CA2107970C - Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge - Google Patents
Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge Download PDFInfo
- Publication number
- CA2107970C CA2107970C CA002107970A CA2107970A CA2107970C CA 2107970 C CA2107970 C CA 2107970C CA 002107970 A CA002107970 A CA 002107970A CA 2107970 A CA2107970 A CA 2107970A CA 2107970 C CA2107970 C CA 2107970C
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- CA
- Canada
- Prior art keywords
- staple
- cartridge
- support shaft
- actuator
- staple cartridge
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0684—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2902—Details of shaft characterized by features of the actuating rod
- A61B2017/2903—Details of shaft characterized by features of the actuating rod transferring rotary motion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
- A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
Abstract
A surgical stapler is provided which is insertable through an endoscopic tube to enable a surgeon to staple a hernia patch to tissue inside a body cavity. The endoscopic surgical stapler includes a staple cartridge pivotally mounted on the distal and of a support tube extending from a handle provided with an actuator mechanism for actuating a staple forming mechanism inside the staple cartridge to fasten staples to the tissue.
The staple cartridge is adjustable to different angular orientations relative to the support tube.
The staple actuator mechanism is operable to actuate the staple cartridge in any of the angular orientations. The support shaft is rotatable about its longitudinal axis relative to the handle to adjust the rotational orientation o~ the support shaft and the staple cartridge. The staple cartridge is rotatable about its longitudinal axis relative to the support shaft to adjust the rotational position of the staple cartridge relative to the support shaft. Separate actuator mechanisms are provided on the handle to control the pivotal movement of the staple cartridge, the rotation of the support shaft, and the rotation of the staple cartridge relative to the support shaft.
The staple cartridge is adjustable to different angular orientations relative to the support tube.
The staple actuator mechanism is operable to actuate the staple cartridge in any of the angular orientations. The support shaft is rotatable about its longitudinal axis relative to the handle to adjust the rotational orientation o~ the support shaft and the staple cartridge. The staple cartridge is rotatable about its longitudinal axis relative to the support shaft to adjust the rotational position of the staple cartridge relative to the support shaft. Separate actuator mechanisms are provided on the handle to control the pivotal movement of the staple cartridge, the rotation of the support shaft, and the rotation of the staple cartridge relative to the support shaft.
Description
~~.o~o~o ENDOSCOPIC SURGICAL STAPLING INSTRUMENT
WITH PIVOTABLE AND ROTATABLE STAPLE CARTRIDGE
FIELD OF THE INVENTION
The present invention relates to a surgical stapling instrument for applying surgical staples to internal body tissue and, more particularly, to a surgical stapler which can be used endoscopically for the repair of hernias. More specifically, this invention relates to an endoscopic surgical stapling instrument including a staple cartridge which is pivotally and rotatably mounted to allow the surgical staples to be applied to the internal body tissue in any desired orientation. Also, this invention concerns a unique staple cartridge with an improved staple forming mechanism for advancing and fastening the staples to the tissue.
BACTCGROUND OF THE INVENTION AND PRIOR ART
With the proliferation of endoscopic surgery, it has been realized that there are many procedures typically performed in open surgery which can be performed endoscopically. A trocar, which is a pointed piercing device, is inserted into the body with a cannula placed around the trocar. After the trocar pierces the abdominal walls, it is removed and the cannula remains in the body. Through this cannula, endoscopic procedures can be conducted.
Generally, the endoscopic procedures are performed under insufflation. Some of the more typical procedures have been gall bladder removal, tissue repair and sterilization procedures such as occluding of the fallopian tubes.
WITH PIVOTABLE AND ROTATABLE STAPLE CARTRIDGE
FIELD OF THE INVENTION
The present invention relates to a surgical stapling instrument for applying surgical staples to internal body tissue and, more particularly, to a surgical stapler which can be used endoscopically for the repair of hernias. More specifically, this invention relates to an endoscopic surgical stapling instrument including a staple cartridge which is pivotally and rotatably mounted to allow the surgical staples to be applied to the internal body tissue in any desired orientation. Also, this invention concerns a unique staple cartridge with an improved staple forming mechanism for advancing and fastening the staples to the tissue.
BACTCGROUND OF THE INVENTION AND PRIOR ART
With the proliferation of endoscopic surgery, it has been realized that there are many procedures typically performed in open surgery which can be performed endoscopically. A trocar, which is a pointed piercing device, is inserted into the body with a cannula placed around the trocar. After the trocar pierces the abdominal walls, it is removed and the cannula remains in the body. Through this cannula, endoscopic procedures can be conducted.
Generally, the endoscopic procedures are performed under insufflation. Some of the more typical procedures have been gall bladder removal, tissue repair and sterilization procedures such as occluding of the fallopian tubes.
2~~'~~~~
Surgeons realize that it may be possible to perform additional procedures endoscopically, once the proper materials and mechanisms become available for performing these procedures. One of the more basic, and quite logical extensions of current endoscopic procedures has been focused on the repair of hernias. It is realized that to have the capability of performing hernia repair endoscopically will benefit the medical community in many ways. Specifically, it is realized that endoscopic hernia repair will allow the patient to recuperate more rapidly, and without the more than likely extensive physical therapy currently practiced as a result of a hernia repair performed by open surgery.
Moreover, it is realized that hernia repair procedures may contain aspects which are applicable in other procedures. For instance, if it is possible to cover, or reinforce and constrain a zo hernia, it may be possible to apply this procedure to other vessels or organs, in a similar manner.
Also, it is realized that once a device becomes available wherein hernias can be repaired, many of the functional components of the hernia repair device will be useful in other devices capable of performing other procedures. Also, naturally, these mechanisms may be useful for procedures in which open surgery is performed.
SUi~~iARY OF THE INVENTION
Accordingly, it is an object of the present invention to provide an endoscopic surgical stapler for applying staples to secure a hernia repair patch to internal body tissue.
Surgeons realize that it may be possible to perform additional procedures endoscopically, once the proper materials and mechanisms become available for performing these procedures. One of the more basic, and quite logical extensions of current endoscopic procedures has been focused on the repair of hernias. It is realized that to have the capability of performing hernia repair endoscopically will benefit the medical community in many ways. Specifically, it is realized that endoscopic hernia repair will allow the patient to recuperate more rapidly, and without the more than likely extensive physical therapy currently practiced as a result of a hernia repair performed by open surgery.
Moreover, it is realized that hernia repair procedures may contain aspects which are applicable in other procedures. For instance, if it is possible to cover, or reinforce and constrain a zo hernia, it may be possible to apply this procedure to other vessels or organs, in a similar manner.
Also, it is realized that once a device becomes available wherein hernias can be repaired, many of the functional components of the hernia repair device will be useful in other devices capable of performing other procedures. Also, naturally, these mechanisms may be useful for procedures in which open surgery is performed.
SUi~~iARY OF THE INVENTION
Accordingly, it is an object of the present invention to provide an endoscopic surgical stapler for applying staples to secure a hernia repair patch to internal body tissue.
Another object of the invention is to provide an endoscopic surgical stapler including a staple cartridge which is pivotally and rotatably mounted to allow the staples to be fastened to the tissue in any desired orientation.
It is also an object of the invention to provide an endoscopic surgical stapling instrument in which the pivotal movement and rotation of the staple cartridge can be controlled from a remote actuator handle assembly.
It is another object of the invention to provide an endoscopic surgical stapling instrument which facilitates manipulation by a surgeon to control the orientation and acutation of the staple cartridge.
A further object of the invention is to provide a staple cartridge for use with a surgical stapling instrument which includes an improved staple forming mechanism for advancing the staples one at a time into engagement with an anvil about which the staple is formed to secure the staple to the tissue.
The present invention achieves an improved endoscopic surgical stapler which is adapted for insertion through an endoscopic tube or cannula into a body cavity to apply one or more surgical staples to the internal body tissue. The surgical sapling instrument includes a staple cartridge which is pivotally mounted at the distal end of a tubular support shaft extending from a handle which includes a staple actuator mechanism for actuating the staple cartridge to fasten the staples seriatim to the tissue. The staple cartridge is mounted for pivotal movement relative to the support shaft about an axis transverse to the longitudinal axis of the support shaft to permit the angular orientation of the staple cartridge to be adjusted.
Also, the staple cartridge is mounted for rotation relative to the support shaft to permit the rotational orientation of the staple cartridge to be adjusted. In addition, the support shaft is rotatable about its longitudinal axis relative to the handle. These features of the stapling instrument allow the staple cartridge to be precisely aligned with the desired region of the internal body tissue to which the staple is applied. Separate actuator mechanisms are provided on the handle for controlling the rotation of the support shaft, the pivoting of the staple cartridge relative to the support shaft, and the rotation of the staple cartridge relative to the support shaft.
These actuator mechanisms facilitate manipulation of the stapling instrument by a surgeon to position the staple cartridge in a desired orientation.
In accordance with one aspect of the invention, the surgical stapling instrument is provided with pivot means at the distal end of the support shaft for mounting the staple cartridge for pivotal movement about an axis transverse to the longitudinal axis of the support shaft. Actuator means is provided on the handle for pivoting the staple cartridge about the transverse axis to adjust the angular position of the staple cartridge relative to the support shaft. The stapling instrument includes means for retaining the staple cartridge in different angular positions relative to the support shaft. The staple cartridge has a staple forming mechanism which can be actuated by the staple actuator mechanism with the staple cartridge oriented in any of its different angular positions.
The surgical stapling instrument includes actuator means on the handle for rotating the support shaft about its longitudinal axis to adjust the rotational orientation of the support shaft and the staple cartridge. Also, means is provided for retaining the support shaft in different rotational positions as the support shaft is rotated about its longitudinal axis.
In a preferred embodiment of the surgical stapling instrument, the staple cartridge is mounted for rotation about its longitudinal axis relative to the support shaft. Actuator means is provided on the handle for rotating the staple cartridge to adjust the rotational position of the staple cartridge relative to the support shaft.
Also, means is provided for retaining the staple cartridge in different rotational positions as the staple cartridge is rotated about its longitudinal axis relative to the support shaft.
In accordance with another aspect of the invention, a staple cartridge for use with a stapling instrument for applying one or more surgical staples to tissue comprises a cartridge housing adapted to receive a plurality of staples in a row for longitudinal movement therethrough, an anvil mounted on the housing, means for advancing the forwardmost staple in the row into engagement with the anvil, means for rotating the forwardmost staple from a transverse orientation into a longitudinal orientation as the staple is advanced toward the anvil, and means for forming the forwardmost staple about the anvil to attach the staple to the tissue. The staple advancing means comprises a staple holder slidably mounted within the cartridge housing for advancing the forwardmost staple from the row and clamping the staple against the anvil. The staple rotating means comprises ramp means on the cartridge housing for engaging and rotating the forwardmost staple into a longitudinal orientation as the staple is advanced by the staple holder. The staple forming means comprises a staple former slidably mounted within l0 the cartridge housing for movement relative to the staple holder and adapted to form the forwardmost staple about the anvil. Preferably, the staple holder includes an ejector arm for removing the forwardmost staple from the anvil after the staple is formed.
A preferred embodiment of the staple cartridge is adapted for use with a staple having a generally U-shaped body including a crown with a central offset portion and a pair of depending legs at opposite sides of the crown. The staple cartridge comprises an elongated hollow cylindrical cartridge housing including a pair of spaced parallel guide rails therein for slidably supporting a stack of staples for longitudinal movement therealong with the staple crowns resting on the guide rails and the staple legs oriented perpendicularly to the longitudinal axis of the cartridge housing. A
staple follower is slidably mounted on the guide rails for urging the staples forwardly on the guide rails toward the distal end of the cartridge housing. An anvil is mounted adjacent to the distal end of the cartridge housing. A staple holder is slidably mounted between the guide rails for engaging the central offset portion of the forwardmost staple to advance the staple from the ~~~~9~~
stack into engagement with the anvil. Ramp means is provided on the cartridge housing for engaging the crown of the forutardmost staple advanced by the staple holder and rotating the staple into a longitudinal orientation with the staple legs oriented parallel to the longitudinal axis of the cartridge housing. A staple former is slidably mounted between the guide rails and movable relative to the staple holder for engaging the crown of the forwardmost staple to forin the staple about the anvil to attach the staple to the tissue.
In the preferred embodiment of the staple cartridge, the~staple former comprises an elongated channel-shaped member including upstanding side flanges extending along its opposite sides for engaging and forming the staple. The staple holder comprises an elongated plate-like member slidably supported on the staple former and located between the side flanges. The staple holder includes a notch at its distal end for receiving the forwardmost staple to be advanced. The staple holder also includes a pusher finger at its distal end for engaging the forwardmost staple and clamping the staple against the anvil. In addition, the staple holder includes an~ejector arm at its distal end for removing-the formed staple from the anvil when the staple holder is retracted.
BRIBF DFSORIPTION OF THF DRAWINGS
The foregoing and other objects, aspects and advantages will be better understood from the following detailed description of the preferred embodiments of the invention with reference to the drawings, in which:
Figure 1 is an overall perspective view of an endoscopic surgical stapling instrument constructed in accordance with this invention:
Figure 2 is a partially cutaway side view of the stapling instrument of Figure 1;
Figure 3 is an enlarged longitudinal section of the stapling head assembly of Figure 2:
Figure 4 is an enlarged longitudinal section of the stapling head assembly from the opposite side of Figure 3:
Figures 5 and 6 are exploded perspective views showing the components of the stapling instrument of Figure 1:
Figure 7 is an enlarged partially cutaway horizontal section of the stapling head assembly and support shaft of Figure 2:
Figure 8 is an enlarged partially cutaway vertical section of the stapling head assembly and support shaft of Figure 2:
Figure 9 is an enlarged, exploded perspective view showing the staple cartridge and the staple forming mechanism of the stapling head assembly:
Figure 10 is an enlarged langitudinal section of the staple cartridge of Figure 9:
Figure 11 is an enlarged longitudinal section of the staple cartridge along line 11-11 of Figure 10:
2~fl'~~~~
Figure 12 is an enlarged proximal end view of the staple cartridge;
Figure 13 is an enlarged distal end view of the stapling head assembly of Figure 3;
° 5 Figure 14 is an enlarged fragmentary section of the staple cartridge taken along line 14-14 of Figure 11;
Figure 15 is a longitudinal section of a slide actuator for pivoting the stapling head assembly;
Figure 16 is a proximal end view of the slide actuator of Figure 15;
Figure 17 is an enlarged plan view of a staple for use with the surgical stapling instrument of this invention;
Figure 18 illustrates a hernia repair patch fastened to tissue with staples applied by the surgical stapling instrument of this invention;
Figure 19 is an enlarged longitudinal section of the staple cartridge of Figure 9 showing the staple forming mechanism in a retracted position;
Figure 20 is an enlarged longitudinal section of the staple cartridge of Figure 9 showing the staple forming mechanism advanced to rotate a staple into a longitudinal orientation;
Figure 21 is an enlarged longitudinal section of the staple cartridge of Figure 9 showing the staple forming mechanism advanced to clamp the staple against an anvil of the staple cartridge;
Figures 22-26 illustrate the operation of the staple forming mechanism in advancing and forming a staple;
Figures 27-31 are fragmentary views showing the operation of a precock ratchet mechanism in the actuator handle assembly;
Figure 32 is an overall perspective view of an alternative embodiment of the surgical stapling instrument constructed in accordance with this invention;
Figure 33 is a partially cutaway side view of the stapling instrument of Figure 32;
Figure 34 is an enlarged longitudinal section of the stapling head assembly from the opposite side of Figure 32:
l0 Figure 35 is an enlarged cross section of the stapling instrument along line 35-35 of Figure 33:
Figure 3E is an enlarged cross section of the stapling instrument along line 36-36 of Figure 33;
Figure 37 is a perspective view of another embodiment of a stapling head assembly for use with the surgical stapling instrument of this invention:
Figure 38 is a side view of the stapling head assembly from the opposite side of Figure 37;
Figure 39 is a partially cutaway side view of the stapling head assembly of Figure 38; and Figure 40 is a partially cutaway side view of the stapling head assembly from the opposite side of Figure 39.
DETAIDED DESCRIPTION OF PREFERRED EMEODIMENTS
Referring to Figure 1, the present invention is embodied in an articulating endoscopic surgical stapling instrument, generally 50, including a distal stapling head assembly 60 which is pivotally connected to an elongated support tube 70 rotatably mounted on a proximal actuator handle assembly 80.
A rotatable adjusting knob 82 is mounted at the distal end of the actuator handle assembly 80 for rotating the support tube 70 about its longitudinal axis. A saddle-shaped actuator 84 is slidably mounted on the actuator handle assembly 80 for controlling the pivotal movement of the stapling head assembly 60 relative to the support tube 70.
The actuator handle assembly 80 includes a depending handle grip 86 and a pivotally mounted staple actuating lever 88 for actuating a staple cartridge 100 on the stapling head assembly 60.
Preferably, the actuator handle assembly 80, the adjusting knob 82, the saddle-shaped actuator 84 and the staple actuating lever 88 consist of plastic material.
Referring to Figure 14, a staple 65 adapted for use with the surgical stapling instrument 50 of the present invention comprises-a wire-like body of circular cross section which is bent in a generally ~-shaped configuration. Preferably, the staple 65 consists of titanium or stainless steel. The staple 65 includes a top portion or crown 66 provided with a central dimpled portion 67 which is offset downwardly from the crown 66 by an amount approximately equal to the diameter of the circular cross section of the staple 65. The opposite sides of the staple 65 are bent downwardly to provide a pair of depending legs 68 which are substantially perpendicular to the crown 66. Each leg 68 has a beveled end 69 which is beveled at an angle of approximately 45 degrees. When the staple 65 is closed by operation of the surgical stapling instrument 50, the staple legs 68 overlap each other as shown by phantom lines in Figure 14 to secure the staple to the tissue.
As shown in Figures 1 and 5, the handle l0 assembly 80 includes a pair of hollow handle sections 91 and 92 which are adapted to snap fit together. The handle sections 91 and 92 include distally extending elongated, semi-cylindrical neck portions 93 and 94 which receive the proximal end of the support tube 70 therebetween and mount the support tube 70 for rotation about its longitudinal axis relative to the handle assembly 80. Each of the handle sections 91 and 92 includes an internal annular flange 95 (one shown) for engaging a radially projecting flange 72 at the proximal end of the support tube 70 to retain the support tube 70 within the handle assembly 80. The staple actuating lever 88 is pivotally mounted on the actuator handle assembly 80 by a pivot pin 96 extending through a pivot hole 90 in the lever 88.
The pivot pin 96 is received in a pair of hollow cylindrical support stems 97 (one shown) formed on the inside of the handle sections 91 and 92.
As shown in Figures 1 and 5, the adjusting knob 82 comprises a pair of elongated hollow, tapered sleeve-like sections 101 and 102 which fit together over the neck portions 93 and 94 of the handle sections 91 and 92, respectively. Each of the sleeve-like knob sections 101 and 102 has an inwardly projecting prong 103 adjacent to its distal end. The prongs 103 are received in a pair of holes 74 (one shown) formed on opposite sides of the support tube 70 to secure the knob sections 101.
and 102 to the support tube 70. Each of the knob sections 101 and 102 includes a semi-circular ratchet 104 on its inner wall for engaging a pair of detents 105 mounted on resilient arms 106 formed on each of the handle sections 91 and 92. The semi-circular ratchets 104 and the detents 105 provide a ratchet mechanism for retaining the support tube 70 in different rotational positions as the support tube 70 is rotated about its longitudinal axis. For example, each ratchet 104 is provided with eight ratchet teeth which allow the support tube to be rotated in sixteen equal angular increments of 22-1/2 degrees. Each of the knob sections 101 and 102 has an enlarged rear section 107 provided with alternating longitudinal ridges 108 and finger-receiving grooves 109 which facilitate the rotation of the adjusting knob 82 and the support tube 70 by the surgeon.
The support tube 70 is an elongated, thin-walled rigid metal tube, e.g., stainless steel.
Inside the support tube 70 are mounted an elongated staple driver 76 and an elongated articulation driver 78 which are slidable longitudinally relative to the support tube 70 and relative to each other. The articulation driver 78 pivots the stapling head assembly 60 in response to movement of the saddle-shaped actuator 84 along the actuator handle assembly 80. The staple driver 76 actuates the staple forming mechanism within the staple cartridge 62 when the staple actuating lever 88 is operated. Preferably, the staple driver 76 and the articulation driver 78 consist of stainless steel.
As shown ir. Figures 5 and 6, the staple driver 76 comprises an elongated thin flat rod including a pair of spaced parallel flanges 110 which extend longitudinally along its top and bottom edges. The staple driver 76 has a pivot hole 111 (Figure 6) adjacent to its distal end and a longitudinal slot 112 (Figure 5) adjacent to its proximal end. The artic~.alation driver 78 comprises an elongated thin flat rod which is slidably mounted adjacent to the l0 staple driver 76 and is slidably received between the flanges 110. The articulation driver 78 has an enlarged distal portion 113 (Figure 6) with a laterally projecting guide pin 114 formed adjacent to its distal end. An assembly hole 115 (Figure 5) is formed adjacent to the proximal end of the articulation driver 78. A driver guide member 116 of generally cylindrical shape is mounted within the proximal end of the support tube 70. The driver guide member 116 has a pair of opposed, outwardly extending posts 117 which are received in a pair of corresponding holes 118 formed adjacent to the proximal end of the support tube 70. The driver guide 116 has a rectangular slot 119 extending therethrough for slidably receiving the staple driver 76 and the articulation driver 78.
As shown in Figures 2 and 5, a driver coupling member 120, preferably made of plastic material, includes an opening 122 extending longitudinally therethrough for receiving the proximal ends of the staple driver 76 and the articulation driver 78.
The driver coupling member 120 is secured to the articulation driver 78 by a coupling pin 124 which is received in the hole 115 in the articulation driver 78 and extends through a pair of apertures 126 formed on opposite sides of the coupling member 120. The coupling pin 124 is slidably received in the longitudinal slot 112 of the staple driver 76 to allow the articulation driver 78 to slide longitudinally relative to the the staple driver 76. A pair of spaced annular flanges 128 and 130 are provided at the proximal end of the coupling member 120 for connection to an articulation control mechanism on the actuator handle assembly 80.
The saddle-shaped actuator 84 operates a slide member 132 which is coupled to the driver coupling member 120 to operate the articulation driver 78.
The saddle slide member 132 is a generally flat metal plate with an elongated neck 134 projecting distally and having a pair of curved depending arms 136 provided with inwardly projecting fingers 138 which are received between the annular flanges 128 and 130 on the driver coupling member 120. The annular flanges 128 and 130 capture the fingers 138 therebetween and connect the coupling member 120 to the saddle slide member 132 for longitudinal movement therewith. The annular flanges 138 allow the coupling member 120 to rotate about its longitudinal axis relative to the saddle slide member 132 when the support shaft 70 is rotated by the adjusting knob 82.
The saddle slide member 132 is slidably mounted on a pair of horizontal support ledges 140 (one shown) formed on the interior of the handle sections 91 and 92. Each support ledge 140 includes a series of uniformly spaced notches 142 arranged in a longitudinal row. The saddle slide member 132 is formed with a transverse notch 144 for receiving a ratchet pin 146 which is biased downwardly into the notch 144 by a coil spring 148 2~~~~~~
mounted on an inclined post 149 formed on the inside of the saddle-shaped actuator 84. A pair of inclined fingers 150 (Figures 15 and 16) is formed on the inside of the saddle-shaped actuator 84 and spaced from opposite sides of the post 149. The ratchet pin 146 extends transversely between the fingers 150 and is slidably received in an inclined slot 151 formed in each of the fingers 150.
The opposite ends of the ratchet pin 146 are received in the notches 142 formed in the support ledges 140. The notches 142 and ratchet pin 146 provide a ratchet mechanism for controlling the angular orientation of the stapling head assembly 60 relative to the longitudinal axis of the support tube 70. The notches 142 provide a series of stop positions which correspond to angular orientations preferably of 0, 15, 30, 45 and 60 degrees relative to the longitudinal axis of the support tube 70.
The saddle-shaped actuator 84 includes a pair of outwardly projecting ribs 85 which serve as finger grips to facilitate the longitudinal movement of the saddle-shaped actuator 84 along the handle assembly 60. The saddle-shaped actuator 84 includes a pair of inwardly projecting guides 87 (Figures 15 and 16) formed on each of its opposite sides which are snap-fit and slidably received into a pair of longitudinally extending channels 89 (one shown) formed on the exterior of the handle sections 91 and 92.
Referring to Figures 2 and 5, the staple actuating mechanism includes a driver link assembly 152 which is coupled to the staple driver 76 and actuated by the staple actuating lever 88. The driver link assembly 152 comprises a block-shaped slide member 154, preferably of plastic material, including a pair of vertically spaced flanges 156 extending from its opposite sides. Each of the handle sections 91 and 92 includes a horizontal support ledge 158 which is received between one pair of the side flanges 156 to slidably support the driver link assembly 152 on the actuator handle assembly 80. A cylindrical connector pin 160 projecting distally from the front of the slide block 154 includes an annular rim 162 for connecting the drive link assembly 152 to the staple driver 76. The connector pin 160 is inserted into a buckle-like connector 164 at the proximal end of the staple driver 76. The buckle like connector 164 has a pair of longitudinally spaced bands 166 and 168 which are curved outwardly in opposite directions and capture the annular flange 162 therebetween to couple the staple driver 76 and the driver link assembly 152 together for movement along the longitudinal axis of the support tube 70. Also, the buckle-like connector 164 is free to rotate about the axis of the connector pin 160 to allow the staple driver 76 and the articulation driver 78 to rotate when the support tube 70 is rotated about its longitudinal axis.
As shown in Figures 2 and 5, the staple actuating lever 88 includes a pair of upright fingers 170 which are spaced apart to receive a rearwardly projecting lug 172 formed on the slide member 154. The lug 172 is connected to a return coil spring 174 which is anchored to a post 176 on the handle section 92. The return spring 174 normally urges the slide 154 rearwardly into engagement with the upright arms 170 to retain the staple actuating lever 88 in the unactuated position (Figure 2).
The driver link asseanbly 152 includes a rearwardly projecting metal leaf spring 178 which is curved downwardly at its proximal end and provided with a pair of spring arms 180 projecting laterally from its opposite sides for engaging a pair of ratchets 182 (one shown) formed on the handle sections 91 and 92. The spring arms 180 and the ratchets 182 provide a ratchet mechanism which retains the driver link assembly 152 at different stages of advancement as the staple actuating lever 88 is actuated. Once the spring arms 180 are engaged with the ratchets 182, the driver link assembly 152 cannot return to its unactuated position until the stapling head assembly 60 is completely fired by operating the staple actuating lever 88.
Referring to Figures 1 and 6, the stapling head assembly 60 is pivotally mounted at the distal end of the support tube 70 for pivotal movement about an axis transverse to the longitudinal axis of the support tube 70. The stapling head assembly 60 is pivotally mounted on the support tube 70 by a pivot connection, generally 200, including a pair of pivot housings 201 and 202 of generally semi-cylindrical shape which are fit together and axe inserted into the distal end of the support tube 70. The pivot housings 201 and 202 are generally shaped as hollow semi-cylindrical sleeves for slidably receiving the staple driver 76 and the articulation driver 78. Adjacent to the proximal end of each of the pivot housings 201 and 202 is a semi-circular groove 204 which receives an O-ring 206 for engaging the interior of the support tube 70. The O-ring 206 helps to vent the staple cartridge 100 at the insufflation pressures of the abdominal cavity.
As shown in Figure 5, each of the pivot housings 201 and 202 includes a side opening 208 formed therein adjacent to the groove 204. When the pivot housings 201 and 202 are assembled, silicone is injected into the side openings 208 about the staple driver 76 and the articulation driver 78. With the pivot housings 201 and 202 inserted into the distal end of the support tube 70, a pair of dimples 210 (Figure 7) is formed on opposite sides of the support tube 70 to deform the tube material into the side openings 208 to fasten the pivot housings 201 and 202. Alternatively, in place of the injected silicone material, a hollow cylindrical silicone plug 209 (Figure 5) can be inserted into the proximal ends of the pivot housings 201 and 202. The silicone plug 209 includes a pair of distally projecting flanges 211 which slidably engage the outer surfaces of the staple driver 76 and the articulation driver 78.
Each of the pivot housings 201 and' 202 includes a distally projecting tang 212 which is provided with a pivot hole 214. The pivot housings 201 and 202 include front semi-circular flanges 216 which engage the distal end of the support tube 70.
The pivot connection 200 includes a pair of clamshell members 221 and 222 which are generally semi-cylindrical in shape and fit together inside a tubular clamshell sleeve 224. The clamshell members 221 and 222 each include a front semi-circular flange 226 which engages the distal edge of the clamshell sleeve 224. The front flanges 226 each include an interior semi-circular groove 228.
Each of the pivot housings 221 and 222 includes a detent arm 230 projecting inwardly through a side opening 232. Also, each pivot housing 221 and 222 includes a rearwardly extending tang 234 provided with an outwardly projecting pivot pin 236. The pivot pins 235 on the clamshell members 221 and 222 are pivotally received in the pivot holes 214 on the pivot housings 201 and 202. As shown in Figure 4, the pivot housing 221 has an arc-shaped groove 238 formed on its interior surface for receiving the guide pin 114 on the articulation driver 78.
The arc-shaped groove 238 and the guide pin 114 convert longitudinal movement of the articulation driver 78 into pivotal movement of the stapling head assemb1y~60. Preferably, the pivot housings 201 and 202 and the clamshell members 221 and 222 consist of plastic material.
Referring to Figure 6, the staple cartridge 100 of the stapling head assembly 60 has a hollow cylindrical housing 240 which is tapered at its distal end. Preferably, the staple cartridge housing 24C is a one-piece molded plastic member.
A hollow, generally cylindrical cartridge retainer 242 is inserted into the open proximal end of the staple cartridge housing 240. The cartridge retainer 242 has a pair of spring-like latch arms 244 located at diametrically opposed positions at the front of the retainer 242. The latch arms 244 are snap-fitted into a pair of diametrically opposed openings 245 adjacent to the proximal end of the cartridge housing 240 to hold the cartridge housing 240 and the retainer 242 together. The retainer 242 includes an annular flange 246 which is received in the annular grooves 228 of the clamshell members 221 and 222 to allow the staple cartridge 100 to rotate about its longitudinal axis relative to the support tube 70 and to the pivot Connection 200. A set of twelve uniformly spaced circumferential teeth 248 is formed at the proximal end of the retainer 242. The teeth 248 are engaged by the detent arms 230 on the clamshell members 221 and 222. The detent arms 230 and teeth 248 provide a ratchet mechanism which allows the rotational orientation of the staple cartridge 100 to be adjusted in increments of 30 degrees.
Inside the staple cartridge 100 is mounted a staple forming mechanism comprising an anvil 250, a staple holder 252 and a staple former 254 which are preferably made of stainless steel. The staple former 254 is channel-shaped in configuration for slidably receiving the staple holder 252 therein.
The staple former 254 has an elongated central slot 256 with a depending prong 258 at the proximal end of the slot 256. The staple holder 252 includes a depending prong 260 which is slidably received in the slot 256 and is biased away from the prong 258 by a compression coil spring 262. A feeder shoe 264 is slidably mounted within the staple cartridge 100 for urging a series of staples 65 toward the distal end of the cartridge 100. The feeder shoe 264 is biased in the distal direction by a compression coil spring 266 which is mounted on a distally projecting prong 268 on the cartridge retainer 242.
The staple driver 76 is connected to the staple former 254 by a plunger 270 which is slidably mounted between the clamshell members 221 and 222. The plunger 270 is a generally flat metal plate, e.g. aluminum, and includes a longitudinally extending side flange 272 slidably received in a longitudinal groove 274 formed in the clamshell member 222. The plunger 270 has a pivot hole 275 adjacent to its proximal end. A pivot link 278 includes a pair of laterally projecting pivot pins 280 and 282 which are pivotally received in the pivot holes 111 and 276, respectively, to attach the staple driver 76 to the plunger 270. The pivot link 278 transfers the longitudinal movement of the staple driver 76 into longitudinal movement of tie plunger 270. Also, the pivot link 278 permits the plunger 270 to pivot relative to the staple driver 76. At the distal end of the plunger 270, a smaller diameter front disk 284 is spaced from a larger diameter rear disk 286. The front disk 284 is inserted between a pair of inwardly projecting fingers 288 at the proximal end of the staple former 254 to transfer the longitudinal movement of the plunger 270 into longitudinal movement of the staple former 254. The front disk 284 and the inwardly projecting fingers 288 permit the staple former 254 to rotate relative to the plunger 270.
Referring to Figure 9, the staple cartridge housing 240 has an elongated hollow cylindrical wall 290 which preferably consists of transparent plastic material. Extending longitudinally inside the staple cartridge housing 240 is a first pair of elongated upstanding flanges 292 which are spaced apart and extend parallel to the longitudinal axis of the cylindrical wall 290. The elongated flanges 292 provide a set of guide rails for slidably supporting the staples 65 for longitudinal movement relative to the staple cartridge housing 240. Each flange or guide rail 292 has a ledge 293 (Figure 10) which is inclined at an angle to the axis of the cartridge housing 240 and terminates in an extension 294 of the guide rail 292 at the open distal end of the cartridge housing 240. Each of the flanges 292 is spaced inwardly from the cylindrical wall 290 to provide a pair of elongated side channels 295 (Figure 12) for receiving the depending legs 68 of the staples 65. The cartridge housing 240 includes a second pair of depending flanges 296 which are spaced apart and extend parallel to the longitudinal axis of the outer cylindrical wall 290. The upper flanges 296 terminate above the lower flanges 292 to provide a sufficient clearance therebetween to receive the crowns 66 of the staples 65. On the inside of each lower flange 292 is an elongated ledge 298 which slidably supports the staple former 254.
The staple cartridge housing 240 has a tapered nose 300 at its distal end including an internal horizontal ledge 302 provided with a longitudinal channel 304 for receiving the anvil 250 of the stapling head assembly 100. The ledge 302 has a rearwardly projecting post 306 to which the anvil 250 is secured. The tapered nose 300 has a central depending tab 308 located above the ledge 302 and provided with a downwardly sloped rear edge 309 which serves as a guide for the dimpled portion 67 of the staple 65 advanced by the staple forming mechanism. Also, the tapered rtase 300 includes a pair of sloped ramps 310 (Figure 11) on opposite sides of the central tab 308 for engaging. the crown 66 of the staple 65 which is advanced by the staple forming mechanism to pivot the staple 65 into an orientation parallel to the longitudinal axis of the cartridge housing 240. Each of the ramps 310 terminates at a ledge 312 located adjacent to one of the extensions 294 of the guide rails 292. A
window 314 is formed on each side of the cartridge housing 240 adjacent to one of the ramps 310 as a result of the molding process used to form the cartridge housing 240.
As shown in Figure 9, the staple former 254 is an elongated, channel-shaped member provided with upstanding side flanges 320 e~etending along its opposite sides. The staple holder 252 is an elongated plate-like member which is slidably supported on the staple former 254 and located between the side flanges 320. The compression coil spring 262 normally biases the staple holder 252 distally relative to the staple former 254 with the depending prong 260 biased against the distal end of the elongated central slot 256. The staple holder 252 and the staple 254 are inserted into the staple cartridge 240 between the lower upstanding flanges 292. The staple former 254 is slidably supported on the ledges 298 formed on the inside of the flanges 292. An ejector arm 322 extending from 2o the distal end of the staple holder 252 has a notch 324 for receiving the dimpled portion 67 of the staple 65. A pusher finger 326 projects forwardly into the notch 324 at the distal end of the staple holder 252 for engaging the dimpled portion 67 of the staple 65 as the staple holder 252 is advanced to move the staple 65 into engagement with the anvil 250. The distal end of the ejector arm 322 is slanted away from the level of the pusher finger 326 and serves to disengage the staple 65 from the anvil 250 as the staple holder 252 is retracted after the staple 65 is formed. A pair of fingers 328 at the tip of the ejector arm 322 are spaced apart to receive the depending tab 308 of the cartridge housing 320 therebetween.
The anvil 250 includes a pair of laterally spaced prongs 330 at its distal end which allow the ejector arm 322 to pass therebetween when the staple holder 252 is advanced. Each prong 330 includes an inclined ramp 332 for guiding the crown 66 of the staple 65 into engagement with the proximal side of the prong 330.
The staple follower 264 is channel-shaped and includes a generally flat top portion 340 which is slidably received between the lower flanges 292 and the upper flanges 296. The staple follower 264 also has a pair of depending side flanges 342 on its opposite sides which are received in the channels 294 adjacent to the lower flanges 292.
The staple follower 264 includes a rearwardly projecting post 344 which is inserted into the distal end of the compression coil spring 266.
Referring to Figures 9 and 19, a stack of staples 65 is mounted in the staple cartridge housing 240 with the staple crowns 66 resting on and.slidably supported by the elongated flanges or guide rails 292. The dimpled portions 67 of the staples 65 rest on top of the staple holder 252.
The row of staples 65 is urged forwardly toward the distal end of the cartridge 240 by the staple follower 264 and the compression coil spring 266.
The staple former 254 is biased rearwardly by the return spring 174 (Figure 2) in the actuator handle assembly 80 to urge the depending prong 258 against the front of the retainer 242. The staple holder 252 is biased forwardly by the compression coil spring 262 which urges the depending prong 260 against the front edge of the.slot 256 in the staple former 254. The ejector arm 322 at the distal end of the staple holder 252 is located ~1~~'~~'~~
adjacent to the guide tab 308 at the front of the tapered nase 300 of the staple cartridge 240.
As shown in Figure 19, the offset or dimpled portion 67 of the forwardmost staple 65 is located at a level different from the remaining staples 65 in the stack. The dimpled portion 67 of the forwardmost staple 65 is reCeiVed iri the notch 324 in front of the pusher finger 326. P~hen the staple holder 252 is advanced, the dimpled portion 67 of the forwardmost staple 65 is advanced along the sloped surface 309 and adjacent to the guide tab 308 by the pusher finger 326. The top portion or crown 66 of the forwardmost staple 65 is advanced along a path between the inclined ramps 310 (Figure 14) and the inclined ledges 293 of the guide rails 292 to rotate the staple 65 by 90 degrees about its dimpled portion 67.
As shown in Figure 20, with the staple holder partially advanced, the forwardmost staple 65 is rotated into a longitudinal orientation with its staple legs 68 parallel to the longitudinal axis of the staple cartridge housing 240. Thereafter, as shown in Figure 21, when the staple holder 252 is fully advanced, the forwardmost staple 65 travels along the extensions 294 of the guide rails 292 and is clamped against the anvil prongs 330 with the staple legs 68 projecting distally from the front of the staple cartridge housing 240. The remaining staples 65 in the stack are restrained by the top of the staple holder 252 which engages the dimpled portions 67 of the staples 65.
The staple forming mechanism of the staple cartridge 100 is actuated by squeezing the staple actuating lever 88 toward the handle grip 86. As a result, the staple actuating lever 88 is pivoted about the pivot pan 96 and the upright fingers i70 advance the slide member 154 in the distal direction. The slide member 154 advances the staple driver 76 in the distal direction which, in turn, advances the plunger 270 to actuate the staple holder 252 and the staple former 254. After the staple holder 252 and the staple former 254 are fully advanced to form one of the staples 65, the staple actuating lever 88 is released and returned to its original position by the return coil spring 174, which retracts the slide block 154 and tine staple driver 76.
The operation of the staple forming mechanism is illustrated in Figures 22-26 which, for clarity, show only one staple 65. Figure 22 shows the staple 65 positioned in the notch 324 in front of the pusher finger 326 at the start of the staple forming cycle which corresponds to the position of the staple holder 252 and staple former 254 shown in Figure 19. Initially, when the staple actuating lever 88 is actuated, the staple holder 252 and the staple former 254 are advanced simultaneously to advance the staple 65 toward the prongs 330 of the anvil 250. As the staple 65 is advanced toward the anvil prongs 330, the staple 65 is rotated by 90 degrees into a longitudinal ori'hntation (Figure 20) with the staple legs 68 pointing distally.
Figure 23 shows the staple holder 252 and the staple former 254 advanced to a staple clamping position corresponding to Figure 21 in which the staple crown 66 is clamped between the pusher finger 326 and the prongs 330 of the anvil 250.
Thereafter, as the staple actuating lever 88 is actuated, only the staple former 254 is advanced while the staple holder 252 remains stationary with ~~ D'~~~0 the staple 65 clamped against the anvil prongs 330.
Figure 24 shows the initial movement of the staple former 254 relative to the staple holder 252 to form the staple 65 about the anvil prongs 330.
The initial contact of the former flanges 320 with the staple 65 results in a slight bending of the staple crown 66 with the staple legs 68 angled toward each other.
Figure 25 shows an intermediate stage of the staple forming cycle in which the former flanges 320 are further advanced to bend the staple crown 66 around the anvil prongs 330 to bring the staple legs 68 closer together. Figure 26 shows the final stage of the staple forming cycle in which the former flanges 320 are fully advanced to bend the staple legs 68 into an overlapping configuration to secure the staple 65 to the tissue.
After the staple 65 is completely formed, the staple actuating lever 88 is released and the staple former 254 is moved rearwardly relative to the staple holder 252 by the compression coil spring 262. When the depending lug 260 is engaged by the front edge of the slot 256, the staple holder 252 and the staple former 254 are retracted together by the return spring 174 in the actuator handle assembly 80. The ejector arm 322 lifts the formed staple 65 from the anvil prongs 330 as the staple holder 252 is retracted. The staple holder 252 and the staple former 254 are returned to the start position shown in Figure 19 where the next staple 65 is received in the notch 324 in front of the pusher finger 326. Then, the staple forming cycle is repeated to form the next staple 65.
The actuator handle assembly 80 includes a precock racthet mechanism comprising the ratchet ~~o~~rro spring 178 and the ratchets 182 which prevents the retraction of the staple forming mechanism until the staple 65 is completely formed. The operation of the ratchet mechanism is illustrated in Figures 27-31 which show the various ratchet positions corresponding to the stages of the staple forming cycle shown in Figures 22-28, respectively.
As shown in Figure 27, each spring arm 180 of the ratchet spring 178 is initially disengaged from each ratchet 182 with the staple holder 252 and the staple former 254 located in the retracted position (Figure 22). As shown in Figure 28, each spring arm 180 of the ratchet spring 178 is engaged in the first notch of each ratchet 182 with the staple holder 252 and the staple former 254 in the advanced position (Figure 23) in which the staple 65 is clamped against the anvil prongs 330.
Thereafter, the engagement of the ratchet spring arms lso with the ratchets 182 prevents the staple holder 252 and the staple Former 254 from being retracted until the staple forming cycle is completed.
As shown in Figure 29, each spring arm 180 of the ratchet spring 178 is engaged in the second notch of each ratchet 182 with the flanges 320 of the staple former 254 initially engaged with the staple crown 66 to begin the forming of the staple 65 (Figure 24). As shown in Figure 30, each spring arm 180 of the ratchet spring 178 is engaged in the third notch of each ratchet 182 with the former flanges 320 advanced to the intermediate stage of the staple forming cycle (Figure 25) in which the staple legs 68 are partially closed.
As shown in Figure 31, each spring arm 180 of the ratchet spring 178 is disengaged from each ratchet 182 with the former flanges 320 fully advanced (Figure 26) to bend the staple legs 68 into an overlapping relationship. Each spring arm 180 travels rearwardly adjacent to the unmatched side of the corresponding ratchet 182 to allow the ratchet spring 178 to return to its retracted position (Figure 27) when the staple actuating lever 88 is released.
In performing a hernia repair procedure, the endoscopic surgical stapling instrument 50 is inserted into,a body cavity through a trocar tube or cannula installed in a body wall. Initially, the surgical stapling instrument 50 is introduced into the body cavity in its non-articulated mode, i.e., with the staple cartridge 100 aligned with the longitudinal axis of the support tube 70. An endoscope may be inserted into the body cavity through a separate trocar tube or cannula for observation of the surgical site. The stapling cartridge 100 is positioned in the desired orientation over the surgical site by operating the rotatable adjusting knob 82 and the saddle-shaped actuator 84 to adjust the rotational orientation of the support tube 70 and the angular orientation of the staple cartridge 100. The staple cartridge 100 can be articulated to angles of 15, 30, 45 and 60 degrees relative to the support tube 70 by retracting the saddle-shaped actuator 84.
If it is desired to change the rotational orientation of the staple cartridge 100 on its axis, the staple cartridge 100 is returned to the non-articulated mode by sliding the saddle-shaped actuator 84 forwardly. The surgical stapling instrument 50 is withdrawn from the trocar tube or cannula and the staple cartridge 100 is rotated 2:~p'~~~~
manually relative to the support tube 70. Then, the surgical stapling instrument 50 is reintroduced into the body cavity in its non-articulated mode and the orientation of the staple cartridge 100 is adjusted by operating the rotatable adjusting knob 82 and the saddle-shaped actuator 84.
With the staple cartridge 100 adjusted to the desired orientation, the staple actuator lever 88 is squeezed to actuate the staple forming mechanism 10' in the staple cartridge 100 to fasten one of the staples 65 to the tissue at the surgical site.
Thereafter, the staple cartridge 100 is shifted to another location and the operation is repeated to fasten another staple 65 to the tissue. When the staple actuator lever 88 is released, the formed staple 65 is disengaged from the anvil 250 of the staple cartridge 100.
Referring to Figure 18, the surgical stapling instrument 50 can be used to secure a hernia patch 62 at a desired surgical site. The hernia patch 62 is attached to internal body tissue 64 by applying a series of staples 65 to the edges of the hernia patch 62. The staple cartridge 100 is readily adjustable into the different orientations to apply the staples 65 at various locations along the edges of the hernia patch 62.
Figures 32 and 33 illustrate an alternative embodiment of the surgical stapling instrument, generally 350, including a distal stapling head assembly 360 which is pivotally connected to an elongated support tube 370 rotatably mounted on a proximal actuator handle assembly 380. A rotatable adjusting knob 382 is mounted at the distal end of the actuator handle assembly 380 for rotating the support tube 370 about its longitudinal axis. A
saddle-shaped actuator 384 is slidably mounted on the actuator handle assembly 380 for controlling the pivotal movement of the stapling head assembly 360 relative to the support tube 370. The actuator handle assembly 380 has a depending handle grip 386 and a pivotally mounted staple actuating lever 388 .
for actuating the stapling head assembly 360. The internal components of the stapling head assembly 360, the support shaft 370 and the actuator handle assembly 380 are substantially identical to the corresponding components of the surgical stapling instrument 50 described above. Accordingly, no detailed description of the internal components of the surgical stapling instrument 350 is necessary, and it will be understood by persons skilled in the art that the previous description of the internal components of the surgical stapling instrument 50 is applicable to the internal components of the surgical stapling instrument 350, unless otherwise described.
The stapling head assembly 360 includes a rotatably mounted staple cartridge 400 which is substantially identical in construction to the stapling cartridge 100 described above. The stapling head assembly 360 is pivotally mounted on on the support tube 370 by a pivot connection 390 which is substantially identical to the pivot connection 200 described above.
As shown in Figure 33, the handle assembly 380 includes a pair of hollow handle sections 392 which are adapted to snap fit together. Each of the handle sections 392 includes a distally extending elongated, semi-cylindrical neck portion 394 in which the proximal end of the support tube 370 is 3~ received and mounted for rotation about its ~~~~~~o longitudinal axis relative to the handle assembly 380. Each of the handle sections 392 includes an internal annular flange 395 (one shown) for engaging a radially projecting flange 372 at the proximal end of the support tube 370 to retain the support tube 370 within the handle assembly 380.
The staple actuating lever 388 is pivotally mounted on the actuator handle assembly 380 by a pivot pin 39E.
As shown in Figures 32 and 33, the adjusting knob 382 comprises a pair of elongated, hollow tapered sleeve-like sections 402 which fit together over the neck portions 394 of the handle sections 392. Each of the sleeve-like knob sections 402 has an inwardly projecting prong 403 adjacent to its distal end. The prongs 403 are received in a pair of holes formed on opposite sides of the support tube 370 to secure the knob sections 402 to the support tube 370. The actuator handle assembly 380 and the adjusting knob 382 include the same ratchet mechanism, described above in connection with the stapling instrument 50, which allows the adjusting knob 382 to rotate the support shaft 370 about its longitudinal axis in sixteen equal intervals of 22-1/2 degrees. Each of the knob sections 402 has an enlarged rear section 407 provided with alternating longitudinal ridges 408 and finger receiving grooves 409 which facilitate the rotation of the adjusting knob 382 and the support tube 370 by the surgeon.
The actuator handle assembly 380 includes a rotatable control knob 410 for controlling the rotation of the staple cartridge 400 about its longitudinal axis relative to the support shaft 370. The control knob 410 includes an elongated hollow, comically tapered portion 412 which is rotatably received between the sleeve-like sections 402 of the adjusting knob 382 and the cylindrical neck portions 394 of the handle secti~ns 392. A
hollow cylindrical, internally toothed geneva gear wheel 414 is secured within the distal end of the comically tapered body 412 for rotation with the control knob 410. A first pinion gear 416 which is rotatably mounted on the inside of the support tube 370 extends through a window 372 (Figure 35) formed in the side of the support tube 370 and engages the internal teeth on the geneva gear wheel 414. The pinion gear 416 is attached to a flexible cable 418 which extends longitudinally through the support shaft 370 and the pivot connection 390. The distal end of the flexible cable 418 is connected to a second pinion gear 420 rotatably supported in a bushing 422 (Figure 34) mounted on the inside of one of the clamshell members 424 forming part of the pivot connection 390. The flexible cable 418 is formed of conventional materials such as steel alloys.. The staple cartridge 400 is mounted on a cylindrical retainer 426 which is rotatably supported by the clamshell members 424 of the pivot connection 390. The cartridge retainer 422 has an internally toothed geneva gear wheel 428 (Figure 36) at its proximal end which engages the pinion gear 420.
In the operation of the surgical stapling instrument 350, the control knob 410 is used to control the rotational orientation of the staple cartridge 400 relative to the support shaft 370 and the pivot connection 390. The rotation of the control knob 410 is transmitted via the flexible cable 418 to the cartridge retainer 422 which 2~~'~~~Q
rotates the staple cartridge 400 about its axis.
As a result, the rotational orientation of the staple cartridge 400 relative to the support shaft 370 is adjustable by the rotation of the control 5 knob 410.
Except for the control knob 410 which rotates the staple cartridge 400, the surgical stapling instrument 350 operates in substantially the same manner as the stapling instrument 50 described 10 above. the rotatable adjusting knob 382 is used to rotate the support shaft 370 relative to the actuator handle assembly 380. ~'he saddle-shaped actuator 384 is slidable longitudinally along the actuator handle assembly 380 to pivot the stapling 15 head assembly 360 about an axis transverse to the longitudinal axis of the support shaft 370. the staple actuating lever 388 is pivoted to actuate the staple forming mechanism of the staple cartridge 400 in substantially the_same manner as 20 described above.
figures 37-40 show an alternative embodiment of a stapling head assembly, generally 460, which can be used with the surgical stapling instrument 50 described above. 'fhe stapling head assembly 460 25 is pivotally mounted at the distal end of the support tube 70 by a pivot connection 470 including a tubular pivot housing 472 secured to the support tube 70 and a tubular cartridge support member 474 pivotally connected to the pivot housing 472 by a 30 pair of pivot pins 476 extending laterally from opposite sides of the cartridge support member 474.
An inclined slot 478 is formed on one side of the cartridge support member 474.
A staple cartridge 500 is mounted at the 35 distal end of the cartridge support member 474.
The staple cartridge 500 is generally cylindrical in shape and is adapted to be received in the open distal end of the cartridge support member 474.
The staple cartridge 500 has a pair of latch pins 502 projecting radially outward its opposite sides.
The latch pins 502 are received and latched in a pair of slots 504 extending longitudinally from the distal end of the cartridge support member 474.
The latch pins 502 and slots 504 allow the staple cartridge 500 to be disengaged from the cartridge support member 474 when it is desired to replace the staple cartridge 500.
As shown Figure 40, an articulation control member 480 is~slidably mounted in the pivot housing 472 and is connected to the articulation driver 78.
A laterally projecting guide pin 482 is located adjacent to the distal end of the articulation control member 480 and is slidably received in the inclined slot 478 of the cartridge support member 474. The inclined slot 478 and the guide pin 482 convert longitudinal movement of the articulation driver 78 into pivotal movement of the stapling head assembly 460 about the pivot pins 476.
As shown in Figure 39, a plunger 490 is slidably mounted for longitudinal movement in the cartridge support member 474. The plunger 490 includes an elongated laterally projecting side flange 492 which is slidably received in a longitudinal slot 494 (Figure 38) formed on the side of the cartridge support member 474. The plunger 490 has a semi-circular rear edge 495 which is engaged by an inclined cam surface 496 on a drive member 498 mounted at the distal end of the staple driver 76. The front end of the plunger 490 is engaged with the staple forming mechanism inside the staple cartridge 500.
then the staple driver 76 is advanced in the distal direction, the plunger 490 is advanced to actuate the staple forming mechanism of the staple cartridge 50o which operates in substantially the same manner as described above. The semi-circular rear edge 496 of the plunger 90 and the inclined cam surface 498 at the distal end of the staple driver 76 allow the staple forming mechanism to be actuated in any angular orientation of the staple cartridge 5o0.
The invention in its broader aspects is not limited to the specific details of the preferred embodiments shown and described, and those skilled in the art will recognize that the invention can be practiced with modification within the spirit and scope of the appended claims.
It is also an object of the invention to provide an endoscopic surgical stapling instrument in which the pivotal movement and rotation of the staple cartridge can be controlled from a remote actuator handle assembly.
It is another object of the invention to provide an endoscopic surgical stapling instrument which facilitates manipulation by a surgeon to control the orientation and acutation of the staple cartridge.
A further object of the invention is to provide a staple cartridge for use with a surgical stapling instrument which includes an improved staple forming mechanism for advancing the staples one at a time into engagement with an anvil about which the staple is formed to secure the staple to the tissue.
The present invention achieves an improved endoscopic surgical stapler which is adapted for insertion through an endoscopic tube or cannula into a body cavity to apply one or more surgical staples to the internal body tissue. The surgical sapling instrument includes a staple cartridge which is pivotally mounted at the distal end of a tubular support shaft extending from a handle which includes a staple actuator mechanism for actuating the staple cartridge to fasten the staples seriatim to the tissue. The staple cartridge is mounted for pivotal movement relative to the support shaft about an axis transverse to the longitudinal axis of the support shaft to permit the angular orientation of the staple cartridge to be adjusted.
Also, the staple cartridge is mounted for rotation relative to the support shaft to permit the rotational orientation of the staple cartridge to be adjusted. In addition, the support shaft is rotatable about its longitudinal axis relative to the handle. These features of the stapling instrument allow the staple cartridge to be precisely aligned with the desired region of the internal body tissue to which the staple is applied. Separate actuator mechanisms are provided on the handle for controlling the rotation of the support shaft, the pivoting of the staple cartridge relative to the support shaft, and the rotation of the staple cartridge relative to the support shaft.
These actuator mechanisms facilitate manipulation of the stapling instrument by a surgeon to position the staple cartridge in a desired orientation.
In accordance with one aspect of the invention, the surgical stapling instrument is provided with pivot means at the distal end of the support shaft for mounting the staple cartridge for pivotal movement about an axis transverse to the longitudinal axis of the support shaft. Actuator means is provided on the handle for pivoting the staple cartridge about the transverse axis to adjust the angular position of the staple cartridge relative to the support shaft. The stapling instrument includes means for retaining the staple cartridge in different angular positions relative to the support shaft. The staple cartridge has a staple forming mechanism which can be actuated by the staple actuator mechanism with the staple cartridge oriented in any of its different angular positions.
The surgical stapling instrument includes actuator means on the handle for rotating the support shaft about its longitudinal axis to adjust the rotational orientation of the support shaft and the staple cartridge. Also, means is provided for retaining the support shaft in different rotational positions as the support shaft is rotated about its longitudinal axis.
In a preferred embodiment of the surgical stapling instrument, the staple cartridge is mounted for rotation about its longitudinal axis relative to the support shaft. Actuator means is provided on the handle for rotating the staple cartridge to adjust the rotational position of the staple cartridge relative to the support shaft.
Also, means is provided for retaining the staple cartridge in different rotational positions as the staple cartridge is rotated about its longitudinal axis relative to the support shaft.
In accordance with another aspect of the invention, a staple cartridge for use with a stapling instrument for applying one or more surgical staples to tissue comprises a cartridge housing adapted to receive a plurality of staples in a row for longitudinal movement therethrough, an anvil mounted on the housing, means for advancing the forwardmost staple in the row into engagement with the anvil, means for rotating the forwardmost staple from a transverse orientation into a longitudinal orientation as the staple is advanced toward the anvil, and means for forming the forwardmost staple about the anvil to attach the staple to the tissue. The staple advancing means comprises a staple holder slidably mounted within the cartridge housing for advancing the forwardmost staple from the row and clamping the staple against the anvil. The staple rotating means comprises ramp means on the cartridge housing for engaging and rotating the forwardmost staple into a longitudinal orientation as the staple is advanced by the staple holder. The staple forming means comprises a staple former slidably mounted within l0 the cartridge housing for movement relative to the staple holder and adapted to form the forwardmost staple about the anvil. Preferably, the staple holder includes an ejector arm for removing the forwardmost staple from the anvil after the staple is formed.
A preferred embodiment of the staple cartridge is adapted for use with a staple having a generally U-shaped body including a crown with a central offset portion and a pair of depending legs at opposite sides of the crown. The staple cartridge comprises an elongated hollow cylindrical cartridge housing including a pair of spaced parallel guide rails therein for slidably supporting a stack of staples for longitudinal movement therealong with the staple crowns resting on the guide rails and the staple legs oriented perpendicularly to the longitudinal axis of the cartridge housing. A
staple follower is slidably mounted on the guide rails for urging the staples forwardly on the guide rails toward the distal end of the cartridge housing. An anvil is mounted adjacent to the distal end of the cartridge housing. A staple holder is slidably mounted between the guide rails for engaging the central offset portion of the forwardmost staple to advance the staple from the ~~~~9~~
stack into engagement with the anvil. Ramp means is provided on the cartridge housing for engaging the crown of the forutardmost staple advanced by the staple holder and rotating the staple into a longitudinal orientation with the staple legs oriented parallel to the longitudinal axis of the cartridge housing. A staple former is slidably mounted between the guide rails and movable relative to the staple holder for engaging the crown of the forwardmost staple to forin the staple about the anvil to attach the staple to the tissue.
In the preferred embodiment of the staple cartridge, the~staple former comprises an elongated channel-shaped member including upstanding side flanges extending along its opposite sides for engaging and forming the staple. The staple holder comprises an elongated plate-like member slidably supported on the staple former and located between the side flanges. The staple holder includes a notch at its distal end for receiving the forwardmost staple to be advanced. The staple holder also includes a pusher finger at its distal end for engaging the forwardmost staple and clamping the staple against the anvil. In addition, the staple holder includes an~ejector arm at its distal end for removing-the formed staple from the anvil when the staple holder is retracted.
BRIBF DFSORIPTION OF THF DRAWINGS
The foregoing and other objects, aspects and advantages will be better understood from the following detailed description of the preferred embodiments of the invention with reference to the drawings, in which:
Figure 1 is an overall perspective view of an endoscopic surgical stapling instrument constructed in accordance with this invention:
Figure 2 is a partially cutaway side view of the stapling instrument of Figure 1;
Figure 3 is an enlarged longitudinal section of the stapling head assembly of Figure 2:
Figure 4 is an enlarged longitudinal section of the stapling head assembly from the opposite side of Figure 3:
Figures 5 and 6 are exploded perspective views showing the components of the stapling instrument of Figure 1:
Figure 7 is an enlarged partially cutaway horizontal section of the stapling head assembly and support shaft of Figure 2:
Figure 8 is an enlarged partially cutaway vertical section of the stapling head assembly and support shaft of Figure 2:
Figure 9 is an enlarged, exploded perspective view showing the staple cartridge and the staple forming mechanism of the stapling head assembly:
Figure 10 is an enlarged langitudinal section of the staple cartridge of Figure 9:
Figure 11 is an enlarged longitudinal section of the staple cartridge along line 11-11 of Figure 10:
2~fl'~~~~
Figure 12 is an enlarged proximal end view of the staple cartridge;
Figure 13 is an enlarged distal end view of the stapling head assembly of Figure 3;
° 5 Figure 14 is an enlarged fragmentary section of the staple cartridge taken along line 14-14 of Figure 11;
Figure 15 is a longitudinal section of a slide actuator for pivoting the stapling head assembly;
Figure 16 is a proximal end view of the slide actuator of Figure 15;
Figure 17 is an enlarged plan view of a staple for use with the surgical stapling instrument of this invention;
Figure 18 illustrates a hernia repair patch fastened to tissue with staples applied by the surgical stapling instrument of this invention;
Figure 19 is an enlarged longitudinal section of the staple cartridge of Figure 9 showing the staple forming mechanism in a retracted position;
Figure 20 is an enlarged longitudinal section of the staple cartridge of Figure 9 showing the staple forming mechanism advanced to rotate a staple into a longitudinal orientation;
Figure 21 is an enlarged longitudinal section of the staple cartridge of Figure 9 showing the staple forming mechanism advanced to clamp the staple against an anvil of the staple cartridge;
Figures 22-26 illustrate the operation of the staple forming mechanism in advancing and forming a staple;
Figures 27-31 are fragmentary views showing the operation of a precock ratchet mechanism in the actuator handle assembly;
Figure 32 is an overall perspective view of an alternative embodiment of the surgical stapling instrument constructed in accordance with this invention;
Figure 33 is a partially cutaway side view of the stapling instrument of Figure 32;
Figure 34 is an enlarged longitudinal section of the stapling head assembly from the opposite side of Figure 32:
l0 Figure 35 is an enlarged cross section of the stapling instrument along line 35-35 of Figure 33:
Figure 3E is an enlarged cross section of the stapling instrument along line 36-36 of Figure 33;
Figure 37 is a perspective view of another embodiment of a stapling head assembly for use with the surgical stapling instrument of this invention:
Figure 38 is a side view of the stapling head assembly from the opposite side of Figure 37;
Figure 39 is a partially cutaway side view of the stapling head assembly of Figure 38; and Figure 40 is a partially cutaway side view of the stapling head assembly from the opposite side of Figure 39.
DETAIDED DESCRIPTION OF PREFERRED EMEODIMENTS
Referring to Figure 1, the present invention is embodied in an articulating endoscopic surgical stapling instrument, generally 50, including a distal stapling head assembly 60 which is pivotally connected to an elongated support tube 70 rotatably mounted on a proximal actuator handle assembly 80.
A rotatable adjusting knob 82 is mounted at the distal end of the actuator handle assembly 80 for rotating the support tube 70 about its longitudinal axis. A saddle-shaped actuator 84 is slidably mounted on the actuator handle assembly 80 for controlling the pivotal movement of the stapling head assembly 60 relative to the support tube 70.
The actuator handle assembly 80 includes a depending handle grip 86 and a pivotally mounted staple actuating lever 88 for actuating a staple cartridge 100 on the stapling head assembly 60.
Preferably, the actuator handle assembly 80, the adjusting knob 82, the saddle-shaped actuator 84 and the staple actuating lever 88 consist of plastic material.
Referring to Figure 14, a staple 65 adapted for use with the surgical stapling instrument 50 of the present invention comprises-a wire-like body of circular cross section which is bent in a generally ~-shaped configuration. Preferably, the staple 65 consists of titanium or stainless steel. The staple 65 includes a top portion or crown 66 provided with a central dimpled portion 67 which is offset downwardly from the crown 66 by an amount approximately equal to the diameter of the circular cross section of the staple 65. The opposite sides of the staple 65 are bent downwardly to provide a pair of depending legs 68 which are substantially perpendicular to the crown 66. Each leg 68 has a beveled end 69 which is beveled at an angle of approximately 45 degrees. When the staple 65 is closed by operation of the surgical stapling instrument 50, the staple legs 68 overlap each other as shown by phantom lines in Figure 14 to secure the staple to the tissue.
As shown in Figures 1 and 5, the handle l0 assembly 80 includes a pair of hollow handle sections 91 and 92 which are adapted to snap fit together. The handle sections 91 and 92 include distally extending elongated, semi-cylindrical neck portions 93 and 94 which receive the proximal end of the support tube 70 therebetween and mount the support tube 70 for rotation about its longitudinal axis relative to the handle assembly 80. Each of the handle sections 91 and 92 includes an internal annular flange 95 (one shown) for engaging a radially projecting flange 72 at the proximal end of the support tube 70 to retain the support tube 70 within the handle assembly 80. The staple actuating lever 88 is pivotally mounted on the actuator handle assembly 80 by a pivot pin 96 extending through a pivot hole 90 in the lever 88.
The pivot pin 96 is received in a pair of hollow cylindrical support stems 97 (one shown) formed on the inside of the handle sections 91 and 92.
As shown in Figures 1 and 5, the adjusting knob 82 comprises a pair of elongated hollow, tapered sleeve-like sections 101 and 102 which fit together over the neck portions 93 and 94 of the handle sections 91 and 92, respectively. Each of the sleeve-like knob sections 101 and 102 has an inwardly projecting prong 103 adjacent to its distal end. The prongs 103 are received in a pair of holes 74 (one shown) formed on opposite sides of the support tube 70 to secure the knob sections 101.
and 102 to the support tube 70. Each of the knob sections 101 and 102 includes a semi-circular ratchet 104 on its inner wall for engaging a pair of detents 105 mounted on resilient arms 106 formed on each of the handle sections 91 and 92. The semi-circular ratchets 104 and the detents 105 provide a ratchet mechanism for retaining the support tube 70 in different rotational positions as the support tube 70 is rotated about its longitudinal axis. For example, each ratchet 104 is provided with eight ratchet teeth which allow the support tube to be rotated in sixteen equal angular increments of 22-1/2 degrees. Each of the knob sections 101 and 102 has an enlarged rear section 107 provided with alternating longitudinal ridges 108 and finger-receiving grooves 109 which facilitate the rotation of the adjusting knob 82 and the support tube 70 by the surgeon.
The support tube 70 is an elongated, thin-walled rigid metal tube, e.g., stainless steel.
Inside the support tube 70 are mounted an elongated staple driver 76 and an elongated articulation driver 78 which are slidable longitudinally relative to the support tube 70 and relative to each other. The articulation driver 78 pivots the stapling head assembly 60 in response to movement of the saddle-shaped actuator 84 along the actuator handle assembly 80. The staple driver 76 actuates the staple forming mechanism within the staple cartridge 62 when the staple actuating lever 88 is operated. Preferably, the staple driver 76 and the articulation driver 78 consist of stainless steel.
As shown ir. Figures 5 and 6, the staple driver 76 comprises an elongated thin flat rod including a pair of spaced parallel flanges 110 which extend longitudinally along its top and bottom edges. The staple driver 76 has a pivot hole 111 (Figure 6) adjacent to its distal end and a longitudinal slot 112 (Figure 5) adjacent to its proximal end. The artic~.alation driver 78 comprises an elongated thin flat rod which is slidably mounted adjacent to the l0 staple driver 76 and is slidably received between the flanges 110. The articulation driver 78 has an enlarged distal portion 113 (Figure 6) with a laterally projecting guide pin 114 formed adjacent to its distal end. An assembly hole 115 (Figure 5) is formed adjacent to the proximal end of the articulation driver 78. A driver guide member 116 of generally cylindrical shape is mounted within the proximal end of the support tube 70. The driver guide member 116 has a pair of opposed, outwardly extending posts 117 which are received in a pair of corresponding holes 118 formed adjacent to the proximal end of the support tube 70. The driver guide 116 has a rectangular slot 119 extending therethrough for slidably receiving the staple driver 76 and the articulation driver 78.
As shown in Figures 2 and 5, a driver coupling member 120, preferably made of plastic material, includes an opening 122 extending longitudinally therethrough for receiving the proximal ends of the staple driver 76 and the articulation driver 78.
The driver coupling member 120 is secured to the articulation driver 78 by a coupling pin 124 which is received in the hole 115 in the articulation driver 78 and extends through a pair of apertures 126 formed on opposite sides of the coupling member 120. The coupling pin 124 is slidably received in the longitudinal slot 112 of the staple driver 76 to allow the articulation driver 78 to slide longitudinally relative to the the staple driver 76. A pair of spaced annular flanges 128 and 130 are provided at the proximal end of the coupling member 120 for connection to an articulation control mechanism on the actuator handle assembly 80.
The saddle-shaped actuator 84 operates a slide member 132 which is coupled to the driver coupling member 120 to operate the articulation driver 78.
The saddle slide member 132 is a generally flat metal plate with an elongated neck 134 projecting distally and having a pair of curved depending arms 136 provided with inwardly projecting fingers 138 which are received between the annular flanges 128 and 130 on the driver coupling member 120. The annular flanges 128 and 130 capture the fingers 138 therebetween and connect the coupling member 120 to the saddle slide member 132 for longitudinal movement therewith. The annular flanges 138 allow the coupling member 120 to rotate about its longitudinal axis relative to the saddle slide member 132 when the support shaft 70 is rotated by the adjusting knob 82.
The saddle slide member 132 is slidably mounted on a pair of horizontal support ledges 140 (one shown) formed on the interior of the handle sections 91 and 92. Each support ledge 140 includes a series of uniformly spaced notches 142 arranged in a longitudinal row. The saddle slide member 132 is formed with a transverse notch 144 for receiving a ratchet pin 146 which is biased downwardly into the notch 144 by a coil spring 148 2~~~~~~
mounted on an inclined post 149 formed on the inside of the saddle-shaped actuator 84. A pair of inclined fingers 150 (Figures 15 and 16) is formed on the inside of the saddle-shaped actuator 84 and spaced from opposite sides of the post 149. The ratchet pin 146 extends transversely between the fingers 150 and is slidably received in an inclined slot 151 formed in each of the fingers 150.
The opposite ends of the ratchet pin 146 are received in the notches 142 formed in the support ledges 140. The notches 142 and ratchet pin 146 provide a ratchet mechanism for controlling the angular orientation of the stapling head assembly 60 relative to the longitudinal axis of the support tube 70. The notches 142 provide a series of stop positions which correspond to angular orientations preferably of 0, 15, 30, 45 and 60 degrees relative to the longitudinal axis of the support tube 70.
The saddle-shaped actuator 84 includes a pair of outwardly projecting ribs 85 which serve as finger grips to facilitate the longitudinal movement of the saddle-shaped actuator 84 along the handle assembly 60. The saddle-shaped actuator 84 includes a pair of inwardly projecting guides 87 (Figures 15 and 16) formed on each of its opposite sides which are snap-fit and slidably received into a pair of longitudinally extending channels 89 (one shown) formed on the exterior of the handle sections 91 and 92.
Referring to Figures 2 and 5, the staple actuating mechanism includes a driver link assembly 152 which is coupled to the staple driver 76 and actuated by the staple actuating lever 88. The driver link assembly 152 comprises a block-shaped slide member 154, preferably of plastic material, including a pair of vertically spaced flanges 156 extending from its opposite sides. Each of the handle sections 91 and 92 includes a horizontal support ledge 158 which is received between one pair of the side flanges 156 to slidably support the driver link assembly 152 on the actuator handle assembly 80. A cylindrical connector pin 160 projecting distally from the front of the slide block 154 includes an annular rim 162 for connecting the drive link assembly 152 to the staple driver 76. The connector pin 160 is inserted into a buckle-like connector 164 at the proximal end of the staple driver 76. The buckle like connector 164 has a pair of longitudinally spaced bands 166 and 168 which are curved outwardly in opposite directions and capture the annular flange 162 therebetween to couple the staple driver 76 and the driver link assembly 152 together for movement along the longitudinal axis of the support tube 70. Also, the buckle-like connector 164 is free to rotate about the axis of the connector pin 160 to allow the staple driver 76 and the articulation driver 78 to rotate when the support tube 70 is rotated about its longitudinal axis.
As shown in Figures 2 and 5, the staple actuating lever 88 includes a pair of upright fingers 170 which are spaced apart to receive a rearwardly projecting lug 172 formed on the slide member 154. The lug 172 is connected to a return coil spring 174 which is anchored to a post 176 on the handle section 92. The return spring 174 normally urges the slide 154 rearwardly into engagement with the upright arms 170 to retain the staple actuating lever 88 in the unactuated position (Figure 2).
The driver link asseanbly 152 includes a rearwardly projecting metal leaf spring 178 which is curved downwardly at its proximal end and provided with a pair of spring arms 180 projecting laterally from its opposite sides for engaging a pair of ratchets 182 (one shown) formed on the handle sections 91 and 92. The spring arms 180 and the ratchets 182 provide a ratchet mechanism which retains the driver link assembly 152 at different stages of advancement as the staple actuating lever 88 is actuated. Once the spring arms 180 are engaged with the ratchets 182, the driver link assembly 152 cannot return to its unactuated position until the stapling head assembly 60 is completely fired by operating the staple actuating lever 88.
Referring to Figures 1 and 6, the stapling head assembly 60 is pivotally mounted at the distal end of the support tube 70 for pivotal movement about an axis transverse to the longitudinal axis of the support tube 70. The stapling head assembly 60 is pivotally mounted on the support tube 70 by a pivot connection, generally 200, including a pair of pivot housings 201 and 202 of generally semi-cylindrical shape which are fit together and axe inserted into the distal end of the support tube 70. The pivot housings 201 and 202 are generally shaped as hollow semi-cylindrical sleeves for slidably receiving the staple driver 76 and the articulation driver 78. Adjacent to the proximal end of each of the pivot housings 201 and 202 is a semi-circular groove 204 which receives an O-ring 206 for engaging the interior of the support tube 70. The O-ring 206 helps to vent the staple cartridge 100 at the insufflation pressures of the abdominal cavity.
As shown in Figure 5, each of the pivot housings 201 and 202 includes a side opening 208 formed therein adjacent to the groove 204. When the pivot housings 201 and 202 are assembled, silicone is injected into the side openings 208 about the staple driver 76 and the articulation driver 78. With the pivot housings 201 and 202 inserted into the distal end of the support tube 70, a pair of dimples 210 (Figure 7) is formed on opposite sides of the support tube 70 to deform the tube material into the side openings 208 to fasten the pivot housings 201 and 202. Alternatively, in place of the injected silicone material, a hollow cylindrical silicone plug 209 (Figure 5) can be inserted into the proximal ends of the pivot housings 201 and 202. The silicone plug 209 includes a pair of distally projecting flanges 211 which slidably engage the outer surfaces of the staple driver 76 and the articulation driver 78.
Each of the pivot housings 201 and' 202 includes a distally projecting tang 212 which is provided with a pivot hole 214. The pivot housings 201 and 202 include front semi-circular flanges 216 which engage the distal end of the support tube 70.
The pivot connection 200 includes a pair of clamshell members 221 and 222 which are generally semi-cylindrical in shape and fit together inside a tubular clamshell sleeve 224. The clamshell members 221 and 222 each include a front semi-circular flange 226 which engages the distal edge of the clamshell sleeve 224. The front flanges 226 each include an interior semi-circular groove 228.
Each of the pivot housings 221 and 222 includes a detent arm 230 projecting inwardly through a side opening 232. Also, each pivot housing 221 and 222 includes a rearwardly extending tang 234 provided with an outwardly projecting pivot pin 236. The pivot pins 235 on the clamshell members 221 and 222 are pivotally received in the pivot holes 214 on the pivot housings 201 and 202. As shown in Figure 4, the pivot housing 221 has an arc-shaped groove 238 formed on its interior surface for receiving the guide pin 114 on the articulation driver 78.
The arc-shaped groove 238 and the guide pin 114 convert longitudinal movement of the articulation driver 78 into pivotal movement of the stapling head assemb1y~60. Preferably, the pivot housings 201 and 202 and the clamshell members 221 and 222 consist of plastic material.
Referring to Figure 6, the staple cartridge 100 of the stapling head assembly 60 has a hollow cylindrical housing 240 which is tapered at its distal end. Preferably, the staple cartridge housing 24C is a one-piece molded plastic member.
A hollow, generally cylindrical cartridge retainer 242 is inserted into the open proximal end of the staple cartridge housing 240. The cartridge retainer 242 has a pair of spring-like latch arms 244 located at diametrically opposed positions at the front of the retainer 242. The latch arms 244 are snap-fitted into a pair of diametrically opposed openings 245 adjacent to the proximal end of the cartridge housing 240 to hold the cartridge housing 240 and the retainer 242 together. The retainer 242 includes an annular flange 246 which is received in the annular grooves 228 of the clamshell members 221 and 222 to allow the staple cartridge 100 to rotate about its longitudinal axis relative to the support tube 70 and to the pivot Connection 200. A set of twelve uniformly spaced circumferential teeth 248 is formed at the proximal end of the retainer 242. The teeth 248 are engaged by the detent arms 230 on the clamshell members 221 and 222. The detent arms 230 and teeth 248 provide a ratchet mechanism which allows the rotational orientation of the staple cartridge 100 to be adjusted in increments of 30 degrees.
Inside the staple cartridge 100 is mounted a staple forming mechanism comprising an anvil 250, a staple holder 252 and a staple former 254 which are preferably made of stainless steel. The staple former 254 is channel-shaped in configuration for slidably receiving the staple holder 252 therein.
The staple former 254 has an elongated central slot 256 with a depending prong 258 at the proximal end of the slot 256. The staple holder 252 includes a depending prong 260 which is slidably received in the slot 256 and is biased away from the prong 258 by a compression coil spring 262. A feeder shoe 264 is slidably mounted within the staple cartridge 100 for urging a series of staples 65 toward the distal end of the cartridge 100. The feeder shoe 264 is biased in the distal direction by a compression coil spring 266 which is mounted on a distally projecting prong 268 on the cartridge retainer 242.
The staple driver 76 is connected to the staple former 254 by a plunger 270 which is slidably mounted between the clamshell members 221 and 222. The plunger 270 is a generally flat metal plate, e.g. aluminum, and includes a longitudinally extending side flange 272 slidably received in a longitudinal groove 274 formed in the clamshell member 222. The plunger 270 has a pivot hole 275 adjacent to its proximal end. A pivot link 278 includes a pair of laterally projecting pivot pins 280 and 282 which are pivotally received in the pivot holes 111 and 276, respectively, to attach the staple driver 76 to the plunger 270. The pivot link 278 transfers the longitudinal movement of the staple driver 76 into longitudinal movement of tie plunger 270. Also, the pivot link 278 permits the plunger 270 to pivot relative to the staple driver 76. At the distal end of the plunger 270, a smaller diameter front disk 284 is spaced from a larger diameter rear disk 286. The front disk 284 is inserted between a pair of inwardly projecting fingers 288 at the proximal end of the staple former 254 to transfer the longitudinal movement of the plunger 270 into longitudinal movement of the staple former 254. The front disk 284 and the inwardly projecting fingers 288 permit the staple former 254 to rotate relative to the plunger 270.
Referring to Figure 9, the staple cartridge housing 240 has an elongated hollow cylindrical wall 290 which preferably consists of transparent plastic material. Extending longitudinally inside the staple cartridge housing 240 is a first pair of elongated upstanding flanges 292 which are spaced apart and extend parallel to the longitudinal axis of the cylindrical wall 290. The elongated flanges 292 provide a set of guide rails for slidably supporting the staples 65 for longitudinal movement relative to the staple cartridge housing 240. Each flange or guide rail 292 has a ledge 293 (Figure 10) which is inclined at an angle to the axis of the cartridge housing 240 and terminates in an extension 294 of the guide rail 292 at the open distal end of the cartridge housing 240. Each of the flanges 292 is spaced inwardly from the cylindrical wall 290 to provide a pair of elongated side channels 295 (Figure 12) for receiving the depending legs 68 of the staples 65. The cartridge housing 240 includes a second pair of depending flanges 296 which are spaced apart and extend parallel to the longitudinal axis of the outer cylindrical wall 290. The upper flanges 296 terminate above the lower flanges 292 to provide a sufficient clearance therebetween to receive the crowns 66 of the staples 65. On the inside of each lower flange 292 is an elongated ledge 298 which slidably supports the staple former 254.
The staple cartridge housing 240 has a tapered nose 300 at its distal end including an internal horizontal ledge 302 provided with a longitudinal channel 304 for receiving the anvil 250 of the stapling head assembly 100. The ledge 302 has a rearwardly projecting post 306 to which the anvil 250 is secured. The tapered nose 300 has a central depending tab 308 located above the ledge 302 and provided with a downwardly sloped rear edge 309 which serves as a guide for the dimpled portion 67 of the staple 65 advanced by the staple forming mechanism. Also, the tapered rtase 300 includes a pair of sloped ramps 310 (Figure 11) on opposite sides of the central tab 308 for engaging. the crown 66 of the staple 65 which is advanced by the staple forming mechanism to pivot the staple 65 into an orientation parallel to the longitudinal axis of the cartridge housing 240. Each of the ramps 310 terminates at a ledge 312 located adjacent to one of the extensions 294 of the guide rails 292. A
window 314 is formed on each side of the cartridge housing 240 adjacent to one of the ramps 310 as a result of the molding process used to form the cartridge housing 240.
As shown in Figure 9, the staple former 254 is an elongated, channel-shaped member provided with upstanding side flanges 320 e~etending along its opposite sides. The staple holder 252 is an elongated plate-like member which is slidably supported on the staple former 254 and located between the side flanges 320. The compression coil spring 262 normally biases the staple holder 252 distally relative to the staple former 254 with the depending prong 260 biased against the distal end of the elongated central slot 256. The staple holder 252 and the staple 254 are inserted into the staple cartridge 240 between the lower upstanding flanges 292. The staple former 254 is slidably supported on the ledges 298 formed on the inside of the flanges 292. An ejector arm 322 extending from 2o the distal end of the staple holder 252 has a notch 324 for receiving the dimpled portion 67 of the staple 65. A pusher finger 326 projects forwardly into the notch 324 at the distal end of the staple holder 252 for engaging the dimpled portion 67 of the staple 65 as the staple holder 252 is advanced to move the staple 65 into engagement with the anvil 250. The distal end of the ejector arm 322 is slanted away from the level of the pusher finger 326 and serves to disengage the staple 65 from the anvil 250 as the staple holder 252 is retracted after the staple 65 is formed. A pair of fingers 328 at the tip of the ejector arm 322 are spaced apart to receive the depending tab 308 of the cartridge housing 320 therebetween.
The anvil 250 includes a pair of laterally spaced prongs 330 at its distal end which allow the ejector arm 322 to pass therebetween when the staple holder 252 is advanced. Each prong 330 includes an inclined ramp 332 for guiding the crown 66 of the staple 65 into engagement with the proximal side of the prong 330.
The staple follower 264 is channel-shaped and includes a generally flat top portion 340 which is slidably received between the lower flanges 292 and the upper flanges 296. The staple follower 264 also has a pair of depending side flanges 342 on its opposite sides which are received in the channels 294 adjacent to the lower flanges 292.
The staple follower 264 includes a rearwardly projecting post 344 which is inserted into the distal end of the compression coil spring 266.
Referring to Figures 9 and 19, a stack of staples 65 is mounted in the staple cartridge housing 240 with the staple crowns 66 resting on and.slidably supported by the elongated flanges or guide rails 292. The dimpled portions 67 of the staples 65 rest on top of the staple holder 252.
The row of staples 65 is urged forwardly toward the distal end of the cartridge 240 by the staple follower 264 and the compression coil spring 266.
The staple former 254 is biased rearwardly by the return spring 174 (Figure 2) in the actuator handle assembly 80 to urge the depending prong 258 against the front of the retainer 242. The staple holder 252 is biased forwardly by the compression coil spring 262 which urges the depending prong 260 against the front edge of the.slot 256 in the staple former 254. The ejector arm 322 at the distal end of the staple holder 252 is located ~1~~'~~'~~
adjacent to the guide tab 308 at the front of the tapered nase 300 of the staple cartridge 240.
As shown in Figure 19, the offset or dimpled portion 67 of the forwardmost staple 65 is located at a level different from the remaining staples 65 in the stack. The dimpled portion 67 of the forwardmost staple 65 is reCeiVed iri the notch 324 in front of the pusher finger 326. P~hen the staple holder 252 is advanced, the dimpled portion 67 of the forwardmost staple 65 is advanced along the sloped surface 309 and adjacent to the guide tab 308 by the pusher finger 326. The top portion or crown 66 of the forwardmost staple 65 is advanced along a path between the inclined ramps 310 (Figure 14) and the inclined ledges 293 of the guide rails 292 to rotate the staple 65 by 90 degrees about its dimpled portion 67.
As shown in Figure 20, with the staple holder partially advanced, the forwardmost staple 65 is rotated into a longitudinal orientation with its staple legs 68 parallel to the longitudinal axis of the staple cartridge housing 240. Thereafter, as shown in Figure 21, when the staple holder 252 is fully advanced, the forwardmost staple 65 travels along the extensions 294 of the guide rails 292 and is clamped against the anvil prongs 330 with the staple legs 68 projecting distally from the front of the staple cartridge housing 240. The remaining staples 65 in the stack are restrained by the top of the staple holder 252 which engages the dimpled portions 67 of the staples 65.
The staple forming mechanism of the staple cartridge 100 is actuated by squeezing the staple actuating lever 88 toward the handle grip 86. As a result, the staple actuating lever 88 is pivoted about the pivot pan 96 and the upright fingers i70 advance the slide member 154 in the distal direction. The slide member 154 advances the staple driver 76 in the distal direction which, in turn, advances the plunger 270 to actuate the staple holder 252 and the staple former 254. After the staple holder 252 and the staple former 254 are fully advanced to form one of the staples 65, the staple actuating lever 88 is released and returned to its original position by the return coil spring 174, which retracts the slide block 154 and tine staple driver 76.
The operation of the staple forming mechanism is illustrated in Figures 22-26 which, for clarity, show only one staple 65. Figure 22 shows the staple 65 positioned in the notch 324 in front of the pusher finger 326 at the start of the staple forming cycle which corresponds to the position of the staple holder 252 and staple former 254 shown in Figure 19. Initially, when the staple actuating lever 88 is actuated, the staple holder 252 and the staple former 254 are advanced simultaneously to advance the staple 65 toward the prongs 330 of the anvil 250. As the staple 65 is advanced toward the anvil prongs 330, the staple 65 is rotated by 90 degrees into a longitudinal ori'hntation (Figure 20) with the staple legs 68 pointing distally.
Figure 23 shows the staple holder 252 and the staple former 254 advanced to a staple clamping position corresponding to Figure 21 in which the staple crown 66 is clamped between the pusher finger 326 and the prongs 330 of the anvil 250.
Thereafter, as the staple actuating lever 88 is actuated, only the staple former 254 is advanced while the staple holder 252 remains stationary with ~~ D'~~~0 the staple 65 clamped against the anvil prongs 330.
Figure 24 shows the initial movement of the staple former 254 relative to the staple holder 252 to form the staple 65 about the anvil prongs 330.
The initial contact of the former flanges 320 with the staple 65 results in a slight bending of the staple crown 66 with the staple legs 68 angled toward each other.
Figure 25 shows an intermediate stage of the staple forming cycle in which the former flanges 320 are further advanced to bend the staple crown 66 around the anvil prongs 330 to bring the staple legs 68 closer together. Figure 26 shows the final stage of the staple forming cycle in which the former flanges 320 are fully advanced to bend the staple legs 68 into an overlapping configuration to secure the staple 65 to the tissue.
After the staple 65 is completely formed, the staple actuating lever 88 is released and the staple former 254 is moved rearwardly relative to the staple holder 252 by the compression coil spring 262. When the depending lug 260 is engaged by the front edge of the slot 256, the staple holder 252 and the staple former 254 are retracted together by the return spring 174 in the actuator handle assembly 80. The ejector arm 322 lifts the formed staple 65 from the anvil prongs 330 as the staple holder 252 is retracted. The staple holder 252 and the staple former 254 are returned to the start position shown in Figure 19 where the next staple 65 is received in the notch 324 in front of the pusher finger 326. Then, the staple forming cycle is repeated to form the next staple 65.
The actuator handle assembly 80 includes a precock racthet mechanism comprising the ratchet ~~o~~rro spring 178 and the ratchets 182 which prevents the retraction of the staple forming mechanism until the staple 65 is completely formed. The operation of the ratchet mechanism is illustrated in Figures 27-31 which show the various ratchet positions corresponding to the stages of the staple forming cycle shown in Figures 22-28, respectively.
As shown in Figure 27, each spring arm 180 of the ratchet spring 178 is initially disengaged from each ratchet 182 with the staple holder 252 and the staple former 254 located in the retracted position (Figure 22). As shown in Figure 28, each spring arm 180 of the ratchet spring 178 is engaged in the first notch of each ratchet 182 with the staple holder 252 and the staple former 254 in the advanced position (Figure 23) in which the staple 65 is clamped against the anvil prongs 330.
Thereafter, the engagement of the ratchet spring arms lso with the ratchets 182 prevents the staple holder 252 and the staple Former 254 from being retracted until the staple forming cycle is completed.
As shown in Figure 29, each spring arm 180 of the ratchet spring 178 is engaged in the second notch of each ratchet 182 with the flanges 320 of the staple former 254 initially engaged with the staple crown 66 to begin the forming of the staple 65 (Figure 24). As shown in Figure 30, each spring arm 180 of the ratchet spring 178 is engaged in the third notch of each ratchet 182 with the former flanges 320 advanced to the intermediate stage of the staple forming cycle (Figure 25) in which the staple legs 68 are partially closed.
As shown in Figure 31, each spring arm 180 of the ratchet spring 178 is disengaged from each ratchet 182 with the former flanges 320 fully advanced (Figure 26) to bend the staple legs 68 into an overlapping relationship. Each spring arm 180 travels rearwardly adjacent to the unmatched side of the corresponding ratchet 182 to allow the ratchet spring 178 to return to its retracted position (Figure 27) when the staple actuating lever 88 is released.
In performing a hernia repair procedure, the endoscopic surgical stapling instrument 50 is inserted into,a body cavity through a trocar tube or cannula installed in a body wall. Initially, the surgical stapling instrument 50 is introduced into the body cavity in its non-articulated mode, i.e., with the staple cartridge 100 aligned with the longitudinal axis of the support tube 70. An endoscope may be inserted into the body cavity through a separate trocar tube or cannula for observation of the surgical site. The stapling cartridge 100 is positioned in the desired orientation over the surgical site by operating the rotatable adjusting knob 82 and the saddle-shaped actuator 84 to adjust the rotational orientation of the support tube 70 and the angular orientation of the staple cartridge 100. The staple cartridge 100 can be articulated to angles of 15, 30, 45 and 60 degrees relative to the support tube 70 by retracting the saddle-shaped actuator 84.
If it is desired to change the rotational orientation of the staple cartridge 100 on its axis, the staple cartridge 100 is returned to the non-articulated mode by sliding the saddle-shaped actuator 84 forwardly. The surgical stapling instrument 50 is withdrawn from the trocar tube or cannula and the staple cartridge 100 is rotated 2:~p'~~~~
manually relative to the support tube 70. Then, the surgical stapling instrument 50 is reintroduced into the body cavity in its non-articulated mode and the orientation of the staple cartridge 100 is adjusted by operating the rotatable adjusting knob 82 and the saddle-shaped actuator 84.
With the staple cartridge 100 adjusted to the desired orientation, the staple actuator lever 88 is squeezed to actuate the staple forming mechanism 10' in the staple cartridge 100 to fasten one of the staples 65 to the tissue at the surgical site.
Thereafter, the staple cartridge 100 is shifted to another location and the operation is repeated to fasten another staple 65 to the tissue. When the staple actuator lever 88 is released, the formed staple 65 is disengaged from the anvil 250 of the staple cartridge 100.
Referring to Figure 18, the surgical stapling instrument 50 can be used to secure a hernia patch 62 at a desired surgical site. The hernia patch 62 is attached to internal body tissue 64 by applying a series of staples 65 to the edges of the hernia patch 62. The staple cartridge 100 is readily adjustable into the different orientations to apply the staples 65 at various locations along the edges of the hernia patch 62.
Figures 32 and 33 illustrate an alternative embodiment of the surgical stapling instrument, generally 350, including a distal stapling head assembly 360 which is pivotally connected to an elongated support tube 370 rotatably mounted on a proximal actuator handle assembly 380. A rotatable adjusting knob 382 is mounted at the distal end of the actuator handle assembly 380 for rotating the support tube 370 about its longitudinal axis. A
saddle-shaped actuator 384 is slidably mounted on the actuator handle assembly 380 for controlling the pivotal movement of the stapling head assembly 360 relative to the support tube 370. The actuator handle assembly 380 has a depending handle grip 386 and a pivotally mounted staple actuating lever 388 .
for actuating the stapling head assembly 360. The internal components of the stapling head assembly 360, the support shaft 370 and the actuator handle assembly 380 are substantially identical to the corresponding components of the surgical stapling instrument 50 described above. Accordingly, no detailed description of the internal components of the surgical stapling instrument 350 is necessary, and it will be understood by persons skilled in the art that the previous description of the internal components of the surgical stapling instrument 50 is applicable to the internal components of the surgical stapling instrument 350, unless otherwise described.
The stapling head assembly 360 includes a rotatably mounted staple cartridge 400 which is substantially identical in construction to the stapling cartridge 100 described above. The stapling head assembly 360 is pivotally mounted on on the support tube 370 by a pivot connection 390 which is substantially identical to the pivot connection 200 described above.
As shown in Figure 33, the handle assembly 380 includes a pair of hollow handle sections 392 which are adapted to snap fit together. Each of the handle sections 392 includes a distally extending elongated, semi-cylindrical neck portion 394 in which the proximal end of the support tube 370 is 3~ received and mounted for rotation about its ~~~~~~o longitudinal axis relative to the handle assembly 380. Each of the handle sections 392 includes an internal annular flange 395 (one shown) for engaging a radially projecting flange 372 at the proximal end of the support tube 370 to retain the support tube 370 within the handle assembly 380.
The staple actuating lever 388 is pivotally mounted on the actuator handle assembly 380 by a pivot pin 39E.
As shown in Figures 32 and 33, the adjusting knob 382 comprises a pair of elongated, hollow tapered sleeve-like sections 402 which fit together over the neck portions 394 of the handle sections 392. Each of the sleeve-like knob sections 402 has an inwardly projecting prong 403 adjacent to its distal end. The prongs 403 are received in a pair of holes formed on opposite sides of the support tube 370 to secure the knob sections 402 to the support tube 370. The actuator handle assembly 380 and the adjusting knob 382 include the same ratchet mechanism, described above in connection with the stapling instrument 50, which allows the adjusting knob 382 to rotate the support shaft 370 about its longitudinal axis in sixteen equal intervals of 22-1/2 degrees. Each of the knob sections 402 has an enlarged rear section 407 provided with alternating longitudinal ridges 408 and finger receiving grooves 409 which facilitate the rotation of the adjusting knob 382 and the support tube 370 by the surgeon.
The actuator handle assembly 380 includes a rotatable control knob 410 for controlling the rotation of the staple cartridge 400 about its longitudinal axis relative to the support shaft 370. The control knob 410 includes an elongated hollow, comically tapered portion 412 which is rotatably received between the sleeve-like sections 402 of the adjusting knob 382 and the cylindrical neck portions 394 of the handle secti~ns 392. A
hollow cylindrical, internally toothed geneva gear wheel 414 is secured within the distal end of the comically tapered body 412 for rotation with the control knob 410. A first pinion gear 416 which is rotatably mounted on the inside of the support tube 370 extends through a window 372 (Figure 35) formed in the side of the support tube 370 and engages the internal teeth on the geneva gear wheel 414. The pinion gear 416 is attached to a flexible cable 418 which extends longitudinally through the support shaft 370 and the pivot connection 390. The distal end of the flexible cable 418 is connected to a second pinion gear 420 rotatably supported in a bushing 422 (Figure 34) mounted on the inside of one of the clamshell members 424 forming part of the pivot connection 390. The flexible cable 418 is formed of conventional materials such as steel alloys.. The staple cartridge 400 is mounted on a cylindrical retainer 426 which is rotatably supported by the clamshell members 424 of the pivot connection 390. The cartridge retainer 422 has an internally toothed geneva gear wheel 428 (Figure 36) at its proximal end which engages the pinion gear 420.
In the operation of the surgical stapling instrument 350, the control knob 410 is used to control the rotational orientation of the staple cartridge 400 relative to the support shaft 370 and the pivot connection 390. The rotation of the control knob 410 is transmitted via the flexible cable 418 to the cartridge retainer 422 which 2~~'~~~Q
rotates the staple cartridge 400 about its axis.
As a result, the rotational orientation of the staple cartridge 400 relative to the support shaft 370 is adjustable by the rotation of the control 5 knob 410.
Except for the control knob 410 which rotates the staple cartridge 400, the surgical stapling instrument 350 operates in substantially the same manner as the stapling instrument 50 described 10 above. the rotatable adjusting knob 382 is used to rotate the support shaft 370 relative to the actuator handle assembly 380. ~'he saddle-shaped actuator 384 is slidable longitudinally along the actuator handle assembly 380 to pivot the stapling 15 head assembly 360 about an axis transverse to the longitudinal axis of the support shaft 370. the staple actuating lever 388 is pivoted to actuate the staple forming mechanism of the staple cartridge 400 in substantially the_same manner as 20 described above.
figures 37-40 show an alternative embodiment of a stapling head assembly, generally 460, which can be used with the surgical stapling instrument 50 described above. 'fhe stapling head assembly 460 25 is pivotally mounted at the distal end of the support tube 70 by a pivot connection 470 including a tubular pivot housing 472 secured to the support tube 70 and a tubular cartridge support member 474 pivotally connected to the pivot housing 472 by a 30 pair of pivot pins 476 extending laterally from opposite sides of the cartridge support member 474.
An inclined slot 478 is formed on one side of the cartridge support member 474.
A staple cartridge 500 is mounted at the 35 distal end of the cartridge support member 474.
The staple cartridge 500 is generally cylindrical in shape and is adapted to be received in the open distal end of the cartridge support member 474.
The staple cartridge 500 has a pair of latch pins 502 projecting radially outward its opposite sides.
The latch pins 502 are received and latched in a pair of slots 504 extending longitudinally from the distal end of the cartridge support member 474.
The latch pins 502 and slots 504 allow the staple cartridge 500 to be disengaged from the cartridge support member 474 when it is desired to replace the staple cartridge 500.
As shown Figure 40, an articulation control member 480 is~slidably mounted in the pivot housing 472 and is connected to the articulation driver 78.
A laterally projecting guide pin 482 is located adjacent to the distal end of the articulation control member 480 and is slidably received in the inclined slot 478 of the cartridge support member 474. The inclined slot 478 and the guide pin 482 convert longitudinal movement of the articulation driver 78 into pivotal movement of the stapling head assembly 460 about the pivot pins 476.
As shown in Figure 39, a plunger 490 is slidably mounted for longitudinal movement in the cartridge support member 474. The plunger 490 includes an elongated laterally projecting side flange 492 which is slidably received in a longitudinal slot 494 (Figure 38) formed on the side of the cartridge support member 474. The plunger 490 has a semi-circular rear edge 495 which is engaged by an inclined cam surface 496 on a drive member 498 mounted at the distal end of the staple driver 76. The front end of the plunger 490 is engaged with the staple forming mechanism inside the staple cartridge 500.
then the staple driver 76 is advanced in the distal direction, the plunger 490 is advanced to actuate the staple forming mechanism of the staple cartridge 50o which operates in substantially the same manner as described above. The semi-circular rear edge 496 of the plunger 90 and the inclined cam surface 498 at the distal end of the staple driver 76 allow the staple forming mechanism to be actuated in any angular orientation of the staple cartridge 5o0.
The invention in its broader aspects is not limited to the specific details of the preferred embodiments shown and described, and those skilled in the art will recognize that the invention can be practiced with modification within the spirit and scope of the appended claims.
Claims (13)
1. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:
a handle including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said handle, said support shaft being mounted to said handle and having a rotating mechanism controlling rotation about said longitudinal axis relative to said handle;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement about an axis transverse to said longitudinal axis of said support shaft and which includes actuator means on said handle for pivoting said staple cartridge about said transverse axis to adjust the angular position of said staple cartridge relative to said support shaft; and an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
a handle including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said handle, said support shaft being mounted to said handle and having a rotating mechanism controlling rotation about said longitudinal axis relative to said handle;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement about an axis transverse to said longitudinal axis of said support shaft and which includes actuator means on said handle for pivoting said staple cartridge about said transverse axis to adjust the angular position of said staple cartridge relative to said support shaft; and an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
2. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue comprising:
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
staple driver means drivingly engaged with said staple actuator mechanism for being operated by said staple actuator mechanism when said staple cartridge is at any angular position relative to said shaft, said staple driver means comprising:
a staple driver suitably mounted for longitudinal movement in said support shaft and coupled to said staple actuator mechanism; and a plunger slidably mounted on said pivot means and actuated by the longitudinal movement of said staple driver for actuating the staple forming mechanism when said staple actuator mechanism is operated.
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
staple driver means drivingly engaged with said staple actuator mechanism for being operated by said staple actuator mechanism when said staple cartridge is at any angular position relative to said shaft, said staple driver means comprising:
a staple driver suitably mounted for longitudinal movement in said support shaft and coupled to said staple actuator mechanism; and a plunger slidably mounted on said pivot means and actuated by the longitudinal movement of said staple driver for actuating the staple forming mechanism when said staple actuator mechanism is operated.
3. The stapling instrument of claim 2, which includes:
a pivot link for connecting said plunger to said staple driver to permit said staple forming mechanism to pivot relative to said staple driver.
a pivot link for connecting said plunger to said staple driver to permit said staple forming mechanism to pivot relative to said staple driver.
4. The stapling instrument of claim 2, wherein:
said plunger is coupled to said staple forming mechanism for longitudinal movement therewith and is adapted to permit said staple forming mechanism to rotate about the longitudinal axis of said staple cartridge relative to said plunger.
said plunger is coupled to said staple forming mechanism for longitudinal movement therewith and is adapted to permit said staple forming mechanism to rotate about the longitudinal axis of said staple cartridge relative to said plunger.
5. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue comprising:
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
6. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue comprising:
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis;
an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft; said actuator means comprising:
a slide member mounted for longitudinal movement on said actuator handle assembly; and a coupling member for connecting said slide member to said articulation driver for transmitting the longitudinal movement of said slide member to said articulation driver to pivot said staple cartridge.
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a shaft rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue, said staple cartridge having a circumferential cross-section no greater than said shaft cross-section;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
cartridge rotating means for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis;
an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft; said actuator means comprising:
a slide member mounted for longitudinal movement on said actuator handle assembly; and a coupling member for connecting said slide member to said articulation driver for transmitting the longitudinal movement of said slide member to said articulation driver to pivot said staple cartridge.
7. The stapling instrument of claim 6, wherein:
said articulation driver is free to rotate relative to said slide member.
said articulation driver is free to rotate relative to said slide member.
8. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said pivot connection structure including a pivotable housing that is pivotable relative to said support shaft;
said staple cartridge being mounted to said pivotable housing for rotation about said cartridge axis, said staple cartridge including a hollow cartridge housing containing a staple advancing and forming mechanism operatively connected to said staple actuator mechanism, said staple advancing and forming mechanism including a former that is longitudinally reciprocatable within said hollow cartridge housing; and said former having a proximal end for rotatably engaging said staple actuator mechanism to accommodate rotation of said former about the cartridge axis relative to said support shaft and said staple actuator mechanism.
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said pivot connection structure including a pivotable housing that is pivotable relative to said support shaft;
said staple cartridge being mounted to said pivotable housing for rotation about said cartridge axis, said staple cartridge including a hollow cartridge housing containing a staple advancing and forming mechanism operatively connected to said staple actuator mechanism, said staple advancing and forming mechanism including a former that is longitudinally reciprocatable within said hollow cartridge housing; and said former having a proximal end for rotatably engaging said staple actuator mechanism to accommodate rotation of said former about the cartridge axis relative to said support shaft and said staple actuator mechanism.
9. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said pivot connection structure including a pivotable housing that is pivotable relative to said support shaft;
said staple cartridge being mounted to said pivotable housing for rotation about said cartridge axis, said staple cartridge including a hollow cartridge housing containing a staple advancing and forming mechanism operatively connected to said staple actuator mechanism, said staple advancing and forming mechanism including a former that is longitudinally reciprocatable within said hollow cartridge housing; and said instrument further including a retainer having (A) a proximal end received in said pivotable housing to accommodate rotation of said retainer relative to said pivotable housing;
and (B) a distal end received in said hollow cartridge housing with a latch to prevent relative rotation between said retainer and said hollow cartridge housing.
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said pivot connection structure including a pivotable housing that is pivotable relative to said support shaft;
said staple cartridge being mounted to said pivotable housing for rotation about said cartridge axis, said staple cartridge including a hollow cartridge housing containing a staple advancing and forming mechanism operatively connected to said staple actuator mechanism, said staple advancing and forming mechanism including a former that is longitudinally reciprocatable within said hollow cartridge housing; and said instrument further including a retainer having (A) a proximal end received in said pivotable housing to accommodate rotation of said retainer relative to said pivotable housing;
and (B) a distal end received in said hollow cartridge housing with a latch to prevent relative rotation between said retainer and said hollow cartridge housing.
10. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said staple cartridge including a cartridge housing that contains a staple storage, advancing, and forming system and a plurality of staples each having (A) a generally U-shaped body including a crown with a central offset portion between two non-offset portions;
(B) a pair of legs at opposite ends of said crown depending from said non-offset portions, said staples being arranged in a side-by-side stack oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis; and said staple storage, advancing, and forming system including a staple advancing and forming mechanism that is operatively engaged with said staple actuator mechanism and that is adapted for engaging the distalmost staple to advance the distalmost staple distally to effect engagement of part of said staple crown with a part of said cartridge housing whereby the staple rotates about ninety degrees to an orientation with the staple legs oriented parallel to the cartridge axis.
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said staple cartridge including a cartridge housing that contains a staple storage, advancing, and forming system and a plurality of staples each having (A) a generally U-shaped body including a crown with a central offset portion between two non-offset portions;
(B) a pair of legs at opposite ends of said crown depending from said non-offset portions, said staples being arranged in a side-by-side stack oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis; and said staple storage, advancing, and forming system including a staple advancing and forming mechanism that is operatively engaged with said staple actuator mechanism and that is adapted for engaging the distalmost staple to advance the distalmost staple distally to effect engagement of part of said staple crown with a part of said cartridge housing whereby the staple rotates about ninety degrees to an orientation with the staple legs oriented parallel to the cartridge axis.
11. A surgical stapling instrument for applying one or more surgical staples to tissue, said instrument comprising:
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said staple cartridge including a hollow cartridge housing containing a plurality of staples and a staple advancing and forming mechanism for moving one of said staples toward the distal end of said cartridge and forming the staple;
each said staple having a generally U-shaped body including a crown with a central offset portion between two non-offset portions and a pair of legs at opposite ends of said crown each depending from one of said non-offset portions;
and said staple cartridge housing including:
a staple storage region defined by a guide surface for supporting and guiding said staple crowns and includes a cavity for receiving said staple legs, said staples being arranged in a side-by-side stack in said storage region with each staple oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis;
a staple feeder shoe in said storage region and a spring biasing said feeder shoe distally along the length of said cartridge to engage the most proximal staple in said stack and urge said stack distally;
an inclined surface and an inclined ramp spaced from said inclined surface for receiving therebetween the distalmost staple from the stack at the distal end of said guide surface, said inclined surface and ramp each being oriented at an oblique angle relative to said cartridge axis; and spaced-apart extension surfaces for receiving said staple crown as said staple advances distally from said inclined surface and inclined ramp whereby either said offset portion or said non-offset portions engage said ramp to rotate said staple about 90° into an orientation with the staple legs oriented parallel to said cartridge axis and pointing toward the distal end of said, cartridge.
a handle including a staple actuator mechanism;
a tubular support shaft having a longitudinal axis and a circumferential cross-section and extending from said handle;
a staple cartridge carried on said support shaft and connected to said staple actuator mechanism for applying one or more staples seriatim to the tissue, said staple cartridge when mounted on said shaft having a circumferential cross-section no greater than said shaft cross-section;
a pivot connection structure connecting said staple cartridge to said support shaft for accommodating pivotal movement of said cartridge about an axis transverse to said longitudinal axis of said support shaft;
a pivot actuator located on said handle and operative to effect the pivoting of said staple cartridge;
and cartridge rotating means on said shaft for rotating said staple cartridge relative to said support shaft about a cartridge axis defined along the length of said cartridge;
said staple cartridge including a hollow cartridge housing containing a plurality of staples and a staple advancing and forming mechanism for moving one of said staples toward the distal end of said cartridge and forming the staple;
each said staple having a generally U-shaped body including a crown with a central offset portion between two non-offset portions and a pair of legs at opposite ends of said crown each depending from one of said non-offset portions;
and said staple cartridge housing including:
a staple storage region defined by a guide surface for supporting and guiding said staple crowns and includes a cavity for receiving said staple legs, said staples being arranged in a side-by-side stack in said storage region with each staple oriented transversely to the cartridge axis with the staple legs oriented perpendicularly to the cartridge axis;
a staple feeder shoe in said storage region and a spring biasing said feeder shoe distally along the length of said cartridge to engage the most proximal staple in said stack and urge said stack distally;
an inclined surface and an inclined ramp spaced from said inclined surface for receiving therebetween the distalmost staple from the stack at the distal end of said guide surface, said inclined surface and ramp each being oriented at an oblique angle relative to said cartridge axis; and spaced-apart extension surfaces for receiving said staple crown as said staple advances distally from said inclined surface and inclined ramp whereby either said offset portion or said non-offset portions engage said ramp to rotate said staple about 90° into an orientation with the staple legs oriented parallel to said cartridge axis and pointing toward the distal end of said, cartridge.
12. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue, said instrument comprising:
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a first rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
a second rotation mechanism controlling rotation of said cartridge about its longitudinal axis relative to said pivot means and to said support shaft;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and n articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a first rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
a second rotation mechanism controlling rotation of said cartridge about its longitudinal axis relative to said pivot means and to said support shaft;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and n articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including a guide pin at its distal end received in an arcuate groove in said pivot means for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
13. An endoscopic surgical stapling instrument for applying one or more surgical staples to internal body tissue, said instrument comprising:
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a first rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
a second rotation mechanism controlling rotation of said cartridge about its longitudinal axis relative to said pivot means and to said support shaft;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including at its distal end one of a guide pin and arcuate groove, said pivot means including the other of said guide pin and arcuate groove, said guide pin being received in said arcuate groove for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
an actuator handle assembly including a staple actuator mechanism;
an elongated tubular support shaft having a longitudinal axis and extending from said actuator handle assembly, said support shaft being mounted to said actuator handle assembly and including a first rotation mechanism controlling rotation of said shaft about its longitudinal axis relative to said actuator handle assembly;
a staple cartridge mounted at the distal end of said support shaft for holding a plurality of staples and including a staple forming mechanism connected to said staple actuator mechanism for applying the staples to the tissue;
pivot means at the distal end of said support shaft for mounting said staple cartridge for pivotal movement relative to said support shaft about an axis transverse to said longitudinal axis of said support shaft;
a second rotation mechanism controlling rotation of said cartridge about its longitudinal axis relative to said pivot means and to said support shaft;
actuator means on said handle assembly for pivoting said staple cartridge relative to said support shaft about said transverse axis; and an articulation driver slidably mounted for longitudinal movement in said support shaft for connecting said actuator means to said pivot means to pivot said staple cartridge relative to said support shaft, said articulation driver including at its distal end one of a guide pin and arcuate groove, said pivot means including the other of said guide pin and arcuate groove, said guide pin being received in said arcuate groove for converting the longitudinal movement of said articulation driver into pivotal movement of said staple cartridge relative to said support shaft.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US959,184 | 1992-10-09 | ||
US07/959,184 US5381943A (en) | 1992-10-09 | 1992-10-09 | Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge |
Publications (2)
Publication Number | Publication Date |
---|---|
CA2107970A1 CA2107970A1 (en) | 1994-04-10 |
CA2107970C true CA2107970C (en) | 2004-04-13 |
Family
ID=25501754
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002107970A Expired - Lifetime CA2107970C (en) | 1992-10-09 | 1993-10-07 | Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge |
Country Status (10)
Country | Link |
---|---|
US (2) | US5381943A (en) |
EP (2) | EP0713684B1 (en) |
JP (1) | JPH06197901A (en) |
AT (1) | ATE162058T1 (en) |
AU (1) | AU666580B2 (en) |
BR (1) | BR9304210A (en) |
CA (1) | CA2107970C (en) |
DE (2) | DE69324272T2 (en) |
ES (2) | ES2111137T3 (en) |
IL (1) | IL107204A0 (en) |
Families Citing this family (1142)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5497933A (en) | 1991-10-18 | 1996-03-12 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5326013A (en) * | 1991-10-18 | 1994-07-05 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
AU657364B2 (en) * | 1991-10-18 | 1995-03-09 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US5289963A (en) * | 1991-10-18 | 1994-03-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US6250532B1 (en) | 1991-10-18 | 2001-06-26 | United States Surgical Corporation | Surgical stapling apparatus |
US5514157A (en) * | 1992-02-12 | 1996-05-07 | United States Surgical Corporation | Articulating endoscopic surgical apparatus |
US5484451A (en) * | 1992-05-08 | 1996-01-16 | Ethicon, Inc. | Endoscopic surgical instrument and staples for applying purse string sutures |
US5662662A (en) | 1992-10-09 | 1997-09-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument and method |
US5431323A (en) * | 1992-10-09 | 1995-07-11 | Ethicon, Inc. | Endoscopic surgical instrument with pivotable and rotatable staple cartridge |
US5626587A (en) * | 1992-10-09 | 1997-05-06 | Ethicon Endo-Surgery, Inc. | Method for operating a surgical instrument |
US5409498A (en) * | 1992-11-05 | 1995-04-25 | Ethicon, Inc. | Rotatable articulating endoscopic fastening instrument |
US6716232B1 (en) * | 1993-04-30 | 2004-04-06 | United States Surgical Corporation | Surgical instrument having an articulated jaw structure and a detachable knife |
US5562682A (en) * | 1993-10-08 | 1996-10-08 | Richard-Allan Medical Industries, Inc. | Surgical Instrument with adjustable arms |
US5560532A (en) * | 1993-10-08 | 1996-10-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to body tissue |
US5743456A (en) * | 1993-12-16 | 1998-04-28 | Stryker Corporation | Hand actuable surgical handpiece |
CA2145723A1 (en) * | 1994-03-30 | 1995-10-01 | Steven W. Hamblin | Surgical stapling instrument with remotely articulated stapling head assembly on rotatable support shaft |
CA2148667A1 (en) * | 1994-05-05 | 1995-11-06 | Carlo A. Mililli | Self-contained powered surgical apparatus |
US5628446A (en) * | 1994-05-05 | 1997-05-13 | United States Surgical Corporation | Self-contained powered surgical apparatus |
US5797538A (en) * | 1994-10-05 | 1998-08-25 | United States Surgical Corporation | Articulating apparatus for applying surgical fasteners to body tissue |
US5713505A (en) * | 1996-05-13 | 1998-02-03 | Ethicon Endo-Surgery, Inc. | Articulation transmission mechanism for surgical instruments |
US5704534A (en) | 1994-12-19 | 1998-01-06 | Ethicon Endo-Surgery, Inc. | Articulation assembly for surgical instruments |
US5762256A (en) * | 1995-08-28 | 1998-06-09 | United States Surgical Corporation | Surgical stapler |
US5782396A (en) * | 1995-08-28 | 1998-07-21 | United States Surgical Corporation | Surgical stapler |
US6007484A (en) | 1995-09-15 | 1999-12-28 | Image Technologies Corporation | Endoscope having elevation and azimuth control of camera |
US6428470B1 (en) | 1995-09-15 | 2002-08-06 | Pinotage, Llc | Imaging system and components thereof |
US6413209B1 (en) | 1995-09-15 | 2002-07-02 | Med Images, Inc. | Imaging system with condensation control |
CA2206156A1 (en) * | 1995-09-15 | 1997-04-03 | Robert Lee Thompson | Surgical/diagnostic imaging device |
US6099537A (en) * | 1996-02-26 | 2000-08-08 | Olympus Optical Co., Ltd. | Medical treatment instrument |
US5823066A (en) * | 1996-05-13 | 1998-10-20 | Ethicon Endo-Surgery, Inc. | Articulation transmission mechanism for surgical instruments |
US5702408A (en) * | 1996-07-17 | 1997-12-30 | Ethicon Endo-Surgery, Inc. | Articulating surgical instrument |
US5865361A (en) | 1997-09-23 | 1999-02-02 | United States Surgical Corporation | Surgical stapling apparatus |
US6171316B1 (en) | 1997-10-10 | 2001-01-09 | Origin Medsystems, Inc. | Endoscopic surgical instrument for rotational manipulation |
US6660010B2 (en) | 1998-01-27 | 2003-12-09 | Scimed Life Systems, Inc. | Bone anchor placement device with recessed anchor mount |
EP1067872B1 (en) | 1998-03-20 | 2006-03-01 | Boston Scientific Limited | Endoscopic suture system |
DE69916045T2 (en) | 1998-05-12 | 2004-08-05 | Boston Scientific Ltd., St. Michael | HAND-OPERATED BONE ANCHOR SETTING DEVICE |
US6030410A (en) * | 1998-05-18 | 2000-02-29 | Zurbruegg; Heinz Robert | Sternal closure technique and kit for performing same |
US6228098B1 (en) * | 1998-07-10 | 2001-05-08 | General Surgical Innovations, Inc. | Apparatus and method for surgical fastening |
US6740122B1 (en) | 1998-09-11 | 2004-05-25 | C. R. Bard, Inc. | Preformed curved prosthesis that is adapted to the external iliac vessels |
US6723133B1 (en) | 1998-09-11 | 2004-04-20 | C. R. Bard, Inc. | Performed curved prosthesis having a reduced incidence of developing wrinkles or folds |
US7344547B2 (en) | 1998-09-15 | 2008-03-18 | Phavel Systems, Inc. | Laparoscopic instruments and trocar systems and related surgical method |
US6530933B1 (en) | 1998-12-31 | 2003-03-11 | Teresa T. Yeung | Methods and devices for fastening bulging or herniated intervertebral discs |
US7695485B2 (en) | 2001-11-30 | 2010-04-13 | Power Medical Interventions, Llc | Surgical device |
US8025199B2 (en) | 2004-02-23 | 2011-09-27 | Tyco Healthcare Group Lp | Surgical cutting and stapling device |
US6835200B2 (en) * | 1999-06-22 | 2004-12-28 | Ndo Surgical. Inc. | Method and devices for tissue reconfiguration |
US7846180B2 (en) * | 1999-06-22 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Tissue fixation devices and methods of fixing tissue |
US6663639B1 (en) * | 1999-06-22 | 2003-12-16 | Ndo Surgical, Inc. | Methods and devices for tissue reconfiguration |
US6821285B2 (en) * | 1999-06-22 | 2004-11-23 | Ndo Surgical, Inc. | Tissue reconfiguration |
US8287554B2 (en) | 1999-06-22 | 2012-10-16 | Ethicon Endo-Surgery, Inc. | Method and devices for tissue reconfiguration |
DE19935904C1 (en) | 1999-07-30 | 2001-07-12 | Karlsruhe Forschzent | Applicator tip of a surgical applicator for placing clips / clips for the connection of tissue |
US6533157B1 (en) * | 2000-02-22 | 2003-03-18 | Power Medical Interventions, Inc. | Tissue stapling attachment for use with an electromechanical driver device |
US8016855B2 (en) | 2002-01-08 | 2011-09-13 | Tyco Healthcare Group Lp | Surgical device |
US6830174B2 (en) | 2000-08-30 | 2004-12-14 | Cerebral Vascular Applications, Inc. | Medical instrument |
US7334717B2 (en) | 2001-10-05 | 2008-02-26 | Tyco Healthcare Group Lp | Surgical fastener applying apparatus |
US6689047B2 (en) | 2000-11-15 | 2004-02-10 | Scimed Life Systems, Inc. | Treating urinary incontinence |
US8033983B2 (en) * | 2001-03-09 | 2011-10-11 | Boston Scientific Scimed, Inc. | Medical implant |
US6991597B2 (en) | 2001-03-09 | 2006-01-31 | Boston Scientific Scimed, Inc. | System for implanting an implant and method thereof |
JP4181410B2 (en) * | 2001-03-09 | 2008-11-12 | ボストン サイエンティフィック リミテッド | System and method for implanting an implant |
US7048748B1 (en) | 2001-03-21 | 2006-05-23 | Uestuener Emin Tuncay | Automatic surgical suturing instrument and method |
DE10120367A1 (en) * | 2001-04-25 | 2002-10-31 | Arnold Pier | Surgical clip applicator |
JP2004534591A (en) * | 2001-07-09 | 2004-11-18 | タイコ ヘルスケア グループ エルピー | Right angle clip applier device and method |
US6755781B2 (en) | 2001-07-27 | 2004-06-29 | Scimed Life Systems, Inc. | Medical slings |
US6719764B1 (en) | 2001-08-24 | 2004-04-13 | Scimed Life Systems, Inc. | Forward deploying suturing device and methods of use |
US6755338B2 (en) | 2001-08-29 | 2004-06-29 | Cerebral Vascular Applications, Inc. | Medical instrument |
JP4754740B2 (en) * | 2001-09-05 | 2011-08-24 | オリンパス株式会社 | Endoscope device |
JP4245480B2 (en) * | 2001-10-05 | 2009-03-25 | タイコ ヘルスケア グループ エルピー | Surgical stapling apparatus and method |
CA2695579C (en) | 2001-10-05 | 2012-09-25 | Tyco Healthcare Group Lp | Surgical stapling device |
US7464847B2 (en) | 2005-06-03 | 2008-12-16 | Tyco Healthcare Group Lp | Surgical stapler with timer and feedback display |
US10285694B2 (en) | 2001-10-20 | 2019-05-14 | Covidien Lp | Surgical stapler with timer and feedback display |
US9113878B2 (en) | 2002-01-08 | 2015-08-25 | Covidien Lp | Pinion clip for right angle linear cutter |
US20030151506A1 (en) * | 2002-02-11 | 2003-08-14 | Mark Luccketti | Method and apparatus for locating missing persons |
EP1503671B1 (en) * | 2002-05-10 | 2006-10-11 | Tyco Healthcare Group Lp | Wound closure material applicator and stapler |
JP4319980B2 (en) | 2002-06-11 | 2009-08-26 | タイコ ヘルスケア グループ エルピー | Hernia mesh tack |
WO2003105727A1 (en) | 2002-06-12 | 2003-12-24 | Scimed Life Systems, Inc. | Medical slings |
CA2489727C (en) | 2002-06-14 | 2011-04-26 | Power Medical Interventions, Inc. | Surgical device |
US6726705B2 (en) | 2002-06-25 | 2004-04-27 | Incisive Surgical, Inc. | Mechanical method and apparatus for bilateral tissue fastening |
US20120145765A1 (en) | 2002-06-25 | 2012-06-14 | Peterson James A | Mechanical method and apparatus for bilateral tissue fastening |
US7112214B2 (en) | 2002-06-25 | 2006-09-26 | Incisive Surgical, Inc. | Dynamic bioabsorbable fastener for use in wound closure |
US8074857B2 (en) | 2002-06-25 | 2011-12-13 | Incisive Surgical, Inc. | Method and apparatus for tissue fastening with single translating trigger operation |
US7950559B2 (en) | 2002-06-25 | 2011-05-31 | Incisive Surgical, Inc. | Mechanical method and apparatus for bilateral tissue fastening |
JP4448449B2 (en) | 2002-10-04 | 2010-04-07 | タイコ ヘルスケア グループ エルピー | Tool assembly for a surgical stapling device |
ES2730694T3 (en) | 2002-10-04 | 2019-11-12 | Covidien Lp | Surgical stapler with universal joint and prior tissue support |
EP2238917B1 (en) | 2002-10-04 | 2012-12-05 | Tyco Healthcare Group LP | Tool assembly for a surgical stapling device |
DE10257760A1 (en) * | 2002-11-26 | 2004-06-17 | Stefan Koscher | Surgical instrument |
WO2004058077A1 (en) * | 2002-12-16 | 2004-07-15 | Edrich Vascular Devices, Inc. | Endovascular stapler |
US7402133B2 (en) * | 2002-12-17 | 2008-07-22 | Boston Scientific Scimed, Inc. | Spacer for sling delivery system |
US6893222B2 (en) * | 2003-02-10 | 2005-05-17 | United Technologies Corporation | Turbine balancing |
US8714429B2 (en) * | 2003-04-29 | 2014-05-06 | Covidien Lp | Dissecting tip for surgical stapler |
US9597078B2 (en) * | 2003-04-29 | 2017-03-21 | Covidien Lp | Surgical stapling device with dissecting tip |
US20040243151A1 (en) | 2003-04-29 | 2004-12-02 | Demmy Todd L. | Surgical stapling device with dissecting tip |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US8926637B2 (en) | 2003-06-13 | 2015-01-06 | Covidien Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
EP1635723B1 (en) | 2003-06-13 | 2011-08-10 | Tyco Healthcare Group LP | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US8715243B2 (en) * | 2003-06-16 | 2014-05-06 | Ethicon Endo-Surgery, Inc. | Injection port applier with downward force actuation |
US20050131352A1 (en) | 2003-06-16 | 2005-06-16 | Conlon Sean P. | Subcutaneous injection port for applied fasteners |
US7374557B2 (en) | 2003-06-16 | 2008-05-20 | Ethicon Endo-Surgery, Inc. | Subcutaneous self attaching injection port with integral fasteners |
US7862546B2 (en) | 2003-06-16 | 2011-01-04 | Ethicon Endo-Surgery, Inc. | Subcutaneous self attaching injection port with integral moveable retention members |
US7561916B2 (en) | 2005-06-24 | 2009-07-14 | Ethicon Endo-Surgery, Inc. | Implantable medical device with indicator |
US8029477B2 (en) | 2003-12-19 | 2011-10-04 | Ethicon Endo-Surgery, Inc. | Applier with safety for implantable medical device |
US7494039B2 (en) * | 2003-06-17 | 2009-02-24 | Tyco Healthcare Group Lp | Surgical stapling device |
JP4664909B2 (en) * | 2003-06-17 | 2011-04-06 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Surgical stapling device |
US6786382B1 (en) * | 2003-07-09 | 2004-09-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an articulation joint for a firing bar track |
US7213736B2 (en) * | 2003-07-09 | 2007-05-08 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an electroactive polymer actuated firing bar track through an articulation joint |
US6981628B2 (en) * | 2003-07-09 | 2006-01-03 | Ethicon Endo-Surgery, Inc. | Surgical instrument with a lateral-moving articulation control |
US7361138B2 (en) | 2003-07-31 | 2008-04-22 | Scimed Life Systems, Inc. | Bioabsorbable casing for surgical sling assembly |
US7850600B1 (en) | 2003-09-23 | 2010-12-14 | Tyco Healthcare Group Lp | Laparoscopic instrument and trocar system and related surgical method |
US8764765B2 (en) * | 2003-09-23 | 2014-07-01 | Covidien Lp | Laparoscopic instrument and related surgical method |
US7753901B2 (en) | 2004-07-21 | 2010-07-13 | Tyco Healthcare Group Lp | Laparoscopic instrument and cannula assembly and related surgical method |
US7296722B2 (en) | 2003-10-17 | 2007-11-20 | Tyco Healthcare Group Lp | Surgical fastener applying apparatus with controlled beam deflection |
CA2542532C (en) * | 2003-10-17 | 2012-08-14 | Tyco Healthcare Group, Lp | Surgical stapling device with independent tip rotation |
US8162897B2 (en) * | 2003-12-19 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Audible and tactile feedback |
US10478179B2 (en) | 2004-04-27 | 2019-11-19 | Covidien Lp | Absorbable fastener for hernia mesh fixation |
EP1746940A2 (en) * | 2004-05-17 | 2007-01-31 | Datascope Investment Corp. | Surgical stapling system |
US7955357B2 (en) | 2004-07-02 | 2011-06-07 | Ellipse Technologies, Inc. | Expandable rod system to treat scoliosis and method of using the same |
US8961407B2 (en) | 2004-07-21 | 2015-02-24 | Covidien Lp | Surgical port assembly |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US8057508B2 (en) | 2004-07-28 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation locking mechanism |
US7506790B2 (en) * | 2004-07-28 | 2009-03-24 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation mechanism |
US7914551B2 (en) | 2004-07-28 | 2011-03-29 | Ethicon Endo-Surgery, Inc. | Electroactive polymer-based articulation mechanism for multi-fire surgical fastening instrument |
US7410086B2 (en) | 2004-07-28 | 2008-08-12 | Ethicon Endo-Surgery, Inc. | Electroactive polymer-based actuation mechanism for circular stapler |
US8905977B2 (en) | 2004-07-28 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser |
US7513408B2 (en) | 2004-07-28 | 2009-04-07 | Ethicon Endo-Surgery, Inc. | Multiple firing stroke surgical instrument incorporating electroactive polymer anti-backup mechanism |
US7879070B2 (en) | 2004-07-28 | 2011-02-01 | Ethicon Endo-Surgery, Inc. | Electroactive polymer-based actuation mechanism for grasper |
US7487899B2 (en) | 2004-07-28 | 2009-02-10 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating EAP complete firing system lockout mechanism |
US7857183B2 (en) | 2004-07-28 | 2010-12-28 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation mechanism |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US7887558B2 (en) | 2004-09-28 | 2011-02-15 | Maquet Cardiovascular Llc | Modular vessel harvesting system and method |
US7922719B2 (en) * | 2004-10-06 | 2011-04-12 | Biodynamics, Llc | Adjustable angle pawl handle for surgical instruments |
EP2641549B1 (en) | 2004-10-08 | 2015-08-12 | Covidien LP | An endoscopic surgical clip applier |
US9763668B2 (en) | 2004-10-08 | 2017-09-19 | Covidien Lp | Endoscopic surgical clip applier |
JP4783372B2 (en) | 2004-10-08 | 2011-09-28 | タイコ ヘルスケア グループ エルピー | Device for applying a surgical clip |
US20060122635A1 (en) * | 2004-12-03 | 2006-06-08 | Naegeli Chad D | Storage system for bioabsorbable fasteners |
EP1719468A1 (en) * | 2004-12-17 | 2006-11-08 | Zimmer GmbH | Intervertebral stabilization system |
US7463932B2 (en) * | 2005-01-14 | 2008-12-09 | Cardiac Pacemakers, Inc. | Fastening device for an epicardial lead |
JP4847475B2 (en) * | 2005-01-26 | 2011-12-28 | ▲蘇▼州天臣国▲際▼医▲療▼科技有限公司 | Stapling head with rotating blade for surgical stapler |
US7784662B2 (en) * | 2005-02-18 | 2010-08-31 | Ethicon Endo-Surgery, Inc. | Surgical instrument with articulating shaft with single pivot closure and double pivot frame ground |
US7559452B2 (en) * | 2005-02-18 | 2009-07-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument having fluid actuated opposing jaws |
US7654431B2 (en) | 2005-02-18 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument with guided laterally moving articulation member |
US7780054B2 (en) * | 2005-02-18 | 2010-08-24 | Ethicon Endo-Surgery, Inc. | Surgical instrument with laterally moved shaft actuator coupled to pivoting articulation joint |
US7559450B2 (en) * | 2005-02-18 | 2009-07-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating a fluid transfer controlled articulation mechanism |
US7784663B2 (en) | 2005-03-17 | 2010-08-31 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having load sensing control circuitry |
US9138226B2 (en) | 2005-03-30 | 2015-09-22 | Covidien Lp | Cartridge assembly for a surgical stapling device |
US7780055B2 (en) * | 2005-04-06 | 2010-08-24 | Tyco Healthcare Group Lp | Loading unit having drive assembly locking mechanism |
US11291443B2 (en) | 2005-06-03 | 2022-04-05 | Covidien Lp | Surgical stapler with timer and feedback display |
EP1937157B1 (en) | 2005-06-03 | 2020-08-05 | Covidien LP | Surgical stapler with timer and feedback display |
US7651483B2 (en) * | 2005-06-24 | 2010-01-26 | Ethicon Endo-Surgery, Inc. | Injection port |
US7918844B2 (en) | 2005-06-24 | 2011-04-05 | Ethicon Endo-Surgery, Inc. | Applier for implantable medical device |
US8100939B2 (en) | 2005-07-15 | 2012-01-24 | Incisive Surgical, Inc. | Mechanical method and apparatus for sequential tissue fastening |
JP5042222B2 (en) * | 2005-07-27 | 2012-10-03 | タイコ ヘルスケア グループ リミテッド パートナーシップ | System and method for forming staple pockets in a surgical stapler |
US20070027468A1 (en) * | 2005-08-01 | 2007-02-01 | Wales Kenneth S | Surgical instrument with an articulating shaft locking mechanism |
US20070185504A1 (en) * | 2005-08-25 | 2007-08-09 | Microline Pentax, Inc. | Medical clip feeding mechanism |
US7419495B2 (en) * | 2005-08-25 | 2008-09-02 | Microline Pentax Inc. | Trigger lockout device for clip applying instrument |
US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US20070194082A1 (en) | 2005-08-31 | 2007-08-23 | Morgan Jerome R | Surgical stapling device with anvil having staple forming pockets of varying depths |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US7472815B2 (en) * | 2005-09-21 | 2009-01-06 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with collapsible features for controlling staple height |
CA2561473C (en) * | 2005-09-30 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Electroactive polymer-based actuation mechanism for linear surgical stapler |
US8123795B1 (en) * | 2005-10-03 | 2012-02-28 | Cardica, Inc. | System for attaching an abdominal aortic stent or the like |
CA2563147C (en) | 2005-10-14 | 2014-09-23 | Tyco Healthcare Group Lp | Surgical stapling device |
US7673783B2 (en) | 2005-11-04 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments structured for delivery of medical agents |
US7799039B2 (en) | 2005-11-09 | 2010-09-21 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a hydraulically actuated end effector |
US7673780B2 (en) | 2005-11-09 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Articulation joint with improved moment arm extension for articulating an end effector of a surgical instrument |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US7651017B2 (en) * | 2005-11-23 | 2010-01-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with a bendable end effector |
FR2895071B1 (en) * | 2005-12-19 | 2008-01-18 | Giat Ind Sa | ANTI-REBOUND LOCKING DEVICE OF A DEPLOYABLE FIN OF A PROJECTILE. |
US7670334B2 (en) | 2006-01-10 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument having an articulating end effector |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US7766210B2 (en) | 2006-01-31 | 2010-08-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with user feedback system |
US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
US7644848B2 (en) | 2006-01-31 | 2010-01-12 | Ethicon Endo-Surgery, Inc. | Electronic lockouts and surgical instrument including same |
US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US7568603B2 (en) | 2006-01-31 | 2009-08-04 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with articulatable end effector |
US7770775B2 (en) | 2006-01-31 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with adaptive user feedback |
US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
US8721630B2 (en) | 2006-03-23 | 2014-05-13 | Ethicon Endo-Surgery, Inc. | Methods and devices for controlling articulation |
US7862573B2 (en) * | 2006-04-21 | 2011-01-04 | Darois Roger E | Method and apparatus for surgical fastening |
EP2018248B1 (en) | 2006-05-19 | 2015-11-04 | Applied Medical Resources Corporation | Surgical stapler |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US7740159B2 (en) | 2006-08-02 | 2010-06-22 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US20110087276A1 (en) | 2009-10-09 | 2011-04-14 | Ethicon Endo-Surgery, Inc. | Method for forming a staple |
US8485412B2 (en) | 2006-09-29 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical staples having attached drivers and stapling instruments for deploying the same |
US8708210B2 (en) | 2006-10-05 | 2014-04-29 | Covidien Lp | Method and force-limiting handle mechanism for a surgical instrument |
US8177794B2 (en) | 2006-10-05 | 2012-05-15 | Tyco Healthcare Group Lp | Flexible endoscopic stitching devices |
US7866525B2 (en) | 2006-10-06 | 2011-01-11 | Tyco Healthcare Group Lp | Surgical instrument having a plastic surface |
US7845535B2 (en) * | 2006-10-06 | 2010-12-07 | Tyco Healthcare Group Lp | Surgical instrument having a plastic surface |
EP1913881B1 (en) | 2006-10-17 | 2014-06-11 | Covidien LP | Apparatus for applying surgical clips |
US7862502B2 (en) | 2006-10-20 | 2011-01-04 | Ellipse Technologies, Inc. | Method and apparatus for adjusting a gastrointestinal restriction device |
US8246533B2 (en) | 2006-10-20 | 2012-08-21 | Ellipse Technologies, Inc. | Implant system with resonant-driven actuator |
US7699203B2 (en) * | 2006-11-13 | 2010-04-20 | Warsaw Orthopedic, Inc. | Variable angle surgical staple inserter |
US7900805B2 (en) | 2007-01-10 | 2011-03-08 | Ethicon Endo-Surgery, Inc. | Surgical instrument with enhanced battery performance |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US7721931B2 (en) | 2007-01-10 | 2010-05-25 | Ethicon Endo-Surgery, Inc. | Prevention of cartridge reuse in a surgical instrument |
US7738971B2 (en) | 2007-01-10 | 2010-06-15 | Ethicon Endo-Surgery, Inc. | Post-sterilization programming of surgical instruments |
US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
US7954682B2 (en) | 2007-01-10 | 2011-06-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument with elements to communicate between control unit and end effector |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US7721936B2 (en) | 2007-01-10 | 2010-05-25 | Ethicon Endo-Surgery, Inc. | Interlock and surgical instrument including same |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US8701958B2 (en) | 2007-01-11 | 2014-04-22 | Ethicon Endo-Surgery, Inc. | Curved end effector for a surgical stapling device |
US7950562B2 (en) | 2007-01-31 | 2011-05-31 | Tyco Healthcare Group Lp | Surgical instrument with replaceable loading unit |
US7753246B2 (en) * | 2007-01-31 | 2010-07-13 | Tyco Healthcare Group Lp | Surgical instrument with replaceable loading unit |
US7682367B2 (en) * | 2007-02-28 | 2010-03-23 | Tyco Healthcare Group Lp | Surgical stapling apparatus |
US7533790B1 (en) * | 2007-03-08 | 2009-05-19 | Cardica, Inc. | Surgical stapler |
US7473258B2 (en) * | 2007-03-08 | 2009-01-06 | Cardica, Inc. | Surgical stapler |
US7431188B1 (en) | 2007-03-15 | 2008-10-07 | Tyco Healthcare Group Lp | Surgical stapling apparatus with powered articulation |
US8727197B2 (en) | 2007-03-15 | 2014-05-20 | Ethicon Endo-Surgery, Inc. | Staple cartridge cavity configuration with cooperative surgical staple |
US20080228199A1 (en) * | 2007-03-16 | 2008-09-18 | Ethicon Endo-Surgery, Inc. | Endoscopic tissue approximation method |
US20080228202A1 (en) * | 2007-03-16 | 2008-09-18 | Ethicon Endo-Surgery, Inc. | Endoscopic tissue approximation system |
ES2627617T3 (en) * | 2007-03-22 | 2017-07-28 | Covidien Lp | Apparatus for forming surgical closures of variable height |
US8852216B2 (en) * | 2007-03-23 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Tissue approximation methods |
US20080234703A1 (en) * | 2007-03-23 | 2008-09-25 | Ethicon Endo-Surgery, Inc. | Tissue approximation system |
CA2679523C (en) | 2007-03-26 | 2015-06-23 | Tyco Healthcare Group Lp | Endoscopic surgical clip applier |
US8056787B2 (en) | 2007-03-28 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with travel-indicating retraction member |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
CN101677813B (en) | 2007-04-11 | 2012-12-05 | Tyco医疗健康集团 | Surgical clip applier |
US8800837B2 (en) | 2007-04-13 | 2014-08-12 | Covidien Lp | Powered surgical instrument |
US7950560B2 (en) * | 2007-04-13 | 2011-05-31 | Tyco Healthcare Group Lp | Powered surgical instrument |
US11259802B2 (en) | 2007-04-13 | 2022-03-01 | Covidien Lp | Powered surgical instrument |
US20080255413A1 (en) | 2007-04-13 | 2008-10-16 | Michael Zemlok | Powered surgical instrument |
US7823760B2 (en) * | 2007-05-01 | 2010-11-02 | Tyco Healthcare Group Lp | Powered surgical stapling device platform |
US7931660B2 (en) | 2007-05-10 | 2011-04-26 | Tyco Healthcare Group Lp | Powered tacker instrument |
US7810693B2 (en) | 2007-05-30 | 2010-10-12 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with articulatable end effector |
US7798386B2 (en) | 2007-05-30 | 2010-09-21 | Ethicon Endo-Surgery, Inc. | Surgical instrument articulation joint cover |
US20080300461A1 (en) * | 2007-05-31 | 2008-12-04 | Ethicon Endo-Surgery, Inc. | Endoscopic Device |
US8157145B2 (en) | 2007-05-31 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with electrical feedback |
US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US7832408B2 (en) | 2007-06-04 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a directional switching mechanism |
US11672531B2 (en) | 2007-06-04 | 2023-06-13 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
US7819299B2 (en) | 2007-06-04 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a common trigger for actuating an end effector closing system and a staple firing system |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US20080308602A1 (en) | 2007-06-18 | 2008-12-18 | Timm Richard W | Surgical stapling and cutting instruments |
US7658311B2 (en) | 2007-06-22 | 2010-02-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with a geared return mechanism |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US7441685B1 (en) | 2007-06-22 | 2008-10-28 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with a return mechanism |
US8308040B2 (en) | 2007-06-22 | 2012-11-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
US7556185B2 (en) * | 2007-08-15 | 2009-07-07 | Tyco Healthcare Group Lp | Surgical instrument with flexible drive mechanism |
US8061576B2 (en) | 2007-08-31 | 2011-11-22 | Tyco Healthcare Group Lp | Surgical instrument |
US7624902B2 (en) * | 2007-08-31 | 2009-12-01 | Tyco Healthcare Group Lp | Surgical stapling apparatus |
US8556151B2 (en) | 2007-09-11 | 2013-10-15 | Covidien Lp | Articulating joint for surgical instruments |
ES2534292T5 (en) | 2007-09-21 | 2018-07-04 | Covidien Lp | Surgical device |
WO2009039510A1 (en) * | 2007-09-21 | 2009-03-26 | Power Medical Interventions, Inc. | Surgical device |
US7703653B2 (en) | 2007-09-28 | 2010-04-27 | Tyco Healthcare Group Lp | Articulation mechanism for surgical instrument |
US9707003B2 (en) * | 2007-10-02 | 2017-07-18 | Covidien Lp | Articulating surgical instrument |
US7942304B2 (en) * | 2007-10-19 | 2011-05-17 | Tyco Healthcare Group Lp | Two piece anvil for surgical stapler |
US20090112262A1 (en) | 2007-10-30 | 2009-04-30 | Scott Pool | Skeletal manipulation system |
US7922063B2 (en) | 2007-10-31 | 2011-04-12 | Tyco Healthcare Group, Lp | Powered surgical instrument |
US7954685B2 (en) | 2007-11-06 | 2011-06-07 | Tyco Healthcare Group Lp | Articulation and firing force mechanisms |
US10022250B2 (en) | 2007-12-12 | 2018-07-17 | Intact Vascular, Inc. | Deployment device for placement of multiple intraluminal surgical staples |
US7896911B2 (en) | 2007-12-12 | 2011-03-01 | Innovasc Llc | Device and method for tacking plaque to blood vessel wall |
US10166127B2 (en) | 2007-12-12 | 2019-01-01 | Intact Vascular, Inc. | Endoluminal device and method |
US8128677B2 (en) | 2007-12-12 | 2012-03-06 | Intact Vascular LLC | Device and method for tacking plaque to a blood vessel wall |
CA2711130C (en) | 2008-01-10 | 2016-08-30 | Power Medical Interventions, Llc | Imaging system for a surgical device |
US8453908B2 (en) | 2008-02-13 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved firing trigger arrangement |
US8540133B2 (en) | 2008-09-19 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US7766209B2 (en) | 2008-02-13 | 2010-08-03 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved firing trigger arrangement |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US8459525B2 (en) | 2008-02-14 | 2013-06-11 | Ethicon Endo-Sugery, Inc. | Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device |
US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
US7857185B2 (en) | 2008-02-14 | 2010-12-28 | Ethicon Endo-Surgery, Inc. | Disposable loading unit for surgical stapling apparatus |
US7861906B2 (en) | 2008-02-14 | 2011-01-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with articulatable components |
US7793812B2 (en) | 2008-02-14 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus |
US8758391B2 (en) * | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US7810692B2 (en) | 2008-02-14 | 2010-10-12 | Ethicon Endo-Surgery, Inc. | Disposable loading unit with firing indicator |
US7819296B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with retractable firing systems |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
US7913891B2 (en) | 2008-02-14 | 2011-03-29 | Ethicon Endo-Surgery, Inc. | Disposable loading unit with user feedback features and surgical instrument for use therewith |
US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US7819297B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with reprocessible handle assembly |
US20090206131A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | End effector coupling arrangements for a surgical cutting and stapling instrument |
US8608044B2 (en) | 2008-02-15 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Feedback and lockout mechanism for surgical instrument |
US20090206142A1 (en) | 2008-02-15 | 2009-08-20 | Ethicon Endo-Surgery, Inc. | Buttress material for a surgical stapling instrument |
US7959051B2 (en) | 2008-02-15 | 2011-06-14 | Ethicon Endo-Surgery, Inc. | Closure systems for a surgical cutting and stapling instrument |
US7980443B2 (en) | 2008-02-15 | 2011-07-19 | Ethicon Endo-Surgery, Inc. | End effectors for a surgical cutting and stapling instrument |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US9615826B2 (en) | 2010-09-30 | 2017-04-11 | Ethicon Endo-Surgery, Llc | Multiple thickness implantable layers for surgical stapling devices |
EP2257227A4 (en) * | 2008-03-14 | 2014-03-26 | Safestitch Medical Inc | Hernia stapler with integrated mesh manipulator |
US8870049B2 (en) | 2008-03-14 | 2014-10-28 | Transenterix, Inc. | Hernia stapler |
US11202707B2 (en) | 2008-03-25 | 2021-12-21 | Nuvasive Specialized Orthopedics, Inc. | Adjustable implant system |
US20090242609A1 (en) * | 2008-03-31 | 2009-10-01 | Medtronic Vascular, Inc. | Vascular Puncture Closure Staple With Tip Protection |
US8864776B2 (en) | 2008-04-11 | 2014-10-21 | Covidien Lp | Deployment system for surgical suture |
US8523040B2 (en) * | 2008-05-01 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Fastener and fastener applier having selective suture attachment |
US9084599B2 (en) * | 2008-05-01 | 2015-07-21 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument for applying a large staple through a small delivery port and a method of using the surgical stapler to secure a tissue fold |
US9016541B2 (en) | 2008-05-09 | 2015-04-28 | Covidien Lp | Varying tissue compression with an anvil configuration |
US7922061B2 (en) | 2008-05-21 | 2011-04-12 | Ethicon Endo-Surgery, Inc. | Surgical instrument with automatically reconfigurable articulating end effector |
US8701959B2 (en) | 2008-06-06 | 2014-04-22 | Covidien Lp | Mechanically pivoting cartridge channel for surgical instrument |
US7942303B2 (en) | 2008-06-06 | 2011-05-17 | Tyco Healthcare Group Lp | Knife lockout mechanisms for surgical instrument |
US7789283B2 (en) * | 2008-06-06 | 2010-09-07 | Tyco Healthcare Group Lp | Knife/firing rod connection for surgical instrument |
US8628545B2 (en) * | 2008-06-13 | 2014-01-14 | Covidien Lp | Endoscopic stitching devices |
US20110040308A1 (en) | 2008-06-13 | 2011-02-17 | Ramiro Cabrera | Endoscopic Stitching Devices |
US7543730B1 (en) | 2008-06-24 | 2009-06-09 | Tyco Healthcare Group Lp | Segmented drive member for surgical instruments |
US8465502B2 (en) | 2008-08-25 | 2013-06-18 | Covidien Lp | Surgical clip applier and method of assembly |
US20110208212A1 (en) | 2010-02-19 | 2011-08-25 | Zergiebel Earl M | Surgical clip applier |
US9358015B2 (en) | 2008-08-29 | 2016-06-07 | Covidien Lp | Endoscopic surgical clip applier with wedge plate |
US8409223B2 (en) | 2008-08-29 | 2013-04-02 | Covidien Lp | Endoscopic surgical clip applier with clip retention |
US8267944B2 (en) | 2008-08-29 | 2012-09-18 | Tyco Healthcare Group Lp | Endoscopic surgical clip applier with lock out |
US7837080B2 (en) | 2008-09-18 | 2010-11-23 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with device for indicating when the instrument has cut through tissue |
US8083120B2 (en) | 2008-09-18 | 2011-12-27 | Ethicon Endo-Surgery, Inc. | End effector for use with a surgical cutting and stapling instrument |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US7988028B2 (en) | 2008-09-23 | 2011-08-02 | Tyco Healthcare Group Lp | Surgical instrument having an asymmetric dynamic clamping member |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US8215532B2 (en) | 2008-09-23 | 2012-07-10 | Tyco Healthcare Group Lp | Tissue stop for surgical instrument |
US7896214B2 (en) | 2008-09-23 | 2011-03-01 | Tyco Healthcare Group Lp | Tissue stop for surgical instrument |
US8628544B2 (en) | 2008-09-23 | 2014-01-14 | Covidien Lp | Knife bar for surgical instrument |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8020743B2 (en) | 2008-10-15 | 2011-09-20 | Ethicon Endo-Surgery, Inc. | Powered articulatable surgical cutting and fastening instrument with flexible drive member |
US7918377B2 (en) | 2008-10-16 | 2011-04-05 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with apparatus for providing anvil position feedback |
US8382756B2 (en) | 2008-11-10 | 2013-02-26 | Ellipse Technologies, Inc. | External adjustment device for distraction device |
FR2939021B1 (en) * | 2008-11-28 | 2011-09-02 | Tornier Sa | ANCILLARY FOR THE INSTALLATION OF COMPRESSION STAPLES AND COMPRESSION STAPLER INSTALLATION ASSEMBLY. |
US7963197B2 (en) * | 2008-11-28 | 2011-06-21 | Steven Starko | Plumbing tool |
US8439244B2 (en) * | 2010-01-20 | 2013-05-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler fastening device with movable anvil |
US20100187283A1 (en) * | 2009-01-26 | 2010-07-29 | Lawrence Crainich | Method For Feeding Staples In a Low Profile Surgical Stapler |
US8602286B2 (en) * | 2009-01-26 | 2013-12-10 | Ethicon Endo-Surgery, Inc. | Apparatus for feeding staples in a low profile surgical stapler |
US8801732B2 (en) * | 2009-01-26 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical stapler to secure a tissue fold |
US9713471B2 (en) | 2009-01-26 | 2017-07-25 | Ethicon Endo-Surgery, Inc. | Surgical device with tandem fasteners |
US20100191262A1 (en) * | 2009-01-26 | 2010-07-29 | Harris Jason L | Surgical stapler for applying a large staple through small delivery port and a method of using the stapler to secure a tissue fold |
US9713468B2 (en) * | 2009-01-26 | 2017-07-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler for applying a large staple through a small delivery port and a method of using the stapler to secure a tissue fold |
US8453905B2 (en) | 2009-01-26 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical fastener for applying a large staple through a small delivery port |
US20130193184A1 (en) * | 2012-01-31 | 2013-08-01 | Matthew D. Holcomb | Surgical stapler fastening device |
US20100187285A1 (en) * | 2009-01-26 | 2010-07-29 | Harris Jason L | Surgical stapler for applying a large staple though a small delivery port and a method of using the stapler to secure a tissue fold |
US8469252B2 (en) * | 2009-01-26 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler fastening device with adjustable anvil |
US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
US8397971B2 (en) | 2009-02-05 | 2013-03-19 | Ethicon Endo-Surgery, Inc. | Sterilizable surgical instrument |
US8485413B2 (en) | 2009-02-05 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising an articulation joint |
US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
JP2012517287A (en) | 2009-02-06 | 2012-08-02 | エシコン・エンド−サージェリィ・インコーポレイテッド | Improvement of driven surgical stapler |
US8197490B2 (en) | 2009-02-23 | 2012-06-12 | Ellipse Technologies, Inc. | Non-invasive adjustable distraction system |
US7918376B1 (en) | 2009-03-09 | 2011-04-05 | Cardica, Inc. | Articulated surgical instrument |
US8066167B2 (en) | 2009-03-23 | 2011-11-29 | Ethicon Endo-Surgery, Inc. | Circular surgical stapling instrument with anvil locking system |
US8292154B2 (en) | 2009-04-16 | 2012-10-23 | Tyco Healthcare Group Lp | Surgical apparatus for applying tissue fasteners |
US9622792B2 (en) | 2009-04-29 | 2017-04-18 | Nuvasive Specialized Orthopedics, Inc. | Interspinous process device and method |
US8096457B1 (en) | 2009-05-05 | 2012-01-17 | Cardica, Inc. | Articulation mechanisms for surgical instrument |
US9289208B1 (en) | 2009-05-05 | 2016-03-22 | Cardica, Inc. | Articulation insert for surgical instrument |
US8127976B2 (en) * | 2009-05-08 | 2012-03-06 | Tyco Healthcare Group Lp | Stapler cartridge and channel interlock |
AT508161B1 (en) * | 2009-05-14 | 2011-08-15 | Peter Dr Metzger | FLEXIBLE SURGICAL BARRIER |
US8132706B2 (en) | 2009-06-05 | 2012-03-13 | Tyco Healthcare Group Lp | Surgical stapling apparatus having articulation mechanism |
US8821514B2 (en) * | 2009-06-08 | 2014-09-02 | Covidien Lp | Powered tack applier |
USD708746S1 (en) | 2009-06-10 | 2014-07-08 | Covidien Lp | Handle for surgical device |
US20110036891A1 (en) * | 2009-08-11 | 2011-02-17 | Tyco Healthcare Group Lp | Surgical stapler with visual positional indicator |
US8342378B2 (en) | 2009-08-17 | 2013-01-01 | Covidien Lp | One handed stapler |
US8657818B2 (en) * | 2009-08-21 | 2014-02-25 | Maquet Cardiovascular Llc | Single handled endoscopic vessel harvesting system with rotation control |
US8490713B2 (en) | 2009-10-06 | 2013-07-23 | Covidien Lp | Handle assembly for endoscopic suturing device |
US9474540B2 (en) * | 2009-10-08 | 2016-10-25 | Ethicon-Endo-Surgery, Inc. | Laparoscopic device with compound angulation |
US8418907B2 (en) * | 2009-11-05 | 2013-04-16 | Covidien Lp | Surgical stapler having cartridge with adjustable cam mechanism |
US8899466B2 (en) | 2009-11-19 | 2014-12-02 | Ethicon Endo-Surgery, Inc. | Devices and methods for introducing a surgical circular stapling instrument into a patient |
US9186136B2 (en) | 2009-12-09 | 2015-11-17 | Covidien Lp | Surgical clip applier |
US8136712B2 (en) | 2009-12-10 | 2012-03-20 | Ethicon Endo-Surgery, Inc. | Surgical stapler with discrete staple height adjustment and tactile feedback |
US8545486B2 (en) | 2009-12-15 | 2013-10-01 | Covidien Lp | Surgical clip applier |
US8568417B2 (en) * | 2009-12-18 | 2013-10-29 | Charles River Engineering Solutions And Technologies, Llc | Articulating tool and methods of using |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8267300B2 (en) | 2009-12-30 | 2012-09-18 | Ethicon Endo-Surgery, Inc. | Dampening device for endoscopic surgical stapler |
US8608046B2 (en) | 2010-01-07 | 2013-12-17 | Ethicon Endo-Surgery, Inc. | Test device for a surgical tool |
WO2011088446A2 (en) * | 2010-01-18 | 2011-07-21 | Safariland, Llc | Locking device safety mechanism and related holster assembly |
WO2011092692A2 (en) | 2010-01-26 | 2011-08-04 | Novolap Medical Ltd. | Articulating medical instrument |
US8403945B2 (en) | 2010-02-25 | 2013-03-26 | Covidien Lp | Articulating endoscopic surgical clip applier |
US8074859B2 (en) | 2010-03-31 | 2011-12-13 | Tyco Healthcare Group Lp | Surgical instrument |
US8348127B2 (en) | 2010-04-07 | 2013-01-08 | Covidien Lp | Surgical fastener applying apparatus |
US9226760B2 (en) | 2010-05-07 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Laparoscopic devices with flexible actuation mechanisms |
US8562592B2 (en) | 2010-05-07 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Compound angle laparoscopic methods and devices |
US9248043B2 (en) | 2010-06-30 | 2016-02-02 | Ellipse Technologies, Inc. | External adjustment device for distraction device |
US8403946B2 (en) | 2010-07-28 | 2013-03-26 | Covidien Lp | Articulating clip applier cartridge |
US8968337B2 (en) * | 2010-07-28 | 2015-03-03 | Covidien Lp | Articulating clip applier |
US8801735B2 (en) | 2010-07-30 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical circular stapler with tissue retention arrangements |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US8789740B2 (en) | 2010-07-30 | 2014-07-29 | Ethicon Endo-Surgery, Inc. | Linear cutting and stapling device with selectively disengageable cutting member |
US8734488B2 (en) | 2010-08-09 | 2014-05-27 | Ellipse Technologies, Inc. | Maintenance feature in magnetic implant |
US8360296B2 (en) | 2010-09-09 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling head assembly with firing lockout for a surgical stapler |
US8632525B2 (en) | 2010-09-17 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Power control arrangements for surgical instruments and batteries |
US9289212B2 (en) | 2010-09-17 | 2016-03-22 | Ethicon Endo-Surgery, Inc. | Surgical instruments and batteries for surgical instruments |
US20120078244A1 (en) | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
US8733613B2 (en) | 2010-09-29 | 2014-05-27 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9351730B2 (en) | 2011-04-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising channels |
US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9700317B2 (en) | 2010-09-30 | 2017-07-11 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a releasable tissue thickness compensator |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9220500B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US9113865B2 (en) | 2010-09-30 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a layer |
US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US9044228B2 (en) | 2010-09-30 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a plurality of fastener cartridges |
US8893949B2 (en) | 2010-09-30 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler with floating anvil |
CA2812553C (en) | 2010-09-30 | 2019-02-12 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a retention matrix and an alignment matrix |
US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
USD650074S1 (en) | 2010-10-01 | 2011-12-06 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
US8899461B2 (en) | 2010-10-01 | 2014-12-02 | Covidien Lp | Tissue stop for surgical instrument |
US9011464B2 (en) | 2010-11-02 | 2015-04-21 | Covidien Lp | Self-centering clip and jaw |
US8308041B2 (en) | 2010-11-10 | 2012-11-13 | Tyco Healthcare Group Lp | Staple formed over the wire wound closure procedure |
US9186153B2 (en) | 2011-01-31 | 2015-11-17 | Covidien Lp | Locking cam driver and jaw assembly for clip applier |
WO2012112396A2 (en) | 2011-02-14 | 2012-08-23 | Ellipse Technologies, Inc. | Device and method for treating fractured bones |
US8968340B2 (en) | 2011-02-23 | 2015-03-03 | Covidien Lp | Single actuating jaw flexible endolumenal stitching device |
US8632462B2 (en) | 2011-03-14 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Trans-rectum universal ports |
US8926598B2 (en) | 2011-03-15 | 2015-01-06 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulatable and rotatable end effector |
US8857693B2 (en) | 2011-03-15 | 2014-10-14 | Ethicon Endo-Surgery, Inc. | Surgical instruments with lockable articulating end effector |
US9044229B2 (en) | 2011-03-15 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical fastener instruments |
US8800841B2 (en) | 2011-03-15 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges |
US8540131B2 (en) | 2011-03-15 | 2013-09-24 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges with tissue tethers for manipulating divided tissue and methods of using same |
US9038880B1 (en) | 2011-04-25 | 2015-05-26 | Cardica, Inc. | Articulated surgical instrument |
US9474527B1 (en) | 2011-04-26 | 2016-10-25 | Bryan D. Knodel | Surgical instrument with discrete articulation |
US9566048B1 (en) | 2011-04-26 | 2017-02-14 | Cardica, Inc. | Surgical instrument with discrete cammed articulation |
US10603044B2 (en) | 2011-04-27 | 2020-03-31 | Covidien Lp | Surgical instruments for use with diagnostic scanning devices |
US9775623B2 (en) | 2011-04-29 | 2017-10-03 | Covidien Lp | Surgical clip applier including clip relief feature |
AU2012250197B2 (en) | 2011-04-29 | 2017-08-10 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
US8852185B2 (en) | 2011-05-19 | 2014-10-07 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US10390977B2 (en) | 2011-06-03 | 2019-08-27 | Intact Vascular, Inc. | Endovascular implant |
US9451959B2 (en) | 2011-06-09 | 2016-09-27 | Covidien Lp | Surgical fastener applying apparatus |
US9289209B2 (en) | 2011-06-09 | 2016-03-22 | Covidien Lp | Surgical fastener applying apparatus |
US9271728B2 (en) | 2011-06-09 | 2016-03-01 | Covidien Lp | Surgical fastener applying apparatus |
US8763876B2 (en) | 2011-06-30 | 2014-07-01 | Covidien Lp | Surgical instrument and cartridge for use therewith |
US20130012958A1 (en) | 2011-07-08 | 2013-01-10 | Stanislaw Marczyk | Surgical Device with Articulation and Wrist Rotation |
US9724095B2 (en) | 2011-08-08 | 2017-08-08 | Covidien Lp | Surgical fastener applying apparatus |
US9155537B2 (en) | 2011-08-08 | 2015-10-13 | Covidien Lp | Surgical fastener applying apparatus |
US9539007B2 (en) | 2011-08-08 | 2017-01-10 | Covidien Lp | Surgical fastener applying aparatus |
US9107663B2 (en) | 2011-09-06 | 2015-08-18 | Ethicon Endo-Surgery, Inc. | Stapling instrument comprising resettable staple drivers |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US10743794B2 (en) | 2011-10-04 | 2020-08-18 | Nuvasive Specialized Orthopedics, Inc. | Devices and methods for non-invasive implant length sensing |
US9016539B2 (en) | 2011-10-25 | 2015-04-28 | Covidien Lp | Multi-use loading unit |
US9016547B2 (en) * | 2011-10-26 | 2015-04-28 | Covidien Lp | EEA tilt top anvil with ratchet/locking mechanism |
WO2013066946A1 (en) | 2011-11-01 | 2013-05-10 | Ellipse Technologies, Inc. | Adjustable magnetic devices and methods of using same |
US20130131697A1 (en) | 2011-11-21 | 2013-05-23 | Covidien Lp | Surgical clip applier |
US8740036B2 (en) | 2011-12-01 | 2014-06-03 | Covidien Lp | Surgical instrument with actuator spring arm |
US9364239B2 (en) | 2011-12-19 | 2016-06-14 | Covidien Lp | Jaw closure mechanism for a surgical clip applier |
US9364216B2 (en) | 2011-12-29 | 2016-06-14 | Covidien Lp | Surgical clip applier with integrated clip counter |
US10299815B2 (en) | 2012-01-19 | 2019-05-28 | Covidien Lp | Surgical instrument with clam releases mechanism |
US8864010B2 (en) | 2012-01-20 | 2014-10-21 | Covidien Lp | Curved guide member for articulating instruments |
CN107157632B (en) * | 2012-01-25 | 2021-05-25 | 因特脉管有限公司 | Endoluminal device and method |
US9629660B2 (en) * | 2012-01-30 | 2017-04-25 | The Brigham And Women's Hospital | Functional uterine manipulator |
US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
US8979827B2 (en) | 2012-03-14 | 2015-03-17 | Covidien Lp | Surgical instrument with articulation mechanism |
US8992547B2 (en) | 2012-03-21 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Methods and devices for creating tissue plications |
US9078653B2 (en) | 2012-03-26 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge |
RU2644272C2 (en) | 2012-03-28 | 2018-02-08 | Этикон Эндо-Серджери, Инк. | Limitation node with tissue thickness compensator |
JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Tissue thickness compensator with multiple layers |
BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
US9408610B2 (en) | 2012-05-04 | 2016-08-09 | Covidien Lp | Surgical clip applier with dissector |
US9526497B2 (en) | 2012-05-07 | 2016-12-27 | Covidien Lp | Surgical instrument with articulation mechanism |
US10575716B2 (en) | 2012-05-11 | 2020-03-03 | Ethicon Llc | Applicator instruments with imaging systems for dispensing surgical fasteners during open repair procedures |
US9364228B2 (en) * | 2012-05-11 | 2016-06-14 | Ethicon, Llc | Applicator instruments having distal end caps for facilitating the accurate placement of surgical fasteners during open repair procedures |
US9532787B2 (en) | 2012-05-31 | 2017-01-03 | Covidien Lp | Endoscopic clip applier |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9364220B2 (en) | 2012-06-19 | 2016-06-14 | Covidien Lp | Apparatus for endoscopic procedures |
US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9408606B2 (en) | 2012-06-28 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Robotically powered surgical device with manually-actuatable reversing system |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
JP6290201B2 (en) | 2012-06-28 | 2018-03-07 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Lockout for empty clip cartridge |
US8747238B2 (en) | 2012-06-28 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Rotary drive shaft assemblies for surgical instruments with articulatable end effectors |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
US9232944B2 (en) | 2012-06-29 | 2016-01-12 | Covidien Lp | Surgical instrument and bushing |
US9402604B2 (en) | 2012-07-20 | 2016-08-02 | Covidien Lp | Apparatus for endoscopic procedures |
US9649114B2 (en) * | 2012-07-24 | 2017-05-16 | Ams Research Corporation | Systems, tools, and methods for connecting to tissue |
US9386985B2 (en) | 2012-10-15 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Surgical cutting instrument |
US9364217B2 (en) | 2012-10-16 | 2016-06-14 | Covidien Lp | In-situ loaded stapler |
AU2013338218B2 (en) | 2012-10-29 | 2017-05-04 | Nuvasive Specialized Orthopedics, Inc. | Adjustable devices for treating arthritis of the knee |
US9113892B2 (en) | 2013-01-08 | 2015-08-25 | Covidien Lp | Surgical clip applier |
US9968362B2 (en) | 2013-01-08 | 2018-05-15 | Covidien Lp | Surgical clip applier |
US9351733B2 (en) | 2013-01-18 | 2016-05-31 | Covidien Lp | Surgical fastener applier |
US9750500B2 (en) | 2013-01-18 | 2017-09-05 | Covidien Lp | Surgical clip applier |
US9345480B2 (en) | 2013-01-18 | 2016-05-24 | Covidien Lp | Surgical instrument and cartridge members for use therewith |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
US10092292B2 (en) | 2013-02-28 | 2018-10-09 | Ethicon Llc | Staple forming features for surgical stapling instrument |
BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
US20140249557A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Thumbwheel switch arrangements for surgical instruments |
RU2669463C2 (en) | 2013-03-01 | 2018-10-11 | Этикон Эндо-Серджери, Инк. | Surgical instrument with soft stop |
US20140257370A1 (en) | 2013-03-05 | 2014-09-11 | Covidien Lp | Anvil Grasper |
US10561432B2 (en) | 2013-03-05 | 2020-02-18 | Covidien Lp | Pivoting screw for use with a pair of jaw members of a surgical instrument |
US9358010B2 (en) | 2013-03-12 | 2016-06-07 | Covidien Lp | Flex cable and spring-loaded tube for tacking device |
US9814463B2 (en) | 2013-03-13 | 2017-11-14 | Covidien Lp | Surgical stapling apparatus |
US9668728B2 (en) | 2013-03-13 | 2017-06-06 | Covidien Lp | Surgical stapling apparatus |
US9345481B2 (en) | 2013-03-13 | 2016-05-24 | Ethicon Endo-Surgery, Llc | Staple cartridge tissue thickness sensor system |
US9717498B2 (en) | 2013-03-13 | 2017-08-01 | Covidien Lp | Surgical stapling apparatus |
US9629628B2 (en) | 2013-03-13 | 2017-04-25 | Covidien Lp | Surgical stapling apparatus |
EP4144303A1 (en) | 2013-03-14 | 2023-03-08 | Applied Medical Resources Corporation | Surgical stapler with partial pockets |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
US9883860B2 (en) | 2013-03-14 | 2018-02-06 | Ethicon Llc | Interchangeable shaft assemblies for use with a surgical instrument |
US9867620B2 (en) | 2013-03-14 | 2018-01-16 | Covidien Lp | Articulation joint for apparatus for endoscopic procedures |
US9668732B2 (en) | 2013-03-15 | 2017-06-06 | Applied Medical Resources Corporation | Surgical stapler handle assembly having actuation mechanism with longitudinally rotatable shaft |
US9655621B2 (en) | 2013-03-15 | 2017-05-23 | Covidien Lp | Surgical instrument for dispensing tacks and solution |
ES2803961T3 (en) | 2013-03-15 | 2021-02-01 | Applied Med Resources | Surgical Stapler with Expandable Jaw |
US9510827B2 (en) | 2013-03-25 | 2016-12-06 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
US10136887B2 (en) | 2013-04-16 | 2018-11-27 | Ethicon Llc | Drive system decoupling arrangement for a surgical instrument |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US9445810B2 (en) | 2013-06-12 | 2016-09-20 | Covidien Lp | Stapling device with grasping jaw mechanism |
US9668740B2 (en) * | 2013-06-14 | 2017-06-06 | Covidien Lp | Anvil assembly with sliding sleeve |
US9358004B2 (en) | 2013-06-28 | 2016-06-07 | Covidien Lp | Articulating apparatus for endoscopic procedures |
US10085746B2 (en) * | 2013-06-28 | 2018-10-02 | Covidien Lp | Surgical instrument including rotating end effector and rotation-limiting structure |
US9351728B2 (en) | 2013-06-28 | 2016-05-31 | Covidien Lp | Articulating apparatus for endoscopic procedures |
US20150032130A1 (en) | 2013-07-24 | 2015-01-29 | Covidien Lp | Expanding absorbable tack |
US9924942B2 (en) | 2013-08-23 | 2018-03-27 | Ethicon Llc | Motor-powered articulatable surgical instruments |
MX369362B (en) | 2013-08-23 | 2019-11-06 | Ethicon Endo Surgery Llc | Firing member retraction devices for powered surgical instruments. |
US9775624B2 (en) | 2013-08-27 | 2017-10-03 | Covidien Lp | Surgical clip applier |
US9662108B2 (en) | 2013-08-30 | 2017-05-30 | Covidien Lp | Surgical stapling apparatus |
US20140171986A1 (en) | 2013-09-13 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Surgical Clip Having Comliant Portion |
US10751094B2 (en) | 2013-10-10 | 2020-08-25 | Nuvasive Specialized Orthopedics, Inc. | Adjustable spinal implant |
CN105682568B (en) | 2013-11-04 | 2018-10-23 | 柯惠Lp公司 | Surgical fasteners bringing device |
CA2926748A1 (en) | 2013-11-04 | 2015-05-07 | Covidien Lp | Surgical fastener applying apparatus |
US11033264B2 (en) | 2013-11-04 | 2021-06-15 | Covidien Lp | Surgical fastener applying apparatus |
US9867613B2 (en) | 2013-12-19 | 2018-01-16 | Covidien Lp | Surgical staples and end effectors for deploying the same |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9681870B2 (en) | 2013-12-23 | 2017-06-20 | Ethicon Llc | Articulatable surgical instruments with separate and distinct closing and firing systems |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9642620B2 (en) | 2013-12-23 | 2017-05-09 | Ethicon Endo-Surgery, Llc | Surgical cutting and stapling instruments with articulatable end effectors |
US9585662B2 (en) | 2013-12-23 | 2017-03-07 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising an extendable firing member |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9629627B2 (en) | 2014-01-28 | 2017-04-25 | Coviden Lp | Surgical apparatus |
US9936952B2 (en) | 2014-02-03 | 2018-04-10 | Covidien Lp | Introducer assembly for a surgical fastener applying apparatus |
EP3106119B1 (en) | 2014-02-12 | 2018-10-10 | Olympus Corporation | Treatment device |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
US9848874B2 (en) | 2014-02-14 | 2017-12-26 | Covidien Lp | Small diameter endoscopic stapler |
CN106232029B (en) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | Fastening system including firing member locking piece |
US20140166725A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple. |
US9804618B2 (en) | 2014-03-26 | 2017-10-31 | Ethicon Llc | Systems and methods for controlling a segmented circuit |
US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US20150272580A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Verification of number of battery exchanges/procedure count |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US9757126B2 (en) | 2014-03-31 | 2017-09-12 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
CN106456176B (en) | 2014-04-16 | 2019-06-28 | 伊西康内外科有限责任公司 | Fastener cartridge including the extension with various configuration |
US11185330B2 (en) | 2014-04-16 | 2021-11-30 | Cilag Gmbh International | Fastener cartridge assemblies and staple retainer cover arrangements |
US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
BR112016023825B1 (en) | 2014-04-16 | 2022-08-02 | Ethicon Endo-Surgery, Llc | STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPLER AND STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
US20150297222A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
JP6532889B2 (en) | 2014-04-16 | 2019-06-19 | エシコン エルエルシーEthicon LLC | Fastener cartridge assembly and staple holder cover arrangement |
US9668733B2 (en) | 2014-04-21 | 2017-06-06 | Covidien Lp | Stapling device with features to prevent inadvertent firing of staples |
US9844377B2 (en) | 2014-04-25 | 2017-12-19 | Incisive Surgical, Inc. | Method and apparatus for wound closure with sequential tissue positioning and retention |
AU2015253313B9 (en) | 2014-04-28 | 2020-09-10 | Nuvasive Specialized Orthopedics, Inc. | System for informational magnetic feedback in adjustable implants |
US9861366B2 (en) | 2014-05-06 | 2018-01-09 | Covidien Lp | Ejecting assembly for a surgical stapler |
WO2015174985A1 (en) | 2014-05-15 | 2015-11-19 | Lp Covidien | Surgical fastener applying apparatus |
US9468434B2 (en) | 2014-06-03 | 2016-10-18 | Covidien Lp | Stitching end effector |
ES2758511T3 (en) | 2014-06-11 | 2020-05-05 | Applied Med Resources | Circumferential trigger surgical stapler |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
CN105310767B (en) * | 2014-07-18 | 2018-04-17 | 神讯电脑(昆山)有限公司 | Have for introscope medical electric burner |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
US10135242B2 (en) | 2014-09-05 | 2018-11-20 | Ethicon Llc | Smart cartridge wake up operation and data retention |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
EP3949872B1 (en) | 2014-09-15 | 2023-11-22 | Applied Medical Resources Corporation | Surgical stapler with self-adjusting staple height |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
MX2017003960A (en) | 2014-09-26 | 2017-12-04 | Ethicon Llc | Surgical stapling buttresses and adjunct materials. |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
CN104257408B (en) * | 2014-09-29 | 2017-08-25 | 北京派尔特医疗科技股份有限公司 | A kind of tube type anastomat |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10702278B2 (en) | 2014-12-02 | 2020-07-07 | Covidien Lp | Laparoscopic surgical ligation clip applier |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
US10004501B2 (en) | 2014-12-18 | 2018-06-26 | Ethicon Llc | Surgical instruments with improved closure arrangements |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
RU2703684C2 (en) | 2014-12-18 | 2019-10-21 | ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи | Surgical instrument with anvil which is selectively movable relative to staple cartridge around discrete fixed axis |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
WO2016105524A1 (en) | 2014-12-26 | 2016-06-30 | Ellipse Technologies, Inc. | Systems and methods for distraction |
USD752219S1 (en) | 2015-01-02 | 2016-03-22 | Incisive Surgical, Inc. | Tissue fastening instrument |
US9931124B2 (en) | 2015-01-07 | 2018-04-03 | Covidien Lp | Reposable clip applier |
US10368876B2 (en) | 2015-01-15 | 2019-08-06 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10292712B2 (en) | 2015-01-28 | 2019-05-21 | Covidien Lp | Surgical clip applier with integrated cutter |
US9375336B1 (en) | 2015-01-29 | 2016-06-28 | Intact Vascular, Inc. | Delivery device and method of delivery |
US9433520B2 (en) | 2015-01-29 | 2016-09-06 | Intact Vascular, Inc. | Delivery device and method of delivery |
FR3032608B1 (en) | 2015-02-13 | 2020-10-23 | Institut Hospitalo Univ De Chirurgie Mini Invasive Guidee Par Limage | ENDOSCOPIC SURGERY SYSTEM FORMED ON THE ONE HAND BY A PLURALITY OF STAPLES AND ON THE OTHER HAND BY AN ENDOSCOPIC APPLICATOR. |
WO2016134326A2 (en) | 2015-02-19 | 2016-08-25 | Nuvasive, Inc. | Systems and methods for vertebral adjustment |
US10039545B2 (en) | 2015-02-23 | 2018-08-07 | Covidien Lp | Double fire stapling |
US10085749B2 (en) | 2015-02-26 | 2018-10-02 | Covidien Lp | Surgical apparatus with conductor strain relief |
US10285698B2 (en) | 2015-02-26 | 2019-05-14 | Covidien Lp | Surgical apparatus |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10321907B2 (en) | 2015-02-27 | 2019-06-18 | Ethicon Llc | System for monitoring whether a surgical instrument needs to be serviced |
US9855040B2 (en) * | 2015-03-04 | 2018-01-02 | Covidien Lp | Surgical stapling loading unit having articulating jaws |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US10045776B2 (en) | 2015-03-06 | 2018-08-14 | Ethicon Llc | Control techniques and sub-processor contained within modular shaft with select control processing from handle |
US10159491B2 (en) | 2015-03-10 | 2018-12-25 | Covidien Lp | Endoscopic reposable surgical clip applier |
US11090097B2 (en) | 2015-03-17 | 2021-08-17 | Covidien Lp | Connecting end effectors to surgical devices |
US9918717B2 (en) | 2015-03-18 | 2018-03-20 | Covidien Lp | Pivot mechanism for surgical device |
US10390825B2 (en) | 2015-03-31 | 2019-08-27 | Ethicon Llc | Surgical instrument with progressive rotary drive systems |
US10463368B2 (en) | 2015-04-10 | 2019-11-05 | Covidien Lp | Endoscopic stapler |
US10117650B2 (en) | 2015-05-05 | 2018-11-06 | Covidien Lp | Adapter assembly and loading units for surgical stapling devices |
US10299789B2 (en) | 2015-05-05 | 2019-05-28 | Covidie LP | Adapter assembly for surgical stapling devices |
US10039532B2 (en) | 2015-05-06 | 2018-08-07 | Covidien Lp | Surgical instrument with articulation assembly |
JP6420501B6 (en) | 2015-05-08 | 2018-12-19 | ジャストライト サージカル,リミティド ライアビリティ カンパニー | Surgical stapler |
US10349941B2 (en) | 2015-05-27 | 2019-07-16 | Covidien Lp | Multi-fire lead screw stapling device |
US10172615B2 (en) | 2015-05-27 | 2019-01-08 | Covidien Lp | Multi-fire push rod stapling device |
US10092286B2 (en) | 2015-05-27 | 2018-10-09 | Covidien Lp | Suturing loading unit |
US10405863B2 (en) | 2015-06-18 | 2019-09-10 | Ethicon Llc | Movable firing beam support arrangements for articulatable surgical instruments |
US10548599B2 (en) | 2015-07-20 | 2020-02-04 | Covidien Lp | Endoscopic stapler and staple |
US9987012B2 (en) | 2015-07-21 | 2018-06-05 | Covidien Lp | Small diameter cartridge design for a surgical stapling instrument |
US10194912B2 (en) * | 2015-07-28 | 2019-02-05 | Ethicon Llc | Surgical staple cartridge with outer edge compression features |
US10064622B2 (en) | 2015-07-29 | 2018-09-04 | Covidien Lp | Surgical stapling loading unit with stroke counter and lockout |
US10045782B2 (en) | 2015-07-30 | 2018-08-14 | Covidien Lp | Surgical stapling loading unit with stroke counter and lockout |
KR20240027156A (en) | 2015-08-06 | 2024-02-29 | 어플라이드 메디컬 리소시스 코포레이션 | Surgical stapler having locking articulation joint |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
US10098642B2 (en) | 2015-08-26 | 2018-10-16 | Ethicon Llc | Surgical staples comprising features for improved fastening of tissue |
BR112018003693B1 (en) | 2015-08-26 | 2022-11-22 | Ethicon Llc | SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPPING INSTRUMENT |
MX2022006189A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10238390B2 (en) | 2015-09-02 | 2019-03-26 | Ethicon Llc | Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns |
US10085747B2 (en) | 2015-09-11 | 2018-10-02 | Incisive Surgical, Inc. | Surgical fastening instrument |
US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10561420B2 (en) | 2015-09-30 | 2020-02-18 | Ethicon Llc | Tubular absorbable constructs |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10285699B2 (en) | 2015-09-30 | 2019-05-14 | Ethicon Llc | Compressible adjunct |
US10213204B2 (en) | 2015-10-02 | 2019-02-26 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
CN113425401A (en) | 2015-10-16 | 2021-09-24 | 诺威适骨科专科公司 | Adjustable device for treating gonitis |
US10772632B2 (en) | 2015-10-28 | 2020-09-15 | Covidien Lp | Surgical stapling device with triple leg staples |
WO2017075752A1 (en) | 2015-11-03 | 2017-05-11 | Covidien Lp | Endoscopic surgical clip applier |
JP6609699B2 (en) | 2015-11-10 | 2019-11-20 | コヴィディエン リミテッド パートナーシップ | Partially disposable surgical clip applier for endoscope |
CA2999906A1 (en) | 2015-11-10 | 2017-05-18 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10390831B2 (en) | 2015-11-10 | 2019-08-27 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10595864B2 (en) | 2015-11-24 | 2020-03-24 | Covidien Lp | Adapter assembly for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof |
US10111660B2 (en) | 2015-12-03 | 2018-10-30 | Covidien Lp | Surgical stapler flexible distal tip |
WO2017100774A1 (en) | 2015-12-10 | 2017-06-15 | Nuvasive Specialized Orthopedics, Inc. | External adjustment device for distraction device |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10993824B2 (en) | 2016-01-01 | 2021-05-04 | Intact Vascular, Inc. | Delivery device and method of delivery |
US10966717B2 (en) | 2016-01-07 | 2021-04-06 | Covidien Lp | Surgical fastener apparatus |
WO2017120734A1 (en) | 2016-01-11 | 2017-07-20 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10660623B2 (en) | 2016-01-15 | 2020-05-26 | Covidien Lp | Centering mechanism for articulation joint |
CN108472027B (en) | 2016-01-18 | 2020-12-29 | 柯惠有限合伙公司 | Endoscopic surgical clip applier |
ES2805657T3 (en) | 2016-01-28 | 2021-02-15 | Nuvasive Specialized Orthopedics Inc | Systems for bone transport |
US10433837B2 (en) | 2016-02-09 | 2019-10-08 | Ethicon Llc | Surgical instruments with multiple link articulation arrangements |
BR112018016098B1 (en) | 2016-02-09 | 2023-02-23 | Ethicon Llc | SURGICAL INSTRUMENT |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
CN109069148B (en) * | 2016-02-09 | 2021-06-22 | 伊西康有限责任公司 | Surgical instrument with articulatable and axially translatable end effector |
US10349937B2 (en) | 2016-02-10 | 2019-07-16 | Covidien Lp | Surgical stapler with articulation locking mechanism |
US10420559B2 (en) | 2016-02-11 | 2019-09-24 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
CA2958160A1 (en) | 2016-02-24 | 2017-08-24 | Covidien Lp | Endoscopic reposable surgical clip applier |
US11045191B2 (en) | 2016-04-01 | 2021-06-29 | Cilag Gmbh International | Method for operating a surgical stapling system |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10413293B2 (en) | 2016-04-01 | 2019-09-17 | Ethicon Llc | Interchangeable surgical tool assembly with a surgical end effector that is selectively rotatable about a shaft axis |
US11284890B2 (en) | 2016-04-01 | 2022-03-29 | Cilag Gmbh International | Circular stapling system comprising an incisable tissue support |
US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
JP6965268B2 (en) | 2016-04-12 | 2021-11-10 | アプライド メディカル リソーシーズ コーポレイション | Surgical stapler with electric handle |
CA3020791A1 (en) | 2016-04-12 | 2017-10-19 | Applied Medical Resources Corporation | Reload shaft assembly for surgical stapler |
AU2017250184B2 (en) | 2016-04-12 | 2022-03-24 | Applied Medical Resources Corporation | Surgical stapler having articulation mechanism |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US10478181B2 (en) | 2016-04-18 | 2019-11-19 | Ethicon Llc | Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US10561419B2 (en) | 2016-05-04 | 2020-02-18 | Covidien Lp | Powered end effector assembly with pivotable channel |
US11065022B2 (en) | 2016-05-17 | 2021-07-20 | Covidien Lp | Cutting member for a surgical instrument |
US10542970B2 (en) | 2016-05-31 | 2020-01-28 | Covidien Lp | Endoscopic stitching device |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
USD822206S1 (en) | 2016-06-24 | 2018-07-03 | Ethicon Llc | Surgical fastener |
CN109310431B (en) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | Staple cartridge comprising wire staples and punch staples |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
US10675024B2 (en) * | 2016-06-24 | 2020-06-09 | Ethicon Llc | Staple cartridge comprising overdriven staples |
US10806464B2 (en) | 2016-08-11 | 2020-10-20 | Covidien Lp | Endoscopic surgical clip applier and clip applying systems |
JP2019524326A (en) | 2016-08-25 | 2019-09-05 | コヴィディエン リミテッド パートナーシップ | Endoscopic surgical clip applier and clip application system |
US10660651B2 (en) | 2016-10-31 | 2020-05-26 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10639044B2 (en) | 2016-10-31 | 2020-05-05 | Covidien Lp | Ligation clip module and clip applier |
US10492795B2 (en) | 2016-11-01 | 2019-12-03 | Covidien Lp | Endoscopic surgical clip applier |
US10610236B2 (en) | 2016-11-01 | 2020-04-07 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10426489B2 (en) | 2016-11-01 | 2019-10-01 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10631857B2 (en) | 2016-11-04 | 2020-04-28 | Covidien Lp | Loading unit for surgical instruments with low profile pushers |
US11642126B2 (en) | 2016-11-04 | 2023-05-09 | Covidien Lp | Surgical stapling apparatus with tissue pockets |
US10492784B2 (en) | 2016-11-08 | 2019-12-03 | Covidien Lp | Surgical tool assembly with compact firing assembly |
US10463371B2 (en) | 2016-11-29 | 2019-11-05 | Covidien Lp | Reload assembly with spent reload indicator |
US10517595B2 (en) | 2016-12-21 | 2019-12-31 | Ethicon Llc | Jaw actuated lock arrangements for preventing advancement of a firing member in a surgical end effector unless an unfired cartridge is installed in the end effector |
BR112019011947A2 (en) | 2016-12-21 | 2019-10-29 | Ethicon Llc | surgical stapling systems |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US10758229B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument comprising improved jaw control |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
US10617414B2 (en) | 2016-12-21 | 2020-04-14 | Ethicon Llc | Closure member arrangements for surgical instruments |
US10675025B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Shaft assembly comprising separately actuatable and retractable systems |
US20180168608A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instrument system comprising an end effector lockout and a firing assembly lockout |
US10682138B2 (en) | 2016-12-21 | 2020-06-16 | Ethicon Llc | Bilaterally asymmetric staple forming pocket pairs |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
CN110099619B (en) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | Lockout device for surgical end effector and replaceable tool assembly |
US10588632B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical end effectors and firing members thereof |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US10588630B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical tool assemblies with closure stroke reduction features |
US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
US20180168648A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Durability features for end effectors and firing assemblies of surgical stapling instruments |
US10709901B2 (en) | 2017-01-05 | 2020-07-14 | Covidien Lp | Implantable fasteners, applicators, and methods for brachytherapy |
US10709455B2 (en) | 2017-02-02 | 2020-07-14 | Covidien Lp | Endoscopic surgical clip applier |
CN110267606B (en) | 2017-02-06 | 2022-06-03 | 柯惠有限合伙公司 | Surgical clip applier with user feedback feature |
US10952767B2 (en) | 2017-02-06 | 2021-03-23 | Covidien Lp | Connector clip for securing an introducer to a surgical fastener applying apparatus |
US10758244B2 (en) | 2017-02-06 | 2020-09-01 | Covidien Lp | Endoscopic surgical clip applier |
US10660725B2 (en) | 2017-02-14 | 2020-05-26 | Covidien Lp | Endoscopic surgical clip applier including counter assembly |
US10603038B2 (en) | 2017-02-22 | 2020-03-31 | Covidien Lp | Surgical clip applier including inserts for jaw assembly |
US20180235618A1 (en) | 2017-02-22 | 2018-08-23 | Covidien Lp | Loading unit for surgical instruments with low profile pushers |
US10548602B2 (en) | 2017-02-23 | 2020-02-04 | Covidien Lp | Endoscopic surgical clip applier |
US10849621B2 (en) | 2017-02-23 | 2020-12-01 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
US11350915B2 (en) | 2017-02-23 | 2022-06-07 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
US11583291B2 (en) | 2017-02-23 | 2023-02-21 | Covidien Lp | Endoscopic surgical clip applier |
US10299790B2 (en) | 2017-03-03 | 2019-05-28 | Covidien Lp | Adapter with centering mechanism for articulation joint |
US10660641B2 (en) | 2017-03-16 | 2020-05-26 | Covidien Lp | Adapter with centering mechanism for articulation joint |
US11324502B2 (en) | 2017-05-02 | 2022-05-10 | Covidien Lp | Surgical loading unit including an articulating end effector |
US10603035B2 (en) | 2017-05-02 | 2020-03-31 | Covidien Lp | Surgical loading unit including an articulating end effector |
US10675043B2 (en) | 2017-05-04 | 2020-06-09 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10524784B2 (en) | 2017-05-05 | 2020-01-07 | Covidien Lp | Surgical staples with expandable backspan |
US10390826B2 (en) | 2017-05-08 | 2019-08-27 | Covidien Lp | Surgical stapling device with elongated tool assembly and methods of use |
US10722235B2 (en) | 2017-05-11 | 2020-07-28 | Covidien Lp | Spring-release surgical clip |
US11311295B2 (en) | 2017-05-15 | 2022-04-26 | Covidien Lp | Adaptive powered stapling algorithm with calibration factor |
US10420551B2 (en) | 2017-05-30 | 2019-09-24 | Covidien Lp | Authentication and information system for reusable surgical instruments |
US10478185B2 (en) | 2017-06-02 | 2019-11-19 | Covidien Lp | Tool assembly with minimal dead space |
US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US20180368844A1 (en) | 2017-06-27 | 2018-12-27 | Ethicon Llc | Staple forming pocket arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US11020114B2 (en) | 2017-06-28 | 2021-06-01 | Cilag Gmbh International | Surgical instruments with articulatable end effector with axially shortened articulation joint configurations |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
US11678880B2 (en) | 2017-06-28 | 2023-06-20 | Cilag Gmbh International | Surgical instrument comprising a shaft including a housing arrangement |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US10660723B2 (en) | 2017-06-30 | 2020-05-26 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10639032B2 (en) | 2017-06-30 | 2020-05-05 | Covidien Lp | Endoscopic surgical clip applier including counter assembly |
US11660218B2 (en) | 2017-07-26 | 2023-05-30 | Intact Vascular, Inc. | Delivery device and method of delivery |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US10675112B2 (en) | 2017-08-07 | 2020-06-09 | Covidien Lp | Endoscopic surgical clip applier including counter assembly |
US10932790B2 (en) | 2017-08-08 | 2021-03-02 | Covidien Lp | Geared actuation mechanism and surgical clip applier including the same |
US10786262B2 (en) | 2017-08-09 | 2020-09-29 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10786263B2 (en) | 2017-08-15 | 2020-09-29 | Covidien Lp | Endoscopic reposable surgical clip applier |
WO2019040542A1 (en) | 2017-08-21 | 2019-02-28 | Freyja Healthcare, Llc | Uterine manipulator with cutting head |
US10624636B2 (en) | 2017-08-23 | 2020-04-21 | Covidien Lp | Surgical stapling device with floating staple cartridge |
US10806452B2 (en) | 2017-08-24 | 2020-10-20 | Covidien Lp | Loading unit for a surgical stapling instrument |
US20190069759A1 (en) * | 2017-09-06 | 2019-03-07 | Biosense Webster (Israel) Ltd. | Single Handled ENT Tool |
US10835341B2 (en) | 2017-09-12 | 2020-11-17 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10835260B2 (en) | 2017-09-13 | 2020-11-17 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10653429B2 (en) | 2017-09-13 | 2020-05-19 | Covidien Lp | Endoscopic surgical clip applier |
US10758245B2 (en) | 2017-09-13 | 2020-09-01 | Covidien Lp | Clip counting mechanism for surgical clip applier |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US11207066B2 (en) | 2017-10-30 | 2021-12-28 | Covidien Lp | Apparatus for endoscopic procedures |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US10987104B2 (en) | 2017-10-30 | 2021-04-27 | Covidien Lp | Apparatus for endoscopic procedures |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10932791B2 (en) | 2017-11-03 | 2021-03-02 | Covidien Lp | Reposable multi-fire surgical clip applier |
US11116513B2 (en) | 2017-11-03 | 2021-09-14 | Covidien Lp | Modular surgical clip cartridge |
US11376015B2 (en) | 2017-11-03 | 2022-07-05 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10828036B2 (en) | 2017-11-03 | 2020-11-10 | Covidien Lp | Endoscopic surgical clip applier and handle assemblies for use therewith |
US10945734B2 (en) | 2017-11-03 | 2021-03-16 | Covidien Lp | Rotation knob assemblies and surgical instruments including the same |
US10925603B2 (en) | 2017-11-14 | 2021-02-23 | Covidien Lp | Reload with articulation stabilization system |
US10863987B2 (en) | 2017-11-16 | 2020-12-15 | Covidien Lp | Surgical instrument with imaging device |
US10722236B2 (en) | 2017-12-12 | 2020-07-28 | Covidien Lp | Endoscopic reposable surgical clip applier |
US10849630B2 (en) | 2017-12-13 | 2020-12-01 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10959737B2 (en) | 2017-12-13 | 2021-03-30 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10743887B2 (en) | 2017-12-13 | 2020-08-18 | Covidien Lp | Reposable multi-fire surgical clip applier |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11179151B2 (en) | 2017-12-21 | 2021-11-23 | Cilag Gmbh International | Surgical instrument comprising a display |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US11051827B2 (en) | 2018-01-16 | 2021-07-06 | Covidien Lp | Endoscopic surgical instrument and handle assemblies for use therewith |
US10945732B2 (en) | 2018-01-17 | 2021-03-16 | Covidien Lp | Surgical stapler with self-returning assembly |
WO2019169010A1 (en) | 2018-02-27 | 2019-09-06 | Applied Medical Resources Corporation | Surgical stapler having a powered handle |
EP3758618A4 (en) | 2018-03-02 | 2021-10-06 | Covidien LP | Surgical stapling instrument |
US10993721B2 (en) | 2018-04-25 | 2021-05-04 | Covidien Lp | Surgical clip applier |
US10849622B2 (en) | 2018-06-21 | 2020-12-01 | Covidien Lp | Articulated stapling with fire lock |
US11497490B2 (en) | 2018-07-09 | 2022-11-15 | Covidien Lp | Powered surgical devices including predictive motor control |
US10786273B2 (en) | 2018-07-13 | 2020-09-29 | Covidien Lp | Rotation knob assemblies for handle assemblies |
US11197665B2 (en) | 2018-08-06 | 2021-12-14 | Covidien Lp | Needle reload device for use with endostitch device |
US10736631B2 (en) | 2018-08-07 | 2020-08-11 | Covidien Lp | End effector with staple cartridge ejector |
US11051828B2 (en) | 2018-08-13 | 2021-07-06 | Covidien Lp | Rotation knob assemblies and surgical instruments including same |
US11278267B2 (en) | 2018-08-13 | 2022-03-22 | Covidien Lp | Latch assemblies and surgical instruments including the same |
US11246601B2 (en) | 2018-08-13 | 2022-02-15 | Covidien Lp | Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same |
US11344316B2 (en) | 2018-08-13 | 2022-05-31 | Covidien Lp | Elongated assemblies for surgical clip appliers and surgical clip appliers incorporating the same |
US11219463B2 (en) | 2018-08-13 | 2022-01-11 | Covidien Lp | Bilateral spring for surgical instruments and surgical instruments including the same |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
US10849620B2 (en) | 2018-09-14 | 2020-12-01 | Covidien Lp | Connector mechanisms for surgical stapling instruments |
US11510669B2 (en) | 2020-09-29 | 2022-11-29 | Covidien Lp | Hand-held surgical instruments |
US11147566B2 (en) | 2018-10-01 | 2021-10-19 | Covidien Lp | Endoscopic surgical clip applier |
US11090051B2 (en) | 2018-10-23 | 2021-08-17 | Covidien Lp | Surgical stapling device with floating staple cartridge |
US11197734B2 (en) | 2018-10-30 | 2021-12-14 | Covidien Lp | Load sensing devices for use in surgical instruments |
US11197673B2 (en) | 2018-10-30 | 2021-12-14 | Covidien Lp | Surgical stapling instruments and end effector assemblies thereof |
US11369372B2 (en) | 2018-11-28 | 2022-06-28 | Covidien Lp | Surgical stapler adapter with flexible cable assembly, flexible fingers, and contact clips |
US10912563B2 (en) | 2019-01-02 | 2021-02-09 | Covidien Lp | Stapling device including tool assembly stabilizing member |
US11202635B2 (en) | 2019-02-04 | 2021-12-21 | Covidien Lp | Programmable distal tilt position of end effector for powered surgical devices |
US11376006B2 (en) | 2019-02-06 | 2022-07-05 | Covidien Lp | End effector force measurement with digital drive circuit |
US11311293B2 (en) | 2019-02-27 | 2022-04-26 | Applied Medical Resources Corporation | Surgical stapling instrument having a two-position lockout mechanism |
US11344297B2 (en) | 2019-02-28 | 2022-05-31 | Covidien Lp | Surgical stapling device with independently movable jaws |
US11219461B2 (en) | 2019-03-08 | 2022-01-11 | Covidien Lp | Strain gauge stabilization in a surgical device |
US11259808B2 (en) | 2019-03-13 | 2022-03-01 | Covidien Lp | Tool assemblies with a gap locking member |
US11524398B2 (en) | 2019-03-19 | 2022-12-13 | Covidien Lp | Gear drive mechanisms for surgical instruments |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
KR20210145248A (en) | 2019-03-29 | 2021-12-01 | 어플라이드 메디컬 리소시스 코포레이션 | Reload cover for surgical stapling system |
US11284892B2 (en) | 2019-04-01 | 2022-03-29 | Covidien Lp | Loading unit and adapter with modified coupling assembly |
US11284893B2 (en) | 2019-04-02 | 2022-03-29 | Covidien Lp | Stapling device with articulating tool assembly |
US11241228B2 (en) | 2019-04-05 | 2022-02-08 | Covidien Lp | Surgical instrument including an adapter assembly and an articulating surgical loading unit |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11229437B2 (en) | 2019-06-28 | 2022-01-25 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
JP2022542050A (en) * | 2019-07-24 | 2022-09-29 | ボストン サイエンティフィック サイムド,インコーポレイテッド | fastening device |
US11224424B2 (en) | 2019-08-02 | 2022-01-18 | Covidien Lp | Linear stapling device with vertically movable knife |
US11406385B2 (en) | 2019-10-11 | 2022-08-09 | Covidien Lp | Stapling device with a gap locking member |
US11123068B2 (en) | 2019-11-08 | 2021-09-21 | Covidien Lp | Surgical staple cartridge |
US11534163B2 (en) | 2019-11-21 | 2022-12-27 | Covidien Lp | Surgical stapling instruments |
US11707274B2 (en) | 2019-12-06 | 2023-07-25 | Covidien Lp | Articulating mechanism for surgical instrument |
US11109862B2 (en) | 2019-12-12 | 2021-09-07 | Covidien Lp | Surgical stapling device with flexible shaft |
US11737747B2 (en) | 2019-12-17 | 2023-08-29 | Covidien Lp | Hand-held surgical instruments |
US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11779340B2 (en) | 2020-01-02 | 2023-10-10 | Covidien Lp | Ligation clip loading device |
US11723669B2 (en) | 2020-01-08 | 2023-08-15 | Covidien Lp | Clip applier with clip cartridge interface |
US11452524B2 (en) | 2020-01-31 | 2022-09-27 | Covidien Lp | Surgical stapling device with lockout |
US11278282B2 (en) | 2020-01-31 | 2022-03-22 | Covidien Lp | Stapling device with selective cutting |
US11458244B2 (en) | 2020-02-07 | 2022-10-04 | Covidien Lp | Irrigating surgical apparatus with positive pressure fluid |
US11553913B2 (en) | 2020-02-11 | 2023-01-17 | Covidien Lp | Electrically-determining tissue cut with surgical stapling apparatus |
US11890014B2 (en) | 2020-02-14 | 2024-02-06 | Covidien Lp | Cartridge holder for surgical staples and having ridges in peripheral walls for gripping tissue |
US11344301B2 (en) | 2020-03-02 | 2022-05-31 | Covidien Lp | Surgical stapling device with replaceable reload assembly |
US11344302B2 (en) | 2020-03-05 | 2022-05-31 | Covidien Lp | Articulation mechanism for surgical stapling device |
US11707278B2 (en) | 2020-03-06 | 2023-07-25 | Covidien Lp | Surgical stapler tool assembly to minimize bleeding |
US11246593B2 (en) | 2020-03-06 | 2022-02-15 | Covidien Lp | Staple cartridge |
US11317911B2 (en) | 2020-03-10 | 2022-05-03 | Covidien Lp | Tool assembly with replaceable cartridge assembly |
US11357505B2 (en) | 2020-03-10 | 2022-06-14 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
US11406383B2 (en) | 2020-03-17 | 2022-08-09 | Covidien Lp | Fire assisted powered EGIA handle |
US11426159B2 (en) | 2020-04-01 | 2022-08-30 | Covidien Lp | Sled detection device |
US11331098B2 (en) | 2020-04-01 | 2022-05-17 | Covidien Lp | Sled detection device |
US11504117B2 (en) | 2020-04-02 | 2022-11-22 | Covidien Lp | Hand-held surgical instruments |
US11937794B2 (en) | 2020-05-11 | 2024-03-26 | Covidien Lp | Powered handle assembly for surgical devices |
US11191537B1 (en) | 2020-05-12 | 2021-12-07 | Covidien Lp | Stapling device with continuously parallel jaws |
US11406387B2 (en) | 2020-05-12 | 2022-08-09 | Covidien Lp | Surgical stapling device with replaceable staple cartridge |
US11534167B2 (en) | 2020-05-28 | 2022-12-27 | Covidien Lp | Electrotaxis-conducive stapling |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
US11191538B1 (en) | 2020-06-08 | 2021-12-07 | Covidien Lp | Surgical stapling device with parallel jaw closure |
US11413129B2 (en) | 2020-06-19 | 2022-08-16 | Davol Inc. | Implantable prosthesis |
US11844517B2 (en) | 2020-06-25 | 2023-12-19 | Covidien Lp | Linear stapling device with continuously parallel jaws |
US11324500B2 (en) | 2020-06-30 | 2022-05-10 | Covidien Lp | Surgical stapling device |
US11517305B2 (en) | 2020-07-09 | 2022-12-06 | Covidien Lp | Contoured staple pusher |
US11446028B2 (en) | 2020-07-09 | 2022-09-20 | Covidien Lp | Tool assembly with pivotable clamping beam |
US11622768B2 (en) | 2020-07-13 | 2023-04-11 | Covidien Lp | Methods and structure for confirming proper assembly of powered surgical stapling systems |
US20220031350A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with double pivot articulation joint arrangements |
US11266402B2 (en) | 2020-07-30 | 2022-03-08 | Covidien Lp | Sensing curved tip for surgical stapling instruments |
US11439392B2 (en) | 2020-08-03 | 2022-09-13 | Covidien Lp | Surgical stapling device and fastener for pathological exam |
US11395654B2 (en) | 2020-08-07 | 2022-07-26 | Covidien Lp | Surgical stapling device with articulation braking assembly |
US11602342B2 (en) | 2020-08-27 | 2023-03-14 | Covidien Lp | Surgical stapling device with laser probe |
US11678878B2 (en) | 2020-09-16 | 2023-06-20 | Covidien Lp | Articulation mechanism for surgical stapling device |
US11660092B2 (en) | 2020-09-29 | 2023-05-30 | Covidien Lp | Adapter for securing loading units to handle assemblies of surgical stapling instruments |
US11406384B2 (en) | 2020-10-05 | 2022-08-09 | Covidien Lp | Stapling device with drive assembly stop member |
US11576674B2 (en) | 2020-10-06 | 2023-02-14 | Covidien Lp | Surgical stapling device with articulation lock assembly |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11771428B2 (en) | 2020-10-29 | 2023-10-03 | Applied Medical Resources Corporation | Actuation shaft retention mechanism for surgical stapler |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
EP4236821A1 (en) | 2020-10-29 | 2023-09-06 | Applied Medical Resources Corporation | Surgical stapler having a powered handle |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11890007B2 (en) | 2020-11-18 | 2024-02-06 | Covidien Lp | Stapling device with flex cable and tensioning mechanism |
US11744580B2 (en) | 2020-11-24 | 2023-09-05 | Covidien Lp | Long stapler reloads with continuous cartridge |
US11653919B2 (en) | 2020-11-24 | 2023-05-23 | Covidien Lp | Stapler line reinforcement continuity |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11737774B2 (en) | 2020-12-04 | 2023-08-29 | Covidien Lp | Surgical instrument with articulation assembly |
US11819200B2 (en) | 2020-12-15 | 2023-11-21 | Covidien Lp | Surgical instrument with articulation assembly |
US11553914B2 (en) | 2020-12-22 | 2023-01-17 | Covidien Lp | Surgical stapling device with parallel jaw closure |
US11759206B2 (en) | 2021-01-05 | 2023-09-19 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
US11744582B2 (en) | 2021-01-05 | 2023-09-05 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
US11759207B2 (en) | 2021-01-27 | 2023-09-19 | Covidien Lp | Surgical stapling apparatus with adjustable height clamping member |
US11517313B2 (en) | 2021-01-27 | 2022-12-06 | Covidien Lp | Surgical stapling device with laminated drive member |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11717300B2 (en) | 2021-03-11 | 2023-08-08 | Covidien Lp | Surgical stapling apparatus with integrated visualization |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11497495B2 (en) | 2021-03-31 | 2022-11-15 | Covidien Lp | Continuous stapler strip for use with a surgical stapling device |
US11666330B2 (en) | 2021-04-05 | 2023-06-06 | Covidien Lp | Surgical stapling device with lockout mechanism |
US11576670B2 (en) | 2021-05-06 | 2023-02-14 | Covidien Lp | Surgical stapling device with optimized drive assembly |
US11812956B2 (en) | 2021-05-18 | 2023-11-14 | Covidien Lp | Dual firing radial stapling device |
US11696755B2 (en) | 2021-05-19 | 2023-07-11 | Covidien Lp | Surgical stapling device with reload assembly removal lockout |
US11771423B2 (en) | 2021-05-25 | 2023-10-03 | Covidien Lp | Powered stapling device with manual retraction |
US11510673B1 (en) | 2021-05-25 | 2022-11-29 | Covidien Lp | Powered stapling device with manual retraction |
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US20220378426A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a mounted shaft orientation sensor |
US11576675B2 (en) | 2021-06-07 | 2023-02-14 | Covidien Lp | Staple cartridge with knife |
US11684362B2 (en) | 2021-06-07 | 2023-06-27 | Covidien Lp | Handheld electromechanical surgical system |
CN113509227B (en) * | 2021-06-09 | 2022-12-13 | 吉林大学 | Intestinal anastomat under scope |
US11707275B2 (en) | 2021-06-29 | 2023-07-25 | Covidien Lp | Asymmetrical surgical stapling device |
US11617579B2 (en) | 2021-06-29 | 2023-04-04 | Covidien Lp | Ultra low profile surgical stapling instrument for tissue resections |
US11771432B2 (en) | 2021-06-29 | 2023-10-03 | Covidien Lp | Stapling and cutting to default values in the event of strain gauge data integrity loss |
US11602344B2 (en) | 2021-06-30 | 2023-03-14 | Covidien Lp | Surgical stapling apparatus with firing lockout assembly |
US11540831B1 (en) | 2021-08-12 | 2023-01-03 | Covidien Lp | Staple cartridge with actuation sled detection |
US11779334B2 (en) | 2021-08-19 | 2023-10-10 | Covidien Lp | Surgical stapling device including a manual retraction assembly |
US11576671B1 (en) | 2021-08-20 | 2023-02-14 | Covidien Lp | Small diameter linear surgical stapling apparatus |
US11707277B2 (en) | 2021-08-20 | 2023-07-25 | Covidien Lp | Articulating surgical stapling apparatus with pivotable knife bar guide assembly |
US11864761B2 (en) | 2021-09-14 | 2024-01-09 | Covidien Lp | Surgical instrument with illumination mechanism |
US11660094B2 (en) | 2021-09-29 | 2023-05-30 | Covidien Lp | Surgical fastening instrument with two-part surgical fasteners |
US11653922B2 (en) | 2021-09-29 | 2023-05-23 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
US11849949B2 (en) | 2021-09-30 | 2023-12-26 | Covidien Lp | Surgical stapling device with firing lockout member |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
US11832823B2 (en) | 2022-02-08 | 2023-12-05 | Covidien Lp | Determination of anvil release during anastomosis |
Family Cites Families (43)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2507710A (en) * | 1949-07-02 | 1950-05-16 | Patrick P Grosso | Adjustable-angle surgical instrument |
US3593903A (en) * | 1968-07-12 | 1971-07-20 | Vnii Khirurgicheskoi Apparatur | Surgical instrument for suturing hollow organs in infants |
US4427008A (en) * | 1982-02-26 | 1984-01-24 | Ethicon, Inc. | Multiple ligating clip applier with rocking escapement |
US4664305A (en) * | 1982-05-04 | 1987-05-12 | Blake Joseph W Iii | Surgical stapler |
US4562839A (en) * | 1983-01-06 | 1986-01-07 | Blake Joseph W Iii | Surgical instrument |
DE3301713A1 (en) * | 1983-01-20 | 1984-07-26 | Horst Dr. 3004 Isernhagen Ziegler | Surgical clip suture apparatus for producing circular joins |
US5125553A (en) * | 1987-03-02 | 1992-06-30 | Stryker Sales Corporation | Surgical suturing instrument and method |
US4944443A (en) * | 1988-04-22 | 1990-07-31 | Innovative Surgical Devices, Inc. | Surgical suturing instrument and method |
US4506819A (en) * | 1983-09-19 | 1985-03-26 | Rand Burt E | Staple supply indicator |
US4607638A (en) * | 1984-04-20 | 1986-08-26 | Design Standards Corporation | Surgical staples |
US4754909A (en) * | 1984-08-09 | 1988-07-05 | Barker John M | Flexible stapler |
US4566620A (en) * | 1984-10-19 | 1986-01-28 | United States Surgical Corporation | Articulated surgical fastener applying apparatus |
US4573622A (en) * | 1984-10-19 | 1986-03-04 | United States Surgical Corporation | Surgical fastener applying apparatus with variable fastener arrays |
US4807628A (en) * | 1985-04-26 | 1989-02-28 | Edward Weck & Company, Inc. | Method and apparatus for storing, dispensing, and applying surgical staples |
US4728020A (en) * | 1985-08-30 | 1988-03-01 | United States Surgical Corporation | Articulated surgical fastener applying apparatus |
US4706668A (en) * | 1985-09-16 | 1987-11-17 | B & B Tools | Aneurysm clip pliers |
US4691853A (en) * | 1985-12-30 | 1987-09-08 | Technalytics, Inc. | Surgical stapler |
US4796627A (en) * | 1986-08-26 | 1989-01-10 | Tucker Wilson H | Clip applicator and spreadable clips for use therein |
US4872456A (en) * | 1987-11-12 | 1989-10-10 | Hasson Harrith M | Template incision device |
US5084057A (en) * | 1989-07-18 | 1992-01-28 | United States Surgical Corporation | Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures |
GB8800909D0 (en) * | 1988-01-15 | 1988-02-17 | Ethicon Inc | Gas powered surgical stapler |
US5114065A (en) * | 1988-05-23 | 1992-05-19 | Technalytics, Inc. | Surgical stapler |
US4880015A (en) * | 1988-06-03 | 1989-11-14 | Nierman David M | Biopsy forceps |
GB2226245A (en) * | 1988-11-18 | 1990-06-27 | Alan Crockard | Endoscope, remote actuator and aneurysm clip applicator. |
US5040715B1 (en) * | 1989-05-26 | 1994-04-05 | United States Surgical Corp | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
DE3934698A1 (en) * | 1989-10-18 | 1991-04-25 | Beiersdorf Ag | SURGICAL DEVICE FOR SETTING WIND CLASPS |
AU7082091A (en) * | 1990-02-13 | 1991-08-15 | Ethicon Inc. | Rotating head skin stapler |
US5161725A (en) * | 1990-02-13 | 1992-11-10 | Ethicon, Inc. | Rotating head skin stapler |
DE9117288U1 (en) * | 1990-10-05 | 1999-10-21 | United States Surgical Corp | Surgical stapling instrument |
US5042707A (en) * | 1990-10-16 | 1991-08-27 | Taheri Syde A | Intravascular stapler, and method of operating same |
US5174487A (en) * | 1991-04-04 | 1992-12-29 | Ethicon, Inc. | Endoscopic stapler and hernia repair mechanism |
US5176702A (en) * | 1991-04-04 | 1993-01-05 | Symbiosis Corporation | Ratchet locking mechanism for surgical instruments |
US5147373A (en) * | 1991-04-29 | 1992-09-15 | Ferzli George S | Laparoscopic instrument |
US5258010A (en) * | 1991-05-30 | 1993-11-02 | United States Surgical Corporation | Anvilless surgical apparatus for applying surgical fasteners |
US5251801A (en) * | 1991-08-05 | 1993-10-12 | Edward Weck Incorporated | Surgical stapler |
US5289963A (en) * | 1991-10-18 | 1994-03-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5326013A (en) * | 1991-10-18 | 1994-07-05 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US5356064A (en) * | 1991-10-18 | 1994-10-18 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
US5163945A (en) * | 1991-10-18 | 1992-11-17 | Ethicon, Inc. | Surgical clip applier |
US5312023A (en) * | 1991-10-18 | 1994-05-17 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
US5240163A (en) * | 1991-10-30 | 1993-08-31 | American Cyanamid Company | Linear surgical stapling instrument |
US5222975A (en) * | 1992-07-13 | 1993-06-29 | Lawrence Crainich | Surgical staples |
US5601224A (en) * | 1992-10-09 | 1997-02-11 | Ethicon, Inc. | Surgical instrument |
-
1992
- 1992-10-09 US US07/959,184 patent/US5381943A/en not_active Expired - Lifetime
-
1993
- 1993-10-06 IL IL107204A patent/IL107204A0/en unknown
- 1993-10-07 CA CA002107970A patent/CA2107970C/en not_active Expired - Lifetime
- 1993-10-08 ES ES93308031T patent/ES2111137T3/en not_active Expired - Lifetime
- 1993-10-08 EP EP96100840A patent/EP0713684B1/en not_active Expired - Lifetime
- 1993-10-08 EP EP93308031A patent/EP0592244B1/en not_active Expired - Lifetime
- 1993-10-08 DE DE69324272T patent/DE69324272T2/en not_active Expired - Lifetime
- 1993-10-08 ES ES96100840T patent/ES2129896T3/en not_active Expired - Lifetime
- 1993-10-08 AU AU48926/93A patent/AU666580B2/en not_active Expired
- 1993-10-08 AT AT93308031T patent/ATE162058T1/en not_active IP Right Cessation
- 1993-10-08 JP JP5277828A patent/JPH06197901A/en active Pending
- 1993-10-08 DE DE69316305T patent/DE69316305T2/en not_active Expired - Lifetime
- 1993-10-11 BR BR9304210A patent/BR9304210A/en unknown
-
1996
- 1996-09-09 US US08/709,961 patent/US5829662A/en not_active Expired - Lifetime
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DE69316305T2 (en) | 1998-05-14 |
CA2107970A1 (en) | 1994-04-10 |
EP0713684A3 (en) | 1996-06-12 |
DE69316305D1 (en) | 1998-02-19 |
DE69324272D1 (en) | 1999-05-06 |
EP0592244A3 (en) | 1994-12-28 |
US5381943A (en) | 1995-01-17 |
AU4892693A (en) | 1994-04-21 |
ATE162058T1 (en) | 1998-01-15 |
EP0713684A2 (en) | 1996-05-29 |
ES2111137T3 (en) | 1998-03-01 |
EP0713684B1 (en) | 1999-03-31 |
US5829662A (en) | 1998-11-03 |
AU666580B2 (en) | 1996-02-15 |
EP0592244B1 (en) | 1998-01-14 |
JPH06197901A (en) | 1994-07-19 |
EP0592244A2 (en) | 1994-04-13 |
DE69324272T2 (en) | 1999-09-09 |
ES2129896T3 (en) | 1999-06-16 |
IL107204A0 (en) | 1994-01-25 |
BR9304210A (en) | 1994-04-12 |
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