DE19951940C2 - Endoskopisch einsetzbares Klammernahtgerät - Google Patents
Endoskopisch einsetzbares KlammernahtgerätInfo
- Publication number
- DE19951940C2 DE19951940C2 DE19951940A DE19951940A DE19951940C2 DE 19951940 C2 DE19951940 C2 DE 19951940C2 DE 19951940 A DE19951940 A DE 19951940A DE 19951940 A DE19951940 A DE 19951940A DE 19951940 C2 DE19951940 C2 DE 19951940C2
- Authority
- DE
- Germany
- Prior art keywords
- clamp
- endoscopic
- head
- elements
- instrument mouth
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07221—Stapler heads curved
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Description
Die Erfindung betrifft ein endoskopisch einsetzbares Klammer
nahtgerät gemäß dem Oberbegriff des ersten Patentanspruchs.
Derartige Klammernahtgeräte dienen zum endoskopischen, luft- und
blutdichten Verschließen von inneren Operationswunden durch
chirurgische Klammern, wobei der diese enthaltende schwenkbare
Klammerkopf des Klammernahtgerätes durch einen Trokar in den
Körper des Patienten eingeschoben und an der zu verschließenden
Operationswunde positioniert wird. Der eigentliche Klammervor
gang, d. h. das endoskopische Setzen der Klammern, wird außer
halb des Körpers des Patienten vom Betätigungsgriff aus geführt.
Eine Vorrichtung zum Anbringen von chirurgischen Klammern, be
stehend aus einem Klammerkopf, einem Betätigungsgriff sowie ei
nem, die beiden vorgenannten Komponenten verbindenden abwinkel-
und um seine Längsachse drehbaren Schaft als Übertragungsele
ment, wird in EP 0 630 614 B1 beschrieben. In dieser Vorrichtung
können die Klammern, welche sich in einem Klammermagazin ähnlich
dem eines Tackers im Klammerkopf eingesetzt sind und in diesem
axial zur Instrumentenkopfspitze nachgeschoben werden, nur ein
zeln gesetzt werden. Die Klammern bestehen dabei aus einem U-
förmigen Draht, der bei der Applizierung in der Mitte geknickt
und die Enden dabei aneinandergebogen werden. Für die für das
Abwinkeln des Schaftes erforderliche Kippvorrichtung im Schaft
nahe dem Klammerkopf werden zwei Ausführungsvarianten vorge
schlagen. Die erste ist eine radial zum Schaft gelagerte Kipp
vorrichtung, welche zur Realisierung der Drehbewegungen mit ei
ner axial zum Schaft gelagerten Drehvorrichtungen kombiniert
werden muss. Bei der zweiten Ausführungsform ist die Kipp- und
Drehvorrichtung konstruktiv in einer Einheit zusammengefasst,
wobei die beiden an der Kippvorrichtung endenden Hülsenenden mit
je einem Reibungsflansch versehen sind, welche durch gegensei
tiges Abrollen im gekippten Zustand Drehbewegungen des Schaftes
ohne Änderung der Kipprichtung übertragen. Die Übertragung der
Funktionen vom Betätigungsgriff zum Klammerkopf erfolgt mittels
Gestänge.
Ferner wird in EP 0 793 943 A1 ein kombiniertes endoskopisches
Klammernaht- und Schneidegerät mit abwinkelbarem Schaft be
schrieben. Der Klammerkopf des Instruments ist als ein unge
krümmtes Instrumentenmaul gestaltet in deren Backen Magazine mit
chirurgischen Klammerelementen, angeordnet in mehreren Reihen,
eingesetzt sind. Die Naht wird durch Schließen des Instru
mentenmaules gesetzt, wobei die Klammern in die jeweiligen ge
genüberliegenden Gegenstücke eingedrückt werden. Ferner kann bei
geschlossenem Instrumentenmaul das zusammengedrückte Körperorgan
durch einen Schneidvorgang getrennt werden.
In US 5.868.760 A wird ein Endoskopisch einsetzbares Klammernaht
gerät, bestehend aus einem Klammerkopf mit einem Instrumenten
maul, in deren Backen u. A. zwei Reihen Klammerelemente einge
setzt sind, einem Betätigungsgriff zur Betätigung der Schließbe
wegung der Backen des Instrumentenmauls sowie zum Applizieren
von Klammerelementen im Gewebe oder Organteil, einem Übertra
gungselement für die Bewegungen von dem Betätigungsgriff auf den
Klammerkopf, wobei das Übertragungselement aus mindestens einem
flexiblen und frei schwenkbaren Bowdenzug besteht und dieses die
Verbindung zwischen dem Betätigungsgriff und dem Klammerkopf
darstellt, sowie einem Hohlschaft als zusätzliche, die Bowdenzü
ge umschließende Verbindung zwischen Klammerkopf und Betäti
gungsgriff, beschrieben.
Der Erfindung liegt die Aufgabe zugrunde, gegenüber dem zuletzt
genannten Stand der Technik beim Einsatz von Klammernahtgeräten
die Freiheitsgrade für eine Positionierung des Klammerkopfes bei
minimalem Bewegungsaufwand der Instrumente im menschlichen Kör
per erheblich zu erweitern.
Die Aufgabe wird durch die in Anspruch 1 beschriebene Vorrich
tung gelöst. Die weiteren Ansprüche geben bevorzugte Ausgestaltungen
der Vorrichtung an.
Das erfindungsgemäße Klammernahtgerät wird im folgenden anhand
von Zeichnungen eines Ausführungsbeispieles erläutert:
Fig. 1 zeigt das erfindungsgemäße Klammernahtgerät perspekti
visch ohne angesetzten Hohlschaft 7.
Fig. 2a zeigt perspektivisch den ansetzbaren Hohlschaft 7.
Fig. 2b zeigt die Kippvorrichtung des ansetzbaren Hohlschaftes
7 im Detail als partielle Schnittdarstellung.
Fig. 3a zeigt den Querschnitt (Ansicht) des Klammerkopfes 1 mit
geschlossenen Instrumentenmaul 2.
Fig. 3b zeigt den Querschnitt (Draufsicht) des Klammerkopfes 1
mit geschlossenen Instrumentenmaul 2.
Fig. 4a zeigt den Querschnitt der unteren Backe 24 und die Po
sition des oberen Magazins 20 des Klammerkopfes 1 bei geschlos
senem Instrumentenmaul vor dem Setzen der Klammerelemente.
Fig. 4b zeigt einen Teil des Längsschnittes der unteren Backe
24 des Klammerkopfes 1 mit der Position des rampenförmig gestal
teten Schlittens 35 bei geschlossenem Instrumentenmaul vor dem
Setzen der Klammerelemente.
Fig. 4c zeigt den Querschnitt der unteren Backe 24 und die Po
sition des oberen Magazins 20 des Klammerkopfes 1 bei geschlos
senem Instrumentenmaul 2 beim Setzen der Klammerelemente.
Fig. 1 zeigt das erfindungsgemäße Klammernahtgerät, bestehend
aus einem Klammerkopf 1 mit einem hier geöffnet dargestellten
Instrumentenmaul 2, einem Betätigungsgriff 3 sowie mindestens
einem, im Beispiel zwei Bowdenzügen 4 als Übertragungselement
für die Bewegungen von dem Betätigungsgriff auf den Klammerkopf.
Der Betätigungsgriff 3 enthält im Beispiel zwei separate Hebel
mechanismen 5 gemäß des allgemeinen Standes der Technik zur Be
tätigung der Schließbewegung der Backen des Instrumentenmauls
sowie zum Applizieren der Klammerelemente im Gewebe oder Organ
teil, jeweils übertragen durch die Bowdenzüge 4 zum Klammerkopf
1. Betätigungsgriff 3 und Klammerkopf 1 sind dabei jeweils fest
mit den Bowdenzugschläuchen 22 der Bowdenzüge 4 verbunden. Die
Klammerelemente 6 sind in Magazinen in den Backen des Instrumen
tenmaules 2 eingesetzt.
Die Bowdenzüge 4 stellen die einzige für die Funktion des Klam
mernahtgerätes erforderliche Verbindung zwischen Betätigungs
griff 3 und Klammerkopf 1 dar. Hierdurch werden die möglichen
Freiheitsgrade bei der Positionierung des Klammerkopfes 1 im
Körper des Patienten bei minimalem Handlingaufwand, d. h. bei
spielsweise ohne erneutes Ansetzens des Klammernahtgerätes
(herausziehen und erneutes Einschieben des Klammerkopfes 1 in
den Körper an einer anderen künstlich geschaffenen Körperöff
nung), erheblich erweitert.
Beim endoskopischen Setzen der Klammernaht im Körper des Patien
ten muss jedoch eine ausreichende Fixierung des Klammerkopfes 3
gewährleistet sein. Dies wird beispielsweise durch den Einsatz
zusätzlicher endoskopisch einsetzbarer Fixierungsinstrumente
oder Zangeninstrumente gewährleistet, mit denen den Klammerkopf
im Körper positioniert und gehalten werden kann.
Zum besseren Einbringen des Klammernahtgerätes durch den Trokar
in den Körper sowie zum Halten und Positionieren im Innern des
Körpers des Patienten kann das erfindungsgemäße Klammernahtgerät
mit einem Hohlschaft als steife, aber abnehmbare zusätzliche
Verbindung zwischen dem Klammerkopf 1 und dem Betätigungsgriff 3
ausgestattet sein.
Fig. 2a zeigt eine Ausführungsform eines Hohlschaftes 7 mit
Kippvorrichtung 8. Der dargestellte Hohlschaft 7 besteht aus ei
nem Innenrohr 13 und einem dieses umhüllendes Außenrohr 14, wel
che über einen Drehknopf 9 und einer in dem Gehäuse 10 unter
gebrachte Zahnrad-Zahnstangen-Übertragung zur Betätigung der
Kippvorrichtung 8 axial gegeneinander verschoben werden können.
Die Kippvorrichtung 8, welche im Detail auch in Fig. 2b zu er
kennen ist, besteht aus einem innen abgestuften Endrohr 11 zur
Aufnahme des Effektorgrundkörpers 15 des Klammerkopfes 1 sowie
axial und parallel zueinander angeordnete Federbänder 12, welche
an jeweils einem Ende fest mit dem Umfang des Endrohres 11 an
jeweils gegenüber zueinander liegenden Seiten verbunden sind.
Die jeweils anderen Enden der beiden Federstreifen 12 sind mit
dem Innenrohr 13 bzw. Außenrohr 14 des Hohlschaftes fest ver
bunden. Die beiden Federstreifenenden dem Innenrohr 13 bzw. Au
ßenrohr 14 folgen auch der axialen Relativbewegung der genannten
Rohre, wodurch aufgrund der starr zueinander befestigten anderen
beiden Federstreifenendenen am Endrohr 11 dieses gegenüber dem
Hohlschaft 7 gekippt wird. Ferner muss der Hohlschaft 7 sowie
das Endrohr für den Ab- und Anbau an das Klammernahtgerät über
die gesamte Länge einen Längsschlitz aufweisen, durch den die
Bowdenzüge 4 des Klammernahtgerätes seitlich durchgeführt werden
können. Im angesetzten Zustand ist der Betätigungsgriff 3 mit
dem Außenrohr 14 und der Klammerkopf 1 mit dem Endrohr 11 des
Hohlschaftes 7 verbunden. Der Schwenkbereich der Kippvorrichtung
gemäß des beschriebenen Ausführungsbeispieles beträgt ca. ±50°.
Das Klammernahtgerät wird mit angesetzten Hohlschaft in den Kör
per eingebracht, wobei der Klammerkopf 1 in die Nähe der inneren
Operationswunde geschoben wird. Im Anschluss wird der Hohlschaft
7 vom Klammernahtgerät wieder gelöst und aus dem Körper gezogen.
Wie zuvor beschrieben, kann der Klammerkopf für das Verschließen
einer inneren Operationswunde mit zusätzlichen Instrumenten ge
nau positioniert werden.
Fig. 3a und b zeigen den Klammerkopf 1 im Detail. Dieser be
steht aus einem Effektorgrundkörper 15 mit der unteren Backe 24
und einer um einen Bolzen 17 drehbaren separaten oberen Backe
18. Ferner ist über den Effektorgrundkörper 15 im Bereich des
Bolzens 17 eine axial bewegliche Schiebehülse 21 angeordnet,
welche mit dem Ende des Bowdenzugschlauchs 22 fest verbunden ist
und über diesen auch vor- und zurückgeschoben wird. Das Bowden
zugkabel 23 dagegen ist mit dem Effektorgrundkörper 15 fest ver
bunden. Ein Vorschieben der Schiebehülse 21 in Richtung des In
strumentenmaules bewirkt ein Andrücken der oberen Backe 18 gegen
die untere Backe 24 und damit ein Verschließen des Instrumenten
maules 2. Die Schiebehülse 21 wird bei diesem Vorgang über einen
Pin 25, welcher in den Innenraum der Schiebehülse 21 hineinragt
und in die Nut 26 in der oberen Backe 18 eingreift, geführt.
Wird die Schiebehülse 21 wieder zurückgeschoben, trifft der Pin
25 am hinteren Ende der Nut 26 auf einen Steg 27, welcher von
dem Pin 25 nach hinten weggedrückt wird, damit die obere Backe
18 aufdrückt und so das Instrumentenmaul 2 wieder öffnet.
Das dargestellte Klammernahtgerät weist ein Instrumentenmaul 2
auf, welches gegenüber dem zuletzt genannten Stand der Technik
nicht gerade, sondern bogenförmig gestaltet ist. Durch die bo
genförmige Gestaltung des Instrumentenmaules 2 können Operati
onswunden gezielter, d. h. bei einem gegenüber gerader Nähten
geringerem Verbrauch an gesundem Gewebe und damit patientenscho
nender, verschlossen werden. Bei der anhand der Fig. 3a und b
beschriebenen Ausführungsform weisen die Backen 18 und 24 das
Instrumentenmaules 2 einen Krümmungswinkel 28 von insgesamt 120°
sowie einen seitlichen Krümmungsradius 29 von 36 mm, bezogen auf
die Mittellinie 30 des Effektorgrundkörpers 15, auf.
Im Bereich des gebogenen Instrumentenmaules sind in der oberen
und unteren Backe 18 bzw. 24 die Magazine 19 bzw. 20 für die
Klammerstifte 31 bzw. -muffen 32 eingesetzt. Während das obere
Magazin 20 fest in der oberen Backe 18 ohne bewegliche Teile po
sitioniert und eingespannt ist, muss in der unteren Backe zu
sätzlich eine Vorrichtung zum Eindrücken der Klammerstifte 31 in
die Klammermuffen 32 vorgesehen werden. In dem beschriebenen
Beispiel ist das untere Magazin 19 segmentiert ausgeführt, wobei
in jedes einzelne Magazinsegment 16 zwei Klammerstifte 31 einge
setzt sind und sich jedes einzelne Magazinsegment 16, geführt
durch zwei in die untere Backe 24 eingesetzte Führungsstifte 33,
in vertikaler Richtung bewegen lässt. In der unteren Backe 24 im
Zwischenraum unterhalb des unteren Magazins 19 befindet sich ein
rampenförmiger Schlitten 35 (vgl. Fig. 4a und b), welcher sich
mit dem Bowdenzugkabel 34 bewegen lässt.
Der eigentliche Nähvorgang lässt sich anhand der Fig. 4a bis c
beschreiben, welche im Detail den Quer- und partiellen Längs
schnitt der unteren Backe 24 und eines Magazinsegmentes 16 vor
sowie den genannten Querschnitt nach dem Eindrücken der Klammer
stifte 31 in die Klammermuffen 32 zeigen. Beim Nähvorgang wird
zunächst das Instrumentenmaul 2 geschlossen, wobei die Operati
onswunde in diesem zusammengedrückt wird. Im Anschluss daran
wird der rampenförmige Schlitten 35 mit dem Bowdenzugkabel 34
unter das untere Magazin 19 über dessen gesamte Länge hindurch
gezogen, wobei die einzelnen Magazinsegmente 16 nacheinander an
gehoben werden und die Klammerstifte 31 durch das zu nähende Gewebe
in die jeweils gegenüberliegenden Klammermuffen 32 im obe
ren Magazin 20 eingeschoben werden und sich in diesen einrasten.
Wird das Instrumentenmaul 2 wieder geöffnet, lösen sich die in
einander verzahnten Klammerstifte 31 und Klammermuffen 32 aus
den Magazinen 19 und 20; das Klammernahtgerät kann im Anschluss
hieran aus den Körper des Patienten herausgezogen werden. Die
bei dem Verfahren eingesetzten Klammerstifte 31 und Kammermuffen
32 sind vorzugsweise aus einem resorbierbaren Material gefer
tigt.
Claims (6)
1. Endoskopisch einsetzbares Klammernahtgerät für die minimal
invasive Chirurgie zum Setzen von Klammernähten zum Ausgren
zen von Geweben oder Organteilen, bestehend aus
- a) einem Klammerkopf (1) mit einem Instrumentenmaul (2), in deren Backen eine oder mehrere Reihen Klammerelemente (6) eingesetzt sind,
- b) einem Betätigungsgriff (3) mit Hebelmechanismen (5) zur Betätigung der Schließbewegung der Backen (18) und (24) des Instrumentenmauls sowie zum Applizieren der Klammere lemente (6) im Gewebe oder Organteil, sowie
- c) einem Übertragungselement für die Bewegungen von dem Be tätigungsgriff (3) auf den Klammerkopf (1), wobei das Ü bertragungselement aus mindestens einem flexiblen und frei schwenkbaren Bowdenzug (4) besteht und dieses die Verbindung zwischen dem Betätigungsgriff (3) und dem Klammerkopf (1) darstellt, sowie
- d) einem Hohlschaft (7) als zusätzliche feste, die Bowdenzü ge (4) umschließende Verbindung zwischen Klammerkopf (1) und Betätigungsgriff (3),
- a) der Hohlschaft (7) von dem endoskopisch einsetzbaren Klammernahtgerät abnehmbar ist.
2. Endoskopisch einsetzbares Klammernahtgerät nach Anspruch 1,
dadurch gekennzeichnet, dass der Hohlschaft (7) ein Gelenk
enthält und damit abwinkelbar ist.
3. Endoskopisch einsetzbares Klammernahtgerät nach einem der
vorstehenden Ansprüche, dadurch gekennzeichnet, dass das In
strumentenmaul (2) des Klammerkopfes (1) gebogen ist und damit
die zu erstellende Klammernaht eine Krümmung aufweist.
4. Endoskopisch einsetzbares Klammernahtgerät nach einem der
vorstehenden Ansprüche, dadurch gekennzeichnet, dass die
Klammerelemente (6) aus einem resorbierbaren Material herge
stellt sind.
5. Endoskopisch einsetzbares Klammernahtgerät nach einem der
vorstehenden Ansprüche, dadurch gekennzeichnet, dass die
Klammerelemente (6) in Magazinen (19) und (20), welche wie
derum in die Backen (18) und (24) des Instrumentenmaules (2)
eingesetzt und positioniert sind, eingesetzt sind.
6. Endoskopisch einsetzbares Klammernahtgerät nach einem der
vorstehenden Ansprüche, dadurch gekennzeichnet, dass die
Klammerelemente (6) aus je einem Klammerstift (31) und einer
Klammermuffe (32) bestehen, wobei die Klammerstifte im ge
schlossenen Instrumentenmaul (2) durch einen Keil oder eine
Nocke durch das Gewebe oder Organteil in die Klammermuffen
gedrückt werden.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE19951940A DE19951940C2 (de) | 1999-10-28 | 1999-10-28 | Endoskopisch einsetzbares Klammernahtgerät |
| DE20016423U DE20016423U1 (de) | 1999-10-28 | 2000-09-22 | Endoskopisch einsetzbares Klammernahtgerät |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE19951940A DE19951940C2 (de) | 1999-10-28 | 1999-10-28 | Endoskopisch einsetzbares Klammernahtgerät |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| DE19951940A1 DE19951940A1 (de) | 2001-06-13 |
| DE19951940C2 true DE19951940C2 (de) | 2001-11-29 |
Family
ID=7927171
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| DE19951940A Expired - Fee Related DE19951940C2 (de) | 1999-10-28 | 1999-10-28 | Endoskopisch einsetzbares Klammernahtgerät |
| DE20016423U Expired - Lifetime DE20016423U1 (de) | 1999-10-28 | 2000-09-22 | Endoskopisch einsetzbares Klammernahtgerät |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| DE20016423U Expired - Lifetime DE20016423U1 (de) | 1999-10-28 | 2000-09-22 | Endoskopisch einsetzbares Klammernahtgerät |
Country Status (1)
| Country | Link |
|---|---|
| DE (2) | DE19951940C2 (de) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7819896B2 (en) * | 2002-10-04 | 2010-10-26 | Tyco Healthcare Group Lp | Tool assembly for a surgical stapling device |
| US8028882B2 (en) * | 2007-05-01 | 2011-10-04 | Tyco Healthcare Group | Anvil position detector for a surgical stapler |
| DE102015113307A1 (de) | 2015-08-12 | 2017-02-16 | Charité - Universitätsmedizin Berlin | Vorrichtung zur Durchtrennung von Gewebeteilen |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7695485B2 (en) * | 2001-11-30 | 2010-04-13 | Power Medical Interventions, Llc | Surgical device |
| US6685079B2 (en) * | 2002-05-24 | 2004-02-03 | Scimed Life Systems, Inc. | Full thickness resectioning device |
| US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
| US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
| US11890012B2 (en) | 2004-07-28 | 2024-02-06 | Cilag Gmbh International | Staple cartridge comprising cartridge body and attached support |
| US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
| US9138226B2 (en) | 2005-03-30 | 2015-09-22 | Covidien Lp | Cartridge assembly for a surgical stapling device |
| US8991676B2 (en) | 2007-03-15 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Surgical staple having a slidable crown |
| US20070194079A1 (en) | 2005-08-31 | 2007-08-23 | Hueil Joseph C | Surgical stapling device with staple drivers of different height |
| US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
| 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 |
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| US7819896B2 (en) * | 2002-10-04 | 2010-10-26 | Tyco Healthcare Group Lp | Tool assembly for a surgical stapling device |
| US8061577B2 (en) | 2002-10-04 | 2011-11-22 | Tyco Healthcare Group Lp | Tool assembly for a surgical stapling device |
| US8408442B2 (en) | 2002-10-04 | 2013-04-02 | Covidien Lp | Tool assembly for a surgical stapling device |
| US8028882B2 (en) * | 2007-05-01 | 2011-10-04 | Tyco Healthcare Group | Anvil position detector for a surgical stapler |
| DE102015113307A1 (de) | 2015-08-12 | 2017-02-16 | Charité - Universitätsmedizin Berlin | Vorrichtung zur Durchtrennung von Gewebeteilen |
| DE102015113307A8 (de) * | 2015-08-12 | 2017-04-06 | Charité - Universitätsmedizin Berlin | Vorrichtung zur Durchtrennung von Gewebeteilen |
| US11013512B2 (en) | 2015-08-12 | 2021-05-25 | Charité —Universitätsmedizin Berlin | Device for separating tissue parts |
Also Published As
| Publication number | Publication date |
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| DE19951940A1 (de) | 2001-06-13 |
| DE20016423U1 (de) | 2001-02-15 |
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