CA2095915C - Surgical apparatus and anvil delivery system therefor - Google Patents
Surgical apparatus and anvil delivery system thereforInfo
- Publication number
- CA2095915C CA2095915C CA002095915A CA2095915A CA2095915C CA 2095915 C CA2095915 C CA 2095915C CA 002095915 A CA002095915 A CA 002095915A CA 2095915 A CA2095915 A CA 2095915A CA 2095915 C CA2095915 C CA 2095915C
- Authority
- CA
- Canada
- Prior art keywords
- anvil
- distal end
- rod
- end portion
- proximal end
- 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 - Lifetime
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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
-
- 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
- A61B2017/07257—Stapler heads characterised by its anvil
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1125—Forceps, specially adapted for performing or assisting anastomosis
-
- 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
- A61B2017/2931—Details of heads or jaws with releasable head
Abstract
An apparatus for delivering a surgical device to a predetermined location within a tubular organ includes an elongated delivery member having a proximal and a distal end, a mounting mechanism for detachably mounting the surgical device at the distal end of the elongated delivery member and a releasing mechanism for releasing the surgical device from the mounting mechanism.
A detachable anvil assembly for use with an apparatus for performing circular anastomosis of tubular organs includes an elongated anvil rod having proximal and distal end portions and an anvil head mounted to the distal end portion of the anvil rod. The distal end portion is pivotally mounted and is adapted to pivot approximately plus or minus ninety degrees relative to a longitudinal axis defined by the rod. An elongated delivery member detachably receives the anvil assembly and facilitates delivery of the anvil assembly to the operative site. The pivoting feature of the distal end reduces the transverse profile of the assembly which consequently facilitates introduction and advancement of the anvil assembly within the tubular organ.
A detachable anvil assembly for use with an apparatus for performing circular anastomosis of tubular organs includes an elongated anvil rod having proximal and distal end portions and an anvil head mounted to the distal end portion of the anvil rod. The distal end portion is pivotally mounted and is adapted to pivot approximately plus or minus ninety degrees relative to a longitudinal axis defined by the rod. An elongated delivery member detachably receives the anvil assembly and facilitates delivery of the anvil assembly to the operative site. The pivoting feature of the distal end reduces the transverse profile of the assembly which consequently facilitates introduction and advancement of the anvil assembly within the tubular organ.
Description
~ ~ 9 5 S 1 ~
-(1291 EPO/CAN) A~VTT. DF.T,IVF.RY SYSTF~I
~CKGROUND OF THF. T~vFNTToN
1. F;eld of the Tnvention This invention relates to a surgical delivery apparatus, and in particular, to an apparatus for delivering an anvil component to a remote location within a hollow organ to effect the joining of hollow organ sections by circular anastomosis.
-(1291 EPO/CAN) A~VTT. DF.T,IVF.RY SYSTF~I
~CKGROUND OF THF. T~vFNTToN
1. F;eld of the Tnvention This invention relates to a surgical delivery apparatus, and in particular, to an apparatus for delivering an anvil component to a remote location within a hollow organ to effect the joining of hollow organ sections by circular anastomosis.
2. Descri~tion of the Prior Art Circular anastomosis is the surgical joining of separate hollow organ sections so that the sections intercommunicate. Typically, the anastomosis procedure follows surgery in which a diseased or defective section of hollow tissue is removed and the remaining end sections are to be joined. In accordance with such procedures, the operative tissue is exposed by making several extensive incisions in the body cavity wall and folding the cut tissue to provide access to the surgical site. The diseased section of the organ is removed thereby leaving two separate end sections of organ which are thereafter fastened by means of a stapling instrument which drives a circular array of staples through the end sections and simultaneously cores out any overlapping tissue to free the tubular passages.
SUMM~RY OF THF T~VF~TION
CA 0209~91~ 1998-01-27 The present invention provides a surgical apparatus for delivering an anvil component to a targeted section of a tubular organ so that anastomosis of two separated organ sections may be achieved using minimally invasive surgical techniques.
In accordance with an embodiment of the present invention there is provided a surgical stapling apparatus having a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
In accordance with another embodiment of the present invention there is provided a surgical apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and an anvil assembly adapted for use with an apparatus for performing a circular anastomosis, the anvil assembly comprising an anvil rod having proximal and distal end portions and a substantially circular anvil head mounted to the distal end portion of the anvil rod, the anvil head having a generally flat staple forming surface and being pivotally secured to the anvil rod proximal end portion, wherein the anvil rod distal end portion is pivotable from a CA 0209~91~ 1998-01-27 first position, wherein the staple forming surface of the anvil head is in general perpendicular alignment with a longitudinal axis defined by the anvil rod proximal end portion, to a second position, wherein the staple forming surface of the anvil head is angularly displaced by about 90~ from the first position.
In accordance with a yet another embodiment of the present invention there is provided a surgical apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and having an anvil assembly for a circular stapling instrument, the anvil assembly having a generally circular anvil head and an anvil rod having proximal and distal end portions, the anvil head being mounted to a distal end of the anvil rod distal end portion, and comprising a pivot pin for pivotably mounting a distal end of the anvil rod proximal end portion to a proximal end of the anvil rod distal end portion, wherein the anvil head and anvil rod distal end portion are pivotable about the pivot pin and pivotable relative to the anvil rod proximal end portion.
Yet another embodiment of the present invention provides a surgical stapling apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and having an elongate shaft, a handle assembly connected to a proximal end of the elongate shaft, a fastener retainer connected to a distal end of the elongate shaft, the fastener retainer having a circular array of fasteners, and an anvil assembly detachably mountable to a distal end of the apparatus, the anvil assembly having an anvil rod, the anvil - 2a -CA 0209~91~ 1998-01-27 rod having proximal and distal end portions and a longitudinal axis, and a substantially circular anvil head mounted to the distal end of the anvil rod, the anvil head having a generally flat staple forming surface in general perpendicular alignment with the longitudinal axis defined by the anvil rod; and the staple forming surface of the anvil head is pivotally secured to the anvil rod proximal end portion, wherein the anvil rod distal end portion is pivotable from a first position, wherein the staple forming surface is in generally perpendicular alignment with the longitudinal axis defined by the anvil rod, to a second position, wherein the staple forming surface has pivotably moved from the first position.
A still further embodiment of the present invention provides a surgical stapling apparatus comprising an anvil delivery system for delivering an anvil component within a tubular organ section, comprising: an elongated delivery member having a proximal end and a distal end and a longitudinal bore extending therethrough; a hand grip portion disposed at the proximal end of the elongated delivery member to facilitate handling of the delivery system, the hand grip portion having a longitudinal bore extending therethrough in axial alignment with the longitudinal bore of the elongated delivery member;
a rod member slidably received within the longitudinal bore of the elongated delivery member and the hand grip portion and adapted to move towards the distal end of the elongated delivery member, the rod member having a proximal end portion extending beyond a proximal end of the hand grip portion; and an anvil component releasably mounted at the distal end of the elongated delivery member, the anvil component having an anvil head and an anvil shaft, the anvil shaft inserted within the bore of the elongated delivery member at the distal end thereof to releasably mount the anvil component to the elongated delivery member; wherein upon a distal force applied to the proximal end portion of the rod member causes the rod member CA 0209~91~ 1998-01-27 to be distally displaced such that a distal end of the rod member engages the anvil shaft to effect release of the anvil component from its engagement with the distal end of the elongated delivery member; and further comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
In use, the distal end of the elongated delivery member with mounted anvil component is inserted within the hollow organ and advanced to a desired location in the tubular organ.
A distal force is applied to the proximal end portion of the rod member, which causes the rod member to distally advance and engage the anvil component to effect release of the anvil component from its engagement with the elongated delivery member to expel the anvil component within the desired organ section.
The present invention also relates to a method for performing circular anastomosis of first and second intestinal sections using minimally invasive surgical techniques. The method comprises providing an anvil delivery system, including - 3a -209lq~ s an elongated delivery member having a proximal and a distal end, mounting means for releasably mounting an anvil component to the distal end of the elongated delivery member and releasing means for releasing the anvil component from the mounting means to expel the anvil component within the targeted organ section. In accordance with the method, the distal end of the elongated delivery member with mounted anvil component is transanally inserted and advanced into the intestine until the anvil component is disposed beyond a diseased tissue section. The releasing means is thereafter actuated to release the anvil - 3b -20359:~
-component from the mounting means and to place the anvil component within an intestinal section beyond the diseased section. The anvil delivery system is then withdrawn from the operative site.
Thereafter, a first and second side of the diseased tissue section is isolated and the diseased section is resected, preferably by laparoscopic means, leaving first and second intestinal sections having first and second stapled ends, respectively, with the anvil component disposed within the second intestinal section. An opening is made in the second stapled end of the second intestinal section so that the anvil component may be grasped and exposed. An apparatus for performing circular anastomosis of the first and second intestinal sections is introduced transanally and advanced into the first intestinal section until a distal end of the apparatus engages the first stapled end. An opening is made in the first stapled end to expose the staple holding component of the apparatus. The anvil shaft is then mounted within the staple holding component. This mounting interposes the two ends of the intestinal sections between the anvil component and the staple holding component. The apparatus is fired and the anastomosis of the first and second intestinal sections is completed. Thereafter, the apparatus is removed from the body.
Generally stated, the present invention is directed to an anvil assembly and associated delivery system, the anvil assembly being adapted for use with an apparatus for performing circular anastomosis. The anvil assembly comprises an elongated anvil rod having proximal and distal end portions and an anvil head detachably mounted to the distal end portion of the anvil rod. The distal end portion is pivotally mounted and is adapted to pivot from a first ~0~91~
operative position to a second non-operative position, whereby at least one dimension of the anvil assembly in the second non-operative position is effectively less than the corresponding dimension in the first operative position.
In a preferred embodiment, the anvil assembly comprises an elongated anvil rod having proximal and distal end portions and an anvil head detachably mounted to the distal end portion of the anvil rod. The distal end portion is pivotal from a first operative position in general alignment with a longitudinal axis defined by the anvil rod to a second non-operative position angularly displaced relative to the longitudinal axis. In the second non-operative position, the anvil rod presents a less obtrusive profile which, accordingly, facilitates advancement of the anvil assembly through body tissue.
The distal end portion is pivotal with respect to the longitudinal axis defined by the anvil rod through an angle of up to about 90 . In particular, the distal end portion is adapted to pivot up to about 90 with respect to each side of the longitudinal axis, thereby providing full pivotal articulation thereof of about 180-.
The distal end portion comprises a circumferential mounting collar which is received within a circular aperture formed within the anvil head to mount the anvil head to the anvil rod. The mounting collar preferably comprises a plurality of longitudinally extending external splines which are engagable with cooperating longitudinally extending internal splines formed within the anvil head to properly align the anvil head with the anvil rod.
The anvil rod also comprises a plurality of longitudinally extending external splines disposed intermediate its proximal and distal end portions. The external splines are engageable with cooperating longitudinally extending internal splines formed within a distal end of the apparatus to properly align the anvil rod with the apparatus.
The anvil apparatus is adapted to be mounted to an elongated delivery member which includes a mounting mechanism for detachably mounting the anvil assembly on a distal end of the elongated delivery member and releasing means for releasing the anvil member from the mounting means.
The present invention is also directed to a surgical apparatus for performing circular anastomosis of first and second tissue sections. The apparatus comprises elongated tubular means having a proximal and distal end, means for firing a plurality of fasteners from the distal end of the elongated tubular means and anvil means detachably mounted to the distal end of the elongated tubular means. The anvil means comprises an anvil rod having proximal and distal end portions and an anvil head detachably mounted to the distal end potion of the anvil rod. The distal end portion is pivotal from a first operative position in general alignment with a longitudinal axis defined by the anvil rod to a second non-operative position angularly displaced relative to the longitudinal axis. The anvil assembly defines an effective cross-sectional area generally transverse to the longitudinal axis. The effective cross-sectional area of the anvil assembly in the second non-operative position is less than the effective cross-sectional area of the anvil assembly in the first operative position to 2 ~ 9 ~
facilitate introduction and advancement of the anvil assembly through body tissue.
209.~91~
BRTFF DF~SCRTPTION OF THF DRAWI~GS
FIG. 1 iS a perspective view of the anvil delivery system of the present invention;
FIG. 2 iS a side view of the delivery system of FIG. 1 with a partial cutaway of the distal end, illustrating the positioning of the anvil shaft of the anvil component and tail portion within the elongated sheath member when the apparatus is in the pre-fired condition;
FIG. 3 iS a perspective view of the delivery system of FIG. 1 in the post-fired condition with the anvil component expelled from the elongated sheath member;
FIG. 4 iS a perspective view of the delivery system of FIG. 1 inserted transanally and extending through a portion of the intestine;
FIG. 5 iS a perspective view of the delivery system of FIG. 1 inserted through the intestine and in the post-fired condition with the anvil component and tail portion expelled from the delivery system;
FIG. 6 is a perspective view illustrating removal of a diseased tissue section by a laparoscopic stapling instrument;
FIG. 7 is a perspective view after application of the laparoscopic stapling instrument, illustrating the formed first and second intestinal sections;
FIG. 8 is a perspective view with a partial cut-aways of the first intestinal section, illustrating advancement of an apparatus for performing anastomosis and exposure of the anvil shaft from the second intestinal section;
FIG. 9 iS a perspective view with partial cutaways of the first and second intestinal sections, illustrating the 209~91~
anvil shaft of the anvil component mounted within the staple holding component;
FIG. 10 iS a perspective view of the anastomosis of the first and second intestinal sections after firing of the anastomosis apparatus;
FIG. 11 iS a perspective view illustrating an alternative method for resection and removal of the diseased tissue section in which the diseased section is to be removed through the rectal opening;
FIG. 12 iS a perspective view after removal of the diseased section through the rectal opening and application of a laparoscopic stapling instrument to the first intestinal section;
FIG. 13 iS a perspective view of a surgical stapler apparatus for performing anastomosis of hollow organs of the type contemplated by the present invention;
FIG. 14 iS a side plan view of an alternative embodiment the detachable anvil rod constructed according to the present invention illustrating the pivotal distal end portion;
FIG. 15 iS a sectional view with parts separated of the distal end portion and the remaining portion of the rod of FIG. 14 illustrating the mounting components for pivotally mounting the distal end portion;
FIG. 16 iS a side plan view of the detachable anvil rod of FIG. 14 with mounted anvil head illustrating the distal end portion of the rod in a generally aligned operative position;
FIGS. 17A-17B are side plan views similar to the view of FIG. 16 illustrating the distal end portion of the 209~9~ 5 anvil rod pivoted 90' with respect to each side of the longitudinal axis defined by the anvil rod;
FIG. 18 is a side view of a delivery system used to deliver the anvil rod to a desired predetermined location within a tubular organ;
FIG. 19 is a perspective view of the intestinal area of a patient illustrating the introduction of the surgical apparatus of FIG. 13 prior to mounting of the anvil rod of the present invention to the apparatus; and FIG. 20 iS a perspective view similar to that of FIG. 19 illustrating mounting of the anvil rod of the present invention to the distal end of the surgical apparatus.
DF~CRIPTION OF THF p~FFF~RFn F~RoDIMF~Ts Referring now to the drawings and, in particular, to FIGS. 1-3, there is shown an anvil delivery system in accordance with one embodiment of the present invention.
Anvil delivery system 10 includes an elongated sheath member 12 having longitudinal bore 13 (see FIG. 2) extending therethrough, rod member 14, and hand grip member 16 disposed at the proximal end portion of sheath member 12. Hand grip member 16 also includes a longitudinal bore extending therethrough in axial alignment with longitudinal bore 13 of sheath member 12. In a preferred embodiment, hand grip member 16 includes a grip enhancing means such as a plurality of circumferential ribs l9 to facilitate grasping and maneuvering of the delivery sys~em.
Anvil delivery system 10 expels anvil component 18 into a hollow tubular tissue section which is to be subsequently attached to an adjacent tissue section by circular anastomosis. Anvil component 18 includes anvil head 20959~
20 mounted on anvil shaft 22. Anvil shaft 22 is intended to be mounted within staple holding component 62 tsee FIG. 8) of a stapling apparatus. Anvil head 20 may include an annular array of staple forming buckets to receive and bend staples fired from staple holding component 62. It is to be noted that the components of delivery system 10 can be modified to accommodate a variety of sizes and types of anvils.
Rod member 14 is slidably received within longitudinal bore 13 of sheath member 12 and the longitudinal bore of hand grip member 16, and is adapted to move in a distal direction relative to the remaining components in the delivery system. In a preferred embodiment, proximal end portion 17 of rod member 14 extends beyond the proximal end of hand grip member 16 as best shown in FIGS. 1 and 2. When a force is applied to proximal end portion 17, rod member 14 slides in a distal direction as shown by the arrow in FIG. 3.
This distal movement causes bearing surface 15 of rod member 14 to engage shaft 22 of anvil component 18 and to release anvil component 18 from its engagement with elongated sheath member 12, and to expel the component into a targeted tissue section.
Anvil component 18 may be mounted to elongated sheath member 12 by conventional means. In a preferred embodiment and as best shown in FIG. 2, anvil shaft 22 is inserted within the distal end of sheath member 12 to mount the anvil component. Preferably, the diameter of shaft 22 is slightly less than the inner diameter of the proximal end of sheath member 12 such that the peripheral surface of shaft 22 frictionally engages the inner peripheral surface of sheath member 12 to assist in retaining anvil component 18 within the sheath member during insertion of the system within the tubular organ.
2~ g ~ ~5 Delivery system 10 may range in length from about 60 cms to about 180 cms, however, any appropriate length may be chosen depending upon the particular application. In a preferred embodiment system 10 is straight, however, it is within the scope of the present invention for system 10 to be curved to facilitate placement of the instrument in particular body structures and to reach remote or relatively inaccessible operative sites. It is also possible for delivery system 10 to be flexible. Preferably all components of delivery system 10 are fabricated from polymeric materials, which thereby reduces the cost of manufacture of the system and makes it economically feasible to dispose the system after use.
Further understanding of the significant aspects of the delivery system of the present invention will become more readily apparent by the following description of the use of same. Referring now to FIGS. 4 - 10, the anvil delivery system 10 in accordance with the present invention is shown in a sequence of operation.
Referring initially to FIG. 4, the surgeon grasps delivery system 10 by hand grip 16 and inserts the distal end of the system with mounted anvil component 18 through the rectal opening 30 and into colon or intestine 32. The system 10 is then advanced within intestine 32 until anvil head 20 extends slightly beyond diseased section 34 of the intestine.
2a9591 5 Referring now to FIG. 5, the delivery system is actuated by the surgeon by depressing proximal end portion 17 of rod member 14 (see FIGS. 1-3) to thereby effect distal movement of the rod member and cause bearing surface 15 of the rod member to engage the proximal end of shaft 22 and eject anvil component 18 into intestine 32. It is to be appreciated that after release from system 10, anvil component 18 is disposed in a section of intestine beyond diseased section 34. At this point in the procedure, delivery system 10 is removed from the colon.
The diseased tissue section is then excised followed by anastomosis of the adjacent severed tissue sections.
Preferably, the remaining operative procedures will be performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. This is a significant aspect of the present invention and is made possible by the prior transanal placement of the anvil component within the intestinal tissue. Such placement removes the need for incising the abdominal cavity to introduce the detached component to the operative site.
Referring now to FIG. 6, the preferred method for resecting diseased section 34 is illustrated. Through appropriate trocar sleeves, the surgeon applies a laparoscopic stapler 50 to both sides of diseased section 34. A suitable stapler for this purpose is described in commonly assigned U.S.
Patent No. 5,040,715 issued August 20, 1991. Each application of the stapler places two triple staggered rows of staples 52 while a knife cuts therebetween. FIG. 6 illustrates the staple rows after the application of stapler 50 to a section of the intestine nearest rectal opening 30.
2~9~
FIG. 6 also shows stapler 50 being applied to a section of the intestine beyond diseased section 34.
Referring now to FIG. 7, after application to both sides of diseased section 34, stapler 50 will have created two separated, closed end tissue sections 36, 40 having stapled ends 38, 42, respectively. This application will also have severed diseased section 34 from the remaining intestinal tissue. In FIG. 7, diseased section 34 is already removed from the operative site, preferably through one of the trocar sleeves (not shown). At this point in the procedure, anvil component 18 is positioned within tissue section 40.
Alternative laparoscopic instruments and methods may be incorporated to isolate diseased section 34 from the remaining intestinal tissue and to remove section 34 from the operative site. Referring to FIG. 11, the lower side of diseased section 34 may be severed from the intestinal tissue by, for example, a conventional scalpel. This step in the procedure creates intestinal section 36 having open end 37.
Thereafter, stapling instrument 50 may be applied to the upper side of section 34 to close off and completely sever the diseased section from the intestine. Since the end of tissue section 36 is not closed, open end 37 provides an avenue to remove diseased section 34, i.e., removing the diseased section through the rectal opening 30. After removal, intestinal section 36 may be closed off as shown in FIG. 12 by conventional means, such as, for example, with a laparoscopic stapling instrument. Alternatively, tissue section 36 may be closed off around the staple holding component by a purse string suture.
It is also within the scope of the present invention to close off the upper side of diseased section 34 20~91~
with a laparoscopic stapling instrument which fires a single row of staples, and then sever the diseased section on its upper side with a scalpel, laser or electrocautery device which is applied through a trocar sleeve. Thereafter, a similar cutting device may be used on the lower side of section 34 and the completely severed diseased section removed through end section 36 and out rectal opening 30 in the same manner as previously described. Intestinal section 36 may then be closed off with the stapling instrument. It is also possible to isolate diseased section 34 using a scalpel on both sides of the diseased section and to leave the ends of intestinal sections 36,40 open. Sections 36,40 may subsequently positioned for attachment by conventional drawstring or purse string sutures.
Referring to Figs. 7-10 rejoining of the tissue ends is accomplished by inserting an apparatus 60 for performing circular surgical stapling of hollow tissue organs through rectal opening 30 and into intestinal section 36.
Apparatus 60 includes staple holding component 62 with trocar 64 detachably mounted therewithin. Apparatus 60 may be any known instrument that is adapted to be inserted transanally to perform circular anastomosis of tissue sections. Examples of such instruments are described in commonly assigned U.S.
Patent Nos. 4,304,236, 4,379,457, 4,573,468, 4,576,167, 4,603,693 and 4,646,745. Apparatus 60 is advanced into section 36 such that staple holding component 62 approaches stapled end 38 and trocar 64 contacts and penetrates the stapled end to form an incision through end 38 to expose the staple holding component. After the incision is formed in stapled end 38, the surgeon, through an appropriate trocar sleeve creates an opening with forceps or the like in stapled end 42 of intestinal section 40 and probes within the opening ~0~9~5 to locate and grasp anvil shaft 22. Preferably, the anvil assembly is provided with a tail 24 to assist in locating and removing the anvil assembly. Tail 24 is a section of thread or the like and is secured to shaft 22 prior to insertion of the delivery system to facilitate withdrawal of the shaft through the opening in stapled end 42. As shown, tail 24 is removed from the opening and pulled away from end 42 by forceps 70 until anvil shaft 22 becomes visible.
Referring to FIG. 8, trocar 64 is released from its engagement with staple holding component 62 and removed from the operative site through one of the trocar sleeves.
Thereafter, the surgeon grasps anvil shaft 22 with grasping tool 80 and pulls the shaft until a portion of the shaft is exposed. At this point in the procedure, intestinal sections 36 and 40 are ready to be joined together by circular anastomosis. Intestinal sections 36, 40 are properly drawn over and secured around staple holding component 62 and anvil component 18, respectively, without maneuvering the tissue around these components. This is a significant feature of the present invention in that intestinal sections 36, 40 are secured in position for attachment without requiring the use of conventional drawstrings or purse string techniques to tighten the tissue sections around their respective stapler components.
Referring now to FIG. 9, through appropriate trocar sleeves, intestinal sections 36,40 are approximated and anvil shaft 22 is mounted within staple component 62. This mounting properly interposes stapled ends 38, 42 of the intestinal sections 36, 40 between staple holding component 62 and anvil head 20, respectively. Thereafter, the stapling instrument is fired to perform the anastomosis. The excess portion of the ends of tissue portions are severed by the action of a knife edge incorporated in the anastomosis instrument. FIG.
10 illustrates the anastomosis of intestinal sections 36,40 after firing of the surgical apparatus. The surgeon thereafter removes the instrument with attached anvil component from the surgical site.
The present invention provides a novel device and method for delivery of an anvil component within a tubular organ which avoids the use of conventional surgery to expose the targeted tissue portion. The device can be manufactured cost-effectively and disposed of after use. The device makes it possible to perform anastomosis of hollow tissue sections entirely by laparoscopic techniques.
Although the present invention has been shown and described in terms of a preferred embodiment, it will be appreciated that various changes and other modifications are contemplated within the spirit and scope of the present invention as defined by the following claims.
Referring to FIG. 13, there is illustrated an apparatus 10' for stapling hollow tubular body organs as by circular anastomosis of intestines, colons, or the like. The apparatus may be utilized to attach two tubular body parts or one tubular body part to a non-tubular body part by circular anastomosis and may be adapted to attach the body parts with deformable metallic staples or bio-absorbable two-part body tissue fasteners.
Such apparatus 10' is disclosed and claimed in U.S. Patent No. 5,119,983, issued June 9, 1992. This apparatus is a stap-ler for anastomosis of hollow body organs such as intestines, colons, etc. Other such devices are disclosed in the following U.S. patents. U.S. Patent No. 4,304,236 issued December 8, 1981; U.S. Patent ~o. 4,379,457, issued April 12, 1983;
U.S. Patent No. 4,573,468, issued March 4, 1986; U.S. Patent No. 4,576,167, issued March 18, 1986; U.S. Patent No.
4,603,693, issued August 5, 1986; U.S. Patent No. 4,646,745, issued March 3, 1987 and U.S. Patent No. 5,122,156, issued June 16, 1992. As will be appreciated from a review of these patents, such devices in some instances may also be manually operated and are sometimes controlled from a location remote from the point of manipulation.
Generally, apparatus 10' includes elongated shaft 12' and handle mechanism 14~ attached to a proximal end of the elongated shaft. Handle mechanism 14~ includes actuating handles 16~ and adjusting wing nut 18~. Fastener retainer component 20~ is connected to the distal end of shaft 12' and houses an annular array of staples therein. A staple firing mechanism expels the staples from fastener retainer component 20'.
An anvil assembly 22~ is detachably mounted to the distal end of elongated shaft 12' by a mounting mechanism within the shaft which cooperatively engages the anvil assembly. Anvil 22~ includes detachable anvil rod 24' with attached anvil head 26'. Anvil head 26' includes staple receiving buckets (not shown) for receiving and clinching the staples expelled by the staple firing mechanism to thereby join the adjacent tissue sections.
Referring now to FIG. 14, there is illustrated the detachable anvil rod 24' constructed according to the present invention. Anvil rod 24' is adapted to be used with apparatus 10' and includes proximal end portion 28' which is received within and engages the mounting mechanism within the distal end of elongated shaft 12'. (FIG. 13) Proximal end 209~
portion 28~ includes a generally conical shaped mounting portion 30' which is advantageously dimensioned to facilitate entry within the distal end of apparatus 10' and which further enables manipulation of rod 24' through body tissue.
Proximal end portion 28' also includes an annular recess 32' which is correspondingly configured to be engaged by the mounting mechanism within the distal end of elongated shaft 12~ of the apparatus.
A plurality of longitudinally extending external splines 34' are disposed in the general midportion of anvil rod 24~. Splines 34' engage correspondingly configured and positioned longitudinal internal splines in the distal end of elongated shaft 12~ during mounting of the rod to the apparatus to ensure proper alignment of the rod with the staple firing mechanism. Each external spline 34' has a chamfered and sloped proximal end 36~. Chamfered ends 36~
engage the internal splines within elongated shaft 12' and cause the rod to rotate slightly if the internal and external splines are initially misaligned during mounting so as to ensure proper mating between the two components.
Distal end portion 38~ of anvil rod 24~ includes an anvil head mounting collar 40' for mounting anvil head 26~ to the rod. Collar 40' includes a plurality of longitudinally extending external splines 42' which engage with cooperating longitudinally extending internal splines in the anvil head 26~ to properly align the staple-receiving buckets in the anvil head with the staples in fastener retainer component 20~. A circumferential groove 44' is formed adjacent collar 40~ and is adapted to receive a U-shaped clamp which securely retains the anvil head on the collar.
Distal end portion 38' of anvil rod 24~ is pivotally mounted about pivoting pin 46' and is adapted to 20~591~
pivot from a position in general alignment with the remainder of rod 24~ through pivoted locations (shown by the arrows) corresponding to plus or minus 90 degrees. As best shown in FIG . 15, distal end portion 38~ includes a projecting member 48~ having a generally circular aperture 50' (shown in phantom), which member 48' is received within a recess 52 defined between two correspondingly dimensioned and positioned projection members 54~ extending from the main portion of rod 24~. Preferably, a slight groove 56' is formed in the main portion of rod adjacent recess 52' to accommodate projecting member 48' during pivoting action of distal end portion 38'. Projections 54' also include apertures 58' (shown in phantom) which align with aperture 50' formed in projecting member 48' of distal end portion 38' to receive pivoting pin 46' to effect the mounting. Other alternative methods for mounting distal end portion 38' to the main portion of rod 24' may be readily determined by one skilled in the art.
Referring now to FIGS. 16, 17A and 17s, anvil rod 24~ is illustrated with anvil head 26' mounted on collar 40' so as to illustrate the advantages of the novel pivoting feature of distal end portion 38'. The pivoting feature of distal end portion 38' facilitates introduction and manipulation of anvil assembly 22' within tubular organ tissue such as the colon, intestines, etc. by orienting anvil head 26' in a manner which reduces the profile of the anvil head and the anvil assembly as the assembly is being advanced through the tubular organ. In particular, when distal end portion 38' is in a generally aligned position as shown in FIG. 16, which position corresponds to the orientation of a conventional anvil assembly, the anvil assembly 22' presents a relatively large cross-sectional dimension or profile which 209591~j must pass through the tubular organ. Specifically, the dimension or profile is equal to the diameter of the anvil head, which in many instances, is greater than the corresponding inner dimension of the tubular organ in which it must pass. Consequently, anvil head 26' inherently engages the inner wall of the tubular organ during manipulation and advancement of the anvil assembly 22~ and, accordingly, impedes such advancement within the tubular organ.
Referring now to FIGS. 17A and 17B, when distal end portion 38' is pivoted to its transverse position by way of the pivoting feature of the present invention, the effective transverse cross-sectional dimension or profile of anvil assembly 22~ is substantially reduced. In particular, since anvil head 26~ is generally parallel to and flush with anvil rod 24~ in this position, the effective transverse cross-sectional dimension of assembly 22' is nearly one-half of the corresponding dimension in the operative position of anvil assembly shown in FIG. 16. It is to be appreciated that distal end portion 38~ may be pivoted through a variety of angles relative to the anvil rod and still present a cross-sectional dimension or profile which is less than that of the generally aligned position of the distal end portion shown in FIG. 16.
In use, distal end portion 38' may be pivoted prior to introduction of anvil assembly within the tubular organ or may be initially inserted in a generally aligned position in which it subsequently assumes a pivoted position during advancement through the tubular organ due to engagement of anvil head 26' with the inner wall of the tubular organ.
In performing intestinal surgery such as a colonoscopy or a colectomy in which the surgery is followed by anastomosis of hollow tubular organs, anvil assembly 22 2~9:1~
may be introduced into che hollow organ through a surgically provided incision, or transanally, and advanced to a predetermined location in the intestinal section so that the anvil assembly may be subsequently mounted to a stapling apparatus to complete the anastomosis.
Referring now to FIG. 18, there is illustrated an apparatus which may be used to deliver anvil assembly 22~ of the present invention to a predetermined desired location within a tubular organ section. System 60' is particularly adapted to deliver an anvil assembly transanally to a desired portion in the colon and includes an elongated sheath member 62' having a longitudinal bore, a pusher rod 64' slidably movable within the bore of the sheath member and hand grip member 66'.
In use with the anvil assembly 22' of the present invention, anvil rod 24' is inserted within the distal end of sheath 62' to mount the assembly to the system. Thereafter, distal end portion 38~ is pivoted to the position shown in either FIGS. 17A or 17B to reduce the effective transverse cross-sectional dimension of the anvil assembly 22'. The delivery system is inserted transanally and advanced through the colon to a predetermined desired location in the organ, preferably beyond the diseased section of tissue. The particular orientation of anvil head 24' facilitates introduction and advancement of anvil assembly 22' within the intestinal section. Thereafter, the delivery system is actuated by depressing the proximal end section 64a' of pusher rod 64', which extends beyond the proximal end of sheath 62', to advance the pusher rod such that it engages anvil rod 24~ and expels the anvil assembly 22' from delivery system 60' and beyond the diseased tissue section. Once anvil assembly 22~ is within the organ, the surgeon may ~0!359~
perform the desired surgery followed by anastomosis of the hollow organ section.
FIGS. 19 and 20 illustrate the use of apparatus 10' and detachable anvil rod 24~ in an anastomosis procedure to effect joining of intestinal sections 66', 68'. Preferably, the anastomosis procedure is performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. At the point in the procedure shown in FIG.
19, a diseased intestinal section had been previously removed preferably with a laparoscopic instrument applied to the operative site through an appropriate trocar sleeve.
Elongated shaft 12' of apparatus 10' had been inserted transanally into intestinal section 66'. Both intestinal sections 66', 68' are also shown temporarily secured about their respective components by conventional means such as a purse string stitch.
In completing the anastomosis, the surgeon through an appropriate trocar sleeve probes within the intestinal section to grasp anvil rod 24', preferably with a grasping instrument 70~ inserted within a cannula, and maneuvers rod 24' towards the distal end of elongated shaft 12'. Mounting portion 30' of rod 24~ is then inserted within the distal end of elongated shaft 12' of the apparatus, as shown in FIG. 20, wherein the mounting mechanism within the distal end of the shaft engages the rod to effect the mounting. Thereafter, the anvil assembly and elongated shaft are approximated to clamp the opposed end portions of tissue between anvil head 26~ and fastener retainer component 20~. Such approximation will also appropriately orientate the anvil head 26~ with the apparatus. The apparatus is fired to complete the anastomosis.
SUMM~RY OF THF T~VF~TION
CA 0209~91~ 1998-01-27 The present invention provides a surgical apparatus for delivering an anvil component to a targeted section of a tubular organ so that anastomosis of two separated organ sections may be achieved using minimally invasive surgical techniques.
In accordance with an embodiment of the present invention there is provided a surgical stapling apparatus having a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
In accordance with another embodiment of the present invention there is provided a surgical apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and an anvil assembly adapted for use with an apparatus for performing a circular anastomosis, the anvil assembly comprising an anvil rod having proximal and distal end portions and a substantially circular anvil head mounted to the distal end portion of the anvil rod, the anvil head having a generally flat staple forming surface and being pivotally secured to the anvil rod proximal end portion, wherein the anvil rod distal end portion is pivotable from a CA 0209~91~ 1998-01-27 first position, wherein the staple forming surface of the anvil head is in general perpendicular alignment with a longitudinal axis defined by the anvil rod proximal end portion, to a second position, wherein the staple forming surface of the anvil head is angularly displaced by about 90~ from the first position.
In accordance with a yet another embodiment of the present invention there is provided a surgical apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and having an anvil assembly for a circular stapling instrument, the anvil assembly having a generally circular anvil head and an anvil rod having proximal and distal end portions, the anvil head being mounted to a distal end of the anvil rod distal end portion, and comprising a pivot pin for pivotably mounting a distal end of the anvil rod proximal end portion to a proximal end of the anvil rod distal end portion, wherein the anvil head and anvil rod distal end portion are pivotable about the pivot pin and pivotable relative to the anvil rod proximal end portion.
Yet another embodiment of the present invention provides a surgical stapling apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of the member, and releasing means for releasing the anvil component from the mounting means; and having an elongate shaft, a handle assembly connected to a proximal end of the elongate shaft, a fastener retainer connected to a distal end of the elongate shaft, the fastener retainer having a circular array of fasteners, and an anvil assembly detachably mountable to a distal end of the apparatus, the anvil assembly having an anvil rod, the anvil - 2a -CA 0209~91~ 1998-01-27 rod having proximal and distal end portions and a longitudinal axis, and a substantially circular anvil head mounted to the distal end of the anvil rod, the anvil head having a generally flat staple forming surface in general perpendicular alignment with the longitudinal axis defined by the anvil rod; and the staple forming surface of the anvil head is pivotally secured to the anvil rod proximal end portion, wherein the anvil rod distal end portion is pivotable from a first position, wherein the staple forming surface is in generally perpendicular alignment with the longitudinal axis defined by the anvil rod, to a second position, wherein the staple forming surface has pivotably moved from the first position.
A still further embodiment of the present invention provides a surgical stapling apparatus comprising an anvil delivery system for delivering an anvil component within a tubular organ section, comprising: an elongated delivery member having a proximal end and a distal end and a longitudinal bore extending therethrough; a hand grip portion disposed at the proximal end of the elongated delivery member to facilitate handling of the delivery system, the hand grip portion having a longitudinal bore extending therethrough in axial alignment with the longitudinal bore of the elongated delivery member;
a rod member slidably received within the longitudinal bore of the elongated delivery member and the hand grip portion and adapted to move towards the distal end of the elongated delivery member, the rod member having a proximal end portion extending beyond a proximal end of the hand grip portion; and an anvil component releasably mounted at the distal end of the elongated delivery member, the anvil component having an anvil head and an anvil shaft, the anvil shaft inserted within the bore of the elongated delivery member at the distal end thereof to releasably mount the anvil component to the elongated delivery member; wherein upon a distal force applied to the proximal end portion of the rod member causes the rod member CA 0209~91~ 1998-01-27 to be distally displaced such that a distal end of the rod member engages the anvil shaft to effect release of the anvil component from its engagement with the distal end of the elongated delivery member; and further comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
In use, the distal end of the elongated delivery member with mounted anvil component is inserted within the hollow organ and advanced to a desired location in the tubular organ.
A distal force is applied to the proximal end portion of the rod member, which causes the rod member to distally advance and engage the anvil component to effect release of the anvil component from its engagement with the elongated delivery member to expel the anvil component within the desired organ section.
The present invention also relates to a method for performing circular anastomosis of first and second intestinal sections using minimally invasive surgical techniques. The method comprises providing an anvil delivery system, including - 3a -209lq~ s an elongated delivery member having a proximal and a distal end, mounting means for releasably mounting an anvil component to the distal end of the elongated delivery member and releasing means for releasing the anvil component from the mounting means to expel the anvil component within the targeted organ section. In accordance with the method, the distal end of the elongated delivery member with mounted anvil component is transanally inserted and advanced into the intestine until the anvil component is disposed beyond a diseased tissue section. The releasing means is thereafter actuated to release the anvil - 3b -20359:~
-component from the mounting means and to place the anvil component within an intestinal section beyond the diseased section. The anvil delivery system is then withdrawn from the operative site.
Thereafter, a first and second side of the diseased tissue section is isolated and the diseased section is resected, preferably by laparoscopic means, leaving first and second intestinal sections having first and second stapled ends, respectively, with the anvil component disposed within the second intestinal section. An opening is made in the second stapled end of the second intestinal section so that the anvil component may be grasped and exposed. An apparatus for performing circular anastomosis of the first and second intestinal sections is introduced transanally and advanced into the first intestinal section until a distal end of the apparatus engages the first stapled end. An opening is made in the first stapled end to expose the staple holding component of the apparatus. The anvil shaft is then mounted within the staple holding component. This mounting interposes the two ends of the intestinal sections between the anvil component and the staple holding component. The apparatus is fired and the anastomosis of the first and second intestinal sections is completed. Thereafter, the apparatus is removed from the body.
Generally stated, the present invention is directed to an anvil assembly and associated delivery system, the anvil assembly being adapted for use with an apparatus for performing circular anastomosis. The anvil assembly comprises an elongated anvil rod having proximal and distal end portions and an anvil head detachably mounted to the distal end portion of the anvil rod. The distal end portion is pivotally mounted and is adapted to pivot from a first ~0~91~
operative position to a second non-operative position, whereby at least one dimension of the anvil assembly in the second non-operative position is effectively less than the corresponding dimension in the first operative position.
In a preferred embodiment, the anvil assembly comprises an elongated anvil rod having proximal and distal end portions and an anvil head detachably mounted to the distal end portion of the anvil rod. The distal end portion is pivotal from a first operative position in general alignment with a longitudinal axis defined by the anvil rod to a second non-operative position angularly displaced relative to the longitudinal axis. In the second non-operative position, the anvil rod presents a less obtrusive profile which, accordingly, facilitates advancement of the anvil assembly through body tissue.
The distal end portion is pivotal with respect to the longitudinal axis defined by the anvil rod through an angle of up to about 90 . In particular, the distal end portion is adapted to pivot up to about 90 with respect to each side of the longitudinal axis, thereby providing full pivotal articulation thereof of about 180-.
The distal end portion comprises a circumferential mounting collar which is received within a circular aperture formed within the anvil head to mount the anvil head to the anvil rod. The mounting collar preferably comprises a plurality of longitudinally extending external splines which are engagable with cooperating longitudinally extending internal splines formed within the anvil head to properly align the anvil head with the anvil rod.
The anvil rod also comprises a plurality of longitudinally extending external splines disposed intermediate its proximal and distal end portions. The external splines are engageable with cooperating longitudinally extending internal splines formed within a distal end of the apparatus to properly align the anvil rod with the apparatus.
The anvil apparatus is adapted to be mounted to an elongated delivery member which includes a mounting mechanism for detachably mounting the anvil assembly on a distal end of the elongated delivery member and releasing means for releasing the anvil member from the mounting means.
The present invention is also directed to a surgical apparatus for performing circular anastomosis of first and second tissue sections. The apparatus comprises elongated tubular means having a proximal and distal end, means for firing a plurality of fasteners from the distal end of the elongated tubular means and anvil means detachably mounted to the distal end of the elongated tubular means. The anvil means comprises an anvil rod having proximal and distal end portions and an anvil head detachably mounted to the distal end potion of the anvil rod. The distal end portion is pivotal from a first operative position in general alignment with a longitudinal axis defined by the anvil rod to a second non-operative position angularly displaced relative to the longitudinal axis. The anvil assembly defines an effective cross-sectional area generally transverse to the longitudinal axis. The effective cross-sectional area of the anvil assembly in the second non-operative position is less than the effective cross-sectional area of the anvil assembly in the first operative position to 2 ~ 9 ~
facilitate introduction and advancement of the anvil assembly through body tissue.
209.~91~
BRTFF DF~SCRTPTION OF THF DRAWI~GS
FIG. 1 iS a perspective view of the anvil delivery system of the present invention;
FIG. 2 iS a side view of the delivery system of FIG. 1 with a partial cutaway of the distal end, illustrating the positioning of the anvil shaft of the anvil component and tail portion within the elongated sheath member when the apparatus is in the pre-fired condition;
FIG. 3 iS a perspective view of the delivery system of FIG. 1 in the post-fired condition with the anvil component expelled from the elongated sheath member;
FIG. 4 iS a perspective view of the delivery system of FIG. 1 inserted transanally and extending through a portion of the intestine;
FIG. 5 iS a perspective view of the delivery system of FIG. 1 inserted through the intestine and in the post-fired condition with the anvil component and tail portion expelled from the delivery system;
FIG. 6 is a perspective view illustrating removal of a diseased tissue section by a laparoscopic stapling instrument;
FIG. 7 is a perspective view after application of the laparoscopic stapling instrument, illustrating the formed first and second intestinal sections;
FIG. 8 is a perspective view with a partial cut-aways of the first intestinal section, illustrating advancement of an apparatus for performing anastomosis and exposure of the anvil shaft from the second intestinal section;
FIG. 9 iS a perspective view with partial cutaways of the first and second intestinal sections, illustrating the 209~91~
anvil shaft of the anvil component mounted within the staple holding component;
FIG. 10 iS a perspective view of the anastomosis of the first and second intestinal sections after firing of the anastomosis apparatus;
FIG. 11 iS a perspective view illustrating an alternative method for resection and removal of the diseased tissue section in which the diseased section is to be removed through the rectal opening;
FIG. 12 iS a perspective view after removal of the diseased section through the rectal opening and application of a laparoscopic stapling instrument to the first intestinal section;
FIG. 13 iS a perspective view of a surgical stapler apparatus for performing anastomosis of hollow organs of the type contemplated by the present invention;
FIG. 14 iS a side plan view of an alternative embodiment the detachable anvil rod constructed according to the present invention illustrating the pivotal distal end portion;
FIG. 15 iS a sectional view with parts separated of the distal end portion and the remaining portion of the rod of FIG. 14 illustrating the mounting components for pivotally mounting the distal end portion;
FIG. 16 iS a side plan view of the detachable anvil rod of FIG. 14 with mounted anvil head illustrating the distal end portion of the rod in a generally aligned operative position;
FIGS. 17A-17B are side plan views similar to the view of FIG. 16 illustrating the distal end portion of the 209~9~ 5 anvil rod pivoted 90' with respect to each side of the longitudinal axis defined by the anvil rod;
FIG. 18 is a side view of a delivery system used to deliver the anvil rod to a desired predetermined location within a tubular organ;
FIG. 19 is a perspective view of the intestinal area of a patient illustrating the introduction of the surgical apparatus of FIG. 13 prior to mounting of the anvil rod of the present invention to the apparatus; and FIG. 20 iS a perspective view similar to that of FIG. 19 illustrating mounting of the anvil rod of the present invention to the distal end of the surgical apparatus.
DF~CRIPTION OF THF p~FFF~RFn F~RoDIMF~Ts Referring now to the drawings and, in particular, to FIGS. 1-3, there is shown an anvil delivery system in accordance with one embodiment of the present invention.
Anvil delivery system 10 includes an elongated sheath member 12 having longitudinal bore 13 (see FIG. 2) extending therethrough, rod member 14, and hand grip member 16 disposed at the proximal end portion of sheath member 12. Hand grip member 16 also includes a longitudinal bore extending therethrough in axial alignment with longitudinal bore 13 of sheath member 12. In a preferred embodiment, hand grip member 16 includes a grip enhancing means such as a plurality of circumferential ribs l9 to facilitate grasping and maneuvering of the delivery sys~em.
Anvil delivery system 10 expels anvil component 18 into a hollow tubular tissue section which is to be subsequently attached to an adjacent tissue section by circular anastomosis. Anvil component 18 includes anvil head 20959~
20 mounted on anvil shaft 22. Anvil shaft 22 is intended to be mounted within staple holding component 62 tsee FIG. 8) of a stapling apparatus. Anvil head 20 may include an annular array of staple forming buckets to receive and bend staples fired from staple holding component 62. It is to be noted that the components of delivery system 10 can be modified to accommodate a variety of sizes and types of anvils.
Rod member 14 is slidably received within longitudinal bore 13 of sheath member 12 and the longitudinal bore of hand grip member 16, and is adapted to move in a distal direction relative to the remaining components in the delivery system. In a preferred embodiment, proximal end portion 17 of rod member 14 extends beyond the proximal end of hand grip member 16 as best shown in FIGS. 1 and 2. When a force is applied to proximal end portion 17, rod member 14 slides in a distal direction as shown by the arrow in FIG. 3.
This distal movement causes bearing surface 15 of rod member 14 to engage shaft 22 of anvil component 18 and to release anvil component 18 from its engagement with elongated sheath member 12, and to expel the component into a targeted tissue section.
Anvil component 18 may be mounted to elongated sheath member 12 by conventional means. In a preferred embodiment and as best shown in FIG. 2, anvil shaft 22 is inserted within the distal end of sheath member 12 to mount the anvil component. Preferably, the diameter of shaft 22 is slightly less than the inner diameter of the proximal end of sheath member 12 such that the peripheral surface of shaft 22 frictionally engages the inner peripheral surface of sheath member 12 to assist in retaining anvil component 18 within the sheath member during insertion of the system within the tubular organ.
2~ g ~ ~5 Delivery system 10 may range in length from about 60 cms to about 180 cms, however, any appropriate length may be chosen depending upon the particular application. In a preferred embodiment system 10 is straight, however, it is within the scope of the present invention for system 10 to be curved to facilitate placement of the instrument in particular body structures and to reach remote or relatively inaccessible operative sites. It is also possible for delivery system 10 to be flexible. Preferably all components of delivery system 10 are fabricated from polymeric materials, which thereby reduces the cost of manufacture of the system and makes it economically feasible to dispose the system after use.
Further understanding of the significant aspects of the delivery system of the present invention will become more readily apparent by the following description of the use of same. Referring now to FIGS. 4 - 10, the anvil delivery system 10 in accordance with the present invention is shown in a sequence of operation.
Referring initially to FIG. 4, the surgeon grasps delivery system 10 by hand grip 16 and inserts the distal end of the system with mounted anvil component 18 through the rectal opening 30 and into colon or intestine 32. The system 10 is then advanced within intestine 32 until anvil head 20 extends slightly beyond diseased section 34 of the intestine.
2a9591 5 Referring now to FIG. 5, the delivery system is actuated by the surgeon by depressing proximal end portion 17 of rod member 14 (see FIGS. 1-3) to thereby effect distal movement of the rod member and cause bearing surface 15 of the rod member to engage the proximal end of shaft 22 and eject anvil component 18 into intestine 32. It is to be appreciated that after release from system 10, anvil component 18 is disposed in a section of intestine beyond diseased section 34. At this point in the procedure, delivery system 10 is removed from the colon.
The diseased tissue section is then excised followed by anastomosis of the adjacent severed tissue sections.
Preferably, the remaining operative procedures will be performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. This is a significant aspect of the present invention and is made possible by the prior transanal placement of the anvil component within the intestinal tissue. Such placement removes the need for incising the abdominal cavity to introduce the detached component to the operative site.
Referring now to FIG. 6, the preferred method for resecting diseased section 34 is illustrated. Through appropriate trocar sleeves, the surgeon applies a laparoscopic stapler 50 to both sides of diseased section 34. A suitable stapler for this purpose is described in commonly assigned U.S.
Patent No. 5,040,715 issued August 20, 1991. Each application of the stapler places two triple staggered rows of staples 52 while a knife cuts therebetween. FIG. 6 illustrates the staple rows after the application of stapler 50 to a section of the intestine nearest rectal opening 30.
2~9~
FIG. 6 also shows stapler 50 being applied to a section of the intestine beyond diseased section 34.
Referring now to FIG. 7, after application to both sides of diseased section 34, stapler 50 will have created two separated, closed end tissue sections 36, 40 having stapled ends 38, 42, respectively. This application will also have severed diseased section 34 from the remaining intestinal tissue. In FIG. 7, diseased section 34 is already removed from the operative site, preferably through one of the trocar sleeves (not shown). At this point in the procedure, anvil component 18 is positioned within tissue section 40.
Alternative laparoscopic instruments and methods may be incorporated to isolate diseased section 34 from the remaining intestinal tissue and to remove section 34 from the operative site. Referring to FIG. 11, the lower side of diseased section 34 may be severed from the intestinal tissue by, for example, a conventional scalpel. This step in the procedure creates intestinal section 36 having open end 37.
Thereafter, stapling instrument 50 may be applied to the upper side of section 34 to close off and completely sever the diseased section from the intestine. Since the end of tissue section 36 is not closed, open end 37 provides an avenue to remove diseased section 34, i.e., removing the diseased section through the rectal opening 30. After removal, intestinal section 36 may be closed off as shown in FIG. 12 by conventional means, such as, for example, with a laparoscopic stapling instrument. Alternatively, tissue section 36 may be closed off around the staple holding component by a purse string suture.
It is also within the scope of the present invention to close off the upper side of diseased section 34 20~91~
with a laparoscopic stapling instrument which fires a single row of staples, and then sever the diseased section on its upper side with a scalpel, laser or electrocautery device which is applied through a trocar sleeve. Thereafter, a similar cutting device may be used on the lower side of section 34 and the completely severed diseased section removed through end section 36 and out rectal opening 30 in the same manner as previously described. Intestinal section 36 may then be closed off with the stapling instrument. It is also possible to isolate diseased section 34 using a scalpel on both sides of the diseased section and to leave the ends of intestinal sections 36,40 open. Sections 36,40 may subsequently positioned for attachment by conventional drawstring or purse string sutures.
Referring to Figs. 7-10 rejoining of the tissue ends is accomplished by inserting an apparatus 60 for performing circular surgical stapling of hollow tissue organs through rectal opening 30 and into intestinal section 36.
Apparatus 60 includes staple holding component 62 with trocar 64 detachably mounted therewithin. Apparatus 60 may be any known instrument that is adapted to be inserted transanally to perform circular anastomosis of tissue sections. Examples of such instruments are described in commonly assigned U.S.
Patent Nos. 4,304,236, 4,379,457, 4,573,468, 4,576,167, 4,603,693 and 4,646,745. Apparatus 60 is advanced into section 36 such that staple holding component 62 approaches stapled end 38 and trocar 64 contacts and penetrates the stapled end to form an incision through end 38 to expose the staple holding component. After the incision is formed in stapled end 38, the surgeon, through an appropriate trocar sleeve creates an opening with forceps or the like in stapled end 42 of intestinal section 40 and probes within the opening ~0~9~5 to locate and grasp anvil shaft 22. Preferably, the anvil assembly is provided with a tail 24 to assist in locating and removing the anvil assembly. Tail 24 is a section of thread or the like and is secured to shaft 22 prior to insertion of the delivery system to facilitate withdrawal of the shaft through the opening in stapled end 42. As shown, tail 24 is removed from the opening and pulled away from end 42 by forceps 70 until anvil shaft 22 becomes visible.
Referring to FIG. 8, trocar 64 is released from its engagement with staple holding component 62 and removed from the operative site through one of the trocar sleeves.
Thereafter, the surgeon grasps anvil shaft 22 with grasping tool 80 and pulls the shaft until a portion of the shaft is exposed. At this point in the procedure, intestinal sections 36 and 40 are ready to be joined together by circular anastomosis. Intestinal sections 36, 40 are properly drawn over and secured around staple holding component 62 and anvil component 18, respectively, without maneuvering the tissue around these components. This is a significant feature of the present invention in that intestinal sections 36, 40 are secured in position for attachment without requiring the use of conventional drawstrings or purse string techniques to tighten the tissue sections around their respective stapler components.
Referring now to FIG. 9, through appropriate trocar sleeves, intestinal sections 36,40 are approximated and anvil shaft 22 is mounted within staple component 62. This mounting properly interposes stapled ends 38, 42 of the intestinal sections 36, 40 between staple holding component 62 and anvil head 20, respectively. Thereafter, the stapling instrument is fired to perform the anastomosis. The excess portion of the ends of tissue portions are severed by the action of a knife edge incorporated in the anastomosis instrument. FIG.
10 illustrates the anastomosis of intestinal sections 36,40 after firing of the surgical apparatus. The surgeon thereafter removes the instrument with attached anvil component from the surgical site.
The present invention provides a novel device and method for delivery of an anvil component within a tubular organ which avoids the use of conventional surgery to expose the targeted tissue portion. The device can be manufactured cost-effectively and disposed of after use. The device makes it possible to perform anastomosis of hollow tissue sections entirely by laparoscopic techniques.
Although the present invention has been shown and described in terms of a preferred embodiment, it will be appreciated that various changes and other modifications are contemplated within the spirit and scope of the present invention as defined by the following claims.
Referring to FIG. 13, there is illustrated an apparatus 10' for stapling hollow tubular body organs as by circular anastomosis of intestines, colons, or the like. The apparatus may be utilized to attach two tubular body parts or one tubular body part to a non-tubular body part by circular anastomosis and may be adapted to attach the body parts with deformable metallic staples or bio-absorbable two-part body tissue fasteners.
Such apparatus 10' is disclosed and claimed in U.S. Patent No. 5,119,983, issued June 9, 1992. This apparatus is a stap-ler for anastomosis of hollow body organs such as intestines, colons, etc. Other such devices are disclosed in the following U.S. patents. U.S. Patent No. 4,304,236 issued December 8, 1981; U.S. Patent ~o. 4,379,457, issued April 12, 1983;
U.S. Patent No. 4,573,468, issued March 4, 1986; U.S. Patent No. 4,576,167, issued March 18, 1986; U.S. Patent No.
4,603,693, issued August 5, 1986; U.S. Patent No. 4,646,745, issued March 3, 1987 and U.S. Patent No. 5,122,156, issued June 16, 1992. As will be appreciated from a review of these patents, such devices in some instances may also be manually operated and are sometimes controlled from a location remote from the point of manipulation.
Generally, apparatus 10' includes elongated shaft 12' and handle mechanism 14~ attached to a proximal end of the elongated shaft. Handle mechanism 14~ includes actuating handles 16~ and adjusting wing nut 18~. Fastener retainer component 20~ is connected to the distal end of shaft 12' and houses an annular array of staples therein. A staple firing mechanism expels the staples from fastener retainer component 20'.
An anvil assembly 22~ is detachably mounted to the distal end of elongated shaft 12' by a mounting mechanism within the shaft which cooperatively engages the anvil assembly. Anvil 22~ includes detachable anvil rod 24' with attached anvil head 26'. Anvil head 26' includes staple receiving buckets (not shown) for receiving and clinching the staples expelled by the staple firing mechanism to thereby join the adjacent tissue sections.
Referring now to FIG. 14, there is illustrated the detachable anvil rod 24' constructed according to the present invention. Anvil rod 24' is adapted to be used with apparatus 10' and includes proximal end portion 28' which is received within and engages the mounting mechanism within the distal end of elongated shaft 12'. (FIG. 13) Proximal end 209~
portion 28~ includes a generally conical shaped mounting portion 30' which is advantageously dimensioned to facilitate entry within the distal end of apparatus 10' and which further enables manipulation of rod 24' through body tissue.
Proximal end portion 28' also includes an annular recess 32' which is correspondingly configured to be engaged by the mounting mechanism within the distal end of elongated shaft 12~ of the apparatus.
A plurality of longitudinally extending external splines 34' are disposed in the general midportion of anvil rod 24~. Splines 34' engage correspondingly configured and positioned longitudinal internal splines in the distal end of elongated shaft 12~ during mounting of the rod to the apparatus to ensure proper alignment of the rod with the staple firing mechanism. Each external spline 34' has a chamfered and sloped proximal end 36~. Chamfered ends 36~
engage the internal splines within elongated shaft 12' and cause the rod to rotate slightly if the internal and external splines are initially misaligned during mounting so as to ensure proper mating between the two components.
Distal end portion 38~ of anvil rod 24~ includes an anvil head mounting collar 40' for mounting anvil head 26~ to the rod. Collar 40' includes a plurality of longitudinally extending external splines 42' which engage with cooperating longitudinally extending internal splines in the anvil head 26~ to properly align the staple-receiving buckets in the anvil head with the staples in fastener retainer component 20~. A circumferential groove 44' is formed adjacent collar 40~ and is adapted to receive a U-shaped clamp which securely retains the anvil head on the collar.
Distal end portion 38' of anvil rod 24~ is pivotally mounted about pivoting pin 46' and is adapted to 20~591~
pivot from a position in general alignment with the remainder of rod 24~ through pivoted locations (shown by the arrows) corresponding to plus or minus 90 degrees. As best shown in FIG . 15, distal end portion 38~ includes a projecting member 48~ having a generally circular aperture 50' (shown in phantom), which member 48' is received within a recess 52 defined between two correspondingly dimensioned and positioned projection members 54~ extending from the main portion of rod 24~. Preferably, a slight groove 56' is formed in the main portion of rod adjacent recess 52' to accommodate projecting member 48' during pivoting action of distal end portion 38'. Projections 54' also include apertures 58' (shown in phantom) which align with aperture 50' formed in projecting member 48' of distal end portion 38' to receive pivoting pin 46' to effect the mounting. Other alternative methods for mounting distal end portion 38' to the main portion of rod 24' may be readily determined by one skilled in the art.
Referring now to FIGS. 16, 17A and 17s, anvil rod 24~ is illustrated with anvil head 26' mounted on collar 40' so as to illustrate the advantages of the novel pivoting feature of distal end portion 38'. The pivoting feature of distal end portion 38' facilitates introduction and manipulation of anvil assembly 22' within tubular organ tissue such as the colon, intestines, etc. by orienting anvil head 26' in a manner which reduces the profile of the anvil head and the anvil assembly as the assembly is being advanced through the tubular organ. In particular, when distal end portion 38' is in a generally aligned position as shown in FIG. 16, which position corresponds to the orientation of a conventional anvil assembly, the anvil assembly 22' presents a relatively large cross-sectional dimension or profile which 209591~j must pass through the tubular organ. Specifically, the dimension or profile is equal to the diameter of the anvil head, which in many instances, is greater than the corresponding inner dimension of the tubular organ in which it must pass. Consequently, anvil head 26' inherently engages the inner wall of the tubular organ during manipulation and advancement of the anvil assembly 22~ and, accordingly, impedes such advancement within the tubular organ.
Referring now to FIGS. 17A and 17B, when distal end portion 38' is pivoted to its transverse position by way of the pivoting feature of the present invention, the effective transverse cross-sectional dimension or profile of anvil assembly 22~ is substantially reduced. In particular, since anvil head 26~ is generally parallel to and flush with anvil rod 24~ in this position, the effective transverse cross-sectional dimension of assembly 22' is nearly one-half of the corresponding dimension in the operative position of anvil assembly shown in FIG. 16. It is to be appreciated that distal end portion 38~ may be pivoted through a variety of angles relative to the anvil rod and still present a cross-sectional dimension or profile which is less than that of the generally aligned position of the distal end portion shown in FIG. 16.
In use, distal end portion 38' may be pivoted prior to introduction of anvil assembly within the tubular organ or may be initially inserted in a generally aligned position in which it subsequently assumes a pivoted position during advancement through the tubular organ due to engagement of anvil head 26' with the inner wall of the tubular organ.
In performing intestinal surgery such as a colonoscopy or a colectomy in which the surgery is followed by anastomosis of hollow tubular organs, anvil assembly 22 2~9:1~
may be introduced into che hollow organ through a surgically provided incision, or transanally, and advanced to a predetermined location in the intestinal section so that the anvil assembly may be subsequently mounted to a stapling apparatus to complete the anastomosis.
Referring now to FIG. 18, there is illustrated an apparatus which may be used to deliver anvil assembly 22~ of the present invention to a predetermined desired location within a tubular organ section. System 60' is particularly adapted to deliver an anvil assembly transanally to a desired portion in the colon and includes an elongated sheath member 62' having a longitudinal bore, a pusher rod 64' slidably movable within the bore of the sheath member and hand grip member 66'.
In use with the anvil assembly 22' of the present invention, anvil rod 24' is inserted within the distal end of sheath 62' to mount the assembly to the system. Thereafter, distal end portion 38~ is pivoted to the position shown in either FIGS. 17A or 17B to reduce the effective transverse cross-sectional dimension of the anvil assembly 22'. The delivery system is inserted transanally and advanced through the colon to a predetermined desired location in the organ, preferably beyond the diseased section of tissue. The particular orientation of anvil head 24' facilitates introduction and advancement of anvil assembly 22' within the intestinal section. Thereafter, the delivery system is actuated by depressing the proximal end section 64a' of pusher rod 64', which extends beyond the proximal end of sheath 62', to advance the pusher rod such that it engages anvil rod 24~ and expels the anvil assembly 22' from delivery system 60' and beyond the diseased tissue section. Once anvil assembly 22~ is within the organ, the surgeon may ~0!359~
perform the desired surgery followed by anastomosis of the hollow organ section.
FIGS. 19 and 20 illustrate the use of apparatus 10' and detachable anvil rod 24~ in an anastomosis procedure to effect joining of intestinal sections 66', 68'. Preferably, the anastomosis procedure is performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. At the point in the procedure shown in FIG.
19, a diseased intestinal section had been previously removed preferably with a laparoscopic instrument applied to the operative site through an appropriate trocar sleeve.
Elongated shaft 12' of apparatus 10' had been inserted transanally into intestinal section 66'. Both intestinal sections 66', 68' are also shown temporarily secured about their respective components by conventional means such as a purse string stitch.
In completing the anastomosis, the surgeon through an appropriate trocar sleeve probes within the intestinal section to grasp anvil rod 24', preferably with a grasping instrument 70~ inserted within a cannula, and maneuvers rod 24' towards the distal end of elongated shaft 12'. Mounting portion 30' of rod 24~ is then inserted within the distal end of elongated shaft 12' of the apparatus, as shown in FIG. 20, wherein the mounting mechanism within the distal end of the shaft engages the rod to effect the mounting. Thereafter, the anvil assembly and elongated shaft are approximated to clamp the opposed end portions of tissue between anvil head 26~ and fastener retainer component 20~. Such approximation will also appropriately orientate the anvil head 26~ with the apparatus. The apparatus is fired to complete the anastomosis.
Claims (15)
1. A surgical stapling apparatus having a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of said member, and releasing means for releasing the anvil component from the mounting means; and comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
2. The surgical stapling apparatus according to claim 1, wherein the anvil rod distal end portion is pivotable up to about 90° with respect to at least one side of the longitudinal axis of the anvil rod proximal end portion.
3. A surgical apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of said member, and releasing means for releasing the anvil component from the mounting means; and an anvil assembly adapted for use with an apparatus for performing a circular anastomosis, the anvil assembly comprising an anvil rod having proximal and distal end portions and a substantially circular anvil head mounted to the distal end portion of the anvil rod, the anvil head having a generally flat staple forming surface and being pivotally secured to the anvil rod proximal end portion, wherein the anvil rod distal end portion is pivotable from a first position, wherein the staple forming surface of the anvil head is in general perpendicular alignment with a longitudinal axis defined by the anvil rod proximal end portion, to a second position, wherein the staple forming surface of the anvil head is angularly displaced by about 90° from the first position.
4. The apparatus according to claim 3, wherein, in the anvil assembly, the anvil head is pivotable up to about 90° with respect to each side of the longitudinal axis defined by the anvil rod proximal end portion.
5. The apparatus according to claim 4, wherein when the anvil rod distal end portion is angularly displaced approximately 90° relative to the longitudinal axis of the anvil rod proximal end portion, the anvil head staple forming surface is generally parallel to the longitudinal axis defined by the anvil rod proximal end portion.
6. The apparatus according to claim 3, wherein, in the anvil assembly, the anvil head is detachably mounted to the distal end portion of the anvil rod.
7. A surgical apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of said member, and releasing means for releasing the anvil component from the mounting means; and having an anvil assembly for a circular stapling instrument, the anvil assembly having a generally circular anvil head and an anvil rod having proximal and distal end portions, the anvil head being mounted to a distal end of the anvil rod distal end portion, and comprising a pivot pin for pivotably mounting a distal end of the anvil rod proximal end portion to a proximal end of the anvil rod distal end portion, wherein the anvil head and anvil rod distal end portion are pivotable about said pivot pin and pivotable relative to the anvil rod proximal end portion.
8. The apparatus according to claim 7, wherein the proximal end of the anvil rod distal end portion has at least one projection having an aperture and the distal end of the anvil rod proximal end portion has at least one projection having an aperture and wherein the pivot pin passes through each of the apertures.
9. The surgical stapling apparatus according to claim 1, wherein the anvil head is detachably mounted to the pivotted distal end portion of the anvil rod.
10. The anvil assembly according to claim 7, wherein the anvil head is detachably mounted to the distal end portion of the anvil rod.
11. A surgical stapling apparatus comprising a delivery system for an anvil component of an anvil assembly including an elongated delivery member, mounting means for releasably mounting an anvil component at the distal end of said member, and releasing means for releasing the anvil component from the mounting means; and having an elongate shaft, a handle assembly connected to a proximal end of the elongate shaft, a fastener retainer connected to a distal end of the elongate shaft, the fastener retainer having a circular array of fasteners, and an anvil assembly detachably mountable to a distal end of the apparatus, the anvil assembly having an anvil rod, the anvil rod having proximal and distal end portions and a longitudinal axis, and a substantially circular anvil head mounted to the distal end of the anvil rod, the anvil head having a generally flat staple forming surface in general perpendicular alignment with the longitudinal axis defined by the anvil rod; and the staple forming surface of the anvil head is pivotally secured to the anvil rod proximal end portion, wherein the anvil rod distal end portion is pivotable from a first position, wherein the staple forming surface is in general perpendicular alignment with the longitudinal axis defined by the anvil rod, to a second position, wherein the staple forming surface has pivotably moved from the first position.
12. The surgical stapling apparatus according to claim 11, wherein the anvil head is detachably mounted to the distal end of the anvil rod.
13. The surgical stapling apparatus according to claim 11, wherein the staple forming surface of the anvil head is pivotable up to about 90° with respect to at least one side of the longitudinal axis defined by the anvil rod.
14. The surgical stapling apparatus according to claim 11, wherein the anvil rod has a proximal end portion and a distal end portion and the proximal end portion is pivotably secured to the distal end portion by a pivot pin.
15. A surgical stapling apparatus comprising an anvil delivery system for delivering an anvil component within a tubular organ section, comprising:
an elongated delivery member having a proximal end and a distal end and a longitudinal bore extending therethrough;
a hand grip portion disposed at said proximal end of said elongated delivery member to facilitate handling of the delivery system, said hand grip portion having a longitudinal bore extending therethrough in axial alignment with said longitudinal bore of said elongated delivery member;
a rod member slidably received within said longitudinal bore of said elongated delivery member and said hand grip portion and adapted to move towards said distal end of said elongated delivery member, said rod member having a proximal end portion extending beyond a proximal end of said hand grip portion; and an anvil component releasably mounted at said distal end of said elongated delivery member, said anvil component having an anvil head and an anvil shaft, said anvil shaft inserted within said bore of said elongated delivery member at said distal end thereof to releasably mount the anvil component to said elongated delivery member;
wherein upon a distal force applied to said proximal end portion of said rod member causes said rod member to be distally displaced such that a distal end of said rod member engages said anvil shaft to effect release of said anvil component from its engagement with said distal end of said elongated delivery member;
and further comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
an elongated delivery member having a proximal end and a distal end and a longitudinal bore extending therethrough;
a hand grip portion disposed at said proximal end of said elongated delivery member to facilitate handling of the delivery system, said hand grip portion having a longitudinal bore extending therethrough in axial alignment with said longitudinal bore of said elongated delivery member;
a rod member slidably received within said longitudinal bore of said elongated delivery member and said hand grip portion and adapted to move towards said distal end of said elongated delivery member, said rod member having a proximal end portion extending beyond a proximal end of said hand grip portion; and an anvil component releasably mounted at said distal end of said elongated delivery member, said anvil component having an anvil head and an anvil shaft, said anvil shaft inserted within said bore of said elongated delivery member at said distal end thereof to releasably mount the anvil component to said elongated delivery member;
wherein upon a distal force applied to said proximal end portion of said rod member causes said rod member to be distally displaced such that a distal end of said rod member engages said anvil shaft to effect release of said anvil component from its engagement with said distal end of said elongated delivery member;
and further comprising an anvil assembly detachably mountable to a distal end of the member, the anvil assembly having an anvil rod having a proximal end portion having a longitudinal axis, and a distal end portion configured to receive a substantially circular anvil head, the anvil rod distal end portion being pivotally secured to the anvil rod proximal portion, wherein the anvil rod distal end portion is pivotable from a first position to a second position relative to the longitudinal axis of the anvil rod proximal end portion.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002221166A CA2221166C (en) | 1992-05-19 | 1993-05-10 | Anvil delivery system |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
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US07/886,040 | 1992-05-19 | ||
US07/886,040 US5314435A (en) | 1992-05-19 | 1992-05-19 | Anvil delivery system |
US07/950,435 | 1992-09-23 | ||
US07/950,435 US5344059A (en) | 1992-05-19 | 1992-09-23 | Surgical apparatus and anvil delivery system therefor |
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Application Number | Title | Priority Date | Filing Date |
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CA002221166A Division CA2221166C (en) | 1992-05-19 | 1993-05-10 | Anvil delivery system |
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CA2095915C true CA2095915C (en) | 1998-12-08 |
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EP (1) | EP0570915B1 (en) |
CA (1) | CA2095915C (en) |
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Families Citing this family (820)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5344059A (en) * | 1992-05-19 | 1994-09-06 | United States Surgical Corporation | Surgical apparatus and anvil delivery system therefor |
AU708637B2 (en) * | 1994-08-25 | 1999-08-12 | United States Surgical Corporation | Anvil for circular stapler |
CA2146508C (en) | 1994-08-25 | 2006-11-14 | Robert H. Schnut | Anvil for circular stapler |
US5868760A (en) * | 1994-12-07 | 1999-02-09 | Mcguckin, Jr.; James F. | Method and apparatus for endolumenally resectioning tissue |
DE19600519A1 (en) * | 1996-01-09 | 1997-07-10 | Arnold Dipl Ing Dr Med Pier | Surgical instrument |
US6338737B1 (en) * | 1997-07-17 | 2002-01-15 | Haviv Toledano | Flexible annular stapler for closed surgery of hollow organs |
US6126058A (en) * | 1998-06-19 | 2000-10-03 | Scimed Life Systems, Inc. | Method and device for full thickness resectioning of an organ |
US6601749B2 (en) | 1998-06-19 | 2003-08-05 | Scimed Life Systems, Inc. | Multi fire full thickness resectioning device |
US6629630B2 (en) | 1998-06-19 | 2003-10-07 | Scimed Life Systems, Inc. | Non-circular resection device and endoscope |
US6206913B1 (en) * | 1998-08-12 | 2001-03-27 | Vascular Innovations, Inc. | Method and system for attaching a graft to a blood vessel |
US6461320B1 (en) | 1998-08-12 | 2002-10-08 | Cardica, Inc. | Method and system for attaching a graft to a blood vessel |
DE19836950B4 (en) * | 1998-08-17 | 2004-09-02 | Deutsches Zentrum für Luft- und Raumfahrt e.V. | Surgical instrument in the form of a suturing device |
US6102271A (en) * | 1998-11-23 | 2000-08-15 | Ethicon Endo-Surgery, Inc. | Circular stapler for hemorrhoidal surgery |
US6142933A (en) * | 1998-11-23 | 2000-11-07 | Ethicon Endo-Surgery, Inc. | Anoscope for hemorrhoidal surgery |
US6083241A (en) * | 1998-11-23 | 2000-07-04 | Ethicon Endo-Surgery, Inc. | Method of use of a circular stapler for hemorrhoidal procedure |
US6626921B2 (en) | 1999-04-16 | 2003-09-30 | Integrated Vascular Interventional Technologies, L.C. | Externally positioned anvil apparatus for cutting anastomosis |
US6652542B2 (en) | 1999-04-16 | 2003-11-25 | Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) | External anastomosis operators and related systems for anastomosis |
US6623494B1 (en) * | 1999-04-16 | 2003-09-23 | Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) | Methods and systems for intraluminally directed vascular anastomosis |
US6726694B2 (en) | 1999-04-16 | 2004-04-27 | Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) | Intraluminally directed anvil apparatus and related methods and systems |
US7981126B2 (en) * | 1999-04-16 | 2011-07-19 | Vital Access Corporation | Locking compression plate anastomosis apparatus |
US6743244B2 (en) | 1999-04-16 | 2004-06-01 | Integrated Vascular Interventional Technologies, L.C. | Soft anvil apparatus for cutting anastomosis fenestra |
US6673088B1 (en) * | 1999-05-18 | 2004-01-06 | Cardica, Inc. | Tissue punch |
AU5143000A (en) | 1999-05-18 | 2000-12-05 | Vascular Innovations, Inc. | Implantable medical device such as an anastomosis device |
US7048751B2 (en) * | 2001-12-06 | 2006-05-23 | Cardica, Inc. | Implantable medical device such as an anastomosis device |
US6719769B2 (en) | 1999-11-15 | 2004-04-13 | Cardica, Inc. | Integrated anastomosis tool with graft vessel attachment device and cutting device |
AU5150600A (en) * | 1999-05-18 | 2000-12-05 | Vascular Innovations, Inc. | Tissue punch |
US6428550B1 (en) | 1999-05-18 | 2002-08-06 | Cardica, Inc. | Sutureless closure and deployment system for connecting blood vessels |
US6461367B1 (en) * | 1999-07-16 | 2002-10-08 | Loma Linda University Medical Center | Method and device for urethral-vesicle anastomosis |
US7682368B1 (en) | 1999-07-28 | 2010-03-23 | Cardica, Inc. | Anastomosis tool actuated with stored energy |
US7850703B2 (en) | 1999-07-28 | 2010-12-14 | Cardica, Inc. | System for performing anastomosis |
US7300444B1 (en) * | 1999-07-28 | 2007-11-27 | Cardica, Inc. | Surgical system and method for connecting hollow tissue structures |
US20050154406A1 (en) * | 1999-07-28 | 2005-07-14 | Cardica, Inc. | Method for anastomosing vessels |
US7285131B1 (en) * | 1999-07-28 | 2007-10-23 | Cardica, Inc. | System for performing anastomosis |
US7063712B2 (en) * | 2001-04-27 | 2006-06-20 | Cardica, Inc. | Anastomosis method |
US7766924B1 (en) * | 1999-07-28 | 2010-08-03 | Cardica, Inc. | System for performing anastomosis |
US6391038B2 (en) | 1999-07-28 | 2002-05-21 | Cardica, Inc. | Anastomosis system and method for controlling a tissue site |
AU7341800A (en) * | 1999-09-01 | 2001-03-26 | Origin Medsystems, Inc. | Method and apparatus for performing anastomosis |
DE19941829A1 (en) * | 1999-09-02 | 2001-03-15 | Voco Gmbh | Autopolymerizing dental composition and its use |
US6626930B1 (en) | 1999-10-21 | 2003-09-30 | Edwards Lifesciences Corporation | Minimally invasive mitral valve repair method and apparatus |
US6736825B2 (en) * | 1999-12-14 | 2004-05-18 | Integrated Vascular Interventional Technologies, L C (Ivit Lc) | Paired expandable anastomosis devices and related methods |
DE19962581A1 (en) * | 1999-12-23 | 2001-06-28 | Ecotec Ag | The surgical clamping sewing apparatus makes circular seams has an opposing pressure plate and offers safe,accurate use |
US9173658B2 (en) * | 2000-03-06 | 2015-11-03 | Covidien Lp | Apparatus and method for performing a bypass procedure in a digestive system |
EP1416861B1 (en) * | 2000-03-06 | 2008-12-03 | Tyco Healthcare Group Lp | Apparatus for performing a bypass procedure in a digestive system |
US7083628B2 (en) | 2002-09-03 | 2006-08-01 | Edwards Lifesciences Corporation | Single catheter mitral valve repair device and method for use |
US6544271B1 (en) | 2000-07-18 | 2003-04-08 | Scimed Life Systems, Inc. | Device for full-thickness resectioning of an organ |
AU2001288462A1 (en) | 2000-08-30 | 2002-03-13 | Cerebral Vascular Applications Inc. | Medical instrument |
US6776785B1 (en) | 2000-10-12 | 2004-08-17 | Cardica, Inc. | Implantable superelastic anastomosis device |
US6471713B1 (en) | 2000-11-13 | 2002-10-29 | Cardica, Inc. | System for deploying an anastomosis device and method of performing anastomosis |
US6520971B1 (en) | 2000-11-27 | 2003-02-18 | Scimed Life Systems, Inc. | Full thickness resection device control handle |
US6540758B1 (en) * | 2000-11-28 | 2003-04-01 | Syed Tasnim Raza | Apparatus for and a method of performing anastomosis of blood vessels |
US20020095166A1 (en) * | 2001-01-16 | 2002-07-18 | Jaime Vargas | Incision tensioning system and method for using the same |
US6890338B1 (en) * | 2001-02-27 | 2005-05-10 | Origin Medsystems, Inc. | Method and apparatus for performing anastomosis using ring having tines with weak sections |
AU2002257122B2 (en) | 2001-04-03 | 2006-09-14 | Covidien Lp | Surgical stapling device for performing circular anastomoses |
US6755338B2 (en) | 2001-08-29 | 2004-06-29 | Cerebral Vascular Applications, Inc. | Medical instrument |
US20070060952A1 (en) * | 2005-09-02 | 2007-03-15 | Roby Mark S | Surgical stapling device with coated knife blade |
CA2462536C (en) | 2001-10-05 | 2010-03-30 | Tyco Healthcare Group Lp | Tilt top anvil for a surgical fastener device |
AU2002348207B2 (en) * | 2001-12-20 | 2008-01-24 | Rex Medical, L.P. | Apparatus and method for treating gastroesophageal reflux disease |
US8012164B1 (en) | 2002-01-22 | 2011-09-06 | Cardica, Inc. | Method and apparatus for creating an opening in the wall of a tubular vessel |
US7029482B1 (en) | 2002-01-22 | 2006-04-18 | Cardica, Inc. | Integrated anastomosis system |
US7335216B2 (en) | 2002-01-22 | 2008-02-26 | Cardica, Inc. | Tool for creating an opening in tissue |
US7223274B2 (en) | 2002-01-23 | 2007-05-29 | Cardica, Inc. | Method of performing anastomosis |
US7094244B2 (en) | 2002-03-26 | 2006-08-22 | Edwards Lifesciences Corporation | Sequential heart valve leaflet repair device and method of use |
IL150855A (en) * | 2002-07-22 | 2007-06-03 | Leonid Monassevitch | Intratubular anastomosis apparatus |
AU2003245015B2 (en) | 2002-07-22 | 2007-03-08 | Niti Medical Technologies Ltd. | Improved intussusception and anastomosis apparatus |
CN100518668C (en) | 2002-07-22 | 2009-07-29 | 尼蒂医学技术有限公司 | Intratubular anastomosis apparatus |
IL150853A0 (en) * | 2002-07-22 | 2003-02-12 | Niti Medical Technologies Ltd | Imppoved intussusception and anastomosis apparatus |
WO2004011037A2 (en) | 2002-07-31 | 2004-02-05 | Tyco Heathcare Group, Lp | Tool member cover and cover deployment device |
DE60327227D1 (en) | 2002-10-04 | 2009-05-28 | Tyco Healthcare | SURGICAL CLIP REPLACEMENT |
US7381210B2 (en) | 2003-03-14 | 2008-06-03 | Edwards Lifesciences Corporation | Mitral valve repair system and method for use |
KR100547166B1 (en) * | 2003-04-11 | 2006-01-26 | 허윤석 | Improved circular stapler |
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 |
AU2004249287B2 (en) * | 2003-06-20 | 2009-12-24 | Covidien Lp | Surgical stapling device |
US8574246B1 (en) | 2004-06-25 | 2013-11-05 | Cardica, Inc. | Compliant anastomosis system utilizing suture |
US7794471B1 (en) | 2003-06-26 | 2010-09-14 | Cardica, Inc. | Compliant anastomosis system |
US6959851B2 (en) | 2003-07-16 | 2005-11-01 | Tyco Healthcare Group Lp | Surgical stapling device with tissue tensioner |
EP2298181B1 (en) * | 2003-10-17 | 2017-04-12 | Covidien LP | Tilt anvil assembly for a surgical stapling device |
US20050149071A1 (en) * | 2003-12-24 | 2005-07-07 | Ryan Abbott | Anastomosis device, tools and method of using |
US20080269784A1 (en) * | 2003-12-24 | 2008-10-30 | Ryan Abbott | Anastomosis device, tools and methods of using |
US7585306B2 (en) * | 2003-12-24 | 2009-09-08 | Maquet Cardiovascular Llc | Anastomosis device, tools and methods of using |
WO2005076928A2 (en) * | 2004-02-06 | 2005-08-25 | Jon Mandelbaum | Anvil introducer |
AU2005226643B2 (en) | 2004-03-19 | 2010-07-22 | Covidien Lp | Anvil assembly with improved cut ring |
US8181840B2 (en) | 2004-03-19 | 2012-05-22 | Tyco Healthcare Group Lp | Tissue tensioner assembly and approximation mechanism for surgical stapling device |
EP1949861B1 (en) | 2004-03-19 | 2012-07-18 | Tyco Healthcare Group LP | Surgical stapling device |
US20050277962A1 (en) * | 2004-05-27 | 2005-12-15 | Myers Stephan R | Introducer device and method for delivering a medical instrument to a target in vivo site |
US8162963B2 (en) * | 2004-06-17 | 2012-04-24 | Maquet Cardiovascular Llc | Angled anastomosis device, tools and method of using |
WO2006014881A2 (en) * | 2004-07-26 | 2006-02-09 | Van Lue Stephen J | Surgical stapler with magnetically secured components |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US20060201989A1 (en) * | 2005-03-11 | 2006-09-14 | Ojeda Herminio F | Surgical anvil and system for deploying the same |
US20060276726A1 (en) * | 2005-06-03 | 2006-12-07 | Holsten Henry E | Tissue tension detection system |
CN100435744C (en) * | 2005-08-04 | 2008-11-26 | 苏州天臣国际医疗科技有限公司 | Turnover nail-anvil assembly |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US8317070B2 (en) | 2005-08-31 | 2012-11-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling devices that produce formed staples having different lengths |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
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 |
US20110295295A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument having recording capabilities |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US7422138B2 (en) * | 2006-02-01 | 2008-09-09 | Ethicon Endo-Surgery, Inc. | Elliptical intraluminal surgical stapler for anastomosis |
US9629626B2 (en) | 2006-02-02 | 2017-04-25 | Covidien Lp | Mechanically tuned buttress material to assist with proper formation of surgical element in diseased tissue |
US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US8540132B2 (en) | 2006-05-16 | 2013-09-24 | Covidien Lp | Tilt anvil assembly |
EP2018248B1 (en) | 2006-05-19 | 2015-11-04 | Applied Medical Resources Corporation | Surgical stapler |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US8205782B2 (en) * | 2006-07-12 | 2012-06-26 | Niti Surgical Solutions Ltd. | Compression assemblies and applicators for use therewith |
US7527185B2 (en) * | 2006-07-12 | 2009-05-05 | Niti Surgical Solutions Ltd. | Compression anastomosis ring assembly and applicator for use therewith |
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 |
US20080065156A1 (en) | 2006-09-08 | 2008-03-13 | Hauser David L | Expandable clip for tissue repair |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
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 |
US8220690B2 (en) | 2006-09-29 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Connected surgical staples and stapling instruments for deploying the same |
US7866525B2 (en) * | 2006-10-06 | 2011-01-11 | Tyco Healthcare Group Lp | Surgical instrument having a plastic surface |
US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US8827133B2 (en) | 2007-01-11 | 2014-09-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling device having supports for a flexible drive mechanism |
US8272555B2 (en) | 2007-03-07 | 2012-09-25 | Tyco Healthcare Group Lp | Stapler for mucosectomy |
US7669747B2 (en) | 2007-03-15 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Washer for use with a surgical stapling instrument |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based 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 |
US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
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 |
US7988026B2 (en) | 2007-09-06 | 2011-08-02 | Cardica, Inc. | Endocutter with staple feed |
US8070036B1 (en) | 2007-09-06 | 2011-12-06 | Cardica, Inc | True multi-fire surgical stapler configured to fire staples of different sizes |
US9168039B1 (en) | 2007-09-06 | 2015-10-27 | Cardica, Inc. | Surgical stapler with staples of different sizes |
US20090082785A1 (en) | 2007-09-24 | 2009-03-26 | Milliman Keith L | Anvil Delivery Device Accessory |
US8011554B2 (en) | 2008-01-09 | 2011-09-06 | Tyco Healthcare Group, Lp | Raised boss for staple guide |
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 |
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 |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
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 |
US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
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 |
US20090206131A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | End effector coupling arrangements for a surgical cutting and stapling instrument |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US9770245B2 (en) | 2008-02-15 | 2017-09-26 | Ethicon Llc | Layer arrangements for surgical staple cartridges |
US20090206139A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | Buttress material for a surgical instrument |
US8733611B2 (en) | 2008-03-12 | 2014-05-27 | Covidien Lp | Ratcheting mechanism for surgical stapling device |
WO2009137761A2 (en) * | 2008-05-09 | 2009-11-12 | Elmer Valin | Laparoscopic gastric and intestinal trocar |
US8678264B2 (en) | 2008-07-07 | 2014-03-25 | Covidien Lp | Surgical instrument with elongated channel |
US8109426B2 (en) * | 2008-08-12 | 2012-02-07 | Tyco Healthcare Group Lp | Surgical tilt anvil assembly |
US20100051668A1 (en) | 2008-09-03 | 2010-03-04 | Milliman Keith L | Surgical instrument with indicator |
US8113405B2 (en) | 2008-09-03 | 2012-02-14 | Tyco Healthcare Group, Lp | Surgical instrument with indicator |
US8181838B2 (en) | 2008-09-10 | 2012-05-22 | Tyco Healthcare Group Lp | Surgical stapling device |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US7832612B2 (en) | 2008-09-19 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Lockout arrangement for a surgical stapler |
US9050083B2 (en) * | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8231042B2 (en) | 2008-11-06 | 2012-07-31 | Tyco Healthcare Group Lp | Surgical stapler |
US8408441B2 (en) | 2009-01-06 | 2013-04-02 | Covidien Lp | Surgical stapler |
US8281974B2 (en) | 2009-01-14 | 2012-10-09 | Tyco Healthcare, Group LP | Surgical stapler with suture locator |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
US8397971B2 (en) | 2009-02-05 | 2013-03-19 | Ethicon Endo-Surgery, Inc. | Sterilizable surgical instrument |
US8485413B2 (en) | 2009-02-05 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising an articulation joint |
CA2751664A1 (en) | 2009-02-06 | 2010-08-12 | Ethicon Endo-Surgery, Inc. | Driven surgical stapler improvements |
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 |
US8453913B2 (en) | 2009-02-06 | 2013-06-04 | Covidien Lp | Anvil for surgical stapler |
US8167898B1 (en) | 2009-05-05 | 2012-05-01 | Cardica, Inc. | Flexible cutter for surgical stapler |
US8418909B2 (en) * | 2009-06-02 | 2013-04-16 | Covidien Lp | Surgical instrument and method for performing a resection |
US8146790B2 (en) | 2009-07-11 | 2012-04-03 | Tyco Healthcare Group Lp | Surgical instrument with safety mechanism |
US20110011916A1 (en) * | 2009-07-16 | 2011-01-20 | New York University | Anastomosis device |
US8328062B2 (en) | 2009-07-21 | 2012-12-11 | Covidien Lp | Surgical instrument with curvilinear tissue-contacting surfaces |
US8267301B2 (en) | 2009-08-19 | 2012-09-18 | Tyco Healthcare Group Lp | Surgical stapler |
US8430292B2 (en) | 2009-10-28 | 2013-04-30 | Covidien Lp | Surgical fastening apparatus |
US8322590B2 (en) | 2009-10-28 | 2012-12-04 | Covidien Lp | Surgical stapling instrument |
US8622275B2 (en) | 2009-11-19 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Circular stapler introducer with rigid distal end portion |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8267300B2 (en) | 2009-12-30 | 2012-09-18 | Ethicon Endo-Surgery, Inc. | Dampening device for endoscopic surgical stapler |
US8714430B2 (en) | 2009-12-31 | 2014-05-06 | Covidien Lp | Indicator for surgical stapler |
US8561871B2 (en) | 2009-12-31 | 2013-10-22 | Covidien Lp | Indicators for surgical staplers |
DE202010000688U1 (en) | 2010-01-07 | 2011-05-12 | Kirchner, Ralf, Dr.med. | cone |
US8608046B2 (en) | 2010-01-07 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Test device for a surgical tool |
DE202010000687U1 (en) | 2010-01-07 | 2011-05-12 | Kirchner, Ralf, Dr.med. | suture clip |
US8328061B2 (en) | 2010-02-02 | 2012-12-11 | Covidien Lp | Surgical instrument for joining tissue |
US8783543B2 (en) * | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US8789740B2 (en) | 2010-07-30 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Linear cutting and stapling device with selectively disengageable cutting member |
US8672207B2 (en) | 2010-07-30 | 2014-03-18 | Ethicon Endo-Surgery, Inc. | Transwall visualization arrangements and methods for surgical circular staplers |
EP2613714B1 (en) | 2010-09-09 | 2021-08-11 | Queen Mary & Westfield College, University of London | Apparatus for forming stoma trephines and anastomoses |
US8360296B2 (en) | 2010-09-09 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling head assembly with firing lockout for a surgical stapler |
US9877720B2 (en) | 2010-09-24 | 2018-01-30 | Ethicon Llc | Control features for articulating surgical device |
US8733613B2 (en) | 2010-09-29 | 2014-05-27 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US9220500B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
US20120080478A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges with detachable support structures and surgical stapling instruments with systems for preventing actuation motions when a cartridge is not present |
US9216019B2 (en) | 2011-09-23 | 2015-12-22 | Ethicon Endo-Surgery, Inc. | Surgical stapler with stationary staple drivers |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US9517063B2 (en) | 2012-03-28 | 2016-12-13 | Ethicon Endo-Surgery, Llc | Movable member for use with a tissue thickness compensator |
US8893949B2 (en) | 2010-09-30 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler with floating anvil |
US8978954B2 (en) | 2010-09-30 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising an adjustable distal portion |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9592050B2 (en) | 2010-09-30 | 2017-03-14 | Ethicon Endo-Surgery, Llc | End effector comprising a distal tissue abutment member |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9351730B2 (en) | 2011-04-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising channels |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US9301753B2 (en) | 2010-09-30 | 2016-04-05 | Ethicon Endo-Surgery, Llc | Expandable tissue thickness compensator |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
BR112013007717B1 (en) | 2010-09-30 | 2020-09-24 | Ethicon Endo-Surgery, Inc. | SURGICAL CLAMPING SYSTEM |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US9320523B2 (en) | 2012-03-28 | 2016-04-26 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising tissue ingrowth features |
US9750502B2 (en) | 2010-10-01 | 2017-09-05 | Covidien Lp | Surgical stapling device for performing circular anastomosis and surgical staples for use therewith |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US8496157B2 (en) | 2011-02-18 | 2013-07-30 | Covidien Lp | Tilting anvil for annular surgical stapler |
US9113884B2 (en) | 2011-03-14 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Modular surgical tool systems |
US8800841B2 (en) | 2011-03-15 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges |
US8490850B2 (en) | 2011-04-29 | 2013-07-23 | Covidien Lp | Circular stapler with controlled tissue compression |
CA2834649C (en) | 2011-04-29 | 2021-02-16 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
BR102012001830B1 (en) * | 2011-05-19 | 2020-10-27 | Ethicon Endo-Surgery, Inc. | stapling refill set for a circular stapling instrument and circular stapling instrument |
US8733615B2 (en) | 2011-05-19 | 2014-05-27 | Ethicon Endo-Surgery, Inc. | Circular stapler with frictional reducing member |
US8573464B2 (en) | 2011-05-19 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Circular stapling instrument having a breakaway washer attachment member |
BR102012001736B1 (en) * | 2011-05-19 | 2021-04-20 | Ethicon Endo-Surgery, Inc | circular stapling instrument |
BR102012001738B1 (en) * | 2011-05-19 | 2020-10-20 | Ethicon Endo-Surgery, Inc. | circular stapling instrument |
US9265503B2 (en) | 2012-09-07 | 2016-02-23 | Covidien Lp | Methods for applying surgical staples to internal walls of hollow tissue organs |
US10561424B2 (en) | 2011-05-20 | 2020-02-18 | Covidien Lp | Methods of inserting a circular stapling apparatus into a body lumen |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US8789739B2 (en) | 2011-09-06 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Continuous stapling instrument |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US8708212B2 (en) | 2011-10-18 | 2014-04-29 | Covidien Lp | Tilt top anvil with torsion spring |
US9016547B2 (en) | 2011-10-26 | 2015-04-28 | Covidien Lp | EEA tilt top anvil with ratchet/locking mechanism |
DE102011054821A1 (en) | 2011-10-26 | 2013-05-02 | Medizinische Hochschule Hannover | Device combination for connecting hollow organs (anastomosis) |
US9113885B2 (en) | 2011-12-14 | 2015-08-25 | Covidien Lp | Buttress assembly for use with surgical stapling device |
US8967448B2 (en) | 2011-12-14 | 2015-03-03 | Covidien Lp | Surgical stapling apparatus including buttress attachment via tabs |
US20130175315A1 (en) * | 2012-01-11 | 2013-07-11 | Covidien Lp | Method and device for performing a surgical anastomosis |
US9010605B2 (en) | 2012-01-12 | 2015-04-21 | Covidien Lp | Sliding sleeve for circular stapling instrument reloads |
US9010612B2 (en) | 2012-01-26 | 2015-04-21 | Covidien Lp | Buttress support design for EEA anvil |
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 |
US9022274B2 (en) | 2012-02-15 | 2015-05-05 | Covidien Lp | Circular stapler with increased lumen diameter |
US9179913B2 (en) | 2012-03-16 | 2015-11-10 | Covidien Lp | Surgical fastening apparatus with directed overcrimp |
WO2013140422A1 (en) * | 2012-03-21 | 2013-09-26 | Universita' Degli Studi Di Padova | Anvil for a chirurgical mechanical circular stapler |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
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 |
JP6224070B2 (en) | 2012-03-28 | 2017-11-01 | 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. | Retainer assembly including tissue thickness compensator |
CN104334098B (en) | 2012-03-28 | 2017-03-22 | 伊西康内外科公司 | Tissue thickness compensator comprising capsules defining a low pressure environment |
US20130284792A1 (en) | 2012-04-26 | 2013-10-31 | Covidien Lp | Surgical Stapling Device Including A Camera |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9351734B2 (en) | 2012-06-19 | 2016-05-31 | Covidien Lp | Spring loaded anvil retainer |
US8747238B2 (en) | 2012-06-28 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Rotary drive shaft assemblies for surgical instruments with articulatable end effectors |
US20140001234A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Coupling arrangements for attaching surgical end effectors to drive systems therefor |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
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 |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US9649111B2 (en) | 2012-06-28 | 2017-05-16 | Ethicon Endo-Surgery, Llc | Replaceable clip cartridge for a clip applier |
US20140005718A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Multi-functional powered surgical device with external dissection features |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
CN104487005B (en) | 2012-06-28 | 2017-09-08 | 伊西康内外科公司 | Empty squeeze latching member |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
US11278284B2 (en) | 2012-06-28 | 2022-03-22 | Cilag Gmbh International | Rotary drive arrangements for surgical instruments |
US10213205B2 (en) | 2012-07-06 | 2019-02-26 | Covidien Lp | T-slot tilt anvil for circular stapling instrument |
US9675359B2 (en) | 2012-10-10 | 2017-06-13 | Covidien Lp | Surgical instrument with preload assembly |
US9572572B2 (en) | 2012-11-09 | 2017-02-21 | Covidien Lp | Circular stapler mechanical lockout |
US9498222B2 (en) * | 2012-11-29 | 2016-11-22 | Ethicon Endo-Surgery, Llc | Pivoting anvil for surgical circular stapler |
US9724100B2 (en) | 2012-12-04 | 2017-08-08 | Ethicon Llc | Circular anvil introduction system with alignment feature |
US9351724B2 (en) | 2013-01-11 | 2016-05-31 | Covidien Lp | Circular stapling instrument |
US9204881B2 (en) | 2013-01-11 | 2015-12-08 | Covidien Lp | Buttress retainer for EEA anvil |
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 |
MX368026B (en) | 2013-03-01 | 2019-09-12 | Ethicon Endo Surgery Inc | Articulatable surgical instruments with conductive pathways for signal communication. |
MX364729B (en) | 2013-03-01 | 2019-05-06 | Ethicon Endo Surgery Inc | Surgical instrument with a soft stop. |
US9700309B2 (en) | 2013-03-01 | 2017-07-11 | Ethicon Llc | Articulatable surgical instruments with conductive pathways for signal communication |
US20140263552A1 (en) | 2013-03-13 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Staple cartridge tissue thickness sensor system |
US9592056B2 (en) | 2013-03-14 | 2017-03-14 | Covidien Lp | Powered stapling apparatus |
WO2014152912A1 (en) * | 2013-03-14 | 2014-09-25 | 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 |
US9629623B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Drive system lockout arrangements for modular surgical instruments |
CN104042292A (en) | 2013-03-15 | 2014-09-17 | 柯惠Lp公司 | Surgical anastomosis device comprising assemblies capable of being repeatedly utilized |
US20140277018A1 (en) * | 2013-03-15 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Percutaneous Instrument and Method |
KR20240039202A (en) | 2013-03-15 | 2024-03-26 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical stapler having actuation mechanism with rotatable shaft |
KR102254476B1 (en) | 2013-03-15 | 2021-05-21 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical stapler with expandable jaw |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
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 |
US10405857B2 (en) | 2013-04-16 | 2019-09-10 | Ethicon Llc | Powered linear surgical stapler |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US9532780B2 (en) | 2013-06-12 | 2017-01-03 | Covidien Lp | EEA anvil snap ring activator |
US9668740B2 (en) | 2013-06-14 | 2017-06-06 | Covidien Lp | Anvil assembly with sliding sleeve |
US10271843B2 (en) | 2013-06-17 | 2019-04-30 | Covidien Lp | Surgical instrument with lockout mechanism |
US9750503B2 (en) | 2013-07-11 | 2017-09-05 | Covidien Lp | Methods and devices for performing a surgical anastomosis |
CN103340661B (en) * | 2013-08-01 | 2016-08-10 | 苏州贝诺医疗器械有限公司 | There is the circular digestive tract stapler of video capability |
CN106028966B (en) | 2013-08-23 | 2018-06-22 | 伊西康内外科有限责任公司 | For the firing member restoring device of powered surgical instrument |
US9808249B2 (en) | 2013-08-23 | 2017-11-07 | Ethicon Llc | Attachment portions for surgical instrument assemblies |
US9662115B2 (en) | 2013-08-26 | 2017-05-30 | Covidien Lp | EEA abdominal access device |
US9693773B2 (en) | 2013-09-11 | 2017-07-04 | Covidien Lp | Anvil assembly with sliding sleeve |
US20140171986A1 (en) | 2013-09-13 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Surgical Clip Having Comliant Portion |
US9554802B2 (en) | 2013-11-13 | 2017-01-31 | Covidien Lp | Anvil assembly with frangible retaining member |
US9517070B2 (en) | 2013-11-13 | 2016-12-13 | Covidien Lp | Anvil assembly and delivery system |
US9687232B2 (en) | 2013-12-23 | 2017-06-27 | Ethicon Llc | Surgical staples |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9681870B2 (en) | 2013-12-23 | 2017-06-20 | Ethicon Llc | Articulatable surgical instruments with separate and distinct closing and firing systems |
US9642620B2 (en) | 2013-12-23 | 2017-05-09 | Ethicon Endo-Surgery, Llc | Surgical cutting and stapling instruments with articulatable end effectors |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
US20140166726A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple |
JP6462004B2 (en) | 2014-02-24 | 2019-01-30 | エシコン エルエルシー | Fastening system with launcher lockout |
US9733663B2 (en) | 2014-03-26 | 2017-08-15 | Ethicon Llc | Power management through segmented circuit and variable voltage protection |
US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US9750499B2 (en) | 2014-03-26 | 2017-09-05 | Ethicon Llc | Surgical stapling instrument system |
US9801627B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Fastener cartridge for creating a flexible staple line |
BR112016023807B1 (en) | 2014-04-16 | 2022-07-12 | Ethicon Endo-Surgery, Llc | CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT |
US20150297225A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
CN106456176B (en) | 2014-04-16 | 2019-06-28 | 伊西康内外科有限责任公司 | Fastener cartridge including the extension with various configuration |
US10299792B2 (en) | 2014-04-16 | 2019-05-28 | Ethicon Llc | Fastener cartridge comprising non-uniform fasteners |
BR112016023825B1 (en) | 2014-04-16 | 2022-08-02 | Ethicon Endo-Surgery, Llc | STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPLER AND STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
US9655626B2 (en) | 2014-04-28 | 2017-05-23 | Covidien Lp | Anvil assembly delivery system |
US9913643B2 (en) | 2014-05-09 | 2018-03-13 | Covidien Lp | Interlock assemblies for replaceable loading unit |
WO2015191887A1 (en) | 2014-06-11 | 2015-12-17 | Applied Medical Resources Corporation | Surgical stapler with circumferential firing |
CN106456166B (en) | 2014-06-12 | 2019-11-01 | 柯惠有限合伙公司 | Surgical stapling device |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
US9867619B2 (en) | 2014-06-24 | 2018-01-16 | Covidien Lp | System for delivering an anvil assembly to a surgical site |
US9861367B2 (en) | 2014-06-24 | 2018-01-09 | Covidien Lp | Anvil assembly delivery systems |
EP3164084B1 (en) | 2014-07-04 | 2020-02-19 | Covidien LP | Loading unit with shipping member for surgical stapling device |
US9757133B2 (en) | 2014-07-09 | 2017-09-12 | Covidien Lp | Methods and devices for performing a surgical anastomosis |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
US10135242B2 (en) | 2014-09-05 | 2018-11-20 | Ethicon Llc | Smart cartridge wake up operation and data retention |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
WO2016044216A1 (en) | 2014-09-15 | 2016-03-24 | Applied Medical Resources Corporation | 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 |
CN107427300B (en) | 2014-09-26 | 2020-12-04 | 伊西康有限责任公司 | Surgical suture buttress and buttress material |
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 |
US10898196B2 (en) | 2014-11-21 | 2021-01-26 | Covidien Lp | Cleaning apparatus for surgical instruments |
US10085744B2 (en) | 2014-12-08 | 2018-10-02 | Covidien Lp | Loading unit attachment band for surgical stapling instrument |
US9855045B2 (en) | 2014-12-09 | 2018-01-02 | Covidien Lp | Anvil assembly delivery system |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
CN107106168B (en) | 2014-12-11 | 2020-03-03 | 柯惠有限合伙公司 | Surgical suture loading unit |
US10772627B2 (en) | 2014-12-11 | 2020-09-15 | Covidien Lp | Stapler with auto-matic lockout mechanism |
JP6518766B2 (en) | 2014-12-17 | 2019-05-22 | コヴィディエン リミテッド パートナーシップ | Surgical stapling device with firing indicator |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US9968355B2 (en) | 2014-12-18 | 2018-05-15 | Ethicon Llc | Surgical instruments with articulatable end effectors and improved firing beam support arrangements |
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 |
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 |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
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 |
US10022126B2 (en) | 2015-01-07 | 2018-07-17 | Covidien Lp | Loading unit locking collar |
US10117656B2 (en) | 2015-01-07 | 2018-11-06 | Covidien Lp | Loading unit locking collar |
US10039549B2 (en) | 2015-01-07 | 2018-08-07 | Covidien Lp | Loading unit retention clip for surgical stapling instrument |
WO2016127433A1 (en) | 2015-02-15 | 2016-08-18 | Covidien Lp | Surgical stapling device with firing indicator of unitary construction |
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 |
US10321907B2 (en) | 2015-02-27 | 2019-06-18 | Ethicon Llc | System for monitoring whether a surgical instrument needs to be serviced |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
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 |
US10548504B2 (en) | 2015-03-06 | 2020-02-04 | Ethicon Llc | Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
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 |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10390825B2 (en) | 2015-03-31 | 2019-08-27 | Ethicon Llc | Surgical instrument with progressive rotary drive systems |
US10881408B2 (en) | 2015-04-22 | 2021-01-05 | Covidien Lp | Interlock assembly for replaceable loading units |
US10426480B2 (en) | 2015-04-29 | 2019-10-01 | Covidien Lp | Cutting ring assembly with rigid cutting member |
US9987001B2 (en) | 2015-06-12 | 2018-06-05 | Covidien Lp | Surgical anastomosis apparatus |
US10178992B2 (en) | 2015-06-18 | 2019-01-15 | Ethicon Llc | Push/pull articulation drive systems for articulatable surgical instruments |
US10111668B2 (en) | 2015-07-02 | 2018-10-30 | Covidien Lp | Anvil assembly with snap backup ring |
US9974536B2 (en) | 2015-07-02 | 2018-05-22 | Covidien Lp | Anvil assemblies and delivery systems |
US10117655B2 (en) | 2015-07-22 | 2018-11-06 | Covidien Lp | Loading unit locking band for surgical stapling instrument |
US10085756B2 (en) | 2015-07-24 | 2018-10-02 | Covidien Lp | Anvil assembly and anvil assembly delivery system |
US10117675B2 (en) | 2015-07-28 | 2018-11-06 | Covidien Lp | Trocar tip protector |
AU2016304601B2 (en) | 2015-08-06 | 2020-10-22 | Applied Medical Resources Corporation | Surgical stapler having locking articulation joint |
US10617418B2 (en) | 2015-08-17 | 2020-04-14 | Ethicon Llc | Implantable layers for a surgical instrument |
BR112018003693B1 (en) | 2015-08-26 | 2022-11-22 | Ethicon Llc | SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPPING INSTRUMENT |
US10357251B2 (en) | 2015-08-26 | 2019-07-23 | Ethicon Llc | Surgical staples comprising hardness variations for improved fastening of tissue |
US10172619B2 (en) | 2015-09-02 | 2019-01-08 | Ethicon Llc | Surgical staple driver arrays |
MX2022006192A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US9980730B2 (en) | 2015-09-21 | 2018-05-29 | Covidien Lp | Loading unit locking collar with rotational actuated release |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-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 |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10111684B2 (en) | 2015-09-25 | 2018-10-30 | Covidien Lp | Adapter assembly including a removable trocar assembly |
US10524788B2 (en) | 2015-09-30 | 2020-01-07 | Ethicon Llc | Compressible adjunct with attachment regions |
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 |
US10271849B2 (en) | 2015-09-30 | 2019-04-30 | Ethicon Llc | Woven constructs with interlocked standing fibers |
US10542992B2 (en) | 2015-10-19 | 2020-01-28 | Covidien Lp | Loading unit with stretchable bushing |
WO2017066918A1 (en) | 2015-10-20 | 2017-04-27 | Covidien Lp | Circular stapler with tissue gap indicator assembly |
EP3364886B1 (en) | 2015-10-21 | 2021-12-01 | Covidien LP | Annular knife for surgical stapler |
US10512466B2 (en) | 2015-11-05 | 2019-12-24 | Covidien Lp | Adapter assembly for surgical device |
CN108289683B (en) | 2015-11-13 | 2021-06-25 | 柯惠有限合伙公司 | Circular stapler with audible indicator mechanism |
CN108289684B (en) | 2015-12-07 | 2021-08-31 | 柯惠有限合伙公司 | Anvil assembly and delivery system |
US10390835B2 (en) | 2015-12-10 | 2019-08-27 | Covidien Lp | Surgical fastener apparatus with linear position sensor |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US10524797B2 (en) | 2016-01-13 | 2020-01-07 | Covidien Lp | Adapter assembly including a removable trocar assembly |
EP3410957B1 (en) | 2016-02-04 | 2020-06-03 | Covidien LP | Circular stapler with visual indicator mechanism |
CN108882932B (en) | 2016-02-09 | 2021-07-23 | 伊西康有限责任公司 | Surgical instrument with asymmetric articulation configuration |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US10588625B2 (en) | 2016-02-09 | 2020-03-17 | Ethicon Llc | Articulatable surgical instruments with off-axis firing beam arrangements |
US10398439B2 (en) | 2016-02-10 | 2019-09-03 | Covidien Lp | Adapter, extension, and connector assemblies for surgical devices |
US10603042B2 (en) | 2016-02-10 | 2020-03-31 | Covidien Lp | Flexible circular stapler |
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 |
JP6945541B2 (en) | 2016-03-04 | 2021-10-06 | コヴィディエン リミテッド パートナーシップ | Robot Surgical Surgery Assembly |
US10307159B2 (en) | 2016-04-01 | 2019-06-04 | Ethicon Llc | Surgical instrument handle assembly with reconfigurable grip portion |
US10271851B2 (en) | 2016-04-01 | 2019-04-30 | Ethicon Llc | Modular surgical stapling system comprising a display |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US11284890B2 (en) | 2016-04-01 | 2022-03-29 | Cilag Gmbh International | Circular stapling system comprising an incisable tissue support |
US11064997B2 (en) | 2016-04-01 | 2021-07-20 | Cilag Gmbh International | Surgical stapling instrument |
ES2938241T3 (en) | 2016-04-12 | 2023-04-05 | Applied Med Resources | Surgical stapler with a motorized handle |
KR102457727B1 (en) | 2016-04-12 | 2022-10-21 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical stapler having articulation mechanism |
EP3442430B1 (en) | 2016-04-12 | 2021-07-14 | Applied Medical Resources Corporation | Reload shaft assembly for surgical stapler |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | 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 |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
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 |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US10363037B2 (en) | 2016-04-18 | 2019-07-30 | Ethicon Llc | Surgical instrument system comprising a magnetic lockout |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US10595871B2 (en) | 2016-05-10 | 2020-03-24 | Covidien Lp | Insertion instrument, adapter assemblies and protector assemblies for a flexible circular stapler |
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 |
USD822206S1 (en) | 2016-06-24 | 2018-07-03 | Ethicon Llc | Surgical fastener |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
US10702270B2 (en) | 2016-06-24 | 2020-07-07 | Ethicon Llc | Stapling system for use with wire staples and stamped staples |
GB201611306D0 (en) | 2016-06-29 | 2016-08-10 | Norwegian Univ Of Science And Tech (Ntnu) | Surgical stapler and a method of stapling tissue |
US11141162B2 (en) | 2016-07-08 | 2021-10-12 | Covidien Lp | Loading unit locking collar with linearly actuated release |
US11452522B2 (en) | 2016-08-15 | 2022-09-27 | Covidien Lp | Circular stapling device with articulating anvil retainer assembly |
US10499922B2 (en) | 2016-11-04 | 2019-12-10 | Covidien Lp | Stapling device with self-releasing knife carrier pusher |
US10426470B2 (en) | 2016-11-04 | 2019-10-01 | Covidien Lp | Stapling device with releasable knife carrier |
JP6983893B2 (en) | 2016-12-21 | 2021-12-17 | エシコン エルエルシーEthicon LLC | Lockout configuration for surgical end effectors and replaceable tool assemblies |
US20180168609A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Firing assembly comprising a fuse |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
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 |
US10980536B2 (en) | 2016-12-21 | 2021-04-20 | Ethicon Llc | No-cartridge and spent cartridge lockout arrangements for surgical staplers |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US10736629B2 (en) | 2016-12-21 | 2020-08-11 | Ethicon Llc | Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation 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 |
US10568625B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Staple cartridges and arrangements of staples and staple cavities therein |
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 |
US10492785B2 (en) | 2016-12-21 | 2019-12-03 | Ethicon Llc | Shaft assembly comprising a lockout |
US10485543B2 (en) | 2016-12-21 | 2019-11-26 | Ethicon Llc | Anvil having a knife slot width |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US10881401B2 (en) | 2016-12-21 | 2021-01-05 | Ethicon Llc | Staple firing member comprising a missing cartridge and/or spent cartridge lockout |
US20180168598A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Staple forming pocket arrangements comprising zoned forming surface grooves |
US20180168647A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments having end effectors with positive opening features |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US10973516B2 (en) | 2016-12-21 | 2021-04-13 | Ethicon Llc | Surgical end effectors and adaptable firing members therefor |
MX2019007311A (en) | 2016-12-21 | 2019-11-18 | Ethicon Llc | Surgical stapling systems. |
US10537325B2 (en) | 2016-12-21 | 2020-01-21 | Ethicon Llc | Staple forming pocket arrangement to accommodate different types of staples |
US20180168575A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling systems |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US11241232B2 (en) | 2017-01-24 | 2022-02-08 | Covidien Lp | Surgical stapling device with resettable anvil assembly |
EP3639755B1 (en) | 2017-01-25 | 2021-06-23 | Covidien LP | Circular stapling device |
US10542993B2 (en) | 2017-02-24 | 2020-01-28 | Covidien Lp | Anvil assembly of circular stapling device including alignment splines |
CN110381852B (en) | 2017-03-09 | 2022-12-27 | 柯惠有限合伙公司 | End effector assembly for circular stapler apparatus |
CN110381853B (en) | 2017-03-09 | 2022-06-07 | 柯惠有限合伙公司 | Surgical stapling device with audible indicator mechanism |
US10342534B2 (en) | 2017-03-23 | 2019-07-09 | Covidien Lp | Surgical stapling device with releasable knife carrier |
EP3600078B1 (en) * | 2017-03-23 | 2022-06-22 | Covidien LP | Circular stapling device with alignment splines |
US10881409B2 (en) | 2017-05-02 | 2021-01-05 | Covidien Lp | Rotation assembly for a surgical device |
US11045199B2 (en) | 2017-06-09 | 2021-06-29 | Covidien Lp | Handheld electromechanical surgical system |
US10932784B2 (en) | 2017-06-09 | 2021-03-02 | Covidien Lp | Handheld electromechanical surgical system |
US11596400B2 (en) | 2017-06-09 | 2023-03-07 | Covidien Lp | Handheld electromechanical surgical system |
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 |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
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 |
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 |
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 |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
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 |
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 |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical 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 |
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 |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
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 |
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 |
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 |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US10631859B2 (en) | 2017-06-27 | 2020-04-28 | Ethicon Llc | Articulation systems for surgical instruments |
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 |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
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 |
US11389161B2 (en) | 2017-06-28 | 2022-07-19 | Cilag Gmbh International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
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 |
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 |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10987107B2 (en) | 2017-07-05 | 2021-04-27 | Covidien Lp | Surgical stapling device |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11090054B2 (en) | 2017-08-07 | 2021-08-17 | Covidien Lp | Stapling device with resettable tilt anvil assembly |
US10828026B2 (en) | 2017-08-08 | 2020-11-10 | Covidien Lp | Tiltable anvil assembly |
US10695069B2 (en) | 2017-08-23 | 2020-06-30 | Covidien Lp | Circular stapling device with offset spline tip |
EP3675748A4 (en) | 2017-09-01 | 2021-01-20 | Covidien LP | Circular stapling device with position ribs |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with 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 |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US11324507B2 (en) | 2017-11-03 | 2022-05-10 | Covidien Lp | Device and method for attachment of a stomal sleeve |
US11141151B2 (en) | 2017-12-08 | 2021-10-12 | Covidien Lp | Surgical buttress for circular stapling |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
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 |
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 |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use 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 |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
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 |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
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 |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
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 |
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 |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11751867B2 (en) | 2017-12-21 | 2023-09-12 | Cilag Gmbh International | Surgical instrument comprising sequenced systems |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
EP3758620A1 (en) | 2018-02-27 | 2021-01-06 | Applied Medical Resources Corporation | Surgical stapler having a powered handle |
US11497501B2 (en) | 2018-03-26 | 2022-11-15 | Covidien Lp | Circular stapling device with A-frame splines |
US11033273B2 (en) | 2018-03-28 | 2021-06-15 | Covidien Lp | Surgical anvil assemblies for surgical stapling instruments |
US10595873B2 (en) | 2018-04-19 | 2020-03-24 | Franklin Institute of Innovation, LLC | Surgical staplers and related methods |
US10952734B2 (en) | 2018-04-23 | 2021-03-23 | Covidien Lp | Stapling device with cut ring biasing member |
US11284896B2 (en) | 2018-05-09 | 2022-03-29 | Covidien Lp | Surgical buttress loading and attaching/detaching assemblies |
US11197676B2 (en) | 2018-06-28 | 2021-12-14 | Covidien Lp | Tie-down method for anvil assembly delivery system |
US11241234B2 (en) | 2018-08-14 | 2022-02-08 | Covidien Lp | Anvil assembly with self-retaining backup member |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
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 |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
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 |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
WO2020037649A1 (en) | 2018-08-24 | 2020-02-27 | Covidien Lp | Powered circular stapling device |
US10806459B2 (en) | 2018-09-14 | 2020-10-20 | Covidien Lp | Drug patterned reinforcement material for circular anastomosis |
US11241236B2 (en) | 2018-09-21 | 2022-02-08 | Covidien Lp | Buttress attachment methods for circular EEA staplers |
US10973544B2 (en) | 2018-10-02 | 2021-04-13 | Covidien Lp | Retaining mechanism for trocar assembly |
US11141163B2 (en) | 2018-10-04 | 2021-10-12 | Covidien Lp | Circular stapling device with anvil rotation locking structure |
US11147560B2 (en) | 2018-11-07 | 2021-10-19 | Covidien Lp | Buttress for circular EEA staplers |
US11065005B2 (en) | 2018-11-07 | 2021-07-20 | Covidien Lp | Reload assembly for a circular stapling device |
US11147561B2 (en) | 2018-11-28 | 2021-10-19 | Covidien Lp | Reload assembly for a circular stapling device |
US11389263B2 (en) | 2018-12-13 | 2022-07-19 | Covidien Lp | Lockout mechanisms for surgical instruments |
US11166728B2 (en) | 2019-02-08 | 2021-11-09 | Covidien Lp | Reload assembly for a circular stapling device |
US11547411B2 (en) | 2019-02-22 | 2023-01-10 | Covidien Lp | Anastomosis wound protector |
US11529144B2 (en) | 2019-02-22 | 2022-12-20 | Covidien Lp | Encapsulated plug assembly for electromechanical surgical devices |
KR20210132146A (en) | 2019-02-27 | 2021-11-03 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical Stapling Instrument with 2-Position Lockout Mechanism |
US11337701B2 (en) | 2019-03-01 | 2022-05-24 | Covidien Lp | Devices and methods for assembling adapter assemblies |
US11331782B2 (en) | 2019-03-01 | 2022-05-17 | Covidien Lp | Reload assembly for a circular stapling device |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11147551B2 (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 |
US11457921B2 (en) | 2019-03-26 | 2022-10-04 | Covidien Lp | Anvil assembly for surgical stapling instrument |
JP2022527154A (en) | 2019-03-29 | 2022-05-31 | アプライド メディカル リソーシーズ コーポレイション | Reload cover for surgical staple fastening system |
US11596410B2 (en) | 2019-04-05 | 2023-03-07 | Covidien Lp | Surgical stapling device |
US11534164B2 (en) | 2019-04-05 | 2022-12-27 | Covidien Lp | Strain gauge stabilization in a surgical device |
US11344330B2 (en) | 2019-04-16 | 2022-05-31 | Covidien Lp | Trocar assemblies for adapter assemblies for surgical stapling instruments |
US11660116B2 (en) | 2019-04-16 | 2023-05-30 | Covidien Lp | Trocar assemblies for adapter assemblies for surgical stapling instruments |
US11419631B2 (en) | 2019-04-16 | 2022-08-23 | Covidien Lp | Trocar assemblies for adapter assemblies for surgical stapling instruments |
US11317945B2 (en) | 2019-04-16 | 2022-05-03 | Covidien Lp | Trocar assemblies for adapter assemblies for surgical stapling instruments |
US11839378B2 (en) | 2019-04-19 | 2023-12-12 | Covidien Lp | Circular stapling instruments |
US11399838B2 (en) | 2019-04-22 | 2022-08-02 | Covidien Lp | Reload assembly for circular stapling devices |
US11246599B2 (en) | 2019-04-25 | 2022-02-15 | Covidien Lp | End effector for circular stapling instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
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 |
JP2022543958A (en) | 2019-05-31 | 2022-10-17 | コヴィディエン リミテッド パートナーシップ | circular stapling device |
US11690624B2 (en) | 2019-06-21 | 2023-07-04 | Covidien Lp | Reload assembly injection molded strain gauge |
US11123101B2 (en) | 2019-07-05 | 2021-09-21 | Covidien Lp | Retaining mechanisms for trocar assemblies |
US11446035B2 (en) | 2019-06-24 | 2022-09-20 | Covidien Lp | Retaining mechanisms for trocar assemblies |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
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 |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
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 |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11357509B2 (en) | 2019-07-11 | 2022-06-14 | Covidien Lp | Reload assembly for a circular stapling device |
US11192227B2 (en) | 2019-07-16 | 2021-12-07 | Covidien Lp | Reload assembly for circular stapling devices |
US11253255B2 (en) | 2019-07-26 | 2022-02-22 | Covidien Lp | Knife lockout wedge |
US11464510B2 (en) | 2019-07-26 | 2022-10-11 | Covidien Lp | Reload assembly with knife carrier lockout |
US11399825B2 (en) | 2019-10-28 | 2022-08-02 | Covidien Lp | Reload assembly with knife carrier lockout |
US11553918B2 (en) | 2019-12-16 | 2023-01-17 | Covidien Lp | Reload assembly with knife carrier lockout |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
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 |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11730481B2 (en) | 2020-01-06 | 2023-08-22 | Covidien Lp | Assemblies for retaining a trocar assembly |
US11517317B2 (en) | 2020-01-06 | 2022-12-06 | Covidien Lp | Trocar release assemblies for a surgical stapler |
US11911038B2 (en) | 2020-01-13 | 2024-02-27 | Covidien Lp | Cut optimization for excessive tissue conditions |
US11523828B2 (en) | 2020-01-28 | 2022-12-13 | Covidien Lp | Sealed reload assembly for stapling device |
US11622767B2 (en) | 2020-02-19 | 2023-04-11 | Covidien Lp | Sealed trocar assembly for stapling device |
US11547438B2 (en) | 2020-02-24 | 2023-01-10 | Covidien Lp | Tip protector for ensuring trocar insertion |
US11382630B2 (en) | 2020-02-25 | 2022-07-12 | Covidien Lp | Surgical stapling device with two part knife assembly |
US11779343B2 (en) | 2020-02-26 | 2023-10-10 | Covidien Lp | Staple reload assembly with releasable knife |
US11298152B2 (en) | 2020-02-28 | 2022-04-12 | Covidien Lp | Trocar retaining mechanism including band support |
US11272998B2 (en) | 2020-03-04 | 2022-03-15 | Covidien Lp | Strain gage fixation in tension |
US11426170B2 (en) | 2020-03-24 | 2022-08-30 | Covidien Lp | Retaining mechanisms for trocar assemblies |
US11350939B2 (en) | 2020-03-24 | 2022-06-07 | Covidien Lp | Retaining mechanisms for trocar assemblies |
US11426169B2 (en) | 2020-03-24 | 2022-08-30 | Covidien Lp | Retaining mechanisms for trocar assemblies |
US11653925B2 (en) | 2020-05-21 | 2023-05-23 | Covidien Lp | Tissue relaxation monitoring for optimized tissue stapling |
US11547405B2 (en) | 2020-05-22 | 2023-01-10 | Covidien Lp | Surgical stapling device |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | 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 |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
US11553921B2 (en) | 2020-07-15 | 2023-01-17 | Covidien Lp | Surgical stapling device with flexible shaft |
US11547412B2 (en) | 2020-07-22 | 2023-01-10 | Covidien Lp | Surgical instruments and methods of assembly |
US20220031351A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with differential articulation joint arrangements for accommodating flexible actuators |
US11877744B2 (en) | 2020-08-14 | 2024-01-23 | Covidien Lp | Low-cost powered stapler with end stop selection |
US11627966B2 (en) | 2020-08-26 | 2023-04-18 | Covidien Lp | Surgical stapling device |
US11801054B2 (en) | 2020-09-22 | 2023-10-31 | Covidien Lp | Surgical stapler with oval tool assembly |
US11712509B2 (en) | 2020-10-02 | 2023-08-01 | Covidien Lp | Seal assembly for circular stapling instrument |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
KR20230096060A (en) | 2020-10-29 | 2023-06-29 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical stapler with power handle |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
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 |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
AU2021368128A1 (en) | 2020-10-29 | 2023-06-01 | Applied Medical Resources Corporation | Actuation shaft retention mechanism for surgical stapler |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
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 |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11627967B2 (en) | 2020-11-23 | 2023-04-18 | Covidien Lp | Trans-anastomotic insertion device |
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 |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
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 |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11877750B2 (en) | 2021-01-21 | 2024-01-23 | Covidien Lp | Surgical stapler with powered and manual functions |
US11786241B2 (en) | 2021-02-16 | 2023-10-17 | Covidien Lp | Surgical stapling device including a hydraulic staple formation mechanism |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
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 |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
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 |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
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 |
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 |
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 |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11553920B2 (en) | 2021-05-03 | 2023-01-17 | Covidien Lp | Trocar retainer assembly for surgical stapler |
US11490894B1 (en) | 2021-05-12 | 2022-11-08 | Covidien Lp | Surgical device with grease filter |
US11642131B2 (en) | 2021-05-17 | 2023-05-09 | Covidien Lp | Devices and methods for shortening a rectal stump during a lower anterior resection procedure |
US11612400B2 (en) | 2021-05-24 | 2023-03-28 | Covidien Lp | Trocar assembly with bearing assembly for load sharing |
US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US20220395275A1 (en) | 2021-06-11 | 2022-12-15 | Covidien Lp | Surgical fastening instrument |
US11819208B2 (en) | 2021-08-05 | 2023-11-21 | Covidien Lp | Handheld electromechanical surgical device with strain gauge drift detection |
US11744592B2 (en) | 2021-08-05 | 2023-09-05 | Covidien Lp | Handheld electromechanical stapler with tissue thickness detection |
US11737759B2 (en) | 2021-08-05 | 2023-08-29 | Covidien Lp | Surgical stapling device accommodating prolapsed tissue |
US11642133B2 (en) | 2021-08-09 | 2023-05-09 | Covidien Lp | Securing ring for use with an end-to-end anastomosis stapling device |
US11883028B2 (en) | 2021-09-08 | 2024-01-30 | Covidien Lp | Systems and methods for post-operative anastomotic leak detection |
US11717299B2 (en) | 2021-10-12 | 2023-08-08 | Covidien Lp | Surgical stapling device with probiotics |
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 (43)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE1057729B (en) * | 1954-03-29 | 1959-05-21 | Lameris Instr N V | Surgical device for connecting two parts of the intestine |
GB787043A (en) * | 1954-09-15 | 1957-11-27 | Sylvania Electric Prod | Method for production of silicon |
CA736256A (en) * | 1962-08-27 | 1966-06-14 | S. Kasoolin Viacheslav | Instrument for suturing esophagus to intestine or stomach |
FR1461464A (en) * | 1965-08-20 | 1966-02-25 | Niiex Khirurgicheskoi Apparatu | Surgical device for suturing organs |
CH470170A (en) * | 1968-02-02 | 1969-03-31 | Vnii Khirurgicheskoi Apparatur | Device for applying round anastomoses |
US3593903A (en) * | 1968-07-12 | 1971-07-20 | Vnii Khirurgicheskoi Apparatur | Surgical instrument for suturing hollow organs in infants |
US4603693A (en) * | 1977-05-26 | 1986-08-05 | United States Surgical Corporation | Instrument for circular surgical stapling of hollow body organs and disposable cartridge therefor |
US4573468A (en) * | 1977-05-26 | 1986-03-04 | United States Surgical Corporation | Hollow body organ stapling instrument and disposable cartridge employing relief vents |
US4304236A (en) * | 1977-05-26 | 1981-12-08 | United States Surgical Corporation | Stapling instrument having an anvil-carrying part of particular geometric shape |
NL7711347A (en) * | 1977-10-17 | 1979-04-19 | Carl Robert Erik Daantje | Stapling instrument for joining intestine ends - has head coupling rod in two parts screwing together with hand grip |
US4198982A (en) * | 1978-03-31 | 1980-04-22 | Memorial Hospital For Cancer And Allied Diseases | Surgical stapling instrument and method |
DE2947107A1 (en) * | 1978-12-07 | 1980-06-26 | United States Surgical Corp | ACCURATELY ALIGNED CARTRIDGE AND INSTRUMENT FOR CLAMPING ANASTOMOSES |
US4319576A (en) * | 1980-02-26 | 1982-03-16 | Senco Products, Inc. | Intralumenal anastomosis surgical stapling instrument |
US4379457A (en) * | 1981-02-17 | 1983-04-12 | United States Surgical Corporation | Indicator for surgical stapler |
US4476863A (en) * | 1981-03-09 | 1984-10-16 | Kanshin Nikolai N | Surgical instrument for establishing circular coloanastomoses |
US4576167A (en) * | 1981-09-03 | 1986-03-18 | United States Surgical Corporation | Surgical stapler apparatus with curved shaft |
SU1114405A1 (en) * | 1982-02-23 | 1984-09-23 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Surgical suturing apparatus for placing compression anastomoses on the organs of digestive tract |
US4473077A (en) * | 1982-05-28 | 1984-09-25 | United States Surgical Corporation | Surgical stapler apparatus with flexible shaft |
US4537193A (en) * | 1982-10-28 | 1985-08-27 | Hgm, Inc. | Laser endocoagulator apparatus |
DE3301713A1 (en) * | 1983-01-20 | 1984-07-26 | Horst Dr. 3004 Isernhagen Ziegler | Surgical clip suture apparatus for producing circular joins |
US4505414A (en) * | 1983-10-12 | 1985-03-19 | Filipi Charles J | Expandable anvil surgical stapler |
US4610383A (en) * | 1983-10-14 | 1986-09-09 | Senmed, Inc. | Disposable linear surgical stapler |
US4671445A (en) * | 1984-08-09 | 1987-06-09 | Baxter Travenol Laboratories, Inc. | Flexible surgical stapler assembly |
US4566620A (en) * | 1984-10-19 | 1986-01-28 | United States Surgical Corporation | Articulated surgical fastener applying apparatus |
AU582625B2 (en) * | 1985-01-28 | 1989-04-06 | Ethicon Inc. | Tissue gripper for use with intraluminal stapling device |
US4728020A (en) * | 1985-08-30 | 1988-03-01 | United States Surgical Corporation | Articulated surgical fastener applying apparatus |
US4700703A (en) * | 1986-03-27 | 1987-10-20 | Semion Resnick | Cartridge assembly for a surgical stapling instrument |
US4903697A (en) * | 1986-03-27 | 1990-02-27 | Semion Resnick | Cartridge assembly for a surgical stapling instrument |
ATE96633T1 (en) * | 1986-04-21 | 1993-11-15 | Globe Control Finanz Aktienges | DEVICE FOR MAKING AN ANASTOMOSE. |
US4848367A (en) * | 1987-02-11 | 1989-07-18 | Odis L. Avant | Method of effecting dorsal vein ligation |
US4873977A (en) * | 1987-02-11 | 1989-10-17 | Odis L. Avant | Stapling method and apparatus for vesicle-urethral re-anastomosis following retropubic prostatectomy and other tubular anastomosis |
US5119983A (en) * | 1987-05-26 | 1992-06-09 | United States Surgical Corporation | Surgical stapler apparatus |
FR2622429A1 (en) * | 1987-11-16 | 1989-05-05 | Blagoveschensky G | SURGICAL SUTURE APPARATUS |
WO1990006085A1 (en) * | 1988-11-29 | 1990-06-14 | Gingold Bruce S | Surgical stapling apparatus |
CH677728A5 (en) * | 1989-10-17 | 1991-06-28 | Bieffe Medital Sa | |
US5104025A (en) * | 1990-09-28 | 1992-04-14 | Ethicon, Inc. | Intraluminal anastomotic surgical stapler with detached anvil |
US5122156A (en) * | 1990-12-14 | 1992-06-16 | United States Surgical Corporation | Apparatus for securement and attachment of body organs |
US5108420A (en) * | 1991-02-01 | 1992-04-28 | Temple University | Aperture occlusion device |
US5271543A (en) * | 1992-02-07 | 1993-12-21 | Ethicon, Inc. | Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism |
US5314435A (en) * | 1992-05-19 | 1994-05-24 | United States Surgical Corporation | Anvil delivery system |
US5344059A (en) * | 1992-05-19 | 1994-09-06 | United States Surgical Corporation | Surgical apparatus and anvil delivery system therefor |
US5405073A (en) * | 1993-12-06 | 1995-04-11 | Ethicon, Inc. | Flexible support shaft assembly |
CA2146508C (en) * | 1994-08-25 | 2006-11-14 | Robert H. Schnut | Anvil for circular stapler |
-
1992
- 1992-09-23 US US07/950,435 patent/US5344059A/en not_active Expired - Lifetime
-
1993
- 1993-05-10 CA CA002095915A patent/CA2095915C/en not_active Expired - Lifetime
- 1993-05-18 DE DE69314848T patent/DE69314848T2/en not_active Expired - Lifetime
- 1993-05-18 EP EP93108098A patent/EP0570915B1/en not_active Expired - Lifetime
-
1999
- 1999-05-10 US US09/309,027 patent/US6053390A/en not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
EP0570915B1 (en) | 1997-10-29 |
US5344059A (en) | 1994-09-06 |
EP0570915A3 (en) | 1995-06-28 |
DE69314848T2 (en) | 1998-03-19 |
DE69314848D1 (en) | 1997-12-04 |
US6053390A (en) | 2000-04-25 |
EP0570915A2 (en) | 1993-11-24 |
CA2095915A1 (en) | 1993-11-20 |
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Legal Events
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EEER | Examination request | ||
MKEX | Expiry |
Effective date: 20130510 |