CN101721233B - 止血植入体 - Google Patents

止血植入体 Download PDF

Info

Publication number
CN101721233B
CN101721233B CN200910179890.6A CN200910179890A CN101721233B CN 101721233 B CN101721233 B CN 101721233B CN 200910179890 A CN200910179890 A CN 200910179890A CN 101721233 B CN101721233 B CN 101721233B
Authority
CN
China
Prior art keywords
porous matrix
hydrogel precursor
implant
hydrogel
solution
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.)
Active
Application number
CN200910179890.6A
Other languages
English (en)
Other versions
CN101721233A (zh
Inventor
史蒂文·贝内特
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
Original Assignee
Covidien LP
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Covidien LP filed Critical Covidien LP
Publication of CN101721233A publication Critical patent/CN101721233A/zh
Application granted granted Critical
Publication of CN101721233B publication Critical patent/CN101721233B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/14Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L31/145Hydrogels or hydrocolloids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04Macromolecular materials
    • A61L31/042Polysaccharides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/08Materials for coatings
    • A61L31/10Macromolecular materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/12Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
    • A61L31/125Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
    • A61L31/129Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix containing macromolecular fillers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L31/00Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/14Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L31/146Porous materials, e.g. foams or sponges
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2400/00Materials characterised by their function or physical properties
    • A61L2400/04Materials for stopping bleeding

Landscapes

  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Vascular Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Dispersion Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Composite Materials (AREA)
  • Materials Engineering (AREA)
  • Materials For Medical Uses (AREA)
  • Surgical Instruments (AREA)

Abstract

本公开涉及一种止血植入体,其包含多孔基质,该多孔基质具有以下述方式对其施加的第一水凝胶前体和第二水凝胶前体,即,直到植入体被置于植入部位并暴露于患者的生理液体前,第一水凝胶前体和第二水凝胶前体不相互反应。

Description

止血植入体
相关申请
本申请要求于2008年10月17日提交的美国临时申请No.61/196,543的优先权。
技术领域
此公开涉及植入体,更具体而言涉及止血植入体,该植入体包含多孔基质,该多孔基质具有对其施加的第一水凝胶前体和第二水凝胶前体。
背景技术
原位止血治疗主要集中于将患者体内的前体溶液转换成固体。用多种手段实现该转换,包括沉淀、聚合、交联和去溶剂。但是,用溶液原位止血治疗时存在明显的局限性。低粘度的溶液可能流走,并在转换和凝固发生前从施用部位被清除。此外,溶液的配方可能很复杂,如前体溶液的制备通常需要前体的重组,或者,当溶液被冷冻贮存时需解冻。
因此,最好能提供原位止血治疗,其包括与那些在水溶性生理液体存在被激活的干燥材料结合的可植入装置。可植入装置与干燥材料的结合能确保原位止血治疗在植入部位起效。
发明内容
本植入体包括多孔基质,其具有对该多孔基质第一部分施加的第一水凝胶前体和对该多孔基质第二部分施加的第二水凝胶前体。在实施方式中,对多孔基质施加作为膜的第一或第二水凝胶前体中的至少一种。在实施方式中,直到植入体被置于植入部位并暴露于患者的生理液体之前,具有对其施加了第一水凝胶前体的基质的第一部分与多孔基质的第二部分在空间上分离,以防止第一和第二水凝胶前体相互反应。将植入体暴露于生理液体引起第一水凝胶前体从多孔基质的第一部分移行到多孔基质的第二部分并与第二水凝胶前体反应。在实施方式中,本植入体在带涂层的多孔基质部分不仅显示出止血性能而且显示出抗粘连性能。
对在出血部位原位形成止血剂的方法也有所说明。按照此方法,放置具有多孔基质的植入体使其与患者的生理液体接触,该多孔基质具有施加到其第一部分的第一水凝胶前体和施加到其第二部分的第二水凝胶前体。确定植入体的方向为,第一部分比第二部分更接近患者的组织。这样定向的植入体随后与患者的组织接触,使生理液体通过多孔基质被吸入,接着溶解第一水凝胶前体,然后溶解第二水凝胶前体涂层。一经溶解,第一和第二水凝胶前体相互反应形成一种生物相容性交联材料。在实施方式中,将第一水凝胶前体作为膜施加于基质的第一部分。经与生理液体接触,该膜溶解,且第一前体被吸入到多孔基质与第二水凝胶前体接触,以形成生物相容性交联材料。
附图说明
附图已被纳入并构成本说明书的一部分,公开的示例性实施方式,连同上述公开的概括说明,以及下面给出的对实施方式的详细说明,用于解释公开的本质。
图1A-D示意性显示了:如本公开中至少一个实施方式所述,对多孔基质施加第一和第二水凝胶前体;
图2示意性显示了图1A-1C所示的实施方式的变化;
图3示意性显示了图1A-1C所示的实施方式的另一变化;
图4A-C示意性显示了:如本公开中至少一个实施方式所述,对多孔基质施加第一水凝胶前体;
图5A-C示意性显示了:如本公开中至少一个实施方式所述,对已施加了第一水凝胶前体的多孔基质施加含有第二水凝胶前体的颗粒;
图6A-C示意性显示了:如本公开中至少一个实施方式所述,对已施加了第一水凝胶前体的多孔基质施加含有第二水凝胶前体的膜;
图7A-B示意性显示了同时形成包含第一水凝胶前体的泡沫和泡沫多孔基质;以及
图8A-C示意性显示了:如本公开中至少一个实施方式所述,对已施加了第一水凝胶前体的多孔基质施加包含第二水凝胶前体的颗粒;
图9A-C示意性显示了:如本公开中至少一个实施方式所述,对已施加了第一水凝胶前体的多孔基质施加含有第二水凝胶前体的膜;
图10示意性显示了:如本公开中至少一个实施方式所述,一种针织纤维性多孔基质,该多孔基质具有包含施加于其第一部分的第一水凝胶前体的颗粒和包含施加于其第二部分的第二水凝胶前体的膜;
图11示意性显示了:如本公开中至少一个实施方式所述,一种针织纤维性多孔基质,该多孔基质具有包含施加于其第一部分的第一水凝胶前体的涂层和包含施加于其第二部分的第二水凝胶前体的膜;以及
图12示意性显示了:如本公开中至少一个实施方式所述,一种无纺纤维性多孔基质,该多孔基质具有包含施加于其第一部分的第一水凝胶前体的颗粒和包含施加于其第二部分的第二水凝胶前体的膜。
具体实施方式
根据此公开的止血植入体包含多孔基质,该多孔基质具有对此多孔基质第一部分施加的第一水凝胶前体和对此多孔基质第二部分施加的第二水凝胶前体。使用时,确定植入体的方向为,施加第一水凝胶前体的部分更靠近组织,具有对其施加的第二水凝胶前体的部分远离组织。在实施方式中,第一和第二部分可以通过添加对比染料、表面纹理、颜色或其他视觉线索而相互区别。例如,一旦接触组织,如受伤的组织,植入体将吸收生理液体且第一水凝胶将被液体溶解。由于液体被吸入并迁移透过植入体,它会带着溶解的第一水凝胶前体一直通过植入体。最后,液体将移动通过植入体足以达到施加了第二水凝胶前体的第二部分,从而溶解第二水凝胶前体。然后,第一和第二水凝胶前体反应以形成生物相容性交联材料,从而协助止血。在一些实施方式中,由第一和第二水凝胶前体反应生成的生物相容性交联材料,不仅具有止血性能还具有防粘连性能。
植入体的多孔基质在其表面的至少一部分具有开口或孔隙。孔隙可以在植入前或植入后在基质中形成。如下详述,形成多孔基质的合适材料包括但不限于:纤维结构(例如,针织结构、纺织结构、无纺结构等)和/或泡沫(例如,开孔或闭孔泡沫)。在实施方式中,孔隙可能有足够的数量和大小以相互连接穿过整个多孔基质的厚度。纺织物、针织物和开孔泡沫是孔隙能够有足够的数量和大小以相互连接穿过整个多孔基质厚度的结构的例证性例子。在一些实施方式中,孔隙不相互连接穿过整个多孔基质的厚度。闭孔泡沫或带胶无纺材料(fused non-woven material)是孔隙不相互连接穿过整个多孔基质厚度的结构的例证性例子。泡沫多孔基质的孔隙可跨越整个多孔基质的厚度。还有一些实施方式,孔隙不扩展到多孔基质的整个厚度,而是处于其厚度的一部分。在实施方式中,开口或孔隙位于多孔基质表面的一部分,而多孔基质的其他部分具有非多孔质地。在其他的实施方式中,孔隙可以在原位植入后形成。可采用任何适合的方法原位进行孔隙的形成。一些非限制的例子包括接触石刷术、活性自由基光敏聚合物(LRPP)体系和盐沥滤法的使用。阅读了本公开的本领域技术人员将可以预想其他的多孔基质的孔隙分布形式和布局。
如果多孔基质为纤维性,这种纤维可以是适合针织或纺织的丝或线,或者可为切断纤维(staple fiber),如那些经常用于制备无纺材料的纤维。该纤维可由任何生物相容性材料制成。因此,这种纤维可由天然材料或合成材料形成。形成纤维的材料可以是生物吸收性的或非生物吸收性的。显然应该了解的是,可将任何天然、合成、生物吸收性和非生物吸收性材料的组合用于形成该纤维。制造纤维的材料的一些非限制性例子包括但不限于聚(乳酸)、聚(羟基乙酸)、聚(丙交酯)、聚(乙交酯)、聚(三亚甲基碳酸酯)、聚(对二氧环己酮)(poly(dioxanone))、聚(羟基丁酸酯)、聚(膦嗪)、聚酯、聚对苯二甲酸乙二酯、超聚合物量聚乙烯、聚乙二醇、聚氧化乙烯、聚丙烯酰胺、聚甲基丙烯酸羟乙酯、聚乙烯吡咯烷酮、聚乙烯醇、聚丙烯酸、聚乙酸酯、聚己内酯、聚丙烯、脂肪族聚酯、甘油、聚(氨基酸)、(醚-酯)共聚物、聚亚烃基草酸酯、多糖、聚酰胺、聚(碳酸亚胺酯)、聚亚烃基草酸酯、聚草酸酯、聚原酸酯、聚磷腈、生物聚合物、聚合物药物和共聚物、嵌段共聚物、均聚物、共混物及其组合物。
如果多孔基质为纤维性,可使用任何适合形成纤维结构的方法形成多孔结构,其包括但不限于针织、纺织、无纺技术、湿纺法、电纺法、挤压法,共挤压法等。制备纤维结构的适合技术是在本领域技术人员的技术范围内。在实施方式中,纺织物具有三维结构,如美国专利No.7,021,086和6,443,964所述的纺织物,其公开的内容以引用的方式全文并入本文。
在实施方式中,多孔基质由氧化纤维素的纤维制成。这种材料是已知的,且包括商品名称为的市售可得的氧化纤维素止血材料。制备氧化纤维素止血材料的方法对于本领域技术人员是已知的,而且已被公开,如美国专利Nos.3,364,200、4,626,253、5,484,913和6,500,777,其公开的内容以引用的方式全文并入本文。
多孔基质为泡沫材料时,该多孔基质可使用任何适合形成泡沫或海绵的方法形成,其包括但不限于对组合物的冻干或冷冻干燥。泡沫可以为交联的或不交联的,并可以包含共价键或离子键。制备泡沫的适合技术是在本领域技术人员的技术范围内。
多孔基质可为至少0.1厘米厚,在实施方式中为约0.2~约1.5厘米厚。多孔基质中孔隙大小可为约2微米~约300微米,在实施方式中为约50微米~约150微米。可以预见,可以以任何方式在基质中排列基质的孔隙。例如,可以以随机或均匀的方式分布空隙。在一些实施方式中,可通过使用藻酸铜形成空隙来产生蜂巢状的多孔基质。在另外一些实施方式中,可分布孔隙以在多孔基质中形成梯度。该梯度可进一步提高多孔基质的吸收生理液体的能力,并引导携带第一水凝胶前体的生理液体向第二水凝胶前体移动。
在实施方式中,植入体是由非变性胶原或由通过加热或任何其他方式至少已部分失去其螺旋结构的胶原制成,其主要由非水解α链组成,分子量接近100KDa。术语“非变性胶原”是指没有失去其螺旋结构的胶原。本植入体中用于植入体的胶原可为天然胶原或缺端胶原(atelocollagen),特别是通过胃蛋白酶消化和/或在如先前定义的适度加热后获得的胶原。胶原可以通过氧化、甲基化、乙基化、琥珀酰化或其他任何已知的方法被预先化学修饰。胶原也可和任何适合的交联剂交联,如京尼平(genipin)、异氰酸酯及醛。胶原的来源和类型可如上述对非植入体的描述。
在实施方式中,植入体可以通过将浓度为2~50g/l、初始温度为4~25℃的胶原的酸性水溶液冷冻干燥获得。胶原在溶液中的浓度可为约1g/l~约30g/l,在实施方式中为约10g/l。此溶液有利地中和为pH值约6~8。
植入体也可以通过冷冻干燥由胶原或加热胶原的溶液制备的流体泡沫,并分别在不同量体积的空气(空气的体积:水的体积在约1~约10间变化)存在下乳化获得。
多孔基质具有对其施加的第一个水凝胶前体和对其施加的第二水凝胶前体。术语“第一水凝胶前体”和“第二水凝胶前体”各自指可参与反应以形成网状交联分子的聚合物、功能聚合物、大分子、小分子或交联剂,例如,水凝胶。
在实施方式中,第一或第二水凝胶前体中的至少一种是约1000Da以下的小分子,且其被称为“交联剂”。交联剂在水溶液中优选具有至少1g/100mL的溶解度。交联分子可以通过离子或共价键、物理作用力或其他吸引力交联。
在实施方式中,第一或第二水凝胶前体中的至少一种是大分子,且其被称为“功能聚合物”。当与交联剂反应结合时,大分子的分子量优选至少比小分子交联剂大5~50倍,且可以小于约60,000Da。在实施方式中,大分子的分子量比所用的交联剂大7~30倍,而且,在实施方式中所用大分子的重量有约10~20倍的不同。此外,所用的是分子量为5,000~50,000的大分子。此处所用的术语聚合物,是指由至少3个重复基团形成的分子。
第一和第二水凝胶前体都是多官能的,也就是说,它包括两个以上亲电子或亲核官能团,即,例如,第一水凝胶前体的亲核官能团可与第二水凝胶前体的亲电子官能团反应形成共价键。第一或第二水凝胶前体中的至少一中包含两种以上的官能团,这样,由于亲电子-亲核反应,前体结合形成交联聚合产物。此反应被称为“交联反应”。
在实施方式中,第一和第二水凝胶前体都只包含一类官能团,或者只有亲核官能团或者只有亲电子官能团,只要是亲核和亲电子前体都被用于交联反应中。因此,举例来说,如果第一水凝胶前体具有如胺的亲核官能团,则第二水凝胶前体可具有如N-羟基琥珀酰亚胺的亲电子官能团。另一方面,如果第一水凝胶前体具有如磺基琥珀酰亚胺的亲电子官能团,则第二水凝胶前体可具有如胺或硫醇的亲核官能团。因此,可以使用功能聚合物,如蛋白质、聚(烯丙胺)、苯乙烯磺酸或胺-封端的双或多官能聚(乙二醇)(PEG)。
第一和第二水凝胶前体可具有无生物活性和水溶性的内核。当聚合物的内核是水溶性聚合区域时,优选的可用聚合物包括:聚醚,例如,聚环氧烷如聚乙二醇(“PEG”)、聚氧化乙烯(“PEO”),聚氧化乙烯聚氧化丙烯共聚物(“PPO”)、聚氧化乙烯嵌段共聚物或无规共聚物和聚乙烯醇(“PVA”);聚(乙烯吡咯烷酮)(“PVP”);聚(氨基酸);多糖,如葡聚糖、壳聚糖、海藻酸盐、羧甲基纤维素、氧化纤维素、羟乙基纤维素、羟甲基纤维素、透明质酸;以及蛋白质,如白蛋白、胶原、酪蛋白和明胶。聚醚,更具体而言是聚(氧化烯)或聚(乙二醇)或聚乙二醇特别被使用。当内核实际上是小分子时,多种亲水性功能体的任一个都可以用来使第一和第二水凝胶前体溶于水。例如,像羟基、胺、磺酸盐和羧酸盐的水溶性官能团,可以用来使前体溶于水。此外,N-羟基琥珀酰亚胺(“NHS”)硬脂酸酯不溶于水,但通过向琥珀酰亚胺环上增加一个磺酸盐基团,可使NHS硬脂酸酯溶于水,而不影响其对胺基的活性。
假如有需要,从第一和第二水凝胶前体的反应产生的生物相容性交联聚合物是可生物降解的或可吸收的,一种或多种第一和第二水凝胶前体可在官能团间存在可生物降解的键。可选的,可生物降解的键也可以作为一种或多种前体的水溶性内核。替代或补充的,也可以选择第一和第二水凝胶前体的官能团,以使它们之间的反应产物产生可生物降解的键。对于每一种方法,可以选择可生物降解的键,以使得到的可生物降解的生物相容性交联聚合物会在所需时间内降解、溶解或被吸收。优选地,选择在生理条件下降解为无毒产物的可生物降解的键。
可生物降解性的键,可为螯合物、可化学或酶水解或吸收。示例性的可化学水解的可生物降解键,包括乙交酯、消旋-丙交酯、左旋-丙交酯、己内酯、二噁烷酮和碳酸亚丙酯的聚合物、共聚物和低聚物。示例性的可酶水解的可生物降解键,包括可由金属蛋白酶和胶原酶裂解的肽键。示例性的其他可生物降解键,包括多(羟基酸)、聚(原碳酸酯)、聚(酸酐),聚(内酯),聚(氨基酸),聚(碳酸酯),多糖和聚(膦酸酯)的聚合物和共聚物。
在实施方式中,可生物降解的连接可含有酯键。一些非限制的例子包括琥珀酸、戊二酸、丙酸、己二酸或氨基酸的酯,以及羧甲基醚。
在实施方式中,可将如三赖氨酸的多官能亲核聚合物用作第一水凝胶前体,而将如用多个NHS基团官能化的多臂PEG的多官能亲核聚合物用作第二水凝胶前体。例如,用多个NHS基团官能化的多臂PEG可具有四、六或八臂,且具有约5,000~约25,000的分子量。许多其他合适的第一和第二前体的例子记载于美国专利Nos.6,152,943;6,165,201;6,179,862;6,514,534;6,566,406;6,605,294;6,673,093;6,703,047;6,818,018;7,009,034和7,347,850中,其各自公开的全部内容通过引用方式并入本文。
将第一水凝胶前体施加于多孔基质的第一部分而将第二水凝胶前体施加于多孔基质的第二部分。例如,前体可以在干燥的形式下使用,例如颗粒状物质或为如膜或泡沫的固体或半固体状态。在实施方式中,第一或第二水凝胶前体中的至少一种是以膜施加于多孔基质。在实施方式中,具有对其施加了第一水凝胶前体的基质的第一部分与具有对其施加了第二水凝胶前体的基质的第二部分在空间上分离。第一和第二水凝胶前体在空间上相互分离防止了在植入体被置于植入部位并接触患者的生理液体前第一和第二水凝胶前体相互反应。
可使用任何本领域技术人员已知的合适方法对多孔基质施加第一水凝胶前体,该方法包括但不限于喷涂、刷涂、浸渍、浇注、层压等。在实施方式中,可将第一水凝胶前体在形成多孔基质前与多孔基质结合。在其他实施方式中,可将第一水凝胶前体在基质形成后置于多孔基质的孔隙内或多孔基质的表面上。在又一其他实施方式中,可在施加第一水凝胶前体前压延多孔基质,从而使第一前体穿透基质上在压延过程中形成的开口。在又一其他一些实施方式中,可在溶液中对多孔基质施加第一水凝胶前体,然后蒸发或者冻干溶剂。在实施方式中,可将第一水凝胶前体作为涂层施加于多孔基质的至少一面或者作为膜层压到基质的至少一面。
同样,可使用任何本领域技术人员已知的合适方法对多孔基质施加第二水凝胶前体,该方法包括但不限于喷涂、刷涂、浸渍、浇注、层压等。在实施方式中,第二水凝胶前体可以任何能形成止血植入体的浓度、尺寸和形状作为涂层施加于基质上。在实施方式中,第二水凝胶前体涂层可穿透多孔基质的孔隙。涂层可形成无孔层或多孔层。在实施方式中,第二水凝胶前体可作为层压在基质的至少一面上的膜被施加于多孔基质。
在实施方式中,当第一或第二水凝胶前体中的任一种形成无孔层,即膜时,膜的厚度可足以使在植入体封闭伤口前仅有部分水凝胶前体与其他水凝胶前体反应。在这些实施方式中,剩余的未反应的水凝胶膜可充当伤口与周围组织的屏障层,以防止粘连的形成。在形成水凝胶植入体中,前体也可赋予生理液体某些特性,如抗粘连性。生理液体水凝胶也可充当伤口与周围组织的屏障层,以防止粘连的形成。在实施方式中,多孔基质还可包含已知能减少或防止粘连的如透明质酸等的非活性材料。在这些实施方式中,非活性物质可防止第一和第二水凝胶前体相互作用后粘连的形成。
除了能够止血以外,植入体还可用于生物活性剂的传送。因此,在一些实施方式中,至少一个生物活性剂可与第一水凝胶前体或第二水凝胶前体中的任一种结合和/或分别施加于多孔基质。试剂可游离地与前体混合,或者可通过多种化学键的任一种与前体链接。在这些实施方式中,本植入体也可作为传递生物活性剂的载体。此处使用的术语“生物活性剂”,意为其最广泛的意义,并包括任何有临床用途的物质或物质混合物。因此,生物活性剂本身可以或不可以具有药理活性,例如,染料或香料。或者,生物活性剂可以是任何具有治疗或预防效果的试剂,影响或参与组织生长、细胞生长、细胞分化的化合物,抗粘连化合物,能引起如免疫反应的生物反应或者可以在一个或多个生物过程中具有任何其他作用的化合物。可以预见的,生物活性剂可以以任何适当的物质形式应用于本植入体,例如,膜、粉末、液体。凝胶等。
根据本公开可利用的生物活性剂的种类的例子包括抗粘连剂、抗微生物药、镇痛剂、退热剂、麻醉剂、抗癫痫剂、抗组胺剂、消炎剂、心血管药物、诊断试剂、拟交感神经药、拟胆碱能剂、抗毒蕈碱药、镇痉剂、激素、生长因子、肌肉松弛剂、肾上腺素能神经元阻滞剂、抗肿瘤药、免疫原性剂、免疫抑制剂、胃肠药物、利尿剂、类固醇、脂类、脂多糖类、多糖、血小板活化药物、凝血因子和酶。同样意指的是,可组合使用生物活性试剂。
可将抗粘连剂用于防止植入式医疗装置与靶组织对面的周围组织之间形成粘连。此外,可将抗粘结剂用于防止植入式医疗装置涂层与包装材料之间形成粘连。这些试剂的一些例子包括但不仅限于亲水性聚合物,如聚(乙烯基吡咯烷酮)、羧甲基纤维素、透明质酸、聚氧化乙烯、聚乙烯醇及其组合物。
可包含于本公开的生物活性涂层中作为生物活性剂的适合抗微生物剂包括:三氯生、也被称为2,4,4′-三氯-2′-羟基二苯醚;双氯苯双胍己烷及其盐,包括醋酸双氯苯双胍己烷、葡萄糖酸双氯苯双胍己烷、盐酸双氯苯双胍己烷和硫酸洗必泰;银及其盐,包括醋酸银、苯甲酸银、碳酸银、柠檬酸银、碘酸银、碘化银、乳酸银、月桂酸银、硝酸银、氧化银、棕榈酸银、蛋白银和磺胺嘧啶银;多粘菌素;四环素;氨基糖甙类,如妥布霉素和庆大霉素;甲哌利福霉素(利福平);杆菌肽;新霉素;氯霉素;咪康唑;喹诺酮类,如噁喹酸、诺氟沙星、萘啶酸、培氟沙星、依诺沙星、环丙沙星;青霉素类如苯唑西林和哌拉西林;壬苯醇醚9;夫西地酸;头孢菌素;及其组合。此外,本公开的生物活性涂层中可包含作为生物活性剂的抗微生物蛋白和肽,如牛乳铁蛋白和乳铁蛋白B。
按照本公开施加的可作为涂层组合物中包含的生物活性剂的其他生物活性剂包括:局部麻醉剂;非甾体类抗生育剂;拟副交感神经剂;精神治疗剂;镇静剂;减充血剂;镇静催眠剂;类固醇;磺胺药剂;拟交感神经剂;疫苗;维生素;抗疟疾剂;抗偏头痛剂;抗帕金森剂如左旋多巴;抗痉挛剂;抗胆碱能剂(如奥昔布宁);镇咳剂;支气管扩张剂;心血管药物如冠状血管扩张药物和硝酸甘油;生物碱;镇痛剂;麻醉剂如可待因、二氢可待因酮、度冷丁、吗啡等;非麻醉剂如水杨酸盐、阿司匹林、对乙酰氨基酚、d-丙氧酚等;阿片受体拮抗剂,如纳曲酮和纳洛酮;抗癌药物;抗惊厥药;止吐药;抗组胺剂,抗炎剂如激素制剂、氢化可的松、泼尼松龙、泼尼松、非激素制剂、别嘌呤醇、吲哚美辛、苯丁唑酮等;前列腺素及胞毒药物;化学治疗剂,雌激素;抗菌剂;抗生素;抗真菌剂;抗病毒剂;抗凝血剂;抗抽搐药;抗抑郁剂;抗组胺剂和免疫制剂。
其他可包含在涂层组合物中的适合的生物活性剂的例子包括:病毒和细胞,肽,多肽和蛋白质,同工体(analog),突变蛋白及其活性片段,如免疫球蛋白,抗体,细胞活素(如淋巴因子、单核因子、化学增活素),凝血因子,造血因子,白介素(IL-2、IL-3、IL-4、IL-6),干扰素(β-IFN、(α-IFN和γ-IFN)),促红细胞生成素,核酸酶,肿瘤坏死因子,集落刺激因子(如,GCSF、GM-CSF、MCSF),胰岛素,抗肿瘤剂和肿瘤抑制剂,血蛋白(bloodprotein),纤维蛋白,凝血酶,纤维蛋白原,合成凝血酶,合成纤维蛋白,合成纤维蛋白原,促性腺激素(例如,FSH、LH、CG等),激素及激素类似物(如生长激素),疫苗(如肿瘤、细菌和病毒抗原);生长抑素;抗原;凝血因子;生长因子(如神经生长因子、胰岛素样生长因子),成骨蛋白,TGF-B,蛋白抑制剂,蛋白拮抗剂以及蛋白激动剂;核酸,如反义分子、DNA、RNA、RNAi;寡核苷酸;多核苷酸以及核酶。
现在转到图1A-D,其显示了一个顺序,其中,将第一水凝胶前体施加于多孔基质的孔隙中并将第二水凝胶前体施加于多孔基质的第二部分。在图1A中,多孔基质20是具有多个局限于基质内的孔隙25的泡沫。将包含溶于溶剂的第一水凝胶前体的溶液35贮存在容器19中。将多孔基质20浸入并完全淹没在溶液35中。如图1B所示,取出后,干燥植入体,从溶液35中去除溶剂并在基质20的孔隙25中沉积了包含第一水凝胶前体30的颗粒。
在图1C中,将包含第一水凝胶前体的多孔基质20与第二水凝胶前体的熔体45接触。冷却后,第二水凝胶前体的熔体45会固化形成覆盖在基质20的至少一部分的膜40。施加第二前体的膜40后,可将植入体修整成任何所需的尺寸和形状。图1D显示了具有第一水凝胶前体和第二水凝胶前体的植入体10,将颗粒30形式的第一水凝胶前体施加于多孔基质20的第一部分22,而将膜40形式的第二水凝胶前体施加于多孔基质20的第二部分24。
除了多孔基质120为具有对其施加的颗粒130形式的第一水凝胶前体和以对其施加的膜140形式第二水凝胶前体的网状材料外,以与图1A-D顺序所示类似的方式制备图2的植入体110。预判可使用无纺布材料(未显示)代替图1A-D所示的泡沫或图2所示的网状物作为多孔基质。
除了多孔基质220为具有对其施加的涂层230形式的第一水凝胶前体和对其施加的膜240形式的第二水凝胶前体的网状材料外,以与图1A-D顺序所示类似的方式制备图3的植入体210。第一水凝胶前体的涂层230可通过将多孔基质220浸入到第一水凝胶前体的溶液或第一水凝胶前体的熔融物中形成。或者,第一水凝胶前体可在施加于基质前与成膜聚合物结合而得到涂层230。阅读了本公开的本领域技术人员将可以预想到将包含第一水凝胶前体的涂层施加于基质的其他方法和材料。
现在转到图4A-C,其显示了一个顺序,其中,将第一水凝胶前体施加于多孔基质的第一部分。在图4A中,多孔基质320是具有多个局限于其内的孔隙325的泡沫材料,其至少具有第一部分322和第二部分324。将包含溶于溶剂的第一水凝胶前体的溶液335贮存在容器319中。将多孔基质320置于溶液335中,其第一部分322朝向溶液335而第二部分324背离溶液335。
在图4B中,如图4A的箭头表示,通过将多孔基质320向溶液335的方向移动,将多孔基质320的第一部分322部分浸入溶液335中。只有多孔基质320的第一部分322与溶液335接触,因此可将足够量的溶液335施加并填充多孔基质320的第一部分322的孔隙325。如图4C所示,取出后,干燥植入体,去除溶液335中的溶剂,并将包含第一水凝胶前体330的颗粒沉积在第一部分322内。颗粒330包含干燥形式的第一水凝胶前体且在空间上局限在第一部分322中。
在图5A-5C中,显示了一个顺序,其中,将包含溶于溶剂的第二水凝胶前体的溶液345施加于多孔基质320的第二部分324,其中包含第一水凝胶前体的颗粒330之前已进入多孔基质320的第一部分322(见图4A-4C)。将多孔基质320置于溶液345中,其第二部分324朝向溶液345而第一部分322背离溶液345。
如图5B所示,如图5A的箭头所示,通过将多孔基质320向溶液345的方向移动,将多孔基质320的第二部分324部分浸入溶液345中。只有多孔基质320的第二部分324与溶液345接触,因此可将足够量的溶液345施加于第二部分324。取出后,干燥植入体以使包含第二水凝胶前体的颗粒340沉积于第二部分324内。颗粒340包含干燥形式的第二水凝胶前体且空间上局限在第二部分324中。图5C所示的多孔基质320,其具有施加于基质第一部分的第一水凝胶前体和施加于多孔基质第二部分的第二水凝胶前体,且基质的第一部分与多孔基质的第二部分在空间上分离。
另外的实施方式中,可以不同的形式对植入体施加第一和第二水凝胶前体。例如,在图6A-6C中,显示的多孔基质含有包含施加于第一部分422的第一水凝胶前体的颗粒430,并且第二部分424朝向包含已施加于支撑体429的第二水凝胶前体的成膜溶液445A。
在图6B中,通过将多孔基质420按图6A中箭头所示的方向移动,使多孔基质420的第二部分424与成膜溶液445接触并且/或者部分浸入成膜溶液445中。只有多孔基质420的第二部分424与成膜溶液445接触,因此可将足量的445材料施加于第二部分424。将成膜溶液445固化(加热或不加热)形成膜覆盖第二部分424的至少一部分。图6C所示的多孔基质420,其具有施加于基质第一部分的颗粒形式的第一水凝胶前体和施加于多孔基质第二部分的膜形式的第二水凝胶前体,且基质的第一部分与多孔基质的第二部分在空间上分离。
现在转到图7A-7B,显示的是一起形成多孔基质和包含第一水凝胶前体的多孔层。在图7A中,容器519包含预定形成多孔基质的溶液525和含有第一水凝胶前体的第二溶液535,其中,两种溶液实际上保持在分离的层中。采用本领域技术人员已知的任何方法将两种溶液冻干以形成如图7B所示的多孔基质,该多孔基质包括与由第二溶液535冻干制得的第二多孔层530的由第一溶液525冻干制得的第一多孔基质520。第二多孔层530包含了第一水凝胶前体,并通过第一部分522连接到第一多孔基质520上以形成具有两层多孔材料的植入体。
在图8A-8C中,显示了一个顺序,其中,将包含第二水凝胶前体的溶液545施加于多孔基质520的第二部分524,其中多孔基质520已具有包含与第一部分522的孔隙结合的第一水凝胶前体。将多孔基质520置于溶液545中,其第二部分524朝向溶液545而第一部分522和第二多孔层530背离溶液545。
如图8B所示,如图8A的箭头表示,通过将多孔基质520向溶液545的方向移动,将多孔基质520的第二部分524部分浸入具有溶于溶剂的第一水凝胶前体的溶液545中。只有多孔基质520的第二部分524与溶液545接触,因此可将足量的溶液545施加于第二部分524。取出后,干燥植入体或使其干燥以去除溶剂并使颗粒540沉积于第二部分524。第二颗粒540包含干燥形式的第二水凝胶前体且空间上局限在第二部分524中。图8C所示的多孔基质520,其具有施加于基质第一部分的泡沫形式的第一水凝胶前体和施加于多孔基质第二部分的颗粒形式的第二水凝胶前体,且基质的第一部分与多孔基质的第二部分在空间上分离。
在另一实施方式中,如图7B所示的多孔基质可与包含第二水凝胶前体的成膜材料结合。如图9A-9C所示,多孔基质620包括第一部分622和第二部分624,其中包含第一水凝胶前体的第二多孔层630在第一部分622与多孔基质620连接。所示第二部分624朝向施加于支撑体629的成膜溶液645。成膜材料645包含第二水凝胶前体和溶剂。
在图9B中,通过将多孔基质620按图9A中箭头所示的方向移动,将多孔基质620的第二部分624与成膜溶液645接触并且/或者部分浸入成膜溶液645中。只有多孔基质620的第二部分624与成膜溶液645接触,因此可将足量的645材料施加于第二部分624。成膜溶液645可以在第二部分624的至少一部分形成膜。图9C所示的多孔基质620,其具有施加于基质第一部分的泡沫形式的第一水凝胶前体和施加于多孔基质第二部分的膜形式的第二水凝胶前体,且基质的第一部分与多孔基质的第二部分在空间上分离。
应当理解的是,除了如图4-9所示的泡沫,多孔基质还可以是纤维结构。因此,在实施方式中,如图10-12的示意性显示,多孔基质可以是纤维结构,即,纺织或无纺结构。采用上述与对泡沫多孔基质20实质上相同的技术,将第一和第二水凝胶前体施加于纤维多孔基质。因此,如同上述泡沫多孔基质,当多孔基质是纤维性时,可施加第一和/或第二水凝胶前体,例如,从溶液中沉积颗粒、干燥成膜溶液形成的无孔膜,或者作为泡沫施加于纤维多孔基质的至少一部分。如图10所示,例如,植入体710包括针织多孔基质720,其包含多个局限于其中的孔隙725,且具有第一部分722和第二部分724。例如,以与上述对泡沫多孔基质20实质上相同的方式,如图4A-C所示,将包含干燥形式的第一水凝胶前体的颗粒730施加于第一部分722。例如,以与上述对泡沫多孔基质720实质上相同的方式,如图5A-C所示,将包含第二水凝胶前体的膜750施加于第二部分724。植入后,将第二部分750施加于需要止血的组织。一旦与组织接触,生理液体会渗透植入体710并以箭头A表示的方向移动,从而在到达颗粒730前与膜750相互作用并使其液化。可以预见,随着液体向基质720的第一部分722被吸入,膜750的溶液将与也将被生理液体溶解并混合的颗粒730接触。此混合将活化第一和第二前体,并使他们相互作用并交联以形成协助植入体止血功能的密封。在实施方式中,此新形成的水凝胶/生理液体植入体也起到粘连屏障的作用。
进一步的考虑,可从包含第一和/或第二水凝胶前体的熔体,而不是从溶液施加第一和/或第二水凝胶前体。例如,在图11中,植入体810包括具有第一部分822和第二部分824的针织多孔基质,其中第二部分824又包括了含有第二水凝胶前体的膜850。在此实施方式中,将第一水凝胶前体830从熔体作为涂层,而不是从溶液作为颗粒施加于第一部分822。如其所示,熔体830基本上涂覆了基质820的第一部分822的至少一部分纤维,同时使孔隙825保持足够的开口以允许流体通过多孔基质820移动。应当理解的是,涂层830可能是不连续的,使基质820的832部分可不被涂覆。
如上所述,多孔基质可以是无纺纤维多孔基质。例如,在图12中,植入体910以具有第一部分922和第二部分924的无纺多孔基质920显示,其中,将包含第一水凝胶前体的颗粒930施加于第一部分922而将包含第二水凝胶前体的膜940施加于第二部分924。
实施例
制备三赖氨酸的饱和硼酸盐缓冲溶液。该溶液每毫升溶液包含20.6毫克三赖氨酸。该溶液的pH值约为9.2。将一片氧化纤维素浸入溶液中,然后固定在架上干燥。将该架置于真空烘箱中。烘箱被泵抽吸到约50mTorr并在约25℃的温度保持约3天,以减少水汽水平至小于2wt%。将具有约15000分子量的八臂N-羟基琥珀酰亚胺基官能化聚乙二醇在约50℃的热板上熔化。放置含三赖氨酸的干燥的氧化纤维素片并使其与熔化的PEG组分接触。冷却后,PEG组分在植入体一面形成了膜。
将得到的产品修整成2英寸×2英寸的正方形,干燥并用箔容器包装。
在使用时,打开箔包装,将植入施加于流血的伤口,PEG膜的一面对着伤口。几秒钟之内,即产生止血作用。
可以理解的是,可以对本公开的实施方式做各种修改。例如,可将两种以上的前体施加于多孔基质以形成止血植入体。又例如,可各自以膜对多孔基质施加第一和第二前体。因此,本领域技术人员将可以设想在权利要求的实质和范围内的其他修改。

Claims (17)

1.一种植入体,该植入体包含多孔基质,其特征在于,所述多孔基质具有对该多孔基质的第一部分施加的第一水凝胶前体和对该多孔基质的第二部分施加的第二水凝胶前体,所述基质的第一部分与所述多孔基质的第二部分在空间上分离。
2.权利要求1所述的植入体,其中,所述多孔基质为泡沫。
3.权利要求1所述的植入体,其中,所述多孔基质为针织物。
4.权利要求1所述的植入体,其中,所述多孔基质为无纺布。
5.权利要求1所述的植入体,其中,所述多孔基质由生物吸收性材料制成。
6.权利要求1所述的植入体,其中,所述多孔基质由非生物吸收性材料制成。
7.权利要求1所述的植入体,其中,所述多孔基质由氧化纤维素制成。
8.权利要求1所述的植入体,其中,所述第一水凝胶前体包含颗粒。
9.权利要求1所述的植入体,其中,所述第一水凝胶前体为泡沫。
10.权利要求1所述的植入体,其中,所述第一水凝胶前体为膜。
11.权利要求1所述的植入体,其中,所述第二水凝胶前体包含颗粒。
12.权利要求1所述的植入体,其中,所述第二水凝胶前体为泡沫。
13.权利要求1所述的植入体,其中,所述第二水凝胶前体为膜。
14.权利要求1所述的植入体,其还包含生物活性剂。
15.一种植入体的制备方法,其特征在于,包括
对多孔基质的第一部分施加第一水凝胶前体;
对所述多孔基质的第二部分施加第二水凝胶前体,
所述基质的第一部分与所述多孔基质的第二部分在空间上分离。
16.权利要求15所述的方法,其中,对所述多孔基质施加作为膜的所述第一水凝胶前体。
17.权利要求15所述的方法,其中,所述基质的第一部分与所述多孔基质的第二部分在空间上分离。
CN200910179890.6A 2008-10-17 2009-10-19 止血植入体 Active CN101721233B (zh)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US19654308P 2008-10-17 2008-10-17
US61/196,543 2008-10-17
US12/573,176 US20100100123A1 (en) 2008-10-17 2009-10-05 Hemostatic implant
US12/573,176 2009-10-05

Publications (2)

Publication Number Publication Date
CN101721233A CN101721233A (zh) 2010-06-09
CN101721233B true CN101721233B (zh) 2014-07-09

Family

ID=41343579

Family Applications (1)

Application Number Title Priority Date Filing Date
CN200910179890.6A Active CN101721233B (zh) 2008-10-17 2009-10-19 止血植入体

Country Status (7)

Country Link
US (1) US20100100123A1 (zh)
EP (4) EP2815774B1 (zh)
JP (1) JP5793279B2 (zh)
CN (1) CN101721233B (zh)
AU (1) AU2009225332B2 (zh)
CA (1) CA2682464C (zh)
ES (3) ES2614047T3 (zh)

Families Citing this family (412)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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
US11998198B2 (en) 2004-07-28 2024-06-04 Cilag Gmbh International Surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
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
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US20110295295A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument having recording capabilities
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
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US11980366B2 (en) 2006-10-03 2024-05-14 Cilag Gmbh International Surgical instrument
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US8840603B2 (en) 2007-01-10 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8827133B2 (en) 2007-01-11 2014-09-09 Ethicon Endo-Surgery, Inc. Surgical stapling device having supports for a flexible drive mechanism
US8590762B2 (en) 2007-03-15 2013-11-26 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configurations
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
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
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
RU2493788C2 (ru) 2008-02-14 2013-09-27 Этикон Эндо-Серджери, Инк. Хирургический режущий и крепежный инструмент, имеющий радиочастотные электроды
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
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
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US10046081B2 (en) 2008-04-11 2018-08-14 The Henry M Jackson Foundation For The Advancement Of Military Medicine, Inc. Electrospun dextran fibers and devices formed therefrom
EP2276879B1 (en) 2008-04-11 2015-11-25 Virginia Commonwealth University Electrospun dextran fibers and devices formed therefrom
GB0809721D0 (en) * 2008-05-28 2008-07-02 Univ Bath Improvements in or relating to joints and/or implants
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting 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
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US9889230B2 (en) * 2008-10-17 2018-02-13 Covidien Lp Hemostatic implant
CA2740597C (en) 2008-10-17 2017-11-21 Sofradim Production Multi-layered surgical patches comprising a first hydrogel precursor and a second hydrogel precursor
US20100100123A1 (en) * 2008-10-17 2010-04-22 Confluent Surgical, Inc. Hemostatic implant
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
JP2012517287A (ja) 2009-02-06 2012-08-02 エシコン・エンド−サージェリィ・インコーポレイテッド 被駆動式手術用ステープラの改良
US9592108B2 (en) 2009-07-29 2017-03-14 Covidien Lp System and method of laparoscopic use of hemostatic patch
US20110108199A1 (en) * 2009-11-10 2011-05-12 Tyco Healthcare Group Lp Hemostatic Tapes and Dispensers Therefor
US20110112572A1 (en) * 2009-11-10 2011-05-12 Tyco Healthcare Group Lp Hemostatic Tapes and Dispensers Therefor
US8771258B2 (en) 2009-12-16 2014-07-08 Baxter International Inc. Hemostatic sponge
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
IT1398443B1 (it) * 2010-02-26 2013-02-22 Lima Lto S P A Ora Limacorporate Spa Elemento protesico integrato
SA111320355B1 (ar) 2010-04-07 2015-01-08 Baxter Heathcare S A إسفنجة لايقاف النزف
US8302323B2 (en) 2010-06-21 2012-11-06 Confluent Surgical, Inc. Hemostatic patch
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8740038B2 (en) 2010-09-30 2014-06-03 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a releasable portion
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8518440B2 (en) * 2010-12-21 2013-08-27 Confluent Surgical, Inc. Biodegradable osmotic pump implant for drug delivery
US9144634B2 (en) * 2011-01-14 2015-09-29 Covidien Lp Medical device with intrapore films
US9084602B2 (en) 2011-01-26 2015-07-21 Covidien Lp Buttress film with hemostatic action for surgical stapling apparatus
CA2834649C (en) 2011-04-29 2021-02-16 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples positioned within a compressible portion thereof
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
EP2726512B1 (en) 2011-06-29 2017-10-11 Covidien LP Dissolution of oxidized cellulose
CA2854294C (en) * 2011-10-18 2018-11-20 St. Teresa Medical, Inc. Method of forming dextran and thrombin sheets
US8697118B2 (en) 2011-10-18 2014-04-15 St. Teresa Medical, Inc. Stabilizers for hemostatic products
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
US11701127B2 (en) * 2012-03-06 2023-07-18 Accumed Radial Systems, Llc Hemostasis apparatus and method
RU2648884C2 (ru) * 2012-03-28 2018-03-28 Этикон Эндо-Серджери, Инк. Расширяемый компенсатор толщины ткани
CN104379068B (zh) 2012-03-28 2017-09-22 伊西康内外科公司 包括组织厚度补偿件的保持器组件
RU2014143258A (ru) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. Компенсатор толщины ткани, содержащий множество слоев
CN104334098B (zh) 2012-03-28 2017-03-22 伊西康内外科公司 包括限定低压强环境的胶囊剂的组织厚度补偿件
US9271937B2 (en) 2012-05-31 2016-03-01 Covidien Lp Oxidized cellulose microspheres
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
BR112014032776B1 (pt) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140001234A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Coupling arrangements for attaching surgical end effectors to drive systems therefor
US9499636B2 (en) 2012-06-28 2016-11-22 Covidien Lp Dissolution of oxidized cellulose and particle preparation by cross-linking with multivalent cations
US11197671B2 (en) 2012-06-28 2021-12-14 Cilag Gmbh International Stapling assembly comprising a lockout
CN104487005B (zh) 2012-06-28 2017-09-08 伊西康内外科公司 空夹仓闭锁件
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
FR2997623B1 (fr) * 2012-11-05 2015-12-18 Lavigne Sainte Suzanne Christophe De Vis intraosseuse pour fixer a un os un fragment osseux ou un transplant et procede de fabrication d’une telle vis intraosseuse
MX368026B (es) 2013-03-01 2019-09-12 Ethicon Endo Surgery Inc Instrumento quirúrgico articulable con vías conductoras para la comunicación de la señal.
BR112015021082B1 (pt) 2013-03-01 2022-05-10 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US10413566B2 (en) 2013-03-15 2019-09-17 Covidien Lp Thixotropic oxidized cellulose solutions and medical applications thereof
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US10405857B2 (en) 2013-04-16 2019-09-10 Ethicon Llc Powered linear surgical stapler
GB2514592A (en) * 2013-05-30 2014-12-03 Medtrade Products Ltd Degradable haemostat composition
CN106028966B (zh) 2013-08-23 2018-06-22 伊西康内外科有限责任公司 用于动力外科器械的击发构件回缩装置
US20150053737A1 (en) 2013-08-23 2015-02-26 Ethicon Endo-Surgery, Inc. End effector detection systems for surgical instruments
US9757330B2 (en) 2013-10-18 2017-09-12 Industrial Technology Research Institute Recipe for in-situ gel, and implant, drug delivery system formed thereby
EP3068446A4 (en) 2013-11-12 2017-08-09 St. Teresa Medical, Inc. Hemostatic products
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
CN106456158B (zh) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 包括非一致紧固件的紧固件仓
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
BR112016023698B1 (pt) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc Cartucho de prendedores para uso com um instrumento cirúrgico
CN106456159B (zh) 2014-04-16 2019-03-08 伊西康内外科有限责任公司 紧固件仓组件和钉保持器盖布置结构
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US9757128B2 (en) 2014-09-05 2017-09-12 Ethicon Llc Multiple sensors with one sensor affecting a second sensor's output or interpretation
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
CN107427300B (zh) 2014-09-26 2020-12-04 伊西康有限责任公司 外科缝合支撑物和辅助材料
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
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
BR112017012996B1 (pt) 2014-12-18 2022-11-08 Ethicon Llc Instrumento cirúrgico com uma bigorna que é seletivamente móvel sobre um eixo geométrico imóvel distinto em relação a um cartucho de grampos
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US11382731B2 (en) 2015-02-27 2022-07-12 Covidien Lp Medical devices with sealing properties
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
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 (ja) 2015-03-06 2020-08-13 エシコン エルエルシーEthicon LLC 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価
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
WO2016143647A1 (ja) 2015-03-10 2016-09-15 国立大学法人 東京大学 ゲル前駆体クラスターを用いた低濃度ゲルの製造方法、及び当該製造方法により得られるゲル
US10390825B2 (en) 2015-03-31 2019-08-27 Ethicon Llc Surgical instrument with progressive rotary drive systems
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
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
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10433846B2 (en) 2015-09-30 2019-10-08 Ethicon Llc Compressible adjunct with crossing spacer fibers
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
WO2017083050A1 (en) 2015-11-12 2017-05-18 St. Teresa Medical, Inc. A method of sealing a durotomy
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
BR112018016098B1 (pt) 2016-02-09 2023-02-23 Ethicon Llc Instrumento cirúrgico
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International 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
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
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses 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
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US10478181B2 (en) 2016-04-18 2019-11-19 Ethicon Llc Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US11191539B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
JP6983893B2 (ja) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC 外科用エンドエフェクタ及び交換式ツールアセンブリのためのロックアウト構成
US10736629B2 (en) 2016-12-21 2020-08-11 Ethicon Llc Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems
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
US10682138B2 (en) 2016-12-21 2020-06-16 Ethicon Llc Bilaterally asymmetric staple forming pocket pairs
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
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
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US20180168609A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Firing assembly comprising a fuse
US10667811B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Surgical stapling instruments and staple-forming anvils
MX2019007295A (es) 2016-12-21 2019-10-15 Ethicon Llc Sistema de instrumento quirúrgico que comprende un bloqueo del efector de extremo y un bloqueo de la unidad de disparo.
US20180168618A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling systems
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
JP7010956B2 (ja) 2016-12-21 2022-01-26 エシコン エルエルシー 組織をステープル留めする方法
US11090048B2 (en) 2016-12-21 2021-08-17 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
BR112019011947A2 (pt) 2016-12-21 2019-10-29 Ethicon Llc sistemas de grampeamento cirúrgico
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
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
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
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
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
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
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
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
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US20180368844A1 (en) 2017-06-27 2018-12-27 Ethicon Llc Staple forming pocket arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US11678880B2 (en) 2017-06-28 2023-06-20 Cilag Gmbh International Surgical instrument comprising a shaft including a housing arrangement
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
EP3420947B1 (en) 2017-06-28 2022-05-25 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US11020114B2 (en) 2017-06-28 2021-06-01 Cilag Gmbh International Surgical instruments with articulatable end effector with axially shortened articulation joint configurations
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
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
US11974742B2 (en) 2017-08-03 2024-05-07 Cilag Gmbh International Surgical system comprising an articulation 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
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10953128B2 (en) 2017-11-02 2021-03-23 St. Teresa Medical, Inc. Fibrin sealant products
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
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
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
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
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
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
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US20190192147A1 (en) 2017-12-21 2019-06-27 Ethicon Llc Surgical instrument comprising an articulatable distal head
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
KR102112539B1 (ko) * 2018-06-28 2020-05-19 에스케이바이오랜드 주식회사 2액형 지혈제 조성물 및 그 제조방법
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
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
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US20220211912A1 (en) * 2019-05-09 2022-07-07 Sherif Soliman Hydrogel retinal tamponade agent
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US12004740B2 (en) 2019-06-28 2024-06-11 Cilag Gmbh International Surgical stapling system having an information decryption protocol
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
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
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US12035913B2 (en) 2019-12-19 2024-07-16 Cilag Gmbh International Staple cartridge comprising a deployable knife
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
KR102164819B1 (ko) * 2020-03-02 2020-10-13 주식회사 이노테라피 지혈용 기구 및 이의 제조방법
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
US20220031350A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with double pivot articulation joint arrangements
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US12053175B2 (en) 2020-10-29 2024-08-06 Cilag Gmbh International Surgical instrument comprising a stowed closure actuator stop
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
JP2024506078A (ja) * 2021-02-10 2024-02-08 エシコン・インコーポレイテッド 合成マトリクス及び生合成接着剤を含む二成分封止システム
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US12108951B2 (en) 2021-02-26 2024-10-08 Cilag Gmbh International Staple cartridge comprising a sensing array and a temperature control system
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11980362B2 (en) 2021-02-26 2024-05-14 Cilag Gmbh International Surgical instrument system comprising a power transfer coil
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
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
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
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
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
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US12102323B2 (en) 2021-03-24 2024-10-01 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising a floatable component
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
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
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11998201B2 (en) 2021-05-28 2024-06-04 Cilag CmbH International Stapling instrument comprising a firing lockout
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11980363B2 (en) 2021-10-18 2024-05-14 Cilag Gmbh International Row-to-row staple array variations
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
US12089841B2 (en) 2021-10-28 2024-09-17 Cilag CmbH International Staple cartridge identification systems

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5201745A (en) * 1988-03-15 1993-04-13 Imedex Visceral surgery patch

Family Cites Families (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3364200A (en) 1960-03-28 1968-01-16 Johnson & Johnson Oxidized cellulose product and method for preparing the same
US4626253A (en) 1984-10-05 1986-12-02 Johnson & Johnson Products, Inc. Surgical hemostat comprising oxidized cellulose
US5306500A (en) * 1988-11-21 1994-04-26 Collagen Corporation Method of augmenting tissue with collagen-polymer conjugates
RU2136319C1 (ru) 1993-12-23 1999-09-10 Джонсон энд Джонсон Медикал, Инк. Биоабсорбируемое хирургическое гемостатическое средство и способ его получения (варианты)
ES2420106T3 (es) * 1995-12-18 2013-08-22 Angiodevice International Gmbh Composiciones de polímeros reticulados y métodos para su uso
US5716408A (en) * 1996-05-31 1998-02-10 C.R. Bard, Inc. Prosthesis for hernia repair and soft tissue reconstruction
US6500777B1 (en) 1996-06-28 2002-12-31 Ethicon, Inc. Bioresorbable oxidized cellulose composite material for prevention of postsurgical adhesions
US7009034B2 (en) * 1996-09-23 2006-03-07 Incept, Llc Biocompatible crosslinked polymers
FR2766698B1 (fr) 1997-08-01 1999-11-05 Cogent Sarl Tissu prothetique tridimensionnel ajoure
US6410044B1 (en) * 1998-03-19 2002-06-25 Surmodics, Inc. Crosslinkable macromers
US6514534B1 (en) * 1998-08-14 2003-02-04 Incept Llc Methods for forming regional tissue adherent barriers and drug delivery systems
EP1104324B8 (en) 1998-08-14 2011-06-22 Incept Llc Apparatus for in situ formation of hydrogels
US6179862B1 (en) 1998-08-14 2001-01-30 Incept Llc Methods and apparatus for in situ formation of hydrogels
US6703047B2 (en) * 2001-02-02 2004-03-09 Incept Llc Dehydrated hydrogel precursor-based, tissue adherent compositions and methods of use
US6818018B1 (en) * 1998-08-14 2004-11-16 Incept Llc In situ polymerizable hydrogels
US7347850B2 (en) * 1998-08-14 2008-03-25 Incept Llc Adhesion barriers applicable by minimally invasive surgery and methods of use thereof
US7790192B2 (en) * 1998-08-14 2010-09-07 Accessclosure, Inc. Apparatus and methods for sealing a vascular puncture
US6152943A (en) 1998-08-14 2000-11-28 Incept Llc Methods and apparatus for intraluminal deposition of hydrogels
US6605294B2 (en) * 1998-08-14 2003-08-12 Incept Llc Methods of using in situ hydration of hydrogel articles for sealing or augmentation of tissue or vessels
CA2353642C (en) * 1998-12-04 2009-11-10 Amarpreet S. Sawhney Biocompatible crosslinked polymers
US20080114092A1 (en) * 1998-12-04 2008-05-15 Incept Llc Adhesion barriers applicable by minimally invasive surgery and methods of use thereof
GB9912240D0 (en) * 1999-05-27 1999-07-28 Smith & Nephew Implantable medical devices
FR2830434B1 (fr) 2001-10-05 2004-01-02 Sofradim Production Renfort de paroi en tricot tridimensionnel et ajoure
US20040106344A1 (en) * 2002-06-28 2004-06-03 Looney Dwayne Lee Hemostatic wound dressings containing proteinaceous polymers
WO2005018429A2 (en) * 2003-08-20 2005-03-03 Histogenics Corporation Acellular matrix implanted into an articular cartilage or osteochondral lesion protected with a biodegradable polymer modified to have extended polymerization time and methods for preparation and use thereof
US20080220047A1 (en) * 2007-03-05 2008-09-11 Sawhney Amarpreet S Low-swelling biocompatible hydrogels
US20100100123A1 (en) * 2008-10-17 2010-04-22 Confluent Surgical, Inc. Hemostatic implant
CA2740597C (en) * 2008-10-17 2017-11-21 Sofradim Production Multi-layered surgical patches comprising a first hydrogel precursor and a second hydrogel precursor
US8349354B2 (en) * 2009-09-22 2013-01-08 Ethicon, Inc. Composite layered hemostasis device

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5201745A (en) * 1988-03-15 1993-04-13 Imedex Visceral surgery patch

Also Published As

Publication number Publication date
CN101721233A (zh) 2010-06-09
ES2727816T3 (es) 2019-10-18
EP2177239A2 (en) 2010-04-21
EP2179753A2 (en) 2010-04-28
AU2009225332B2 (en) 2014-07-03
EP2179753B1 (en) 2014-12-03
JP2010094519A (ja) 2010-04-30
CA2682464C (en) 2016-11-22
JP5793279B2 (ja) 2015-10-14
EP3150237B1 (en) 2019-04-17
ES2527302T3 (es) 2015-01-22
AU2009225332A1 (en) 2010-05-06
EP2815774B1 (en) 2016-12-14
EP2815774A1 (en) 2014-12-24
EP3150237A1 (en) 2017-04-05
ES2614047T3 (es) 2017-05-29
EP2177239B1 (en) 2014-10-08
CA2682464A1 (en) 2010-04-17
EP2179753A3 (en) 2011-01-12
US20100100123A1 (en) 2010-04-22
EP2177239A3 (en) 2011-01-12

Similar Documents

Publication Publication Date Title
CN101721233B (zh) 止血植入体
US9889230B2 (en) Hemostatic implant
JP5612426B2 (ja) メッシュインプラント
AU2008288168B2 (en) Dural repair material
JP5599886B2 (ja) 生物再吸収性不貫通性層で被覆された保持織物
JP2010104791A (ja) 遅延ゲル化組成物およびその使用法
JP2011101797A (ja) 止血テープおよびそのディスペンサー
JP2011101798A (ja) 止血テープおよびそのディスペンサー
US20130103076A1 (en) Cellulose-containing medical device having a multi-layer structure produced without adhesive
CN116133701A (zh) 具有可移除中间分隔层的密封剂敷料

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
ASS Succession or assignment of patent right

Owner name: TYCO HEALTHCARE GROUP

Free format text: FORMER OWNER: CONFLUENT SUGICAL INC.

Effective date: 20120625

C41 Transfer of patent application or patent right or utility model
TA01 Transfer of patent application right

Effective date of registration: 20120625

Address after: American Connecticut

Applicant after: TYCO Healthcare

Address before: Massachusetts, USA

Applicant before: Confluent Surgical Inc.

C53 Correction of patent of invention or patent application
CB02 Change of applicant information

Address after: American Connecticut

Applicant after: Covidien LP

Address before: American Connecticut

Applicant before: TYCO Healthcare

COR Change of bibliographic data

Free format text: CORRECT: APPLICANT; FROM: TYCO HEALTHCARE TO: COVIDIEN LP COMPANY

C14 Grant of patent or utility model
GR01 Patent grant