CA1270170A - Articulated surgical fastener applying apparatus - Google Patents
Articulated surgical fastener applying apparatusInfo
- Publication number
- CA1270170A CA1270170A CA000516804A CA516804A CA1270170A CA 1270170 A CA1270170 A CA 1270170A CA 000516804 A CA000516804 A CA 000516804A CA 516804 A CA516804 A CA 516804A CA 1270170 A CA1270170 A CA 1270170A
- Authority
- CA
- Canada
- Prior art keywords
- shaft assembly
- fastener
- assembly
- articulation
- holding part
- 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.)
- Expired - Fee Related
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
- A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
- Manipulator (AREA)
Abstract
ARTICULATED SURGICAL
FASTENER APPLYING APPARATUS
Abstract of the Disclosure Surgical fastener applying apparatus having an articulated shaft assembly intermediate a proximal actuator assembly and a distal fastener applying assembly. The rotational axis of the articulation is transverse to the proximal-distal axis of the shaft assembly. The apparatus is fully operational at any rotational position of the articulation. A
detent mechanism may be included to releasably hold the articulation in any of its rotational postions.
A locking mechanism may also be provided for locking the articulation in any of its rotational positions.
The shaft assembly may also include a second articu-lation whose rotational axis is the proximal-distal axis. The apparatus is fully operational at any rotational position of the second articulation, and detent and locking mechanisms may also be associated with the second articulation.
FASTENER APPLYING APPARATUS
Abstract of the Disclosure Surgical fastener applying apparatus having an articulated shaft assembly intermediate a proximal actuator assembly and a distal fastener applying assembly. The rotational axis of the articulation is transverse to the proximal-distal axis of the shaft assembly. The apparatus is fully operational at any rotational position of the articulation. A
detent mechanism may be included to releasably hold the articulation in any of its rotational postions.
A locking mechanism may also be provided for locking the articulation in any of its rotational positions.
The shaft assembly may also include a second articu-lation whose rotational axis is the proximal-distal axis. The apparatus is fully operational at any rotational position of the second articulation, and detent and locking mechanisms may also be associated with the second articulation.
Description
This invention relates to surgical fastener applying apparatus, and more particularly to surgical fastener applying apparatus of the type that applies surgical fasteners to body tissue clamped between relatively movable fastener holding and anvil parts of the apparatus.
Several types of surgical fastener applying instruments are known for applying surgical fasteners to body tissue clamped between relatively movable fastener holding and anvil parts of the apparatus.
See, for example, Hirsch et al. U.S. patent 3,275,211.
The surgical fasteners may be either metal staples as shown in the Hirsch et al. patent, or they may be non-metallic resinous materials as shown, for example, in Green U.S. patent 4,402,445. In the case of metal staples, the staple legs are typically driven through the tissue and clinched by the anvil to secure the staples in the tissue. In the case of non-metallic fasteners, each fastener may initially consist of two separate parts: a fastener part disposed in the ~5 fastener holding part of the apparatus, and a retainer part disposed in the anvil part of the apparatus.
The leg or legs of the fastener parts are driven through the tissue and interlock with the retainer , .
., V7~
parts to secure the fasteners in the tissue. Although most metal sur~ical staples are biologically inert and therefore remain permanently in the body, biolog-ically absorbable metal surgical staples are known.
Surgical fasteners of non-metallic resinous materials can also be made either biologically absorbable or non-absorbable.
The type or orm of the fasteners employed forms no part of the present invention. As used herein, the term "surgical fastener" is yeneric to all of the above~mentioned fastener t~pes. Similarly, the terms "fastener holding part" and "anvil part"
are also used generically herein.
In most of the known instruments for applying surgical fasteners to tissue clamped between the fastener holding and anvil parts of the instru-ment, the distal fastener applying assembly (which includes the fastener holding and anvil parts) of the instrument is rigidly connected to the proximal actuator portion of the instrument. This is true, for example, of the instruments shown in the above-mentioned Hirsch et al. and Green patents.
Recently, however, there has been increasing interest in instruments in which the connection between the fastener applying asse~bly and the actuator assembly is not completely rigid. For example, Noiles et al. U.S. patent 4,473,077 shows a surgical stapler in which the shaft assembly connected between the fastener applying and actuator assemblies is transversely flexible in one plane (i.e., the plane of the paper in Noiles et al. Figure 5). This may be a desirable feature in an instrument of the type shown by Noiles et al. which is intended for insertion into a tubular body organ. In such appli-cations, the flexible shaft of the instrument conformsto the curval;ure of the surrounding body organ.
However, in instruments which are not usually 7~
supported by surrounding body structures (e.g.l instruments of the type shown in the above-mentioned Hirsch et al. and Green patents), excessive flexibility in the instrument between the fastener applying and actuator assemblies may mean that the location of the fastener applying assembly cannot be controlled from the actuator assembly and that each oE these assemblies must be separately supported during placement of the instrument relative to the tissue to be fastened. This may mean that two people are required to handle the instrument during placement and removal.
In view of the forgoing, it is an object of this invention to provide surgical fastener applying apparatus of the type described above in which the Eastener applying assembly is not rigi.dly connected to the actuator assembly, but in which the location of the fastener applying assembly can be substantially controlled from the actuator assembly.
. It is another object of this invention ~o provide surgical fastener applying apparatus of the type described above in which -the fastener applying assembly is not rigidly connected to the actuator assembly, but in which the fastener applying assembly can be completely controlled from the actuator assembly with the fastener applying assembly in any position relative to the actuator assembly.
Accordingly, one aspect of the invention provides surgical fastener applying apparatus comprising:
Sa) distal fastener applying assembly including a fastener holding part initially conta.ining at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and ~c) first means for driving the fastener from the fastener holding part at. least partially through the clamped tissue to the anvil part, a proximal actuator assembly including second means for producing the work necessary to operate the first means, and a longitudinal .
r3 J
- 3a -shaft assembly for suppor-ting the fastener applyin~
assembly relative to the actuator assembly and for transmitting -the work produced by the second means to the first means, the shaf-t assembly including a first articulation for allowing rotation of -the fastener applying assembly relative -to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means a-t any rotational positiDn of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the Eirst axis, the shaft assembly further including first stop means for preventing the fastener applying assembly from rotating relative to the actuator assembly for more -than a prede-termined amount in either direction about the first axis.
Ano-ther aspect of the invention provides apparatus for clampiny tissue and applying a plurality of surgical fasteners in a linear array, to the clamped tissue comprising: a pro~imal actuator assembly including (a) a main body and (b) first means movably mounted on the main body for producing the work necessary to clamp the tissue and apply the fasteners, a distal fastener applying assembly including (a) a U shaped Erame hav;ng substantially parallel distal and proximal legs joined together at one end by a base, ~b) an anvil part moun-ted on the distal leg of the frame, (c~ a fastener holding part disposed adjacent the proximal leg of the frame, Id~
second means for mov:ing .the proximal leg of the frame relative to the fa tener holding part so that the frame can be moved proximally toward the fast~ner holding part to clamp the tissue bqtween the anvil part and the fastqner holding part, and (e) third means for driving the fasteners from the fastener holding part at least 3~ partly through the clamped tissue to the anvil part, and a longitudinal shaft assembly for supporting the fastener holding part at a fixed distance from the main body and for operatively transmitting the work produced by the . ~ ~
"
~'7~
- 3b -first means to the second and -third means. Thus, the invention provides suryical Eas-tener applying apparatus in which the fastener applying assembly is connected to -the ac-tuator assembly by a longitudinal shaf-t assembly including an articulation Eor allowing rvtatiorl of the fastener applying assembly rela-tive to the actuator assembly about an ~'7~
axis which is transverse to the longitudinal axis of the shaft assembly. The shaft assembly is operative in any rotational position of the articulation to transmit from the actuator assembly to the fastener applying assembly the forces and motions ("work") necessary to operate the fastener applying assembly.
The shaft assembly is also preferably rigid about all other axes parallel to the axis of rotation of the above-described articulation.
In the preferred embodiment, multi-position detent means are associated with the articulation to releasably retain the articulation i.n any of a plurality of rotational positions. L.ocking means may also be provided to lock the articulation in any of a plurality of rotational positions. Stop means may also be associated with the articulation to con-fine the articulation to a predetermined rotational range. Both the tissue clamping operation and the fastener applying operation are preferably completely controlled from the actuator assembly, and the neces-sary work is preferably transmitted from the actuator assembly to the fastener applying assembly by shaft assembly members which are proximally movable tension force transmitting members. These members are pref-erably transversely flexible adjacent to the articu-lation, and pass through the articulation along axes which are coincident with the axis of rotation of the articulation. The fastener applying part of the apparatus is preferably mounted at a fixed distance from the main body of the actuator assembly, and the - anvil part is mounted so that it moves toward the fastener holding part in response to appropriate operation of the actuator assembly.
If desired, the shaft assembly may also include a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the ':
q;~
shaf-t assembly. As in the case of the first articu-lation, the shaft assembly is operative in any rotational position of the second articulation to transmit from the actuator assembly -to -the fastener applying assembly the work necessary to operate the fastener applying assembly. Any or all of detent means, locking means, and stop means may be asso-ciated with the second articulation in a manner similar to the association of such elements wi-th the first ar-ticulation.
Embodiments of the i:nvention will now be described in detail and by way of example with reference to the accompanying drawings, in which:
Figure l is a perspective view of an illus-trative embodiment Of sur~ical fastener a~plying apparatus;
Figure 2 is a partly sectional elevational view of the apparatus of Figure l showing an ini-tial stage in the operating cycle of that apparatus;
Figures 3 and 4 are views similar to Figure 2 showing successive stages in the operating cycle of the apparatus of Figure l;
Figure 5 is a partly exploded perspective view of the apparatus of Figure l in the condition shown in Figure 2;
Figure 6 is a partly exploded perspective view of the distal portion of the apparatus of Figure l;
Figure 7 is a fragmentary perspective view of the distal portion of the apparatus of Figure l;
Figure 8 is a further exploded perspective view of the distal portion of the apparatus of Figure 1;J
.,~, .
' Figure 9 is a par-tly sectional elevational view of the distal portion of the apparatus of Figure 1 in the condition shown in Figure 2;
Figures 10-13 are views similar to Figure 9 showing successive stages in t:he operatiny cycle of the apparatus of Figure 1, Figures ~0 an~ 11 showiny the same operating cycle stages as are shown in Figures 3 and 4, respectively;
Figure 14 is a sectional view taken along the line 14-14 in Figure 10;
Figure 15 is a sec-tional view taken along the line 15-15 in E'igure 12;
Figure 16 is an exploded perspective view of the intermediate por-tion of the apparatus of Figure l;
Figure 17 is a partly sectional elevational view of the intermediate portion of the apparatus of Figure 1 ;
Figure 18 is a view similar to Figure 17 showing a different operating condition of the appa-ratus of Figure l;
Figure 19 is a partly sectional bottom plan view of the intermediate portion of the apparatus of Figure 1 in the condition shown in Figure 17;
Figure 20 is a sectional view taken along the line 20-20 in Figure 17; and Figure 21 is a bottom plan view of the distal portion of the apparatus of Figure 1.
I. Overall Construction and Operation As shown in Figure 1, an illustrative embodiment of the surgical fastener applying apparatus or instrument 10 of this invention includes proximal actuator assembly 20, distal fastener applying assembly 200, and intermediate shaft assembly 100.
.
Fastener applying assembly 200 includes proximal fastener holding part 210 which is mounted on the distal end of shaf-t assembly 100 for rotation by hand about axis 112, the rotational axis of first 5 articulation 110. It should be noted that axis 112 is transverse to the longitudinal axis 102 of shaft assembly lOo. In particular, axis 112 is perpendi~
cular to axis 102, although that is not necessarily the case. It should also be noted that axis 112 is parallel to the longitudinal axis of fastener holding part 210, although again that is not necessarily the case. Articulation llO allows fastener applying assembly 200 to be moved to any rotational position about axis 112 within the limits indicated by the ends of double-headed arrow 114 .in Figure 1. In the depicted embodiment, fastener holding assembly 200 can be rotated approximately 90 to either side of axis 102 (total rotation approximately 180).
Shaft assembly 100 also includes a second articulation 140, the components of which are best seen in Figures 16-20 and which is described in greater detail below. In general, articulation 140 allows the distal portion (including articulation 110) of shaft assembly 100 to be rotated by hand relative to the proximal portion of the shaft assembly about longitudinal axis 102. Thus, articulation 140 allows fastener applying assembly 200 to be moved to any rotational position about axis 102 within the limits indicated by the ends of double headed 30 arrow 104 in Figures l and 20. Preferably, actuator assembly 200 can be rotated about axis 102 at least about 90 in either direction from the position shown in Figure l (total rotation at least about 180), more preferably approximately 150~ in either direction from the position shown in Figure 1 (total rotation approximately 300).
, .. .
:: ,.
'7~74~
.
A U-shaped frame 280 is movably mounted on fastener holding part 210. In particular, the prox-imal le~ 282 of frame 280 is adjacent fastener holding par-t 210, while the distal leg 284 of frame 280 is dis-tally spaced from fastener holding part 210.
Anvil part 290 is mounted on distal leg 284.
In use, after fastener applying assembly 200 has been properly oriented by manual operation of arti-culations 110 and 140, tissue 12 to be fastened is located between fastener holdinq part 210 and anvll part 290 with those parts spaced apart as shown in Figure 2. Clamp actuator 50 is then pivoted down by hand toward the main body 30 of actuator assembly 20 as is shown progressively in Fi~ures 3 and 4. This causes frame 280 to translate in the proximal direc~
tion, thereby c]amping tissue 12 between fastener holding part 210 and anvil part 290. The tissue can now be fastened. This is accomplished by manually pivoting safety latch 60 down to the dotted line position shown in Figure 4 and manually pivoting fastener actuator 70 back toward the dotted line position also shown in Figure 4. This causes fastener holding part 210 to drive a plurality of surgical fastener parts 212 (Figures 9-13 and 15) from fastener holding part 210, partly through tissue 12, and into interlocking engagement with retainer parts 214 which are removably mounted in anvil part 290. The tissue fastening procedure is now complete and instrument 10 is removed from the tissue by manually pivoting clamp actuator 50 away from main body 30 to cause anvil part 290 to move distally away from fastener holding part 210, thereby releasing the clamping pressure on the tissue. After use as described above, instrument 10 is discarded.
.
' -:' ' . .
; ~ :
.
Instrument 10 is fully operational in any rotational positions of articulations 110 and 140.
Articulations 110 and 140 allow the surgeon to select any of a wide range of positions of fastener holding assemhly 200 relative to actuator assembly 20, thereby greatly facilitating placement and use of instru-ment 10. Except for articulations 110 and 140 ~and the moving parts associated with each of assem-blies 20, 100, and 200~, instrument 10 is a rigid structure. For example, there is no other axis parallel to axis 112 about which instrument 10 is flexible to any degree. This fact, combined with the detent and locking means associated with each articulation as described in detail below, allows the surgeon to first select the desired relative rotational positions of assemblies 20 and 209, and to thereafter fully control placement and operation of the instrument from the proximal end of the instrument.
Although in the depicted embodiment the tissue is fastened by means of two~part interlocking fasteners which are typically made of a non metallic resinous material, those skilled in the art will appreciate that metal surgical staples could also be used. Similarly, although depicted ins-trument 10 is designed to be discarded after a single use (thereby allowing the hospital to avoid all difficulty and expense associated with cleaning, steriliæing, and reloading the instrument for reuse~, those skilled in the art will also appreciate that the apparatus could be made permanent and reusable if desired.
II. Detailed Construction and Opexation of Actuator Assembly 20 Considering now the construction and opera-tion of actuator assembly 20 in relation -to Figures 2-5, main body 30 is made up of an interior . . .
. .
: ,' ''':'' ..
.: . . .
.. ... ..
..
, ~. .
~2~
frame structure 32 surrounded by two mirror-image shell mer~ers 34 and 36. Clamp actuator 50 is pivot ally connected to main body 30 by means of pivot pin 42. Clamp actuator 50 is also pivotally connected by pivot pin 52 to one end of toggle link 54. The other end of toggle link 54 is pivotally connected by pivot pln 56 to clamp actuator cable anchor 58.
Anchor 58 is mounted in main body 30 for reciprocal motion parallel to axis 102. The proximal end of clamp actuator cable 106 is fixedly attached to anchor 58.
When clamp actuator 50 is pivoted down toward main body 30 as is shown progressively in Figures 2-4, toggle link 54 causes anchor 58 to move in the proximal direction. Cable 106 is pulled in the proximal direction by anchor 58. Anchor 58 is releasably retained in the intermediate rest position shown in Figure 3 by engagement of anchor tooth 59 with frame step 38. This holds actuator assembly 200 in the position shown in Figure 3 even though the manual pivoting force has been removed from clamp actuator 50. The surgeon is thereby afforded an opportunity to inspect and, if necessary, adjust the placement of the instrument relative to tissue 12 while the tissue is substantially enclosed within fastener applying assembly 200 but before full clamping pressure has been applied to the tissue.
If desired, the instrument can be reopened by lifting up on clamp actuator 50, thereby lifting anchor 30 tooth 59 over step 38. Anchor 58 is also releasably retained in the proximal position shown in Figure 4 by virtue of the fact that in that position, pivot pin 52 is slightly over center (i.e., slightly below a line connecting pivot pins 42 and 56 as viewed in Figure 4). Once again, the instrument can be reopened from this position by lifting up on clamp actuator 50.
.. , , ....
:, ' ..
.
7~
Safety latch 60 is pivo-tally connected to main body 30 by pivot pin 44, and fastener actuator 70 is pivotally connected to main body 30 by pivot pin 46. The proximal end of fastener actuator cable 108 is fixedly attached to fastener actuator 70.
Cable 108 is pulled in the proximal direction when fastener actuator 70 is pivoted as shown in F'igure 4.
III. Detailed Construction and Operation of Shaft Assemblv 100 ~ . . .
The construction of shaft assembly 100 is best seen in Figures 16-20. The principal structural member of shaft assembly 100 is tubular member 160 which is fixedly connected adjacent its proximal end to the frame structure 32 of actuator assembly 20.
Cables 106 and 108 pass freely through tube 160.
The proximal portion of tubular stem member 142 fits into the distal end of tube 160 and is rotatable rela-tive to tube 160 to provide articulation 140.
Cables 106 and 108 also pass freely through stem 142 into fastener holding part 210 which is pivotally mounted on the distal end of stem 142 to provide articulation 110.
Stem 142 is retained in tube 160 by the pro]ection of inwardly extending tube shoulders 162 into annular stem groove 144. Another inwardly extending tube shoulder 164 extends into stem groove 146. Groove 146 is interrupted on one side by stop member 148. Accordingly, stem 142 can rotate in either direction relative to tube 160 until stop member 148 contacts shoulder 164. Elements 148 and 164 therefore cooperate to provide stop means for articulation 140.
Tube 160 is surrounded by another tubular structure including tube 170, collar 180, bushin~s 184 and 186, thrust ring 188, and locking ring 190.
Tube 170 and locking ring 190 are rotatable relative - ~
' 3~;2t;JO~
to tube 160. Collar 1~0 is prevented from rotating relative to tube 160 by projection of collar keys 181 in-to tube ke~7ays 166. Bushings 184 and 186 are made of a compressible material such as rubber.
Thrust ring 188 is made of a relatively low friction material such as polytetrafluoroethylene to facili-tate rotation of locking ring 190 relative to ele-ments 180, 184, and 186. Tube 170 is constrained to rotate with stem 142 by virtue of the projeckion of stem keys 150 into keyways 172 near the dis-tal end of tube 170. Arcuate toothed rack 174 adjacent the distal end of tube 170 engages toothed pinion seg ment 116 on fastener holding part 110 Elements 116 and 170 are concentric with axis 112. Proximal-facing teeth 176 on the proximal end of tube 170 engage distal-~acing teeth 182 on collar 180. The end sur-faces 178a and 178b of rack 174 respectively cooperate with the two side plates 218 of fastener holding part 210 to stop the pivoting of fastener applying assembly 200 about axis 112 when assembly 200 has been pivoted about 90 to either side of axis 102.
Accordingly, surfaces 178 and plates 218 cooperate to provide s-top means for articulation 110.
In the unlocked position, locking ring 190 is rotated so that proximally extending teeth 192 extend into relatively deep notches 40a in the distal end of main body 30. In this position of locking ring 190, bushings 184 and 186 are only very lightly compressed between thrust ring 188 and collar 180.
Accordingly, collar 180 and tube 170 are relatively lightly and resiliently urged in the distal direction.
Teeth 182 and 176 are therefore only lightly held in engagement with one another, and that engagement can be relatively easily overcome when fastener applying assembly 200 is deliberately rotated relative to actuator assembly 20 about axis 102. However, the engagement of teeth 182 and 176 is sufficient to ..
~7~
releasably hold ar-ticulation 140 in any rotational position in which teeth 182 and 176 are engaged.
Teeth 182 and 176 and their associated elements therefore comprise detent means for releasably retaining articulation 140 in any of a plurality of rotational positions. On the other hand, when locking ring 190 is rotated so that teeth 192 are displaced from notches 40a ~e.g., to re:Latively shallow notches 40b), locking ring 190 is thereby shifted somewhat in the distal direct:ion. As a result, bush-ings 184 and 186 are more highly compressed, and collar 180 and tube 170 are strongly urged in the distal direction. This causes, teeth 182 and 176 to engage one another much more securely, thereby locking articulation 140 in its current rotational position.
The above-described structure operates in a similar manner in relation to rack 174 and pinion 116. When locking ring teeth 192 are aligned with notches 40a, rack 174 engages pinion 116 only relatively lightly, and elements 116 and 174 there-fore act as detent means for releasably holding articulation 110 in any of a plurality of rotational positions. When locking ring teeth 192 are not aligned with notches 40a, rack 174 engages pinion 116 much more securely, thereby locking articulation 110 in its current position.
In use, the surgeon typically manually rotates fastener applying assembly 200 relative to actuator assembly 20 about either or both of articu-lation axes 102 and 112. Detent elements 116, 174, 176, and 182 releasably hold assemblies 20 and 200 in the selected relative positions. When the surgeon is satisfied with the relative positions of assem blies 20 and 200, the surgeon rotates locking ring 190 so that teeth 192 move from notches 40a to notches 40b, thereby locking articulations 110 and 140 in their current positions. If further adjust-., .
, , `
;
;~.;, . . . i , '71D
-~4-ment is required, locklng ring 190 can be rotated again to align teeth 192 with notches 40a, thereby unlocking articulations 110 and 140.
IV. Detailed Construction and Operation of Fastener Applyinc~ Assembly 200 Considering now the detailed construction and operation of fastener applying assembly 200 as shown in Figures 6-15, fastener holding par-t 210 is, as has been mentioned, pivotally mounted on the distal end of stem 142 to provide articulation 110. Movably mounted on each side of fastener holding part 210 is a frame mounting cam plate 260a or 260b. Each of cam plates 260 is sandwiched between fastener holding part 210 and the adjacent lateral side of the proximal leg 282 of frame structure 280. Cam plates 260 are guided for vertical reciprocation relative to fastener holding part 210 by projection of cam followers 262 into cam slots 216 in the sides of fastener holding part 210. Frame 280 is positioned in relation to fastener holding part 210 by the projection of cam followers 286 into cam slots 264 in cam plates 260, by the projection of finger 288 between fastener holding part side plates 218, and by the projection of pin 289 into 510t5 220 in plates 218. Frame 280 is resiliently urged in the distal direction by pre-stressed compression coil spring 224 acting between fastener holding part 210 and frame 280.
Each of cam plates 260 has a finger 266 which extends into a vertical opening 222 near the rear of fastener holding part 210. Fingers 266 overlap one another inside opening 222, and the distal end of clamp actuator cable 106 is anchored to the fingers where they overlap (see Figure 7). Cam plates 260 are resiliently urged upward relative to fastener holcling part 210 by prestressed compression ., , .
: ':: ' ` ` ; `
.:
.
71El coil spring 226 acting between fingers 266 and asurface of fastener holding part 210.
In order to reach fingers 266, the distal end portion of cable 106 is redirected approximately 90 by the distal end portion of stem 142 from an alignmen-t in shaft assembly 100 parallel to axis 102 to an alignment in fastener holding part 210 parallel to axis 112 (see Figures 7 and 9-13). Accordingly, when clamp actuator 50 pulls cable 106 in the proximal direction, the distal end of cable 106 pulls cam plates 260 vertically down re:Lative to fastener holding part 210 as shown progressively in Fig-ures 9-12. The presence of p.in 289 in slots 220 prevents frame 280 from moving downwardly with cam plates 260. Accordingly, cam followers 286 are con-strained to move up along cam slots 264, thereby causing frame 280 to move in the proximal direction.
Pin 289 moves with frame 280 in the pxoximal direc-tion, traversing slots 220. Cam slots 264 are shaped to cause distal frame leg 284 to first pivot into-parallelism with the distal face of fastener holding part 210, and to then translate proximally toward fastener holding part 210 50 that at the end of the stroke of clamp actuator 50, the tissue 12 to be fastened is clamped between the distal face of fastener holdin~ part 210 and the parallel proximal face of anvil part 290.
Proper alignment between fas-tener holdin~
part 210 and anvil part 290 is facilitated by align-ment pin 230 which automatically extends from fastener holding part 210 into anYil part 290 as tissue 12 isclamped. Alignment pin 230 is reciprocated by pin carrier 232 which is pivotally mounted on the rear of fastener holding part 210. Pin carrier 232 is resiliently biased to retract pin 230 in the proximal direction as shown in Figure 9 by leaf spring 234.
The lower portion of pin carrier 232 includes c~m , ~27(~7(~
follower surfaces 236 which are in contact with cam surfaces 268 on the proximal edges of cam plates 260.
Surfaces 236 and 268 are cooperatively shaped to allow spring 234 to proximally retract alignment pin 230 when cam plates 260 are in their uppermost positions, and to pivot pin carrier 232 and thereby distally extend alignment pin 230 as cam plates 260 are pulled down by cable 106. By the time clamp actuator 50 has reached the intermediate rest posi-tion shown in Figuxe 3 (with tooth 59 engaging step 38), alignment pin 230 is fully extended and has begun to enter anvil aperture 292 as shown in Figure 10. Accordingly, alignment pin 230 helps to confine tissue 12 to the space between fastener hold-ing part 210 and anvil part 290 during any instrument placement adjustments the surgeon may wish to make and during final clamping of the tissue. When tissue clamping continues as shown in Figure 11, anvil aper-ture 292 is pulled farther onto the distal end of alignment pln 230, thereby ensuring proper alignment of fastener holding part 210 and anvil part 290.
After tissue 12 has been clamped as described above, fastener parts 212 are driven by elements best seen in Figures 7-13 and 15. Fastener parts 212 are initially disposed in apertures 242 in holder 240 which forms the distal portion of fastener holding part 210. A pusher finger 244 extends into the rear of each aperture 242. Pusher fingers 244 may be advantageously interconnected in small groups (e.g., pairs) to reduce the number of separate parts and to stabilize the individual pusher fingers without creating a single large pusher structure that might tend to bind in apertures 242. The proximal ends of all of pusher fingers 244 are spanned by a single rigid pusher follower member 246. Pusher actuator 248 is located on the proximal side of follower ~46 and is supported by cam follower pins 250 which extend .~, : ;;' , ' .
. ... : .
"' ~ '' ~,:
.:' ,. , ':
~ :
::
7~
in-to c~ slots 252 in the side plates 218 of fastener holding part 210.
The distal end of fastener actuator cable 108 is attached to pusher actuator 248. As in the case of cable 106, the distal end portion of cable 108 is redirected approximately 90 by the distal end portion of stem 142 from an alignment in shaft assembly 100 parallel to axis 102 to an align-ment in fastener holding part 210 parallel to axis 11 in order to reach pusher actuator 248. When fastener actuator 70 is operated to pull cable 108 in the proximal direction, the distal end of cable 108 pulls down on pusher ac-tuator ~48. As pusher actuator 248 moves down, it is also forced to move in the distal direction by cooperation of elements 250 and 252 (see Figure 12). The distal motion of pusher actu-ator 248 is imparted to pusher fingers 244 via pusher follower 246, thereby driving fastener parts 212 partly through tissue 12 and into interlocking engage-ment with retainer parts 214 to fasten the tissue.
After tissue 12 has been fastened as des-cribed above, the clamping pressure on the tissue is released by raising clamp actuator 50. Springs 224 and 226 restore cam plates 260 and fr~me 280 to their initial positions, and spring 234 causes proximal retraction of alignment pin 230. Accordingly, fastened tissue 12 is released from the instrument as shown in Figure 13 and the instrument can be removed from the surgical site.
It should be noted that the work required for tissue clamping and fastener application is transmitted from actuator assembly 20 to fastener applying assembly 200 by proximally movable tension force transmitting members 106 and 108 which are both transversely and torsionally flexible. The transverse flexibility of cables 106 and 108 allows them to be redirected adjacent the distal end of , .~..
, .
t'~
18^
stem 142. It should also be noted that the path lengths of cables 106 and 108 are substantially unaffected by the rotational positions of articula-tions llO and 140 because each cable is substantially coincident with the axis 102 or 112 of each articu-lation at the location of that articulation. For example, cables 106 and 108 are both substantially coincident with axis 102 at the point where stem 142 rotates relative to tube 160. Accordingly, cables 106 and 108 twist slightly when articulation 140 is oper-ated, but the path lengths of cables 106 and 108 do not change significantly. Similarly, cables 106 and 108 are both substantially coincident with axis 112 at the point where fastener holding part 210 is rotatably mounted on stem 142. Thus again, operation of articulation 140 causes cables 106 and 108 to twist slightly but does not significantly alter the path length of either cable. (As used in this con-text, the term "coincident" means that cables 106 and 108 either approximately intersect or are approx-imately coaxial with the specified axis at the specified location.) The transverse and torsional flexibility of cables 106 and 108 and the constant path lengths of those cables facilitate articulation of the instrument as described above and allow operation of the instrument with articulations llO
and 140 at any of their rotational positions.
.
. ~ "
Several types of surgical fastener applying instruments are known for applying surgical fasteners to body tissue clamped between relatively movable fastener holding and anvil parts of the apparatus.
See, for example, Hirsch et al. U.S. patent 3,275,211.
The surgical fasteners may be either metal staples as shown in the Hirsch et al. patent, or they may be non-metallic resinous materials as shown, for example, in Green U.S. patent 4,402,445. In the case of metal staples, the staple legs are typically driven through the tissue and clinched by the anvil to secure the staples in the tissue. In the case of non-metallic fasteners, each fastener may initially consist of two separate parts: a fastener part disposed in the ~5 fastener holding part of the apparatus, and a retainer part disposed in the anvil part of the apparatus.
The leg or legs of the fastener parts are driven through the tissue and interlock with the retainer , .
., V7~
parts to secure the fasteners in the tissue. Although most metal sur~ical staples are biologically inert and therefore remain permanently in the body, biolog-ically absorbable metal surgical staples are known.
Surgical fasteners of non-metallic resinous materials can also be made either biologically absorbable or non-absorbable.
The type or orm of the fasteners employed forms no part of the present invention. As used herein, the term "surgical fastener" is yeneric to all of the above~mentioned fastener t~pes. Similarly, the terms "fastener holding part" and "anvil part"
are also used generically herein.
In most of the known instruments for applying surgical fasteners to tissue clamped between the fastener holding and anvil parts of the instru-ment, the distal fastener applying assembly (which includes the fastener holding and anvil parts) of the instrument is rigidly connected to the proximal actuator portion of the instrument. This is true, for example, of the instruments shown in the above-mentioned Hirsch et al. and Green patents.
Recently, however, there has been increasing interest in instruments in which the connection between the fastener applying asse~bly and the actuator assembly is not completely rigid. For example, Noiles et al. U.S. patent 4,473,077 shows a surgical stapler in which the shaft assembly connected between the fastener applying and actuator assemblies is transversely flexible in one plane (i.e., the plane of the paper in Noiles et al. Figure 5). This may be a desirable feature in an instrument of the type shown by Noiles et al. which is intended for insertion into a tubular body organ. In such appli-cations, the flexible shaft of the instrument conformsto the curval;ure of the surrounding body organ.
However, in instruments which are not usually 7~
supported by surrounding body structures (e.g.l instruments of the type shown in the above-mentioned Hirsch et al. and Green patents), excessive flexibility in the instrument between the fastener applying and actuator assemblies may mean that the location of the fastener applying assembly cannot be controlled from the actuator assembly and that each oE these assemblies must be separately supported during placement of the instrument relative to the tissue to be fastened. This may mean that two people are required to handle the instrument during placement and removal.
In view of the forgoing, it is an object of this invention to provide surgical fastener applying apparatus of the type described above in which the Eastener applying assembly is not rigi.dly connected to the actuator assembly, but in which the location of the fastener applying assembly can be substantially controlled from the actuator assembly.
. It is another object of this invention ~o provide surgical fastener applying apparatus of the type described above in which -the fastener applying assembly is not rigidly connected to the actuator assembly, but in which the fastener applying assembly can be completely controlled from the actuator assembly with the fastener applying assembly in any position relative to the actuator assembly.
Accordingly, one aspect of the invention provides surgical fastener applying apparatus comprising:
Sa) distal fastener applying assembly including a fastener holding part initially conta.ining at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and ~c) first means for driving the fastener from the fastener holding part at. least partially through the clamped tissue to the anvil part, a proximal actuator assembly including second means for producing the work necessary to operate the first means, and a longitudinal .
r3 J
- 3a -shaft assembly for suppor-ting the fastener applyin~
assembly relative to the actuator assembly and for transmitting -the work produced by the second means to the first means, the shaf-t assembly including a first articulation for allowing rotation of -the fastener applying assembly relative -to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means a-t any rotational positiDn of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the Eirst axis, the shaft assembly further including first stop means for preventing the fastener applying assembly from rotating relative to the actuator assembly for more -than a prede-termined amount in either direction about the first axis.
Ano-ther aspect of the invention provides apparatus for clampiny tissue and applying a plurality of surgical fasteners in a linear array, to the clamped tissue comprising: a pro~imal actuator assembly including (a) a main body and (b) first means movably mounted on the main body for producing the work necessary to clamp the tissue and apply the fasteners, a distal fastener applying assembly including (a) a U shaped Erame hav;ng substantially parallel distal and proximal legs joined together at one end by a base, ~b) an anvil part moun-ted on the distal leg of the frame, (c~ a fastener holding part disposed adjacent the proximal leg of the frame, Id~
second means for mov:ing .the proximal leg of the frame relative to the fa tener holding part so that the frame can be moved proximally toward the fast~ner holding part to clamp the tissue bqtween the anvil part and the fastqner holding part, and (e) third means for driving the fasteners from the fastener holding part at least 3~ partly through the clamped tissue to the anvil part, and a longitudinal shaft assembly for supporting the fastener holding part at a fixed distance from the main body and for operatively transmitting the work produced by the . ~ ~
"
~'7~
- 3b -first means to the second and -third means. Thus, the invention provides suryical Eas-tener applying apparatus in which the fastener applying assembly is connected to -the ac-tuator assembly by a longitudinal shaf-t assembly including an articulation Eor allowing rvtatiorl of the fastener applying assembly rela-tive to the actuator assembly about an ~'7~
axis which is transverse to the longitudinal axis of the shaft assembly. The shaft assembly is operative in any rotational position of the articulation to transmit from the actuator assembly to the fastener applying assembly the forces and motions ("work") necessary to operate the fastener applying assembly.
The shaft assembly is also preferably rigid about all other axes parallel to the axis of rotation of the above-described articulation.
In the preferred embodiment, multi-position detent means are associated with the articulation to releasably retain the articulation i.n any of a plurality of rotational positions. L.ocking means may also be provided to lock the articulation in any of a plurality of rotational positions. Stop means may also be associated with the articulation to con-fine the articulation to a predetermined rotational range. Both the tissue clamping operation and the fastener applying operation are preferably completely controlled from the actuator assembly, and the neces-sary work is preferably transmitted from the actuator assembly to the fastener applying assembly by shaft assembly members which are proximally movable tension force transmitting members. These members are pref-erably transversely flexible adjacent to the articu-lation, and pass through the articulation along axes which are coincident with the axis of rotation of the articulation. The fastener applying part of the apparatus is preferably mounted at a fixed distance from the main body of the actuator assembly, and the - anvil part is mounted so that it moves toward the fastener holding part in response to appropriate operation of the actuator assembly.
If desired, the shaft assembly may also include a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the ':
q;~
shaf-t assembly. As in the case of the first articu-lation, the shaft assembly is operative in any rotational position of the second articulation to transmit from the actuator assembly -to -the fastener applying assembly the work necessary to operate the fastener applying assembly. Any or all of detent means, locking means, and stop means may be asso-ciated with the second articulation in a manner similar to the association of such elements wi-th the first ar-ticulation.
Embodiments of the i:nvention will now be described in detail and by way of example with reference to the accompanying drawings, in which:
Figure l is a perspective view of an illus-trative embodiment Of sur~ical fastener a~plying apparatus;
Figure 2 is a partly sectional elevational view of the apparatus of Figure l showing an ini-tial stage in the operating cycle of that apparatus;
Figures 3 and 4 are views similar to Figure 2 showing successive stages in the operating cycle of the apparatus of Figure l;
Figure 5 is a partly exploded perspective view of the apparatus of Figure l in the condition shown in Figure 2;
Figure 6 is a partly exploded perspective view of the distal portion of the apparatus of Figure l;
Figure 7 is a fragmentary perspective view of the distal portion of the apparatus of Figure l;
Figure 8 is a further exploded perspective view of the distal portion of the apparatus of Figure 1;J
.,~, .
' Figure 9 is a par-tly sectional elevational view of the distal portion of the apparatus of Figure 1 in the condition shown in Figure 2;
Figures 10-13 are views similar to Figure 9 showing successive stages in t:he operatiny cycle of the apparatus of Figure 1, Figures ~0 an~ 11 showiny the same operating cycle stages as are shown in Figures 3 and 4, respectively;
Figure 14 is a sectional view taken along the line 14-14 in Figure 10;
Figure 15 is a sec-tional view taken along the line 15-15 in E'igure 12;
Figure 16 is an exploded perspective view of the intermediate por-tion of the apparatus of Figure l;
Figure 17 is a partly sectional elevational view of the intermediate portion of the apparatus of Figure 1 ;
Figure 18 is a view similar to Figure 17 showing a different operating condition of the appa-ratus of Figure l;
Figure 19 is a partly sectional bottom plan view of the intermediate portion of the apparatus of Figure 1 in the condition shown in Figure 17;
Figure 20 is a sectional view taken along the line 20-20 in Figure 17; and Figure 21 is a bottom plan view of the distal portion of the apparatus of Figure 1.
I. Overall Construction and Operation As shown in Figure 1, an illustrative embodiment of the surgical fastener applying apparatus or instrument 10 of this invention includes proximal actuator assembly 20, distal fastener applying assembly 200, and intermediate shaft assembly 100.
.
Fastener applying assembly 200 includes proximal fastener holding part 210 which is mounted on the distal end of shaf-t assembly 100 for rotation by hand about axis 112, the rotational axis of first 5 articulation 110. It should be noted that axis 112 is transverse to the longitudinal axis 102 of shaft assembly lOo. In particular, axis 112 is perpendi~
cular to axis 102, although that is not necessarily the case. It should also be noted that axis 112 is parallel to the longitudinal axis of fastener holding part 210, although again that is not necessarily the case. Articulation llO allows fastener applying assembly 200 to be moved to any rotational position about axis 112 within the limits indicated by the ends of double-headed arrow 114 .in Figure 1. In the depicted embodiment, fastener holding assembly 200 can be rotated approximately 90 to either side of axis 102 (total rotation approximately 180).
Shaft assembly 100 also includes a second articulation 140, the components of which are best seen in Figures 16-20 and which is described in greater detail below. In general, articulation 140 allows the distal portion (including articulation 110) of shaft assembly 100 to be rotated by hand relative to the proximal portion of the shaft assembly about longitudinal axis 102. Thus, articulation 140 allows fastener applying assembly 200 to be moved to any rotational position about axis 102 within the limits indicated by the ends of double headed 30 arrow 104 in Figures l and 20. Preferably, actuator assembly 200 can be rotated about axis 102 at least about 90 in either direction from the position shown in Figure l (total rotation at least about 180), more preferably approximately 150~ in either direction from the position shown in Figure 1 (total rotation approximately 300).
, .. .
:: ,.
'7~74~
.
A U-shaped frame 280 is movably mounted on fastener holding part 210. In particular, the prox-imal le~ 282 of frame 280 is adjacent fastener holding par-t 210, while the distal leg 284 of frame 280 is dis-tally spaced from fastener holding part 210.
Anvil part 290 is mounted on distal leg 284.
In use, after fastener applying assembly 200 has been properly oriented by manual operation of arti-culations 110 and 140, tissue 12 to be fastened is located between fastener holdinq part 210 and anvll part 290 with those parts spaced apart as shown in Figure 2. Clamp actuator 50 is then pivoted down by hand toward the main body 30 of actuator assembly 20 as is shown progressively in Fi~ures 3 and 4. This causes frame 280 to translate in the proximal direc~
tion, thereby c]amping tissue 12 between fastener holding part 210 and anvil part 290. The tissue can now be fastened. This is accomplished by manually pivoting safety latch 60 down to the dotted line position shown in Figure 4 and manually pivoting fastener actuator 70 back toward the dotted line position also shown in Figure 4. This causes fastener holding part 210 to drive a plurality of surgical fastener parts 212 (Figures 9-13 and 15) from fastener holding part 210, partly through tissue 12, and into interlocking engagement with retainer parts 214 which are removably mounted in anvil part 290. The tissue fastening procedure is now complete and instrument 10 is removed from the tissue by manually pivoting clamp actuator 50 away from main body 30 to cause anvil part 290 to move distally away from fastener holding part 210, thereby releasing the clamping pressure on the tissue. After use as described above, instrument 10 is discarded.
.
' -:' ' . .
; ~ :
.
Instrument 10 is fully operational in any rotational positions of articulations 110 and 140.
Articulations 110 and 140 allow the surgeon to select any of a wide range of positions of fastener holding assemhly 200 relative to actuator assembly 20, thereby greatly facilitating placement and use of instru-ment 10. Except for articulations 110 and 140 ~and the moving parts associated with each of assem-blies 20, 100, and 200~, instrument 10 is a rigid structure. For example, there is no other axis parallel to axis 112 about which instrument 10 is flexible to any degree. This fact, combined with the detent and locking means associated with each articulation as described in detail below, allows the surgeon to first select the desired relative rotational positions of assemblies 20 and 209, and to thereafter fully control placement and operation of the instrument from the proximal end of the instrument.
Although in the depicted embodiment the tissue is fastened by means of two~part interlocking fasteners which are typically made of a non metallic resinous material, those skilled in the art will appreciate that metal surgical staples could also be used. Similarly, although depicted ins-trument 10 is designed to be discarded after a single use (thereby allowing the hospital to avoid all difficulty and expense associated with cleaning, steriliæing, and reloading the instrument for reuse~, those skilled in the art will also appreciate that the apparatus could be made permanent and reusable if desired.
II. Detailed Construction and Opexation of Actuator Assembly 20 Considering now the construction and opera-tion of actuator assembly 20 in relation -to Figures 2-5, main body 30 is made up of an interior . . .
. .
: ,' ''':'' ..
.: . . .
.. ... ..
..
, ~. .
~2~
frame structure 32 surrounded by two mirror-image shell mer~ers 34 and 36. Clamp actuator 50 is pivot ally connected to main body 30 by means of pivot pin 42. Clamp actuator 50 is also pivotally connected by pivot pin 52 to one end of toggle link 54. The other end of toggle link 54 is pivotally connected by pivot pln 56 to clamp actuator cable anchor 58.
Anchor 58 is mounted in main body 30 for reciprocal motion parallel to axis 102. The proximal end of clamp actuator cable 106 is fixedly attached to anchor 58.
When clamp actuator 50 is pivoted down toward main body 30 as is shown progressively in Figures 2-4, toggle link 54 causes anchor 58 to move in the proximal direction. Cable 106 is pulled in the proximal direction by anchor 58. Anchor 58 is releasably retained in the intermediate rest position shown in Figure 3 by engagement of anchor tooth 59 with frame step 38. This holds actuator assembly 200 in the position shown in Figure 3 even though the manual pivoting force has been removed from clamp actuator 50. The surgeon is thereby afforded an opportunity to inspect and, if necessary, adjust the placement of the instrument relative to tissue 12 while the tissue is substantially enclosed within fastener applying assembly 200 but before full clamping pressure has been applied to the tissue.
If desired, the instrument can be reopened by lifting up on clamp actuator 50, thereby lifting anchor 30 tooth 59 over step 38. Anchor 58 is also releasably retained in the proximal position shown in Figure 4 by virtue of the fact that in that position, pivot pin 52 is slightly over center (i.e., slightly below a line connecting pivot pins 42 and 56 as viewed in Figure 4). Once again, the instrument can be reopened from this position by lifting up on clamp actuator 50.
.. , , ....
:, ' ..
.
7~
Safety latch 60 is pivo-tally connected to main body 30 by pivot pin 44, and fastener actuator 70 is pivotally connected to main body 30 by pivot pin 46. The proximal end of fastener actuator cable 108 is fixedly attached to fastener actuator 70.
Cable 108 is pulled in the proximal direction when fastener actuator 70 is pivoted as shown in F'igure 4.
III. Detailed Construction and Operation of Shaft Assemblv 100 ~ . . .
The construction of shaft assembly 100 is best seen in Figures 16-20. The principal structural member of shaft assembly 100 is tubular member 160 which is fixedly connected adjacent its proximal end to the frame structure 32 of actuator assembly 20.
Cables 106 and 108 pass freely through tube 160.
The proximal portion of tubular stem member 142 fits into the distal end of tube 160 and is rotatable rela-tive to tube 160 to provide articulation 140.
Cables 106 and 108 also pass freely through stem 142 into fastener holding part 210 which is pivotally mounted on the distal end of stem 142 to provide articulation 110.
Stem 142 is retained in tube 160 by the pro]ection of inwardly extending tube shoulders 162 into annular stem groove 144. Another inwardly extending tube shoulder 164 extends into stem groove 146. Groove 146 is interrupted on one side by stop member 148. Accordingly, stem 142 can rotate in either direction relative to tube 160 until stop member 148 contacts shoulder 164. Elements 148 and 164 therefore cooperate to provide stop means for articulation 140.
Tube 160 is surrounded by another tubular structure including tube 170, collar 180, bushin~s 184 and 186, thrust ring 188, and locking ring 190.
Tube 170 and locking ring 190 are rotatable relative - ~
' 3~;2t;JO~
to tube 160. Collar 1~0 is prevented from rotating relative to tube 160 by projection of collar keys 181 in-to tube ke~7ays 166. Bushings 184 and 186 are made of a compressible material such as rubber.
Thrust ring 188 is made of a relatively low friction material such as polytetrafluoroethylene to facili-tate rotation of locking ring 190 relative to ele-ments 180, 184, and 186. Tube 170 is constrained to rotate with stem 142 by virtue of the projeckion of stem keys 150 into keyways 172 near the dis-tal end of tube 170. Arcuate toothed rack 174 adjacent the distal end of tube 170 engages toothed pinion seg ment 116 on fastener holding part 110 Elements 116 and 170 are concentric with axis 112. Proximal-facing teeth 176 on the proximal end of tube 170 engage distal-~acing teeth 182 on collar 180. The end sur-faces 178a and 178b of rack 174 respectively cooperate with the two side plates 218 of fastener holding part 210 to stop the pivoting of fastener applying assembly 200 about axis 112 when assembly 200 has been pivoted about 90 to either side of axis 102.
Accordingly, surfaces 178 and plates 218 cooperate to provide s-top means for articulation 110.
In the unlocked position, locking ring 190 is rotated so that proximally extending teeth 192 extend into relatively deep notches 40a in the distal end of main body 30. In this position of locking ring 190, bushings 184 and 186 are only very lightly compressed between thrust ring 188 and collar 180.
Accordingly, collar 180 and tube 170 are relatively lightly and resiliently urged in the distal direction.
Teeth 182 and 176 are therefore only lightly held in engagement with one another, and that engagement can be relatively easily overcome when fastener applying assembly 200 is deliberately rotated relative to actuator assembly 20 about axis 102. However, the engagement of teeth 182 and 176 is sufficient to ..
~7~
releasably hold ar-ticulation 140 in any rotational position in which teeth 182 and 176 are engaged.
Teeth 182 and 176 and their associated elements therefore comprise detent means for releasably retaining articulation 140 in any of a plurality of rotational positions. On the other hand, when locking ring 190 is rotated so that teeth 192 are displaced from notches 40a ~e.g., to re:Latively shallow notches 40b), locking ring 190 is thereby shifted somewhat in the distal direct:ion. As a result, bush-ings 184 and 186 are more highly compressed, and collar 180 and tube 170 are strongly urged in the distal direction. This causes, teeth 182 and 176 to engage one another much more securely, thereby locking articulation 140 in its current rotational position.
The above-described structure operates in a similar manner in relation to rack 174 and pinion 116. When locking ring teeth 192 are aligned with notches 40a, rack 174 engages pinion 116 only relatively lightly, and elements 116 and 174 there-fore act as detent means for releasably holding articulation 110 in any of a plurality of rotational positions. When locking ring teeth 192 are not aligned with notches 40a, rack 174 engages pinion 116 much more securely, thereby locking articulation 110 in its current position.
In use, the surgeon typically manually rotates fastener applying assembly 200 relative to actuator assembly 20 about either or both of articu-lation axes 102 and 112. Detent elements 116, 174, 176, and 182 releasably hold assemblies 20 and 200 in the selected relative positions. When the surgeon is satisfied with the relative positions of assem blies 20 and 200, the surgeon rotates locking ring 190 so that teeth 192 move from notches 40a to notches 40b, thereby locking articulations 110 and 140 in their current positions. If further adjust-., .
, , `
;
;~.;, . . . i , '71D
-~4-ment is required, locklng ring 190 can be rotated again to align teeth 192 with notches 40a, thereby unlocking articulations 110 and 140.
IV. Detailed Construction and Operation of Fastener Applyinc~ Assembly 200 Considering now the detailed construction and operation of fastener applying assembly 200 as shown in Figures 6-15, fastener holding par-t 210 is, as has been mentioned, pivotally mounted on the distal end of stem 142 to provide articulation 110. Movably mounted on each side of fastener holding part 210 is a frame mounting cam plate 260a or 260b. Each of cam plates 260 is sandwiched between fastener holding part 210 and the adjacent lateral side of the proximal leg 282 of frame structure 280. Cam plates 260 are guided for vertical reciprocation relative to fastener holding part 210 by projection of cam followers 262 into cam slots 216 in the sides of fastener holding part 210. Frame 280 is positioned in relation to fastener holding part 210 by the projection of cam followers 286 into cam slots 264 in cam plates 260, by the projection of finger 288 between fastener holding part side plates 218, and by the projection of pin 289 into 510t5 220 in plates 218. Frame 280 is resiliently urged in the distal direction by pre-stressed compression coil spring 224 acting between fastener holding part 210 and frame 280.
Each of cam plates 260 has a finger 266 which extends into a vertical opening 222 near the rear of fastener holding part 210. Fingers 266 overlap one another inside opening 222, and the distal end of clamp actuator cable 106 is anchored to the fingers where they overlap (see Figure 7). Cam plates 260 are resiliently urged upward relative to fastener holcling part 210 by prestressed compression ., , .
: ':: ' ` ` ; `
.:
.
71El coil spring 226 acting between fingers 266 and asurface of fastener holding part 210.
In order to reach fingers 266, the distal end portion of cable 106 is redirected approximately 90 by the distal end portion of stem 142 from an alignmen-t in shaft assembly 100 parallel to axis 102 to an alignment in fastener holding part 210 parallel to axis 112 (see Figures 7 and 9-13). Accordingly, when clamp actuator 50 pulls cable 106 in the proximal direction, the distal end of cable 106 pulls cam plates 260 vertically down re:Lative to fastener holding part 210 as shown progressively in Fig-ures 9-12. The presence of p.in 289 in slots 220 prevents frame 280 from moving downwardly with cam plates 260. Accordingly, cam followers 286 are con-strained to move up along cam slots 264, thereby causing frame 280 to move in the proximal direction.
Pin 289 moves with frame 280 in the pxoximal direc-tion, traversing slots 220. Cam slots 264 are shaped to cause distal frame leg 284 to first pivot into-parallelism with the distal face of fastener holding part 210, and to then translate proximally toward fastener holding part 210 50 that at the end of the stroke of clamp actuator 50, the tissue 12 to be fastened is clamped between the distal face of fastener holdin~ part 210 and the parallel proximal face of anvil part 290.
Proper alignment between fas-tener holdin~
part 210 and anvil part 290 is facilitated by align-ment pin 230 which automatically extends from fastener holding part 210 into anYil part 290 as tissue 12 isclamped. Alignment pin 230 is reciprocated by pin carrier 232 which is pivotally mounted on the rear of fastener holding part 210. Pin carrier 232 is resiliently biased to retract pin 230 in the proximal direction as shown in Figure 9 by leaf spring 234.
The lower portion of pin carrier 232 includes c~m , ~27(~7(~
follower surfaces 236 which are in contact with cam surfaces 268 on the proximal edges of cam plates 260.
Surfaces 236 and 268 are cooperatively shaped to allow spring 234 to proximally retract alignment pin 230 when cam plates 260 are in their uppermost positions, and to pivot pin carrier 232 and thereby distally extend alignment pin 230 as cam plates 260 are pulled down by cable 106. By the time clamp actuator 50 has reached the intermediate rest posi-tion shown in Figuxe 3 (with tooth 59 engaging step 38), alignment pin 230 is fully extended and has begun to enter anvil aperture 292 as shown in Figure 10. Accordingly, alignment pin 230 helps to confine tissue 12 to the space between fastener hold-ing part 210 and anvil part 290 during any instrument placement adjustments the surgeon may wish to make and during final clamping of the tissue. When tissue clamping continues as shown in Figure 11, anvil aper-ture 292 is pulled farther onto the distal end of alignment pln 230, thereby ensuring proper alignment of fastener holding part 210 and anvil part 290.
After tissue 12 has been clamped as described above, fastener parts 212 are driven by elements best seen in Figures 7-13 and 15. Fastener parts 212 are initially disposed in apertures 242 in holder 240 which forms the distal portion of fastener holding part 210. A pusher finger 244 extends into the rear of each aperture 242. Pusher fingers 244 may be advantageously interconnected in small groups (e.g., pairs) to reduce the number of separate parts and to stabilize the individual pusher fingers without creating a single large pusher structure that might tend to bind in apertures 242. The proximal ends of all of pusher fingers 244 are spanned by a single rigid pusher follower member 246. Pusher actuator 248 is located on the proximal side of follower ~46 and is supported by cam follower pins 250 which extend .~, : ;;' , ' .
. ... : .
"' ~ '' ~,:
.:' ,. , ':
~ :
::
7~
in-to c~ slots 252 in the side plates 218 of fastener holding part 210.
The distal end of fastener actuator cable 108 is attached to pusher actuator 248. As in the case of cable 106, the distal end portion of cable 108 is redirected approximately 90 by the distal end portion of stem 142 from an alignment in shaft assembly 100 parallel to axis 102 to an align-ment in fastener holding part 210 parallel to axis 11 in order to reach pusher actuator 248. When fastener actuator 70 is operated to pull cable 108 in the proximal direction, the distal end of cable 108 pulls down on pusher ac-tuator ~48. As pusher actuator 248 moves down, it is also forced to move in the distal direction by cooperation of elements 250 and 252 (see Figure 12). The distal motion of pusher actu-ator 248 is imparted to pusher fingers 244 via pusher follower 246, thereby driving fastener parts 212 partly through tissue 12 and into interlocking engage-ment with retainer parts 214 to fasten the tissue.
After tissue 12 has been fastened as des-cribed above, the clamping pressure on the tissue is released by raising clamp actuator 50. Springs 224 and 226 restore cam plates 260 and fr~me 280 to their initial positions, and spring 234 causes proximal retraction of alignment pin 230. Accordingly, fastened tissue 12 is released from the instrument as shown in Figure 13 and the instrument can be removed from the surgical site.
It should be noted that the work required for tissue clamping and fastener application is transmitted from actuator assembly 20 to fastener applying assembly 200 by proximally movable tension force transmitting members 106 and 108 which are both transversely and torsionally flexible. The transverse flexibility of cables 106 and 108 allows them to be redirected adjacent the distal end of , .~..
, .
t'~
18^
stem 142. It should also be noted that the path lengths of cables 106 and 108 are substantially unaffected by the rotational positions of articula-tions llO and 140 because each cable is substantially coincident with the axis 102 or 112 of each articu-lation at the location of that articulation. For example, cables 106 and 108 are both substantially coincident with axis 102 at the point where stem 142 rotates relative to tube 160. Accordingly, cables 106 and 108 twist slightly when articulation 140 is oper-ated, but the path lengths of cables 106 and 108 do not change significantly. Similarly, cables 106 and 108 are both substantially coincident with axis 112 at the point where fastener holding part 210 is rotatably mounted on stem 142. Thus again, operation of articulation 140 causes cables 106 and 108 to twist slightly but does not significantly alter the path length of either cable. (As used in this con-text, the term "coincident" means that cables 106 and 108 either approximately intersect or are approx-imately coaxial with the specified axis at the specified location.) The transverse and torsional flexibility of cables 106 and 108 and the constant path lengths of those cables facilitate articulation of the instrument as described above and allow operation of the instrument with articulations llO
and 140 at any of their rotational positions.
.
. ~ "
Claims (40)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. Surgical fastener applying apparatus comprising:
(a) distal fastener applying assembly including a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener front the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means, the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including first stop means for preventing the fastener applying assembly from rotating relative to the actuator assembly for more than a predetermined amount in either direction about the first axis.
(a) distal fastener applying assembly including a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener front the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means, the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including first stop means for preventing the fastener applying assembly from rotating relative to the actuator assembly for more than a predetermined amount in either direction about the first axis.
2. The apparatus defined in claim 1, wherein the first stop means allows the fastener applying assembly to rotate at least 180° about the first axis relative to the actuator assembly.
3. Surgical fastener applying apparatus comprising:
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means, the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the second articulation, the shaft assembly also including second detent means for releasably retaining the second articulation in any of a plurality of rotational positions.
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means, the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the second articulation, the shaft assembly also including second detent means for releasably retaining the second articulation in any of a plurality of rotational positions.
4. Surgical fastener applying apparatus comprising:
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means in the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the second articulation, the shaft assembly also including second locking means for locking the second articulation in any of a plurality of rotational positions.
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means in the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the second articulation, the shaft assembly also including second locking means for locking the second articulation in any of a plurality of rotational positions.
5. Surgical fastener applying apparatus comprising:
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means, the shaft assembly comprising a tube and means including a single first articulation at one end of said tube for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly further including a second articulation for allowing rotation of the fastener applying assembly and the first axis relative to the actuator assembly about the longitudinal axis of the axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation and at any rotational positional of the second articulation, and the shaft assembly being substantially inflexible about all axes other than the first axis transverse to the longitudinal axis of the shaft assembly.
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for producing the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means, the shaft assembly comprising a tube and means including a single first articulation at one end of said tube for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly further including a second articulation for allowing rotation of the fastener applying assembly and the first axis relative to the actuator assembly about the longitudinal axis of the axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation and at any rotational positional of the second articulation, and the shaft assembly being substantially inflexible about all axes other than the first axis transverse to the longitudinal axis of the shaft assembly.
6. Surgical fastener applying apparatus comprising:
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including first detent means for releasably retaining the first articulation in any of a plurality of rotational positions so that the fastener applying assembly can be rotated from one rotational position to another merely by a manual application of a torque above a predetermined threshold.
a distal fastener applying assembly including (a) a fastener holding part initially containing at least one surgical fastener, (b) an anvil part movable relative to the fastener holding part for clamping tissue to be fastened between the fastener holding part and the anvil part, and (c) first means for driving the fastener from the fastener holding part at least partially through the clamped tissue to the anvil part;
a proximal actuator assembly including second means for the work necessary to operate the first means; and a longitudinal shaft assembly for supporting the fastener applying assembly relative to the actuator assembly and for transmitting the work produced by the second means to the first means the shaft assembly including a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the first articulation, and the shaft assembly being substantially inflexible about all other axes parallel to the first axis, the shaft assembly further including first detent means for releasably retaining the first articulation in any of a plurality of rotational positions so that the fastener applying assembly can be rotated from one rotational position to another merely by a manual application of a torque above a predetermined threshold.
7. The apparatus defined in claim 1, wherein the first axis is perpendicular to the longitudinal axis of the shaft assembly.
8. The apparatus defined in claim 7, wherein the first axis is adjacent to the distal end of the shaft assembly.
9. The apparatus defined in claim 6, wherein the shaft assembly further includes first locking means for locking the first articulation in any of a plurality of rotational positions to that a rotation of said fastener applying assembly from one rotational position to another upon an actuation of said locking means requires a deactuation of said locking means in addition and prior to a manual application of a torque above said predetermined threshold.
10. The apparatus defined in claim 1, wherein the shaft assembly further includes first stop means for preventing the fastener applying assembly from rotating relative to the actuator assembly more than a predetermined amount in either direction about the first axis.
11. The apparatus defined in claim 1, wherein the first stop means allows the fastener applying assembly to rotate at least about 180° about the first axis relative to the actuator assembly.
12. The apparatus defined in claim 6, wherein the shaft assembly further includes a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the second means to the first means at any rotational position of the second articulation.
13. The apparatus defined in claim 12, wherein the shaft assembly further includes second detent means for releasably retaining the second articulation in any of a plurality of rotational positions.
14. The apparatus defined in claim 12, wherein the shaft assembly further includes second locking means for locking the second articulation in any of a plurality of rotational positions.
15. The apparatus defined in claim 12, wherein the shaft assembly further includes second stop means for preventing the fastener applying assembly from rotating relative to the actuator assembly more than a predetermined amount in either direction about the longitudinal axis of the shaft assembly.
16. The apparatus defined in claim 1, wherein the second stop means allows the fastener applying assembly to rotate at least about 180° about the longitudinal axis of the shaft assembly.
17. The apparatus defined in claim 1, wherein the shaft assembly transmits the work produced by the second means to the first means via a first proximally movable tension force transmitting member which is transversely and torsionally flexible adjacent the first articulation.
18. The apparatus defined in claim 17, wherein the first member is coincident with the first axis adjacent the first articulation.
19. The apparatus defined in claim 6, wherein the actuator assembly further includes third means for producing the work necessary to move the anvil part relative to the fastener holding part to clamp the tissue, and wherein the shaft assembly further includes fourth means for operatively transmitting the work produced by the third means to the fastener applying assembly, the fourth means being operative to transmit work from the third means to the fastener applying assembly at any rotational position of the first articulation.
20. The apparatus defined in claim 1, wherein the fourth means comprises a second proximally movable tension force transmitting member which is transversely and torsionally flexible adjacent the first articulation.
21. The apparatus defined in claim 20, wherein the second member is coincident with the first axis adjacent the first articulation.
22. The apparatus defined in claim 6, wherein the fastener applying assembly applies a plurality of surgical fasteners in a linear array whose longitudinal axis is transverse to the longitudinal axis of the shaft assembly, and wherein the first axis is parallel to the longitudinal axis of the linear array.
23. The apparatus defined in claim 22, wherein the shaft assembly transmits the work produced by the second means to the first means via a first proximally movable member, wherein the first means drives the fasteners in the distal direction, and wherein the fastener applying assembly further includes means for converting the proximal motion of the first member to distal motion of the first means.
24. Apparatus for clamping tissue and applying a plurality of surgical fasteners in a linear array, to the clamped tissue comprising:
a proximal actuator assembly including (a) a main body and (b) first means movably mounted on the main body for producing the work necessary to clamp the tissue and apply the fasteners;
a distal fastener applying assembly including (a) a U shaped frame having substantially parallel distal and proximal legs joined together at one end by a base, (b) an anvil part mounted on the distal leg of the frame, (c) a fastener holding part disposed adjacent the proximal leg of the frame, (d) second means for moving the proximal leg of the frame relative to the fastener holding part so that the frame can be moved proximally toward the fastener holding part to clamp the tissue between the anvil part and the fastener holding part, and (e) third means for driving the fasteners from the fastener holding part at least partly through the clamped tissue to the anvil part; and a longitudinal shaft assembly for supporting the fastener holding part at a fixed distance from the main body and for operatively transmitting the work produced by the first means to the second and third means.
a proximal actuator assembly including (a) a main body and (b) first means movably mounted on the main body for producing the work necessary to clamp the tissue and apply the fasteners;
a distal fastener applying assembly including (a) a U shaped frame having substantially parallel distal and proximal legs joined together at one end by a base, (b) an anvil part mounted on the distal leg of the frame, (c) a fastener holding part disposed adjacent the proximal leg of the frame, (d) second means for moving the proximal leg of the frame relative to the fastener holding part so that the frame can be moved proximally toward the fastener holding part to clamp the tissue between the anvil part and the fastener holding part, and (e) third means for driving the fasteners from the fastener holding part at least partly through the clamped tissue to the anvil part; and a longitudinal shaft assembly for supporting the fastener holding part at a fixed distance from the main body and for operatively transmitting the work produced by the first means to the second and third means.
25. The apparatus defined in claim 24, wherein the second means comprises:
cam plates mounted on the fastener holding part for motion transverse to the longitudinal axis of the shaft assembly; and cooperating cam and cam follower means on the frame and cam plates for causing the frame to move proximally in response to transverse motion of the cam plates.
cam plates mounted on the fastener holding part for motion transverse to the longitudinal axis of the shaft assembly; and cooperating cam and cam follower means on the frame and cam plates for causing the frame to move proximally in response to transverse motion of the cam plates.
26. The apparatus defined in claim 25, wherein the shaft assembly transmits work from the first means to the second means via a first proximally movable, transversely flexible, tension force transmitting member disposed in the shaft assembly, the distal and of the first member being connected to the cam plates at a point which is transversely spaced from the axis of the first member in the shaft assembly so that proximal motion of the first member produces transverse motion of the cam plates.
27. The apparatus defined in claim 24, wherein the third means drives the fasteners in the distal direction, wherein the shaft assembly transmits work from the first means to the third means via a second proximally movable, transversely flexible, tension force transmitting member disposed in the shaft assembly, and wherein the third means comprises fourth means for converting the proximal motion of the second member to distal motion of the fasteners.
28. The apparatus defined in claim 27, wherein the fourth means comprises:
a pusher actuator member movably mounted in the fastener holding part:
cooperating cam and cam follower means on the pusher actuator member and the fastener holding part for causing the pusher actuator member to move in the distal direction in response to motion of the pusher actuator member transverse to the longitudinal axis of the shaft assembly the distal end of the second member being connected to the pusher actuator member at a point which is transversely spaced from the axis of the second member in the shaft assembly so that proximal motion of the second member produces transverse motion of the pusher actuator member; and pusher means for applying the distal motion of the pusher actuator member to the fasteners.
a pusher actuator member movably mounted in the fastener holding part:
cooperating cam and cam follower means on the pusher actuator member and the fastener holding part for causing the pusher actuator member to move in the distal direction in response to motion of the pusher actuator member transverse to the longitudinal axis of the shaft assembly the distal end of the second member being connected to the pusher actuator member at a point which is transversely spaced from the axis of the second member in the shaft assembly so that proximal motion of the second member produces transverse motion of the pusher actuator member; and pusher means for applying the distal motion of the pusher actuator member to the fasteners.
29. The apparatus defined in claim 24 wherein the shaft assembly includes a first articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about a first axis which is transverse to the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the first means to the second and third means at any rotational position of the first articulation.
30. The apparatus defined in claim 29 wherein the shaft assembly transmits work from the first means to the second and third means via proximally movable tension force transmitting members which are transversely and torsionally flexible adjacent the first articulation and which are coincident with the first axis adjacent the first articulation.
31. The apparatus defined in claim 30 wherein the first axis is adjacent the distal end of the shaft assembly and perpendicular to the longitudinal axis of the shaft assembly.
32. The apparatus defined in claim 29, wherein the shaft assembly further includes first detent means for releasably retaining the first articulation in any of a plurality of rotational positions.
33. The apparatus defined in claim 29. wherein the shaft assembly further includes first locking means for locking the first articulation in any of a plurality of rotational positions.
34. The apparatus defined in claim 24, wherein the shaft assembly includes a second articulation for allowing rotation of the fastener applying assembly relative to the actuator assembly about the longitudinal axis of the shaft assembly, the shaft assembly being operative to transmit work from the first means to the second and third means at any rotational position of the second articulation.
35. The apparatus defined in claim 34, wherein the shaft assembly transmits work from the first means to the second and third means via proximally movable tension force transmitting members which are transversely and torsionally flexible adjacent the second articulation and which are coincident with the longitudinal axis adjacent the second articulation.
36. The apparatus defined in claim 34, wherein the shaft assembly further includes second detent means for releasably retaining the second articulation in any of a plurality of rotational positions.
37. The apparatus defined in claim 34, wherein the shaft assembly further includes second locking means for locking the second articulation in any of a plurality of rotational positions.
38. A surgical fastener applying apparatus comprising a proximal actuator assembly having a main body and a clamp actuator movably mounted on said main body;
a shaft assembly extending from said main body;
a fastener holding part mounted on a distal end of said shaft assembly;
a U-shaped frame movably mounted on said fastener holding part, said frame having a distal leg and a proximal leg receiving said fastener holding part;
an anvil part mounted on said distal leg in facing relation to said fastener holding part; and means connecting said clamp actuator to said frame for moving said frame proximally toward said fastener holding part to clamp tissue between said anvil part and said fastener holding part.
a shaft assembly extending from said main body;
a fastener holding part mounted on a distal end of said shaft assembly;
a U-shaped frame movably mounted on said fastener holding part, said frame having a distal leg and a proximal leg receiving said fastener holding part;
an anvil part mounted on said distal leg in facing relation to said fastener holding part; and means connecting said clamp actuator to said frame for moving said frame proximally toward said fastener holding part to clamp tissue between said anvil part and said fastener holding part.
39. An apparatus as set forth in claim 38 which further comprises means for driving fasteners from said fastener holding part into tissue clamped between said anvil part and said fastener holding part.
40. An apparatus as set forth in claim 39, wherein said fastener holding part is pivotal about a first axis transverse to said shaft assembly and rotatable about a second axis parallel to said shaft assembly.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US771,845 | 1977-02-25 | ||
US06/771,845 US4728020A (en) | 1985-08-30 | 1985-08-30 | Articulated surgical fastener applying apparatus |
Publications (1)
Publication Number | Publication Date |
---|---|
CA1270170A true CA1270170A (en) | 1990-06-12 |
Family
ID=25093116
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA000516804A Expired - Fee Related CA1270170A (en) | 1985-08-30 | 1986-08-26 | Articulated surgical fastener applying apparatus |
Country Status (8)
Country | Link |
---|---|
US (2) | US4728020A (en) |
EP (1) | EP0216532B1 (en) |
JP (1) | JPS62101238A (en) |
AT (1) | ATE61514T1 (en) |
AU (1) | AU586882B2 (en) |
BR (1) | BR8604158A (en) |
CA (1) | CA1270170A (en) |
DE (1) | DE3678080D1 (en) |
Families Citing this family (996)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB8422863D0 (en) * | 1984-09-11 | 1984-10-17 | Univ London | Sewing machine |
US4580712A (en) * | 1984-10-19 | 1986-04-08 | United States Surgical Corporation | Surgical fastener applying apparatus with progressive application of fastener |
GB8800909D0 (en) * | 1988-01-15 | 1988-02-17 | Ethicon Inc | Gas powered surgical stapler |
US4907591A (en) * | 1988-03-29 | 1990-03-13 | Pfizer Hospital Products Group, Inc. | Surgical instrument for establishing compression anastomosis |
US5318221A (en) * | 1989-05-26 | 1994-06-07 | United States Surgical Corporation | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
US5040715B1 (en) * | 1989-05-26 | 1994-04-05 | United States Surgical Corp | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
US5413268A (en) * | 1989-05-26 | 1995-05-09 | United States Surgical Corporation | Apparatus and method for placing stables in laparoscopic or endoscopic procedures |
US5100042A (en) * | 1990-03-05 | 1992-03-31 | United States Surgical Corporation | Surgical fastener apparatus |
US5005754A (en) * | 1990-04-04 | 1991-04-09 | Ethicon, Inc. | Bladder and mandrel for use with surgical stapler |
US5116349A (en) * | 1990-05-23 | 1992-05-26 | United States Surgical Corporation | Surgical fastener apparatus |
CA2052176A1 (en) * | 1990-10-05 | 1992-04-06 | Daniel P. Rodak | Controlled closure mechanism |
DE69120208T3 (en) * | 1990-10-05 | 2001-02-15 | United States Surgical Corp | Device for attaching clips during laparoscopic or endoscopic procedures |
US5470009A (en) * | 1990-12-06 | 1995-11-28 | United States Surgical Corporation | Surgical fastening apparatus with locking mechanism |
CA2055943C (en) * | 1990-12-06 | 2003-09-23 | Daniel P. Rodak | Surgical fastening apparatus with locking mechanism |
CA2098721C (en) * | 1990-12-18 | 2002-10-22 | Alan K. Plyley | Safety device for a surgical stapler cartridge |
CA2060040A1 (en) * | 1991-02-08 | 1992-08-10 | Miguel A. Velez | Surgical staple and endoscopic stapler |
CA2061885A1 (en) * | 1991-03-14 | 1992-09-15 | David T. Green | Approximating apparatus for surgical jaw structure |
US5336232A (en) * | 1991-03-14 | 1994-08-09 | United States Surgical Corporation | Approximating apparatus for surgical jaw structure and method of using the same |
US5217472A (en) * | 1991-05-07 | 1993-06-08 | United States Surgical Corporation | Surgical fastening device |
US5257713A (en) * | 1991-05-07 | 1993-11-02 | United States Surgical Corporation | Surgical fastening device |
US5413267A (en) * | 1991-05-14 | 1995-05-09 | United States Surgical Corporation | Surgical stapler with spent cartridge sensing and lockout means |
US5137198A (en) * | 1991-05-16 | 1992-08-11 | Ethicon, Inc. | Fast closure device for linear surgical stapling instrument |
US5228256A (en) * | 1991-10-02 | 1993-07-20 | Ross Dreveny | Anchor means and apparatus for installing same |
US5431322A (en) * | 1991-10-18 | 1995-07-11 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US5289963A (en) * | 1991-10-18 | 1994-03-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5478003A (en) * | 1991-10-18 | 1995-12-26 | United States Surgical Corporation | Surgical apparatus |
US5326013A (en) * | 1991-10-18 | 1994-07-05 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
AU660712B2 (en) * | 1991-10-18 | 1995-07-06 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5364001A (en) * | 1991-10-18 | 1994-11-15 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US5579978A (en) * | 1991-10-18 | 1996-12-03 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5356064A (en) * | 1991-10-18 | 1994-10-18 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5711472A (en) * | 1991-10-18 | 1998-01-27 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
EP0537571B1 (en) * | 1991-10-18 | 1997-03-05 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5397046A (en) * | 1991-10-18 | 1995-03-14 | United States Surgical Corporation | Lockout mechanism for surgical apparatus |
AU657364B2 (en) * | 1991-10-18 | 1995-03-09 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US5312023A (en) * | 1991-10-18 | 1994-05-17 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US6250532B1 (en) * | 1991-10-18 | 2001-06-26 | United States Surgical Corporation | Surgical stapling apparatus |
CA2078794C (en) * | 1991-10-18 | 1998-10-06 | Frank J. Viola | Locking device for an apparatus for applying surgical fasteners |
US5497933A (en) * | 1991-10-18 | 1996-03-12 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5197649A (en) * | 1991-10-29 | 1993-03-30 | The Trustees Of Columbia University In The City Of New York | Gastrointestinal endoscoptic stapler |
US5240163A (en) * | 1991-10-30 | 1993-08-31 | American Cyanamid Company | Linear surgical stapling instrument |
US5395034A (en) * | 1991-11-07 | 1995-03-07 | American Cyanamid Co. | Linear surgical stapling instrument |
US5271543A (en) * | 1992-02-07 | 1993-12-21 | Ethicon, Inc. | Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism |
US5514157A (en) | 1992-02-12 | 1996-05-07 | United States Surgical Corporation | Articulating endoscopic surgical apparatus |
US5484095A (en) * | 1992-03-31 | 1996-01-16 | United States Surgical Corporation | Apparatus for endoscopically applying staples individually to body tissue |
US5344059A (en) * | 1992-05-19 | 1994-09-06 | United States Surgical Corporation | Surgical apparatus and anvil delivery system therefor |
US5485952A (en) * | 1992-09-23 | 1996-01-23 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5423471A (en) * | 1992-10-02 | 1995-06-13 | United States Surgical Corporation | Apparatus for applying two-part surgical fasteners in laparoscopic or endoscopic procedures |
US5573169A (en) * | 1992-10-02 | 1996-11-12 | United States Surgical Corporation | Apparatus for applying two-part surgical fasteners in laparoscopic or endoscopic procedures |
US5381943A (en) * | 1992-10-09 | 1995-01-17 | Ethicon, Inc. | Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge |
US5626587A (en) * | 1992-10-09 | 1997-05-06 | Ethicon Endo-Surgery, Inc. | Method for operating a surgical instrument |
US5431323A (en) * | 1992-10-09 | 1995-07-11 | Ethicon, Inc. | Endoscopic surgical instrument with pivotable and rotatable staple cartridge |
US5662662A (en) * | 1992-10-09 | 1997-09-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument and method |
US5601224A (en) * | 1992-10-09 | 1997-02-11 | Ethicon, Inc. | Surgical instrument |
US5409498A (en) * | 1992-11-05 | 1995-04-25 | Ethicon, Inc. | Rotatable articulating endoscopic fastening instrument |
US5292334A (en) * | 1993-03-31 | 1994-03-08 | United States Surgical Corporation | Surgical fastener |
CA2159348A1 (en) * | 1993-04-30 | 1994-11-10 | Claude A. Vidal | Surgical instrument having an articulated jaw structure and a detachable knife |
US6716232B1 (en) * | 1993-04-30 | 2004-04-06 | United States Surgical Corporation | Surgical instrument having an articulated jaw structure and a detachable knife |
US5441193A (en) * | 1993-09-23 | 1995-08-15 | United States Surgical Corporation | Surgical fastener applying apparatus with resilient film |
US5439155A (en) * | 1993-10-07 | 1995-08-08 | United States Surgical Corporation | Cartridge for surgical fastener applying apparatus |
US5562682A (en) * | 1993-10-08 | 1996-10-08 | Richard-Allan Medical Industries, Inc. | Surgical Instrument with adjustable arms |
US5487499A (en) * | 1993-10-08 | 1996-01-30 | United States Surgical Corporation | Surgical apparatus for applying surgical fasteners including a counter |
US5560532A (en) * | 1993-10-08 | 1996-10-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to body tissue |
US5465894A (en) * | 1993-12-06 | 1995-11-14 | Ethicon, Inc. | Surgical stapling instrument with articulated stapling head assembly on rotatable and flexible support shaft |
US5405073A (en) * | 1993-12-06 | 1995-04-11 | Ethicon, Inc. | Flexible support shaft assembly |
US5743456A (en) * | 1993-12-16 | 1998-04-28 | Stryker Corporation | Hand actuable surgical handpiece |
US5470008A (en) * | 1993-12-20 | 1995-11-28 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5452836A (en) * | 1994-02-07 | 1995-09-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved jaw closure and staple firing actuator mechanism |
US5413107A (en) * | 1994-02-16 | 1995-05-09 | Tetrad Corporation | Ultrasonic probe having articulated structure and rotatable transducer head |
US5507773A (en) * | 1994-02-18 | 1996-04-16 | Ethicon Endo-Surgery | Cable-actuated jaw assembly for surgical instruments |
WO1995023557A1 (en) * | 1994-03-01 | 1995-09-08 | United States Surgical Corporation | Surgical stapler with anvil sensor and lockout |
EP0677275B1 (en) * | 1994-03-17 | 2004-01-28 | Terumo Kabushiki Kaisha | Surgical instrument |
CA2145723A1 (en) * | 1994-03-30 | 1995-10-01 | Steven W. Hamblin | Surgical stapling instrument with remotely articulated stapling head assembly on rotatable support shaft |
US5628446A (en) * | 1994-05-05 | 1997-05-13 | United States Surgical Corporation | Self-contained powered surgical apparatus |
CA2148667A1 (en) * | 1994-05-05 | 1995-11-06 | Carlo A. Mililli | Self-contained powered surgical apparatus |
US5533521A (en) * | 1994-07-15 | 1996-07-09 | United States Surgical Corporation | Interchangeable tissue measuring device |
US5779130A (en) * | 1994-08-05 | 1998-07-14 | United States Surgical Corporation | Self-contained powered surgical apparatus |
US5507426A (en) * | 1994-08-05 | 1996-04-16 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
EP0699418A1 (en) * | 1994-08-05 | 1996-03-06 | United States Surgical Corporation | Self-contained powered surgical apparatus |
US5797538A (en) * | 1994-10-05 | 1998-08-25 | United States Surgical Corporation | Articulating apparatus for applying surgical fasteners to body tissue |
US5901895A (en) * | 1994-10-05 | 1999-05-11 | United States Surgical Corporation | Articulating apparatus for applying surgical fasteners to body tissue |
EP0705571A1 (en) * | 1994-10-07 | 1996-04-10 | United States Surgical Corporation | Self-contained powered surgical apparatus |
US5988479A (en) * | 1994-12-13 | 1999-11-23 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5636779A (en) * | 1994-12-13 | 1997-06-10 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
US5704534A (en) * | 1994-12-19 | 1998-01-06 | Ethicon Endo-Surgery, Inc. | Articulation assembly for surgical instruments |
US5713505A (en) * | 1996-05-13 | 1998-02-03 | Ethicon Endo-Surgery, Inc. | Articulation transmission mechanism for surgical instruments |
US5735445A (en) * | 1995-03-07 | 1998-04-07 | United States Surgical Corporation | Surgical stapler |
US5630540A (en) * | 1995-05-24 | 1997-05-20 | United States Surgical Corporation | Surgical staple and staple drive member |
US5706998A (en) * | 1995-07-17 | 1998-01-13 | United States Surgical Corporation | Surgical stapler with alignment pin locking mechanism |
US5715988A (en) * | 1995-08-14 | 1998-02-10 | United States Surgical Corporation | Surgical stapler with lockout mechanism |
US5782396A (en) | 1995-08-28 | 1998-07-21 | United States Surgical Corporation | Surgical stapler |
US5762256A (en) | 1995-08-28 | 1998-06-09 | United States Surgical Corporation | Surgical stapler |
US5651491A (en) * | 1995-10-27 | 1997-07-29 | United States Surgical Corporation | Surgical stapler having interchangeable loading units |
US5697158A (en) * | 1995-12-21 | 1997-12-16 | Minnesota Mining And Manufacturing Company | Orthopedic surgical device having a rotatable portion and lock |
US5697543A (en) * | 1996-03-12 | 1997-12-16 | Ethicon Endo-Surgery, Inc. | Linear stapler with improved firing stroke |
US5810240A (en) * | 1996-03-15 | 1998-09-22 | United States Surgical Corporation | Surgical fastener applying device |
US5823066A (en) * | 1996-05-13 | 1998-10-20 | Ethicon Endo-Surgery, Inc. | Articulation transmission mechanism for surgical instruments |
US5702408A (en) * | 1996-07-17 | 1997-12-30 | Ethicon Endo-Surgery, Inc. | Articulating surgical instrument |
US6109500A (en) * | 1996-10-04 | 2000-08-29 | United States Surgical Corporation | Lockout mechanism for a surgical stapler |
US5752965A (en) * | 1996-10-21 | 1998-05-19 | Bio-Vascular, Inc. | Apparatus and method for producing a reinforced surgical fastener suture line |
US5865361A (en) | 1997-09-23 | 1999-02-02 | United States Surgical Corporation | Surgical stapling apparatus |
US5954746A (en) | 1997-10-09 | 1999-09-21 | Ethicon Endo-Surgery, Inc. | Dual cam trigger for a surgical instrument |
US6171316B1 (en) | 1997-10-10 | 2001-01-09 | Origin Medsystems, Inc. | Endoscopic surgical instrument for rotational manipulation |
US6332889B1 (en) * | 1998-08-27 | 2001-12-25 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
US7951071B2 (en) | 1999-06-02 | 2011-05-31 | Tyco Healthcare Group Lp | Moisture-detecting shaft for use with an electro-mechanical surgical device |
US6793652B1 (en) | 1999-06-02 | 2004-09-21 | Power Medical Interventions, Inc. | Electro-mechanical surgical device |
US7695485B2 (en) | 2001-11-30 | 2010-04-13 | Power Medical Interventions, Llc | Surgical device |
US6264087B1 (en) | 1999-07-12 | 2001-07-24 | Powermed, Inc. | Expanding parallel jaw device for use with an electromechanical driver device |
US6443973B1 (en) | 1999-06-02 | 2002-09-03 | Power Medical Interventions, Inc. | Electromechanical driver device for use with anastomosing, stapling, and resecting instruments |
US6517565B1 (en) | 1999-06-02 | 2003-02-11 | Power Medical Interventions, Inc. | Carriage assembly for controlling a steering wire steering mechanism within a flexible shaft |
US6716233B1 (en) * | 1999-06-02 | 2004-04-06 | Power Medical Interventions, Inc. | Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities |
US8025199B2 (en) | 2004-02-23 | 2011-09-27 | Tyco Healthcare Group Lp | Surgical cutting and stapling device |
US6491201B1 (en) | 2000-02-22 | 2002-12-10 | Power Medical Interventions, Inc. | Fluid delivery mechanism for use with anastomosing, stapling, and resecting instruments |
US6325810B1 (en) | 1999-06-30 | 2001-12-04 | Ethicon, Inc. | Foam buttress for stapling apparatus |
US6533157B1 (en) | 2000-02-22 | 2003-03-18 | Power Medical Interventions, Inc. | Tissue stapling attachment for use with an electromechanical driver device |
US7770773B2 (en) | 2005-07-27 | 2010-08-10 | Power Medical Interventions, Llc | Surgical device |
US6488197B1 (en) | 2000-02-22 | 2002-12-03 | Power Medical Interventions, Inc. | Fluid delivery device for use with anastomosing resecting and stapling instruments |
US8016855B2 (en) * | 2002-01-08 | 2011-09-13 | Tyco Healthcare Group Lp | Surgical device |
US6273897B1 (en) | 2000-02-29 | 2001-08-14 | Ethicon, Inc. | Surgical bettress and surgical stapling apparatus |
IL139788A (en) * | 2000-11-20 | 2006-10-05 | Minelu Zonnenschein | Stapler for endoscopes |
US6805273B2 (en) * | 2002-11-04 | 2004-10-19 | Federico Bilotti | Surgical stapling instrument |
AU2001288462A1 (en) * | 2000-08-30 | 2002-03-13 | Cerebral Vascular Applications Inc. | Medical instrument |
US6817508B1 (en) | 2000-10-13 | 2004-11-16 | Tyco Healthcare Group, Lp | Surgical stapling device |
US7407076B2 (en) * | 2000-10-13 | 2008-08-05 | Tyco Healthcare Group Lp | Surgical stapling device |
US7485124B2 (en) | 2000-10-19 | 2009-02-03 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a fastener delivery mechanism |
US8286845B2 (en) * | 2000-11-27 | 2012-10-16 | Boston Scientific Scimed, Inc. | Full thickness resection device control handle |
US7131980B1 (en) | 2001-01-18 | 2006-11-07 | Dvl Acquisitions Sub, Inc. | Surgical suturing instrument and method of use |
US7011668B2 (en) * | 2001-07-23 | 2006-03-14 | Dvl Acquistion Sub, Inc. | Surgical suturing instrument and method of use |
US6755338B2 (en) | 2001-08-29 | 2004-06-29 | Cerebral Vascular Applications, Inc. | Medical instrument |
AU2002326917A1 (en) * | 2001-09-14 | 2003-04-01 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
ES2571339T3 (en) * | 2001-10-05 | 2016-05-24 | Covidien Lp | Surgical stapling device |
CN100522096C (en) | 2001-12-04 | 2009-08-05 | 能量医学介入公司 | System and method for calibrating a surgical instrument |
US9113878B2 (en) | 2002-01-08 | 2015-08-25 | Covidien Lp | Pinion clip for right angle linear cutter |
US20030151506A1 (en) * | 2002-02-11 | 2003-08-14 | Mark Luccketti | Method and apparatus for locating missing persons |
AU2003241521A1 (en) * | 2002-05-17 | 2003-12-02 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
ATE347316T1 (en) * | 2002-06-14 | 2006-12-15 | Power Med Interventions Inc | DEVICE FOR CLAMPING, CUTTING AND STAPING TISSUE TOGETHER |
US20120145765A1 (en) | 2002-06-25 | 2012-06-14 | Peterson James A | Mechanical method and apparatus for bilateral tissue fastening |
US7950559B2 (en) * | 2002-06-25 | 2011-05-31 | Incisive Surgical, Inc. | Mechanical method and apparatus for bilateral tissue fastening |
US6726705B2 (en) * | 2002-06-25 | 2004-04-27 | Incisive Surgical, Inc. | Mechanical method and apparatus for bilateral tissue fastening |
US7112214B2 (en) * | 2002-06-25 | 2006-09-26 | Incisive Surgical, Inc. | Dynamic bioabsorbable fastener for use in wound closure |
US8074857B2 (en) * | 2002-06-25 | 2011-12-13 | Incisive Surgical, Inc. | Method and apparatus for tissue fastening with single translating trigger operation |
EP3085315B1 (en) | 2002-10-04 | 2019-03-13 | Covidien LP | Surgical stapler with tissue pre-clamp |
US20060163312A1 (en) * | 2002-10-04 | 2006-07-27 | Viola Frank J | Angled surgical fastener apparatus |
EP1545332B1 (en) * | 2002-10-04 | 2007-08-22 | Tyco Healthcare Group Lp | Tool assembly for surgical stapling device |
JP4545589B2 (en) | 2002-10-04 | 2010-09-15 | タイコ ヘルスケア グループ エルピー | Tool assembly for a surgical stapling device |
US20040243151A1 (en) | 2003-04-29 | 2004-12-02 | Demmy Todd L. | Surgical stapling device with dissecting tip |
US9597078B2 (en) | 2003-04-29 | 2017-03-21 | Covidien Lp | Surgical stapling device with dissecting tip |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
ES2516091T3 (en) * | 2003-06-17 | 2014-10-30 | Covidien Lp | Surgical stapling device |
US7494039B2 (en) * | 2003-06-17 | 2009-02-24 | Tyco Healthcare Group Lp | Surgical stapling device |
US7111769B2 (en) * | 2003-07-09 | 2006-09-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis |
US8770459B2 (en) * | 2003-10-17 | 2014-07-08 | Covidien Lp | Surgical stapling device with independent tip rotation |
US7147650B2 (en) * | 2003-10-30 | 2006-12-12 | Woojin Lee | Surgical instrument |
US7842028B2 (en) * | 2005-04-14 | 2010-11-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument guide device |
US7686826B2 (en) * | 2003-10-30 | 2010-03-30 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US7338513B2 (en) * | 2003-10-30 | 2008-03-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20050143759A1 (en) * | 2003-12-30 | 2005-06-30 | Kelly William D. | Curved cutter stapler shaped for male pelvis |
US6988650B2 (en) * | 2003-12-30 | 2006-01-24 | Ethicon Endo-Surgery, Inc. | Retaining pin lever advancement mechanism for a curved cutter stapler |
US7354447B2 (en) * | 2005-11-10 | 2008-04-08 | Ethicon Endo-Surgery, Inc. | Disposable loading unit and surgical instruments including same |
US8905977B2 (en) | 2004-07-28 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
WO2006027014A1 (en) * | 2004-09-10 | 2006-03-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
EP1719468A1 (en) * | 2004-12-17 | 2006-11-08 | Zimmer GmbH | Intervertebral stabilization system |
US9138226B2 (en) | 2005-03-30 | 2015-09-22 | Covidien Lp | Cartridge assembly for a surgical stapling device |
US7780055B2 (en) * | 2005-04-06 | 2010-08-24 | Tyco Healthcare Group Lp | Loading unit having drive assembly locking mechanism |
US8100939B2 (en) * | 2005-07-15 | 2012-01-24 | Incisive Surgical, Inc. | Mechanical method and apparatus for sequential tissue fastening |
US8409175B2 (en) * | 2005-07-20 | 2013-04-02 | Woojin Lee | Surgical instrument guide device |
US8579176B2 (en) | 2005-07-26 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting device and method for using the device |
US10314583B2 (en) | 2005-07-26 | 2019-06-11 | Ethicon Llc | Electrically self-powered surgical instrument with manual release |
US8627995B2 (en) | 2006-05-19 | 2014-01-14 | Ethicon Endo-Sugery, Inc. | Electrically self-powered surgical instrument with cryptographic identification of interchangeable part |
US9662116B2 (en) | 2006-05-19 | 2017-05-30 | Ethicon, Llc | Electrically self-powered surgical instrument with cryptographic identification of interchangeable part |
US9554803B2 (en) | 2005-07-26 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Electrically self-powered surgical instrument with manual release |
US8573462B2 (en) | 2006-05-19 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Electrical surgical instrument with optimized power supply and drive |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US20070194079A1 (en) * | 2005-08-31 | 2007-08-23 | Hueil Joseph C | Surgical stapling device with staple drivers of different height |
US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US7500979B2 (en) | 2005-08-31 | 2009-03-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with multiple stacked actuator wedge cams for driving staple drivers |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US7467740B2 (en) * | 2005-09-21 | 2008-12-23 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments having flexible channel and anvil features for adjustable staple heights |
CA2563147C (en) | 2005-10-14 | 2014-09-23 | Tyco Healthcare Group Lp | Surgical stapling device |
US20070102472A1 (en) * | 2005-11-04 | 2007-05-10 | Ethicon Endo-Surgery, Inc. | Electrosurgical stapling instrument with disposable severing / stapling unit |
US7607557B2 (en) * | 2005-11-04 | 2009-10-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments structured for pump-assisted delivery of medical agents |
US7673783B2 (en) * | 2005-11-04 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments structured for delivery of medical agents |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US7651017B2 (en) * | 2005-11-23 | 2010-01-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with a bendable end effector |
FR2895071B1 (en) * | 2005-12-19 | 2008-01-18 | Giat Ind Sa | ANTI-REBOUND LOCKING DEVICE OF A DEPLOYABLE FIN OF A PROJECTILE. |
US7568603B2 (en) * | 2006-01-31 | 2009-08-04 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with articulatable end effector |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US7464849B2 (en) * | 2006-01-31 | 2008-12-16 | Ethicon Endo-Surgery, Inc. | Electro-mechanical surgical instrument with closure system and anvil alignment components |
US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
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 |
US7770775B2 (en) | 2006-01-31 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with adaptive user feedback |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
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 |
US7644848B2 (en) | 2006-01-31 | 2010-01-12 | Ethicon Endo-Surgery, Inc. | Electronic lockouts and surgical instrument including same |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US7464846B2 (en) * | 2006-01-31 | 2008-12-16 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a removable battery |
US20070175950A1 (en) * | 2006-01-31 | 2007-08-02 | Shelton Frederick E Iv | Disposable staple cartridge having an anvil with tissue locator for use with a surgical cutting and fastening instrument and modular end effector system therefor |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US7766210B2 (en) | 2006-01-31 | 2010-08-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with user feedback system |
US7575144B2 (en) | 2006-01-31 | 2009-08-18 | Ethicon Endo-Surgery, Inc. | Surgical fastener and cutter with single cable actuator |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US7431190B2 (en) * | 2006-03-01 | 2008-10-07 | Ethicon Endo-Surgery, Inc. | Linear stapler with improved firing mechanism |
US7568605B2 (en) * | 2006-03-22 | 2009-08-04 | Ethicon Endo-Surgery, Inc. | Surgical stapler shaft cover |
US8721630B2 (en) | 2006-03-23 | 2014-05-13 | Ethicon Endo-Surgery, Inc. | Methods and devices for controlling articulation |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
EP2018248B1 (en) * | 2006-05-19 | 2015-11-04 | Applied Medical Resources Corporation | Surgical stapler |
US8105350B2 (en) * | 2006-05-23 | 2012-01-31 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US7615067B2 (en) | 2006-06-05 | 2009-11-10 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US8029531B2 (en) | 2006-07-11 | 2011-10-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US20080029574A1 (en) * | 2006-08-02 | 2008-02-07 | Shelton Frederick E | Pneumatically powered surgical cutting and fastening instrument with actuator at distal end |
US7740159B2 (en) * | 2006-08-02 | 2010-06-22 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist |
US7448525B2 (en) * | 2006-08-02 | 2008-11-11 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with manually operated retraction apparatus |
US7708758B2 (en) | 2006-08-16 | 2010-05-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
US8794496B2 (en) | 2006-09-11 | 2014-08-05 | Covidien Lp | Rotating knob locking mechanism for surgical stapling device |
US7648519B2 (en) * | 2006-09-13 | 2010-01-19 | Cambridge Endoscopic Devices, Inc. | Surgical 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 |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US20080078802A1 (en) | 2006-09-29 | 2008-04-03 | Hess Christopher J | Surgical staples and stapling instruments |
US8708210B2 (en) | 2006-10-05 | 2014-04-29 | Covidien Lp | Method and force-limiting handle mechanism for a surgical instrument |
US7866525B2 (en) | 2006-10-06 | 2011-01-11 | Tyco Healthcare Group Lp | Surgical instrument having a plastic surface |
US8807414B2 (en) | 2006-10-06 | 2014-08-19 | Covidien Lp | System and method for non-contact electronic articulation sensing |
US7481348B2 (en) * | 2006-10-06 | 2009-01-27 | Tyco Healthcare Group Lp | Surgical instrument with articulating tool assembly |
US8584921B2 (en) * | 2006-10-06 | 2013-11-19 | Covidien Lp | Surgical instrument with articulating tool assembly |
DK2088955T3 (en) * | 2006-10-06 | 2011-06-06 | Tirex Surgical Gmbh | Lockable joint |
RU2446748C2 (en) * | 2006-10-06 | 2012-04-10 | Орион Серджикал Гмбх | Lockable connection |
EP1932485B1 (en) * | 2006-12-14 | 2010-05-19 | Ethicon Endo-Surgery, Inc. | Laparoscopic stapling device |
US7738971B2 (en) | 2007-01-10 | 2010-06-15 | Ethicon Endo-Surgery, Inc. | Post-sterilization programming of surgical instruments |
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 |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US7900805B2 (en) | 2007-01-10 | 2011-03-08 | Ethicon Endo-Surgery, Inc. | Surgical instrument with enhanced battery performance |
US7954682B2 (en) | 2007-01-10 | 2011-06-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument with elements to communicate between control unit and end effector |
US7721931B2 (en) * | 2007-01-10 | 2010-05-25 | Ethicon Endo-Surgery, Inc. | Prevention of cartridge reuse in a surgical instrument |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US7721936B2 (en) | 2007-01-10 | 2010-05-25 | Ethicon Endo-Surgery, Inc. | Interlock and surgical instrument including same |
US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | 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 |
US20080169332A1 (en) * | 2007-01-11 | 2008-07-17 | Shelton Frederick E | Surgical stapling device with a curved cutting member |
US20090001121A1 (en) | 2007-03-15 | 2009-01-01 | Hess Christopher J | Surgical staple having an expandable portion |
US7490749B2 (en) * | 2007-03-28 | 2009-02-17 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with manually retractable firing member |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US8056787B2 (en) | 2007-03-28 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with travel-indicating retraction member |
US20080249563A1 (en) * | 2007-04-04 | 2008-10-09 | Peterson James A | Method and apparatus for tissue fastening |
US20080262492A1 (en) * | 2007-04-11 | 2008-10-23 | Cambridge Endoscopic Devices, Inc. | Surgical Instrument |
EP2343024B1 (en) * | 2007-05-18 | 2018-05-02 | Boston Scientific Scimed, Inc. | Drive systems |
US8409245B2 (en) * | 2007-05-22 | 2013-04-02 | Woojin Lee | Surgical instrument |
US7549564B2 (en) * | 2007-06-22 | 2009-06-23 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulating end effector |
US7798386B2 (en) | 2007-05-30 | 2010-09-21 | Ethicon Endo-Surgery, Inc. | Surgical instrument articulation joint cover |
US7810693B2 (en) | 2007-05-30 | 2010-10-12 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with articulatable end effector |
US8157145B2 (en) | 2007-05-31 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with electrical feedback |
US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US11672531B2 (en) | 2007-06-04 | 2023-06-13 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
US7832408B2 (en) | 2007-06-04 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a 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 |
US20080308602A1 (en) * | 2007-06-18 | 2008-12-18 | Timm Richard W | Surgical stapling and cutting instruments |
US7597229B2 (en) | 2007-06-22 | 2009-10-06 | Ethicon Endo-Surgery, Inc. | End effector closure system for a surgical stapling instrument |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US7604150B2 (en) * | 2007-06-22 | 2009-10-20 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an anti-back up mechanism |
US7658311B2 (en) * | 2007-06-22 | 2010-02-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with a geared return mechanism |
US8408439B2 (en) | 2007-06-22 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
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 |
US7600663B2 (en) * | 2007-07-05 | 2009-10-13 | Green David T | Apparatus for stapling and incising tissue |
JP4837628B2 (en) * | 2007-07-06 | 2011-12-14 | ルネサスエレクトロニクス株式会社 | Semiconductor device |
US9005238B2 (en) * | 2007-08-23 | 2015-04-14 | Covidien Lp | Endoscopic surgical devices |
US8061576B2 (en) | 2007-08-31 | 2011-11-22 | Tyco Healthcare Group Lp | Surgical instrument |
US7624902B2 (en) | 2007-08-31 | 2009-12-01 | Tyco Healthcare Group Lp | Surgical stapling apparatus |
US8257386B2 (en) * | 2007-09-11 | 2012-09-04 | Cambridge Endoscopic Devices, Inc. | Surgical instrument |
AU2008302039B2 (en) * | 2007-09-21 | 2013-07-18 | Covidien Lp | Surgical device |
JP5357161B2 (en) | 2007-09-21 | 2013-12-04 | コヴィディエン リミテッド パートナーシップ | Surgical equipment |
US7703653B2 (en) | 2007-09-28 | 2010-04-27 | Tyco Healthcare Group Lp | Articulation mechanism for surgical instrument |
US7954685B2 (en) | 2007-11-06 | 2011-06-07 | Tyco Healthcare Group Lp | Articulation and firing force mechanisms |
US20090171147A1 (en) * | 2007-12-31 | 2009-07-02 | Woojin Lee | Surgical instrument |
US8453908B2 (en) | 2008-02-13 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved firing trigger arrangement |
US7766209B2 (en) * | 2008-02-13 | 2010-08-03 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved firing trigger arrangement |
US8540133B2 (en) | 2008-09-19 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
US7857185B2 (en) | 2008-02-14 | 2010-12-28 | Ethicon Endo-Surgery, Inc. | Disposable loading unit for surgical stapling apparatus |
US7819297B2 (en) * | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with reprocessible handle assembly |
US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US7913891B2 (en) * | 2008-02-14 | 2011-03-29 | Ethicon Endo-Surgery, Inc. | Disposable loading unit with user feedback features and surgical instrument for use therewith |
US7819296B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with retractable firing systems |
US7810692B2 (en) * | 2008-02-14 | 2010-10-12 | Ethicon Endo-Surgery, Inc. | Disposable loading unit with firing indicator |
BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
US20090206133A1 (en) * | 2008-02-14 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | Articulatable loading units for surgical stapling and cutting instruments |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US7861906B2 (en) | 2008-02-14 | 2011-01-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with articulatable components |
US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
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 |
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 |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US7959051B2 (en) * | 2008-02-15 | 2011-06-14 | Ethicon Endo-Surgery, Inc. | Closure systems for a surgical cutting and stapling instrument |
US20090206131A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | End effector coupling arrangements for a surgical cutting and stapling instrument |
US20090206137A1 (en) * | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | Disposable loading units for a surgical cutting and stapling instrument |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US20090206139A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | Buttress material for a surgical instrument |
US10390823B2 (en) | 2008-02-15 | 2019-08-27 | Ethicon Llc | End effector comprising an adjunct |
US7980443B2 (en) * | 2008-02-15 | 2011-07-19 | Ethicon Endo-Surgery, Inc. | End effectors for a surgical cutting and stapling instrument |
US20090234379A1 (en) * | 2008-03-14 | 2009-09-17 | Rehnke Robert D | Apparatuses for the performance of a minimally invasive ventral hernia repair |
US8048024B2 (en) | 2008-03-17 | 2011-11-01 | Boston Scientific Scimed, Inc. | Steering mechanism |
CA2665017A1 (en) | 2008-05-05 | 2009-11-05 | Tyco Healthcare Group Lp | Surgical instrument with sequential clamping and cutting |
US8424738B2 (en) | 2008-06-04 | 2013-04-23 | Covidien Lp | Attachable clamp for surgical stapler |
US8701959B2 (en) | 2008-06-06 | 2014-04-22 | Covidien Lp | Mechanically pivoting cartridge channel for surgical instrument |
US7942303B2 (en) | 2008-06-06 | 2011-05-17 | Tyco Healthcare Group Lp | Knife lockout mechanisms for surgical instrument |
US7789283B2 (en) | 2008-06-06 | 2010-09-07 | Tyco Healthcare Group Lp | Knife/firing rod connection for surgical instrument |
US8048025B2 (en) * | 2008-07-07 | 2011-11-01 | Boston Scientific Scimed, Inc. | Multi-plane motion control mechanism |
US8801752B2 (en) * | 2008-08-04 | 2014-08-12 | Covidien Lp | Articulating surgical device |
US8968355B2 (en) * | 2008-08-04 | 2015-03-03 | Covidien Lp | Articulating surgical device |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US8215532B2 (en) | 2008-09-23 | 2012-07-10 | Tyco Healthcare Group Lp | Tissue stop for 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 |
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 |
US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US7896214B2 (en) | 2008-09-23 | 2011-03-01 | Tyco Healthcare Group Lp | Tissue stop for surgical instrument |
US8628544B2 (en) | 2008-09-23 | 2014-01-14 | Covidien Lp | Knife bar for surgical instrument |
US7988028B2 (en) | 2008-09-23 | 2011-08-02 | Tyco Healthcare Group Lp | Surgical instrument having an asymmetric dynamic clamping member |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8070038B2 (en) | 2008-10-10 | 2011-12-06 | Tyco Healthcare Group, Lp | Surgical instrument with pivotable jaw member |
US8020743B2 (en) * | 2008-10-15 | 2011-09-20 | Ethicon Endo-Surgery, Inc. | Powered articulatable surgical cutting and fastening instrument with flexible drive member |
US7963197B2 (en) * | 2008-11-28 | 2011-06-21 | Steven Starko | Plumbing tool |
US8397971B2 (en) | 2009-02-05 | 2013-03-19 | Ethicon Endo-Surgery, Inc. | Sterilizable surgical instrument |
US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
US20100193566A1 (en) * | 2009-02-05 | 2010-08-05 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
US8485413B2 (en) * | 2009-02-05 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising an articulation joint |
BRPI1008667A2 (en) | 2009-02-06 | 2016-03-08 | Ethicom Endo Surgery Inc | improvement of the operated surgical stapler |
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 |
US8453907B2 (en) * | 2009-02-06 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with cutting member reversing mechanism |
US8393516B2 (en) | 2009-02-26 | 2013-03-12 | Covidien Lp | Surgical stapling apparatus with curved cartridge and anvil assemblies |
US7918376B1 (en) | 2009-03-09 | 2011-04-05 | Cardica, Inc. | Articulated surgical instrument |
US8066167B2 (en) * | 2009-03-23 | 2011-11-29 | Ethicon Endo-Surgery, Inc. | Circular surgical stapling instrument with anvil locking system |
US20100249497A1 (en) * | 2009-03-30 | 2010-09-30 | Peine William J | Surgical instrument |
US8292154B2 (en) | 2009-04-16 | 2012-10-23 | Tyco Healthcare Group Lp | Surgical apparatus for applying tissue fasteners |
US9289208B1 (en) | 2009-05-05 | 2016-03-22 | Cardica, Inc. | Articulation insert for surgical instrument |
US8096457B1 (en) | 2009-05-05 | 2012-01-17 | Cardica, Inc. | Articulation mechanisms for surgical instrument |
US8353436B2 (en) | 2009-05-06 | 2013-01-15 | Covidien Lp | Pin locking mechanism for a surgical instrument |
US8328064B2 (en) * | 2009-05-06 | 2012-12-11 | Covidien Lp | Pin locking mechanism for a surgical instrument |
US8127976B2 (en) | 2009-05-08 | 2012-03-06 | Tyco Healthcare Group Lp | Stapler cartridge and channel interlock |
US8132706B2 (en) | 2009-06-05 | 2012-03-13 | Tyco Healthcare Group Lp | Surgical stapling apparatus having articulation mechanism |
US20100324551A1 (en) * | 2009-06-18 | 2010-12-23 | Tyco Healthcare Group Lp | Laparoscopic shaft articulation by means of a rotating collar |
US8342378B2 (en) | 2009-08-17 | 2013-01-01 | Covidien Lp | One handed stapler |
US8141762B2 (en) | 2009-10-09 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical stapler comprising a staple pocket |
US8418907B2 (en) | 2009-11-05 | 2013-04-16 | Covidien Lp | Surgical stapler having cartridge with adjustable cam mechanism |
US20110112517A1 (en) * | 2009-11-06 | 2011-05-12 | Peine Willliam J | Surgical instrument |
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 |
US8235272B2 (en) | 2009-11-20 | 2012-08-07 | Tyco Healthcare Group Lp | Surgical stapling device with captive anvil |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8267300B2 (en) | 2009-12-30 | 2012-09-18 | Ethicon Endo-Surgery, Inc. | Dampening device for endoscopic surgical stapler |
US8608046B2 (en) | 2010-01-07 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Test device for a surgical tool |
WO2011088446A2 (en) * | 2010-01-18 | 2011-07-21 | Safariland, Llc | Locking device safety mechanism and related holster assembly |
US8328061B2 (en) | 2010-02-02 | 2012-12-11 | Covidien Lp | Surgical instrument for joining tissue |
US20110238108A1 (en) * | 2010-03-23 | 2011-09-29 | Peine William J | Surgical instrument |
US8827137B2 (en) * | 2010-03-25 | 2014-09-09 | Covidien Lp | Pin alignment assembly for surgical stapler |
US8074859B2 (en) | 2010-03-31 | 2011-12-13 | Tyco Healthcare Group Lp | Surgical instrument |
US8348127B2 (en) | 2010-04-07 | 2013-01-08 | Covidien Lp | Surgical fastener applying apparatus |
US8940000B2 (en) | 2010-05-12 | 2015-01-27 | Covidien Lp | Surgical instruments with flexible member attachment structures |
US8409246B2 (en) | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8789740B2 (en) | 2010-07-30 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Linear cutting and stapling device with selectively disengageable cutting member |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US8360296B2 (en) | 2010-09-09 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling head assembly with firing lockout for a surgical stapler |
US20120078244A1 (en) | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9861361B2 (en) | 2010-09-30 | 2018-01-09 | Ethicon Llc | Releasable tissue thickness compensator and fastener cartridge having the same |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US10123798B2 (en) | 2010-09-30 | 2018-11-13 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US8864009B2 (en) | 2010-09-30 | 2014-10-21 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator for a surgical stapler comprising an adjustable anvil |
CN103140178B (en) * | 2010-09-30 | 2015-09-23 | 伊西康内外科公司 | Comprise the closure system keeping matrix and alignment matrix |
US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US9839420B2 (en) | 2010-09-30 | 2017-12-12 | Ethicon Llc | Tissue thickness compensator comprising at least one medicament |
US8840003B2 (en) | 2010-09-30 | 2014-09-23 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with compact articulation control arrangement |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US8893949B2 (en) | 2010-09-30 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler with floating anvil |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US8444038B2 (en) * | 2010-10-01 | 2013-05-21 | Covidien Lp | Tissue stop for surgical instrument |
US8899461B2 (en) | 2010-10-01 | 2014-12-02 | Covidien Lp | Tissue stop for surgical instrument |
US8308041B2 (en) | 2010-11-10 | 2012-11-13 | Tyco Healthcare Group Lp | Staple formed over the wire wound closure procedure |
US8336754B2 (en) * | 2011-02-04 | 2012-12-25 | Covidien Lp | Locking articulation mechanism for surgical stapler |
US8348124B2 (en) | 2011-02-08 | 2013-01-08 | Covidien Lp | Knife bar with geared overdrive |
US8632462B2 (en) | 2011-03-14 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Trans-rectum universal ports |
US8800841B2 (en) | 2011-03-15 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges |
US9168050B1 (en) | 2011-03-24 | 2015-10-27 | Cambridge Endoscopic Devices, Inc. | End effector construction |
US8573463B2 (en) * | 2011-03-31 | 2013-11-05 | Covidien Lp | Locking articulation mechanism |
US9038880B1 (en) | 2011-04-25 | 2015-05-26 | Cardica, Inc. | Articulated surgical instrument |
US9474527B1 (en) | 2011-04-26 | 2016-10-25 | Bryan D. Knodel | Surgical instrument with discrete articulation |
US9566048B1 (en) | 2011-04-26 | 2017-02-14 | Cardica, Inc. | Surgical instrument with discrete cammed articulation |
JP6026509B2 (en) | 2011-04-29 | 2016-11-16 | 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. | Staple cartridge including staples disposed within a compressible portion of the staple cartridge itself |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9289209B2 (en) | 2011-06-09 | 2016-03-22 | Covidien Lp | Surgical fastener applying apparatus |
US9271728B2 (en) | 2011-06-09 | 2016-03-01 | Covidien Lp | Surgical fastener applying apparatus |
US9451959B2 (en) | 2011-06-09 | 2016-09-27 | Covidien Lp | Surgical fastener applying apparatus |
US8763876B2 (en) | 2011-06-30 | 2014-07-01 | Covidien Lp | Surgical instrument and cartridge for use therewith |
US20130012958A1 (en) | 2011-07-08 | 2013-01-10 | Stanislaw Marczyk | Surgical Device with Articulation and Wrist Rotation |
US9155537B2 (en) | 2011-08-08 | 2015-10-13 | Covidien Lp | Surgical fastener applying apparatus |
US9539007B2 (en) | 2011-08-08 | 2017-01-10 | Covidien Lp | Surgical fastener applying aparatus |
US9724095B2 (en) | 2011-08-08 | 2017-08-08 | Covidien Lp | Surgical fastener applying apparatus |
US9107663B2 (en) | 2011-09-06 | 2015-08-18 | Ethicon Endo-Surgery, Inc. | Stapling instrument comprising resettable staple drivers |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US9016539B2 (en) | 2011-10-25 | 2015-04-28 | Covidien Lp | Multi-use loading unit |
US8740036B2 (en) | 2011-12-01 | 2014-06-03 | Covidien Lp | Surgical instrument with actuator spring arm |
US10299815B2 (en) | 2012-01-19 | 2019-05-28 | Covidien Lp | Surgical instrument with clam releases mechanism |
US8864010B2 (en) | 2012-01-20 | 2014-10-21 | Covidien Lp | Curved guide member for articulating instruments |
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 |
US8979827B2 (en) | 2012-03-14 | 2015-03-17 | Covidien Lp | Surgical instrument with articulation mechanism |
US9078653B2 (en) | 2012-03-26 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | 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. | Tissue thickness compensator with multiple layers |
MX353040B (en) | 2012-03-28 | 2017-12-18 | Ethicon Endo Surgery Inc | Retainer assembly including a tissue thickness compensator. |
US9211134B2 (en) | 2012-04-09 | 2015-12-15 | Carefusion 2200, Inc. | Wrist assembly for articulating laparoscopic surgical instruments |
US9526497B2 (en) | 2012-05-07 | 2016-12-27 | Covidien Lp | Surgical instrument with articulation mechanism |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US20140001234A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Coupling arrangements for attaching surgical end effectors to drive systems therefor |
US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
US9649111B2 (en) | 2012-06-28 | 2017-05-16 | Ethicon Endo-Surgery, Llc | Replaceable clip cartridge for a clip applier |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
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 |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
US9232944B2 (en) | 2012-06-29 | 2016-01-12 | Covidien Lp | Surgical instrument and bushing |
US9364217B2 (en) | 2012-10-16 | 2016-06-14 | Covidien Lp | In-situ loaded stapler |
US9345480B2 (en) | 2013-01-18 | 2016-05-24 | Covidien Lp | Surgical instrument and cartridge members for use therewith |
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 |
BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
US20140249557A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Thumbwheel switch arrangements for surgical instruments |
JP6345707B2 (en) | 2013-03-01 | 2018-06-20 | 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. | Surgical instrument with soft stop |
US10561432B2 (en) | 2013-03-05 | 2020-02-18 | Covidien Lp | Pivoting screw for use with a pair of jaw members of a surgical instrument |
US9668728B2 (en) | 2013-03-13 | 2017-06-06 | Covidien Lp | Surgical stapling apparatus |
US20140263552A1 (en) | 2013-03-13 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Staple cartridge tissue thickness sensor system |
US9629628B2 (en) | 2013-03-13 | 2017-04-25 | Covidien Lp | Surgical stapling apparatus |
US9717498B2 (en) | 2013-03-13 | 2017-08-01 | Covidien Lp | Surgical stapling apparatus |
US9814463B2 (en) | 2013-03-13 | 2017-11-14 | Covidien Lp | Surgical stapling apparatus |
EP2967564B1 (en) | 2013-03-14 | 2018-09-12 | Applied Medical Resources Corporation | Surgical stapler with partial pockets |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
US9808244B2 (en) | 2013-03-14 | 2017-11-07 | Ethicon Llc | Sensor arrangements for absolute positioning system for surgical instruments |
JP6396417B2 (en) | 2013-03-15 | 2018-09-26 | アプライド メディカル リソーシーズ コーポレイション | Surgical stapler having an actuating mechanism with a rotatable shaft |
WO2014143699A1 (en) | 2013-03-15 | 2014-09-18 | Applied Medical Resources Corporation | Surgical stapler with expandable jaw |
US9510827B2 (en) | 2013-03-25 | 2016-12-06 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
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 |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
US9867612B2 (en) | 2013-04-16 | 2018-01-16 | Ethicon Llc | Powered surgical stapler |
US9357984B2 (en) | 2013-04-23 | 2016-06-07 | Covidien Lp | Constant value gap stabilizer for articulating links |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US9445810B2 (en) | 2013-06-12 | 2016-09-20 | Covidien Lp | Stapling device with grasping jaw mechanism |
JP6416260B2 (en) | 2013-08-23 | 2018-10-31 | エシコン エルエルシー | Firing member retractor for a powered surgical instrument |
US9775609B2 (en) | 2013-08-23 | 2017-10-03 | Ethicon Llc | Tamper proof circuit for surgical instrument battery pack |
US9662108B2 (en) | 2013-08-30 | 2017-05-30 | Covidien Lp | Surgical stapling apparatus |
US20140171986A1 (en) | 2013-09-13 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Surgical Clip Having Comliant Portion |
CN105682567B (en) | 2013-11-04 | 2021-09-10 | 柯惠Lp公司 | Surgical fastener applying apparatus |
AU2013403917A1 (en) | 2013-11-04 | 2016-04-28 | Covidien Lp | Surgical fastener applying apparatus |
AU2013403915A1 (en) | 2013-11-04 | 2016-04-28 | Covidien Lp | Surgical fastener applying apparatus |
US9867613B2 (en) | 2013-12-19 | 2018-01-16 | Covidien Lp | Surgical staples and end effectors for deploying the same |
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 |
US9687232B2 (en) | 2013-12-23 | 2017-06-27 | Ethicon Llc | Surgical staples |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9629627B2 (en) | 2014-01-28 | 2017-04-25 | Coviden Lp | Surgical apparatus |
US9936952B2 (en) | 2014-02-03 | 2018-04-10 | Covidien Lp | Introducer assembly for a surgical fastener applying apparatus |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
US9848874B2 (en) | 2014-02-14 | 2017-12-26 | Covidien Lp | Small diameter endoscopic stapler |
CN106232029B (en) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | Fastening system including firing member locking piece |
US9839422B2 (en) | 2014-02-24 | 2017-12-12 | Ethicon Llc | Implantable layers and methods for altering implantable layers for use with surgical fastening instruments |
US9750499B2 (en) | 2014-03-26 | 2017-09-05 | Ethicon Llc | Surgical stapling instrument system |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US9826977B2 (en) | 2014-03-26 | 2017-11-28 | Ethicon Llc | Sterilization verification circuit |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
US9757126B2 (en) | 2014-03-31 | 2017-09-12 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
CN106456158B (en) | 2014-04-16 | 2019-02-05 | 伊西康内外科有限责任公司 | Fastener cartridge including non-uniform fastener |
JP6636452B2 (en) | 2014-04-16 | 2020-01-29 | エシコン エルエルシーEthicon LLC | Fastener cartridge including extension having different configurations |
US10299792B2 (en) | 2014-04-16 | 2019-05-28 | Ethicon Llc | Fastener cartridge comprising non-uniform fasteners |
US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
BR112016023807B1 (en) | 2014-04-16 | 2022-07-12 | Ethicon Endo-Surgery, Llc | CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT |
US20150297223A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
US9668733B2 (en) | 2014-04-21 | 2017-06-06 | Covidien Lp | Stapling device with features to prevent inadvertent firing of staples |
US9844377B2 (en) | 2014-04-25 | 2017-12-19 | Incisive Surgical, Inc. | Method and apparatus for wound closure with sequential tissue positioning and retention |
US9861366B2 (en) | 2014-05-06 | 2018-01-09 | Covidien Lp | Ejecting assembly for a surgical stapler |
WO2015174985A1 (en) | 2014-05-15 | 2015-11-19 | Lp Covidien | Surgical fastener applying apparatus |
US9901341B2 (en) | 2014-05-16 | 2018-02-27 | Covidien Lp | Surgical instrument |
WO2015191887A1 (en) | 2014-06-11 | 2015-12-17 | Applied Medical Resources Corporation | Surgical stapler with circumferential firing |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
US10016199B2 (en) | 2014-09-05 | 2018-07-10 | Ethicon Llc | Polarity of hall magnet to identify cartridge type |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
KR102649260B1 (en) | 2014-09-15 | 2024-03-20 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical stapler with self-adjusting staple height |
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 |
BR112017005981B1 (en) | 2014-09-26 | 2022-09-06 | Ethicon, Llc | ANCHOR MATERIAL FOR USE WITH A SURGICAL STAPLE CARTRIDGE AND SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
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 |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
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 |
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 |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
US9943309B2 (en) | 2014-12-18 | 2018-04-17 | Ethicon Llc | Surgical instruments with articulatable end effectors and movable firing beam support arrangements |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
BR112017012996B1 (en) | 2014-12-18 | 2022-11-08 | Ethicon Llc | SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE |
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 |
US10702269B2 (en) | 2014-12-25 | 2020-07-07 | Covidien Lp | Surgical stapling devices |
USD752219S1 (en) | 2015-01-02 | 2016-03-22 | Incisive Surgical, Inc. | Tissue fastening instrument |
US9775611B2 (en) | 2015-01-06 | 2017-10-03 | Covidien Lp | Clam shell surgical stapling loading unit |
US10039545B2 (en) | 2015-02-23 | 2018-08-07 | Covidien Lp | Double fire stapling |
US10085749B2 (en) | 2015-02-26 | 2018-10-02 | Covidien Lp | Surgical apparatus with conductor strain relief |
US10130367B2 (en) | 2015-02-26 | 2018-11-20 | Covidien Lp | Surgical apparatus |
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 |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US9931118B2 (en) | 2015-02-27 | 2018-04-03 | Ethicon Endo-Surgery, Llc | Reinforced battery for a surgical instrument |
US9855040B2 (en) | 2015-03-04 | 2018-01-02 | Covidien Lp | Surgical stapling loading unit having articulating jaws |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
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 |
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 |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US9918717B2 (en) | 2015-03-18 | 2018-03-20 | Covidien Lp | Pivot mechanism for surgical device |
US10213201B2 (en) | 2015-03-31 | 2019-02-26 | Ethicon Llc | Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw |
US10463368B2 (en) | 2015-04-10 | 2019-11-05 | Covidien Lp | Endoscopic stapler |
US10117650B2 (en) | 2015-05-05 | 2018-11-06 | Covidien Lp | Adapter assembly and loading units for surgical stapling devices |
US10299789B2 (en) | 2015-05-05 | 2019-05-28 | Covidie LP | Adapter assembly for surgical stapling devices |
US10039532B2 (en) | 2015-05-06 | 2018-08-07 | Covidien Lp | Surgical instrument with articulation assembly |
US10143474B2 (en) | 2015-05-08 | 2018-12-04 | Just Right Surgical, Llc | Surgical stapler |
US10349941B2 (en) | 2015-05-27 | 2019-07-16 | Covidien Lp | Multi-fire lead screw stapling device |
US10172615B2 (en) | 2015-05-27 | 2019-01-08 | Covidien Lp | Multi-fire push rod stapling device |
US10368861B2 (en) | 2015-06-18 | 2019-08-06 | Ethicon Llc | Dual articulation drive system arrangements for articulatable surgical instruments |
US10548599B2 (en) | 2015-07-20 | 2020-02-04 | Covidien Lp | Endoscopic stapler and staple |
US9987012B2 (en) | 2015-07-21 | 2018-06-05 | Covidien Lp | Small diameter cartridge design for a surgical stapling instrument |
US10064622B2 (en) | 2015-07-29 | 2018-09-04 | Covidien Lp | Surgical stapling loading unit with stroke counter and lockout |
US10045782B2 (en) | 2015-07-30 | 2018-08-14 | Covidien Lp | Surgical stapling loading unit with stroke counter and lockout |
WO2017024300A2 (en) | 2015-08-06 | 2017-02-09 | Applied Medical Resources Corporation | Surgical stapler having locking articulation joint |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
JP6828018B2 (en) | 2015-08-26 | 2021-02-10 | エシコン エルエルシーEthicon LLC | Surgical staple strips that allow you to change the characteristics of staples and facilitate filling into cartridges |
MX2022009705A (en) | 2015-08-26 | 2022-11-07 | Ethicon Llc | Surgical staples comprising hardness variations for improved fastening of tissue. |
US10166026B2 (en) | 2015-08-26 | 2019-01-01 | Ethicon Llc | Staple cartridge assembly including features for controlling the rotation of staples when being ejected therefrom |
MX2022006192A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10357252B2 (en) | 2015-09-02 | 2019-07-23 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples |
US10085747B2 (en) | 2015-09-11 | 2018-10-02 | Incisive Surgical, Inc. | Surgical fastening instrument |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-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 |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10736633B2 (en) | 2015-09-30 | 2020-08-11 | Ethicon Llc | Compressible adjunct with looping members |
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 |
US10478188B2 (en) | 2015-09-30 | 2019-11-19 | Ethicon Llc | Implantable layer comprising a constricted configuration |
US10213204B2 (en) | 2015-10-02 | 2019-02-26 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
US10772632B2 (en) | 2015-10-28 | 2020-09-15 | Covidien Lp | Surgical stapling device with triple leg staples |
US10595864B2 (en) | 2015-11-24 | 2020-03-24 | Covidien Lp | Adapter assembly for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof |
US10111660B2 (en) | 2015-12-03 | 2018-10-30 | Covidien Lp | Surgical stapler flexible distal tip |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10966717B2 (en) | 2016-01-07 | 2021-04-06 | Covidien Lp | Surgical fastener apparatus |
US10660623B2 (en) | 2016-01-15 | 2020-05-26 | Covidien Lp | Centering mechanism for articulation joint |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
BR112018016098B1 (en) | 2016-02-09 | 2023-02-23 | Ethicon Llc | SURGICAL INSTRUMENT |
US10245029B2 (en) | 2016-02-09 | 2019-04-02 | Ethicon Llc | Surgical instrument with articulating and axially translatable end effector |
US10349937B2 (en) | 2016-02-10 | 2019-07-16 | Covidien Lp | Surgical stapler with articulation locking mechanism |
US10420559B2 (en) | 2016-02-11 | 2019-09-24 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | 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 |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US11284890B2 (en) | 2016-04-01 | 2022-03-29 | Cilag Gmbh International | Circular stapling system comprising an incisable tissue support |
US10413293B2 (en) | 2016-04-01 | 2019-09-17 | Ethicon Llc | Interchangeable surgical tool assembly with a surgical end effector that is selectively rotatable about a shaft axis |
US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
US10456140B2 (en) | 2016-04-01 | 2019-10-29 | Ethicon Llc | Surgical stapling system comprising an unclamping lockout |
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 |
WO2017180785A1 (en) | 2016-04-12 | 2017-10-19 | Applied Medical Resources Corporation | Reload shaft assembly for surgical stapler |
WO2017180706A1 (en) | 2016-04-12 | 2017-10-19 | Applied Medical Resources Corporation | Surgical stapler having articulation mechanism |
ES2938241T3 (en) | 2016-04-12 | 2023-04-05 | Applied Med Resources | Surgical stapler with a motorized handle |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses 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 |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US10426469B2 (en) | 2016-04-18 | 2019-10-01 | Ethicon Llc | Surgical instrument comprising a primary firing lockout and a secondary firing lockout |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US10561419B2 (en) | 2016-05-04 | 2020-02-18 | Covidien Lp | Powered end effector assembly with pivotable channel |
US11065022B2 (en) | 2016-05-17 | 2021-07-20 | Covidien Lp | Cutting member for a surgical instrument |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
CN109310431B (en) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | Staple cartridge comprising wire staples and punch staples |
US10702270B2 (en) | 2016-06-24 | 2020-07-07 | Ethicon Llc | Stapling system for use with wire staples and stamped staples |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
USD814632S1 (en) | 2016-10-21 | 2018-04-03 | Covidien Lp | Staple cartridge |
US10631857B2 (en) | 2016-11-04 | 2020-04-28 | Covidien Lp | Loading unit for surgical instruments with low profile pushers |
US11642126B2 (en) | 2016-11-04 | 2023-05-09 | Covidien Lp | Surgical stapling apparatus with tissue pockets |
US10492784B2 (en) | 2016-11-08 | 2019-12-03 | Covidien Lp | Surgical tool assembly with compact firing assembly |
WO2018092235A1 (en) * | 2016-11-17 | 2018-05-24 | オリンパス株式会社 | Stapler |
US10463371B2 (en) | 2016-11-29 | 2019-11-05 | Covidien Lp | Reload assembly with spent reload indicator |
AU2017258826A1 (en) | 2016-12-02 | 2018-06-21 | Covidien Lp | Surgical stapling instrument with curved end effector |
US11160551B2 (en) | 2016-12-21 | 2021-11-02 | Cilag Gmbh International | Articulatable surgical stapling instruments |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US10568626B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Surgical instruments with jaw opening features for increasing a jaw opening distance |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
US10758230B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument with primary and safety processors |
US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
CN110087565A (en) | 2016-12-21 | 2019-08-02 | 爱惜康有限责任公司 | Surgical stapling system |
US20180168619A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling systems |
US10568624B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Surgical instruments with jaws that are pivotable about a fixed axis and include separate and distinct closure and firing systems |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
US10537324B2 (en) | 2016-12-21 | 2020-01-21 | Ethicon Llc | Stepped staple cartridge with asymmetrical staples |
CN110099619B (en) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | Lockout device for surgical end effector and replaceable tool assembly |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
US10667809B2 (en) | 2016-12-21 | 2020-06-02 | Ethicon Llc | Staple cartridge and staple cartridge channel comprising windows defined therein |
US10758229B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument comprising improved jaw control |
US10835245B2 (en) | 2016-12-21 | 2020-11-17 | Ethicon Llc | Method for attaching a shaft assembly to a surgical instrument and, alternatively, to a surgical robot |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
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 |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
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 |
US10898186B2 (en) | 2016-12-21 | 2021-01-26 | Ethicon Llc | Staple forming pocket arrangements comprising primary sidewalls and pocket sidewalls |
US10709901B2 (en) | 2017-01-05 | 2020-07-14 | Covidien Lp | Implantable fasteners, applicators, and methods for brachytherapy |
US10952767B2 (en) | 2017-02-06 | 2021-03-23 | Covidien Lp | Connector clip for securing an introducer to a surgical fastener applying apparatus |
US20180235618A1 (en) | 2017-02-22 | 2018-08-23 | Covidien Lp | Loading unit for surgical instruments with low profile pushers |
US11350915B2 (en) | 2017-02-23 | 2022-06-07 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
US10849621B2 (en) | 2017-02-23 | 2020-12-01 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
US10299790B2 (en) | 2017-03-03 | 2019-05-28 | Covidien Lp | Adapter with centering mechanism for articulation joint |
US10660641B2 (en) | 2017-03-16 | 2020-05-26 | Covidien Lp | Adapter with centering mechanism for articulation joint |
US10603035B2 (en) | 2017-05-02 | 2020-03-31 | Covidien Lp | Surgical loading unit including an articulating end effector |
US11324502B2 (en) | 2017-05-02 | 2022-05-10 | Covidien Lp | Surgical loading unit including an articulating end effector |
US10524784B2 (en) | 2017-05-05 | 2020-01-07 | Covidien Lp | Surgical staples with expandable backspan |
US10390826B2 (en) | 2017-05-08 | 2019-08-27 | Covidien Lp | Surgical stapling device with elongated tool assembly and methods of use |
US10420551B2 (en) | 2017-05-30 | 2019-09-24 | Covidien Lp | Authentication and information system for reusable surgical instruments |
US10478185B2 (en) | 2017-06-02 | 2019-11-19 | Covidien Lp | Tool assembly with minimal dead space |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
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 |
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 |
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 |
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 |
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 |
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 |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
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 |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
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 |
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 |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
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 |
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 |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US11141154B2 (en) | 2017-06-27 | 2021-10-12 | Cilag Gmbh International | Surgical end effectors and anvils |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US11058424B2 (en) | 2017-06-28 | 2021-07-13 | Cilag Gmbh International | Surgical instrument comprising an offset articulation joint |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
US10588633B2 (en) | 2017-06-28 | 2020-03-17 | Ethicon Llc | Surgical instruments with open and closable jaws and axially movable firing member that is initially parked in close proximity to the jaws prior to firing |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
EP4070740A1 (en) | 2017-06-28 | 2022-10-12 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
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 |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member 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 |
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 |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US10624636B2 (en) | 2017-08-23 | 2020-04-21 | Covidien Lp | Surgical stapling device with floating staple cartridge |
US10806452B2 (en) | 2017-08-24 | 2020-10-20 | Covidien Lp | Loading unit for a surgical stapling instrument |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
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 |
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 |
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 |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
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 |
US10993714B2 (en) | 2017-11-28 | 2021-05-04 | Covidien Lp | Surgical stapling instrument and associated trigger mechanisms |
US10925603B2 (en) | 2017-11-14 | 2021-02-23 | Covidien Lp | Reload with articulation stabilization system |
US10863987B2 (en) | 2017-11-16 | 2020-12-15 | Covidien Lp | Surgical instrument with imaging device |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
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 |
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 |
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 |
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 |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
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 |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
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 |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US11583274B2 (en) | 2017-12-21 | 2023-02-21 | Cilag Gmbh International | Self-guiding stapling instrument |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
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 |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US10945732B2 (en) | 2018-01-17 | 2021-03-16 | Covidien Lp | Surgical stapler with self-returning assembly |
WO2019169010A1 (en) | 2018-02-27 | 2019-09-06 | Applied Medical Resources Corporation | Surgical stapler having a powered handle |
WO2019165640A1 (en) | 2018-03-02 | 2019-09-06 | Covidien Lp | Surgical stapling instrument |
US10849622B2 (en) | 2018-06-21 | 2020-12-01 | Covidien Lp | Articulated stapling with fire lock |
US10945730B2 (en) | 2018-06-25 | 2021-03-16 | Covidien Lp | Stapling device with selectively advanceable alignment pin |
US10736631B2 (en) | 2018-08-07 | 2020-08-11 | Covidien Lp | End effector with staple cartridge ejector |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
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 |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
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 |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US10849620B2 (en) | 2018-09-14 | 2020-12-01 | Covidien Lp | Connector mechanisms for surgical stapling instruments |
US11510669B2 (en) | 2020-09-29 | 2022-11-29 | Covidien Lp | Hand-held surgical instruments |
US11090051B2 (en) | 2018-10-23 | 2021-08-17 | Covidien Lp | Surgical stapling device with floating staple cartridge |
US11197673B2 (en) | 2018-10-30 | 2021-12-14 | Covidien Lp | Surgical stapling instruments and end effector assemblies thereof |
US10912563B2 (en) | 2019-01-02 | 2021-02-09 | Covidien Lp | Stapling device including tool assembly stabilizing member |
CN111466974B (en) * | 2019-01-24 | 2021-05-14 | 苏州英途康医疗科技有限公司 | Surgical instrument and linear stapler |
JP2022522421A (en) | 2019-02-27 | 2022-04-19 | アプライド メディカル リソーシーズ コーポレイション | Surgical stapling instrument with two-position lockout mechanism |
US11344297B2 (en) | 2019-02-28 | 2022-05-31 | Covidien Lp | Surgical stapling device with independently movable jaws |
US11259808B2 (en) | 2019-03-13 | 2022-03-01 | Covidien Lp | Tool assemblies with a gap locking member |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | 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 |
US11147551B2 (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 |
US11717293B2 (en) | 2019-03-29 | 2023-08-08 | Applied Medical Resources Corporation | Reload cover for surgical stapling system |
US11284892B2 (en) | 2019-04-01 | 2022-03-29 | Covidien Lp | Loading unit and adapter with modified coupling assembly |
US11284893B2 (en) | 2019-04-02 | 2022-03-29 | Covidien Lp | Stapling device with articulating tool assembly |
US11241228B2 (en) | 2019-04-05 | 2022-02-08 | Covidien Lp | Surgical instrument including an adapter assembly and an articulating surgical loading unit |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
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 |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11241235B2 (en) | 2019-06-28 | 2022-02-08 | Cilag Gmbh International | Method of using multiple RFID chips with a surgical assembly |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11224424B2 (en) | 2019-08-02 | 2022-01-18 | Covidien Lp | Linear stapling device with vertically movable knife |
EP4007529A4 (en) | 2019-08-02 | 2023-07-26 | Covidien LP | Surgical stapling device with curved tool assembly |
US11406385B2 (en) | 2019-10-11 | 2022-08-09 | Covidien Lp | Stapling device with a gap locking member |
CN114727818A (en) | 2019-11-01 | 2022-07-08 | 柯惠有限合伙公司 | Surgical stapling device with blade lock |
US11123068B2 (en) | 2019-11-08 | 2021-09-21 | Covidien Lp | Surgical staple cartridge |
US11534163B2 (en) | 2019-11-21 | 2022-12-27 | Covidien Lp | Surgical stapling instruments |
US11395653B2 (en) | 2019-11-26 | 2022-07-26 | Covidien Lp | Surgical stapling device with impedance sensor |
US11707274B2 (en) | 2019-12-06 | 2023-07-25 | Covidien Lp | Articulating mechanism for surgical instrument |
US11109862B2 (en) | 2019-12-12 | 2021-09-07 | Covidien Lp | Surgical stapling device with flexible shaft |
US11737747B2 (en) | 2019-12-17 | 2023-08-29 | Covidien Lp | Hand-held surgical instruments |
JP2023513999A (en) | 2019-12-18 | 2023-04-05 | コヴィディエン リミテッド パートナーシップ | Surgical stapling device with shipping cap |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
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 |
KR20220122732A (en) | 2019-12-31 | 2022-09-02 | 어플라이드 메디컬 리소시스 코포레이션 | Electrosurgical system using tissue and maximum current identification |
US11452524B2 (en) | 2020-01-31 | 2022-09-27 | Covidien Lp | Surgical stapling device with lockout |
US11278282B2 (en) | 2020-01-31 | 2022-03-22 | Covidien Lp | Stapling device with selective cutting |
EP4103070A4 (en) | 2020-02-14 | 2023-11-08 | Covidien LP | Cartridge holder for surgical staples and having ridges in peripheral walls for gripping tissue |
US11344301B2 (en) | 2020-03-02 | 2022-05-31 | Covidien Lp | Surgical stapling device with replaceable reload assembly |
US11344302B2 (en) | 2020-03-05 | 2022-05-31 | Covidien Lp | Articulation mechanism for surgical stapling device |
US11707278B2 (en) | 2020-03-06 | 2023-07-25 | Covidien Lp | Surgical stapler tool assembly to minimize bleeding |
US11246593B2 (en) | 2020-03-06 | 2022-02-15 | Covidien Lp | Staple cartridge |
US11317911B2 (en) | 2020-03-10 | 2022-05-03 | Covidien Lp | Tool assembly with replaceable cartridge assembly |
US11357505B2 (en) | 2020-03-10 | 2022-06-14 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
US11406383B2 (en) | 2020-03-17 | 2022-08-09 | Covidien Lp | Fire assisted powered EGIA handle |
US11426159B2 (en) | 2020-04-01 | 2022-08-30 | Covidien Lp | Sled detection device |
US11331098B2 (en) | 2020-04-01 | 2022-05-17 | Covidien Lp | Sled detection device |
US11504117B2 (en) | 2020-04-02 | 2022-11-22 | Covidien Lp | Hand-held surgical instruments |
US11937794B2 (en) | 2020-05-11 | 2024-03-26 | Covidien Lp | Powered handle assembly for surgical devices |
US11406387B2 (en) | 2020-05-12 | 2022-08-09 | Covidien Lp | Surgical stapling device with replaceable staple cartridge |
US11191537B1 (en) | 2020-05-12 | 2021-12-07 | Covidien Lp | Stapling device with continuously parallel jaws |
US11534167B2 (en) | 2020-05-28 | 2022-12-27 | Covidien Lp | Electrotaxis-conducive stapling |
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 |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
US11191538B1 (en) | 2020-06-08 | 2021-12-07 | Covidien Lp | Surgical stapling device with parallel jaw closure |
US11744584B2 (en) | 2020-06-09 | 2023-09-05 | Covidien Lp | Alignment pin assembly for surgical stapler |
US11844517B2 (en) | 2020-06-25 | 2023-12-19 | Covidien Lp | Linear stapling device with continuously parallel jaws |
US11324500B2 (en) | 2020-06-30 | 2022-05-10 | Covidien Lp | Surgical stapling device |
US11517305B2 (en) | 2020-07-09 | 2022-12-06 | Covidien Lp | Contoured staple pusher |
US11446028B2 (en) | 2020-07-09 | 2022-09-20 | Covidien Lp | Tool assembly with pivotable clamping beam |
US20220031320A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with flexible firing member actuator constraint arrangements |
US11266402B2 (en) | 2020-07-30 | 2022-03-08 | Covidien Lp | Sensing curved tip for surgical stapling instruments |
US11439392B2 (en) | 2020-08-03 | 2022-09-13 | Covidien Lp | Surgical stapling device and fastener for pathological exam |
US11395654B2 (en) | 2020-08-07 | 2022-07-26 | Covidien Lp | Surgical stapling device with articulation braking assembly |
US11602342B2 (en) | 2020-08-27 | 2023-03-14 | Covidien Lp | Surgical stapling device with laser probe |
US11678878B2 (en) | 2020-09-16 | 2023-06-20 | Covidien Lp | Articulation mechanism for surgical stapling device |
US11660092B2 (en) | 2020-09-29 | 2023-05-30 | Covidien Lp | Adapter for securing loading units to handle assemblies of surgical stapling instruments |
US11406384B2 (en) | 2020-10-05 | 2022-08-09 | Covidien Lp | Stapling device with drive assembly stop member |
US11576674B2 (en) | 2020-10-06 | 2023-02-14 | Covidien Lp | Surgical stapling device with articulation lock assembly |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
AU2021369828A1 (en) | 2020-10-29 | 2023-06-01 | Applied Medical Resources Corporation | Surgical stapler having a powered handle |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
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 |
US11771428B2 (en) | 2020-10-29 | 2023-10-03 | Applied Medical Resources Corporation | Actuation shaft retention mechanism for surgical stapler |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11890007B2 (en) | 2020-11-18 | 2024-02-06 | Covidien Lp | Stapling device with flex cable and tensioning mechanism |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
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 |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11737774B2 (en) | 2020-12-04 | 2023-08-29 | Covidien Lp | Surgical instrument with articulation assembly |
US11819200B2 (en) | 2020-12-15 | 2023-11-21 | Covidien Lp | Surgical instrument with articulation assembly |
US11553914B2 (en) | 2020-12-22 | 2023-01-17 | Covidien Lp | Surgical stapling device with parallel jaw closure |
US11759206B2 (en) | 2021-01-05 | 2023-09-19 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
US11744582B2 (en) | 2021-01-05 | 2023-09-05 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
CN112754574B (en) * | 2021-01-20 | 2022-07-26 | 苏州市东挺河智能科技发展有限公司 | Arc-shaped cutting anastomat and operation method thereof |
US11759207B2 (en) | 2021-01-27 | 2023-09-19 | Covidien Lp | Surgical stapling apparatus with adjustable height clamping member |
US11517313B2 (en) | 2021-01-27 | 2022-12-06 | Covidien Lp | Surgical stapling device with laminated drive member |
US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11950777B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Staple cartridge comprising an information access control system |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11717300B2 (en) | 2021-03-11 | 2023-08-08 | Covidien Lp | Surgical stapling apparatus with integrated visualization |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
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 |
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 |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
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 |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11497495B2 (en) | 2021-03-31 | 2022-11-15 | Covidien Lp | Continuous stapler strip for use with a surgical stapling device |
US11666330B2 (en) | 2021-04-05 | 2023-06-06 | Covidien Lp | Surgical stapling device with lockout mechanism |
US11576670B2 (en) | 2021-05-06 | 2023-02-14 | Covidien Lp | Surgical stapling device with optimized drive assembly |
US11812956B2 (en) | 2021-05-18 | 2023-11-14 | Covidien Lp | Dual firing radial stapling device |
US11696755B2 (en) | 2021-05-19 | 2023-07-11 | Covidien Lp | Surgical stapling device with reload assembly removal lockout |
US11771423B2 (en) | 2021-05-25 | 2023-10-03 | Covidien Lp | Powered stapling device with manual retraction |
US11510673B1 (en) | 2021-05-25 | 2022-11-29 | Covidien Lp | Powered stapling device with manual retraction |
US11701119B2 (en) | 2021-05-26 | 2023-07-18 | Covidien Lp | Powered stapling device with rack release |
US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11576675B2 (en) | 2021-06-07 | 2023-02-14 | Covidien Lp | Staple cartridge with knife |
US11707275B2 (en) | 2021-06-29 | 2023-07-25 | Covidien Lp | Asymmetrical surgical stapling device |
US11617579B2 (en) | 2021-06-29 | 2023-04-04 | Covidien Lp | Ultra low profile surgical stapling instrument for tissue resections |
US11602344B2 (en) | 2021-06-30 | 2023-03-14 | Covidien Lp | Surgical stapling apparatus with firing lockout assembly |
US11540831B1 (en) | 2021-08-12 | 2023-01-03 | Covidien Lp | Staple cartridge with actuation sled detection |
US11779334B2 (en) | 2021-08-19 | 2023-10-10 | Covidien Lp | Surgical stapling device including a manual retraction assembly |
US11707277B2 (en) | 2021-08-20 | 2023-07-25 | Covidien Lp | Articulating surgical stapling apparatus with pivotable knife bar guide assembly |
US11576671B1 (en) | 2021-08-20 | 2023-02-14 | Covidien Lp | Small diameter linear surgical stapling apparatus |
US11864761B2 (en) | 2021-09-14 | 2024-01-09 | Covidien Lp | Surgical instrument with illumination mechanism |
US11653922B2 (en) | 2021-09-29 | 2023-05-23 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
US11660094B2 (en) | 2021-09-29 | 2023-05-30 | Covidien Lp | Surgical fastening instrument with two-part surgical fasteners |
US11849949B2 (en) | 2021-09-30 | 2023-12-26 | Covidien Lp | Surgical stapling device with firing lockout member |
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 (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE869388C (en) * | 1940-11-01 | 1953-03-05 | Heinrich C Ulrich | Medical operating forceps |
DE869527C (en) * | 1951-07-17 | 1953-03-05 | Heinrich C Ulrich | Staple sewing apparatus with crimping jaws running against each other |
US3275211A (en) | 1965-05-10 | 1966-09-27 | United States Surgical Corp | Surgical stapler with replaceable cartridge |
US3949924A (en) * | 1974-10-18 | 1976-04-13 | United States Surgical Corporation | Surgical stapling instrument |
US4196836A (en) * | 1978-02-14 | 1980-04-08 | Senco Products Inc. | Surgical stapling instrument |
US4185762A (en) * | 1978-03-27 | 1980-01-29 | Minnesota Mining And Manufacturing Company | Medical stapling device |
US4204623A (en) * | 1978-07-17 | 1980-05-27 | United States Surgical Corporation | Manually powered surgical stapling instrument |
US4440170A (en) * | 1979-03-06 | 1984-04-03 | Ethicon, Inc. | Surgical clip applying instrument |
US4606343A (en) * | 1980-08-18 | 1986-08-19 | United States Surgical Corporation | Self-powered surgical fastening instrument |
US4402444A (en) * | 1981-04-20 | 1983-09-06 | United States Surgical Corporation | Surgical stapling instrument with automatic frame reinforcement |
US4576167A (en) * | 1981-09-03 | 1986-03-18 | United States Surgical Corporation | Surgical stapler apparatus with curved shaft |
US4442964A (en) * | 1981-12-07 | 1984-04-17 | Senco Products, Inc. | Pressure sensitive and working-gap controlled surgical stapling instrument |
US4471781A (en) * | 1982-02-03 | 1984-09-18 | Ethicon, Inc. | Surgical instrument with rotatable front housing and latch mechanism |
US4473077A (en) * | 1982-05-28 | 1984-09-25 | United States Surgical Corporation | Surgical stapler apparatus with flexible shaft |
US4485817A (en) * | 1982-05-28 | 1984-12-04 | United States Surgical Corporation | Surgical stapler apparatus with flexible shaft |
US4488523A (en) * | 1982-09-24 | 1984-12-18 | United States Surgical Corporation | Flexible, hydraulically actuated device for applying surgical fasteners |
FR2542188B1 (en) * | 1983-03-11 | 1985-08-16 | Foures Bernard | SURGICAL FORCEPS FOR LINEAR MECHANICAL SUTURES OF VISCARS OF THE THORACIC AND ABDOMINAL CAVITIES |
US4527724A (en) * | 1983-06-10 | 1985-07-09 | Senmed, Inc. | Disposable linear surgical stapling instrument |
US4530453A (en) * | 1983-10-04 | 1985-07-23 | United States Surgical Corporation | Surgical fastener applying apparatus |
US4610383A (en) * | 1983-10-14 | 1986-09-09 | Senmed, Inc. | Disposable linear surgical stapler |
US4566620A (en) * | 1984-10-19 | 1986-01-28 | United States Surgical Corporation | Articulated surgical fastener applying apparatus |
US4580712A (en) * | 1984-10-19 | 1986-04-08 | United States Surgical Corporation | Surgical fastener applying apparatus with progressive application of fastener |
US4573622A (en) * | 1984-10-19 | 1986-03-04 | United States Surgical Corporation | Surgical fastener applying apparatus with variable fastener arrays |
-
1985
- 1985-08-30 US US06/771,845 patent/US4728020A/en not_active Expired - Lifetime
-
1986
- 1986-08-26 CA CA000516804A patent/CA1270170A/en not_active Expired - Fee Related
- 1986-08-27 AU AU61885/86A patent/AU586882B2/en not_active Ceased
- 1986-08-28 AT AT86306671T patent/ATE61514T1/en not_active IP Right Cessation
- 1986-08-28 EP EP86306671A patent/EP0216532B1/en not_active Expired - Lifetime
- 1986-08-28 DE DE8686306671T patent/DE3678080D1/en not_active Expired - Lifetime
- 1986-08-29 BR BR8604158A patent/BR8604158A/en unknown
- 1986-08-29 JP JP61203547A patent/JPS62101238A/en active Granted
-
1988
- 1988-02-29 US US07/161,987 patent/US4869414A/en not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
EP0216532A1 (en) | 1987-04-01 |
JPS62101238A (en) | 1987-05-11 |
ATE61514T1 (en) | 1991-03-15 |
US4869414A (en) | 1989-09-26 |
EP0216532B1 (en) | 1991-03-13 |
AU6188586A (en) | 1987-03-05 |
JPH0468941B2 (en) | 1992-11-04 |
DE3678080D1 (en) | 1991-04-18 |
AU586882B2 (en) | 1989-07-27 |
BR8604158A (en) | 1987-04-28 |
US4728020A (en) | 1988-03-01 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CA1270170A (en) | Articulated surgical fastener applying apparatus | |
CA1236745A (en) | Articulated surgical fastener applying apparatus | |
US11559301B2 (en) | Surgical stapling device | |
EP0198873B1 (en) | Surgical fastener applying apparatus with progressive application of fasteners | |
EP0136950B1 (en) | Surgical fastener applying apparatus | |
CN101500498B (en) | Surgical stapling and cutting device and method for using the device | |
US7494039B2 (en) | Surgical stapling device | |
WO2004032762A1 (en) | Tool assembly for a surgical stapling device | |
US11622764B2 (en) | Surgical handle assembly |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
MKLA | Lapsed |