CN1861012A - 将装置定位在内窥镜上的方法 - Google Patents
将装置定位在内窥镜上的方法 Download PDFInfo
- Publication number
- CN1861012A CN1861012A CNA2006100802582A CN200610080258A CN1861012A CN 1861012 A CN1861012 A CN 1861012A CN A2006100802582 A CNA2006100802582 A CN A2006100802582A CN 200610080258 A CN200610080258 A CN 200610080258A CN 1861012 A CN1861012 A CN 1861012A
- Authority
- CN
- China
- Prior art keywords
- endoscope
- supply pipe
- track
- sheath
- end cap
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/005—Flexible endoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/00135—Oversleeves mounted on the endoscope prior to insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/00137—End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/0014—Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Biophysics (AREA)
- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Endoscopes (AREA)
- Instruments For Viewing The Inside Of Hollow Bodies (AREA)
Abstract
本发明公开了一种方法,该方法用于在内窥镜上定位诸如端帽的装置。所述方法可用于例如使将端帽按压在内窥镜上的操作更为容易,包括其中将端帽设置护套中并将端帽定位在护套的远端处的那些应用。
Description
相关申请的交叉引用
本申请要求下列专利申请的优先权,这些专利申请在此引入作为参考:序列号为US 10/440,957(公开号US 2004/0230095);US10/440,660(公开号US 2004/0230096);US 10/440,956(公开号US 2004/0230097)的专利申请;其中的每一个均于2003年5月16日提交。
本申请还引入下述美国专利申请作为参考并要求其优先权:Long等人于2005年5月12日提交的“Medical Instrument Havinga Guidewire and an Add-to Catheter”(代理卷号:END-5335USNP5),其序列号为_____。
技术领域
本发明总的涉及医疗装置,尤其涉及用于内窥镜手术的装置和方法。
背景技术
与传统的开放式医疗手术过程相比,期望进行微创手术,因为这种手术可减小疼痛并且提供相对较快的恢复期。许多微创手术通过内窥镜(包括但不限于腹腔镜)来执行。这种手术允许医生通过在患者体内的小的接触开口来定位、操纵和观察在患者内的医疗器械和附件。术语腹腔镜检查是用于描述使用内窥镜(通常为刚性的腹腔镜)的这种“内镜手术”方法。在这种类型的手术中,经常通过经体壁放置的插管将辅助装置插入患者体内。
更为微创的治疗包括通过经由自然存在的身体开口将内窥镜插入治疗部位来进行的治疗。该方法的例子包括但不限于膀胱镜检查、子宫镜检查、食管胃镜检查和结肠镜检查。很多这种手术在手术期间采用挠性内窥镜。挠性内窥镜通常在远端附近具有挠性的关节运动部分,可由用户通过利用在近端的控制来控制所述远端。
一些挠性内窥镜较小(直径1mm-3mm),并且没有一体的辅助通道(也称为活组织检查通道或者工作通道)。其它挠性内窥镜(包括胃镜和结肠镜)具有一体的工作通道,该工作通道直径为大约2.0-3.5mm,以导入和去除医疗装置和其它辅助装置,从而在患者体内进行诊断或治疗。因此,可由所使用的镜的辅助通道的直径限制医生使用的辅助装置的尺寸。另外,医生在使用具有一个工作通道的标准内窥镜时,可被限制来操作单个辅助装置。
可获得某些专用内窥镜,例如工作通道直径为5mm的长工作通道内窥镜,其能用于通过较大的辅助装置,或者用于提供抽吸大血块的能力。其它专用内窥镜包括具有两个工作通道的那些内窥镜。这种大直径/多通道的内窥镜的一个缺点在于,这种装置可能较为昂贵。另外,这种大直径/多通道的内窥镜可具有这样的外径,即,使得内窥镜较刚硬或者难以插进。
各参考文献描述了披露与内窥镜有关的构造的方法或系统,这些参考文献例如:授予Silverstein的美国专利5,025,778;授予Opie的美国专利4,947,827;Sauer提交的2002年8月公布的美国申请2002/107530;授予Matsui的美国专利6,352,503。已知系统的一个缺点在于,内窥镜外部使用的装置的远端可能以相对未控制的方式运动,从而导致辅助装置缺乏保持在内窥镜的成像性能的所需视野内的准确性或者能力。
Herrman提交的2000年8月24日公布的WO 00/48506公开了一种可变形的内窥镜,其具有至少一个辅助装置。包括内窥镜和辅助装置的单元具有非圆形的截面。这种非圆形的内窥镜在成本、复杂性或者在清洁/消毒的方面是不利的。例如具有光滑的基本上为圆形的截面的标准内窥镜较易于消毒和清洁。
Kortenbach提交的2000年8月24日公布的WO 00/48506公开了用于在内窥镜的外部上供应医疗器械的方法和装置,以允许使用太大而不能通过内窥镜的腔体装配的器械。Kortenbach公开了与内窥镜一起使用的环圈、弹性带、具有可重新闭合的缝的挠性护套、挠性聚合物挤压件和限定了具有不规则(可折叠)的截面的腔体的柔性切向护套。Kortenbach还公开了具有倒T型构造的轨道。
内窥镜还可与供给管一起使用。例如,已知通过内窥镜的内部通道推进供给管。还已知的是与内窥镜一起推进供给管,例如通过一对从内窥镜的远端延伸的镊子保持供给管的远端,在将内窥镜推进到期望位置时沿着内窥镜的外侧“拖拽”供给管。
但是,科学家和工程师们仍然在寻找改进的用于将医疗装置引入胃肠道的装置和方法,包括在患者体内放置供给管的改进庄装置和方法。
发明内容
在一个实施方案中,本发明提供了用于将装置定位在内窥镜上的方法。所述方法会包括如下步骤:设置内窥镜;设置诸如端帽的装置,其尺寸适于被定位在内窥镜的端部上;以及在内窥镜上施加拉力的同时在装置上施加推力,其中,施加在内窥镜上的拉力被施加穿过在装置中的开口。可在内窥镜上施加拉力穿过端帽中的孔。在一个实施方案中,所述方法提供了用于按压与护套相关联的端帽到内窥镜上,将该内窥镜设置在护套内而不需抓握护套。
在某些实施方案中,关于涉及经皮内窥镜胃造口术(PEG)管和/或通过经皮内窥镜胃造口术的空肠管(JET PEG)手术可以采用本发明。
(1)本发明涉及一种用于将装置定位在内窥镜上的方法,其包括如下步骤:
设置内窥镜;
设置其尺寸适于被定位在内窥镜的端部上的装置;以及
在内窥镜上施加拉力的同时在装置上施加推力,其中,施加在内窥镜上的拉力通过装置中的开口施加。
(2)如第(1)项所述的方法,其中,施加在内窥镜上的拉力通过装置中的通孔施加。
(3)如第(1)项所述的方法,其中,通过在装置中的其尺寸可容纳内窥镜端部的开口施加拉力。
(4)如第(1)项所述的方法,其中,所述装置包括具有用于容纳内窥镜端部的孔的端帽,并且拉力通过端帽中的孔施加到内窥镜上。
(5)如第(1)项所述的方法,其中,将所述装置定位在设置在护套中的内窥镜上,并且完成了在内窥镜上施加拉力的步骤而不需抓握护套。
(6)如第(1)项所述的方法,其中,在内窥镜上沿径向向内窥镜外表面的内部的方向施加拉力。
(7)如第(1)项所述的方法,其中,施加拉力到内窥镜内的通道的表面上。
(8)如第(1)项所述的方法,其中,围绕内窥镜的远端施加拉力。
(9)如第(1)项所述的方法,其包括接合内窥镜内表面的步骤。
(10)如第(1)项所述的方法,其包括通过在内窥镜内伸长构件来接合内窥镜内表面的步骤。
(11)本发明还涉及一种在内窥镜上定位端帽的方法,其包括如下步骤:
设置内窥镜;
设置与护套的远端相关联的端帽;
将内窥镜至少部分地定位在护套内;以及
在内窥镜上施加力穿过端帽。
(12)如第(11)项所述的方法,其还包括在端帽上施加力的步骤。
(13)如第(11)项所述的方法,其还包括在内窥镜上施加拉力的同时在端帽上施加推力的步骤。
(14)如第(11)项所述的方法,其中,完成了在内窥镜上施加力的步骤而不会接触护套。
(15)如第(11)项所述的方法,其包括:在端帽上施加推力的同时在内窥镜上施加拉力,其中施加拉力到内窥镜的外表面上。
(16)如第(11)项所述的方法,其包括:在端帽上施加推力的同时在内窥镜上施加拉力,其中施加拉力到与内窥镜的内部通道相关联的表面上。
(17)本发明还涉及一种将端帽定位在内窥镜上的方法,其包括如下步骤:
设置内窥镜;
设置在护套的远端处设置的端帽;
将内窥镜至少部分地定位在护套内;以及
按压端帽到内窥镜地远端上而不需抓握护套。
(18)本发明还涉及一种将端帽定位在内窥镜上的方法,其包括如下步骤:
设置内窥镜;
设置具有第一端部和第二端部的承载元件,该第二端部适于可拆卸地接合内窥镜的远端;
将承载元件可拆卸地定位在内窥镜的远端上;
将承载元件的第一端部至少部分地插入穿过端帽;以及
在端帽上推动的同时在承载元件上牵引。
附图说明
图1是内窥镜护套和轨道的示意图。
图1A是插入到手柄中的内窥镜的示意图,该手柄具有处于打开构造的铰接闩。
图1B是与图1A相类似的示意图,示出了铰接闩处于闭合位置,并且供给管和承载器被在轨道上推进。
图2是图1中护套的远端的示意图,示出了承载器被在轨道上推进。
图2A是示出了端帽的近端的示意性等轴测图。
图3示出了设置在护套上的轨道的不同部分。
图4是一部分轨道的俯视图。
图5是支撑在护套上的轨道的横截面图(应当理解,该护套可由薄膜形成,在没有内部构件、例如内窥镜设置在护套中时,其不会保持图5中所示的圆形构造)。
图6是根据本发明一个实施方案的供给管承载器的示意图。
图7是护套和轨道的远侧部分的示意图,示出了推进到轨道上的远侧位置的承载器,并且指示凸条延伸通过端帽中的狭槽,以通过内窥镜进行观察。
图8是示出了内窥镜的远端被推进通过护套的示意图,其中护套、轨道、承载器以横截面示出。
图9是护套、轨道、承载器的远侧部分的示意图,示出了被推进到轨道上的远侧位置的承载器和供给管。
图10是具有用于与轨道滑动接合的零件的供给管的示意图。
图11是图10中所示零件的近侧部分的示意图。
图12是一端口的示意图,该端口用于在供给管定位后并且轨道已经被从胃肠道缩回时使供给管在GI道中保持在期望的位置。
图13是图10所示供给管的远侧部分的示意性侧视图,(以虚线)示出了通道的远侧部分,通过该通道引导营养物,这样该通道的远侧部分不需要弯曲或折弯以与远侧供应端口连通,其中供给管延伸到远侧供应端口的远侧的部分关于该通道倾斜,并且在图中示出了在供给管的远端处采用的配重(虚线)。
图14是用于在将内窥镜和承载器从患者的GI道处移除时将供给管保持在期望位置的构件的远侧部分的示意图。
图15是图14中构件的远端的示意图,示出了被定位、设定尺寸和/或设定形状用于与供给管相关联的导轨零件的近端处的接触表面接合的接触表面。
图16是相对于在供给管上的导轨零件的近端定位的图14中构件的远侧部分的示意图。
图17是在供给管上的导轨零件和图14中构件的相邻部分的示意性仰视图。
图18示出了将医疗装置(该医疗装置可包括手柄、护套、端帽和轨道)中的内窥镜引入患者的GI道,端帽和轨道的远端位于小肠(例如空肠)中。
图19示出了在如图18所示已经定位内窥镜和轨道之后在轨道上一起推进承载器和供给管,供给管的远端处于空肠中。
图20示出了在将内窥镜与医疗装置(该医疗装置可包括手柄、护套、端帽和轨道)从患者沿向近侧方向移除时将构件向远侧供应到供给管之后的位置处,以将供给管在GI道中保持就位。
图21示出了定位成从嘴外侧延伸到小肠中的供给管。
图22示出了提供通过鼻子的转换管。
图23示出了将该转换管的端部与供给管的近端相连。
图24示出了(例如与图23的转换管一起)将供给管的近端拉动穿过喉部和鼻腔,从而使供给管的近端从患者的鼻子(从鼻孔)延伸。
图25示出了将医疗装置(该医疗装置可包括手柄、护套、端帽和轨道)中的内窥镜定位到GI道中,将端帽和轨道的远端定位在胃中,例如用于PEG管供应方法,并且图25示出了用于形成通过腹壁的经皮切口的插管/针可用与内窥镜相连的光源透射。
图26示出了将针从插管移除并且通过插管引入结圈的导丝,并且示出了内窥镜的远端、端帽、护套和轨道经过结圈的导丝的圈。
图27在轨道上推进PEG管(例如其长度基本上小于轨道长度的PEG管),并且PEG管如此设置在轨道上,即,要定位在身体内的PEG管的第一端部在要通过经皮切口定位的PEG管的第二端部前推进,示出了PEG管的第一端部被推离轨道。
图28示出了PEG管的第二端部推离导轨,并且用结圈的导丝抓住一段从PEG管的第二端部延伸的缝合线。
图29示出了通过经皮切口拉动缝合线圈和PEG管的第二端部,并且抵靠着胃壁的内侧表面将缓冲件放置在PEG管的第一端部处,并且内窥镜被定位成提供对放置的观察。
图30示出了从GI道移除医疗装置和内窥镜,PEG管的外侧部分适于通过腹壁引入营养物。
图31示出了将设置在医疗装置(该医疗装置可包括手柄、护套、端帽和轨道)中的内窥镜(例如胃窥镜)定位到GI道中,将端帽、胃窥镜的远端和轨道的远端定位在胃中,例如用于JET-PEG管供应方法,并且图31还示出了胃窥镜被用于透照腹壁,针/插管可用来形成切口和/或穿过该切口进入胃中。
图32示出了通过插管移除针和引入结圈的导丝,在此之后,医疗装置(与设置在其中的胃窥镜一起)通过结圈的导丝推进,并且该医疗装置的远端和胃窥镜的远端被推进到空肠中(例如通过特赖茨带)。
图33示出了在轨道上定位供给管(例如该供给管长度基本上小于轨道长度)和承载器,沿着轨道推进供给管,直到该供给管的远端位于空肠中并且可由内窥镜观察。
图34示出了将医疗装置和胃窥镜向近侧缩回到胃中,同时将构件在近侧定位在供给管之后,以将供给管推离轨道远端,还示出了用结圈的导丝抓住一段从供给管延伸的缝合线。
图35示出了通过腹壁通过切口拉动缝合线和供给管的端部,并且将供给管的远端留在空肠中。
图36示出了适于通过腹壁引入营养物的供给管的外侧部分,并且供给管的远端置于空肠中。
图37示出了就位的供给管,并且胃窥镜和医疗装置被移除。
图38示出了端帽装载元件,其用于内窥镜的远端上的端帽。
图38A为端帽装载元件的挠性叉头的横截面示意图。
图39示出了设置在内窥镜的远端的端帽装载元件,设置在护套中的内窥镜,设置在护套内并与内窥镜的外表面接合的端帽装载元件的挠性叉头,0形环挤压挠性叉头并抵靠端帽的近侧面定位,端帽装载元件的远侧部分延伸穿过端帽的孔。
图40示出了在端帽装载元件上向近侧滑动以抵靠端帽的远侧面定位的手柄。
图40A为示出了手柄的近侧面和延伸到手柄中的中央孔的端帽装载元件示意图。
图41示出了能够被连接到端帽装载元件的远侧部分的环。
图42示出了在环上向远侧拉动而在手柄上向近侧推动,以由手柄在端帽的远侧表面提供推力,同时由挠性叉头在内窥镜的外表面上提供拉动牵引力,从而使端帽和O形环滑动离开端帽装载元件到达内窥镜的远端。
图43示出了接合内窥镜的内表面并能用于将端帽推到内窥镜上的设备的示意性等轴测图。
图44是图43中设备的截面示意图。
图45是示意性等轴测图,示出了内窥镜的远端、端帽和图43的设备的前向部分,并且设备的一部分被插入内窥镜的工作通道。
图46是示意性等轴测图,示出了被插入内窥镜的工作通道中的一部分设备的扩张。
图47是示意性等轴测图,示出了图43中设备的致动器的向后运动,以沿第一方向将端帽推到内窥镜上,同时沿相反方向拉动内窥镜。图48是图43中设备的一部分的示意性剖视图。
图49是图43中设备的一部分的示意性剖视图。
具体实施方式
图1和2示出了根据本发明一个实施方案的医疗设备10。在一个实施方案中,设备10包括手柄100、从手柄100延伸的挠性导管或者护套200、设置在护套200上的挠性轨道300以及设置在护套200远端的端帽400。手柄100和挠性护套200每一个的尺寸均可容纳从中穿过的内窥镜。
设备10还包括一承载器500,如图2所示,该承载器500适于以可滑动的方式接合轨道300。端帽400的尺寸和形状被设置成可以接合内窥镜(例如图2中所示的内窥镜1000)的远端。内窥镜1000可以为任何可从商业渠道获得的内窥镜,例如胃镜或结肠镜,其具有可进行关节运动的远侧部分,并包括观察元件1100和工作通道1200。任何合适的内窥镜(包括但不限于胃镜和儿科结肠镜)可以与本发明一起使用。可以与本发明一起使用的合适的内窥镜包括但不限于由日本Olympus Corporation制造的PCF100、PCF130L、PCF140L或者PCF160AL型内窥镜。手柄100、护套200和端帽400的尺寸被设定成可以容纳各种直径的内窥镜,例如但不限于其直径从大约9mm至大约14mm的内窥镜。
为了将内窥镜1000与设备10一起引入患者体内,操作者可以从清洁干燥的内窥镜开始。护套200优选地由薄的、轻质的、可皱褶的聚合物薄膜材料形成,该材料相对柔软并且可弹性地延展,其基本上不具有抗扭刚度和扭转载荷承受能力。使用术语“可皱褶的”指的是所述护套在没有支撑所述护套的内部结构(例如内窥镜)的情况下不保持圆形的或其它规则的横截面形状。
在一个实施方案中,所述护套200由具有如下弹性模量的材料形成,该弹性模量小于大约20ksi,更特别的小于大约15ksi,再特别的小于大约10ksi,最特别的小于大约7ksi。所述护套可由具有如下屈服强度的材料形成,该屈服强度小于大约500psi,更特别的小于大约300psi,再特别的小于大约200psi,最特别的小于大约125psi。在一个实施方案中,所述护套可由其屈服强度在大约90psi和大约120psi之间的材料形成。该弹性模量和屈服强度可以由五或更多次测量值的平均值来确定,并且通过如下方式来确定,使用ASTM#D882(薄塑料片材拉伸特性的标准测试方法)测试采用4.0英寸的标准长度、1.0英寸的标准宽度、测试厚度等于薄膜的厚度(例如大约0.005英寸),测试机的速度为0.4in/minute。在一个实施方案中,所述护套可由这样的薄膜形成,该薄膜的模量小于大约7ksi,其屈服强度小于大约125psi,其在破裂时的抗张强度在至少大约1MPa(兆帕斯卡)、特别是在至少大约5MPa,更特别是在大约10MPa或更大。所述护套可由这样的薄膜形成,该薄膜的抗张伸展率(采用ASTM D638)为至少大约200%,更特别的为至少大约500%,并且最特别的为大约800%或更大。所述模量、屈服强度、抗张强度和伸展率由至少五次测量值的平均值确定。
在一些实施方案中,可能希望护套200在不使用润滑剂的情况下被插入到所述镜的插入长度上。在一个实施方案中,护套200可以具有不光滑的质地粗糙(textured)的内表面210,这防止挠性护套的内表面“粘附”到内窥镜的插入部分的外表面上。例如在期望使该护套和内窥镜一起旋转时,质地粗糙的内表面还能够通过护套200辅助夹持内窥镜。可以使内表面质地粗糙并且外表面大致光滑,或者内和外表面二者均质地粗糙。该护套200的内表面可具有与外侧表面相同的质地、或者比外表面相对更粗糙的质地、或者比外侧表面相对不粗糙的质地。
质地粗糙的内表面可以设有升起的部分、下降的部分、或者升起和下降部分的组合。例如,所述内表面可包括任意隔开的凸起部或突起,或者可选择的,可设有升起部分(例如凸起部或突起),该升起部分以规则隔开的间距设置,并且该间距为大致均匀的间隔。内表面的质地可以以粗糙度平均测量值来测量,其中“粗糙度平均值”或“Ra”为测量的轮廓高度偏离量的绝对值除以测量长度的算术平均值,如在机械手册第27版第728页所述的,该手册在此引入作为参考。所述粗糙度平均值可采用光学干涉法使用由Middlefield,Conn.,Zygo Corporation投入市场的ZygoNewView 100 3D成像表面结构分析仪来测量。可以使用下述测量参数和分析参数:
测量参数:获取模式为“扫描”;摄像机模式为320×240常规;相位控制(AGC为“开”;Phase res为“高”;Min Mod为1%;Min Area size为7;Discon Action为“滤光器”;ConnectionOrder为“位置”;Remove Fringes为“关”;Image Zoom为1x);扫描控制(扫描长度为“延长”;延长扫描长度为11000微英寸;FDA Res为“低”)。
分析参数:滤光器为“低通过”;滤光器类型为“平均”;滤光器窗口尺寸为13;滤光器高频1/mil;滤光器低频1/mil;滤光器Trim为“关”;Remove为“平面”;Trim为0;Remove Spikes为“开”;Spike Height(xRMS)为1.25;数据填充为“开”;最大数据填充为25。所述测量可使用5x Michelson物镜进行,并且样品可以被涂覆有金或以其它方式涂覆,以便提供反射光的大致不透明的表面。金涂层可由Hummer6.2阴极真空喷镀系统来涂覆。
在一个实施方案中,护套200的内表面可以具有小于大约500微英寸(0.000500英寸)的粗糙度平均值Ra,更特别的该粗糙度平均值小于大约400微英寸,再特别的该粗糙度平均值小于大约250微英寸,最特别的该粗糙度平均值小于大约150微英寸。在一个实施方案中,内表面的粗糙度平均值在大约50和大约500微英寸之间,更特别的在大约50和大约250微英寸之间,最特别的在大约75和大约125微英寸之间。该粗糙度平均值确定为至少五次测量的平均值。
护套200的内表面具有这样的摩擦系数,该摩擦系数适合于用该护套200夹持内窥镜,但也允许在不需要费很大力的条件下将内窥镜定位在该护套内。合适的内表面可具有均小于大约1.0的静摩擦系数和滑动摩擦系数。在一个实施方案中,使用Ultem1000材料形成的摩擦滑块(sled),静摩擦系数可以在大约0.3和大约0.6之间(更特别的在大约0.4和大约0.5之间),并且滑动摩擦系数可以在大约0.3和大约0.6之间(更特别的在大约0.4和大约0.5之间)。使用440C不锈钢形成的摩擦测试滑块(sled),该静摩擦系数可以在大约0.2和大约0.5之间(更特别的在大约0.3和大约0.4之间),并且滑动摩擦系数可以在大约0.2和大约0.5之间(更特别的在大约0.3和大约0.4之间)。静摩擦系数和滑动摩擦系数可采用ASTM测试#D1894(塑料薄膜和片材的静摩擦系数和动摩擦系数的标准测试方法)来测量。该摩擦系数确定为至少五次测量的平均值。
在一个实施方案中,该护套200可以由其厚度小于大约0.010英寸的热塑性聚烯烃薄膜形成,并且可以由聚丙烯、聚乙烯和其混合物构成。在一个实施方案中,该护套可以由其厚度在大约0.004和0.006英寸之间、更特别的为大约0.005英寸的薄膜形成。可获得的一种合适的薄膜为由Netherlands,Hoofdorp,Basell NV制造的Basell Softell Q020F,其例如可由Pa.Royersford,SpecialtyExtrusion,Inc.提供。
手柄100可由任何合适的材料形成,包括但不限于相对硬的生物相容性金属和塑料。一种可以用来形成手柄100的合适的材料为模制聚乙烯,例如可从Houston TX,Huntsman Corp.获得的Huntsman12N25ACS296。
如图1所示,手柄100具有大致圆柱形的近侧部分102和邻接的远侧收缩圆锥形部分104,该近侧部分102具有用于容纳内窥镜的近侧开口。手柄100在其近端包括用于容纳内窥镜的开口101。手柄的用于容纳内窥镜的内通道包括对应于部分102的大致圆柱形的通道部分103(以虚线示出),以及对应于部分104的大致圆锥形的通道部分105(以虚线示出)。大致圆锥形的通道部分105随着该通道部分105向远侧延伸而从相对较大内径渐缩成相对较小内径。示出的轨道支撑结构120从部分102和104延伸,从而相对于部分102和104的纵向轴线以一倾斜角度支撑轨道斜面130。轨道斜面130能够支撑轨道300的近侧部分。
图1A和1B示出了插入手柄100的内窥镜1000的等轴测图。铰接闩140可以被定位在轨道300的近端处或附近。所述闩140可以例如通过活动铰链或机械销型的铰链铰接到所述轨道斜面130或结构120上。示出的所述闩在图1A中处于打开位置,在图1B中处于闭合位置。当处于闭合位置时,该闩在轨道的近端处或附近在轨道300上方延伸,并且可以辅助防止以滑动方式支撑在轨道300上的组成元件在使用过程中从轨道300上“拉开”或否则从轨道300上移开。在图1B中,示出了用手使承载器500和供给管600(将在下面对二者进行更详细的描述)沿轨道300沿向远侧方向前进。
可以采用可弹性伸展构件在内窥镜上形成远侧偏压力并且在手柄100上形成近侧偏压力。例如,手柄100可包括弹性带150(如图18和19所示)。该弹性带可从手柄100的一部分(例如轨道斜面130或者结构120)延伸,以形成围绕内窥镜1000的一部分(例如内窥镜辅助通道端口)的环圈。所述弹性带150对于调节内窥镜长度的变化、辅助保持护套的张紧度和辅助保持内窥镜在手柄中的接合很有用。可以采用该弹性带来补偿由于镜的弯曲而产生的长度变化,并且提供将内窥镜向远侧推入手柄和护套的弹性偏压力。作为选择,可以使用相对无弹性的带来代替弹性带,并且在手柄或者护套中可采用偏压构件来防止护套和轨道在内窥镜上打褶或者“起皱”。例如,所述带可以为一般不伸长的,并且手柄由可弹性伸长材料形成,或者手柄的几何形状(例如长度)为在所述带被接合到相对较长的内窥镜上时可伸长。
端帽400可由热塑性塑料弹性体形成,用于装配在内窥镜1000的远端上。端帽400可由这样的材料形成,该材料的计示硬度小于大约100,并且更特别的在大约50和大约90之间(根据ASTM D2240使用A标尺、0.120英寸进行测试)。该端帽可以被压(例如,略微膨胀以装配)到内窥镜的远端上,并且该内窥镜的远端由所述端帽400夹持。一种可用于形成端帽400的合适的材料为模制的Santoprene牌热塑性弹性体。可能需要由例如热塑性弹性体的材料形成的端帽400,因为这种端帽400能被压到内窥镜的远端上,如下面更详细说明的。
参考图1、2和2A,端帽400包括大致圆柱形的主体部分410、远侧表面412、近侧表面414以及在其中穿过的中央穿孔开口420,该中央穿孔开口用于容纳内窥镜1000的远端。端帽400可具有内部的周向延伸的沟槽422,该沟槽沿所述中央穿孔开口420的内表面的长度间隔开。可在主体部分410的上半部分形成轨道凹槽424(图2A)。该凹槽424从近侧表面414向远侧延伸,并且其尺寸和形状被设定成容纳轨道300的远端。如果需要,穿孔开口420的近侧边缘可以为斜削的或斜切的,以辅助将该端帽压到内窥镜的远端。
所述端帽400还包括狭槽430(图2和2A),该狭槽延伸穿过至少一部分主体部分410并且在远侧表面412上开口。狭槽430可从限制轨道凹槽424边界的表面向远侧延伸,以相对于轨道300设置成与轨道300大致相同的“点钟”位置。如下所述,狭槽430的尺寸和形状被设定成容纳凸条或其它指示装置。在一个实施方案中,狭槽430的近端大致与轨道300的通道320对准(下面进行说明),并且狭槽430的远端随着狭槽430从凹槽424沿着远侧方向延伸而沿径向向内倾斜,这样延伸穿过狭槽430的凸条或其它指示装置向远侧并沿径向向内指向,以便可以通过内窥镜1000的光学系统观察。端帽400可由任何合适的方法(例如超声焊接)连结到护套200的远端。
轨道300可由护套200支撑,并从手柄100延伸到端帽400。图3示出了支撑在护套200上的轨道300,其中部分轨道以虚线示出。图4示出了轨道300的俯视平面图,而图5示出了由护套200支撑的轨道300的横截面图。在图5中,示出了护套200就好像将其设置在内窥镜上时的横截面,以用于显示目的,可以理解的是,在一个实施方案中,护套200的壁可以是大致松弛的和可起皱的,并且在没有内窥镜的支撑或其它内部支撑的情况下缺少足够的刚度保持图5所示的形状。
轨道300为大致连续的材料一体件,其沿纵向延伸足够的长度,以从患者体外的一点到达患者胃部中或远侧的一点,例如通过幽门进入肠中。轨道300可以由挠性聚合物材料、例如挤压聚丙烯形成。可以形成轨道300的一种合适的材料为可从Houston TX,HuntsmanCorp.获得的Huntsman 23R2Acs321。护套200可以通过任何合适的连接方法(例如通过超声焊接)连接到轨道300上。轨道300的远端嵌件注塑到端帽400上,或者在凹槽424中连接到端帽400。手柄100可通过任何合适的连接方法(例如通过超声焊接)连接到护套200的近端和轨道300的远端。
轨道300可包括大致C形的通道主体310,在横截面中该通道主体310限定了倒T形通道320。该主体310包括底面312、竖直的侧壁314和向内延伸的尖端(prong)316。主体310还包括多个周向延伸的侧凸条330,其从主体310向外延伸。在轨道300每一侧上的相邻凸条330例如通过扇形缺口(如图3中虚线所示)或通过其它间隔方法(例如开槽口)间隔开,以保持轨道300的挠性。示出的凸条330被连接到护套200的内表面210。凸条330可以通过任何合适的方式(例如使用粘合剂或其它粘合方法)连接到该内表面210。
不受理论的限制,当内窥镜置于护套200中时,可以采用凸条330使轨道300相对于内窥镜稳定。该凸条帮助保持该轨道通道320的对称轴线相对于内窥镜1000的径向对准。因此,护套200和轨道300可以作为一个整体围绕内窥镜1000沿周向旋转到不同点钟位置,并且凸条330帮助将轨道300(和通道320)相对于内窥镜保持在正确的径向方位。通道320的期望的径向方位在图5中示出,其中通道320的横截面中心线和对称轴线与从内窥镜的中央延伸的径向线大致对准。
根据本发明的一个实施方案,轨道300具有至少一个其挠性大于该轨道的另一部分的挠性的部分。例如,该轨道300包括一其弯曲挠性和轴向挠性比轨道的另一部分的弯曲挠性和轴向挠性大的部分。参考图3,示意性地示出了轨道300具有三个不同挠性的部分。作为轨道300的最远侧部分的部分A在弯曲和轴向延伸方面是轨道的最具挠性的部分。部分A可以与内窥镜的最远侧部分、例如内窥镜的关节运动部分相关联。部分B与部分A相比具有相对小的挠性(更硬)。部分C是轨道300的近侧部分,并且与部分B相比具有相对小的挠性。在一个实施方案中,部分A可以延长大约10英寸,部分B可以延长大约26英寸。在一个实施方案中,轨道300的长度可以为至少大约50英寸。
在图中所示的实施方案中,部分A和B沿着它们各自的长度以一定间隔截断,以减小该部分的弯曲刚度和轴向刚度,而部分C基本上不被截断。在部分A和B中的截断由一连串的狭缝340形成。如图3和4所示,在轨道主体310两侧上的狭缝340相对彼此错开(沿纵向偏移),在轨道主体310一侧上的狭缝不与在轨道主体310另一侧上的狭缝对准。在示出的实施方案中,在轨道一侧上的每个狭缝340定位在该轨道的相对侧上的两个相邻狭缝之间的中间。凸条330的每一个被定位在一对相邻狭缝340之间。在一个实施方案中,该狭缝340的宽度(平行于通道320的长度测量)小于大约0.010英寸,更特别的小于大约0.005英寸。该狭缝340可由任何合适的刀或其它切割器械来形成。不受理论限制,该狭缝340的宽度和错开可以提供轨道300的充足挠性,同时防止以可滑动方式设置在轨道上的构件例如由于在内窥镜弯曲(或轨道弯曲的其它位姿,或者呈现弯曲的位姿)的位置处尖端316的偏斜而从承载器上“拉开”或从轨道上“弹跳出”。在轨道中可选择放置的截断设置允许轨道跟随内窥镜的曲率,而不会显著增加护套200和内窥镜组件的弯曲刚度。
在一个实施方案中,狭缝340延伸通过轨道的整个厚度(沿图5中竖直方向测量的厚度)。另外,狭缝可从轨道的一侧延伸,以跨过其中一个尖端316的整个宽度延伸,并且狭缝可至少跨过底面312的一半延伸。
在图3和4所示的一个实施方案中,每个狭缝340可延伸通过轨道的整个厚度。另外,取决于狭缝340沿着轨道长度的位置,狭缝340可延伸超过一半,但不完全跨过轨道的宽度。例如,狭缝340在图3的部分A中可延伸跨过轨道纵向中心线。参考图5,尺寸W示出了狭缝延伸超过一半的宽度,但不完全跨过轨道的宽度。在轨道300的同侧上的狭缝340之间的间隔342(图3)在部分A中为大约0.120英寸至大约0.130英寸,并且在部分B中大约为0.250英寸。
延伸到轨道中心线之外的狭缝340的错开布置能够提供如下优点,即,轨道300不具有用于承载拉伸载荷或弯曲载荷的纵向连续载荷通路。不受理论限制,狭缝340的错开布置可被看作在轨道300中形成弯曲部分(在图4中由附图标记344标示)。弯曲部分344具有长度346(图4),该长度346由在轨道相对侧上的狭缝340的叠置的量限定,并且弯曲部分344具有宽度348,该宽度348由一个狭缝与从轨道的相对侧延伸的最临近的狭缝的纵向间隔限定。在一个实施方案中,在部分A中的长度346为大约0.038英寸至大约0.040英寸,并且宽度348为大约0.0625英寸。
图6示出了承载器500,图7示出了被推进到轨道300的最远侧位置的承载器500。承载器500可从近端502延伸到远端504。承载器500的长度为足够从患者体外的一点到达患者胃部内或远侧的点的长度。在一个实施方案中,承载器500的长度可为至少大约100cm,并且更特别的是至少大约72英寸。承载器500包括主体520、大致垂直延伸的腹板530以及轨道接合导轨534。承载器500可滑动地接合轨道300,并且导轨534的尺寸和形状被设定成适合在轨道300的通道320内滑动。承载器500为整体结构,可被模制成或由合适的材料形成。在一个实施方案中,承载器500由相对低摩擦的材料形成,例如挤压的PTFE(特氟隆)。
图8提供了支撑在轨道300上的承载器500的横截面图,其中示出的内窥镜1000的远端推进通过该横截面,以示出在内窥镜远端上的组成元件相对于轨道300的位置的一个位置。如图8所示,腹板530从主体520大致沿径向向内延伸到承载器主体520的沿径向的内侧的导轨534。腹板530和导轨534二者一起的横截面形成大致的倒T形结构。
承载器主体520包括通道522。该通道522基本上延伸过主体520的整个长度。该通道522可由通道底面512和相对的侧壁514限定边界。主体520还包括向内延伸的尖端516,所述尖端516具有相对的侧面518,所述相对的侧面518被间隔开以限定通道522的开口的喉部。
轨道接合导轨534的最远侧部分可向远侧延伸到主体520之外,以提供一挠性的指示器凸条536。凸条536的尺寸和形状被设定成由在端帽400中的狭槽430接收。当承载器500在轨道300上向远侧推进时,一旦承载器500已经到达其在轨道300上的最远侧位置,凸条536可由内窥镜1000的光学系统观察到。参考图7和8,当凸条536从狭槽430的远端向远侧沿径向向内前进时,可通过内窥镜光学元件1100观察凸条536。
在一个实施方案中,承载器500具有至少一个其挠性比该承载器的其它部分的挠性大的部分。例如,该承载器500可包括主体520,该主体520具有其弯曲挠性和轴向挠性大于该承载器的更近侧主体部分520B的弯曲挠性和轴向挠性的远侧部分520A。参考图6,图中示意性地示出该承载器具有两个不同挠性的部分。承载器部分520A可为该承载器的最远侧部分,并且在弯曲和轴向延伸方面为该承载器最具挠性的部分。部分520A具有至少大约2英寸的长度。在一个实施方案中,部分520A的长度在大约4英寸和大约10英寸之间,更特别的,该部分520A的长度在大约6英寸和大约8英寸之间。
在图中所示的实施方案中,示出了主体部分520A沿着其长度以一定间隔截断,以减小主体520的远侧部分的弯曲刚度和轴向刚度。所述截断由一连串的狭缝540形成。如图6和7所示,在承载器主体520两侧上的狭缝540相对彼此错开(沿纵向偏移),在主体520一侧上的狭缝不与在主体520另一侧上的狭缝对准。在示出的实施方案中,在承载器主体一侧上的每个狭缝540定位在该承载器主体的相对侧上的两个相邻狭缝之间的中间。相邻尖端516由狭缝540隔开。
不受理论限制,该挠性凸条536和狭缝540可帮助防止承载器500的远侧部分从轨道上“拉开”或“弹跳出”。例如,挠性凸条536可“桥接”在轨道300中的狭缝340之间的空间上,以帮助防止承载器与轨道300沿径向离开。不受理论限制,狭缝540的宽度和错开也可提供承载器500的充足挠性,同时防止以可滑动方式设置在承载器中的构件从该承载器“拉开”或从该承载器“弹跳出”。
在一个实施方案中,狭缝540延伸通过承载器主体的整个厚度(沿图8中竖直方向测量的厚度)。另外,狭缝可从承载器主体的一侧延伸,以跨过其中一个尖端516的整个宽度延伸,并且狭缝可连续通过至少底面512的一部分。每个狭缝540可延伸通过承载器主体520的整个厚度,并且每个狭缝540可延伸超过一半,但不完全跨过承载器主体的宽度。在承载器主体的同侧上的狭缝540之间的间隔542(图6)在承载器主体部分520A中为大约0.1英寸至大约0.6英寸之间。狭缝540的错开布置能够提供如下优点,即,承载器主体部分520A不具有用于承载拉伸载荷或弯曲载荷的纵向连续载荷通路。
图9-13示出了可与轨道300和承载器500一起使用的供给管600。该供给管600具有近端602和远端604。该供给管600包括:供给管主体610,该供给管主体610具有用于通过营养物的营养物管道620;以及零件660,其适于提供供给管600与另一构件的可松开的接合。例如,零件660可包括用于提供该供给管与轨道或承载器500的滑动接合的导轨。
管道620可从近端602延伸到出口622,营养物通过该出口622离开管道620进入患者的GI道。如图10和13所示,供给管600的延伸到出口622远侧的部分相对于管道620的纵向轴线倾斜,并且出口622具有大致渐缩(tapered)的细长构造。因此,如图10和13所示,管道620相对于供给管600的纵向轴线大致平行,并且除了管主体610自身弯曲延伸之外,该管道620不弯曲或转弯,以与出口622连通。使管道620基本上直的延伸到出口622并且供给管的远侧末端部分相对于管道620倾斜可以提供如下优点,即,例如通过使导丝从供给管的近侧入口通过管道620并从出口622穿出可以容易地清洁管道620。
参考图12,供给管600可包括定位于出口622近侧或远侧的一个或多个抽吸端口。抽吸端口可以用于在放置管600后将管600的远端保持在体内的期望位置,并且防止供给管600在供给过程中移动。在图10中,所示出的抽吸端口680位于出口622的远侧。抽吸端口680包括多个沿径向向内延伸的凸条682,该凸条682在组织通过施加到抽吸端口680的真空被拉到管600中时能够接合和保持组织。该凸条682可通过切割或割开管主体610的外壁而形成,或者该凸条682可被形成在分开的构件中,例如被形成为包括凸条682的金属或非金属的插入件,其被置于管主体610的壁上的开孔中。真空可以通过与营养物管道620连通或与之独立延伸的真空管道(未示出)传递给抽吸端口680。配重690设置在管600的远端以辅助移动和定位供给管600。
零件600可沿着供给管600的长度的至少一部分延伸。在图10中,示出的零件660沿着供给管600长度的一部分而不是全长延伸。零件660可从零件660的近端662延伸到远端664。零件660的近端662与供给管600的近端以距离L隔开,这样该供给管600的在其保持就位时延伸通过患者的喉和/或鼻的部分不会刺激患者或者干扰供给。所述的距离L在大约6英寸和大约24英寸之间,在一个实施方案中为大约18英寸。
该零件660可与管主体610(例如通过模制或者挤压)一体地形成。或者,该零件660可与管主体610分开地制造,然后例如通过使用任何合适的粘接或连接方法连接到主体610。零件660的形状和尺寸可以被设定成允许供给管600与另一构件(例如轨道300或承载器500)可松开地接合,例如通过滑动接合。在图9中,示出的供给管600可滑动地支撑在承载器500上。零件660包括导轨666和腹板668,并且腹板668从管主体610大致沿径向延伸,从而与管主体610以隔开关系支撑导轨666。在图9中,导轨666置于通道522中,并且腹板668延伸通过通道522的喉部。不受理论的限制,认为在轨道300上可滑动地支撑承载器500的同时在承载器500上可滑动地支撑供给管600有利于在患者体内提供供给管600的平滑的相对低摩擦的定位。或者,供给管600例如通过使导轨666与轨道300直接接合而可滑动地直接支撑在轨道300上。例如,如果需要,轨道300可以涂覆特氟隆或者其它合适的低摩擦涂层。
图11示出了零件660的近端662。锥形表面662可以被设置在近端662,以防止组织在腹板668和导轨666相对于承载器500的通道522滑动时被捕获或夹住。导轨666的近端可例如通过逐渐变细的方式形成,以在腹板668的两侧上提供设置在导轨666的近端处的接触表面674。接触表面674可相对于供给管600的纵向轴线成角度(在图11中,表面674倾斜,以随着其向远侧延伸而向外延伸)。接触表面672提供了这样的表面,在该表面上可以施加对零件660的作用力,以沿着承载器500向远侧推动供给管600。可以相对于供给管600的纵向轴线如此选择接触表面672的定向,即,被施加用来在承载器500上向远侧推动管600的作用力不会趋向于将零件660推到承载器500中的通道522之外。
如果需要,承载器500和供给管600与零件660可以被包装在一起。例如,承载器500和供给管600可以被包装在一起,并且例如通过使管与承载器500滑动接合而将供给管600预组装在承载器500上。承载器500与沿着其长度受到支撑的管600可以在使用的时刻拆包,承载器500和管600的组件可以沿着轨道300推进。
图14是供给管定位构件700的远侧部分的侧视图。该构件700可用于沿着承载器500向远侧推动供给管和/或在将内窥镜从患者处缩回时将供给管600在GI道中保持在期望的位置。图15是该构件700的远端的放大图。图16示出了被定位成将供给管600保持在期望位置的构件700,而图17为构件700的远端和在供给管600上的零件660的近端662接合的放大仰视图。在一个实施方案中,构件700的长度为至少大约36英寸,这样当供给管定位在患者的GI道中的期望位置时构件700能够从患者体外的一点延伸以接合在供给管600上的接触表面672。
参考图14和15,构件700可具有类似于承载器500的结构。或者,构件700可具有不同的横截面形状。构件700可包括主体部分710,其可包括狭缝740以提供挠性。构件700包括与主体710成隔开关系的导轨766,并且腹板768从主体710延伸,从而与主体710以隔开关系支撑导轨766。导轨766的尺寸和形状被设定成用于在承载器500的通道520内滑动地运动。
如图15所示,构件700的远端702具有位于主体部分710上的斜面772。导轨766的远端被形成为具有V形凹口,该V形凹口带有两个被设置成与供给管600上的表面674接合的表面774。表面774定位于表面772的远侧,并且其尺寸和形状被设定成接触在供给管600上的表面674,这样构件700的导轨766可以被用来在供给管的导轨666上施加作用力,该作用力大致平行于导轨766和导轨666。这种表面可形成期望的纵向定向的作用力,而没有径向分力或其它可能以不期望的方式将供给管600推出承载器500的分力。
与护套200和轨道300一起的内窥镜可以被如此定位在患者体内,即,内窥镜的远端被定位在GI道中的期望的位置,用于供给管布置。可通过在患者体外将供给管滑动到承载器500上而将供给管600定位在承载器500上(或者可以预包装组件提供供给管600和承载器500),并且承载器500和供给管600然后可沿着轨道300一起推进到在GI道中的期望位置,例如将供给管的远侧部分定位在胃中或小肠中。承载器500上的凸条536在该凸条536延伸穿过端帽400时可通过内窥镜的光学系统进行观察,由此提供承载器和供给管已经到达期望位置的视觉指示。或者,承载器500可推进成沿着轨道300,然后供给管600沿着承载器500推进到期望位置。
一旦供给管600的远端已经被推进到体内的期望位置,内窥镜、护套200、轨道300和承载器500可从GI道移出,从而将供给管留下保持就位。为了防止在其它组成元件从体内移出时供给管“退回”或沿着向近侧方向运动,供给管定位构件700被用来在其它组成元件移出的过程中保持供给管的位置。在供给管600定位后(并且在内窥镜、护套200、轨道300和承载器500移出之前),构件700可被插入到承载器500中(并且导轨766定位在承载器500的通道520中,从而使构件700滑动接合承载器500),并且构件700可以沿着承载器500向远侧推进,直到构件700的远端邻近在供给管600上的导轨666的近端662。当内窥镜、护套200、轨道300和承载器500沿向近侧方向从患者体内缩回时,构件700可以(例如通过医生的手、医生助手或者固定装置)被保持就位,以相对于内窥镜、护套、轨道和承载器使构件700保持静止,并且在各表面774和各表面674的接触面处在供给管导轨666上施加作用力,由此在内窥镜和其它组成元件缩回的过程中“阻止”供给管600向近侧退回。
图18-24示出了根据本发明一个实施方案的用于定位供给管的方法中采用的步骤。内窥镜可被插入到护套200中,并且端帽400定位在护套200的远端,手柄100定位在护套200的近端,轨道300沿着护套200从端帽400延伸到手柄100。在以下使用的术语“护套组件”指的是护套200、手柄100、端帽400和轨道300的组件。在患者体外将内窥镜插入护套组件之后,该护套组件和内窥镜可插入自然存在的人体开口(例如嘴)中,并且该护套组件和内窥镜一起推进,从而使内窥镜的远端和端帽400定位在期望的位置,例如小肠处。图18示出了被定位在患者的GI道中的护套组件,其中轨道300从体外的一个位置延伸到小肠中的某一位置。
可以例如通过在承载器500的通道520中滑动供给管导轨666而在患者体外将供给管600定位在承载器500上,直到该供给管600沿着承载器500的长度定位,并且该供给管的远端定位在承载器500的远端处或附近。参考图19,承载器500和供给管600可然后沿着轨道300(例如用手沿着箭头2的方向)一起推进,并且承载器和供给管从患者体外的一个位置推进到供给管的远端被定位在期望部位(在图19中为小肠)的位置处。在一个实施方案中,供给管600的长度为至少大约140cm长,并且供给管的远端定位在离患者门齿大约130cm至140cm之间。通过以非限定的例子方式给出,例如通过粘结或其它方式将腹板和导轨连接到140cm长10Fr Dobb-Hoff型供给管(可从Viasys Healthcare,Inc.获得)而使该管被改进成具有导轨666的特征。儿科结肠镜(例如Olympus PCF 100型儿科结肠镜)可与所述护套组件一起使用。
参考图20,一旦供给管600处于期望位置,构件700可沿着轨道300(例如通过手沿着箭头4的方向)向远侧推进,直到构件700的远端与供给管600的导轨666的近端形成接触。然后,在使构件700相对于患者身体和该护套组件保持静止时,将护套组件(和内窥镜一起)与承载器500沿着由箭头6标示的方向从身体向近侧缩回。供给管600在内窥镜、护套组件和承载器500的缩回过程中向近侧运动的任何趋势通过在构件700上的各表面774与在供给管导轨666上的各表面674的抵接接合来防止。因此,在内窥镜、护套组件和承载器500从身体缩回时由构件700使供给管600保持就位。
图21示出了在移除了内窥镜、护套组件和承载器500之后在患者GI道中就位的供给管。在图21中,供给管600从供给管近端602(定位在患者体外)延伸到供给管远端604(定位在小肠中),并且供给管600通过嘴、食管、胃延伸入小肠。
如果需要,供给管可用于图21所示的位置中。但是,通常需要使供给管的近端从鼻子延伸。图22示出了可被插入而从嘴和鼻子延伸的转换管12的使用。如图23所示,转换管从嘴延伸的端部可被连接到供给管的近端602。转换管12从鼻子延伸的端部可然后被拉动,如图24所示,这样供给管的近端602被重定向而从鼻子延伸。如图24所示,适合的接头14可随后被安装到供给管的近端602上。
图25-30示出了在患者体内定位供给管的可选择的方法,用于通过在患者腹壁中的切口提供供应接触。图25-30示出了作为标准PEG手术的可选方式的在胃中放置供给管的方法。首先参考图25,设置在包括手柄100、护套200和端帽400的护套组件内的内窥镜可通过嘴推进,以将内窥镜的远端和端帽400定位在患者的胃中。可采用光源(例如与内窥镜的远端相关联的光源)从胃内透照腹壁,从而可从患者体外观察内窥镜在胃中的位置。可通过腹壁形成小的经皮切口,针22/插管24(例如14号针22/插管24)可通过所述切口插入,这样针的远侧尖端和插管的远端可被定位在胃中。
参考图26,可将针22缩回,从而留下插管24以提供从胃内延伸到患者体外一点处的接触通道。结圈的导丝32可穿过所述插管,并且内窥镜和护套组件可被定向成延伸通过由导丝32形成的环圈。
参考图27,其中示出了相对短的供给管800,该供给管的长度基本上小于轨道300的长度。在本实施方案中的供给管800具有小于大约3英寸的长度。供给管800可以为可从商业渠道获得的PEG型供给管,其被改进为具有诸如导轨(未示出)的零部件,以用于允许该供给管800可滑动地接合轨道300和/或承载器500。例如,供给管800可以通过将腹板和导轨连接到可从商业渠道获得的PEG供给管来形成,诸如通过粘接或其它方式将腹板和导轨连接到供给管(或者,供给管800可通过挤压或使供给管形成为具有内部腹板和导轨来形成)。可以构造供给管800的一种可从商业渠道获得的PEG型供给管可从IL,Viasys Healthcare of Wheeling获得,市售为与推动技术或拉动技术一起使用的Corflo-Max牌PEG套件。供给管800可包括密封缓冲件或垫810和锥形的膨胀末端820。
参考图27,在护套组件延伸通过由导丝32形成的环圈的情况下,供给管800可沿着护套组件向远侧推进并进入胃部。供给管800可被定位在轨道300上,并且通过使用构件700作为推动元件而沿着轨道300向远侧推进到胃中。或者,供给管可被设置在承载器500上,并且该承载器500和供给管800一起沿着轨道300推进到胃部。
参考图28,可使用诸如如上所述的构件700的构件来使供给管800离开护套组件的远端。在供给管800被推离护套组件时,从末端820延伸的缝合线830(或其它合适的挠性丝或系绳)可由导丝32抓住,从而该缝合线830能够被拉动穿过插管24。
参考图29,(例如使用镊子或止血钳)拉动缝合线830,使末端820延伸通过经皮切口经过腹壁并且密封缓冲件810抵靠胃壁的内侧表面(胃的内侧表面)定位。
参考图30,护套组件可从患者身上移除,并且外部密封件840可在供给管800上推进,以在所述切口附近抵靠患者皮肤安装。可以切割供给管800,以将末端820从供给管上切断,并且将接头850定位在供给管的在患者体外的端部处。在图25-30示出的过程中,供给管通过自然存在的口被引入患者体内,并在内窥镜已经被放置在胃中后沿着内窥镜向远侧推动。供给管随后被拉动穿过切口,以提供通过切口延伸到患者的GI道的供给接触通道。
图31-37示出了根据本发明另一个实施方案的用于定位供给管的方法中采用的步骤。图31-37示出了作为标准JET-PEG型手术的可选方式的在小肠中放置供给管的方法。
首先参考图31,设置在包括手柄100、护套200和端帽400的护套组件内的内窥镜1000可通过嘴推进,以将内窥镜的远端和端帽400定位在患者的胃中。可采用光源(例如与内窥镜的远端相关联的光源)从胃内透照腹壁,从而可从患者体外观察内窥镜在胃中的位置。可通过腹壁形成小的经皮切口,针22/插管24(例如14号针22/插管24)可通过所述切口插入,这样针的远侧尖端和插管的远端可被定位在胃中。
参考图32,可将针22缩回,从而留下插管24以提供从胃内延伸到患者体外一点处的接触通道。结圈的导丝32可穿过所述插管,并且内窥镜和护套组件可被定向成延伸通过由导丝32形成的环圈。如图32所示,内窥镜和护套组件可从胃向远侧推进到小肠。
参考图33,供给管900可沿着护套组件的长度推进,使该供给管900延伸通过由导丝32形成的环圈。在图33中示出的供给管900包括远侧部分904和近侧部分906,所述远侧部分904具有与上述供给管600类似的结构,所述近侧部分906具有与上述供给管800类似的结构。近侧部分906包括锥形的膨胀末端920和缓冲件或垫910。近侧部分906可以使用用于拉动技术或推动技术的Corflo-Max牌PEG套件中提供的PEG供给管类型来构造,所述套件可从IL,ViasysHealthcare of Wheeling获得。
通过其将食物输送到GI道的开口位于远侧部分904中。供给管900包括诸如在部分904和906的一个或两个上的导轨(如图10、11和13所示的类型)的零部件,使供给管能够可滑动的接合轨道300和/或承载器500。在一个实施方案中,供给管900在患者体外被设置在承载器500上,并且该供给管900和承载器一起沿着轨道300推进到胃部。定位构件700可在供给管900之后沿着承载器500推进。如果需要,定位构件700可包括夹持夹具715,其能够夹持或被紧固到构件700上,以辅助沿着承载器500夹持并推动构件700。
参考图34,在定位构件700保持就位的条件下,内窥镜和护套组件可从胃部向近侧缩回,使在内窥镜和护套组件缩回时由定位构件700将供给管900推离护套组件的端部。从末端920延伸的缝合线930可由结圈的导丝32抓住。
参考图35,缝合线930和末端920可被拉动穿过切口,直到缓冲件910抵靠胃的内侧表面定位,并且供给管的部分904包括位于小肠(诸如空肠)中的端口,通过该端口提供食物。参考图36,外部密封件940可在供给管900上推进,以在所述切口附近抵靠患者皮肤安装。可以切割供给管900,以将末端920与任何不需要的管长一起从供给管上切断,并且将接头950定位在供给管的在患者体外的端部处。在图37中,示出的内窥镜和护套组件从患者体内移除,示出的供给管900被定位成所述远侧部分904放置在小肠中,并且供给管900从小肠通过胃延伸,以穿过切口、胃、患者的腹壁和皮肤。
在图31-37示出的过程中,供给管通过自然存在的口被引入患者体内,并在内窥镜已经被放置在胃中后沿着内窥镜向远侧推动。供给管随后被拉动穿过切口,以提供通过经皮切口延伸到患者的GI道(例如小肠)的供给接触通道。
在一些实施方案中,可能期望包括例如围绕轨道300、承载器500和/或供给管的盖或管道,以减少供给管在其推进到期望位置时被污染的危险,例如由口中的物质(诸如口菌丛)污染。所述盖或管道可由薄的挠性材料(诸如赛珞玢材料或形成护套200的材料)形成,并且可至少部分地沿着轨道、承载器和/或供给管的长度延伸。例如,承载器、供给管和挠性盖的组件可提供为预包装的组件。承载器、供给管和挠性盖然后可沿着轨道推进。如果需要,挠性盖可如此设置在承载器上,即,该盖和承载器缩回,而留下供给管保持就位。在另一个实施方案中,护套200可被形成为包括沿着轨道在其上延伸的管道,这样承载器和供给管可通过该管道推进。或者,轨道可被设置在护套的内侧表面上、或内窥镜的表面上,从而供给管在该护套内推进。上述作为参考的序列号为US 10/440,957(公开号为US 2004/0230095)的申请公开了护套和沿着护套的内侧表面推进的辅助装置,例如在US 2004/0230095的图6的实施方案中。可以采用这种布置,并且供给管在护套内推进。
图38-42示出了在将内窥镜插到护套组件上进入患者体内之前将端帽400(例如弹性体端帽400)和护套200定位在内窥镜1000上的方法。在一些应用中,很难例如通过手抓取组成元件而手动地将内窥镜装载到具有端帽的护套中。例如,很难通过护套抓住内窥镜并且施加适当的作用力推动该端帽装配在内窥镜的远端上。或者,可能期望保持端帽相对于内窥镜的某一角度“点钟”方位。在施加作用力将端帽推压到内窥镜上的过程中,可能会无意中失掉期望的点钟方位,从而需要重安装。在图38-42中示出的方法和组成元件可用于辅助将端帽(以及相关联的护套和轨道)正确地安装到内窥镜上。另外,可以采用该方法和组成元件在甚至没有使用护套或轨道的情况下将端帽安装到内窥镜上。
参考图38,示出的端帽装载元件为鼻锥体2100的形式。该鼻锥体2100是一次性的,可由轻质材料(例如聚合物材料)形成。鼻锥体2100可包括主体部分2110和多个挠性叉头(prong)2120(图38中示出了六个叉头)。主体部分2110的远端2102为圆形的或锥形的。主体部分2110包括通孔2112,其沿着与主体部分2110的纵向轴线横交的方向延伸穿过主体部分2110的宽度。主体部分2110和叉头2120的尺寸和形状被设定成穿过端帽400的中央穿孔开口。
主体部分2110包括多个径向键条2114,其沿着主体部分2110的长度延伸。每个键条2114与圆角的或倾斜的叉头肩2118相连。每个叉头肩2118与挠性叉头2120相连。每个挠性叉头2120从叉头肩2118向近侧延伸到近侧叉头端部2122。每个圆角的叉头肩2118从在主体部分2110上的相连的键条2114沿径向向外延伸至与该叉头肩相连的挠性叉头2120。
键条2114的沿径向向外的表面限定了鼻锥体2100的第一直径,而叉头2120的沿径向向外的表面限定了该鼻锥体的第二直径,并且该第二直径大于第一直径。每个圆角的叉头肩2118的沿径向向外的表面可被成形为提供从每个键条到其相连的叉头的平滑径向过渡。因此,各圆角的叉头肩2118一起形成了从第一直径到第二直径的平滑径向过渡。各挠性叉头2120的沿径向向内面向的表面被(或者通过以该方式形成,或者由于施加的作用力)间隔开,以容纳内窥镜1000的远端。
键条2114、圆角的叉头肩2118和叉头2120以大致等角度的间距沿周向隔开(例如,对于六个键条、六个叉头肩和六个叉头,每个相关的键条、叉头肩和叉头可围绕主体部分2110的圆周以60度的间隔隔开)。
如图38A和图40A所示,每个叉头2120具有形成在向外面向的表面中的狭槽2124。在各叉头2120中的狭槽2124一起提供了沿周向断裂的沟槽,可扩张的环(诸如硅树脂O形环或特氟隆O形环2160)可置于该沟槽中。在图38A中示出的叉头2120的径向厚度2123可通过考虑各种因素来设定尺寸,诸如端帽的内径和材料、内窥镜1000的远端的外径、在鼻锥体2100上的叉头2120的数量,这样当叉头2120被设置在内窥镜的远端的外表面和端帽的内表面之间时,端帽沿径向的内表面与内窥镜的外表面隔开。当使用六个叉头2120时的一个合适的厚度2123为大约0.032英寸。
在将O形环2160放置在狭槽2124中之前,内窥镜1000的远端可插入各叉头2120之间。该O形环2160然后可在鼻锥体2100的主体2110上滑动并到达圆角的叉头肩2118。O形环可在各肩2118上伸展并被置于在叉头2120中的狭槽2124内。该O形环可由此在叉头2120上形成沿径向向内的压缩力,从而将各叉头2120的沿径向向内面向的表面推压成与内窥镜1000的远端的外表面接合。
在鼻锥体2100定位在内窥镜1000的远端上的条件下,内窥镜1000被装载到护套组件(包括手柄100、护套200、轨道300和端帽400)上。内窥镜被如此装载到护套组件上,即,如图39所示,鼻锥体2100的主体部分2110从端帽400向远侧延伸,端帽400的近侧面抵靠叉头肩。在图39中以虚线示出了O形环2160和两个近侧叉头端部2122,如该O形环和叉头端部在护套内侧的那样(但在护套200由基本上透明的薄膜材料制成时可见)。
现在参考图40和图40A,示出的手柄2200具有一对向外延伸的臂2204,该臂2204从中央毂2208延伸出。毂2208包括一刻槽的穿孔2210。穿孔2210具有沟槽,该沟槽的尺寸和形状被设定成允许手柄2200沿在鼻锥体2100上的主体部分2110的键条2114沿纵向滑动。键条2114与刻槽的孔2210的接合可防止手柄2200相对于鼻锥体2100和端帽400的转动。尽管在一个没有采用键条和沟槽的可选实施方案中允许手柄2200相对于鼻锥体2100转动,但防止手柄2200相对于鼻锥体2100的旋转是有利的。例如,可能期望以如下方式将端帽400和轨道300装载到内窥镜上,即,使轨道300相对于诸如内窥镜远端中的光学系统和/或工作通道的零部件保持期望的点钟方位。使手柄2200保持相对于鼻锥体2100在旋转方面固定可辅助避免轨道300相对于内窥镜1000的远端角度不对准。
图40A示出了从手柄2200的近侧延伸到孔2210中的鼻锥体2100。手柄2200的近侧包括一个或多个表面,用于提供对端帽400的远侧表面412的压力。在图40A中,示出的手柄2200具有多个大致楔形的延伸部分2700,其从手柄2200的近侧延伸。在图40A中,设置有六个延伸部分2700,每个用于通孔2210中的一个沟槽。延伸部分2700可被基本上等于通孔2210中的沟槽宽度的距离隔开。延伸部分2700的每个均具有面向近侧的表面2710。在手柄2200沿着鼻锥体2100向近侧推进时,各表面2710一起接合端帽400的远侧表面412。提供单独的隔开的表面2710在下述方面是有益的,即,在手柄2200提供向端帽400的推力而叉头在内窥镜的远端提供拉力时,防止端帽400的材料夹在鼻锥体2100和手柄2200之间。
参考图41,示出的拉环2300例如通过销2308连接到鼻锥体2100的远端,该销2308延伸穿过拉环环圈2304并进入鼻锥体2100中的通孔2112。拉环2300安装在鼻锥体2100的远端以及手柄2200借助键条和沟槽布置而可滑动地支撑在鼻锥体2100上,通过这种组合允许使用者借助鼻锥体2100通过端帽400在内窥镜1000上提供向远侧的拉(拉伸)力,同时借助手柄2200的各表面2710在端帽400的远侧表面上施加向近侧的推(压缩)力。
参考图42,通过箭头2250和2350示意性地示出了这种力的应用。通过沿由箭头2350标示的方向拉动拉环2300,同时沿箭头2250标示的方向推动手柄2200,端帽400被推到内窥镜1000的远端,并且迫使O形环离开叉头2120,从而使叉头2120与内窥镜1000的远端脱离接合,并被拉动通过端帽400的通孔420。O形环2160在端帽400的近侧保持围绕内窥镜定位。
在图38-42中示出的安装的实施方案中,在由手柄2200向端帽400的远侧面提供近侧推力时,向远侧的拉力被挠性叉头2120施加到内窥镜1000的外侧表面。图43-47示出了在将端帽定位到内窥镜上的过程中使用的可选的设备和方法,可用来在向端帽施加推力时在内窥镜的内表面、例如内窥镜的工作通道的内表面提供拉力。为了清楚起见,图中略去了护套和轨道,应当理解,在图43-47中示出的设备和方法可被用于将端帽定位在内窥镜的远端,包括其中不适用护套和/或轨道的应用。
图43是装载设备3000的示意性等轴测图,而图44是设备3000的局部剖视图。在图43和44中,为了示意的目的而示出了端帽400,应当理解,端帽400不是设备3000的一部分。图45、46和47示出了采用设备3000将端帽400装载到内窥镜上的步骤,其中内窥镜和端帽为了显示和清楚目的而被示出为基本上透明的(如果需要,端帽400和内窥镜可由基本上透明的材料形成)。
设备3000包括主体部分3100、转动部分3200和平移部分3300以及环3400。如图45和46所示,设备3000包括一个或多个可扩张构件,例如弹性圆柱体3500,其例如可通过定位在内窥镜的工作通道中而与内窥镜的内表面接合。圆柱体3500可由任何适合的材料(例如橡胶或合成弹性体材料)形成,其在受到轴向压缩时沿径向扩张。或者,可采用可扩张构件的其它类型,例如通过充气而扩张的构件。
参考图46,圆柱体3500可扩张以接合工作通道的内侧表面。如下面将要更详细描述的,可以部分地与转动部分3200的旋转结合来提供橡胶圆柱体的扩张。
参考图47,在圆柱体3500在内窥镜的工作通道内扩张以压缩接合工作通道的沿径向的内表面的情况下,平移部分3300可相对于主体部分3100被向远侧拉动(如在图47中箭头3302标示的)。如图中所示,主体部分3100包括凹槽3120,其具有用于接合端帽400的远侧表面412的面向近侧的表面3122。在平移部分3300相对于主体部分3100被向远侧拉动时,圆柱体3500相对于主体部分3100被向远侧缩回。因此,由被向远侧拉动同时接合工作通道的内侧表面的圆柱体3500提供到内窥镜上的拉力,由表面3122施加在端帽400的远侧表面412上的附加反作用推力,上述二者的结合用于将端帽400压到内窥镜的远端上。因此,设备3000可用于将端帽400安装到内窥镜的远端,而不需要保持内窥镜或护套(如果使用了护套)或者与之接触。
现参考图43-47以及图48和49的剖视图更加详细地说明设备3000的组成元件和操作。主体部分3100包括由两个半个主体3106和3108形成的外表面。所述的半个主体可以任何合适的方式(例如采用螺纹型紧固件、铆接、使用粘合剂,等等)连接到一起。
平移部分3300可至少部分地设置在主体部分3100内,并包括毂3316和向外延伸的环把手3318。环把手3318可从毂3316经过设置在主体部分半个外壳3106和3108之间的狭槽向外延伸。
参考图44和48,转动部分3200可被支撑在主体部分3100的端部处,从而转动部分3200可相对于主体部分3100转动,并且转动部分可相对于平移部分3300转动。如图48所示,转动部分3200具有端部3202,其被容纳在由半个主体3106和3108形成的凹槽3105内。端部3202包括形成在端部3202的外表面上的环3204。环3204容纳在形成于半个主体3106和3108的内侧表面上的沟槽3107中。环3204在沟槽3107的配合允许部分3200相对于主体部分3100转动,同时防止部分3200相对于主体部分3100的平移。
转动部分3200包括环圈3208,其可由手指抓握以转动所述的部分3200。环3400支撑在转动部分3200的端部处,这样环3400可与转动部分3200的位置无关地围绕转动部分3200的纵向轴线自由转动。因此,环3400可被对准,以与在平移部分3300上的环把手3318具有相同的平面定向,而无论转动部分3200怎样转动。
图48提供了平移部分3300和转动部分3200的各部分的示意性放大剖视图,而图49提供了设备的用来接合端帽或内窥镜的部分的示意性放大剖视图。平移部分3300具有沿着该平移部分的长度延伸的中央孔3342。示出的中央孔3342包括放大的孔部分3344,其沿着毂3316的长度延伸。轴3350延伸穿过中央孔3342,其关于孔3342设定尺寸并在孔3342中受到支撑,以在孔3342中自由转动。轴3350从第一端部3352延伸到第二端部3354。第二端部3354相对于轴3350的剩余长度具有放大的直径,从而第二端部3354可用于压缩圆柱体3350。
参考图48,内部攻有螺纹的构件3360设置在毂3316的端部处。该内部攻有螺纹的构件3360可以为具有内部攻有螺纹的通孔的螺母,其与中央孔3342和放大的孔部分3344大致同轴对准。该内部攻有螺纹的构件3360相对于平移部分3300固定。
转动部分3200包括纵向延伸的内部通道3242,其关于孔3342大致同轴地对准。外部攻有螺纹的构件3260被设置成在孔3242中滑动。构件3260为螺钉的形式,该螺钉具有非圆形头部3262、纵向延伸的外螺纹部分3264以及纵向延伸的通孔3266。通孔3266延伸螺钉的长度,并具有内径,该内径的尺寸被设定成容纳从中穿过的轴3350。通孔3266的尺寸被设定成该轴3350可相对于螺钉3260自由旋转。
螺钉3260的头部3262可具有规则的多边形形状。在转动部分3200中的孔3242具有类似于头部3262的非圆形的横截面形状(例如如果头部3262为六边形,则为六边形横截面),从而螺钉3260能够相对于转动部分3200在孔3242中平移,但限制螺钉3260与转动部分3200一起转动。或者,螺钉3260具有头部3262,该头部3262包括键或者其它允许螺钉3260在孔3242内滑动平移、同时确保螺钉与转动部分3200一起旋转的零部件。
轴环圈3356设置在轴3350的轴端3352处或附近。轴环圈3356例如通过定位螺钉、销、粘合剂或任何其它合适的将环圈3356固定到轴3350的紧固方式被固定到轴3350。环圈3356设置在孔3242中并具有外径,该外径的尺寸被设定成允许该环圈3356关于转动部分3200自由平移和旋转。如图48所示,环圈3356的表面3358抵接或接合螺钉头部3262的端面。
参考图49,圆柱体3500支撑在轴3350的从孔3342延伸的一部分上。圆柱体3500可被支撑在轴3350从平移部分3300的端面3302向外延伸的一部分上。一个圆柱体3500可以被设置在轴3350上位于轴端部3354和垫圈3352之间。垫圈3352由比圆柱体3500相对较硬和具较小弹性的材料形成,且该垫圈3352可为金属垫圈。第二圆柱体3500可设置在轴3350上位于垫圈3352和一对垫圈3354之间。如图49所示,垫圈3354可以设置在轴3350上于第二圆柱体3500和端面3302之间。
为了采用设备3000将端帽装载到内窥镜上,使该设备3000相对于端帽和内窥镜设置,如图45所示,并且平移部分3300相对于主体部分3100处于向前位置,轴端部3350和圆柱体3500设置在内窥镜的工作通道中,平移部分3300的端面3302抵靠内窥镜的远端面,主体部分3100的表面3122抵靠端帽的远侧面。然后使转动部分3200(例如借助环圈3208)转动,该转动又导致螺钉3260在螺母3360中转动。随着螺钉3260转动,取决于在螺钉3260上的螺纹螺距,螺钉3260在孔3242中向后平移。螺钉3260的向后运动向后推动轴环圈3356,这又导致轴3350和轴端部3354相对平移部分3100向后运动,由此挤压圆柱体3500并导致圆柱体沿径向扩张,并且挤压接合内窥镜工作通道的内侧表面。
然后,在圆柱体3500在内窥镜的工作通道中扩张的情况下,将拇指插入环3400并将两个手指插入环把手3318。在环把手3318中的手指在平移部分3300上施加向后作用力,从而相对于主体部分3100向后拉动部分3300。如图47所示(沿箭头3302方向)向后拉动平移部分3300还导致轴3350和圆柱体3500向后运动。因为轴3350和圆柱体3500与平移部分3300一起向后运动,圆柱体不再进一步扩张。在轴3350上向后的力(在轴3350中的拉伸力)和圆柱体3500上向后的力(接合内窥镜的内表面)在内窥镜上施加向后的力(在内窥镜上的拉力),而主体部分3100上的表面3122推压端帽的远侧面。因此,在相对于主体部分3100向后拉动部分3300时,拉力施加在内窥镜的内表面上,而推力施加在端帽的远侧面上,由此将端帽推压到内窥镜的远端。
尽管已经通过数个实施方案的说明示出了本发明,但本发明人不是要将附在后面的权利要求的精神和范围限制到如此的细节。各种其它改变、变化和替换在不背离本发明范围的情况下对本领域普通技术人员是显而易见的。例如,本发明的装置和方法已经就通过嘴和食管的供给管的使用进行了说明,但应当理解,本发明可应用到身体的其它部分,例如,可被用于通过其它开口(包括在身体上的自然存在的其它开口)将医疗辅助装置引导到体内。而且,与本发明相关联的每个元件的结构或者可被描述为用于提供该元件所执行的功能的部件。可以理解,上述说明是以例子方式给出,在不背离后附权利要求的范围和精神的条件下,其它变型对本领域普通技术人员是显而易见的。
Claims (10)
1.一种用于将装置定位在内窥镜上的方法,其包括如下步骤:
设置内窥镜;
设置其尺寸适于被定位在内窥镜的端部上的装置;以及
在内窥镜上施加拉力的同时在装置上施加推力,其中,施加在内窥镜上的拉力通过装置中的开口施加。
2.如权利要求1所述的方法,其中,施加在内窥镜上的拉力通过装置中的通孔施加。
3.如权利要求1所述的方法,其中,通过在装置中的其尺寸可容纳内窥镜端部的开口施加拉力。
4.如权利要求1所述的方法,其中,所述装置包括具有用于容纳内窥镜端部的孔的端帽,并且拉力通过端帽中的孔施加到内窥镜上。
5.如权利要求1所述的方法,其中,将所述装置定位在设置在护套中的内窥镜上,并且完成了在内窥镜上施加拉力的步骤而不需抓握护套。
6.如权利要求1所述的方法,其中,在内窥镜上沿径向向内窥镜外表面的内部的方向施加拉力。
7.如权利要求1所述的方法,其中,施加拉力到内窥镜内的通道的表面上。
8.如权利要求1所述的方法,其中,围绕内窥镜的远端施加拉力。
9.如权利要求1所述的方法,其包括接合内窥镜内表面的步骤。
10.如权利要求1所述的方法,其包括通过在内窥镜内伸长构件来接合内窥镜内表面的步骤。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/129,592 US7648457B2 (en) | 2005-05-13 | 2005-05-13 | Method of positioning a device on an endoscope |
US11/129,592 | 2005-05-13 |
Publications (1)
Publication Number | Publication Date |
---|---|
CN1861012A true CN1861012A (zh) | 2006-11-15 |
Family
ID=36791627
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CNA2006100802582A Pending CN1861012A (zh) | 2005-05-13 | 2006-05-15 | 将装置定位在内窥镜上的方法 |
Country Status (10)
Country | Link |
---|---|
US (1) | US7648457B2 (zh) |
EP (1) | EP1721567A3 (zh) |
JP (1) | JP5042522B2 (zh) |
KR (1) | KR20060117285A (zh) |
CN (1) | CN1861012A (zh) |
AR (1) | AR055951A1 (zh) |
AU (1) | AU2006202011A1 (zh) |
BR (1) | BRPI0602624A (zh) |
CA (1) | CA2547037A1 (zh) |
SG (1) | SG127818A1 (zh) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102869296A (zh) * | 2009-12-18 | 2013-01-09 | 库克医学技术有限责任公司 | 内窥镜护套 |
CN112930135A (zh) * | 2018-11-02 | 2021-06-08 | 波士顿科学有限公司 | 用于活检帽和壳体的装置、系统和方法 |
Families Citing this family (556)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE60122894T2 (de) | 2000-07-14 | 2007-03-15 | Xillix Technologies Corp., Richmond | Kompaktes fluorezenz endoskopisches video system |
US20060241496A1 (en) | 2002-01-15 | 2006-10-26 | Xillix Technologies Corp. | Filter for use with imaging endoscopes |
US20070203393A1 (en) * | 2003-05-16 | 2007-08-30 | David Stefanchik | Apparatus for positioning a medical device |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
US7658738B2 (en) * | 2004-05-14 | 2010-02-09 | Ethicon Endo-Surgery, Inc. | Medical devices for use with endoscope |
US11998198B2 (en) | 2004-07-28 | 2024-06-04 | Cilag Gmbh International | Surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
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 |
US20070194082A1 (en) | 2005-08-31 | 2007-08-23 | Morgan Jerome R | Surgical stapling device with anvil having staple forming pockets of varying depths |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
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 |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US20070149850A1 (en) * | 2005-12-22 | 2007-06-28 | Spivey James T | Endoscope endcap attachment tool |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US20110295295A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument having recording capabilities |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
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 |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
WO2007106624A2 (en) | 2006-02-07 | 2007-09-20 | Novadaq Technologies Inc. | Near infrared imaging |
US7803137B2 (en) | 2006-03-22 | 2010-09-28 | Ethicon Endo-Surgery, Inc. | Intubation system for use with an endoscope |
US7771396B2 (en) | 2006-03-22 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Intubation device for enteral feeding |
US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
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 |
US8529440B2 (en) * | 2006-07-06 | 2013-09-10 | Smart Medical Systems Ltd. | Endoscopy systems |
US8408269B2 (en) * | 2006-07-28 | 2013-04-02 | Novadaq Technologies, Inc. | System and method for deposition and removal of an optical element on an endoscope objective |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US8360297B2 (en) | 2006-09-29 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling instrument with self adjusting anvil |
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 |
US8498695B2 (en) | 2006-12-22 | 2013-07-30 | Novadaq Technologies Inc. | Imaging system with a single color image sensor for simultaneous fluorescence and color video endoscopy |
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 |
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 |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US8540128B2 (en) | 2007-01-11 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with a curved end effector |
US7655004B2 (en) | 2007-02-15 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Electroporation ablation apparatus, system, and method |
US7815662B2 (en) | 2007-03-08 | 2010-10-19 | Ethicon Endo-Surgery, Inc. | Surgical suture anchors and deployment device |
US20090001121A1 (en) | 2007-03-15 | 2009-01-01 | Hess Christopher J | Surgical staple having an expandable portion |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US8075572B2 (en) | 2007-04-26 | 2011-12-13 | Ethicon Endo-Surgery, Inc. | Surgical suturing apparatus |
US8100922B2 (en) | 2007-04-27 | 2012-01-24 | Ethicon Endo-Surgery, Inc. | Curved needle suturing tool |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11857181B2 (en) | 2007-06-04 | 2024-01-02 | Cilag Gmbh International | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US8408439B2 (en) | 2007-06-22 | 2013-04-02 | 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 |
US8568410B2 (en) | 2007-08-31 | 2013-10-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation surgical instruments |
US8262655B2 (en) | 2007-11-21 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Bipolar forceps |
US8579897B2 (en) | 2007-11-21 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Bipolar forceps |
US8480657B2 (en) | 2007-10-31 | 2013-07-09 | Ethicon Endo-Surgery, Inc. | Detachable distal overtube section and methods for forming a sealable opening in the wall of an organ |
US20090112059A1 (en) | 2007-10-31 | 2009-04-30 | Nobis Rudolph H | Apparatus and methods for closing a gastrotomy |
US20090182195A1 (en) * | 2008-01-11 | 2009-07-16 | Ethicon Endo-Surgery, Inc. | Endoscopic guide system |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
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 |
JP5410110B2 (ja) | 2008-02-14 | 2014-02-05 | エシコン・エンド−サージェリィ・インコーポレイテッド | Rf電極を有する外科用切断・固定器具 |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US10390823B2 (en) | 2008-02-15 | 2019-08-27 | Ethicon Llc | End effector comprising an adjunct |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US8262680B2 (en) | 2008-03-10 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Anastomotic device |
EP3117765B1 (en) | 2008-03-18 | 2021-10-27 | Stryker European Operations Limited | Imaging system for combined full-colour reflectance and near-infrared imaging |
US8652150B2 (en) | 2008-05-30 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Multifunction surgical device |
US8317806B2 (en) | 2008-05-30 | 2012-11-27 | Ethicon Endo-Surgery, Inc. | Endoscopic suturing tension controlling and indication devices |
US8771260B2 (en) | 2008-05-30 | 2014-07-08 | Ethicon Endo-Surgery, Inc. | Actuating and articulating surgical device |
US8070759B2 (en) | 2008-05-30 | 2011-12-06 | Ethicon Endo-Surgery, Inc. | Surgical fastening device |
US8114072B2 (en) | 2008-05-30 | 2012-02-14 | Ethicon Endo-Surgery, Inc. | Electrical ablation device |
US8679003B2 (en) | 2008-05-30 | 2014-03-25 | Ethicon Endo-Surgery, Inc. | Surgical device and endoscope including same |
US8906035B2 (en) | 2008-06-04 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Endoscopic drop off bag |
US8403926B2 (en) | 2008-06-05 | 2013-03-26 | Ethicon Endo-Surgery, Inc. | Manually articulating devices |
US8361112B2 (en) | 2008-06-27 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical suture arrangement |
US8262563B2 (en) | 2008-07-14 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Endoscopic translumenal articulatable steerable overtube |
US8888792B2 (en) | 2008-07-14 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Tissue apposition clip application devices and methods |
US8211125B2 (en) | 2008-08-15 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Sterile appliance delivery device for endoscopic procedures |
US8529563B2 (en) | 2008-08-25 | 2013-09-10 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8241204B2 (en) | 2008-08-29 | 2012-08-14 | Ethicon Endo-Surgery, Inc. | Articulating end cap |
US8480689B2 (en) | 2008-09-02 | 2013-07-09 | Ethicon Endo-Surgery, Inc. | Suturing device |
US8409200B2 (en) | 2008-09-03 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical grasping device |
US8114119B2 (en) | 2008-09-09 | 2012-02-14 | Ethicon Endo-Surgery, Inc. | Surgical grasping device |
PL3476312T3 (pl) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Stapler chirurgiczny z urządzeniem do dopasowania wysokości zszywek |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US8337394B2 (en) | 2008-10-01 | 2012-12-25 | Ethicon Endo-Surgery, Inc. | Overtube with expandable tip |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8157834B2 (en) | 2008-11-25 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Rotational coupling device for surgical instrument with flexible actuators |
US8172772B2 (en) | 2008-12-11 | 2012-05-08 | Ethicon Endo-Surgery, Inc. | Specimen retrieval device |
US8361066B2 (en) | 2009-01-12 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8828031B2 (en) | 2009-01-12 | 2014-09-09 | Ethicon Endo-Surgery, Inc. | Apparatus for forming an anastomosis |
US9226772B2 (en) | 2009-01-30 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Surgical device |
US8252057B2 (en) | 2009-01-30 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Surgical access device |
US8037591B2 (en) | 2009-02-02 | 2011-10-18 | Ethicon Endo-Surgery, Inc. | Surgical scissors |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
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 |
AU2010210795A1 (en) | 2009-02-06 | 2011-08-25 | Ethicon Endo-Surgery, Inc. | Driven surgical stapler improvements |
US9254245B2 (en) | 2009-04-09 | 2016-02-09 | University Of Utah | Optically guided medical tube and control unit assembly and methods of use |
US8361041B2 (en) | 2009-04-09 | 2013-01-29 | University Of Utah Research Foundation | Optically guided feeding tube, catheters and associated methods |
GB2474309B (en) | 2009-10-12 | 2011-09-07 | Endoguard Ltd | Flow guide for an endoscope |
US20110098704A1 (en) | 2009-10-28 | 2011-04-28 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8608652B2 (en) | 2009-11-05 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Vaginal entry surgical devices, kit, system, and method |
US8496574B2 (en) | 2009-12-17 | 2013-07-30 | Ethicon Endo-Surgery, Inc. | Selectively positionable camera for surgical guide tube assembly |
US8353487B2 (en) | 2009-12-17 | 2013-01-15 | Ethicon Endo-Surgery, Inc. | User interface support devices for endoscopic surgical instruments |
US9028483B2 (en) | 2009-12-18 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8506564B2 (en) | 2009-12-18 | 2013-08-13 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US9005198B2 (en) | 2010-01-29 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
TWI407933B (zh) | 2010-07-27 | 2013-09-11 | Ind Tech Res Inst | 曲式咽喉直達鏡及應用此曲式咽喉直達鏡的手術器械總成 |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US20120029272A1 (en) | 2010-07-30 | 2012-02-02 | Shelton Iv Frederick E | Apparatus and methods for protecting adjacent structures during the insertion of a surgical instrument into a tubular organ |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US9480476B2 (en) | 2010-09-30 | 2016-11-01 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising resilient members |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US10213198B2 (en) | 2010-09-30 | 2019-02-26 | Ethicon Llc | Actuator for releasing a tissue thickness compensator from a fastener cartridge |
US9839420B2 (en) | 2010-09-30 | 2017-12-12 | Ethicon Llc | Tissue thickness compensator comprising at least one medicament |
US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
US9295464B2 (en) | 2010-09-30 | 2016-03-29 | Ethicon Endo-Surgery, Inc. | Surgical stapler anvil comprising a plurality of forming pockets |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US11849952B2 (en) | 2010-09-30 | 2023-12-26 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9517063B2 (en) | 2012-03-28 | 2016-12-13 | Ethicon Endo-Surgery, Llc | Movable member for use with a tissue thickness compensator |
BR112013007717B1 (pt) | 2010-09-30 | 2020-09-24 | Ethicon Endo-Surgery, Inc. | Sistema de grampeamento cirúrgico |
US9216019B2 (en) | 2011-09-23 | 2015-12-22 | Ethicon Endo-Surgery, Inc. | Surgical stapler with stationary staple drivers |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US10092291B2 (en) | 2011-01-25 | 2018-10-09 | Ethicon Endo-Surgery, Inc. | Surgical instrument with selectively rigidizable features |
US9254169B2 (en) | 2011-02-28 | 2016-02-09 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9314620B2 (en) | 2011-02-28 | 2016-04-19 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9233241B2 (en) | 2011-02-28 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
CN107582016B (zh) | 2011-03-08 | 2020-04-28 | 诺瓦达克技术公司 | 全光谱led照明器 |
WO2012125785A1 (en) | 2011-03-17 | 2012-09-20 | Ethicon Endo-Surgery, Inc. | Hand held surgical device for manipulating an internal magnet assembly within a patient |
GB2489487B (en) * | 2011-03-30 | 2013-02-13 | Endoguard Ltd | Applicator for an endoscope |
BR112013027794B1 (pt) | 2011-04-29 | 2020-12-15 | Ethicon Endo-Surgery, Inc | Conjunto de cartucho de grampos |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
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 |
US8986199B2 (en) | 2012-02-17 | 2015-03-24 | Ethicon Endo-Surgery, Inc. | Apparatus and methods for cleaning the lens of an endoscope |
MX353040B (es) | 2012-03-28 | 2017-12-18 | Ethicon Endo Surgery Inc | Unidad retenedora que incluye un compensador de grosor de tejido. |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
RU2639857C2 (ru) | 2012-03-28 | 2017-12-22 | Этикон Эндо-Серджери, Инк. | Компенсатор толщины ткани, содержащий капсулу для среды с низким давлением |
JP6305979B2 (ja) | 2012-03-28 | 2018-04-04 | 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. | 複数の層を含む組織厚さコンペンセーター |
US9427255B2 (en) | 2012-05-14 | 2016-08-30 | Ethicon Endo-Surgery, Inc. | Apparatus for introducing a steerable camera assembly into a patient |
US20130334280A1 (en) * | 2012-06-14 | 2013-12-19 | Covidien Lp | Sliding Anvil/Retracting Cartridge Reload |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
US20140005718A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Multi-functional powered surgical device with external dissection features |
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 |
US9226751B2 (en) | 2012-06-28 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Surgical instrument system including replaceable end effectors |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
RU2636861C2 (ru) | 2012-06-28 | 2017-11-28 | Этикон Эндо-Серджери, Инк. | Блокировка пустой кассеты с клипсами |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9078662B2 (en) | 2012-07-03 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Endoscopic cap electrode and method for using the same |
US9545290B2 (en) | 2012-07-30 | 2017-01-17 | Ethicon Endo-Surgery, Inc. | Needle probe guide |
US10314649B2 (en) | 2012-08-02 | 2019-06-11 | Ethicon Endo-Surgery, Inc. | Flexible expandable electrode and method of intraluminal delivery of pulsed power |
US9572623B2 (en) | 2012-08-02 | 2017-02-21 | Ethicon Endo-Surgery, Inc. | Reusable electrode and disposable sheath |
US9277957B2 (en) | 2012-08-15 | 2016-03-08 | Ethicon Endo-Surgery, Inc. | Electrosurgical devices and methods |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
US10098527B2 (en) | 2013-02-27 | 2018-10-16 | Ethidcon Endo-Surgery, Inc. | System for performing a minimally invasive surgical procedure |
MX368026B (es) | 2013-03-01 | 2019-09-12 | Ethicon Endo Surgery Inc | Instrumento quirúrgico articulable con vías conductoras para la comunicación de la señal. |
US9554794B2 (en) | 2013-03-01 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Multiple processor motor control for modular surgical instruments |
JP6345707B2 (ja) | 2013-03-01 | 2018-06-20 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | ソフトストップを備えた外科用器具 |
US9345481B2 (en) | 2013-03-13 | 2016-05-24 | Ethicon Endo-Surgery, Llc | Staple cartridge tissue thickness sensor system |
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 |
US9814460B2 (en) | 2013-04-16 | 2017-11-14 | Ethicon Llc | Modular motor driven surgical instruments with status indication arrangements |
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 |
JP5663712B2 (ja) * | 2013-07-05 | 2015-02-04 | 国立大学法人鳥取大学 | 内視鏡装置用補助具 |
US9283054B2 (en) | 2013-08-23 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Interactive displays |
RU2678363C2 (ru) | 2013-08-23 | 2019-01-28 | ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи | Устройства втягивания пускового элемента для хирургических инструментов с электропитанием |
US9763662B2 (en) | 2013-12-23 | 2017-09-19 | Ethicon Llc | Fastener cartridge comprising a firing member configured to directly engage and eject fasteners from the fastener cartridge |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
CN106232029B (zh) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | 包括击发构件锁定件的紧固系统 |
US9884456B2 (en) | 2014-02-24 | 2018-02-06 | Ethicon Llc | Implantable layers and methods for altering one or more properties of implantable layers for use with fastening instruments |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US10004497B2 (en) | 2014-03-26 | 2018-06-26 | Ethicon Llc | Interface systems for use with surgical instruments |
US10013049B2 (en) | 2014-03-26 | 2018-07-03 | Ethicon Llc | Power management through sleep options of segmented circuit and wake up control |
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 |
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 |
US10561422B2 (en) | 2014-04-16 | 2020-02-18 | Ethicon Llc | Fastener cartridge comprising deployable tissue engaging members |
US10426476B2 (en) | 2014-09-26 | 2019-10-01 | Ethicon Llc | Circular fastener cartridges for applying radially expandable fastener lines |
BR112016023698B1 (pt) | 2014-04-16 | 2022-07-26 | Ethicon Endo-Surgery, Llc | Cartucho de prendedores para uso com um instrumento cirúrgico |
US20150297222A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
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 |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
BR112017004361B1 (pt) | 2014-09-05 | 2023-04-11 | Ethicon Llc | Sistema eletrônico para um instrumento cirúrgico |
US20160066913A1 (en) | 2014-09-05 | 2016-03-10 | Ethicon Endo-Surgery, Inc. | Local display of tissue parameter stabilization |
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 |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
MX2017003960A (es) | 2014-09-26 | 2017-12-04 | Ethicon Llc | Refuerzos de grapas quirúrgicas y materiales auxiliares. |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
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 |
US10004501B2 (en) | 2014-12-18 | 2018-06-26 | Ethicon Llc | Surgical instruments with improved closure arrangements |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
MX2017008108A (es) | 2014-12-18 | 2018-03-06 | Ethicon Llc | Instrumento quirurgico con un yunque que puede moverse de manera selectiva sobre un eje discreto no movil con relacion a un cartucho de grapas. |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US10045779B2 (en) | 2015-02-27 | 2018-08-14 | Ethicon Llc | Surgical instrument system comprising an inspection station |
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 |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
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 |
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 |
US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
US10433844B2 (en) | 2015-03-31 | 2019-10-08 | Ethicon Llc | Surgical instrument with selectively disengageable threaded drive systems |
US10368861B2 (en) | 2015-06-18 | 2019-08-06 | Ethicon Llc | Dual articulation drive system arrangements for articulatable surgical instruments |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
CN108348233B (zh) | 2015-08-26 | 2021-05-07 | 伊西康有限责任公司 | 用于允许改变钉特性并实现轻松仓加载的外科钉条 |
US10357251B2 (en) | 2015-08-26 | 2019-07-23 | Ethicon Llc | Surgical staples comprising hardness variations for improved fastening of tissue |
MX2022009705A (es) | 2015-08-26 | 2022-11-07 | Ethicon Llc | Metodo para formar una grapa contra un yunque de un instrumento de engrapado quirurgico. |
MX2022006192A (es) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Configuraciones de grapas quirurgicas con superficies de leva situadas entre porciones que soportan grapas quirurgicas. |
US10251648B2 (en) | 2015-09-02 | 2019-04-09 | Ethicon Llc | Surgical staple cartridge staple drivers with central support features |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-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 |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10433846B2 (en) | 2015-09-30 | 2019-10-08 | Ethicon Llc | Compressible adjunct with crossing spacer fibers |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US10478188B2 (en) | 2015-09-30 | 2019-11-19 | Ethicon Llc | Implantable layer comprising a constricted configuration |
WO2017079844A1 (en) | 2015-11-13 | 2017-05-18 | Novadaq Technologies Inc. | Systems and methods for illumination and imaging of a target |
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 |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
EP3408654B1 (en) | 2016-01-26 | 2022-08-03 | Stryker European Operations Limited | Fluorescence imaging system and method for fluorescence imaging |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
JP6911054B2 (ja) | 2016-02-09 | 2021-07-28 | エシコン エルエルシーEthicon LLC | 非対称の関節構成を備えた外科用器具 |
US10245029B2 (en) | 2016-02-09 | 2019-04-02 | Ethicon Llc | Surgical instrument with articulating and axially translatable end effector |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10293122B2 (en) | 2016-03-17 | 2019-05-21 | Novadaq Technologies ULC | Endoluminal introducer with contamination avoidance |
US10413297B2 (en) | 2016-04-01 | 2019-09-17 | Ethicon Llc | Surgical stapling system configured to apply annular rows of staples having different heights |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US10433840B2 (en) | 2016-04-18 | 2019-10-08 | Ethicon Llc | Surgical instrument comprising a replaceable cartridge jaw |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
USD916294S1 (en) | 2016-04-28 | 2021-04-13 | Stryker European Operations Limited | Illumination and imaging device |
WO2017214730A1 (en) | 2016-06-14 | 2017-12-21 | Novadaq Technologies Inc. | Methods and systems for adaptive imaging for low light signal enhancement in medical visualization |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
US10702270B2 (en) | 2016-06-24 | 2020-07-07 | Ethicon Llc | Stapling system for use with wire staples and stamped staples |
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 |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
US11141147B2 (en) * | 2016-08-10 | 2021-10-12 | Apollo Endosurgery Us, Inc. | Endoscopic suturing system having external instrument channel |
US10485543B2 (en) | 2016-12-21 | 2019-11-26 | Ethicon Llc | Anvil having a knife slot width |
US20180168647A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments having end effectors with positive opening features |
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 |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US10881401B2 (en) | 2016-12-21 | 2021-01-05 | Ethicon Llc | Staple firing member comprising a missing cartridge and/or spent cartridge lockout |
US20180168633A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments and staple-forming anvils |
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 |
US10542982B2 (en) | 2016-12-21 | 2020-01-28 | Ethicon Llc | Shaft assembly comprising first and second articulation lockouts |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US11160551B2 (en) | 2016-12-21 | 2021-11-02 | Cilag Gmbh International | Articulatable surgical stapling instruments |
US10695055B2 (en) | 2016-12-21 | 2020-06-30 | Ethicon Llc | Firing assembly comprising a lockout |
US10813638B2 (en) | 2016-12-21 | 2020-10-27 | Ethicon Llc | Surgical end effectors with expandable tissue stop arrangements |
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 |
US10758230B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument with primary and safety processors |
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 |
US10687809B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Surgical staple cartridge with movable camming member configured to disengage firing member lockout features |
US10537325B2 (en) | 2016-12-21 | 2020-01-21 | Ethicon Llc | Staple forming pocket arrangement to accommodate different types of staples |
MX2019007311A (es) | 2016-12-21 | 2019-11-18 | Ethicon Llc | Sistemas de engrapado quirurgico. |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
CN110114014B (zh) | 2016-12-21 | 2022-08-09 | 爱惜康有限责任公司 | 包括端部执行器闭锁件和击发组件闭锁件的外科器械系统 |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US20180168598A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Staple forming pocket arrangements comprising zoned forming surface grooves |
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 |
US11140305B2 (en) | 2017-02-10 | 2021-10-05 | Stryker European Operations Limited | Open-field handheld fluorescence imaging systems and methods |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
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 |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
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 |
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 |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
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 |
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 |
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 |
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 |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
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 |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
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 |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
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 |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US20180368844A1 (en) | 2017-06-27 | 2018-12-27 | Ethicon Llc | Staple forming pocket arrangements |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
US11478242B2 (en) | 2017-06-28 | 2022-10-25 | Cilag Gmbh International | Jaw retainer arrangement for retaining a pivotable surgical instrument jaw in pivotable retaining engagement with a second surgical instrument jaw |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
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 |
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 |
US11484310B2 (en) | 2017-06-28 | 2022-11-01 | Cilag Gmbh International | Surgical instrument comprising a shaft including a closure tube profile |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
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 |
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 |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
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 |
US11974742B2 (en) | 2017-08-03 | 2024-05-07 | Cilag Gmbh International | Surgical system comprising an articulation bailout |
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 |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
WO2019084162A1 (en) * | 2017-10-25 | 2019-05-02 | Boston Scientific Scimed Inc. | DIRECT VISUALIZATION CATHETER AND SYSTEM THEREOF |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
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 |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
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 |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
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 |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
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 |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11364027B2 (en) | 2017-12-21 | 2022-06-21 | Cilag Gmbh International | Surgical instrument comprising speed control |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US20200390319A1 (en) * | 2018-01-08 | 2020-12-17 | GI Scientific, LLC | Device delivery tools and systems |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
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 |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
WO2020227253A1 (en) * | 2019-05-08 | 2020-11-12 | Boston Scientific Scimed, Inc. | Medical systems, devices, and related methods |
DE102019003840A1 (de) * | 2019-06-03 | 2020-12-03 | Karl Storz Se & Co. Kg | Videoendoskop und Verfahren zum Konfigurieren eines Videoendoskops |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US12004740B2 (en) | 2019-06-28 | 2024-06-11 | Cilag Gmbh International | Surgical stapling system having an information decryption protocol |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11229437B2 (en) | 2019-06-28 | 2022-01-25 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
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 |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
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 |
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 |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
US20220031346A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Articulatable surgical instruments with articulation joints comprising flexible exoskeleton arrangements |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
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 |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
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 |
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 |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
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 |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
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 |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11950779B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Method of powering and communicating with a staple cartridge |
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 |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
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 |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
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 |
US11950777B2 (en) | 2021-02-26 | 2024-04-09 | Cilag Gmbh International | Staple cartridge comprising an information access control system |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
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 |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
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 |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
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 |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11998201B2 (en) | 2021-05-28 | 2024-06-04 | Cilag CmbH International | Stapling instrument comprising a firing lockout |
CN115414598B (zh) * | 2021-10-11 | 2024-06-04 | 河南省肿瘤医院 | 一种可视化食管癌放射粒子注药装置 |
US11980363B2 (en) | 2021-10-18 | 2024-05-14 | Cilag Gmbh International | Row-to-row staple array variations |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (106)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3662451A (en) * | 1970-07-30 | 1972-05-16 | Webster Electric Co Inc | Hydraulic puller apparatus for attaching a coupling to a hose |
JPS574963Y2 (zh) * | 1973-06-21 | 1982-01-29 | ||
US3858577A (en) * | 1974-04-05 | 1975-01-07 | Univ Southern California | Fiber optic laser light delivery system |
US4436087A (en) * | 1977-12-11 | 1984-03-13 | Kabushiki Kaisha Medos Kenkyusho | Bioptic instrument |
US4989256A (en) * | 1981-08-06 | 1991-01-29 | Buckley Bruce S | Self-organizing circuits |
US4580551A (en) * | 1984-11-02 | 1986-04-08 | Warner-Lambert Technologies, Inc. | Flexible plastic tube for endoscopes and the like |
US4646722A (en) * | 1984-12-10 | 1987-03-03 | Opielab, Inc. | Protective endoscope sheath and method of installing same |
DE3504292C1 (de) | 1985-02-08 | 1986-07-24 | Richard Wolf Gmbh, 7134 Knittlingen | Instrument fuer endoskopische Eingriffe,insbesondere zur perkutanen Gallensteinentfernung oder Gallenblasenveroedung |
US4688965A (en) * | 1986-05-27 | 1987-08-25 | Barber-Greene Co. | Extendable screed and method for paving non-coplanar road surface |
US4794911A (en) * | 1986-09-20 | 1989-01-03 | Olympus Optical Company Ltd. | Means to facilitate detachably mounting cap to distal end of endoscope |
US4721097A (en) * | 1986-10-31 | 1988-01-26 | Circon Corporation | Endoscope sheaths and method and apparatus for installation and removal |
US4773394A (en) * | 1987-10-14 | 1988-09-27 | Reichstein Irving P | Upper gastrointestinal endoscope intubator |
JPH0689191B2 (ja) * | 1988-05-26 | 1994-11-09 | 出光石油化学株式会社 | ポリプロピレン系樹脂組成物よりなるシート類の製造方法 |
US4947827A (en) * | 1988-12-30 | 1990-08-14 | Opielab, Inc. | Flexible endoscope |
DE9010130U1 (de) * | 1989-07-13 | 1990-09-13 | American Medical Systems, Inc., Minnetonka, Minn. | Instrument zum Anbringen eines Aufweitimplantats |
US5476899A (en) | 1989-09-14 | 1995-12-19 | Idemitsu Kosan Co., Ltd. | Process for produce a readily slidable film |
US5257617A (en) * | 1989-12-25 | 1993-11-02 | Asahi Kogaku Kogyo Kabushiki Kaisha | Sheathed endoscope and sheath therefor |
US5025778A (en) | 1990-03-26 | 1991-06-25 | Opielab, Inc. | Endoscope with potential channels and method of using the same |
US5503616A (en) * | 1991-06-10 | 1996-04-02 | Endomedical Technologies, Inc. | Collapsible access channel system |
US5237984A (en) * | 1991-06-24 | 1993-08-24 | Xomed-Treace Inc. | Sheath for endoscope |
US5217001A (en) * | 1991-12-09 | 1993-06-08 | Nakao Naomi L | Endoscope sheath and related method |
US5630782A (en) * | 1992-09-01 | 1997-05-20 | Adair; Edwin L. | Sterilizable endoscope with separable auxiliary assembly |
CA2143639C (en) * | 1992-09-01 | 2004-07-20 | Edwin L. Adair | Sterilizable endoscope with separable disposable tube assembly |
US5643175A (en) * | 1992-09-01 | 1997-07-01 | Adair; Edwin L. | Sterilizable endoscope with separable disposable tube assembly |
US5352503A (en) * | 1992-09-21 | 1994-10-04 | Rexham Graphics Inc. | Recording paper for ink jet recording processes |
CA2155217A1 (en) * | 1993-02-02 | 1994-08-18 | Ingemar H. Lundquist | Transurethral needle ablation device and method |
US5458132A (en) * | 1993-03-15 | 1995-10-17 | Olympus Optical Co., Ltd. | Endoscope cover-sheathed endoscope system |
US5363843A (en) * | 1993-03-16 | 1994-11-15 | Yousef Daneshvar | Special instrument covers |
US5347995A (en) * | 1993-03-25 | 1994-09-20 | Slater William M | Laryngoscope blade cover |
US5411022A (en) * | 1993-07-01 | 1995-05-02 | Mccue; Michael | Continuous pH monitoring system and method of using same |
ZA945387B (en) * | 1993-07-22 | 1995-03-10 | Xomed Treace Inc | Disposable endoscope sheath |
US5607386A (en) * | 1993-09-21 | 1997-03-04 | Flam; Gary H. | Malleable fiberoptic intubating stylet and method |
US5465857A (en) * | 1993-09-24 | 1995-11-14 | Yang; Heng-Te | Vacuum cap for liquor bottles |
US5746695A (en) * | 1993-11-18 | 1998-05-05 | Asahi Kogaku Kogyo Kabushiki Kaisha | Front end structure of endoscope |
US5665064A (en) * | 1993-12-06 | 1997-09-09 | Sherwood Medical Company | Gastroenteric feeding tube for endoscopic placement and method of use |
US5390663A (en) * | 1993-12-23 | 1995-02-21 | Schaefer; Nicholas E. | Canal obstruction remover |
US5581445A (en) * | 1994-02-14 | 1996-12-03 | Us3, Inc. | Plastic integrated circuit card with reinforcement structure for protecting integrated circuit module |
US5645519A (en) * | 1994-03-18 | 1997-07-08 | Jai S. Lee | Endoscopic instrument for controlled introduction of tubular members in the body and methods therefor |
US5505686A (en) * | 1994-05-05 | 1996-04-09 | Imagyn Medical, Inc. | Endoscope with protruding member and method of utilizing the same |
US5630730A (en) * | 1994-10-14 | 1997-05-20 | Molex Incorporated | Electrical connector for surface mounting to a printed circuit board |
US5695449A (en) | 1995-04-18 | 1997-12-09 | Olympus Optical Co., Ltd. | Cover-sheathed endoscope |
US6257753B1 (en) * | 2000-04-21 | 2001-07-10 | David Marshall King | Method of mixing viscous fluids |
US5733241A (en) * | 1996-02-01 | 1998-03-31 | King; George Hwa Kou | Fiberoptic intubation stylet |
US5749889A (en) * | 1996-02-13 | 1998-05-12 | Imagyn Medical, Inc. | Method and apparatus for performing biopsy |
JP3574530B2 (ja) * | 1996-05-13 | 2004-10-06 | ペンタックス株式会社 | 内視鏡の処置具案内具 |
US5690620A (en) * | 1996-05-14 | 1997-11-25 | Knott; Michael Mcfarland | Anatomically conforming nasogastric tube with normally-curved tip and method for using same |
US5746694A (en) * | 1996-05-16 | 1998-05-05 | Wilk; Peter J. | Endoscope biopsy channel liner and associated method |
US5882293A (en) | 1996-09-05 | 1999-03-16 | Asahi Kogaku Kogyo Kabushiki Kaisha | Treatment accessories for endoscope |
US6355034B2 (en) * | 1996-09-20 | 2002-03-12 | Ioan Cosmescu | Multifunctional telescopic monopolar/bipolar surgical device and method therefor |
US5895373A (en) * | 1996-10-11 | 1999-04-20 | Abbott Laboratories | Feeding tube retaining member filling tool |
US5944654A (en) * | 1996-11-14 | 1999-08-31 | Vista Medical Technologies, Inc. | Endoscope with replaceable irrigation tube |
DE69832288T2 (de) * | 1997-03-20 | 2006-07-13 | Genzyme Corp., Cambridge | Biologisch abbaubarer gewebespreizer |
CA2292614A1 (en) * | 1997-06-02 | 1998-12-03 | Cook Urological Inc. | Replaceable, medical device handle |
US5868662A (en) * | 1997-06-16 | 1999-02-09 | Advanced Urological Developments | Method for improving observation conditions in urethra and a cystoscope for carrying out the method |
US6059719A (en) * | 1997-08-06 | 2000-05-09 | Olympus Optical Co., Ltd. | Endoscope system |
US6238389B1 (en) * | 1997-09-30 | 2001-05-29 | Boston Scientific Corporation | Deflectable interstitial ablation device |
US5928203A (en) * | 1997-10-01 | 1999-07-27 | Boston Scientific Corporation | Medical fluid infusion and aspiration |
JP4121615B2 (ja) * | 1997-10-31 | 2008-07-23 | オリンパス株式会社 | 内視鏡 |
US5989231A (en) | 1998-01-15 | 1999-11-23 | Scimed Life Systems, Inc. | Optical gastrostomy and jejunostomy |
US6464686B1 (en) * | 1998-01-21 | 2002-10-15 | Abbott Laboratories | Polyurethane feeding tube and associated adaptors |
US6146389A (en) * | 1998-04-23 | 2000-11-14 | Boston Scientific Corporation | Stent deployment device and method for deploying a stent |
US6352503B1 (en) * | 1998-07-17 | 2002-03-05 | Olympus Optical Co., Ltd. | Endoscopic surgery apparatus |
US5916145A (en) * | 1998-08-07 | 1999-06-29 | Scimed Life Systems, Inc. | Device and method of using a surgical assembly with mesh sheath |
KR100277798B1 (ko) * | 1999-01-08 | 2000-12-15 | 김순택 | 음극선관 |
US6530881B1 (en) * | 1999-01-21 | 2003-03-11 | Vision Sciences, Inc. | Sheath apparatus for endoscopes and methods for forming same |
DE19906191A1 (de) * | 1999-02-15 | 2000-08-17 | Ingo F Herrmann | Endoskop |
US6179776B1 (en) * | 1999-03-12 | 2001-01-30 | Scimed Life Systems, Inc. | Controllable endoscopic sheath apparatus and related method of use |
JP3901404B2 (ja) * | 1999-08-27 | 2007-04-04 | 株式会社小糸製作所 | 車輌用灯具 |
US6398775B1 (en) * | 1999-10-21 | 2002-06-04 | Pulmonx | Apparatus and method for isolated lung access |
LU90496B1 (fr) * | 1999-12-30 | 2003-06-19 | Filmop Srl | Balai pourvu d'un régulateur du débit de produits pour le nettoyage et le traitement des sols |
DE10000091A1 (de) | 2000-01-04 | 2001-07-05 | Ingo F Herrmann | Endoskop |
US6527753B2 (en) * | 2000-02-29 | 2003-03-04 | Olympus Optical Co., Ltd. | Endoscopic treatment system |
US6638587B1 (en) * | 2000-04-18 | 2003-10-28 | Allegiance Corporation | Elastomeric article having silicone-based composite coating |
WO2001083017A1 (en) * | 2000-05-02 | 2001-11-08 | Wilson-Cook Medical, Inc. | Introducer device for catheters o.t.l. with eversible sleeve |
WO2001087144A1 (en) * | 2000-05-15 | 2001-11-22 | C.R. Bard, Inc. | Endoscopic accessory attachment mechanism |
US6309346B1 (en) * | 2000-06-29 | 2001-10-30 | Ashkan Farhadi | Creeping colonoscope |
US6921361B2 (en) * | 2000-07-24 | 2005-07-26 | Olympus Corporation | Endoscopic instrument for forming an artificial valve |
DE10036675B4 (de) * | 2000-07-27 | 2012-05-03 | Zf Friedrichshafen Ag | Ausrückeranordnung für eine Doppelkupplungsanordnung |
JP2002177201A (ja) * | 2000-10-02 | 2002-06-25 | Olympus Optical Co Ltd | 内視鏡 |
JP2002177198A (ja) * | 2000-10-02 | 2002-06-25 | Olympus Optical Co Ltd | 内視鏡 |
JP2002112946A (ja) * | 2000-10-11 | 2002-04-16 | Olympus Optical Co Ltd | 内視鏡用フード |
US6569085B2 (en) * | 2001-08-16 | 2003-05-27 | Syntheon, Llc | Methods and apparatus for delivering a medical instrument over an endoscope while the endoscope is in a body lumen |
JP4681729B2 (ja) * | 2000-12-27 | 2011-05-11 | Hoya株式会社 | 側方視型内視鏡の先端部 |
JP2002209833A (ja) * | 2001-01-16 | 2002-07-30 | Asahi Optical Co Ltd | 内視鏡の挿入部 |
US6997931B2 (en) * | 2001-02-02 | 2006-02-14 | Lsi Solutions, Inc. | System for endoscopic suturing |
JP3939158B2 (ja) | 2001-02-06 | 2007-07-04 | オリンパス株式会社 | 内視鏡装置 |
US6793621B2 (en) | 2001-03-08 | 2004-09-21 | Atropos Limited | Colonic overtube |
JP3722729B2 (ja) * | 2001-06-04 | 2005-11-30 | オリンパス株式会社 | 内視鏡用処置装置 |
DE10139153A1 (de) | 2001-08-09 | 2003-02-27 | Ingo F Herrmann | Einweg-Endoskopmantel |
US6911005B2 (en) * | 2001-10-25 | 2005-06-28 | Pentax Corporation | Endoscope with detachable sheath |
US7081097B2 (en) * | 2002-01-04 | 2006-07-25 | Vision Sciences, Inc. | Endoscope sheath assemblies having an attached biopsy sampling device |
US6740030B2 (en) * | 2002-01-04 | 2004-05-25 | Vision Sciences, Inc. | Endoscope assemblies having working channels with reduced bending and stretching resistance |
DE60301284T2 (de) * | 2002-02-25 | 2006-06-01 | Olympus Corporation | Endoskop mit Kühleinrichtung |
US7261728B2 (en) | 2002-03-15 | 2007-08-28 | Ethicon Endo-Surgery, Inc. | Biopsy forceps device and method |
US20030178880A1 (en) * | 2002-03-20 | 2003-09-25 | Hannah Richard E. | Headrest assembly for a wheelchair |
US20030225393A1 (en) | 2002-05-31 | 2003-12-04 | Kimberly-Clark Worldwide, Inc. | Low profile transpyloric jejunostomy system and method to enable |
EP1542577B1 (en) * | 2002-09-06 | 2016-05-25 | C.R. Bard, Inc. | Endoscopic accessory mounting adaptor |
JP4131012B2 (ja) * | 2002-10-10 | 2008-08-13 | Hoya株式会社 | 外套シース付内視鏡 |
US6958035B2 (en) * | 2002-10-15 | 2005-10-25 | Dusa Pharmaceuticals, Inc | Medical device sheath apparatus and method of making and using same |
US7815565B2 (en) | 2003-05-16 | 2010-10-19 | Ethicon Endo-Surgery, Inc. | Endcap for use with an endoscope |
US7431694B2 (en) | 2003-05-16 | 2008-10-07 | Ethicon Endo-Surgery, Inc. | Method of guiding medical devices |
JP3521910B1 (ja) * | 2003-05-29 | 2004-04-26 | 清輝 司馬 | 内視鏡の外部鉗子チャンネル装置 |
US20050143625A1 (en) * | 2003-12-03 | 2005-06-30 | Whitmore Willet F.Iii | Method and device for covering a medical instrument |
US20050171468A1 (en) * | 2004-02-04 | 2005-08-04 | Wood Scott D. | Gastric aspirate intestinal feeding tube |
US7654980B2 (en) | 2004-05-14 | 2010-02-02 | Boston Scientific Scimed, Inc. | Method for percutaneously implanting a medical catheter and medical catheter implanting assembly |
US20070249908A1 (en) * | 2006-04-24 | 2007-10-25 | Ifung Lu | Medical cannula and medical cannula system |
-
2005
- 2005-05-13 US US11/129,592 patent/US7648457B2/en active Active
-
2006
- 2006-05-12 JP JP2006134116A patent/JP5042522B2/ja not_active Expired - Fee Related
- 2006-05-12 AU AU2006202011A patent/AU2006202011A1/en not_active Abandoned
- 2006-05-12 EP EP06252507A patent/EP1721567A3/en not_active Withdrawn
- 2006-05-13 SG SG200603179A patent/SG127818A1/en unknown
- 2006-05-15 BR BRPI0602624-9A patent/BRPI0602624A/pt not_active IP Right Cessation
- 2006-05-15 CA CA002547037A patent/CA2547037A1/en not_active Abandoned
- 2006-05-15 AR ARP060101952A patent/AR055951A1/es not_active Application Discontinuation
- 2006-05-15 KR KR1020060043577A patent/KR20060117285A/ko not_active Application Discontinuation
- 2006-05-15 CN CNA2006100802582A patent/CN1861012A/zh active Pending
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102869296A (zh) * | 2009-12-18 | 2013-01-09 | 库克医学技术有限责任公司 | 内窥镜护套 |
CN102869296B (zh) * | 2009-12-18 | 2015-09-09 | 库克医学技术有限责任公司 | 内窥镜护套 |
CN112930135A (zh) * | 2018-11-02 | 2021-06-08 | 波士顿科学有限公司 | 用于活检帽和壳体的装置、系统和方法 |
Also Published As
Publication number | Publication date |
---|---|
SG127818A1 (en) | 2006-12-29 |
EP1721567A3 (en) | 2006-12-06 |
AU2006202011A1 (en) | 2006-11-30 |
US7648457B2 (en) | 2010-01-19 |
BRPI0602624A (pt) | 2007-01-09 |
US20060258910A1 (en) | 2006-11-16 |
CA2547037A1 (en) | 2006-11-13 |
AR055951A1 (es) | 2007-09-12 |
JP5042522B2 (ja) | 2012-10-03 |
KR20060117285A (ko) | 2006-11-16 |
JP2006334397A (ja) | 2006-12-14 |
EP1721567A2 (en) | 2006-11-15 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN1861012A (zh) | 将装置定位在内窥镜上的方法 | |
CN1861016A (zh) | 用于医疗装置的改进的轨道 | |
CN1861015A (zh) | 与内窥镜一起使用的改进的护套 | |
CN1861014A (zh) | 供给管和轨道 | |
CN1861011A (zh) | 用于将装置定位在内窥镜上的设备 | |
CN1861013A (zh) | 改进的供给管 | |
CN1860986A (zh) | 插入供给管的方法 | |
CN1861010A (zh) | 用于与内窥镜一起使用的医疗装置 | |
MXPA06005502A (en) | Apparatus useful for positioning a device on an endoscope | |
MXPA06005504A (en) | Improved sheath for use with an endoscope | |
MXPA06005505A (en) | Method of positioning a device on an endoscope |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
C06 | Publication | ||
PB01 | Publication | ||
C10 | Entry into substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
C02 | Deemed withdrawal of patent application after publication (patent law 2001) | ||
WD01 | Invention patent application deemed withdrawn after publication |
Open date: 20061115 |