CN110505844A - 用于微创缝合的设备及方法 - Google Patents

用于微创缝合的设备及方法 Download PDF

Info

Publication number
CN110505844A
CN110505844A CN201880024645.5A CN201880024645A CN110505844A CN 110505844 A CN110505844 A CN 110505844A CN 201880024645 A CN201880024645 A CN 201880024645A CN 110505844 A CN110505844 A CN 110505844A
Authority
CN
China
Prior art keywords
needle
stitching devices
devices according
position detection
detection circuit
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.)
Granted
Application number
CN201880024645.5A
Other languages
English (en)
Other versions
CN110505844B (zh
Inventor
J·C·米德
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Intuitive Surgical Operations Inc
Original Assignee
Endoevolution LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Endoevolution LLC filed Critical Endoevolution LLC
Publication of CN110505844A publication Critical patent/CN110505844A/zh
Application granted granted Critical
Publication of CN110505844B publication Critical patent/CN110505844B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0491—Sewing machines for surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
    • 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
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A61B2017/00128—Electrical control of surgical instruments with audible or visual output related to intensity or progress of surgical action
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00199—Electrical control of surgical instruments with a console, e.g. a control panel with a display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00221—Electrical control of surgical instruments with wireless transmission of data, e.g. by infrared radiation or radiowaves
    • 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
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • 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
    • A61B2017/00411—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like actuated by application of energy from an energy source outside 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
    • 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
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00734—Aspects not otherwise provided for battery operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00778—Operations on blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/047—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from 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
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/0608—J-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • 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
    • A61B2034/303—Surgical robots specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
    • 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
    • A61B2090/0807—Indication means
    • A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Robotics (AREA)
  • Surgical Instruments (AREA)

Abstract

公开了一种用于微创缝合的装置和方法。一种用于微创缝合的缝合装置，其包括近段，所述近段具有近端端部、远端端部以及在它们之间的纵向轴线；缝合头部组件，其从近段的远端端部延伸；缝合针，其具有尖端和钝端，缝合针能够围绕大致垂直于近段的纵向轴线的轴线旋转，其中缝合针的尖端在缝合针旋转之前和之后定位在缝合头部组件中；以及致动器，其从近段的近端端部延伸以致动具有针驱动器的驱动机构，所述针驱动器用于接合和旋转缝合针。

Description

用于微创缝合的设备及方法
相关申请的交叉引用
本专利申请要求2017年2月26日提交的美国临时申请序列号62/463,724和2017年9月29日提交的美国专利申请序列号15/720,853的优先权。出于任何目的，上述专利申请的全部通过引用并入本文。
技术领域
本文公开的实施例涉及一种用于缝合组织的医疗装置，更具体地涉及一种用于在微创缝合期间操纵和控制缝合针的装置、用于制造这种装置的方法以及使用这种装置用于缝合组织的方法。
背景技术
微创手术(MIS)已经使得医生能够在比传统的开放手术具有更少疼痛和残疾的情况下执行许多外科手术。传统的开放手术中，手术部位可通过大切口轻松接近，从而使得外科医生能够轻松地观察和操纵组织和器械，与传统的开放手术不同，MIS要求外科医生通过小穿孔(“锁孔手术”)或通过天然孔(包括例如阴道、食道或肛门)插入和操纵器械进行远程操作。
在MIS中，通常在身体上实施小穿孔。然后通过套管插入医疗器械。套管具有小内直径，通常为5-10毫米(mm)，有时甚至高达20毫米(mm)或更大。对于任何给定的操作，可以将许多这样的套管插入体内。微创手术器械需要更小，并且通常也更长，因此更难以精确地操作。
MIS中最成问题的手术任务可能是缝合。缝合需要用双手协调操作小针和缝线以及通常用于手动缝合的几种器械(包括针驱动器和捡拾钳)，这些小针和缝线很难看到(特别是当只有间接的二维视频成像时)。在空间有限、可视化有限和移动有限的环境中，许多外科医生发现手工微创缝合是一项非常困难，通常几乎不可能的手术任务。
美国专利No.7,862,572和8,821,519中的实施例减轻了上述问题中的很多问题。然而，申请人已经认识到对这种类型的装置的进一步改进可以促进其使用。本公开涉及这种改进。
发明内容
本文公开了用于对身体内部组织进行微创缝合的装置和方法。特别地，提供了一种缝合装置，其包括弧形针，其具有前端、第二端和一段缝合部；壳体，在该壳体中限定轨道，该轨道接收针并限定针穿过的路径；针驱动器，其可操作为沿圆形路径旋转针；以及针位置检测电路。针位置检测电路优选地被配置并设置成指示针的一部分何时定位在沿圆形针路径的预定位置处。
在各种实施方式中，针位置检测电路被配置为可操作地耦合到电源。如果需要，针可以配置成当针存在于预定位置时闭合电路，从而显示针的位置。例如，电流可以穿过或沿着针的一部分流动，以便闭合电路。在一些实施方式中，针可被配置成致动闭合电路的机械开关。
在其他实施方式中，当针存在于预定位置时，针可以断开电路，以便检测针的位置。例如，针可以致动断开电路的机械开关。
在一些实施方式中，针位置检测电路可被配置为电耦合至缝合装置的缝合装置防旋转弹簧、缝合装置的驱动卡爪或缝合装置的另一部分。例如，针位置检测电路被配置为电耦合到缝合装置的针轨道，该针轨道限定针穿过的路径。
在一些实施例中，针位置检测电路可被配置为当针定位于预定位置时激活指示器。指示器可包括例如至少一个发光二极管，或其他照明装置、振动装置(例如，压电元件)或发声装置。在进一步的实施方式中，电路可以可操作地耦合到计算装置或无线装置，以将针位置信息发送到计算装置，使得针位置可以指示于用户装置的屏幕、手术室显示器等上。
在一些实施方式中，所述至少一个发光二极管可位于缝合装置的手柄中或手柄上。如果需要，指示器可包括多个发光二极管。例如，多个发光二极管可以设置成弧形并且间隔开以指示缝合装置中的针位置。
除了上面讨论的优点之外，本公开实施例的缝合装置相对简单且制造成本低。因此，缝合装置应该找到包括单缝线或连续缝线的广泛缝合应用(例如，螺旋缝合、直褥式缝合、荷包缝合等)，其需要闭合组织切口、附着移植物等。
通过下文描述的实施例说明了当前公开的实施例的这些和其他优点。因此，当前公开的实施例包括构造特征、元件组合和部件设置，这些将在以下详细描述中举例说明。
附图说明
参考附图将进一步解释本公开的实施例，其中在数个视图中相同的结构由相同的数字表示。所示的附图不一定按比例绘制，而是通常将重点放在说明当前公开的实施例的原理上。
图1-15是根据本公开的缝合装置的各种视图。
图16-23描述了具有针位置指示器电路的这种缝合装置的各方面。
虽然上述附图阐述了本公开的实施例，但如在讨论中所指出的，也可以考虑其他实施例。本公开通过表示而非限制的方式呈现说明性实施例。本领域技术人员可以设计出许多落入本发明公开的实施例的原理的范围和构思内的其他修改和实施例。
具体实施方式
图1和2示出了通常以150示出的缝合装置的可替代实施例。参考图1和2，缝合装置150可用于产生连续或间断的缝线或缝合，以便能够封闭患者体内的开口。缝合装置150可用于缝合任何类型的解剖腔体中的任何类型的解剖组织；因此，虽然下文中装置150描述为在内窥镜手术(诸如腹腔镜检查)中与套管一起使用，但装置150可用于开放手术并且可以与实现接近小腔体(诸如静脉和动脉)以及大腔体(诸如腹部)的导管和其他小直径及大直径管状或中空圆柱形构件一起使用。
在实施例中，缝合装置150包括通常以152示出的致动器机构，其包括细长筒154以及在细长筒154的近端端部处从下侧延伸的手柄160。位于细长筒154内的机械部件包括缆线，所述缆线从细长筒154穿过球形部分158延伸并且然后与缝合头部组件156中的驱动机构接合。球形部分158位于细长筒154的远端部分内并且以低摩擦旋转。在一个实施例中，驱动机构170包括滑轮系统以及从缝合头部组件156的远端端部延伸到细长筒154的近端端部的缆线。
缝合头部组件156容纳用于在完整的360度圆弧中驱动弯曲针220的机构。缝合头部组件156的定向为使得当针220附接到缝合头部组件156时，针220围绕大致垂直于装置150的纵向轴线的轴线以弯曲路径被驱动。以这种方式，当在圆弧中驱动针220时，针220可以被最优地可视。而且，如图1和图2所示，针220处于平行于驱动机构的平面中并且装配至缝合头部组件156中的相同空间中。
由缝合头部组件156的形状和构造提供的改进可见性使得能够在切口上精确地放置装置，并且在每次缝线之后均匀地推进缝合装置150以提供均匀且对称的缝合，从而最小化由于缝线定位得太靠近切开组织的边缘而撕裂组织和出血风险。在一个实施例中，整个装置150或装置150的一部分(诸如缝合头部组件156、细长筒154、手柄160和针220)由可消毒的医用级塑料材料构成，在这种情况下，整个装置150或装置150的一部分可以在一次使用之后丢弃并处置。在实施例中，装置150由可消毒的医用级金属材料(诸如不锈钢)构成，以使得在先前使用之后的消毒之后能够重复使用。在另一个实施例中，装置150由可消毒的医用级金属材料(诸如钛)组成，以便在先前使用之后的消毒之后重复使用。钛的使用对于某些手术是有益的，包括磁共振成像(MRI)和计算机断层扫描(CT)，这是因为钛具有X射线透射性并且不干扰MRI和CT扫描。
图3提供了缝合头部组件156的组装视图。缝合头部组件156由多个部件制成，包括保持器组件190、针保持器组件188、闩锁210、以及驱动机构170的一部分(包括涉及驱动针驱动器198通过半圆形路径的多个滑轮172,174和176以及两个惰轮滑轮180)。滑轮172和174可包括一组四个滑轮或两组滑轮，标记为178。在一个实施例中，针驱动器是卡爪198。肩螺钉208和多个针组件延伸部194可用于保持闩锁210锁定在针保持器组件188和缝合针220上方的适当位置处。针保持器组件188包括针220所乘骑的弯曲轨道192。滑轮172,174和176与致动器臂202接合，该致动器臂202附接到卡爪198。卡爪198与位于针220的面上的间隔大约180度的两个凹口232相互配合，该卡爪198在圆弧中驱动弯曲针220。缝合头部组件156被配置成使得卡爪198或本领域已知的其他针驱动器不会侵入或阻塞针220的弯曲部内的区域。针220的圆弧内的区域是畅通的；在圆弧的中心处没有毂，使得装置150可以在弯曲针220的圆弧内包围最大体积的组织。以这种方式，针220可以穿过相对大的弧旋转，从而允许针220获得对组织中的足够“咬合”。优选地，针220的曲率半径为约3mm至约40mm。在一个实施例中，装置150在缝合头部组件156的直径的限度内进行缝合，这有利于在微创手术期间穿过小套管进行缝合。在一个实施例中，弯曲针220的直径不超过缝合头部组件156的直径。
图4A和4B示出了关于在装置150的使用期间驱动针220的位于缝合头部组件156中的驱动机构170的详细视图(针保持器组件188和保持器组件190已被移除以详细示出驱动机构170)。驱动机构170包括与滑轮172,174和176接合的致动器臂202以及通过弯曲路径驱动针220的卡爪198。卡爪198位于致动器臂202的远端端部并且能够接合沿着针220的面定位的凹口232。扁平弹簧200使卡爪198保持接合到针220的凹口232中。当针220被推动时，卡爪198将克服扁平弹簧200被向上推回并允许针220轮转。当手柄160关闭和打开时，卡爪198移动通过与滑轮相同的弧度。致动器臂202由用户在挤压手柄160时启动，并且能够在跨越大约190度或更大的弧度中来回摆动。
图5示出了针保持器组件188的放大视图，示出了针220所在的弯曲轨道192以及有助于将闩锁210保持在适当位置的针保持器组件延伸部194。在缝合针220旋转期间，缝合针220沿着轨道192遵循弯曲路径。用于针220的弯曲轨道192可以加工到针组件188中并提供圈限弯曲轨道192，使得针220可以被精确驱动。弯曲轨道192包括内侧狭槽以及围绕内侧狭槽的更大狭槽。更大外侧狭槽为卡爪198提供游隙，使得卡爪198可以在不撞击任何东西的情况下机动，并且更小内侧狭槽为卡爪尖端199提供游隙，该卡爪尖端199穿过更小内侧狭槽然后进入针220中使得卡爪尖端199可以驱动针220。
图6示出了视图中具有针保持器组件188、保持器组件190、闩锁210和针220的缝合头部组件156的放大视图以及卡爪198和致动器臂202之间关于针220的关系。针220被封闭在针保持器组件188内，因此针220的尖锐尖端224不会暴露。在装载时的该针220位置被称为“原始”位置。在原始位置，针220完全容纳在针保持器组件188内，以在处理缝合头部组件156期间消除针刺。针组件延伸部194与闩锁210形成“榫槽”连接，其保持来自针220的力不会打开闩锁210的薄构件。针组件延伸部194在缝合装置的远端端部处引起截留，从而将闩锁210锁定在适当位置。挤压设备手柄160使装置150完整操作一个完整循环。对手柄160的第一完整致动驱动针220通过大约190度的弧度。针220的尖端224离开针保持器组件188的保护壳，驱动穿过待缝合的组织，并重新进入装置150的针保持器组件188的保护。在对手柄160的第一挤压之后，该位置称为“旋转”位置。然后释放手柄160，并且针220保持在旋转位置，而卡爪198和致动器臂220返回到它们的起始位置。然后再次挤压手柄160，从而驱动针220通过大约190度的弧度，使针220返回原始位置。扁平卡爪弹簧200使卡爪198保持接合在针220上的卡爪凹口232中。当针220被推动时，卡爪198将克服扁平卡爪弹簧200被向上推回并允许针220轮转。
图7和8示出了缝合头部组件156的顶视图。针保持器组件188与闩锁210形成连接。闩锁210在缝合针220上方形成顶盖，该缝合针220位于针保持器组件188的弯曲轨道192中。图7示出了处于打开位置的闩锁210，其用于将针220移除并用于将针220插入保持器组件188。为了插入和/或移除针220，用户可以将针220在其弯曲轨道192中自拉出位置旋转180度。用户可以用手或用手术工具抓住针220以安装针220或移除针220。通过抓住并提起针220，针220被移除。通过抓住针220，当闩锁210处于打开位置时，可以插入针220。图8示出了处于锁定位置的闩锁210，也称为前向位置。
图9示出了缝合针220。两个凹口232在针220的面上间隔大约180度定位并且有助于驱动针220。当驱动针220圆周运动时，卡爪198接合凹口232。第三凹口234位于针220的外表面上。凹口234通过防止针220的旋转而提供防旋转特征。针220形成为具有间隙222、尖锐尖端224以及钝端部226的圆形开口环。针220还包括开口230，以容纳缝合材料或线246的前端。在一个实施例中，开口230是眼睛状的，缝合材料或线246的前端可以穿过该开口230以用于附接到针220。在所示的针220中，针220包括呈圆柱形孔形式的开口230，该开口230相对于针220轴向对齐且位于钝端部226处。开口230可以沿着弧形或针220定位在顶点228和钝端部226之间的任何位置。缝合材料或线246的前端插入开口230中并通过机械夹持或本领域已知的其他连接方法约束。为了使针220能够穿透组织至所需深度，针220的弧长优选为约240度至约300度。针220包括沿着面的两个对称凹口232(“驱动凹口”)。凹口232直接彼此相反定位。类似的凹口234位于针220的径向外边缘上(“外凹口”)，其靠近更接近尖锐尖端224的内凹口232。外凹口234与防旋转弹簧接合，由此可以防止针220沿与前进方向相反的方向旋转或防止“针后退”。外凹口234在缝合装置的操作期间针的积极配合防止针220在缝合过程中偏离次序。
图10示出了与针220的驱动凹口232接合的卡爪尖端199的放大视图。驱动凹口232由驱动机构170的卡爪尖端199接合并使得针220能够在驱动机构170致动时经历旋转运动，从而使针220穿透组织并穿过组织前进。
图11和12示出了包括返回滑轮172和174的驱动机构170的一部分。滑轮172和174使用线材175彼此连接。如图4A和图4B所示，滑轮172和174由四个滑轮178组成，该四个滑轮178通过激光焊接或本领域已知的其他方法连接在一起。四个滑轮178产生大约190度的过旋转。过旋转导致其中在每组滑轮178上均存在线材175的线材175设计。如图11和图12所示，存在与四个滑轮178一起的两根线材175，从而导致四个滑轮178即使在负载下也彼此同步。四个滑轮178旋转同步，即，一个滑轮178将跟随另一个滑轮178，这是因为线材175被配置为彼此拉动。线材175可以通过线材175所焊接至的孔而附接到滑轮178。图12示出了缝合头部组件156的侧视图，其示出了将四个滑轮178连接在一起以用于同步旋转的两根线材175。
图13和14结合图15分别示出了缆线184和186至驱动滑轮176以及至返回滑轮172和174的连接和位置，以及缆线184和186在手柄160处于打开位置时的连接和位置。缆线184和186可以由不锈钢制成。连接在缝合头部组件156的近端端部处的是球形部分158，其包含驱动机构170的一部分，包括两个惰轮滑轮180以及缆线184和186。图13示出了缝合头部组件156的俯视图，其中缆线184穿过两个惰轮滑轮180延伸并缠绕在驱动滑轮176周围。图14示出了缝合头部组件156的俯视图，其中缆线186穿过两个惰轮滑轮180延伸并缠绕在返回滑轮174周围。缆线186从返回滑轮174穿过细长圆筒154延伸并且到达手柄160的极近端端部。将针220从原始位置(如图13和14所示)移动到旋转位置的力来自复位弹簧240，该复位弹簧240连接到缆线184，导致预加载(如图15所示)。当手柄160的扳机被挤压闭合时，手柄160移动到关闭位置，并且驱动滑轮176逆时针转动，从而驱动针220。同时，缆线186逆时针驱动返回滑轮174并使致动器臂202轮转以驱动针220向前穿过组织。针220以圆周运动驱动通过一个循环，并且缆线184在另一端部压缩复位弹簧240。当手柄160更进一步闭合时，致动器臂202驱动针。当手柄160的扳机被释放时，现在用复位弹簧240完全负载的前滑轮178将使针220返回到原始位置。复位弹簧240拉动缆线184，使滑轮返回到它们的起始位置，并使致动器臂202返回到与针220的第二驱动凹口接合的位置。第二压缩释放循环使针220返回到原始位置。放松手柄160的扳机不需要动力。
图15示出了缝合装置150的侧视图。手柄160包括多个内部部件，缆线连接器182具有孔和肩部。肩部乘靠复位弹簧240的端部，并且孔为缆线184提供开口。复位弹簧240被压缩并且缆线184被焊合或锁定到连接器182，使得缆线184在复位弹簧240上提供预加载。缆线184从连接器182在滑轮244上方延伸通过复位弹簧240、延伸通过细长筒154、延伸通过球形部分158、在惰轮滑轮180之间延伸并固定到驱动滑轮176。缆线186连接在手柄160的极近端端部处并且位于滑轮245下方、滑轮242上方、通过细长筒154、通过球形部分158、在惰轮滑轮180之间并固定到返回滑轮174。
当手柄160从打开位置平移到闭合位置时，针220被驱动穿过组织。当针220移动时，用户具有触感。如果针220穿过不可穿透的东西，则手柄160将停止移动并且用户可以在握住手柄的手中感觉到这一点。当手柄160处于关闭位置时，复位弹簧240承担负载，复位弹簧240长度缩短。当手柄160被释放时，复位弹簧240拉动缆线184并使针220返回到原始位置并且还使手柄160返回到打开位置。复位弹簧240在缆线184上提供负载。在整个缝合装置150上形成环，其包括缆线184和186以及滑轮172,174和176，使得缆线184在一个端部处附接到复位弹簧240并且在另一端部处附接到驱动滑轮176。缆线186附接到返回滑轮174，然后缆线186附接到手柄160的极近端端部，从而形成环。复位弹簧240可以设定为所需的弹簧刚度，使得复位弹簧240按照用户的要求执行。复位弹簧240应该具有少量预加载以确保手柄160一直打开，这实现了驱动机构170将使针220返回到原始位置。
缆线184和186延伸通过细长筒154并连接到缝合头部组件156中的驱动机构170。缆线184和186的长长度提供少量弹簧缓冲器。如果缝合装置150将受困或者在缝合头部组件156处锁卡某物，则这将不会平移。如果用户继续拉动手柄160以关闭手柄160，则缆线184和186将伸展并且不应断裂。驱动缆线184和186的两个惰轮滑轮180位于球形部分158中。如图11所示，两个惰轮滑轮180看起来彼此叠置，但是它们位于具有滑轮174和176或滑轮178的平面中(见图3)。
进一步根据本公开，提供了缝合装置的实施例，其包括具有前端、第二端部和一段缝合部的弧形针；在其中限定轨道的壳体，该轨道接收针并限定针穿过的路径；可操作为沿着圆形轨道中的圆形路径推进针的针驱动器；以及包括针位置检测电路的针位置检测器。针位置检测电路优选地被配置和设置成指示针的一部分何时定位在沿着圆形针路径的预定位置处。
出于说明而非限制的目的，图16-23描绘了如上所述或如US 9,642,613中所述的缝合装置的各个方面，该缝合装置另外具有针位置检测器，该针位置检测器又包括针位置检测电路，该针位置检测电路被配置成确定缝合针相对于缝合装置的针轨道的位置。应当理解，关于针位置检测电路的本教导适用于具有圆形针驱动器的其他装置。在一些实施例中，针可被配置成当针存在于预定位置时闭合电路，从而显示针的位置。例如，电流可以穿过针的一部分或沿着针的一部分流动，以便闭合电路。在一些实施方式中，针可被配置成致动闭合电路的机械开关。例如，缝合装置可以沿着针轨道设置有离散开关，这些离散开关可以通过针压靠它们而接合和移位。当针的压力施加到这些离散开关时，这些开关可以闭合或打开电路。在相关实施例中，当针存在于预定位置时，针可以断开电路，以便检测针的位置。例如，针可以致动断开电路的机械开关。在一些实施例中，针位置检测电路可被配置为当针位于预定位置时激活指示器。指示器可包括例如至少一个发光二极管，或其他照明装置、振动装置(例如，压电元件)或发声装置。在进一步的实施方式中，电路可以可操作地耦合到计算装置或无线装置，以将针位置信息发送到计算装置，使得针位置可以指示于用户装置的屏幕、手术室显示器等上。
在一些实施例中，至少一个发光二极管可以位于缝合装置的手柄中或手柄上。如果需要，指示器可包括多个发光二极管。例如，多个发光二极管可以布置成弧形并且间隔开以指示针在缝合装置中的位置。
参考图16，可以提供闩锁712的替代实施例以覆盖缝合装置的缝合头部内的缝合针。具体而言，如图16-19所示，提供了闩锁712并且优选地将闩锁712偏压(例如，通过弹簧)至关闭位置。虽然闩锁712可以通过推动闩锁712自身而向近端缩回，但是在手术期间，闩锁712可能不容易接近。因此，如果装置应该卡住，为了避免难以向后移动闩锁以允许针从装置中脱离，则提供拉线716，其在其远端端部处附接到闩锁712(孔口714的内部)且在其近端端部处附接到释放扳机，与图72的实施例一样。
然而，如图所示，第二孔口715也在孔口714旁设置在闩锁712中。孔口715连接到通道720，该通道720被切成至闩锁712的下侧。孔口720自孔口715的远端端部处的接合部延伸并延伸通过闩锁712的长度，终止于闩锁712的弧形端，当闩锁闭合时，闩锁712的该弧形端紧邻装置的针，从而将针保持在针轨道中的适当位置。设置在通道720内的是导体722，其包括由绝缘层726围绕的导电内部构件724，诸如电线。导电内部构件724的远侧尖端部分至少在其下侧暴露并且设置成当缝合针的一部分与电线724重合时接触弧形缝合针。在一些实施例中，接收闩锁712的保持器组件190电耦合到缝合装置的手柄760(诸如通过单独的导体或者通过缝合装置的导电部分)，该手柄760又电耦合到LED和电源780，诸如电池或电容器。因此，当针接触导电内部构件724并且还接触保持器组件190时，可以导通电路，这使得LED770发光。这可以通过由金属或其他导电材料来制造部件190以及缝合装置的其他部件来促进。可替代地，第二导体或导电垫可以放置在针轨道上和/或针轨道本身可以是金属，或者设置有导电涂层。同样，第二绝缘导体可以通过导体722从缝合头部向近端途径至手柄，以允许针位置检测电路延伸到缝合装置的手柄中。可以理解，当针与导体724不接触时，电路是断开的而不是闭合的，并且没有检测到针的存在。
进一步参考图20，呈现了缝合装置的手柄760。一个或多个导体774向近端延伸到手柄中，该一个或多个导体774承载指示如本文所述的一个或多个针位置检测电路的闭合的电信号。一个或多个导体774延伸通过手柄760以通过耦合到电源780和LED来导通针位置检测电路。如果需要，该电路还可以包括本领域已知的无线发射器792，以无线地发送针位置信息。而且，如果需要，针位置检测电路的一部分，包括电池和/或无线发射器，可以设置在无菌的可移除模块790中，并且可以在使用前在手术室中附接到缝合装置。在另一个实施例中，针位置检测电路的所有部件可以整体地形成在手柄或缝合装置的其他所需部分中。
在进一步的实施例中，可以提供沿着针轨道设置在间隔位置处的多个(两个或更多个)导体。如果需要，导体可以沿针轨道每15度、30度、45度、60度或90度放置，如图21-22的实施例那样。图21示出了沿着闩锁712的弧形远侧边缘放置十一个接触垫728的实施例，其中每个垫连接到单独的绝缘导体729，该绝缘导体729穿过闩锁712的通道720返回到手柄。当缝合针沿着针轨道前进时，每个连续的接触垫728被针接触，通过导体729导通相对于每个垫728的电路。该信息可用于照亮装置手柄上的相应LED。如果需要，如图22所示，LED802可以周向布置，使得每个接触垫728沿着针轨道的周向位置对应于手柄上的显示器800上的每个LED的周向位置，从而提供关于针的位置的连续反馈。如果需要，通过提供与接触垫配准的位置处的间隙以及实际缝合装置的间隙，可以在标记中提供间隙810在针轨道中的相对位置。应当理解，当缝合装置位于患者体内并且可见度不可用时，通过电接触的位置确认可以非常有效地确认针位置。
图23是包括机器人操纵器920的手术机器人900的示意图，机器人操纵器920可以可释放地附接到缝合头部(例如，156)并且由计算机930控制，计算机930又可以设置有显示器940。缝合头部/机器人的旋转接头可以设置有线性或旋转电位计，例如以确认机器人操纵器920的各种部件的角位移。计算机930可以特别适于操作机器人操纵器，并且可以配置成在显示器940上显示所需的图像。在一些实施方式中，计算机930可以使用来自本文所述的针位置检测电路的信号来确定针在缝合头部156的针轨道中的位置。然后可以使用针位置信息在显示器940上显示针相对于针轨道的位置。在各种实施方式中，针位置检测电路被配置为可操作地耦合到电源，例如电池，如上所述。可替代地，缝合装置可设置有电源和/或数据端口(例如，794)，以便于消毒以及针位置信息的发送。
在一些实施方式中，针位置检测电路可被配置为电耦合至缝合装置的缝合装置防旋转弹簧、缝合装置的驱动卡爪或缝合装置的另一部分。例如，针位置检测电路被配置为电耦合到缝合装置的针轨道，该针轨道限定针穿过的路径。还应当理解，本文所述的缝合装置的各种部件可以配置成传导低压信号以确认何时相对于针发生某些物理接触。例如，防旋转弹簧116、卡爪98或驱动销198/弹簧200可以设置有电流，当它们接触针时可以通过针导通电路。在一些实施例中，针的表面可涂覆有绝缘材料，但针的凹口的接合表面/针的尾缘可被暴露。这可用于确认，例如，何时针的驱动凹口与针驱动器接合，以及何时防旋转凹口与针接合。
本公开实施例的缝合装置可用于腹腔镜手术，包括但不限于腹腔镜结肠造口术、结肠切除术、肾上腺切除术、脾切除术、食管疝修补术、腹股沟疝修补术、腹侧疝修补术、尼森胃底折叠术、肝叶切除术、胃切除术、小肠切除术、治疗小肠梗阻、远端胰腺切除术、肾切除术和胃旁路术。本领域技术人员将认识到，本发明公开的实施例可用于其他腹腔镜手术。
在使用当前公开的实施例的装置150时，腹部充满气体以为用户创造工作空间。可以使用本领域技术人员已知的任何气体，包括但不限于氮气或二氧化碳。在适合特定外科手术的位置使用套管针建立进入端口。然后可以通过这些进入端口/套管将各种手术器械插入体内。然后用户将缝合装置150的远端端部部分引入套管中，然后使用位于手柄160顶部的远侧的铰接杆166侧向铰接缝合头部组件156。然后将缝合头部组件156相对于要缝合在一起的组织/血管定位，且用户将使用锁定杆164将缝合头部组件156锁定到适当位置。然后用户通过操纵缝合装置150将多个分离的组织片段定位到在缝合头部组件156的远端端部部分处以及在针保持器组件188的孔218内限定的开口中。用户可以仅使用一只手操纵装置150，同时致动手柄160以用连续缝合闭合切口，该连续缝合的缝线可以沿着缝合的长度精确且均匀地单独地张紧，类似于以常规方式用手进行的缝合。用户可以使用延伸切口的整个长度的单个缝合或多个缝合。因此，通过利用跨越切开的组织部段的针保持器组件孔218来放置缝合装置150并且致动手柄160，缝合装置150使得用户能够放下延伸缝线或间断缝线以按时间有效方式闭合组织切口。本领域技术人员将认识到，用于进行腹腔镜手术的任何常规程序可与装置150一起使用。
用户可以继续操纵缝合装置150，交替地推进和致动针220围绕大致平行于前进方向的轴的旋转，以产生可以延伸穿过切口的整个长度的连续缝合或一系列间断的缝线。在铺设每个单独的缝线之后，通过在缝合材料或线246上施加拉力来紧固缝线，使得所得的缝合沿着切开的组织部段的长度均匀地张紧。因此，实现了部段的紧密闭合，并且使组织的出血和撕裂最小化。一旦放置了适当量的缝合材料或线246，用户就可以使用针抓紧器来收紧和打结所形成的缝线。
本文引用的所有专利，专利申请和公开的参考文献均通过引用整体并入本文。应当理解，上述公开的和其他特征和功能中的一个或多个或其替代方案可以按需组合到许多其他不同的系统或应用中。本领域技术人员随后可以进行各种目前无法预料或未预料到的替代、修改、变化或改进，其也旨在被本公开所涵盖。

Claims (20)

1.一种缝合装置，包括：
弧形针，其具有前端、第二端部以及一段缝合部；
壳体，在壳体中限定轨道，所述轨道接收所述针并限定所述针穿过的路径；
针驱动器，其能够操作为沿圆形路径旋转所述针；以及
针位置检测电路，其中所述针位置检测电路被配置并设置成指示所述针的一部分何时定位于沿所述圆形针路径的预定位置处。
2.根据权利要求1所述的缝合装置，其中，所述针位置检测电路被配置为可操作地耦合到电源。
3.根据权利要求1所述的缝合装置，其中，当所述针存在于所述预定位置时，所述针闭合电路。
4.根据权利要求3所述的缝合装置，其中，电流穿过所述针的一部分或沿着所述针的一部分流动，以便闭合所述电路。
5.根据权利要求3所述的缝合装置，其中，所述针致动闭合所述电路的机械开关。
6.根据权利要求1所述的缝合装置，其中，当所述针存在于所述预定位置时，所述针断开电路，以用于检测所述针的位置。
7.根据权利要求6所述的缝合装置，其中，所述针致动断开所述电路的机械开关。
8.根据权利要求1所述的缝合装置，其中，所述针位置检测电路被配置为电耦合到所述缝合装置的防旋转弹簧。
9.根据权利要求1所述的缝合装置，其中，所述针位置检测电路被配置为电耦合到所述缝合装置的驱动卡爪。
10.根据权利要求1所述的缝合装置，其中，所述针位置检测电路被配置为电耦合到所述缝合装置的针轨道，所述针轨道限定所述针穿过的路径。
11.根据权利要求1所述的缝合装置，其中，所述针位置检测电路被配置为当所述针位于所述预定位置时激活指示器。
12.根据权利要求11所述的缝合装置，其中，所述指示器包括至少一个发光二极管。
13.根据权利要求12所述的缝合装置，其中，所述发光二极管位于所述缝合装置的手柄中。
14.根据权利要求12所述的缝合装置，其中，所述指示器包括多个发光二极管。
15.根据权利要求14所述的缝合装置，其中，所述多个发光二极管设置成弧形并且间隔开以指示在所述缝合装置中的针定位。
16.一种机器人手术系统，其包括可操作地耦合到计算机的机器人操纵器，所述机器人操纵器包括可操作地耦接到所述机器人操纵器的根据权利要求1的缝合装置。
17.根据权利要求16所述的系统，其中，由所述针位置检测电路检测的针位置检测数据被发送到计算机，其中所述计算机被配置成基于所述针位置检测数据确定所述针的位置。
18.根据权利要求17所述的系统，其中，所述系统被配置为在所述系统的显示器上实时显示所述针在所述缝合装置内的位置的呈现。
19.根据权利要求2所述的缝合装置，其中，所述电源包括电池。
20.根据权利要求19所述的缝合装置，其中，所述电池容纳在可移除的无菌模块中，所述可移除的无菌模块包括至少一个LED以及用于发送指示所述针的位置的数据的至少一个无线发射器。
CN201880024645.5A 2017-02-26 2018-02-19 用于微创缝合的设备及方法 Active CN110505844B (zh)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US201762463724P 2017-02-26 2017-02-26
US62/463,724 2017-02-26
US15/720,853 2017-09-29
US15/720,853 US20180242967A1 (en) 2017-02-26 2017-09-29 Apparatus and method for minimally invasive suturing
PCT/US2018/018627 WO2018156456A1 (en) 2017-02-26 2018-02-19 Apparatus and method for minimally invasive suturing

Publications (2)

Publication Number Publication Date
CN110505844A true CN110505844A (zh) 2019-11-26
CN110505844B CN110505844B (zh) 2023-09-01

Family

ID=63245464

Family Applications (1)

Application Number Title Priority Date Filing Date
CN201880024645.5A Active CN110505844B (zh) 2017-02-26 2018-02-19 用于微创缝合的设备及方法

Country Status (5)

Country Link
US (3) US20180242967A1 (zh)
EP (1) EP3585273A4 (zh)
KR (1) KR102577941B1 (zh)
CN (1) CN110505844B (zh)
WO (1) WO2018156456A1 (zh)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111419310A (zh) * 2020-04-20 2020-07-17 邦尼医疗科技(常州)有限公司 腹腔镜缝合器
WO2021217373A1 (zh) * 2020-04-27 2021-11-04 浙江左元医疗技术有限公司 缝合器、具有缝合器的治疗装置以及治疗系统

Families Citing this family (132)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11871901B2 (en) 2012-05-20 2024-01-16 Cilag Gmbh International Method for situational awareness for surgical network or surgical network connected device capable of adjusting function based on a sensed situation or usage
US11504192B2 (en) * 2014-10-30 2022-11-22 Cilag Gmbh International Method of hub communication with surgical instrument systems
CN112353490A (zh) * 2015-05-15 2021-02-12 直观外科手术操作公司 用于微创切割器械操作的系统和方法
US11241576B2 (en) 2015-09-14 2022-02-08 University Of Iowa Research Foundation Controlled position electrode array
US12011594B2 (en) 2015-09-14 2024-06-18 Iotamotion, Inc. Modular implant delivery and positioning system
WO2018152203A2 (en) 2017-02-14 2018-08-23 Iotamotion, Inc. Modular implant delivery and positioning system
AU2016323425B2 (en) 2015-09-15 2020-10-22 Savage Medical, Inc. Devices and methods for anchoring a sheath in a tissue cavity
US11064904B2 (en) 2016-02-29 2021-07-20 Extremity Development Company, Llc Smart drill, jig, and method of orthopedic surgery
US10945761B2 (en) * 2017-02-14 2021-03-16 Iotamotion, Inc. Modular implant delivery and positioning system
US11801098B2 (en) 2017-10-30 2023-10-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11026687B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Clip applier comprising clip advancing systems
US11510741B2 (en) 2017-10-30 2022-11-29 Cilag Gmbh International Method for producing a surgical instrument comprising a smart electrical system
US11317919B2 (en) 2017-10-30 2022-05-03 Cilag Gmbh International Clip applier comprising a clip crimping system
US11291510B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11911045B2 (en) 2017-10-30 2024-02-27 Cllag GmbH International Method for operating a powered articulating multi-clip applier
US10980560B2 (en) 2017-10-30 2021-04-20 Ethicon Llc Surgical instrument systems comprising feedback mechanisms
US11229436B2 (en) 2017-10-30 2022-01-25 Cilag Gmbh International Surgical system comprising a surgical tool and a surgical hub
US11311342B2 (en) 2017-10-30 2022-04-26 Cilag Gmbh International Method for communicating with surgical instrument systems
US11564756B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11253315B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Increasing radio frequency to create pad-less monopolar loop
US11659023B2 (en) 2017-12-28 2023-05-23 Cilag Gmbh International Method of hub communication
US11857152B2 (en) 2017-12-28 2024-01-02 Cilag Gmbh International Surgical hub spatial awareness to determine devices in operating theater
US11376002B2 (en) 2017-12-28 2022-07-05 Cilag Gmbh International Surgical instrument cartridge sensor assemblies
US11234756B2 (en) 2017-12-28 2022-02-01 Cilag Gmbh International Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter
US11786245B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Surgical systems with prioritized data transmission capabilities
US11464559B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Estimating state of ultrasonic end effector and control system therefor
US11132462B2 (en) 2017-12-28 2021-09-28 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11903601B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Surgical instrument comprising a plurality of drive systems
US11109866B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Method for circular stapler control algorithm adjustment based on situational awareness
US11633237B2 (en) 2017-12-28 2023-04-25 Cilag Gmbh International Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures
US11100631B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Use of laser light and red-green-blue coloration to determine properties of back scattered light
US11969142B2 (en) 2017-12-28 2024-04-30 Cilag Gmbh International Method of compressing tissue within a stapling device and simultaneously displaying the location of the tissue within the jaws
US11559307B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method of robotic hub communication, detection, and control
US11424027B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Method for operating surgical instrument systems
US11896443B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Control of a surgical system through a surgical barrier
US11540855B2 (en) 2017-12-28 2023-01-03 Cilag Gmbh International Controlling activation of an ultrasonic surgical instrument according to the presence of tissue
US11291495B2 (en) 2017-12-28 2022-04-05 Cilag Gmbh International Interruption of energy due to inadvertent capacitive coupling
US20190201139A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Communication arrangements for robot-assisted surgical platforms
US11937769B2 (en) 2017-12-28 2024-03-26 Cilag Gmbh International Method of hub communication, processing, storage and display
US11612408B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Determining tissue composition via an ultrasonic system
US11273001B2 (en) 2017-12-28 2022-03-15 Cilag Gmbh International Surgical hub and modular device response adjustment based on situational awareness
US11284936B2 (en) 2017-12-28 2022-03-29 Cilag Gmbh International Surgical instrument having a flexible electrode
US11419630B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Surgical system distributed processing
US11998193B2 (en) 2017-12-28 2024-06-04 Cilag Gmbh International Method for usage of the shroud as an aspect of sensing or controlling a powered surgical device, and a control algorithm to adjust its default operation
US11969216B2 (en) 2017-12-28 2024-04-30 Cilag Gmbh International Surgical network recommendations from real time analysis of procedure variables against a baseline highlighting differences from the optimal solution
US11304720B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Activation of energy devices
US11257589B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes
US11571234B2 (en) 2017-12-28 2023-02-07 Cilag Gmbh International Temperature control of ultrasonic end effector and control system therefor
US11602393B2 (en) 2017-12-28 2023-03-14 Cilag Gmbh International Surgical evacuation sensing and generator control
US11744604B2 (en) 2017-12-28 2023-09-05 Cilag Gmbh International Surgical instrument with a hardware-only control circuit
US11423007B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Adjustment of device control programs based on stratified contextual data in addition to the data
US11324557B2 (en) 2017-12-28 2022-05-10 Cilag Gmbh International Surgical instrument with a sensing array
US11432885B2 (en) 2017-12-28 2022-09-06 Cilag Gmbh International Sensing arrangements for robot-assisted surgical platforms
US11559308B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure
US11056244B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks
US10943454B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Detection and escalation of security responses of surgical instruments to increasing severity threats
US11069012B2 (en) 2017-12-28 2021-07-20 Cilag Gmbh International Interactive surgical systems with condition handling of devices and data capabilities
US11529187B2 (en) 2017-12-28 2022-12-20 Cilag Gmbh International Surgical evacuation sensor arrangements
US11589888B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Method for controlling smart energy devices
US10944728B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Interactive surgical systems with encrypted communication capabilities
US11166772B2 (en) 2017-12-28 2021-11-09 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
US10892995B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11410259B2 (en) 2017-12-28 2022-08-09 Cilag Gmbh International Adaptive control program updates for surgical devices
US11364075B2 (en) 2017-12-28 2022-06-21 Cilag Gmbh International Radio frequency energy device for delivering combined electrical signals
US11076921B2 (en) 2017-12-28 2021-08-03 Cilag Gmbh International Adaptive control program updates for surgical hubs
US11678881B2 (en) 2017-12-28 2023-06-20 Cilag Gmbh International Spatial awareness of surgical hubs in operating rooms
US10595887B2 (en) 2017-12-28 2020-03-24 Ethicon Llc Systems for adjusting end effector parameters based on perioperative information
US11304745B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical evacuation sensing and display
US11672605B2 (en) 2017-12-28 2023-06-13 Cilag Gmbh International Sterile field interactive control displays
US11051876B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Surgical evacuation flow paths
US11266468B2 (en) 2017-12-28 2022-03-08 Cilag Gmbh International Cooperative utilization of data derived from secondary sources by intelligent surgical hubs
US11096693B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing
US11304699B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11896322B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub
US11786251B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11278281B2 (en) 2017-12-28 2022-03-22 Cilag Gmbh International Interactive surgical system
US11666331B2 (en) 2017-12-28 2023-06-06 Cilag Gmbh International Systems for detecting proximity of surgical end effector to cancerous tissue
US11308075B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical network, instrument, and cloud responses based on validation of received dataset and authentication of its source and integrity
US11446052B2 (en) 2017-12-28 2022-09-20 Cilag Gmbh International Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue
US11160605B2 (en) 2017-12-28 2021-11-02 Cilag Gmbh International Surgical evacuation sensing and motor control
US10987178B2 (en) 2017-12-28 2021-04-27 Ethicon Llc Surgical hub control arrangements
US10758310B2 (en) 2017-12-28 2020-09-01 Ethicon Llc Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US11389164B2 (en) 2017-12-28 2022-07-19 Cilag Gmbh International Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices
US11464535B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Detection of end effector emersion in liquid
US11202570B2 (en) 2017-12-28 2021-12-21 Cilag Gmbh International Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems
US11419667B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Ultrasonic energy device which varies pressure applied by clamp arm to provide threshold control pressure at a cut progression location
US11179208B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Cloud-based medical analytics for security and authentication trends and reactive measures
US11612444B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Adjustment of a surgical device function based on situational awareness
US11317937B2 (en) 2018-03-08 2022-05-03 Cilag Gmbh International Determining the state of an ultrasonic end effector
US11311306B2 (en) 2017-12-28 2022-04-26 Cilag Gmbh International Surgical systems for detecting end effector tissue distribution irregularities
US11832899B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical systems with autonomously adjustable control programs
US10932872B2 (en) 2017-12-28 2021-03-02 Ethicon Llc Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set
US11304763B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Image capturing of the areas outside the abdomen to improve placement and control of a surgical device in use
US11213359B2 (en) 2017-12-28 2022-01-04 Cilag Gmbh International Controllers for robot-assisted surgical platforms
US11818052B2 (en) 2017-12-28 2023-11-14 Cilag Gmbh International Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US20190201039A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Situational awareness of electrosurgical systems
US11832840B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical instrument having a flexible circuit
US11864728B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Characterization of tissue irregularities through the use of mono-chromatic light refractivity
US11147607B2 (en) 2017-12-28 2021-10-19 Cilag Gmbh International Bipolar combination device that automatically adjusts pressure based on energy modality
US10898622B2 (en) 2017-12-28 2021-01-26 Ethicon Llc Surgical evacuation system with a communication circuit for communication between a filter and a smoke evacuation device
US10966791B2 (en) 2017-12-28 2021-04-06 Ethicon Llc Cloud-based medical analytics for medical facility segmented individualization of instrument function
US11576677B2 (en) 2017-12-28 2023-02-14 Cilag Gmbh International Method of hub communication, processing, display, and cloud analytics
US11259830B2 (en) 2018-03-08 2022-03-01 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
US11839396B2 (en) 2018-03-08 2023-12-12 Cilag Gmbh International Fine dissection mode for tissue classification
US11701162B2 (en) 2018-03-08 2023-07-18 Cilag Gmbh International Smart blade application for reusable and disposable devices
US11589865B2 (en) 2018-03-28 2023-02-28 Cilag Gmbh International Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems
US11090047B2 (en) 2018-03-28 2021-08-17 Cilag Gmbh International Surgical instrument comprising an adaptive control system
US11096688B2 (en) 2018-03-28 2021-08-24 Cilag Gmbh International Rotary driven firing members with different anvil and channel engagement features
US10973520B2 (en) 2018-03-28 2021-04-13 Ethicon Llc Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature
US11219453B2 (en) 2018-03-28 2022-01-11 Cilag Gmbh International Surgical stapling devices with cartridge compatible closure and firing lockout arrangements
US11166716B2 (en) 2018-03-28 2021-11-09 Cilag Gmbh International Stapling instrument comprising a deactivatable lockout
US11471156B2 (en) 2018-03-28 2022-10-18 Cilag Gmbh International Surgical stapling devices with improved rotary driven closure systems
US11278280B2 (en) 2018-03-28 2022-03-22 Cilag Gmbh International Surgical instrument comprising a jaw closure lockout
US11207067B2 (en) 2018-03-28 2021-12-28 Cilag Gmbh International Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing
US20220104883A1 (en) * 2019-01-30 2022-04-07 Extremity Development Company, Llc Position sensing system for medical devices, orthopedic drill or driver, and method of performing surgery
IL264561A (en) * 2019-01-31 2020-08-31 Lydus Medical Ltd device for anastomosis
US11751872B2 (en) 2019-02-19 2023-09-12 Cilag Gmbh International Insertable deactivator element for surgical stapler lockouts
US11291445B2 (en) 2019-02-19 2022-04-05 Cilag Gmbh International Surgical staple cartridges with integral authentication keys
US11369377B2 (en) 2019-02-19 2022-06-28 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout
US11357503B2 (en) 2019-02-19 2022-06-14 Cilag Gmbh International Staple cartridge retainers with frangible retention features and methods of using same
US11317915B2 (en) 2019-02-19 2022-05-03 Cilag Gmbh International Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers
USD950728S1 (en) 2019-06-25 2022-05-03 Cilag Gmbh International Surgical staple cartridge
USD952144S1 (en) 2019-06-25 2022-05-17 Cilag Gmbh International Surgical staple cartridge retainer with firing system authentication key
USD964564S1 (en) 2019-06-25 2022-09-20 Cilag Gmbh International Surgical staple cartridge retainer with a closure system authentication key
US11653912B2 (en) 2019-12-12 2023-05-23 Intuitive Surgical Operations, Inc. Needle driver devices and related systems and methods
US11896442B2 (en) 2019-12-30 2024-02-13 Cilag Gmbh International Surgical systems for proposing and corroborating organ portion removals
US11832996B2 (en) 2019-12-30 2023-12-05 Cilag Gmbh International Analyzing surgical trends 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
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
US12002571B2 (en) 2019-12-30 2024-06-04 Cilag Gmbh International Dynamic surgical visualization systems
US11744667B2 (en) 2019-12-30 2023-09-05 Cilag Gmbh International Adaptive visualization by a surgical system
US11284963B2 (en) 2019-12-30 2022-03-29 Cilag Gmbh International Method of using imaging devices in surgery

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070239206A1 (en) * 2006-03-31 2007-10-11 Shelton Frederick E Iv Suture with adhesive/sealant delivery mechanism
WO2008147555A2 (en) * 2007-05-24 2008-12-04 Suturtek Incorporated Apparatus and method for minimally invasive suturing
US20090024145A1 (en) * 2006-01-27 2009-01-22 Meade John C Apparatus and method for sternotomy closure
US20100152751A1 (en) * 2004-09-20 2010-06-17 Endoevolution, Llc Apparatus and method for minimally invasive suturing
US20120095478A1 (en) * 2009-03-17 2012-04-19 Ams Research Corporation Implantable device and tissue anchor
JP2013146613A (ja) * 2006-03-31 2013-08-01 Ethicon Endo Surgery Inc 着脱可能な取っ手を備えた外科用縫合器械
CN103813756A (zh) * 2011-05-08 2014-05-21 阿波罗体内手术公司 内窥镜缝合系统
CN104605905A (zh) * 2008-11-25 2015-05-13 远藤发展有限责任公司 用于微创缝合的装置及方法
US20170150961A1 (en) * 2015-12-01 2017-06-01 Covidien Lp Powered endoscopic suturing device

Family Cites Families (203)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE275129C (zh) 1912-11-02
US1327577A (en) 1919-03-11 1920-01-06 Joseph S Turner Surgical-needle holder
US1822330A (en) 1930-01-13 1931-09-08 Ainslie George Suturing instrument
US2327353A (en) 1940-12-12 1943-08-24 Singer Mfg Co Instrument for suturing
US2601564A (en) 1950-07-08 1952-06-24 David P Smith Suturing device
US3197997A (en) 1960-11-17 1965-08-03 Leonard D Kurtz Suture needle
US3311110A (en) 1964-07-15 1967-03-28 American Cyanamid Co Flexible composite suture having a tandem linkage
US3344790A (en) 1964-11-02 1967-10-03 Richard L Dorner Surgical suturing device with auxiliary spool-brake means
US3762418A (en) 1972-05-17 1973-10-02 W Wasson Surgical suture
US3834599A (en) 1972-08-04 1974-09-10 N Herr Needle
US3835912A (en) 1973-06-25 1974-09-17 S K S Ltd Method of joining a filament to a metal rod
US3910282A (en) 1974-05-22 1975-10-07 American Cyanamid Co Needling monofilament sutures
US3951261A (en) 1974-08-28 1976-04-20 Ethicon, Inc. Needled suture mounting and dispensing device and package
US3972418A (en) 1974-11-25 1976-08-03 Ethicon, Inc. Molded suture package
US4027608A (en) 1976-02-20 1977-06-07 Raymond Kelder Suturing device
US4074732A (en) 1977-01-05 1978-02-21 Wilkens Kenneth A Wire cutting, stripping and twisting tool
JPS556270A (en) 1978-06-29 1980-01-17 Tokyo Electric Co Ltd Label issuing method
US4235177A (en) 1979-02-23 1980-11-25 Raymond C. Kelder Suturing device
JPS55151956A (en) 1979-05-17 1980-11-26 Janome Sewing Machine Co Ltd Sewing machine for medical treatment
US4327655A (en) 1979-11-19 1982-05-04 Addy Clarence A Sewing needle
US4527564A (en) 1980-02-06 1985-07-09 Janome Sewing Machine Co. Ltd. Suturing needle for medical operation
US4331277A (en) 1980-05-23 1982-05-25 United States Surgical Corporation Self-contained gas powered surgical stapler
DE3150052C2 (de) 1981-12-17 1985-02-21 Sterimed Gesellschaft für medizinischen Bedarf mbH, 6600 Saarbrücken Katheter zur Katheterung zentraler Venen
SE441643B (sv) 1983-02-08 1985-10-28 Innova Ab Suturinstrument
US4621640A (en) 1984-01-09 1986-11-11 Mulhollan James S Mechanical needle carrier and method for its use
GB8422863D0 (en) 1984-09-11 1984-10-17 Univ London Sewing machine
US4899746A (en) 1988-04-28 1990-02-13 Brunk Industries, Inc. Suturing apparatus
FR2643251B1 (fr) 1989-02-20 1994-03-04 Ethnor Suture chirurgicale, notamment pour fermeture de sternotomie
EP0413862B1 (en) 1989-08-22 1994-11-30 Haruo Takase Surgical needle for plastic surgery or the like
US5358498A (en) 1990-02-01 1994-10-25 Deknatel Technology Corporation, Inc. Needled suture
US5080663A (en) 1990-09-26 1992-01-14 Univerity College London Sewing device
FR2669039A1 (fr) 1990-11-09 1992-05-15 Lectra Systemes Sa Procede pour decouper des peaux de cuirs.
US5201760A (en) 1990-12-24 1993-04-13 American Cyanamid Company Surgical needle-suture combination and apparatus and method for attaching the same
DK166600B1 (da) 1991-01-17 1993-06-21 Therkel Bisgaard Vaerktoejssaet til brug ved suturering i dybe operationsaabninger eller legemshulrum
US5174300A (en) 1991-04-04 1992-12-29 Symbiosis Corporation Endoscopic surgical instruments having rotatable end effectors
US5373101A (en) 1991-05-03 1994-12-13 Motorola, Inc. Electrical interconnect apparatus
US5210376A (en) 1991-10-25 1993-05-11 Imperial Underground Sprinkler Co. Sealed electrical connection device and method
WO1993010713A1 (en) 1991-12-02 1993-06-10 W.L. Gore & Associates, Inc. A needle holder for a suture package
DE4201337A1 (de) 1992-01-20 1993-07-22 Storz Karl Instrument mit einem zangenartigen nadelhalter
US5318578A (en) 1992-03-17 1994-06-07 Harrith M. Hasson Apparatus for delivering a suture into a body cavity and method of using the apparatus
HU215301B (hu) 1992-03-30 1999-01-28 György Lichtenberger Orvosi műszer átöltő fonal elhelyezésére, főként testüregekben
US5318566A (en) 1992-06-22 1994-06-07 Danek Medical, Inc. Sternotomy cable and method
US5305281A (en) 1992-08-06 1994-04-19 National Semiconductor Corporation Multiple array memory device with staggered read/write for high speed data access
US5308353A (en) 1992-08-31 1994-05-03 Merrimac Industries, Inc. Surgical suturing device
US5306281A (en) 1992-08-31 1994-04-26 Merrimac Industries, Inc. Suturing cassette device
US6048351A (en) 1992-09-04 2000-04-11 Scimed Life Systems, Inc. Transvaginal suturing system
US5364408A (en) 1992-09-04 1994-11-15 Laurus Medical Corporation Endoscopic suture system
US5540704A (en) 1992-09-04 1996-07-30 Laurus Medical Corporation Endoscopic suture system
US5713910A (en) 1992-09-04 1998-02-03 Laurus Medical Corporation Needle guidance system for endoscopic suture device
US5578044A (en) 1992-09-04 1996-11-26 Laurus Medical Corporation Endoscopic suture system
US7060077B2 (en) 1992-09-04 2006-06-13 Boston Scientific Scimed, Inc. Suturing instruments and methods of use
US5269806A (en) 1992-10-09 1993-12-14 Ethicon, Inc. I-beam needle having true I-beam cross-section
US5330502A (en) 1992-10-09 1994-07-19 Ethicon, Inc. Rotational endoscopic mechanism with jointed drive mechanism
US5330442A (en) 1992-10-09 1994-07-19 United States Surgical Corporation Suture retaining clip
CN2169381Y (zh) 1993-04-01 1994-06-22 田文端 一种结扎引线器及缝针
US5403344A (en) 1993-07-22 1995-04-04 American Cyanamid Co. Multi-faceted surgical needle
US5344061A (en) 1993-08-03 1994-09-06 Lawrence Crainich Ratchet assembly for medical instrument
US5478344A (en) 1993-10-08 1995-12-26 United States Surgical Corporation Surgical suturing apparatus with loading mechanism
US5474568A (en) 1993-10-08 1995-12-12 United States Surgical Corporation Instrument for closing trocar puncture wounds
US5503266A (en) 1993-10-15 1996-04-02 United States Surgical Corporation Molded suture retainer with needle park
US5478327A (en) 1993-10-18 1995-12-26 Ethicon, Inc. Surgical needle with decreased penetration
AU1041795A (en) 1993-10-25 1995-05-22 Children's Medical Center Corporation Retractable suture needle with self-contained driver
US5474598A (en) 1993-12-29 1995-12-12 Osprey Corporation Multi-line drum filter
US5437681A (en) 1994-01-13 1995-08-01 Suturtek Inc. Suturing instrument with thread management
US5454819A (en) 1994-03-17 1995-10-03 Nusurg Medical, Inc. Spring biased laparoscopic surgical needle holder
US5480409A (en) 1994-05-10 1996-01-02 Riza; Erol D. Laparoscopic surgical instrument
JPH07328021A (ja) 1994-06-07 1995-12-19 Matsutani Seisakusho Co Ltd 医療用糸付針の誘導具
US5833695A (en) 1994-07-13 1998-11-10 Yoon; Inbae Surgical stapling system and method of applying staples from multiple staple cartridges
US5478345A (en) 1994-08-19 1995-12-26 United States Surgical Corporation Mechanism for endoscopic suturing device
US5462558A (en) 1994-08-29 1995-10-31 United States Surgical Corporation Suture clip applier
US5514159A (en) 1994-09-13 1996-05-07 United States Surgical Corporation Guillotine suture clip
WO1996009769A1 (en) 1994-09-27 1996-04-04 Unilever N.V. Ready-to-bake brioche doughs
US5814071A (en) 1994-11-10 1998-09-29 Innovasive Devices, Inc. Suture anchor assembly and methods
US5643295A (en) 1994-12-29 1997-07-01 Yoon; Inbae Methods and apparatus for suturing tissue
US5665109A (en) 1994-12-29 1997-09-09 Yoon; Inbae Methods and apparatus for suturing tissue
US5645552A (en) 1995-01-11 1997-07-08 United States Surgical Corporation Surgical apparatus for suturing body tissue
US5665096A (en) 1995-03-07 1997-09-09 Yoon; Inbae Needle driving apparatus and methods of suturing tissue
US5755729A (en) 1995-04-27 1998-05-26 General Surgical Innovations, Inc. Magazine for loading a needle and a length of suture onto a surgical instrument
US5540705A (en) 1995-05-19 1996-07-30 Suturtek, Inc. Suturing instrument with thread management
US6056771A (en) 1995-06-02 2000-05-02 United States Surgical Corporation Radiused tip surgical needles and surgical incision members
US5675961A (en) 1995-06-06 1997-10-14 Ethicon, Inc. Suture dispenser
US5669490A (en) 1995-06-07 1997-09-23 United States Surgical Corporation Suture retainer
US5860992A (en) 1996-01-31 1999-01-19 Heartport, Inc. Endoscopic suturing devices and methods
US5911727A (en) 1996-02-20 1999-06-15 Cardiothoracic Systems, Inc. Stitcher
US5709693A (en) 1996-02-20 1998-01-20 Cardiothoracic System, Inc. Stitcher
US5891160A (en) 1996-02-23 1999-04-06 Cardiovascular Technologies, Llc Fastener delivery and deployment mechanism and method for placing the fastener in minimally invasive surgery
US5715942A (en) 1996-11-15 1998-02-10 Li Medical Technologies, Inc. Package and holder for suture anchor with sutures and surgical needles attacked
US6159224A (en) 1996-11-27 2000-12-12 Yoon; Inbae Multiple needle suturing instrument and method
US5993466A (en) 1997-06-17 1999-11-30 Yoon; Inbae Suturing instrument with multiple rotatably mounted spreadable needle holders
US5759188A (en) 1996-11-27 1998-06-02 Yoon; Inbae Suturing instrument with rotatably mounted needle driver and catcher
US5766186A (en) 1996-12-03 1998-06-16 Simon Fraser University Suturing device
US5968077A (en) 1997-04-04 1999-10-19 Alto Development Corporation Double wire sternothomy suture
US5830234A (en) 1997-04-04 1998-11-03 Alto Development Corporation Method for double wire sternotomy suture
US5814069A (en) 1997-04-08 1998-09-29 Ethicon Endo-Surgery, Inc. Load assist device for a suture cartridge
US6126666A (en) 1997-04-14 2000-10-03 Forschungszcutrum Karlsruhe Gmbh Device for inserting a surgical suture needle into an endoscopic suture apparatus
US5908426A (en) 1997-04-24 1999-06-01 Pierce; Javin Suture needle manipulator
US6080180A (en) 1997-05-01 2000-06-27 Yoon; Inbae Surgical instrument with rotatably mounted offset end effector and method of using the same
US5908428A (en) 1997-05-27 1999-06-01 United States Surgical Corporation Stitching devices for heart valve replacement surgery
IL121752A0 (en) 1997-09-11 1998-02-22 Gaber Benny Stitching tool
DE19744543A1 (de) 1997-10-09 1999-04-22 Braun Surgical S A B Nahtmaterialspender
US5906273A (en) 1997-12-05 1999-05-25 Ethicon, Inc. Armed suture package with universal dispensing capability
IL123275A0 (en) 1998-02-12 1998-09-24 Urogyn Ltd Surgical suture instrument
US6016905A (en) 1998-03-06 2000-01-25 United States Surgical Corporation Surgical suture retainer package
DE69938942D1 (de) 1998-03-20 2008-07-31 Boston Scient Ltd Endoskopische Nähsysteme
JPH11276492A (ja) 1998-03-30 1999-10-12 Iken Kogyo:Kk 外科用針及び外科用針の針素材の成形装置
US6036694A (en) 1998-08-03 2000-03-14 Innovasive Devices, Inc. Self-tensioning soft tissue fixation device and method
US6270508B1 (en) 1998-10-26 2001-08-07 Charles H. Klieman End effector and instrument for endoscopic and general surgery needle control
JP2000139931A (ja) 1998-11-17 2000-05-23 Keisei Ika Kogyo Kk マイクロ縫合針およびその製造方法
US7125403B2 (en) * 1998-12-08 2006-10-24 Intuitive Surgical In vivo accessories for minimally invasive robotic surgery
US6053908A (en) 1999-01-07 2000-04-25 Design Standards Corporation Ratchet assembly for surgical instrument
US6136010A (en) 1999-03-04 2000-10-24 Perclose, Inc. Articulating suturing device and method
US6071289A (en) 1999-03-15 2000-06-06 Ethicon Endo-Surgery, Inc. Surgical device for suturing tissue
US6821285B2 (en) 1999-06-22 2004-11-23 Ndo Surgical, Inc. Tissue reconfiguration
US6494888B1 (en) 1999-06-22 2002-12-17 Ndo Surgical, Inc. Tissue reconfiguration
US6835200B2 (en) 1999-06-22 2004-12-28 Ndo Surgical. Inc. Method and devices for tissue reconfiguration
US6663639B1 (en) 1999-06-22 2003-12-16 Ndo Surgical, Inc. Methods and devices for tissue reconfiguration
US6506196B1 (en) 1999-06-22 2003-01-14 Ndo Surgical, Inc. Device and method for correction of a painful body defect
US7416554B2 (en) 2002-12-11 2008-08-26 Usgi Medical Inc Apparatus and methods for forming and securing gastrointestinal tissue folds
US7955340B2 (en) 1999-06-25 2011-06-07 Usgi Medical, Inc. Apparatus and methods for forming and securing gastrointestinal tissue folds
KR20020027543A (ko) 1999-08-12 2002-04-13 우로진 리미티드 수지 유도용 외과 기구
EP1078602A3 (en) 1999-08-26 2001-04-04 Mani, Inc. Suturing needle for medical use
US7220266B2 (en) 2000-05-19 2007-05-22 C. R. Bard, Inc. Tissue capturing and suturing device and method
US6719763B2 (en) 2000-09-29 2004-04-13 Olympus Optical Co., Ltd. Endoscopic suturing device
US6755843B2 (en) 2000-09-29 2004-06-29 Olympus Optical Co., Ltd. Endoscopic suturing device
US6997931B2 (en) 2001-02-02 2006-02-14 Lsi Solutions, Inc. System for endoscopic suturing
US8313496B2 (en) 2001-02-02 2012-11-20 Lsi Solutions, Inc. System for endoscopic suturing
US6454777B1 (en) 2001-02-27 2002-09-24 David T. Green Apparatus and method for suturing a blood vessel
US6997932B2 (en) 2001-05-21 2006-02-14 Boston Scientific Scimed, Inc. Suture passer
US6558400B2 (en) 2001-05-30 2003-05-06 Satiety, Inc. Obesity treatment tools and methods
US7144401B2 (en) 2001-06-07 2006-12-05 Olympus Optical Co., Ltd. Suturing device for endoscope
WO2002102226A2 (en) 2001-06-14 2002-12-27 Suturtek Incorporated Apparatus and method for surgical suturing with thread management
US7011668B2 (en) 2001-07-23 2006-03-14 Dvl Acquistion Sub, Inc. Surgical suturing instrument and method of use
US6719764B1 (en) 2001-08-24 2004-04-13 Scimed Life Systems, Inc. Forward deploying suturing device and methods of use
CA2461880A1 (en) 2001-10-04 2003-04-10 Gibbens & Borders, Llc Apparatus and method for thread advancing
US7344545B2 (en) 2002-01-30 2008-03-18 Olympus Corporation Endoscopic suturing system
US7618425B2 (en) 2002-01-30 2009-11-17 Olympus Corporation Endoscopic suturing system
CN1309349C (zh) 2002-04-30 2007-04-11 普雷西梅德公司 用于最小侵入骨关节手术的扩孔钻导杆
AU2003248671B2 (en) 2002-06-12 2009-03-26 Boston Scientific Limited Suturing instruments
JP4373146B2 (ja) 2002-07-11 2009-11-25 オリンパス株式会社 内視鏡用縫合装置
US7041111B2 (en) 2002-08-02 2006-05-09 Boston Scientific Scimed, Inc. Placing sutures
US6746460B2 (en) 2002-08-07 2004-06-08 Satiety, Inc. Intra-gastric fastening devices
US7214233B2 (en) 2002-08-30 2007-05-08 Satiety, Inc. Methods and devices for maintaining a space occupying device in a relatively fixed location within a stomach
US7666195B2 (en) 2002-09-09 2010-02-23 Brian Kelleher Device and method for endoluminal therapy
WO2004028402A2 (en) 2002-09-26 2004-04-08 Bioaccess, Inc. Orthopedic medical device with unitary components
US7338504B2 (en) 2002-10-03 2008-03-04 Gibbens Group, L.L.C. Cycling suturing and knot-tying device
US20080132919A1 (en) 2002-10-03 2008-06-05 Faising Chui Cycling suturing and knot-tying device
US7229428B2 (en) 2002-10-23 2007-06-12 Satiety, Inc. Method and device for use in endoscopic organ procedures
US6656194B1 (en) 2002-11-05 2003-12-02 Satiety, Inc. Magnetic anchoring devices
US7942898B2 (en) 2002-12-11 2011-05-17 Usgi Medical, Inc. Delivery systems and methods for gastric reduction
US6908427B2 (en) 2002-12-30 2005-06-21 PARÉ Surgical, Inc. Flexible endoscope capsule
US8187288B2 (en) 2003-03-10 2012-05-29 Boston Scientific Scimed, Inc. Re-shapeable medical device
WO2004086986A1 (en) 2003-03-28 2004-10-14 Gibbens Group Llc Leverage locking reversible cyclic suturing and knot-tying device
US7175638B2 (en) 2003-04-16 2007-02-13 Satiety, Inc. Method and devices for modifying the function of a body organ
US7862584B2 (en) 2003-05-07 2011-01-04 Anpa Medical, Inc. Suture lock
US7166116B2 (en) 2003-06-23 2007-01-23 Ethicon, Inc. Tissue grasper/suture passer instrument
US6877352B1 (en) 2003-07-10 2005-04-12 System for securing a suture to a needle in a swaged fashion
US7520382B2 (en) 2003-07-18 2009-04-21 Tyco Healthcare Group Lp Suture packaging
US20050070931A1 (en) 2003-08-06 2005-03-31 Rhodemann Li Method and apparatus for creating a restriction in the stomach or other anatomical structure
JP3868410B2 (ja) 2003-09-05 2007-01-17 株式会社ベアーメディック 針付縫合糸
WO2005061025A1 (en) 2003-12-22 2005-07-07 Medela Holding Ag Drainage apparatus and method
WO2005077279A1 (en) 2004-02-09 2005-08-25 Eclectic Grey Mater Designs, Llc Safety suture needle assemblies and methods
CN1960828B (zh) 2004-04-15 2011-04-27 密尔沃基电动工具公司 动力工具
US7976555B2 (en) 2008-07-17 2011-07-12 Endoevolution, Llc Apparatus and method for minimally invasive suturing
US7993354B1 (en) 2010-10-01 2011-08-09 Endoevolution, Llc Devices and methods for minimally invasive suturing
US9775600B2 (en) 2010-10-01 2017-10-03 Endoevolution, Llc Devices and methods for minimally invasive suturing
JP4855405B2 (ja) 2004-09-20 2012-01-18 スターテック インコーポレイテッド 最小侵襲の縫合のための装置および方法
US9463012B2 (en) * 2004-10-26 2016-10-11 P Tech, Llc Apparatus for guiding and positioning an implant
JP2005253987A (ja) 2005-03-25 2005-09-22 Olympus Corp 保持装置
US8211143B2 (en) 2005-03-31 2012-07-03 David Stefanchik Suturing device
US9545191B2 (en) 2005-06-13 2017-01-17 Ethicon Endo-Surgery, Inc. Method for suture lacing
US7846169B2 (en) 2005-06-13 2010-12-07 Ethicon Endo-Surgery, Inc. Adjustable vacuum chamber for a surgical suturing apparatus
US7833236B2 (en) 2005-06-13 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical suturing apparatus with collapsible vacuum chamber
US7766925B2 (en) 2005-06-13 2010-08-03 Ethicon Endo-Surgery, Inc. Surgical suturing apparatus
US8641728B2 (en) 2005-06-13 2014-02-04 Ethicon Endo-Surgery, Inc. Attachment apparatus for coupling with an endoscope
US7615060B2 (en) 2005-06-13 2009-11-10 Ethicon-Endo Surgery, Inc. Endoscopic suturing device
US7628796B2 (en) 2005-06-13 2009-12-08 Ethicon Endo-Surgery, Inc. Surgical suturing apparatus with anti-backup system
WO2008058005A2 (en) 2006-11-03 2008-05-15 The Penn State Research Foundation Endosurgery suturing device
US20080140091A1 (en) 2006-12-12 2008-06-12 Dedeyne Patrick G Minimally invasive suture-based repair of soft tissue
CN101594828B (zh) 2007-01-11 2011-04-13 马尼株式会社 缝合针
US20100130990A1 (en) 2007-07-03 2010-05-27 Saliman Justin D Methods of suturing and repairing tissue using a continuous suture passer device
CN201082170Y (zh) 2007-09-26 2008-07-09 同济大学 一种新型缝合器
US20100036415A1 (en) 2008-08-07 2010-02-11 Tyco Healthcare Group Lp Surgical needle with reduced contact area
US9107684B2 (en) * 2010-03-05 2015-08-18 Covidien Lp System and method for transferring power to intrabody instruments
US8906043B2 (en) 2010-11-15 2014-12-09 Ethicon Endo-Surgery, Inc. Laparoscopic suturing instrument with perpendicular eccentric needle motion
CA2856346C (en) * 2011-08-18 2022-08-30 Anchor Orthopedics Xt Inc. Suture passing instrumentation and methods of use thereof
US9427226B2 (en) 2012-03-14 2016-08-30 Ethicon Endo-Surgery, Llc Laparoscopic suturing instrument with rack drive
US9220496B2 (en) 2012-12-13 2015-12-29 Ethicon Endo-Surgery, Llc Packaging for surgical needle cartridge and suture
US9370354B1 (en) 2013-03-11 2016-06-21 Ethicon Endo-Surgery, Llc Automated needle loader
US9125645B1 (en) 2013-03-11 2015-09-08 Ethicon Endo-Surgery, Inc. Reciprocating needle drive without cables
US20150351749A1 (en) 2014-06-06 2015-12-10 Ethicon Endo-Surgery, Inc. Needle Cartridge with Moveable Cover
US9375212B2 (en) 2014-06-06 2016-06-28 Ethicon Endo-Surgery, Llc Circular needle applier with cleats
US9867612B2 (en) 2013-04-16 2018-01-16 Ethicon Llc Powered surgical stapler
US20150351745A1 (en) 2014-06-06 2015-12-10 Ethicon Endo-Surgery, Inc. Ratchet Controlled Circular Needle Driver
US9908655B2 (en) 2015-04-29 2018-03-06 Ethicon, Inc. Stylus winding fixture for winding surgical sutures and method of winding a suture
US20160346827A1 (en) 2015-05-26 2016-12-01 Ethicon Endo-Surgery, Llc Method of Fabricating a Surgical Needle with Recessed Features
US10022120B2 (en) 2015-05-26 2018-07-17 Ethicon Llc Surgical needle with recessed features
US10004491B2 (en) 2015-06-15 2018-06-26 Ethicon Llc Suturing instrument with needle motion indicator
US9782164B2 (en) 2015-06-16 2017-10-10 Ethicon Endo-Surgery, Llc Suturing instrument with multi-mode cartridges
US9888914B2 (en) 2015-06-16 2018-02-13 Ethicon Endo-Surgery, Llc Suturing instrument with motorized needle drive
US9839419B2 (en) 2015-06-16 2017-12-12 Ethicon Endo-Surgery, Llc Suturing instrument with jaw having integral cartridge component
US10070858B2 (en) 2015-06-17 2018-09-11 Ethicon Llc Barbed suture dispenser
US10405855B2 (en) * 2015-06-26 2019-09-10 Ethicon Llc Firing circuit for surgical stapler
US10292698B2 (en) 2017-07-27 2019-05-21 Endoevolution, Llc Apparatus and method for minimally invasive suturing

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100152751A1 (en) * 2004-09-20 2010-06-17 Endoevolution, Llc Apparatus and method for minimally invasive suturing
US20160051253A1 (en) * 2004-09-20 2016-02-25 Endoevolution, Llc Apparatus and method for minimally invasive suturing
US20090024145A1 (en) * 2006-01-27 2009-01-22 Meade John C Apparatus and method for sternotomy closure
US20070239206A1 (en) * 2006-03-31 2007-10-11 Shelton Frederick E Iv Suture with adhesive/sealant delivery mechanism
JP2013146613A (ja) * 2006-03-31 2013-08-01 Ethicon Endo Surgery Inc 着脱可能な取っ手を備えた外科用縫合器械
WO2008147555A2 (en) * 2007-05-24 2008-12-04 Suturtek Incorporated Apparatus and method for minimally invasive suturing
CN104605905A (zh) * 2008-11-25 2015-05-13 远藤发展有限责任公司 用于微创缝合的装置及方法
US20120095478A1 (en) * 2009-03-17 2012-04-19 Ams Research Corporation Implantable device and tissue anchor
CN103813756A (zh) * 2011-05-08 2014-05-21 阿波罗体内手术公司 内窥镜缝合系统
US20170150961A1 (en) * 2015-12-01 2017-06-01 Covidien Lp Powered endoscopic suturing device

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111419310A (zh) * 2020-04-20 2020-07-17 邦尼医疗科技(常州)有限公司 腹腔镜缝合器
WO2021217373A1 (zh) * 2020-04-27 2021-11-04 浙江左元医疗技术有限公司 缝合器、具有缝合器的治疗装置以及治疗系统

Also Published As

Publication number Publication date
US11253250B2 (en) 2022-02-22
CN110505844B (zh) 2023-09-01
US20180242967A1 (en) 2018-08-30
EP3585273A1 (en) 2020-01-01
KR20190117016A (ko) 2019-10-15
WO2018156456A1 (en) 2018-08-30
US20190307443A1 (en) 2019-10-10
EP3585273A4 (en) 2020-12-09
US20220160348A1 (en) 2022-05-26
KR102577941B1 (ko) 2023-09-15

Similar Documents

Publication Publication Date Title
CN110505844A (zh) 用于微创缝合的设备及方法
US10028652B2 (en) Rapid laparoscopy exchange system and method of use thereof
US9724089B1 (en) Reciprocating needle drive without cables
CN103370014B (zh) 用于吻合或管封闭器械中刀位置的指示符
US10238381B1 (en) Automated needle loader
JP4855405B2 (ja) 最小侵襲の縫合のための装置および方法
EP2083702B1 (en) Axial stitching device
CN102300507B (zh) 用于微创缝合的装置
JP4658557B2 (ja) 自己配置ファスナーのための単一内腔吻合用アプライヤー
Hashizume et al. Early experiences of endoscopic procedures in general surgery assisted by a computer-enhanced surgical system
JP5873501B2 (ja) 低侵襲縫合するための装置及び方法
EP0920280B1 (en) Fingertip-mounted minimally invasive surgical instruments
US20110264114A1 (en) Surgical instrument
EP2525720A1 (en) System of deploying an elongate unit in a body cavity
US20210137581A1 (en) Electrosurgical instrument with otomy feature for a teleoperated medical system
KR101868007B1 (ko) 최소 침습 봉합을 위한 장치 및 방법
CN108392234A (zh) 内窥镜缝合装置
KR102195714B1 (ko) 수술용 트로카 및 이를 이용한 영상 획득 방법
CN115460995A (zh) 缝合器设备及其使用方法
KR102596872B1 (ko) 이중구조 복강경 수술용 기구
JPWO2017164359A1 (ja) 縫合装置
KR100994676B1 (ko) 수술용 인스트루먼트 및 그 셋팅방법
US9782167B1 (en) Button actuated needle loader
Yang et al. Distal Subtotal Gastrectomy with D2 Lymph Node Dissection
King et al. Laparoscopy and Research in Surgical Oncology: Current State of the Art and Future Trends

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication
TA01 Transfer of patent application right
TA01 Transfer of patent application right

Effective date of registration: 20191202

Address after: California, USA

Applicant after: INTUITIVE SURGICAL OPERATIONS, Inc.

Address before: Massachusetts, USA

Applicant before: EndoEvolution, LLC

SE01 Entry into force of request for substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant