WO1999003407A1 - An electrosurgical instrument - Google Patents

An electrosurgical instrument Download PDF

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Publication number
WO1999003407A1
WO1999003407A1 PCT/GB1998/002080 GB9802080W WO9903407A1 WO 1999003407 A1 WO1999003407 A1 WO 1999003407A1 GB 9802080 W GB9802080 W GB 9802080W WO 9903407 A1 WO9903407 A1 WO 9903407A1
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WO
WIPO (PCT)
Prior art keywords
tissue
electrode
instrument
electrosurgical instrument
tissue treatment
Prior art date
Application number
PCT/GB1998/002080
Other languages
French (fr)
Inventor
Nigel Mark Goble
Colin Charles Owen Goble
Alan Nigel Syrop
Original Assignee
Gyrus Medical Limited
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 GB9715197.1 priority Critical
Priority to GB9715197A priority patent/GB2327350A/en
Priority to GB9726952.6 priority
Priority to GBGB9726952.6A priority patent/GB9726952D0/en
Priority to GB9814727.5 priority
Priority to GBGB9814727.5A priority patent/GB9814727D0/en
Application filed by Gyrus Medical Limited filed Critical Gyrus Medical Limited
Priority claimed from KR1020007000545A external-priority patent/KR20010021980A/en
Publication of WO1999003407A1 publication Critical patent/WO1999003407A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/148Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/149Probes or electrodes therefor bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1482Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1485Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00184Moving parts
    • A61B2018/00196Moving parts reciprocating lengthwise
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00184Moving parts
    • A61B2018/00202Moving parts rotating
    • A61B2018/00208Moving parts rotating actively driven, e.g. by a motor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00505Urinary tract
    • A61B2018/00517Urinary bladder or urethra
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00559Female reproductive organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601Cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1213Generators therefor creating an arc
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/1253Generators therefor characterised by the output polarity monopolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1472Probes or electrodes therefor for use with liquid electrolyte, e.g. virtual electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/16Indifferent or passive electrodes for grounding
    • A61B2018/162Indifferent or passive electrodes for grounding located on the probe body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • A61B2018/1861Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument inserted into a body lumen or cavity, e.g. a catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007Aspiration

Abstract

An electrosurgical instrument is provided for the treatment of tissue in the presence of an electrically-conductive fluid medium. The instrument comprises an instrument shaft (10), a tissue treatment electrode (12) at the distal end of the shaft for electrosurgically excising tissue pieces at an operation site, morcellation means for electrosurgically reducing the size of excised tissue pieces, and removal means for removing morcellated tissue pieces. The instrument has an apertured portion (20a) through which matter can be aspirated by the removal means from the region surrounding the tissue treatment electrode (12). The removal means comprises a channel formed within the instrument shaft (10) and leading from the apertured portion (20a). The tissue treatment electrode (12) is movable cyclically relative to the distal end of the shaft (10), and constitutes the morcellation means.

Description

AN ELECTROSURGICAL INSTRUMENT

This invention relates to an electrosurgical instrument for the treatment of tissue in the presence of an electrically-conductive fluid medium, to electrosurgical apparatus including such an instrument, and to an electrode unit for use in such an instrument. Endoscopic electrosurgery is useful for treating tissue in cavities of the body, and is normally performed in the presence of a distension medium. When the distension medium is a liquid, this is commonly referred to as underwater electrosurgery, this term denoting electrosurgery in which living tissue is treated using an electrosurgical instrument with a treatment electrode or electrodes immersed in liquid at the operation site. A gaseous medium is commonly employed when endoscopic surgery is performed in a distensible body cavity of larger potential volume in which a liquid medium would be unsuitable, as is often the case in laparoscopic or gastroenterological surgery.

Underwater surgery is commonly performed using endoscopic techniques, in which the endoscope itself may provide a conduit (commonly referred to as a working channel) for the passage of an electrode. Alternatively, the endoscope may be specifically adapted (as in a resectoscope) to include means for mounting an electrode, or the electrode may be introduced into a body cavity via a separate access means at an angle with respect to the endoscope - a technique commonly referred to as triangulation. These variations in technique can be subdivided by surgical speciality, where one or other of the techniques has particular advantages given the access route to the specific body cavity. Endoscopes with integral working channels, or those characterised as resectoscopes, are generally employed when the body cavity may be accessed through a natural body opening - such as the cervical canal to access the endometrial cavity of the uterus, or the urethra to access the prostate gland and the bladder. Endoscopes specifically designed for use in the endometrial cavity are referred to as hysteroscopes, and those designed for use in the urinary tract include cystoscopes, urethroscopes and resectoscopes. The procedures of transurethal resection or vaporisation of the prostate gland are known as TURP and EVAP respectively. When there is no natural body opening through which an endoscope may be passed, the technique of triangulation is commonly employed. Triangulation is commonly used during underwater endoscopic surgery on joint cavities such as the knee and the shoulder. The endoscope used in these procedures is commonly referred to as an arthroscope.

Electrosurgery is usually carried out using either a monopolar instrument or a bipolar instrument. With monopolar electrosurgery, an active electrode is used in the operating region, and a conductive return plate is secured to the patient's skin. With this arrangement, current passes from the active electrode through the patient's tissues to the external return plate. Since the patient represents a significant portion of the circuit, input power levels have to be high (typically 150 to 250 watts), to compensate for the resistive current limiting of the patient's tissues and, in the case of underwater electrosurgery, power losses due to the fluid medium which is rendered partially conductive by the presence of blood or other body fluids. Using high power with a monopolar arrangement is also hazardous, due to the tissue heating that occurs at the return plate, which can cause severe skin burns. There is also the risk of capacitive coupling between the instrument and patient tissues at the entry point into the body cavity.

With bipolar electrosurgery, a pair of electrodes (an active electrode and a return electrode) are used together at the tissue application site. This arrangement has advantages from the safety standpoint, due to the relative proximity of the two electrodes so that radio frequency currents are limited to the region between the electrodes. However, the depth of effect is directly related to the distance between the two electrodes; and, in applications requiring very small electrodes, the inter-electrode spacing becomes very small, thereby limiting tissue effect and the output power. Spacing the electrodes further apart would often obscure vision of the application site, and would require a modification in surgical technique to ensure direct contact of both electrodes with the tissue. There are a number of variations to the basic design of the bipolar probe. For example, U.S. Patent Specification No. 4706667 describes one of the fundamentals of the design, namely that the ratio of the contact areas of the return electrode and of the active electrode is greater than 7:1 and smaller than 20:1 for cutting purposes. This range relates only to cutting electrode configurations. When a bipolar instrument is used for desiccation or coagulation, the ratio of the contact areas of the two electrodes may be reduced to approximately 1 : 1 to avoid differential electrical stresses occurring at the contact between the tissue and the electrode.

The electrical junction between the return electrode and tissue can be supported by wetting of the tissue by a conductive solution such as normal saline. This ensures that the surgical effect is Umited to the active electrode, with the electric circuit between the two electrodes being completed by the tissue. One of the obvious limitations with the design is that the active electrode (typically a needle) must be completely buried in the tissue to enable the return electrode to complete the circuit. Another problem is one of the orientation: even a relatively small change in application angle from the ideal perpendicular contact with respect to the tissue surface, will change the contact area ratio, so that a surgical effect can occur in the tissue in contact with the return electrode.

Cavity distension provides space for gaining access to the operation site, to improve visualisation, and to allow for manipulation of instruments. In low volume body cavities, particularly where it is desirable to distend the cavity under higher pressure, liquid rather than gas is more commonly used due to better optical characteristics, and because it washes blood away from the operative site.

Conventional underwater electrosurgery has been performed using a non-conductive liquid (such as 1.5% glycine) as an irrigant, or as a distension medium to eliminate electrical conduction losses. Glycine is used in isotonic concentrations to prevent osmotic changes in the blood when intra-vascular absorption occurs. In the course of an operation, veins may be severed, with resultant infusion of the liquid into the circulation, which could cause, among other things, a dilution of serum sodium which can lead to a condition known as water intoxication.

The applicants have found that it is possible to use a conductive liquid medium, such as normal saline, in underwater endoscopic electrosurgery in place of non-conductive, electrolyte-free solutions. Normal saline is the preferred distension medium in underwater endoscopic surgery when electrosurgery is not contemplated, or a non-electrical tissue effect such as laser treatment is being used. Although normal saline (0.9%w/v; 150mmol/l) has an electrical conductivity somewhat greater than that of most body tissue, it has the advantage that displacement by absorption or extravasation from the operative site produces little physiological effect, and the so-called water intoxication effects of non-conductive, electrolyte-free solutions are avoided.

Carbon dioxide is the preferred gaseous distension medium, primarily because of its non-toxic nature and high water solubility.

The applicants have developed a bipolar instrument suitable for underwater electrosurgery using a conductive liquid or gaseous medium. This electrosurgical instrument for the treatment of tissue in the presence of a fluid medium, comprises an instrument body having a handpiece and an instrument shaft and an electrode assembly, at one end of the shaft. The electrode assembly comprises a tissue treatment (active) electrode which is exposed at the extreme distal end of the instrument, and a return electrode which is electrically insulated from the tissue treatment electrode and has a fluid contact surface spaced proximally from the exposed part of the tissue treatment electrode. In use of the instrument, the tissue treatment electrode is applied to the tissue to be treated whilst the return electrode, being spaced proximally from the exposed part of the tissue treatment electrode, is normally spaced from the tissue and serves to complete an electrosurgical current loop from the tissue treatment electrode through the tissue and the fluid medium. This electrosurgical instrument is described in the specification of our International Patent Application No. PCT/GB96/01473. The electrode structure of this instrument, in combination with an electrically- conductive fluid medium largely avoids the problems experienced with monopolar or bipolar electrosurgery. In particular, input power levels are much lower than those generally necessary with a monopolar arrangement (typically 100 watts). Moreover, because of the relatively large spacing between its electrodes, an improved depth of effect is obtained compared with conventional bipolar arrangements.

The specification of our International Patent Application No. GB96/01472 describes an irrigated bipolar electrosurgical instrument that can be used in open air or gas-filled environments. This instrument includes an internal channel for feeding electrically- conductive fluid (typically saline) to the exposed end of a tissue treatment electrode so as to provide a conductive fluid path that completes an electrical circuit to a return electrode when the instrument is in use. This instrument also includes an internal channel for removing fluid from the region of the exposed end of the tissue treatment electrode. When the fluid is a liquid, such as saline, the presence of that liquid can cause collateral tissue damage, so its removal is desirable. This type of instrument is intended primarily for use in open air or gas-filled environments, and is not suitable for use with electrosurgical procedures which require distension of a body cavity.

However, where the volume of a body cavity is small - for example in arthroscopic surgery where even the large joints, such as the knee, may only accommodate 50-60 ml of irrigation fluid - the following problems may occur, namely :-

(i) Heated fluid in the immediate vicinity of the tissue contact electrode can cause collateral tissue damage;

(ii) The products of the tissue vaporised by the tissue contact electrode can cause visualisation problems; and (iii) Soft tissue present in a joint space tends to move about, making it difficult to apply the active electrode to vaporise such tissue. An arthroscope electrode may be characterised as short (100 to 140 mm), and rigid with a working diameter up to 5 mm. It can be introduced through a stab incision into a joint cavity (with or without a cannula) using the triangulation technique. Such an electrode is operated with a motion which moves the electrode between the 9 01 Clock and 3 0' Clock positions on the arthroscopic image. As a result, the tissue to be treated is usually approached at a shallow working angle with respect to the axis of the electrode. An arthroscopic electrode thus needs to have an effect consistent with this angled approach to the tissue. The tissue to be treated, such as meniscal cartilage, is commonly dense and of a high electrical impedance. An arthroscope electrode requires output power and voltage settings that reflect the type of tissue being treated, the size of electrode, and the fact that arthroscopists are seeking a speed of effect comparable to that of the mechanical shaver devices they currently employ, albeit with an electrode of smaller dimensions than a shaver blade for improved access.

The specification of our British Patent Application 9612993.7 describes an electrosurgical instrument for the treatment of tissue in the presence of an electrically- conductive fluid medium. The instrument comprises an instrument shaft, and an electrode assembly at one end of the shaft, the electrode assembly comprising a tissue treatment electrode and a return electrode which is electrically insulated from the tissue treatment electrode by means of an insulation member. The tissue treatment electrode has an exposed end for treating tissue, and the return electrode has a fluid contact surface which is spaced from the tissue treatment electrode in such a manner as to define, in use, a conductive fluid path that completes an electrical circuit between the tissue treatment electrode and the return electrode. The electrode assembly is provided with a plurality of apertures in the region of the tissue treatment electrode, through which apertures vapour bubbles and/or paniculate material can be aspirated from the region surrounding the tissue treatment electrode.

An RF generator is provided for powering the electrode assembly. The power required from the RF generator to achieve vaporisation depends on a number of variables more fully described in the specification of our International Patent Application No. GB97/00065. Of these variables two, are of particular importance in the context of the present invention; one being the cooling effect produced by the aspiration of conductive fluid in the region of the tissue contact electrode, and the other being the disruption of the vapour pocket formed around the tissue contact electrode by the flow of conductive fluid. These problems can be partially overcome by co-ordinating the aspiration by monitoring the output features of the generator which indicate the vaporisation power threshold has been exceeded. This usually results in a series of suction pulses as the vaporisation threshold is repeatedly exceeded between pulses and then elevated during the suction pulses so that, should vaporisation be maintained, the suction will be applied continuously. By using this technique, heated saline in the vicinity of the tissue contact electrode and vaporisation products can be successfully removed. The other desirable feature is the aspiration of loose tissue towards the tissue contact electrode, so that it can be stabilised during vaporisation. Whilst this can be achieved according to this technique; there are two significant performance limitations.

The first of these limitations is that the gaseous products of tissue vaporisation contain fatty products which have a sublimation property, i.e. they condense directly to a solid; sublimation chaining at temperatures well above boiling point. As the electrode shaft within the body cavity is cooled by the surrounding saline, these products are easily condensed. Thus, if a parallel suction shaft is used, the build up is along its entire length, and eventually completely blocks the tube. This process, even at the flow rates dictated by minimal influence on the power threshold, can cause very rapid blocking. For example, it is found that, with a moderately large electrode tip, using a 1mm internal diameter suction tube, complete blockage occurs after 30 seconds of activation. Obviously, a larger tube bore would increase the time before blockage, but this occurs so rapidly that the required bore size for a useful electrode life is beyond the dimensions of the maximum shaft diameter. The problems of sublimation are compounded by aspiration of tissue pieces which are incompletely vaporised before being excised from the remainder of the tissue. Given the need to attract tissue and, therefore, the requirement for a strong suction pressure which, once tissue is engaged with the tissue contact electrode and the vaporisation threshold is continually exceeded by cessation of flow, increases the propensity for aspiration of unvaporised tissue and blockage of the aspiration channel.

The second of these limitations also relates to adherence of tissue to the tissue contact electrode. As indicated above, once the tissue obstructs flow, the vaporisation power threshold is exceeded, and suction is continuously applied. Under these circumstances, and particularly when aspiration channels are provided adjacent to the tissue treatment electrode, a steady state can be reached wherein the tissue is held around the periphery of the tissue contact electrode, the portion of tissue in the immediate vicinity of the tissue treatment electrode is vaporised but, without moving the application site or redirecting suction solely through the tissue treatment electrode, no further removal of tissue will occur. For example, large pieces of tissue tend to bridge the tissue treatment electrode, so that all tissue in contact with the electrode is removed, but the bulk of the tissue is left in place. Applying suction solely through the tissue treatment electrode limits the size of the electrode otherwise two extremes are created where, on the one hand during activation in conductive fluid, the vaporisation power threshold is very elevated despite synchronising suction pulses with the RF output, typically > 200 Watts, yet, on the other hand, can be reduced to below 50% of this level once tissue is engaged. With a static tissue contact electrode, there is an inevitable compromise between these performances variables.

The aim of the invention to provide an improved electrosurgical instrument of this type.

The present invention provides an electrosurgical instrument for the treatment of tissue in the presence of an electrically-conductive fluid medium, the instrument comprising an instrument shaft, a tissue treatment electrode mounted at the distal end of the shaft for electrosurgically excising tissue pieces at an operation site, morcellation means for electrosurgically reducing the size of excised tissue pieces, and removal means for removing morcellated tissue pieces, the instrument having an apertured portion through which matter can be aspirated by the removal means from the region surrounding the tissue treatment electrode, the removal means comprising a channel formed within the instrument shaft and leading from the apertured portion, wherein the tissue treatment electrode is movable cyclically relative to the distal end of the shaft, and constitutes the morcellation means.

Preferably, the instrument further comprises drive means for moving the tissue treatment electrode relative to the distal end of the shaft.

Morcellation is the division of a tissue piece into many smaller pieces in order to facilitate its surgical removal.

Advantageously, the tissue treatment electrode is such that the cyclical movement thereof is effective to prevent excised tissue pieces adhering to the distal end portion of the instrument. Preferably, the tissue treatment electrode is such that the cyclical movement thereof causes a portion thereof to wipe the entire distal end portion of the instrument which, in use, contacts tissue.

Advantageously, the instrument further comprises a return electrode which is electrically insulated from the tissue treatment electrode by insulation means, the tissue treatment electrode being exposed at the distal end of the instrument, and the return electrode having a fluid contact surface spaced proximally from the exposed end of the tissue treatment electrode.

In a preferred embodiment, the tissue treatment electrode is movable cyclically relative to the return electrode so as to move the tissue treatment electrode cyclically into, and out of, at least one position in which arcing occurs between the tissue treatment and return electrodes.

Preferably, the channel is defined by the instrument shaft.

Conveniently, the tissue treatment electrode is provided at the distal end of a rod mounted within, and movable relative to, the instrument shaft. Thus, movement of the rod results in movement of the tissue treatment electrode, and this prevents tissue bridging, as the tendency for tissue to obstruct the channel is obviated by the electrode movement ensuring that such tissue is treated. Tissue can, therefore, be electrosurgically removed from an operation site by a vaporisation technique, and can be electrosurgically morcellated in this region by the moving tissue treatment electrode, this process being analogous to a miniature liquidiser. Preferably, the tissue treatment electrode is constituted by the distal end portion of the rod.

Advantageously, the rod is constituted by a tungsten wire having a diameter in the range of from 0.2mm to 1.0mm. Preferably, the tungsten wire has a diameter in the range of from 0.4mm to 0.6mm.

Advantageously, the tissue treatment electrode is angled with respect to the longitudinal axis of the instrument shaft, and the instrument further comprises an insulating sleeve surrounding the rod proximally of said angled end portion. The insulating sleeve may be a ceramic sleeve.

Preferably, the insulation means comprises an insulation member provided at the distal end of the instrument shaft, the insulation member defining said apertured portion. The insulation member may be made of a ceramic material.

Advantageously, the insulation member is formed with a slot which constitutes the apertured portion, the tissue treatment electrode passing through the slot. Alternatively, the apertured portion is constituted by a gap between the tissue treatment electrode and the insulation member.

In a preferred embodiment, the drive means is such as to reciprocate the rod within the channel. Advantageously, the drive means is constituted by a motor and coupling means for converting the rotary output of the motor into reciprocatory movement of the rod. In this case, the angled end portion of the rod may be at right-angles to the longitudinal axis of the instrument shaft, and the tip of the angled end portion may constitute the tissue contacting portion of the tissue treatment electrode. This electrode is, therefore, a side effect electrode.

In another preferred embodiment, the drive means is such as to rotate the rod within the channel. An electric motor may constitute the drive means.

Advantageously, the angled end portion of the rod is at right-angles to the longitudinal axis of the instrument shaft, and the distal end surface of said angled end portion constitutes the tissue contacting portion of the tissue treatment electrode. The rotation of the angled end portion of the rod permits the use of a small diameter rod, and hence the use of a small tissue treatment electrode, whilst providing a relatively large area tissue contacting position. The use of a small diameter tissue treatment electrode also permits the use of lower electrosurgical powers and/or higher fluid medium flow rates.

Alternatively, the angled end portion of the rod makes an acute angle with the longitudinal axis of the instrument shaft, and the insulation member is provided with an inclined cam surface which is engagable with the apex of the angled end portion of the rod.

It is also possible for the angled end portion of the rod to be bent back around the distal end portion of the insulating sleeve.

Preferably, the removal means further comprises a pump connected to the channel at a region thereof remote from the apertured portion of the instrument. The pump may be activated cyclically whereby matter is aspirated by the removal means in a pulsed fashion. Conveniently, the pump is activated only when the tissue treatment electrode is powered for tissue vaporisation. The instrument may further comprise an RF generator having a bipolar output connected to the tissue treatment electrode and the return electrode. Advantageously, the RF generator supplies energy to the drive means. Preferably, the pump is controlled in dependence upon the output characteristics of the RF generator.

The electrosurgical instrument of the invention is useful for dissection, resection, vaporisation, desiccation and coagulation of tissue, as well as for combinations of these functions. It has a particular application in arthroscopic surgery as it pertains to endoscopic and percutaneous procedures performed on joints of the body including, but not limited to, such techniques as they apply to the spine and other non-synovial joints. Arthroscopic operative procedures may include: partial or complete meniscectomy of the knee joint including meniscal cystectomy; lateral retinacular release of the knee joint; removal of anterior and posterior cruciate ligaments or remnants thereof; labral tear resection, acromioplasty, bursectomy and subacromial decompression of the shoulder joint; anterior release of the temperomandibular joint; synovectomy, cartilage debridement, chondroplasty, division of intra-articular adhesions, fracture and tendon debridement as applied to any of the synovial joints of the body; inducing thermal shrinkage of joint capsules as a treatment for recurrent dislocation, subluxation or repetitive stress injury to any articulated joint of the body; discectomy either in the treatment of a disc prolapse or as part of a spinal fusion via a posterior or anterior approach to the cervical, thoracic and lumbar spine or any other fibrous joint for similar purposes; excision of diseased tissue; and haemostasis.

The instrument of the invention is also useful for dissection, resection, vaporisation, desiccation and coagulation of tissue, as well as combinations of these functions, with particular application in urological endoscopic (urethroscopy, cystoscopy, ureteroscopy and nephroscopy) and percutaneous surgery. Urological procedures may include: electro-vaporisation of the prostate gland (EVAP) and other variants of the procedure commonly referred to as transurethral resection of the prostate (TURP) including, but not limited to, interstitial ablation of the prostate gland by a percutaneous or perurethral route whether performed for benign or malignant disease; transurethral or percutaneous resection of urinary tract tumours as they may arise as primary or secondary neoplasms, and further as they may arise anywhere in the urological tract from the calyces of the kidney to the external urethral meatus; division of strictures as they may arise at the pelviureteric junction (PUJ), ureter, ureteral orifice, bladder neck or urethra; correction of ureterocoele; shrinkage of bladder diverticular; cystoplasty procedures as they pertain to corrections of voiding dysfunction; thermally induced shrinkage of the pelvic floor as a corrective treatment for bladder neck descent; excision of diseased tissue; and haemostasis.

The electrosurgical instrument of the invention is also useful for dissection, resection, vaporisation, desiccation and coagulation of tissue and combinations of these functions with particular application in laparascopic, colposcopic (including vaginal speculum) and open surgical procedures on the female genital tract and adnexal related diseases. Laparascopic operative procedures may include: removal of subserosal and pedunculated fibroids, ablation of ectopic endometrium, ovarian cystectomy and ovarian drilling procedures; oophorectomy, salpingo-oophorectomy, subtotal hysterectomy and laparaoscopically assisted vaginal hysterectomy (LAVH) as may be performed for benign or malignant diseases; laparascopic uterosacral nerve ablation (LUNA); fallopian tube surgery as correction of ectopic pregnancy or complications arising from acquired obstructions; division of abdominal adhesions; and haemostasis.

The electrosurgical instrument of the invention is also useful in the lower female genital tract, including treatment of cervix, vagina and external genitalia whether accessed directly or using instrumentation comprising generally speculae and colposcopes. Such applications include: vaginal hysterectomy and other pelvic procedures utilising vaginal access; LLETZ/LEEP procedure (large loop excision of the transformation zone) or excision of the transformation zone of the endocervix; removal of cystic or septic lesions; ablation of genital or venereal warts; excision of benign and malignant lesions; cosmetic and surgical repairs including vaginal prolapse; excision of diseased tissue; and haemostasis. The electrosurgical instrument of the invention is also useful for dissection, resection, vaporisation, desiccation and coagulation of tissue and combinations of these functions with particular application in surgery on the ear, nose and throat (ENT), and more particularly procedures performed on the oropharynx, nasopharynx and sinuses. These procedures may be performed through the mouth or nose using speculae or gags or using endoscopic techniques such as functional endoscopic sinus surgery (FESS). Functional endoscopic sinus procedures may include: removal of chronically-diseased inflamed and hypertrophic mucus linings, polyps and neoplasms from the various anatomical sinuses of the skull; excision of diseased tissue; and haemostasis. Procedures on the nasopharynx may include: removal of chronically-diseased inflamed and hypertrophic mucus linings, polyps and neoplasms from the turbinates and nasal passages; submucous resection of the nasal septum; excision of diseased tissue; and haemostasis. Procedures on the oropharynx may include: removal of chronically- diseased, inflamed and hypertrophic tissue, polyps and neoplasms particularly as they occur related to the tonsil, adenoid, epi-glottic and supra-glottic regions, and salivary glands; as an alternative method to perform the procedure commonly known as laser assisted uvolopalatoplasty (LAUP); excision of diseased tissue; and haemostasis.

It is evident from the scope of applications of the invention that it has further additional applications for dissection, resection, vaporisation, desiccation and coagulation of tissue and combinations of these functions in general laparoscopic, thoracscopic and neurosurgical procedures, being particularly useful in the removal of diseased tissue and neoplastic disease whether benign or malignant.

Surgical procedures using the electrosurgical instrument of the invention may also include introducing the electrode assembly to the surgical site, whether through an artificial conduit (a cannula) or a natural conduit, which may be in an anatomical body cavity or space, or one created surgically. The cavity or space may be distended during the procedure using a fluid, or may be naturally held open by anatomical structures. The surgical site may be bathed in a continuous flow of conductive fluid such as saline solution either to fill and distend the cavity, or to create a locally-irrigated environment around the tip of the electrode assembly in a gas filled cavity. The irrigating fluid may be aspirated from the surgical site to remove products created by application of the RF energy, tissue debris or blood. The procedures may include simultaneous viewing of the site via an endoscope, or using an indirect visualisation means. An irrigated bipolar electrosurgical instrument is described in the specification of our International Patent Application No. PCT/GB96/01472.

The invention will now be described in greater detail, by way of example with reference to the drawings, in which :- Figure 1 is a diagram showing an electrosurgical apparatus constructed in accordance with the invention;

Figure 2 is a diagrammatic side elevation, partially broken away, of a first form of electrode unit constructed in accordance with the invention;

Figure 3 is a diagrammatic side elevation of the electrode assembly of the electrode unit of Figure 2;

Figure 4 is a diagrammatic side elevation, partially broken away, of a second form of electrode unit constructed in accordance with the invention;

Figure 5 is a diagrammatic side elevation of the electrode assembly of the electrode unit of Figure 4; Figure 6 is a diagrammatic side elevation, partially broken away, of a third form of electrode unit constructed in accordance with the invention;

Figure 7 is a diagrammatic side elevation of the electrode assembly of the electrode unit of Figure 6;

Figure 8 is a diagrammatic side elevation, partially broken away, of a fourth form of electrode unit constructed in accordance with the invention; and

Figure 9 is a diagrammatic side elevation of the electrode assembly of the electrode unit of Figure 8.

Referring to the drawings, Figure 1 shows electrosurgical apparatus including a generator 1 having an output socket 2 providing a radio frequency (RF) output, via a connection cord 4, for an instrument in the form of a handpiece 3. Activation of the generator 1 may be performed from the handpiece 3 via a control connection (not shown) in the cord 4, or by means of a foots witch unit 5 connected separately to the rear of the generator 1 by a foots witch connection cord 6. In the illustrated embodiment, the footswitch unit 5 has two footswitches 5a and 5b for selecting a desiccation mode and a vaporisation mode of the generator 1 respectively. The generator front panel has push buttons 7a and 7b for respectively setting desiccation and vaporisation power levels, which are indicated in a display 8. Push buttons 9 are provided as an alternative means for selection between the desiccation and vaporisation modes.

The handpiece 3 mounts a detachable electrode unit E, such as the electrode units El and E4 to be described below.

Figure 2 shows the first form of electrode unit El for detachable fastening to the electrosurgical instrument handpiece 3, the electrode unit comprising a shaft 10, which is constituted by a tube made of stainless steel. A tissue treatment (active) electrode

12 is provided at the distal end portion of the shaft 10. The active electrode 12 is provided by the distal end portion of a rod 14 made of tungsten, the active electrode extending at right angles to the rod. The rod 14 has a diameter of 0.4 to 0.6 mm. A ceramic tube 18 is fixed to the rod 14 immediately adjacent to the active electrode 12.

A ceramic tip 20 is fixed within the out-turned distal end portion of the shaft 10.

As shown in Figure 2, the active electrode 12 protrudes through a longitudinal slot 20a formed in the ceramic tip 20. That portion of the rod 14 not covered by the ceramic tube 18 is provided with an insulating sleeve 22 made of polyimide, polytetrafluoroethylene or by separate sleeves made by these two substances. A heat sleeve 24 made of polytetrafluoroethylene or polyimide, covers the adjoining regions of the ceramic tube 18 and the sleeve 22.

The major portion of the length of the shaft 10 is provided with an insulating heat shrink sleeve 26 made of polyvinylidenefluoride. The sleeve 26 does not cover the distal end portion of the shaft 10, that region of the shaft constituting a return electrode 28.

The rod 14 is mounted for reciprocal movement within the shaft 10, that end of the rod remote from the active electrode 12 being fixed to a coupling member 30 slidably mounted within one end 32a of a sleeve 32 made of stainless steel. The other end 32b of the sleeve 32 is fixed to the adjacent end portion of the shaft 10. A top hat washer 34 is located within the sleeve end 32b, the washer constituting a backing member for a silicone gland 36 and a delrin bush 38. A return spring 40 acts between the bush 38 and the coupling member 30. The rod 14 passes through apertures in the washer 34, the gland 36 and the bush 38.

An off -set shaft 30a is fixed to the end face of the coupling member 30, the free end of this shaft being engageable with an inclined end face 42a of a rotatable coupling member 42 fixed to the rotary output shaft of a motor 44. Hence, rotation of the output shaft of the motor 44 results in reciprocation of the coupling member 30 and the rod 14.

The hollow interior of the shaft 10 is connected to a transverse tubular member 10a which is connected to a suction pump (not shown) , and so constitutes a suction/exhaust port. As shown in Figure 2, the active electrode 12 is positioned at the end of an aspiration channel constituted by the annular cavity defined by the interior of the shaft 10 and the rod 14, so that vapour bubbles and/or paniculate material which, in use, are formed in the region of the active electrode, can be aspirated from the region for removal via the slot 20a, the aspiration channel and the port 10a.

The RF generator 1 (not shown in Figure 2) delivers an electrosurgical current to the electrodes 12 and 28 via connectors 46 and 48 provided respectively on the coupling member 30 and on the sleeve 32. The generator 1 includes means for varying the delivered output power to suit different electrosurgical requirements. Thus, in a first output power range of from about 140 volts to 200 volts, the active electrode 12 is used for tissue desiccation; and, in a second output power range of from about 250 volts to 600 volts, the active electrode is used for tissue removal by cutting or vaporisation. For both ranges, the voltages are peak voltages. The generator 1 may be as described in the specification of our European Patent Application 96304558.8.

This electrosurgical instrument is particularly useful for rapid tissue debulking and the removal of loose tissue. One of the problems which could be encountered when tissue is rapidly debulked using an arthoscopic electrode configuration, particularly when working in small joint spaces, is the production of vapour bubbles generated as an end product of tissue vaporisation. Such bubbles obscure vision, and can coalesce at the site of tissue application, so that the electrical circuit between the active and return electrodes becomes compromised by the absence of conductive fluid. Irregular active electrodes having filamentary, mesh or coiled spring forms goes some way to solving this problem as it reduces the vaporisation threshold as disclosed in the specification of our International patent application No. GB97/00065.

The provision of the suction pump ensures the elimination of vapour bubbles from an operation site, which is particularly advantageous during aggressive tissue debulking. The suction pump is activated only when the active electrode 12 is powered for tissue vaporisation. The pump is, therefore, pulsed so as to pull saline over the active electrode 12 (and to extract vapour bubbles and/or paniculate material). This cools the active electrode 12, resulting in the collapse of the vapour pocket surrounding the active electrode. This, in turn, leads to the suction pump being turned off, thereby reducing the flow of saline over the active electrode 12. This electrode 12 then heats up again, leading to the re-formation of a vapour pocket, and the re-activation of the suction pump. This cycle then repeats until the generator 1 is turned off when the instrument is removed from the operation site.

The suction pump must be controlled so that the flow of bubbles from the active electrode 12 is balanced to the output characteristics of the RF generator 1 to prevent excessive cooling of the active electrode and a resultant increase in its vaporisation power threshold. The thermal mass of the thin, wire-form active electrode 12 is lower than that of a standard solid form active electrode, and this assists in rapidly reestablishing the vapour pocket around the active electrode should this collapse following excessive cooling.

The electrode unit El is intended primarily for use in arthroscopic surgery which requires rapid tissue debulking by vaporisation. The side-effect electrode (i.e. where the treatment axis is perpendicular to the shaft) configuration of the unit El is particularly advantageous for this purpose. In use, the electrosurgical instrument is manipulated to introduce the electrode assembly constituted by the active electrode 12 and the return electrode 28 into a selected operation site (e.g. within the joint space of a knee), so that the active electrode contacts the tissue to be treated, and the tissue and the electrode assembly are immersed in saline.

The footswitch 5b (or the push button 7b) is then operated to activate the generator 1. The generator 1 then provides sufficient RF power to the electrode assembly to vaporise the saline surrounding the active electrode 12, and to maintain a vapour pocket surrounding this electrode. Using a brushing technique, with firm pressure against the tissue surface, rapid debulking of the tissue is achieved. Gently touching the tissue will reduce the effect, and can be used to sculpture and smooth the residual tissue surface.

With tissue engagement, the flow of irrigant away from the active electrode 12 will be reduced, the amount of reduction depending on the nature of the tissue surface, the application pressure and the suction pressure. Speed of debulking will, therefore, depend on these variables. Once the vaporisation occurs, the products will include vapour bubbles, carbon particles and tissue debris. All of these products are removed from the region of the active electrode 12, via the shaft 10 and the port 10a, by the suction pump.

All the constituents removed from the active tip are at high temperatures. This could lead to a potentially dangerous heating of the electrode shaft 10, which could cause tissue damage at the entry point. It may be, therefore, necessary to aspirate additional coolant saline from the body cavity along the inside surface of the shaft. To ensure that this saline is indeed at a safe temperature, it is taken from the rear of the return electrode 28 via a mesh filter (not shown) .

In use, when the generator 1 is turned on, the motor 44 begins to rotate, causing the rod 14 to oscillate with an amplitude of 0.5mm. The oscillation of the rod 14 within the shaft 10 provides a mechanical agitation within the shaft that is sufficient to dislodge any sublimation products which condense within the shaft. In this way, blockage of the shaft 10 is prevented, so that the instrument can be used on a continuous basis.

The oscillation of the active electrode 12 also ensures that tissue pieces removed electrosurgically by vaporisation from an operation side are morcellated electrosurgically by the oscillating electrode, thereby preventing large tissue pieces bridging the aspiration channel.

The electrode unit El is also very effective in removing heated saline (distension fluid) from within a joint cavity. The risk of hot distension fluid occurs primarily during power application to reach the vaporisation threshold. Once the threshold has been reached, the power requirement falls by 30-50%.

Whilst aspiration from the region of the active electrode 12 will remove heated saline from the body cavity, and remove any risk of overheating through prolonged activation under conditions where the vaporisation threshold is not reached, the cooling effect and disruption of vapour pockets created around the active electrode will increase the vaporisation threshold. A vicious cycle can, therefore, be created, wherein the more suction applied at the active electrode 12, the more power required to reach the vaporisation threshold, and the greater the risk of heating. The other factor influencing the vaporisation threshold is the ratio of return: active contact area, and the insulation separation between the active electrode 12 and the return electrode 28. The size of the active electrode 12 and the insulation separation, must, therefore, be reduced to the minimum necessary to achieve the function in order to offset the effects of aspiration in elevating the power threshold of vaporisation.

The specification of our International Patent Application GB97/00065 discloses techniques for controlling the vaporisation threshold by employing active electrode designs which assist in capturing vapour pockets and preventing cooling of the active electrode application site by screening from the flow of irrigant provided by channels in an endoscope. An alternative method of reducing the vaporisation power threshold is to pulse the suction pressure, thereby allowing the threshold to be attained between pulses. Such pulses may be synchronised with the output features of the RF generator 1 to provide power bursts during active suction to sustain the vapour pocket, and clear any tissue occluding the apertures in the active electrode 12.

A known technique in arthroscopic surgery is to apply suction through a mechanical, tissue-nibbling device so that soft tissue present in the joint space, such as the infrapatellar fat pad, can be held in position within the nibbler jaws by suction whilst it is progressively "nibbled away".

Attracting tissue to the active electrode 12 of the electrode unit El has a similar effect as, for the reasons already given above, compliant tissue adhering to the active electrode will result in a reduction of the vaporisation power threshold. Adherent tissue will be rapidly vaporised, and small tissue particles produced during vaporisation will be aspirated from the application site.

Because of its speed of debulking and side-effect configuration, the electrode unit El also has advantages in urological surgery as an EVAP technique for use in conjunction with a resectoscope. A resectoscope electrode unit is introduced very differently, in that is mounted on an endoscope prior to passage of the assembled instrument through a working sheath via the urethra. The proximal end of the electrode unit is connected to a trigger assembly and an electrical contact which is integral with the resectoscope. By this means, the electrode unit El can be moved back and forth through a defined range of motion by operating the trigger mechanism. As the electrode unit El is assembled prior to introduction, the size of the tip is not constrained by working channel dimensions, but rather by the diameter of the working sheath which can be up to 10 mm. Part of this diameter is occupied by the support wires to the electrode unit El, which wires are commonly bent in a downward angle, with respect to the endoscopic image, to the working tip, so that they do not interfere with either visulation or its operation. Because of the reciprocatory movement of the rod 14, the active electrode 12 operates over a length lying within the range of from 3 mm to 4 mm and a width lying in the range of from 2 mm to 3 mm, and this size is necessary for urological surgery given that, on average, 20-30 grammes of prostate tissue must be removed.

Because of the reservoir effect of the urinary bladder, and the mounting of the endoscope to view the tip of the active electrode 12 from below, bubble generation during vaporisation is less of a problem during endoscopic urology, as the bubbles flow away from the endoscope to accumulate in the bladder. Nevertheless, the use of the electrode unit El substantially reduces the possibility of bubble generation causing problems.

Although the electrode unit El is intended primarily for use in the vaporisation of tissue it can also be used for desiccation, particularly of synovial membranes or to separate muscle attachments. In this case, once the electrode assembly of the electrode unit El has been introduced into a selected operation site, the RF generator 1 is actuated using the footswitch 5 a or the push button 7a. The generator 1 will then provide sufficient RF power to the electrode assembly to maintain the saline adjacent to the active electrode 12 substantially at its boiling point without creating a vapour pocket surrounding that electrode. The instrument can then be manipulated by moving the active electrode 12 across the surface of the tissue to be treated in a side-to-side "painting" technique. The electrode unit El can also be used for delivering a blended power output. This is achieved by automatically alternating the output of the RF generator 1 between the desiccation and vaporisation power levels, more haemostasis being produced then is possible in the vaporisation mode. As a consequence, the speed of tissue debulking is reduced, but the increased haemostasis is useful when cutting or debulking vascular tissue structures. Alternatively, the output of the RF generator 1 can be pulsed at the vaporisation power level, without cycled activation of the desiccation mode. This produces a less aggressive tissue vaporisation than occurs in the vaporisation mode, with a consequent reduction in both bubble formation and the risk of tissue charring.

The active electrode 12 of the unit El is a side effect electrode (i.e. its treatment axis is perpendicular to the shaft). Axial agitation is advantageous with such electrodes, in that the entire electrode can be brought into contact with tissue. As a result, the exposed area can be made very small, allowing operation at lower powers and less at higher saline flow rates.

Figures 4 and 5 show the second form of electrode unit E2. This instrument is a modification of that shown in Figures 2 and 3, and so like reference numerals will be used for like parts, and only the modifications will be described in detail. There are two main modifications, the first being to the drive to the rod 14, and the second to the configuration of the active electrode 12.

In the first modification, the motor 44 rotatably drives the rod 14 via a coupling assembly 42. As with the embodiment of Figures 2 and 3, the rod 14 passes through aligned apertures in the washer 34, the gland 36 and the delrin bush 38. The bush 38 is somewhat longer than the equivalent bush of the embodiment of Figures 2 and 3 extending to the end 32a of the sleeve 32. A slip ring 46a is provided to connect the connector 46 to the rod 14.

The other main modification is that the active electrode 12 (the free end of the tungsten rod 14 - in this embodiment of 0.5mm diameter) is bent back over the free end of the ceramic tube 18. The turned-back portion 12a of the electrode 12 constitutes a side effect electrode. An apertured region 20a is formed between the ceramic tip 20 and the active electrode 12, this region loading to the aspiration channel defined by the interior of the shaft 10.

Another modification is that the rod 14 is a flexible drive rod whose distal end portion is off-set with respect to the central longitudinal axis of the shaft 10. In use, when the generator 1 is turned on, the motor 44 begins to rotate, causing the rod 14 to rotate within the shaft 10. This rotation provides a mechanical agitation that is sufficient to dislodge any sublimation products which condense within the shaft. The off-set of the rod 14 results in an unstable oscillation being set up in the rod, which sweeps adherent tissue debris from the inner wall of the shaft 10.

Figures 6 and 7 show the third form of electrode unit E3. This unit E3 is a modification of the unit E2, so like reference numerals will be used for like parts, and only the modifications will be described in detail. The main modification is to the configuration of the active electrode assembly. Thus, as shown in Figure 7, the active electrode 12 is shaped like a crank handle, and defines an elbow 12b which is off-set from the axis of the ceramic tube 18. The ceramic tip 20 is formed with an inclined cam surface 20b which, in use, engages with the elbow 12b to force the tip of the active electrode 12 outwardly, and to ensure better tissue engagement. This crank handle configuration of the active electrode 12 also ensures that, as the tip rotates, the elbow 12b is pushed around the inner surface of the ceramic tip 20, thereby removing debris which would otherwise tend to build up there.

Figures 8 and 9 show the fourth form of electrode unit E4. This unit E4 is also a modification of the unit E2, so like reference numerals will be used for like parts, and only the modifications will be described in detail. Here, the main modification is to the configuration of the active electrode 12 which, in this case, is an end effect electrode, being constituted by a simple hook-shaped end portion 12a at the end of the rod 14. As with the embodiments of Figures 4 and 5, the rod 14 is a flexible drive rod whose distal end portion off -set with respect to the central longitudinal axis of the shaft 10.

As has already been described, the adherence of tissue over the active electrode 12 may induce a steady state condition, and the aspiration method must allow for removal of unvaporised tissue particles whilst not quenching vapour pocket formation. Rotation of the active electrode 12 of the electrode units E2 to E4 provides several advantages to overcome these performance issues. Thus, rotating the active electrode 12 increases the effective size of the electrode, as far as tissue contact area is concerned, for one complete rotation, whilst reducing the physical size of the active electrode. Reducing the size of the active electrode 12 reduces the vaporisation power threshold to a degree sufficient to enable aspiration along the axis of rotation when the generator control method is employed.

The introduction of rotation and aspiration through the active electrode 12, or more accurately through a channel within the range of motion of the active electrode, prevents the steady state being reached, and so prevents tissue bridging. This is achieved as tissue temporarily obstructing the aspiration channel is always treated, as opposed to positioning aspiration channels outside the range of motion of the active electrode 12, in which case only tissue adjacent to that obstructing the aspiration channel would be treated.

Given that the aspiration channel is required to cope with unvaporised tissue, the active electrode 12 is only required to incise the tissue such that the tip of the tissue in the aspiration channel is detached from the body of the tissue and then aspirated through the channel. Ideally, the truncated portion of tissue is also morcellated or partially vaporised by the active electrode 12 to reduce the size of tissue pieces. This morcellation is accomplished by introducing an off-set in the drive shaft/connector to the active electrode 12 which rotates in the aspiration channel of larger internal diameter than the external diameter of the connector, a feature which has additional advantages in preventing blocking of the aspiration channel, as is described below. The relative contributions of tissue incision or morcellation and tissue vaporisation to the overall tissue debulking process can be controlled by the interaction of the bore of the terminal aspiration channel, the suction pressure and the bulk of the active electrode 12. Owing to the overall size constraints on the external diameter of the instrument it is, in general, the diameter of the drive rod 14 whose distal tip forms the active electrode 12 and which, therefore, also provides the means of electrical connection to the active electrode, which determines whether tissue removal occurs primarily by incision/morcellation or vaporisation. Typically a drive rod 14 (and hence active electrode 12) formed from 0.2-1.0 mm diameter tungsten wire provides incision/morcellation, and a drive rod active electrode formed from 0.5mm diameter tungsten wire primarily provides vaporisation. The incision/morcellation technique has advantages when dealing with soft friable tissue, whereas the vaporisation technique has advantages when application is made to dense fibrous or cartilaginous tissue. The design can, therefore, be optimised for the type of tissue encountered during use in particular surgical specialities or, alternatively, a multi functional design with a drive rod and active electrode typically formed from 0.4-0.6mm tungsten can be used.

For all four electrode units El to E4, agitation within the aspiration shaft 10 significantly reduces the risk of blockage, either by morcellated tissue, sublimated products of vaporisation or both. This can be accomplished by axial or rotary motion of the rod 14 which is positioned within the aspiration channel, with or without other means of fluid agitation, including the cycling of suction pressure, which may be provided as an integral feature of generator output, control of suction, and sonic pressure waves. To enhance the effect of agitation, it is beneficial to construct the drive rod 14 from a lubricious material to reduce adherence.

Each of the electrode units El and E4, has the additional advantage that the aspiration in the region of the active electrode 12 restricts the flow of convection currents in the saline surrounding the electrode assembly. As the power threshold required to reach vaporisation is dependent on the power dissipation of the active electrode 12 and the flow characteristics around it, the power threshold is dependent upon the maximum rate of convection. Consequently, the restriction of the convection currents reduces the power threshold and/or permits the use of higher saline flow rates, and this is advantageous as it enables the use of a cheaper RF generator, as well as avoiding problems such as dissipation within the instrument, and catastrophic overheating of the active electrode. It also facilitates control of the generator once vaporisation commences. The importance of power threshold of vaporisation is discussed in greater detail in the specification of our International Patent Application No. GB97/00065.

Moreover, each of the electrode units El to E4 is such as to prevent tissue bridging, as the tendency for tissue to obstruct the aspiration channel is, in each case, obviated by the movement of the active electrode ensuring that such tissue is treated. The movement of the active electrode 12 also ensures tissue morcellation, though this is effected by electrosurgery rather than by mechanical cutting.

It is a feature of each of the electrode units El to E4 that pieces of morcellated tissue separated from a surgical site will be drawn into the aspiration channel by the suction pressure. Should such pieces be too large to enter the aspiration channel, they will be reduced in size by a combination of the mechanical action of the agitated electrode 12 and the electrosurgical action created by the positioning of the return electrode 28 in relation to the aspiration channel. In the limit, the spacing of the return electrode 28 relative to the motion of the agitated electrode 12 can be adjusted to allow a controlled level of periodic arcing between the two. This aspect permits control of the relative strength of the mechanical and electrosurgical actions in keeping the aspiration channel clear. This aspect is described in greater detail in the specification of our British Patent Application

It will be apparent that modifications could be made to the electrode units described above. For example, instead of providing an off-set drive rod 14, this rod could be loosely coiled so that the coils lie against the inner wall of the aspiration channel, whereby, during rotation, a worm screw action occurs to encourage proximal movement of tissue debris, as well as cleaning of the inner wall of the channel.

The motor 44 of each of the embodiments could be powered by the RF generator 1. This has the advantage that the motor 44 can be controlled by means that require the RF output voltage to exceed the vaporisation power threshold before sufficient power is delivered to energise the motor. Control means for this purpose could be mounted with the motor 44 within the handpiece 3.

It would also be possible to introduce axial motion during rotation. Thus, for the electrode unit E4, the simple 90° hook form active electrode 12 can rotate on a bearing surface provided by the distal end face of the ceramic tube 18, this end face being provided with ratchet teeth features. Thus, as the rod 14 rotates, the hook-shaped end portion 12a moves in and out as it engages and disengages the ratchet teeth, this axial movement being permitted by the off-set flexible drive rod 14 repeatedly elongating and shortening.

As an alternative to an electric motor, each of the units El to E4 could be powered by a fluid drive generated through a rotary vane or similar apparatus, which, in turn, may be powered by the suction means.

It is also possible to power the rotary drive by the RF generator 1 , so that an integral and interactive system of the rotary drive, the active electrode 12, the RF generator and the suction means is provided.

The upper limit of the speed of rotation of the units E2 to E4 is defined at that level which elevates the vaporisation power threshold beyond the output range of the RF generator 1, which will, in turn, be dependent upon the geometry of the active electrode 12. Typically, the speed of tissue removal is increased with increased rotary speed when primarily employing the incision/morcellation technique, and is increased with decreased rotary speed when primarily employing the vaporisation technique. It is, therefore, evident that, in a multi-functional design, it is advantageous for the user to vary the rotary speed depending on the nature of the tissue being treated. To this end, a typical range of rotary speeds would be from 100 revs/min to 1000 revs/min.

With the rotary action electrode units E2 to E4, the effective size of the active electrode 12 is increased, and a significant aspect is the incision of tissue. The active electrode 12 is fabricated from the distal end of the drive rod 14, so simple wire form electrodes meet these performance requirements. The only drawback of these simple electrode forms is that asymmetry of the tissue contact can make it difficult to maintain an accurate location on a tissue surface, particularly when that surface is comprised of more fibrous or more dense tissue.

If the wire form active electrode 12 protrudes from the ceramic tube 18, for example in a simple loop form as with the electrode unit E2, then the potential exists for the loop to excise tissue pieces too large for aspiration through the distal opening of the aspiration channel. Should this occur, the exposed distal end of the drive rod 14 within the aspiration channel performs an important function in morcellating and vaporising such tissue pieces, so that they are reduced in size sufficiently to enter the aspiration channel. This function is enhanced by the eccentric motion of the drive rod 14 within the aspiration charmel.

Whilst the amount of protrusion of the active electrode 12 from the distal end of the ceramic tube 18 is governed by the rules described in our International Patent Application GB96/01473, the effect of aspiration in increasing vaporisation threshold changes these rules. The other performance factor governing the dimension of the active electrode 12 is similar to that defining the diameter of the wire. Thus, the thinner wire forms, which are used on soft tissue, can protrude from the distal end of the ceramic tube 18 in the treatment axis; whilst the thicker wire forms, which are used on more dense tissue, ideally extend beyond the distal end of the ceramic tube in the treatment axis by an amount not exceeding the diameter of the wire. The active electrode 12 may also take on more convoluted or more complex generally planar forms of end effect electrodes and generally axial forms for side effect electrodes, for example coils, spirals, meshes or multiple spokes.

Our International Patent Application GB96/01472 describes a technique of introducing a conductive fluid to the region of a tissue treatment (active) electrode in order to define, in use, a conductive fluid path between the active electrode and a return electrode. The electrode units El to E4 of the present invention could be modified to incorporate those features. In particular, these units could be modified for use in gaseous operating environments, either on the surface of a body or within body cavities.

The specification of our British Patent Application 9612993.7 describes a technique of aspiration in the vicinity of a tissue treatment (active) electrode, wherein the suction pressure is controlled by generator output features in order to facilitate vaporisation by intermittently lowering the vaporisation threshold by cessation of suction flow. The techniques could advantageously be incorporated in the electrode units El to E4, both to ensure the vaporisation threshold is exceeded between suction pulses, and as a result of the suction pulsing assisting in preventing blockage of the aspiration channel.

As a suction pulse is initiated only once the vaporisation threshold has been exceeded, tissue can only be attracted to the active electrode once the threshold is exceeded by activation remote from the tissue within the surrounding distension medium. It is known that the vaporisation threshold is lowered once tissue is engaged by the active electrode. It is, therefore, advantageous for suction to be applied initially without RF activation as a variable time delay feature.

In summary the electrosurgical instrument of the invention has the following advantageous features :-

1. A small active electrode surface which is able to treat large tissue areas by virtue of active electrode movement. 2. A small active electrode to enable vaporisation, despite the cooling effects created by aspiration.

3. A mechanical movement at the active electrode tip, compatible with material removal within the aspiration channel.

5 4. Aspiration operation is dependent upon the vaporisation condition.

5. At least the outside of the shaft 10 is coated with a non-stick material such as polytetrafluoroethylene - ideally the inside of the shaft as well.

6. Active electrode tip movement occurs across the face of the aspiration channel, so that any lodged tissue is electrosurgically morcellated.

1 0 7. Active electrode agitation is dependent upon the vaporisation condition.

8. Discontinuities within the agitator rod ensure that the internal surfaces of the shaft are cleaned; or the rod flexes sufficiently to create the same effect.

9. A ceramic-to-ceramic interface at the active electrode tip ensures that the internal circumference of the outer ceramic is wiped by the inner ceramic.

1 5 10. The agitator rod is independently insulated in ceramic at its tip.

11. Offset rotary action for a side-effect electrode to enable flat surface engagement.

Claims

1. An electrosurgical instrument for the treatment of tissue in the presence of an electrically-conductive fluid medium, the instrument comprising an instrument shaft, a tissue treatment electrode mounted at the distal end of the shaft for electrosurgically excising tissue pieces at an operation site, morcellation means for electrosurgically reducing the size of excised tissue pieces, and removal means for removing morcellated tissue pieces, the instrument having an apertured portion through which matter can be aspirated by the removal means from the region surrounding the tissue treatment electrode, the removal means comprising a channel formed within the instrument shaft and leading from the apertured portion, wherein the tissue treatment electrode is movable cyclically relative to the distal end of the shaft, and constitutes the morcellation means.
2. An electrosurgical instrument as claimed in claim 1, further comprising drive means for moving the tissue treatment electrode relative to the distal end of the shaft.
3. An electrosurgical instrument as claimed in claim 1 or claim 2, wherein the tissue treatment electrode is such that the cyclical movement thereof is effective to prevent excised tissue pieces adhering to the distal end portion of the instrument.
4. An electrosurgical instrument as claimed in claim 3, wherein the tissue treatment electrode is such that the cyclical movement thereof causes a portion thereof to wipe the entire distal end portion of the instrument which, in use, contacts tissue.
5. An electrosurgical instrument as claimed in any one of claims 1 to 4, further comprising a return electrode which is electrically insulated from the tissue treatment electrode by insulation means, the tissue treatment electrode being exposed at the distal end of the instrument, and the return electrode having a fluid contact surface spaced proximally from the end of the tissue treatment electrode.
6. An electrosurgical instrument as claimed in claim 5, wherein the tissue treatment electrode is movable cyclically relative to the return electrode so as to move the tissue treatment electrode cyclically into, and out of, at least one position in which arcing occurs between the tissue treatment and return electrodes.
7. An electrosurgical instrument as claimed in any one of claims 1 to 6, wherein the channel is defined by the instrument shaft.
8. An electrosurgical instrument as claimed in any one of claims 1 to 7, wherein the tissue treatment electrode is provided at the distal end of a rod mounted within, and movable relative to, the instrument shaft.
9. An electrosurgical instrument as claimed in claim 8, wherein the tissue treatment electrode is constituted by the distal end portion of the rod.
10. An electrosurgical instrument as claimed in claim 9, wherein the rod is constituted by a tungsten wire having a diameter in the range of from 0.2mm to 1.0mm.
11. An electrosurgical instrument as claimed in claim 10, wherein the tungsten wire has a diameter in the range of from 0.4mm to 0.6mm.
12. An electrosurgical instrument as claimed in any one of claims 9 to 11, wherein the tissue treatment electrode is angled with respect to the longitudinal axis of the instrument shaft.
13. An electrosurgical instrument as claimed in claim 12, further comprising an insulating sleeve surrounding the rod proximally of said angled end portion.
14. An electrosurgical instrument as claimed in claim 13, wherein the insulating sleeve is a ceramic sleeve.
15. An electrosurgical instrument as claimed in any one of claims 8 to 14 when appendant to claim 5 , wherein the insulation means comprises an insulation member provided at the distal end of the instrument shaft, the insulation member defining said apertured portion.
5
16. An electrosurgical instrument as claimed in claim 15, wherein the insulation member is formed with a slot which constitutes the apertured portion, the tissue treatment electrode passing through the slot.
1 0 17. An electrosurgical instrument as claimed in claim 15, wherein the apertured portion is constituted by a gap between the tissue treatment electrode and the insulation member.
18. An electrosurgical instrument as claimed in any one of claims 8 to 17 when
1 5 appendant to claim 2, wherein the drive means is such as to reciprocate the rod within the channel.
19. An electrosurgical instrument as claimed in claim 18, wherein the drive means is constituted by a motor and coupling means for converting the rotary output of the
20 motor into reciprocatory movement of the rod.
20. An electrosurgical instrument as claimed in claim 18 or claim 19, wherein the angled end portion of the rod is at right-angles to the longitudinal axis of the instrument shaft, and the tip of the angled end portion constitutes the tissue contacting portion of
25 the tissue treatment electrode.
21. An electrosurgical instrument as claimed in any one of claims 8 to 17 when appendant to claim 2, wherein the drive means such as to rotate the rod within the channel.
30
22. An electrosurgical instrument as claimed in claim 21, wherein an electric motor constitutes the drive means.
23. An electrosurgical instrument as claimed in claim 21 or claim 22, wherein the angled end portion of the rod is at right-angles to the longitudinal axis of the instrument shaft, and the distal end surface of said angled end portion constitutes the tissue contacting portion of the tissue treatment electrode.
24. An electrosurgical instrument as claimed in claim 21 or claim 22, wherein the angled end portion of the rod makes an acute angle with the longitudinal axis of the instrument shaft.
25. An electrosurgical instrument as claimed in claim 24 when appendant to claim 15, wherein the insulation member is provided with an inclined cam surface which is engagable with the apex of the angled end portion of the rod.
26. An electrosurgical instrument as claimed in either of claims 21 and 22 when appendant to claim 13, wherein the angled end portion of the rod is bent back around the distal end portion of the insulating sleeve.
27. An electrosurgical instrument as claimed in any one of claims 1 to 26, wherein the removal means further comprises a pump connected to the channel at a region thereof remote from the apertured portion of the instrument.
28. An electrosurgical instrument as claimed in claim 27, wherein the pump is activated cyclically whereby matter is aspirated by the removal means in a pulsed fashion.
29. An electrosurgical instrument as claimed in claim 28, wherein the pump is activated only when the tissue treatment electrode is powered for tissue vaporisation.
30. An electrosurgical instrument as claimed in claim 5, or in any one of claims 6 to 29 when appendant to claim 5, further comprising an RF generator having a bipolar output connected to the tissue treatment electrode and the return electrode.
31. An electrosurgical instrument as claimed in claim 30 when appendant to claim 2, wherein the RF generator supplies energy to the drive means.
32. An electrosurgical instrument as claimed in claim 30 when appendant to any one of claims 27 to 29, wherein the pump is controlled in dependence upon the output characteristics of the RF generator.
PCT/GB1998/002080 1997-07-18 1998-07-15 An electrosurgical instrument WO1999003407A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
GB9715197.1 1997-07-18
GB9715197A GB2327350A (en) 1997-07-18 1997-07-18 Electrosurgical instrument
GB9726952.6 1997-12-19
GBGB9726952.6A GB9726952D0 (en) 1997-12-19 1997-12-19 An electrosurgical instrument
GBGB9814727.5A GB9814727D0 (en) 1997-12-19 1998-07-07 An electrosurgical instrument
GB9814727.5 1998-07-07

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
EP19980933801 EP0996376A1 (en) 1997-07-18 1998-07-15 An electrosurgical instrument
AU83497/98A AU731398B2 (en) 1997-07-18 1998-07-15 An electrosurgical instrument
JP2000502715A JP2001510066A (en) 1997-07-18 1998-07-15 Electrosurgical instrument
KR1020007000545A KR20010021980A (en) 1997-07-18 1998-07-15 An electrosurgical instrument
CA 2297081 CA2297081A1 (en) 1997-07-18 1998-07-15 An electrosurgical instrument

Publications (1)

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WO1999003407A1 true WO1999003407A1 (en) 1999-01-28

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EP (1) EP0996376A1 (en)
JP (1) JP2001510066A (en)
AU (1) AU731398B2 (en)
CA (1) CA2297081A1 (en)
WO (1) WO1999003407A1 (en)

Cited By (248)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002053047A1 (en) * 2000-12-30 2002-07-11 Prime Meditech Corp. Skin pore contracting device
WO2010026268A1 (en) 2008-09-03 2010-03-11 Asociacion De Investigacion Y Cooperacion Industrial De Andalucia (Aicia) Apparatus for obtaining information on work and infrastructures which is based on an unmanned air vehicle
US8066167B2 (en) 2009-03-23 2011-11-29 Ethicon Endo-Surgery, Inc. Circular surgical stapling instrument with anvil locking system
USD650074S1 (en) 2010-10-01 2011-12-06 Ethicon Endo-Surgery, Inc. Surgical instrument
US8083120B2 (en) 2008-09-18 2011-12-27 Ethicon Endo-Surgery, Inc. End effector for use with a surgical cutting and stapling instrument
US8113410B2 (en) 2008-02-14 2012-02-14 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features
US8136712B2 (en) 2009-12-10 2012-03-20 Ethicon Endo-Surgery, Inc. Surgical stapler with discrete staple height adjustment and tactile feedback
US8141762B2 (en) 2009-10-09 2012-03-27 Ethicon Endo-Surgery, Inc. Surgical stapler comprising a staple pocket
US8157153B2 (en) 2006-01-31 2012-04-17 Ethicon Endo-Surgery, Inc. Surgical instrument with force-feedback capabilities
US8157145B2 (en) 2007-05-31 2012-04-17 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with electrical feedback
US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8186560B2 (en) 2007-06-29 2012-05-29 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
US8196796B2 (en) 2007-06-04 2012-06-12 Ethicon Endo-Surgery, Inc. Shaft based rotary drive system for surgical instruments
US8196795B2 (en) 2008-02-14 2012-06-12 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US8205781B2 (en) 2008-09-19 2012-06-26 Ethicon Endo-Surgery, Inc. Surgical stapler with apparatus for adjusting staple height
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
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
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US8317070B2 (en) 2005-08-31 2012-11-27 Ethicon Endo-Surgery, Inc. Surgical stapling devices that produce formed staples having different lengths
US8322589B2 (en) 2007-06-22 2012-12-04 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US8348131B2 (en) 2006-09-29 2013-01-08 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical indicator to show levels of tissue compression
US8353439B2 (en) 2009-11-19 2013-01-15 Ethicon Endo-Surgery, Inc. Circular stapler introducer with radially-openable distal end portion
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US8361069B2 (en) 2009-09-25 2013-01-29 Covidien Lp Energized needles for wound sealing
US8371491B2 (en) 2008-02-15 2013-02-12 Ethicon Endo-Surgery, Inc. Surgical end effector having buttress retention features
US8393514B2 (en) 2010-09-30 2013-03-12 Ethicon Endo-Surgery, Inc. Selectively orientable implantable fastener cartridge
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8414577B2 (en) 2009-02-05 2013-04-09 Ethicon Endo-Surgery, Inc. Surgical instruments and components for use in sterile environments
US8424740B2 (en) 2007-06-04 2013-04-23 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
US8453907B2 (en) 2009-02-06 2013-06-04 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with cutting member reversing mechanism
US8453908B2 (en) 2008-02-13 2013-06-04 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
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
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US8464923B2 (en) 2005-08-31 2013-06-18 Ethicon Endo-Surgery, Inc. Surgical stapling devices for forming staples with different formed heights
US8479969B2 (en) 2007-01-10 2013-07-09 Ethicon Endo-Surgery, Inc. Drive interface for operably coupling a manipulatable surgical tool to a robot
US8485413B2 (en) 2009-02-05 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising an articulation joint
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8534528B2 (en) 2007-06-04 2013-09-17 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US8540133B2 (en) 2008-09-19 2013-09-24 Ethicon Endo-Surgery, Inc. Staple cartridge
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
US8540129B2 (en) 2008-02-13 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US8540128B2 (en) 2007-01-11 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling device with a curved end effector
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US8567656B2 (en) 2005-08-31 2013-10-29 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US8573461B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with cam-driven staple deployment arrangements
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
US8602288B2 (en) 2008-09-23 2013-12-10 Ethicon Endo-Surgery. Inc. Robotically-controlled motorized surgical end effector system with rotary actuated closure systems having variable actuation speeds
US8608046B2 (en) 2010-01-07 2013-12-17 Ethicon Endo-Surgery, Inc. Test device for a surgical tool
US8608044B2 (en) 2008-02-15 2013-12-17 Ethicon Endo-Surgery, Inc. Feedback and lockout mechanism 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
US8616431B2 (en) 2007-06-04 2013-12-31 Ethicon Endo-Surgery, Inc. Shiftable drive interface for robotically-controlled surgical tool
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US8632462B2 (en) 2011-03-14 2014-01-21 Ethicon Endo-Surgery, Inc. Trans-rectum universal ports
US8631987B2 (en) 2006-08-02 2014-01-21 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
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US8657176B2 (en) 2010-09-30 2014-02-25 Ethicon Endo-Surgery, Inc. Tissue thickness compensator for a surgical stapler
US8672207B2 (en) 2010-07-30 2014-03-18 Ethicon Endo-Surgery, Inc. Transwall visualization arrangements and methods for surgical circular staplers
USRE44834E1 (en) 2005-09-30 2014-04-08 Covidien Ag Insulating boot for electrosurgical forceps
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8733613B2 (en) 2010-09-29 2014-05-27 Ethicon Endo-Surgery, Inc. Staple cartridge
US8747238B2 (en) 2012-06-28 2014-06-10 Ethicon Endo-Surgery, Inc. Rotary drive shaft assemblies for surgical instruments with articulatable end effectors
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8783541B2 (en) 2003-05-20 2014-07-22 Frederick E. Shelton, IV Robotically-controlled surgical end effector system
US8789739B2 (en) 2011-09-06 2014-07-29 Ethicon Endo-Surgery, Inc. Continuous stapling instrument
US8789740B2 (en) 2010-07-30 2014-07-29 Ethicon Endo-Surgery, Inc. Linear cutting and stapling device with selectively disengageable cutting member
US8789741B2 (en) 2010-09-24 2014-07-29 Ethicon Endo-Surgery, Inc. Surgical instrument with trigger assembly for generating multiple actuation motions
US8800841B2 (en) 2011-03-15 2014-08-12 Ethicon Endo-Surgery, Inc. Surgical staple cartridges
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8844789B2 (en) 2006-01-31 2014-09-30 Ethicon Endo-Surgery, Inc. Automated end effector component reloading system for use with a robotic system
US8852228B2 (en) 2009-01-13 2014-10-07 Covidien Lp Apparatus, system, and method for performing an electrosurgical procedure
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8858554B2 (en) 2009-05-07 2014-10-14 Covidien Lp Apparatus, system, and method for performing an electrosurgical procedure
US8857693B2 (en) 2011-03-15 2014-10-14 Ethicon Endo-Surgery, Inc. Surgical instruments with lockable articulating end effector
US8875972B2 (en) 2008-02-15 2014-11-04 Ethicon Endo-Surgery, Inc. End effector coupling arrangements for a surgical cutting and stapling instrument
US8882766B2 (en) 2006-01-24 2014-11-11 Covidien Ag Method and system for controlling delivery of energy to divide tissue
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US8893722B2 (en) 1997-09-04 2014-11-25 Smith & Nephew, Inc. Surgical endoscopic cutting device and method for its use
US8898888B2 (en) 2009-09-28 2014-12-02 Covidien Lp System for manufacturing electrosurgical seal plates
US8905977B2 (en) 2004-07-28 2014-12-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US8911471B2 (en) 2006-03-23 2014-12-16 Ethicon Endo-Surgery, Inc. Articulatable surgical device
US8926598B2 (en) 2011-03-15 2015-01-06 Ethicon Endo-Surgery, Inc. Surgical instruments with articulatable and rotatable end effector
US8945125B2 (en) 2002-11-14 2015-02-03 Covidien Ag Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion
US8968314B2 (en) 2008-09-25 2015-03-03 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US8979842B2 (en) 2011-06-10 2015-03-17 Medtronic Advanced Energy Llc Wire electrode devices for tonsillectomy and adenoidectomy
EP2621389B1 (en) 2010-10-01 2015-03-18 Applied Medical Resources Corporation Electrosurgical instrument with jaws and with an electrode
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9023043B2 (en) 2007-09-28 2015-05-05 Covidien Lp Insulating mechanically-interfaced boot and jaws for electrosurgical forceps
US9028519B2 (en) 2008-09-23 2015-05-12 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9028493B2 (en) 2009-09-18 2015-05-12 Covidien Lp In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor
US9044229B2 (en) 2011-03-15 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical fastener 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
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US9060800B1 (en) 2001-10-26 2015-06-23 Smith & Nephew, Inc. Reciprocating rotary arthroscopic surgical instrument
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
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
US9095347B2 (en) 2003-11-20 2015-08-04 Covidien Ag Electrically conductive/insulative over shoe for tissue fusion
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9107672B2 (en) 1998-10-23 2015-08-18 Covidien Ag Vessel sealing forceps with disposable electrodes
US9113940B2 (en) 2011-01-14 2015-08-25 Covidien Lp Trigger lockout and kickback mechanism for surgical instruments
US9113905B2 (en) 2008-07-21 2015-08-25 Covidien Lp Variable resistor jaw
US9113898B2 (en) 2008-10-09 2015-08-25 Covidien Lp Apparatus, system, and method for performing an electrosurgical procedure
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US9125550B2 (en) 2004-08-27 2015-09-08 Smith & Nephew, Inc. Tissue resecting system
US9149323B2 (en) 2003-05-01 2015-10-06 Covidien Ag Method of fusing biomaterials with radiofrequency energy
US9155454B2 (en) 2010-09-28 2015-10-13 Smith & Nephew, Inc. Hysteroscopic system
US9198717B2 (en) 2005-08-19 2015-12-01 Covidien Ag Single action tissue sealer
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US9204878B2 (en) 2008-02-14 2015-12-08 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9204880B2 (en) 2012-03-28 2015-12-08 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising capsules defining a low pressure environment
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US9283054B2 (en) 2013-08-23 2016-03-15 Ethicon Endo-Surgery, Llc Interactive displays
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9289212B2 (en) 2010-09-17 2016-03-22 Ethicon Endo-Surgery, Inc. Surgical instruments and batteries for surgical instruments
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9301752B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising a plurality of capsules
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9307986B2 (en) 2013-03-01 2016-04-12 Ethicon Endo-Surgery, Llc Surgical instrument soft stop
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US9345481B2 (en) 2013-03-13 2016-05-24 Ethicon Endo-Surgery, Llc Staple cartridge tissue thickness sensor system
US9351726B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Articulation control system for articulatable surgical instruments
US9358005B2 (en) 2010-09-30 2016-06-07 Ethicon Endo-Surgery, Llc End effector layer including holding features
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US9364230B2 (en) 2012-06-28 2016-06-14 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotary joint assemblies
US9375271B2 (en) 1998-10-23 2016-06-28 Covidien Ag Vessel sealing system
US9375254B2 (en) 2008-09-25 2016-06-28 Covidien Lp Seal and separate algorithm
US9386985B2 (en) 2012-10-15 2016-07-12 Ethicon Endo-Surgery, Llc Surgical cutting instrument
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US9492225B2 (en) 2003-06-13 2016-11-15 Covidien Ag Vessel sealer and divider for use with small trocars and cannulas
US9539053B2 (en) 2006-01-24 2017-01-10 Covidien Lp Vessel sealer and divider for large tissue structures
US9549775B2 (en) 2005-09-30 2017-01-24 Covidien Ag In-line vessel sealer and divider
US9549735B2 (en) 2013-12-23 2017-01-24 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a firing member including fastener transfer surfaces
US9554841B2 (en) 2007-09-28 2017-01-31 Covidien Lp Dual durometer insulating boot for electrosurgical forceps
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US9585716B2 (en) 2002-10-04 2017-03-07 Covidien Ag Vessel sealing instrument with electrical cutting mechanism
US9603652B2 (en) 2008-08-21 2017-03-28 Covidien Lp Electrosurgical instrument including a sensor
US9615826B2 (en) 2010-09-30 2017-04-11 Ethicon Endo-Surgery, Llc Multiple thickness implantable layers for surgical stapling devices
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9642620B2 (en) 2013-12-23 2017-05-09 Ethicon Endo-Surgery, Llc Surgical cutting and stapling instruments with articulatable end effectors
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
US9681870B2 (en) 2013-12-23 2017-06-20 Ethicon Llc Articulatable surgical instruments with separate and distinct closing and firing systems
US9690362B2 (en) 2014-03-26 2017-06-27 Ethicon Llc Surgical instrument control circuit having a safety processor
US9693777B2 (en) 2014-02-24 2017-07-04 Ethicon Llc Implantable layers comprising a pressed region
US9724098B2 (en) 2012-03-28 2017-08-08 Ethicon Endo-Surgery, Llc Staple cartridge comprising an implantable layer
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9724094B2 (en) 2014-09-05 2017-08-08 Ethicon Llc Adjunct with integrated sensors to quantify tissue compression
US9737357B2 (en) 2001-04-06 2017-08-22 Covidien Ag Vessel sealer and divider
US9743929B2 (en) 2014-03-26 2017-08-29 Ethicon Llc Modular powered surgical instrument with detachable shaft assemblies
US9743928B2 (en) 2006-01-31 2017-08-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9795382B2 (en) 2005-08-31 2017-10-24 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
US9801627B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Fastener cartridge for creating a flexible staple line
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US9814462B2 (en) 2010-09-30 2017-11-14 Ethicon Llc Assembly for fastening tissue comprising a compressible layer
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US9826978B2 (en) 2010-09-30 2017-11-28 Ethicon Llc End effectors with same side closure and firing motions
US9833241B2 (en) 2014-04-16 2017-12-05 Ethicon Llc Surgical fastener cartridges with driver stabilizing arrangements
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
US9844368B2 (en) 2013-04-16 2017-12-19 Ethicon Llc Surgical system comprising first and second drive systems
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
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
US9848938B2 (en) 2003-11-13 2017-12-26 Covidien Ag Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US9895147B2 (en) 2005-11-09 2018-02-20 Ethicon Llc End effectors for surgical staplers
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US9931118B2 (en) 2015-02-27 2018-04-03 Ethicon Endo-Surgery, Llc Reinforced battery for a surgical instrument
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10004498B2 (en) 2006-01-31 2018-06-26 Ethicon Llc Surgical instrument comprising a plurality of articulation joints
US10028744B2 (en) 2015-08-26 2018-07-24 Ethicon Llc Staple cartridge assembly including staple guides
US10039529B2 (en) 2010-09-17 2018-08-07 Ethicon Llc Power control arrangements for surgical instruments and batteries
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for 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
US10052102B2 (en) 2015-06-18 2018-08-21 Ethicon Llc Surgical end effectors with dual cam actuated jaw closing features
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
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US10154848B2 (en) 2011-07-11 2018-12-18 Covidien Lp Stand alone energy-based tissue clips
US10172620B2 (en) 2015-09-30 2019-01-08 Ethicon Llc Compressible adjuncts with bonding nodes
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
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
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US10201349B2 (en) 2013-08-23 2019-02-12 Ethicon Llc End effector detection and firing rate modulation systems for surgical instruments
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US10206676B2 (en) 2008-02-14 2019-02-19 Ethicon Llc Surgical cutting and fastening instrument
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10213250B2 (en) 2015-11-05 2019-02-26 Covidien Lp Deployment and safety mechanisms for surgical instruments
US10226249B2 (en) 2013-03-01 2019-03-12 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
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
US10245030B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instruments with tensioning arrangements for cable driven articulation systems
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10251696B2 (en) 2001-04-06 2019-04-09 Covidien Ag Vessel sealer and divider with stop members
US10258333B2 (en) 2012-06-28 2019-04-16 Ethicon Llc Surgical fastening apparatus with a rotary end effector drive shaft for selective engagement with a motorized drive system
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10271851B2 (en) 2016-04-01 2019-04-30 Ethicon Llc Modular surgical stapling system comprising a display
US10271849B2 (en) 2015-09-30 2019-04-30 Ethicon Llc Woven constructs with interlocked standing fibers
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
USRE47375E1 (en) 2003-05-15 2019-05-07 Coviden Ag Tissue sealer with non-conductive variable stop members and method of sealing tissue
US10285699B2 (en) 2015-09-30 2019-05-14 Ethicon Llc Compressible adjunct

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2005204768A (en) * 2004-01-21 2005-08-04 Pentax Corp High-frequency incision equipment for endoscope
JP2005204773A (en) * 2004-01-21 2005-08-04 Pentax Corp High-frequency incision equipment for endoscope
US20070255303A1 (en) * 2006-05-01 2007-11-01 Ethicon Endo-Surgery, Inc. Integrated Guidewire Needle Knife Device
DE102012000392A1 (en) * 2011-12-05 2013-06-06 Heraeus Medical Gmbh Adapters for rotary and lavage system

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4706667A (en) 1984-06-25 1987-11-17 Berchtold Medizin-Elektronik Gmbh & Co. Electro surgical high frequency cutting instrument
FR2645008A1 (en) * 1989-03-28 1990-10-05 Technomed Int Sa Apparatus for resection of soft or hard tissues, which can be used in particular for the resection of the prostate, having a rotating loop, and resection means
US5211625A (en) * 1990-03-20 1993-05-18 Olympus Optical Co., Ltd. Ultrasonic treatment apparatus
US5257990A (en) * 1992-02-24 1993-11-02 Kensey Nash Corporation Electrosurgical catheter instrument with impacting working head and method of use
US5527331A (en) * 1993-10-13 1996-06-18 Femrx Method for prostatic tissue resection
WO1997000646A1 (en) 1995-06-23 1997-01-09 Gyrus Medical Limited An electrosurgical instrument
WO1997000647A1 (en) 1995-06-23 1997-01-09 Gyrus Medical Limited An electrosurgical instrument
DE29617461U1 (en) * 1996-10-09 1997-01-09 Aesculap Ag A surgical device
EP0754437A2 (en) * 1995-06-23 1997-01-22 Gyrus Medical Limited An electrosurgical generator and system
WO1997024993A1 (en) 1996-01-09 1997-07-17 Gyrus Medical Limited An electrosurgical instrument

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4706667A (en) 1984-06-25 1987-11-17 Berchtold Medizin-Elektronik Gmbh & Co. Electro surgical high frequency cutting instrument
FR2645008A1 (en) * 1989-03-28 1990-10-05 Technomed Int Sa Apparatus for resection of soft or hard tissues, which can be used in particular for the resection of the prostate, having a rotating loop, and resection means
US5211625A (en) * 1990-03-20 1993-05-18 Olympus Optical Co., Ltd. Ultrasonic treatment apparatus
US5257990A (en) * 1992-02-24 1993-11-02 Kensey Nash Corporation Electrosurgical catheter instrument with impacting working head and method of use
US5527331A (en) * 1993-10-13 1996-06-18 Femrx Method for prostatic tissue resection
WO1997000646A1 (en) 1995-06-23 1997-01-09 Gyrus Medical Limited An electrosurgical instrument
WO1997000647A1 (en) 1995-06-23 1997-01-09 Gyrus Medical Limited An electrosurgical instrument
EP0754437A2 (en) * 1995-06-23 1997-01-22 Gyrus Medical Limited An electrosurgical generator and system
WO1997024993A1 (en) 1996-01-09 1997-07-17 Gyrus Medical Limited An electrosurgical instrument
DE29617461U1 (en) * 1996-10-09 1997-01-09 Aesculap Ag A surgical device

Cited By (627)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9226765B2 (en) 1997-09-04 2016-01-05 Smith & Nephew, Inc. Surgical cutting device and method for its use
US9750520B2 (en) 1997-09-04 2017-09-05 Covidien Lp Surgical endoscopic cutting device and method for its use
US8893722B2 (en) 1997-09-04 2014-11-25 Smith & Nephew, Inc. Surgical endoscopic cutting device and method for its use
US9089358B2 (en) 1997-09-04 2015-07-28 Smith & Nephew, Inc. Surgical cutting device and method for its use
US9427247B2 (en) 1997-09-04 2016-08-30 Smith & Nephew, Inc. Surgical cutting device and method for its use
US9226650B2 (en) 1997-09-04 2016-01-05 Smith & Nephew, Inc. Surgical cutting device and method for its use
US9375270B2 (en) 1998-10-23 2016-06-28 Covidien Ag Vessel sealing system
US9107672B2 (en) 1998-10-23 2015-08-18 Covidien Ag Vessel sealing forceps with disposable electrodes
US9463067B2 (en) 1998-10-23 2016-10-11 Covidien Ag Vessel sealing system
US9375271B2 (en) 1998-10-23 2016-06-28 Covidien Ag Vessel sealing system
WO2002053047A1 (en) * 2000-12-30 2002-07-11 Prime Meditech Corp. Skin pore contracting device
US10265121B2 (en) 2001-04-06 2019-04-23 Covidien Ag Vessel sealer and divider
US9861430B2 (en) 2001-04-06 2018-01-09 Covidien Ag Vessel sealer and divider
US10251696B2 (en) 2001-04-06 2019-04-09 Covidien Ag Vessel sealer and divider with stop members
US9737357B2 (en) 2001-04-06 2017-08-22 Covidien Ag Vessel sealer and divider
US9066745B2 (en) 2001-10-26 2015-06-30 Smith & Nephew, Inc. Reciprocating rotary arthroscopic surgical instrument
US9060801B1 (en) 2001-10-26 2015-06-23 Smith & Nephew, Inc. Reciprocating rotary arthroscopic surgical instrument
US9060800B1 (en) 2001-10-26 2015-06-23 Smith & Nephew, Inc. Reciprocating rotary arthroscopic surgical instrument
US9636130B2 (en) 2001-10-26 2017-05-02 Covidien Lp Reciprocating rotary arthroscopic surgical instrument
US9585716B2 (en) 2002-10-04 2017-03-07 Covidien Ag Vessel sealing instrument with electrical cutting mechanism
US8945125B2 (en) 2002-11-14 2015-02-03 Covidien Ag Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion
US9149323B2 (en) 2003-05-01 2015-10-06 Covidien Ag Method of fusing biomaterials with radiofrequency energy
USRE47375E1 (en) 2003-05-15 2019-05-07 Coviden Ag Tissue sealer with non-conductive variable stop members and method of sealing tissue
US8783541B2 (en) 2003-05-20 2014-07-22 Frederick E. Shelton, IV Robotically-controlled surgical end effector system
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US10278772B2 (en) 2003-06-13 2019-05-07 Covidien Ag Vessel sealer and divider
US9492225B2 (en) 2003-06-13 2016-11-15 Covidien Ag Vessel sealer and divider for use with small trocars and cannulas
US9848938B2 (en) 2003-11-13 2017-12-26 Covidien Ag Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion
US9095347B2 (en) 2003-11-20 2015-08-04 Covidien Ag Electrically conductive/insulative over shoe for tissue fusion
US9980770B2 (en) 2003-11-20 2018-05-29 Covidien Ag Electrically conductive/insulative over-shoe for tissue fusion
US9585663B2 (en) 2004-07-28 2017-03-07 Ethicon Endo-Surgery, Llc Surgical stapling instrument configured to apply a compressive pressure to tissue
US9282966B2 (en) 2004-07-28 2016-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US9737303B2 (en) 2004-07-28 2017-08-22 Ethicon Llc Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US8905977B2 (en) 2004-07-28 2014-12-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US8517244B2 (en) 2004-07-28 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US9737302B2 (en) 2004-07-28 2017-08-22 Ethicon Llc Surgical stapling instrument having a restraining member
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US10278702B2 (en) 2004-07-28 2019-05-07 Ethicon Llc Stapling system comprising a firing bar and a lockout
US9510830B2 (en) 2004-07-28 2016-12-06 Ethicon Endo-Surgery, Llc Staple cartridge
US9603991B2 (en) 2004-07-28 2017-03-28 Ethicon Endo-Surgery, Llc Surgical stapling instrument having a medical substance dispenser
US9844379B2 (en) 2004-07-28 2017-12-19 Ethicon Llc Surgical stapling instrument having a clearanced opening
US9125550B2 (en) 2004-08-27 2015-09-08 Smith & Nephew, Inc. Tissue resecting system
US9936861B2 (en) 2004-08-27 2018-04-10 Covidien Lp Tissue resecting system
US10076237B2 (en) 2004-08-27 2018-09-18 Covidien Lp Tissue resecting system
US9198717B2 (en) 2005-08-19 2015-12-01 Covidien Ag Single action tissue sealer
US10188452B2 (en) 2005-08-19 2019-01-29 Covidien Ag Single action tissue sealer
US9844373B2 (en) 2005-08-31 2017-12-19 Ethicon Llc Fastener cartridge assembly comprising a driver row arrangement
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US9307988B2 (en) 2005-08-31 2016-04-12 Ethicon Endo-Surgery, Llc Staple cartridges for forming staples having differing formed staple heights
US8464923B2 (en) 2005-08-31 2013-06-18 Ethicon Endo-Surgery, Inc. Surgical stapling devices for forming staples with different formed heights
US9592052B2 (en) 2005-08-31 2017-03-14 Ethicon Endo-Surgery, Llc Stapling assembly for forming different formed staple heights
US9839427B2 (en) 2005-08-31 2017-12-12 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and a staple driver arrangement
US10278697B2 (en) 2005-08-31 2019-05-07 Ethicon Llc Staple cartridge comprising a staple driver arrangement
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US8636187B2 (en) 2005-08-31 2014-01-28 Ethicon Endo-Surgery, Inc. Surgical stapling systems that produce formed staples having different lengths
US9561032B2 (en) 2005-08-31 2017-02-07 Ethicon Endo-Surgery, Llc Staple cartridge comprising a staple driver arrangement
US9326768B2 (en) 2005-08-31 2016-05-03 Ethicon Endo-Surgery, Llc Staple cartridges for forming staples having differing formed staple heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US8317070B2 (en) 2005-08-31 2012-11-27 Ethicon Endo-Surgery, Inc. Surgical stapling devices that produce formed staples having different lengths
US10271846B2 (en) 2005-08-31 2019-04-30 Ethicon Llc Staple cartridge for use with a surgical stapler
US9848873B2 (en) 2005-08-31 2017-12-26 Ethicon Llc Fastener cartridge assembly comprising a driver and staple cavity arrangement
US10070863B2 (en) 2005-08-31 2018-09-11 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil
US8567656B2 (en) 2005-08-31 2013-10-29 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US10245035B2 (en) 2005-08-31 2019-04-02 Ethicon Llc Stapling assembly configured to produce different formed staple heights
US10245032B2 (en) 2005-08-31 2019-04-02 Ethicon Llc Staple cartridges for forming staples having differing formed staple heights
US9795382B2 (en) 2005-08-31 2017-10-24 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
US10271845B2 (en) 2005-08-31 2019-04-30 Ethicon Llc Fastener cartridge assembly comprising a cam and driver arrangement
USRE44834E1 (en) 2005-09-30 2014-04-08 Covidien Ag Insulating boot for electrosurgical forceps
US9549775B2 (en) 2005-09-30 2017-01-24 Covidien Ag In-line vessel sealer and divider
US9579145B2 (en) 2005-09-30 2017-02-28 Covidien Ag Flexible endoscopic catheter with ligasure
US9895147B2 (en) 2005-11-09 2018-02-20 Ethicon Llc End effectors for surgical staplers
US10149679B2 (en) 2005-11-09 2018-12-11 Ethicon Llc Surgical instrument comprising drive systems
US10028742B2 (en) 2005-11-09 2018-07-24 Ethicon Llc Staple cartridge comprising staples with different unformed heights
US9968356B2 (en) 2005-11-09 2018-05-15 Ethicon Llc Surgical instrument drive systems
US8882766B2 (en) 2006-01-24 2014-11-11 Covidien Ag Method and system for controlling delivery of energy to divide tissue
US9539053B2 (en) 2006-01-24 2017-01-10 Covidien Lp Vessel sealer and divider for large tissue structures
US9439649B2 (en) 2006-01-31 2016-09-13 Ethicon Endo-Surgery, Llc Surgical instrument having force feedback capabilities
US10010322B2 (en) 2006-01-31 2018-07-03 Ethicon Llc Surgical instrument
US10052099B2 (en) 2006-01-31 2018-08-21 Ethicon Llc Surgical instrument system comprising a firing system including a rotatable shaft and first and second actuation ramps
US9326770B2 (en) 2006-01-31 2016-05-03 Ethicon Endo-Surgery, Llc Surgical instrument
US8844789B2 (en) 2006-01-31 2014-09-30 Ethicon Endo-Surgery, Inc. Automated end effector component reloading system for use with a robotic system
US10052100B2 (en) 2006-01-31 2018-08-21 Ethicon Llc Surgical instrument system configured to detect resistive forces experienced by a tissue cutting implement
US10058963B2 (en) 2006-01-31 2018-08-28 Ethicon Llc Automated end effector component reloading system for use with a robotic system
US10278722B2 (en) 2006-01-31 2019-05-07 Ethicon Llc Motor-driven surgical cutting and fastening instrument
US9326769B2 (en) 2006-01-31 2016-05-03 Ethicon Endo-Surgery, Llc Surgical instrument
US9743928B2 (en) 2006-01-31 2017-08-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US9370358B2 (en) 2006-01-31 2016-06-21 Ethicon Endo-Surgery, Llc Motor-driven surgical cutting and fastening instrument with tactile position feedback
US9113874B2 (en) 2006-01-31 2015-08-25 Ethicon Endo-Surgery, Inc. Surgical instrument system
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
US9320520B2 (en) 2006-01-31 2016-04-26 Ethicon Endo-Surgery, Inc. Surgical instrument system
US8157153B2 (en) 2006-01-31 2012-04-17 Ethicon Endo-Surgery, Inc. Surgical instrument with force-feedback capabilities
US8820605B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instruments
US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8292155B2 (en) 2006-01-31 2012-10-23 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with tactile position feedback
US10004498B2 (en) 2006-01-31 2018-06-26 Ethicon Llc Surgical instrument comprising a plurality of articulation joints
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US10098636B2 (en) 2006-01-31 2018-10-16 Ethicon Llc Surgical instrument having force feedback capabilities
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8167185B2 (en) 2006-01-31 2012-05-01 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8172124B2 (en) 2006-01-31 2012-05-08 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8746529B2 (en) 2006-01-31 2014-06-10 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8752747B2 (en) 2006-01-31 2014-06-17 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US9451958B2 (en) 2006-01-31 2016-09-27 Ethicon Endo-Surgery, Llc Surgical instrument with firing actuator lockout
US9517068B2 (en) 2006-01-31 2016-12-13 Ethicon Endo-Surgery, Llc Surgical instrument with automatically-returned firing member
US10201363B2 (en) 2006-01-31 2019-02-12 Ethicon Llc Motor-driven surgical instrument
US10070861B2 (en) 2006-03-23 2018-09-11 Ethicon Llc Articulatable surgical device
US9301759B2 (en) 2006-03-23 2016-04-05 Ethicon Endo-Surgery, Llc Robotically-controlled surgical instrument with selectively articulatable end effector
US9149274B2 (en) 2006-03-23 2015-10-06 Ethicon Endo-Surgery, Inc. Articulating endoscopic accessory channel
US10213262B2 (en) 2006-03-23 2019-02-26 Ethicon Llc Manipulatable surgical systems with selectively articulatable fastening device
US9492167B2 (en) 2006-03-23 2016-11-15 Ethicon Endo-Surgery, Llc Articulatable surgical device with rotary driven cutting member
US10064688B2 (en) 2006-03-23 2018-09-04 Ethicon Llc Surgical system with selectively articulatable end effector
US9402626B2 (en) 2006-03-23 2016-08-02 Ethicon Endo-Surgery, Llc Rotary actuatable surgical fastener and cutter
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8911471B2 (en) 2006-03-23 2014-12-16 Ethicon Endo-Surgery, Inc. Articulatable surgical device
US9320521B2 (en) 2006-06-27 2016-04-26 Ethicon Endo-Surgery, Llc Surgical instrument
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US8631987B2 (en) 2006-08-02 2014-01-21 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
US9706991B2 (en) 2006-09-29 2017-07-18 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples including a lateral base
US10172616B2 (en) 2006-09-29 2019-01-08 Ethicon Llc Surgical staple cartridge
US9179911B2 (en) 2006-09-29 2015-11-10 Ethicon Endo-Surgery, Inc. End effector for use with a surgical fastening instrument
US8899465B2 (en) 2006-09-29 2014-12-02 Ethicon Endo-Surgery, Inc. Staple cartridge comprising drivers for deploying a plurality of staples
US8973804B2 (en) 2006-09-29 2015-03-10 Ethicon Endo-Surgery, Inc. Cartridge assembly having a buttressing member
US8365976B2 (en) 2006-09-29 2013-02-05 Ethicon Endo-Surgery, Inc. Surgical staples having dissolvable, bioabsorbable or biofragmentable portions and stapling instruments for deploying the same
US8485412B2 (en) 2006-09-29 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical staples having attached drivers and stapling instruments for deploying the same
US9408604B2 (en) 2006-09-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instrument comprising a firing system including a compliant portion
US8763875B2 (en) 2006-09-29 2014-07-01 Ethicon Endo-Surgery, Inc. End effector for use with a surgical fastening instrument
US8499993B2 (en) 2006-09-29 2013-08-06 Ethicon Endo-Surgery, Inc. Surgical staple cartridge
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US8348131B2 (en) 2006-09-29 2013-01-08 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical indicator to show levels of tissue compression
US9603595B2 (en) 2006-09-29 2017-03-28 Ethicon Endo-Surgery, Llc Surgical instrument comprising an adjustable system configured to accommodate different jaw heights
US8360297B2 (en) 2006-09-29 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling instrument with self adjusting anvil
US10206678B2 (en) 2006-10-03 2019-02-19 Ethicon Llc Surgical stapling instrument with lockout features to prevent advancement of a firing assembly unless an unfired surgical staple cartridge is operably mounted in an end effector portion of the instrument
US8517243B2 (en) 2007-01-10 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US8479969B2 (en) 2007-01-10 2013-07-09 Ethicon Endo-Surgery, Inc. Drive interface for operably coupling a manipulatable surgical tool to a robot
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US9757123B2 (en) 2007-01-10 2017-09-12 Ethicon Llc Powered surgical instrument having a transmission system
US8840603B2 (en) 2007-01-10 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8746530B2 (en) 2007-01-10 2014-06-10 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US10278780B2 (en) 2007-01-10 2019-05-07 Ethicon Llc Surgical instrument for use with robotic system
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US9700321B2 (en) 2007-01-11 2017-07-11 Ethicon Llc Surgical stapling device having supports for a flexible drive mechanism
US9724091B2 (en) 2007-01-11 2017-08-08 Ethicon Llc Surgical stapling device
US9775613B2 (en) 2007-01-11 2017-10-03 Ethicon Llc Surgical stapling device with a curved end effector
US9999431B2 (en) 2007-01-11 2018-06-19 Ethicon Endo-Surgery, Llc Surgical stapling device having supports for a flexible drive mechanism
US8540128B2 (en) 2007-01-11 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling device with a curved end effector
US9675355B2 (en) 2007-01-11 2017-06-13 Ethicon Llc Surgical stapling device with a curved end effector
US9750501B2 (en) 2007-01-11 2017-09-05 Ethicon Endo-Surgery, Llc Surgical stapling devices having laterally movable anvils
US9603598B2 (en) 2007-01-11 2017-03-28 Ethicon Endo-Surgery, Llc Surgical stapling device with a curved end effector
US9655624B2 (en) 2007-01-11 2017-05-23 Ethicon Llc Surgical stapling device with a curved end effector
US9730692B2 (en) 2007-01-11 2017-08-15 Ethicon Llc Surgical stapling device with a curved staple cartridge
US9757130B2 (en) 2007-02-28 2017-09-12 Ethicon Llc Stapling assembly for forming different formed staple heights
US8157145B2 (en) 2007-05-31 2012-04-17 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with electrical feedback
US9750498B2 (en) 2007-06-04 2017-09-05 Ethicon Endo Surgery, Llc Drive systems for surgical instruments
US8196796B2 (en) 2007-06-04 2012-06-12 Ethicon Endo-Surgery, Inc. Shaft based rotary drive system for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8424740B2 (en) 2007-06-04 2013-04-23 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US9585658B2 (en) 2007-06-04 2017-03-07 Ethicon Endo-Surgery, Llc Stapling systems
US9795381B2 (en) 2007-06-04 2017-10-24 Ethicon Endo-Surgery, Llc 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
US9987003B2 (en) 2007-06-04 2018-06-05 Ethicon Llc Robotic actuator assembly
US9186143B2 (en) 2007-06-04 2015-11-17 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8616431B2 (en) 2007-06-04 2013-12-31 Ethicon Endo-Surgery, Inc. Shiftable drive interface for robotically-controlled surgical tool
US9138225B2 (en) 2007-06-22 2015-09-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US8408439B2 (en) 2007-06-22 2013-04-02 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US8322589B2 (en) 2007-06-22 2012-12-04 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US8353437B2 (en) 2007-06-22 2013-01-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with a geared return mechanism
US9662110B2 (en) 2007-06-22 2017-05-30 Ethicon Endo-Surgery, Llc Surgical stapling instrument with an articulatable end effector
US8333313B2 (en) 2007-06-22 2012-12-18 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with a firing member return mechanism
US8991676B2 (en) 2007-06-29 2015-03-31 Ethicon Endo-Surgery, Inc. Surgical staple having a slidable crown
US8186560B2 (en) 2007-06-29 2012-05-29 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
US8590762B2 (en) 2007-06-29 2013-11-26 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configurations
US9872682B2 (en) 2007-06-29 2018-01-23 Ethicon Llc Surgical stapling instrument having a releasable buttress material
US8925788B2 (en) 2007-06-29 2015-01-06 Ethicon Endo-Surgery, Inc. End effectors for surgical stapling instruments
US9289206B2 (en) 2007-06-29 2016-03-22 Ethicon Endo-Surgery, Llc Lateral securement members for surgical staple cartridges
US8668130B2 (en) 2007-06-29 2014-03-11 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
US8672208B2 (en) 2007-06-29 2014-03-18 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a releasable buttress material
US9023043B2 (en) 2007-09-28 2015-05-05 Covidien Lp Insulating mechanically-interfaced boot and jaws for electrosurgical forceps
US9554841B2 (en) 2007-09-28 2017-01-31 Covidien Lp Dual durometer insulating boot for electrosurgical forceps
US9687231B2 (en) 2008-02-13 2017-06-27 Ethicon Llc Surgical stapling 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
US8540129B2 (en) 2008-02-13 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US9901344B2 (en) 2008-02-14 2018-02-27 Ethicon Llc Stapling assembly
US9084601B2 (en) 2008-02-14 2015-07-21 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US9901345B2 (en) 2008-02-14 2018-02-27 Ethicon Llc Stapling assembly
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
US9901346B2 (en) 2008-02-14 2018-02-27 Ethicon Llc Stapling assembly
US9095339B2 (en) 2008-02-14 2015-08-04 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US9962158B2 (en) 2008-02-14 2018-05-08 Ethicon Llc Surgical stapling apparatuses with lockable end effector positioning systems
US9980729B2 (en) 2008-02-14 2018-05-29 Ethicon Endo-Surgery, Llc Detachable motor powered surgical instrument
US9072515B2 (en) 2008-02-14 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus
US9999426B2 (en) 2008-02-14 2018-06-19 Ethicon Llc Detachable motor powered surgical instrument
US9877723B2 (en) 2008-02-14 2018-01-30 Ethicon Llc Surgical stapling assembly comprising a selector arrangement
US8657178B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US10004505B2 (en) 2008-02-14 2018-06-26 Ethicon Llc Detachable motor powered surgical instrument
US9872684B2 (en) 2008-02-14 2018-01-23 Ethicon Llc Surgical stapling apparatus including firing force regulation
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
US8573461B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with cam-driven staple deployment arrangements
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US9867618B2 (en) 2008-02-14 2018-01-16 Ethicon Llc Surgical stapling apparatus including firing force regulation
US8991677B2 (en) 2008-02-14 2015-03-31 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US9498219B2 (en) 2008-02-14 2016-11-22 Ethicon Endo-Surgery, Llc Detachable motor powered surgical instrument
US8540130B2 (en) 2008-02-14 2013-09-24 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US9204878B2 (en) 2008-02-14 2015-12-08 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
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
US8998058B2 (en) 2008-02-14 2015-04-07 Ethicon Endo-Surgery, Inc. Detachable motor powered surgical instrument
US10206676B2 (en) 2008-02-14 2019-02-19 Ethicon Llc Surgical cutting and fastening instrument
US10238387B2 (en) 2008-02-14 2019-03-26 Ethicon Llc Surgical instrument comprising a control system
US9211121B2 (en) 2008-02-14 2015-12-15 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US10265067B2 (en) 2008-02-14 2019-04-23 Ethicon Llc Surgical instrument including a regulator and a control system
US8196795B2 (en) 2008-02-14 2012-06-12 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US9522029B2 (en) 2008-02-14 2016-12-20 Ethicon Endo-Surgery, Llc Motorized surgical cutting and fastening instrument having handle based power source
US8113410B2 (en) 2008-02-14 2012-02-14 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features
US10238385B2 (en) 2008-02-14 2019-03-26 Ethicon Llc Surgical instrument system for evaluating tissue impedance
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US9913647B2 (en) 2008-02-15 2018-03-13 Ethicon Llc Disposable loading unit for use with a surgical instrument
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US8371491B2 (en) 2008-02-15 2013-02-12 Ethicon Endo-Surgery, Inc. Surgical end effector having buttress retention features
US9839429B2 (en) 2008-02-15 2017-12-12 Ethicon Endo-Surgery, Llc Stapling system comprising a lockout
US10058327B2 (en) 2008-02-15 2018-08-28 Ethicon Llc End effector coupling arrangements for a surgical cutting and stapling instrument
US8875972B2 (en) 2008-02-15 2014-11-04 Ethicon Endo-Surgery, Inc. End effector coupling arrangements for a surgical cutting and stapling instrument
US9585657B2 (en) 2008-02-15 2017-03-07 Ethicon Endo-Surgery, Llc Actuator for releasing a layer of material from a surgical end effector
US8608044B2 (en) 2008-02-15 2013-12-17 Ethicon Endo-Surgery, Inc. Feedback and lockout mechanism for surgical instrument
US9113905B2 (en) 2008-07-21 2015-08-25 Covidien Lp Variable resistor jaw
US9247988B2 (en) 2008-07-21 2016-02-02 Covidien Lp Variable resistor jaw
US9603652B2 (en) 2008-08-21 2017-03-28 Covidien Lp Electrosurgical instrument including a sensor
WO2010026268A1 (en) 2008-09-03 2010-03-11 Asociacion De Investigacion Y Cooperacion Industrial De Andalucia (Aicia) Apparatus for obtaining information on work and infrastructures which is based on an unmanned air vehicle
US8083120B2 (en) 2008-09-18 2011-12-27 Ethicon Endo-Surgery, Inc. End effector for use with a surgical cutting and stapling instrument
US8205781B2 (en) 2008-09-19 2012-06-26 Ethicon Endo-Surgery, Inc. Surgical stapler with apparatus for adjusting staple height
US9289210B2 (en) 2008-09-19 2016-03-22 Ethicon Endo-Surgery, Llc Surgical stapler with apparatus for adjusting staple height
US8540133B2 (en) 2008-09-19 2013-09-24 Ethicon Endo-Surgery, Inc. Staple cartridge
US10258336B2 (en) 2008-09-19 2019-04-16 Ethicon Llc Stapling system configured to produce different formed staple heights
US9326771B2 (en) 2008-09-19 2016-05-03 Ethicon Endo-Surgery, Llc Staple cartridge
US9028519B2 (en) 2008-09-23 2015-05-12 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9549732B2 (en) 2008-09-23 2017-01-24 Ethicon Endo-Surgery, Llc Motor-driven surgical cutting instrument
US9050083B2 (en) 2008-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US10105136B2 (en) 2008-09-23 2018-10-23 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US10238389B2 (en) 2008-09-23 2019-03-26 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US10045778B2 (en) 2008-09-23 2018-08-14 Ethicon Llc Robotically-controlled motorized surgical instrument with an end effector
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9655614B2 (en) 2008-09-23 2017-05-23 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument with an end effector
US10130361B2 (en) 2008-09-23 2018-11-20 Ethicon Llc Robotically-controller motorized surgical tool with an end effector
US8602287B2 (en) 2008-09-23 2013-12-10 Ethicon Endo-Surgery, Inc. Motor driven surgical cutting instrument
US8602288B2 (en) 2008-09-23 2013-12-10 Ethicon Endo-Surgery. Inc. Robotically-controlled motorized surgical end effector system with rotary actuated closure systems having variable actuation speeds
US9375254B2 (en) 2008-09-25 2016-06-28 Covidien Lp Seal and separate algorithm
US8968314B2 (en) 2008-09-25 2015-03-03 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US9113898B2 (en) 2008-10-09 2015-08-25 Covidien Lp Apparatus, system, and method for performing an electrosurgical procedure
US9370364B2 (en) 2008-10-10 2016-06-21 Ethicon Endo-Surgery, Llc Powered surgical cutting and stapling apparatus with manually retractable firing system
US10149683B2 (en) 2008-10-10 2018-12-11 Ethicon Llc Powered surgical cutting and stapling apparatus with manually retractable firing system
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US9655674B2 (en) 2009-01-13 2017-05-23 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US8852228B2 (en) 2009-01-13 2014-10-07 Covidien Lp Apparatus, system, and method for performing an electrosurgical procedure
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
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8453907B2 (en) 2009-02-06 2013-06-04 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with cutting member reversing mechanism
US9486214B2 (en) 2009-02-06 2016-11-08 Ethicon Endo-Surgery, Llc Motor driven surgical fastener device with switching system configured to prevent firing initiation until activated
US9393015B2 (en) 2009-02-06 2016-07-19 Ethicon Endo-Surgery, Llc Motor driven surgical fastener device with cutting member reversing mechanism
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
US8066167B2 (en) 2009-03-23 2011-11-29 Ethicon Endo-Surgery, Inc. Circular surgical stapling instrument with anvil locking system
US10085794B2 (en) 2009-05-07 2018-10-02 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US8858554B2 (en) 2009-05-07 2014-10-14 Covidien Lp Apparatus, system, and method for performing an electrosurgical procedure
US9345535B2 (en) 2009-05-07 2016-05-24 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US9028493B2 (en) 2009-09-18 2015-05-12 Covidien Lp In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor
US9931131B2 (en) 2009-09-18 2018-04-03 Covidien Lp In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor
US8361069B2 (en) 2009-09-25 2013-01-29 Covidien Lp Energized needles for wound sealing
US10188454B2 (en) 2009-09-28 2019-01-29 Covidien Lp System for manufacturing electrosurgical seal plates
US9750561B2 (en) 2009-09-28 2017-09-05 Covidien Lp System for manufacturing electrosurgical seal plates
US9265552B2 (en) 2009-09-28 2016-02-23 Covidien Lp Method of manufacturing electrosurgical seal plates
US8898888B2 (en) 2009-09-28 2014-12-02 Covidien Lp System for manufacturing electrosurgical seal plates
US8348129B2 (en) 2009-10-09 2013-01-08 Ethicon Endo-Surgery, Inc. Surgical stapler having a closure mechanism
US8141762B2 (en) 2009-10-09 2012-03-27 Ethicon Endo-Surgery, Inc. Surgical stapler comprising a staple pocket
US8899466B2 (en) 2009-11-19 2014-12-02 Ethicon Endo-Surgery, Inc. Devices and methods for introducing a surgical circular stapling instrument into a patient
US8353439B2 (en) 2009-11-19 2013-01-15 Ethicon Endo-Surgery, Inc. Circular stapler introducer with radially-openable distal end portion
US8353438B2 (en) 2009-11-19 2013-01-15 Ethicon Endo-Surgery, Inc. Circular stapler introducer with rigid cap assembly configured for easy removal
US8622275B2 (en) 2009-11-19 2014-01-07 Ethicon Endo-Surgery, Inc. Circular stapler introducer with rigid distal end portion
US8136712B2 (en) 2009-12-10 2012-03-20 Ethicon Endo-Surgery, Inc. Surgical stapler with discrete staple height adjustment and tactile feedback
US9675372B2 (en) 2009-12-24 2017-06-13 Ethicon Llc Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8453914B2 (en) 2009-12-24 2013-06-04 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US9307987B2 (en) 2009-12-24 2016-04-12 Ethicon Endo-Surgery, Llc 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
US9585660B2 (en) 2010-01-07 2017-03-07 Ethicon Endo-Surgery, Llc Method for testing 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
US8801735B2 (en) 2010-07-30 2014-08-12 Ethicon Endo-Surgery, Inc. Surgical circular stapler with tissue retention arrangements
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US9597075B2 (en) 2010-07-30 2017-03-21 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8801734B2 (en) 2010-07-30 2014-08-12 Ethicon Endo-Surgery, Inc. Circular stapling instruments with secondary cutting arrangements and methods of using same
US8672207B2 (en) 2010-07-30 2014-03-18 Ethicon Endo-Surgery, Inc. Transwall visualization arrangements and methods for surgical circular staplers
US9232945B2 (en) 2010-09-09 2016-01-12 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US8794497B2 (en) 2010-09-09 2014-08-05 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US10188393B2 (en) 2010-09-17 2019-01-29 Ethicon Llc Surgical instrument battery comprising a plurality of cells
US10039529B2 (en) 2010-09-17 2018-08-07 Ethicon Llc 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
US8789741B2 (en) 2010-09-24 2014-07-29 Ethicon Endo-Surgery, Inc. Surgical instrument with trigger assembly for generating multiple actuation motions
US10251539B2 (en) 2010-09-28 2019-04-09 Covidien Lp Hysteroscopic system
US9155454B2 (en) 2010-09-28 2015-10-13 Smith & Nephew, Inc. Hysteroscopic system
US8733613B2 (en) 2010-09-29 2014-05-27 Ethicon Endo-Surgery, Inc. Staple cartridge
US9131940B2 (en) 2010-09-29 2015-09-15 Ethicon Endo-Surgery, Inc. Staple cartridge
US10130363B2 (en) 2010-09-29 2018-11-20 Ethicon Llc Staple cartridge
US10258330B2 (en) 2010-09-30 2019-04-16 Ethicon Llc End effector including an implantable arrangement
US9044228B2 (en) 2010-09-30 2015-06-02 Ethicon Endo-Surgery, Inc. Fastener system comprising a plurality of fastener cartridges
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
US9861361B2 (en) 2010-09-30 2018-01-09 Ethicon Llc Releasable tissue thickness compensator and fastener cartridge having the same
US9795383B2 (en) 2010-09-30 2017-10-24 Ethicon Llc Tissue thickness compensator comprising resilient members
US9277919B2 (en) 2010-09-30 2016-03-08 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising fibers to produce a resilient load
US9272406B2 (en) 2010-09-30 2016-03-01 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US10265072B2 (en) 2010-09-30 2019-04-23 Ethicon Llc Surgical stapling system comprising an end effector including an implantable layer
US9044227B2 (en) 2010-09-30 2015-06-02 Ethicon Endo-Surgery, Inc. Collapsible fastener cartridge
US9808247B2 (en) 2010-09-30 2017-11-07 Ethicon Llc Stapling system comprising implantable layers
US9848875B2 (en) 2010-09-30 2017-12-26 Ethicon Llc Anvil layer attached to a proximal end of an end effector
US9566061B2 (en) 2010-09-30 2017-02-14 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a releasably attached tissue thickness compensator
US10265074B2 (en) 2010-09-30 2019-04-23 Ethicon Llc Implantable layers for surgical stapling devices
US9307965B2 (en) 2010-09-30 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-microbial agent
US9572574B2 (en) 2010-09-30 2017-02-21 Ethicon Endo-Surgery, Llc Tissue thickness compensators comprising therapeutic agents
US10064624B2 (en) 2010-09-30 2018-09-04 Ethicon Llc End effector with implantable layer
US9826978B2 (en) 2010-09-30 2017-11-28 Ethicon Llc End effectors with same side closure and firing motions
US10028743B2 (en) 2010-09-30 2018-07-24 Ethicon Llc Staple cartridge assembly comprising an implantable layer
US8763877B2 (en) 2010-09-30 2014-07-01 Ethicon Endo-Surgery, Inc. Surgical instruments with reconfigurable shaft segments
US9016542B2 (en) 2010-09-30 2015-04-28 Ethicon Endo-Surgery, Inc. Staple cartridge comprising compressible distortion resistant components
US9883861B2 (en) 2010-09-30 2018-02-06 Ethicon Llc Retainer assembly including a tissue thickness compensator
US9833242B2 (en) 2010-09-30 2017-12-05 Ethicon Endo-Surgery, Llc Tissue thickness compensators
US9592053B2 (en) 2010-09-30 2017-03-14 Ethicon Endo-Surgery, Llc Staple cartridge comprising multiple regions
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US8777004B2 (en) 2010-09-30 2014-07-15 Ethicon Endo-Surgery, Inc. Compressible staple cartridge comprising alignment members
US9844372B2 (en) 2010-09-30 2017-12-19 Ethicon Llc Retainer assembly including a tissue thickness compensator
US9801634B2 (en) 2010-09-30 2017-10-31 Ethicon Llc Tissue thickness compensator for a surgical stapler
US8978954B2 (en) 2010-09-30 2015-03-17 Ethicon Endo-Surgery, Inc. Staple cartridge comprising an adjustable distal portion
US9480476B2 (en) 2010-09-30 2016-11-01 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising resilient members
US10258332B2 (en) 2010-09-30 2019-04-16 Ethicon Llc Stapling system comprising an adjunct and a flowable adhesive
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US9615826B2 (en) 2010-09-30 2017-04-11 Ethicon Endo-Surgery, Llc Multiple thickness implantable layers for surgical stapling devices
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US8783542B2 (en) 2010-09-30 2014-07-22 Ethicon Endo-Surgery, Inc. Fasteners supported by a fastener cartridge support
US9833238B2 (en) 2010-09-30 2017-12-05 Ethicon Endo-Surgery, Llc Retainer assembly including a tissue thickness compensator
US9592050B2 (en) 2010-09-30 2017-03-14 Ethicon Endo-Surgery, Llc End effector comprising a distal tissue abutment member
US8657176B2 (en) 2010-09-30 2014-02-25 Ethicon Endo-Surgery, Inc. Tissue thickness compensator for a surgical stapler
US9113862B2 (en) 2010-09-30 2015-08-25 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with a variable staple forming system
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9358005B2 (en) 2010-09-30 2016-06-07 Ethicon Endo-Surgery, Llc End effector layer including holding features
US9433419B2 (en) 2010-09-30 2016-09-06 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of layers
US9168038B2 (en) 2010-09-30 2015-10-27 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a tissue thickness compensator
US8925782B2 (en) 2010-09-30 2015-01-06 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge comprising multiple layers
US8757465B2 (en) 2010-09-30 2014-06-24 Ethicon Endo-Surgery, Inc. Fastener system comprising a retention matrix and an alignment matrix
US9295464B2 (en) 2010-09-30 2016-03-29 Ethicon Endo-Surgery, Inc. Surgical stapler anvil comprising a plurality of forming pockets
US9924947B2 (en) 2010-09-30 2018-03-27 Ethicon Llc Staple cartridge comprising a compressible portion
US8978956B2 (en) 2010-09-30 2015-03-17 Ethicon Endo-Surgery, Inc. Jaw closure arrangements for surgical instruments
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US10213198B2 (en) 2010-09-30 2019-02-26 Ethicon Llc Actuator for releasing a tissue thickness compensator from a fastener cartridge
US9345477B2 (en) 2010-09-30 2016-05-24 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator comprising incorporating a hemostatic agent
US8393514B2 (en) 2010-09-30 2013-03-12 Ethicon Endo-Surgery, Inc. Selectively orientable implantable fastener cartridge
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US9700317B2 (en) 2010-09-30 2017-07-11 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a releasable tissue thickness compensator
US8899463B2 (en) 2010-09-30 2014-12-02 Ethicon Endo-Surgery, Inc. Surgical staple cartridges supporting non-linearly arranged staples and surgical stapling instruments with common staple-forming pockets
US9301752B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising a plurality of capsules
US10194910B2 (en) 2010-09-30 2019-02-05 Ethicon Llc Stapling assemblies comprising a layer
US8474677B2 (en) 2010-09-30 2013-07-02 Ethicon Endo-Surgery, Inc. Fastener system comprising a retention matrix and a cover
US10123798B2 (en) 2010-09-30 2018-11-13 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
US9833236B2 (en) 2010-09-30 2017-12-05 Ethicon Llc Tissue thickness compensator for surgical staplers
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US8740038B2 (en) 2010-09-30 2014-06-03 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a releasable portion
US9301755B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Compressible staple cartridge assembly
US10182819B2 (en) 2010-09-30 2019-01-22 Ethicon Llc Implantable layer assemblies
US9113865B2 (en) 2010-09-30 2015-08-25 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a layer
US8864009B2 (en) 2010-09-30 2014-10-21 Ethicon Endo-Surgery, Inc. Tissue thickness compensator for a surgical stapler comprising an adjustable anvil
US9282962B2 (en) 2010-09-30 2016-03-15 Ethicon Endo-Surgery, Llc Adhesive film laminate
US10136890B2 (en) 2010-09-30 2018-11-27 Ethicon Llc Staple cartridge comprising a variable thickness compressible portion
US8529600B2 (en) 2010-09-30 2013-09-10 Ethicon Endo-Surgery, Inc. Fastener system comprising a retention matrix
US8857694B2 (en) 2010-09-30 2014-10-14 Ethicon Endo-Surgery, Inc. Staple cartridge loading assembly
US8814024B2 (en) 2010-09-30 2014-08-26 Ethicon Endo-Surgery, Inc. Fastener system comprising a plurality of connected retention matrix elements
US8752699B2 (en) 2010-09-30 2014-06-17 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge comprising bioabsorbable layers
US9320518B2 (en) 2010-09-30 2016-04-26 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an oxygen generating agent
US8746535B2 (en) 2010-09-30 2014-06-10 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising detachable portions
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US8740037B2 (en) 2010-09-30 2014-06-03 Ethicon Endo-Surgery, Inc. Compressible fastener cartridge
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
US10149682B2 (en) 2010-09-30 2018-12-11 Ethicon Llc Stapling system including an actuation system
US9113864B2 (en) 2010-09-30 2015-08-25 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instruments with separate and distinct fastener deployment and tissue cutting systems
US8740034B2 (en) 2010-09-30 2014-06-03 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with interchangeable staple cartridge arrangements
US9814462B2 (en) 2010-09-30 2017-11-14 Ethicon Llc Assembly for fastening tissue comprising a compressible layer
US8864007B2 (en) 2010-09-30 2014-10-21 Ethicon Endo-Surgery, Inc. Implantable fastener cartridge having a non-uniform arrangement
US9033203B2 (en) 2010-09-30 2015-05-19 Ethicon Endo-Surgery, Inc. Fastening instrument for deploying a fastener system comprising a retention matrix
US8840003B2 (en) 2010-09-30 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with compact articulation control arrangement
US9687236B2 (en) 2010-10-01 2017-06-27 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
EP2621389B1 (en) 2010-10-01 2015-03-18 Applied Medical Resources Corporation Electrosurgical instrument with jaws and with an electrode
USD650074S1 (en) 2010-10-01 2011-12-06 Ethicon Endo-Surgery, Inc. Surgical instrument
US9113940B2 (en) 2011-01-14 2015-08-25 Covidien Lp Trigger lockout and kickback mechanism for surgical instruments
US10130352B2 (en) 2011-03-14 2018-11-20 Ethicon Llc Surgical bowel retractor devices
US9089330B2 (en) 2011-03-14 2015-07-28 Ethicon Endo-Surgery, Inc. Surgical bowel retractor devices
US8827903B2 (en) 2011-03-14 2014-09-09 Ethicon Endo-Surgery, Inc. Modular tool heads for use with circular surgical instruments
US9113884B2 (en) 2011-03-14 2015-08-25 Ethicon Endo-Surgery, Inc. Modular surgical tool systems
US8632462B2 (en) 2011-03-14 2014-01-21 Ethicon Endo-Surgery, Inc. Trans-rectum universal ports
US10045769B2 (en) 2011-03-14 2018-08-14 Ethicon Llc Circular surgical staplers with foldable anvil assemblies
US9918704B2 (en) 2011-03-14 2018-03-20 Ethicon Llc Surgical instrument
US9033204B2 (en) 2011-03-14 2015-05-19 Ethicon Endo-Surgery, Inc. Circular stapling devices with tissue-puncturing anvil features
US9113883B2 (en) 2011-03-14 2015-08-25 Ethicon Endo-Surgery, Inc. Collapsible anvil plate assemblies for circular surgical stapling devices
US9125654B2 (en) 2011-03-14 2015-09-08 Ethicon Endo-Surgery, Inc. Multiple part anvil assemblies for circular surgical stapling devices
US8978955B2 (en) 2011-03-14 2015-03-17 Ethicon Endo-Surgery, Inc. Anvil assemblies with collapsible frames for circular staplers
US8734478B2 (en) 2011-03-14 2014-05-27 Ethicon Endo-Surgery, Inc. Rectal manipulation devices
US9211122B2 (en) 2011-03-14 2015-12-15 Ethicon Endo-Surgery, Inc. Surgical access devices with anvil introduction and specimen retrieval structures
US9980713B2 (en) 2011-03-14 2018-05-29 Ethicon Llc Anvil assemblies with collapsible frames for circular staplers
US8858590B2 (en) 2011-03-14 2014-10-14 Ethicon Endo-Surgery, Inc. Tissue manipulation devices
US9974529B2 (en) 2011-03-14 2018-05-22 Ethicon Llc Surgical instrument
US8800841B2 (en) 2011-03-15 2014-08-12 Ethicon Endo-Surgery, Inc. Surgical staple cartridges
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
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
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US10117652B2 (en) 2011-04-29 2018-11-06 Ethicon Llc End effector comprising a tissue thickness compensator and progressively released attachment members
US9351730B2 (en) 2011-04-29 2016-05-31 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising channels
US9211120B2 (en) 2011-04-29 2015-12-15 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a plurality of medicaments
US9775614B2 (en) 2011-05-27 2017-10-03 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotatable staple deployment arrangements
US9271799B2 (en) 2011-05-27 2016-03-01 Ethicon Endo-Surgery, Llc Robotic surgical system with removable motor housing
US9913648B2 (en) 2011-05-27 2018-03-13 Ethicon Endo-Surgery, Llc Surgical system
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US10130366B2 (en) 2011-05-27 2018-11-20 Ethicon Llc Automated reloading devices for replacing used end effectors on robotic surgical systems
US10231794B2 (en) 2011-05-27 2019-03-19 Ethicon Llc Surgical stapling instruments with rotatable staple deployment arrangements
US10004506B2 (en) 2011-05-27 2018-06-26 Ethicon Llc Surgical system
US10071452B2 (en) 2011-05-27 2018-09-11 Ethicon Llc Automated end effector component reloading system for use with a robotic system
US8979842B2 (en) 2011-06-10 2015-03-17 Medtronic Advanced Energy Llc Wire electrode devices for tonsillectomy and adenoidectomy
US10154848B2 (en) 2011-07-11 2018-12-18 Covidien Lp Stand alone energy-based tissue clips
US9198661B2 (en) 2011-09-06 2015-12-01 Ethicon Endo-Surgery, Inc. Stapling instrument comprising a plurality of staple cartridges stored therein
US8789739B2 (en) 2011-09-06 2014-07-29 Ethicon Endo-Surgery, Inc. Continuous stapling instrument
US8833632B2 (en) 2011-09-06 2014-09-16 Ethicon Endo-Surgery, Inc. Firing member displacement system for a stapling instrument
US9107663B2 (en) 2011-09-06 2015-08-18 Ethicon Endo-Surgery, Inc. Stapling instrument comprising resettable staple drivers
US9592054B2 (en) 2011-09-23 2017-03-14 Ethicon Endo-Surgery, Llc Surgical stapler with stationary staple drivers
US9687237B2 (en) 2011-09-23 2017-06-27 Ethicon Endo-Surgery, Llc Staple cartridge including collapsible deck arrangement
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9216019B2 (en) 2011-09-23 2015-12-22 Ethicon Endo-Surgery, Inc. Surgical stapler with stationary staple drivers
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
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
US9730697B2 (en) 2012-02-13 2017-08-15 Ethicon Endo-Surgery, Llc Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US10166025B2 (en) 2012-03-26 2019-01-01 Ethicon Llc Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge
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
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9314247B2 (en) 2012-03-28 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating a hydrophilic agent
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
US9517063B2 (en) 2012-03-28 2016-12-13 Ethicon Endo-Surgery, Llc Movable member for use with a tissue thickness compensator
US9724098B2 (en) 2012-03-28 2017-08-08 Ethicon Endo-Surgery, Llc Staple cartridge comprising an implantable layer
US9918716B2 (en) 2012-03-28 2018-03-20 Ethicon Llc Staple cartridge comprising implantable layers
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9974538B2 (en) 2012-03-28 2018-05-22 Ethicon Llc Staple cartridge comprising a compressible layer
US9204880B2 (en) 2012-03-28 2015-12-08 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising capsules defining a low pressure environment
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US10064621B2 (en) 2012-06-15 2018-09-04 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9907620B2 (en) 2012-06-28 2018-03-06 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US9364230B2 (en) 2012-06-28 2016-06-14 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotary joint assemblies
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US10258333B2 (en) 2012-06-28 2019-04-16 Ethicon Llc Surgical fastening apparatus with a rotary end effector drive shaft for selective engagement with a motorized drive system
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
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9649111B2 (en) 2012-06-28 2017-05-16 Ethicon Endo-Surgery, Llc Replaceable clip cartridge for a clip applier
US9226751B2 (en) 2012-06-28 2016-01-05 Ethicon Endo-Surgery, Inc. Surgical instrument system including replaceable end effectors
US9204879B2 (en) 2012-06-28 2015-12-08 Ethicon Endo-Surgery, Inc. Flexible drive member
US9386985B2 (en) 2012-10-15 2016-07-12 Ethicon Endo-Surgery, Llc Surgical cutting instrument
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
US9554794B2 (en) 2013-03-01 2017-01-31 Ethicon Endo-Surgery, Llc Multiple processor motor control for modular surgical instruments
US9307986B2 (en) 2013-03-01 2016-04-12 Ethicon Endo-Surgery, Llc Surgical instrument soft stop
US9326767B2 (en) 2013-03-01 2016-05-03 Ethicon Endo-Surgery, Llc Joystick switch assemblies for surgical instruments
US9782169B2 (en) 2013-03-01 2017-10-10 Ethicon Llc Rotary powered articulation joints for surgical instruments
US9468438B2 (en) 2013-03-01 2016-10-18 Eticon Endo-Surgery, LLC Sensor straightened end effector during removal through trocar
US9358003B2 (en) 2013-03-01 2016-06-07 Ethicon Endo-Surgery, Llc Electromechanical surgical device with signal relay arrangement
US10226249B2 (en) 2013-03-01 2019-03-12 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US9398911B2 (en) 2013-03-01 2016-07-26 Ethicon Endo-Surgery, Llc Rotary powered surgical instruments with multiple degrees of freedom
US9700309B2 (en) 2013-03-01 2017-07-11 Ethicon Llc Articulatable surgical instruments with conductive pathways for signal communication
US9345481B2 (en) 2013-03-13 2016-05-24 Ethicon Endo-Surgery, Llc Staple cartridge tissue thickness sensor system
US9883860B2 (en) 2013-03-14 2018-02-06 Ethicon Llc Interchangeable shaft assemblies for use with a surgical instrument
US9351727B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Drive train control arrangements for modular surgical instruments
US9351726B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Articulation control system for articulatable surgical instruments
US9332987B2 (en) 2013-03-14 2016-05-10 Ethicon Endo-Surgery, Llc Control arrangements for a drive member of a surgical instrument
US9629623B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgery, Llc Drive system lockout arrangements for modular surgical instruments
US9687230B2 (en) 2013-03-14 2017-06-27 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9808244B2 (en) 2013-03-14 2017-11-07 Ethicon Llc Sensor arrangements for absolute positioning system for surgical instruments
US9888919B2 (en) 2013-03-14 2018-02-13 Ethicon Llc Method and system for operating a surgical instrument
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US10238391B2 (en) 2013-03-14 2019-03-26 Ethicon Llc Drive train control arrangements for modular surgical instruments
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
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
US9867612B2 (en) 2013-04-16 2018-01-16 Ethicon Llc Powered surgical stapler
US9826976B2 (en) 2013-04-16 2017-11-28 Ethicon Llc Motor driven surgical instruments with lockable dual drive shafts
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
US9801626B2 (en) 2013-04-16 2017-10-31 Ethicon Llc Modular motor driven surgical instruments with alignment features for aligning rotary drive shafts with surgical end effector shafts
US10149680B2 (en) 2013-04-16 2018-12-11 Ethicon Llc Surgical instrument comprising a gap setting system
US9814460B2 (en) 2013-04-16 2017-11-14 Ethicon Llc Modular motor driven surgical instruments with status indication arrangements
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US9924942B2 (en) 2013-08-23 2018-03-27 Ethicon Llc Motor-powered articulatable surgical instruments
US9510828B2 (en) 2013-08-23 2016-12-06 Ethicon Endo-Surgery, Llc Conductor arrangements for electrically powered surgical instruments with rotatable end effectors
US9283054B2 (en) 2013-08-23 2016-03-15 Ethicon Endo-Surgery, Llc Interactive displays
US9445813B2 (en) 2013-08-23 2016-09-20 Ethicon Endo-Surgery, Llc Closure indicator systems for surgical instruments
US10201349B2 (en) 2013-08-23 2019-02-12 Ethicon Llc End effector detection and firing rate modulation systems for surgical instruments
US9987006B2 (en) 2013-08-23 2018-06-05 Ethicon Llc Shroud retention arrangement for sterilizable surgical instruments
US9700310B2 (en) 2013-08-23 2017-07-11 Ethicon Llc Firing member retraction devices for powered surgical instruments
US9775609B2 (en) 2013-08-23 2017-10-03 Ethicon Llc Tamper proof circuit for surgical instrument battery pack
US9808249B2 (en) 2013-08-23 2017-11-07 Ethicon Llc Attachment portions for surgical instrument assemblies
US10265065B2 (en) 2013-12-23 2019-04-23 Ethicon Llc Surgical staples and staple cartridges
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9642620B2 (en) 2013-12-23 2017-05-09 Ethicon Endo-Surgery, Llc Surgical cutting and stapling instruments with articulatable end effectors
US9681870B2 (en) 2013-12-23 2017-06-20 Ethicon Llc Articulatable surgical instruments with separate and distinct closing and firing systems
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
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9549735B2 (en) 2013-12-23 2017-01-24 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a firing member including fastener transfer surfaces
US9585662B2 (en) 2013-12-23 2017-03-07 Ethicon Endo-Surgery, Llc Fastener cartridge comprising an extendable firing member
US9968354B2 (en) 2013-12-23 2018-05-15 Ethicon Llc Surgical staples and methods for making the same
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9839422B2 (en) 2014-02-24 2017-12-12 Ethicon Llc Implantable layers and methods for altering implantable layers for use with surgical fastening instruments
US9839423B2 (en) 2014-02-24 2017-12-12 Ethicon Llc Implantable layers and methods for modifying the shape of the implantable layers for use with a surgical fastening instrument
US9775608B2 (en) 2014-02-24 2017-10-03 Ethicon Llc Fastening system comprising a firing member lockout
US9757124B2 (en) 2014-02-24 2017-09-12 Ethicon Llc Implantable layer assemblies
US9693777B2 (en) 2014-02-24 2017-07-04 Ethicon Llc Implantable layers comprising a pressed region
US9884456B2 (en) 2014-02-24 2018-02-06 Ethicon Llc Implantable layers and methods for altering one or more properties of implantable layers for use with fastening instruments
US10028761B2 (en) 2014-03-26 2018-07-24 Ethicon Llc Feedback algorithms for manual bailout systems for surgical instruments
US10117653B2 (en) 2014-03-26 2018-11-06 Ethicon Llc Systems and methods for controlling a segmented circuit
US9730695B2 (en) 2014-03-26 2017-08-15 Ethicon Endo-Surgery, Llc Power management through segmented circuit
US9804618B2 (en) 2014-03-26 2017-10-31 Ethicon Llc Systems and methods for controlling a segmented circuit
US9733663B2 (en) 2014-03-26 2017-08-15 Ethicon Llc Power management through segmented circuit and variable voltage protection
US9826977B2 (en) 2014-03-26 2017-11-28 Ethicon Llc Sterilization verification circuit
US9743929B2 (en) 2014-03-26 2017-08-29 Ethicon Llc Modular powered surgical instrument with detachable shaft assemblies
US10004497B2 (en) 2014-03-26 2018-06-26 Ethicon Llc Interface systems for use with surgical instruments
US10136889B2 (en) 2014-03-26 2018-11-27 Ethicon Llc Systems and methods for controlling a segmented circuit
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US10201364B2 (en) 2014-03-26 2019-02-12 Ethicon Llc Surgical instrument comprising a rotatable shaft
US9690362B2 (en) 2014-03-26 2017-06-27 Ethicon Llc Surgical instrument control circuit having a safety processor
US9750499B2 (en) 2014-03-26 2017-09-05 Ethicon Llc Surgical stapling instrument system
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9877721B2 (en) 2014-04-16 2018-01-30 Ethicon Llc Fastener cartridge comprising tissue control features
US9844369B2 (en) 2014-04-16 2017-12-19 Ethicon Llc Surgical end effectors with firing element monitoring arrangements
US9833241B2 (en) 2014-04-16 2017-12-05 Ethicon Llc Surgical fastener cartridges with driver stabilizing arrangements
US10010324B2 (en) 2014-04-16 2018-07-03 Ethicon Llc Fastener cartridge compromising fastener cavities including fastener control features
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US10135242B2 (en) 2014-09-05 2018-11-20 Ethicon Llc Smart cartridge wake up operation and data retention
US9737301B2 (en) 2014-09-05 2017-08-22 Ethicon Llc Monitoring device degradation based on component evaluation
US10016199B2 (en) 2014-09-05 2018-07-10 Ethicon Llc Polarity of hall magnet to identify cartridge type
US9724094B2 (en) 2014-09-05 2017-08-08 Ethicon Llc Adjunct with integrated sensors to quantify tissue compression
US9788836B2 (en) 2014-09-05 2017-10-17 Ethicon Llc Multiple motor control for powered medical device
US9757128B2 (en) 2014-09-05 2017-09-12 Ethicon Llc Multiple sensors with one sensor affecting a second sensor's output or interpretation
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
US9801627B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Fastener cartridge for creating a flexible staple line
US10206677B2 (en) 2014-09-26 2019-02-19 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
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
US10052104B2 (en) 2014-10-16 2018-08-21 Ethicon Llc Staple cartridge comprising a tissue thickness compensator
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
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
US10245027B2 (en) 2014-12-18 2019-04-02 Ethicon Llc Surgical instrument with an anvil that is selectively movable about a discrete non-movable axis relative to a staple cartridge
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
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
US10004501B2 (en) 2014-12-18 2018-06-26 Ethicon Llc Surgical instruments with improved closure arrangements
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
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
US10245028B2 (en) 2015-02-27 2019-04-02 Ethicon Llc Power adapter for a surgical instrument
US9931118B2 (en) 2015-02-27 2018-04-03 Ethicon Endo-Surgery, Llc Reinforced battery for a surgical instrument
US10045779B2 (en) 2015-02-27 2018-08-14 Ethicon Llc Surgical instrument system comprising an inspection station
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US10159483B2 (en) 2015-02-27 2018-12-25 Ethicon Llc Surgical apparatus configured to track an end-of-life parameter
US10226250B2 (en) 2015-02-27 2019-03-12 Ethicon Llc Modular stapling assembly
US10182816B2 (en) 2015-02-27 2019-01-22 Ethicon Llc Charging system that enables emergency resolutions for charging a battery
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
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
US10206605B2 (en) 2015-03-06 2019-02-19 Ethicon Llc Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor 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
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10052102B2 (en) 2015-06-18 2018-08-21 Ethicon Llc Surgical end effectors with dual cam actuated jaw closing features
US10098642B2 (en) 2015-08-26 2018-10-16 Ethicon Llc Surgical staples comprising features for improved fastening of tissue
US10188394B2 (en) 2015-08-26 2019-01-29 Ethicon Llc Staples configured to support an implantable adjunct
US10166026B2 (en) 2015-08-26 2019-01-01 Ethicon Llc Staple cartridge assembly including features for controlling the rotation of staples when being ejected therefrom
US10028744B2 (en) 2015-08-26 2018-07-24 Ethicon Llc Staple cartridge assembly including staple guides
US10213203B2 (en) 2015-08-26 2019-02-26 Ethicon Llc Staple cartridge assembly without a bottom cover
US10251648B2 (en) 2015-09-02 2019-04-09 Ethicon Llc Surgical staple cartridge staple drivers with central support features
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
US10238390B2 (en) 2015-09-02 2019-03-26 Ethicon Llc Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns
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
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
US10285699B2 (en) 2015-09-30 2019-05-14 Ethicon Llc Compressible adjunct
US10172620B2 (en) 2015-09-30 2019-01-08 Ethicon Llc Compressible adjuncts with bonding nodes
US10271849B2 (en) 2015-09-30 2019-04-30 Ethicon Llc Woven constructs with interlocked standing fibers
US10213250B2 (en) 2015-11-05 2019-02-26 Covidien Lp Deployment and safety mechanisms for surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10245029B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instrument with articulating and axially translatable end effector
US10245030B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instruments with tensioning arrangements for cable driven articulation systems
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10285705B2 (en) 2016-04-01 2019-05-14 Ethicon Llc Surgical stapling system comprising a grooved forming pocket
US10271851B2 (en) 2016-04-01 2019-04-30 Ethicon Llc Modular surgical stapling system comprising a display
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
US10285695B2 (en) 2016-09-23 2019-05-14 Ethicon Llc Articulatable surgical instruments with conductive pathways
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

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EP0996376A1 (en) 2000-05-03
AU731398B2 (en) 2001-03-29

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