US20100133320A1 - Surgical Stapling Instrument - Google Patents

Surgical Stapling Instrument Download PDF

Info

Publication number
US20100133320A1
US20100133320A1 US12/699,910 US69991010A US2010133320A1 US 20100133320 A1 US20100133320 A1 US 20100133320A1 US 69991010 A US69991010 A US 69991010A US 2010133320 A1 US2010133320 A1 US 2010133320A1
Authority
US
United States
Prior art keywords
stapling instrument
anvil
device
characterized
staple
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.)
Abandoned
Application number
US12/699,910
Inventor
Federico Bilotti
Michele D'Arcangelo
Antonio Longo
Jesse J. Kuhns
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.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
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
Priority to PCT/EP2004/010138 priority Critical patent/WO2006027014A1/en
Priority to US66210507A priority
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Priority to US12/699,910 priority patent/US20100133320A1/en
Publication of US20100133320A1 publication Critical patent/US20100133320A1/en
Assigned to ETHICON ENDO-SURGERY, INC. reassignment ETHICON ENDO-SURGERY, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: D'ARCANGELO, MICHELE, KUHNS, JESSE J., BILOTTI, FEDERICO, LONGO, ANTONIO
Application status is Abandoned legal-status Critical

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/00131Accessories for endoscopes
    • A61B1/0014Fastening elements for attaching accessories to the outside of an endoscope shaft, e.g. clips, clamps or bands
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00296Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07221Stapler heads curved
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/0725Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2905Details of shaft flexible

Abstract

A surgical stapling instrument (1) comprises a staple fastening assembly (2) including a curved cartridge device (10) and a curved anvil (12). The cartridge device (10) comprises at least one curved open row of staples which are formed by a staple forming face of the anvil (12). The anvil (12) can be moved relatively with respect to the cartridge device (10). A handle (4) in the proximal end region of the instrument is operatively connected to the staple fastening assembly (2). A flexible backbone, preferably an endoscope (6), is arranged between the handle (4) and the staple fastening assembly (2) and guides force transmitters (8, 9) of the moving device and the staple driving device.

Description

    REFERENCE TO RELATED APPLICATIONS
  • This continuation application claims the benefit of U.S. patent application Ser. No. 11/662,105 entitled: “Surgical Stapling Instrument”, filed on Jul. 9, 2007. Which is a 371 of PCT/EP2004/010138, filed on Oct. 9, 2004.
  • The invention relates to a surgical stapling instrument, which can be used, e.g., in the diagnosis and/or therapy of pathologies of the lower gastrointestinal tract.
  • Such a surgical stapling instrument is known from WO 01/91646 A1. WO 01/91646 A1 discloses a surgical stapling instrument having a staple fastening assembly located in the distal end region of the stapling instrument, a rigid shaft, and a handle extending from the shaft in the proximal end region of the stapling instrument. The staple fastening assembly includes a curved cartridge device, which comprises several curved open rows of staples having a concave side and a convex side. A curved anvil is arranged opposite to the cartridge device. The anvil has a staple forming face and is adapted to cooperate with the cartridge device for forming the ends of the staples exiting from the cartridge device. The anvil can be moved relatively with respect to the cartridge device from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue. Moreover, a knife is contained in the cartridge device and is positioned on the concave side of at least one row of staples and optionally the convex side of at least one row of staples.
  • The surgical stapling instrument disclosed in WO 01/91646 A1 can be used to excise tissue, e.g. polyps, and to stop bleeding virtually immediately. In a surgical procedure, the stapling instrument is introduced, e.g., into the anal canal and moved to the site of the tissue to be resected. The tissue to be excised can be pulled into the area between the anvil and the cartridge device, when the cartridge device and the anvil are in a spaced or open position, by means of a separate tissue grasping instrument. Afterwards, the anvil is moved relatively with respect to the cartridge device in order to clamp the tissue. When the cartridge device and the anvil have reached the closed position, the surgeon can “fire” the instrument, which means that the staples are driven out of the cartridge device, penetrate the tissue, whereupon the ends are bent by the anvil, and the knife is moved towards the anvil in order to cut the tissue. When the instrument is opened, the completely excised tissue can be safely removed from the patient's body together with or prior to removing the instrument itself
  • A particular advantage of the surgical stapling instrument disclosed in WO 01/91646 A1 is the shape of the staple fastening assembly in which the cartridge device and the anvil have a generally arc-like shape in a cross-sectional plane. This allows for unobstructed view and access towards the concave inner faces of the cartridge device and of the anvil.
  • When introduced, e.g., into the anal canal, the operational range of the instrument known from WO 01/91646 A1 is restricted, however, and it cannot be used to excise tissue more remote from the rectum because of its limited shaft length.
  • It is the object of the invention to provide a surgical stapling instrument which has at least two major benefits, i.e. a larger operational range than the stapling instrument disclosed in WO 01/91646 A1 and the ability of being used by gastroenterologists (e.g. GI) in a colonoscopy setting thanks to the possibility to provide the stapling instrument in a size noticeable smaller than the one disclosed in the stapling instrument of WO 01/91646 A1.
  • This problem is solved by a surgical stapling instrument having the features of claim 1. Advantageous versions of the invention follow from the dependent claims.
  • The surgical stapling instrument according to the invention comprises, in the distal end region of the instrument, a staple fastening assembly including a curved cartridge device and, opposite to the cartridge device, a curved anvil. The cartridge device comprises at least one curved open row of staples having a concave side and a convex side. The anvil has a staple forming face and is adapted to cooperate with the cartridge device for forming the ends of the staples exiting from the cartridge device. Moreover, a moving device is adapted to move the anvil relatively with respect to the cartridge device, essentially in parallel relationship, from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue. A staple driving device is adapted to drive the staples out of the cartridge device towards the anvil. In the proximal end region of the instrument, a handle is operatively connected to the staple fastening assembly and comprises actuating members coupled to force transmitters of the moving device and of the staple driving device.
  • Optionally, the stapling instrument includes a knife, which is contained in the cartridge device and which is positioned on the concave side of at least one row of staples and possibly the convex side of at least one row of staples. The knife can be moved towards the anvil by means of a knife actuating device, which is preferably coupled to the staple driving device, e.g. such that, upon actuation of the actuating member of the staple driving device, the staples and the knife advance simultaneously, the knife following the staples such that the tissue is cut after having been stapled.
  • According to the invention, a flexible backbone is arranged between the handle and the staple fastening assembly. The flexible backbone is a kind of flexible shaft or flexible connection between the handle and the staple fastening assembly and guides the force transmitters of the moving device and of the staple driving device. The flexible backbone can be rather long. It enables the stapling instrument to be introduced, e.g., into the anal canal and to be moved forward for a rather long distance to allow for the treatment of tissue at a site remote from the anus. Upon advancement of the stapling instrument, the flexible backbone adapts to the curvature of the intestine.
  • In a preferred version of the invention, the flexible backbone comprises a flexible endoscope, which preferably is removably mounted (i.e. it can be detached from the rest of the instrument). The endoscope usually includes observational optics and a light source and optionally comprises a working channel in its longitudinal direction. The working channel can be utilized to place surgical tools at the site of surgery, e.g. an endoscopic gripping instrument for pulling tissue into the space between the cartridge device and the anvil. The application of a flexible endoscope in the backbone of the stapling instrument has the advantage that a standard component is used which can provide flexibility as well as strength to the stapling instrument.
  • The stapling instrument can be adapted to be used with an independent flexible endoscope forming at least part of the flexible backbone. That means, the stapling instrument according to the invention is distributed without the endoscope, and in order to put it into an operational state, the independently or separately distributed endoscope is connected to the other parts of the instrument. Alternatively, the flexible endoscope is a component or even an integral component of the stapling instrument. These options allow for a large design versatility and cost effectiveness.
  • In an advantageous version of the invention, the force transmitters of the moving device and of the staple driving device are located at the outside of the endoscope and are attached to the endoscope by a plurality of spaced holders. If the knife actuating device has an independent actuating member at the handle, a force transmitter of the knife actuating device can be arranged at the outside of the endoscope as well. This design uses the endoscope as the only structural connection between the handle and the staple fastening assembly and is particularly simple.
  • In another version, the flexible backbone comprises a flexible guide, which is arranged alongside the endoscope and which accommodates the force transmitters of the moving device and of the staple driving device. The guide, depending on its design, can connect the handle and the staple fastening assembly in a structural sense.
  • In a preferred version of the invention, at least one of the force transmitters of the moving device and of the staple driving device comprises a flexible rotary rod adapted to be rotated around its longitudinal axis upon actuation of the related actuating member of the handle and adapted to transform its rotary motion to a longitudinal motion at the staple fastening assembly. The term flexible rod is to be understood in a rather broad sense; it includes, e.g., a tightly wound helix, which is flexible and can transmit torque, and even designs comprising linked members. When force is transmitted from the actuating member at the handle to the staple fastening assembly via a rotary motion, the actual curved shape of the flexible backbone is not affected by this rotary action in which the rotary rod rotates in some guide or sheath. In contrast thereto, a translational movement of force transmitters in a curved flexible shaft tends to straighten the shaft, which would be a great disadvantage in the use of such instrument.
  • Preferably, at least one of the force transmitters is adapted to be rotated via a gear transmission operated by the related actuating member. Moreover, at least one of the force transmitters can be adapted to transform its rotary motion to a longitudinal motion (required for the relative movement of the anvil with respect to the cartridge device or for expelling the staples) via a screw drive.
  • The staple forming face of the anvil can be generally planar, but other shapes, e.g. an undulated shape, are conceivable as well.
  • In an advantageous version of the invention, the staple fastening assembly is adapted to allow unobstructed access towards concave inner faces of the cartridge device and of the anvil. Such design, which is generally known from WO 01/91646 A1, largely facilitates the handling of the stapling instrument in a surgical procedure.
  • Preferably, the cartridge device and the anvil have a generally arc-like shape in a cross-sectional plane, the arc extending over an angle in the range 10° to 350°.
  • In a preferred version of the invention, the anvil is supported by means of at least one arm extending from an end of the anvil and generally running in parallel to the direction of relative movement of the anvil with respect to the cartridge device. This arm can be driven by the moving device if the anvil is movable with respect to a fixed cartridge device. An optional second arm, preferably at the other end of the anvil, provides additional strength and facilitates an accurate alignment of the anvil with respect to the cartridge device, which is important for a precise alignment of the ends of the staples with the staple forming face of the anvil. This kind of support allows for a large unobstructed area between the cartridge device and the anvil.
  • Preferably, the distance between the cartridge device and the anvil in the closed position is adjustable. For example, the moving device can comprise an adjustable stop, e.g. at the related actuating member of the handle, in order to prevent the cartridge device (or anvil) from moving beyond the stop position and from clamping the tissue too much. Or a series of cartridge devices with different built-in tissue stops can be used according to the tissue thickness. It is also conceivable to use a series of cartridge devices which have different longitudinal dimensions which are adapted to the desired distance between the cartridge device and the anvil in the closed position. By adjusting the distance between the cartridge device and the anvil in the closed position, the instrument can be matched to the thickness and type of tissue to be stapled.
  • In an advantageous version of the surgical stapling instrument, the cartridge device comprises a replaceable cartridge containing the staples. In this way, a used cartridge without staples can be replaced with a fresh one, if required. This is particularly beneficial when the instrument is to be used several times in the same patient.
  • Preferably, the staple fastening assembly and/or the handle are removably mounted, relative to the flexible backbone, which allows for easier handling and/or partial replacement of the stapling instrument.
  • Some of the features discussed above are already known from WO 01/91646 A1, in particular an arc-like shape of the cartridge device and the anvil and a support arm extending from an end of the anvil, which enables an easy access to the site of surgery, e.g., for endoscopic optics or additional surgical instruments. Generally, the stapling instrument according to the invention can be used in all kinds of surgery disclosed in WO 01/91646 A1, which is incorporated by reference herein. A particular advantage of the invention, however, is the ability to perform such surgery at locations more remote from an opening in the patient's body and using GI techniques (e.g. non-surgical), such as local anesthesia or sedation.
  • Herein, the term “staple” is used in a very general sense. It includes metal staples or clips, but also surgical fasteners made of synthetic material and similar fasteners. Synthetic fasteners usually have a counterpart (retainer member) held at the anvil. In this sense, the terms “anvil” and “staple forming face” also have a broad meaning which includes, in the case of two-part synthetic fasteners, the anvil-like tool and its face where the retainer members are held, and similar devices.
  • In the following, the invention is described in more detail by means of embodiments. The drawings show in
  • FIG. 1 an overall isometric view of a first embodiment of the surgical stapling instrument according to the invention, including an endoscope, a staple fastening assembly in the distal end region and a handle in the proximal end region,
  • FIG. 2 an isometric view of the distal portion of the stapling instrument of FIG. 1,
  • FIG. 3 an isometric view of one of several holders spaced along the endoscope,
  • FIG. 4 an isometric view of the internal mechanism of the handle,
  • FIG. 5 a side view of the internal mechanism of the handle,
  • FIG. 6 an isometric view of the distal end of the endoscope, the staple fastening assembly being removed,
  • FIG. 7 an isometric view of the components of the staple fastening assembly driven by the mechanism in the handle, i.e. an arm supporting the anvil and a pusher base used for expelling the staples,
  • FIG. 8 an isometric view similar to FIG. 7, with the staples and a knife added,
  • FIG. 9 an isometric view of some parts of FIG. 8 in a different perspective,
  • FIG. 10 an isometric view of the staple forming face of the anvil and two guide rails used for guiding the knife,
  • FIG. 11 an isometric view of the fully assembled staple fastening assembly with the anvil being in a spaced position,
  • FIG. 12 an isometric view of the staple fastening assembly, a housing being removed, with the anvil being in a closed position and the staples just fired,
  • FIG. 13 an isometric view of parts of FIG. 12 from a different perspective,
  • FIG. 14 an isometric view similar to FIG. 12 with the housing being attached and including the endoscope,
  • FIG. 15 an exploded view of the staple fastening assembly,
  • FIG. 16 an isometric overall view of a second embodiment of the surgical stapling instrument according to the invention, including a flexible guide and an endoscope, and
  • FIG. 17 an isometric view of the distal end region of the embodiment of FIG. 16.
  • FIG. 1 is an isometric overall view of the surgical stapling instrument 1 according to a first embodiment. The stapling instrument 1 comprises, in its distal end region, a stapling fastening assembly 2 and, in its proximal end region, a handle 4. The handle 4 and the staple fastening assembly 2 are connected via a flexible endoscope 6. In the embodiment, the endoscope 6 is a commercially available endoscope which is not modified in order to be used in the stapling instrument. The endoscope 6 serves as a flexible backbone and provides structural strength.
  • As shown in FIGS. 1 and 2, two force transmitters 8 and 9 running from the handle 4 to the staple fastening assembly 2 are guided by the endoscope 6. The force transmitters are used for transmitting forces from the handle 4 to the staple fastening assembly 2 in order to perform the functions of the stapling instrument 1.
  • The main components of the staple fastening assembly 2 are a cartridge device 10, which contains several curved open rows of staples as well as a knife, and a curved anvil 12, which has a staple forming face and is adapted to cooperate with the cartridge device for forming the ends of the staples expelled from the cartridge device when stapling instrument 1 is “fired”.
  • The anvil 12 can be moved with respect to the cartridge device 10 in a parallel relationship, i.e. in a direction parallel to the longitudinal axis of the distal end portion of the endoscope 6. In the view of FIG. 2, the anvil 12 has been entirely moved towards the cartridge device 10.
  • The mechanism and its components of the stapling instrument 1 used for moving anvil 12 relative to cartridge device 10 are generally called moving device, whereas the mechanism and the components used for advancing the staples are generally called staple driving device.
  • FIG. 2 illustrates that the cartridge device 10 and the anvil 12 have a generally arc-like shape. This design enables an easy access to the working area between cartridge device 10 and anvil 12.
  • Moreover, FIG. 2 illustrates the arrangement of the distal portion of the endoscope 6 and the staple fastening assembly 2. The distal end face of endoscope 6 has two openings, one for observational optics 14 and one for a light source 15. Optionally, the endoscope can include a working channel which allows the introduction of a surgical instrument having a flexible shaft through the working channel of the endoscope to the site of surgery, i.e. to the area of the staple fastening assembly 2.
  • In the embodiment, the force transmitters 8 and 9 are attached to the endoscope 6 by means of a plurality of spaced holders 16. FIG. 3 shows one of the holders 16 in enlarged view. Each holder 16 has a lock 17 and two recesses 18 and 19 for accommodating the force transmitters 8 and 9, respectively. For assemblage, the lock 17, which comprises a dovetail-shaped protrusion and a notch fitting thereto, can be opened. The holder 16, which is manufactured from flexible material, allows the insertion of the endoscope 6.
  • The mechanical connection between the endoscope 6 and the staple fastening assembly 2 or the handle 4 can be entirely accomplished by means of the holders 16 and the force transmitters 8, 9. In particular in the area of handle 4, the flexibility of this design, with no rigid attachment of the handle 4 to the endoscope 6, can be advantageous. In the distal end region of stapling instrument 1, the endoscope 6 may be additionally fixed to the cartridge device 10 of the staple fastening assembly 2, e.g. by bonding.
  • FIGS. 4 and 5 illustrate the internal mechanism of the handle 4. Handle 4 comprises a grip 20 designed to rest in the operator's palm and a gear housing 22.
  • An actuating member 24 is part of the moving device. When actuating member 24, which is swivellably mounted, is moved towards grip 20, a rack 26 shifts in distal direction and rotates gears 28. The direction of the rotational axis is changed by 90° by means of a pinion 29 at the proximal end of a bearing 30, which supports the proximal end of the force transmitter 8 of the moving device. The force transmitter 8 comprises a rotary rod (see below), the proximal end of which is fixed to pinion 29. Thus, upon pressing the actuating member 24, the rotary rod of the force transmitter 8 is caused to a rotary movement about a longitudinal axis. Because of the gear ratio provided by gears 28 and pinion 29, this rotational movement is relatively fast.
  • In a similar way, upon pressing a swivellably mounted actuating member 32 against the force of a spring 33 (“firing” the instrument), a rack 34 shifts in distal direction and drives gears 36 and a pinion 37 at the proximal end of a bearing 38, which results in a relatively fast rotational movement of a rotary rod of the force transmitter 9 of the staple driving device.
  • In order to release (retract) the staple driving device after the staples have been “fired”, a release button 40 has to be pressed against the force exerted by a spring 41. After “firing” and before pressing release button 40, a catch 42 engages to a protrusion of the staple driving device and keeps rack 34 in a distal position. Moreover, rack 26 is held forward and in place by this mechanism as well, while actuating member 32 is pressed. Pressing release button 40 lifts the catch 42, which releases the protrusion of the staple driving device such that, via the action of spring 33, rack 34 returns to its original proximal position.
  • A safety feature (not shown in detail) is a pin held by a part 44 until part 44 is pushed out of the way upon actuation of actuating member 24. This ensures that actuating member 32 cannot be used prior to actuating member 24.
  • FIG. 6 shows the distal end region of the force transmitters 8 of the moving device and 9 of the staple driving device, including the most distal holder 16 and the distal end area of endoscope 6.
  • Force transmitter 8 comprises a flexible rotary rod 50 which is rotatably mounted in a flexible sheath 51. In the embodiment, rotary rod 50 is a single flexible structure all along. Different designs, e.g. a structure comprising flexibly linked short rigid members or a tightly wound helix, are conceivable as well. At its distal end, rotary rod 50 is fixed to a connector 52 which is attached to the proximal end of a drive screw 53. In a similar way, force transmitter 9 includes a rotary rod 54, which is guided in a sheath 55 and ends at a connector 56 fixed to a drive screw 57.
  • FIG. 7 displays the components driven by the screws 53 and 57, but not yet the guiding parts or rails for these components. Screw 53 fits into a threaded hole extending into longitudinal direction inside an arm 60 which supports an anvil housing 62. Similarly, screw 57 fits into a threaded hole in a pusher base 64. Thus, by rotating rotary rods 50 or 54, the arm 60 and the pusher base 64, respectively, are moved in longitudinal direction of the staple fastening assembly 2.
  • FIG. 8 shows additional components of the staple fastening assembly 2. Both screws 53 and 57 are guided by bores in an arcuate base 65 of the staple fastening assembly 2. Pusher base 64 supports (via an intermediate part 67) a pusher platform 66 from which a plurality of pusher fingers 68 extend longitudinally. Each of the pusher fingers 68 supports a staple 70 such that the pointed ends of the staples 70 are aligned in distal direction. The pusher fingers 68 and the related staples 70 are guided in individual slots (not shown in FIG. 8) formed in the housing of the cartridge device 10. Moreover, the intermediate part 67 supports an arcuate knife 72 having a concave side (seen in FIG. 8), a convex side opposite to the concave side and a cutting edge 73. FIG. 8 also shows a guide arm 74 of the anvil 12 which extends from the anvil housing 62 and runs in parallel to arm 60.
  • FIG. 9 provides a better impression of the arrangement of the staples 70 (which are not shown in FIG. 9 but indicated by the locations of the pusher fingers 68) and the knife 72.
  • The cartridge device 10 comprises three curved open rows of staples, i.e. two rows 76 and 77 on the convex side of knife 72 and one row 78 on the concave side of knife 72.
  • A staple forming face 80, which is mounted on the anvil housing 62 (see FIG. 8), is shown in FIG. 10. The staple forming face 80 is preferably made of metal and comprises three rows of staple forming depression 82, which are aligned to the pointed ends of staples 70. Moreover, FIG. 10 displays a knife depression 84, which is aligned to the cutting edge 73 of knife 72 and preferably filled with a plastics material which acts as cutting block but can be cut by the knife 72.
  • Fixed to the staple forming face 80, there are two guide rails 86 and 87 which have a lateral slot each for precisely guiding the knife 72, even when it is very close to the staple forming face 80, as illustrated in FIG. 10. When the anvil 12 is moved with respect to the cartridge device 10 by means of the moving device, the guide rails 86 and 87 move in longitudinal direction as well and slide through holes 88 and 89 (see FIG. 9) provided in the intermediate part 67 and the pusher platform 66. This movement does not affect the position of the knife 72, because knife 72 is fixed to the intermediate part 67.
  • FIG. 11 is a view similar to FIG. 8, but the cartridge device 10 has been completed by a housing 90. In the embodiment, the housing 90 is an injection-molded part made of medical grade plastics material.
  • FIG. 11 illustrates the state in which the anvil 12 has been moved to a spaced position, i.e. to a position in which the distance between the cartridge device 10 and the staple forming face 80 of the anvil 12 is large. This corresponds to a large exposed area of drive screw 53 in FIG. 8.
  • In this spaced position, tissue of a patient to be excised can be pulled between the staple forming face 80 of anvil 12 and the cartridge device 10. Thereafter, actuating member 24 of the moving device is pressed towards grip 20, which causes a rotational movement of rotary rod 50 and drive screw 53, resulting in a shift of the anvil 12 in proximal direction. In this way, the anvil 12 reaches a closed position and the tissue is clamped.
  • The next step of the procedure is shown in FIG. 12 (in which the housing 90 is removed). As explained, the anvil 12 has been moved to a closed position, which is evident from a small exposed area of drive screw 53. Moreover, actuating member 32 has been pressed, which results in a rotational movement of screw 57 and a longitudinal movement in distal direction of the pusher base 64, the intermediate part 67, the pusher platform 66, the pusher fingers 68, the staples 70 and the knife 72, wherein the cutting edge 73 of knife 72 follows the pointed ends of the staples 70. FIG. 12 shows the state when the staples 70 have been formed by staple forming face 80. FIG. 13 displays the same state.
  • FIG. 14 shows a complete view of the cartridge device 10, the anvil 12 and the distal end region of endoscope 6 in the same state. After the tissue has been stapled, it is cut and excised by the knife 72. In this way, the tissue to stay with the patient is safely stapled by the rows 76 and 77 of staples on the convex side of knife 72, which immediately stops bleeding, whereas the part of the tissue to be removed from the patient is stapled and held together by the staples of row 78. After stapling, release button 40 is pressed, such that rack 34 and actuating member 32, by means of the force exerted by spring 33, return to their original positions. Additionally, this effects a reverse motion of the moving device, increasing the distance between the anvil 12 and the cartridge device 10 in order to release the clamped tissue and to be able to remove the stapling instrument 1 from the patient. The excised portion of the tissue remains in the staple fastening assembly 2.
  • FIG. 15 illustrates the components of the staple fastening assembly 2 of the embodiment described so far in an exploded view. Screws 92 and 93 are used to attach the arcuate base 65 to part of the housing 90 of cartridge device 10.
  • FIGS. 16 and 17 display a second embodiment of the surgical stapling instrument, i.e. the stapling instrument 100. Its staple fastening assembly 102 and its handle 104 have a similar design as the staple fastening assembly 2 and the handle 4 of the first embodiment. In contrast thereto, however, the force transmitters are not exposed at the outer periphery of endoscope 106, but are accommodated in a flexible guide 108. The endoscope 106 and the flexible guide 108 form the flexible backbone of stapling instrument 100.
  • In the embodiment, the flexible guide 108 is made of plastics material and comprises two longitudinal channels for guiding rotary rods of the force transmitters of the moving device and of the staple driving device. An open channel 109 longitudinally extends alongside flexible guide 108. The endoscope 106 can rest within open channel 109, as shown in FIGS. 16 and 17.
  • The function and use of the stapling instrument 100 are the same as those of stapling instrument 1.

Claims (17)

1. Surgical stapling instrument comprising:
a staple fastening assembly (2; 102) in the distal end region of the instrument (1; 100), including a curved cartridge device (10), which comprises at least one curved open row (76, 77, 78) of staples (70) having a concave side and a convex side, and, opposite to the cartridge device (10), a curved anvil (12), which has a staple forming face (80) and is adapted to cooperate with the cartridge device (10) for forming the ends of the staples (70) exiting from the cartridge device (10),
a moving device (8, 24, 26, 28, 29, 30, 53, 60) adapted to move the anvil (12) relatively with respect to the cartridge device (10), essentially in parallel relationship, from a spaced position for positioning tissue therebetween to a closed position for clamping the tissue,
a staple driving device (9, 32, 34, 36, 37, 38, 57, 64) adapted to drive the staples (70) out of the cartridge device (10) towards the anvil (12),
a handle (4; 104) in the proximal end region of the instrument (1; 100), which handle (4; 104) is operatively connected to the staple fastening assembly (2; 102) and which comprises actuating members (24, 32) coupled to force transmitters (8, 9) of the moving device and of the staple driving device,
characterized in that a flexible backbone (6; 106, 108) is arranged between the handle (4; 104) and the staple fastening assembly (2; 102), which flexible backbone (6; 106, 108) guides the force transmitters (8, 9) of the moving device and of the staple driving device.
2. Stapling instrument according to claim 1, characterized by
a knife (72), which is contained in the cartridge device (10) and which is positioned on the concave side of at least one row (76, 77) of staples (70), and
a knife actuating device (9, 32, 34, 36, 37, 38, 57, 64) adapted to move the knife (72) towards the anvil (12), which knife actuating device preferably is coupled to the staple driving device.
3. Stapling instrument according to claim 1 or 2, characterized in that the flexible backbone (6; 106, 108) comprises a flexible endoscope (6; 106), which preferably is removably mounted.
4. Stapling instrument according to claim 1 or 2, characterized in that the stapling instrument (1; 100) is adapted to be used with an independent flexible endoscope (6; 106) forming at least part of the flexible backbone (6; 106, 108).
5. Stapling instrument according to claim 3 or 4, characterized in that the force transmitters (8, 9) of the moving device and of the staple driving device are located at the outside of the endoscope (6) and are attached to the endoscope (6) by a plurality of spaced holders (16).
6. Stapling instrument according to claim 3 or 4, characterized in that the flexible backbone (106, 108) comprises a flexible guide (108), which is arranged alongside the endoscope (106) and which accommodates the force transmitters of the moving device and of the staple driving device.
7. Stapling instrument according to one of claims 1 to 6, characterized in that at least one of the force transmitters (8, 9) of the moving device and of the staple driving device comprises a flexible rotary rod (50, 54) adapted to be rotated around its longitudinal axis upon actuation of the related actuating member (24, 32) of the handle (4) and adapted to transform its rotary motion to a longitudinal motion at the staple fastening assembly (2).
8. Stapling instrument according to claim 7, characterized in that the at least one of the force transmitters (8, 9) is adapted to be rotated via a gear transmission (26, 28, 29; 34, 36, 37) operated by the related actuating member (24, 32).
9. Stapling instrument according to claim 7 or 8, characterized in that the at least one of the force transmitters (8, 9) is adapted to transform its rotary motion to a longitudinal motion via a screw drive (53, 57).
10. Stapling instrument according to one of claims 1 to 9, characterized in that the staple fastening assembly (2) is adapted to allow unobstructed access towards concave inner faces of the cartridge device (10) and of the anvil (12).
11. Stapling instrument according to one of claims 1 to 10, characterized in that the staple forming face (80) of the anvil (12) is generally planar.
12. Stapling instrument according to one of claims 1 to 11, characterized in that the cartridge device (10) and the anvil (12) have a generally arc-like shape in a cross-sectional plane, the arc extending over an angle in the range 10° to 350°.
13. Stapling instrument according to one of claims 1 to 12, characterized in that the anvil (12) is supported by means of at least one arm (60, 74) extending from an end of the anvil (12) and generally running in parallel to the direction of relative movement of the anvil (12) with respect to the cartridge device (10).
14. Stapling instrument according to one of claims 1 to 13, characterized in that the distance between the cartridge device (10) and the anvil (12) in the closed position is adjustable.
15. Stapling instrument according to one of claims 1 to 14, characterized in that the cartridge device comprises a replaceable cartridge containing the staples.
16. Stapling instrument according to one of claims 1 to 15, characterized in that the staple fastening assembly is removably mounted.
17. Stapling instrument according to one of claims 1 to 16, characterized in that the handle is removably mounted.
US12/699,910 2004-09-10 2010-02-04 Surgical Stapling Instrument Abandoned US20100133320A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
PCT/EP2004/010138 WO2006027014A1 (en) 2004-09-10 2004-09-10 Surgical stapling instrument
US66210507A true 2007-07-09 2007-07-09
US12/699,910 US20100133320A1 (en) 2004-09-10 2010-02-04 Surgical Stapling Instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US12/699,910 US20100133320A1 (en) 2004-09-10 2010-02-04 Surgical Stapling Instrument

Related Parent Applications (2)

Application Number Title Priority Date Filing Date
PCT/EP2004/010138 Continuation WO2006027014A1 (en) 2004-09-10 2004-09-10 Surgical stapling instrument
US66210507A Continuation 2007-07-09 2007-07-09

Publications (1)

Publication Number Publication Date
US20100133320A1 true US20100133320A1 (en) 2010-06-03

Family

ID=34959001

Family Applications (2)

Application Number Title Priority Date Filing Date
US11/662,105 Active 2025-10-02 US7810690B2 (en) 2004-09-10 2004-10-09 Surgical stapling instrument
US12/699,910 Abandoned US20100133320A1 (en) 2004-09-10 2010-02-04 Surgical Stapling Instrument

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US11/662,105 Active 2025-10-02 US7810690B2 (en) 2004-09-10 2004-10-09 Surgical stapling instrument

Country Status (10)

Country Link
US (2) US7810690B2 (en)
EP (1) EP1788954A1 (en)
JP (1) JP4879900B2 (en)
CN (1) CN100569190C (en)
AU (1) AU2004323140B2 (en)
BR (1) BRPI0419039B1 (en)
CA (1) CA2579606C (en)
IL (1) IL181648D0 (en)
MX (1) MX2007002841A (en)
WO (1) WO2006027014A1 (en)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070225762A1 (en) * 2006-03-25 2007-09-27 Sandbox Llc Self closing tissue fastener
US20100001038A1 (en) * 2008-07-02 2010-01-07 Shalom Levin Pivoting tacker
US20110068147A1 (en) * 2008-05-05 2011-03-24 Danyel Racenet Surgical instrument with sequential clamping and cutting
US20120071897A1 (en) * 2008-06-04 2012-03-22 Dino Kasvikis Attachable clamp for surgical stapler
US20130119108A1 (en) * 2011-11-14 2013-05-16 Nir Altman Drive mechanism for articulating tacker
US8474678B2 (en) 2008-06-04 2013-07-02 Covidien Lp Surgical stapling instrument with independent sequential firing
US8920311B2 (en) 2008-11-18 2014-12-30 Aponos Medical Corp. Adapter for attaching devices to endoscopes
US20170181603A1 (en) * 2015-05-28 2017-06-29 Roland Quaye Steerable endoscopes

Families Citing this family (272)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5865361A (en) 1997-09-23 1999-02-02 United States Surgical Corporation Surgical stapling apparatus
ES2435094T3 (en) 2000-05-19 2013-12-18 C.R. Bard, Inc. Device and method for capturing and suture tissue
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US8905977B2 (en) 2004-07-28 2014-12-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US20070194082A1 (en) 2005-08-31 2007-08-23 Morgan Jerome R Surgical stapling device with anvil having staple forming pockets of varying depths
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
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8161977B2 (en) 2006-01-31 2012-04-24 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
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
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
AT462360T (en) 2006-07-07 2010-04-15 Ethicon Endo Surgery Inc Delivery system for a surgical instrument
US7740159B2 (en) 2006-08-02 2010-06-22 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist
AT440549T (en) * 2006-09-08 2009-09-15 Ethicon Endo Surgery Inc A surgical instrument and actuating device for motion transmission for
US7665647B2 (en) 2006-09-29 2010-02-23 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling device with closure apparatus for limiting maximum tissue compression force
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US7845535B2 (en) 2006-10-06 2010-12-07 Tyco Healthcare Group Lp Surgical instrument having a plastic surface
DE602006012069D1 (en) * 2006-12-04 2010-03-18 Ethicon Endo Surgery Inc Gewebeklemmvorrictung for transanal haemorrhoidopexy or hemorrhoidectomy
DE602006012342D1 (en) * 2006-12-04 2010-04-01 Ethicon Endo Surgery Inc Means for endoluminal or laparoscopic detecting and cutting a tissue sample from the body of a patient
EP1932485B1 (en) * 2006-12-14 2010-05-19 Ethicon Endo-Surgery, Inc. Laparoscopic stapling device
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
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
US7708182B2 (en) * 2007-04-17 2010-05-04 Tyco Healthcare Group Lp Flexible endoluminal surgical instrument
US8631991B2 (en) 2007-05-30 2014-01-21 Ethicon Endo-Surgery, Inc. Surgical instrument
US7905380B2 (en) * 2007-06-04 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US7832408B2 (en) 2007-06-04 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8534528B2 (en) 2007-06-04 2013-09-17 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
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
US7669747B2 (en) 2007-06-29 2010-03-02 Ethicon Endo-Surgery, Inc. Washer for use with a surgical stapling instrument
US8061576B2 (en) 2007-08-31 2011-11-22 Tyco Healthcare Group Lp Surgical instrument
US8453908B2 (en) 2008-02-13 2013-06-04 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US7766209B2 (en) 2008-02-13 2010-08-03 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US7793812B2 (en) 2008-02-14 2010-09-14 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled 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
US8459525B2 (en) 2008-02-14 2013-06-11 Ethicon Endo-Sugery, Inc. Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
JP5410110B2 (en) 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Ethicon Endo−Surgery,Inc. The surgical cutting and fastening instrument with Rf electrode
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8608044B2 (en) 2008-02-15 2013-12-17 Ethicon Endo-Surgery, Inc. Feedback and lockout mechanism for surgical instrument
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US20090206131A1 (en) 2008-02-15 2009-08-20 Ethicon Endo-Surgery, Inc. End effector coupling arrangements for a surgical cutting and stapling instrument
US8371491B2 (en) 2008-02-15 2013-02-12 Ethicon Endo-Surgery, Inc. Surgical end effector having buttress retention features
US8628545B2 (en) 2008-06-13 2014-01-14 Covidien Lp Endoscopic stitching devices
US8678264B2 (en) * 2008-07-07 2014-03-25 Covidien Lp Surgical instrument with elongated channel
US7905381B2 (en) 2008-09-19 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with cutting member arrangement
US8540133B2 (en) 2008-09-19 2013-09-24 Ethicon Endo-Surgery, Inc. Staple cartridge
US7896214B2 (en) 2008-09-23 2011-03-01 Tyco Healthcare Group Lp Tissue stop for surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9050083B2 (en) 2008-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US7988028B2 (en) 2008-09-23 2011-08-02 Tyco Healthcare Group Lp Surgical instrument having an asymmetric dynamic clamping member
US8628544B2 (en) 2008-09-23 2014-01-14 Covidien Lp Knife bar for surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
DE202008015256U1 (en) * 2008-11-18 2009-02-12 DAUMÜLLER, Thomas A surgical instrument with Transmission
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8485413B2 (en) 2009-02-05 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising an articulation joint
US8414577B2 (en) 2009-02-05 2013-04-09 Ethicon Endo-Surgery, Inc. Surgical instruments and components for use in sterile environments
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US20110006101A1 (en) 2009-02-06 2011-01-13 EthiconEndo-Surgery, Inc. Motor driven surgical fastener device with cutting member lockout arrangements
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
US8292154B2 (en) 2009-04-16 2012-10-23 Tyco Healthcare Group Lp Surgical apparatus for applying tissue fasteners
US8353439B2 (en) 2009-11-19 2013-01-15 Ethicon Endo-Surgery, Inc. Circular stapler introducer with radially-openable distal end portion
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
US8267300B2 (en) 2009-12-30 2012-09-18 Ethicon Endo-Surgery, Inc. Dampening device for endoscopic surgical stapler
US8608046B2 (en) 2010-01-07 2013-12-17 Ethicon Endo-Surgery, Inc. Test device for a surgical tool
US8789740B2 (en) 2010-07-30 2014-07-29 Ethicon Endo-Surgery, Inc. Linear cutting and stapling device with selectively disengageable cutting member
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8672207B2 (en) 2010-07-30 2014-03-18 Ethicon Endo-Surgery, Inc. Transwall visualization arrangements and methods for surgical circular staplers
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US8632525B2 (en) 2010-09-17 2014-01-21 Ethicon Endo-Surgery, Inc. Power control arrangements for surgical instruments and batteries
US9289212B2 (en) 2010-09-17 2016-03-22 Ethicon Endo-Surgery, Inc. Surgical instruments and batteries for surgical instruments
US9877720B2 (en) 2010-09-24 2018-01-30 Ethicon Llc Control features for articulating surgical device
US8733613B2 (en) 2010-09-29 2014-05-27 Ethicon Endo-Surgery, Inc. Staple cartridge
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
US9517063B2 (en) 2012-03-28 2016-12-13 Ethicon Endo-Surgery, Llc Movable member for use with a tissue thickness compensator
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
BR112013007717A2 (en) 2010-09-30 2016-08-09 Ethicon Endo Surgery Inc System fasteners which comprises a retaining matrix array and an alignment
US9433419B2 (en) 2010-09-30 2016-09-06 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of layers
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
US9016542B2 (en) 2010-09-30 2015-04-28 Ethicon Endo-Surgery, Inc. Staple cartridge comprising compressible distortion resistant components
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US8840003B2 (en) 2010-09-30 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with compact articulation control arrangement
RU2606493C2 (en) 2011-04-29 2017-01-10 Этикон Эндо-Серджери, Инк. Staple cartridge, containing staples, located inside its compressible part
JP6224070B2 (en) 2012-03-28 2017-11-01 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. Retainer assembly including a tissue thickness compensator
US9700317B2 (en) 2010-09-30 2017-07-11 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a releasable tissue thickness compensator
US9615826B2 (en) 2010-09-30 2017-04-11 Ethicon Endo-Surgery, Llc Multiple thickness implantable layers for surgical stapling devices
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US20120080498A1 (en) 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Curved end effector for a stapling instrument
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US8899461B2 (en) 2010-10-01 2014-12-02 Covidien Lp Tissue stop for surgical instrument
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
KR101024344B1 (en) 2010-11-15 2011-03-23 동국대학교 산학협력단 Medical anastomosis apparatus
US8632462B2 (en) 2011-03-14 2014-01-21 Ethicon Endo-Surgery, Inc. Trans-rectum universal ports
US8926598B2 (en) 2011-03-15 2015-01-06 Ethicon Endo-Surgery, Inc. Surgical instruments with articulatable and rotatable end effector
US9044229B2 (en) 2011-03-15 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical fastener instruments
US8800841B2 (en) 2011-03-15 2014-08-12 Ethicon Endo-Surgery, Inc. Surgical staple cartridges
US8857693B2 (en) 2011-03-15 2014-10-14 Ethicon Endo-Surgery, Inc. Surgical instruments with lockable articulating end effector
US8540131B2 (en) 2011-03-15 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical staple cartridges with tissue tethers for manipulating divided tissue and methods of using same
US9566048B1 (en) 2011-04-26 2017-02-14 Cardica, Inc. Surgical instrument with discrete cammed articulation
US9474527B1 (en) * 2011-04-26 2016-10-25 Bryan D. Knodel Surgical instrument with discrete articulation
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US9271728B2 (en) 2011-06-09 2016-03-01 Covidien Lp Surgical fastener applying apparatus
US9289209B2 (en) 2011-06-09 2016-03-22 Covidien Lp Surgical fastener applying apparatus
US9451959B2 (en) 2011-06-09 2016-09-27 Covidien Lp Surgical fastener applying apparatus
US8763876B2 (en) 2011-06-30 2014-07-01 Covidien Lp Surgical instrument and cartridge for use therewith
US9539007B2 (en) 2011-08-08 2017-01-10 Covidien Lp Surgical fastener applying aparatus
US9155537B2 (en) 2011-08-08 2015-10-13 Covidien Lp Surgical fastener applying apparatus
US9724095B2 (en) 2011-08-08 2017-08-08 Covidien Lp Surgical fastener applying apparatus
US9107663B2 (en) 2011-09-06 2015-08-18 Ethicon Endo-Surgery, Inc. Stapling instrument comprising resettable staple drivers
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9016539B2 (en) 2011-10-25 2015-04-28 Covidien Lp Multi-use loading unit
US8740036B2 (en) 2011-12-01 2014-06-03 Covidien Lp Surgical instrument with actuator spring arm
WO2013087092A1 (en) * 2011-12-13 2013-06-20 Ethicon Endo-Surgery, Inc. An applier and a method for anchoring a lining to a hollow organ
US8864010B2 (en) 2012-01-20 2014-10-21 Covidien Lp Curved guide member for articulating instruments
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
US8979827B2 (en) 2012-03-14 2015-03-17 Covidien Lp Surgical instrument with articulation mechanism
US9078653B2 (en) 2012-03-26 2015-07-14 Ethicon Endo-Surgery, Inc. Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge
RU2014143245A (en) 2012-03-28 2016-05-27 Этикон Эндо-Серджери, Инк. Compensator tissue thickness, comprising a capsule for a medium with a low pressure
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9526497B2 (en) 2012-05-07 2016-12-27 Covidien Lp Surgical instrument with articulation mechanism
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US8747238B2 (en) 2012-06-28 2014-06-10 Ethicon Endo-Surgery, Inc. Rotary drive shaft assemblies for surgical instruments with articulatable end effectors
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US20140005678A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Rotary drive arrangements for surgical instruments
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US9364230B2 (en) 2012-06-28 2016-06-14 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotary joint assemblies
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9232944B2 (en) 2012-06-29 2016-01-12 Covidien Lp Surgical instrument and bushing
US9265503B2 (en) 2012-09-07 2016-02-23 Covidien Lp Methods for applying surgical staples to internal walls of hollow tissue organs
US9386985B2 (en) 2012-10-15 2016-07-12 Ethicon Endo-Surgery, Llc Surgical cutting instrument
US9364217B2 (en) 2012-10-16 2016-06-14 Covidien Lp In-situ loaded stapler
US9345480B2 (en) 2013-01-18 2016-05-24 Covidien Lp Surgical instrument and cartridge members for use therewith
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
BR112015021098A2 (en) 2013-03-01 2017-07-18 Ethicon Endo Surgery Inc articulated surgical instruments with conductive pathways to sign communication
US20140249557A1 (en) 2013-03-01 2014-09-04 Ethicon Endo-Surgery, Inc. Thumbwheel switch arrangements for surgical instruments
US9629628B2 (en) 2013-03-13 2017-04-25 Covidien Lp Surgical stapling apparatus
US9566064B2 (en) 2013-03-13 2017-02-14 Covidien Lp Surgical stapling apparatus
US9814463B2 (en) 2013-03-13 2017-11-14 Covidien Lp Surgical stapling apparatus
US9717498B2 (en) 2013-03-13 2017-08-01 Covidien Lp Surgical stapling apparatus
US20140263552A1 (en) 2013-03-13 2014-09-18 Ethicon Endo-Surgery, Inc. Staple cartridge tissue thickness sensor system
US9629623B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgery, Llc Drive system lockout arrangements for modular surgical instruments
US9351726B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Articulation control system for articulatable surgical instruments
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
AU2014227602B2 (en) * 2013-03-15 2019-03-28 Applied Medical Resources Corporation Surgical stapler having actuation mechanism with rotatable shaft
US9510827B2 (en) 2013-03-25 2016-12-06 Covidien Lp Micro surgical instrument and loading unit for use therewith
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
US9844368B2 (en) 2013-04-16 2017-12-19 Ethicon Llc Surgical system comprising first and second drive systems
US10136887B2 (en) 2013-04-16 2018-11-27 Ethicon Llc Drive system decoupling arrangement for a surgical instrument
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US9445810B2 (en) 2013-06-12 2016-09-20 Covidien Lp Stapling device with grasping jaw mechanism
US9629633B2 (en) 2013-07-09 2017-04-25 Covidien Lp Surgical device, surgical adapters for use between surgical handle assembly and surgical loading units, and methods of use
US9987006B2 (en) 2013-08-23 2018-06-05 Ethicon Llc Shroud retention arrangement for sterilizable surgical instruments
MX2016002328A (en) 2013-08-23 2016-12-14 Ethicon Endo-Surgery Llc End effector detection systems for surgical instruments.
US9662108B2 (en) 2013-08-30 2017-05-30 Covidien Lp Surgical stapling apparatus
JP2016534796A (en) * 2013-11-04 2016-11-10 コヴィディエン リミテッド パートナーシップ The surgical fastener applying apparatus
US9867613B2 (en) 2013-12-19 2018-01-16 Covidien Lp Surgical staples and end effectors for deploying the same
US9642620B2 (en) 2013-12-23 2017-05-09 Ethicon Endo-Surgery, Llc Surgical cutting and stapling instruments with articulatable end effectors
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9681870B2 (en) 2013-12-23 2017-06-20 Ethicon Llc Articulatable surgical instruments with separate and distinct closing and firing systems
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
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
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9848874B2 (en) 2014-02-14 2017-12-26 Covidien Lp Small diameter endoscopic stapler
US9757124B2 (en) 2014-02-24 2017-09-12 Ethicon Llc Implantable layer assemblies
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
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US9757126B2 (en) 2014-03-31 2017-09-12 Covidien Lp Surgical stapling apparatus with firing lockout mechanism
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
US9668733B2 (en) 2014-04-21 2017-06-06 Covidien Lp Stapling device with features to prevent inadvertent firing of staples
US9861366B2 (en) 2014-05-06 2018-01-09 Covidien Lp Ejecting assembly for a surgical stapler
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US9737301B2 (en) 2014-09-05 2017-08-22 Ethicon Llc Monitoring device degradation based on component evaluation
US9801627B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Fastener cartridge for creating a flexible staple line
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
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
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
CN104398301A (en) * 2014-11-19 2015-03-11 中国人民解放军第四军医大学 Heat setting cutting pliers
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US9968355B2 (en) 2014-12-18 2018-05-15 Ethicon Llc Surgical instruments with articulatable end effectors and improved firing beam support arrangements
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
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
US9775611B2 (en) 2015-01-06 2017-10-03 Covidien Lp Clam shell surgical stapling loading unit
US10039545B2 (en) 2015-02-23 2018-08-07 Covidien Lp Double fire stapling
US20160249929A1 (en) 2015-02-26 2016-09-01 Covidien Lp Surgical apparatus
US10085749B2 (en) 2015-02-26 2018-10-02 Covidien Lp Surgical apparatus with conductor strain relief
US20160249916A1 (en) 2015-02-27 2016-09-01 Ethicon Endo-Surgery, Llc System for monitoring whether a surgical instrument needs to be serviced
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
US10226250B2 (en) 2015-02-27 2019-03-12 Ethicon Llc Modular stapling assembly
US9855040B2 (en) 2015-03-04 2018-01-02 Covidien Lp Surgical stapling loading unit having articulating jaws
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
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
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9918717B2 (en) 2015-03-18 2018-03-20 Covidien Lp Pivot mechanism for surgical device
US20160287250A1 (en) 2015-03-31 2016-10-06 Ethicon Endo-Surgery, Llc Surgical instrument with progressive rotary drive systems
US10117650B2 (en) 2015-05-05 2018-11-06 Covidien Lp Adapter assembly and loading units for surgical stapling devices
US10039532B2 (en) 2015-05-06 2018-08-07 Covidien Lp Surgical instrument with articulation assembly
US10143474B2 (en) 2015-05-08 2018-12-04 Just Right Surgical, Llc Surgical stapler
US10172615B2 (en) 2015-05-27 2019-01-08 Covidien Lp Multi-fire push rod stapling device
US20160367246A1 (en) 2015-06-18 2016-12-22 Ethicon Endo-Surgery, Llc Dual articulation drive system arrangements for articulatable surgical instruments
US9987012B2 (en) 2015-07-21 2018-06-05 Covidien Lp Small diameter cartridge design for a surgical stapling instrument
US10064622B2 (en) 2015-07-29 2018-09-04 Covidien Lp Surgical stapling loading unit with stroke counter and lockout
US20170027576A1 (en) * 2015-07-30 2017-02-02 Teleflex Medical Incorporated Snap-on surgical clip cartridge
US10045782B2 (en) 2015-07-30 2018-08-14 Covidien Lp Surgical stapling loading unit with stroke counter and lockout
US20170056000A1 (en) 2015-08-26 2017-03-02 Ethicon Endo-Surgery, Llc Surgical stapling configurations for curved and circular stapling instruments
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
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
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US20170086832A1 (en) 2015-09-30 2017-03-30 Ethicon Endo-Surgery, Llc Tubular absorbable constructs
US10213204B2 (en) 2015-10-02 2019-02-26 Covidien Lp Micro surgical instrument and loading unit for use therewith
US10111660B2 (en) 2015-12-03 2018-10-30 Covidien Lp Surgical stapler flexible distal tip
US20170224335A1 (en) 2016-02-09 2017-08-10 Ethicon Endo-Surgery, Llc Articulatable surgical instruments with off-axis firing beam arrangements
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
USD826405S1 (en) 2016-06-24 2018-08-21 Ethicon Llc Surgical fastener
USD822206S1 (en) 2016-06-24 2018-07-03 Ethicon Llc Surgical fastener
USD814632S1 (en) 2016-10-21 2018-04-03 Covidien Lp Staple cartridge
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces

Citations (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4728020A (en) * 1985-08-30 1988-03-01 United States Surgical Corporation Articulated surgical fastener applying apparatus
US5395030A (en) * 1992-06-04 1995-03-07 Olympus Optical Co., Ltd. Surgical device for stapling and fastening body tissues
US5605272A (en) * 1996-03-12 1997-02-25 Ethicon Endo-Surgery, Inc. Trigger mechanism for surgical instruments
US5667473A (en) * 1994-03-18 1997-09-16 Clarus Medical Systems, Inc. Surgical instrument and method for use with a viewing system
US5762256A (en) * 1995-08-28 1998-06-09 United States Surgical Corporation Surgical stapler
US5762255A (en) * 1996-02-20 1998-06-09 Richard-Allan Medical Industries, Inc. Surgical instrument with improvement safety lockout mechanisms
US5779132A (en) * 1995-10-19 1998-07-14 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
US5797536A (en) * 1992-10-09 1998-08-25 Ethicon, Inc. Endoscopic surgical instrument with pivotable and rotatable staple cartridge
US5807393A (en) * 1992-12-22 1998-09-15 Ethicon Endo-Surgery, Inc. Surgical tissue treating device with locking mechanism
US6443973B1 (en) * 1999-06-02 2002-09-03 Power Medical Interventions, Inc. Electromechanical driver device for use with anastomosing, stapling, and resecting instruments
US20030127491A1 (en) * 1998-06-19 2003-07-10 Adams Ronald D. Integrated surgical staple retainer for a full thickness resectioning device
US6669073B2 (en) * 1997-09-23 2003-12-30 United States Surgical Corporation Surgical stapling apparatus
US6695199B2 (en) * 2000-02-22 2004-02-24 Power Medical Interventions, Inc. Fluid delivery mechanism for use with anastomosing, stapling, and resecting instruments
US6716233B1 (en) * 1999-06-02 2004-04-06 Power Medical Interventions, Inc. Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US20040084505A1 (en) * 2002-11-04 2004-05-06 Federico Bilotti Surgical stapling instrument
US7111769B2 (en) * 2003-07-09 2006-09-26 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis
US20060241692A1 (en) * 2001-01-31 2006-10-26 Mcguckin James F Jr Apparatus and method for resectioning gastro-esophageal tissue
US7210609B2 (en) * 2004-07-30 2007-05-01 Tools For Surgery, Llc Stapling apparatus having a curved anvil and driver
US20070246507A1 (en) * 2000-11-20 2007-10-25 Medigus Ltd. Stapler for endoscopes
US20080015618A1 (en) * 2006-07-16 2008-01-17 Elazar Sonnenschein Devices and methods for treating morbid obesity
US20080167665A1 (en) * 2004-06-14 2008-07-10 Scott Arp Endoscopic Threaded Clip
US7434717B2 (en) * 2007-01-11 2008-10-14 Ethicon Endo-Surgery, Inc. Apparatus for closing a curved anvil of a surgical stapling device
US20090024156A1 (en) * 1995-07-13 2009-01-22 Chin Albert K Tissue Dissection Method
US7506791B2 (en) * 2006-09-29 2009-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression
US7575144B2 (en) * 2006-01-31 2009-08-18 Ethicon Endo-Surgery, Inc. Surgical fastener and cutter with single cable actuator
US20100001037A1 (en) * 2008-07-07 2010-01-07 Racenet Danyel Tarinelli Surgical instrument with elongated channel
US20100048988A1 (en) * 2006-07-07 2010-02-25 Alessandro Pastorelli A deployment system for introducing a surgical instrument in a patients body

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1616624A1 (en) 1987-07-14 1990-12-30 Предприятие П/Я А-3697 Surgical suturing apparatus
US6126058A (en) * 1998-06-19 2000-10-03 Scimed Life Systems, Inc. Method and device for full thickness resectioning of an organ
US6601749B2 (en) * 1998-06-19 2003-08-05 Scimed Life Systems, Inc. Multi fire full thickness resectioning device
US6517565B1 (en) * 1999-06-02 2003-02-11 Power Medical Interventions, Inc. Carriage assembly for controlling a steering wire steering mechanism within a flexible shaft
DE10026683C2 (en) 2000-05-30 2003-07-10 Ethicon Endo Surgery Europe The surgical instrument
BR0318356A (en) * 2003-06-16 2006-08-01 Ethicon Endo Surgery Inc surgical system with clipping instrument and a retractor

Patent Citations (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4728020A (en) * 1985-08-30 1988-03-01 United States Surgical Corporation Articulated surgical fastener applying apparatus
US5395030A (en) * 1992-06-04 1995-03-07 Olympus Optical Co., Ltd. Surgical device for stapling and fastening body tissues
US5797536A (en) * 1992-10-09 1998-08-25 Ethicon, Inc. Endoscopic surgical instrument with pivotable and rotatable staple cartridge
US5807393A (en) * 1992-12-22 1998-09-15 Ethicon Endo-Surgery, Inc. Surgical tissue treating device with locking mechanism
US5667473A (en) * 1994-03-18 1997-09-16 Clarus Medical Systems, Inc. Surgical instrument and method for use with a viewing system
US20090024156A1 (en) * 1995-07-13 2009-01-22 Chin Albert K Tissue Dissection Method
US5762256A (en) * 1995-08-28 1998-06-09 United States Surgical Corporation Surgical stapler
US5779132A (en) * 1995-10-19 1998-07-14 Ethicon Endo-Surgery, Inc. Endoscopic surgical stapler with compact profile
US5762255A (en) * 1996-02-20 1998-06-09 Richard-Allan Medical Industries, Inc. Surgical instrument with improvement safety lockout mechanisms
US5605272A (en) * 1996-03-12 1997-02-25 Ethicon Endo-Surgery, Inc. Trigger mechanism for surgical instruments
US6669073B2 (en) * 1997-09-23 2003-12-30 United States Surgical Corporation Surgical stapling apparatus
US20030127491A1 (en) * 1998-06-19 2003-07-10 Adams Ronald D. Integrated surgical staple retainer for a full thickness resectioning device
US20040134964A1 (en) * 1998-06-19 2004-07-15 Adams Ronald D. Integrated surgical staple retainer for a full thickness resectioning device
US6716233B1 (en) * 1999-06-02 2004-04-06 Power Medical Interventions, Inc. Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities
US6443973B1 (en) * 1999-06-02 2002-09-03 Power Medical Interventions, Inc. Electromechanical driver device for use with anastomosing, stapling, and resecting instruments
US6695199B2 (en) * 2000-02-22 2004-02-24 Power Medical Interventions, Inc. Fluid delivery mechanism for use with anastomosing, stapling, and resecting instruments
US20070246507A1 (en) * 2000-11-20 2007-10-25 Medigus Ltd. Stapler for endoscopes
US20090272785A1 (en) * 2000-11-20 2009-11-05 Medigus Ltd. Stapler for endoscopes
US20060241692A1 (en) * 2001-01-31 2006-10-26 Mcguckin James F Jr Apparatus and method for resectioning gastro-esophageal tissue
US6805273B2 (en) * 2002-11-04 2004-10-19 Federico Bilotti Surgical stapling instrument
US20040084505A1 (en) * 2002-11-04 2004-05-06 Federico Bilotti Surgical stapling instrument
US7111769B2 (en) * 2003-07-09 2006-09-26 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis
US20080167665A1 (en) * 2004-06-14 2008-07-10 Scott Arp Endoscopic Threaded Clip
US7210609B2 (en) * 2004-07-30 2007-05-01 Tools For Surgery, Llc Stapling apparatus having a curved anvil and driver
US7575144B2 (en) * 2006-01-31 2009-08-18 Ethicon Endo-Surgery, Inc. Surgical fastener and cutter with single cable actuator
US20100048988A1 (en) * 2006-07-07 2010-02-25 Alessandro Pastorelli A deployment system for introducing a surgical instrument in a patients body
US20080015618A1 (en) * 2006-07-16 2008-01-17 Elazar Sonnenschein Devices and methods for treating morbid obesity
US7506791B2 (en) * 2006-09-29 2009-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression
US7434717B2 (en) * 2007-01-11 2008-10-14 Ethicon Endo-Surgery, Inc. Apparatus for closing a curved anvil of a surgical stapling device
US20100001037A1 (en) * 2008-07-07 2010-01-07 Racenet Danyel Tarinelli Surgical instrument with elongated channel

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070225762A1 (en) * 2006-03-25 2007-09-27 Sandbox Llc Self closing tissue fastener
US9408594B2 (en) 2006-03-25 2016-08-09 Aponos Medical Corporation Self closing tissue fastener
US9737297B2 (en) 2008-05-05 2017-08-22 Covidien Lp Surgical instrument with sequential clamping and cutting
US20110068147A1 (en) * 2008-05-05 2011-03-24 Danyel Racenet Surgical instrument with sequential clamping and cutting
US8936185B2 (en) 2008-05-05 2015-01-20 Covidien Lp Surgical instrument with sequential clamping and cutting
US8757467B2 (en) 2008-05-05 2014-06-24 Covidien Lp Surgical instrument with sequential clamping and cutting
US8474678B2 (en) 2008-06-04 2013-07-02 Covidien Lp Surgical stapling instrument with independent sequential firing
US20120071897A1 (en) * 2008-06-04 2012-03-22 Dino Kasvikis Attachable clamp for surgical stapler
US20100001038A1 (en) * 2008-07-02 2010-01-07 Shalom Levin Pivoting tacker
US8087142B2 (en) * 2008-07-02 2012-01-03 Easylap Ltd. Pivoting tacker
US8920311B2 (en) 2008-11-18 2014-12-30 Aponos Medical Corp. Adapter for attaching devices to endoscopes
US9486213B2 (en) * 2011-11-14 2016-11-08 Thd Lap Ltd. Drive mechanism for articulating tacker
US20130119108A1 (en) * 2011-11-14 2013-05-16 Nir Altman Drive mechanism for articulating tacker
US20170181603A1 (en) * 2015-05-28 2017-06-29 Roland Quaye Steerable endoscopes
US10010246B2 (en) * 2015-05-28 2018-07-03 Roland Quaye Steerable endoscopes

Also Published As

Publication number Publication date
BRPI0419039B1 (en) 2015-11-10
IL181648D0 (en) 2007-07-04
BRPI0419039A (en) 2007-12-11
US20090236399A1 (en) 2009-09-24
JP2008512155A (en) 2008-04-24
JP4879900B2 (en) 2012-02-22
CA2579606A1 (en) 2006-03-16
WO2006027014A1 (en) 2006-03-16
AU2004323140B2 (en) 2011-11-24
AU2004323140A1 (en) 2006-03-16
CN100569190C (en) 2009-12-16
US7810690B2 (en) 2010-10-12
EP1788954A1 (en) 2007-05-30
MX2007002841A (en) 2007-04-30
CN101043850A (en) 2007-09-26
CA2579606C (en) 2012-04-17

Similar Documents

Publication Publication Date Title
US7810693B2 (en) Surgical stapling and cutting instrument with articulatable end effector
US9597071B1 (en) Apparatus and method for minimally invasive suturing
US6719763B2 (en) Endoscopic suturing device
EP1982657B1 (en) Flexible endoluminal surgical instrument
EP2286740B1 (en) Surgical stapler
US7575144B2 (en) Surgical fastener and cutter with single cable actuator
CN101327135B (en) Cable driven surgical stapling and cutting instrument with apparatus for preventing inadvertant cable disengagement
DE69532942T2 (en) Independent, powered surgical apparatus
US4610383A (en) Disposable linear surgical stapler
AU2006202051B2 (en) Surgical instrument with articulation shaft with double pivot closure and single pivot frame ground
CN101675896B (en) Surgical stapler with apparatus for adjusting staple height
JP4799930B2 (en) Surgical stapling instrument equipped with a multi-stroke type firing mechanism including a rotary transmission
CA1255565A (en) Flexible surgical stapler assembly
US6866178B2 (en) Integrated surgical staple retainer for a full thickness resectioning device
AU2004212963B2 (en) Transmitting an actuating force along a curved instrument
JP4336386B2 (en) Using a surgical stapling and cutting device and this device
US8083120B2 (en) End effector for use with a surgical cutting and stapling instrument
US9216020B2 (en) Endoscopic surgical cutting stapler with a chain articulation
JP5377827B2 (en) Incorporating multiple stroke firing mechanism with a flexible rack surgical stapling instrument
US7694864B2 (en) Tissue stapler with positioning mechanism
US9370360B2 (en) Surgical stapling apparatus with powered retraction
US8006889B2 (en) Method and device for full thickness resectioning of an organ
CA2467795C (en) Surgical stapling instrument having separate distinct closing and firing systems
JP5490420B2 (en) With improved firing trigger sequence, surgical stapling instrument
US8322455B2 (en) Manually driven surgical cutting and fastening instrument

Legal Events

Date Code Title Description
AS Assignment

Owner name: ETHICON ENDO-SURGERY, INC., OHIO

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BILOTTI, FEDERICO;D ARCANGELO, MICHELE;LONGO, ANTONIO;AND OTHERS;SIGNING DATES FROM 20070420 TO 20070522;REEL/FRAME:025065/0703