CA2037427C - Surgical fastener apparatus - Google Patents
Surgical fastener apparatusInfo
- Publication number
- CA2037427C CA2037427C CA002037427A CA2037427A CA2037427C CA 2037427 C CA2037427 C CA 2037427C CA 002037427 A CA002037427 A CA 002037427A CA 2037427 A CA2037427 A CA 2037427A CA 2037427 C CA2037427 C CA 2037427C
- Authority
- CA
- Canada
- Prior art keywords
- fastener
- distal
- holding cartridge
- movement
- pushing
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
- Y10T29/49826—Assembling or joining
- Y10T29/49945—Assembling or joining by driven force fit
Abstract
An instrument for cutting body tissue and applying a plurality of two part surgical fasteners to the body tissue on each side of the cut. The instrument includes a U-shaped distal portion, and a body having a longitudinal portion for enclosing an axial drive means for pushing fasteners into position in the body tissue.
The axial drive means is off-centered from the fastener pushing means in the fastener cartridge at the U-shaped distal portion. A
trigger operated diverter is provided with a unique system of force conversion and transmission for converting a single off-centered axial drive force to a uniformly distributed drive force for pushing the fastener pushers, and the knife assembly.
The axial drive means is off-centered from the fastener pushing means in the fastener cartridge at the U-shaped distal portion. A
trigger operated diverter is provided with a unique system of force conversion and transmission for converting a single off-centered axial drive force to a uniformly distributed drive force for pushing the fastener pushers, and the knife assembly.
Description
~ 2~3~4,~7 203-284 (1124) SURGICAL FASTENER APPARATUS
BACKGROUND OF THE lNV~NLlON
1. Field of the Invention This invention relates to an apparatus for applying a plurality of surgical fasteners to body tissue and more particularly to an apparatus for simultaneously applying a plurality of two part bioabsorbable surgical fasteners.
BACKGROUND OF THE lNV~NLlON
1. Field of the Invention This invention relates to an apparatus for applying a plurality of surgical fasteners to body tissue and more particularly to an apparatus for simultaneously applying a plurality of two part bioabsorbable surgical fasteners.
2. Descri~tion of the Prior Art Surgical fastener applicator apparatus in which surgical fasteners are simultaneously applied to body tissue are known.
Typically, these devices include a fastener holder positioned on one side of the tissue to be fastened and an anvil parallel to the fastener holder positioned on the other side of the tissue.
Typically, means is provided for linearly translating the fastener holder and the anvil toward one another to clamp the tissue between them. Means is also provided for driving the fasteners from the fastener holder so that the ends of the fasteners pass through the tissue and form finished fasteners as they make contact with the anvil assembly, thereby producing an array of finished fasteners in the tissue.
Also in use are instruments for applying two part fasteners having a fastener portion and a retainer portion. The fastener portion generally has barbed prongs for penetrating body tissue and engaging corresponding openings in the retainer portion.
Once engaged, the fastener and retainer are locked together. Such two-part fasteners are usually constructed from bioabsorbable material.
In common use are apparatus in which the fastener holder and anvil are removably mounted in or on an actuator for supporting and actuating the cartridge. The apparatus can be disposed of after a single use or it can be reused for another surgical fastening procedure after cleaning, sterilizing and reloading with a fresh cartridge. Also in use are fully disposable surgical instruments in which the cartridge and actuator are preassembled ready for use and disposed of after only a single use.
U.S. Patent No. 4,665,916 (Green) describes a surgical fastener apparatus for applying rows of fasteners laterally through hollow body organs such as the thorax, trachea, stomach, uterus or intestines. The cartridge includes an alignment pin which achieves and maintains proper relative positioning of the fastener holder and anvil components thereof. When the fully assembled instrument is actuated, it is positioned in such a way that the body tissue to be fastened is clamped in place between the staple-ejecting surface of the fastener holder and the anvil assembly. The clamping pressure exerted against both sides of the tissue is sufficient to provide effective hemostasis along two linear sites which, upon nfiring" of the instrument, receive substantially parallel rows of fasteners on either side of an incision formed by a tissue cutting knife which is also incorporated in the holder. The deployment of the knife is mechanically synchronized to immediately follow the insertion of the fasteners.
U.S. Patent No. 4,819,853 (Green) discloses a surgical fastener applicator which includes tissue gripping elements provided along the sides of a knife slot to prevent body tissue from pulling away from the fasteners after the latter are positioned in place and the incision is made. Thereafter, clamping pressure is released.
U.S. Patent No. 4,881,545 (Isaacs et al.) discloses a surgical fastener cartridge possessing an improved body cutting knife assembly. The knife element of the assembly is held in permanent locking engagement with a knife holder.
U.S. Patent No. 4,767,044 (Green) discloses a fastener applying apparatus including means for preventing all of the - 2037~27 fasteners from re~chlng peak formation force at the same time in order to reduce the ~i force required to operate the apparatus.
U.S. Patent No. 4,728,020 (Green et al.) discloses an articulated surgical fastener applying apparatus having a linear drive mech~ni which is offset from the centerline of movement of the surgical fasteners. The drive force is proximally directed, i.e. it is a pulling force transmitted by a tensioned cable mech~ni~ rather than by a drive rod.
While the prior art instruments, such as those mentioned above, have been serving the needs of the medical community by providing surgeons with quick and simple means to make and/or seal incisions in body tissue, improvements are nevertheless desirable.
For example, surgeons prefer to have a greater visibility of the area of tissue upon which they are operating. It should be noted that in the prior art instruments, the drive rod for driving the fastener pushers operates axially and is centered at the rear of the fastener holding cartridge. The longitudinal frame of the instrument, therefore, often interferes with the surgeon's line of sight and obstructs visibility of the operation site.
An off-centered axially moving drive rod would therefore be desirable since it would enable the surgeon to have greater visibility of the operating site. Up to now however, the use of an off-centered drive rod has not been recognized as a solution to the problem. Unlike the cable drive means, the drive rod operates by applying a distally directed, or "pushing" drive force. The central location of the drive rod of the prior art instruments prevents the fastener pushers and the knife, if there is one, from pivoting and jamming within the fastener holding cartridge due to the critical location of the force. Such jamming would occur if the fastener pushers were driven by an off-center force in previously known instruments. Moreover, cable drive means restrict the ability of prior art instruments to be "resetn after initial firing.
The present invention provides such an apparatus in which improved visibility of the operation site is facilitated while avoiding direct off-centered driving force application to the fastener pushing members.
- 2û3~27 SUMMARY OF THE lNV~NLlON
Apparatus for substantially simultaneously applying a plurality of surgical fasteners to body tissue or the like, which comprises a body having a longitudinal portion enclosing axial drive means, a distal portion thereof defining a tissue reception aperture. Anvil means is positioned at the distal portion of the tissue reception aperture and fastener holding means is pivotally mounted relative to the anvil means adjacent one end portion thereof and defines a space therebetween. The fastener holding means contains a plurality of surgical fasteners arranged in generally parallel rows extending generally transversely to the longitudinal portion and the longitudinal portion is generally offset from the center of the rows of staples. Means is provided for initially advancing the fastener holding means distally at least sufficient to contact body tissue positioned within the aperture, and means is provided for reception of proximally directed user applied force and for translating same to distally directed drive force on the axial drive means generally in alignment with the longitudinal portion.
The invention comprises means for translating the distally directed drive force to distally directed staple drive force distributed generally uniformly over the length of the plurality of staples to apply the staples to the body tissue.
In a preferred embodiment, the apparatus disclosed herein for substantially simultaneously applying a plurality of surgical fasteners includes a handle; a trigger means for applying the fasteners; a body with a longitudinal portion enclosing an axial drive means; a U-shaped distal portion; an anvil assembly positioned at the distal leg of the U-shaped distal portion; a fastener holding cartridge pivotally mounted relative to the anvil assembly and adjacent one end of the anvil assembly thereby defining a gap between them, and cont~ining a plurality of surgical fasteners, and optionally including a knife means forcutting body tissue. The apparatus further includes approximating means for actuating the fastener holding cartridge; and a fastener pushing means for substantially simultaneously pushing all of the fasteners from the fastener holding cartridge. The apparatus is characterized in that the axis of the longit~ldinAl portion of the body is in off-center alignment relative to the axial centerline of movement of the fastener pushing means, and said apparatus further includes means for translating an off-centered axial drive force to an evenly distributed driven force across the proximal end of the fastener pushing means.
The U-shaped distal portion of the apparatus is defined by two U-shaped plate portions of frame means mounted in parallel spaced apart relation to each other, the mutually facing surfaces of the plate portions being flat. The two U-shaped plate portions are connected by a spacer pin transversely mounted therebetween at the ends of their respective proximal legs. The said plate portions of the frame means and the spacer pin cooperate so as to align the anvil assembly with the fastener holding cartridge.
The knife means possesses a distally facing elongated surface for contacting the proximal end of the fastener pushing means, the distally facing elongated surface of the knife means abutting and moving said fastener pushing means in response to the distal movement of the axial drive means.
The fastener pushing means includes a pusher plate which is substantially flat on two opposite sides and which has a plurality of fastener-pushing members distally projecting from a back portion, and interference means associated with at least one of the flat sides for frictionally e~gAeing a cooperating surface of the fastener holding cartridge to prevent the fastener pusher plate from moving proximally after it has been moved to its most distal position in response to movement of the axial drive means. The interference means can comprises one or more detents projecting from the side of the pusher plate.
The anvil assembly includes a retainer mounting bar comprising an elongated bar having a plurality of mounting posts projecting transversely from said bar, said posts being frictionally e~gAgAhle with the retainers for holding said retainers in a fixed position relative to the instrument until said retainers are fully engaged with their respective fasteners.
20374~7 Although the preferred embodiment described herein pertains to an instrument for substantially simultaneously applying the fasteners, it is also envisioned as being within the scope of the present invention for the instrument to apply the fasteners sequentially. Furthermore, although two-part bioabsorbable surgical fasteners are referred to hereinbelow, instruments for applying other types of surgical fasteners including non-bioabsorbable staples and the like are contemplated as being within the scope of the present invention. Additionally, although the embodiments described hereinbelow are described in conjunction with the fasteners and retainers, it is within the scope of the present invention to provide an instrument in an unloaded condition, such as a reloadable instrument with replaceable fastener and retainer means.
2~37427 ~ -BRIEF DESCRIPTION OF THE DRAWINGS
Preferred embodiments of the invention are described hereinbelow with reference to the drawings wherein:
Fig. 1 is a perspective view of the fastener applying apparatus of the present invention;
Fig. 2 is a perspective cut-away view of the apparatus of the present invention;
Figs. 3, 4, 5, and 6 are exploded perspective views of the fastener applying me~hAni ! of the apparatus;
Fig. 7 is a perspective view of the retainer support arm of the apparatus;
Fig. 8 is a perspective view of the retainer mounting strip of the apparatus;
Fig. 9 is an enlarged perspective view of a two part surgical fastener which can be applied to body tissue by means of the apparatus of the present invention;
Figs. 10, 11, 12 and 13 are elevational views partially cut-away, sequentially illustrating the fastener application with the apparatus of the invention;
Figs. 14 and 15 are cross-sectional views of the fastener cartridge and anvil assembly, illustrating the operation of the apparatus in prefired and fired conditions, respectively; and Fig. 16 is an elevational cut-away view of the fastener cartridge and anvil assembly after the apparatus has been fired.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring initially to Figs. 1 to 4, left and right body portions, 10 and 20 respectively, provide means for housing the actuating -~hAni of the invention and also provides means for allowing the user to hold the instrument. Each body portion has a handle portion, 11 and 21 for the left and right body portions respectively, and a longit~ldinAIly or axially extending portion 12 and 22, respectively. The body portions also each have internal struts 23 which include recessed portions 23a associated with the internal wall surface of the handle. The struts provide added strength and support. The recessed portions 23a receive and hold the frame extension S0 in a fixed position. Aperture 25 in the right body portion and a corresponding aperture in the left body portion receive trigger pivot pin 140 shown in Fig. 3. Recessed portions 24 and 14 of the right and left body portions form a slot for receiving the pivot arm lSl of safety catch lS0.
Referring to Fig. 3, left frame 60 is an elongated member having an axially extending longitudinal portion 63; a proximal portion 61 which is inclined from the longit~ldinAl portion and which defines aperture 62 for receiving trigger pivot pin 140; a U-shaped distal portion 64 having a distal leg 64a, a proximal leg 64b, aperture 64c for receiving shoulder rivet 70, and apertures 64d for receiving rivets 250 for mounting to the retainer housing 240 (see Fig. 6); and notch 65 for eneAging one of the detents 211 of the spring retainer 210.
Referring now to Fig. 4, right frame 30 is an elongated member having an axially extending longitudinal portion 33; a proximal portion 31 which is inclined from the longit~ldinAl portion and which possesses an aperture 32 for receiving trigger pivot pin 140; a U-shaped distal portion 34 having a distal leg 34a, a proximal leg 34b, aperture 34c for receiving shoulder rivet 70, and apertures 34d for receiving rivets 250 for mounting to the retainer housing 240 as shown in Fig. 6; and notch 35 for engAging one of the detents 211 of the spring retainer 210 as shown in Fig.
4. Additionally, right frame 30 is fixedly mounted to frame extension 50 such that both have aperture 32 in common. Frame extension 50 has an indentation 51 on its distal edge for accommodating the pivot arm 151 of safety latch lS0.
Referring now to Fig. 6, left and right frames 60 and 30, respectively, are mounted in a parallel spaced apart relationship to each other. The distal U-shaped portions define the U-shaped distal end of the instrument. The mutually facing surfaces of the distal portions of the frames are flat thus eliminating intermediate components and facilitating improved component alignment and ini i 7ing dimensional tolerance variations. This is in contrast to prior art instruments in which similarly shaped distal plates possessed inward indentations or jogs to demarcate the distal leg which supported an anvil assembly of lesser width than the fastener holder. In the prior art instruments (see e.g. U.S. Patent No.
4,665,916) alignment of fastener components and body tissue was provided by a longitudinally mounted alignment pin which pierced the body tissue being fastened. In the present invention alignment is facilitated by the provision of closer tolerances between the flat inner sides of the frames and the fastener holder, by spacer pin 70 which maintains a predetermined distance between the ends of proximal legs 64b and 34b, and through the use of a material of construction for the frames which ensures that the frames will neither deform nor fatigue during use. Preferably, the frames are constructed from stainless steel having a thickness of at least 0.07 inches and preferably of from 0.07 to 0.08 inches. Parallelism and close tolerances are thereby maintained for proper alignment of the fastener holder with the anvil.
In Figs. 10 and 11, spacer pin 70 extends laterally between the proximal legs 64b and 34b of the left and right frames, and projections 71 are received into apertures 64c and 34c. Spacer pin 70 spaces the left and right frames apart at a fixed predetermined distance and serves as a guide for the fastener holding cartridge.
Referring to Figs. 2 and 3, actuator 80 serves as part of the fastener cartridge actuation means, i.e. approximating means to move the fastener cartridge from a proximal open position such that body tissue can be freely inserted into the gap between the fastener cartridge and the anvil assembly, into a distal closed position wherein it can hold body tissue clamped between it and the anvil assembly, as discussed below. Actuator 80 is a lever pivotally mounted to the left and right body portions 10 and 20 by means of a pin 230 disposed through aperture 81. Aperture 82 receives pin 90 for mounting lever rod 110. Actuator 80 has a forked distal end 83 and a longit~in~l central slot 84. Thumb rest 85 is at the proximal end.
g Lever rod 110 is an elongated member defining longitudin~l central slot 111. Lever rod 110 is slidably mounted within slot 84 of the actuator by means of pin 90 disposed through aperture 82, washer 100 and slot 111.
Trigger 130 is an elongated lever arm having a forked end with curved hook-like members 131 shown in Fig. 3. Central slot 132 extends longitlldin~lly along the underside of the trigger 130. Side slots 133 are provided for engaging the snap prongs 154 of the safety catch 150. Central slot 132 is provided in trigger 130 for receiving trigger insert 120, which is mounted therein. Trigger insert 120 has an aperture 121 which is aligned with the curved hook-like members 131 such that trigger pivot pin 140 is received therethrough. Trigger insert 120 has an end with projection 122 for contacting the proximal end of lever rod 110.
Referring once again to Figs. 2 and 3, trigger pivot pin 140 is transversely mounted with left and right ends fixed respectively in apertures 25 in the interior surfaces of the left and right body portions 10 and 20, and is disposed respectively through apertures 62, 121, and 32, of the left frame, trigger insert and right frame.
Referring to Figs. 4, 10 and 11, clamp 160 is an elongated member with longitudinAl central slot 161. Cap 170 is mounted on the proximal end of clamp 160 with vertical slot 171 of the cap being aligned with longit~din~l slot 161 of the clamp to permit passage therethrough of lever 110. Cap 170 preferably has a sloped proximal surface 172 for being contacted by the forked end 83 of the actuator. Clamp 160 has a transversely extending aperture 162 for receiving clamp pin 90.
Thrust bar 180 is an elongated member which is slidably mounted within slot 161 of the clamp. Thrust bar 180 has a longitlldinAl slot 181 through which clamp pin 90 is disposed.
Proximal end 183 is for contacting the distal end of lever 110.
Distal edge 184 is for contacting the cam assembly discussed below and is preferably inclined to facilitate c~ Ing action between it and link 340. Thrust bar 180 has a distally projecting post 182 for mounting a washer 190, and coiled spring 200.
Spring retainer 210 is a block shaped piece having longitudinally extending detents 211-for engaging slots 65 and 35 in the left and right frames. The proximal end 212 serves as a backstop for spring 200 such that spring 200 biases the slidable thrust bar 180 in the proximal direction. The distal end has a curved portion 213 for receiving a leaf spring 220.
Retainer pin 231 extends transversely across the underside of the leaf spring 220 and is fixed at its ends in corresponding apertures in the body portions. Retainer pin 231 maintains the spring 220 in a fixed position.
Referring additionally to Figs. 5 and 6, the fastener holder 460 of the present invention is an assembly which includes several unique features.
The cam assembly, which is housed within the fastener holder 460, is a non-torquing force diverter comprising an assembly of links and a cam plate which converts the off-centered axial drive force to a balanced linear drive force uniformly distributed across the proximal end of the knife blade assembly. With such means for providing this conversion, the need to provide an off-centered drive force directly to the knife assembly is avoided. Such last mentioned force application method would result in unbalanced force and unwanted torque which would pivot and jam the knife and fastener pushers. Moreover, in the present invention, force transmissions and conversions are provided through compression members thereby facilitating definitive and accurate force transmission and conversion. Furthermore, tension cables or the like as utilized in prior developments are avoided.
Referring to Fig. 5, the cam assembly includes curved link 340 having a distal end pivotally mounted in socket 331 in the fastener cartridge 330 by means of pin 370 disposed through aperture 341. The proximal end of link 340 is pivotally attached by a pin 360 to one end of an intermediate link 350. The other end of the intermediate link 350 is pivotally attached by a pin 360 to cam bar 380. Cam bar 380 has a flat distal c ing surface 381, a rear projection 382 with aperture 383 for receiving a pivot pin 360, and upper and lower bolts 384 and 385 which project into and ride along 203~427 the inclined slots 291, 292, 301, and 302 of the right and left side plates. The flat distal c~ ine surface 381 of the cam bar is for contacting the proximal surface 421a of the back of the blade channel 420.
The movement of the cam bar has a vector component linearly aligned with the path of movement of the fastener pushers 410, knife 440, and blade channel 420. Unaligned components of motion are not transmitted to the blade channel 420 because the cam bar's distal surface 381 remains in a perpendicular orientation relative to the center line of movement of the fastener pushers 410 and blade channel 420, and because the c~ ing surface 381 is slidable relative to proximal surface 421a.
Referring once again to Fig. 5, the knife blade assembly, also housed within the fastener holder 460, includes blade channel 420, leaf spring 390, blade holder 430, and knife blade 440.
Blade channel 420 has two parallel dovetail shaped portions 424 projecting distally from a back portion 421. The dovetail portions define apertures 422 for engaging projections 432 of the blade holder 430. Together, dovetail portions 424 define a channel 423 in which leaf spring 390 is located. The back portion 421 has a proximal surface 421a for contacting the distal c~ ing surface 381 of the cam bar, and a distal surface 421b which is contacted by leaf spring 390.
Curved leaf spring 390 is located between the blade holder 430 and the blade channel 420. Its ends are retained by inwardly projecting stubs 321 of the cartridge cap 320. Spring 390 contacts the distal surface 421b of the back of the blade channel 420, thereby biasing the blade channel 420 proximally.
The distal end of blade holder 430 has a slot 431 for mounting a knife blade 440. Projections 432 on the sides of the blade holder are mounting fixtures received into apertures 422 of the blade channel.
Knife blade 440 has a sharp distal edge 441 for cutting body tissue. The proximal edge of blade holder 430 shown in Fig. 5 is mounted in slot 431 of the blade holder.
-Referring once again to Fig. 5, cartridge pushers 410 are substantially flat strips having distal pointing finger-like projections 411 for pushing the fasteners through slots 332, and out of the cartridge 330 into engagement with their respective retainers 280 in the anvil assembly. At least one side of each pusher possesses an interference means, such as one or more detents 412, which frictionally engage the surface 335 of the corresponding slot in the fastener cartridge 330 in which the pusher slides. (See Fig.
15.) These detents advantageously prevent the pushers from retracting once they have been moved to their most distal position, thereby preventing the fasteners from migrating or deflecting back into slots 332. Such migration or deflection, if tmi ,.eded, may result in non-engagement of the fastener with its corresponding retainer. The proximal edges 413 are contacted by surfaces 433 of the blade holder such that when the blade holder is moved distally, surfaces 433 urge the fastener pushers 410 towards the distal direction.
Fastener holder 460 also comprises cartridge 330 having a plurality of fastener slots 332, a knife slot 333, a rear slot 334 through which the distal end 184 of the thrust bar enters, and socket 331 for retAinine distal end 341 of the curved link.
Cartridge cap 320, which is mounted to cartridge 330, has inwardly projecting stubs 321 for ret~ining the ends of the leaf spring 390.
Left and right side plates 300 and 290 respectively each have two inclined slots (301 and 302 in side plate 300; 291 and 292 in side plate 290) for ret~inlng the bolts 384 and 385, which are slidably received therein. Said slots are defined by guide surfaces (301a, 302a, 291a, 292a, respectively) which contact the circumferential surfaces of the respective ends of the bolts disposed therethrough and restrain the movement of the bolts to a predetermined linear path. The width of the slots 301, 302, 291, and 292 closely match the width of the respective bolts 384 and 385 while leaving enough clearance for free sliding of the bolts. Slots 304 and 294 receive cartridge pivot pin 260, which pivotally mounts the fastener holder 460 to the frame. Slots 303 and 293 receive bosses 36 of the inner sides of the respective frames. Pins 310 are disposed respectively through apertures in the left side plate 300, the cartridge cap 320, the cartridge 330, and the right side plate 290.
The anvil assembly comprises retainer support arm 240, anvil block 400, retainer holding strips 270, and retainers 280.
Arm 240 is mounted between the distal arms 64a and 34a of the frames by means of pins 250 disposed through corresponding apertures 241 in the arm 240, and apertures 64d and 34d in the frames. Aperture 242 in the arm receives cartridge pivot pin 260. In other embodiments, the anvil assembly can include a means for replacing retainers (for example in reusable/reloadable instruments), or crimping means (for example, with metal staples).
Referring additionally now to Fig. 9, two-part bioabsorbable surgical fasteners useful in the present invention generally comprise a fastener portion 450 having a backspan 451, and prongs 452 with barbs 453 at the tips thereof. The fasteners are initially located in slots 332 of the cartridge. When the pusher members 410 are distally moved, the finger-like projections 411 each contact the backspan 451 of a fastener 450, thereby moving it through and out of its respective slot 332. The retainer portion 280 of the two-part fastener comprises a base 283 with columnar members 282 having apertures 281 for receiving the barbed prongs 452 of the fastener. Once engaged, the fastener and the retainer lock together, hence the desirability of constructing them of bioabsorbable material such as polyglycolide, polylactide or copolymers thereof for suturing body tissue.
Referring again to Fig. 6 and additionally to Figs. 7 and 8, retainers 280 are preferably mounted on retainer mounting strips 270 in arm member 240 such that each retainer is aligned with a corresponding fastener portion in the respective fastener slots 332. Mounting strip 270 includes a plurality of mounting posts 271 each of which frictionally engages a respective aperture 281 of the retainer. Mounting strip 270 also includes projections 273 which ride in a corresponding slot in retainer support arm 240, and which serve as a limiter to prevent lateral sliding of the mounting strip. Hook-shaped catches 272 snap into windows 243 of the retainer support arm 240 thereby preventing the retainer mounting strips 270 from dropping out of the support arm 240. Mounting strip 270 is thus adapted to be loaded with retainers prior to its introduction into retainer support arm 240. This external retainer-loading feature of mounting strip 270 is particularly advantageous because the retainers are typically quite small, e.g., about 0.2 inches in length, and are therefore difficult to handle.
Mounting strip 270 permits retainers to be conveniently mounted onto mounting posts 271 and then the entire mounted assembly is easily snapped into retainer support arm 240. Reloading of mounting strip 270 is also facilitated by simply removing the mounting strip from the retainer support arm, mounting fresh retainers, and repositioning within retainer support arm 240.
Preferably, at least two rows of retainers 280 are mounted in arm 240. The rows are separated by an anvil block 400 which provides a means for contacting body tissue and providing a backstop surface for the cutting edge 441 of the knife. When the barbed prongs 452 enter the top of the column members 282, the posts 271 are pushed out of the opposite end of the aperture 281 by the entering barb 453, and thereby disengage the retainer 280, releasing it from the anvil assembly.
Referring to Figs. 10 to 13, the instrument is initially in the open and unfired condition illustrated in Fig. 10. For use in surgical operations it is positioned by the surgeon such that the body tissue to be fastened is located in the U-shaped distal portion between the jaws of the instrument, i.e. in the gap between the fastener holder 460 and the anvil assembly. The surgeon then actuates the instrument: by pivoting actuator lever 80 down (i.e.
clockwise as shown) from the position shown in Fig. 10 to the position shown in Fig. 11. By this .v. -nt, the fastener holder 460 will move distally to a closed position wherein it contacts the body tissue (not shown) to secure the body tissue in a fixed position. Moving the actuator lever 80 down also moves the clamp 160 forward and aligns lever 110 along the longitudinal axis of the 2~37427 instrument. The distal end of clamp 160 contacts the fastener cartridge 460 and moves it from the open position to a closed position. It should be noted that until lever 110 is aligned, the fasteners cannot be fired.
The instrument at this point is in the condition illustrated by Figs. 11 and 14. The next step for the surgeon is to release the safety catch 150 by pivoting it down (counter-clockwise as shown), thereby putting the instrument in a nready to firen condition.
To fire the instrument, the surgeon pivots the trigger lever 130 (counter-clockwise as shown) by manual application of a proximally directed force. This movement, in turn, pivots trigger insert 120 and converts the proximally directed force to a distally directed force such that portion 122 moves lever 110 distally.
Lever 110 pushes the thrust bar 180 distally, and thrust bar 180 presses on link 340. This motion is transferred by link 350 to cam bar 380. Cam bar 380 has a path of movement defined by slots 291, 292, 301, and 302, all of which are aligned in the same predetermined direction. The vector components of motion of the cam bar include a vector component linearly aligned with the center line of motion of the knife assembly and fastener pushers 410. Although the path of ~,~. ~nt of the cam bar 380 is in a directional line which is at an angle from the center line of movement of the knife assembly and fastener pushers, it does not exert pivotal or torquing motion on these parts. Torque is avoided because the cam bar is constrained to an orientation perpendicular to that of the above mentioned center line of movement by the relatively close fit of the bolts 384 and 385 within their respective guide slots 291, 292, 301, and 302, and because the distal surface 381 of the cam bar will slide across surface 421a, thereby preventing unaligned vector components of cam bar motion from being transmitted to blade channel 420. Thus the force conversion and transmission is positive and accurate due to the precise movement of compressor members in engagement with each other.
The blade channel 420 is moved forward by the cam bar 380 and surface 433 pushes the fastener pushers distally, thereby driving the fasteners out of the slots, and into the retainers.
Detents 412 on the fastener pushers 410 frictionally engage the surface 335 of their respective slots in cartridge 330. This frictional engagement prevents the fastener pushers from returning to their proximal position after they have been moved to their distal position. Knife blade 440 is moved distally through slot 333 thereby cutting any body tissue 470 (shown in Fig. 15) between the knife and the anvil block 400 which the knife edge 441 impinges.
The instrument thereby creates an incision into body tissue which is sealed by a row of fasteners on each side.
The prongs 154 of the safety catch snap into locking engagement with slots 133 of the trigger and thereby prevent inadvertent firing of an unloaded instrument.
The instrument is now in the fired position illustrated by Figs. 12 and lS.
Referring now to Figs. 13, 15 and 16, to open the instrument and release the body tissue, the surgeon pivots the actuator lever 80 counterclockwise into the upward position as shown in Fig. 13. The knife assembly, being biased proximally by spring 390, retracts into the fastener holder 460. The fastener holder 460 moves back to an open position thereby releasing the body tissue.
The thrust bar 180 and clamp 160 return to their proximal position because of the biasing force of spring 20.
The instrument can be made of any size suitable for its purpose of fastening body tissue, and the various parts can be made of materials appropriate to their function. For example, the body, actuator lever, and trigger can be injection molded from a high strength polymer. The frames, cam assembly, fastener pushers, and blade channel can be constructed from an appropriate metal.
The instrument has application in a full range of surgical applications including abd~ inAl, gynecological, pediatric, and thoracic surgery for resection and transection. In a preferred embodiment, the instrument includes bioabsorbable fasteners and retainers and has application in the creation of a temporary opening such as hysterotomy, to align the tissue layers and inl i7e bleeding during a cesarean delivery.
While the above description contains many specific details, these details should not be construed as limitations on the scope of the invention, but merely as examples of preferred embodiments thereof. Those skilled in the art will envision many other possible variations that are within the scope and spirit of the invention as defined by the claims appended hereto.
Typically, these devices include a fastener holder positioned on one side of the tissue to be fastened and an anvil parallel to the fastener holder positioned on the other side of the tissue.
Typically, means is provided for linearly translating the fastener holder and the anvil toward one another to clamp the tissue between them. Means is also provided for driving the fasteners from the fastener holder so that the ends of the fasteners pass through the tissue and form finished fasteners as they make contact with the anvil assembly, thereby producing an array of finished fasteners in the tissue.
Also in use are instruments for applying two part fasteners having a fastener portion and a retainer portion. The fastener portion generally has barbed prongs for penetrating body tissue and engaging corresponding openings in the retainer portion.
Once engaged, the fastener and retainer are locked together. Such two-part fasteners are usually constructed from bioabsorbable material.
In common use are apparatus in which the fastener holder and anvil are removably mounted in or on an actuator for supporting and actuating the cartridge. The apparatus can be disposed of after a single use or it can be reused for another surgical fastening procedure after cleaning, sterilizing and reloading with a fresh cartridge. Also in use are fully disposable surgical instruments in which the cartridge and actuator are preassembled ready for use and disposed of after only a single use.
U.S. Patent No. 4,665,916 (Green) describes a surgical fastener apparatus for applying rows of fasteners laterally through hollow body organs such as the thorax, trachea, stomach, uterus or intestines. The cartridge includes an alignment pin which achieves and maintains proper relative positioning of the fastener holder and anvil components thereof. When the fully assembled instrument is actuated, it is positioned in such a way that the body tissue to be fastened is clamped in place between the staple-ejecting surface of the fastener holder and the anvil assembly. The clamping pressure exerted against both sides of the tissue is sufficient to provide effective hemostasis along two linear sites which, upon nfiring" of the instrument, receive substantially parallel rows of fasteners on either side of an incision formed by a tissue cutting knife which is also incorporated in the holder. The deployment of the knife is mechanically synchronized to immediately follow the insertion of the fasteners.
U.S. Patent No. 4,819,853 (Green) discloses a surgical fastener applicator which includes tissue gripping elements provided along the sides of a knife slot to prevent body tissue from pulling away from the fasteners after the latter are positioned in place and the incision is made. Thereafter, clamping pressure is released.
U.S. Patent No. 4,881,545 (Isaacs et al.) discloses a surgical fastener cartridge possessing an improved body cutting knife assembly. The knife element of the assembly is held in permanent locking engagement with a knife holder.
U.S. Patent No. 4,767,044 (Green) discloses a fastener applying apparatus including means for preventing all of the - 2037~27 fasteners from re~chlng peak formation force at the same time in order to reduce the ~i force required to operate the apparatus.
U.S. Patent No. 4,728,020 (Green et al.) discloses an articulated surgical fastener applying apparatus having a linear drive mech~ni which is offset from the centerline of movement of the surgical fasteners. The drive force is proximally directed, i.e. it is a pulling force transmitted by a tensioned cable mech~ni~ rather than by a drive rod.
While the prior art instruments, such as those mentioned above, have been serving the needs of the medical community by providing surgeons with quick and simple means to make and/or seal incisions in body tissue, improvements are nevertheless desirable.
For example, surgeons prefer to have a greater visibility of the area of tissue upon which they are operating. It should be noted that in the prior art instruments, the drive rod for driving the fastener pushers operates axially and is centered at the rear of the fastener holding cartridge. The longitudinal frame of the instrument, therefore, often interferes with the surgeon's line of sight and obstructs visibility of the operation site.
An off-centered axially moving drive rod would therefore be desirable since it would enable the surgeon to have greater visibility of the operating site. Up to now however, the use of an off-centered drive rod has not been recognized as a solution to the problem. Unlike the cable drive means, the drive rod operates by applying a distally directed, or "pushing" drive force. The central location of the drive rod of the prior art instruments prevents the fastener pushers and the knife, if there is one, from pivoting and jamming within the fastener holding cartridge due to the critical location of the force. Such jamming would occur if the fastener pushers were driven by an off-center force in previously known instruments. Moreover, cable drive means restrict the ability of prior art instruments to be "resetn after initial firing.
The present invention provides such an apparatus in which improved visibility of the operation site is facilitated while avoiding direct off-centered driving force application to the fastener pushing members.
- 2û3~27 SUMMARY OF THE lNV~NLlON
Apparatus for substantially simultaneously applying a plurality of surgical fasteners to body tissue or the like, which comprises a body having a longitudinal portion enclosing axial drive means, a distal portion thereof defining a tissue reception aperture. Anvil means is positioned at the distal portion of the tissue reception aperture and fastener holding means is pivotally mounted relative to the anvil means adjacent one end portion thereof and defines a space therebetween. The fastener holding means contains a plurality of surgical fasteners arranged in generally parallel rows extending generally transversely to the longitudinal portion and the longitudinal portion is generally offset from the center of the rows of staples. Means is provided for initially advancing the fastener holding means distally at least sufficient to contact body tissue positioned within the aperture, and means is provided for reception of proximally directed user applied force and for translating same to distally directed drive force on the axial drive means generally in alignment with the longitudinal portion.
The invention comprises means for translating the distally directed drive force to distally directed staple drive force distributed generally uniformly over the length of the plurality of staples to apply the staples to the body tissue.
In a preferred embodiment, the apparatus disclosed herein for substantially simultaneously applying a plurality of surgical fasteners includes a handle; a trigger means for applying the fasteners; a body with a longitudinal portion enclosing an axial drive means; a U-shaped distal portion; an anvil assembly positioned at the distal leg of the U-shaped distal portion; a fastener holding cartridge pivotally mounted relative to the anvil assembly and adjacent one end of the anvil assembly thereby defining a gap between them, and cont~ining a plurality of surgical fasteners, and optionally including a knife means forcutting body tissue. The apparatus further includes approximating means for actuating the fastener holding cartridge; and a fastener pushing means for substantially simultaneously pushing all of the fasteners from the fastener holding cartridge. The apparatus is characterized in that the axis of the longit~ldinAl portion of the body is in off-center alignment relative to the axial centerline of movement of the fastener pushing means, and said apparatus further includes means for translating an off-centered axial drive force to an evenly distributed driven force across the proximal end of the fastener pushing means.
The U-shaped distal portion of the apparatus is defined by two U-shaped plate portions of frame means mounted in parallel spaced apart relation to each other, the mutually facing surfaces of the plate portions being flat. The two U-shaped plate portions are connected by a spacer pin transversely mounted therebetween at the ends of their respective proximal legs. The said plate portions of the frame means and the spacer pin cooperate so as to align the anvil assembly with the fastener holding cartridge.
The knife means possesses a distally facing elongated surface for contacting the proximal end of the fastener pushing means, the distally facing elongated surface of the knife means abutting and moving said fastener pushing means in response to the distal movement of the axial drive means.
The fastener pushing means includes a pusher plate which is substantially flat on two opposite sides and which has a plurality of fastener-pushing members distally projecting from a back portion, and interference means associated with at least one of the flat sides for frictionally e~gAeing a cooperating surface of the fastener holding cartridge to prevent the fastener pusher plate from moving proximally after it has been moved to its most distal position in response to movement of the axial drive means. The interference means can comprises one or more detents projecting from the side of the pusher plate.
The anvil assembly includes a retainer mounting bar comprising an elongated bar having a plurality of mounting posts projecting transversely from said bar, said posts being frictionally e~gAgAhle with the retainers for holding said retainers in a fixed position relative to the instrument until said retainers are fully engaged with their respective fasteners.
20374~7 Although the preferred embodiment described herein pertains to an instrument for substantially simultaneously applying the fasteners, it is also envisioned as being within the scope of the present invention for the instrument to apply the fasteners sequentially. Furthermore, although two-part bioabsorbable surgical fasteners are referred to hereinbelow, instruments for applying other types of surgical fasteners including non-bioabsorbable staples and the like are contemplated as being within the scope of the present invention. Additionally, although the embodiments described hereinbelow are described in conjunction with the fasteners and retainers, it is within the scope of the present invention to provide an instrument in an unloaded condition, such as a reloadable instrument with replaceable fastener and retainer means.
2~37427 ~ -BRIEF DESCRIPTION OF THE DRAWINGS
Preferred embodiments of the invention are described hereinbelow with reference to the drawings wherein:
Fig. 1 is a perspective view of the fastener applying apparatus of the present invention;
Fig. 2 is a perspective cut-away view of the apparatus of the present invention;
Figs. 3, 4, 5, and 6 are exploded perspective views of the fastener applying me~hAni ! of the apparatus;
Fig. 7 is a perspective view of the retainer support arm of the apparatus;
Fig. 8 is a perspective view of the retainer mounting strip of the apparatus;
Fig. 9 is an enlarged perspective view of a two part surgical fastener which can be applied to body tissue by means of the apparatus of the present invention;
Figs. 10, 11, 12 and 13 are elevational views partially cut-away, sequentially illustrating the fastener application with the apparatus of the invention;
Figs. 14 and 15 are cross-sectional views of the fastener cartridge and anvil assembly, illustrating the operation of the apparatus in prefired and fired conditions, respectively; and Fig. 16 is an elevational cut-away view of the fastener cartridge and anvil assembly after the apparatus has been fired.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring initially to Figs. 1 to 4, left and right body portions, 10 and 20 respectively, provide means for housing the actuating -~hAni of the invention and also provides means for allowing the user to hold the instrument. Each body portion has a handle portion, 11 and 21 for the left and right body portions respectively, and a longit~ldinAIly or axially extending portion 12 and 22, respectively. The body portions also each have internal struts 23 which include recessed portions 23a associated with the internal wall surface of the handle. The struts provide added strength and support. The recessed portions 23a receive and hold the frame extension S0 in a fixed position. Aperture 25 in the right body portion and a corresponding aperture in the left body portion receive trigger pivot pin 140 shown in Fig. 3. Recessed portions 24 and 14 of the right and left body portions form a slot for receiving the pivot arm lSl of safety catch lS0.
Referring to Fig. 3, left frame 60 is an elongated member having an axially extending longitudinal portion 63; a proximal portion 61 which is inclined from the longit~ldinAl portion and which defines aperture 62 for receiving trigger pivot pin 140; a U-shaped distal portion 64 having a distal leg 64a, a proximal leg 64b, aperture 64c for receiving shoulder rivet 70, and apertures 64d for receiving rivets 250 for mounting to the retainer housing 240 (see Fig. 6); and notch 65 for eneAging one of the detents 211 of the spring retainer 210.
Referring now to Fig. 4, right frame 30 is an elongated member having an axially extending longitudinal portion 33; a proximal portion 31 which is inclined from the longit~ldinAl portion and which possesses an aperture 32 for receiving trigger pivot pin 140; a U-shaped distal portion 34 having a distal leg 34a, a proximal leg 34b, aperture 34c for receiving shoulder rivet 70, and apertures 34d for receiving rivets 250 for mounting to the retainer housing 240 as shown in Fig. 6; and notch 35 for engAging one of the detents 211 of the spring retainer 210 as shown in Fig.
4. Additionally, right frame 30 is fixedly mounted to frame extension 50 such that both have aperture 32 in common. Frame extension 50 has an indentation 51 on its distal edge for accommodating the pivot arm 151 of safety latch lS0.
Referring now to Fig. 6, left and right frames 60 and 30, respectively, are mounted in a parallel spaced apart relationship to each other. The distal U-shaped portions define the U-shaped distal end of the instrument. The mutually facing surfaces of the distal portions of the frames are flat thus eliminating intermediate components and facilitating improved component alignment and ini i 7ing dimensional tolerance variations. This is in contrast to prior art instruments in which similarly shaped distal plates possessed inward indentations or jogs to demarcate the distal leg which supported an anvil assembly of lesser width than the fastener holder. In the prior art instruments (see e.g. U.S. Patent No.
4,665,916) alignment of fastener components and body tissue was provided by a longitudinally mounted alignment pin which pierced the body tissue being fastened. In the present invention alignment is facilitated by the provision of closer tolerances between the flat inner sides of the frames and the fastener holder, by spacer pin 70 which maintains a predetermined distance between the ends of proximal legs 64b and 34b, and through the use of a material of construction for the frames which ensures that the frames will neither deform nor fatigue during use. Preferably, the frames are constructed from stainless steel having a thickness of at least 0.07 inches and preferably of from 0.07 to 0.08 inches. Parallelism and close tolerances are thereby maintained for proper alignment of the fastener holder with the anvil.
In Figs. 10 and 11, spacer pin 70 extends laterally between the proximal legs 64b and 34b of the left and right frames, and projections 71 are received into apertures 64c and 34c. Spacer pin 70 spaces the left and right frames apart at a fixed predetermined distance and serves as a guide for the fastener holding cartridge.
Referring to Figs. 2 and 3, actuator 80 serves as part of the fastener cartridge actuation means, i.e. approximating means to move the fastener cartridge from a proximal open position such that body tissue can be freely inserted into the gap between the fastener cartridge and the anvil assembly, into a distal closed position wherein it can hold body tissue clamped between it and the anvil assembly, as discussed below. Actuator 80 is a lever pivotally mounted to the left and right body portions 10 and 20 by means of a pin 230 disposed through aperture 81. Aperture 82 receives pin 90 for mounting lever rod 110. Actuator 80 has a forked distal end 83 and a longit~in~l central slot 84. Thumb rest 85 is at the proximal end.
g Lever rod 110 is an elongated member defining longitudin~l central slot 111. Lever rod 110 is slidably mounted within slot 84 of the actuator by means of pin 90 disposed through aperture 82, washer 100 and slot 111.
Trigger 130 is an elongated lever arm having a forked end with curved hook-like members 131 shown in Fig. 3. Central slot 132 extends longitlldin~lly along the underside of the trigger 130. Side slots 133 are provided for engaging the snap prongs 154 of the safety catch 150. Central slot 132 is provided in trigger 130 for receiving trigger insert 120, which is mounted therein. Trigger insert 120 has an aperture 121 which is aligned with the curved hook-like members 131 such that trigger pivot pin 140 is received therethrough. Trigger insert 120 has an end with projection 122 for contacting the proximal end of lever rod 110.
Referring once again to Figs. 2 and 3, trigger pivot pin 140 is transversely mounted with left and right ends fixed respectively in apertures 25 in the interior surfaces of the left and right body portions 10 and 20, and is disposed respectively through apertures 62, 121, and 32, of the left frame, trigger insert and right frame.
Referring to Figs. 4, 10 and 11, clamp 160 is an elongated member with longitudinAl central slot 161. Cap 170 is mounted on the proximal end of clamp 160 with vertical slot 171 of the cap being aligned with longit~din~l slot 161 of the clamp to permit passage therethrough of lever 110. Cap 170 preferably has a sloped proximal surface 172 for being contacted by the forked end 83 of the actuator. Clamp 160 has a transversely extending aperture 162 for receiving clamp pin 90.
Thrust bar 180 is an elongated member which is slidably mounted within slot 161 of the clamp. Thrust bar 180 has a longitlldinAl slot 181 through which clamp pin 90 is disposed.
Proximal end 183 is for contacting the distal end of lever 110.
Distal edge 184 is for contacting the cam assembly discussed below and is preferably inclined to facilitate c~ Ing action between it and link 340. Thrust bar 180 has a distally projecting post 182 for mounting a washer 190, and coiled spring 200.
Spring retainer 210 is a block shaped piece having longitudinally extending detents 211-for engaging slots 65 and 35 in the left and right frames. The proximal end 212 serves as a backstop for spring 200 such that spring 200 biases the slidable thrust bar 180 in the proximal direction. The distal end has a curved portion 213 for receiving a leaf spring 220.
Retainer pin 231 extends transversely across the underside of the leaf spring 220 and is fixed at its ends in corresponding apertures in the body portions. Retainer pin 231 maintains the spring 220 in a fixed position.
Referring additionally to Figs. 5 and 6, the fastener holder 460 of the present invention is an assembly which includes several unique features.
The cam assembly, which is housed within the fastener holder 460, is a non-torquing force diverter comprising an assembly of links and a cam plate which converts the off-centered axial drive force to a balanced linear drive force uniformly distributed across the proximal end of the knife blade assembly. With such means for providing this conversion, the need to provide an off-centered drive force directly to the knife assembly is avoided. Such last mentioned force application method would result in unbalanced force and unwanted torque which would pivot and jam the knife and fastener pushers. Moreover, in the present invention, force transmissions and conversions are provided through compression members thereby facilitating definitive and accurate force transmission and conversion. Furthermore, tension cables or the like as utilized in prior developments are avoided.
Referring to Fig. 5, the cam assembly includes curved link 340 having a distal end pivotally mounted in socket 331 in the fastener cartridge 330 by means of pin 370 disposed through aperture 341. The proximal end of link 340 is pivotally attached by a pin 360 to one end of an intermediate link 350. The other end of the intermediate link 350 is pivotally attached by a pin 360 to cam bar 380. Cam bar 380 has a flat distal c ing surface 381, a rear projection 382 with aperture 383 for receiving a pivot pin 360, and upper and lower bolts 384 and 385 which project into and ride along 203~427 the inclined slots 291, 292, 301, and 302 of the right and left side plates. The flat distal c~ ine surface 381 of the cam bar is for contacting the proximal surface 421a of the back of the blade channel 420.
The movement of the cam bar has a vector component linearly aligned with the path of movement of the fastener pushers 410, knife 440, and blade channel 420. Unaligned components of motion are not transmitted to the blade channel 420 because the cam bar's distal surface 381 remains in a perpendicular orientation relative to the center line of movement of the fastener pushers 410 and blade channel 420, and because the c~ ing surface 381 is slidable relative to proximal surface 421a.
Referring once again to Fig. 5, the knife blade assembly, also housed within the fastener holder 460, includes blade channel 420, leaf spring 390, blade holder 430, and knife blade 440.
Blade channel 420 has two parallel dovetail shaped portions 424 projecting distally from a back portion 421. The dovetail portions define apertures 422 for engaging projections 432 of the blade holder 430. Together, dovetail portions 424 define a channel 423 in which leaf spring 390 is located. The back portion 421 has a proximal surface 421a for contacting the distal c~ ing surface 381 of the cam bar, and a distal surface 421b which is contacted by leaf spring 390.
Curved leaf spring 390 is located between the blade holder 430 and the blade channel 420. Its ends are retained by inwardly projecting stubs 321 of the cartridge cap 320. Spring 390 contacts the distal surface 421b of the back of the blade channel 420, thereby biasing the blade channel 420 proximally.
The distal end of blade holder 430 has a slot 431 for mounting a knife blade 440. Projections 432 on the sides of the blade holder are mounting fixtures received into apertures 422 of the blade channel.
Knife blade 440 has a sharp distal edge 441 for cutting body tissue. The proximal edge of blade holder 430 shown in Fig. 5 is mounted in slot 431 of the blade holder.
-Referring once again to Fig. 5, cartridge pushers 410 are substantially flat strips having distal pointing finger-like projections 411 for pushing the fasteners through slots 332, and out of the cartridge 330 into engagement with their respective retainers 280 in the anvil assembly. At least one side of each pusher possesses an interference means, such as one or more detents 412, which frictionally engage the surface 335 of the corresponding slot in the fastener cartridge 330 in which the pusher slides. (See Fig.
15.) These detents advantageously prevent the pushers from retracting once they have been moved to their most distal position, thereby preventing the fasteners from migrating or deflecting back into slots 332. Such migration or deflection, if tmi ,.eded, may result in non-engagement of the fastener with its corresponding retainer. The proximal edges 413 are contacted by surfaces 433 of the blade holder such that when the blade holder is moved distally, surfaces 433 urge the fastener pushers 410 towards the distal direction.
Fastener holder 460 also comprises cartridge 330 having a plurality of fastener slots 332, a knife slot 333, a rear slot 334 through which the distal end 184 of the thrust bar enters, and socket 331 for retAinine distal end 341 of the curved link.
Cartridge cap 320, which is mounted to cartridge 330, has inwardly projecting stubs 321 for ret~ining the ends of the leaf spring 390.
Left and right side plates 300 and 290 respectively each have two inclined slots (301 and 302 in side plate 300; 291 and 292 in side plate 290) for ret~inlng the bolts 384 and 385, which are slidably received therein. Said slots are defined by guide surfaces (301a, 302a, 291a, 292a, respectively) which contact the circumferential surfaces of the respective ends of the bolts disposed therethrough and restrain the movement of the bolts to a predetermined linear path. The width of the slots 301, 302, 291, and 292 closely match the width of the respective bolts 384 and 385 while leaving enough clearance for free sliding of the bolts. Slots 304 and 294 receive cartridge pivot pin 260, which pivotally mounts the fastener holder 460 to the frame. Slots 303 and 293 receive bosses 36 of the inner sides of the respective frames. Pins 310 are disposed respectively through apertures in the left side plate 300, the cartridge cap 320, the cartridge 330, and the right side plate 290.
The anvil assembly comprises retainer support arm 240, anvil block 400, retainer holding strips 270, and retainers 280.
Arm 240 is mounted between the distal arms 64a and 34a of the frames by means of pins 250 disposed through corresponding apertures 241 in the arm 240, and apertures 64d and 34d in the frames. Aperture 242 in the arm receives cartridge pivot pin 260. In other embodiments, the anvil assembly can include a means for replacing retainers (for example in reusable/reloadable instruments), or crimping means (for example, with metal staples).
Referring additionally now to Fig. 9, two-part bioabsorbable surgical fasteners useful in the present invention generally comprise a fastener portion 450 having a backspan 451, and prongs 452 with barbs 453 at the tips thereof. The fasteners are initially located in slots 332 of the cartridge. When the pusher members 410 are distally moved, the finger-like projections 411 each contact the backspan 451 of a fastener 450, thereby moving it through and out of its respective slot 332. The retainer portion 280 of the two-part fastener comprises a base 283 with columnar members 282 having apertures 281 for receiving the barbed prongs 452 of the fastener. Once engaged, the fastener and the retainer lock together, hence the desirability of constructing them of bioabsorbable material such as polyglycolide, polylactide or copolymers thereof for suturing body tissue.
Referring again to Fig. 6 and additionally to Figs. 7 and 8, retainers 280 are preferably mounted on retainer mounting strips 270 in arm member 240 such that each retainer is aligned with a corresponding fastener portion in the respective fastener slots 332. Mounting strip 270 includes a plurality of mounting posts 271 each of which frictionally engages a respective aperture 281 of the retainer. Mounting strip 270 also includes projections 273 which ride in a corresponding slot in retainer support arm 240, and which serve as a limiter to prevent lateral sliding of the mounting strip. Hook-shaped catches 272 snap into windows 243 of the retainer support arm 240 thereby preventing the retainer mounting strips 270 from dropping out of the support arm 240. Mounting strip 270 is thus adapted to be loaded with retainers prior to its introduction into retainer support arm 240. This external retainer-loading feature of mounting strip 270 is particularly advantageous because the retainers are typically quite small, e.g., about 0.2 inches in length, and are therefore difficult to handle.
Mounting strip 270 permits retainers to be conveniently mounted onto mounting posts 271 and then the entire mounted assembly is easily snapped into retainer support arm 240. Reloading of mounting strip 270 is also facilitated by simply removing the mounting strip from the retainer support arm, mounting fresh retainers, and repositioning within retainer support arm 240.
Preferably, at least two rows of retainers 280 are mounted in arm 240. The rows are separated by an anvil block 400 which provides a means for contacting body tissue and providing a backstop surface for the cutting edge 441 of the knife. When the barbed prongs 452 enter the top of the column members 282, the posts 271 are pushed out of the opposite end of the aperture 281 by the entering barb 453, and thereby disengage the retainer 280, releasing it from the anvil assembly.
Referring to Figs. 10 to 13, the instrument is initially in the open and unfired condition illustrated in Fig. 10. For use in surgical operations it is positioned by the surgeon such that the body tissue to be fastened is located in the U-shaped distal portion between the jaws of the instrument, i.e. in the gap between the fastener holder 460 and the anvil assembly. The surgeon then actuates the instrument: by pivoting actuator lever 80 down (i.e.
clockwise as shown) from the position shown in Fig. 10 to the position shown in Fig. 11. By this .v. -nt, the fastener holder 460 will move distally to a closed position wherein it contacts the body tissue (not shown) to secure the body tissue in a fixed position. Moving the actuator lever 80 down also moves the clamp 160 forward and aligns lever 110 along the longitudinal axis of the 2~37427 instrument. The distal end of clamp 160 contacts the fastener cartridge 460 and moves it from the open position to a closed position. It should be noted that until lever 110 is aligned, the fasteners cannot be fired.
The instrument at this point is in the condition illustrated by Figs. 11 and 14. The next step for the surgeon is to release the safety catch 150 by pivoting it down (counter-clockwise as shown), thereby putting the instrument in a nready to firen condition.
To fire the instrument, the surgeon pivots the trigger lever 130 (counter-clockwise as shown) by manual application of a proximally directed force. This movement, in turn, pivots trigger insert 120 and converts the proximally directed force to a distally directed force such that portion 122 moves lever 110 distally.
Lever 110 pushes the thrust bar 180 distally, and thrust bar 180 presses on link 340. This motion is transferred by link 350 to cam bar 380. Cam bar 380 has a path of movement defined by slots 291, 292, 301, and 302, all of which are aligned in the same predetermined direction. The vector components of motion of the cam bar include a vector component linearly aligned with the center line of motion of the knife assembly and fastener pushers 410. Although the path of ~,~. ~nt of the cam bar 380 is in a directional line which is at an angle from the center line of movement of the knife assembly and fastener pushers, it does not exert pivotal or torquing motion on these parts. Torque is avoided because the cam bar is constrained to an orientation perpendicular to that of the above mentioned center line of movement by the relatively close fit of the bolts 384 and 385 within their respective guide slots 291, 292, 301, and 302, and because the distal surface 381 of the cam bar will slide across surface 421a, thereby preventing unaligned vector components of cam bar motion from being transmitted to blade channel 420. Thus the force conversion and transmission is positive and accurate due to the precise movement of compressor members in engagement with each other.
The blade channel 420 is moved forward by the cam bar 380 and surface 433 pushes the fastener pushers distally, thereby driving the fasteners out of the slots, and into the retainers.
Detents 412 on the fastener pushers 410 frictionally engage the surface 335 of their respective slots in cartridge 330. This frictional engagement prevents the fastener pushers from returning to their proximal position after they have been moved to their distal position. Knife blade 440 is moved distally through slot 333 thereby cutting any body tissue 470 (shown in Fig. 15) between the knife and the anvil block 400 which the knife edge 441 impinges.
The instrument thereby creates an incision into body tissue which is sealed by a row of fasteners on each side.
The prongs 154 of the safety catch snap into locking engagement with slots 133 of the trigger and thereby prevent inadvertent firing of an unloaded instrument.
The instrument is now in the fired position illustrated by Figs. 12 and lS.
Referring now to Figs. 13, 15 and 16, to open the instrument and release the body tissue, the surgeon pivots the actuator lever 80 counterclockwise into the upward position as shown in Fig. 13. The knife assembly, being biased proximally by spring 390, retracts into the fastener holder 460. The fastener holder 460 moves back to an open position thereby releasing the body tissue.
The thrust bar 180 and clamp 160 return to their proximal position because of the biasing force of spring 20.
The instrument can be made of any size suitable for its purpose of fastening body tissue, and the various parts can be made of materials appropriate to their function. For example, the body, actuator lever, and trigger can be injection molded from a high strength polymer. The frames, cam assembly, fastener pushers, and blade channel can be constructed from an appropriate metal.
The instrument has application in a full range of surgical applications including abd~ inAl, gynecological, pediatric, and thoracic surgery for resection and transection. In a preferred embodiment, the instrument includes bioabsorbable fasteners and retainers and has application in the creation of a temporary opening such as hysterotomy, to align the tissue layers and inl i7e bleeding during a cesarean delivery.
While the above description contains many specific details, these details should not be construed as limitations on the scope of the invention, but merely as examples of preferred embodiments thereof. Those skilled in the art will envision many other possible variations that are within the scope and spirit of the invention as defined by the claims appended hereto.
Claims (23)
1. An apparatus for substantially simultaneously applying a plurality of surgical fasteners to body tissue, the apparatus comprising a body having, in use and relative to a user, a distal portion at a distal end, a proximal portion at a proximal end, and an intermediate longitudinal portion connected to the distal portion and the proximal portion, the longitudinal portion enclosing an axial drive mechanism for transmitting a distally-directed drive force, the distal portion including a tissue reception space, the apparatus including:
an anvil assembly for closing the surgical fasteners, the anvil assembly being positioned at a distal portion of the tissue reception space;
a fastener holder for initially holding the surgical fasteners, the fastener holder being pivotally mounted relative to the anvil assembly to be adjacent one end portion thereof, the tissue reception space extending between the anvil assembly and the fastener holder, the fastener holder containing a plurality of surgical fasteners arranged in generally parallel rows extending transversely to the longitudinal portion and being movable distally along respective paths each having a centerline generally parallel to the longitudinal portion of the apparatus, the center-lines defining a center plane, the longitudinal portion of the apparatus being generally offset from the center plane;
an advancement mechanism for initially advancing the fastener holder distally at least a distance sufficient to contact body tissue positioned within the tissue reception space;
an actuator for receiving a proximally-directed user-applied force and for translating said force into the distally-directed drive force on the axial drive mechanism in general alignment with the longitudinal portion of the apparatus; and a transfer mechanism for translating the distally-directed drive force into a distally-directed fastener drive force distributed generally uniformly over the length of the rows of the plurality of fasteners, the fastener drive force applying the fasteners to the body tissue positioned within the tissue reception space.
an anvil assembly for closing the surgical fasteners, the anvil assembly being positioned at a distal portion of the tissue reception space;
a fastener holder for initially holding the surgical fasteners, the fastener holder being pivotally mounted relative to the anvil assembly to be adjacent one end portion thereof, the tissue reception space extending between the anvil assembly and the fastener holder, the fastener holder containing a plurality of surgical fasteners arranged in generally parallel rows extending transversely to the longitudinal portion and being movable distally along respective paths each having a centerline generally parallel to the longitudinal portion of the apparatus, the center-lines defining a center plane, the longitudinal portion of the apparatus being generally offset from the center plane;
an advancement mechanism for initially advancing the fastener holder distally at least a distance sufficient to contact body tissue positioned within the tissue reception space;
an actuator for receiving a proximally-directed user-applied force and for translating said force into the distally-directed drive force on the axial drive mechanism in general alignment with the longitudinal portion of the apparatus; and a transfer mechanism for translating the distally-directed drive force into a distally-directed fastener drive force distributed generally uniformly over the length of the rows of the plurality of fasteners, the fastener drive force applying the fasteners to the body tissue positioned within the tissue reception space.
2. An apparatus for substantially simultaneously applying a plurality of surgical fasteners to body tissue, the apparatus including:
a body having, in use and relative to a user, a distal portion at a distal end, a proximal portion at a proximal end and a longitudinal portion intermediate of the distal and proximal portions, the longitudinal portion enclosing a longitudinal drive mechanism, the proximal portion defining a handle, the distal portion being U-shaped and having a distal leg;
a trigger mechanism pivotally connected to the body and movable in response to a user-applied drive force for transmitting the drive force to the longitudinal drive mechanism, the longitudinal drive mechanism transmitting the drive force distally along a lengthwise path;
an anvil assembly positioned at the distal leg of the U-shaped distal portion;
a fastener holding cartridge pivotally mounted relative to the anvil assembly and adjacent one end of the anvil assembly, thereby defining a gap between them, the cartridge containing a plurality of surgical fasteners and optionally including a knife mechanism for cutting body tissue;
an approximation mechanism for actuating the fastener holding cartridge;
a fastener pushing mechanism for substantially simultaneously pushing all of the fasteners from the fastener holding cartridge, the fastener pushing mechanism having a proximal end and being linearly movable along a path having an axial centerline of movement in response to a drive force applied to the proximal end; and a transfer mechanism for translating the distally-directed drive force into an evenly-distributed fastener drive force across the proximal end of the fastener pushing mechanism;
wherein the lengthwise path of the distally-directed drive force transmitted by the longitudinal drive mechanism is in an off-center alignment relative to the axial centerline of movement of the fastener pushing mechanism.
a body having, in use and relative to a user, a distal portion at a distal end, a proximal portion at a proximal end and a longitudinal portion intermediate of the distal and proximal portions, the longitudinal portion enclosing a longitudinal drive mechanism, the proximal portion defining a handle, the distal portion being U-shaped and having a distal leg;
a trigger mechanism pivotally connected to the body and movable in response to a user-applied drive force for transmitting the drive force to the longitudinal drive mechanism, the longitudinal drive mechanism transmitting the drive force distally along a lengthwise path;
an anvil assembly positioned at the distal leg of the U-shaped distal portion;
a fastener holding cartridge pivotally mounted relative to the anvil assembly and adjacent one end of the anvil assembly, thereby defining a gap between them, the cartridge containing a plurality of surgical fasteners and optionally including a knife mechanism for cutting body tissue;
an approximation mechanism for actuating the fastener holding cartridge;
a fastener pushing mechanism for substantially simultaneously pushing all of the fasteners from the fastener holding cartridge, the fastener pushing mechanism having a proximal end and being linearly movable along a path having an axial centerline of movement in response to a drive force applied to the proximal end; and a transfer mechanism for translating the distally-directed drive force into an evenly-distributed fastener drive force across the proximal end of the fastener pushing mechanism;
wherein the lengthwise path of the distally-directed drive force transmitted by the longitudinal drive mechanism is in an off-center alignment relative to the axial centerline of movement of the fastener pushing mechanism.
3. The apparatus of claim 2, wherein the transfer mechanism for translating the distally-directed drive force comprises:
a movable cam bar having a distal camming surface;
a surface for receiving movement from the off-center alignment of the longitudinal drive mechanism;
a link mechanism, including at least one pivotable link, for transmitting movement from the longitudinal drive mechanism to the cam bar;
a support for maintaining the distal surface of the cam bar in an orientation substantially perpendicular to the centerline of movement of the fastener pushing mechanism; and a motion transfer mechanism for transferring motion from the distal camming surface to the fastener pushing mechanism.
a movable cam bar having a distal camming surface;
a surface for receiving movement from the off-center alignment of the longitudinal drive mechanism;
a link mechanism, including at least one pivotable link, for transmitting movement from the longitudinal drive mechanism to the cam bar;
a support for maintaining the distal surface of the cam bar in an orientation substantially perpendicular to the centerline of movement of the fastener pushing mechanism; and a motion transfer mechanism for transferring motion from the distal camming surface to the fastener pushing mechanism.
4. The apparatus of claim 3, wherein the support for maintaining the distal surface of the cam bar in the substantially perpendicular orientation comprises at least one first member which projects from the cam bar and which is fixedly attached thereto, and at least one second member associated with the fastener holding cartridge, the second member having at least one guide surface contacted by the first member for restraining the movement of the first member to a predetermined path.
5. The apparatus of claim 4, wherein the second member is stationary relative to the fastener holder.
6. The apparatus of claim 5, wherein the second member comprises a side plate having a slot defined by the at least one guide surface.
7. An apparatus for substantially simultaneously applying a plurality of two-part surgical fasteners to body tissue, the two-part surgical fasteners each having a fastener portion and a retainer portion, the apparatus including:
a body with a longitudinal portion enclosing an axial drive means for transmitting a drive force along a lengthwise path, the body also having in use and relative to a user a distal portion, the distal portion being U-shaped and having a distal leg;
a handle at one end of the body;
a trigger mechanism connected to the handle for receiving a user-applied force;
an anvil assembly for holding the retainer portions of the fasteners, said anvil assembly being mounted at the distal leg of the U-shaped distal portion;
a fastener holding cartridge pivotally mounted relative to the anvil assembly adjacent one end of the anvil assembly, thereby defining a gap between them, the cartridge containing a plurality of fasteners and optionally including a knife mechanism for cutting body tissue;
an approximating mechanism for actuating the fastener holding cartridge; and a fastener pushing means for substantially simultaneously pushing all of the fasteners from the fastener holding cartridge;
wherein the U-shaped distal portion of the apparatus is defined by two U-shaped plate portions of supporting frame means mounted in parallel spaced apart relation to each other and having flat mutually facing surfaces and proximal legs with end portions extending above the fastener holding cartridge, the two U-shaped plate portions being connected by a spacer pin transversely mounted therebetween at the end portions of their respective proximal legs, the plate portions of the frame means and the spacer pin cooperating so as to align the anvil assembly with the fastener holding cartridge.
a body with a longitudinal portion enclosing an axial drive means for transmitting a drive force along a lengthwise path, the body also having in use and relative to a user a distal portion, the distal portion being U-shaped and having a distal leg;
a handle at one end of the body;
a trigger mechanism connected to the handle for receiving a user-applied force;
an anvil assembly for holding the retainer portions of the fasteners, said anvil assembly being mounted at the distal leg of the U-shaped distal portion;
a fastener holding cartridge pivotally mounted relative to the anvil assembly adjacent one end of the anvil assembly, thereby defining a gap between them, the cartridge containing a plurality of fasteners and optionally including a knife mechanism for cutting body tissue;
an approximating mechanism for actuating the fastener holding cartridge; and a fastener pushing means for substantially simultaneously pushing all of the fasteners from the fastener holding cartridge;
wherein the U-shaped distal portion of the apparatus is defined by two U-shaped plate portions of supporting frame means mounted in parallel spaced apart relation to each other and having flat mutually facing surfaces and proximal legs with end portions extending above the fastener holding cartridge, the two U-shaped plate portions being connected by a spacer pin transversely mounted therebetween at the end portions of their respective proximal legs, the plate portions of the frame means and the spacer pin cooperating so as to align the anvil assembly with the fastener holding cartridge.
8. The apparatus of claim 7, wherein the U-shaped plate portions are fabricated from stainless steel having a thickness of at least 0.07 inches.
9. An apparatus for applying a plurality of surgical fasteners to body tissue, the apparatus having, in use and relative to a user, a distal end and a proximal end and comprising:
a body with a longitudinal portion enclosing an axial drive mechanism for translating a distally-directed drive force along a longitudinal path through said body;
a handle associated with said body;
a trigger mechanism associated with said body for receiving a user-applied force;
an anvil assembly;
a fastener holding cartridge pivotally mounted relative to the anvil assembly adjacent one end of the anvil assembly, thereby defining a gap between them, the fastener holding cartridge containing a plurality of surgical fasteners and including a knife mechanism for cutting body tissue, the knife mechanism being distally movable in response to movement of the axial drive mechanism;
an approximating means for actuating the fastener holding cartridge;
a fastener pushing mechanism responsive to movement of the axial drive mechanism for pushing the fasteners from the fastener holding cartridge, the fastener pushing mechanism being movable along a path, the centerline of said fastener pushing mechanism path being non-colinear with the centerline of the distally-directed drive force path; and, a transfer mechanism for translating the drive force from the axial drive mechanism to a force evenly distributed along a proximal surface of the fastener pushing mechanism;
wherein the knife mechanism has a distally-facing elongated surface for contacting the proximal end of the fastener pushing mechanism, the distally-facing elongated surface of the knife mechanism abutting and moving the fastener pushing mechanism in response to the distal movement of the axial drive mechanism.
, 25
a body with a longitudinal portion enclosing an axial drive mechanism for translating a distally-directed drive force along a longitudinal path through said body;
a handle associated with said body;
a trigger mechanism associated with said body for receiving a user-applied force;
an anvil assembly;
a fastener holding cartridge pivotally mounted relative to the anvil assembly adjacent one end of the anvil assembly, thereby defining a gap between them, the fastener holding cartridge containing a plurality of surgical fasteners and including a knife mechanism for cutting body tissue, the knife mechanism being distally movable in response to movement of the axial drive mechanism;
an approximating means for actuating the fastener holding cartridge;
a fastener pushing mechanism responsive to movement of the axial drive mechanism for pushing the fasteners from the fastener holding cartridge, the fastener pushing mechanism being movable along a path, the centerline of said fastener pushing mechanism path being non-colinear with the centerline of the distally-directed drive force path; and, a transfer mechanism for translating the drive force from the axial drive mechanism to a force evenly distributed along a proximal surface of the fastener pushing mechanism;
wherein the knife mechanism has a distally-facing elongated surface for contacting the proximal end of the fastener pushing mechanism, the distally-facing elongated surface of the knife mechanism abutting and moving the fastener pushing mechanism in response to the distal movement of the axial drive mechanism.
, 25
10. The apparatus of claim 9, wherein the knife mechanism comprises a knife blade with a distal cutting edge and a proximal edge fixed to a blade holder which is slidably mounted within the fastener holding cartridge, said blade holder having at least one distally-facing elongated surface parallel to and on each side of said knife blade.
11. The apparatus of claim 9, wherein said fastener pushing mechanism comprises at least one pusher plate having a plurality of distally-projecting flat finger-like projections, each projection being for pushing a respective one of the fasteners from the fastener holding cartridge.
12. An apparatus for applying a plurality of surgical fasteners to body tissue, the apparatus having, in use and relative to a user, a distal end and a proximal end and comprising:
a body with a longitudinal portion intermediate the distal and proximal ends and enclosing an axial drive mechanism for transmitting a drive force longitudinally through the apparatus;
a handle associated with said body;
a trigger mechanism associated with said body for receiving a user-applied force;
an anvil assembly;
a fastener holding cartridge pivotally mounted relative to the anvil assembly and being adjacent one end of the anvil assembly, thereby defining a gap between said fastener holding cartridge and said anvil assembly, said fastener holding cartridge containing a plurality of surgical fasteners and optionally including a knife mechanism for cutting body tissue, said knife mechanism being distally movable in response to movement of the axial drive mechanism;
an approximating mechanism for actuating the fastener holding cartridge; and, a fastener pushing mechanism for pushing the fasteners from the fastener holding cartridge, said fastener pushing mechanism including a pusher plate movable from a proximal position to a distal position in response to movement of the axial drive mechanism, the pusher plate being substantially flat on two opposite sides and having a plurality of fastener-pushing members distally projecting from a back portion and an interference mechanism associated with at least one of the flat sides, the interference mechanism frictionally engaging a cooperating surface of the fastener holding cartridge to prevent the fastener pusher plate from moving proximally after said plate has been moved to said distal position in response to movement of the axial drive mechanism, said fastener pushing mechanism having a centerline of movement non-colinear with said axial drive mechanism; and a directing mechanism for converting the drive force transmitted by said axial drive mechanism to a drive force evenly distributed to the fastener pushing mechanism.
a body with a longitudinal portion intermediate the distal and proximal ends and enclosing an axial drive mechanism for transmitting a drive force longitudinally through the apparatus;
a handle associated with said body;
a trigger mechanism associated with said body for receiving a user-applied force;
an anvil assembly;
a fastener holding cartridge pivotally mounted relative to the anvil assembly and being adjacent one end of the anvil assembly, thereby defining a gap between said fastener holding cartridge and said anvil assembly, said fastener holding cartridge containing a plurality of surgical fasteners and optionally including a knife mechanism for cutting body tissue, said knife mechanism being distally movable in response to movement of the axial drive mechanism;
an approximating mechanism for actuating the fastener holding cartridge; and, a fastener pushing mechanism for pushing the fasteners from the fastener holding cartridge, said fastener pushing mechanism including a pusher plate movable from a proximal position to a distal position in response to movement of the axial drive mechanism, the pusher plate being substantially flat on two opposite sides and having a plurality of fastener-pushing members distally projecting from a back portion and an interference mechanism associated with at least one of the flat sides, the interference mechanism frictionally engaging a cooperating surface of the fastener holding cartridge to prevent the fastener pusher plate from moving proximally after said plate has been moved to said distal position in response to movement of the axial drive mechanism, said fastener pushing mechanism having a centerline of movement non-colinear with said axial drive mechanism; and a directing mechanism for converting the drive force transmitted by said axial drive mechanism to a drive force evenly distributed to the fastener pushing mechanism.
13. The apparatus of claim 12, wherein said interference mechanism comprises at least one detent projecting from the side of said pusher plate.
14. A fastener holding cartridge for use in an instrument for applying a plurality of surgical fasteners, the cartridge comprising:
a housing having, in use and relative to a user, a distal end and a proximal end and containing a plurality of surgical fasteners, each fastener being slidably mounted within a slot;
a fastener pushing mechanism which is movable in a path having a centerline of movement for linearly pushing said fasteners from their respective slots in response to application of an off-centered linear drive force provided by a drive mechanism which is movable in a linear path which is non-colinear with the centerline of movement of the fastener pushing mechanism;
a redirecting mechanism for converting the off-centered drive force to a drive force evenly distributed to the fastener pushing mechanism, said redirecting mechanism including a surface for receiving the off-centered drive force, a mechanism for transmitting said force to a cam bar, said cam bar having a substantially flat distal surface for contacting the fastener pushing mechanism and having a path of movement with a vector component aligned with the path of movement of the fastener pushing mechanism, the redirecting mechanism further including a restraint mechanism for restraining the orientation and movement of the cam bar such that the distal surface of the cam bar remains perpendicular relative to the centerline of movement of the fastener pushing mechanism.
a housing having, in use and relative to a user, a distal end and a proximal end and containing a plurality of surgical fasteners, each fastener being slidably mounted within a slot;
a fastener pushing mechanism which is movable in a path having a centerline of movement for linearly pushing said fasteners from their respective slots in response to application of an off-centered linear drive force provided by a drive mechanism which is movable in a linear path which is non-colinear with the centerline of movement of the fastener pushing mechanism;
a redirecting mechanism for converting the off-centered drive force to a drive force evenly distributed to the fastener pushing mechanism, said redirecting mechanism including a surface for receiving the off-centered drive force, a mechanism for transmitting said force to a cam bar, said cam bar having a substantially flat distal surface for contacting the fastener pushing mechanism and having a path of movement with a vector component aligned with the path of movement of the fastener pushing mechanism, the redirecting mechanism further including a restraint mechanism for restraining the orientation and movement of the cam bar such that the distal surface of the cam bar remains perpendicular relative to the centerline of movement of the fastener pushing mechanism.
15. The fastener holding cartridge of claim 14, wherein said fastener pushing mechanism comprises at least one pusher plate having a plurality of distally-projecting, flat, finger-like projections, each projection being for pushing a respective one of the fasteners from the fastener holding cartridge.
16. The fastener holding cartridge of claim 15, wherein said pusher plate is movable from a proximal position to a distal position and has an interference mechanism for frictionally engaging a cooperating surface of the fastener holding cartridge when said pusher plate is in the distal position to prevent said pusher plate from returning to its proximal position.
17. The fastener holding cartridge of claim 16, wherein said interference mechanism comprises at least one detent projecting from at least one of the at least one pusher plate.
18. The fastener holding cartridge of claim 14, further comprising a knife mechanism for cutting body tissue, the knife mechanism being movable between a proximal position in which said knife mechanism is completely enclosed by said cartridge and a distal position wherein a cutting edge of the knife mechanism projects out of a corresponding slot in the distal end of the cartridge, the movement of the knife mechanism being in response to movement of the linear drive force.
19. The fastener holding cartridge of claim 18, and further including a resilient mechanism for biasing the knife mechanism to its proximal position.
20. The fastener holding cartridge of claim 19, wherein said resilient mechanism comprises a leaf spring.
21. The fastener holding cartridge of claim 14, wherein the restraint mechanism for restraining the orientation and movement of the cam bar comprises at least one first member which projects from the cam bar and is fixedly attached thereto, and at least one second member which is associated with the fastener holding cartridge, the second member having at least one guide slot for receiving the first member and for restraining movement of the first member to a predetermined path.
22. The fastener holding cartridge of claim 21, wherein said second member is stationary relative to the fastener holding cartridge.
23. The fastener holding cartridge of claim 22, wherein said second member is a side plate.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US488,182 | 1990-03-05 | ||
| US07/488,182 US5100042A (en) | 1990-03-05 | 1990-03-05 | Surgical fastener apparatus |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2037427A1 CA2037427A1 (en) | 1991-09-06 |
| CA2037427C true CA2037427C (en) | 1995-09-05 |
Family
ID=23938655
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002037427A Expired - Lifetime CA2037427C (en) | 1990-03-05 | 1991-03-01 | Surgical fastener apparatus |
Country Status (4)
| Country | Link |
|---|---|
| US (2) | US5100042A (en) |
| EP (1) | EP0446012B1 (en) |
| CA (1) | CA2037427C (en) |
| DE (1) | DE69115955T2 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112754628A (en) * | 2021-01-11 | 2021-05-07 | 朱明花 | Vacuum suction type obstetric and gynecologic delivery device |
Families Citing this family (569)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5470009A (en) * | 1990-12-06 | 1995-11-28 | United States Surgical Corporation | Surgical fastening apparatus with locking mechanism |
| CA2055943C (en) * | 1990-12-06 | 2003-09-23 | Daniel P. Rodak | Surgical fastening apparatus with locking mechanism |
| DE69119607T2 (en) * | 1990-12-18 | 1996-11-14 | United States Surgical Corp | SAFETY DEVICE FOR SURGICAL CLAMPING DEVICES |
| US5336232A (en) * | 1991-03-14 | 1994-08-09 | United States Surgical Corporation | Approximating apparatus for surgical jaw structure and method of using the same |
| CA2061885A1 (en) * | 1991-03-14 | 1992-09-15 | David T. Green | Approximating apparatus for surgical jaw structure |
| US5413267A (en) * | 1991-05-14 | 1995-05-09 | United States Surgical Corporation | Surgical stapler with spent cartridge sensing and lockout means |
| GB9121132D0 (en) * | 1991-10-04 | 1991-11-13 | Johnson & Johnson Orthopaedics | An acetabular cup inserter |
| CA2078794C (en) * | 1991-10-18 | 1998-10-06 | Frank J. Viola | Locking device for an apparatus for applying surgical fasteners |
| US5579978A (en) * | 1991-10-18 | 1996-12-03 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| AU660712B2 (en) * | 1991-10-18 | 1995-07-06 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| DE537571T1 (en) * | 1991-10-18 | 1993-10-14 | United States Surgical Corp | Device for attaching surgical fasteners. |
| US5395034A (en) * | 1991-11-07 | 1995-03-07 | American Cyanamid Co. | Linear surgical stapling instrument |
| US5163943A (en) * | 1992-03-12 | 1992-11-17 | Mohiuddin Mohammed M | Circumcision instrument with staple means |
| US5368599A (en) * | 1992-10-08 | 1994-11-29 | United States Surgical Corporation | Surgical fastening apparatus with suture array |
| US6716232B1 (en) * | 1993-04-30 | 2004-04-06 | United States Surgical Corporation | Surgical instrument having an articulated jaw structure and a detachable knife |
| CA2159348A1 (en) * | 1993-04-30 | 1994-11-10 | Claude A. Vidal | Surgical instrument having an articulated jaw structure and a detachable knife |
| US5364003A (en) * | 1993-05-05 | 1994-11-15 | Ethicon Endo-Surgery | Staple cartridge for a surgical stapler |
| US5441193A (en) * | 1993-09-23 | 1995-08-15 | United States Surgical Corporation | Surgical fastener applying apparatus with resilient film |
| US5439155A (en) * | 1993-10-07 | 1995-08-08 | United States Surgical Corporation | Cartridge for surgical fastener applying apparatus |
| US5465894A (en) * | 1993-12-06 | 1995-11-14 | Ethicon, Inc. | Surgical stapling instrument with articulated stapling head assembly on rotatable and flexible support shaft |
| US5470008A (en) * | 1993-12-20 | 1995-11-28 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| WO1995023557A1 (en) * | 1994-03-01 | 1995-09-08 | United States Surgical Corporation | Surgical stapler with anvil sensor and lockout |
| US5636779A (en) * | 1994-12-13 | 1997-06-10 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| US5988479A (en) * | 1994-12-13 | 1999-11-23 | United States Surgical Corporation | Apparatus for applying surgical fasteners |
| US5735445A (en) * | 1995-03-07 | 1998-04-07 | United States Surgical Corporation | Surgical stapler |
| US5641111A (en) * | 1995-06-28 | 1997-06-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with anvil cutting guide |
| US5706998A (en) * | 1995-07-17 | 1998-01-13 | United States Surgical Corporation | Surgical stapler with alignment pin locking mechanism |
| US5651491A (en) * | 1995-10-27 | 1997-07-29 | United States Surgical Corporation | Surgical stapler having interchangeable loading units |
| US5797537A (en) * | 1996-02-20 | 1998-08-25 | Richard-Allan Medical Industries, Inc. | Articulated surgical instrument with improved firing mechanism |
| US5820009A (en) * | 1996-02-20 | 1998-10-13 | Richard-Allan Medical Industries, Inc. | Articulated surgical instrument with improved jaw closure mechanism |
| US5810240A (en) * | 1996-03-15 | 1998-09-22 | United States Surgical Corporation | Surgical fastener applying device |
| US6109500A (en) | 1996-10-04 | 2000-08-29 | United States Surgical Corporation | Lockout mechanism for a surgical stapler |
| US5979037A (en) * | 1997-02-06 | 1999-11-09 | Sony Corporation | Mounting assembly and method for locating and assembling parts with a tight press fit |
| US5908428A (en) * | 1997-05-27 | 1999-06-01 | United States Surgical Corporation | Stitching devices for heart valve replacement surgery |
| US6332889B1 (en) * | 1998-08-27 | 2001-12-25 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
| US8016855B2 (en) | 2002-01-08 | 2011-09-13 | Tyco Healthcare Group Lp | Surgical device |
| US7770773B2 (en) | 2005-07-27 | 2010-08-10 | Power Medical Interventions, Llc | Surgical device |
| EP1261282B1 (en) | 2000-03-03 | 2013-09-25 | C. R. Bard, Inc. | Endoscopic tissue apposition device with multiple suction ports |
| US7993368B2 (en) | 2003-03-13 | 2011-08-09 | C.R. Bard, Inc. | Suture clips, delivery devices and methods |
| US6592596B1 (en) | 2000-05-10 | 2003-07-15 | Scimed Life Systems, Inc. | Devices and related methods for securing a tissue fold |
| US8105351B2 (en) | 2001-05-18 | 2012-01-31 | C.R. Bard, Inc. | Method of promoting tissue adhesion |
| US7220266B2 (en) | 2000-05-19 | 2007-05-22 | C. R. Bard, Inc. | Tissue capturing and suturing device and method |
| US6805273B2 (en) * | 2002-11-04 | 2004-10-19 | Federico Bilotti | Surgical stapling instrument |
| US6817508B1 (en) | 2000-10-13 | 2004-11-16 | Tyco Healthcare Group, Lp | Surgical stapling device |
| US7407076B2 (en) * | 2000-10-13 | 2008-08-05 | Tyco Healthcare Group Lp | Surgical stapling device |
| US7131980B1 (en) | 2001-01-18 | 2006-11-07 | Dvl Acquisitions Sub, Inc. | Surgical suturing instrument and method of use |
| DE10121305A1 (en) * | 2001-05-02 | 2002-12-12 | Ethicon Endo Surgery Europe | Surgical instrument |
| US7011668B2 (en) * | 2001-07-23 | 2006-03-14 | Dvl Acquistion Sub, Inc. | Surgical suturing instrument and method of use |
| JP2005502416A (en) * | 2001-09-14 | 2005-01-27 | オーナックス・メディカル・インコーポレーテッド | Surgical suture instrument and method of use |
| US9113878B2 (en) | 2002-01-08 | 2015-08-25 | Covidien Lp | Pinion clip for right angle linear cutter |
| WO2003096885A2 (en) * | 2002-05-17 | 2003-11-27 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
| US20040158125A1 (en) | 2002-09-06 | 2004-08-12 | Aznoian Harold M. | Integrated endoscope and accessory treatment device |
| EP1545335A1 (en) * | 2002-10-04 | 2005-06-29 | Tyco Healthcare Group Lp | Angled surgical fastener apparatus |
| CN1822794B (en) | 2003-05-16 | 2010-05-26 | C.R.巴德有限公司 | Single intubation, multi-stitch endoscopic suturing system |
| US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
| US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
| US7207472B2 (en) * | 2003-12-30 | 2007-04-24 | Ethicon Endo-Surgery, Inc. | Cartridge with locking knife for a curved cutter stapler |
| US7134587B2 (en) * | 2003-12-30 | 2006-11-14 | Ethicon Endo-Surgery, Inc. | Knife retraction arm for a curved cutter stapler |
| US20050143759A1 (en) * | 2003-12-30 | 2005-06-30 | Kelly William D. | Curved cutter stapler shaped for male pelvis |
| US20050139636A1 (en) * | 2003-12-30 | 2005-06-30 | Schwemberger Richard F. | Replaceable cartridge module for a surgical stapling and cutting instrument |
| US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
| US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
| US7438208B2 (en) * | 2005-01-25 | 2008-10-21 | Entrigue Surgical, Inc. | Septal stapler apparatus |
| US7500979B2 (en) | 2005-08-31 | 2009-03-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with multiple stacked actuator wedge cams for driving staple drivers |
| US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
| US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
| US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
| US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
| US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
| US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
| US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
| US20070194082A1 (en) | 2005-08-31 | 2007-08-23 | Morgan Jerome R | Surgical stapling device with anvil having staple forming pockets of varying depths |
| US7472815B2 (en) | 2005-09-21 | 2009-01-06 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with collapsible features for controlling staple height |
| US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
| US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
| US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
| US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
| US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
| US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
| US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
| US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
| US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
| US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
| US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
| US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
| US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
| US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
| US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
| US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
| US8029520B2 (en) * | 2006-02-07 | 2011-10-04 | Ethicon Endo-Surgery, Inc. | Method for performing trans-anal resection with a curved cutter stapler |
| US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
| US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
| US9005220B2 (en) | 2006-04-04 | 2015-04-14 | C.R. Bard, Inc. | Suturing devices and methods with energy emitting elements |
| AU2007249293C1 (en) * | 2006-05-12 | 2013-06-27 | Arthrocare Corporation | Middle turbinate medializer |
| US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
| US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
| US8485412B2 (en) | 2006-09-29 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical staples having attached drivers and stapling instruments for deploying the same |
| US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
| US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
| US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
| US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
| US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
| US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
| US8701958B2 (en) | 2007-01-11 | 2014-04-22 | Ethicon Endo-Surgery, Inc. | Curved end effector for a surgical stapling device |
| US20080215090A1 (en) * | 2007-02-14 | 2008-09-04 | Entrigue Surgical, Inc. | Method and System for Tissue Fastening |
| US8727197B2 (en) | 2007-03-15 | 2014-05-20 | Ethicon Endo-Surgery, Inc. | Staple cartridge cavity configuration with cooperative surgical staple |
| US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
| US11672531B2 (en) | 2007-06-04 | 2023-06-13 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
| US7832408B2 (en) | 2007-06-04 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a directional switching mechanism |
| US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
| US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
| US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
| US20080308602A1 (en) * | 2007-06-18 | 2008-12-18 | Timm Richard W | Surgical stapling and cutting instruments |
| US8308040B2 (en) | 2007-06-22 | 2012-11-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
| US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
| US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
| US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
| US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
| US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
| US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
| US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
| US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
| US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
| US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
| US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
| US8459525B2 (en) | 2008-02-14 | 2013-06-11 | Ethicon Endo-Sugery, Inc. | Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device |
| US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
| BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
| US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
| US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
| US7793812B2 (en) | 2008-02-14 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus |
| US9615826B2 (en) | 2010-09-30 | 2017-04-11 | Ethicon Endo-Surgery, Llc | Multiple thickness implantable layers for surgical stapling devices |
| US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
| CA2665017A1 (en) | 2008-05-05 | 2009-11-05 | Tyco Healthcare Group Lp | Surgical instrument with sequential clamping and cutting |
| US8016176B2 (en) | 2008-06-04 | 2011-09-13 | Tyco Healthcare Group, Lp | Surgical stapling instrument with independent sequential firing |
| US8424738B2 (en) * | 2008-06-04 | 2013-04-23 | Covidien Lp | Attachable clamp for surgical stapler |
| AU2009293181B2 (en) | 2008-09-17 | 2014-07-24 | Arthrocare Corporation | Methods and systems for medializing a turbinate |
| PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
| US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
| US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
| US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
| US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
| US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
| WO2010036227A1 (en) | 2008-09-29 | 2010-04-01 | C R . Bard, Inc . | Endoscopic suturing device |
| US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
| US8070038B2 (en) | 2008-10-10 | 2011-12-06 | Tyco Healthcare Group, Lp | Surgical instrument with pivotable jaw member |
| US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
| US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
| US8397971B2 (en) | 2009-02-05 | 2013-03-19 | Ethicon Endo-Surgery, Inc. | Sterilizable surgical instrument |
| JP2012517287A (en) | 2009-02-06 | 2012-08-02 | エシコン・エンド−サージェリィ・インコーポレイテッド | Improvement of driven surgical stapler |
| 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 |
| US8393516B2 (en) | 2009-02-26 | 2013-03-12 | Covidien Lp | Surgical stapling apparatus with curved cartridge and anvil assemblies |
| US8328064B2 (en) | 2009-05-06 | 2012-12-11 | Covidien Lp | Pin locking mechanism for a surgical instrument |
| US8353436B2 (en) | 2009-05-06 | 2013-01-15 | Covidien Lp | Pin locking mechanism for a surgical instrument |
| US8523042B2 (en) * | 2009-10-21 | 2013-09-03 | The General Hospital Corporation | Apparatus and method for preserving a tissue margin |
| US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
| US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
| US8827137B2 (en) * | 2010-03-25 | 2014-09-09 | Covidien Lp | Pin alignment assembly for surgical stapler |
| US8940000B2 (en) | 2010-05-12 | 2015-01-27 | Covidien Lp | Surgical instruments with flexible member attachment structures |
| US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
| US20120078244A1 (en) | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
| US9220500B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
| US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
| US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
| US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
| US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
| US9700317B2 (en) | 2010-09-30 | 2017-07-11 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a releasable tissue thickness compensator |
| US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
| 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 |
| US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
| US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
| US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
| US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
| US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
| US9113865B2 (en) | 2010-09-30 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a layer |
| US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
| US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
| US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
| US9351730B2 (en) | 2011-04-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising channels |
| CA2812553C (en) | 2010-09-30 | 2019-02-12 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a retention matrix and an alignment matrix |
| US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
| US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
| US8348124B2 (en) | 2011-02-08 | 2013-01-08 | Covidien Lp | Knife bar with geared overdrive |
| AU2012250197B2 (en) | 2011-04-29 | 2017-08-10 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
| US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
| US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
| US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
| US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
| US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
| RU2644272C2 (en) | 2012-03-28 | 2018-02-08 | Этикон Эндо-Серджери, Инк. | Limitation node with tissue thickness compensator |
| BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
| JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． | Tissue thickness compensator with multiple layers |
| US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
| US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
| US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
| US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
| US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
| US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
| US8747238B2 (en) | 2012-06-28 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Rotary drive shaft assemblies for surgical instruments with articulatable end effectors |
| US9408606B2 (en) | 2012-06-28 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Robotically powered surgical device with manually-actuatable reversing system |
| 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 |
| US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
| JP6290201B2 (en) | 2012-06-28 | 2018-03-07 | エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． | Lockout for empty clip cartridge |
| US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
| US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
| US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
| BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
| 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 |
| US20140249557A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Thumbwheel switch arrangements for surgical instruments |
| BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
| RU2669463C2 (en) | 2013-03-01 | 2018-10-11 | Этикон Эндо-Серджери, Инк. | Surgical instrument with soft stop |
| 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 |
| US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
| US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
| US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
| US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
| BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
| US10136887B2 (en) | 2013-04-16 | 2018-11-27 | Ethicon Llc | Drive system decoupling arrangement for a surgical instrument |
| US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
| MX369362B (en) | 2013-08-23 | 2019-11-06 | Ethicon Endo Surgery Llc | Firing member retraction devices for powered surgical instruments. |
| US9924942B2 (en) | 2013-08-23 | 2018-03-27 | Ethicon Llc | Motor-powered articulatable surgical instruments |
| US9585662B2 (en) | 2013-12-23 | 2017-03-07 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising an extendable firing member |
| US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
| US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
| US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
| US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
| US20140166725A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple. |
| CN106232029B (en) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | Fastening system including firing member locking piece |
| US10499908B2 (en) | 2014-03-04 | 2019-12-10 | Maquet Cardiovascular Llc | Surgical implant and method and instrument for installing the same |
| WO2015134682A1 (en) | 2014-03-04 | 2015-09-11 | Maquet Cardiovascular Llc | Surgical implant and method and instrument for installing the same |
| US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
| US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
| BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
| US9804618B2 (en) | 2014-03-26 | 2017-10-31 | Ethicon Llc | Systems and methods for controlling a segmented circuit |
| US20150272580A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Verification of number of battery exchanges/procedure count |
| CA2942427C (en) * | 2014-04-04 | 2018-05-01 | Touchstone International Medical Science Co., Ltd. | Medical anastomosis device |
| US20150297222A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
| CN106456176B (en) | 2014-04-16 | 2019-06-28 | 伊西康内外科有限责任公司 | Fastener cartridge including the extension with various configuration |
| US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
| BR112016023825B1 (en) | 2014-04-16 | 2022-08-02 | Ethicon Endo-Surgery, Llc | STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPLER AND STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
| JP6532889B2 (en) | 2014-04-16 | 2019-06-19 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | Fastener cartridge assembly and staple holder cover arrangement |
| US11185330B2 (en) | 2014-04-16 | 2021-11-30 | Cilag Gmbh International | Fastener cartridge assemblies and staple retainer cover arrangements |
| US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
| BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
| US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
| US10135242B2 (en) | 2014-09-05 | 2018-11-20 | Ethicon Llc | Smart cartridge wake up operation and data retention |
| US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
| US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
| MX2017003960A (en) | 2014-09-26 | 2017-12-04 | Ethicon Llc | Surgical stapling buttresses and adjunct materials. |
| US9924943B2 (en) | 2014-10-01 | 2018-03-27 | Covidien Lp | Method of manufacturing jaw members for surgical stapling instrument |
| US9700316B2 (en) | 2014-10-01 | 2017-07-11 | Covidien Lp | Surgical loading units and mounting members thereof |
| US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
| US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
| US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
| US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
| US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
| US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
| US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
| US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
| US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
| US10004501B2 (en) | 2014-12-18 | 2018-06-26 | Ethicon Llc | Surgical instruments with improved closure arrangements |
| US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
| RU2703684C2 (en) | 2014-12-18 | 2019-10-21 | ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи | Surgical instrument with anvil which is selectively movable relative to staple cartridge around discrete fixed axis |
| 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 |
| CN107106169B (en) | 2014-12-25 | 2020-11-24 | 柯惠有限合伙公司 | Surgical stapling device |
| US9775611B2 (en) | 2015-01-06 | 2017-10-03 | Covidien Lp | Clam shell surgical stapling loading unit |
| US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
| US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
| US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
| US10321907B2 (en) | 2015-02-27 | 2019-06-18 | Ethicon Llc | System for monitoring whether a surgical instrument needs to be serviced |
| US9855040B2 (en) * | 2015-03-04 | 2018-01-02 | Covidien Lp | Surgical stapling loading unit having articulating jaws |
| US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
| 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 |
| 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 |
| US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
| US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
| US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
| JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
| US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
| US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
| 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 |
| US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
| US10390825B2 (en) | 2015-03-31 | 2019-08-27 | Ethicon Llc | Surgical instrument with progressive rotary drive systems |
| US10405863B2 (en) | 2015-06-18 | 2019-09-10 | Ethicon Llc | Movable firing beam support arrangements for articulatable surgical instruments |
| US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
| US10098642B2 (en) | 2015-08-26 | 2018-10-16 | Ethicon Llc | Surgical staples comprising features for improved fastening of tissue |
| BR112018003693B1 (en) | 2015-08-26 | 2022-11-22 | Ethicon Llc | SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPPING INSTRUMENT |
| MX2022006189A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
| US10238390B2 (en) | 2015-09-02 | 2019-03-26 | Ethicon Llc | Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns |
| US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
| US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
| US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
| US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
| US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
| 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 |
| US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
| US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
| US10285699B2 (en) | 2015-09-30 | 2019-05-14 | Ethicon Llc | Compressible adjunct |
| US10561420B2 (en) | 2015-09-30 | 2020-02-18 | Ethicon Llc | Tubular absorbable constructs |
| US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
| US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
| US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
| US10433837B2 (en) | 2016-02-09 | 2019-10-08 | Ethicon Llc | Surgical instruments with multiple link articulation arrangements |
| US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
| BR112018016098B1 (en) | 2016-02-09 | 2023-02-23 | Ethicon Llc | SURGICAL INSTRUMENT |
| US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
| US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
| US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
| US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
| US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
| US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
| US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
| US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
| US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
| US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
| US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
| US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
| US10478181B2 (en) | 2016-04-18 | 2019-11-19 | Ethicon Llc | Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments |
| US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
| US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
| US10675024B2 (en) | 2016-06-24 | 2020-06-09 | Ethicon Llc | Staple cartridge comprising overdriven staples |
| USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
| USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
| USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
| CN109310431B (en) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | Staple cartridge comprising wire staples and punch staples |
| USD814632S1 (en) | 2016-10-21 | 2018-04-03 | Covidien Lp | Staple cartridge |
| AU2017258826A1 (en) | 2016-12-02 | 2018-06-21 | Covidien Lp | Surgical stapling instrument with curved end effector |
| US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
| US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
| US10588630B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical tool assemblies with closure stroke reduction features |
| US10758229B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument comprising improved jaw control |
| US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
| JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
| US10588632B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical end effectors and firing members thereof |
| US10682138B2 (en) | 2016-12-21 | 2020-06-16 | Ethicon Llc | Bilaterally asymmetric staple forming pocket pairs |
| US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
| US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
| US10617414B2 (en) | 2016-12-21 | 2020-04-14 | Ethicon Llc | Closure member arrangements for surgical instruments |
| US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
| US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
| BR112019011947A2 (en) | 2016-12-21 | 2019-10-29 | Ethicon Llc | surgical stapling systems |
| US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
| US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
| US10517595B2 (en) | 2016-12-21 | 2019-12-31 | Ethicon Llc | Jaw actuated lock arrangements for preventing advancement of a firing member in a surgical end effector unless an unfired cartridge is installed in the end effector |
| US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
| US20180168608A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instrument system comprising an end effector lockout and a firing assembly lockout |
| US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
| CN110099619B (en) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | Lockout device for surgical end effector and replaceable tool assembly |
| US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
| US20180168648A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Durability features for end effectors and firing assemblies of surgical stapling instruments |
| US10675025B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Shaft assembly comprising separately actuatable and retractable systems |
| US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
| US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
| USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
| US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
| US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
| US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
| US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
| US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
| USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
| US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
| US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
| US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
| US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
| USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
| US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
| US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
| US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
| US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
| US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
| US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
| US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
| US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
| US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
| US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
| US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
| US20180368844A1 (en) | 2017-06-27 | 2018-12-27 | Ethicon Llc | Staple forming pocket arrangements |
| US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
| USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
| US11678880B2 (en) | 2017-06-28 | 2023-06-20 | Cilag Gmbh International | Surgical instrument comprising a shaft including a housing arrangement |
| US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
| US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
| US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
| US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
| US11020114B2 (en) | 2017-06-28 | 2021-06-01 | Cilag Gmbh International | Surgical instruments with articulatable end effector with axially shortened articulation joint configurations |
| USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
| USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
| US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
| USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
| US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
| EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
| US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
| US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
| US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
| US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
| US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
| US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
| US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
| US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
| US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
| USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
| US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
| USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
| US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
| US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
| USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
| US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
| US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
| US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
| US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
| US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
| US10993714B2 (en) | 2017-11-28 | 2021-05-04 | Covidien Lp | Surgical stapling instrument and associated trigger mechanisms |
| US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
| US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
| US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
| US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
| US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
| US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
| US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
| US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
| US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
| US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
| US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
| US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
| USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
| US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
| US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
| US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
| US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
| US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
| US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
| US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
| US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
| US11179151B2 (en) | 2017-12-21 | 2021-11-23 | Cilag Gmbh International | Surgical instrument comprising a display |
| US10945730B2 (en) | 2018-06-25 | 2021-03-16 | Covidien Lp | Stapling device with selectively advanceable alignment pin |
| US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
| US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
| US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
| US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
| USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
| US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
| US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
| US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
| US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
| US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
| US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
| US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
| US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
| US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
| US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
| US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
| US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
| US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
| US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
| US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
| US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
| US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
| US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
| US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
| US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
| US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
| US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
| US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
| US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
| US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
| US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
| US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
| US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
| US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
| US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
| US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
| US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
| US11229437B2 (en) | 2019-06-28 | 2022-01-25 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
| US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
| US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
| US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
| US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
| US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
| US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
| US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
| EP4007529A4 (en) | 2019-08-02 | 2023-07-26 | Covidien LP | Surgical stapling device with curved tool assembly |
| EP4051133A4 (en) | 2019-11-01 | 2023-06-28 | Covidien LP | Surgical stapling device with knife blade lock |
| WO2021120046A1 (en) | 2019-12-18 | 2021-06-24 | Covidien Lp | Surgical stapling device with shipping cap |
| US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
| US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
| US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
| US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
| US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
| US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
| US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
| US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
| US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
| US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
| US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
| US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
| US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
| US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
| US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
| USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
| USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
| USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
| USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
| USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
| USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
| USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
| US11744584B2 (en) | 2020-06-09 | 2023-09-05 | Covidien Lp | Alignment pin assembly for surgical stapler |
| US20220031350A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with double pivot articulation joint arrangements |
| US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
| US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
| US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
| USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
| US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
| USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
| US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
| US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
| US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
| US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
| US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
| US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
| US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
| US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
| US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
| US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
| US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
| US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
| US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
| US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
| CN112617942A (en) * | 2020-12-02 | 2021-04-09 | 苏州贝诺医疗器械有限公司 | Stable anastomat with high safety |
| US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
| US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
| US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
| US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
| US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
| US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
| US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
| US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
| US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
| US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
| US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
| US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
| US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
| US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
| US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
| US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
| US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
| US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
| US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
| US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
| US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
| US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
| US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
| US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
| US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
| US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
| US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
| US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
| US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
| US20220378426A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a mounted shaft orientation sensor |
| US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
| US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (16)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US3269630A (en) * | 1964-04-30 | 1966-08-30 | Fleischer Harry | Stapling instrument |
| US4241861A (en) * | 1977-12-20 | 1980-12-30 | Fleischer Harry N | Scissor-type surgical stapler |
| US4354628A (en) * | 1980-09-29 | 1982-10-19 | United States Surgical Corporation | Surgical stapler apparatus having pivotally related staple holder and anvil |
| US4422567A (en) * | 1981-11-17 | 1983-12-27 | Haynes Taylor H | Medical suturing device |
| US4506670A (en) * | 1983-03-30 | 1985-03-26 | United States Surgical Corporation | Two-part surgical fastener applying apparatus with frangible member |
| US4506671A (en) * | 1983-03-30 | 1985-03-26 | United States Surgical Corporation | Apparatus for applying two-part surgical fasteners |
| US4602634A (en) * | 1983-09-23 | 1986-07-29 | Ethicon, Inc. | Method and instrument for applying a fastener to a tissue using means to grasp, guide and pull the fastener through the tissue |
| US4741336A (en) * | 1984-07-16 | 1988-05-03 | Ethicon, Inc. | Shaped staples and slotted receivers (case VII) |
| US4606345A (en) * | 1984-07-16 | 1986-08-19 | Ethicon, Inc. | Surgical instrument for applying two-piece fasteners comprising U-shaped staples and frictionally held receivers (Case II) |
| US4767044A (en) * | 1984-10-19 | 1988-08-30 | United States Surgical Corporation | Surgical fastener applying apparatus |
| US4665916A (en) * | 1985-08-09 | 1987-05-19 | United States Surgical Corporation | Surgical stapler apparatus |
| US4728020A (en) * | 1985-08-30 | 1988-03-01 | United States Surgical Corporation | Articulated surgical fastener applying apparatus |
| US4715520A (en) * | 1985-10-10 | 1987-12-29 | United States Surgical Corporation | Surgical fastener applying apparatus with tissue edge control |
| US4819853A (en) * | 1987-12-31 | 1989-04-11 | United States Surgical Corporation | Surgical fastener cartridge |
| GB8800909D0 (en) * | 1988-01-15 | 1988-02-17 | Ethicon Inc | Gas powered surgical stapler |
| US4881545A (en) * | 1988-12-08 | 1989-11-21 | United States Surgical Corporation | Surgical fastener cartridge with improved body tissue cutting knife assembly |
-
1990
- 1990-03-05 US US07/488,182 patent/US5100042A/en not_active Expired - Lifetime
-
1991
- 1991-03-01 CA CA002037427A patent/CA2037427C/en not_active Expired - Lifetime
- 1991-03-05 EP EP91301808A patent/EP0446012B1/en not_active Expired - Lifetime
- 1991-03-05 DE DE69115955T patent/DE69115955T2/en not_active Expired - Lifetime
-
1993
- 1993-08-24 US US08/111,026 patent/US5344060A/en not_active Expired - Lifetime
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112754628A (en) * | 2021-01-11 | 2021-05-07 | 朱明花 | Vacuum suction type obstetric and gynecologic delivery device |
Also Published As
| Publication number | Publication date |
|---|---|
| EP0446012A3 (en) | 1991-10-16 |
| DE69115955T2 (en) | 1996-06-20 |
| EP0446012A2 (en) | 1991-09-11 |
| DE69115955D1 (en) | 1996-02-15 |
| CA2037427A1 (en) | 1991-09-06 |
| EP0446012B1 (en) | 1996-01-03 |
| US5100042A (en) | 1992-03-31 |
| US5344060A (en) | 1994-09-06 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| CA2037427C (en) | Surgical fastener apparatus | |
| EP0458568B1 (en) | Surgical fastener apparatus | |
| US20220047263A1 (en) | Surgical stapler with tissue engagement features around tissue containment pin | |
| US11701109B2 (en) | Surgical stapler with sloped staple deck for varying tissue compression | |
| US5470009A (en) | Surgical fastening apparatus with locking mechanism | |
| US4665916A (en) | Surgical stapler apparatus | |
| US5462215A (en) | Locking device for an apparatus for applying surgical fasteners | |
| US5470006A (en) | Surgical fastening apparatus with locking mechanism | |
| US5718359A (en) | Surgical stapler with lockout mechanism | |
| EP0323016B1 (en) | Surgical fastener cartridge | |
| JP4448449B2 (en) | Tool assembly for a surgical stapling device | |
| US7703653B2 (en) | Articulation mechanism for surgical instrument | |
| US11202629B2 (en) | Clamping based lockout mechanism for right angle surgical stapler | |
| US11324504B2 (en) | Cartridge based lockout mechanism for right angle surgical stapler | |
| CN113727662A (en) | Tissue cutting gasket for right angle surgical stapler | |
| JP2004344660A (en) | Surgical stapler having lockout for used cartridge | |
| US11166721B2 (en) | Staple retainer for surgical stapler cartridge | |
| JPH0352978B2 (en) |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKEX | Expiry |