|Publication number||US3552626 A|
|Publication date||5 Jan 1971|
|Filing date||4 Apr 1968|
|Priority date||2 Feb 1968|
|Also published as||DE1766398B|
|Publication number||US 3552626 A, US 3552626A, US-A-3552626, US3552626 A, US3552626A|
|Inventors||Pavel Iosifovich Androsov, Georgy Vasilievich Astafiev, Svetoslav Ivanovich Babkin, Tatiana Lukianovna Ivanova, Anatoly Nikolaevich Ozhgikhin|
|Original Assignee||Anatoly Nikolaevich Ozhgikhin, Georgy Vasilievich Astafiev, Pavel Iosifovich Androsov, Svetoslav Ivanovich Babkin, Tatiana Lukianovna Ivanova|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (3), Referenced by (255), Classifications (7)|
|External Links: USPTO, USPTO Assignment, Espacenet|
United States Patent lnventors INSTRUMENT FOR CIRCULAR SUTURING OF HOLLOW BODY ORGANS 4 Claims, 11 Drawing Figs.
 Int. Cl... B3lb l/00; B27f 7/00  Field olSearch 128/305. 334, 335, 337; 227/8, 19, 76, 109
 References Cited UNITED STATES PATENTS 3,193,165 7/1965 Arhalaya et al 227/8 3,252,643 5/1966 Strekopytov et a1. 227/109 3,388,847 6/1968 Kasulin et al. 227/19 Primary Examiner-Dalton L. Pruluck Attorney-Waters, Roditi, Schwartz & Nissen PATENTEU JAN 51971 $552,626
sum 1 or 6 PATENIEU JAN 5197 saw a nr 6 w wilwilllllrl llluu 1% l flllllI/I mimmm slsn V 3552626 SHEET 3 UF 6 PATENTED m 5197! 3,552,626
SHEET 1% [IF 6 PAT-ENTED JAN SIB?! sum 5 0F 6 PATENTEDJAN 519?! 1 I 3552.626
saw 6 OF 6 FIG. 10
INSTRUMENT FOR CIRCULAR SUTURING OF HOLLOW BODY ORGANS The present invention relates to surgical instruments for ap plying circular staple sutures when placing anastomoses on hollow organs, and particularly to instruments for placing circular anastomoses between the organs of the alimentary canal.
There are known in present day surgical practice instruments for placing circular anastomoses between hollow organs (cf. USSR Authors Certificates Nos. 195,041 and l4l,589; Patents: British No. 942,122, Canadian No. 736,256, U.S. No. 3,l93,l 65, Swiss No. 407,407, French Nos. 1,349,201 and l,46l,464, Italian Nos. 674,175 and 724,978, Japanese No, 456,544, Belgian No. 668,917). Said instruments feature a tubular body which houses a central stem and a hollow movable rod carrying a cylindrical-shaped knife and a staple ejector, a staple portion, a detachable head with radial depressions for the staples to bend and with a recess for a replaceable semirigid washer.
A principal disadvantage inherent in the known surgical instruments of the character set forth hereinabove resides in the fact that each particular instrument is only suitable for applying circular staple sutures to the organs of a certain diameter, which depends upon the diameter of the tubular body of the instrument involved, in whose end face are provided grooves for staples.
It is common knowledge that tubular organs that constitute make the human alimentary canal (i.e. the esophagus, large and small intestines) feature different diameters at various levels even in the same man. Variationsin the diameters of said organs take place in dependence of the age and habitus of a man, etc.
In order to place circular anastomoses between the organs of the alimentary canal, both the instrument body and its supporting head are introduced into the inner space of the organs being sutured. It is evident that the diameter of the instrument must correspond to that of the organs to be sutured.
Another disadvantage of the known surgical instruments for placing circular staple sutures is that the bodies of said instruments are fixed in length.
However, the experience of clinical application of the known instruments has proven that for placing anastomoses on the organs situated in deep operational wounds, instruments of greater length are required as compared to those to be employed for placing anastomoses on the organs located in shallow wounds.
In connection with the above, a necessity arises for a complete set of instruments incorporating tubular bodies of different diameters and lengths which is inexpedient from the economical viewpoint, especially for users to whom the acquisition of a number of such instruments will be rather costly.
In keeping with all set forth her'einabove, an object of the present invention is to devise a surgical instrument for placing circular anastomoses on all the organs of the human alimentary canal irrespective of the diameter thereof.
Another object of the present invention is to provide an instrument capable of placing a suture at any depth of the operational field.
Said objects are achieved in that in the surgical instrument for placing circular anastomoses, according to the present invention, the staple portion thereof is made as an individual structural component, i.e. a staple head with a built-in slidable staple ejector, and is adapted to be mounted with the possibility of rapid removal at the end of an extension tube which connects the staple head to the body, said tube being provided with a device enabling the staple body, the stem and the tubular rod to be aligned with respect to one another, whereby staple heads of different size can be mounted on said extension tube so that the staple slots be positioned strictly opposite to the depressions in the supporting heads.
For insuring simple and reliable operation of the instrument, said aligning device incorporates a double-headed key fixed in position at the end of said extension tube and adapted to fit into the longitudinal guide slots of the staple head, tubular rod and stem.
In order to provide for a quick removal or mounting of the staple head, according to the invention, its tailpiece is threaded, whereas on the extension tubea union nut is loosely set which is screwable onto the tailpiece of the staple head.
According to the invention, the slidable staple ejector built in into the staple head, is fixed to the tubular rod directly via a knife screwed onto the rod end projecting from the hole in the bottom of the staple ejector.
With the purpose of varying the length of the instrument, according to the invention, the replaceable extension tube is made fast on the body by a union nut loosely set on said tube and screwable onto the threaded end' of the body.
In order to accurately align the extension tube with the body, a groove is cut in the threaded portion thereof, whereas the corresponding end of the tube carries a key to fit into said groove.
Other objects and advantages of the present invention will become evident upon considering an embodiment thereof described hereinafter by way of examplewith reference to the accompanying drawings, wherein: 5
FIG. I is a diagrammatic side view of the surgical instrument for placing circular anastomoses, according to the present invention;
FIG. 2 is a longitudinal sectional view of the working portion of the instrument represented in FIG. 1;
FIG. 3 is a section on line A-A of FIG. 2;
FIG. 4 is a diagrammatic side view of the staple ejector;
FIG. 5 is a section on line B-B of FIG. 2;
FIG. 6 is a diagrammatic bottom view ofthe tubular rod;
FIG. 7 is a section on line C-C of FIG. 2;
FIG. 8 is a schematic diagram of the arrangement ofthe organs to be sutured, prior to placing an anastomosis;
FIG. 9 is a cross-sectional view of an anastomosis placed by the instrument of the invention;
FIG. 10 is a diagrammatic view of the instrument for placing circular anastomoses provided with interchangeable tubes; and
FIG. 11 is a portion of the instrument shown in section at the place where an interchangeable tube is coupled to the in strument body. I
In describing the particular embodiment of the present invention illustrated in the appended drawings, specific terminology has been resorted to for the sake of clarity. It should be understood, however, that the present invention is in no way limited to the terms so selected and that each such term covers all equivalent elements operating in a similar manner and employed for solving similar problems.
Now referring to FIG. 1, the instrument of the invention comprises a body 1 rigidly secured to an extension tube 2, a movable handle 3 articulated to said body and a fixed handle 4 rigidly coupled thereto.
A replaceable staple head 6 (FIGS. 1, 2) is fastened at the end of the extension tube 2 by means ofa union nut 5.
The staple head 6 incorporates a cylindrical sleeve 7 inside which a splined ring 8 is fixed in position to form staple slots 9 (FIGS. 2, 3) in association with the sleeve surface.
Furthermore, accommodated inside the sleeve 7 is a slidable cylindrical staple ejector 10 (FIG. 4) provided with a hole 11 at its bottom and with peripherally spaced toothlike tabs 12 to drive the staples out of the slots 9. The ejector 10 is held in place inside the head 6 by means of a cover 13 (FIG. 2) which has a tubular tailpiece 14 provided with male thread for threadably engaging the union nut 5.
A groove 15 is provided in the tailpiece 14. In order to insure that the replaceable heads assume a definite position with respect to the extension tube, the latter is provided with an aligning device made as a double-headed key 16 fixed in place at the end of the extension tube 2. When mounting a staple head onto the extension tube, the outer head ofthe key 16 engages the groove 15 in the tubular tailpiece 14 of the staple head cover (FIGS. 2,5).
Thus, a strong and reliable fastening of the replaceable staple head 6 at the end of the extension tube 2 in a strictly definite position is attained. It is evident, that the staple heads may be made for both recurrent and single use, i.e. of metal or plastic, respectively.
Extending inside the extension tube 2 and the body 1 is a tubular rod 17 (FIGS. 2, 6) provided with a front threaded portion 18 and a longitudinal groove 19 which serves for passage of the innerhead of the key 16, whereby the rod 17 is fixed to assume only its definite position.
A replaceable cylindrical knife 20 is screwed onto the threaded end 18, said knife forcing the ejector 10 against a projection 21 of the tubular rod, thus preventing its spontaneous movement towards the staple slots 9, whereby a premature staple ejection is obviated.
A stem 22 passes inside the tubular rod 17, said stern being provided with a longitudinal groove 23 for the passage of the inner head of the double-headed key 16.
The pointed front end of stem 22 is provided with a thread 24 onto which a replaceable supporting head 25 (FIG. 2) is screwed.
The supporting head is a composite of three portions: a cylindrical portion 26, a taper portion 27 and a die portion 28.
The cylindrical and taper portions are interconnected with the possibility of independent rotation of the taper portion around its axis when the cylindrical portion remains immovable. 1
The cylindrical portion 26 has a hole 29so profiled as to suit the shape of the cross-sectional area of that portion of the stem 22 whereon the supporting head is mounted (FIG. 7).
The provision of such a shape of hole makes it possible to set a replaceable supporting head in a strictly definite position with respect to the stem 22.
A cylindrical depression 30 is made in the supporting head 25 for accommodating a single-use semirigid washer 31, said washer protecting the cutting edge of the knife 20 from becoming blunt and contributing to the complete excision of the tissues during operation (FIG. 2).
An annular recess 32 is provided at the bottom of the depression 30, the diameter of said recess being equal to that of the cutting edge of the knife 20 (FIG. 2).
The die 28 has thrust depressions 33 for the staple ends to bend when suturing (FIG. 2).
A nut 34 (FIG. 1) is mounted at the end of the body 1, whereby the stem 22 together with the supporting head 25 is moved. The end of the stem facing the instrument body is provided with a thread 35 which corresponds to that of the nut 34.
In order to displace the tubular rod 17 and, consequently, the staple ejector 10 together with the knife 20, use is made of the movable handle 3. A shorter effective arm of the handle 3 is made as a fork so as to enter the body 1 through a port 37 and to straddle flat side surfaces 38 of the rod 17 (FIG. 6). When moving the handle 3, its arm 36 presses upon projections 39 or 40 on the tubular rod 17, thereby causing the latter to travel'in either direction along the instrument depending upon the direction of movement of the handle 3.
INSTRUMENT APPLICATION TECHNIQUE Prior to making use of the instrument of the invention, it should be prepared for operation, for which purpose the diameter of the supporting and staple heads with the knife required for the operation should be determined. Then, the slots 9 in the staple head are loaded with staples and a semirigid replaceable washer is placed into the depression 30 in the supporting head, whereupon the staple head and the knife, as well as the supporting head are mounted in position on the instrument. This done, both heads are brought together as far as they will go. In that position, the instrument is sterilized.
Intestinal walls 41 and 42 (FIG, 8) to be sutured are placed between the end-face portions of the supporting head 25 and the staple head 6 spaced fully apart.
For the purpose ofjuxtaposing the tissues being sutured, the stem 22, together with the supportinghead, is moved with respect to the body 1 by rotating the nut 34 (FIG. 1).
Then, by pressing the handles 3 and 4 together, the rod 17 is made to move, as a result of which the toothlike tabs 12 of the moving ejector 10 act upon the staples so as to move them out of the slots 9; while moving, the pointed ends of the staples pierce the tissues being sutured and, upon meeting the thrust depressions 33 in the head 25, are bent to assume a B-shaped form.
ture, then reaches the semirigid washer 31,,enters the same and cuts out the tissues, thus forming a circular anastomotic aperture 43(FIGS.2and 9).
The instrument of the invention is applicable for placing end-to-end, end-to-side, side-to-side" and "side-to end anastomoses.
An alternative embodiment of the present invention is the same instrument but provided with the replaceable extension tubes, rods and stems, which allow the length of the instrument to be varied so as to be practicable for placing anastomoses at any depth of location of the operational field (FIG. 10).
The principal component part of such instrument is its body 44 on which a replaceable extension tube 46 is fixed in place by means of a union nut 45. Each replaceable tube corresponds to its particular replaceable tubular rod 47 and a replaceable stem 48.
An accurate setting of the intermediate tube on the instrument body is attainable by a key 49 (FIG. 11) fixed in position on the extension tube and engaging a groove 50 provided on a threaded cylindrical portion 51, said groove being provided with a thread for threadably engaging the union nut 45.
As to all other respects, the design of the instrument is entirely similar to that considered herein'above.
Though this invention has been described hereinabove with reference to the preferred embodiment thereof, it will be understood that various alterations and modifications may be made without departing from the spirit and scope of the invention, as will be readily understood by those skilled in the art.
Such alterations and modifications are to be considered as falling within the limits of the spirit and scope of the invention and the appended claims.
1. An instrument for placing circular anastomoses between organs of the alimentary canal, said instrument comprising a body with a cylindrical threaded portion having a groove and a detachable extension tube provided thereon, said tube having ends with aligning means constituted as keys, one being a oneheaded key at one end of the tube and the other a doubleheaded key at the opposite end of the tube, a detachable tubular rod in said extension tube and body and having threads on the forward end thereof and a longitudinal groove receiving the inner end of said double-headed key; a stem including a pointed threaded forward end, said stem having a longitudinal groove receiving the inner end of said double-headed key, said stem being slidable longitudinally within said rod; a replaceable supporting head including two parts coupled so that one part is capable of rotating with respect to the other and having in one of its parts a shaped opening corresponding to the shape of the cross section of said threaded end of the stem, and a central threaded opening in its other part which is detachably secured in a definite position on said end of the stem, said other of the parts of the head having depressions for bending the staples; a replaceable staple head having slots for U-shaped staples and a threaded tailpiece having a longitudinal groove receiving the outer end of said double-headed key for securing said staple head at the end of the extension tube in a definite position with respect to said supporting head so that said staple slots are aligned exactly opposite said depressions; and a slidable cylindrical ejector slidably mounted in said staple head and having a bottom portion with an opening therein for passage of said rod; a cylindrical knife mounted on said rod; and means for moving said ejectorand knife.
The knife 20, while moving togetherjwith the rod 17, forces the tissues being sutured inside the alreadyformed circular suthrough the opening in the bottom portion of the ejector.
4. An instrument as claimed in claim 1 comprising a nut securing the detachable extension tubeto the body, said nut being freely mounted on said tube and screwed to the cylindrical threaded portion of the body.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US3193165 *||27 Aug 1962||6 Jul 1965||Akhalaya Mikhail Gueorguievich||Instrument for suturing esophagus to intestine or stomach|
|US3252643 *||24 Dec 1962||24 May 1966||Strekopytov Alexey Alexcevich||Instrument for suturing living tissue|
|US3388847 *||26 Aug 1965||18 Jun 1968||Gambashidze Galina Mikhailovna||Surgical instrument for suturing hollow organs|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US3638652 *||1 Jun 1970||1 Feb 1972||James L Kelley||Surgical instrument for intraluminal anastomosis|
|US3789847 *||19 Aug 1971||5 Feb 1974||Lehmann A||Tool for lower colon surgery|
|US4198982 *||31 Mar 1978||22 Apr 1980||Memorial Hospital For Cancer And Allied Diseases||Surgical stapling instrument and method|
|US4207898 *||27 Mar 1978||17 Jun 1980||Senco Products, Inc.||Intralumenal anastomosis surgical stapling instrument|
|US4289133 *||28 Feb 1980||15 Sep 1981||Senco Products, Inc.||Cut-through backup washer for the scalpel of an intraluminal surgical stapling instrument|
|US4304236 *||10 Apr 1980||8 Dec 1981||United States Surgical Corporation||Stapling instrument having an anvil-carrying part of particular geometric shape|
|US4319576 *||26 Feb 1980||16 Mar 1982||Senco Products, Inc.||Intralumenal anastomosis surgical stapling instrument|
|US4351466 *||16 Oct 1980||28 Sep 1982||United States Surgical Corporation||Disposable instrument for surgical fastening|
|US4379457 *||17 Feb 1981||12 Apr 1983||United States Surgical Corporation||Indicator for surgical stapler|
|US4466436 *||23 Dec 1981||21 Aug 1984||Sukoo Lee||Surgical stapler|
|US4473077 *||28 May 1982||25 Sep 1984||United States Surgical Corporation||Surgical stapler apparatus with flexible shaft|
|US4476863 *||9 Mar 1981||16 Oct 1984||Kanshin Nikolai N||Surgical instrument for establishing circular coloanastomoses|
|US4485817 *||28 May 1982||4 Dec 1984||United States Surgical Corporation||Surgical stapler apparatus with flexible shaft|
|US4505272 *||22 Feb 1983||19 Mar 1985||Vsesojozny Naucho-Issledovatelsky i Ispytatelny Institut Meditsinskoi Tekhniki||Surgical suturing instrument for performing anastomoses between structures of the digestive tract|
|US4576167 *||3 Sep 1981||18 Mar 1986||United States Surgical Corporation||Surgical stapler apparatus with curved shaft|
|US4592354 *||11 Oct 1983||3 Jun 1986||Senmed, Inc.||Tissue retention spool for intraluminal anastomotic surgical stapling instrument and methods|
|US4603693 *||7 Dec 1981||5 Aug 1986||United States Surgical Corporation||Instrument for circular surgical stapling of hollow body organs and disposable cartridge therefor|
|US4606343 *||18 Aug 1980||19 Aug 1986||United States Surgical Corporation||Self-powered surgical fastening instrument|
|US4607637 *||22 Jul 1983||26 Aug 1986||Anders Berggren||Surgical instrument for performing anastomosis with the aid of ring-like fastening elements and the fastening elements for performing anastomosis|
|US4624257 *||21 Feb 1984||25 Nov 1986||Anders Berggren||Surgical instrument for performing anastomosis|
|US4646745 *||22 Nov 1985||3 Mar 1987||United States Surgical Corporation||Surgical stapler apparatus with curved shaft|
|US4917090 *||19 Jan 1988||17 Apr 1990||Unilink, Inc.||Method for performing an anastomosis|
|US4930674 *||24 Feb 1989||5 Jun 1990||Abiomed, Inc.||Surgical stapler|
|US5197649 *||29 Oct 1991||30 Mar 1993||The Trustees Of Columbia University In The City Of New York||Gastrointestinal endoscoptic stapler|
|US5333773 *||16 Nov 1992||2 Aug 1994||Ethicon, Inc.||Sealing means for endoscopic surgical anastomosis stapling instrument|
|US5350104 *||12 Jan 1994||27 Sep 1994||Ethicon, Inc.||Sealing means for endoscopic surgical anastomosis stapling instrument|
|US5376098 *||9 Oct 1992||27 Dec 1994||United States Surgical Corporation||Fragmentable anastomosis ring applier|
|US5411508 *||30 Mar 1993||2 May 1995||The Trustees Of Columbia University In The City Of New York||Gastrointestinal approximating and tissue attaching device|
|US5443198 *||7 Jul 1994||22 Aug 1995||United States Surgical Corporation||Surgical fastener applying apparatus|
|US5454824 *||22 Sep 1993||3 Oct 1995||United States Surgical Corporation||Fragmentable ring applier|
|US5474223 *||5 Jul 1994||12 Dec 1995||United States Surgical Corporation||Surgical fastener applying apparatus|
|US5609285 *||6 Apr 1995||11 Mar 1997||Ethicon, Inc.||Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism|
|US5628762 *||17 Jan 1996||13 May 1997||Al-Tameem; Moshin||Method of using a device for excision of a fistula|
|US5643305 *||18 Nov 1994||1 Jul 1997||Al-Tameem; Moshin||Device for excision of a fistula|
|US5662259 *||9 Apr 1996||2 Sep 1997||Yoon; Inbae||Method of stapling anatomical tissue|
|US5662260 *||9 Apr 1996||2 Sep 1997||Yoon; Inbae||Surgical staple cartridge|
|US5709335 *||31 Oct 1995||20 Jan 1998||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US5732872 *||6 Feb 1996||31 Mar 1998||Heartport, Inc.||Surgical stapling instrument|
|US5758814 *||27 May 1997||2 Jun 1998||United States Surgical Corporation||Anvil for circular stapler|
|US5817113 *||23 Jan 1997||6 Oct 1998||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US5881943 *||20 Nov 1997||16 Mar 1999||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US5915616 *||10 Oct 1997||29 Jun 1999||United States Surgical Corporation||Surgical fastener applying apparatus|
|US5947363 *||20 Mar 1998||7 Sep 1999||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US5957363 *||19 Jun 1997||28 Sep 1999||Elf Atochem S.A.||Method of performing vascular anastomosis|
|US5976159 *||8 Feb 1996||2 Nov 1999||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US6126058 *||19 Jun 1998||3 Oct 2000||Scimed Life Systems, Inc.||Method and device for full thickness resectioning of an organ|
|US6171321||18 May 1999||9 Jan 2001||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6176413||20 Jan 2000||23 Jan 2001||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6179195||21 May 1999||30 Jan 2001||Scimed Life Systems, Inc.||Method and device for full thickness resectioning of an organ|
|US6209773||7 Sep 1999||3 Apr 2001||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US6241140||25 Oct 2000||5 Jun 2001||Scimed Life Systems, Inc.||Method and device for full-thickness resectioning of an organ|
|US6280460||13 Feb 1998||28 Aug 2001||Heartport, Inc.||Devices and methods for performing vascular anastomosis|
|US6315184||2 Jun 1999||13 Nov 2001||Powermed, Inc.||Stapling device for use with an electromechanical driver device for use with anastomosing, stapling, and resecting instruments|
|US6371965||8 Jan 2001||16 Apr 2002||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6398795||30 Nov 2000||4 Jun 2002||Scimed Life Systems, Inc.||Stapling and cutting in resectioning for full thickness resection devices|
|US6443965 *||8 Jan 2001||3 Sep 2002||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6443973||2 Jun 1999||3 Sep 2002||Power Medical Interventions, Inc.||Electromechanical driver device for use with anastomosing, stapling, and resecting instruments|
|US6450390||8 Jan 2001||17 Sep 2002||Hearport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6451034||28 Sep 2001||17 Sep 2002||Gifford, Iii Hanson S.||Devices and methods for performing a vascular anastomosis|
|US6461365||15 May 2001||8 Oct 2002||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US6464707||31 Mar 2000||15 Oct 2002||David B. Bjerken||Vacuum-assisted remote suture placement system|
|US6488197||22 Feb 2000||3 Dec 2002||Power Medical Interventions, Inc.||Fluid delivery device for use with anastomosing resecting and stapling instruments|
|US6491201||22 Feb 2000||10 Dec 2002||Power Medical Interventions, Inc.||Fluid delivery mechanism for use with anastomosing, stapling, and resecting instruments|
|US6491704||26 Jul 2001||10 Dec 2002||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6505768||4 Jun 2001||14 Jan 2003||Power Medical Interventions, Inc.||Expanding parallel jaw device for use with an electromechanical driver device|
|US6517565||22 Feb 2000||11 Feb 2003||Power Medical Interventions, Inc.||Carriage assembly for controlling a steering wire steering mechanism within a flexible shaft|
|US6520971||27 Nov 2000||18 Feb 2003||Scimed Life Systems, Inc.||Full thickness resection device control handle|
|US6533157||22 Feb 2000||18 Mar 2003||Power Medical Interventions, Inc.||Tissue stapling attachment for use with an electromechanical driver device|
|US6544271||18 Jul 2000||8 Apr 2003||Scimed Life Systems, Inc.||Device for full-thickness resectioning of an organ|
|US6588643||2 Feb 2001||8 Jul 2003||Hearport, Inc.||Surgical stapling instrument and method thereof|
|US6601749||30 Mar 2001||5 Aug 2003||Scimed Life Systems, Inc.||Multi fire full thickness resectioning device|
|US6629630||17 Jul 2001||7 Oct 2003||Scimed Life Systems, Inc.||Non-circular resection device and endoscope|
|US6631837||28 Aug 2001||14 Oct 2003||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US6659327||31 Jul 2002||9 Dec 2003||Heartport, Inc.||Surgical anastomosis apparatus and method thereof|
|US6676678||20 Sep 2001||13 Jan 2004||Heartport, Inc.||Devices and methods for performing a vascular anastomosis|
|US6681979||25 Nov 2002||27 Jan 2004||Power Medical Interventions, Inc.||Fluid delivery device for use with anastomosing stapling, and resecting instruments|
|US6698643||13 Jan 2003||2 Mar 2004||Power Medical Interventions, Inc.||Expanding parallel jaw device for use with an electromechanical driver device|
|US6709441||23 Apr 2001||23 Mar 2004||Heartport, Inc.||Devices and methods for performing vascular anastomosis|
|US6716222 *||26 Feb 2002||6 Apr 2004||Scimed Life Systems, Inc.||Stapling and cutting in resectioning for full thickness resection devices|
|US6716230||21 Nov 2001||6 Apr 2004||Power Medical Interventions, Inc.||Vessel and lumen expander attachment for use with an electromechanical driver device|
|US6716233||22 Feb 2000||6 Apr 2004||Power Medical Interventions, Inc.||Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities|
|US6763993||20 May 2003||20 Jul 2004||Bolduc Lee R||Surgical stapling instrument and method thereof|
|US6793652||28 Nov 2000||21 Sep 2004||Power Medical Interventions, Inc.||Electro-mechanical surgical device|
|US6843403||13 Nov 2001||18 Jan 2005||Power Medical Interventions, Inc.||Surgical clamping, cutting and stapling device|
|US6846307||27 Sep 2002||25 Jan 2005||Power Medical Interventions, Inc.||Electro-mechanical surgical device|
|US6846308||26 Sep 2002||25 Jan 2005||Power Medical Interventions, Inc.||Electro-mechanical surgical device|
|US6846309||26 Sep 2002||25 Jan 2005||Power Medical Interventions, Inc.||Electro-mechanical surgical device|
|US6849071||26 Sep 2002||1 Feb 2005||Power Medical Interventions, Inc.||Electro-mechanical surgical device|
|US6899718||23 Apr 2004||31 May 2005||Heartport, Inc.||Devices and methods for performing avascular anastomosis|
|US6957758||4 Oct 2002||25 Oct 2005||Tyco Healthcare Group, Lp||Tilt top anvil for a surgical fastener device|
|US6959851||16 Jul 2004||1 Nov 2005||Tyco Healthcare Group Lp||Surgical stapling device with tissue tensioner|
|US6962596||14 Mar 2003||8 Nov 2005||Bolduc Lee R||System for performing vascular anastomoses|
|US6966917||9 Nov 2000||22 Nov 2005||Innovation Interventional Technologies B.V.||Deformable connector for mechanically connecting hollow structures|
|US6981941||17 Apr 2001||3 Jan 2006||Power Medical Interventions||Electro-mechanical surgical device|
|US6984238||23 Apr 2004||10 Jan 2006||Gifford Iii Hanson S||Devices and methods for performing avascular anastomosis|
|US7018387||1 Apr 2003||28 Mar 2006||Innovative Interventional Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US7022127||1 Apr 2003||4 Apr 2006||Innovative Interventional Technologies Bv||Mechanical anastomosis system for hollow structures|
|US7032798||22 Jun 2001||25 Apr 2006||Power Medical Interventions, Inc.||Electro-mechanical surgical device|
|US7077856||20 Jan 2004||18 Jul 2006||Power Medical Interventions, Inc.||Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities|
|US7112211||9 Jan 2003||26 Sep 2006||Heartport, Inc.||Devices and methods for performing avascular anastomosis|
|US7114642||20 Jan 2004||3 Oct 2006||Power Medical Interventions, Inc.||Expanding parallel jaw device for use with an electromechanical driver device|
|US7122044||28 Apr 2004||17 Oct 2006||Heartport, Inc.||Surgical stapling instrument and method thereof|
|US7168604||21 Jun 2004||30 Jan 2007||Tyco Healthcare Group Lp||Surgical stapling device|
|US7235089||27 Oct 2000||26 Jun 2007||Boston Scientific Corporation||Surgical apparatus and method|
|US7303106||6 Oct 2003||4 Dec 2007||Tyco Healthcare Group Lp||Surgical stapling device with visual indicator|
|US7325713||9 Jun 2005||5 Feb 2008||Tyco Healthcare Group Lp||Tilt top anvil for a surgical fastener device|
|US7335212||16 Dec 2003||26 Feb 2008||Edrich Vascular Devices, Inc.||Multiple stapling device for narrow blood vessels|
|US7364060||18 Oct 2004||29 Apr 2008||Tyco Healthcare Group Lp||Surgical stapling device with tiltable anvil head|
|US7399305||28 Jul 2006||15 Jul 2008||Tyco Healthcare Group Lp||Surgical stapling device with tissue tensioner|
|US7431191||20 Apr 2007||7 Oct 2008||Tyco Healthcare Group Lp||Surgical stapling device with tiltable anvil head|
|US7494038||16 Mar 2005||24 Feb 2009||Tyco Healthcare Group Lp||Anvil assembly with improved cut ring|
|US7516877||18 May 2007||14 Apr 2009||Tyco Healthcare Group Lp||Tilt top anvil for a surgical fastener device|
|US7537602||2 Oct 2006||26 May 2009||Power Medical Interventions, Inc.||Expanding parallel jaw device for use with an electromechanical driver device|
|US7546940||29 Oct 2007||16 Jun 2009||Tyco Healthcare Group Lp||Pivoting anvil assembly for surgical stapling device|
|US7556186||14 Apr 2008||7 Jul 2009||Tyco Healthcare Group Lp||Surgical stapling device having trigger lock and associated lockout mechanism|
|US7651510||12 Jan 2001||26 Jan 2010||Heartport, Inc.||System for performing vascular anastomoses|
|US7666198||22 Mar 2004||23 Feb 2010||Innovative Interventional Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US7695485||13 Apr 2010||Power Medical Interventions, Llc||Surgical device|
|US7743960||11 Jun 2003||29 Jun 2010||Power Medical Interventions, Llc||Surgical device|
|US7758613||20 Jul 2010||Power Medical Interventions, Llc||Electromechanical driver and remote surgical instrument attachment having computer assisted control capabilities|
|US7763041||29 Jul 2003||27 Jul 2010||Heartport, Inc.||Surgical clips and methods for tissue approximation|
|US7802712||20 Mar 2009||28 Sep 2010||Tyco Healthcare Group, Lp||Surgical stapling device|
|US7803151||4 Dec 2002||28 Sep 2010||Power Medical Interventions, Llc||System and method for calibrating a surgical instrument|
|US7845538||26 May 2009||7 Dec 2010||Power Medical Interventions, Llc||Expanding parallel jaw device for use with an electromechanical driver device|
|US7857187||18 Jun 2009||28 Dec 2010||Tyco Healthcare Group Lp||Surgical stapler with tiltable anvil assembly|
|US7918230||5 Apr 2011||Tyco Healthcare Group Lp||Surgical device having a rotatable jaw portion|
|US7935129||1 Mar 2004||3 May 2011||Heartport, Inc.||Device for engaging tissue having a preexisting opening|
|US7942302||11 Jul 2008||17 May 2011||Tyco Healthcare Group Lp||Surgical stapling device with coated knife blade|
|US7951071||15 Mar 2002||31 May 2011||Tyco Healthcare Group Lp||Moisture-detecting shaft for use with an electro-mechanical surgical device|
|US7963433||22 Sep 2008||21 Jun 2011||Tyco Healthcare Group Lp||Surgical device having multiple drivers|
|US7975895||30 Apr 2010||12 Jul 2011||Tyco Healthcare Group L.P.||Tissue tensioner assembly and approximation mechanism for surgical stapling device|
|US7992758||9 Aug 2011||Tyco Healthcare Group Lp||Surgical device having a rotatable jaw portion|
|US8011554||6 Jan 2009||6 Sep 2011||Tyco Healthcare Group, Lp||Raised boss for staple guide|
|US8016855||8 Mar 2002||13 Sep 2011||Tyco Healthcare Group Lp||Surgical device|
|US8016858||19 Jul 2010||13 Sep 2011||Tyco Healthcare Group Ip|
|US8021373||20 Sep 2011||Tyco Healthcare Group Lp||Surgical device|
|US8025199||23 Feb 2004||27 Sep 2011||Tyco Healthcare Group Lp||Surgical cutting and stapling device|
|US8056786||14 May 2010||15 Nov 2011||Tyco Healthcare Group Lp||Surgical device|
|US8056791||6 Dec 2010||15 Nov 2011||Tyco Healthcare Group Lp||Expanding parallel jaw device for use with an electromechanical driver device|
|US8066723||9 Nov 2001||29 Nov 2011||De Vries & Metman||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels, as well as auxiliary devices|
|US8118208||3 Oct 2011||21 Feb 2012||Tyco Healthcare Group Lp||Expanding parallel jaw device for use with an electromechanical driver device|
|US8123103||29 Nov 2010||28 Feb 2012||Tyco Healthcare Group Lp||Adaptor for anvil delivery|
|US8141763||27 Mar 2007||27 Mar 2012||Tyco Healthcare Group Lp||Anvil assembly with improved cut ring|
|US8146790||17 May 2010||3 Apr 2012||Tyco Healthcare Group Lp||Surgical instrument with safety mechanism|
|US8181838||31 Aug 2009||22 May 2012||Tyco Healthcare Group Lp||Surgical stapling device|
|US8181840||16 Mar 2005||22 May 2012||Tyco Healthcare Group Lp||Tissue tensioner assembly and approximation mechanism for surgical stapling device|
|US8182498||4 Jun 2002||22 May 2012||Innovative International Technologies B.V.||Mechanical anastomosis system for hollow structures|
|US8186559||18 Jan 2012||29 May 2012||Tyco Healthcare Group Lp||Expanding parallel jaw device for use with an electromechanical driver device|
|US8231042||20 Oct 2009||31 Jul 2012||Tyco Healthcare Group Lp||Surgical stapler|
|US8267301||21 Jun 2010||18 Sep 2012||Tyco Healthcare Group Lp||Surgical stapler|
|US8272554||20 Apr 2011||25 Sep 2012||Tyco Healthcare Group Lp||Surgical device having multiple drivers|
|US8272555||7 Mar 2007||25 Sep 2012||Tyco Healthcare Group Lp||Stapler for mucosectomy|
|US8281974||7 Jan 2010||9 Oct 2012||Tyco Healthcare, Group LP||Surgical stapler with suture locator|
|US8313013||6 Apr 2006||20 Nov 2012||Synovis Life Technologies, Inc.||Method and assembly for anastomosis|
|US8317075||1 Aug 2011||27 Nov 2012||Covidien Lp||Raised boss for staple guide|
|US8322590||6 Oct 2010||4 Dec 2012||Covidien Lp||Surgical stapling instrument|
|US8342379||19 Apr 2011||1 Jan 2013||Covidien Lp||Surgical device having multiple drivers|
|US8343185||2 May 2012||1 Jan 2013||Covidien Lp||Surgical stapling device|
|US8348122||5 Sep 2006||8 Jan 2013||Tyco Healthcare Group Lp||Surgical stapling device|
|US8353440||15 Jan 2013||Covidien Lp||Surgical device having a rotatable jaw portion|
|US8357144||1 Feb 2005||22 Jan 2013||Covidien, LP||Electro-mechanical surgical device|
|US8360295||21 May 2012||29 Jan 2013||Covidien Lp||Surgical stapling device|
|US8365974||26 Jan 2012||5 Feb 2013||Covidien Lp||Surgical stapling device|
|US8424535||5 Jul 2012||23 Apr 2013||Covidien Lp||Circular surgical stapler with mating anvil and shell assembly|
|US8430292||7 Oct 2010||30 Apr 2013||Covidien Lp||Surgical fastening apparatus|
|US8453911||18 Aug 2012||4 Jun 2013||Covidien Lp||Surgical stapler|
|US8453913||16 Jan 2010||4 Jun 2013||Covidien Lp||Anvil for surgical stapler|
|US8459523||26 Apr 2012||11 Jun 2013||Covidien Lp||Expanding parallel jaw device for use with an electromechanical driver device|
|US8512359||11 Aug 2011||20 Aug 2013||Covidien Lp||Surgical device|
|US8518074||25 Aug 2011||27 Aug 2013||Covidien Lp||Surgical device|
|US8540132||16 May 2006||24 Sep 2013||Covidien Lp||Tilt anvil assembly|
|US8540733||3 Oct 2011||24 Sep 2013||Covidien Lp||Surgical method and device having a first jaw and a second jaw in opposed correspondence for clamping, cutting, and stapling tissue|
|US8579937||31 Jul 2003||12 Nov 2013||Covidien Lp||Tool member cover and cover deployment device|
|US8590763||4 Jan 2013||26 Nov 2013||Covidien Lp||Surgical stapling device|
|US8617190||28 Mar 2011||31 Dec 2013||Heartport, Inc.||Device for engaging tissue having a preexisting opening|
|US8628467||25 Apr 2011||14 Jan 2014||Covidien Lp||Moisture-detecting shaft for use with an electro-mechanical surgical device|
|US8684248||29 Feb 2012||1 Apr 2014||Covidien Lp||Surgical instrument with safety mechanism|
|US8684251||24 Aug 2012||1 Apr 2014||Covidien Ag||Stapler for mucosectomy|
|US8684252||2 Nov 2012||1 Apr 2014||Covidien Lp||Surgical stapling instrument|
|US8690913||27 Jul 2011||8 Apr 2014||Covidien Lp||Electromechanical drive and remote surgical instrument attachment having computer assisted control capabilities|
|US8708212||18 Oct 2011||29 Apr 2014||Covidien Lp||Tilt top anvil with torsion spring|
|US8740932||12 Aug 2013||3 Jun 2014||Covidien Lp||Surgical device|
|US8752748||10 Feb 2011||17 Jun 2014||Covidien Lp||Surgical device having a rotatable jaw portion|
|US8781604||1 Apr 2009||15 Jul 2014||Cardiac Pacemakers, Inc.||Method of implanting stimulation lead with biased curved section through the interatrial septum|
|US8833630||14 Feb 2014||16 Sep 2014||Covidien Lp||Surgical instrument with safety mechanism|
|US8858579 *||2 Jan 2009||14 Oct 2014||Innovative International Technologies, B.V.||Method for performing a vascular anastomosis|
|US8858589||31 Jul 2013||14 Oct 2014||Covidien Lp||Surgical device|
|US8875974||21 Feb 2014||4 Nov 2014||Covidien Ag||Stapler for mucosectomy|
|US8893948||13 Mar 2014||25 Nov 2014||Covidien Lp||Tilt top anvil with torsion spring|
|US8905289||17 Feb 2014||9 Dec 2014||Covidien Lp||Surgical stapling instrument|
|US8931680||13 Aug 2014||13 Jan 2015||Covidien Lp||Surgical instrument with safety mechanism|
|US9010605||12 Jan 2012||21 Apr 2015||Covidien Lp||Sliding sleeve for circular stapling instrument reloads|
|US9016547||26 Oct 2011||28 Apr 2015||Covidien Lp||EEA tilt top anvil with ratchet/locking mechanism|
|US9017371||19 Apr 2011||28 Apr 2015||Covidien Lp||Surgical device having multiple drivers|
|US9022274||15 Feb 2012||5 May 2015||Covidien Lp||Circular stapler with increased lumen diameter|
|US9033868||25 Apr 2011||19 May 2015||Covidien Lp||Couplings for interconnecting components of an electro-mechanical surgical device|
|US9078654||21 May 2014||14 Jul 2015||Covidien Lp||Surgical device|
|US9113847||9 Jan 2013||25 Aug 2015||Covidien Lp||Electro-mechanical surgical device|
|US9113871||18 Dec 2012||25 Aug 2015||Covidien Lp||Surgical stapling device|
|US9113878||11 Aug 2011||25 Aug 2015||Covidien Lp||Pinion clip for right angle linear cutter|
|US9113886||27 Oct 2014||25 Aug 2015||Covidien Lp||Tilt top anvil with torsion spring|
|US9119604||29 May 2013||1 Sep 2015||Covidien Lp||Tool member cover and cover deployment device|
|US9119621||29 Sep 2014||1 Sep 2015||Covidien Ag||Stapler for mucosectomy|
|US20010001826 *||12 Jan 2001||24 May 2001||Heartport, Inc.||System for performing vascular anastomoses|
|US20010031975 *||17 Apr 2001||18 Oct 2001||Whitman Michael P.||Electro-mechanical surgical device|
|US20020082616 *||26 Feb 2002||27 Jun 2002||Mcalister Gary||Stapling and cutting in resectioning for full thickness resection devices|
|US20030055441 *||4 Jun 2002||20 Mar 2003||Suyker Wilhelmus Joseph Leonardus||Mechanical anastomosis system for hollow structures|
|US20040073240 *||29 Jul 2003||15 Apr 2004||Bolduc Lee R.||Surgical clips and methods for tissue approximation|
|US20040094597 *||11 Jun 2003||20 May 2004||Whitman Michael P.||Surgical device|
|US20040111081 *||15 Mar 2002||10 Jun 2004||Whitman Michael P.||Electro-mechanical surgical device|
|US20040149802 *||20 Jan 2004||5 Aug 2004||Whitman Michael P.||Expanding parallel jaw device for use with an electromechanical driver device|
|US20040153124 *||20 Jan 2004||5 Aug 2004||Whitman Michael P.|
|US20040167551 *||1 Mar 2004||26 Aug 2004||Gifford Hanson S.||Devices and methods for performing a vascular anastomosis|
|US20040186490 *||31 Mar 2004||23 Sep 2004||Gifford Hanson S.||Devices and methods for performing avascular anastomosis|
|US20040195289 *||4 Oct 2002||7 Oct 2004||Ernie Aranyi||Tilt top anvil for a surgical fastener device|
|US20040199188 *||23 Apr 2004||7 Oct 2004||Gifford Hanson S.||Devices and methods for performing avascular anastomosis|
|US20040200876 *||28 Apr 2004||14 Oct 2004||Bolduc Lee R.||Surgical stapling instrument and method thereof|
|US20040215221 *||22 Mar 2004||28 Oct 2004||Suyker Wilhelmus Joseph Leonar||Mechanical anastomosis system for hollow structures|
|US20050006433 *||21 Jun 2004||13 Jan 2005||Milliman Keith L.||Surgical stapling device|
|US20050096675 *||29 Nov 2004||5 May 2005||Gifford Hanson S.Iii||Devices and methods for performing avascular anastomosis|
|US20050096676 *||29 Nov 2004||5 May 2005||Gifford Hanson S.Iii||Devices and methods for performing a vascular anastomosis|
|US20050149077 *||16 Feb 2005||7 Jul 2005||Gifford Hanson S.Iii||Devices and methods for performing a vascular anastomosis|
|US20050187576 *||23 Feb 2004||25 Aug 2005||Whitman Michael P.||Surgical cutting and stapling device|
|US20050205639 *||16 Mar 2005||22 Sep 2005||Tyco Healthcare Group, Lp||Anvil assembly with improved cut ring|
|US20050205640 *||16 Mar 2005||22 Sep 2005||Tyco Healthcare Group, Lp||Surgical stapling device|
|US20050236459 *||31 Jul 2003||27 Oct 2005||Gresham Richard D||Tool member cover and cover deployment device|
|US20050251164 *||4 Feb 2005||10 Nov 2005||Gifford Hanson S Iii||Devices and methods for performing avascular anastomosis|
|US20050279803 *||9 Jun 2005||22 Dec 2005||Ernest Aranyi||Tilt top anvil for a surgical fastener device|
|US20050288693 *||12 Aug 2005||29 Dec 2005||Suyker Wilhemus J L||Connector, applicator and method for mechanically connecting hollow structures, in particular small blood vessels|
|US20060006198 *||5 Jan 2005||12 Jan 2006||L'oreal||Lockable dispensing head|
|US20060036268 *||16 Sep 2005||16 Feb 2006||Tyco Healthcare Group, Lp||Surgical stapling device with tissue tensioner|
|US20060097025 *||6 Oct 2003||11 May 2006||Tyco Healthcare Graoup Llp||Surgical stapling device|
|US20070038248 *||28 Jul 2006||15 Feb 2007||Russell Heinrch||Surgical stapling device with tissue tensioner|
|US20070055304 *||17 Jul 2006||8 Mar 2007||Whitman Michael P|
|US20070075116 *||2 Oct 2006||5 Apr 2007||Whitman Michael P||Expanding parallel jaw device for use with an electromechanical driver device|
|US20070075117 *||5 Sep 2006||5 Apr 2007||Milliman Keith L||Surgical stapling device|
|US20070078486 *||20 Nov 2006||5 Apr 2007||Tyco Healthcare Group Lp||Surgical stapling device|
|US20120193394 *||21 Jun 2011||2 Aug 2012||Holcomb Matthew D||Surgical Stapler Having an Adjustment Feature|
|DE2822803A1 *||24 May 1978||7 Dec 1978||United States Surgical Corp||Chirurgisches instrument und einwegpatrone zum herstellen von runden klammernaehten in hohlen koerperorganen|
|DE2851144A1 *||25 Nov 1978||4 Oct 1979||Senco Products||Chirurgisches klammerinstrument|
|DE2858032C2 *||24 May 1978||22 Aug 1985||United States Surgical Corp., Norwalk, Conn., Us||Title not available|
|DE3106490A1 *||21 Feb 1981||18 Feb 1982||Senco Products||Chirurgisches klammerinstrument|
|DE3107159A1 *||26 Feb 1981||21 Jan 1982||Senco Products||Druckelement fuer ein chirurgisches klammerninstrument|
|DE3152411C2 *||21 Sep 1981||21 Aug 1986||United States Surgical Corp., Norwalk, Conn., Us||Title not available|
|DE3152428C2 *||9 Oct 1981||14 Aug 1986||United States Surgical Corp., Norwalk, Conn., Us||Title not available|
|EP0050553A1 *||9 Oct 1981||28 Apr 1982||United States Surgical Corporation||Disposable surgical stapler for performing anastomosis|
|EP0074878A2 *||1 Sep 1982||23 Mar 1983||United States Surgical Corporation||Surgical stapler apparatus with curved shaft|
|EP0539762A1 *||5 Oct 1992||5 May 1993||American Cyanamid Company||Linear surgical stapling instrument|
|EP2524655A1 *||21 May 2012||21 Nov 2012||Ethicon Endo-Surgery, Inc.||Circular stapling instrument having a breakaway washer attachment member|
|WO1981000668A1 *||5 Sep 1980||19 Mar 1981||A Jansen||Medical device for connecting two portions of the intestine,ancillary device for use therewith,and method for insertion of an intestinal button suture with the aid of this device|
|WO1981001958A1 *||15 Jan 1981||23 Jul 1981||S Lee||Surgical cutter stapler|
|WO1982001307A1 *||9 Oct 1981||29 Apr 1982||States Surgical Corp United||Disposable instrument for surgical fastening|
|WO1983000807A1 *||25 Jun 1982||17 Mar 1983||United States Surgical Corp||Surgical stapler apparatus with curved shaft|
|WO1983004173A1 *||11 May 1983||8 Dec 1983||United States Surgical Corp||Surgical stapler apparatus with flexible shaft|
|WO2014139440A1 *||13 Mar 2014||18 Sep 2014||Covidien Lp||Surgical stapling apparatus|
|U.S. Classification||227/76, 227/19|
|International Classification||A61B17/115, A61B17/03|
|Cooperative Classification||A61B17/115, A61B17/1155|