公开(公告)号：US07706889B2

公开(公告)日：2010-04-27

申请号：US11799113

申请日：2007-04-30

申请人： Martin T. Gerber ,  John C. Rondoni

发明人： Martin T. Gerber ,  John C. Rondoni

IPC分类号： A61N1/36

CPC分类号： A61N1/36071 ,  A61N1/37247 ,  G06F19/00

摘要： The disclosure describes an implantable stimulation system that guides programming with a therapeutic tree. All possible stimulation parameters are arranged on the therapeutic tree, with each level of the therapeutic tree containing a different stimulation parameter type. Each level includes nodes that are connected to nodes of adjacent levels. A program path is created by moving through nodes of lower levels. The stimulation parameter types are arranged so that coarse adjustments occur at higher levels of the tree and fine adjustments occur at lower levels of the tree. The nodes of the program path define the stimulation parameters of the delivered stimulation therapy. Performance feedback may be used by the system to evaluate nodes of the therapeutic tree and define the program path. The performance feedback may include beneficial effects, adverse effects, and system performance related to the stimulation therapy. Additionally, one or more sensors may provide the performance feedback.

摘要翻译： 本公开描述了一种用治疗树引导编程的可植入刺激系统。 所有可能的刺激参数被布置在治疗树上，治疗树的每个水平含有不同的刺激参数类型。 每个级别包括连接到相邻级别的节点的节点。 通过移动较低级别的节点创建程序路径。 刺激参数类型被布置为使得在较高级别的树上进行粗调，并且在较低级别处发生精细调整。 程序路径的节点定义了递送的刺激疗法的刺激参数。 系统可以使用性能反馈来评估治疗树的节点并定义程序路径。 性能反馈可以包括与刺激疗法相关的有益效果，不利影响和系统性能。 另外，一个或多个传感器可以提供性能反馈。

公开(公告)号：US07684873B2

公开(公告)日：2010-03-23

申请号：US11706146

申请日：2007-02-14

申请人： Martin T. Gerber

发明人： Martin T. Gerber

IPC分类号： A61N1/00

CPC分类号： A61N1/3605 ,  A61N1/0534 ,  A61N1/0536 ,  A61N1/0558 ,  A61N1/36017

摘要： An implantable medical elongated member includes a first outer surface portion and a second outer surface portion extending around at least ten percent of an outer perimeter of the elongated member. A fixation element extends a distance from the first outer surface portion of the implantable medical elongated member. A longitudinally-extending section of the second outer surface portion proximate to a distal end of the elongated member is substantially devoid of any fixation elements that extend the distance from second outer surface portion. In some embodiments, the longitudinally-extending section of the second outer surface portion is substantially devoid of any exposed electrodes.

摘要翻译： 可植入医疗细长构件包括第一外表面部分和围绕细长构件的外周边的至少十分之一延伸的第二外表面部分。 固定元件从可植入医疗细长构件的第一外表面部分延伸一段距离。 靠近细长构件的远端的第二外表面部分的纵向延伸部分基本上没有延伸距第二外表面部分的距离的任何固定元件。 在一些实施例中，第二外表面部分的纵向延伸部分基本上没有任何暴露的电极。

公开(公告)号：US20090270947A1

公开(公告)日：2009-10-29

申请号：US12111822

申请日：2008-04-29

申请人： Richard T. Stone ,  Steven M. Goetz ,  Gregory F. Molnar ,  Gabriela C. Miyazawa ,  Martin T. Gerber

发明人： Richard T. Stone ,  Steven M. Goetz ,  Gregory F. Molnar ,  Gabriela C. Miyazawa ,  Martin T. Gerber

IPC分类号： A61N1/08

CPC分类号： A61N1/0534 ,  A61N1/0551 ,  A61N1/36082 ,  A61N1/37247

摘要： Techniques for configuring electrical stimulation therapy utilizing one or more stimulation intensity values are described. In one example, a method includes receiving a stimulation intensity value that corresponds to an equal intensity function; determining a pulse width value and a pulse amplitude value based on the equal intensity function; and controlling delivery of electrical stimulation pulses with the determined pulse width value and amplitude value to a patient. A stimulation intensity value may correspond to a plurality of paired pulse width and amplitude values having substantially the same intensity. For example, the plurality of paired pulse width and amplitude values may activate a substantially equal volume of tissue when a stimulation pulse with the paired values is delivered.

摘要翻译： 描述了利用一个或多个刺激强度值来配置电刺激治疗的技术。 在一个示例中，一种方法包括接收对应于等强度函数的刺激强度值; 基于等强度函数确定脉冲宽度值和脉冲振幅值; 并且以确定的脉冲宽度值和振幅值来控制对电刺激脉冲的传递给患者。 刺激强度值可以对应于具有基本上相同强度的多个成对的脉冲宽度和幅度值。 例如，当递送具有成对值的刺激脉冲时，多个成对的脉冲宽度和振幅值可以激活基本上相等体积的组织。

公开(公告)号：US07604629B2

公开(公告)日：2009-10-20

申请号：US11737181

申请日：2007-04-19

申请人： Martin T. Gerber ,  John C. Rondoni

发明人： Martin T. Gerber ,  John C. Rondoni

IPC分类号： A61K9/22

CPC分类号： A61B5/0031 ,  A61B5/01 ,  A61B5/024 ,  A61B5/0452 ,  A61B5/0488 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/0816 ,  A61B5/11 ,  A61B5/14539 ,  A61B5/14546 ,  A61B5/1473

摘要： Methods for monitoring an infection in proximity to an implantable medical device include monitoring a first indicator of infection in proximity to a medical device implanted in a patient; monitoring a second patient parameter; and determining whether the combination of the first indicator and the second parameter are indicative of infection in proximity to the implanted device. If a determination is made that the combination of the first indicator and the second parameter are indicative of infection, an alert may be issued.

摘要翻译： 用于监测在植入式医疗装置附近的感染的方法包括监测植入患者体内的医疗装置附近的第一感染指示器; 监测第二个患者参数; 以及确定所述第一指示符和所述第二参数的组合是否指示所述植入装置附近的感染。 如果确定第一指示符和第二参数的组合指示感染，则可以发出警报。

公开(公告)号：US07585271B2

公开(公告)日：2009-09-08

申请号：US10698131

申请日：2003-11-01

申请人： Martin T. Gerber ,  Warren L. Starkebaum ,  John M. Swoyer

发明人： Martin T. Gerber ,  Warren L. Starkebaum ,  John M. Swoyer

IPC分类号： A61F2/02

CPC分类号： A61B17/00234 ,  A61B17/06109 ,  A61B17/3478 ,  A61B90/39 ,  A61B2017/00805 ,  A61B2017/00898 ,  A61B2017/306 ,  A61F2/0036 ,  A61L31/145

摘要： In general, the invention is directed to treatment of urinary incontinence by the implantation of one or more bulking prostheses proximate to a urethral sphincter. These bulking prostheses, which may include biocompatible hydrogel, are implanted into the tissue outside the urethra, proximate to a urethral sphincter. When implanted, the bulking prostheses are in a miniature state. Upon introduction into the body, the devices enter an enlarged state. In their enlarged state, the bulking prostheses supply extra bulk to the tissues proximate to the external urethral sphincter. With the extra bulk, the patient can exercise voluntary control over the external urethral sphincter to close or maintain closure of the urethra and maintain urinary continence.

摘要翻译： 通常，本发明涉及通过植入靠近尿道括约肌的一个或多个膨胀假体来治疗尿失禁。 这些可能包括生物相容性水凝胶的膨胀假体植入尿道外侧的组织中，靠近尿道括约肌。 当植入时，膨胀假体处于微型状态。 引入身体后，设备进入放大状态。 在扩大的状态下，膨胀假体对靠近外部尿道括约肌的组织提供额外的体积。 随着额外的体积，患者可以对外部尿道括约肌进行自愿控制，以关闭或保持尿道闭合并维持尿路。

公开(公告)号：US20080300650A1

公开(公告)日：2008-12-04

申请号：US11755578

申请日：2007-05-30

申请人： Martin T. Gerber ,  John C. Rondoni

发明人： Martin T. Gerber ,  John C. Rondoni

IPC分类号： A61N1/36

CPC分类号： A61N1/36007 ,  A61B5/04882 ,  A61B5/202 ,  A61B5/204 ,  A61B5/205 ,  A61B5/42 ,  A61N1/05

摘要： An implantable medical lead includes at least one stimulation electrode and at least one sensor configured to generate an electrical signal that varies as a function of a parameter associated with a voiding event of a patient. In some embodiments, the sensor may be at least one of a microphone that captures sounds associated with voiding events, a pressure sensor, a flow sensor, a strain gauge, a physiological parameter sensing electrode or a temperature sensor. The electrical signal generated by the sensor may used to detect an occurrence of a voiding event. Thus, the lead may be coupled wirelessly or via a wired connection to a device that processes the electrical signal from the sensor, generates voiding information based on the electrical signal, and in some cases, records the voiding information for later retrieval and analysis.

摘要翻译： 可植入医疗引线包括至少一个刺激电极和至少一个传感器，该至少一个传感器被配置为产生随着与患者的排尿事件相关联的参数的函数而变化的电信号。 在一些实施例中，传感器可以是麦克风中的至少一个，其中捕获与排尿事件相关的声音，压力传感器，流量传感器，应变计，生理参数感测电极或温度传感器。 由传感器产生的电信号可以用于检测排气事件的发生。 因此，引线可以无线地或经由有线连接耦合到处理来自传感器的电信号的设备，基于电信号产生空隙信息，并且在一些情况下，记录用于稍后检索和分析的排尿信息。

公开(公告)号：US20080262379A1

公开(公告)日：2008-10-23

申请号：US11737176

申请日：2007-04-19

申请人： Martin T. Gerber ,  John C. Rondoni

发明人： Martin T. Gerber ,  John C. Rondoni

IPC分类号： A61B5/01

CPC分类号： A61B5/076 ,  A61B5/0031 ,  A61B5/01 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/14539 ,  A61B5/14546 ,  A61B5/1473

摘要： A method for monitoring infection in proximity to an implanted medical device includes monitoring an indicator of infection in proximity to the device and determining whether a value associated the indicator of infection crosses a first threshold indicative of infection. The method further includes detecting an event associated with the device. The event is capable of affecting the indicator of infection. The method also includes determining whether the value associated with the indicator of infection crosses a second threshold indicative of infection if the event is detected. The method may further include issuing an alert if (i) the first threshold is crossed and the event is not detected, or (ii) the second threshold is crossed and the event is detected.

摘要翻译： 用于在植入式医疗装置附近监测感染的方法包括监测靠近装置的感染指示器，并确定与感染指标相关联的值是否穿过指示感染的第一阈值。 该方法还包括检测与该设备相关联的事件。 该事件能够影响感染指标。 该方法还包括确定与感染指标相关联的值是否在检测到事件时指示感染的第二阈值。 该方法还可以包括如果（i）超过第一阈值并且未检测到该事件，或者（ii）超过第二阈值并且检测到该事件，则发出警报。

公开(公告)号：US07427280B2

公开(公告)日：2008-09-23

申请号：US10836558

申请日：2004-04-30

申请人： Martin T. Gerber

发明人： Martin T. Gerber

IPC分类号： A61M31/00 ,  A61K9/22

CPC分类号： A61N1/326 ,  A61N1/36007 ,  A61N1/36071

摘要： Described are implantable devices and methods for treating various disorders of the pelvic floor by delivering one or more drugs to a patient's hypogastric nerve or branches or portions thereof, prostatic plexus nerve or branches or portions thereof, sacral splanchnic nerve or branches or portions thereof, pelvic splanchnic nerve or branches or portions thereof, prostate or branches or portions thereof, pelvic floor, colon or branches or portions thereof, bladder or portions thereof, vagina or portions thereof, anus or portions thereof, external anal sphincter or portions thereof, urethra or portions thereof, penile dorsal nerve or portions thereof, inferior rectal nerves or branches or portions thereof, perineal nerves or branches or portions thereof, scrotal nerves or branches or portions thereof, scrotum or portions thereof, Alcock's Canal or branches or portions thereof, sacro-tuberous ligament or branches or portions thereof, ischial tuberosity or branches or portions thereof, greater sciatic foramen or branches or portions thereof, or lesser sciatic foramen or branches or portions thereof. One, two or more drug delivery regimes are provided on a continuous, alternating, intermittent or other basis to one or more selected nerves, nerve portions or tissues in an amount and manner effective to treat a number of disorders, including, but not limited to, urinary and/or fecal voiding dysfunctions such as constipation, incontinence disorders such as urge frequency and urinary retention disorders, sexual dysfunctions such as orgasmic and erectile dysfunction, pelvic pain, prostatitis, prostatalgia and prostatodynia.

摘要翻译： 描述了通过将一种或多种药物递送到患者的下腹神经或其分支或部分，前列腺神经或其分支或部分，骶神经内脏神经或其分支或部分来治疗盆底的各种疾病的可植入装置和方法，骨盆 内脏神经或分支或其部分，前列腺或其分支或部分，盆底，结肠或其分支或部分，膀胱或其部分，阴道或其部分，肛门或其部分，外肛门括约肌或其部分，尿道或部分 阴茎背神经或其部分，下直肠神经或其分支或部分，会阴神经或其分支或部分，阴囊神经或其分支或部分，阴囊或其部分，阿尔科克运河或其分支或部分，骶骨结节 韧带或分支或其部分，坐骨结节或其分支或部分，gre 一个坐骨神经孔或其分支或其部分，或较小的坐骨神经孔或分支或其部分。 以连续的，交替的，间歇的或其他的基础向一个或多个选择的神经，神经部分或组织以有效治疗多种病症的量和方式提供一种，两种或更多种药物递送方案，包括但不限于 尿液和/或粪便排泄功能障碍如便秘，失禁症例如呼吸频率和尿潴留障碍，性功能障碍如高血压和勃起功能障碍，盆腔疼痛，前列腺炎，前列腺痛和前列腺痛。

公开(公告)号：US20080103580A1

公开(公告)日：2008-05-01

申请号：US11591450

申请日：2006-10-31

申请人： Martin T. Gerber

发明人： Martin T. Gerber

IPC分类号： A61N1/05

CPC分类号： A61N1/0536 ,  A61M5/14276 ,  A61N1/0534 ,  A61N1/0558 ,  A61N1/057

摘要： An implanted elongated member, e.g., a medical lead or catheter, includes one or more conduits that are configured to accept a stylet to guide the elongated member during implantation and deliver a solidifying substance to an outer surface of the distal portion of the elongated member via one or more exit ports. Once the elongated member is correctly positioned within the patient, the stylet is removed from the conduit and the solidifying substance is delivered into the conduit. The solidifying substance is cured in situ from moisture in the surrounding tissue, UV light or some other curing method. The solidifying substance helps secure the elongated member to a target tissue site. The solidifying substance may form fixation structures that extend away from the elongated member, form an adhesive bond between the elongated member and the tissue, or inflate a balloon element that that engages with the adjacent tissue.

摘要翻译： 植入的细长构件，例如医疗引线或导管，包括一个或多个管道，其被构造成在植入期间接纳探针以引导细长构件，并且将固化物质输送到细长构件的远端部分的外表面，经由 一个或多个出口。 一旦细长构件正确地定位在患者体内，则探针从导管中移出，固化物质被输送到导管中。 固化物质在周围组织中的湿气中固化，UV光或其它一些固化方法。 固化物质有助于将细长构件固定到目标组织部位。 固化物质可以形成从细长构件延伸的固定结构，在细长构件和组织之间形成粘合剂结合，或者膨胀与相邻组织接合的球囊元件。

公开(公告)号：US20080103579A1

公开(公告)日：2008-05-01

申请号：US11591443

申请日：2006-10-31

申请人： Martin T. Gerber

发明人： Martin T. Gerber

IPC分类号： A61N1/05

CPC分类号： A61N1/0558 ,  A61N1/057

摘要： The disclosure is directed to securing electrodes of a medical lead adjacent to a target tissue site. The medical lead may include at least one adhesive element disposed along a longitudinal outer surface of the lead body to adhere the adjacent tissue to the lead. Adhesive elements may be disposed proximal to, distal to, or in-between the electrodes of the lead. Each adhesive element may be inactive during lead implantation and activated by removing a covering sheath to expose the adhesive elements to moisture in the tissue or presenting an energy, e.g. ultraviolet light, to the adhesive elements. Once active, the adhesive elements secure the lead to surrounding tissue to prevent migration of the electrodes from the target tissue.

摘要翻译： 本公开涉及固定与目标组织部位相邻的医疗引线的电极。 医疗引线可以包括沿着引线主体的纵向外表面设置的至少一个粘合元件，以将相邻的组织粘附到引线上。 粘合元件可以设置在引线的电极的近端，远侧或中间。 每个粘合元件在引线植入期间可能是无活性的，并且通过移除覆盖护套以将粘合剂元件暴露于组织中的湿气或呈现能量，例如， 紫外线，粘合元件。 一旦活动，粘合剂元件将引线固定到周围的组织，以防止电极从靶组织移动。