CN101156796A - 用于单腔进入吻合的紧固件的施放器 - Google Patents
用于单腔进入吻合的紧固件的施放器 Download PDFInfo
- Publication number
- CN101156796A CN101156796A CNA2007101627227A CN200710162722A CN101156796A CN 101156796 A CN101156796 A CN 101156796A CN A2007101627227 A CNA2007101627227 A CN A2007101627227A CN 200710162722 A CN200710162722 A CN 200710162722A CN 101156796 A CN101156796 A CN 101156796A
- Authority
- CN
- China
- Prior art keywords
- distally
- actuation member
- ring
- nearside
- proximal
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
Abstract
一种用于单腔进入吻合的紧固件的施放器，环装置具有由近侧和远侧铰接臂连接的近侧、中央和远侧环，环装置未被致动时铰接臂具有基本上为长方形的径向回缩的形状，环装置被致动时铰接臂具有折叠的径向突出的形状，施放器包括：细长的执行部分和连接到其上的手柄；远侧致动构件，包括在锁定位置径向向外突出以接合所述远侧环的锁扣装置；近侧致动构件，其能够接合近侧环；致动机构，其布置在手柄处并能够使近侧和远侧致动构件沿着执行部分的纵向轴线朝向彼此运动，以接近近侧和远侧环，使铰接臂致动。远侧致动构件可绕着纵向轴线从锁定位置旋转到释放位置，由此沿着执行部分处的偏离表面滑动，能够径向向内推动锁扣装置使其与远侧环脱离。
Description
技术领域
本发明整体上涉及用于外科修复器官和脉管的装置和方法。更具体而言，本发明涉及用于将两个器官连接在一起的吻合装置，例如用于将两段小肠彼此连接、将一段小肠连接到胃上、或者在胆总管十二指肠吻合术中将胆总管连接到十二指肠上。
背景技术
世界上患病态肥胖症的人口比例正稳步增长。严重肥胖的人患心脏病、中风、糖尿病、肺病和其它意外疾病的风险增加。由于病态肥胖症对患者生活的影响，一直在研究治疗病态肥胖症的方法。
已经尝试各种非手术病态肥胖症治疗方法，但没有获得长效的成功。饮食咨询、行为矫正、用线将患者鄂关闭、药理方法都已经进行了尝试，尽管暂时有效，但不能根本矫正肥胖。另外，将例如食管-胃囊的物体导入胃中以填充胃的方法已经被用来治疗肥胖症。但是，这些方法易于引起胃功能紊乱，而且不能长期有效。
通过外科手术治疗肥胖症获得越来越大的成功。这些方法可以归结为：减小胃的有效尺寸，从而限制进食量的方法；以及引起所进食物的吸收不良的方法。例如，一些患者从可调节的胃束带(AGB)受益，所述胃束带在腹腔镜下围绕胃部放置，以形成所需尺寸的造口，允许食物填充胃的上部，从而引起饱涨感。为了能够在植入后调节造口的尺寸，流体导管在AGB的内置流体囊和经皮放置在患者胸骨前面的流体注射端口之间连通。然后，注射器针头可以根据需要注射或抽回流体以调节AGB。
尽管某种治疗肥胖症的方法对一些患者有效，但是其它患者发现他们的生活方式被不希望地改变，而进食量的限制使这种改变成为必须。另外，患者的身体状况暗示需要更长久有效的解决方案。为此，外科方法已经用来改变胃和/或小肠的用于消化食物的部分。产生吻合或者说在两根正常情况下不同的脉管之间通过外科方法形成通道是许多外科手术的关键步骤。在将小肠的两个部分连接在一起或者将小肠的另一部分连接到患者的胃上的胃旁路术尤其如此。在胰腺癌手术中通过从胆管将胆汁排向小肠以减轻胆总管的堵塞的手术中也是如此。
特别对于胃旁路手术，用于胃旁路术的进行腹腔镜吻合的现有方法包括钉合、缝合、以及放置可生物变碎环的方法，每种方法都具有大的挑战。例如，缝合很费时，并且取决于技术和熟练程度。钉合需要放置钉砧，钉砧是不能通过套管针端口导入的较大装置。必须通过剖腹来导入端口，这由于将内腔拉到剖腹手术进入部位而增加了伤口感染的机会。
作为钉合方法的一个例子，美国专利No.6543456公开的用于胃旁路术的方法包括将近侧和远侧吻合构件(例如钉砧)用抓钳经口插入。通过外科切割和钉合器械在内窥镜下横切胃和小肠，以形成胃囊、排出环以及鲁氏翼(Roux limb)。在内窥镜下插入的圆形钉合器连接到远侧吻合构件上以将排出环连接到小肠的远侧部分上，圆形钉合器连接到近侧吻合构件上以将鲁氏翼连接到胃囊上。之后，移除吻合构件以在胃和小肠的连接部分之间形成开孔。这种方法减小了腹腔镜端口的数量，避免了在腹腔镜下将吻合器械(例如圆形钉合器)插入扩大的手术端口，并消除了对肠切开和肠闭合的需要。
对于许多吻合术，医生使用圆形钉合器，直线型钉合器，或者手工缝合。但是，为了减小切口尺寸，并使手术过程技术要求更低更不费时，已经提出了单件式吻合装置，其在通过吻合施放器展开期间可变形以将组织部分保持在一起。美国专利公开2005/0070926A1和2005/0070935(通过引用将其包含在这里)描述了具有执行部分的吻合施放器，该执行部分接收具有圆柱的未致动形状的吻合环装置，该吻合环装置一端具有近侧环，另一端具有远侧环。该环装置还具有连接到近侧环上的近侧臂和连接到远侧环上的远侧臂。远侧臂的指向内侧的端部在中央环处连接到近侧环的指向内侧的端部上，使得当环在施放器致动期间被拉向一起时臂向外致动。闩锁机构将环锁定在铆钉状致动形状下。施放器包括径向突出的锁扣，其与环接合，使得可通过锁扣的平移运动来减小远侧环与中央环之间的间距和近侧环与中央环之间的间距。为了从致动的闩锁的环装置移除施放器，在每个锁扣的近侧设置释放斜面，当释放斜面与下一个完全致动的更近侧的环接触时使锁扣向内运动。美国专利申请US2005/0070926A1和US2005/0070935公开的吻合施放器和环装置使得可通过存在的套管针端口进行单腔进入吻合术，并在腔之间形成吻合连接，使得减轻对外科缝合和钉合的需要。
尽管如此，这些已知的装置的缺点在于，释放机构首先响应于锁扣的轴向运动而被击发，这使得环装置变形，然后响应于释放斜面与环装置的直接接触而被击发。因此，施放器可仅通过一次预定环变形来展开环装置，否则施放器从展开的环装置的回缩是不可能的。这意味着必须提供不同的施放器用于不同的组织厚度或不同的组织压缩程度，并且在环装置展开期间对组织压缩进行调节(远侧环和近侧环之间的距离的调节)是不可能的。
发明内容
因此，本发明目的在于改进已知的吻合施放器，使得可进行环压缩或者环逼近(即组织厚度)的调节并且可使用可调节的环装置。
通过根据后附权利要求1所述的吻合施放器来实现这些和其它目的。有利的实施方式是从属权利要求的目的。
根据本发明，提出一种用于吻合术环装置的施放器，所述环装置具有分别由近侧铰接臂和远侧铰接臂连接的近侧环、中央环和远侧环，当所述环装置未被致动时所述铰接臂具有基本上为长方形的径向回缩的形状，当所述环装置被致动时所述铰接臂具有折叠的径向突出的形状。所述施放器包括：细长的执行部分；连接到所述执行部分上的手柄；远侧致动构件，其包括锁扣装置，所述锁扣装置在锁定位置径向向外突出，以接合所述远侧环；近侧致动构件，其能够接合所述近侧环；致动机构，其布置在所述手柄处并能够使所述近侧和远侧致动构件沿着所述执行部分的纵向轴线朝向彼此运动，以接近所述近侧和远侧环，由此使所述铰接臂致动，其中，所述远侧致动构件可绕着所述纵向轴线从所述锁定位置旋转到释放位置，由此沿着所述执行部分处的偏离表面滑动，从而能够径向向内推动所述锁扣装置使其与所述远侧环脱离。由于绕执行部分的纵向轴线的旋转释放运动，释放独立于致动构件的轴向平移，并因此独立于环装置的变形的状态。这使得可利用吻合施放器来可调节地展开可闩锁的环装置，实现不同的环距离和不同的组织厚度。此外，通过在施放器的执行部分处设置偏离表面而不是将其形成在环装置上，可以优化环装置的设计用于两个组织部分的吻合连接，而无须考虑施放器结构。同样，施放器具有更多功能并且更不依赖于环装置。因此，不同的环装置(当然所有的都具有前面描述的基本特征)可通过吻合施放器展开。
根据本发明的有利的实施方式，致动机构适于使近侧致动构件向远侧运动并使远侧致动构件向近侧运动，从而使所述环装置的铰接臂致动，同时使所述中央环在所述执行部分上基本上保持固定。通过同时使两个致动构件朝向彼此运动，可将吻合环装置从其原始的圆柱形状展开并偏转成致动的铆钉形状，避免了施放器相对于组织的运动。对于现有技术，这种施放器的运动是必须的，以补偿环装置的中心沿着执行轴的运动。
根据本发明的另一方面，致动机构能够独立于远侧致动构件的轴向平移使近侧致动构件轴向平移，反之亦然。这使得施放器可选择地分别致动远侧和近侧铰接臂中的仅一组，以在组织夹紧之前辅助或改进组织定位和接近。此外，近侧和远侧致动构件的独立的平移运动使得可使环装置(即其中央环)例如在铰接臂展开和致动期间或者之前以受控的方式沿着执行部分平移。
根据本发明的一种替代实施方式，致动机构适于使远侧致动构件轴向平移，而近侧致动构件包括面向远侧的固定捕获表面，所述捕获表面形成在所述执行部分处，使得整体上形成特别简单且坚固的致动机构和施放器。本领域技术人员应当理解，通过朝着捕获表面向近侧拉动远侧致动构件，环装置会同时向近侧平移并且变形成其致动的铆钉形状。
回到施放器的释放机构，根据本发明的一个方面，执行部分包括具有轴向延伸的远侧窗槽的基本上圆柱形的外壳，远侧致动构件包括可滑动地接收于所述外壳内的轴和多个翼片形状的锁扣，多个翼片形状的锁扣从所述轴向外突出并通过所述远侧窗槽延伸，使得在处于所述锁定位置时，所述多个锁扣接合吻合环装置的远侧环。在该锁定位置，翼片能够径向或者切向延伸，或者在径向和切向之间成一角度倾斜地延伸。优选地，翼片沿着与致动构件从锁定位置转向释放位置的方向相反的方向偏斜或者倾斜，由此便于通过相应的窗槽的侧纵向边缘使翼片向内偏离，所述边缘用作上述偏离表面。
根据一种优选实施方式，圆柱形外壳还限定了多个轴线延伸的近侧窗槽，近侧致动构件包括可滑动地接收于所述外壳内的轴和多个翼片形状的锁扣，多个翼片形状的锁扣从所述轴向外突出并通过所述近侧窗槽延伸，使得在锁定位置时，所述多个锁扣接合吻合环装置的近侧环。近侧锁扣的布置、形状和释放机构优选与前面描述的远侧锁扣相同。远侧和近侧窗槽也可纵向连接并连续，从而相同窗槽的近侧和远侧部分分别用作近侧和远侧窗槽。
有利地，近侧和远侧致动构件被布置成可相对于彼此轴向滑动，而在绕纵向轴线旋转方面相联接，从而可通过两个致动构件相对于执行部分外壳的一个共同的旋转运动使远侧和近侧锁扣同时到达释放位置。
本发明具体涉及：
(1)、一种用于吻合环装置的施放器，所述环装置具有分别由近侧铰接臂和远侧铰接臂连接的近侧环、中央环和远侧环，当所述环装置未被致动时所述铰接臂具有基本上为长方形的径向回缩的形状，当所述环装置被致动时所述铰接臂具有折叠的径向突出的形状，所述施放器包括：
细长的执行部分和连接到所述执行部分上的手柄；
远侧致动构件，其包括锁扣装置，所述锁扣装置在锁定位置径向向外突出，以接合所述远侧环；
近侧致动构件，其能够接合所述近侧环；
致动机构，其布置在所述手柄处并能够使所述近侧和远侧致动构件沿着所述执行部分的纵向轴线朝向彼此运动，以接近所述近侧和远侧环，由此使所述铰接臂致动，
其特征在于，所述远侧致动构件可绕着所述纵向轴线从所述锁定位置旋转到释放位置，由此沿着所述执行部分处的偏离表面滑动，从而能够径向向内推动所述锁扣装置使其与所述远侧环脱离。
(2)、根据第(1)项所述的施放器，其中，所述致动机构能够使所述近侧致动构件向远侧运动并使所述远侧致动构件向近侧运动，从而使所述环装置的铰接臂致动，同时使所述中央环在所述执行部分上基本上保持固定。
(3)、根据第(1)项所述的施放器，其中，所述致动机构能够独立于所述远侧致动构件的轴向平移使所述近侧致动构件轴向平移，并且所述致动机构能够独立于所述近侧致动构件的轴向平移使所述远侧致动构件轴向平移。
(4)、根据第(1)项所述的施放器，其中，所述近侧致动构件包括面向远侧的固定捕获表面，所述捕获表面形成在所述执行部分处并能够接合所述近侧环，所述致动机构能够使所述远侧致动构件朝着所述捕获表面向近侧平移。
(5)、根据前述任一项所述的施放器，其中，所述执行部分包括具有轴向延伸的远侧窗槽的基本上圆柱形的外壳，所述远侧致动构件包括可滑动地接收于所述外壳内的轴，多个远侧锁扣从所述轴向外突出并通过所述远侧窗槽延伸，使得所述多个远侧锁扣接合吻合环装置的远侧环，在处于所述锁定位置时，所述远侧锁扣能够响应于所述远侧致动构件从所述锁定位置到所述释放位置的旋转而通过所述远侧窗槽的侧边缘径向向内偏离。
(6)、根据前述任一项所述的施放器，其中，所述圆柱形外壳还包括多个轴向延伸的近侧窗槽，所述近侧致动构件包括可滑动地接收于所述外壳内的轴，多个近侧锁扣从所述轴向外突出并通过所述近侧窗槽延伸，使得所述多个近侧锁扣接合吻合环装置的近侧环，在处于所述锁定位置时，所述近侧锁扣能够响应于所述近侧致动构件从所述锁定位置到所述释放位置的旋转而通过所述近侧窗槽的侧边缘径向向内偏离。
(7)、根据第(5)或(6)项所述的施放器，其中，所述锁扣基本上为翼片形状，在所述锁定位置，所述翼片沿着与所述致动构件从所述锁定位置旋转到所述释放位置的方向相反的方向倾斜，以便于使所述翼片通过所述窗槽的侧边缘)向内偏离。
(8)、根据第(5)或(6)项所述的施放器，其中，所述近侧和远侧致动构件被布置成可相对于彼此轴向滑动，而在绕纵向轴线旋转方面相联接，从而可通过两个致动构件相对于外壳的一个共同的旋转运动使远侧和近侧锁扣同时到达释放位置。
(9)、根据前述任一项所述的施放器，包括布置在近侧致动构件和远侧致动构件之间的中央致动构件，所述中央致动构件具有锁扣装置，所述锁扣装置能够接合所述环装置的中央环，以在所述远侧和/或近侧致动构件的致动运动期间控制其位置，所述中央致动构件能够绕纵向轴线从锁定位置旋转到释放位置，由此沿着执行部分处的偏离表面滑动，从而能够径向向内推动所述锁扣装置使其与所述远侧环脱离。
(10)、根据前述任一项所述的施放器，其中，所述中央致动构件本身也可通过中央环滑动控制器朝着近侧致动构件向近侧轴向运动和/或朝着远侧致动构件向远侧轴向运动。
(11)、根据第(9)或(10)项所述的施放器，其中，所述中央致动构件和远侧致动构件，或者所述中央致动构件、远侧致动构件和近侧致动构件被布置成可轴向滑动，而在转动方面相联接，从而可通过所有致动构件相对于外壳的一个共同的旋转运动使远侧、中央和近侧锁扣同时到达释放位置。
(12)、根据前述任一项所述的施放器，包括闩锁机构，所述闩锁机构能够携带可拆卸的按扣部件，所述按扣部件与环装置分离并且能够使所述近侧环与所述远侧环压扣连接，以将所述环装置锁定在其致动构型中。
(13)、根据前述任一项所述的施放器，其中，所述闩锁机构包括一个或多个可纵向平移的推动部分，所述推动部分相对于所述近侧锁扣或所述近侧捕获表面布置在近侧，并能够接合所述按扣部件的近侧端面并将按扣部件向近侧推动成与所述吻合环装置压扣接合。
(14)、根据前述任一项所述的施放器，其中，所述施放器装备有所述按扣部件，所述按扣部件包括环形近侧肩部和纵向部分，所述环形近侧肩部能够接合近侧环的近侧端面，所述纵向部分从环形近侧肩部向远侧突出并形成从纵向部分径向向外延伸的弹性支撑的按扣齿，以使远侧环能压扣接合，所述按扣部件的纵向部分限定了与所述近侧锁扣或捕获表面对齐并且与所述远侧锁扣对齐的槽，从而所述按扣部件可被推动成与所述环装置接合，而不会与所述致动构件发生干涉。
(15)、根据第(14)项所述的施放器，其中，所述按扣部件能够锁定所述环装置，使所述近侧环和所述远侧环之间具有不同的可调节距离。
(16)、根据前述任一项所述的施放器，其中，所述按扣部件包括多个按扣齿，所述多个按扣齿布置成沿着纵向部分的纵向延伸的列，从而所述环形近侧肩部与相同列的不同的按扣齿之间的距离对应于环装置的近侧和远侧环之间的不同的可调节距离。
(17)、根据第(15)或(16)项所述的施放器，其中，所述按扣部件的环形近侧肩部包括向远侧突出的具有外螺纹的调节部分，所述调节部分与设置在纵向部分的近侧基部处的内螺纹配合，从而可通过将调节部分或多或少地拧入纵向部分来调节肩部和按扣齿之间的距离。
(18)、根据第(17)项所述的施放器，其中，所述具有螺纹的调节部分也带有槽，以便在所述环装置的锁定期间不会与所述近侧锁扣或者捕获表面发生干涉。
(19)、根据第(13)或(17)项所述的施放器，其中，所述推动部分能够绕纵向轴线转动，并且能够接合按扣部件的环形肩部，从而所述旋转调节运动使得环形肩部可调节地拧入纵向部分。
附图说明
本发明的这些和其他特征和优点通过下面示例地示出了本发明的实施方式的附图将会变得更加清楚，这些附图和上面的总的描述以及下面对实施方式的具体描述一起用于解释本发明的原理，其中：
图1是用于内腔吻合的单腔进入的可展开的环的透视图，其安装于在腹腔镜下插入患者小肠的两个部分中每一个上的吻合目标部位的施放器上；
图2是单腔进入的可展开的环致动以接近小肠的两个部分之后的图1的施放器的视图；
图3是施放器的执行部分的详细的透视图，其携带了单腔进入的可展开的环，该环处于长方形的未致动的构型，施放器致动构件处于锁定位置；
图4是施放器的执行部分的详细的透视图，其携带了单腔进入的可展开的环，该环处于折叠的致动构型，施放器致动构件还是处于锁定位置；
图5是施放器的执行部分的详细的透视图，其携带了单腔进入的可展开的环，该环处于折叠的致动构型，施放器致动构件回缩在释放位置；
图6是施放器的执行部分和单腔进入的可展开的环的详细的透视图，该环处于折叠的致动构型，施放器通过环的中心移出；
图7和8是分别处于锁定位置和释放位置的施放器致动部分的放大的剖视图；
图9是根据本发明示例性实施方式的施放器的致动机构的详细的示意性透视图；
图9A是根据本发明示例性第二实施方式的施放器的致动机构的详细的示意性透视图；
图10-13示出了根据本发明第二实施方式的施放器的不同的操作构型；
图14-17示出了根据本发明第三实施方式的施放器的不同的操作构型；
图18-22示出了根据本发明的施放器的可拆卸的可调节按扣元件的不同方式。
具体实施方式
参照附图，其中所有附图中相同的附图标记表示相同的部件，图1示出了具有细长执行部分2的施放器1，该细长执行部分的尺寸适于通过套管针或者腹腔镜端口插入组织壁3、4以吻合两个内腔。施放器1的远侧引导尖端5通过吻合部位7处的开口6穿刺以定位致动部分8，该致动部分8保持用于单腔吻合的环装置9。环装置9具有三个主环，分别为近侧环10、中央环11和远侧环12，这些环彼此成一圆柱对齐。近侧环10通过近侧臂13纵向连接到中央环11上，中央环11又通过远侧臂14连接到远侧环12上。近侧臂13和远侧臂1 4分别通过铰接接头15和16分成两部分，铰接接头15和16限定了铰接到中央环11上的内壁段17、18和分别铰接到近侧环10和远侧环12上的外壁段19、20。在如图1所示的未致动状态，壁13、14基本上是长方形，并且环装置9至少大致是圆柱形。内壁段17、18和外壁段19、20的相对长度可以被选择以提供与组织壁3、4成需要的角度进行接触。在示例性形式中，这种关系类似于与内壁段17、18的悬臂接触，内壁段17、18致动成与组织壁3、4成大致平行关系。
手柄部分21在近侧连接到执行部分2的轴22上。轴22可以是刚性的或柔性的，是柔性时适于插入内腔，例如通过食道。手柄21包括用于纵向定位环装置9的环10、11、12的控制器。在示例性形式中，这包括远侧环滑动控制器23和近侧环滑动控制器24。尽管为了清楚示出了手动定位和致动的施放器1，但是应当理解，根据本发明的各个方面可以使用遥控定位和致动的施放器，以例如允许以更受控的方式放置，从而避免扰乱显像方式，或者其他别的原因。手柄21还可包括用于远侧尖端照明能力的控制器，使得远侧臂14在远侧内腔中的致动可以从内窥镜在近侧观察。应当理解，这里使用的术语“近侧”和“远侧”是相对于握持施放器1的手柄部分21的临床医生而言的。
在图2中，远侧环滑动控制器23已经向近侧回缩，近侧环滑动控制器24已经向远侧推进，使得远侧环12和近侧环10与中央环11锁定地接近，中央环11保持基本上不动。响应于此，近侧臂13和远侧臂14从环装置9的纵向轴线向外枢转，形成中空铆钉或沙漏形状，用于将组织壁3、4置于附近。中央环11座于内腔之间的组织接头处，远侧环12和近侧环10靠在相应的内腔中。通过在致动时将环10、11、12相互闩锁，环装置9保持在致动位置，弯曲的壁13、14接近组织。如图所示，近侧臂13可以与远侧臂14交错，以形成用于压缩的组织的弯曲路径。或者，壁13和14可以对齐以直接彼此配合。图3-8示例性示出了根据本发明第一实施方式的施放器1。
执行部分2包括基本上圆柱形的外壳25，其在致动部分8的区域中限定了多个轴向延伸的远侧窗槽26和多个轴向延伸的近侧窗槽27，远侧窗槽26和近侧窗槽27分别沿着远侧环12和近侧环10的致动运动的轨迹延伸。
远侧致动构件28包括轴29，其可滑动地收纳于外壳25中并可操作地通过拉杆31与远侧环滑动控制器23连接。多个翼片状的远侧锁扣30从轴29向外突出并通过远侧窗槽26延伸，使得它们在锁定位置时结合远侧环12的远端表面。在这种情况下，可通过使远侧环滑动控制器23在近侧方向移动而使远侧环12向近侧运动。
同样，近侧致动构件32包括轴33，其可滑动地收纳于外壳25中并可操作地通过推杆34与近侧环滑动控制器24连接。多个翼片状的近侧锁扣35从轴33向外突出并通过近侧窗槽27延伸，使得它们在锁定位置时结合近侧环10的近端表面。在这种情况下，可通过使近侧环滑动控制器24在远侧方向移动而使近侧环10向远侧运动。
如图9示意性示出的，近侧和远侧致动构件28、32能够相对于彼此(优选独立于彼此)平移，但它们在绕着执行部分2的纵向轴线X旋转方面例如通过几何连接件35相对于彼此有利地锁定。
手柄21包括释放控制器，例如旋钮37，其连接到拉杆31和/或推杆34上，并适于至少使远侧致动构件28(并优选使致动构件28和32)围绕执行部分2的纵向轴线X从锁定位置旋转到释放位置，在释放位置，锁扣30、35从吻合环装置9脱离，使得施放器的执行部分可通过环装置9的中央开口向近侧回缩。
如上面已经描述的，根据本发明，施放器1从环装置9的脱离通过如下特征实现：在致动构件28、32的旋转过程中，环装置的一部分在执行部分处(特别是在外壳25处)沿着偏离表面滑动，这能够径向向内推动锁扣30、35，至少使它们与远侧环12脱离。本领域技术人员应当理解，为了从环装置回缩施放器，近侧锁扣不必回缩。
根据附图所示的实施方式，锁扣30、35优选沿着与从锁定位置转向释放位置的方向相反的方向偏斜或者倾斜，由此便于通过相应的窗槽26、27的侧纵向边缘38使锁扣向内偏离，所述边缘38用作上述偏离表面。
在示例性形式中，外壳25和每个致动构件28、32由刚性聚合物或者金属片材形成。
在图3中，长方形的未致动的环装置9施加到施放器1的致动部分8上，远侧锁扣30和近侧锁扣35通过相应的窗槽26、27向外突出，并且与环装置9的远侧和近侧环12、10接合。
图4示例性示出了远侧环滑动控制器23已经向近侧移动并且近侧环滑动控制器24已经向远侧移动之后的情形，致动构件28、32使远侧环12和近侧环10朝着中央环11逼近，并且环装置9通过未示出的闩锁特征锁定在其致动的铆钉形状。在这种构型中，远侧和近侧锁扣30、35还处于其锁定位置，即，它们向外突出并防止施放器1从致动的环装置9回缩。
图5示例性示出了释放控制器37已经被旋转之后的情形，使得致动构件28、32围绕纵向轴线X从锁定位置旋转到释放位置，在释放位置，锁扣30、35通过窗边缘38向内弯曲并且与环装置9脱离。如图6所示，现在可将施放器1通过已致动且已展开的环装置9的中央开口向近侧移出。
图9-12示例性示出了根据本发明的第二实施方式的吻合施放器40，其中近侧致动构件和近侧环滑动控制器被去除，并且由固定的近侧捕获表面39替代，近侧捕获表面39适于与近侧环10的近侧端面接触，而远侧致动构件28基本上实施为参照图3-7描述的实施方式，除了远侧锁扣30的运动轨迹并因此远侧窗槽26的长度和远侧环滑动控制器23的滑动轨迹的长度对应于环装置的整个致动长度。
根据第三实施方式，如图14-17所示，施放器41包括闩锁机构，其适于携带与环装置9分离的可拆卸的按扣部件42，并适于使近侧环10和远侧环12压扣连接，以将环装置9锁定在其致动的铆钉形状。闩锁机构包括一个或多个可纵向平移的推动部分43，其相对于近侧锁扣35或近侧捕获表面39布置在近侧并且适于与按扣部件42的近端表面42接合并将按扣部件42向远侧推动成与吻合环装置9接合。推动部分43通过推杆(例如施加到执行部分2外部的管状推杆44)连接到专用的闩锁滑动控制器，例如推杆44的布置在手柄部分21附近的凸缘部分45。这允许在环装置9致动之后锁定环装置9，由此防止了可能妨碍对环逼近和施加到由环装置9夹紧的组织壁3、4上的压力的进行微调的自动锁定。
根据该实施方式，按扣部件42包括适于接合近侧环10的近端表面的环状近侧肩部46和从近侧肩部46向远侧突出并形成弹性支撑的按扣齿48的纵向部分47，所述按扣齿48从纵向部分47径向向外延伸，使远侧环12可压扣接合。按扣部件的纵向部分47和按扣齿48限定了与近侧锁扣35或捕获表面39对齐并优选与施放器1、40、41的远侧锁扣30对齐的槽49或者窗口，以能够将按扣部件42推动成与远侧环12对齐，而不会与施放器1的致动构件28、32发生干涉。
根据一种实施方式，按扣部件42适于锁定环装置9使近侧环10和远侧环之间12具有不同的可调节距离。该特征和施放器的上述适于独立于环装置的特定致动构型来释放环装置的环释放机构一起，使得可以以不同的组织厚度和压力等级来展开吻合环装置，并在环装置施放期间调节环构型和组织压力。
根据按扣部件42的示例性第一实施方式(图18、19)，多个按扣齿48、48′(其中至少两个)布置成沿着纵向部分47的纵向延伸的列，使得环形近侧肩部46与相同列的不同的按扣齿48、48′之间的距离对应于环装置9的近侧环和远侧环10、12之间的不同的可调节距离。
根据示例性第二实施方式(图20、21)，按扣部件42的纵向部分47限定了按扣齿48的仅一个周向排(至少两个沿直径相对布置的按扣齿)，其适于与远侧环12压扣接合，而环形近侧肩部46包括向远侧突出的外部有螺纹的调节部分50，其与设置在纵向部分47的近侧基部51处的内螺纹配合，使得可通过或多或少地将调节部分50旋拧到纵向部分47中来调节肩部46和按扣齿48之间的距离。为了使按扣部件与施放器的致动机构相适应，有螺纹的调节部分50可开槽，以在闩锁期间不会与锁扣35或捕获表面39发生干涉。在该具体实施方式中，螺纹调节必须按分别与槽49或锁扣30、35的角度偏移相对应的角度逐步进行。
回到图14-17的实施方式，管状推杆44的凸缘部分45除了用作闩锁滑动控制器(平移闩锁运动)之外，优选用作用于使推动部分43围绕执行部分2的纵向轴线转动的旋转调节控制器。为此，推动部分43优选包括几何连接装置(例如齿、凹槽)，其适于接合按扣部件42的环形肩部46，从而推动部分43的旋转调节运动使得环形肩部46拧入纵向部分47或者从其拧出。
根据示例性第三实施方式(图22)，按扣部件42包括粗调装置和附加的微调装置。粗调装置由多个按扣齿48、48′实施，多个锁扣齿48、48′(其中至少两个)布置成沿着纵向部分47的纵向延伸的列，使得环形近侧肩部46与相同列的不同的按扣齿48、48′之间的距离与环装置9的近侧环和远侧环10、12之间的不同的可粗调距离相对应。微调装置由有外螺纹的调节部分50实施，其从环形近侧肩部46向远侧突出并与设置在纵向部分47的近侧基部51处的内螺纹配合。这样，可通过或多或少地将调节部分50旋拧到纵向部分47中来微调肩部46和所选的按扣齿48之间的距离。
根据又一种实施方式(图中未示出)，按扣部件42本身限定了用于接收一组针或者缝钉的座，使得响应于推动部分43的远侧运动，按扣部件42运动成与环10、12压扣接合，并同时在吻合环装置9中推动该组针或者缝钉，由此穿刺保持在近侧环臂和远侧环臂之间的组织3、4。在这种情况下，该组针可有利地包括自支撑针环，其可布置在按扣部件42的环形肩部46上。
根据本发明的又一实施方式，其特征可与前述实施方式中描述和示出的特征相适应或着相结合，施放器1还包括中央致动构件52，其布置在近侧致动构件32和远侧致动构件28之间并具有锁扣装置53，该锁扣装置53适于接合环装置的中央环11，以在近侧和/或远侧致动构件的致动运动期间将其保持固定。
为了轴向锁定中央环11的位置，中央致动构件52的锁扣装置53包括合适的锁定表面，其径向向外突出并与中央环11的相应的凹槽或锁定表面接合，或者包围中央环或者其一部分，从而防止中央环沿近侧和远侧方向运动。
根据一种实施方式，中央致动构件52轴向固定但可绕着纵向轴线X从锁定位置转动到释放位置，由此在执行部分2处沿着偏离表面滑动，这能够径向向内推动锁扣装置53，以使其与中央环11脱离，如对于远侧或近侧致动构件的描述一样。
根据又一实施方式，中央致动构件52本身可通过中央环滑动控制器(图中未示出)朝着近侧致动构件向近侧轴向运动和/或朝着远侧致动构件向远侧轴向运动，该控制器优选构造成如远侧和近侧环滑动控制器23、24描述的一样。
具体而言，可独立于近侧和/或远侧致动构件的致动来优选保持中央致动构件52的固定位置或者进行中央致动构件52的纵向平移。
就致动构件从环装置的释放操作而言，根据一种实施方式，中央致动构件52和远侧致动构件28或者中央、远侧和近侧致动构件52、28和32布置成可轴向滑动但是转动相联的关系，使得可通过所有的致动构件相对于外壳25围绕纵向轴线X的一个共同的旋转运动使远侧、中央和近侧锁扣可同时到达其释放位置。
在使用中，环装置9接收在施放器1的执行部分2的致动部分8上。具体而言，环装置9的近侧环10靠在近侧锁扣35上，并且远侧环致动构件28的远侧锁扣30接合环装置9的远侧环12。临床医生操纵手柄21以将执行部分2插入穿过套管针的插管、腹腔镜端口或者穿过例如食道的内腔，以插入到吻合部位7。组织壁3、4放置在远侧(从医生的视角看)，并且执行部分2的导入尖端5穿过形成在这些壁3、4中的开口6。导入尖端可具有穿刺形状和/或具有电磁或者热增强的切割特征，以辅助形成开口6。一旦环装置9的远侧臂14位于远侧内腔内，远侧环滑动控制器23可向近侧运动以将远侧臂致动成部分致动的环形。如此保持的远侧组织壁4可在必要时向近侧回缩，使得近侧臂13位于第一内腔内。
向远侧逐渐推动近侧环滑动控制器24使得近侧臂13部分致动。如果定位是正确的，则滑动控制器23、24可完全滑动，使得近侧和远侧臂13、14完全致动。如果环装置9设有自己的闩锁机构，其可在完全致动构型中自动闩锁，否则向远侧滑动和闩锁滑动控制器45，按扣部件42进入环装置9的内径内，并且与其近侧环和远侧环压扣接合。现在可通过旋转使得锁扣径向回缩的释放控制器37，来使得将施放器1保持到环装置9上的锁扣30、35脱离。然后，施放器的远侧尖端5从环装置9回缩，保持环装置9展开，形成吻合连接。随着时间经过，组织壁3、4永久地愈合在一起并且环装置9可以排出消化道，尤其是当其可生物变碎时更是如此。
尽管已经通过几种实施方式的描述示例性描述了本发明，尽管示例性实施方式已经描述得相当详细，但是申请人并不意图将后附权利要求的范围限制或者以任何方式限定为这些细节。本领域技术人员清楚地了解其它优点和变型。
例如，本发明的各个方面可应用于内窥镜和腹腔镜外科手术，也可应用于开放手术。这些或者类似术语的使用不应理解为将本发明限制成仅仅一类外科手术。
又如，尽管已经描述了用于使胃肠道的部分形成旁路的肥胖症手术，应当理解，通过吻合施放器和具有这里描述的各个方面的环装置可以使其它手术受益，例如胆管和血管旁路术。
Claims (4)
1.一种用于吻合环装置(9)的施放器(1)，所述环装置具有分别由近侧铰接臂(13)和远侧铰接臂(14)连接的近侧环(10)、中央环(11)和远侧环(12)，当所述环装置(9)未被致动时所述铰接臂(13、14)具有基本上为长方形的径向回缩的形状，当所述环装置(9)被致动时所述铰接臂(13、14)具有折叠的径向突出的形状，所述施放器(1)包括：
细长的执行部分(2)和连接到所述执行部分(2)上的手柄(21)；
远侧致动构件(28)，其包括锁扣装置(30)，所述锁扣装置(30)在锁定位置径向向外突出，以接合所述远侧环(12)；
近侧致动构件(32)，其能够接合所述近侧环(10)；
致动机构(23、24)，其布置在所述手柄(21)处并能够使所述远侧和近侧致动构件(28、32)沿着所述执行部分(2)的纵向轴线(X)朝向彼此运动，以接近所述近侧和远侧环(10、12)，由此使所述铰接臂(13、14)致动，
其特征在于，所述远侧致动构件(28)可绕着所述纵向轴线(X)从所述锁定位置旋转到释放位置，由此沿着所述执行部分(2)处的偏离表面(38)滑动，从而能够径向向内推动所述锁扣装置(30)使其与所述远侧环(12)脱离。
2.根据权利要求1所述的施放器(1)，其中，所述致动机构能够使所述近侧致动构件(32)向远侧运动并使所述远侧致动构件(28)向近侧运动，从而使所述环装置(9)的铰接臂(13、14)致动，同时使所述中央环(11)在所述执行部分(2)上基本上保持固定。
3.根据权利要求1所述的施放器(1)，其中，所述致动机构能够独立于所述远侧致动构件(28)的轴向平移使所述近侧致动构件(32)轴向平移，并且所述致动机构能够独立于所述近侧致动构件(32)的轴向平移使所述远侧致动构件(28)轴向平移。
4.根据权利要求1所述的施放器(1)，其中，所述近侧致动构件(32)包括面向远侧的固定捕获表面(39)，所述捕获表面(39)形成在所述执行部分(2)处并能够接合所述近侧环(10)，所述致动机构(23)能够使所述远侧致动构件(28)朝着所述捕获表面(39)向近侧平移。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| EP06021066A EP1908422B1 (en) | 2006-10-06 | 2006-10-06 | Improvements relating to an anastomotic ring applier |
| EP06021066.3 | 2006-10-06 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101156796A true CN101156796A (zh) | 2008-04-09 |
| CN101156796B CN101156796B (zh) | 2010-11-17 |
Family
ID=37820627
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2007101627227A Expired - Fee Related CN101156796B (zh) | 2006-10-06 | 2007-10-08 | 用于单腔进入吻合的紧固件的施放器 |
Country Status (5)
| Country | Link |
|---|---|
| US (1) | US7871418B2 (zh) |
| EP (1) | EP1908422B1 (zh) |
| CN (1) | CN101156796B (zh) |
| AT (1) | ATE435613T1 (zh) |
| DE (1) | DE602006007712D1 (zh) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103491680A (zh) * | 2013-09-17 | 2014-01-01 | 深圳市朗恒电子有限公司 | 档位控制方法、装置及照明系统 |
| CN104888296A (zh) * | 2015-05-25 | 2015-09-09 | 王洛 | 套管式胃穿刺冲洗减压装置 |
| CN111601561A (zh) * | 2018-01-10 | 2020-08-28 | C.R.巴德公司 | 铰接式手术器械 |
Families Citing this family (486)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
| US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
| US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
| US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
| US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
| US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
| US7673781B2 (en) | 2005-08-31 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with staple driver that supports multiple wire diameter staples |
| US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
| US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
| US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
| US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
| US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
| US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
| US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
| US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
| US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
| US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
| US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
| US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
| US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
| US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
| US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
| US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
| US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
| US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
| US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
| US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
| US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
| US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
| US8236010B2 (en) | 2006-03-23 | 2012-08-07 | Ethicon Endo-Surgery, Inc. | Surgical fastener and cutter with mimicking end effector |
| US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
| US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
| US8348131B2 (en) | 2006-09-29 | 2013-01-08 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with mechanical indicator to show levels of tissue compression |
| US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
| US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
| US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
| US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
| US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
| US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
| US8540128B2 (en) | 2007-01-11 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with a curved end effector |
| US7438209B1 (en) | 2007-03-15 | 2008-10-21 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments having a releasable staple-forming pocket |
| US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
| US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
| US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
| US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
| US8408439B2 (en) | 2007-06-22 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
| US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
| US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
| US9301761B2 (en) | 2007-10-22 | 2016-04-05 | James E. Coleman | Anastomosis devices and methods |
| US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
| US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
| US8459525B2 (en) | 2008-02-14 | 2013-06-11 | Ethicon Endo-Sugery, Inc. | Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device |
| US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
| US8622274B2 (en) * | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
| US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
| US7793812B2 (en) | 2008-02-14 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus |
| US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
| US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
| US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
| US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
| RU2493788C2 (ru) | 2008-02-14 | 2013-09-27 | Этикон Эндо-Серджери, Инк. | Хирургический режущий и крепежный инструмент, имеющий радиочастотные электроды |
| US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
| US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
| US10390823B2 (en) | 2008-02-15 | 2019-08-27 | Ethicon Llc | End effector comprising an adjunct |
| US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
| PL3476312T3 (pl) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Stapler chirurgiczny z urządzeniem do dopasowania wysokości zszywek |
| US7857186B2 (en) | 2008-09-19 | 2010-12-28 | Ethicon Endo-Surgery, Inc. | Surgical stapler having an intermediate closing position |
| US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
| US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
| US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
| US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
| US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
| US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
| US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
| BRPI1008667A2 (pt) | 2009-02-06 | 2016-03-08 | Ethicom Endo Surgery Inc | aperfeiçoamento do grampeador cirúrgico acionado |
| US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
| US8899466B2 (en) | 2009-11-19 | 2014-12-02 | Ethicon Endo-Surgery, Inc. | Devices and methods for introducing a surgical circular stapling instrument into a patient |
| US9149797B2 (en) * | 2009-12-15 | 2015-10-06 | SDCmaterials, Inc. | Catalyst production method and system |
| US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
| US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
| US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
| US8672207B2 (en) | 2010-07-30 | 2014-03-18 | Ethicon Endo-Surgery, Inc. | Transwall visualization arrangements and methods for surgical circular staplers |
| US8360296B2 (en) | 2010-09-09 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling head assembly with firing lockout for a surgical stapler |
| US9877720B2 (en) | 2010-09-24 | 2018-01-30 | Ethicon Llc | Control features for articulating surgical device |
| US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
| US9566061B2 (en) | 2010-09-30 | 2017-02-14 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a releasably attached tissue thickness compensator |
| US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
| US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
| US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
| US9241714B2 (en) | 2011-04-29 | 2016-01-26 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator and method for making the same |
| US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
| US9517063B2 (en) | 2012-03-28 | 2016-12-13 | Ethicon Endo-Surgery, Llc | Movable member for use with a tissue thickness compensator |
| US9113862B2 (en) | 2010-09-30 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with a variable staple forming system |
| US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
| US9301753B2 (en) | 2010-09-30 | 2016-04-05 | Ethicon Endo-Surgery, Llc | Expandable tissue thickness compensator |
| US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
| US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
| US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
| US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
| US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
| US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
| AU2011308701B2 (en) | 2010-09-30 | 2013-11-14 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a retention matrix and an alignment matrix |
| US10123798B2 (en) | 2010-09-30 | 2018-11-13 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
| US8893949B2 (en) | 2010-09-30 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler with floating anvil |
| US8740038B2 (en) | 2010-09-30 | 2014-06-03 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a releasable portion |
| US9216019B2 (en) | 2011-09-23 | 2015-12-22 | Ethicon Endo-Surgery, Inc. | Surgical stapler with stationary staple drivers |
| US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
| US9033204B2 (en) | 2011-03-14 | 2015-05-19 | Ethicon Endo-Surgery, Inc. | Circular stapling devices with tissue-puncturing anvil features |
| WO2012129234A1 (en) | 2011-03-21 | 2012-09-27 | Endo Pharmaceuticals Inc. | Urethral anastomosis device and method |
| AU2012250197B2 (en) | 2011-04-29 | 2017-08-10 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
| US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
| US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
| US8833632B2 (en) | 2011-09-06 | 2014-09-16 | Ethicon Endo-Surgery, Inc. | Firing member displacement system for a stapling instrument |
| US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
| US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
| BR112014024102B1 (pt) | 2012-03-28 | 2022-03-03 | Ethicon Endo-Surgery, Inc | Conjunto de cartucho de prendedores para um instrumento cirúrgico, e conjunto de atuador de extremidade para um instrumento cirúrgico |
| US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
| JP6105041B2 (ja) | 2012-03-28 | 2017-03-29 | エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． | 低圧環境を画定するカプセルを含む組織厚コンペンセーター |
| MX353040B (es) | 2012-03-28 | 2017-12-18 | Ethicon Endo Surgery Inc | Unidad retenedora que incluye un compensador de grosor de tejido. |
| US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
| BR112014032776B1 (pt) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico |
| US20140001234A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Coupling arrangements for attaching surgical end effectors to drive systems therefor |
| US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
| US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
| US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
| US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
| US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
| US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
| US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
| US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
| US8747238B2 (en) | 2012-06-28 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Rotary drive shaft assemblies for surgical instruments with articulatable end effectors |
| EP2866686A1 (en) | 2012-06-28 | 2015-05-06 | Ethicon Endo-Surgery, Inc. | Empty clip cartridge lockout |
| US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
| US9649111B2 (en) | 2012-06-28 | 2017-05-16 | Ethicon Endo-Surgery, Llc | Replaceable clip cartridge for a clip applier |
| US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
| US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
| US10092292B2 (en) | 2013-02-28 | 2018-10-09 | Ethicon Llc | Staple forming features for surgical stapling instrument |
| US9307986B2 (en) | 2013-03-01 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Surgical instrument soft stop |
| BR112015021098B1 (pt) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | Cobertura para uma junta de articulação e instrumento cirúrgico |
| MX364729B (es) | 2013-03-01 | 2019-05-06 | Ethicon Endo Surgery Inc | Instrumento quirúrgico con una parada suave. |
| US20140263552A1 (en) | 2013-03-13 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Staple cartridge tissue thickness sensor system |
| US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
| US9888919B2 (en) | 2013-03-14 | 2018-02-13 | Ethicon Llc | Method and system for operating a surgical instrument |
| US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
| US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
| US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
| ITRM20130217A1 (it) * | 2013-04-10 | 2014-10-11 | Longo Antonio | Suturatrice chirurgica |
| US9867612B2 (en) | 2013-04-16 | 2018-01-16 | Ethicon Llc | Powered surgical stapler |
| BR112015026109B1 (pt) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | Instrumento cirúrgico |
| US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
| US9775609B2 (en) | 2013-08-23 | 2017-10-03 | Ethicon Llc | Tamper proof circuit for surgical instrument battery pack |
| MX369362B (es) | 2013-08-23 | 2019-11-06 | Ethicon Endo Surgery Llc | Dispositivos de retraccion de miembros de disparo para instrumentos quirurgicos electricos. |
| US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
| US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
| US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
| US20150173749A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical staples and staple cartridges |
| US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
| US9757124B2 (en) | 2014-02-24 | 2017-09-12 | Ethicon Llc | Implantable layer assemblies |
| BR112016019387B1 (pt) | 2014-02-24 | 2022-11-29 | Ethicon Endo-Surgery, Llc | Sistema de instrumento cirúrgico e cartucho de prendedores para uso com um instrumento cirúrgico de fixação |
| BR112016021943B1 (pt) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico |
| US10028761B2 (en) | 2014-03-26 | 2018-07-24 | Ethicon Llc | Feedback algorithms for manual bailout systems for surgical instruments |
| US9826977B2 (en) | 2014-03-26 | 2017-11-28 | Ethicon Llc | Sterilization verification circuit |
| US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
| US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
| US11517315B2 (en) | 2014-04-16 | 2022-12-06 | Cilag Gmbh International | Fastener cartridges including extensions having different configurations |
| JP6612256B2 (ja) | 2014-04-16 | 2019-11-27 | エシコン エルエルシー | 不均一な締結具を備える締結具カートリッジ |
| US20150297225A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
| US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
| JP6636452B2 (ja) | 2014-04-16 | 2020-01-29 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | 異なる構成を有する延在部を含む締結具カートリッジ |
| JP6532889B2 (ja) | 2014-04-16 | 2019-06-19 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | 締結具カートリッジ組立体及びステープル保持具カバー配置構成 |
| US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
| BR112017004361B1 (pt) | 2014-09-05 | 2023-04-11 | Ethicon Llc | Sistema eletrônico para um instrumento cirúrgico |
| US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
| US20160066913A1 (en) | 2014-09-05 | 2016-03-10 | Ethicon Endo-Surgery, Inc. | Local display of tissue parameter stabilization |
| US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
| US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
| CN107427300B (zh) | 2014-09-26 | 2020-12-04 | 伊西康有限责任公司 | 外科缝合支撑物和辅助材料 |
| US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
| US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
| US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
| US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
| US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
| US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
| US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
| US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
| US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
| BR112017012996B1 (pt) | 2014-12-18 | 2022-11-08 | Ethicon Llc | Instrumento cirúrgico com uma bigorna que é seletivamente móvel sobre um eixo geométrico imóvel distinto em relação a um cartucho de grampos |
| US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
| US10245027B2 (en) | 2014-12-18 | 2019-04-02 | Ethicon Llc | Surgical instrument with an anvil that is selectively movable about a discrete non-movable axis relative to a staple cartridge |
| US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
| US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
| US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
| US10182816B2 (en) | 2015-02-27 | 2019-01-22 | Ethicon Llc | Charging system that enables emergency resolutions for charging a battery |
| US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
| US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
| US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
| US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
| US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
| US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
| US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
| US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
| US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
| US10045776B2 (en) | 2015-03-06 | 2018-08-14 | Ethicon Llc | Control techniques and sub-processor contained within modular shaft with select control processing from handle |
| US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
| JP2020121162A (ja) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価 |
| US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
| US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
| US10390825B2 (en) | 2015-03-31 | 2019-08-27 | Ethicon Llc | Surgical instrument with progressive rotary drive systems |
| US10178992B2 (en) | 2015-06-18 | 2019-01-15 | Ethicon Llc | Push/pull articulation drive systems for articulatable surgical instruments |
| US10835249B2 (en) | 2015-08-17 | 2020-11-17 | Ethicon Llc | Implantable layers for a surgical instrument |
| CN108348233B (zh) | 2015-08-26 | 2021-05-07 | 伊西康有限责任公司 | 用于允许改变钉特性并实现轻松仓加载的外科钉条 |
| US11103248B2 (en) | 2015-08-26 | 2021-08-31 | Cilag Gmbh International | Surgical staples for minimizing staple roll |
| MX2022009705A (es) | 2015-08-26 | 2022-11-07 | Ethicon Llc | Metodo para formar una grapa contra un yunque de un instrumento de engrapado quirurgico. |
| US10314587B2 (en) | 2015-09-02 | 2019-06-11 | Ethicon Llc | Surgical staple cartridge with improved staple driver configurations |
| MX2022006191A (es) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Configuraciones de grapas quirurgicas con superficies de leva situadas entre porciones que soportan grapas quirurgicas. |
| US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
| US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
| US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
| US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
| US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
| US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
| US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
| US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
| US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
| US10736633B2 (en) | 2015-09-30 | 2020-08-11 | Ethicon Llc | Compressible adjunct with looping members |
| US10172620B2 (en) | 2015-09-30 | 2019-01-08 | Ethicon Llc | Compressible adjuncts with bonding nodes |
| US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
| US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
| US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| CN108882932B (zh) | 2016-02-09 | 2021-07-23 | 伊西康有限责任公司 | 具有非对称关节运动构造的外科器械 |
| US10588625B2 (en) | 2016-02-09 | 2020-03-17 | Ethicon Llc | Articulatable surgical instruments with off-axis firing beam arrangements |
| US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
| US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10307159B2 (en) | 2016-04-01 | 2019-06-04 | Ethicon Llc | Surgical instrument handle assembly with reconfigurable grip portion |
| US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
| US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
| US11284890B2 (en) | 2016-04-01 | 2022-03-29 | Cilag Gmbh International | Circular stapling system comprising an incisable tissue support |
| US11045191B2 (en) | 2016-04-01 | 2021-06-29 | Cilag Gmbh International | Method for operating a surgical stapling system |
| US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
| US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
| US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
| US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
| US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
| US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
| US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
| US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
| US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
| US10426469B2 (en) | 2016-04-18 | 2019-10-01 | Ethicon Llc | Surgical instrument comprising a primary firing lockout and a secondary firing lockout |
| US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
| US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
| USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
| USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
| CN109310431B (zh) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | 包括线材钉和冲压钉的钉仓 |
| USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
| US10542979B2 (en) | 2016-06-24 | 2020-01-28 | Ethicon Llc | Stamped staples and staple cartridges using the same |
| CN110099619B (zh) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | 用于外科端部执行器和可替换工具组件的闭锁装置 |
| US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
| US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
| US10980536B2 (en) | 2016-12-21 | 2021-04-20 | Ethicon Llc | No-cartridge and spent cartridge lockout arrangements for surgical staplers |
| BR112019011947A2 (pt) | 2016-12-21 | 2019-10-29 | Ethicon Llc | sistemas de grampeamento cirúrgico |
| US10888322B2 (en) | 2016-12-21 | 2021-01-12 | Ethicon Llc | Surgical instrument comprising a cutting member |
| US20180168648A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Durability features for end effectors and firing assemblies of surgical stapling instruments |
| US10835246B2 (en) | 2016-12-21 | 2020-11-17 | Ethicon Llc | Staple cartridges and arrangements of staples and staple cavities therein |
| JP7010956B2 (ja) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | 組織をステープル留めする方法 |
| US10639034B2 (en) | 2016-12-21 | 2020-05-05 | Ethicon Llc | Surgical instruments with lockout arrangements for preventing firing system actuation unless an unspent staple cartridge is present |
| US10695055B2 (en) | 2016-12-21 | 2020-06-30 | Ethicon Llc | Firing assembly comprising a lockout |
| US10485543B2 (en) | 2016-12-21 | 2019-11-26 | Ethicon Llc | Anvil having a knife slot width |
| US10542982B2 (en) | 2016-12-21 | 2020-01-28 | Ethicon Llc | Shaft assembly comprising first and second articulation lockouts |
| US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
| US20180168618A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling systems |
| US10537325B2 (en) | 2016-12-21 | 2020-01-21 | Ethicon Llc | Staple forming pocket arrangement to accommodate different types of staples |
| US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
| US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
| US10610224B2 (en) | 2016-12-21 | 2020-04-07 | Ethicon Llc | Lockout arrangements for surgical end effectors and replaceable tool assemblies |
| US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
| US10898186B2 (en) | 2016-12-21 | 2021-01-26 | Ethicon Llc | Staple forming pocket arrangements comprising primary sidewalls and pocket sidewalls |
| US10758230B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument with primary and safety processors |
| US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
| US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
| US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
| US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
| US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
| US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
| US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
| US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
| USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
| US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
| US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
| US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
| US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
| US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
| US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
| US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
| US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
| USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
| USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
| US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
| US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
| US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
| US11141154B2 (en) | 2017-06-27 | 2021-10-12 | Cilag Gmbh International | Surgical end effectors and anvils |
| US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
| US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
| US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
| US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
| US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
| US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
| US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
| USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
| US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
| US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
| EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
| US10786253B2 (en) | 2017-06-28 | 2020-09-29 | Ethicon Llc | Surgical end effectors with improved jaw aperture arrangements |
| USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
| USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
| US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
| US11389161B2 (en) | 2017-06-28 | 2022-07-19 | Cilag Gmbh International | Surgical instrument comprising selectively actuatable rotatable couplers |
| USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
| US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
| US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
| US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
| US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
| US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
| US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
| US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
| US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
| US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
| US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
| USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
| US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
| USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
| US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
| US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
| US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
| US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
| USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
| US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
| US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
| US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
| US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
| US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
| US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
| US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
| US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
| US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
| US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
| US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
| US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
| US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
| US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
| US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
| US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
| US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
| US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
| US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
| US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
| USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
| US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
| US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
| US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
| US11576668B2 (en) | 2017-12-21 | 2023-02-14 | Cilag Gmbh International | Staple instrument comprising a firing path display |
| US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
| US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
| USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
| US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
| US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
| US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
| US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
| US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
| US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
| US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
| US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
| US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
| US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
| US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
| US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
| US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
| US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
| US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
| US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
| US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
| US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
| US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
| US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
| US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
| US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
| US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
| US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
| US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
| US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
| US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
| US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
| US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
| US11241235B2 (en) | 2019-06-28 | 2022-02-08 | Cilag Gmbh International | Method of using multiple RFID chips with a surgical assembly |
| US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
| US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
| US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
| US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
| US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
| US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
| US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
| US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
| US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
| US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
| US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
| US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
| US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
| US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
| US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
| US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
| US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
| US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
| US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
| US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
| US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
| US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
| US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
| US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
| US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
| US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
| US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
| US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
| USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
| USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
| USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
| USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
| USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
| USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
| USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
| US20220031351A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with differential articulation joint arrangements for accommodating flexible actuators |
| US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
| US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
| US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
| USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
| US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
| US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
| US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
| US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
| USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
| US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
| US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
| US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
| US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
| US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
| US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
| US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
| US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
| US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
| US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
| US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
| US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
| US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
| US11950777B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Staple cartridge comprising an information access control system |
| US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
| US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
| US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
| US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
| US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
| US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
| US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
| US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
| US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
| US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
| US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
| US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
| US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
| US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
| US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
| US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
| US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
| US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
| US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
| US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
| US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
| US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
| US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
| US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
| US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
| US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
| US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
| US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
| US20220378425A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a control system that controls a firing stroke length |
| US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
| US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
| US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE69824137T2 (de) * | 1997-10-02 | 2005-05-25 | Sherwood Services Ag | Einführvorrichtung für einen transanal anastomose ring |
| US20020091397A1 (en) * | 2001-01-05 | 2002-07-11 | Te-Chuan Chen | Structure of intestinal anastomosis gun |
| US7452363B2 (en) * | 2003-09-30 | 2008-11-18 | Ethicon Endo-Surgery, Inc. | Applier for fastener for single lumen access anastomosis |
-
2006
- 2006-10-06 EP EP06021066A patent/EP1908422B1/en active Active
- 2006-10-06 DE DE602006007712T patent/DE602006007712D1/de active Active
- 2006-10-06 AT AT06021066T patent/ATE435613T1/de not_active IP Right Cessation
-
2007
- 2007-08-30 US US11/847,363 patent/US7871418B2/en active Active
- 2007-10-08 CN CN2007101627227A patent/CN101156796B/zh not_active Expired - Fee Related
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103491680A (zh) * | 2013-09-17 | 2014-01-01 | 深圳市朗恒电子有限公司 | 档位控制方法、装置及照明系统 |
| CN103491680B (zh) * | 2013-09-17 | 2017-01-18 | 深圳市朗恒电子有限公司 | 档位控制方法、装置及照明系统 |
| CN104888296A (zh) * | 2015-05-25 | 2015-09-09 | 王洛 | 套管式胃穿刺冲洗减压装置 |
| CN104888296B (zh) * | 2015-05-25 | 2017-10-24 | 王洛 | 套管式胃穿刺冲洗减压装置 |
| CN111601561A (zh) * | 2018-01-10 | 2020-08-28 | C.R.巴德公司 | 铰接式手术器械 |
| CN111601561B (zh) * | 2018-01-10 | 2024-02-02 | C.R.巴德公司 | 铰接式手术器械 |
Also Published As
| Publication number | Publication date |
|---|---|
| ATE435613T1 (de) | 2009-07-15 |
| EP1908422B1 (en) | 2009-07-08 |
| US7871418B2 (en) | 2011-01-18 |
| US20080221596A1 (en) | 2008-09-11 |
| CN101156796B (zh) | 2010-11-17 |
| DE602006007712D1 (de) | 2009-08-20 |
| EP1908422A1 (en) | 2008-04-09 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CN101156796B (zh) | 用于单腔进入吻合的紧固件的施放器 | |
| US9521995B2 (en) | Devices and systems for approximation and fastening of soft tissue | |
| US8357174B2 (en) | Single fold device for tissue fixation | |
| US7743958B2 (en) | End-to-end anastomosis instrument and method for performing same | |
| EP1859745B1 (en) | Endoscopic gastric restriction device | |
| US7309341B2 (en) | Single lumen anastomosis applier for self-deploying fastener | |
| US20060217748A1 (en) | Method for Hybrid Gastro-Jejunostomy | |
| US20120165842A1 (en) | Endoluminal fold creation | |
| US20070162056A1 (en) | Single fold system for tissue approximation and fixation | |
| EP1908419B1 (en) | A locking device for an anastomotic device | |
| MX2007006073A (es) | Dispositivo de fijacion de sutura. | |
| EP1908420A1 (en) | Anastomotic ring device with locking means | |
| WO2006112849A1 (en) | Single fold device for tissue fixation | |
| EP2537471A1 (en) | A surgical fastener having a safety feature | |
| AU2005330683B2 (en) | Single fold device for tissue fixation | |
| US11678885B2 (en) | Circular stapling device and method of use | |
| EP2537473A1 (en) | A surgical stapler having an adjustment feature | |
| WO2012072137A1 (en) | An endoluminal lining system and a method for endoluminally lining a hollow organ | |
| WO2012072136A2 (en) | An endoluminal lining system and a method for endoluminally lining a hollow organ | |
| AU2007201158A1 (en) | Method for hybrid gastro-jejunostomy |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20101117 Termination date: 20201008 |
|
| CF01 | Termination of patent right due to non-payment of annual fee |