线移动,减小和增大至少一次。 [0055] According to a second general design of the device, in a plane through the axis of the apparatus viewed in the vertical, with the movement along the axis of the plane, the circumference of the device increases and decreases at least twice, or with the plane along the moving axis, decrease and increase at least once. 例如,所述设备可以基本上构造地类似肾形。 For example, the devices can be substantially similar structure to the kidney-shaped.

[0056] 所述运动约束设备的远端部分具有细长的、圆整的、弯曲的和/或曲线形状。 [0056] The distal portion of the motion restraint device having an elongated, rounded, curved and / or curvilinear shape.

[0057] 所述运动约束设备的远端部分具有至少30、50、80、120、150、180或220mm的周长。 [0057] The distal portion of the motion restraint device having at least 30,50,80,120,150,180 or 220mm circumference.

[0058] 所述运动约束设备的远端部分具有介于0. 0001至0. OOlm3范围内、或者0. 00001 至0. OOlm3范围内、或者0. 0001至0. 0002m3范围内的体积。 [0058] The motion of the distal end portion having a restraint device within the range of 0.0001 to 0. OOlm3 range, or the range, or the volume in the range of 0.0001 to 0. 0002m3 0. 00001 to 0. OOlm3. 所述体积填充设备的体积小于 The volume of the volume filling device is less than

0. ooan3。 0. ooan3.

[0059] 所述运动约束设备的远端部分可以包括至少两个可互联的部分,这两个部分适于作为单独的部分安置在胃的内侧或外侧。 [0059] movement of the distal end portion of the restraint device may comprise at least two interconnected parts, the two parts adapted as a separate part arranged inside or outside of the stomach.

[0060] 所述运动约束设备的远端部分可以包括弹性材料、生物相容材料和/或硅酮。 [0060] movement of the distal end portion of the restraint device may comprise an elastic material, biocompatible material and / or a silicone. 适当的是,所述运动约束设备的远端部分和近端部分至少其中之一设置有至少一个料层。 Suitably, the motion restraint device distal portion and a proximal end portion is provided with at least one of the at least one layer of material. 例如,金属层、聚对二甲苯层、聚四氟乙烯层或者聚亚安酯层。 For example, a metal layer, layer of parylene, Teflon layer or a polyurethane layer. 所述料层可以包括排成任何顺序的多个层。 The material layer may comprise a plurality of layers arranged in any order. 适当的是,其中一个层可以用金属、硅酮或PTFE制成。 Suitably, one layer may be made of metal, silicone or PTFE. 所述体积填充设备可以包括硅酮、聚亚安酯、特富龙或者聚四氟乙烯、金属、聚对二甲苯、PTFE或者它们的组合材料所制成的外表面层。 The volume filling device may include silicone, polyurethane, Teflon, or polytetrafluoroethylene, metal, polyethylene outer surface layer of p-xylene, PTFE or a composite material made of. 所述体积填充设备可以包括硅酮、聚亚安酯、特富龙或者聚四氟乙烯、 金属、聚对二甲苯、PTFE或者它们的组合材料所制成的内表面层。 The volume filling device may include silicone, polyurethane, Teflon, or polytetrafluoroethylene, metal, poly inner surface layer of p-xylene, PTFE or a composite material made of. 其他组合层包括聚四氟乙烯内表面层和硅酮外层;聚四氟乙烯内表面层、硅酮中间层和聚对二甲苯外层;聚亚安酯内表面层和硅酮外层;和聚亚安酯内表面层、硅酮中间层和聚对二甲苯外层。 Other combinations layer comprises an inner layer of Teflon and silicone outer surface; the inner surface layer of polytetrafluoroethylene, a silicone intermediate layer and an outer layer of parylene; inner surface layer of polyurethane and silicone outer layer; esters and polyurethane inner surface layer, an intermediate layer of silicone and parylene layer.

[0061] 所述运动约束设备的远端部分可以包括适于转化成固态或固定形式的流体。 [0061] movement of the distal end portion of the restraint device may include fixed or adapted to be converted to solid form of the fluid. 所述流体可以是液体聚亚安酯或者等张流体(isotonic)。 The fluid may be a liquid polyurethane or isotonic fluid (isotonic). 所述流体可以包括大分子,诸如碘分子,以防止扩散。 The fluid may comprise large molecules, such as iodine molecules, to prevent proliferation.

[0062] 所述运动约束设备的远端部分可以具有至少50毫米的最大周长,优选至少80毫米。 [0062] movement of the distal end portion of restraint devices may have a maximum circumference of at least 50 mm, preferably at least 80 mm. 适当的是,所述运动约束设备的远端部分能变形到最大直径,从而可以插入到腹腔镜套管针中。 Suitably, the distal end portion of the motion restraint device can be deformed to the maximum diameter which can be inserted into the laparoscopic trocar.

[0063] 优选,所述运动约束设备的远端部分适于利用胃到胃的缝合线或者卡钉保持就位,从而将所述设备内陷在胃壁中。 [0063] Preferably, the distal portion of the motion restraint device is adapted to use the stomach to stomach sutures or staples held in place, so that the retraction of the device in the stomach wall. 具有优势的是,所述运动约束设备的远端部分具有可变周长,以更好地保持内陷在患者胃壁中的位置。 It has the advantage that the distal end portion of the motion restraint device has a variable circumference, in order to better maintain retraction in patients with stomach position. 所述胃到胃的缝合线或者卡钉可以设置有固定部分,所述固定部分表现为适于与胃壁接触的结构,以促使人体组织生长,从而长期固定连接到胃壁的体积填充设备的位置。 The stomach to stomach sutures or staples may be provided with a fixed portion, the fixed portion is adapted to the structure and performance of the stomach wall in contact, to promote tissue growth, and thus a long position of the stomach wall fixedly connected to the filling volume of the device. 所述结构可以包括网状结构。 The structure may include a mesh structure.

[0064] 在本发明的实施方式中,所述装置包括安置在胃壁外侧并适于牵拉一部分胃壁的牵拉设备,由此影响患者食欲。 [0064] In an embodiment of the present invention, the apparatus comprising disposed on the outside of the stomach wall and is adapted to stretch a portion of the stomach wall pulling device, thereby affecting patients appetite. 在体积填充设备可膨胀时,所述装置可以包括互联所述牵拉设备和所述体积填充设备的流体连接部。 When the inflatable volume filling device, the device may comprise a fluid connector portion interconnecting said drawing device and the volume filling device.

[0065] 所述牵拉设备可以液压地调节。 [0065] The hydraulic pulling device can be adjusted. 在这种情况下,可以设置连接到液压调节的牵拉设备的可皮下植入的液压容器,由此所述液压调节的牵拉设备在植入患者体内时,适于利用来自所述液压容器的流体进行非侵入式地调节。 In this case, you can set up a connection to a hydraulic pulling device for regulating the hydraulic container subcutaneously implanted, thereby regulating the hydraulic pulling device when implanted in a patient, adapted for use from the hydraulic container The fluid is a non-invasive adjustments. 在一种实施方式中,所述液压调节的牵拉设备通过手动按压所述液压容器来进行非侵入式地调节。 In one embodiment, the hydraulic adjustment device by manually pulling the hydraulic pressing container to be adjusted non-invasively. 此外,所述运动约束设备适当地包括可膨胀的主体,并设置与所述主体流体连接的泵和腔室,其中所述泵通过从所述主体向所述腔室泵送流体或空气而调节所述液压容器。 In addition, the motion restraint device comprises an inflatable body appropriately, and provided with the pump body and fluidly connected to the chamber, wherein the pump by pumping fluid or air from the chamber to the body is adjusted The hydraulic container.

[0066] 所述装置可以包括可植入的刺激设备,所述刺激设备向贲门肌肉特别是贲门括约 [0066] The apparatus may comprise an implantable stimulation device, the cardiac stimulation device to particular cardia sphincter muscle

29肌发出刺激脉冲,以刺激贲门肌肉并由此进一步闭合贲门,以额外地防止反流疾病。 29 issued muscle stimulation pulses to stimulate cardiac muscle and thus further closing the cardia to additionally prevent reflux disease. 所述刺激设备包括至少一个导体和至少一个电极,所述电极接收刺激脉冲并将其应用于贲门括约肌,从而刺激贲门括约肌。 The stimulation device comprising at least one conductor and at least one electrode, said electrode and applies stimulation pulses received cardiac sphincter, thereby stimulating the cardiac sphincter. 所述至少一个电极也可以利用胃到胃的缝合线或者通过内陷在胃壁中而保持就位。 At least one electrode of the stomach may also be used to stomach sutures or retraction through the stomach wall and held in place. 所述刺激脉冲可以作为脉冲串发出,其中所述脉冲串重复发送且两个脉冲串之间具有时间间歇,所述间歇扩展(extend)所述脉冲串中每个脉冲之间的间歇。 The stimulation pulses may be emitted as a pulse train, wherein the transmission range of the burst repetition time interval between two bursts, the intermittent extension (extend) the interval between each pulse in the pulse train. 优选,所述刺激设备成列地发出多个脉冲串,随后是比脉冲串之间的间歇更长的间歇,以允许肌肉休息,保持贲门括约肌闭合。 Preferably, the stimulation device to emit a plurality of columns to burst, followed by a longer interval than the interval between bursts to allow the muscles to rest, to maintain cardiac sphincter closed. 所述刺激设备可以包括电子电路和能源,所述能源优选适于地包含所述所述电路和能源。 The stimulation device may comprise an electronic circuit and energy, the energy is preferably adapted to contain said circuit and energy.

[0067] 所述刺激设备优选包括至少一个传感器,用于感测患者身体参数或者运动约束设备的功能参数;和用于控制所述刺激设备的内部控制单元。 [0067] The stimulation device preferably comprises at least one sensor for measuring a physical parameter or sense the patient motion restraint device function parameters; and means for controlling the stimulation device of the internal control unit.

[0068] 通常,所述内部控制单元响应来自所述传感器的信息来控制所述刺激设备。 [0068] Typically, the internal control unit in response to information from the sensor to control the stimulation device.

[0069] 感测食管收缩波或者与食物摄入相关的任何其他参数的传感器,向所述内部控制单元发送信息,然后所述内部控制单元响应来自所述传感器的所述信息而停止刺激。 [0069] esophageal contraction wave sensing or any sensor associated with the food intake of other parameters, the internal control unit to send a message, then the internal control unit in response to the information from the sensor and stop stimulation.

[0070] 所述刺激设备在任何时候都可以由患者控制。 [0070] The stimulation device can be controlled by the patient at any time.

[0071] 所述目的还通过提供一种装置来实现,所述装置包括可植入的运动约束设备,该设备具有细长形状并且在植入患者体内时,具有近端部分和远端部分,其中所述近端部分适于被患者胃底壁至少部分地内陷,并且具有优选包括生物相容材料的外表面,其中所述运动约束设备的近端部分的外表面的主要部分适于在患者横膈膜和内陷胃底壁下部的至少一部分之间的位置抵靠胃壁而不会损伤胃壁,在所述运动约束设备植入时,使得患者胃的心切迹向着患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持患者腹部施加在患者贲门括约肌上的支撑压力。 [0071] The object is also achieved by providing an apparatus, the apparatus comprises implantable motion restraint device, the device has an elongated shape and, when implanted in a patient, having a proximal portion and a distal portion, wherein said proximal end portion adapted to be at least partially patients gastric wall retraction, and having an outer surface preferably comprises a biocompatible material, wherein the main portion of the outer surface of the proximal portion of the motion restraint device in the patient adapted between the diaphragm and the position of at least a portion of the fundus retraction abutting the lower portion of the stomach wall without damaging the stomach, when the motion restraint device implanted so that the patient's heart notch toward the stomach in patients with diaphragmatic movement is constraint, thereby preventing cardiac patient by patient chest diaphragm opening slide, thereby maintaining the patient's abdomen is applied to the patient support cardiac sphincter pressure. 所述运动约束设备的远端部分稳定并保持所述近端部分,并且适于基本上内陷在胃壁中。 The movement of the distal end portion of restraint device stable and holding the proximal end portion and adapted to substantially retraction in the stomach wall. 所述胃底壁更容易移动,并利用内陷在至少部分地位于胃底壁下方的胃壁中的所述远端部分进行稳定。 The gastric wall is easier to move, and the use of retraction at least partially located below the stomach fundus wall of the distal portion of the stabilizer. 所述运动约束设备的近端部分的尺寸至少为125mm3,周长至少为15mm,进一步包括可植入的刺激设备,所述刺激设备适于接合患者贲门括约肌;和用于控制所述刺激设备来刺激贲门括约肌的控制设备,其中利用能量脉冲对贲门括约肌进行刺激,以增加括约肌强直性,以使贲门闭合,并且所述控制设备可以由患者操作,在于它可以设置成停止操作,其中所述控制设备另外可以由患者操作,从而将刺激设备设置成启动操作,在所述操作状态下,在患者不吞咽时,所述刺激设备在操作模式和休止模式之间连续切换,在所述操作模式下,以所述能量脉冲刺激贲门括约肌,而在所述休止模式下,不刺激贲门括约肌。 The dimensions of the proximal portion of the motion restraint device of at least 125mm3, the perimeter of at least 15mm, further comprising an implantable stimulation device, the stimulation device is adapted to engage the patient cardiac sphincter; and means for controlling the stimulation device stimulation of cardiac sphincter control apparatus, wherein the use of the energy pulse stimulation of cardiac sphincter, sphincter ankylosing to increase, so that the cardia is closed and the control device may operate by the patient, provided that it can stop the operation, wherein the control Further the device can operate by the patient, so that the stimulation device arranged to start operation in the operating state, when the patient is not swallowing, the stimulation device to switch between a continuous operating mode and a sleep mode, in the mode of operation to the cardiac sphincter stimulation energy pulses, and in the sleep mode, it does not stimulate the cardiac sphincter.

[0072] 运动约束设备 [0072] motion restraint device

[0073] 现在将描述所述装置的运动约束设备。 [0073] movement restraining device will now be described the apparatus. 应该理解,在本发明的情景下,在这一部分针对运动约束设备描述的全部特征、功能或者适于,均涉及其近端部分,即便并未如此明示。 It should be understood, in the scenario of the present invention, all of the features in this section for a description of the motion restraint device, function, or suitable for, all related to its proximal end portion, even if is not so explicit. 但是,在本申请中所述的全部特征、实施方式或者实施方式的部分以及任何方法,如果恰当,可以用于所述设备的近端部分或远端部分。 However, all the characteristics described in the present application, as well as any portion of a method embodiment or embodiments, if appropriate, may be used for the proximal portion or distal portion of the device.

[0074] 所述装置包括可植入的运动约束设备,该设备具有包括生物相容材料的外表面, 其中所述运动约束设备适于利用其至少一部分外表面在患者横膈膜和胃底壁之间的位置抵靠患者胃底壁,以使患者胃的心切迹朝向患者横膈膜的运动受到约束,由此实现了一种用来治疗胃食管返流疾病的装置。 [0074] The apparatus comprises an implantable motion restraint device, the device has an outer surface including a biocompatible material, wherein the motion restraint device is adapted to use at least a portion of the outer surface of the diaphragm and the gastric wall in patients positions against the patient's gastric wall, so that the patient's heart notch toward the stomach in patients with diaphragmatic movement is constrained, thereby realizing a method for the treatment of gastroesophageal reflux disease means. 所述运动约束设备的尺寸至少为125mm3,周长至少为15mm,并且约束患者胃的心切迹朝向患者横膈膜的运动,由此阻止贲门通过患者横膈膜开口滑入患者胸腔中,保持患者腹部施加在患者贲门括约肌上的支撑压力。 The size of the motion restraint device at least 125mm3, the circumference of at least 15mm, and the constraint of heart patients stomach notch diaphragm movement towards the patient, thereby preventing cardiac patient by patient slides into the diaphragm opening the chest, keeping the patient applied to the patient's cardiac sphincter pressure abdominal support. 固定设备适于将所述运动约束设备固定在所述位置。 Fixation device adapted for fixing the position of the movement in the device constraints.

[0075] 通过适于所述植入式运动约束设备的外表面以抵靠胃底壁,发生并发症诸如组织损伤转移的风险最小,因为胃底并没有食管那么脆弱。 [0075] The outer surface adapted to the motion restraint device implanted in the fundus against the wall, the risk of complications such as damage to tissue transfer a minimum because of esophageal and gastric and not so fragile.

[0076] 在本发明第一实施方式中,固定设备包括缝合线或卡钉,所述缝合线或卡钉将包围所述运动约束设备的胃底壁部分连接在一起,从而将所述运动约束设备固定在所述位置,即所述运动约束设备至少部分地安置在内陷空间中。 [0076] In a first embodiment of the invention, the fixed devices including sutures or staples, the sutures or staples will surround the motion constraints gastric wall portion of the device are connected together, so that the motion constraints The device is fixed in position, i.e., the motion restraint device at least partially disposed in the retraction space. 因此,通过采用这种方式间接附连可植入的运动约束设备,在运动约束设备和组织之间不需要缝合,这样降低了出现并发症的风险。 Thus, by using this indirect attachment implantable device motion constraints between exercise restraint devices and organizations require sutures, which reduces the risk of complications. 以这种方式将运动约束设备保持就位,形成了长期特性得到改善的弹性悬挂。 In this way, the motion restraint device held in place, forming a long-term characteristics are improved elastic suspension.

[0077] 固定设备,诸如缝合线或卡钉,可以将胃底壁部分连接在一起,从而从患者胃壁内侧或外侧基本上或者完全内陷所述运动约束设备。 [0077] fixtures, such as sutures or staples can be connected together fundus wall portion, whereby the patient from the inside or outside of the stomach substantially or completely said retraction motion restraint device. 在运动约束设备安置在患者胃壁外侧上的情况下,所述运动约束设备由胃底壁内陷,以使胃空腔明显减小,减小的体积基本上超过运动约束设备的体积。 In the motion restraint device placed on the outside of the stomach of a patient case, the motion restraint device retraction by the gastric wall to the stomach cavity is significantly reduced, the volume decreases substantially exceeds the volume of motion restraint device.

[0078] 在本发明的另一种实施方式中,所述固定设备包括可植入的第一固定设备,该第一固定设备将运动约束设备在所述位置连接到胃底壁;第二固定设备,所述第二固定设备将运动约束设备间接或直接地连接到食管的希斯角附近;和第三固定设备,所述第三固定设备将所述运动约束设备间接或直接地连接到患者横膈肌或者相关联的肌肉。 [0078] In another embodiment of the present invention, the fixing device comprises a first implantable fixing device, the fixing device will first movement restraining device in the position connected to the gastric wall; a second fixed device, the second fixture will kinematic constraints directly or indirectly connected to the esophagus near the equipment Hiss angle; and a third fixed equipment, said third fixation device to the motion restraint devices directly or indirectly connected to the patient Or cross the diaphragm muscle is associated. 第一、第二和第三固定设备任一可以由多个缝合线或卡钉构成。 First, second and third fixing device can be composed of any one of a plurality of sutures or staples. 所述第一固定设备可以包括组织生长促进结构,用于保持所述运动约束设备长期连接到胃壁。 The first fixation device may include tissue growth promoting structure for long-term retention of the motion restraint device is connected to the stomach wall. 所述组织生长促进结构可以以朝向胃的相对较大的接触表面缝合到胃壁。 The tissue growth promoting structure toward the stomach may be relatively large contact surface of the suture to the stomach wall. 所述结构的相对较大的表面,诸如网,将允许人体组织生长,用于长期保持所述运动约束设备就位。 Relatively large surface of the structure, such as a network, will allow growth of human tissue for long-term holding of the motion restraint device in place. 组织生长促进结构可以包括将所述网状结构连接到胃底壁的缝合线或卡钉。 Tissue growth promoting structure may comprise a mesh structure is connected to the wall of the gastric sutures or staples.

[0079] 除了内陷根据本发明第一实施方式的运动约束设备之外,第二固定设备可以用来将所述运动约束设备间接或直接地固定到患者食管的希斯角附近,并且第三固定设备可以用于将运动约束设备间接或直接地固定到患者横膈肌或者其他肌肉组织。 [0079] In addition to the retraction according to the first embodiment of the invention of the motion restraint device, the second fixed device can be used to the motion restraint device directly or indirectly secured to the patient's esophagus near the corner of Heath, and the third fixed equipment can be used to motion constraints equipment directly or indirectly secured to the patient or other cross diaphragm muscle tissue.

[0080] 运动约束设备至少一部分可以用能被胃酸破坏或者不能被胃酸破坏的材料制成。 [0080] at least part of the motion restraint device can be made of acid damage or destruction of material that can not be acid.

[0081] 所述运动约束设备可以膨胀并适于利用凝胶或流体膨胀。 [0081] movement of the restraint device can be expanded and adapted to the use of gel or fluid expansion. 可以设置用于接收流体以膨胀运动约束设备的流体或凝胶接收构件。 It may be provided for receiving inflation fluid or gel fluid receiving member motion restraint device.

[0082] 所述运动约束设备可以包括同质材料并且可以是实心体。 [0082] movement of the restraint device may comprise a homogeneous material and can be a solid body.

[0083] 所述运动约束设备可以包括限定腔室的包围壁。 [0083] movement of the restraint device may include defining a chamber surrounded by a wall.

[0084] 所述运动约束设备可以具有刚性、弹性或挠性外壁。 [0084] movement of the restraint device may have a rigid, elastic or flexible outer wall. 在外壁具有刚性的情况下,其刚性要足够保持在承受胃运动产生的作用力时不会发生变形。 The outer wall having a rigid case, it should be enough to maintain rigidity without distortion when subjected to the force of the stomach Movement. 根据上述第一实施方式,在运动约束设备内陷的情况下,所述运动约束设备优选包括主体,该主体适于被患者胃底壁至少部分地内陷并且具有包括生物相容材料的外表面。 According to the above-described first embodiment, the motion restraint device in the case of retraction, the motion restraint device preferably comprises a body adapted to be at least partially a patient fundus wall and having an outer surface including a retraction biocompatible material. 所述主体的外表面的主要部分适于在患者横膈膜和内陷胃底壁下部的部分之间的所述位置抵靠胃壁。 The main portion of the outer surface of the body is adapted to the position in some patients between the diaphragm and the retraction of the gastric wall of the lower against the stomach walls. 适当的是,所述主体用软于25或15舒尔的材料制成。 Suitably, the body with a soft 25 or 15 Shure material.

[0085] 根据所述主体的第一种一般设计,在垂直于贯穿该主体的轴线的平面上观察,所述主体具有最大周长。 [0085] According to a first general design of the body, on a plane perpendicular to the axis of the body observed through said body having a maximum circumference. 在垂直于所述轴线的其他平面上观察,所述主体的周长等于所述最大周长,或者沿着所述轴线从来自所述最大周长的方向观察,所述主体的直径从最大周长减小。 On the other plane perpendicular to the axis of observation, the perimeter of the body is equal to the maximum circumference, or viewed from a direction from the circumference of the largest along the axis, from the maximum diameter of the main body of the Week length decreases. 例如,所述主体可以基本上为卵形、球形,或者基本上构造成中部带有凹陷的类卵形, 或者类似于弯曲的卵形。 For example, the body may be substantially ovoid, spherical, oval or substantially configured with a central oval recess classes, or similar curved.

[0086] 根据所述主体的第二种一般设计,在垂直于贯穿所述主体的轴线的平面上观察, 随着所述平面沿着所述轴线移动,所述主体的周长增大和减小至少两次,或者随着所述平面沿着所述轴线移动,减小和增大至少一次。 [0086] According to a second general design of the body, in a plane through the axis of the body viewed in the vertical, with the plane along the moving axis, the perimeter of the body increases and decreases at least two times, or with the plane along the moving axis, decrease and increase at least once. 例如,所述主体可以基本上构造成类似肾形。 For example, the body may be configured substantially similar to the kidney-shaped.

[0087] 优选,所述主体的尺寸确定为大于胃的肠道出口的尺寸。 [0087] Preferably the size of the body to determine the size of the stomach and intestines to be greater than exports. 所述主体可以的最小外径为30或40mm或者更大,并且最小外周长为150、110、90、70、50或30mm。 The body may be a minimum outer diameter of 40mm, or 30 or more, and a minimum outer circumference 150,110,90,70,50 or 30mm.

[0088] 适当的是,所述主体具有圆形轮廓,不具有可能损伤患者胃壁的太尖锐的边缘,并且具有用来抵靠胃底壁的大致光滑的外表面。 [0088] Suitably, the body has a circular profile, with possible damage to the patient is not too sharp edges of the stomach wall, and having against the gastric wall for substantially smooth outer surface.

[0089] 所述主体可以植入患者胃的内侧或外侧,并且适于通过手术连接到患者胃壁。 [0089] The implant body may be inside or outside the patient's stomach, the stomach wall and adapted to be connected to the patient by surgery. 所述主体可以变化,以呈现直径小于腹腔镜所用套管针的细长形式,由此在变成所述细长形式时,所述主体可以被推送或牵引经过所述套管针。 The body may be varied to exhibit a diameter smaller than laparoscopic trocar used in the form of an elongate, whereby when the elongated into the form of a body can be pushed through the trocar or traction. 所述主体可以包括限定腔室的挠性外壁,该腔室以流体诸如凝胶填充,允许所述主体经过所述套管针。 The body may comprise a flexible outer wall defining a chamber, the chamber is filled with a fluid such as a gel, allowing the body through the trocar. 作为替代,所述主体可以包括弹性可压缩材料,允许所述主体经过所述套管针。 Alternatively, the body may comprise a resiliently compressible material, allowing the body through the trocar.

[0090] 所述主体可以为中空形式,并且包括至少两个单独部件,这两个单独部件适于插入所述中空主体,并且进一步适于在所述主体内放在一起形成单一部件,由此允许所述主体经过腹腔镜所用的套管针。 [0090] The body may be in the form of a hollow, and includes at least two separate parts, these two separate members adapted to be inserted into the hollow body, and further adapted to be placed within the main body together form a single member, whereby allowing the body through the use of laparoscopic trocar. 作为替代,所述主体可以包括外壁和中空的压缩内部部分,用于在插入患者身体之后利用流体或凝胶填充。 Alternatively, the body may include an inner portion and an outer wall of the hollow compression, for use in the body of the patient after insertion of fluid or gel-filled.

[0091] 所述主体可以包括带有注入端口的腔室,其中所述主体的腔室以流体通过所述注入端口填充。 [0091] The body may include a chamber with an injection port, a chamber wherein said body fluid is filled through the injection port.

[0092] 所述主体可以包括至少一个保持设备,所述保持设备适于用于推送或牵拉所述主体穿过腹腔镜所用的套管针。 [0092] The body may comprise at least one holding device, the holding device is adapted for pushing or pulling of the body through the laparoscopic trocar used. 所述保持设备适于保持所述主体的延长部,该延长部适于利用手术器械保持。 The holding device adapted to hold said extension body, the extension portion is adapted to maintain the use of surgical instruments. 更具体地说,所述保持设备适于保持穿过所述保持设备插入的线或带材。 More specifically, the holding device is adapted to hold the holding device is inserted through the wire or strip. 如果所述主体包括外壁,则所述保持设备至少部分地安置在所述主体的外壁的内侧。 If the body comprises an outer wall, the holding device is at least partially disposed in the inner side of the outer wall of the body.

[0093] 在具有优势的实施方式中,所述主体尺寸可以调节并内陷在患者胃底壁中。 [0093] In an advantageous manner, the body size can be adjusted and retraction in patients with gastric wall. 因此, 所述主体在其尺寸增大时,牵拉患者胃底壁,由此为还罹患肥胖症的患者产生饱足感。 Therefore, the body in its size increases, pulling patient gastric wall, resulting satiety is also suffering from obesity patients. 至少两个可植入的可调牵拉设备可以用来牵拉患者胃壁的不同部分,由此通过有效地影响患者食欲来治疗肥胖。 At least two implantable adjustable traction device can be used to pull the different parts of a patient's stomach wall, thereby effectively influence by the patient to treat obesity appetite. 这两个牵拉设备从患者体外进行适当地调节,由此在第一时刻调节第一牵拉设备,以牵拉患者胃壁的第一部分,而在第二时刻调节第二牵拉设备,以牵拉患者胃壁的第二部分。 Both traction device from outside the patient appropriately adjusted, thereby adjusting the first time in a first drawing device for drawing a first portion of the stomach wall of the patient, and a second time adjusting the second pulling device to pull Pull the second part of the stomach in patients.

[0094] 所述牵拉设备可以液压地调节。 [0094] The hydraulic pulling device can be adjusted. 在这种情况下,可以设置连接到液压调节的牵拉设备的可皮下植入的液压容器,由此所述液压调节的牵拉设备适于通过手动按压所述液压容器进行非侵入式地调节。 In this case, you can set up a connection to a hydraulically adjustable hydraulic pulling device implanted subcutaneously container, thereby regulating the hydraulic pulling device is adapted to be non-invasively adjusted by manually pressing the hydraulic container . 此外,所述运动约束设备适当地包括可膨胀的主体,并设置与所述主体流体连接的泵和腔室,其中所述泵通过从所述主体向所述腔室泵送流体或空气而调节所述液压容器。 In addition, the motion restraint device comprises an inflatable body appropriately, and provided with the pump body and fluidly connected to the chamber, wherein the pump by pumping fluid or air from the chamber to the body is adjusted The hydraulic container.

[0095] 所述装置可以包括可植入的刺激设备,所述刺激设备向贲门肌肉特别是贲门括约肌发出刺激脉冲,以刺激贲门肌肉并由此进一步闭合贲门,以额外地防止反流疾病。 Means [0095] may include an implantable stimulation device, the cardiac muscle stimulation device to emit especially cardiac sphincter stimulation pulses to stimulate cardiac muscle and thus further closing the cardia to additionally prevent reflux disease. 所述刺激设备由至少一个导体和至少一个电极构成,所述电极接收刺激脉冲并将其应用于贲门括约肌,从而刺激贲门括约肌。 The stimulation device consists of at least one conductor and at least one electrode, said electrode and applies stimulation pulses received cardiac sphincter, thereby stimulating the cardiac sphincter. 所述至少一个电极也可以利用胃到胃的缝合线或者通过内陷在胃壁中而保持就位。 At least one electrode of the stomach may also be used to stomach sutures or retraction through the stomach wall and held in place. 所述刺激脉冲可以作为脉冲串发出,其中所述脉冲串重复发送且两个脉冲串之间具有时间间歇,所述间歇扩展所述脉冲串中每个脉冲之间的间歇。 The stimulation pulses may be emitted as a pulse train, wherein the burst repetition transmission range of the time interval between two bursts, the intermittent extension of the interval between each pulse burst. 优选,所述刺激设备可以包括电子电路和能源,所述能源优选适于包含所述电子电路和能源。 Preferably, the stimulation device can include an electronic circuit, and energy, the energy is preferably adapted to contain the electronic circuit and energy.

[0096] 所述刺激设备优选包括至少一个传感器,用于感测患者身体参数或者运动约束设备的功能参数;和用于控制所述刺激设备的内部控制单元。 [0096] The stimulation device preferably comprises at least one sensor for measuring a physical parameter or sense the patient motion restraint device function parameters; and means for controlling the stimulation device of the internal control unit.

[0097] 通常,所述内部控制单元响应来自所述传感器的信息来控制所述刺激设备。 [0097] Typically, the internal control unit in response to information from the sensor to control the stimulation device.

[0098] 感测食管收缩波或者与食物摄入相关的任何其他参数的传感器,向所述内部控制单元发送信息,然后所述内部控制单元响应来自所述传感器的所述信息而停止刺激。 [0098] esophageal contraction wave sensing or any sensor associated with the food intake of other parameters, the internal control unit to send a message, then the internal control unit in response to the information from the sensor and stop stimulation.

[0099] 所述刺激设备在任何时候都可以由患者控制。 [0099] The stimulation device can be controlled by the patient at any time.

[0100] 刺激设备 [0100] stimulation device

[0101] 现在将描述所述装置的刺激设备。 [0101] stimulation apparatus will now be described the apparatus.

[0102] 所述控制设备可以由患者操作来控制所述刺激设备在操作模式和休止模式之间连续切换,在所述操作模式下,以能量脉冲刺激贲门括约肌,而在所述休止模式下,不刺激贲门括约肌。 [0102] The control device may operate by the patient to control the stimulation device to switch between a continuous operating mode and a sleep mode, in the mode of operation, the energy pulse stimulation to cardiac sphincter, while in the dormant mode, It does not stimulate the cardiac sphincter. (术语“患者”包括动物和人类。)在操作模式和休止模式之间连续切换带来的优势是贲门括约肌能在休止模式期间“恢复”,因此在操作模式下更为敏感。 (The term "patient" includes animals and humans.) Between the operating mode and a sleep mode switching benefits of continuous cardiac sphincter is able to sleep mode during the "recovery" and therefore more sensitive in operating mode. 另一项优势在于,这种新装置的能耗较之上述现有技术中的刺激系统显著更低。 Another advantage is that, compared to the above prior art system stimulation significantly lower power consumption of this new device. 此外,由于控制设备能由患者操作,他或她可以选择所述装置何时应该操作。 Further, since the control apparatus can be operated by the patient, he or she can choose when to operate the device. 例如,对于一些患者来说,可能在患者感觉到反流问题时保持所述装置临时“启动”就足够了,诸如在晚上患者平躺时,而其他患者可能需要保持该装置始终“启动”,除了当患者进餐时。 For example, for some patients, the patient may feel reflux problem holding the device temporarily "start" is sufficient, such as at night when the patient is lying down, while other patients may need to keep the device always "start", except when the patient meal.

[0103] 根据本发明的优选实施方式,所述装置包括能源,其中所述控制设备控制所述能源以释放能量,在所述刺激设备植入后用作所述刺激设备的动力。 According to a preferred embodiment of the present invention, the apparatus [0103] includes energy, wherein the control device controls the energy to release energy, when used as the power of the stimulation device implanted stimulation device. 因此,本发明的装置对于供应给该装置的植入部件提供简单有效的控制,这样保证所述装置的持久可靠的起作用, 可能用于患者余生或者至少使用许多年。 Thus, the device of the present invention is to supply to the implant components of the device provides a simple and effective control, thus ensuring durable and reliable functioning of the device, a patient may use the rest of his life or at least for many years.

[0104] 在优选实施方式中,所述控制设备可以从患者体外受到控制,以控制所述刺激设备来随着时间改变贲门括约肌的刺激强度。 [0104] In a preferred embodiment, the control device can be controlled from outside the patient to control the stimulation device to change over time cardiac sphincter stimulation intensity. 更具体地说,所述控制设备可以适于控制所述刺激设备改变贲门括约肌的刺激强度,以使贲门括约肌的强直性发生变化。 More specifically, the control device may be adapted to control the stimulation device to change the cardiac sphincter stimulation intensity, so that changes in cardiac sphincter of tonic. 优选,所述能源包括电能源,并且所述控制设备适于控制所述电能源向所述刺激设备输送电脉冲。 Preferably, the energy source comprises an electrical energy source, and the control device is adapted to control the electrical energy to the electrical stimulation pulse delivery device. 可以提供可植入的电开关,用于切换从所述电能源输送电脉冲。 It can provide an implantable electrical switch for switching pulse from the electric energy transport electricity. 所述开关可以由患者手动操作,或者作为替代,所述控制设备可以包括可由患者操作来控制所述开关的无线遥控器。 The switch can be manually operated by the patient, or alternatively, the control device may include a patient by controlling the operation of the wireless remote control switch.

[0105] 在所述刺激设备利用电脉冲刺激贲门括约肌的情况下,可能存在的问题是提供足够强的电压强度,以实现对贲门括约肌的期望的电刺激。 [0105] In the case of the use of electrical stimulation device stimulation pulse cardia sphincter, possible problems is to provide a sufficiently strong voltage strength, cardiac sphincter in order to achieve desired electrical stimulation. 这是因为电刺激的强度可能随着时间减弱,原因在于在电导体接合贲门括约肌的地方形成的纤维化组织增大了电阻。 This is because the electrical stimulation strength may decrease with time because of fibrotic tissue engaging local electrical conductors formed cardiac sphincter increased resistance. 这种问题由本发明的主要实施方式来解决,其中所述刺激设备包括接合贲门括约肌的电导体, 所述电能源适于提供通过所述电导体的电流,并且所述控制设备适于控制所述电能源来释放电能,以使通过所述电导体的电流强度达到预定的值。 This problem by the primary embodiment of the present invention is to solve, wherein the engagement device comprises a cardiac sphincter stimulation electrical conductor, adapted to provide a current through said electrical conductor of said electrical energy source, and the control device is adapted to control the electrical energy to release energy, so to reach a predetermined value by the current strength of the electrical conductor. 因此,由于在导体接合贲门括约肌的地方形成纤维化组织导致的电流强度下降可以得到补偿。 Thus, since the cardiac sphincter fibrotic tissue leads to the formation of local current intensity in the conductor engaging decrease can be compensated. 因此,如果通过该导体的电流下降,则控制设备自动地控制所述电能源以释放更多的电能来恢复期望的电流强度。 Therefore, if the current through the conductor decreases, the control device automatically controlling the electrical energy to release more power to recover the desired amperage.

[0106] 具有优势的是,所述控制设备适于控制所述电能源,以释放交变电流形式的能量。 [0106] Advantageously the control device adapted to control the electrical energy to release energy in the form of alternating current.

33发明人发现,与交变电流不同,直流电流可能在贲门括约肌上导致电解作用。 33 inventors have found that, with different alternating current, direct current electrolysis may result in the cardiac sphincter. 这种电解作用可能伤害贲门括约肌。 This electrolysis may harm the cardiac sphincter.

[0107] 以上全部实施方式可以与至少一个用来感测至少一个患者身体参数的可植入传感器组合,其中所述控制设备可以响应来自所述传感器的信号来控制所述刺激设备。 All the above embodiment [0107] at least one mode can be used for sensing at least one physical parameter of the patient implantable sensor combination, wherein the control device may respond to a signal from said sensor to control the stimulation device. 具体来说,所述传感器可以感测作为身体参数的由患者吞咽食物所导致的食管收缩波。 In particular, the sensor may sense esophageal contraction wave as a physical parameter measured by the patient swallowing food caused. 在这种情况下,所述刺激设备适于响应传感器感测到患者食管中的收缩波而停止刺激贲门括约肌。 In this case, the stimulation device adapted to respond to sensor senses the patient's esophagus to stop the contraction wave stimulate the cardiac sphincter.

[0108] 作为替代,所述传感器可以包括用来直接或间接感测食管内的压力的压力传感器。 [0108] Alternatively, the sensor may be used include direct and indirect sense the pressure within the esophagus of a pressure sensor. 术语“间接感测食管内的压力”应该理解为包括这种情况,即传感器感测到施加在所述刺激设备或者患者身体组织上的压力。 The term "indirect pressure sensing the esophagus" should be understood to include the case that the sensor senses the pressure exerted on the device or the patient's body tissue stimulation.

[0109] 所述控制设备可以包括内部控制单元,所述内部控制单元优选包括微处理器,可以植入患者体内用来控制所述刺激设备。 [0109] The control device may comprise an internal control unit, the internal control unit preferably comprises a microprocessor, it can be implanted in the patient for controlling the stimulation device. 所述内部控制单元影响来自所述传感器的信号而适当地直接控制所述刺激设备。 The internal control unit affects the signal from the sensor and appropriately controls the direct stimulation device. 响应来自传感器的信号,例如压力,患者位置、患者食管内的收缩波或者任何其他重要的身体参数,所述控制单元可以将与之有关的信息发送到患者体外。 In response to signals from the sensors, such as pressure, patient position, patient esophageal contraction wave or any other important physical parameter, the control unit may transmit information relating thereto to the patient's body. 所述控制单元还可以响应来自所述传感器的信号而自动地控制所述刺激设备。 The control unit may also respond to a signal from said sensor and automatically controlling the stimulation device. 例如,所述控制单元可以控制所述刺激设备,以有效地刺激贲门括约肌,以使贲门响应传感器感测到患者平躺而确定地完全闭合。 For example, the control unit may control the stimulation device to stimulate the cardiac sphincter effectively, so that the sensor senses the cardiac response to determine patient is lying down and completely closed.

[0110] 或者作为替代,所述控制设备还可以包括位于患者体外的外部控制单元,其中所述内部控制单元可以利用外部控制单元编程,例如用于随着时间控制所述刺激设备。 [0110] or alternatively, the control device may further comprises an external control unit outside the patient, wherein the internal control unit may be programmed with an external control unit, for example for controlling the stimulation device over time. 作为替代,所述内部控制单元可以根据可以适于患者需要的活动日程程序随着时间控制所述刺激设备。 As an alternative, the internal control unit can be adapted to a patient in need of Events Calendar program to control the stimulation device over time.

[0111] 所述外部控制单元也可以响应来自所述传感器的信号适当地直接控制所述刺激设备。 [0111] The external control unit may be in response to a signal from the sensor is suitably directly control the stimulation device. 所述外部控制单元可以将有关传感器感测到的身体参数的信息存储起来,并可以手动操作,以便根据存储的信息控制所述刺激设备。 The external control unit may be information about the sensor sensed body parameters stored, and can be manually operated to control the stimulation device based on the information stored. 此外,可以存在至少一个可植入的传感器,用于发送有关传感器感测到的身体参数的信息。 In addition, there may be at least one implantable sensor, the sensor transmits the relevant physical parameter sensed information is used.

[0112] 巨大的优势在于,在一天中患者愿意的任何时候,患者都能利所述控制设备借助所述刺激设备保持贲门完全闭合。 [0112] huge advantage is that at any time of day the patient is willing and able to benefit the patient by means of the control device to maintain cardiac stimulation device fully closed. 这种优势不应该被低估,因为在患者需要呕吐的情况下, 如果他无法立即停止对贲门的刺激,他将非常难于这样做。 This advantage should not be underestimated, because in the case of a patient in need vomiting, if he can not stop cardiac stimulation immediately, he will be very difficult to do so.

[0113] 方便的是,所述外部控制单元可以根据仅由医生授权的加载模式来以数据加载内部控制单元。 [0113] Conveniently, the external control unit may load the internal control unit with data only by a physician licensed in accordance with load mode. 对于刺激设备的具体控制来说,诸如电力、电脉冲频率等,所述外部控制单元可以根据仅授权用于医生的医生模式来控制所述内部控制单元。 For specific control devices for stimulation, such as electricity, electrical pulse frequency, the external control unit may only be used according to the authorization doctor doctors mode to control the internal control unit. 为了简单地控制所述刺激设备,诸如“启动”或“停止”,所述外部控制单元可以根据允许用于患者的患者模式来控制所述内部控制单元。 In order to easily control the stimulation device, such as a "start" or "stop", the external control unit may be used in accordance with the patient mode allows the patient to control the internal control unit. 因此,通过根据不同模式使用所述外部控制单元,可以让刺激设备的某些功能由患者控制,而其他更为高级的功能由医生控制,这样允许灵活地对患者进行术后治疗。 Thus, by using the external control unit depending on the mode, the stimulation device can make some functions controlled by the patient, and other more advanced functions controlled by the doctor, which allows flexibility in the patient after treatment.

[0114] 所述控制设备可以适于控制所述能源,以释放能量,例如间歇性地以能量脉冲串的形式释放能量,直接用作刺激设备的动力。 [0114] The control device may be adapted to control the energy to release energy, e.g., energy to intermittently release energy in the form of a burst, stimulate direct use as power devices. 根据适当的实施方式,所述控制设备控制所述能源,以释放能量,并且所述装置进一步包括可植入的电容器,用于从被释放的能量产生能量脉冲串。 According to a suitable embodiment, the control device controls the energy to release energy, and the apparatus further comprises an implantable capacitor for producing energy from a burst of energy is released. 在这种情况下,术语“直接” 一方面用来指代所释放的能量在由控制设备释放时,所释放的能量也被使用,另一方面用来指代在用作刺激设备的动力之前,所释放的能量例如可以利用能量稳定器而施加秒级的延时。 Before this case, the energy term "direct" is used to refer to aspect when released by the release control device, the energy released is also used, on the other hand is used to refer to the power generation of the stimulation device , the energy released may be applied, for example, the use of energy-second delay stabilizer.

[0115] 以下描述的是有关能量供应和控制的进一步实施方式。 [0115] The following is a further implementation of the relevant energy supply and control the manner described. 所有的实施方式都可以用于本申请中全部不同的适用实施方式,而不仅仅用于刺激设备。 All embodiments may be used in the present application, all of the different embodiments applies, not just for the stimulation device.

[0116] 根据本发明的实施方式,所述装置包括可植入的电气部件,所述电气部件包括至少一个或者仅包括一个单电压水平保险装置和电容器或蓄能器,其中电容器或者蓄能器的充电和放电利用该电压水平保险装置来控制。 According to an embodiment of the present invention, the device [0116] comprising implantable electrical components, the electrical component comprising at least one or only one single voltage level safety device and a capacitor or accumulator, wherein the capacitor or accumulator The charging and discharging of the voltage level of the use of safety devices to control.

[0117] 在一种实施方式中,所述能源位于患者体外,并且所述控制设备控制所述能源来释放无线能量。 [0117] In one embodiment, said energy source located outside the patient, and the control device controls the energy to release the wireless energy. 储能设备,优选电蓄能器,可以植入患者体内,用于存储从外部能源释放的无线能量。 Energy storage device, preferably electric accumulator, may be implanted in the patient for storing the wireless energy released from the external source. 所述电蓄能器可以包括至少一个电容器或者至少一个可充电电池,或者至少一个电容器和至少一个可充电电池的组合体。 The electric accumulator may comprise at least one capacitor or at least one rechargeable battery, or at least one capacitor and at least one rechargeable battery assembly. 作为替代,电池可以植入患者体内,除了供应无线能量之外,还用于向该装置的植入式耗电部件供应电能。 As an alternative, the battery can be implanted in a patient, in addition to the supply of wireless energy, but also for power to the implantable components of the device power supply. 在控制设备包括可植入的控制单元的情况下,所述控制设备的电路和所述刺激设备可利用转化来的无线能量或者来自植入式储能设备或电池的能量直接提供动力。 In the case of the control device comprises an implantable control unit, said control circuit device and the device can be used to stimulate the conversion to wireless energy or energy from the implanted energy storage device or battery powered directly.

[0118] 在一种实施方式中,无线能量直接用于为刺激设备提供动力,即当利用所述控制设备从所述外部能源释放无线能量时,向所述刺激设备提供动力。 [01] In one embodiment, the wireless energy directly used to provide power for the stimulation device that, when released by the control device when the wireless energy from the external energy to the stimulation device to power. 在这种情况下,术语“直接”一方面用来指代所述刺激设备利用所述释放的能量立即提供动力,而不会首先存储能量,另一方面用来指代在用于为刺激设备提供动力之前,所释放的能量例如可以利用能量稳定器发生秒级的延迟。 In this case, the term "directly" on the one hand to use the released energy device refers to power the stimulation immediately, without first stored energy, on the other hand used to refer to the equipment used to stimulate Before providing power, the energy released can be used, for example, the energy level of the second stabilizer delay occurs. 无线能量可以用来产生直接的动能,直接影响所述装置的无线场, 或者利用能量转化设备,即将无线能量转化成电能,该电能可以用来在无线能量发射过程中直接给所述装置的任何耗能部件提供动力,或者在给蓄能器充电之后,间接提供动力。 Any wireless energy may be directly used to generate kinetic energy, directly affects the wireless field device, or the use of energy conversion devices, i.e. wireless energy into electrical energy, which can be used to transmit wireless energy directly to the process of the apparatus energy components powered, or after the accumulator charge to indirectly provide the impetus. 因此,实现了非常简单的刺激设备控制,并且仅存在所述装置的少数植入部件。 Therefore, to achieve a very simple stimulation device control, and there are only a few implanted components of the device. 例如,不存在植入式能源,诸如电池,也不存在植入式复杂信号控制系统。 For example, there is no implanted energy, such as a battery, there is no implanted complicated signal control system. 这样带来的优势在于,所述装置将极其可靠。 Such benefits that the device will be extremely reliable.

[0119] 在一种实施方式中,所述能源包括可植入的能源。 [0119] In one embodiment, the energy source comprises an implantable energy. 因此,在内部能源植入患者体内时,所述控制设备从患者体外控制它,以释放能量。 Therefore, when the internal energy implanted in a patient, the control device controls it from outside the patient, to release the energy. 对于所述装置的复杂实施方式来说,其中所述装置具有相对较高的能耗,并且无法利用直接供应无线能量来满足,则这种方案具有优势。 For complex is an embodiment of the apparatus, wherein said apparatus has a relatively high energy consumption, and can not be used to meet the direct supply of wireless energy, this arrangement is advantageous. 所述内部能源优选包括电能源,诸如蓄能器或电池。 The internal energy preferably comprises electric energy, such as accumulators or batteries. 作为替代,所述控制设备可以适于从所述内部能源释放无线能量,并控制所述刺激设备,以所释放的无线能量刺激患者的贲门括约肌。 Alternatively, the control device may be adapted to release wireless energy from the internal energy, and controlling the stimulation device, the wireless energy released to stimulate the patient's cardiac sphincter. 所述无线能量可以包括辐射能或者声能,诸如超声能量。 The wireless energy may comprise radiant energy or acoustic energy, such as ultrasonic energy.

[0120] 在本发明的一种实施方式中,所述装置包括植入患者体内的开关,用于直接或间接切换刺激设备的动力;和植入患者体内的内部电能源,诸如电池,用于供应电能作为刺激设备的动力,其中所述开关直接或间接影响从所述内部电能源供应电能。 [0120] In one embodiment of the present invention, the apparatus comprises a switch implanted in the patient for directly or indirectly switching the power of the stimulation device; and implanted in the patient's internal electrical energy source, such as a battery, for Supply of electricity as power-stimulation device, which directly or indirectly affect the switch from the internal electrical energy supply electrical energy. 对于具有相对较高的能耗并且无法通过直接供应无线能量来满足的本发明的实施方式来说,这种方案具有优势。 For the embodiment with a relatively high power consumption and can not meet the direct supply of wireless energy to the present invention, this scheme has the advantage.

[0121] 在本发明一种实施方式中,所述开关在“停止”模式和“启动”模式之间切换,在所述停止模式下,不使用内部电能源,而在所述启动模式下,内部电能源供应电能作为刺激设备的动力。 [0121] In one embodiment of the invention, the switch between the "stop" mode and the "Start" mode switch in the stop mode, without the use of internal electrical energy, and in the start-up mode, Internal electrical energy supply electricity as power-stimulation device. 在这种情况下,利用从所述外部能源释放的无线能量方便地操作所述开关,以便在“启动”和“停止”模式之间切换。 In this case, the use of wireless energy from the external energy released easily operate the switch, so that between the "start" and "stop" mode. 所述控制设备优选包括无线遥控器,可以控制所述外部能源,以释放无线能量。 The control apparatus preferably includes a wireless remote control, you can control the external energy to release wireless energy. 这种实施方式的优势在于,植入式电能源诸如电池的使用寿命可以显著延长,因为植入式能源在所述开关处于停止模式时不供应能量。 The advantage of this embodiment is that implantable electrical energy source such as a battery life can be significantly prolonged, since the energy does not supply energy implanted when the switch is in the stop mode.

[0122] 在一种实施方式中,所述控制设备包括无线遥控器,用于控制所述内部电能源。 [0122] In one embodiment, the control device comprises a wireless remote control for controlling the internal electrical energy. 在这种情况下,所述开关利用来自外部能源的无线能量操作,以便在“停止”模式和“待命”模式之间切换,在所述停止模式下,不使用所述内部电能源和遥控器,而在所述待命模式下, 允许所述遥控器控制所述内部电能源提提供电能作为刺激设备的动力。 In this case, the switch using the wireless energy from the external energy operation, so that between the "stop" mode and the "standby" mode switch in the stop mode, without the use of electrical energy and the internal remote control , while in the standby mode, the remote control allows the internal electrical energy can be used as the power supply mention stimulation device.

[0123] 在一种实施方式中,所述装置进一步包括:植入患者体内的能量转化设备,用于将无线能量转化成可存储的能量;和用于存储所述可存储的能量的可植入的储能设备,其中所述开关能利用来自所述植入式储能设备的能量在“停止”模式和“启动”模式之间切换, 在所述停止模式下,不使用所述内部电能源,而在所述启动模式下,所述内部电能源提提供电能作为所述刺激设备的动力。 [0123] In one embodiment, the apparatus further comprising: a patient implanted energy transforming device for transforming the wireless energy into storable energy; and means for storing the energy that can be stored in the implantable into the energy storage device, wherein the switch can use the energy from the implanted energy storage device between the "stop" mode and the "start" mode switch in the stop mode, the internal circuit is not used energy, and in the start-up mode, the internal electrical energy source can be used as the power supply mention the stimulation device. 在这种情况下,所述控制设备适当地包括无线遥控器,用于控制所述储能设备来操作所述开关。 In this case, the control device suitably includes a wireless remote control for controlling the energy storage device to operate the switch.

[0124] 可以在患者体外提供外部数据通信器,并且可以在患者体内植入内部数据通信器,用于与所述外部数据通信器通信。 [0124] the external data communicator may be provided outside the patient, and an internal data communicator may be implanted in the patient for communicating with the external data communicator. 所述内部通信器可以将有关患者或者有关刺激设备的数据回馈到所述外部数据通信器。 The internal communicator may be reserved data about the patient, or related to the stimulation device to the external data communicator. 作为替代或者相组合,所述外部数据通信器可以向所述内部数据通信器馈送数据。 Alternatively or in combination, the external data communicator may feed data to the internal data communicator. 所述内部数据通信器可以适当地馈送有关至少一个患者身体参数的数据。 The internal data communicator may suitably feed data related to at least one physical parameter of the patient.

[0125] 适当的是,可植入的稳定器,诸如电容器、可充电蓄能器等,可以用于稳定由所述控制设备释放的电能。 [0125] Suitably, an implantable stabilizer, such as a capacitor, a rechargeable accumulator or the like, may be used to stabilize the control apparatus by a release of energy. 此外,所述控制设备可以控制所述能源以释放能量并持续确定的时间周期或者释放确定数量的能量脉冲。 Further, the control device may control the energy to release energy and duration determined period of time or to release a determined number of energy pulses.

[0126] 上述实施方式全部优选进行遥控。 [0126] All the above-described preferred embodiments remote control. 因此,所述控制设备具有优势地包括无线遥控器,用于发射至少一个无线控制信号,用于控制所述刺激设备。 Thus, the control device advantageously comprises a wireless remote control for transmitting at least one wireless control signal for controlling the stimulation device. 利用这种遥控器,可以将所述装置的功能适于患者日常需要,这对于治疗患者有好处。 With this remote control, the function of the apparatus may be adapted to the daily needs of the patient, which is good for the treatment of patients.

[0127] 所述无线遥控器能获得有关刺激设备状态的信息并能响应所述信息来控制刺激设备。 [0127] The wireless remote control to get information about the stimulation device status and can respond to the information to control the stimulation device. 而且,所述遥控器能从患者体内将有关刺激设备的信息发送到患者体外。 Also, the remote control from the patient's body will send information about the stimulation device to the patient's body.

[0128] 在本发明的特定实施方式中,所述无线遥控器包括至少一个外部信号发射器或收发器和可植入患者体内的至少一个内部信号接收器或收发器。 [0128] In certain embodiments of the present invention, the wireless remote control comprises at least one external signal transmitter or transceiver and can be implanted in a patient at least one internal signal receiver or transceiver. 在本发明另一种特定实施方式中,所述无线遥控器包括至少一个外部信号接收器或者收发器;和可植入患者体内的至少一个内部信号发射器或收发器。 In another particular embodiment of the invention, the wireless remote control comprises at least one external signal receiver or transceiver; and implanted in a patient at least one internal signal transmitter or transceiver.

[0129] 所述遥控器可以发射载波信号,用于承载所述控制信号,其中所述载波信号为频率、幅值或频率和幅值调制信号,并且是数字、模拟或者数字和模拟信号。 [0129] The remote control may transmit a carrier signal for carrying the control signal, wherein the carrier signal is frequency, amplitude or frequency and amplitude modulated signal, and a digital, analog or digital and analog signals. 而且,用于载波信号的控制信号可以是频率、幅值或者频率和幅值调制信号。 Further, the control signal for the carrier signal may be frequency, amplitude or frequency and amplitude modulated signal.

[0130] 所述控制信号包括波形信号,例如声波信号诸如超声波信号,电磁波信号诸如红外光信号、可见光信号、紫外光信号、激光信号、微波信号、无线电波信号、X射线辐射信号, 或者伽马辐射信号。 [0130] The control signal comprises a wave signal, for example, an ultrasonic acoustic signal such as a signal, an electromagnetic wave signal, such as an infrared light signal, a visible light signal, an ultraviolet light signal, a laser signal, a microwave signal, a radio wave signal, X-ray radiation signal or a gamma radiation signal. 如果合适,两种或者更多种上述信号可以组合。 If appropriate, two or more of the above signals may be combined.

[0131 ] 所述控制信号可以是数字或模拟信号,并且可以包括电场或磁场。 [0131] The control signal may be a digital or analog, and may comprise an electric field or a magnetic field. 适当的是,所述无线遥控器可以发射电磁载波信号,用于承载数字或模拟控制信号。 Suitably, the wireless remote control may transmit an electromagnetic carrier signal carrying the digital or analog control signal. 例如,使用模拟载波信号承载数字控制信号将提供安全通信。 For example, the use of analog carrier signals carrying the digital control signal will provide secure communications. 所述控制信号可以由所述无线遥控器以脉冲发射。 The control signal may be a pulse emitted by the wireless remote control. [0132] 所述控制设备可以采用手动方式或非手动方式激活,以控制所述能源释放能量。 [0132] The control device may be manually or non-manually activated using, for controlling the energy to release energy. [0133] 在上述本发明的实施方式中,被释放的能量可以包括电能,并且具有小于0. 1 μ F 的容量的可植入的电容器可以用于产生上述能量脉冲串。 [0133] In an embodiment of the present invention, the energy released may include energy, and an implantable capacitor having a capacity less than 0. 1 μ F may be used to produce the above-described energy burst.

[0134] 一般来说,所述无线能量包括信号。 [0134] Generally, the wireless energy comprises a signal.

[0135] 所述装置可以进一步包括可植入的能量转化设备,用于将例如表现为声波形式的无线能量直接或间接转化成电能,用于给刺激设备提供动力。 Means [0135] may further comprise an implantable energy conversion device for example, the performance of the acoustic form of wireless energy into electricity, directly or indirectly, to provide power to the stimulation device. 更具体地说,所述能量转化设备可以包括电容器,该电容器适于从所述转化的电能产生电脉冲。 More specifically, the energy conversion device may comprise a capacitor adapted to produce electric pulses from the transformed electric energy.

[0136] 一般来说,刺激设备具有优势地嵌入柔软或凝胶状材料中,诸如硬度小于20舒尔的硅酮材料。 [0136] In general, the stimulation device has advantages embedded in soft or gel-like material, such as hardness of less than 20 Shure silicone material.

[0137] 所述刺激设备可以包括用于围绕贲门施加的带材,其中所述带材具有接触贲门括约肌的电导体。 [0137] The stimulation device may include a strip around the cardia applied, wherein the strip has contact with the electrical conductor cardiac sphincter. 所述电导体可以包括挂钩,以便将所述导体固定在贲门上。 The electrical conductor may include a hook to be fixed on the conductor cardia. 本发明还提供一种用于治疗烧心和反流疾病的系统,所述系统包括可植入的刺激设备,所述刺激设备适于刺激患者贲门括约肌,以增大括约肌强直性;和控制设备,所述控制设备控制所述刺激设备在操作模式和休止模式之间连续切换,在所述操作模式下,利用能量脉冲刺激贲门括约肌,而在所述休止模式下,不刺激贲门括约肌。 The present invention also provides a system for treating heartburn and reflux disease, the system includes an implantable stimulation device, the stimulation device is adapted to stimulate the patient cardiac sphincter to increase sphincter tonic; and control equipment, The control device controls the stimulation device to switch between continuous operation mode and a sleep mode, in the operating mode, use energy pulses to stimulate cardiac sphincter, while in the sleep mode, does not stimulate the cardiac sphincter. 所述能量脉冲可以包括电脉冲。 The energy pulses may comprise an electrical pulse. 所述刺激设备可以包括用于接合贲门括约肌的电导体,并且电能源可以适于提供通过所述电导体的电流,以形成所述电脉冲。 The stimulation device may comprise for engaging cardiac sphincter electrical conductors, and the electrical energy can be adapted to provide electrical current through said conductor to form the electrical pulses. 具有优势的是,所述控制设备可以控制所述电能源来释放电能,以使通过所述电导体的电流达到预定的值。 It has the advantage that the control device may control the electrical energy to release energy, so to reach a predetermined value of the electrical current through the conductor.

[0138] 在适当的情况下,全部上述各种部件可以在不同的实施方式中组合。 [0138] In appropriate circumstances, all of these various components can be combined in various embodiments. 而且,在适当的情况下,针对本发明上述实施方式描述的各种功能可以用于不同应用。 Further, in appropriate cases, the various functions for the above-described embodiments of the invention described herein may be used for different applications.

[0139] 在说明书中陈述的全部各种传输能量和控制能量的方式可以通过使用所述的各种部件和方案来实践。 [0139] All the various transport energy and control energy manner set forth in the specification may be practiced by the use of the various components and programs.

[0140] 本发明还提供用于治疗烧心和反流疾病的方法。 [0140] The present invention also provides a method for the treatment of heartburn and reflux disease.

[0141] 相应地,根据第一替代方法,提供了一种治疗烧心和反流疾病的方法,所述方法包括步骤:在患者体内植入刺激设备,以使所述刺激设备接合贲门;和控制所述刺激设备以连续在操作模式和休止模式之间切换,在所述操作模式下,利用能量脉冲刺激贲门括约肌以增加括约肌强直性,以使贲门完全闭合,而在所述休止模式下,不刺激贲门括约肌。 [0141] Accordingly, according to the first alternative, there is provided a method of treating heartburn and reflux disease, the method comprising the steps of: in vivo stimulation device implanted in a patient, so that the engagement cardiac stimulation device; and control The stimulation device to continuously between the operating mode and a sleep mode switching, in the mode of operation, the use of the energy pulse stimulation to increase sphincter ankylosing cardiac sphincter, cardia completely closed so that, while in the sleep mode, is not stimulate cardiac sphincter.

[0142] 第一替代方法还可以利用腹腔镜来实现。 [0142] The first alternative method can also use laparoscopy to achieve. 因此,提供了一种治疗烧心和反流疾病的腹腔镜方法,所述方法包括步骤:利用腹腔镜在患者体内植入刺激设备,以使所述刺激设备接合贲门;和控制所述刺激设备以连续在操作模式和休止模式之间切换,在所述操作模式下,利用能量脉冲刺激贲门括约肌以增加括约肌强直性,以使贲门完全闭合,而在所述休止模式下,不刺激贲门括约肌。 Thus, there is provided a method of treating laparoscopic reflux disease and heartburn, said method comprising the steps of: use of laparoscopy in vivo stimulation device implanted in a patient, so that the engagement cardiac stimulation device; and control the stimulation device to between continuous operation mode and the sleep mode switching, in the mode of operation, the use of the energy pulse stimulation to increase sphincter ankylosing cardiac sphincter, cardia completely closed so that, while in the sleep mode, does not stimulate the cardiac sphincter.

[0143] 根据第二替代方法,提供了一种治疗患有烧心和反流疾病的患者的方法,所述方法包括: [0143] According to the second alternative method, a method of a patient suffering from heartburn and reflux disease treatment, said method comprising:

[0144] (a)在患者体内手术植入接合贲门的电刺激设备; [0144] (a) in vivo cardiac surgery patients with implanted electrical stimulation devices engaged;

[0145] (b)在患者体外提供能源; [0145] (b) the provision of energy in the patient's body;

[0146] (c)从患者体外控制所述能源,以释放无线能量;和 [0146] (c) control patients from outside the energy to release wireless energy; and

[0147] (d)利用所述释放的无线能量为所述刺激设备提供动力。 [0147] (d) utilizing the wireless energy released by the stimulation device is powered.

[0148] 所述第二替代方法可以进一步包括植入能量转化设备;控制所述外部能源以释放无线能量;和利用所述能量转化设备将所述无线能量转化为不同于所述无线能量的能量, [0148] The second alternative method may further comprise implantable energy transforming device; controlling the external energy to release wireless energy; and using said energy conversion device to the wireless energy into energy different than the wireless energy ,

37用于为所述刺激设备提供动力。 37 is used to power the stimulation device. 所述方法可以进一步包括在患者体内植入稳定器,用于稳定由所述能量转化设备转化的能量。 The method may further comprise implanting a stabilizer in the patient for stabilizing the energy transformed by the energy conversion device.

[0149] 还提供了一种治疗烧心和反流疾病的方法,所述方法包括步骤:在患者体内植入刺激设备,以接合贲门括约肌;提供控制设备控制所述刺激设备以刺激贲门括约肌来增加括约肌强直性,以使贲门完全闭合;和允许患者操作所述控制设备来改变刺激强度。 [0149] also provides a method of treating heartburn and reflux disease, the method comprising the steps of: stimulation device implanted in a patient to engage the cardiac sphincter; providing a control device to control the stimulation device to stimulate the cardiac sphincter to increase sphincter tonic to make cardia completely closed; and operating the control device allows the patient to change the intensity of stimulation.

[0150] 在一种实施方式中,提供了一种装置,其中利用能量脉冲刺激贲门括约肌以增加括约肌强直性,以使贲门完全闭合,并且所述控制设备可以由患者操作,患者可以将其设置为停止操作,其中所述控制设备由患者操作,将所述刺激设备设置成进行操作,其中在操作状态下,所述刺激设备在操作模式和休止模式之间连续切换,在所述操作模式下,利用所述能量脉冲刺激贲门括约肌,而在所述休止模式下,不刺激贲门括约肌,其中所述装置进一步包括至少一个可植入的传感器,用于感测患者的至少一个身体参数,其中所述控制设备适于控制所述刺激设备,以停止在操作模式和休止模式之间的连续切换,并且响应传感器感测到患者的身体参数而将所述刺激设备设置在休止模式。 [0150] In one embodiment, there is provided an apparatus, wherein the use of the energy pulse stimulation to increase cardiac sphincter sphincter ankylosing so cardia completely closed, and the control device may operate by the patient, the patient can be set to stop the operation, wherein said operation control device by the patient, the stimulation device arranged to operate, which in the operating state, the stimulation device successively switching between the operating mode and the sleep mode, in the mode of operation using said energy pulse stimulation cardiac sphincter, while in the sleep mode, does not stimulate the cardiac sphincter, wherein said apparatus further comprises at least one implantable sensor for sensing at least one physical measured patient parameter, wherein said control device is adapted to control the stimulation device to stop the continuous switching between the operating mode and the sleep mode, and in response to the sensor sensing a physical parameter of a patient and the stimulation device disposed in the sleep mode.

[0151] 在一种实施方式中,提供了一种装置,其中利用能量脉冲刺激贲门括约肌以增加括约肌强直性,以使贲门完全闭合,并且所述控制设备可以由患者操作,患者可以将其设置为停止操作,其中所述控制设备由患者操作,将所述刺激设备设置成进行操作,其中在操作状态下,所述刺激设备在操作模式和休止模式之间连续切换,在所述操作模式下,利用所述能量脉冲刺激贲门括约肌,而在所述休止模式下,不刺激贲门括约肌,其中所述装置进一步包括至少一个可植入的传感器,用于感测作为患者身体参数的由患者吞咽食物导致的食管收缩波,其中所述控制设备适于控制所述刺激设备,以停止在操作模式和休止模式之间的连续切换,并且响应传感器感测到患者的食管收缩波而将所述刺激设备设置在休止模式。 [0151] In one embodiment, there is provided an apparatus, wherein the use of the energy pulse stimulation to increase cardiac sphincter sphincter ankylosing so cardia completely closed, and the control device may operate by the patient, the patient can be set to stop the operation, wherein said operation control device by the patient, the stimulation device arranged to operate, which in the operating state, the stimulation device successively switching between the operating mode and the sleep mode, in the mode of operation using said energy pulse stimulation cardiac sphincter, while in the sleep mode, does not stimulate the cardiac sphincter, wherein said apparatus further comprises at least one implantable sensor for sensing a physical parameter of the patient by the patient swallowing food esophagus caused by contraction wave, wherein the control device is adapted to control the stimulation device to stop the continuous switching between the operating mode and the sleep mode, and in response to the sensor sensing the patient's esophagus and the contraction wave stimulation device Set in the sleep mode.

[0152] 表面结构 [0152] surface structure

[0153] 现在描述本发明的各种植入件的表面结构。 [0153] Now to describe various implant surface structure of the present invention.

[0154] 本发明涉及植入件,所述植入件适于可以术后调节并且包括至少一个可扩展区段,其中所述植入件适于可以在第一塌缩状态和第二扩张状态之间调节。 [0154] The present invention relates to implant, said implant is adapted to be adjusted after and including at least one expandable section, wherein the implant is adapted to be collapsed in a first state and a second expanded state adjust between. 在所述第一塌缩状态下,所述可扩张区段塌缩,而在所述第二扩张状态下,所述可扩张区段扩张。 In the first collapsed state, the expandable section collapsed, while in the second expanded state, the expandable segment expansion. 所述可扩张区段的外表面至少部分地包括升高区域和降低区域交替的表面结构。 The outer surface of the expandable section at least partially comprises raising and lowering the surface area regions of alternating structure. 所述可扩张区段适于,在所述第一塌缩状态和第二扩张状态至少其中一种状态下,在相邻的升高区域之间具有第一距离,所述第一距离充分扩展以防止纤维化组织生长直接互联相邻的升高区域达到损害所述植入件在第一塌缩状态和第二扩张状态之间的调节性的程度。 The expandable section is adapted, at least one state, between adjacent elevated region having a first distance in said first collapsed state and a second expanded state, said first distance sufficiently spread to prevent the growth of fibrotic tissue adjacent to the raised area directly interconnected to achieve the degree of damage to the implant adjustability between a first collapsed state and a second expanded state. 所述可扩张区段进一步包括位于相邻的升高区域和降低区域之间的连接区域,所述可扩张区段进一步适于, 在所述第一塌缩状态和第二扩张状态至少其中一种状态下,在相邻的连接区域之间具有第二距离,所述第二距离充分扩展,以防止纤维化组织生长直接互联相邻的连接区域达到损害所述植入件在第一塌缩状态和第二扩张状态之间的调节性的程度。 The expandable section further includes a raised area adjacent to and lower the connection area between the regions, the expandable section is further adapted to, at least in the first collapsed state and a second expanded state By state, the connection between the adjacent region having a second distance, the second from the fully extended to prevent the growth of fibrotic tissue direct Internet connection region adjacent to affect prejudicially the implant in the first collapse the degree of regulatory status and the second expansion states.

[0155] 根据一种实施方式,所述可扩张区段为中空区段,或者包括中空主体。 [0155] According to one embodiment, the expandable segment of hollow section, or comprise a hollow body.

[0156] 根据另一种实施方式,所述植入件基本上完全中空,或者包括基本上沿着所述植入件的全部长度和/或全部体积延伸的中空主体。 [0156] According to another embodiment, the implant is substantially completely hollow or comprises substantially along the entire length of the implant, and / or all of the volume of the hollow body extends.

[0157] 纤维化组织通常可以具有大约0. 5mm到大约1. 5mm的延伸度或厚度,因此所述表面结构的元件的相关表面之间的距离适当地大于大约3mm,因此大于大约hi. 5mm。 [0157] Fibrosis typically may have from about 0. 5mm to about 1. 5mm thickness or degree of elongation, and therefore the surface element associated distance between the surface structure is suitably greater than about 3mm, and therefore greater than about hi. 5mm . 但是根据情况,大于大约1. Omm到大约3mm的距离也可能就足够。 However, according to circumstances, greater than about 3mm to about 1. Omm distance might be sufficient. 在纤维化组织预期延伸度或厚度超过大约1. 5mm的情况下,所述表面结构的元件的相关表面之间的距离以适当的方式适配。 In the case of fibrosis or anticipated elongation greater than about 1. 5mm thickness, the distance of the relevant surface element between the surface structure adapted in an appropriate manner.

[0158] 所述表面结构包括升高和降低区域,并且可以适当地让升高和降低区域的不同平面之间的距离大于特定的阈值,以便于所述植入件的塌缩和/或扩张功能。 [0158] The surface structure comprising elevated and lowered areas, and may be suitably raised and lowered so that the distance between the different planes region is greater than a certain threshold, in order to collapse the implant and / or expansion function. 如果所述距离太小,则所述植入件的塌缩和/或扩张功能会受到限制。 If the distance is too small, the collapse of the implant and / or expansion of the functions are restricted. 用于所述距离的适当间隔是大约0. 5到10mm,更适当的是大约2_8mm,最适当的是大于3_7mm。 Suitable interval for said distance is about 0.5 to 10mm, more suitably about 2_8mm, most suitably greater than 3_7mm. 所述表面结构可以包括不同的几何元件或形状,并且只要能满足上述条件,也可以是这些元件或形状的任意组合。 The surface structure may comprise different geometrical elements or shapes, and as long as the above conditions are satisfied, it can be any element or combination of these shapes. 所述表面结构例如可以包括不同形状的凸棱和凹槽。 The surface structure may comprise different shapes such as ribs and grooves. 所述凸棱和凹槽可以分别具有例如楔形、 多边形、方形、四边形、四面体形状、截头四面体形状。 The ribs and grooves may each have a wedge e.g., polygonal, square, quadrilateral, tetrahedral shape, truncated tetrahedral shape. 此外,所述凸棱和凹槽可以具有不同形状。 Further, the ribs and grooves may have different shapes. 所述表面结构一般也可以包括波纹件结构,或者相同或不同类型的几何物体置于表面上的表面结构。 The surface structure may comprise a generally bellows configuration, or the same or different types of geometric objects placed on the surface of the surface structure. 所述几何物体实际上可以随机地安置在表面上,或者根据某种机制来安置。 The geometric object can actually be randomly placed on the surface, or according to some mechanism to placement.

[0159] 这种表面结构可能适合的一种植入件是有能力显著改变形状和/或尺寸的植入件。 [0159] Such a surface structure may be suitable for one implant it is able to significantly change the shape and / or size of the implant. 因此,纤维化组织的存在明显可能影响或阻碍所述植入件的功能的情形就是这种情况。 Thus, there is significant fibrosis may affect or impede the function of the implant case is the case. 但是,所述表面结构可以被任何植入件使用,其中表面结构的特性应该对该植入件具有优势。 However, the surface structure may be used in any implant, wherein the characteristic of the surface structure of the implant should be an advantage.

[0160] 结合吧胖治疗 [0160] it fat combination therapy

[0161] 各种实施方式可以与各种方法组合来治疗肥胖。 [0161] Various embodiments may be combined with a variety of methods to treat obesity. 以下特别描述两个实施方式,一个包括牵拉设备,而另一个包括体积填充设备。 The following description of two particular embodiments, comprises a pulling device and the other comprises a volume filling device.

[0162] 用于治疗肥胖的牵拉设备 [0162] for the treatment of obesity pulling equipment

[0163] 请注意,在适当的情况下,全部实施方式或实施方式的部分或者方法可以用于本申请中的全部不同实施方式。 [0163] Note that, in appropriate cases, the implementation of all or part of the method or methods may be used in embodiments of the present application in all different embodiments. 除了各种实施方式,用于治疗反流的装置可以与用于治疗肥胖的设备相结合,基础是发现通过对胃壁造成牵拉作用,可以产生饱足感。 In addition to various embodiments, an apparatus for the treatment of reflux apparatus may be used in combination with obesity treatment, is found based on the stomach wall caused by the pulling effect, can produce satiety. 借助提供一种带有牵拉设备的装置,并且牵拉设备牵拉一部分胃壁,提供了一种更简单、更安全和更长久的工作装置。 With the provided device with a traction device and traction device traction portion of the stomach wall, it provides a simpler, more secure and more long-term working mechanism.

[0164] 术语“提供了动力”应该立即为利用任何事物激励二不需手工作用力,优选使用电能。 [0164] The term "provided the impetus" should immediately use anything excitation two without manual force, it is preferable to use electricity. 换句话说,调节设备以非手动的方式操作。 In other words, the regulating device in a non-manual manner. 术语“非手动的方式”应该理解为指的是调节设备不通过手动接触皮下植入的装置部件来操作,也不通过接触患者皮肤来调节。 The term "non-manual manner" should be understood to mean that the device does not contact the regulating member implanted subcutaneously by means manually operated, nor to adjust the patient by skin contact. 因此, 与现有技术中治疗肛门失禁不同,本发明的调节设备并不通过手工作用力来操作,诸如不通过手工按压植入患者阴囊或大阴唇区域中的含流体球胆来操作。 Thus, the prior art different incontinence treatment, conditioning device of the present invention is not operated by manual forces, such as implanted in a patient without manually pressing the scrotum or labia majora region of the fluid-containing bladder to operate the ball. 当然,也可以使用手动操作植入式容器或者其他机械或液压技术方案以及手动操纵皮下启动按键等机构用来激活提供了动力的操纵设备,在本发明的范围内,任何情况都是允许的。 Of course, you can use the manual operation of implantable containers or other mechanical or hydraulic technology programs, and manual control subcutaneous start button and other agencies to provide a power steering activation device, within the scope of the present invention, in any case is allowed.

[0165] 作为替代或者优选与提供有动力的操作设备相结合,可以使用伺服装置,所述伺服装置允许例如马达以高速和低作用力运行,并且例如利用齿轮箱来降低速度并增大作用力或扭矩。 [0165] Alternatively, or preferably an operating device is provided with a combination of power, you can use the servo means, such as a motor of the servo means to allow to run at high speed and low force, and for example the use of the gearbox to reduce speed and increase force or torque. 所述伺服装置可以包括液压装置、电控装置、磁性装置或者机械装置,这些装置可以通过手动操作装置和/或遥控器来激活。 The servo means may comprise hydraulic means, electric control means, magnetic means, or mechanical means, such means may be activated by manual means and / or the remote control. 采用伺服系统将节省调节所述调节设备所用的作用力,这对于许多场合非常重要。 Adjusted using the servo system will save the adjustment force device used, which is very important for many occasions.

[0166] 术语“伺服装置”包括通常定义的伺服机构,即借助非常少量的动力控制大量动力的自动设备,但是可以替代地或另外包括这样定义的机构,即该机构将作用在行程较长的运动元件上的弱作用力转化为作用在行程较短的另一运动元件上的强作用力。 [0166] The term "servo means" includes generally defined servo mechanism, i.e., by means of a large number of very small amounts of power of the automatic power control device, but may alternatively or additionally include means thus defined, i.e., the agency will act longer stroke weak force on the moving element into another stronger force on the moving elements of the short trip. 所述伺服装置可以包括马达,优选电动马达,该马达可以反向。 The servo means may comprise a motor, preferably an electric motor, the motor can be reversed.

[0167] 作为替代,或者优选地与手动操作相结合,可以使用反向伺服装置,该反向伺服装置例如允许患者的手使用较大的作用力例如用于调节液压容器来以强作用力移动少量流体,以控制更大量的流体。 [0167] Alternatively, or preferably combined with a manual operation, a reverse servo may be used, for example, the reverse servo means allow the patient's hand, for example using a larger force for regulating a hydraulic container with a strong force to move a small amount of fluid, in order to control a greater amount of fluid. 这种反向伺服装置可以包括液压装置、电控装置、磁性装置或机械装置,这些装置可以用手动操作装置和/或遥控装置激活。 Such a reverse servo means may comprise hydraulic means, electric control means, magnetic means, or mechanical means, such means may be activated by manual means and / or the remote control device. 使用反向伺服系统将节省调节调节设备时所用的行程,这对于许多场合非常重要。 Using a reverse servo system will save the adjustment device used when adjusting stroke, which is very important for many occasions.

[0168] 术语“反向伺服装置”包括这样定义的设备,即该设备利用较高的作用力和较小的行程控制,即例如以强作用力移动少量流体而通过非常小的作用力控制大量流体移动,但是也可以替代地或者另外包括这样定义的机构,即该机构将作用在行程较短的运动元件上的强作用力转化为作用在行程较长的另一运动元件上的小作用力。 [0168] The term "reverse servo means" includes such devices as defined, i.e., the use of the apparatus and smaller high force stroke control, i.e., for example, to move a small amount of strong force fluid through the control of a large number of very small force fluid movement, but it may alternatively or additionally include a mechanism so defined that the agency will act on a shorter stroke moving elements into the strong force acting on another moving element stroke longer a small force . 反向伺服装置优选在可以通过完好皮肤手动控制所述设备的时候采用。 Reverse servo means preferably through intact skin can manually control when using the device.

[0169] 一般来说,胃壁上的两点应该相对于彼此并彼此背离地移动,以造成一小部分胃壁扩张,由此产生饱足感。 [0169] In general, two points on the stomach should be relative to each other and move away from one another to cause a small portion of the stomach to expand, thereby producing satiety. 这种作用可以采用许多不同的方式来实现。 This effect can be used in many different ways. 一种方式是扩张内陷在胃壁中的内陷设备。 One way is to expand in the stomach wall retraction retraction device. 另一种方式是移动胃壁上的两个固定点。 Another way is to move the two fixed points on the stomach wall. 当然,第一和第二位置可以通过许多可行的方式缝合或固定到胃壁,并且本发明覆盖通过彼此背离地移动胃壁的两部分并由此所述设备的第一固定件相对于第二固定件移动,来扩张胃壁,至少胃壁上的两个位置的全部可能方式。 Of course, the first and second positions can be in many possible ways sutured or fixed to the stomach wall, and the present invention covers by moving away from each other two portions of the stomach wall and thereby fixing the first member of the device relative to the second fixed member Mobile, to expand the stomach, at least all the possible ways the two positions on the stomach wall. 但是,优选采用通过内陷所述设备的至少一个适配部分而实现的软悬挂到胃壁的形式,此时纤维化的胃到胃的组织协助提供长期稳定位置。 Preferably, however, the use of the device by the retraction portion of the at least one adaptation realized soft suspension to form the stomach wall, then fibrosis stomach to stomach tissue to help provide long-term stable position.

[0170] 可以使用任何类型的机械结构。 [0170] You can use any type of mechanical structure. 可以使用机械或液压驱动的任何机械结构或者任何气压结构。 You can use mechanical or hydraulic drive of any mechanical structure or structure of any pressure. 任何马达或任何泵或者任何在提供动力时改变形式的移动材料,都可以用来实现通过彼此背离地移动胃壁的至少两个部分来牵拉一部分胃壁的简单目标。 Any motor or pump, or any change in any form in the provision of power to move material, can be used to achieve the target by simply moving away from each other at least two portions of the stomach wall to stretch a part of the stomach wall.

[0171] 可以使用任何类型的液压操作。 [0171] You can use any type of hydraulic operation. 应该理解,代替液压操作,可以使用气压操作,其中空气替代液压流体在容器和由牵拉设备形成的腔室之间移动。 It should be understood that instead of hydraulic operation, pneumatic operation can be used, which replace the hydraulic fluid to move the air between the container and the chamber formed by the stretching device. 优选,所述容器具有锁止位置,以保持其处于期望位置,如果被患者操作的话。 Preferably, the container having a locking position to keep it in the desired position, if the patient is then operated. 为了挤压所述容器,它优选停留在被挤压状态,并且在再次挤压之后释放。 In order to squeeze the container, it is preferred to stay in the state of being squeezed and released again after extrusion.

[0172] 可以为牵拉设备使用任何类型的液压方案。 [0172] You can use any type of hydraulic solutions for traction equipment. 液压机构可以机械地驱动或者利用任何马达或泵以及手动提供动力。 Hydraulic mechanism can be mechanically driven or powered by any motor or pump and manual.

[0173] 当然,仅仅扩张胃的内陷部分也拉开胃壁,这也可以机械地、液压地、气压地实现, 并且利用马达或泵或者手动作用力提供动力。 [0173] Of course, only the expansion of the retraction portion of the stomach also opened the stomach wall, which may be mechanically, hydraulically, pneumatic realized, and powered by a motor or pump or a manual force.

[0174] 用于治疗肥胖的体积填充设备 [0174] for the treatment of obesity volume filling equipment

[0175] 除了各种实施方式,用于治疗反流的装置可以适于另外治疗肥胖,基础在于胃中的细长的运动约束设备的远端部分的体积填充能力产生饱足感。 [0175] In addition to the various embodiments, for the treatment of reflux Further means may be adapted to treat obesity, wherein a volume basis of the distal end portion of the stomach filling ability elongated motion restraint device of satiety. 在本发明的情景中,在讨论体积填充设备及其特征、功能和适配时,指的是细长运动约束设备的远端部分。 In the scenario of the present invention, in discussing the volume filling device and its features, functions and adaptation, referring to the distal portion of the elongated motion restraint device. 请注意, 文中所述的任何特征、实施方式、实施方式的部分或者方法,在适当的情况下,可以用于运动约束设备的远端或近端部分。 Note that some method or any of the features described herein, embodiments, embodiments, in appropriate cases, the distal or proximal portion may be used for the motion restraint device.

[0176] 以下实施方式建立在发现通过利用患者胃壁内陷体积填充设备(这里表述为运动约束设备的远端部分),该可膨胀物体受到保护而不受胃酸影响,并且因此长期保持功 [0176] The following embodiments based on the discovery by using the patient's stomach retraction volume filling device (referred to herein as the distal portion of the motion restraint device), are protected from gastric acid affect the expandable body, and thus long-term work

40能。 40 can.

[0177] 根据本发明一种实施方式,提供了一种装置治疗具有带食物空腔的胃的患者的肥胖和反流,所述装置包括至少一个体积填充设备,该设备适于至少基本上被患者的胃壁部分内陷,其中所述体积填充设备适于安置在胃壁外侧,以使食物空腔的体积尺寸减小,减小的体积明显超过体积填充设备的体积,其中所述体积填充设备的表面包括生物相容材料, 其中体积填充设备的表面的主要部分适于抵靠胃壁外侧,并且其中所述体积填充设备具有至少30mm的最大周长。 [0177] According to one embodiment of the invention, there is provided an apparatus for the treatment of obesity and reflux patients have stomach cavity with food, said device comprising at least one volume filling apparatus which is adapted to at least substantially invaginated stomach wall portion of a patient, wherein the volume of the volume filling device is adapted to placed in the outside of the stomach wall, so that the volume of the food cavity is reduced in size, a reduced significantly more than the volume of the volume filling device, wherein the volume filling device surface comprises biocompatible material, wherein the major portion of the surface of the volume filling device is adapted to abut against the outside of the stomach wall, and wherein the volume filling device has a maximum circumference of at least 30mm.

[0178] 通过利用患者胃壁部分在胃壁外侧内陷体积填充设备,所述体积填充设备受到保护而不受胃酸影响,由此提供了将持续很长时间的设备。 [0178] Some patients through the use of gastric parietal retraction volume filling on the outside of the device, the volume filling device being protected from gastric acid influence, thereby providing the equipment will last a long time.

[0179] 所述体积填充设备适于安置成让体积填充设备的外表面抵靠胃壁,以使食物空腔的体积减小,减小的体积显著超过体积填充设备的体积。 [0179] The volume filling device is adapted positioned to make the outer surface to volume filling device against the stomach wall, so that the volume of food cavity is reduced, the volume decreases significantly exceeds the volume filling device volume. 体积填充设备具有至少30mm的最大周长。 Volume filling device has a maximum circumference of at least 30mm. 相应地,本发明的装置良好地适合治疗肥胖患者的肥胖症,以及相同患者的反流疾病。 Accordingly, the apparatus of the present invention is well suited for the treatment of obesity in obese patients, and patients with the same disease reflux. 这是具有优势的,因为在患有肥胖症的人群中,反流疾病是非常常见的情况。 This is advantageous because the obese population, reflux disease is a very common situation.

[0180] 根据第一可选方案,体积填充设备适于安置在胃内侧,使得体积填充设备的外表面抵靠胃壁内侧。 [0180] According to a first alternative, the volume filling device is adapted to placed on the inside of the stomach, making the volume filling device against the inside of the outer surface of the stomach wall.

[0181] 根据第二种可选方案,体积填充设备适于安置在胃外侧,使得体积填充设备的外表面抵靠胃壁外侧。 [0181] According to a second alternative, the volume filling device is adapted to placed on the outside of the stomach, making the volume filling device against the outside of the outer surface of the stomach wall.

[0182] 优选,体积填充设备适于被患者胃壁完全内陷,并且利用胃镜器械安置在胃内侧或外侧。 [0182] Preferably, the volume of the stomach filling device is adapted to be patient completely sunk, and the use of endoscopy instruments positioned inside or outside of the stomach. 为此,体积填充设备可以包括适于与夹持器械协作的连接设备。 For this reason, the volume filling device may comprise a clamping device adapted to cooperate with a connection device. 适当的是,体积填充设备适于可以术后非侵入式地调节。 Suitably, the volume filling device is adapted to be able to adjust the non-invasive surgery.

[0183] 所述装置可以包括固定设备,适当地包括两个或更多个固定设备,所述固定设备适于参与将体积填充设备固定到胃壁。 Means [0183] may comprise fixed equipment, suitably comprising two or more fixtures, the fixture is adapted to participate in the volume filling device is secured to the stomach wall. 所述体积填充设备可以包括保持设备,该保持设备适于被器械保持,适当地包括两个或多个保持设备,以简化设备植入过程。 The volume filling device may comprise a holding device, the holding device is adapted to maintain equipment, suitably comprising two or more holding devices, to simplify the device implantation.

[0184] 所述体积填充设备至少一部分可以用不会被胃酸破坏的材料制成。 [0184] at least a portion of the volume of the device can be filled with material is not made of acid damage. 所述体积填充设备可以被酸例如盐酸破坏。 The volume filling device may be an acid such as hydrochloric acid damage.

[0185] 在实施方式中,体积填充设备可以膨胀到扩张状态,并包括限定腔室的包围壁,其中所述体积填充设备利用供应到所述腔室中的凝胶或流体膨胀。 [0185] In an embodiment, the device can be expanded to fill the volume of the expanded state, and including a wall defining a chamber enclosing, wherein the volume filling device utilizing supplied to the chamber in a gel or fluid expansion. 至少一个管件可以连接到所述体积填充设备,用于向所述腔室供应凝胶或流体。 At least one tubular member may be connected to the volume filling device, for supplying fluid to the gel or the chamber. 可以提供能与所述管件连接的注入端口。 It provides injection port can be connected with the tubular member. 作为替代,所述体积填充设备可以设置有用于流体或凝胶的进入端口,所述进入端口可以连接到胃镜器械,其中所述进入端口包括适于互联所述可膨胀设备和所述胃镜器械的流体连接部。 Alternatively, the device may be provided with a fill volume for a fluid or gel into the port, the inlet port may be connected to the endoscopic instrument, wherein the access port comprises an expandable device adapted to interconnect the devices and the gastroscope fluid connection.

[0186] 所述体积填充设备可以包括同质材料,诸如舒尔值小于15的凝胶。 [0186] The volume filling device may comprise a homogeneous material, such as Shure value less than 15 gels. 所述设备也可以是实心体。 The device may also be a solid body.

[0187] 所述体积填充设备可以具有刚性、弹性或挠性外表面。 [0187] The volume filling device may have an outer surface of the rigid, resilient or flexible. 如果外表面为刚性外表面, 则其刚性足够大,以保持在承受由胃运动产生的作用力时不发生变形。 If the outer surface of the rigid outer surface, its rigidity is large enough to keep the deformation does not occur in the stomach to withstand forces generated during movement. 所述体积填充设备可以包括挠性的非弹性材料。 The volume filling device may comprise a flexible non-elastic material.

[0188] 根据所述体积填充设备的第一种一般设计,在垂直于贯穿所述设备轴线的平面上观察时,所述设备具有最大周长。 [0188] According to a first general design of the volume filling device, when viewed perpendicular to the plane through the axis of the device, the device has a maximum circumference. 在垂直于所述轴线的其他平面上观察时,所述设备的周长等于所述最大周长或者从来自所述最大周长的方向沿着所述轴线减小。 When viewed perpendicular to the plane of the other axis is equal to the circumference of the device from the direction of maximum circumference or decrease from the maximum circumference along the axis. 例如,所述设备可以基本上为卵形、球形或者基本上中部带有凹陷的类卵形或者类似弯曲的卵形。 For example, the device may be substantially ovoid, spherical or ovoid with a substantially curved central recess oval or similar type.

[0189] 根据所述设备的第二种一般设计,在垂直于贯穿所述设备的轴线的平面上观察, 随着所述平面沿着所述轴线移动,所述设备的周长增加和减小至少两次,或者随着所述平面沿着所述轴线移动,减小和增大至少一次。 [0189] According to a second general design of the device, in a plane through the axis of the apparatus viewed in the vertical, with the movement along the axis of the plane, the circumference of the device increases and decreases at least twice, or with the plane along the moving axis, decrease and increase at least once. 例如,所述设备可以基本上构造地类似肾形。 For example, the devices can be substantially similar structure to the kidney-shaped.

[0190] 所述体积填充设备具有细长的、圆整的、弯曲的和/或曲线形状。 [0190] The volume filling device has an elongated, rounded, curved and / or curved shape.

[0191] 所述体积填充设备具有至少120、150、180或220mm的周长。 [0191] The volume filling device has at least 120,150,180 or 220mm circumference.

[0192] 所述体积填充设备具有介于0. 0001至0. OOlm3范围内、或者0. 00001至0. OOlm3 范围内、或者0. 00001至0. 0002m3范围内的体积。 [0192] The volume filling device has a range from 0.0001 to 0. OOlm3 within the scope of, or within the range of 0.00001 to 0. OOlm3, or volume in the range of 0.00001 to 0. 0002m3. 所述体积填充设备的体积小于0. 0002m3。 The volume of the volume filling device is less than 0. 0002m3.

[0193] 所述体积填充设备可以包括至少两个可互联的部分,这两个部分适于作为单独的部分安置在胃的内侧或外侧。 [0193] The volume filling device may comprise at least two interconnected parts, the two parts adapted as a separate part arranged inside or outside of the stomach.

[0194] 所述体积填充设备可以包括弹性材料、生物相容材料和/或硅酮。 [0194] The volume filling device may comprise an elastic material, biocompatible material and / or a silicone.

[0195] 适当的是,所述体积填充设备设置有至少一个料层。 [0195] Suitably, the volume filling device is provided with at least one layer of material. 例如,聚对二甲苯层、聚四氟乙烯层或者聚亚安酯层。 For example, parylene layer, Teflon layer or polyurethane layer. 所述涂层可以包括多层涂层。 The coating may comprise a multi-layer coating. 所述体积填充设备可以包括聚亚安酯、特富龙或PTFE或者它们的组合材料所制成的外表面层。 The volume filling device may comprise a polyurethane, Teflon or PTFE or the outer surface layer thereof made of composite material.

[0196] 所述体积填充设备可以包括适于转化成固态或固定形式的流体。 [0196] The volume filling device may comprise a solid or adapted to be converted into a fixed form of fluid. 所述流体可以是液体聚亚安酯或者等张流体。 The fluid may be a liquid polyurethane or isotonic fluid. 所述流体可以包括大分子,诸如碘分子,以防止扩散。 The fluid may comprise large molecules, such as iodine molecules, to prevent proliferation.

[0197] 所述体积填充设备可以具有至少50毫米的最大周长,优选至少80毫米。 [0197] The volume filling device may have a maximum circumference of at least 50 mm, preferably at least 80 mm. 适当的是,所述体积填充设备能变形到最大直径,从而可以插入到腹腔镜套管针中。 Suitably, the volume filling device can be deformed to the maximum diameter which can be inserted into the laparoscopic trocar.

[0198] 优选,所述体积填充设备适于利用胃到胃的缝合线或者卡钉保持就位,从而将所述设备内陷在胃壁中。 [0198] Preferably, the volume filling device is adapted to use the stomach to stomach sutures or staples held in place, so that the retraction of the device in the stomach wall. 具有优势的是,所述体积填充设备具有可变周长,以更好地保持内陷在患者胃壁中的位置。 It has the advantage that the volume filling device has a variable circumference, in order to better maintain the retraction position in the patient stomach. 所述胃到胃的缝合线或者卡钉可以设置有固定部分,所述固定部分表现为适于与胃壁接触的结构,以促使人体组织生长,从而长期固定连接到胃壁的体积填充设备的位置。 The stomach to stomach sutures or staples may be provided with a fixed portion, the fixed portion is adapted to the structure and performance of the stomach wall in contact, to promote tissue growth, and thus a long position of the stomach wall fixedly connected to the filling volume of the device. 所述结构可以包括网状结构。 The structure may include a mesh structure.

[0199] 在本发明的实施方式中,所述装置包括安置在胃壁外侧并适于牵拉一部分胃壁的牵拉设备,由此影响患者食欲。 [0199] In an embodiment of the present invention, the apparatus comprising disposed on the outside of the stomach wall and is adapted to stretch a portion of the stomach wall pulling device, thereby affecting patients appetite. 在体积填充设备可膨胀时,所述装置可以包括互联所述牵拉设备和所述体积填充设备的流体连接部。 When the inflatable volume filling device, the device may comprise a fluid connector portion interconnecting said drawing device and the volume filling device.

[0200] 在实施方式中,所述装置包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁;和操作设备,所述操作设备用于操作植入后的所述牵拉设备,以牵拉所述一部分胃壁,以产生饱足感。 [0200] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the device can be implanted in the drawing obese patient and adapted to stretch a portion of the stomach in patients ; and operating the equipment, the operation of the traction device for operating the device after implantation to pull a portion of the stomach to produce satiety.

[0201] 在实施方式中,所述装置包括至少一个可操作的牵拉设备,所述牵拉设备能植入患者体内并适于牵拉患者一部分胃壁;和可植入的控制单元,在所述控制单元和所述牵拉设备植入后,所述控制单元用于自动地控制所述可操作的牵拉设备,以牵拉正在进餐的患者的所述一部分胃壁,以产生饱足感。 [0201] In an embodiment, the apparatus comprises at least one operable stretching device, the stretching device implanted in a patient and adapted to be able to stretch the stomach wall portion of the patient; and the implantable control unit, in the After the control unit and the implanted pulling apparatus, the control unit for automatically controlling the operable stretching device to stretch the meal being part of the stomach wall of a patient, to produce satiety.

[0202] 在实施方式中,所述装置包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,其中所述牵拉设备包括可扩张的牵拉容器;和操作设备,所述操作设备用于操作植入后的所述牵拉设备,以牵拉所述一部分胃壁,其中所述运动约束设备至少远端部分可以膨胀并且与所述牵拉容器流体连接,其中所述操作设备包括泵,用于在所述主容器和所述牵拉容器之间泵送流体,以牵拉所述一部分胃壁,以产生饱足感。 [0202] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the device can be implanted in the drawing obese patient and adapted to stretch a portion of the stomach in patients wherein the traction device comprises an expandable container drawing; and operating the equipment, the operation of the drawing device for operating the device after implantation, in order to stretch the stomach wall portion, wherein the motion restraint device At least the distal portion is expandable and connected to the traction fluid container, wherein the operation device comprises a pump for the main container between the container and the pull pump fluid to stretch the stomach wall portion to produce satiety. 可以提供控制设备来控制包括所述泵的所述牵拉设备。 It may provide control device to control the pump including the traction device. 所述控制设备可以包括:无线遥控器,所述无线遥控器适于从患者体外控制所述牵拉设备,或者可植入的控制单元,用于控制所述牵拉设备。 The control device may include: wireless remote control, wireless remote control adapted from the patient's body for controlling the traction device, or implantable control unit for controlling the traction device. 作为替代,所述控制设备可以包括皮下安置的开关或容器,所述开关或容器适于从患者体外控制所述牵拉设备。 Alternatively, the control device may comprise a switch disposed subcutaneous or container, the container is adapted to switch from the patient's body or the traction control device. 可以提供将植入患者体内的传感器或传感设备,其中所述可植入的控制单元适于利用来自所述传感器或者传感设备的信息从患者体内控制所述牵拉设备,所述传感器或者传感设备适于直接或间接感测患者食物摄入。 It can be implanted in a patient to provide a sensor or sensing device, wherein the implantable control unit is adapted to use information from the sensor or the sensing device from the body of the patient pulling the control device, the sensor or sensing device is adapted to sense the patient directly or indirectly measuring food intake.

[0203] 在实施方式中,所述运动约束设备的远端部分包括主体积填充容器;牵拉设备,所述牵拉设备包括至少一个可操作地牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,其中所述牵拉设备包括可扩张的牵拉容器,适于内陷在胃上部部分处的胃壁中,在患者直立时高于所述可膨胀的主体积填充设备,其中所述体积填充设备可以膨胀并与所述牵拉容器流体连接,其中胃壁针对食物摄入的正常收缩导致流体从较低地安置在所述胃壁上的所述内陷的主体积填充容器流动,适于导致所述牵拉容器牵拉所述胃壁部分,以产生饱足感。 [0203] In an embodiment, the distal end portion of the motion restraint device includes a main volume of the filled container; drawing apparatus, said drawing device comprising at least one apparatus operable to pull the pulling apparatus can implant obese patient and adapted to stretch the stomach wall portion of the patient, wherein the drawing device comprises an expandable container traction adapted invagination of the stomach in an upper portion of the stomach wall, when the patient is higher than the upright expandable master volume filling device, wherein the volume filling device can be expanded and connected with the traction fluid container, which shrink the stomach for normal food intake results in fluid from the lower placed on the stomach wall retraction master volume filling container flow, pull container adapted to cause the stomach wall portion of the stretch, to produce satiety. 所述主体积填充容器和所述牵拉容器之间的流体连接包括止回阀。 The main volume of fluid filling the container and container connection between the pull includes a check. 所述主体积填充容器和所述牵拉容器之间的流体连接部包括释放功能,所述释放功能适于将所述牵拉容器中的体积释放返回所述主体积填充容器。 Fluid connection to the main volume filling between the container and the container includes a stretch release function, the release function adapted to the release pull container volume is returned to the main volume filling containers. 所述释放功能可以包括面积显著小于所述流体连接部的流体返回连接部,以便将流体从所述牵拉容器缓慢释放返回所述主体积填充设备容器,以释放对胃壁部分的牵拉。 The release function may include an area substantially smaller than the fluid portion of the return fluid connection connecting portion, so that the fluid is released slowly return the main volume of the container from the filling device the container pulled to release part of the stomach wall stretch. 可以提供进一步的手动控制设备,以进一步影响牵拉设备牵拉所述胃壁部分,该手动控制设备包括皮下安置的容器,该皮下安置的容器适于从患者体外控制所述牵拉设备。 Can provide further manual control device to further influence traction devices stretch the stomach wall portion of the manual control device comprises a container subcutaneous placement, the container is adapted from the subcutaneous placed outside the patient controls the traction device.

[0204] 在实施方式中,可以提供适于可以膨胀的主体积填充容器,其中所述运动约束设备的远端部分进一步包括可扩张的结构,所述可扩张的结构适于在所述设备植入胃壁之后扩张,其中所述结构包括适于适应所述设备植入后包围所述设备的纤维化组织的波纹件, 以使所述波纹件的运动基本上不受所述纤维化组织的影响。 [0204] In an embodiment, may be provided adapted to be expanded primary volume filled container, wherein the distal end portion of the motion restraint device further comprises an expandable structure, the expandable structure adapted to implant the device After expanding the stomach wall, wherein said structure comprises a device adapted to accommodate the rear of the device implant fibrotic tissue surrounds the bellows member, such that movement of the bellows member is substantially free from the influence of the fibrotic tissue .

[0205] 在实施方式中,所述装置包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,并且其中所述牵拉设备包括可扩张的结构,所述可扩张的结构适于在所述设备植入胃壁之后扩张并牵拉所述胃壁部分,其中所述结构包括专用的波纹件,所述波纹件适应所述设备植入后包围所述设备的纤维化组织,以使所述波纹件的运动基本上不受所述纤维化组织的影响。 [0205] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the device can be implanted in the drawing obese patient and adapted to stretch a portion of the stomach in patients and wherein the traction device comprises an expandable structure, the expandable structure after the device is adapted to expand and stretch the stomach wall implanted portion of the stomach wall, wherein said structure comprises a dedicated corrugated member, the said bellows adapted to implant the device after the fibrous tissue that surrounds the device, so that the movement of the bellows is substantially unaffected by the fibrotic tissue. 可以提供用于操作所述牵拉设备的操作设备,以牵拉所述胃壁部分,以产生饱足感。 May be provided for operating said pulling device operating device to stretch the stomach wall portion, in order to produce satiety. 所述装置可以包括可植入的控制单元,用于在所述控制单元和所述牵拉设备植入后,控制所述可操作的牵拉设备,以牵拉正在进餐的患者的胃壁部分,以产生饱足感。 The apparatus may comprise an implantable control unit for pulling the stomach wall portion of the patient is eating the control unit and the traction device after implantation, control of the traction device operable,, to produce satiety.

[0206] 在实施方式中,所述装置包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,以产生饱足感。 [0206] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the device can be implanted in the drawing obese patient and adapted to stretch a portion of the stomach in patients to produce satiety. 所述控制设备可以包括无线遥控器,所述无线遥控器适于从患者体外控制所述牵拉设备;或者可植入的控制单元,用于控制所述牵拉设备。 The control device may include a wireless remote control, wireless remote control adapted from the patient's body for controlling the traction device; or an implantable control unit for controlling the traction device. 作为替代,所述控制设备可以包括皮下安置的开关或容器,所述开关或容器适于从患者体外控制所述牵拉设备。 Alternatively, the control device may comprise a switch disposed subcutaneous or container, the container is adapted to switch from the patient's body or the traction control device. 可以提供适于植入患者体内的传感器或传感设备,其中所述可植入的控制单元适于利用来自所述传感器或者传感设备的信息从患者体内控制所述牵拉设备,所述传感器或者传感设备适于直接或间接感测患者食物摄入。 Adapted for implantation into a patient to provide a sensor or sensing device, wherein the implantable control unit is adapted to use information from the sensor or the sensing device from the body of the patient pulling the control device, the sensor or a sensing device adapted to sense the patient directly or indirectly food intake. [0207] 在实施方式中,所述装置适于治疗反流疾病。 [0207] In an embodiment, the apparatus is adapted to treat reflux disease. 为此,所述装置进一步包括可植入的运动约束设备,所述运动约束设备成具有近端部分和远端部分的细长形状,所述近端部分适于至少部分地被患者胃底壁内陷,并具有包括生物相容材料的外表面。 To this end, the apparatus further comprising an implantable movement restraining device, the motion restraint device into an elongated shape having a proximal portion and a distal portion, the proximal portion adapted to be at least partially gastric wall in patients retraction, and having an outer surface including a biocompatible material. 所述运动约束设备的近端部分的外表面的主要部分适于在患者横膈膜和内陷胃底壁下部的至少一部分之间的位置抵靠胃壁而不损伤胃壁,以使在所述运动约束设备的近端部分内陷之后,患者胃的心切迹朝向患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持患者腹部施加在患者贲门括约肌上的支撑压力。 Position at least a portion between the main portion of the outer surface of the proximal portion of the motion restraint device adapted to patient diaphragm and retraction of the gastric wall lower against the stomach walls without damaging the stomach, so that the movement After retraction of the proximal part of the restraint device, the patient's heart notch toward the stomach in patients with diaphragmatic movement is constrained, thereby preventing cardiac patient by patient slides into the chest diaphragm opening, thereby maintaining the patient's abdomen is applied to the patient cardiac sphincter The support pressure. 运动约束设备的近端部分具有至少125mm3的尺寸,周长至少为15mm。 Motion constraints proximal portion of the device having at least 125mm3 in size, girth at least 15mm. 远端部分稳定并保持近端部分,并适于基本上内陷在胃壁中。 Stabilize the distal portion and a proximal end portion to maintain and adapted to substantially retraction in the stomach wall.

[0208] 在另一种实施方式中,所述装置适于治疗反流疾病。 [0208] In another embodiment, the apparatus is adapted to treat reflux disease. 为此,所述装置进一步包括可植入的运动约束设备,所述运动约束设备成具有近端部分和远端部分的细长形状,并具有包括生物相容材料的外表面。 To this end, the apparatus further comprising an implantable movement restraining device, the motion restraint device into an elongated shape having a proximal portion and a distal portion, and having an outer surface including a biocompatible material. 所述运动约束设备的近端部分适于以其至少一部分外表面在患者横膈膜和胃底壁之间的位置抵靠患者胃底壁,以使在所述运动约束设备的近端部分内陷之后,患者胃的心切迹朝向患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持患者腹部施加在患者贲门括约肌上的支撑压力,其中运动约束设备的近端部分具有至少125mm3的尺寸,周长至少为15mm。 The proximal portion of the motion restraint device adapted to at least a portion of its outer surface at a position between the diaphragm and gastric wall of the patient against the patient gastric wall, so that within the proximal portion of the motion restraint device After the collapse, the patient's stomach in patients with heart notch toward the diaphragm movement is constrained, thereby preventing cardiac patient by patient slides into the chest diaphragm opening, thereby maintaining the patient's abdomen is applied to the patient's cardiac sphincter pressure support, including motion constraints The proximal portion of the device having a size of at least 125mm3, circumference at least 15mm. 在运动约束设备内陷之后,附连设备适于将运动约束设备的近端部分固定在所述位置。 After retraction motion restraint device, the attachment device is adapted to the proximal portion of the motion restraint device fixed at the position. 远端部分稳定并保持近端部分, 并适于基本上内陷在胃壁中。 Stabilize the distal portion and a proximal end portion to maintain and adapted to substantially retraction in the stomach wall.

[0209] 在另一种实施方式中,所述装置适于治疗反流疾病。 [0209] In another embodiment, the apparatus is adapted to treat reflux disease. 为此,所述装置进一步包括可植入的运动约束设备,所述运动约束设备成具有近端部分和远端部分的细长形状,并具有包括生物相容材料的外表面,所述近端部适于至少部分地被患者胃底壁内陷。 To this end, the apparatus further comprising an implantable movement restraining device, the motion restraint device into an elongated shape having a proximal portion and a distal portion, and having an outer surface including a biocompatible material, the proximal end section adapted to at least partially gastric wall retraction patient. 所述运动约束设备的近端部分的外表面的主要部分适于在患者横膈膜和内陷胃底壁下部的至少一部分之间的位置抵靠胃壁而不损伤胃壁,以使在所述运动约束设备的近端部分内陷之后,患者胃的心切迹朝向患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持患者腹部施加在患者贲门括约肌上的支撑压力,运动约束设备具有至少125mm3的尺寸,周长至少为15mm,进一步包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,以产生饱足感。 Position at least a portion between the main portion of the outer surface of the proximal portion of the motion restraint device adapted to patient diaphragm and retraction of the gastric wall lower against the stomach walls without damaging the stomach, so that the movement After retraction of the proximal part of the restraint device, the patient's heart notch toward the stomach in patients with diaphragmatic movement is constrained, thereby preventing cardiac patient by patient slides into the chest diaphragm opening, thereby maintaining the patient's abdomen is applied to the patient cardiac sphincter The support pressure, motion restraint device having a size of at least 125mm3, the perimeter of at least 15mm, further comprising pulling devices, the pulling device comprises at least one pulling device operable, the device can be implanted in the drawing obese patients part of the body and is adapted to pull the stomach in patients to produce satiety. 远端部分稳定并保持近端部分,并适于基本上内陷在胃壁中。 Stabilize the distal portion and a proximal end portion to maintain and adapted to substantially retraction in the stomach wall.

[0210] 在另一种实施方式中,所述装置适于治疗反流疾病。 [0210] In another embodiment, the apparatus is adapted to treat reflux disease. 为此,所述装置进一步包括可植入的运动约束设备,所述运动约束设备成具有近端部分和远端部分的细长形状,并具有包括生物相容材料的外表面。 To this end, the apparatus further comprising an implantable movement restraining device, the motion restraint device into an elongated shape having a proximal portion and a distal portion, and having an outer surface including a biocompatible material. 所述运动约束设备的近端部分适于以其至少一部分外表面在患者横膈膜和胃底壁之间的位置抵靠患者胃底壁,以使在所述运动约束设备的近端部分内陷之后,患者胃的心切迹朝向患者横膈膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔,从而保持患者腹部施加在患者贲门括约肌上的支撑压力,其中运动约束设备的近端部分具有至少125mm3的尺寸,周长至少为15mm,和在运动约束设备植入之后, 固定设备适于将所述运动约束设备固定在所述位置。 The proximal portion of the motion restraint device adapted to at least a portion of its outer surface at a position between the diaphragm and gastric wall of the patient against the patient gastric wall, so that within the proximal portion of the motion restraint device After the collapse, the patient's stomach in patients with heart notch toward the diaphragm movement is constrained, thereby preventing cardiac patient by patient slides into the chest diaphragm opening, thereby maintaining the patient's abdomen is applied to the patient's cardiac sphincter pressure support, including motion constraints the proximal portion of the device having at least 125mm3 in size, circumference of at least 15mm, and after the motion restraint device implanted fixation device adapted to the movement device is fixed to the location constraints. 远端部分稳定并保持近端部分,并适于基本上内陷在胃壁中。 Stabilize the distal portion and a proximal end portion to maintain and adapted to substantially retraction in the stomach wall. 所述装置进一步包括牵拉设备,所述牵拉设备包括至少一个可操作的牵拉设备,所述牵拉设备能植入肥胖患者体内并适于牵拉患者一部分胃壁,以产生饱足感。 The apparatus further comprises a drawing device, said drawing device comprising at least one operable stretching device, the device can be implanted in the drawing obese patient and adapted to stretch the stomach wall portion of the patient in order to produce satiety.

44[0211] 在实施方式中,所述装置进一步包括牵拉设备,所述牵拉设备包括3个或更多个机械部件,所述机械部件与胃壁上的不同部件接合,一个接合一个,其中所述接合包括缝合或卡钉连接到胃壁,或者利用胃到胃的缝合线将所述机械部件内陷在胃壁部分中,其中所述3个或更多个机械部件适于相对于彼此移动,适于牵拉3个不同的壁部分,所述牵拉设备进一步适于具有被彼此独立地牵拉的壁部分,其中所述独立针对用来牵拉胃壁部分的作用力以及施加牵拉的时间周期,还有施加牵拉的时刻。 44 [0211] In an embodiment, the apparatus further comprises a drawing device, said drawing device comprising three or more mechanical parts, mechanical parts and the different parts of the stomach wall engage an engaging one, wherein the engagement includes suturing or stapling to the stomach wall is connected, or with stomach to stomach sutures retraction of the mechanical parts in the stomach wall portion, wherein the three or more mechanical parts adapted to move relative to one another, adapted to stretch three different wall portions, the pulling apparatus is further adapted to stretch independently of each other having a wall portion, wherein the independent time for applying a pulling force to stretch the stomach wall portion as well as cycle, as well as traction is applied moment.

[0212] 在实施方式中,所述装置进一步包括牵拉设备,所述牵拉设备包括接合胃壁的不同部件的两个或更多个液压部件,一个部件接合一个不同部件,其中所述接合包括将液压部件缝合或者卡钉接合到胃壁,或者利用胃到胃的缝合线将液压部件内陷在胃壁部分中, 其中所述两个或更多个液压部件适于相对于彼此移动,适于牵拉三个不同的壁部分,所述牵拉设备进一步适于让所述壁部分被彼此独立地牵拉,所述独立针对用来牵拉胃壁部分的作用力以及施加牵拉的时间周期,还有施加牵拉的时刻。 [0212] In an embodiment, the apparatus further comprises a drawing device, said drawing device comprising two or more different hydraulic components stomach wall engaging member, an engaging member of a different member, wherein said engagement comprises The sutures or staples hydraulic components bonded to the stomach wall, or with stomach to stomach sutures retraction of the hydraulic components in the stomach section, wherein the two or more hydraulic parts adapted to move relative to each other, adapted pull Pull three different wall portions, the stretching device further adapted to let the wall portion is drawn independently of one another, is used for the independent pulling force applied to stretch the stomach wall portion as well as the time period, but also There are always applied traction.

[0213] 在实施方式中,所述装置进一步包括牵拉设备,所述牵拉设备与一部分胃壁接合, 包括将所述牵拉设备缝合或卡钉连接到胃壁,或者利用胃到胃的缝合线将所述牵拉设备内陷在胃壁部分中,其中所述牵拉设备进一步适于牵拉胃壁部分,控制用来牵拉胃壁部分的作用力、施加牵拉的时间周期以及施加牵拉的时刻。 In an embodiment, the apparatus [0213] further comprises a pulling device, the pulling device engagement with a portion of the stomach wall, including drawing the suture or stapling device is connected to the stomach wall, or with stomach to stomach sutures the traction device retraction in the stomach wall section, wherein the traction device is further adapted to stretch the stomach wall portion control is used to stretch the stomach wall portion force application time period and applying traction traction moment .

[0214] 在实施方式中,所述装置进一步包括牵拉设备,所述牵拉设备包括接合胃壁的不同部件的两个部件,一个部件接合一个不同部件,其中所述接合包括将部件缝合或者卡钉接合到胃壁,或者利用胃到胃的缝合线将部件内陷在胃壁部分中,其中所述牵拉设备进一步适于彼此独立地牵拉不同的壁部分,控制用来牵拉胃壁部分的作用力、施加牵拉的时间周期以及施加牵拉的时刻。 [0214] In an embodiment, the apparatus further comprises a drawing device, said drawing device comprising two joining members different parts of the stomach wall, an engaging member of a different member, wherein said engagement means comprises suturing or card Nail joined to the stomach wall, or with stomach to stomach sutures retraction member in the stomach wall portion, wherein the apparatus is further adapted to stretch independently of each other wall portions of different stretch, to stretch the stomach wall portion controlling effect force application time period and a time of applying a pulling traction.

[0215] 在实施方式中,所述装置进一步包括外部控制单元,用于从患者体外控制运动约束设备的远端部分。 [0215] In an embodiment, the apparatus further comprises an external control unit for controlling the distal portion of the patient's body motion restraint device. 所述外部控制单元可以包括无线遥控器,所述无线遥控器适于从患者体外控制所述设备。 The external control unit may include a wireless remote control, the wireless remote control adapted to control the device from the patient's body. 作为替代,所述外部控制单元可以包括皮下安置的开关或容器,所述开关或容器适于从患者体外控制所述设备。 Alternatively, the external control unit may comprise a switch disposed subcutaneous or container, or the container is adapted to control the switching device from the patient's body.

[0216] 可以提供将植入患者体内的传感器或传感设备,其中所述可植入的控制单元适于利用来自所述传感器或者传感设备的信息从患者体内控制所述牵拉设备,所述传感器或者传感设备适于直接或间接感测患者食物摄入。 [0216] can be implanted in a patient to provide a sensor or sensing device, wherein the implantable control unit is adapted to use information from the sensor or the sensing device from the body of the patient traction control device, the said sensor or sensing device adapted to sense the patient directly or indirectly measuring food intake.

[0217] 根据本发明的另一方面,提供了一种用来治疗具有带食物空腔的胃的肥胖患者的反流疾病和肥胖症的装置,所述装置包括可植入的运动约束设备,所述运动约束设备具有近端部分和远端部分,所述远端部分适于至少基本上被患者胃壁部分内陷,并具有包括生物相容材料的外表面,其中所述运动约束设备的远端部分适于安置在胃内侧,使得体积填充设备的外表面抵靠胃壁内侧,以使所述食物空腔的体积减小,减小的体积显著超过体积填充设备的体积。 [0217] According to another aspect of the present invention, there is provided a reflux disease and obesity device used to treat obese patients have stomach cavity with the food, the apparatus comprises implantable motion restraint device, The motion restraint device having a proximal portion and a distal portion, said distal portion adapted to be at least substantially invaginated stomach wall portion of patients, and has an outer surface including a biocompatible material, wherein the motion restraint device far end portion adapted to rest on the inside of the stomach, so that the outer surface of the volume filling device against the inside of the stomach wall, so that the volume of the food cavity is reduced, the volume decreases significantly exceeds the volume of volume filling device. 所述运动约束设备的远端部分的最大周长至少为30mm。 The distal portion of the motion restraint device maximum circumference of at least 30mm.

[0218] 应该注意,文中所述的任何实施方式或者实施方式的一部分、或者特征、或者方法、或者相关系统、或者该系统的一部分可以组合成任意组合。 [0218] It is noted that a portion of any embodiment or embodiments described herein, or features, or method, or a related system, or the system can be combined into any combination thereof.

附图说明 Brief Description

[0219] 现在将参照附图,作为非限制性示例,更为详细地描述本发明,在附图中:[0220] 图IA-C是植入人类患者体内用于治疗胃食管反流疾病的装置的各种实施方式的示意图; [0219] Referring now to the drawings, non-limiting example, the present invention is described in more detail, in the drawings: [0220] Figure IA-C is implanted in a human patient in vivo for the treatment of gastroesophageal reflux disease a schematic view of various embodiments of the apparatus;

[0221] 图2A-B是植入人类患者体内用于治疗胃食管反流疾病的装置的各种实施方式的示意图; [0221] Figures 2A-B is a schematic view of implanted human patient for treatment of various embodiments of the apparatus of gastroesophageal reflux disease;

[0222] 图3A-B是植入人类患者体内用于治疗胃食管反流疾病的装置的各种实施方式的示意图; [0222] Figures 3A-B is a schematic view of implanted human patient for treatment of various embodiments of the apparatus of gastroesophageal reflux disease;

[0223] 图4A-D是植入人类患者体内用于治疗胃食管反流疾病和肥胖症的装置的实施方式的示意图; [0223] Figures 4A-D are implanted in the body of a human patient for treatment of gastroesophageal reflux schematic view of an embodiment of the apparatus of the disease and obesity;

[0224] 图5是植入人类患者体内用于治疗胃食管反流疾病的装置的实施方式的示意图; [0224] FIG. 5 is a schematic view of implanted human patient for the treatment of gastroesophageal reflux disease an embodiment of the apparatus;

[0225] 图6A-D和7-9示出了植入人类患者体内用于治疗胃食管反流疾病的运动约束设备的替代形状; [0225] FIG. 6A-D and 7-9 shows the implanted human patient for treatment of gastroesophageal reflux disease alternate shape motion restraint device;

[0226] 图10是带有用于治疗胃食管反流疾病的植入式运动约束设备的患者的总体图; [0226] FIG. 10 is an overall view for the treatment of gastroesophageal reflux disease in patients with implanted devices of motion constraints;

[0227] 图11-27是为用于治疗胃食管反流疾病的装置提供动力的各种方式的示意图; [0227] FIG. 11-27 is a schematic diagram to power the device for the treatment of gastroesophageal reflux disease in various ways;

[0228] 图28-34是为用于治疗胃食管反流疾病的装置布置液压动力或气压动力的各种方式的示意图; [0228] FIG. 28-34 is an apparatus for treatment of gastroesophageal reflux disease, hydraulic power, or pneumatic power arrangement of the various ways schematic;

[0229] 图35是植入用于治疗胃食管反流疾病的运动约束设备时实施的步骤的流程图; [0229] FIG. 35 is a flowchart used to treat gastroesophageal reflux disease exercise restraint device implantation step implementation;

[0230] 图36-41示出了用来恢复患有胃食管反流疾病的患者的贲门和胃底位置的方法; [0230] Figure 36-41 shows a position to restore the gastric cardia and gastroesophageal reflux disease in patients with a method;

[0231] 图42-46示出了包含在根据本发明的装置中的反流治疗设备的不同形状和特征; [0231] Figure 42-46 shows the different shapes and features included in the device according to the invention reflux treatment equipment;

[0232] 图47a_d示出了包含在根据本发明的装置中的紧缩的可膨胀的反流治疗设备,以及用来将所述反流治疗设备安置在患者胃壁外侧的器械; [0232] FIG 47a_d shows included in the device according to the invention austerity expandable reflux treatment equipment, as well as for the treatment of reflux device placed equipment on the outside of the stomach of the patient;

[0233] 图48a_i示出了将图47a所示的可膨胀设备内陷在患者胃壁外侧上的不同步骤; [0233] FIG 48a_i shows an inflatable retraction device shown in Figure 47a different steps on the outside of the stomach of a patient;

[0234] 图49示出了反流治疗装置还适于治疗肥胖的实施方式; [0234] FIG. 49 illustrates a reflow treatment apparatus further embodiment suitable for the treatment of obesity;

[0235] 图50-51示出了反流治疗装置还适于治疗肥胖的实施方式; [0235] Figure 50-51 shows the reflux treatment device also suitable for the treatment of obesity embodiment;

[0236] 图示出了将图47a所示的可膨胀设备内陷在患者胃壁内侧上的不同步骤; [0236] illustrates an inflatable retraction device shown in Fig. 47a on the inside of the stomach in patients with different steps;

[0237] 图53a_c示出了用于形成胃壁内陷的器械; [0237] FIG 53a_c shows retraction of equipment used to form the stomach;

[0238] 图54-55示出了用于治疗反流疾病的腹部方法; [0238] Figure 54-55 shows a method for the treatment of abdominal reflux disease;

[0239] 图56是示意方块图,示出了本发明的反流疾病装置的实施方式,其中从外部能源释放无线能量,用作刺激设备的动力; [0239] FIG. 56 is a schematic block diagram showing an embodiment of reflux disease apparatus of the present invention, wherein the wireless energy released from the external energy source, as a power of the stimulation device;

[0240] 图57是示意方块图,示出了本发明的另一种实施方式,其中从内部能源释放无线 [0240] FIG. 57 is a schematic block diagram showing another embodiment of the present invention, wherein the release wireless energy from the internal

能量; Energy;

[0241] 图58-61是示意方块图,分别示出了本发明的4种实施方式,其中开关植入患者体内,用于直接或间接切换刺激设备的动力; [0241] FIG. 58-61 is a schematic block diagram, respectively, showing a fourth embodiment of the present invention, wherein the switch implanted in the patient for directly or indirectly switching the power of the stimulation device;

[0242] 图62是示意方块图,示出了可植入部件的可以想到的组合,用于实现各种可选的通信方案; [0242] FIG. 62 is a schematic block diagram showing the components of an implantable conceivable combination, a variety of options for implementing communications programs;

[0243] 图63示出了根据本发明植入患者体内的装置;和 [0243] FIG. 63 illustrates a patient implanted device according to the present invention; and

[0244] 图64是方块图,示出了本发明实施方式的遥控部件; [0244] FIG. 64 is a block diagram showing the remote control unit embodiment of the present invention;

[0245] 图65-68是用于通过牵拉胃壁来治疗肥胖的装置的实施方式,所述装置可以与植入人类患者体内的反流治疗装置组合; [0245] Figure 65-68 embodiment is used by pulling the stomach wall to treat obesity apparatus, the reflow apparatus may be combined with the treatment device implanted in human patients;

[0246] 图69是本发明的植入式设备的表面结构的一般描述;[0247] 图70-76是用于治疗肥胖的装置的各种实施方式的视图,所述装置可以与植入人类患者体内的反流治疗装置组合; [0246] FIG. 69 is a general description of the surface structure of the implantable device of the present invention; [0247] FIG. 70-76 are views of various embodiments of the apparatus for the treatment of obesity, the apparatus may be implanted in humans Reflux treatment device assembly patient;

[0248] 图77-93示出了为治疗肥胖的装置提供动力的各种方式,该装置可以与植入人类患者体内的反流治疗装置相结合; [0248] Figure 77-93 shows the power the device for treatment of obesity in various ways, the device can be combined with reflux treatment device implanted in human patients;

[0249] 图94-100示出了为植入人类患者体内的治疗肥胖的装置提供液压或气压动力的各种方式; [0249] Figure 94-100 shows provide hydraulic or pneumatic power for the device in vivo treatment of obesity in a human patient implants in various ways;

[0250] 图101-105示出了用来治疗反流和肥胖的各种器械; [0250] FIG. 101-105 shows used to treat reflux and obesity variety of equipment;

[0251] 图106-107示出了用来治疗反流和肥胖的手术方法; [0251] FIG. 106-107 shows reflux and surgical methods for the treatment of obesity;

[0252] 图108示出了在组装前,成组件形式的运动约束设备的实施方式; [0252] FIG. 108 shows before assembly, the embodiment as a component in the form of the motion restraint device;

[0253] 图109示出了在第一和第二部分组装好之后的运动约束设备的实施方式; [0253] FIG. 109 shows an embodiment of the first and second parts assembled after exercise restraint device in;

[0254] 图110示出了在第三和第四部分组装之后的图109所示的实施方式; [0254] FIG. 110 shows the embodiment shown in FIG assembled after the third and fourth part 109;

[0255] 图111示出了在组装完最后部分时的图110所示实施方式; [0255] Figure 111 shows the embodiment during assembly after the final portion 110 shown in FIG;

[0256] 图112示出了在最终组装好之后的图108-111所示的实施方式; [0256] FIG. 112 illustrates 108-111 embodiment shown in Fig after the final assembled;

[0257] 图113a示出了带有操作通道的图108所示实施方式的芯部部件; [0257] Figure 113a shows a diagram with the operation of the channel portion of the core member 108 as shown in the embodiment;

[0258] 图113b至113f分别示出了根据平面1-1、11-11、III-III、IV-IV的图113s所示芯部部件的横截面视图; [0258] FIG 113b to 113f respectively show a plan 1-1,11-11, III-III, IV-IV of FIG 113s shown a cross-sectional view of the core member;

[0259] 图114和115示出了如图108所示设备的替代实施方式。 [0259] FIG. 114 and 115 illustrate an alternative embodiment of the device 108 shown in FIG.

具体实施方式 DETAILED DESCRIPTION

[0260] 运动约束设备 [0260] motion restraint device

[0261] 图IA是描绘装置11的简略视图,装置11包括根据本发明以生物相容材料制成并植入患者体内用于治疗胃食管返流疾病的运动约束设备10,在图IA中,设备10内陷在胃底。 [0261] FIG. IA is a schematic view depicting apparatus 11, the apparatus 11 includes a biocompatible material and implanted in accordance with the present invention a patient for the treatment of gastroesophageal reflux disease exercise restraint device 10, in Fig. IA, the retraction device 10 in the fundus. 设备10包括主体13,主体具有外表面15,该外表面适合在患者横膈膜18与内陷胃底壁16下部的至少一部分之间抵靠胃底壁16的外侧壁16a的一部分。 Apparatus 10 includes a body 13, the body having an outer surface 15 of the outer surface of the diaphragm 18 is suitable for some patients with retraction of gastric wall 16 between at least a portion of the lower portion abuts against the outer wall 16 of the gastric wall 16a. 因此,在设备10以这种方式内陷的情况下,患者胃的心切迹朝向患者横膈膜的运动受到约束,因此阻止贲门滑过患者横膈膜开口进入患者胸腔20,并且保持患者腹部施加在患者贲门括约肌上的支撑压力。 Thus, in the case of the device 10 in such a manner retraction, the patient's stomach in patients with heart notch toward the diaphragm movement is constrained, thereby preventing cardiac patients over the diaphragm opening into the patient's chest 20, and is applied to maintain the patient's abdomen In support of the patient cardiac sphincter pressure.

[0262] 主体13可以膨胀,适于用凝胶或流体填充。 [0262] Body 13 may be expanded, adapted to be filled with a gel or fluid. 可以提供用于接收流体来填充所述运动约束设备的流体或凝胶接收构件。 It may be provided for receiving a fluid or gel filled with the motive fluid receiving member restraint device. 作为替代,主体13包括同质材料并且可以是实心体。 As an alternative, the body 13 includes a homogeneous material and can be a solid body. 作为替代,主体13包括呈限定腔室的包围壁形式的外壁。 Alternatively, the body 13 comprises, in the form of an outer wall defining a wall surrounding the chamber. 所述外壁可以是刚性壁、弹性壁或挠性壁。 The outer wall may be rigid, flexible wall or flexible wall. 如果外壁为刚性壁,则在承受胃蠕动产生的作用力时,其刚性要足以保持不会发生变形。 If the rigid outer wall, then subjected to the force generated by gastric motility, its rigidity sufficient to maintain the deformation does not occur.

[0263] 运动约束设备10的主体13可以以多种不同的方式附连到胃底16的壁16a上。 [0263] the main motion restraint device 10 13 may in many different ways attached to the gastric wall 16a 16's. 在图IA所示实施方式中,设备10从胃的外侧内陷入胃底壁上。 In the embodiment shown in FIG. IA, the apparatus 10 into the gastric wall from the outside of the stomach. 在内陷之后,施加由多个胃到胃的缝合线或卡钉2构成的第一固定设备,在短期内将所述内陷状态保持完好。 After retraction, applied by a plurality of the stomach to the first fixture stomach sutures or staples 2 constituted, in the short term the retraction state intact. 这样允许人体组织生长,从而长期将所述内陷状态保持完好。 This allows the body tissue growth, thus the long-term the retraction state intact.

[0264] 可以可选地存在第二固定设备,该第二固定设备由设置在胃底16的壁16a和食管24的壁2之间的多条缝合线或卡钉22b构成,将设备10保持在患者横膈膜18以及内陷胃底壁16下部至少一部分之间的所述位置。 [0264] may optionally be present a second fixing device, the fixing device consists of a plurality of second suture 16a is disposed between the wall 16 of the fundus and esophagus walls 24 2 or staples 22b constituting the holding device 10 At least a portion of said position between the lower portion of the diaphragm 18 patients with gastric wall 16 and retraction. 因此,设备10利用该第二固定设备附连到所述位置。 Thus, using the second apparatus fixing device 10 attached to the position. 可以采用将设备10直接或间接附连到横膈膜肌肉18或者其他肌肉组织。 The device 10 can be used directly or indirectly attached to the diaphragm muscle 18 or other muscle tissue. 作为替代方案,可以采用将设备10直接或间接固定到食管24。 Alternatively, the device 10 may be used directly or indirectly fixed to the esophagus 24. 作为替代,或者另外,可以存在成设置在胃底16的壁16a和横膈膜18之间的缝合线或卡钉22c形式的第三固定设备,将设备10固定在所述位置。 Alternatively, or in addition, there may be provided on the suture to the fundus wall 16a and the diaphragm 16 or 18 between the staple 22c form a third fixing device, the fixing device 10 at the position.

[0265] 图IB示出了基本上类似于图IA所示实施方式的实施方式。 [0265] Figure IB shows a substantially similar embodiment shown in Figure IA embodiments. 在图IB中,除了附连部22之外,主体13和内陷部采用反流主体13和横膈膜18之间的缝合线和/或卡钉22c 固定,将所述设备保持在位于贲门14上方的位置。 In Figure IB, in addition to the attachment portion 22 of the main body 13 and the retraction of reflux using suture body between 13 and diaphragm 18 and / or staples 22c fixed, the device is placed in the cardia 14 above location.

[0266] 图IC示出了另一种基本上类似于图IA所示实施方式的实施方式。 [0266] Figure IC illustrates another substantially similar to the embodiment shown in FIG. IA embodiments. 在图IC中,反流治疗设备采用将胃底16的壁16a连接到胃底16的壁16a的胃到胃的缝合线或卡钉22a 保持就位。 In view of the IC, the reflux treatment device using the gastric wall 16 is connected to the wall 16a 16a 16 of the fundus of the stomach to stomach sutures or staples 22a in place. 此外,采用来自胃底16a的壁16到食管Ma的壁的缝合线22b或卡钉,以及来自胃底16a的壁到横膈膜的缝合线或卡钉,将反流治疗设备10保持就位。 In addition, the use of wall 16a from the fundus 16 to the wall of the esophagus Ma 22b sutures or staples, and a wall from the fundus to the diaphragm 16a of sutures or staples, the reflux treatment device 10 remains in place .

[0267] 根据本发明,用于治疗胃食管反流疾病的装置17的替代实施方式在图2A中示出。 [0267] According to the present invention, an alternative embodiment of the device for treatment of gastroesophageal reflux disease, 17 shown in FIG. 2A. 该实施方式在许多方面类似于参照图IA至IC所述的实施方式。 This embodiment is similar in many respects to the embodiment with reference to FIG IA said IC. 因此,图中示出的运动约束设备10植入患者体内并内陷在胃底中。 Thus, the figure shows the motion restraint device implanted in a patient 10 and retraction of the fundus. 但是,在图2A所示实施方式中,设备10从胃的内侧内陷,而非像图IA至IC那样从胃的外侧。 However, in the illustrated embodiment of FIG. 2A, the device 10 from the inside of the stomach retraction, rather like Figure IA to IC from the outside as the stomach. 运动约束设备10包括主体13,该主体适于在患者横隔膜18和内陷胃底壁16下部至少一部分之间的位置抵靠胃底壁16内侧壁的一部分。 Movement restraining device 10 includes a body 13, patients in the lower part of the body is adapted to the diaphragm 18 and the retraction position at least a portion of gastric wall 16 between the wall 16 against the part of the inner wall of the fundus. 在这种实施方式中,主体13位于直立人类或者哺乳动物患者的贲门区域14上方。 In this embodiment, the body 13 is positioned upright cardia region above the human or mammalian patient 14. 设备10的主体13构造成抵靠胃底16的壁16a,此外,具有适合抵靠该胃底壁的外表面15。 The main device 10 is configured to abut 13 gastric wall 16a 16, in addition, it has adapted to the gastric wall against the outer surface 15. 因此,在设备10以如上参照图IA所述方式内陷时,患者胃的心切迹朝向患者横膈膜的运动受到约束,由此防止贲门滑过患者横膈膜开口进入患者胸腔20,并且保持患者腹部施加在患者贲门括约肌上的支撑压力。 Thus, when the device 10 in the manner described above with reference to FIG IA retraction, the patient's stomach in patients with cardiac notch towards the diaphragm movement is constrained, thereby preventing cardiac patients over the chest diaphragm opening into the patient 20, and to maintain applied to the patient's cardiac sphincter pressure in patients with abdominal support.

[0268] 内陷之后,从胃16内侧施加包括第一固定设备的多条胃到胃的缝合线或卡钉33a,在短期内保持该内陷状态完好。 [0268] After the retraction, the stomach from the inside applied 16 includes a plurality of the stomach to stomach sutures or first fixed equipment staples 33a, maintaining the retraction in good condition in the short term. 这样允许人体组织生长,长期保持该内陷状态完好。 This allows the body tissue growth, long-term retention of the retraction in good condition. 可以在形成设备10的内陷状态的一部分的胃底16的壁部分16b和食管M的壁2之间提供包括第二固定设备的另外的缝合线或卡钉22b,将设备10保持在所述位置。 May provide additional suture including a second fixing device 22b or staple forming portion between the fundus retraction status of the device 10 of the wall portion 16 of wall 16b and esophagus M 2, the device 10 will remain at the Location. 类似地,成缝合线或卡钉22c形式的第三固定设备可以设置在形成设备10的内陷状态的一部分的胃底16的壁部分16c和横膈膜18之间,将设备10保持在所述位置。 Similarly, a suture or staples 22c form a third fixing device may be provided between a portion of the fundus retraction state forming apparatus 10 and the wall portion 16c of the diaphragm 18 16, 10 remain in the device said position.

[0269] 替代实施方式在图2B中示出。 [0269] In an alternative embodiment shown in FIG. 2B. 该实施方式在许多方面类似于参照图2A所述的实施方式。 This embodiment is similar in many respects with reference to the embodiment described in Figure 2A. 但是,这时缝合线和卡钉22b和33c全部连接到反流治疗设备10的固定件。 However, when the sutures and staples 22b and 33c are all connected to the reflux treatment device fitting 10. 这种实施方式缺少胃到横膈膜的缝合线或卡钉。 This embodiment lacks the stomach to the diaphragm sutures or staples.

[0270] 用于治疗胃食管反流疾病的装置19的替代方案在图3A中描绘。 Alternatives [0270] means for the treatment of gastroesophageal reflux disease, 19 is depicted in Figure 3A. 该替代方案在许多方面类似于参照图IA至IC和2A至2B所述的实施方式。 This alternative is similar in many respects to IC and IA with reference to FIG. 2A and 2B of the embodiment of. 因此,图中示出运动约束设备10植入患者体内。 Thus, there is shown a motion restraint device 10 implanted in the patient. 设备10包括主体13,该主体适于在患者隔膜18和胃底壁16之间的位置抵靠胃底壁16的一部分。 Apparatus 10 includes a body 13, the body is adapted to the position of the diaphragm 18 between the patient and the gastric wall 16 against the part of the gastric wall 16. 但是,在这种替代方案中,设备10并不内陷在胃16中。 However, in this alternative, the retraction device 10 is not in the stomach 16. 相反, 设备10的附连件包括连接结构10a,该结构优选为网状结构,适于与胃底壁16a接触,促使人体组织生长,从而长期固定连接到胃壁的胃食管反流疾病治疗设备的位置。 On the contrary, the attachment device 10 comprises a connecting structure 10a, the structure is preferably a mesh structure, and is adapted to contact with gastric wall 16a, to promote the growth of tissue, so long fixedly connected to the stomach wall gastroesophageal reflux disease treatment apparatus Location. 在短期内,可以在连接结构IOa和胃底壁16a之间提供成缝合线或卡钉4形式的第一固定设备,以保持连接结构IOa就位。 In the short term, it may be provided between the connecting structure IOa and gastric wall 16a into sutures or staples 4 form of a first fixed equipment, to maintain the connection structure IOa place.

[0271] 连接结构IOa可以适配地用于设置在胃底16的壁16a和食管M的壁2之间、 [0271] IOa connection structure can be adapted to be used to set between the walls 16a and esophageal and gastric 16 M wall 2,

48成缝合线或卡钉44b形式的第二固定设备,从而将设备10保持在患者横膈膜18和胃底壁16之间的所述位置。 48 to sutures or staples 44b in the form of a second fixed equipment, which the device 10 is held at the position of the diaphragm 18 patients between 16 and gastric wall. 类似地,连接结构IOa也可以适配地用于设置在胃底16的壁16a和横膈膜18之间、成缝合线或卡钉Mc形式的第三固定设备,同样将设备10保持在所述位置。 Similarly, the connection structure can be adapted to be used IOa disposed between the fundus wall 16a of the diaphragm 18 and 16, into sutures or staples in the form of third-Mc fixtures, as the device 10 in the said position.

[0272] 替代实施方式在图:3B中示出。 [0272] In an alternative embodiment of FIG: 3B shows. 该实施方式在许多方面类似于参照图3A所述的实施方式。 This embodiment is similar in many respects with reference to FIG. 3A according to the embodiment. 在这种实施方式中,反流治疗设备10与图2A至2B相同,从胃的内侧内陷。 In this embodiment, the reflux treatment device 10 is the same as in Fig. 2B to 2A, sunk from the inside of the stomach. 连接结构IOa定位在胃底16的壁16a上,位于由反流治疗设备10构成的内陷部的上方和周围。 IOa connecting structure is positioned on the gastric wall 16a 16 located above and around the reflux treatment device 10 is configured retraction portion.

[0273] 根据本发明,用于治疗胃食管反流疾病的装置21的替代实施方式在图4A中描绘。 [0273] According to the present invention, an alternative embodiment of the apparatus for the treatment of gastroesophageal reflux disease 21 depicted in FIG. 4A. 该实施方式在许多方面类似于参照图IA至IC所述的实施方式。 This embodiment is similar in many respects to the embodiment with reference to FIG IA said IC. 在图4A中,示出了根据本发明,用于治疗胃食管反流疾病的设备10的视图,该设备植入患者体内。 In Figure 4A, it shows a view of the present invention, a device for the treatment of gastroesophageal reflux disease, 10 of the device implanted in the patient. 在图4A中,运动约束设备10同样内陷在胃底16中。 In Figure 4A, the motion restraint device 10 is also sunk in the fundus 16. 设备10包括主体13,该主体具有适合在患者横膈膜18和内陷胃底壁16下部至少一部分之间的位置抵靠胃底壁16的外侧壁16a的一部分的外表面15。 Apparatus 10 includes a main body 13, the body having a suitable location between at least a portion of the diaphragm 18 and the lower portion of the patient retraction gastric wall 16 abuts against the outer surface 16a of the outer side wall 15 and gastric wall 16 part. 主体13构造成抵靠胃底16的外侧壁16a。 Body 13 is configured to abut the outer wall 16a 16 of the fundus. 因此,在设备10以这种方式内陷时, 患者胃的心切迹朝向患者隔膜的运动受到约束,由此阻止贲门通过患者横膈膜开口滑入患者胸腔20,并且保持患者腹部施加在患者贲门括约肌上的支撑压力。 Therefore, when the retraction device 10 in this manner, the patient's stomach in patients with cardiac notch towards the diaphragm movement is constrained by the patient thereby preventing cardiac patients chest diaphragm slide opening 20, and is applied to keep the patient's abdomen in patients with cardiac support pressure on the sphincter.

[0274] 在图4A的实施方式中,如图IA的实施方式,在设备10内陷在胃底16中之后,施加由多条胃到胃的缝合线或卡钉2构成的第一固定设备,在短期内保持该内陷状态完好。 [0274] In the embodiment of FIG. 4A, the embodiment of FIG. IA, the retraction device 10 in the fundus 16 after application of the first fixing device by a plurality of the stomach to stomach sutures or staples constituted 2 In the short term maintaining the retraction in good condition. 提供由多条缝合线或卡钉22b构成的第二固定设备,将设备10保持在患者横膈膜18和内陷胃底壁16下部的至少一部分之间的所述位置。 Providing a second fixing device by a plurality of sutures or staples 22b consisting of the holding device 10 in the diaphragm 18 and the position of the patient at least a portion of the wall 16 between the lower portion of the fundus retraction. 此外,可以在胃底16的壁16a和横膈膜18之间提供成缝合线或卡钉22c形式的第三固定设备,同样将设备保持在所述位置。 In addition, you can offer to sutures or staples 22c form a third fixture between the gastric wall 16a of the diaphragm 18 and 16, the device is held in the same position.

[0275] 在图4A所示的实施方式中,运动约束设备10的尺寸可以在植入的同时进行调节。 [0275] In the embodiment shown in FIG. 4A, the size of the motion restraint device 10 can be adjusted while the implant. 设备10与借助引线52b连接到设备10的液压容器52相关联,由此可以通过手动按压容器52来进行非侵入式的调节。 Device 10 is connected by means of wire 52b to the hydraulic container 52 associated with device 10, which may be non-intrusive regulation by manually pressing the container 52. 设备10进而连接到一个或多个更小的腔室10b。 Device 10 is further connected to one or more smaller chambers 10b.

[0276] 此外,上述实施方式可以替代地也用于治疗肥胖症。 [0276] In addition, the above-described embodiments may also alternatively be used in the treatment of obesity. 在这种实施方式中,该装置适于通过利用运动约束主体13的体积来包含流体、并进一步利用连接到主体13的一个或多个较小腔室IOb以泵填充流体来牵拉胃底壁以产生饱足感,由此治疗肥胖症。 In this embodiment, the apparatus is adapted by using motion constrained volume 13 to contain body fluids, and further connected to one or more of the use of small chamber body 13 is filled with a fluid pump IOb to be pulled gastric wall to produce satiety, thereby treating obesity. 小腔室IOb 也适于内陷到胃底壁中,并且在填充流体时,发生扩张以导致人体感知器反馈产生饱足感。 Also suitable for small chamber IOb sunk into gastric wall, and when the fill fluid, the expansion occurs to cause human perception feedback satiety. 通过将小型液压容器/泵皮下置入患者体内,患者能根据需要泵送液压流体填充该小型腔室以感觉到饱足。 By small hydraulic container / pump subcutaneously into the patient, the patient according to the hydraulic fluid to be pumped fills the small chamber to feel satisfied.

[0277] 替代实施方式在图4B中示出。 [0277] In an alternative embodiment shown in Figure 4B. 该实施方式基本上类似于图4A所示的实施方式, 但是区别在于如何控制反流治疗设备10和腔室10b。 This embodiment is substantially similar to the embodiment shown in Fig. 4A, but the difference lies in how to control the reflux treatment device 10 and the chamber 10b. 这时,腔室IOb并不是利用皮下泵来控制,而是利用通电的内部控制单元56来控制。 At this time, the chamber IOb not use subcutaneous pump control, but the use of internal power-control unit 56 to control. 内部控制单元56包括用于患者控制设备10如何使用来治疗反流和/或肥胖的部件。 Internal control unit 56 includes a patient how to use the control device 10 to treat reflux and / or fat components. 它还可以包括向该设备提提供动力力的部件。 It can also include a reference to the device powered force member.

[0278] 内部控制单元56可以包括电池70、电开关72、马达/泵44、容器52和注入端口1001。 [0278] The internal control unit 56 may include a battery 70, a power switch 72, the motor / pump 44, container 52 and injection port 1001. 带有遥控器的能量发射设备34适于用于控制该设备并给该设备提供动力。 Energy with a remote control transmitter device 34 is used to control the device and adapted to provide power to the device. 元件根据情况进行选择,例如该设备是否为电气、液压、气压或机械操作设备。 Element is selected according to the situation, such as whether the device is electrical, hydraulic, pneumatic or mechanical handling equipment.

[0279] 该控制单元可以从任何传感器76接收输入,特别是从压力传感器接收。 [0279] The control unit can receive input from any of the sensors 76, especially received from the pressure sensor. 可以提供任何类型的传感器。 We can provide any type of sensor. 内部控制单元56优选包括呈FPGA或MCU或ASIC形式的芯片或者其他任何电路、部件或存储器(更为广泛的描述参见以下的“系统”部分)。 Internal control unit 56 preferably comprises, in an FPGA or ASIC MCU or any other form of chips or circuits, components or memory (see the following description of the wider "system" section).

[0280] 图4C基本上示出了与图4A相同的内容,区别在于只有一个小型腔室IOb而非像 [0280] Figure 4C shows essentially the same content Fig. 4A, the difference is only a small chamber rather like IOb

49图4A中那样是两个。 49 Figure 4A as two. 图4C示出的小型腔室IOb处于清空状态,而图4D示出的小型腔室IOb已经填充并且膨大以产生饱足感。 4C shows a small chamber IOb in empty state, and Fig. 4D shows IOb small chamber has been filled and inflated to produce satiety.

[0281] 根据本发明,用于治疗胃食管反流疾病的装置23的另一种替代实施方式在图5A 中描绘。 [0281] According to the present invention, apparatus for treatment of gastroesophageal reflux disease, an alternative embodiment 23 depicted in FIG. 5A. 同样,该实施方式在许多方面类似于以上参照图IA至IC所述的实施方式。 Also, this embodiment is similar in many respects to the above with reference to FIG IA IC of embodiment. 因此, 如同图IA所示的实施方式,内陷在胃底中的运动约束设备10包括主体13,该主体具有外表面15,该外表面适合在患者横膈膜18和内陷胃底壁16下部的至少一部分之间的位置抵靠胃底壁16的外侧壁16a的一部分。 Accordingly, as in the embodiment shown in Figure IA, in the fundus retraction motion restraint device 10 comprises a main body 13, the body 15 has an outer surface, the outer surface of the diaphragm 18 and is suitable for patients with gastric wall invagination 16 position at least a portion of the abutment between the lower part of the outer wall 16a of the gastric wall 16. 设备10的主体13构造成抵靠胃底16的外侧壁16a,并且具有大致光滑的、适合用于抵靠该胃底壁的外表面15。 The body 13 of the device 10 is configured to abut the outer side wall 16 of the gastric 16a, and having a substantially smooth, suitable for abutting the outer surface 15 of the gastric wall. 而且,同样,在设备10内陷在胃底16中之后,施加由多条胃到胃的缝合线或者卡钉2构成的第一固定设备,在短期内保持内陷状态完好。 And, just after retraction device 10 in the fundus 16 is applied by a plurality of first fixture stomach to stomach sutures or staples 2 constructed, maintained in good condition retraction in the short term. 在胃底16的壁16a和食管M的壁2之间施加由多条缝合线或者卡钉22b构成的第二固定设备,将设备10保持在所述位置。 Applying a second fixed device by a plurality of sutures or staples 22b formed between the gastric wall 16a and the wall of the esophagus 16 M 2, the device 10 is held at the position.

[0282] 在图5A所示的替代实施方式中,装置23进一步包括刺激设备沈,用于发出刺激脉冲,该刺激脉冲适于刺激贲门肌肉,以进一步闭合贲门,从而额外地防止胃食管反流疾病。 [0282] In an alternative embodiment shown in FIG. 5A, the apparatus 23 further comprises a stimulation device sink, for emitting stimulation pulses, the stimulation of cardiac muscle stimulation pulses adapted to further close cardia, thus additionally preventing gastro-oesophageal reflux disease. 装置23包括适于接收所述刺激脉冲的至少一个导体26a和至少一个电极^b。 Means 23 comprising the stimulation pulses adapted to receive at least one conductor and at least one electrode 26a ^ b.

[0283] 刺激设备尤选包括电子电路和能量源,在该优选实施方式中,能量源设置在设备10中。 [0283] In particular election stimulation device comprises an electronic circuit and an energy source, in this preferred embodiment, the energy source provided in the device 10.

[0284] 刺激设备沈优选以脉冲串的形式发射刺激脉冲,其中所述脉冲串适于以一时间间歇进行重复,该间歇扩展(extending)脉冲串中每个脉冲之间的间歇。 [0284] Shen stimulation device is preferably in the form of bursts to transmit stimulation pulses, wherein the pulse train is adapted to be repeated for a time interval, the interval of intermittent extension (extending) burst between each pulse.

[0285] 图5B基本上示出了与图5A相同的实施方式,并增加了内部控制单元56、遥控器观和外部能量发射设备34。 [0285] FIG. 5B shows a substantially same embodiment Fig. 5A, and an increase in the internal control unit 56, a remote control concept and the external energy transmission device 34. 内部控制单元56利用电引线56b连接到该刺激设备。 The use of the internal control unit 56 connected to the electrical lead 56b stimulation device. 内部控制单元57可以包括电池70和电开关72以及以下在“系统”部分描述的其他部件。 Internal control unit 57 may include a battery 70 and the electrical switch 72, and the following other components the "system" as described in section.

[0286] 根据本发明一种实施方式,反流疾病治疗设备10可以形成为大致卵形主体,如图6A所示。 [0286] According to one embodiment of the present invention, reflux disease treatment device 10 may be formed in a substantially oval body, shown in Figure 6A. 根据本发明另一种实施方式,反流疾病治疗设备10还可以形成卵形或球形主体, 中部带有凹痕,如图6B所示。 According to another embodiment of the present invention, reflux disease treatment device 10 may also be formed oval or spherical body, with a central dent, shown in Figure 6B. 根据本发明另一种实施方式,反流疾病治疗设备可以进一步形成为略微弯曲的卵形主体,如图6C所示。 According to another embodiment of the present invention, reflux disease treatment device may further be formed as a slightly curved oval body, shown in Figure 6C.

[0287] 根据本发明另一种实施方式,反流疾病治疗设备10可以形成为大致球形主体,如图6D所示。 [0287] According to another embodiment of the present invention, reflux disease treatment device 10 may be formed as a substantially spherical body, shown in Figure 6D.

[0288] 如上所述,反流治疗设备10固定在位于直立患者食管上方的位置。 [0288] As noted above, 10 is fixed at the top of the upright position esophageal reflux treatment device. 为了实现这种位置,图7所示的反流治疗设备的一种实施方式包括固定件10d,该固定件例如用作缝合线或卡钉的连接点。 To achieve this position, an embodiment reflux treatment apparatus shown in Figure 7 comprises a fixing member 10d, for example, as the fixing member point of attachment sutures or staples. 所述固定件可以是环圈或带孔或不带孔的脊凸,或者可以具有使其适合固定反流治疗设备10的任何其他形状。 The fixture may be ring or perforated or not perforated ridge convex, or may have to fit a fixed reflux treatment device 10 of any other shape.

[0289] 图8示出了反流治疗设备10的一种实施方式,其中可以通过液压部件进行调节, 并且IOe是注入端口,液压流体可以从该注入端口注入,以扩张该设备。 [0289] FIG. 8 shows a reflux treatment apparatus embodiment 10, wherein can be adjusted by hydraulic components, and IOe the injection port, the hydraulic fluid can be injected from the injection port to expand the device. 作为替代,在一种实施方式中,反流治疗设备10可以在手术过程中从小尺寸膨胀到较大尺寸,其中具有优势的是该设备初始为小尺寸,例如在腹腔镜手术过程中。 Alternatively, in one embodiment, the reflux treatment device 10 can swell in size from small to large size during surgery, which has the advantage is that the device is initially small size, for example, in laparoscopic surgery. 在这种实施方式中,任何填充材料、 固体、液体或气体可以通过注入端口IOe注入,以便让反流治疗设备10达成其最终形状。 In this embodiment, any filler material, a solid, liquid or gas can be injected through the injection port IOe, so that reflux treatment device 10 to reach its final shape.

[0290] 图9示出了一种实施方式,其中反流治疗设备10具有下沉式脊凸IOf,该脊凸适于能用手术工具保持。 [0290] FIG. 9 shows an embodiment in which the reflux treatment device 10 has a sunken ridge protruding IOf, suitable for use in the spine protruding surgical tool holder. 该脊凸将用于例如植入反流治疗设备的手术过程中。 The ridge protruding implant surgery procedure will be used, for example reflux treatment device.

[0291] 当反流疾病治疗设备10大致为球形时,由此它可以制作成整体或部分地包围食管,则反流疾病治疗设备10的内径D优选使得其可以包围食管和至少一部分胃底,以使该设备植入时并不直接抵靠食管壁。 [0291] When the reflux disease treatment device 10 is substantially spherical, whereby it can be made integrally or partially surround the esophagus, the reflux disease treatment apparatus 10 of the inner diameter D is preferably such that it can surround at least a portion of the esophagus and the fundus, so that the device implanted was not directly against the esophageal wall.

[0292] 运动约束设备10可以呈现任何能使该设备10停靠在约束患者胃的心切迹朝向患者隔膜的运动的位置的任何形式,由此阻止贲门滑过患者横膈膜开口进入患者胸腔,并且保持患者腹部施加在患者贲门括约肌上的支撑压力。 [0292] motion restraint device 10 may be presented in any form whatever enables the device 10 stops at the position constraint heart patients with gastric notch towards the patient's diaphragm movement, thereby preventing cardiac patients over the diaphragm opening into the patient's chest, and applied to the patient's cardiac sphincter pressure was maintained to support the patient's abdomen.

[0293] [0293]

[0294] 将要包含在根据本发明的装置中的能量和操作系统,一般以28指代,现在将参照图10至27对其进行描述。 [0294] will be included in the device according to the invention, the energy and operating system, generally refers to 28 generations, now with reference to FIG. 10-27 to describe it.

[0295] 图10所示的系统观包括呈植入式能量转化设备30形式的内部能源,该能量转化设备30适于经由电源线32向反流疾病治疗装置的耗能部件提供能量。 System Concept [0295] shown in Fig. 10 comprises, in an implantable energy transforming device 30 in the form of internal energy, the energy conversion device 30 is adapted to provide energy to energy consuming components of reflux disease treatment apparatus 32 via the power supply line. 外部能量发射设备34包括发射无线信号的无线遥控器,该无线信号被信号接收器接收,信号接收器可以包含在植入式能量转化设备30中,或者可以单独存在。 The external energy transmission device 34 comprises a wireless remote control transmitting a wireless signal, a radio signal is received by the signal receiver, the signal receiver may comprise an implanted energy transforming device 30, or may stand alone. 植入式能量转化设备30从该信号将能量转化为电能,该电能经由电源线32供应。 Implantable energy conversion device 30 from the signal energy into electrical energy, which supply 32 via the power cord.

[0296] 图10的系统观在图11中以更为概括的方块图形式表示,其中患者皮肤36—般以垂直线示出,将患者四分成位于该直线右侧的患者内部,位于该直线左侧的患者外部。 [0296] systems view in Figure 11. Figure 10 to more general block diagram form, where a patient's skin 36- shown as a vertical line, the patients were divided into four patients located inside the right side of the line, located in the line external to the patient's left side.

[0297] 图11示出了简化的方块图,示出了运动约束设备10、经由电源线32为设备10提供动力的能量转化设备30以及外部能量发射设备34。 [0297] FIG. 11 shows a simplified block diagram showing the motion restraint device 10, via the power supply line 32 for the device 10 to power the energy conversion device 30 and the external energy transmission device 34.

[0298] 图12示出了与图11所示相同的本发明的实施方式,除了利用极化能量可操作的呈电开关38形式的反向设备也植入患者四体内,用于让设备10反向。 [0298] FIG. 12 shows the same embodiment as shown in FIG. 11 of the present invention, in addition to using the polarization energy electrically operable switch 38 in the form of reverse four devices implanted in the body of the patient, so that the device 10 for reverse. 外部能量发射设备34的无线遥控器发射无线信号,该无线信号携带极化能量,并且植入式能量转化设备30将该无线极化能量转化为极化电流,用于操作电开关38。 The external energy transmission device 34 of the wireless remote control transmitting a wireless signal, the radio signal carries polarized energy and the implanted energy transforming device 30 the wireless polarized energy into polarization current for operating an electrical switch 38. 当利用植入式能量转化设备30切换电流极性时,电开关38反转由设备10实现的功能。 When utilizing implantable energy conversion device 30 switching current polarity reversal electric switch 38 functions implemented by the device 10.

[0299] 图13示出了与图11相同的本发明的实施方式,除了植入患者体内用于调节反流疾病治疗设备10的操作设备40设置在植入式能量转化设备30和设备10之间。 [0299] FIG. 13 and FIG. 11 illustrates the same embodiment of the present invention, in addition implanted in the patient for adjusting reflux disease treatment device 40 of the operation of the device 10 in the implanted energy conversion devices 30 and 10 of the Room. 操作设备可以表现为马达40的形式,诸如电动伺服马达。 Operation of the device can take the form of a motor 40, such as an electric servo motor. 在外部能量发射设备34的遥控器发射无线信号到植入式能量转化设备30的接收器的同时,马达40利用来自植入式能量转化设备30的能量提供动力。 While the external energy transmission device 34 of the remote control transmitting a wireless signal to the implantable energy transforming device of the receiver 30, the motor 40 utilize the energy from the implanted energy transforming device 30 to provide power.

[0300] 图14示出了与图11所示相同的本发明的实施方式,除了它还包括呈组件42形式的操作设备,该组件包括马达/泵单元78和植入患者体内的流体容器46。 [0300] FIG. 14 shows the same embodiment as shown in FIG. 11 of the present invention, further comprises, in addition to the operation of the device 42 in the form of assembly, the assembly including a motor / pump unit 78 and implanted in the patient fluid container 46 . 在这种情况下, 设备10是液压操作的设备,即液压流体被马达/泵单元44从流体容器46经由导管48泵送到设备10来操作该设备,并且液压流体被马达/泵单元44从设备10泵送回到流体容器46,从而将设备10返回到起始位置。 In this case, the device 10 is a hydraulically operated device, i.e. the hydraulic fluid by the motor / pump unit 44 is pumped into the conduit 48 to apparatus 10 via the operation of the device from the fluid container 46, and the hydraulic fluid by the motor / pump unit 44 from Back to the fluid reservoir 10 pumping device 46, so that the device 10 is returned to the starting position. 植入式能量转化设备30将无线能量转化为电流,例如极化电流,用于经由电源线50向马达/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, for supplying power via a power supply line 50 to the motor / pump unit 44.

[0301] 与液压操作的运动约束设备10不同,还可以设想所述操作设备包括气压操作设备。 [0301] and a hydraulically operated 10 different sports restraint device, it can also envisage the operation of the device comprises a pneumatic handling equipment. 在这种情况下,可以利用加压气体来进行调节,并且用气舱来代替流体容器,用空气代替流体。 In this case, the use of pressurized gas can be adjusted, and the gas tank to replace the fluid container, with air instead of fluid.

[0302] 在全部这些实施方式中,能量转化设备30可以包括可充电的蓄能器,比如可以通过无线能量充电并为该装置的任何耗能部件提供动力的电容器或电池。 [0302] In all of these embodiments, the energy conversion device 30 may include a rechargeable accumulator, such as may be charged by the wireless energy and to provide power for the capacitor or battery of any energy consuming components of the apparatus.

[0303] 外部能量发射设备34优选为无线设备,并且可以包括用于从人体外侧控制设备10的遥控控制设备。 [0303] the external energy transmission device 34 is preferably a wireless device, and may include a remote control device from the outside of the body 10 of the control device.

[0304] 这种控制设备可以包括无线遥控器以及手动控制器,该手动控制器具有置于皮肤下面的任何植入部件,以便由患者的手进行接触,很可能间接接触,例如按压按键。 [0304] The control device may include a wireless remote control and manual control, the manual controller having the implant placed under the skin of any part, in order to contact the patient's hand, probably indirect contact, such as pressing buttons.

[0305] 图15示出了本发明的实施方式,包括带有其无线遥控器的外部能量发射设备34、 在这种情况下以液压形式操作的设备10、和植入式能量转化设备30,还进一步包括液压流体容器52、马达/泵单元44以及呈液压阀切换设备M形式的反向设备,全部植入患者体内。 [0305] FIG. 15 illustrates an embodiment of the present invention, including external energy with its wireless remote control transmitter device 34, in which case the device 10, and an implantable form of energy in the operation of the hydraulic conversion device 30, further comprising a hydraulic fluid reservoir 52, the motor / pump unit 44 and a hydraulic valve switching device M was in the form of reverse device, all implanted in the patient. 当然,液压操作可以通过仅改变泵送方向而方便的实施,因此可以省略液压阀。 Of course, can be done by changing only the hydraulic pumping direction and convenient embodiment, the hydraulic valve can be omitted. 遥控器可以是与外部能量发射设备分开的设备,或者是包括在其中的设备。 It may be a remote control device separate from the external energy transmission device, or the device is included therein. 马达/泵单元44的马达是电动马达。 Motor / pump unit 44 of the motor is an electric motor. 响应来自外部能量发射设备34的无线遥控器的控制信号,植入式能量转化设备30利用该控制信号携带的能量为马达/泵单元44提供动力,由此马达/泵单元44在液压流体容器52和设备10之间分配液压流体。 Response from the wireless remote control of the external energy transmission device 34 a control signal, the implanted energy transforming device 30 using the energy carried by the control signal of the motor / pump unit 44 to power, whereby the motor / pump unit 44 in the hydraulic fluid reservoir 52 and distribution of hydraulic fluid between the apparatus 10. 外部能量发射设备34的遥控器控制液压阀切换设备M以在两个方向之间切换液压流体流动方向,其中一个方向是马达/泵单元44 从液压流体容器52向设备10泵送流体以操作设备10的方向,另一个相反的方向是由马达/泵单元44将流体从设备10泵送回到液压流体容器52以便将设备10返回起始位置的方向。 External energy transmission device 34 of the remote control hydraulic valve switching device M to switch between the two directions of hydraulic fluid flow direction, one direction is the motor / pump unit 44 from the hydraulic fluid reservoir 52 to the device 10 pumping fluid handling equipment direction 10, and the other in the opposite direction by the motor / pump unit 44 from the apparatus 10 to pump fluid back to the hydraulic fluid reservoir 52 to the device 10 returns to the starting position direction.

[0306] 图16示出了与图15所示实施方式相同的实施方式,除了由外部能量发射设备34 的无线遥控器控制的内部控制单元M、蓄能器58和电容器60也植入患者体内。 [0306] FIG. 16 illustrates the embodiment shown in FIG. 15 to the same embodiment, in addition to the internal control unit M from the external energy transmission device 34 of the wireless remote control, the accumulator 58 and capacitor 60 are implanted into the patient . 内部控制单元56布置成将从植入式能量转化设备30接收的电能存储在蓄能器58中,该蓄能器向设备10供应能量。 Internal control unit 56 is arranged from the implantable energy conversion apparatus 30 receives the energy stored in the accumulator 58, the accumulator 10 supplies energy to the device. 响应来自外部能量发射设备34的无线遥控器的控制信号,内部控制单元56从蓄能器58释放电能并经由电线62和64转化释放的能量,或者经由电线66、稳定电流用的电容器60、电线68以及电线64间接转化来自植入式能量转化设备30的电能,用于设备10的操作。 Response from the wireless remote control of the external energy transmission device 34 a control signal, the internal control unit 56 releases energy from the accumulator 58 and the released energy via wires 62 and 64 transformed, or via wires 66, the capacitor 60 with a constant current, wire 68 and 64 indirect wire conversion from energy into electrical energy implantable device 30 for operation of device 10.

[0307] 内部控制单元优选可以从患者身体外侧进行编程。 [0307] Preferably the internal control unit can be programmed from outside the patient's body. 在优选实施方式中,内部控制单元进行编程以调节设备10,根据预先编程的时间安排,或者根据来自感测患者任何可能的身体参数或者所述设备的功能参数的任何传感器的输入,牵拉胃部。 In a preferred embodiment, the internal control unit is programmed to adjust the device 10, arranged according to a pre-programmed time, or in accordance with any sensor input function parameters measured from the flu or any possible physical parameters of the device, pull the stomach section.

[0308] 根据替代方案,可以省略图16所示的实施方式中的电容器60。 [0308] According to an alternative, the embodiment may be omitted as shown in Fig. 16 the capacitor 60. 根据另一种替代方案,可以省略该实施方式中的蓄能器58。 According to another alternative, it may be omitted in this embodiment of the accumulator 58.

[0309] 图17示出了与图10所示实施方式相同的本发明的实施方式,除了为操作设备10 供应能量的电池70和切换设备10的操作的电开关72也植入患者体内。 [0309] FIG. 17 illustrates the embodiment shown in FIG. 10 of the same embodiment of the present invention, in addition to the operation of the battery power supply device 10 and switching device 70 operated electrical switch 10 is also implanted within the patient 72. 电开关70由植入式能量转化设备30供应的能量操作,从停止模式切换到启动模式,其中在停止模式(off mode)电池70不工作,在启动模式(on mode)电池70供应能量用于操作所述设备10。 Electric switch 70 by the implantable energy conversion device 30 supplies energy to operate, switching from stop mode to start mode, in which the stop mode (off mode) the battery 70 does not work, start mode (on mode) the battery 70 for supplying energy Operation of the apparatus 10.

[0310] 图18示出了与图16所示实施方式相同的本发明的实施方式,除了由外部能量发射设备34的无线遥控器控制的内部控制单元46也植入患者体内。 [0310] FIG. 18 illustrates an embodiment shown in FIG. 16 the same way as the embodiment of the present invention, in addition to the internal control unit by the external energy transmission device 34 of the wireless remote control 46 is also implanted in the patient. 在这种情况下,电开关72被由植入式能量转化设备30供应的能量操作,从停止模式切换到待命模式(standby mode),其中在停止模式,无线遥控器被阻止控制内部控制单元56并且电池不工作,在待命模式,遥控器被允许控制内部控制单元56以从电池70释放电能用于操作所述设备10。 In this case, the electric switch 72 is converted by the implantable device 30 energy supply energy to operate, switching from stop mode to standby mode (standby mode), in which the stop mode, the wireless remote control is prevented from controlling the internal control unit 56 and the battery does not work in the standby mode, the remote control is permitted to control the internal control unit 56 to release electric energy from the battery 70 for operating the device 10.

[0311] 图19示出了与图17所示实施方式相同的本发明的实施方式,除了蓄能器58替换电池70并且植入式部件互联方式不同。 [0311] FIG. 19 illustrates an embodiment shown in FIG. 17 and the same embodiment of the present invention, in addition to the accumulator 58 to replace the battery 70 and the implanted components interconnected in different ways. 在这种情况下,蓄能器58存储来自植入式能量转化设备30的能量。 In this case, the accumulator 58 stores energy from the implanted energy transforming device 30. 响应来自外部能量发射设备34的无线遥控器的控制信号,内部控制单元56控制电开关72从停止模式切换到启动模式,其中在停止模式蓄能器58不工作,在启动模式蓄能器58为操作所述设备10供应能量。 In response to a control signal from the external energy transmission device 34 of the wireless remote control, the internal control unit 56 controls the electric switch 72 from stop mode to start mode, stop mode in which the accumulator 58 does not work, start-up mode in the accumulator 58 Operation of the apparatus 10 to supply energy.

[0312] 图20示出了与图18所示实施方式相同的本发明的实施方式,除了电池70也植入患者体内并且植入式部件的互联形式不同。 [0312] FIG. 20 shows the same embodiment as shown in FIG. 18 embodiment of the present invention, in addition to the battery 70 is also implanted in the patient and implanted in different forms of network components. 响应来自外部能量发射设备34的无线遥控器的控制信号,内部控制单元56控制蓄能器58输送能量以操作电开关72从电池70不工作的停止模式切换到电池70为操作所述设备10供应电能的启动模式。 Response from the wireless remote control of the external energy transmission device 34 a control signal, the internal control unit 56 controls the accumulator 58 to operate the electrical energy delivered switch 72 is switched from the battery 70 does not stop working mode of operation of the battery 70 to the supply device 10 energy startup mode.

[0313] 作为替代,电开关72可以利用蓄能器58供应的能量操作,以便从无线遥控器被阻止控制电池70供应电能并且不工作的停止模式切换到无线遥控器被允许控制电池70为操作设备10供应电能的待命模式。 [0313] Alternatively, the electrical switch 72 can take advantage of the accumulator 58 supplies energy to operate, so that from the wireless remote control is prevented from controlling the battery 70 and the power supply does not work stop mode is switched to the wireless remote control is permitted to control the battery 70 to operate Equipment 10 supply electricity in standby mode.

[0314] 应该理解,所述开关应该从最宽泛的实施方式解释。 [0314] It should be understood from the switch should be interpreted in the broadest embodiment. 这意味着FPGA或者DA转换器或者任何其他电子部件或者优选从患者身体外侧控制或者由内部控制单元控制的可以切换电力接通和关断的电路。 This means an FPGA or a DA converter or any other electronic component or preferably outside of the patient's body or the control unit controls the power switching circuit may be turned on and off by the control from the inside.

[0315] 图21示出了与图17所示实施方式相同的本发明的实施方式,除了马达40、呈齿轮箱74形式的机械反向设备和用于控制齿轮箱74的内部控制单元也植入患者体内。 [0315] FIG. 21 and FIG. 17 shows the same embodiment as shown in the embodiment of the present invention, in addition to the motor 40, the gear box 74 was the reverse form of mechanical device for controlling the gearbox 74 also internal control unit implanted into the patient. 内部控制单元56控制齿轮箱74以反转由设备10实施的功能(机械操作)。 Internal control unit 56 controls the gearbox 74 to reverse the functions implemented by the device 10 (mechanical operation). 甚至更简单的是,电子地切换马达的方向。 Even more simply, electronic switching direction of the motor.

[0316] 图22示出了与图20所示实施方式相同的本发明的实施方式,除了植入式部件的互联方式不同。 [0316] FIG. 22 illustrates the embodiment shown in FIG. 20 the same manner as the embodiment of the present invention, in addition to interconnect different implantable member. 就是说,在这种情况下,当蓄能器58 (合适的话为电容器)激活电开关72 以切换到启动模式时,内部控制单元56由电池70提供动力。 That is, in this case, when the accumulator 58 (if appropriate capacitor) activation electrical switch 72 to switch to start mode, the internal control unit 56 is powered by a battery 70. 当电开关72处于其启动模式时,内部控制单元56被允许控制电池70为操作设备10供应能量或者不供应能量。 When the power switch 72 is in its start-up mode, the internal control unit 56 is permitted to control the battery 70 to supply energy for the operation of the device 10 or do not supply energy.

[0317] 图23简略示出了用于实现各种通信选项的所述装置的植入式部件的能考虑到的组合方式。 [0317] Figure 23 schematically illustrates a way to take into account the combination of the means for achieving various communication options implantable member. 基本上,就是设备10、内部控制单元56、马达或泵单元44和包括外部无线遥控器的外部能量发射设备34。 Basically, that is, the device 10, the internal control unit 56, the motor or pump unit 44 and the external energy, including external wireless remote control transmitting device 34. 正如上述,无线遥控器发射控制信号,所述控制信号被内部控制单元56接收,而内部控制单元进而控制所述装置的各种植入式部件。 As described above, wireless remote control transmitter signal, the control signal is received by the internal control unit 56, and the internal control unit in turn controls the various implanted device components.

[0318] 优选表现为传感器76形式的反馈设备,可以植入患者体内,用于感测患者的身体参数,诸如通知患者在吃东西的食管收缩波。 [0318] Preferably the performance of the sensor 76 in the form of feedback devices can be implanted in the patient for sensing a physical parameter of the patient, such as notification of the esophagus in patients with eating contraction wave. 内部控制单元56,或者作为替代,外部能量发射设备34的外部无线遥控器,可以响应来自传感器76的信号来控制设备10。 Internal control unit 56, or alternatively, the external energy transmission device 34, an external wireless remote control, may respond to signals from the sensor 76 to the control device 10. 收发器可以与传感器76组合,用于将有关感测到的身体参数的信息发送给外部无线遥控器。 Transceiver in combination with the sensor 76 for sending information on the sensed physical parameter to the external wireless remote control. 无线遥控器可以包括信号发射器或者收发器,并且内部控制单元46可以包括信号接收器或者收发器。 Wireless remote control may comprise a signal transmitter or transceiver and the internal control unit 46 may comprise a signal receiver or transceiver. 作为替代,无线遥控器可以包括信号接收器或者收发器,而内部控制单元56可以包括信号发射器或者收发器。 Alternatively, the wireless remote control may comprise a signal receiver or transceiver and the internal control unit 56 may comprise a signal transmitter or transceiver. 上述收发器、发射器和接收器可以用于从患者体内将设备10相关信息或数据发送到患者体外。 Above transceivers, transmitters and receivers can be used to send the device from the patient 10 related information or data to the patient's body.

[0319] 作为替代,传感器76可以设置成感测设备10的功能参数。 [0319] Alternatively, the sensor 76 may be configured to function parameter sensing device 10.

[0320] 在植入马达/泵单元44和用于为马达/泵单元44提供动力的电池70的情况下, 电池70可以配装有收发器,用于发送有关电池70状态的信息。 [0320] In the case of implanted motor / pump unit 44 and used to power the motor / pump unit 44 battery 70, the battery 70 can be fitted with a transceiver for sending information about the status of the battery 70. 更准确地说,在以能量为电池或蓄能器充电时,与所述充电过程相关的反馈信息被发送,并且能量供应相应改变。 More specifically, the energy in the battery or accumulator charging, the charging process associated with the feedback information is transmitted, and the energy supply is changed accordingly.

[0321] 图M示出的替代实施方式中,设备10被从患者体外调节。 [0321] M alternate embodiment shown in FIG., Device 10 is regulated from outside the patient. 系统观包括经由皮下开关80连接到电池70的运动约束设备10。 System concept includes a switch 80 via subcutaneous connected to the battery 70 motion restraint device 10. 因此,通过手动按压该皮下开关,非侵入式地实施对设备10的调节,由此设备10的操作切换成启动或停止。 Thus, by manually pressing the subcutaneous switch, implemented for non-invasively regulating device 10, the operation of this device 10 is switched to start or stop. 应该理解,图示实施方式是简化的实施方式,并且额外的部件诸如内部控制单元或者本申请中公开的任何其他部件可以添加到该系统中。 It should be understood that the illustrated embodiment is a simplified embodiment, and additional components, such as the internal control unit or any other components disclosed herein may be added to the system.

[0322] 图25示出的替代实施方式中,系统观包括与液压流体容器52流体连接的运动约束设备10。 Alternative embodiments [0322] FIG. 25 shows, the system concept includes a motion restraint device and the hydraulic fluid reservoir 52 fluid connection 10. 通过手动按压连接到设备10的液压容器,进行非侵入式调节。 By manually pressing the container is connected to a hydraulic device 10, non-intrusive regulation.

[0323] 包括在根据本发明的装置中的系统的进一步的实施方式包括反馈设备,该反馈设备用于从患者体内向患者体外发送信息,以给出与运动约束设备或者所述装置的至少一个功能参数或者患者的身体参数相关的反馈信息,由此优化所述装置的性能。 [0323] includes a feedback device comprises, for transmitting the feedback device according to a further embodiment of the apparatus of the present invention to a patient from a system outside the patient information, or the apparatus to give the at least one motion restraint device Function parameters or physical parameters related to patient feedback, thereby optimizing the performance of the device.

[0324] 所述设备的一个优选功能参数与用于为内部能源充电的能量转移相关联。 [0324] A preferred feature of the device parameters is used to charge the internal energy associated with energy transfer.

[0325] 在图沈中,简略示出了用于向植入患者体内的系统观供应精确度量的能量的结构,患者皮肤36以垂直线表示。 [0325] FIG sink in, schematically shows the structure for implantation in a patient's system to supply accurate measure of the energy concept, the patient's skin 36 vertical lines. 运动约束设备10连接到植入式能量转化设备30,而该植入式能量转化设备可能位于患者体内,优选恰好位于患者皮肤36以下。 Motion restraint device 10 is connected to the implantable energy conversion device 30, and the implantable energy conversion device may be located in the patient's body, preferably 36 or less just in the patient's skin. 一般来说,植入式能量转化设备30可以安置在腹部、胸部、肌膜(例如,腹壁中)、皮下或者任何其他合适的位置。 In general, the implantable energy conversion device 30 may be placed in the abdomen, chest, myofascial (for example, the abdominal wall), subcutaneous, or any other suitable location. 植入式能量转化设备30适于接收从外部能源3发射的无线能量E,所述外部能源设置在外部能量发射设备34中,外部能量发生设备位于患者皮肤36外侧,位于植入式能量转化设备30的附近。 Implantable energy conversion device 30 is adapted to receive energy from an external transmitting 3 wireless energy E, the external energy is set in the external energy transmission device 34, the external energy generating device 36 located outside of the patient's skin, located implantable energy conversion device near 30.

[0326] 正如本领域所熟知,无线能量E—般可以借助任何合适的经皮能量转移(TET)设备转移,所述TET诸如包括布置在外部能源34a中的初级线圈和布置在植入式能量转化设备30中的相邻次级线圈的设备。 [0326] As known in the art, as the wireless energy E- can use any suitable transcutaneous energy transfer (TET) transfer device, such as the TET comprises an external energy source 34a disposed in the primary coil and disposed in the implantable energy conversion device 30 adjacent the secondary coil device. 当电流通过初级线圈馈送时,呈电压形式的能量感生在次级线圈中,该能量可以用于操作运动约束设备,例如在将到来的能量存储在任何能量存储设备或蓄能器诸如电池或电容器之后。 When the current through the primary coil is fed, was the voltage induced in the secondary winding form of energy, the energy can be used to operate the motion restraint device, for example, the arrival of the energy stored in the energy storage device, or any device such as a battery or accumulator After capacitor. 但是,本发明一般并不限制于任何特定的能量转移技术、TET设备或能量存储设备以及任何形式的无线能量。 However, the present invention is generally not limited to any particular energy transfer technique, TET devices or energy storage device, and any form of wireless energy.

[0327] 设备主体内接收的能量多少可以与所述设备使用的能量相比较。 [0327] received energy in the device body can be compared to how much energy the devices. 所述设备使用的量应理解为也包括所述设备存储的能量。 The amount of the equipment should be understood to include the energy storage device. 转移的能量多少可以借助根据所确定的能量平衡来控制外部能量源34a的外部控制单元34b来调节,如上所述。 Energy transfer means according to how much energy balance can be determined to control the external energy source 34a of the external control unit 34b is adjusted, as described above. 为了转移正确量度的能量, 能量平衡和要求的能量量度可以借助连接到反流疾病治疗设备10的内部控制单元56来确定。 To transfer the correct measure of energy, energy balance and energy required measurement can use to connect to the internal reflux disease treatment device 10 of the control unit 56 to determine. 内部控制单元56则可以布置成接收由适当的传感器等部件获得的各种测量值,所述传感器等部件测量rlO的特定特征,一定程度上反映正确操作设备10所需的要求的能量量度。 Internal control unit 56 may be arranged to receive various measurements and other components by a suitable sensor available, the sensor means measuring a particular feature rlO reflects the energy required for the correct operation of the device 10 requires a measure to some extent. 此外,还可以借助适当的测量设备或传感器检测患者当前状态,以便提供反映患者状态的参数。 In addition, you can also use the appropriate measuring devices or sensors to detect the current state of the patient, in order to provide the parameters to reflect the status of the patient. 因此,这些特征和/或参数可以与设备10的当前状态关联起来,设备的当前状态诸如功耗、操作模式和温度,以及例如由体温、血压、心率和呼吸所反映的患者状态。 Therefore, these features and / or parameters may be associated with the current state of the device 10, the current state of the device, such as power consumption, operating mode and temperature, as well as the state of the patient such as body temperature, blood pressure, heart rate and respiration reflected.

[0328] 此外,能量存储设备或蓄能器58可以可选地连接到植入式能量转化设备30,用于积蓄接收到的能量,以便以后由设备10所使用。 [0328] In addition, the energy storage device or accumulator 58 may optionally be connected to an implanted energy transforming device 30 for accumulating received energy for later use by the device 10. 作为替代或者另外,也可以测量这种蓄能器的特征,该特征也反映了要求的能量量度。 Alternatively or in addition, can measure the characteristics of such an accumulator, characterized in that the energy measure also reflects the requirements. 所述蓄能器可以被电池取代,并且测量到的特征可以关联到电池的当前状态,诸如电压、温度等,以便向设备10提供充足的电压和电流, 而且也避免过度加热,应该清楚地理解,电池应该可选地通过从植入式能量转化设备30接收正确量度的能量,即不太少也不太多的能量,由此进行充电。 The accumulator battery may be substituted, and the measured characteristics may be associated with the current state of the battery, such as voltage, temperature, etc., so that the device 10 to provide sufficient voltage and current, and also to avoid excessive heating, it should be clearly understood The battery should optionally receive proper measure of energy by converting from the implantable device 30 energy, that is, not too little nor too much energy, thereby charging. 所述蓄能器还可以是具备相应特征的电容器。 The accumulator can also be characterized with the appropriate capacitor.

[0329] 例如,电池特性可以根据常规进行测量,以确定电池的电流状态,然后将电流状态作为状态信息存储在内部控制单元56的适当存储部件中。 [0329] For example, the battery characteristics can be measured in accordance with conventional, in order to determine the current state of the battery, then the current status as the state information stored in the internal control unit in the appropriate storage device 56. 因此,在任何时候进行新的测量 Thus, any time a new measurement

54时,可以相应地更新存储的电池状态信息。 54, that you can update information stored in the battery status. 采用这种方式,可以通过传送正确量度的能量, 可以“校准”电池状态,从而保持电池处于优化状态。 In this way, the energy can be measured by sending the right, you can "calibrate" battery state to keep the battery in optimal state.

[0330] 因此,内部控制单元56适配地根据反流疾病治疗设备10或者患者或者可能采用的能量存储设备上的测量设备或者上述传感器、或者它们的任意组合,确定能量平衡和/ 或当前要求的能量量度,(每时间单位的能量或者累积能量)。 [0330] Thus, the internal control unit 56 adapted measuring apparatus according reflux disease treatment device 10 or the energy storage device, or the patient may be used on or in the sensor, or any combination thereof, to determine the energy balance and / or current requirements energy measurement, (energy per time unit or accumulated energy). 内部控制单元56进一步连接到内部信号发射器82,该信号发射器布置成将反映所确定的需求能量量度的控制信号发送给连接到外部控制单元34b的外部信号接收器34c。 Internal control unit 56 is further connected to the internal signal transmitter 82, the signal transmitter arranged to reflect the needs of the control signal to determine a measure of the energy transmitted to an external control unit connected to the external signal receiver 34b of 34c. 然后,可以根据接收到的控制信号调节从外部能量源3发射的能量量度。 Then, a measure of energy emitted can be adjusted from the external energy source 3 according to the received control signal.

[0331] 作为替代,传感器测量值可以直接发射给外部控制单元34b,可以由外部控制单元34b确定能量平衡和/或当前所需的能量量度,因此将内部控制单元56的上述功能整合到外部控制单元34b中。 [0331] Alternatively, the sensor measurements may be transmitted directly to the external control unit 34b, 34b can determine the energy balance and / or the current measure of the energy required by an external control unit, so the internal control unit 56 of the above functions into external control unit (34b). 在这种情况下,内部控制单元56可以省略,并且传感器测量值可以直接供应给内部信号发射器82,该内部信号发射器将测量值发送给外部信号接收器3和外部控制单元34b。 In this case, the internal control unit 56 may be omitted, and the sensor measured values can be supplied directly to the internal signal transmitter 82, the internal signal transmitter transmits the measured values to an external signal receiver 3 and external control unit 34b. 然后可以由外部控制单元34b根据这些传感器测量值确定能量平衡和当前需要的能量量度。 34b then determining the energy balance and energy measurement currently required by the external control unit based on these sensor measurements.

[0332] 因此,本发明的方案采用了指示需求能量的反馈信息,这较之先前的方案更为有效,因为它是基于与接收到的能量相比较的能量实际使用情况的,例如针对能量量度、能量差异或者较之设备10的能量使用率的能量接收率。 [0332] Accordingly, the present invention uses a feedback information indicating demand for energy, which is more effective than the previous program, because it is based on the energy received compared to actual energy usage, such as a measure for energy energy than the energy difference or energy utilization device 10 receiving rate. 设备10可以使用接收到的能量用于消耗或者存储在能量存储设备等中。 Device 10 may use the received energy to be dissipated or stored in the energy storage device and the like. 如果相关或者需要,则可以使用以上所述的不同参数,然后作为工具用来确定实际能量平衡。 If relevant or necessary, you can use different parameters described above, and then as a tool to determine the actual energy balance. 但是,这些参数也可能本身需要用于内部实施的任何动作来具体地操作所述设备。 However, these parameters may also be a need for any action itself to the implementation of the internal operation of the particular device.

[0333] 内部信号发射器82和外部信号接收器3可以利用适当的信号传输部件实施为单独的单元,诸如无线电、IR(红外)或超声信号。 [0333] 82 and the external signal receiver 3 internal signal transmitter can use an appropriate signal transmission member implemented as a single unit, such as a radio, IR (Infrared) or ultrasonic signals. 作为替代,内部信号发射器82和外部信号接收器3可以分别集成在植入式能量转化设备30和外部能源3中,从而利用相同的发射技术相对于能量转移而言将控制信号以相反方向传送。 Alternatively, an external signal receiver 82 and the internal signal transmitter may be respectively integrated in 3 implanted energy transforming device 30 and the external energy 3, thereby using the same technique with respect to the emission energy transfer in terms of the control signal is transmitted in the opposite direction as the . 所述控制信号可以针对频率、 相位或者幅值进行调制。 The control signal may be modulated for frequency, phase, or amplitude.

[0334] 总之,图沈所示的能量供应结构可以基本上采用以下方式操作。 [0334] In summary, FIG Shen energy supply structure can be substantially in the following manner. 首先由内部控制单元56确定能量平衡。 First, the control unit 56 is determined by the internal energy balance. 反映所要求的能量量度的控制信号也由内部控制单元56产生,并且该控制信号从内部信号发射器82发射到外部信号接收器34c。 Reflect the desired control signal is also a measure of the energy generated by the internal control unit 56, and the control signal is transmitted from the internal signal transmitter 82 to the external signal receiver 34c. 作为替代,根据实施方案, 替代地由外部控制单元34b来确定能量平衡,如上所述。 As an alternative, according to an embodiment, alternatively the external control unit 34b determines the energy balance, as described above. 在这种情况下,所述控制信号可以携带来自各个传感器的测量结果。 In this case, the control signal may carry measurement results from various sensors. 然后由外部控制单元34b,根据所确定的能量平衡,例如响应接收到的控制信号,来调节从外部能源3发出的能量量度。 And then by the external control unit 34b, based on the determined energy balance, e.g., in response to the received control signal, to adjust the energy emitted from an external energy 3 metric. 在正在进行的能量转移过程中,该过程可以以特定的间隔而间歇性地重复,或者可以在能量转移过程中以大致连续的形式执行。 In the ongoing energy transfer process, the process may be repeated intermittently at specific intervals, or may be performed in the form of a substantially continuous energy transfer process.

[0335] 可以通过调节外部能源34a中的各种发射参数来大致调节转移的能量量度,诸如电压、电流、幅值、波形频率和脉冲特性。 [0335] Energy can be adjusted by an external energy source 34a various transmission parameters to substantially regulate the transfer of measurements, such as voltage, current, amplitude, wave frequency and pulse characteristics.

[0336] 因此,提供了一种方法来控制发送无线能量,以供应给植入患者体内的可电动操作的反流疾病治疗设备。 [0336] Accordingly, there is provided a method of controlling the transmission of wireless energy to supply the reflux disease treatment device to be implanted in a patient's electric operations. 无线能量E从位于患者体外的外部能源发送,并由位于患者体内的内部能量接收器接收,所述内部能量接收器连接到设备10,用于向其直接或间接供应接收到的能量。 Wireless energy E is transmitted from the external energy source located outside the patient, the patient is located inside the energy received by the receiver, the internal energy receiver is connected to the device 10 for directly or indirectly receiving the energy supplied thereto. 因此在内部能量接收器接收到的能量和用于设备10的能量之间确定了能量平衡。 Therefore, the internal energy of the energy received by the receiver and a device for determining the energy balance between the energy 10. 然后根据所确定的能量平衡来控制从外部能源发送的无线能量E。 Then according to the determined energy balance to control the radio energy transmitted from the external energy E.

[0337] 还提供了一种系统来控制发送无线能量以供应给植入患者体内的可电动操作的运动约束设备10。 [0337] Also provided is a system for controlling the transmission of wireless energy for supply to implanted in a patient can be electrically operated motion restraint device 10. 该系统适于从位于患者体外的外部能源发送无线能量E,并且所述无线能量被位于患者体内的植入式能量转化设备接收,所述植入式能量转化设备连接到设备10,用于向其直接或间接供应所接收到的能量。 The system is adapted to transmit wireless energy E from the external energy source located outside the patient, and the wireless energy is located in the patient receiving an implantable energy transforming device, the implantable device is connected to the energy conversion device 10, for the the direct or indirect supply the received energy. 所述系统进一步适于确定植入式能量转化设备接收到的能量与用于设备10的能量之间的能量平衡,并根据所确定的能量平衡控制从外部能源发送的无线能量E。 The system is further adapted to determine an implantable energy transforming device receives energy for energy between the energy balance of the apparatus 10, and the energy balance control radio energy transmitted from the outside of the determined energy E.

[0338] 所述设备的功能参数与用于给内部能源充电的能量传输相关联。 [0338] The functional parameters of the device and the energy used to charge the internal energy associated with transmission.

[0339] 在另一种替代实施方式中,所述外部能源从患者体外进行控制,以释放电磁无线能量,并且所述释放的电磁无线能量用于操作所述设备10。 [0339] In another alternative embodiment, the external energy is controlled from outside the patient, to release electromagnetic wireless energy, and released electromagnetic wireless energy for the operation of the apparatus 10.

[0340] 在另一种实施方式中,所述外部能源从患者体外进行控制,以释放非磁性无线能量,并且所述释放的非磁性无线能量用于操作所述设备10。 [0340] In another embodiment, the external energy is controlled from outside the patient, to release non-magnetic wireless energy, and the release of non-magnetic wireless energy for operation of the apparatus 10.

[0341] 本领域技术人员应该认识到根据图14-26的以上各种实施方式可以以不同的方式进行组合。 [0341] The skilled artisan will appreciate that can be combined in different ways according to the above various embodiments 14-26 of FIG. 例如,电开关38操作的极化能量可以包含在图12、15-21所示的任何实施方式中,液压阀切换设备M可以包含在图M所示的实施方式中,并且齿轮箱74可以包含在图33所示的实施方式中。 For example, the polarization energy level operation switch 38 may be included in any of the embodiments shown in Fig. 12,15-21, hydraulic valve switching device M may be included in the embodiment shown in FIG M, and the gear box 74 may comprise In the embodiment shown in FIG. 33. 应该注意,所述开关可以简单地表示电子电路或者部件。 It should be noted, the switch may simply represent an electronic circuit or component.

[0342] 以上描述了无线转移能量用于操作运动约束设备10,以允许非侵入式操作。 Above [0342] describe wireless transfer of energy used to operate the motion restraint device 10 to allow non-intrusive operation. 应该理解,设备10也可以利用导线接合的能量进行操作。 It should be understood, device 10 can also be used to operate the wire bonding energy. 这样的一个示例在图沈中示出,其中外部开关84借助电线86和88互联在外部能源3和操作设备之间,操作设备诸如调节设备10的电动马达。 One such example is shown in Fig sink, where the external switch 84 by means of wires 86 and 88 are interconnected between the external energy 3 and operating equipment, operating equipment, such as adjusting the electric motor device 10. 外部控制单元34b控制外部开关的操作,以引发设备10正常操作。 The external control unit 34b controls the operation of an external switch, to initiate normal operation of the device 10.

[0343] 液压或气压动力供应 [0343] a hydraulic or pneumatic power supply

[0344] 图28-31更为详细地示出了以液压或气压方式为根据本发明的运动约束设备提供动力的4种不同方式的方块图。 [0344] Figure 28-31 illustrates in more detail in the way of a hydraulic or pneumatic powered motion restraint device according to the present invention, four different ways of a block diagram.

[0345] 图观示出了如上所述用于治疗反流疾病的系统。 [0345] FIG concept illustrates the system described above for the treatment of reflux disease. 所述系统包括设备10并另外包括单独的调节容器46、单向泵44和交替阀M。 The system includes a device 10 and additionally include a separate adjustment container 46, pump 44 and alternating one-way valve M.

[0346] 图四示出了设备10和流体容器46。 [0346] Figure IV shows a device 10 and the fluid reservoir 46. 通过移动调节容器的壁或者以任何其他不同方式改变其尺寸,可以不用任何阀来进行所述设备的调节,仅仅通过移动容器壁来释放流体容道。 Adjusted by moving the walls of the container, or in any other different ways to change its size, can not be adjusted in any of the valve device, only to release the fluid channel capacity by moving the container wall.

[0347] 图30示出了设备10、双向泵44和调节容器46。 [0347] FIG. 30 shows a device 10, two-way pump 44 and regulating container 46.

[0348] 图31示出了反向伺服系统的方块图,第一闭合系统控制第二闭合系统。 [0348] FIG. 31 illustrates a block diagram of a reverse servo system, a first closed system controlling a second closed system. 该伺服系统包括调节容器46和伺服容器90。 The servo system includes a servo regulating container 46 and the container 90. 伺服容器90经由机械互联件94机械地控制运动约束设备10。 Servo control vessel 90 via mechanical motion restraint device 94 mechanically interconnect 10. 设备10具有可膨胀/可收缩的腔室。 Device 10 having an expandable / collapsible chamber. 该腔室优选通过从与设备10流体连接的较大的可调容器92供应液压流体来膨胀或收缩。 The chamber is preferably adjustable from a larger container by the device 10 fluidly connected to the hydraulic fluid supply 92 to expand or contract. 作为替代,所述腔室包括可压缩的气体,所述可压缩的气体可以在伺服容器90的控制下被压缩和膨胀。 Alternatively, the chamber comprising a compressible gas, the compressible gas can be compressed and expanded under the control of the servo 90 of the container.

[0349] 伺服容器90也可以是该设备的一部分。 [0349] The servo container 90 may also be part of the device.

[0350] 在一种实施方式中,所述调节容器置于患者皮肤以下,并且借助手指按压其外表面来操作。 [0350] In one embodiment, the patient's skin conditioning vessel disposed below and to the outer surface thereof by means of a finger pressing operation. 所述反流疾病治疗设备在图32c中示出。 The reflux disease treatment apparatus is shown in Fig. 32c. 在图31中,挠性皮下调节容器46示出借助导管48连接到鼓包形状的伺服容器90。 In Figure 31, the flexible skin conditioning vessel 46 is shown by means of conduit 48 is connected to the shape of the servo drum kit container 90. 这种波纹管形状的伺服容器90包括在挠性运动约束设备10中。 Servo This bellows-shaped container 90 includes a flexible motion restraint device 10 in. 在图32所示的状态下,伺服容器90包含最少的流体,而在调节容器46中存在最多的流体。 In the state shown in FIG. 32, a servo fluid container 90 contains the minimal, and the presence of most of the fluid in the container 46 in the regulation. 由于伺服容器90和设备10之间机械互联件,所以设备10的外部形状收缩,即,其占据比最大体积要小的体积。 Since the servo vessels between 90 and 10 interconnected pieces of equipment, machinery, so the contraction of the external shape of the device 10, that is, it occupies smaller volume than the maximum volume. 所述最大体积在幅图中以虚线示出。 The maximum volume of the web is shown in phantom in FIG.

[0351] 图32示出了这样的状态,其中使用者诸如植入该设备的患者,按压调节容器46, 以使包含在其中的流体流过导管48并进入伺服容器90,而伺服容器由于其波纹管形状,所以纵向发生膨胀。 [0351] FIG. 32 shows a state in which the user of the device implanted in a patient such as a pressed adjusting container 46, so that the fluid contained therein to flow through conduit 48 and into the servo container 90, and the servo container due to its bellows shape, it expands lengthwise. 这种膨胀转而使设备10膨胀,以使其占据最大体积,由此牵拉其接触的胃壁(未示出)。 This in turn allows the expansion device 10 is expanded, so as to occupy a maximum volume, thereby stretching the stomach wall contact (not shown).

[0352] 调节容器46优选设置有用于在压缩后保持其形状的部件46a。 [0352] regulating container 46 is preferably provided with means for keeping its shape after compression member 46a. 该部件在附图中简略示出,因此即使使用者释放了调节容器,该部件也将设备10保持在拉伸位置。 The means schematically illustrated in the drawings, even if the user releases the regulating container, the member will remain in the stretched position device 10. 以这种方式,所述调节容器基本上作为反流疾病治疗系统的on/off开关来操作。 In this way, the conditioning vessel substantially as reflux disease treatment system on / off switch is operated.

[0353] 现在将参照图33和34描述液压或气压操作的替代实施方式。 [0353] will now be described with reference to FIGS. 33 and 34 an alternative embodiment of a hydraulic or pneumatic operation.