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Publication numberCN105361986 A
Publication typeApplication
Application numberCN 201510085229
Publication date2 Mar 2016
Filing date12 Oct 2009
Priority date10 Oct 2008
Also published asCA2749778A1, CA2749782A1, CA2749792A1, CA2776479A1, CN101980673A, CN101980673B, CN101980674A, CN102245133A, CN102245133B, CN104323877A, 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 number201510085229.4, CN 105361986 A, CN 105361986A, CN 201510085229, CN-A-105361986, CN105361986 A, CN105361986A, CN201510085229, CN201510085229.4
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 105361986 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W其近端部分的外表面在患者横福膜和胃底壁之间的位置抵靠患者胃底壁,W便在运动约束设备植入患者体内时,约束患者胃的必切迹朝向患者横福膜的运动,由此阻止责口通过患者横福膜开口滑入患者胸腔,从而保持由患者腹部施加在患者责口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. An apparatus for treating a human or mammal reflux disease, said apparatus comprising an implantable movement restraining device, the motion restraint device configured with an outer surface of the elongated, 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 the outer surface of the proximal end portion W of the film in the banner in patients between the gastric wall and the position of the patient against the gastric wall, W will be during exercise restraint device implanted in a patient, the patient restraint stomach will notch toward horizontal movement of the patient fu film, thereby preventing cross-responsibility through the patient port Four film opening slide patient's breast, thereby maintaining the patient's responsibility sphincter of Oddi support pressure exerted by the patient's abdomen; and wherein the distal portion of the motion restraint device stable and holding said proximal portion, said distal end portion adapted retraction in substantially 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W稳定所述细长的运动约束设备的近端部分,W防止责口通过患者横福膜开口滑入患者胸腔。 2. The apparatus according to claim 1, wherein the distal end portion of the elongated retraction motion restraint device having a proximal end portion of sufficient length W of the elongate stabilizing the motion restraint device, responsible for preventing W mouth by the patient cross-fu film opening slide patients 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,W防止责口通过患者横福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 movement of the restraint device, W preventing responsible mouth by the patient cross-fu film opening slide patients chest.
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 said proximal portion of the motion restraint device size is 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, when implanted in the motion restraint device, the fixing device is adapted to the proximal portion of the motion restraint device fixed at the 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, characterized in that the fixing device comprises a first fixing implantable 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 of said restraining device at the holding 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 invagination.
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, characterized in that said fixation 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 to the position of the kinematic constraints.
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 fundus wall portions connected together, the sutures or staples to 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 of restraint device retraction from the inside of 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 wall 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, characterized in that the fixing device comprises a second fixing device, together with the proximal end portion after the motion restraint device implanted in a patient together, the second fixing device the motion constraints directly or indirectly secured to the patient's esophagus device near angle Heath.
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 sutures or staples constitute, together with the following motion restraint device implanted in a patient together, the suture or staples gastric wall and connecting patients esophageal wall, the motion restraint device remains in 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H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H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福肌或者其他肌肉组织。 17. The apparatus according to claim 15, characterized in that said first fixing device H fixing device, together with the proximal end portion after the motion restraint device implanted in a patient together, the fixing device of the first H said motion restraint devices directly or indirectly secured to the patient or other cross-fu muscle muscle tissue.
18. 根据权利要求17所述的装置,其特征在于,所述第H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福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, characterized in that the fixing device by a plurality of sutures or staples constituting H, following along with the motion restraint device implanted in a patient together, the suture or staples gastric wall and connecting the cross blessing muscle or other muscles, 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福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 the motion restraint device comprises a proximal end portion of a body adapted to be at least partially gastric wall in patients having an outer surface and a retraction biocompatible material comprising the main portion of the outer surface of said body is adapted to position the membrane between the patient and the banner in gastric invagination of the lower wall portion against the stomach walls.
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 classes oval.
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 the 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, wherein said body has a circular contour, with possible damage to the patient without too sharp edges of the stomach wall.
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W调节所述主体的尺寸。 25. The apparatus according to claim 19, wherein said body comprises forming a fluid-tight chambers, implanted in the body when the patient, the amount of fluid contained within the size of the body can be controlled by adjusting W .
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 the 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, wherein said implantable body having a substantially smooth outer surface, for abutting 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 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, characterized in that the body adapted to be connected to a patient through a stomach surgery.
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 outside of the patient positioned in the 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,W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, W exhibits a smaller diameter than the laparoscopic trocar elongate form, thereby become said elongate form, the body can be pushed through the trocar or towing.
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挽性外壁,允许所述主体经过腹腔镜所用的套管针。 33. The apparatus according to claim 19, wherein the body includes an outer wall defining a fluid-filled chambers of the pull 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,送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 in the form of a hollow, and includes at least two separate parts, adapted to send two separate parts of the hollow body is inserted, 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, with a fluid or gel used to fill 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 having injection ports, wherein the body cavity through the injection port of the fill fluid.
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, which allows 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W软于25舒尔的材料制成。 39. The apparatus according to claim 19, characterized in that, in the main body 25 made of W Shure soft material.
40. 根据权利要求19所述的装置,其特征在于,所述主体W软于15舒尔的材料制成。 40. The apparatus according to claim 19, characterized in that, in the main body 15 made of W 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 the holding device is inserted through the wire 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, wherein said body comprises an outer wall, the holding device is at least partially disposed in the inner side of the body wall.
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 outside diameter of the body of 30mm or larger.
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 outside diameter of the body is 40mm or larger.
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 the 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 of claim according to claim 56, characterized in that the motion restraint device is hydraulically adjustable to the size, 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 via hydraulic fluid between the reservoir and the hydraulic fluid to move the motion restraint device is non-invasive adjustments.
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 of claim according to claim 57, further comprising; 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 at dispensing fluid through the hydraulic pressure 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, 利用所述容器中的泉被液压流体填充,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, the use of the container is filled with hydraulic fluid springs, thereby pulling the gastric wall so that patients have full foot feeling.
60.根据权利要求56所述的装置,包括;H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W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H 容器中较大体积的液压流体,所述第H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W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; H adjustable with the hydraulic fluid container, wherein the container comprises a first part, the subcutaneous placement of the first container the second container in a first closed system higher small volume of fluid per unit area W of the compression force is used to move a small volume of hydraulic fluid, and the second container wherein the first hydraulic fluid H influence larger volume container, said second container is a closed first H part of the system, is greater than the volume of the first container, whereby a smaller W per unit area of a larger force to produce a movement of the total volume 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, wherein said body has a first chamber, and further comprising at least one additional body, the additional body is formed smaller than the first chamber a second chamber, said 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, characterized in that 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 medium 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 said hydraulic container having a wall defining the volume, and the volume of the container by a hydraulic moving part of the wall of the vessel wall of the hydraulic pressure 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泉,并且所述液压容器利用泉在液压容器和所述至少一个腔室之间泉送流体来调节。 67. The apparatus according to claim 58, characterized in that the hydraulic control device comprises a spring, and the spring between the hydraulic container utilizing hydraulic container and said at least one chamber to adjust the spring to send 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 apparatus 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 located in two patients each filled 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,W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, wherein said apparatus is adapted to treat reflux disease is non-invasive surgery adjusted and adapted to be adjusted from time to time, W so that at a first time, wherein a filling the body portion of the volume of the stomach filling, and at a second time, another filling body filling volume located at another portion of the stomach.
73. 根据权利要求I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. I The apparatus according to claim, further comprising: at least one adjustable traction device, when implanted in a patient, pulling a portion of the stomach wall of the patient pulling apparatus, 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 the stomach wall portion by this appetite by affecting a 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, characterized in that the motion restraint device includes a body having a chamber therein, 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 said 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 said body and said 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 a chamber, and when implanted in a patient, the second chamber as a pulling device to treat obesity, the when implanted in a patient, the main chamber and the second chamber communicate with each other, whereby the fluid or air movement between the main chamber and the second chamber, whereby the patient gastric wall generating pulling action, 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 motion device includes a proximal portion bound body, when implanted in the patient, the size of the body is adjustable, and in patients with gastric invagination wall, thereby increasing the size of the body when pulling patients gastric wall, 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 different parts of the patient pulling device pulling 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,W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,W牵拉患者胃壁的第二部分。 81. The apparatus according to claim 80, characterized in that, when implanted in the patient, drawing the two adjusting devices from the patient's body, thereby adjusting the first time at the first drawing device, W retractor the first part of the stomach wall of the patient pulling, and at a second time stretch a second adjusting device, W pull the patient a second portion of the stomach wall.
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. 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 the non-invasive adjustments.
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泉和腔室,其中在植入患者体内时,所述泉通过从所述主体向所述腔室泉送流体或空气而调节所述液压容器。 84. The apparatus according to claim 82, characterized in that the motion restraint device comprises an expandable body, said body further comprising a fluid chamber and connected to the springs, which when implanted into the patient, the spring from the body by feeding fluid or air to the spring 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 using 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 internal energy implantation into a 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, wherein 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; can be implanted in a patient's internal power supply, when implanted in the patient, the internal energy can use 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H固定设备,在植入患者体内时,该第H固定设备将所述运动约束设备的近端部分固定到患者横福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, so 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 H fixtures, when implanted in a patient, the first H fixture the motion restraint device proximal portion secured to the patient or other cross-fu muscle 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 extending through the axis of the body viewed in the vertical, said body having a maximum circumference, and two relatively movable along the axis of said continuous when connected to the plane, when starting from the largest circumference in a direction away from the one or both of said maximum circumference is moved, as the plane along the axis of displacement, decrease or remain 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 main body, wherein at least a plane perpendicular to an axis extending through the body of the observation, the body has a circumference, and along the comparison 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 than having the minimum circumference between the end of the larger circumference at 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, wherein the proximal portion of the motion restraint device is adapted to substantially inset the patient 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,W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 stationary equipment motion restraining device when the implant, the fixing device is adapted to the proximal portion of the motion restraint device is connected to the gastric wall, W put 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 the motion restraint device proximal portion is expandable and is adapted to 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W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; W for receiving a fluid receiving member fluid or gel the motion restraint device expansion.
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 the motion restraint device comprises a proximal end portion of 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必体。 99. The apparatus according to claim 1, characterized in that the motion restraint device of the proximal portion at least partially comprises a solid body will be.
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, characterized in that the motion restraint 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 the proximal portion of the motion restraint device 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, characterized in that the motion restraint device of the proximal portion at least partially having a resilient 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挽性外壁。 103. The apparatus according to claim 1, characterized in that the motion restraint device of the proximal portion at least partially having an outer wall of the harness.
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W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 W 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, characterized in that the motion restraint device adapted to pass through a trocar or laparoscopic or endoscopic trocar 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,W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, characterized in that the motion restraint device capable of changing form, W will be able to pass through the laparoscopic trocar or trocar or endoscopic instruments.
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,W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 having a circular contour, not too sharp edges, W so that the motion restraint device when implanted does not damage 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, characterized in that the volume of the motion restraint device is capable of non-invasive adjustments.
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, characterized in that the motion restraint device is adapted to be completely sunk in patients with gastric wall.
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, wherein the device is adapted retraction motion constraints, so that the motion restraint device placed 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 of the inflatable chamber in order to adjust 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, wherein said movement restraining device formed by at least a portion of the material can be acid damage.
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 not destroyed by stomach 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 extending through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along the axis from the first axis endpoint having 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, 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H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H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 extending through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along the axis from the 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 first intermediate point H having the second largest perimeter moves, the circumference continues to increase or remains constant and H intermediate point from the first to the second end of the axis is moved, the circumference continues to decrease or remain constant.
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,W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, wherein the distal end portion of the elongated retraction motion restraint device in the stomach wall, W so that the volume of the food cavity is reduced, the amount of substantially reduced volume movement of the elongated confined volume than the distal end portion of the device.
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 further by reducing the volume of the cavity to the food treat obesity, reduce the amount of volume substantially exceeding 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I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. I The apparatus according to claim, characterized in that the motion restraint device comprises a distal end portion 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 said expandable device having an inlet port for fluid or gel, and is adapted to be connected to a gastroscopic instrument after 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 inlet port adapted for interconnection comprising the inflatable device and fluid connection of the endoscopic instrument or 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 comprising an elastomeric 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娃丽。 126. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion Wa Korea.
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 said at least one motion restraint device proximal portion and a distal portion 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 layer of material comprises a layer of parylene.
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氣己帰层。 129. The apparatus according to claim 127, wherein said at least one layer of material comprises a layer of polytetrafluoroethylene kaesa gas hexyl.
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醋。 130. The apparatus according to claim 127, wherein said at least one layer of material comprises a polyurethane vinegar.
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 movement of said distal end portion of the 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醋。 133. The apparatus according to claim 131, wherein said fluid is a liquid polyurethane vinegar.
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 said fluid is an 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W防止扩散。 135. The apparatus according to claim 131, wherein the fluid comprises W to prevent diffusion of macromolecules.
136. 根据权利要求131所述的装置,其特征在于,所述流体包括贿分子。 136. The apparatus according to claim 131, wherein the fluid comprises a molecule-corruption.
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 the homogenous 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必体。 138. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device must be at least a part 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 the 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挽性外表面。 142. The apparatus according to claim 117, wherein said pull motion comprising at least a portion of an outer surface of the distal end portion of the device of the constraint.
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 distal end portion of the perimeter of the largest motion restraint device is 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 perimeter 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.OOOOl和0. 00Im3之间。 145. The apparatus according to claim 117, wherein movement of said distal end portion of the confined volume between the device and 0.OOOOl 0. 00Im3.
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.OOOOl和0. 0002m3之间。 146. The apparatus according to claim 145, wherein said distal end portion of the volume of the motion restraint device between 0.OOOOl 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,W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, W caused by the insertion of laparoscopic trocar.
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 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 .
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,W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 the stomach to stomach sutures or staples is provided with a fixed portion, the fixed portion is adapted to the performance of the stomach wall in contact with the structure, W promote the growth of tissue position of the distal end portion of the long-term by fixedly attached to the stomach wall motion 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 is adapted to post-operative non-invasive adjustments.
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,W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, W is adapted to maintain better 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 device 117, comprising Claim; disposed on the outside of the stomach wall and is adapted to stretch a portion of the stomach wall traction device, thereby affecting appetite of patients, said interconnecting means further comprises the drawing of the apparatus and the said motion constraints fluid connection portion of the distal 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 adapted to communicate via the inside stomach wall disposed gastroscopic instrument.
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 portion of the apparatus comprises at least two interconnected portions of the motion constraint, said portion is adapted to be interconnected 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W下述材料至少一种制成的外表面层:聚亚安醋、特富龙敏、或者聚四氣己帰、聚对二甲苯、 金、银、铁或者其他金属。 156. The apparatus according to claim 117, wherein the distal end portion of the motion restraint device includes an outer surface layer of at least one of the following materials W made: Polyurethane vinegar, Teflon-sensitive, or poly has four gas kaesa, parylene, gold, silver, iron 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 end 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 the 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 in 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,W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, in the proximal portion of the motion restraint device is implanted, the device is adapted to be fixed to the distal portion of the motion restraint device is fixed to the stomach wall , W to maintain the motion constraint distal portion of the 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.OOOl和0. 00Im3之间。 164. The apparatus according to claim 117, wherein movement of said distal end portion of the confined volume between the device and 0.OOOl 0. 00Im3.
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 movement of said distal end portion of the circumference of the restraint device is 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 movement of said distal end portion of the circumference of the restraint device is 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 movement of said distal end portion of the circumference of the restraint device is 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 movement of said distal end portion of the circumference of the restraint device is 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挽性但非弹性材料。 169. The apparatus according to claim 117, wherein said distal end portion of the motion restraint device comprising at least a portion of the harness, 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 a distal portion of the motion restraint device fixed 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 movement of the distal end of the fixed restraint device 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W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 use a simplified W keeps the instrument during 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W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 simplify the use of equipment to maintain the device implanted W 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, and 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: a port capable of injecting the associated pipe.
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 device, the distal end portion of the motion restraint device has a maximum circumference and perpendicular to said through other devices on the plane when the axis of the observation, the perimeter of the device is equal to the maximum circumference or from the direction of the circumference of the largest decreases see 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 displacement along the axis of said plane, said distal end portion of the motion restraint device the circumference increases and decreases at least twice, or with the plane along the axis of displacement, 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娃丽层。 178. The apparatus according to claim 127, wherein said at least one layer of material comprises a layer of Li Wa.
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 layer of material 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、和铁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 iron, 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駭层。 181. The apparatus according to claim 127, wherein said at least one layer of material comprises a layer of Teflon startle.
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,W牵拉所述一部分胃壁从而产生饱足感。 182. reflux disease and for the treatment of obesity apparatus 1, characterized in that the device comprises a pulling motion restraint device, the pulling device comprises a pulling device operable to at least one claim that said traction device can be implanted in obese patients and patients adapted to stretch a portion of the stomach; and operating the equipment, the operating device for operating the implantation of the traction device, W drawing the part 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,W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 the motion restraint device distal portion and a proximal portion comprising at least one of:. A stretch of at least one apparatus operable, the pulling device can be implanted in a patient and adapted to stretch a portion of the patients stomach; and b implantable control unit when the control unit and the traction device implanted, the control unit for automatically controlling the pulling device operable, the W stretch is part of a meal in patients with 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,W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泉,用于在所述主容器和所述牵拉容器之间泉送流体,W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, characterized in that the 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 can be implanted in obese patients and patients adapted to stretch a portion of the stomach wall, wherein the drawing device comprises an expandable container traction; and operating the equipment, the the operation device for operating the pulling device after implantation, W pulling the stomach wall portion, wherein the distal end portion of the motion restraint device is expandable and connected to the pull fluid container, wherein the operating device including spring, for between the main container and the container pull spring feed fluid, W drawing the part 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,用于控制包括所述泉的所述牵拉设备。 185. The apparatus according to claim 184, comprising: a control device for controlling the pulling apparatus comprising the spring.
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 the control device comprises a wireless remote control, wireless remote control adapted to the patient's body from the traction control 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 the control device comprises a switch disposed subcutaneous or container, or the container is adapted to switch from outside the patient to control the drawing 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 sensor 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 a drawing device operable, the said pulling device can be implanted within an obese patient and adapted to stretch the stomach wall portion of the patient, wherein the drawing device comprises an expandable container traction, adapted retraction stomach wall at the upper part of the stomach, the high vertical when the patient said primary 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 results in contraction of fluid from the lower ground placed on the stomach wall of the main volume of the filled container retraction outflow adapted to cause the container to stretch the stomach wall portion of the drawing to produce 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 to the main volume of the container and filling the container between the drawing comprises a check 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 to the main volume of the container and filling the container between the drawing comprises a release function, the release function adapted to release said pulling vessel 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,W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 significantly smaller than the area of the fluid connection connecting the fluid return portion, the slow release W begins drawing the fluid return container master 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,W进一步影响牵拉设备牵拉所述胃壁部分。 194. The device 190, comprising Claim; additional manual control device, the manual control device includes a container subcutaneous placement, placement of the container is adapted to subcutaneous retractor further influence from outside the patient to control the drawing apparatus, W 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,W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 said distal end portion of the motion restraint device is implanted in the stomach after expansion, wherein said structure comprises a bellows, the bellows is adapted to consider the device after implantation of the device in case enclosing fibrosis, W so that the corrugated member the movement is not substantially affect fibrosis.
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,W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 device comprises at least a drawing device operable, the apparatus can stretch implanted within an obese patient and adapted to stretch the stomach wall portion of the patient, and wherein the drawing device comprises an expandable structure, the expandable structure is adapted to the retraction device after the drawing and expansion in the stomach stomach wall portion, wherein said structure comprises a dedicated bellows, the bellows is adapted to implant the device after considering the situation surrounding the apparatus fibrosis, W so that movement of said bellows member is substantially free from fibrosis influences.
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,W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 when implanted operation device, W 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,W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, W stretch was dining part of the stomach in patients resulting in 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 subcutaneously placed switch or container, or the container is adapted to switch from outside the patient to control the drawing 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 sensor 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W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 the motion restraint device distal portion and a proximal portion further comprises at least one drawing device, said drawing device comprising three or more mechanical parts, machine 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 inside the machine member stuck in the stomach wall portion, and wherein the three or more mechanical 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 section is drawn independently from each other, said independent for; to pull the stomach and part of the force W applied to stretch the time period, as well as the time of applying 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H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W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 constraint distal and proximal end portions of the apparatus further comprises a pulling device, the device comprises a pulling engagement with the different parts of the stomach wall two or more of hydraulic components, a different part of a joining member, wherein said engaging means comprises a hydraulic or stitched bonded staples to the stomach wall, with stomach to stomach or sutures hydraulic retraction member in the stomach in parts, wherein the two or more hydraulic parts are adapted to move relative to one another, adapted to different H stretch wall portions, the pulling device is further adapted to let the wall portion are each independently pulling the independence for: to stretch the stomach wall W, and part of the force applied to stretch the time period, as well as 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W及施加牵拉的时刻。 205. The apparatus according to claim 117, wherein the motion restraint device distal portion and a proximal portion further comprises at least one drawing device, the drawing device portion engaging the stomach wall, comprising pull the suture or stapling device is connected to the stomach wall, with stomach to stomach or sutures pulling the retraction 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, to apply tension to the time period and a time to apply tension to the W.
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W及施加牵拉的时刻。 206. The apparatus according to claim 117, wherein the motion restraint device distal portion and a proximal portion further comprises at least one of two different parts of the stomach wall member engageable member engages a different one 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 pulling of wall portion is different from each other independently traction control; pulling force to the stomach wall portion, applying traction time period W and a time of applying 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 said at least one motion restraint device proximal portion and a distal portion further comprising a control device, the control device comprises an external control unit, from the patient for in vitro restraint device controls the motion of the distal end 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, 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 the control device comprises a switch disposed subcutaneous or container, or the container is adapted to switch from outside the patient to control the movement of the distal end portion of the 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 from the sensing device to control the patient said apparatus, said sensor or sensing device is adapted to directly or indirectly sense the food intake of the patient.
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。 117 or 212. The apparatus according to one of the preceding claims, characterized in that said kinematic constraint between the distal end portion and a proximal portion of the device by means of suitable devices positioned in the inside of the gastric endoscopy.
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 patient positioned on the inside of the stomach wall 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 is disposed at least in the distal portion of the inner side of the patient invagination of the 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,送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 the distal portion of the apparatus comprises at least two interconnected portions of the motion constraint, two feeding portion is adapted to be interconnected via a separate part of the inside of the stomach is placed on the outside of the stomach wall and stomach wall 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,送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 the distal portion of the apparatus comprises at least two interconnected portions of the motion constraint, two feeding portion is adapted to be interconnected via a separate part of the outside of the stomach are placed on the outside of the stomach wall and stomach wall 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 disposed through the inside of the stomach and the stomach wall on 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 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,送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 the distal portion of the apparatus comprises at least two interconnected portions of the motion constraint, two feeding portion is adapted to be interconnected via a separate part of the inside of the stomach is and placed on the inside of the stomach wall retraction stomach.
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,送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 the distal portion of the apparatus comprises at least two interconnected portions of the motion constraint, two feeding portion is adapted to be interconnected via a separate part of the outside of the stomach are and placed on the inside of the stomach wall retraction stomach.
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W其至少一部分外表面在患者横福膜和胃底壁之间的位置抵靠患者胃底壁,W使在运动约束设备植入患者体内时,患者胃的必切迹朝向患者横福膜的运动受到约束,由此阻止责口通过患者横福膜开口滑入患者胸腔中,从而保持由患者腹部施加在患者责口括约肌上的支撑压力。 117 or 223. The apparatus according to one of the preceding claims, characterized in that, comprising two or more components of the motion restraint device, the movement assembly is adapted to be assembled into devices having a controlled size constraint implantable, involves the movement of at least proximal portion restraint device, the assembly motion restraint device adapted to at least a portion of the outer surface of the W position between the patient cross-fu films and gastric wall and gastric wall abutting the patient, so that W in the motion restraint device implanted into the patient when the body, the patient's stomach will notch toward horizontal movement of the patient fu film is restrained, thereby preventing the mouth by the patient responsible for cross-fu film opening slide into the chest of patients, thereby holding the support on the patient's mouth responsibility sphincter exerted by the patient's abdomen pressure.
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,如果它离开在横福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 the device is adapted to the assembly motion constraints broken down into components, if it leaves the position between the film and the cross blessing gastric wall at least partial contact with 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W保持胃内侧的位置。 225. The apparatus according to claim 223, wherein said assembly is adapted to retraction motion restraint device in the stomach wall, wherein the assembly is adapted to the motion restraint device disassembled into components, if it is left implanted in the stomach position, including position holding pierce the stomach wall W 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, for the motion restraint device in the assembled 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挽性外部形状。 228. The apparatus according to claim 227, wherein the motion restraint device adapted to pass through a trocar assembly having the external shape of the harness.
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 restraining device assembly is adapted to allow their assembly having the shape upon implantation 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, 具有挽性外表面。 230. The apparatus according to claim 223, wherein said movement restraining device components as a hollow member having an outer surface of the harness.
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W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 assembly is adapted to the motion restraint device W fluids, foams, gels harden into a solid material or a fluid wherein the at least one filler.
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必体。 232. The apparatus according to claim 223, wherein the motion restraint device must be a real component thereof.
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 is adapted to temporarily maintain their 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 invagination of the 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 said 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,W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, wherein each component has at least one mounting element means, said mounting member substantially at least one component with another assembly element, W so that the assembly by mating the mounting element It can be assembled into an implantable motion restraint device.
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 the 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 select from fully cooperate with flanges 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 fitting projection 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 around the core member of 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 223-242 claim, characterized in that said apparatus further comprises a guide device, said guide device is operable for assembling the 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, when the operation wire with the use of the abdominal cavity may occur in body fluids made of biodegradable materials, 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,W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 said core member and said outer member, W so that the outer member can 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 the wire operation.
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 two-channel operation.
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,W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 surface of the core member is located in a first slot of the second opening, W so that the receiving at said first displacement operation of the operation wire passage direction away from the end surface of 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,W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 having two openings, W will be moved in a direction away from the direction of the end face when the operating wire is connected to the first operating 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 part, through the use of the outer core member having a slot designated for each passage opening operation of the operation wire, wherein the outer member is 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,W使其可W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,W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W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, at the W W so that use of equipment to operate the wire and the first external operation so as to move the element, so that the W and the mounting flange portion of the core member element specified for the mounting flange with a first slot assembly, and W in a predetermined order by the same manner as the rest of the exterior moving member, whereby the assembly implantable motion restraint device.
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,所述刺激设备向责口括约肌发出刺激脉冲,W刺激责口括约肌并由此使责口进一步闭合,W额外地防止反流疾病。 223 or 255. The apparatus, further comprises: an implantable stimulation device, when implanted in a patient, the device sends stimulation pulses to stimulate responsible mouth sphincter, W and thereby stimulate the sphincter of Oddi responsibility make further responsibilities mouth closed, W additionally prevent reflux disease.
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责口括约肌,从而刺激责口括约肌。 256. The apparatus according to claim 255, wherein the stimulation device by at least one conductor and at least one electrode, when implanted in a patient, said stimulation pulses and receiving electrode which is applied to the sphincter of Oddi responsibility to stimulate responsible for sphincter of Oddi.
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 emitted as a pulse train, wherein the pulse train is repeatedly transmitted in a 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,W允许肌肉休息,仍保持责口括约肌闭合。 258. The apparatus according to claim 257, wherein the stimulation device to emit pulse trains to the column, followed by a longer interval than the interval between bursts, W allows the muscles to rest, remains responsible sphincter of Oddi is 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 emitted as a pulse train, wherein the burst repetition transmission range between two burst time interval, the interval of the extension 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W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引经过所述套管针。 261. The apparatus according to claim 223, wherein the motion restraint device assembly is variable W exhibits a smaller diameter than the laparoscopic trocar elongate form, whereby in the elongated into when the form of assembly of the body can be pushed through the trocar or towing.
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挽性外壁,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 the body includes an outer wall defining a fluid or pull of 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 at least one component is a hollow form, comprising at least one chamber with the injection port, wherein the body cavity through the injection port of the fill fluid.
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W软于25舒尔的材料制成。 265. The apparatus according to claim 223, wherein said component W is made in 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W软于15舒尔的材料制成。 266. The apparatus according to claim 223, wherein said component W is made in 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 said assembly comprises in assembling rendered substantially spherical 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 laparoscopic trocar assemblies used .
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 extension, the extension portion is adapted to be held surgical instruments.
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 the holding device is inserted through the wire 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 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 apparatus, the adjusting apparatus 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 said motion constraints size of the apparatus 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 is thus non-invasively adjust the size of the moving body by 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; 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 in the fluid to be allocated by the non-invasive adjustments in hydraulic pressure between the container and the at least one 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泉W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 is filled by the hydraulic fluid in the container Stephen W, 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H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W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H容器中较大体积的液压流体,所述第H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W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 means, including the reverse servo H adjustable with the hydraulic fluid container, wherein a first container comprising a second the first part of the container closure system, the higher the subcutaneous placement of the first container in a small volume of fluid per unit area W of the compression force is used to move a small volume of hydraulic fluid, and wherein the second container Effect H container larger volume of hydraulic fluid, the second part of the first H container closure system, is greater than the volume of the first container, whereby a smaller W per unit area of a larger force to produce a total volume of hydraulic fluid exercise.
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 a 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 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 internal energy implantation into a 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; can be implanted in a patient's internal power supply, when implanted in the patient, the internal energy can use 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 the receiver, further comprising an internal signal receiver and transmitter, the internal signal receiver and transmitter It can be implanted in a patient for receiving a signal from said external signal transmitted by the transmitter and providing a feedback signal back to the remote control.
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。 272 or 284. The apparatus, further comprises: a wireless energy transmitter for when you need to replenish their energy, non-intrusive 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 at least one energy transmitter by wireless energy emitted energy signal.
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 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W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、X射线福射信号,或者伽马福射信号。 287. The apparatus according to claim 286, wherein said wave signal from the selection signal W down: 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, a radio wave signal, X-ray emitting signal blessing, or Jiama Fu radio 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电。 289. The apparatus according to claim 286, further comprising; implantable accumulator and the energy conversion device, said energy conversion device to the wireless energy into electric energy, wherein said electrical energy to said at least partially for accumulator charging.
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. An apparatus according to claim 1 or according to claim 272, 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 of the parameters.
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 of charged 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. The apparatus 291 or 292, and further comprises: a feedback device, when implanted in a patient, the patient feedback device from outside the patient to transmit the feedback information, the feedback information and the functional parameters associated .
294. 根据权利要求291所述的装置,进一步包括巧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 291, further comprising an implantable internal control unit Qiao, the internal control unit in response to the sensor sensing a functional parameter to control the movement of the 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 a physical parameter patient.
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 a physical parameter of the 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 a physical parameter to control the movement of the 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,W控制其尺寸和/或形状。 272 or 299. The apparatus, further comprises: operating the device, the operating device for operating the motion restraint device, W to control the 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泉。 300. The apparatus according to claim 299, wherein the operation device comprises a motor or a spring.
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,W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, wherein said movement restraining device further adapted to receive wireless energy, wherein the wireless energy for operation of the device to provide power, W energy is generated for the said motion 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,W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, W generates its kinetic energy 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W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、X射线福射信号,或者伽马福射信号。 303. The apparatus according to claim 301, wherein the wireless energy comprises a wave signal, the signal from the wave W under selection signal: acoustic signal, an ultrasonic signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, UV light signal, a laser signal, microwave signal, a radio wave signal, X-ray emitting signal blessing, or Jiama Fu radio 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 including at least one electrical component of the voltage level of 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 comprises 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,W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, said energy conversion device for wireless energy into electric energy, wherein at the time when the wireless energy transmitted by the energy transmitting device, the wireless energy for directly powering the operation device, W generates 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 extending through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along the axis from the first axis end to an intermediate position while moving with the greatest circumference, the circumference remains constant or increases continuously, and point to the end point of the second axis when moving from said intermediate, or continues to decrease and the perimeter keep 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H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H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 extending through the axis of the body viewed in the vertical, said body having a perimeter, and wherein along the axis from the first axis a first end having a first intermediate point of maximum circumference is moved, 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 move the circumference continues to decrease or remain constant along the axis from the second intermediate point to the first intermediate point H having the second largest perimeter moves, the circumference continues to increase or remain constant and H intermediate point from the first to the second terminal of the axis is moved, the circumference continues to decrease or remain constant.
310. 根据权利要求237至254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。 310. The apparatus according to any one 237-254 claim, wherein the at least one fitting member assembly along a first plane of each of the motion restraint device is secured to the core member, and the and said core member assembly motion restraint device further comprises a second assembly member, and after the assembly of the assembled core member, the second mounting member along the first plane into a second angle the plane of each component and the core member 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 second member is a mating mounting member, the projections and recesses provided in the matching with the motion restraint device and assembly of 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 mounting element further comprises at least one 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 at least one mounting element comprises a portion of said core member in the fitting slot, and in said mounting flange assembly, and wherein the mating member comprises in said slot in said projection and the recess on the flange; or the mounting element comprises at least a portion of the core member and the mounting flange assembly in said slot in the assembly, and wherein said engaging member comprises a slot in said protrusion and the flange 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 said at least one motion restraint device and a proximal portion of the distal end portion is provided with a plurality of material layers.
316. 根据权利要求315所述的装置,包括;W聚亚安醋、特富龙、或者聚四氣己帰、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; an outer surface layer W vinegar polyurethane, Teflon, or polytetrafluoroethylene gas has kaesa, parylene, metal or combinations thereof made.
317. 根据权利要求315所述的装置,包括;W聚亚安醋、特富龙、或者聚四氣己帰、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; an inner surface layer W vinegar polyurethane, Teflon, or polytetrafluoroethylene gas has kaesa, parylene, metal or combinations thereof made.
318. 根据权利要求315所述的装置,包括康四氣己帰内表面层和娃丽外表面层。 318. The apparatus according to claim 315, including the inside Kang had four gas kaesa surface layer and the outer surface layer of baby Lai.
319. 根据权利要求315所述的装置,包括康四氣己帰内表面层、娃丽中间层和聚对二甲苯外表面层。 319. The apparatus according to claim 315, including the inside Kang had four gas kaesa the surface layer, an intermediate layer and baby Lai outer surface layer of parylene.
320. 根据权利要求315所述的装置,包括康亚安醋内表面层和娃丽外层。 320. The apparatus according to claim 315, comprising vinegar Kangya An inner surface layer and an outer layer baby Korea.
321. 根据权利要求315所述的装置,包括康亚安醋内表面层、娃丽中间层和和聚对二甲苯外层。 321. The apparatus according to claim 315, comprising vinegar Kangya An inner surface layer and the intermediate layer and the baby Korea parylene layer.
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 constraint proximal portion and a distal portion of the apparatus 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

[0001] 本申请是申请日为2009年10月12日、申请号为200980149807. 9、发明名称为"治疗胃食管反流疾病的装置"的专利申请的分案申请。 [0001] The present application is filed on October 12, 2009, Application No. 200980149807.9, entitled to a divisional application "means the treatment of gastroesophageal reflux disease," the patent application.

技术领域 TECHNICAL FIELD

[0002] 本发明涉及治疗胃食管反流疾病(GERD)的装置。 [0002] The present invention relates to a device for treatment of gastroesophageal reflux disease (GERD) in.

[0003] 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。 [0003] 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 holding cardia in the correct position and stabilize the proximal end and adapted to the additional treatment of obesity remote. 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 device is adapted to engage a patient to stimulate cardiac sphincter; and for controlling the stimulation device to stimulate the 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 further be combined with various methods of treatment of obesity, especially in combination with padding by pulling the stomach or the stomach volume to produce satiety approach.

背景技术 Background technique

[0004] 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。 [0004] 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 between the stomach and esophagus temporary or permanent damage. 这种情况可能源于下食管括约肌(LES)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 result from the lower esophageal sphincter (LES) disability, transient LES relaxation, reflux from the stomach was removed from the damaged esophagus or esophageal hernia pear-shaped.

[0005] 胃食管反流疾病可以采用许多不同的方式进行治疗。 [0005] 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 (gastric) is wound 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。 This process typically use laparoscopic surgery to complete.

[0006] 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。 [0006] Another surgical treatment has begun using Anglechik prosthetics, which form a similar horseshoe-shaped device 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.

[0007] 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。 [0007] The medical implant device experience, already know implanted suture equipment and human organizations can not be long-term. 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 the human tissue is sutured to body tissue, whereby the device is held 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, tissue growth and allow the body to the device, thereby maintaining the equipment in place long-term.

[0008] 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。 [0008] Esophageal issues associated with an implantable device is that the outer surface only of the esophagus in esophageal muscle tissue, muscle tissue that 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 said Anglechik a reason such as migration.

[0009] 另一方面,胃外侧具有浆膜,由此为缝合提供更强韧的膜。 [0009] On the other hand, outside of the stomach with a serous membrane, thereby to provide a more robust stitching film. 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 sewn to the esophagus, to obtain better results.

[0010] 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。 [0010] 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 SUMMARY

[0011] 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。 [0011] object 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 object and purpose of the use of the rights of other incidental requirements.

[0012] 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。 [0012] The present invention is reflux disease treatment apparatus provides an improved long-term behavior, the device can also provide additional functionality treatment of obesity.

[0013] 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。 [0013] Said object and other objects use the appended claims means 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 apparatus includes an implantable motion restraint device, the motion restraint device having an elongated shape and an outer surface, using the patient's stomach wall the device is adapted 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 proximal and distal ends, and wherein the apparatus is adapted with its outer surface in a position between the proximal end of the diaphragm and the fundus wall of the patient at least partially against patients with gastric wall, in order to exercise restraint device is implanted in a patient, the patient restraint stomach heart patients notch toward the diaphragm movement, thereby preventing cardiac patients through the diaphragm opening slide patients chest to maintain the patient's abdomen is applied on the patient's cardiac sphincter pressure support. 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。 Said apparatus further adapted to use and maintain the stability of its distal end a proximal end, said distal end adapted to substantially inset in the stomach wall, in order to prevent the opening of the diaphragm slide through the patient cardiac patient's breast. 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 of the 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。 Accordingly, as the proximal anatomical position, referring to the body closest to the center, or at the start 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。 Elongated motion restraint device distal end portion of the retraction length long enough to stabilize the proximal end of the elongate motion restraint device to prevent cardiac patients through the diaphragm opening slide patients chest. 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。 Perimeter of the distal end of the elongated motion restraint device retraction portion such that the stability of the proximal portion of the elongated motion restraint device, thereby preventing cardiac patients through the diaphragm opening slide patients chest. 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, circumference of at least 15mm.

[0014] 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。 [0014] Preferably, the implantable device comprising a first fixing device, the fixing device will first proximal portion of the motion restraint device fixed constraint heart stomach notch towards the diaphragm movement position of the patient, and the outer surface of the apparatus of the motion constraint substantially 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 fixing device may comprise sutures or staples, staples fundus portion after connecting the suture 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, no movement between the tissue and suture restraint device, 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 proximal portion of the motion restraint device is held in place, bringing the long-term characteristics improved elastic suspension.

[0015] 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。 [0015] The first fixing device, such as sutures or staples, the gastric wall portions together, from the patient's stomach to the inside or outside of the retraction motion constraints proximal portion of the device.

[0016] 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。 [0016] Alternatively, tissue growth promoting structure can be sutured to the stomach wall, 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 holding of the proximal portion of the motion 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 include a mesh structure is connected to the wall of the gastric sutures or staples.

[0017] 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。 [0017] In order to increase the motion restraint device attached to the proximal end portion is connected to the gastric wall can be fixed using a second device. 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。 The second fixing device may be used to the proximal portion of the motion restraint device relative to the cardia attached. 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 transverse diaphragm, the attachment 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) near the corner of the second device can be fixed proximal portion motion restraint device is fixed 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。 A second fixing 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.

[0018] 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。 [0018] The apparatus may further comprise a third fixing device, fixing device of the third part of the motion restraint device of the proximal end is 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 fixation device suitably comprises a plurality of sutures or staples, sutures or staples of the gastric wall and the horizontal connection diaphragmatic muscle or other tissue to keep the motion restraint device is in the position.

[0019] 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。 [0019] a 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.

[0020] 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。 [0020] The 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, significantly reduced volume than the volume of the motion restraint device.

[0021] 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 a portion of the acid can be damaged or destroyed material can not be [0021] made the motion restraint device.

[0022] 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。 [0022] In an embodiment, the proximal portion of the motion restraint device may be adapted to use a gel or swell and expansion of the fluid. 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 motion constraints to the expansion device.

[0023] 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。 [0023] The proximal portion of the motion restraint device may comprise a homogenous material, and may be a solid body.

[0024] 运动约束设备的近端部分可以包括限定腔室的包围壁。 [0024] The proximal portion of the motion restraint device may comprise a wall defining a chamber surrounded.

[0025] 运动约束设备的近端部分可以具有刚性、弹性或挠性外壁。 [0025] 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 wall is a rigid outer wall, its rigidity is large enough to keep the deformation does not occur in the stomach to withstand forces generated during movement.

[0026] 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。 [0026] According to a preferred embodiment of the apparatus, a proximal portion of the motion restraint device comprising a main 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 is adapted in some 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 is made in a soft 25 or 15 Shure (shure) material.

[0027] 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。 [0027] According to a first general design of the body, on a plane perpendicular to an axis through the body of observation, 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 circumference of the body is equal to the maximum circumference or along the axis direction as viewed from 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 component, or a similar curved oval.

[0028] 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。 [0028] According to a second general design of the body, in a plane extending through the axis of the body viewed in vertical plane with the axis moving along the circumference of the body increases and decreases at least twice, with the plane or along the axis to move, 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.

[0029] 优选,所述主体的尺寸确定为大于胃的肠道出口的尺寸。 [0029] Preferably the size, the body size is determined to be greater than the gastric intestinal 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.

[0030] 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。 [0030] Suitably, the body has a circular profile, with possible damage to the patient without too sharp edges of the stomach wall and gastric wall has to abut against a substantially smooth outer surface.

[0031] 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。 [0031] The implant body may be inside or outside the patient's stomach, the stomach wall and is 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, in order to exhibit a diameter smaller than the laparoscopic trocar elongate form, whereby when the elongate form into 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.

[0032] 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。 [0032] The body may be in the form of a hollow, and includes at least two separate parts, these two separate members adapted for insertion into the hollow body, and further adapted to be placed within the body together form a single member, whereby allowing the body through the laparoscopic trocar used. 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 comprise an inner portion and an outer wall of the hollow compression, for inserting the body of the patient after the use of fluid or gel-filled.

[0033] 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。 [0033] The body may include an injection port having a chamber, wherein said chamber through said body to a fluid injection port filled.

[0034] 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。 [0034] 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 the extension portion of the main body, the extended 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 includes an outer wall, the holding device is at least partially disposed in the inner side of the body wall.

[0035] 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。 [0035] In one embodiment, the apparatus according to the present invention further comprises a regulating device (adjustment device), for regulating the movement of at least a proximal portion of the restraint device. 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 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(hydraulicregulation 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 (hydraulicregulation device), the apparatus comprising 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 by distribution of hydraulic fluid between the container and the at least one chamber for containing a non-invasive adjustments of the amount of hydraulic fluid within the 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 by 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。 Furthermore, the regulating device may further comprise a reverse servo, wherein a small volume of fluid within the container is greater force to compress, and the chamber with relatively small 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, and 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 pressure within the container is preferably disposed in 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, and the volume of the hydraulic vessel may be adjusted by moving the hydraulic part of the wall of the vessel 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 apparatus may include a pump, and the hydraulic pressure between the hydraulic pressure in the container with a pump container and said at least one fluid pumping chamber is adjusted. 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 pressure control apparatus with the operation moves. 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 further includes a motor for mechanically regulating the motion restraint device.

[0036] 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。 [0036] In one embodiment, the apparatus according to the present invention further comprises a second body, with the body when implanted in the 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 apparatus to noninvasively and adjusted adapted surgery, and is adapted to be adjusted from time to time, so that at a first time, wherein the volume of a filling body filling the stomach at a portion, and in the second time, another filled body filler is located in another portion of the volume of the stomach.

[0037] 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。 [0037] In one embodiment, the apparatus of the present 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。 The size of the motion restraint device can 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 moves hydraulic fluid rather than invasive adjustments. 所述运动约束设备可以视为主体。 The motion can be regarded 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 distribution of body fluids by the non-invasive adjustments in 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(adjustablereservoir),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。 Furthermore, the adjusting device may comprise a reverse servo, the reverse servo comprises three adjustable containers (adjustablereservoir) having a hydraulic fluid, wherein the first part of the second container is a container comprising a first closure system, subcutaneously the placement of the first container to the small volume of fluid per unit area of high compression forces, for moving a small volume of hydraulic fluid, wherein the second and third hydraulic fluid container affect a larger volume of the container, the first the second part of the container closure system of the three, is greater than the volume of the first container, whereby a smaller force per unit area produce a greater total volume of the movement of the hydraulic fluid.

[0038] 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。 [0038] In a particular embodiment, as outlined in the previous paragraph the motion restraint device comprises two or more components of the motion restraint device, preferably comprising three or more components, which 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 of the diaphragm position between the patient and the patient against the gastric wall and gastric wall, so that during exercise restraint devices implanted in a patient, the patient's stomach heart patients notch toward the diaphragm movement is constrained, thereby preventing cardiac patients through the diaphragm opening slide into the chest of patients, thereby maintaining the patient's abdomen is applied to the patient's cardiac sphincter pressure support. 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 be motion constraints may be broken down into components, if it is left in position between the diaphragm and the fundus wall at least partial contact with the wall of the gastric implant position words. 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 adapted to exercise restraint device retraction 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 the trocar assembly, for the motion restraint device in the assembled 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 a 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 assembled into the shape of the motion restraint device 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 assembly may be adapted to the motion restraint device in a fluid, foam, or gel can harden into a solid material wherein the fluid 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 held.

[0039] 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。 [0039] For assembly, the motion restraint device is provided with at least one mounting element, the mounting element and the at least another component with a fitting element sufficiently to enable use of the component mounting mating elements may be assembled into the motion constraint implanted device. 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 element selected in the flanges and slots cooperate fully with the 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。 Adapted to receive said core member and said outer member is assembled into an implantable motion restraint device, and is preferably in the motion restraint device when assembled, fitting the core member having a slot, said slot assembly corresponding to the groove adapted to receive the mounting flange of 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 surrounding 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 a slot to cooperate fully with the flange, 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 to each of the motion restraint device along a first plane component secured to the core member, and the movement restraining device and said core assembly further includes a first member two mounting elements, with the second mounting member and the assembly of the core member in the assembly of each component and the portion of the core member along a first plane and the 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。 The second mounting member comprises a mating member, the mating member preferably has a movement restraining device in the assembly, and the core member of the projection and mating recess is provided, 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。 Preferably, the mounting element comprises at least a portion of said core member in the fitting slot, and in said mounting flange assembly, and said engaging member comprises said projection and slot are located said concave flange portions, or alternatively, the mounting element comprises at least one member on the mounting flange of the core and the fitting is located in the slot of the assembly, and said engaging member comprises a slot the projection and the recess is located in the flange.

[0040] 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 device [0040] Further preferably comprises a guide device, the guide device can be operated for assembling components into the motion restraint device implantable 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.

[0041] 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。 [0041] 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。 To assist the assembly process, each component may be provided with at least one mounting element, the mounting element with another component sufficiently to at least one fitting member, so that the use of the component mounting mating element 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.

[0042] 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。 [0042] The core member adapted to receive the external components and assembled into an implantable exercise 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 surrounding 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 adapted to fit exercise restraint device is in its implanted 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 degradation of the device will also help to guide the movement of the restraint device disassembled into components that are designed not to cause any obstruction to the patient or any other form of damage.

[0043] 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。 [0043] 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 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 the core member is preferably provided with at least one working channel for receiving the wire operation. 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 member using the operation wire is connected 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 at the end face of the core member and the first opening is located in the core slot of the first member so that the direction away from the end face receiving at said first displacement operation of the operation wire passage, a first outer member is 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 to the end face in the direction away from the movement of the operation wire is 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, thereby moving the first conductor and the outer traction member so that it and the mounting flange portion of the core member the mounting flange for the designated slot with a first fitting, 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 comprise three or more outer parts with the pulling wire through the slot in each of the specified portion of the core member has a passage opening operation, these external parts 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 discussed below, other shapes and additional functional elements also form part of the present invention.

[0044] 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。 [0044] In the following description section 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 may be on any of the following characteristics of the distal portion of the motion restraint device of the combination.

[0045] 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 [0045] It is 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。 Thus, the body in its size increases, pulling the patient gastric wall, thereby producing satiety patient is also suffering from obesity. 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 adjustable implantable device can be used to stretch the stomach wall drawing different parts of the patient, thereby affecting the appetite of patients by efficiently treating obesity. 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 suitably adjusted, thereby adjusting the first time at a first traction device, so as to stretch the first part of the patient's stomach wall, and at a second time stretch a second adjusting device, in order to pull pull the second part of the stomach in patients.

[0046] 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。 [0046] 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 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.

[0047] 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。 [0047] According to a first alternative, the motion restraint device of the distal end portion adapted to rest on the inside of the stomach, such that the outer surface of the distal end portion abutting the inner side of the stomach wall.

[0048] 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。 [0048] According to a second alternative, the motion restraint device adapted for placement on the outside of the distal portion of the stomach, so that the outer surface of the volume filling device against the outside of the stomach wall.

[0049] 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。 [0049] Preferably, the kinematic constraints distal portion of the device is adapted to be completely sunk in patients with stomach, and the stomach via endoscopy instruments placed 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 distal portion of the motion restraint device may include a connection device, the connection device is adapted to cooperate with a grasping instrument. 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。 Appropriately, the distal end portion of the motion restraint device can be adapted to non-invasively adjusted after surgery.

[0050] 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 [0050] may include a fixed device, suitably comprising two or more fixtures, the fixture is adapted to participate in the movement of the distal end of the fixed restraint device 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 simplify the use of the instrument during implantation of the holding device, the instrument is suitably two or more holding devices.

[0051] 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。 [0051] the motion restraint device of the distal end portion of at least part of the material can not be destroyed by stomach acid formed. 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 destroyed acids, such as hydrochloric acid is destroyed.

[0052] 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。 [0052] In one embodiment, the distal end portion of the motion restraint device may be expanded to an expanded state, and comprising a wall defining a chamber enclosing the distal portion of the motion restraint device using 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 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 and can be injected into the tube 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, the inlet port may be connected to the endoscopic instrument, wherein the access port comprises said expandable adapted for interconnection with the device said fluid connection endoscopy instruments.

[0053] 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。 [0053] The movement of the restraint device may include a distal portion of homogeneous material, such as Shure value is less than the gel 15. 所述设备也可以是实心体。 The device may also be a solid body.

[0054] 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。 [0054] wherein at least a portion of said at least one movement restraining device proximal portion and a distal portion may comprise an outer surface of the rigid, flexible or elastic. 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。 When the outer surface of a rigid, its rigidity is large enough to withstand the pressure in the stomach during the movement, to maintain the deformation does not occur. 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.

[0055] 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。 [0055] According to a first general design of the distal end portion of the motion 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, the perimeter of the device is equal to the maximum circumference or from the direction from the maximum circumference decreases 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 apparatus may be substantially ovoid, spherical or ovoid with a substantially curved central recess oval or similar type.

[0056] 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。 [0056] According to a second general design of the device, in a plane through the axis of the device viewed in vertical plane with the axis moving along the circumference of the device increases and decreases at least twice, with the plane or along the axis to move, 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 device may be configured substantially similar to the kidney-shaped. [0057] 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。 [0057] The distal portion of the motion restraint device has an elongated, rounded, curved and / or curved shape.

[0058] 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。 [0058] movement of the distal portion of the restraint device has at least 30,50,80,120,150,180 or 220mm circumference.

[0059] 所述运动约束设备的远端部分具有介于0. 0001至0. 001m3范围内、或者0. 00001 至0. 001m3范围内、或者0. 0001至0. 0002m3范围内的体积。 [0059] The distal portion of the motion restraint device has ranged within the range of 0.0001 to 0. 001m3 or within the scope of, or volume in the range of 0.0001 to 0. 0002m3 0. 00001 to 0. 001m3. 所述体积填充设备的体积小于0 002m3。 The volume of the volume filling device is less than 0 002m3.

[0060] 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。 [0060] The movement of the distal end portion of the restraint device may comprise at least two interconnected portions, the two parts adapted to separate a portion disposed inside or outside of the stomach.

[0061] 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。 [0061] The distal portion of the motion 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 portion of at least one of which is provided with 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 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 of the layers can 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, poly 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娃酮外层;聚四氟乙烯内表面层、娃酮中间层和聚对二甲苯外层;聚亚安酯内表面层和娃酮外层;和聚亚安酯内表面层、娃酮中间层和聚对二甲苯外层。 Other combinations include inner layer PTFE outer surface layer and one baby; polytetrafluoroethylene surface layer, an intermediate layer and a baby one outer layer of parylene; polyurethane inner surface layer and the outer one baby; and the inner surface of the polyurethane layer, an intermediate layer and one baby parylene layer.

[0062] 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。 [0062] The movement of the restraint device may comprise a distal portion adapted to be converted into the form of a solid or a fixed 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 molecular iodine, to prevent proliferation.

[0063] 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。 [0063] the motion restraint device of the distal portion 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.

[0064] 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。 [0064] Preferably, the motion restraint device is adapted to use the distal portion of 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。 Advantageously, the distal end portion of the motion restraint device has a variable circumference, in order to better maintain the retraction in patients with stomach location. 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 performance of the structure in contact with the stomach wall, to promote growth of human tissue, whereby the position of the stomach wall is connected to the long-term fixed volume filling device. 所述结构可以包括网状结构。 The structure may comprise a mesh structure.

[0065] 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。 [0065] In the 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 traction device, thereby affecting the 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 inflatable volume filling device, the device may comprise a fluid connector portion interconnecting the traction device and the volume filling device.

[0066] 所述牵拉设备可以液压地调节。 [0066] 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, it sets up a connection to a hydraulically adjustable hydraulic pulling device can be implanted subcutaneously in the container, thereby regulating the hydraulic pulling device when implanted in a patient, adapted for the use of the hydraulic pressure from the container fluid 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 hydraulic pressing the container to the non-invasive adjustments. 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 expandable body Suitably, the body and provided with the pump chamber and the fluid connection, wherein the pump by pumping fluid or air from the chamber of the body to be adjusted the hydraulic container.

[0067]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 [0067] 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 comprises at least one conductor and at least one electrode which receives and applies stimulation pulses 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 can also be used to stomach sutures or retraction by held in place in the stomach wall. 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 can be emitted as a pulse train, wherein the pulse train is repeatedly transmitted in a time interval between two bursts, the intermittent extended (extend) the interval between each pulse burst. 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 device to emit said stimulation pulse trains to the column, followed by a longer interval than the interval between bursts, in order 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 circuitry and energy, the energy is preferably adapted to contain the circuitry and the energy.

[0068] 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。 [0068] 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.

[0069]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。 [0069] Typically, the internal control unit in response to information from the sensor to control the stimulation device.

[0070]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。 [0070] sensing esophageal contraction wave or food intake with any other sensor-related 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.

[0071] 所述刺激设备在任何时候都可以由患者控制。 [0071] The stimulation device can be controlled by the patient at any time.

[0072] 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。 [0072] 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 partly the patient 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 part of the lower wall of the fundus retraction against the stomach wall without damaging the stomach when the motion restraint device implanted so that the patient's stomach in patients with heart notch toward the diaphragm movement is constraints, thereby preventing cardiac patients through the diaphragm opening slide patients chest to maintain the patient's abdomen is applied to the patient's cardiac sphincter pressure support. 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 distal portion of the motion restraint device stable and holding the proximal end portion and adapted to substantially inset 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 underlies 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125_ 3,周长至少为15_,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 proximal portion of the size of the motion restraint device 125_ at least 3, at least 15_ perimeter, further comprising an implantable stimulation device, the device is adapted to engage the patient to stimulate the cardiac sphincter; and means for controlling the stimulation device to stimulate cardiac sphincter control apparatus, wherein the use of the energy pulse stimulation of the cardiac sphincter, sphincter ankylosing to increase, so that the cardia is closed and the control device may be operable by the patient, provided that it can stop the operation, wherein Further control device can be operable by the patient, thus stimulating the apparatus is 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 , the energy pulse stimulation to the cardiac sphincter, while in the sleep mode, does not stimulate the cardiac sphincter.

[0073] 运动约束设各 [0073] Let each motion constraints

[0074] 现在将描述所述装置的运动约束设备。 [0074] device will now be described kinematic constraints of the device. 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 that 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 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 features described in this application, as well as any portion of a method embodiment or embodiments, if appropriate, can be used for the proximal portion or distal portion of the device.

[0075] 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。 [0075] The implantable device comprises a motion restraint device, the device has an outer surface including a biocompatible material, wherein the movement restraining device is adapted to use at least a portion of the outer surface of the diaphragm and the gastric wall in patients position between the abutment patients gastric wall of the stomach so that the patient's heart notch towards the patient's diaphragm movement is constrained, thereby realizing a method for the treatment of gastroesophageal reflux disease apparatus. 所述运动约束设备的尺寸至少为125_3,周长至少为15_,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 125_3 circumference of at least 15_ and constraints heart patients stomach notch diaphragm movement towards the patient, thereby preventing cardiac patients through the diaphragm opening slide into the chest of patients, maintaining patient applied to the patient's cardiac sphincter pressure to support the abdomen. 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 device in motion constraint.

[0076] 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。 [0076] The outer surface of the implant is adapted to the motion restraint device to the fundus against the wall, the risk of complications such as damage to tissue transfer a minimum because gastric and esophageal not so fragile.

[0077] 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。 [0077] In a first embodiment of the present invention, the fixing device includes sutures or staples, the sutures or staples will surround the motion constraint gastric wall portion of the device are connected together, so that the motion constraints fixing the position of the device, namely 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 of an 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 elastic suspension characteristics are improved.

[0078] 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。 [0078] fixtures, such as sutures or staples may fundus wall portions connected together, so that 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 patient's stomach, the fundus of the motion restraint device by a wall retraction, so that the stomach cavity is significantly reduced, the volume is reduced substantially exceeds the volume of the motion restraint device.

[0079] 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。 [0079] In another embodiment of the present invention, the fixing device comprises a first fixing implantable device, the fixing device will first movement restraining device in the position connected to the gastric wall; a second fixed device, the second fixture motion constraint directly or indirectly connected to the esophagus near the equipment Hiss angle; and a third fixture, the fixture will be the third motion restraint devices directly or indirectly connected to the patient cross diaphragmatic muscle or 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 may be constituted by 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 a tissue growth promoting structure for maintaining the long-term movement of restraining 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 a 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 the long-term 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.

[0080] 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。 [0080] In addition to the retraction according to the first embodiment of the invention of the motion restraint device, the second fixing device can be used to the motion restraint device directly or indirectly fixed to a corner near the Heath patient's esophagus, and the third fixed equipment can be used to the motion restraint devices directly or indirectly secured to the patient or other cross-diaphragmatic muscle tissue.

[0081 ] 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。 [0081] at least part of the motion restraint device can be made that can not be damaged or gastric acid damage the material. [0082] 所述运动约束设备可以膨胀并适于利用凝胶或流体膨胀。 [0082] 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 movement constraint device.

[0083] 所述运动约束设备可以包括同质材料并且可以是实心体。 [0083] The motion restraint device may comprise a homogeneous material and can be solid body.

[0084] 所述运动约束设备可以包括限定腔室的包围壁。 [0084] The motion restraint device may include defining a chamber surrounded by a wall.

[0085] 所述运动约束设备可以具有刚性、弹性或挠性外壁。 [0085] The motion restraint device may be rigid or flexible resilient 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 generated by the movement of the stomach. 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 first embodiment, the motion restraint device in the case of retraction, the motion restraint device preferably comprises a body which is adapted to the patient at least partially sunk fundus 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 abutment stomach. 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.

[0086] 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。 [0086] According to a first general design of the body, on a plane perpendicular to an axis through the body of observation, 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 another plane perpendicular to the axis of the observation, the circumference 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 circumference of the body 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 type or similar curved.

[0087] 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。 [0087] According to a second general design of the body, in a plane extending through the axis of the body viewed in vertical plane with the axis moving along the circumference of the body is increased and decreased at least two times, or with said moving plane along the 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. [0088] 优选,所述主体的尺寸确定为大于胃的肠道出口的尺寸。 [0088] Preferably the size, the body size is determined to be greater than the gastric intestinal 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.

[0089] 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。 [0089] Suitably, the body has a circular profile, with possible damage to the patient without too sharp edges of the stomach wall and gastric wall has to abut against a substantially smooth outer surface.

[0090] 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。 [0090] The implant body may be inside or outside the patient's stomach, the stomach wall and is 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, in order to exhibit a diameter smaller than the laparoscopic trocar elongate form, whereby when the elongate form into the body may be push or pull through the trocar. 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.

[0091] 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。 [0091] The body may be in the form of a hollow, and includes at least two separate parts, these two separate members adapted for insertion into the hollow body, and further adapted to be placed within the body together form a single member, whereby allowing the body through the laparoscopic trocar used. 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 comprise an inner portion and an outer wall of the hollow compression, for inserting the body of the patient after the use of fluid or gel-filled.

[0092] 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。 [0092] The body may include an injection port having a chamber, wherein said chamber through said body to a fluid injection port filled.

[0093] 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。 [0093] 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 the extension portion of the main body, the extended 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 includes an outer wall, the holding device is at least partially disposed in the inner side of the body wall.

[0094] 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。 [0094] In advantageous embodiments, 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。 Thus, the body in its size increases, pulling the patient gastric wall, thereby producing satiety patient is also suffering from obesity. 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 adjustable implantable device can be used to stretch the stomach wall drawing different parts of the patient, thereby affecting the appetite of patients by efficiently treating obesity. 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 suitably adjusted, thereby adjusting the first time at a first traction device, so as to stretch the first part of the patient's stomach wall, and at a second time stretch a second adjusting device, in order to pull pull the second part of the stomach in patients.

[0095] 所述牵拉设备可以液压地调节。 [0095] 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 can be implanted subcutaneously in the container, thereby adjusting the hydraulic pulling device is adapted to 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 expandable body Suitably, the body and provided with the pump chamber and the fluid connection, wherein the pump by pumping fluid or air from the chamber of the body to be adjusted the hydraulic container.

[0096] 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 [0096] 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 receiving stimulation pulses and applies 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 can also be used to stomach sutures or retraction by held in place in the stomach wall. 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 between two burst time interval, 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 may comprise an electronic circuitry and energy, the energy is preferably adapted to contain the electronic circuit and energy.

[0097] 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。 [0097] 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.

[0098] 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。 [0098] Typically, the internal control unit in response to information from the sensor to control the stimulation device.

[0099] 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。 [0099] sensing esophageal contraction wave or food intake with any other sensor-related 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.

[0100] 所述刺激设备在任何时候都可以由患者控制。 [0100] The stimulation device can be controlled by the patient at any time.

[0101] 刺激设各 [0101] Let each stimulus

[0102] 现在将描述所述装置的刺激设备。 [0102] stimulation apparatus will now be described the apparatus.

[0103] 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。 [0103] The control device may be operable by the patient to control the stimulation device to switch between a continuous operating mode and a sleep mode, in the operating mode to cardiac sphincter stimulation pulse energy, and in the resting 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 continuous benefits can cardiac sphincter is in the 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 with 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 device 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 counter-flow problems of the holding means temporary "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 is eating.

[0104] 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 of [0104] energy, wherein the control device controls the energy to release energy, after the implant stimulation device is used as the power of the 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, the supply to the implant member of the apparatus to provide a simple and effective control, thus ensuring long-lasting and reliable functioning of the device, a patient may use the rest of his life or at least for many years.

[0105] 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。 [0105] 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 intensity of stimulation cardiac sphincter, cardia sphincter tonic to make a change. 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 delivery device to the electrical stimulation pulse. 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 transmission 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 the operation by the patient to control the switch of the wireless remote control.

[0106] 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。 [0106] In the case of the stimulation device uses electrical impulses to stimulate the cardiac sphincter, and possible problems is to provide a sufficiently strong voltage strength, in order to achieve the desired electrical cardiac sphincter 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 of strength may decrease with time because of fibrotic tissue in place of electrical conductors formed by joining the 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。 The main problems caused by this embodiment of the present invention is to solve, wherein the stimulation device comprises electric conductors for engaging the cardiac sphincter, is adapted to provide the electrical current through the conductor of electrical energy, and the control device is adapted to control the electrical energy to release energy, so that the predetermined value through said electrical conductor current intensity. 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。 Therefore, since the cardiac sphincter formed where fibrotic tissue leads to decrease in the intensity of the current conductor bonding 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's decline, the control device automatically controlling the electrical energy to release more electric energy to restore the desired current strength.

[0107] 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。 [0107] Advantageously, the control device adapted to control the electrical energy to release energy in the form of alternating current. 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。 The inventors 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。 Such electrolysis could harm the cardiac sphincter.

[0108] 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。 [0108] All of the above embodiments may be used with at least one 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。 Specifically, the sensor may sense esophageal contraction wave as a physical parameter measured by the patient swallowing 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 response of the sensor device is adapted to stimulate the senses of esophageal contraction wave stopped stimulate cardiac sphincter.

[0109] 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。 [0109] Alternatively, the sensor may be used include, directly or indirectly sense the pressure esophageal 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 "indirectly sensing the pressure within the esophagus" should be understood to include the case that the sensor senses the pressure applied to the device or the patient's body tissue irritation.

[0110] 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。 [0110] The control device may comprise an internal control unit, the internal control unit preferably includes 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, with the control unit may send information related 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.

[0111] 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。 [0111] or alternatively, the apparatus may further include a control outside of a patient external control unit, wherein the internal control unit can 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 program activities with time schedule to control the stimulation device.

[0112] 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。 [0112] The external control unit may be in response to a signal from the sensor to properly control the stimulation device directly. 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 senses a physical parameter of the stored and can be manually operated to control the stimulation device based on the stored information. 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.

[0113] 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。 [0113] a huge advantage 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 of vomit, if he can not stop cardiac stimulation immediately, he will be very difficult to do so.

[0114] 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。 [0114] Conveniently, the external control unit may load the internal control unit in accordance with the data only by a physician authorized loading 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 device for stimulating such as electricity, electrical pulse frequency, according to the external control unit may be authorized only for doctors doctor 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。 To simply controlling the stimulation device, such as a "start" or "stop", according to the external control unit may allow the patient to the patient to control the pattern of 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.

[0115] 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。 [0115] The control device may be adapted to control the energy to release energy, for instance to intermittently release energy in the form of bursts of energy, direct stimulation as a power device. 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 controlling the energy to release energy, and the apparatus further comprises an implantable capacitor for generating a train of energy pulses from the released energy. 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。 In this common case, the energy term "direct" is used to refer aspect when released by the controlled release device, the energy released can be used, on the other hand is used to refer to the power generation of the stimulation device , e.g., the energy released may be applied using the energy of the delayed second stage stabilizer.

[0116] 以下描述的是有关能量供应和控制的进一步实施方式。 [0116] 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 of this application may be used in the first embodiment is applied all different, not just for the stimulation device.

[0117] 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 [0117] comprising implantable electrical components, the electrical component comprises at least one or only one single voltage level safety device and a capacitor or accumulator, wherein the capacitor or accumulator charging and discharging of the voltage level of the use of safety devices to control.

[0118] 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。 [0118] In one embodiment, the energy outside of a 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。 The 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。 Alternatively, the battery may be implanted in the 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, the control circuit and the device can be used to stimulate the conversion device to wireless energy or energy from the implanted energy storage device or battery powered directly.

[0119] 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。 [0119] In one embodiment, the wireless energy directly used to power the stimulation device that, when released by the control device when the wireless energy from the external energy source, the stimulation device to provide 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 for the release of energy utilization equipment refers to power the stimulation immediately, rather than first stored energy, on the other hand used to refer to the equipment used to stimulate before providing power, the energy released, for example using the energy level of the second stabilization 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. the wireless energy into electric energy which can be used to transmit wireless energy directly to the device during the energy component to power, or after charging to the accumulator, power indirectly. 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 was no complicated signal control system implanted. 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.

[0120] 在一种实施方式中,所述能源包括可植入的能源。 [0120] 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 power source implanted in the patient, the control device controls it from outside the patient, to release 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 to implement for the device, wherein said device has a relatively high energy consumption, and can not be used to meet the direct supply of wireless energy, this solution has the advantage. 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 to control the stimulation device to 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 radiation or acoustic energy, such as ultrasonic energy.

[0121] 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。 [0121] 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; implantation into a patient and an 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 power supply of 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 be directly supplied by wireless energy to meet the present invention, this solution has the advantage.

[0122] 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。 [0122] In one embodiment of the invention, the switch between the "Stop" mode and the "start" mode switch in the stop mode, do not use the internal electrical energy, and in the start-up mode, internal power supply of electrical energy as a 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, by the wireless energy released from the external energy source conveniently 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 the implanted source of electrical energy such as battery life can be significantly extended because not implanted energy supply energy when the switch is in the stop mode.

[0123] 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。 [0123] In one embodiment, the control device comprises a wireless remote control for controlling the internal source of 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 use of wireless energy from outside the switching operation of the energy, so that between the "stop" mode and the "standby" mode switch in the stop mode, without using the remote control, and an internal electrical energy source , while in the standby mode, the remote control allows the internal electrical energy supply can mention as a power-stimulation device.

[0124] 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。 [0124] In one embodiment, the apparatus further comprising: a patient implanted energy conversion device for wireless energy into storable energy; and means for storing the energy storable Implantable 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 mode, the internal electrical energy supply can mention as the power of 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 comprises a wireless remote control for controlling the operation of the energy storage device to switch.

[0125] 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。 [0125] external data communicator may be provided outside the patient, and the 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.

[0126] 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。 [0126] Suitably, an implantable stabilizer, such as a capacitor, a rechargeable accumulator or the like, may be used by the stabilization of the control device releases electric 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。 In addition, the control device may control the energy to release energy and duration or period of time to determine the release of the determined number of energy pulses.

[0127] 上述实施方式全部优选进行遥控。 [0127] All the above-described preferred embodiment of 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 functionality of the device is adapted to the daily needs of the patient, which is good for patients.

[0128] 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。 [0128] The wireless remote control to get information about the status of the device and can stimulate the response 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 be sent information about the stimulation device to the patient's body.

[0129] 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。 [0129] In particular 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 can be implanted in a patient at least one internal signal transmitter or transceiver.

[0130] 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。 [0130] 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 the 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。 Moreover, the control signal for the carrier signal may be frequency, amplitude or frequency and amplitude modulated signal.

[0131] 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。 [0131] The control signal comprises a wave signal, for example an ultrasonic signal as an acoustic 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 signals. 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.

[0132] 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。 [0132] The control signal may be 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 an analog carrier signal carrying a digital control signal to 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.

[0133] 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。 [0133] The control device may be manually or non-manually activated using, for controlling the energy to release energy.

[0134] 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. 1μF 的容量的可植入的电容器可以用于产生上述能量脉冲串。 Implantable capacitor [0134] In the above-described embodiment of the present invention, energy is released energy may comprise, and has a capacity of less than 0. 1μF may be used to generate said train of energy pulses.

[0135] 一般来说,所述无线能量包括信号。 [0135] Generally, the wireless energy comprises a signal.

[0136] 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 [0136] may further comprise an implantable energy conversion device, for example, the performance of acoustic waves in the form of wireless energy into electricity, directly or indirectly, for the stimulation device to provide power. 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.

[0137] 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舒尔的石圭酮材料。 [0137] Generally, the stimulation device advantageously is embedded in a soft or gel-like material, such as hardness of less than 20 Shure stone Kyu-one material.

[0138] 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。 [0138] The stimulation device may include a surrounding strip is applied to the cardia, wherein said strip having an electrical conductor contacting the 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, so that the conductor is fixed to the 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 device is adapted to stimulate the patient to stimulate the 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 mode of operation, the use of energy pulses to stimulate the 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 electrical energy pulse may comprise a 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 include means for engaging the cardiac sphincter of the electrical conductors, and 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。 Advantageously, the control device may control the electrical energy to release energy, so that the predetermined value of the electrical current through the conductor.

[0139] 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。 [0139] In appropriate circumstances, all of the above-described 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, for the various functions of the above-described embodiments of the invention described herein may be used for different applications.

[0140] 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。 [0140] All the various energy transmission and energy control in a manner set forth in the specification may be practiced by the use of the various components and programs.

[0141] 本发明还提供用于治疗烧心和反流疾病的方法。 [0141] The present invention also provides a method for the treatment of heartburn and reflux disease.

[0142] 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。 [0142] Accordingly, according to the first alternative, there is provided a method of treating heartburn and reflux disease, said 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 between a continuous operating mode and a sleep mode switching, in the operation mode, using the energy pulse stimulation to increase cardiac sphincter, sphincter ankylosing so cardia completely closed, while in the sleep mode, no stimulate the cardiac sphincter.

[0143] 第一替代方法还可以利用腹腔镜来实现。 [0143] 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 laparoscopic treatment of heartburn and reflux disease, the method comprising the steps 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 mode and the sleep mode switching operation, in the operation mode, using the energy pulse stimulation to increase cardiac sphincter, sphincter ankylosing so cardia completely closed, while in the sleep mode, does not stimulate the cardiac sphincter.

[0144] 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: [0144] According to a second alternative method, there is provided a method for a patient suffering from heartburn and reflux disease treatment, said method comprising:

[0145] (a)在患者体内手术植入接合贲门的电刺激设备; [0145] (a) engage in vivo surgical patients implanted cardiac electrical stimulation device;

[0146] (b)在患者体外提供能源; [0146] (b) the provision of energy in the patient's body;

[0147](c)从患者体外控制所述能源,以释放无线能量;和 [0147] (c) the patient from external control energy to release wireless energy; and

[0148] (d)利用所述释放的无线能量为所述刺激设备提供动力。 [0148] (d) utilizing said release wireless energy for powering the stimulation device.

[0149] 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, 用于为所述刺激设备提供动力。 [0149] The second alternative method may further comprise implantable energy transforming device; controlling the external energy to release wireless energy; and the energy conversion apparatus utilizing the wireless energy into energy different than the wireless energy , 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 transforming device.

[0150] 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。 [0150] also provides a method of treating heartburn and reflux disease, said method comprising the steps of: stimulation device implanted in a patient's body to engage the cardiac sphincter; providing a control device controls the stimulation device to stimulate the cardiac sphincter to increase sphincter tonic, so cardia completely closed; and allow patients to control operation of the device to change the intensity of stimulation.

[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。 [0151] In one embodiment, an apparatus is provided, in which the use of the energy pulse stimulation to increase cardiac sphincter, sphincter ankylosing so cardia fully closed, and the control device may be operable by the patient, the patient can be set to stop the operation, wherein the control device operable by the patient, the stimulation device arranged to operate, which in the operating state, the stimulation device to switch between a continuous operating mode and a sleep mode, in the operating mode 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 operation mode and switch between the sleep mode, and in response to the sensor sensing a physical parameter of the patient and the stimulation device disposed in the sleep mode.

[0152] 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。 [0152] In one embodiment, an apparatus is provided, in which the use of the energy pulse stimulation to increase cardiac sphincter, sphincter ankylosing so cardia fully closed, and the control device may be operable by the patient, the patient can be set to stop the operation, wherein the control device operable by the patient, the stimulation device arranged to operate, which in the operating state, the stimulation device to switch between a continuous operating mode and a sleep mode, in the operating mode 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 a patient by the patient swallowing food esophageal contractions due to waves, wherein said control device is adapted to control the stimulation device to stop the continuous operation mode and switch between 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.

[0153] 表面结构 [0153] surface structure

[0154] 现在描述本发明的各种植入件的表面结构。 [0154] Now to describe various implant surface structure of the present invention.

[0155] 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。 [0155] The present invention relates to an implant, said implant 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 adjustment 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 a raised area and reduce the surface area 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 in one state, between adjacent elevated regions 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 directly adjacent to the raised area network 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, said second distance fully extended to prevent fibrotic tissue growth directly interconnecting adjacent connecting zone to the damage of the implant in the first collapse the degree of regulatory status and the second expansion states.

[0156] 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。 [0156] According to one embodiment, the expandable segment of hollow section, or comprises a hollow body.

[0157] 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。 [0157] According to another embodiment, the implant is substantially completely hollow or comprises substantially along the entire length of said implant, and / or all of the volume of the hollow body extends.

[0158] 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3_,因此大于大约2x1. 5_。 [0158] Fibrosis generally have from about 0. 5mm to about 1. 5mm thickness or degree of elongation, so the distance between the relevant surface element of the surface structure are suitably greater than about between 3_, thus more than about 2x1. 5_ . 但是根据情况,大于大约1. 〇_到大约3mm的距离也可能就足够。 However, according to circumstances, greater than about 1 to about 3mm 〇_ distance may 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 elongation or fibrosis expected exceed about 1. 5mm thickness, the distance of the surface of the surface element associated structure between the adaptation in an appropriate manner.

[0159] 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。 [0159] The surface structure comprising elevated and lowered areas and may be suitably raised and lowered so that the distance between the plane of the different area is larger than a certain threshold, in order to implant the collapse and / or expansion Features. 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 functions are restricted. 用于所述距离的适当间隔是大约0. 5到10_,更适当的是大约2-8_,最适当的是大于3-7_。 Appropriate intervals for the distance is about 10_ to 0.5, more suitably about 2-8_, most suitably greater than 3-7_. 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, or may be any combination of these elements or 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 rib and groove may for example each have a wedge-shaped, polygonal, rectangular, square, tetrahedral shape, truncated tetrahedral shape. 此外,所述凸棱和凹槽可以具有不同形状。 In addition, 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 also include a generally bellows configuration, by 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 objects may actually be randomly arranged on the surface of, or based on some kind of mechanism to accommodate.

[0160] 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。 [0160] 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 can be used with any implant, wherein the characteristic of the surface structure of the implant should be an advantage.

[0161] 结合肥胖治疗 [0161] combined treatment of obesity

[0162] 各种实施方式可以与各种方法组合来治疗肥胖。 [0162] various embodiments may be combined with a variety of ways 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 device comprises a volume filling.

[0163] 用干治疗肥胖的牵柃设各 [0163] the treatment of obesity with a dry set of all pull Eurya

[0164] 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。 [0164] Note that, in appropriate cases, the implementation of all or part of the way or method embodiments may be used in the present application, all of 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, apparatus for the treatment of reflux apparatus may be used in combination with obesity treatment, it is found based on the stomach wall caused by the pulling action, 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 apparatus provided with a traction device and traction device pulling part of the stomach, to provide a simpler, safer and more long-term working mechanism.

[0165] 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。 [0165] The term "provided the impetus" should immediately take advantage of any incentives two things without manual force, preferably electric power used. 换句话说,调节设备以非手动的方式操作。 In other words, non-manual adjustment device to operate in a 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 adjustment device does not contact device components implanted subcutaneously by manually operated, nor to adjust the patient's skin through 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 treatment of incontinence different, adjusting apparatus of the present invention is not operated by manual forces, such as by manually pressing implanted in a patient without 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 also use manually operated implantable containers or other mechanical or hydraulic technology programs, and manual control institutions such as subcutaneous start button to activate the power steering device is provided within the scope of the present invention, any circumstances allowed.

[0166] 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。 [0166] Alternatively, or preferably provided with operating power equipment combined with servo means may be used, such as a motor of the servo means allow to run at high speed and low force, for example, and use 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。 Servo system will save the adjustment device to adjust the force used, which is very important for many occasions.

[0167] 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。 [0167] 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 on a longer stroke weak force on the moving element into another stronger force on the moving elements of the shorter stroke. 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 which can be reversed.

[0168] 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。 [0168] Alternatively, or preferably combined with manual operation, a reverse servo may be used, e.g., the reverse servo means allow the patient's hand to use greater force to the container, for example for regulating a hydraulic force to move the strong 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。 This 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 time adjusting device used to adjust the stroke, which is very important for many occasions.

[0169] 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。 [0169] 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 institutions such definitions that the agency will act on a shorter stroke moving elements into a 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.

[0170] -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。 [0170] - In general two points on the stomach should respect 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 sewn 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 retraction of at least a portion adapted to achieve a soft suspension form of the stomach wall, then fibrosis stomach to stomach tissue to help provide long-term stable position.

[0171] 可以使用任何类型的机械结构。 [0171] 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 pressure or any mechanical structure structure. 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 pump or motor or any form of any change in the provision of power to move material, can be used to achieve the simple goal of moving away from each other by at least two portions of the stomach wall to stretch a portion of the stomach wall.

[0172] 可以使用任何类型的液压操作。 [0172] 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 appreciated, instead of hydraulic operation, pneumatic operation can be used, in which the air replacement hydraulic fluid to move between the container and the chamber formed by the stretching device is formed. 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, in order 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 preferable to stay in a pressed state, and are released again after extrusion.

[0173] 可以为牵拉设备使用任何类型的液压方案。 [0173] 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.

[0174] 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。 [0174] Of course, only the expansion of the retraction portion of the stomach also opened the stomach wall, which may be mechanically, hydraulically, pneumatic achieved, and powered by a motor or a pump or a manual force.

[0175] 用干治疗肥胖的体积填充设各 [0175] the treatment of obesity with a dry set of all volume fill

[0176] 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。 [0176] In addition to the various embodiments, for the treatment of reflux Further means may be adapted to treat obesity, wherein the volume filling capacity of the foundation of the distal portion of the stomach elongated motion restraint device 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, when discussing the volume filling device and its features, functions and adaptation, referring to the movement of the distal end portion of the elongate 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。 Please note that some or method of any of the features described herein, embodiments and methods, in appropriate circumstances, can be used for distal or proximal portion of the motion restraint device.

[0177] 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能。 [0177] The following embodiments based on the discovery by using the patient's stomach retraction volume filling device (referred to herein as the distal end portion of the motion restraint device), the expandable body being protected from gastric acid influence, and therefore long-term function.

[0178] 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。 [0178] According to one embodiment of the invention, there is provided a device for treatment of obesity and reflux patients having stomach cavity with food, the apparatus includes at least one volume filling apparatus which is adapted to at least substantially retraction patients stomach wall portion, wherein the volume of the volume filling device is adapted to reside outside 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 It comprises a biocompatible material surface, 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.

[0179] 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。 [0179] By utilizing some patients the stomach outside the stomach wall retraction volume filling device, the filling volume of the apparatus has been protected from the impact of gastric acid, thereby providing the equipment will last a long time.

[0180] 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。 [0180] The volume filling device is adapted to allow placement of the outer surface of the volume filling device against the stomach wall, so that the volume of the cavity is reduced food, reduced volume significantly exceeds the volume filling device volume. 体积填充设备具有至少30_的最大周长。 Volume filling device has a maximum circumference of at least 30_. 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.

[0181] 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。 [0181] According to a first alternative, the volume filling device is adapted for placement on the inside of the stomach, so that the volume filling device against the inside of the outer surface of the stomach wall.

[0182] 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。 [0182] According to a second alternative, the volume filling device is adapted for placement on the outside of the stomach, so that the volume filling device against the outside of the outer surface of the stomach wall.

[0183] 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。 [0183] Preferably, the volume filling device is adapted to be completely sunk in patients with stomach, and the use of endoscopy instruments placed in the stomach inside or outside. 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 device adapted to cooperate with the clamping device is connected. 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 for non-invasive surgery can be adjusted.

[0184] 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 [0184] may include a fixed device, suitably comprising two or more fixtures, the fixture is adapted to participate in the volume filling device is fixed 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 be held instruments, suitably comprising two or more holding devices, in order to simplify the process of implantation of the device.

[0185] 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。 [0185] at least a portion of the volume of the device can be filled with the material will not be 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.

[0186] 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。 [0186] In the embodiment, the volume of the filling apparatus can be expanded to the expanded state, and comprising a wall defining a chamber enclosing, wherein the volume filling device utilizing supplied to the chamber or expansion of the fluid in the gel. 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, or gel for supplying fluid to the chamber. 可以提供能与所述管件连接的注入端口。 It provides injection port connectable to the tube. 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 apparatus may be provided with a fill volume for a fluid or a gel inlet port, the inlet port may be connected to a gastroscopic instrument, wherein the access port comprises a device adapted for interconnecting the inflatable devices and the gastroscope fluid connection.

[0187] 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。 [0187] The volume filling device may comprise a homogeneous material, such as Shure gel value of less than 15. 所述设备也可以是实心体。 The device may also be a solid body.

[0188] 所述体积填充设备可以具有刚性、弹性或挠性外表面。 [0188] The volume filling device may have an outer surface of the rigid, flexible or elastic. 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, which is large enough rigidity to maintain 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.

[0189] 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。 [0189] 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, the perimeter of the device is equal to the maximum circumference or from the direction from the maximum circumference decreases 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 apparatus may be substantially ovoid, spherical or ovoid with a substantially curved central recess oval or similar type.

[0190] 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。 [0190] According to a second general design of the device, in a plane through the axis of the device viewed in vertical plane with the axis moving along the circumference of the device increases and decreases at least twice, with the plane or along the axis to move, 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 device may be configured substantially similar to the kidney-shaped.

[0191] 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。 [0191] The volume filling device has an elongated, rounded, curved and / or curved shape.

[0192] 所述体积填充设备具有至少120、150、180或220mm的周长。 [0192] The volume filling device has at least 120,150,180 or 220mm circumference.

[0193] 所述体积填充设备具有介于0. 0001至0. 001m3范围内、或者0. 00001至0. 001m3 范围内、或者〇. 00001至〇. 0002m3范围内的体积。 [0193] The device has a filling volume within the range of 0.0001 to 0. 001m3 range, or 0.00001 to 0. 001m3 within the scope of, or square. 00001 billion to 0002m3 volume within the range. 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.

[0194] 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。 [0194] The volume filling device may comprise at least two interconnected portions, the two parts adapted to separate a portion disposed inside or outside of the stomach.

[0195] 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。 [0195] The volume filling device may comprise an elastic material, biocompatible material and / or a silicone.

[0196] 适当的是,所述体积填充设备设置有至少一个料层。 [0196] 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, a layer of polytetrafluoroethylene or polyurethane layer. 所述涂层可以包括多层涂层。 The coating can comprise a multilayer 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 of the layer of material combinations made.

[0197] 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。 [0197] The volume filling device may include fixed or adapted to be converted into solid form 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 molecular iodine, to prevent proliferation.

[0198] 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。 [0198] 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.

[0199] 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。 [0199] 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。 Advantageously, 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 performance of the structure in contact with the stomach wall, to promote growth of human tissue, whereby the position of the stomach wall is connected to the long-term fixed volume filling device. 所述结构可以包括网状结构。 The structure may comprise a mesh structure.

[0200] 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。 [0200] In the 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 traction device, thereby affecting the 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 inflatable volume filling device, the device may comprise a fluid connector portion interconnecting the traction device and the volume filling device.

[0201] 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。 [0201] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the drawing device can be implanted within an obese patient and adapted to stretch the stomach wall portion of the patient ; and operating the equipment, the operation of the traction device for operating the device after implantation, a portion of the stomach wall to stretch, to produce satiety.

[0202] 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。 [0202] In an embodiment, the apparatus comprises at least one apparatus operable drawing, the drawing 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 drawing, and the control unit implanted device, 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.

[0203] 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。 [0203] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the drawing device can be implanted within an obese patient and adapted to stretch the stomach wall portion of the patient wherein the drawing device comprises an expandable container traction; and operation of the device, the drawing operation of the apparatus for operating the device after implantation, in order to stretch the stomach wall portion, wherein the motion restraint device at least the distal portion may be expanded and connected to the pull fluid container, wherein the operation device comprises a pump for between the main tank and the drawing pump fluid container, a portion of the stomach wall to stretch 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 can provide a control device to control the pump includes the drawing 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 to the patient's body from the traction control 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 apparatus may include a control switch disposed subcutaneous or container, or the container is adapted to switch from outside the patient to control the drawing 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 the patient to provide a sensor or sensing device, wherein the implantable control unit is adapted to use information from the sensor or from the sensing device to control the body of the patient pulling apparatus, the sensor or sensing device is adapted to directly or indirectly flu measured food intake.

[0204] 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。 [0204] In an embodiment, the distal end portion of the motion restraint device includes a main volume filled container; drawing apparatus, said drawing device comprising at least one apparatus operable to pull the pulling device can be implanted obese patient and adapted to stretch the stomach wall portion of the patient, wherein the drawing device comprises an expandable container traction and retraction in the stomach wall is adapted at the upper portion of the stomach when the patient is upright above the expandable master volume filling device, wherein the volume filling device can be expanded and connected with the traction fluid container, wherein the stomach for normal food intake leads to contraction of the fluid from the lower placed on the stomach wall retraction master volume filling the container flow, adapted to cause the container to stretch the stomach wall portion of the drawing 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 the fluid filling the container and the 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 of the main volume of the filled container and the pull between the containers include release function, the release function adapted to pull the container volume is released to return to the main volume of the container is filled. 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 functions may include release significantly smaller than the area of said fluid return fluid connection connecting portion, so as to return to the slow release of the fluid volume of the main filling apparatus from the container vessel pulled to release part of the stomach wall of pulling. 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 the drawing portion of the stomach wall drawing device, the manual control device comprising a container placed subcutaneously, subcutaneous placement of the container is adapted to control the patient's body pulled from the device.

[0205] 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。 [0205] In an embodiment, the expansion can be adapted to provide the primary volume filled container, wherein movement of the distal end portion of said restraint device further comprises an expandable structure, the expandable structure adapted to implant the device after the expansion of the stomach wall, wherein said structure comprises a device adapted to accommodate the rear of the device implanted fibrosis surrounds the bellows member, such that movement of said bellows member is substantially unaffected by the fibrotic tissue .

[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,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。 [0206] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the drawing device can be implanted within an obese patient and adapted to stretch the stomach wall portion of the patient and wherein the drawing 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 the corrugated structure comprises a dedicated member, the said bellows adapt to implant the device after the device surrounded by fibrotic tissue, 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 equipment, in order to stretch the stomach wall portion, 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 being of a patient meals and the control unit implanted after the pulling device, operable to control the traction device, to produce satiety.

[0207] 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。 [0207] In an embodiment, the apparatus comprises a drawing device, said drawing device comprising at least one operable stretching device, the drawing device can be implanted within an obese patient and adapted to stretch the stomach wall portion of the patient 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 to the patient's body from the traction control 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 apparatus may include a control switch disposed subcutaneous or container, or the container is adapted to switch from outside the patient to control the drawing 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 from the sensing device to control the body of the patient pulling apparatus, said sensor or sensing device is adapted to directly or indirectly sense the patient food intake.

[0208] 在实施方式中,所述装置适于治疗反流疾病。 [0208] 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 having an elongated shape of the proximal and distal portions, said proximal end portion adapted to be at least partially gastric wall of the patient 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 the patient and diaphragm retraction gastric wall of the lower abutment stomach without damaging the stomach, so that in the motion after retraction of the proximal part of the restraint device, the patient's stomach in patients with heart notch toward the diaphragm movement is constrained, thereby preventing cardiac patients through the diaphragm opening slide patients chest to maintain the patient's abdomen is applied on the patient's 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, circumference of 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 and maintain the distal portion proximal portion 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。 To this end, the apparatus further comprising an implantable movement restraining device, the motion restraint device having an elongated shape of the proximal and distal portions, 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 of the diaphragm position between the patient and the patient against the gastric wall and gastric wall, so that the proximal end of the inner 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 patients through the diaphragm opening slide patients chest to maintain the patient's abdomen is applied to the patient's cardiac sphincter pressure support, wherein the motion constraint a proximal portion having at least 125mm3 device size, perimeter is 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 motion restraint device is fixed to the proximal portion of 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 and maintain the distal portion proximal portion 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,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 having a proximal portion and a distal portion of the elongated shape, and has an outer surface including a biocompatible material, said proximal end portion adapted to at least partially gastric wall in patients with retraction. 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15_,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 the patient and diaphragm retraction gastric wall of the lower abutment stomach without damaging the stomach, so that in the motion after retraction of the proximal part of the restraint device, the patient's stomach in patients with heart notch toward the diaphragm movement is constrained, thereby preventing cardiac patients through the diaphragm opening slide patients chest to maintain the patient's abdomen is applied on the patient's cardiac sphincter the support pressure, motion restraint device having a size of at least 125mm3, circumference at least 15_, further comprising drawing apparatus, the drawing device comprising at least one operable stretching device, the drawing device can be implanted in obese patients the body portion and is adapted to pull the patients stomach 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 and maintain the distal portion proximal portion and adapted to substantially retraction in the stomach wall.

[0211] 在另一种实施方式中,所述装置适于治疗反流疾病。 [0211] 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 having an elongated shape of the proximal and distal portions, 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 of the diaphragm position between the patient and the patient against the gastric wall and gastric wall, so that the proximal end of the inner 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 patients through the diaphragm opening slide patients chest to maintain the patient's abdomen is applied to the patient's cardiac sphincter pressure support, wherein the motion constraint 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 motion device is fixed to the position constraint. 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 and maintain the distal portion proximal portion 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 drawing device can be implanted within an obese patient and adapted to stretch the stomach wall portion of the patient to produce satiety.

[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。 [0212] In an embodiment, the apparatus further comprises a drawing device, said drawing device comprising three or more mechanical parts, machine parts and the different parts of the stomach wall engages an engaging one, wherein said engagement includes sutures or staples is connected to the stomach wall, or with stomach to stomach sutures retraction of the mechanical parts in the stomach wall section, wherein the three or more mechanical parts adapted to move relative to one another, appropriate to pull three different wall portions, the stretching device further adapted to have drawn independently from each other wall portions, wherein said separate time period for applying a pulling force for pulling the stomach wall portion, and , as well as applying traction moment.

[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。 [0213] In an embodiment, the apparatus further comprises a drawing device, said drawing device comprising two or more different hydraulic stomach wall member engaging member, a member engaging a different member, wherein the engaging comprises the hydraulic engagement member sutures or staples to the stomach wall, with stomach to stomach or sutures hydraulic retraction member in the stomach wall portion, wherein the two or more hydraulic parts adapted to move relative to one another, adapted to pull pull three different wall portions, the stretching device further adapted to allow said wall portions are each independently pulled, the pulling force to separate for part of the stomach wall and to apply tension to the time period, but also there are always applied pulling.

[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 [0214] further comprises a drawing device, the drawing device engages with a portion of the stomach wall, including drawing the suture or stapling device is connected to the stomach wall, with stomach to stomach or sutures the retraction device will pull 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 of the force applied to stretch the time period and applying a stretch of time .

[0215] 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。 [0215] In an embodiment, the apparatus further comprises a drawing device, said drawing device comprising two joining members different parts of the stomach wall, one part engaging a different member, wherein the engaging member comprises a suture or the card nail bonded to the stomach wall, with stomach to stomach or 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 to apply tension to the pull of.

[0216] 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。 [0216] In an embodiment, the apparatus further comprises an external control unit, from the patient's body for controlling the distal end portion of the 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 controller is 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 arranged subcutaneous or container, or the container is adapted to control the switching device from the patient's body.

[0217] 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。 [0217] can be implanted in the 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 a patient directly or indirectly measured food intake.

[0218] 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。 [0218] According to another aspect of the present invention, there is provided reflux disease and obesity means a method for the treatment of obesity in patients having gastric band cavity of food, said apparatus comprising an implantable motion restraint device, the motion restraint device having a proximal portion and a distal portion, said distal portion being substantially adapted to at least partially sunk in patients stomach wall, and having 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 cavity is reduced food, reduced volume significantly exceeds the volume of the volume filling device. 所述运动约束设备的远端部分的最大周长至少为30_。 The distal portion of the apparatus of motion constraint of the maximum circumference of at least 30_.

[0219] 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。 [0219] 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 in any combination.

附图说明 BRIEF DESCRIPTION

[0220] 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] Referring now to the drawings, as a non-limiting example, the present invention is described in more detail in the drawings:

[0221] 图1A-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; [0221] Figure 1A-C is added to the human patient a schematic view of various embodiments of the treatment of gastroesophageal reflux disease apparatus;

[0222] 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; [0222] Figures 2A-B are implanted in the body of a human patient for a schematic view of various embodiments of the treatment of gastroesophageal reflux disease apparatus;

[0223] 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不意图; [0223] Figures 3A-B is implanted in a human patient in vivo in various embodiments of gastroesophageal reflux disease treated is not intended device;

[0224] 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; [0224] Figures 4A-D are implanted in the body of a human patient for the treatment of gastroesophageal reflux is a schematic view of an embodiment of the apparatus of diseases and obesity;

[0225] 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; [0225] FIG. 5 is a schematic view of implanted human patient for the treatment of gastroesophageal reflux disease an embodiment of the apparatus;

[0226] 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; [0226] FIG. 6A-D and 7-9 shows the implanted human patient for the treatment of gastroesophageal reflux disease alternate shape motion restraint device;

[0227] 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; [0227] FIG. 10 is an overall view for the treatment of gastroesophageal reflux disease in patients with implantable devices for motion constraints;

[0228] 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; [0228] FIG. 11-27 is a schematic diagram to power the device for the treatment of gastroesophageal reflux disease in various ways;

[0229] 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; [0229] FIG. 28-34 is an apparatus for treatment of gastroesophageal reflux disease disposed hydraulic power, or pneumatic power the various ways a schematic view;

[0230] 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; [0230] FIG. 35 is a flowchart used to treat gastroesophageal reflux disease exercise restraint device implemented step implantation;

[0231] 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; [0231] FIG. 36-41 illustrates a position to restore the gastric cardia and gastroesophageal reflux disease in patients with a method;

[0232] 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; [0232] FIG. 42-46 illustrates a different shapes and features included in the device according to the invention reflux treatment equipment;

[0233] 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; [0233] FIG. 47a_d shows included in the device according to the invention austerity inflatable reflux treatment equipment, as well as for the treatment of reflux device placed outside the patient instrument of the stomach wall;

[0234] 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; [0234] FIG. 48a_i shows an inflatable retraction device shown in Fig. 47a different steps on the outside of the patient's stomach;

[0235] 图49示出了反流治疗装置还适于治疗肥胖的实施方式; [0235] FIG. 49 shows a reflow treatment apparatus suitable for the treatment of obesity further embodiment;

[0236] 图50、图51a至51c以及图51_3a至51_3i示出了反流治疗装置还适于治疗肥胖的实施方式; [0236] FIG. 50, Fig. 51a to 51c and Fig 51_3a to 51_3i shows reflux treatment device is also suitable for the treatment of obesity embodiment;

[0237] 图52a_h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; [0237] FIG. 52a_h shows an inflatable retraction device shown in Fig. 47a on the inside of the stomach in patients with different steps;

[0238] 图53a_c示出了用于形成胃壁内陷的器械; [0238] FIG. 53a_c shows a retraction of the stomach wall for forming devices;

[0239] 图54-55示出了用于治疗反流疾病的腹部方法; [0239] FIG. 54-55 illustrates a method for the treatment of abdominal reflux disease;

[0240] 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; [0240] 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;

[0241] 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能量; [0241] FIG. 57 is a schematic block diagram showing another embodiment of the present invention, in which wireless energy released from the internal power source;

[0242] 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; [0242] Figure 58-61 are schematic block diagrams 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;

[0243] 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; [0243] FIG. 62 is a schematic block diagram showing the components of the implantable conceivable combination, a variety of options for implementing the communication scheme;

[0244] 图63示出了根据本发明植入患者体内的装置;和 [0244] FIG. 63 illustrates an implanted in a patient according to the apparatus of the invention; and

[0245] 图64是方块图,示出了本发明实施方式的遥控部件; [0245] FIG. 64 is a block diagram showing a remote control unit embodiment of the present invention;

[0246] 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; [0246] FIG. 65-68 are used in embodiments of the stomach wall to treat obesity by pulling apparatus, the apparatus may be combined with reflow treatment device implanted in a human patient;

[0247] 图69是本发明的植入式设备的表面结构的一般描述; [0247] FIG. 69 is a general description of the surface structure of the present invention, an implantable device;

[0248] 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; [0248] FIG. 70-76 is a view of various embodiments of the apparatus the treatment of obesity, said device may be combined with reflow treatment device implanted in a human patient;

[0249] 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; [0249] FIG. 77-93 shows the power the device for treatment of obesity in various ways, the device may be combined with reflux treatment device implanted in human patients;

[0250] 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; [0250] FIG 94-100 shows a hydraulic or pneumatic power to provide means for the treatment of obesity in patients with the human body in various ways implant;

[0251] 图101-105示出了用来治疗反流和肥胖的各种器械; [0251] FIG. 101-105 shows used to treat reflux and obesity variety of equipment;

[0252] 图106-107示出了用来治疗反流和肥胖的手术方法; [0252] FIG. 106-107 shows reflux and surgical methods for the treatment of obesity;

[0253] 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; [0253] FIG. 108 shows before assembly, the embodiment as a component in the form of the motion restraint device;

[0254] 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; [0254] FIG. 109 shows the embodiment of the first and second portions assembled after exercise restraint device in;

[0255] 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; [0255] FIG. 110 shows the embodiment shown in the third and fourth part of the assembly after 109;

[0256] 图111示出了在组装完最后部分时的图110所示实施方式; [0256] Figure 111 shows the embodiment when assembled after the last portion of Figure 110;

[0257] 图112示出了在最终组装好之后的图108-111所示的实施方式; [0257] FIG. 112 shows an embodiment of 108-111 shown after the final assembled Fig;

[0258] 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; [0258] Figure 113a shows a diagram with the operation of the channel portion of the core member 108 as shown in the embodiment;

[0259] 图113b至113f分别示出了根据平面II、II-II、III-III、IV-IV的图113a所示芯部部件的横截面视图; [0259] FIG 113b to 113f respectively show a plan II, II-II, III-III, IV-IV cross-sectional view of FIG core member 113a is shown;

[0260] 图114和115示出了如图108所示设备的替代实施方式。 [0260] FIG. 114 108 and 115 is shown an alternative embodiment of the device shown in FIG.

具体实施方式 detailed description

[0261] 运动约束设各 [0261] Let each motion constraints

[0262] 图1A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1A中,设备10内陷在胃底。 [0262] FIG 1A is a schematic view depicting apparatus 11, the apparatus 11 comprises a biocompatible material and implanted into a patient in accordance with the present invention for the treatment of gastroesophageal reflux disease motion restraint device 10, in Figure 1A, 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。 Device 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 gastric retraction of the lower portion of the wall 16 by contact between at least a portion of 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 retraction device 10 in this manner, the patient's stomach in patients with heart notch toward the diaphragm movement is constrained, thus preventing cardiac patients over the diaphragm opening 20 into the patient's chest, abdomen and keep the patient exert on the patient's cardiac sphincter pressure support.

[0263] 主体13可以膨胀,适于用凝胶或流体填充。 [0263] Body 13 may be expanded, adapted to be filled with fluid or gel. 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。 May be provided for receiving a fluid or gel filled with said fluid receiving member motion 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 comprises a homogeneous material and can be 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 or resilient wall 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, rigidity sufficient to maintain the deformation does not occur.

[0264] 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。 [0264] The body motion restraint device 10 may be a variety of 13 different ways attached to the gastric wall 16a 16. 在图1A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. 1A, the device 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22a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, it is applied by a plurality of the stomach to stomach sutures or staples 22a first fixing device 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, so long will the retraction state intact.

[0265] 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24a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。 [0265] may optionally be present a second fixing device, the fixing device by a plurality of second suture 16a is disposed between the wall 16 of the fundus and esophagus walls 24 of the staple 24a (22b) or the holding device 10 at least a portion of the 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, by using the second device 10 attached to the fixed position device. 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 may 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 can be secured directly or indirectly 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 disposed within the suture 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.

[0266] 图1B示出了基本上类似于图1A所示实施方式的实施方式。 [0266] Figure 1B illustrates a manner substantially similar to that shown in FIG. 1A embodiment embodiment. 在图1B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 Fig. 1B, in addition to the attachment portion 22 outside the main body portion 13 and the retraction body by reverse flow suture 13 and 18 between the diaphragm and / or staples 22c fixed to the holding device located in the cardia 14 above location.

[0267] 图1C示出了另一种基本上类似于图1A所示实施方式的实施方式。 [0267] Figure 1C illustrates another embodiment similar to that shown in Figure 1A is substantially the embodiment. 在图1C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 Fig. 1C, the equipment used to treat reflux and gastric wall 16 is connected to the wall 16a 16a 16 gastric stomach to stomach sutures or staples 22a in place. 此外,采用来自胃底16a的壁16到食管24a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 gastric wall 16a from the 16 to the wall of the esophagus 24a sutures or staples 22b, 16a and a wall from the fundus to the diaphragm sutures or staples, the reflux treatment device 10 remains in place .

[0268] 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。 [0268] According to the present invention, an alternative embodiment of the device for the treatment of gastroesophageal reflux disease 17 shown in Figure 2A. 该实施方式在许多方面类似于参照图1A至1C所述的实施方式。 This embodiment is similar in many respects with reference to the embodiment of FIG. 1A to 1C. 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1A至1C那样从胃的外侧。 However, in the embodiment shown in FIG. 2A, the device 10 from the inside of the stomach retraction, rather than as 1A to 1C as from the outside of 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, in the lower part of the body is adapted to the patient 18 and the diaphragm retraction gastric wall 16 is at least a portion of the position between the abutment part of the inner wall of the gastric wall 16. 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 upright body 13 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。 13 of the main device 10 is configured to abut gastric wall 16a 16, in addition, having a fit against the outer surface of the gastric wall 15. 因此,在设备10以如上参照图1A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. 1A retraction, and gastric cardiac notch towards the patient's movement of diaphragm constrained, thereby preventing cardiac patients over the diaphragm aperture 20 into the patient's chest, maintaining and applied to the patient's cardiac sphincter pressure to support the patient's abdomen.

[0269] 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。 [0269] After retraction, the inside of the stomach from 16 is applied includes a plurality of the stomach to stomach sutures first fixture or 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 to maintain 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24的壁24a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 further comprise providing a second fixture suture or staple the fundic portion 22b is formed between the retraction status of the device 10 of the wall portion 16b of the wall 24 and the esophagus 24a, the device 10 will remain at the position. 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, sutures or staples to form a third fixing device 22c may be disposed between the fundus retraction portion forming apparatus 10 of state of the wall portion 16c and the diaphragm 1816 of the apparatus 10 in the said position.

[0270] 替代实施方式在图2B中示出。 [0270] 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 of FIG. 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.

[0271] 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 [0271] means 19 for the treatment of gastroesophageal reflux disease is depicted in Figure 3A. 该替代方案在许多方面类似于参照图1A至1C和2A至2B所述的实施方式。 This alternative is similar in many respects with reference to FIG. 1A to 1C and 2A-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 the 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。 Device 10 includes a body 13, the body is adapted to the position between the patient 18 and the diaphragm 16 against the gastric wall and gastric wall portion 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l〇a,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 includes a connecting structure l〇a, the structure is preferably a network structure, and gastric wall 16a adapted to contact tissue growth prompting the body, fixedly connected to the stomach wall so long gastroesophageal reflux disease treatment location of the device. 在短期内,可以在连接结构l〇a和胃底壁16a之间提供成缝合线或卡钉44a形式的第一固定设备,以保持连接结构l〇a就位。 In the short term, it may be provided to sutures or staples 44a form a first fixture between the connecting structure l〇a and gastric wall 16a, to maintain the connection structure l〇a place.

[0272] 连接结构10a可以适配地用于设置在胃底16的壁16a和食管24的壁24a之间、 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。 [0272] connection structure 10a may be adapted to be used to set between the walls 16a and 16 esophageal and gastric wall 24 24a, as sutures or staples 44b form a second fixing device so as to maintain the device 10 in the patient the position of the diaphragm 18 and 16 between the gastric wall. 类似地,连接结构10a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44c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 10a can also be adapted to be used to set up between the gastric wall 16a and the diaphragm 1816, as sutures or staples 44c form a third fixed equipment, the same equipment will be held at the 10 said position.

[0273] 替代实施方式在图3B中示出。 [0273] In an alternative embodiment shown in FIG. 3B. 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 the embodiment of Figure 3A herein. 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, inset from the inside of the stomach. 连接结构l〇a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。 L〇a connection structure positioned on the gastric wall 16a 16 located above and around the reflux treatment device 10 constructed retraction portion.

[0274] 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。 [0274] According to the present invention, an alternative embodiment of the device 21 for the treatment of gastroesophageal reflux disease is depicted in Figure 4A. 该实施方式在许多方面类似于参照图1A至1C所述的实施方式。 This embodiment is similar in many respects with reference to the embodiment of FIG. 1A to 1C. 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 Fig. 4A, there is shown a view of the present invention, a device for the treatment of gastroesophageal reflux disease 10, 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 Fig. 4A, the motion restraint device 10 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 of the part. 主体13构造成抵靠胃底16的外侧壁16a。 Main body 13 is configured to abut against 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 cardiac notch towards the patient stomach diaphragm travel restrained, thereby preventing the opening of the diaphragm slide into the patient through the cardiac patient's breast 20, and is applied to keep the abdomen of a patient in cardiac patients support pressure on the sphincter.

[0275] 在图4A的实施方式中,如图1A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22a构成的第一固定设备,在短期内保持该内陷状态完好。 [0275] In the embodiment of Figure 4A, the embodiment of FIG. 1A, 10 in the apparatus 16 after retraction fundus, applying a first plurality of the stomach by a fixing device to stomach sutures or staples 22a formed 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) of the holding device 10 in the patient 18 and the position of the diaphragm 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, may be provided to sutures or staples 22c form a third fixture between the gastric wall 16a and the diaphragm 1816, the same equipment will be held at the position.

[0276] 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。 [0276] In the embodiment shown in FIG. 4A, the size of the motion restraint device 10 can be adjusted at the same time implantation. 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 to the container by means of wire 52b to a hydraulic device 10 is associated with 52, which can be adjusted non-invasively by manually pressing type 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 of the smaller chamber 10b.

[0277] 此外,上述实施方式可以替代地也用于治疗肥胖症。 [0277] Further, 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l〇b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 to the main body 13 comprises a fluid volume, and further connected to one or more of the use of small chamber body 13 is filled with fluid to the pump l〇b to stretch the stomach the bottom wall to create a sense of satiety, thereby treating obesity. 小腔室10b 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。 Small chamber 10b is also adapted to the gastric wall retraction, 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 needs of the small pumping hydraulic fluid-filled chamber in order to feel satisfied.

[0278] 替代实施方式在图4B中示出。 [0278] In an alternative embodiment shown in FIG. 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l〇b。 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 l〇b. 这时,腔室10b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。 In this case, the chamber 10b not use subcutaneous pump to control, but to use the internal power-control unit 56 is controlled. 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 control device 10 to the patient how to treat reflux and / or obese member. 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.

[0279] 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。 [0279] 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 the remote control transmitter device 34 is adapted for controlling the device and 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 selected according to the situation, such as whether the device is an electrical, hydraulic, pneumatic or mechanical device.

[0280] 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。 [0280] The control unit 76 may receive input from any sensor, in particular, 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 FPGA or MCU or ASIC chip or any other form of circuit components or memory (see the following description of a broader "system" section).

[0281] 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10b而非像图4A中那样是两个。 [0281] Figure 4C shows a substantially same contents of FIG. 4A, except that only a rather small chamber 10b as in FIG. 4A that is two. 图4C示出的小型腔室10b处于清空状态,而图4D示出的小型腔室10b已经填充并且膨大以产生饱足感。 Figure 4C shows a small chamber 10b is in empty state, and small chamber 10b shown in Fig. 4D has been filled and inflated to produce satiety.

[0282]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。 [0282] According to the present invention, apparatus for treatment of gastroesophageal reflux disease an alternative embodiment 23 is depicted in FIG. 5A. 同样,该实施方式在许多方面类似于以上参照图1A至1C所述的实施方式。 Also, this embodiment is similar to the above embodiment with reference to FIG. 1A to 1C described in many ways. 因此, 如同图1A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。 Thus, as the embodiment shown in Figure 1A, inset in the fundus of the motion restraint device 10 includes a body 13, the body having an outer surface 15 of the outer surface of the diaphragm 18 is suitable for patients with gastric wall 16 and retraction position at least a portion between the lower abutment portion of the outer side 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。 13 apparatus main body 10 is positioned against one of the outer side wall 16 of the gastric 16a, and has a generally 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22a构成的第一固定设备,在短期内保持内陷状态完好。 And, similarly, after the retraction device 10 in the fundus 16, the device is applied to the first fixed by a plurality of the stomach to stomach sutures or staples 22a constituted retraction kept in good condition in the short term. 在胃底16的壁16a和食管24的壁24a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 fixing device by a plurality of sutures or staples 22b formed between the wall 16a and the esophagus fundus 16 24 wall 24a, the device 10 is held at the position.

[0283]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26,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。 [0283] In an alternative embodiment shown in FIG. 5A, the device 23 further comprises a stimulation device 26, for emitting stimulation pulses, the stimulation pulses suitable to stimulate cardiac muscle, cardiac further closed, thereby 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26b。 23 comprises means adapted to receive at least one of said stimulation pulses at least one conductor electrode 26a and 26b.

[0284]刺激设备26优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。 [0284] stimulation device 26 preferably comprises an electronic circuit and a source of energy, in the preferred embodiment, the energy source is set in the device 10.

[0285]刺激设备26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。 [0285] stimulation device 26 is preferably in the form of bursts to transmit stimulation pulses, wherein said pulse train is adapted to intermittently repeated one time, the intermittent extended batch (the Extending) burst between each pulse.

[0286] 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28和外部能量发射设备34。 [0286] Figure 5B shows substantially the same embodiment Fig. 5A, and an increase of the internal control unit 56, the remote controller 28 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 electrically connected to the 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 a power switch 72, and the following other components of the "system" as described in the section.

[0287]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。 [0287] According to one embodiment of the present invention, reflux disease treatment device 10 may be formed as 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 be a spherical body or oval in shape, 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 apparatus may further be formed as a slightly curved oval body, shown in Figure 6C.

[0288]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。 [0288] 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.

[0289] 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。 [0289] As described 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 such a position, one embodiment of the reflux treatment apparatus shown in Figure 7 includes a fixed member 1Od, 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 a ring or perforated or not perforated ridge convex or may have to fit a fixed reflux treatment device 10 of any other shape.

[0290] 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l〇e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。 [0290] FIG. 8 shows a reflux treatment apparatus embodiment 10, which can be adjusted by hydraulic components, and l〇e 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 may be expanded in size from small surgical procedure to a larger size, 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l〇e注入,以便让反流治疗设备10达成其最终形状。 In this embodiment, any fill material, solid, liquid or gas can be injected through the injection port l〇e so that reflux treatment device 10 to reach its final shape.

[0291] 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10f,该脊凸适于能用手术工具保持。 [0291] FIG. 9 shows an embodiment in which reflux treatment device 10 has a sunken ridge projections 10f, which can be adapted to the convex ridge 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 spinal implant surgery, for example, the projection process reflux treatment device.

[0292] 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。 [0292] 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 part of the esophagus and the fundus, so that the device is not implanted directly against the esophageal wall.

[0293] 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。 [0293] movement restraining device 10 may be presented in any form whatever enables the device 10 stops at a position constraint heart patients stomach notch towards the patient movement of the diaphragm, thereby preventing cardiac patients over the diaphragm opening into the patient's chest, and applied to the patient's cardiac sphincter pressure support to maintain the patient's abdomen.

[0294] 系统 [0294] System

[0295] 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。 [0295] will be included in the apparatus according to the present invention, the energy and operating systems, generally refers to 28, now reference to FIGS. 10-27 to describe it.

[0296] 图10所示的系统28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。 The system shown in [0296] FIG. 10 showed 28 includes an implantable device 30 in the form of energy into internal energy, the energy conversion device 30 is adapted to provide energy to the energy component of reflux disease treatment device via the power line 32. 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。 External energy transmission device 34 transmitting a wireless signal including a wireless remote control, the wireless signal is received by the signal receiver, the signal receiver may comprise an implanted energy conversion 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.

[0297] 图10的系统28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29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。 [0297] In the system 28 of FIG. 10 to FIG. 11 more general block diagram form, where the patient skin like a vertical line 36- is shown, the patient 29 is located inside the patient into the right side of the straight line, the straight line located external to the patient's left side.

[0298] 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。 [0298] FIG. 11 shows a simplified block diagram showing the motion restraint device 10, via a supply line 32 for the device 10 to power the energy conversion device 30, and the external energy transmission device 34.

[0299] 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29体内,用于让设备10反向。 [0299] 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 devices implanted in the patient body 29, 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 a polarized 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 by the device 10 functions implemented.

[0300]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。 [0300] 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 to operate the equipment 10 40 provided in implantable energy conversion devices 30 and 10 of the between. 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 be expressed in 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 from the use of energy implantable energy conversion apparatus 30 to provide power.

[0301] 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。 [0301] FIG. 14 shows the same embodiment shown in FIG. 11 of the present invention, it comprises, in addition to an operating device 42 in the form of components, the assembly comprises a motor / pump unit 78 and implanted into 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 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 fluid pumping device 10 back to the container 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。 Implantable energy conversion device 30 to the wireless energy into a current, for example, the polarization current, for supplying power via the power supply line 50 to the motor / pump unit 44.

[0302] 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。 [0302] and a hydraulically operated device 10 different motion constraints, it is also conceivable the operating 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, it can be adjusted by means of pressurized gas, and the gas tank to replace the fluid container, with air instead of fluid.

[0303] 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。 [0303] In all of these embodiments, the energy conversion device 30 may include a rechargeable accumulator, for example, can be charged by the wireless energy and to provide a capacitor or battery power for any energy consuming components of the device.

[0304] 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。 [0304] 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.

[0305] 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。 [0305] 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, so that the patient's hand contact, indirect contact is likely, for example, press the keys.

[0306] 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54形式的反向设备,全部植入患者体内。 [0306] FIG. 15 illustrates an embodiment of the present invention, including external energy with its wireless remote control transmitting device 34, in which case the device 10, and an implantable energy in the form of hydraulic operating conversion device 30, further comprising a hydraulic fluid reservoir 52, the motor / pump unit 44 and a switching device 54 form a hydraulic valve in the form of reverse equipment, 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 devices, or a device included therein. 马达/泵单元44的马达是电动马达。 The 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 of the control signal, the implanted energy transforming device 30 the control signal using the energy carried by 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 device 10. 外部能量发射设备34的遥控器控制液压阀切换设备54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 controlled hydraulic valve switching device 54 to switch between the two directions of hydraulic fluid flow direction, a direction in which the motor / pump unit 44 from the hydraulic fluid reservoir 52 to the device 10 to operate fluid pumping device 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 so that the device 10 returns to the starting position direction.

[0307] 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54、蓄能器58和电容器60也植入患者体内。 [0307] FIG. 16 illustrates an embodiment shown in FIG. 15 to the same embodiment, in addition to the internal control unit by the external energy transmission device 34 of the wireless remote control 54, the accumulator 58 and a 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 implanted energy transforming device 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 of the control signal, the internal control unit 56 to release electric energy from the accumulator 58 and the release of energy conversion via wires 62 and 64, or via wires 66, the capacitor 60 with a constant current, wire 68 and wire 64 indirect conversion of energy into electrical energy from the implantable device 30 for operation of device 10.

[0308] 内部控制单元优选可以从患者身体外侧进行编程。 [0308] 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 according to any sensor input function parameters measured from the flu or any possible physical parameter of the device, pull the stomach unit.

[0309] 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。 [0309] According to an alternative, the embodiment may be omitted as shown in FIG. 16 in 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.

[0310] 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。 [0310] FIG. 17 illustrates the embodiment shown in FIG. 10 of the same embodiment of the present invention, in addition to the supply of energy for the operation of the device 10 of the battery 70 and the switching device 10 is electrically operated switch 72 is also implanted in the patient. 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(onmode)电池70供应能量用于操作所述设备10。 Electric switch 70 by the implanted energy transforming device 30 supplies energy to operate, switching from stop mode to start mode, in which the stop mode (off mode) battery 70 does not work, start mode (onmode) battery 70 supplies energy for the operation the apparatus 10.

[0311] 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。 [0311] 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 implanted by the energy conversion device 30 supplies 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.

[0312] 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。 [0312] FIG. 19 shows the embodiment of Figure 17 with the same manner as the 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, boot mode accumulator 58 operation of the apparatus 10 to supply energy.

[0313] 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。 [0313] 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 in different forms of interconnection of the implantable member. 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 of the control signal, the internal control unit 56 controls the accumulator 58 to operate the delivery of energy electric switch 72 is switched from the battery 70 does not work as a stop mode of operation of the battery 70 to the supply device 10 energy startup mode.

[0314] 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。 [0314] 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 electric power supply device 10 standby mode.

[0315] 应该理解,所述开关应该从最宽泛的实施方式解释。 [0315] It should be understood, the switch should be from the broadest embodiment of explanation. 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 that the 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 circuit can be switched on and off by the internal control from.

[0316] 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。 [0316] 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 and the internal control unit 74 is also 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.

[0317] 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。 [0317] FIG. 22 illustrates the embodiment shown in FIG. 20 the same manner as the embodiment of the present invention, in addition to the implantable component interconnect different. 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) when you turn the power switch 72 to switch to startup 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 supplies energy for the operation of the device 10 or do not supply energy.

[0318] 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。 [0318] FIG. 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, the device is 10, the internal control unit 56, 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, the 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 components of the apparatus.

[0319] 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。 [0319] 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 patients eating esophageal 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。 Transceivers may be a combination of 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。 As an alternative, 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。 Said transceiver, transmitter and receiver can be used from the patient will be sent the relevant information or data device 10 to the outside of the patient.

[0320] 作为替代,传感器76可以设置成感测设备10的功能参数。 [0320] Alternatively, the sensor 76 may be configured to function parameter sensing device 10.

[0321] 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。 [0321] In the case of implanted motor / pump unit 44 and is used to power the motor / pump unit 44 of the 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, in the energy accumulator or battery charging, the charging process associated with the feedback information is transmitted, and the energy supply is changed accordingly.

[0322] 图24示出的替代实施方式中,设备10被从患者体外调节。 [0322] Figure 24 shows an alternative embodiment of the apparatus 10 to be adjusted from outside of the patient. 系统28包括经由皮下开关80连接到电池70的运动约束设备10。 System 28 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, noninvasively embodiment of the adjusting device 10, whereby the operation of the 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, 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.

[0323] 图25示出的替代实施方式中,系统28包括与液压流体容器52流体连接的运动约束设备10。 Alternative Embodiment [0323] FIG. 25 shows, the system 28 includes a motion restraint device 52 and the hydraulic fluid in the fluid reservoir 10 is connected. 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 connected to a hydraulic device 10, non-intrusive regulation.

[0324] 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。 [0324] includes a feedback device comprises, for transmitting the feedback device according to a further embodiment of the apparatus of the present invention from the patient to the system outside the patient information, and to give the device or at least one motion restraint device function parameters or physical parameters of the patient-related feedback information, thereby optimizing the performance of the device.

[0325] 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。 [0325] A preferred feature of the device parameters and the energy used to charge the internal energy transfer associated.

[0326] 在图26中,简略示出了用于向植入患者体内的系统28供应精确度量的能量的结构,患者皮肤36以垂直线表示。 [0326] In Figure 26, schematically shows a structure for implantation into a patient to the supply system 28 in a precise measure of the energy, to 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。 Movement restraining device 10 is connected to the implantable energy conversion device 30, and the implanted energy conversion device may be located in the body of the patient, the patient's skin 36 is preferably located just less. 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 transforming device 30 can be placed in the abdomen, thorax, muscle membrane (e.g., the abdominal wall), subcutaneously, or any other suitable location. 植入式能量转化设备30适于接收从外部能源34a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 wireless energy E transmitted from an external source 34a, the external energy source provided in the external energy transmission device 34, the external energy generating device 36 is located in the outer skin of the patient, the implanted energy transforming device located near 30.

[0327] 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。 [0327] As known in the art, as the wireless energy E- can by any suitable transcutaneous energy transfer (TET) transfer of equipment, 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 to the secondary coil of the 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 feeding, showing the voltage induced in the secondary coil form of energy, this energy can be used to operate the motion restraint device, such as the arrival of the energy stored in the energy storage device, or any device such as a battery or accumulator after the 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, the TET devices or energy storage devices, and any kind of wireless energy.

[0328] 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。 [0328] energy within the body receiving apparatus can be compared to how much energy the device. 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 by controlling the external energy source 34a is adjusted to the external control unit 34b, 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。 In order to correctly measure the transfer of energy, energy balance and energy requirements of the measure 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 from the sensors and other components suitable for obtaining a sensor means measuring a particular feature rlO reflects the energy required for the proper 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 device or sensor to detect the current state of the patient, in order to provide parameters reflecting the state 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 by the state of the patient such as body temperature, blood pressure, heart rate and breathing reflected.

[0329] 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。 [0329] 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, the characteristics are also a measure of the energy required. 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, but also to avoid excessive heating, it should be clearly understood the battery should optionally receive the correct measure of energy by conversion device 30 from the implanted 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 have the appropriate characteristics of the capacitor.

[0330] 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。 [0330] For example, the battery characteristics can be measured according to routine, to determine the current state of the battery, then the current state as the state information stored in the internal control unit 56 in the appropriate storage part. 因此,在任何时候进行新的测量时,可以相应地更新存储的电池状态信息。 Therefore, any time new measurements, 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, energy can be transferred through proper measure that can "calibrate" the battery state to keep the battery in optimal state.

[0331] 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)。 [0331] Thus, the internal control unit 56 adapted to measuring apparatus according reflux disease treatment device 10 or the patient or the energy storage unit may be fitted on or in the sensor, or any combination thereof, to determine the energy balance and / or current requirements the measure of energy, (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 the external unit connected to an external control signal receiver 34b, 34c. 然后,可以根据接收到的控制信号调节从外部能量源34a发射的能量量度。 You can then adjust the energy emitted from an external energy source 34a metric based on the received control signal.

[0332] 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。 [0332] 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 the 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34c和外部控制单元34b。 In this case, the internal control unit 56 may be omitted and the sensor measurements may be supplied directly to the internal signal transmitter 82, the internal signal transmitter to send measurements to the external signal receiver 34c and the 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 can then determine the energy balance and energy measurement currently required by the external control unit based on these sensor measurements.

[0333] 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。 [0333] Accordingly, the present invention uses a feedback indicating demand for energy, which is more efficient than the previous program, because it is based on the received energy compared to actual energy usage, for example, a measure of energy , the difference in energy than the energy 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 can use the received energy to be dissipated or stored in the energy storage device, etc. 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 need, you can use different parameters described above, and 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 inside themselves to particular embodiments operate the device.

[0334] 内部信号发射器82和外部信号接收器34c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。 [0334] 82 and the external signal receiver 34c may be internal signal transmitter with a suitable signal transmission member implemented as separate units, such as a radio, the IR (infrared) or an ultrasonic signal. 作为替代,内部信号发射器82和外部信号接收器34c可以分别集成在植入式能量转化设备30和外部能源34a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 34c, respectively, may be integrated in the implanted energy transforming device 30 and the external energy source 34a, thereby using the same technique with respect to the emission energy transfer in terms of transmitting control signals 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.

[0335] 总之,图26所示的能量供应结构可以基本上采用以下方式操作。 [0335] In summary, the energy supply structure shown in Fig. 26 may be substantially in the following manner. 首先由内部控制单元56确定能量平衡。 First, the internal control unit 56 is determined by the 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 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 the embodiment, alternatively the external control unit 34b to determine 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34a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 receiving a control signal 34a to adjust the energy measure energy emitted from outside. 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 process of energy transfer in progress, the process may be repeated intermittently at specific intervals, or may be performed in a substantially continuous form in the energy transfer process.

[0336] 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。 [0336] Energy can be adjusted by an external energy transmitter 34a various parameters to substantially regulate the transfer of metrics, such as voltage, current, amplitude, wave frequency and pulse characteristics.

[0337] 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。 [0337] Accordingly, there is provided a method for controlling transmission of wireless energy to supply the reflux disease treatment device to be implanted in a patient's electrically operated. 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。 Transmitting wireless energy E from the external energy source external to the patient, the patient is located inside the energy received by the receiver, the internal energy receiver is connected to the device 10 for direct or indirect supply to which the energy received. 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, in the internal energy receiver receives energy and apparatus 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 wireless energy transmitted from the external energy E.

[0338] 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。 [0338] 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 external to the patient, and the wireless energy is located in the body of a patient receiving an implantable energy conversion device, the implanted energy transforming device is connected to a device 10 for the its 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 the energy transforming device implantable energy received between the energy and the energy for the balance of the apparatus 10, and controls the wireless energy balance transmitted from an external source based on the determined energy E.

[0339] 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。 [0339] The functional parameters of the device with the energy used to charge the internal energy associated with transmission.

[0340] 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。 [0340] 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.

[0341] 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。 [0341] In another embodiment, the external energy is controlled from outside the patient, to release non-magnetic wireless energy, and the released non-magnetic wireless energy for operation of the apparatus 10.

[0342] 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。 [0342] The skilled artisan will appreciate that can be combined in different ways according to various embodiments of the above FIG. 14-26. 例如,电开关38操作的极化能量可以包含在图12U5-21所示的任何实施方式中,液压阀切换设备54可以包含在图24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. 12U5-21, hydraulic valve switching device 54 may be included in the embodiment shown in FIG. 24, and the gear box 74 can be included in FIG. 33 in the embodiment shown. 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.

[0343] 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。 [0343] The above description of the 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26中示出,其中外部开关84借助电线86和88互联在外部能源34a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. 26, wherein an external switch 84 by means of wires 86 and 88 are interconnected between the external energy source 34a and the operation of the device, the device operation such as adjusting device 10 of the electric motor. 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.

[0344] 液压或气压动力供应 [0344] a hydraulic or pneumatic power supply

[0345] 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。 [0345] Figure 28-31 shows in more detail a manner as to provide a hydraulic or pneumatic powered motion restraint device according to the present invention, four kinds of different ways in a block diagram.

[0346] 图28示出了如上所述用于治疗反流疾病的系统。 [0346] FIG. 28 shows a system as 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54。 The system includes a device 10, additionally including a separate adjusting container 46, pump 44 and check valve 54 alternately.

[0347] 图29示出了设备10和流体容器46。 [0347] FIG. 29 shows a device 10 and fluid containers 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 changing dimensions can be adjusted without any of the valve device, only to release the fluid path volume by moving the container wall.

[0348] 图30示出了设备10、双向泵44和调节容器46。 [0348] FIG. 30 shows a device 10, two-way pump 44 and adjusting container 46.

[0349] 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。 [0349] 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 motion control vessel 90 via a mechanical restraint device 94 is 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 supply of hydraulic fluid 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 comprises a compressible gas, the compressible gas can be compressed and expanded under the control of a servo of the container 90.

[0350] 伺服容器90也可以是该设备的一部分。 [0350] The servo container 90 may also be part of the device.

[0351]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。 [0351] In one embodiment, the conditioning vessel disposed below the skin of patients, and the outer surface thereof by means of finger pressure to operate. 所述反流疾病治疗设备在图32c中示出。 The reflux disease treatment apparatus 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 the conduit 48 is connected to a servo bulge shape 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。 This servo bellows-shaped container 90 comprises 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, the container 90 contains the minimal servo fluid, and the presence of a fluid container 46 up in 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 containers between 90 and 10 interconnect the mechanical equipment, the external shape of the device 10 contraction, namely, that occupies a volume smaller 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 dashed lines in FIG.

[0352] 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。 [0352] 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 container due to the servo bellows shape, the longitudinal expansion occurs. 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 the maximum volume, thereby stretching the stomach wall contact (not shown).

[0353]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。 [0353] regulating container 46 is preferably provided with means for maintaining 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 regulation of the container, the member will remain in the stretched position of the 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 to operate.

[0354] 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。 [0354] Referring now to FIG. 33 and 34 describe an alternative embodiment of a hydraulic or pneumatic operation. 图33所示的方块图包括第一闭合系统控制第二闭合系统。 A block diagram shown in Fig. 33 includes a first closed system controlling a second closed system. 第一系统包括调节容器46和伺服容器90。 The first system includes a container 4