EP2704631A1 - Cathéter à capteurs de position électromagnétiques, système de localisation, cathéters, et fils de guidage - Google Patents

Cathéter à capteurs de position électromagnétiques, système de localisation, cathéters, et fils de guidage

Info

Publication number
EP2704631A1
EP2704631A1 EP12729203.5A EP12729203A EP2704631A1 EP 2704631 A1 EP2704631 A1 EP 2704631A1 EP 12729203 A EP12729203 A EP 12729203A EP 2704631 A1 EP2704631 A1 EP 2704631A1
Authority
EP
European Patent Office
Prior art keywords
catheter
guide wire
longitudinal axis
electromagnetic position
orientation
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.)
Withdrawn
Application number
EP12729203.5A
Other languages
German (de)
English (en)
Inventor
Sara CONDINO
Vincenzo Ferrari
Aldo Alberti
Mauro Ferrari
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Universita di Pisa
Original Assignee
Universita di Pisa
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Universita di Pisa filed Critical Universita di Pisa
Publication of EP2704631A1 publication Critical patent/EP2704631A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/06Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
    • A61B5/061Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
    • A61B5/062Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2051Electromagnetic tracking systems

Definitions

  • the present invention relates to a catheter comprising:
  • tubular body to be introduced into a body cavity, said tubular body having a distal part including at least one curved or curvable portion, and corresponding catheter segments at the ends of said curved or curvable portion;
  • a plurality of electromagnetic position sensors each of which is positioned on a respective one of said catheter segments, and is designed to generate, in response to an externally generated magnetic field, an electrical signal representative of the position and orientation of the respective catheter segment.
  • Endovascular technology is a minimally invasive branch of vascular surgery which has also come to be adopted in other fields such as interventional radiology, cardiology, cardiac surgery, thoracic surgery, digestive surgery and neurosurgery.
  • the endovascular procedure is based on transarterial or transvenous catheterization, in which the devices are navigated along metal guides to reach the site of the vessel to be treated.
  • vascular access is a retrograde transfemoral access (via the common femoral artery), following local anaesthesia, with catheterization by the Seldinger technique. If this is impossible, due to occlusion of the common or iliac femoral artery, a brachial or radial access is formed.
  • the guide is inserted into the needle, which is subsequently extracted, and a standard introducer is then inserted and a diagnostic arteriography is performed after a "pigtail" catheter has been positioned.
  • the angiography reveals the anatomy of the vessel by the injection of a contrast medium (a radio-opaque dye) which is projected live on the angiograph monitor by means of X-rays.
  • a contrast medium a radio-opaque dye
  • endovascular technology has led to an improvement in the results in terms of morbidity and mortality, thus increasing the number of treatable patients.
  • endovascular technology is not free of complications, and, although it is minimally invasive, this method has not yet been perfected, owing to the risks associated with injection of contrast medium (which is a nephrotoxic drug) [1] and the use of ionizing radiation (13.4 +/- 8.6 mSv for endovascular aneurysm repair (EVAR)) [2].
  • contrast medium which is a nephrotoxic drug
  • ionizing radiation (13.4 +/- 8.6 mSv for endovascular aneurysm repair (EVAR)
  • the projects described in the literature include a system developed by S. Pujol [3, 10] for the treatment of abdominal aortic aneurysm (AAA), based on the electromagnetic location of the endoprosthesis and the recording of 3D models of the patient's anatomy acquired in the preoperative period by a computerized tomography (CT) scanning procedure.
  • AAA abdominal aortic aneurysm
  • CT computerized tomography
  • the system proposed by S. Pujol is based on the use of a single electromagnetic sensor housed in a suitably modified endoprosthesis.
  • the first validation tests of the system [3] were conducted by using a vascular catheter (diameter 3F, length 260 cm) fitted with an Aurora® electromagnetic sensor with five degrees of freedom (diameter 0.8 mm, length 10 mm), produced by Northern Digital Inc.
  • S. Pujol has also described in [5] the use of an electromagnetic navigation system for neurological intervention.
  • a catheter fitted with a single Aurora® electromagnetic sensor was used.
  • a catheter of the type defined in the introduction, provided with a plurality of electromagnetic position sensors, is described in EP 2 238 901.
  • This known catheter has a plurality of sensors each composed of a single coil, distributed along the distal part of the catheter, and placed concentrically with the longitudinal axis of the catheter.
  • the use of sensors may lead to problems due to the undesired creation of obstacles within the lumen of the catheter, the increase of the transverse dimensions of the instrument, and/or the reduction of its flexibility.
  • One object of the present invention is to provide a new arrangement of sensors which simplifies the sensor system fitted on the catheter, so as to reduce to a minimum any negative effect on the instrument, and which simultaneously makes it possible to obtain the necessary data to determine the position and path of the catheter and of its guide wire during use.
  • This object is achieved according to the invention with a catheter of the type defined initially, wherein
  • each of said electromagnetic position sensors has a substantially needle-shaped body having a longitudinal axis placed parallel to the longitudinal axis of the respective catheter segment, and is located at the wall of the respective catheter segment, eccentrically with respect to the longitudinal axis thereof.
  • a further object of the invention is a location system for catheters and guide wires, including
  • generating means for generating a magnetic field a catheter comprising
  • tubular body to be introduced into a body cavity, said tubular body having a distal part including at least one curved or curvable portion, and corresponding catheter segments at the ends of said curved or curvable portion; and - a plurality of electromagnetic position sensors, each of which is positioned on a respective one of said catheter segments, and is designed to provide, in response to the generated magnetic field, an electrical signal representative of the position and orientation of the respective catheter segment;
  • processing means for processing the electric signals of said electromagnetic position sensors in order to provide data concerning the position and orientation of said distal part of the tubular body
  • each of said electromagnetic position sensors has a substantially needle- shaped body having a longitudinal axis placed parallel to the longitudinal axis of the respective catheter segment, and is located at the wall of the respective catheter segment, eccentrically with respect to the longitudinal axis thereof.
  • FIG. 1 is a schematic perspective view of a catheter according to the invention.
  • FIG. 1 is a view in longitudinal section of the catheter of Figure 1;
  • FIG. 4 is a schematic illustration of a steerable catheter according to the invention, in two different operating positions.
  • FIG. 5 is a schematic perspective view of a guide wire according to the invention.
  • the number 1 indicates the whole of a catheter, or more precisely a distal part thereof.
  • the catheter 1 comprises a tubular body 3 to be introduced into a body cavity.
  • This tubular body 3, or rather the distal part thereof, includes at least one curved or curvable portion 5 and respective catheter segments 7, 9 at the ends of the curved or curvable portion 5.
  • the catheter 1 further comprises a plurality of electromagnetic position sensors 17, 19. Each of these sensors is positioned on a respective one of said catheter segments 7, 9, and is designed to provide, in response to an externally generated magnetic field, an electrical signal representative of the position and orientation of the respective catheter segment.
  • This catheter can be used for endovascular surgery, which is a "minimally invasive" method used for the repair of vessels without surgical isolation of the artery concerned.
  • This surgical procedure is performed endoluminally, using the lumen of the artery itself for access to the lesions, this lumen being reached by the cannulation of a peripheral artery (the femoral or axillary artery) which can be accessed in local anaesthesia by a transcutaneous puncture or mini-incision and through which are inserted the guide wires, catheters and prostheses (endoprostheses) which are guided under fluoroscopic control to reach the target lesion.
  • a peripheral artery the femoral or axillary artery
  • the catheter according to the invention can be used for the provision of a computerized intraoperative assistance system for endovascular surgery, and in particular for the provision of a navigator based on the electromagnetic location of the surgical instruments.
  • the principle of electromagnetic location is based on the use of electromagnetic coils which, when connected to a field generator, supply information concerning their position and orientation in space.
  • Each of the electromagnetic position sensors 17, 19 of the catheter 1 is preferably a five- degrees-of-freedom sensor comprising a single solenoid coil. These sensors can be used to determine in a precise manner their position in space (more specifically, the position of the centre of each coil) and the direction of their longitudinal axis. Their orientation is therefore defined by means of the rotation about this axis.
  • each of the electromagnetic position sensors of the catheters could be a six-degrees-of- freedom sensor, comprising two or more connected coils. These sensors supply all the information required to identify both their position and their orientation in space, namely three degrees of translation and three degrees of rotation.
  • Each of the sensors 17, 19 of the catheter 1 has an body which is essentially needle-shaped, in other words straight and elongate in form, and has a longitudinal axis placed parallel to the longitudinal axis of the respective catheter segment.
  • An example of a commercial electromagnetic sensor which can be used in the present invention is the NDI Aurora® five-degrees-of-freedom sensor produced by Northern Digital Inc., which has extremely compact dimensions (0.5 mm in diameter x 8 mm in length).
  • An NDI Aurora® sensor with six degrees of freedom has dimensions of 1.8 mm in diameter and 9 mm in length. The overall dimensions of the sensors can therefore be reduced by selecting coils with five degrees of freedom. These sensors have smaller dimensions than those of the six-degrees- of-freedom sensors, and are therefore preferable for use in the production of minimally invasive sensorized catheters and guide wires, within the size limits of standard endovascular instruments.
  • Each sensor 17, 19 is positioned at the wall of the corresponding catheter segment, eccentrically relative to the longitudinal axis of the segment.
  • the sensor can be positioned on the radially outer surface of this wall, as in the illustrated example, or within the thickness of the wall.
  • the electromagnetic position sensors 17, 19 are all positioned coplanarly with each other.
  • the specific arrangement of the sensors described above enables the overall dimensions to be reduced to a minimum, while also enabling the position and orientation of different "segments" of the catheter to be detected at the location of each sensor.
  • the term "segment” signifies any portion of a catheter in which there is an intrinsic direction of the tangent to the longitudinal axis of the catheter which differs or can be made to differ from that of another portion of the catheter.
  • the calibration procedure is used to calculate the position and orientation of the centre of the catheter lumen at the location of each sensor, when the positions of the sensors and the orientation of their longitudinal axis (supplied by the location system) are known.
  • this procedure can be used to determine the translations which align the axes of the coil with the axis of the catheter at the location of each sensor.
  • the aforesaid translations can be defined after the identification of the versors orthogonal to the axis of each coil and directed towards the centre of the catheter lumen (indicated by x and 1 ⁇ 2 in Figure 1 ). These versors can be identified by using at least a pair of coils, positioned as shown in Figure 2.
  • the versors and 1 ⁇ 2 which lie on the plane of the two sensors, and which are, respectively, perpendicular to 1 ⁇ 2 and 3 ⁇ 4 (the axes of the first and second coil), can be determined by simple geometrical operations, once the position and orientation of the axes of the two coils are known.
  • the curve of the curved portion 5 lying between the two sensors can finally be estimated by interpolation methods, and consequently the path of the whole distal portion of the catheter can then be determined.
  • Figure 3 shows examples of catheters of different shapes.
  • the first image on the left shows a vertebral catheter; only two sensors are required to reconstruct its curvature.
  • the six central examples represent various types of Simmons catheters, while the last two on the right represent "shepherd's hook" catheters.
  • At least three sensors are required (one for each catheter segment between one curved portion and the next).
  • Figure 4 shows the distal part of a catheter 1 of the type which can be steered by means of wires to vary the curvature of the aforesaid distal part.
  • the catheter segments 7, 9 on which the sensors 17, 19 are positioned are connected by a curvable part 5, the curvature of which is selectively modifiable (into the configuration shown in broken lines, for example) by actuating control means manoeuvred by an operator.
  • Commercially available steerable catheters include designs having a double inner lumen.
  • one of the two lumens can be used to house the electromagnetic sensors without the need for any particular design modifications to the existing steering system or changes in the dimensions of the catheter.
  • the present invention also relates to straight, non-steered catheters. These catheters are known to be flexible, and therefore curvable, so as to be able to adapt to the variations of the body cavity into which they are intended to be introduced.
  • the number 21 indicates the whole of the distal part of an example of a guide wire for guiding the catheter 1.
  • Guide wires are essential instruments for the performance of endovascular procedures: they provide a support for the insertion and manoeuvring of catheters, allow access and passage through lesions, and provide a support for catheters used for interventions.
  • a guide wire must have a flexible and non-injurious tip and a more rigid body which imparts manoeuvrability (or "pushability" of the guide wire) to the instrument.
  • the guide wire 21 shown in Figure 5 has a tubular body 23 of flexible material, such as Nitinol, within which is positioned a reinforcing tubular core 25, made of medical stainless steel for example. At its distal end, the guide wire 21 is free of the tubular core 25, in order to enable an electromagnetic position sensor 27 to be housed.
  • the electrical output cable sensor to external processing means (not shown).
  • the sensor 27 is positioned on the tip of the guide wire 21, and is designed to provide, in response to an externally generated magnetic field, an electrical signal representative of the position and orientation of the tip of the guide wire.
  • the electromagnetic position sensor 27 of the guide wire 21 has a substantially needle-shaped body, in other words a body of straight and elongate shape, and has a longitudinal axis placed in alignment with the longitudinal axis of the guide wire.
  • the electromagnetic position sensor 27 of the guide wire 21 is a five-degrees- of-freedom sensor, comprising a single solenoid coil.
  • the sensorized guide wire used in combination with the sensorized catheter described above during computer-assisted navigation, can provide all the functions required for the performance of complete endovascular procedures (identification of the distal portion of the catheter and of the distal portion of the guide wire).
  • the information supplied by a single five-degrees-of-freedom sensor, positioned on the axis of the guide wire as shown in Figure 5, is sufficient to describe the position and orientation of the distal end of the guide wire.
  • this arrangement optimizes the overall dimensions of the sensor system while keeping within the dimensional limits of standard endovascular instruments. Secondly, the mechanical characteristics of the guide wire are not compromised by any excessive stiffening of its structure due to multiple sensors and corresponding cables to be housed within it, arid finally the costs are also reduced.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Robotics (AREA)
  • Human Computer Interaction (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention porte sur un cathéter (1) qui comprend un corps tubulaire (3) destiné à être introduit dans une cavité corporelle, et une pluralité de capteurs de position électromagnétiques (17, 19), chacun d'entre eux étant positionné sur un segment respectif desdits segments de cathéter (7, 9), et étant conçu pour générer, en réponse à un champ magnétique généré extérieurement, un signal électrique représentatif de la position et de l'orientation du segment de cathéter respectif. Chacun desdits capteurs de position électromagnétiques présente un corps sensiblement en forme d'aiguille ayant un axe longitudinal situé parallèlement à l'axe longitudinal du segment de cathéter respectif, et est disposé au niveau de la paroi du segment de cathéter respectif, de façon excentrée par rapport à l'axe longitudinal de celui-ci.
EP12729203.5A 2011-05-05 2012-05-03 Cathéter à capteurs de position électromagnétiques, système de localisation, cathéters, et fils de guidage Withdrawn EP2704631A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT000394A ITTO20110394A1 (it) 2011-05-05 2011-05-05 Catetere munito di sensori elettromagnetici di posizione, e sistema di localizzazione per cateteri e fili guida
PCT/IB2012/052219 WO2012150567A1 (fr) 2011-05-05 2012-05-03 Cathéter à capteurs de position électromagnétiques, système de localisation, cathéters, et fils de guidage

Publications (1)

Publication Number Publication Date
EP2704631A1 true EP2704631A1 (fr) 2014-03-12

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP12729203.5A Withdrawn EP2704631A1 (fr) 2011-05-05 2012-05-03 Cathéter à capteurs de position électromagnétiques, système de localisation, cathéters, et fils de guidage

Country Status (3)

Country Link
EP (1) EP2704631A1 (fr)
IT (1) ITTO20110394A1 (fr)
WO (1) WO2012150567A1 (fr)

Families Citing this family (91)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10835307B2 (en) 2001-06-12 2020-11-17 Ethicon Llc Modular battery powered handheld surgical instrument containing elongated multi-layered shaft
US9089360B2 (en) 2008-08-06 2015-07-28 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
US8663220B2 (en) 2009-07-15 2014-03-04 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US11090104B2 (en) 2009-10-09 2021-08-17 Cilag Gmbh International Surgical generator for ultrasonic and electrosurgical devices
US8956349B2 (en) 2009-10-09 2015-02-17 Ethicon Endo-Surgery, Inc. Surgical generator for ultrasonic and electrosurgical devices
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US8469981B2 (en) 2010-02-11 2013-06-25 Ethicon Endo-Surgery, Inc. Rotatable cutting implement arrangements for ultrasonic surgical instruments
US8795327B2 (en) 2010-07-22 2014-08-05 Ethicon Endo-Surgery, Inc. Electrosurgical instrument with separate closure and cutting members
US9192431B2 (en) 2010-07-23 2015-11-24 Ethicon Endo-Surgery, Inc. Electrosurgical cutting and sealing instrument
US9259265B2 (en) 2011-07-22 2016-02-16 Ethicon Endo-Surgery, Llc Surgical instruments for tensioning tissue
WO2013119545A1 (fr) 2012-02-10 2013-08-15 Ethicon-Endo Surgery, Inc. Instrument chirurgical robotisé
US9439668B2 (en) 2012-04-09 2016-09-13 Ethicon Endo-Surgery, Llc Switch arrangements for ultrasonic surgical instruments
US20140005705A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Surgical instruments with articulating shafts
US9226767B2 (en) 2012-06-29 2016-01-05 Ethicon Endo-Surgery, Inc. Closed feedback control for electrosurgical device
US20140005702A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments with distally positioned transducers
US9326788B2 (en) 2012-06-29 2016-05-03 Ethicon Endo-Surgery, Llc Lockout mechanism for use with robotic electrosurgical device
US9393037B2 (en) 2012-06-29 2016-07-19 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9198714B2 (en) 2012-06-29 2015-12-01 Ethicon Endo-Surgery, Inc. Haptic feedback devices for surgical robot
US9408622B2 (en) 2012-06-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9351754B2 (en) 2012-06-29 2016-05-31 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments with distally positioned jaw assemblies
BR112015007010B1 (pt) 2012-09-28 2022-05-31 Ethicon Endo-Surgery, Inc Atuador de extremidade
US9095367B2 (en) 2012-10-22 2015-08-04 Ethicon Endo-Surgery, Inc. Flexible harmonic waveguides/blades for surgical instruments
US20140135804A1 (en) 2012-11-15 2014-05-15 Ethicon Endo-Surgery, Inc. Ultrasonic and electrosurgical devices
US9204841B2 (en) 2012-12-31 2015-12-08 Biosense Webster (Israel) Ltd. Catheter with serially connected sensing structures and methods of calibration and detection
US9204820B2 (en) 2012-12-31 2015-12-08 Biosense Webster (Israel) Ltd. Catheter with combined position and pressure sensing structures
US9814514B2 (en) 2013-09-13 2017-11-14 Ethicon Llc Electrosurgical (RF) medical instruments for cutting and coagulating tissue
DE102013222230A1 (de) 2013-10-31 2015-04-30 Fiagon Gmbh Chirurgisches Instrument
US9265926B2 (en) 2013-11-08 2016-02-23 Ethicon Endo-Surgery, Llc Electrosurgical devices
GB2521228A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
US9795436B2 (en) 2014-01-07 2017-10-24 Ethicon Llc Harvesting energy from a surgical generator
US9554854B2 (en) 2014-03-18 2017-01-31 Ethicon Endo-Surgery, Llc Detecting short circuits in electrosurgical medical devices
US10463421B2 (en) 2014-03-27 2019-11-05 Ethicon Llc Two stage trigger, clamp and cut bipolar vessel sealer
US10092310B2 (en) 2014-03-27 2018-10-09 Ethicon Llc Electrosurgical devices
US9737355B2 (en) 2014-03-31 2017-08-22 Ethicon Llc Controlling impedance rise in electrosurgical medical devices
US9913680B2 (en) 2014-04-15 2018-03-13 Ethicon Llc Software algorithms for electrosurgical instruments
DE102014110457A1 (de) 2014-07-24 2016-01-28 Biotronik Ag Kathetersystem zur Implantation eines Körperteilersatzes und Verfahren zur Positionsbestimmung desselben
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
US10639092B2 (en) 2014-12-08 2020-05-05 Ethicon Llc Electrode configurations for surgical instruments
US10245095B2 (en) 2015-02-06 2019-04-02 Ethicon Llc Electrosurgical instrument with rotation and articulation mechanisms
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US11051873B2 (en) 2015-06-30 2021-07-06 Cilag Gmbh International Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters
US10898256B2 (en) 2015-06-30 2021-01-26 Ethicon Llc Surgical system with user adaptable techniques based on tissue impedance
US11129669B2 (en) 2015-06-30 2021-09-28 Cilag Gmbh International Surgical system with user adaptable techniques based on tissue type
US11141213B2 (en) 2015-06-30 2021-10-12 Cilag Gmbh International Surgical instrument with user adaptable techniques
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US10194973B2 (en) 2015-09-30 2019-02-05 Ethicon Llc Generator for digitally generating electrical signal waveforms for electrosurgical and ultrasonic surgical instruments
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
US11129670B2 (en) 2016-01-15 2021-09-28 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization
US10779849B2 (en) 2016-01-15 2020-09-22 Ethicon Llc Modular battery powered handheld surgical instrument with voltage sag resistant battery pack
US11229471B2 (en) 2016-01-15 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization
US10716615B2 (en) 2016-01-15 2020-07-21 Ethicon Llc Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade
US10555769B2 (en) 2016-02-22 2020-02-11 Ethicon Llc Flexible circuits for electrosurgical instrument
US10646269B2 (en) 2016-04-29 2020-05-12 Ethicon Llc Non-linear jaw gap for electrosurgical instruments
US10485607B2 (en) 2016-04-29 2019-11-26 Ethicon Llc Jaw structure with distal closure for electrosurgical instruments
US10702329B2 (en) 2016-04-29 2020-07-07 Ethicon Llc Jaw structure with distal post for electrosurgical instruments
US10456193B2 (en) 2016-05-03 2019-10-29 Ethicon Llc Medical device with a bilateral jaw configuration for nerve stimulation
US10376305B2 (en) 2016-08-05 2019-08-13 Ethicon Llc Methods and systems for advanced harmonic energy
US11266430B2 (en) 2016-11-29 2022-03-08 Cilag Gmbh International End effector control and calibration
US20210259769A1 (en) * 2018-08-17 2021-08-26 St. Jude Medical, Cardiology Division, Inc. Optical balloon catheters and methods for mapping and ablation
EP3719749A1 (fr) 2019-04-03 2020-10-07 Fiagon AG Medical Technologies Procédé et configuration d'enregistrement
KR20220004073A (ko) 2019-05-02 2022-01-11 인터섹트 엔트 인터내셔널 게엠베하 센서 캐리어
US11779329B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Surgical instrument comprising a flex circuit including a sensor system
US11660089B2 (en) 2019-12-30 2023-05-30 Cilag Gmbh International Surgical instrument comprising a sensing system
US12082808B2 (en) 2019-12-30 2024-09-10 Cilag Gmbh International Surgical instrument comprising a control system responsive to software configurations
US12023086B2 (en) 2019-12-30 2024-07-02 Cilag Gmbh International Electrosurgical instrument for delivering blended energy modalities to tissue
US11452525B2 (en) 2019-12-30 2022-09-27 Cilag Gmbh International Surgical instrument comprising an adjustment system
US11937863B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Deflectable electrode with variable compression bias along the length of the deflectable electrode
US11684412B2 (en) 2019-12-30 2023-06-27 Cilag Gmbh International Surgical instrument with rotatable and articulatable surgical end effector
US11986201B2 (en) 2019-12-30 2024-05-21 Cilag Gmbh International Method for operating a surgical instrument
US12076006B2 (en) 2019-12-30 2024-09-03 Cilag Gmbh International Surgical instrument comprising an orientation detection system
US11786291B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Deflectable support of RF energy electrode with respect to opposing ultrasonic blade
US11950797B2 (en) 2019-12-30 2024-04-09 Cilag Gmbh International Deflectable electrode with higher distal bias relative to proximal bias
US11944366B2 (en) 2019-12-30 2024-04-02 Cilag Gmbh International Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode
US11759251B2 (en) 2019-12-30 2023-09-19 Cilag Gmbh International Control program adaptation based on device status and user input
US20210196357A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instrument with asynchronous energizing electrodes
US11812957B2 (en) 2019-12-30 2023-11-14 Cilag Gmbh International Surgical instrument comprising a signal interference resolution system
US11911063B2 (en) 2019-12-30 2024-02-27 Cilag Gmbh International Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade
US20210196359A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instruments with electrodes having energy focusing features
US12064109B2 (en) 2019-12-30 2024-08-20 Cilag Gmbh International Surgical instrument comprising a feedback control circuit
US11696776B2 (en) 2019-12-30 2023-07-11 Cilag Gmbh International Articulatable surgical instrument
US11937866B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Method for an electrosurgical procedure
US12053224B2 (en) 2019-12-30 2024-08-06 Cilag Gmbh International Variation in electrode parameters and deflectable electrode to modify energy density and tissue interaction
US11779387B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Clamp arm jaw to minimize tissue sticking and improve tissue control
CN115212434A (zh) * 2021-04-15 2022-10-21 上海微创电生理医疗科技股份有限公司 一种医疗导管及三维磁定位系统
EP4193908A1 (fr) 2021-12-08 2023-06-14 Koninklijke Philips N.V. Amélioration de mappage d'une cavité anatomique et/ou de suivi d'emplacement dans la cavité anatomique
EP4198998A1 (fr) 2021-12-17 2023-06-21 Koninklijke Philips N.V. Aide à l'analyse d'un élément anatomique d'un sujet
EP4202846A1 (fr) 2021-12-23 2023-06-28 Koninklijke Philips N.V. Modélisation 3d adaptative d'une cavité anatomique

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6443974B1 (en) * 1996-07-28 2002-09-03 Biosense, Inc. Electromagnetic cardiac biostimulation
WO2005067563A2 (fr) * 2004-01-12 2005-07-28 Calypso Medical Technologies, Inc. Instruments munis de marqueurs de position et procede de reperage d'instruments presents dans des passages anatomiques
US8535308B2 (en) * 2007-10-08 2013-09-17 Biosense Webster (Israel), Ltd. High-sensitivity pressure-sensing probe
WO2009069395A1 (fr) * 2007-11-29 2009-06-04 Olympus Medical Systems Corp. Dispositif de commande de courbure d'endoscope et système d'endoscope
US8611984B2 (en) 2009-04-08 2013-12-17 Covidien Lp Locatable catheter

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2012150567A1 *

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