CN102525644B - 具有触觉反馈的电外科封闭工具 - Google Patents

具有触觉反馈的电外科封闭工具 Download PDF

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CN102525644B
CN102525644B CN201110402624.2A CN201110402624A CN102525644B CN 102525644 B CN102525644 B CN 102525644B CN 201110402624 A CN201110402624 A CN 201110402624A CN 102525644 B CN102525644 B CN 102525644B
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feedback
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sense
instrument
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C·乌尔里希
A·莫达里斯
P·格雷戈里奥
C·西梅克
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00297—Means for providing haptic feedback
    • A61B2018/00303—Means for providing haptic feedback active, e.g. with a motor creating vibrations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607—Coagulation and cutting with the same instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument
    • A61B2090/3784—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument both receiver and transmitter being in the instrument or receiver being also transmitter

Abstract

公开了一种具有触觉反馈的电外科封闭工具。一种外科工具系统，包括：用于封闭和横切组织的电外科工具，以及集成在所述工具的柄部上并至少以触觉效果的形式来向用户生成相关反馈的触知反馈系统。该触知反馈系统向用户警告组织性质，即位于工具钳口内部的组织何时被完全封闭，何时就绪切割组织，切割速率或速度，位于工具钳口内部的组织量，以及血管是否完全位于工具钳口以内。此外，触知反馈会向用户警告该过程中的能量施加的工作状态。

Description

具有触觉反馈的电外科封闭工具
技术领域
本文的实施例涉及用于治疗组织的外科工具，其中与组织治疗相关联的信息被处理，并以一种或多种集成在工具柄部上的反馈模式显示给用户。
背景技术
与外科医生在病人皮肤上切割相对较大的切口以触及内部器官的开放手术相反，微创手术过程是通过产生相对较小的切口以及随后通过该切口插入工具来触及这些器官的。通常，微创手术会使住院治疗时间变短，降低治疗需求，减小疼痛，减少伤痕，以及降低复杂度。
虽然涉及较小切口的微创手术过程包含了很多优于开放手术的益处，但是微创手术仍旧可能对外科医生提出挑战。例如，外科医生通常需要依靠经由切口引入的微型相机来查看病人内部器官，以及查看工具的移动及操作如何作用于器官。相机将图像传送到视觉显示器，以便允许外科医生查看内部器官和组织，以及查看其他微创工具对器官和组织的作用。由此，外科医生能够执行腹腔镜手术、剥离、烧灼、内窥镜检查、远程手术等等。
然而，与开放手术相比，微创手术在视觉和触觉感知方面呈现诸多限制，并且产生了只有这种手术才有的挑战。同时涉及开放手术和微创手术的一个关注焦点是组织有可能受到损伤，这种损伤有可能归因于不恰当的用力或是能量/热量的过度施加。例如，电外科工具是通过用高频电流刺激组织来工作的。电流的频率控制工具的行为，这些行为可以包括封闭/凝结和/或剥离。在开放手术和微创手术中，正待封闭的组织被夹在组织封闭工具的钳口内部，并且无法被用户看到，因此直接目视在确定何时达到电外科结束点，即，何时被夹组织完全封闭的过程中是没有帮助的。外科医生往往需要依靠经验和间接目视来确定组织何时被封闭、剥离，以及何时在组织中发生其他变化。基于上述内容，需要一种改进的微创外科工具，并且尤其需要一种具有与手术过程相关的改进的反馈的微创外科工具。
附图说明
通过以下在附图中示出的关于本发明实施例的描述，将会显见本发明的前述及其他特征和优点。在这里引入并构成说明书一部分的附图进一步用于解释本发明的原理，以及允许相关领域的技术人员制造和使用本发明。此外，这些附图并非按比例绘制的。
图1是示出了根据本文的一个实施例并且包括腹腔镜外科工具和外部控制系统的外科工具系统的侧视图的图示。
图1A是图1的腹腔镜外科工具的远端的放大视图。
图2是图1的外科工具系统的框图。
图3是根据本文的一个实施例而将与组织封闭循环相关的触觉效果传递给用户的外科工具系统的框图。
图4是根据本文的一个实施例而将与切割就绪相关的触觉效果传递给用户的外科工具系统的框图。
图5是根据本文的一个实施例而将与外科工具钳口内部的组织量或厚度相关的触觉效果传递给用户的外科工具系统的框图。
图6是根据本文的一个实施例而将与外科工具钳口内部的血管感测相关的触觉效果传递给用户的外科工具系统的框图。
图7是根据本文的一个实施例而将与能量应用状态相关的触觉效果传递给用户的外科工具系统的框图。
图8是示出了根据本文的一个实施例的具有触觉和音频反馈机制的外科工具系统的侧视图的图示。
图9是示出了根据本文的另一个实施例的具有触觉、音频和视觉反馈机制的外科工具系统的侧视图的图示。
具体实施方式
现在将参考附图来描述本发明的具体实施例，其中相似的参考数字指示相同或功能相似的部件。在以下描述中，术语“远侧”和“近侧”是相对于与执行治疗的临床医生的位置或方向来使用的。“远侧的”或“远侧地”指的是远离临床医生的位置或是处于离开临床医生的方向。“近侧的”和“近侧地”则指的是靠近临床医生的位置或是朝向临床医生的方向。
以下详细描述本质上只是说明性的，其目的并不是为了限制本发明或是本发明的应用和用途。此外，在先前的技术领域、背景技术、发明内容或是后续的详细描述中给出的任何明示或默示的理论都没有限制意义。
本发明的实施例涉及一种外科工具系统101，该系统包括：用于封闭和横切组织的腹腔镜外科工具100，用于向工具100提供电外科能量的控制系统112，以及整合在工具100中并且至少以触觉效果的形式来向用户产生相关反馈的触知反馈系统120。正如在本文将更详细解释的，反馈系统120提供的触知反馈会向工具用户告知组织性质，例如但不局限于位于工具100的钳口内部的组织何时已被完全封闭，何时就绪切割组织，切割速率或速度，位于工具100的钳口内部的组织的量，以及血管是否位于工具100的钳口内部。此外，如这里更详细说明的，反馈系统120提供的触知反馈可以向用户供应与工具100的工作状态相关的信息，例如但不局限于是否存在能量施加。
图1、1A和2示出的是包含了外科工具或设备100以及控制系统112的例示外科工具系统101的实施例。在一个实施例中，外科工具100是腹腔镜工具，它被配置成通过套针或其他微创进入口而插入。在另一个实施例(未显示)中，外科工具100是一个适于开放的医疗组织封闭过程的外科设备。外科工具100包括柄部102、杆部104以及具有钳口构件108、109的远侧部分106。钳口构件108、109分别包括相对表面108A、109A，这些相对表面被布置成彼此接近，并且夹紧或抓紧其间的组织。钳口构件108、109分别包括在其内形成的通道(在图1中并未显示)，以便接收通过钳口构件108、109前进的可部署切割部件119。单纯出于例证目的，在图1中将切割部件119显示成了部分部署在开放的钳口构件108、109的内部。本领域普通技术人员将会了解，在操作过程中，只有在钳口构件108、109彼此接近并且夹住其内的组织时，切割部件119才会被推进/部署。杆部104被设计成将柄部102连接到远侧部分106，以及将柄部102的机械和电行为传递到远侧部分106。更具体地，柄部102的操作会通过从柄部102延伸到远侧部分106的内部机械连接器(未显示)，以便打开和闭合钳口构件108、109。根据其中工具100是腹腔镜工具的图1实施例的一些示例，杆部104的长度可以是大约20cm到30cm，并且远侧部分106的长度可以是大约10mm到15mm。此外，杆部104的直径通常是5mm，但是通常也会使用直径为3mm、10mm和12mm的工具。通过操纵杆部102，操作者可以将远侧部分106插入病人腹部，并且控制钳口构件108、109。在一个实施例中，柄部102可以包括用于将钳口构件108、109旋入抓紧和夹住组织的位置的可旋转旋钮103。在将组织定位在钳口构件之间之后，钳口构件108、109将会彼此接近，以便将组织夹在其间，并且电外科能量将会借助控制系统112而被应用于封闭所述被夹住的组织。在被夹住的组织发生凝结之后，可以推进切割部件119来切割夹住的组织。在一个实施例中，柄部102可以包括用于推进切割构件119的可部署触发器121，以及借以应用电外科能量的可选通断开关123。例如，外科工具100可以是由Endo-Surgery，Inc开发的ENSEAL TRIO设备或是其他适合封闭和横切组织的腹腔镜工具。
更具体地，为了封闭夹住的组织，钳口构件108、109分别在表面108A、109A的一部分上包含了双极性电极110、111。在一个实施例中，电极110、111彼此偏离，以使得既便在组织很薄的情况下也不会接触。控制系统112向电极110、111提供电外科能量，以便封闭或凝结位于钳口构件108、109之间的组织。在一个实施例中，电极110、111是射频(RF)电极，控制系统112包括射频(RF)发生器，并且电极110、111将RF能量从控制系统112应用到组织。然而，本领域普通技术人员应该理解，控制系统112可以产生用于加热或切除组织的其他类型的能量，其中包括电能、超声波能量、冷冻消融能量等等，并且在每一种情况中，电极110、111都是应用该类型的能量的适当的相应组件。更进一步，在与替换类型的能量一起使用时，控制系统112可以监测适当的组织、系统和/或操作属性，以便指示治疗过程何时结束。
如所示，外科工具100是双极性工具，并且在控制系统112、电极110和111以及在电极110与111之间延伸的组织之间形成了完整的电路。然而，对本领域普通技术人员来说显见的是，外科工具100可以是包含了处于该工具的远侧部分的一个或多个电极以及位于病人体外的位置可调的参考电极(即皮肤贴片电极或接地板)的单极性工具。在单极性实施例中，电流和/或电压从控制系统112通过该工具远侧部分的电极流到病人外部的接地板或参考电极。如果多个电极位于该工具的远侧部分，那么相同的电流和/或电压将会流经每一个电极并进入病人体外的接地板或参考电极。
电极110、111分别经由两条导电引线113、115连接到控制系统112，其中所述引线是通过杆部的至少一个内腔(未显示)延伸的。电极110、111可以通过任何适当的手段固定附着于两个导电引线的远端。例如，这些电极可以借助焊接、焊锡、通过使用导电粘合剂、通过在其间添加连接部件或是通过别的机械方法来附着。虽然被显示成具有通过杆部104延伸的两条引线113、115，但是本领域普通技术人员应该理解，这两条引线仅仅是在工具100的远侧部分106整合双极性电极的工具所必需的。与此相反，在单极性工具中只需要一条引线通过杆部104延伸，以便将控制系统112连接到一个或多个电极，而外部引线或接地线则连接到病人外部的接地板或参考电极。
图2是进一步示出了外科工具系统101的主要组件之间的关系的外科工具系统101的框图。控制系统112提供电力以允许工具100执行组织封闭过程，并且与工具100的远端106以及工具100的柄部102进行通信以向用户提供触觉效果。更具体地，控制系统112包括电源114，用于接收来自工具100的一个或多个传感器140的测量值的处理器116(将在本文中更详细描述)，以及被配置成将来自处理器116的传感器信息处理成触知反馈信号或命令的控制器或触知映射逻辑118。在一个实施例中，电源114、处理器116以及触知映射逻辑118合并成一个整体外部组件，该组件与外科工具100分离并且经由内部或外部导线电连接到电极110、111以及触觉反馈系统120。换句话说，控制系统112的所有组件全都可以处于同一外部设备单元内。然而在另一个实施例中，电源114、处理器116和/或触知映射逻辑118可以是电连接在一起的分离的外部组件。在再一个实施例中，电源114、处理器116以及触知映射逻辑118中的一个或多个可以安装在外科工具100的柄部102之内或其上，并且仅仅经由内部导线电连接到电极110、111以及触觉反馈系统120。
电源114产生具有足以封闭/凝结组织的适当功率水平和频率的交流电。在一个实施例中，电源116可以是由俄亥俄州Cincinnati，的Ethicon或是由马萨诸塞州Mansfield的Covidien制造的RF电源发生器，这两者都能提供最大输出介于50W-200W之间的高输出功率。例如，电源116可以产生用于凝结的大约处于450kHz的100W，虽然在该过程中，频率及其功率是可变的，从而虑及组织特异性等等。如上所述，引线113、115电连接电源114和RF电极110、111，以便为后者供应RF电力。
如将在本文更详细解释的，一个或多个传感器140可以根据期望的触觉效果而包括阻抗传感器、力传感器、位移传感器和/或压力传感器中的一种或多种。处理器116经由一条或多条引线或其他传输介质(未显示)电连接到传感器140。在工具的操作过程中，处理器116接收来自一个或多个传感器140的数据或测量值，并且根据需要来相应处理或分析传感器数据/测量值，以便向触知映射逻辑118提供正确类型的输入。处理器116可以包括逻辑资源，例如微处理器，并且还可以包括其他那些为分析和存储来自一个或多个传感器140的数据/测量值所必需的依赖于传感器的特定组件。
处理器116将源于工具100的一个或多个传感器的信息输出到触知映射逻辑118，所述逻辑则根据特定算法和操作者选择来进一步处理该信息。更具体地说，触知映射逻辑118被配置成将源于一个或多个工具传感器的感测到/计算得出的值映射到触知反馈信号或命令上。映射可以包括函数或查找表，或者可以包括更复杂的算法，如有需要也可以包括有限状态机。触知映射逻辑118确定响应于感测到/计算得到的值来产生什么样的触觉效果以及以何种顺序来产生这些效果。该触知映射逻辑118可以是通用或专用处理设备或微控制器。在一个实施例中，触知映射逻辑118可以与用于存储数据和/或指令的存储器设备(未显示)相关联。存储器设备可以是任何类型的存储设备或计算机可读介质，例如随机存取存储器(“RAM”)或只读存储器(“ROM”)。存储器设备存储的是由触知映射逻辑118执行的逻辑指令、命令和/或代码。该存储器设备还可以位于控制系统112内部或是内部与外部存储器的任何组合。在另一个实施例中，逻辑指令、命令和/或代码可以在硬件中实现，并且可以通过使用离散逻辑电路、专用集成电路(“ASIC”)、可编程门阵列(“PGA”)、现场可编程门阵列(“FPGA”)等等或是其任何组合而被并入触知映射逻辑118。在再一个实施例中，逻辑指令、命令和/或代码可以同时以触知映射逻辑118中的硬件以及存储器保存的软件/固件实现。虽然与处理器116是分开描述的，但是本领域普通技术人员应该理解，这种功能描述只是说明性的，并且同一个设备是可以作为处理器116和触知映射逻辑118使用的。
触知映射逻辑118向耦合到工具100的柄部102的触觉反馈系统120输出控制信号，以便在执行过程时向操作者提供反馈信息。所述控制信号则是经由将触知映射逻辑118电连接到触觉反馈系统120的第三引线或系绳117(参见图1)来传递的。此外，在控制系统112与柄部102之间还有可能提供第四引线(未显示)，以便为在本文将更详细描述的处于柄部102内部的低电压执行器电路提供隔离接地线。
触觉反馈系统120包括至少一个执行器驱动电路122(如图2所示)，该电路耦合到触觉执行器124(如图2所示)，以便向操作者提供触觉反馈。为了向操作者提供触觉反馈，触觉反馈系统120电连接到控制系统112。在一个实施例中，为了将命令从触知映射逻辑118传递到触觉执行器124，控制系统112沿着引线或系绳117向工具100的柄部102提供马达电压。如在本文将更详细解释的，触觉执行器124可以包括但不局限于一个或多个振动触知或者动觉执行器，这些执行器使用任何适当仪器化来提供期望的触觉效果，所使用的仪器例如但不局限于与工具100耦合的摩擦制动器或是动态马达。由此，触知映射逻辑118将控制信号输出到包含了用于为触觉执行器124供应所需电流和电压的电子组件和电路的驱动电路122，以便产生期望的触觉效果。如上所述，还可在控制系统112与手柄102之间提供第四引线(未显示)，以便为柄部102中的驱动电路122提供隔离接地线，由此触知映射逻辑118经由具有两条导线的隔离DC电压线路来与触觉反馈系统120进行通信。
触觉反馈可被产生并提供给用户，这其中包括振动触知，动觉，手柄变形和/或其他类型的触知反馈，例如纹理和热度。触觉执行器124可以包括电磁马达、通过马达来移动偏心质量的偏心旋转质量(“ERM”)执行器、附着于弹簧的质量被来回驱动的线性共振执行器(“LRA”)、记形合金、响应于信号而变形的电活性聚合物、用于改变刚性的机构、振动触知执行器、惯量执行器、压电致动器或其他适当类型的执行设备。在一个实施例中，触觉执行器124可以作为惯量执行器来实现，以便向操作者提供振动触知反馈。在另一个实施例中，举例来说，动觉触觉反馈可以使用改变柄部102的刚度/阻尼的螺线管，改变柄部102大小的小型空气袋，或是形变材料。关于适合在这里使用的驱动电路和触觉执行器的详细描述可以在2007年9月28日提交的美国专利申请11/862,639(律师案卷号IMM274)中找到，其中该申请在这里全部引入作为参考。
在一个实施例中，触觉执行器124是在柄部102产生用于触觉反馈的振动的振动触知设备。例如，在一个实施例中，可以将一个或多个振动触知执行器并入柄部102内与外科医生手部的手指和大拇指相对应的若干个位置，以便在整个柄部提供高带宽振动触知反馈。如果在谐振时具有介于4-5G的目标加速度，以及具有100-250Hz且大于2.5G的响应，那么将会是非常理想的。在一个实施例中，所有与触觉执行器124的执行相关的移动质量成分全都处于工具100内部。
在另一个实施例中，触觉执行器124是诸如摩擦制动器或启用可变电阻的马达之类的用于触觉反馈的动觉设备，以便在柄部102上移动、锁定和制动显示。例如，在一个实施例中，用于切割部件118的触发器121可以配备有动觉执行装置，以便能够实现动觉触觉效果。此外，可以将一个或多个动觉执行器并入柄部102内与外科医生手部的手指和大拇指相对应的若干个位置处，以便在柄部的整个握紧部分提供运动阻力。动觉执行器至少必须能够明显阻碍运动。例如，在一个实施例中，动觉执行器可以具有介于最大作用力20％与30％之间的阻力，以便显示有效的障碍力度。在另一个实施例中，动觉执行器能够阻止所有的用户运动，以便传递“封锁”模式。
如先前所述，一个或多个工具传感器的类型以及处理器116的操作取决于期望的触觉效果。在一个实施例中，传感器是阻抗传感器并且处理器持续测量夹在工具100的钳口108、109之间的组织的阻抗，以便提供组织封闭循环或治疗何时结束的指示。特别地，电外科能量目的是封闭处于治疗位置的细胞，同时保持组织的基本结构完好无损。由于用户不应该在充分封闭之前切割组织，因此，用户有必要知道封闭循环何时结束。虽然某些封闭工具包括在被假设成是封闭循环结尾的预定时间量结束时的预定音频警报(即，十五秒)，但是该音频警报很容易与其他音频警报相混淆，并且在嘈杂的手术室环境中未必会被听到。此外，单独使用时间并不能很好地指示封闭质量。实时阻抗测量则可允许用户估计凝结治疗的完成状态，即组织封闭程度。已封闭的组织将会阻碍电信号，这一点可以通过同时监测组织的阻抗而被精确指示。相应的，通过监测阻抗，可以指示封闭处理何时完成，以及何时可以向工具的柄部提供触觉效果，以便警告用户封闭循环已经完成。
更具体地，如图3所示，外科工具300包括一对能够测量组织阻抗的辅助电极340A和340B，并且控制系统包括封闭循环处理器316。电极340A、340B可以分别位于钳口构件108、109上的相邻电极110、111的相对表面108A、109A。电极340A经由引线(未显示)电连接到电源114，并且电极340B经由引线(未显示)电连接到封闭循环处理器316。电源114和封闭循环处理器316通过一起工作来连续实时地测量目标组织阻抗。电源114能够产生范围在1kHz到500kHz或是为生物阻抗测定领域中的技术人员所知的其他适当频率的无害交流电，以便允许测量阻抗。例如，所使用的可以是处于50KHz且大小为2微安的电流。在电流流动时，封闭循环处理器316将会测量电极340A、340B之间的相应电阻。然后，封闭循环处理器316用算术方法将电阻转换成阻抗测量值。为了测量阻抗，封闭循环处理器316可以包括逻辑资源，例如微处理器、电压电流转换电路、放大电路、A/D转换电路以及阻抗算术运算部分。为了确定适当的组织封闭，封闭循环处理器316可以记录和/或计算不同的参数，这其中包括电流、电压、功率、阻抗以及这些参数的变化率。虽然在这里是作为经由一对辅助电极340A、340B来测量阻抗而描述的，但是本领域普通技术人员将会理解，工具100的配置可被调整成交替地在电极110、111之间监测阻抗，由此消除对于辅助电极对的需要。
当阻抗或是其他被测量/计算的一个或多个系统参数表明组织封闭完成时，触知反馈系统120会向用户提供触觉效果。组织封闭循环的完成必须指示给用户，以便允许用户继续进行手术。在一个实施例中，触觉效果可以是表明组织封闭循环完成的单个触觉警报，例如振动触知警告。在另一个实施例中，在组织阻抗接近于组织封闭循环结束时，触觉效果可以包括基于现场阻抗值的连续反馈，例如在柄部102的触发器121上具有一系列递增振幅的振动触知反馈和/或动觉障碍或抗力。本领域普通技术人员应该理解，触觉效果可以包括警报以及连续反馈两者，并且可以包括振动触知和动觉效果两者。
对处于治疗部位或其附近的阻抗进行监测以及确定治疗完成度的处理可以依照任何判据来确定。例如，适当的组织封闭可以借助于检测电阻抗的具体值(即，假设组织在阻抗达到450欧的时候封闭)或是借助于检测在期望时段或是规定数量的连续阻抗测量值上相对恒定的一系列阻抗测量值来确定。在一个实施例中，完成的组织封闭可以与10欧的阻抗变化相关联。通过使用查找或功能表，可以将感测到/计算得到的阻抗值映射到触知反馈信号或命令上，以便在组织封闭时向外科医生提供逐渐增大的反馈。其他查找功能同样是可行的，并且是可供用户选择的。在另一个实施例中，完成的组织封闭可以是不同观察参量的函数，例如阻抗、阻抗变化、电流、电压、功率等等，或者可以是从组织模型的输出映射而来的。
在一个实施例中，为了封闭组织而施加的能量将会持续预定时段，其中该预定时段被假设成是封闭循环的结束。例如，能量可以在大小为15秒的封闭循环中施加。如果阻抗信息并未指示完成封闭，那么可以在该预定时段结束时提供一个负价的振动触知警报，而如果阻抗信息表明完成封闭，则可以在该预定时段结束时提供一个正价的振动触知警报。相应地，用户可以在决定是否需要将附加封闭循环应用于目标部位来完全封闭组织时使用触觉警报。
在再一个实施例中，触觉映射逻辑118可以向电源114输出命令信号。例如，当组织的阻抗表明完成组织封闭时，触觉映射逻辑118可以输出一个命令信号来关闭电源114，由此防止向组织传递附加能量以及控制工具100的行为。
在图4所示的另一个实施例中，阻抗测量值可被用于提供与切割就绪状态和/或速率相关的反馈。腹腔镜封闭工具可以依靠操作者来控制切割部件在封闭处理过程中的推进。除了执行剥离之外，由于刀刃的推进将会控制施加于夹在工具钳口之间的组织上的压力，因此，切割部件119还在该过程的封闭处理部分起着重要的作用。在实现完全封闭的过程中，特别是对较厚的组织和/或血管而言，足够的压力是至关重要的。因此，用户经常希望推进切割部件至紧邻组织的位置，以便达到用于封闭组织的最大压力，而且还希望暂缓推进切割部件至组织中，直至其被充分封闭。切割就绪状态处理器416执行阻抗或其他电参数计算，这些计算可以用于向用户提供与进行切割的组织就绪以及切割的恰当速率或速度有关的指导。为了确保充分组织封闭，限制或控制切割部件的推进是非常重要的，由此，关于恰当的切割速度的反馈是有用的。如图4所示，在该实施例中，工具400包括：一对用于监测阻抗的辅助电极340A和340B，能够测量切割部件119的位移的位移传感器440，以及切割就绪状态处理器416。位移传感器440与切割部件119耦合，以便提供关于切割部件119的位置的信息，并且电极340A、340B以及位移传感器440全都经由一条或多条引线(未显示)电连接到切割-就绪状态处理器416。钳口位移可由位于钳口构件铰链上的电位器或其他适当的位置编码器来测量的。位移传感器440持续监测切割部件119的位置，以便向处理器416提供与切割部件119何时紧邻该组织而使其进一步推进会导致组织切割相关的信息，即，切割部件119何时处于切割位置的信息。切割就绪状态处理器416还持续接收来自电极340A、340B的阻抗测量值，并且如上文中对照处理器316描述的来计算阻抗。
基于来自传感器440的位移测量值以及来自电极340A、340B的阻抗测量值，可以将切割就绪状态和/或切割速度反馈提供给用户。切割反馈可以用不同的模式提供，例如训练模式和经验模式，由此适应对工具具有不同经验程度的用户的需要。在训练模式中，触觉效果可以包括基于现场阻抗值在柄部102的触发器121上的连续主动阻力反馈，以便防止过早和/或过快的切割。例如，在来自位移传感器440的测量值表明切割部件119处于切割位置时，在阻抗值小于100欧姆的过程中将会提供最大阻力，并且在会为大于450欧姆的阻抗值提供零阻力。在阻抗值介于100与450欧姆的过程中，触发器121上的阻力会以一种连续或步进的方式从最大值逐渐降低至零。在经验模式中，如果来自位移传感器440的测量值表明切割部件119处于切割位置，并且阻抗小于450欧姆，那么在该行程(stroke)的切割部分开始时，触觉效果可以包括在柄部102的触发器121上进行的相对较小的制动。此外，经验模式可以包括具有用于100与450欧姆之间的阻抗值的一系列振幅递增且连续的振动触知反馈。在另一个实施例中，制动振幅是组织阻抗的函数，由此，当组织处于低阻抗状态时，呈现出粗糙纹理或阻碍序列，并且它们其会随着组织阻抗的增大而逐渐减小。该反馈可以采用时间连续的方式显现，或者只在切割部件运动期间显现。
除了与切割就绪状态和/或切割速率相关的触觉效果之外，在切割过程中还可以提供与被切割的组织类型相关的触觉反馈。例如，在触发器121和/或柄部102上与外科医生手部的手指或大拇指相对应的若干个位置可以提供被动的动觉阻力。在切割部件119的运动过程中，动觉阻力可以是感测到的组织性质的函数。例如，动觉阻力可以依照被切割组织的硬度改变，其中所述硬度可以借助处于工具远侧尖端的应变仪或是其他适当传感器感测。关于监测硬度之类的组织性质的处理以及提供与之相关的触觉效果的处理的更详细描述可以在2007年12月13日提交的美国专利申请11/955,563(律师案卷号IMM273)中找到，其中该申请在这里全部引入作为参考。
在图5中示出的另一个实施例中，触知反馈系统120向工具用户告知位于工具100钳口内部的组织的量，以便告知用户是否封闭了过多组织。封闭工具通常是为最大组织和/或血管厚度设定的，并且应当在夹在钳口构件108、109内部的组织量超出该限度的情况下向用户发出警报。此外，钳口中的组织量还会影响封闭质量。工具500至少包括耦合至工具500的柄部102的力传感器540A，以及处于控制系统中的组织量处理器516。所述力传感器可以是能够测量用户为了封闭工具500的抓紧器柄部所施加的力的任何类型的力传感器，例如箔式应变计、压力应变仪、力感测电阻器、压力传感器或其他适当的传感器。可以用于力传感器540A的例示产品包括Tekscan力传感电阻器以及Omega箔式应变计。工具500还可以包括耦合至工具远端以监测钳口构件之间间隔的位移传感器540B。钳口位移可以借助位于钳口构件铰链或工具杆部的电位器或其他适当的位置编码器来测量。由于钳口部件接近闭合时的高位力信号没有钳口构件刚开始关闭时的高位力信号那么显著，因此可以使用位移传感器540B来补充来自力传感器540A的信号。由此，在一个实施例中，力传感器540A和位移传感器540B将会结合使用，以便确定何时会有超量的组织位于钳口构件以内。组织量处理器516持续监测从力传感器540A和位移传感器540B接收的力的测量值(如果有的话)，并且从所述力的测量值中计算/估计位于工具500的钳口内部的组织的量。在一个实施例中，关于组织厚度的最佳指示符乃至由组织量处理器516监测的参数是与钳口间隙位移相对的力的变化率。此外，在一个实施例中，用户可以将力的状态(即高、中、低)输入图形用户界面，以使得处理器516执行的计算与被所述工具抓紧的组织的等级/类型是相符的。
基于来自传感器540的力的测量值，可以向用户提供组织量/厚度反馈。触觉反馈将会通过若干阈值作为力测量值而被提供给用户。例如，为了警告用户在钳口中有可能存在过多的组织，该反馈可以包括通过阈值作为力测量值且振幅递增的振动触知警报，和/或柄部102的抓紧器上的通过阈值作为力测量值且幅度递增的动觉反馈。在另一个实施例中，如果设备内部的组织量超出设备规定范围，那么可以给出负价的振动触知警报，如果处于设备内部的组织量处于设备规定范围以内，则可以给出正价振动触知警报。此外、触觉反馈可以采用不同模式提供，例如训练模式和经验模式，以便适应那些对工具具有不同经验程度的用户的需要。在训练或初学者模式中，当所述力超出当前最大值(即4500mNm)时，触觉效果可以包括用于防止切割组织的动觉锁定触发器121，和/或用于防止用户夹紧组织的柄部102的抓紧器。此外，脉冲发生的振动触知警报或错误可被传递给用户。在经验模式中，当所述力超出当前最大力(即4500mNm)时，如果用户开始切割，那么触觉效果可以包括负价振动触知警报和/或触发器121上的高幅动觉障碍。
在再一个实施例中，触知反馈系统120向工具用户告知外科工具钳口内部的血管组织的定向。如果血管结构超出钳口内部的阈值直径，那么将会向用户发出通知，并且更重要的是，如果血管组织尚未完全处于钳口内部或者没有在钳口中被良好定向时，那么将会向用户发出通知。工具600包括与工具远端106耦合的一个或多个压力传感器640A和一个或多个位移传感器640B，以及处于控制系统内部的血管感测处理器616。钳口位移可以借助位于钳口构件铰链上的电位器或是其他适当的位置编码器来被测量。压力感测是用诸如通过压力分布系统产生的电容性压力传感器阵列而被最有效地实现的。在一个实施例中，微传感器阵列耦合至工具远端106，以便感测钳口构件的压力和位移。血管感测处理器616持续监测分别从传感器640A、640B接收的压力和位移测量值，并且通过解释压力/脉动数据来确定血管是否延伸并超出设备的远侧尖端。对于使用适合在这里使用的微创工具来检测血管的可能适合的传感器和方法来说，与之相关的详细描述可以在以下专利申请中找到：2009年1月15日提交的美国专利公开2010/0179423；2008年12月3日提交的美国专利公开2010/0137845；2008年12月12日提交的美国专利公开2010/0152586；2009年1月15日提交的美国专利公开2010/0179587，其中每一份专利公开都在这里引入作为参考。用于血管感测的触觉反馈可以同时包括振动触知和动觉效果。例如，为了警告用户血管仅仅部分处于工具600的内部，触觉效果可以包括用于防止切割组织的动觉锁定触发器121，和/或用于防止用户夹紧组织或是啮合切割构件的柄部102的抓紧器。此外，脉冲发生的振动触知警报或错误也可被传递给用户。
在另一个实施例中，压力传感器640A、位移传感器640B和血管感测处理器616还可以用于警告工具用户封闭处理是否成功封闭了位于外科工具钳口内部的组织。由于用户在充分封闭之前不应该将夹住的组织从外科工具的钳口中释放，因此，用户必须知道组织是否已通过电外科处理封闭。通过检测充分封闭，可以防止灾难性出血，这种情况有可能会在没有夹住足够多的需封闭血管的情况下发生。更具体地，在释放夹住的组织之前，血管感测处理器616可以使用来自一个或多个压力传感器640A以及一个或多个位移传感器640B的测量值信号来确定所述封闭两侧是否仍旧存在血管脉动，即，显著内腔(patent lumen)。如果在完成电外科处理之后组织被封闭，那么不会有血流/脉动通过血管。用于封闭完成度的触觉反馈可以同时包括振动触知和动觉效果。例如，为了警告用户组织尚未完全封闭，触觉效果可以包括触发器121上防止切割组织的动觉封锁或高幅障碍。在另一个实施例中，如果组织尚未完全封闭，那么可以给出负价的振动触知警报。
触觉反馈可以为用户提供帮助的另一领域包括控制系统112和/或工具100的不同工作状况。在图7所示的外科工具700的另一个实施例中，触知反馈系统120向用户提供与电源114的工作状态相关的信息，即，指示何时通过该工具来施加电外科能量。当在封闭工具上激活电外科能量时，需要与这里描述的封闭工具一起使用的发生器来提供至少一个音频警报。然而在嘈杂的手术室环境中，音频指示未必会被清楚传达给用户。在这个实施例中，用于施加电外科能量的开关123将被仪器化，以便允许能量状态处理器716监测其工作状态。当启用能量并且开关123处于“接通”位置时，用户将会感受到触觉效果，例如细微的变压器类型的震动杂声或感觉，以便指示在工具700中存在能量流。此外，在启用能量时，用户可以感觉到动觉机械制动.如果在切割过程中能量停止，那么可以向用户传递脉冲发生的振动触知警报或错误。此外，振动触知警报可以与发生器提供的音频警报一起使用，并且在趋近和/或达到诸如15秒的预定时间量时，可以使用具有更高振幅和频率的不同的振动触知警报。该预定时间量可以对应于完成组织封闭处理所需要的平均或估计时间。
上述实施例涉及的是可被监测并以触觉效果形式传达给用户的不同状况。虽然用于阻抗监测、切割就绪状态、组织量、血管感测和能量状态的触觉效果在这里是各自分开描述的，但是本领域普通技术人员应该理解，外科封闭工具可以引入上述实施例的任何组合。特别地，触觉反馈可以包括采用了空间触觉纹理或组合的动觉振动触知刺激的形式的信号组合。此外，包括一个或多个上述实施例的外科封闭工具的单个处理器可以被配置成接收来自不同传感器设备的输入/测量值，以及对其执行所需要的任务或计算。
如这里所述，脉冲发生的振动触知警报或错误可以在不同的状况中使用，以指示工具100的不恰当使用。该振动触知错误警报可以用于确保符合关于使用工具100的所有恰当指令，这其中包括这里描述的感测到的不恰当使用，或是其他可编程的不恰当使用，例如时段或步骤顺序。在一个实施例中，振动触知误差触觉效果可以对于所有的错误状态是相同的，但是也可以包括改进的触觉、听觉或视觉效果，这些效果会向用户提供关于特定错误状态的信息。这些改进的效果可以包括具有用户可辨认包络的附加触觉脉冲，以便指示不同的状况。作为替换，差错效果可以取决于状况的严重性采用不同的时间间隔显现。在另一个实施例中，正价或负价警报可以是在发生了警报状况之后的固定持续时间中执行的，在一些情况中，当手术刀返回其静止位置时，它有可能会继续该时间。
举个例子，参考图8，该图显示的是为操作者引入了两种反馈类型或模式的实施例。特别地，触觉反馈系统820同时经由触觉执行器124和音频设备或扬声器826提供触觉和音频反馈。根据启用这些反馈机制中的哪一个以及如何对其进行控制来提供其各自的输出，触知映射逻辑118将经过处理的信息传递到触觉执行器124和音频设备826中的一个或多个。在一个实施例中，反馈可以是在操作者执行手术时被连续提供给操作者的。在另一个实施例中，反馈可以是在满足特定状况而向操作者发出警报以进行通知或警告时提供给操作者的。更进一步，一种反馈(即，触觉或音频)可以是连续提供的，而另一种反馈则是作为警报提供的。此外，触觉反馈警报可以是递增的连续触觉反馈。在一个实施例中，无害的听觉反馈可以用于指示正常操作，触知/触觉反馈则可被用作警报或警告，以向用户指示何时存在特定状况或状态，并且听觉和/或视觉反馈(例如蜂鸣声和闪光)可以用作警报来向用户指示何时存在严重的状况或状态。
参考图9，该图显示的是为操作者引入了三种反馈类型或模式的实施例。特别地，触觉反馈系统920分别借助触觉执行器124、音频设备或者扬声器826、以及视觉显示器928提供触觉、音频和视觉反馈。根据启用了这些反馈机制中的哪一个以及如何对其进行控制来提供其各自的输出，触知映射逻辑118将经过处理的信息传递到触觉执行器124，音频设备826、视觉显示器928中的一个或多个。在这个实施例中，视觉显示器928是处于柄部102背部区域上的液晶显示器(LCD)屏幕。在另一个实施例中，视觉显示器928可以并入腹腔镜的摄像监测器显示器，以使视觉反馈始终处于用户的视线以内。视觉显示器928可被用于显示RF电源114的阻抗信息和/或工作状态。在一个实施例中，超声换能器(未显示)可以耦合到工具100的远侧部分106，并且视觉显示器928可以被配置成显示超声图像信息，以便帮助外科医生根据需要来定位工具。视觉显示器928可以包括触摸屏，它可以被配置成向操作者呈现信息，并且还可以被配置成感测操作者何时按下触摸屏的特定部分。这样一来，触摸屏可以充当具有图形表示能力的可触摸用户界面。视觉显示器928可以包括图形用户设备，该设备允许外科医生选择不同的反馈简档，调节传感器行为，修改补充信息等等。
根据图9的实施例，外科工具900的柄部902还可以包括一个或多个按钮932。按钮932可以被配置成使用任何适当的机制来允许操作者控制提供给所述操作者的反馈的特性。按钮932可以包括允许调节某些等级、强度或幅度或是允许对向操作者呈现的输出进行某些选择的设备。在一些实施例中，按钮932可以被配置成开关，例如瞬时拨动开关，由此允许操作者选择将传感器信息映射或提供至各输出设备的不同方式。按钮932可以作为摇臂开关或是作为一维控制表面而实现。根据按钮932的一种功能，通过控制是否基于感测信号来将输出信号提供给各输出设备，操作者可以启用或禁用一个或多个输出机构。按钮932的另一种功能包括启用一个或多个输出机构的能力。关于这一点，操作者可以控制是否以及如何以视觉、听觉和/或触觉方式来呈现反馈。如果反馈适合的是外科医生的偏好，那么该工具可以提供反馈来补充操作者的经验，以便实现更好的操作和性能。
本领域普通技术人员将会显见的是，本文的实施例涉及的是可以由操作者操作的任何类型的工具。更具体地，在本公开中描述的工具包括以机械方式控制工具远侧部分的柄部。根据本文的一个实施例，位于外科工具上的一个或多个传感器以及触觉反馈系统可以一起发挥作用，以便提取与工具的工作状态相关的相关信息，所述信息随后将会作为触觉、音频和/或视觉反馈传递给操作者。虽然所公开的实施例是用于腹腔镜手术的，但是其他实施例可以用于非腹腔镜手术，例如用在脉管或其他的导管插入术中，其中从工具尖端的传感器检测到的信息可以被回传到导管柄部。更进一步，对于内窥镜检查过程来说，从柔性内窥镜上的传感器检测到的信息可以被回传到内窥镜柄部。举例来说，其他实施例也可用于远距手术或远程呈现，以便执行例行的外部检查和/或由远程医生使用开放外科工具。另一个实施例是将这类反馈包括在机器人外科系统中，例如Intuitive Surgical，Inc的da外科系统，以使操作者能够具有直接的触知反馈。
虽然在上文中根据本发明已经描述了不同实施例，但是应该理解，这些实施例仅仅是作为例证和示例而不是作为限制给出的。相关领域的技术人员将会显见的是，可在其中进行各种形式和细节方面的变化而不脱离本发明的精神和范围。由此，本发明的广度和范围不应该受上述任一例示实施例的限制，而应该仅根据所附权利要求及其等效方案限定。此外还应该理解，在这里论述以及在这里引用的每一个实施例的每一个特征都可以与其他任何实施例的特征结合使用。这里论述的所有专利和公开都被全文引入以作为参考。

Claims (9)

1.一种外科工具系统，包括：
被配置成封闭组织的电外科工具，该工具包括远侧部分，该远侧部分包括经由杆部与柄部相连的组织封闭机构；
与所述电外科工具耦合的传感器，其中该传感器被配置成监测组织性质；
与传感器电连接的控制系统，其中该控制系统从接收自传感器的信号计算传感器信息，并且将传感器信息处理成信号命令；
包括一个或多个触觉执行器的与柄部耦合且与控制系统电连接的反馈系统，其中所述控制系统将信号命令传递到反馈系统，并且反馈系统使用信号命令来向柄部产生与传感器信息相关的触觉反馈；
处于工具的远侧部分的可部署切割部件以及与切割部件耦合的位移传感器，其中反馈系统产生的触觉反馈还向用户告知通过切割部件来切割组织是否就绪或是切割部件的切割速度；以及
与可部署的切割部件耦合的触发器，其中一个或多个触觉执行器包括与触发器耦合的动觉执行器，以使得能够向运动施加可变阻力作为触觉反馈。
2.根据权利要求1所述的外科工具系统，其中传感器被配置成监测电组织性质，并且反馈系统产生的触觉反馈向用户告知组织已被完全封闭。
3.根据权利要求2所述的外科工具系统，其中传感器是与电外科工具的远侧部分耦合的阻抗传感器。
4.根据权利要求1所述的外科工具系统，其中传感器包括：与柄部耦合的第一力传感器，以及与耦合至工具的远侧部分的两个相对的钳口构件相耦合的第二位移传感器，并且反馈系统产生的触觉反馈向用户告知位于与工具的远侧部分相耦合的两个相对钳口构件内的组织的厚度。
5.根据权利要求1所述的外科工具系统，其中组织是血管，并且其中传感器耦合到工具的远侧部分，并且从压力传感器和位移传感器中选出，以及反馈系统产生的触觉反馈向用户告知血管仅仅部分位于与工具的远侧部分耦合的两个相对钳口构件内。
6.根据权利要求1所述的外科工具系统，其中反馈系统被配置成产生还向用户告知与电外科工具电耦合的电源的工作状态的触觉反馈。
7.根据权利要求1所述的外科工具系统，其中反馈系统被配置成产生至少包括振动或动觉反馈的触觉反馈。
8.根据权利要求1所述的外科工具系统，其中传感器耦合至工具的远侧部分，并且是从压力传感器和位移传感器中选出的，以及其中反馈系统被配置成产生通过检测到不存在通过血管的脉搏来向用户告知组织已被完全封闭的触觉反馈。
9.根据权利要求1所述的外科工具系统，其中用于产生触觉反馈的信号命令取决于用户的经验等级。
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Families Citing this family (532)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11134978B2 (en) 2016-01-15 2021-10-05 Cilag Gmbh International Modular battery powered handheld surgical instrument with self-diagnosing control switches for reusable handle assembly
US11229472B2 (en) 2001-06-12 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with multiple magnetic position sensors
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
US8182501B2 (en) 2004-02-27 2012-05-22 Ethicon Endo-Surgery, Inc. Ultrasonic surgical shears and method for sealing a blood vessel using same
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
PL1802245T3 (pl) 2004-10-08 2017-01-31 Ethicon Endosurgery Llc Ultradźwiękowy przyrząd chirurgiczny
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US8365976B2 (en) 2006-09-29 2013-02-05 Ethicon Endo-Surgery, Inc. Surgical staples having dissolvable, bioabsorbable or biofragmentable portions and stapling instruments for deploying the same
US20070191713A1 (en) 2005-10-14 2007-08-16 Eichmann Stephen E Ultrasonic device for cutting and coagulating
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US7621930B2 (en) 2006-01-20 2009-11-24 Ethicon Endo-Surgery, Inc. Ultrasound medical instrument having a medical ultrasonic blade
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
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
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
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
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
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
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8727197B2 (en) 2007-03-15 2014-05-20 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configuration with cooperative surgical staple
US8142461B2 (en) 2007-03-22 2012-03-27 Ethicon Endo-Surgery, Inc. Surgical instruments
US8057498B2 (en) 2007-11-30 2011-11-15 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instrument blades
US8911460B2 (en) 2007-03-22 2014-12-16 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US11672531B2 (en) 2007-06-04 2023-06-13 Cilag Gmbh International Rotary drive systems for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based 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
US20110046659A1 (en) * 2007-07-09 2011-02-24 Immersion Corporation Minimally Invasive Surgical Tools With Haptic Feedback
US8523889B2 (en) 2007-07-27 2013-09-03 Ethicon Endo-Surgery, Inc. Ultrasonic end effectors with increased active length
US8808319B2 (en) 2007-07-27 2014-08-19 Ethicon Endo-Surgery, Inc. Surgical instruments
US8430898B2 (en) 2007-07-31 2013-04-30 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US8512365B2 (en) 2007-07-31 2013-08-20 Ethicon Endo-Surgery, Inc. Surgical instruments
US9044261B2 (en) 2007-07-31 2015-06-02 Ethicon Endo-Surgery, Inc. Temperature controlled ultrasonic surgical instruments
EP2796102B1 (en) 2007-10-05 2018-03-14 Ethicon LLC Ergonomic surgical instruments
US10010339B2 (en) 2007-11-30 2018-07-03 Ethicon Llc Ultrasonic surgical blades
BRPI0901282A2 (pt) 2008-02-14 2009-11-17 Ethicon Endo Surgery Inc instrumento cirúrgico de corte e fixação dotado de eletrodos de rf
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US9089360B2 (en) 2008-08-06 2015-07-28 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
BRPI1008667A2 (pt) 2009-02-06 2016-03-08 Ethicom Endo Surgery Inc aperfeiçoamento do grampeador cirúrgico acionado
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
US9700339B2 (en) 2009-05-20 2017-07-11 Ethicon Endo-Surgery, Inc. Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments
US8663220B2 (en) 2009-07-15 2014-03-04 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US8951248B2 (en) 2009-10-09 2015-02-10 Ethicon Endo-Surgery, Inc. Surgical generator for ultrasonic and electrosurgical devices
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US11090104B2 (en) 2009-10-09 2021-08-17 Cilag Gmbh International Surgical generator for ultrasonic and electrosurgical devices
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8469981B2 (en) 2010-02-11 2013-06-25 Ethicon Endo-Surgery, Inc. Rotatable cutting implement arrangements for ultrasonic surgical instruments
US8486096B2 (en) 2010-02-11 2013-07-16 Ethicon Endo-Surgery, Inc. Dual purpose surgical instrument for cutting and coagulating tissue
US8951272B2 (en) 2010-02-11 2015-02-10 Ethicon Endo-Surgery, Inc. Seal arrangements for ultrasonically powered surgical instruments
US8795327B2 (en) 2010-07-22 2014-08-05 Ethicon Endo-Surgery, Inc. Electrosurgical instrument with separate closure and cutting members
US9192431B2 (en) 2010-07-23 2015-11-24 Ethicon Endo-Surgery, Inc. Electrosurgical cutting and sealing instrument
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
EP2417925B1 (en) 2010-08-12 2016-12-07 Immersion Corporation Electrosurgical tool having tactile feedback
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
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
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US8657176B2 (en) 2010-09-30 2014-02-25 Ethicon Endo-Surgery, Inc. Tissue thickness compensator for a surgical stapler
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8523043B2 (en) 2010-12-07 2013-09-03 Immersion Corporation Surgical stapler having haptic feedback
EP3278744B1 (en) * 2011-02-15 2021-10-20 Intuitive Surgical Operations, Inc. Indicator for knife location in a stapling or vessel sealing instrument
PL2497427T3 (pl) * 2011-03-10 2020-05-18 Erbe Elektromedizin Gmbh Instrument chirurgiczny z cyfrowym złączem danych
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
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US8845667B2 (en) 2011-07-18 2014-09-30 Immersion Corporation Surgical tool having a programmable rotary module for providing haptic feedback
US9259265B2 (en) 2011-07-22 2016-02-16 Ethicon Endo-Surgery, Llc Surgical instruments for tensioning tissue
JP6165780B2 (ja) 2012-02-10 2017-07-19 エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． ロボット制御式の手術器具
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
US11399898B2 (en) 2012-03-06 2022-08-02 Briteseed, Llc User interface for a system used to determine tissue or artifact characteristics
BR112014024194B1 (pt) 2012-03-28 2022-03-03 Ethicon Endo-Surgery, Inc Conjunto de cartucho de grampos para um grampeador cirúrgico
MX350846B (es) 2012-03-28 2017-09-22 Ethicon Endo Surgery Inc Compensador de grosor de tejido que comprende cápsulas que definen un ambiente de baja presión.
BR112014024102B1 (pt) 2012-03-28 2022-03-03 Ethicon Endo-Surgery, Inc Conjunto de cartucho de prendedores para um instrumento cirúrgico, e conjunto de atuador de extremidade para um instrumento cirúrgico
US9439668B2 (en) 2012-04-09 2016-09-13 Ethicon Endo-Surgery, Llc Switch arrangements for ultrasonic surgical instruments
US20130304066A1 (en) * 2012-05-09 2013-11-14 Tyco Healthcare Group Lp Apparatus for Activating an Electrosurgical Vessel Sealing Instrument Having an Electrical Cutting Mechanism
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
CN104487005B (zh) 2012-06-28 2017-09-08 伊西康内外科公司 空夹仓闭锁件
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US11197671B2 (en) 2012-06-28 2021-12-14 Cilag Gmbh International Stapling assembly comprising a lockout
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
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
US20140005705A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Surgical instruments with articulating shafts
US9649111B2 (en) 2012-06-28 2017-05-16 Ethicon Endo-Surgery, Llc Replaceable clip cartridge for a clip applier
US9393037B2 (en) 2012-06-29 2016-07-19 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9351754B2 (en) 2012-06-29 2016-05-31 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments with distally positioned jaw assemblies
US20140005702A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments with distally positioned transducers
US9198714B2 (en) 2012-06-29 2015-12-01 Ethicon Endo-Surgery, Inc. Haptic feedback devices for surgical robot
US9326788B2 (en) 2012-06-29 2016-05-03 Ethicon Endo-Surgery, Llc Lockout mechanism for use with robotic electrosurgical device
US9408622B2 (en) 2012-06-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9226767B2 (en) 2012-06-29 2016-01-05 Ethicon Endo-Surgery, Inc. Closed feedback control for electrosurgical device
US9820768B2 (en) 2012-06-29 2017-11-21 Ethicon Llc Ultrasonic surgical instruments with control mechanisms
IN2015DN02432A (zh) 2012-09-28 2015-09-04 Ethicon Endo Surgery Inc
US10201365B2 (en) * 2012-10-22 2019-02-12 Ethicon Llc Surgeon feedback sensing and display methods
US9095367B2 (en) 2012-10-22 2015-08-04 Ethicon Endo-Surgery, Inc. Flexible harmonic waveguides/blades for surgical instruments
US20140135804A1 (en) 2012-11-15 2014-05-15 Ethicon Endo-Surgery, Inc. Ultrasonic and electrosurgical devices
CN103019253A (zh) * 2012-12-14 2013-04-03 徐州泰诺仕视觉科技有限公司 一种随动式窥头控制装置
MX364729B (es) 2013-03-01 2019-05-06 Ethicon Endo Surgery Inc Instrumento quirúrgico con una parada suave.
BR112015021098B1 (pt) 2013-03-01 2022-02-15 Ethicon Endo-Surgery, Inc Cobertura para uma junta de articulação e instrumento cirúrgico
US11154313B2 (en) * 2013-03-12 2021-10-26 The Volcano Corporation Vibrating guidewire torquer and methods of use
US10226273B2 (en) 2013-03-14 2019-03-12 Ethicon Llc Mechanical fasteners for use with surgical energy devices
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9883860B2 (en) 2013-03-14 2018-02-06 Ethicon Llc Interchangeable shaft assemblies for use with a surgical instrument
KR102115447B1 (ko) * 2013-03-27 2020-05-27 한양대학교 에리카산학협력단 내시경 장치
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
US10292752B2 (en) * 2013-04-19 2019-05-21 Anna Brzezinski Electrocautery tactile feedback systems and methods
US9510828B2 (en) 2013-08-23 2016-12-06 Ethicon Endo-Surgery, Llc Conductor arrangements for electrically powered surgical instruments with rotatable end effectors
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
US10162416B2 (en) * 2013-09-06 2018-12-25 Immersion Corporation Dynamic haptic conversion system
US9814514B2 (en) 2013-09-13 2017-11-14 Ethicon Llc Electrosurgical (RF) medical instruments for cutting and coagulating tissue
US9207764B2 (en) * 2013-09-18 2015-12-08 Immersion Corporation Orientation adjustable multi-channel haptic device
WO2015061471A1 (en) * 2013-10-22 2015-04-30 Kindara, Inc. Integrated wireless fertility tracking system
US9265926B2 (en) 2013-11-08 2016-02-23 Ethicon Endo-Surgery, Llc Electrosurgical devices
GB2521228A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
GB2521229A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
US9795436B2 (en) 2014-01-07 2017-10-24 Ethicon Llc Harvesting energy from a surgical generator
US9468454B2 (en) * 2014-01-28 2016-10-18 Ethicon Endo-Surgery, Inc. Motor control and feedback in powered surgical devices
US9802033B2 (en) * 2014-01-28 2017-10-31 Ethicon Llc Surgical devices having controlled tissue cutting and sealing
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9554854B2 (en) 2014-03-18 2017-01-31 Ethicon Endo-Surgery, Llc Detecting short circuits in electrosurgical medical devices
JP6511471B2 (ja) 2014-03-25 2019-05-15 ブライトシード・エルエルシーＢｒｉｔｅｓｅｅｄ，Ｌｌｃ 脈管検出器及び検出方法
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
US20150272557A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Modular surgical instrument system
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US10463421B2 (en) 2014-03-27 2019-11-05 Ethicon Llc Two stage trigger, clamp and cut bipolar vessel sealer
US10092310B2 (en) 2014-03-27 2018-10-09 Ethicon Llc Electrosurgical devices
US9737355B2 (en) 2014-03-31 2017-08-22 Ethicon Llc Controlling impedance rise in electrosurgical medical devices
US9980769B2 (en) 2014-04-08 2018-05-29 Ethicon Llc Methods and devices for controlling motorized surgical devices
US9675405B2 (en) 2014-04-08 2017-06-13 Ethicon Llc Methods and devices for controlling motorized surgical devices
US9808307B2 (en) * 2014-04-08 2017-11-07 Ethicon Llc Methods and devices for controlling motorized surgical devices
US9918730B2 (en) 2014-04-08 2018-03-20 Ethicon Llc Methods and devices for controlling motorized surgical devices
US9913680B2 (en) 2014-04-15 2018-03-13 Ethicon Llc Software algorithms for electrosurgical instruments
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US9833241B2 (en) 2014-04-16 2017-12-05 Ethicon Llc Surgical fastener cartridges with driver stabilizing arrangements
BR112016023698B1 (pt) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc Cartucho de prendedores para uso com um instrumento 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
US10426476B2 (en) 2014-09-26 2019-10-01 Ethicon Llc Circular fastener cartridges for applying radially expandable fastener lines
JP6532889B2 (ja) 2014-04-16 2019-06-19 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 締結具カートリッジ組立体及びステープル保持具カバー配置構成
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
US9737301B2 (en) 2014-09-05 2017-08-22 Ethicon Llc Monitoring device degradation based on component evaluation
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
JP6648119B2 (ja) 2014-09-26 2020-02-14 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 外科ステープル留めバットレス及び付属物材料
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10639092B2 (en) 2014-12-08 2020-05-05 Ethicon Llc Electrode configurations for surgical instruments
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
MX2017008108A (es) 2014-12-18 2018-03-06 Ethicon Llc Instrumento quirurgico con un yunque que puede moverse de manera selectiva sobre un eje discreto no movil con relacion a un cartucho de grapas.
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9848937B2 (en) * 2014-12-22 2017-12-26 Ethicon Llc End effector with detectable configurations
US10245095B2 (en) 2015-02-06 2019-04-02 Ethicon Llc Electrosurgical instrument with rotation and articulation mechanisms
EP3258840B1 (en) 2015-02-19 2021-09-15 Briteseed, LLC System and method for determining vessel size using light absorption
ES2907824T3 (es) 2015-02-19 2022-04-26 Briteseed Llc Sistema para determinar el borde de un vaso
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
JP2020121162A (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
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10052044B2 (en) 2015-03-06 2018-08-21 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US10390825B2 (en) 2015-03-31 2019-08-27 Ethicon Llc Surgical instrument with progressive rotary drive systems
JP6582549B2 (ja) * 2015-05-25 2019-10-02 ソニー株式会社 振動検出モジュール、振動検出装置、振動検出方法及び手術システム
US11020140B2 (en) 2015-06-17 2021-06-01 Cilag Gmbh International Ultrasonic surgical blade for use with ultrasonic surgical instruments
US11129669B2 (en) 2015-06-30 2021-09-28 Cilag Gmbh International Surgical system with user adaptable techniques based on tissue type
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US10898256B2 (en) 2015-06-30 2021-01-26 Ethicon Llc Surgical system with user adaptable techniques based on tissue impedance
US10357303B2 (en) 2015-06-30 2019-07-23 Ethicon Llc Translatable outer tube for sealing using shielded lap chole dissector
US11051873B2 (en) 2015-06-30 2021-07-06 Cilag Gmbh International Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters
US10765470B2 (en) 2015-06-30 2020-09-08 Ethicon Llc Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters
US10154852B2 (en) 2015-07-01 2018-12-18 Ethicon Llc Ultrasonic surgical blade with improved cutting and coagulation features
US11058425B2 (en) 2015-08-17 2021-07-13 Ethicon Llc Implantable layers for a surgical instrument
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
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
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US11033322B2 (en) 2015-09-30 2021-06-15 Ethicon Llc Circuit topologies for combined generator
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
US11690623B2 (en) 2015-09-30 2023-07-04 Cilag Gmbh International Method for applying an implantable layer to a fastener cartridge
US10271849B2 (en) 2015-09-30 2019-04-30 Ethicon Llc Woven constructs with interlocked standing fibers
WO2017062720A1 (en) 2015-10-08 2017-04-13 Briteseed Llc System and method for determining vessel size
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10456189B2 (en) 2015-10-28 2019-10-29 Elliquence RF generator for an electrosurgical instrument
US11304716B2 (en) 2015-12-16 2022-04-19 Covidien Lp Surgical instruments including touch-sensing actuation
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
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
WO2017123796A1 (en) * 2016-01-12 2017-07-20 Intuitive Surgical Operations, Inc. Staged force feedback transitioning between control states
US10716615B2 (en) 2016-01-15 2020-07-21 Ethicon Llc Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade
US11129670B2 (en) 2016-01-15 2021-09-28 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization
US11229471B2 (en) 2016-01-15 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization
JP6911054B2 (ja) 2016-02-09 2021-07-28 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 非対称の関節構成を備えた外科用器具
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10433837B2 (en) 2016-02-09 2019-10-08 Ethicon Llc Surgical instruments with multiple link articulation arrangements
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10555769B2 (en) 2016-02-22 2020-02-11 Ethicon Llc Flexible circuits for electrosurgical instrument
JP2017176534A (ja) * 2016-03-30 2017-10-05 ソニー株式会社 圧排子及び圧排装置
US10413297B2 (en) 2016-04-01 2019-09-17 Ethicon Llc Surgical stapling system configured to apply annular rows of staples having different heights
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
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
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
JP6214831B1 (ja) * 2016-04-26 2017-10-18 オリンパス株式会社 処置システム及び制御装置
US10702329B2 (en) 2016-04-29 2020-07-07 Ethicon Llc Jaw structure with distal post for electrosurgical instruments
US10646269B2 (en) 2016-04-29 2020-05-12 Ethicon Llc Non-linear jaw gap for electrosurgical instruments
US10485607B2 (en) 2016-04-29 2019-11-26 Ethicon Llc Jaw structure with distal closure for electrosurgical instruments
US10456193B2 (en) 2016-05-03 2019-10-29 Ethicon Llc Medical device with a bilateral jaw configuration for nerve stimulation
US10646197B2 (en) * 2016-07-06 2020-05-12 Biosense Webster (Israel) Ltd. Ascertaining tissue thickness
US10245064B2 (en) 2016-07-12 2019-04-02 Ethicon Llc Ultrasonic surgical instrument with piezoelectric central lumen transducer
US10893883B2 (en) 2016-07-13 2021-01-19 Ethicon Llc Ultrasonic assembly for use with ultrasonic surgical instruments
US10842522B2 (en) 2016-07-15 2020-11-24 Ethicon Llc Ultrasonic surgical instruments having offset blades
US10376305B2 (en) 2016-08-05 2019-08-13 Ethicon Llc Methods and systems for advanced harmonic energy
US10285723B2 (en) 2016-08-09 2019-05-14 Ethicon Llc Ultrasonic surgical blade with improved heel portion
USD847990S1 (en) 2016-08-16 2019-05-07 Ethicon Llc Surgical instrument
US10952759B2 (en) 2016-08-25 2021-03-23 Ethicon Llc Tissue loading of a surgical instrument
US10376328B2 (en) * 2016-08-25 2019-08-13 Novartis Ag Surgical probe with an integrated motion sensor
US11350959B2 (en) 2016-08-25 2022-06-07 Cilag Gmbh International Ultrasonic transducer techniques for ultrasonic surgical instrument
WO2018044722A1 (en) 2016-08-30 2018-03-08 Briteseed Llc System and method for determining vessel size with angular distortion compensation
US11931122B2 (en) 2016-11-11 2024-03-19 Intuitive Surgical Operations, Inc. Teleoperated surgical system with surgeon skill level based instrument control
US10603064B2 (en) 2016-11-28 2020-03-31 Ethicon Llc Ultrasonic transducer
US11266430B2 (en) * 2016-11-29 2022-03-08 Cilag Gmbh International End effector control and calibration
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
US10667809B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Staple cartridge and staple cartridge channel comprising windows defined therein
US10617414B2 (en) 2016-12-21 2020-04-14 Ethicon Llc Closure member arrangements for surgical instruments
US10898186B2 (en) 2016-12-21 2021-01-26 Ethicon Llc Staple forming pocket arrangements comprising primary sidewalls and pocket sidewalls
US10537325B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Staple forming pocket arrangement to accommodate different types of staples
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
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
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
MX2019007311A (es) 2016-12-21 2019-11-18 Ethicon Llc Sistemas de engrapado quirurgico.
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
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US10893864B2 (en) 2016-12-21 2021-01-19 Ethicon Staple cartridges and arrangements of staples and staple cavities therein
US10492785B2 (en) 2016-12-21 2019-12-03 Ethicon Llc Shaft assembly comprising a lockout
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
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
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US11571210B2 (en) 2016-12-21 2023-02-07 Cilag Gmbh International Firing assembly comprising a multiple failed-state fuse
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
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
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
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
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
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
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
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
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
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
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
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US20180368844A1 (en) 2017-06-27 2018-12-27 Ethicon Llc Staple forming pocket arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US11696759B2 (en) 2017-06-28 2023-07-11 Cilag Gmbh International Surgical stapling instruments comprising shortened staple cartridge noses
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
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
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
US20190000459A1 (en) 2017-06-28 2019-01-03 Ethicon Llc Surgical instruments with jaws constrained to pivot about an axis upon contact with a closure member that is parked in close proximity to the pivot axis
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
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
US10820920B2 (en) 2017-07-05 2020-11-03 Ethicon Llc Reusable ultrasonic medical devices and methods of their use
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
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
JP7220206B2 (ja) 2017-09-05 2023-02-09 ブライトシード・エルエルシー 組織及び／又はアーチファクト特性を判定するために使用されるシステム及び方法
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US10765429B2 (en) * 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
JP2021500995A (ja) * 2017-10-30 2021-01-14 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ フィードバック機構を備える外科用器具システム
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
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
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
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
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
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
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
US11179152B2 (en) 2017-12-21 2021-11-23 Cilag Gmbh International Surgical instrument comprising a tissue grasping system
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
JP7313353B2 (ja) 2017-12-22 2023-07-24 ブライトシード・エルエルシー 組織又はアーチファクト特性を決定するために使用される小型システム
WO2019142252A1 (ja) * 2018-01-17 2019-07-25 オリンパス株式会社 制御装置及び制御装置の作動方法
US11026585B2 (en) 2018-06-05 2021-06-08 Synaptive Medical Inc. System and method for intraoperative video processing
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
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
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
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
CN109171950B (zh) * 2018-09-25 2020-12-29 高传玉 一种去肾动脉交感神经术用射频消融钳
NL2022018B1 (en) * 2018-11-16 2020-05-26 Efi Holding B V Surgical instrument
US11147553B2 (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
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11350938B2 (en) 2019-06-28 2022-06-07 Cilag Gmbh International Surgical instrument comprising an aligned rfid sensor
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
CN110664486B (zh) * 2019-09-25 2022-02-08 中国科学院重庆绿色智能技术研究院 一种应用于手术机器人的器械和设备
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11589916B2 (en) 2019-12-30 2023-02-28 Cilag Gmbh International Electrosurgical instruments with electrodes having variable energy densities
US11696776B2 (en) 2019-12-30 2023-07-11 Cilag Gmbh International Articulatable surgical instrument
US11779387B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Clamp arm jaw to minimize tissue sticking and improve tissue control
US11937866B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Method for an electrosurgical procedure
US11779329B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Surgical instrument comprising a flex circuit including a sensor system
US11786291B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Deflectable support of RF energy electrode with respect to opposing ultrasonic blade
US11707318B2 (en) 2019-12-30 2023-07-25 Cilag Gmbh International Surgical instrument with jaw alignment features
US11911063B2 (en) 2019-12-30 2024-02-27 Cilag Gmbh International Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade
US11812957B2 (en) 2019-12-30 2023-11-14 Cilag Gmbh International Surgical instrument comprising a signal interference resolution system
US11452525B2 (en) 2019-12-30 2022-09-27 Cilag Gmbh International Surgical instrument comprising an adjustment system
US11660089B2 (en) 2019-12-30 2023-05-30 Cilag Gmbh International Surgical instrument comprising a sensing system
US11944366B2 (en) 2019-12-30 2024-04-02 Cilag Gmbh International Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode
US11786294B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Control program for modular combination energy device
US11937863B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Deflectable electrode with variable compression bias along the length of the deflectable electrode
US11950797B2 (en) 2019-12-30 2024-04-09 Cilag Gmbh International Deflectable electrode with higher distal bias relative to proximal bias
US11723716B2 (en) 2019-12-30 2023-08-15 Cilag Gmbh International Electrosurgical instrument with variable control mechanisms
US20210330375A1 (en) * 2020-04-22 2021-10-28 Covidien Lp Surgical system and methods for treating tissue
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
USD975850S1 (en) 2020-06-02 2023-01-17 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
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
US20220031350A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with double pivot articulation joint arrangements
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
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
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
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
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
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
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
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
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
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
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
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
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
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
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US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
EP4241713A1 (en) * 2022-03-11 2023-09-13 Cilag GmbH International Electrosurgical instrument with clamp closure sensor
WO2023170645A1 (en) * 2022-03-11 2023-09-14 Cilag Gmbh International Electrosurgical instrument with clamp closure sensor

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5688270A (en) * 1993-07-22 1997-11-18 Ethicon Endo-Surgery,Inc. Electrosurgical hemostatic device with recessed and/or offset electrodes
US20070043352A1 (en) * 2005-08-19 2007-02-22 Garrison David M Single action tissue sealer
US20080251568A1 (en) * 2007-04-13 2008-10-16 Michael Zemlok Powered surgical instrument
CN101401736A (zh) * 2007-10-05 2009-04-08 Tyco医疗健康集团 动力手术缝合装置
WO2010065314A1 (en) * 2008-12-03 2010-06-10 Immersion Corporation Tool having multiple feedback devices

Family Cites Families (132)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3785381A (en) 1973-01-22 1974-01-15 L Laufe Pressure sensing obstetrical forceps
US3950984A (en) 1973-09-21 1976-04-20 Russell John D Force transducer for strain gage
US4407686A (en) 1981-11-17 1983-10-04 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Inflatable device for installing strain gage bridges
US4608861A (en) 1984-11-07 1986-09-02 Macleod Laboratories, Inc. MWD tool for measuring weight and torque on bit
US4858611A (en) 1987-06-03 1989-08-22 Dimed, Inc. Sensing system and method for sensing minute ventilation
US4841987A (en) 1987-07-02 1989-06-27 Accudent, Inc. Automatically resetting, force-sensing probe and related method of operation
US5047046A (en) 1988-07-13 1991-09-10 Bodoia Rodger D Surgical forceps
US5188111A (en) 1991-01-18 1993-02-23 Catheter Research, Inc. Device for seeking an area of interest within a body
US5339799A (en) 1991-04-23 1994-08-23 Olympus Optical Co., Ltd. Medical system for reproducing a state of contact of the treatment section in the operation unit
US5279309A (en) 1991-06-13 1994-01-18 International Business Machines Corporation Signaling device and method for monitoring positions in a surgical operation
US5713896A (en) 1991-11-01 1998-02-03 Medical Scientific, Inc. Impedance feedback electrosurgical system
US5762458A (en) 1996-02-20 1998-06-09 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5357956A (en) 1992-11-13 1994-10-25 American Cardiac Ablation Co., Inc. Apparatus and method for monitoring endocardial signal during ablation
US5836894A (en) 1992-12-21 1998-11-17 Artann Laboratories Apparatus for measuring mechanical parameters of the prostate and for imaging the prostate using such parameters
US5558671A (en) 1993-07-22 1996-09-24 Yates; David C. Impedance feedback monitor for electrosurgical instrument
US5403312A (en) * 1993-07-22 1995-04-04 Ethicon, Inc. Electrosurgical hemostatic device
US5807393A (en) 1992-12-22 1998-09-15 Ethicon Endo-Surgery, Inc. Surgical tissue treating device with locking mechanism
US5389849A (en) 1993-01-20 1995-02-14 Olympus Optical Co., Ltd. Tactility providing apparatus and manipulating device using the same
US5817093A (en) 1993-07-22 1998-10-06 Ethicon Endo-Surgery, Inc. Impedance feedback monitor with query electrode for electrosurgical instrument
US5709680A (en) 1993-07-22 1998-01-20 Ethicon Endo-Surgery, Inc. Electrosurgical hemostatic device
US5503320A (en) 1993-08-19 1996-04-02 United States Surgical Corporation Surgical apparatus with indicator
DE4332580A1 (de) 1993-09-24 1995-03-30 Deutsche Aerospace Vorrichtung zur Nachbildung oder Simulation des Tastsinns in einem chirurgischen Instrument
US5411511A (en) 1993-11-12 1995-05-02 Hall; Gary W. Method and device for determining placement of keratotomy incisions
US5529235A (en) 1994-04-28 1996-06-25 Ethicon Endo-Surgery, Inc. Identification device for surgical instrument
US5623582A (en) 1994-07-14 1997-04-22 Immersion Human Interface Corporation Computer interface or control input device for laparoscopic surgical instrument and other elongated mechanical objects
AU694225B2 (en) 1994-08-02 1998-07-16 Ethicon Endo-Surgery, Inc. Ultrasonic hemostatic and cutting instrument
US5685474A (en) 1994-10-04 1997-11-11 United States Surgical Corporation Tactile indicator for surgical instrument
US5649934A (en) 1994-12-06 1997-07-22 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Apparatus for assisting childbirth
US6690963B2 (en) 1995-01-24 2004-02-10 Biosense, Inc. System for determining the location and orientation of an invasive medical instrument
US5630426A (en) 1995-03-03 1997-05-20 Neovision Corporation Apparatus and method for characterization and treatment of tumors
US5728044A (en) 1995-03-10 1998-03-17 Shan; Yansong Sensor device for spacial imaging of endoscopes
US5771902A (en) 1995-09-25 1998-06-30 Regents Of The University Of California Micromachined actuators/sensors for intratubular positioning/steering
US5649956A (en) 1995-06-07 1997-07-22 Sri International System and method for releasably holding a surgical instrument
DE19527957C1 (de) 1995-07-29 1996-08-22 Karlsruhe Forschzent Taktiler, optoelektronischer Drucksensor
US5833634A (en) 1995-11-09 1998-11-10 Uromed Corporation Tissue examination
US6436107B1 (en) 1996-02-20 2002-08-20 Computer Motion, Inc. Method and apparatus for performing minimally invasive surgical procedures
US5733281A (en) 1996-03-19 1998-03-31 American Ablation Co., Inc. Ultrasound and impedance feedback system for use with electrosurgical instruments
US5767840A (en) 1996-06-28 1998-06-16 International Business Machines Corporation Six-degrees-of-freedom movement sensor having strain gauge mechanical supports
US6132441A (en) 1996-11-22 2000-10-17 Computer Motion, Inc. Rigidly-linked articulating wrist with decoupled motion transmission
US5989199A (en) 1996-11-27 1999-11-23 Assurance Medical, Inc. Tissue examination
AU6262698A (en) 1997-02-04 1998-08-25 National Aeronautics And Space Administration - Nasa Multimodality instrument for tissue characterization
US5928158A (en) 1997-03-25 1999-07-27 Aristides; Arellano Medical instrument with nerve sensor
US6267761B1 (en) 1997-09-09 2001-07-31 Sherwood Services Ag Apparatus and method for sealing and cutting tissue
US6063031A (en) 1997-10-14 2000-05-16 Assurance Medical, Inc. Diagnosis and treatment of tissue with instruments
US6810281B2 (en) 2000-12-21 2004-10-26 Endovia Medical, Inc. Medical mapping system
US6001112A (en) 1998-04-10 1999-12-14 Endicor Medical, Inc. Rotational atherectomy device
US6354147B1 (en) 1998-06-26 2002-03-12 Cidra Corporation Fluid parameter measurement in pipes using acoustic pressures
US6375471B1 (en) 1998-07-10 2002-04-23 Mitsubishi Electric Research Laboratories, Inc. Actuator for independent axial and rotational actuation of a catheter or similar elongated object
US6096004A (en) 1998-07-10 2000-08-01 Mitsubishi Electric Information Technology Center America, Inc. (Ita) Master/slave system for the manipulation of tubular medical tools
US7137980B2 (en) 1998-10-23 2006-11-21 Sherwood Services Ag Method and system for controlling output of RF medical generator
US6451015B1 (en) * 1998-11-18 2002-09-17 Sherwood Services Ag Method and system for menu-driven two-dimensional display lesion generator
US6423057B1 (en) 1999-01-25 2002-07-23 The Arizona Board Of Regents On Behalf Of The University Of Arizona Method and apparatus for monitoring and controlling tissue temperature and lesion formation in radio-frequency ablation procedures
US6594552B1 (en) 1999-04-07 2003-07-15 Intuitive Surgical, Inc. Grip strength with tactile feedback for robotic surgery
US6190334B1 (en) 1999-05-24 2001-02-20 Rbp, Inc. Method and apparatus for the imaging of tissue
US6454781B1 (en) 1999-05-26 2002-09-24 Ethicon Endo-Surgery, Inc. Feedback control in an ultrasonic surgical instrument for improved tissue effects
US7366562B2 (en) 2003-10-17 2008-04-29 Medtronic Navigation, Inc. Method and apparatus for surgical navigation
AU2626401A (en) 2000-01-03 2001-07-16 Johns Hopkins University, The Surgical devices and methods of use thereof for enhanced tactile perception
US6817973B2 (en) 2000-03-16 2004-11-16 Immersion Medical, Inc. Apparatus for controlling force for manipulation of medical instruments
US20020107514A1 (en) 2000-04-27 2002-08-08 Hooven Michael D. Transmural ablation device with parallel jaws
US6494882B1 (en) 2000-07-25 2002-12-17 Verimetra, Inc. Cutting instrument having integrated sensors
US6945981B2 (en) 2000-10-20 2005-09-20 Ethicon-Endo Surgery, Inc. Finger operated switch for controlling a surgical handpiece
US20020112547A1 (en) 2000-11-22 2002-08-22 Eltaib Mohamed Elsayed Hossney Tactile probe
US7250048B2 (en) 2001-04-26 2007-07-31 Medtronic, Inc. Ablation system and method of use
WO2002096296A1 (en) 2001-05-30 2002-12-05 Ams Research Corporation Surgical suture passer
JP4660679B2 (ja) 2001-08-08 2011-03-30 琢也 野嶋 スマートツール
EP1416981B1 (en) 2001-08-14 2013-07-24 Applied Medical Resources Corporation Access sealing apparatus
NL1018874C2 (nl) 2001-09-03 2003-03-05 Michel Petronella Hub Vleugels Chirurgisch instrument.
US7464847B2 (en) 2005-06-03 2008-12-16 Tyco Healthcare Group Lp Surgical stapler with timer and feedback display
WO2003054849A1 (en) 2001-10-23 2003-07-03 Immersion Corporation Method of using tactile feedback to deliver silent status information to a user of an electronic device
US6730021B2 (en) 2001-11-07 2004-05-04 Computer Motion, Inc. Tissue spreader with force measurement, force indication or force limitation
US7122028B2 (en) 2001-12-19 2006-10-17 Allegiance Corporation Reconfiguration surgical apparatus
WO2005089065A2 (en) 2004-03-23 2005-09-29 Dune Medical Devices Ltd. Clean margin assessment tool
US7831292B2 (en) 2002-03-06 2010-11-09 Mako Surgical Corp. Guidance system and method for surgical procedures with improved feedback
AU2003218010A1 (en) 2002-03-06 2003-09-22 Z-Kat, Inc. System and method for using a haptic device in combination with a computer-assisted surgery system
US8010180B2 (en) 2002-03-06 2011-08-30 Mako Surgical Corp. Haptic guidance system and method
US6974455B2 (en) 2002-04-10 2005-12-13 Boston Scientific Scimed, Inc. Auto advancing radio frequency array
ES2377483T3 (es) 2002-04-25 2012-03-28 Tyco Healthcare Group Lp Instrumentos quirúrgicos que incluyen sistemas microelectromecánicos (MEMS)
SG165160A1 (en) 2002-05-06 2010-10-28 Univ Johns Hopkins Simulation system for medical procedures
US7769427B2 (en) 2002-07-16 2010-08-03 Magnetics, Inc. Apparatus and method for catheter guidance control and imaging
WO2004010883A1 (en) 2002-07-25 2004-02-05 Sherwood Services Ag Electrosurgical pencil with drag sensing capability
AU2003249061B2 (en) * 2002-08-21 2009-02-05 Resect Medical, Inc. Apparatus and method for tissue resection
US7270664B2 (en) * 2002-10-04 2007-09-18 Sherwood Services Ag Vessel sealing instrument with electrical cutting mechanism
US8192425B2 (en) 2006-09-29 2012-06-05 Baylis Medical Company Inc. Radiofrequency perforation apparatus
WO2004082468A2 (en) 2003-03-17 2004-09-30 Da Silva, Luiz, B. Optical biopsy system with single use needle probe
US7126303B2 (en) 2003-07-08 2006-10-24 Board Of Regents Of The University Of Nebraska Robot for surgical applications
WO2005079189A2 (en) 2003-09-12 2005-09-01 The Regents Of The University Of California Arterial endothelial function measurement method and apparatus
US7280863B2 (en) 2003-10-20 2007-10-09 Magnetecs, Inc. System and method for radar-assisted catheter guidance and control
US20070018958A1 (en) 2003-10-24 2007-01-25 Tavakoli Seyed M Force reflective robotic control system and minimally invasive surgical device
US20070142749A1 (en) 2004-03-04 2007-06-21 Oussama Khatib Apparatus for medical and/or simulation procedures
US7850642B2 (en) 2004-03-05 2010-12-14 Hansen Medical, Inc. Methods using a robotic catheter system
US7505030B2 (en) 2004-03-18 2009-03-17 Immersion Medical, Inc. Medical device and procedure simulation
US20050245910A1 (en) 2004-04-29 2005-11-03 Wright David W Tactile feedback finger tip device
US7799021B2 (en) * 2004-08-04 2010-09-21 Kimberly-Clark Inc. Electrosurgical treatment in conjunction with monitoring
US8441433B2 (en) 2004-08-11 2013-05-14 Immersion Corporation Systems and methods for providing friction in a haptic feedback device
DE102004052515B4 (de) 2004-10-22 2019-01-03 Aesculap Ag Chirurgische Schere und Verfahren zum Herstellen einer chirurgischen Schere
US20060207978A1 (en) 2004-10-28 2006-09-21 Rizun Peter R Tactile feedback laser system
US7200445B1 (en) * 2005-10-21 2007-04-03 Asthmatx, Inc. Energy delivery devices and methods
US20080009747A1 (en) 2005-02-02 2008-01-10 Voyage Medical, Inc. Transmural subsurface interrogation and ablation
JP2006280485A (ja) 2005-03-09 2006-10-19 Motoharu Hasegawa 血圧検出装置、血圧検出方法、血圧検出プログラム及び血圧検出歪みセンサ
US7771424B2 (en) 2005-03-16 2010-08-10 Starion Instruments Integrated metalized ceramic heating element for use in a tissue cutting and sealing device
CA2550077C (en) 2005-06-10 2014-01-21 Mpb Technologies Inc. Replaceable instrument mechanism for haptic devices
US20070062547A1 (en) 2005-07-21 2007-03-22 Carlo Pappone Systems for and methods of tissue ablation
US8038046B2 (en) 2006-05-19 2011-10-18 Ethicon Endo-Surgery, Inc. Electrical surgical instrument with optimized power supply and drive
CA2520942C (en) 2005-09-23 2013-03-19 Queen's University At Kingston Tactile amplification instrument and method of use
US20070073282A1 (en) 2005-09-26 2007-03-29 Starion Instruments Corporation Resistive heating device and method for turbinate ablation
US7789878B2 (en) 2005-09-30 2010-09-07 Covidien Ag In-line vessel sealer and divider
US7645220B2 (en) 2005-11-08 2010-01-12 Anatasol, Llc Perineometer with wireless biofeedback
AU2006321918B2 (en) 2005-12-06 2011-08-25 St. Jude Medical, Atrial Fibrillation Division Inc. Assessment of electrode coupling for tissue ablation
US8449535B2 (en) 2005-12-06 2013-05-28 St. Jude Medical, Atrial Fibrillation Division, Inc. System and method for assessing coupling between an electrode and tissue
US7422139B2 (en) 2006-01-31 2008-09-09 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting fastening instrument with tactile position feedback
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8174512B2 (en) 2006-06-02 2012-05-08 Immersion Corporation Hybrid haptic device utilizing mechanical and programmable haptic effects
US7731717B2 (en) * 2006-08-08 2010-06-08 Covidien Ag System and method for controlling RF output during tissue sealing
US8807414B2 (en) 2006-10-06 2014-08-19 Covidien Lp System and method for non-contact electronic articulation sensing
US10085798B2 (en) 2006-12-29 2018-10-02 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation electrode with tactile sensor
US20080167662A1 (en) 2007-01-08 2008-07-10 Kurtz Anthony D Tactile feel apparatus for use with robotic operations
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US20110046659A1 (en) 2007-07-09 2011-02-24 Immersion Corporation Minimally Invasive Surgical Tools With Haptic Feedback
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US20090254080A1 (en) * 2008-04-07 2009-10-08 Satoshi Honda Surgical operation apparatus
US8834465B2 (en) 2008-07-15 2014-09-16 Immersion Corporation Modular tool with signal feedback
US8968314B2 (en) 2008-09-25 2015-03-03 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US8608045B2 (en) * 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8551002B2 (en) 2008-12-12 2013-10-08 Immersion Corporation Spatial array of sensors mounted on a tool
US8216212B2 (en) 2009-01-15 2012-07-10 Immersion Corporation Providing haptic feedback to the handle of a tool
US8652046B2 (en) 2009-01-15 2014-02-18 Immersion Corporation Palpation algorithms for computer-augmented hand tools
US8708211B2 (en) 2009-02-12 2014-04-29 Covidien Lp Powered surgical instrument with secondary circuit board
US8205779B2 (en) 2009-07-23 2012-06-26 Tyco Healthcare Group Lp Surgical stapler with tactile feedback system
US8360299B2 (en) 2009-08-11 2013-01-29 Covidien Lp Surgical stapling apparatus
EP2417925B1 (en) 2010-08-12 2016-12-07 Immersion Corporation Electrosurgical tool having tactile feedback
US9161803B2 (en) 2010-11-05 2015-10-20 Ethicon Endo-Surgery, Inc. Motor driven electrosurgical device with mechanical and electrical feedback
US8523043B2 (en) 2010-12-07 2013-09-03 Immersion Corporation Surgical stapler having haptic feedback

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5688270A (en) * 1993-07-22 1997-11-18 Ethicon Endo-Surgery,Inc. Electrosurgical hemostatic device with recessed and/or offset electrodes
US20070043352A1 (en) * 2005-08-19 2007-02-22 Garrison David M Single action tissue sealer
US20080251568A1 (en) * 2007-04-13 2008-10-16 Michael Zemlok Powered surgical instrument
CN101401736A (zh) * 2007-10-05 2009-04-08 Tyco医疗健康集团 动力手术缝合装置
WO2010065314A1 (en) * 2008-12-03 2010-06-10 Immersion Corporation Tool having multiple feedback devices

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