|Publication number||US3811449 A|
|Publication date||21 May 1974|
|Filing date||8 Mar 1972|
|Priority date||8 Mar 1972|
|Publication number||US 3811449 A, US 3811449A, US-A-3811449, US3811449 A, US3811449A|
|Inventors||Barringer H, Gravlee L|
|Original Assignee||Becton Dickinson Co|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (3), Non-Patent Citations (1), Referenced by (166), Classifications (6)|
|External Links: USPTO, USPTO Assignment, Espacenet|
[111 3,811,449 [451 May 21, 1974 DILATING APPARATUS AND METHOD Inventors: Leland C. Gravlee, Mountain Brook, Ala.; Hulbert V. Barringer, Hohokus, NJ.
Becton Dickinson and Company, East Rutherford, NJ.
Filed: Mar. 8, 1972 Appl. No.: 232,748
US. Cl......' 128/343, 128/343 Int. Cl A61m 29/00 References Cited UNITED STATES PATENTS 3,196,876 7/1965 Miller 128/343 2,024,982 12/1935 Scott 128/349R FOREIGN PATENTS OR APPLICATIONS 258,116 3/1913 Germany 128/276 OTHER PUBLICATIONS Vlietstra Surgery, Vol. 37, No. 5, May, 1955, pp. 811-819.
Field of Search 128/341, 343, 348, 349 R, I
Primary Examiner-Dalton L. Truluck Attorney, Agent, or Firm-Kane, Dalsimer, Kane, Sullivan and Kurucz [5 7] ABSTRACT To accurately dilate tissue preparatory to introducing medical instruments therein, an elongated, flexible probe of uniform diameter having a rounded insertion tip is employed to sound the tissue. An elongated, hollow, flexible dilator is then slidably passed over the probe to coaxially abut the probe insertion tip. The probe is withdrawn through the dilator. A second, hollow, flexible dilator is coaxially inserted over the first dilator and the first dilator is withdrawn from the second dilator. Thereafter the procedure is repeated with dilators of successively larger internal diameter such that a final dilator is implanted which stretches the tis-' sue to a desired degree. A medical instrument may thereafter be passed through the final dilator in proper alignment for treating purposes. The final dilator is thereafter withdrawn leaving the medical instrument to be utilized as needed. The apparatus provides for accurate insertion of subsequent dilators and the desired medical instrument with reduced patient trauma.
1 Claim, 5 Drawing Figures PATENTED MAY 21 I974 SHEET 1 Bf 2 DILATING APPARATUS AND METHOD BACKGROUND OF THE INVENTION The present invention relates to a dilating apparatus permitting extremely accurate insertion and dilation with significantly reduced patient trauma. More particularly, it relates to a dilating apparatus permitting accurate insertion of medical instruments with reduced patient trauma.
In order to treat various internal portions of the body it is often necessary to dilate stretchable tissue and insert the required medical instrument into the cavity to be treated. For example, dilation of the cervical canal is required in the performance of several female medical procedures. In order to insert an intrauterine coil, curettes or the Gravlee JET WASHER described in U.S. Pat. No. 3,527,203, there must be an extremely accurate dilation and insertion procedure. Conventionally, this has been accomplished by employing a series of Hegar dilators. These instruments are round, rigid and metal probes of graduated sizes which are sequentially inserted and removed from the cervical os, each probe larger in diameter than the other. Because of the difficulty of passing an instrument into the uterine cavity, the cervix is usually dilated to a point larger than the instrument itself. Often this procedure can be pain ful, usually requiring anesthetic.
In many cases there is considerable pain associated with the inaccurate insertion of the metal probes and- /or medical instruments. Often the passage to be dilated closes after removal of the conventional dilators. Finding the originally dilated opening in the partially closed passage can be difficult, painful and time consuming. I
Other body cavities also require dilation prior to treatment. The urinary tract in both males and females is often probed and dilated as part of routine medical procedure. Dilation of the Sphincter of Oddi to facilitate passage of residual stones or debris left in the common duct is a common procedure.
In U.S. Pat. No. 3,196,876, issued to Miller, it has been proposed to employ a metal probe having a rigid handle and a bulbous tip on the guide probe. Thereafter, a series of sleeves are inserted over the imbedded guide probe to dilate the passage. The sleeves also have an enlarged, oval-shaped tip. It is impossible to insert a medical instrument into the dilated passage employing the Miller device without first withdrawing all the dilators and, thereafter, also withdrawing the implanted probe. This procedure must be followed because the bulbous tip on the Miller probe does not permit it to be removed from the passage without the prior removal of the subsequently inserted sleeves. Should the Miller dilated passage relax and close, after removal of the sleeves and probe, then insertion of a medical instrument therein can be difficult, traumatic and time consuming for both the doctor and patient.
Particularly, on the battlefield there is an urgent need for a dilation apparatus that would allow rapid and accurate dilation ofa bullet wound passage and the subsequent introduction of a medical instrument to remove the bullet. Conventional dilating apparatus, particularly, rigid dilating apparatus, do not permit this procedure to be carried out rapidly, accurately and with reduced trauma to the patient.
SUMMARY OF THE INVENTION It is, therefore, a primary object of the present invention to provide a dilating apparatus adapted to dilate a passage with increased accuracy and reduced trauma as compared to prior art apparatus.
It is another object of the invention to provide a dilating apparatus which permits the rapid and accurate insertion of a medical instrument into an internal cavity while the opening to the cavity remains in a dilated state, greater than the size of the medical instrument.
It is also an object to provide a method for accurately dilating a body passage to permit an immediate, accurate, insertion of a medical instrument through a final dilator into the passage.
The above and other objects are obtained by the combination of an elongated, flexible probe of uniform diameter and at least one elongated, hollow, flexible dilator adapted to be slidably guided over the probe whereinthe probe and dilator are removably mounted with respect to each other. The probe has a rounded insertion tip which permits the probe to be freely retracted through the surrounding hollow dilator, after sounding.
To expand the probed passage a plurality of elongated, hollow, flexible, uniform dilators are provided wherein successive dilators are adapted to be slidably mounted over each other. The dilator of least diameter is adapted to be slidably guided along the probe to at least concentric abutment with the probe insertion tip. The probe and dilator of least diameter are removably mounted with respect to each other. Likewise, the dilators of successively increasing diameter are removably mounted with respect to each other.
A method is also provided for accurately dilating stretchable tissue as body orifices, ducts or wounds with reduced trauma and for accurately introducing medical instruments into the dilated orifices, ducts or wounds. The method includes inserting an elongated, flexible probe of uniform diameter into the stretchable tissue to a predetermined position therein. The probe has a rounded insertion tip. A first elongated flexible hollow dilator is inserted over the probe up to the insertion tip of the probe. Then, the flexible probe is removed from the tissue through the dilator.
Next, a second elongated, hollow, flexible dilator is inserted over the first dilator co-extensive with the first dilator. The second dilator is of slightly larger internal diameter than the external diameter of the first dilator. Thereafter, the first dilator is removed from the tissue through the second dilator. Dilators of successively greater internal diameter are sequentially inserted over dilators of lesser diameter and the smaller, inner dilators removed therefrom, until the tissue is stretched to a predetermined size by a final dilator.
Thereafter, a desired medical instrument, such as a curette or JET WASHER or even an intrauterine coil is passed through the final dilator. The final dilator is withdrawn from the tissue such that the medical instrument remains in a predetermined position for treatment.
BRIEF DESCRIPTION OF THE DRAWINGS Other objects and advantages of the present invention will be readily apparent from the following detailed description taken in conjunction with the accompanying drawings wherein:
FIG. 1 is a fragmentary view of the flexible probe and a pair of dilators of successively greater diameter;
FIG. 2 is a schematic view illustrating the positioning of the probe of FIG. 1 in a cervical canal;
FIG. 3 is a schematic view illustrating the withdrawal of the probe from the cervical canal after insertion of a dilator over the probe;
FIG. 4 is a schematic view illustrating the withdrawal of the dilator subsequent to the enlargement of the cervical canal by the insertion ofa dilator with a larger diameter; and
FIG. 5 is a schematic view illustrating the enlargement of the cervical canal by a final dilator to a predetermined size and the placement of a Jet Washer therein.
DESCRIPTION OF PREFERRED EMBODIMENTS Referring now to the drawings and, more particularly, to FIG. I, there is illustrated elongated, smooth, flexible probe of uniform external and internal diameter having a rounded insertion tip 12. In order to facilitate exploration. and sounding a pre-formed curve is formed into the body of the probe adjacent the insertion tip 12. The probe is fabricated from smooth, flexible materials, as flexible thermoplastic resins, such as polyethylene, polypropylene, vinyl, polyvinyl chloride, and copyolymers and homopolymers of the same and the like. The probe may be formed from a solid or hollow tube. It is preferred that the probe be manufactured from non-irritating materials.
The probe is employed in conjunction with at least one hollow, flexible tubular dilator 14. It is preferred that both probe 10 and dilator 14 are of such uniform diameter such that dilator 14 may be inserted over the proximal end 16 of probe 10 and advanced down the external surface 18 of the probe until the distal end 20 of the dilator is coaxial with the probe insertion tip 12. For this and other purposes, it is preferred that dilator 14 be formed from flexible, non-irritating plastic resins such as vinyl, polyethylene, polypropylene, polyvinyl chloride and homopolymers and copolymers thereof. In general, dilator 14 should be of sufficient thickness in order that it be able to withstand the pressures involved in introducing the dilator into the desired body cavity over the probe. p
In order to permit dilation to a desired degree, additional dilators are provided, as required. The succeeding dilators are formed from flexible materials as described hereinbefore and are uniform diameter, each dilator ofincreasingly larger internal diameter. As illustrated in FIG. 4, dilator 22 is of sufficient internal diameter, as to slidably pass over dilator 14.
A workable dilating apparatus includes a probe formed from a flexible vinyl polymer. The probe is 12.5 inches long having a curved portion with a radius of4 inches at the distal end. The internal diameter of the probe is 0.040 inch and the outer wall of the probe is 0.024 inch thick. A first dilator adapted to be slidably mounted over the probe is 6.6 inches long. The dilator is formed from a vinyl polymer and has an internal bore of 0.095 inch and a thickness of 0.030 inch. Additional dilators of the same material having successively larger internal diameters are provided, as needed.
The above described dilating apparatus is useful for various medical procedures. The apparatus may be employed for dilating or enlarging the cervical canal, the urinary tract in both males and females and body ducts, as well as wound cavities. After dilation, various medical instruments such as an intrauterine coil, curettes, Jet Washers, forceps and the like may be introduced into the cavity, held retracted by the final dilator. Thereafter, the final dilator is withdrawn thereby allowing accurate insertion of the instrument.
Turning now to FIGS. 2-5 there is illustrated a medical procedure wherein the cervical canal is probed and dilated. Thereafter, a Jet Washer, the subject of US. Pat. No. 3,527,203, is inserted therein. As shown in FIG. 2 the distal tip 12 of probe 10 is inserted into the cervical 0s. The opening is probed and the directions determined. As illustrated in FIG. 3, dilator 14 (solid arrow) is inserted over the proximal end 16 of probe 10 and passed over the outer surface of the probe until in approximate coaxial alignment with distal end 12 of the probe. In this manner the dilator is accurately inserted into the cervical canal with a minimum of movement and a corresponding reduction in patient trauma. Next, probe 10 is withdrawn (dotted arrow) from the bore of dilator 14.
At this point, if desired, a syringe adapter (not shown) may be connected to the proximal end 15 of the dilator 14. If desired, the syringe adapter may be permanently connected to the proximal end 15 of the dilator. Thereafter, a syringe containing a desired medicament may be connected to and injected into the bore of dilator 14, thus introducing a desired medication into the uterine cavity.
As illustrated in FIG. 4 the cervical canal 30 is enlarged by the sequential passage and removal of successive dilators of increasing internal diameter. As de' picted in FIG. 4 dilator 14 is withdrawn (dotted arrow) from the cervical canal after having served as a guide for the introduction of dilator 22 (solid arrow). After the cervical canal has been enlarged to a desired degree by the use of successive dilators, as depicted in FIG. 5, a medical instrument, the Gravlee Jet Washer 34, is inserted through the bore of the final dilator 32 (solid arrow). For this purpose, final dilator 32 should be of sufficient internal diameter to permit the free passage of the Jet Washer 34. The dilator is then withdrawn (dotted arrow) leaving the instrument 34 in accurate alignment. In use, a solution is discharged through holes in the Washer and thereafter collected through other orifices. The collected solution contains cell specimens.
The above described procedure is applicable with obvious modifications for the medical procedures outlined hereinabove. For example, a small fine probe may be employed to sound a bullet wound to locate a bullet. Next, a hollow dilator is introduced over the original probe to retract the tissue and vessels and the probe is withdrawn. A dilator of larger internal diameter is slidably engaged over the dilator to further retract the tissue and the first dilator is removed. Thereafter, a series of dilators are slidably engaged over successive dilators to further retract the tissue and vessels to a point where the bullet may be removed through the inside bore of the final dilator.
Likewise, in a tubal ligation only a small incision need be made in the abdomen. A series of dilators as described hereinabove can be employed to stretch the tissue to a point where the final dilator would have increased the diameter of the incision sufficiently to a point where the fallopian tube is exposed. The tube is tied off, the dilator removed, with only one or two sutures necessary to close the incision.
While we have described a somewhat preferred form dilating apparatus and method, it is to be understood that various modifications may be made herein without departing from the spirit of the invention as defined in the appended claims.
1. A method of facilitating entrance through a body orifice and dilation of the orifice thereafter to a desired degree comprising:
inserting an elongated flexible plastic probe of uniform diameter throughout its length and having distal and proximal ends into the body orifice to the desired extent;
shifting at least one elongated hollow flexible plastic dilator member of uniform inner and outer diameter and open at both ends and having a slightly larger inner diameter than the outer diameter of the probe axially with respect to the probe from the proximal end to the distal end thereof into a concentric position therewith after the probe has been inserted into the orifice so as to dilate the orifice;
facilitating dilation by providing a probe and each dilator member which are conformable in configuration to the orifice; and
removing the probe from within the dilator member by shifting the probe from the concentric relationship with the dilator member in the orifice so as to remove the probe while retaining the dilator member in the dilated orifice with the dilator member independently retaining the orifice in the dilated condition, providing an access passageway through the hollow dilator member to facilitate insertion and removal of instruments to and from the interior of the body, and providing a support for insertion of a further dilator member when one is to be employed.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US2024982 *||19 Dec 1934||17 Dec 1935||Harry C Scott||Surgical instrument|
|US3196876 *||10 May 1961||27 Jul 1965||Miller Maurice M||Dilator|
|DE258116C *||Title not available|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US4580568 *||1 Oct 1984||8 Apr 1986||Cook, Incorporated||Percutaneous endovascular stent and method for insertion thereof|
|US4592341 *||7 May 1985||3 Jun 1986||Olympus Optical Co., Ltd.||Method and apparatus for guiding prosthesis|
|US4610671 *||28 Mar 1985||9 Sep 1986||Luther Medical Products, Inc.||Assembly of stylet and catheter|
|US4652258 *||18 Dec 1984||24 Mar 1987||The Kendall Company||Catheter with expansible connector and method|
|US4677978 *||27 Sep 1984||7 Jul 1987||University Of Florida||Emergency cricothyrotomy system and cricothyrotomy kit|
|US4862891 *||14 Mar 1988||5 Sep 1989||Canyon Medical Products||Device for sequential percutaneous dilation|
|US4964854 *||23 Jan 1989||23 Oct 1990||Luther Medical Products, Inc.||Intravascular catheter assembly incorporating needle tip shielding cap|
|US5003918 *||28 Dec 1989||2 Apr 1991||Interventional Technologies, Inc.||Apparatus for manufacturing atherectomy torque tubes|
|US5071410 *||14 Mar 1991||10 Dec 1991||Pazell John A||Arthroscopic surgery system|
|US5295493 *||10 Nov 1992||22 Mar 1994||Interventional Technologies, Inc.||Anatomical guide wire|
|US5320611 *||4 Feb 1993||14 Jun 1994||Peter M. Bonutti||Expandable cannula having longitudinal wire and method of use|
|US5382238 *||20 May 1993||17 Jan 1995||Quinton Instrument Company||Catheter stiffeners|
|US5573517 *||6 Jun 1994||12 Nov 1996||Peter M. Bonutti||Expandable cannulas|
|US5674240 *||6 Jun 1995||7 Oct 1997||Peter M. Bonutti||Expandable cannula|
|US5683370 *||21 Nov 1996||4 Nov 1997||Luther Medical Products, Inc.||Hard tip over-the-needle catheter and method of manufacturing the same|
|US5913848 *||6 Jun 1996||22 Jun 1999||Luther Medical Products, Inc.||Hard tip over-the-needle catheter and method of manufacturing the same|
|US5916208 *||21 Nov 1996||29 Jun 1999||Luther Medical Products, Inc.||Hard tip over-the-needle catheter and method of manufacturing the same|
|US5957893 *||8 Sep 1998||28 Sep 1999||Becton Dickinson & Co.||Hard tip over-the needle catheter and method of manufacturing the same|
|US5961499 *||6 Jun 1995||5 Oct 1999||Peter M. Bonutti||Expandable cannula|
|US6056772 *||26 May 1998||2 May 2000||Bonutti; Peter M.||Method and apparatus for positioning a suture anchor|
|US6338730||6 Jun 1995||15 Jan 2002||Peter M. Bonutti||Method of using expandable cannula|
|US6364897||22 Mar 2000||2 Apr 2002||Peter M. Bonutti||Method and apparatus for positioning a suture anchor|
|US6613038||16 Nov 2001||2 Sep 2003||Bonutti 2003 Trust-A||Method of using expandable cannula|
|US6650923||13 Apr 2000||18 Nov 2003||Ev3 Sunnyvale, Inc.||Method for accessing the left atrium of the heart by locating the fossa ovalis|
|US6666891 *||13 Nov 2001||23 Dec 2003||Frank H. Boehm, Jr.||Device and method for lumbar interbody fusion|
|US6692462||11 Dec 2000||17 Feb 2004||Mackenzie Andrew J.||System and method for establishing vascular access|
|US6702821||28 Aug 2001||9 Mar 2004||The Bonutti 2003 Trust A||Instrumentation for minimally invasive joint replacement and methods for using same|
|US6730126||12 Feb 2003||4 May 2004||Frank H. Boehm, Jr.||Device and method for lumbar interbody fusion|
|US6770078||11 Oct 2001||3 Aug 2004||Peter M. Bonutti||Movable knee implant and methods therefor|
|US6814715||16 Nov 2001||9 Nov 2004||Bonutti 2003 Trust A||Expandable cannula|
|US6942684||19 Feb 2002||13 Sep 2005||Bonutti Ip, Llc||Method and apparatus for positioning an anchor member|
|US6994092||15 Aug 2003||7 Feb 2006||Ev3 Sunnyvale, Inc.||Device for containing embolic material in the LAA having a plurality of tissue retention structures|
|US7056294||15 Mar 2002||6 Jun 2006||Ev3 Sunnyvale, Inc||Method and apparatus for accessing the left atrial appendage|
|US7104996||8 Jul 2002||12 Sep 2006||Marctec. Llc||Method of performing surgery|
|US7479150||16 Sep 2004||20 Jan 2009||Tyco Healthcare Group Lp||Trocar insertion apparatus|
|US7488324||8 Dec 2003||10 Feb 2009||Biomet Manufacturing Corporation||Femoral guide for implanting a femoral knee prosthesis|
|US7510557||18 Jan 2005||31 Mar 2009||Bonutti Research Inc.||Cutting guide|
|US7615054||3 Dec 2003||10 Nov 2009||Martec, LLC||Bicompartmental knee implant and method|
|US7635390||8 Oct 2003||22 Dec 2009||Marctec, Llc||Joint replacement component having a modular articulating surface|
|US7643884||31 Jan 2005||5 Jan 2010||Warsaw Orthopedic, Inc.||Electrically insulated surgical needle assembly|
|US7695479||12 Apr 2005||13 Apr 2010||Biomet Manufacturing Corp.||Femoral sizer|
|US7695520||31 May 2006||13 Apr 2010||Biomet Manufacturing Corp.||Prosthesis and implementation system|
|US7708740||30 Jun 2005||4 May 2010||Marctec, Llc||Method for total knee arthroplasty and resecting bone in situ|
|US7708741||30 Jun 2005||4 May 2010||Marctec, Llc||Method of preparing bones for knee replacement surgery|
|US7749229||30 Jun 2005||6 Jul 2010||Marctec, Llc||Total knee arthroplasty through shortened incision|
|US7780672||27 Feb 2006||24 Aug 2010||Biomet Manufacturing Corp.||Femoral adjustment device and associated method|
|US7789885||15 Feb 2005||7 Sep 2010||Biomet Manufacturing Corp.||Instrumentation for knee resection|
|US7806896||25 Nov 2003||5 Oct 2010||Marctec, Llc||Knee arthroplasty method|
|US7806897||30 Jun 2005||5 Oct 2010||Marctec, Llc||Knee arthroplasty and preservation of the quadriceps mechanism|
|US7811303||26 Aug 2003||12 Oct 2010||Medicine Lodge Inc||Bodily tissue dilation systems and methods|
|US7828852||9 Mar 2007||9 Nov 2010||Marctec, Llc.||Inlaid articular implant|
|US7837690||15 Jan 2003||23 Nov 2010||Biomet Manufacturing Corp.||Method and apparatus for less invasive knee resection|
|US7837736||30 Oct 2007||23 Nov 2010||Marctec, Llc||Minimally invasive surgical systems and methods|
|US7887542||31 Aug 2004||15 Feb 2011||Biomet Manufacturing Corp.||Method and apparatus for less invasive knee resection|
|US7892236||18 Jan 2005||22 Feb 2011||Marctec, Llc||System and method for total joint replacement|
|US7931690||9 Mar 2007||26 Apr 2011||Marctec, Llc||Method of resurfacing an articular surface of a bone|
|US7959635||8 Mar 2004||14 Jun 2011||Marctec, Llc.||Limited incision total joint replacement methods|
|US7972359||16 Sep 2005||5 Jul 2011||Atritech, Inc.||Intracardiac cage and method of delivering same|
|US7993329||13 Aug 2003||9 Aug 2011||Cook Medical Technologies Llc||ERCP catheter with a removable handle for lithotriptor compatible basket|
|US8043329||15 May 2006||25 Oct 2011||Atritech, Inc.||Method of implanting an adjustable occlusion device|
|US8070752||9 Jan 2008||6 Dec 2011||Biomet Manufacturing Corp.||Patient specific alignment guide and inter-operative adjustment|
|US8080041 *||30 Jul 2008||20 Dec 2011||Warsaw Orthopedic, Inc.||Device and method for lumbar interbody fusion|
|US8092455||7 Feb 2005||10 Jan 2012||Warsaw Orthopedic, Inc.||Device and method for operating a tool relative to bone tissue and detecting neural elements|
|US8123758||9 Feb 2009||28 Feb 2012||Biomet Manufacturing Corp.||Femoral guide for implanting a femoral knee prosthesis|
|US8133229||14 Oct 2003||13 Mar 2012||Marctec, Llc.||Knee arthroplasty method|
|US8425430||10 Dec 2009||23 Apr 2013||Warsaw Orthopedic, Inc.||Electrically insulated surgical needle assembly|
|US8425522||21 May 2010||23 Apr 2013||Bonutti Skeletal Innovations Llc||Joint replacement method|
|US8496657||29 Aug 2008||30 Jul 2013||P Tech, Llc.||Methods for utilizing vibratory energy to weld, stake and/or remove implants|
|US8518047||3 Aug 2010||27 Aug 2013||Biomet Manufacturing, Llc||Method and apparatus for less invasive knee resection|
|US8523897||27 Sep 2006||3 Sep 2013||Atritech, Inc.||Device for left atrial appendage occlusion|
|US8551100||23 Jan 2006||8 Oct 2013||Biomet Manufacturing, Llc||Instrumentation for knee resection|
|US8617185||13 Feb 2008||31 Dec 2013||P Tech, Llc.||Fixation device|
|US8623030||14 Mar 2013||7 Jan 2014||Bonutti Skeletal Innovations Llc||Robotic arthroplasty system including navigation|
|US8632552||14 Mar 2013||21 Jan 2014||Bonutti Skeletal Innovations Llc||Method of preparing a femur and tibia in knee arthroplasty|
|US8641726||14 Mar 2013||4 Feb 2014||Bonutti Skeletal Innovations Llc||Method for robotic arthroplasty using navigation|
|US8652140||3 Jan 2012||18 Feb 2014||Warsaw Orthopedic, Inc.||Device and method for operating a tool relative to bone tissue and detecting neural elements|
|US8663273||17 Oct 2011||4 Mar 2014||Atritech, Inc.||Method of implanting an adjustable occlusion device|
|US8747439||10 Jul 2006||10 Jun 2014||P Tech, Llc||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US8784495||8 Jun 2010||22 Jul 2014||Bonutti Skeletal Innovations Llc||Segmental knee arthroplasty|
|US8795326||2 Oct 2008||5 Aug 2014||Covidien Lp||Expanding seal anchor for single incision surgery|
|US8801746||4 May 2004||12 Aug 2014||Covidien Lp||System and method for delivering a left atrial appendage containment device|
|US8808329||3 Apr 2012||19 Aug 2014||Bonutti Skeletal Innovations Llc||Apparatus and method for securing a portion of a body|
|US8814902||31 Jul 2006||26 Aug 2014||Bonutti Skeletal Innovations Llc||Method of securing body tissue|
|US8834486||21 Feb 2012||16 Sep 2014||Biomet Manufacturing, Llc||Femoral guide for implanting a femoral knee prosthesis|
|US8834490||29 Oct 2013||16 Sep 2014||Bonutti Skeletal Innovations Llc||Method for robotic arthroplasty using navigation|
|US8840629||29 Oct 2013||23 Sep 2014||Bonutti Skeletal Innovations Llc||Robotic arthroplasty system including navigation|
|US8845687||17 Sep 2013||30 Sep 2014||Bonutti Skeletal Innovations Llc||Anchor for securing a suture|
|US8845699||6 Mar 2012||30 Sep 2014||Bonutti Skeletal Innovations Llc||Method of securing tissue|
|US8858557||29 Oct 2013||14 Oct 2014||Bonutti Skeletal Innovations Llc||Method of preparing a femur and tibia in knee arthroplasty|
|US8870883||28 Jan 2011||28 Oct 2014||Biomet Manufacturing, Llc||Method for less invasive knee resection|
|US9023053||7 Oct 2013||5 May 2015||Biomet Manufacturing, Llc||Instrumentation for knee resection|
|US9060767||2 Mar 2009||23 Jun 2015||P Tech, Llc||Tissue fastener and methods for using same|
|US9060797||5 Aug 2014||23 Jun 2015||Bonutti Skeletal Innovations Llc||Method of preparing a femur and tibia in knee arthroplasty|
|US9067362||31 Oct 2007||30 Jun 2015||P Tech, Llc||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US9089323||21 Feb 2006||28 Jul 2015||P Tech, Llc||Device and method for securing body tissue|
|US9101443||29 Feb 2012||11 Aug 2015||Bonutti Skeletal Innovations Llc||Methods for robotic arthroplasty|
|US9131849||16 Sep 2005||15 Sep 2015||Atritech, Inc.||Method and apparatus for accessing the left atrial appendage|
|US9138222||17 Feb 2004||22 Sep 2015||P Tech, Llc||Method and device for securing body tissue|
|US9149281||7 Jun 2013||6 Oct 2015||P Tech, Llc||Robotic system for engaging a fastener with body tissue|
|US9155544||20 Mar 2002||13 Oct 2015||P Tech, Llc||Robotic systems and methods|
|US9173647||21 Feb 2006||3 Nov 2015||P Tech, Llc||Tissue fixation system|
|US9173650||31 May 2011||3 Nov 2015||P Tech, Llc||Methods and devices for trauma welding|
|US9192395||7 May 2013||24 Nov 2015||P Tech, Llc||Robotic fastening system|
|US9192459||22 Apr 2014||24 Nov 2015||Bonutti Skeletal Innovations Llc||Method of performing total knee arthroplasty|
|US9226828||20 Sep 2013||5 Jan 2016||P Tech, Llc||Devices and methods for stabilizing tissue and implants|
|US9271741||8 Aug 2013||1 Mar 2016||P Tech, Llc||Robotic ultrasonic energy system|
|US9271766||11 Nov 2013||1 Mar 2016||P Tech, Llc||Devices and methods for stabilizing tissue and implants|
|US9271779||13 Aug 2013||1 Mar 2016||P Tech, Llc||Methods of using a robotic spine system|
|US9314249||25 Jul 2014||19 Apr 2016||Covidien Lp||System and method for delivering a left atrial appendage containment device|
|US9387313||2 Aug 2005||12 Jul 2016||Interventional Spine, Inc.||Telescopic percutaneous tissue dilation systems and related methods|
|US9402668||4 Dec 2013||2 Aug 2016||P Tech, Llc||Tissue fixation system and method|
|US9421005||6 Feb 2007||23 Aug 2016||P Tech, Llc||Methods and devices for intracorporeal bonding of implants with thermal energy|
|US9439642||24 Feb 2010||13 Sep 2016||P Tech, Llc||Methods and devices for utilizing bondable materials|
|US9445784||22 Sep 2005||20 Sep 2016||Boston Scientific Scimed, Inc||Intravascular ultrasound catheter|
|US9445895||4 Sep 2015||20 Sep 2016||Atritech, Inc.||Intracardiac cage and method of delivering same|
|US9463012||5 Oct 2005||11 Oct 2016||P Tech, Llc||Apparatus for guiding and positioning an implant|
|US9474518||20 Jun 2014||25 Oct 2016||Covidien Lp||Expanding seal anchor for single incision surgery|
|US9486227||25 Jul 2013||8 Nov 2016||P Tech, Llc||Robotic retractor system|
|US9522070||7 Mar 2013||20 Dec 2016||Interventional Spine, Inc.||Intervertebral implant|
|US9545268||12 Mar 2014||17 Jan 2017||P Tech, Llc||Devices and methods for stabilizing tissue and implants|
|US9579129||11 Mar 2014||28 Feb 2017||P Tech, Llc||Devices and methods for stabilizing tissue and implants|
|US9585725||21 Jun 2013||7 Mar 2017||P Tech, Llc||Robotic arthroplasty system|
|US9610073||22 Mar 2007||4 Apr 2017||P Tech, Llc||Methods and devices for intracorporeal bonding of implants with thermal energy|
|US9629687||12 Aug 2016||25 Apr 2017||P Tech, Llc||Robotic arthroplasty system|
|US9681880||23 Oct 2013||20 Jun 2017||Warsaw Orthopedic, Inc.||Device and method for operating a tool relative to bone tissue and detecting neural elements|
|US9693788||4 May 2015||4 Jul 2017||Biomet Manufacturing, Llc||Instrumentation for knee resection|
|US9700329||16 Nov 2016||11 Jul 2017||Biomet Manufacturing, Llc||Patient-specific orthopedic instruments|
|US20020029045 *||28 Aug 2001||7 Mar 2002||Bonutti Peter M.||Method of performing surgery|
|US20020087189 *||19 Feb 2002||4 Jul 2002||Bonutti Peter M.||Method and apparatus for positioning a suture anchor|
|US20020169377 *||15 Mar 2002||14 Nov 2002||Khairkhahan Alexander K.||Method and apparatus for accessing the left atrial appendage|
|US20030028196 *||8 Jul 2002||6 Feb 2003||Bonutti Peter M.||Method of performing surgery|
|US20040034366 *||15 Aug 2003||19 Feb 2004||Ev3 Sunnyvale, Inc., A California Corporation||Device for containing embolic material in the LAA having a plurality of tissue retention structures|
|US20040093003 *||5 Nov 2003||13 May 2004||Mackenzie Andrew J.||System and method for establishing vascular access|
|US20050080443 *||26 Aug 2003||14 Apr 2005||Medicinelodge, Inc.||Bodily tissue dilation systems and methods|
|US20050203565 *||16 Sep 2004||15 Sep 2005||Rethy Csaba L.||Trocar insertion apparatus|
|US20050203625 *||11 Mar 2004||15 Sep 2005||Boehm Frank H.Jr.||Device and method for lumbar interbody fusion|
|US20050240227 *||29 Jun 2005||27 Oct 2005||Bonutti Peter M||Method and apparatus for positioning an anchor member|
|US20050245958 *||6 Jul 2005||3 Nov 2005||Carlson John E||System and method for establishing vascular access|
|US20050245959 *||6 Jul 2005||3 Nov 2005||Carlson John E||System and method for establishing vascular access|
|US20050256525 *||19 Jan 2005||17 Nov 2005||Brad Culbert||Dilation introducer for orthopedic surgery|
|US20050283179 *||17 Jun 2004||22 Dec 2005||Lentz David J||Introducer sheath|
|US20060009715 *||16 Sep 2005||12 Jan 2006||Khairkhahan Alexander K||Method and apparatus for accessing the left atrial appendage|
|US20060030872 *||3 Aug 2004||9 Feb 2006||Brad Culbert||Dilation introducer for orthopedic surgery|
|US20060173374 *||31 Jan 2005||3 Aug 2006||Neubardt Seth L||Electrically insulated surgical probing tool|
|US20060173521 *||31 Jan 2005||3 Aug 2006||Pond John D Jr||Electrically insulated surgical needle assembly|
|US20060178593 *||7 Feb 2005||10 Aug 2006||Neubardt Seth L||Device and method for operating a tool relative to bone tissue and detecting neural elements|
|US20060178594 *||7 Feb 2005||10 Aug 2006||Neubardt Seth L||Apparatus and method for locating defects in bone tissue|
|US20060200023 *||4 Mar 2005||7 Sep 2006||Sdgi Holdings, Inc.||Instruments and methods for nerve monitoring in spinal surgical procedures|
|US20060206148 *||15 May 2006||14 Sep 2006||Khairkhahan Alexander K||Method of implanting an adjustable occlusion device|
|US20060241695||10 Jul 2006||26 Oct 2006||Bonutti Peter M||Method of using ultrasonic vibration to secure body tissue with fastening element|
|US20070066993 *||16 Sep 2005||22 Mar 2007||Kreidler Marc S||Intracardiac cage and method of delivering same|
|US20080039845 *||6 Feb 2007||14 Feb 2008||Bonutti Peter M||Methods and devices for intracorporeal bonding of implants with thermal energy|
|US20080051734 *||31 Oct 2007||28 Feb 2008||Bonutti Peter M||Expandable cannula|
|US20080147075 *||30 Oct 2007||19 Jun 2008||Peter M Bonutti||Minimally Invasive Surgical Systems and Methods|
|US20080215058 *||31 May 2007||4 Sep 2008||Zucherman James F||Spine distraction implant and method|
|US20080243169 *||11 Jun 2008||2 Oct 2008||Carlson John E||System and method for establishing vascular access|
|US20080287981 *||21 May 2008||20 Nov 2008||Interventional Spine, Inc.||Dilation introducer and methods for orthopedic surgery|
|US20080294171 *||30 Jul 2008||27 Nov 2008||Boehm Jr Frank H||Device and method for lumbar interbody fusion|
|US20090093850 *||2 Oct 2008||9 Apr 2009||Tyco Healthcare Group Lp||Expanding seal anchor for single incision surgery|
|US20090105745 *||4 Apr 2006||23 Apr 2009||Triage Medical||Tissue Dilation Systems and Related Methods|
|US20090131871 *||16 Jan 2009||21 May 2009||Csaba Rethy||Trocar insertion apparatus|
|US20090149857 *||2 Aug 2005||11 Jun 2009||Triage Medical||Telescopic Percutaneous Tissue Dilation Systems and Related Methods|
|US20090299439 *||2 Jun 2008||3 Dec 2009||Warsaw Orthopedic, Inc.||Method, system and tool for surgical procedures|
|US20100256517 *||15 Jun 2010||7 Oct 2010||Neubardt Seth L||Electrically insulated surgical probing tool|
|EP0935974A1 *||2 Feb 1999||18 Aug 1999||PORGES, Société Anonyme dite:||Telescopic device to dilate a body vessel|
|WO2015171390A1 *||29 Apr 2015||12 Nov 2015||Avent, Inc.||Medical port with replaceable catheter|
|U.S. Classification||606/191, 604/523, 604/104|