CN1853579B - 外科夹子施加器 - Google Patents

外科夹子施加器 Download PDF

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CN1853579B
CN1853579B CN200610075216XA CN200610075216A CN1853579B CN 1853579 B CN1853579 B CN 1853579B CN 200610075216X A CN200610075216X A CN 200610075216XA CN 200610075216 A CN200610075216 A CN 200610075216A CN 1853579 B CN1853579 B CN 1853579B
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D·维塔利
N·G·莫利托尔
T·W·惠特马
R·L·小科克
B·D·伯特克
K·A·拉森
R·P·福赫斯
M·A·戴维逊
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Ethicon Endo Surgery Inc
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips 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
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
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    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/032—Automatic limiting or abutting means, e.g. for safety pressure limiting, e.g. hydrostatic
    • 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

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Abstract

本发明提供了用于在进行外科手术期间将外科夹子施加到脉管、管路、分路等的外科夹子施加器和方法。在一个示范性实施例中，所提供的外科夹子施加器具有带有扳机的壳和伸长轴，扳机可移动地连结到壳而伸长轴从壳延伸出来，相对的钳口形成在伸长轴的远端。扳机适合于使夹子前进，以将夹子定位在钳口之间，并且使钳口从打开位置移动到闭合位置，以挤压定位在钳口之间的夹子。

Description

外科夹子施加器
技术领域
本发明概括地涉及外科装置，并且更具体地涉及用于将外科夹子施加到管路、脉管、分路等的方法和装置。
背景技术
近年来，由于采用了像胆囊切除术、胃造口术、阑尾切除术和疝气修复术那样的腹腔镜外科手术和内窥镜外科手术，外科学已经取得了令人瞩目的进展。这些手术通过作为用于刺破体腔的外科器械的套管针组件实现。典型地，套管针包含尖锐的闭塞件尖端和套管针管或套管。通过使用闭塞件尖端以刺透皮肤，套管针套管插入到皮肤内，以进入体腔。在刺透之后，闭塞件移除而套管针套管留在体内。外科器械经过该套管放置。
一种通常与套管针套管一起使用的外科器械是用于在手术期间结扎血管、管路、分路或一部分身体组织的外科夹子施加器。典型地，大多数夹子施加器具有带有伸长轴的把手，伸长轴具有一对形成在其一端的可移动的相对的钳口，用于在其之间保持并且形成结扎夹子。钳口定位成围绕脉管或管路，并且通过使钳口闭合，夹子挤压在脉管上或形成在脉管上。
在许多现有技术的夹子施加器中，进给机构和形成机构需要构件的精确的定时和协调移动以进行操作。对精确定时和精确控制的需要导致对复杂机械设计的需要，由此增加了夹子施加器的成本。许多现有技术夹子施加器也使用弹簧加载的夹子前进组件，以使一个或多个夹子前进经过装置的轴。因此，钳口必须包含用于在夹子形成之前防止夹子意外地从装置突出出来的机构。当前夹子施加器的其他缺点包括不能在多种情况下对通过扳机施加到钳口的过载进行操纵。许多装置需要钳口完全闭合，当定位在钳口之间的脉管或管路由于过大而不能完全闭合的时候，或当异物定位在钳口之间的时候，这可能在钳口上导致过载。
因此，需要对用于将外科夹子施加到脉管、管路、分路等的改进的方法和装置。
发明内容
本发明提供了用于将外科夹子施加到脉管、管路、分路等的方法和装置。在一个示范性实施例中，所提供的外科夹子施加器具有带有扳机的壳和伸长轴，扳机可移动地连结到壳而伸长轴从壳延伸出来，相对的钳口形成在伸长轴的远端。扳机适合于使夹子前进，以将夹子定位在钳口之间，并且使钳口从打开位置移动到闭合位置，以挤压定位在钳口之间的夹子。
外科夹子施加器可以具有多种构形，并且它可以包括多种特征，以有助于外科夹子的前进和形成。在一个实施例中，外科夹子施加器可以包括可滑动地布置在伸长轴内并且适合于驱动至少一个外科夹子经过伸长轴的进给器底托(shoe)。在示范性实施例中，进给器底托可以只适合于在远端方向上移动，从而大致上防止了进给器底托的近端移动。伸长轴也可以包括布置在其内并且适合于安置至少一个外科夹子的夹子轨道。进给器底托可滑动地布置在夹子轨道内。
多种技术可以使用，以有助于进给器底托的远端移动和防止近端移动。在一个示范性实施例中，进给器底托可以包括适合于接合夹子轨道的柄脚，以防止进给器底托在夹子轨道内进行近端移动而允许进给器底托在夹子轨道内进行远端移动。夹子轨道可以包括几个形成在其上的开口，用于容纳柄脚，以防止进给器底托在夹子轨道内进行近端移动。在另一个示范性实施例中，进给器底托可以包括柄脚，而进给棒可以包括几个形成在其内并且适合于接合柄脚的制动件，以当进给棒在远端方向上移动的时候，在远端方向上移动进给器底托。
在另一个实施例中，伸长轴可以包括可滑动地布置在其内并且连结到扳机的进给棒，从而使扳机朝向闭合位置的移动适合于使进给棒在远端方向上前进，由此使进给器底托在远端方向上前进。作为非限制性例子，通过与扳机配合的扳机插入件，并且通过在扳机插入件和进给棒近端之间延伸的联接件，进给棒可以连结到扳机。进给棒的近端可以包括适合于容纳联接件的部分的连结件。进给棒也可以包括具有前进器的远端，前进器适合于接合最远端的夹子，并且适合于将最远端的夹子驱动到钳口内。在某些示范性实施例中，进给棒可以适合于在使进给器底托开始前进之前，接合并且使最远端的夹子开始前进到钳口内。
在另一个实施例中，提供了用于使夹子前进经过外科夹子施加器的夹子前进组件。夹子前进组件可以与多种外科夹子施加器一起使用，包括那些在本领域中所已知的外科夹子施加器。在一个示范性实施例中，夹子前进组件可以包括适合于安置至少一个夹子的夹子轨道和适合于可滑动地与夹子轨道配合并且适合于在远端方向上移动以使至少一个布置在夹子轨道内的夹子在远端方向上移动的进给器底托。在一个示范性实施例中，进给器底托可以包括适合于接合夹子轨道以防止进给器底托在夹子轨道内进行近端移动并且适合于允许进给器底托在夹子轨道内进行远端移动的柄脚。夹子轨道可以包括多个形成在其内的开口，用于容纳柄脚，以防止进给器底托在夹子轨道内进行近端移动。
夹子前进组件也可以包括适合于连结到形成在外科夹子施加器的壳上的可移动的扳机并且适合于当扳机闭合的时候可滑动地在远端方向上进行移动以使进给器底托和至少一个布置在夹子轨道内的夹子前进的进给棒。进给棒可以具有多种构形，并且在一个示范性实施例中，进给棒的远端可以包括适合于接合最远端的夹子的前进器，以将最远端的夹子从夹子轨道驱动到形成在外科夹子施加器的远端的钳口内。在另一个示范性实施例中，进给器底托可以包括柄脚，而进给棒可以包括多个形成在其内的适合于接合柄脚的制动件，以当进给棒在远端方向上移动的时候，在远端方向上移动进给器底托。在使用时，进给棒的近端可以包括适合于容纳用于将进给棒连结到外科夹子施加器的扳机的联接件的连结件。
也提供了用于使外科夹子前进经过外科夹子施加器的伸长轴的示范性方法。在一个实施例中，进给棒可以在外科夹子施加器的伸长轴内在远端方向上前进，以在远端方向上驱动布置在伸长轴内的进给器底托，由此在远端方向上使至少一个夹子前进。例如通过驱使连结到壳的与伸长轴的近端配合的扳机，进给棒可以在远端方向上前进。在一个示范性实施例中，当进给棒在远端方向上前进的时候，在进给棒的远端的前进器可以接合最远端的夹子，并且使夹子在形成在伸长轴的远端的相对的钳口之间前进。该方法也可以包括在近端方向上收回在伸长轴内的进给棒，同时使进给器底托维持在大致上固定的位置。
在另一个示范性实施例中，所提供的用于施加外科夹子的方法包 括使连结到壳的扳机朝向闭合位置移动第一距离，以驱使布置在壳内的夹子前进组件，由此使夹子前进到形成在伸长轴的远端的钳口组件内，并且进一步使扳机朝向闭合位置移动第二距离，以驱使布置在壳内的夹子形成组件，由此形成布置在钳口组件内的夹子。在驱使夹子形成组件期间，扳机优选地是可相对于夹子前进组件弯曲的。在驱使夹子形成组件期间，夹子形成组件也能够是可相对于钳口组件弯曲的。
在其它方面，所提供的过载机构用于与外科装置一起使用。在一个示范性实施例中，过载机构可以包括枢转地并且可滑动地布置在壳内并且具有带有第一端和相对的第二端的表面的力接收部件和布置在壳内并且适合于阻止力接收部件移动的偏置组件。在示范性实施例中，从第一端到第二端，阻力是增加的。
力接收部件可以具有多种构形，但在一个实施例中，形成在其上的力接收表面定位在位于壳内的开口内。力接收表面可以包括适合于接收用于使在壳内的力接收部件进行枢转移动的力的第一部分和适合于接收用于使在壳内的力接收部件进行可滑动移动的力的第二部分。偏置组件也可以具有多种构形，但在一个示范性实施例中，偏置组件可以包括围绕弹簧柱布置的弹簧和相对于弹簧柱可滑动地布置的柱塞，柱塞具有形成在其上的头并且适合于当柱塞朝向弹簧柱移动时对弹簧进行压缩。
在另一个实施例中，壳可以包括连结在力接收部件和偏置组件之间的枢转组件，从而使枢转组件适合于将施加到力接收部件的力传递到偏置组件，以克服阻力。在一个示范性实施例中，枢转组件可以包括枢转地连结到力接收部件的肘接联接件和枢转地连结到肘接联接件并且适合于当其进行枢转移动时将力施加到偏置组件的枢转联接件。
在另一个实施例中，所提供的外科夹子施加器具有用于防止施加到夹子施加器的钳口的闭合力过载的过载机构。在一个示范性实施例中，外科夹子施加器可以包括具有扳机的壳、伸长轴和布置在壳和伸长轴内并且连结到扳机的凸轮系统组件，扳机可移动地连结到壳而伸长轴从壳延伸出来，相对的钳口形成在伸长轴的远端并且可以在打开位置和闭合位置之间移动。当驱使扳机时，凸轮系统组件可以适合于将闭合力施加到钳口，以使钳口从打开位置朝向闭合位置移动。当闭 合力大于过载机构施加到凸轮系统组件的阻力的时候，凸轮系统组件也可以适合于将闭合力传递到布置在壳内的过载机构。在示范性实施例中，过载机构的阻力与使钳口从打开位置朝向闭合位置移动所需要的力相关联。
尽管多种技术可以使用以将凸轮系统组件连结到过载机构，但在一个示范性实施例中，凸轮系统组件相对于过载机构的力接收表面进行移动，从而当扳机受到驱使以使得凸轮系统组件从打开位置朝向闭合位置移动钳口的时候，使凸轮系统组件的闭合力经过过载机构的力接收表面施加。过载机构的力接收表面可以适合于阻止在近端方向上的移动，并且当扳机受到驱使以使得凸轮系统组件相对于力接收表面进行移动并且使钳口从打开位置朝向闭合位置移动的时候，阻力可以增加。
在另一个示范性实施例中，过载机构可以包括具有异形(profile)联接件的壳，异形联接件可滑动地并且枢转地布置在壳内，并且具有形成其上的力接收表面并且定位成邻近形成在壳内的开口。力接收表面可以包括适合于接收用于使在壳内的力接收部件进行枢转移动的力的第一部分和适合于接收用于使在壳内的力接收部件进行可滑动移动的力的第二部分。过载机构也可以包括适合于将阻力施加到异形联接件的偏置组件。在一个示范性实施例中，通过适合于当异形联接件进行枢转移动时进行枢转并且适合于当异形联接件进行可滑动移动时进行滑动的枢转组件，偏置组件可以连结到异形联接件，以将力施加到偏置组件，以克服阻力。
也提供了用于施加具有过载机构的外科夹子施加器的方法。在一个示范性实施例中，闭合力可以施加到一对形成在外科夹子施加器上的相对的钳口。闭合力可以有效地使相对的钳口从打开位置移动到闭合位置。当闭合力大于过载机构的阀值力的时候，闭合力传递到布置在外科夹子施加器内的过载机构。在示范性实施例中，当钳口从打开位置朝向闭合位置移动的时候，过载机构的阀值力是增加的。
尽管过载机构可以具有多种构形，但在一个实施例中，过载机构可以包括适合于接收闭合力的力接收元件和适合于阻止力接收元件由于闭合力而进行移动的偏置组件。外科夹子施加器可以包括凸轮系统组件，凸轮系统组件适合于将闭合力施加到钳口，并且包括当闭合力 施加到钳口的时候滚动经过力接收元件的滚子部件。当滚子部件滚动经过力接收元件的时候，过载机构的阀值力可以增加。特别地，当滚子部件滚动经过力接收元件的第一部分的时候，如果闭合力大于阀值力，那么力接收元件就可以进行枢转，而当滚子部件滚动经过力接收元件的第二部分的时候，如果闭合力大于阀值力，那么力接收元件就可以进行滑动。在示范性实施例中，使力接收元件进行枢转所需要的阀值力小于使力接收元件进行滑动所需要的阀值力。
在其它方面，提供外科夹子施加器，且其可以包括连结到扳机并且适合于使至少一个外科夹子前进经过从壳延伸出来的伸长轴的夹子前进组件和连结到扳机并且适合于驱使形成在伸长轴的远端的钳口组件以形成外科夹子的夹子形成组件。扳机可以连结到壳，并且适合于驱使夹子前进组件和夹子形成组件。在示范性实施例中，扳机具有两个连续的驱使阶段。扳机可以在第一驱使阶段期间，有效地驱使夹子前进组件，并且扳机可以在第二驱使阶段期间，有效地驱使夹子形成组件，同时，扳机是可相对于夹子前进组件弯曲的。
附图说明
通过接下来就附图所进行的详细描述，将要更完全地理解本发明，附图如下：
图1A是外科夹子施加器的一个示范性实施例的侧视图；
图1B是图1A所示的外科夹子施加器的分解图；
图2A是图1A所示的外科夹子施加器的钳口保持器组件的顶视图；
图2B是图2A所示的钳口保持器组件的底视图；
图2C是图2B所示的钳口保持器组件的侧视图；
图2D是图2C所示的钳口保持器组件经过线D-D所做的截面图；
图3A是用于与图2A-2D所示的钳口保持器组件一起使用的进给器底托的顶视图；
图3B是图3A所示的进给器底托的底视图；
图4A是成形为使图3A和3B的进给器底托前进经过图2A-2D所示的钳口保持器组件的进给棒的侧面透视图；
图4B是图4A所示的进给棒的近端和图2A和2B所示的钳口保持器轴的近端的侧视图，显示了处在最近端位置的进给棒；
图4C是图4B所示的进给棒和钳口保持器轴的侧视图，显示了处在最远端位置的进给棒；
图4D是显示成与图2A和2B所示的钳口保持器轴的近端连接在一起的进给棒的近端的另一个实施例的侧视图，显示了处在最近端位置的进给棒；
图4E是图4D所示的进给棒和钳口保持器轴的侧视图，显示了处在最远端位置的进给棒；
图4F是显示成与图2A和2B所示的钳口保持器轴的近端连接在一起的进给棒的近端的又一个实施例的侧视图，显示了处在最近端位置的进给棒；
图4G是图4F所示的进给棒和钳口保持器轴的侧视图，显示了处在中间位置的进给棒；
图4H是图4F所示的进给棒和钳口保持器轴的侧视图，显示了处在最远端位置的进给棒；
图5A是成形为连结到图4A所示的进给棒的远端的前进器的侧面透视图；
图5B是成形为连结到图4A所示的进给棒的远端的前进器的另一个实施例的侧面透视图；
图6A是包括图2A-2D所示的钳口保持器组件、图3A-3B所示的进给器底托和图4A所示的进给棒的夹子前进组件的截面图，显示了相对于钳口保持器组件的夹子轨道处在初始近端位置的进给棒；
图6B是图6A所示的夹子前进组件的截面图，显示了在远端方向上移动的进给棒；
图6C是图6B所示的夹子前进组件的截面图，显示了进一步在远端方向上移动进给棒由此在远端方向上移动进给器底托和布置在进给器底托远端的夹子供给器；
图6D是图6C所示的夹子前进组件的截面图，显示了返回到图6A所示的初始近端位置的进给棒，而进给器底托和夹子供给器留在图6C所示的前进位置；
图6E是图5A所示的布置在图2A-2D所示的钳口保持器组件的夹子轨道内的前进器的底面透视图，显示了处在最近端位置的前进器；
图6F是图6E所示的前进器的底面透视图，显示了在使夹子前进 到外科夹子施加器的钳口内之后处在最远端位置的前进器；
图7是图1A所示的外科夹子施加器的一对钳口的侧面透视图；
图8是用于与图7所示的钳口一起使用的凸轮的侧面透视图；
图9是适合于连结到图8所示的凸轮以使凸轮相对于图7所示的钳口进行移动的推杆的顶面透视图；
图10A是图8所示的连结到图7所示的钳口的凸轮的顶视图，显示了处在初始位置并且处在钳口开口内的凸轮；
图10B是图8所示的连结到图7所示的钳口的凸轮的顶视图，显示了在钳口之上前进的凸轮和处在闭合位置的钳口；
图11是适合于连结到图2A-2D所示的钳口保持器组件的夹子轨道的远端的组织停止件的顶面透视图；
图12是图1A所示的外科夹子施加器的远端的顶视图，显示了图11所示的定位在图7所示的钳口之间的组织停止件；
图13是图1A所示的外科夹子施加器的把手部分的侧面局部截面图；
图14是图1A所示的外科夹子施加器的扳机插入件的侧面透视图；
图15A是图1A所示的外科夹子施加器的进给棒连结件的一半的侧面透视图；
图15B是图15A所示的进给棒连结件的另一半的侧面透视图；
图16是形成图1A所示的外科夹子施加器的夹子前进组件的部分的柔性联接件的顶面透视图；
图17A是图1A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了处在初始位置的夹子前进组件；
图17B是图17A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了受到部分驱使的夹子前进组件；
图17C是图17B所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了受到完全驱使的夹子前进组件；
图17D是图17A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了受到驱使的夹子形成组件；
图18是形成图1A所示的外科夹子施加器的夹子形成组件的部分的闭合联接件滚子的侧视图；
图19是连结到图18所示的闭合联接件滚子以形成图1A所示的外科夹子施加器的夹子形成组件的部分的闭合联接件的顶面透视图；
图20A是连结到图19所示的闭合联接件并且也形成图1A所示的外科夹子施加器的夹子形成组件的部分的闭合联接件连结件的顶面透视图；
图20B是图20A所示的连结到图9的推杆并且具有布置在其内的偏置元件的一个实施例的闭合联接件的底视图；
图20C是图20A所示的连结到图9的推杆并且具有布置在其内的偏置元件的另一个实施例的闭合联接件的底视图；
图21A是图1A所示的外科夹子施加器的抗倒退机构的放大侧面透视图；
图21B是图21A所示的抗倒退机构的棘爪机构的透视图；
图22A是图1A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了处在初始位置的抗倒退机构；
图22B是图22A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了处在受到部分驱使的位置的抗倒退机构；
图22C是图22B所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了处在受到完全驱使的位置的抗倒退机构；
图22D是图22C所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了正在返回到初始位置的抗倒退机构；
图22E是图22D所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了已经返回到初始位置的抗倒退机构；
图23A是图1A所示的外科夹子施加器的过载机构的分解图；
图23B是图23A所示的过载机构的局部截面图，显示了首先与异形联接件相接触的闭合联接件滚子；
图23C是图23B所示的过载机构的局部截面图，显示了将力施加到异形联接件使得异形联接件进行枢转的闭合联接件滚子；
图23D是用于与外科夹子施加器一起使用的过载机构的另一个实施例的透视图；
图24A是图1A所示的外科夹子施加器的夹子数量指示器轮的侧面透视图；
图24B是图24A所示的夹子数量指示器轮的侧视图；
图25是用于与图24所示的夹子数量指示器轮一起使用的夹子数量驱使器的顶面透视图；
图26A是图1A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了图25的夹子数量驱使器和图24的夹子数量指示器轮的移动；和
图26B是图26A所示的外科夹子施加器的把手的部分的侧面局部截面图，显示了图25的夹子数量驱使器和图24的夹子数量指示器轮的进一步移动。
具体实施方式
本发明大体上提供了外科夹子施加器和用于在外科手术期间使用外科夹子施加器以将外科夹子施加到脉管、管路、分路等的方法。像在这里所描述的那样并且像在附图中所图示的那样，示范性的外科夹子施加器可以包括多种有助于施加外科夹子的特征。然而，本领域的技术人员应该意识到的是，外科夹子施加器可以只包括这些特征中的一些，和/或它可以包括多种在本领域中所已知的其它特征。在这里所描述的外科夹子施加器只是旨在表现某些示范性实施例。
图1A图示了一个示范性的外科夹子施加器10。像所显示的那样，夹子施加器10大体上包括具有固定的把手14和可移动的把手或扳机16的壳12，可移动的把手或扳机16枢转地连结到壳12。伸长轴18从壳12延伸出来，且其包括一对形成在其远端的用于挤压外科夹子的相对的钳口20。伸长轴18可以可转动地连结到壳12，并且它可以包括用于相对于壳12转动伸长轴18的转动旋钮22。图1B图示了图1A所示的外科夹子施加器10的分解图，并且在下面将要对多种构件进行更详细的描述。
图2A-12图示了外科夹子施加器10的轴18的多种构件的示范性实施例。参考图1B，轴18大体上包括容纳轴构件的外部管24，轴构件可以包括具有钳口保持器轴28的钳口保持组件26，钳口保持器轴28带有形成在其上的夹子轨道30和推杆通道32。钳口20可以成形为与夹子轨道30的远端配合。轴组件18也可以包括夹子前进组件，在一个示范性实施例中，夹子前进组件可以包括适合于可滑动地布置在夹子轨道30内以使定位在其内的一系列夹子36前进的进给器底托34和适合于驱动进给器底托34经过夹子轨道30的进给棒38。进给棒38可 以包括适合于与其远端配合以使最远端的夹子前进到钳口20内的前进器组件40。轴组件18也可以包括夹子形成组件或凸轮系统组件，在一个示范性实施例中，夹子形成组件或凸轮系统组件可以包括适合于可滑动地与钳口20配合的凸轮42和可以连结到凸轮42以使凸轮42相对于钳口20进行移动的推杆44。轴组件也可以包括可以与夹子轨道30的远端配合以有助于相对于外科位点定位钳口20的组织停止件46。
在图2A-5中，更详细地显示了一个示范性夹子前进组件的多种构件。首先参考图2A-2D，显示钳口保持组件26，且其包括伸长的、大致上平的钳口保持器轴28，钳口保持器轴28具有与外部管24匹配的近端28a和适合于与钳口20匹配的远端28b。尽管多种技术可以使用以使钳口保持器轴28的近端28a与外部管24匹配，但在所图示的实施例中，近端28a包括形成在其相对侧的齿31和形成在其内的切除部分29，齿31适合于容纳在形成在外部管24内的相应的孔或开口(未显示)内，切除部分29允许近端28a的相对侧偏斜或形成弹簧。特别地，当钳口保持器轴28插入到外部管24内的时候，切除部分29允许钳口保持器轴28的近端28a的相对侧朝向彼此压缩。一旦齿31与在外部管24内的相应的开口对准，钳口保持器轴28的近端28a就恢复成其初始的、没有压缩的构形，由此使得齿31延伸到相应的开口内，以接合外部管24。像在下面就图4A更详细讨论的那样，装置也可以包括在使用装置期间防止钳口保持器轴28的近端28a的相对侧压缩的特征部，以防止齿31与外部管24发生意外脱离。
多种技术也可以使用以使钳口保持器轴28的远端28b与钳口20匹配，然而，在所图示的实施例中，钳口保持器轴28的远端28b包括几个形成在其内的切除部分或齿78，以与形成在钳口20上的相应的突出部分或齿94匹配，在下面就图7对此进行了更详细的讨论。齿78允许钳口20的近端部分大致上与钳口保持器轴28共平面。
钳口保持组件26也可以包括形成在其上的推杆通道32，以可滑动地容纳推杆44，推杆44用于使凸轮42在钳口20之上前进，像在下面更详细讨论的那样。使用多种技术，推杆通道32可以形成，并且基于推杆44的形状和尺寸，推杆通道32可以具有任何形状和尺寸。如图2D所示，例如通过焊接，推杆通道32固定地接附到保持器轴28的上部表面，并且推杆通道32具有大致上为矩形的形状，并且限定了延伸 经过其的路径32a。推杆通道32也可以沿着保持器轴28的全部延伸，或只沿着保持器轴28的部分延伸。本领域的技术人员应该意识到的是，钳口保持组件26不必为了有助于推杆44在外科夹子施加器10的伸长轴18内进行移动而包括推杆通道32。
还如图2A-2D所示，钳口保持组件26也可以包括与其匹配或形成在其上的夹子轨道30。所显示的夹子轨道30与钳口保持器轴28的下部表面匹配，并且夹子轨道30在远端方向上延伸超过钳口保持器轴28的远端28b，以允许夹子轨道30的远端30b大致上与钳口20对准。在使用时，夹子轨道30成形为在其内安置至少一个夹子，并且优选地安置一系列夹子。因此，夹子轨道30可以包括适合于在其内安置一个或多个夹子的相对腿的相对侧轨80a、80b，从而使夹子的腿在轴向方向上彼此对准。在示范性实施例中，夹子轨道30可以成形为安置大约20个在制造期间预先布置在夹子轨道30内的夹子。本领域的技术人员应该意识到的是，基于适合于容纳在夹子轨道30内的夹子或其它像钉那样的闭合装置的形状、尺寸和构形，夹子轨道30的形状、尺寸和构形可以发生改变。而且，除了夹子轨道30，多种其它技术可以使用，以使夹子供给器与伸长轴18保持在一起。
像在下面更详细讨论的那样，夹子轨道30也可以包括几个形成在其内的开口30c，以容纳形成在进给器底托34上的适合于布置在夹子轨道30内的柄脚82a。在示范性实施例中，夹子轨道30包括一定量的开口30c，开口30c的数目至少相应于适合于预先布置在装置10内并且在使用期间施加的夹子的数目。开口30c优选地是彼此等距离的，以当进给器底托34每次前进的时候，都能确保在进给器底托34上的柄脚82a接合开口30c。尽管没有显示，但除了开口30c，夹子轨道30还可以包括制动件，或夹子轨道30可以包括其它允许夹子轨道30接合进给器底托34并且防止进给器底托34进行远端移动而允许进给器底托34进行近端移动的特征部。如图2B所示，夹子轨道30也可以包括形成在其上的停止柄脚118，像在下面更详细讨论的那样，停止柄脚118有效地与形成在进给器底托34上的相应的停止柄脚接合，以防止进给器底托34移动超过最远端位置。停止柄脚118可以具有多种构形，但在一个示范性实施例中，停止柄脚118的形式是两个邻近的片，两个片朝向彼此延伸，以包围夹子轨道的部分，这样就允许夹子通过 夹子轨道。
93在图3A和3B中更详细显示示范性的进给器底托34，且其可以适合于直接驱动夹子经过夹子轨道30。尽管进给器底托34可以具有多种构形，并且多种其他技术可以使用，以驱动夹子经过夹子轨道30，但在示范性实施例中，进给器底托34具有带有近端34a和远端34b的大体上伸长的形状。远端34b可以适合于支撑在夹子轨道30内的最近端的夹子，以推动夹子(或多个夹子)经过夹子轨道30。在所图示的示范性实施例中，远端34b大致上是V形的，以安置夹子的V形弯曲部分。远端34b也包括形成在其内的矩形凹口34c，以允许前进器40接合最远端的夹子，并且使它前进到钳口20内，像在下面更详细讨论的那样。当然，基于与装置10一起使用的夹子或其它闭合机构的构形，远端34b可以发生改变。
在另一个示范性实施例中，进给器底托34也可以包括有助于进给器底托34在夹子轨道30内进行远端移动并且大致上防止进给器底托34在夹子轨道30内进行近端移动的特征部。像在下面更详细讨论的那样，这种构形可以确保在夹子轨道30内使夹子前进并且适当地定位夹子，这样，当每次驱使扳机16的时候，都允许最远端的夹子在钳口20之间前进。在所图示的示范性实施例中，进给器底托34包括形成在其上部表面34s上的柄脚82a，柄脚82a在近端方向上成某个角度，以接合形成在夹子轨道30内的开口30c中的一个。在使用时，柄脚82a的角度允许进给器底托34在夹子轨道30内在远端方向上进行滑动。当进给器底托34每次前进的时候，柄脚82a都在远端方向上从在夹子轨道30内的一个开口30c移动到下一个开口30c。像在下面更详细讨论的那样，柄脚82a与在夹子轨道30内的开口30c的接合可以防止进给器底托34在近端方向上移动以返回到先前位置。
如图3B所致，为了有助于进给器底托34在夹子轨道30内进行近端移动，进给器底托34也可以包括形成在其下部表面34i上的柄脚82b，以当进给棒38在远端方向上进行移动的时候，允许进给器底托34与进给棒38(图4A)接合。下部柄脚82b类似于上部柄脚82a，即它也可以在近端方向上成某个角度。在使用时，当进给棒38在远端方向上每次移动的时候，形成在进给棒38内的制动件84都可以接合下部柄脚82b，并且使进给器底托34在夹子轨道30内在远端方向上移动 某个预定距离。然后，进给棒38可以在近端方向上移动以返回到它的初始位置，并且下部柄脚82b的角度允许柄脚82b滑动到形成在进给棒38内的下一个制动件84内。像先前所注意到的那样，除了柄脚82a、82b和开口30c或制动件84，多种其它特征部也可以使用，以控制进给器底托34在夹子轨道30内的移动。
像先前所提及到的那样，进给器底托34也可以包括形成在其上的停止件，当进给器底托34处在最远端位置并且在装置10内没有剩下夹子的时候，停止件适合于使进给器底托34的移动停止。尽管停止件可以具有多种构形，但图3A和3B图示了形成在进给器底托34上的第三柄脚82c，第三柄脚82c向下延伸，以接合形成在夹子轨道30上的停止柄脚118(图2B)。第三柄脚82c定位为使得当进给器底托34处在最远端位置的时候，第三柄脚82c接合在夹子轨道30上的停止柄脚118，由此当夹子供给器用尽的时候，防止进给器底托34和进给棒38的移动。
图4A图示了示范性的用于驱动进给器底托34经过钳口保持组件26的夹子轨道30的进给棒38。像所显示的那样，进给棒38具有带有近端38a和远端38b的大体上伸长的形状。进给棒38的近端38a可以适合于与进给棒连结件50(图1B)匹配，在下面对此进行了更详细的讨论。进给棒连结件50可以与进给联接件52匹配，当驱使扳机16时，进给联接件52有效地使进给棒38在伸长轴18内在远端方向上进行可滑动的移动。进给棒38b的远端38b可以适合于与前进器40、40’匹配，在图5A和5B中显示了前进器40、40’的示范性实施例，前进器40、40’有效地将布置在夹子轨道30内的最远端的夹子驱动到钳口20内，在下面对此进行了更详细的讨论。
像先前所提及到的那样，进给棒38的近端38a可以包括在使用装置期间防止钳口保持器轴28(图2A和2B)的近端28a的相对侧压缩的特征部，以防止齿31与外部管24发生意外脱离。在图4A-4C所显示的一个示范性实施例中，进给棒38的近端38a可以包括形成在其上的突出部分39，突出部分39适合于延伸到形成在钳口保持器轴28的近端28a中的开口29内。如图4B所示，当进给棒38处在最近端位置的时候(即当扳机16处在打开位置的时候)，突出部分39定位在开口29的近端，允许钳口保持器轴28的近端28a压缩，以允许轴28滑 动到外部管24内。如图4C所示，当进给棒38处在最远端位置的时候(即当扳机16处在至少部分闭合的位置的时候)，突出部分39定位在邻近齿31的中间部位，以防止钳口保持器轴28的近端28a压缩。在使用装置期间，这是特别有利的，因为在使用装置期间突出部分39防止了钳口保持器轴28与外部管24发生意外脱离。尽管图4A-4C所图示的突出部分39具有带有倒圆边缘的矩形截面形状，但突出部分39可以具有多种其它形状和尺寸。例如，如图4D和4E所示，突出部分39’具有稍微成三角形的带有适合于在齿31之间延伸的渐尖端部的截面形状，以在使用装置期间，进一步确保钳口保持器轴28的近端28a不会压缩。也可以使用多于一个的突出部分。例如，在图4F-4H所图示的另一个实施例中，进给棒38的近端38a’包括两个形成在其上并且彼此间隔了某个距离的突出部分39a、39b。如图4F所示，当进给棒38处在最近端位置的时候，并且如图4H所示，当进给棒38处在最远端位置的时候，两个突出部分39a、39b防止钳口保持器轴28的近端28a压缩。如图4G所示，只当进给棒38处在中间位置的时候，钳口保持器轴28的近端28a的压缩可以出现，从而使齿31定位在突出部分39a、39b之间。
像先前也提及到的那样，进给棒38可以包括一个或多个形成在其内的制动件84，以接合形成在进给器底托34上的下部柄脚82b。制动件84的数量可以发生改变，但在示范性实施例中，进给棒38所具有的制动件84的数量相应于或大于适合于由装置10发送的夹子的数量，并且更优选地，与适合于由装置10发送的夹子的数量相比，进给棒38具有多出一个的制动件84。就非限制性例子而言，进给棒38可以包括18个形成在其内的制动件84，以发送17个预先布置在夹子轨道30内的夹子。这种构形允许进给棒38使进给器底托34前进17次，由此使17个夹子前进到钳口20内用于施加。制动件84优选地也是彼此等距离的，以当进给棒38每次前进的时候，都能确保进给器底托34与进给棒38接合并且通过进给棒38前进。
进给棒38也可以包括对进给棒38相对于夹子轨道30的移动量进行控制的特征部。当扳机16每次受到驱使的时候，这种构形都可以确保进给器底托34前进某个预定距离，由此只使单一的夹子前进到钳口20内。尽管多种技术可以使用以对进给棒38的远端移动进行控制，但 在示范性实施例中，进给棒38可以包括形成在其上的突出部分86，突出部分86适合于可滑动地容纳在形成在钳口保持器轴28内的相应的槽88(图2B)内。槽88的长度有效地限制了突出部分86在其内的移动，这样就限制了进给棒38的移动。因此，在使用时，进给棒38可以相对于夹子轨道30在固定的近端位置和固定的远端位置之间进行滑动，由此当进给棒38每次前进的时候，都允许进给棒38使进给器底托34前进某个预定距离。
图5A图示了适合于与进给棒38的远端38b匹配并且有效地将最远端的夹子从夹子轨道30驱动到钳口20内的前进器40的一个示范性实施例。多种技术可以使用以使前进器40与进给棒38匹配，但在所图示的实施例中，前进器40的近端40a的形式是适合于容纳形成在进给棒38的远端38b的凸连接器的凹连接器。优选地，前进器40固定地与进给棒38匹配，然而，可选择地，前进器40可以与进给棒38整合形成。优选地，进给棒38的远端40b适合于使夹子前进到钳口20内，这样，前进器40的远端40b就可以包括例如形成在其上的夹子推动器部件90。夹子推动器部件90可以具有多种形状和尺寸，但在一个示范性实施例中，夹子推动器部件90具有带有形成在其远端的凹处92的伸长的形状，以安置夹子的弯曲部分。基于夹子的特别构形，凹处92的形状可以发生改变。夹子推动器部件90也可以相对于前进器40的纵向轴线A以某个角度向上延伸。这种构形允许夹子推动器部件90延伸到夹子轨道30内，以接合夹子，同时，前进器40的剩余部分延伸成大致上平行于夹子轨道30。图5B图示了前进器40’的夹子推动器部件90’的另一个示范性实施例。在这个实施例中，夹子推动器部件90’是更稍微较狭窄的，并且它具有形成在其最远端的小的凹处92’。在使用时，前进器40可以只接合布置在夹子轨道30内的最远端的夹子，并且只使这个夹子前进到钳口20内。像先前所讨论的那样，这是由于可以可滑动地在固定的近端位置和固定的远端位置之间移动的进给棒38的定位。
图6A-6G图示了在使用时的夹子前进组件，并且特别地，图6A-6D图示了进给棒38在夹子轨道30内进行移动以使进给器底托34和夹子供给器36前进，而图6E-6F图示了前进器40进行移动以使最远端的夹子前进到钳口20内。在下面，对在壳12内的用于驱使夹子前进 组件的构件进行了更详细的讨论。
如图6A所示，在静止位置，进给棒38处在最近端位置，从而使突出部分86在近端方向上定位在位于钳口保持器轴28内的伸长槽88内。进给器底托34布置在夹子轨道30内，并且假设装置10还没有使用，那么进给器底托34就处在最近端位置，从而使在进给器底托34上的上部柄脚82a与形成在夹子轨道30内的最近端的开口或第一开口30c1接合，以防止进给器底托34进行近端移动，而在进给器底托34上的下部柄脚82b定位在位于进给棒38内的第一制动件841和第二制动件842之间，从而使下部柄脚82b通过进给棒38向上偏置。在进给棒内的制动件84依次标示为841、842等，而在夹子轨道30内的开口30c依次标示为30c1、30c2等。还如图6A所示，一系列依次标示为361、362、……36x的夹子36定位在位于进给器底托34的远端的夹子轨道30内，而36x是最远端的夹子。
当驱使扳机16时，进给棒38在远端方向上前进，使得突出部分86在槽88内在远端方向上进行滑动。当进给棒38在远端方向上进行移动的时候，在进给器底托34上的下部柄脚82b滑动到在进给棒38内的第一制动件841内。此外，如图6B所示，进给棒38的远端移动使得第一制动件841接合下部柄脚82b，并且使得在远端方向上移动进给器底托34和夹子供给器361、362等。如图6C所示，当突出部分86邻接在钳口保持器轴28内的长槽88的远端的时候，防止进给棒38进一步的远端移动。在这个位置，进给器底托34已经前进了某个预定距离，以使夹子供给器361、362、……36x在夹子轨道30内前进某个预定距离。进给器底托34的上部柄脚82a已经前进到在夹子轨道30内的第二开口30c2内，以防止进给器底托34进行近端移动，而在进给器底托34上的下部柄脚82b仍然与在进给棒38内的第一制动件841接合。
进给棒38从图6A所示的初始的最近端位置移动到图6C所示的最终的最远端位置，这也可以使最远端的夹子36x前进到钳口20内。特别地，如图6E所示，进给棒38的远端移动可以使得接附到进给棒38的远端的前进器40的夹子推动器部件90接合布置在夹子轨道30内的最远端的夹子36x，并且使夹子36x前进到钳口20内，如图6F所示。在示范性实施例中，前进器40可以在接合并且使进给器底托34开始前进之前，接合并且使最远端的夹子36x开始前进。因此，最远端的夹 子36x可以前进的距离大于进给器底托34所行进的距离。这种构形只允许最远端的夹子36x前进到钳口20内，而不会意外地使另外的夹子前进到钳口20内。
一旦夹子36x已经部分地或完全地形成，扳机16就可以释放，以释放已经形成的夹子36x。释放扳机16，这也可以在近端方向上收回进给棒38，直到突出部分86返回到在伸长槽88内的初始的最近端位置，如图6D所示。当进给棒38在近端方向上收回的时候，由于上部柄脚82a接合在夹子轨道30内的第二开口30c2，进给器底托34不会在近端方向上进行移动。下部柄脚82b不会干扰进给棒38的近端移动，并且一旦进给棒38像所显示的那样处在初始的最近端位置，下部柄脚82b就可以定位在位于进给棒38内的第二制动件842和第三制动件843之间。
过程可以重复进行，以使另一个夹子前进到钳口20内。通过每次驱使扳机16，下部柄脚82b可以与下一个制动件接合，即与形成在进给棒38内的制动件842接合，在进给器底托34上的上部柄脚82a可以在远端方向上移动到下一个开口内，即移动到在夹子轨道30上的开口30c3内，并且最远端的夹子可以前进到钳口20内并且释放。在装置10包括预定数量的夹子的情况下，例如在装置10包括17个夹子的情况下，扳机16可以受到17次驱使。一旦最后的夹子已经施加，在进给器底托34上的停止件，例如第三柄脚82c，就可以接合在夹子轨道30上的停止柄脚118，以防止进给器底托34进行进一步的远端移动。
图7-9图示了夹子形成组件的多种示范性构件。首先参考图7，显示了钳口20的示范性实施例。像先前所提及到的那样，钳口20可以包括具有齿94的近端部分20a，齿94用于与形成在钳口保持轴28上的相应的齿78匹配。然而，其它技术可以使用，以使钳口20与钳口保持轴28匹配。例如，燕尾连接、凸凹连接等可以使用。可选择地，钳口20可以与保持轴28整合形成。钳口20的远端部分20b可以适合于在其之间容纳夹子，这样，远端部分20b可以包括相对的第一钳口部件96a和第二钳口部件96b，第一钳口部件96a和第二钳口部件96b可以相对于彼此进行移动。在示范性实施例中，钳口部件96a、96b偏置到打开位置，并且需要力，以使钳口部件96a、96b朝向彼此进行移动。钳口部件96a、96b每个都可以包括形成在其内的在其相对的内部 表面上的凹槽(只显示了一个凹槽97)，以容纳与钳口部件96a、96b对准的夹子的腿。钳口部件96a、96b每个也可以包括形成在其内的凸轮轨道98a、98b，以允许凸轮42接合钳口部件96a、96b，并且使钳口部件96a、96b朝向彼此进行移动。在示范性实施例中，凸轮轨道98a、98b形成在钳口部件96a、96b的上部表面上。
图8图示了用于与钳口部件96、96b可滑动地匹配并且接合钳口部件96、96b的示范性的凸轮42。凸轮42可以具有多种构形，但在所图示的实施例中，凸轮42包括近端42a和远端42b，近端42a适合于与推杆44匹配，在下面对此进行了更详细的讨论，远端42b适合于接合钳口部件96a、96b。多种技术可以使用，以使凸轮42与推杆44匹配，但在所图示的示范性实施例中，凸轮42包括形成在其内的凹的或装键的切除部分100，切除部分100适合于容纳形成在推杆44的远端44b的凸的或键部件102。在图示了推杆44的图9中，更详细地显示了凸的部件102。像所显示的那样，凸的部件102的形状相应于切除部分100的形状，以允许两个部件42、44匹配起来。本领域的技术人员应该意识到的是，可选择地，凸轮42和推杆44可以彼此整合形成。推杆44的近端44a可以适合于与闭合联接件组件匹配，以相对于钳口20移动推杆44和凸轮42，在下面对此进行了更详细的讨论。
还如图8所示，凸轮42也可以包括形成在其上的突出部分42c，突出部分42c适合于可滑动地容纳在形成在钳口20内的伸长槽20c内。在使用时，突出部分42c和槽20c可以发挥功能，以形成用于夹子形成组件的近端停止件。
返回来参考图8，凸轮42的远端42b可以适合于接合钳口部件96a、96b。尽管多种技术可以使用，但在所图示的示范性实施例中，远端42b包括形成在其内的凸轮系统通道或渐尖的凹处104，以可滑动地容纳在钳口部件96a、96b上的凸轮轨道98a、98b。在使用时，如图10A和10B所示，凸轮42可以从钳口部件96a、96b彼此间隔某个距离的近端位置前进到钳口部件96a、96b定位成彼此邻近并且处在闭合位置的远端位置。当凸轮42在钳口部件96a、96b上前进的时候，渐尖的凹处104可以朝向彼此推动钳口部件96a、96b，由此挤压布置在其之间的夹子。
像先前所提及到的那样，外科夹子施加器10也可以包括组织停止 件46，以有助于在钳口20内定位处在外科位点的组织。图11所显示的组织停止件46的一个示范性实施例具有近端46a和远端46b。近端46a可以适合于与夹子轨道30的远端匹配，以将组织停止件46定位成邻近钳口20。然而，组织停止件46可以与夹子轨道30整合形成，或组织停止件46可以适合于与轴18的多种其它构件匹配或与轴18的多种其它构件整合形成。组织停止件46的远端46b的形状可以适合于在其之间安置脉管、管路、分路等，以相对于目标位点定位并且对准钳口20。如图11所示，组织停止件46的远端46b大致上是V形的。远端46b也可以具有弧形的构形，以有助于放置装置经过套管针或其它进入管。可选择地，组织停止件46的远端46b也可以包括其它有助于夹子在其上进行移动的特征部。例如，如图11所示，组织停止件46包括形成在远端46b的中间部分的斜面47，以使夹子与前进器组件40的尖端维持对准。特别地，斜面47可以允许夹子的顶点沿着其行进，这样就防止了夹子相对于在远端方向上推动夹子的前进器组件40发生未对准。本领域的技术人员应该意识到的是，组织停止件46可以具有多种其它构形，并且组织停止件46可以包括多种有助于使夹子沿着其前进的特征部。
图12图示了在使用时的组织停止件46。像所显示的那样，组织停止件46恰好定位在钳口20的下部，并且定位在允许脉管、管路、分路等容纳在钳口20之间的部位。还像所显示的那样，外科夹子36定位在钳口20之间，从而使夹子36的弯曲部分36a对准组织停止件46。这可以允许夹子36的腿36b定位成完全围绕脉管、管路、分路等或其它目标位点。
图13-26B图示了壳12的多种示范性的用于控制夹子前进和形成的内部构件。像先前所提及到的那样，外科夹子施加器10可以包括在这里所披露的特征中的一些或全部，并且外科夹子施加器10可以包括多种在本领域中所已知的其它特征。在某些示范性实施例中，夹子施加器10的内部构件可以包括连结到轴18的夹子前进组件用于使至少一个夹子前进经过伸长轴18以将夹子定位在钳口20之间的夹子前进组件和连结到轴18的夹子形成组件用于使钳口20闭合以形成部分闭合或完全闭合的夹子的夹子形成组件。其它示范性的特征部包括用于控制扳机16移动的抗倒退机构、用于防止由夹子形成组件施加到钳口 20的力过载的过载机构和用于指示剩余在装置10内的夹子的数量的夹子数量指示器。
图13-16D图示了壳12的用于实现在轴18内的进给棒38的移动的夹子前进组件的示范性实施例。大体上，夹子前进组件可以包括连结到扳机16的扳机插入件48、可以与进给棒38的近端38a匹配的进给棒连结件50和适合于在扳机插入件48和进给棒连结件50之间延伸以将运动从扳机插入件48传递到进给棒连结件50的进给联接件52。
图14更详细地图示了扳机插入件48。基于壳12的其它构件，扳机插入件48的形状可以发生改变，但在所图示的实施例中，扳机插入件48包括适合于枢转地与壳12匹配的中心部分48a和适合于延伸到扳机16内并且与扳机16匹配的伸长部分48b。中心部分48a可以包括延伸经过其以容纳用于枢转地使扳机插入件48与壳12匹配的轴的钻孔106。中心部分48a也可以包括形成在上侧边缘以容纳进给联接件52的部分的第一凹处108。优选地，第一凹处108的尺寸和形状允许进给联接件52的部分在其内延伸，从而当扳机插入件48由于扳机16的移动而进行枢转的时候，使得促使进给联接件52进行枢转。如图14所示，第一凹处108大致上是伸长的，并且包括形成在其内的大致上为圆形的部分，用于安置形成在进给联接件52的近端的轴，在下面就图16对此进行了更详细的讨论。扳机插入件48也可以包括形成在后侧边缘以容纳闭合联接件滚子54的第二凹处110和形成在其底侧边缘用于与棘爪60匹配以控制扳机16的移动的棘轮齿112，闭合联接件滚子54连结到推杆44，用于移动凸轮42，以使钳口20闭合，在下面对此进行了更详细的讨论。
在图15A和15B中，更详细地显示了示范性的进给棒连结件50，并且示范性的进给棒连结件50可以适合于将进给棒38的近端连结到进给联接件52的远端。尽管多种技术可以使用以使进给棒连结件50与进给棒38的近端38a匹配，但在示范性实施例中，进给棒连结件50由两个分开的半部分50a、50b形成，两个分开的半部分50a、50b匹配在一起，以使进给棒38的近端38a维持在其之间。当匹配的时候，两个半部分50a、50b一起限定了中心轴50c，中心轴50c具有形成在其相对端并且限定了在其之间的凹处50f以安置进给联接件52的远端部分的大致上为圆形的凸缘50d、50e。中心轴50c限定了经过其的腔 50g，以容纳进给棒38的近端38a并且将进给棒38锁定在相对于进给棒连结件50大致上固定的位置。然而，进给棒连结件50可以与进给棒38整合形成，并且进给棒连结件50可以具有多种其它形状和尺寸，以有助于与进给联接件52匹配。
图16图示了可以在扳机插入件48和进给棒连结件52之间延伸的示范性的进给联接件52。大体上，进给联接件52可以具有带有近端52a和远端52b的大致上平的伸长的形状。近端52a适合于可转动地位于扳机插入件48的第一凹处108内，这样，就像先前所讨论的那样，近端52a可以包括延伸经过其的轴53(图1B)。轴53可以适合于在扳机插入件48的第一凹处108内进行枢转的转动，由此允许扳机插入件48使进给联接件52进行枢转。进给联接件52的远端52b可以适合于连结到进给棒连结件50，这样，在示范性实施例中，进给联接件52的远端52b包括形成在其上的相对的臂114a、114b，臂114a、114b限定了在其之间的开口116，以安置进给棒连结件50的中心轴50a。当进给联接件52围绕枢转轴线X进行枢转的时候，臂114a、114b有效地接合连结件50并且使连结件50进行移动。枢转轴线X可以由进给联接件52连结到壳12的部位限定，并且枢转轴线X可以定位在进给联接件52上的任何地方，但在所图示的实施例中，枢转轴线X定位成邻近进给联接件52的近端52a。
在示范性实施例中，进给联接件52可以是柔性的，以不必对夹子前进组件和夹子形成组件进行校准。特别地，进给联接件52允许扳机16朝向闭合位置进行连续的移动，即使在进给棒38和进给棒连结件50处在最远端位置之后，并且进给联接件52为夹子形成组件和夹子前进组件提供了一些自由。换言之，在使扳机闭合期间，扳机16是可相对于进给棒38弯曲的。
基于夹子前进组件和夹子形成组件的构形，进给联接件52的具体硬度和强度可以发生改变，但在一个示范性实施例中，进给联接件52所具有的硬度的范围在75到110磅每英寸内，并且更优选地为大约93磅每英寸(像在位于联接件52和进给棒连结件50之间的界面测量到的那样)，并且进给联接件52所具有的强度的范围在25磅到50磅内，并且更优选地为大约35磅。进给联接件52也可以由多种材料形成，包括多种聚合物、金属等。一种示范性的材料是玻璃加固的聚醚酰亚 胺，但许多加固的热塑性塑料可以使用，包括玻璃加固的液晶聚合物、玻璃加固的尼龙和这些的碳纤维加固的形式及类似的热塑性塑料。像热固聚酯那样的纤维加固的热固聚合物也可以使用。进给联接件52也可以由像弹簧钢那样的金属制造，以实现受限制的柔性和受控制的强度的需要的组合。
图17A-17D图示了在使用时的示范性的夹子前进组件。图17A显示了初始位置，在其中，扳机16处在打开位置，进给棒连结件50和进给棒38处在最近端位置，而进给联接件52在扳机插入件48和进给棒连结件50之间延伸。像先前所讨论的那样，在初始打开位置，在进给棒38上的突出部分86定位在位于钳口保持器轴28内的伸长槽88的近端。第一偏置部件，例如弹簧120，连结到扳机插入件48和壳12，以使扳机插入件48和扳机16维持在打开位置，而第二偏置部件，例如弹簧122，在可转动地使轴18与壳12匹配的轴连结件124和进给棒连结件50之间延伸，以使进给棒连结件50和进给棒38维持在最近端位置。
如图17B所示，当扳机16受到驱使并且朝向闭合位置即朝向固定的把手14进行移动以克服由弹簧120、122施加的偏置力的时候，扳机插入件48开始在逆时针方向上进行枢转。因此，促使进给联接件52在逆时针方向上进行枢转，由此使进给棒连结件50和进给棒38在远端方向上进行移动。这样，在进给棒38上的突出部分86就在钳口保持器轴28内的伸长槽88内在远端方向上进行移动，由此使布置在夹子轨道内的进给器底托34和夹子36前进。弹簧120在壳和扳机插入件48之间延伸，而弹簧122在进给棒连结件50和轴连结件124之间受到压缩。
当扳机16进一步受到驱使并且扳机插入件48继续进行枢转的时候，进给棒连结件50和进给棒38最终到达最远端位置。像先前所讨论的那样，在该位置，在进给棒38上的突出部分86定位在位于钳口保持器轴28内的槽88的远端，而夹子定位在钳口20之间。如图17C和17D所示，弹簧122在轴连结件124和进给棒连结件50之间受到完全压缩，而进给联接件52发生弯曲。当进给联接件52发生弯曲的时候，并且更优选地，一旦进给联接件52发生完全弯曲，夹子形成组件就受到驱使，以使钳口20闭合。在驱使夹子形成组件期间，例如在第 二驱使阶段期间，进给联接件52保持弯曲，从而使扳机插入件48是可相对于夹子形成组件弯曲的，并且特别地，是可相对于进给棒38弯曲的。
在图18-20中，更详细地显示了壳12的示范性的夹子形成组件。大体上，夹子形成组件布置在壳12内，并且夹子形成组件有效地使推杆44和凸轮42相对于钳口20进行移动，以使钳口20移动到闭合位置，由此挤压定位在其之间的夹子。尽管夹子形成组件可以具有多种构形，但所图示的示范性的夹子形成组件包括可滑动地连结到扳机插入件48的闭合联接件滚子54、适合于连结到闭合联接件滚子54的闭合联接件56和适合于连结到闲合联接件56和推杆44的闭合连结件58。
图18更详细地图示了闭合联接件滚子54，像所显示的那样，闭合联接件滚子54包括具有大致上为圆形的凸缘54b、54c的中心轴54a，凸缘54b、54c邻近中心轴54a的相对终端形成。中心轴54a可以适合于位于在扳机插入件48内的第二凹处10内，从而使凸缘54b、54c容纳在扳机插入件48的相对侧。中心轴54a也可以适合于与闭合联接件56的相对的臂126a、126b匹配，以将臂定位在扳机插入件48的相对侧。
在图19中，更详细地图示了闭合联接件56的示范性实施例，像所显示的那样，闭合联接件56具有彼此间隔了某个距离的相对的臂126a、126b。臂126a包括近端128a和远端130a，而臂126b包括近端128b和远端130b，近端128a、128b适合于接合闭合联接件滚子54的中心轴54a，而远端130a、130b适合于与闭合连结件58匹配，以将闭合联接件滚子54和闭合联接件56连结到推杆44。在示范性实施例中，臂126a的近端128a和臂126b的近端128b适合于枢转地与闭合联接件滚子54匹配，这样，臂126a、126b就可以包括例如形成在其上的钩形部件132a、132b，以接合中心轴54a。钩形部件132a、132b在相对的方向上延伸，以有助于在闭合联接件56和闭合联接件滚子54之间的接合。臂126a的远端130a和臂126b的远端130b可以彼此匹配，并且它们可以包括延伸经过其的腔134，以容纳适合于枢转地使闭合联接件56与闭合连结件58匹配的轴。本领域的技术人员应该意识到的是，多种其它技术可以使用，以使闭合联接件56与闭合联接件滚子54和 闭合连结件58匹配。
在图20A中，更详细地显示了示范性的闭合连结件58，并且像所显示的那样，闭合连结件58包括具有两个臂136a、136b的近端部分58a，两个臂136a、136b带有延伸经过其并且适合于与在闭合联接件56内的腔134对准的腔138a、138b，用于容纳轴，以使两个构件匹配。闭合连结件58也可以包括适合于与推杆44的近端44a(图9)匹配的远端部分58b。在示范性实施例中，闭合连结件58包括形成在其内的切除部分59(图20B和20C)，切除部分59的形状适合于安置推杆44的近端44a。闭合连结件58的远端部分58b也可以成形为当扳机16处在打开位置的时候容纳进给棒连结件50的部分。本领域的技术人员应该意识到的是，多种其它匹配技术可以使用，以使闭合连结件58与推杆44匹配，并且可选择地，闭合连结件58和推杆44可以彼此整合形成。
在图20B和20C所示的其它示范性实施例中，偏置部件可以布置在切除部分59内，以使推杆44在远端方向上发生偏置。如果使用者松开扳机16，那么这种构形就可以防止夹子从钳口意外释放，特别是在早期闭合阶段期间。特别地，尽管在下面更详细讨论的抗倒退机构可以适合于防止扳机16打开，直到扳机16到达预定位置，但抗倒退机构可以允许扳机16进行一些微小的移动。这样，在使用者松开扳机16并且扳机16进行了微小的打开的情况下，偏置部件就使推杆44在远端方向上发生偏置，由此使推杆44维持在大致上固定的位置。尽管多种偏置部件可以使用，但在图20B所示的实施例中，偏置部件是定位在推杆44的近端44a和凹处59的后部壁之间以使推杆44在远端方向上发生偏置的悬臂梁61。悬臂梁61可以由像Nitinol那样的形状记忆材料形成，当指向近端方向的力施加到梁61的时候，形状记忆材料允许梁61弯曲或变平。梁61也可以由多种其它材料形成，例如弹簧钢或加固的聚合物，并且可以使用多于一个的梁。图20C图示了偏置部件的另一个实施例，这个实施例的形式是卷簧或其它类型的弹簧63。像所显示的那样，弹簧63布置在推杆44的近端44a和凹处59的后部壁之间，以使推杆44在远端方向上发生偏置。当指向近端方向的力施加到弹簧63的时候，弹簧63适合于压缩。本领域的技术人员应该意识到的是，多种其它偏置部件可以使用，包括弹性体压缩部件。
再次参考图17A-17D，在使用时，当扳机16开始从打开位置朝向闭合位置进行移动的时候，闭合联接件滚子54在位于扳机插入件48内的凹处110内进行滚动。一旦进给棒38和进给棒连结件50处在最远端位置，如图17C所示，对扳机16的进一步驱使就使得在扳机插入件48内的凹处110接合闭合联接件滚子54，促使闭合联接件滚子54与扳机插入件48一起进行枢转，如图17D所示。因此，闭合联接件58在远端方向上进行移动，由此使得推杆44在远端方向上进行移动。当推杆44在远端方向上前进的时候，凸轮42在钳口20上前进，以使钳口20闭合并且挤压定位在其之间的夹子。可选择地，扳机16可以部分地闭合，以使钳口20部分地闭合，这样就部分地挤压了定位在其之间的夹子。在下面，更详细地讨论了用于有助于可选择地使夹子完全地和部分地闭合的示范性技术。一旦施加了夹子，扳机16就可以释放，由此允许弹簧120将扳机插入件48拉回到它的初始位置，并且允许弹簧122使进给棒连结件50和进给棒38回到近端位置。当扳机插入件48返回到它的初始位置的时候，闭合联接件滚子54也移动回到它的初始位置，由此在近端方向上拉动闭合联接件56、闭合连结件58和推杆44。
外科夹子施加器10也可以包括多种其它有助于使用装置10的特征部。在一个示范性实施例中，外科夹子施加器10可以包括用于对扳机16的移动进行控制的抗倒退机构。特别地，抗倒退机构可以在部分闭合行程期间，防止扳机16打开。然而，一旦扳机到达定位在钳口之间的夹子可以受到部分的挤压的预定位置，抗倒退机构就可以释放扳机，以像使用者所想要的那样，允许扳机打开并且释放夹子，或允许扳机闭合以完全地挤压夹子。
图21A和21B图示了抗倒退机构的一个形式为棘轮的示范性实施例。像所显示的那样，棘轮包括一组形成在扳机插入件48上的齿112和适合于可转动地布置在壳12内并且定位成邻近扳机插入件48的棘爪60，从而使扳机16的闭合和扳机插入件48的枢转移动可以使得棘爪60接合齿112。齿112可以成形为防止棘爪60进行转动，直到棘爪60到达棘爪60可以自由转动的预定位置，由此允许扳机16打开或闭合。预定的位置优选地相应于钳口20部分闭合的位置。像所显示的那样，在示范性实施例中，齿112包括具有防止棘爪60相对其进行转动 的尺寸的第一组齿112a，例如10个齿，这样，当棘爪60与齿112的第一组112a接合的时候，就防止了扳机16打开。齿112也可以包括称为托科鸟齿112b的末端齿或终端齿，其具有这样的尺寸，即当棘爪60与托科鸟齿112b接合的时候，允许棘爪60相对于其进行转动。特别地，托科鸟齿112b的尺寸优选地大致上大于第一组齿112a的尺寸，从而使相对大的凹口140形成在第一组齿112a和托科鸟齿112b之间。凹口140的尺寸允许棘爪60在其内进行枢转，这样就允许棘爪60可选择地移动超过托科鸟齿112b或朝向第一组齿112a向后移动。本领域的技术人员应该意识到的是，托科鸟齿112b的尺寸可以与第一组10个齿112a相同，或小于第一组10个齿112a，但仍然提供形成在其之间的允许棘爪60在其内进行枢转的凹口140。
图22A-22D图示了在使用时的棘轮机构。如图22A所示，当扳机16开始朝向闭合位置进行移动的时候，棘爪60接合第一组齿112a，由此防止了扳机16打开。对扳机16的进一步驱使使得棘爪60前进越过第一组齿112a，直到棘爪60到达紧邻托科鸟齿112b的凹口140。一旦棘爪60到达托科鸟齿112b，此时，钳口20由于凸轮42在钳口20上部分地进行远端移动而部分地闭合，棘爪60就可以自由地进行转动，由此像使用者所想要的那样，允许扳机16打开或闭合。图22C图示了在完全闭合位置的扳机16，而图22D和22E图示了返回到打开位置的扳机16。
棘轮转机构也可以成形为发出指示钳口20的位置的听得到的声音。例如，当棘爪60接合第一组齿112a的时候，可以发出第一声音，而当棘爪60接合托科鸟齿112b的时候，可以发出第二不同的声音，例如较大的声音。因此，当扳机16到达棘爪60与托科鸟齿112b接合的预定位置的时候，第二声音指示使用者钳口20处在部分闭合的位置。这样，使用者就可以释放扳机16，以释放部分闭合的夹子，或使用者可以使扳机16完全闭合，以使夹子完全闭合。
在另一个示范性实施例中，外科夹子施加器10可以包括适合于防止由扳机16施加到钳口20的力过载的过载机构。典型地，在施加外科夹子期间，需要某个大小的力，以使钳口20闭合并且将夹子围绕定位在钳口20之间的组织挤压。当形成过程进行并且夹子至少部分闭合的时候，继续使钳口20围绕夹子闭合所需要的力显著地增加。因此， 在示范性实施例中，过载机构所具有的阻力可以与使钳口20闭合所需要的力关联。换言之，当使钳口20闭合所需要的力增加的时候，过载机构的阻力可以增加。然而，阻力优选地稍大于使钳口20闭合所需要的力，以防止意外地驱使过载机构。因此，如果当扳机16开始受到驱使的时候防止钳口20闭合，那么克服过载机构的阻力所需要的力是相对小的。这是特别有利的，因为当钳口20打开或只是部分闭合的时候，钳口20更易于发生变形。在早期夹子形成阶段，过载机构更容易驱使，以防止钳口发生变形。相反地，当钳口20大致上闭合的时候，阻力是相对大的，从而使过载机构可以只当将相当大的力施加到钳口20时才受到驱使。
显示成分解图的图23A图示了过载机构62的一个示范性实施例。大体上，过载机构可以包括由两个半部分64a、64b形成的过载壳64，过载壳64包含异形联接件66、肘接联接件68、枢转联接件70和偏置组件72。偏置组件72可以包括连结到壳64的弹簧柱150，弹簧柱150包括延伸经过其的钻孔，以容纳柱塞154。弹簧152围绕弹簧柱150布置，而柱塞154延伸经过弹簧柱150，并且柱塞154包括形成在其上的适合于邻接靠在弹簧152上的头154a。枢转联接件70可以是大体上L形的，并且枢转联接件70可以通过延伸经过其的枢转销156连结到壳64。枢转联接件70的近端70a可以接触柱塞154的头154a，而枢转联接件70的远端70b可以通过枢转销166枢转地连结到肘接联接件68。接下来，肘接联接件68可以连结到异形联接件66，其可以邻近形成在壳内的开口64d可滑动地并且枢转地定位在壳64内。例如通过延伸经过异形联接件66并且布置在形成在壳64的每个半部分64a、64b内的第一槽160a(只显示了一个槽)内的枢转销158，异形联接件66可以在壳64内进行枢转移动，而例如通过形成在异形联接件66上的容纳在形成在壳64的每个半部分64a、64b内的第二槽160b(只显示了一个槽)内的相对的突出部分168a、168b，异形联接件66可以在壳64内进行可滑动移动。
在使用时，异形联接件66可以适合于接收来自夹子形成组件的力，并且适合于由偏置组件72的阻力对抗这个力。特别地，过载机构62使用连同肘接联接件68和枢转联接件70的弹簧152，以使异形联接件66发生偏置而不会围绕枢转销158进行转动或靠在壳64上进行滑 动。就转动而言，由受到压缩的弹簧152施加的力传递经过肘接联接件68和枢转联接件70，从而将转动力矩施加到异形联接件66靠在壳64上。这样，该组件就使得异形联接件66抵抗相对于壳64进行转动。如果由来自靠在异形联接件66上的闭合联接件滚子54的径向负载产生的力矩超过了枢转联接件70和肘接联接件68的力矩，那么异形联接件66就开始进行转动，使肘接联接件68变弯，并且使得枢转联接件70进一步压缩弹簧152。就滑动而言，枢转联接件70、肘接联接件68和异形联接件66对准，从而使滑动力(对滑动的阻力)是使肘接联接件68和枢转联接件70变弯所需要的力。如果来自靠在异形联接件66上的闭合联接件滚子54的径向负载超过了联动装置的变弯力，那么，当异形联接件66在近端方向上进行滑动的时候，枢转联接件70就进一步压缩弹簧152。
这在图23B-23C中得以更详细的显示，并且像所显示的那样，在壳64内的开口64d允许夹子形成组件的闭合联接件滚子54靠在异形联接件66上进行滚动。因此，当扳机16受到驱使并且朝向闭合位置移动的时候，闭合联接件滚子54将力施加到异形联接件66。然而，过载弹簧152的阻力使异形联接件66维持在大致上固定的位置，除非由闭合联接件滚子54施加的力增加到大于这个阻力，例如阀值力。例如，这可以通过定位在钳口20之间的异物实现，或当钳口20完全闭合而夹子和脉管、管路、分路等处在其之间的时候实现。当钳口20不能进一步闭合的时候，由于扳机16的闭合运动而施加到闭合联接件滚子54的力传递到异形联接件66，然后，异形联接件66在壳64内进行枢转和滑动，由此使得枢转联接件70进行枢转，这促使柱塞154压缩过载弹簧152。
像先前所注意到的那样，驱使过载机构所需要的力可以与使钳口20闭合所需要的力相关，当扳机16移动到闭合位置的时候，驱使过载机构所需要的力增加了。由于异形联接件66的构形，这可以实现。特别地，如图23B所示，当闭合联接件滚子54首先与异形联接件66相接触，由此处在下部位置的时候，异形联接件66可以在壳64内进行枢转。如图23C所示，当闭合联接件滚子54向上沿着异形联接件66进行移动的时候，克服过载机构的阻力所需要的力增加了，因为异形联接件66必须在壳64内进行滑动。使异形联接件66进行枢转所需要 的力可以小于使异形联接件66进行滑动所需要的力。因此，如果当扳机开始受到驱使的时候，例如由于异物防止钳口20闭合，那么就需要微小的力，以使得闭合联接件滚子54将力传递到异形联接件66的下部部分，这使得异形联接件66进行枢转。当钳口20大致上闭合而扳机16几乎受到完全驱使的时候，需要相当大的力，以使得闭合联接件滚子54将力传递到异形联接件66的上部部分，这使得异形联接件66在壳64内进行滑动，以克服过载弹簧152的阻力。尽管驱使过载机构所需要的力的量可以大于使钳口20闭合所需要的力，并且相对于使钳口20闭合所需要的力，驱使过载机构所需要的力可以增加，但优选地，驱使过载机构所需要的力只是稍大于使钳口20闭合所需要的力，以防止钳口20发生变形或受到其它损坏。本领域的技术人员应该意识到的是，基于使钳口20闭合所需要的力，阻力可以调整。
异形联接件66，特别是异形联接件66的面向远端的表面66s，也可以具有有助于使驱使过载机构所需要的力和使钳口20闭合所需要的力关联起来的形状。例如，在使钳口20闭合所需要的力以线性比率增加的情况下，异形联接件66的面向远端的表面66s可以是平的，以防止异形联接件66干涉闭合联接件滚子54在其上移动，并且允许将线性力施加到扳机16，以使钳口20闭合。相反地，在当扳机16移动到闭合位置的时候使钳口20闭合所需要的力是非线性的情况下，异形联接件66可以具有相应于非线性力的非线性形状。这种构形可以防止使凸轮42(图8)闭合所需要的力变得太大。
作为非限制性的例子，由于在凸轮42内的适合于推动钳口部件96a、96b朝向彼此的凹处104的形状，使钳口20闭合所需要的力可以是非线性的。如图8所示，凹处104可以具有弧形的构形，从而当凸轮42在钳口部件96a、96b上通过的时候，使力可以发生改变。因此，异形联接件66可以具有相应弧形的面向远端的表面，从而当闭合联接件滚子54在其上通过的时候，使力也可以发生改变。如图23A和23B所示，异形联接件66是弧形的，从而使异形联接件66的下部部分是大致上凸起的而异形联接件66的上部部分是大致上凹陷的。本领域的技术人员应该意识到的是，异形联接件66可以具有多种其它形状，并且多种其它技术可以使用，以对使钳口20闭合所需要的力和驱使过载机构所需要的力进行优化。
本领域的技术人员也应该意识到的是，过载机构可以具有多种其它构形。作为非限制性的例子，图23D图示了形式为用于接收由闭合联接件滚子54施加的力的悬臂梁170的过载机构。梁170可以具有大致上弧形的部件172，弧形的部件172带有连结到其一端的支架174。当负载了大于弧形的部件172所具有的弯曲力矩的力的时候，弧形的部件172可变弯，以呈现低刚性状态。支架174可以将更大的刚性提供给弧形的部件172，从而使邻近支架174的弯曲力矩增加。在使用时，梁170可以加载在夹子施加器10的壳12内，从而使闭合联接件滚子54接触凹陷的表面，并且梁170可以以某个角度定位，从而当扳机16开始受到驱使的时候，使闭合联接件滚子54更加远离梁，并且当扳机16移动到闭合位置的时候，使闭合联接件滚子54更加接近梁。因此，当闭合联接件滚子54进行移动并且夹子施加器的扳机16移动到闭合位置的时候，对变弯的阻力可以增加。虽然没有显示，但可选择地，可以以堆叠的方式使用多个梁，并且梁(或多个梁)的终端或自由端可以确定轮廓为在沿着梁的长度的某个特别的点定制变弯负载。
在另一个示范性实施例中，外科夹子施加器10可以包括用于指示剩余在装置10内的夹子的数量的夹子数量指示器。尽管多种技术可以使用以指示剩余的夹子的数量，但图24A-25所图示的夹子数量指示器的一个示范性实施例具有指示器轮74和指示器驱使器76。
在图24A和24B中，更详细地显示了指示器轮74，并且像所显示的那样，指示器轮74具有大体上为圆形的或圆柱形的限定了中心轴线Y的形状，指示器轮74适合于围绕中心轴线Y进行转动。轮74包括围绕其形成且适合于与指示器驱使器76接合的齿142和指示器部件144。指示器部件144可以具有多种构形，但在示范性实施例中，指示器部件144的形式为对比色垫，对比色垫具有不同于指示器轮74的剩余部分的颜色，例如橙色、红色等。
图25更详细地图示了示范性的指示器驱使器76。驱使器76适合于可滑动地布置在壳12内，并且适合于连结到进给联接件连结件50，并且当进给棒连结件50和进给棒38进行移动的时候，驱使器76进行移动。因此，指示器驱使器76可以包括形成在其下部表面的突出部分146，以延伸到形成在位于进给棒连结件50上的圆形凸缘50d、50e之间的凹处50f内，只显示了突出部分146的部分。突出部分146允许指 示器驱使器76与进给棒连结件50接合并且与其一起进行移动。指示器驱使器76也可以包括形成在其上的接合机构148，接合机构148适合于接合形成在指示器轮74上的齿142。如图25所示，在指示器驱使器76上的接合机构148的形式为具有形成在其端部的片以接合齿142的臂。
在使用时，如图26A-26B所示，指示器轮74可转动地布置在壳12内，而指示器驱使器76可滑动地布置在壳12内，从而使接合机构148定位成邻近指示器轮74而突出部分146延伸到进给棒连结件50内。壳12包括形成在其内的窗12a，以提供看到指示器轮144的通道。当扳机16移动到闭合位置而进给棒连结件50在远端方向上进行移动的时候，指示器驱使器76与进给棒38和进给棒连结件50一起在远端方向上进行移动。因此，在指示器驱使器76上的接合机构148接合在指示器轮74上的齿142，由此当夹子前进到钳口20内的时候，使得轮74进行转动。当扳机16每次受到驱使以使夹子20前进到钳口20内的时候，指示器驱使器74都使指示器轮76进行转动。当夹子供给器还剩下两个或三个夹子的时候，在指示器轮74上的对比色垫144开始出现在形成在壳12内的窗12a内，由此指示给使用者只剩下几个夹子。当夹子供给器用尽的时候，对比色垫144可以适合于占据整个窗12a。
在另一个示范性实施例中，指示器轮74可以包括适合于防止指示器轮74在前进之后在相反方向上例如在逆时针方向上进行转动的抗倒退机构。尽管抗倒退机构可以具有多种构形，但在图24B所示的实施例中，指示器轮74包括大致上平行于轴线Y延伸的相对的臂73a、73b。每个臂73a、73b具有形成在其最远端的适合于接合形成在壳12上的相应的齿的棘爪75a、75b。尽管没有显示，但相应的齿可以形成在位于邻近窗12a的壳12的内部部分上的圆形的突出部分内。当指示器轮74布置在壳12内的时候，臂73a、73b延伸到围绕其内部圆周形成的圆形的突出部分内。当夹子得以施加而指示器轮74进行转动的时候，臂73a、73b可以在位于壳内的齿上发生偏转，以移动到下一个位置。当指示器驱使器76在近端方向上进行滑动以返回到它的初始位置的时候，臂73a、73b接合在壳内的齿，以防止指示器轮74在相反方向上进行转动，即防止指示器轮74返回到先前位置。本领域的技术人员应该意识到的是，多种其它技术可以使用，以防止指示器轮74发生倒退。
像先前所提及到的那样，外科夹子施加器10可以使用，以将部分闭合的或完全闭合的夹子施加到像脉管、管路、分路等那样的外科位点。在进行腹腔镜手术和内窥镜手术中，在患者的身体上进行小的切口，以进入外科位点。典型地，套管或进入端口用于限定从皮肤切口延伸到外科位点的工作通道。在进行外科手术期间，经常必需的是使经过脉管或其它管路的血流停止下来，并且一些手术可能需要使用分路。这样，外科夹子就可以用于挤压脉管或将分路固定到脉管。因此，像夹子施加器10那样的外科夹子施加器可以经过套管导入或另外导入到外科位点内，以将钳口20成围绕脉管、分路或其它管路等定位。组织停止件46可以有助于将钳口20围绕目标位点定位。然后，扳机16可以受到驱使，以使得夹子在钳口之间前进并且围绕目标位点定位，并且使得钳口闭合，以挤压夹子。基于夹子的用途，如棘爪60到达托科鸟齿112b的听得到的声音指示的，扳机16可以受到部分的驱使，或扳机16可以受到完全的驱使。然后，扳机16释放，以释放部分闭合的或完全闭合的夹子，并且如果需要施加更多的夹子，那么这个过程就可以重复进行。
基于上述实施例，本领域的一个技术人员应该意识到本发明的其它特征和优点。因此，除了像后附的权利要求书所指示的那样，本发明不受已经特别显示和描述的东西的限制。在这里，将在这里所引用的所有出版物和参考文献确切地通过参考完全地合并起来。

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1.一种外科夹子施加器，其具有用于防止施加到夹子施加器的钳口的闭合力过载的过载机构，外科夹子施加器包括具有扳机的壳、伸长轴和布置在壳和伸长轴内并且连结到扳机的凸轮系统组件，扳机可移动地连结到壳而伸长轴从壳延伸出来，相对的钳口形成在伸长轴的远端并且能够在打开位置和闭合位置之间移动。
2.根据权利要求1所述的外科夹子施加器，其特征在于，当驱使扳机时，凸轮系统组件适合于将闭合力施加到钳口，以使钳口从打开位置朝向闭合位置移动。
3.根据权利要求1所述的外科夹子施加器，其特征在于，当闭合力大于过载机构施加到凸轮系统组件的阻力时，凸轮系统组件也适合于将闭合力传递到布置在壳内的过载机构。
4.根据权利要求3所述的外科夹子施加器，其特征在于，过载机构的阻力与使钳口从打开位置朝向闭合位置移动所需要的力相关联。
5.根据权利要求1所述的外科夹子施加器，其特征在于，凸轮系统组件相对于过载机构的力接收表面进行移动，从而当扳机受到驱使以使得凸轮系统组件从打开位置朝向闭合位置移动钳口时，使凸轮系统组件的闭合力经过过载机构的力接收表面施加。
6.根据权利要求3所述的外科夹子施加器，其特征在于，过载机构的力接收表面适合于阻止在近端方向上的移动，并且当扳机受到驱使以使得凸轮系统组件相对于力接收表面进行移动并且使钳口从打开位置朝向闭合位置移动时，阻力增加。
7.根据权利要求5所述的外科夹子施加器，其特征在于，过载机构包括具有异形联接件的壳，异形联接件可滑动地并且枢转地布置在壳内，并且具有形成其上的力接收表面并且定位成邻近形成在壳内的开口。
8.根据权利要求5所述的外科夹子施加器，其特征在于，力接收表面包括适合于接收用于使在壳内的力接收部件进行枢转移动的力的第一部分，和适合于接收用于使在壳内的力接收部件进行可滑动移动的力的第二部分。
9.根据权利要求5所述的外科夹子施加器，其特征在于，过载机构也包括适合于将阻力施加到异形联接件的偏置组件。
10.根据权利要求9所述的外科夹子施加器，其特征在于，通过适合于当异形联接件进行枢转移动时进行枢转并且适合于当异形联接件进行可滑动移动时进行滑动的枢转组件，偏置组件连结到异形联接件，以将力施加到偏置组件，以克服阻力。
11.根据权利要求1所述的外科夹子施加器，该过载机构包括枢转地并且可滑动地布置在壳内并且具有带有第一端和相对的第二端的表面的力接收部件，和布置在壳内并且适合于阻止力接收部件移动的偏置组件。
12.根据权利要求11所述的外科夹子施加器，其特征在于，从第一端到第二端，阻力是增加的。
13.根据权利要求11所述的外科夹子施加器，其特征在于，形成在过载机构上的力接收表面定位在位于壳内的开口内。
14.根据权利要求11所述的外科夹子施加器，其特征在于，力接收表面包括适合于接收用于使在壳内的力接收部件进行枢转移动的力的第一部分，和适合于接收用于使在壳内的力接收部件进行可滑动移动的力的第二部分。
15.根据权利要求11所述的外科夹子施加器，其特征在于，偏置组件包括围绕弹簧柱布置的弹簧和相对于弹簧柱可滑动地布置的柱塞，柱塞具有形成在其上的头并且适合于当柱塞朝向弹簧柱移动时对弹簧进行压缩。
16.根据权利要求11所述的外科夹子施加器，其特征在于，壳包括连结在力接收部件和偏置组件之间的枢转组件，从而使枢转组件适合于将施加到力接收部件的力传递到偏置组件，以克服阻力。
17.根据权利要求16所述的外科夹子施加器，其特征在于，枢转组件包括枢转地连结到力接收部件的肘接联接件，和枢转地连结到肘接联接件并且适合于当其进行枢转移动时将力施加到偏置组件的枢转联接件。
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Families Citing this family (893)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11229472B2 (en) 2001-06-12 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with multiple magnetic position sensors
ES2616695T3 (es) 2003-03-11 2017-06-14 Covidien Lp Aparato de aplicación de grapas con mordaza inclinada
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US11998198B2 (en) 2004-07-28 2024-06-04 Cilag Gmbh International Surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
EP2875786B1 (en) 2004-10-08 2017-02-01 Covidien LP Apparatus for applying surgical clips
US9763668B2 (en) 2004-10-08 2017-09-19 Covidien Lp Endoscopic surgical clip applier
ES2547214T3 (es) 2004-10-08 2015-10-02 Covidien Lp Un aplicador endoscópico de clips o grapas quirúrgicos
US7819886B2 (en) 2004-10-08 2010-10-26 Tyco Healthcare Group Lp Endoscopic surgical clip applier
US8409222B2 (en) 2004-10-08 2013-04-02 Covidien Lp Endoscopic surgical clip applier
US7297149B2 (en) 2005-04-14 2007-11-20 Ethicon Endo-Surgery, Inc. Surgical clip applier methods
US7686820B2 (en) 2005-04-14 2010-03-30 Ethicon Endo-Surgery, Inc. Surgical clip applier ratchet mechanism
US8523882B2 (en) 2005-04-14 2013-09-03 Ethicon Endo-Surgery, Inc. Clip advancer mechanism with alignment features
US7740641B2 (en) 2005-04-14 2010-06-22 Ethicon Endo-Surgery, Inc. Clip applier with migrational resistance features
US7288098B2 (en) 2005-04-14 2007-10-30 Ethicon Endo-Surgery, Inc. Force limiting mechanism for medical instrument
US8038686B2 (en) 2005-04-14 2011-10-18 Ethicon Endo-Surgery, Inc. Clip applier configured to prevent clip fallout
US7261724B2 (en) 2005-04-14 2007-08-28 Ethicon Endo-Surgery, Inc. Surgical clip advancement mechanism
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US7673781B2 (en) 2005-08-31 2010-03-09 Ethicon Endo-Surgery, Inc. Surgical stapling device with staple driver that supports multiple wire diameter staples
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US7799039B2 (en) 2005-11-09 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument having a hydraulically actuated end effector
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
US20110295295A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument having recording capabilities
US7766210B2 (en) 2006-01-31 2010-08-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with user feedback system
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US7770775B2 (en) 2006-01-31 2010-08-10 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with adaptive user feedback
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US8236010B2 (en) 2006-03-23 2012-08-07 Ethicon Endo-Surgery, Inc. Surgical fastener and cutter with mimicking end effector
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US20080078802A1 (en) 2006-09-29 2008-04-03 Hess Christopher J Surgical staples and stapling instruments
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US11980366B2 (en) 2006-10-03 2024-05-14 Cilag Gmbh International Surgical instrument
US8708210B2 (en) 2006-10-05 2014-04-29 Covidien Lp Method and force-limiting handle mechanism for a surgical instrument
EP1913881B1 (en) 2006-10-17 2014-06-11 Covidien LP Apparatus for applying surgical clips
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8840603B2 (en) 2007-01-10 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8827133B2 (en) 2007-01-11 2014-09-09 Ethicon Endo-Surgery, Inc. Surgical stapling device having supports for a flexible drive mechanism
US8590762B2 (en) 2007-03-15 2013-11-26 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configurations
AU2008230841B2 (en) 2007-03-26 2013-09-12 Covidien Lp Endoscopic surgical clip applier
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
WO2008127968A2 (en) 2007-04-11 2008-10-23 Tyco Healthcare Group Lp Surgical clip applier
US7810693B2 (en) 2007-05-30 2010-10-12 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting instrument with articulatable end effector
US7798386B2 (en) * 2007-05-30 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument articulation joint cover
US11672531B2 (en) 2007-06-04 2023-06-13 Cilag Gmbh International Rotary drive systems for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US7832408B2 (en) 2007-06-04 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US8534528B2 (en) 2007-06-04 2013-09-17 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US7905380B2 (en) 2007-06-04 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US7753245B2 (en) * 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US7905381B2 (en) 2008-09-19 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with cutting member arrangement
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US7861906B2 (en) 2008-02-14 2011-01-04 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with articulatable components
US7819297B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with reprocessible handle assembly
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
RU2493788C2 (ru) 2008-02-14 2013-09-27 Этикон Эндо-Серджери, Инк. Хирургический режущий и крепежный инструмент, имеющий радиочастотные электроды
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US8459525B2 (en) 2008-02-14 2013-06-11 Ethicon Endo-Sugery, Inc. Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
US7793812B2 (en) 2008-02-14 2010-09-14 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US7819296B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with retractable firing systems
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US8733611B2 (en) * 2008-03-12 2014-05-27 Covidien Lp Ratcheting mechanism for surgical stapling device
US9089360B2 (en) 2008-08-06 2015-07-28 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
US8465502B2 (en) 2008-08-25 2013-06-18 Covidien Lp Surgical clip applier and method of assembly
US8056565B2 (en) 2008-08-25 2011-11-15 Tyco Healthcare Group Lp Surgical clip applier and method of assembly
US20110208212A1 (en) 2010-02-19 2011-08-25 Zergiebel Earl M Surgical clip applier
US8585717B2 (en) 2008-08-29 2013-11-19 Covidien Lp Single stroke endoscopic surgical clip applier
US8267944B2 (en) 2008-08-29 2012-09-18 Tyco Healthcare Group Lp Endoscopic surgical clip applier with lock out
CN103083059B (zh) * 2008-08-29 2015-03-18 柯惠Lp公司 具有连接板的内窥镜手术施夹器
US9358015B2 (en) 2008-08-29 2016-06-07 Covidien Lp Endoscopic surgical clip applier with wedge plate
US8409223B2 (en) 2008-08-29 2013-04-02 Covidien Lp Endoscopic surgical clip applier with clip retention
US20100051668A1 (en) 2008-09-03 2010-03-04 Milliman Keith L Surgical instrument with indicator
US8113405B2 (en) * 2008-09-03 2012-02-14 Tyco Healthcare Group, Lp Surgical instrument with indicator
PL3476312T3 (pl) 2008-09-19 2024-03-11 Ethicon Llc Stapler chirurgiczny z urządzeniem do dopasowania wysokości zszywek
US8360298B2 (en) 2008-09-23 2013-01-29 Covidien Lp Surgical instrument and loading unit for use therewith
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9050083B2 (en) 2008-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US7988028B2 (en) 2008-09-23 2011-08-02 Tyco Healthcare Group Lp Surgical instrument having an asymmetric dynamic clamping member
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US8279242B2 (en) * 2008-09-26 2012-10-02 Microsoft Corporation Compensating for anticipated movement of a device
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8414577B2 (en) 2009-02-05 2013-04-09 Ethicon Endo-Surgery, Inc. Surgical instruments and components for use in sterile environments
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8453907B2 (en) 2009-02-06 2013-06-04 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with cutting member reversing mechanism
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
JP2012517287A (ja) 2009-02-06 2012-08-02 エシコン・エンド−サージェリィ・インコーポレイテッド 被駆動式手術用ステープラの改良
US8663220B2 (en) 2009-07-15 2014-03-04 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US8342378B2 (en) 2009-08-17 2013-01-01 Covidien Lp One handed stapler
US10172669B2 (en) 2009-10-09 2019-01-08 Ethicon Llc Surgical instrument comprising an energy trigger lockout
US9060776B2 (en) 2009-10-09 2015-06-23 Ethicon Endo-Surgery, Inc. Surgical generator for ultrasonic and electrosurgical devices
US8262679B2 (en) 2009-10-09 2012-09-11 Ethicon Endo-Surgery, Inc. Clip advancer
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US11090104B2 (en) 2009-10-09 2021-08-17 Cilag Gmbh International Surgical generator for ultrasonic and electrosurgical devices
US8267945B2 (en) * 2009-10-09 2012-09-18 Ethicon Endo-Surgery, Inc. Clip advancer with lockout mechanism
US8734469B2 (en) 2009-10-13 2014-05-27 Covidien Lp Suture clip applier
US8225979B2 (en) 2009-10-30 2012-07-24 Tyco Healthcare Group Lp Locking shipping wedge
US9186136B2 (en) 2009-12-09 2015-11-17 Covidien Lp Surgical clip applier
US8545486B2 (en) 2009-12-15 2013-10-01 Covidien Lp Surgical clip applier
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8267300B2 (en) 2009-12-30 2012-09-18 Ethicon Endo-Surgery, Inc. Dampening device for endoscopic surgical stapler
US8561871B2 (en) 2009-12-31 2013-10-22 Covidien Lp Indicators for surgical staplers
US8714430B2 (en) 2009-12-31 2014-05-06 Covidien Lp Indicator for surgical stapler
US8469981B2 (en) 2010-02-11 2013-06-25 Ethicon Endo-Surgery, Inc. Rotatable cutting implement arrangements for ultrasonic surgical instruments
US8403945B2 (en) 2010-02-25 2013-03-26 Covidien Lp Articulating endoscopic surgical clip applier
US10136898B2 (en) 2010-03-09 2018-11-27 Teleflex Medical Incorporated Narrow profile surgical ligation clip
WO2011112877A1 (en) 2010-03-10 2011-09-15 Menn Pavel Surgical clips for laparoscopic procedures
US20120265220A1 (en) 2010-04-06 2012-10-18 Pavel Menn Articulating Steerable Clip Applier for Laparoscopic Procedures
GB2480498A (en) 2010-05-21 2011-11-23 Ethicon Endo Surgery Inc Medical device comprising RF circuitry
US9144455B2 (en) 2010-06-07 2015-09-29 Just Right Surgical, Llc Low power tissue sealing device and method
JP5511530B2 (ja) * 2010-06-10 2014-06-04 Ｈｏｙａ株式会社 眼内レンズ挿入装置
US8795327B2 (en) * 2010-07-22 2014-08-05 Ethicon Endo-Surgery, Inc. Electrosurgical instrument with separate closure and cutting members
US9192431B2 (en) 2010-07-23 2015-11-24 Ethicon Endo-Surgery, Inc. Electrosurgical cutting and sealing instrument
US8403946B2 (en) 2010-07-28 2013-03-26 Covidien Lp Articulating clip applier cartridge
US8968337B2 (en) 2010-07-28 2015-03-03 Covidien Lp Articulating clip applier
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US20120078244A1 (en) 2010-09-24 2012-03-29 Worrell Barry C Control features for articulating surgical device
BR112013007717B1 (pt) 2010-09-30 2020-09-24 Ethicon Endo-Surgery, Inc. Sistema de grampeamento cirúrgico
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9480476B2 (en) 2010-09-30 2016-11-01 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising resilient members
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9204880B2 (en) 2012-03-28 2015-12-08 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising capsules defining a low pressure environment
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US8740038B2 (en) 2010-09-30 2014-06-03 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a releasable portion
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US8444038B2 (en) 2010-10-01 2013-05-21 Covidien Lp Tissue stop for surgical instrument
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US9039694B2 (en) 2010-10-22 2015-05-26 Just Right Surgical, Llc RF generator system for surgical vessel sealing
US9011464B2 (en) 2010-11-02 2015-04-21 Covidien Lp Self-centering clip and jaw
US9186153B2 (en) 2011-01-31 2015-11-17 Covidien Lp Locking cam driver and jaw assembly for clip applier
US8496157B2 (en) 2011-02-18 2013-07-30 Covidien Lp Tilting anvil for annular surgical stapler
US9113884B2 (en) 2011-03-14 2015-08-25 Ethicon Endo-Surgery, Inc. Modular surgical tool systems
US8397972B2 (en) 2011-03-18 2013-03-19 Covidien Lp Shipping wedge with lockout
US9775623B2 (en) 2011-04-29 2017-10-03 Covidien Lp Surgical clip applier including clip relief feature
CA2834649C (en) 2011-04-29 2021-02-16 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples positioned within a compressible portion thereof
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US9259265B2 (en) 2011-07-22 2016-02-16 Ethicon Endo-Surgery, Llc Surgical instruments for tensioning tissue
CN104039248A (zh) 2011-09-15 2014-09-10 泰利福医疗公司 手动外科结扎夹钳施用器
CN103930054A (zh) 2011-09-15 2014-07-16 泰利福医疗公司 手动外科结扎夹钳施用器
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9370400B2 (en) 2011-10-19 2016-06-21 Ethicon Endo-Surgery, Inc. Clip applier adapted for use with a surgical robot
JP6234932B2 (ja) 2011-10-24 2017-11-22 エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． 医療用器具
US20130131697A1 (en) 2011-11-21 2013-05-23 Covidien Lp Surgical clip applier
US9364239B2 (en) 2011-12-19 2016-06-14 Covidien Lp Jaw closure mechanism for a surgical clip applier
US9931123B2 (en) * 2011-12-21 2018-04-03 Joseph W Blake, III Surgical clip applier
US9364216B2 (en) 2011-12-29 2016-06-14 Covidien Lp Surgical clip applier with integrated clip counter
EP2811932B1 (en) 2012-02-10 2019-06-26 Ethicon LLC Robotically controlled surgical instrument
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9113881B2 (en) 2012-03-16 2015-08-25 Covidien Lp Travel clip for surgical staple cartridge
RU2014143258A (ru) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. Компенсатор толщины ткани, содержащий множество слоев
CN104334098B (zh) 2012-03-28 2017-03-22 伊西康内外科公司 包括限定低压强环境的胶囊剂的组织厚度补偿件
CN104379068B (zh) 2012-03-28 2017-09-22 伊西康内外科公司 包括组织厚度补偿件的保持器组件
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US9439668B2 (en) 2012-04-09 2016-09-13 Ethicon Endo-Surgery, Llc Switch arrangements for ultrasonic surgical instruments
US9421037B2 (en) * 2012-05-01 2016-08-23 Globus Medical, Inc. Dispensing fasteners
US9408610B2 (en) 2012-05-04 2016-08-09 Covidien Lp Surgical clip applier with dissector
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
US9532787B2 (en) 2012-05-31 2017-01-03 Covidien Lp Endoscopic clip applier
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US8747238B2 (en) 2012-06-28 2014-06-10 Ethicon Endo-Surgery, Inc. Rotary drive shaft assemblies for surgical instruments with articulatable end effectors
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US20140001234A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Coupling arrangements for attaching surgical end effectors to drive systems therefor
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
BR112014032776B1 (pt) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
CN104487005B (zh) 2012-06-28 2017-09-08 伊西康内外科公司 空夹仓闭锁件
US11197671B2 (en) 2012-06-28 2021-12-14 Cilag Gmbh International Stapling assembly comprising a lockout
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140005705A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Surgical instruments with articulating shafts
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9393037B2 (en) 2012-06-29 2016-07-19 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9226767B2 (en) 2012-06-29 2016-01-05 Ethicon Endo-Surgery, Inc. Closed feedback control for electrosurgical device
US9408622B2 (en) 2012-06-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9351754B2 (en) 2012-06-29 2016-05-31 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments with distally positioned jaw assemblies
US9198714B2 (en) 2012-06-29 2015-12-01 Ethicon Endo-Surgery, Inc. Haptic feedback devices for surgical robot
US9326788B2 (en) 2012-06-29 2016-05-03 Ethicon Endo-Surgery, Llc Lockout mechanism for use with robotic electrosurgical device
US20140005702A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments with distally positioned transducers
IN2015DN02432A (zh) 2012-09-28 2015-09-04 Ethicon Endo Surgery Inc
US9095367B2 (en) 2012-10-22 2015-08-04 Ethicon Endo-Surgery, Inc. Flexible harmonic waveguides/blades for surgical instruments
US20140135804A1 (en) 2012-11-15 2014-05-15 Ethicon Endo-Surgery, Inc. Ultrasonic and electrosurgical devices
US9113892B2 (en) 2013-01-08 2015-08-25 Covidien Lp Surgical clip applier
US9968362B2 (en) 2013-01-08 2018-05-15 Covidien Lp Surgical clip applier
US9750500B2 (en) 2013-01-18 2017-09-05 Covidien Lp Surgical clip applier
US20140316440A1 (en) * 2013-02-01 2014-10-23 Mark Gordon Multiple clip endoscopic tissue clipping system and device
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
US9700309B2 (en) 2013-03-01 2017-07-11 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
MX368026B (es) 2013-03-01 2019-09-12 Ethicon Endo Surgery Inc Instrumento quirúrgico articulable con vías conductoras para la comunicación de la señal.
BR112015021082B1 (pt) 2013-03-01 2022-05-10 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US10561432B2 (en) 2013-03-05 2020-02-18 Covidien Lp Pivoting screw for use with a pair of jaw members of a surgical instrument
US20140263552A1 (en) 2013-03-13 2014-09-18 Ethicon Endo-Surgery, Inc. Staple cartridge tissue thickness sensor system
US9474530B2 (en) * 2013-03-14 2016-10-25 C.R. Bard, Inc. Handling of fasteners within a surgical instrument
US9427230B2 (en) * 2013-03-14 2016-08-30 C.R. Bard, Inc. Handling of fasteners within a surgical instrument
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US10405857B2 (en) 2013-04-16 2019-09-10 Ethicon Llc Powered linear surgical stapler
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US20150053737A1 (en) 2013-08-23 2015-02-26 Ethicon Endo-Surgery, Inc. End effector detection systems for surgical instruments
CN106028966B (zh) 2013-08-23 2018-06-22 伊西康内外科有限责任公司 用于动力外科器械的击发构件回缩装置
US9775624B2 (en) 2013-08-27 2017-10-03 Covidien Lp Surgical clip applier
US9814514B2 (en) 2013-09-13 2017-11-14 Ethicon Llc Electrosurgical (RF) medical instruments for cutting and coagulating tissue
US9265926B2 (en) 2013-11-08 2016-02-23 Ethicon Endo-Surgery, Llc Electrosurgical devices
US10779838B1 (en) 2013-11-13 2020-09-22 Joseph W Blake, III Instrument for serially applying clips to a surgical site
EP2873391A1 (en) * 2013-11-15 2015-05-20 Atttinger Technik AG Intraocular lens injector, method for folding an intraocular lens and intraocular lens injector system
GB2521228A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US20150173756A1 (en) 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling methods
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9687232B2 (en) 2013-12-23 2017-06-27 Ethicon Llc Surgical staples
US9795436B2 (en) 2014-01-07 2017-10-24 Ethicon Llc Harvesting energy from a surgical generator
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9693777B2 (en) 2014-02-24 2017-07-04 Ethicon Llc Implantable layers comprising a pressed region
JP6462004B2 (ja) 2014-02-24 2019-01-30 エシコン エルエルシー 発射部材ロックアウトを備える締結システム
BR102014006114B1 (pt) * 2014-03-14 2022-05-10 Antônio Francisco Neves Filho Stent com válvula cardíaca mecânica ou biológica para procedimento de troca de válvula minimamente invasivo e dispositivo aplicador de stent
US9554854B2 (en) 2014-03-18 2017-01-31 Ethicon Endo-Surgery, Llc Detecting short circuits in electrosurgical medical devices
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US10028761B2 (en) 2014-03-26 2018-07-24 Ethicon Llc Feedback algorithms for manual bailout systems for surgical instruments
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US10092310B2 (en) 2014-03-27 2018-10-09 Ethicon Llc Electrosurgical devices
US10463421B2 (en) 2014-03-27 2019-11-05 Ethicon Llc Two stage trigger, clamp and cut bipolar vessel sealer
US9737355B2 (en) 2014-03-31 2017-08-22 Ethicon Llc Controlling impedance rise in electrosurgical medical devices
US9913680B2 (en) 2014-04-15 2018-03-13 Ethicon Llc Software algorithms for electrosurgical instruments
CN106456158B (zh) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 包括非一致紧固件的紧固件仓
CN106456159B (zh) 2014-04-16 2019-03-08 伊西康内外科有限责任公司 紧固件仓组件和钉保持器盖布置结构
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
BR112016023698B1 (pt) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc Cartucho de prendedores para uso com um instrumento cirúrgico
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
DE102014207900A1 (de) * 2014-04-28 2015-10-29 Aesculap Ag Maulteil für ein chirurgisches Rohrschaft-Instrument
DE102014207971A1 (de) 2014-04-28 2015-10-29 Aesculap Ag Maulteil mit Schichtaufbau für ein chirurgisches Instrument
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
US10098641B1 (en) 2014-08-21 2018-10-16 Joseph W Blake, III Jaws and cams for clip applying instruments
US10194972B2 (en) 2014-08-26 2019-02-05 Ethicon Llc Managing tissue treatment
US9757128B2 (en) 2014-09-05 2017-09-12 Ethicon Llc Multiple sensors with one sensor affecting a second sensor's output or interpretation
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
CN107427300B (zh) 2014-09-26 2020-12-04 伊西康有限责任公司 外科缝合支撑物和辅助材料
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US9968363B2 (en) 2014-10-20 2018-05-15 Joseph W. Blake, III Multi-clip applier
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US11504192B2 (en) 2014-10-30 2022-11-22 Cilag Gmbh International Method of hub communication with surgical instrument systems
KR101649718B1 (ko) * 2014-10-31 2016-08-19 한희상 의료용 오토메틱 클립 애플라이어
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10702278B2 (en) 2014-12-02 2020-07-07 Covidien Lp Laparoscopic surgical ligation clip applier
US10639092B2 (en) 2014-12-08 2020-05-05 Ethicon Llc Electrode configurations for surgical instruments
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
BR112017012996B1 (pt) 2014-12-18 2022-11-08 Ethicon Llc Instrumento cirúrgico com uma bigorna que é seletivamente móvel sobre um eixo geométrico imóvel distinto em relação a um cartucho de grampos
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US10159524B2 (en) 2014-12-22 2018-12-25 Ethicon Llc High power battery powered RF amplifier topology
US10092348B2 (en) 2014-12-22 2018-10-09 Ethicon Llc RF tissue sealer, shear grip, trigger lock mechanism and energy activation
US10111699B2 (en) 2014-12-22 2018-10-30 Ethicon Llc RF tissue sealer, shear grip, trigger lock mechanism and energy activation
US9931124B2 (en) 2015-01-07 2018-04-03 Covidien Lp Reposable clip applier
US10368876B2 (en) * 2015-01-15 2019-08-06 Covidien Lp Endoscopic reposable surgical clip applier
US10292712B2 (en) 2015-01-28 2019-05-21 Covidien Lp Surgical clip applier with integrated cutter
US10245095B2 (en) 2015-02-06 2019-04-02 Ethicon Llc Electrosurgical instrument with rotation and articulation mechanisms
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US10159483B2 (en) 2015-02-27 2018-12-25 Ethicon Llc Surgical apparatus configured to track an end-of-life parameter
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
JP2020121162A (ja) 2015-03-06 2020-08-13 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10159491B2 (en) * 2015-03-10 2018-12-25 Covidien Lp Endoscopic reposable surgical clip applier
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10092290B2 (en) 2015-03-17 2018-10-09 Covidien Lp Surgical instrument, loading unit for use therewith and related methods
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US10390825B2 (en) 2015-03-31 2019-08-27 Ethicon Llc Surgical instrument with progressive rotary drive systems
US10314638B2 (en) 2015-04-07 2019-06-11 Ethicon Llc Articulating radio frequency (RF) tissue seal with articulating state sensing
US10130410B2 (en) 2015-04-17 2018-11-20 Ethicon Llc Electrosurgical instrument including a cutting member decouplable from a cutting member trigger
US10368861B2 (en) 2015-06-18 2019-08-06 Ethicon Llc Dual articulation drive system arrangements for articulatable surgical instruments
US10898256B2 (en) 2015-06-30 2021-01-26 Ethicon Llc Surgical system with user adaptable techniques based on tissue impedance
US11129669B2 (en) 2015-06-30 2021-09-28 Cilag Gmbh International Surgical system with user adaptable techniques based on tissue type
US11141213B2 (en) 2015-06-30 2021-10-12 Cilag Gmbh International Surgical instrument with user adaptable techniques
US11051873B2 (en) 2015-06-30 2021-07-06 Cilag Gmbh International Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
US10166026B2 (en) 2015-08-26 2019-01-01 Ethicon Llc Staple cartridge assembly including features for controlling the rotation of staples when being ejected therefrom
RU2725081C2 (ru) 2015-08-26 2020-06-29 ЭТИКОН ЭлЭлСи Полоски с хирургическими скобами, допускающие наличие скоб с переменными свойствами и обеспечивающие простую загрузку кассеты
MX2022009705A (es) 2015-08-26 2022-11-07 Ethicon Llc Metodo para formar una grapa contra un yunque de un instrumento de engrapado quirurgico.
US10357252B2 (en) 2015-09-02 2019-07-23 Ethicon Llc Surgical staple configurations with camming surfaces located between portions supporting surgical staples
MX2022006189A (es) 2015-09-02 2022-06-16 Ethicon Llc Configuraciones de grapas quirurgicas con superficies de leva situadas entre porciones que soportan grapas quirurgicas.
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10751108B2 (en) 2015-09-30 2020-08-25 Ethicon Llc Protection techniques for generator for digitally generating electrosurgical and ultrasonic electrical signal waveforms
US10433846B2 (en) 2015-09-30 2019-10-08 Ethicon Llc Compressible adjunct with crossing spacer fibers
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
EP3359061B1 (en) 2015-10-10 2020-06-10 Covidien LP Endoscopic surgical clip applier
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10959771B2 (en) 2015-10-16 2021-03-30 Ethicon Llc Suction and irrigation sealing grasper
AU2015413639A1 (en) 2015-11-03 2018-04-05 Covidien Lp Endoscopic surgical clip applier
US10702280B2 (en) 2015-11-10 2020-07-07 Covidien Lp Endoscopic reposable surgical clip applier
JP6678741B2 (ja) 2015-11-10 2020-04-08 コヴィディエン リミテッド パートナーシップ 内視鏡部分使い捨て外科用クリップアプライア
US10390831B2 (en) 2015-11-10 2019-08-27 Covidien Lp Endoscopic reposable surgical clip applier
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10959806B2 (en) 2015-12-30 2021-03-30 Ethicon Llc Energized medical device with reusable handle
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
EP3402417A4 (en) 2016-01-11 2019-12-04 Covidien LP ENDOSCOPIC RESTABLE SURGICAL STAPLER APPLICATOR
US10537351B2 (en) 2016-01-15 2020-01-21 Ethicon Llc Modular battery powered handheld surgical instrument with variable motor control limits
US10716615B2 (en) 2016-01-15 2020-07-21 Ethicon Llc Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade
US11229471B2 (en) 2016-01-15 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization
US11129670B2 (en) 2016-01-15 2021-09-28 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization
AU2016388454A1 (en) 2016-01-18 2018-07-19 Covidien Lp Endoscopic surgical clip applier
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10245030B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instruments with tensioning arrangements for cable driven articulation systems
BR112018016098B1 (pt) 2016-02-09 2023-02-23 Ethicon Llc Instrumento cirúrgico
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10555769B2 (en) 2016-02-22 2020-02-11 Ethicon Llc Flexible circuits for electrosurgical instrument
CA2958160A1 (en) 2016-02-24 2017-08-24 Covidien Lp Endoscopic reposable surgical clip applier
US11284890B2 (en) 2016-04-01 2022-03-29 Cilag Gmbh International Circular stapling system comprising an incisable tissue support
US10357246B2 (en) 2016-04-01 2019-07-23 Ethicon Llc Rotary powered surgical instrument with manually actuatable bailout system
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10456140B2 (en) 2016-04-01 2019-10-29 Ethicon Llc Surgical stapling system comprising an unclamping lockout
US10314582B2 (en) 2016-04-01 2019-06-11 Ethicon Llc Surgical instrument comprising a shifting mechanism
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US10478181B2 (en) 2016-04-18 2019-11-19 Ethicon Llc Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
EP3445256B1 (en) * 2016-04-21 2024-01-10 Applied Medical Resources Corporation Laparoscopic clip applier
US10856934B2 (en) 2016-04-29 2020-12-08 Ethicon Llc Electrosurgical instrument with electrically conductive gap setting and tissue engaging members
US10646269B2 (en) 2016-04-29 2020-05-12 Ethicon Llc Non-linear jaw gap for electrosurgical instruments
US10702329B2 (en) 2016-04-29 2020-07-07 Ethicon Llc Jaw structure with distal post for electrosurgical instruments
US10485607B2 (en) 2016-04-29 2019-11-26 Ethicon Llc Jaw structure with distal closure for electrosurgical instruments
US10987156B2 (en) 2016-04-29 2021-04-27 Ethicon Llc Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members
US10456193B2 (en) 2016-05-03 2019-10-29 Ethicon Llc Medical device with a bilateral jaw configuration for nerve stimulation
CN109310431B (zh) 2016-06-24 2022-03-04 伊西康有限责任公司 包括线材钉和冲压钉的钉仓
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
US10702270B2 (en) 2016-06-24 2020-07-07 Ethicon Llc Stapling system for use with wire staples and stamped staples
USD826405S1 (en) 2016-06-24 2018-08-21 Ethicon Llc Surgical fastener
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
US10376305B2 (en) 2016-08-05 2019-08-13 Ethicon Llc Methods and systems for advanced harmonic energy
US10806464B2 (en) 2016-08-11 2020-10-20 Covidien Lp Endoscopic surgical clip applier and clip applying systems
CN109640841B (zh) * 2016-08-22 2022-05-31 波士顿科学有限公司 带套管接合的止血可再装载夹持装置
AU2016420481A1 (en) 2016-08-25 2019-01-17 Covidien Lp Endoscopic surgical clip applier and clip applying systems
US10751117B2 (en) 2016-09-23 2020-08-25 Ethicon Llc Electrosurgical instrument with fluid diverter
US10660651B2 (en) * 2016-10-31 2020-05-26 Covidien Lp Endoscopic reposable surgical clip applier
US10639044B2 (en) 2016-10-31 2020-05-05 Covidien Lp Ligation clip module and clip applier
US10426489B2 (en) 2016-11-01 2019-10-01 Covidien Lp Endoscopic reposable surgical clip applier
US10492795B2 (en) 2016-11-01 2019-12-03 Covidien Lp Endoscopic surgical clip applier
US10610236B2 (en) 2016-11-01 2020-04-07 Covidien Lp Endoscopic reposable surgical clip applier
US11266430B2 (en) 2016-11-29 2022-03-08 Cilag Gmbh International End effector control and calibration
KR101762761B1 (ko) 2016-12-12 2017-07-28 (주) 써지코어 클립 어플라이어
US11090048B2 (en) 2016-12-21 2021-08-17 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
BR112019011947A2 (pt) 2016-12-21 2019-10-29 Ethicon Llc sistemas de grampeamento cirúrgico
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US10682138B2 (en) 2016-12-21 2020-06-16 Ethicon Llc Bilaterally asymmetric staple forming pocket pairs
US10736629B2 (en) 2016-12-21 2020-08-11 Ethicon Llc Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems
US10537324B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Stepped staple cartridge with asymmetrical staples
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US20180168618A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling systems
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
JP6983893B2 (ja) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC 外科用エンドエフェクタ及び交換式ツールアセンブリのためのロックアウト構成
US10568624B2 (en) 2016-12-21 2020-02-25 Ethicon Llc Surgical instruments with jaws that are pivotable about a fixed axis and include separate and distinct closure and firing systems
JP7010956B2 (ja) 2016-12-21 2022-01-26 エシコン エルエルシー 組織をステープル留めする方法
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US10667811B2 (en) 2016-12-21 2020-06-02 Ethicon Llc Surgical stapling instruments and staple-forming anvils
MX2019007295A (es) 2016-12-21 2019-10-15 Ethicon Llc Sistema de instrumento quirúrgico que comprende un bloqueo del efector de extremo y un bloqueo de la unidad de disparo.
US20180168609A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Firing assembly comprising a fuse
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US11191539B2 (en) 2016-12-21 2021-12-07 Cilag Gmbh International Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system
US10709455B2 (en) 2017-02-02 2020-07-14 Covidien Lp Endoscopic surgical clip applier
EP3576643B1 (en) * 2017-02-06 2022-04-06 Covidien LP Surgical clip applier with user feedback feature
US10758244B2 (en) 2017-02-06 2020-09-01 Covidien Lp Endoscopic surgical clip applier
US10660725B2 (en) 2017-02-14 2020-05-26 Covidien Lp Endoscopic surgical clip applier including counter assembly
US11033325B2 (en) 2017-02-16 2021-06-15 Cilag Gmbh International Electrosurgical instrument with telescoping suction port and debris cleaner
US10603038B2 (en) 2017-02-22 2020-03-31 Covidien Lp Surgical clip applier including inserts for jaw assembly
US10548602B2 (en) 2017-02-23 2020-02-04 Covidien Lp Endoscopic surgical clip applier
US11583291B2 (en) 2017-02-23 2023-02-21 Covidien Lp Endoscopic surgical clip applier
US10799284B2 (en) 2017-03-15 2020-10-13 Ethicon Llc Electrosurgical instrument with textured jaws
US11497546B2 (en) 2017-03-31 2022-11-15 Cilag Gmbh International Area ratios of patterned coatings on RF electrodes to reduce sticking
US10675043B2 (en) 2017-05-04 2020-06-09 Covidien Lp Reposable multi-fire surgical clip applier
US10722235B2 (en) 2017-05-11 2020-07-28 Covidien Lp Spring-release surgical clip
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US20180368844A1 (en) 2017-06-27 2018-12-27 Ethicon Llc Staple forming pocket arrangements
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10603117B2 (en) 2017-06-28 2020-03-31 Ethicon Llc Articulation state detection mechanisms
US11678880B2 (en) 2017-06-28 2023-06-20 Cilag Gmbh International Surgical instrument comprising a shaft including a housing arrangement
US11020114B2 (en) 2017-06-28 2021-06-01 Cilag Gmbh International Surgical instruments with articulatable end effector with axially shortened articulation joint configurations
EP3420947B1 (en) 2017-06-28 2022-05-25 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10660723B2 (en) 2017-06-30 2020-05-26 Covidien Lp Endoscopic reposable surgical clip applier
US10639032B2 (en) * 2017-06-30 2020-05-05 Covidien Lp Endoscopic surgical clip applier including counter assembly
US11974742B2 (en) 2017-08-03 2024-05-07 Cilag Gmbh International Surgical system comprising an articulation bailout
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
US10675112B2 (en) 2017-08-07 2020-06-09 Covidien Lp Endoscopic surgical clip applier including counter assembly
US10932790B2 (en) 2017-08-08 2021-03-02 Covidien Lp Geared actuation mechanism and surgical clip applier including the same
US10863992B2 (en) 2017-08-08 2020-12-15 Covidien Lp Endoscopic surgical clip applier
US10786262B2 (en) 2017-08-09 2020-09-29 Covidien Lp Endoscopic reposable surgical clip applier
US10786263B2 (en) 2017-08-15 2020-09-29 Covidien Lp Endoscopic reposable surgical clip applier
US10835341B2 (en) 2017-09-12 2020-11-17 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US10653429B2 (en) 2017-09-13 2020-05-19 Covidien Lp Endoscopic surgical clip applier
US10758245B2 (en) 2017-09-13 2020-09-01 Covidien Lp Clip counting mechanism for surgical clip applier
US10835260B2 (en) 2017-09-13 2020-11-17 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US11484358B2 (en) 2017-09-29 2022-11-01 Cilag Gmbh International Flexible electrosurgical instrument
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US11490951B2 (en) 2017-09-29 2022-11-08 Cilag Gmbh International Saline contact with electrodes
US11033323B2 (en) 2017-09-29 2021-06-15 Cilag Gmbh International Systems and methods for managing fluid and suction in electrosurgical systems
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US11317919B2 (en) 2017-10-30 2022-05-03 Cilag Gmbh International Clip applier comprising a clip crimping system
US11911045B2 (en) 2017-10-30 2024-02-27 Cllag GmbH International Method for operating a powered articulating multi-clip applier
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11510741B2 (en) 2017-10-30 2022-11-29 Cilag Gmbh International Method for producing a surgical instrument comprising a smart electrical system
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US11311342B2 (en) 2017-10-30 2022-04-26 Cilag Gmbh International Method for communicating with surgical instrument systems
US11793537B2 (en) 2017-10-30 2023-10-24 Cilag Gmbh International Surgical instrument comprising an adaptive electrical system
US11406390B2 (en) 2017-10-30 2022-08-09 Cilag Gmbh International Clip applier comprising interchangeable clip reloads
US11229436B2 (en) 2017-10-30 2022-01-25 Cilag Gmbh International Surgical system comprising a surgical tool and a surgical hub
US11801098B2 (en) 2017-10-30 2023-10-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
JP7317819B2 (ja) 2017-10-30 2023-07-31 エシコン エルエルシー ロック可能なエンドエフェクタソケットを備える外科用器具
US11564756B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
EP3476316B1 (en) 2017-10-30 2023-05-17 Ethicon LLC Surgical clip applier comprising adaptive firing control
US11291510B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Method of hub communication with surgical instrument systems
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10945734B2 (en) 2017-11-03 2021-03-16 Covidien Lp Rotation knob assemblies and surgical instruments including the same
US10828036B2 (en) 2017-11-03 2020-11-10 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US11116513B2 (en) 2017-11-03 2021-09-14 Covidien Lp Modular surgical clip cartridge
US10932791B2 (en) 2017-11-03 2021-03-02 Covidien Lp Reposable multi-fire surgical clip applier
US11376015B2 (en) 2017-11-03 2022-07-05 Covidien Lp Endoscopic surgical clip applier and handle assemblies for use therewith
US10722236B2 (en) 2017-12-12 2020-07-28 Covidien Lp Endoscopic reposable surgical clip applier
US10743887B2 (en) 2017-12-13 2020-08-18 Covidien Lp Reposable multi-fire surgical clip applier
US10849630B2 (en) 2017-12-13 2020-12-01 Covidien Lp Reposable multi-fire surgical clip applier
US10959737B2 (en) 2017-12-13 2021-03-30 Covidien Lp Reposable multi-fire surgical clip applier
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US20190192147A1 (en) 2017-12-21 2019-06-27 Ethicon Llc Surgical instrument comprising an articulatable distal head
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11410259B2 (en) 2017-12-28 2022-08-09 Cilag Gmbh International Adaptive control program updates for surgical devices
US11896443B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Control of a surgical system through a surgical barrier
US11832899B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical systems with autonomously adjustable control programs
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
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
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
US11304720B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Activation of energy devices
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
US11364075B2 (en) 2017-12-28 2022-06-21 Cilag Gmbh International Radio frequency energy device for delivering combined electrical signals
US11540855B2 (en) 2017-12-28 2023-01-03 Cilag Gmbh International Controlling activation of an ultrasonic surgical instrument according to the presence of tissue
US10892899B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Self describing data packets generated at an issuing instrument
US11464559B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Estimating state of ultrasonic end effector and control system therefor
US10987178B2 (en) 2017-12-28 2021-04-27 Ethicon Llc Surgical hub control arrangements
US11903601B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Surgical instrument comprising a plurality of drive systems
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
US11132462B2 (en) 2017-12-28 2021-09-28 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11937769B2 (en) 2017-12-28 2024-03-26 Cilag Gmbh International Method of hub communication, processing, storage and display
US11324557B2 (en) 2017-12-28 2022-05-10 Cilag Gmbh International Surgical instrument with a sensing array
US11424027B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Method for operating surgical instrument systems
US11147607B2 (en) 2017-12-28 2021-10-19 Cilag Gmbh International Bipolar combination device that automatically adjusts pressure based on energy modality
US10849697B2 (en) 2017-12-28 2020-12-01 Ethicon Llc Cloud interface for coupled surgical 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
US11056244B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks
US11234756B2 (en) 2017-12-28 2022-02-01 Cilag Gmbh International Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter
US10943454B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Detection and escalation of security responses of surgical instruments to increasing severity threats
US11612444B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Adjustment of a surgical device function 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
US11602393B2 (en) 2017-12-28 2023-03-14 Cilag Gmbh International Surgical evacuation sensing and generator control
US11213359B2 (en) 2017-12-28 2022-01-04 Cilag Gmbh International Controllers for robot-assisted surgical platforms
US11045591B2 (en) 2017-12-28 2021-06-29 Cilag Gmbh International Dual in-series large and small droplet filters
US11464535B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Detection of end effector emersion in liquid
US11419630B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Surgical system distributed processing
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
US11678881B2 (en) 2017-12-28 2023-06-20 Cilag Gmbh International Spatial awareness of surgical hubs in operating rooms
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
US11744604B2 (en) 2017-12-28 2023-09-05 Cilag Gmbh International Surgical instrument with a hardware-only control circuit
US11589888B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Method for controlling smart energy devices
US11304745B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical evacuation sensing and display
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
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
US20190201146A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Safety systems for smart powered surgical stapling
US11179208B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Cloud-based medical analytics for security and authentication trends and reactive measures
US11304699B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11771487B2 (en) 2017-12-28 2023-10-03 Cilag Gmbh International Mechanisms for controlling different electromechanical systems of an electrosurgical instrument
US10966791B2 (en) 2017-12-28 2021-04-06 Ethicon Llc Cloud-based medical analytics for medical facility segmented individualization of instrument function
US11291495B2 (en) 2017-12-28 2022-04-05 Cilag Gmbh International Interruption of energy due to inadvertent capacitive coupling
US11179175B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Controlling an ultrasonic surgical instrument according to tissue location
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
US11659023B2 (en) 2017-12-28 2023-05-23 Cilag Gmbh International Method of hub communication
US11166772B2 (en) 2017-12-28 2021-11-09 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
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
US11278281B2 (en) 2017-12-28 2022-03-22 Cilag Gmbh International Interactive surgical system
US12096916B2 (en) 2017-12-28 2024-09-24 Cilag Gmbh International Method of sensing particulate from smoke evacuated from a patient, adjusting the pump speed based on the sensed information, and communicating the functional parameters of the system to the hub
US11559307B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method of robotic hub communication, detection, and control
US11559308B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure
US10944728B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Interactive surgical systems with encrypted communication capabilities
US11576677B2 (en) 2017-12-28 2023-02-14 Cilag Gmbh International Method of hub communication, processing, display, and cloud analytics
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
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
US12062442B2 (en) 2017-12-28 2024-08-13 Cilag Gmbh International Method for operating surgical instrument systems
US11026751B2 (en) 2017-12-28 2021-06-08 Cilag Gmbh International Display of alignment of staple cartridge to prior linear staple line
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
US11109866B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Method for circular stapler control algorithm adjustment based on situational awareness
US11832840B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical instrument having a flexible circuit
US11160605B2 (en) 2017-12-28 2021-11-02 Cilag Gmbh International Surgical evacuation sensing and motor control
US11786251B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11376002B2 (en) 2017-12-28 2022-07-05 Cilag Gmbh International Surgical instrument cartridge sensor assemblies
US11864728B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Characterization of tissue irregularities through the use of mono-chromatic light refractivity
US11432885B2 (en) 2017-12-28 2022-09-06 Cilag Gmbh International Sensing arrangements for robot-assisted surgical platforms
US11076921B2 (en) 2017-12-28 2021-08-03 Cilag Gmbh International Adaptive control program updates for surgical hubs
US20190201087A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Smoke evacuation system including a segmented control circuit for interactive surgical platform
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
US11317937B2 (en) 2018-03-08 2022-05-03 Cilag Gmbh International Determining the state of an ultrasonic end effector
US11571234B2 (en) 2017-12-28 2023-02-07 Cilag Gmbh International Temperature control of ultrasonic end effector and control system therefor
US11311306B2 (en) 2017-12-28 2022-04-26 Cilag Gmbh International Surgical systems for detecting end effector tissue distribution irregularities
US11273001B2 (en) 2017-12-28 2022-03-15 Cilag Gmbh International Surgical hub and modular device response adjustment based on situational awareness
US10695081B2 (en) 2017-12-28 2020-06-30 Ethicon Llc Controlling a surgical instrument according to sensed closure parameters
US11666331B2 (en) 2017-12-28 2023-06-06 Cilag Gmbh International Systems for detecting proximity of surgical end effector to cancerous tissue
US11786245B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Surgical systems with prioritized data transmission capabilities
US11284936B2 (en) 2017-12-28 2022-03-29 Cilag Gmbh International Surgical instrument having a flexible electrode
US11051876B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Surgical evacuation flow paths
US11253315B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Increasing radio frequency to create pad-less monopolar loop
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
US11013563B2 (en) 2017-12-28 2021-05-25 Ethicon Llc Drive arrangements for robot-assisted surgical platforms
US11857152B2 (en) 2017-12-28 2024-01-02 Cilag Gmbh International Surgical hub spatial awareness to determine devices in operating theater
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
US11266468B2 (en) 2017-12-28 2022-03-08 Cilag Gmbh International Cooperative utilization of data derived from secondary sources by intelligent surgical hubs
US20190206569A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Method of cloud based data analytics for use with the hub
US11051827B2 (en) 2018-01-16 2021-07-06 Covidien Lp Endoscopic surgical instrument and handle assemblies for use therewith
US10675042B2 (en) * 2018-02-08 2020-06-09 Ethicon Llc Surgical clip applier with living hinge jaws
US11399858B2 (en) 2018-03-08 2022-08-02 Cilag Gmbh International Application of smart blade technology
US11678927B2 (en) 2018-03-08 2023-06-20 Cilag Gmbh International Detection of large vessels during parenchymal dissection using a smart blade
US11259830B2 (en) 2018-03-08 2022-03-01 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
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
US11471156B2 (en) 2018-03-28 2022-10-18 Cilag Gmbh International Surgical stapling devices with improved rotary driven closure systems
US11219453B2 (en) 2018-03-28 2022-01-11 Cilag Gmbh International Surgical stapling devices with cartridge compatible closure and firing lockout arrangements
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
US11096688B2 (en) 2018-03-28 2021-08-24 Cilag Gmbh International Rotary driven firing members with different anvil and channel engagement features
US11278280B2 (en) 2018-03-28 2022-03-22 Cilag Gmbh International Surgical instrument comprising a jaw closure lockout
US11213294B2 (en) 2018-03-28 2022-01-04 Cilag Gmbh International Surgical instrument comprising co-operating lockout features
US11259806B2 (en) 2018-03-28 2022-03-01 Cilag Gmbh International Surgical stapling devices with features for blocking advancement of a camming assembly of an incompatible cartridge installed therein
US11090047B2 (en) 2018-03-28 2021-08-17 Cilag Gmbh International Surgical instrument comprising an adaptive control system
US10993721B2 (en) 2018-04-25 2021-05-04 Covidien Lp Surgical clip applier
US10786273B2 (en) 2018-07-13 2020-09-29 Covidien Lp Rotation knob assemblies for handle assemblies
US11259887B2 (en) 2018-08-10 2022-03-01 Covidien Lp Feedback mechanisms for handle assemblies
US11051828B2 (en) 2018-08-13 2021-07-06 Covidien Lp Rotation knob assemblies and surgical instruments including same
US11033256B2 (en) 2018-08-13 2021-06-15 Covidien Lp Linkage assembly for reusable surgical handle assemblies
US11253267B2 (en) 2018-08-13 2022-02-22 Covidien Lp Friction reduction mechanisms for handle assemblies
US11344316B2 (en) 2018-08-13 2022-05-31 Covidien Lp Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same
US11278267B2 (en) 2018-08-13 2022-03-22 Covidien Lp Latch assemblies and surgical instruments including the same
US11246601B2 (en) 2018-08-13 2022-02-15 Covidien Lp Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same
US11219463B2 (en) 2018-08-13 2022-01-11 Covidien Lp Bilateral spring for surgical instruments and surgical instruments including the same
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US11147566B2 (en) 2018-10-01 2021-10-19 Covidien Lp Endoscopic surgical clip applier
USD904611S1 (en) 2018-10-10 2020-12-08 Bolder Surgical, Llc Jaw design for a surgical instrument
US11090052B2 (en) 2018-10-31 2021-08-17 Cilag Gmbh International Surgical clip applier with passive jaw closure
CN113316424B (zh) * 2019-01-03 2024-09-27 奥林巴斯株式会社 用于大的缺陷、穿孔和瘘管的夹持装置
US11369377B2 (en) 2019-02-19 2022-06-28 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout
US11331100B2 (en) 2019-02-19 2022-05-17 Cilag Gmbh International Staple cartridge retainer system with authentication keys
US11317915B2 (en) 2019-02-19 2022-05-03 Cilag Gmbh International Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers
US11357503B2 (en) 2019-02-19 2022-06-14 Cilag Gmbh International Staple cartridge retainers with frangible retention features and methods of using same
US11751872B2 (en) 2019-02-19 2023-09-12 Cilag Gmbh International Insertable deactivator element for surgical stapler lockouts
US11524398B2 (en) 2019-03-19 2022-12-13 Covidien Lp Gear drive mechanisms for surgical instruments
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
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
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US12004740B2 (en) 2019-06-28 2024-06-11 Cilag Gmbh International Surgical stapling system having an information decryption protocol
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
KR102356304B1 (ko) * 2019-12-11 2022-02-03 주식회사 인텍메디 조직 절제 장치 및 조직 절제 시스템
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US12035913B2 (en) 2019-12-19 2024-07-16 Cilag Gmbh International Staple cartridge comprising a deployable knife
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11779387B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Clamp arm jaw to minimize tissue sticking and improve tissue control
US11684412B2 (en) 2019-12-30 2023-06-27 Cilag Gmbh International Surgical instrument with rotatable and articulatable surgical end effector
US12023086B2 (en) 2019-12-30 2024-07-02 Cilag Gmbh International Electrosurgical instrument for delivering blended energy modalities to tissue
US11974801B2 (en) 2019-12-30 2024-05-07 Cilag Gmbh International Electrosurgical instrument with flexible wiring assemblies
US11779329B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Surgical instrument comprising a flex circuit including a sensor system
US11950797B2 (en) 2019-12-30 2024-04-09 Cilag Gmbh International Deflectable electrode with higher distal bias relative to proximal bias
US12082808B2 (en) 2019-12-30 2024-09-10 Cilag Gmbh International Surgical instrument comprising a control system responsive to software configurations
US11937863B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Deflectable electrode with variable compression bias along the length of the deflectable electrode
US20210196361A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instrument with monopolar and bipolar energy capabilities
US12053224B2 (en) 2019-12-30 2024-08-06 Cilag Gmbh International Variation in electrode parameters and deflectable electrode to modify energy density and tissue interaction
US12114912B2 (en) 2019-12-30 2024-10-15 Cilag Gmbh International Non-biased deflectable electrode to minimize contact between ultrasonic blade and electrode
US11812957B2 (en) 2019-12-30 2023-11-14 Cilag Gmbh International Surgical instrument comprising a signal interference resolution system
US11786294B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Control program for modular combination energy device
US11911063B2 (en) 2019-12-30 2024-02-27 Cilag Gmbh International Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade
US11786291B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Deflectable support of RF energy electrode with respect to opposing ultrasonic blade
US11937866B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Method for an electrosurgical procedure
US11660089B2 (en) 2019-12-30 2023-05-30 Cilag Gmbh International Surgical instrument comprising a sensing system
US12064109B2 (en) 2019-12-30 2024-08-20 Cilag Gmbh International Surgical instrument comprising a feedback control circuit
US11986201B2 (en) 2019-12-30 2024-05-21 Cilag Gmbh International Method for operating a surgical instrument
US11452525B2 (en) 2019-12-30 2022-09-27 Cilag Gmbh International Surgical instrument comprising an adjustment system
US12076006B2 (en) 2019-12-30 2024-09-03 Cilag Gmbh International Surgical instrument comprising an orientation detection system
US11944366B2 (en) 2019-12-30 2024-04-02 Cilag Gmbh International Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode
US11696776B2 (en) 2019-12-30 2023-07-11 Cilag Gmbh International Articulatable surgical instrument
US11779340B2 (en) 2020-01-02 2023-10-10 Covidien Lp Ligation clip loading device
US11723669B2 (en) 2020-01-08 2023-08-15 Covidien Lp Clip applier with clip cartridge interface
US10993764B1 (en) 2020-01-14 2021-05-04 Microline Surgical, Inc. Insulating grips for minimally invasive surgical instruments
US12114866B2 (en) 2020-03-26 2024-10-15 Covidien Lp Interoperative clip loading device
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
US20220031350A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with double pivot articulation joint arrangements
USD934423S1 (en) 2020-09-11 2021-10-26 Bolder Surgical, Llc End effector for a surgical device
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US12053175B2 (en) 2020-10-29 2024-08-06 Cilag Gmbh International Surgical instrument comprising a stowed closure actuator stop
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
CN114680999A (zh) * 2020-12-31 2022-07-01 江苏风和医疗器材股份有限公司 施夹钳
CN112826564B (zh) * 2020-12-31 2022-06-28 江苏三联星海医疗器械有限公司 一种可换夹盘的旋转送夹式结扎夹连发施夹钳
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US12108951B2 (en) 2021-02-26 2024-10-08 Cilag Gmbh International Staple cartridge comprising a sensing array and a temperature control system
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11980362B2 (en) 2021-02-26 2024-05-14 Cilag Gmbh International Surgical instrument system comprising a power transfer coil
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US12102323B2 (en) 2021-03-24 2024-10-01 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising a floatable component
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11944336B2 (en) 2021-03-24 2024-04-02 Cilag Gmbh International Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
USD1046129S1 (en) 2021-04-14 2024-10-08 Bolder Surgical, Llc End effector for a surgical instrument
US11998201B2 (en) 2021-05-28 2024-06-04 Cilag CmbH International Stapling instrument comprising a firing lockout
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11980363B2 (en) 2021-10-18 2024-05-14 Cilag Gmbh International Row-to-row staple array variations
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
US12089841B2 (en) 2021-10-28 2024-09-17 Cilag CmbH International Staple cartridge identification systems
US11957342B2 (en) 2021-11-01 2024-04-16 Cilag Gmbh International Devices, systems, and methods for detecting tissue and foreign objects during a surgical operation

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5009661A (en) * 1989-04-24 1991-04-23 Michelson Gary K Protective mechanism for surgical rongeurs
US5286255A (en) * 1991-07-29 1994-02-15 Linvatec Corporation Surgical forceps
US6096058A (en) * 1997-07-22 2000-08-01 Karl Storz Gmbh & Co. Kg Surgical instrument with an apparatus for limiting the transfer of a force
EP0908152B1 (en) * 1997-10-10 2002-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic clamp coagulator apparatus having force-limiting clamping mechanism

Family Cites Families (253)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR900376A (fr) 1943-12-04 1945-06-27 Tracteur universel pour petites exploitations agricoles
US2968041A (en) * 1958-09-25 1961-01-17 John F Skold Applicator for surgical clamps
DE1993372U (de) 1965-10-18 1968-09-05 Richard Lietz Kraftfahrzeugrueckblickspiegel.
US3459029A (en) 1967-02-28 1969-08-05 Buchanan Electric Products Cor Adjustable crimping tool
US3780416A (en) * 1972-07-10 1973-12-25 G Rider Surgical tubing clip clenching tool
US3856016A (en) * 1972-11-03 1974-12-24 H Davis Method for mechanically applying an occlusion clip to an anatomical tubular structure
JPS552966Y2 (zh) * 1974-02-08 1980-01-24
GB1486351A (en) 1975-06-06 1977-09-21 Rocket Of London Ltd Surgical clip applicator
US4080820A (en) * 1976-09-02 1978-03-28 Walter Kidde & Company, Inc. In-line crimping tool
US4166466A (en) * 1976-10-08 1979-09-04 Jarvik Robert K Repeating hemostatic clip applying instruments and multi-clip cartridges therefor
AU518664B2 (en) 1976-10-08 1981-10-15 K. Jarvik Robert Surgical' clip applicator
SU620263A1 (ru) 1977-02-21 1978-08-25 Ордена Трудового Красного Знамени Днепропетровский Медицинский Институт Устройство дл наложени клипс
US4611595A (en) 1977-08-05 1986-09-16 Charles H. Klieman Spring activated hemostatic clip applicator
US4452376A (en) * 1977-08-05 1984-06-05 Charles H. Klieman Hemostatic clip applicator
US4188953A (en) * 1977-08-05 1980-02-19 Charles H. Klieman, M.D. Hemostatic clip
US4242902A (en) * 1978-05-11 1981-01-06 United States Surgical Corporation Surgical clip applicator
US4152920A (en) * 1977-10-17 1979-05-08 United States Surgical Corporation System for applying surgical clips
US4246903A (en) 1979-04-02 1981-01-27 American Cyanamid Company Surgical instrument to apply a hemostatic clip to a vessel and method of using the same
US4296751A (en) * 1979-08-02 1981-10-27 Blake Joseph W Iii Surgical device
US4372316A (en) * 1979-08-02 1983-02-08 Blake Joseph W Iii Surgical device
US4532925A (en) 1979-08-02 1985-08-06 Joseph W. Blake, III Ligator device
US4662374A (en) 1979-08-02 1987-05-05 American Hospital Supply Corp. Ligator device
US4298072A (en) * 1979-08-31 1981-11-03 Senco Products, Inc. Control arrangement for electro-mechanical tool
US4349028A (en) 1980-10-03 1982-09-14 United States Surgical Corporation Surgical stapling apparatus having self-contained pneumatic system for completing manually initiated motion sequence
US4408603A (en) 1980-10-24 1983-10-11 Blake Joseph W Iii Surgical device
US4522207A (en) 1981-02-06 1985-06-11 Charles H. Klieman Spring activated hemostatic clip applicator
US4449530A (en) 1981-07-15 1984-05-22 Ethicon, Inc. Hemostatic clips and method of manufacture
AU8990982A (en) 1981-10-08 1983-04-27 Ford Motor Co. Signal lamp control system
US4513746A (en) 1981-10-09 1985-04-30 United States Surgical Corp. Instrument for applying plastic-like surgical fastening devices
US4509518A (en) 1982-02-17 1985-04-09 United States Surgical Corporation Apparatus for applying surgical clips
US4448193A (en) * 1982-02-26 1984-05-15 Ethicon, Inc. Surgical clip applier with circular clip magazine
US4674504A (en) * 1982-10-06 1987-06-23 Klieman Charles H Spring activated hemostatic clip applicator
US4556058A (en) * 1983-08-17 1985-12-03 United States Surgical Corporation Apparatus for ligation and division with fixed jaws
AU569730B2 (en) 1983-03-30 1988-02-18 United States Surgical Corporation Surgical occluding and cutting
US4944443A (en) 1988-04-22 1990-07-31 Innovative Surgical Devices, Inc. Surgical suturing instrument and method
US4557263A (en) 1984-01-23 1985-12-10 United States Surgical Corporation Apparatus for applying surgical clips
US4576165A (en) * 1984-01-23 1986-03-18 United States Surgical Corporation Surgical ligation and cutting device with safety means
GB8402985D0 (en) 1984-02-03 1984-03-07 Fluid Devices Ltd Readout module
US4741336A (en) * 1984-07-16 1988-05-03 Ethicon, Inc. Shaped staples and slotted receivers (case VII)
US4588580B2 (en) 1984-07-23 1999-02-16 Alaz Corp Transdermal administration of fentanyl and device therefor
US4616650A (en) * 1984-07-27 1986-10-14 United States Surgical Corporation Apparatus for applying surgical clips
US4651737A (en) 1984-10-15 1987-03-24 American Cyanamid Company Nonmetallic surgical clip
US4590937A (en) 1985-01-07 1986-05-27 American Cyanamid Company Nonmetallic surgical clip
JPS622528A (ja) 1985-06-27 1987-01-08 Matsushita Electric Ind Co Ltd 液相エピタキシヤル成長溶液の製造装置
US4712549A (en) 1985-07-01 1987-12-15 Edward Weck & Co. Automatic hemostatic clip applier
US5047038A (en) 1985-07-01 1991-09-10 Edward Weck Incorporated Automatic hemostatic clip applier
US4676504A (en) * 1986-01-21 1987-06-30 Ponza Larry J Tennis and baseball dispensing apparatus
US4702274A (en) 1986-06-17 1987-10-27 Martinson Manufacturing Company, Inc. Quick disconnect for sewage system
US5270171A (en) 1987-03-06 1993-12-14 Boris Cercek Cancer-associated SCM-recognition factor, preparation and method of use
US4844066A (en) 1987-04-06 1989-07-04 Richard-Allan Medical Industries, Inc. Surgical clip
US4850355A (en) 1987-04-06 1989-07-25 Richard-Allan Medical Industries, Inc. Hemostatic clip applicator for applying multiple hemostatic clips
US4799481A (en) 1987-04-08 1989-01-24 Ethicon, Inc. Surgical hemostatic clips
US4979950A (en) 1987-04-08 1990-12-25 Ethicon, Inc. Surgical hemostatic clips
US5542949A (en) * 1987-05-14 1996-08-06 Yoon; Inbae Multifunctional clip applier instrument
US5100418A (en) 1987-05-14 1992-03-31 Inbae Yoon Suture tie device system and applicator therefor
US4834096A (en) 1987-10-26 1989-05-30 Edward Weck Incorporated Plastic ligating clips
US5129885A (en) 1990-02-13 1992-07-14 United States Surgical Corporation Safety device for trocars and surgical instruments therefor
US5084057A (en) 1989-07-18 1992-01-28 United States Surgical Corporation Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures
US5100420A (en) 1989-07-18 1992-03-31 United States Surgical Corporation Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures
US5030226A (en) 1988-01-15 1991-07-09 United States Surgical Corporation Surgical clip applicator
US5197970A (en) 1988-01-15 1993-03-30 United States Surgical Corporation Surgical clip applicator
US5383881A (en) 1989-07-18 1995-01-24 United States Surgical Corporation Safety device for use with endoscopic instrumentation
US5049152A (en) 1989-03-07 1991-09-17 Richard-Allan Medical Industries Hemostatic clip applicator
SU1560125A1 (ru) 1988-07-29 1990-04-30 Челябинский государственный медицинский институт Микрохирургический фиксатор
US5062846A (en) 1989-03-28 1991-11-05 Edward Weck Incorporated Penetrating plastic ligating clip
US4976722A (en) 1989-05-22 1990-12-11 Ethicon, Inc. Surgical hemostatic clips
US5104395A (en) 1989-07-03 1992-04-14 Edward Weck Incorporated Automatic hemostatic clip applicator
US5382254A (en) 1989-07-18 1995-01-17 United States Surgical Corporation Actuating handle for surgical instruments
US5012666A (en) * 1989-07-24 1991-05-07 Chen Ching Wen Crimp tool with adjustable jaw
US5100416A (en) 1989-10-17 1992-03-31 Edward Weck Incorporated Ligating clip applying instrument
US5222961A (en) * 1989-12-26 1993-06-29 Naomi Nakao Endoscopic stapling device and related staple
US5156609A (en) * 1989-12-26 1992-10-20 Nakao Naomi L Endoscopic stapling device and method
US5232450A (en) 1990-02-13 1993-08-03 United States Surgical Corporation Safety device for trocars and surgical instruments thereof
DE4015562C2 (de) 1990-05-15 1996-12-19 Storz Karl Zange zum Anlegen von blutstillenden Clips
US5116349A (en) * 1990-05-23 1992-05-26 United States Surgical Corporation Surgical fastener apparatus
US5127730A (en) 1990-08-10 1992-07-07 Regents Of The University Of Minnesota Multi-color laser scanning confocal imaging system
CA2052176A1 (en) 1990-10-05 1992-04-06 Daniel P. Rodak Controlled closure mechanism
US5269790A (en) * 1990-10-16 1993-12-14 Noboru Funatsu Clip forceps
US5282807A (en) * 1990-11-05 1994-02-01 Knoepfler Dennis J Automatic stapler for laparoscopic procedure with selective cutter, nontraumatic jaws and suction irrigator
JP2941041B2 (ja) 1990-11-16 1999-08-25 シスメックス株式会社 フローサイトメトリーによる白血球の分類方法
USRE36720E (en) * 1990-12-13 2000-05-30 United States Surgical Corporation Apparatus and method for applying latchless surgical clips
US5366458A (en) 1990-12-13 1994-11-22 United States Surgical Corporation Latchless surgical clip
US5086901A (en) * 1991-02-14 1992-02-11 Applied Robotics, Inc. Robot overload detection device
CA2060281A1 (en) 1991-02-20 1992-08-21 John C. Phillips Hemostatic clip applier
US5336232A (en) 1991-03-14 1994-08-09 United States Surgical Corporation Approximating apparatus for surgical jaw structure and method of using the same
CA2061885A1 (en) 1991-03-14 1992-09-15 David T. Green Approximating apparatus for surgical jaw structure
US5171249A (en) 1991-04-04 1992-12-15 Ethicon, Inc. Endoscopic multiple ligating clip applier
US5171247A (en) * 1991-04-04 1992-12-15 Ethicon, Inc. Endoscopic multiple ligating clip applier with rotating shaft
US5112343A (en) 1991-04-05 1992-05-12 Edward Weck Incorporated Endoscopic clip appliers
CH687672A5 (de) * 1991-07-15 1997-01-31 Straumann Inst Ag Zur Befestigung eines Zahnersatzes am Kiefer dienendes Implantat.
US5201746A (en) 1991-10-16 1993-04-13 United States Surgical Corporation Surgical hemostatic clip
US5497933A (en) * 1991-10-18 1996-03-12 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue
US5163945A (en) * 1991-10-18 1992-11-17 Ethicon, Inc. Surgical clip applier
US5433721A (en) * 1992-01-17 1995-07-18 Ethicon, Inc. Endoscopic instrument having a torsionally stiff drive shaft for applying fasteners to tissue
US5383880A (en) * 1992-01-17 1995-01-24 Ethicon, Inc. Endoscopic surgical system with sensing means
US5271543A (en) * 1992-02-07 1993-12-21 Ethicon, Inc. Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism
DE4303544A1 (en) 1992-02-07 1993-09-23 Storz Karl Gmbh & Co Surgical instrument for applying clips to surgical incision - has reloading magazine which holds clips in sterile environment
CA2088883A1 (en) 1992-02-13 1993-08-14 David T. Green Endoscopic ligating instrument
US5246450A (en) 1992-03-10 1993-09-21 Edward Weck Incorporated High capacity medical clip feeding and dispensing mechanism
US5484095A (en) * 1992-03-31 1996-01-16 United States Surgical Corporation Apparatus for endoscopically applying staples individually to body tissue
US5484451A (en) * 1992-05-08 1996-01-16 Ethicon, Inc. Endoscopic surgical instrument and staples for applying purse string sutures
US5192288A (en) 1992-05-26 1993-03-09 Origin Medsystems, Inc. Surgical clip applier
US5431667A (en) 1992-05-26 1995-07-11 Origin Medsystems, Inc. Gas-sealed instruments for use in laparoscopic surgery
US5269792A (en) 1992-05-26 1993-12-14 Origin Medsystems, Inc. Surgical clip
US5354304A (en) 1992-10-13 1994-10-11 American Cyanamid Co. Modular ligation clip applicator
US5601224A (en) * 1992-10-09 1997-02-11 Ethicon, Inc. Surgical instrument
US5725538A (en) 1992-10-09 1998-03-10 United States Surgical Corporation Surgical clip applier
US5300081A (en) 1992-10-09 1994-04-05 United States Surgical Corporation Surgical clip applier having clip advancement control
CA2133687C (en) 1992-10-09 2007-03-27 David T. Green Surgical clip applier
CA2107635C (en) 1992-10-09 1999-08-17 David T. Green Surgical clip applier
US5868761A (en) * 1992-10-09 1999-02-09 United States Surgical Corporation Surgical clip applier
US5409498A (en) 1992-11-05 1995-04-25 Ethicon, Inc. Rotatable articulating endoscopic fastening instrument
US5403327A (en) 1992-12-31 1995-04-04 Pilling Weck Incorporated Surgical clip applier
US5382255A (en) 1993-01-08 1995-01-17 United States Surgical Corporation Apparatus and method for assembly of surgical instruments
US5403326A (en) * 1993-02-01 1995-04-04 The Regents Of The University Of California Method for performing a gastric wrap of the esophagus for use in the treatment of esophageal reflux
US5468250A (en) * 1993-04-01 1995-11-21 Ethicon, Inc. Endoscopic mechanism with friction maintaining handle
CA2120828C (en) 1993-04-16 1999-11-02 Paul J. Phillips Surgical hemostatic clip
EP0622048B1 (en) * 1993-04-27 1997-05-21 American Cyanamid Company Automatic laparoscopic ligation clip applicator
US5431668A (en) * 1993-04-29 1995-07-11 Ethicon, Inc. Ligating clip applier
US5431669A (en) 1993-07-16 1995-07-11 Origin Medsystems, Inc. Surgical clip applier with distal hook
US5582617A (en) * 1993-07-21 1996-12-10 Charles H. Klieman Surgical instrument for endoscopic and general surgery
US5792165A (en) * 1993-07-21 1998-08-11 Charles H. Klieman Endoscopic instrument with detachable end effector
US5858018A (en) * 1993-08-25 1999-01-12 Apollo Camera, Llc Low profile tool for applying spring action ligation clips
WO1995007662A1 (en) * 1993-09-14 1995-03-23 Microsurge, Inc. Endoscopic surgical instrument with guided jaws and ratchet control
US5607436A (en) 1993-10-08 1997-03-04 United States Surgical Corporation Apparatus for applying surgical clips
US5496333A (en) * 1993-10-20 1996-03-05 Applied Medical Resources Corporation Laparoscopic surgical clamp
US5776147A (en) 1993-10-20 1998-07-07 Applied Medical Resources Corporation Laparoscopic surgical clamp
US5527320A (en) * 1994-02-10 1996-06-18 Pilling Weck Inc. Surgical clip applying instrument
US5681330A (en) 1994-03-02 1997-10-28 Ethicon Endo-Surgery, Inc. Sterile occlusion fasteners and instrument and method for their placement
CA2143560C (en) 1994-03-02 2007-01-16 Mark Fogelberg Sterile occlusion fasteners and instrument and method for their placement
US5421412A (en) 1994-03-10 1995-06-06 North Carolina State University Methods and compositions for fracturing subterranean formations
DE4411099C2 (de) * 1994-03-30 1998-07-30 Wolf Gmbh Richard Chirurgisches Instrument
CA2145723A1 (en) 1994-03-30 1995-10-01 Steven W. Hamblin Surgical stapling instrument with remotely articulated stapling head assembly on rotatable support shaft
US5470007A (en) 1994-05-02 1995-11-28 Minnesota Mining And Manufacturing Company Laparoscopic stapler with overload sensor and interlock
DE4415891A1 (de) 1994-05-05 1995-11-09 Wilo Medizintechnik Gmbh Pistole zum Setzen chirurgischer Klammern
US5814057A (en) * 1994-06-03 1998-09-29 Gunze Limited Supporting element for staple region
US5501693A (en) 1994-07-06 1996-03-26 United States Surgical Corporation Surgical hemostatic clip
US5833695A (en) * 1994-07-13 1998-11-10 Yoon; Inbae Surgical stapling system and method of applying staples from multiple staple cartridges
US5626585A (en) 1994-09-16 1997-05-06 United States Surgical Corporation Ligating clip advance
DE4434864C2 (de) 1994-09-29 1997-06-19 United States Surgical Corp Chirurgischer Klammerapplikator mit auswechselbarem Klammermagazin
US6152920A (en) * 1997-10-10 2000-11-28 Ep Technologies, Inc. Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body
US5562694A (en) * 1994-10-11 1996-10-08 Lasersurge, Inc. Morcellator
US5632432A (en) * 1994-12-19 1997-05-27 Ethicon Endo-Surgery, Inc. Surgical instrument
US5704534A (en) 1994-12-19 1998-01-06 Ethicon Endo-Surgery, Inc. Articulation assembly for surgical instruments
US5643248A (en) 1995-02-07 1997-07-01 Yoon; Inbae Medical instrument with force limiting mechanism
US5695505A (en) * 1995-03-09 1997-12-09 Yoon; Inbae Multifunctional spring clips and cartridges and applicators therefor
US5575806A (en) * 1995-03-10 1996-11-19 Nakao; Naomi Biopsy forceps with tissue ejection means
US5624452A (en) * 1995-04-07 1997-04-29 Ethicon Endo-Surgery, Inc. Hemostatic surgical cutting or stapling instrument
US5656062A (en) * 1995-05-31 1997-08-12 Betzdearborn Inc. Method for inhibiting deposits in the calcination of fluxed iron ore pellets
WO1997001989A1 (en) * 1995-07-03 1997-01-23 Frater Dirk A System for mounting bolster material on tissue staplers
US5810855A (en) 1995-07-21 1998-09-22 Gore Enterprise Holdings, Inc. Endoscopic device and method for reinforcing surgical staples
DE19534320C1 (de) 1995-09-15 1997-02-27 Aesculap Ag Applikator zum Anlegen und Lösen eines chirurgischen Clips
DE19537299A1 (de) 1995-10-06 1997-04-10 Busse Design Ulm Gmbh Klammerapplikator
DE19643073A1 (de) 1995-10-18 1997-04-24 Hermann Schilling Medizinisches Instrument zum Ligieren von Gefäßen mittels Klammern
US5700270A (en) * 1995-10-20 1997-12-23 United States Surgical Corporation Surgical clip applier
US5700271A (en) * 1995-10-20 1997-12-23 United States Surgical Corporation Apparatus for applying surgical clips
US5575206A (en) 1995-10-25 1996-11-19 Elexon Ltd. Screen printing apparatus with pallet registration
US5582615A (en) 1995-10-30 1996-12-10 Pilling Weck, Incorporated Handle for surgical clip applicator systems
US5607273A (en) 1995-11-06 1997-03-04 Vsi Corporation Printed circuit board wedge section retainer
JP3225813B2 (ja) 1995-11-20 2001-11-05 富士通株式会社 半導体記憶装置
DE19603889C2 (de) 1996-02-03 1999-05-06 Aesculap Ag & Co Kg Chirurgisches Anlegegerät
JPH09224947A (ja) 1996-02-26 1997-09-02 Olympus Optical Co Ltd クリップアプライヤー
US5772673A (en) 1996-03-07 1998-06-30 United States Surgical Corporation Apparatus for applying surgical clips
US5697543A (en) 1996-03-12 1997-12-16 Ethicon Endo-Surgery, Inc. Linear stapler with improved firing stroke
US5605272A (en) 1996-03-12 1997-02-25 Ethicon Endo-Surgery, Inc. Trigger mechanism for surgical instruments
EP0893970B1 (en) 1996-04-19 2006-06-21 Applied Medical Resources Corporation Grasping clip applier
US5706824A (en) 1996-05-20 1998-01-13 Symbiosis Corporation Endoscopic biopsy forceps instrument having a constant force spring biasing the jaws closed
US5810848A (en) * 1996-08-21 1998-09-22 Hayhurst; John O. Suturing system
US5830221A (en) 1996-09-20 1998-11-03 United States Surgical Corporation Coil fastener applier
DE29616632U1 (de) 1996-09-24 1996-11-28 Aesculap Ag, 78532 Tuttlingen Chirurgisches Anlegegerät für U-förmige Clipse
US5833696A (en) 1996-10-03 1998-11-10 United States Surgical Corporation Apparatus for applying surgical clips
US5792149A (en) 1996-10-03 1998-08-11 United States Surgical Corporation Clamp applicator
US5713911A (en) 1996-10-03 1998-02-03 United States Surgical Corporation Surgical clip
DE19647354A1 (de) 1996-11-15 1998-05-20 Tontarra Medizintechnik Gmbh Chirurgisches Instrument
US6727071B1 (en) * 1997-02-27 2004-04-27 Cellomics, Inc. System for cell-based screening
US5843101A (en) 1997-05-02 1998-12-01 Fry; William R. Disposable clip for temporary vessel occulsion
US5941439A (en) * 1997-05-14 1999-08-24 Mitek Surgical Products, Inc. Applicator and method for deploying a surgical fastener in tissue
US5928251A (en) 1997-09-18 1999-07-27 United States Surgical Corporation Occlusion clamp and occlusion clamp applicator
US5972003A (en) 1997-10-01 1999-10-26 Sherwood Services Ag Single-free ligation clip module
US5868759A (en) * 1997-10-10 1999-02-09 United States Surgical Corporation Surgical clip applier
US6248590B1 (en) 1998-02-27 2001-06-19 Cytomation, Inc. Method and apparatus for flow cytometry
US6066145A (en) 1998-03-26 2000-05-23 Wurster; Helmut Multi-ligator device that generates a signal when a ligation ring is released
US6241740B1 (en) 1998-04-09 2001-06-05 Origin Medsystems, Inc. System and method of use for ligating and cutting tissue
US6059799A (en) * 1998-06-25 2000-05-09 United States Surgical Corporation Apparatus for applying surgical clips
DE19829981C2 (de) 1998-07-04 2002-10-17 Zeiss Carl Jena Gmbh Verfahren und Anordnung zur konfokalen Mikroskopie
US6158142A (en) * 1998-07-23 2000-12-12 Meurer Industries, Inc. Method of and apparatus for drying and conveying screenings
US6228097B1 (en) 1999-01-22 2001-05-08 Scion International, Inc. Surgical instrument for clipping and cutting blood vessels and organic structures
GB9901365D0 (en) * 1999-01-22 1999-03-10 Isis Innovations Ltd Confocal microscopy apparatus and method
US6217590B1 (en) 1999-01-22 2001-04-17 Scion International, Inc. Surgical instrument for applying multiple staples and cutting blood vessels and organic structures and method therefor
WO2002028268A2 (en) 2000-10-06 2002-04-11 Applied Medical Resources Corporation Multiple clip applier apparatus and method
DE60042150D1 (de) 1999-01-25 2009-06-18 Applied Med Resources Modulares ligationsgerät und methode
EP1177092A4 (en) * 1999-02-18 2004-11-17 Corning Inc HONEYCOMB SILICA GLASS STRUCTURE MADE BY EXTRUSION OF SILICA SOOT
US6507400B1 (en) * 1999-02-27 2003-01-14 Mwi, Inc. Optical system for multi-part differential particle discrimination and an apparatus using the same
US6548796B1 (en) 1999-06-23 2003-04-15 Regents Of The University Of Minnesota Confocal macroscope
DE19933672C2 (de) 1999-07-17 2001-12-06 Aesculap Ag & Co Kg Chirurgisches Instrument
DE19934634C1 (de) 1999-07-23 2000-12-21 Aesculap Ag & Co Kg Anlegeinstrument für chirurgische Clips
US6458142B1 (en) * 1999-10-05 2002-10-01 Ethicon Endo-Surgery, Inc. Force limiting mechanism for an ultrasonic surgical instrument
KR20010036685A (ko) 1999-10-11 2001-05-07 김윤 펜타닐을 함유하는 매트릭스형 경피투여제
US6610073B1 (en) 1999-10-19 2003-08-26 Scion International, Inc. Surgical clip, clip applicator and method therefor
US6695854B1 (en) 1999-11-29 2004-02-24 General Surgical Innovations, Inc. Blood vessel clip and applicator
CN1302754C (zh) 2000-02-04 2007-03-07 康曼德公司 手术夹置放器
US6840945B2 (en) 2001-02-28 2005-01-11 Microline, Inc. Medical clip applier safety arrangement
US6911033B2 (en) * 2001-08-21 2005-06-28 Microline Pentax Inc. Medical clip applying device
US6306149B1 (en) 2000-02-15 2001-10-23 Microline, Inc. Medical clip device with cyclical pusher mechanism
US6569171B2 (en) 2001-02-28 2003-05-27 Microline, Inc. Safety locking mechanism for a medical clip device
US6277131B1 (en) * 2000-02-15 2001-08-21 Microline, Inc Ladder-type medical clip feeding mechanism
US7141056B2 (en) * 2000-02-15 2006-11-28 Microline Pentax Inc. Multiplier extension arrangement
US6646742B1 (en) 2000-02-19 2003-11-11 Mwi, Inc. Optical device and method for multi-angle laser light scatter
US6533157B1 (en) * 2000-02-22 2003-03-18 Power Medical Interventions, Inc. Tissue stapling attachment for use with an electromechanical driver device
US6423079B1 (en) 2000-03-07 2002-07-23 Blake, Iii Joseph W Repeating multi-clip applier
DE20007177U1 (de) 2000-04-19 2000-08-03 Karl Storz GmbH & Co. KG, 78532 Tuttlingen Medizinisches Instrument mit sperrbarem Kraftübertragungselement
US6549275B1 (en) * 2000-08-02 2003-04-15 Honeywell International Inc. Optical detection system for flow cytometry
US6597438B1 (en) 2000-08-02 2003-07-22 Honeywell International Inc. Portable flow cytometry
US6544271B1 (en) * 2000-07-18 2003-04-08 Scimed Life Systems, Inc. Device for full-thickness resectioning of an organ
GB0020263D0 (en) 2000-08-18 2000-10-04 Femcare Cyprus Ltd Improvements in or relating to applicators
US6716226B2 (en) * 2001-06-25 2004-04-06 Inscope Development, Llc Surgical clip
US20020138086A1 (en) * 2000-12-06 2002-09-26 Robert Sixto Surgical clips particularly useful in the endoluminal treatment of gastroesophageal reflux disease (GERD)
DE10110106B4 (de) * 2001-03-02 2007-08-02 Richard Wolf Gmbh Chirurgische Zange
US20020177863A1 (en) 2001-05-24 2002-11-28 Mandel Stanley R. Surface treated ligating clip
US7090685B2 (en) * 2001-06-25 2006-08-15 Ethicon Endo-Surgery, Inc. Surgical tool having a distal ratchet mechanism
CN1397256A (zh) 2001-07-02 2003-02-19 有限公司英普类思特 外科用夹子赋予装置
JP2004534591A (ja) * 2001-07-09 2004-11-18 タイコ ヘルスケア グループ エルピー 直角クリップアプライア装置および方法
US6824547B2 (en) 2001-07-13 2004-11-30 Pilling Weck Incorporated Endoscopic clip applier and method
US7208005B2 (en) * 2001-08-06 2007-04-24 The Penn State Research Foundation Multifunctional tool and method for minimally invasive surgery
GB0120645D0 (en) * 2001-08-24 2001-10-17 Smiths Group Plc Medico-surgical devices
JP4350924B2 (ja) * 2001-09-07 2009-10-28 富士フイルム株式会社 固体撮像装置およびその駆動方法
US6835173B2 (en) * 2001-10-05 2004-12-28 Scimed Life Systems, Inc. Robotic endoscope
US7331968B2 (en) * 2004-06-14 2008-02-19 Ethicon Endo-Surgery, Inc. Endoscopic clip applier with threaded clip
US6869435B2 (en) * 2002-01-17 2005-03-22 Blake, Iii John W Repeating multi-clip applier
EP1487352A4 (en) * 2002-03-25 2006-07-12 Dvl Acquisition Sub Inc SUTURE SURGICAL INSTRUMENT AND METHOD OF USE
US7211092B2 (en) * 2002-11-19 2007-05-01 Pilling Weck Incorporated Automated-feed surgical clip applier and related methods
US7052504B2 (en) * 2002-11-19 2006-05-30 Teleflex Incorporated Automated-feed surgical clip applier and related methods
EP1590517A4 (en) 2002-11-29 2010-03-10 John R Liddicoat DEVICE AND METHOD FOR MANIPULATING TISSUE
JP4331504B2 (ja) * 2003-04-09 2009-09-16 オリンパス株式会社 超音波処置装置
US7055731B2 (en) 2003-07-09 2006-06-06 Ethicon Endo-Surgery Inc. Surgical stapling instrument incorporating a tapered firing bar for increased flexibility around the articulation joint
US7901461B2 (en) 2003-12-05 2011-03-08 Ethicon, Inc. Viable tissue repair implants and methods of use
CA2512948C (en) 2004-07-28 2013-10-01 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US7354447B2 (en) 2005-11-10 2008-04-08 Ethicon Endo-Surgery, Inc. Disposable loading unit and surgical instruments including same
US7559452B2 (en) 2005-02-18 2009-07-14 Ethicon Endo-Surgery, Inc. Surgical instrument having fluid actuated opposing jaws
US7740641B2 (en) 2005-04-14 2010-06-22 Ethicon Endo-Surgery, Inc. Clip applier with migrational resistance features
US7261724B2 (en) * 2005-04-14 2007-08-28 Ethicon Endo-Surgery, Inc. Surgical clip advancement mechanism
US7297149B2 (en) * 2005-04-14 2007-11-20 Ethicon Endo-Surgery, Inc. Surgical clip applier methods
US7686820B2 (en) * 2005-04-14 2010-03-30 Ethicon Endo-Surgery, Inc. Surgical clip applier ratchet mechanism
US7731724B2 (en) 2005-04-14 2010-06-08 Ethicon Endo-Surgery, Inc. Surgical clip advancement and alignment mechanism
US8038686B2 (en) * 2005-04-14 2011-10-18 Ethicon Endo-Surgery, Inc. Clip applier configured to prevent clip fallout
US8523882B2 (en) * 2005-04-14 2013-09-03 Ethicon Endo-Surgery, Inc. Clip advancer mechanism with alignment features
US7288098B2 (en) * 2005-04-14 2007-10-30 Ethicon Endo-Surgery, Inc. Force limiting mechanism for medical instrument
EP1913881B1 (en) 2006-10-17 2014-06-11 Covidien LP Apparatus for applying surgical clips
US20090242610A1 (en) 2008-03-26 2009-10-01 Shelton Iv Frederick E Disposable loading unit and surgical instruments including same
US7731641B1 (en) 2009-01-22 2010-06-08 Paul Chen Adjustable dumbbell
US8267945B2 (en) * 2009-10-09 2012-09-18 Ethicon Endo-Surgery, Inc. Clip advancer with lockout mechanism
US8262679B2 (en) * 2009-10-09 2012-09-11 Ethicon Endo-Surgery, Inc. Clip advancer
US8435174B2 (en) 2009-12-11 2013-05-07 Ethicon Endo-Surgery, Inc. Methods and devices for accessing a body cavity

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5009661A (en) * 1989-04-24 1991-04-23 Michelson Gary K Protective mechanism for surgical rongeurs
US5286255A (en) * 1991-07-29 1994-02-15 Linvatec Corporation Surgical forceps
US6096058A (en) * 1997-07-22 2000-08-01 Karl Storz Gmbh & Co. Kg Surgical instrument with an apparatus for limiting the transfer of a force
EP0908152B1 (en) * 1997-10-10 2002-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic clamp coagulator apparatus having force-limiting clamping mechanism

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