CN110325092B - 多护罩脊柱进入系统 - Google Patents
多护罩脊柱进入系统 Download PDFInfo
- Publication number
- CN110325092B CN110325092B CN201880013056.7A CN201880013056A CN110325092B CN 110325092 B CN110325092 B CN 110325092B CN 201880013056 A CN201880013056 A CN 201880013056A CN 110325092 B CN110325092 B CN 110325092B
- Authority
- CN
- China
- Prior art keywords
- shield
- tube
- outer shield
- access
- nerve
- 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
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
- A61B1/00043—Operational features of endoscopes provided with output arrangements
- A61B1/00045—Display arrangement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00089—Hoods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00091—Nozzles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00094—Suction openings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00096—Optical elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00103—Constructional details of the endoscope body designed for single use
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00112—Connection or coupling means
- A61B1/00121—Connectors, fasteners and adapters, e.g. on the endoscope handle
- A61B1/00128—Connectors, fasteners and adapters, e.g. on the endoscope handle mechanical, e.g. for tubes or pipes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/00133—Drive units for endoscopic tools inserted through or with the endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B1/051—Details of CCD assembly
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
- A61B1/055—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances having rod-lens arrangements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
- A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
- A61B1/126—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for cleaning in-use
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/233—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
- A61B1/2676—Bronchoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/3132—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for laparoscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/3135—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for examination of the epidural or the spinal space
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
- A61B1/317—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for bones or joints, e.g. osteoscopes, arthroscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/32—Devices for opening or enlarging the visual field, e.g. of a tube of the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
-
- 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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
- A61B17/7032—Screws or hooks with U-shaped head or back through which longitudinal rods pass
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
- A61B17/7076—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation
- A61B17/7077—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae
- A61B17/708—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling for driving, positioning or assembling spinal clamps or bone anchors specially adapted for spinal fixation for moving bone anchors attached to vertebrae, thereby displacing the vertebrae with tubular extensions coaxially mounted on the bone anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
- A61B5/068—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe using impedance sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
- A61B5/4041—Evaluating nerves condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4058—Detecting, measuring or recording for evaluating the nervous system for evaluating the central nervous system
- A61B5/407—Evaluating the spinal cord
-
- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/361—Image-producing devices, e.g. surgical cameras
-
- 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
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
-
- 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
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
- A61B90/57—Accessory clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
- A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
- A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00149—Holding or positioning arrangements using articulated arms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1637—Hollow drills or saws producing a curved cut, e.g. cylindrical
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1671—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1703—Guides or aligning means for drills, mills, pins or wires using imaging means, e.g. by X-rays
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1757—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the spine
-
- 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
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- 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
- A61B17/3205—Excision instruments
- A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3439—Cannulas with means for changing the inner diameter of the cannula, e.g. expandable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7074—Tools specially adapted for spinal fixation operations other than for bone removal or filler handling
- A61B17/7083—Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00261—Discectomy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00314—Separate linked members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00345—Micromachines, nanomachines, microsystems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00407—Ratchet means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00738—Aspects not otherwise provided for part of the tool being offset with respect to a main axis, e.g. for better view for the surgeon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00858—Material properties high friction, non-slip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
- A61B2017/00871—Material properties shape memory effect polymeric
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00946—Material properties malleable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00982—General structural features
- A61B2017/00991—Telescopic means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/025—Joint distractors
- A61B2017/0256—Joint distractors for the spine
- A61B2017/0262—Joint distractors for the spine with a provision for protecting nerves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B2017/1602—Mills
-
- 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
- A61B2017/320072—Working tips with special features, e.g. extending parts
- A61B2017/320074—Working tips with special features, e.g. extending parts blade
- A61B2017/320075—Working tips with special features, e.g. extending parts blade single edge blade, e.g. for cutting
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3443—Cannulas with means for adjusting the length of a cannula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/3445—Cannulas used as instrument channel for multiple instruments
- A61B2017/3447—Linked multiple cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B2017/345—Cannulas for introduction into a natural body opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3454—Details of tips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/347—Locking means, e.g. for locking instrument in cannula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
- A61B2017/3488—Fixation to inner organ or inner body tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00339—Spine, e.g. intervertebral disc
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00565—Bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/1861—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument inserted into a body lumen or cavity, e.g. a catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/1869—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument interstitially inserted into the body, e.g. needles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
-
- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
-
- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/036—Abutting means, stops, e.g. abutting on tissue or skin abutting on tissue or skin
-
- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
-
- 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
-
- 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
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
- A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/371—Surgical systems with images on a monitor during operation with simultaneous use of two cameras
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/007—Aspiration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
-
- 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
- A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
- A61F2002/4635—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor using minimally invasive surgery
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Animal Behavior & Ethology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Optics & Photonics (AREA)
- Radiology & Medical Imaging (AREA)
- Neurology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Neurosurgery (AREA)
- Physiology (AREA)
- Mechanical Engineering (AREA)
- Transplantation (AREA)
- Otolaryngology (AREA)
- Physical Education & Sports Medicine (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Pulmonology (AREA)
- Dentistry (AREA)
- Human Computer Interaction (AREA)
- Electromagnetism (AREA)
- Surgical Instruments (AREA)
- Endoscopes (AREA)
- Aerials With Secondary Devices (AREA)
- Memory System Of A Hierarchy Structure (AREA)
Abstract
本发明公开了用于进入椎间盘的进入装置,该进入装置具有外部护罩和内部护罩,该外部护罩包括具有从皮肤向下到达小关节线的较大直径(约16mm至30mm)的进入护罩,该内部护罩具有延伸经过该进入护罩并向下到达椎间盘水平面的较小的第二直径(约5mm至12mm)。这结合了直接视觉显微外科手术/微开口入路和经皮“超‑MIS”技术的优点。
Description
背景技术
现今,通过微开管和牵开器在显微镜视图下进行的显微外科脊柱骨切除术和脊柱减压术正在成为脊柱外科手术护理的标准。这些进入工具的内径通常为介于约16mm和30mm之间。这里,在脊柱外科医生熟悉入路和减压技术的情况下,以及在可以使用标准设备和器械的情况下,应当将这些已知技术视为可以进一步创新的基础。
然而,进行安全椎间盘进入所穿过的Kambin三角区的解剖窗口的尺寸非常有限。可以通过切除上关节突的至少一部分来放大此进入窗口。但无论如何,经由此入路将植入物安全地引入到椎间隙所需的工作护罩的长度必须为在直径约8mm至12mm的范围内,从而从小关节线到达椎间盘进入点。
发明内容
本发明的发明人设想通过以上提及的第一外部护罩引入第二内部护罩。第二内部护罩延伸经过第一外部护罩以到达紧邻神经组织的位置,由此遮护神经使其避开穿过椎间盘间隙的器械或装置。在步骤期间,外部护罩允许此可视安全地放置内部护罩。
在一个实施方案中,提供了一种外部护罩(其可以为例如管或刀片),其包括从皮肤向下到达骨线的具有较大直径(约12mm至30mm)的进入护罩,其中具有较小的第二直径(约5mm至12mm)的内部护罩延伸经过进入护罩并且向下到达椎间盘水平。这将显微外科/微开口入路的直接可视的益处和经皮技术相结合(图1a至图1b和图2)。
外部护罩具有多个特征和优点。首先,外部护罩能够在显微镜视图下的标准显微外科减压/骨切除术期间,基于熟悉MIS技术的外科医生能够执行的标准过程,促使周围软组织的分离和保护以及可视化。其次,它能够在小关节或小关节各部分的检测和移除期间,基于熟悉MIS技术的外科医生能够执行的标准过程,促使周围软组织的分离和保护以及可视化。第三,它能够在牵开敏感组织和非牵开敏感组织之间的边界(例如,小关节线)的下方在直接可视控制下,基于熟悉MIS技术的外科医生能够执行的标准过程,促使敏感(例如,神经)组织(穿出神经根、下行神经根、硬脑膜)的识别、制备和保护。第四,它能够在直接可视控制下,促使内部护罩的插入以及内部护罩在椎间盘间隙中或在椎骨处的可能对接。
同样,内部护罩具有多个特征和优点。首先,它能够保护神经组织(穿出神经根、下行神经根、硬脑膜),使其避开引入到椎间盘中的器械。其次,它能够引导椎间盘内器械(椎间盘切除器械、可视化器械、椎间盘切除检查器械、植入物插入器械、骨移植物填充器械)。第三,因为外部护罩的尺寸较小,所以可以插入护罩,而对脊柱后柱区域中的骨和软组织的损伤或创伤最小,这与经皮进入器械相当。
因此,根据本发明,提供了一种进入患者体内的椎间盘的方法,方法包括以下步骤:
a)在患者的皮肤中制备切口,
b)通过切口经皮地插入具有基本上管状形状的外部护罩(诸如管或多槽牵开器),外部护罩具有的长度适于从切口延伸到患者脊柱中的敏感组织与不敏感组织之间的边界(例如,上关节突(SAP)或椎板),
c)将此外部护罩固定到椎弓根锚固件,
d)插入外部护罩整体式光学可视化器械,
e)切除上关节突的一部分,并且/或者执行显微外科减压手术,
f)穿过外部护罩插入内部护罩或从外部护罩部署内部护罩,以使得内部护罩的远侧端部部分延伸到椎间盘,内部护罩具有外表面,
g)使护罩的外表面与神经根接触以遮护神经根,
h)对被认为引起神经卡压的任何组织进行显微外科减压,
i)提取椎间盘材料,包括从椎骨终板移除软骨材料,
j)插入椎体间装置,以及
k)部署稳定机构以使椎间节段稳定。
根据本发明,还提供了一种进入患者体内的椎间盘的方法,方法包括以下步骤:
a)在患者的皮肤中制备切口,
b)通过切口经由皮肤插入具有基本上管状形状的外部护罩,
c)将此外部护罩固定到椎弓根锚固件,
d)通过外部护罩插入内部护罩,以使得内部护罩的远侧端部部分延伸到椎间盘,内部护罩具有外表面,
e)将护罩的外表面与神经根接触以遮护神经根,
f)对被认为引起神经卡压的任何组织进行显微外科减压,
g)提取椎间盘材料,包括从椎骨终板移除软骨材料,
h)插入椎体间装置,以及
i)部署稳定机构以使椎间节段稳定。
根据本发明,还提供了一种用于进入椎间盘的进入装置,包括:
a)外部护罩,其具有基本上管状部分、适于从切口延伸到敏感组织与不敏感组织之间的边界(例如,关节突或椎板)的长度、近侧端部部分、远侧端部部分、外表面和限定内表面的纵向通孔,
b)内部护罩,其具有i)第一基本上管状部分和ii)纵向凸缘,第一基本上管状部分具有近侧端部部分、远侧端部部分、限定内表面的纵向通孔和限定直径的外表面,纵向凸缘从基本上管状部分的远侧端部部分朝远侧延伸,
其中内部护罩的外表面基本上嵌套在外部护罩的内表面内,以使得
i)凸缘朝远侧延伸经过外部护罩的远侧端部部分。
附图说明
图1a示出了通过进入装置递送的椎体间装置。
图1b示出了进入装置的端视图。
图2a和图2b是进入装置的套管式实施方案的不同视图。
图3a至图3d示出了内部护罩的不同轴向横截面。
图4示出了内部护罩的颈缩漏斗形实施方案。
图5至图6示出了同心和不同心的内部护罩的不同纵向横截面。
图7示出了接合的进入装置。
图8a示出了内部护罩的带凸缘实施方案。
图8b示出了具有近侧止动件的内部护罩。
图9示出了两个端口附接到外部护罩的进入装置。一个端口是用于保持外管的连接器,而另一个端口是针对光源的接口。
图10公开了外管的横截面,其中外管壁具有适于包含可视化单元(诸如摄像头)的第一通道和适于包含清洁系统(诸如透镜清洁装置)的第二通道。
图11公开了外管的横截面,其中外管壁包含透镜清洁装置和摄像头。
图12公开了顶端封装芯片实施方案,包括外管的横截面,其中外管壁具有包含内窥镜的通道,内窥镜在其远侧端部附近具有视频芯片。
图13公开了外管的远侧端部,外管以其远侧端部附近的视频芯片为特征。
图14公开了用于内窥镜的镜架。
图15a至图15b示出了具有近侧弯管的内部护罩。
图16示出了在外部护罩内的内部护罩上具有远侧尖端的进入装置。
图17示出了在内部护罩与外部护罩之间具有定位环的进入装置。
图18示出了具有由内部护罩和外部护罩形成的深度调整装置的进入装置。
图19公开了整体式牵开器,其具有容纳于外管245的切口内的平坦内面。
图20公开了牵开器,其具有容纳于外管内的平坦内面。
图21公开了外管,其具有与外管的外面嵌套的牵开器。
图22至图24b示出了牵开实施方案。
图25至图30示出了具有延伸护罩的进入装置。
图31示出了具有内部护罩和外部护罩的进入装置。
图32至图34示出了内部护罩。
图35公开了径向软组织牵开器。
图36公开了外管/内部牵开器组件,其中第一内部牵开器和第二内部牵开器均向内倾斜以牵开软组织。
图37至图46公开了涉及进入装置的优选外科手术方法。
图47a至图47c公开了导航插塞,其包括基座,基座具有附接到其的阵列,其中插塞适于装配在外管内。
图48公开了从外管的端部延伸的超声波切割器的曲奇切割器型远侧端部,其中远侧端部具有多个切割齿。
图49a至图49b公开了用于引导骨切割装置的模板的各种横截面。
图50公开了具有半圆形切割件切割器骨头的超声波切割器的曲奇切割器型远侧端部。
图51公开了将外管和螺钉延伸部连接的微型柔性臂。
图52公开了外管/内牵开器组件,其中内牵开器向内倾斜以牵开软组织。
图53公开了外管/内牵开器组件,其中内牵开器与外管平行地运行。
图54公开了容纳于外管内的内窥镜和从外管延伸的内管。
图55至图63公开了在本文所公开的优选手术中所用的器械中的一些。
图64至图90公开了在本文所公开的优选手术中以其预期的脊柱内使用取向的器械中的一些。
具体实施方式
执行荧光镜透视检查可视化以限定初始参考阵列放置的切口部位以及进入椎间盘的切口。
一般来讲,本发明的护罩能够应用于脊柱手术中常用的任何常规方法。然而,考虑到进入装置的临床益处及其基本原理,优选在椎间盘的椎板间隙入路、椎间孔外入路或经椎间孔入路中使用这些护罩是合适的。
现在参见图1至图7,提供了一种用于进入椎间盘的进入装置,其包括:
a)外部护罩1,其具有基本上管状部分、适于从切口延伸到敏感组织与不敏感组织之间的边界(例如,关节突)的长度、近侧端部部分3、远侧端部部分5、外表面7和限定内表面10的纵向通孔9,
b)内部护罩11,其具有i)第一基本上管状部分13和ii)纵向凸缘25,第一基本上管状部分13具有近侧端部部分15、远侧端部部分17、限定内表面21的纵向通孔19和限定直径的外表面23,纵向凸缘25从基本上管状部分的远侧端部部分朝远侧延伸,
其中内部护罩的外表面基本上嵌套在外部护罩的内表面内,以使得凸缘朝远侧延伸经过外部护罩的远侧端部部分,并且
内部护罩的基本上管状部分的远侧端部部分朝远侧延伸经过外部护罩的远侧端部。
外部护罩实施方案:
在外部护罩的设计中,可以使用传统的管或对开管/牵开器概念。也可以采用更新的概念,诸如“柔性管”。外部护罩可以是简单的圆柱形管。外部护罩也可以是对开管,这样常规的牵开器被认为是对开管。外部护罩可以是柔性管。外部护罩可以是具有从近侧端部延伸到远侧端部的狭槽的管。各种形状实施方案可以是:
a)具有内径D的圆柱形管(图3a);
b)高度a与长度b不同的椭圆形管(图3b);
c)具有直径D的基本上圆形或椭圆形横截面的“半月形”管,其中截面(或弦)“a”被切割(图3c);以及
d)具有高度a和宽度b的矩形管(图3d)。
在一些实施方案中,远侧端部部分5的形状包括不对称形状,以更好地将组织侧向牵开到SAP。
外部护罩可以优选地与(即,宽度)范围为6mm至25mm且长度范围为40mm至200mm的各种进入窗口尺寸一起使用。通常,外部护罩包括允许附接稳定机构的特征,稳定机构允许适当的附接灵活性(例如,球形接头)。在一个实施方案中,外部护罩具有适于引入内窥镜或摄像头的定制特征,定制特征允许将内窥镜引入到预定深度,其中在外部护罩的远侧部分处的工作窗口可以被可视化。
内部护罩实施方案:
现在参见图3a至图3d,内部护罩11也可以包含各种设计。
在第一实施方案中,内部护罩是完全包围(即,延伸360度)的刚性管。内部护罩具有各种横截面,诸如:
e)具有内径D的圆柱形管(图3a);
f)高度a与长度b不同的椭圆形管(图3b);
g)具有直径D的圆形横截面的“半月形”管,其中截面(或弦)“a”被切割(图3c);以及
h)具有高度a和宽度b的矩形管(图3d)。
内部护罩可以具有不同的纵向形状。例如,在第二实施方案中,并且现在参见图4至图7,内部护罩11是漏斗形(例如,颈缩)管(如图4所示)。在此实施方案中,内部护罩改变了它沿护罩的横截面形状/面积,其中在近侧部分具有较大的直径/工作区域,并且对具有更大直径的此区域的长度进行调整使其成为内部护罩的将嵌套在外部护罩内的部分,以及具有较小的直径/工作区域,其中内部护罩使外部护罩延伸。这种设计增加了椎间盘内工具的运动范围并促使更好的可视化。在图4中,凸缘是第二基本上管状部分25,其直径小于内部护罩的第一基本上管状部分13的直径。颈缩区域27设置在第一基本上管状部分与第二基本上管状部分之间。
在一些实施方案中,内部护罩可以呈多个牵开器刀片中的一个牵开器刀片的形式。
在管状实施方案中,较小的管可以与较大的管同心,也可以不与其同心。在图5中,内部护罩的第一基本上管状部分和第二基本上管状部分是同心的(a=b)。在图6中,内部护罩的第一基本上管状部分和第二基本上管状部分是不同心的(a>b)。
在一些实施方案中,在较大和较小管之间提供球形接头,从而允许两个管之间的角度发生变化(图7)。在图7中,内部护罩的外表面23基本上嵌套在外部护罩的内表面10内,以使得内部护罩的基本上管状部分的近侧端部终止于外部护罩内。而且,内部护罩的远侧端部部分朝远侧变窄以限定第一半径R1,并且内部护罩的近侧端部部分朝远侧变窄以限定第二半径,并且内部护罩的近侧端部部分嵌套在外部护罩的远侧端部部分内以允许内部护罩的多轴向枢转。
在一些实施方案中,内部护罩是部分包围的管/护罩或“凸缘”,仅被设计用于保护神经。对于一些应用,内管的唯一目的可能是遮护/保护穿出神经根。在这种情况下,内部护罩可能被简化为圆柱体,其具有从其朝远侧延伸的凸缘25,以使得凸缘仅仅是为整个圆的约四分之一的护罩。参看图8a,或如果安装在外部护罩上,则参看图9。
神经保护器的深度调整
可以通过依赖于在外部护罩与内部护罩之间在沿外部护罩或内部护罩的任何位置处的干扰的机构来将前述外部护罩以其深度定位并固定。
在图8b中,内部护罩的第一基本上管状部分13的近侧端部部分包括适于邻接外部护罩的近侧端部部分的止动件31,止动件31适于防止内部护罩的过度远侧移动。优选地,止动件基本上径向地围绕内部护罩的基本上管状部分的近侧端部部分延伸。另外,止动件还可以包括适于抓紧的纹理化径向表面33。它既充当止动件又充当用于扭转护罩的柄部。
在图9中,内部护罩的外表面基本上嵌套在外部护罩的内表面内,以使得内部护罩的基本上管状部分的近侧端部部分朝近侧延伸经过外部护罩的近侧端部。而且在图9中,外部护罩的外表面还包括适于连接到导航器械或稳定点的第一端口41,以及适于连接到摄像头/灯系统的第二端口43。
外部护罩的导航:
第一端口允许对外部护罩进行导航以确定其相对于治疗部位的位置(深度和取向)。在一个实施方案中,外部护罩的外表面具有允许直接或间接附接导航器械的特征。在另一个实施方案中,外部护罩的内表面具有允许直接或间接附接导航器械的特征。
外部护罩中的内窥镜:
在一些实施方案中,外部护罩具有整体式内窥镜,其可以相对于解剖结构设置在固定的或可变的(角度或周向)位置。这种内窥镜可视化可以用于后续手术步骤,包括骨移除、内部护罩部署、椎间盘切除术和植入物插入。优选地,内窥镜具有用于原位自动清洁透镜的整体式透镜清洁机构。
图10公开了外管的横截面,其中外管壁138具有适于包含摄像头的第一通道238和适于包含透镜清洁装置的第二通道338。
图11公开了外管的横截面,其中外管壁包含透镜清洁装置139和摄像头239。
图12公开了顶端封装芯片实施方案,包括外管的横截面,其中外管壁具有包含内窥镜240的通道140,内窥镜240在其远侧端部附近具有视频芯片340。
图13公开了外管的远侧端部,外管以其远侧端部附近的视频芯片141为特征。
固定式内窥镜:
这种内窥镜可以是具有小于5mm的外径并且具有与外部护罩的长度基本上匹配的增量长度的顶端封装芯片型内窥镜。整体式顶端封装芯片型内窥镜/外部护罩实施方案的益处包括在外部护罩的孔内具有相对自由空间,从而增强可视化。
优选地,内窥镜在端口内成角度或具有内置透镜角度,由此使得在端口内最终定位时,外部护罩的远侧部分的圆周是可见的,并且圆周内的区域也是可见的。
在一些实施方案中,可以从外部护罩的壁上移除内窥镜并且将其独立地插入到外部护罩孔中以检查治疗部位(例如,插入椎间盘间隙中以确认适当椎间盘切除术)。
图14公开了用于内窥镜237的镜保持器137。
仍然参见图9,在一些实施方案中,内部护罩的凸缘25具有弓形横截面。在一些实施方案中,凸缘的弓形横截面限定凸缘的外表面47,其曲率基本上类似于外部护罩的内表面10的曲率。优选地,凸缘限定第二基本上管状部分,其直径小于或等于内部护罩的第一基本上管状部分的直径。
现在参见图15a至图15b和图16,内部护罩可以是可以被安装到/钩挂到外管的单个刀片。在这种情况下,弯管51用作止动件并且也用作外管的连接器。另外,内部护罩的近侧端部可以形成锚固销钉53。
有许多方法将内部护罩固定或定位到椎间盘上并且/或者固定或定位到外部护罩上。在一个实施方案中,这提供了内部护罩的针对滑移/脱位的安全性,包括将内部护罩朝远侧安装(到椎骨终板或椎间盘纤维环之上或之内)并且/或者朝近侧安装(到外部护罩之上)。
内部护罩与解剖结构的远侧固定可以包括:a)椎间盘纤维环内的固定,b)抵靠椎骨的固定,c)抵靠其他结构的固定,d)基尔希纳钢丝,其朝远侧延伸穿过内部护罩的壁并锚固到解剖结构,和e)销钉,其使远侧部分(图15)延伸以锚固到解剖结构。
内部护罩在外部护罩上的近侧固定可以涉及定位环或深度调整。现在参见图17,内部护罩在外部护罩上的近侧固定可以涉及定位环55。假设外部护罩应当相对于解剖结构固定,则应当选择在外侧具有外管形状以及在内侧具有内管形状的定位环。当放置在内部护罩上并进入外部护罩时,这种环应当使近侧内部护罩相对于外部护罩以及相对于解剖结构(考虑到以上假设)的位置或至少取向稳定。
现在参见图18,内部护罩在外部护罩上的近侧固定可以涉及深度调整装置57。这应当另外通过将内部护罩经由棘轮系统锚固或钩挂到外部护罩中来使内部护罩相对于解剖结构的顶端位置稳定或锚固。棘轮系统也可以定位在外部护罩的内表面与内部护罩的外表面之间或定位在外部护罩的壁内。它还可以包括弹簧系统以增加内部护罩与外部护罩之间的摩擦。
内部护罩部署(周向):
具有分开的外部护罩和内部护罩实施方案允许内部护罩相对于外部护罩的独立定位。而且,较小的内部护罩(相对于外部护罩)的使用允许在不存在牵开敏感组织的入口处允许最大程度的可视化。这种最大程度的可视化允许内部护罩的准确放置。在外部护罩的远侧存在牵开敏感组织的情况下,相对较小的内部护罩允许允许最小程度的牵开,同时提供穿过或经过这些组织的通路。优选地,内部护罩的内径不超过外部护罩的内径的40%至100%。
在一些实施方案中,将内部护罩-外部护罩构型替换为:a)初级护罩,其具有基本上管状形状,基本上管状形状具有切口,和b)次级护罩,其具有基本上可插入切口中的形状。优选地,初级护罩具有基本上环形形状并且次级护罩具有与初级护罩的环形形状基本上匹配的弓形横截面。此实施方案允许次级护罩相对于初级护罩倾斜。
内部护罩部署(径向):
在另一个神经保护实施方案中,护罩的牵开运动是径向的而不是旋转的。在这些实施方案中,可以使用直的内部护罩或卡口式内部护罩。内部护罩可以定位在受保护组织将被定位的区域上方。然后,凸缘护罩可以在外部护罩的远侧端部处成角度地(例如,朝向尾椎弓根)形成进入窗口的中心。凸缘护罩可以然后后续地纵向推进到神经根的近中侧上,形成如Kambin所述的“安全区”。凸缘护罩随后成角度,由此使得内部护罩的远侧顶端侧向成角度,其中内部护罩的外部远侧表面将穿出神经根轻轻地推开并且/或者遮护穿出神经根使其避开为进行椎间盘内手术而进一步向内侧引入到护罩的工具。此实施方案可以被构造成由此使得内部护罩基本上嵌套在a)外部护罩的壁内(图19(a))、b)外部护罩的内表面的内部(图20(b))或c)外部护罩的外表面的外部(图21(c))。在一些实施方案中,内部护罩内置于外部护罩的壁内或甚至外部护罩的外部。
图19公开了整体式牵开器,其具有容纳于外管245内的平坦内面145。
图20公开了牵开器,其具有容纳于外管内的平坦内面144。
图21公开了外管150,其具有与外管的外面350嵌套的牵开器250。
神经保护器的深度控制:
可以通过依赖于在外部护罩与内部护罩之间在沿外部护罩或内部护罩的任何位置处的干扰的机构来将前述外部护罩以其深度进行控制。
有多种途径可以由本发明的装置使用来撑开椎间盘间隙并且/或者在安装时提供神经保护。
在一个牵开实施方案中,使用旋转展延器。这是一种常规的概念,涉及插入到椎间盘中的卵形或矩形横截面形状的棒,棒的较小维度指向椎骨终板。在力的作用下将展延器转动90°后,较大维度指向椎骨终板,这通过两个横截面尺寸的差将椎间盘撑开。
在第二牵开实施方案中,如现在参见图22至图24b,内部护罩可以包括展延器,其包括框架60、头部刀片61和尾部刀片63。
将在头部位置和尾部位置具有头部撑开刀片61和尾部撑开刀片63的展延器以塌陷/渐缩构型引入到椎间盘中(图22)。然后将展延器刀片用内芯65撑开(内芯65与刀片上的反作用几何形状匹配以免侧向滑脱),从而使椎间高度从d1升至d2(图22至图23)。然后将与内芯高度匹配的侧壁67向内侧/向侧面引入(图24a),以周向地封闭四壁式护罩。一旦内芯被移除,堆叠式护罩就使椎体保持以撑开状态分开(图24b)。
现在参见图25至图26,内部护罩还可包括旋转凸缘71,其在旋转时向侧面/向内侧移动以遮护神经根。
在神经保护实施方案中,并且现在参见图27至图30,使用旋转漏斗70。优选地,可以巧妙地引入凸缘护罩71以在插入时保护穿出神经根。如果通过外部护罩引入此护罩,则此护罩可以指向尾椎弓根。此位置是“保存区”。一旦远侧顶端达到椎间盘水平,内部护罩就可以顺时针转动约90°(即旋转),以使得凸缘将穿出神经根轻轻地推开并且/或者遮护穿出神经根使其避开为进行椎间盘内手术而进一步向内侧引入到护罩的工具。
在第二神经保护实施方案中,并且现在参见图31至图34,使用同心排列的多护罩来轻轻地移动和/或遮护神经。旋转漏斗原理也可以应用于多于一个旋转护罩。如果只需要对位于单一侧的结构提供保护,则单个护罩可能是合适的。然而,在其他情况下,朝向椎间盘的护罩入口在内侧和侧面应当均受到穿出神经和下行神经的约束,因此内部护罩需要遮护两个相对的结构。在这种情况下,两个同心地布置的外旋转凸缘81和内旋转凸缘83在相应的顺时针和逆时针方向上转动90°以达到最终构型,其中相对的护罩保护神经使其避开为进行椎间盘内手术而进一步引入的工具。
在另一个神经保护实施方案中,径向牵开的多护罩用于轻轻地移动和/或遮护神经。径向牵开原理也可以应用于多于一个径向牵开护罩。
图35公开了径向软组织牵开器136。
图36公开了外管/内部牵开器组件,其中第一内部牵开器153和第二内部牵开器253均向内倾斜以牵开软组织。
如果只需要对位于单一侧的结构提供保护,则单个护罩可能是合适的。然而,在其他情况下,进入椎间盘的护罩入口在内侧和侧面应当均受到穿出神经和下行神经的约束,以使得内部护罩需要遮护两个相对的结构。在这种情况下,两个相对的内凸缘初始朝向外管进入窗口的中心定位,并且随后向外牵开以遮护相对的神经使其避开为进行椎间盘内手术而进一步引入的工具。
图37至图46公开了涉及套管式进入装置的优选外科手术方法。
在一个实施方案中,并且现在参见图37,外科医生放置基于椎弓根螺钉的锚固件,向锚固件添加导航参考框架101,并使用商用导航系统进行导航。在一些实施方案中,参照与治疗部位基本上对称地相邻的解剖学特征(例如,对侧颅骨或尾椎弓根)来将导航阵列放置到解剖结构上。
在一些实施方案中,通过Kambin三角区将探头导航到小关节囊或椎间盘间隙。优选地,在切开筋膜和肌肉之后,引入启用了导航可视化的探头以获得初始锚固点。在一个实施方案中,将探头通过指向上关节突的外侧缘的外部而插入到椎间盘间隙中,并且可以任选地利用神经检测和/或可视化功能/在它们的支持下来启用。在另一个实施方案中,将探头引入到小关节囊中。
在一些实施方案中,在导航探头上存在扩张。在初始锚固点之后,执行扩张以针对进行治疗所需的端口大小来准备手术部位。然后执行顺序扩张直至获得优选大小的端口窗口。然后通过相关扩张器引入端口。在一个实施方案中,在椎间盘间隙中进行初始锚固并且应当使用一个或多个同心顺序扩张装置以便围绕初始锚固点同心地牵开组织(在外侧使SAP的侧向部分,以及在内侧使Kambin三角区暴露)。在另一个实施方案中,在小关节囊内进行初始锚固并且可以使用一个或多个偏心顺序扩张装置以将组织牵开侧向地集中在SAP和Kambin三角区的侧向部分。
在一些实施方案中,将外部护罩固定到解剖学参考物上。外部护罩具有基本上管状部分,其具有被设计用于附接到稳定机构的点或特征,稳定机构继而固定到治疗部位的头部或尾部的椎体上的解剖学特征。
图38公开了外管,进入其中的插塞包含用于引导骨切割装置的模板。
在一些实施方案中,外部套管附接到稳定机构。在一个实施方案中,此稳定装置应当是一种具有足够的长度以在治疗部位的对侧上到达解剖学固定点(例如,椎弓根螺钉)的装置。机构(包括其连接到外部护罩和解剖学锚固件的连接特征)允许外部护罩的放置具有足够的灵活性,并且足够稳定以将外部护罩保持在适当位置,直到使用者松开为止。稳定方法应当为由此使得使用者可以决定硬度。
在另一个实施方案中,此装置具有足够的长度以在治疗部位的同侧上到达解剖学固定点(例如,椎弓根螺钉)。同样地,机构(包括其连接到外部护罩和解剖学锚固件的连接特征)应当允许外部护罩的放置具有足够的灵活性,并且足够稳定以将外部护罩保持在适当位置,直到使用者松开为止。稳定方法应当为由此使得使用者可以决定硬度。
在另一个实施方案中,此装置应当是一种具有足够的长度以在患者的中线上到达解剖学固定点(例如,椎弓根螺钉)的装置。同样地,机构(包括其连接到外部护罩和解剖学锚固件的连接特征)应当允许外部护罩的放置具有足够的灵活性,并且足够稳定以将外部护罩保持在适当位置,除非使用者松开。稳定方法应当为由此使得使用者可以决定硬度。
现在参见图39a至图39b,外科医生然后使组织扩张到超过基于椎弓根的锚固件,并插入连接至锚固件的外部护罩1,其近侧端部指向上关节突。在受到影响的椎间盘上进行一直到骨头的钝性分离,然后在受到影响的椎间盘上进行肌肉牵开。这种牵开涉及在直接可视化下对肌肉和筋膜到骨水平的钝性分离。
现在参见图40,外科医生然后将外部护罩1转向层间空间,根据病理需要执行中央双侧减压,然后将护罩转回其初始位置。
在一些实施方案中,从切口位点向内侧倾斜进入通道的替代形式可以是使用应当更为内侧的另选进入位点。在一些实施方案中,椎间盘空间中的初始锚固点将在下关节突的内侧。对于在小关节囊中具有初始锚固点的实施方案,偏心扩张器的扩张将从囊向内进行扩张。此外,将通过骨移除区段移除部分椎板和下关节突。
现在参见图41,外科医生然后将骨移除工具(未示出)插入外部护罩管并切除上关节突的侧向部分以向内延伸传统的Kambin三角形。
在直接或内窥镜式可视化下,骨移除装置被引入外部护罩并用于至少移除SAP的侧向部分。此类装置的长度和尺寸可供选择,从而允许通过40mm至200mm的进入窗口和10mm至25mm的窗口尺寸进行安全引入和使用。
在一个实施方案中,骨移除装置是超声切割装置。在另一个实施方案中,骨移除装置是往复式切割表面。在又一个实施方案中,骨移除装置是旋转切割工具。在另一个实施方案中,骨移除装置是行程长度为介于10mm至30mm之间的机械冲头。可以以这样的方式移除骨,即将尺寸小于进入尺寸的骨切除并移除。可使用独立插入外部护罩中并用于引导骨切割和移除的方向的模板执行骨移除。
负模板是插入外部进入管中的插头式装置。根据需要被移除的组织的横截面形状,它包括不同形状的纵向切口,相应的组织的横截面形状需要被覆盖并由此免受任何外科手术相互作用。通过将例如铣刀的切割装置插入纵向切口中,外科医生能够移除组织而不危及被覆盖的组织/结构。结合近侧止动系统(在外部进入管的近侧端部和/或铣削系统的轴上),外科医生可逐层移除组织。层的厚度以及由此的切割程序的进展可通过标尺支持的止动系统进行控制。此系统允许外科医生利用受控的连续工作流程执行安全的组织移除:检查解剖情况→调节止动系统以限定需要被移除的组织的横截面厚度→在止动系统接合之前插入铣削系统→在平面(2D)上(也是盲目地)铣削/切割组织→移除铣削系统→检查解剖情况→调节止动系统。
可以认为连续的工作流程比并行工作流程更安全,因为外科医生一次只需关注一个参数(此处为:铣刀的平面位置,然后是铣刀的深度,然后是铣刀的平面位置……),但是并行工作流程需要一次控制两个或更多个参数(此处为:铣刀的平面位置与其深度)。
SAP移除的导航可利用上述骨移除装置进行,骨移除装置适于通过其与导航系统的机械或视觉连接来导航。
现在参见图42至图43,外科医生然后将内部护罩管插入外部护罩管中,内部护罩用于将外管从小关节线向前延伸,直到内部护罩的末端达到椎间盘的水平面。神经根由内部护罩保护。
现在参见图44,外科医生然后识别椎间盘,并利用楔形骨凿展开椎间盘;检查松动,并移除后缘、骨刺和环带,直到打开最小的环形窗口。外科医生然后将椎间盘移除工具201插入进入装置中,移除椎间盘并准备终板。
图44中规定的椎间盘清理步骤的另选实施方案应当是将椎间盘移除工具通过其与导航系统的机械或视觉连接进行导航。
现在参见图45,外科医生然后执行暂时的椎间盘空间牵张,用骨移植物填充椎间盘空间的一部分,并将融合笼203插入剩余的椎间盘空间中。
现在参见图46,外科医生然后加入后部固定103。
观察元件
在一些实施方案中,使用了基于芯片在末端上的技术并被集成到端口的壁中的可视化元件。此实施方案与安装在管壁处的标准棒状透镜内窥镜相比具有许多优点:
·制造成本。芯片在末端上的技术允许非常有成本效率的制造,因此可作为‘一次性’器械销售。
·仅在远侧末端处的刚性部分。尽管标准的棒状透镜内窥镜系统在整个管上具有刚性的圆柱形状,但是芯片在末端上的内窥镜在近侧外管端部可具有非圆柱形构造。优选地,此形状是扁平缆线形状。在一些新颖的实施方案中,相对于标准棒状透镜内窥镜,芯片在末端上的内窥镜具有相对较短的“刚性”节段(约20mm),其中近侧端部包括可以是柔性的缆线。在其他实施方案中,刚性部分较短(产生较小的芯片组件)并且主动进行关节运动的概念用于改变透镜角度。由于缆线集成在管壁中,端口窗口的形状在整个程序中得以保持。例如,5mm芯片在末端上的内窥镜将15mm的圆形进入窗口变成肾状进入窗口。
·相机单元的尺寸/重量。标准的棒状透镜内窥镜具有标准目镜,其为具有一定尺寸的通用接口。连接到此类系统的相机必须内置于一定的尺寸中以与目镜兼容。此要求产生了具有诸多缺点的相对笨重的相机附件(直径为约3cm至6cm,长度为约5cm至10cm)。首先,此较大的相机构造可能是工作中的物理障碍,特别是当工作端口的轨迹改变或干扰相机时。其次,这种常规构造的尺寸和重量变得足够大,以致在棒状透镜内窥镜上产生某些不希望的力,特别是在弯曲时。第三,相对脆弱的常规棒状透镜内窥镜必须嵌入诸如金属管的稳定结构中,从而进一步减少活动工作窗口。
利用本文所公开的芯片在末端上的实施方案,其芯片缆线嵌入在外管的壁中,在近侧外管壁处离开的缆线不在工作端口上产生类似的力。此外,就将芯片在末端上的内窥镜安装在管壁中的附接机构而言,由于没有产生弯曲力从而提高了采用机械上不必非常稳定的相对较薄的附接选项的可能性。
·工作环境。通常,在脊柱内窥镜检查应用中使用恒定的流体环境(盐水溶液的持续流动)。然而,在微开口和显微外科手术环境中,由于解剖条件差异很大,因此流体环境没有帮助。因此,在本文所述的优选新颖程序中,芯片在末端上的内窥镜在干燥的开放空气环境中工作。然而,芯片在末端上的内窥镜在其中所使用的开放的干燥空气环境可能对内窥镜的透镜部件产生不希望的凝结效应。例如,较冷的透镜在潮湿的体温环境中可能起雾。此外,来自单极手术刀或止血工具的钻屑、毛刺碎片或烟雾可同样影响内窥镜的透镜从而降低可视性。因此,期望周期性地清洁芯片在末端上的内窥镜的透镜。
神经偏转(管中管)
在通过门静脉进行的微创脊柱手术中,经常使用一组扩张器来准备接收门静脉的位点。美国专利公开US 2012-0232552(Morgenstern)中示出了一种此类技术。在这种常规技术(其具有偏心扩张器)中,任何一个扩张器的外径与下一个连续的(外部)扩张器的内径相同。这种直径的同一性对于荧光镜透视检查辅助的经皮肌肉扩张是必需的。
由于本申请的一些实施方案描述了在脊柱关节的水平面与椎间盘之间的程序,所以在直接可视化下解剖手术位点。因此,在这些新颖程序中使用的连续扩张器的直径不必匹配。在这些新颖程序中宽松的“精确直径”要求允许外科医生在许多管设计区域中更加自由。例如,它允许使用锥形管。它也允许外科医生自由使用不同轴的外部端口和内部端口。它还允许内部端口相对于外部端口的轨迹在某些治疗步骤中在角度上发生变化。最后,它允许内部端口相对于外部端口的轨迹在某些治疗步骤中在距离上发生变化。
由于荧光镜透视检查辅助,经皮肌肉扩张在没有直接可视化下进行,因此这是使用具有限制的盲目的程序。这些限制包括无法进行出于安全考虑而需要直接可视化的手术步骤。需要直接可视化的一个此类治疗步骤是对骨和与神经结构直接相邻的韧带组织进行直接减压。
由于本文所述的一些实施方案允许对解剖结构直接可视化,所以这些实施方案还特别地允许对骨和与神经结构直接相邻的韧带组织进行直接减压,并且更一般地允许通过完全保留组织的“管中管”入口对与管相邻的组织进行操作或移除。
Morgenstern还描述了一种方法,其中在荧光镜透视检查的引导下(即,无直接可视化),通过椎间盘空间将导丝直接引入Kambin三角形。Morgenstern还描述了使用基于电的神经监测探头的可能性。此外,Morgenstern描述了一种通过随后从SAP和椎弓根中锉掉骨的扩大棘突的方法。
本文所述的新颖程序仅在小关节线上方的安全区域中执行非可视化程序(例如,扩张)。在解剖学上更为关键的小关节水平面与椎间盘之间的区域中,该新颖程序在直接可视化下解剖手术位点,从而允许外科医生尽可能多且尽可能有意义地留出骨。
导航
通过术中实时显示,导航增强了静态X射线、CT或MRI数据,其中实际使用的器械与患者的解剖结构相关。因此,它通过显示它们的形状、轨迹和定位甚至更重要的是它支持外科医生在执行操作期间保持器械取向来增加这些器械的安全性。
不希望受理论束缚,据信,微创技术不常使用的一个原因是与小切口技术相比,需要明显更高的X射线暴露来保持取向,其中外科医生仍然具有直接可视化所以实际上可以利用显微镜或小型放大镜看到活动位点。对于经常接触辐射的外科医生而言,X射线暴露的效果更强。此挑战通过本文所述的新颖程序中实现的导航技术来解决,因为它们允许将X射线暴露减少到用于对准目的的理想的最小总共两个X射线。一旦单次侧向拍摄和单次前后拍摄已被对准,所有使用的器械(例如,Jamshidi针、指示器、扩张器、进入管、骨凿、可伸展保持架本身、椎间盘移除装置……)就都可以实时投影到这些静态荧光图像中。另一个积极效果是可以节省大量时间。使导航系统就位也有助于外科医生了解内窥镜的取向(轨迹和深度),并因此了解他或她利用相机实际上看到的内容。这可以通过直接导航相机或通过将相机设置在集成到导航进入管中的固定位置中来间接实现。
Jamshidi针、指示器、扩张器和进入管器械都可以使用一个器械,即FOX导航多功能工具进行导航。
图47a至图47c公开了一种导航插头,其包括基座147,基座147具有与其连接的阵列247,其中插头适于配合在外管347内。
骨切割器
在一些实施方案中,新颖程序使用用于SAP移除的超声骨切割装置,其仅切割骨并且将不切割软组织。基于用于椎间体融合的常规可扩展笼式装置的实施方案可能需要至少与12mm一样大的进入窗口。这么大的窗口只能通过(部分)移除上关节突(SAP)以延伸Kambin三角形来实现。由于超声骨切割装置在意外碰到神经时不切断神经而显着增加了此程序的安全性。如果切割装置刀片被设计成朝远侧达到椎间盘空间的水平面的内管/刀片的形状和直径(即,曲奇切割器设计),则SAP移除可以被最小化(更少的创伤、对患者的压力更小、恢复更快)并且在单个步骤中执行(比多步骤程序更快)。
图48公开了从外管243的端部延伸的超声切割器的曲奇切割器型远侧端部143,其中远侧端部143具有多个切割齿343。
另一种提高骨切割安全性的方法是利用负引导对骨进行深度控制的手动铣削。负引导涵盖那些将不被移除的区域(负模板)。深度控制允许在外科医生的连续控制下逐层铣削骨层。深度控制的参考以及轨迹可以是外部进入管(还可参见导航段落)。
图49a至图49b公开了用于引导骨切割装置的模板的各种横截面。
骨切割器
在一些实施方案中,骨移除装置是具有曲奇切割器设计的谐波手术刀。手术刀具有与外管接合的月牙形切割表面。手术刀被用作单程器械,一次性移除预定量的骨。在一些实施方案中,手术刀还具有喷洒水以用于冲洗的管,而外管具有用于清除已移除骨的浆液的抽吸管线。
在一些实施方案中,手术刀可以被导航并且骑在设置在外管内壁上的狭槽中。狭槽的深度可以预先确定,以提供深度控制的铣削并控制切割器的走向。这是有利的,因为据信徒手切割很容易碰到神经。切割表面的形状和尺寸可限定待移除的骨的特定区域。切割的特异性是有利的,因为它将骨的移除量降至最小,这对及其无力的小关节是有利的。因此,实现了更快的程序,更少的创伤(更少的疼痛)以及更稳定的结构。
观察元件(黄褐色)
在一些实施方案中,芯片观察元件可以成角度以便使其可以看到管的周围角落,
在常规的内窥镜中,可视化是2D的(即,没有深度感知),所以当两个神经实际相距2cm时,它们可能看起来紧密靠近。因此,在一些实施方案中,内窥镜被修改以使得芯片起到测距仪的作用。具体地讲,芯片识别并评估距离芯片已知距离的参考结构,然后基于该评估测量神经距离芯片(管端部)有多远。
神经偏转(管中管)
在一些实施方案中,外部护罩上具有压力传感器以测量神经上的压力。使用可以测量距离的超声技术,系统可以测量回缩时神经的伸长,并限定最大伸长极限(例如,20%),然后在超过伸长极限时向外科医生发出警告。在一些实施方案中,系统将超声集成到端口中并由此导航端口。
在一些实施方案中,外科医生导航相机。这允许外科医生了解相机的取向。
在一些实施方案中,可视化提供了椎间盘的轴向视图,因此外科医生可以了解椎间盘移除工具的位置。
神经监测分析
目前,神经监测装置可用于获得可能在手术环境中引起的潜在神经健康或神经损伤的指示。通过测量手术位点附近的神经与神经的远端之间的电脉冲来实现神经健康的这种指示。例如,可以在脊柱的神经根和腿上的某个点之间测量脉冲。
神经损伤可通过直接手动接触神经而引起。除了诸如切断或压碎神经的严重损伤之外,对神经施加其他较小的力也可造成损伤。例如,使神经移位,拉伸神经或压迫神经可导致严重的损伤。在一些情况下,将此类力扩展施加到神经可减少流经神经的血液,再次导致神经损伤。通常情况下,此暴露时间取决于施加的力的量。因此,对于外科医生能够装载神经多长时间似乎没有已知的坚定规则。
除了神经监测之外,评估潜在神经损伤的替代形式可能为程序期间的神经保护带来新的见解。就这一点而言,神经操作测量可以产生对神经风险的指示。如果神经在程序期间发生移位,它可能被拉长或者可能被侧向移位。可测量神经物理特征的这些改变并用于预测潜在的神经损伤。因此,可测量其他潜在特征并用于预测潜在的神经损伤,包括弧长和神经本身的直径等。这些特征可通过诸如超声的技术以可量化的术语测量。所得的测量值然后根据绝对值、百分比变化或一些其他指示可从数据库或文库中获得的潜在神经风险/损伤的度量(通过软件或手动)进行分析。在一些实施方案中,这些度量可用作安全时间长度的预测因子,在安全时间长度内,神经可具有给定的移位或变形而不引起长期损伤。还可使用计算或算法来确定最大安全变形,或者神经可具有给定变形特征的最大许可时间。
这种测量可通过许多方式获得。它可以通过手动、光学或其他成像形式进行测量。这可以发生开腹手术、MIS中的皮下注射或其他类型的程序。直接可视化可使用相机完成。之前和之后的图像可被解释为计算绝对变形量或百分比变化量。测量可以通过诸如超声或可以“看见”软组织或识别与周围组织相关的神经组织的其他形式的成像(X射线、CAT/PET扫描、MRI等)来获得。
根据此实施方案可以使用的其他测量方法可包括a)测量由于装载引起的神经内的密度变化,或者b)血流量的变化。此类测量可以通过雷达、超声和其他成像方法获得。
在一些神经监测实施方案中,测量神经或脉冲内的阻抗是可能的,其中这可以相对于神经的特定变形区域局部完成。具体地讲,在本文所讨论的一些实施方案中,神经护罩可以在护罩的相对边缘上具有传感器,其应当接触两个不同神经位置中的相同神经。这些传感器应当允许外科医生在神经扩张之前读取诸如脉冲或阻力的电气值,然后在发生扩张或实现扩张时再次测量电气值。这些测量值的差值可以是变形程度的指标。
图50公开了具有半圆形切割件切割器骨的超声波切割器的曲奇切割器型远侧端部142。
图51公开了连接外管246和螺钉伸出部346的小型挠曲臂146。
图52公开了外管/内部牵开器组件,其中内部牵开器151向内倾斜以牵引软组织。
图53公开了外管/内部牵开器组件,其中内部牵开器152平行于外管252延伸。
图54公开了容纳在外管内的内窥镜154和从外管延伸的内管254。
在上文所公开的许多实施方案中,内部护罩嵌套在外部护罩内。然而,在所有这些实施方案的另选实施方案中,内部护罩被集成到形成在外部护罩的壁内的切口中的可移除刀片代替。在这种情况下,内部护罩的外表面基本上嵌套在外部护罩的外表面内,以使得凸缘朝远侧延伸经过外部护罩的远侧端部。
在上文所公开的许多实施方案中,内部护罩的基本上管状部分的近侧端部部分包括适于抵靠外部护罩的近侧端部部分的止动件,止动件适于防止内部护罩的过度远侧移动。在其他实施方案中,支座发生在沿着外部护罩的任何地方。
图55至图63公开了在本文所公开的优选手术中所用的器械中的一些。
具有参考阵列的椎弓根柱
现在参见图55,导航手术的第一步骤是将椎弓根螺钉(诸如Viper 2或ViperPrime,购自DePuy Synthes Spine,Raynham,MA)放置在对侧尾椎体内,然后插入包括多轴向阻挡柱503的中心芯501,多轴向阻挡柱503与椎弓根螺钉的锁定盖的螺纹接合。当拧紧时,螺钉的多轴向度完全被阻挡。螺钉505将中心芯与多轴向阻挡柱锁定。具有偏心杆的夹具507将参考阵列509牢固地连接在椎弓根柱上。两个附加螺钉连接件511、513允许外科医生将与相机一起设置的参考阵列对准到导航系统,导航系统通常被放置在患者的尾侧。
应当将参考阵列直接安装在阻挡芯上(请参见椎弓根锚固件)。在一些实施方案中,柱上存在阵列的可调节取向。在一些实施方案中,注意确保柄部和反扭矩插入件的顶部之间的距离大于螺钉的长度。在一些实施方案中,导航阵列足够强以充当用于多轴向阻挡件的反扭矩(其应当在对准之前进行)。
多工具
现在参见图56,提供了包括主体515的多工具探针,主体515包括导航阵列(单件)、钝型细探针517、尖锐细探针519和可拆卸柄部521。这组特征允许外科医生将装置用作导航指示器(具有钝型细探针)、导航贾姆什迪针(尖锐尖端)以及用于导航扩张管和进入管的插入的装置(参见下文)。此工具使用单个阵列,并且所得的单个对准规程涵盖四个功能。在一些实施方案中,阵列是可拆卸柄部的一部分。
椎弓根锚固件
现在参见图57,提供了基于常规螺钉的椎弓根锚固件,椎弓根锚固件包括中心芯523,其包括与螺钉的锁定盖的螺纹接合的多轴向阻挡柱525。当拧紧时,螺钉的多轴向度完全被阻挡。螺钉527将中心芯与多轴向阻挡柱锁定。在不包括具有参考阵列的上述椎弓根柱的其他实施方案中,附接装置(微型柔性臂)的接口不是通过使用夹具而是通过不可拆卸的结构(球体,529)实现的。这提供了足够的稳定性,并且是现有螺钉系统的简单附加件。
扩张管
现在参见图58,提供了包括一组管531的扩张系统,这组管的外径与12mm、15mm和18mm的现有进入管(外部护罩)内径匹配。它们在横截面平面中都为圆形,并且在纵向轴线上开槽以便被放置在多工具探针(参见上文)上并且通过导航阵列与多工具的空心圆柱形本体的连接。在一些实施方案中,这组管的外径(OD)为OD1=12mm、OD2=15mm和OD3=18mm。
微型柔性臂
现在参见图59,提供了由两个夹具533、535构成的微型柔性臂,这些夹具附接到椎弓根锚固件上的球形连接器和进入管(外部护罩),并且因此允许对附接装置进行多轴向调节。在解锁位置,与多轴向夹具结合的具有球窝元件537的分段臂允许进入管(外部护罩)的非限制性三维放置。可用使多芯线541绷紧的单点柄部539来锁定所述系统。可通过调节线的有效长度来在螺钉543上补偿线随时间的潜在伸长,线随时间的潜在伸长应当对装置的固定特性产生负面影响。
具有软组织牵开器的进入管(外部护罩)
现在参见图60,提供了进入管(外部护罩)545,其为具有远侧凸缘的简单圆柱形管,其具有将其与微型柔性臂连接的不可拆卸的结构(球体,547)。将软组织回缩刀片(内部护罩)549放置在进入管内。附接弹簧551允许中心插入。一旦释放刀片(柄部,553),弹簧就将刀片(内部护罩)推靠在进入管(外部护罩)的内壁上,因此使远端上的软组织回缩。刀片(内部护罩)保持自由旋转,并通过纯摩擦力与进入管(外部护罩)保持在一起。在一些实施方案中,可以选择同时使用两个软组织回缩刀片(内部护罩),这应当满足将此实施方案用于TLIF手术的要求,因为其允许横向和现有神经的回缩。在一些实施方案中,可拆卸柄部由长度为约25mm的简单永久柄部代替。
具有整体式内窥镜的进入管(外部护罩)
现在参见图61,提供了进入管(外部护罩),其具有整体式内窥镜和将其与微型柔性臂连接的不可拆卸的结构(球体,555)。深度可调节内窥镜系统被保持在通道557中,通道557具有用于增加摩擦的弹簧特征559并因此将内窥镜保持在适当的位置。内窥镜系统561由内窥镜本身(OD=4mm)和2个管组成,一个用于冲洗的管563,另一个用于抽吸的管565。在一些实施方案中,内窥镜为深度可调节的。在一些实施方案中,内窥镜的通道将平行于进入管(外部护罩)腔。
导航插塞
现在参见图62,在一些实施方案中,存在导航插塞567,其被放置在进入管(外部护罩)569中并且允许将多工具(参见上文)放置在与导航插塞的远端齐平的进入管(外部护罩)的中心中。此实施方案允许在导航系统中可视化进入管(外部护罩)的中心纵向轴线以及其远端。因为,在一些实施方案中,进入轨迹被认为比深度更重要,所以轨迹线可被刻度化以提供与已知端口长度相结合的深度信息。
具有柄部的椎间盘切除工具
现在参见图63,提供了可附接柄部571,其经由适配器板575直接附接到标准的基于抽吸的椎间盘切除工具573,适配器板575通过3个螺钉夹持到椎间盘切除工具容纳件。在此适配器板的第一实施方案中,其仅保持可附接柄部,而在第二实施方式中,其保持附加导航阵列。导航阵列是预先校准的:在让导航系统获知当前使用的特定椎间盘切除工具后,其在预先对准的X射线视图中实时显示装置的正确尺寸和尖端。
图64至图90公开了在本文所公开的优选手术中以其预期的脊柱内使用取向的器械中的一些。
步骤1 参考阵列的放置
步骤2 椎弓根锚固件的放置
步骤3 进入管的放置
步骤4 SAP移除
步骤5 软组织回缩
步骤6 椎间盘移除
步骤7 插入可伸展的保持架和骨替代物
步骤8 后部稳定性
步骤1参考阵列的放置
现在参见图64至图65,在一个实施方案中,经由柱576将多轴向螺钉对侧地插入脊柱中。然后,将导航参考阵列577固定安装在多轴向阻挡柱579上,并且接合到椎弓根螺钉的锁定盖的远侧螺纹(不可见的,内螺纹/插片)中。
步骤2椎弓根锚固件的放置
现在参见图66,具有连接器接口583的椎弓根锚固件581被放置在对侧上。
现在参见图67,椎弓根锚固件585被放置在同侧上。
步骤3进入管的放置
现在参见图68,将多工具587插入脊柱中以用于确定目标区域589和扩张器/进入管的轨迹。
现在参见图69,将基尔希纳钢丝和柄部从多工具中移除以进行下一步。在放置多工具591之后,需要移除基尔希纳钢丝593以便允许移除柄部595。
现在参见图70,进行多步扩张以为进入管(外部护罩)插入做准备。柄部的移除(参见先前的步骤)允许放置第一扩张器、第二扩张器和第三扩张器597以为进入管插入做准备。
现在参见图71,从多工具基部移除导航阵列。由于保持进入管(外部护罩)定位的目标点在临床上是重要的,因此可通过移除导航阵列将进入端口放置在多工具的主体599上,留下导航阵列接口601,导航阵列接口601允许参考阵列的无间隙、承重和双独特固定。
现在参见图72,将进入管(外部护罩)插在扩张器602上(其中观察元件顶端封装芯片型镜被预先安装)。进入管(外部护罩)是可伸缩的,并且可调节长度也可用棘轮机构603稳定。它包括远侧段605,其保持容纳在通道609中的深度可调节顶端封装芯片型相机607,通道609被集成到远侧段的壁中。进入管(外部护罩)611的近侧部分在远侧段上滑动并保持连接器接口613。
现在参见图73,一旦扩张器以及多工具的主体已经被移除,进入管(外部护罩)615就可自由进入SAP。
图74公开了可视化盒和清洁盒(水和抽吸)的连接器。顶端封装芯片型相机包括设置在进入管(外部护罩)中的实际相机617和向相机提供电源、数据电缆和光的主连接器插头619。还存在用于冲洗和抽吸的两个管621、623以提供用于相机镜头的清洁特征,这两个管合并到连接到相机并从进入管(外部护罩)延伸的单个缆线625中。
现在参见图75,进入管(外部护罩)被固定到同侧或对侧椎弓根锚固件。进入管627经由连接器631刚性地附接到对侧629或同侧(未示出)椎弓根锚固件。此连接器允许将进入管锁定在任何3D位置。它包括球窝段635、两个接口夹具637a、637b和内线材(不可见),内线材由可调节的639单点固定柄部641置于张力下,从而通过增加两个接口夹具和段的单个接头的绝对摩擦来阻挡这些接头。单点固定连接器被设计成在构造的紧固期间最小化进入管以及椎弓根锚固件上的累积力。另一连接器设计(未示出)在功能上是相反的,因为它是永久稳定的,除非经由单点固定柄部释放内线材。
步骤4 SAP移除
现在参见图76,提供了进入管的轴向视图,其中外科医生已准备好开始切割SAP。该图中公开了:微型柔性臂的单段643;连接器接口645;伸缩式进入管的外近侧部分647;伸缩式进入管的内远侧部分649;整体式顶端封装芯片型相机的电缆651;和未回缩神经UN。
现在参见图77,提供了整体式镜的配置,整体式镜包括:伸缩式进入管的外近侧管653;伸缩式进入管的内远侧管655;整体式顶端封装芯片型相机的穿出电缆657;外壳内的顶端封装芯片型相机659;和顶端封装芯片型相机的投影视场PF。
现在参考图78,在一些实施方案中,通过使用具有导航插塞的多工具,存在进入管的可选的导航。结合导航插塞661,多工具663还可用于使用导航来可视化进入管665的轨迹以及远端。导航插塞位于伸缩式进入管的内远侧管的近侧边缘上,这导致深度感知的精确可视化与外近侧管的位置以及因此进入管的总长度无关。
现在参见图79,提供了经由使用MIS高速钻机或手动工具来进行SAP移除。将使用高速电动工具(诸如Anspach系统667)(部分地)移除SAP。毛刺669将被部分地遮护以增加安全性。
现在参见图80,示出了对于不同的解剖平面,由MIS高速钻机或手动工具进一步移除SAP。具有毛刺671的SAP的移除在约10mm至20mm的神经(2)水平NL的上方发生。
步骤5软组织回缩
图81至图82公开了软组织回缩,示出了直接在进入管上的夹具,内侧到侧向回缩。图81示出了在神经径向回缩之前的软组织牵开器673。在此状态下,软组织牵开器已与进入管675接合。图82公开了在神经径向回缩之后的软组织牵开器673。
图83公开了根据患者解剖结构的神经遮护和定位。图83示出了完全接合的软组织牵开器675,其中夹具677将其保持在伸缩式进入管的近侧外管679上。神经N完全回缩并且受到软组织牵开器的保护。
步骤6椎间盘移除
现在参见图84至图85,使用基于抽吸的椎间盘切除工具681进行椎间盘清理,椎间盘切除工具681保持待导航的选项。因此,在椎间盘切除工具的轴683上安装(焊接/胶合)环(不可见的),环允许无间隙地安装导航阵列685。
步骤7保持架插入
在图86中将可伸展的保持架687插入到椎间盘间隙中。在图87中,保持架687被扩展至完全伸展。
现在参见图88,经由递送系统将骨移植物689插入在保持架周围。在拆卸插入器之前,可伸展的保持架687处于其最终位置。已将骨替代物689放置在装置周围(插入保持架之前和之后)以确保适当的融合过程。
步骤8后部固定
图89公开了插入剩余的螺钉691,而图90公开了放置杆693并且固定所述构造。
Claims (9)
1.一种用于进入椎间盘的进入装置,包括:
a) 外部护罩,所述外部护罩具有基本上管状部分、适于从切口延伸到关节突的长度、近侧端部部分、远侧端部部分、外表面和限定内表面的纵向通孔,
b) 内部护罩,所述内部护罩具有限定纵向凸缘的远侧端部和限定柄部的近侧端部,
其中所述进入装置包括相机,
其中所述进入装置连接到连接器的第一臂并且所述连接器经由所述连接器的第二臂连接到骨锚固件,使得所述进入装置和所述相机由所述骨锚固件稳定,并且
其中所述内部护罩构造成基本上嵌套在所述外部护罩的所述内表面内,以使得所述凸缘朝远侧延伸经过所述外部护罩的所述远侧端部部分。
2.根据权利要求1所述的装置,其中,所述凸缘具有弓形横截面。
3.根据权利要求2所述的装置,其中,所述凸缘的所述弓形横截面限定所述凸缘的外表面,所述外表面具有的曲率基本上类似于所述外部护罩的所述内表面的曲率。
4.根据权利要求1所述的装置,其中,所述外部护罩的所述外表面还包括适于连接到导航器械的第一端口。
5.根据权利要求4所述的装置,还包括:
-所述导航器械,其中,所述第一端口连接到所述导航器械。
6.根据权利要求1所述的装置,其中,所述内部护罩包括弹簧,以允许将所述内部护罩在中心插入到所述外部护罩中。
7.根据权利要求6所述的装置,其中,所述弹簧构造成在将所述内部护罩插入到所述外部护罩中之后将所述内部护罩推靠在所述外部护罩的所述内表面上,以利用所述纵向凸缘来使软组织回缩。
8.根据权利要求1所述的装置,其中,所述外部护罩包括用于多轴向联接至所述外部护罩的连接器接口。
9.根据权利要求1所述的装置,其中,所述外部护罩包括外壳,所述外壳容纳具有视频芯片的所述相机。
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201562214297P | 2015-09-04 | 2015-09-04 | |
US15/437792 | 2017-02-21 | ||
US15/437,792 US10874425B2 (en) | 2015-09-04 | 2017-02-21 | Multi-shield spinal access system |
US201762468475P | 2017-03-08 | 2017-03-08 | |
PCT/US2018/018905 WO2018156550A1 (en) | 2015-09-04 | 2018-02-21 | Multi-shield spinal access system |
US15/901,435 US11344190B2 (en) | 2015-09-04 | 2018-02-21 | Surgical visualization systems and related methods |
Publications (2)
Publication Number | Publication Date |
---|---|
CN110325092A CN110325092A (zh) | 2019-10-11 |
CN110325092B true CN110325092B (zh) | 2022-06-07 |
Family
ID=68172031
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201680051245.4A Pending CN108135440A (zh) | 2015-09-04 | 2016-09-02 | 多护罩脊柱进入系统 |
CN201880013056.7A Active CN110325092B (zh) | 2015-09-04 | 2018-02-21 | 多护罩脊柱进入系统 |
CN201880058099.7A Pending CN111278365A (zh) | 2015-09-04 | 2018-08-21 | 多护罩脊柱进入系统 |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201680051245.4A Pending CN108135440A (zh) | 2015-09-04 | 2016-09-02 | 多护罩脊柱进入系统 |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201880058099.7A Pending CN111278365A (zh) | 2015-09-04 | 2018-08-21 | 多护罩脊柱进入系统 |
Country Status (6)
Country | Link |
---|---|
US (15) | US10987129B2 (zh) |
EP (4) | EP3344112B1 (zh) |
JP (1) | JP6816122B2 (zh) |
CN (3) | CN108135440A (zh) |
AU (1) | AU2018225113B2 (zh) |
WO (3) | WO2017040873A1 (zh) |
Families Citing this family (171)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE10154163A1 (de) | 2001-11-03 | 2003-05-22 | Advanced Med Tech | Vorrichtung zum Aufrichten und Stabilisieren der Wirbelsäule |
ATE524121T1 (de) | 2004-11-24 | 2011-09-15 | Abdou Samy | Vorrichtungen zur platzierung eines orthopädischen intervertebralen implantats |
US8979931B2 (en) | 2006-12-08 | 2015-03-17 | DePuy Synthes Products, LLC | Nucleus replacement device and method |
JP5250632B2 (ja) | 2007-10-05 | 2013-07-31 | ジンテス ゲゼルシャフト ミット ベシュレンクテル ハフツング | 拡張システム |
US8764806B2 (en) * | 2009-12-07 | 2014-07-01 | Samy Abdou | Devices and methods for minimally invasive spinal stabilization and instrumentation |
US9913577B2 (en) | 2010-09-28 | 2018-03-13 | Obp Medical Corporation | Speculum |
US8845728B1 (en) | 2011-09-23 | 2014-09-30 | Samy Abdou | Spinal fixation devices and methods of use |
US9622779B2 (en) | 2011-10-27 | 2017-04-18 | DePuy Synthes Products, Inc. | Method and devices for a sub-splenius / supra-levator scapulae surgical access technique |
WO2013067179A2 (en) | 2011-11-01 | 2013-05-10 | Synthes Usa, Llc | Dilation system |
US20130226240A1 (en) | 2012-02-22 | 2013-08-29 | Samy Abdou | Spinous process fixation devices and methods of use |
US9265490B2 (en) | 2012-04-16 | 2016-02-23 | DePuy Synthes Products, Inc. | Detachable dilator blade |
US9198767B2 (en) | 2012-08-28 | 2015-12-01 | Samy Abdou | Devices and methods for spinal stabilization and instrumentation |
US9480855B2 (en) | 2012-09-26 | 2016-11-01 | DePuy Synthes Products, Inc. | NIR/red light for lateral neuroprotection |
US9320617B2 (en) | 2012-10-22 | 2016-04-26 | Cogent Spine, LLC | Devices and methods for spinal stabilization and instrumentation |
FR3005569B1 (fr) | 2013-05-16 | 2021-09-03 | Ldr Medical | Implant vertebral, dispositif de fixation vertebrale d'implant et instrumentation d'implantation |
US11253246B2 (en) * | 2018-06-21 | 2022-02-22 | Mako Surgical Corp. | Electronic force measuring joint distraction lever and method of use thereof |
US10918368B2 (en) | 2014-05-28 | 2021-02-16 | Mako Surgical Corp. | Force measuring joint distraction lever |
US9980737B2 (en) | 2014-08-04 | 2018-05-29 | Medos International Sarl | Flexible transport auger |
US10111712B2 (en) | 2014-09-09 | 2018-10-30 | Medos International Sarl | Proximal-end securement of a minimally invasive working channel |
US9924979B2 (en) | 2014-09-09 | 2018-03-27 | Medos International Sarl | Proximal-end securement of a minimally invasive working channel |
US10264959B2 (en) | 2014-09-09 | 2019-04-23 | Medos International Sarl | Proximal-end securement of a minimally invasive working channel |
US10420538B2 (en) | 2015-02-05 | 2019-09-24 | Obp Medical Corporation | Illuminated surgical retractor |
US9867602B2 (en) | 2015-02-05 | 2018-01-16 | Obp Medical Corporation | Illuminated surgical retractor |
US10786264B2 (en) | 2015-03-31 | 2020-09-29 | Medos International Sarl | Percutaneous disc clearing device |
US10881387B2 (en) | 2015-06-03 | 2021-01-05 | Obp Medical Corporation | Retractor |
DK3302292T3 (da) | 2015-06-03 | 2024-01-02 | Obp Surgical Corp | Retraktor |
US10939899B2 (en) | 2015-06-03 | 2021-03-09 | Obp Medical Corporation | End cap assembly for retractor and other medical devices |
EP3307186B1 (en) | 2015-06-11 | 2024-04-03 | Howmedica Osteonics Corp. | Spine-anchored targeting systems and methods for posterior spinal surgery |
US11439380B2 (en) | 2015-09-04 | 2022-09-13 | Medos International Sarl | Surgical instrument connectors and related methods |
US11672562B2 (en) | 2015-09-04 | 2023-06-13 | Medos International Sarl | Multi-shield spinal access system |
US11744447B2 (en) | 2015-09-04 | 2023-09-05 | Medos International | Surgical visualization systems and related methods |
US10987129B2 (en) | 2015-09-04 | 2021-04-27 | Medos International Sarl | Multi-shield spinal access system |
CN113143355A (zh) | 2015-09-04 | 2021-07-23 | 美多斯国际有限公司 | 多护罩脊柱进入系统 |
US10857003B1 (en) | 2015-10-14 | 2020-12-08 | Samy Abdou | Devices and methods for vertebral stabilization |
US11141221B2 (en) * | 2015-11-19 | 2021-10-12 | Eos Imaging | Method of preoperative planning to correct spine misalignment of a patient |
US10299838B2 (en) | 2016-02-05 | 2019-05-28 | Medos International Sarl | Method and instruments for interbody fusion and posterior fixation through a single incision |
US10349823B2 (en) | 2016-03-11 | 2019-07-16 | Colorado Voice Clinic, P.C. | Retractor and tip extender therefor |
WO2017200555A1 (en) * | 2016-05-20 | 2017-11-23 | Choicespine, Lp | Access instruments to extend a surgical working channel |
US11413064B2 (en) * | 2016-07-01 | 2022-08-16 | Intuitive Surgical Operations, Inc. | Computer-assisted tele-operated surgery systems and methods |
US10722621B2 (en) | 2016-07-11 | 2020-07-28 | Obp Medical Corporation | Illuminated suction device |
GB2556616B (en) * | 2016-07-21 | 2019-09-25 | Cipher Surgical Ltd | Scope assembly |
US10744000B1 (en) | 2016-10-25 | 2020-08-18 | Samy Abdou | Devices and methods for vertebral bone realignment |
US10973648B1 (en) | 2016-10-25 | 2021-04-13 | Samy Abdou | Devices and methods for vertebral bone realignment |
WO2018165367A1 (en) * | 2017-03-08 | 2018-09-13 | Medos International Sàrl | Devices and methods for providing surgical access |
WO2018165365A2 (en) * | 2017-03-08 | 2018-09-13 | Medos International Sàrl | Surgical visualization systems and related methods |
WO2018162647A1 (en) | 2017-03-08 | 2018-09-13 | Medos International Sarl | Surgical access port stabilization |
USD866759S1 (en) | 2017-03-13 | 2019-11-12 | Colorado Voice Clinic, P.C. | Retractor |
DE102017106714A1 (de) * | 2017-03-29 | 2018-10-04 | Karl Storz Se & Co. Kg | Beobachtungsinstrument mit optischer Anordnung |
US10449006B2 (en) * | 2017-04-05 | 2019-10-22 | Warsaw Orthopedic, Inc. | Surgical instrument and method |
US20220184358A1 (en) * | 2017-04-20 | 2022-06-16 | Resnent, Llc | Endoscopic balloon dilator systems |
US10334687B2 (en) * | 2017-04-20 | 2019-06-25 | Ngok Wing Jimmy Kwok | Multispectral switch fiber optic lighting laryngoscope |
US20180333061A1 (en) * | 2017-05-18 | 2018-11-22 | DePuy Synthes Products, Inc. | Neural monitoring devices and methods |
US11076745B2 (en) * | 2017-05-26 | 2021-08-03 | Covidien Lp | Bronchoscopy coupling devices |
USD839816S1 (en) * | 2017-07-17 | 2019-02-05 | Brunswick Corporation | Dipstick |
US10687793B2 (en) | 2017-07-18 | 2020-06-23 | Obp Medical Corporation | Minimally invasive no touch (MINT) procedure for harvesting the great saphenous vein (GSV) and venous hydrodissector and retractor for use during the MINT procedure |
US10849654B2 (en) | 2017-08-23 | 2020-12-01 | Memic Innovative Surgery Ltd. | Tools and methods for vaginal access |
AU2018329438A1 (en) * | 2017-09-07 | 2023-02-02 | Medos International Sarl | Multi-shield spinal access system |
US10278572B1 (en) | 2017-10-19 | 2019-05-07 | Obp Medical Corporation | Speculum |
CN107874735B (zh) * | 2017-10-25 | 2018-10-19 | 珠海康弘发展有限公司 | 一种适用于镜下融合器的大通道经皮脊柱内窥镜 |
EP3731727A4 (en) | 2017-12-27 | 2021-10-20 | Ethicon LLC | FLUORESCENCE IMAGING IN AN INSUFFICIENTLY LIGHTED ENVIRONMENT |
US11076920B2 (en) | 2018-01-16 | 2021-08-03 | Microendoscopic Spine Institute, LLC | Instrumentation and surgical method for image-guided microendoscopic decompression |
US10646212B2 (en) * | 2018-01-30 | 2020-05-12 | Rebound Therapeutics Corporation | Devices and method for access and visualization for lumbar interbody fusion (LIF) |
US10799229B2 (en) | 2018-02-20 | 2020-10-13 | Obp Medical Corporation | Illuminated medical devices |
WO2019164795A1 (en) | 2018-02-20 | 2019-08-29 | Obp Medical Corporation | Illuminated medical devices |
EP3755198A4 (en) * | 2018-02-21 | 2021-10-27 | Medos International Sàrl | SURGICAL VISUALIZATION SYSTEMS AND RELATED PROCEDURES |
US11141816B2 (en) * | 2018-05-17 | 2021-10-12 | Raytheon Technologies Corporation | Nozzle cover |
WO2020003573A1 (ja) * | 2018-06-28 | 2020-01-02 | 株式会社村田製作所 | 振動装置及び光学検出装置 |
US11559298B2 (en) | 2018-07-16 | 2023-01-24 | Cilag Gmbh International | Surgical visualization of multiple targets |
CN114126473A (zh) * | 2018-08-27 | 2022-03-01 | 梅迪特瑞纳公司 | 内窥镜及其使用方法 |
CN109171888B (zh) * | 2018-08-30 | 2019-05-21 | 重庆市肿瘤研究所 | 一种用于肝胆外科的可视超声刀以及远程超声手术系统 |
US11179248B2 (en) | 2018-10-02 | 2021-11-23 | Samy Abdou | Devices and methods for spinal implantation |
US10646104B1 (en) | 2018-10-29 | 2020-05-12 | G.I. View Ltd. | Disposable endoscope |
CA3120320C (en) * | 2018-11-29 | 2022-12-06 | Board Of Regents, The University Of Texas System | Devices, systems and methods for cleaning of elongated instrument surface |
WO2020123911A1 (en) * | 2018-12-13 | 2020-06-18 | Vantari Medical Llc | Navigational device to guide placment of spinal screws |
US11358184B2 (en) * | 2019-01-18 | 2022-06-14 | Johnson Controls Tyco IP Holdings LLP | Sensor system having transparent window contaminant removal using vibration |
WO2020154596A1 (en) * | 2019-01-24 | 2020-07-30 | Noah Medical Corporation | Single use devices with integrated vision capabilities |
USD911521S1 (en) | 2019-02-19 | 2021-02-23 | Obp Medical Corporation | Handle for medical devices including surgical retractors |
US11013530B2 (en) | 2019-03-08 | 2021-05-25 | Medos International Sarl | Surface features for device retention |
EP4360583A2 (en) * | 2019-03-13 | 2024-05-01 | Medos International Sàrl | Spinal access system |
US11241252B2 (en) | 2019-03-22 | 2022-02-08 | Medos International Sarl | Skin foundation access portal |
US11129727B2 (en) | 2019-03-29 | 2021-09-28 | Medos International Sari | Inflatable non-distracting intervertebral implants and related methods |
US11813026B2 (en) | 2019-04-05 | 2023-11-14 | Medos International Sarl | Systems, devices, and methods for providing surgical trajectory guidance |
USD904607S1 (en) | 2019-05-07 | 2020-12-08 | Obp Medical Corporation | Nasal retractor |
US11278358B2 (en) * | 2019-05-14 | 2022-03-22 | Medos International Sarl | Assembly for coupling a patient reference array to a medical implant such as a pedicle screw |
US10806539B1 (en) | 2019-05-15 | 2020-10-20 | Medos International Sarl | Adjustable patient reference array |
WO2020243270A1 (en) * | 2019-05-29 | 2020-12-03 | Stryker Corporation | Systems and methods for intraoperative surgical scope cleaning |
US11298242B2 (en) | 2019-06-14 | 2022-04-12 | Medos International Sarl | Biomaterial delivery device, and related systems and methods |
US11550057B2 (en) | 2019-06-20 | 2023-01-10 | Cilag Gmbh International | Offset illumination of a scene using multiple emitters in a fluorescence imaging system |
US11122967B2 (en) | 2019-06-20 | 2021-09-21 | Cilag Gmbh International | Driving light emissions according to a jitter specification in a fluorescence imaging system |
US11280737B2 (en) | 2019-06-20 | 2022-03-22 | Cilag Gmbh International | Super resolution and color motion artifact correction in a pulsed fluorescence imaging system |
US11674848B2 (en) | 2019-06-20 | 2023-06-13 | Cilag Gmbh International | Wide dynamic range using a monochrome image sensor for hyperspectral imaging |
US10841504B1 (en) | 2019-06-20 | 2020-11-17 | Ethicon Llc | Fluorescence imaging with minimal area monolithic image sensor |
US11624830B2 (en) | 2019-06-20 | 2023-04-11 | Cilag Gmbh International | Wide dynamic range using a monochrome image sensor for laser mapping imaging |
US11903563B2 (en) | 2019-06-20 | 2024-02-20 | Cilag Gmbh International | Offset illumination of a scene using multiple emitters in a fluorescence imaging system |
US11931009B2 (en) | 2019-06-20 | 2024-03-19 | Cilag Gmbh International | Offset illumination of a scene using multiple emitters in a hyperspectral imaging system |
US11700995B2 (en) | 2019-06-20 | 2023-07-18 | Cilag Gmbh International | Speckle removal in a pulsed fluorescence imaging system |
US11898909B2 (en) | 2019-06-20 | 2024-02-13 | Cilag Gmbh International | Noise aware edge enhancement in a pulsed fluorescence imaging system |
US12013496B2 (en) | 2019-06-20 | 2024-06-18 | Cilag Gmbh International | Noise aware edge enhancement in a pulsed laser mapping imaging system |
US11925328B2 (en) | 2019-06-20 | 2024-03-12 | Cilag Gmbh International | Noise aware edge enhancement in a pulsed hyperspectral imaging system |
US11237270B2 (en) | 2019-06-20 | 2022-02-01 | Cilag Gmbh International | Hyperspectral, fluorescence, and laser mapping imaging with fixed pattern noise cancellation |
US11788963B2 (en) | 2019-06-20 | 2023-10-17 | Cilag Gmbh International | Minimizing image sensor input/output in a pulsed fluorescence imaging system |
US11612309B2 (en) | 2019-06-20 | 2023-03-28 | Cilag Gmbh International | Hyperspectral videostroboscopy of vocal cords |
US11758256B2 (en) | 2019-06-20 | 2023-09-12 | Cilag Gmbh International | Fluorescence imaging in a light deficient environment |
US11187658B2 (en) | 2019-06-20 | 2021-11-30 | Cilag Gmbh International | Fluorescence imaging with fixed pattern noise cancellation |
US11531112B2 (en) | 2019-06-20 | 2022-12-20 | Cilag Gmbh International | Offset illumination of a scene using multiple emitters in a hyperspectral, fluorescence, and laser mapping imaging system |
US11633089B2 (en) | 2019-06-20 | 2023-04-25 | Cilag Gmbh International | Fluorescence imaging with minimal area monolithic image sensor |
US11671691B2 (en) | 2019-06-20 | 2023-06-06 | Cilag Gmbh International | Image rotation in an endoscopic laser mapping imaging system |
US11716543B2 (en) | 2019-06-20 | 2023-08-01 | Cilag Gmbh International | Wide dynamic range using a monochrome image sensor for fluorescence imaging |
US11147436B2 (en) | 2019-06-20 | 2021-10-19 | Cilag Gmbh International | Image rotation in an endoscopic fluorescence imaging system |
US11793399B2 (en) | 2019-06-20 | 2023-10-24 | Cilag Gmbh International | Super resolution and color motion artifact correction in a pulsed hyperspectral imaging system |
US11622094B2 (en) | 2019-06-20 | 2023-04-04 | Cilag Gmbh International | Wide dynamic range using a monochrome image sensor for fluorescence imaging |
US11540696B2 (en) | 2019-06-20 | 2023-01-03 | Cilag Gmbh International | Noise aware edge enhancement in a pulsed fluorescence imaging system |
US11337596B2 (en) | 2019-06-20 | 2022-05-24 | Cilag Gmbh International | Controlling integral energy of a laser pulse in a fluorescence imaging system |
US11516388B2 (en) | 2019-06-20 | 2022-11-29 | Cilag Gmbh International | Pulsed illumination in a fluorescence imaging system |
US11464653B2 (en) * | 2019-06-30 | 2022-10-11 | Innovasis, Inc. | Minimally invasive surgery (MIS) methods and devices |
US11065033B2 (en) * | 2019-07-02 | 2021-07-20 | Musc Foundation For Research Development | Minimally invasive subdural evacuating system |
US11464648B2 (en) * | 2019-09-09 | 2022-10-11 | Amplify Surgical, Inc. | Multi-portal surgical systems |
US11678906B2 (en) * | 2019-09-09 | 2023-06-20 | Amplify Surgical, Inc. | Multi-portal surgical systems, cannulas, and related technologies |
AU2020381246A1 (en) * | 2019-11-04 | 2022-06-09 | Gulf Medical Technologies | Cleaning device for surgical tool |
US11944356B2 (en) * | 2019-11-22 | 2024-04-02 | Medos International Sarl | Control member for adjusting access tube position, and related systems and methods |
US11759193B2 (en) | 2019-12-20 | 2023-09-19 | Medos International Sarl | Retractor members, and related systems and methods |
US11819242B2 (en) | 2019-12-29 | 2023-11-21 | Biosense Webster (Israel) Ltd. | Navigated trocar with internal camera |
US20210196319A1 (en) * | 2019-12-29 | 2021-07-01 | Biosense Webster (Israel) Ltd | Trocar with internal camera providing tilted view angle |
US11744667B2 (en) * | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Adaptive visualization by a surgical system |
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 |
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 |
US11832996B2 (en) | 2019-12-30 | 2023-12-05 | Cilag Gmbh International | Analyzing surgical trends by a surgical system |
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 |
US11219501B2 (en) | 2019-12-30 | 2022-01-11 | Cilag Gmbh International | Visualization systems using structured light |
US11896442B2 (en) | 2019-12-30 | 2024-02-13 | Cilag Gmbh International | Surgical systems for proposing and corroborating organ portion removals |
US11284963B2 (en) | 2019-12-30 | 2022-03-29 | Cilag Gmbh International | Method of using imaging devices in surgery |
US12002571B2 (en) | 2019-12-30 | 2024-06-04 | Cilag Gmbh International | Dynamic surgical visualization systems |
US11013399B1 (en) * | 2020-01-27 | 2021-05-25 | Board Of Regents, The University Of Texas System | Wiper assembly for imaging element cleaning apparatus |
BR212022007502U2 (pt) * | 2020-01-30 | 2022-08-23 | Renato De Abreu Igor | Disposição construtiva aplicada em endoscópio rígido para limpeza da lente objetiva durante o procedimento vídeo-cirúrgico |
US10959609B1 (en) | 2020-01-31 | 2021-03-30 | Obp Medical Corporation | Illuminated suction device |
US10966702B1 (en) | 2020-02-25 | 2021-04-06 | Obp Medical Corporation | Illuminated dual-blade retractor |
USD944986S1 (en) * | 2020-03-25 | 2022-03-01 | Seffiline S.R.L. | Surgical guide |
US20210369098A1 (en) * | 2020-05-26 | 2021-12-02 | Covidien Lp | Endoscope including a cleaning assembly |
CN111920488B (zh) * | 2020-08-06 | 2022-03-25 | 江苏新智源医学科技有限公司 | 一种可适应不同病患的卡扣式可伸缩穿刺管组件 |
CN111920491B (zh) * | 2020-08-06 | 2022-04-29 | 重庆橙壹科技有限公司 | 一种医用套管组件及其长度调节方法 |
CN111920484B (zh) * | 2020-08-06 | 2021-12-14 | 张波 | 一种可适应不同病患的穿刺器 |
CN113331928A (zh) * | 2020-08-17 | 2021-09-03 | 重庆橙壹科技有限公司 | 一种用于微创手术包含自适应锁扣的套管组件 |
CN111938780B (zh) * | 2020-08-17 | 2021-10-08 | 山东南道北数字科技有限公司 | 一种用于外科手术包含径向卡块的细长管组件 |
CN111920492B (zh) * | 2020-08-17 | 2022-09-13 | 重庆橙壹科技有限公司 | 一种用于硬管腔镜手术包含三层管的细长管组件 |
CN111938770B (zh) * | 2020-08-17 | 2022-06-14 | 辐瑞森生物科技(昆山)有限公司 | 一种用于硬管腔镜手术包含弹性夹头的细长管组件 |
CN111887955B (zh) * | 2020-08-17 | 2022-04-26 | 常州市康心医疗器械有限公司 | 一种用于微创手术包含杠杆锁的细长管组件 |
US11998403B2 (en) | 2020-08-17 | 2024-06-04 | Covidien Lp | Endoscope cleaning device |
US20220079618A1 (en) * | 2020-09-15 | 2022-03-17 | Covidien Lp | Trocar stabilization clamp |
US20220133293A1 (en) * | 2020-10-30 | 2022-05-05 | Baxter International Inc. | Organ retractor |
US20220183722A1 (en) * | 2020-12-10 | 2022-06-16 | Sanjay Amarasinghe | Pedicle tract stabilization system |
US11389204B2 (en) * | 2020-12-17 | 2022-07-19 | Institute For Spine & Scoliosis, P.A. | Method for improved spinal correction surgery implementing non-fusion anterior scoliosis correction techniques for release of discs |
CN112754653B (zh) * | 2021-01-15 | 2022-05-24 | 江苏省人民医院 | 一种腹腔镜微波针 |
US11806054B2 (en) | 2021-02-23 | 2023-11-07 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant, system and methods |
US11771517B2 (en) | 2021-03-12 | 2023-10-03 | Medos International Sarl | Camera position indication systems and methods |
US20220211263A1 (en) * | 2021-03-23 | 2022-07-07 | Axcess Instruments Inc. | Multi-piece access port imaging systems |
US11844583B2 (en) | 2021-03-31 | 2023-12-19 | Moon Surgical Sas | Co-manipulation surgical system having an instrument centering mode for automatic scope movements |
US11832909B2 (en) | 2021-03-31 | 2023-12-05 | Moon Surgical Sas | Co-manipulation surgical system having actuatable setup joints |
CA3212211A1 (en) | 2021-03-31 | 2022-10-06 | David Paul Noonan | Co-manipulation surgical system for use with surgical instruments for performing laparoscopic surgery |
US11812938B2 (en) | 2021-03-31 | 2023-11-14 | Moon Surgical Sas | Co-manipulation surgical system having a coupling mechanism removeably attachable to surgical instruments |
US11819302B2 (en) | 2021-03-31 | 2023-11-21 | Moon Surgical Sas | Co-manipulation surgical system having user guided stage control |
CN113456251A (zh) * | 2021-06-30 | 2021-10-01 | 南京希麦迪医药科技有限公司 | 基于贝叶斯模型的肿瘤统计分析方法及系统 |
US20230128242A1 (en) * | 2021-10-26 | 2023-04-27 | Medos International Sarl | Flexible surgical access port |
WO2023118984A1 (en) * | 2021-12-20 | 2023-06-29 | Lem Surgical Ag | Synchronized robotic bone milling |
US20230200864A1 (en) * | 2021-12-28 | 2023-06-29 | Nuvasive, Inc. | Adapter for patient reference array and bone anchor assembly |
US20230218284A1 (en) * | 2022-01-11 | 2023-07-13 | Ryan Park | Inflatable balloon retractor with pressure sensing and feedback capabilities for avoidance of excess applied pressure in brain surgery |
US20240065533A1 (en) * | 2022-08-30 | 2024-02-29 | Integrated Endoscopy, Inc. | Endoscope with interchangeable cannula adapter |
US11931011B1 (en) | 2022-09-25 | 2024-03-19 | Robert Michael Evans | Telescope maintenance devices and assemblies |
JP2024079660A (ja) * | 2022-11-30 | 2024-06-11 | ニューヴェイジヴ,インコーポレイテッド | 外科用開創器システム及び構成要素 |
US11950770B1 (en) | 2022-12-01 | 2024-04-09 | Amplify Surgical, Inc. | Multi-portal split cannulas, endoscopic hemostatic dispensers and surgical tools |
US11986165B1 (en) | 2023-01-09 | 2024-05-21 | Moon Surgical Sas | Co-manipulation surgical system for use with surgical instruments for performing laparoscopic surgery while estimating hold force |
US11839442B1 (en) | 2023-01-09 | 2023-12-12 | Moon Surgical Sas | Co-manipulation surgical system for use with surgical instruments for performing laparoscopic surgery while estimating hold force |
Family Cites Families (475)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4132227A (en) | 1974-08-08 | 1979-01-02 | Winter & Ibe | Urological endoscope particularly resectoscope |
US4318401A (en) | 1980-04-24 | 1982-03-09 | President And Fellows Of Harvard College | Percutaneous vascular access portal and catheter |
US4573448A (en) | 1983-10-05 | 1986-03-04 | Pilling Co. | Method for decompressing herniated intervertebral discs |
US4678459A (en) | 1984-07-23 | 1987-07-07 | E-Z-Em, Inc. | Irrigating, cutting and aspirating system for percutaneous surgery |
US4646738A (en) | 1985-12-05 | 1987-03-03 | Concept, Inc. | Rotary surgical tool |
US4874375A (en) | 1987-04-13 | 1989-10-17 | Ellison Arthur E | Tissue retractor |
US4807593A (en) | 1987-05-08 | 1989-02-28 | Olympus Optical Co. Ltd. | Endoscope guide tube |
US4863430A (en) | 1987-08-26 | 1989-09-05 | Surgical Dynamics, Inc. | Introduction set with flexible trocar with curved cannula |
US5529580A (en) | 1987-10-30 | 1996-06-25 | Olympus Optical Co., Ltd. | Surgical resecting tool |
US4888146A (en) | 1988-05-19 | 1989-12-19 | Dandeneau James V | Method and apparatus of forming extruded article |
US5772661A (en) | 1988-06-13 | 1998-06-30 | Michelson; Gary Karlin | Methods and instrumentation for the surgical correction of human thoracic and lumbar spinal disease from the antero-lateral aspect of the spine |
US5080662A (en) | 1989-11-27 | 1992-01-14 | Paul Kamaljit S | Spinal stereotaxic device and method |
US5269785A (en) | 1990-06-28 | 1993-12-14 | Bonutti Peter M | Apparatus and method for tissue removal |
US5207213A (en) | 1991-02-01 | 1993-05-04 | Circon Corporation | Laparoscope having means for removing image impeding material from a distal lens |
US5285795A (en) | 1991-09-12 | 1994-02-15 | Surgical Dynamics, Inc. | Percutaneous discectomy system having a bendable discectomy probe and a steerable cannula |
IT1249714B (it) | 1991-10-11 | 1995-03-09 | Mauro Caponi | Strumento chirurgico a doppia cannula. |
US5195541A (en) | 1991-10-18 | 1993-03-23 | Obenchain Theodore G | Method of performing laparoscopic lumbar discectomy |
US5395317A (en) | 1991-10-30 | 1995-03-07 | Smith & Nephew Dyonics, Inc. | Unilateral biportal percutaneous surgical procedure |
JPH05207962A (ja) | 1992-01-31 | 1993-08-20 | Olympus Optical Co Ltd | 硬性内視鏡 |
JPH0681501A (ja) | 1992-09-03 | 1994-03-22 | Hitachi Zosen Corp | 立体駐車場入出庫管理装置 |
US5447446A (en) | 1992-11-05 | 1995-09-05 | Thomas & Betts Corporation | Electrical connector component having secured seal |
US5735792A (en) | 1992-11-25 | 1998-04-07 | Clarus Medical Systems, Inc. | Surgical instrument including viewing optics and an atraumatic probe |
US5540706A (en) | 1993-01-25 | 1996-07-30 | Aust; Gilbert M. | Surgical instrument |
US5439464A (en) | 1993-03-09 | 1995-08-08 | Shapiro Partners Limited | Method and instruments for performing arthroscopic spinal surgery |
JPH0681501U (ja) | 1993-03-16 | 1994-11-22 | 嗣郎 坂本 | 硬性内視鏡の洗浄具 |
US5387220A (en) | 1993-06-15 | 1995-02-07 | Pisharodi; Maohaven | Stereotactic frame and localization method |
AU7365294A (en) | 1993-07-22 | 1995-02-20 | Xomed, Inc | Disposable endoscope sheath |
US5513827A (en) | 1993-07-26 | 1996-05-07 | Karlin Technology, Inc. | Gooseneck surgical instrument holder |
US5697888A (en) | 1994-04-21 | 1997-12-16 | Olympus Optical Co., Ltd. | Endoscope apparatus having valve device for supplying water and gas |
US6017333A (en) | 1995-04-13 | 2000-01-25 | Bailey; Robert W. | Irrigating laparoscopic cannula |
DE9415039U1 (de) | 1994-09-16 | 1994-11-03 | Kernforschungszentrum Karlsruhe Gmbh, 76133 Karlsruhe | Vorrichtung zur Führung chirurgischer Instrumente |
US5562695A (en) | 1995-01-10 | 1996-10-08 | Obenchain; Theodore G. | Nerve deflecting conduit needle and method |
US5569290A (en) | 1995-01-30 | 1996-10-29 | Paul C. McAfee | Method of and apparatus for laparoscopic or endoscopic spinal surgery using an unsealed anteriorly inserted transparent trochar |
US5615690A (en) | 1995-02-15 | 1997-04-01 | Symbiosis Corporation | Tissue core biopsy cannula |
JP2001509685A (ja) | 1995-03-22 | 2001-07-24 | イー ヴィー アイ コーポレイション | 動脈内障害物切除装置及び方法 |
JPH08278456A (ja) | 1995-04-10 | 1996-10-22 | Toshiba Corp | 内視鏡 |
DE19520277C1 (de) | 1995-06-02 | 1996-11-21 | Winter & Ibe Olympus | Endoskopisches Instrument |
US5618293A (en) | 1995-06-06 | 1997-04-08 | Smith & Nephews Dyonics, Inc. | Surgical instrument |
JPH10505286A (ja) | 1995-06-20 | 1998-05-26 | シン ング、ワン | 医療処置のための関節アーム |
US5591187A (en) | 1995-07-14 | 1997-01-07 | Dekel; Moshe | Laparoscopic tissue retrieval device and method |
US5749602A (en) | 1995-07-31 | 1998-05-12 | Mend Technologies, Inc. | Medical device |
US5733242A (en) | 1996-02-07 | 1998-03-31 | Rayburn; Robert L. | Intubation system having an axially moveable memory cylinder |
EP1466564B1 (en) * | 1996-03-22 | 2010-10-20 | Warsaw Orthopedic, Inc. | Devices for percutaneous surgery related applications |
US6679833B2 (en) | 1996-03-22 | 2004-01-20 | Sdgi Holdings, Inc. | Devices and methods for percutaneous surgery |
US5792044A (en) | 1996-03-22 | 1998-08-11 | Danek Medical, Inc. | Devices and methods for percutaneous surgery |
JP3819962B2 (ja) | 1996-04-01 | 2006-09-13 | ペンタックス株式会社 | 椎体間固定インプラントのガイド装置 |
US5928137A (en) | 1996-05-03 | 1999-07-27 | Green; Philip S. | System and method for endoscopic imaging and endosurgery |
DE69726491T2 (de) | 1996-05-09 | 2004-10-28 | Olympus Optical Co., Ltd. | Knochenchirurgisches Werkzeug zum Halten eines Hohlraums, chirurgisches Werkzeug zum Halten eines Hohlraums, System für die endoskopische Chirurgie mit Verwendung eines Werkzeugs zum Halten eines Hohlraums |
US7104986B2 (en) | 1996-07-16 | 2006-09-12 | Arthrocare Corporation | Intervertebral disc replacement method |
US6322498B1 (en) | 1996-10-04 | 2001-11-27 | University Of Florida | Imaging scope |
US6033105A (en) | 1996-11-15 | 2000-03-07 | Barker; Donald | Integrated bone cement mixing and dispensing system |
US5894369A (en) | 1996-11-15 | 1999-04-13 | Fuji Photo Optical Co., Ltd. | Lens device with anti-fogging |
AU7175398A (en) | 1997-05-02 | 1998-11-27 | Medtronic, Inc. | Adjustable supporting bracket having plural ball and socket joints |
US5976146A (en) | 1997-07-11 | 1999-11-02 | Olympus Optical Co., Ltd. | Surgical operation system and method of securing working space for surgical operation in body |
US6175758B1 (en) | 1997-07-15 | 2001-01-16 | Parviz Kambin | Method for percutaneous arthroscopic disc removal, bone biopsy and fixation of the vertebrae |
NL1006944C2 (nl) | 1997-09-04 | 1999-03-11 | Mark Hans Emanuel | Chirurgische endoscopische snij-inrichting. |
US6139563A (en) | 1997-09-25 | 2000-10-31 | Allegiance Corporation | Surgical device with malleable shaft |
US5803904A (en) | 1997-10-28 | 1998-09-08 | Mehdizadeh; Hamid | Nerve root retractor and disc space separator |
US5976075A (en) | 1997-12-15 | 1999-11-02 | University Of Massachusetts | Endoscope deployment apparatus |
AU2332699A (en) | 1998-01-23 | 1999-08-09 | United States Surgical Corporation | Surgical instrument |
AUPP294698A0 (en) | 1998-04-15 | 1998-05-07 | Gray, Bruce | Removable ball joint |
US6110182A (en) | 1998-06-22 | 2000-08-29 | Ohio Medical Instruments Company, Inc. | Target socket |
US6063021A (en) | 1998-07-31 | 2000-05-16 | Pilling Weck Incorporated | Stabilizer for surgery |
US6053907A (en) | 1998-08-13 | 2000-04-25 | Endius Incorporated | Surgical instruments with flexible drive shaft |
US6296644B1 (en) | 1998-08-26 | 2001-10-02 | Jean Saurat | Spinal instrumentation system with articulated modules |
US6126592A (en) | 1998-09-12 | 2000-10-03 | Smith & Nephew, Inc. | Endoscope cleaning and irrigation sheath |
US6663563B1 (en) * | 1998-10-02 | 2003-12-16 | Minnesota Scientific, Inc. | Fastening system for retractor support |
US6286179B1 (en) | 1998-10-19 | 2001-09-11 | Donny M. Byrne | Apparatus and method for removing debris from the lens-cleaning nozzle of an endoscope |
JP2000126190A (ja) | 1998-10-28 | 2000-05-09 | Suma Hisayoshi | 外科手術用器具の取付支持具 |
US6626830B1 (en) | 1999-05-04 | 2003-09-30 | Cardiothoracic Systems, Inc. | Methods and devices for improved tissue stabilization |
US7637905B2 (en) | 2003-01-15 | 2009-12-29 | Usgi Medical, Inc. | Endoluminal tool deployment system |
US6283966B1 (en) | 1999-07-07 | 2001-09-04 | Sulzer Spine-Tech Inc. | Spinal surgery tools and positioning method |
US6200322B1 (en) | 1999-08-13 | 2001-03-13 | Sdgi Holdings, Inc. | Minimal exposure posterior spinal interbody instrumentation and technique |
US6685724B1 (en) | 1999-08-24 | 2004-02-03 | The Penn State Research Foundation | Laparoscopic surgical instrument and method |
DE29916026U1 (de) | 1999-09-11 | 1999-11-18 | Aesculap Ag & Co Kg | Haltevorrichtung für ein chirurgisches Instrument |
US6575899B1 (en) | 1999-10-20 | 2003-06-10 | Sdgi Holdings, Inc. | Methods and instruments for endoscopic interbody surgical techniques |
US6447446B1 (en) | 1999-11-02 | 2002-09-10 | Medtronic Xomed, Inc. | Method and apparatus for cleaning an endoscope lens |
US6354992B1 (en) | 1999-11-08 | 2002-03-12 | Daniel T. Kato | Automated laparoscopic lens cleaner |
US6648915B2 (en) | 1999-12-23 | 2003-11-18 | John A. Sazy | Intervertebral cage and method of use |
US6684886B1 (en) | 2000-01-21 | 2004-02-03 | Prospine, Inc. | Intervertebral disc repair methods and apparatus |
NL1014255C2 (nl) | 2000-02-01 | 2001-08-02 | Univ Medisch Centrum Utrecht | Steunarm voor operatiedoeleinden. |
US6808505B2 (en) | 2000-02-01 | 2004-10-26 | Kadan Jeffrey S | Diagnostic needle arthroscopy and lavage system |
US20030191474A1 (en) | 2000-02-16 | 2003-10-09 | Cragg Andrew H. | Apparatus for performing a discectomy through a trans-sacral axial bore within the vertebrae of the spine |
US6575979B1 (en) | 2000-02-16 | 2003-06-10 | Axiamed, Inc. | Method and apparatus for providing posterior or anterior trans-sacral access to spinal vertebrae |
AU2001238377A1 (en) | 2000-02-18 | 2001-08-27 | University Of Massachussets | Devices and methods for warming and cleaning lenses of optical surgical instruments |
US6383191B1 (en) | 2000-03-15 | 2002-05-07 | Sdgi Holdings, Inc. | Laparoscopic instrument sleeve |
DE10019321C2 (de) | 2000-04-19 | 2002-03-14 | Storz Karl Gmbh & Co Kg | Flexible Spannvorrichtung ,insbesondere für medizinische Zwecke |
US6357710B1 (en) | 2000-04-25 | 2002-03-19 | Steven S. Fielden | Item holding device |
DE10024728A1 (de) | 2000-05-19 | 2001-11-22 | Ami Gmbh | Optikreinigungsvorrichtung für ein Endoskopiegerät |
AU2001270180A1 (en) | 2000-06-30 | 2002-01-14 | Abbott Laboratories | Surgical support clamp |
US6579281B2 (en) | 2000-10-11 | 2003-06-17 | Popcab, Llc | Instrument stabilizer for through-a-port surgery |
US6558407B1 (en) | 2000-10-24 | 2003-05-06 | Tyco Healthcare Group Lp | Breast stabilizer with instrument guide |
US6676597B2 (en) | 2001-01-13 | 2004-01-13 | Medtronic, Inc. | Method and device for organ positioning |
US6673023B2 (en) | 2001-03-23 | 2004-01-06 | Stryker Puerto Rico Limited | Micro-invasive breast biopsy device |
US6544274B2 (en) | 2001-05-02 | 2003-04-08 | Novare Surgical Systems, Inc. | Clamp having bendable shaft |
US7144393B2 (en) | 2001-05-15 | 2006-12-05 | Dipoto Gene P | Structure for receiving surgical instruments |
IL143682A0 (en) | 2001-06-11 | 2002-04-21 | Shalman Michael | Endoscope with cleaning optics |
US7137949B2 (en) | 2001-07-13 | 2006-11-21 | United States Surgical Corporation | Surgical instrument |
US6887198B2 (en) | 2001-10-05 | 2005-05-03 | Burns P. Phillips | Gooseneck surgical retractor positioner and method of its use |
US20030083555A1 (en) | 2001-10-29 | 2003-05-01 | Scott Hunt | Segmented arm support system and method for stabilizing tissue |
US7824410B2 (en) | 2001-10-30 | 2010-11-02 | Depuy Spine, Inc. | Instruments and methods for minimally invasive spine surgery |
US7008431B2 (en) | 2001-10-30 | 2006-03-07 | Depuy Spine, Inc. | Configured and sized cannula |
US7001342B2 (en) | 2001-10-30 | 2006-02-21 | Movdice Holding, Inc. | Biopsy/access tool with integrated biopsy device and access cannula and use thereof |
US7182731B2 (en) | 2002-01-23 | 2007-02-27 | Genesee Biomedical, Inc. | Support arm for cardiac surgery |
US6520495B1 (en) | 2002-01-24 | 2003-02-18 | Christopher La Mendola | Clamping device with flexible arm |
US6896675B2 (en) | 2002-03-05 | 2005-05-24 | Baylis Medical Company Inc. | Intradiscal lesioning device |
US7261688B2 (en) | 2002-04-05 | 2007-08-28 | Warsaw Orthopedic, Inc. | Devices and methods for percutaneous tissue retraction and surgery |
US6758809B2 (en) | 2002-06-06 | 2004-07-06 | Medtronic, Inc. | Surgical tool for engagement of body tissue |
US7074226B2 (en) | 2002-09-19 | 2006-07-11 | Sdgi Holdings, Inc. | Oval dilator and retractor set and method |
US20050080435A1 (en) | 2002-09-20 | 2005-04-14 | Kevin Smith | Tissue retractor and method for using the retractor |
US7837687B2 (en) | 2002-09-27 | 2010-11-23 | Surgitech, Llc | Surgical assembly for tissue removal |
US8808284B2 (en) | 2008-09-26 | 2014-08-19 | Relievant Medsystems, Inc. | Systems for navigating an instrument through bone |
ES2236422T3 (es) | 2002-10-25 | 2005-07-16 | Brainlab Ag | Aparato y procedimiento para calibrar un elemento. |
WO2004039235A2 (en) | 2002-10-25 | 2004-05-13 | Endius Incorporated | Apparatus and methods for shielding body structures during surgery |
US6951562B2 (en) | 2002-11-13 | 2005-10-04 | Ralph Fritz Zwirnmann | Adjustable length tap and method for drilling and tapping a bore in bone |
US8090542B2 (en) | 2002-11-14 | 2012-01-03 | Dharmacon Inc. | Functional and hyperfunctional siRNA |
US7636596B2 (en) | 2002-12-20 | 2009-12-22 | Medtronic, Inc. | Organ access device and method |
US7004971B2 (en) | 2002-12-31 | 2006-02-28 | Depuy Acromed, Inc. | Annular nucleus pulposus replacement |
US20040158286A1 (en) | 2003-02-12 | 2004-08-12 | Daniel Roux | Hemostatic tissue clamp |
US7641659B2 (en) | 2003-03-13 | 2010-01-05 | Zimmer Spine, Inc. | Spinal access instrument |
US20040199052A1 (en) | 2003-04-01 | 2004-10-07 | Scimed Life Systems, Inc. | Endoscopic imaging system |
CA2522865C (en) | 2003-04-22 | 2015-11-24 | Jorge A. Campos | System, apparatus, and method for viewing a visually obscured portion of a cavity |
US7794456B2 (en) | 2003-05-13 | 2010-09-14 | Arthrocare Corporation | Systems and methods for electrosurgical intervertebral disc replacement |
JP2007511247A (ja) | 2003-05-19 | 2007-05-10 | ユーエスジーアイ メディカル, インコーポレイテッド | 管腔ツール展開システム |
DE20309079U1 (de) | 2003-06-12 | 2003-08-21 | Aesculap Ag & Co Kg | Saug-Spül-Trokar für chirurgische Zwecke |
CN2659368Y (zh) | 2003-07-03 | 2004-12-01 | 王海泉 | 内窥镜激光椎间盘治疗仪 |
US20100081875A1 (en) | 2003-07-15 | 2010-04-01 | EndoRobotics Inc. | Surgical Device For Minimal Access Surgery |
US20050021040A1 (en) | 2003-07-21 | 2005-01-27 | Rudolf Bertagnoli | Vertebral retainer-distracter and method of using same |
WO2005011476A2 (en) | 2003-07-29 | 2005-02-10 | Endoscopic Technologies, Inc. | Tissue positioner |
US7771384B2 (en) | 2003-08-20 | 2010-08-10 | Biagio Ravo | Trocar with integral irrigation and suction tube |
US7811303B2 (en) | 2003-08-26 | 2010-10-12 | Medicine Lodge Inc | Bodily tissue dilation systems and methods |
US7226451B2 (en) | 2003-08-26 | 2007-06-05 | Shluzas Alan E | Minimally invasive access device and method |
US7905840B2 (en) | 2003-10-17 | 2011-03-15 | Nuvasive, Inc. | Surgical access system and related methods |
US7655012B2 (en) | 2003-10-02 | 2010-02-02 | Zimmer Spine, Inc. | Methods and apparatuses for minimally invasive replacement of intervertebral discs |
EP1523932B1 (de) | 2003-10-17 | 2006-05-03 | Henke-Sass, Wolf GmbH | Endoskop |
US7338495B2 (en) | 2003-10-22 | 2008-03-04 | Medtronic Xomed, Inc. | Angled tissue cutting instruments having flexible inner tubular members of tube and sleeve construction |
US7946981B1 (en) | 2003-10-23 | 2011-05-24 | Anthony Cubb | Two-piece video laryngoscope |
US7766313B2 (en) | 2003-11-12 | 2010-08-03 | Amarillo Hardware Company | Spring clamp system |
US7226413B2 (en) | 2003-11-17 | 2007-06-05 | Aeolin Llc | Nerve root retractor and sucker |
US7179261B2 (en) | 2003-12-16 | 2007-02-20 | Depuy Spine, Inc. | Percutaneous access devices and bone anchor assemblies |
US7527638B2 (en) | 2003-12-16 | 2009-05-05 | Depuy Spine, Inc. | Methods and devices for minimally invasive spinal fixation element placement |
CN1913834B (zh) | 2003-12-18 | 2010-12-01 | 德普伊斯派尔公司 | 手术牵开器系统 |
US20050137461A1 (en) | 2003-12-18 | 2005-06-23 | Depuy Spine, Inc. | Telescoping blade assembly and instruments for adjusting an adjustable blade |
WO2005076868A2 (en) | 2004-02-06 | 2005-08-25 | Depuy Spine, Inc. | Devices and methods for inserting a spinal fixation element |
JP2007522881A (ja) | 2004-02-19 | 2007-08-16 | アプライド メディカル リソーシーズ コーポレイション | 塞栓除去捕獲シース |
US8784421B2 (en) | 2004-03-03 | 2014-07-22 | Boston Scientific Scimed, Inc. | Apparatus and methods for removing vertebral bone and disc tissue |
US20060041270A1 (en) | 2004-05-07 | 2006-02-23 | Jay Lenker | Medical access sheath |
US7434325B2 (en) | 2004-07-26 | 2008-10-14 | Warsaw Orthopedic, Inc. | Systems and methods for determining optimal retractor length in minimally invasive procedures |
US7811228B2 (en) | 2004-07-26 | 2010-10-12 | Medtronic Xomed, Inc. | Disposable endoscope sheath having adjustable length |
US9387313B2 (en) | 2004-08-03 | 2016-07-12 | Interventional Spine, Inc. | Telescopic percutaneous tissue dilation systems and related methods |
JP5164571B2 (ja) | 2004-08-03 | 2013-03-21 | インターヴェンショナル スパイン インコーポレイテッド | 経皮組織拡張システムおよび関連方法 |
US8460310B2 (en) | 2004-08-04 | 2013-06-11 | Leslie Stern | Surgical base unit and retractor support mechanism |
EP1786338B1 (en) | 2004-08-15 | 2020-02-12 | Kevin Seex | Distraction and retraction assemblies |
US7931591B2 (en) | 2004-09-03 | 2011-04-26 | Mccarthy Patrick M | Surgical retractor |
US7666189B2 (en) | 2004-09-29 | 2010-02-23 | Synthes Usa, Llc | Less invasive surgical system and methods |
US7479106B2 (en) | 2004-09-30 | 2009-01-20 | Boston Scientific Scimed, Inc. | Automated control of irrigation and aspiration in a single-use endoscope |
US8585584B2 (en) | 2004-10-11 | 2013-11-19 | Nitesh Ratnakar | Dual view endoscope |
US7578819B2 (en) | 2005-05-16 | 2009-08-25 | Baxano, Inc. | Spinal access and neural localization |
US6983930B1 (en) | 2004-10-28 | 2006-01-10 | Christopher Louis La Mendola | Clamping device with flexible arm |
WO2006049917A2 (en) | 2004-10-29 | 2006-05-11 | Depuy Spine, Inc | Expandable ports and methods for minimally invasive surgery |
US8579809B2 (en) | 2004-12-23 | 2013-11-12 | Symmetry Medical Manufacturing, Inc. | Radially expanding surgical retractor |
US8568305B2 (en) | 2004-12-29 | 2013-10-29 | Us Spine, Inc. | Minimally-invasive portal system for performing lumbar decompression, instrumented fusion/stabilization, and the like |
US8182422B2 (en) | 2005-12-13 | 2012-05-22 | Avantis Medical Systems, Inc. | Endoscope having detachable imaging device and method of using |
EP1834575B1 (en) | 2005-01-07 | 2011-09-21 | Olympus Medical Systems Corp. | Endoscope-use insertion unit |
EP1834571A4 (en) | 2005-01-07 | 2012-12-05 | Olympus Medical Systems Corp | INSERTION UNIT FOR ENDOSCOPE |
WO2006073121A1 (ja) | 2005-01-07 | 2006-07-13 | Olympus Medical Systems Corp. | 内視鏡用挿入部 |
US7643884B2 (en) | 2005-01-31 | 2010-01-05 | Warsaw Orthopedic, Inc. | Electrically insulated surgical needle assembly |
US8078266B2 (en) | 2005-10-25 | 2011-12-13 | Voyage Medical, Inc. | Flow reduction hood systems |
US20060200186A1 (en) | 2005-03-04 | 2006-09-07 | Marchek Connie P | Adjustable access device for surgical procedures |
US20060206178A1 (en) | 2005-03-11 | 2006-09-14 | Kim Daniel H | Percutaneous endoscopic access tools for the spinal epidural space and related methods of treatment |
US9675235B2 (en) | 2005-03-21 | 2017-06-13 | Jonas V. Lieponis | Multi-purpose surgical instrument with removable component |
US8092464B2 (en) | 2005-04-30 | 2012-01-10 | Warsaw Orthopedic, Inc. | Syringe devices and methods useful for delivering osteogenic material |
US7509156B2 (en) | 2005-05-18 | 2009-03-24 | Clarian Health Partners, Inc. | System for managing glucose levels in patients with diabetes or hyperglycemia |
US8360970B2 (en) | 2005-06-22 | 2013-01-29 | Vycor Medical, Inc. | Surgical access instruments for use with spinal or orthopedic surgery |
US20070021767A1 (en) | 2005-07-25 | 2007-01-25 | Breznock Eugene M | Steerable endoluminal punch |
ATE495701T1 (de) | 2005-07-29 | 2011-02-15 | Vertos Medical Inc | Perkutane gewebeexzisionsvorrichtungen |
US20070055259A1 (en) | 2005-08-17 | 2007-03-08 | Norton Britt K | Apparatus and methods for removal of intervertebral disc tissues |
US20070049794A1 (en) | 2005-09-01 | 2007-03-01 | Ezc Medical Llc | Visualization stylet for medical device applications having self-contained power source |
WO2007038429A1 (en) | 2005-09-27 | 2007-04-05 | Endius, Inc. | Methods and apparatuses for stabilizing the spine through an access device |
CN100411594C (zh) | 2005-09-30 | 2008-08-20 | 申屠作本 | 一种针镜微创手术法成套医疗手术装置 |
DE502006007744D1 (en) | 2005-10-05 | 2010-10-07 | Rold Orlando Da | Flexible hohlwelle |
US20070129634A1 (en) | 2005-10-17 | 2007-06-07 | Hickey Katherine M | Biomedical positioning and stabilization system |
WO2007056458A2 (en) | 2005-11-07 | 2007-05-18 | Vanderbilt University | Adjustable universal surgical platform |
US7815659B2 (en) | 2005-11-15 | 2010-10-19 | Ethicon Endo-Surgery, Inc. | Suture anchor applicator |
US7927361B2 (en) | 2005-11-29 | 2011-04-19 | Medtronic Xomed, Inc. | Method and apparatus for removing material from an intervertebral disc space, such as in performing a nucleotomy |
TW200744518A (en) | 2006-01-06 | 2007-12-16 | Olympus Medical Systems Corp | Medical system conducted percutaneous or using naturally ocurring body orifice |
US7590490B2 (en) | 2006-01-09 | 2009-09-15 | Mitac International Corporation | Smart detour |
US7655008B2 (en) | 2006-02-09 | 2010-02-02 | Warsaw Orthopedic, Inc. | Methods and instruments for spinal derotation |
US20070203396A1 (en) | 2006-02-28 | 2007-08-30 | Mccutcheon John G | Endoscopic Tool |
US7407483B2 (en) | 2006-03-16 | 2008-08-05 | Perez-Cruet Mick J | Minimally invasive surgical access device |
US20070225556A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Disposable endoscope devices |
EP1891882A3 (en) | 2006-04-05 | 2008-12-31 | Arthrex, Inc. | Deflectable tip videoarthroscope |
US7837714B2 (en) | 2006-04-10 | 2010-11-23 | Warsaw Orthopedic, Inc. | Methods and devices for the interconnection of bone attachment devices |
US7794393B2 (en) | 2006-04-13 | 2010-09-14 | Larsen Dane M | Resectoscopic device and method |
US8114085B2 (en) | 2006-04-13 | 2012-02-14 | General Electric Company | Percutaneous registration-and-access tool for minimally invasive spinal surgery |
US7955255B2 (en) | 2006-04-20 | 2011-06-07 | Boston Scientific Scimed, Inc. | Imaging assembly with transparent distal cap |
US7794387B2 (en) | 2006-04-26 | 2010-09-14 | Medtronic, Inc. | Methods and devices for stabilizing tissue |
US8167899B2 (en) | 2006-05-04 | 2012-05-01 | Warsaw Orthopedic, Inc. | Retractable stylet and cannula combination |
US8230863B2 (en) | 2006-05-30 | 2012-07-31 | Mini-Lap Technologies, Inc. | Platform for fixing surgical instruments during surgery |
US8992425B2 (en) | 2006-06-06 | 2015-03-31 | Globus Medical, Inc. | Surgical retractor system |
EP2037794B1 (en) | 2006-06-13 | 2021-10-27 | Intuitive Surgical Operations, Inc. | Minimally invasive surgical system |
US20080033251A1 (en) | 2006-06-30 | 2008-02-07 | Ali Araghi | Surgical retractor and method of use |
US20090018566A1 (en) | 2006-06-30 | 2009-01-15 | Artheromed, Inc. | Atherectomy devices, systems, and methods |
US7959564B2 (en) | 2006-07-08 | 2011-06-14 | Stephen Ritland | Pedicle seeker and retractor, and methods of use |
JP5030507B2 (ja) | 2006-08-30 | 2012-09-19 | オリンパスメディカルシステムズ株式会社 | 内視鏡の先端フードとフード付き内視鏡 |
US20080081951A1 (en) | 2006-09-29 | 2008-04-03 | Depuy Spine, Inc. | Inflatable retractor |
EP2073721B1 (en) | 2006-10-03 | 2018-11-07 | Virtual Ports Ltd. | A clip device and system for assisting surgical procedures |
JP4981403B2 (ja) | 2006-10-11 | 2012-07-18 | オリンパスメディカルシステムズ株式会社 | 内視鏡洗浄シース及びそれを備える内視鏡装置 |
US20100286477A1 (en) | 2009-05-08 | 2010-11-11 | Ouyang Xiaolong | Internal tissue visualization system comprising a rf-shielded visualization sensor module |
ES2279733B1 (es) | 2006-11-27 | 2008-08-16 | Rudolf Morgenstern Lopez | Dispositivo para eliminacion de tejido en operaciones endoscopicas. |
US7803159B2 (en) | 2006-11-29 | 2010-09-28 | Mi4Spine, Llc | Disc space preparation device for spinal surgery |
US8052710B2 (en) | 2006-12-15 | 2011-11-08 | Parviz Kambin | Endoscopic balloon tissue dissector and retractor |
US7987001B2 (en) * | 2007-01-25 | 2011-07-26 | Warsaw Orthopedic, Inc. | Surgical navigational and neuromonitoring instrument |
US20080188714A1 (en) | 2007-02-07 | 2008-08-07 | Boston Scientific Scimed, Inc. | Electromechanical in-situ cleaning of optical elements |
US8535220B2 (en) | 2007-02-16 | 2013-09-17 | Robert MONDSCHEIN | Laparoscope cleaning system |
US8202216B2 (en) | 2007-03-08 | 2012-06-19 | Warsaw Orthopedic, Inc. | Tissue retractor |
AU2008232660A1 (en) | 2007-03-29 | 2008-10-09 | Frantz Medical Development, Ltd. | Securable cannula and method |
US7627208B2 (en) | 2007-04-23 | 2009-12-01 | Fujifilm Corporation | Optical probe and optical tomography apparatus |
US20100256446A1 (en) | 2007-05-11 | 2010-10-07 | Board Of Regents, The University Of Texas System | Medical scope carrier and scope as system and method |
US8888689B2 (en) | 2007-06-19 | 2014-11-18 | Minimally Invasive Devices, Inc. | Systems and methods for optimizing and maintaining visualization of a surgical field during the use of surgical scopes |
US9211059B2 (en) | 2007-06-19 | 2015-12-15 | Minimally Invasive Devices, Inc. | Systems and methods for optimizing and maintaining visualization of a surgical field during the use of surgical scopes |
US9050036B2 (en) | 2007-06-19 | 2015-06-09 | Minimally Invasive Devices, Inc. | Device for maintaining visualization with surgical scopes |
US8372131B2 (en) | 2007-07-16 | 2013-02-12 | Power Ten , LLC | Surgical site access system and deployment device for same |
US20090024158A1 (en) | 2007-07-16 | 2009-01-22 | Zimmer Spine, Inc. | Access Port Expander And Method |
US20110098628A1 (en) | 2007-07-25 | 2011-04-28 | Yeung Jeffrey E | Internal and external disc shunts alleviate back pain |
KR20100047870A (ko) | 2007-08-27 | 2010-05-10 | 스파인 뷰 인코포레이티드 | 척추에 접근하여 시각화하기 위한 풍선 캐뉼라 시스템 및 관련 방법 |
WO2009033207A1 (en) | 2007-09-12 | 2009-03-19 | Columna Pty Ltd | Equipment for, and a method of, removing tissue from a site in a patient's body |
GB0718268D0 (en) | 2007-09-19 | 2008-10-08 | Ayrshire And Arran Health Board | Retractor with integrated light source |
US20090287061A1 (en) | 2007-10-01 | 2009-11-19 | Gft Technologies | Surgical access device for minimally invasive surgery |
US20090105543A1 (en) | 2007-10-19 | 2009-04-23 | Miller Eric C | Endoscope Lens Cleaner |
US8096944B2 (en) | 2007-10-26 | 2012-01-17 | Harrel Stephen K | Air shield for videoscope imagers |
US8043381B2 (en) | 2007-10-29 | 2011-10-25 | Zimmer Spine, Inc. | Minimally invasive interbody device and method |
US20090125032A1 (en) | 2007-11-14 | 2009-05-14 | Gutierrez Robert C | Rod removal instrument |
US8236006B2 (en) | 2008-01-17 | 2012-08-07 | Life Spine, Inc. | One step entry pedicular preparation device and disc access system |
JP2009189637A (ja) | 2008-02-15 | 2009-08-27 | Fujinon Corp | 内視鏡の流体供給装置 |
US8740912B2 (en) | 2008-02-27 | 2014-06-03 | Ilion Medical Llc | Tools for performing less invasive orthopedic joint procedures |
US20090240111A1 (en) | 2008-03-18 | 2009-09-24 | Joshua Kessler | Light Source and Lens Cleaner for Laparoscopic Surgery |
JP5164644B2 (ja) * | 2008-04-04 | 2013-03-21 | オリンパスメディカルシステムズ株式会社 | 内視鏡 |
JP5108595B2 (ja) | 2008-04-04 | 2012-12-26 | オリンパスメディカルシステムズ株式会社 | 内視鏡、先端キャップ付き内視鏡および内視鏡用洗浄シース |
US7828775B2 (en) | 2008-04-11 | 2010-11-09 | Tyco Healthcare Group Lp | Telescoping cannula |
JP5129004B2 (ja) | 2008-04-16 | 2013-01-23 | オリンパス株式会社 | 内視鏡装置 |
US20090264895A1 (en) * | 2008-04-22 | 2009-10-22 | Warsaw Orthopedic, Inc. | Systems and methods for implanting a bone fastener and delivering a bone filling material |
KR101464983B1 (ko) | 2008-05-01 | 2014-11-25 | 스파인셀 프러프라이어테리 리미티드 | 조직 보형물의 형성 및 삽입기구 및 그의 시스템 및 방법 |
US20100004651A1 (en) | 2008-06-13 | 2010-01-07 | The University Of Toledo | Transpedicular access to the intervertebral disc space for discectomy, end plate preparation, and interbody fusion |
JP5166133B2 (ja) | 2008-06-23 | 2013-03-21 | 富士フイルム株式会社 | 内視鏡 |
US8932207B2 (en) | 2008-07-10 | 2015-01-13 | Covidien Lp | Integrated multi-functional endoscopic tool |
US20100016885A1 (en) | 2008-07-21 | 2010-01-21 | Eidenschink Tracee E J | Device to close openings in body tissue |
US20100022824A1 (en) | 2008-07-22 | 2010-01-28 | Cybulski James S | Tissue modification devices and methods of using the same |
JP5124376B2 (ja) | 2008-07-22 | 2013-01-23 | 富士フイルム株式会社 | 内視鏡の光学系装置およびこれを備えた内視鏡 |
US20100076476A1 (en) | 2008-07-25 | 2010-03-25 | To John T | Systems and methods for cable-based tissue removal |
EP2339972B1 (en) | 2008-09-26 | 2018-04-11 | Relievant Medsystems, Inc. | Systems for navigating an instrument through bone |
WO2010048208A1 (en) | 2008-10-20 | 2010-04-29 | Spine View, Inc. | Retractor cannula system for accessing and visualizing spine and related methods |
US20100114147A1 (en) | 2008-10-30 | 2010-05-06 | The University Of Toledo | Directional soft tissue dilator and docking pin with integrated light source for optimization of retractor placement in minimally invasive spine surgery |
CN201290744Y (zh) | 2008-11-14 | 2009-08-19 | 解西胜 | 硬膜外穿刺针 |
WO2010064234A2 (en) | 2008-12-01 | 2010-06-10 | Mazor Surgical Technologies Ltd. | Robot guided oblique spinal stabilization |
JP5587906B2 (ja) | 2008-12-04 | 2014-09-10 | ピボット・メディカル,インコーポレーテッド | 入れ子式アクセスカニューレ |
US8864654B2 (en) | 2010-04-20 | 2014-10-21 | Jeffrey B. Kleiner | Method and apparatus for performing retro peritoneal dissection |
US9655639B2 (en) | 2008-12-16 | 2017-05-23 | Nico Corporation | Tissue removal device for use with imaging devices in neurosurgical and spinal surgery applications |
US8470043B2 (en) | 2008-12-23 | 2013-06-25 | Benvenue Medical, Inc. | Tissue removal tools and methods of use |
US8688186B1 (en) | 2009-02-04 | 2014-04-01 | Vioptix, Inc. | Retractor device with oximeter sensor and force sensor |
US8468637B2 (en) | 2009-02-06 | 2013-06-25 | Endoclear Llc | Mechanically-actuated endotracheal tube cleaning device |
US8062218B2 (en) | 2009-02-27 | 2011-11-22 | Warsaw Orthopedic, Inc. | Surgical access instrument |
US9848904B2 (en) | 2009-03-06 | 2017-12-26 | Procept Biorobotics Corporation | Tissue resection and treatment with shedding pulses |
FR2942750B1 (fr) | 2009-03-09 | 2017-11-24 | Lohr Ind | Ensemble aerien pour la fourniture d'energie electrique a un vehicule terrestre. |
DE102009015391A1 (de) | 2009-03-20 | 2010-09-23 | Aesculap Ag | Chirurgischer Haltearm und chirurgische Haltevorrichtung |
US8206357B2 (en) | 2009-03-26 | 2012-06-26 | Tyco Healthcare Group Lp | Articulating surgical portal apparatus with spring |
ES2762203T3 (es) * | 2009-03-27 | 2020-05-22 | New View Surgical Inc | Cánula con iluminación y cámara integrada |
US8801739B2 (en) | 2009-04-17 | 2014-08-12 | Spine View, Inc. | Devices and methods for arched roof cutters |
US8343035B2 (en) | 2009-04-20 | 2013-01-01 | Spine View, Inc. | Dilator with direct visualization |
US20100274276A1 (en) | 2009-04-22 | 2010-10-28 | Ricky Chow | Aneurysm treatment system, device and method |
US20100280325A1 (en) | 2009-04-30 | 2010-11-04 | Tamer Ibrahim | Retractors and surgical systems including the same |
US20100284580A1 (en) | 2009-05-07 | 2010-11-11 | Ouyang Xiaolong | Tissue visualization systems and methods for using the same |
CA2762606A1 (en) | 2009-05-20 | 2010-11-25 | Synthes Usa, Llc | Patient-mounted retraction |
CN102802545A (zh) | 2009-05-29 | 2012-11-28 | 阿萨卢斯医疗器械有限公司 | 腹腔镜进入口装置和进入口套筒结构 |
WO2010138083A1 (en) | 2009-05-29 | 2010-12-02 | Nanyang Technological University | Robotic system for flexible endoscopy |
US8926502B2 (en) | 2011-03-07 | 2015-01-06 | Endochoice, Inc. | Multi camera endoscope having a side service channel |
WO2012077117A1 (en) | 2010-12-09 | 2012-06-14 | Peermedical Ltd. | Flexible electronic circuit board multi-camera endoscope |
US10165929B2 (en) | 2009-06-18 | 2019-01-01 | Endochoice, Inc. | Compact multi-viewing element endoscope system |
US9101268B2 (en) | 2009-06-18 | 2015-08-11 | Endochoice Innovation Center Ltd. | Multi-camera endoscope |
US8721536B2 (en) | 2009-07-28 | 2014-05-13 | Trinity Orthopedics, Llc | Arcuate surgical guidance system and methods |
US8876712B2 (en) | 2009-07-29 | 2014-11-04 | Edwards Lifesciences Corporation | Intracardiac sheath stabilizer |
US8152720B2 (en) | 2009-08-05 | 2012-04-10 | Thomas Stuart Loftus | Retracto component system and method of using same |
US8648932B2 (en) | 2009-08-13 | 2014-02-11 | Olive Medical Corporation | System, apparatus and methods for providing a single use imaging device for sterile environments |
US20120232350A1 (en) | 2009-08-31 | 2012-09-13 | Kevin Seex | Retractor blade including a flexible member for anchorage engagement |
KR101109700B1 (ko) | 2009-09-07 | 2012-01-31 | 신경민 | 기도용 풍선 카데터 |
US9024237B2 (en) | 2009-09-29 | 2015-05-05 | Covidien Lp | Material fusing apparatus, system and method of use |
JP5330180B2 (ja) | 2009-10-02 | 2013-10-30 | オリンパス株式会社 | 内視鏡装置 |
GB2474309B (en) | 2009-10-12 | 2011-09-07 | Endoguard Ltd | Flow guide for an endoscope |
GB2481727B (en) | 2009-10-12 | 2012-05-09 | Endoguard Ltd | Flow guide for an endoscope |
US9801732B2 (en) | 2009-10-30 | 2017-10-31 | Spinefrontier, Inc | System and method for an intervertebral implant assembly |
US8795162B2 (en) | 2009-11-10 | 2014-08-05 | Invuity, Inc. | Illuminated suction apparatus |
US8226657B2 (en) | 2009-11-10 | 2012-07-24 | Carefusion 207, Inc. | Systems and methods for vertebral or other bone structure height restoration and stabilization |
GB2488284B (en) | 2009-11-10 | 2015-12-09 | Nuvasive Inc | Apparatus for performing spinal fusion surgery |
EP2498668A4 (en) | 2009-11-13 | 2013-08-07 | Hologic Inc | ACCESS SYSTEM WITH DETACHABLE DISCHARGE CHANNEL |
US8460186B2 (en) | 2009-12-11 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Methods and devices for providing access through tissue to a surgical site |
US8435174B2 (en) | 2009-12-11 | 2013-05-07 | Ethicon Endo-Surgery, Inc. | Methods and devices for accessing a body cavity |
CN102695541B (zh) | 2009-12-16 | 2015-04-22 | 迈克罗普拉塔公司 | 用于治疗胃肠道损伤的基本为刚性和稳定的腔内外科手术套件 |
US8267896B2 (en) | 2009-12-18 | 2012-09-18 | Tyco Healthcare Group Lp | Surgical instrument cleaning arrangement |
WO2011082390A2 (en) | 2010-01-02 | 2011-07-07 | Yeung Jeffrey E | Internal and external disc shunts alleviate back pain |
US9078562B2 (en) | 2010-01-11 | 2015-07-14 | Minimally Invasive Devices, Inc. | Systems and methods for optimizing and maintaining visualization of a surgical field during the use of surgical scopes |
US8636655B1 (en) | 2010-01-19 | 2014-01-28 | Ronald Childs | Tissue retraction system and related methods |
US20110201888A1 (en) | 2010-02-18 | 2011-08-18 | Verner Sarah N | Medical Devices and Methods |
US9265622B2 (en) | 2010-03-22 | 2016-02-23 | Amendia, Inc. | Percutaneous arthrodesis method and system |
MX2012010981A (es) | 2010-03-25 | 2012-11-06 | Olive Medical Corp | Sistema y metodo para proporcionar un dipositivo de generacion de imagenes de un solo uso para aplicaciones medicas. |
US8523873B2 (en) | 2010-04-08 | 2013-09-03 | Warsaw Orthopedic, Inc. | Neural-monitoring enabled sleeves for surgical instruments |
US8460180B1 (en) | 2010-04-16 | 2013-06-11 | Hector Zarate | Endoscopic lens cleaner |
BR112012025806A2 (pt) | 2010-04-23 | 2017-11-28 | Synthes Gmbh | conjuntos de instrumentos e métodos para cirurgias de coluna |
JP2011245004A (ja) | 2010-05-26 | 2011-12-08 | Olympus Corp | 内視鏡装置 |
AU2011268433A1 (en) | 2010-06-14 | 2013-01-10 | Maquet Cardiovascular Llc | Surgical instruments, systems and methods of use |
JP5485041B2 (ja) | 2010-06-18 | 2014-05-07 | オリンパス株式会社 | 内視鏡装置 |
EP2590579B1 (en) | 2010-07-07 | 2019-08-28 | Carevature Medical Ltd. | Surgical device for tissue removal |
US9486296B2 (en) | 2010-07-08 | 2016-11-08 | Warsaw Orthopedic, Inc. | Surgical assembly with flexible arm |
US8617062B2 (en) | 2010-07-08 | 2013-12-31 | Warsaw Orthopedic, Inc. | Over dilation |
JP5584057B2 (ja) | 2010-08-30 | 2014-09-03 | 富士フイルム株式会社 | 硬性内視鏡 |
US8845734B2 (en) | 2010-09-03 | 2014-09-30 | Globus Medical, Inc. | Expandable fusion device and method of installation thereof |
JP5685406B2 (ja) | 2010-09-06 | 2015-03-18 | 富士フイルム株式会社 | 画像撮像装置およびその作動方法 |
CA2812097A1 (en) | 2010-09-20 | 2012-03-29 | Peermedical Ltd. | Multi-camera endoscope having fluid channels |
EP2618750A4 (en) | 2010-09-20 | 2017-11-01 | Spine View, Inc. | Cannulotome |
JP5752910B2 (ja) | 2010-09-30 | 2015-07-22 | オリンパス株式会社 | 内視鏡装置及びその動作制御方法 |
US8870756B2 (en) | 2010-10-08 | 2014-10-28 | ERBE-USA, Inc. | Hybrid apparatus for fluid supply for endoscopic irrigation and lens cleaning |
US9011323B2 (en) | 2010-10-08 | 2015-04-21 | Invuity, Inc. | Method and apparatus for soft tissue retraction |
US9795771B2 (en) | 2010-10-19 | 2017-10-24 | Warsaw Orthopedic, Inc. | Expandable spinal access instruments and methods of use |
US9763567B2 (en) | 2010-10-20 | 2017-09-19 | Covidien Lp | Endoscope wiper blade cleaner |
US8690764B2 (en) | 2010-10-20 | 2014-04-08 | Covidien Lp | Endoscope cleaner |
WO2012068181A2 (en) | 2010-11-15 | 2012-05-24 | Spine View, Inc. | Tissue removal system with retention mechanism |
US9522017B2 (en) | 2010-12-03 | 2016-12-20 | Minimally Invasive Devices, Inc. | Devices, systems, and methods for performing endoscopic surgical procedures |
WO2012088167A2 (en) | 2010-12-20 | 2012-06-28 | Spine View, Inc. | Articulating tissue removal systems and methods |
US8998798B2 (en) | 2010-12-29 | 2015-04-07 | Covidien Lp | Multi-lumen tracheal tube with visualization device |
US8905921B2 (en) | 2011-02-16 | 2014-12-09 | The General Hospital Corporation | Optical coupler for an endoscope |
JP5331840B2 (ja) | 2011-02-28 | 2013-10-30 | 富士フイルム株式会社 | 内視鏡 |
US8518087B2 (en) | 2011-03-10 | 2013-08-27 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US8394129B2 (en) | 2011-03-10 | 2013-03-12 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
JP5318142B2 (ja) | 2011-03-31 | 2013-10-16 | 富士フイルム株式会社 | 電子内視鏡 |
US9211060B2 (en) | 2011-04-05 | 2015-12-15 | Covidien Lp | Visualization device and holder for use with a tracheal tube |
CN102727309B (zh) | 2011-04-11 | 2014-11-26 | 上海优益基医疗器械有限公司 | 结合内窥镜影像的外科手术导航系统 |
US20120265022A1 (en) | 2011-04-18 | 2012-10-18 | Tyco Healthcare Group Lp | Trocar with integrated light and/or scope optical fibers |
US8974381B1 (en) | 2011-04-26 | 2015-03-10 | Nuvasive, Inc. | Cervical retractor |
US9307972B2 (en) | 2011-05-10 | 2016-04-12 | Nuvasive, Inc. | Method and apparatus for performing spinal fusion surgery |
JP6083028B2 (ja) | 2011-05-12 | 2017-02-22 | デピュー シンセス プロダクツ, インコーポレーテッドDePuy Synthes Products, Inc. | 相互接続を最適化する許容誤差がある画像センサ |
US8834507B2 (en) | 2011-05-17 | 2014-09-16 | Warsaw Orthopedic, Inc. | Dilation instruments and methods |
US9603510B2 (en) | 2011-05-17 | 2017-03-28 | Mario Ammirati | Method and apparatus for delivering an endoscope via microsurgical instruments while performing microscopic surgery |
US20120298820A1 (en) | 2011-05-25 | 2012-11-29 | Spiros Manolidis | Surgical tool holder |
US8556809B2 (en) | 2011-06-10 | 2013-10-15 | Raghavendra Rao Vijayanagar | Surgical tissue retractor |
US8523767B2 (en) | 2011-06-16 | 2013-09-03 | Warsaw Orthopedic, Inc. | Add-on retractor element for retractor system |
EP2734169B1 (en) | 2011-07-22 | 2016-12-28 | Frederick Sklar | Surgical head holder and surgical accessories for use with same |
WO2013016698A1 (en) | 2011-07-28 | 2013-01-31 | Spine View, Inc. | Discectomy devices and related methods |
US9232935B2 (en) | 2011-08-01 | 2016-01-12 | Misder, Llc | Handle for actuating a device |
JP5788261B2 (ja) | 2011-08-03 | 2015-09-30 | オリンパス株式会社 | 内視鏡 |
CN204218948U (zh) | 2011-08-31 | 2015-03-25 | 兰克斯股份有限公司 | 一种外科手术牵开器 |
US9113853B1 (en) | 2011-08-31 | 2015-08-25 | Nuvasive, Inc. | Systems and methods for performing spine surgery |
CN202211669U (zh) | 2011-09-01 | 2012-05-09 | 北京爱乐曼科技有限公司 | 一种椎间孔椎管脊柱内镜 |
US8992717B2 (en) | 2011-09-01 | 2015-03-31 | Covidien Lp | Catheter with helical drive shaft and methods of manufacture |
US9247997B2 (en) | 2011-09-30 | 2016-02-02 | Ethicon Endo-Surgery, Inc. | Patient-referenced surgical support frame |
US9237933B2 (en) | 2011-10-21 | 2016-01-19 | Specialty Surgical Instrumentation Inc. | Universal arm system |
US20130103103A1 (en) * | 2011-10-24 | 2013-04-25 | Warsaw Orthopedic, Inc | Surgical system methods for spinal access |
US8795167B2 (en) | 2011-11-15 | 2014-08-05 | Baxano Surgical, Inc. | Spinal therapy lateral approach access instruments |
US9028522B1 (en) | 2011-11-15 | 2015-05-12 | Seaspine, Inc. | Tissue dilator and retractor system and method of use |
US20130150670A1 (en) | 2011-12-07 | 2013-06-13 | Covidien Lp | Thoracic scope port cleaner |
US20130150674A1 (en) | 2011-12-07 | 2013-06-13 | Covidien Lp | Thoracic scope port sponge cleaner |
CN202740102U (zh) | 2011-12-27 | 2013-02-20 | 金晓锋 | 双通道椎间盘镜手术器械 |
US9668643B2 (en) | 2011-12-29 | 2017-06-06 | Cook Medical Technologies Llc | Space-optimized visualization catheter with oblong shape |
WO2013101901A1 (en) | 2011-12-29 | 2013-07-04 | Cook Medical Technologies Llc | Space-optimized visualization catheter having a camera train holder in a catheter with off-centered lumens |
US8936605B2 (en) | 2011-12-30 | 2015-01-20 | Blackstone Medical, Inc. | Direct vertebral rotation tool and method of using same |
US8852253B2 (en) | 2012-01-27 | 2014-10-07 | Kyphon Sarl | Anchoring cannula |
US8585726B2 (en) | 2012-01-31 | 2013-11-19 | Globus Medical, Inc. | Surgical disc removal tool |
US20140074170A1 (en) | 2012-02-10 | 2014-03-13 | Herbert H. Mertens | Delivery Device With Interior Dilation Element Channel |
US8986199B2 (en) | 2012-02-17 | 2015-03-24 | Ethicon Endo-Surgery, Inc. | Apparatus and methods for cleaning the lens of an endoscope |
US9498297B2 (en) | 2012-04-18 | 2016-11-22 | United Arab Emirates University | Manipulator for surgical tools |
US20130289399A1 (en) | 2012-04-27 | 2013-10-31 | Vertiflex, Inc. | Decompression systems and methods of using the same |
US20150342621A1 (en) | 2014-05-29 | 2015-12-03 | Avery M. Jackson, III | Illuminated endoscopic pedicle probe with dynamic real time monitoring for proximity to nerves |
US9642606B2 (en) | 2012-06-27 | 2017-05-09 | Camplex, Inc. | Surgical visualization system |
US9492065B2 (en) | 2012-06-27 | 2016-11-15 | Camplex, Inc. | Surgical retractor with video cameras |
US20160008007A1 (en) * | 2012-07-17 | 2016-01-14 | Truminim, LLC | Percutaneous system and methods for enhanced epidural access for spine surgery |
US9474538B2 (en) | 2012-07-18 | 2016-10-25 | Warsaw Orthopedic, Inc. | Systems and methods for guiding anchors for facet fixation |
WO2014018949A2 (en) | 2012-07-26 | 2014-01-30 | Olive Medical Corporation | Wide dynamic range using monochromatic sensor |
WO2014018948A2 (en) | 2012-07-26 | 2014-01-30 | Olive Medical Corporation | Camera system with minimal area monolithic cmos image sensor |
IN2015MN00022A (zh) | 2012-07-26 | 2015-10-16 | Olive Medical Corp | |
WO2014018936A2 (en) | 2012-07-26 | 2014-01-30 | Olive Medical Corporation | Continuous video in a light deficient environment |
TWI481382B (zh) | 2012-08-31 | 2015-04-21 | Univ Nat Cheng Kung | 經皮穿刺輔助裝置及經皮導引組件 |
KR101195997B1 (ko) | 2012-09-03 | 2012-11-01 | 주식회사 메타바이오메드 | 광섬유와 카메라를 이용한 카테터 |
ES2544994T3 (es) | 2012-09-06 | 2015-09-07 | Medacta International S.A. | Dispositivo quirúrgico para fusión espinal mínimamente invasiva y sistema quirúrgico que comprende el mismo |
CN108186076B (zh) | 2012-09-11 | 2021-02-23 | 卡尔维通医疗有限公司 | 组织移除装置 |
SG11201502034WA (en) * | 2012-09-19 | 2015-05-28 | Univ Nanyang Tech | Flexible master - slave robotic endoscopy system |
US9480855B2 (en) | 2012-09-26 | 2016-11-01 | DePuy Synthes Products, Inc. | NIR/red light for lateral neuroprotection |
EP2901913A4 (en) | 2012-09-28 | 2016-08-31 | Olympus Corp | ENDOSCOPE DEVICE COMPRISING A CLEANING MECHANISM |
WO2014064698A2 (en) | 2012-10-25 | 2014-05-01 | Laryngoport Ltd. | A pre-shaped rigid port |
US20140142584A1 (en) | 2012-11-16 | 2014-05-22 | Spinal Generations, Llc | Multichannel cannula and methods for using same |
US9198674B2 (en) | 2012-12-14 | 2015-12-01 | Warsaw Orthopedic, Inc. | Surgical instrument and method |
EP2934342A4 (en) | 2012-12-20 | 2016-07-13 | Spine View Inc | DEVICES AND METHODS OF DISCECTOMY |
EP4115791A1 (en) | 2013-02-01 | 2023-01-11 | DEKA Products Limited Partnership | Endoscope with pannable camera |
US20140215736A1 (en) | 2013-02-05 | 2014-08-07 | Next Wave Surgical LLC | Minimally invasive apparatus and method for cleaning endoscope lenses |
US9877786B2 (en) | 2013-03-06 | 2018-01-30 | Stryker European Holdings I, Llc | Modular navigable probe |
US9277928B2 (en) | 2013-03-11 | 2016-03-08 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US20140257489A1 (en) | 2013-03-11 | 2014-09-11 | Interventional Spine, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
JP2016515861A (ja) | 2013-03-12 | 2016-06-02 | ケイ. アルーワリア,プラバート | 子宮マニピュレータ |
US9993353B2 (en) | 2013-03-14 | 2018-06-12 | DePuy Synthes Products, Inc. | Method and apparatus for minimally invasive insertion of intervertebral implants |
US20140261545A1 (en) | 2013-03-14 | 2014-09-18 | Acclarent, Inc. | Apparatus for wiping angled window of endoscope |
US9662466B2 (en) | 2013-03-15 | 2017-05-30 | Sanovas, Inc. | Imaging stylet for intubation |
US20140275793A1 (en) | 2013-03-15 | 2014-09-18 | John Song | Minimally Invasive Retractor |
EP2967294B1 (en) | 2013-03-15 | 2020-07-29 | DePuy Synthes Products, Inc. | Super resolution and color motion artifact correction in a pulsed color imaging system |
EP3539457B1 (en) | 2013-03-15 | 2021-12-08 | DePuy Synthes Products, Inc. | Image rotation using software for endoscopic applications |
DE112014001466T5 (de) | 2013-03-15 | 2015-12-03 | Pro Med Instruments Gmbh | Flexibler Arm und Verfahren zu dessen Verwendung |
US9603610B2 (en) | 2013-03-15 | 2017-03-28 | DePuy Synthes Products, Inc. | Tools and methods for tissue removal |
US9700378B2 (en) | 2013-04-26 | 2017-07-11 | Medtronic Xomed, Inc. | Endoscope lens cleaning device |
US20170065287A1 (en) | 2013-04-28 | 2017-03-09 | Octavio Cesar Silva | Infrared Endoscopic Probe |
US9421110B2 (en) | 2013-05-10 | 2016-08-23 | Sidewinder Medical Products Llc | Expandable spinal fusion cage |
WO2014185334A1 (ja) | 2013-05-16 | 2014-11-20 | アドバンストヘルスケア株式会社 | トロカール、ポートおよび手術支援システム |
WO2014188808A1 (ja) | 2013-05-22 | 2014-11-27 | オリンパスメディカルシステムズ株式会社 | 内視鏡システム |
WO2014188796A1 (ja) | 2013-05-23 | 2014-11-27 | オリンパスメディカルシステムズ株式会社 | 医療用具の先端構成部材,内視鏡洗浄シース及びこの内視鏡洗浄シースを用いる内視鏡システム |
US20140357945A1 (en) | 2013-05-30 | 2014-12-04 | Edward Duckworth | Laparoscopic Trocar with Ventriculoperitoneal Shunt Entry Port |
WO2014205140A2 (en) * | 2013-06-18 | 2014-12-24 | Minimally Invasive Devices, Inc. | Sheath for hand-held and robotic laparoscopes |
US10709434B2 (en) | 2013-07-09 | 2020-07-14 | Globus Medical, Inc. | Surgical access systems and methods |
EP3035870A1 (en) | 2013-08-19 | 2016-06-29 | Smith & Nephew, Inc. | Bone removal under direct visualization |
US20160174814A1 (en) | 2013-08-31 | 2016-06-23 | Morena Medical Applications Ltd. | Endoscope with shared working channel |
JP6407977B2 (ja) | 2013-09-20 | 2018-10-17 | アプライド メディカル リソーシーズ コーポレイション | 生まれつきの開口用のアクセス器具 |
CN105849244B (zh) | 2013-09-30 | 2019-05-17 | 长濑医药品株式会社 | 内窥镜镜头清洗剂 |
US9028401B1 (en) | 2013-11-11 | 2015-05-12 | Cross Bay Medical, Inc. | Apparatus and methods for accessing and sealing bodily vessels and cavities |
DE202013105202U1 (de) | 2013-11-18 | 2013-11-26 | Fehling Instruments Gmbh & Co. Kg | Spreizer, insbesondere für die Schädelchirurgie |
US20160095505A1 (en) | 2013-11-22 | 2016-04-07 | Massachusetts Institute Of Technology | Instruments for minimally invasive surgical procedures |
US9370295B2 (en) | 2014-01-13 | 2016-06-21 | Trice Medical, Inc. | Fully integrated, disposable tissue visualization device |
US20160345952A1 (en) | 2014-01-29 | 2016-12-01 | Spinal Usa, Inc. | Minimally invasive devices, systems and methods for treating the spine |
US9980710B2 (en) | 2014-03-14 | 2018-05-29 | Globus Medical, Inc. | Surgical devices for access to surgical sites |
DE102014205312A1 (de) | 2014-03-21 | 2015-09-24 | Olympus Winter & Ibe Gmbh | Endoskopobjektiv, Verfahren zum Reinigen eines Endoskopobjektivs und zum Reparieren eines Endoskops |
EP3123963B1 (en) | 2014-03-27 | 2019-10-30 | Fujifilm Corporation | Endoscope surgical device, surgical tool and guide member |
US9414828B2 (en) | 2014-05-01 | 2016-08-16 | Blackstone Medical, Inc. | Integrated retractor-distractor system for use with modular bone screws |
US20150313633A1 (en) | 2014-05-05 | 2015-11-05 | Rainbow Medical Ltd. | Pericardial access device |
CN106659375A (zh) | 2014-05-13 | 2017-05-10 | Vycor医学有限责任公司 | 用于手术导引器的引导系统安装件 |
US20150335389A1 (en) | 2014-05-20 | 2015-11-26 | I. Melbourne Greenberg | Surgical tension setting system |
EP3685734B1 (en) | 2014-05-22 | 2022-03-09 | Invuity, Inc. | Medical device featuring cladded waveguide |
CN103976779B (zh) * | 2014-05-30 | 2016-09-21 | 上海市东方医院 | 椎间孔镜穿刺系统 |
US9566055B2 (en) | 2014-06-23 | 2017-02-14 | Kyphon SÀRL | Cannula with deployable anchor wire and methods of use |
WO2015200032A1 (en) | 2014-06-25 | 2015-12-30 | Spine Wave, Inc. | Minimally invasive posterolateral fusion |
US9980737B2 (en) | 2014-08-04 | 2018-05-29 | Medos International Sarl | Flexible transport auger |
WO2016025020A2 (en) | 2014-08-13 | 2016-02-18 | Nuvasive, Inc. | Minimally disruptive retractor and associated methods for spinal surgery |
US9924979B2 (en) | 2014-09-09 | 2018-03-27 | Medos International Sarl | Proximal-end securement of a minimally invasive working channel |
US10111712B2 (en) | 2014-09-09 | 2018-10-30 | Medos International Sarl | Proximal-end securement of a minimally invasive working channel |
CN107148235B (zh) | 2014-09-10 | 2019-10-08 | 直观外科手术操作公司 | 使用配合的导管尖端和工具的装置、系统及方法 |
US10426454B2 (en) | 2014-10-21 | 2019-10-01 | Globus Medical, Inc. | Orthopedic tools for implantation |
US10080488B2 (en) | 2014-12-12 | 2018-09-25 | Medix3d LLC | Cleaning device for cleaning a scope, laparoscope or microscope used in surgery or other medical procedures and a method of using the device during surgical or other medical procedures |
JP6750152B2 (ja) | 2015-01-09 | 2020-09-02 | 東レ・メディカル株式会社 | 内視鏡レンズ用清拭デバイス及びこの清拭デバイスを備えた内視鏡 |
DE102015100932A1 (de) | 2015-01-22 | 2016-07-28 | Aesculap Ag | Stent-Retraktor/Distraktor |
WO2016125013A2 (en) | 2015-02-05 | 2016-08-11 | Pro Med Instruments Gmbh | System and method for invasive and non-invasive head fixation |
KR101556881B1 (ko) | 2015-02-10 | 2015-10-01 | 강윤식 | 내시경 |
EP3258854A4 (en) | 2015-02-16 | 2018-10-31 | Eftekhar, Behzad | Surgical rectractor blade with distal end formation for engaging anchor pin |
US10143355B2 (en) | 2015-03-06 | 2018-12-04 | Innerspace Surgical Corporation | Instrument sleeve strengthening device |
US10786264B2 (en) | 2015-03-31 | 2020-09-29 | Medos International Sarl | Percutaneous disc clearing device |
US11337586B2 (en) | 2015-04-15 | 2022-05-24 | Trustees Of Boston University | Retractable endoscopic suction tube |
WO2016191419A1 (en) | 2015-05-27 | 2016-12-01 | University Of Maryland, Baltimore | Apparatus and method for placement of device along wall of a body lumen |
US10548467B2 (en) | 2015-06-02 | 2020-02-04 | GI Scientific, LLC | Conductive optical element |
EP3307186B1 (en) | 2015-06-11 | 2024-04-03 | Howmedica Osteonics Corp. | Spine-anchored targeting systems and methods for posterior spinal surgery |
WO2016204711A1 (en) | 2015-06-16 | 2016-12-22 | Spine Wave, Inc. | Instrument and system for placing graft, implant and graft material for minimally invasive posterolateral fusion |
WO2017006684A1 (ja) | 2015-07-07 | 2017-01-12 | 株式会社カネカ | 内視鏡用レンズ清掃具 |
EP3115004B1 (en) | 2015-07-09 | 2022-11-02 | Carevature Medical Ltd. | Abrasive cutting surgical instrument |
KR20180041140A (ko) | 2015-07-21 | 2018-04-23 | 지아이 사이언티픽, 엘엘씨 | 각도 조정성 배출 포털을 갖는 내시경 부속품 |
US10709324B2 (en) | 2015-07-31 | 2020-07-14 | Purdue Research Foundation | Systems and methods for performing a surgical procedure |
EP3334322A1 (en) | 2015-08-11 | 2018-06-20 | Trice Medical, Inc. | Fully integrated, disposable tissue visualization device |
US20220378408A1 (en) | 2015-09-04 | 2022-12-01 | Medos International Sarl | Surgical instrument connectors and related methods |
US10987129B2 (en) | 2015-09-04 | 2021-04-27 | Medos International Sarl | Multi-shield spinal access system |
CN113143355A (zh) | 2015-09-04 | 2021-07-23 | 美多斯国际有限公司 | 多护罩脊柱进入系统 |
US11672562B2 (en) | 2015-09-04 | 2023-06-13 | Medos International Sarl | Multi-shield spinal access system |
US11744447B2 (en) | 2015-09-04 | 2023-09-05 | Medos International | Surgical visualization systems and related methods |
US11439380B2 (en) | 2015-09-04 | 2022-09-13 | Medos International Sarl | Surgical instrument connectors and related methods |
WO2017083648A1 (en) | 2015-11-13 | 2017-05-18 | Bodner Daryl | Endoscope |
CN105286776B (zh) | 2015-11-19 | 2017-11-21 | 苏州点合医疗科技有限公司 | 一种全景式脊柱内镜装置 |
US10299838B2 (en) | 2016-02-05 | 2019-05-28 | Medos International Sarl | Method and instruments for interbody fusion and posterior fixation through a single incision |
US10813692B2 (en) | 2016-02-29 | 2020-10-27 | Covidien Lp | 90-degree interlocking geometry for introducer for facilitating deployment of microwave radiating catheter |
CA3013802A1 (en) | 2016-04-27 | 2017-11-02 | Csa Medical, Inc. | Vision preservation system for medical devices |
US10463402B2 (en) | 2016-07-13 | 2019-11-05 | Medos International Sàrl | Bone anchor assemblies and related instrumentation |
US11419614B2 (en) | 2017-01-11 | 2022-08-23 | Carevature Medical Ltd. | Surgical instrument with bended shaft |
JP6969875B2 (ja) | 2017-02-07 | 2021-11-24 | 株式会社Jimro | 内視鏡装置 |
US10499897B2 (en) | 2017-03-06 | 2019-12-10 | Thompson Surgical Instruments, Inc. | Distractor with bidirectional ratchet |
WO2018165365A2 (en) | 2017-03-08 | 2018-09-13 | Medos International Sàrl | Surgical visualization systems and related methods |
US20180333061A1 (en) | 2017-05-18 | 2018-11-22 | DePuy Synthes Products, Inc. | Neural monitoring devices and methods |
JP6242560B1 (ja) | 2017-08-02 | 2017-12-06 | 国立大学法人 長崎大学 | 硬性内視鏡のカバーおよび内視鏡ユニット |
WO2021209987A1 (en) | 2020-04-16 | 2021-10-21 | Carevature Medical Ltd. | Tissue debulking device |
-
2016
- 2016-09-01 US US15/254,877 patent/US10987129B2/en active Active
- 2016-09-02 EP EP16843037.9A patent/EP3344112B1/en active Active
- 2016-09-02 EP EP20212396.4A patent/EP3900607A1/en active Pending
- 2016-09-02 WO PCT/US2016/050022 patent/WO2017040873A1/en active Application Filing
- 2016-09-02 CN CN201680051245.4A patent/CN108135440A/zh active Pending
- 2016-09-02 JP JP2018511695A patent/JP6816122B2/ja active Active
-
2017
- 2017-02-21 US US15/437,792 patent/US10874425B2/en active Active
- 2017-08-31 US US15/692,845 patent/US11331090B2/en active Active
- 2017-09-07 US US15/697,494 patent/US11000312B2/en active Active
- 2017-10-18 US US15/786,891 patent/US10682130B2/en active Active
- 2017-10-18 US US15/786,846 patent/US10779810B2/en active Active
- 2017-10-18 US US15/786,858 patent/US10758220B2/en active Active
- 2017-10-18 US US15/786,923 patent/US10869659B2/en active Active
-
2018
- 2018-02-21 WO PCT/US2018/018905 patent/WO2018156550A1/en unknown
- 2018-02-21 CN CN201880013056.7A patent/CN110325092B/zh active Active
- 2018-02-21 EP EP18758290.3A patent/EP3585241A4/en active Pending
- 2018-02-21 AU AU2018225113A patent/AU2018225113B2/en active Active
- 2018-02-21 US US15/901,435 patent/US11344190B2/en active Active
- 2018-08-21 WO PCT/US2018/047136 patent/WO2019050666A1/en unknown
- 2018-08-21 CN CN201880058099.7A patent/CN111278365A/zh active Pending
- 2018-08-21 EP EP18854503.2A patent/EP3678559A4/en not_active Withdrawn
-
2020
- 2020-05-14 US US15/931,839 patent/US11801070B2/en active Active
- 2020-08-04 US US16/985,200 patent/US11806043B2/en active Active
-
2021
- 2021-01-26 US US17/159,129 patent/US11712264B2/en active Active
- 2021-03-26 US US17/214,759 patent/US11883064B2/en active Active
-
2022
- 2022-05-09 US US17/740,305 patent/US11793546B2/en active Active
-
2023
- 2023-09-30 US US18/479,048 patent/US20240023987A1/en active Pending
Also Published As
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN110325092B (zh) | 多护罩脊柱进入系统 | |
JP7208206B2 (ja) | マルチシールド脊椎アクセスシステム | |
US11672562B2 (en) | Multi-shield spinal access system | |
CA2836835A1 (en) | Method and apparatus for performing retro peritoneal dissection | |
JP7451660B2 (ja) | マルチシールド脊椎アクセスシステム | |
JP7346386B2 (ja) | マルチシールド脊椎アクセスシステム | |
US20240206909A1 (en) | Multi-shield spinal access system | |
EP3937820B1 (en) | Spinal access system |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
GR01 | Patent grant | ||
GR01 | Patent grant |