CA2574748A1 - Vessel sealer and divider for large tissue structures - Google Patents
Vessel sealer and divider for large tissue structuresInfo
- Publication number
- CA2574748A1 CA2574748A1 CA002574748A CA2574748A CA2574748A1 CA 2574748 A1 CA2574748 A1 CA 2574748A1 CA 002574748 A CA002574748 A CA 002574748A CA 2574748 A CA2574748 A CA 2574748A CA 2574748 A1 CA2574748 A1 CA 2574748A1
- Authority
- CA
- Canada
- Prior art keywords
- jaw members
- knife
- assembly
- tissue
- pivot
- 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.)
- Granted
Links
- 238000013519 translation Methods 0.000 claims abstract description 16
- 230000000694 effects Effects 0.000 claims abstract description 12
- 238000007789 sealing Methods 0.000 claims description 62
- 239000012636 effector Substances 0.000 description 44
- 230000004913 activation Effects 0.000 description 24
- 238000000034 method Methods 0.000 description 17
- 230000008901 benefit Effects 0.000 description 13
- 238000005520 cutting process Methods 0.000 description 13
- 239000000463 material Substances 0.000 description 11
- 230000007246 mechanism Effects 0.000 description 10
- 238000001356 surgical procedure Methods 0.000 description 9
- 230000000007 visual effect Effects 0.000 description 9
- 238000004519 manufacturing process Methods 0.000 description 8
- 230000008569 process Effects 0.000 description 7
- PXHVJJICTQNCMI-UHFFFAOYSA-N Nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 description 6
- 230000000712 assembly Effects 0.000 description 6
- 238000000429 assembly Methods 0.000 description 6
- 230000006835 compression Effects 0.000 description 6
- 238000007906 compression Methods 0.000 description 6
- 230000002028 premature Effects 0.000 description 6
- 239000012212 insulator Substances 0.000 description 5
- 229910052751 metal Inorganic materials 0.000 description 5
- 239000002184 metal Substances 0.000 description 5
- 230000037361 pathway Effects 0.000 description 5
- 210000004204 blood vessel Anatomy 0.000 description 4
- 230000001276 controlling effect Effects 0.000 description 4
- 230000002093 peripheral effect Effects 0.000 description 4
- 238000003466 welding Methods 0.000 description 4
- 239000000853 adhesive Substances 0.000 description 3
- 230000001070 adhesive effect Effects 0.000 description 3
- 238000005345 coagulation Methods 0.000 description 3
- 230000015271 coagulation Effects 0.000 description 3
- 238000013461 design Methods 0.000 description 3
- 238000005516 engineering process Methods 0.000 description 3
- 238000010438 heat treatment Methods 0.000 description 3
- 229910052759 nickel Inorganic materials 0.000 description 3
- 241000237503 Pectinidae Species 0.000 description 2
- 208000006011 Stroke Diseases 0.000 description 2
- 230000003213 activating effect Effects 0.000 description 2
- 238000005452 bending Methods 0.000 description 2
- 230000000740 bleeding effect Effects 0.000 description 2
- 238000000576 coating method Methods 0.000 description 2
- 238000000151 deposition Methods 0.000 description 2
- 230000000994 depressogenic effect Effects 0.000 description 2
- 230000002708 enhancing effect Effects 0.000 description 2
- 230000008713 feedback mechanism Effects 0.000 description 2
- 238000010304 firing Methods 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 229910001055 inconels 600 Inorganic materials 0.000 description 2
- 238000001746 injection moulding Methods 0.000 description 2
- 239000011810 insulating material Substances 0.000 description 2
- 230000003993 interaction Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000000750 progressive effect Effects 0.000 description 2
- 239000005060 rubber Substances 0.000 description 2
- 235000020637 scallop Nutrition 0.000 description 2
- 238000000926 separation method Methods 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 241001631457 Cannula Species 0.000 description 1
- VYZAMTAEIAYCRO-UHFFFAOYSA-N Chromium Chemical compound [Cr] VYZAMTAEIAYCRO-UHFFFAOYSA-N 0.000 description 1
- 102000008186 Collagen Human genes 0.000 description 1
- 108010035532 Collagen Proteins 0.000 description 1
- ATJFFYVFTNAWJD-UHFFFAOYSA-N Tin Chemical compound [Sn] ATJFFYVFTNAWJD-UHFFFAOYSA-N 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 239000002390 adhesive tape Substances 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- SJKRCWUQJZIWQB-UHFFFAOYSA-N azane;chromium Chemical compound N.[Cr] SJKRCWUQJZIWQB-UHFFFAOYSA-N 0.000 description 1
- 230000004888 barrier function Effects 0.000 description 1
- 230000002146 bilateral effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 229910010293 ceramic material Inorganic materials 0.000 description 1
- 239000011651 chromium Substances 0.000 description 1
- 230000007012 clinical effect Effects 0.000 description 1
- 230000001112 coagulating effect Effects 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 229920001436 collagen Polymers 0.000 description 1
- 238000012790 confirmation Methods 0.000 description 1
- 230000008021 deposition Effects 0.000 description 1
- 230000001627 detrimental effect Effects 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 239000013536 elastomeric material Substances 0.000 description 1
- 238000012976 endoscopic surgical procedure Methods 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 238000010348 incorporation Methods 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 238000000465 moulding Methods 0.000 description 1
- CLDVQCMGOSGNIW-UHFFFAOYSA-N nickel tin Chemical compound [Ni].[Sn] CLDVQCMGOSGNIW-UHFFFAOYSA-N 0.000 description 1
- 150000004767 nitrides Chemical class 0.000 description 1
- 238000002355 open surgical procedure Methods 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 230000001105 regulatory effect Effects 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 238000005507 spraying Methods 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- -1 stamping Substances 0.000 description 1
- 238000010561 standard procedure Methods 0.000 description 1
- 239000000758 substrate Substances 0.000 description 1
- 238000007751 thermal spraying Methods 0.000 description 1
- 230000000451 tissue damage Effects 0.000 description 1
- 231100000827 tissue damage Toxicity 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2945—Curved jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00404—Blood vessels other than those in or around the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/0063—Sealing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1412—Blade
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
- A61B2018/1432—Needle curved
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
- A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Otolaryngology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
An endoscopic bipolar forceps includes a housing having a shaft affixed thereto, the shaft including jaw members at a distal end thereof. The shaft includes a longitudinal axis defined therethrough and the jaw members are adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal.
The forceps also includes a drive assembly which moves the jaw member relative to one another from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for manipulating tissue. A movable handle is included which is rotatable about a pivot to force the drive assembly to move the jaw members between the first and second positions. The pivot is located a fixed distance above the longitudinal axis. A
knife assembly is also included which has a movable knife bar having a generally t-shaped proximal end dimensioned to operatively engage a corresponding slot defined within the housing, the slot being dimensioned to guide the movement of the knife bar during translation thereof.
The forceps also includes a drive assembly which moves the jaw member relative to one another from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for manipulating tissue. A movable handle is included which is rotatable about a pivot to force the drive assembly to move the jaw members between the first and second positions. The pivot is located a fixed distance above the longitudinal axis. A
knife assembly is also included which has a movable knife bar having a generally t-shaped proximal end dimensioned to operatively engage a corresponding slot defined within the housing, the slot being dimensioned to guide the movement of the knife bar during translation thereof.
Description
VESSEL SEALER AND DIVIDER FOR LARGE TISSUE STRUCTURES
BACKGROUND
The present disclosure relates to an electrosurgical forceps and, more particularly, to an endoscopic bipolar electrosurgicai forceps for sealing and/or cutting large tissue structures.
Technical Field Electrosurgical forceps utilize both mechanical clamping action and electrical energy to affect hemostasis by heating the tissue and blood vessels to coagulate, cauterize and/or seal tissue. Many surgical procedures require cutting and/or ligating large blood vessels and large tissue structures. Due to the inherent spatial considerations of the surgical cavity, surgeons often have difficulty suturing vessels or performing other traditional methods of controlling bleeding, e.g., clamping and/or tying-off transected blood vessels or tissue. By utilizing an elongated electrosurgical forceps, a surgeon can either cauterize, coagulate/desiccate and/or simply reduce or slow bleeding simply by controlling the intensity, frequency and duration of the electrosurgical energy applied through the jaw members to the tissue. Most small blood vessels, i.e., in the range below two millimeters in diameter, can often be closed using standard electrosurgical instruments and techniques. However, larger vessels can be more difficult to close using these standard techniques.
In order to resolve many of the known issues described above and other issues relevant to cauterization and coagulation, a recently developed technology has been developed by Valleylab, Inc. of Boulder, Colorado, called vessel or tissue sealing.
The process of coagulating vessels is fundamentally different than electrosurgical vessel sealing. For the purposes herein, "coagulation" is defined as a process of desiccating tissue wherein the tissue cells are ruptured and dried. "Vessel sealing" or "tissue sealing"
is defined as the process of liquefying the collagen in the tissue so that it reforms into a fused mass with limited demarcation between opposing tissue structures.
Coagulation of small vessels is sufficient to permanently close them, while larger vessels and tissue need to be sealed to assure permanent closure.
In order to effectively seal larger vessels (or tissue) two predominant mechanical parameters are accurately controlled - the pressure applied to the vessel (tissue) and the gap distance between the electrodes - both of which are affected by the thickness of the sealed vessel. More particularly, accurate application of pressure is important to oppose the walls of the vessel; to reduce the tissue impedance to a low enough value that allows enough electrosurgical energy through the tissue; to overcome the forces of expansion during tissue heating; and to contribute to the end tissue thickness, which is an indication of a good seal.
As mentioned above, in order to properly and effectively seal larger vessels or tissue, a greater closure force between opposing jaw members is required.
It is known that a large closure force between the jaws typically requires a large moment about the pivot for each jaw. This presents a design challenge because the jaw members are typically affixed with pins that are positioned to have small moment arms with respect to the pivot of each jaw member. A large force, coupled with a small moment arm, is undesirable because the large forces may shear the pins. As a result, designers compensate for these large closure forces by either designing instruments with metal pins and/or by designing instruments that at least partially offload these closure forces to reduce the chances of mechanical failure. As can be appreciated, if metal pivot pins are employed, the metal pins should be insulated to avoid the pin acting as an alternate current path between the jaw members, which may prove detrimental to effective sealing.
Increasing the closure forces between electrodes may have other undesirable effects, e.g., it may cause the opposing electrodes to come into close contact with one another, which may result in a short circuit and a small closure force may cause pre-mature movement of the tissue during compression and prior to activation.
As a result thereof, providing an instrument that consistently provides the appropriate closure force between opposing electrode within a preferred pressure range will enhance the chances of a successful seal. As can be appreciated, relying on a surgeon to manually provide the appropriate closure force within the appropriate range on a consistent basis would be difficult and the resultant effectiveness and quality of the seal may vary. Moreover, the overall success of creating an effective tissue seal is greatly reliant upon the user's expertise, vision, dexterity, and experience in judging the appropriate closure force to uniformly, consistently and effectively seal the vessel. In other words, the success of the seal would greatly depend upon the ultimate skill of the surgeon rather than the efficiency of the instrument.
It has been found that the pressure range for assuring a consistent and effective seal for large vessels and tissue structures is between about 3 kg/cm2 to about 16 kg/cm2 and, desirably, within a working range of 7 kg/cm2 to 13 kg/cm2. As can be appreciated, manufacturing an instrument that is capable of consistently providing a closure pressure within these working ranges is quite a design challenge for instrument manufacturers.
Various force-actuating assemblies have been developed in the past for providing the appropriate closure forces to affect vessel sealing. For example, one such actuating assembly has been developed by Valleylab, Inc. of Boulder, Colorado, for use with Valleylab's vessel sealing and dividing instrument for sealing large vessels and tissue structures commonly sold under the trademark LIGASURE ATLAS . The LIGASURE ATLAS is presently designed to fit through a 10mm cannula and includes a bi-lateral jaw closure mechanism and is activated by a foot switch.
Other force-actuating assemblies have also been developed by the Valleylab, Inc. of Boulder, Colorado, for use with Valleylab's vessel sealing and dividing instrument for sealing large vessels and tissue structures commonly sold under the trademark LIGASURE 5mm." The LIGASURE 5mmT" is presently designed to fit through a 5mm cannula and includes a unilateral jaw closure mechanism and is activated by a hand switch.
SUMMARY
The forceps includes a housing, a shaft having a longitudinal axis defined therethrough, a drive assembly and a movable handle. The shaft includes an end effector assembly having a pair of jaw members attached to a distal end thereof. The jaw members are movable from a first position in spaced relation to one another to at least a second position doser to one another. The jaw members are for grasping tissue therebetween. Each of the jaw members is adapted to connect to an electrosurgical energy source, thus enabling the jaw members to conduct energy through tissue held between the jaw members to create a tissue seal.
The drive assembly moves the jaw members relative to one another from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for manipulating tissue. The movable handle is rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions. The pivot is located a fixed distance above the longitudinal axis and the drive flange is located generally along the longitudinal axis. This mechanical arrangement creates level-iike mechanical advantage about the pivot to facilitate closing the jaw members about tissue. The forceps also includes a knife assembly having a generally t-shaped movable knife bar that is dimensioned to operatively engage a corresponding slot defined within the housing. The slot guides the movement of the knife bar during translation thereof.
In one embodiment, the knife bar is operatively coupled to a knife slidingly disposed within the shaft. The forceps further includes a finger actuator operatively coupled to the knife assembly wherein movement of the finger actuator moves the knife bar, which, in turn, moves the knife to cut tissue disposed between the jaw members.
In another embodiment, the shaft includes a drive sleeve slidingly disposed therein that operatively connects to the drive assembly for moving the jaw members and the knife assembly includes a cuff at the distal end of the knife bar. The cuff is dimensioned to encapsulate and move atop the drive sleeve upon movement of the knife bar. The forceps may also include a finger actuator operatively connected to the knife assembly.
The finger actuator includes two generally u-shaped flanges that rotate about a pivot to abut and force the cuff distally, which, in turn, results in distal translation of the knife bar.
In yet another embodiment, a spring is included that biases the knife assembly in a proximal-most orientation. A rotating assembly is also included and is configured to rotate the jaw members about the longitudinal axis defined through the shaft, A hand switch may also be included within the housing that is adapted to connect to the source of electrosurgical energy. The hand switch allows a user to selectively supply bipolar energy to the jaw members to affect a tissue seal.
At least one of the jaw members includes a series of stop members disposed thereon for regulating the distance between the jaw members during sealing.
The present disclosure also relates to a bipolar forceps that includes a housing having a shaft affixed thereto. The shaft includes jaw members attached at a distal end thereof having a longitudinal axis defined therethrough. The jaw members are adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal. The forceps also includes a drive assembly that moves the jaw member relative to one another about a pivot from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for manipulating tissue.
A movable handle is included that is rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions. The pivot is located a fixed distance above the longitudinal axis and the drive flange is located generally along the longitudinal axis. A trigger assembly is included that is operatively coupled to the housing and operatively coupied to a knife assembly. The knife assembly includes a drive rod that, upon actuation of the trigger assembly, selectively translates a knife through tissue disposed between the jaw members. A knife guide may also be included that is dimensioned to facilitate alignment and translation of the knife through and into a knife channel defined between the jaw members.
In one embodiment, the knife guide includes two engageable halves that insulate the jaw members from one another. The knife guide may also include one or more apertures defined therein that allow the pivot to extend therethrough.
The drive assembly may also include a cam pin at a distal end thereof that operatively engages the jaw members and the knife guide may be configured to include one or more slots defined therein that allow the cam pin to extend therethrough.
In another embodiment, the pivot includes an aperture defined therein that allows the knife to extend therethrough. The pivot may include a stem and a cap that matingly engage on opposite sides of the shaft to seci.are the jaw members during assembly.
In still yet another embodiment, the trigger assembly selectively translates the knife through tissue disposed between the jaw members and the knife assembly includes a knife carriage having a t-shaped distal end that engages the trigger assembly and a proximal end that engages a knife bar slidingly mounted within the housing. The knife bar may include a cuff at a distal end thereof that defines an aperture located therethrough. The shaft is dimensioned to rotate and slide through the aperture of the cuff.
The drive assembly may further include a cam pin that operatively couples the distal end of the drive sleeve to the jaw members for actuation thereof.
The knife may be dimensioned to include a slot defined therein that allows the cam pin to extend therethrough.
BRIEF DESCRIPTION OF THE DRAWINGS
Various embodiments of the subject instrument are described herein with reference to the drawings wherein:
Fig. IA is a perspective view of a bipolar forceps shown in open configuration and including a housing, a shaft, handle assembly, trigger assembly and an end effector assembly according to the present disclosure;
Fig. 1B is a perspective view of the bipolar forceps of Fig. 1A shown in closed configuration;
Fig. 2 is a rear view of the forceps of Fig. 1A;
Fig. 3A is an enlarged, front perspective view of the end effector assembly of Fig. IA shown in an open configuration;
Fig. 3B is an enlarged, front perspective view of the end effector assembly of Fig. 1A shown in a closed configuration;
Fig. 3C is an enlarged, side view of the end effector assembly of Fig. 1A
shown in open configuration;
Fig. 3D is an enlarge, front view of the end effector assembly of Fig. 1A
shown in open configuration;
Fig. 3E is a greatly-enlarged, exploded perspective view of the top jaw member;
Fig. 3F is a greatly-enlarged, exploded perspective view of the bottom jaw member;
Fig. 4 is a perspective view of the endoscopic forceps of Fig. 1A with the internal working components of the forceps exposed;
Fig. 5A is side view of the endoscopic forceps of Fig. 1 A with the internal working components of the forceps exposed;
Fig. 5B is side view of the endoscopic forceps of Fig. 1 B with the internal working components of the forceps exposed;
Fig. 5C is a greatly-enlarged, perspective view of the handle assembly in open configuration;
Fig. 5D is a greatly-enlarged, perspective view of the handle assembly in closed configuration;
Fig. 6A is an internal, perspective view of the endoscopic forceps of Fig.
1 B with the internal working components of the forceps exposed and the trigger shown in an un-actuated position;
Fig. 6B is an intemal, perspective view of the endoscopic forceps of Fig.
1 B with the internal working components of the forceps exposed and the trigger shown in an actuated position;
Fig. 6C is a schematic representation of the electrical configuration for the trigger assembly;
Fig. 7 is an internal, side view of the endoscopic forceps of Fig. 1 B with the trigger shown in an actuated position;
Fig. 8A is a side cross-sectional view showing the trigger in an actuated position;
Fig. 8B is an enlarged, side cross-sectional view showing the jaw members in a spaced apart orientation;
Fig. 8C is an enlarged, side cross-sectional view showing the jaw members in a closed orientation;
Fig. 9A is side cross-sectional view of the housing showing both the trigger and the handle un-actuated;
Fig. 9B is side cross-sectional view of the housing showing both the trigger and the handle actuated;
Fig. 10A is an enlarged, side cross-sectional view showing the end effector in a closed position and the knife in an unactuated position;
Fig. 10B is an enlarged, side cross-sectional view showing the end effector in a closed position and the knife in an actuated position;
Fig. 10C is an enlarged, front perspective view of a bottom jaw member of the end effector assembly showing the knife in an unactuated position;
Fig. 10D is an enlarged, front perspective view of the bottom jaw member showing the knife in an actuated position;
Fig. 11 is an exploded, perspective view of the forceps of Fig. 1A;
Fig. 12 is an enlarged, exploded perspective view of the housing;
Fig. 13 is an enlarged, exploded perspective view of the end effector assembly and the shaft; and Fig. 14 is a greatly enlarged, exploded perspective view of the end effector assembly.
DETAILED DESCRIPTION
Turning now to Figs. IA-2, one embodiment of a bipolar forceps 10 is shown for use with various surgical procedures and generally includes a housing 20, a handle assembly 30, a rotating assembly 80, a trigger assembly 70 and an end effector assembly 100, which mutually cooperate to grasp, seal and divide large tubular vessels and large vascular tissues. Although the majority of the figure drawings depict a bipolar forceps 10 for use in connection with endoscopic surgical procedures, the present disclosure may be used for more traditional open surgical procedures. For the purposes herein, the forceps 10 is described in terms of an endoscopic instrument;
however, it is contemplated that an open version of the forceps may also include the same or similar operating components and features as described below.
Forceps 10 includes a shaft 12 that has a distal end 16 dimensioned to mechanically engage the end effector assembly 100 and a proximal end 14 that mechanically engages the housing 20. Details of how the shaft 12 connects to the end effector are described in more detail below with respect to Figs. 13 and 14.
The proximal end 14 of shaft 12 is received within the housing 20 and the corinections relating thereto are also described in detail below with respect to Figs. 11 and 12. In the drawings and in the descriptions that follow, the term "proximal," as is traditional, will refer to the end of the forceps 10 that is closer to the user, while the term "distal" will refer to the end that is farther from the user.
As best seen in Figs. 1 A and 2, forceps 10 also includes an electrosurgical cable 310 that connects the forceps 10 to a source of electrosurgical energy, e.g., a generator 500 (shown schematically). Generators such as those sold by Valleylab, located in Boulder, Colorado may be used as a source of electrosurgical energy, e.g., Ligasure"'" Generator, FORCE EZTM Electrosurgical Generator, FORCE
FXTM Electrosurgical Generator, FORCE 1CT"", FORCE 2TM Generator, SurgiStatTM
II
or other suitable generators that may perform different or enhanced functions.
In one embodiment, the generator 500 includes various safety and performance features including isolated output, independent activation of accessories.
The electrosurgical generator may include Valleylab's Instant ResponseTM
technology features, which provides an advanced feedback system to sense changes in tissue two hundred times per second and adjust voltage and current to maintain appropriate power. The Instant ResponseTM technology is believed to provide one or more of the following benefits to surgical procedure:
= Consistent clinical effect through all tissue types;
= Reduced thermal spread and risk of collateral tissue damage;
= Less need to "turn up the generator"; and = Designed for the minimally invasive environment.
Cable 310 is internally divided into cable leads 310a, 310b and 325b (FIG.
6C), which are designed to transmit electrical potentials through their respective feed paths through the forceps 10 to the end effector assembly 100. More particularly, cable feed 325b connects through the forceps housing 20 and through the rotating assembly to jaw member 120. Lead 310a connects to one side of the switch 60 and lead 310c connects to the opposite side of the switch 60 such that, upon activation of the switch, energy is transmitted from lead 310a to 310c. Lead 310c is spliced with lead 310b, which connects through the rotating assembly to jaw member 110 (See Fig. 6C).
Details relating to the electrical connections are explained in more detail below with the discussion of the switch 60.
Handle assembly 30 includes a fixed handle 50 and a movable handle 40.
Fixed handle 50 is integrally associated with housing 20 and handle 40 is movable relative to fixed handle 50 as explained in more detail below with respect to the operation of the forceps 10. Fixed handle 50 is oriented approximately thirty degrees relative a longitudinal axis "A-A" defined through shaft 12. Fixed handle 50 may include one or more ergonomic enhancing elements to facilitate handling, e.g., scallops, protuberances, elastomeric material, etc.
Rotating assembly 80 is operatively associated with the housing 20 and is rotatable approximately 180 degrees about a longitudinal axis "A-A" (See Fig.
1A).
Details of the rotating assembly 80 are described in more detail with respect to Fig. 11.
As mentioned above, end effector assembly 100 is attached at the distal end 14 of shaft 12 and includes a pair of opposing jaw members 110 and 120.
Movable handle 40 of handle assembly 30 is ultimately connected to a drive assembly (FIG.5A), which, together, mechanically cooperate to impart movement of the jaw members 110 and 120 from an open position wherein the jaw members 110 and 120 are disposed in spaced relation relative to one another, to a clamping or closed position wherein the jaw members 110 and 120 cooperate to grasp tissue therebetween.
Forceps 10 may be designed such that it is fully or partially disposable depending upon a particular purpose or to achieve a particular result. For example, end effector assembly 100 may be selectively and releasably engageable with the distal end 16 of the shaft 12 and/or the proximal end 14 of shaft 12 may be selectively and releasably engageable with the housing 20 and the handle assembly 30. In either of these two instances, the forceps 10 would be considered "partially disposable"
or "reposable", i.e., a new or different end effector assembiy 100 (or end effector assembly 100 and shaft 12) selectively replaces the old end effector assembly 100 as needed.
As can be appreciated, the presently disclosed electrical connections would have to be altered to modify the instrument to a reposable forceps.
Tuming now to the more detailed features of the present disclosure as described with respect to Figs. 1 A- 14, movable handle 40 includes a finger loop 43 that has an aperture 41 defined therethrough, which enables a user to grasp and move the handle 40 relative to the fixed handle 50. Finger loop 43 is typically ergonomically enhanced and may include one or more gripping elements (not shown) disposed along the inner peripheral edge of aperture 41 that are designed to facilitate gripping of the movable handle 40 during activation, e.g., a so called "soft touch" material.
Gripping elements may include one or more protuberances, scallops and/or ribs to enhance gripping.
As best seen in Figs. 5A and 5B, movable handle 40 is selectively movable about a pivot pin 45 from a first position relative to fixed handle 50 to a second position in closer proximity to the fixed handle 50, which, as explained below, imparts movement of the jaw members 110 and 120 relative to one another. The movable handle includes a clevis 46 that forms a pair of upper flanges 46a and 46b each having an aperture at an upper end thereof for receiving a pivot pin 45 (See Fig. 12) therethrough and mounting the upper end of the handle 40 to the housing 20. In turn, pivot pin 45 mounts to respective housing halves 20a and 20b. Pivot pin 45 is dimensioned to mount within socket 45a of housing half 20b.
Each upper flange 46a and 46b also includes a force-actuating flange or drive flange 47a and 47b (See Fig. 7), respectively, which are aligned along longitudinal axis "A" and that abut the drive assembly 130 such that pivotal movement of the handle 40 forces actuating flanges 47a and 47b against the drive assembly 130, which, in turn, closes the jaw members 110 and 120 (See Figs. 5A and 5B). For the purposes herein, 47a and 47b that act simultaneously on the drive assembly 130 are referred to as "driving flange 47". A more detailed explanation of the inter-cooperating components of the handle assembly 30 and the drive assembly 130 is discussed below.
As best shown in Fig. 5C, the lower end of the movable handle 40 includes a flange 42 that is typically integrally associated with or operatively connected to movable handle 40. Flange 42 is typically T-shaped and includes a pin-like element 44 that projects laterally or transversally from a distal end thereof and is configured to engage a corresponding railway 55 disposed within fixed handle 50. More particularly, the pin 44 is configured to ride within a pre-defined channel 53 disposed within the railway 55 to lock the movable handle 40 relative to the fixed handle 50 upon reciprocation thereof. Additional features with respect to the t-shaped flange 42 are explained below in the detailed discussion of the operational features of the forceps 10.
Movable handle 40 is designed to provide a distinct mechanical advantage over conventional handle assemblies due to the unique position of the pivot pin 45 (i.e., pivot point) relative to the longitudinal axis "A" of the shaft 12 and the disposition of the driving flange 47 along longitudinal axis W. In other words, by positioning the pivot pin 45 above the driving flange 47, the user gains lever-like mechanical advantage to actuate the jaw members 110 and 120 enabling the user to close the jaw members 110 and 120 with lesser force while still generating the required forces necessary to effect a proper and effective tissue seal.
As shown best in Figs. 3A-3F, 13 and 14, the end effector assembly 100 includes opposing jaw members 110 and 120 that cooperate to effectively grasp tissue for sealing purposes. The end effector assembly 100 is designed as a bilateral assembly, i.e., both jaw members 110 and 120 pivot relative to one another about a pivot pin 95 disposed therethrough. The jaw members 110 and 120 are curved to facilitate manipulation of tissue and to provide better "line of sight" for accessing organs and large tissue structures.
A reciprocating drive sleeve 134 is slidingly disposed within the shaft 12 and is remotely operable by the drive assembly 130 as explained in more detail below.
Drive sleeve 134 includes a bifurcated distal end composed of halves 134a and 134b, respectively, which define a cavity 134' therebetween for receiving jaw members 110 and 120. More particuiarly and as best illustrated in Figs. 13 and 14, jaw members 110 and 120 include proximal flanges 113 and 123, respectively, which each include an elongated angled slot 117 and 127, respectively, defined therethrough. A drive pin 139 (See Fig. 13) mounts jaw members 110 and 120 to the end of a sleeve 134 and within cavity 134' disposed between flanges 134a and 134b. Cam pin or drive pin 139 mounts through apertures 139a and 139b defined in flanges 134a and 134b, respectively, and is reciprocable within slots 16a' and 16b' disposed at the distal ends 16a and 16b of shaft 12 (See Fig. 14). Slots 16a' and 16b' may extend into aperture 95' and 95" to facilitate assembly of pin 139. Pin 139 may be composed of two mechanically interfacing elements that are dimensioned to frictionally receive one another to retain pin 139 in place once assembled. Alternatively, or in addition, pin 139 may be held in place by one of several known manufacturing techniques including: laser or heat-based welding, press-fit mechanical interaction (or other mechanically interlocking geometry, adhesives, chemical bonding, etc. A component disposed on the outside of shaft may also be utilized to retain the pin 139 in place once assembled. For example, a heat shrink material, adhesive tape, rubber or other insulating boot or silicone may be used for this purpose. A varying diameter version of pin 139 may be utilized to prevent the pin from coming loose once assembled. A cap or stem (not shown) arrangement may also be employed for this purpose as well.
Drive sleeve 134, which ultimately connects to the drive assembly 130, is dimensioned to slidingly receive knife drive rod 193, knife 190 and posts 171a and 171b of halves 170a and 170b of knife guide 170. Drive sleeve 134, in tum, is received within shaft 12. Upon actuation of the drive assembly 130, the drive sleeve reciprocates, which, in turn, causes the drive pin 139 to ride within slots 117 and 127 to open and close the jaw members 110 and 120 as desired. The jaw members 110 and 120, in tum, pivot about pivot pin 95 disposed through respective pivot holes 11 3a and 123a disposed within flanges 113 and 123. As can be appreciated, squeezing handle 40 toward handle 50 pulls drive sleeve 134 and drive pin 139 proximally to close the jaw members 110 and 120 about tissue grasped therebetween and pushing the sleeve distally opens the jaw members 110 and 120 for grasping purposes.
Turning back to the details of the jaw member 110 and 120 as best shown in Figs. 3A-3F, jaw member 110 includes a support base 119 that extends distally from flange 113 and that is dimensioned to support an insulative plate 119' thereon.
Insulative plate 119', in turn, is configured to support an electrically conductive tissue engaging surface or sealing plate 112 thereon. The sealing plate 112 may be affixed atop the insulative plate 119' and support base 119 in any suitable manner, such as snap-fit, over-molding, stamping, ultrasonically welded, etc. Support base 119 together with the insulative plate 119' and electrically conductive tissue engaging surface 112 are encapsulated by an outer insulative housing 116. Outer housing 116 includes a cavity 116a that is dimensioned to securely engage the electrically conductive sealing surface 112 as well as the support base 119 and insulative plate 119'. This may be accomplished by stamping, by overmolding, by overmolding a stamped electrically conductive sealing piate and/or by overmolding a metal injection molded seal plate or other suitable methods (e.g., a conductive surface bound to a structural support via an insulating material). All of these manufacturing techniques produce jaw member having an electrically conductive surface 112 that is substantially surrounded by an insulating housing or substrate 116.
For example, and as shown in Fig. 3E, the electrically conductive sealing plate 112 includes a peripheral flange 112a that surrounds the periphery of the sealing plate 112. Flange 112a is designed to matingly engage an inner lip 116b of the outer insulator 116. Again, this may be accomplished by any of the aforementioned processes, e.g., overmolding. Lead 310b, which extends from switch 60 (See Fig. 6C), terminates within the outer insulator 116 and is designed to electro-mechanically couple to the sealing plate 112 by virtue of a crimp-like connection 326a. Insulator 119', electrically conductive sealing surface 112 and the outer, non-conductive jaw housing 116 are preferably dimensioned to limit and/or reduce many of the known undesirable effects related to tissue sealing, e.g., flashover, thermal spread and stray current dissipation.
The electrically conductive sealing surface 112 may also include an outer peripheral edge that has a pre-defined radius and the outer housing 116 meets the electrically conductive sealing surface 112 along an adjoining edge of the sealing surface 112 in a generally tangential position. At the interface, the electrically conductive surface 112 is raised relative to the outer housing 116.
The electrically conductive surface or sealing plate 112 and the outer housing 116, when assembled, form a longitudinally-oriented slot 115a defined therethrough for reciprocation of the knife blade 190 (See Fig. 13). Knife slot 115a cooperates with a corresponding knife slot 11 5b defined in jaw member 120 to facilitate longitudinal extension of the knife blade 190 along a preferred cutting plane to effectively and accurately separate the tissue along the formed tissue seal.
Together, knife slots 11 5a and 11 5b form knife channel 115 for reciprocation of the knife 190. As best illustrated in Figs. 3A-3F, knife channel 115 runs through the center of the jaw members 110 and 120, respectively, such that a blade 190 from the knife assembly 70 can cut the tissue grasped between the jaw members 110 and 120 when the jaw members 110 and 120 are in a closed position. As described in more detail below, handle 30a includes a passive lockout flange 49' that prevents actuation of the knife assembly 70 when the handle 40 is open thus preventing accidental or premature activation of the blade 190 through the tissue. In addition, the passive lockout flange 49' is dimensioned to force the trigger 70 to retract the knife 190 when the handle 40 is moved to an open position.
As explained above and as illustrated in Figs. 3F, 8B, 8C, 10C and 10D, the knife channel 115 is formed when the jaw members 110 and 120 are closed.
In other words, the knife channel 115 includes two kriife channel halves - knife slot 11 5a disposed in sealing plate 112 of jaw member 110 and knife slot 11 5b disposed sealing plate 122 of jaw member 120. The knife channel 115 may be dimensioned to include some degree of curvature to cause the knife 190 to move through tissue in a curved fashion. Alternatively, the knife channel 115 may be configured as a straight slot with no degree of curvature, which, in turn, causes the knife 190 to move through the tissue in a substantially straight fashion. Insulating plate 119' also forms part of the knife channel 115 and includes slot 115a' defined therein that extends along insulating plate 119' and that aligns in vertical registration with knife slot 115a to facilitate translation of distal end 192 of the knife 190 therethrough.
As mentioned above, end effector assembly 100 also includes knife guide 170 that is dimensioned to facilitate alignment and translation of the knife 190 through and into the knife channel 115. More particularly, knife guide 170 includes half 170a and half 170b that mechariically interface to encapsulate the knife 190 upon assembly (See Fig. 13). Knife guide 170, once assembled, aligns the knife 190 for facile translation through knife channel 115 upon reciprocation of a knife drive rod 193 (Fig.
13). The operation of the drive rod 193 is described below with reference to the operational features of the forceps 10. Each half 170a and 170b of the knife guide 170 includes various interfaces thereon and apertures defined therein that allow unencumbered movement of the various operating features of the end effector assembly 100, e.g., pivot 95, drive pin 139 and knife 190. More particularly, halves 170a and 170b include apertures 173a and 173b, respectively, defined therethrough that allow passage of the pivot 95 during assembly. Halves 170a and 170b also include laterally-aligned slots 172a and 172b defined therein that allow reciprocation of the drive pin 139 upon opening and closing of the jaw members 110 and 120. One or more guides 327 (Fig. 14) may also be included to guide leads, e.g., lead 325a, along knife guide 170 and to the electrically conductive plates, e.g., plate 122.
Knife guide halves 170a and 170b also include posts 171 a and 171 b that extend proximally into slot 16' upon assembly to engage knife 190.
Knife channel 115 runs through the center of the jaw members 110 and 120, respectively, such that a distal end 192 of the knife 190 can cut the tissue grasped between the jaw members 110 and 120 when the jaw members 110 and 120 are in a closed position. More particularly, and as described in more detail below with respect to the operation of the forceps 10, the knife 190 can only be advanced through the tissue when the jaw members 110 and 120 are closed, thus preventing accidental or premature activation of the knife 190 through the tissue. Passive lockout flange 49' detailed below prevents unintended translation of the knife 190 while the jaw members 110 and 120 are disposed in an open configuration. The knife 190 may be dimensioned to allow other components to pass therethrough, which additionally creates the benefit of enhancing he overall flexibility of the knife to facilitate passage through the knife channel 115.
Alternatively, one or both jaw members may also include a safety lockout to prevent the knife 190 from advancing while the jaw members are in an open configuration.
Jaw member 120 includes similar elements to jaw member 110, such as jaw housing 126, which encapsulates a support plate 129, an insulator plate 129' and an electrically conductive sealing surface 122. Likewise, the electrically conductive surface 122 and the insulator plate 129', when assembled, include respective longitudinally-oriented knife slots 11 5b and 115b' defined therethrough for reciprocation of the knife blade 190. As mentioned above, when the jaw members 110 and 120 are closed about tissue, knife slots 115a and 115b form a complete knife channel 115 to allow longitudinal extension of the knife 190 in a distal fashion to sever tissue along a tissue seal. The knife channel 115 may be completely disposed in one of the two jaw merribers, e.g., jaw member 120, depending upon a particular purpose. Jaw member 120 may be assembled in a similar manner as described above with respect to jaw member 110. More particularly, the sealing plate 122 may be dimensioned to include an outer peripheral rim 122a that is dimensioned to mechanically interface with an inner lip 126b of housing 126 to secure the sealing plate 122 to the housing 126 with plates 129 and 129' encapsulated therein.
As best seen in Fig. 3F, jaw member 120 includes a series of stop members 90 disposed on the inner facing surface of the electrically conductive sealing surface 122 to facilitate gripping and manipulation of tissue and to define a gap "G"
(Fig. 10B) between opposing jaw members 110 and 120 during sealing and cutting of tissue. The series of stop members 90 may be employed on one or both jaw members 110 and 120 depending upon a particular purpose or to achieve a desired result.
Jaw member 120 is connected to a second electrical lead 325b extending from switch 60 (See Fig. 6B) that terminates within the jaw housing 126 and is designed to electro-mechanically couple to the sealing plate 122 by virtue of a crimp-like connection 326b. As explained in more detail below, leads 310b and 325b allow a user to selectively supply bipolar electrosurgical energy to the jaw members 110 and 120 as needed during surgery.
Jaw members 110 and 120 are electrically isolated from one another such that electrosurgical energy can be effectively transferred through the tissue to form a tissue seal. For example, and as best illustrated in Figs. 3A-3F, each jaw member 110 and 120 includes a uniquely-designed electrosurgical cable path that transmits electrosurgical energy through the cable leads 310b and 325b to the electrically conductive sealing surfaces 112 and 122, respectively. Cable leads 310b and 325b are held loosely but securely along the cable path to permit rotation of the jaw members 110 and 120. As can be appreciated, this isolates electrically conductive sealing surfaces 112 and 122 from the remaining operative components of the end effector assembly 100 and shaft 12. The two electrical potentials are isolated from one another by virtue of the insulative sheathing surrounding the cable leads 310b and 325b.
Jaw members 110 and 120 are engaged to the end of rotating shaft 12 by pivot pin 95 such that rotation of the rotating assembly 80 correspondingly rotates shaft 12 (along with sleeve 134 and knife 190), which, in turn, rotates end effector assembly 100 (See Fig. 1A). More particularly, the distal end of rotating shaft 12 is bifurcated to include ends 16a and 16b that define a channel 16' therein for receiving jaw members 110 and 120. Pivot pin 95 includes a stem 95a and cap 95b arrangement that is dimensioned to engage through aperture 95' and 95" disposed in ends 16b and 16a, respectively. Upon assembly and as best illustrated in Figs. 13 and 14, the stem 95a of pivot pin 95 extends, in order, through end 16a of shaft 12, aperture 123a of jaw member 120, aperture 173a of half 170a or knife guide 170, aperture 173b of half 170b of knife guide 170, aperture 113a of jaw member 110 and end 16b of shaft 12 to engage cap 95b. Slots 16a' and 16b' are defined within distal ends 16a and 16b and are dimensioned to allow reciprocation of drive pin 139 therein. Stem 95a includes a pass through hole 96 defined therein that allows passage of the knife 190 therethrough for severing tissue while still allowing a large rotational surface area for the jaw members during loading.
Turning now to the cooperating components of the housing, Figs. 5A, 5B, 6A, 6B, 11 and 12 show the details of the housing 20 and the component features thereof, namely, the drive assembly 130, the rotating assembly 80, the knife actuating assembly 160, the trigger assembly 70 and the handles 40 and 50. More particularly, Figs. 5A and 5B show the above-identified assemblies and components in an assembled form in the housing 20 and Figs. 11 and 12 show an exploded view of each of the above-identified assemblies and components.
As mentioned above and as best shown in Figs. 11 and 12, the proximal end of shaft 12 is mechanically engaged to the housing 20. Housing 20 is formed from two (2) housing halves 20a and 20b, which each include a plurality of interfaces that are dimensioned to mechanically aiign and engage one another to form housing 20 and enclose the internal working components of forceps 10. As can be appreciated, fixed handle 50 that, as mentioned above, is integrally associated with housing 20, includes halves 50a and 50b that take the shape of handle 50 upon the assembly of the housing halves 20a and 20b.
A plurality of additional interfaces (not shown) may disposed at various points around the periphery of housing halves 20a and 20b for ultrasonic welding purposes, e.g., energy direction/deflection points. It is contemplated that ultrasonic welding provides better dimensional stability, strength and joint reliability that other, more traditional, methods. For example, the housing halves may be ultrasonically welded utilizing a combination of a primary weld joint using traditional triangular (or similar) energy directors to form a bonded joint coupled with a secondary hard stop surface (removed from the primary joint surface) for preventing over compression of the joint. A tertiary set of alignment pins may be utilized throughout the housing halves 20a and 20b, which are configured to both accurately align the halves 20a and 20b during assembly and provide strength and stability during manufacture, handling and transport.
Housing halves 20a and 20b (as well as the other components desc(bed below) may be assembled together in any suitable fashion. For example, alignment pins, snap-like interfaces, tongue and groove interfaces, locking tabs, adhesive ports, etc. may all be utilized either alone or in combination for assembly purposes.
As best seen in Figs. 11 and 12, rotating assembly 80 includes two C-shaped halves 80a and 80b that, when assembled, form the rotating assembly 80.
Half 80a includes a series of detents/flanges (not shown) that are dimensioned to engage a pair of corresponding sockets or other mechanical interfaces (not shown) disposed within rotating half 80b. Half 80a also includes a tab 84a (phantomly illustrated) that, together with a corresponding tab 84b disposed on half 80b, cooperate to matingly engage slot 80' disposed on shaft 12. As can be appreciated, this permits selective rotation of the shaft 12 about axis "A-A" by manipulating the rotating member 80 in the direction of the arrow "B", which, in turn, rotates the end effector assembly in the direction of arrow "C" (See Fig. 1A). The rotating assembly may include one or more mechanical interfaces that essentially lock the rotating assembly in a fully counter-clock wise rotational position or a fully clockwise rotational position. This may allow left-handed or right-handed orientations for the end effector assembly for particular users.
As mentioned above, and as best illustrated in Figs. 5A, 5B, 6A and 6B, the movable handle 40 includes clevis 46 that forms upper flanges 46a and 46b, which pivot about pins 45a and 45b to pull the reciprocating sleeve 134 along longitudinal axis "A-A" and force driving flanges 47a and 47b against the drive assembly 130, which, in turn, closes the jaw members 110 and 120. The various moving relationships of the flanges 47a and 47b and the drive assembly 130 are explained in more detail below with respect to the operation of the forceps 10. The arrangement of the driving flanges 47a and 47b and the pivot point 45 of the movable handle 40 provides a distinct mechanical advantage over conventional handle assemblies due to the unique position of the pivot pins 45a and 45b (i.e., pivot point) relative to the longitudinal axis "A-A" of the driving flanges 47a and 47b. In other words, by positioning the pivot pins 45a and 45b above the driving flanges 47a and 47b, the user gains lever-like mechanical advantage to actuate the jaw members 110 and 120. This reduces the overall amount of mechanical force necessary to close the jaw members 110 and 120 to affect a tissue seal.
Handle 40 also includes a finger loop 43 that defines opening 41, which is dimensioned to facilitate grasping the handle 40. In one embodiment, finger loop 43 includes a rubber insert that enhances the overall ergonomic "feel" of the handle member 40. A locking flange 49' is disposed on the outer periphery of the handle member 40 above the finger loop 43. Locking flange 49' may be designed as a safety lock out mechanism to prevent the trigger assembly 70 from firing when the handle member 40 is oriented in a non-actuated position, i.e., the jaw members 110 and 120 are open. As can be appreciated, this would prevent accidental or premature severing of tissue prior to completion of the tissue seal.
Fixed handle 50 includes halves 50a and 50b that, when assembled, form handle 50. Fixed handle 50 includes a channel 51 defined therein that is dimensioned to receive flange 42 in a proximal moving manner when movable handle 40 is actuated.
The t-shaped pin 44 of handle 40 is dimensioned for facile reception within channel 51 of handle 50. Flange 42 may be dimensioned to allow a user to selectively, progressively and/or incrementally move jaw members 110 and 120 relative to one another from the open to closed positions. For example, it is also contemplated that flange 42 may include a ratchet-like interface that lockingly engages the movable handle 40 and, therefore, jaw members 110 and 120 at selective, incremental positions relative to one another depending upon a particular purpose. Other suitable mechanisms may also be employed to control and/or limit the movement of handle relative to handle 50 (and jaw members 110 and 120) such as, e.g., hydraulic, semi-hydraulic, linear actuator(s), gas-assisted mechanisms and/or gearing systems.
As best illustrated in Figs. 5D and 12, housing halves 20a and 20b, when assembled, form an internal cavity 52 that predefines the channel 51 within fixed handle 50 adjacent the railway 55, which reciprocates t-shaped pin 44 therein. Once assembled, the railway 55 is seated within cavity 52 in registration with entrance pathway 51 for reciprocation of the flange 42. Flange 42 and the housing halves 20a and 20b are designed to facilitate accurate and consistent reception of the t-shaped pin 44 into railway 55.
During movement of the flange 42 along the entrance to channel 51, the t-shaped pin 44 rides through passage 53 along railway 55 and is forced into a catch basin or seat 55' to lock the handle 40 relative to handle 50. When the user releases the handle 40, the catch basin 55' retains the t-shaped pin 44 in a secured position relative to the handle 50 as explained in further detail below. Railway 55 may be seated on one or pivot elements 55a that allows the railway 55 to pivot upon reception of the t-shaped pin 44 therethrough. A spring element 57 biases the railway 55 to return to the original reception position once the t-shaped pin 44 is seated.
The railway 55, again, may pivot in response to release of the t-shaped pin 44 from catch basin 55'.
Actuation of the handle 40 along with the inter-cooperating elements of the drive assembly 130 close the jaw members 110 and 120 about tissue with a pre-determinable and consistent closure pressure to effect a tissue seal. As mentioned above, closure pressures for sealing large tissue structures preferably fall within the range of about 3kg/cm2 to about 16 kg/cmZ.
When handle 40 is regrasped, the t-shaped pin 44 is forced out of or disengaged from the catch basin 55' and moves along an exit pathway to release handle 40 from channel 51. A spring or other biasing member 57 may be employed to facilitate securing the flange 42 within the catch basin 55' and also configured to facilitate release of the flange 42 from catch basin 55' upon re-grasping of the handle 40.
As explained in more detail below, once actuated, handle 40 moves in a generally arcuate fashion towards fixed handle 50 about pivot pins 45a and 45b, which forces driving assembly 130 proximally that, in turn, pulls reciprocating sleeve 134 in a generally proximal direction to close jaw members 110 and 120 relative to one another.
As best shown in Figs. 5A, 5B and 11, the drive assembly 130 mounts atop the proximal portion of the drive sleeve 134. A pair of retaining rings or clips 131' and 131" (See Fig. 11) cooperate with a corresponding pair of relieved portions 133a and 133b disposed on the drive sleeve 134 to mount the drive assembly 130 atop the drive sleeve 134 such that relative movement of the drive assembly correspondingly moves the drive sleeve 134. As handle 40 pivots about pivot point 45 and moves relative to handle 50 and flange 42 is incorporated into charinel 51 of fixed handle 50, the driving flanges 47a and 47b, through the mechanical advantage of the above-the-center pivot point, force the drive assembly 130 proximally against spring 131.
As a result thereof, drive sleeve 134 reciprocates proximally, which, in turn, closes the jaw members 110 and 120. The utilization of an over-the-center pivoting mechanism will enable the user to selectively compress the coil spring 131 a specific distance, which, iri turn, imparts a specific load on the reciprocating sleeve 134 that is converted to a rotational torque about the jaw pivot pin 95. As a result, a specific closure force can be transmitted to the opposing jaw members 110 and 120.
Figs. 5A and 5B show the initial actuation of handle 40 towards fixed handle 50 that causes the pin 44 of flange 42 to move generally proximally and upwardly along entrance pathway 51. During movement of the flange 42 along the entrance pathway 51, respectively, the t-shaped pin 44 rides through passageway 53 aiong railway 55 as explained above. Once the desired position for the sealing site is determined and the jaw members 110 and 120 are properly positioned, handle 40 may be compressed fully such that the t-shaped pin 44 of flange 42 seats within catch basin 55'. Once pin 44 clears an edge or passes a predetermined point in the passageway 53 at the edge of the catch basin 55', releasing movement of the handle 40 and flange 42 is redirected into a catch basin 55'.
More particularly, upon a slight reduction in the closing pressure of handle 40 against handle 50, the handle 40 returns slightly distally towards entrance pathway 51 but is re-directed to seat within catch basin 55. At this point, the release or return pressure between the handles 40 and 50, which is attributable and directly proportional to the release pressure associated with the compression of the drive assembly 130, causes the pin 44 of flange 42 to settle or lock within catch basin 55'.
Handle 40 is now secured in position within fixed handle 50, which, in turn, locks the jaw members 110 and 120 in a closed position against the tissue.
As mentioned above, the jaw members 110 and 120 may be opened, closed and rotated to manipulate tissue until sealing is desired. This enables the user to position and re-position the forceps 10 prior to activation and sealing. As illustrated in Fig. 1A, the end effector assembly 100 is rotatable about longitudinal axis "A-A"
through rotation of the rotating assembly 80. As explained in more detail below, the uriique feed path of the cable leads 325a and 325b through the rotating assembly 80, along shaft 12 and, ultimately, to the jaw members 110 and 120 enables the user to rotate the end effector assembly 100 about 180 degrees across the clockwise and counterclockwise directions without tangling or causing undue strain on cable leads 325a and 325b. As can be appreciated, this facilitates the grasping and manipulation of tissue.
As best shown in Figs. 5A, 5B, 6A, 9A, 9B, 11 and 12, trigger assembly 70 mounts atop movable handle 40 and cooperates with the knife assembly 160 to selectively translate knife 190 through a tissue seal. More particulady, the trigger assembly 70 includes a U-shaped finger actuator 71 having a pair upwardly-extending flanges 71a and 71b. A pivot pin 179 extends through a pair of apertures 162a and 162b in each of the flanges 71 a and 71 b, respectively, to mount the trigger assembly 70 to a knife carriage 165, as explained in more detail below. Finger actuator 71 is selectively pivotable within a pre-defined slot 21 disposed within housing 20 (See Fig.
6A). More particularly, a pair of pivots 77a and 77b is disposed on either side of the finger actuator 71 and are configured to mount between housing halves 20a and 20b to pivot the finger actuator within slot 21.
The knife assembly 160 includes a reciprocating knife bar 167 that mounts atop the drive sleeve 134 and between upwardly extending flanges 71a and 71b. Knife bar 167 includes a t-shaped proximal end 167' and a cuff 137 disposed at the distal end thereof. Cuff 137 is dimensioned to encapsulate drive sleeve 134 when the knife assembly 160 is assembled. A spring 76 biases the cuff in a proximal-most orientation. Proximal end 167' is dimensioned to mount and slidingly reciprocate within a slot 167" formed by housings 20a and 20b at assembly (See Fig. 12). A
locking cap 137a and a mounting pin 179 secure the cuff 137 to the proximal end 193b of the knife rod 193 through aperture 197 disposed therein such that proximal movement to the finger actuator 71 results in distal movement of the knife bar 193. Cuff 137 and cap 137a also allow 360 degrees of rotation of the drive sleeve 134 therethrough.
As mentioned above,, a knife carriage 165 mounts to the upwardly extending flanges 71a and 71b of the finger actuator 71. More particularly, the distal end 162 of the knife carriage 165 is t-shaped and includes two laterally extending pins 162c and 162d that engage apertures 162a and 162b, respectively, in flanges 71 a and 71b. The proximal end 161 of the knife carriage 165 includes an aperture 161a defined therein that mates with a detent 167a that extends transversally through knife carriage 165.
As best illustrated in Figs. 5A-7, when the handle 40 is disposed in a spaced-apart or open configuration relative to handle 50, flange 49', which extends from handle 40, prevents actuation of the trigger assembly 70. More particularly, finger actuator 71 is prevented from being actuated proximally by flange 49' when the jaw members 110 and 120 are open. As can be appreciated, this prevents premature actuation of the knife 190 when tissue is not grasped between jaw members 110 and 120. When handle 40 is selectively moved relative to handle 50, a gap 21 is formed between the flange 49' and the finger actuator 71 (See Fig. 5B). Thus, the user is free to selectively actuate the knife 190 by squeezing the finger actuator 71 proximally within gap 21.
As best shown in Figs. 6B, 7 and 8A, once the clearance is provided by movement of handle 40, proximal movement of the finger actuator 71 about pivot results in distal translation of the knife bar 167, which, in turn, results in distal translation of the knife rod 193 and kriife 190. More particularly, when finger actuator 71 is squeezed proximally, the U-shaped flanges 71 a and 71 b rotate about pivot 74 to abut cuff 137 and essentially throw the knife carriage 165 forward, which, in turn, carries the knife bar 167 forward to force the knife rod 193 distally. Slot 167" is configured to smoothly guide the knife bar 167 distally through the forward and return stroke. As shown in Figs. 10A and 10BC, distal translation of the knife rod 193 translates the knife 190 through channel 115 in the jaw members 110 and 120. As mentioned above, the knife rod 193 mounts the knife 190 via one or more mechanically interfacing elements or may be affixed in any known manner in the art. A slot 197 defined within the knife 190 provides clearance for pin 139 of the drive sleeve 134 during reciprocation of the knife 190. Upon release of finger actuator 71, spring 76 biases the knife assembly back to a proximal-most position. The knife bar 167 provides variable mechanical advantage and linear advantage when triggering the knife 190. In addition, the incorporation of the knife bar 167 significantly reduces friction loss and provides smoother mechanical cutting than previously known methods.
Turning now in detail to the operation of the drive assembly as best seen in Figs. 5A, 5B, 11 and 12, drive assembly 130 includes reciprocating sleeve 134, drive housing 135, spring 131, drive rings 135a and 135b, drive stops 135c and 135d and retaining nngs 131' and 131", which all cooperate to form the drive assembly 130. Stop 135c may be removed and ring 131" would perform stop 135c's intended function.
The proximal end 132 of the reciprocating sleeve 134 is positioned within an aperture 135' defined through the drive housing 135 to permit selective reciprocation of the drive sleeve 134 therethrough upon actuation of the movable handle 40. The spring 131 is assembled atop the drive housing 135 between a rear stop 135d and ring 135b such that movement handle 40 about pivot 45 moves the entire drive assembly 130 and sleeve 134 proximally, which, in tum, pulls cam pin 139 proximally to close the jaw members 110 and 120. Once the jaw members 110 and 120 close about tissue, the drive assembly 130 essentially bottoms out (i.e., further proximal movement of the reciprocating sleeve is prevented) and further movement of handle 40 about pivot 45 compresses spring 131 resulting in additional closure force on the tissue.
Moreover, spring 131 also tends to bias the jaw mernbers 110 and 120 and the movable handle 40 in an open configuration.
Tuming back to Fig. 12, which shows the exploded view of the housing 20, rotating assembly 80, trigger assembly 70, movable handle 40 and fixed handle 50, all of these various component parts along with the shaft 12 and the end effector assembly 100 are assembled during the manufacturing process to form a partially and/or fully disposable forceps 10. For example and as mentioned above, the shaft 12 and/or end effector assembly 100 may be disposable and, therefore, selectively/releasably engageable with the housing 20 and rotating assembly 80 to form a partially disposable forceps 10 and/or the entire forceps 10 may be disposable after use.
As best seen in Figs. 5A, 5B and 13, once assembled, spring 131 is poised for compression atop drive housing 135 upon actuation of the movable handle 40. More particularly, movement of the handle 40 about pivot pins 45a and 45b reciprocates the flange 42 into fixed handle 50 and forces drive assembly 130 to compress spring 131 against the rear stop 135d to reciprocate the sleeve 134.
As mentioned above, the trigger assembly 70 is initially prevented from firing by the locking flange 49' disposed on movable handle 40, which abuts against the trigger assembly 70 prior to actuation. The opposing jaw members 110 and 120 may be rotated and partially opened and_ closed without unlocking the trigger assembly 70, which, as can be appreciated, allows the user to grip and manipulate the tissue without premature activation of the knife assembly 160. As mentioned below, only when the t-shaped pin 44 of flange 42 is completely reciprocated within channel 51 of the fixed handle 50 and seated within pre-defined catch basin 55' will the locking flange 49' allow full activation of the trigger assembly 70. The operating features and relative movements of these internal working components of the forceps 10 are shown by phantom representation and directional arrows and are best illustrated in the various figures.
The mechanical advantage of the over-the-center pivot may enable the user to selectively compress the coil spring 131 a specific distance, which, in turn, imparts a specific load on the reciprocating sleeve 134. The reciprocating sleeve's 134 load is converted to a torque about the jaw pivot 95. As a result, a specific closure force can be transmitted to the opposing jaw members 110 and 120. As mentioned above, the jaw members 110 and 120 may be opened, closed and rotated to manipulate tissue until sealing is desired without unlocking the trigger assembly 70.
This enables the user to position and re-position the forceps 10 prior to activation and sealing. More particularly, as illustrated in Fig. IA, the end effector assembly 100 is rotatable about longitudinal axis "A-A" through rotation of the rotating assembly 80.
Once the desired position for the sealing site is determined and the jaw members 110 and 120 are properly positioned, handle 40 may be compressed fully such that the t-shaped pin 44 of flange 42 clears a pre-defined railway edge located atop the railway 55. Once end 44 clears the railway edge, the end 44 is directed into catch basin 55' to lock the handle 40 relative to handle 50. The release or return pressure between the handles 40 and 50, which is attributable and directly proportional to the release pressure associated with the compression of the drive assembly 130, causes the end 44 of flange 42 to settle or lock within catch basin 55'.
Handle 40 is now secured in position within fixed handle 50, which, in turn, locks the jaw members 110 and 120 in a closed position against the tissue.
At this point the jaws members 110 and 120 are fully compressed about the tissue. Moreover, the forceps 10 is now ready for selective application of electrosurgical energy and subsequent separation of the tissue, i.e., as t-shaped end 44 seats within catch basin 55', locking flange 49' moves into a position to permit activation of the trigger assembly 70.
As the t-shaped end 44 of flange 42 seats within catch basin 55', a proportional axial force on the reciprocating sleeve 134 is maintained, which, in tum, maintains a compressive force between opposing jaw members 110 and 120 against the tissue. The end effector assembly 100 and/or the jaw members 110 and 120 may be dimensioned to ofi-load some of the excessive clamping forces to prevent mechanical failure of certain internal operating elements of the end effector 100.
As can be appreciated, the combination of the mechanical advantage of the over-the-center pivot along with the compressive force associated with the compression spring 131 facilitate and assure consistent, uniform and accurate closure pressure about the tissue within the desired working pressure range of about 3 kg/cm2 to about 16 kg/cm2 and, desirably, about 7 kg/cm2 to about 13 kg/cm2. By controlling the intensity, frequency and duration of the electrosurgical energy applied to the tissue, the user can treat tissue, i.e., seal tissue.
As mentioned above, two mechanical factors play an important role in determining the resulting thickness of the sealed tissue and effectiveness of the seal, i.e., the pressure applied between opposing jaw members 110 and 120 and the gap distance "G" between the opposing sealing surfaces 112, 122 of the jaw members and 120 during the sealing process. However, thickness of the resulting tissue seal cannot be adequately controlled by force alone. In other words, too much force and the two jaw members 110 and 120 would touch and possibly short resulting in little energy traveling through the tissue thus resulting in a bad tissue sea1450. Too little force and the seal would be too thick.
Applying the correct force is also important for other reasons: to oppose the walls of the vessel; to reduce the tissue impedance to a low enough value that allows enough current through the tissue; and to overcome the forces of expansion during tissue heating in addition to contributing towards creating the required end tissue thickness, which is an indication of a good seal.
In one embodiment, the electrically conductive sealing surfaces 112 and 122 of the jaw members 110 and 120, respectively, are relatively flat to avoid current concentrations at sharp edges and to avoid arcing between high points. In addition and due to the reaction force of the tissue when engaged, jaw members 110 and 120 can be manufactured to resist bending. For example, the jaw members 110 and 120 may be tapered along the width thereof, which is advantageous for two reasons: 1) the taper will apply constant pressure for a constant tissue thickness at parallel; 2) the thicker proximal portion of the jaw members 110 and 120 will resist bending due to the reaction force of the tissue.
As mentioned above, at least one jaw member, e.g., 120, may include one or more stop members 90 that limit the movement of the two opposing jaw members 110 and 120 relative to one another. In one embodiment, the stop members 90 extend from the sealing surface 122 a predetermined distance according to the specific material properties (e.g., compressive strength, thermal expansion, etc.) to yield a consistent and accurate gap distance "G" during sealing (Fig. 10B). It is envisioned for the gap distance between opposing sealing surfaces 112 and 122 during sealing ranges from about 0.001 inches to about 0.006 inches and, desirably, between about 0.002 and about 0.005 inches. In one embodiment, the non-conductive stop members 90 are molded onto the jaw members 110 and 120 (e.g., overmolding, injection molding, etc.), stamped onto the jaw members 110 and 120 or deposited (e.g., deposition) onto the jaw members 110 and 120. For example, one technique involves themially spraying a ceramic material onto the surface of the jaw member 110 and 120 to form the stop members 90. Several thermal spraying techniques are contemplated that involve depositing a broad range of heat resistant and insulative materials on various surfaces to create stop members 90 for controlling the gap distance between electrically conductive surfaces 112 and 122.
As energy is being selectively transferred to the end effector assembly 100, across the jaw members 110 and 120 and through the tissue, a tissue seal forms isolating two tissue halves. At this point and with other known vessel sealing instruments, the user may remove and replace the forceps 10 with a cutting instrument (not shown) to divide the tissue halves along the tissue seal. As can be appreciated, this is both time consuming and tedious and may result in inaccurate tissue division across the tissue seal due to misalignment or misplacement of the cutting instrument along the ideal tissue cutting plane.
As explained in detail above, the present disclosure incorporates knife assembly 160 that, when activated via the trigger assembly 70, progressively and selectively divides the tissue along an ideal tissue plane in a precise manner to effectively and reliably divide the tissue into two sealed halves. The knife assembly 160 allows the user to quickly separate the tissue immediately after sealing without substituting a cutting instrument through a cannula or trocar port. As can be appreciated, accurate sealing and dividing of tissue is accomplished with the same forceps 10.
Knife blade 190 may also be coupled to the same or an alternative electrosurgical energy source to facilitate separation of the tissue along the tissue seal.
Moreover, the angle of the trip of the knife blade 190 may be dimensioned to provide more or less aggressive cutting angles depending upon a particular purpose.
For example, the knife blade 190 may be positioned at an angle that reduces "tissue wisps"
associated with cutting. Moreover, the knife blade 190 may be designed having different blade geometries such as serrated, notched, perforated, hollow, concave, convex etc. depending upon a particular purpose or to achieve a particular result. The knife assembly 160 generally cuts in a progressive, uni-directional fashion (i.e., distally).
Once the tissue is divided into tissue halves, the jaw members 110 and 120 may be opened by re-grasping the handle 40 as explained below. Re-initiation or re-grasping of the handle 40 again moves t-shaped pin 44 of flange 42 generally proximally.
As best shown in Fig. 13, the proximal portions of the jaw members 110 and 120 and the distal end 16 of shaft 12 may be covered by a resilient or flexible insulating material 185 to reduce stray current concentrations during electrosurgical activation. The tail or proximal end of the jaw members 110 and 120 may be removed and covered with an extended section of the guide element 170 creating a semi insulative barrier to reduce stray current concentrations during electrosurgical activation. An insulating boot (not shown) may also be positioned atop the proximal portions of the jaw members 110 and 120 to further reduce current concentrations and stray currents from damaging adjacent tissue. Details relating to one envisioned insulating boot 220 are described with respect to commonly-owned U.S.
Provisional Application Serial No. 60/722,213 entitled "INSULATING BOOT FOR
ELECTROSURGICAL FORCEPS", which is incorporated by reference herein.
Switch 60 is ergonomically dimensioned and conforms to the outer shape of housing 20 (once assembled). Switch 60 is designed to electromechanically cooperate with a flex circuit 400 (See Fig. 6C) to allow a user to selectively activate the jaw members 110 and 120. It is contemplated that a flex circuit design facilitates manufacturing due to the circuit unique ability to conform as needed into tightly spaced areas. The switch 60 may also permit the user to selectively activate the forceps 10 in a variety of different orientations, i.e., multi-oriented activation or toggle-like activation.
As can be appreciated, this simplifies activation. Switch 60 may also be designed as a so called "dome switch", which also provides tactile feedback to the user when activated.
When switch 60 is depressed, trigger lead 310b carries the first electrical potential to jaw member 110 thus completing a bipolar circuit. More particularly, when switch 60 is depressed and flex circuit 400 is activated, the generator recognizes a voltage drop across leads 310a and 310c, which initiates activation of the generator to supply a first electrical potential to jaw member 110 and a second electrical potential to jaw member 120. Switch 60 acts as a control circuit and is protected or removed from the actual current loop that supplies electrical energy to the jaw members 110 and 120.
This reduces the chances of electrical failure of the switch 60 due to high current loads during activation. A footswitch (not shown), which may also be utilized with the forceps 10, also operates in a similar manner, i.e., upon activation of the footswitch, the generator recognizes a voltage drop across the input and output leads of the footswitch, which, in turn, signals the generator to initiate electrosurgical activation of the jaw members 110 and 120.
A safety switch or circuit (not shown) may be employed such that the switch cannot fire unless the jaw members 110 and 120 are closed and/or unless the jaw members 110 and 120 have tissue held therebetween.
In the latter instance, a suitable sensor (not shown) may be employed to determine if tissue is held therebetween. In addition, other sensor mechanisms may be employed that determine pre-surgical, concurrent surgical (i.e., during surgery) and/or post surgical conditions. The sensor mechanisms may also be utilized with a closed-loop feedback system coupled to the electrosurgical generator to regulate the electrosurgical energy based upon one or more pre-surgical, concurrent surgical or post surgical conditions.
The conductive surfaces 115a and 115b are electrically isolated from one another and jaw members 110 and 120 such that electrosurgical energy can be effectively transferred through the tissue to form the seal. The cable leads 310b and 325b are held loosely but securely along the cable path to permit rotation of the jaw members 110 and 120 about longitudinal axis "A" (See Fig 1A). More particularly, cable leads 310b and 325b are fed through respective halves 80a and 80b of the rotating assembly 80 in such a manner to allow rotation of the shaft 12 (via rotation of the rotating assembly 80) in the clockwise or counter-clockwise direction without unduly tangling or twisting the cable leads 310b and 325b. The presently disclosed cable lead feed path may allow rotation of the rotation assembly approximately 180 degrees in either direction.
From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. For example, it may be preferable to add other features to the forceps 10, e.g., an articulating assembly to axially displace the end effector assembly 100 relative to the elongated shaft 12.
It is also contemplated that the forceps 10 (and/or the electrosurgical generator used in connection with the forceps 10) may include a sensor or feedback mechanism (not shown) that automatically selects the appropriate amount of electrosurgical energy to effectively seal the particularly-sized tissue grasped between the jaw members 110 and 120. The sensor or feedback mechanism may also measure the impedance across the tissue during sealing and provide an indicator (visual and/or audible) that an effective seal has been created between the jaw members 110 and 120.
Moreover, the trigger assembly 70 may include other types of recoil mechanism that are designed to accomplish the same purpose, e.g., gas-actuated recoil, electrically-actuated recoil (i.e., solenoid), etc. The forceps 10 may also be used to cut tissue without sealing. Alternatively, the knife assembly 70 may be coupled to the same or alternate electrosurgical energy source to facilitate cutting of the tissue.
The outer surface of the end effector assembly 100 may include a nickel-based material, coating, stamping, metal injection molding that is designed to reduce adhesion between the jaw members 110 and 120 with the surrounding tissue during activation and sealing. Moreover, the conductive surfaces 112 and 122 of the jaw members 110 and 120 may be manufactured from one (or a combination of one or more) of the following materials: nickel-chrome, chromium nitride, MedCoat manufactured by The Electrolizing Corporation of OHIO, inconel 600 and tin-nickel.
The tissue conductive surfaces 112 and 122 may also be coated with one or more of the above materials to achieve the same result, i.e., a "non-stick surface".
As can be appreciated, reducing the amount that the tissue "sticks" during sealing improves the overall efficacy of the instrument.
One particular class of materials disclosed herein has demonstrated superior non-stick properties and, in some instances, superior seal quality.
For example, nitride coatings that include, but not are not limited to: TiN, ZrN, TiAIN, and CrN are preferred materials used for non-stick purposes. CrN has been found to be particularly useful for non-stick purposes due to its overall surface properties and optimal performance. Other classes of materials have also been found to reducing overall sticking. For example, high nickel/chrome alloys with a Ni/Cr ratio of approximately 5:1 have been found to significantly reduce sticking in bipolar instrumentation. One particularly useful non-stick material in this class is Inconel 600.
Bipolar instrumentation having sealing surfaces 112 and 122 made from or coated with Ni200, Ni201 (-100% Ni) also showed improved non-stick performance over typical bipolar stainless steel electrodes.
As can be appreciated, locating the switch 60 on the forceps 10 has many advantages. For example, the switch 60 reduces the amount of electrica{ cable in the operating room and eliminates the possibility of activating the wrong instrument during a surgical procedure due to "line-of-sight" activation. Moreover, the switch 60 may be configured such that it is mechanically or electro-mechanically decommissioned during trigger activation to eliminate u ri intentionally activating the device during the cutting process. The switch 60 may also be disposed on another part of the forceps 10, e.g., the fixed handle 50, rotating assembly 80, housing 20, etc.
The forceps 10 may be equipped with an automatic, electro-mechanical release mechanism (not shown) that releases the tissue once an end seal is determined (i.e., end-tone signal from the generator). For example, an electromechanical interface may be configured to automatically release the t-shaped pin 44 from catch basin 55 upon an end tone condition.
It is also contemplated that the forceps 10 may be dimensioned to include a trigger assembly 70 that operates in lieu of the switch assembly 60 to activate the forceps to seal tissue while also advancing the knife 190 to divide the tissue across the seal. For example, the trigger assembly 70 could be configured to have two stages: a first or initial stroke stage that activates the generator to selectively seal tissue; and a second or subsequent stage that advances the knife through the tissue.
Alternatively, another embodiment may include a trigger assembly that simultaneously activates the jaw members 110 and 120 to seal tissue and advances the knife 190 through the tissue during activation.
The rotating assembly 80 may be equipped with one or more mechanical interfaces that are rotatable with or within the rotating assembly 80 and that are configured to produce tactile and/or audible feedback to the user during rotation. The tactile and/or audible feedback (i.e., a "click") may be configured to correspond to a particular degree of rotation of the end effector assembly 100 about the axis "A". It is also contemplated that one or more types of visual indicia may also be employed with the rotating assembly 80 to correspond to the amount or degree of rotation of the end effector assembly 100 and may be designed correspond to or relate to the audible and/or tactile feedback depending upon a particular purpose.
Another version of the forceps 10 may include a telescoping shaft that allows the user to selectively regulate the length of the instrument for particular surgical purposes. For example, the shaft may include two slidingly reciprocatable and extendible elements that, upon exertion (i.e., pulling, twisting, or by virtue of a mechanical lever on the handle), either lengthen or shorten the size of the elongated shaft 12 depending upon a particular surgical purpose.
Moreover, it is also contemplated that the diameter of shaft 12 may be selectively expandable depending upon a particular surgical purpose or to provide rigidity of the forceps 10 inside the surgical cavity or to enhance the sealing effect of the shaft through a trocar. More particularly, it is contemplated that the shaft 12 may be configured to expand upon exertion (i.e., twisting or rotating one element inside another (iris-like), sliding a mechanical lever, an inflatable system, a mechanically expanding system or other types of known expansion systems). As a result, the surgeon can selectively expand the outer diameter of the shaft 12 to enhance the rigidity of the shaft 12 within a trocar and/or erihance the sealing effect of the shaft 12 within the trocar to reduce the possibility of pressure leakage from surgical cavity during use.
Moreover, a single forceps may be selectively adaptable to work with differently-sized trocars and/or cannulas, which may prove advantageous for particular operations and other surgical procedures.
It is also contemplated that the forceps 10 may be configured such that handle 50 is selectively replaceable or selectively positionable depending upon user preference. For example, handle 50 may be selectively detached and replaced with another handle 50 that is of different dimension (i.e., size, weight, angle, orientation to user's hand, etc.), which facilitates handling during surgical procedures.
Alternatively, handle 50 may be selectively positionable relative to the housing 20 (i.e., the angle of the handle to the housing is adjustable) to facilitate handling and use during particuiar surgical procedures or for user comfort.
The forceps may be configure to include a visual indicator (which cooperates with the "end tone" indicator on the generator) to provide visual confirmation of a successful seal (e.g., a green LED indicator). The visual indicator (not shown) may be employed on or in connection with the end effector assembly 100 or shaft 12 that is in line-of-site of the surgeon during use. The visual indicator may also be designed to warn the user of a mis-seal condition or a re-grasp condition (e.g., a red LED
indicator).
Alternatively, the visual indicator may also be configured to provide progressive feedback of the formation of the seal during the seaiing process. For example, a series of LEDs may be employed on the end effector assembly 100 (or shaft 12) that progressively illuminate through the sealing process to provide visual feedback to the user regarding the status of the seal. Moreover, one or both jaw members may include visual markings that indicate the end of a seal and/or the length of the seal cut.
The guide element 170 (See Fig. 14) may be configured to not only guide the knife 190 into the knife channel 115 disposed between the jaw members 110 and 120, but may also be dimensioned to precisely space the jaw mernbers 110 and relative to one another about the pivot 95. Moreover, the guide element 170 may be configured to include one or more grooves of tracks (not shown) to guide the electrical connections or wires 310b and 325b through the end effector assembly 100. The guide element 170 may also be configured to limit the distal movement of the drive rod 193 for the knife 190, which, in turn, limits the overall travel of the knife 190 through the knife channel 115. The distal end of the guide element may be extended to work with the overmolded jaw elements 116 and 126 to create a set of tissue blocking features that inhibit tissue from getting behind or moving proximal to the active electrode surface.
The stem 95a of the pivot pin 95 may include a stepped diameter that securely compresses the jaw members 110 and 120 together when mechanically secured with the cap 95b. Moreover, the pivot may be dimensioned to include a pass through or aperture 96 that allows translation of the knife therethrough. The two-piece pivot 95 including stem 95a and cap 95b may be assembled during the manufacturing process by any one of several known manufacturing techniques including: laser or heat-based welding, press-fit mechanical interaction (or other mechanically interlocking geometry, adhesives, chemical bonding, etc.
The shaft may be dimensioned to enhance visibility and/or non-symmetric depending upon a particular purpose, For example, it is contemplated that the shaft may be generally oval in dimension thereby providing uni-directional strength in one dimension versus another and maximized visibility to the operating site in one direction versus another. Alternatively, the shaft may be other geometric configurations depending upon a particular purpose, I-beam, square, poiygonal, etc.
The end effector assembly 100 is optimized for reengaging long tissue sections and visibility of the operating site. The jaw members 110 and 120 may also be dimensioned to include distal ends configured for gross or biunt dissection.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the ciaims appended hereto.
BACKGROUND
The present disclosure relates to an electrosurgical forceps and, more particularly, to an endoscopic bipolar electrosurgicai forceps for sealing and/or cutting large tissue structures.
Technical Field Electrosurgical forceps utilize both mechanical clamping action and electrical energy to affect hemostasis by heating the tissue and blood vessels to coagulate, cauterize and/or seal tissue. Many surgical procedures require cutting and/or ligating large blood vessels and large tissue structures. Due to the inherent spatial considerations of the surgical cavity, surgeons often have difficulty suturing vessels or performing other traditional methods of controlling bleeding, e.g., clamping and/or tying-off transected blood vessels or tissue. By utilizing an elongated electrosurgical forceps, a surgeon can either cauterize, coagulate/desiccate and/or simply reduce or slow bleeding simply by controlling the intensity, frequency and duration of the electrosurgical energy applied through the jaw members to the tissue. Most small blood vessels, i.e., in the range below two millimeters in diameter, can often be closed using standard electrosurgical instruments and techniques. However, larger vessels can be more difficult to close using these standard techniques.
In order to resolve many of the known issues described above and other issues relevant to cauterization and coagulation, a recently developed technology has been developed by Valleylab, Inc. of Boulder, Colorado, called vessel or tissue sealing.
The process of coagulating vessels is fundamentally different than electrosurgical vessel sealing. For the purposes herein, "coagulation" is defined as a process of desiccating tissue wherein the tissue cells are ruptured and dried. "Vessel sealing" or "tissue sealing"
is defined as the process of liquefying the collagen in the tissue so that it reforms into a fused mass with limited demarcation between opposing tissue structures.
Coagulation of small vessels is sufficient to permanently close them, while larger vessels and tissue need to be sealed to assure permanent closure.
In order to effectively seal larger vessels (or tissue) two predominant mechanical parameters are accurately controlled - the pressure applied to the vessel (tissue) and the gap distance between the electrodes - both of which are affected by the thickness of the sealed vessel. More particularly, accurate application of pressure is important to oppose the walls of the vessel; to reduce the tissue impedance to a low enough value that allows enough electrosurgical energy through the tissue; to overcome the forces of expansion during tissue heating; and to contribute to the end tissue thickness, which is an indication of a good seal.
As mentioned above, in order to properly and effectively seal larger vessels or tissue, a greater closure force between opposing jaw members is required.
It is known that a large closure force between the jaws typically requires a large moment about the pivot for each jaw. This presents a design challenge because the jaw members are typically affixed with pins that are positioned to have small moment arms with respect to the pivot of each jaw member. A large force, coupled with a small moment arm, is undesirable because the large forces may shear the pins. As a result, designers compensate for these large closure forces by either designing instruments with metal pins and/or by designing instruments that at least partially offload these closure forces to reduce the chances of mechanical failure. As can be appreciated, if metal pivot pins are employed, the metal pins should be insulated to avoid the pin acting as an alternate current path between the jaw members, which may prove detrimental to effective sealing.
Increasing the closure forces between electrodes may have other undesirable effects, e.g., it may cause the opposing electrodes to come into close contact with one another, which may result in a short circuit and a small closure force may cause pre-mature movement of the tissue during compression and prior to activation.
As a result thereof, providing an instrument that consistently provides the appropriate closure force between opposing electrode within a preferred pressure range will enhance the chances of a successful seal. As can be appreciated, relying on a surgeon to manually provide the appropriate closure force within the appropriate range on a consistent basis would be difficult and the resultant effectiveness and quality of the seal may vary. Moreover, the overall success of creating an effective tissue seal is greatly reliant upon the user's expertise, vision, dexterity, and experience in judging the appropriate closure force to uniformly, consistently and effectively seal the vessel. In other words, the success of the seal would greatly depend upon the ultimate skill of the surgeon rather than the efficiency of the instrument.
It has been found that the pressure range for assuring a consistent and effective seal for large vessels and tissue structures is between about 3 kg/cm2 to about 16 kg/cm2 and, desirably, within a working range of 7 kg/cm2 to 13 kg/cm2. As can be appreciated, manufacturing an instrument that is capable of consistently providing a closure pressure within these working ranges is quite a design challenge for instrument manufacturers.
Various force-actuating assemblies have been developed in the past for providing the appropriate closure forces to affect vessel sealing. For example, one such actuating assembly has been developed by Valleylab, Inc. of Boulder, Colorado, for use with Valleylab's vessel sealing and dividing instrument for sealing large vessels and tissue structures commonly sold under the trademark LIGASURE ATLAS . The LIGASURE ATLAS is presently designed to fit through a 10mm cannula and includes a bi-lateral jaw closure mechanism and is activated by a foot switch.
Other force-actuating assemblies have also been developed by the Valleylab, Inc. of Boulder, Colorado, for use with Valleylab's vessel sealing and dividing instrument for sealing large vessels and tissue structures commonly sold under the trademark LIGASURE 5mm." The LIGASURE 5mmT" is presently designed to fit through a 5mm cannula and includes a unilateral jaw closure mechanism and is activated by a hand switch.
SUMMARY
The forceps includes a housing, a shaft having a longitudinal axis defined therethrough, a drive assembly and a movable handle. The shaft includes an end effector assembly having a pair of jaw members attached to a distal end thereof. The jaw members are movable from a first position in spaced relation to one another to at least a second position doser to one another. The jaw members are for grasping tissue therebetween. Each of the jaw members is adapted to connect to an electrosurgical energy source, thus enabling the jaw members to conduct energy through tissue held between the jaw members to create a tissue seal.
The drive assembly moves the jaw members relative to one another from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for manipulating tissue. The movable handle is rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions. The pivot is located a fixed distance above the longitudinal axis and the drive flange is located generally along the longitudinal axis. This mechanical arrangement creates level-iike mechanical advantage about the pivot to facilitate closing the jaw members about tissue. The forceps also includes a knife assembly having a generally t-shaped movable knife bar that is dimensioned to operatively engage a corresponding slot defined within the housing. The slot guides the movement of the knife bar during translation thereof.
In one embodiment, the knife bar is operatively coupled to a knife slidingly disposed within the shaft. The forceps further includes a finger actuator operatively coupled to the knife assembly wherein movement of the finger actuator moves the knife bar, which, in turn, moves the knife to cut tissue disposed between the jaw members.
In another embodiment, the shaft includes a drive sleeve slidingly disposed therein that operatively connects to the drive assembly for moving the jaw members and the knife assembly includes a cuff at the distal end of the knife bar. The cuff is dimensioned to encapsulate and move atop the drive sleeve upon movement of the knife bar. The forceps may also include a finger actuator operatively connected to the knife assembly.
The finger actuator includes two generally u-shaped flanges that rotate about a pivot to abut and force the cuff distally, which, in turn, results in distal translation of the knife bar.
In yet another embodiment, a spring is included that biases the knife assembly in a proximal-most orientation. A rotating assembly is also included and is configured to rotate the jaw members about the longitudinal axis defined through the shaft, A hand switch may also be included within the housing that is adapted to connect to the source of electrosurgical energy. The hand switch allows a user to selectively supply bipolar energy to the jaw members to affect a tissue seal.
At least one of the jaw members includes a series of stop members disposed thereon for regulating the distance between the jaw members during sealing.
The present disclosure also relates to a bipolar forceps that includes a housing having a shaft affixed thereto. The shaft includes jaw members attached at a distal end thereof having a longitudinal axis defined therethrough. The jaw members are adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal. The forceps also includes a drive assembly that moves the jaw member relative to one another about a pivot from a first position wherein the jaw members are disposed in spaced relation relative to one another to a second position wherein the jaw members are closer to one another for manipulating tissue.
A movable handle is included that is rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions. The pivot is located a fixed distance above the longitudinal axis and the drive flange is located generally along the longitudinal axis. A trigger assembly is included that is operatively coupled to the housing and operatively coupied to a knife assembly. The knife assembly includes a drive rod that, upon actuation of the trigger assembly, selectively translates a knife through tissue disposed between the jaw members. A knife guide may also be included that is dimensioned to facilitate alignment and translation of the knife through and into a knife channel defined between the jaw members.
In one embodiment, the knife guide includes two engageable halves that insulate the jaw members from one another. The knife guide may also include one or more apertures defined therein that allow the pivot to extend therethrough.
The drive assembly may also include a cam pin at a distal end thereof that operatively engages the jaw members and the knife guide may be configured to include one or more slots defined therein that allow the cam pin to extend therethrough.
In another embodiment, the pivot includes an aperture defined therein that allows the knife to extend therethrough. The pivot may include a stem and a cap that matingly engage on opposite sides of the shaft to seci.are the jaw members during assembly.
In still yet another embodiment, the trigger assembly selectively translates the knife through tissue disposed between the jaw members and the knife assembly includes a knife carriage having a t-shaped distal end that engages the trigger assembly and a proximal end that engages a knife bar slidingly mounted within the housing. The knife bar may include a cuff at a distal end thereof that defines an aperture located therethrough. The shaft is dimensioned to rotate and slide through the aperture of the cuff.
The drive assembly may further include a cam pin that operatively couples the distal end of the drive sleeve to the jaw members for actuation thereof.
The knife may be dimensioned to include a slot defined therein that allows the cam pin to extend therethrough.
BRIEF DESCRIPTION OF THE DRAWINGS
Various embodiments of the subject instrument are described herein with reference to the drawings wherein:
Fig. IA is a perspective view of a bipolar forceps shown in open configuration and including a housing, a shaft, handle assembly, trigger assembly and an end effector assembly according to the present disclosure;
Fig. 1B is a perspective view of the bipolar forceps of Fig. 1A shown in closed configuration;
Fig. 2 is a rear view of the forceps of Fig. 1A;
Fig. 3A is an enlarged, front perspective view of the end effector assembly of Fig. IA shown in an open configuration;
Fig. 3B is an enlarged, front perspective view of the end effector assembly of Fig. 1A shown in a closed configuration;
Fig. 3C is an enlarged, side view of the end effector assembly of Fig. 1A
shown in open configuration;
Fig. 3D is an enlarge, front view of the end effector assembly of Fig. 1A
shown in open configuration;
Fig. 3E is a greatly-enlarged, exploded perspective view of the top jaw member;
Fig. 3F is a greatly-enlarged, exploded perspective view of the bottom jaw member;
Fig. 4 is a perspective view of the endoscopic forceps of Fig. 1A with the internal working components of the forceps exposed;
Fig. 5A is side view of the endoscopic forceps of Fig. 1 A with the internal working components of the forceps exposed;
Fig. 5B is side view of the endoscopic forceps of Fig. 1 B with the internal working components of the forceps exposed;
Fig. 5C is a greatly-enlarged, perspective view of the handle assembly in open configuration;
Fig. 5D is a greatly-enlarged, perspective view of the handle assembly in closed configuration;
Fig. 6A is an internal, perspective view of the endoscopic forceps of Fig.
1 B with the internal working components of the forceps exposed and the trigger shown in an un-actuated position;
Fig. 6B is an intemal, perspective view of the endoscopic forceps of Fig.
1 B with the internal working components of the forceps exposed and the trigger shown in an actuated position;
Fig. 6C is a schematic representation of the electrical configuration for the trigger assembly;
Fig. 7 is an internal, side view of the endoscopic forceps of Fig. 1 B with the trigger shown in an actuated position;
Fig. 8A is a side cross-sectional view showing the trigger in an actuated position;
Fig. 8B is an enlarged, side cross-sectional view showing the jaw members in a spaced apart orientation;
Fig. 8C is an enlarged, side cross-sectional view showing the jaw members in a closed orientation;
Fig. 9A is side cross-sectional view of the housing showing both the trigger and the handle un-actuated;
Fig. 9B is side cross-sectional view of the housing showing both the trigger and the handle actuated;
Fig. 10A is an enlarged, side cross-sectional view showing the end effector in a closed position and the knife in an unactuated position;
Fig. 10B is an enlarged, side cross-sectional view showing the end effector in a closed position and the knife in an actuated position;
Fig. 10C is an enlarged, front perspective view of a bottom jaw member of the end effector assembly showing the knife in an unactuated position;
Fig. 10D is an enlarged, front perspective view of the bottom jaw member showing the knife in an actuated position;
Fig. 11 is an exploded, perspective view of the forceps of Fig. 1A;
Fig. 12 is an enlarged, exploded perspective view of the housing;
Fig. 13 is an enlarged, exploded perspective view of the end effector assembly and the shaft; and Fig. 14 is a greatly enlarged, exploded perspective view of the end effector assembly.
DETAILED DESCRIPTION
Turning now to Figs. IA-2, one embodiment of a bipolar forceps 10 is shown for use with various surgical procedures and generally includes a housing 20, a handle assembly 30, a rotating assembly 80, a trigger assembly 70 and an end effector assembly 100, which mutually cooperate to grasp, seal and divide large tubular vessels and large vascular tissues. Although the majority of the figure drawings depict a bipolar forceps 10 for use in connection with endoscopic surgical procedures, the present disclosure may be used for more traditional open surgical procedures. For the purposes herein, the forceps 10 is described in terms of an endoscopic instrument;
however, it is contemplated that an open version of the forceps may also include the same or similar operating components and features as described below.
Forceps 10 includes a shaft 12 that has a distal end 16 dimensioned to mechanically engage the end effector assembly 100 and a proximal end 14 that mechanically engages the housing 20. Details of how the shaft 12 connects to the end effector are described in more detail below with respect to Figs. 13 and 14.
The proximal end 14 of shaft 12 is received within the housing 20 and the corinections relating thereto are also described in detail below with respect to Figs. 11 and 12. In the drawings and in the descriptions that follow, the term "proximal," as is traditional, will refer to the end of the forceps 10 that is closer to the user, while the term "distal" will refer to the end that is farther from the user.
As best seen in Figs. 1 A and 2, forceps 10 also includes an electrosurgical cable 310 that connects the forceps 10 to a source of electrosurgical energy, e.g., a generator 500 (shown schematically). Generators such as those sold by Valleylab, located in Boulder, Colorado may be used as a source of electrosurgical energy, e.g., Ligasure"'" Generator, FORCE EZTM Electrosurgical Generator, FORCE
FXTM Electrosurgical Generator, FORCE 1CT"", FORCE 2TM Generator, SurgiStatTM
II
or other suitable generators that may perform different or enhanced functions.
In one embodiment, the generator 500 includes various safety and performance features including isolated output, independent activation of accessories.
The electrosurgical generator may include Valleylab's Instant ResponseTM
technology features, which provides an advanced feedback system to sense changes in tissue two hundred times per second and adjust voltage and current to maintain appropriate power. The Instant ResponseTM technology is believed to provide one or more of the following benefits to surgical procedure:
= Consistent clinical effect through all tissue types;
= Reduced thermal spread and risk of collateral tissue damage;
= Less need to "turn up the generator"; and = Designed for the minimally invasive environment.
Cable 310 is internally divided into cable leads 310a, 310b and 325b (FIG.
6C), which are designed to transmit electrical potentials through their respective feed paths through the forceps 10 to the end effector assembly 100. More particularly, cable feed 325b connects through the forceps housing 20 and through the rotating assembly to jaw member 120. Lead 310a connects to one side of the switch 60 and lead 310c connects to the opposite side of the switch 60 such that, upon activation of the switch, energy is transmitted from lead 310a to 310c. Lead 310c is spliced with lead 310b, which connects through the rotating assembly to jaw member 110 (See Fig. 6C).
Details relating to the electrical connections are explained in more detail below with the discussion of the switch 60.
Handle assembly 30 includes a fixed handle 50 and a movable handle 40.
Fixed handle 50 is integrally associated with housing 20 and handle 40 is movable relative to fixed handle 50 as explained in more detail below with respect to the operation of the forceps 10. Fixed handle 50 is oriented approximately thirty degrees relative a longitudinal axis "A-A" defined through shaft 12. Fixed handle 50 may include one or more ergonomic enhancing elements to facilitate handling, e.g., scallops, protuberances, elastomeric material, etc.
Rotating assembly 80 is operatively associated with the housing 20 and is rotatable approximately 180 degrees about a longitudinal axis "A-A" (See Fig.
1A).
Details of the rotating assembly 80 are described in more detail with respect to Fig. 11.
As mentioned above, end effector assembly 100 is attached at the distal end 14 of shaft 12 and includes a pair of opposing jaw members 110 and 120.
Movable handle 40 of handle assembly 30 is ultimately connected to a drive assembly (FIG.5A), which, together, mechanically cooperate to impart movement of the jaw members 110 and 120 from an open position wherein the jaw members 110 and 120 are disposed in spaced relation relative to one another, to a clamping or closed position wherein the jaw members 110 and 120 cooperate to grasp tissue therebetween.
Forceps 10 may be designed such that it is fully or partially disposable depending upon a particular purpose or to achieve a particular result. For example, end effector assembly 100 may be selectively and releasably engageable with the distal end 16 of the shaft 12 and/or the proximal end 14 of shaft 12 may be selectively and releasably engageable with the housing 20 and the handle assembly 30. In either of these two instances, the forceps 10 would be considered "partially disposable"
or "reposable", i.e., a new or different end effector assembiy 100 (or end effector assembly 100 and shaft 12) selectively replaces the old end effector assembly 100 as needed.
As can be appreciated, the presently disclosed electrical connections would have to be altered to modify the instrument to a reposable forceps.
Tuming now to the more detailed features of the present disclosure as described with respect to Figs. 1 A- 14, movable handle 40 includes a finger loop 43 that has an aperture 41 defined therethrough, which enables a user to grasp and move the handle 40 relative to the fixed handle 50. Finger loop 43 is typically ergonomically enhanced and may include one or more gripping elements (not shown) disposed along the inner peripheral edge of aperture 41 that are designed to facilitate gripping of the movable handle 40 during activation, e.g., a so called "soft touch" material.
Gripping elements may include one or more protuberances, scallops and/or ribs to enhance gripping.
As best seen in Figs. 5A and 5B, movable handle 40 is selectively movable about a pivot pin 45 from a first position relative to fixed handle 50 to a second position in closer proximity to the fixed handle 50, which, as explained below, imparts movement of the jaw members 110 and 120 relative to one another. The movable handle includes a clevis 46 that forms a pair of upper flanges 46a and 46b each having an aperture at an upper end thereof for receiving a pivot pin 45 (See Fig. 12) therethrough and mounting the upper end of the handle 40 to the housing 20. In turn, pivot pin 45 mounts to respective housing halves 20a and 20b. Pivot pin 45 is dimensioned to mount within socket 45a of housing half 20b.
Each upper flange 46a and 46b also includes a force-actuating flange or drive flange 47a and 47b (See Fig. 7), respectively, which are aligned along longitudinal axis "A" and that abut the drive assembly 130 such that pivotal movement of the handle 40 forces actuating flanges 47a and 47b against the drive assembly 130, which, in turn, closes the jaw members 110 and 120 (See Figs. 5A and 5B). For the purposes herein, 47a and 47b that act simultaneously on the drive assembly 130 are referred to as "driving flange 47". A more detailed explanation of the inter-cooperating components of the handle assembly 30 and the drive assembly 130 is discussed below.
As best shown in Fig. 5C, the lower end of the movable handle 40 includes a flange 42 that is typically integrally associated with or operatively connected to movable handle 40. Flange 42 is typically T-shaped and includes a pin-like element 44 that projects laterally or transversally from a distal end thereof and is configured to engage a corresponding railway 55 disposed within fixed handle 50. More particularly, the pin 44 is configured to ride within a pre-defined channel 53 disposed within the railway 55 to lock the movable handle 40 relative to the fixed handle 50 upon reciprocation thereof. Additional features with respect to the t-shaped flange 42 are explained below in the detailed discussion of the operational features of the forceps 10.
Movable handle 40 is designed to provide a distinct mechanical advantage over conventional handle assemblies due to the unique position of the pivot pin 45 (i.e., pivot point) relative to the longitudinal axis "A" of the shaft 12 and the disposition of the driving flange 47 along longitudinal axis W. In other words, by positioning the pivot pin 45 above the driving flange 47, the user gains lever-like mechanical advantage to actuate the jaw members 110 and 120 enabling the user to close the jaw members 110 and 120 with lesser force while still generating the required forces necessary to effect a proper and effective tissue seal.
As shown best in Figs. 3A-3F, 13 and 14, the end effector assembly 100 includes opposing jaw members 110 and 120 that cooperate to effectively grasp tissue for sealing purposes. The end effector assembly 100 is designed as a bilateral assembly, i.e., both jaw members 110 and 120 pivot relative to one another about a pivot pin 95 disposed therethrough. The jaw members 110 and 120 are curved to facilitate manipulation of tissue and to provide better "line of sight" for accessing organs and large tissue structures.
A reciprocating drive sleeve 134 is slidingly disposed within the shaft 12 and is remotely operable by the drive assembly 130 as explained in more detail below.
Drive sleeve 134 includes a bifurcated distal end composed of halves 134a and 134b, respectively, which define a cavity 134' therebetween for receiving jaw members 110 and 120. More particuiarly and as best illustrated in Figs. 13 and 14, jaw members 110 and 120 include proximal flanges 113 and 123, respectively, which each include an elongated angled slot 117 and 127, respectively, defined therethrough. A drive pin 139 (See Fig. 13) mounts jaw members 110 and 120 to the end of a sleeve 134 and within cavity 134' disposed between flanges 134a and 134b. Cam pin or drive pin 139 mounts through apertures 139a and 139b defined in flanges 134a and 134b, respectively, and is reciprocable within slots 16a' and 16b' disposed at the distal ends 16a and 16b of shaft 12 (See Fig. 14). Slots 16a' and 16b' may extend into aperture 95' and 95" to facilitate assembly of pin 139. Pin 139 may be composed of two mechanically interfacing elements that are dimensioned to frictionally receive one another to retain pin 139 in place once assembled. Alternatively, or in addition, pin 139 may be held in place by one of several known manufacturing techniques including: laser or heat-based welding, press-fit mechanical interaction (or other mechanically interlocking geometry, adhesives, chemical bonding, etc. A component disposed on the outside of shaft may also be utilized to retain the pin 139 in place once assembled. For example, a heat shrink material, adhesive tape, rubber or other insulating boot or silicone may be used for this purpose. A varying diameter version of pin 139 may be utilized to prevent the pin from coming loose once assembled. A cap or stem (not shown) arrangement may also be employed for this purpose as well.
Drive sleeve 134, which ultimately connects to the drive assembly 130, is dimensioned to slidingly receive knife drive rod 193, knife 190 and posts 171a and 171b of halves 170a and 170b of knife guide 170. Drive sleeve 134, in tum, is received within shaft 12. Upon actuation of the drive assembly 130, the drive sleeve reciprocates, which, in turn, causes the drive pin 139 to ride within slots 117 and 127 to open and close the jaw members 110 and 120 as desired. The jaw members 110 and 120, in tum, pivot about pivot pin 95 disposed through respective pivot holes 11 3a and 123a disposed within flanges 113 and 123. As can be appreciated, squeezing handle 40 toward handle 50 pulls drive sleeve 134 and drive pin 139 proximally to close the jaw members 110 and 120 about tissue grasped therebetween and pushing the sleeve distally opens the jaw members 110 and 120 for grasping purposes.
Turning back to the details of the jaw member 110 and 120 as best shown in Figs. 3A-3F, jaw member 110 includes a support base 119 that extends distally from flange 113 and that is dimensioned to support an insulative plate 119' thereon.
Insulative plate 119', in turn, is configured to support an electrically conductive tissue engaging surface or sealing plate 112 thereon. The sealing plate 112 may be affixed atop the insulative plate 119' and support base 119 in any suitable manner, such as snap-fit, over-molding, stamping, ultrasonically welded, etc. Support base 119 together with the insulative plate 119' and electrically conductive tissue engaging surface 112 are encapsulated by an outer insulative housing 116. Outer housing 116 includes a cavity 116a that is dimensioned to securely engage the electrically conductive sealing surface 112 as well as the support base 119 and insulative plate 119'. This may be accomplished by stamping, by overmolding, by overmolding a stamped electrically conductive sealing piate and/or by overmolding a metal injection molded seal plate or other suitable methods (e.g., a conductive surface bound to a structural support via an insulating material). All of these manufacturing techniques produce jaw member having an electrically conductive surface 112 that is substantially surrounded by an insulating housing or substrate 116.
For example, and as shown in Fig. 3E, the electrically conductive sealing plate 112 includes a peripheral flange 112a that surrounds the periphery of the sealing plate 112. Flange 112a is designed to matingly engage an inner lip 116b of the outer insulator 116. Again, this may be accomplished by any of the aforementioned processes, e.g., overmolding. Lead 310b, which extends from switch 60 (See Fig. 6C), terminates within the outer insulator 116 and is designed to electro-mechanically couple to the sealing plate 112 by virtue of a crimp-like connection 326a. Insulator 119', electrically conductive sealing surface 112 and the outer, non-conductive jaw housing 116 are preferably dimensioned to limit and/or reduce many of the known undesirable effects related to tissue sealing, e.g., flashover, thermal spread and stray current dissipation.
The electrically conductive sealing surface 112 may also include an outer peripheral edge that has a pre-defined radius and the outer housing 116 meets the electrically conductive sealing surface 112 along an adjoining edge of the sealing surface 112 in a generally tangential position. At the interface, the electrically conductive surface 112 is raised relative to the outer housing 116.
The electrically conductive surface or sealing plate 112 and the outer housing 116, when assembled, form a longitudinally-oriented slot 115a defined therethrough for reciprocation of the knife blade 190 (See Fig. 13). Knife slot 115a cooperates with a corresponding knife slot 11 5b defined in jaw member 120 to facilitate longitudinal extension of the knife blade 190 along a preferred cutting plane to effectively and accurately separate the tissue along the formed tissue seal.
Together, knife slots 11 5a and 11 5b form knife channel 115 for reciprocation of the knife 190. As best illustrated in Figs. 3A-3F, knife channel 115 runs through the center of the jaw members 110 and 120, respectively, such that a blade 190 from the knife assembly 70 can cut the tissue grasped between the jaw members 110 and 120 when the jaw members 110 and 120 are in a closed position. As described in more detail below, handle 30a includes a passive lockout flange 49' that prevents actuation of the knife assembly 70 when the handle 40 is open thus preventing accidental or premature activation of the blade 190 through the tissue. In addition, the passive lockout flange 49' is dimensioned to force the trigger 70 to retract the knife 190 when the handle 40 is moved to an open position.
As explained above and as illustrated in Figs. 3F, 8B, 8C, 10C and 10D, the knife channel 115 is formed when the jaw members 110 and 120 are closed.
In other words, the knife channel 115 includes two kriife channel halves - knife slot 11 5a disposed in sealing plate 112 of jaw member 110 and knife slot 11 5b disposed sealing plate 122 of jaw member 120. The knife channel 115 may be dimensioned to include some degree of curvature to cause the knife 190 to move through tissue in a curved fashion. Alternatively, the knife channel 115 may be configured as a straight slot with no degree of curvature, which, in turn, causes the knife 190 to move through the tissue in a substantially straight fashion. Insulating plate 119' also forms part of the knife channel 115 and includes slot 115a' defined therein that extends along insulating plate 119' and that aligns in vertical registration with knife slot 115a to facilitate translation of distal end 192 of the knife 190 therethrough.
As mentioned above, end effector assembly 100 also includes knife guide 170 that is dimensioned to facilitate alignment and translation of the knife 190 through and into the knife channel 115. More particularly, knife guide 170 includes half 170a and half 170b that mechariically interface to encapsulate the knife 190 upon assembly (See Fig. 13). Knife guide 170, once assembled, aligns the knife 190 for facile translation through knife channel 115 upon reciprocation of a knife drive rod 193 (Fig.
13). The operation of the drive rod 193 is described below with reference to the operational features of the forceps 10. Each half 170a and 170b of the knife guide 170 includes various interfaces thereon and apertures defined therein that allow unencumbered movement of the various operating features of the end effector assembly 100, e.g., pivot 95, drive pin 139 and knife 190. More particularly, halves 170a and 170b include apertures 173a and 173b, respectively, defined therethrough that allow passage of the pivot 95 during assembly. Halves 170a and 170b also include laterally-aligned slots 172a and 172b defined therein that allow reciprocation of the drive pin 139 upon opening and closing of the jaw members 110 and 120. One or more guides 327 (Fig. 14) may also be included to guide leads, e.g., lead 325a, along knife guide 170 and to the electrically conductive plates, e.g., plate 122.
Knife guide halves 170a and 170b also include posts 171 a and 171 b that extend proximally into slot 16' upon assembly to engage knife 190.
Knife channel 115 runs through the center of the jaw members 110 and 120, respectively, such that a distal end 192 of the knife 190 can cut the tissue grasped between the jaw members 110 and 120 when the jaw members 110 and 120 are in a closed position. More particularly, and as described in more detail below with respect to the operation of the forceps 10, the knife 190 can only be advanced through the tissue when the jaw members 110 and 120 are closed, thus preventing accidental or premature activation of the knife 190 through the tissue. Passive lockout flange 49' detailed below prevents unintended translation of the knife 190 while the jaw members 110 and 120 are disposed in an open configuration. The knife 190 may be dimensioned to allow other components to pass therethrough, which additionally creates the benefit of enhancing he overall flexibility of the knife to facilitate passage through the knife channel 115.
Alternatively, one or both jaw members may also include a safety lockout to prevent the knife 190 from advancing while the jaw members are in an open configuration.
Jaw member 120 includes similar elements to jaw member 110, such as jaw housing 126, which encapsulates a support plate 129, an insulator plate 129' and an electrically conductive sealing surface 122. Likewise, the electrically conductive surface 122 and the insulator plate 129', when assembled, include respective longitudinally-oriented knife slots 11 5b and 115b' defined therethrough for reciprocation of the knife blade 190. As mentioned above, when the jaw members 110 and 120 are closed about tissue, knife slots 115a and 115b form a complete knife channel 115 to allow longitudinal extension of the knife 190 in a distal fashion to sever tissue along a tissue seal. The knife channel 115 may be completely disposed in one of the two jaw merribers, e.g., jaw member 120, depending upon a particular purpose. Jaw member 120 may be assembled in a similar manner as described above with respect to jaw member 110. More particularly, the sealing plate 122 may be dimensioned to include an outer peripheral rim 122a that is dimensioned to mechanically interface with an inner lip 126b of housing 126 to secure the sealing plate 122 to the housing 126 with plates 129 and 129' encapsulated therein.
As best seen in Fig. 3F, jaw member 120 includes a series of stop members 90 disposed on the inner facing surface of the electrically conductive sealing surface 122 to facilitate gripping and manipulation of tissue and to define a gap "G"
(Fig. 10B) between opposing jaw members 110 and 120 during sealing and cutting of tissue. The series of stop members 90 may be employed on one or both jaw members 110 and 120 depending upon a particular purpose or to achieve a desired result.
Jaw member 120 is connected to a second electrical lead 325b extending from switch 60 (See Fig. 6B) that terminates within the jaw housing 126 and is designed to electro-mechanically couple to the sealing plate 122 by virtue of a crimp-like connection 326b. As explained in more detail below, leads 310b and 325b allow a user to selectively supply bipolar electrosurgical energy to the jaw members 110 and 120 as needed during surgery.
Jaw members 110 and 120 are electrically isolated from one another such that electrosurgical energy can be effectively transferred through the tissue to form a tissue seal. For example, and as best illustrated in Figs. 3A-3F, each jaw member 110 and 120 includes a uniquely-designed electrosurgical cable path that transmits electrosurgical energy through the cable leads 310b and 325b to the electrically conductive sealing surfaces 112 and 122, respectively. Cable leads 310b and 325b are held loosely but securely along the cable path to permit rotation of the jaw members 110 and 120. As can be appreciated, this isolates electrically conductive sealing surfaces 112 and 122 from the remaining operative components of the end effector assembly 100 and shaft 12. The two electrical potentials are isolated from one another by virtue of the insulative sheathing surrounding the cable leads 310b and 325b.
Jaw members 110 and 120 are engaged to the end of rotating shaft 12 by pivot pin 95 such that rotation of the rotating assembly 80 correspondingly rotates shaft 12 (along with sleeve 134 and knife 190), which, in turn, rotates end effector assembly 100 (See Fig. 1A). More particularly, the distal end of rotating shaft 12 is bifurcated to include ends 16a and 16b that define a channel 16' therein for receiving jaw members 110 and 120. Pivot pin 95 includes a stem 95a and cap 95b arrangement that is dimensioned to engage through aperture 95' and 95" disposed in ends 16b and 16a, respectively. Upon assembly and as best illustrated in Figs. 13 and 14, the stem 95a of pivot pin 95 extends, in order, through end 16a of shaft 12, aperture 123a of jaw member 120, aperture 173a of half 170a or knife guide 170, aperture 173b of half 170b of knife guide 170, aperture 113a of jaw member 110 and end 16b of shaft 12 to engage cap 95b. Slots 16a' and 16b' are defined within distal ends 16a and 16b and are dimensioned to allow reciprocation of drive pin 139 therein. Stem 95a includes a pass through hole 96 defined therein that allows passage of the knife 190 therethrough for severing tissue while still allowing a large rotational surface area for the jaw members during loading.
Turning now to the cooperating components of the housing, Figs. 5A, 5B, 6A, 6B, 11 and 12 show the details of the housing 20 and the component features thereof, namely, the drive assembly 130, the rotating assembly 80, the knife actuating assembly 160, the trigger assembly 70 and the handles 40 and 50. More particularly, Figs. 5A and 5B show the above-identified assemblies and components in an assembled form in the housing 20 and Figs. 11 and 12 show an exploded view of each of the above-identified assemblies and components.
As mentioned above and as best shown in Figs. 11 and 12, the proximal end of shaft 12 is mechanically engaged to the housing 20. Housing 20 is formed from two (2) housing halves 20a and 20b, which each include a plurality of interfaces that are dimensioned to mechanically aiign and engage one another to form housing 20 and enclose the internal working components of forceps 10. As can be appreciated, fixed handle 50 that, as mentioned above, is integrally associated with housing 20, includes halves 50a and 50b that take the shape of handle 50 upon the assembly of the housing halves 20a and 20b.
A plurality of additional interfaces (not shown) may disposed at various points around the periphery of housing halves 20a and 20b for ultrasonic welding purposes, e.g., energy direction/deflection points. It is contemplated that ultrasonic welding provides better dimensional stability, strength and joint reliability that other, more traditional, methods. For example, the housing halves may be ultrasonically welded utilizing a combination of a primary weld joint using traditional triangular (or similar) energy directors to form a bonded joint coupled with a secondary hard stop surface (removed from the primary joint surface) for preventing over compression of the joint. A tertiary set of alignment pins may be utilized throughout the housing halves 20a and 20b, which are configured to both accurately align the halves 20a and 20b during assembly and provide strength and stability during manufacture, handling and transport.
Housing halves 20a and 20b (as well as the other components desc(bed below) may be assembled together in any suitable fashion. For example, alignment pins, snap-like interfaces, tongue and groove interfaces, locking tabs, adhesive ports, etc. may all be utilized either alone or in combination for assembly purposes.
As best seen in Figs. 11 and 12, rotating assembly 80 includes two C-shaped halves 80a and 80b that, when assembled, form the rotating assembly 80.
Half 80a includes a series of detents/flanges (not shown) that are dimensioned to engage a pair of corresponding sockets or other mechanical interfaces (not shown) disposed within rotating half 80b. Half 80a also includes a tab 84a (phantomly illustrated) that, together with a corresponding tab 84b disposed on half 80b, cooperate to matingly engage slot 80' disposed on shaft 12. As can be appreciated, this permits selective rotation of the shaft 12 about axis "A-A" by manipulating the rotating member 80 in the direction of the arrow "B", which, in turn, rotates the end effector assembly in the direction of arrow "C" (See Fig. 1A). The rotating assembly may include one or more mechanical interfaces that essentially lock the rotating assembly in a fully counter-clock wise rotational position or a fully clockwise rotational position. This may allow left-handed or right-handed orientations for the end effector assembly for particular users.
As mentioned above, and as best illustrated in Figs. 5A, 5B, 6A and 6B, the movable handle 40 includes clevis 46 that forms upper flanges 46a and 46b, which pivot about pins 45a and 45b to pull the reciprocating sleeve 134 along longitudinal axis "A-A" and force driving flanges 47a and 47b against the drive assembly 130, which, in turn, closes the jaw members 110 and 120. The various moving relationships of the flanges 47a and 47b and the drive assembly 130 are explained in more detail below with respect to the operation of the forceps 10. The arrangement of the driving flanges 47a and 47b and the pivot point 45 of the movable handle 40 provides a distinct mechanical advantage over conventional handle assemblies due to the unique position of the pivot pins 45a and 45b (i.e., pivot point) relative to the longitudinal axis "A-A" of the driving flanges 47a and 47b. In other words, by positioning the pivot pins 45a and 45b above the driving flanges 47a and 47b, the user gains lever-like mechanical advantage to actuate the jaw members 110 and 120. This reduces the overall amount of mechanical force necessary to close the jaw members 110 and 120 to affect a tissue seal.
Handle 40 also includes a finger loop 43 that defines opening 41, which is dimensioned to facilitate grasping the handle 40. In one embodiment, finger loop 43 includes a rubber insert that enhances the overall ergonomic "feel" of the handle member 40. A locking flange 49' is disposed on the outer periphery of the handle member 40 above the finger loop 43. Locking flange 49' may be designed as a safety lock out mechanism to prevent the trigger assembly 70 from firing when the handle member 40 is oriented in a non-actuated position, i.e., the jaw members 110 and 120 are open. As can be appreciated, this would prevent accidental or premature severing of tissue prior to completion of the tissue seal.
Fixed handle 50 includes halves 50a and 50b that, when assembled, form handle 50. Fixed handle 50 includes a channel 51 defined therein that is dimensioned to receive flange 42 in a proximal moving manner when movable handle 40 is actuated.
The t-shaped pin 44 of handle 40 is dimensioned for facile reception within channel 51 of handle 50. Flange 42 may be dimensioned to allow a user to selectively, progressively and/or incrementally move jaw members 110 and 120 relative to one another from the open to closed positions. For example, it is also contemplated that flange 42 may include a ratchet-like interface that lockingly engages the movable handle 40 and, therefore, jaw members 110 and 120 at selective, incremental positions relative to one another depending upon a particular purpose. Other suitable mechanisms may also be employed to control and/or limit the movement of handle relative to handle 50 (and jaw members 110 and 120) such as, e.g., hydraulic, semi-hydraulic, linear actuator(s), gas-assisted mechanisms and/or gearing systems.
As best illustrated in Figs. 5D and 12, housing halves 20a and 20b, when assembled, form an internal cavity 52 that predefines the channel 51 within fixed handle 50 adjacent the railway 55, which reciprocates t-shaped pin 44 therein. Once assembled, the railway 55 is seated within cavity 52 in registration with entrance pathway 51 for reciprocation of the flange 42. Flange 42 and the housing halves 20a and 20b are designed to facilitate accurate and consistent reception of the t-shaped pin 44 into railway 55.
During movement of the flange 42 along the entrance to channel 51, the t-shaped pin 44 rides through passage 53 along railway 55 and is forced into a catch basin or seat 55' to lock the handle 40 relative to handle 50. When the user releases the handle 40, the catch basin 55' retains the t-shaped pin 44 in a secured position relative to the handle 50 as explained in further detail below. Railway 55 may be seated on one or pivot elements 55a that allows the railway 55 to pivot upon reception of the t-shaped pin 44 therethrough. A spring element 57 biases the railway 55 to return to the original reception position once the t-shaped pin 44 is seated.
The railway 55, again, may pivot in response to release of the t-shaped pin 44 from catch basin 55'.
Actuation of the handle 40 along with the inter-cooperating elements of the drive assembly 130 close the jaw members 110 and 120 about tissue with a pre-determinable and consistent closure pressure to effect a tissue seal. As mentioned above, closure pressures for sealing large tissue structures preferably fall within the range of about 3kg/cm2 to about 16 kg/cmZ.
When handle 40 is regrasped, the t-shaped pin 44 is forced out of or disengaged from the catch basin 55' and moves along an exit pathway to release handle 40 from channel 51. A spring or other biasing member 57 may be employed to facilitate securing the flange 42 within the catch basin 55' and also configured to facilitate release of the flange 42 from catch basin 55' upon re-grasping of the handle 40.
As explained in more detail below, once actuated, handle 40 moves in a generally arcuate fashion towards fixed handle 50 about pivot pins 45a and 45b, which forces driving assembly 130 proximally that, in turn, pulls reciprocating sleeve 134 in a generally proximal direction to close jaw members 110 and 120 relative to one another.
As best shown in Figs. 5A, 5B and 11, the drive assembly 130 mounts atop the proximal portion of the drive sleeve 134. A pair of retaining rings or clips 131' and 131" (See Fig. 11) cooperate with a corresponding pair of relieved portions 133a and 133b disposed on the drive sleeve 134 to mount the drive assembly 130 atop the drive sleeve 134 such that relative movement of the drive assembly correspondingly moves the drive sleeve 134. As handle 40 pivots about pivot point 45 and moves relative to handle 50 and flange 42 is incorporated into charinel 51 of fixed handle 50, the driving flanges 47a and 47b, through the mechanical advantage of the above-the-center pivot point, force the drive assembly 130 proximally against spring 131.
As a result thereof, drive sleeve 134 reciprocates proximally, which, in turn, closes the jaw members 110 and 120. The utilization of an over-the-center pivoting mechanism will enable the user to selectively compress the coil spring 131 a specific distance, which, iri turn, imparts a specific load on the reciprocating sleeve 134 that is converted to a rotational torque about the jaw pivot pin 95. As a result, a specific closure force can be transmitted to the opposing jaw members 110 and 120.
Figs. 5A and 5B show the initial actuation of handle 40 towards fixed handle 50 that causes the pin 44 of flange 42 to move generally proximally and upwardly along entrance pathway 51. During movement of the flange 42 along the entrance pathway 51, respectively, the t-shaped pin 44 rides through passageway 53 aiong railway 55 as explained above. Once the desired position for the sealing site is determined and the jaw members 110 and 120 are properly positioned, handle 40 may be compressed fully such that the t-shaped pin 44 of flange 42 seats within catch basin 55'. Once pin 44 clears an edge or passes a predetermined point in the passageway 53 at the edge of the catch basin 55', releasing movement of the handle 40 and flange 42 is redirected into a catch basin 55'.
More particularly, upon a slight reduction in the closing pressure of handle 40 against handle 50, the handle 40 returns slightly distally towards entrance pathway 51 but is re-directed to seat within catch basin 55. At this point, the release or return pressure between the handles 40 and 50, which is attributable and directly proportional to the release pressure associated with the compression of the drive assembly 130, causes the pin 44 of flange 42 to settle or lock within catch basin 55'.
Handle 40 is now secured in position within fixed handle 50, which, in turn, locks the jaw members 110 and 120 in a closed position against the tissue.
As mentioned above, the jaw members 110 and 120 may be opened, closed and rotated to manipulate tissue until sealing is desired. This enables the user to position and re-position the forceps 10 prior to activation and sealing. As illustrated in Fig. 1A, the end effector assembly 100 is rotatable about longitudinal axis "A-A"
through rotation of the rotating assembly 80. As explained in more detail below, the uriique feed path of the cable leads 325a and 325b through the rotating assembly 80, along shaft 12 and, ultimately, to the jaw members 110 and 120 enables the user to rotate the end effector assembly 100 about 180 degrees across the clockwise and counterclockwise directions without tangling or causing undue strain on cable leads 325a and 325b. As can be appreciated, this facilitates the grasping and manipulation of tissue.
As best shown in Figs. 5A, 5B, 6A, 9A, 9B, 11 and 12, trigger assembly 70 mounts atop movable handle 40 and cooperates with the knife assembly 160 to selectively translate knife 190 through a tissue seal. More particulady, the trigger assembly 70 includes a U-shaped finger actuator 71 having a pair upwardly-extending flanges 71a and 71b. A pivot pin 179 extends through a pair of apertures 162a and 162b in each of the flanges 71 a and 71 b, respectively, to mount the trigger assembly 70 to a knife carriage 165, as explained in more detail below. Finger actuator 71 is selectively pivotable within a pre-defined slot 21 disposed within housing 20 (See Fig.
6A). More particularly, a pair of pivots 77a and 77b is disposed on either side of the finger actuator 71 and are configured to mount between housing halves 20a and 20b to pivot the finger actuator within slot 21.
The knife assembly 160 includes a reciprocating knife bar 167 that mounts atop the drive sleeve 134 and between upwardly extending flanges 71a and 71b. Knife bar 167 includes a t-shaped proximal end 167' and a cuff 137 disposed at the distal end thereof. Cuff 137 is dimensioned to encapsulate drive sleeve 134 when the knife assembly 160 is assembled. A spring 76 biases the cuff in a proximal-most orientation. Proximal end 167' is dimensioned to mount and slidingly reciprocate within a slot 167" formed by housings 20a and 20b at assembly (See Fig. 12). A
locking cap 137a and a mounting pin 179 secure the cuff 137 to the proximal end 193b of the knife rod 193 through aperture 197 disposed therein such that proximal movement to the finger actuator 71 results in distal movement of the knife bar 193. Cuff 137 and cap 137a also allow 360 degrees of rotation of the drive sleeve 134 therethrough.
As mentioned above,, a knife carriage 165 mounts to the upwardly extending flanges 71a and 71b of the finger actuator 71. More particularly, the distal end 162 of the knife carriage 165 is t-shaped and includes two laterally extending pins 162c and 162d that engage apertures 162a and 162b, respectively, in flanges 71 a and 71b. The proximal end 161 of the knife carriage 165 includes an aperture 161a defined therein that mates with a detent 167a that extends transversally through knife carriage 165.
As best illustrated in Figs. 5A-7, when the handle 40 is disposed in a spaced-apart or open configuration relative to handle 50, flange 49', which extends from handle 40, prevents actuation of the trigger assembly 70. More particularly, finger actuator 71 is prevented from being actuated proximally by flange 49' when the jaw members 110 and 120 are open. As can be appreciated, this prevents premature actuation of the knife 190 when tissue is not grasped between jaw members 110 and 120. When handle 40 is selectively moved relative to handle 50, a gap 21 is formed between the flange 49' and the finger actuator 71 (See Fig. 5B). Thus, the user is free to selectively actuate the knife 190 by squeezing the finger actuator 71 proximally within gap 21.
As best shown in Figs. 6B, 7 and 8A, once the clearance is provided by movement of handle 40, proximal movement of the finger actuator 71 about pivot results in distal translation of the knife bar 167, which, in turn, results in distal translation of the knife rod 193 and kriife 190. More particularly, when finger actuator 71 is squeezed proximally, the U-shaped flanges 71 a and 71 b rotate about pivot 74 to abut cuff 137 and essentially throw the knife carriage 165 forward, which, in turn, carries the knife bar 167 forward to force the knife rod 193 distally. Slot 167" is configured to smoothly guide the knife bar 167 distally through the forward and return stroke. As shown in Figs. 10A and 10BC, distal translation of the knife rod 193 translates the knife 190 through channel 115 in the jaw members 110 and 120. As mentioned above, the knife rod 193 mounts the knife 190 via one or more mechanically interfacing elements or may be affixed in any known manner in the art. A slot 197 defined within the knife 190 provides clearance for pin 139 of the drive sleeve 134 during reciprocation of the knife 190. Upon release of finger actuator 71, spring 76 biases the knife assembly back to a proximal-most position. The knife bar 167 provides variable mechanical advantage and linear advantage when triggering the knife 190. In addition, the incorporation of the knife bar 167 significantly reduces friction loss and provides smoother mechanical cutting than previously known methods.
Turning now in detail to the operation of the drive assembly as best seen in Figs. 5A, 5B, 11 and 12, drive assembly 130 includes reciprocating sleeve 134, drive housing 135, spring 131, drive rings 135a and 135b, drive stops 135c and 135d and retaining nngs 131' and 131", which all cooperate to form the drive assembly 130. Stop 135c may be removed and ring 131" would perform stop 135c's intended function.
The proximal end 132 of the reciprocating sleeve 134 is positioned within an aperture 135' defined through the drive housing 135 to permit selective reciprocation of the drive sleeve 134 therethrough upon actuation of the movable handle 40. The spring 131 is assembled atop the drive housing 135 between a rear stop 135d and ring 135b such that movement handle 40 about pivot 45 moves the entire drive assembly 130 and sleeve 134 proximally, which, in tum, pulls cam pin 139 proximally to close the jaw members 110 and 120. Once the jaw members 110 and 120 close about tissue, the drive assembly 130 essentially bottoms out (i.e., further proximal movement of the reciprocating sleeve is prevented) and further movement of handle 40 about pivot 45 compresses spring 131 resulting in additional closure force on the tissue.
Moreover, spring 131 also tends to bias the jaw mernbers 110 and 120 and the movable handle 40 in an open configuration.
Tuming back to Fig. 12, which shows the exploded view of the housing 20, rotating assembly 80, trigger assembly 70, movable handle 40 and fixed handle 50, all of these various component parts along with the shaft 12 and the end effector assembly 100 are assembled during the manufacturing process to form a partially and/or fully disposable forceps 10. For example and as mentioned above, the shaft 12 and/or end effector assembly 100 may be disposable and, therefore, selectively/releasably engageable with the housing 20 and rotating assembly 80 to form a partially disposable forceps 10 and/or the entire forceps 10 may be disposable after use.
As best seen in Figs. 5A, 5B and 13, once assembled, spring 131 is poised for compression atop drive housing 135 upon actuation of the movable handle 40. More particularly, movement of the handle 40 about pivot pins 45a and 45b reciprocates the flange 42 into fixed handle 50 and forces drive assembly 130 to compress spring 131 against the rear stop 135d to reciprocate the sleeve 134.
As mentioned above, the trigger assembly 70 is initially prevented from firing by the locking flange 49' disposed on movable handle 40, which abuts against the trigger assembly 70 prior to actuation. The opposing jaw members 110 and 120 may be rotated and partially opened and_ closed without unlocking the trigger assembly 70, which, as can be appreciated, allows the user to grip and manipulate the tissue without premature activation of the knife assembly 160. As mentioned below, only when the t-shaped pin 44 of flange 42 is completely reciprocated within channel 51 of the fixed handle 50 and seated within pre-defined catch basin 55' will the locking flange 49' allow full activation of the trigger assembly 70. The operating features and relative movements of these internal working components of the forceps 10 are shown by phantom representation and directional arrows and are best illustrated in the various figures.
The mechanical advantage of the over-the-center pivot may enable the user to selectively compress the coil spring 131 a specific distance, which, in turn, imparts a specific load on the reciprocating sleeve 134. The reciprocating sleeve's 134 load is converted to a torque about the jaw pivot 95. As a result, a specific closure force can be transmitted to the opposing jaw members 110 and 120. As mentioned above, the jaw members 110 and 120 may be opened, closed and rotated to manipulate tissue until sealing is desired without unlocking the trigger assembly 70.
This enables the user to position and re-position the forceps 10 prior to activation and sealing. More particularly, as illustrated in Fig. IA, the end effector assembly 100 is rotatable about longitudinal axis "A-A" through rotation of the rotating assembly 80.
Once the desired position for the sealing site is determined and the jaw members 110 and 120 are properly positioned, handle 40 may be compressed fully such that the t-shaped pin 44 of flange 42 clears a pre-defined railway edge located atop the railway 55. Once end 44 clears the railway edge, the end 44 is directed into catch basin 55' to lock the handle 40 relative to handle 50. The release or return pressure between the handles 40 and 50, which is attributable and directly proportional to the release pressure associated with the compression of the drive assembly 130, causes the end 44 of flange 42 to settle or lock within catch basin 55'.
Handle 40 is now secured in position within fixed handle 50, which, in turn, locks the jaw members 110 and 120 in a closed position against the tissue.
At this point the jaws members 110 and 120 are fully compressed about the tissue. Moreover, the forceps 10 is now ready for selective application of electrosurgical energy and subsequent separation of the tissue, i.e., as t-shaped end 44 seats within catch basin 55', locking flange 49' moves into a position to permit activation of the trigger assembly 70.
As the t-shaped end 44 of flange 42 seats within catch basin 55', a proportional axial force on the reciprocating sleeve 134 is maintained, which, in tum, maintains a compressive force between opposing jaw members 110 and 120 against the tissue. The end effector assembly 100 and/or the jaw members 110 and 120 may be dimensioned to ofi-load some of the excessive clamping forces to prevent mechanical failure of certain internal operating elements of the end effector 100.
As can be appreciated, the combination of the mechanical advantage of the over-the-center pivot along with the compressive force associated with the compression spring 131 facilitate and assure consistent, uniform and accurate closure pressure about the tissue within the desired working pressure range of about 3 kg/cm2 to about 16 kg/cm2 and, desirably, about 7 kg/cm2 to about 13 kg/cm2. By controlling the intensity, frequency and duration of the electrosurgical energy applied to the tissue, the user can treat tissue, i.e., seal tissue.
As mentioned above, two mechanical factors play an important role in determining the resulting thickness of the sealed tissue and effectiveness of the seal, i.e., the pressure applied between opposing jaw members 110 and 120 and the gap distance "G" between the opposing sealing surfaces 112, 122 of the jaw members and 120 during the sealing process. However, thickness of the resulting tissue seal cannot be adequately controlled by force alone. In other words, too much force and the two jaw members 110 and 120 would touch and possibly short resulting in little energy traveling through the tissue thus resulting in a bad tissue sea1450. Too little force and the seal would be too thick.
Applying the correct force is also important for other reasons: to oppose the walls of the vessel; to reduce the tissue impedance to a low enough value that allows enough current through the tissue; and to overcome the forces of expansion during tissue heating in addition to contributing towards creating the required end tissue thickness, which is an indication of a good seal.
In one embodiment, the electrically conductive sealing surfaces 112 and 122 of the jaw members 110 and 120, respectively, are relatively flat to avoid current concentrations at sharp edges and to avoid arcing between high points. In addition and due to the reaction force of the tissue when engaged, jaw members 110 and 120 can be manufactured to resist bending. For example, the jaw members 110 and 120 may be tapered along the width thereof, which is advantageous for two reasons: 1) the taper will apply constant pressure for a constant tissue thickness at parallel; 2) the thicker proximal portion of the jaw members 110 and 120 will resist bending due to the reaction force of the tissue.
As mentioned above, at least one jaw member, e.g., 120, may include one or more stop members 90 that limit the movement of the two opposing jaw members 110 and 120 relative to one another. In one embodiment, the stop members 90 extend from the sealing surface 122 a predetermined distance according to the specific material properties (e.g., compressive strength, thermal expansion, etc.) to yield a consistent and accurate gap distance "G" during sealing (Fig. 10B). It is envisioned for the gap distance between opposing sealing surfaces 112 and 122 during sealing ranges from about 0.001 inches to about 0.006 inches and, desirably, between about 0.002 and about 0.005 inches. In one embodiment, the non-conductive stop members 90 are molded onto the jaw members 110 and 120 (e.g., overmolding, injection molding, etc.), stamped onto the jaw members 110 and 120 or deposited (e.g., deposition) onto the jaw members 110 and 120. For example, one technique involves themially spraying a ceramic material onto the surface of the jaw member 110 and 120 to form the stop members 90. Several thermal spraying techniques are contemplated that involve depositing a broad range of heat resistant and insulative materials on various surfaces to create stop members 90 for controlling the gap distance between electrically conductive surfaces 112 and 122.
As energy is being selectively transferred to the end effector assembly 100, across the jaw members 110 and 120 and through the tissue, a tissue seal forms isolating two tissue halves. At this point and with other known vessel sealing instruments, the user may remove and replace the forceps 10 with a cutting instrument (not shown) to divide the tissue halves along the tissue seal. As can be appreciated, this is both time consuming and tedious and may result in inaccurate tissue division across the tissue seal due to misalignment or misplacement of the cutting instrument along the ideal tissue cutting plane.
As explained in detail above, the present disclosure incorporates knife assembly 160 that, when activated via the trigger assembly 70, progressively and selectively divides the tissue along an ideal tissue plane in a precise manner to effectively and reliably divide the tissue into two sealed halves. The knife assembly 160 allows the user to quickly separate the tissue immediately after sealing without substituting a cutting instrument through a cannula or trocar port. As can be appreciated, accurate sealing and dividing of tissue is accomplished with the same forceps 10.
Knife blade 190 may also be coupled to the same or an alternative electrosurgical energy source to facilitate separation of the tissue along the tissue seal.
Moreover, the angle of the trip of the knife blade 190 may be dimensioned to provide more or less aggressive cutting angles depending upon a particular purpose.
For example, the knife blade 190 may be positioned at an angle that reduces "tissue wisps"
associated with cutting. Moreover, the knife blade 190 may be designed having different blade geometries such as serrated, notched, perforated, hollow, concave, convex etc. depending upon a particular purpose or to achieve a particular result. The knife assembly 160 generally cuts in a progressive, uni-directional fashion (i.e., distally).
Once the tissue is divided into tissue halves, the jaw members 110 and 120 may be opened by re-grasping the handle 40 as explained below. Re-initiation or re-grasping of the handle 40 again moves t-shaped pin 44 of flange 42 generally proximally.
As best shown in Fig. 13, the proximal portions of the jaw members 110 and 120 and the distal end 16 of shaft 12 may be covered by a resilient or flexible insulating material 185 to reduce stray current concentrations during electrosurgical activation. The tail or proximal end of the jaw members 110 and 120 may be removed and covered with an extended section of the guide element 170 creating a semi insulative barrier to reduce stray current concentrations during electrosurgical activation. An insulating boot (not shown) may also be positioned atop the proximal portions of the jaw members 110 and 120 to further reduce current concentrations and stray currents from damaging adjacent tissue. Details relating to one envisioned insulating boot 220 are described with respect to commonly-owned U.S.
Provisional Application Serial No. 60/722,213 entitled "INSULATING BOOT FOR
ELECTROSURGICAL FORCEPS", which is incorporated by reference herein.
Switch 60 is ergonomically dimensioned and conforms to the outer shape of housing 20 (once assembled). Switch 60 is designed to electromechanically cooperate with a flex circuit 400 (See Fig. 6C) to allow a user to selectively activate the jaw members 110 and 120. It is contemplated that a flex circuit design facilitates manufacturing due to the circuit unique ability to conform as needed into tightly spaced areas. The switch 60 may also permit the user to selectively activate the forceps 10 in a variety of different orientations, i.e., multi-oriented activation or toggle-like activation.
As can be appreciated, this simplifies activation. Switch 60 may also be designed as a so called "dome switch", which also provides tactile feedback to the user when activated.
When switch 60 is depressed, trigger lead 310b carries the first electrical potential to jaw member 110 thus completing a bipolar circuit. More particularly, when switch 60 is depressed and flex circuit 400 is activated, the generator recognizes a voltage drop across leads 310a and 310c, which initiates activation of the generator to supply a first electrical potential to jaw member 110 and a second electrical potential to jaw member 120. Switch 60 acts as a control circuit and is protected or removed from the actual current loop that supplies electrical energy to the jaw members 110 and 120.
This reduces the chances of electrical failure of the switch 60 due to high current loads during activation. A footswitch (not shown), which may also be utilized with the forceps 10, also operates in a similar manner, i.e., upon activation of the footswitch, the generator recognizes a voltage drop across the input and output leads of the footswitch, which, in turn, signals the generator to initiate electrosurgical activation of the jaw members 110 and 120.
A safety switch or circuit (not shown) may be employed such that the switch cannot fire unless the jaw members 110 and 120 are closed and/or unless the jaw members 110 and 120 have tissue held therebetween.
In the latter instance, a suitable sensor (not shown) may be employed to determine if tissue is held therebetween. In addition, other sensor mechanisms may be employed that determine pre-surgical, concurrent surgical (i.e., during surgery) and/or post surgical conditions. The sensor mechanisms may also be utilized with a closed-loop feedback system coupled to the electrosurgical generator to regulate the electrosurgical energy based upon one or more pre-surgical, concurrent surgical or post surgical conditions.
The conductive surfaces 115a and 115b are electrically isolated from one another and jaw members 110 and 120 such that electrosurgical energy can be effectively transferred through the tissue to form the seal. The cable leads 310b and 325b are held loosely but securely along the cable path to permit rotation of the jaw members 110 and 120 about longitudinal axis "A" (See Fig 1A). More particularly, cable leads 310b and 325b are fed through respective halves 80a and 80b of the rotating assembly 80 in such a manner to allow rotation of the shaft 12 (via rotation of the rotating assembly 80) in the clockwise or counter-clockwise direction without unduly tangling or twisting the cable leads 310b and 325b. The presently disclosed cable lead feed path may allow rotation of the rotation assembly approximately 180 degrees in either direction.
From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. For example, it may be preferable to add other features to the forceps 10, e.g., an articulating assembly to axially displace the end effector assembly 100 relative to the elongated shaft 12.
It is also contemplated that the forceps 10 (and/or the electrosurgical generator used in connection with the forceps 10) may include a sensor or feedback mechanism (not shown) that automatically selects the appropriate amount of electrosurgical energy to effectively seal the particularly-sized tissue grasped between the jaw members 110 and 120. The sensor or feedback mechanism may also measure the impedance across the tissue during sealing and provide an indicator (visual and/or audible) that an effective seal has been created between the jaw members 110 and 120.
Moreover, the trigger assembly 70 may include other types of recoil mechanism that are designed to accomplish the same purpose, e.g., gas-actuated recoil, electrically-actuated recoil (i.e., solenoid), etc. The forceps 10 may also be used to cut tissue without sealing. Alternatively, the knife assembly 70 may be coupled to the same or alternate electrosurgical energy source to facilitate cutting of the tissue.
The outer surface of the end effector assembly 100 may include a nickel-based material, coating, stamping, metal injection molding that is designed to reduce adhesion between the jaw members 110 and 120 with the surrounding tissue during activation and sealing. Moreover, the conductive surfaces 112 and 122 of the jaw members 110 and 120 may be manufactured from one (or a combination of one or more) of the following materials: nickel-chrome, chromium nitride, MedCoat manufactured by The Electrolizing Corporation of OHIO, inconel 600 and tin-nickel.
The tissue conductive surfaces 112 and 122 may also be coated with one or more of the above materials to achieve the same result, i.e., a "non-stick surface".
As can be appreciated, reducing the amount that the tissue "sticks" during sealing improves the overall efficacy of the instrument.
One particular class of materials disclosed herein has demonstrated superior non-stick properties and, in some instances, superior seal quality.
For example, nitride coatings that include, but not are not limited to: TiN, ZrN, TiAIN, and CrN are preferred materials used for non-stick purposes. CrN has been found to be particularly useful for non-stick purposes due to its overall surface properties and optimal performance. Other classes of materials have also been found to reducing overall sticking. For example, high nickel/chrome alloys with a Ni/Cr ratio of approximately 5:1 have been found to significantly reduce sticking in bipolar instrumentation. One particularly useful non-stick material in this class is Inconel 600.
Bipolar instrumentation having sealing surfaces 112 and 122 made from or coated with Ni200, Ni201 (-100% Ni) also showed improved non-stick performance over typical bipolar stainless steel electrodes.
As can be appreciated, locating the switch 60 on the forceps 10 has many advantages. For example, the switch 60 reduces the amount of electrica{ cable in the operating room and eliminates the possibility of activating the wrong instrument during a surgical procedure due to "line-of-sight" activation. Moreover, the switch 60 may be configured such that it is mechanically or electro-mechanically decommissioned during trigger activation to eliminate u ri intentionally activating the device during the cutting process. The switch 60 may also be disposed on another part of the forceps 10, e.g., the fixed handle 50, rotating assembly 80, housing 20, etc.
The forceps 10 may be equipped with an automatic, electro-mechanical release mechanism (not shown) that releases the tissue once an end seal is determined (i.e., end-tone signal from the generator). For example, an electromechanical interface may be configured to automatically release the t-shaped pin 44 from catch basin 55 upon an end tone condition.
It is also contemplated that the forceps 10 may be dimensioned to include a trigger assembly 70 that operates in lieu of the switch assembly 60 to activate the forceps to seal tissue while also advancing the knife 190 to divide the tissue across the seal. For example, the trigger assembly 70 could be configured to have two stages: a first or initial stroke stage that activates the generator to selectively seal tissue; and a second or subsequent stage that advances the knife through the tissue.
Alternatively, another embodiment may include a trigger assembly that simultaneously activates the jaw members 110 and 120 to seal tissue and advances the knife 190 through the tissue during activation.
The rotating assembly 80 may be equipped with one or more mechanical interfaces that are rotatable with or within the rotating assembly 80 and that are configured to produce tactile and/or audible feedback to the user during rotation. The tactile and/or audible feedback (i.e., a "click") may be configured to correspond to a particular degree of rotation of the end effector assembly 100 about the axis "A". It is also contemplated that one or more types of visual indicia may also be employed with the rotating assembly 80 to correspond to the amount or degree of rotation of the end effector assembly 100 and may be designed correspond to or relate to the audible and/or tactile feedback depending upon a particular purpose.
Another version of the forceps 10 may include a telescoping shaft that allows the user to selectively regulate the length of the instrument for particular surgical purposes. For example, the shaft may include two slidingly reciprocatable and extendible elements that, upon exertion (i.e., pulling, twisting, or by virtue of a mechanical lever on the handle), either lengthen or shorten the size of the elongated shaft 12 depending upon a particular surgical purpose.
Moreover, it is also contemplated that the diameter of shaft 12 may be selectively expandable depending upon a particular surgical purpose or to provide rigidity of the forceps 10 inside the surgical cavity or to enhance the sealing effect of the shaft through a trocar. More particularly, it is contemplated that the shaft 12 may be configured to expand upon exertion (i.e., twisting or rotating one element inside another (iris-like), sliding a mechanical lever, an inflatable system, a mechanically expanding system or other types of known expansion systems). As a result, the surgeon can selectively expand the outer diameter of the shaft 12 to enhance the rigidity of the shaft 12 within a trocar and/or erihance the sealing effect of the shaft 12 within the trocar to reduce the possibility of pressure leakage from surgical cavity during use.
Moreover, a single forceps may be selectively adaptable to work with differently-sized trocars and/or cannulas, which may prove advantageous for particular operations and other surgical procedures.
It is also contemplated that the forceps 10 may be configured such that handle 50 is selectively replaceable or selectively positionable depending upon user preference. For example, handle 50 may be selectively detached and replaced with another handle 50 that is of different dimension (i.e., size, weight, angle, orientation to user's hand, etc.), which facilitates handling during surgical procedures.
Alternatively, handle 50 may be selectively positionable relative to the housing 20 (i.e., the angle of the handle to the housing is adjustable) to facilitate handling and use during particuiar surgical procedures or for user comfort.
The forceps may be configure to include a visual indicator (which cooperates with the "end tone" indicator on the generator) to provide visual confirmation of a successful seal (e.g., a green LED indicator). The visual indicator (not shown) may be employed on or in connection with the end effector assembly 100 or shaft 12 that is in line-of-site of the surgeon during use. The visual indicator may also be designed to warn the user of a mis-seal condition or a re-grasp condition (e.g., a red LED
indicator).
Alternatively, the visual indicator may also be configured to provide progressive feedback of the formation of the seal during the seaiing process. For example, a series of LEDs may be employed on the end effector assembly 100 (or shaft 12) that progressively illuminate through the sealing process to provide visual feedback to the user regarding the status of the seal. Moreover, one or both jaw members may include visual markings that indicate the end of a seal and/or the length of the seal cut.
The guide element 170 (See Fig. 14) may be configured to not only guide the knife 190 into the knife channel 115 disposed between the jaw members 110 and 120, but may also be dimensioned to precisely space the jaw mernbers 110 and relative to one another about the pivot 95. Moreover, the guide element 170 may be configured to include one or more grooves of tracks (not shown) to guide the electrical connections or wires 310b and 325b through the end effector assembly 100. The guide element 170 may also be configured to limit the distal movement of the drive rod 193 for the knife 190, which, in turn, limits the overall travel of the knife 190 through the knife channel 115. The distal end of the guide element may be extended to work with the overmolded jaw elements 116 and 126 to create a set of tissue blocking features that inhibit tissue from getting behind or moving proximal to the active electrode surface.
The stem 95a of the pivot pin 95 may include a stepped diameter that securely compresses the jaw members 110 and 120 together when mechanically secured with the cap 95b. Moreover, the pivot may be dimensioned to include a pass through or aperture 96 that allows translation of the knife therethrough. The two-piece pivot 95 including stem 95a and cap 95b may be assembled during the manufacturing process by any one of several known manufacturing techniques including: laser or heat-based welding, press-fit mechanical interaction (or other mechanically interlocking geometry, adhesives, chemical bonding, etc.
The shaft may be dimensioned to enhance visibility and/or non-symmetric depending upon a particular purpose, For example, it is contemplated that the shaft may be generally oval in dimension thereby providing uni-directional strength in one dimension versus another and maximized visibility to the operating site in one direction versus another. Alternatively, the shaft may be other geometric configurations depending upon a particular purpose, I-beam, square, poiygonal, etc.
The end effector assembly 100 is optimized for reengaging long tissue sections and visibility of the operating site. The jaw members 110 and 120 may also be dimensioned to include distal ends configured for gross or biunt dissection.
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the ciaims appended hereto.
Claims (20)
1. A bipolar forceps, comprising:
a housing;
a shaft coupled to the housing having jaw members at a distal end thereof, the shaft having a longitudinal axis defined therethrough, the jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal;
a drive assembly operable to move the jaw members relative to one another from a first position, wherein the jaw members are disposed in spaced relation relative to one another, to a second position, wherein the jaw members are closer to one another, for manipulating tissue;
a movable handle rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions, the pivot located a fixed distance above the longitudinal axis and the drive flange located generally along the longitudinal axis; and a knife assembly having a movable knife bar that includes a generally t-shaped proximal end dimensioned to engage a corresponding slot defined within the housing, the slot guiding the movement of the knife bar during translation thereof.
a housing;
a shaft coupled to the housing having jaw members at a distal end thereof, the shaft having a longitudinal axis defined therethrough, the jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal;
a drive assembly operable to move the jaw members relative to one another from a first position, wherein the jaw members are disposed in spaced relation relative to one another, to a second position, wherein the jaw members are closer to one another, for manipulating tissue;
a movable handle rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions, the pivot located a fixed distance above the longitudinal axis and the drive flange located generally along the longitudinal axis; and a knife assembly having a movable knife bar that includes a generally t-shaped proximal end dimensioned to engage a corresponding slot defined within the housing, the slot guiding the movement of the knife bar during translation thereof.
2. A bipolar forceps according to claim 1, wherein the knife bar is coupled to a knife slidingly disposed within the shaft and the forceps further comprises a finger actuator associated with the knife assembly, wherein movement of the finger actuator moves the knife bar, which, in turn, moves the knife to cut tissue disposed between the jaw members.
3. A bipolar forceps according to claim 1, wherein the shaft includes a drive sleeve slidingly disposed therein that couples to the drive assembly for moving the jaw members and the knife assembly includes a cuff at the distal end of the knife bar, the cuff being dimensioned to encapsulate and move atop the drive sleeve upon movement of the knife bar.
4. A bipolar forceps according to claim 3, further comprising a finger actuator associated with the knife assembly, the finger actuator including two generally u-shaped flanges that rotate about a pivot to abut and force the cuff distally, which, in turn, results in distal translation of the knife bar.
5. A bipolar forceps according to claim 1, further comprising a spring that biases the knife assembly in a proximal-most orientation.
6. A bipolar forceps according to claim 3, further comprising a spring that is biased against the cuff to force the knife assembly in a proximal-most orientation.
7. A bipolar forceps according to claim 1, further comprising a rotating assembly operable to rotate the jaw members about the longitudinal axis defined through the shaft.
8. A bipolar forceps according to claim 1, further comprising a hand switch disposed within the housing and adapted to connect to the source of electrosurgical energy, the hand switch operable to allow a user to selectively supply bipolar energy to the jaw members to effect a tissue seal.
9. A bipolar forceps according to claim 1, wherein at least one of the jaw members includes a series of stop members disposed thereon configured to regulate the distance between the jaw members during sealing.
10. A bipolar forceps, comprising:
a housing;
a shaft coupled to the housing having jaw members at a distal end thereof, the shaft having a longitudinal axis defined therethrough, the jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal;
a drive assembly operable to move the jaw member relative to one another about a pivot from a first position, wherein the jaw members are disposed in spaced relation relative to one another, to a second position, wherein the jaw members are closer to one another, for manipulating tissue;
a movable handle rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions, the pivot located a fixed distance above the longitudinal axis and the drive flange located generally along the longitudinal axis;
a trigger assembly coupled to the housing and coupled to a knife assembly having a drive rod that, upon actuation of the trigger assembly, selectively translates a knife through tissue disposed between the jaw members; and a knife guide dimensioned to facilitate alignment and translation of the knife through and into a knife channel defined between the jaw members.
a housing;
a shaft coupled to the housing having jaw members at a distal end thereof, the shaft having a longitudinal axis defined therethrough, the jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal;
a drive assembly operable to move the jaw member relative to one another about a pivot from a first position, wherein the jaw members are disposed in spaced relation relative to one another, to a second position, wherein the jaw members are closer to one another, for manipulating tissue;
a movable handle rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions, the pivot located a fixed distance above the longitudinal axis and the drive flange located generally along the longitudinal axis;
a trigger assembly coupled to the housing and coupled to a knife assembly having a drive rod that, upon actuation of the trigger assembly, selectively translates a knife through tissue disposed between the jaw members; and a knife guide dimensioned to facilitate alignment and translation of the knife through and into a knife channel defined between the jaw members.
11. A bipolar forceps according to claim 10, wherein the knife guide includes two engageable halves that insulate the jaw members from one another.
12. A bipolar forceps according to claim 10, wherein the knife guide includes at least one aperture defined therein that allows the pivot to extend therethrough.
13. A bipolar forceps according to claim 10, wherein the drive assembly includes a cam pin at a distal end thereof that engages the jaw members and wherein the knife guide includes at least one slot defined therein that allows the cam pin to extend therethrough.
14. A bipolar forceps according to claim 10, wherein the pivot includes an aperture defined therein that allows the knife to extend therethrough.
15. A bipolar forceps according to claim 14, wherein the pivot includes a stem and a cap that matingly engage on opposite sides of the shaft to secure the jaw members during assembly.
16. A bipolar forceps, comprising:
a housing;
a shaft coupled to the housing having jaw members at a distal end thereof, the shaft having a longitudinal axis defined therethrough, the jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal;
a drive assembly operable to move the jaw member relative to one another about a pivot from a first position, wherein the jaw members are disposed in spaced relation relative to one another, to a second position, wherein the jaw members are closer to one another, for manipulating tissue;
a movable handle rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions, the pivot located a fixed distance above the longitudinal axis and the drive flange located generally along the longitudinal axis;
a trigger assembly coupled with the housing and coupled to a knife assembly having a drive rod that, upon actuation of the trigger assembly, selectively translates a knife through tissue disposed between the jaw members, the knife assembly including a knife carriage having a t-shaped distal end that engages the trigger assembly and a proximal end that engages a knife bar slidingly mounted within the housing; and a knife guide dimensioned to facilitate alignment and translation of the knife through and into a knife channel defined between the jaw members.
a housing;
a shaft coupled to the housing having jaw members at a distal end thereof, the shaft having a longitudinal axis defined therethrough, the jaw members adapted to connect to a source of electrosurgical energy such that the jaw members are capable of conducting energy through tissue held therebetween to effect a tissue seal;
a drive assembly operable to move the jaw member relative to one another about a pivot from a first position, wherein the jaw members are disposed in spaced relation relative to one another, to a second position, wherein the jaw members are closer to one another, for manipulating tissue;
a movable handle rotatable about a pivot to force a drive flange of the drive assembly to move the jaw members between the first and second positions, the pivot located a fixed distance above the longitudinal axis and the drive flange located generally along the longitudinal axis;
a trigger assembly coupled with the housing and coupled to a knife assembly having a drive rod that, upon actuation of the trigger assembly, selectively translates a knife through tissue disposed between the jaw members, the knife assembly including a knife carriage having a t-shaped distal end that engages the trigger assembly and a proximal end that engages a knife bar slidingly mounted within the housing; and a knife guide dimensioned to facilitate alignment and translation of the knife through and into a knife channel defined between the jaw members.
17. A bipolar forceps according to claim 16, wherein the knife bar includes a cuff at a distal end thereof that defines an aperture located therethrough, the shaft being rotatingly and slideably disposed through the aperture.
18. A bipolar forceps according to claim 16, wherein the pivot includes an aperture defined therein that allows the knife to extend therethrough.
19. A bipolar forceps according to claim 16, wherein the drive assembly includes an elongated drive sleeve that couples at a proximal end to the movable handle to move the jaw members between the first and second positions, the drive assembly further including a cam pin that couples the distal end of the drive sleeve to the jaw members for actuation thereof.
20. A bipolar forceps according to claim 19, wherein the knife includes a slot defined therein that allows the cam pin to extend therethrough.
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US76144206P | 2006-01-24 | 2006-01-24 | |
US60/761,442 | 2006-01-24 | ||
US11/595,194 US7766910B2 (en) | 2006-01-24 | 2006-11-09 | Vessel sealer and divider for large tissue structures |
US11/595,194 | 2006-11-09 |
Publications (2)
Publication Number | Publication Date |
---|---|
CA2574748A1 true CA2574748A1 (en) | 2007-07-24 |
CA2574748C CA2574748C (en) | 2015-03-24 |
Family
ID=37908198
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA2574748A Active CA2574748C (en) | 2006-01-24 | 2007-01-22 | Vessel sealer and divider for large tissue structures |
Country Status (7)
Country | Link |
---|---|
US (2) | US7766910B2 (en) |
EP (4) | EP2286752B2 (en) |
JP (3) | JP5196793B2 (en) |
AU (1) | AU2007200294B2 (en) |
CA (1) | CA2574748C (en) |
DE (1) | DE602007001898D1 (en) |
ES (3) | ES2391541T3 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN113906369A (en) * | 2019-03-28 | 2022-01-07 | Abb瑞士股份有限公司 | User interface device for controlling a marine vessel |
Families Citing this family (505)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6447511B1 (en) | 1994-12-13 | 2002-09-10 | Symbiosis Corporation | Bipolar endoscopic surgical scissor blades and instrument incorporating the same |
US6726686B2 (en) | 1997-11-12 | 2004-04-27 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US7435249B2 (en) | 1997-11-12 | 2008-10-14 | Covidien Ag | Electrosurgical instruments which reduces collateral damage to adjacent tissue |
WO2002080786A1 (en) | 2001-04-06 | 2002-10-17 | Sherwood Services Ag | Electrosurgical instrument which reduces collateral damage to adjacent tissue |
US6228083B1 (en) | 1997-11-14 | 2001-05-08 | Sherwood Services Ag | Laparoscopic bipolar electrosurgical instrument |
US7267677B2 (en) | 1998-10-23 | 2007-09-11 | Sherwood Services Ag | Vessel sealing instrument |
US7364577B2 (en) | 2002-02-11 | 2008-04-29 | Sherwood Services Ag | Vessel sealing system |
US7582087B2 (en) | 1998-10-23 | 2009-09-01 | Covidien Ag | Vessel sealing instrument |
US7118570B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealing forceps with disposable electrodes |
US7887535B2 (en) | 1999-10-18 | 2011-02-15 | Covidien Ag | Vessel sealing wave jaw |
US20030109875A1 (en) | 1999-10-22 | 2003-06-12 | Tetzlaff Philip M. | Open vessel sealing forceps with disposable electrodes |
US7101371B2 (en) | 2001-04-06 | 2006-09-05 | Dycus Sean T | Vessel sealer and divider |
US10849681B2 (en) | 2001-04-06 | 2020-12-01 | Covidien Ag | Vessel sealer and divider |
JP4499992B2 (en) | 2001-04-06 | 2010-07-14 | コヴィディエン アクチェンゲゼルシャフト | Vascular sealing machine and splitting machine having non-conductive stop member |
US10835307B2 (en) | 2001-06-12 | 2020-11-17 | Ethicon Llc | Modular battery powered handheld surgical instrument containing elongated multi-layered shaft |
US7270664B2 (en) | 2002-10-04 | 2007-09-18 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
US7276068B2 (en) | 2002-10-04 | 2007-10-02 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
US7931649B2 (en) | 2002-10-04 | 2011-04-26 | Tyco Healthcare Group Lp | Vessel sealing instrument with electrical cutting mechanism |
US7799026B2 (en) | 2002-11-14 | 2010-09-21 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US7776036B2 (en) | 2003-03-13 | 2010-08-17 | Covidien Ag | Bipolar concentric electrode assembly for soft tissue fusion |
US8128624B2 (en) | 2003-05-01 | 2012-03-06 | Covidien Ag | Electrosurgical instrument that directs energy delivery and protects adjacent tissue |
AU2004237772B2 (en) | 2003-05-01 | 2009-12-10 | Covidien Ag | Electrosurgical instrument which reduces thermal damage to adjacent tissue |
US7160299B2 (en) | 2003-05-01 | 2007-01-09 | Sherwood Services Ag | Method of fusing biomaterials with radiofrequency energy |
US7491201B2 (en) | 2003-05-15 | 2009-02-17 | Covidien Ag | Tissue sealer with non-conductive variable stop members and method of sealing tissue |
USD956973S1 (en) | 2003-06-13 | 2022-07-05 | Covidien Ag | Movable handle for endoscopic vessel sealer and divider |
US7857812B2 (en) | 2003-06-13 | 2010-12-28 | Covidien Ag | Vessel sealer and divider having elongated knife stroke and safety for cutting mechanism |
US7156846B2 (en) | 2003-06-13 | 2007-01-02 | Sherwood Services Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7150749B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Vessel sealer and divider having elongated knife stroke and safety cutting mechanism |
US9848938B2 (en) | 2003-11-13 | 2017-12-26 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US7367976B2 (en) | 2003-11-17 | 2008-05-06 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US7500975B2 (en) | 2003-11-19 | 2009-03-10 | Covidien Ag | Spring loaded reciprocating tissue cutting mechanism in a forceps-style electrosurgical instrument |
US7131970B2 (en) | 2003-11-19 | 2006-11-07 | Sherwood Services Ag | Open vessel sealing instrument with cutting mechanism |
US7811283B2 (en) | 2003-11-19 | 2010-10-12 | Covidien Ag | Open vessel sealing instrument with hourglass cutting mechanism and over-ratchet safety |
US7442193B2 (en) | 2003-11-20 | 2008-10-28 | Covidien Ag | Electrically conductive/insulative over-shoe for tissue fusion |
US8182501B2 (en) | 2004-02-27 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical shears and method for sealing a blood vessel using same |
US7780662B2 (en) | 2004-03-02 | 2010-08-24 | Covidien Ag | Vessel sealing system using capacitive RF dielectric heating |
US7195631B2 (en) | 2004-09-09 | 2007-03-27 | Sherwood Services Ag | Forceps with spring loaded end effector assembly |
US7540872B2 (en) | 2004-09-21 | 2009-06-02 | Covidien Ag | Articulating bipolar electrosurgical instrument |
US7384421B2 (en) * | 2004-10-06 | 2008-06-10 | Sherwood Services Ag | Slide-activated cutting assembly |
US7955332B2 (en) | 2004-10-08 | 2011-06-07 | Covidien Ag | Mechanism for dividing tissue in a hemostat-style instrument |
MX2007004151A (en) | 2004-10-08 | 2007-09-11 | Johnson & Johnson | Ultrasonic surgical instrument. |
US7686827B2 (en) | 2004-10-21 | 2010-03-30 | Covidien Ag | Magnetic closure mechanism for hemostat |
US7686804B2 (en) | 2005-01-14 | 2010-03-30 | Covidien Ag | Vessel sealer and divider with rotating sealer and cutter |
US7909823B2 (en) | 2005-01-14 | 2011-03-22 | Covidien Ag | Open vessel sealing instrument |
US7918848B2 (en) | 2005-03-25 | 2011-04-05 | Maquet Cardiovascular, Llc | Tissue welding and cutting apparatus and method |
US8197472B2 (en) | 2005-03-25 | 2012-06-12 | Maquet Cardiovascular, Llc | Tissue welding and cutting apparatus and method |
US7491202B2 (en) | 2005-03-31 | 2009-02-17 | Covidien Ag | Electrosurgical forceps with slow closure sealing plates and method of sealing tissue |
US7837685B2 (en) | 2005-07-13 | 2010-11-23 | Covidien Ag | Switch mechanisms for safe activation of energy on an electrosurgical instrument |
US7628791B2 (en) | 2005-08-19 | 2009-12-08 | Covidien Ag | Single action tissue sealer |
US7879035B2 (en) | 2005-09-30 | 2011-02-01 | Covidien Ag | Insulating boot for electrosurgical forceps |
US7922953B2 (en) * | 2005-09-30 | 2011-04-12 | Covidien Ag | Method for manufacturing an end effector assembly |
US7789878B2 (en) | 2005-09-30 | 2010-09-07 | Covidien Ag | In-line vessel sealer and divider |
US7722607B2 (en) | 2005-09-30 | 2010-05-25 | Covidien Ag | In-line vessel sealer and divider |
ES2381560T3 (en) | 2005-09-30 | 2012-05-29 | Covidien Ag | Insulating sleeve for electrosurgical forceps |
CA2561034C (en) | 2005-09-30 | 2014-12-09 | Sherwood Services Ag | Flexible endoscopic catheter with an end effector for coagulating and transfecting tissue |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
US7621930B2 (en) | 2006-01-20 | 2009-11-24 | Ethicon Endo-Surgery, Inc. | Ultrasound medical instrument having a medical ultrasonic blade |
US8298232B2 (en) * | 2006-01-24 | 2012-10-30 | Tyco Healthcare Group Lp | Endoscopic vessel sealer and divider for large tissue structures |
US7766910B2 (en) | 2006-01-24 | 2010-08-03 | Tyco Healthcare Group Lp | Vessel sealer and divider for large tissue structures |
US8241282B2 (en) | 2006-01-24 | 2012-08-14 | Tyco Healthcare Group Lp | Vessel sealing cutting assemblies |
US8734443B2 (en) | 2006-01-24 | 2014-05-27 | Covidien Lp | Vessel sealer and divider for large tissue structures |
US8882766B2 (en) | 2006-01-24 | 2014-11-11 | Covidien Ag | Method and system for controlling delivery of energy to divide tissue |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US7846158B2 (en) | 2006-05-05 | 2010-12-07 | Covidien Ag | Apparatus and method for electrode thermosurgery |
US7776037B2 (en) * | 2006-07-07 | 2010-08-17 | Covidien Ag | System and method for controlling electrode gap during tissue sealing |
WO2008008457A2 (en) * | 2006-07-13 | 2008-01-17 | Bovie Medical | Surgical sealing and cutting apparatus |
US7744615B2 (en) | 2006-07-18 | 2010-06-29 | Covidien Ag | Apparatus and method for transecting tissue on a bipolar vessel sealing instrument |
US20080033428A1 (en) * | 2006-08-04 | 2008-02-07 | Sherwood Services Ag | System and method for disabling handswitching on an electrosurgical instrument |
US8597297B2 (en) | 2006-08-29 | 2013-12-03 | Covidien Ag | Vessel sealing instrument with multiple electrode configurations |
US8070746B2 (en) | 2006-10-03 | 2011-12-06 | Tyco Healthcare Group Lp | Radiofrequency fusion of cardiac tissue |
US7951149B2 (en) | 2006-10-17 | 2011-05-31 | Tyco Healthcare Group Lp | Ablative material for use with tissue treatment device |
USD649249S1 (en) | 2007-02-15 | 2011-11-22 | Tyco Healthcare Group Lp | End effectors of an elongated dissecting and dividing instrument |
US8911460B2 (en) | 2007-03-22 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8142461B2 (en) | 2007-03-22 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8057498B2 (en) | 2007-11-30 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument blades |
US8267935B2 (en) * | 2007-04-04 | 2012-09-18 | Tyco Healthcare Group Lp | Electrosurgical instrument reducing current densities at an insulator conductor junction |
WO2009005850A1 (en) | 2007-06-29 | 2009-01-08 | Tyco Healthcare Group, Lp | Method and system for monitoring tissue during an electrosurgical procedure |
DE202007009165U1 (en) * | 2007-06-29 | 2007-08-30 | Kls Martin Gmbh + Co. Kg | Surgical instrument e.g. tube shaft, for use in e.g. high frequency coagulation instrument, has separator inserted through opening such that largest extension of opening transverse to moving direction corresponds to dimension of separator |
US8523889B2 (en) | 2007-07-27 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Ultrasonic end effectors with increased active length |
US8808319B2 (en) | 2007-07-27 | 2014-08-19 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8512365B2 (en) | 2007-07-31 | 2013-08-20 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US9044261B2 (en) | 2007-07-31 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Temperature controlled ultrasonic surgical instruments |
US8430898B2 (en) | 2007-07-31 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US7877853B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing end effector assembly for sealing tissue |
US7877852B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing an end effector assembly for sealing tissue |
US9023043B2 (en) | 2007-09-28 | 2015-05-05 | Covidien Lp | Insulating mechanically-interfaced boot and jaws for electrosurgical forceps |
US8267936B2 (en) | 2007-09-28 | 2012-09-18 | Tyco Healthcare Group Lp | Insulating mechanically-interfaced adhesive for electrosurgical forceps |
US8235992B2 (en) | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Insulating boot with mechanical reinforcement for electrosurgical forceps |
US8235993B2 (en) | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Insulating boot for electrosurgical forceps with exohinged structure |
US8251996B2 (en) | 2007-09-28 | 2012-08-28 | Tyco Healthcare Group Lp | Insulating sheath for electrosurgical forceps |
US8236025B2 (en) | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Silicone insulated electrosurgical forceps |
US8241283B2 (en) | 2007-09-28 | 2012-08-14 | Tyco Healthcare Group Lp | Dual durometer insulating boot for electrosurgical forceps |
US8221416B2 (en) | 2007-09-28 | 2012-07-17 | Tyco Healthcare Group Lp | Insulating boot for electrosurgical forceps with thermoplastic clevis |
AU2008308606B2 (en) | 2007-10-05 | 2014-12-18 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
DE102007053359B3 (en) | 2007-10-30 | 2009-06-04 | Aesculap Ag | Surgical instrument |
US9050098B2 (en) * | 2007-11-28 | 2015-06-09 | Covidien Ag | Cordless medical cauterization and cutting device |
US10010339B2 (en) | 2007-11-30 | 2018-07-03 | Ethicon Llc | Ultrasonic surgical blades |
DE112008003419B4 (en) | 2007-12-18 | 2018-08-30 | Bovie Medical Corporation | Surgical device with removable instrument plug-in module |
US8728076B2 (en) * | 2007-12-18 | 2014-05-20 | Bovie Medical Corporation | Surgical apparatus with removable tool cartridge |
US8764748B2 (en) | 2008-02-06 | 2014-07-01 | Covidien Lp | End effector assembly for electrosurgical device and method for making the same |
US8398673B2 (en) | 2008-02-15 | 2013-03-19 | Surgical Innovations V.O.F. | Surgical instrument for grasping and cutting tissue |
US8623276B2 (en) | 2008-02-15 | 2014-01-07 | Covidien Lp | Method and system for sterilizing an electrosurgical instrument |
US8388646B2 (en) * | 2008-02-22 | 2013-03-05 | Covidien Lp | Monocoque jaw design |
EP2265196B9 (en) | 2008-03-31 | 2013-10-02 | Applied Medical Resources Corporation | Electrosurgical system with means for measuring permittivity and conductivity of tissue |
US20090254081A1 (en) | 2008-04-08 | 2009-10-08 | Tyco Electronics Corporation | System and method for surgical jaw assembly |
US9968396B2 (en) | 2008-05-27 | 2018-05-15 | Maquet Cardiovascular Llc | Surgical instrument and method |
US9402680B2 (en) * | 2008-05-27 | 2016-08-02 | Maquet Cardiovasular, Llc | Surgical instrument and method |
US8469956B2 (en) | 2008-07-21 | 2013-06-25 | Covidien Lp | Variable resistor jaw |
US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US8257387B2 (en) | 2008-08-15 | 2012-09-04 | Tyco Healthcare Group Lp | Method of transferring pressure in an articulating surgical instrument |
US8162973B2 (en) | 2008-08-15 | 2012-04-24 | Tyco Healthcare Group Lp | Method of transferring pressure in an articulating surgical instrument |
US9603652B2 (en) | 2008-08-21 | 2017-03-28 | Covidien Lp | Electrosurgical instrument including a sensor |
US8784417B2 (en) | 2008-08-28 | 2014-07-22 | Covidien Lp | Tissue fusion jaw angle improvement |
US8317787B2 (en) | 2008-08-28 | 2012-11-27 | Covidien Lp | Tissue fusion jaw angle improvement |
US8795274B2 (en) | 2008-08-28 | 2014-08-05 | Covidien Lp | Tissue fusion jaw angle improvement |
US8303582B2 (en) | 2008-09-15 | 2012-11-06 | Tyco Healthcare Group Lp | Electrosurgical instrument having a coated electrode utilizing an atomic layer deposition technique |
US8535312B2 (en) | 2008-09-25 | 2013-09-17 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US8968314B2 (en) | 2008-09-25 | 2015-03-03 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US9375254B2 (en) | 2008-09-25 | 2016-06-28 | Covidien Lp | Seal and separate algorithm |
US8142473B2 (en) | 2008-10-03 | 2012-03-27 | Tyco Healthcare Group Lp | Method of transferring rotational motion in an articulating surgical instrument |
US8469957B2 (en) | 2008-10-07 | 2013-06-25 | Covidien Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8016827B2 (en) | 2008-10-09 | 2011-09-13 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8636761B2 (en) | 2008-10-09 | 2014-01-28 | Covidien Lp | Apparatus, system, and method for performing an endoscopic electrosurgical procedure |
US8852179B2 (en) | 2008-10-10 | 2014-10-07 | Covidien Lp | Apparatus, system and method for monitoring tissue during an electrosurgical procedure |
US8486107B2 (en) | 2008-10-20 | 2013-07-16 | Covidien Lp | Method of sealing tissue using radiofrequency energy |
US9782217B2 (en) | 2008-11-13 | 2017-10-10 | Covidien Ag | Radio frequency generator and method for a cordless medical cauterization and cutting device |
US8302948B2 (en) * | 2008-11-21 | 2012-11-06 | Raytheon Company | Test fixture with high-current electrical connection |
US8197479B2 (en) | 2008-12-10 | 2012-06-12 | Tyco Healthcare Group Lp | Vessel sealer and divider |
US8114122B2 (en) * | 2009-01-13 | 2012-02-14 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8226650B2 (en) * | 2009-03-26 | 2012-07-24 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an endoscopic electrosurgical procedure |
US8277446B2 (en) | 2009-04-24 | 2012-10-02 | Tyco Healthcare Group Lp | Electrosurgical tissue sealer and cutter |
WO2010126129A1 (en) * | 2009-04-30 | 2010-11-04 | テルモ株式会社 | Medical manipulator |
US8187273B2 (en) | 2009-05-07 | 2012-05-29 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US9700339B2 (en) | 2009-05-20 | 2017-07-11 | Ethicon Endo-Surgery, Inc. | Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments |
US8246618B2 (en) | 2009-07-08 | 2012-08-21 | Tyco Healthcare Group Lp | Electrosurgical jaws with offset knife |
US8663220B2 (en) | 2009-07-15 | 2014-03-04 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
GB2472012A (en) | 2009-07-20 | 2011-01-26 | Microoncology Ltd | Microwave antenna with flat paddle shape |
GB2472972A (en) | 2009-07-20 | 2011-03-02 | Microoncology Ltd | A microwave antenna |
USD630324S1 (en) * | 2009-08-05 | 2011-01-04 | Tyco Healthcare Group Lp | Dissecting surgical jaw |
US9955858B2 (en) | 2009-08-21 | 2018-05-01 | Maquet Cardiovascular Llc | Surgical instrument and method for use |
US8430876B2 (en) | 2009-08-27 | 2013-04-30 | Tyco Healthcare Group Lp | Vessel sealer and divider with knife lockout |
US8357159B2 (en) * | 2009-09-03 | 2013-01-22 | Covidien Lp | Open vessel sealing instrument with pivot assembly |
US8568412B2 (en) * | 2009-09-09 | 2013-10-29 | Covidien Lp | Apparatus and method of controlling cutting blade travel through the use of etched features |
US8439911B2 (en) * | 2009-09-09 | 2013-05-14 | Coviden Lp | Compact jaw including through bore pivot pin |
US20110060335A1 (en) * | 2009-09-10 | 2011-03-10 | Tyco Healthcare Group Lp | Apparatus for Tissue Fusion and Method of Use |
US8133254B2 (en) * | 2009-09-18 | 2012-03-13 | Tyco Healthcare Group Lp | In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor |
US8112871B2 (en) | 2009-09-28 | 2012-02-14 | Tyco Healthcare Group Lp | Method for manufacturing electrosurgical seal plates |
US9820806B2 (en) * | 2009-09-29 | 2017-11-21 | Covidien Lp | Switch assembly for electrosurgical instrument |
US10172669B2 (en) * | 2009-10-09 | 2019-01-08 | Ethicon Llc | Surgical instrument comprising an energy trigger lockout |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US8951248B2 (en) | 2009-10-09 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US8343151B2 (en) | 2009-10-09 | 2013-01-01 | Covidien Lp | Vessel sealer and divider with captured cutting element |
US8906016B2 (en) * | 2009-10-09 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Surgical instrument for transmitting energy to tissue comprising steam control paths |
US8747404B2 (en) | 2009-10-09 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Surgical instrument for transmitting energy to tissue comprising non-conductive grasping portions |
US8939974B2 (en) | 2009-10-09 | 2015-01-27 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising first and second drive systems actuatable by a common trigger mechanism |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
US8574231B2 (en) | 2009-10-09 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Surgical instrument for transmitting energy to tissue comprising a movable electrode or insulator |
US8480671B2 (en) * | 2010-01-22 | 2013-07-09 | Covidien Lp | Compact jaw including split pivot pin |
US8328061B2 (en) | 2010-02-02 | 2012-12-11 | Covidien Lp | Surgical instrument for joining tissue |
BR112012003356B1 (en) | 2010-02-04 | 2021-02-02 | Aesculap Ag | electrosurgical device |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
US8951272B2 (en) | 2010-02-11 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Seal arrangements for ultrasonically powered surgical instruments |
US8696665B2 (en) | 2010-03-26 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical cutting and sealing instrument with reduced firing force |
US8074859B2 (en) | 2010-03-31 | 2011-12-13 | Tyco Healthcare Group Lp | Surgical instrument |
DE102010016291A1 (en) * | 2010-04-01 | 2011-10-06 | Erbe Elektromedizin Gmbh | Surgical instrument, in particular electrosurgical instrument |
US8834518B2 (en) | 2010-04-12 | 2014-09-16 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with cam-actuated jaws |
US8623044B2 (en) | 2010-04-12 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Cable actuated end-effector for a surgical instrument |
US8496682B2 (en) * | 2010-04-12 | 2013-07-30 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with cam-actuated jaws |
US8709035B2 (en) | 2010-04-12 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with jaws having a parallel closure motion |
US8623018B2 (en) * | 2010-04-13 | 2014-01-07 | Covidien Lp | Sealing plate temperature control |
US8535311B2 (en) | 2010-04-22 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument comprising closing and firing systems |
US8632458B2 (en) * | 2011-10-26 | 2014-01-21 | Macroplata Inc. | Gentle hemorrhoid treatment offering a substantially painless healing |
US8439913B2 (en) * | 2010-04-29 | 2013-05-14 | Covidien Lp | Pressure sensing sealing plate |
US20110270251A1 (en) | 2010-04-29 | 2011-11-03 | Tyco Healthcare Group Lp | Insulated Sealing Plate |
US20110270245A1 (en) * | 2010-04-29 | 2011-11-03 | Tyco Healthcare Group Lp | Sealing Plate Having Depressions with Ceramic Insulation |
US8685020B2 (en) | 2010-05-17 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instruments and end effectors therefor |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US8491624B2 (en) * | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8469992B2 (en) | 2010-06-02 | 2013-06-25 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8409246B2 (en) * | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8491626B2 (en) | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8540749B2 (en) | 2010-06-02 | 2013-09-24 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8430877B2 (en) * | 2010-06-02 | 2013-04-30 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8409247B2 (en) | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8469991B2 (en) | 2010-06-02 | 2013-06-25 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8491625B2 (en) | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8585736B2 (en) | 2010-06-02 | 2013-11-19 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8926607B2 (en) | 2010-06-09 | 2015-01-06 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing multiple positive temperature coefficient electrodes |
US8888776B2 (en) | 2010-06-09 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing an electrode |
US8790342B2 (en) | 2010-06-09 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing pressure-variation electrodes |
US8795276B2 (en) | 2010-06-09 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing a plurality of electrodes |
US8753338B2 (en) | 2010-06-10 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing a thermal management system |
US9005199B2 (en) | 2010-06-10 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Heat management configurations for controlling heat dissipation from electrosurgical instruments |
US8764747B2 (en) | 2010-06-10 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument comprising sequentially activated electrodes |
US9028495B2 (en) | 2010-06-23 | 2015-05-12 | Covidien Lp | Surgical instrument with a separable coaxial joint |
US9149324B2 (en) | 2010-07-08 | 2015-10-06 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an articulatable end effector |
US8453906B2 (en) | 2010-07-14 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical instruments with electrodes |
US20120016413A1 (en) | 2010-07-14 | 2012-01-19 | Ethicon Endo-Surgery, Inc. | Surgical fastening devices comprising rivets |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US8702704B2 (en) | 2010-07-23 | 2014-04-22 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US8979844B2 (en) | 2010-07-23 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US9011437B2 (en) * | 2010-07-23 | 2015-04-21 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US8979843B2 (en) | 2010-07-23 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US8663270B2 (en) | 2010-07-23 | 2014-03-04 | Conmed Corporation | Jaw movement mechanism and method for a surgical tool |
US8795269B2 (en) | 2010-07-26 | 2014-08-05 | Covidien Lp | Rotary tissue sealer and divider |
US8814864B2 (en) | 2010-08-23 | 2014-08-26 | Covidien Lp | Method of manufacturing tissue sealing electrodes |
US8721635B2 (en) | 2010-08-25 | 2014-05-13 | Covidien Lp | Bipolar chondroplasty device |
US9498278B2 (en) | 2010-09-08 | 2016-11-22 | Covidien Lp | Asymmetrical electrodes for bipolar vessel sealing |
US9545253B2 (en) | 2010-09-24 | 2017-01-17 | Ethicon Endo-Surgery, Llc | Surgical instrument with contained dual helix actuator assembly |
US20120078244A1 (en) * | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9005200B2 (en) | 2010-09-30 | 2015-04-14 | Covidien Lp | Vessel sealing instrument |
AU2016201424B2 (en) * | 2010-09-30 | 2017-09-14 | Covidien Lp | Vessel sealing instrument |
US8979890B2 (en) | 2010-10-01 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument with jaw member |
US9017372B2 (en) | 2010-10-01 | 2015-04-28 | Covidien Lp | Blade deployment mechanisms for surgical forceps |
EP2621389B1 (en) | 2010-10-01 | 2015-03-18 | Applied Medical Resources Corporation | Electrosurgical instrument with jaws and with an electrode |
US9345534B2 (en) | 2010-10-04 | 2016-05-24 | Covidien Lp | Vessel sealing instrument |
US9655672B2 (en) | 2010-10-04 | 2017-05-23 | Covidien Lp | Vessel sealing instrument |
AU2016231557B2 (en) * | 2010-10-04 | 2018-03-22 | Covidien Lp | Vessel sealing instrument |
SG189325A1 (en) * | 2010-10-15 | 2013-05-31 | Surgiclamp Pty Ltd | Surgical clamping devices and tools for use therewith |
US8628529B2 (en) | 2010-10-26 | 2014-01-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument with magnetic clamping force |
US20120116265A1 (en) | 2010-11-05 | 2012-05-10 | Houser Kevin L | Surgical instrument with charging devices |
US10881448B2 (en) | 2010-11-05 | 2021-01-05 | Ethicon Llc | Cam driven coupling between ultrasonic transducer and waveguide in surgical instrument |
US9782214B2 (en) | 2010-11-05 | 2017-10-10 | Ethicon Llc | Surgical instrument with sensor and powered control |
US10660695B2 (en) | 2010-11-05 | 2020-05-26 | Ethicon Llc | Sterile medical instrument charging device |
US9011471B2 (en) | 2010-11-05 | 2015-04-21 | Ethicon Endo-Surgery, Inc. | Surgical instrument with pivoting coupling to modular shaft and end effector |
US9072523B2 (en) | 2010-11-05 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Medical device with feature for sterile acceptance of non-sterile reusable component |
US9526921B2 (en) * | 2010-11-05 | 2016-12-27 | Ethicon Endo-Surgery, Llc | User feedback through end effector of surgical instrument |
US9089338B2 (en) | 2010-11-05 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Medical device packaging with window for insertion of reusable component |
US9039720B2 (en) | 2010-11-05 | 2015-05-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument with ratcheting rotatable shaft |
US9510895B2 (en) | 2010-11-05 | 2016-12-06 | Ethicon Endo-Surgery, Llc | Surgical instrument with modular shaft and end effector |
US9782215B2 (en) | 2010-11-05 | 2017-10-10 | Ethicon Endo-Surgery, Llc | Surgical instrument with ultrasonic transducer having integral switches |
US20120116381A1 (en) | 2010-11-05 | 2012-05-10 | Houser Kevin L | Surgical instrument with charging station and wireless communication |
US9017851B2 (en) | 2010-11-05 | 2015-04-28 | Ethicon Endo-Surgery, Inc. | Sterile housing for non-sterile medical device component |
US10085792B2 (en) | 2010-11-05 | 2018-10-02 | Ethicon Llc | Surgical instrument with motorized attachment feature |
US9421062B2 (en) | 2010-11-05 | 2016-08-23 | Ethicon Endo-Surgery, Llc | Surgical instrument shaft with resiliently biased coupling to handpiece |
US9381058B2 (en) | 2010-11-05 | 2016-07-05 | Ethicon Endo-Surgery, Llc | Recharge system for medical devices |
US9649150B2 (en) | 2010-11-05 | 2017-05-16 | Ethicon Endo-Surgery, Llc | Selective activation of electronic components in medical device |
US9161803B2 (en) | 2010-11-05 | 2015-10-20 | Ethicon Endo-Surgery, Inc. | Motor driven electrosurgical device with mechanical and electrical feedback |
US9017849B2 (en) | 2010-11-05 | 2015-04-28 | Ethicon Endo-Surgery, Inc. | Power source management for medical device |
US9000720B2 (en) | 2010-11-05 | 2015-04-07 | Ethicon Endo-Surgery, Inc. | Medical device packaging with charging interface |
US9597143B2 (en) | 2010-11-05 | 2017-03-21 | Ethicon Endo-Surgery, Llc | Sterile medical instrument charging device |
US9375255B2 (en) | 2010-11-05 | 2016-06-28 | Ethicon Endo-Surgery, Llc | Surgical instrument handpiece with resiliently biased coupling to modular shaft and end effector |
US10959769B2 (en) | 2010-11-05 | 2021-03-30 | Ethicon Llc | Surgical instrument with slip ring assembly to power ultrasonic transducer |
US9247986B2 (en) | 2010-11-05 | 2016-02-02 | Ethicon Endo-Surgery, Llc | Surgical instrument with ultrasonic transducer having integral switches |
US9333002B2 (en) | 2010-11-19 | 2016-05-10 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8715277B2 (en) | 2010-12-08 | 2014-05-06 | Ethicon Endo-Surgery, Inc. | Control of jaw compression in surgical instrument having end effector with opposing jaw members |
CN101991454B (en) * | 2010-12-10 | 2012-06-13 | 苏州天臣国际医疗科技有限公司 | Novel handle component |
US20120172868A1 (en) | 2010-12-30 | 2012-07-05 | Tyco Healthcare Group Lp | Apparatus for Performing an Electrosurgical Procedure |
US8945175B2 (en) | 2011-01-14 | 2015-02-03 | Covidien Lp | Latch mechanism for surgical instruments |
US9113940B2 (en) | 2011-01-14 | 2015-08-25 | Covidien Lp | Trigger lockout and kickback mechanism for surgical instruments |
US20120191091A1 (en) | 2011-01-24 | 2012-07-26 | Tyco Healthcare Group Lp | Reusable Medical Device with Advanced Counting Capability |
US9017370B2 (en) | 2011-02-17 | 2015-04-28 | Covidien Lp | Vessel sealer and divider with captured cutting element |
USD661394S1 (en) * | 2011-02-24 | 2012-06-05 | Tyco Healthcare Group Lp | Device jaw |
DE102011001372A1 (en) * | 2011-03-17 | 2012-09-20 | Aesculap Ag | Surgical system for connecting body tissue and control methods for such a surgical system |
US20120239034A1 (en) * | 2011-03-17 | 2012-09-20 | Tyco Healthcare Group Lp | Method of Manufacturing Tissue Seal Plates |
US9375230B2 (en) * | 2011-03-30 | 2016-06-28 | Covidien Lp | Ultrasonic surgical instruments |
US20120265241A1 (en) * | 2011-04-12 | 2012-10-18 | Tyco Healthcare Group Lp | Surgical Forceps and Method of Manufacturing Thereof |
US8568408B2 (en) * | 2011-04-21 | 2013-10-29 | Covidien Lp | Surgical forceps |
US8444664B2 (en) * | 2011-05-16 | 2013-05-21 | Covidien Lp | Medical ultrasound instrument with articulated jaws |
US9339327B2 (en) | 2011-06-28 | 2016-05-17 | Aesculap Ag | Electrosurgical tissue dissecting device |
US9844384B2 (en) | 2011-07-11 | 2017-12-19 | Covidien Lp | Stand alone energy-based tissue clips |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
US10004526B2 (en) * | 2011-07-25 | 2018-06-26 | Covidien Lp | Ultrasonic dissection system |
US9044243B2 (en) | 2011-08-30 | 2015-06-02 | Ethcon Endo-Surgery, Inc. | Surgical cutting and fastening device with descendible second trigger arrangement |
US9113938B2 (en) | 2011-09-09 | 2015-08-25 | Covidien Lp | Apparatus for performing electrosurgical procedures having a spring mechanism associated with the jaw members |
US20130123776A1 (en) | 2011-10-24 | 2013-05-16 | Ethicon Endo-Surgery, Inc. | Battery shut-off algorithm in a battery powered device |
US8968312B2 (en) | 2011-11-16 | 2015-03-03 | Covidien Lp | Surgical device with powered articulation wrist rotation |
USD680220S1 (en) | 2012-01-12 | 2013-04-16 | Coviden IP | Slider handle for laparoscopic device |
US9113897B2 (en) | 2012-01-23 | 2015-08-25 | Covidien Lp | Partitioned surgical instrument |
US8968360B2 (en) | 2012-01-25 | 2015-03-03 | Covidien Lp | Surgical instrument with resilient driving member and related methods of use |
EP2811932B1 (en) | 2012-02-10 | 2019-06-26 | Ethicon LLC | Robotically controlled surgical instrument |
US8747434B2 (en) | 2012-02-20 | 2014-06-10 | Covidien Lp | Knife deployment mechanisms for surgical forceps |
US9717518B2 (en) | 2012-02-22 | 2017-08-01 | Boston Scientific Scimed, Inc. | Medical device for cutting |
US9439668B2 (en) | 2012-04-09 | 2016-09-13 | Ethicon Endo-Surgery, Llc | Switch arrangements for ultrasonic surgical instruments |
US10966780B2 (en) | 2012-04-17 | 2021-04-06 | Covidien Lp | Electrosurgical instrument having a coated electrode |
US9668807B2 (en) | 2012-05-01 | 2017-06-06 | Covidien Lp | Simplified spring load mechanism for delivering shaft force of a surgical instrument |
US9034009B2 (en) | 2012-05-01 | 2015-05-19 | Covidien Lp | Surgical forceps |
US8968311B2 (en) | 2012-05-01 | 2015-03-03 | Covidien Lp | Surgical instrument with stamped double-flag jaws and actuation mechanism |
US8920461B2 (en) | 2012-05-01 | 2014-12-30 | Covidien Lp | Surgical forceps with bifurcated flanged jaw components |
US9820765B2 (en) | 2012-05-01 | 2017-11-21 | Covidien Lp | Surgical instrument with stamped double-flange jaws |
US9192432B2 (en) | 2012-05-29 | 2015-11-24 | Covidien Lp | Lever latch assemblies for surgical improvements |
US8679140B2 (en) | 2012-05-30 | 2014-03-25 | Covidien Lp | Surgical clamping device with ratcheting grip lock |
US9770255B2 (en) * | 2012-06-26 | 2017-09-26 | Covidien Lp | One-piece handle assembly |
US20140005640A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical end effector jaw and electrode configurations |
US20140005705A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulating shafts |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9351754B2 (en) | 2012-06-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with distally positioned jaw assemblies |
US9393037B2 (en) | 2012-06-29 | 2016-07-19 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US9820768B2 (en) | 2012-06-29 | 2017-11-21 | Ethicon Llc | Ultrasonic surgical instruments with control mechanisms |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US8939975B2 (en) * | 2012-07-17 | 2015-01-27 | Covidien Lp | Gap control via overmold teeth and hard stops |
US10368945B2 (en) | 2012-07-17 | 2019-08-06 | Covidien Lp | Surgical instrument for energy-based tissue treatment |
US9192421B2 (en) | 2012-07-24 | 2015-11-24 | Covidien Lp | Blade lockout mechanism for surgical forceps |
US9492224B2 (en) | 2012-09-28 | 2016-11-15 | EthiconEndo-Surgery, LLC | Multi-function bi-polar forceps |
US9681908B2 (en) | 2012-10-08 | 2017-06-20 | Covidien Lp | Jaw assemblies for electrosurgical instruments and methods of manufacturing jaw assemblies |
US9265566B2 (en) | 2012-10-16 | 2016-02-23 | Covidien Lp | Surgical instrument |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
EP2890309B1 (en) | 2012-11-09 | 2016-10-26 | Gyrus Acmi Inc. | Forceps with a rotation assembly |
US20140135804A1 (en) | 2012-11-15 | 2014-05-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic and electrosurgical devices |
US9498281B2 (en) * | 2012-11-27 | 2016-11-22 | Covidien Lp | Surgical apparatus |
US10722222B2 (en) | 2012-12-14 | 2020-07-28 | Covidien Lp | Surgical system including a plurality of handle assemblies |
BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
US9655673B2 (en) * | 2013-03-11 | 2017-05-23 | Covidien Lp | Surgical instrument |
US9456863B2 (en) | 2013-03-11 | 2016-10-04 | Covidien Lp | Surgical instrument with switch activation control |
US10070916B2 (en) | 2013-03-11 | 2018-09-11 | Covidien Lp | Surgical instrument with system and method for springing open jaw members |
US9427251B2 (en) | 2013-03-13 | 2016-08-30 | Covidien Lp | Saber tooth harvester |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
US9314254B2 (en) * | 2013-03-15 | 2016-04-19 | DePuy Synthes Products, Inc. | Methods and devices for removing a spinal disc |
EP2777583B1 (en) * | 2013-03-15 | 2020-07-01 | Erbe Elektromedizin GmbH | Instrument for vessel fusion and separation |
CN105451670B (en) | 2013-08-07 | 2018-09-04 | 柯惠有限合伙公司 | Surgery forceps |
US10405874B2 (en) | 2013-08-13 | 2019-09-10 | Covidien Lp | Surgical instrument |
US9295514B2 (en) | 2013-08-30 | 2016-03-29 | Ethicon Endo-Surgery, Llc | Surgical devices with close quarter articulation features |
PL2845549T3 (en) * | 2013-09-10 | 2016-12-30 | Surgical instrument with improved actuating mechanism | |
US9814514B2 (en) | 2013-09-13 | 2017-11-14 | Ethicon Llc | Electrosurgical (RF) medical instruments for cutting and coagulating tissue |
US9861428B2 (en) | 2013-09-16 | 2018-01-09 | Ethicon Llc | Integrated systems for electrosurgical steam or smoke control |
USD788302S1 (en) | 2013-10-01 | 2017-05-30 | Covidien Lp | Knife for endoscopic electrosurgical forceps |
US9526565B2 (en) | 2013-11-08 | 2016-12-27 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
US9265926B2 (en) * | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
GB2521228A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
GB2521229A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
US9795436B2 (en) | 2014-01-07 | 2017-10-24 | Ethicon Llc | Harvesting energy from a surgical generator |
US9408660B2 (en) | 2014-01-17 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Device trigger dampening mechanism |
US10231776B2 (en) | 2014-01-29 | 2019-03-19 | Covidien Lp | Tissue sealing instrument with tissue-dissecting electrode |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US10524852B1 (en) | 2014-03-28 | 2020-01-07 | Ethicon Llc | Distal sealing end effector with spacers |
US9737355B2 (en) | 2014-03-31 | 2017-08-22 | Ethicon Llc | Controlling impedance rise in electrosurgical medical devices |
US9913680B2 (en) | 2014-04-15 | 2018-03-13 | Ethicon Llc | Software algorithms for electrosurgical instruments |
US9757186B2 (en) | 2014-04-17 | 2017-09-12 | Ethicon Llc | Device status feedback for bipolar tissue spacer |
US20150324317A1 (en) | 2014-05-07 | 2015-11-12 | Covidien Lp | Authentication and information system for reusable surgical instruments |
AU2015258819B2 (en) | 2014-05-16 | 2019-12-12 | Applied Medical Resources Corporation | Electrosurgical system |
US9851741B2 (en) | 2014-05-16 | 2017-12-26 | Gyrus Acmi, Inc. | Endoscopic cutting forceps with jaw clamp lever latching mechanism |
EP3369392A1 (en) | 2014-05-30 | 2018-09-05 | Applied Medical Resources Corporation | Electrosurgical seal and dissection systems |
US9700333B2 (en) | 2014-06-30 | 2017-07-11 | Ethicon Llc | Surgical instrument with variable tissue compression |
US10285724B2 (en) | 2014-07-31 | 2019-05-14 | Ethicon Llc | Actuation mechanisms and load adjustment assemblies for surgical instruments |
US10499976B2 (en) * | 2014-08-11 | 2019-12-10 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy and adenoidectomy procedures |
US10194976B2 (en) | 2014-08-25 | 2019-02-05 | Ethicon Llc | Lockout disabling mechanism |
US9877776B2 (en) | 2014-08-25 | 2018-01-30 | Ethicon Llc | Simultaneous I-beam and spring driven cam jaw closure mechanism |
US10194972B2 (en) | 2014-08-26 | 2019-02-05 | Ethicon Llc | Managing tissue treatment |
US10231777B2 (en) | 2014-08-26 | 2019-03-19 | Covidien Lp | Methods of manufacturing jaw members of an end-effector assembly for a surgical instrument |
US10660694B2 (en) | 2014-08-27 | 2020-05-26 | Covidien Lp | Vessel sealing instrument and switch assemblies thereof |
US10080606B2 (en) | 2014-09-17 | 2018-09-25 | Covidien Lp | Method of forming a member of an end effector |
CN106999231B (en) * | 2014-09-25 | 2021-03-02 | 柯惠有限合伙公司 | End effector assembly for surgical instrument |
WO2016065225A1 (en) | 2014-10-24 | 2016-04-28 | GYRUS ACMI, INC. (d/b/a OLYMPUS SURGICAL TECHNOLOGIES AMERICA) | Instrument comprising a forceps with resilient jaws |
US10136938B2 (en) | 2014-10-29 | 2018-11-27 | Ethicon Llc | Electrosurgical instrument with sensor |
CN104352259B (en) * | 2014-11-07 | 2016-07-20 | 常州市康迪医用吻合器有限公司 | The singlehanded Endo-GIA resetted |
US9687294B2 (en) | 2014-11-17 | 2017-06-27 | Covidien Lp | Deployment mechanism for surgical instruments |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
US10092348B2 (en) | 2014-12-22 | 2018-10-09 | Ethicon Llc | RF tissue sealer, shear grip, trigger lock mechanism and energy activation |
US10111699B2 (en) | 2014-12-22 | 2018-10-30 | Ethicon Llc | RF tissue sealer, shear grip, trigger lock mechanism and energy activation |
US10159524B2 (en) | 2014-12-22 | 2018-12-25 | Ethicon Llc | High power battery powered RF amplifier topology |
US9848937B2 (en) | 2014-12-22 | 2017-12-26 | Ethicon Llc | End effector with detectable configurations |
US10420603B2 (en) | 2014-12-23 | 2019-09-24 | Applied Medical Resources Corporation | Bipolar electrosurgical sealer and divider |
USD748259S1 (en) | 2014-12-29 | 2016-01-26 | Applied Medical Resources Corporation | Electrosurgical instrument |
GB2534147B (en) * | 2015-01-14 | 2018-11-14 | Gyrus Medical Ltd | Manufacturing electrosurgical instruments |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US10064642B2 (en) * | 2015-03-04 | 2018-09-04 | Covidien Lp | Surgical instrument for dissecting tissue |
US10321950B2 (en) | 2015-03-17 | 2019-06-18 | Ethicon Llc | Managing tissue treatment |
US10342602B2 (en) | 2015-03-17 | 2019-07-09 | Ethicon Llc | Managing tissue treatment |
US10595929B2 (en) | 2015-03-24 | 2020-03-24 | Ethicon Llc | Surgical instruments with firing system overload protection mechanisms |
US10314638B2 (en) | 2015-04-07 | 2019-06-11 | Ethicon Llc | Articulating radio frequency (RF) tissue seal with articulating state sensing |
US10117702B2 (en) | 2015-04-10 | 2018-11-06 | Ethicon Llc | Surgical generator systems and related methods |
US10130410B2 (en) | 2015-04-17 | 2018-11-20 | Ethicon Llc | Electrosurgical instrument including a cutting member decouplable from a cutting member trigger |
US9872725B2 (en) | 2015-04-29 | 2018-01-23 | Ethicon Llc | RF tissue sealer with mode selection |
US9918781B2 (en) | 2015-05-22 | 2018-03-20 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US9918780B2 (en) | 2015-05-22 | 2018-03-20 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US9918779B2 (en) | 2015-05-22 | 2018-03-20 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US10624662B2 (en) * | 2015-05-22 | 2020-04-21 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US10828084B2 (en) | 2015-05-22 | 2020-11-10 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US9848935B2 (en) * | 2015-05-27 | 2017-12-26 | Covidien Lp | Surgical instruments including components and features facilitating the assembly and manufacturing thereof |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
US10034704B2 (en) | 2015-06-30 | 2018-07-31 | Ethicon Llc | Surgical instrument with user adaptable algorithms |
US11051873B2 (en) | 2015-06-30 | 2021-07-06 | Cilag Gmbh International | Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters |
US11129669B2 (en) | 2015-06-30 | 2021-09-28 | Cilag Gmbh International | Surgical system with user adaptable techniques based on tissue type |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
US10765470B2 (en) | 2015-06-30 | 2020-09-08 | Ethicon Llc | Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters |
US10357303B2 (en) | 2015-06-30 | 2019-07-23 | Ethicon Llc | Translatable outer tube for sealing using shielded lap chole dissector |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
US9987078B2 (en) | 2015-07-22 | 2018-06-05 | Covidien Lp | Surgical forceps |
US10219818B2 (en) | 2015-07-24 | 2019-03-05 | Covidien Lp | Shaft-based surgical forceps and method of manufacturing the same |
US10987159B2 (en) | 2015-08-26 | 2021-04-27 | Covidien Lp | Electrosurgical end effector assemblies and electrosurgical forceps configured to reduce thermal spread |
US10687884B2 (en) | 2015-09-30 | 2020-06-23 | Ethicon Llc | Circuits for supplying isolated direct current (DC) voltage to surgical instruments |
US10959771B2 (en) | 2015-10-16 | 2021-03-30 | Ethicon Llc | Suction and irrigation sealing grasper |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
US10213250B2 (en) | 2015-11-05 | 2019-02-26 | Covidien Lp | Deployment and safety mechanisms for surgical instruments |
US10335179B2 (en) * | 2015-11-24 | 2019-07-02 | Ethicon Llc | Surgical device with knife lockout |
US10959806B2 (en) | 2015-12-30 | 2021-03-30 | Ethicon Llc | Energized medical device with reusable handle |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
DE102017100298A1 (en) | 2016-01-12 | 2017-07-13 | Gyrus Medical Limited | Electrosurgical device |
GB2546274B (en) * | 2016-01-12 | 2021-06-16 | Gyrus Medical Ltd | Electrosurgical device |
GB201600574D0 (en) | 2016-01-12 | 2016-02-24 | Gyrus Medical Ltd | Electrosurgical device |
GB201600550D0 (en) | 2016-01-12 | 2016-02-24 | Gyrus Medical Ltd | Electrosurgical device |
GB201600546D0 (en) | 2016-01-12 | 2016-02-24 | Gyrus Medical Ltd | Electrosurgical device |
US10716615B2 (en) | 2016-01-15 | 2020-07-21 | Ethicon Llc | Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade |
US10251664B2 (en) | 2016-01-15 | 2019-04-09 | Ethicon Llc | Modular battery powered handheld surgical instrument with multi-function motor via shifting gear assembly |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
US11129670B2 (en) | 2016-01-15 | 2021-09-28 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization |
US10426543B2 (en) | 2016-01-23 | 2019-10-01 | Covidien Lp | Knife trigger for vessel sealer |
US10695123B2 (en) * | 2016-01-29 | 2020-06-30 | Covidien Lp | Surgical instrument with sensor |
US10555769B2 (en) | 2016-02-22 | 2020-02-11 | Ethicon Llc | Flexible circuits for electrosurgical instrument |
US10098689B2 (en) | 2016-02-24 | 2018-10-16 | Covidien Lp | Methods of manufacturing jaw members of surgical forceps |
US10765471B2 (en) | 2016-04-15 | 2020-09-08 | Bolder Surgical, Llc | Electrosurgical sealer and divider |
US10856934B2 (en) | 2016-04-29 | 2020-12-08 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting and tissue engaging members |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10987156B2 (en) | 2016-04-29 | 2021-04-27 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
US10245064B2 (en) | 2016-07-12 | 2019-04-02 | Ethicon Llc | Ultrasonic surgical instrument with piezoelectric central lumen transducer |
US10893883B2 (en) | 2016-07-13 | 2021-01-19 | Ethicon Llc | Ultrasonic assembly for use with ultrasonic surgical instruments |
US10842522B2 (en) | 2016-07-15 | 2020-11-24 | Ethicon Llc | Ultrasonic surgical instruments having offset blades |
US10856933B2 (en) | 2016-08-02 | 2020-12-08 | Covidien Lp | Surgical instrument housing incorporating a channel and methods of manufacturing the same |
US10682154B2 (en) | 2016-08-02 | 2020-06-16 | Covidien Lp | Cutting mechanisms for surgical end effector assemblies, instruments, and systems |
US10376305B2 (en) | 2016-08-05 | 2019-08-13 | Ethicon Llc | Methods and systems for advanced harmonic energy |
US10285723B2 (en) | 2016-08-09 | 2019-05-14 | Ethicon Llc | Ultrasonic surgical blade with improved heel portion |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
US10779847B2 (en) | 2016-08-25 | 2020-09-22 | Ethicon Llc | Ultrasonic transducer to waveguide joining |
US10751117B2 (en) | 2016-09-23 | 2020-08-25 | Ethicon Llc | Electrosurgical instrument with fluid diverter |
US11207091B2 (en) | 2016-11-08 | 2021-12-28 | Covidien Lp | Surgical instrument for grasping, treating, and/or dividing tissue |
US10918407B2 (en) | 2016-11-08 | 2021-02-16 | Covidien Lp | Surgical instrument for grasping, treating, and/or dividing tissue |
US11272947B2 (en) | 2016-11-17 | 2022-03-15 | Covidien Lp | Surgical instruments for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US11007003B2 (en) | 2016-11-17 | 2021-05-18 | Covidien Lp | Surgical instruments and methods of manufacturing surgical instruments for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US10603064B2 (en) | 2016-11-28 | 2020-03-31 | Ethicon Llc | Ultrasonic transducer |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
US10639093B2 (en) | 2016-12-01 | 2020-05-05 | Covidien Lp | Surgical instrument including a wire guide |
US10039590B2 (en) * | 2016-12-09 | 2018-08-07 | Sutter Medizintechnik Gmbh | Connector having an alignment element for fixing the arms of a forcep |
US11033325B2 (en) | 2017-02-16 | 2021-06-15 | Cilag Gmbh International | Electrosurgical instrument with telescoping suction port and debris cleaner |
US10492852B2 (en) | 2017-02-27 | 2019-12-03 | Covidien Lp | Wire guide for surgical instruments and surgical instruments including a wire guide |
US10799284B2 (en) | 2017-03-15 | 2020-10-13 | Ethicon Llc | Electrosurgical instrument with textured jaws |
US11497546B2 (en) | 2017-03-31 | 2022-11-15 | Cilag Gmbh International | Area ratios of patterned coatings on RF electrodes to reduce sticking |
AU2018257642B2 (en) | 2017-04-28 | 2024-03-21 | Stryker Corporation | Control console and accessories for RF nerve ablation and methods of operating the same |
US11166759B2 (en) | 2017-05-16 | 2021-11-09 | Covidien Lp | Surgical forceps |
US10603117B2 (en) | 2017-06-28 | 2020-03-31 | Ethicon Llc | Articulation state detection mechanisms |
US10820920B2 (en) | 2017-07-05 | 2020-11-03 | Ethicon Llc | Reusable ultrasonic medical devices and methods of their use |
US20190015124A1 (en) * | 2017-07-11 | 2019-01-17 | Conmed Corporation | Jaw assembly for a vessel sealer |
GB2565133B (en) * | 2017-08-04 | 2022-09-21 | Gyrus Medical Ltd | Bipolar surgical instruments |
GB2565132B (en) * | 2017-08-04 | 2022-09-21 | Gyrus Medical Ltd | Bipolar surgical instruments |
US11490951B2 (en) | 2017-09-29 | 2022-11-08 | Cilag Gmbh International | Saline contact with electrodes |
US11033323B2 (en) | 2017-09-29 | 2021-06-15 | Cilag Gmbh International | Systems and methods for managing fluid and suction in electrosurgical systems |
US11484358B2 (en) | 2017-09-29 | 2022-11-01 | Cilag Gmbh International | Flexible electrosurgical instrument |
GB2567469A (en) * | 2017-10-13 | 2019-04-17 | Creo Medical Ltd | Electrosurgical apparatus |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10918393B2 (en) * | 2017-11-05 | 2021-02-16 | Grena Usa Llc | Surgical appliance |
US11179190B2 (en) | 2017-12-12 | 2021-11-23 | Gyrus Acmi, Inc. | Laparoscopic forceps assembly with an operable mechanism |
US11564733B2 (en) * | 2018-01-17 | 2023-01-31 | Covidien Lp | Surgical instruments incorporating ultrasonic and electrosurgical functionality |
US10786299B2 (en) | 2018-03-30 | 2020-09-29 | Gyrus Acmi, Inc. | Closure assembly that is laterally movable for selective locking |
US10849682B2 (en) | 2018-03-30 | 2020-12-01 | Gyrus Acmi, Inc. | Forceps including a double biased handle latch |
US10849641B2 (en) | 2018-03-30 | 2020-12-01 | Gyrus Acmi, Inc. | Forceps including a pre-loaded handle latch |
US11123133B2 (en) | 2018-04-24 | 2021-09-21 | Covidien Lp | Method of reprocessing a surgical instrument |
US10842516B2 (en) | 2018-04-30 | 2020-11-24 | Gyrus Acmi, Inc. | Forceps including a pre-loaded handle latch |
EP3768186B1 (en) * | 2018-05-31 | 2022-09-14 | St. Jude Medical, Cardiology Division, Inc. | Catheter handle with compliant circuit |
PL3578118T3 (en) * | 2018-06-05 | 2022-11-21 | Erbe Elektromedizin Gmbh | Surgical instrument |
US20200054321A1 (en) * | 2018-08-20 | 2020-02-20 | Ethicon Llc | Surgical instruments with progressive jaw closure arrangements |
US11864812B2 (en) | 2018-09-05 | 2024-01-09 | Applied Medical Resources Corporation | Electrosurgical generator control system |
US11419665B2 (en) | 2018-10-26 | 2022-08-23 | Covidien Lp | Electrosurgical forceps |
KR20210092263A (en) | 2018-11-16 | 2021-07-23 | 어플라이드 메디컬 리소시스 코포레이션 | electrosurgical system |
US11026710B2 (en) | 2019-01-10 | 2021-06-08 | Covidien Lp | Surgical instruments and methods of manufacturing surgical instruments for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US11510725B2 (en) | 2019-01-30 | 2022-11-29 | Covidien Lp | Electrosurgical forceps |
US11304743B2 (en) | 2019-01-30 | 2022-04-19 | Covidien Lp | Electrosurgical forceps |
US11497545B2 (en) | 2019-02-14 | 2022-11-15 | Covidien Lp | Electrosurgical forceps |
US11350957B2 (en) | 2019-03-27 | 2022-06-07 | Gyms Acmi, Inc. | Laparoscopic forceps assembly for gripping and dissection |
US11553956B2 (en) * | 2019-04-04 | 2023-01-17 | Cilag Gmbh International | Surgical devices with visual indicators |
US11241269B2 (en) | 2019-04-04 | 2022-02-08 | Cilag Gmbh International | Surgical devices switchable between monopolar functionality and bipolar functionality |
US11471212B2 (en) | 2019-04-04 | 2022-10-18 | Cilag Gmbh International | Electrosurgical devices with monopolar and bipolar functionality |
EP3744266B1 (en) | 2019-05-27 | 2024-02-28 | Erbe Elektromedizin GmbH | Electro-surgical instrument |
US11259864B2 (en) | 2019-06-06 | 2022-03-01 | Covidien Lp | Surgical instrument with enhanced trigger |
GB2585056B (en) * | 2019-06-27 | 2023-12-27 | Gyrus Medical Ltd | Sprung latch |
US11413102B2 (en) | 2019-06-27 | 2022-08-16 | Cilag Gmbh International | Multi-access port for surgical robotic systems |
US11547468B2 (en) | 2019-06-27 | 2023-01-10 | Cilag Gmbh International | Robotic surgical system with safety and cooperative sensing control |
US11612445B2 (en) | 2019-06-27 | 2023-03-28 | Cilag Gmbh International | Cooperative operation of robotic arms |
US11607278B2 (en) | 2019-06-27 | 2023-03-21 | Cilag Gmbh International | Cooperative robotic surgical systems |
US11723729B2 (en) | 2019-06-27 | 2023-08-15 | Cilag Gmbh International | Robotic surgical assembly coupling safety mechanisms |
EP4003193A1 (en) * | 2019-07-31 | 2022-06-01 | CONMED Corporation | Force limiting mechanism for surgical instruments |
US20210100607A1 (en) * | 2019-10-06 | 2021-04-08 | Covidien Lp | Surgical instruments for performing tonsillectomy, adenoidectomy, and other surgical procedures |
US20210196349A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with flexible wiring assemblies |
US20210196361A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with monopolar and bipolar energy capabilities |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11950797B2 (en) | 2019-12-30 | 2024-04-09 | Cilag Gmbh International | Deflectable electrode with higher distal bias relative to proximal bias |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11684412B2 (en) | 2019-12-30 | 2023-06-27 | Cilag Gmbh International | Surgical instrument with rotatable and articulatable surgical end effector |
US11779329B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a flex circuit including a sensor system |
US11911063B2 (en) | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11786294B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Control program for modular combination energy device |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US11937866B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Method for an electrosurgical procedure |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US11877790B2 (en) | 2020-01-07 | 2024-01-23 | Covidien Lp | Surgical forceps having jaw members |
US11844562B2 (en) | 2020-03-23 | 2023-12-19 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
US11931026B2 (en) | 2021-06-30 | 2024-03-19 | Cilag Gmbh International | Staple cartridge replacement |
US20230081874A1 (en) | 2021-09-15 | 2023-03-16 | Covidien Lp | Vessel sealer with smart cutting |
US11957342B2 (en) | 2021-11-01 | 2024-04-16 | Cilag Gmbh International | Devices, systems, and methods for detecting tissue and foreign objects during a surgical operation |
US20230355295A1 (en) | 2022-05-09 | 2023-11-09 | Covidien Lp | Electrosurgical systems and methods for time domain reflectometry based tissue sensing |
Family Cites Families (566)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US371664A (en) | 1887-10-18 | stone | ||
US702472A (en) | 1898-08-08 | 1902-06-17 | Louis M Pignolet | Surgical forceps. |
US722213A (en) | 1902-07-24 | 1903-03-10 | Tazwell C De Hart | Coffee-pot. |
US728883A (en) | 1902-07-29 | 1903-05-26 | Andrew J Downes | Electrothermic instrument. |
US1586645A (en) | 1925-07-06 | 1926-06-01 | Bierman William | Method of and means for treating animal tissue to coagulate the same |
US1813902A (en) | 1928-01-18 | 1931-07-14 | Liebel Flarsheim Co | Electrosurgical apparatus |
US2011169A (en) | 1932-04-13 | 1935-08-13 | Wappler Frederick Charles | Forcipated surgical electrode |
US2031682A (en) | 1932-11-18 | 1936-02-25 | Wappler Frederick Charles | Method and means for electrosurgical severance of adhesions |
US2002594A (en) | 1933-03-24 | 1935-05-28 | Wappler Frederick Charles | Instrument for electro-surgical treatment of tissue |
US2176479A (en) | 1937-03-20 | 1939-10-17 | David A Willis | Apparatus for finding and removing metal particles from human and animal bodies |
US2279753A (en) | 1940-03-25 | 1942-04-14 | Knapp Monarch Co | Switch |
US2305156A (en) | 1941-04-17 | 1942-12-15 | Weck & Co Edward | Box lock pivot and method of assembling same |
US2632661A (en) | 1948-08-14 | 1953-03-24 | Cristofv Cristjo | Joint for surgical instruments |
US2668538A (en) | 1952-01-30 | 1954-02-09 | George P Pilling & Son Company | Surgical clamping means |
US2796065A (en) | 1955-05-12 | 1957-06-18 | Karl A Kapp | Surgical clamping means |
US3459187A (en) | 1967-03-09 | 1969-08-05 | Weck & Co Inc Edward | Surgical instrument and method of manufacture |
US3866610A (en) | 1967-08-28 | 1975-02-18 | Harold D Kletschka | Cardiovascular clamps |
US3636943A (en) | 1967-10-27 | 1972-01-25 | Ultrasonic Systems | Ultrasonic cauterization |
US3643663A (en) | 1968-10-16 | 1972-02-22 | F L Fischer | Coagulating instrument |
US3651811A (en) | 1969-10-10 | 1972-03-28 | Aesculap Werke Ag | Surgical cutting instrument |
DE2030776A1 (en) | 1970-06-23 | 1971-12-30 | Siemens Ag | Handpiece for high frequency electrodes |
SU401367A1 (en) | 1971-10-05 | 1973-10-12 | Тернопольский государственный медицинский институт | BIAKTIVNYE ELECTRO SURGICAL INSTRUMENT |
GB1365225A (en) | 1972-05-26 | 1974-08-29 | Stanley Tools Ltd | Retractable blade knife |
DE2324658B2 (en) | 1973-05-16 | 1977-06-30 | Richard Wolf Gmbh, 7134 Knittlingen | PROBE FOR COAGULATING BODY TISSUE |
CA1018419A (en) | 1973-07-04 | 1977-10-04 | Gerald Turp | Instrument for laparoscopic tubal cauterization |
US3921641A (en) | 1973-12-14 | 1975-11-25 | Research Corp | Controlling forceps |
DE2415263A1 (en) | 1974-03-29 | 1975-10-02 | Aesculap Werke Ag | Surgical H.F. coagulation probe has electrode tongs - with exposed ends of insulated conductors forming tong-jaws |
US3952749A (en) | 1974-05-15 | 1976-04-27 | Pilling Co. | Box lock surgical instrument |
US3911766A (en) | 1974-05-15 | 1975-10-14 | Pilling Co | Box lock surgical instrument and method of its manufacture |
US3987795A (en) | 1974-08-28 | 1976-10-26 | Valleylab, Inc. | Electrosurgical devices having sesquipolar electrode structures incorporated therein |
US4043342A (en) | 1974-08-28 | 1977-08-23 | Valleylab, Inc. | Electrosurgical devices having sesquipolar electrode structures incorporated therein |
DE2514501A1 (en) | 1975-04-03 | 1976-10-21 | Karl Storz | Bipolar coagulation instrument for endoscopes - has two high frequency electrodes looped over central insulating piece |
US4005714A (en) | 1975-05-03 | 1977-02-01 | Richard Wolf Gmbh | Bipolar coagulation forceps |
FR2315286A2 (en) | 1975-06-26 | 1977-01-21 | Lamidey Marcel | H.F. blood coagulating dissecting forceps - with adjustable stops to vary clamping space and circuit making contacts |
US4041952A (en) | 1976-03-04 | 1977-08-16 | Valleylab, Inc. | Electrosurgical forceps |
US4074718A (en) | 1976-03-17 | 1978-02-21 | Valleylab, Inc. | Electrosurgical instrument |
US4088134A (en) | 1976-08-05 | 1978-05-09 | Joseph A. Caprini | Forceps |
DE2642489C3 (en) | 1976-09-22 | 1979-04-19 | Richard Wolf Gmbh, 7134 Knittlingen | Unipolar coagulation forceps |
US4112950A (en) | 1976-10-22 | 1978-09-12 | Aspen Laboratories | Medical electronic apparatus and components |
US4127222A (en) | 1976-11-26 | 1978-11-28 | Adams Roberta V | Sewing thimble |
US4165746A (en) | 1977-06-30 | 1979-08-28 | Burgin Kermit H | Plastic forceps |
JPS5563638A (en) | 1978-11-09 | 1980-05-13 | Olympus Optical Co | Renal pelvis forceps |
US4418692A (en) | 1978-11-17 | 1983-12-06 | Guay Jean Louis | Device for treating living tissue with an electric current |
US4233734A (en) | 1979-01-22 | 1980-11-18 | The Stanley Works | Retractable blade knife |
US4315510A (en) | 1979-05-16 | 1982-02-16 | Cooper Medical Devices Corporation | Method of performing male sterilization |
USD263020S (en) | 1980-01-22 | 1982-02-16 | Rau Iii David M | Retractable knife |
US4370980A (en) | 1981-03-11 | 1983-02-01 | Lottick Edward A | Electrocautery hemostat |
US5116332A (en) | 1981-03-11 | 1992-05-26 | Lottick Edward A | Electrocautery hemostat |
US5026370A (en) | 1981-03-11 | 1991-06-25 | Lottick Edward A | Electrocautery instrument |
CA1192465A (en) | 1981-03-11 | 1985-08-27 | Edward A. Lottick | Removable switch electrocautery instruments |
US4375218A (en) | 1981-05-26 | 1983-03-01 | Digeronimo Ernest M | Forceps, scalpel and blood coagulating surgical instrument |
US4452246A (en) | 1981-09-21 | 1984-06-05 | Bader Robert F | Surgical instrument |
US4416276A (en) | 1981-10-26 | 1983-11-22 | Valleylab, Inc. | Adaptive, return electrode monitoring system |
US4492231A (en) | 1982-09-17 | 1985-01-08 | Auth David C | Non-sticking electrocautery system and forceps |
US4827929A (en) | 1983-08-29 | 1989-05-09 | Joseph Hodge | Angulated surgical instrument |
CH662263A5 (en) | 1983-09-13 | 1987-09-30 | Gegauf Fritz Ag | HYSTERECTOMIUM. |
DE3490633T (en) | 1984-01-30 | 1985-12-12 | Char'kovskaja oblastnaja kliničeskaja bol'nica, Char'kov | Bipolar electrosurgical device |
US4574804A (en) | 1984-02-27 | 1986-03-11 | Board Of Regents, The University Of Texas System | Optic nerve clamp |
DE3423356C2 (en) | 1984-06-25 | 1986-06-26 | Berchtold Medizin-Elektronik GmbH & Co, 7200 Tuttlingen | Electrosurgical high frequency cutting instrument |
US4657016A (en) | 1984-08-20 | 1987-04-14 | Garito Jon C | Electrosurgical handpiece for blades, needles and forceps |
US4655215A (en) | 1985-03-15 | 1987-04-07 | Harold Pike | Hand control for electrosurgical electrodes |
DE3511107A1 (en) | 1985-03-27 | 1986-10-02 | Fischer MET GmbH, 7800 Freiburg | DEVICE FOR BIPOLAR HIGH-FREQUENCY COAGULATION OF BIOLOGICAL TISSUE |
US4655216A (en) | 1985-07-23 | 1987-04-07 | Alfred Tischer | Combination instrument for laparoscopical tube sterilization |
US4662372A (en) | 1985-08-12 | 1987-05-05 | Acme United Corporation | Disposable surgical instrument and method of forming |
US4750488A (en) | 1986-05-19 | 1988-06-14 | Sonomed Technology, Inc. | Vibration apparatus preferably for endoscopic ultrasonic aspirator |
USD295893S (en) | 1985-09-25 | 1988-05-24 | Acme United Corporation | Disposable surgical clamp |
USD295894S (en) | 1985-09-26 | 1988-05-24 | Acme United Corporation | Disposable surgical scissors |
US4763669A (en) | 1986-01-09 | 1988-08-16 | Jaeger John C | Surgical instrument with adjustable angle of operation |
AU6757187A (en) | 1986-01-22 | 1987-07-23 | Retief, C.T. | Closure for a container |
US4846171A (en) | 1986-10-06 | 1989-07-11 | Gv Medical, Inc. | Laser catheter adjustable control apparatus |
DE8712328U1 (en) | 1987-09-11 | 1988-02-18 | Jakoubek, Franz, 7201 Emmingen-Liptingen, De | |
US5035695A (en) | 1987-11-30 | 1991-07-30 | Jaroy Weber, Jr. | Extendable electrocautery surgery apparatus and method |
GB2213416B (en) | 1987-12-11 | 1991-12-18 | Stanley Works Ltd | Blade-carriers for retractable-blade knives |
US5084057A (en) | 1989-07-18 | 1992-01-28 | United States Surgical Corporation | Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures |
ATE132047T1 (en) | 1988-01-20 | 1996-01-15 | G2 Design Ltd | DIATHERMY DEVICE |
GB8801177D0 (en) | 1988-01-20 | 1988-02-17 | Goble N M | Diathermy unit |
US4887612A (en) | 1988-04-27 | 1989-12-19 | Esco Precision, Inc. | Endoscopic biopsy forceps |
CA1308782C (en) | 1988-10-13 | 1992-10-13 | Gyrus Medical Limited | Screening and monitoring instrument |
AU4958590A (en) | 1988-12-05 | 1990-07-10 | Trustees Of Columbia University In The City Of New York, The | Novel derivatives of cyclosporine a, antibodies directed thereto and uses thereof |
US4938761A (en) | 1989-03-06 | 1990-07-03 | Mdt Corporation | Bipolar electrosurgical forceps |
US5425739A (en) | 1989-03-09 | 1995-06-20 | Avatar Design And Development, Inc. | Anastomosis stent and stent selection system |
DE3917328A1 (en) | 1989-05-27 | 1990-11-29 | Wolf Gmbh Richard | BIPOLAR COAGULATION INSTRUMENT |
DE4017626A1 (en) | 1989-05-31 | 1990-12-06 | Kyocera Corp | BLUTGEFAESSKOAGULATIONS - / - hemostatic DEVICE |
IN177831B (en) | 1989-07-13 | 1997-02-22 | Nat Res Dev | |
US5007908A (en) | 1989-09-29 | 1991-04-16 | Everest Medical Corporation | Electrosurgical instrument having needle cutting electrode and spot-coag electrode |
US5797958A (en) | 1989-12-05 | 1998-08-25 | Yoon; Inbae | Endoscopic grasping instrument with scissors |
US5665100A (en) | 1989-12-05 | 1997-09-09 | Yoon; Inbae | Multifunctional instrument with interchangeable operating units for performing endoscopic procedures |
US5984939A (en) | 1989-12-05 | 1999-11-16 | Yoon; Inbae | Multifunctional grasping instrument with cutting member and operating channel for use in endoscopic and non-endoscopic procedures |
US6099550A (en) | 1989-12-05 | 2000-08-08 | Yoon; Inbae | Surgical instrument having jaws and an operating channel and method for use thereof |
US5893863A (en) | 1989-12-05 | 1999-04-13 | Yoon; Inbae | Surgical instrument with jaws and movable internal hook member for use thereof |
US5217457A (en) | 1990-03-15 | 1993-06-08 | Valleylab Inc. | Enhanced electrosurgical apparatus |
US5244462A (en) | 1990-03-15 | 1993-09-14 | Valleylab Inc. | Electrosurgical apparatus |
US5215101A (en) | 1990-05-10 | 1993-06-01 | Symbiosis Corporation | Sharply angled kelly (Jacobs's) clamp |
JP2806511B2 (en) | 1990-07-31 | 1998-09-30 | 松下電工株式会社 | Manufacturing method of sintered alloy |
US5282799A (en) | 1990-08-24 | 1994-02-01 | Everest Medical Corporation | Bipolar electrosurgical scalpel with paired loop electrodes |
US5391183A (en) | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
US5509922A (en) | 1990-10-05 | 1996-04-23 | United States Surgical Corporation | Endoscopic surgical instrument |
US5626609A (en) | 1990-10-05 | 1997-05-06 | United States Surgical Corporation | Endoscopic surgical instrument |
US5190541A (en) | 1990-10-17 | 1993-03-02 | Boston Scientific Corporation | Surgical instrument and method |
JPH06505654A (en) | 1991-02-06 | 1994-06-30 | ラパロームド コーポレイション | electrosurgical device |
JP2951418B2 (en) | 1991-02-08 | 1999-09-20 | トキコ株式会社 | Sample liquid component analyzer |
DE4104755A1 (en) | 1991-02-15 | 1992-08-20 | Heidmueller Harald | SURGICAL INSTRUMENT |
US5147357A (en) | 1991-03-18 | 1992-09-15 | Rose Anthony T | Medical instrument |
US5217460A (en) | 1991-03-22 | 1993-06-08 | Knoepfler Dennis J | Multiple purpose forceps |
US5396900A (en) | 1991-04-04 | 1995-03-14 | Symbiosis Corporation | Endoscopic end effectors constructed from a combination of conductive and non-conductive materials and useful for selective endoscopic cautery |
US5391166A (en) | 1991-06-07 | 1995-02-21 | Hemostatic Surgery Corporation | Bi-polar electrosurgical endoscopic instruments having a detachable working end |
US5472443A (en) | 1991-06-07 | 1995-12-05 | Hemostatic Surgery Corporation | Electrosurgical apparatus employing constant voltage and methods of use |
US5324289A (en) | 1991-06-07 | 1994-06-28 | Hemostatic Surgery Corporation | Hemostatic bi-polar electrosurgical cutting apparatus and methods of use |
US5484436A (en) | 1991-06-07 | 1996-01-16 | Hemostatic Surgery Corporation | Bi-polar electrosurgical instruments and methods of making |
US5176695A (en) | 1991-07-08 | 1993-01-05 | Davinci Medical, Inc. | Surgical cutting means |
US5258001A (en) | 1991-09-05 | 1993-11-02 | Baylor College Of Medicine | Retractable scalpel with blade-activated lock |
US5196009A (en) | 1991-09-11 | 1993-03-23 | Kirwan Jr Lawrence T | Non-sticking electrosurgical device having nickel tips |
USD348930S (en) * | 1991-10-11 | 1994-07-19 | Ethicon, Inc. | Endoscopic stapler |
US5366477A (en) | 1991-10-17 | 1994-11-22 | American Cyanamid Company | Actuating forces transmission link and assembly for use in surgical instruments |
US5250047A (en) | 1991-10-21 | 1993-10-05 | Everest Medical Corporation | Bipolar laparoscopic instrument with replaceable electrode tip assembly |
US5531744A (en) | 1991-11-01 | 1996-07-02 | Medical Scientific, Inc. | Alternative current pathways for bipolar surgical cutting tool |
US5282827A (en) | 1991-11-08 | 1994-02-01 | Kensey Nash Corporation | Hemostatic puncture closure system and method of use |
US5411520A (en) | 1991-11-08 | 1995-05-02 | Kensey Nash Corporation | Hemostatic vessel puncture closure system utilizing a plug located within the puncture tract spaced from the vessel, and method of use |
US5197964A (en) | 1991-11-12 | 1993-03-30 | Everest Medical Corporation | Bipolar instrument utilizing one stationary electrode and one movable electrode |
US5433725A (en) | 1991-12-13 | 1995-07-18 | Unisurge, Inc. | Hand-held surgical device and tools for use therewith, assembly and method |
JP3156863B2 (en) | 1991-12-26 | 2001-04-16 | 日本ジーイープラスチックス株式会社 | Reinforced flame retardant polyester resin composition |
US5681282A (en) | 1992-01-07 | 1997-10-28 | Arthrocare Corporation | Methods and apparatus for ablation of luminal tissues |
US5250063A (en) | 1992-01-24 | 1993-10-05 | Leonard Bloom | Surgical scalpel with retractable guard |
GB9204217D0 (en) | 1992-02-27 | 1992-04-08 | Goble Nigel M | Cauterising apparatus |
GB9204218D0 (en) | 1992-02-27 | 1992-04-08 | Goble Nigel M | A surgical cutting tool |
US5217458A (en) | 1992-04-09 | 1993-06-08 | Everest Medical Corporation | Bipolar biopsy device utilizing a rotatable, single-hinged moving element |
US5499997A (en) | 1992-04-10 | 1996-03-19 | Sharpe Endosurgical Corporation | Endoscopic tenaculum surgical instrument |
US5318589A (en) | 1992-04-15 | 1994-06-07 | Microsurge, Inc. | Surgical instrument for endoscopic surgery |
US5261918A (en) | 1992-04-27 | 1993-11-16 | Edward Weck Incorporated | Sheathed surgical instrument and applicator kit |
US5443463A (en) | 1992-05-01 | 1995-08-22 | Vesta Medical, Inc. | Coagulating forceps |
US5277201A (en) | 1992-05-01 | 1994-01-11 | Vesta Medical, Inc. | Endometrial ablation apparatus and method |
US5389098A (en) | 1992-05-19 | 1995-02-14 | Olympus Optical Co., Ltd. | Surgical device for stapling and/or fastening body tissues |
CA2094220A1 (en) | 1992-05-21 | 1993-11-22 | Mark A. Rydell | Surgical scissors with bipolar coagulation feature |
US5478351A (en) | 1992-06-24 | 1995-12-26 | Microsurge, Inc. | Endoscopic surgical tool with handle and detachable tool assembly |
US5413571A (en) | 1992-07-16 | 1995-05-09 | Sherwood Medical Company | Device for sealing hemostatic incisions |
US5258006A (en) | 1992-08-21 | 1993-11-02 | Everest Medical Corporation | Bipolar electrosurgical forceps |
US5308357A (en) | 1992-08-21 | 1994-05-03 | Microsurge, Inc. | Handle mechanism for manual instruments |
CA2104423A1 (en) | 1992-08-24 | 1994-02-25 | Boris Zvenyatsky | Handle for endoscopic instruments and jaw structure |
US5342393A (en) | 1992-08-27 | 1994-08-30 | Duke University | Method and device for vascular repair |
US5275615A (en) | 1992-09-11 | 1994-01-04 | Anthony Rose | Medical instrument having gripping jaws |
CA2106126A1 (en) | 1992-09-23 | 1994-03-24 | Ian M. Scott | Bipolar surgical instruments |
US5411519A (en) | 1992-09-23 | 1995-05-02 | United States Surgical Corporation | Surgical apparatus having hinged jaw structure |
US5336220A (en) | 1992-10-09 | 1994-08-09 | Symbiosis Corporation | Tubing for endoscopic electrosurgical suction-irrigation instrument |
US5415657A (en) | 1992-10-13 | 1995-05-16 | Taymor-Luria; Howard | Percutaneous vascular sealing method |
US5336221A (en) | 1992-10-14 | 1994-08-09 | Premier Laser Systems, Inc. | Method and apparatus for applying thermal energy to tissue using a clamp |
US5383897A (en) | 1992-10-19 | 1995-01-24 | Shadyside Hospital | Method and apparatus for closing blood vessel punctures |
US5304203A (en) | 1992-10-20 | 1994-04-19 | Numed Technologies, Inc. | Tissue extracting forceps for laparoscopic surgery |
US5578052A (en) | 1992-10-27 | 1996-11-26 | Koros; Tibor | Insulated laparoscopic grasper with removable shaft |
US5389104A (en) | 1992-11-18 | 1995-02-14 | Symbiosis Corporation | Arthroscopic surgical instruments |
US5807393A (en) | 1992-12-22 | 1998-09-15 | Ethicon Endo-Surgery, Inc. | Surgical tissue treating device with locking mechanism |
US5558671A (en) | 1993-07-22 | 1996-09-24 | Yates; David C. | Impedance feedback monitor for electrosurgical instrument |
US5403312A (en) | 1993-07-22 | 1995-04-04 | Ethicon, Inc. | Electrosurgical hemostatic device |
US5462546A (en) | 1993-02-05 | 1995-10-31 | Everest Medical Corporation | Bipolar electrosurgical forceps |
US5514134A (en) | 1993-02-05 | 1996-05-07 | Everest Medical Corporation | Bipolar electrosurgical scissors |
US5342359A (en) | 1993-02-05 | 1994-08-30 | Everest Medical Corporation | Bipolar coagulation device |
DE4303882C2 (en) | 1993-02-10 | 1995-02-09 | Kernforschungsz Karlsruhe | Combination instrument for separation and coagulation for minimally invasive surgery |
US5342381A (en) | 1993-02-11 | 1994-08-30 | Everest Medical Corporation | Combination bipolar scissors and forceps instrument |
US5443464A (en) | 1993-02-16 | 1995-08-22 | Memphis Orthopaedic Design, Inc. | External fixator apparatus |
US5425705A (en) | 1993-02-22 | 1995-06-20 | Stanford Surgical Technologies, Inc. | Thoracoscopic devices and methods for arresting the heart |
US5643294A (en) | 1993-03-01 | 1997-07-01 | United States Surgical Corporation | Surgical apparatus having an increased range of operability |
US5445638B1 (en) | 1993-03-08 | 1998-05-05 | Everest Medical Corp | Bipolar coagulation and cutting forceps |
US5344424A (en) | 1993-03-12 | 1994-09-06 | Roberts Philip L | Selectively retractable, disposable surgical knife |
DE59301475D1 (en) | 1993-03-16 | 1996-02-29 | Krupp Koppers Gmbh | Gasification apparatus for the pressure gasification of fine-particle fuels |
US5496347A (en) | 1993-03-30 | 1996-03-05 | Olympus Optical Co., Ltd. | Surgical instrument |
GB9309142D0 (en) | 1993-05-04 | 1993-06-16 | Gyrus Medical Ltd | Laparoscopic instrument |
CA2121194A1 (en) | 1993-05-06 | 1994-11-07 | Corbett Stone | Bipolar electrosurgical instruments |
GB9314391D0 (en) | 1993-07-12 | 1993-08-25 | Gyrus Medical Ltd | A radio frequency oscillator and an electrosurgical generator incorporating such an oscillator |
US5569243A (en) | 1993-07-13 | 1996-10-29 | Symbiosis Corporation | Double acting endoscopic scissors with bipolar cautery capability |
US5356408A (en) | 1993-07-16 | 1994-10-18 | Everest Medical Corporation | Bipolar electrosurgical scissors having nonlinear blades |
US5827323A (en) | 1993-07-21 | 1998-10-27 | Charles H. Klieman | Surgical instrument for endoscopic and general surgery |
GR940100335A (en) | 1993-07-22 | 1996-05-22 | Ethicon Inc. | Electrosurgical device for placing staples. |
US5810811A (en) | 1993-07-22 | 1998-09-22 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device |
US5817093A (en) | 1993-07-22 | 1998-10-06 | Ethicon Endo-Surgery, Inc. | Impedance feedback monitor with query electrode for electrosurgical instrument |
US5709680A (en) | 1993-07-22 | 1998-01-20 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device |
US5688270A (en) | 1993-07-22 | 1997-11-18 | Ethicon Endo-Surgery,Inc. | Electrosurgical hemostatic device with recessed and/or offset electrodes |
US5693051A (en) * | 1993-07-22 | 1997-12-02 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device with adaptive electrodes |
US5368600A (en) | 1993-07-23 | 1994-11-29 | Ethicon, Inc. | Steerable bulldog clamp applier |
US5376089A (en) | 1993-08-02 | 1994-12-27 | Conmed Corporation | Electrosurgical instrument |
US5354271A (en) | 1993-08-05 | 1994-10-11 | Voda Jan K | Vascular sheath |
US5431674A (en) | 1993-09-07 | 1995-07-11 | Pa Consulting Group | Compound motion cutting device |
US5334215A (en) | 1993-09-13 | 1994-08-02 | Chen Shih Chieh | Pincers having disposable end members |
DE4333983A1 (en) | 1993-10-05 | 1995-04-06 | Delma Elektro Med App | High frequency electrosurgical instrument |
US5496312A (en) | 1993-10-07 | 1996-03-05 | Valleylab Inc. | Impedance and temperature generator control |
GB9322464D0 (en) | 1993-11-01 | 1993-12-22 | Gyrus Medical Ltd | Electrosurgical apparatus |
US5571100B1 (en) | 1993-11-01 | 1998-01-06 | Gyrus Medical Ltd | Electrosurgical apparatus |
US5620453A (en) | 1993-11-05 | 1997-04-15 | Nallakrishnan; Ravi | Surgical knife with retractable blade and depth of cut control |
ES2113034T3 (en) | 1993-11-09 | 1998-04-16 | Ricoh Kk | IMAGE FORMATION DEVICE WITH A CONTACT ELEMENT IN CONTACT WITH AN IMAGE SUPPORT. |
US5437292A (en) | 1993-11-19 | 1995-08-01 | Bioseal, Llc | Method for sealing blood vessel puncture sites |
US5458598A (en) | 1993-12-02 | 1995-10-17 | Cabot Technology Corporation | Cutting and coagulating forceps |
US5422567A (en) | 1993-12-27 | 1995-06-06 | Valleylab Inc. | High frequency power measurement |
DE4403252A1 (en) | 1994-02-03 | 1995-08-10 | Michael Hauser | Instrument shaft for min. invasive surgery |
US5501698A (en) | 1994-02-14 | 1996-03-26 | Heartport, Inc. | Endoscopic microsurgical instruments and methods |
US5352222A (en) | 1994-03-15 | 1994-10-04 | Everest Medical Corporation | Surgical scissors with bipolar coagulation feature |
DE4411099C2 (en) | 1994-03-30 | 1998-07-30 | Wolf Gmbh Richard | Surgical instrument |
US5425690A (en) | 1994-04-20 | 1995-06-20 | Chang; Sreter | Wrist exerciser |
US5431672A (en) | 1994-05-09 | 1995-07-11 | Becton, Dickinson And Company | Surgical scalpel with retractable blade |
US5782749A (en) | 1994-05-10 | 1998-07-21 | Riza; Erol D. | Laparoscopic surgical instrument with adjustable grip |
US5480409A (en) | 1994-05-10 | 1996-01-02 | Riza; Erol D. | Laparoscopic surgical instrument |
US5429616A (en) | 1994-05-31 | 1995-07-04 | Schaffer; David I. | Occludable catheter |
US5505730A (en) | 1994-06-24 | 1996-04-09 | Stuart D. Edwards | Thin layer ablation apparatus |
GB9413070D0 (en) | 1994-06-29 | 1994-08-17 | Gyrus Medical Ltd | Electrosurgical apparatus |
US5540684A (en) | 1994-07-28 | 1996-07-30 | Hassler, Jr.; William L. | Method and apparatus for electrosurgically treating tissue |
DE69534011T8 (en) | 1994-07-29 | 2006-07-06 | Olympus Optical Co., Ltd. | Medical instrument for use in combination with endoscopes |
AU694225B2 (en) | 1994-08-02 | 1998-07-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic hemostatic and cutting instrument |
US5766130A (en) | 1994-08-16 | 1998-06-16 | Selmonosky; Carlos A. | Vascular testing method |
US5456684A (en) | 1994-09-08 | 1995-10-10 | Hutchinson Technology Incorporated | Multifunctional minimally invasive surgical instrument |
US5573535A (en) | 1994-09-23 | 1996-11-12 | United States Surgical Corporation | Bipolar surgical instrument for coagulation and cutting |
USD384413S (en) * | 1994-10-07 | 1997-09-30 | United States Surgical Corporation | Endoscopic suturing instrument |
US5575805A (en) | 1994-10-07 | 1996-11-19 | Li Medical Technologies, Inc. | Variable tip-pressure surgical grasper |
US5893875A (en) | 1994-10-07 | 1999-04-13 | Tnco, Inc. | Surgical instrument with replaceable jaw assembly |
US5601711A (en) * | 1994-10-31 | 1997-02-11 | Gelman Sciences Inc. | Selective separation filter device |
US5921984A (en) | 1994-11-30 | 1999-07-13 | Conmed Corporation | Bipolar electrosurgical instrument with coagulation feature |
GB9425781D0 (en) | 1994-12-21 | 1995-02-22 | Gyrus Medical Ltd | Electrosurgical instrument |
US5540685A (en) | 1995-01-06 | 1996-07-30 | Everest Medical Corporation | Bipolar electrical scissors with metal cutting edges and shearing surfaces |
US5603723A (en) | 1995-01-11 | 1997-02-18 | United States Surgical Corporation | Surgical instrument configured to be disassembled for cleaning |
US5603711A (en) | 1995-01-20 | 1997-02-18 | Everest Medical Corp. | Endoscopic bipolar biopsy forceps |
US5637110A (en) | 1995-01-31 | 1997-06-10 | Stryker Corporation | Electrocautery surgical tool with relatively pivoted tissue engaging jaws |
CA2168404C (en) | 1995-02-01 | 2007-07-10 | Dale Schulze | Surgical instrument with expandable cutting element |
US5573424A (en) | 1995-02-09 | 1996-11-12 | Everest Medical Corporation | Apparatus for interfacing a bipolar electrosurgical instrument to a monopolar generator |
US5649959A (en) | 1995-02-10 | 1997-07-22 | Sherwood Medical Company | Assembly for sealing a puncture in a vessel |
DE19506363A1 (en) | 1995-02-24 | 1996-08-29 | Frost Lore Geb Haupt | Non-invasive thermometry in organs under hyperthermia and coagulation conditions |
US5611798A (en) | 1995-03-02 | 1997-03-18 | Eggers; Philip E. | Resistively heated cutting and coagulating surgical instrument |
US6464701B1 (en) | 1995-03-07 | 2002-10-15 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US5766166A (en) | 1995-03-07 | 1998-06-16 | Enable Medical Corporation | Bipolar Electrosurgical scissors |
US6179837B1 (en) | 1995-03-07 | 2001-01-30 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US5647871A (en) | 1995-03-10 | 1997-07-15 | Microsurge, Inc. | Electrosurgery with cooled electrodes |
US5599350A (en) * | 1995-04-03 | 1997-02-04 | Ethicon Endo-Surgery, Inc. | Electrosurgical clamping device with coagulation feedback |
US5624452A (en) | 1995-04-07 | 1997-04-29 | Ethicon Endo-Surgery, Inc. | Hemostatic surgical cutting or stapling instrument |
US5569300A (en) | 1995-04-12 | 1996-10-29 | Redmon; Henry A. | Dilating surgical forceps having illumination means on blade inner surface |
US5957923A (en) | 1995-04-20 | 1999-09-28 | Symbiosis Corporation | Loop electrodes for electrocautery probes for use with a resectoscope |
US5707369A (en) | 1995-04-24 | 1998-01-13 | Ethicon Endo-Surgery, Inc. | Temperature feedback monitor for hemostatic surgical instrument |
US5779701A (en) | 1995-04-27 | 1998-07-14 | Symbiosis Corporation | Bipolar endoscopic surgical scissor blades and instrument incorporating the same |
DE19515914C1 (en) | 1995-05-02 | 1996-07-25 | Aesculap Ag | Tong or scissor-shaped surgical instrument |
US5626578A (en) | 1995-05-08 | 1997-05-06 | Tihon; Claude | RF valvulotome |
DE19518388C2 (en) | 1995-05-19 | 1997-07-03 | Wolf Gmbh Richard | Medical instrument with an angled distal end piece |
US5638003A (en) | 1995-05-23 | 1997-06-10 | Underwriters Laboratories, Inc. | Method and apparatus for testing surface breakdown of dielectric materials caused by electrical tracking |
US5720744A (en) | 1995-06-06 | 1998-02-24 | Valleylab Inc | Control system for neurosurgery |
GB9526627D0 (en) | 1995-12-29 | 1996-02-28 | Gyrus Medical Ltd | An electrosurgical instrument and an electrosurgical electrode assembly |
US6293942B1 (en) | 1995-06-23 | 2001-09-25 | Gyrus Medical Limited | Electrosurgical generator method |
GB9604770D0 (en) | 1995-06-23 | 1996-05-08 | Gyrus Medical Ltd | An electrosurgical generator and system |
EP0771176B2 (en) | 1995-06-23 | 2006-01-04 | Gyrus Medical Limited | An electrosurgical instrument |
CA2224975A1 (en) | 1995-06-23 | 1997-01-09 | Gyrus Medical Limited | An electrosurgical instrument |
US6458125B1 (en) | 1995-07-10 | 2002-10-01 | I. C. Medical, Inc. | Electro-surgical unit pencil apparatus and method therefor |
US5667526A (en) | 1995-09-07 | 1997-09-16 | Levin; John M. | Tissue retaining clamp |
US5722421A (en) | 1995-09-15 | 1998-03-03 | Symbiosis Corporation | Clevis having deflection limiting stops for use in an endoscopic biopsy forceps instrument |
US5827271A (en) | 1995-09-19 | 1998-10-27 | Valleylab | Energy delivery system for vessel sealing |
US6887240B1 (en) | 1995-09-19 | 2005-05-03 | Sherwood Services Ag | Vessel sealing wave jaw |
US5662667A (en) | 1995-09-19 | 1997-09-02 | Ethicon Endo-Surgery, Inc. | Surgical clamping mechanism |
US5776130A (en) | 1995-09-19 | 1998-07-07 | Valleylab, Inc. | Vascular tissue sealing pressure control |
US5797927A (en) | 1995-09-22 | 1998-08-25 | Yoon; Inbae | Combined tissue clamping and suturing instrument |
US5674220A (en) | 1995-09-29 | 1997-10-07 | Ethicon Endo-Surgery, Inc. | Bipolar electrosurgical clamping device |
USH1745H (en) | 1995-09-29 | 1998-08-04 | Paraschac; Joseph F. | Electrosurgical clamping device with insulation limited bipolar electrode |
ES2098198B1 (en) | 1995-10-18 | 1998-01-01 | Bofill Brosa Ramon | FORCEPS FOR THE SURGICAL INTRODUCTION OF CATHETERS AND THE LIKE. |
AU703455B2 (en) | 1995-10-20 | 1999-03-25 | Ethicon Endo-Surgery, Inc. | Self protecting knife for curved jaw surgical instruments |
US5792137A (en) | 1995-10-27 | 1998-08-11 | Lacar Microsystems, Inc. | Coagulating microsystem |
WO1997018766A1 (en) | 1995-11-20 | 1997-05-29 | Storz Endoskop Gmbh | Bipolar high-frequency surgical instrument |
US5658281A (en) | 1995-12-04 | 1997-08-19 | Valleylab Inc | Bipolar electrosurgical scissors and method of manufacture |
US5827281A (en) | 1996-01-05 | 1998-10-27 | Levin; John M. | Insulated surgical scissors |
US7115123B2 (en) | 1996-01-05 | 2006-10-03 | Thermage, Inc. | Handpiece with electrode and non-volatile memory |
US5755717A (en) | 1996-01-16 | 1998-05-26 | Ethicon Endo-Surgery, Inc. | Electrosurgical clamping device with improved coagulation feedback |
US6126656A (en) | 1996-01-30 | 2000-10-03 | Utah Medical Products, Inc. | Electrosurgical cutting device |
US5882567A (en) | 1996-02-16 | 1999-03-16 | Acushnet Company | Method of making a golf ball having multiple layers |
US5725536A (en) | 1996-02-20 | 1998-03-10 | Richard-Allen Medical Industries, Inc. | Articulated surgical instrument with improved articulation control mechanism |
US5762255A (en) | 1996-02-20 | 1998-06-09 | Richard-Allan Medical Industries, Inc. | Surgical instrument with improvement safety lockout mechanisms |
DE19608716C1 (en) | 1996-03-06 | 1997-04-17 | Aesculap Ag | Bipolar surgical holding instrument |
US5702390A (en) | 1996-03-12 | 1997-12-30 | Ethicon Endo-Surgery, Inc. | Bioplar cutting and coagulation instrument |
US5700261A (en) | 1996-03-29 | 1997-12-23 | Ethicon Endo-Surgery, Inc. | Bipolar Scissors |
JP2873366B2 (en) | 1996-04-01 | 1999-03-24 | ▼しずか▲ 加▼せ▲田 | Forceps |
US5960544A (en) | 1996-04-03 | 1999-10-05 | Beyers; Greg L. | Double-ended dual mechanism retractable blade utility knife |
US5893877A (en) | 1996-04-10 | 1999-04-13 | Synergetics, Inc. | Surgical instrument with offset handle |
US6620155B2 (en) | 1996-07-16 | 2003-09-16 | Arthrocare Corp. | System and methods for electrosurgical tissue contraction within the spine |
DE19632298B4 (en) | 1996-08-10 | 2004-09-23 | Deutsches Zentrum für Luft- und Raumfahrt e.V. | Gripping device for use in minimally invasive surgery |
US5814043A (en) | 1996-09-06 | 1998-09-29 | Mentor Ophthalmics, Inc. | Bipolar electrosurgical device |
DE29616210U1 (en) | 1996-09-18 | 1996-11-14 | Winter & Ibe Olympus | Handle for surgical instruments |
US7112199B2 (en) | 1996-09-20 | 2006-09-26 | Ioan Cosmescu | Multifunctional telescopic monopolar/bipolar surgical device and method therefore |
US5843080A (en) | 1996-10-16 | 1998-12-01 | Megadyne Medical Products, Inc. | Bipolar instrument with multi-coated electrodes |
US5820630A (en) | 1996-10-22 | 1998-10-13 | Annex Medical, Inc. | Medical forceps jaw assembly |
US5954720A (en) | 1996-10-28 | 1999-09-21 | Endoscopic Concepts, Inc. | Bipolar electrosurgical end effectors |
US5923475A (en) | 1996-11-27 | 1999-07-13 | Eastman Kodak Company | Laser printer using a fly's eye integrator |
US5827279A (en) * | 1996-12-06 | 1998-10-27 | Ethicon Endo-Surgery, Inc. | Knife coupler mechanism for an endoscopic instrument |
US5891142A (en) | 1996-12-06 | 1999-04-06 | Eggers & Associates, Inc. | Electrosurgical forceps |
US5951549A (en) | 1996-12-20 | 1999-09-14 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6113596A (en) | 1996-12-30 | 2000-09-05 | Enable Medical Corporation | Combination monopolar-bipolar electrosurgical instrument system, instrument and cable |
US5827548A (en) | 1997-01-14 | 1998-10-27 | Lisco, Inc. | Golf ball injection mold |
JP3311287B2 (en) | 1997-01-16 | 2002-08-05 | 旭光学工業株式会社 | Surgical forceps under endoscopic observation |
FR2759165A1 (en) | 1997-01-31 | 1998-08-07 | Canon Kk | METHOD AND DEVICE FOR DETERMINING THE QUANTITY OF PRODUCT PRESENT IN A TANK, PRODUCT TANK AND ELECTRIC SIGNAL PROCESSING DEVICE FOR SUCH A DETERMINATION DEVICE |
US6626901B1 (en) | 1997-03-05 | 2003-09-30 | The Trustees Of Columbia University In The City Of New York | Electrothermal instrument for sealing and joining or cutting tissue |
US5800449A (en) | 1997-03-11 | 1998-09-01 | Ethicon Endo-Surgery, Inc. | Knife shield for surgical instruments |
US6033399A (en) | 1997-04-09 | 2000-03-07 | Valleylab, Inc. | Electrosurgical generator with adaptive power control |
US5925043A (en) | 1997-04-30 | 1999-07-20 | Medquest Products, Inc. | Electrosurgical electrode with a conductive, non-stick coating |
US5961514A (en) | 1997-05-14 | 1999-10-05 | Ethicon Endo-Surger, Inc. | Cordless electrosurgical instrument |
USH1904H (en) | 1997-05-14 | 2000-10-03 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic method and device |
USH2037H1 (en) | 1997-05-14 | 2002-07-02 | David C. Yates | Electrosurgical hemostatic device including an anvil |
US5911719A (en) | 1997-06-05 | 1999-06-15 | Eggers; Philip E. | Resistively heating cutting and coagulating surgical instrument |
US6096037A (en) | 1997-07-29 | 2000-08-01 | Medtronic, Inc. | Tissue sealing electrosurgery device and methods of sealing tissue |
US6402747B1 (en) | 1997-07-21 | 2002-06-11 | Sherwood Services Ag | Handswitch cord and circuit |
US6280458B1 (en) | 1997-07-22 | 2001-08-28 | Karl Storz Gmbh & Co. Kg | Surgical grasping and holding forceps |
US6102909A (en) | 1997-08-26 | 2000-08-15 | Ethicon, Inc. | Scissorlike electrosurgical cutting instrument |
US6024744A (en) | 1997-08-27 | 2000-02-15 | Ethicon, Inc. | Combined bipolar scissor and grasper |
US6083223A (en) | 1997-08-28 | 2000-07-04 | Baker; James A. | Methods and apparatus for welding blood vessels |
US5891141A (en) | 1997-09-02 | 1999-04-06 | Everest Medical Corporation | Bipolar electrosurgical instrument for cutting and sealing tubular tissue structures |
DE19738457B4 (en) | 1997-09-03 | 2009-01-02 | Celon Ag Medical Instruments | Method and device for in vivo deep coagulation of biological tissue volumes while sparing the tissue surface with high frequency alternating current |
DE19739699A1 (en) | 1997-09-04 | 1999-03-11 | Laser & Med Tech Gmbh | Electrode arrangement for the electro-thermal treatment of the human or animal body |
US6267761B1 (en) | 1997-09-09 | 2001-07-31 | Sherwood Services Ag | Apparatus and method for sealing and cutting tissue |
DE69841285D1 (en) | 1997-09-10 | 2009-12-24 | Covidien Ag | Bipolar electrode instrument |
US5964758A (en) | 1997-09-18 | 1999-10-12 | Dresden; Scott | Laparoscopic electrosurgical instrument |
US5913874A (en) * | 1997-09-25 | 1999-06-22 | Cabot Technology Corporation | Cartridge for a surgical instrument |
US5908420A (en) | 1997-10-03 | 1999-06-01 | Everest Medical Corporation | Surgical scissors with bipolar distal electrodes |
US6123701A (en) | 1997-10-09 | 2000-09-26 | Perfect Surgical Techniques, Inc. | Methods and systems for organ resection |
US5976132A (en) | 1997-10-10 | 1999-11-02 | Morris; James R. | Bipolar surgical shears |
US7135020B2 (en) | 1997-11-12 | 2006-11-14 | Sherwood Services Ag | Electrosurgical instrument reducing flashover |
US7435249B2 (en) | 1997-11-12 | 2008-10-14 | Covidien Ag | Electrosurgical instruments which reduces collateral damage to adjacent tissue |
WO2002080786A1 (en) | 2001-04-06 | 2002-10-17 | Sherwood Services Ag | Electrosurgical instrument which reduces collateral damage to adjacent tissue |
US6187003B1 (en) | 1997-11-12 | 2001-02-13 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US6726686B2 (en) | 1997-11-12 | 2004-04-27 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US6050996A (en) | 1997-11-12 | 2000-04-18 | Sherwood Services Ag | Bipolar electrosurgical instrument with replaceable electrodes |
US6352536B1 (en) | 2000-02-11 | 2002-03-05 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US20030014052A1 (en) | 1997-11-14 | 2003-01-16 | Buysse Steven P. | Laparoscopic bipolar electrosurgical instrument |
US6228083B1 (en) | 1997-11-14 | 2001-05-08 | Sherwood Services Ag | Laparoscopic bipolar electrosurgical instrument |
DE19751108A1 (en) | 1997-11-18 | 1999-05-20 | Beger Frank Michael Dipl Desig | Electrosurgical operation tool, especially for diathermy |
EP0923907A1 (en) | 1997-12-19 | 1999-06-23 | Gyrus Medical Limited | An electrosurgical instrument |
US6273887B1 (en) | 1998-01-23 | 2001-08-14 | Olympus Optical Co., Ltd. | High-frequency treatment tool |
US6736813B2 (en) | 1998-01-23 | 2004-05-18 | Olympus Optical Co., Ltd. | High-frequency treatment tool |
US5989277A (en) | 1998-01-30 | 1999-11-23 | Lemaire, Iii; Norman J. | Surgical instrument with offset jaw actuator |
US6562037B2 (en) | 1998-02-12 | 2003-05-13 | Boris E. Paton | Bonding of soft biological tissues by passing high frequency electric current therethrough |
WO1999040861A1 (en) | 1998-02-17 | 1999-08-19 | Baker James A | Radiofrequency medical instrument for vessel welding |
US6126658A (en) | 1998-02-19 | 2000-10-03 | Baker; James A. | Radiofrequency medical instrument and methods for vessel welding |
US5902301A (en) | 1998-02-23 | 1999-05-11 | Everest Medical Corporation | Cutting/coagulating forceps with interleaved electrodes |
US6010516A (en) | 1998-03-20 | 2000-01-04 | Hulka; Jaroslav F. | Bipolar coaptation clamps |
US5908432A (en) | 1998-03-27 | 1999-06-01 | Pan; Huai C. | Scalpel with retractable blade |
US6514252B2 (en) | 1998-05-01 | 2003-02-04 | Perfect Surgical Techniques, Inc. | Bipolar surgical instruments having focused electrical fields |
US6030384A (en) | 1998-05-01 | 2000-02-29 | Nezhat; Camran | Bipolar surgical instruments having focused electrical fields |
US6193718B1 (en) | 1998-06-10 | 2001-02-27 | Scimed Life Systems, Inc. | Endoscopic electrocautery instrument |
US6679882B1 (en) | 1998-06-22 | 2004-01-20 | Lina Medical Aps | Electrosurgical device for coagulating and for making incisions, a method of severing blood vessels and a method of coagulating and for making incisions in or severing tissue |
US6053914A (en) | 1998-06-29 | 2000-04-25 | Ethicon, Inc. | Pivot screw for bipolar surgical instruments |
US5906630A (en) | 1998-06-30 | 1999-05-25 | Boston Scientific Limited | Eccentric surgical forceps |
JP4225624B2 (en) | 1998-08-27 | 2009-02-18 | オリンパス株式会社 | High frequency treatment device |
US6086586A (en) | 1998-09-14 | 2000-07-11 | Enable Medical Corporation | Bipolar tissue grasping apparatus and tissue welding method |
US6090107A (en) | 1998-10-20 | 2000-07-18 | Megadyne Medical Products, Inc. | Resposable electrosurgical instrument |
US7582087B2 (en) | 1998-10-23 | 2009-09-01 | Covidien Ag | Vessel sealing instrument |
US7901400B2 (en) | 1998-10-23 | 2011-03-08 | Covidien Ag | Method and system for controlling output of RF medical generator |
US7267677B2 (en) | 1998-10-23 | 2007-09-11 | Sherwood Services Ag | Vessel sealing instrument |
USD449886S1 (en) | 1998-10-23 | 2001-10-30 | Sherwood Services Ag | Forceps with disposable electrode |
DE69925854T2 (en) | 1998-10-23 | 2006-05-11 | Sherwood Services Ag | ENDOSCOPIC BIPOLAR ELECTRO-SURGICAL TONGUE |
US6511480B1 (en) | 1998-10-23 | 2003-01-28 | Sherwood Services Ag | Open vessel sealing forceps with disposable electrodes |
USD425201S (en) | 1998-10-23 | 2000-05-16 | Sherwood Services Ag | Disposable electrode assembly |
US7137980B2 (en) | 1998-10-23 | 2006-11-21 | Sherwood Services Ag | Method and system for controlling output of RF medical generator |
US6796981B2 (en) | 1999-09-30 | 2004-09-28 | Sherwood Services Ag | Vessel sealing system |
US20040167508A1 (en) | 2002-02-11 | 2004-08-26 | Robert Wham | Vessel sealing system |
US6398779B1 (en) | 1998-10-23 | 2002-06-04 | Sherwood Services Ag | Vessel sealing system |
USD424694S (en) | 1998-10-23 | 2000-05-09 | Sherwood Services Ag | Forceps |
US7118570B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealing forceps with disposable electrodes |
US6585735B1 (en) | 1998-10-23 | 2003-07-01 | Sherwood Services Ag | Endoscopic bipolar electrosurgical forceps |
US6277117B1 (en) | 1998-10-23 | 2001-08-21 | Sherwood Services Ag | Open vessel sealing forceps with disposable electrodes |
US20040249374A1 (en) | 1998-10-23 | 2004-12-09 | Tetzlaff Philip M. | Vessel sealing instrument |
US6221039B1 (en) | 1998-10-26 | 2001-04-24 | Scimed Life Systems, Inc. | Multi-function surgical instrument |
US6270508B1 (en) | 1998-10-26 | 2001-08-07 | Charles H. Klieman | End effector and instrument for endoscopic and general surgery needle control |
DE19850068C1 (en) | 1998-10-30 | 2000-06-08 | Storz Karl Gmbh & Co Kg | Medical instrument for tissue preparation |
US6319451B1 (en) | 1998-12-17 | 2001-11-20 | Acushnet Company | Method of molding a layer around a body |
DE19858512C1 (en) | 1998-12-18 | 2000-05-25 | Storz Karl Gmbh & Co Kg | Bipolar medical instrument for minimally invasive surgery for endoscopic operations; has mutually insulated leads passing through tubular shaft to conductor elements on linked jaw parts |
US6224593B1 (en) | 1999-01-13 | 2001-05-01 | Sherwood Services Ag | Tissue sealing using microwaves |
US20030171747A1 (en) | 1999-01-25 | 2003-09-11 | Olympus Optical Co., Ltd. | Medical treatment instrument |
US6174309B1 (en) | 1999-02-11 | 2001-01-16 | Medical Scientific, Inc. | Seal & cut electrosurgical instrument |
GB9905211D0 (en) | 1999-03-05 | 1999-04-28 | Gyrus Medical Ltd | Electrosurgery system and instrument |
GB9905209D0 (en) | 1999-03-05 | 1999-04-28 | Gyrus Medical Ltd | Electrosurgery system |
US6110171A (en) | 1999-03-09 | 2000-08-29 | Everest Medical Corporation | Electrosurgical cutting and coagulating instrument for open surgery |
US6190386B1 (en) | 1999-03-09 | 2001-02-20 | Everest Medical Corporation | Electrosurgical forceps with needle electrodes |
US6152923A (en) | 1999-04-28 | 2000-11-28 | Sherwood Services Ag | Multi-contact forceps and method of sealing, coagulating, cauterizing and/or cutting vessels and tissue |
GB9911956D0 (en) | 1999-05-21 | 1999-07-21 | Gyrus Medical Ltd | Electrosurgery system and method |
GB9911954D0 (en) | 1999-05-21 | 1999-07-21 | Gyrus Medical Ltd | Electrosurgery system and instrument |
GB9912625D0 (en) | 1999-05-28 | 1999-07-28 | Gyrus Medical Ltd | An electrosurgical generator and system |
GB9912627D0 (en) | 1999-05-28 | 1999-07-28 | Gyrus Medical Ltd | An electrosurgical instrument |
GB9913652D0 (en) | 1999-06-11 | 1999-08-11 | Gyrus Medical Ltd | An electrosurgical generator |
US6117158A (en) | 1999-07-07 | 2000-09-12 | Ethicon Endo-Surgery, Inc. | Ratchet release mechanism for hand held instruments |
US6692445B2 (en) | 1999-07-27 | 2004-02-17 | Scimed Life Systems, Inc. | Biopsy sampler |
DE19935478C1 (en) | 1999-07-28 | 2001-04-19 | Karlsruhe Forschzent | Endoscopic surgical instrument for tissue coagulation and separation has coagulation clamps and scissor blades each pivoted about common pivot axis via respective lever mechanisms |
GB9919722D0 (en) | 1999-08-20 | 1999-10-20 | Surgical Innovations Ltd | Laparoscopic forceps handle |
US6685724B1 (en) | 1999-08-24 | 2004-02-03 | The Penn State Research Foundation | Laparoscopic surgical instrument and method |
US6409728B1 (en) | 1999-08-25 | 2002-06-25 | Sherwood Services Ag | Rotatable bipolar forceps |
DE19940689A1 (en) | 1999-08-27 | 2001-04-05 | Storz Karl Gmbh & Co Kg | Bipolar medical instrument |
US6419675B1 (en) | 1999-09-03 | 2002-07-16 | Conmed Corporation | Electrosurgical coagulating and cutting instrument |
JP4233742B2 (en) | 1999-10-05 | 2009-03-04 | エシコン・エンド−サージェリィ・インコーポレイテッド | Connecting curved clamp arms and tissue pads used with ultrasonic surgical instruments |
US7887535B2 (en) | 1999-10-18 | 2011-02-15 | Covidien Ag | Vessel sealing wave jaw |
US20030109875A1 (en) | 1999-10-22 | 2003-06-12 | Tetzlaff Philip M. | Open vessel sealing forceps with disposable electrodes |
US6302424B1 (en) | 1999-12-09 | 2001-10-16 | Holland Hitch Company | Force-sensing fifth wheel |
DE10003020C2 (en) | 2000-01-25 | 2001-12-06 | Aesculap Ag & Co Kg | Bipolar barrel instrument |
ES2643763T3 (en) | 2000-03-06 | 2017-11-24 | Salient Surgical Technologies, Inc. | Fluid supply system and controller for electrosurgical devices |
US6558385B1 (en) | 2000-09-22 | 2003-05-06 | Tissuelink Medical, Inc. | Fluid-assisted medical device |
US6689131B2 (en) | 2001-03-08 | 2004-02-10 | Tissuelink Medical, Inc. | Electrosurgical device having a tissue reduction sensor |
US6953461B2 (en) | 2002-05-16 | 2005-10-11 | Tissuelink Medical, Inc. | Fluid-assisted medical devices, systems and methods |
US6358268B1 (en) | 2000-03-06 | 2002-03-19 | Robert B. Hunt | Surgical instrument |
US6391035B1 (en) | 2000-03-24 | 2002-05-21 | Timothy Appleby | Hemostatic clip removal instrument |
DE20007177U1 (en) | 2000-04-19 | 2000-08-03 | Storz Karl Gmbh & Co Kg | Medical instrument with lockable power transmission element |
JP3791893B2 (en) | 2000-04-27 | 2006-06-28 | オリンパス株式会社 | Surgical instrument |
DE10027727C1 (en) | 2000-06-03 | 2001-12-06 | Aesculap Ag & Co Kg | Scissors-shaped or forceps-shaped surgical instrument |
DE10045375C2 (en) | 2000-09-14 | 2002-10-24 | Aesculap Ag & Co Kg | Medical instrument |
US6809508B2 (en) | 2000-10-20 | 2004-10-26 | Ethicon Endo-Surgery, Inc. | Detection circuitry for surgical handpiece system |
US6500176B1 (en) | 2000-10-23 | 2002-12-31 | Csaba Truckai | Electrosurgical systems and techniques for sealing tissue |
US6656177B2 (en) | 2000-10-23 | 2003-12-02 | Csaba Truckai | Electrosurgical systems and techniques for sealing tissue |
US20030139741A1 (en) | 2000-10-31 | 2003-07-24 | Gyrus Medical Limited | Surgical instrument |
US6652521B2 (en) | 2001-01-24 | 2003-11-25 | Ethicon, Inc. | Surgical instrument with a bi-directional cutting element |
US6443970B1 (en) | 2001-01-24 | 2002-09-03 | Ethicon, Inc. | Surgical instrument with a dissecting tip |
US6458128B1 (en) | 2001-01-24 | 2002-10-01 | Ethicon, Inc. | Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element |
US6620161B2 (en) | 2001-01-24 | 2003-09-16 | Ethicon, Inc. | Electrosurgical instrument with an operational sequencing element |
US6464702B2 (en) | 2001-01-24 | 2002-10-15 | Ethicon, Inc. | Electrosurgical instrument with closing tube for conducting RF energy and moving jaws |
US20020111624A1 (en) | 2001-01-26 | 2002-08-15 | Witt David A. | Coagulating electrosurgical instrument with tissue dam |
US20020107517A1 (en) | 2001-01-26 | 2002-08-08 | Witt David A. | Electrosurgical instrument for coagulation and cutting |
WO2002067798A1 (en) | 2001-02-26 | 2002-09-06 | Ntero Surgical, Inc. | System and method for reducing post-surgical complications |
US6682527B2 (en) | 2001-03-13 | 2004-01-27 | Perfect Surgical Techniques, Inc. | Method and system for heating tissue with a bipolar instrument |
USD457958S1 (en) | 2001-04-06 | 2002-05-28 | Sherwood Services Ag | Vessel sealer and divider |
US7101371B2 (en) | 2001-04-06 | 2006-09-05 | Dycus Sean T | Vessel sealer and divider |
US7083618B2 (en) * | 2001-04-06 | 2006-08-01 | Sherwood Services Ag | Vessel sealer and divider |
US7101372B2 (en) | 2001-04-06 | 2006-09-05 | Sherwood Sevices Ag | Vessel sealer and divider |
US20030229344A1 (en) | 2002-01-22 | 2003-12-11 | Dycus Sean T. | Vessel sealer and divider and method of manufacturing same |
US7101373B2 (en) | 2001-04-06 | 2006-09-05 | Sherwood Services Ag | Vessel sealer and divider |
USD457959S1 (en) | 2001-04-06 | 2002-05-28 | Sherwood Services Ag | Vessel sealer |
DE60115295T2 (en) | 2001-04-06 | 2006-08-10 | Sherwood Services Ag | VASILY DEVICE |
US20090292282A9 (en) | 2001-04-06 | 2009-11-26 | Dycus Sean T | Movable handle for vessel sealer |
AU2002250551B2 (en) | 2001-04-06 | 2006-02-02 | Covidien Ag | Molded insulating hinge for bipolar instruments |
DE60109328T2 (en) * | 2001-04-06 | 2006-04-06 | Sherwood Services Ag | VESSEL SEALING DEVICE AND VACUUM CLEANER |
JP4499992B2 (en) | 2001-04-06 | 2010-07-14 | コヴィディエン アクチェンゲゼルシャフト | Vascular sealing machine and splitting machine having non-conductive stop member |
US7090673B2 (en) | 2001-04-06 | 2006-08-15 | Sherwood Services Ag | Vessel sealer and divider |
US7118587B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealer and divider |
US6726068B2 (en) | 2001-04-09 | 2004-04-27 | Dennis J. Miller | Elastomeric thimble |
US7090689B2 (en) | 2001-04-18 | 2006-08-15 | Olympus Corporation | Surgical instrument |
US20030018332A1 (en) | 2001-06-20 | 2003-01-23 | Schmaltz Dale Francis | Bipolar electrosurgical instrument with replaceable electrodes |
US6808525B2 (en) | 2001-08-27 | 2004-10-26 | Gyrus Medical, Inc. | Bipolar electrosurgical hook probe for cutting and coagulating tissue |
US6966907B2 (en) | 2001-08-27 | 2005-11-22 | Gyrus Medical Limited | Electrosurgical generator and system |
US6994709B2 (en) | 2001-08-30 | 2006-02-07 | Olympus Corporation | Treatment device for tissue from living tissues |
JP2005501609A (en) | 2001-09-05 | 2005-01-20 | ティシューリンク・メディカル・インコーポレーテッド | Fluid-assisted medical device, fluid supply system and controller and method for the device |
US6652514B2 (en) | 2001-09-13 | 2003-11-25 | Alan G. Ellman | Intelligent selection system for electrosurgical instrument |
US6802843B2 (en) | 2001-09-13 | 2004-10-12 | Csaba Truckai | Electrosurgical working end with resistive gradient electrodes |
US6773434B2 (en) | 2001-09-18 | 2004-08-10 | Ethicon, Inc. | Combination bipolar forceps and scissors instrument |
US6773409B2 (en) | 2001-09-19 | 2004-08-10 | Surgrx Llc | Surgical system for applying ultrasonic energy to tissue |
US6527771B1 (en) | 2001-09-28 | 2003-03-04 | Ethicon, Inc. | Surgical device for endoscopic vein harvesting |
US6616661B2 (en) | 2001-09-28 | 2003-09-09 | Ethicon, Inc. | Surgical device for clamping, ligating, and severing tissue |
US7070597B2 (en) | 2001-10-18 | 2006-07-04 | Surgrx, Inc. | Electrosurgical working end for controlled energy delivery |
US6929644B2 (en) | 2001-10-22 | 2005-08-16 | Surgrx Inc. | Electrosurgical jaw structure for controlled energy delivery |
US7083619B2 (en) | 2001-10-22 | 2006-08-01 | Surgrx, Inc. | Electrosurgical instrument and method of use |
US6926716B2 (en) | 2001-11-09 | 2005-08-09 | Surgrx Inc. | Electrosurgical instrument |
US7041102B2 (en) | 2001-10-22 | 2006-05-09 | Surgrx, Inc. | Electrosurgical working end with replaceable cartridges |
US20030216732A1 (en) | 2002-05-20 | 2003-11-20 | Csaba Truckai | Medical instrument with thermochromic or piezochromic surface indicators |
US7011657B2 (en) | 2001-10-22 | 2006-03-14 | Surgrx, Inc. | Jaw structure for electrosurgical instrument and method of use |
US6770072B1 (en) | 2001-10-22 | 2004-08-03 | Surgrx, Inc. | Electrosurgical jaw structure for controlled energy delivery |
US6616658B2 (en) | 2001-11-08 | 2003-09-09 | Leonard Ineson | Electrosurgical pencil |
US6757977B2 (en) | 2001-11-20 | 2004-07-06 | Jai Surgicals Limited | Disposable surgical safety scalpel |
US7753908B2 (en) | 2002-02-19 | 2010-07-13 | Endoscopic Technologies, Inc. (Estech) | Apparatus for securing an electrophysiology probe to a clamp |
US7052496B2 (en) | 2001-12-11 | 2006-05-30 | Olympus Optical Co., Ltd. | Instrument for high-frequency treatment and method of high-frequency treatment |
US20030114851A1 (en) | 2001-12-13 | 2003-06-19 | Csaba Truckai | Electrosurgical jaws for controlled application of clamping pressure |
US6660072B2 (en) | 2001-12-21 | 2003-12-09 | Hewlett-Packard Development Company, L.P. | Reduced-corrosion inkjet inks and methods for making same |
US6942662B2 (en) | 2001-12-27 | 2005-09-13 | Gyrus Group Plc | Surgical Instrument |
US6602252B2 (en) | 2002-01-03 | 2003-08-05 | Starion Instruments Corporation | Combined dissecting, cauterizing, and stapling device |
US6676660B2 (en) | 2002-01-23 | 2004-01-13 | Ethicon Endo-Surgery, Inc. | Feedback light apparatus and method for use with an electrosurgical instrument |
US6932816B2 (en) | 2002-02-19 | 2005-08-23 | Boston Scientific Scimed, Inc. | Apparatus for converting a clamp into an electrophysiology device |
US6733498B2 (en) | 2002-02-19 | 2004-05-11 | Live Tissue Connect, Inc. | System and method for control of tissue welding |
JP4089252B2 (en) | 2002-03-11 | 2008-05-28 | オムロン株式会社 | DC load contact structure and switch having the structure |
US20040115296A1 (en) | 2002-04-05 | 2004-06-17 | Duffin Terry M. | Retractable overmolded insert retention apparatus |
JP4131011B2 (en) | 2002-04-09 | 2008-08-13 | Hoya株式会社 | Endoscopic sputum treatment device |
US20040030330A1 (en) | 2002-04-18 | 2004-02-12 | Brassell James L. | Electrosurgery systems |
WO2003090630A2 (en) | 2002-04-25 | 2003-11-06 | Tyco Healthcare Group, Lp | Surgical instruments including micro-electromechanical systems (mems) |
US20030236325A1 (en) | 2002-05-30 | 2003-12-25 | Michela Bonora | Agricultural articles |
AU2003245381B2 (en) | 2002-06-06 | 2009-02-05 | Covidien Ag | Laparoscopic bipolar electrosurgical instrument |
US7033356B2 (en) | 2002-07-02 | 2006-04-25 | Gyrus Medical, Inc. | Bipolar electrosurgical instrument for cutting desiccating and sealing tissue |
US20040260281A1 (en) | 2002-09-19 | 2004-12-23 | Baxter Chester O. | Finger tip electrosurgical medical device |
US20040064151A1 (en) | 2002-09-27 | 2004-04-01 | Starion Instruments Corporation | Ultrasonic forceps |
US7087054B2 (en) | 2002-10-01 | 2006-08-08 | Surgrx, Inc. | Electrosurgical instrument and method of use |
US7276068B2 (en) | 2002-10-04 | 2007-10-02 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
US7270664B2 (en) | 2002-10-04 | 2007-09-18 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
EP1545361B1 (en) | 2002-10-04 | 2007-03-28 | Sherwood Services AG | Electrosurgical instrument for sealing vessels |
US7799026B2 (en) | 2002-11-14 | 2010-09-21 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US7314471B2 (en) | 2002-11-18 | 2008-01-01 | Trevor John Milton | Disposable scalpel with retractable blade |
US7044948B2 (en) | 2002-12-10 | 2006-05-16 | Sherwood Services Ag | Circuit for controlling arc energy from an electrosurgical generator |
US7033354B2 (en) | 2002-12-10 | 2006-04-25 | Sherwood Services Ag | Electrosurgical electrode having a non-conductive porous ceramic coating |
USD493888S1 (en) * | 2003-02-04 | 2004-08-03 | Sherwood Services Ag | Electrosurgical pencil with pistol grip |
US7169146B2 (en) | 2003-02-14 | 2007-01-30 | Surgrx, Inc. | Electrosurgical probe and method of use |
WO2004073488A2 (en) | 2003-02-20 | 2004-09-02 | Sherwood Services Ag | System and method for connecting an electrosurgical instrument to a generator |
US7909820B2 (en) | 2003-03-06 | 2011-03-22 | Salient Surgical Technologies, Inc. | Electrosurgical generator and bipolar electrosurgical device adaptors |
US7776036B2 (en) | 2003-03-13 | 2010-08-17 | Covidien Ag | Bipolar concentric electrode assembly for soft tissue fusion |
DE10330604A1 (en) | 2003-04-01 | 2004-10-28 | Tuebingen Scientific Surgical Products Gmbh | Surgical instrument |
US7128741B1 (en) | 2003-04-04 | 2006-10-31 | Megadyne Medical Products, Inc. | Methods, systems, and devices for performing electrosurgical procedures |
WO2004098385A2 (en) | 2003-05-01 | 2004-11-18 | Sherwood Services Ag | Method and system for programing and controlling an electrosurgical generator system |
US7160299B2 (en) | 2003-05-01 | 2007-01-09 | Sherwood Services Ag | Method of fusing biomaterials with radiofrequency energy |
US8128624B2 (en) | 2003-05-01 | 2012-03-06 | Covidien Ag | Electrosurgical instrument that directs energy delivery and protects adjacent tissue |
AU2004237772B2 (en) | 2003-05-01 | 2009-12-10 | Covidien Ag | Electrosurgical instrument which reduces thermal damage to adjacent tissue |
USD496997S1 (en) | 2003-05-15 | 2004-10-05 | Sherwood Services Ag | Vessel sealer and divider |
US7491201B2 (en) | 2003-05-15 | 2009-02-17 | Covidien Ag | Tissue sealer with non-conductive variable stop members and method of sealing tissue |
USD499181S1 (en) | 2003-05-15 | 2004-11-30 | Sherwood Services Ag | Handle for a vessel sealer and divider |
US7156846B2 (en) * | 2003-06-13 | 2007-01-02 | Sherwood Services Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7597693B2 (en) | 2003-06-13 | 2009-10-06 | Covidien Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7150749B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Vessel sealer and divider having elongated knife stroke and safety cutting mechanism |
US7150097B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Method of manufacturing jaw assembly for vessel sealer and divider |
US7857812B2 (en) | 2003-06-13 | 2010-12-28 | Covidien Ag | Vessel sealer and divider having elongated knife stroke and safety for cutting mechanism |
DE60333799D1 (en) * | 2003-06-13 | 2010-09-23 | Covidien Ag | VESSEL HANDLING AND DISCONNECTING DEVICE FOR USE WITH SMALL TROCAR AND CANNULA |
CA2528919C (en) * | 2003-06-13 | 2012-02-28 | Sherwood Services Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7344268B2 (en) | 2003-07-07 | 2008-03-18 | Xenonics, Inc. | Long-range, handheld illumination system |
USD509297S1 (en) * | 2003-10-17 | 2005-09-06 | Tyco Healthcare Group, Lp | Surgical instrument |
US7396336B2 (en) | 2003-10-30 | 2008-07-08 | Sherwood Services Ag | Switched resonant ultrasonic power amplifier system |
US20050096645A1 (en) | 2003-10-31 | 2005-05-05 | Parris Wellman | Multitool surgical device |
US7232440B2 (en) | 2003-11-17 | 2007-06-19 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US7367976B2 (en) | 2003-11-17 | 2008-05-06 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US7500975B2 (en) | 2003-11-19 | 2009-03-10 | Covidien Ag | Spring loaded reciprocating tissue cutting mechanism in a forceps-style electrosurgical instrument |
US7811283B2 (en) | 2003-11-19 | 2010-10-12 | Covidien Ag | Open vessel sealing instrument with hourglass cutting mechanism and over-ratchet safety |
US7252667B2 (en) | 2003-11-19 | 2007-08-07 | Sherwood Services Ag | Open vessel sealing instrument with cutting mechanism and distal lockout |
US7131970B2 (en) | 2003-11-19 | 2006-11-07 | Sherwood Services Ag | Open vessel sealing instrument with cutting mechanism |
US7131860B2 (en) | 2003-11-20 | 2006-11-07 | Sherwood Services Ag | Connector systems for electrosurgical generator |
US7156842B2 (en) | 2003-11-20 | 2007-01-02 | Sherwood Services Ag | Electrosurgical pencil with improved controls |
US7442193B2 (en) | 2003-11-20 | 2008-10-28 | Covidien Ag | Electrically conductive/insulative over-shoe for tissue fusion |
US7300435B2 (en) | 2003-11-21 | 2007-11-27 | Sherwood Services Ag | Automatic control system for an electrosurgical generator |
US7145757B2 (en) | 2004-01-13 | 2006-12-05 | Eaton Corporation | System for eliminating arcing faults and power distribution system employing the same |
JP4436698B2 (en) | 2004-02-25 | 2010-03-24 | オリンパス株式会社 | High frequency treatment tool |
US7342754B2 (en) | 2004-03-02 | 2008-03-11 | Eaton Corporation | Bypass circuit to prevent arcing in a switching device |
US7780662B2 (en) | 2004-03-02 | 2010-08-24 | Covidien Ag | Vessel sealing system using capacitive RF dielectric heating |
US6979786B2 (en) | 2004-03-18 | 2005-12-27 | Delphi Technologies, Inc. | Contact structures for sliding switches |
USD541938S1 (en) | 2004-04-09 | 2007-05-01 | Sherwood Services Ag | Open vessel sealer with mechanical cutter |
DE102004026179B4 (en) | 2004-05-14 | 2009-01-22 | Erbe Elektromedizin Gmbh | Electrosurgical instrument |
JP4273039B2 (en) | 2004-05-24 | 2009-06-03 | Hoya株式会社 | Endoscopy forceps |
USD533942S1 (en) | 2004-06-30 | 2006-12-19 | Sherwood Services Ag | Open vessel sealer with mechanical cutter |
US7195631B2 (en) | 2004-09-09 | 2007-03-27 | Sherwood Services Ag | Forceps with spring loaded end effector assembly |
US7540872B2 (en) | 2004-09-21 | 2009-06-02 | Covidien Ag | Articulating bipolar electrosurgical instrument |
USD535027S1 (en) | 2004-10-06 | 2007-01-09 | Sherwood Services Ag | Low profile vessel sealing and cutting mechanism |
USD541418S1 (en) | 2004-10-06 | 2007-04-24 | Sherwood Services Ag | Lung sealing device |
USD525361S1 (en) | 2004-10-06 | 2006-07-18 | Sherwood Services Ag | Hemostat style elongated dissecting and dividing instrument |
USD531311S1 (en) | 2004-10-06 | 2006-10-31 | Sherwood Services Ag | Pistol grip style elongated dissecting and dividing instrument |
US7628792B2 (en) | 2004-10-08 | 2009-12-08 | Covidien Ag | Bilateral foot jaws |
USD567943S1 (en) * | 2004-10-08 | 2008-04-29 | Sherwood Services Ag | Over-ratchet safety for a vessel sealing instrument |
US7955332B2 (en) | 2004-10-08 | 2011-06-07 | Covidien Ag | Mechanism for dividing tissue in a hemostat-style instrument |
US20060190035A1 (en) | 2004-10-08 | 2006-08-24 | Sherwood Services Ag | Latching mechanism for forceps |
USD564662S1 (en) | 2004-10-13 | 2008-03-18 | Sherwood Services Ag | Hourglass-shaped knife for electrosurgical forceps |
US7686804B2 (en) | 2005-01-14 | 2010-03-30 | Covidien Ag | Vessel sealer and divider with rotating sealer and cutter |
US7909823B2 (en) | 2005-01-14 | 2011-03-22 | Covidien Ag | Open vessel sealing instrument |
US7491202B2 (en) | 2005-03-31 | 2009-02-17 | Covidien Ag | Electrosurgical forceps with slow closure sealing plates and method of sealing tissue |
US20060287642A1 (en) | 2005-06-16 | 2006-12-21 | Alfred Perlin | Laparoscopic surgical instrument having lockable handles with a latch feature |
US7837685B2 (en) | 2005-07-13 | 2010-11-23 | Covidien Ag | Switch mechanisms for safe activation of energy on an electrosurgical instrument |
US7628791B2 (en) | 2005-08-19 | 2009-12-08 | Covidien Ag | Single action tissue sealer |
USD533027S1 (en) * | 2005-09-28 | 2006-12-05 | Calphalon Corporation | Cookware handle |
US7879035B2 (en) | 2005-09-30 | 2011-02-01 | Covidien Ag | Insulating boot for electrosurgical forceps |
US7922953B2 (en) | 2005-09-30 | 2011-04-12 | Covidien Ag | Method for manufacturing an end effector assembly |
CA2561034C (en) | 2005-09-30 | 2014-12-09 | Sherwood Services Ag | Flexible endoscopic catheter with an end effector for coagulating and transfecting tissue |
ES2381560T3 (en) | 2005-09-30 | 2012-05-29 | Covidien Ag | Insulating sleeve for electrosurgical forceps |
US7722607B2 (en) | 2005-09-30 | 2010-05-25 | Covidien Ag | In-line vessel sealer and divider |
US7789878B2 (en) | 2005-09-30 | 2010-09-07 | Covidien Ag | In-line vessel sealer and divider |
US7594916B2 (en) | 2005-11-22 | 2009-09-29 | Covidien Ag | Electrosurgical forceps with energy based tissue division |
US20070118115A1 (en) | 2005-11-22 | 2007-05-24 | Sherwood Services Ag | Bipolar electrosurgical sealing instrument having an improved tissue gripping device |
US7766910B2 (en) | 2006-01-24 | 2010-08-03 | Tyco Healthcare Group Lp | Vessel sealer and divider for large tissue structures |
US8882766B2 (en) | 2006-01-24 | 2014-11-11 | Covidien Ag | Method and system for controlling delivery of energy to divide tissue |
US8734443B2 (en) * | 2006-01-24 | 2014-05-27 | Covidien Lp | Vessel sealer and divider for large tissue structures |
US8298232B2 (en) * | 2006-01-24 | 2012-10-30 | Tyco Healthcare Group Lp | Endoscopic vessel sealer and divider for large tissue structures |
US8241282B2 (en) * | 2006-01-24 | 2012-08-14 | Tyco Healthcare Group Lp | Vessel sealing cutting assemblies |
US7641653B2 (en) | 2006-05-04 | 2010-01-05 | Covidien Ag | Open vessel sealing forceps disposable handswitch |
US7846158B2 (en) | 2006-05-05 | 2010-12-07 | Covidien Ag | Apparatus and method for electrode thermosurgery |
US20070260238A1 (en) | 2006-05-05 | 2007-11-08 | Sherwood Services Ag | Combined energy level button |
US20070265616A1 (en) | 2006-05-10 | 2007-11-15 | Sherwood Services Ag | Vessel sealing instrument with optimized power density |
US7776037B2 (en) | 2006-07-07 | 2010-08-17 | Covidien Ag | System and method for controlling electrode gap during tissue sealing |
US20080015575A1 (en) | 2006-07-14 | 2008-01-17 | Sherwood Services Ag | Vessel sealing instrument with pre-heated electrodes |
US7744615B2 (en) | 2006-07-18 | 2010-06-29 | Covidien Ag | Apparatus and method for transecting tissue on a bipolar vessel sealing instrument |
US20080033428A1 (en) | 2006-08-04 | 2008-02-07 | Sherwood Services Ag | System and method for disabling handswitching on an electrosurgical instrument |
US8597297B2 (en) | 2006-08-29 | 2013-12-03 | Covidien Ag | Vessel sealing instrument with multiple electrode configurations |
US8070746B2 (en) | 2006-10-03 | 2011-12-06 | Tyco Healthcare Group Lp | Radiofrequency fusion of cardiac tissue |
USD575395S1 (en) * | 2007-02-15 | 2008-08-19 | Tyco Healthcare Group Lp | Hemostat style elongated dissecting and dividing instrument |
USD575401S1 (en) * | 2007-06-12 | 2008-08-19 | Tyco Healthcare Group Lp | Vessel sealer |
DE202007009317U1 (en) | 2007-06-26 | 2007-08-30 | Aesculap Ag & Co. Kg | Surgical instrument e.g. shear, for minimal invasive surgery, has tool unit connected with force transmission unit over flexible drive unit in sections for transmitting actuating force from force transmission unit to tool unit |
USD617900S1 (en) * | 2009-05-13 | 2010-06-15 | Tyco Healthcare Group Lp | End effector tip with undercut bottom jaw |
USD617903S1 (en) * | 2009-05-13 | 2010-06-15 | Tyco Healthcare Group Lp | End effector pointed tip |
USD617901S1 (en) * | 2009-05-13 | 2010-06-15 | Tyco Healthcare Group Lp | End effector chamfered tip |
USD617902S1 (en) * | 2009-05-13 | 2010-06-15 | Tyco Healthcare Group Lp | End effector tip with undercut top jaw |
USD618798S1 (en) * | 2009-05-13 | 2010-06-29 | Tyco Healthcare Group Lp | Vessel sealing jaw seal plate |
-
2006
- 2006-11-09 US US11/595,194 patent/US7766910B2/en active Active
-
2007
- 2007-01-22 CA CA2574748A patent/CA2574748C/en active Active
- 2007-01-23 JP JP2007013194A patent/JP5196793B2/en active Active
- 2007-01-24 EP EP10185386.9A patent/EP2286752B2/en not_active Expired - Fee Related
- 2007-01-24 DE DE602007001898T patent/DE602007001898D1/en active Active
- 2007-01-24 EP EP09005051.9A patent/EP2085043B1/en not_active Expired - Fee Related
- 2007-01-24 ES ES10185386T patent/ES2391541T3/en active Active
- 2007-01-24 EP EP07001488A patent/EP1810625B1/en active Active
- 2007-01-24 ES ES07001488T patent/ES2330261T3/en active Active
- 2007-01-24 ES ES10185405T patent/ES2393061T3/en active Active
- 2007-01-24 AU AU2007200294A patent/AU2007200294B2/en not_active Ceased
- 2007-01-24 EP EP10185405A patent/EP2286750B1/en not_active Expired - Fee Related
-
2010
- 2010-07-09 US US12/833,270 patent/US8070748B2/en active Active
-
2012
- 2012-04-13 JP JP2012092308A patent/JP2012139545A/en not_active Withdrawn
- 2012-04-13 JP JP2012092309A patent/JP5603368B2/en not_active Expired - Fee Related
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN113906369A (en) * | 2019-03-28 | 2022-01-07 | Abb瑞士股份有限公司 | User interface device for controlling a marine vessel |
CN113906369B (en) * | 2019-03-28 | 2023-12-01 | Abb瑞士股份有限公司 | User interface device for controlling a marine vessel |
Also Published As
Publication number | Publication date |
---|---|
JP2012139545A (en) | 2012-07-26 |
CA2574748C (en) | 2015-03-24 |
JP5603368B2 (en) | 2014-10-08 |
EP2085043B1 (en) | 2013-10-09 |
EP2286752B1 (en) | 2012-08-29 |
EP2286752A1 (en) | 2011-02-23 |
US20100280515A1 (en) | 2010-11-04 |
ES2330261T3 (en) | 2009-12-07 |
AU2007200294A1 (en) | 2007-08-09 |
EP2286752B2 (en) | 2016-05-04 |
EP2286750A1 (en) | 2011-02-23 |
JP2012179372A (en) | 2012-09-20 |
US7766910B2 (en) | 2010-08-03 |
ES2393061T3 (en) | 2012-12-18 |
EP1810625A1 (en) | 2007-07-25 |
JP5196793B2 (en) | 2013-05-15 |
EP2286750B1 (en) | 2012-08-22 |
EP2085043A1 (en) | 2009-08-05 |
US20070173814A1 (en) | 2007-07-26 |
JP2007195982A (en) | 2007-08-09 |
US8070748B2 (en) | 2011-12-06 |
EP1810625B1 (en) | 2009-08-12 |
DE602007001898D1 (en) | 2009-09-24 |
ES2391541T3 (en) | 2012-11-27 |
AU2007200294B2 (en) | 2013-03-14 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CA2574748C (en) | Vessel sealer and divider for large tissue structures | |
US9918782B2 (en) | Endoscopic vessel sealer and divider for large tissue structures | |
US9539053B2 (en) | Vessel sealer and divider for large tissue structures | |
US8241282B2 (en) | Vessel sealing cutting assemblies | |
US20190223940A1 (en) | Vessel sealer and divider for use with small trocars and cannulas | |
US9655675B2 (en) | Vessel sealer and divider | |
US7857812B2 (en) | Vessel sealer and divider having elongated knife stroke and safety for cutting mechanism | |
US7771425B2 (en) | Vessel sealer and divider having a variable jaw clamping mechanism | |
CA2528918C (en) | Vessel sealer and divider for use with small trocars and cannulas | |
AU2016200297B2 (en) | Vessel sealer and divider for large tissue structures | |
AU2013206054B2 (en) | Vessel sealer and divider for large tissue structures |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
EEER | Examination request |