WO1992022257A1 - Bi-polar electrosurgical endoscopic instruments and methods of use - Google Patents
Bi-polar electrosurgical endoscopic instruments and methods of use Download PDFInfo
- Publication number
- WO1992022257A1 WO1992022257A1 PCT/US1992/004665 US9204665W WO9222257A1 WO 1992022257 A1 WO1992022257 A1 WO 1992022257A1 US 9204665 W US9204665 W US 9204665W WO 9222257 A1 WO9222257 A1 WO 9222257A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- members
- tissue
- instrument
- electrodes
- range
- Prior art date
Links
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
- A61B18/1206—Generators therefor
-
- 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
-
- 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
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F21—LIGHTING
- F21V—FUNCTIONAL FEATURES OR DETAILS OF LIGHTING DEVICES OR SYSTEMS THEREOF; STRUCTURAL COMBINATIONS OF LIGHTING DEVICES WITH OTHER ARTICLES, NOT OTHERWISE PROVIDED FOR
- F21V11/00—Screens not covered by groups F21V1/00, F21V3/00, F21V7/00 or F21V9/00
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
- G02B6/0001—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings specially adapted for lighting devices or systems
- G02B6/0005—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings specially adapted for lighting devices or systems the light guides being of the fibre type
- G02B6/001—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings specially adapted for lighting devices or systems the light guides being of the fibre type the light being emitted along at least a portion of the lateral surface of the fibre
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
- G02B6/0001—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings specially adapted for lighting devices or systems
- G02B6/0096—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings specially adapted for lighting devices or systems the lights guides being of the hollow type
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
- A61B17/2256—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means
- A61B17/2258—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves with means for locating or checking the concrement, e.g. X-ray apparatus, imaging means integrated in a central portion of the shock wave apparatus
-
- 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
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- 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
- A61B18/1402—Probes for open surgery
-
- 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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/0088—Material properties ceramic
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00119—Coatings on the energy applicator with metal oxide nitride
-
- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
-
- 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
- A61B18/1206—Generators therefor
- A61B2018/1213—Generators therefor creating an arc
-
- 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
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
-
- 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
- A61B2018/1412—Blade
- A61B2018/1415—Blade multiple blades
-
- 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
- A61B2018/146—Scissors
-
- 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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
- A61B2018/1861—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument inserted into a body lumen or cavity, e.g. a catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
Definitions
- This invention relates to hemostatic electrosurgical instruments, and particularly to improved bi-polar electrosurgical instruments for manipulating and causing hemostasis of tissue during endoscopic surgical procedures.
- Endoscopic surgery no longer requires cutting a large gaping incision through the body wall, and permits patients to undergo some major surgeries practically pain-free, with little or no post-operative hospital stay.
- the surgeon forgoes manual access to the tissues being operated upon. In doing so, he gives up his traditional means of controlling bleeding by clamping and tying off transected blood vessels. Consequently, in endoscopic surgery it is important that tissues that are cut must not bleed.
- Hemostatic surgical techniques are known for reducing the bleeding from incised tissue during open surgical procedures, i.e., where overlying body tissue is severed and displaced to gain access to internal organs.
- Such techniques include electrosurgery, that is, passing a high frequency or radio frequency current through the patient's tissue between two electrodes for cutting and coagulating the blood vessels contained within the tissue.
- the current passing through the tissue causes joulean (ohmic) heating of the tissue as a function of the current density and the resistance of the tissue through which the current passes. This heating dehydrates the tissues and denatures the tissue proteins to form a coagulum which seals bleeding sites, so that the body's own collagen is reformed as a glistening white layer on the cut surface, sealing the tissues against bleeding.
- Previously known monopolar electrosurgical instruments employ a small electrode at the end of a handle in the surgeon's hand and a large electrode plate beneath and in contact with the patient. Only, one of the two electrodes required to complete the electrical circuit is manipulated by the surgeon and placed on or near the tissue being operated on. The other electrode is the large plate beneath the patient.
- a power supply impresses high frequency voltage spikes of thousands of volts between the two electrodes of the electrosurgical instrument, sufficient to cause arcing from the small operating electrode the surgeon holds to the most proximate tissues, then through the patient to the large electrode plate beneath the patient.
- the electrical current becomes converted to heat; hottest in the tissues immediately below the small hand-held electrode where the currents are most concentrated.
- Devices such as the forceps Model No. A5261, and electrode Model No. A5266, available from Olympus Corporation Medical Instrument Division, Milpitas, California, are representative of such monopolar instruments.
- a principal disadvantage of monopolar electrocautery is that current flows completely through the patient. These high voltage electrical currents may arc from the small electrode to nearby non-targeted vital structures, or may follow erratic paths as they flow through the patient's body, thereby causing damage to tissues both near and at some distance from the electrode.
- Bipolar electrosurgical devices for open surgical procedures are known to enable the surgeon to obtain hemostasis in precise local areas without also heating and causing undesirable trauma to adjacent tissue.
- Bipolar devices have two electrodes closely spaced together so that current flow is confined to the tissue disposed between the electrodes.
- Such instruments have had limited use in endoscopic applications because of the inherent problem of electrically isolating the high voltage electrodes while providing an instrument small enough for use with conventional trocar tubes — typically 5 to 10 mm in diameter.
- One such device is described in Tischer U.S. Patent 4,655,216.
- the complicated structure of the device described in that patent illustrates the difficulty encountered in providing the requisite isolation of the electrodes.
- a second such device is the Olympus Model 05127 bipolar endoscopic forceps, available from Olympus Corporation Medical Instrument Division, Milpitas, California.
- a further disadvantage inherent in all previously known monopolar and bipolar electrosurgical devices is that of coagulum buildup on the working surfaces of the device.
- Previously known power supplies used in electrosurgical applications have generally provided high voltage-low current power outputs, which poorly match the impedance of the tissue over the range of conditions typically encountered in electrosurgery. This mismatch, in combination with the arcing characteristic of previously known instruments, leads to charring of the tissue and excessive coagulum buildup on the instrument surfaces.
- Yet another difficulty encountered in endoscopic surgery is the limited range of motion available to the surgeon at the surgical site. In particular, because of the relatively small incision through which the instruments are inserted for endoscopic procedures, the surgeon's range of movement of the instrument is greatly restricted.
- bipolar electrosurgical instruments for hemostatically severing or manipulating tissue in endoscopic surgical procedures that overcome these disadvantages of such previously known instruments.
- Such instruments would enable a large number of operations to be carried out endoscopically, thereby reducing the need and risk of open surgical procedures.
- an object of the present invention to provide improved endoscopic surgical instruments, the existence of which will expand the field of endoscopic surgery.
- the existence of instruments providing heretofore unavailable functions, ease of use, and enhanced safety will encourage the conversion of a number of surgeries — now carried out as open procedures — to endoscopic procedures.
- Such conversion from open to endoscopic surgeries will reduce the risk of surgery to the patient, reduce the trauma to adjacent tissue from the surgery, and enable faster post-operative recovery.
- the bipolar devices constructed in accordance with the present invention confine current flow to the tissue immediately adjacent to the electrodes of the instrument. Thus, these devices significantly reduce the likelihood of creating aberrant current arcs that can perforate the peritonea or other adjacent tissue.
- the overall safety of endoscopic procedures is thereby enhanced, permitting a larger number of surgeries to be performed endoscopically.
- endoscopic bipolar instruments are employed in conjunction with power supplies providing load- independent substantially constant voltage output. Voltage and current ranges are provided that significantly reduce coagulum buildup and charring of tissue.
- the instrument constructed in accordance with the principles of this invention therefore includes means for rotating the working end of the instrument while it is positioned at the surgical site.
- bipolar electrosurgical instruments having an elongated barrel for insertion through a trocar tube at the patient's skin, a working end disposed on the distal end of the elongated barrel, and handle members for actuating the instrument. Means are provided near the proximal end of the barrel for rotating the working end of the instrument.
- the instrument includes means for connecting the instrument to a power supply to energize the electrodes at the working end.
- Bipolar instruments constructed in accordance with the present invention have a working end that comprises bipolar electrodes and movable members capable of performing any of a number of functions.
- a layer of insulation is provided on one or both of the mating surfaces of the movable members to maintain electrical isolation of those components.
- a working end constructed in accordance with the present invention may comprise a scissors-like cutting instrument which simultaneously causes hemostasis of tissue and mechanically severs that tissue in a continuous manner, a dissector-like instrument for grasping and achieving hemostasis of tissue, or a dissector for blunt dissection, which hemostatically separates tissue.
- the movable members of the working end comprise scissor members having opposing mating surfaces. Electrodes associated with the scissor members conduct high frequency current to tissue to coagulate the blood vessels extending through the tissue while cutting edges of the scissor members mechanically sever the tissue. A layer of insulating material is disposed on at least one of the mating surfaces of the scissor members so that the electrically active portions of the scissor members do not contact each other at any point during operation of the instrument. Thus, current flows through tissue between the scissor members, but short circuits, which would terminate hemostasis, do not occur. With this arrangement, hemostasis and cutting occurs in a continuous manner along tissue disposed between the scissor members, thereby providing a smooth and precise surgical cut.
- Another embodiment of the invention comprises an endoscopic hemostatic dissector, wherein the movable members comprise opposing jaws for simultaneously grasping and causing hemostasis of the tissue.
- the jaw members include shank portions forming opposing mating surfaces.
- a layer of insulating material is disposed on at least one of these mating surfaces so that electrically active portions of the members do not contact each other during operation of the instrument.
- the movable members of either embodiment may be curved so that the tips of the members lie in a plane parallel to, and separate from, the longitudinal axis of the elongated barrel. This feature enhances the surgeon's view of the working end of the instrument, thereby providing greater precision in manipulating the tissue at the operative site.
- the present invention also includes methods of endoscopically using bipolar electrosurgical instruments to simultaneously grasp or mechanically sever tissue while thermally reforming the collagen of the tissue to seal the tissue against bleeding.
- the methods include the steps of:
- steps of the methods include the step of setting the power supply to provide a voltage across the electrodes in the range of 10 to 120 volts (RMS) and a frequency in the range of 100 kHz to 2 MHz.
- the methods further include the use of alternating-current voltage waveforms having a crest factor — ratio of peak voltage to root-mean-square (RMS) voltage — near unity.
- FIG. 1 is an elevated perspective view of an illustrative embodiment of the instrument of the present invention
- FIG. 2 is an elevation cross-sectional side view of the instrument taken along the line 2—2 of FIG. 1, in which an intermediate portion of the elongated barrel has been omitted for clarity;
- FIG. 3 is an exploded perspective view of the working end of the instrument taken along line 3—3 of
- FIG. 4 is an exploded perspective view, similar to FIG. 3, of an alternate embodiment of the working end of the instrument;
- FIGS. 5A and 5B show, respectively, open and closed enlarged cross-sectional views of the working end of the instrument shown in FIG. 2;
- FIGS. 6A, 6B, and 6C show, respectively, cross-sections of alternative embodiments of the working end of the instrument shown in FIG. 5A, taken along line 6—6 of FIG. 5A.
- FIG. 7 is a cross-sectional view of an alternate embodiment of the scissors-like working end of the present invention.
- FIGS. 8A and 8B are cross- sectional views, similar to FIGS. 5A and 5B, showing a dissector embodiment of the working end of the present invention.
- FIG. 9 is a plan view of an alternate embodiment of the dissector embodiment of the present invention.
- FIGS. 1 and 2 a bipolar electrosurgical instrument 10 for performing endoscopic surgical procedures is described. While an instrument constructed in accordance with the principles of the present invention may include any of a variety of severing or grasping members at its working end 11, the illustrative embodiment of FIGS. 1 and 2 includes scissor-like shearing members for simultaneously severing and causing hemostasis of a patient's tissue.
- Instrument 10 includes actuating means comprising handle members 12 and 13 joined for relative movement at pivot 14, tubular elongated barrel 15, and working- end 11.
- Drive rod 16 disposed in elongated barrel 15 has electrical terminals 17 that are connected to movable members 18 and 19 of working end 11 to provide an electrical potential therebetween.
- Handle member 12 has a pistol-like configuration, including a body portion 20 having a longitudinal bore 21 and a portion defining a hole for one or more fingers.
- Handle member 12 may be made of a light-weight rigid material, for example cast aluminum.
- Elongated barrel 15 comprises a tube having a proximal end mounted in body portion 20 and a distal portion forming part of working end 11. The proximal end of elongated barrel 15 is mounted in bore 21 of body portion 20 so that elongated barrel 15 can be rotated about its longitudinal axis.
- Elongated barrel may consist of a rigid structural material, for example a stainless steel alloy, e.g., SS 304, and may include a coating of abherent material, such as Teflon, on its exterior surface.
- Knurled rotation knob 22 is mounted on a portion of elongated barrel 15 disposed in body portion 21, so that it projects through slots 23 intersecting bore 21 of body portion 20. Rotation of knurled knob 22 causes elongated barrel 15 to rotate about its longitudinal axis, thereby also rotating working end 11.
- Body member 20 has bore 24 communicating with bore 21 so that set screw 25 disposed in bore 24 engages elongated barrel 15 substantially perpendicularly to the longitudinal axis of the barrel.
- Set screw 25 has locking knob 26 at one end and teat 27 at the other end to engage elongated barrel 15. Rotation of locking knob 26 may impose a load on elongated barrel 15 to establish a threshold torque for rotating knurled rotation knob 22. Alternatively, locking knob 26 may be rotated so that teat 27 of set screw 25 effectively locks elongated barrel 15 in a given angular orientation, and against further rotation.
- Handle member 13 has a lower portion defining a finger or thumb hole and an upper portion 28 having longitudinal bore 29. Longitudinal bore 29 aligns with longitudinal bore 21 in body portion 20 of handle member 12 when handle members 12 and 13 are joined for relative movement at pivot 14.
- Handle member 13 comprises a similar material as handle member 12, e.g., a cast aluminum alloy.
- Drive rod 16 has a proximal end 30 disposed within elongated barrel 15 and a distal end 31 engaged with working end 11.
- Proximal end 30 of drive rod 16 has electrical terminals 17 projecting from its endface 32, and a portion adjacent to endface 31 that defines a semi-circular groove 33. Because drive rod 16 has a high electrical potential relative to handle members 12 and 13 when electrical terminals 17 are connected to a power supply, drive rod 16 is electrically insulated from handle member 13 and elongated barrel 15 by a coating of electrically insulating material disposed on the exterior surface of drive rod 16.
- Groove 33 of drive rod 16 is captured in insulating disk 34 between insulating pins 35.
- Insulating disk 34 seats in circular aperture 36 in upper portion 28 of handle member 13.
- Insulating disk 34 may comprise a high strength plastic, such as, Ultem (a proprietary plastic of the General Electric Company, Fort Wayne, Indiana, fabricated from polyethermide) , or a ceramic material.
- Longitudinal bore 37 extends through insulating disk 34 in alignment with longitudinal bore 29 of upper portion 28, for accepting proximal portion 30 of drive rod 16.
- Insulating disk 34 includes a pair of bores that perpendicularly intersect bore 37, the pair of bores accepting insulating pins 35. Insulating disk 34 is capable of angular movement in circular aperture 36, when handle member 13 rotates relative to handle member 12 about pivot 14.
- Insulating pins 35 which may comprise a sturdy electrically insulating material such as ceramic or anodized aluminum, engage groove 33 in drive rod 16 so that the drive rod 16 is capable of rotating about its longitudinal axis, but cannot move transversely with respect to insulating pins 35. Accordingly, drive rod 16 is mounted to handle member 13 for rotation about its longitudinal axis in insulating pins 35 and for transverse motion with respect to handle member 12 by virtue of angular movement of insulating disk 34 in aperture 36.
- the distal end of elongated barrel 15 has diametrically opposed U- shaped slots 38 extending proximally from distal endface 39. Apertures 40 in the distal end of elongated barrel 15 are aligned across the diameter of the barrel to accept insulating pivot pin 41.
- Proximal end 31 of drive rod 16 comprises semi-circular halves 16*, each half 16' having an indentation 42 extending inward from its distal endface 43. Indentations 42 of halves 16' oppose each other to create a slot in the distal end of drive rod 16 within which the shanks of the movable members of working end 11 are disposed.
- Halves 16' have layer 45 of insulating material disposed on contacting surfaces 44, so that no current passes through those contacting surfaces. Layer 45 of insulating material also covers the outer surfaces of drive rod halves 16' to provide electrical insulation between drive rod 16 and elongated barrel 15.
- Insulating drive pin 46 extends through apertures 47 near the endfaces 43 of halves 16'.
- drive rod 16 comprises drive member 70 carrying electrode assembly 71.
- Electrode assembly 71 in turn comprises semi-circular electrode halves 72 separated by insulating strip 73.
- Insulating strip 73 extends from the distal end of drive member 70 to a position near the shanks of the movable members to form a slot in the end of drive rod 16 for accepting the shanks of the movable members of working end 11.
- the inner surfaces of electrode halves 72 need not include a layer of insulating material, because insulating strip 71 serves to electrically isolate the electrode halves from each other.
- Electrode halves 72 are coated with an abrasion-resistant electrically insulating material 45' that electrically isolates the electrode halves from elongated barrel 15.
- Insulating material 45' may comprise, for example. Teflon or polyimide.
- Insulating drive pin 46 extends through apertures 47' located near the distal endfaces 43' of the electrode halves, as in the previously described embodiment.
- electrode halves 72 are affixed to either side of insulating strip 73 by insulating pins 74.
- Insulating pins 74 extend through apertures 75 in electrode halves 72 and apertures 76 in insulating strip 73, respectively.
- Insulating pins may comprise a sturdy electrically insulating material, for example, ceramic or anodized aluminum.
- the proximal end of insulating strip 73 is inserted into slot 77 in the distal end of drive member 70.
- drive member 70 which comprises the major portion of drive rod 16, may comprise a sturdy electrically insulating material, such as Teflon or nylon.
- Drive member may then be formed, for example by extrusion, having two bores 78 to accept electrical connectors 79 projecting from the proximal faces of electrode halves 72. Bores 78 may then contain electrical leads that connect electrode halves 72 to electrical terminals 17 projecting from the proximal end of drive rod 16.
- pins 80 extend through apertures 81, provided for that purpose adjacent the slot 77 in drive member 70, and apertures 82 in insulating strip 73, respectively.
- Pins 80 comprise a sturdy electrically conducting or insulating material, inasmuch as pins 80 do not form a part of the electrical circuit of instrument 10.
- pins 80 may comprise, for example, either stainless steel or alumina.
- working end 11 of instrument 10 includes first and second members 18 and 19.
- First and second members 18 and 19 comprise scissor halves pivotally connected by insulating pivot pin 41.
- Tube insulator halves 48 are disposed adjacent to the exterior surfaces of members 18 and 19 to electrically insulate those members from elongated barrel 15.
- Insulating pivot pin 41 has its ends flush with the outer surface of elongated barrel 15 and extends, from side to side, through a first tube insulator half 48, members 18 and 19, and a second tube insulator half 48.
- Insulating pivot pin may comprise an electrically insulating metallic pin, e.g. ,-anodized aluminum, having its ends deformed by peening.
- insulating pivot pin 41 may comprise a rod-like member having a threaded recess at either end to accept a screw.
- the screws engage the threaded recesses and permit an adjustable compressive load to be applied to elongated barrel 15, and hence members 18 and 19.
- Members 18 and 19 include, respectively, shearing surfaces 50 and 60, cutting edges 51 and 61, exterior surfaces 52 and 62, apertures 53 and 63, and shank portions 54 and 64.
- a thin layer 49 of insulating coating is provided on one (FIG. 6B) or both (FIG. 6A) of the opposing mating surfaces of members 18 and 19, including one or both of the shearing surfaces 50 and 60, and one or both of the mating surfaces of the shank portions 54 and 64.
- Members 18 and 19 are configured to constitute the individual electrodes of a bipolar electrode instrument.
- opposing members 18 and 19 are made of an electrically conducting material and serve as both the electrodes and shearing surfaces.
- the opposing members are made of an electrically insulating material and have electrically conductive portions disposed on the exterior surfaces.
- members 18 and 19 are shown in contact with tissue 100.
- members 18 and 19 may be constructed of metallic alloys that offer good electrical conduction, adequate hardness and tensile strength sufficient to allow the members to be oriented toward each other to effect adequate wiping at the cutting edges.
- Materials having these characteristics include stainless steel, e.g., 301, 302, 304 and 316, martensitic stainless steels, e.g. 410, 420, 430 and 440, and precipitation hardened steels, e.g., 17-4PH and 17-7PH alloys.
- the use of such materials permit members 18 and 19 to be formed by numerous methods, including forging followed by machining, die casting, metal injection molding, and electrodischarge machining (EDM) cut-out of the features.
- EDM electrodischarge machining
- Exterior surfaces 52 and 62 of the members may have optional coating 66 of a high electrical and thermal conductivity material, e.g., silver or copper, other than on their respective shearing surfaces 50 and 60. Coating 66 facilitates good electrical contact between exterior surfaces 52 and 62 and the tissue that comes into contact with those surfaces as members 18 and 19 are moved relative to one another.
- a high electrical and thermal conductivity material e.g., silver or copper
- Coating 66 reduces localized heating of the exterior surfaces 52 and 62 of members 18 and 19 by dissipating the heat throughout the thermally conducting surface area of the coating. Coating 66 also reduces the likelihood that joulean heating of members 18 and 19 will occur, because any localized current flow is re-distributed throughout the entire coating. Consequently, coating 66, if applied, reduces thermal decomposition and sticking of blood and tissue to exterior surfaces 52 and 62 during use.
- Layer 49 of insulating coating covers the inside face of one or both of cutting edges 51 and 61, so that the cutting edges are electrically isolated from each other.
- the arrangement of the present invention confines current flow between regions 67 and 68 of exterior surfaces 52 and 62 to a region from where cutting edges 51 and 61 contact each other to a point distal to the cutting point. That distal point is where either the tissue no longer forms an electrical connection between the electrode surfaces or the spacing between members 18 and 19 is sufficiently large that the current density is too low to cause significant joulean heating of the tissue. It is therefore apparent that as members 18 and 19 gradually close together, the cutting point moves along cutting edges 51 and 61 distally of insulating pivot pin 41 and is preceded by a region in which a current flows from one member to the other to achieve hemostasis of the tissue. Thus, hemostasis occurs at a location just in advance of the cutting point while cutting edges 51 and 61 simultaneously sever the hemostatically heated tissue.
- layer 49 disposed on one or both of the opposing mating surfaces of the shank portions prevents electrical shorting between those surfaces as well.
- layer 49 electrically isolates shank portions 54 and 64 in the same manner that it electrically isolates shearing surfaces 50 and 60.
- layer 49 need not be be disposed on the interior surfaces of one or both shank portions 54 and 64, but may comprise an electrically insulating washer disposed, for example, on insulating drive pin 46 between shank portions 54 and 64, thereby separating the shank portions.
- shank portions 54 and 64 of members 18 and 19 include angled slots 55 and 65.
- the exterior surfaces of shank portions 54 and 64 contact the interior surfaces of halves 16' at indentations 42. Since the interior surfaces of indentations 42 are not covered by insulating material 45, halves 16' are in direct electrical contact with shank portions 54 and 64.
- Members 18 and 19 and drive rod halves 16' are constructed of a metallic material that provides good electrical contact, such that the sliding contact resistance of each member 18 and 19 and its respective drive rod halve 16' is less than 5 ohms, and preferably less than 1 ohm.
- the interior surfaces of indentations 42 and the exterior surfaces of shank portions 54 and 64 may be gold plated to reduce the sliding electrical contact resistance.
- the electrical circuit energizing each bipolar electrode extends from electrical terminals 17 on the proximal portion 30 of drive rod 16, through halve 16' of drive rod 16 to proximal portion 31 of halve 16*.
- the outwardly disposed shank portion of the respective members 18 and 19 are in sliding electrical contact with the interior surfaces of indentations 42 of each of drive rod halves 16' , thereby providing a voltage potential across the tissue contacting portions of working end 11.
- Insulating layer 45 (or insulating strip 73 of the embodiment of FIG. 4) electrically isolates halves 16' (or electrode halves 72) , while layer 49 of insulating material on one or both of members 18 and 19 electrically isolates those members, as described heretofore.
- Insulating drive pin 46 extends through slots 55 and 65 of shank portions 54 and 64. The ends of insulating drive pin 46 are disposed in apertures 47 of drive rod halves 16' so that they do not interfere with reciprocatory movement of drive rod 16 in elongated barrel 15. Insulating pin 46 may be comprised of, for example, silicon nitride, zirconia, alumina, or other material which has the mechanical strength to withstand the loads imposed on the pins during opening and closing of members 18 and 19, while providing the requisite electrical insulation between shank portions 54 and 64.
- slots 55 and 65 are configured so that when the handle members are actuated to urge drive rod 16 in a distal direction, insulating drive pin 46 is urged to the distal ends of slots 55 and 65, thereby opening members 18 and 19 (see FIG. 5A) .
- working end 11 may be positioned so that members 18 and 19 are located proximate to the tissue, without imposing any mechanical load thereon.
- Layer 49 of electrically insulating material may have a hardness that is greater or substantially greater than the steel or other electrically conducting material used to manufacture conventional scissors- like devices.
- members 18 and 19 may be made of a martensitic stainless steel, e.g., AISI 420.
- Insulating layer 49 may then comprise, for example, a ceramic material such as alumina or zirconia, or an inorganic electrically insulating material such as a glass, nitride, boride or synthetic diamond.
- layer 49 may be deposited on shearing surface 52 of member 18 by conventional techniques, for example, plasma or flame-sprayed deposition.
- the applied coating forms a non-conductive cutting edge for that member and has a greater hardness than the steel substrate and the steel of opposing member 19. Consequently, as layer 49 rubs against the cutting edge 61 or shearing surface 60 of member 19, steel shearing surface 60 and cutting edge 61 are mechanically ground or polished by the harder insulating layer 49. Cutting edges 51 and 61 are therefore self-sharpening and remain sharp during continued use.
- Insulating layer 49 has a thickness in the range of 0.002 inches to about 0.050 inches, more preferably .003 to .007 inches. The applicant has determined that at thicknesses 0.001 inch or less, the thickness of the insulating layer 49 is insufficient to prevent shorting of the electrodes.
- Insulating layer thicknesses above 0.002 inches and below 0.050 inches cause adequate hemostasis. It has been observed, however, that the greater the minimum distance between the proximate current conducting portions of the opposing electrodes in the region of current flow through the tissue, the longer the current path through the tissue and the more difficult it becomes to obtain the desired localized and intense heating to achieve adequate hemostasis. Insulating layer thicknesses above 0.050 inches are believed to be too large for most practical applications, for the ceramic insulating materials described.
- opposing members 118 and 119 are made of an electrically insulating material, e.g., a ceramic material such as zirconium oxide or aluminum oxide-based ceramics.
- the exterior surfaces 152 and 162 of members 118 and 119 i.e., those portions other than the shearing surfaces 150 and 160 and cutting edges 151 and 161, have coating 166 comprising a material of high electrical and thermal conductivity, e.g., copper, silver or nickel.
- Coating 166 thereby provides opposing electrodes for conduction of high frequency current through tissue between coatings 166 on exterior surfaces 152 and 162 of members 118 and 119.
- coating 166 covers most of the exterior surface of shearing members 118 and 119 such that the current carrying sections closest to cutting edges 151 and 161 are no closer than .002 to 0.050 inches, and more preferably 0.003 to 0.007 inches.
- members 118 and 119 provide the desired insulating material between the electrodes.
- FIG. 7 shows an alternative embodiment of the working end of FIGS. 5A and 5B, in which like numbers designate similar elements.
- the embodiment of FIG. 7 differs from that of FIGS. 5A-B chiefly in that the cutting edges 51 and 61 are curved rather than straight, and member 19 is fixed relative to the longitudinal axis of elongated barrel 15.
- reciprocatory movement of drive pin 46 moves member 18 between the open and closed positions.
- Curved cutting edges 51 and 61 ensure that the tissue to be severed does not slip from between members 18 and 19 during the cutting action, thereby providing enhanced precision in cutting tissue.
- Jaw-like members 18' and 19' have shank portions 54' and 64', respectively.
- Shank portions 54' and 64' in turn have angled slots 55' and 65', respectively.
- Insulated drive pin 46' extends through slots 55' and 65' and has its ends secured in apertures 47' of indentations 42' .
- Members 18' and 19' have grasping surfaces 50' and 60', teeth 51' and 61', and exterior surfaces 52' and 62', respectively.
- Teeth 51' and 61' are disposed in opposing relation on grasping surfaces 50' and 60' to grasp tissue captured between members 18' and 19' .
- the grasping surfaces may include a pattern of pyramidal teeth that serve to grasp the tissue.
- members 18' and 19' of the device of FIGS. 8A-B comprise the electrodes of a bipolar device.
- a thin layer 49' of insulation may be disposed on one or both of the mating surfaces of shank portions 54' and 64' to prevent electrical shorting between members 18' and 19' when those members are moved between the open and closed positions.
- layer 49' may comprise an insulating washer disposed on insulating drive pin 46 between the shank portions to electrically isolate shank portions 54• and 64' .
- Layer 49' of insulating material may in addition cover the opposing surfaces of teeth 51' and 61' of the respective members.
- teeth 51' an. 61' may be dimensioned so that when the members are in the closed position, a gap exists between teeth 51' and 61' sufficient to prevent direct shorting between the members.
- Actuation of the handle members of the instrument urges drive pin 46' to move members 18' and 19' from a first position where the members can be disposed around a mass of tissue, to a second position where the members grasp the tissue.
- Members 18' and 19' therefore move through a graspers-like range ' of motion, similar to that of a conventional pliers.
- In the second position current flows between members 18* and 19' to achieve hemostasis of the tissue captured therebetween.
- Exterior surfaces 52' and 62' of members 18' and 19' may have a smooth, rounded, cross-section to facilitate blunt dissection. For example, such an instrument may be inserted — with members 18' and 19' closed together — into an incision made in a multilayer tissue mass.
- the tissue merely contacts the outer surface of members 18' and 19' , without imposing a substantial mechanical load thereon.
- the electrodes may then be energized, and jaw-like members 18' and 19' may be gradually opened to separate the layers of tissue while simultaneously causing hemostasis of the tissue.
- members 18' and 19' are moved to this second position, the outer surfaces of the members engage the tissue and separate the tissue layers along tissue boundaries without severing.
- FIG. 9 shows an alternative embodiment of the working end of FIG. 8, in which the tips of members 18' and 19* are curved so that they lie in a plane parallel to the longitudinal axis of elongated barrel 15' . Because' the endoscope is typically inserted into the surgical area adjacent to the surgical instrument, the parallax resulting from the acute angle formed between the endoscope and the surgical instrument may restrict the surgeon's view of the surgical site. Thus, the surgeon may have only a limited view of the working end of the surgical instrument.
- FIG. 9 resolves this difficulty by enhancing the surgeons's view of the working end of the instrument.
- Providing a curved working end, so that its tips lie in a plane parallel to the longitudinal axis of elongated barrel 15' enhances the precision of the surgical procedure.
- any of the previously discussed embodiments of working end 11 of the present invention similarly could be provided with curved tips to enhance the surgeon's field of view.
- the tips of members 18' and 19' should not extend beyond the diameter of elongated barrel 15.
- the present invention includes use of such instruments in combination with a power supply providing a substantially constant voltage at selectable output levels, wherein the voltage output is independent of the load impedance.
- a power supply providing a substantially constant voltage at selectable output levels, wherein the voltage output is independent of the load impedance.
- the present invention includes the method steps of employing an apparatus having movable members that include electrodes with an interposed layer of insulating material, wherein operation of the apparatus simultaneously manipulates and causes hemostasis of the tissue.
- Applicant has observed that use of apparatus constructed in accordance with the principles of this invention provides good results, with little sticking or coagulum accumulation, when used in conjunction with a power supply having a load-independent substantially constant voltage output. Frequencies in the range of 100 kHz to 2 MHz and voltages in the range of 10 to 120 volts (RMS) (across the bipolar electrodes) have been determined to provide highly satisfactory performance under a wide range of conditions.
- the method of the present invention suitable for use in performing a great variety of endoscopic surgical procedures on a patient's internal tissue, comprises the steps of:
- steps (g) and (b) described above can be combined by simply providing an apparatus as hereinbefore described. Operation of the apparatus in the range 10 to 90 volts (RMS) is desirable in many cases, depending upon the impedance of the tissue encountered during the surgical procedure.
- RMS 90 volts
- a power supply having a selectable substantially constant voltage level output that is independent of load impedance provides sufficient power to cause effective hemostasis.
- Use of voltage output levels lower than those generally used in previously known electrosurgical instruments reduces the power delivered to the electrodes when they are not in contact with tissue, i.e., open-circuited, and reduces the likelihood of generating a current arc when the electrodes are brought into contact with the tissue.
- Use of a constant voltage level output that is independent of the load impedance inhibits excessive current flow through the tissue, as the tissue resistance increases during desiccation. Consequently, the depth of hemostasis obtained within the tissue can be more precisely controlled, and localized overheating of the electrodes better avoided.
- the present invention may be practiced using an actuating means comprising a pistol style grip having a spring-biased trigger to reciprocate drive rod 16, rather than the handle members described hereinbefore.
- actuating means comprising a pistol style grip having a spring-biased trigger to reciprocate drive rod 16, rather than the handle members described hereinbefore.
Abstract
Endoscopic surgical instruments are provided that have bipolar electrodes on opposing movable members (18, 19) for passing a high frequency current through tissue for simultaneously severing or manipulating the tissue and causing hemostasis of the tissue. An electrically insulating material is interposed between the movable members (18, 19) so that the electrodes (18, 19) are spaced apart from 0.002 to 0.050 inches and the current passes between the opposing electrodes (18, 19) through the tissue. Methods of endoscopically achieving hemostasis while simultaneously, manipulating and cutting tissue are also provided. Use of a constant voltage high frequency power supply to deliver current to the tissue to cause hemostasis is described in conjunction with those methods.
Description
BI-POLAR ELECTROSURGICAL ENDOSCOPIC INSTRUMENTS AND METHODS OF USE
This invention relates to hemostatic electrosurgical instruments, and particularly to improved bi-polar electrosurgical instruments for manipulating and causing hemostasis of tissue during endoscopic surgical procedures.
Background of the Invention
In "open" surgical procedures, the surgeon gains access to work inside the body by cutting large incisions through the body wall, then stretching the overlying tissue apart to provide visibility and room to manipulate his hands and instruments. Vital structures are generally held away from the surgical site and shielded from instruments by being covered with cloth pads. The surgeon can touch and manipulate the tissues. As the surgeon manipulates, cuts and dissects tissues, he controls the resultant bleeding by blotting or suctioning away the accumulating blood, enabling him to see the bleeding vessels and clamp and tie them off.
The creation of a large opening in the patient's body tissue greatly increases the risk of surgery to the patient's health, by increasing the probability of complications. Those complications can arise not only from treatment of the target tissue.
i.e., that tissue necessitating the surgery, but also from the trauma caused to adjacent tissue in creating an opening providing the surgeon with access to the target tissue. Once the internal tissue is operated upon, the surgeon faces the time-consuming task of closing up the surgical site. In addition, the patient may require extensive post-operative care and an extensive hospital stay.
Development of the endoscope, a miniaturized television camera that is inserted through a puncture wound in the body wall to provide a video image of the inside of the body cavity, has enabled surgeons to perform surgery using specially designed surgical instruments that are inserted through other small puncture wounds. Some previously known devices have been constructed that enable a surgeon to operate on internal tissue while viewing manipulation of the instrument through an endoscope. One such device is described in Falk, U.S. Patent 4,994,024. Such previously known endoscopic instruments have several disadvantages, especially the inability to effectively stem blood flow from incised tissue.
Endoscopic surgery no longer requires cutting a large gaping incision through the body wall, and permits patients to undergo some major surgeries practically pain-free, with little or no post-operative hospital stay. However, in performing endoscopic surgery the surgeon forgoes manual access to the tissues being operated upon. In doing so, he gives up his traditional means of controlling bleeding by clamping and tying off transected blood vessels. Consequently, in endoscopic surgery it is important that tissues that are cut must not bleed.
Hemostatic surgical techniques are known for reducing the bleeding from incised tissue during open
surgical procedures, i.e., where overlying body tissue is severed and displaced to gain access to internal organs. Such techniques include electrosurgery, that is, passing a high frequency or radio frequency current through the patient's tissue between two electrodes for cutting and coagulating the blood vessels contained within the tissue. The current passing through the tissue causes joulean (ohmic) heating of the tissue as a function of the current density and the resistance of the tissue through which the current passes. This heating dehydrates the tissues and denatures the tissue proteins to form a coagulum which seals bleeding sites, so that the body's own collagen is reformed as a glistening white layer on the cut surface, sealing the tissues against bleeding.
Heretofore, endoscopic electrosurgical techniques have been limited primarily to onopolar devices. Previously known monopolar electrosurgical instruments employ a small electrode at the end of a handle in the surgeon's hand and a large electrode plate beneath and in contact with the patient. Only, one of the two electrodes required to complete the electrical circuit is manipulated by the surgeon and placed on or near the tissue being operated on. The other electrode is the large plate beneath the patient. A power supply impresses high frequency voltage spikes of thousands of volts between the two electrodes of the electrosurgical instrument, sufficient to cause arcing from the small operating electrode the surgeon holds to the most proximate tissues, then through the patient to the large electrode plate beneath the patient. In the patient, the electrical current becomes converted to heat; hottest in the tissues immediately below the small hand-held electrode where the currents are most concentrated. Devices, such as the forceps Model No.
A5261, and electrode Model No. A5266, available from Olympus Corporation Medical Instrument Division, Milpitas, California, are representative of such monopolar instruments. A principal disadvantage of monopolar electrocautery is that current flows completely through the patient. These high voltage electrical currents may arc from the small electrode to nearby non-targeted vital structures, or may follow erratic paths as they flow through the patient's body, thereby causing damage to tissues both near and at some distance from the electrode.
While monopolar devices have proven useful in open surgical procedures, where the surgeon is able to view the effects of the current arc, the problems encountered in open surgical procedures become even more important in endoscopic surgical applications. In particular, when using a monopolar device endoscopically, the surgeon's view of the electric arc generated by the instrument is restricted by the limited field of view provided by the endoscope. Consequently, aberrant current arcs — the existence of which the surgeon may not even be aware — can cause deep tissue necrosis and inadvertent damage to adjacent tissue masses.
The foregoing limitation has proved especially dangerous for surgeries performed in the abdomen, and in the vicinity of the peritonea and bowel wall. Practical experience has established that aberrant current arcs generated by endoscopic monopolar devices can cause perforation of the adjacent bowel wall when used on abdominal tissue masses. While such damage typically is not apparent to the surgeon during the procedure, it may later be manifested as
peritonitis, which results in death in as many as 25% of all such cases.
Bipolar electrosurgical devices for open surgical procedures are known to enable the surgeon to obtain hemostasis in precise local areas without also heating and causing undesirable trauma to adjacent tissue. Bipolar devices have two electrodes closely spaced together so that current flow is confined to the tissue disposed between the electrodes. Heretofore, such instruments have had limited use in endoscopic applications because of the inherent problem of electrically isolating the high voltage electrodes while providing an instrument small enough for use with conventional trocar tubes — typically 5 to 10 mm in diameter. One such device is described in Tischer U.S. Patent 4,655,216. The complicated structure of the device described in that patent illustrates the difficulty encountered in providing the requisite isolation of the electrodes. A second such device is the Olympus Model 05127 bipolar endoscopic forceps, available from Olympus Corporation Medical Instrument Division, Milpitas, California.
A further disadvantage inherent in all previously known monopolar and bipolar electrosurgical devices is that of coagulum buildup on the working surfaces of the device. Previously known power supplies used in electrosurgical applications have generally provided high voltage-low current power outputs, which poorly match the impedance of the tissue over the range of conditions typically encountered in electrosurgery. This mismatch, in combination with the arcing characteristic of previously known instruments, leads to charring of the tissue and excessive coagulum buildup on the instrument surfaces.
Yet another difficulty encountered in endoscopic surgery is the limited range of motion available to the surgeon at the surgical site. In particular, because of the relatively small incision through which the instruments are inserted for endoscopic procedures, the surgeon's range of movement of the instrument is greatly restricted.
It would therefore be desirable to provide bipolar electrosurgical instruments for hemostatically severing or manipulating tissue in endoscopic surgical procedures that overcome these disadvantages of such previously known instruments. Such instruments would enable a large number of operations to be carried out endoscopically, thereby reducing the need and risk of open surgical procedures.
Summary of the Invention
In view of the foregoing, it is an object of the present invention to provide improved endoscopic surgical instruments, the existence of which will expand the field of endoscopic surgery. In particular, the existence of instruments providing heretofore unavailable functions, ease of use, and enhanced safety will encourage the conversion of a number of surgeries — now carried out as open procedures — to endoscopic procedures. Such conversion from open to endoscopic surgeries will reduce the risk of surgery to the patient, reduce the trauma to adjacent tissue from the surgery, and enable faster post-operative recovery. It is, therefore, an object of this invention to provide bipolar electrosurgical instruments for endoscopic surgical procedures that have a simple structure, yet provide the necessary electrical isolation of the bipolar electrodes. The bipolar devices constructed in accordance with the present
invention confine current flow to the tissue immediately adjacent to the electrodes of the instrument. Thus, these devices significantly reduce the likelihood of creating aberrant current arcs that can perforate the peritonea or other adjacent tissue. The overall safety of endoscopic procedures is thereby enhanced, permitting a larger number of surgeries to be performed endoscopically.
It is another object of the present invention to provide bipolar endoscopic instruments which experience little sticking or coagulum buildup during extended use. In accordance with the present invention, endoscopic bipolar instruments are employed in conjunction with power supplies providing load- independent substantially constant voltage output. Voltage and current ranges are provided that significantly reduce coagulum buildup and charring of tissue.
It is another object of this invention to provide bipolar electrosurgical instruments that provide the surgeon with a high degree of maneuverability of the instrument once it is located at the surgical site. The instrument constructed in accordance with the principles of this invention therefore includes means for rotating the working end of the instrument while it is positioned at the surgical site.
These and other objects are accomplished in accordance with the principles of the present invention by providing bipolar electrosurgical instruments having an elongated barrel for insertion through a trocar tube at the patient's skin, a working end disposed on the distal end of the elongated barrel, and handle members for actuating the instrument. Means are provided near the proximal end of the barrel for rotating the working
end of the instrument. The instrument includes means for connecting the instrument to a power supply to energize the electrodes at the working end.
Bipolar instruments constructed in accordance with the present invention have a working end that comprises bipolar electrodes and movable members capable of performing any of a number of functions. A layer of insulation is provided on one or both of the mating surfaces of the movable members to maintain electrical isolation of those components. A working end constructed in accordance with the present invention may comprise a scissors-like cutting instrument which simultaneously causes hemostasis of tissue and mechanically severs that tissue in a continuous manner, a dissector-like instrument for grasping and achieving hemostasis of tissue, or a dissector for blunt dissection, which hemostatically separates tissue.
In a first embodiment, the movable members of the working end comprise scissor members having opposing mating surfaces. Electrodes associated with the scissor members conduct high frequency current to tissue to coagulate the blood vessels extending through the tissue while cutting edges of the scissor members mechanically sever the tissue. A layer of insulating material is disposed on at least one of the mating surfaces of the scissor members so that the electrically active portions of the scissor members do not contact each other at any point during operation of the instrument. Thus, current flows through tissue between the scissor members, but short circuits, which would terminate hemostasis, do not occur. With this arrangement, hemostasis and cutting occurs in a continuous manner along tissue disposed between the
scissor members, thereby providing a smooth and precise surgical cut.
Another embodiment of the invention comprises an endoscopic hemostatic dissector, wherein the movable members comprise opposing jaws for simultaneously grasping and causing hemostasis of the tissue. Like the first embodiment, the jaw members include shank portions forming opposing mating surfaces. A layer of insulating material is disposed on at least one of these mating surfaces so that electrically active portions of the members do not contact each other during operation of the instrument.
The movable members of either embodiment may be curved so that the tips of the members lie in a plane parallel to, and separate from, the longitudinal axis of the elongated barrel. This feature enhances the surgeon's view of the working end of the instrument, thereby providing greater precision in manipulating the tissue at the operative site. The present invention also includes methods of endoscopically using bipolar electrosurgical instruments to simultaneously grasp or mechanically sever tissue while thermally reforming the collagen of the tissue to seal the tissue against bleeding. For endoscopically performing surgery on a patient's internal tissue using a bipolar electrosurgical instrument in combination with a power supply having a selectable substantially constant voltage load- independent output, the instrument having an elongated barrel, a working end comprising electrodes, and means for actuating the working end, the methods include the steps of:
(a) connecting the electrodes of the bipolar electrosurgical instrument to the power supply;
(b) incising the patient's tissue with a trocar or similar device to create a small opening;
(c) inserting the working end and elongated barrel of the bipolar electrosurgical instrument through a trocar tube so that the working end is disposed proximal to the internal tissue; and
(d) operating the actuating means to simultaneously manipulate and cause hemostasis of the tissue. Further steps of the methods include the step of setting the power supply to provide a voltage across the electrodes in the range of 10 to 120 volts (RMS) and a frequency in the range of 100 kHz to 2 MHz. The methods further include the use of alternating-current voltage waveforms having a crest factor — ratio of peak voltage to root-mean-square (RMS) voltage — near unity.
Brief Description of the Drawings
The above and other objects and advantages of the invention will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference numerals refer to like parts throughout, and in which: FIG. 1 is an elevated perspective view of an illustrative embodiment of the instrument of the present invention;
FIG. 2 is an elevation cross-sectional side view of the instrument taken along the line 2—2 of FIG. 1, in which an intermediate portion of the elongated barrel has been omitted for clarity;
FIG. 3 is an exploded perspective view of the working end of the instrument taken along line 3—3 of
FIG. 1;
FIG. 4 is an exploded perspective view, similar to FIG. 3, of an alternate embodiment of the working end of the instrument;
FIGS. 5A and 5B show, respectively, open and closed enlarged cross-sectional views of the working end of the instrument shown in FIG. 2;
FIGS. 6A, 6B, and 6C show, respectively, cross-sections of alternative embodiments of the working end of the instrument shown in FIG. 5A, taken along line 6—6 of FIG. 5A.
FIG. 7 is a cross-sectional view of an alternate embodiment of the scissors-like working end of the present invention;
FIGS. 8A and 8B, respectively, are cross- sectional views, similar to FIGS. 5A and 5B, showing a dissector embodiment of the working end of the present invention; and
FIG. 9 is a plan view of an alternate embodiment of the dissector embodiment of the present invention.
Detailed Description of the Invention
Referring to FIGS, l and 2, a bipolar electrosurgical instrument 10 for performing endoscopic surgical procedures is described. While an instrument constructed in accordance with the principles of the present invention may include any of a variety of severing or grasping members at its working end 11, the illustrative embodiment of FIGS. 1 and 2 includes scissor-like shearing members for simultaneously severing and causing hemostasis of a patient's tissue. Instrument 10 includes actuating means comprising handle members 12 and 13 joined for relative movement at pivot 14, tubular elongated barrel 15, and working- end 11. Drive rod 16 disposed in elongated
barrel 15 has electrical terminals 17 that are connected to movable members 18 and 19 of working end 11 to provide an electrical potential therebetween. Handle member 12 has a pistol-like configuration, including a body portion 20 having a longitudinal bore 21 and a portion defining a hole for one or more fingers. Handle member 12 may be made of a light-weight rigid material, for example cast aluminum. Elongated barrel 15 comprises a tube having a proximal end mounted in body portion 20 and a distal portion forming part of working end 11. The proximal end of elongated barrel 15 is mounted in bore 21 of body portion 20 so that elongated barrel 15 can be rotated about its longitudinal axis. Elongated barrel may consist of a rigid structural material, for example a stainless steel alloy, e.g., SS 304, and may include a coating of abherent material, such as Teflon, on its exterior surface.
Knurled rotation knob 22 is mounted on a portion of elongated barrel 15 disposed in body portion 21, so that it projects through slots 23 intersecting bore 21 of body portion 20. Rotation of knurled knob 22 causes elongated barrel 15 to rotate about its longitudinal axis, thereby also rotating working end 11.
Body member 20 has bore 24 communicating with bore 21 so that set screw 25 disposed in bore 24 engages elongated barrel 15 substantially perpendicularly to the longitudinal axis of the barrel. Set screw 25 has locking knob 26 at one end and teat 27 at the other end to engage elongated barrel 15. Rotation of locking knob 26 may impose a load on elongated barrel 15 to establish a threshold torque for rotating knurled rotation knob 22. Alternatively, locking knob 26 may be rotated so that teat 27 of set
screw 25 effectively locks elongated barrel 15 in a given angular orientation, and against further rotation.
Handle member 13 has a lower portion defining a finger or thumb hole and an upper portion 28 having longitudinal bore 29. Longitudinal bore 29 aligns with longitudinal bore 21 in body portion 20 of handle member 12 when handle members 12 and 13 are joined for relative movement at pivot 14. Handle member 13 comprises a similar material as handle member 12, e.g., a cast aluminum alloy.
Drive rod 16 has a proximal end 30 disposed within elongated barrel 15 and a distal end 31 engaged with working end 11. Proximal end 30 of drive rod 16 has electrical terminals 17 projecting from its endface 32, and a portion adjacent to endface 31 that defines a semi-circular groove 33. Because drive rod 16 has a high electrical potential relative to handle members 12 and 13 when electrical terminals 17 are connected to a power supply, drive rod 16 is electrically insulated from handle member 13 and elongated barrel 15 by a coating of electrically insulating material disposed on the exterior surface of drive rod 16.
Groove 33 of drive rod 16 is captured in insulating disk 34 between insulating pins 35.
Insulating disk 34 seats in circular aperture 36 in upper portion 28 of handle member 13. Insulating disk 34 may comprise a high strength plastic, such as, Ultem (a proprietary plastic of the General Electric Company, Fort Wayne, Indiana, fabricated from polyethermide) , or a ceramic material. Longitudinal bore 37 extends through insulating disk 34 in alignment with longitudinal bore 29 of upper portion 28, for accepting proximal portion 30 of drive rod 16. Insulating disk 34 includes a pair of bores that perpendicularly
intersect bore 37, the pair of bores accepting insulating pins 35. Insulating disk 34 is capable of angular movement in circular aperture 36, when handle member 13 rotates relative to handle member 12 about pivot 14.
Insulating pins 35, which may comprise a sturdy electrically insulating material such as ceramic or anodized aluminum, engage groove 33 in drive rod 16 so that the drive rod 16 is capable of rotating about its longitudinal axis, but cannot move transversely with respect to insulating pins 35. Accordingly, drive rod 16 is mounted to handle member 13 for rotation about its longitudinal axis in insulating pins 35 and for transverse motion with respect to handle member 12 by virtue of angular movement of insulating disk 34 in aperture 36.
Referring now to FIG. 3, a scissors-like embodiment of working end 11 is described. The distal end of elongated barrel 15 has diametrically opposed U- shaped slots 38 extending proximally from distal endface 39. Apertures 40 in the distal end of elongated barrel 15 are aligned across the diameter of the barrel to accept insulating pivot pin 41.
Proximal end 31 of drive rod 16 comprises semi-circular halves 16*, each half 16' having an indentation 42 extending inward from its distal endface 43. Indentations 42 of halves 16' oppose each other to create a slot in the distal end of drive rod 16 within which the shanks of the movable members of working end 11 are disposed. Halves 16' have layer 45 of insulating material disposed on contacting surfaces 44, so that no current passes through those contacting surfaces. Layer 45 of insulating material also covers the outer surfaces of drive rod halves 16' to provide electrical insulation between drive rod 16 and
elongated barrel 15. No insulation is provided on the interior surfaces of indentations 42, so that the interior surfaces of indentations 42 are in electrical contact with the shanks of the movable members. Insulating drive pin 46 extends through apertures 47 near the endfaces 43 of halves 16'.
An alternative embodiment of the drive rod is illustrated in FIG. 4, wherein drive rod 16 comprises drive member 70 carrying electrode assembly 71. Electrode assembly 71 in turn comprises semi-circular electrode halves 72 separated by insulating strip 73. Insulating strip 73. extends from the distal end of drive member 70 to a position near the shanks of the movable members to form a slot in the end of drive rod 16 for accepting the shanks of the movable members of working end 11. The inner surfaces of electrode halves 72 need not include a layer of insulating material, because insulating strip 71 serves to electrically isolate the electrode halves from each other. The outer surfaces of electrode halves 72 are coated with an abrasion-resistant electrically insulating material 45' that electrically isolates the electrode halves from elongated barrel 15. Insulating material 45' may comprise, for example. Teflon or polyimide. Insulating drive pin 46 extends through apertures 47' located near the distal endfaces 43' of the electrode halves, as in the previously described embodiment.
Still referring to FIG. 4, electrode halves 72 are affixed to either side of insulating strip 73 by insulating pins 74. Insulating pins 74 extend through apertures 75 in electrode halves 72 and apertures 76 in insulating strip 73, respectively. Insulating pins may comprise a sturdy electrically insulating material, for example, ceramic or anodized aluminum.
The proximal end of insulating strip 73 is inserted into slot 77 in the distal end of drive member 70. In this embodiment, drive member 70, which comprises the major portion of drive rod 16, may comprise a sturdy electrically insulating material, such as Teflon or nylon. Drive member may then be formed, for example by extrusion, having two bores 78 to accept electrical connectors 79 projecting from the proximal faces of electrode halves 72. Bores 78 may then contain electrical leads that connect electrode halves 72 to electrical terminals 17 projecting from the proximal end of drive rod 16.
The proximal end of insulating strip 73 is affixed to the distal end of drive member 70 by pins 80. Pins 80 extend through apertures 81, provided for that purpose adjacent the slot 77 in drive member 70, and apertures 82 in insulating strip 73, respectively. Pins 80 comprise a sturdy electrically conducting or insulating material, inasmuch as pins 80 do not form a part of the electrical circuit of instrument 10. Thus, pins 80 may comprise, for example, either stainless steel or alumina.
For the illustrative embodiment shown in FIGS. 1-5, working end 11 of instrument 10 includes first and second members 18 and 19. First and second members 18 and 19 comprise scissor halves pivotally connected by insulating pivot pin 41. Tube insulator halves 48 are disposed adjacent to the exterior surfaces of members 18 and 19 to electrically insulate those members from elongated barrel 15. Insulating pivot pin 41 has its ends flush with the outer surface of elongated barrel 15 and extends, from side to side, through a first tube insulator half 48, members 18 and 19, and a second tube insulator half 48.
Insulating pivot pin may comprise an electrically insulating metallic pin, e.g. ,-anodized aluminum, having its ends deformed by peening. Alternatively, insulating pivot pin 41 may comprise a rod-like member having a threaded recess at either end to accept a screw. The screws engage the threaded recesses and permit an adjustable compressive load to be applied to elongated barrel 15, and hence members 18 and 19. Members 18 and 19 include, respectively, shearing surfaces 50 and 60, cutting edges 51 and 61, exterior surfaces 52 and 62, apertures 53 and 63, and shank portions 54 and 64. A thin layer 49 of insulating coating is provided on one (FIG. 6B) or both (FIG. 6A) of the opposing mating surfaces of members 18 and 19, including one or both of the shearing surfaces 50 and 60, and one or both of the mating surfaces of the shank portions 54 and 64.
Members 18 and 19 are configured to constitute the individual electrodes of a bipolar electrode instrument. In a first family of embodiments, illustrated in FIGS. 6A and 6B, opposing members 18 and 19 are made of an electrically conducting material and serve as both the electrodes and shearing surfaces. In a second family of embodiments, illustrated in FIG. 6C, the opposing members are made of an electrically insulating material and have electrically conductive portions disposed on the exterior surfaces. In FIGS. 6A through 6C, members 18 and 19 are shown in contact with tissue 100.
For the scissors-like embodiment of the working end shown in FIGS. 1-5, members 18 and 19 may be constructed of metallic alloys that offer good electrical conduction, adequate hardness and tensile strength sufficient to allow the members to be oriented
toward each other to effect adequate wiping at the cutting edges. Materials having these characteristics include stainless steel, e.g., 301, 302, 304 and 316, martensitic stainless steels, e.g. 410, 420, 430 and 440, and precipitation hardened steels, e.g., 17-4PH and 17-7PH alloys. The use of such materials permit members 18 and 19 to be formed by numerous methods, including forging followed by machining, die casting, metal injection molding, and electrodischarge machining (EDM) cut-out of the features.
Exterior surfaces 52 and 62 of the members may have optional coating 66 of a high electrical and thermal conductivity material, e.g., silver or copper, other than on their respective shearing surfaces 50 and 60. Coating 66 facilitates good electrical contact between exterior surfaces 52 and 62 and the tissue that comes into contact with those surfaces as members 18 and 19 are moved relative to one another.
Coating 66 reduces localized heating of the exterior surfaces 52 and 62 of members 18 and 19 by dissipating the heat throughout the thermally conducting surface area of the coating. Coating 66 also reduces the likelihood that joulean heating of members 18 and 19 will occur, because any localized current flow is re-distributed throughout the entire coating. Consequently, coating 66, if applied, reduces thermal decomposition and sticking of blood and tissue to exterior surfaces 52 and 62 during use.
Layer 49 of insulating coating covers the inside face of one or both of cutting edges 51 and 61, so that the cutting edges are electrically isolated from each other. Thus, current flows through tissue 100 between exterior surfaces 52 and 62 of members 18 and 19 in the region near cutting edges 51 and 61, while ensuring that members 18 and 19 do not
electrically contact each other within the range of the cutting or opening motion of the members.
Consequently, hemostasis of tissue occurs at a location just in advance of the cutting point while cutting edges 51 and 61 simultaneously sever the hemoεtatically heated tissue. This configuration enables the cutting edges to contact each other to sever tissue while preventing short circuiting, which would impede simultaneous coagulation of the blood vessels extending through the tissue. Layer 49 substantially prevents current flow directly between opposing shearing surfaces 50 and 60 when members 18 and 19 are closed together. Rather, the current flows through the path of least resistance between the electrodes, i.e., through the tissue in direct contact with regions 67 and 68, respectively, of exterior surfaces 52 and 62 of the members. This current flow is represented schematically by flux lines 99 shown in FIGS. 6A-6C. The arrangement of the present invention confines current flow between regions 67 and 68 of exterior surfaces 52 and 62 to a region from where cutting edges 51 and 61 contact each other to a point distal to the cutting point. That distal point is where either the tissue no longer forms an electrical connection between the electrode surfaces or the spacing between members 18 and 19 is sufficiently large that the current density is too low to cause significant joulean heating of the tissue. It is therefore apparent that as members 18 and 19 gradually close together, the cutting point moves along cutting edges 51 and 61 distally of insulating pivot pin 41 and is preceded by a region in which a current flows from one member to the other to achieve hemostasis of the tissue. Thus, hemostasis
occurs at a location just in advance of the cutting point while cutting edges 51 and 61 simultaneously sever the hemostatically heated tissue.
Because shank portions 54 and 64 also move through a range of motion wherein the opposing mating surfaces of shank portions 54 and 64 move across each other, layer 49 disposed on one or both of the opposing mating surfaces of the shank portions prevents electrical shorting between those surfaces as well. Thus, layer 49 electrically isolates shank portions 54 and 64 in the same manner that it electrically isolates shearing surfaces 50 and 60. Alternatively, layer 49 need not be be disposed on the interior surfaces of one or both shank portions 54 and 64, but may comprise an electrically insulating washer disposed, for example, on insulating drive pin 46 between shank portions 54 and 64, thereby separating the shank portions.
Referring again to FIG. 3, shank portions 54 and 64 of members 18 and 19 include angled slots 55 and 65. The exterior surfaces of shank portions 54 and 64 contact the interior surfaces of halves 16' at indentations 42. Since the interior surfaces of indentations 42 are not covered by insulating material 45, halves 16' are in direct electrical contact with shank portions 54 and 64.
Members 18 and 19 and drive rod halves 16' are constructed of a metallic material that provides good electrical contact, such that the sliding contact resistance of each member 18 and 19 and its respective drive rod halve 16' is less than 5 ohms, and preferably less than 1 ohm. The interior surfaces of indentations 42 and the exterior surfaces of shank portions 54 and 64 may be gold plated to reduce the sliding electrical contact resistance.
Accordingly, the electrical circuit energizing each bipolar electrode extends from electrical terminals 17 on the proximal portion 30 of drive rod 16, through halve 16' of drive rod 16 to proximal portion 31 of halve 16*. The outwardly disposed shank portion of the respective members 18 and 19 are in sliding electrical contact with the interior surfaces of indentations 42 of each of drive rod halves 16' , thereby providing a voltage potential across the tissue contacting portions of working end 11.
Insulating layer 45 (or insulating strip 73 of the embodiment of FIG. 4) electrically isolates halves 16' (or electrode halves 72) , while layer 49 of insulating material on one or both of members 18 and 19 electrically isolates those members, as described heretofore.
Insulating drive pin 46 extends through slots 55 and 65 of shank portions 54 and 64. The ends of insulating drive pin 46 are disposed in apertures 47 of drive rod halves 16' so that they do not interfere with reciprocatory movement of drive rod 16 in elongated barrel 15. Insulating pin 46 may be comprised of, for example, silicon nitride, zirconia, alumina, or other material which has the mechanical strength to withstand the loads imposed on the pins during opening and closing of members 18 and 19, while providing the requisite electrical insulation between shank portions 54 and 64.
As shown in FIGS. 5A and 5B, slots 55 and 65 are configured so that when the handle members are actuated to urge drive rod 16 in a distal direction, insulating drive pin 46 is urged to the distal ends of slots 55 and 65, thereby opening members 18 and 19 (see FIG. 5A) . In this first position, working end 11 may be positioned so that members 18 and 19 are located
proximate to the tissue, without imposing any mechanical load thereon.
On the other hand, when handle members 12 and 13 are rotated towards each other, drive rod 16 is reciprocated proximally. This motion pulls drive pin 46 toward to the proximal ends of slots 55 and 65, thereby closing members 18 and 19 as shown in FIG 5B. As members 18 and 19 are gradually closed, the cutting point defined by the intersection of cutting edges 51 and 61, moves along those cutting edges, so that a current flows through the tissue to cause hemostasis of the tissue immediately prior to its being severed mechanically. Thus, in this second position, hemostasis is achieved in the tissue by the current flowing between members 18 and 19, and then mechanically severed.
Layer 49 of electrically insulating material may have a hardness that is greater or substantially greater than the steel or other electrically conducting material used to manufacture conventional scissors- like devices. For example, members 18 and 19 may be made of a martensitic stainless steel, e.g., AISI 420. Insulating layer 49 may then comprise, for example, a ceramic material such as alumina or zirconia, or an inorganic electrically insulating material such as a glass, nitride, boride or synthetic diamond. Depending upon the material selected, layer 49 may be deposited on shearing surface 52 of member 18 by conventional techniques, for example, plasma or flame-sprayed deposition. The applied coating forms a non-conductive cutting edge for that member and has a greater hardness than the steel substrate and the steel of opposing member 19. Consequently, as layer 49 rubs against the cutting edge 61 or shearing surface 60 of member 19, steel shearing surface 60 and cutting edge 61 are
mechanically ground or polished by the harder insulating layer 49. Cutting edges 51 and 61 are therefore self-sharpening and remain sharp during continued use. Insulating layer 49 has a thickness in the range of 0.002 inches to about 0.050 inches, more preferably .003 to .007 inches. The applicant has determined that at thicknesses 0.001 inch or less, the thickness of the insulating layer 49 is insufficient to prevent shorting of the electrodes. Insulating layer thicknesses above 0.002 inches and below 0.050 inches cause adequate hemostasis. It has been observed, however, that the greater the minimum distance between the proximate current conducting portions of the opposing electrodes in the region of current flow through the tissue, the longer the current path through the tissue and the more difficult it becomes to obtain the desired localized and intense heating to achieve adequate hemostasis. Insulating layer thicknesses above 0.050 inches are believed to be too large for most practical applications, for the ceramic insulating materials described.
Referring to FIG. 6C, an embodiment representative of a second family of embodiments constructed in accordance with the present invention is described, with similar components indicated by numbers increased by 100. In this embodiment, which outwardly resembles the instrument of FIG. 5A, opposing members 118 and 119 are made of an electrically insulating material, e.g., a ceramic material such as zirconium oxide or aluminum oxide-based ceramics. The exterior surfaces 152 and 162 of members 118 and 119, i.e., those portions other than the shearing surfaces 150 and 160 and cutting edges 151 and 161, have coating 166 comprising a material of high electrical and thermal
conductivity, e.g., copper, silver or nickel. Coating 166 thereby provides opposing electrodes for conduction of high frequency current through tissue between coatings 166 on exterior surfaces 152 and 162 of members 118 and 119. In this embodiment, coating 166 covers most of the exterior surface of shearing members 118 and 119 such that the current carrying sections closest to cutting edges 151 and 161 are no closer than .002 to 0.050 inches, and more preferably 0.003 to 0.007 inches. With the configuration of the embodiment of FIG. 6C, members 118 and 119 provide the desired insulating material between the electrodes.
FIG. 7 shows an alternative embodiment of the working end of FIGS. 5A and 5B, in which like numbers designate similar elements. The embodiment of FIG. 7 differs from that of FIGS. 5A-B chiefly in that the cutting edges 51 and 61 are curved rather than straight, and member 19 is fixed relative to the longitudinal axis of elongated barrel 15. Thus, reciprocatory movement of drive pin 46 moves member 18 between the open and closed positions. Curved cutting edges 51 and 61 ensure that the tissue to be severed does not slip from between members 18 and 19 during the cutting action, thereby providing enhanced precision in cutting tissue.
Referring now to FIGS. 8A and 8B, an alternate embodiment of working end 11 of the present invention is described, in which like-primed numbers designate similar elements. Jaw-like members 18' and 19' have shank portions 54' and 64', respectively. Shank portions 54' and 64' in turn have angled slots 55' and 65', respectively. Insulated drive pin 46' extends through slots 55' and 65' and has its ends secured in apertures 47' of indentations 42' . Members 18' and 19' have grasping surfaces 50' and 60', teeth
51' and 61', and exterior surfaces 52' and 62', respectively. Teeth 51' and 61' are disposed in opposing relation on grasping surfaces 50' and 60' to grasp tissue captured between members 18' and 19' . Alternatively, the grasping surfaces may include a pattern of pyramidal teeth that serve to grasp the tissue.
As for the embodiment of FIGS. 5A and 5B, members 18' and 19' of the device of FIGS. 8A-B comprise the electrodes of a bipolar device. A thin layer 49' of insulation may be disposed on one or both of the mating surfaces of shank portions 54' and 64' to prevent electrical shorting between members 18' and 19' when those members are moved between the open and closed positions. Alternatively, layer 49' may comprise an insulating washer disposed on insulating drive pin 46 between the shank portions to electrically isolate shank portions 54• and 64' .
Layer 49' of insulating material may in addition cover the opposing surfaces of teeth 51' and 61' of the respective members. Alternatively, teeth 51' an. 61' may be dimensioned so that when the members are in the closed position, a gap exists between teeth 51' and 61' sufficient to prevent direct shorting between the members.
Actuation of the handle members of the instrument urges drive pin 46' to move members 18' and 19' from a first position where the members can be disposed around a mass of tissue, to a second position where the members grasp the tissue. Members 18' and 19' therefore move through a graspers-like range' of motion, similar to that of a conventional pliers. In the second position, current flows between members 18* and 19' to achieve hemostasis of the tissue captured therebetween.
Exterior surfaces 52' and 62' of members 18' and 19' may have a smooth, rounded, cross-section to facilitate blunt dissection. For example, such an instrument may be inserted — with members 18' and 19' closed together — into an incision made in a multilayer tissue mass. In this first position, the tissue merely contacts the outer surface of members 18' and 19' , without imposing a substantial mechanical load thereon. The electrodes may then be energized, and jaw-like members 18' and 19' may be gradually opened to separate the layers of tissue while simultaneously causing hemostasis of the tissue. When members 18' and 19' are moved to this second position, the outer surfaces of the members engage the tissue and separate the tissue layers along tissue boundaries without severing.
FIG. 9 shows an alternative embodiment of the working end of FIG. 8, in which the tips of members 18' and 19* are curved so that they lie in a plane parallel to the longitudinal axis of elongated barrel 15' . Because' the endoscope is typically inserted into the surgical area adjacent to the surgical instrument, the parallax resulting from the acute angle formed between the endoscope and the surgical instrument may restrict the surgeon's view of the surgical site. Thus, the surgeon may have only a limited view of the working end of the surgical instrument.
The embodiment of FIG. 9, however, resolves this difficulty by enhancing the surgeons's view of the working end of the instrument. Providing a curved working end, so that its tips lie in a plane parallel to the longitudinal axis of elongated barrel 15' , enhances the precision of the surgical procedure. Of course, it will be apparent to one skilled in the art
that any of the previously discussed embodiments of working end 11 of the present invention similarly could be provided with curved tips to enhance the surgeon's field of view. To ensure that the working end of the instrument will pass easily through standard trocar tubes, the tips of members 18' and 19' should not extend beyond the diameter of elongated barrel 15.
In addition to the above-described endoscopic bipolar instruments, the present invention includes use of such instruments in combination with a power supply providing a substantially constant voltage at selectable output levels, wherein the voltage output is independent of the load impedance. Such devices are described, for example, in U.S. Patent Nos. 4,092,986 and 4,969,885.
To reduce coagulum buildup on the working surfaces of the scissors, applicant has developed power supplies providing substantially constant voltage output that is independent of the load impedance, low source impedance and a alternating-current voltage waveform having a crest factor — the ratio of peak voltage to RMS voltage — near unity. The present invention, when powered by such experimental power supplies, has been observed to provide highly satisfactory hemostasis without arcing or charring of the tissue, and little coagulum buildup.
The present invention includes the method steps of employing an apparatus having movable members that include electrodes with an interposed layer of insulating material, wherein operation of the apparatus simultaneously manipulates and causes hemostasis of the tissue. Applicant has observed that use of apparatus constructed in accordance with the principles of this invention provides good results, with little sticking or coagulum accumulation, when used in conjunction with
a power supply having a load-independent substantially constant voltage output. Frequencies in the range of 100 kHz to 2 MHz and voltages in the range of 10 to 120 volts (RMS) (across the bipolar electrodes) have been determined to provide highly satisfactory performance under a wide range of conditions.
The method of the present invention, suitable for use in performing a great variety of endoscopic surgical procedures on a patient's internal tissue, comprises the steps of:
(a) providing an instrument having an elongated barrel, actuating means, and a working end comprising first and second members movable between first and second positions, the first and second members having opposing mating surfaces that move across each other when the first and second members are moved between the first and second positions, each of the first and second members having an electrode associated therewith; (b) providing an electrically insulating material between the first and second electrodes so that the electrodes do not contact each other when the opposing mating surfaces move across each other; (c) connecting the electrodes to a power supply;
(d) incising the patient's tissue with a trocar or similar device to create a small opening into the patient's body cavity; (e) inserting the working end and elongated barrel of the instrument through a trocar tube so that the working end is disposed adjacent to the internal tissue;
(f) selecting and maintaining a substantially constant voltage level output across the
power supply, the voltage level output independent of the load impedance;
(g) placing the electrodes in electrical contact with the tissue; and (h) operating the actuating means to move the first and second members between the first and second positions to simultaneously manipulate the tissue and cause hemostasis of the tissue by passing a current therethrough. Of course, it will be apparent to one skilled in the art that steps (a) and (b) described above can be combined by simply providing an apparatus as hereinbefore described. Operation of the apparatus in the range 10 to 90 volts (RMS) is desirable in many cases, depending upon the impedance of the tissue encountered during the surgical procedure. Of course, one skilled in the art will also recognize that the above-stated voltages are those imposed across the electrodes of the bipolar instrument, rather than the output terminals of the power supply, since allowance must be made for line losses encountered in the cables connecting the electrosurgical instrument to the power supply.
The use of a power supply having a selectable substantially constant voltage level output that is independent of load impedance provides sufficient power to cause effective hemostasis. Use of voltage output levels lower than those generally used in previously known electrosurgical instruments reduces the power delivered to the electrodes when they are not in contact with tissue, i.e., open-circuited, and reduces the likelihood of generating a current arc when the electrodes are brought into contact with the tissue. Use of a constant voltage level output that is independent of the load impedance inhibits excessive
current flow through the tissue, as the tissue resistance increases during desiccation. Consequently, the depth of hemostasis obtained within the tissue can be more precisely controlled, and localized overheating of the electrodes better avoided. Reduced localized heating of the electrodes also inhibits coagulum buildup, which can both interfere with efficient hemostasis and impede maneuverability of the instrument. The various embodiments described herein are presented for purposes of illustration and not limitation, as the present invention can be practiced with endoscopic surgical instruments of any type having two opposing members movable with respect to one another. The instruments and methods of the present invention may be adapted, as may be required, for use in operating on any internal tissue, vessel, or organ.
For example, the present invention may be practiced using an actuating means comprising a pistol style grip having a spring-biased trigger to reciprocate drive rod 16, rather than the handle members described hereinbefore. One skilled in the art will appreciate that the present invention can be practiced by other than the described embodiments, and that the present invention is limited only by the claims that follow.
Claims
1. An instrument for performing endoscopic electrosurgery on a tissue by passing current through the tissue to cause hemostasis thereof, the instrument comprising: an elongated barrel having a proximal end and a distal end; first and second members disposed on the distal end of the elongated barrel, the first and second members movable from a first position wherein the first and second members are proximate to the tissue, to a second position wherein the first and second members engage the tissue, the first and second members having opposing mating surfaces that move across each other when the first and second members move between the first and second positions; first and second electrodes associated with the first and second members, respectively, the first and second electrodes contacting the tissue; electrically insulating material interposed between the opposing mating surfaces of the first and second members to electrically isolate the first and second electrodes when the opposing mating surfaces move across each other; and actuating means connected to the proximal end of the elongated barrel to move the first and second members between the first and second positions, so that current flows between the first and second electrodes and the tissue in contact therewith.
2. An instrument as defined in claim l wherein the actuating means comprises first and second handle members and means for fastening the first and second handle members together for relative movement.
3. The instrument as defined in claim 1 wherein the elongated barrel has a longitudinal axis, the first and second members have first and second tips, and the first and second members are curved so that the first and second tips lie in a plane parallel to and separated from the longitudinal axis of the elongated barrel.
4. An instrument as defined in claim l wherein the first member comprises a first shearing surface, a first cutting edge, and a first exterior surface and the second member comprises a second shearing surface, a second cutting edge, and a second exterior surface, the instrument further comprising: means for connecting the first and second members so that the first and second shearing surfaces move through a range of motion in a scissors-like cutting action, the scissor-like cutting action defining a cutting point that moves along the first and second cutting edges through the range of motion, the first and second electrodes moving through the same range of motion as the first and second shearing surfaces; and electrically insulating material interposed between the first and second electrodes so that the first and second electrodes do not contact each other in the range of motion and the current passes between the first and second electrodes distal to the cutting point and not between the first and second shearing surfaces.
5. An instrument as defined in claim 4 wherein at least one of the first and second cutting edges is curved.
6. An instrument as defined in claim 4 wherein the first and second members are made of an electrically conducting material, the first electrode further comprises the first member, the second electrode further comprises the second member, and the electrically insulating material is a first layer of material disposed on the first shearing surface to form the first cutting edge and the first shearing surface.
7. An instrument as defined in claim 6 wherein the first layer of electrically insulating material has a hardness that is greater than the hardness of the cutting edge and shearing surface of the other of the first and second members.
8. An instrument as defined in claim 6 wherein the first layer has a thickness selected in the range of 0.002 to 0.050 inches.
9. An instrument as defined in claim 6 wherein the first layer has a thickness selected in the range of 0.003 to 0.007 inches.
10. An instrument as defined in claim 6 further comprising a second layer of electrically insulating material disposed on the shearing surface of the second member to form the second cutting edge and the second shearing surface.
11. An instrument as defined in claim 10 wherein the first layer has a first thickness and the second layer has a second thickness and the sum of the first and second thicknesses is in the range of 0.002 and 0.050 inches.
12. An instrument as defined in.claim 11 wherein the sum of the first and second thicknesses is in the range of 0.003 to 0.007 inches.
13. An instrument as defined in claim 1 wherein the first member comprises a first grasping surface and the second member comprises a second grasping surface, the instrument further comprising: means for connecting the irst and second members so that the first and second grasping surfaces move through a range of motion in a graspers-like action to grasp tissue disposed therebetween, the first and second electrodes moving through the same range of motion as the first and second grasping surfaces; and an electrically insulating material interposed between the first and second electrodes so that the first and second electrodes do not contact each other in the range of motion and the current passes between the first and second electrodes and through the tissue disposed between the first and second grasping surfaces.
14. An instrument as defined in claim 13 wherein the first and second members are made of an electrically conducting material, the first electrode further comprises the first member and the second electrode further comprises the second member.
15. The instrument as defined in claim 14 further comprising portions of the first and second grasping surfaces defining serrations or a pyramidal array for grasping the tissue.
16. An instrument as defined in claim 14 wherein the first and second members include shank portions having mating surfaces, and the opposing mating surfaces of the first and second members comprise the mating surfaces of the shank portions.
17. An instrument as defined in claim 16 wherein the electrically insulating material comprises a layer disposed on at least one of the mating surfaces of the shank portions.
18. An instrument as defined in claim 16 wherein the electrically insulating material comprises an insulating washer interposed between the mating surfaces of the shank portions to electrically isolate the shank portions.
19. An instrument as defined in claim 1 for performing endoscopic electrosurgery wherein layers of tissue are hemostatically separated, wherein the first and second members are closed together and inserted into the tissue in the first position, and the actuating means, when operated, cause the first and second members to open while moving to the second position, thereby separating the layers of tissue while simultaneously achieving hemostasis by passing current through the layers of tissue and between the first and second electrodes.
20. The instrument as defined in claim 19 wherein the elongated barrel has a longitudinal axis, the first and second members have first and second tips, and the first and second members are curved so that the first and second tips lie in a plane parallel to and separated from the longitudinal axis of the elongated barrel.
21. The apparatus of claim 1 in combination with a power supply that provides a high frequency alternating-current waveform, the power supply having a selectable substantially constant voltage level output that is independent of the load impedance, and means for electrically connecting the power supply to the first and second electrodes.
22. The apparatus of claim 21 wherein the substantially constant voltage level output of the power supply is selectable to provide a voltage across the first and second electrodes from the range of 10 to 120 volts (RMS) .
23. The apparatus of claim 21 wherein the power supply provides a voltage waveform having a crest factor near unity.
24. The apparatus of claim 21 wherein the power supply provides an alternating-current voltage waveform having a high frequency selected from the range of 100 to 2 MHz.
25. An instrument as defined in claim 4 wherein the first and second members are made of a non- electrically conducting material, the first electrode is a first layer of electrically conducting material disposed on the first exterior surface and the second electrode is a second layer of electrically conducting material disposed on the second exterior surface, and the electrically insulating material comprises the first and second members.
26. An instrument as defined in claim 25 wherein the first and second layers are spaced apart, at the cutting point, a distance in the range of 0.002 to 0.050 inches, as the cutting point moves through the range of motion.
27. The apparatus of claim 25 in combination with a power supply that provides a high frequency alternating-current waveform, the power supply having a selectable substantially constant voltage level output that is independent of the load impedance, and means for electrically connecting the power supply to the first and second electrodes.
28. The apparatus of claim 27 wherein the substantially constant voltage level output of the power supply is selectable to provide a voltage across the first and second electrodes from the range of 10 to 120 volts (RMS) .
29. The apparatus of claim 27 wherein the power supply provides a voltage waveform having a crest factor near unity.
30. The apparatus of claim 27 wherein the power supply provides an alternating-current voltage waveform having a high frequency selected from the range of 100 to 2 MHz.
31. A method of endoscopically manipulating and causing hemostasis of a patient's internal tissue, the method comprising the steps of:
(a) providing an instrument having an elongated barrel, actuating means, and a working end comprising first and second members movable between first and second positions, the first and second members having opposing mating surfaces that move across each other when the first and second members are moved between the first and second positions, each of the irst and second members having an electrode associated therewith;
(b) providing an electrically insulating material between the first and second electrodes so that the electrodes do not contact each other when the opposing mating surfaces move across each other;
(c) providing a power supply providing a high frequency alternating-current waveform having a selectable voltage level output that is independent of the load impedance;
(d) connecting the electrodes to the power supply;
(e) incising the patient's tissue with a trocar or similar device to create a small opening into the patient's body cavity;
(f) inserting the working end. and elongated barrel of the instrument through a trocar tube so that the working end is disposed adjacent to the internal tissue;
(g) selecting and maintaining a substantially constant voltage level output across the electrodes;
(h) placing the electrodes in electrical contact with the internal tissue; and
(i) operating the actuating means to move the first and second members between the first and second positions to simultaneously manipulate the tissue and pass a current through the internal tissue sufficient to cause hemostasis of that tissue.
32. The method of claim 31 further comprising the step of selecting and maintaining a substantially constant voltage level across the first and second electrodes from the range of 10 to 120 volts (RMS) ;
33. The apparatus of claim 32 wherein the power supply provides a voltage waveform having a crest factor near unity.
34. The method of claim 31 further comprising the step of setting the power supply to provide an alternating-current voltage waveform with a frequency in the range of 100 to 2 MHz.
35. The method of claim 32 wherein the voltage level is selected from the range of 30-90 volts (RMS) .
36. The method of claim 31 wherein the internal tissue has multiple layers, the method further comprising the steps of: inserting the working end of the instrument into the multiple layers of internal tissue with the first and second members in the first position, so that those members are closed together and the first and second electrodes contact the internal tissue; and wherein the step of operating the actuating means causes the first and second members to open while moving to the second position, so that the multiple layers of internal tissue are simultaneously separated and hemostasis of the internal tissue is achieved.
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002110922A CA2110922C (en) | 1991-06-07 | 1992-06-05 | Bi-polar electrosurgical endoscopic instruments |
JP5500916A JP3053218B2 (en) | 1991-06-07 | 1992-06-05 | Bipolar electrosurgical endoscopic instrument and method of use |
CH00480/93A CH686608A5 (en) | 1991-06-07 | 1992-06-05 | Low voltage appts. for performing electrosurgery |
KR1019930703770A KR100235151B1 (en) | 1991-06-07 | 1992-06-05 | Hemostatic bi-polar electrosurgical cutting apparatus |
AU22200/92A AU656405B2 (en) | 1991-06-07 | 1992-06-05 | Bi-polar electrosurgical endoscopic instruments and methods of use |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US71192091A | 1991-06-07 | 1991-06-07 | |
US711,920 | 1991-06-07 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1992022257A1 true WO1992022257A1 (en) | 1992-12-23 |
Family
ID=24860043
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1992/004663 WO1992022256A1 (en) | 1991-06-07 | 1992-06-05 | Electrosurgical apparatus and method employing constant voltage |
PCT/US1992/004664 WO1992021301A1 (en) | 1991-06-07 | 1992-06-05 | Hemostatic bi-polar electrosurgical cutting apparatus and method |
PCT/US1992/004665 WO1992022257A1 (en) | 1991-06-07 | 1992-06-05 | Bi-polar electrosurgical endoscopic instruments and methods of use |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1992/004663 WO1992022256A1 (en) | 1991-06-07 | 1992-06-05 | Electrosurgical apparatus and method employing constant voltage |
PCT/US1992/004664 WO1992021301A1 (en) | 1991-06-07 | 1992-06-05 | Hemostatic bi-polar electrosurgical cutting apparatus and method |
Country Status (13)
Country | Link |
---|---|
US (6) | US5330471A (en) |
EP (3) | EP0517243B1 (en) |
JP (6) | JPH06511400A (en) |
KR (2) | KR100235151B1 (en) |
AU (3) | AU656405B2 (en) |
CA (3) | CA2110922C (en) |
CH (3) | CH688750A5 (en) |
DE (3) | DE69221942T2 (en) |
DK (3) | DK0518230T3 (en) |
ES (3) | ES2084873T3 (en) |
GR (3) | GR3019387T3 (en) |
IE (3) | IE74395B1 (en) |
WO (3) | WO1992022256A1 (en) |
Cited By (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1995009576A1 (en) * | 1993-10-07 | 1995-04-13 | Valleylab, Inc. | Automatic control for electrosurgical generator |
DE202011000742U1 (en) | 2011-03-31 | 2011-06-01 | Golsen Ltd. | Electrosurgical bipolar scissors for tissue incisions with pre-coagulation |
EP2366354A2 (en) | 2010-03-15 | 2011-09-21 | "Golsen Limited" | Blade for surgical instrument, surgical scissors, and electrosurgical bipolar scissors for dissection and coagulation |
US8419727B2 (en) | 2010-03-26 | 2013-04-16 | Aesculap Ag | Impedance mediated power delivery for electrosurgery |
US8827992B2 (en) | 2010-03-26 | 2014-09-09 | Aesculap Ag | Impedance mediated control of power delivery for electrosurgery |
US8870867B2 (en) | 2008-02-06 | 2014-10-28 | Aesculap Ag | Articulable electrosurgical instrument with a stabilizable articulation actuator |
US8888770B2 (en) | 2005-05-12 | 2014-11-18 | Aesculap Ag | Apparatus for tissue cauterization |
US9173698B2 (en) | 2010-09-17 | 2015-11-03 | Aesculap Ag | Electrosurgical tissue sealing augmented with a seal-enhancing composition |
US9339327B2 (en) | 2011-06-28 | 2016-05-17 | Aesculap Ag | Electrosurgical tissue dissecting device |
US9339323B2 (en) | 2005-05-12 | 2016-05-17 | Aesculap Ag | Electrocautery method and apparatus |
US9872724B2 (en) | 2012-09-26 | 2018-01-23 | Aesculap Ag | Apparatus for tissue cutting and sealing |
US9918778B2 (en) | 2006-05-02 | 2018-03-20 | Aesculap Ag | Laparoscopic radiofrequency surgical device |
US10314642B2 (en) | 2005-05-12 | 2019-06-11 | Aesculap Ag | Electrocautery method and apparatus |
Families Citing this family (866)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5569245A (en) * | 1990-03-13 | 1996-10-29 | The Regents Of The University Of California | Detachable endovascular occlusion device activated by alternating electric current |
US5482054A (en) * | 1990-05-10 | 1996-01-09 | Symbiosis Corporation | Edoscopic biopsy forceps devices with selective bipolar cautery |
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 |
US5330471A (en) * | 1991-06-07 | 1994-07-19 | Hemostatic Surgery Corporation | Bi-polar electrosurgical endoscopic instruments and methods of use |
US5484436A (en) * | 1991-06-07 | 1996-01-16 | Hemostatic Surgery Corporation | Bi-polar electrosurgical instruments and methods of making |
US5633578A (en) * | 1991-06-07 | 1997-05-27 | Hemostatic Surgery Corporation | Electrosurgical generator adaptors |
US6053172A (en) * | 1995-06-07 | 2000-04-25 | Arthrocare Corporation | Systems and methods for electrosurgical sinus surgery |
USRE40863E1 (en) | 1992-04-23 | 2009-07-21 | Boston Scientific Scimed, Inc. | Apparatus and method for sealing vascular punctures |
CA2094220A1 (en) * | 1992-05-21 | 1993-11-22 | Mark A. Rydell | Surgical scissors with bipolar coagulation feature |
US5258006A (en) * | 1992-08-21 | 1993-11-02 | Everest Medical Corporation | Bipolar electrosurgical forceps |
US5772597A (en) | 1992-09-14 | 1998-06-30 | Sextant Medical Corporation | Surgical tool end effector |
US5762609A (en) | 1992-09-14 | 1998-06-09 | Sextant Medical Corporation | Device and method for analysis of surgical tissue interventions |
CA2106126A1 (en) * | 1992-09-23 | 1994-03-24 | Ian M. Scott | Bipolar surgical instruments |
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 |
US5807393A (en) * | 1992-12-22 | 1998-09-15 | Ethicon Endo-Surgery, Inc. | Surgical tissue treating device with locking mechanism |
AU672060B2 (en) * | 1993-01-08 | 1996-09-19 | Silady, Eugenia Emilia | Improvements in laparoscopic instruments |
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 |
DE4490796T1 (en) * | 1993-02-11 | 1996-01-11 | Symbiosis Corp | Forceps with selective bipolar cauterization for endoscopic biopsy |
US5342381A (en) * | 1993-02-11 | 1994-08-30 | Everest Medical Corporation | Combination bipolar scissors and forceps instrument |
DE4307234A1 (en) * | 1993-03-08 | 1994-09-15 | Tomic Dobrivoje | Working parts for surgical gripping and cutting instruments |
EP0697839B1 (en) * | 1993-04-23 | 2005-03-23 | Scimed Life Systems, Inc. | Apparatus for sealing vascular punctures |
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 |
US5395369A (en) * | 1993-06-10 | 1995-03-07 | Symbiosis Corporation | Endoscopic bipolar electrocautery instruments |
DE4323093A1 (en) * | 1993-07-10 | 1995-01-19 | Wolf Gmbh Richard | Surgical forceps |
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 |
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 |
GR940100335A (en) * | 1993-07-22 | 1996-05-22 | Ethicon Inc. | Electrosurgical device for placing staples. |
US5352222A (en) * | 1994-03-15 | 1994-10-04 | Everest Medical Corporation | Surgical scissors with bipolar coagulation feature |
GB9409625D0 (en) * | 1994-05-13 | 1994-07-06 | Univ London | Surgical cutting tool |
US5601576A (en) * | 1994-08-10 | 1997-02-11 | Heartport Inc. | Surgical knot pusher and method of use |
US5573535A (en) * | 1994-09-23 | 1996-11-12 | United States Surgical Corporation | Bipolar surgical instrument for coagulation and cutting |
JPH08131448A (en) * | 1994-11-11 | 1996-05-28 | Olympus Optical Co Ltd | Treating device for endoscope |
US6447511B1 (en) | 1994-12-13 | 2002-09-10 | Symbiosis Corporation | Bipolar endoscopic surgical scissor blades and instrument incorporating the same |
US5976130A (en) * | 1994-12-13 | 1999-11-02 | Symbiosis Corporation | Bipolar push rod assembly for a bipolar endoscopic surgical instrument and instruments incorporating the same |
US5846240A (en) * | 1994-12-13 | 1998-12-08 | Symbiosis Corporation | Ceramic insulator for a bipolar push rod assembly for a bipolar endoscopic surgical instrument |
GB9425781D0 (en) * | 1994-12-21 | 1995-02-22 | Gyrus Medical Ltd | Electrosurgical instrument |
US5713895A (en) * | 1994-12-30 | 1998-02-03 | Valleylab Inc | Partially coated electrodes |
US5540685A (en) * | 1995-01-06 | 1996-07-30 | Everest Medical Corporation | Bipolar electrical scissors with metal cutting edges and shearing surfaces |
EP0955920A1 (en) | 1995-01-24 | 1999-11-17 | Symbiosis Corporation | Bipolar endoscopic surgical scissor instrument |
CA2168404C (en) * | 1995-02-01 | 2007-07-10 | Dale Schulze | Surgical instrument with expandable cutting element |
US6464701B1 (en) | 1995-03-07 | 2002-10-15 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6179837B1 (en) | 1995-03-07 | 2001-01-30 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6391029B1 (en) | 1995-03-07 | 2002-05-21 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US5766166A (en) * | 1995-03-07 | 1998-06-16 | Enable Medical Corporation | Bipolar Electrosurgical scissors |
US5599350A (en) * | 1995-04-03 | 1997-02-04 | Ethicon Endo-Surgery, Inc. | Electrosurgical clamping device with coagulation feedback |
US6203542B1 (en) * | 1995-06-07 | 2001-03-20 | Arthrocare Corporation | Method for electrosurgical treatment of submucosal tissue |
US5779701A (en) * | 1995-04-27 | 1998-07-14 | Symbiosis Corporation | Bipolar endoscopic surgical scissor blades and instrument incorporating the same |
US6090108A (en) * | 1995-04-27 | 2000-07-18 | 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 |
US5993445A (en) * | 1995-05-22 | 1999-11-30 | Advanced Closure Systems, Inc. | Resectoscope electrode assembly with simultaneous cutting and coagulation |
US5658280A (en) * | 1995-05-22 | 1997-08-19 | Issa; Muta M. | Resectoscope electrode assembly with simultaneous cutting and coagulation |
US5637111A (en) * | 1995-06-06 | 1997-06-10 | Conmed Corporation | Bipolar electrosurgical instrument with desiccation feature |
US6293942B1 (en) | 1995-06-23 | 2001-09-25 | Gyrus Medical Limited | Electrosurgical generator method |
US6015406A (en) | 1996-01-09 | 2000-01-18 | Gyrus Medical Limited | Electrosurgical instrument |
ES2233239T3 (en) | 1995-06-23 | 2005-06-16 | Gyrus Medical Limited | ELECTROCHIRURGICAL INSTRUMENT. |
ES2154824T5 (en) | 1995-06-23 | 2005-04-01 | Gyrus Medical Limited | ELECTROCHIRURGICAL INSTRUMENT. |
US6780180B1 (en) | 1995-06-23 | 2004-08-24 | Gyrus Medical Limited | Electrosurgical instrument |
WO1997001305A1 (en) * | 1995-06-27 | 1997-01-16 | Symbiosis Corporation | Bipolar endoscopic surgical scissor blades and instrument incorporating the same |
US5693052A (en) * | 1995-09-01 | 1997-12-02 | Megadyne Medical Products, Inc. | Coated bipolar electrocautery |
US6887240B1 (en) | 1995-09-19 | 2005-05-03 | Sherwood Services Ag | Vessel sealing wave jaw |
US5683385A (en) * | 1995-09-19 | 1997-11-04 | Symbiosis Corporation | Electrocautery connector for a bipolar push rod assembly |
USH1745H (en) * | 1995-09-29 | 1998-08-04 | Paraschac; Joseph F. | Electrosurgical clamping device with insulation limited bipolar electrode |
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 |
US6090106A (en) | 1996-01-09 | 2000-07-18 | Gyrus Medical Limited | Electrosurgical instrument |
US6013076A (en) | 1996-01-09 | 2000-01-11 | Gyrus Medical Limited | Electrosurgical instrument |
US5683388A (en) * | 1996-01-11 | 1997-11-04 | Symbiosis Corporation | Endoscopic bipolar multiple sample bioptome |
US6270495B1 (en) * | 1996-02-22 | 2001-08-07 | Radiotherapeutics Corporation | Method and device for enhancing vessel occlusion |
US5941876A (en) * | 1996-03-11 | 1999-08-24 | Medical Scientific, Inc. | Electrosurgical rotating cutting device |
US5702390A (en) * | 1996-03-12 | 1997-12-30 | Ethicon Endo-Surgery, Inc. | Bioplar cutting and coagulation instrument |
US5817013A (en) * | 1996-03-19 | 1998-10-06 | Enable Medical Corporation | Method and apparatus for the minimally invasive harvesting of a saphenous vein and the like |
US5700261A (en) * | 1996-03-29 | 1997-12-23 | Ethicon Endo-Surgery, Inc. | Bipolar Scissors |
US5893846A (en) * | 1996-05-15 | 1999-04-13 | Symbiosis Corp. | Ceramic coated endoscopic scissor blades and a method of making the same |
US6565561B1 (en) | 1996-06-20 | 2003-05-20 | Cyrus Medical Limited | Electrosurgical instrument |
GB2314274A (en) | 1996-06-20 | 1997-12-24 | Gyrus Medical Ltd | Electrode construction for an electrosurgical instrument |
GB9612993D0 (en) | 1996-06-20 | 1996-08-21 | Gyrus Medical Ltd | Electrosurgical instrument |
US5913870A (en) * | 1996-08-13 | 1999-06-22 | United States Surgical Corporation | Surgical dissector |
US5954720A (en) * | 1996-10-28 | 1999-09-21 | Endoscopic Concepts, Inc. | Bipolar electrosurgical end effectors |
US6019771A (en) * | 1996-12-02 | 2000-02-01 | Cardiothoracic Systems, Inc. | Devices and methods for minimally invasive harvesting of a vessel especially the saphenous vein for coronary bypass grafting |
US5891142A (en) | 1996-12-06 | 1999-04-06 | Eggers & Associates, Inc. | Electrosurgical forceps |
GB9626512D0 (en) | 1996-12-20 | 1997-02-05 | Gyrus Medical Ltd | An improved electrosurgical generator and system |
US5951549A (en) | 1996-12-20 | 1999-09-14 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6270494B1 (en) | 1996-12-26 | 2001-08-07 | Cryogen, Inc. | Stretchable cryoprobe sheath |
US6113596A (en) * | 1996-12-30 | 2000-09-05 | Enable Medical Corporation | Combination monopolar-bipolar electrosurgical instrument system, instrument and cable |
DE19700605B4 (en) * | 1997-01-10 | 2007-03-29 | Günter Bissinger Medizintechnik GmbH | Instrument, in particular for endoscopic surgery |
EP1006906A4 (en) * | 1997-01-13 | 2000-06-14 | Medicor Corp | Electrosurgical instrument |
US5925043A (en) * | 1997-04-30 | 1999-07-20 | Medquest Products, Inc. | Electrosurgical electrode with a conductive, non-stick coating |
US6312426B1 (en) * | 1997-05-30 | 2001-11-06 | Sherwood Services Ag | Method and system for performing plate type radiofrequency ablation |
US6071283A (en) * | 1997-06-06 | 2000-06-06 | Medical Scientific, Inc. | Selectively coated electrosurgical instrument |
US5938680A (en) * | 1997-06-19 | 1999-08-17 | Cardiothoracic Systems, Inc. | Devices and methods for harvesting vascular conduits |
US5947996A (en) * | 1997-06-23 | 1999-09-07 | Medicor Corporation | Yoke for surgical instrument |
US5849020A (en) * | 1997-06-30 | 1998-12-15 | Ethicon Endo-Surgery, Inc. | Inductively coupled electrosurgical instrument |
US6096037A (en) | 1997-07-29 | 2000-08-01 | Medtronic, Inc. | Tissue sealing electrosurgery device and methods of sealing tissue |
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 |
US6267761B1 (en) * | 1997-09-09 | 2001-07-31 | Sherwood Services Ag | Apparatus and method for sealing and cutting tissue |
EP1011493B1 (en) | 1997-09-10 | 2005-03-23 | Sherwood Services AG | Bipolar instrument for vessel fusion |
US5964758A (en) * | 1997-09-18 | 1999-10-12 | Dresden; Scott | Laparoscopic electrosurgical instrument |
US6494881B1 (en) | 1997-09-30 | 2002-12-17 | Scimed Life Systems, Inc. | Apparatus and method for electrode-surgical tissue removal having a selectively insulated electrode |
US6283963B1 (en) | 1997-10-08 | 2001-09-04 | Ethicon, Inc. | Bipolar electrosurgical scissors for fine or delicate surgical dissection |
AU1187899A (en) * | 1997-10-09 | 1999-05-03 | Camran Nezhat | Methods and systems for organ resection |
US5976132A (en) * | 1997-10-10 | 1999-11-02 | Morris; James R. | Bipolar surgical shears |
US6187003B1 (en) | 1997-11-12 | 2001-02-13 | 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 |
US6726686B2 (en) | 1997-11-12 | 2004-04-27 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US6352536B1 (en) | 2000-02-11 | 2002-03-05 | 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 |
US6228083B1 (en) | 1997-11-14 | 2001-05-08 | Sherwood Services Ag | Laparoscopic bipolar electrosurgical instrument |
US20030014052A1 (en) | 1997-11-14 | 2003-01-16 | Buysse Steven P. | Laparoscopic bipolar electrosurgical instrument |
WO1999035983A1 (en) * | 1998-01-14 | 1999-07-22 | Surx, Inc. | Ribbed electrodes and methods for their use |
JPH11249599A (en) * | 1998-02-26 | 1999-09-17 | Denso:Kk | Light emitting display |
US6517498B1 (en) | 1998-03-03 | 2003-02-11 | Senorx, Inc. | Apparatus and method for tissue capture |
US6875182B2 (en) | 1998-03-03 | 2005-04-05 | Senorx, Inc. | Electrosurgical specimen-collection system |
GB9807303D0 (en) | 1998-04-03 | 1998-06-03 | Gyrus Medical Ltd | An electrode assembly for an electrosurgical instrument |
US6270831B2 (en) | 1998-04-30 | 2001-08-07 | Medquest Products, Inc. | Method and apparatus for providing a conductive, amorphous non-stick coating |
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 |
US6080152A (en) * | 1998-06-05 | 2000-06-27 | Medical Scientific, Inc. | Electrosurgical instrument |
US6193718B1 (en) | 1998-06-10 | 2001-02-27 | Scimed Life Systems, Inc. | Endoscopic electrocautery instrument |
DE19828976C2 (en) | 1998-06-29 | 2002-12-05 | Ethicon Inc | Bipolar electrosurgical instrument |
FR2781141B1 (en) * | 1998-07-17 | 2000-09-01 | Guy Lebosse | MICROCLIP AND ELECTROCOAGULATING SURGERY IN BIPOLAR, PREHENSILE, ROTATING AND REMOVABLE MODE |
US7695470B1 (en) | 1998-08-12 | 2010-04-13 | Maquet Cardiovascular Llc | Integrated vessel ligator and transector |
EP0979635A2 (en) | 1998-08-12 | 2000-02-16 | Origin Medsystems, Inc. | Tissue dissector apparatus |
US6086586A (en) * | 1998-09-14 | 2000-07-11 | Enable Medical Corporation | Bipolar tissue grasping apparatus and tissue welding method |
US7364577B2 (en) | 2002-02-11 | 2008-04-29 | Sherwood Services Ag | Vessel sealing system |
USD425201S (en) * | 1998-10-23 | 2000-05-16 | Sherwood Services Ag | Disposable electrode assembly |
ES2241369T3 (en) | 1998-10-23 | 2005-10-16 | Sherwood Services Ag | ENDOSCOPIC ELECTROCHIRURGICAL BIPOLAR FORCEPS. |
US7582087B2 (en) | 1998-10-23 | 2009-09-01 | Covidien Ag | Vessel sealing instrument |
US6511480B1 (en) | 1998-10-23 | 2003-01-28 | Sherwood Services Ag | Open 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 |
USD424694S (en) * | 1998-10-23 | 2000-05-09 | Sherwood Services Ag | Forceps |
US20040249374A1 (en) | 1998-10-23 | 2004-12-09 | Tetzlaff Philip M. | Vessel sealing instrument |
US7118570B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealing forceps with disposable electrodes |
US7267677B2 (en) | 1998-10-23 | 2007-09-11 | Sherwood Services Ag | Vessel sealing instrument |
DE19850068C1 (en) * | 1998-10-30 | 2000-06-08 | Storz Karl Gmbh & Co Kg | Medical instrument for tissue preparation |
DE19855812C2 (en) * | 1998-12-03 | 2001-05-03 | Aesculap Ag & Co Kg | Surgical bipolar scissors |
US6190385B1 (en) * | 1998-12-11 | 2001-02-20 | Ethicon, Inc. | Cable for bipolar electro-surgical instrument |
GB2345857B (en) * | 1999-01-23 | 2000-12-06 | Ahmad Fahmi Juanroyee | Scissors-clip diathermy (SCD) |
US20030171747A1 (en) | 1999-01-25 | 2003-09-11 | Olympus Optical Co., Ltd. | Medical treatment instrument |
US6193715B1 (en) | 1999-03-19 | 2001-02-27 | Medical Scientific, Inc. | Device for converting a mechanical cutting device to an electrosurgical cutting device |
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 |
US6716233B1 (en) | 1999-06-02 | 2004-04-06 | Power Medical Interventions, Inc. | Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities |
US7695485B2 (en) | 2001-11-30 | 2010-04-13 | Power Medical Interventions, Llc | Surgical device |
US7951071B2 (en) | 1999-06-02 | 2011-05-31 | Tyco Healthcare Group Lp | Moisture-detecting shaft for use with an electro-mechanical surgical device |
US6264087B1 (en) | 1999-07-12 | 2001-07-24 | Powermed, Inc. | Expanding parallel jaw device for use with an electromechanical driver device |
US8025199B2 (en) | 2004-02-23 | 2011-09-27 | Tyco Healthcare Group Lp | Surgical cutting and stapling device |
JP3497104B2 (en) * | 1999-07-27 | 2004-02-16 | 株式会社長田中央研究所 | Laser hemostat |
DE19935477C1 (en) * | 1999-07-28 | 2001-04-05 | Karlsruhe Forschzent | Endoscopic surgical instrument for tissue coagulation and separation has pivoted jaws with coagulation surfaces and tissue separation surfaces operated via displacement rod and lever mechanism |
US6409728B1 (en) | 1999-08-25 | 2002-06-25 | Sherwood Services Ag | Rotatable bipolar forceps |
ES2261392T3 (en) | 1999-09-01 | 2006-11-16 | Sherwood Services Ag | ELECTROCHIRURGICAL INSTRUMENT THAT REDUCES THERMAL DISPERSION. |
US6419675B1 (en) | 1999-09-03 | 2002-07-16 | Conmed Corporation | Electrosurgical coagulating and cutting instrument |
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 |
US6974452B1 (en) * | 2000-01-12 | 2005-12-13 | Clinicon Corporation | Cutting and cauterizing surgical tools |
US20040068307A1 (en) * | 2000-02-08 | 2004-04-08 | Gyrus Medical Limited | Surgical instrument |
GB0223348D0 (en) * | 2002-10-08 | 2002-11-13 | Gyrus Medical Ltd | A surgical instrument |
US8016855B2 (en) | 2002-01-08 | 2011-09-13 | Tyco Healthcare Group Lp | Surgical device |
US6506208B2 (en) | 2000-03-06 | 2003-01-14 | Robert B. Hunt | Surgical instrument |
US6358268B1 (en) | 2000-03-06 | 2002-03-19 | Robert B. Hunt | Surgical instrument |
DE10027727C1 (en) * | 2000-06-03 | 2001-12-06 | Aesculap Ag & Co Kg | Scissors-shaped or forceps-shaped surgical instrument |
US6652551B1 (en) | 2000-07-21 | 2003-11-25 | Frederick W. Heiss | Biliary sphincter scissors |
US6558313B1 (en) | 2000-11-17 | 2003-05-06 | Embro Corporation | Vein harvesting system and method |
US6673087B1 (en) | 2000-12-15 | 2004-01-06 | Origin Medsystems | Elongated surgical scissors |
US6443970B1 (en) | 2001-01-24 | 2002-09-03 | Ethicon, Inc. | Surgical instrument with a dissecting tip |
US6554829B2 (en) | 2001-01-24 | 2003-04-29 | Ethicon, Inc. | Electrosurgical instrument with minimally invasive jaws |
US6620161B2 (en) | 2001-01-24 | 2003-09-16 | Ethicon, Inc. | Electrosurgical instrument with an operational sequencing element |
US6652521B2 (en) | 2001-01-24 | 2003-11-25 | Ethicon, Inc. | Surgical instrument with a bi-directional cutting element |
US6464702B2 (en) * | 2001-01-24 | 2002-10-15 | Ethicon, Inc. | Electrosurgical instrument with closing tube for conducting RF energy and moving jaws |
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 |
US7118587B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealer and divider |
US7101372B2 (en) | 2001-04-06 | 2006-09-05 | Sherwood Sevices Ag | Vessel sealer and divider |
DE60115295T2 (en) | 2001-04-06 | 2006-08-10 | Sherwood Services Ag | VASILY DEVICE |
USD457958S1 (en) | 2001-04-06 | 2002-05-28 | Sherwood Services Ag | Vessel sealer and divider |
ES2240723T3 (en) | 2001-04-06 | 2005-10-16 | Sherwood Services Ag | MOLDED INSULATING HINGE FOR BIPOLAR INSTRUMENTS. |
US7083618B2 (en) | 2001-04-06 | 2006-08-01 | Sherwood Services Ag | Vessel sealer and divider |
USD457959S1 (en) | 2001-04-06 | 2002-05-28 | Sherwood Services Ag | Vessel sealer |
US7101371B2 (en) | 2001-04-06 | 2006-09-05 | Dycus Sean T | Vessel sealer and divider |
US7090673B2 (en) | 2001-04-06 | 2006-08-15 | Sherwood Services Ag | Vessel sealer and divider |
US7101373B2 (en) | 2001-04-06 | 2006-09-05 | Sherwood Services Ag | Vessel sealer and divider |
US7473253B2 (en) | 2001-04-06 | 2009-01-06 | Covidien Ag | Vessel sealer and divider with non-conductive stop members |
US10849681B2 (en) | 2001-04-06 | 2020-12-01 | Covidien Ag | Vessel sealer and divider |
US7107996B2 (en) * | 2001-04-10 | 2006-09-19 | Ganz Robert A | Apparatus and method for treating atherosclerotic vascular disease through light sterilization |
AU2002254712A1 (en) | 2001-04-20 | 2002-11-05 | Power Medical Interventions, Inc. | Bipolar or ultrasonic surgical device |
US6913579B2 (en) * | 2001-05-01 | 2005-07-05 | Surgrx, Inc. | Electrosurgical working end and method for obtaining tissue samples for biopsy |
US11229472B2 (en) | 2001-06-12 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with multiple magnetic position sensors |
US6802843B2 (en) * | 2001-09-13 | 2004-10-12 | Csaba Truckai | Electrosurgical working end with resistive gradient electrodes |
US6773409B2 (en) | 2001-09-19 | 2004-08-10 | Surgrx Llc | Surgical system for applying ultrasonic energy to tissue |
US6929644B2 (en) * | 2001-10-22 | 2005-08-16 | Surgrx Inc. | Electrosurgical jaw structure for controlled energy delivery |
US20050267464A1 (en) * | 2001-10-18 | 2005-12-01 | Surgrx, Inc. | Electrosurgical instrument and method of use |
US7070597B2 (en) * | 2001-10-18 | 2006-07-04 | Surgrx, Inc. | Electrosurgical working end for controlled energy delivery |
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 |
US7354440B2 (en) * | 2001-10-22 | 2008-04-08 | Surgrx, Inc. | Electrosurgical instrument and method of use |
US7189233B2 (en) * | 2001-10-22 | 2007-03-13 | Surgrx, Inc. | Electrosurgical instrument |
US8075558B2 (en) | 2002-04-30 | 2011-12-13 | Surgrx, Inc. | Electrosurgical instrument and method |
US6905497B2 (en) * | 2001-10-22 | 2005-06-14 | Surgrx, Inc. | Jaw structure for electrosurgical instrument |
US7083619B2 (en) | 2001-10-22 | 2006-08-01 | Surgrx, Inc. | Electrosurgical instrument and method of use |
US7517349B2 (en) | 2001-10-22 | 2009-04-14 | Vnus Medical Technologies, Inc. | Electrosurgical instrument and method |
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 |
JP4458464B2 (en) | 2001-12-04 | 2010-04-28 | パワー メディカル インターベンションズ, エルエルシー | System and method for calibrating a surgical instrument |
US9113878B2 (en) | 2002-01-08 | 2015-08-25 | Covidien Lp | Pinion clip for right angle linear cutter |
WO2003061456A2 (en) * | 2002-01-22 | 2003-07-31 | Sciogen Llc | Electrosurgical instrument and method of use |
US6997926B2 (en) * | 2002-02-04 | 2006-02-14 | Boston Scientific Scimed, Inc. | Resistance heated tissue morcellation |
US6749609B1 (en) | 2002-02-05 | 2004-06-15 | Origin Medsystems, Inc. | Electrocautery scissors |
JP4131011B2 (en) * | 2002-04-09 | 2008-08-13 | Hoya株式会社 | Endoscopic sputum treatment device |
US6780178B2 (en) * | 2002-05-03 | 2004-08-24 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparatus for plasma-mediated thermo-electrical ablation |
US8043286B2 (en) * | 2002-05-03 | 2011-10-25 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparatus for plasma-mediated thermo-electrical ablation |
CN101803938B (en) | 2002-06-14 | 2012-06-20 | Tyco医疗健康集团 | Device for clamping cutting and stapling tissue |
US7033356B2 (en) * | 2002-07-02 | 2006-04-25 | Gyrus Medical, Inc. | Bipolar electrosurgical instrument for cutting desiccating and sealing tissue |
US6749610B2 (en) | 2002-08-15 | 2004-06-15 | Kirwan Surgical Products, Inc. | Electro-surgical forceps having fully plated tines and process for manufacturing same |
US7087054B2 (en) * | 2002-10-01 | 2006-08-08 | Surgrx, Inc. | Electrosurgical instrument and method of use |
US7931649B2 (en) | 2002-10-04 | 2011-04-26 | Tyco Healthcare Group Lp | 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 |
US7276068B2 (en) | 2002-10-04 | 2007-10-02 | Sherwood Services Ag | 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 |
US7033354B2 (en) | 2002-12-10 | 2006-04-25 | Sherwood Services Ag | Electrosurgical electrode having a non-conductive porous ceramic coating |
US7195627B2 (en) | 2003-01-09 | 2007-03-27 | Gyrus Medical Limited | Electrosurgical generator |
WO2004062516A1 (en) | 2003-01-09 | 2004-07-29 | Gyrus Medical Limited | An electrosurgical generator |
DE602004012232T2 (en) | 2003-01-31 | 2009-03-12 | Smith & Nephew, Inc., Andover | CARTILAGE TREATMENT PROBE |
US8066700B2 (en) * | 2003-01-31 | 2011-11-29 | Smith & Nephew, Inc. | Cartilage treatment probe |
US7736361B2 (en) * | 2003-02-14 | 2010-06-15 | The Board Of Trustees Of The Leland Stamford Junior University | Electrosurgical system with uniformly enhanced electric field and minimal collateral damage |
US7169146B2 (en) * | 2003-02-14 | 2007-01-30 | Surgrx, Inc. | Electrosurgical probe and method of use |
WO2004082495A1 (en) | 2003-03-13 | 2004-09-30 | Sherwood Services Ag | Bipolar concentric electrode assembly for soft tissue fusion |
JP4131014B2 (en) * | 2003-03-18 | 2008-08-13 | Hoya株式会社 | Endoscopic sputum treatment device |
US8128624B2 (en) | 2003-05-01 | 2012-03-06 | Covidien Ag | Electrosurgical instrument that directs energy delivery and protects adjacent tissue |
EP1617778A2 (en) | 2003-05-01 | 2006-01-25 | Sherwood Services 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 |
WO2004105625A1 (en) * | 2003-05-12 | 2004-12-09 | Levin John M | Insulated surgical scissors including cauterizing tip |
WO2004103156A2 (en) | 2003-05-15 | 2004-12-02 | Sherwood Services 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 |
USD496997S1 (en) | 2003-05-15 | 2004-10-05 | Sherwood Services Ag | 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 |
US7597693B2 (en) | 2003-06-13 | 2009-10-06 | Covidien Ag | Vessel sealer and divider for use with small trocars and cannulas |
AU2015242957B2 (en) * | 2003-06-13 | 2017-04-20 | Covidien Ag | Vessel sealer and divider for use with small trocars and cannulas |
USD956973S1 (en) | 2003-06-13 | 2022-07-05 | Covidien Ag | Movable handle for endoscopic vessel sealer and divider |
US7150749B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Vessel sealer and divider having elongated knife stroke and safety cutting mechanism |
US7156846B2 (en) | 2003-06-13 | 2007-01-02 | Sherwood Services Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7150097B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Method of manufacturing jaw assembly for vessel sealer and divider |
AU2004249284A1 (en) * | 2003-06-18 | 2004-12-29 | The Board Of Trustees Of The Leland Stanford Junior University | Electro-adhesive tissue manipulator |
WO2005009531A1 (en) * | 2003-07-23 | 2005-02-03 | University Hospitals Of Cleveland | Mapping probe system for neuromuscular electrical stimulation apparatus |
US7169180B2 (en) | 2003-09-03 | 2007-01-30 | Brennan William A | System and method for breast augmentation |
US8092527B2 (en) | 2003-09-03 | 2012-01-10 | Brennan William A | System and method for breast augmentation |
US7138316B2 (en) * | 2003-09-23 | 2006-11-21 | Intel Corporation | Semiconductor channel on insulator structure |
US20050096670A1 (en) * | 2003-10-31 | 2005-05-05 | Parris Wellman | Surgical end effector |
US20050096646A1 (en) * | 2003-10-31 | 2005-05-05 | Parris Wellman | Surgical system for retracting and severing tissue |
US20050096671A1 (en) * | 2003-10-31 | 2005-05-05 | Parris Wellman | Control mechanism for a surgical instrument |
US7314479B2 (en) * | 2003-10-31 | 2008-01-01 | Parris Wellman | Space-creating retractor with vessel manipulator |
US20060173474A1 (en) * | 2003-10-31 | 2006-08-03 | Parris Wellman | Surgical device having a track to guide an actuator |
US20050096645A1 (en) * | 2003-10-31 | 2005-05-05 | Parris Wellman | Multitool surgical device |
CA2543792A1 (en) * | 2003-11-05 | 2005-07-14 | Applied Medical Resources Corporation | Multiple-angle scissor blade |
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 |
US7232440B2 (en) | 2003-11-17 | 2007-06-19 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US7309849B2 (en) * | 2003-11-19 | 2007-12-18 | Surgrx, Inc. | Polymer compositions exhibiting a PTC property and methods of fabrication |
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 |
US7500975B2 (en) | 2003-11-19 | 2009-03-10 | Covidien Ag | Spring loaded reciprocating tissue cutting mechanism in a forceps-style electrosurgical instrument |
US7442193B2 (en) | 2003-11-20 | 2008-10-28 | Covidien Ag | Electrically conductive/insulative over-shoe for tissue fusion |
US7632269B2 (en) * | 2004-01-16 | 2009-12-15 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with replaceable cartridge |
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 |
US7955331B2 (en) | 2004-03-12 | 2011-06-07 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument and method of use |
WO2006002337A2 (en) | 2004-06-24 | 2006-01-05 | Arthrocare Corporation | Electrosurgical device having planar vertical electrode and related methods |
DE102004055671B4 (en) * | 2004-08-11 | 2010-01-07 | Erbe Elektromedizin Gmbh | Electrosurgical instrument |
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 |
PL1802245T3 (en) | 2004-10-08 | 2017-01-31 | Ethicon Endosurgery Llc | Ultrasonic surgical instrument |
US7955332B2 (en) | 2004-10-08 | 2011-06-07 | Covidien Ag | Mechanism for dividing tissue in a hemostat-style instrument |
AU2011250820B2 (en) * | 2004-10-08 | 2013-11-14 | Covidien Ag | Bilateral foot jaws |
US7628792B2 (en) | 2004-10-08 | 2009-12-08 | Covidien Ag | Bilateral foot jaws |
US7686827B2 (en) | 2004-10-21 | 2010-03-30 | Covidien Ag | Magnetic closure mechanism for hemostat |
US7909823B2 (en) | 2005-01-14 | 2011-03-22 | Covidien Ag | Open vessel sealing instrument |
US7686804B2 (en) | 2005-01-14 | 2010-03-30 | Covidien Ag | Vessel sealer and divider with rotating sealer and cutter |
DE102005005523B4 (en) * | 2005-02-01 | 2013-05-23 | Aesculap Ag | Electrosurgical instrument |
US7491202B2 (en) | 2005-03-31 | 2009-02-17 | Covidien Ag | Electrosurgical forceps with slow closure sealing plates and method of sealing tissue |
US8728072B2 (en) | 2005-05-12 | 2014-05-20 | Aesculap Ag | Electrocautery method and apparatus |
US7803156B2 (en) | 2006-03-08 | 2010-09-28 | Aragon Surgical, Inc. | Method and apparatus for surgical electrocautery |
US9095325B2 (en) | 2005-05-23 | 2015-08-04 | Senorx, Inc. | Tissue cutting member for a biopsy device |
US20060271037A1 (en) * | 2005-05-25 | 2006-11-30 | Forcept, Inc. | Assisted systems and methods for performing transvaginal hysterectomies |
US20070005061A1 (en) * | 2005-06-30 | 2007-01-04 | Forcept, Inc. | Transvaginal uterine artery occlusion |
US7837685B2 (en) | 2005-07-13 | 2010-11-23 | Covidien Ag | Switch mechanisms for safe activation of energy on an electrosurgical instrument |
US7641651B2 (en) * | 2005-07-28 | 2010-01-05 | Aragon Surgical, Inc. | Devices and methods for mobilization of the uterus |
US7572236B2 (en) | 2005-08-05 | 2009-08-11 | Senorx, Inc. | Biopsy device with fluid delivery to tissue specimens |
US8317725B2 (en) | 2005-08-05 | 2012-11-27 | Senorx, Inc. | Biopsy device with fluid delivery to tissue specimens |
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 |
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 |
EP1769765B1 (en) | 2005-09-30 | 2012-03-21 | Covidien AG | Insulating boot 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 |
US7922953B2 (en) | 2005-09-30 | 2011-04-12 | Covidien Ag | Method for manufacturing an end effector assembly |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
US7594916B2 (en) | 2005-11-22 | 2009-09-29 | Covidien Ag | Electrosurgical forceps with energy based tissue division |
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 |
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 |
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 |
DE102006006812B4 (en) * | 2006-02-14 | 2011-04-07 | Erbe Elektromedizin Gmbh | Electrosurgical instrument |
US20070208341A1 (en) * | 2006-03-03 | 2007-09-06 | Kirwan Surgical Products, Inc. | Electro-surgical forceps having fully copper-plated tines and process for manufacturing same |
US8574229B2 (en) | 2006-05-02 | 2013-11-05 | Aesculap Ag | Surgical tool |
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 |
US20070265613A1 (en) * | 2006-05-10 | 2007-11-15 | Edelstein Peter Seth | Method and apparatus for sealing tissue |
US7758579B2 (en) * | 2006-05-15 | 2010-07-20 | Ethicon Endo-Surgery, Inc. | Bipolar probe with an injection needle |
US7749222B2 (en) * | 2006-05-19 | 2010-07-06 | Ethicon Endo-Surgery, Inc. | Bipolar forceps |
US20070282331A1 (en) * | 2006-05-30 | 2007-12-06 | Pentax Corporation | Bipolar high-frequency incision tool for an endoscope |
US9770230B2 (en) | 2006-06-01 | 2017-09-26 | Maquet Cardiovascular Llc | Endoscopic vessel harvesting system components |
US7776037B2 (en) | 2006-07-07 | 2010-08-17 | Covidien Ag | System and method for controlling electrode gap during tissue sealing |
US7744615B2 (en) | 2006-07-18 | 2010-06-29 | Covidien Ag | Apparatus and method for transecting tissue on a bipolar vessel sealing instrument |
US7419490B2 (en) * | 2006-07-27 | 2008-09-02 | Applied Medical Resources Corporation | Bipolar electrosurgical scissors |
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 |
US8475453B2 (en) | 2006-10-06 | 2013-07-02 | Covidien Lp | Endoscopic vessel sealer and divider having a flexible articulating shaft |
US7951149B2 (en) | 2006-10-17 | 2011-05-31 | Tyco Healthcare Group Lp | Ablative material for use with tissue treatment device |
WO2008057410A2 (en) | 2006-11-02 | 2008-05-15 | Peak Surgical, Inc. | Electric plasma-mediated cutting and coagulation of tissue and surgical apparatus |
US7935130B2 (en) * | 2006-11-16 | 2011-05-03 | Intuitive Surgical Operations, Inc. | Two-piece end-effectors for robotic surgical tools |
USD649249S1 (en) | 2007-02-15 | 2011-11-22 | Tyco Healthcare Group Lp | End effectors of an elongated dissecting and dividing instrument |
US7655004B2 (en) | 2007-02-15 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Electroporation ablation apparatus, system, and method |
US7815662B2 (en) | 2007-03-08 | 2010-10-19 | Ethicon Endo-Surgery, Inc. | Surgical suture anchors and deployment device |
US8911460B2 (en) | 2007-03-22 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8057498B2 (en) | 2007-11-30 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument blades |
US8142461B2 (en) | 2007-03-22 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8267935B2 (en) | 2007-04-04 | 2012-09-18 | Tyco Healthcare Group Lp | Electrosurgical instrument reducing current densities at an insulator conductor junction |
DE102007018993A1 (en) | 2007-04-21 | 2008-10-30 | Sutter Medizintechnik Gmbh | Bipolar scissors with curved shear blades |
US8075572B2 (en) | 2007-04-26 | 2011-12-13 | Ethicon Endo-Surgery, Inc. | Surgical suturing apparatus |
US8100922B2 (en) | 2007-04-27 | 2012-01-24 | Ethicon Endo-Surgery, Inc. | Curved needle suturing tool |
JP2009006128A (en) * | 2007-05-25 | 2009-01-15 | Kazuya Akaboshi | High-frequency treatment instrument |
US8808319B2 (en) | 2007-07-27 | 2014-08-19 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8523889B2 (en) | 2007-07-27 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Ultrasonic end effectors with increased active length |
US9044261B2 (en) | 2007-07-31 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Temperature controlled ultrasonic surgical instruments |
US8512365B2 (en) | 2007-07-31 | 2013-08-20 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8430898B2 (en) | 2007-07-31 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8579897B2 (en) | 2007-11-21 | 2013-11-12 | Ethicon Endo-Surgery, Inc. | Bipolar forceps |
US8568410B2 (en) | 2007-08-31 | 2013-10-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation surgical instruments |
US8262655B2 (en) | 2007-11-21 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Bipolar forceps |
US7877852B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing an end effector assembly for sealing tissue |
US7877853B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing end effector assembly for sealing tissue |
CN101801284B (en) | 2007-09-21 | 2012-10-03 | Tyco医疗健康集团 | Surgical device |
JP5357161B2 (en) | 2007-09-21 | 2013-12-04 | コヴィディエン リミテッド パートナーシップ | Surgical equipment |
US8235993B2 (en) * | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Insulating boot for electrosurgical forceps with exohinged structure |
US8235992B2 (en) | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Insulating boot with mechanical reinforcement for electrosurgical forceps |
US8267936B2 (en) | 2007-09-28 | 2012-09-18 | Tyco Healthcare Group Lp | Insulating mechanically-interfaced adhesive for electrosurgical forceps |
AU2008221509B2 (en) | 2007-09-28 | 2013-10-10 | Covidien Lp | Dual durometer insulating boot for electrosurgical forceps |
US8251996B2 (en) | 2007-09-28 | 2012-08-28 | Tyco Healthcare Group Lp | Insulating sheath for electrosurgical forceps |
US8221416B2 (en) | 2007-09-28 | 2012-07-17 | Tyco Healthcare Group Lp | Insulating boot for electrosurgical forceps with thermoplastic clevis |
US8236025B2 (en) | 2007-09-28 | 2012-08-07 | Tyco Healthcare Group Lp | Silicone insulated electrosurgical forceps |
US9023043B2 (en) | 2007-09-28 | 2015-05-05 | Covidien Lp | Insulating mechanically-interfaced boot and jaws for electrosurgical forceps |
EP2217157A2 (en) | 2007-10-05 | 2010-08-18 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
US8480657B2 (en) | 2007-10-31 | 2013-07-09 | Ethicon Endo-Surgery, Inc. | Detachable distal overtube section and methods for forming a sealable opening in the wall of an organ |
US20090112059A1 (en) | 2007-10-31 | 2009-04-30 | Nobis Rudolph H | Apparatus and methods for closing a gastrotomy |
US10010339B2 (en) | 2007-11-30 | 2018-07-03 | Ethicon Llc | Ultrasonic surgical blades |
US8353907B2 (en) | 2007-12-21 | 2013-01-15 | Atricure, Inc. | Ablation device with internally cooled electrodes |
US8998892B2 (en) | 2007-12-21 | 2015-04-07 | Atricure, Inc. | Ablation device with cooled electrodes and methods of use |
US8298231B2 (en) * | 2008-01-31 | 2012-10-30 | Tyco Healthcare Group Lp | Bipolar scissors for adenoid and tonsil removal |
US8764748B2 (en) | 2008-02-06 | 2014-07-01 | Covidien Lp | End effector assembly for electrosurgical device and method for making the same |
US8623276B2 (en) | 2008-02-15 | 2014-01-07 | Covidien Lp | Method and system for sterilizing an electrosurgical instrument |
US8262680B2 (en) | 2008-03-10 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Anastomotic device |
ES2428719T3 (en) | 2008-03-31 | 2013-11-11 | Applied Medical Resources Corporation | Electrosurgical system with means to measure tissue permittivity and conductivity |
US8357158B2 (en) | 2008-04-22 | 2013-01-22 | Covidien Lp | Jaw closure detection system |
US8652150B2 (en) | 2008-05-30 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Multifunction surgical device |
US8114072B2 (en) | 2008-05-30 | 2012-02-14 | Ethicon Endo-Surgery, Inc. | Electrical ablation device |
US8771260B2 (en) | 2008-05-30 | 2014-07-08 | Ethicon Endo-Surgery, Inc. | Actuating and articulating surgical device |
US8070759B2 (en) | 2008-05-30 | 2011-12-06 | Ethicon Endo-Surgery, Inc. | Surgical fastening device |
US8317806B2 (en) | 2008-05-30 | 2012-11-27 | Ethicon Endo-Surgery, Inc. | Endoscopic suturing tension controlling and indication devices |
US8679003B2 (en) | 2008-05-30 | 2014-03-25 | Ethicon Endo-Surgery, Inc. | Surgical device and endoscope including same |
US8906035B2 (en) * | 2008-06-04 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Endoscopic drop off bag |
US8403926B2 (en) | 2008-06-05 | 2013-03-26 | Ethicon Endo-Surgery, Inc. | Manually articulating devices |
US20090306642A1 (en) * | 2008-06-10 | 2009-12-10 | Vankov Alexander B | Method for low temperature electrosugery and rf generator |
US8361112B2 (en) | 2008-06-27 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical suture arrangement |
US8888792B2 (en) | 2008-07-14 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Tissue apposition clip application devices and methods |
US8262563B2 (en) | 2008-07-14 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Endoscopic translumenal articulatable steerable overtube |
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 |
US8211125B2 (en) | 2008-08-15 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Sterile appliance delivery device for endoscopic procedures |
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 |
US8529563B2 (en) | 2008-08-25 | 2013-09-10 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
GB0815515D0 (en) * | 2008-08-26 | 2008-10-01 | Gyrus Medical Ltd | Electrosurgical instrument and system |
US8784417B2 (en) | 2008-08-28 | 2014-07-22 | Covidien Lp | Tissue fusion jaw angle improvement |
US8795274B2 (en) | 2008-08-28 | 2014-08-05 | Covidien Lp | Tissue fusion jaw angle improvement |
US8317787B2 (en) | 2008-08-28 | 2012-11-27 | Covidien Lp | Tissue fusion jaw angle improvement |
US8241204B2 (en) | 2008-08-29 | 2012-08-14 | Ethicon Endo-Surgery, Inc. | Articulating end cap |
US8480689B2 (en) | 2008-09-02 | 2013-07-09 | Ethicon Endo-Surgery, Inc. | Suturing device |
US8409200B2 (en) | 2008-09-03 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical grasping device |
US8114119B2 (en) | 2008-09-09 | 2012-02-14 | Ethicon Endo-Surgery, Inc. | Surgical grasping device |
US8303582B2 (en) | 2008-09-15 | 2012-11-06 | Tyco Healthcare Group Lp | Electrosurgical instrument having a coated electrode utilizing an atomic layer deposition technique |
US20100069903A1 (en) | 2008-09-18 | 2010-03-18 | Tyco Healthcare Group Lp | Vessel Sealing Instrument With Cutting Mechanism |
US9375254B2 (en) | 2008-09-25 | 2016-06-28 | Covidien Lp | Seal and separate algorithm |
US8968314B2 (en) | 2008-09-25 | 2015-03-03 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US8535312B2 (en) | 2008-09-25 | 2013-09-17 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US8337394B2 (en) | 2008-10-01 | 2012-12-25 | Ethicon Endo-Surgery, Inc. | Overtube with expandable tip |
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 |
US8636761B2 (en) | 2008-10-09 | 2014-01-28 | Covidien Lp | Apparatus, system, and method for performing an endoscopic electrosurgical procedure |
US8016827B2 (en) | 2008-10-09 | 2011-09-13 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8486107B2 (en) | 2008-10-20 | 2013-07-16 | Covidien Lp | Method of sealing tissue using radiofrequency energy |
US8157834B2 (en) | 2008-11-25 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Rotational coupling device for surgical instrument with flexible actuators |
US8197479B2 (en) | 2008-12-10 | 2012-06-12 | Tyco Healthcare Group Lp | Vessel sealer and divider |
US8172772B2 (en) | 2008-12-11 | 2012-05-08 | Ethicon Endo-Surgery, Inc. | Specimen retrieval device |
US8137345B2 (en) | 2009-01-05 | 2012-03-20 | Peak Surgical, Inc. | Electrosurgical devices for tonsillectomy and adenoidectomy |
US8828031B2 (en) | 2009-01-12 | 2014-09-09 | Ethicon Endo-Surgery, Inc. | Apparatus for forming an anastomosis |
US8361066B2 (en) | 2009-01-12 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8114122B2 (en) | 2009-01-13 | 2012-02-14 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8252057B2 (en) | 2009-01-30 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Surgical access device |
US9226772B2 (en) | 2009-01-30 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Surgical device |
US20100198248A1 (en) * | 2009-02-02 | 2010-08-05 | Ethicon Endo-Surgery, Inc. | Surgical dissector |
US8037591B2 (en) * | 2009-02-02 | 2011-10-18 | Ethicon Endo-Surgery, Inc. | Surgical scissors |
US8444642B2 (en) * | 2009-04-03 | 2013-05-21 | Device Evolutions, Llc | Laparoscopic nephrectomy device |
DE102009002768A1 (en) * | 2009-04-30 | 2010-11-04 | Celon Ag Medical Instruments | Material layer and electrosurgical system for electrosurgical tissue fusion |
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 |
US8852183B2 (en) * | 2009-06-05 | 2014-10-07 | Microline Surgical Inc. | Scissor tip for bipolar high frequency endoscope |
DE102009031424B3 (en) * | 2009-07-01 | 2010-10-21 | Olympus Winter & Ibe Gmbh | Surgical jaw instrument with sliding attachment |
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 |
US8430876B2 (en) | 2009-08-27 | 2013-04-30 | Tyco Healthcare Group Lp | Vessel sealer and divider with knife lockout |
DE102009041329A1 (en) | 2009-09-15 | 2011-03-24 | Celon Ag Medical Instruments | Combined Ultrasonic and HF Surgical System |
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 |
US9024237B2 (en) | 2009-09-29 | 2015-05-05 | Covidien Lp | Material fusing apparatus, system and method of use |
US8512371B2 (en) | 2009-10-06 | 2013-08-20 | Covidien Lp | Jaw, blade and gap manufacturing for surgical instruments with small jaws |
US10172669B2 (en) | 2009-10-09 | 2019-01-08 | Ethicon Llc | Surgical instrument comprising an energy trigger lockout |
USRE47996E1 (en) | 2009-10-09 | 2020-05-19 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US9039695B2 (en) | 2009-10-09 | 2015-05-26 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US9168054B2 (en) * | 2009-10-09 | 2015-10-27 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US20110098704A1 (en) | 2009-10-28 | 2011-04-28 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
US8608652B2 (en) | 2009-11-05 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Vaginal entry surgical devices, kit, system, and method |
US8496574B2 (en) | 2009-12-17 | 2013-07-30 | Ethicon Endo-Surgery, Inc. | Selectively positionable camera for surgical guide tube assembly |
US8353487B2 (en) | 2009-12-17 | 2013-01-15 | Ethicon Endo-Surgery, Inc. | User interface support devices for endoscopic surgical instruments |
US9028483B2 (en) | 2009-12-18 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8506564B2 (en) | 2009-12-18 | 2013-08-13 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8480671B2 (en) | 2010-01-22 | 2013-07-09 | Covidien Lp | Compact jaw including split pivot pin |
US8556929B2 (en) | 2010-01-29 | 2013-10-15 | Covidien Lp | Surgical forceps capable of adjusting seal plate width based on vessel size |
US9005198B2 (en) | 2010-01-29 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
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 |
US8425511B2 (en) * | 2010-03-26 | 2013-04-23 | Covidien Lp | Clamp and scissor forceps |
DE102010014435B4 (en) | 2010-04-09 | 2015-11-19 | Olympus Winter & Ibe Gmbh | Electrosurgical laparoscopic instrument with electrical lead |
US8597295B2 (en) | 2010-04-12 | 2013-12-03 | Covidien Lp | Surgical instrument with non-contact electrical coupling |
US8834518B2 (en) | 2010-04-12 | 2014-09-16 | 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 |
US20110270251A1 (en) | 2010-04-29 | 2011-11-03 | Tyco Healthcare Group Lp | Insulated Sealing Plate |
US8439913B2 (en) | 2010-04-29 | 2013-05-14 | Covidien Lp | Pressure sensing sealing plate |
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 |
US8491626B2 (en) | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8491624B2 (en) * | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8469991B2 (en) | 2010-06-02 | 2013-06-25 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8409247B2 (en) | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8430877B2 (en) | 2010-06-02 | 2013-04-30 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8409246B2 (en) | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US9144455B2 (en) | 2010-06-07 | 2015-09-29 | Just Right Surgical, Llc | Low power tissue sealing device and method |
US9005199B2 (en) | 2010-06-10 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Heat management configurations for controlling heat dissipation from electrosurgical instruments |
KR101010568B1 (en) * | 2010-06-11 | 2011-01-24 | 정명준 | Apparatus for endoscopic mucosal resection |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US8298233B2 (en) | 2010-08-20 | 2012-10-30 | Tyco Healthcare Group Lp | Surgical instrument configured for use with interchangeable hand grips |
US8814864B2 (en) | 2010-08-23 | 2014-08-26 | Covidien Lp | Method of manufacturing tissue sealing electrodes |
US20120059372A1 (en) * | 2010-09-07 | 2012-03-08 | Johnson Kristin D | Electrosurgical Instrument |
US9498278B2 (en) | 2010-09-08 | 2016-11-22 | Covidien Lp | Asymmetrical electrodes for bipolar vessel sealing |
USD670808S1 (en) | 2010-10-01 | 2012-11-13 | Tyco Healthcare Group Lp | Open vessel sealing forceps |
US8979890B2 (en) | 2010-10-01 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument with jaw member |
JP6143362B2 (en) | 2010-10-01 | 2017-06-07 | アプライド メディカル リソーシーズ コーポレイション | Electrosurgical instrument with jaws and / or electrodes and electrosurgical amplifier |
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 |
US8906018B2 (en) | 2010-10-18 | 2014-12-09 | Covidien Lp | Surgical forceps |
US9039694B2 (en) | 2010-10-22 | 2015-05-26 | Just Right Surgical, Llc | RF generator system for surgical vessel sealing |
US10448992B2 (en) | 2010-10-22 | 2019-10-22 | Arthrocare Corporation | Electrosurgical system with device specific operational parameters |
USD668337S1 (en) * | 2010-11-15 | 2012-10-02 | Erbe Elektromedizin Gmbh | Electro-surgical clamp and cutting device |
US8932293B2 (en) | 2010-11-17 | 2015-01-13 | Covidien Lp | Method and apparatus for vascular tissue sealing with reduced energy consumption |
US8685021B2 (en) | 2010-11-17 | 2014-04-01 | Covidien Lp | Method and apparatus for vascular tissue sealing with active cooling of jaws at the end of the sealing cycle |
US8784418B2 (en) | 2010-11-29 | 2014-07-22 | Covidien Lp | Endoscopic surgical forceps |
US8945175B2 (en) | 2011-01-14 | 2015-02-03 | Covidien Lp | Latch mechanism for surgical instruments |
US8603134B2 (en) | 2011-01-14 | 2013-12-10 | 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 |
US8747401B2 (en) | 2011-01-20 | 2014-06-10 | Arthrocare Corporation | Systems and methods for turbinate reduction |
US10092291B2 (en) | 2011-01-25 | 2018-10-09 | Ethicon Endo-Surgery, Inc. | Surgical instrument with selectively rigidizable features |
US9271784B2 (en) | 2011-02-09 | 2016-03-01 | Arthrocare Corporation | Fine dissection electrosurgical device |
US9168082B2 (en) | 2011-02-09 | 2015-10-27 | Arthrocare Corporation | Fine dissection electrosurgical device |
US9017370B2 (en) | 2011-02-17 | 2015-04-28 | Covidien Lp | Vessel sealer and divider with captured cutting element |
US8968316B2 (en) | 2011-02-18 | 2015-03-03 | Covidien Lp | Apparatus with multiple channel selective cutting |
US9314620B2 (en) | 2011-02-28 | 2016-04-19 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9233241B2 (en) | 2011-02-28 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9254169B2 (en) | 2011-02-28 | 2016-02-09 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9011428B2 (en) | 2011-03-02 | 2015-04-21 | Arthrocare Corporation | Electrosurgical device with internal digestor electrode |
DE102011005067A1 (en) * | 2011-03-03 | 2012-09-06 | Celon Ag Medical Instruments | High frequency surgical device and HF surgical system |
US10413349B2 (en) | 2011-03-04 | 2019-09-17 | Covidien Lp | System and methods for identifying tissue and vessels |
WO2012125785A1 (en) | 2011-03-17 | 2012-09-20 | Ethicon Endo-Surgery, Inc. | Hand held surgical device for manipulating an internal magnet assembly within a patient |
US8968305B2 (en) | 2011-03-28 | 2015-03-03 | Covidien Lp | Surgical forceps with external cutter |
US8974479B2 (en) | 2011-03-30 | 2015-03-10 | Covidien Lp | Ultrasonic surgical instruments |
US8568408B2 (en) | 2011-04-21 | 2013-10-29 | Covidien Lp | Surgical forceps |
US8939972B2 (en) | 2011-05-06 | 2015-01-27 | Covidien Lp | Surgical forceps |
US8900232B2 (en) | 2011-05-06 | 2014-12-02 | Covidien Lp | Bifurcated shaft for surgical instrument |
US9113933B2 (en) | 2011-05-16 | 2015-08-25 | Covidien Lp | Optical energy-based methods and apparatus for tissue sealing |
US9456870B2 (en) | 2011-05-16 | 2016-10-04 | Covidien Lp | Optical energy-based methods and apparatus for tissue sealing |
US10117705B2 (en) | 2011-05-16 | 2018-11-06 | Covidien Lp | Optical recognition of tissue and vessels |
US8685009B2 (en) | 2011-05-16 | 2014-04-01 | Covidien Lp | Thread-like knife for tissue cutting |
US9113934B2 (en) | 2011-05-16 | 2015-08-25 | Covidien Lp | Optical energy-based methods and apparatus for tissue sealing |
US9265568B2 (en) | 2011-05-16 | 2016-02-23 | Coviden Lp | Destruction of vessel walls for energy-based vessel sealing enhancement |
US8852185B2 (en) | 2011-05-19 | 2014-10-07 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8968283B2 (en) | 2011-05-19 | 2015-03-03 | Covidien Lp | Ultrasound device for precise tissue sealing and blade-less cutting |
US9161807B2 (en) | 2011-05-23 | 2015-10-20 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
WO2012170364A1 (en) | 2011-06-10 | 2012-12-13 | Medtronic, Inc. | Wire electrode devices for tonsillectomy and adenoidectomy |
US9615877B2 (en) | 2011-06-17 | 2017-04-11 | Covidien Lp | Tissue sealing forceps |
US9039704B2 (en) | 2011-06-22 | 2015-05-26 | Covidien Lp | Forceps |
US8745840B2 (en) | 2011-07-11 | 2014-06-10 | Covidien Lp | Surgical forceps and method of manufacturing thereof |
US9844384B2 (en) | 2011-07-11 | 2017-12-19 | Covidien Lp | Stand alone energy-based tissue clips |
US9039732B2 (en) | 2011-07-11 | 2015-05-26 | Covidien Lp | Surgical forceps |
US8628557B2 (en) | 2011-07-11 | 2014-01-14 | Covidien Lp | Surgical forceps |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
US8702737B2 (en) | 2011-08-08 | 2014-04-22 | Covidien Lp | Surgical forceps |
US8852186B2 (en) | 2011-08-09 | 2014-10-07 | Covidien Lp | Microwave sensing for tissue sealing |
US8968306B2 (en) | 2011-08-09 | 2015-03-03 | Covidien Lp | Surgical forceps |
US8968317B2 (en) | 2011-08-18 | 2015-03-03 | Covidien Lp | Surgical forceps |
US9028492B2 (en) | 2011-08-18 | 2015-05-12 | Covidien Lp | Surgical instruments with removable components |
US8968307B2 (en) | 2011-08-18 | 2015-03-03 | Covidien Lp | Surgical forceps |
US9044243B2 (en) | 2011-08-30 | 2015-06-02 | Ethcon Endo-Surgery, Inc. | Surgical cutting and fastening device with descendible second trigger arrangement |
US9113909B2 (en) | 2011-09-01 | 2015-08-25 | Covidien Lp | Surgical vessel sealer and divider |
US9788882B2 (en) | 2011-09-08 | 2017-10-17 | Arthrocare Corporation | Plasma bipolar forceps |
US9113938B2 (en) | 2011-09-09 | 2015-08-25 | Covidien Lp | Apparatus for performing electrosurgical procedures having a spring mechanism associated with the jaw members |
US8679098B2 (en) | 2011-09-13 | 2014-03-25 | Covidien Lp | Rotation knobs for surgical instruments |
KR101296359B1 (en) | 2011-09-15 | 2013-08-14 | 연세대학교 산학협력단 | Endoscope treatment device for endoscopic submucosal dissection |
US8845636B2 (en) | 2011-09-16 | 2014-09-30 | Covidien Lp | Seal plate with insulation displacement connection |
US9636169B2 (en) | 2011-09-19 | 2017-05-02 | Covidien Lp | Electrosurgical instrument |
US9486220B2 (en) | 2011-09-28 | 2016-11-08 | Covidien Lp | Surgical tissue occluding device |
US8961515B2 (en) | 2011-09-28 | 2015-02-24 | Covidien Lp | Electrosurgical instrument |
US8756785B2 (en) | 2011-09-29 | 2014-06-24 | Covidien Lp | Surgical instrument shafts and methods of manufacturing shafts for surgical instruments |
US9668806B2 (en) | 2011-09-29 | 2017-06-06 | Covidien Lp | Surgical forceps including a removable stop member |
US9060780B2 (en) | 2011-09-29 | 2015-06-23 | Covidien Lp | Methods of manufacturing shafts for surgical instruments |
US8864795B2 (en) | 2011-10-03 | 2014-10-21 | Covidien Lp | Surgical forceps |
US9314295B2 (en) | 2011-10-20 | 2016-04-19 | Covidien Lp | Dissection scissors on surgical device |
US8968308B2 (en) | 2011-10-20 | 2015-03-03 | Covidien Lp | Multi-circuit seal plates |
US9492221B2 (en) | 2011-10-20 | 2016-11-15 | Covidien Lp | Dissection scissors on surgical device |
US9421060B2 (en) | 2011-10-24 | 2016-08-23 | Ethicon Endo-Surgery, Llc | Litz wire battery powered device |
US8968309B2 (en) | 2011-11-10 | 2015-03-03 | Covidien Lp | Surgical forceps |
US9265565B2 (en) | 2011-11-29 | 2016-02-23 | Covidien Lp | Open vessel sealing instrument and method of manufacturing the same |
US9113899B2 (en) | 2011-11-29 | 2015-08-25 | Covidien Lp | Coupling mechanisms for surgical instruments |
US8968310B2 (en) | 2011-11-30 | 2015-03-03 | Covidien Lp | Electrosurgical instrument with a knife blade lockout mechanism |
US9259268B2 (en) | 2011-12-06 | 2016-02-16 | Covidien Lp | Vessel sealing using microwave energy |
JP2013138844A (en) * | 2011-12-08 | 2013-07-18 | River Seikoo:Kk | High frequency cautery dissection scissors device for endoscope |
CN102528826B (en) * | 2011-12-12 | 2015-11-25 | 杭州巨星工具有限公司 | Cut scissors |
US8864753B2 (en) | 2011-12-13 | 2014-10-21 | Covidien Lp | Surgical Forceps Connected to Treatment Light Source |
RU2486929C1 (en) * | 2011-12-29 | 2013-07-10 | Александр Васильевич Тимашов | Method for reducing blood loss |
US9023035B2 (en) | 2012-01-06 | 2015-05-05 | Covidien Lp | Monopolar pencil with integrated bipolar/ligasure tweezers |
USD680220S1 (en) | 2012-01-12 | 2013-04-16 | Coviden IP | Slider handle for laparoscopic device |
US9113882B2 (en) | 2012-01-23 | 2015-08-25 | Covidien Lp | Method of manufacturing an electrosurgical instrument |
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 |
US8961513B2 (en) | 2012-01-25 | 2015-02-24 | Covidien Lp | Surgical tissue sealer |
US9693816B2 (en) | 2012-01-30 | 2017-07-04 | Covidien Lp | Electrosurgical apparatus with integrated energy sensing at tissue site |
US20130197515A1 (en) * | 2012-01-31 | 2013-08-01 | Boston Scientific Scimed, Inc. | Endoscopic instrument having a cutting tool |
EP2626010B1 (en) * | 2012-02-10 | 2015-08-26 | W & H Dentalwerk Bürmoos GmbH | Medical, in particular dental or surgical instrument with coating |
JP6165780B2 (en) | 2012-02-10 | 2017-07-19 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Robot-controlled surgical instrument |
US8986199B2 (en) | 2012-02-17 | 2015-03-24 | Ethicon Endo-Surgery, Inc. | Apparatus and methods for cleaning the lens of an endoscope |
US8747434B2 (en) | 2012-02-20 | 2014-06-10 | Covidien Lp | Knife deployment mechanisms for surgical forceps |
US8887373B2 (en) | 2012-02-24 | 2014-11-18 | Covidien Lp | Vessel sealing instrument with reduced thermal spread and method of manufacture therefor |
US9011435B2 (en) | 2012-02-24 | 2015-04-21 | Covidien Lp | Method for manufacturing vessel sealing instrument with reduced thermal spread |
US8961514B2 (en) | 2012-03-06 | 2015-02-24 | Covidien Lp | Articulating surgical apparatus |
US8752264B2 (en) | 2012-03-06 | 2014-06-17 | Covidien Lp | Surgical tissue sealer |
USD743547S1 (en) | 2012-03-08 | 2015-11-17 | Covidien Lp | Handle for laparoscopic device with distal rotation wheel |
USD748260S1 (en) | 2012-03-08 | 2016-01-26 | Covidien Lp | Handle for laparoscopic device with integral rotation wheel |
USD744100S1 (en) | 2012-03-08 | 2015-11-24 | Covidien Lp | Handle for laparoscopic device |
US8968298B2 (en) | 2012-03-15 | 2015-03-03 | Covidien Lp | Electrosurgical instrument |
US9375282B2 (en) | 2012-03-26 | 2016-06-28 | Covidien Lp | Light energy sealing, cutting and sensing surgical device |
US9265569B2 (en) | 2012-03-29 | 2016-02-23 | Covidien Lp | Method of manufacturing an electrosurgical forceps |
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 |
US9713493B2 (en) | 2012-04-30 | 2017-07-25 | Covidien Lp | Method of switching energy modality on a cordless RF device |
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 |
US9039731B2 (en) | 2012-05-08 | 2015-05-26 | Covidien Lp | Surgical forceps including blade safety mechanism |
US9375258B2 (en) | 2012-05-08 | 2016-06-28 | Covidien Lp | Surgical forceps |
US9113901B2 (en) | 2012-05-14 | 2015-08-25 | Covidien Lp | Modular surgical instrument with contained electrical or mechanical systems |
US9427255B2 (en) | 2012-05-14 | 2016-08-30 | Ethicon Endo-Surgery, Inc. | Apparatus for introducing a steerable camera assembly into a patient |
US9192432B2 (en) | 2012-05-29 | 2015-11-24 | Covidien Lp | Lever latch assemblies for surgical improvements |
US9084606B2 (en) | 2012-06-01 | 2015-07-21 | Megadyne Medical Products, Inc. | Electrosurgical scissors |
US8968313B2 (en) | 2012-06-12 | 2015-03-03 | Covidien Lp | Electrosurgical instrument with a knife blade stop |
US9770255B2 (en) | 2012-06-26 | 2017-09-26 | Covidien Lp | One-piece handle assembly |
US9510891B2 (en) | 2012-06-26 | 2016-12-06 | Covidien Lp | Surgical instruments with structures to provide access for cleaning |
US9011436B2 (en) | 2012-06-26 | 2015-04-21 | Covidien Lp | Double-length jaw system for electrosurgical instrument |
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 |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9072524B2 (en) | 2012-06-29 | 2015-07-07 | Covidien Lp | Surgical forceps |
US9820768B2 (en) | 2012-06-29 | 2017-11-21 | Ethicon Llc | Ultrasonic surgical instruments with control mechanisms |
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 |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US9039691B2 (en) | 2012-06-29 | 2015-05-26 | Covidien Lp | Surgical forceps |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US9078662B2 (en) | 2012-07-03 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Endoscopic cap electrode and method for using the same |
US8939975B2 (en) | 2012-07-17 | 2015-01-27 | Covidien Lp | Gap control via overmold teeth and hard stops |
US9833285B2 (en) | 2012-07-17 | 2017-12-05 | Covidien Lp | Optical sealing device with cutting ability |
US10368945B2 (en) | 2012-07-17 | 2019-08-06 | Covidien Lp | Surgical instrument for energy-based tissue treatment |
US9301798B2 (en) | 2012-07-19 | 2016-04-05 | Covidien Lp | Surgical forceps including reposable end effector assemblies |
US9192421B2 (en) | 2012-07-24 | 2015-11-24 | Covidien Lp | Blade lockout mechanism for surgical forceps |
US9545290B2 (en) | 2012-07-30 | 2017-01-17 | Ethicon Endo-Surgery, Inc. | Needle probe guide |
US10314649B2 (en) | 2012-08-02 | 2019-06-11 | Ethicon Endo-Surgery, Inc. | Flexible expandable electrode and method of intraluminal delivery of pulsed power |
US9572623B2 (en) | 2012-08-02 | 2017-02-21 | Ethicon Endo-Surgery, Inc. | Reusable electrode and disposable sheath |
US9636168B2 (en) | 2012-08-09 | 2017-05-02 | Covidien Lp | Electrosurgical instrument including nested knife assembly |
US9277957B2 (en) | 2012-08-15 | 2016-03-08 | Ethicon Endo-Surgery, Inc. | Electrosurgical devices and methods |
US20140052120A1 (en) | 2012-08-17 | 2014-02-20 | Medtronic Ablation Frontiers Llc | Electrophysiology catheter design |
US9433461B2 (en) | 2012-09-07 | 2016-09-06 | Covidien Lp | Instruments, systems, and methods for sealing tissue structures |
CN104853688B (en) | 2012-09-28 | 2017-11-28 | 伊西康内外科公司 | Multifunctional bipolar tweezers |
US9687290B2 (en) | 2012-10-02 | 2017-06-27 | Covidien Lp | Energy-based medical devices |
US9439711B2 (en) | 2012-10-02 | 2016-09-13 | Covidien Lp | Medical devices for thermally treating tissue |
US9526564B2 (en) | 2012-10-08 | 2016-12-27 | Covidien Lp | Electric stapler device |
US9549749B2 (en) | 2012-10-08 | 2017-01-24 | Covidien Lp | Surgical forceps |
US9681908B2 (en) | 2012-10-08 | 2017-06-20 | Covidien Lp | Jaw assemblies for electrosurgical instruments and methods of manufacturing jaw assemblies |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
US9375259B2 (en) | 2012-10-24 | 2016-06-28 | Covidien Lp | Electrosurgical instrument including an adhesive applicator assembly |
US9572529B2 (en) | 2012-10-31 | 2017-02-21 | Covidien Lp | Surgical devices and methods utilizing optical coherence tomography (OCT) to monitor and control tissue sealing |
US10206583B2 (en) | 2012-10-31 | 2019-02-19 | Covidien Lp | Surgical devices and methods utilizing optical coherence tomography (OCT) to monitor and control tissue sealing |
US9375205B2 (en) | 2012-11-15 | 2016-06-28 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10772674B2 (en) | 2012-11-15 | 2020-09-15 | Covidien Lp | Deployment mechanisms for surgical instruments |
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 |
US9433462B2 (en) | 2012-12-21 | 2016-09-06 | Cook Medical Technologies Llc | Tissue fusion system, apparatus and method |
US9254166B2 (en) | 2013-01-17 | 2016-02-09 | Arthrocare Corporation | Systems and methods for turbinate reduction |
US9149325B2 (en) * | 2013-01-25 | 2015-10-06 | Ethicon Endo-Surgery, Inc. | End effector with compliant clamping jaw |
US9375256B2 (en) | 2013-02-05 | 2016-06-28 | Covidien Lp | Electrosurgical forceps |
US10265119B2 (en) | 2013-02-15 | 2019-04-23 | Covidien Lp | Electrosurgical forceps |
US9713491B2 (en) | 2013-02-19 | 2017-07-25 | Covidien Lp | Method for manufacturing an electrode assembly configured for use with an electrosurigcal instrument |
US9375262B2 (en) | 2013-02-27 | 2016-06-28 | Covidien Lp | Limited use medical devices |
US10098527B2 (en) | 2013-02-27 | 2018-10-16 | Ethidcon Endo-Surgery, Inc. | System for performing a minimally invasive surgical procedure |
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 |
US9655673B2 (en) | 2013-03-11 | 2017-05-23 | Covidien Lp | Surgical instrument |
US9877775B2 (en) | 2013-03-12 | 2018-01-30 | Covidien Lp | Electrosurgical instrument with a knife blade stop |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
DE102013006598A1 (en) * | 2013-04-17 | 2014-10-23 | Oerlikon Trading Ag, Trübbach | Coating system with ZrO₂ for electrosurgical devices |
US9468453B2 (en) | 2013-05-03 | 2016-10-18 | Covidien Lp | Endoscopic surgical forceps |
USD728786S1 (en) | 2013-05-03 | 2015-05-05 | Covidien Lp | Vessel sealer with mechanical cutter and pistol-grip-style trigger |
US9622810B2 (en) | 2013-05-10 | 2017-04-18 | Covidien Lp | Surgical forceps |
JP6180785B2 (en) * | 2013-05-17 | 2017-08-16 | 株式会社リバーセイコー | Endoscopic high-frequency cautery incision fistula |
PL2805682T3 (en) | 2013-05-24 | 2019-07-31 | Erbe Elektromedizin Gmbh | Power controlled coagulation device |
KR101380891B1 (en) * | 2013-05-30 | 2014-04-04 | 유앤아이 주식회사 | Electrosurgical device for ablation of a needless body tissue |
US9649151B2 (en) | 2013-05-31 | 2017-05-16 | Covidien Lp | End effector assemblies and methods of manufacturing end effector assemblies for treating and/or cutting tissue |
WO2014194317A1 (en) | 2013-05-31 | 2014-12-04 | Covidien Lp | Surgical device with an end-effector assembly and system for monitoring of tissue during a surgical procedure |
US9554845B2 (en) | 2013-07-18 | 2017-01-31 | Covidien Lp | Surgical forceps for treating and cutting tissue |
WO2015017995A1 (en) | 2013-08-07 | 2015-02-12 | Covidien Lp | Bipolar surgical instrument with tissue stop |
US10966779B2 (en) | 2013-08-07 | 2021-04-06 | Covidien Lp | Bipolar surgical instrument |
KR102128705B1 (en) | 2013-08-07 | 2020-07-02 | 코비디엔 엘피 | Bipolar surgical instrument |
KR102134566B1 (en) | 2013-08-07 | 2020-07-17 | 코비디엔 엘피 | Bipolar surgical instrument |
USD726910S1 (en) | 2013-08-07 | 2015-04-14 | Covidien Lp | Reusable forceps for open vessel sealer with mechanical cutter |
USD744644S1 (en) | 2013-08-07 | 2015-12-01 | Covidien Lp | Disposable housing for open vessel sealer with mechanical cutter |
USD737439S1 (en) | 2013-08-07 | 2015-08-25 | Covidien Lp | Open vessel sealer with mechanical cutter |
WO2015017992A1 (en) | 2013-08-07 | 2015-02-12 | Covidien Lp | Surgical forceps |
US10405874B2 (en) | 2013-08-13 | 2019-09-10 | Covidien Lp | Surgical instrument |
US9439717B2 (en) | 2013-08-13 | 2016-09-13 | Covidien Lp | Surgical forceps including thermal spread control |
WO2015022842A1 (en) * | 2013-08-16 | 2015-02-19 | 住友ベークライト株式会社 | High-frequency treatment instrument |
US9295514B2 (en) | 2013-08-30 | 2016-03-29 | Ethicon Endo-Surgery, Llc | Surgical devices with close quarter articulation features |
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 |
US9445865B2 (en) | 2013-09-16 | 2016-09-20 | Covidien Lp | Electrosurgical instrument with end-effector assembly including electrically-conductive, tissue-engaging surfaces and switchable bipolar electrodes |
US9943357B2 (en) | 2013-09-16 | 2018-04-17 | Covidien Lp | Split electrode for use in a bipolar electrosurgical instrument |
DE102013110394B4 (en) * | 2013-09-20 | 2016-10-27 | NMI Naturwissenschaftliches und Medizinisches Institut an der Universität Tübingen | Surgical instrument with a voltage-resistant, electrically insulating coating |
US9717548B2 (en) | 2013-09-24 | 2017-08-01 | Covidien Lp | Electrode for use in a bipolar electrosurgical instrument |
US10231772B2 (en) | 2013-09-25 | 2019-03-19 | Covidien Lp | Wire retention unit for a surgical instrument |
US10610289B2 (en) | 2013-09-25 | 2020-04-07 | Covidien Lp | Devices, systems, and methods for grasping, treating, and dividing tissue |
US9642671B2 (en) | 2013-09-30 | 2017-05-09 | Covidien Lp | Limited-use medical device |
US9265926B2 (en) | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
US9526565B2 (en) | 2013-11-08 | 2016-12-27 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
US9974601B2 (en) | 2013-11-19 | 2018-05-22 | Covidien Lp | Vessel sealing instrument with suction system |
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 |
US10130413B2 (en) | 2014-02-11 | 2018-11-20 | Covidien Lp | Temperature-sensing electrically-conductive tissue-contacting plate and methods of manufacturing same |
US11090109B2 (en) | 2014-02-11 | 2021-08-17 | Covidien Lp | Temperature-sensing electrically-conductive tissue-contacting plate configured for use in an electrosurgical jaw member, electrosurgical system including same, and methods of controlling vessel sealing using same |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
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 |
US10278768B2 (en) | 2014-04-02 | 2019-05-07 | Covidien Lp | Electrosurgical devices including transverse electrode configurations |
US10058377B2 (en) | 2014-04-02 | 2018-08-28 | Covidien Lp | Electrosurgical devices including transverse electrode configurations |
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 |
US9687295B2 (en) | 2014-04-17 | 2017-06-27 | Covidien Lp | Methods of manufacturing a pair of jaw members of an end-effector assembly for a surgical instrument |
US20150324317A1 (en) | 2014-05-07 | 2015-11-12 | Covidien Lp | Authentication and information system for reusable surgical instruments |
KR102537276B1 (en) | 2014-05-16 | 2023-05-26 | 어플라이드 메디컬 리소시스 코포레이션 | Electrosurgical system |
KR102420273B1 (en) | 2014-05-30 | 2022-07-13 | 어플라이드 메디컬 리소시스 코포레이션 | Electrosurgical instrument for fusing and cutting tissue and an electrosurgical generator |
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 |
US20160038220A1 (en) | 2014-08-11 | 2016-02-11 | 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 |
US10820939B2 (en) | 2014-09-15 | 2020-11-03 | Covidien Lp | Vessel-sealing device including force-balance interface and electrosurgical system including same |
US9877777B2 (en) | 2014-09-17 | 2018-01-30 | Covidien Lp | Surgical instrument having a bipolar end effector assembly and a deployable monopolar assembly |
US9987076B2 (en) | 2014-09-17 | 2018-06-05 | Covidien Lp | Multi-function surgical instruments |
US10080606B2 (en) | 2014-09-17 | 2018-09-25 | Covidien Lp | Method of forming a member of an end effector |
US9918785B2 (en) | 2014-09-17 | 2018-03-20 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10039592B2 (en) | 2014-09-17 | 2018-08-07 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10080605B2 (en) | 2014-09-17 | 2018-09-25 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10258360B2 (en) | 2014-09-25 | 2019-04-16 | Covidien Lp | Surgical instruments |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
US10463422B2 (en) | 2014-12-18 | 2019-11-05 | Covidien Lp | Surgical instrument with stopper assembly |
US9848937B2 (en) | 2014-12-22 | 2017-12-26 | Ethicon Llc | End effector with detectable configurations |
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 |
US10092348B2 (en) | 2014-12-22 | 2018-10-09 | Ethicon Llc | RF tissue sealer, shear grip, trigger lock mechanism and energy activation |
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 |
US10172612B2 (en) | 2015-01-21 | 2019-01-08 | Covidien Lp | Surgical instruments with force applier and methods of use |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US10653476B2 (en) | 2015-03-12 | 2020-05-19 | Covidien Lp | Mapping vessels for resecting body tissue |
US10206736B2 (en) | 2015-03-13 | 2019-02-19 | Covidien Lp | Surgical forceps with scalpel functionality |
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 |
PL3075340T3 (en) * | 2015-03-30 | 2023-11-20 | Erbe Elektromedizin Gmbh | Tissue shears for biological tissue |
US10314638B2 (en) | 2015-04-07 | 2019-06-11 | Ethicon Llc | Articulating radio frequency (RF) tissue seal with articulating state sensing |
JP6472538B2 (en) | 2015-04-10 | 2019-02-20 | ジャイラス エーシーエムアイ インク | Medical forceps with offset teeth |
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 |
US10758257B2 (en) | 2015-04-24 | 2020-09-01 | Covidien Lp | Vessel sealing device with fine dissection function |
US10595933B2 (en) | 2015-04-24 | 2020-03-24 | Covidien Lp | Multifunctional vessel sealing and divider device |
US9872725B2 (en) | 2015-04-29 | 2018-01-23 | Ethicon Llc | RF tissue sealer with mode selection |
US10441340B2 (en) | 2015-05-27 | 2019-10-15 | Covidien Lp | Surgical forceps |
US10226269B2 (en) | 2015-05-27 | 2019-03-12 | Covidien Lp | Surgical forceps |
US9974602B2 (en) | 2015-05-27 | 2018-05-22 | Covidien Lp | Surgical instruments and devices and methods facilitating the manufacture of the same |
US9848935B2 (en) | 2015-05-27 | 2017-12-26 | Covidien Lp | Surgical instruments including components and features facilitating the assembly and manufacturing thereof |
US9956022B2 (en) | 2015-05-27 | 2018-05-01 | Covidien Lp | Surgical forceps and methods of manufacturing the same |
US10722293B2 (en) | 2015-05-29 | 2020-07-28 | Covidien Lp | Surgical device with an end effector assembly and system for monitoring of tissue before and after a surgical procedure |
US10034684B2 (en) | 2015-06-15 | 2018-07-31 | Ethicon Llc | Apparatus and method for dissecting and coagulating tissue |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
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 |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
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 |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
DE102015212389A1 (en) * | 2015-07-02 | 2017-01-05 | Aesculap Ag | Coating for applicators in electrosurgery |
US9987078B2 (en) | 2015-07-22 | 2018-06-05 | Covidien Lp | Surgical forceps |
US10631918B2 (en) | 2015-08-14 | 2020-04-28 | Covidien Lp | Energizable surgical attachment for a mechanical clamp |
WO2017031712A1 (en) | 2015-08-26 | 2017-03-02 | Covidien Lp | Electrosurgical end effector assemblies and electrosurgical forceps configured to reduce thermal spread |
US11058475B2 (en) | 2015-09-30 | 2021-07-13 | Cilag Gmbh International | Method and apparatus for selecting operations of a surgical instrument based on user intention |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
US10959771B2 (en) | 2015-10-16 | 2021-03-30 | Ethicon Llc | Suction and irrigation sealing grasper |
US10213221B2 (en) | 2015-10-28 | 2019-02-26 | Covidien Lp | Surgical instruments including cam surfaces |
US10154877B2 (en) | 2015-11-04 | 2018-12-18 | Covidien Lp | Endoscopic surgical instrument |
US10213250B2 (en) | 2015-11-05 | 2019-02-26 | Covidien Lp | Deployment and safety mechanisms for surgical instruments |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10959806B2 (en) | 2015-12-30 | 2021-03-30 | Ethicon Llc | Energized medical device with reusable handle |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
US10172672B2 (en) | 2016-01-11 | 2019-01-08 | Covidien Lp | Jaw force control for electrosurgical forceps |
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 |
US10709469B2 (en) | 2016-01-15 | 2020-07-14 | Ethicon Llc | Modular battery powered handheld surgical instrument with energy conservation techniques |
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 |
US10537381B2 (en) | 2016-02-26 | 2020-01-21 | Covidien Lp | Surgical instrument having a bipolar end effector assembly and a deployable monopolar assembly |
USD819815S1 (en) | 2016-03-09 | 2018-06-05 | Covidien Lp | L-shaped blade trigger for an electrosurgical instrument |
USD828554S1 (en) | 2016-03-09 | 2018-09-11 | Covidien Lp | Contoured blade trigger for an electrosurgical instrument |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10856934B2 (en) | 2016-04-29 | 2020-12-08 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting and tissue engaging members |
US10987156B2 (en) | 2016-04-29 | 2021-04-27 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
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 |
US10517665B2 (en) | 2016-07-14 | 2019-12-31 | Covidien Lp | Devices and methods for tissue sealing and mechanical clipping |
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 |
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 |
US10631887B2 (en) | 2016-08-15 | 2020-04-28 | Covidien Lp | Electrosurgical forceps for video assisted thoracoscopic surgery and other surgical procedures |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US10441305B2 (en) | 2016-08-18 | 2019-10-15 | Covidien Lp | Surgical forceps |
US10772642B2 (en) | 2016-08-18 | 2020-09-15 | Covidien Lp | Surgical forceps |
US10420580B2 (en) | 2016-08-25 | 2019-09-24 | Ethicon Llc | Ultrasonic transducer for surgical instrument |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
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 |
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 |
US10813695B2 (en) | 2017-01-27 | 2020-10-27 | Covidien Lp | Reflectors for optical-based vessel sealing |
US11229480B2 (en) | 2017-02-02 | 2022-01-25 | Covidien Lp | Latching mechanism for in-line activated electrosurgical device |
US10881445B2 (en) | 2017-02-09 | 2021-01-05 | Covidien Lp | Adapters, systems incorporating the same, and methods for providing an electrosurgical forceps with clip-applying functionality |
US11033325B2 (en) | 2017-02-16 | 2021-06-15 | Cilag Gmbh International | Electrosurgical instrument with telescoping suction port and debris cleaner |
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 |
US11172980B2 (en) | 2017-05-12 | 2021-11-16 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
US10973567B2 (en) | 2017-05-12 | 2021-04-13 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
US11166759B2 (en) | 2017-05-16 | 2021-11-09 | Covidien Lp | Surgical forceps |
US10512501B2 (en) | 2017-06-08 | 2019-12-24 | Covidien Lp | Electrosurgical apparatus |
USD843574S1 (en) | 2017-06-08 | 2019-03-19 | Covidien Lp | Knife for open vessel sealer |
USD854149S1 (en) | 2017-06-08 | 2019-07-16 | Covidien Lp | End effector for open vessel sealer |
USD854684S1 (en) | 2017-06-08 | 2019-07-23 | Covidien Lp | Open vessel sealer with mechanical cutter |
USD859658S1 (en) | 2017-06-16 | 2019-09-10 | Covidien Lp | Vessel sealer for tonsillectomy |
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 |
US11484358B2 (en) | 2017-09-29 | 2022-11-01 | Cilag Gmbh International | Flexible electrosurgical instrument |
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 |
US11419657B2 (en) * | 2017-11-30 | 2022-08-23 | Boston Scientific Scimed, Inc. | Compensation assembly for fluid injection line of intravascular catheter system |
US11123132B2 (en) | 2018-04-09 | 2021-09-21 | Covidien Lp | Multi-function surgical instruments and assemblies therefor |
US11696795B2 (en) * | 2018-07-13 | 2023-07-11 | Medtronic Advanced Energy Llc | Amplitude modulated waveform circuitry for electrosurgical devices and systems, and related methods |
AU2019335013A1 (en) | 2018-09-05 | 2021-03-25 | Applied Medical Resources Corporation | Electrosurgical generator control system |
USD904611S1 (en) | 2018-10-10 | 2020-12-08 | Bolder Surgical, Llc | Jaw design for a surgical instrument |
EP3880099A1 (en) | 2018-11-16 | 2021-09-22 | Applied Medical Resources Corporation | Electrosurgical system |
AU2019400030A1 (en) * | 2018-12-10 | 2021-06-24 | Solta Medical Ireland Limited | Ceramic applicator for transcutaneous delivery of energy |
SG11202111518WA (en) | 2019-05-09 | 2021-11-29 | Gyrus Acmi Inc D/B/A Olympus Surgical Technologies America | Electrosurgical systems and methods |
US20230255680A1 (en) * | 2019-05-31 | 2023-08-17 | Robert F. Rioux | Biocompatible metal devices for delivering ablative energy |
US11607267B2 (en) | 2019-06-10 | 2023-03-21 | Covidien Lp | Electrosurgical forceps |
US11612445B2 (en) | 2019-06-27 | 2023-03-28 | Cilag Gmbh International | Cooperative operation of robotic arms |
US11413102B2 (en) | 2019-06-27 | 2022-08-16 | Cilag Gmbh International | Multi-access port for surgical robotic systems |
US11607278B2 (en) | 2019-06-27 | 2023-03-21 | Cilag Gmbh International | Cooperative robotic surgical systems |
US11547468B2 (en) | 2019-06-27 | 2023-01-10 | Cilag Gmbh International | Robotic surgical system with safety and cooperative sensing control |
US11723729B2 (en) | 2019-06-27 | 2023-08-15 | Cilag Gmbh International | Robotic surgical assembly coupling safety mechanisms |
US11090050B2 (en) | 2019-09-03 | 2021-08-17 | Covidien Lp | Trigger mechanisms for surgical instruments and surgical instruments including the same |
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 |
US20210196363A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with electrodes operable in bipolar and monopolar modes |
US20210196361A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with monopolar and bipolar energy capabilities |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11786294B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Control program for modular combination energy device |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11744636B2 (en) | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Electrosurgical systems with integrated and external power sources |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
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 |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US10993764B1 (en) | 2020-01-14 | 2021-05-04 | Microline Surgical, Inc. | Insulating grips for minimally invasive surgical instruments |
US11844562B2 (en) | 2020-03-23 | 2023-12-19 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
USD934423S1 (en) | 2020-09-11 | 2021-10-26 | Bolder Surgical, Llc | End effector for a surgical device |
DE102020134062A1 (en) | 2020-12-17 | 2022-06-23 | Olympus Winter & Ibe Gmbh | Electrosurgical Generator |
US11931026B2 (en) | 2021-06-30 | 2024-03-19 | Cilag Gmbh International | Staple cartridge replacement |
AU2022206785A1 (en) * | 2021-07-30 | 2023-02-16 | Grinsell, Damien Glen | A Surgical Dissector Instrument |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3651811A (en) * | 1969-10-10 | 1972-03-28 | Aesculap Werke Ag | Surgical cutting instrument |
US4003380A (en) * | 1974-09-05 | 1977-01-18 | F.L. Fisher | Bipolar coagulation instrument |
FR2355521A1 (en) * | 1976-06-22 | 1978-01-20 | Mendez Rene | Surgical forceps for biopsy and electro-coagulation - with insulation along complete tube length and over jaws to prevent random burning |
Family Cites Families (53)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US659409A (en) * | 1900-08-25 | 1900-10-09 | Charles L Mosher | Electric bipolar dilator. |
US1586645A (en) * | 1925-07-06 | 1926-06-01 | Bierman William | Method of and means for treating animal tissue to coagulate the same |
US1798902A (en) * | 1928-11-05 | 1931-03-31 | Edwin M Raney | Surgical instrument |
US3685518A (en) * | 1970-07-29 | 1972-08-22 | Aesculap Werke Ag | Surgical instrument for high-frequency surgery |
US3730188A (en) * | 1971-03-24 | 1973-05-01 | I Ellman | Electrosurgical apparatus for dental use |
JPS4912482A (en) * | 1972-05-16 | 1974-02-02 | ||
US3996508A (en) * | 1972-11-20 | 1976-12-07 | Northrop Corporation | Three phase primary power regulator |
US3875496A (en) * | 1974-03-13 | 1975-04-01 | Glenayre Electronics Ltd | Static inverter using multiple signal control loops |
US4041952A (en) * | 1976-03-04 | 1977-08-16 | Valleylab, Inc. | Electrosurgical forceps |
SU575103A2 (en) * | 1976-05-14 | 1977-10-05 | Харьковская Областная Клиническая Больница | Bipolar biologically active shears |
US4092986A (en) * | 1976-06-14 | 1978-06-06 | Ipco Hospital Supply Corporation (Whaledent International Division) | Constant output electrosurgical unit |
DE2642489C3 (en) * | 1976-09-22 | 1979-04-19 | Richard Wolf Gmbh, 7134 Knittlingen | Unipolar coagulation forceps |
US4271838A (en) * | 1978-04-05 | 1981-06-09 | Laschal Instruments Corp. | Suture cutter |
US4232676A (en) * | 1978-11-16 | 1980-11-11 | Corning Glass Works | Surgical cutting instrument |
DE2944730A1 (en) * | 1978-11-16 | 1980-05-29 | Corning Glass Works | SURGICAL INSTRUMENT |
US4848337A (en) * | 1979-09-10 | 1989-07-18 | Shaw Robert F | Abherent surgical instrument and method |
CA1161326A (en) * | 1979-09-10 | 1984-01-31 | Robert F. Shaw | Abherent surgical instrument and method |
US4314559A (en) * | 1979-12-12 | 1982-02-09 | Corning Glass Works | Nonstick conductive coating |
US4353371A (en) * | 1980-09-24 | 1982-10-12 | Cosman Eric R | Longitudinally, side-biting, bipolar coagulating, surgical instrument |
US4370980A (en) * | 1981-03-11 | 1983-02-01 | Lottick Edward A | Electrocautery hemostat |
US4492231A (en) * | 1982-09-17 | 1985-01-08 | Auth David C | Non-sticking electrocautery system and forceps |
FR2536924A1 (en) * | 1982-11-25 | 1984-06-01 | Courtois Michele | ELECTRO-SURGERY DEVICE COMPRISING A GENERATOR OF VERY STRAIGHT FRONT RECTANGULAR SLOTS |
US4590934A (en) * | 1983-05-18 | 1986-05-27 | Jerry L. Malis | Bipolar cutter/coagulator |
US4669471A (en) * | 1983-11-10 | 1987-06-02 | Olympus Optical Co., Ltd. | Forceps device for use in an endoscope |
US4671274A (en) * | 1984-01-30 | 1987-06-09 | Kharkovsky Nauchno-Issledovatelsky Institut Obschei I | Bipolar electrosurgical instrument |
DE8418993U1 (en) * | 1984-06-23 | 1984-09-20 | Richard Wolf Gmbh, 7134 Knittlingen | Medical forceps |
GB8501509D0 (en) * | 1985-01-22 | 1985-02-20 | Secr Defence | Esters |
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 |
US4763669A (en) * | 1986-01-09 | 1988-08-16 | Jaeger John C | Surgical instrument with adjustable angle of operation |
JPS62137009U (en) * | 1986-02-21 | 1987-08-28 | ||
JPS62287999A (en) * | 1986-05-31 | 1987-12-14 | ソル レビン | Spontaneous cutter for cutting edge and manufacture thereof |
DE3629809A1 (en) * | 1986-09-02 | 1988-03-10 | Wolf Gmbh Richard | COAGULATION PLIERS |
US4785807B1 (en) * | 1987-02-24 | 1996-07-16 | American Medical Products Inc | Electrosurgical knife |
DE3736150A1 (en) * | 1987-10-26 | 1989-05-03 | Wolf Gmbh Richard | PLIERS, ESPECIALLY HOOK PUNCH |
EP0316469B2 (en) * | 1987-11-17 | 1998-11-25 | Erbe Elektromedizin GmbH | High frequence surgical device to cut and/or coagulate biological tissues |
GB2213381B (en) * | 1987-12-12 | 1992-06-03 | Univ Wales Medicine | Surgical diathermy instruments |
DE3800331A1 (en) * | 1988-01-08 | 1989-07-27 | Fehling Medizintechnik Gmbh | MICROSURGICAL PLIERS, IN PART. FOR BIOPSY |
US4940468A (en) * | 1988-01-13 | 1990-07-10 | Petillo Phillip J | Apparatus for microsurgery |
US4887612A (en) * | 1988-04-27 | 1989-12-19 | Esco Precision, Inc. | Endoscopic biopsy forceps |
DE3815835A1 (en) * | 1988-05-09 | 1989-11-23 | Flachenecker Gerhard | HIGH FREQUENCY GENERATOR FOR TISSUE CUTTING AND COAGULATION IN HIGH FREQUENCY SURGERY |
DE3917328A1 (en) * | 1989-05-27 | 1990-11-29 | Wolf Gmbh Richard | BIPOLAR COAGULATION INSTRUMENT |
US5151102A (en) * | 1989-05-31 | 1992-09-29 | Kyocera Corporation | Blood vessel coagulation/stanching device |
US5009656A (en) * | 1989-08-17 | 1991-04-23 | Mentor O&O Inc. | Bipolar electrosurgical instrument |
US5085659A (en) * | 1990-11-21 | 1992-02-04 | Everest Medical Corporation | Biopsy device with bipolar coagulation capability |
US5147357A (en) * | 1991-03-18 | 1992-09-15 | Rose Anthony T | Medical instrument |
US5147356A (en) * | 1991-04-16 | 1992-09-15 | Microsurge, Inc. | Surgical instrument |
US5391166A (en) * | 1991-06-07 | 1995-02-21 | Hemostatic Surgery Corporation | Bi-polar electrosurgical endoscopic instruments having a detachable working end |
US5330471A (en) * | 1991-06-07 | 1994-07-19 | Hemostatic Surgery Corporation | Bi-polar electrosurgical endoscopic instruments and methods of use |
FR2680314B1 (en) * | 1991-08-16 | 1993-11-19 | Guy Lebosse | STRAIGHT OR CURVED SCALE OF ELECTROCOAGULATING FIELDS IN BI-POLAR MODE. |
KR0145453B1 (en) * | 1992-01-21 | 1998-07-01 | 알렌 제이 | Electrosurgical trocar control device |
US5312434A (en) * | 1992-12-21 | 1994-05-17 | Lawrence Crainich | Medical instrument |
US5352222A (en) * | 1994-03-15 | 1994-10-04 | Everest Medical Corporation | Surgical scissors with bipolar coagulation feature |
-
1992
- 1992-05-01 US US07/877,704 patent/US5330471A/en not_active Expired - Lifetime
- 1992-05-01 US US07/877,703 patent/US5324289A/en not_active Expired - Lifetime
- 1992-06-05 KR KR1019930703770A patent/KR100235151B1/en not_active IP Right Cessation
- 1992-06-05 WO PCT/US1992/004663 patent/WO1992022256A1/en active Application Filing
- 1992-06-05 CH CH00478/93A patent/CH688750A5/en not_active IP Right Cessation
- 1992-06-05 EP EP92109540A patent/EP0517243B1/en not_active Expired - Lifetime
- 1992-06-05 DE DE69221942T patent/DE69221942T2/en not_active Expired - Fee Related
- 1992-06-05 JP JP5500642A patent/JPH06511400A/en active Pending
- 1992-06-05 DE DE69210683T patent/DE69210683T2/en not_active Expired - Fee Related
- 1992-06-05 CA CA002110922A patent/CA2110922C/en not_active Expired - Fee Related
- 1992-06-05 DK DK92109539.4T patent/DK0518230T3/en active
- 1992-06-05 AU AU22200/92A patent/AU656405B2/en not_active Ceased
- 1992-06-05 CA CA002110921A patent/CA2110921C/en not_active Expired - Fee Related
- 1992-06-05 DK DK92109541.0T patent/DK0517244T3/en active
- 1992-06-05 EP EP92109541A patent/EP0517244B1/en not_active Expired - Lifetime
- 1992-06-05 AU AU21883/92A patent/AU672751B2/en not_active Ceased
- 1992-06-05 CA CA002110923A patent/CA2110923C/en not_active Expired - Fee Related
- 1992-06-05 DK DK92109540.2T patent/DK0517243T3/en active
- 1992-06-05 JP JP5500916A patent/JP3053218B2/en not_active Expired - Fee Related
- 1992-06-05 EP EP92109539A patent/EP0518230B1/en not_active Expired - Lifetime
- 1992-06-05 ES ES92109541T patent/ES2084873T3/en not_active Expired - Lifetime
- 1992-06-05 JP JP50091593A patent/JP3415147B2/en not_active Expired - Fee Related
- 1992-06-05 AU AU21999/92A patent/AU672753B2/en not_active Ceased
- 1992-06-05 ES ES92109540T patent/ES2106798T3/en not_active Expired - Lifetime
- 1992-06-05 CH CH00480/93A patent/CH686608A5/en not_active IP Right Cessation
- 1992-06-05 DE DE69209146T patent/DE69209146T2/en not_active Expired - Lifetime
- 1992-06-05 JP JP05500642A patent/JP3090949B2/en not_active Expired - Lifetime
- 1992-06-05 CH CH00479/93A patent/CH694070A5/en not_active IP Right Cessation
- 1992-06-05 WO PCT/US1992/004664 patent/WO1992021301A1/en active Application Filing
- 1992-06-05 ES ES92109539T patent/ES2087343T3/en not_active Expired - Lifetime
- 1992-06-05 WO PCT/US1992/004665 patent/WO1992022257A1/en active Application Filing
- 1992-07-01 IE IE921829A patent/IE74395B1/en not_active IP Right Cessation
- 1992-07-01 IE IE921830A patent/IE74396B1/en not_active IP Right Cessation
- 1992-07-01 IE IE921831A patent/IE80440B1/en not_active IP Right Cessation
-
1993
- 1993-12-07 KR KR1019930703799A patent/KR100235143B1/en not_active IP Right Cessation
-
1995
- 1995-05-23 US US08/447,628 patent/US5769849A/en not_active Expired - Fee Related
-
1996
- 1996-03-21 GR GR950403730T patent/GR3019387T3/en unknown
- 1996-05-16 GR GR960400842T patent/GR3019920T3/en unknown
-
1997
- 1997-01-03 US US08/778,511 patent/US5776128A/en not_active Expired - Lifetime
- 1997-01-03 US US08/778,512 patent/US5810808A/en not_active Expired - Lifetime
- 1997-01-03 US US08/778,510 patent/US5766170A/en not_active Expired - Fee Related
- 1997-09-04 GR GR970402227T patent/GR3024620T3/en unknown
-
2003
- 2003-01-22 JP JP2003014071A patent/JP2003199763A/en active Pending
- 2003-01-22 JP JP2003014072A patent/JP2003199764A/en active Pending
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3651811A (en) * | 1969-10-10 | 1972-03-28 | Aesculap Werke Ag | Surgical cutting instrument |
US4003380A (en) * | 1974-09-05 | 1977-01-18 | F.L. Fisher | Bipolar coagulation instrument |
FR2355521A1 (en) * | 1976-06-22 | 1978-01-20 | Mendez Rene | Surgical forceps for biopsy and electro-coagulation - with insulation along complete tube length and over jaws to prevent random burning |
Non-Patent Citations (1)
Title |
---|
"The Cavitron Bipolar Coagulator", 1979, CAVITRON SURGICAL SYSTEMS, Both Sides of the Brochure. * |
Cited By (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1995009576A1 (en) * | 1993-10-07 | 1995-04-13 | Valleylab, Inc. | Automatic control for electrosurgical generator |
US9339323B2 (en) | 2005-05-12 | 2016-05-17 | Aesculap Ag | Electrocautery method and apparatus |
US10314642B2 (en) | 2005-05-12 | 2019-06-11 | Aesculap Ag | Electrocautery method and apparatus |
US8888770B2 (en) | 2005-05-12 | 2014-11-18 | Aesculap Ag | Apparatus for tissue cauterization |
US11058478B2 (en) | 2006-05-02 | 2021-07-13 | Aesculap Ag | Laparoscopic radiofrequency surgical device |
US9918778B2 (en) | 2006-05-02 | 2018-03-20 | Aesculap Ag | Laparoscopic radiofrequency surgical device |
US8870867B2 (en) | 2008-02-06 | 2014-10-28 | Aesculap Ag | Articulable electrosurgical instrument with a stabilizable articulation actuator |
EP2366354A2 (en) | 2010-03-15 | 2011-09-21 | "Golsen Limited" | Blade for surgical instrument, surgical scissors, and electrosurgical bipolar scissors for dissection and coagulation |
US8827992B2 (en) | 2010-03-26 | 2014-09-09 | Aesculap Ag | Impedance mediated control of power delivery for electrosurgery |
US9277962B2 (en) | 2010-03-26 | 2016-03-08 | Aesculap Ag | Impedance mediated control of power delivery for electrosurgery |
US10130411B2 (en) | 2010-03-26 | 2018-11-20 | Aesculap Ag | Impedance mediated control of power delivery for electrosurgery |
US8419727B2 (en) | 2010-03-26 | 2013-04-16 | Aesculap Ag | Impedance mediated power delivery for electrosurgery |
US9173698B2 (en) | 2010-09-17 | 2015-11-03 | Aesculap Ag | Electrosurgical tissue sealing augmented with a seal-enhancing composition |
DE202011000742U1 (en) | 2011-03-31 | 2011-06-01 | Golsen Ltd. | Electrosurgical bipolar scissors for tissue incisions with pre-coagulation |
US9339327B2 (en) | 2011-06-28 | 2016-05-17 | Aesculap Ag | Electrosurgical tissue dissecting device |
US10004555B2 (en) | 2011-06-28 | 2018-06-26 | Aesculap Ag | Electrosurgical tissue dissecting device |
US9872724B2 (en) | 2012-09-26 | 2018-01-23 | Aesculap Ag | Apparatus for tissue cutting and sealing |
Also Published As
Similar Documents
Publication | Publication Date | Title |
---|---|---|
EP0518230B1 (en) | Bi-polar electrosurgical endoscopic instruments | |
US5391166A (en) | Bi-polar electrosurgical endoscopic instruments having a detachable working end | |
US6358249B1 (en) | Scissorlike electrosurgical cutting instrument | |
US7442194B2 (en) | Bipolar forceps having monopolar extension | |
EP2040634B1 (en) | Surgical sealing and cutting apparatus | |
AU2013254884B2 (en) | Bipolar forceps having monopolar extension | |
US20130023874A1 (en) | Bipolar forceps having monopolar extension | |
JPH0630947A (en) | Surgery apparatus |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): AT AU BB BG BR CA CH CS FI HU JP KP KR LK MG MN MW NO PL RO RU SD SE |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): BF BJ CF CG CI CM GA GN ML MR SN TD TG |
|
DFPE | Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101) | ||
WWE | Wipo information: entry into national phase |
Ref document number: 2110922 Country of ref document: CA |