CN104244850B - 具有组织密度感测的外科器械 - Google Patents

具有组织密度感测的外科器械 Download PDF

Info

Publication number
CN104244850B
CN104244850B CN201380020955.7A CN201380020955A CN104244850B CN 104244850 B CN104244850 B CN 104244850B CN 201380020955 A CN201380020955 A CN 201380020955A CN 104244850 B CN104244850 B CN 104244850B
Authority
CN
China
Prior art keywords
end effector
tissue
sensor
surgical device
surgical instruments
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201380020955.7A
Other languages
English (en)
Other versions
CN104244850A (zh
Inventor
W·D·丹纳赫
D·W·普莱斯
C·G·金博尔
W·D·凯利
S·莱
J·S·吉
B·D·伯特科
A·L·韦玲
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of CN104244850A publication Critical patent/CN104244850A/zh
Application granted granted Critical
Publication of CN104244850B publication Critical patent/CN104244850B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00075—Motion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320097—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with stapling means
    • 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

Abstract

本发明公开一种设备，该设备包括端部执行器、主体组件、功率源和控制模块。该端部执行器可操作以用于外科手术并且能够向手术部位传送能量。该端部执行器包括至少一个传感器。该传感器能够测量与手术部位相关的至少一个物理特性。该主体组件与端部执行器相联。功率源与主体组件相联并且可操作以向端部执行器传送功率。该控制模块与传感器相联并且可操作以基于来自传感器的指示组织密度改变的数据来改变向端部执行器传送的功率。

Description

具有组织密度感测的外科器械
背景技术
在一些情况下，内窥镜式外科器械可以优于传统的开放式外科装置，因为较小切口可减少术后恢复时间和并发症。因此，一些内窥镜式外科器械可适于穿过套管针的插管来将远侧端部执行器放置在期望手术部位处。这些远侧端部执行器能以多种方式来接合组织以便达到诊断或治疗的效果，所述远侧端部执行器如：直线切割器、抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因治疗传送装置以及使用超声、射频、激光等的能量传送装置。内窥镜式外科器械可包括轴，该轴介于端部执行器与临床医生所操纵的柄部部分之间。这样的轴可以允许插入期望深度并绕轴的纵向轴线旋转，从而利于将端部执行器定位在患者体内。
内窥镜式外科器械的例子包括公开于下述专利中的那些：2006年4月13日公布的名称为“Tissue Pad for Use with an Ultrasonic Surgical Instrument”的美国专利公布2006/0079874，其公开内容以引用方式并入本文；2007年8月16日公布的名称为“Ultrasonic Device for Cutting and Coagulating”的美国专利公布2007/0191713，其公开内容以引用方式并入本文；2007年12月6日公布的名称为“Ultrasonic Waveguide andBlade”的美国专利公布2007/0282333，其公开内容以引用方式并入本文；2008年8月21日公布的名称为“Ultrasonic Device for Cutting and Coagulating”的美国专利公布2008/0200940，其公开内容以引用方式并入本文；2011年1月20日公布的名称为“RotatingTransducer Mount for Ultrasonic Surgical Instruments”的美国专利公布2011/0015660，其公开内容以引用方式并入本文；2002年12月31日公布的名称为“Electrosurgical Systems and Techniques for Sealing Tissue”的美国专利6,500,176，其公开内容以引用方式并入本文；以及2011年4月14日公布的名称为“SurgicalInstrument Comprising First and Second Drive Systems Actuatable by a CommonTrigger Mechanism”的美国专利公布2011/0087218，其公开内容以引用方式并如本文。另外，这些外科工具可包括无线换能器，例如公开于2009年6月4日公布的名称为“CordlessHand-held Ultrasonic Cautery Cutting Device”的美国专利公布2009/0143797中的无线操作，其公开内容以引用方式并入本文。另外，外科器械可用于或可适用于机器人辅助的外科装置，例如公开于2004年8月31日公布的名称为“Robotic Surgical Tool withUltrasound Cauterizing and Cutting Instrument”的美国专利6,783,524中的机器人辅助外科装置，其公开内容以引用方式并入本文。
虽然已制造并使用了多种外科器械，但是据信，在本发明人之前还无人研制出或使用如本文所描述的发明。
附图说明
虽然在说明书之后提供了特别指出和清楚地要求保护本发明的权利要求书，但是据信通过对下面某些实施例的描述并结合附图可以更好地理解本发明，附图中类似的附图标记表示相同元件，其中：
图1示出了示例性外科器械的方框图；
图2示出了示例性超声外科器械的透视图；
图3示出了示例性外科器械的方框图；
图4示出了使用图3的外科器械的示例性方法的流程图；
图5示出了使用图3的外科器械的替代形式的示例性方法的流程图；
图6示出了使用图3的外科器械的另一种替代形式的示例性方法的流程图；
图7示出了使用图3的外科器械的又一种替代形式的示例性方法的流程图；
图8示出了使用图3的外科器械的再一种替代形式的示例性方法的流程图；
图9示出了使用图3的外科器械的再一种替代形式的示例性方法的流程图；并且
图10示出了使用图3的外科器械的再一种替代形式的示例性方法的流程图；
附图并非意在以任何方式进行限制，并且可以预期本发明的各种实施例能够以多种其它方式来执行，包括那些未必在附图中示出的方式。附图并入本说明书中并形成其一部分，示出了本发明的若干方面，并与说明书一起用于解释本发明的原理；然而，应当理解，本发明并不限于所示出的精确安排。
具体实施方式
对本发明的某些例子的如下描述不应用来限制本发明的范围。通过以下举例说明设想用于实施本发明的最佳方式之一的描述，本领域的技术人员将显而易见本发明的其它例子、结构、方面、实施例和优点。正如将会意识到的，本发明可以是其它不同且明显的方面，只要不脱离本发明即可。例如，尽管各种。因此，附图和具体实施方式应被视为实质上是示例性而非限制性的。
还应当理解，本文所述的教导内容、表达方式、实施例、实例等中的任何一个或多个可与本文所述的其它教导内容、表达方式、实施例、实例等中的任何一个或多个相结合。因此，下述教导内容、表达方式、实施例、例子等不应视为彼此隔离。参考本文教导内容，其中本文教导内容可结合的各种合适方式对于本领域的普通技术人员而言将会显而易见。此类修改形式以及变型旨在包括在权利要求书的范围内。
I.示例性外科器械的概述
图1以图解方块图的形式示出了示例性医疗装置和/或外科器械10的部件。如图所示，医疗装置10包括控制模块12、功率源14和端部执行器16。仅示例性的功率源14可包括镍氢电池、锂离子电池(例如，棱柱状电池型锂离子电池等)、镍铬电池或者任何其它类型的功率源，按照本文的教导内容，这对本领域技术人员而言可能是显而易见的。控制模块12可包括微处理器、专用集成电路(ASIC)、存储器、印刷电路板(PCB)、存储装置(诸如固态驱动器或硬盘)、固件、软件或者任何其它合适的控制模块组件，按照本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。控制模块12和功率源14通过诸如缆线和/或电路板中的迹线等的电连接件22联接，以将功率从功率源14传送到控制模块12。作为另外一种选择，功率源14可选择性地联接到控制模块12。这允许功率源14从医疗装置10分离和移除，其可进一步允许功率源14容易地进行再充电或回收以用于重新消毒和再利用。除此之外或者可替代的是，控制模块12可被移除以用于维护、测试、替换或其它目的，根据本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。控制模块12还可操作以通过使用功率源14来提供脉冲能量，如将在下文进一步讨论的。
端部执行器16通过另一个电连接件22联接到控制模块12。端部执行器16能够执行医疗装置10的期望功能。仅以举例的方式，这样的功能可以包括烧灼组织、消融组织、切割组织、超声振动、缝合组织或者用于医疗装置10的任何其它期望的任务。从而，端部执行器16可以包括主动结构，例如超声刀、一对夹紧钳口、尖锐小刀、缝合驱动组件、单级RF电极、一对双极RF电极、加热元件和/或各种其它组件。端部执行器16还能够从医疗装置10移除，以用于维护、测试、替换或任何其它目的，参考本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。在一些型式中，端部执行器16是模块化的，使得医疗装置10可以与不同类型的端部执行器一起使用(例如，如序列号为61/410,603的美国临时申请所教导的等)。根据医疗装置10的目的，可提供端部执行器16的各种其它构型以用于各种不同的功能；根据本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。相似地，根据本文的教导内容，能够从功率源14接收功率的其它类型的医疗装置10的组件对本领域技术人员而言将是显而易见的。
本例子的医疗装置10包括触发器18和传感器20，但是应当理解，这样的组件仅仅是任选的。触发器18通过电连接件22联接到控制模块12和功率源14。触发器18能够选择性地将功率从功率源14提供到端部执行器16(和/或到医疗装置10的一些其它组件)，以在执行手术时激活医疗装置10。传感器20也通过电连接件22联接到控制模块12并且也许能够在手术期间向控制模块12提供多种信息。仅以举例的方式，此类构型可包括感测端部执行器16处的温度或确定端部执行器16的摆动速率。来自传感器20的数据可通过控制模块12处理，以实现功率到端部执行器16的传送(例如在反馈回路等中)。根据医疗装置10的目的，可提供传感器20的各种其它构型；根据本文的教导内容，这对于本领域的普通技术人员而言将是显而易见的。当然，和本文所述的其它组件一样，医疗装置10可以具有不止一个传感器20，或者如果需要传感器20可以简单地被省略。下文将讨论关于传感器20的进一步的细节及其变型。
II.示例性超声外科器械
图2示出了外科系统11，该外科系统11包括上文所述的器械10的示例性超声型式50。当器械50的超声部件为非活动时，可根据需要容易地夹持和操纵组织，而不进行组织切割。当超声部件被启动时，器械50允许组织被端部执行器80抓持用于与超声能量耦联，以进行组织凝固，并施加增加的压力，从而有效地进行组织切割和凝固。如果需要，可以在不使用端部执行器80的夹持机构的情况下，通过适当操纵超声刀82来将超声能量施加到组织。
仅以举例的方式，外科系统11能够根据任何合适的教导内容或者来自以下专利中的任意一个的教导内容的组合被构造并且/或者操作：2010年6月15日公布的名称为“Post-Sterilization Programming of Surgical Instruments”的美国专利7,738,971，其公开内容以引用方式并入本文；2006年4月13日公布的名称为“Tissue Pad for Use with anUltrasonic Surgical Instrument”的美国公布2006/0079874，其公开内容以引用方式并入本文；2007年8月16日公布的名称为“Ultrasonic Device for Cutting andCoagulating”的美国公布2007/0191713，其公开内容以引用方式并入本文；2007年12月6日公布的名称为“Ultrasonic Waveguide and Blade”的美国公布2007/0282333，其公开内容以引用方式并入本文；2008年8月21日公布的名称为“Ultrasonic Device for Cuttingand Coagulating”的美国公布2008/0200940，其公开内容以引用方式并入本文；2009年6月4日公布的名称为“Cordless Hand-held Ultrasonic Cautery Cutting Device”的美国专利公布2009/0143797，其公开内容以引用方式并入本文；2009年8月20日公布的名称为“Motorized Surgical Cutting and Fastening Instrument Having Handle BasedPower Source”的美国公布2009/0209990，其公开内容以引用方式并入本文；2010年3月18日公布的名称为“Ultrasonic Device for Fingertip Control”的美国公布2010/0069940，其公开内容以引用方式并入本文；以及2011年1月20日公布的名称为“RotatingTransducer Mount for Ultrasonic Surgical Instruments”的美国专利公布2011/0015660的图1中，其公开内容以引用方式并入本文。类似地，医疗装置能够包括便携式功率源的若干方式公开于2010年11月5日提交的名称为“Energy-Based SurgicalInstruments”的美国临时专利申请序列号61/410,603中，其公开内容以引用方式并入本文。
示例性超声外科系统11包括超声外科器械50、发生器21和缆线30，该缆线可操作以将发生器21联接到外科器械50。合适的发生器21为由Ethicon Endo-Surgery,Inc.(Cincinnati,Ohio)出售的GEN 300。仅以举例的方式，发生器21可根据2011年4月14日公布的名称为“Surgical Generator for Ultrasonic and Electrosurgical Devices”的美国公布2011/0087212的教导内容进行构造，其公开内容以引用方式并入本文。应该指出的是，将参照超声外科器械来描述外科器械50；然而，如根据本文的教导内容对于本领域的普通技术人员而言显而易见的是，下文所述的技术可用于多种外科器械，包括但不限于内切割器、抓紧器、切割器、缝合器、施夹钳、进入装置、药物/基因治疗传送装置、以及使用超声、射频、激光等的能量传送装置、和/或它们的任何组合。此外，尽管本实例将参照缆线连接的外科器械50进行描述，但应当理解，外科器械50可适于无线操作，例如公开于美国专利公布2009/0143797。此外，外科装置50还可以用于或适于用于例如美国专利6,783,524中所公开的机器人辅助的外科装置。
本实例的外科器械50包括多部件柄部组件60、细长的传输组件70、和换能器100。传输组件70在传输组件70的近端处联接至多部件柄部组件60并且从多部件柄部组件60向远侧延伸。在本例子中，传输组件70能够为细长的、细管状组件以用于内窥镜式用途，但应当理解，作为另外一种选择，传输组件70可为短组件，例如美国专利公布2007/0282333和美国专利公布2008/0200940中所公开的。本例子的传输组件70包括外部护套72、内部管状致动构件(未示出)、波导(未示出)、以及位于传输组件70远端的端部执行器80。在本例子中，端部执行器80包括联接至波导的刀82、可操作以在传输组件70的近端处枢转的夹持臂84、以及任选的可联接至夹持臂84的一个或多个夹持垫86。还应当理解，夹持臂84以及相关的结构可根据1999年11月9日公布的名称为“Ultrasonic Clamp Coagulator ApparatusHaving Improved Clamp Arm Pivot Mount”的美国专利5,980,510的教导内容中的至少一些进行构造和操作，其公开内容以引用方式并入本文。还应当理解，端部执行器80的一些型式可以不具有夹持臂84。例如，端部执行器80可以仅仅包括刀82。能够将超声能量从换能器100传播到刀82的波导可以为柔性、半柔性或刚性的。一种仅为示例性的超声换能器100为由位于Cincinnati,Ohio的Ethicon Endo-Surgery公司出售的型号HP054。如本领域中所熟知，波导也能够为将通过波导传播到刀82的机械振动放大。波导还可具有用于控制沿波导的纵向振动的增益的结构，并且具有用于将波导调谐至系统共振频率的结构。
在这个例子中，刀82的远端设置在波腹附近，以便在声学组件未被组织承载时将声学组件调谐至优选的共振频率fo。当换能器100通电时，刀82的远端能够在例如大约10至500微米峰间范围内、并且优选地在约20至约200微米的范围内以例如55.5kHz的预先确定的振动频率fo纵向运动。当本例子的换能器100激活时，这些机械振荡通过波导被传播到端部执行器80。在本例子中，耦合到波导的刀82在超声频率下振荡。因此，当将组织固定在刀82和夹持臂84之间时，刀82的超声振荡可同时切割组织并且使相邻组织细胞中的蛋白变性，由此提供具有相对较少热扩散的促凝效果。也可通过刀82和夹持臂84提供电流以另外烧灼组织。尽管已描述出传输组件70和换能器100的一些构型，但根据本文的教导内容，传输组件70和换能器100的其他合适构型对于本领域的普通技术人员而言将是显而易见的。
本例子的多部件柄部组件60包括配对外壳部分62和下部64。配对外壳部分62能够在配对外壳部分62的近端接纳换能器100并且在配对外壳部分62的远端接纳传输组件70的近端。在配对外壳部分62的远端上设有孔以用于插入各种传输组件70。在本例子中示出了用于旋转传输组件70和/或换能器100的旋转旋钮66，但应当理解，旋转旋钮66仅为任选的。多部件柄部组件60的下部64包括触发器68并且能够供使用者单手抓紧。下部64的一个仅为示例性的替代构造示于美国专利公布2011/0015660的图1中。触发按钮(未示出)可位于下部64的远侧表面上，并且可操作以利用发生器21以不同操作水平激活换能器100。例如，第一触发按钮可激活最大能量水平下的换能器100而第二触发按钮可激活最小、非零能量水平下的换能器100。当然，根据本文的教导内容对于本领域普通技术人员来说显而易见的是，触发按钮可能够用于除最大和/或最小能量水平之外的能量水平。此外，触发按钮可位于多部件柄部组件60上、换能器100上、和/或远离外科器械50的任何其它位置，并且可提供任意数量的触发按钮。尽管已参照两个不同部分62,64来描述多部件柄部组件60，但应当理解，多部件柄部组件60可为两个部分62,64结合在一起的一体组件。作为另外一种选择，多部件柄部组件60可分成多个分立元件，例如单独的触发器部分(可通过用户的手或脚来操作)和单独的配对外壳部分62。触发器部分可操作以启动换能器100并且可远离配对外壳部分62。如根据本文的教导内容对于本领域的普通技术人员而言显而易见的是，多部件柄部组件60可由耐用塑料(例如聚碳酸酯或液晶聚合物)、陶瓷、和/或金属、或者任何其他合适的材料进行构造。根据本文的教导内容，多部件柄部组件60的其他构型对于本领域的普通技术人员而言将是显而易见的。例如，器械50可作为机器人系统的一部分进行操作。根据本文的教导内容，多部件柄部组件60的其它构造对于本领域的普通技术人员也将是显而易见的。
根据本文的教导内容，系统11可以采用的进一步其它合适的形式对于本领域的普通技术人员而言将是显而易见的。
III.具有声学感测的示例性外科器械
应当领会，在使用外科器械50时，外科器械50可能遇到密度不同的组织。例如，当在肌肉、骨、脂肪、疤痕组织、或任何其它类型的组织之间过渡时，外科器械50可能遇到不同的密度。当在组织中使用外科器械50期间，可能期望了解外科器械50何时遇到组织密度的改变。在一些情况下，了解遇到了不同的组织密度是足够的。还可能期望了解不同类型的组织的性质。此外，在一些情况下，应当领会，一旦到达不同的组织密度，就可能期望使外科器械50自动改变其行为。除此之外或可替代地，可以通过一些方式通知使用者外科器械50正在接近不同类型的组织或者与该不同类型的组织相接触，这时使用者可以决定手动改变他/她对外科器械50的操作。
图3示出了示例性外科器械200的示意图，该外科器械200具有手动件202，该手动件202与端部执行器204相联。应当理解，外科器械200是上文所述的外科器械10,50的变型。端部执行器204与手动件202选择性地相联，但是应当理解，在一些型式中，端部执行器204可以与手动件202整体形成。根据本文的教导内容，可使用其它合适的构型对于本领域的普通技术人员而言将是显而易见的。端部执行器204包括多个部件，其中包括至少一个传声器210、至少一个传感器212、和至少一个加速度计208。当然，端部执行器204可以包括多个其它部件，其中包括但不限于超声刀、夹持臂、电外科特征、缝钉施布组件等。在端部执行器204包括超声刀的型式中，端部执行器可能不具有夹持构件。例如，端部执行器204可根据美国专利公布2008/0200940的教导内容中的至少一些进行构造，其公开内容以引用方式并入本文。考虑到本文的教导内容，仅具有刀的端部执行器204可以采用的其它合适的形式对于本领域的普通技术人员而言将是显而易见的。在包括超声刀和夹持构件的端部执行器204的型式中，端部执行器204可以根据美国专利公布2007/0191713、美国专利公布2007/0282333、和美国专利公布2006/0079874的教导内容中的至少一些进行构造，所述专利公布中的每一个的公开内容以引用方式并入本文。根据本文的教导内容，端部执行器204可以采用其它合适的形式对于本领域的普通技术人员而言将是显而易见的。
尽管本例子的端部执行器204包括传声器210、传感器212、和加速度计208，但是应当理解，端部执行器204不必包含传声器210、传感器212、和加速度计208中的每一个。此外，尽管图3将传声器210、传感器212、和加速度计208示为与端部执行器204分开，但是应当理解，传声器210、传感器212、和加速度计208中的任何一个或全部可以集成到端部执行器204中，或者作为供选择的替代方案可以与端部执行器204一体地构造。应当理解，传声器210和/或加速度计208能够定位在手动件202中。例如，传声器210能够定位成使得传声器210可操作以在手动件202中的谐波波导的近端处监测声学信号。同样，加速度计208可以定位在手动件202中，以在外科器械200移动穿过组织时监测手动件202的运动。根据本文的教导内容，可利用其它合适的变型对于本领域的普通技术人员而言将是显而易见的。
传声器210可总体操作以起到声学传感器的作用。应当理解，传声器210可操作以在超声频率、听觉频率、和/或次声频下检测声学信号。传声器210与计算模块214相联，将在下文对该计算模块214进行进一步的讨论，该计算模块214可操作以检测和记录可能出现在传声器210周围的任何东西的声音样本。例如，应当理解，当使用外科器械200时，外科器械200的部件可能产生能够指示与将与外科器械200相接触的组织的性质和/或密度相关的信息的各种声学信号或者脉冲。这些声学信号或脉冲可能在产生各种声学信号或脉冲之间被传声器210接收到；并且/或者可以由备选的传声器接收到。在外科器械200引导端部执行器204穿过密度不同的组织的情况下可能存在的一个例子中，外科器械200可以基于各种阻尼水平或者测量到的由组织造成的信号强度的损失来产生不同的声学信号。传声器210能够定位以在与端部执行器204相联的刀或波导处监测声学信号。超声刀所遇到的组织的类型/密度可能改变与包括刀的声学组件相关的声学信号特性。这种改变可能发生在超声频率、听觉频率、和/或次声频下。因此，可以基于所监测到的声学信号得出对组织密度和/或类型的推断，由此可以向使用者提供关于受外科器械200影响的组织类型的信息。
如上所述，传声器210可操作以在各种特定频率(例如，超声频率、听觉频率、和/或次声频等)下监测声音。例如，传声器210能够结合各种过滤器、放大器等使用，以关注出现在特定频率下的信号，从而避免可能不提供关于外科器械200的有用信息的一些声学信号。能够对传声器信号应用快速傅立叶变换(FFT)或者其它类似的计算法，以交互操作从换能器/刀共振结构发射的一个或多个频率。这些频率的改变能够用作模态耦合的替代物并且因此用作检测不期望的振动状态或模式的方式。一旦被检测到，这能够用作反馈的方式以警示使用者，通过改变驱动信号特性来改变共振系统的行为，或者同时警示使用者并且通过改变驱动信号特性来改变共振系统的行为。根据本文的教导内容，一个或多个传声器210可以用于检测组织密度和/或组织密度的改变的进一步其它合适的方式对于本领域的普通技术人员而言将是显而易见的。
此外，如根据本文的教导内容对于本领域的普通技术人员而言显而易见的是，传感器212可以包括阻抗传感器、温度传感器、力传感器、和/或任何其它合适类型的传感器。在传感器212包括阻抗传感器的型式中，传感器212可以用于感测与端部执行器204相接触的组织的阻抗。端部执行器204所遇到的组织的阻抗可以基于这种组织的密度发生变化。例如，与密度较低的组织(例如，脂肪组织)所表现出的阻抗相比，相对致密的组织(例如，疤痕组织)可能表现出相对较高的阻抗。因此，传感器212可以用于检测作为阻抗的函数的组织密度的改变。应当理解，这种阻抗可以包括电阻抗和/或声学阻抗。例如，相对致密的组织可以同时表现出相对较高的电阻抗和相对较高的声学阻抗。还应当理解，可以通过不同的方式来测量阻抗。仅以举例的方式，模拟电路可以用于通过产生两个与电压和电流振幅成比例的两个电压来测量平均电阻抗(例如，rms、峰间、或简单平均值)并且随后除以这些电压以提供与电阻抗成比例的模拟电压输出。作为另一个仅仅是说明性的例子，可以通过数字并且瞬时读取和计算电阻抗。具体而言，系统可以读取实际瞬时电压和实际瞬时电流；随后相除这些数值以计算瞬时阻抗。根据本文的教导内容，电阻抗传感器可以实施成传感器212的各种合适的方式对于本领域的普通技术人员而言将是显而易见的。类似地，根据本文的教导内容，声学阻抗传感器可以实施成传感器212的各种合适的方式对于本领域的普通技术人员而言将是显而易见的。
作为另一个仅仅是说明性的例子，不同的组织密度可以对端部执行器204做出不同的热反应。因此，在传感器212包括温度传感器的型式中，传感器212可以用于检测作为温度的函数的组织密度的改变。在传感器212包括力传感器(例如，应变仪等)的型式中，传感器212可以用于检测作为当端部执行器204挤压组织时端部执行器204所遇到的力/应变的函数的组织密度的改变。根据本文的教导内容，可以用于检测组织密度和/或组织密度的改变的进一步其它合适类型的传感器212对于本领域的普通技术人员而言将是显而易见的。
加速度计208可操作以检测端部执行器204的运动。应当理解，从加速度计208收集到的信息可以用于确定使端部执行器204运动的力。还应当理解，可以确定与端部执行器204的运动相关的单纯的速度、相对速度、平均速度、变化率、或者任何其它合适的度量标准。当端部执行器204遇到相对致密的组织时，这可能造成端部执行器204沿其运动路径减速，并且加速度计208能够检测到该减速。类似地，端部执行器204可以在沿其行进路径从致密组织过渡到密度相对较小的组织时经历加速，加速度计208能够检测到该加速。计算模块214还能够区分基于组织密度改变的加速/减速与基于外科医生的手部运动改变加速/减速。例如，计算模块214能够比较来自加速度计208的数据与来自一些其它类型的传感器(例如，柄部组件202中的应变仪等)的数据，以辨别基于组织密度改变的加速/减速与基于外科医生的手部运动改变的加速/减速。根据本文的教导内容，一个或多个加速度计208可以用于检测组织密度和/或组织密度的改变的进一步其它合适的方式对于本领域的普通技术人员而言将是显而易见的。
功率源206也与柄部组件202相联并且可操作以向端部执行器204传送功率。尽管图示的型式将功率源206示为与柄部组件204分开，但是功率源206可以集成到柄部组件204中。
此外，外科器械200包括与端部执行器204相联的计算模块214、功率源206、加速度计208、传声器210、和传感器212。计算模块214可以包括任何合适的部件，所述任何合适的部件可以包括处理器、存储器、或者如根据本文的教导内容对于本领域的普通技术人员而言将显而易见的任何其它合适的与计算相关的部件。计算模块214可操作以执行或运行与外科器械200的部件中的任何部件的操作相关的程序或算法。例如，计算模块214可操作以控制端部执行器204的步骤或者传声器210、传感器212、和加速度计208的步骤。此外，计算模块214可以通过柄部组件204与功率源206相联，使得计算模块214可操作以控制或利用功率源206来执行计算模块214的任何合适的例行程序和/或程序。因此，计算模块214可操作以执行控制逻辑。
尽管计算模块214被示为定位在柄部组件202内，但是应当理解，计算模块214可以定位在任何合适的位置处。例如，计算模块214可以定位在端部执行器204中、功率源206中、并且/或者甚至可以被容纳在定位于柄部组件202与功率源206之间的模块内。在进一步其它的示例性型式中，应当理解，计算模块214不必限于单个计算模块214。计算模块214可以能够使得使用多个计算模块214，其中所述多个计算模块214可以定位在单一位置处或者遍布外科器械200或者甚至远程地定位。
如上所述，端部执行器204包括传声器210、传感器212、和加速度计208。还应当理解，在外科手术中使用端部执行器204可能涉及通过端部执行器204向手术部位提供超声振动。还应当理解，向手术部位传送超声振动造成由端部执行器204产生音调或音高。例如，应当理解，如果由超声刀(例如，像上文所述的刀82)从端部执行器204传送振动，则当端部执行器204的刀行进穿过不同类型的组织密度时，来自端部执行器204的振动将由于振动以不同的速度行进穿过密度不同的组织而产生声学特性不同的声音。因此，还应当理解，不仅穿过不同组织的振动所产生的声音不同，传声器210可操作以在振动被传送到密度不同的组织时检测声音的差异。这些声音的差异可能被刀82本身以及与刀82声学相联的部件和/或波导捕捉到。还应当理解，端部执行器204能够传送不同频率的振动并且传声器210可以在不同的频率下监测声学信号。例如，通过在不同的频率下监测声学信号，不同的数据是能够确定的。在一些情况下，组织密度的某些改变可能更明显或者能够在特定频率下被检测到。
IV.使用外科器械的示例性方法
图4示出了使用外科器械200的一个示例性方法。方框400涉及使用者启动外科器械200。应当理解，在一些型式中，外科器械200可以不必被启动—其可以默认处于“开”状态。
方框410包括开始声学监测。在一些型式中，外科器械200可以连续监测与该外科器械200的声学传动系(例如，超声换能器、喇叭、波导、和超声刀)相关的声学信号。应当理解，可以使用与计算模块214相联的传声器210来执行声学监测。传声器210连续检测与外科器械200的声学传动系相关的声音信号。计算模块214连续接收代表传声器210所捕获的声音信号的数据。应当理解，可以在计算模块214接收声学信号的同时使用计算模块214来执行声学监测。方框420涉及使用者在手术部位处使用外科器械200，通过端部执行器204操纵组织。在使用期间，方框430连续监测声学信号，以确定声学信号是否超过特定的预先确定的阈值，该特定的预先确定的阈值能够持续更新并且通过计算模块214计算出。
尽管本公开经常使用术语“阈值”，但是能够构想，该术语可以包括最小值或底线(floor)。换句话讲，如本文所使用的例如“超过阈值”的短语可以被理解成也涵盖数值下降到特定设定中的预先确定的最小值或底线以下的情况。因此，应当理解，在方框430监测以确定声学信号是否超过特定的预先确定的阈值的情况下，这可以包括监测声学信号是否下降到预先确定的最小值或底线以下。还将理解，声学信号的某种改变(例如，超过阈值)可以指示组织密度的改变，这可以指示组织类型的改变。因此，一旦在方框440中通知使用者该改变，使用者就能够停止使用外科器械200、继续使用外科器械200、或改变对外科器械200的使用。
存在可以执行图4中所示的方法的多种方式，其中包括可以执行方框430的多种方式。例如，一些型式的计算模块214以及端部执行器204的多个传感器210,212,208可操作以具有两种监测模式：横向监测模式和组织密度监测模式。在横向监测模式中，计算模块214可操作以对声学样本执行快速傅立叶变换，以识别其横向模式及相关频率。计算模块214还可操作以当端部执行器204未负载时，在将外科器械200用于组织上之前建立多个样本及其相关频率的基线模态间距(baseline modal spacing)。一旦外科手术中在使用外科器械200期间将负载施加到端部执行器204上，计算模块214就可操作以比较所识别出的横向模式与基线。最后，在外科手术中使用外科器械200期间所感测到的横向模式信号超过特定阈值或下降到底线以下的情况下，计算模块214可操作以停止与外科器械200相关的任何换能器的操作或者以其它方式使端部执行器204在至少一个时间周期期间至少部分地不可操作。
在组织密度监测模式中，计算模块214还可操作以对声学样本执行快速傅立叶变换，从而在不同的频率下识别其振幅。计算模块214还可操作以当端部执行器204未负载时，在将外科器械200用于组织上之前建立多个样本及其相关频率的基线振幅。一旦外科手术中在使用外科器械200期间将负载施加到端部执行器204上，计算模块214就可操作以比较在每一个频率下所感测到的振幅与预先建立的基线。最后，在测量到的频率的振幅下降到预先确定的范围以下的情况下，计算模块214可操作以表达端部执行器204正在遇到潜在的致密组织。例如，计算模块214可以联接到指示器，该指示器在视觉上和/或通过声音警示使用者已遇到致密组织。一旦振幅回到基线范围，那么计算模块214就可以向指示器通讯以停止警示使用者或为使用者产生不同的视觉和/或声音警示。除此之外或可替代地，计算模块214可以响应于组织密度的改变而影响端部执行器204的操作特性。当然，根据本文的教导内容，计算模块214的其它合适的用途和性能对于本领域的普通技术人员而言将是显而易见的。
图5示出了使用外科器械200的另一种示例性方法。应当理解，在一些情况下，外科器械200可以用于腹壁成形术、脂肪组织的体型塑造、和/或可能遇到疤痕组织或其它致密组织的一些其它的手术的应用中。应当理解，可能期望更多的电流以用于使用外科器械200，使得能够在使用者并未注意到外科器械200的性能改变的情况下切割疤痕组织。因此，方框500示出了外科器械200被启动。之后，方框510涉及开始监测组织阻抗和/或力。可以例如使用图3的传感器212来完成阻抗监测，该传感器212可以包括能够感测端部执行器204所遇到的组织的阻抗的阻抗传感器。此外，可以结合计算模块214使用加速度计208来测量力，以感测受端部执行器204挤压的组织所展现出的物理阻力的量。尽管图示的型式示出了所监测的组织阻抗和/或力，但是应当理解，可以除此之外或可替代地使用传声器210，以便监测外科器械200的声学信号。方框520随后示出了使用者在外科手术中使用外科器械200。在手术期间，方框530监测所感测到的阻抗和力，以确定阻抗或力是否超过任何特定的阈值(或下降到任何特定的底线以下)。在发生任一种的情况下，方框540引导外科器械200以通过使用功率源206来增大电流，由此通过更大的功率来驱动端部执行器204。
还应当理解，电流可以响应于由传声器210监测到的声学信号的改变而增大。例如，被高度阻尼的声学信号可以指示较致密的组织，外科器械200将通过电流增大对该信号做出响应。通过方框550产生反馈回路，其中方框550监测以确定阻抗和/或力是否在方框540中电流增大之后已下降到预先确定的阈值以下。因此，在端部执行器204遇到坚硬的疤痕组织的情况下，电流将继续增大，以便向外科医生提供流畅的切割体验。在阻抗水平、力水平、和/或声学信号再次下降到预先确定的阈值以下的情况下，方框560就使电流再次减小到先前在方框520处所使用的水平。
应当理解，选定的阈值可以取决于若干因素，其中包括但不限于换能器的组合以及所使用的端部执行器204的类型、使用者的使用习惯和熟练程度、所进行的外科手术的类型、以及患者与患者之间组织的不同。可以基于任何单一因素或因素的组合来建立初始阈值。在一些情况下，端部执行器的类型将是主要因素并且这可以用于阈值的初始设定。随后可以基于其它的因素来调节该初始阈值设定。例如，外科医生可以通过姓名以及/或者通过输入特定于其器械使用简介的代码来识别他自己/她自己的身份。还应当理解，系统可以是学习系统，其中阈值开始于特定的初始设定并且在外科医生使用该系统时被调节。在一些这种情况下，外科医生可以从相对较为容易的组织开始(例如，提供低于阈值的数据值)，随后随着手术进行过渡到较为坚硬的组织。器械200的该早期使用可以用于在手术早期有效地为阈值设定基线并且随后允许阈值根据预先确定的最大和最小的范围限制向上/向下调节。根据本文的教导内容，可建立阈值的其它合适的方式对于本领域的普通技术人员而言将是显而易见的。
应当理解，在例如外科器械200用于从骨移除组织的应用的场景中，可能期望避免在移除软组织的过程中由于疏忽而切割骨。因此，与响应于如图5中所示的组织密度改变而增大电流相反，电流可以取而代之地减小。为此，图6的方框600示出了外科器械200被启动。方框610示出了开始监测阻抗和力。例如，加速度计208可以用于检测端部执行器204穿过组织的运动的减慢或停止。传感器212还可以包括用于监测端部执行器204所遇到的组织的阻抗的阻抗传感器。除此之外或可替代地，方框610能够用于监测外科器械200的声学信号，以确定是否应当减小被提供给外科器械200的电流。在方框620中，使用者使用外科器械200。方框630示出了检查和连续监测阻抗和/或力测量结果，以确定是否超过任何预先确定的阈值(或者下降到任何特定的底线以下)。除此之外或可替代地，方框630还可以监测声学信号。在超过阈值的情况下，可以指示外科器械200遇到骨组织。因此，在方框640中，由功率源206提供给外科器械200的电流减小，由此减少或停止端部执行器204处的功率。通过方框650形成反馈回路，其中方框650连续监测以确定阻抗、力、和/或声学测量结果是否已再次下降到预先确定的阈值以下。如果不是这样，则指示骨组织可能仍然在附近，因此需要较少的电流来驱动端部执行器204。一旦确定阻抗、力、和/或声学测量结果已下降到阈值量以下，则方框660引导外科器械200使电流再次增大到先前在方框620处所使用的水平。
在一些情况下，应当理解，与将外科器械200调节成所感测到的组织环境相反，可能期望使外科器械200简单地通知使用者，使得使用者能够调节对外科器械200的使用。例如，图7示出了其中外科器械被启动的方框700。之后，方框710指示组织阻抗监测开始。例如，可以通过图3中所示的传感器212来完成组织阻抗监测。应当理解，除此之外或可替代地，通过传声器210检测到的声学信号和/或通过加速度计208检测到的运动也可以被监测。之后，使用者可以开始切割，如方框720中所示。方框730连续监测由传感器212检测到的组织阻抗、力、和/或声学信号。在阻抗、端部执行器204的运动、和/或声学信号发生快速改变时，方框740警示使用者。这种警示可以包括声音警示、视觉警示、或者如根据本文的教导内容对于本领域的普通技术人员而言将显而易见的任何其它合适的警示。警示(声音、视觉等)可以集成到手持件202中或者甚至功率源206中，使得使用者可以通过注意到出现在手持件202上的警示而被警示。除此之外或可替代地，警示装置能够从以下位置被注意到：功率源206或者使用者可视觉感知的任何其它合适的位置或者使用者的听觉范围内(如果警示装置包括声音警示的话)。在方框750中，使用者随后可以警示外科器械200的运动或定位并且之后继续切割组织，如方框760中所示。例如，使用者可以在往复的“弓形锯运动(hacksaw motion)”中移动端部执行器204，以便更有效地横切致密组织。当使用者移动端部执行器204穿过致密组织时，一旦组织变为密度较小，就可以向使用者提供警示，指示致密组织的区域已通过。因此，使用者可以在往复的“弓形锯运动”之前重新使用用于移动端部执行器204的运动。如根据本文的教导内容，本领域的普通技术人员将显而易见的是，在可供选择的替代方案中，使用者可以将他或她对端部执行器204的移动改变成任何合适的运动。
应当理解，在一些型式中，在管理电流的方式中，可能需要外科器械200更加柔性。与仅仅增大电流或减小电流相反，可能期望以外科器械200能够基于端部执行器204所接合的组织密度或者组织密度的改变智能地确定是否需要来增大电流或减小电流的方式来使用外科器械200。例如，在图8中，方框800涉及启动外科器械200。方框810开始能量脉动以及使用外科器械200。在超声外科器械50的情况下，外科器械50可以通过刀82向手术部位传送超声振动。这种振动可以通过将电功率脉动到外科器械50的换能器而产生。在一些型式中，启动脉冲以处于从一个脉冲每10毫秒至一个脉冲每100毫秒的范围内的频率被传送到换能器100。当然，根据本文的教导内容，对于本领域的普通技术人员将而言显而易见的是，可使用任何其它合适的脉冲频率。这些启动脉冲造成换能器100中的压电元件将电功率转化成机械振荡/振动功率，形成沿声学波导连通到超声刀82的超声振荡。在被传送给换能器100以产生超声振动的电启动脉冲之间，外科器械50向传感器212提供电压，以检测相邻的组织的阻抗。在如方框830中所示的检测到高阻抗的情况下，电流可以如方框860中所示的在下一个功率传送脉冲中增大，以便有助于外科器械200在手术部位处切入相对致密的组织。在如方框840中所示的检测到低阻抗的情况下，在下一个功率传送脉冲中被传送到外科器械200的电流可以如方框850所示的被保持或降低。应当理解，所保持的电流水平可以为大约250mA或者如根据本文的教导内容对于本领域的普通技术人员而言将显而易见的任何其它合适的电流水平。
在一些情况下，可能期望确定手术组织定位在脂肪组织还是肌肉组织中。应当理解，外科器械200的声学传动系(例如，超声换能器、喇叭、波导、和超声刀)可以基于端部执行器204与例如脂肪组织的组织还是将更大的声学负载施加在端部执行器204上的例如肌肉的相对较致密的组织相接触而表现出不同的谐振频率。例如，当端部执行器204挤压脂肪组织时，例如脂肪组织的低负载可以在声学传动系的谐振频率中提供相对较小的偏移。例如肌肉或软骨的较致密的组织可以相对于端部执行器204提供较高的机械/声学负载，导致声学传动系的谐振频率相对较大。这些效果甚至可能在端部执行器204被用作刀而不是剪刀时更明显。当端部执行器204被用作刀时，使用者可以基于所选择的组织类型以及作为刀的端部执行器204施加在组织上的压力的量来确定有效的负载。施加的力或压力越高，声学负载就越高并且谐振频率的偏移就越大。当端部执行器204被用作剪刀时(例如，通过像夹持臂84等的夹持特征的步骤)，压力分布可能较少地取决于夹持特征与超声刀之间的组织的量/类型。这使得使用者能够更多地关注将横切哪个组织并且较少地关注施加于各种类型的组织的力的细微差别。在一些这种型式中，使用者可以通过将超声刀刃抬起到组织中来实现较快的处理次数，其中力传感器212提供在端部执行器204处对超声刀与夹持构件之间的压力的测量。
处理谐振频率的改变的例子示于图9中。方框900示出了启动外科器械200。方框910示出了确定谐振频率Fn，然后将初始频率设定成Fn_start，如方框920中所示。这建立了用于与稍后检测到的谐振频率比较的基线谐振频率。应当理解，这种基线谐振频率(Fn_start)可以通过在将端部执行器204施加到组织上之前启动端部执行器204的超声刀、以及通过传感器212在端部执行器2040处感测力来获得。使用者随后可以切割组织，如方框930中所示。当组织被切割时，传感器212继续监测谐振频率(Fn)，如方框940中所示。当更新Fn时，Fn相对于Fn_start的改变率被监测，以捕捉谐振频率的偏移。在观察到较慢的Fn的改变率的情况下，则能够推断出外科器械200处于肌肉组织中。使用者可能希望了解肌肉组织的存在，因此方框990向使用者提供反馈，该反馈可以呈可听音、振动、如根据本文的教导内容对于本领域的普通技术人员而言将显而易见的任何其它合适的反馈方式的型式。之后，被提供给外科器械200的电流响应于所感测到的组织密度增大而如方框995中所示的手动或自动地增大，以通过更多能量来驱动端部执行器204从而横切相对致密的组织。在Fn的改变率如方框960中所示的快时，能够推断外科器械200处于脂肪组织中。因此，电流可以如方框980中所示的手动或自动地减小，以通过较少的能量来驱动端部执行器204从而横切相对柔软的组织。
还应当理解，在一些情况下，可能期望使外科器械200可操作以同时监测若干不同的特性，其中包括力改变、功率/阻抗改变、谐振频率改变、和/或运动改变，以确定被切割的组织的密度是否改变。图10示出了这种系统并且通过使用者启动外科器械200的方框1000开始。使用者随后使用外科器械200来切割组织，如方框1010中所示。当使用外科器械200时，力、加速度、功率、阻抗、以及声学信号水平和曲线被连续监测，如方框1020中所示。之后，可以检测到如方框1030中所示的力的任何增大。此外，可以检测到如方框1040中所示的功率的增大，并且也可以检测到如方框1050中所示的运动的任何减少。因此，可以相应地调节电流和/或功率(增大或减小)，如方框1060中所示。例如，方框1060和/或方框1070可以基于离散的数值和/或趋势、基于在方框1030,1040,1050中的任何一个中出现并且被检测到的数值和/或趋势的各种组合。应当理解，阻抗数值/趋势和声学信号的特定组合可以指示特定的组织密度特性。同样，特定的加速度计数值和声学信号的组合可以指示另一种组织密度特性。应当理解，阻抗、声学信号、和/或加速度计读数的各种组合可以用于指示组织密度的特性，这可以被编程或者通过其它方式集成到计算模块214中。随后相应地，计算模块214可操作以在方框1060,1070处提供相应的指令和/或命令，以使得端部执行器204能够继续横贯组织。
外科器械200还可操作以基于方框1030,1040,1050中的监测来具体识别组织类型并且相应地警示使用者。例如，可以基于声学、阻抗、和/或力信号的特定组合来通知使用者端部执行器204与骨相接合。信号的其它组合可以用于指示所接合的组织是脂肪组织、疤痕组织等。之后，可以将方框1070中所示的声音反馈提供给使用者，以通知使用者任何组织密度改变。还应当理解，可以除了或代替声音反馈之外使用例如视觉反馈、触觉反馈的其它的反馈机构、和/或端部执行器204控制改型，如根据本文的教导内容将对于本领域的普通技术人员而言显而易见的。此外，应当理解，所讨论的方法仅仅是示例性的并且可以使用其它合适的方法，如本领域的普通技术人员将显而易见的。
在穿过套管针或其它的进入端口使用外科器械200的一些情况下(例如，在微创手术中)，外科器械200的轴可以关于患者体内的套管针的进入点以枢转方式运动。应当理解，患者体内的套管针的进入点因此可以起到运动的虚拟中心的作用。在柄部组件202处测量到的运动可以与相对支点(患者体内的器械200的长度/患者体外的器械200的长度)成比例。在端部执行器204处测量到的运动、力、加速度等可以与组织效果直接相关。定位在柄部组件202中的传感器可需要按比例绘制以反映枢轴-支点关系，以便准确地表示端部执行器204与组织的界面处所发生的情况。根据本文的教导内容，说明穿过套管针或其它的进入端口使用器械200的该方式以及其它合适的方式对于本领域的普通技术人员而言将是显而易见的。
V.其它方面
尽管上文的例子与呈超声器械形式的外科器械10相关，但是应当理解，本文的教导内容可以易于应用于各种类型的电外科器械，包括但不限于以下专利中所教导的电外科器械：2002年12月31日公布的名称为“Electrosurgical Systems and Techniques forSealing Tissue,”的美国专利6,500,176，其公开内容以引用方式并入本文；2006年9月26日公布的名称为“Electrosurgical Instrument and Method of Use”的美国专利7,112,201，其公开内容以引用方式并入本文；2006年10月24日公布的名称为“ElectrosurgicalWorking End for Controlled Energy Delivery”的美国专利7,125,409，其公开内容以引用方式并入本文；2007年1月30日公布的名称为“Electrosurgical Probe and Method ofUse”的美国专利7,169,146，其公开内容以引用方式并入本文；2007年3月6日公布的名称为“Electrosurgical Jaw Structure for Controlled Energy Delivery”的美国专利7,186,253，其公开内容以引用方式并入本文；2007年3月13日公布的名称为“Electrosurgical Instrument”的美国专利7,189,233，其公开内容以引用方式并入本文；2007年5月22日公布的名称为“Surgical Sealing Surfaces and Methods of Use”的美国专利7,220,951，其公开内容以引用方式并入本文；2007年12月18日公布的名称为“PolymerCompositions Exhibiting a PTC Property and Methods of Fabrication”的美国专利7,309,849，其公开内容以引用方式并入本文；2007年12月25日公布的名称为“Electrosurgical Instrument and Method of Use”的美国专利7,311,709，其公开内容以引用方式并入本文；2008年4月8日公布的名称为“Electrosurgical Instrument andMethod of Use”的美国专利7,354,440，其公开内容以引用方式并入本文；2008年6月3日公布的名称为“Electrosurgical Instrument”的美国专利7,381,209，其公开内容以引用方式并入本文；2011年4月14日公布的名称为“Surgical Instrument Comprising First andSecond Drive Systems Actuatable by a Common Trigger Mechanism”的美国公布2011/0087218，其公开内容以引用方式并入本文；以及2011年6月2日提交的名称为“MotorDriven Electrosurgical Device with Mechanical and Electrical Feedback”的美国专利申请13/151,181，其公开内容以引用方式并入本文。
此外，本文的教导内容可以易于应用于各种类型的电动切割和缝合器械，包括但不限于以下专利中所教导的那些电动切割和缝合器械：2008年8月26日公布的名称为“Motor-Driven Surgical Cutting and Fastening Instrument with Loading ForceFeedback”的美国专利7,416,101，其公开内容以引用方式并入本文；2009年8月20日公布的名称为“Motorized Cutting and Fastening Instrument Having Control Circuit forOptimizing Battery Usage”的美国公布2009/0209979；以及2011年6月2日提交的名称为“Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback”的美国专利申请13/151,181，其公开内容以引用方式并入本文。可应用本文的教导的进一步其它的合适类型的装置对于本领域的普通技术人员将是显而易见的。
应当理解，所述以引用的方式并入本文中的任何专利、出版物或其它公开材料，无论是全文或部分，仅在所并入的材料与本公开中给出的定义、陈述或者其它公开材料不冲突的范围内来并入本文。由此，在必要程度下，本文所明确阐述的公开内容将会取代以引用的方式并入本文中的任何相冲突的材料。如果据述以引用的方式并入本文但与本文所述现有定义、陈述或者其它公开材料相冲突的任何材料或其部分，仅在所并入的材料与现有公开材料之间不产生冲突的程度下并入本文。
本发明的一些型式可应用于常规的内窥镜式和开放性手术器械以及机器人辅助的手术。示例性的机器人辅助外科系统公开于2004年8月31日公布的名称为“RoboticSurgical Tool with Ultrasound Cauterizing and Cutting Instrument”的美国专利6,783,524中，其公开内容以引用方式并入本文。
本文所公开的装置的型式可设计为使用一次后丢弃，也可设计为供多次使用。在上述任一种或两种情况下，都可针对这些型式进行修复，以便在使用至少一次后重复使用。修复可以包括以下步骤任何组合：拆卸装置，然后清洗或者更换特定部件，并且随后重新组装。具体地讲，可拆卸所述装置的型式，并且可选择性地以任何组合形式来更换或拆除所述装置的任意数量的特定部件或零件。清洗和/或更换具体零件后，所述装置的型式可在修复设施中进行重新组装以供随后使用，或者在即将进行外科手术前由外科手术团队进行重新组装。本领域的技术人员将会知道，装置修复可以利用多种技术进行拆卸、清洗/更换以及重新组装。此类技术的使用和所得修复装置全都在本申请的范围内。
仅以举例的方式，本文所述的型式可在外科手术之前进行处理。首先，可以获取新的或用过的器械，并且根据需要进行清洗。然后，可对器械进行消毒。在一种消毒技术中，装置放置在闭合并密封的容器、诸如塑料袋或TYVEK袋中。随后，可将容器和装置放置在可穿透容器的诸如γ辐射、X射线或高能电子等的辐射场中。辐射可以杀死装置上和容器中的细菌。消毒后的装置随后可以存放在消毒容器中。该密封容器可将器械保持在无菌状态，直到在外科设施中打开该容器。还可使用在本领域中已知的任何其它技术进行装置消毒，所述技术包括但不限于β或γ辐射、环氧乙烷或者蒸汽消毒。
在已经示出并描述了本发明的各种型式的情况下，本领域的普通技术人员可在不脱离本发明范围的前提下进行适当修改。已经提及若干此类潜在修改形式，并且其它修改形式对于本领域的技术人员而言将会显而易见。例如，上文所讨论的例子、型式、几何形状、材料、尺寸、比率、步骤等等均是示例性的而非所要求的。因此，本发明的范围应以以下权利要求书作考虑，并且应理解为不限于说明书和附图中示出并描述的结构以及操作细节。

Claims (15)

1.一种外科设备，包括：
(a)能够在外科手术中使用的端部执行器，其中所述端部执行器包括联接到声学传动系的超声刀，其中所述端部执行器能够借助于所述超声刀向手术部位处的组织传送超声能量，其中所述端部执行器包括至少一个传感器，所述至少一个传感器包括传声器，其中所述至少一个传感器能够通过采用传声器感测超声刀的与其相接触的组织的性质和/或密度相关联的信息的各种声学信号或者脉冲而获得由所述超声刀碰到的所述组织的类型或密度；
(b)与所述端部执行器相联的主体组件；
(c)与所述主体组件相联的功率源，其中所述功率源可操作以向所述端部执行器传送功率；以及
(d)与所述至少一个传感器相联的控制模块，其中所述控制模块可操作以基于来自指示组织密度改变的至少一个传感器的数据来改变向所述端部执行器传送的功率。
2.根据权利要求1所述的外科设备，其中所述传声器能够执行下列中的一个或多个：传播声音、接收声音、或测量声音。
3.根据权利要求2所述的外科设备，其中所述传声器能够感测与处于启动状态下的超声刀的独特模态耦合相关的超声振动、听觉振动、或次声振动。
4.根据权利要求1所述的外科设备，其中所述至少一个传感器包括阻抗传感器。
5.根据权利要求4所述的外科设备，其中所述阻抗传感器能够感测与组织相关的电阻抗。
6.根据权利要求1所述的外科设备，其中所述端部执行器可操作以基于由所述超声刀碰到的组织的密度来产生不同的声学信号。
7.根据权利要求1所述的外科设备，还包括与所述控制模块相联的听觉反馈装置。
8.根据权利要求1所述的外科设备，还包括与所述控制模块相联的触觉反馈装置。
9.根据权利要求1所述的外科设备，其中所述至少一个传感器包括加速度计。
10.根据权利要求1所述的外科设备，其中控制模块能够通知使用者所述至少一个传感器检测到的改变。
11.根据权利要求1所述的外科设备，其中所述至少一个传感器包括能够监测不同的物理属性的多个传感器。
12.根据权利要求1所述的外科设备，其中控制模块能够被编程以具有至少一个预定义的阈值参数。
13.根据权利要求1所述的外科设备，其中控制模块能够执行同步阻抗和力监测。
14.根据权利要求1所述的外科设备，其中控制模块能够响应于来自所述传感器的指示组织密度增加的数据而增加向所述端部执行器传送的功率。
15.根据权利要求1所述的外科设备，还包括声学传动系，其中所述超声刀与所述声学传动系相联，其中所述传感器可操作以感测与所述声学传动系相关的谐振频率，其中所述控制模块可操作以检测所述传感器检测到的谐振频率的偏移。
CN201380020955.7A 2012-04-18 2013-04-15 具有组织密度感测的外科器械 Active CN104244850B (zh)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US13/449,837 US9788851B2 (en) 2012-04-18 2012-04-18 Surgical instrument with tissue density sensing
US13/449,837 2012-04-18
PCT/US2013/036587 WO2013158545A1 (en) 2012-04-18 2013-04-15 Surgical instrument with tissue density sensing

Publications (2)

Publication Number Publication Date
CN104244850A CN104244850A (zh) 2014-12-24
CN104244850B true CN104244850B (zh) 2017-12-12

Family

ID=48444559

Family Applications (1)

Application Number Title Priority Date Filing Date
CN201380020955.7A Active CN104244850B (zh) 2012-04-18 2013-04-15 具有组织密度感测的外科器械

Country Status (9)

Country Link
US (2) US9788851B2 (zh)
EP (1) EP2838447B1 (zh)
JP (1) JP6271512B2 (zh)
CN (1) CN104244850B (zh)
AU (1) AU2013249514B2 (zh)
BR (1) BR112014025798B1 (zh)
CA (1) CA2870536C (zh)
IN (1) IN2014DN08374A (zh)
WO (1) WO2013158545A1 (zh)

Families Citing this family (707)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10835307B2 (en) 2001-06-12 2020-11-17 Ethicon Llc Modular battery powered handheld surgical instrument containing elongated multi-layered shaft
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
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
US20060079874A1 (en) 2004-10-08 2006-04-13 Faller Craig N Tissue pad for use with an ultrasonic surgical instrument
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
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
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
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
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
US20110295295A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument having recording capabilities
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
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
US7665647B2 (en) 2006-09-29 2010-02-23 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling device with closure apparatus for limiting maximum tissue compression force
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
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US20080169333A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapler end effector with tapered distal end
US8727197B2 (en) 2007-03-15 2014-05-20 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configuration with cooperative surgical staple
US8226675B2 (en) 2007-03-22 2012-07-24 Ethicon Endo-Surgery, Inc. Surgical instruments
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
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US11564682B2 (en) 2007-06-04 2023-01-31 Cilag Gmbh International Surgical stapler device
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
US8523889B2 (en) 2007-07-27 2013-09-03 Ethicon Endo-Surgery, Inc. Ultrasonic end effectors with increased active length
US8882791B2 (en) 2007-07-27 2014-11-11 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US8808319B2 (en) 2007-07-27 2014-08-19 Ethicon Endo-Surgery, Inc. Surgical instruments
US9044261B2 (en) 2007-07-31 2015-06-02 Ethicon Endo-Surgery, Inc. Temperature controlled ultrasonic 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
US8623027B2 (en) 2007-10-05 2014-01-07 Ethicon Endo-Surgery, Inc. Ergonomic surgical instruments
US10010339B2 (en) 2007-11-30 2018-07-03 Ethicon Llc Ultrasonic surgical blades
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
JP5410110B2 (ja) 2008-02-14 2014-02-05 エシコン・エンド−サージェリィ・インコーポレイテッド Ｒｆ電極を有する外科用切断・固定器具
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US10390823B2 (en) 2008-02-15 2019-08-27 Ethicon Llc End effector comprising an adjunct
US9089360B2 (en) 2008-08-06 2015-07-28 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
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
CA2751664A1 (en) 2009-02-06 2010-08-12 Ethicon Endo-Surgery, Inc. Driven surgical stapler improvements
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
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US9168054B2 (en) 2009-10-09 2015-10-27 Ethicon Endo-Surgery, Inc. Surgical generator for ultrasonic and electrosurgical devices
USRE47996E1 (en) 2009-10-09 2020-05-19 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US9060775B2 (en) 2009-10-09 2015-06-23 Ethicon Endo-Surgery, Inc. 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
US8486096B2 (en) 2010-02-11 2013-07-16 Ethicon Endo-Surgery, Inc. Dual purpose surgical instrument for cutting and coagulating tissue
US8579928B2 (en) 2010-02-11 2013-11-12 Ethicon Endo-Surgery, Inc. Outer sheath and blade arrangements for ultrasonic surgical instruments
US8469981B2 (en) 2010-02-11 2013-06-25 Ethicon Endo-Surgery, Inc. Rotatable cutting implement arrangements for ultrasonic surgical instruments
US8961547B2 (en) 2010-02-11 2015-02-24 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments with moving cutting implement
US8951272B2 (en) 2010-02-11 2015-02-10 Ethicon Endo-Surgery, Inc. Seal arrangements for ultrasonically powered surgical instruments
GB2480498A (en) 2010-05-21 2011-11-23 Ethicon Endo Surgery Inc Medical device comprising RF circuitry
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
US9517063B2 (en) 2012-03-28 2016-12-13 Ethicon Endo-Surgery, Llc Movable member for use with a tissue thickness compensator
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US8864009B2 (en) 2010-09-30 2014-10-21 Ethicon Endo-Surgery, Inc. Tissue thickness compensator for a surgical stapler comprising an adjustable anvil
US9351730B2 (en) 2011-04-29 2016-05-31 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising channels
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9592050B2 (en) 2010-09-30 2017-03-14 Ethicon Endo-Surgery, Llc End effector comprising a distal tissue abutment member
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
CA2811235C (en) 2010-10-01 2020-03-10 Applied Medical Resources Corporation Portable laparoscopic trainer
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
AU2012250197B2 (en) 2011-04-29 2017-08-10 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
US9259265B2 (en) 2011-07-22 2016-02-16 Ethicon Endo-Surgery, Llc Surgical instruments for tensioning tissue
ES2640005T3 (es) 2011-10-21 2017-10-31 Applied Medical Resources Corporation Estructura de tejido simulado para entrenamiento quirúrgico
CA2859967A1 (en) 2011-12-20 2013-06-27 Applied Medical Resources Corporation Advanced surgical simulation
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
CN104379068B (zh) 2012-03-28 2017-09-22 伊西康内外科公司 包括组织厚度补偿件的保持器组件
CN104321024B (zh) 2012-03-28 2017-05-24 伊西康内外科公司 包括多个层的组织厚度补偿件
CN104334098B (zh) 2012-03-28 2017-03-22 伊西康内外科公司 包括限定低压强环境的胶囊剂的组织厚度补偿件
US9724118B2 (en) 2012-04-09 2017-08-08 Ethicon Endo-Surgery, Llc Techniques for cutting and coagulating tissue for ultrasonic surgical instruments
US9237921B2 (en) 2012-04-09 2016-01-19 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
US9226766B2 (en) 2012-04-09 2016-01-05 Ethicon Endo-Surgery, Inc. Serial communication protocol for medical device
US9439668B2 (en) 2012-04-09 2016-09-13 Ethicon Endo-Surgery, Llc Switch arrangements for ultrasonic surgical instruments
US9241731B2 (en) 2012-04-09 2016-01-26 Ethicon Endo-Surgery, Inc. Rotatable electrical connection for ultrasonic surgical instruments
US9788851B2 (en) 2012-04-18 2017-10-17 Ethicon Llc Surgical instrument with tissue density sensing
US11871901B2 (en) 2012-05-20 2024-01-16 Cilag Gmbh International Method for situational awareness for surgical network or surgical network connected device capable of adjusting function based on a sensed situation or usage
US20130331875A1 (en) * 2012-06-11 2013-12-12 Covidien Lp Temperature estimation and tissue detection of an ultrasonic dissector from frequency response monitoring
US11076880B2 (en) * 2012-06-11 2021-08-03 Covidien Lp Temperature estimation and tissue detection of an ultrasonic dissector from frequency response monitoring
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
BR112014032776B1 (pt) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140005705A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Surgical instruments with articulating shafts
RU2636861C2 (ru) 2012-06-28 2017-11-28 Этикон Эндо-Серджери, Инк. Блокировка пустой кассеты с клипсами
US20140001234A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Coupling arrangements for attaching surgical end effectors to drive systems therefor
US11278284B2 (en) 2012-06-28 2022-03-22 Cilag Gmbh International Rotary drive arrangements for surgical instruments
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9820768B2 (en) 2012-06-29 2017-11-21 Ethicon Llc Ultrasonic surgical instruments with control mechanisms
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
US9283045B2 (en) 2012-06-29 2016-03-15 Ethicon Endo-Surgery, Llc Surgical instruments with fluid management system
US9408622B2 (en) 2012-06-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9326788B2 (en) 2012-06-29 2016-05-03 Ethicon Endo-Surgery, Llc Lockout mechanism for use with robotic electrosurgical device
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
US9226767B2 (en) 2012-06-29 2016-01-05 Ethicon Endo-Surgery, Inc. Closed feedback control for electrosurgical device
CA2880277A1 (en) 2012-08-03 2014-02-06 Applied Medical Resources Corporation Simulated stapling and energy based ligation for surgical training
WO2014052373A1 (en) 2012-09-26 2014-04-03 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
CA3159450A1 (en) 2012-09-27 2014-04-03 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
ES2715285T3 (es) 2012-09-27 2019-06-03 Applied Med Resources Modelo de entrenamiento quirúrgico para procedimientos laparoscópicos
US10679520B2 (en) 2012-09-27 2020-06-09 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US10395559B2 (en) 2012-09-28 2019-08-27 Applied Medical Resources Corporation Surgical training model for transluminal laparoscopic procedures
AU2013323255B2 (en) 2012-09-28 2018-02-08 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
EP2900158B1 (en) 2012-09-28 2020-04-15 Ethicon LLC Multi-function bi-polar forceps
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
US20140114464A1 (en) * 2012-10-23 2014-04-24 Christopher Williams System and method for remotely positioning an end effector
US20140135804A1 (en) 2012-11-15 2014-05-15 Ethicon Endo-Surgery, Inc. Ultrasonic and electrosurgical devices
EP3929895A3 (en) 2013-03-01 2022-01-12 Applied Medical Resources Corporation Advanced surgical simulation constructions and methods
JP6345707B2 (ja) 2013-03-01 2018-06-20 エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． ソフトストップを備えた外科用器具
RU2672520C2 (ru) 2013-03-01 2018-11-15 Этикон Эндо-Серджери, Инк. Шарнирно поворачиваемые хирургические инструменты с проводящими путями для передачи сигналов
US9888919B2 (en) 2013-03-14 2018-02-13 Ethicon Llc Method and system for operating a surgical instrument
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US10226273B2 (en) 2013-03-14 2019-03-12 Ethicon Llc Mechanical fasteners for use with surgical energy devices
US9241728B2 (en) 2013-03-15 2016-01-26 Ethicon Endo-Surgery, Inc. Surgical instrument with multiple clamping mechanisms
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US9814460B2 (en) 2013-04-16 2017-11-14 Ethicon Llc Modular motor driven surgical instruments with status indication arrangements
AU2014265412B2 (en) 2013-05-15 2018-07-19 Applied Medical Resources Corporation Hernia model
CA3232626A1 (en) 2013-06-18 2014-12-24 Applied Medical Resources Corporation Gallbladder model
WO2015013516A1 (en) 2013-07-24 2015-01-29 Applied Medical Resources Corporation First entry model
US10198966B2 (en) 2013-07-24 2019-02-05 Applied Medical Resources Corporation Advanced first entry model for surgical simulation
MX369362B (es) 2013-08-23 2019-11-06 Ethicon Endo Surgery Llc Dispositivos de retraccion de miembros de disparo para instrumentos quirurgicos electricos.
US9283054B2 (en) 2013-08-23 2016-03-15 Ethicon Endo-Surgery, Llc Interactive displays
US9814514B2 (en) 2013-09-13 2017-11-14 Ethicon Llc Electrosurgical (RF) medical instruments for cutting and coagulating tissue
US9265926B2 (en) 2013-11-08 2016-02-23 Ethicon Endo-Surgery, Llc Electrosurgical devices
WO2015088014A1 (ja) 2013-12-13 2015-06-18 オリンパス株式会社 処置具、処置具ユニット及び処置システム
GB2521229A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
GB2521228A (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
US10363085B2 (en) * 2014-01-30 2019-07-30 Fulmer Instruments, Llc Surgical cutting device
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
CN105873532B (zh) 2014-02-17 2019-01-04 奥林巴斯株式会社 把持处置装置
BR112016019387B1 (pt) 2014-02-24 2022-11-29 Ethicon Endo-Surgery, Llc Sistema de instrumento cirúrgico e cartucho de prendedores para uso com um instrumento cirúrgico de fixação
US9554854B2 (en) 2014-03-18 2017-01-31 Ethicon Endo-Surgery, Llc Detecting short circuits in electrosurgical medical devices
US10028761B2 (en) 2014-03-26 2018-07-24 Ethicon Llc Feedback algorithms for manual bailout systems for surgical instruments
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
US9826977B2 (en) 2014-03-26 2017-11-28 Ethicon Llc Sterilization verification circuit
AU2015235994B2 (en) 2014-03-26 2019-11-21 Applied Medical Resources Corporation Simulated dissectible tissue
US10004497B2 (en) 2014-03-26 2018-06-26 Ethicon Llc Interface systems for use with surgical instruments
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
US9913680B2 (en) 2014-04-15 2018-03-13 Ethicon Llc Software algorithms for electrosurgical instruments
BR112016023807B1 (pt) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc Conjunto de cartucho de prendedores para uso com um instrumento cirúrgico
BR112016023698B1 (pt) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc Cartucho de prendedores para uso com um instrumento cirúrgico
US11517315B2 (en) 2014-04-16 2022-12-06 Cilag Gmbh International Fastener cartridges including extensions having different configurations
US20150297225A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
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
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
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
US9724094B2 (en) 2014-09-05 2017-08-08 Ethicon Llc Adjunct with integrated sensors to quantify tissue compression
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
BR112017005981B1 (pt) 2014-09-26 2022-09-06 Ethicon, Llc Material de escora para uso com um cartucho de grampos cirúrgicos e cartucho de grampos cirúrgicos para uso com um instrumento cirúrgico
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US11504192B2 (en) 2014-10-30 2022-11-22 Cilag Gmbh International Method of hub communication with surgical instrument systems
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
KR102518089B1 (ko) 2014-11-13 2023-04-05 어플라이드 메디컬 리소시스 코포레이션 시뮬레이션된 조직 모델들 및 방법들
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
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
BR112017012996B1 (pt) 2014-12-18 2022-11-08 Ethicon Llc Instrumento cirúrgico com uma bigorna que é seletivamente móvel sobre um eixo geométrico imóvel distinto em relação a um cartucho de grampos
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10245095B2 (en) 2015-02-06 2019-04-02 Ethicon Llc Electrosurgical instrument with rotation and articulation mechanisms
AU2016219865B2 (en) 2015-02-19 2021-07-08 Applied Medical Resources Corporation Simulated tissue structures and methods
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US10321907B2 (en) 2015-02-27 2019-06-18 Ethicon Llc System for monitoring whether a surgical instrument needs to be serviced
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
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
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
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
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
WO2016183412A1 (en) 2015-05-14 2016-11-17 Applied Medical Resources Corporation Synthetic tissue structures for electrosurgical training and simulation
AU2016276771B2 (en) 2015-06-09 2022-02-03 Applied Medical Resources Corporation Hysterectomy model
US10034684B2 (en) 2015-06-15 2018-07-31 Ethicon Llc Apparatus and method for dissecting and coagulating tissue
US11020140B2 (en) 2015-06-17 2021-06-01 Cilag Gmbh International Ultrasonic surgical blade for use with ultrasonic surgical instruments
US10765470B2 (en) 2015-06-30 2020-09-08 Ethicon Llc Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US11129669B2 (en) * 2015-06-30 2021-09-28 Cilag Gmbh International Surgical system with user adaptable techniques based on tissue type
US10357303B2 (en) 2015-06-30 2019-07-23 Ethicon Llc Translatable outer tube for sealing using shielded lap chole dissector
US10898256B2 (en) 2015-06-30 2021-01-26 Ethicon Llc Surgical system with user adaptable techniques based on tissue impedance
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
US10154852B2 (en) 2015-07-01 2018-12-18 Ethicon Llc Ultrasonic surgical blade with improved cutting and coagulation features
EP3323122B1 (en) 2015-07-16 2020-09-02 Applied Medical Resources Corporation Simulated dissectable tissue
CA2993197A1 (en) 2015-07-22 2017-01-26 Applied Medical Resources Corporation Appendectomy model
CN107106202B (zh) * 2015-07-27 2020-02-21 奥林巴斯株式会社 能量处置系统以及能量控制装置
US11058425B2 (en) 2015-08-17 2021-07-13 Ethicon Llc Implantable layers for a surgical instrument
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10327769B2 (en) * 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US10687884B2 (en) 2015-09-30 2020-06-23 Ethicon Llc Circuits for supplying isolated direct current (DC) voltage to surgical instruments
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10524788B2 (en) 2015-09-30 2020-01-07 Ethicon Llc Compressible adjunct with attachment regions
KR20240037386A (ko) 2015-10-02 2024-03-21 어플라이드 메디컬 리소시스 코포레이션 자궁 절제술 모델
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10706743B2 (en) 2015-11-20 2020-07-07 Applied Medical Resources Corporation Simulated dissectible tissue
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
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
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
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
US11058448B2 (en) 2016-01-15 2021-07-13 Cilag Gmbh International Modular battery powered handheld surgical instrument with multistage generator circuits
CN109069840B (zh) 2016-02-04 2022-03-15 心脏起搏器股份公司 具有用于无引线心脏装置的力传感器的递送系统
CN108882932B (zh) 2016-02-09 2021-07-23 伊西康有限责任公司 具有非对称关节运动构造的外科器械
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10413291B2 (en) 2016-02-09 2019-09-17 Ethicon Llc Surgical instrument articulation mechanism with slotted secondary constraint
US10258331B2 (en) * 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) * 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
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
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
US10413297B2 (en) 2016-04-01 2019-09-17 Ethicon Llc Surgical stapling system configured to apply annular rows of staples having different heights
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control 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
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved 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
US10363037B2 (en) 2016-04-18 2019-07-30 Ethicon Llc Surgical instrument system comprising a magnetic lockout
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
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
ES2946810T3 (es) 2016-06-27 2023-07-26 Applied Med Resources Pared abdominal simulada
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
JP6643482B2 (ja) * 2016-07-25 2020-02-12 オリンパス株式会社 エネルギー制御装置及び処置システム
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
US10531929B2 (en) * 2016-08-16 2020-01-14 Ethicon Llc Control of robotic arm motion based on sensed load on cutting tool
USD847990S1 (en) 2016-08-16 2019-05-07 Ethicon Llc Surgical instrument
US10390895B2 (en) 2016-08-16 2019-08-27 Ethicon Llc Control of advancement rate and application force based on measured forces
US10709511B2 (en) * 2016-08-16 2020-07-14 Ethicon Llc Control of jaw or clamp arm closure in concert with advancement of device
US10828056B2 (en) 2016-08-25 2020-11-10 Ethicon Llc Ultrasonic transducer to waveguide acoustic coupling, connections, and configurations
US10952759B2 (en) 2016-08-25 2021-03-23 Ethicon Llc Tissue loading of a surgical instrument
CN106377299B (zh) * 2016-10-13 2019-01-04 武汉大学 一种高强度高韧性自感知智能陶瓷针刀
CN106361406B (zh) * 2016-10-13 2019-01-29 武汉大学 一种多角度可视化高强度高韧性智能陶瓷针刀
CN106264676B (zh) * 2016-10-13 2019-01-04 武汉大学 一种多角度可视化高强度高韧性自感知陶瓷针刀
CN106344116B (zh) * 2016-10-13 2019-01-29 武汉大学 一种可视化智能陶瓷针刀
CN106377298B (zh) * 2016-10-13 2019-01-18 武汉大学 一种可视化高强度高韧性智能陶瓷针刀
CN106333730B (zh) * 2016-10-13 2019-01-04 武汉大学 一种自感知高强度预警陶瓷针刀
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
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
US10667810B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Closure members with cam surface arrangements for surgical instruments with separate and distinct closure and firing systems
US10639035B2 (en) 2016-12-21 2020-05-05 Ethicon Llc Surgical stapling instruments and replaceable tool assemblies thereof
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
US10893864B2 (en) 2016-12-21 2021-01-19 Ethicon Staple cartridges and arrangements of staples and staple cavities therein
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US20180168598A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Staple forming pocket arrangements comprising zoned forming surface grooves
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
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US10695055B2 (en) 2016-12-21 2020-06-30 Ethicon Llc Firing assembly comprising a lockout
US10588630B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical tool assemblies with closure stroke reduction features
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
BR112019011947A2 (pt) 2016-12-21 2019-10-29 Ethicon Llc sistemas de grampeamento cirúrgico
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
US11090048B2 (en) 2016-12-21 2021-08-17 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
US20180168618A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling systems
CN110099619B (zh) 2016-12-21 2022-07-15 爱惜康有限责任公司 用于外科端部执行器和可替换工具组件的闭锁装置
US10542982B2 (en) 2016-12-21 2020-01-28 Ethicon Llc Shaft assembly comprising first and second articulation lockouts
FR3062296B1 (fr) * 2017-01-30 2021-10-22 Soc Pour La Conception Des Applications Des Techniques Electroniques Appareil de traitement a ultrasons avec controle automatique de consigne
CA3053498A1 (en) 2017-02-14 2018-08-23 Applied Medical Resources Corporation Laparoscopic training system
US10847057B2 (en) 2017-02-23 2020-11-24 Applied Medical Resources Corporation Synthetic tissue structures for electrosurgical training and simulation
US11229473B2 (en) * 2017-05-22 2022-01-25 Cilag Gmbh International Combination ultrasonic and electrosurgical instrument with clamp arm position input and method for identifying tissue state
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
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
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
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
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
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
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
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
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting 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
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
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
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10786253B2 (en) 2017-06-28 2020-09-29 Ethicon Llc Surgical end effectors with improved jaw aperture arrangements
EP3420947B1 (en) 2017-06-28 2022-05-25 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US11000279B2 (en) 2017-06-28 2021-05-11 Ethicon Llc Surgical instrument comprising an articulation system ratio
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
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
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
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
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
US11974742B2 (en) 2017-08-03 2024-05-07 Cilag Gmbh International Surgical system comprising an articulation bailout
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11134975B2 (en) 2017-08-31 2021-10-05 Cilag Gmbh International Apparatus and method to control operation of surgical instrument based on audible feedback
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
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with 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
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
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US11510741B2 (en) 2017-10-30 2022-11-29 Cilag Gmbh International Method for producing a surgical instrument comprising a smart electrical system
US11229436B2 (en) 2017-10-30 2022-01-25 Cilag Gmbh International Surgical system comprising a surgical tool and a surgical hub
US11311342B2 (en) 2017-10-30 2022-04-26 Cilag Gmbh International Method for communicating with surgical instrument systems
US11123070B2 (en) 2017-10-30 2021-09-21 Cilag Gmbh International Clip applier comprising a rotatable clip magazine
US11911045B2 (en) 2017-10-30 2024-02-27 Cllag GmbH International Method for operating a powered articulating multi-clip applier
US11564756B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11026712B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Surgical instruments comprising a shifting mechanism
US11317919B2 (en) 2017-10-30 2022-05-03 Cilag Gmbh International Clip applier comprising a clip crimping system
US11291510B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11801098B2 (en) 2017-10-30 2023-10-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US11565365B2 (en) * 2017-11-13 2023-01-31 Taiwan Semiconductor Manufacturing Co., Ltd. System and method for monitoring chemical mechanical polishing
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
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
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
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
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
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
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
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
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
US10966791B2 (en) 2017-12-28 2021-04-06 Ethicon Llc Cloud-based medical analytics for medical facility segmented individualization of instrument function
US11257589B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes
US10849697B2 (en) 2017-12-28 2020-12-01 Ethicon Llc Cloud interface for coupled surgical devices
US11179208B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Cloud-based medical analytics for security and authentication trends and reactive measures
US11864728B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Characterization of tissue irregularities through the use of mono-chromatic light refractivity
US11266468B2 (en) 2017-12-28 2022-03-08 Cilag Gmbh International Cooperative utilization of data derived from secondary sources by intelligent surgical hubs
US11446052B2 (en) 2017-12-28 2022-09-20 Cilag Gmbh International Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue
US11026751B2 (en) 2017-12-28 2021-06-08 Cilag Gmbh International Display of alignment of staple cartridge to prior linear staple line
US11278281B2 (en) 2017-12-28 2022-03-22 Cilag Gmbh International Interactive surgical system
US11419630B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Surgical system distributed processing
US11432885B2 (en) 2017-12-28 2022-09-06 Cilag Gmbh International Sensing arrangements for robot-assisted surgical platforms
US11818052B2 (en) 2017-12-28 2023-11-14 Cilag Gmbh International Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11857152B2 (en) 2017-12-28 2024-01-02 Cilag Gmbh International Surgical hub spatial awareness to determine devices in operating theater
US11659023B2 (en) 2017-12-28 2023-05-23 Cilag Gmbh International Method of hub communication
US10695081B2 (en) 2017-12-28 2020-06-30 Ethicon Llc Controlling a surgical instrument according to sensed closure parameters
US11147607B2 (en) 2017-12-28 2021-10-19 Cilag Gmbh International Bipolar combination device that automatically adjusts pressure based on energy modality
US11389164B2 (en) 2017-12-28 2022-07-19 Cilag Gmbh International Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices
US11571234B2 (en) 2017-12-28 2023-02-07 Cilag Gmbh International Temperature control of ultrasonic end effector and control system therefor
US11284936B2 (en) 2017-12-28 2022-03-29 Cilag Gmbh International Surgical instrument having a flexible electrode
US10987178B2 (en) 2017-12-28 2021-04-27 Ethicon Llc Surgical hub control arrangements
US20190201042A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Determining the state of an ultrasonic electromechanical system according to frequency shift
US11896443B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Control of a surgical system through a surgical barrier
US11304763B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Image capturing of the areas outside the abdomen to improve placement and control of a surgical device in use
US11202570B2 (en) 2017-12-28 2021-12-21 Cilag Gmbh International Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems
US11166772B2 (en) 2017-12-28 2021-11-09 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
US11423007B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Adjustment of device control programs based on stratified contextual data in addition to the data
US10758310B2 (en) 2017-12-28 2020-09-01 Ethicon Llc Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US11308075B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical network, instrument, and cloud responses based on validation of received dataset and authentication of its source and integrity
US11678881B2 (en) 2017-12-28 2023-06-20 Cilag Gmbh International Spatial awareness of surgical hubs in operating rooms
US11304699B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11903601B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Surgical instrument comprising a plurality of drive systems
US20190201039A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Situational awareness of electrosurgical systems
US11559307B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method of robotic hub communication, detection, and control
US11376002B2 (en) 2017-12-28 2022-07-05 Cilag Gmbh International Surgical instrument cartridge sensor assemblies
US11832840B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical instrument having a flexible circuit
US11291495B2 (en) 2017-12-28 2022-04-05 Cilag Gmbh International Interruption of energy due to inadvertent capacitive coupling
US11160605B2 (en) 2017-12-28 2021-11-02 Cilag Gmbh International Surgical evacuation sensing and motor control
US11969216B2 (en) 2017-12-28 2024-04-30 Cilag Gmbh International Surgical network recommendations from real time analysis of procedure variables against a baseline highlighting differences from the optimal solution
US11633237B2 (en) 2017-12-28 2023-04-25 Cilag Gmbh International Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures
US10943454B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Detection and escalation of security responses of surgical instruments to increasing severity threats
US11832899B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical systems with autonomously adjustable control programs
US11666331B2 (en) 2017-12-28 2023-06-06 Cilag Gmbh International Systems for detecting proximity of surgical end effector to cancerous tissue
US11612444B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Adjustment of a surgical device function based on situational awareness
US11540855B2 (en) 2017-12-28 2023-01-03 Cilag Gmbh International Controlling activation of an ultrasonic surgical instrument according to the presence of tissue
US11051876B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Surgical evacuation flow paths
US11896322B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub
US11786245B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Surgical systems with prioritized data transmission capabilities
US11069012B2 (en) 2017-12-28 2021-07-20 Cilag Gmbh International Interactive surgical systems with condition handling of devices and data capabilities
US10932872B2 (en) 2017-12-28 2021-03-02 Ethicon Llc Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set
US11317937B2 (en) 2018-03-08 2022-05-03 Cilag Gmbh International Determining the state of an ultrasonic end effector
US10898622B2 (en) 2017-12-28 2021-01-26 Ethicon Llc Surgical evacuation system with a communication circuit for communication between a filter and a smoke evacuation device
US11253315B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Increasing radio frequency to create pad-less monopolar loop
US11969142B2 (en) 2017-12-28 2024-04-30 Cilag Gmbh International Method of compressing tissue within a stapling device and simultaneously displaying the location of the tissue within the jaws
US11937769B2 (en) 2017-12-28 2024-03-26 Cilag Gmbh International Method of hub communication, processing, storage and display
US11100631B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Use of laser light and red-green-blue coloration to determine properties of back scattered light
US11696760B2 (en) 2017-12-28 2023-07-11 Cilag Gmbh International Safety systems for smart powered surgical stapling
US11419667B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Ultrasonic energy device which varies pressure applied by clamp arm to provide threshold control pressure at a cut progression location
US11304745B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical evacuation sensing and display
US11529187B2 (en) 2017-12-28 2022-12-20 Cilag Gmbh International Surgical evacuation sensor arrangements
US11424027B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Method for operating surgical instrument systems
US11234756B2 (en) 2017-12-28 2022-02-01 Cilag Gmbh International Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter
US11364075B2 (en) 2017-12-28 2022-06-21 Cilag Gmbh International Radio frequency energy device for delivering combined electrical signals
US11324557B2 (en) 2017-12-28 2022-05-10 Cilag Gmbh International Surgical instrument with a sensing array
US11056244B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks
US11213359B2 (en) 2017-12-28 2022-01-04 Cilag Gmbh International Controllers for robot-assisted surgical platforms
US11304720B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Activation of energy devices
US11744604B2 (en) 2017-12-28 2023-09-05 Cilag Gmbh International Surgical instrument with a hardware-only control circuit
US11273001B2 (en) 2017-12-28 2022-03-15 Cilag Gmbh International Surgical hub and modular device response adjustment based on situational awareness
US11464535B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Detection of end effector emersion in liquid
US11589888B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Method for controlling smart energy devices
US10944728B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Interactive surgical systems with encrypted communication capabilities
US20190201139A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Communication arrangements for robot-assisted surgical platforms
US20190201087A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Smoke evacuation system including a segmented control circuit for interactive surgical platform
US11464559B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Estimating state of ultrasonic end effector and control system therefor
US11109866B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Method for circular stapler control algorithm adjustment based on situational awareness
US10892995B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11786251B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11602393B2 (en) 2017-12-28 2023-03-14 Cilag Gmbh International Surgical evacuation sensing and generator control
US11096693B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing
US11311306B2 (en) 2017-12-28 2022-04-26 Cilag Gmbh International Surgical systems for detecting end effector tissue distribution irregularities
US10892899B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Self describing data packets generated at an issuing instrument
US11076921B2 (en) 2017-12-28 2021-08-03 Cilag Gmbh International Adaptive control program updates for surgical hubs
US11576677B2 (en) 2017-12-28 2023-02-14 Cilag Gmbh International Method of hub communication, processing, display, and cloud analytics
US11410259B2 (en) 2017-12-28 2022-08-09 Cilag Gmbh International Adaptive control program updates for surgical devices
US11132462B2 (en) 2017-12-28 2021-09-28 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11559308B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure
EP3745969A4 (en) * 2018-02-03 2021-10-13 Caze Technologies SURGICAL SYSTEMS WITH AUTOMATIC DETECTION AND LEARNING CAPABILITIES AND RELATED PROCESSES
US11678927B2 (en) * 2018-03-08 2023-06-20 Cilag Gmbh International Detection of large vessels during parenchymal dissection using a smart blade
US11259830B2 (en) 2018-03-08 2022-03-01 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
US11534196B2 (en) 2018-03-08 2022-12-27 Cilag Gmbh International Using spectroscopy to determine device use state in combo instrument
EP3536264B1 (en) * 2018-03-08 2022-02-23 Ethicon LLC Smart blade application for reusable and disposable devices
US11589865B2 (en) 2018-03-28 2023-02-28 Cilag Gmbh International Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems
US11096688B2 (en) 2018-03-28 2021-08-24 Cilag Gmbh International Rotary driven firing members with different anvil and channel engagement features
US11090047B2 (en) 2018-03-28 2021-08-17 Cilag Gmbh International Surgical instrument comprising an adaptive control system
US11471156B2 (en) 2018-03-28 2022-10-18 Cilag Gmbh International Surgical stapling devices with improved rotary driven closure systems
US11278280B2 (en) 2018-03-28 2022-03-22 Cilag Gmbh International Surgical instrument comprising a jaw closure lockout
US11219453B2 (en) 2018-03-28 2022-01-11 Cilag Gmbh International Surgical stapling devices with cartridge compatible closure and firing lockout arrangements
US11129611B2 (en) 2018-03-28 2021-09-28 Cilag Gmbh International Surgical staplers with arrangements for maintaining a firing member thereof in a locked configuration unless a compatible cartridge has been installed therein
US11207067B2 (en) 2018-03-28 2021-12-28 Cilag Gmbh International Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing
US10973520B2 (en) 2018-03-28 2021-04-13 Ethicon Llc Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature
WO2019198217A1 (ja) * 2018-04-12 2019-10-17 オリンパス株式会社 医療機器システム、異常判定方法、及び異常判定プログラム
US20200015900A1 (en) 2018-07-16 2020-01-16 Ethicon Llc Controlling an emitter assembly pulse sequence
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
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
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
WO2020095389A1 (ja) * 2018-11-07 2020-05-14 オリンパス株式会社 医療装置、残熱判定方法、及び残熱判定プログラム
CN109620415B (zh) * 2019-02-14 2024-03-26 北京水木天蓬医疗技术有限公司 机器人辅助超声骨动力系统
US11369377B2 (en) 2019-02-19 2022-06-28 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout
US11331100B2 (en) 2019-02-19 2022-05-17 Cilag Gmbh International Staple cartridge retainer system with authentication keys
US11317915B2 (en) 2019-02-19 2022-05-03 Cilag Gmbh International Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers
US11751872B2 (en) 2019-02-19 2023-09-12 Cilag Gmbh International Insertable deactivator element for surgical stapler lockouts
US11357503B2 (en) 2019-02-19 2022-06-14 Cilag Gmbh International Staple cartridge retainers with frangible retention features and methods of using same
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 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
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
USD950728S1 (en) 2019-06-25 2022-05-03 Cilag Gmbh International Surgical staple cartridge
USD952144S1 (en) 2019-06-25 2022-05-17 Cilag Gmbh International Surgical staple cartridge retainer with firing system authentication key
USD964564S1 (en) 2019-06-25 2022-09-20 Cilag Gmbh International Surgical staple cartridge retainer with a closure system authentication key
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
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
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11350938B2 (en) 2019-06-28 2022-06-07 Cilag Gmbh International Surgical instrument comprising an aligned rfid sensor
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US20210169559A1 (en) * 2019-12-06 2021-06-10 Board Of Regents, The University Of Texas System Acoustic monitoring for electrosurgery
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
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
US11786291B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Deflectable support of RF energy electrode with respect to opposing ultrasonic blade
US11284963B2 (en) 2019-12-30 2022-03-29 Cilag Gmbh International Method of using imaging devices in surgery
US11950797B2 (en) 2019-12-30 2024-04-09 Cilag Gmbh International Deflectable electrode with higher distal bias relative to proximal bias
US11744667B2 (en) 2019-12-30 2023-09-05 Cilag Gmbh International Adaptive visualization by a surgical system
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
US11219501B2 (en) 2019-12-30 2022-01-11 Cilag Gmbh International Visualization systems using structured light
US11759283B2 (en) 2019-12-30 2023-09-19 Cilag Gmbh International Surgical systems for generating three dimensional constructs of anatomical organs and coupling identified anatomical structures thereto
US20210196344A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Surgical system communication pathways
US11684412B2 (en) 2019-12-30 2023-06-27 Cilag Gmbh International Surgical instrument with rotatable and articulatable surgical end effector
US11812957B2 (en) 2019-12-30 2023-11-14 Cilag Gmbh International Surgical instrument comprising a signal interference resolution 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
US11660089B2 (en) 2019-12-30 2023-05-30 Cilag Gmbh International Surgical instrument comprising a sensing system
US11974801B2 (en) 2019-12-30 2024-05-07 Cilag Gmbh International Electrosurgical instrument with flexible wiring assemblies
US11896442B2 (en) 2019-12-30 2024-02-13 Cilag Gmbh International Surgical systems for proposing and corroborating organ portion removals
US11937863B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Deflectable electrode with variable compression bias along the length of the deflectable electrode
US11776144B2 (en) 2019-12-30 2023-10-03 Cilag Gmbh International System and method for determining, adjusting, and managing resection margin about a subject tissue
US11779329B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Surgical instrument comprising a flex circuit including a sensor system
US11696776B2 (en) 2019-12-30 2023-07-11 Cilag Gmbh International Articulatable surgical instrument
US11452525B2 (en) 2019-12-30 2022-09-27 Cilag Gmbh International Surgical instrument comprising an adjustment system
US11832996B2 (en) 2019-12-30 2023-12-05 Cilag Gmbh International Analyzing surgical trends by a surgical system
US11648060B2 (en) 2019-12-30 2023-05-16 Cilag Gmbh International Surgical system for overlaying surgical instrument data onto a virtual three dimensional construct of an organ
US20210196359A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instruments with electrodes having energy focusing features
USD975278S1 (en) 2020-06-02 2023-01-10 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
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
US20220008118A1 (en) * 2020-07-08 2022-01-13 Covidien Lp Surgical devices, systems, and methods providing visual notifications
US20220031320A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with flexible firing member actuator constraint arrangements
US20240016543A1 (en) * 2020-08-06 2024-01-18 Ipg Photonics Corporation Systems and methods for controlling laser treatments
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
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
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
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US20220160373A1 (en) * 2020-11-25 2022-05-26 Medtronic, Inc. Ultrasonic bone cutting device with integrated sensing
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
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
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
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
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
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
JP2024516111A (ja) 2021-04-07 2024-04-12 エクスパンス テクノロジー パートナーズ，エルエルシー 吸引カテーテル
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
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
GB2619278A (en) * 2022-05-25 2023-12-06 Alesi Surgical Ltd Surgical assembly and system
US20240008888A1 (en) * 2022-07-11 2024-01-11 Verb Surgical Inc. Method and system for detecting that an ultrasonic instrument is in contact with an object

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1251507A (zh) * 1996-08-29 2000-04-26 博士伦外科公司 眼科显微手术系统
WO2005122917A1 (ja) * 2004-06-16 2005-12-29 Olympus Corporation 超音波手術装置
CN102209503A (zh) * 2008-12-31 2011-10-05 奥林巴斯医疗株式会社 手术系统以及控制方法

Family Cites Families (54)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5980510A (en) 1997-10-10 1999-11-09 Ethicon Endo-Surgery, Inc. Ultrasonic clamp coagulator apparatus having improved clamp arm pivot mount
US7901400B2 (en) * 1998-10-23 2011-03-08 Covidien Ag Method and system for controlling output of RF medical generator
US20040034340A1 (en) 1999-10-13 2004-02-19 Spineco, Inc., An Ohio Corporation Smart dissector
DE60111517T2 (de) * 2000-04-27 2006-05-11 Medtronic, Inc., Minneapolis Vibrationsempfindliche ablationsvorrichtung
US20020049551A1 (en) 2000-10-20 2002-04-25 Ethicon Endo-Surgery, Inc. Method for differentiating between burdened and cracked ultrasonically tuned blades
US6500176B1 (en) 2000-10-23 2002-12-31 Csaba Truckai Electrosurgical systems and techniques for sealing tissue
US20080214967A1 (en) * 2004-02-17 2008-09-04 Ernest Aranyi Ultrasonic surgical instrument
US6783524B2 (en) 2001-04-19 2004-08-31 Intuitive Surgical, Inc. Robotic surgical tool with ultrasound cauterizing and cutting instrument
ES2327907T3 (es) * 2001-10-11 2009-11-05 Tyco Healthcare Group Lp Cuchilla de corte iltrasonico larga formada por cuchillas mas pequeñas estratificadas.
US6929644B2 (en) 2001-10-22 2005-08-16 Surgrx Inc. Electrosurgical jaw structure for controlled energy delivery
US7311709B2 (en) 2001-10-22 2007-12-25 Surgrx, Inc. Electrosurgical instrument and method of use
US7189233B2 (en) 2001-10-22 2007-03-13 Surgrx, Inc. Electrosurgical instrument
US7125409B2 (en) 2001-10-22 2006-10-24 Surgrx, Inc. Electrosurgical working end for controlled energy delivery
US7354440B2 (en) 2001-10-22 2008-04-08 Surgrx, Inc. Electrosurgical instrument and method of use
US20030114851A1 (en) * 2001-12-13 2003-06-19 Csaba Truckai Electrosurgical jaws for controlled application of clamping pressure
CA2733282C (en) 2002-01-22 2017-02-14 Surgrx, Inc. Electrosurgical instrument and method of use
US7776027B2 (en) 2002-07-11 2010-08-17 Misonix, Incorporated Medical handpiece with automatic power switching means
US7169146B2 (en) 2003-02-14 2007-01-30 Surgrx, Inc. Electrosurgical probe and method of use
CA2529740C (en) * 2003-06-17 2013-12-24 Ethicon Endo-Surgery, Inc. Hand activated ultrasonic instrument
US7309849B2 (en) 2003-11-19 2007-12-18 Surgrx, Inc. Polymer compositions exhibiting a PTC property and methods of fabrication
US7220951B2 (en) 2004-04-19 2007-05-22 Surgrx, Inc. Surgical sealing surfaces and methods of use
FR2873282B1 (fr) * 2004-07-23 2007-04-13 Hacene Zerazhi Trocart pour biopsie osteo-medulaire
US20060079874A1 (en) 2004-10-08 2006-04-13 Faller Craig N Tissue pad for use with an ultrasonic surgical instrument
US20060173480A1 (en) 2005-01-31 2006-08-03 Yi Zhang Safety penetrating method and apparatus into body cavities, organs, or potential spaces
US20070191713A1 (en) 2005-10-14 2007-08-16 Eichmann Stephen E Ultrasonic device for cutting and coagulating
EP1964518A4 (en) 2005-12-14 2010-05-26 Teijin Pharma Ltd ULTRASONIC MEDICAL DEVICE HAVING IRRADIATION POSITION CONFIRMATION FUNCTION
AU2007200299B2 (en) 2006-01-24 2012-11-15 Covidien Ag System and method for tissue sealing
US7416101B2 (en) 2006-01-31 2008-08-26 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with loading force feedback
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US20070282333A1 (en) 2006-06-01 2007-12-06 Fortson Reginald D Ultrasonic waveguide and blade
US7738971B2 (en) 2007-01-10 2010-06-15 Ethicon Endo-Surgery, Inc. Post-sterilization programming of surgical instruments
CA2675770C (en) 2007-01-16 2016-04-12 Ethicon Endo-Surgery, Inc. Ultrasonic device for cutting and coagulating
US20090143800A1 (en) 2007-12-03 2009-06-04 Derek Dee Deville Cordless Hand-Held Ultrasonic Cautery Cutting Device
US8221418B2 (en) * 2008-02-07 2012-07-17 Tyco Healthcare Group Lp Endoscopic instrument for tissue identification
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US8469956B2 (en) * 2008-07-21 2013-06-25 Covidien Lp Variable resistor jaw
US9089360B2 (en) 2008-08-06 2015-07-28 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
CA2736870A1 (en) 2008-09-12 2010-03-18 Ethicon Endo-Surgery, Inc. Ultrasonic device for fingertip control
WO2011004449A1 (ja) 2009-07-06 2011-01-13 オリンパスメディカルシステムズ株式会社 超音波手術装置
US8461744B2 (en) 2009-07-15 2013-06-11 Ethicon Endo-Surgery, Inc. Rotating transducer mount for ultrasonic surgical instruments
US8932282B2 (en) 2009-08-03 2015-01-13 Covidien Lp Power level transitioning in a surgical instrument
US8939974B2 (en) 2009-10-09 2015-01-27 Ethicon Endo-Surgery, Inc. Surgical instrument comprising first and second drive systems actuatable by a common trigger mechanism
US9060775B2 (en) 2009-10-09 2015-06-23 Ethicon Endo-Surgery, Inc. Surgical generator for ultrasonic and electrosurgical devices
US8038693B2 (en) 2009-10-21 2011-10-18 Tyco Healthcare Group Ip Methods for ultrasonic tissue sensing and feedback
WO2011060311A2 (en) * 2009-11-13 2011-05-19 Intuitive Surgical Operations, Inc. End effector with redundant closing mechanisms
AU2011200961B2 (en) 2010-03-12 2014-05-29 Covidien Lp Method and apparatus for determining parameters of linear motion in a surgical instrument
US9144455B2 (en) 2010-06-07 2015-09-29 Just Right Surgical, Llc Low power tissue sealing device and method
US20120010506A1 (en) * 2010-07-08 2012-01-12 Immersion Corporation Multimodal laparoscopic ultrasound device with feedback system
US9161803B2 (en) 2010-11-05 2015-10-20 Ethicon Endo-Surgery, Inc. Motor driven electrosurgical device with mechanical and electrical feedback
AU2012214166A1 (en) * 2011-02-10 2013-09-12 Actuated Medical, Inc. Medical tool with electromechanical control and feedback
US9420394B2 (en) 2011-02-16 2016-08-16 Apple Inc. Panning presets
WO2012135705A1 (en) 2011-03-30 2012-10-04 Tyco Healthcare Group Lp Ultrasonic surgical instruments
US9788851B2 (en) 2012-04-18 2017-10-17 Ethicon Llc Surgical instrument with tissue density sensing

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1251507A (zh) * 1996-08-29 2000-04-26 博士伦外科公司 眼科显微手术系统
WO2005122917A1 (ja) * 2004-06-16 2005-12-29 Olympus Corporation 超音波手術装置
CN102209503A (zh) * 2008-12-31 2011-10-05 奥林巴斯医疗株式会社 手术系统以及控制方法

Also Published As

Publication number Publication date
CA2870536C (en) 2020-06-30
US20130282038A1 (en) 2013-10-24
AU2013249514A1 (en) 2014-10-16
BR112014025798A2 (zh) 2017-06-20
BR112014025798B1 (pt) 2022-04-12
US9788851B2 (en) 2017-10-17
WO2013158545A1 (en) 2013-10-24
CN104244850A (zh) 2014-12-24
EP2838447A1 (en) 2015-02-25
US10653437B2 (en) 2020-05-19
JP6271512B2 (ja) 2018-01-31
US20180070976A1 (en) 2018-03-15
IN2014DN08374A (zh) 2015-05-08
JP2015515344A (ja) 2015-05-28
CA2870536A1 (en) 2013-10-24
AU2013249514B2 (en) 2017-08-31
EP2838447B1 (en) 2023-01-25

Similar Documents

Publication Publication Date Title
CN104244850B (zh) 具有组织密度感测的外科器械
CN105764435B (zh) 具有电外科特征部的超声外科器械
CN104203129B (zh) 具有神经检测特征结构的外科器械
CN104334100B (zh) 具有应力传感器的外科器械
CN103281983B (zh) 具有传感器和动力控制的外科器械
JP4504332B2 (ja) 手術システム及びそのシステム稼働情報告知方法
CN103237512B (zh) 用于切割和凝固组织的装置和技术
CN105744904B (zh) 用于联接外科器械轴组件与器械主体的特征结构
US10729458B2 (en) Ultrasonic surgical instruments
US9339290B2 (en) Ultrasonic surgical instruments
EP3448282B1 (en) Lifecycle monitoring features for surgical instrument
CN104349731A (zh) 具有取向感测的外科器械
MX2014012240A (es) Conexion electrica giratoria para instrumentos quirurgicos ultrasonicos.
JP4493625B2 (ja) 超音波手術システム
JP2009261935A (ja) 手術用電源供給装置及び共振周波数探査方法

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant