CA2144211C - Surgical instruments useful for endoscopic spinal procedures - Google Patents
Surgical instruments useful for endoscopic spinal procedures Download PDFInfo
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- CA2144211C CA2144211C CA002144211A CA2144211A CA2144211C CA 2144211 C CA2144211 C CA 2144211C CA 002144211 A CA002144211 A CA 002144211A CA 2144211 A CA2144211 A CA 2144211A CA 2144211 C CA2144211 C CA 2144211C
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- 238000003780 insertion Methods 0.000 claims description 6
- 230000037431 insertion Effects 0.000 claims description 6
- 239000000463 material Substances 0.000 claims description 5
- 230000001154 acute effect Effects 0.000 claims description 3
- 238000001356 surgical procedure Methods 0.000 abstract description 9
- 238000013459 approach Methods 0.000 abstract description 8
- 210000001519 tissue Anatomy 0.000 description 9
- 208000003618 Intervertebral Disc Displacement Diseases 0.000 description 7
- 206010050296 Intervertebral disc protrusion Diseases 0.000 description 7
- 230000004927 fusion Effects 0.000 description 5
- 210000000988 bone and bone Anatomy 0.000 description 4
- 238000002684 laminectomy Methods 0.000 description 4
- 210000003205 muscle Anatomy 0.000 description 4
- 210000005036 nerve Anatomy 0.000 description 4
- 208000008035 Back Pain Diseases 0.000 description 3
- 238000002674 endoscopic surgery Methods 0.000 description 3
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- 238000013519 translation Methods 0.000 description 2
- 208000002193 Pain Diseases 0.000 description 1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00261—Discectomy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- 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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2936—Pins in guiding slots
-
- 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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2943—Toothed members, e.g. rack and pinion
-
- 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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2944—Translation of jaw members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/442—Intervertebral or spinal discs, e.g. resilient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
Abstract
The present invention provides endoscopic instrumentation and surgical techniques especially useful for accessing at least a portion of an intervertebral disc. Vertebrae spreading instruments are provided for spreading adjacent vertebrae to facilitate access to the intervertebral disc are. The disclosed surgical method uses an anterior approach to access the intervertebral disc and spreads adjacent vertebrae utilizing an endoscopic vertebrae spreading instrument.
Description
SURGICAL INSTRUMENTS USEFUL FOR ENDOSCOPIC SPINAL PROCEDURES
BACKGROUND OF THE INVENTION
1. Field of the Invention The invention relates to surgical instruments and, more particularly, to endoscopic surgical instruments useful to perform endoscopic discectomy procedures and other minimally invasive spinal procedures.
BACKGROUND OF THE INVENTION
1. Field of the Invention The invention relates to surgical instruments and, more particularly, to endoscopic surgical instruments useful to perform endoscopic discectomy procedures and other minimally invasive spinal procedures.
2. Description of the Related Art Back pain is a common affliction affecting millions of people. In many instances, back pain is caused by a herniated intervertebral disc. Intervertebral discs are generally cylindrical-shaped structures corresponding t.o the margins of the adjacent vertebrae. An outer ring known as the annulus fibrosus composed of concentric layers of fibrous tissue and fibrocartilage surrounds a cartilage-like core known as the nucleus pulposus. When an intervertebral disc is herniated, the softer nucleus projects through a torn portion of the annulus, creating a bulge which extends beyond the intervertebral foramen.
As a result of the bulging disc, various spinal nerves may be compressed, causing pain or numbness.
Various procedures are used to treat herniated intervertebral discs. In mild disc herniation, pressure on adjacent nerves is lessened through non-surgical techniques.
Such techniques include drugs (analgesics, anti-inflammatory drugs, muscle relaxants), physical therapy, and rest. If these non-surgical approaches are not successful, surgical intervention is necessary. Various surgical procedures have been developed to remove at least a portion of the herniated disc. Such procedures include laminotomies, laminectomies, and percutaneous discectomy.
In laminotomy (also referred to as interlaminar exploration), a posterior approach is used to access the spine through a longitudinal incision. Small amounts of the bony spinal lamina are removed, allowing access to, and removal of, portions of the herniated nucleus pulposus.
Laminectomy is a surgical procedure which, like laminotomy, uses a posterior approach to the herniated disc. In laminectomy, a larger portion of the spinal lamina or laminae are removed to access and remove portions of a herniated disc nucleus. Because both laminotomy and laminectomy require removal of bone and retraction of nerves and muscles, hospitalization and recuperation periods are lengthy. Additionally, removal of bone may lead to future spinal instability.
To minimize the need to remove portions of the vertebrae, other approaches to the herniated disc have been used. In particular, percutaneous discectomy employs a postern-lateral approach. Instruments are inserted through a cannula inserted through the patient's side. The disc annulus is pierced and the herniated nucleus is mechanically disintegrated, the pieces being removed through suction. This technique is shown for example in U.S. Patent Nos. 4,545,374, 5,242,439 and RE 33,258.
Endoscopic surgery involves incising through body walls via small incisions, generally by use of a trocar having an obturator with sharp tip removably positioned in a cannula. After penetration, the obturator is removed leaving the cannula positioned in the body for reception of a camera or endoscope to transmit images to a remote TV monitor. Specialized instruments such as forceps, cutters, and applicators are inserted through other trocar sites for performing the surgical procedure while being viewed by the surgeon on the monitor. With the advent of endoscopic surgery and the recognition of its advantages over open procedures in reducing costs by shortening the patient's hospital stay and time of recovery so the patient can resume normal activity sooner, the industry has been viewing endoscopic discectomy as an alternative to the techniques and surgical methods described above. However, to date, the need exists for endoscopic instrumentation to properly and atraumatically improve access to the disc to facilitate removal for successful performance of endoscopic discectomy.
U.S. Patent No. 5,195,541 discloses a laparoscopic surgical method for performing lumbar discectomy utilizing a single device. The single device is inserted into the patient anteriorly, the device comprising a sleeve having an endoscope receiving means, a laser fiber receiving means and a suction and irrigation channel means. This device, however, is of relatively large diameter because it must accommodate a variety of surgical instruments and therefore may obstruct the surgeon's view (on the TV monitor) and provide limited access to the disc.
There is a need in the art for surgical instrumentation which facilitates minimally invasive surgical techniques for anteriorly accessing the herniated disc. The instrumentation and techniques should advantageously improve access to the surgical site and permit the surgeon to endoscopically remove any desired amount of disc material with minimal interference to spinal nerves and adjacent back muscles. Such instrumentation and techniques would permit the surgical alleviation of back pain while providing the benefits attendant endoscopic/laparoscopic surgery, namely avoiding large incisions and long periods of hospital stay and patient recovery.
As a result of the bulging disc, various spinal nerves may be compressed, causing pain or numbness.
Various procedures are used to treat herniated intervertebral discs. In mild disc herniation, pressure on adjacent nerves is lessened through non-surgical techniques.
Such techniques include drugs (analgesics, anti-inflammatory drugs, muscle relaxants), physical therapy, and rest. If these non-surgical approaches are not successful, surgical intervention is necessary. Various surgical procedures have been developed to remove at least a portion of the herniated disc. Such procedures include laminotomies, laminectomies, and percutaneous discectomy.
In laminotomy (also referred to as interlaminar exploration), a posterior approach is used to access the spine through a longitudinal incision. Small amounts of the bony spinal lamina are removed, allowing access to, and removal of, portions of the herniated nucleus pulposus.
Laminectomy is a surgical procedure which, like laminotomy, uses a posterior approach to the herniated disc. In laminectomy, a larger portion of the spinal lamina or laminae are removed to access and remove portions of a herniated disc nucleus. Because both laminotomy and laminectomy require removal of bone and retraction of nerves and muscles, hospitalization and recuperation periods are lengthy. Additionally, removal of bone may lead to future spinal instability.
To minimize the need to remove portions of the vertebrae, other approaches to the herniated disc have been used. In particular, percutaneous discectomy employs a postern-lateral approach. Instruments are inserted through a cannula inserted through the patient's side. The disc annulus is pierced and the herniated nucleus is mechanically disintegrated, the pieces being removed through suction. This technique is shown for example in U.S. Patent Nos. 4,545,374, 5,242,439 and RE 33,258.
Endoscopic surgery involves incising through body walls via small incisions, generally by use of a trocar having an obturator with sharp tip removably positioned in a cannula. After penetration, the obturator is removed leaving the cannula positioned in the body for reception of a camera or endoscope to transmit images to a remote TV monitor. Specialized instruments such as forceps, cutters, and applicators are inserted through other trocar sites for performing the surgical procedure while being viewed by the surgeon on the monitor. With the advent of endoscopic surgery and the recognition of its advantages over open procedures in reducing costs by shortening the patient's hospital stay and time of recovery so the patient can resume normal activity sooner, the industry has been viewing endoscopic discectomy as an alternative to the techniques and surgical methods described above. However, to date, the need exists for endoscopic instrumentation to properly and atraumatically improve access to the disc to facilitate removal for successful performance of endoscopic discectomy.
U.S. Patent No. 5,195,541 discloses a laparoscopic surgical method for performing lumbar discectomy utilizing a single device. The single device is inserted into the patient anteriorly, the device comprising a sleeve having an endoscope receiving means, a laser fiber receiving means and a suction and irrigation channel means. This device, however, is of relatively large diameter because it must accommodate a variety of surgical instruments and therefore may obstruct the surgeon's view (on the TV monitor) and provide limited access to the disc.
There is a need in the art for surgical instrumentation which facilitates minimally invasive surgical techniques for anteriorly accessing the herniated disc. The instrumentation and techniques should advantageously improve access to the surgical site and permit the surgeon to endoscopically remove any desired amount of disc material with minimal interference to spinal nerves and adjacent back muscles. Such instrumentation and techniques would permit the surgical alleviation of back pain while providing the benefits attendant endoscopic/laparoscopic surgery, namely avoiding large incisions and long periods of hospital stay and patient recovery.
Such instrumentation could also advantageously be used for aiding other minimally invasive surgical spinal procedures such as spinal fusion.
SUMMARY OF THE INVENTION
The present invention provides a method for accessing at least a portion of an intervertebral disc for removal. The method comprises the steps of endoscopically accessing the invertebrae disc space through an anterior endoscopic port, inserting an endoscopic spreading instrument into the endoscopic port, spreading apart vertebrae adjacent to an intervertebral disc using the endoscopic spreading instrument, accessing an intervertebral disc nucleus, and removing at least a portion of the disc nucleus through the anterior endoscopic port.
The surgical method incorporating an anterior approach to access the intervertebral disc in combination with spreading of adjacent vertebrae permits the surgeon to have optimal viewing of the operation site as well as improves access to the site. Thus, the surgeon can accurately remove any desired amount of disc material to achieve the desired decompression of adjacent nerves and muscles.
The present invention also provides an endoscopic apparatus for spreading the vertebrae which includes a handle portion including an actuation member for manipulating an actuation mechanism, and an elongated endoscopic section defining a longitudinal axis and extending distally from the handle portion.
The actuation mechanism at least partially extends within said elongated endoscopic section and movable in response to movement of the actuation member. A vertebrae spreading mechanism is operatively associated with a distal end of the endoscopic section and is movable between open and closed positions by the actuation mechanism in response to movement of the actuation _2144211 member, the vertebrae spreading mechanism including at least two vertebrae spreading arm members having exterior vertebrae contacting surfaces. The vertebrae contacting surfaces may form an acute angle of elevation towards a proximal end of the instrument with respect to the longitudinal axis. The vertebrae spreading arms spread the vertebrae to assist endoscopic discectomy procedures as well as other minimally invasive spinal procedures such as spinal fusion.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of an endoscopic surgical instrument for spreading the vertebrae according to the present invention;
FIG. lA is an enlarged perspective view of the distal end of the instrument of FIG. 1 with the vertebrae spreading arms in an open position;
FIG. 2 is a cross-sectional view of the instrument taken along lines 2-2 of FIG. 1;
FIG. 3 is a cross-sectional view of the instrument taken along lines 3-3 of FIG. 2;
FIG. 4 is a cross-sectional view of the instrument taken along lines 4-4 of FIG. 3;
FIG. 5 is a cross-sectional view illustrating the vertebrae spreading portion of the instrument taken along lines 5-5 of FIG.
lA;
FIG. 6 is a perspective view with parts separated of the distal end of the instrument of FIG. 1.
FIG. 7 is a perspective view of an alternative embodiment adapted to spread vertebrae constructed according to the present invention;
_2144211 FIG. 8 is a side plan view of the distal end portion of the instrument of FIG. 7 illustrating the vertebrae spreading members in a generally closed position:
FIG. 9 is a view similar to the plan view of Fig. 8 depicting the vertebrae spreading members in an open position;
FIG. 10 is a plan view of the double rack and pinion mechanism used to open and close the vertebrae spreading members of FIG. 7;
FIG. 11 is a perspective view of another alternative embodiment of an instrument adapted to spread vertebrae;
FIG. 11A is an enlarged perspective view of the distal end of the instrument of FIG. 11 with the vertebrae spreading arms in an open position;
FIG. 12 is a cross-sectional view of the handle of the instrument of FIG. 11 taken along the lines 12-12 of FIG. 11; and FIG. 13 is a plan view of the linkage mechanism for causing movement of the vertebrae spreading members of the instrument of FIG. 11.
DETAINED DESCRIPTION OF THE PREFERRED EMBODIMENT
A. Instrumentation Turning now to the drawings in detail in which like reference numerals identify similar or identical elements throughout the several views, FIG. 1 depicts an endoscopic surgical instrument 100 which may be used as a tissue spreader and particularly as a vertebrae spreader during an endoscopic discectomy procedure. By spreading the vertebrae, access to the disc is improved. In describing the surgical instruments of the present invention, the term "proximal" refers to a direction of the instrument away from the patient and towards the user while the term "distal" refers to a direction of the instrument towards the patient and away from the user.
~~~4z1~
_7_ Surgical instrument 100 generally comprises proximal handle portion 110 having actuating member 132.~Endoscopic portion 140 extends distally from handle portion 110 and is configured to support vertebrae spreading mechanism 160 at its distal end.
Vertebrae spreading mechanism 160 includes a pair of serrated vertebrae spreading arms 162 shown in a closed position in FIG. 1 and in an open position in Fig. lA.
Referring now to FIGS. 2 and 3, in conjunction with the axial cross-sectional view of Fig. 4, the actuating mechanism 130 comprises a rotatable collar actuating member 132 and translatable inner cylindrical member 134. Translatable inner cylindrical member 134 is provided with angled caroming slot 135 for cooperating with cylindrical caroming pin 133. Caroming pin 133, mounted to rotatable actuating member 132, travels within caroming slot 135 during rotation of member 132 to axially translate cylindrical member 134 within handle portion 120 and proximal end portion of endoscopic portion 140. To ensure longitudinal reciprocal motion of the cylindrical member 134, guide pin 124 is mounted through handle portion 120 into cylindrical member longitudinal guide slots 126. Cam slot 135 includes angled portion 136 to lock the caroming pin 133 when the arms 162 are in the open position.
Referring now to FIGS. 2 and 3, in conjunction with FIG. 6, mounted within the distal end of the cylindrical member 134 is actuating rod 144. Actuating rod 144 passes coaxially through endoscopic portion 140 to move vertebrae spreading mechanism 160 between open and closed positions. A separate seal, such as O-ring 145 can be provided to prevent passage of gases from the body cavity. At its distal end, actuating rod 144 terminates in flattened portion 145 having flat surfaces 146 and 147. To link vertebrae spreading mechanism 160 to actuating rod 144, linkage mechanism 150 is provided, as shown in Fig. 6. A transverse _214421, _8_ bearing post 152 which interfits with vertebrae spreading arms 162 is attached to actuating rod 144 through aperture 148.
Linkage mechanism 150 is contained within linkage mechanism housing 154, a hollow member supported at the distal end of endoscopic portion 140 through an interference fit.
Each of vertebrae spreading members 162 has a proximally-extending planar arm portion 163 mounted within linkage mechanism housing 154. Planar arm portions 163 are each provided with an angled caroming slot 164 to permit movement of the vertebrae spreading members between open and closed positions. Vertebrae spreading members 162 include proximal transverse circular apertures 166 configured to receive transverse pivot pins 156 mounted through linkage mechanism housing 154. Bearing post 152 interfits within angled caroming slots 164 to translate the longitudinal reciprocal motion of actuating rod 144 into pivotal motion of vertebrae spreading members 164 about transverse pivot pins 156. FIG. 5 illustrates actuator rod 144 fully extended to thereby move vertebrae spreading members 162 to the fully opened position. Tissue gripping surface 167 formed on an outer surface of arms 162 preferably includes a plurality of teeth to prevent slippage of gripping surface 167 on tissue when spreading members 162 are open.
As best seen in FIG. 3, the tissue gripping surface 167 of each of the vertebrae spreading arms 162 forms an acute angle of elevation, T, with the longitudinal axis defined by endoscopic portion 140, towards the proximal end of instrument 100. This configuration aids in spreading the vertebrae since the distalmost portion of the vertebrae spreading arms are narrower than the proximalmost portion, enabling insertion of the instrument within confined spaces, such as, between adjacent vertebrae. Each of the vertebrae spreading arms are composed of rigid material such as stainless steel or rigid polymer.
,214~21~
Referring now to FIG. 7 there is illustrated an alternative embodiment of an instrument useful as a vertebrae spreader constructed according to the invention. Instrument 200 includes handle portion 210 having actuating knob 212 and elongated member 214 extending distally form the handle portion 210. Supported at the distal end of elongated member 214 is vertebrae spreading housing member 218 which houses vertebrae spreading members 220.
Handle portion 210 and connected elongated member 214 may be similar to a conventional allen wrench, appropriately re-configured and dimensioned to be received within a trocar or cannula. The distal end of elongated (endoscopic) member 214 (not shown) preferably defines a generally hexagonal shape in cross section which is received within a correspondingly dimensioned hexagonal-shaped recess formed in inlet portion 222 of housing member 218 to releasably connect the elongated member to the housing member. Inlet portion 222 rotates in response to rotational movement of handle portion 210 and elongated member 214, the significance of which will become appreciated from the description provided below. This releasable connection of elongated member 214 to inlet portion 222 allows the vertebrae spreading arms to be positioned and left in the body during the remainder of the operation, while the elongated member 214 is removed to free the port (trocar site) for insertion of other instrumentation. At any time during the procedure, elongated member 214 can be reinserted into the body and re-connected to inlet portion 222 and vertebrae spreading arms 220 to move the arms to the closed position (Fig. 8) for withdrawal from the body.
Referring now more specifically to FIGS. 8-10, in conjunction with FIG. 7, housing member 218 houses vertebrae spreading members 220 which are adapted for reciprocal sliding movement within channel 224 formed in the housing. Vertebrae spreading members 220 move to and from the center of housing member 218 through actuation of a double rack and pinion system 226 as depicted in FIG. 10. Double rack and pinion system 226 includes racks 228 and pinion 230. Racks 228 intermesh with pinion 230 and move to and from the center of housing member 218 in response to rotational movement of pinion 230. Pinion 230 is operatively connected to inlet portion 222 of housing member 218 through pin 232, and rotates with the inlet portion.
Each vertebrae spreading member 220 is operatively connected to a single rack 228 by connecting pins 234 (see Fig. 10) and, accordingly, moves either inwardly or outwardly relative to the center of housing member 218 in response to corresponding movement of the rack. Thus, rotation of handle portion 210 and elongated member 214 in the clockwise direction causes corresponding clockwise motion of pinion 230 which, accordingly, positions vertebrae spreading members adjacent each other as illustrated in FIG. 8. Consequently, counter clockwise rotation of pinion 230 (FIG. 10) positions spreading members 220 in the outward open condition depicted in FIG. 9. It should be noted that the movement of arms 220 is transverse to the longitudinal axis of the instrument and arm 220 remain substantially parallel (e. g. in parallel planes) to the longitudinal axis during movement between the open and closed positions.
Referring now to FIGS. 11-13, there is illustrated another embodiment of a surgical instrument useful as a vertebrae spreader, constructed according to the present invention.
Vertebrae spreader 300 includes a handle portion 310 having an actuating member 312 at a proximal end and an elongated, substantially cylindrical endoscopic portion 340 extending distally from the handle portion. A vertebrae spreading mechanism 330 is supported at the distal end of endoscopic portion 340. Spreading mechanism 330 includes a pair of _144211 vertebrae spreading members 332, shown in a deployed position in FIG. 11A, useful for spreading vertebrae during an endoscopic discectomy procedure.
As shown in FIG. 12, handle portion 310 includes rotatable actuating knob member 312 provided with a threaded axial interior bore 314. Threaded bore 314 engages a threaded driving member 316 having an elongated threaded body portion 318. Lateral longitudinal slots 320 in driving member 316 cooperate with through pin 322 to permit axial translation of threaded driving member 316 during rotational movement of knob member 312 while prohibiting rotational movement of the driving member.
A rod member 324 is connected to the distal end portion 316a of driving member 316 by conventional means. Rod member 324 moves -axially in direct response to corresponding axial movement of driving member 316.
Referring now to FIG. 13, the distal end of rod member 324 is connected via pin 326 to a pair of link members 328. Link members 328 are connected to respective vertebrae spreading members 332 via connecting pins 334. A transverse pin 336 is positioned within an aperture 338 formed in each vertebrae spreading member. Pin 336 traverses the longitudinal bore of endoscopic portion 340 and is securely mounted to the endoscopic portion 340 by conventional means (FIG. 11).
In use of instrument 300, rotation of actuating member 312 produces axial translation of driving member 316 and rod member 324. During distal movement of rod member 324 (as shown by the arrow A in FIG. 13), link members 328 move outwardly, in the direction shown by the directional arrows, which outward movement causes vertebrae spreading members 332 to pivot about pin 336 to an open position. Proximal movement of rod member 324 causes inward movement of link members 328 and corresponding inward _2144211 pivoting movement of vertebrae spreading members 332 to a closed condition.
As noted above, FIGS. 1-13 illustrate vertebrae spreaders useful for spreading apart adjacent vertebrae during endoscopic discectomy procedures. However, these instruments can also be utilized in other surgical procedures and for spreading other types of tissue besides bone.
The instruments described above are preferably composed of relatively inexpensive materials so that they are single-use disposable instruments which can be discarded after use.
However, it is also contemplated that they can be re-usable or semi-reusable in that a portion of the instrument is re-sterilized, e.g.~.the handle, and the remaining portion is disposable, e.g. the jaw structure.
B. Surgical Method Use of the surgical instruments of Figs. 1-13 will be described in conjunction with an anterior endoscopic lumbar discectomy according to the present invention. While they have particular application in this procedure, it is recognized that the instruments of the present invention may be used to perform surgical spreading procedures anywhere in the body. In describing the procedure, the term "anterior" is broadly used to describe the ventral surface of a body opposite the back. This term includes, but is not limited to, the abdominal region of the body.
For performing an anterior endoscopic lumbar discectomy, the patient is placed in the supine position and entry is made through the abdomen, which is insufflated according to known procedures. Specific points of entry are determined by the particular intervertebral disc to be removed. For removal of intervertebral discs of the lumbar vertebrae, ports are ~2144211 established in the lower abdomen using standard trocars. One port is dedicated to viewing via an endoscope, while remaining ports are used for surgical instrument insertion and manipulation.
To access the intervertebral disc, soft tissue is dissected, providing a pathway through the abdominal region. Fascia and other soft tissue may be spread using a surgical retractor or tissue spreader. Organs such as the colon are retracted away from the operating site to increase exposure and facilitate observation of the spinal column.
l0 Upon reaching the spinal column, blunt dissection is performed to expose the intervertebral disc. Fascia is removed from the disc area and spread using a retractor or instrument for spreading tissue.
To further facilitate access to the intervertebral disc, the adjacent vertebrae are spread using any one of the instruments of the present invention. The distal end of the selected instrument is placed between the vertebral bodies. Deployment of the vertebrae spreader causes the arms to expand against each adjacent vertebral body, relieving pressure of the vertebrae on the disc and improving access to ease disc removal.
The herniated disc nucleus is accessed through the disc annulus. The disc annulus may be incised using a conventional endoscopic cutting instrument. Such instruments include for example endoscopic scissors. A portion of the disc annulus may be removed to form an access channel, or, an incision may be created and the incision edges spread open through the tissue spreading element. Alternatively, the disc annulus may be incised using a laser or an access port created using a trephine.
The cutting instrument is inserted into the disc nucleus.
Following insertion into the disc nucleus, the cutting instrument slices away portions of the disc nucleus which may be removed using forceps, rongeurs, or suction instruments. Other _ 2144211 instruments may be selected for disc removal including lasers, rongeurs, and the like. Using the anterior approach, as much or as little of the herniated nucleus may be removed as needed to alleviate compression of adjacent muscles and nerves. This surgical procedure permits the surgeon to directly monitor the disc removal process by means of an endoscope.
Although the use of the instrumentation of the present invention has been described in conjunction with endoscopic discectomy procedures, the instruments can be used for facilitating other endoscopic (minimally invasive) surgical procedures. These include, for example, spreading the vertebrae to aid spinal fusion. Spinal fusion is used to stabilize spinal segments and is currently performed using fusion baskets, bone plugs or other internal fixation devices.
While the invention has been particularly shown and described with reference to the preferred embodiments, it will be understood by those skilled in the art that various modifications and changes in form and detail may be made without departing from the scope and spirit of the invention. Accordingly, modifications such as those suggested above, but not limited thereto, are to be considered within the scope of the invention.
SUMMARY OF THE INVENTION
The present invention provides a method for accessing at least a portion of an intervertebral disc for removal. The method comprises the steps of endoscopically accessing the invertebrae disc space through an anterior endoscopic port, inserting an endoscopic spreading instrument into the endoscopic port, spreading apart vertebrae adjacent to an intervertebral disc using the endoscopic spreading instrument, accessing an intervertebral disc nucleus, and removing at least a portion of the disc nucleus through the anterior endoscopic port.
The surgical method incorporating an anterior approach to access the intervertebral disc in combination with spreading of adjacent vertebrae permits the surgeon to have optimal viewing of the operation site as well as improves access to the site. Thus, the surgeon can accurately remove any desired amount of disc material to achieve the desired decompression of adjacent nerves and muscles.
The present invention also provides an endoscopic apparatus for spreading the vertebrae which includes a handle portion including an actuation member for manipulating an actuation mechanism, and an elongated endoscopic section defining a longitudinal axis and extending distally from the handle portion.
The actuation mechanism at least partially extends within said elongated endoscopic section and movable in response to movement of the actuation member. A vertebrae spreading mechanism is operatively associated with a distal end of the endoscopic section and is movable between open and closed positions by the actuation mechanism in response to movement of the actuation _2144211 member, the vertebrae spreading mechanism including at least two vertebrae spreading arm members having exterior vertebrae contacting surfaces. The vertebrae contacting surfaces may form an acute angle of elevation towards a proximal end of the instrument with respect to the longitudinal axis. The vertebrae spreading arms spread the vertebrae to assist endoscopic discectomy procedures as well as other minimally invasive spinal procedures such as spinal fusion.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of an endoscopic surgical instrument for spreading the vertebrae according to the present invention;
FIG. lA is an enlarged perspective view of the distal end of the instrument of FIG. 1 with the vertebrae spreading arms in an open position;
FIG. 2 is a cross-sectional view of the instrument taken along lines 2-2 of FIG. 1;
FIG. 3 is a cross-sectional view of the instrument taken along lines 3-3 of FIG. 2;
FIG. 4 is a cross-sectional view of the instrument taken along lines 4-4 of FIG. 3;
FIG. 5 is a cross-sectional view illustrating the vertebrae spreading portion of the instrument taken along lines 5-5 of FIG.
lA;
FIG. 6 is a perspective view with parts separated of the distal end of the instrument of FIG. 1.
FIG. 7 is a perspective view of an alternative embodiment adapted to spread vertebrae constructed according to the present invention;
_2144211 FIG. 8 is a side plan view of the distal end portion of the instrument of FIG. 7 illustrating the vertebrae spreading members in a generally closed position:
FIG. 9 is a view similar to the plan view of Fig. 8 depicting the vertebrae spreading members in an open position;
FIG. 10 is a plan view of the double rack and pinion mechanism used to open and close the vertebrae spreading members of FIG. 7;
FIG. 11 is a perspective view of another alternative embodiment of an instrument adapted to spread vertebrae;
FIG. 11A is an enlarged perspective view of the distal end of the instrument of FIG. 11 with the vertebrae spreading arms in an open position;
FIG. 12 is a cross-sectional view of the handle of the instrument of FIG. 11 taken along the lines 12-12 of FIG. 11; and FIG. 13 is a plan view of the linkage mechanism for causing movement of the vertebrae spreading members of the instrument of FIG. 11.
DETAINED DESCRIPTION OF THE PREFERRED EMBODIMENT
A. Instrumentation Turning now to the drawings in detail in which like reference numerals identify similar or identical elements throughout the several views, FIG. 1 depicts an endoscopic surgical instrument 100 which may be used as a tissue spreader and particularly as a vertebrae spreader during an endoscopic discectomy procedure. By spreading the vertebrae, access to the disc is improved. In describing the surgical instruments of the present invention, the term "proximal" refers to a direction of the instrument away from the patient and towards the user while the term "distal" refers to a direction of the instrument towards the patient and away from the user.
~~~4z1~
_7_ Surgical instrument 100 generally comprises proximal handle portion 110 having actuating member 132.~Endoscopic portion 140 extends distally from handle portion 110 and is configured to support vertebrae spreading mechanism 160 at its distal end.
Vertebrae spreading mechanism 160 includes a pair of serrated vertebrae spreading arms 162 shown in a closed position in FIG. 1 and in an open position in Fig. lA.
Referring now to FIGS. 2 and 3, in conjunction with the axial cross-sectional view of Fig. 4, the actuating mechanism 130 comprises a rotatable collar actuating member 132 and translatable inner cylindrical member 134. Translatable inner cylindrical member 134 is provided with angled caroming slot 135 for cooperating with cylindrical caroming pin 133. Caroming pin 133, mounted to rotatable actuating member 132, travels within caroming slot 135 during rotation of member 132 to axially translate cylindrical member 134 within handle portion 120 and proximal end portion of endoscopic portion 140. To ensure longitudinal reciprocal motion of the cylindrical member 134, guide pin 124 is mounted through handle portion 120 into cylindrical member longitudinal guide slots 126. Cam slot 135 includes angled portion 136 to lock the caroming pin 133 when the arms 162 are in the open position.
Referring now to FIGS. 2 and 3, in conjunction with FIG. 6, mounted within the distal end of the cylindrical member 134 is actuating rod 144. Actuating rod 144 passes coaxially through endoscopic portion 140 to move vertebrae spreading mechanism 160 between open and closed positions. A separate seal, such as O-ring 145 can be provided to prevent passage of gases from the body cavity. At its distal end, actuating rod 144 terminates in flattened portion 145 having flat surfaces 146 and 147. To link vertebrae spreading mechanism 160 to actuating rod 144, linkage mechanism 150 is provided, as shown in Fig. 6. A transverse _214421, _8_ bearing post 152 which interfits with vertebrae spreading arms 162 is attached to actuating rod 144 through aperture 148.
Linkage mechanism 150 is contained within linkage mechanism housing 154, a hollow member supported at the distal end of endoscopic portion 140 through an interference fit.
Each of vertebrae spreading members 162 has a proximally-extending planar arm portion 163 mounted within linkage mechanism housing 154. Planar arm portions 163 are each provided with an angled caroming slot 164 to permit movement of the vertebrae spreading members between open and closed positions. Vertebrae spreading members 162 include proximal transverse circular apertures 166 configured to receive transverse pivot pins 156 mounted through linkage mechanism housing 154. Bearing post 152 interfits within angled caroming slots 164 to translate the longitudinal reciprocal motion of actuating rod 144 into pivotal motion of vertebrae spreading members 164 about transverse pivot pins 156. FIG. 5 illustrates actuator rod 144 fully extended to thereby move vertebrae spreading members 162 to the fully opened position. Tissue gripping surface 167 formed on an outer surface of arms 162 preferably includes a plurality of teeth to prevent slippage of gripping surface 167 on tissue when spreading members 162 are open.
As best seen in FIG. 3, the tissue gripping surface 167 of each of the vertebrae spreading arms 162 forms an acute angle of elevation, T, with the longitudinal axis defined by endoscopic portion 140, towards the proximal end of instrument 100. This configuration aids in spreading the vertebrae since the distalmost portion of the vertebrae spreading arms are narrower than the proximalmost portion, enabling insertion of the instrument within confined spaces, such as, between adjacent vertebrae. Each of the vertebrae spreading arms are composed of rigid material such as stainless steel or rigid polymer.
,214~21~
Referring now to FIG. 7 there is illustrated an alternative embodiment of an instrument useful as a vertebrae spreader constructed according to the invention. Instrument 200 includes handle portion 210 having actuating knob 212 and elongated member 214 extending distally form the handle portion 210. Supported at the distal end of elongated member 214 is vertebrae spreading housing member 218 which houses vertebrae spreading members 220.
Handle portion 210 and connected elongated member 214 may be similar to a conventional allen wrench, appropriately re-configured and dimensioned to be received within a trocar or cannula. The distal end of elongated (endoscopic) member 214 (not shown) preferably defines a generally hexagonal shape in cross section which is received within a correspondingly dimensioned hexagonal-shaped recess formed in inlet portion 222 of housing member 218 to releasably connect the elongated member to the housing member. Inlet portion 222 rotates in response to rotational movement of handle portion 210 and elongated member 214, the significance of which will become appreciated from the description provided below. This releasable connection of elongated member 214 to inlet portion 222 allows the vertebrae spreading arms to be positioned and left in the body during the remainder of the operation, while the elongated member 214 is removed to free the port (trocar site) for insertion of other instrumentation. At any time during the procedure, elongated member 214 can be reinserted into the body and re-connected to inlet portion 222 and vertebrae spreading arms 220 to move the arms to the closed position (Fig. 8) for withdrawal from the body.
Referring now more specifically to FIGS. 8-10, in conjunction with FIG. 7, housing member 218 houses vertebrae spreading members 220 which are adapted for reciprocal sliding movement within channel 224 formed in the housing. Vertebrae spreading members 220 move to and from the center of housing member 218 through actuation of a double rack and pinion system 226 as depicted in FIG. 10. Double rack and pinion system 226 includes racks 228 and pinion 230. Racks 228 intermesh with pinion 230 and move to and from the center of housing member 218 in response to rotational movement of pinion 230. Pinion 230 is operatively connected to inlet portion 222 of housing member 218 through pin 232, and rotates with the inlet portion.
Each vertebrae spreading member 220 is operatively connected to a single rack 228 by connecting pins 234 (see Fig. 10) and, accordingly, moves either inwardly or outwardly relative to the center of housing member 218 in response to corresponding movement of the rack. Thus, rotation of handle portion 210 and elongated member 214 in the clockwise direction causes corresponding clockwise motion of pinion 230 which, accordingly, positions vertebrae spreading members adjacent each other as illustrated in FIG. 8. Consequently, counter clockwise rotation of pinion 230 (FIG. 10) positions spreading members 220 in the outward open condition depicted in FIG. 9. It should be noted that the movement of arms 220 is transverse to the longitudinal axis of the instrument and arm 220 remain substantially parallel (e. g. in parallel planes) to the longitudinal axis during movement between the open and closed positions.
Referring now to FIGS. 11-13, there is illustrated another embodiment of a surgical instrument useful as a vertebrae spreader, constructed according to the present invention.
Vertebrae spreader 300 includes a handle portion 310 having an actuating member 312 at a proximal end and an elongated, substantially cylindrical endoscopic portion 340 extending distally from the handle portion. A vertebrae spreading mechanism 330 is supported at the distal end of endoscopic portion 340. Spreading mechanism 330 includes a pair of _144211 vertebrae spreading members 332, shown in a deployed position in FIG. 11A, useful for spreading vertebrae during an endoscopic discectomy procedure.
As shown in FIG. 12, handle portion 310 includes rotatable actuating knob member 312 provided with a threaded axial interior bore 314. Threaded bore 314 engages a threaded driving member 316 having an elongated threaded body portion 318. Lateral longitudinal slots 320 in driving member 316 cooperate with through pin 322 to permit axial translation of threaded driving member 316 during rotational movement of knob member 312 while prohibiting rotational movement of the driving member.
A rod member 324 is connected to the distal end portion 316a of driving member 316 by conventional means. Rod member 324 moves -axially in direct response to corresponding axial movement of driving member 316.
Referring now to FIG. 13, the distal end of rod member 324 is connected via pin 326 to a pair of link members 328. Link members 328 are connected to respective vertebrae spreading members 332 via connecting pins 334. A transverse pin 336 is positioned within an aperture 338 formed in each vertebrae spreading member. Pin 336 traverses the longitudinal bore of endoscopic portion 340 and is securely mounted to the endoscopic portion 340 by conventional means (FIG. 11).
In use of instrument 300, rotation of actuating member 312 produces axial translation of driving member 316 and rod member 324. During distal movement of rod member 324 (as shown by the arrow A in FIG. 13), link members 328 move outwardly, in the direction shown by the directional arrows, which outward movement causes vertebrae spreading members 332 to pivot about pin 336 to an open position. Proximal movement of rod member 324 causes inward movement of link members 328 and corresponding inward _2144211 pivoting movement of vertebrae spreading members 332 to a closed condition.
As noted above, FIGS. 1-13 illustrate vertebrae spreaders useful for spreading apart adjacent vertebrae during endoscopic discectomy procedures. However, these instruments can also be utilized in other surgical procedures and for spreading other types of tissue besides bone.
The instruments described above are preferably composed of relatively inexpensive materials so that they are single-use disposable instruments which can be discarded after use.
However, it is also contemplated that they can be re-usable or semi-reusable in that a portion of the instrument is re-sterilized, e.g.~.the handle, and the remaining portion is disposable, e.g. the jaw structure.
B. Surgical Method Use of the surgical instruments of Figs. 1-13 will be described in conjunction with an anterior endoscopic lumbar discectomy according to the present invention. While they have particular application in this procedure, it is recognized that the instruments of the present invention may be used to perform surgical spreading procedures anywhere in the body. In describing the procedure, the term "anterior" is broadly used to describe the ventral surface of a body opposite the back. This term includes, but is not limited to, the abdominal region of the body.
For performing an anterior endoscopic lumbar discectomy, the patient is placed in the supine position and entry is made through the abdomen, which is insufflated according to known procedures. Specific points of entry are determined by the particular intervertebral disc to be removed. For removal of intervertebral discs of the lumbar vertebrae, ports are ~2144211 established in the lower abdomen using standard trocars. One port is dedicated to viewing via an endoscope, while remaining ports are used for surgical instrument insertion and manipulation.
To access the intervertebral disc, soft tissue is dissected, providing a pathway through the abdominal region. Fascia and other soft tissue may be spread using a surgical retractor or tissue spreader. Organs such as the colon are retracted away from the operating site to increase exposure and facilitate observation of the spinal column.
l0 Upon reaching the spinal column, blunt dissection is performed to expose the intervertebral disc. Fascia is removed from the disc area and spread using a retractor or instrument for spreading tissue.
To further facilitate access to the intervertebral disc, the adjacent vertebrae are spread using any one of the instruments of the present invention. The distal end of the selected instrument is placed between the vertebral bodies. Deployment of the vertebrae spreader causes the arms to expand against each adjacent vertebral body, relieving pressure of the vertebrae on the disc and improving access to ease disc removal.
The herniated disc nucleus is accessed through the disc annulus. The disc annulus may be incised using a conventional endoscopic cutting instrument. Such instruments include for example endoscopic scissors. A portion of the disc annulus may be removed to form an access channel, or, an incision may be created and the incision edges spread open through the tissue spreading element. Alternatively, the disc annulus may be incised using a laser or an access port created using a trephine.
The cutting instrument is inserted into the disc nucleus.
Following insertion into the disc nucleus, the cutting instrument slices away portions of the disc nucleus which may be removed using forceps, rongeurs, or suction instruments. Other _ 2144211 instruments may be selected for disc removal including lasers, rongeurs, and the like. Using the anterior approach, as much or as little of the herniated nucleus may be removed as needed to alleviate compression of adjacent muscles and nerves. This surgical procedure permits the surgeon to directly monitor the disc removal process by means of an endoscope.
Although the use of the instrumentation of the present invention has been described in conjunction with endoscopic discectomy procedures, the instruments can be used for facilitating other endoscopic (minimally invasive) surgical procedures. These include, for example, spreading the vertebrae to aid spinal fusion. Spinal fusion is used to stabilize spinal segments and is currently performed using fusion baskets, bone plugs or other internal fixation devices.
While the invention has been particularly shown and described with reference to the preferred embodiments, it will be understood by those skilled in the art that various modifications and changes in form and detail may be made without departing from the scope and spirit of the invention. Accordingly, modifications such as those suggested above, but not limited thereto, are to be considered within the scope of the invention.
Claims (19)
1. An endoscopic surgical instrument for spreading vertebrae, which comprises:
a handle portion including an actuation member for manipulating an actuation mechanism;
an elongated endoscopic section defining a longitudinal axis and extending distally from said handle portion;
said actuation mechanism at least partially extending within said elongated endoscopic section and movable in response to movement of said actuation member; and a vertebrae spreading mechanism operatively associated with a distal end of said endoscopic section and movable between open and closed positions by said actuation mechanism in response to movement of said actuation member, said vertebrae spreading mechanism including at least two vertebrae spreading arm members having exterior tissue contacting surfaces, each tissue contacting surface longitudinally extending along a major portion of the length of a respective arm member, said tissue contacting surfaces obliquely oriented relative to said longitudinal axis when in said closed position of said vertebrae spreading mechanism to define a reduced profile of said vertebrae spreading mechanism to facilitate insertion within adjacent vertebrae.
a handle portion including an actuation member for manipulating an actuation mechanism;
an elongated endoscopic section defining a longitudinal axis and extending distally from said handle portion;
said actuation mechanism at least partially extending within said elongated endoscopic section and movable in response to movement of said actuation member; and a vertebrae spreading mechanism operatively associated with a distal end of said endoscopic section and movable between open and closed positions by said actuation mechanism in response to movement of said actuation member, said vertebrae spreading mechanism including at least two vertebrae spreading arm members having exterior tissue contacting surfaces, each tissue contacting surface longitudinally extending along a major portion of the length of a respective arm member, said tissue contacting surfaces obliquely oriented relative to said longitudinal axis when in said closed position of said vertebrae spreading mechanism to define a reduced profile of said vertebrae spreading mechanism to facilitate insertion within adjacent vertebrae.
2. An endoscopic surgical instrument according to claim 1, wherein said at least two vertebrae spreading arm members are pivotal between said open and closed positions.
3. An endoscopic surgical instrument according to claim 2, wherein said at least two vertebrae spreading arm members include camming slots operatively associated with said actuation mechanism for movement of said arm members between said open and closed positions.
4. An endoscopic surgical instrument according to claim 3, wherein said actuation mechanism includes an actuation rod adapted for coaxial reciprocable movement within said endoscopic section, said actuation rod including means interfitting with said camming slots of said arm members, said interfitting means moving said arm members between said open and closed positions.
5. An endoscopic surgical instrument according to any one of claims 1 to 4, wherein said tissue contacting surfaces are obliquely oriented relative to said longitudinal axis when in said open position of said vertebrae spreading mechanism.
6. An endoscopic surgical instrument according to any one of claims 1 to 4, wherein said tissue contacting surfaces of said first and second arm members are respectively oriented at positive and negative oblique angles with respect to said longitudinal axis when in said closed position.
7. An endoscopic surgical instrument for spreading tissue such as vertebrae which comprises:
a handle portion an elongated portion extending distally from said handle portion and defining a longitudinal axis;
a tissue spreading mechanism supported at a distal end of said elongated portion, said tissue spreading mechanism including at least two spreading members, said tissue spreading mechanism movable between a first closed position wherein said first and second tissue spreading members are generally adjacent each other and a second at least partially open position wherein said tissue spreading members are displaced from each other;
each of said spreading members having an inner surface adjacent the opposing spreading member and an outer surface, said outer surface including a longitudinally extending tissue gripping surface, each said spreading member defining a cross-sectional dimension which gradually increases from distal to proximal over a major portion of its length such that said tissue gripping surfaces are obliquely oriented relative to said longitudinal axis when in said first position; and an actuating mechanism for moving said at least two spreading members between said first position and said second position.
a handle portion an elongated portion extending distally from said handle portion and defining a longitudinal axis;
a tissue spreading mechanism supported at a distal end of said elongated portion, said tissue spreading mechanism including at least two spreading members, said tissue spreading mechanism movable between a first closed position wherein said first and second tissue spreading members are generally adjacent each other and a second at least partially open position wherein said tissue spreading members are displaced from each other;
each of said spreading members having an inner surface adjacent the opposing spreading member and an outer surface, said outer surface including a longitudinally extending tissue gripping surface, each said spreading member defining a cross-sectional dimension which gradually increases from distal to proximal over a major portion of its length such that said tissue gripping surfaces are obliquely oriented relative to said longitudinal axis when in said first position; and an actuating mechanism for moving said at least two spreading members between said first position and said second position.
8. An endoscopic surgical instrument according to claim 7, wherein said actuating mechanism comprises:
a rod member adapted to reciprocally slide within said elongated portions and a linkage mechanism supported at a distal end of said rod member and operatively connecting said rod member with said tissue spreading mechanism such that distal axial movement of said rod member causes said at least two spreading members to move to said second open position and proximal movement of said rod member causes said at least two spreading members to move to said first closed position.
a rod member adapted to reciprocally slide within said elongated portions and a linkage mechanism supported at a distal end of said rod member and operatively connecting said rod member with said tissue spreading mechanism such that distal axial movement of said rod member causes said at least two spreading members to move to said second open position and proximal movement of said rod member causes said at least two spreading members to move to said first closed position.
9. An endoscopic surgical instrument according to claim 7 or 8, wherein each of said spreading members is composed of a material of sufficient rigidity to spread the vertebrae when moved to said open position.
10. An endoscopic surgical instrument according to any one of claims 7 to 9, wherein each said spreading member defines a cross-sectional dimension at a distal end thereof which is less than a cross-sectional dimension defined at a proximal end thereof.
11. An endoscopic surgical instrument according to any one of claims 7 to 10, wherein said actuation member is adapted to pivot said spreading members with respect to said longitudinal axis.
12. An endoscopic surgical instrument according to claim 7, wherein said actuation member comprises a rotatable knob.
13. An endoscopic surgical instrument according to any one of claims 7 to 12, wherein said tissue gripping surfaces of each said spreading members include irregularities to facilitate engagement with tissue.
14. An endoscopic surgical instrument for spreading vertebrae, which comprises:
a handle portion including a frame dimensioned to be grasped by the hand of a user and an actuating member movable mounted to the frame;
an elongated portion connected to the frame and having proximal and distal ends;
a tissue spreading assembly mounted to the distal end of the elongated portion and defining a longitudinal axis, the tissue spreading assembly including first and second tissue spreading members mounted for movement between a closed position and an at least partially open position, the first and second tissue spreading members each having an outer engaging surface extending along a major portion of the length thereof, the outer engaging surfaces of the first and second tissue spreading members being angularly oriented at respective positive and negative acute angles relative to said longitudinal axis when in said closed position thereof to thereby define a reduced profile of the tissue spreading assembly to facilitate insertion between adjacent vertebrae:
and an actuator mounted to the handle portion and operatively connected to the tissue spreading assembly, the actuator movable to cause movement of the first and second tissue spreading members between the closed and open positions.
a handle portion including a frame dimensioned to be grasped by the hand of a user and an actuating member movable mounted to the frame;
an elongated portion connected to the frame and having proximal and distal ends;
a tissue spreading assembly mounted to the distal end of the elongated portion and defining a longitudinal axis, the tissue spreading assembly including first and second tissue spreading members mounted for movement between a closed position and an at least partially open position, the first and second tissue spreading members each having an outer engaging surface extending along a major portion of the length thereof, the outer engaging surfaces of the first and second tissue spreading members being angularly oriented at respective positive and negative acute angles relative to said longitudinal axis when in said closed position thereof to thereby define a reduced profile of the tissue spreading assembly to facilitate insertion between adjacent vertebrae:
and an actuator mounted to the handle portion and operatively connected to the tissue spreading assembly, the actuator movable to cause movement of the first and second tissue spreading members between the closed and open positions.
15. The endoscopic surgical instrument according to claim 14, wherein the outer engaging surfaces include irregularities to facilitate engagement with the adjacent vertebrae.
16. The endoscopic surgical instrument according to claim 14 or 15, wherein the outer engaging surfaces of the first and second tissue spreading members are in general parallel relation when in the at least partially open position.
17. An endoscopic surgical instrument for spreading vertebrae, which comprises:
a handle portion including a frame dimensioned to be grasped by the hand of a user and an actuating member movably mounted to the frame;
an elongated portion connected to the frame and having proximal and distal ends a tissue spreading assembly mounted to the distal end of the elongated portion and defining a longitudinal axis, the tissue spreading assembly including first and second tissue spreading members mounted for movement between a closed position and an at least partially open position, the first and second tissue spreading members each having an inner surface adjacent the other spreading member and an outer engaging surface, the outer engaging surfaces of the first and second tissue spreading member each lying in a plane angularly oriented relative to said longitudinal axis when in said closed position thereof, the outer engaging surfaces including irregularities to facilitate engagement with vertebrae.
a handle portion including a frame dimensioned to be grasped by the hand of a user and an actuating member movably mounted to the frame;
an elongated portion connected to the frame and having proximal and distal ends a tissue spreading assembly mounted to the distal end of the elongated portion and defining a longitudinal axis, the tissue spreading assembly including first and second tissue spreading members mounted for movement between a closed position and an at least partially open position, the first and second tissue spreading members each having an inner surface adjacent the other spreading member and an outer engaging surface, the outer engaging surfaces of the first and second tissue spreading member each lying in a plane angularly oriented relative to said longitudinal axis when in said closed position thereof, the outer engaging surfaces including irregularities to facilitate engagement with vertebrae.
18. An endoscopic instrument according to claim 17, wherein the outer engaging surfaces of each of the first and second tissue spreading members extend along a major portion of the length of the respective tissue spreading members.
19. The endoscopic instrument according to claim 17 or 18, wherein the tissue spreading assembly includes a rack and pinion system, the rack and pinion system operatively connected to the first and second tissue spreading members and being configured and dimensioned to move the first and second tissue spreading,members between the closed and open positions, the rack and pinion system being operably connected to the actuating member of the handle portion and movable in response to movement of the actuating member.
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11026627B2 (en) | 2013-03-15 | 2021-06-08 | Cadwell Laboratories, Inc. | Surgical instruments for determining a location of a nerve during a procedure |
US11177610B2 (en) | 2017-01-23 | 2021-11-16 | Cadwell Laboratories, ino. | Neuromonitoring connection system |
US11253182B2 (en) | 2018-05-04 | 2022-02-22 | Cadwell Laboratories, Inc. | Apparatus and method for polyphasic multi-output constant-current and constant-voltage neurophysiological stimulation |
US11443649B2 (en) | 2018-06-29 | 2022-09-13 | Cadwell Laboratories, Inc. | Neurophysiological monitoring training simulator |
Families Citing this family (694)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6245072B1 (en) * | 1995-03-27 | 2001-06-12 | Sdgi Holdings, Inc. | Methods and instruments for interbody fusion |
US6206922B1 (en) | 1995-03-27 | 2001-03-27 | Sdgi Holdings, Inc. | Methods and instruments for interbody fusion |
DE69723832T2 (en) * | 1996-02-22 | 2004-04-08 | SDGI Holding, Inc., Wilmington | DEVICE FOR INTERVERTEBRAL FUSION |
EP0873145A2 (en) | 1996-11-15 | 1998-10-28 | Advanced Bio Surfaces, Inc. | Biomaterial system for in situ tissue repair |
US20080027552A1 (en) * | 1997-01-02 | 2008-01-31 | Zucherman James F | Spine distraction implant and method |
US20080215058A1 (en) * | 1997-01-02 | 2008-09-04 | Zucherman James F | Spine distraction implant and method |
DE19750382A1 (en) | 1997-11-13 | 1999-05-20 | Augustin Prof Dr Med Betz | Operative correction equipment for displaced vertebrae used in minimally invasive surgery |
AU2451099A (en) * | 1998-01-05 | 1999-07-26 | Tegementa, L.L.C. | Distraction device for vertebral disc procedures |
US6241729B1 (en) * | 1998-04-09 | 2001-06-05 | Sdgi Holdings, Inc. | Method and instrumentation for posterior interbody fusion |
US6126660A (en) * | 1998-07-29 | 2000-10-03 | Sofamor Danek Holdings, Inc. | Spinal compression and distraction devices and surgical methods |
US6187000B1 (en) * | 1998-08-20 | 2001-02-13 | Endius Incorporated | Cannula for receiving surgical instruments |
JP4215400B2 (en) | 1998-10-02 | 2009-01-28 | ジンテーズ ゲゼルシャフト ミト ベシュレンクテル ハフツング | Spinal disc space distractor |
WO2000038574A1 (en) | 1998-12-23 | 2000-07-06 | Nuvasive, Inc. | Nerve surveillance cannulae systems |
CA2591678C (en) * | 1999-03-07 | 2008-05-20 | Active Implants Corporation | Method and apparatus for computerized surgery |
US6159212A (en) * | 1999-08-02 | 2000-12-12 | Schoedinger, Iii; George R. | Surgical tool and method to reduce vertebral displacement |
US6936001B1 (en) * | 1999-10-01 | 2005-08-30 | Computer Motion, Inc. | Heart stabilizer |
US8632590B2 (en) * | 1999-10-20 | 2014-01-21 | Anulex Technologies, Inc. | Apparatus and methods for the treatment of the intervertebral disc |
US20030153976A1 (en) * | 1999-10-20 | 2003-08-14 | Cauthen Joseph C. | Spinal disc annulus reconstruction method and spinal disc annulus stent |
US8128698B2 (en) | 1999-10-20 | 2012-03-06 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7951201B2 (en) * | 1999-10-20 | 2011-05-31 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US7935147B2 (en) | 1999-10-20 | 2011-05-03 | Anulex Technologies, Inc. | Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus |
US7052516B2 (en) * | 1999-10-20 | 2006-05-30 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and deformable spinal disc annulus stent |
US7615076B2 (en) | 1999-10-20 | 2009-11-10 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US6592625B2 (en) | 1999-10-20 | 2003-07-15 | Anulex Technologies, Inc. | Spinal disc annulus reconstruction method and spinal disc annulus stent |
US7004970B2 (en) | 1999-10-20 | 2006-02-28 | Anulex Technologies, Inc. | Methods and devices for spinal disc annulus reconstruction and repair |
US6830570B1 (en) * | 1999-10-21 | 2004-12-14 | Sdgi Holdings, Inc. | Devices and techniques for a posterior lateral disc space approach |
WO2001028469A2 (en) | 1999-10-21 | 2001-04-26 | Sdgi Holdings, Inc. | Devices and techniques for a posterior lateral disc space approach |
US6764491B2 (en) | 1999-10-21 | 2004-07-20 | Sdgi Holdings, Inc. | Devices and techniques for a posterior lateral disc space approach |
JP4854900B2 (en) * | 1999-11-24 | 2012-01-18 | ヌバシブ, インコーポレイテッド | EMG measurement method |
DE10007919C2 (en) * | 2000-02-21 | 2003-07-17 | Wolf Gmbh Richard | Forceps for free preparation of tissue in a body cavity |
US6402750B1 (en) * | 2000-04-04 | 2002-06-11 | Spinlabs, Llc | Devices and methods for the treatment of spinal disorders |
US6805695B2 (en) * | 2000-04-04 | 2004-10-19 | Spinalabs, Llc | Devices and methods for annular repair of intervertebral discs |
AU2001263239A1 (en) * | 2000-05-18 | 2001-11-26 | Nuvasive, Inc. | Tissue discrimination and applications in medical procedures |
US6673113B2 (en) * | 2001-10-18 | 2004-01-06 | Spinecore, Inc. | Intervertebral spacer device having arch shaped spring elements |
US7169182B2 (en) * | 2001-07-16 | 2007-01-30 | Spinecore, Inc. | Implanting an artificial intervertebral disc |
US6817974B2 (en) | 2001-06-29 | 2004-11-16 | Intuitive Surgical, Inc. | Surgical tool having positively positionable tendon-actuated multi-disk wrist joint |
JP4246059B2 (en) * | 2001-06-29 | 2009-04-02 | ウォーソー・オーソペディック・インコーポレーテッド | Positioning device and alignment device for fluoroscopy |
US7063705B2 (en) * | 2001-06-29 | 2006-06-20 | Sdgi Holdings, Inc. | Fluoroscopic locator and registration device |
US20060178556A1 (en) | 2001-06-29 | 2006-08-10 | Intuitive Surgical, Inc. | Articulate and swapable endoscope for a surgical robot |
EP1417000B1 (en) * | 2001-07-11 | 2018-07-11 | Nuvasive, Inc. | System for determining nerve proximity during surgery |
WO2003026482A2 (en) * | 2001-09-25 | 2003-04-03 | Nuvasive, Inc. | System and methods for performing surgical procedures and assessments |
US7771477B2 (en) | 2001-10-01 | 2010-08-10 | Spinecore, Inc. | Intervertebral spacer device utilizing a belleville washer having radially spaced concentric grooves |
US7713302B2 (en) * | 2001-10-01 | 2010-05-11 | Spinecore, Inc. | Intervertebral spacer device utilizing a spirally slotted belleville washer having radially spaced concentric grooves |
US7664544B2 (en) | 2002-10-30 | 2010-02-16 | Nuvasive, Inc. | System and methods for performing percutaneous pedicle integrity assessments |
AU2002336694A1 (en) * | 2001-11-01 | 2003-05-12 | Lawrence M. Boyd | Devices and methods for the restoration of a spinal disc |
US7799833B2 (en) | 2001-11-01 | 2010-09-21 | Spine Wave, Inc. | System and method for the pretreatment of the endplates of an intervertebral disc |
US6669699B2 (en) * | 2001-11-30 | 2003-12-30 | Spinecore, Inc. | Distraction instrument for use in anterior cervical fixation surgery |
US8038713B2 (en) | 2002-04-23 | 2011-10-18 | Spinecore, Inc. | Two-component artificial disc replacements |
US20080027548A9 (en) * | 2002-04-12 | 2008-01-31 | Ferree Bret A | Spacerless artificial disc replacements |
US6706068B2 (en) | 2002-04-23 | 2004-03-16 | Bret A. Ferree | Artificial disc replacements with natural kinematics |
AU2003234508A1 (en) | 2002-05-06 | 2003-11-17 | Warsaw Orthopedic, Inc. | Instrumentation and methods for preparation of an intervertebral space |
US8147421B2 (en) * | 2003-01-15 | 2012-04-03 | Nuvasive, Inc. | System and methods for determining nerve direction to a surgical instrument |
US7004947B2 (en) * | 2002-06-24 | 2006-02-28 | Endius Incorporated | Surgical instrument for moving vertebrae |
US8317798B2 (en) * | 2002-06-25 | 2012-11-27 | Warsaw Orthopedic | Minimally invasive expanding spacer and method |
US7070598B2 (en) | 2002-06-25 | 2006-07-04 | Sdgi Holdings, Inc. | Minimally invasive expanding spacer and method |
US7087055B2 (en) * | 2002-06-25 | 2006-08-08 | Sdgi Holdings, Inc. | Minimally invasive expanding spacer and method |
US7582058B1 (en) | 2002-06-26 | 2009-09-01 | Nuvasive, Inc. | Surgical access system and related methods |
US20040087947A1 (en) * | 2002-08-28 | 2004-05-06 | Roy Lim | Minimally invasive expanding spacer and method |
JP2006501947A (en) * | 2002-10-08 | 2006-01-19 | エスディージーアイ・ホールディングス・インコーポレーテッド | Orthopedic graft insertion devices and techniques |
US8137284B2 (en) * | 2002-10-08 | 2012-03-20 | Nuvasive, Inc. | Surgical access system and related methods |
US6966929B2 (en) * | 2002-10-29 | 2005-11-22 | St. Francis Medical Technologies, Inc. | Artificial vertebral disk replacement implant with a spacer |
US7909853B2 (en) * | 2004-09-23 | 2011-03-22 | Kyphon Sarl | Interspinous process implant including a binder and method of implantation |
US7497859B2 (en) * | 2002-10-29 | 2009-03-03 | Kyphon Sarl | Tools for implanting an artificial vertebral disk |
US7273496B2 (en) * | 2002-10-29 | 2007-09-25 | St. Francis Medical Technologies, Inc. | Artificial vertebral disk replacement implant with crossbar spacer and method |
US7931674B2 (en) * | 2005-03-21 | 2011-04-26 | Kyphon Sarl | Interspinous process implant having deployable wing and method of implantation |
EP1575439B1 (en) | 2002-12-06 | 2012-04-04 | Intuitive Surgical, Inc. | Flexible wrist for surgical tool |
US7691057B2 (en) | 2003-01-16 | 2010-04-06 | Nuvasive, Inc. | Surgical access system and related methods |
US7819801B2 (en) * | 2003-02-27 | 2010-10-26 | Nuvasive, Inc. | Surgical access system and related methods |
EP1635744A4 (en) * | 2003-03-06 | 2013-03-13 | Spinecore Inc | Instrumentation and methods for use in implanting a cervical disc replacement device |
US6908484B2 (en) * | 2003-03-06 | 2005-06-21 | Spinecore, Inc. | Cervical disc replacement |
US7674265B2 (en) * | 2003-04-24 | 2010-03-09 | Warsaw Orthopedic, Inc. | Minimally invasive instruments and methods for preparing vertebral endplates |
US20040225228A1 (en) * | 2003-05-08 | 2004-11-11 | Ferree Bret A. | Neurophysiological apparatus and procedures |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
TW587932B (en) * | 2003-05-21 | 2004-05-21 | Guan-Gu Lin | Removable animal tissue filling device |
WO2005013805A2 (en) * | 2003-08-05 | 2005-02-17 | Nuvasive, Inc. | Systemand methods for performing dynamic pedicle integrity assessments |
US7235082B2 (en) * | 2003-08-12 | 2007-06-26 | Depuy Spine, Inc. | Device for insertion of implants |
US7320693B2 (en) * | 2003-08-21 | 2008-01-22 | Pollak Stanley B | Methods and instruments for closing laparoscopic trocar puncture wounds |
US9326806B2 (en) | 2003-09-02 | 2016-05-03 | Crosstrees Medical, Inc. | Devices and methods for the treatment of bone fracture |
US7905840B2 (en) | 2003-10-17 | 2011-03-15 | Nuvasive, Inc. | Surgical access system and related methods |
WO2005030318A1 (en) | 2003-09-25 | 2005-04-07 | Nuvasive, Inc. | Surgical access system and related methods |
US7632294B2 (en) | 2003-09-29 | 2009-12-15 | Promethean Surgical Devices, Llc | Devices and methods for spine repair |
US8313430B1 (en) | 2006-01-11 | 2012-11-20 | Nuvasive, Inc. | Surgical access system and related methods |
US7320707B2 (en) * | 2003-11-05 | 2008-01-22 | St. Francis Medical Technologies, Inc. | Method of laterally inserting an artificial vertebral disk replacement implant with crossbar spacer |
US7670377B2 (en) | 2003-11-21 | 2010-03-02 | Kyphon Sarl | Laterally insertable artifical vertebral disk replacement implant with curved spacer |
US20050283237A1 (en) * | 2003-11-24 | 2005-12-22 | St. Francis Medical Technologies, Inc. | Artificial spinal disk replacement device with staggered vertebral body attachments |
US7503935B2 (en) * | 2003-12-02 | 2009-03-17 | Kyphon Sarl | Method of laterally inserting an artificial vertebral disk replacement with translating pivot point |
US7481839B2 (en) * | 2003-12-02 | 2009-01-27 | Kyphon Sarl | Bioresorbable interspinous process implant for use with intervertebral disk remediation or replacement implants and procedures |
US20050143826A1 (en) * | 2003-12-11 | 2005-06-30 | St. Francis Medical Technologies, Inc. | Disk repair structures with anchors |
EP1729672A2 (en) | 2004-01-08 | 2006-12-13 | Spine Wave, Inc. | Apparatus and method for injecting fluent material at a distracted tissue site |
US7625379B2 (en) * | 2004-01-26 | 2009-12-01 | Warsaw Orthopedic, Inc. | Methods and instrumentation for inserting intervertebral grafts and devices |
AU2005260592B2 (en) * | 2004-06-29 | 2011-08-18 | Spine Wave, Inc. | Methods for treating defects and injuries of an intervertebral disc |
US7608080B2 (en) * | 2004-07-02 | 2009-10-27 | Warsaw Orthopedic, Inc. | Device for inserting implants |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
US7776045B2 (en) * | 2004-08-20 | 2010-08-17 | Warsaw Orthopedic, Inc. | Instrumentation and methods for vertebral distraction |
US7575600B2 (en) * | 2004-09-29 | 2009-08-18 | Kyphon Sarl | Artificial vertebral disk replacement implant with translating articulation contact surface and method |
US20060069438A1 (en) * | 2004-09-29 | 2006-03-30 | Zucherman James F | Multi-piece artificial spinal disk replacement device with multi-segmented support plates |
US7481840B2 (en) * | 2004-09-29 | 2009-01-27 | Kyphon Sarl | Multi-piece artificial spinal disk replacement device with selectably positioning articulating element |
US8979857B2 (en) * | 2004-10-06 | 2015-03-17 | DePuy Synthes Products, LLC | Modular medical tool and connector |
WO2006042241A2 (en) | 2004-10-08 | 2006-04-20 | Nuvasive, Inc. | Surgical access system and related methods |
US7938830B2 (en) | 2004-10-15 | 2011-05-10 | Baxano, Inc. | Powered tissue modification devices and methods |
US8221397B2 (en) | 2004-10-15 | 2012-07-17 | Baxano, Inc. | Devices and methods for tissue modification |
US9247952B2 (en) | 2004-10-15 | 2016-02-02 | Amendia, Inc. | Devices and methods for tissue access |
US20110190772A1 (en) | 2004-10-15 | 2011-08-04 | Vahid Saadat | Powered tissue modification devices and methods |
US8048080B2 (en) | 2004-10-15 | 2011-11-01 | Baxano, Inc. | Flexible tissue rasp |
US7578819B2 (en) * | 2005-05-16 | 2009-08-25 | Baxano, Inc. | Spinal access and neural localization |
US7887538B2 (en) | 2005-10-15 | 2011-02-15 | Baxano, Inc. | Methods and apparatus for tissue modification |
US7738969B2 (en) | 2004-10-15 | 2010-06-15 | Baxano, Inc. | Devices and methods for selective surgical removal of tissue |
US20100331883A1 (en) | 2004-10-15 | 2010-12-30 | Schmitz Gregory P | Access and tissue modification systems and methods |
US7555343B2 (en) | 2004-10-15 | 2009-06-30 | Baxano, Inc. | Devices and methods for selective surgical removal of tissue |
WO2006044727A2 (en) | 2004-10-15 | 2006-04-27 | Baxano, Inc. | Devices and methods for tissue removal |
US8430881B2 (en) | 2004-10-15 | 2013-04-30 | Baxano, Inc. | Mechanical tissue modification devices and methods |
US8062300B2 (en) | 2006-05-04 | 2011-11-22 | Baxano, Inc. | Tissue removal with at least partially flexible devices |
US8257356B2 (en) | 2004-10-15 | 2012-09-04 | Baxano, Inc. | Guidewire exchange systems to treat spinal stenosis |
US9101386B2 (en) | 2004-10-15 | 2015-08-11 | Amendia, Inc. | Devices and methods for treating tissue |
US8613745B2 (en) | 2004-10-15 | 2013-12-24 | Baxano Surgical, Inc. | Methods, systems and devices for carpal tunnel release |
US20060106288A1 (en) | 2004-11-17 | 2006-05-18 | Roth Alex T | Remote tissue retraction device |
WO2006058221A2 (en) | 2004-11-24 | 2006-06-01 | Abdou Samy M | Devices and methods for inter-vertebral orthopedic device placement |
US7842045B2 (en) * | 2005-01-19 | 2010-11-30 | Applied Medical Resources Corporation | Single fire vascular clip applier with disposable jaw |
US7785253B1 (en) | 2005-01-31 | 2010-08-31 | Nuvasive, Inc. | Surgical access system and related methods |
US8568331B2 (en) * | 2005-02-02 | 2013-10-29 | Nuvasive, Inc. | System and methods for monitoring during anterior surgery |
US7998208B2 (en) * | 2005-02-17 | 2011-08-16 | Kyphon Sarl | Percutaneous spinal implants and methods |
US20070276373A1 (en) * | 2005-02-17 | 2007-11-29 | Malandain Hugues F | Percutaneous Spinal Implants and Methods |
US8096994B2 (en) * | 2005-02-17 | 2012-01-17 | Kyphon Sarl | Percutaneous spinal implants and methods |
US7927354B2 (en) * | 2005-02-17 | 2011-04-19 | Kyphon Sarl | Percutaneous spinal implants and methods |
US8029567B2 (en) * | 2005-02-17 | 2011-10-04 | Kyphon Sarl | Percutaneous spinal implants and methods |
US8092459B2 (en) * | 2005-02-17 | 2012-01-10 | Kyphon Sarl | Percutaneous spinal implants and methods |
US8034080B2 (en) * | 2005-02-17 | 2011-10-11 | Kyphon Sarl | Percutaneous spinal implants and methods |
US20060184248A1 (en) * | 2005-02-17 | 2006-08-17 | Edidin Avram A | Percutaneous spinal implants and methods |
US8096995B2 (en) * | 2005-02-17 | 2012-01-17 | Kyphon Sarl | Percutaneous spinal implants and methods |
US7993342B2 (en) | 2005-02-17 | 2011-08-09 | Kyphon Sarl | Percutaneous spinal implants and methods |
US8696707B2 (en) * | 2005-03-08 | 2014-04-15 | Zyga Technology, Inc. | Facet joint stabilization |
JP2006253316A (en) * | 2005-03-09 | 2006-09-21 | Sony Corp | Solid-state image sensing device |
US20060241641A1 (en) * | 2005-04-22 | 2006-10-26 | Sdgi Holdings, Inc. | Methods and instrumentation for distraction and insertion of implants in a spinal disc space |
US7615052B2 (en) * | 2005-04-29 | 2009-11-10 | Warsaw Orthopedic, Inc. | Surgical instrument and method |
US20060243464A1 (en) * | 2005-04-29 | 2006-11-02 | Sdgi Holdings, Inc. | Torque and angular rotation measurement device and method |
US20060253198A1 (en) * | 2005-05-03 | 2006-11-09 | Disc Dynamics, Inc. | Multi-lumen mold for intervertebral prosthesis and method of using same |
US20060253199A1 (en) * | 2005-05-03 | 2006-11-09 | Disc Dynamics, Inc. | Lordosis creating nucleus replacement method and apparatus |
US8740783B2 (en) * | 2005-07-20 | 2014-06-03 | Nuvasive, Inc. | System and methods for performing neurophysiologic assessments with pressure monitoring |
US8328851B2 (en) * | 2005-07-28 | 2012-12-11 | Nuvasive, Inc. | Total disc replacement system and related methods |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US20070194079A1 (en) | 2005-08-31 | 2007-08-23 | Hueil Joseph C | Surgical stapling device with staple drivers of different height |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled 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 |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US8206312B2 (en) * | 2005-09-22 | 2012-06-26 | Nuvasive, Inc. | Multi-channel stimulation threshold detection algorithm for use in neurophysiology monitoring |
US8568317B1 (en) | 2005-09-27 | 2013-10-29 | Nuvasive, Inc. | System and methods for nerve monitoring |
US8062298B2 (en) | 2005-10-15 | 2011-11-22 | Baxano, Inc. | Flexible tissue removal devices and methods |
US8092456B2 (en) | 2005-10-15 | 2012-01-10 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US8366712B2 (en) | 2005-10-15 | 2013-02-05 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US20080086034A1 (en) | 2006-08-29 | 2008-04-10 | Baxano, Inc. | Tissue Access Guidewire System and Method |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
FR2895233B1 (en) * | 2005-12-22 | 2008-10-10 | Sdgi Holdings Inc | REPLACEMENT IMPLANT OF A VERTEBRAL BODY, DEVICE FOR DISTRACTING THE SPRAY FOR ITS PLACEMENT, AND DEVICE FOR ITS ASSEMBLY |
US20070161962A1 (en) * | 2006-01-09 | 2007-07-12 | Edie Jason A | Device and method for moving fill material to an implant |
US7935148B2 (en) | 2006-01-09 | 2011-05-03 | Warsaw Orthopedic, Inc. | Adjustable insertion device for a vertebral implant |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
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 |
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 |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback 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 |
US7875034B2 (en) | 2006-03-14 | 2011-01-25 | Warsaw Orthopedic, Inc. | Spinal disc space preparation instruments and methods for interbody spinal implants |
US8066714B2 (en) * | 2006-03-17 | 2011-11-29 | Warsaw Orthopedic Inc. | Instrumentation for distraction and insertion of implants in a spinal disc space |
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 |
US7985246B2 (en) * | 2006-03-31 | 2011-07-26 | Warsaw Orthopedic, Inc. | Methods and instruments for delivering interspinous process spacers |
US8092536B2 (en) | 2006-05-24 | 2012-01-10 | Disc Dynamics, Inc. | Retention structure for in situ formation of an intervertebral prosthesis |
US20070276491A1 (en) * | 2006-05-24 | 2007-11-29 | Disc Dynamics, Inc. | Mold assembly for intervertebral prosthesis |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US20080082104A1 (en) * | 2006-07-27 | 2008-04-03 | Lanx, Llc | Methods and apparatuses for facilitating percutaneous fusion |
US8062303B2 (en) * | 2006-08-16 | 2011-11-22 | K2M, Inc. | Apparatus and methods for inserting an implant |
US8357168B2 (en) * | 2006-09-08 | 2013-01-22 | Spine Wave, Inc. | Modular injection needle and seal assembly |
US20080078802A1 (en) | 2006-09-29 | 2008-04-03 | Hess Christopher J | Surgical staples and stapling instruments |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US20080177298A1 (en) * | 2006-10-24 | 2008-07-24 | St. Francis Medical Technologies, Inc. | Tensioner Tool and Method for Implanting an Interspinous Process Implant Including a Binder |
US7896884B2 (en) * | 2006-12-01 | 2011-03-01 | Aesculap, Inc. | Interbody distractor |
US7955392B2 (en) | 2006-12-14 | 2011-06-07 | Warsaw Orthopedic, Inc. | Interspinous process devices and methods |
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 |
US20080169332A1 (en) | 2007-01-11 | 2008-07-17 | Shelton Frederick E | Surgical stapling device with a curved cutting member |
US20090001121A1 (en) | 2007-03-15 | 2009-01-01 | Hess Christopher J | Surgical staple having an expandable portion |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US20080243177A1 (en) * | 2007-03-30 | 2008-10-02 | T.A.G. Medical Products, A Limited Partnership | Surgical instrument usable as a grasper and/or probe |
US20080243178A1 (en) * | 2007-03-30 | 2008-10-02 | T.A.G. Medical Products A Limited Partnership | Surgical instrument particularly useful as tweezers for grasping and holding objects of different thicknesses |
US20080243174A1 (en) * | 2007-03-30 | 2008-10-02 | T.A.G. Medical Products A Limited Partnership | Finger mounting for surgical instruments particularly useful in open and endoscopic surgery |
AU2008236665B2 (en) * | 2007-04-03 | 2013-08-22 | Nuvasive, Inc. | Neurophysiologic monitoring system |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11672531B2 (en) | 2007-06-04 | 2023-06-13 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
US8408439B2 (en) | 2007-06-22 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
EP2194861A1 (en) | 2007-09-06 | 2010-06-16 | Baxano, Inc. | Method, system and apparatus for neural localization |
EP2209427A1 (en) * | 2007-09-14 | 2010-07-28 | Crosstrees Medical, Inc. | Method and apparatus for bone removal |
US8343189B2 (en) | 2007-09-25 | 2013-01-01 | Zyga Technology, Inc. | Method and apparatus for facet joint stabilization |
WO2009055541A1 (en) * | 2007-10-23 | 2009-04-30 | K2M, Inc. | Implant insertion tool |
US8591587B2 (en) | 2007-10-30 | 2013-11-26 | Aesculap Implant Systems, Llc | Vertebral body replacement device and method for use to maintain a space between two vertebral bodies within a spine |
US8142441B2 (en) * | 2008-10-16 | 2012-03-27 | Aesculap Implant Systems, Llc | Surgical instrument and method of use for inserting an implant between two bones |
US8192436B2 (en) | 2007-12-07 | 2012-06-05 | Baxano, Inc. | Tissue modification devices |
US20090198241A1 (en) * | 2008-02-04 | 2009-08-06 | Phan Christopher U | Spine distraction tools and methods of use |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US10390823B2 (en) | 2008-02-15 | 2019-08-27 | Ethicon Llc | End effector comprising an adjunct |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US8449554B2 (en) * | 2008-03-07 | 2013-05-28 | K2M, Inc. | Intervertebral implant and instrument with removable section |
US8221425B2 (en) * | 2008-04-30 | 2012-07-17 | Warsaw Orthopedic, Inc. | Percutaneous discectomy and endplate preparation tool |
US8398641B2 (en) | 2008-07-01 | 2013-03-19 | Baxano, Inc. | Tissue modification devices and methods |
US8409206B2 (en) | 2008-07-01 | 2013-04-02 | Baxano, Inc. | Tissue modification devices and methods |
WO2010009093A2 (en) | 2008-07-14 | 2010-01-21 | Baxano, Inc | Tissue modification devices |
US9314253B2 (en) | 2008-07-01 | 2016-04-19 | Amendia, Inc. | Tissue modification devices and methods |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US8114088B2 (en) | 2008-09-19 | 2012-02-14 | Zimmer Spine, Inc. | Geared spinal implant inserter-distractor |
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 |
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 |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8163022B2 (en) | 2008-10-14 | 2012-04-24 | Anulex Technologies, Inc. | Method and apparatus for the treatment of the intervertebral disc annulus |
US8876851B1 (en) | 2008-10-15 | 2014-11-04 | Nuvasive, Inc. | Systems and methods for performing spinal fusion surgery |
CN107260231A (en) | 2008-10-20 | 2017-10-20 | 脊柱诊察公司 | Retractor cannula system for entering and watching backbone |
US8382767B2 (en) * | 2008-10-31 | 2013-02-26 | K2M, Inc. | Implant insertion tool |
US8114131B2 (en) * | 2008-11-05 | 2012-02-14 | Kyphon Sarl | Extension limiting devices and methods of use for the spine |
AU2009329873A1 (en) | 2008-12-26 | 2011-11-03 | Scott Spann | Minimally-invasive retroperitoneal lateral approach for spinal surgery |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
US8453907B2 (en) | 2009-02-06 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with cutting member reversing mechanism |
BRPI1008667A2 (en) | 2009-02-06 | 2016-03-08 | Ethicom Endo Surgery Inc | improvement of the operated surgical stapler |
US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
CA2749673A1 (en) | 2009-03-13 | 2010-09-16 | Baxano, Inc. | Flexible neural localization devices and methods |
EP2416710A2 (en) * | 2009-04-03 | 2012-02-15 | Mitchell A. Hardenbrook | Surgical retractor system |
US9351845B1 (en) | 2009-04-16 | 2016-05-31 | Nuvasive, Inc. | Method and apparatus for performing spine surgery |
US8287597B1 (en) | 2009-04-16 | 2012-10-16 | Nuvasive, Inc. | Method and apparatus for performing spine surgery |
KR101070049B1 (en) * | 2009-05-06 | 2011-10-04 | 국립암센터 | Surgical instrument |
US20100286701A1 (en) * | 2009-05-08 | 2010-11-11 | Kyphon Sarl | Distraction tool for distracting an interspinous space |
US8394102B2 (en) | 2009-06-25 | 2013-03-12 | Baxano, Inc. | Surgical tools for treatment of spinal stenosis |
US8394125B2 (en) | 2009-07-24 | 2013-03-12 | Zyga Technology, Inc. | Systems and methods for facet joint treatment |
US8968358B2 (en) | 2009-08-05 | 2015-03-03 | Covidien Lp | Blunt tissue dissection surgical instrument jaw designs |
US8764806B2 (en) | 2009-12-07 | 2014-07-01 | Samy Abdou | Devices and methods for minimally invasive spinal stabilization and instrumentation |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8652153B2 (en) * | 2010-01-11 | 2014-02-18 | Anulex Technologies, Inc. | Intervertebral disc annulus repair system and bone anchor delivery tool |
US8945227B2 (en) * | 2010-02-01 | 2015-02-03 | X-Spine Systems, Inc. | Spinal implant co-insertion system and method |
CA2789959A1 (en) * | 2010-02-15 | 2011-08-18 | Nlt Spine Ltd. | Expanding conduits |
US8147526B2 (en) | 2010-02-26 | 2012-04-03 | Kyphon Sarl | Interspinous process spacer diagnostic parallel balloon catheter and methods of use |
US20220015926A1 (en) * | 2010-04-21 | 2022-01-20 | Globus Medical, Inc. | Implant packaging cartridge and insertion tool |
US8663293B2 (en) | 2010-06-15 | 2014-03-04 | Zyga Technology, Inc. | Systems and methods for facet joint treatment |
US9233006B2 (en) | 2010-06-15 | 2016-01-12 | Zyga Technology, Inc. | Systems and methods for facet joint treatment |
BR112013002765A2 (en) | 2010-07-15 | 2017-09-19 | Nlt Spine Ltd | deflectable implant, system and methods for implantation |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US9392953B1 (en) | 2010-09-17 | 2016-07-19 | Nuvasive, Inc. | Neurophysiologic monitoring |
US9839420B2 (en) | 2010-09-30 | 2017-12-12 | Ethicon Llc | Tissue thickness compensator comprising at least one medicament |
US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9861361B2 (en) | 2010-09-30 | 2018-01-09 | Ethicon Llc | Releasable tissue thickness compensator and fastener cartridge having the same |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
CN103140178B (en) | 2010-09-30 | 2015-09-23 | 伊西康内外科公司 | Comprise the closure system keeping matrix and alignment matrix |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
US10123798B2 (en) | 2010-09-30 | 2018-11-13 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US8864009B2 (en) | 2010-09-30 | 2014-10-21 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator for a surgical stapler comprising an adjustable anvil |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US9358122B2 (en) | 2011-01-07 | 2016-06-07 | K2M, Inc. | Interbody spacer |
US8377140B2 (en) | 2011-01-12 | 2013-02-19 | Ebi, Llc | Expandable spinal implant device |
US9445825B2 (en) * | 2011-02-10 | 2016-09-20 | Wright Medical Technology, Inc. | Expandable surgical device |
US8790406B1 (en) | 2011-04-01 | 2014-07-29 | William D. Smith | Systems and methods for performing spine surgery |
US8540721B2 (en) | 2011-04-04 | 2013-09-24 | Amicus Design Group, Llc | Adjustable apparatus and methods for inserting an implant |
JP6026509B2 (en) | 2011-04-29 | 2016-11-16 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Staple cartridge including staples disposed within a compressible portion of the staple cartridge itself |
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 |
WO2013028571A1 (en) | 2011-08-19 | 2013-02-28 | Lanx, Inc. | Surgical retractor system and methods of use |
EP3170457A3 (en) | 2011-08-31 | 2017-11-01 | Lanx, Inc. | Lateral retractor system and methods of use |
WO2013043850A2 (en) * | 2011-09-20 | 2013-03-28 | The University Of Toledo | Expandable inter-vertebral cage and method of installing same |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US8845728B1 (en) | 2011-09-23 | 2014-09-30 | Samy Abdou | Spinal fixation devices and methods of use |
US9198765B1 (en) | 2011-10-31 | 2015-12-01 | Nuvasive, Inc. | Expandable spinal fusion implants and related methods |
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 |
US20130226240A1 (en) | 2012-02-22 | 2013-08-29 | Samy Abdou | Spinous process fixation devices and methods of use |
US9060815B1 (en) | 2012-03-08 | 2015-06-23 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
US9888859B1 (en) | 2013-03-14 | 2018-02-13 | Nuvasive, Inc. | Directional dilator for intraoperative monitoring |
JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Tissue thickness compensator with multiple layers |
MX353040B (en) | 2012-03-28 | 2017-12-18 | Ethicon Endo Surgery Inc | Retainer assembly including a tissue thickness compensator. |
BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
EP2854716A1 (en) | 2012-05-28 | 2015-04-08 | NLT Spine Ltd. | Surgical impaling member |
EP3281609B1 (en) | 2012-05-29 | 2019-02-27 | NLT Spine Ltd. | Expanding implant |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9204879B2 (en) * | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
US9649111B2 (en) | 2012-06-28 | 2017-05-16 | Ethicon Endo-Surgery, Llc | Replaceable clip cartridge for a clip applier |
US20140001234A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Coupling arrangements for attaching surgical end effectors to drive systems therefor |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
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 |
EP2866686A1 (en) | 2012-06-28 | 2015-05-06 | Ethicon Endo-Surgery, Inc. | Empty clip cartridge lockout |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9198767B2 (en) | 2012-08-28 | 2015-12-01 | Samy Abdou | Devices and methods for spinal stabilization and instrumentation |
US9320617B2 (en) | 2012-10-22 | 2016-04-26 | Cogent Spine, LLC | Devices and methods for spinal stabilization and instrumentation |
US11259737B2 (en) | 2012-11-06 | 2022-03-01 | Nuvasive, Inc. | Systems and methods for performing neurophysiologic monitoring during spine surgery |
US11877860B2 (en) | 2012-11-06 | 2024-01-23 | Nuvasive, Inc. | Systems and methods for performing neurophysiologic monitoring during spine surgery |
US9757067B1 (en) | 2012-11-09 | 2017-09-12 | Nuvasive, Inc. | Systems and methods for performing neurophysiologic monitoring during spine surgery |
EP2919717A1 (en) | 2012-11-15 | 2015-09-23 | Zyga Technology, Inc. | Systems and methods for facet joint treatment |
US9198671B2 (en) * | 2012-12-04 | 2015-12-01 | DePuy Synthes Products, Inc. | Surgical cutting tool |
US9192402B2 (en) * | 2012-12-14 | 2015-11-24 | Gyrus Acmi, Inc. | Retrieval basket apparatus |
US9737294B2 (en) | 2013-01-28 | 2017-08-22 | Cartiva, Inc. | Method and system for orthopedic repair |
AU2014209124A1 (en) | 2013-01-28 | 2015-09-17 | Cartiva, Inc. | Systems and methods for orthopedic repair |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
US9757072B1 (en) | 2013-02-11 | 2017-09-12 | Nuvasive, Inc. | Waveform marker placement algorithm for use in neurophysiologic monitoring |
BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
JP6345707B2 (en) | 2013-03-01 | 2018-06-20 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Surgical instrument with soft stop |
US20140249557A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Thumbwheel switch arrangements for surgical instruments |
US20140263552A1 (en) | 2013-03-13 | 2014-09-18 | Ethicon Endo-Surgery, Inc. | Staple cartridge tissue thickness sensor system |
US10327910B2 (en) | 2013-03-14 | 2019-06-25 | X-Spine Systems, Inc. | Spinal implant and assembly |
US9808244B2 (en) | 2013-03-14 | 2017-11-07 | Ethicon Llc | Sensor arrangements for absolute positioning system for surgical instruments |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
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 |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
US9867612B2 (en) | 2013-04-16 | 2018-01-16 | Ethicon Llc | Powered surgical stapler |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US10149770B2 (en) | 2013-07-09 | 2018-12-11 | Seaspine, Inc. | Orthopedic implant with adjustable angle between tissue contact surfaces |
US9775609B2 (en) | 2013-08-23 | 2017-10-03 | Ethicon Llc | Tamper proof circuit for surgical instrument battery pack |
JP6416260B2 (en) | 2013-08-23 | 2018-10-31 | エシコン エルエルシー | Firing member retractor for a powered surgical instrument |
WO2015063721A1 (en) | 2013-10-31 | 2015-05-07 | Nlt Spine Ltd. | Adjustable implant |
EP3079637B1 (en) | 2013-12-11 | 2018-03-21 | NLT Spine Ltd. | Worm-gear actuated orthopedic implants. |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
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 |
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 |
US9839422B2 (en) | 2014-02-24 | 2017-12-12 | Ethicon Llc | Implantable layers and methods for altering implantable layers for use with surgical fastening instruments |
CN106232029B (en) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | Fastening system including firing member locking piece |
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 |
US9826977B2 (en) | 2014-03-26 | 2017-11-28 | Ethicon Llc | Sterilization verification circuit |
US9750499B2 (en) | 2014-03-26 | 2017-09-05 | Ethicon Llc | Surgical stapling instrument system |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US10299792B2 (en) | 2014-04-16 | 2019-05-28 | Ethicon Llc | Fastener cartridge comprising non-uniform fasteners |
US20150297223A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
JP6636452B2 (en) | 2014-04-16 | 2020-01-29 | エシコン エルエルシーEthicon LLC | Fastener cartridge including extension having different configurations |
BR112016023807B1 (en) | 2014-04-16 | 2022-07-12 | Ethicon Endo-Surgery, Llc | CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT |
US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
CN106456158B (en) | 2014-04-16 | 2019-02-05 | 伊西康内外科有限责任公司 | Fastener cartridge including non-uniform fastener |
US9585650B2 (en) | 2014-05-29 | 2017-03-07 | Warsaw Orthopedic, Inc. | Surgical spacer instrument and method |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
WO2015198335A1 (en) | 2014-06-25 | 2015-12-30 | Nlt Spine Ltd. | Expanding implant with hinged arms |
US9662123B2 (en) * | 2014-07-31 | 2017-05-30 | Amendia, Inc. | Vertical cutter and method of use |
US10016199B2 (en) | 2014-09-05 | 2018-07-10 | Ethicon Llc | Polarity of hall magnet to identify cartridge type |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
US10420480B1 (en) | 2014-09-16 | 2019-09-24 | Nuvasive, Inc. | Systems and methods for performing neurophysiologic monitoring |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
BR112017005981B1 (en) | 2014-09-26 | 2022-09-06 | Ethicon, Llc | ANCHOR MATERIAL FOR USE WITH A SURGICAL STAPLE CARTRIDGE AND SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
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 |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
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 |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US9943309B2 (en) | 2014-12-18 | 2018-04-17 | Ethicon Llc | Surgical instruments with articulatable end effectors and movable firing beam support arrangements |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
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 |
US9931118B2 (en) | 2015-02-27 | 2018-04-03 | Ethicon Endo-Surgery, Llc | Reinforced battery for a surgical instrument |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
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 |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
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 |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
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 |
US10213201B2 (en) | 2015-03-31 | 2019-02-26 | Ethicon Llc | Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw |
US10368861B2 (en) | 2015-06-18 | 2019-08-06 | Ethicon Llc | Dual articulation drive system arrangements for articulatable surgical instruments |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
US10166026B2 (en) | 2015-08-26 | 2019-01-01 | Ethicon Llc | Staple cartridge assembly including features for controlling the rotation of staples when being ejected therefrom |
JP6828018B2 (en) | 2015-08-26 | 2021-02-10 | エシコン エルエルシーEthicon LLC | Surgical staple strips that allow you to change the characteristics of staples and facilitate filling into cartridges |
MX2022009705A (en) | 2015-08-26 | 2022-11-07 | Ethicon Llc | Surgical staples comprising hardness variations for improved fastening of tissue. |
US10357252B2 (en) | 2015-09-02 | 2019-07-23 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples |
MX2022006192A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
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 |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
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 |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US10478188B2 (en) | 2015-09-30 | 2019-11-19 | Ethicon Llc | Implantable layer comprising a constricted configuration |
US10736633B2 (en) | 2015-09-30 | 2020-08-11 | Ethicon Llc | Compressible adjunct with looping members |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10857003B1 (en) | 2015-10-14 | 2020-12-08 | Samy Abdou | Devices and methods for vertebral stabilization |
WO2017091812A1 (en) | 2015-11-25 | 2017-06-01 | Talon Medical, LLC | Tissue engagement devices, systems, and methods |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US9937054B2 (en) * | 2016-01-28 | 2018-04-10 | Warsaw Orthopedic, Inc. | Expandable implant and insertion tool |
US10531816B2 (en) * | 2016-02-01 | 2020-01-14 | Zimmer Biomet Spine, Inc. | Expandable paddle distractor |
BR112018016098B1 (en) | 2016-02-09 | 2023-02-23 | Ethicon Llc | SURGICAL INSTRUMENT |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US10245029B2 (en) | 2016-02-09 | 2019-04-02 | Ethicon Llc | Surgical instrument with articulating and axially translatable end effector |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
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 |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10426469B2 (en) | 2016-04-18 | 2019-10-01 | Ethicon Llc | Surgical instrument comprising a primary firing lockout and a secondary firing lockout |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
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 |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
US10702270B2 (en) | 2016-06-24 | 2020-07-07 | Ethicon Llc | Stapling system for use with wire staples and stamped staples |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
US10973648B1 (en) | 2016-10-25 | 2021-04-13 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10744000B1 (en) | 2016-10-25 | 2020-08-18 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
CN110099619B (en) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | Lockout device for surgical end effector and replaceable tool assembly |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
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 |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
CN110087565A (en) | 2016-12-21 | 2019-08-02 | 爱惜康有限责任公司 | Surgical stapling system |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US10537324B2 (en) | 2016-12-21 | 2020-01-21 | Ethicon Llc | Stepped staple cartridge with asymmetrical staples |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
US10568624B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Surgical instruments with jaws that are pivotable about a fixed axis and include separate and distinct closure and firing systems |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US20180168619A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling systems |
US11160551B2 (en) | 2016-12-21 | 2021-11-02 | Cilag Gmbh International | Articulatable surgical stapling instruments |
US10758229B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument comprising improved jaw control |
US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
US10835245B2 (en) | 2016-12-21 | 2020-11-17 | Ethicon Llc | Method for attaching a shaft assembly to a surgical instrument and, alternatively, to a surgical robot |
US10568626B2 (en) | 2016-12-21 | 2020-02-25 | Ethicon Llc | Surgical instruments with jaw opening features for increasing a jaw opening distance |
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 |
US10898186B2 (en) | 2016-12-21 | 2021-01-26 | Ethicon Llc | Staple forming pocket arrangements comprising primary sidewalls and pocket sidewalls |
US10758230B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument with primary and safety processors |
US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
US10667809B2 (en) | 2016-12-21 | 2020-06-02 | Ethicon Llc | Staple cartridge and staple cartridge channel comprising windows defined therein |
US10716553B2 (en) | 2017-04-19 | 2020-07-21 | Pantheon Spinal, Llc | Spine surgery retractor system and related methods |
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 |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
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 |
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 |
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 |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
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 |
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 |
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 |
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 |
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 |
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 |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US11141154B2 (en) | 2017-06-27 | 2021-10-12 | Cilag Gmbh International | Surgical end effectors and anvils |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
US11058424B2 (en) | 2017-06-28 | 2021-07-13 | Cilag Gmbh International | Surgical instrument comprising an offset articulation joint |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
EP4070740A1 (en) | 2017-06-28 | 2022-10-12 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
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 |
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 |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
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 |
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 |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
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 |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
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 |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
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 |
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 |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
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 |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
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 |
US11583274B2 (en) | 2017-12-21 | 2023-02-21 | Cilag Gmbh International | Self-guiding stapling instrument |
EP3761888A4 (en) * | 2018-03-05 | 2022-03-09 | University of Maryland, Baltimore | Trans-esophageal aortic flow rate control |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
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 |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
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 |
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 |
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US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
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US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
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US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
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US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
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 |
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US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
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USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
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US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
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US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (50)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE8303342U1 (en) * | 1983-07-14 | Storz-Endoskop GmbH, 6207 Schaffhausen | Medical grasping instrument | |
US832201A (en) * | 1904-12-12 | 1906-10-02 | Samuel L Kistler | Dilator. |
US1331737A (en) * | 1918-03-30 | 1920-02-24 | Ylisto Emil | Dilator |
US1400648A (en) * | 1920-06-04 | 1921-12-20 | Robert H Whitney | Dilator |
US1737488A (en) * | 1928-12-06 | 1929-11-26 | John P Zohlen | Dilator |
US2067031A (en) * | 1934-03-23 | 1937-01-05 | Wappler Frederick Charles | Instrument for insertion into constricted body cavities |
US2137121A (en) * | 1936-04-18 | 1938-11-15 | Greenwald Company Inc I | Surgical instrument |
US2689568A (en) * | 1952-08-14 | 1954-09-21 | Charlie E Wakefield | Dilator |
US3486505A (en) * | 1967-05-22 | 1969-12-30 | Gordon M Morrison | Orthopedic surgical instrument |
US3916907A (en) * | 1974-06-21 | 1975-11-04 | Wendell C Peterson | Spreader instrument for use in performing a spinal fusion |
US4034746A (en) * | 1975-08-01 | 1977-07-12 | Williams Robert W | Retractor |
US4174715A (en) * | 1977-03-28 | 1979-11-20 | Hasson Harrith M | Multi-pronged laparoscopy forceps |
US4369788A (en) * | 1980-01-31 | 1983-01-25 | Goald Harold J | Reversed forceps for microdisc surgery |
US4393872A (en) * | 1980-05-27 | 1983-07-19 | Eder Instrument Co., Inc. | Aspirating surgical forceps |
EP0077159A1 (en) * | 1981-10-14 | 1983-04-20 | Brian Norman Atkins | Vertebrae spreader |
US4545374A (en) * | 1982-09-03 | 1985-10-08 | Jacobson Robert E | Method and instruments for performing a percutaneous lumbar diskectomy |
US4655219A (en) * | 1983-07-22 | 1987-04-07 | American Hospital Supply Corporation | Multicomponent flexible grasping device |
US4573448A (en) * | 1983-10-05 | 1986-03-04 | Pilling Co. | Method for decompressing herniated intervertebral discs |
USRE33258E (en) * | 1984-07-23 | 1990-07-10 | Surgical Dynamics Inc. | Irrigating, cutting and aspirating system for percutaneous surgery |
JPS61209647A (en) * | 1985-03-14 | 1986-09-17 | 須广 久善 | Incision opening retractor for connecting blood vessel |
US4599086A (en) * | 1985-06-07 | 1986-07-08 | Doty James R | Spine stabilization device and method |
US4909789A (en) * | 1986-03-28 | 1990-03-20 | Olympus Optical Co., Ltd. | Observation assisting forceps |
GB8620937D0 (en) * | 1986-08-29 | 1986-10-08 | Shepperd J A N | Spinal implant |
US4747394A (en) * | 1986-10-08 | 1988-05-31 | Watanabe Orthopedic Systems, Inc. | Spinal retractor |
DE3707097A1 (en) * | 1986-12-05 | 1988-06-09 | S & G Implants Gmbh | PLIERS FOR SPREADING SPINE BODIES |
US5019081A (en) * | 1986-12-10 | 1991-05-28 | Watanabe Robert S | Laminectomy surgical process |
US4926849A (en) * | 1986-12-19 | 1990-05-22 | Downey Ernest L | Apparatus for separating vertebrae |
US5000163A (en) * | 1987-06-25 | 1991-03-19 | Surgical Dynamics, Inc. | Retraction device |
US4896661A (en) * | 1988-02-05 | 1990-01-30 | Pfizer, Inc. | Multi purpose orthopedic ratcheting forceps |
DE3809793A1 (en) * | 1988-03-23 | 1989-10-05 | Link Waldemar Gmbh Co | SURGICAL INSTRUMENT SET |
US4932395A (en) * | 1988-05-18 | 1990-06-12 | Mehdizadeh Hamid M | Hemi-laminectomy retractor attachment device |
US5242439A (en) * | 1990-01-12 | 1993-09-07 | Laserscope | Means for inserting instrumentation for a percutaneous diskectomy using a laser |
US5197971A (en) * | 1990-03-02 | 1993-03-30 | Bonutti Peter M | Arthroscopic retractor and method of using the same |
US5027793A (en) * | 1990-03-30 | 1991-07-02 | Boehringer Mannheim Corp. | Surgical retractor |
DE4021153A1 (en) * | 1990-07-03 | 1992-01-16 | Wolf Gmbh Richard | ORGAN MANIPULATOR |
FR2668695B1 (en) * | 1990-11-06 | 1995-09-29 | Ethnor | ENDOSCOPIC SURGICAL INSTRUMENT FOR MOVING TISSUES OR ORGANS. |
US5176129A (en) * | 1991-03-01 | 1993-01-05 | Tekdyne, Inc. | Self-retaining refractor |
US5178133A (en) * | 1991-03-26 | 1993-01-12 | Pena Louis T | Laparoscopic retractor and sheath |
US5241972A (en) * | 1991-05-03 | 1993-09-07 | Meditron Devices, Inc. | Method for debulking tissue to remove pressure on a nerve |
US5275610A (en) * | 1991-05-13 | 1994-01-04 | Cook Incorporated | Surgical retractors and method of use |
US5199419A (en) * | 1991-08-05 | 1993-04-06 | United States Surgical Corporation | Surgical retractor |
US5235966A (en) * | 1991-10-17 | 1993-08-17 | Jay Jamner | Endoscopic retractor |
US5195506A (en) * | 1991-10-18 | 1993-03-23 | Life Medical Products, Inc. | Surgical retractor for puncture operation |
US5313962A (en) * | 1991-10-18 | 1994-05-24 | Obenchain Theodore G | Method of performing laparoscopic lumbar discectomy |
US5195541A (en) * | 1991-10-18 | 1993-03-23 | Obenchain Theodore G | Method of performing laparoscopic lumbar discectomy |
US5152279A (en) * | 1991-11-15 | 1992-10-06 | Wilk Peter J | Retractor and associated method for use in laparoscopic surgery |
US5213112A (en) * | 1992-01-29 | 1993-05-25 | Pfizer Hospital Products Group, Inc. | Tension meter for orthopedic surgery |
US5339801A (en) * | 1992-03-12 | 1994-08-23 | Uresil Corporation | Surgical retractor and surgical method |
US5171279A (en) * | 1992-03-17 | 1992-12-15 | Danek Medical | Method for subcutaneous suprafascial pedicular internal fixation |
US5439464A (en) * | 1993-03-09 | 1995-08-08 | Shapiro Partners Limited | Method and instruments for performing arthroscopic spinal surgery |
-
1995
- 1995-03-08 CA CA002144211A patent/CA2144211C/en not_active Expired - Fee Related
- 1995-03-16 DE DE69513074T patent/DE69513074T2/en not_active Expired - Lifetime
- 1995-03-16 EP EP95103860A patent/EP0676176B1/en not_active Expired - Lifetime
- 1995-05-05 US US08/435,511 patent/US5697889A/en not_active Expired - Lifetime
-
1996
- 1996-01-29 US US08/593,191 patent/US5599279A/en not_active Expired - Lifetime
Cited By (5)
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US11177610B2 (en) | 2017-01-23 | 2021-11-16 | Cadwell Laboratories, ino. | Neuromonitoring connection system |
US11949188B2 (en) | 2017-01-23 | 2024-04-02 | Cadwell Laboratories, Inc. | Methods for concurrently forming multiple electrical connections in a neuro-monitoring system |
US11253182B2 (en) | 2018-05-04 | 2022-02-22 | Cadwell Laboratories, Inc. | Apparatus and method for polyphasic multi-output constant-current and constant-voltage neurophysiological stimulation |
US11443649B2 (en) | 2018-06-29 | 2022-09-13 | Cadwell Laboratories, Inc. | Neurophysiological monitoring training simulator |
Also Published As
Publication number | Publication date |
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EP0676176A1 (en) | 1995-10-11 |
CA2144211A1 (en) | 1995-09-17 |
DE69513074T2 (en) | 2000-04-06 |
US5697889A (en) | 1997-12-16 |
DE69513074D1 (en) | 1999-12-09 |
EP0676176B1 (en) | 1999-11-03 |
US5599279A (en) | 1997-02-04 |
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