US20030097140A1 - Wound site management and wound closure device - Google Patents
Wound site management and wound closure device Download PDFInfo
- Publication number
- US20030097140A1 US20030097140A1 US10/338,466 US33846603A US2003097140A1 US 20030097140 A1 US20030097140 A1 US 20030097140A1 US 33846603 A US33846603 A US 33846603A US 2003097140 A1 US2003097140 A1 US 2003097140A1
- Authority
- US
- United States
- Prior art keywords
- staple
- tissue
- wound
- sleeve
- rod
- 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.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00637—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00646—Type of implements
- A61B2017/00668—Type of implements the implement being a tack or a staple
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0641—Surgical staples, i.e. penetrating the tissue having at least three legs as part of one single body
-
- 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
- A61B2017/2913—Handles transmission of forces to actuating rod or piston cams or guiding means
-
- 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
- A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
- A61B2017/292—Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
Definitions
- the present invention relates to a wound site management and wound closure device and method, for use during and after an invasive medical procedure. More specifically, the present invention relates to a staple and stapling device for closing a puncture made in the wall of an artery or vein during a medical procedure.
- the puncture may be the result of a catheter-based intervention, although any puncture is contemplated, accidental or intentional.
- the present invention has particular utility for use in and around the femoral, radial, and brachial arteries after coronary/cardiac procedures. Other utilities include soft-tissue anchoring, tendon and artery joining, meniscal repair, thoracic lung closure, heart repair, endoscopic procedures, esophageal repair, laparoscopy, skin/epidermal wound closure and general tissue closure.
- Catheters/catheterization procedures are well known, and typically involve insertions through the femoral artery for diagnosis or to treat cardiovascular and/or peripheral vascular diseases. After a diagnostic or interventional catheterization, the puncture formed by the catheter must be closed. The puncture opening in the artery typically ranges from 5 F for a diagnostic procedure to 6-10 F for an interventional procedure. Traditionally, intense pressure has been applied to the puncture site for at least 30-45 minutes after removal of the catheter. Other approaches include a thrombotic or collagen plug, and/or other suturing methodology for sealing the puncture.
- Surgical stapling instruments have been proposed to resolve some of the aforementioned problems associated with vascular procedures.
- U.S. Pat. No. 5,709,335 issued to Heck discloses a wholly distal surgical stapling instrument for stapling a tubular tissue structure to a luminal structure, such as a vascular lumen.
- This device can be used for anastomotic stapling of a tubular vessel having two untethered ends, and is especially useful for making the primary anastomotic connection of a bypass vein to a coronary artery or to the aorta.
- the device essentially includes a rod that is placed within the tubular vessel and an anvil that forces staples (associated with the rod) to bend outwardly against the vessel and a target (such as a coronary artery).
- a target such as a coronary artery
- this device requires that the stapler device be placed within the tubular vessel (e.g., vein or artery) for operation. While this device is useful when stapling a graft vein or the like, unfortunately, this device would be inappropriate when the entirety of the tubular tissue is not accessible, such as wound closure following an percutaneous transluminal diagnostic procedures and less invasive medical procedures.
- the present invention provides a tissue staple comprising a plurality of prongs connected to a plurality of tabs and arranged about a centerline axis.
- the prongs have a shoulder portion extending substantially orthogonal from the prong toward the centerline axis.
- Each prong has a tapered tissue-piercing portion on the distal end thereof.
- the staple of the present invention comprises a plurality of prongs arranged about a centerline axis, each prong having a shoulder portion extending substantially orthogonal from the prong toward said centerline axis, and a plurality of web portions connecting each prong to one another, each prong having a tapered tissue-piercing portion on the distal end thereof.
- the present invention provides a stapler that includes an elongated sleeve having an inside diameter, an elongated rod with a flared mandrel couple to a distal end, the rod and mandrel sized to fit within the inside diameter of the tube, an actuator mechanism to move the rod relative to the sleeve, a staple adapted to fit between said mandrel and said sleeve, and, said actuator mechanism adapted to move said mandrel relative to said staple and said sleeve causing said staple to close on tissue located about a wound site.
- the stapler include a distal tip comprising a sleeve and a rod inserted into said sleeve, said rod comprising a flared distal tip; an actuator coupled to said sleeve and said rod, said actuator adapted to cause said sleeve to move relative to said rod; and a tissue staple comprising a plurality of tissue piercing prongs placed around said rod between said sleeve and said flared distal tip.
- Wound closure procedures include a process for closing a wound comprising the steps of: inserting an introducer into a tissue wound, placing a sheath around the introducer and locating the sheath approximate to said wound, inserting the distal end of a stapler into said sheath to approach the tissue wound site, said stapler including a tissue staple on the distal end of said stapler, expanding a portion of the staple about said wound, and contracting at least a portion of said staple pulling the tissue surrounding the wound together.
- Other wound closing methods include a process for closing a wound in an artery with a staple, comprising the steps of: inserting an introducer with a plurality of guide wires coupled thereto into an artery, guiding a stapler and staple to the wound site, expanding said staple to surround said wound site before entering said tissue, and closing said staple on said tissue to close said wound.
- the present invention provides an introducer that includes a sheath having an inside diameter and a distal end, a dilator sized to fit within the inside diameter of the sheath, and a plurality of flexible wire guides having first ends and second ends, the first ends coupled to the distal end of the sheath, wherein the sheath being approximated to a wound site and the wire guides placed approximate to tissue surrounding the wound site to hold said sheath approximately centered on said wound site.
- the introducer of the present invention includes a tubular sheath, and at least one flexible wire guide affixed to the sheath, said wire guide placed approximate to tissue surrounding a wound site to hold said sheath approximately centered on said wound site.
- the present invention also includes wound site stabilization methodology including the steps of: approximating an elongated sheath to a wound site;
- Other procedural embodiments include a method for stabilizing a wound site, comprising the steps of: approximating an elongated sheath to a wound site; inserting one or more wire guides into the wound site; placing said wire guides approximate to tissue surrounding said wound site; and centering said sheath about said wound site.
- FIGS. 1 - 3 are isometric views of one embodiment of the staple of the present invention in formed, opened and deployed positions, respectively;
- FIG. 3A depicts an isometric view of alternative staple of the embodiment of FIGS. 1 - 3 ;
- FIGS. 4 - 6 are isometric views of another embodiment of the staple of the present invention in formed, opened and deployed positions, respectively;
- FIG. 7 depicts one embodiment of the stapler of the present invention
- FIG. 8 is an isometric view of the distal tip of the stapler of FIG. 7 adapted to hold and deploy the staple of FIGS. 1 - 6 ;
- FIGS. 9 A- 11 B are isometric views of the cooperative movement of the distal tip of the stapler and the staple of the present invention.
- FIGS. 12 - 15 are isometric views of an exemplary staple deployment mechanism of the stapler of the present invention.
- FIGS. 16 and 17 are isometric views of another exemplary staple deployment mechanism of the stapler of the present invention.
- FIGS. 18 - 26 depict various views of procedural embodiments of the present invention, including FIG. 20 depicting one embodiment of the introducer of the present invention.
- a staple is provided to close a tissue wound after a medical procedure.
- the preferred use of the staple of the present invention is to close an artery or vein following a diagnostic or interventional procedure, it should be recognized at the outset that the staple may be used for general tissue repair, not just limited to vascular repair.
- the staple of the present invention can be formed of any biocompatible and/or bioabsorbable materials, including, for example, Titanium (and Titanium alloys), stainless steel, polymeric materials (synthetic and/or natural), ceramic, etc.
- the staple of the present invention is preferably formed of a deformable material (such as those listed above) that undergoes plastic deformation (i.e., deformation with negligible elastic component.)
- plastic deformation i.e., deformation with negligible elastic component.
- the staple of the present invention undergoes two positions of deformation: a first position to extend the distal ends of the prongs of the staple outwardly to grab a greater amount of tissue (and also to grab tissue away from the wound locus), and a second position to move the prongs inwardly to close the wound.
- FIG. 1 is the staple in it's formed position
- FIG. 2 is the staple just prior to deployment into tissue with the prongs extended outwardly
- FIG. 3 is the staple closed around tissue.
- the staple 10 of this embodiment comprises a plurality of prongs 12 A- 12 D and a plurality of tabs 14 A- 14 D, arranged about a centerline axis 100 .
- Common portions, or shoulders 16 A- 16 D are formed where the tabs meet the prongs.
- Each shoulder is common to both the prong and the tab and is generally defined by a relatively flat portion generally orthogonal to the centerline axis.
- Shoulders 16 A- 16 D may be viewed as an extension of each prong, bent inwardly toward the centerline axis.
- prongs 12 A- 12 D extend generally parallel to central axis 100 , as shown.
- tapered points 18 A- 18 D is formed to extend inwardly toward the centerline axis 100 .
- shoulders 16 A- 16 D meet at prongs 12 A- 12 D, respectively.
- Tabs 14 A- 14 D are generally U-shaped, and are formed between each prong. The proximal portions of each tab are joined at consecutive shoulders, as shown.
- Each proximal portion of the U extends first generally outward from the shoulder, and second bends inwardly and distally toward centerline axis 100 , connecting together nearest the centerline axis to form the U shape.
- the U-shape defines slots 20 A- 20 D within each tab having a base positioned at the bottom thereof.
- the staple 10 is deformed so that prongs 12 A- 12 D extend outwardly from the centerline axis, prior to deployment into tissue. It is advantageous to extend the prongs outwardly as shown so as to grasp a large portion of tissue, and so that insertion of the prongs into the tissue occurs at a locus away from the wound site, thereby providing a more consistent wound closure (by closing the wound with more of the surrounding tissue) and ensuring complete (or near complete) closure of the wound.
- a force F 1 is applied to tabs 14 A- 14 D, as shown in relief in FIG. 2A.
- Force F 1 is generally outward (from the centerline axis) and proximal to the top of the staple, as shown in relief in FIG. 2A.
- This force causes the tabs to move outward from the centerline axis 100 .
- the outward movement of the tabs causes the shoulder portions to pivot roughly about the juncture between the shoulder and the prong (i.e., at the outer portion of the shoulder), causing the inner portions of the shoulders to move inwardly toward the centerline axis and distally. Since the prongs are attached to the outer portion of the shoulders, the movement of the shoulders in this manner causes the prongs to move outwardly.
- the cross-sectional diameter of the staple gets larger at the distal end (with respect to the cross-sectional diameter of the formed staple of FIG. 1).
- the movement of the prongs is generally greater at the distal portions thereof than at the proximal portions thereof.
- movement of the prongs as shown in FIG. 2 is pivoted from the shoulder, thus producing a staple with outwardly extending prongs.
- a holding force may be applied downwardly (i.e., substantially parallel to the centerline axis) against the base of the slots 20 A- 20 D to hold the staple in place.
- these forces are simultaneously applied to each tab of the staple to produce uniform deformation of each prong of the staple.
- the plastic deformation of the staple is semi-permanent, so that the staple does not tend to return to the shape depicted in FIG. 1 (i.e.,non-elastic deformation). Deformation of the staple into this position will be described in greater detail below in reference to the preferred stapler device of the present invention.
- FIG. 3 depicts the staple 10 in a closed position.
- the closed position as stated herein generally means that the prongs of the staple are moved inwardly toward each other.
- FIG. 3 depicts the tapered tip portions of the prongs meeting generally in the vicinity of the centerline axis, however, it should be understood that the term “closed” or “deployed” as used in reference to the staple need not necessarily mean this precise configuration. It may be required (or desirable) for some procedures to move the prongs inwardly toward each other to a greater or lesser extent than as depicted in FIG. 3.
- a force F 3 is applied to the inner surfaces 30 A- 30 D of the shoulders.
- This force is generally orthogonal to the centerline axis, and the angle between each force approximates the angle between the inner surfaces 30 A- 30 D (which, in the staple of this embodiment is approximately 90 degrees).
- This force causes the slots 20 A- 20 D to spread apart and urges the shoulders outwardly. Movement in this manner also causes the shoulders to move outwardly and proximally. Proximal movement of the shoulders causes the prongs to move toward each other.
- deformation shown in FIG. 3 results in an expanded cross-sectional diameter of the proximal end of staple, and a diminished cross-sectional diameter of the distal end of the staple (with respect to the formed staple of FIG. 1 and the deformed staple of FIG. 2). Again, deformation of the staple 10 into this position will be described in greater detail below in reference to the preferred stapler device of the present invention.
- the staple of the present invention is deployed into tissue such that the prongs do not fully pierce through the tissue, but rather grasp and hold the tissue together.
- the tissue piercing tapered ends not enter the bloodstream, but rather pierce into the tissue and stop short of piercing through the tissue wall.
- the staple 10 ′ of the present invention can be adapted with tissue stops 32 A- 32 D.
- tissue stops 32 A- 32 D are located along the length of each prong, and positioned from the distal tip of the prong to permit the tapered ends to pierce tissue, but not pierce all the way through the tissue. Accordingly, the position of the stops 32 A- 32 D along the length of the prongs is selected to facilitate tissue grabbing (but not complete tissue piercing) and can vary from application to application.
- FIGS. 4 - 6 depict another embodiment of a staple 50 of the present invention.
- FIG. 4 is the staple in it's formed position
- FIG. 5 is the staple just prior to deployment into tissue with the prongs extended outwardly
- FIG. 6 is the staple closed around tissue.
- the staple 50 of this embodiment comprises a plurality of prongs 52 A- 52 D arranged about a centerline axis 100 .
- a shoulder 56 A- 56 D is provided and is generally defined by a relatively flat surface, generally orthogonal to centerline axis. Shoulders 56 A- 56 D may be viewed as an extension of each prong, bent inwardly toward the centerline axis.
- webs 54 A- 54 D are connected to and between each prong, and are formed to extend inwardly from each prong toward the centerline axis, creating a U shape generally orthogonal to the centerline axis (as opposed to the previous embodiment in which the U-shaped tab is positioned generally parallel to the centerline axis).
- prongs 52 A- 52 D extend generally parallel to central axis 100 , as shown.
- tapered points 58 A- 58 D are formed to extend inwardly toward the centerline axis 100 .
- shoulders 56 A- 56 D meet at prongs 52 A- 52 D, respectively.
- Web portions (webs) 54 A- 54 D are generally U-shaped, and are formed between each prong extending inwardly toward the centerline axis. As shown, webs connect the prongs at a position distal to the shoulders. The precise position of the webs is determined by the desired extent to which the prongs are extended outwardly, and the extent to which the web curves inward toward the centerline axis. The space between the shoulders and the web portions defines a slot 60 A- 60 D.
- the staple 50 is deformed so that prongs 52 A- 52 D extend outwardly from the centerline axis, prior to deployment into tissue.
- a force F 1 is applied to webs 54 A- 54 D, as shown in relief in FIG. 5A.
- Force F 1 is generally outward from the centerline axis and causes the webs to deform outwardly, i.e. straightening the bend of the web by moving the centermost point of the web outwardly. By deformation of the web portions in this manner, the prongs move outwardly.
- the cross-sectional diameter of the staple gets larger at the distal end (with respect to the cross-sectional diameter of the formed staple of FIG. 4). Note that the movement of the prongs is generally greater at the distal portions thereof than at the proximal portions thereof, thus producing a staple with outwardly extending prongs.
- a holding force may be applied downwardly (i.e., substantially parallel to the centerline axis) against the top of the webs in slots 60 A- 60 D to hold the staple in place.
- these forces are simultaneously applied to each web of the staple to produce uniform deformation of each prong of the staple.
- the deformation of the staple is plastic, so that the staple does not tend to return to the shape depicted in FIG. 4. Deformation of the staple into this position will be described in greater detail below in reference to the preferred stapler device of the present invention.
- FIG. 6 depicts the staple 50 in a closed or deployed position.
- the closed position as stated herein generally means that the prongs of the staple are moved inwardly toward each other.
- a force F 3 is applied to the inner surfaces 62 A- 62 D of the shoulders. This force is generally orthogonal to the centerline axis, and the angle between each force approximates the angle between the inner surfaces 62 A- 62 D about the centerline axis (which, in the staple of this embodiment is approximately 90 degrees). This force urges the shoulders outwardly. Note that shoulders can only extend outwardly as far as the web portions will permit.
- each of the prongs, tabs and shoulders depicts four each of the prongs, tabs and shoulders, this should be only be considered exemplary. It may be desirable to adapt the staple 10 or the staple 50 with more or fewer prongs, tabs and shoulders for a given application. Also, it is not necessary that each prong is the same length, or that each prong has the same overall dimensions.
- the entire staple, or selected portions thereof can be alternatively fashioned from an elastic or shape memory (e.g., nitinol, and/or other elastic materials, including for example temperature dependant shape memory materials) material thereby permitting elastic deformation from the a static closed position to an expanded position and then elastically close about the wound.
- the embodiment of FIGS. 4 - 6 can be adapted with a tissue stop positioned along the length of the prong, as shown in FIG. 3A.
- the stapler of the present invention includes a distal tip for holding and deploying a staple, and an actuator mechanism to cause a staple, or at least the tissue piercing portions of a staple, to expand outwardly and then close about a wound.
- the stapler of the present invention facilitates one object of the present invention to ensure that the staple closes a greater amount of tissue as compared with conventional stapling mechanisms.
- FIG. 7 depicts an isometric view of one embodiment of a stapling device 100 of the present invention.
- the device generally includes an actuation mechanism 104 and a distal tip 102 .
- FIG. 8 is a more detailed view of the distal tip 102 of the stapler device 200 .
- the distal tip preferably comprises an inner rod member 110 slidable within an outer sleeve 112 .
- Rod 110 includes a flared or mandrel portion 114 .
- Mandrel 114 also includes slots 118 A- 118 D, which in use are aligned with fingers 116 A- 116 D. Fingers 116 A- 116 D mate with slots 20 A- 20 D and 60 A- 60 D of the staple 10 and 50 , respectively.
- rod 110 is removable for staple attachment thereto, where a staple is positioned between the mandrel and the sleeve. The mandrel, as will be described below, is responsible for the forces generated on the staple.
- FIGS. 9, 10A, 10 B, 11 A and 11 B depict the working relationship between the staple 10 ′ and/or 50 of the present invention and the mandrel 114 /sleeve 112 of the stapler mechanism 200 .
- the staple 10 ′ is placed between the mandrel 114 and sleeve 112 .
- Slots 20 A- 20 D of the staple engage fingers 116 A- 116 D of the sleeve.
- the prongs 12 A- 12 D of the staple are dimensioned so as to fit over the mandrel, and tabs 14 A- 14 D are dimensioned so as to fit over the rod 110 , as shown.
- tabs 14 A- 14 D are dimensioned so as to fit over the rod 110 , as shown.
- the staple 50 engages the mandrel 114 and sleeve 112 (not shown). This is a static position, as no forces are applied to the staple to cause deformation.
- the staple 10 ′ is urged into the first deformed position (of FIG. 2) by the relative movement of the rod/mandrel and the sleeve. As shown, the mandrel is urged proximally. As the mandrel moves, the tabs of the staple meet the narrowest part of the mandrel. Further movement forces the tabs to move outwardly, causing the prongs to likewise move outwardly (as described above with reference to FIG. 2).
- FIG. 11A depicts final deployment of the staple into tissue. As the mandrel is drawn further proximally and once the tabs have cleared the mandrel, the shoulders (not shown) are spread outward, forcing the prongs to move together (toward the centerline axis) and closing tissue therebetween.
- FIG. 11B depicts the same actuation, but for the staple 50 of FIGS. 4 - 6 .
- FIGS. 12 - 15 depict an exemplary actuator mechanism 104 , showing the relative motion of the sleeve 112 and the mandrel rod 110 .
- the mechanism includes a cam 408 movable in a linear motion along a slot 412 . Movement of the cam can be manual or through an electronically controllable motor (not shown).
- the cam 408 has lobes 408 A and 408 C located on a first side of the cam 408 and a lobe 408 B located on a second and opposing side of the cam 408 .
- a first cam follower 418 is coupled to the mandrel rod 110 , and is selectably engagable with lobes 408 A and 408 C.
- a second cam follower 416 is coupled to the sleeve 112 , and is selectably engagable with lobe 408 B.
- FIG. 12 depicts that neither cam follower is in contact with the lobes, and is indicative of an initial position of the mechanism.
- FIG. 13 depicts the mechanism 104 in a position to expand the staple between the mandrel 114 and the sleeve 112 , as shown in FIG. 9A.
- cam 408 As cam 408 is moved (as indicated by the arrow), lobe 408 A urges cam follower 418 along slot 426 .
- the mandrel rod 110 is moved proximally, causing the prongs to extend outwardly (as shown in FIGS. 2 and 5) as a result of the force of the mandrel 114 on the tabs or the web portions. With further movement of the cam 408 (FIG.
- lobe 408 B now urges cam follower 416 to move distally, thereby moving the sleeve distally relative to the mandrel rod and causing further expansion of the prongs and causing the staple to move distally.
- the cam is urged yet further and cam follower 418 is urged by lobe 408 C causing the mandrel and madrel rod to extend further proximally.
- This relative movement between the cam rod and the sleeve causes the mandrel to apply a force to the shoulder portions of the staple, in turn causing inward movement of the prongs.
- Lobe 408 C causes closure of the prongs and decouples the staple from the mandrel. This is the fully deployed staple movement.
- FIGS. 16 and 17 show an alternative cam mechanism. Similar to the previous example, cam 608 is urged in a direction indicated by the arrow to cause relative motion between the mandrel rod and the sleeve. Lobes 608 A and 608 B are located on opposite sides of cam 608 . As the cam 608 is moved along slot 612 , the lobe 608 A urges a cam follower 618 in a linear motion along a slot 626 . This urges the cam follower 618 proximally. The cam follower 618 is coupled to a mandrel rod 604 . This deforms staple 10 / 50 in the second configuration (see FIG. 2 or 5 ).
- cam follower 618 moves distally to stay in contact with the lobe 608 A. This urges mandrel rod 604 distally.
- cam follower 616 urges lobe 608 B to urge cam follower 616 distally.
- the cam follower 616 is coupled to a sleeve 606 . This urges sleeve 606 distally.
- the downward slope of lobe 608 A is parallel with upward slope of lobe 608 B so the mandrel rod 604 and the sleeve 606 move distally in unison and the staple is advanced into the tissue.
- the actuation mechanism can include a rotating drum (not shown) to replace the cam 408 and 612 .
- the drum may be adapted with lobes formed thereon, similar to lobes 408 A- 408 C and 608 A- 608 B, respectively.
- Other alternatives may include a rotating screw having a variable width in accordance with lobes 408 A- 408 C or 608 A- 608 B to actuate the mandrel rod and/or sleeve.
- direct linkage may be used to actuate the mandrel rod and/or sleeve.
- FIGS. 18 - 25 A depict procedural embodiments of wound site management during and after a medical procedure, such as angioplasty.
- FIG. 18 depicts a conventional tubular dilator 500 extending through the skin of a patient.
- the dilator 500 is left in the skin following a completed medical procedure.
- the wound site must be stabilized.
- the blood flow may not be completely stopped, the blood flow is reduced to a point where the coagulants in the blood can complete the wound closure.
- the doctor inserts a flexible guide wire 502 through an opening 504 in the end of the dilator 500 .
- FIG. 19 shows the step of removing the introducer 500 from the wound site after the guide wire 502 is properly inserted through the skin and into the artery.
- FIG. 20 depicts the introducer 510 of the present invention, and continues the process from FIGS. 18 and 19 where the introducer 510 slides over the guide wire 502 through an opening in the introducer 510 and a portion of the introducer is placed into the artery. Details of the introducer 510 are disclosed below.
- FIG. 20 depicts the introducer 510 inserted over the guide wire 502 (already in the artery) and inserted into the artery.
- the introducer includes a hollow elongated guide sheath 512 and dilator 520 .
- the doctor urges the distal tip 516 of the dilator 520 into and through the guide sheath 512 (over guide wire 502 ).
- a flexible distal end 516 of the dilator 520 is inserted into the wound, until a blood marker BM indicates that the dilator 520 is properly positioned in the artery.
- the blood marker BM located at a predetermined length along the dilator 520 allows blood to flow through a cavity 540 to alert the doctor that the dilator 520 , and more specifically the flexible distal tip 516 , is properly inserted in an artery.
- the distal tip 516 of the dilator includes a tapered portion 522 to facilitate easier ingress into the artery.
- An additional blood marking passageway (not shown) can be included on the distal end of sheath 512 as precautionary indicator of the depth of the sheath. Presence of blood in this additional passageway is indicative of the sheath being pressed too far and into the arterial wall or into the artery.
- the diameter of distal end of the guide sheath 512 can expand if outward pressure is applied from inside surface of the guide sheath 512 . More preferably, slits or weakened tear seams (described below) are formed in the distal end of the guide sheath 512 to allow the diameter of the guide sheath to increase when pressure is applied.
- a feature of the guide sheath of the present invention is the use of two or more wire guides to maintain the sheath centered on the wound site, to permit opposing sides of the wound to approximate, and to ensure that the closure device (e.g., stapler/staple, suturing device, cauterization, etc) remains centered about the wound so that wound closure is centered.
- the closure device e.g., stapler/staple, suturing device, cauterization, etc
- wire guides are formed on opposing sides of the guide sheath 512 .
- the wire guides are delivered into the artery by the dilator 520 , as shown in FIGS. 21 and 26.
- the wire guide 514 are preferably flexible, and removably coupled to the distal end 516 of the dilator 520 and deployed into the wound, as shown in FIG. 26.
- the wire guides can be held in openings or slots (not shown) on the sides of dilator. Once the dilator is properly inserted into the wound to a proper depth (as indicated by the BM passageway), the dilator is removed from the wound and the guide sheath. To remove the dilator 520 from the guide sheath 512 , the doctor first holds the guide sheath 512 and advances the dilator 520 inward (and upward) through the guide sheath 512 . This decouples the guide wires 514 A and 514 B from the openings.
- a mechanism that does not allow withdrawal until the guide rod has been inserted a predetermined distance.
- this mechanism can include a hub mechanism that requires a twisting motion or other action prior to withdrawal.
- the doctor simply extracts the guide rod. This leaves the guide sheath 512 centered on the wound with the guide wires 514 A and 514 B extending inside the wound.
- a puncture in an artery or vein has a general tendency to manifest a slit or an elongated opening, since the cell structure forming this tissue forms circumferentially (rather than longitudinal) to support radial expansion and contraction of the vessel.
- the wire guides 514 A and 514 B of the present invention enable the wound to approximate the natural state of the wound, i.e., elongated circumferentially.
- the sheath has a diameter approximately equal to the diameter of the opening or wound, so that the wire guides 514 A and 514 B on the sides of the sheath approximate the diameter of the long axis of the wound, as best shown in FIG. 23.
- Approximation in this sense may mean that the wire guides are less than or greater than (or equal to) this diameter.
- the wire guides in this position limit movement of the sheath along the long axis, and since the wound is elongated, movement along the short axis is likewise limited. This ensures that any device inserted through the sheath is approximately centered on the wound.
- the wound opening tends to assume the shape shown in FIG. 23 even in the absence of the wire guides, the opposing tissue located along the short axis tends to approximate.
- the present invention takes advantage of this tendency. If the position of the wire guides define a diameter larger than the diameter of the wound, the tissue along the short axis tends to approximate more (i.e., the tissue is stretched along the long axis). However, sufficient wound site management does not require that the wire guides stretch the wound. Rather, if the position of the wire guides are shorter than the wound length, the wire guides still serve to maintain the sheath generally centered at the wound.
- FIG. 23 also shows examples of locations S 1 , S 2 , S 3 , and S 4 of where the prongs of the staple to be inserted will line-up relative to the wound opening WO.
- the guide wires 514 are preferably disposed on opposing sides of the guide sheath 512 , and more preferable, the guide wires are inserted into the wound opening transversally to the long axis of the artery or vein, so that the wound is pulled taught in a transverse direction.
- FIG. 22 shows the distal end of a stapler 104 with a staple 10 / 50 being inserted through the guide sheath 512 of the introducer 510 .
- FIG. 22A depicts a relief view of the introducer 510 , and more clearly depicts the slits or weakened tear seams 700 .
- the staple can be deployed into the tissue.
- FIG. 24 shows the first step of staple deployment, the process of which is described in detail above. Note that in FIG. 24A, the extension of the staple prongs causes the weakened tear seam or slits to separate.
- FIGS. 25 and 25A depict the staple fully deployed into tissue, the process of which is described above.
- the stapler can now be removed from the guide sheath 512 .
- the guide sheath 512 can now be urged away from the wound opening WO and the guide wires 514 A and 514 B are extracted from the closed opening.
Abstract
A staple and stapler and introducer are disclosed for closing a wound and for wound site management. The staple is deformable, and includes a plurality of tissue-piercing prongs which are expanded outwardly, inserted into tissue and collapsed inwardly to close the wound. The stapler includes a plurality of mechanisms to deform the staple into various positions. An introducer is provided that includes a plurality of spaced-apart wire guides for securing and centering the wound opening during a medical procedure, and during closure of the wound.
Description
- 1. Field of the Invention
- The present invention relates to a wound site management and wound closure device and method, for use during and after an invasive medical procedure. More specifically, the present invention relates to a staple and stapling device for closing a puncture made in the wall of an artery or vein during a medical procedure. The puncture may be the result of a catheter-based intervention, although any puncture is contemplated, accidental or intentional. The present invention has particular utility for use in and around the femoral, radial, and brachial arteries after coronary/cardiac procedures. Other utilities include soft-tissue anchoring, tendon and artery joining, meniscal repair, thoracic lung closure, heart repair, endoscopic procedures, esophageal repair, laparoscopy, skin/epidermal wound closure and general tissue closure.
- 2. Description of Related Art
- Catheters/catheterization procedures are well known, and typically involve insertions through the femoral artery for diagnosis or to treat cardiovascular and/or peripheral vascular diseases. After a diagnostic or interventional catheterization, the puncture formed by the catheter must be closed. The puncture opening in the artery typically ranges from 5 F for a diagnostic procedure to 6-10 F for an interventional procedure. Traditionally, intense pressure has been applied to the puncture site for at least 30-45 minutes after removal of the catheter. Other approaches include a thrombotic or collagen plug, and/or other suturing methodology for sealing the puncture. Patients who have had a femoral puncture are then required to remain at bed rest, essentially motionless and often with a heavy sandbag placed on their upper legs, for several hours to ensure that the bleeding has stopped. This traditional method of hemostasis following femoral artery access has many inadequacies. When a blockage is removed during a procedure, the patient quickly feels better and they often have more energy than they have had in years, but they must remain motionless for several hours. The weight of the sandbag on the femoral artery often causes the lower leg to tingle or go numb. The recovery time from the medical procedure may be as little as ½ hour, but the recovery time from the wound can exceed 24 hours. This makes wound site management the longer critical care item. The longer the recovery time, the more expensive the procedure becomes, the greater the patient discomfort, and the greater the risk of complications.
- Surgical stapling instruments have been proposed to resolve some of the aforementioned problems associated with vascular procedures. U.S. Pat. No. 5,709,335 issued to Heck discloses a wholly distal surgical stapling instrument for stapling a tubular tissue structure to a luminal structure, such as a vascular lumen. This device can be used for anastomotic stapling of a tubular vessel having two untethered ends, and is especially useful for making the primary anastomotic connection of a bypass vein to a coronary artery or to the aorta. The device essentially includes a rod that is placed within the tubular vessel and an anvil that forces staples (associated with the rod) to bend outwardly against the vessel and a target (such as a coronary artery). Thus, this device requires that the stapler device be placed within the tubular vessel (e.g., vein or artery) for operation. While this device is useful when stapling a graft vein or the like, unfortunately, this device would be inappropriate when the entirety of the tubular tissue is not accessible, such as wound closure following an percutaneous transluminal diagnostic procedures and less invasive medical procedures.
- Another example is found in U.S. Pat. No. 5,695,504 issued to Gifford, III et al., discloses an end-to-side vascular anastomosis device to perform end-to-side anastomosis between a graft vessel and the wall of a target vessel. This device involves a procedure in which the end of a graft vessel is passed through an inner sleeve of the device until the end of the vessel extends from the distal end of the device. The distal end of the graft is then affixed to the wall of the target, using a staple and stapler which forces a staple into both tissues. Similar to the previous disclosures, this device is useful for the attachment of one tubular tissue onto another, however, is inadequate in sealing a puncture in an artery, vein or other tissue left by certain medical procedures.
- Moreover, the prior art has failed to provide a device that permits a doctor or clinician to gain access to a puncture site and remain centered on that site throughout the entire procedure, including closure of the puncture. Additionally, prior art devices do not permit a doctor or clinician to directly or indirectly view the wound site, for example through an endoscope, and thus wound site management is compromised.
- Accordingly, it is an overall object of the present invention to provide a device and method for wound site management during and after medical procedures.
- Accordingly, it is an overall object of the present invention to provide a device and method for wound site management and closure during and after medical procedures.
- In one aspect, the present invention provides a tissue staple comprising a plurality of prongs connected to a plurality of tabs and arranged about a centerline axis. The prongs have a shoulder portion extending substantially orthogonal from the prong toward the centerline axis. Each prong has a tapered tissue-piercing portion on the distal end thereof.
- Alternatively, the staple of the present invention comprises a plurality of prongs arranged about a centerline axis, each prong having a shoulder portion extending substantially orthogonal from the prong toward said centerline axis, and a plurality of web portions connecting each prong to one another, each prong having a tapered tissue-piercing portion on the distal end thereof.
- In another aspect, the present invention provides a stapler that includes an elongated sleeve having an inside diameter, an elongated rod with a flared mandrel couple to a distal end, the rod and mandrel sized to fit within the inside diameter of the tube, an actuator mechanism to move the rod relative to the sleeve, a staple adapted to fit between said mandrel and said sleeve, and, said actuator mechanism adapted to move said mandrel relative to said staple and said sleeve causing said staple to close on tissue located about a wound site.
- Broader aspects of the stapler include a distal tip comprising a sleeve and a rod inserted into said sleeve, said rod comprising a flared distal tip; an actuator coupled to said sleeve and said rod, said actuator adapted to cause said sleeve to move relative to said rod; and a tissue staple comprising a plurality of tissue piercing prongs placed around said rod between said sleeve and said flared distal tip.
- Wound closure procedures according to the present invention include a process for closing a wound comprising the steps of: inserting an introducer into a tissue wound, placing a sheath around the introducer and locating the sheath approximate to said wound, inserting the distal end of a stapler into said sheath to approach the tissue wound site, said stapler including a tissue staple on the distal end of said stapler, expanding a portion of the staple about said wound, and contracting at least a portion of said staple pulling the tissue surrounding the wound together.
- Other wound closing methods include a process for closing a wound in an artery with a staple, comprising the steps of: inserting an introducer with a plurality of guide wires coupled thereto into an artery, guiding a stapler and staple to the wound site, expanding said staple to surround said wound site before entering said tissue, and closing said staple on said tissue to close said wound.
- In yet another aspect, the present invention provides an introducer that includes a sheath having an inside diameter and a distal end, a dilator sized to fit within the inside diameter of the sheath, and a plurality of flexible wire guides having first ends and second ends, the first ends coupled to the distal end of the sheath, wherein the sheath being approximated to a wound site and the wire guides placed approximate to tissue surrounding the wound site to hold said sheath approximately centered on said wound site.
- In broader embodiment, the introducer of the present invention includes a tubular sheath, and at least one flexible wire guide affixed to the sheath, said wire guide placed approximate to tissue surrounding a wound site to hold said sheath approximately centered on said wound site.
- In method form, the present invention also includes wound site stabilization methodology including the steps of: approximating an elongated sheath to a wound site;
- inserting one or more wire guides into the wound site; placing said wire guides approximate to tissue surrounding said wound site; and allowing opposing sides of said tissue surrounding said wound site to approximate one another.
- Other procedural embodiments include a method for stabilizing a wound site, comprising the steps of: approximating an elongated sheath to a wound site; inserting one or more wire guides into the wound site; placing said wire guides approximate to tissue surrounding said wound site; and centering said sheath about said wound site.
- It will be appreciated by those skilled in the art that although the following Detailed Description will proceed with reference being made to preferred embodiments, the present invention is not intended to be limited to these preferred embodiments. Other features and advantages of the present invention will become apparent as the following Detailed Description proceeds, and upon reference to the Drawings, wherein like numerals depict like parts, and wherein:
- FIGS.1-3 are isometric views of one embodiment of the staple of the present invention in formed, opened and deployed positions, respectively;
- FIG. 3A depicts an isometric view of alternative staple of the embodiment of FIGS.1-3;
- FIGS.4-6 are isometric views of another embodiment of the staple of the present invention in formed, opened and deployed positions, respectively;
- FIG. 7 depicts one embodiment of the stapler of the present invention;
- FIG. 8 is an isometric view of the distal tip of the stapler of FIG. 7 adapted to hold and deploy the staple of FIGS.1-6;
- FIGS.9A-11B are isometric views of the cooperative movement of the distal tip of the stapler and the staple of the present invention;
- FIGS.12-15 are isometric views of an exemplary staple deployment mechanism of the stapler of the present invention;
- FIGS. 16 and 17 are isometric views of another exemplary staple deployment mechanism of the stapler of the present invention; and
- FIGS.18-26 depict various views of procedural embodiments of the present invention, including FIG. 20 depicting one embodiment of the introducer of the present invention.
- Tissue Staple
- In one aspect of the present invention, a staple is provided to close a tissue wound after a medical procedure. Although the preferred use of the staple of the present invention is to close an artery or vein following a diagnostic or interventional procedure, it should be recognized at the outset that the staple may be used for general tissue repair, not just limited to vascular repair. It will be appreciated throughout the following description that the staple of the present invention can be formed of any biocompatible and/or bioabsorbable materials, including, for example, Titanium (and Titanium alloys), stainless steel, polymeric materials (synthetic and/or natural), ceramic, etc. It will also be apparent from the following description that the staple of the present invention is preferably formed of a deformable material (such as those listed above) that undergoes plastic deformation (i.e., deformation with negligible elastic component.) As a general overview, the staple of the present invention undergoes two positions of deformation: a first position to extend the distal ends of the prongs of the staple outwardly to grab a greater amount of tissue (and also to grab tissue away from the wound locus), and a second position to move the prongs inwardly to close the wound.
- FIGS. 1, 2 and3 depict one embodiment of
staple 10 of the present invention. FIG. 1 is the staple in it's formed position, FIG. 2 is the staple just prior to deployment into tissue with the prongs extended outwardly, and FIG. 3 is the staple closed around tissue. Thestaple 10 of this embodiment comprises a plurality ofprongs 12A-12D and a plurality oftabs 14A-14D, arranged about acenterline axis 100. Common portions, or shoulders 16A-16D are formed where the tabs meet the prongs. Each shoulder is common to both the prong and the tab and is generally defined by a relatively flat portion generally orthogonal to the centerline axis.Shoulders 16A-16D may be viewed as an extension of each prong, bent inwardly toward the centerline axis. Each of these features of thestaple 10 of this embodiment is detailed below. - In the formed position (FIG. 1), prongs12A-12D extend generally parallel to
central axis 100, as shown. At the distal end of each prong, taperedpoints 18A-18D is formed to extend inwardly toward thecenterline axis 100. At the proximal end, shoulders 16A-16D meet atprongs 12A-12D, respectively.Tabs 14A-14D are generally U-shaped, and are formed between each prong. The proximal portions of each tab are joined at consecutive shoulders, as shown. Each proximal portion of the U (i.e., each “leg” of the U-shape tab) extends first generally outward from the shoulder, and second bends inwardly and distally towardcenterline axis 100, connecting together nearest the centerline axis to form the U shape. The U-shape definesslots 20A-20D within each tab having a base positioned at the bottom thereof. - Referring specifically to FIG. 2, the
staple 10 is deformed so thatprongs 12A-12D extend outwardly from the centerline axis, prior to deployment into tissue. It is advantageous to extend the prongs outwardly as shown so as to grasp a large portion of tissue, and so that insertion of the prongs into the tissue occurs at a locus away from the wound site, thereby providing a more consistent wound closure (by closing the wound with more of the surrounding tissue) and ensuring complete (or near complete) closure of the wound. To deform the staple into the position shown in FIG. 2, a force F1 is applied totabs 14A-14D, as shown in relief in FIG. 2A. Force F1 is generally outward (from the centerline axis) and proximal to the top of the staple, as shown in relief in FIG. 2A. This force causes the tabs to move outward from thecenterline axis 100. The outward movement of the tabs causes the shoulder portions to pivot roughly about the juncture between the shoulder and the prong (i.e., at the outer portion of the shoulder), causing the inner portions of the shoulders to move inwardly toward the centerline axis and distally. Since the prongs are attached to the outer portion of the shoulders, the movement of the shoulders in this manner causes the prongs to move outwardly. Thus, the cross-sectional diameter of the staple gets larger at the distal end (with respect to the cross-sectional diameter of the formed staple of FIG. 1). Note that the movement of the prongs is generally greater at the distal portions thereof than at the proximal portions thereof. In other words, movement of the prongs as shown in FIG. 2 is pivoted from the shoulder, thus producing a staple with outwardly extending prongs. For completeness, it should be noted that a holding force may be applied downwardly (i.e., substantially parallel to the centerline axis) against the base of theslots 20A-20D to hold the staple in place. Also, it is preferred that these forces are simultaneously applied to each tab of the staple to produce uniform deformation of each prong of the staple. As mentioned above, it is preferable that the plastic deformation of the staple is semi-permanent, so that the staple does not tend to return to the shape depicted in FIG. 1 (i.e.,non-elastic deformation). Deformation of the staple into this position will be described in greater detail below in reference to the preferred stapler device of the present invention. - FIG. 3 depicts the staple10 in a closed position. The closed position, as stated herein generally means that the prongs of the staple are moved inwardly toward each other. Although FIG. 3 depicts the tapered tip portions of the prongs meeting generally in the vicinity of the centerline axis, however, it should be understood that the term “closed” or “deployed” as used in reference to the staple need not necessarily mean this precise configuration. It may be required (or desirable) for some procedures to move the prongs inwardly toward each other to a greater or lesser extent than as depicted in FIG. 3. To draw the staple into the closed position depicted in this Figure, a force F3 is applied to the
inner surfaces 30A-30D of the shoulders. This force is generally orthogonal to the centerline axis, and the angle between each force approximates the angle between theinner surfaces 30A-30D (which, in the staple of this embodiment is approximately 90 degrees). This force causes theslots 20A-20D to spread apart and urges the shoulders outwardly. Movement in this manner also causes the shoulders to move outwardly and proximally. Proximal movement of the shoulders causes the prongs to move toward each other. Opposite to the movement of FIG. 2, deformation shown in FIG. 3 results in an expanded cross-sectional diameter of the proximal end of staple, and a diminished cross-sectional diameter of the distal end of the staple (with respect to the formed staple of FIG. 1 and the deformed staple of FIG. 2). Again, deformation of the staple 10 into this position will be described in greater detail below in reference to the preferred stapler device of the present invention. - For certain tissue applications, it may be desirable that the staple of the present invention is deployed into tissue such that the prongs do not fully pierce through the tissue, but rather grasp and hold the tissue together. For example, for vascular closure applications it may be desirable that the tissue piercing tapered ends not enter the bloodstream, but rather pierce into the tissue and stop short of piercing through the tissue wall. To that end, and referring to FIG. 3A, the staple10′ of the present invention can be adapted with tissue stops 32A-32D. Preferably, tissue stops 32A-32D are located along the length of each prong, and positioned from the distal tip of the prong to permit the tapered ends to pierce tissue, but not pierce all the way through the tissue. Accordingly, the position of the stops 32A-32D along the length of the prongs is selected to facilitate tissue grabbing (but not complete tissue piercing) and can vary from application to application.
- FIGS.4-6 depict another embodiment of a
staple 50 of the present invention. FIG. 4 is the staple in it's formed position, FIG. 5 is the staple just prior to deployment into tissue with the prongs extended outwardly, and FIG. 6 is the staple closed around tissue. Similar to the first embodiment, thestaple 50 of this embodiment comprises a plurality ofprongs 52A-52D arranged about acenterline axis 100. Ashoulder 56A-56D is provided and is generally defined by a relatively flat surface, generally orthogonal to centerline axis.Shoulders 56A-56D may be viewed as an extension of each prong, bent inwardly toward the centerline axis. In this embodiment,webs 54A-54D are connected to and between each prong, and are formed to extend inwardly from each prong toward the centerline axis, creating a U shape generally orthogonal to the centerline axis (as opposed to the previous embodiment in which the U-shaped tab is positioned generally parallel to the centerline axis). Each of the features of thestaple 50 of this embodiment is detailed below. - In the formed position (FIG. 4), prongs52A-52D extend generally parallel to
central axis 100, as shown. At the distal end of each prong, taperedpoints 58A-58D are formed to extend inwardly toward thecenterline axis 100. At the proximal end, shoulders 56A-56D meet atprongs 52A-52D, respectively. Web portions (webs) 54A-54D are generally U-shaped, and are formed between each prong extending inwardly toward the centerline axis. As shown, webs connect the prongs at a position distal to the shoulders. The precise position of the webs is determined by the desired extent to which the prongs are extended outwardly, and the extent to which the web curves inward toward the centerline axis. The space between the shoulders and the web portions defines a slot 60A-60D. - Referring specifically to FIG. 5, the
staple 50 is deformed so thatprongs 52A-52D extend outwardly from the centerline axis, prior to deployment into tissue. As with the previous embodiment, it is advantageous to extend the prongs outwardly as shown so as to grasp a large portion of tissue, and so that insertion of the prongs into the tissue occurs at a locus away from the wound site, thereby providing a more consistent wound closure (by closing the wound with more of the surrounding tissue) and ensuring complete (or near complete) closure of the wound. To deform the staple into the position shown in FIG. 5, a force F1 is applied towebs 54A-54D, as shown in relief in FIG. 5A. Force F1 is generally outward from the centerline axis and causes the webs to deform outwardly, i.e. straightening the bend of the web by moving the centermost point of the web outwardly. By deformation of the web portions in this manner, the prongs move outwardly. Thus, the cross-sectional diameter of the staple gets larger at the distal end (with respect to the cross-sectional diameter of the formed staple of FIG. 4). Note that the movement of the prongs is generally greater at the distal portions thereof than at the proximal portions thereof, thus producing a staple with outwardly extending prongs. For completeness, it should be noted that a holding force may be applied downwardly (i.e., substantially parallel to the centerline axis) against the top of the webs in slots 60A-60D to hold the staple in place. Also, it is preferred that these forces are simultaneously applied to each web of the staple to produce uniform deformation of each prong of the staple. As mentioned above, it is preferable that the deformation of the staple is plastic, so that the staple does not tend to return to the shape depicted in FIG. 4. Deformation of the staple into this position will be described in greater detail below in reference to the preferred stapler device of the present invention. - FIG. 6 depicts the staple50 in a closed or deployed position. The closed position, as stated herein generally means that the prongs of the staple are moved inwardly toward each other. To draw the staple into the closed position depicted in this Figure, a force F3 is applied to the
inner surfaces 62A-62D of the shoulders. This force is generally orthogonal to the centerline axis, and the angle between each force approximates the angle between theinner surfaces 62A-62D about the centerline axis (which, in the staple of this embodiment is approximately 90 degrees). This force urges the shoulders outwardly. Note that shoulders can only extend outwardly as far as the web portions will permit. Outward movement of the shoulders causes the prongs to move toward each other, since, there is a general pivot about the web portions. Opposite to the movement of FIG. 5, deformation shown in FIG. 6 results in an expanded cross-sectional diameter of the proximal end of staple, and a diminished cross-sectional diameter of the distal end of the staple (with respect to the formed staple of FIG. 4 and the deformed staple of FIG. 5). Again, deformation of the staple 50 into this position will be described in greater detail below in reference to the preferred stapler device of the present invention. - In either embodiment described above, it should be evident that although the Figures depict four each of the prongs, tabs and shoulders, this should be only be considered exemplary. It may be desirable to adapt the staple10 or the staple 50 with more or fewer prongs, tabs and shoulders for a given application. Also, it is not necessary that each prong is the same length, or that each prong has the same overall dimensions. In alternative embodiments, the entire staple, or selected portions thereof can be alternatively fashioned from an elastic or shape memory (e.g., nitinol, and/or other elastic materials, including for example temperature dependant shape memory materials) material thereby permitting elastic deformation from the a static closed position to an expanded position and then elastically close about the wound. Also, the embodiment of FIGS. 4-6 can be adapted with a tissue stop positioned along the length of the prong, as shown in FIG. 3A.
- Stapler Device
- Another aspect of the present invention is a stapler device to deploy the
staple 10 of FIGS. 1-3, the staple 10′ of FIG. 3A, and thestaple 50 of FIGS. 4-6. As a general overview, the stapler of the present invention includes a distal tip for holding and deploying a staple, and an actuator mechanism to cause a staple, or at least the tissue piercing portions of a staple, to expand outwardly and then close about a wound. The stapler of the present invention facilitates one object of the present invention to ensure that the staple closes a greater amount of tissue as compared with conventional stapling mechanisms. The following description will detail various exemplary mechanisms to accomplish this goal, but it should be recognized that numerous alternatives will be readily apparent to those skilled in the art, and all such alternatives are to accomplish these objectives are deemed within the scope of the present invention. FIG. 7 depicts an isometric view of one embodiment of astapling device 100 of the present invention. The device generally includes anactuation mechanism 104 and adistal tip 102. FIG. 8 is a more detailed view of thedistal tip 102 of thestapler device 200. The distal tip preferably comprises aninner rod member 110 slidable within anouter sleeve 112.Rod 110 includes a flared ormandrel portion 114.Mandrel 114 also includesslots 118A-118D, which in use are aligned withfingers 116A-116D.Fingers 116A-116D mate withslots 20A-20D and 60A-60D of the staple 10 and 50, respectively. Preferably,rod 110 is removable for staple attachment thereto, where a staple is positioned between the mandrel and the sleeve. The mandrel, as will be described below, is responsible for the forces generated on the staple. - FIGS. 9, 10A,10B, 11A and 11B depict the working relationship between the staple 10′ and/or 50 of the present invention and the
mandrel 114/sleeve 112 of thestapler mechanism 200. In FIG. 9A, the staple 10′ is placed between themandrel 114 andsleeve 112.Slots 20A-20D of the staple engagefingers 116A-116D of the sleeve. Theprongs 12A-12D of the staple are dimensioned so as to fit over the mandrel, andtabs 14A-14D are dimensioned so as to fit over therod 110, as shown. Similarly, for the staple 50 shown in FIG. 9B thestaple 50 engages themandrel 114 and sleeve 112 (not shown). This is a static position, as no forces are applied to the staple to cause deformation. In FIG. 10A, the staple 10′ is urged into the first deformed position (of FIG. 2) by the relative movement of the rod/mandrel and the sleeve. As shown, the mandrel is urged proximally. As the mandrel moves, the tabs of the staple meet the narrowest part of the mandrel. Further movement forces the tabs to move outwardly, causing the prongs to likewise move outwardly (as described above with reference to FIG. 2). Once the tabs clear the mandrel, outward movement of the tabs and prongs ceases. Similarly, in FIG. 10B, the movement of the mandrel forces webs to extend outwardly causing the prongs to extend outwardly (as described above with reference to FIG. 5). Once the webs clear the mandrel, outward movement of the prongs ceases. FIG. 11A depicts final deployment of the staple into tissue. As the mandrel is drawn further proximally and once the tabs have cleared the mandrel, the shoulders (not shown) are spread outward, forcing the prongs to move together (toward the centerline axis) and closing tissue therebetween. FIG. 11B depicts the same actuation, but for thestaple 50 of FIGS. 4-6. - FIGS.12-15 depict an
exemplary actuator mechanism 104, showing the relative motion of thesleeve 112 and themandrel rod 110. The mechanism includes acam 408 movable in a linear motion along aslot 412. Movement of the cam can be manual or through an electronically controllable motor (not shown). Thecam 408 haslobes cam 408 and alobe 408B located on a second and opposing side of thecam 408. Afirst cam follower 418 is coupled to themandrel rod 110, and is selectably engagable withlobes second cam follower 416 is coupled to thesleeve 112, and is selectably engagable withlobe 408B. FIG. 12 depicts that neither cam follower is in contact with the lobes, and is indicative of an initial position of the mechanism. - FIG. 13 depicts the
mechanism 104 in a position to expand the staple between themandrel 114 and thesleeve 112, as shown in FIG. 9A. Ascam 408 is moved (as indicated by the arrow),lobe 408A urgescam follower 418 alongslot 426. Themandrel rod 110 is moved proximally, causing the prongs to extend outwardly (as shown in FIGS. 2 and 5) as a result of the force of themandrel 114 on the tabs or the web portions. With further movement of the cam 408 (FIG. 14),lobe 408B now urgescam follower 416 to move distally, thereby moving the sleeve distally relative to the mandrel rod and causing further expansion of the prongs and causing the staple to move distally. Finally, in FIG. 15, the cam is urged yet further andcam follower 418 is urged bylobe 408C causing the mandrel and madrel rod to extend further proximally. This relative movement between the cam rod and the sleeve causes the mandrel to apply a force to the shoulder portions of the staple, in turn causing inward movement of the prongs.Lobe 408C causes closure of the prongs and decouples the staple from the mandrel. This is the fully deployed staple movement. - FIGS. 16 and 17 show an alternative cam mechanism. Similar to the previous example,
cam 608 is urged in a direction indicated by the arrow to cause relative motion between the mandrel rod and the sleeve.Lobes cam 608. As thecam 608 is moved alongslot 612, thelobe 608A urges acam follower 618 in a linear motion along aslot 626. This urges thecam follower 618 proximally. Thecam follower 618 is coupled to amandrel rod 604. This deforms staple 10/50 in the second configuration (see FIG. 2 or 5). As thecam 608 is urged further, thecam follower 618 moves distally to stay in contact with thelobe 608A. This urgesmandrel rod 604 distally. The same movement of thecam 608 urges lobe 608B to urgecam follower 616 distally. Thecam follower 616 is coupled to asleeve 606. This urgessleeve 606 distally. The downward slope oflobe 608A is parallel with upward slope oflobe 608B so themandrel rod 604 and thesleeve 606 move distally in unison and the staple is advanced into the tissue. The movement of thecam follower 618 down the slope oflobe 608A then ceases while the movement ofcam follower 616 continues up the slope oflobe 608B, the staple 10/50 is deformed into the closed or deployed configuration (see FIG. 3 or 6).Springs cam followers slot 612 to movecam 608 back to an original position. - Alternatively, the actuation mechanism can include a rotating drum (not shown) to replace the
cam lobes 408A-408C and 608A-608B, respectively. Other alternatives may include a rotating screw having a variable width in accordance withlobes 408A-408C or 608A-608B to actuate the mandrel rod and/or sleeve. Of course, instead of the cam mechanisms depicted in the Figures, direct linkage may be used to actuate the mandrel rod and/or sleeve. - Wound Site Management and Dilator
- FIGS.18-25A depict procedural embodiments of wound site management during and after a medical procedure, such as angioplasty. FIG. 18 depicts a conventional
tubular dilator 500 extending through the skin of a patient. Typically, thedilator 500 is left in the skin following a completed medical procedure. When the medical procedure has been completed, the wound site must be stabilized. Although the blood flow may not be completely stopped, the blood flow is reduced to a point where the coagulants in the blood can complete the wound closure. To start the stabilization process of the wound site, the doctor inserts aflexible guide wire 502 through anopening 504 in the end of thedilator 500. FIG. 19 shows the step of removing theintroducer 500 from the wound site after theguide wire 502 is properly inserted through the skin and into the artery. - To facilitate efficient wound closure, another aspect of the present invention provides an introducer formed to stretch the wound site for more efficient and effective closure. FIG. 20 depicts the
introducer 510 of the present invention, and continues the process from FIGS. 18 and 19 where theintroducer 510 slides over theguide wire 502 through an opening in theintroducer 510 and a portion of the introducer is placed into the artery. Details of theintroducer 510 are disclosed below. - FIG. 20 depicts the
introducer 510 inserted over the guide wire 502 (already in the artery) and inserted into the artery. The introducer includes a hollowelongated guide sheath 512 anddilator 520. Referring to FIG. 20A, the doctor urges thedistal tip 516 of thedilator 520 into and through the guide sheath 512 (over guide wire 502). A flexibledistal end 516 of thedilator 520 is inserted into the wound, until a blood marker BM indicates that thedilator 520 is properly positioned in the artery. The blood marker BM located at a predetermined length along thedilator 520 allows blood to flow through acavity 540 to alert the doctor that thedilator 520, and more specifically the flexibledistal tip 516, is properly inserted in an artery. Most preferable, thedistal tip 516 of the dilator includes a taperedportion 522 to facilitate easier ingress into the artery. An additional blood marking passageway (not shown) can be included on the distal end ofsheath 512 as precautionary indicator of the depth of the sheath. Presence of blood in this additional passageway is indicative of the sheath being pressed too far and into the arterial wall or into the artery. - Preferably, the diameter of distal end of the
guide sheath 512 can expand if outward pressure is applied from inside surface of theguide sheath 512. More preferably, slits or weakened tear seams (described below) are formed in the distal end of theguide sheath 512 to allow the diameter of the guide sheath to increase when pressure is applied. - A feature of the guide sheath of the present invention is the use of two or more wire guides to maintain the sheath centered on the wound site, to permit opposing sides of the wound to approximate, and to ensure that the closure device (e.g., stapler/staple, suturing device, cauterization, etc) remains centered about the wound so that wound closure is centered. Preferably, wire guides are formed on opposing sides of the
guide sheath 512. The wire guides are delivered into the artery by thedilator 520, as shown in FIGS. 21 and 26. Thewire guide 514 are preferably flexible, and removably coupled to thedistal end 516 of thedilator 520 and deployed into the wound, as shown in FIG. 26. The wire guides can be held in openings or slots (not shown) on the sides of dilator. Once the dilator is properly inserted into the wound to a proper depth (as indicated by the BM passageway), the dilator is removed from the wound and the guide sheath. To remove thedilator 520 from theguide sheath 512, the doctor first holds theguide sheath 512 and advances thedilator 520 inward (and upward) through theguide sheath 512. This decouples theguide wires guide wires dilator 520 before the dilator is withdrawn, a mechanism is provided that does not allow withdrawal until the guide rod has been inserted a predetermined distance. As shown in the drawing this mechanism can include a hub mechanism that requires a twisting motion or other action prior to withdrawal. After the guide rod has been inserted the predetermined distance, the doctor simply extracts the guide rod. This leaves theguide sheath 512 centered on the wound with theguide wires - As is understood to those skilled in the diagnostic and interventional arts, a puncture in an artery or vein has a general tendency to manifest a slit or an elongated opening, since the cell structure forming this tissue forms circumferentially (rather than longitudinal) to support radial expansion and contraction of the vessel. The wire guides514A and 514B of the present invention enable the wound to approximate the natural state of the wound, i.e., elongated circumferentially. Preferably, the sheath has a diameter approximately equal to the diameter of the opening or wound, so that the wire guides 514A and 514B on the sides of the sheath approximate the diameter of the long axis of the wound, as best shown in FIG. 23. Approximation in this sense may mean that the wire guides are less than or greater than (or equal to) this diameter. In effect, the wire guides in this position limit movement of the sheath along the long axis, and since the wound is elongated, movement along the short axis is likewise limited. This ensures that any device inserted through the sheath is approximately centered on the wound.
- Importantly, since the wound opening tends to assume the shape shown in FIG. 23 even in the absence of the wire guides, the opposing tissue located along the short axis tends to approximate. The present invention takes advantage of this tendency. If the position of the wire guides define a diameter larger than the diameter of the wound, the tissue along the short axis tends to approximate more (i.e., the tissue is stretched along the long axis). However, sufficient wound site management does not require that the wire guides stretch the wound. Rather, if the position of the wire guides are shorter than the wound length, the wire guides still serve to maintain the sheath generally centered at the wound. In both circumstances, the wire guides ensure that a staple deployment is centered, and that a significant amount of tissue is grasped by the staple for closure. Also, if the wound opening in the tissue is held taught by the introducer, there is less tendency for the tissue surrounding the opening to slip down into the vessel during staple deployment (which would reduce the effectiveness of the closure). FIG. 23 also shows examples of locations S1, S2, S3, and S4 of where the prongs of the staple to be inserted will line-up relative to the wound opening WO. The
guide wires 514 are preferably disposed on opposing sides of theguide sheath 512, and more preferable, the guide wires are inserted into the wound opening transversally to the long axis of the artery or vein, so that the wound is pulled taught in a transverse direction. - FIG. 22 shows the distal end of a
stapler 104 with a staple 10/50 being inserted through theguide sheath 512 of theintroducer 510. FIG. 22A depicts a relief view of theintroducer 510, and more clearly depicts the slits or weakened tear seams 700. When the distal end of thestapler 104 is properly inserted in theguide sheath 512, the staple can be deployed into the tissue. FIG. 24 shows the first step of staple deployment, the process of which is described in detail above. Note that in FIG. 24A, the extension of the staple prongs causes the weakened tear seam or slits to separate. This further causes the wire guides to expand against the long axis of the wound, thereby further approximating the tissue surrounding the opening. The diameter formed by the prongs of the staple 10/50 is now larger than the original outside diameter of theguide sheath 512. FIGS. 25 and 25A depict the staple fully deployed into tissue, the process of which is described above. The stapler can now be removed from theguide sheath 512. Theguide sheath 512 can now be urged away from the wound opening WO and theguide wires - Although the present invention has been described in relation to particular embodiments thereof, many other variations and modifications and other uses will become apparent to those skilled in the art. It is preferred, therefore, that the present invention be limited not by the specific disclosure herein, but only by the appended claims.
Claims (10)
1. A tissue stapler, comprising
an elongated sleeve having an inside diameter,
an elongated rod with a flared mandrel couple to a distal end, the rod and mandrel sized to fit within the inside diameter of the tube,
an actuator mechanism to move the rod relative to the sleeve,
a staple adapted to fit between said mandrel and said sleeve, and
said actuator mechanism adapted to move said mandrel relative to said staple and said sleeve causing said staple to close on tissue located about a wound site.
2. A tissue stapler as claimed in claim 1 , said actuator mechanism comprising a cam for urging said sleeve to move relative to said mandrel.
3. The stapling device of claim 2 , further comprising a first cam follower coupled to said sleeve and a second cam follower coupled to said mandrel rod, said cam urging said first and second cam followers to move said sleeve relative to said mandrel.
4. The stapling device of claim 1 , wherein said mandrel causing at least a portion of said staple to expand before causing said staple to close on said tissue.
5. The stapling device of claim 1 , wherein said mandrel causes the staple prongs to contract inward thereby deploying said staple into said tissue.
6. A stapler, comprising:
a distal tip comprising a sleeve and a rod inserted into said sleeve, said rod comprising a flared distal tip;
an actuator coupled to said sleeve and said rod, said actuator adapted to cause said sleeve to move relative to said rod; and
a tissue staple comprising a plurality of tissue piercing prongs placed around said rod between said sleeve and said flared distal tip.
7. A stapler as claimed in claim 6 , wherein said movement of said sleeve relative to said rod causing said flared distal tip to expand said tissue piercing prongs away from said rod.
8. A stapler as claimed in claim 6 , wherein said movement of said sleeve relative to said rod causing said tissue piercing prongs to move together.
9. A process for closing a wound, comprising the steps of:
inserting an introducer into a tissue wound,
placing a sheath around the introducer and locating the sheath approximate to said wound,
inserting the distal end of a stapler into said sheath to approach the tissue wound site, said stapler including a tissue staple on the distal end of said stapler,
expanding a portion of the staple about said wound, and
contracting at least a portion of said staple pulling the tissue surrounding the wound together.
10. A process for closing a wound in an artery with a staple, comprising the steps of:
inserting an introducer with a plurality of guide wires coupled thereto into an artery,
guiding a stapler and staple to the wound site,
expanding said staple to surround said wound site before entering said tissue, and
closing said staple on said tissue to close said wound.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/338,466 US20030097140A1 (en) | 2000-09-01 | 2003-01-08 | Wound site management and wound closure device |
US11/278,908 US8551134B2 (en) | 2000-09-01 | 2006-04-06 | Wound site management and wound closure device |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US23023400P | 2000-09-01 | 2000-09-01 | |
US09/658,787 US6506210B1 (en) | 2000-09-01 | 2000-09-11 | Wound site management and wound closure device |
US10/178,030 US6767356B2 (en) | 2000-09-01 | 2002-06-21 | Advanced wound site management systems and methods |
US10/338,466 US20030097140A1 (en) | 2000-09-01 | 2003-01-08 | Wound site management and wound closure device |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/658,787 Continuation US6506210B1 (en) | 2000-09-01 | 2000-09-11 | Wound site management and wound closure device |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/278,908 Continuation US8551134B2 (en) | 2000-09-01 | 2006-04-06 | Wound site management and wound closure device |
Publications (1)
Publication Number | Publication Date |
---|---|
US20030097140A1 true US20030097140A1 (en) | 2003-05-22 |
Family
ID=29999114
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/178,030 Expired - Fee Related US6767356B2 (en) | 2000-09-01 | 2002-06-21 | Advanced wound site management systems and methods |
US10/338,466 Abandoned US20030097140A1 (en) | 2000-09-01 | 2003-01-08 | Wound site management and wound closure device |
US10/899,911 Expired - Lifetime US7597706B2 (en) | 2000-09-01 | 2004-07-27 | Advanced wound site management systems and methods |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/178,030 Expired - Fee Related US6767356B2 (en) | 2000-09-01 | 2002-06-21 | Advanced wound site management systems and methods |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/899,911 Expired - Lifetime US7597706B2 (en) | 2000-09-01 | 2004-07-27 | Advanced wound site management systems and methods |
Country Status (5)
Country | Link |
---|---|
US (3) | US6767356B2 (en) |
EP (1) | EP1515648A1 (en) |
JP (1) | JP2005530559A (en) |
AU (1) | AU2003279226A1 (en) |
WO (1) | WO2004000133A1 (en) |
Cited By (69)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20030199924A1 (en) * | 2000-09-08 | 2003-10-23 | James Coleman | Surgical stapler |
US20040028502A1 (en) * | 2001-06-07 | 2004-02-12 | Christy Cummins | Surgical staple |
US20040236355A1 (en) * | 2001-08-09 | 2004-11-25 | Thomas Anthony | Surgical stapling device |
US20040249391A1 (en) * | 2001-08-09 | 2004-12-09 | Christy Cummins | Surgical stapling device and method |
US20050256537A1 (en) * | 2002-07-03 | 2005-11-17 | Christy Cummins | Surgical stapling device |
US20060190014A1 (en) * | 2000-01-05 | 2006-08-24 | Ginn Richard S | Integrated vascular device with puncture site closure component and sealant and methods of use |
US20060217744A1 (en) * | 2005-03-28 | 2006-09-28 | Cardica, Inc. | Vascular closure system |
US20080071294A1 (en) * | 2006-09-15 | 2008-03-20 | Bender Theodore M | Apparatus and method for closure of patent foramen ovale |
US20080217376A1 (en) * | 2007-03-08 | 2008-09-11 | Cardica, Inc. | Surgical Stapler |
US7458978B1 (en) | 2005-03-28 | 2008-12-02 | Cardica, Inc. | Vascular closure system utilizing a staple |
US20080312666A1 (en) * | 2003-01-30 | 2008-12-18 | Abbott Laboratories | Clip applier and methods of use |
US20090093826A1 (en) * | 2007-10-05 | 2009-04-09 | Cardica, Inc. | Patent Foramen Ovale Closure System |
US7533790B1 (en) | 2007-03-08 | 2009-05-19 | Cardica, Inc. | Surgical stapler |
US20090254121A1 (en) * | 2008-04-02 | 2009-10-08 | Cardica, Inc. | Vascular Closure with Multi-Pronged Clip |
USD611144S1 (en) | 2006-06-28 | 2010-03-02 | Abbott Laboratories | Apparatus for delivering a closure element |
US7806910B2 (en) | 2002-11-26 | 2010-10-05 | Abbott Laboratories | Multi-element biased suture clip |
US7806904B2 (en) | 2000-12-07 | 2010-10-05 | Integrated Vascular Systems, Inc. | Closure device |
US7819895B2 (en) | 2000-01-05 | 2010-10-26 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
US7828817B2 (en) | 2000-01-05 | 2010-11-09 | Integrated Vascular Systems, Inc. | Apparatus and methods for delivering a closure device |
US7842068B2 (en) | 2000-12-07 | 2010-11-30 | Integrated Vascular Systems, Inc. | Apparatus and methods for providing tactile feedback while delivering a closure device |
US7841502B2 (en) | 2007-12-18 | 2010-11-30 | Abbott Laboratories | Modular clip applier |
US7850709B2 (en) | 2002-06-04 | 2010-12-14 | Abbott Vascular Inc. | Blood vessel closure clip and delivery device |
US7850797B2 (en) | 2002-12-31 | 2010-12-14 | Integrated Vascular Systems, Inc. | Methods for manufacturing a clip and clip |
US7867249B2 (en) | 2003-01-30 | 2011-01-11 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US7879071B2 (en) | 2000-12-07 | 2011-02-01 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US7931669B2 (en) | 2000-01-05 | 2011-04-26 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant and methods of use |
US8007512B2 (en) | 2002-02-21 | 2011-08-30 | Integrated Vascular Systems, Inc. | Plunger apparatus and methods for delivering a closure device |
US8202294B2 (en) | 2003-01-30 | 2012-06-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8226681B2 (en) | 2007-06-25 | 2012-07-24 | Abbott Laboratories | Methods, devices, and apparatus for managing access through tissue |
US8303624B2 (en) | 2010-03-15 | 2012-11-06 | Abbott Cardiovascular Systems, Inc. | Bioabsorbable plug |
US8313497B2 (en) | 2005-07-01 | 2012-11-20 | Abbott Laboratories | Clip applier and methods of use |
US8323312B2 (en) | 2008-12-22 | 2012-12-04 | Abbott Laboratories | Closure device |
US8398676B2 (en) | 2008-10-30 | 2013-03-19 | Abbott Vascular Inc. | Closure device |
US8398656B2 (en) | 2003-01-30 | 2013-03-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8556930B2 (en) | 2006-06-28 | 2013-10-15 | Abbott Laboratories | Vessel closure device |
US8556932B2 (en) | 2011-05-19 | 2013-10-15 | Abbott Cardiovascular Systems, Inc. | Collapsible plug for tissue closure |
US8590760B2 (en) | 2004-05-25 | 2013-11-26 | Abbott Vascular Inc. | Surgical stapler |
US8603116B2 (en) | 2010-08-04 | 2013-12-10 | Abbott Cardiovascular Systems, Inc. | Closure device with long tines |
US8617184B2 (en) | 2011-02-15 | 2013-12-31 | Abbott Cardiovascular Systems, Inc. | Vessel closure system |
US8672953B2 (en) | 2007-12-17 | 2014-03-18 | Abbott Laboratories | Tissue closure system and methods of use |
US8690910B2 (en) | 2000-12-07 | 2014-04-08 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8758400B2 (en) | 2000-01-05 | 2014-06-24 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US8758398B2 (en) | 2006-09-08 | 2014-06-24 | Integrated Vascular Systems, Inc. | Apparatus and method for delivering a closure element |
US8758399B2 (en) | 2010-08-02 | 2014-06-24 | Abbott Cardiovascular Systems, Inc. | Expandable bioabsorbable plug apparatus and method |
US8808310B2 (en) | 2006-04-20 | 2014-08-19 | Integrated Vascular Systems, Inc. | Resettable clip applier and reset tools |
US8821534B2 (en) | 2010-12-06 | 2014-09-02 | Integrated Vascular Systems, Inc. | Clip applier having improved hemostasis and methods of use |
US8858594B2 (en) | 2008-12-22 | 2014-10-14 | Abbott Laboratories | Curved closure device |
US8893947B2 (en) | 2007-12-17 | 2014-11-25 | Abbott Laboratories | Clip applier and methods of use |
US8905937B2 (en) | 2009-02-26 | 2014-12-09 | Integrated Vascular Systems, Inc. | Methods and apparatus for locating a surface of a body lumen |
US8920442B2 (en) | 2005-08-24 | 2014-12-30 | Abbott Vascular Inc. | Vascular opening edge eversion methods and apparatuses |
US8926633B2 (en) | 2005-06-24 | 2015-01-06 | Abbott Laboratories | Apparatus and method for delivering a closure element |
US9089674B2 (en) | 2000-10-06 | 2015-07-28 | Integrated Vascular Systems, Inc. | Apparatus and methods for positioning a vascular sheath |
US9089311B2 (en) | 2009-01-09 | 2015-07-28 | Abbott Vascular Inc. | Vessel closure devices and methods |
US20150250461A1 (en) * | 2012-09-26 | 2015-09-10 | Eric Berreklouw | Constrictor for closing or narrowing a passage through tissue of a hollow organ |
US9149276B2 (en) | 2011-03-21 | 2015-10-06 | Abbott Cardiovascular Systems, Inc. | Clip and deployment apparatus for tissue closure |
US9173644B2 (en) | 2009-01-09 | 2015-11-03 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US9282965B2 (en) | 2008-05-16 | 2016-03-15 | Abbott Laboratories | Apparatus and methods for engaging tissue |
US9314230B2 (en) | 2009-01-09 | 2016-04-19 | Abbott Vascular Inc. | Closure device with rapidly eroding anchor |
US9332976B2 (en) | 2011-11-30 | 2016-05-10 | Abbott Cardiovascular Systems, Inc. | Tissue closure device |
US9364209B2 (en) | 2012-12-21 | 2016-06-14 | Abbott Cardiovascular Systems, Inc. | Articulating suturing device |
US9414820B2 (en) | 2009-01-09 | 2016-08-16 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US9414824B2 (en) | 2009-01-16 | 2016-08-16 | Abbott Vascular Inc. | Closure devices, systems, and methods |
CN105943169A (en) * | 2016-04-19 | 2016-09-21 | 上海市肺科医院 | 3D-printed in-vitro assistant positioning device for lung mass and preparation method for same |
US9456811B2 (en) | 2005-08-24 | 2016-10-04 | Abbott Vascular Inc. | Vascular closure methods and apparatuses |
US9486191B2 (en) | 2009-01-09 | 2016-11-08 | Abbott Vascular, Inc. | Closure devices |
US9579091B2 (en) | 2000-01-05 | 2017-02-28 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US9585647B2 (en) | 2009-08-26 | 2017-03-07 | Abbott Laboratories | Medical device for repairing a fistula |
US20170360441A1 (en) * | 2016-06-15 | 2017-12-21 | Covidien Lp | Tool assembly for leak resistant tissue dissection |
EP3563776A3 (en) * | 2013-11-13 | 2020-08-05 | Arthrex, Inc | Staples for generating and applying compression within a body |
Families Citing this family (667)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8177762B2 (en) | 1998-12-07 | 2012-05-15 | C. R. Bard, Inc. | Septum including at least one identifiable feature, access ports including same, and related methods |
US8137364B2 (en) | 2003-09-11 | 2012-03-20 | Abbott Laboratories | Articulating suturing device and method |
US6964668B2 (en) | 1999-03-04 | 2005-11-15 | Abbott Laboratories | Articulating suturing device and method |
US8551134B2 (en) * | 2000-09-01 | 2013-10-08 | Medtronic Vascular, Inc. | Wound site management and wound closure device |
US8062377B2 (en) | 2001-03-05 | 2011-11-22 | Hudson Surgical Design, Inc. | Methods and apparatus for knee arthroplasty |
US7094245B2 (en) * | 2001-10-05 | 2006-08-22 | Scimed Life Systems, Inc. | Device and method for through the scope endoscopic hemostatic clipping |
US20120145765A1 (en) | 2002-06-25 | 2012-06-14 | Peterson James A | Mechanical method and apparatus for bilateral tissue fastening |
US7267682B1 (en) * | 2002-12-04 | 2007-09-11 | Cardica, Inc. | Anastomosis staple |
ES2279231T3 (en) | 2003-05-09 | 2007-08-16 | Tyco Healthcare Group Lp | ANASTOMOTIC STAPLE WITH CAPILLARY TUBE THAT DISPENSES FLUIDS. |
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 |
CN1787782A (en) * | 2003-06-11 | 2006-06-14 | 库尔斯恩蒂斯股份公司 | Bone clamp |
US7635367B2 (en) * | 2003-08-05 | 2009-12-22 | Medicrea International | Osteosynthesis clip and insertion tool for use with bone tissue fragments |
US7462188B2 (en) | 2003-09-26 | 2008-12-09 | Abbott Laboratories | Device and method for suturing intracardiac defects |
ES2387016T3 (en) | 2003-10-17 | 2012-09-11 | Tyco Healthcare Group Lp | Surgical stapling device |
US20050107820A1 (en) * | 2003-11-13 | 2005-05-19 | Forsberg Andrew T. | Vascular puncture depth locator |
US20060030854A1 (en) | 2004-02-02 | 2006-02-09 | Haines Timothy G | Methods and apparatus for wireplasty bone resection |
US20050267520A1 (en) | 2004-05-12 | 2005-12-01 | Modesitt D B | Access and closure device and method |
US7678133B2 (en) | 2004-07-10 | 2010-03-16 | Arstasis, Inc. | Biological tissue closure device and method |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
FR2874809B1 (en) * | 2004-09-06 | 2008-02-01 | Newdeal Sa Sa | IMPLANT FOR FIXING A BONE GRAFT WITHIN A JOINT TO ENSURE THE ARTHRODESIS OF THE JOINT |
US9474888B2 (en) | 2005-03-04 | 2016-10-25 | C. R. Bard, Inc. | Implantable access port including a sandwiched radiopaque insert |
US7947022B2 (en) | 2005-03-04 | 2011-05-24 | C. R. Bard, Inc. | Access port identification systems and methods |
WO2006096686A1 (en) | 2005-03-04 | 2006-09-14 | C.R. Bard, Inc. | Access port identification systems and methods |
US8029482B2 (en) | 2005-03-04 | 2011-10-04 | C. R. Bard, Inc. | Systems and methods for radiographically identifying an access port |
US8147455B2 (en) | 2005-04-27 | 2012-04-03 | C. R. Bard, Inc. | Infusion apparatuses and methods of use |
US10307581B2 (en) | 2005-04-27 | 2019-06-04 | C. R. Bard, Inc. | Reinforced septum for an implantable medical device |
EP1896117B1 (en) | 2005-04-27 | 2011-01-12 | C.R.Bard, Inc. | Power injector system for injecting contrast media into an intravenous line |
AU2006247355B2 (en) | 2005-05-12 | 2013-01-10 | Arstasis, Inc. | Access and closure device and method |
DE202005009061U1 (en) * | 2005-05-31 | 2006-10-12 | Karl Storz Gmbh & Co. Kg | Clip and clip setter for closing blood vessels |
CA2549224A1 (en) * | 2005-06-02 | 2006-12-02 | Tyco Healthcare Group Lp | Expandable backspan staple |
US20080312686A1 (en) * | 2005-07-01 | 2008-12-18 | Abbott Laboratories | Antimicrobial closure element and closure element applier |
US8100939B2 (en) | 2005-07-15 | 2012-01-24 | Incisive Surgical, Inc. | Mechanical method and apparatus for sequential tissue fastening |
US8029535B2 (en) * | 2005-08-05 | 2011-10-04 | Ethicon Endo-Surgery, Inc. | Fasteners for use with gastric restriction |
US8083754B2 (en) * | 2005-08-08 | 2011-12-27 | Abbott Laboratories | Vascular suturing device with needle capture |
US8758397B2 (en) * | 2005-08-24 | 2014-06-24 | Abbott Vascular Inc. | Vascular closure methods and apparatuses |
US20070060895A1 (en) | 2005-08-24 | 2007-03-15 | Sibbitt Wilmer L Jr | Vascular closure methods and apparatuses |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | 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 |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US20070194082A1 (en) | 2005-08-31 | 2007-08-23 | Morgan Jerome R | Surgical stapling device with anvil having staple forming pockets of varying depths |
US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US8123795B1 (en) * | 2005-10-03 | 2012-02-28 | Cardica, Inc. | System for attaching an abdominal aortic stent or the like |
US7799039B2 (en) | 2005-11-09 | 2010-09-21 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a hydraulically actuated end effector |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
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 |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
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 |
JP5584464B2 (en) * | 2006-03-25 | 2014-09-03 | アポノス・メデイカル・コーポレイシヨン | Self-closing tissue fastener |
US20070233187A1 (en) * | 2006-04-04 | 2007-10-04 | Medtronic Vascular, Inc. | Self-closing medical staple |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US20110022099A1 (en) * | 2006-08-18 | 2011-01-27 | Ashman Richard B | Shape-Transforming Implant Device |
WO2008028133A2 (en) * | 2006-09-01 | 2008-03-06 | Creighton University | Surgical fastener and method of use |
US20080065153A1 (en) * | 2006-09-08 | 2008-03-13 | Warsaw Orthopedic, Inc. | Surgical staple |
US8136711B2 (en) | 2006-09-08 | 2012-03-20 | Tyco Healthcare Group Lp | Dissection tip and introducer for surgical instrument |
US8403196B2 (en) | 2006-09-08 | 2013-03-26 | Covidien Lp | Dissection tip and introducer for surgical instrument |
US20080065154A1 (en) * | 2006-09-08 | 2008-03-13 | Warsaw Orthopedic, Inc | Surgical staple |
WO2008033558A2 (en) * | 2006-09-15 | 2008-03-20 | Vascular Precision | Tissue closure, delivery device and method of use |
US8485412B2 (en) | 2006-09-29 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical staples having attached drivers and stapling instruments for deploying the same |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US9642986B2 (en) | 2006-11-08 | 2017-05-09 | C. R. Bard, Inc. | Resource information key for an insertable medical device |
US9265912B2 (en) | 2006-11-08 | 2016-02-23 | C. R. Bard, Inc. | Indicia informative of characteristics of insertable medical devices |
US7699203B2 (en) * | 2006-11-13 | 2010-04-20 | Warsaw Orthopedic, Inc. | Variable angle surgical staple inserter |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
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 |
US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
US8701958B2 (en) | 2007-01-11 | 2014-04-22 | Ethicon Endo-Surgery, Inc. | Curved end effector for a surgical stapling device |
JP5046966B2 (en) * | 2007-01-23 | 2012-10-10 | パナソニック株式会社 | Electromechanical resonator and manufacturing method thereof |
US20080173691A1 (en) * | 2007-01-24 | 2008-07-24 | Medtronic Vascular, Inc. | Low-Profile Vascular Closure Systems and Methods of Using Same |
US7655004B2 (en) | 2007-02-15 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Electroporation ablation apparatus, system, and method |
US20080221614A1 (en) * | 2007-03-09 | 2008-09-11 | Medtronic Vascular, Inc. | Method for Closing an Arteriotomy |
US8979872B2 (en) * | 2007-03-13 | 2015-03-17 | Longevity Surgical, Inc. | Devices for engaging, approximating and fastening tissue |
WO2008112942A2 (en) | 2007-03-13 | 2008-09-18 | Harris Peter S | Methods and devices for reducing gastric volume |
US8727197B2 (en) | 2007-03-15 | 2014-05-20 | Ethicon Endo-Surgery, Inc. | Staple cartridge cavity configuration with cooperative surgical staple |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US20080262541A1 (en) | 2007-04-23 | 2008-10-23 | Medtronic Vascular, Inc. | Blood vessel closure |
US7727251B2 (en) * | 2007-04-25 | 2010-06-01 | Medtronic Vascular, Inc. | Low profile dilator for arteriotomy closure system |
US8147504B2 (en) * | 2007-05-05 | 2012-04-03 | Medtronic, Inc. | Apparatus and methods for delivering fasteners during valve replacement |
US20080287989A1 (en) * | 2007-05-17 | 2008-11-20 | Arch Day Design, Llc | Tissue holding implants |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
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 |
US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US11672531B2 (en) | 2007-06-04 | 2023-06-13 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
US8257325B2 (en) | 2007-06-20 | 2012-09-04 | Medical Components, Inc. | Venous access port with molded and/or radiopaque indicia |
US8308040B2 (en) | 2007-06-22 | 2012-11-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US8574244B2 (en) | 2007-06-25 | 2013-11-05 | Abbott Laboratories | System for closing a puncture in a vessel wall |
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 |
EP2180915B1 (en) | 2007-07-19 | 2017-10-04 | Medical Components, Inc. | Venous access port assembly with x-ray discernable indicia |
US9610432B2 (en) | 2007-07-19 | 2017-04-04 | Innovative Medical Devices, Llc | Venous access port assembly with X-ray discernable indicia |
US7866523B1 (en) * | 2007-09-21 | 2011-01-11 | Cardica, Inc. | Soft-tipped anvil |
US20090082802A1 (en) * | 2007-09-26 | 2009-03-26 | Medtronic Vascular, Inc. | Mechanism and Method for Closing an Arteriotomy |
US9579496B2 (en) | 2007-11-07 | 2017-02-28 | C. R. Bard, Inc. | Radiopaque and septum-based indicators for a multi-lumen implantable port |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
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 |
US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
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 |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
US7819296B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with retractable firing systems |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US7861906B2 (en) | 2008-02-14 | 2011-01-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with articulatable components |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US7819297B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with reprocessible handle assembly |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US9615826B2 (en) | 2010-09-30 | 2017-04-11 | Ethicon Endo-Surgery, Llc | Multiple thickness implantable layers for surgical stapling devices |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US20090228040A1 (en) * | 2008-03-04 | 2009-09-10 | Medtronic Vascular, Inc. | Mechanism and Method for Closing an Arteriotomy |
US20090228037A1 (en) * | 2008-03-07 | 2009-09-10 | Medtronic Vascular, Inc | Vascular Closure Implant |
GB0804654D0 (en) | 2008-03-13 | 2008-04-16 | Smith & Nephew | Vacuum closure device |
US20090242609A1 (en) * | 2008-03-31 | 2009-10-01 | Medtronic Vascular, Inc. | Vascular Puncture Closure Staple With Tip Protection |
US20090259249A1 (en) * | 2008-04-10 | 2009-10-15 | Medtronic Vascular, Inc. | Arteriotomy stapling system for non-orthogonal tissue tracks and methods of use therein |
WO2009129369A1 (en) | 2008-04-16 | 2009-10-22 | Children's Medical Center Corporation | Tissue clip |
US7942301B2 (en) * | 2008-04-17 | 2011-05-17 | Medtronic Vascular, Inc. | Vascular puncture stapling system |
US8016857B2 (en) * | 2008-04-18 | 2011-09-13 | Medtronic Vascular, Inc. | Vascular puncture closure |
US7959648B2 (en) * | 2008-04-22 | 2011-06-14 | Medtronic Vascular, Inc. | Device and method for effecting hemostasis about a puncture |
US20100080520A1 (en) * | 2008-05-12 | 2010-04-01 | Howard Lind | Flexible silicone cable system integrated with hollow tubing for fluid delivery |
US8888792B2 (en) | 2008-07-14 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Tissue apposition clip application devices and methods |
WO2010011695A1 (en) | 2008-07-21 | 2010-01-28 | Arstasis, Inc. | Devices, methods, and kits for forming tracts in tissue |
US8062297B2 (en) * | 2008-07-24 | 2011-11-22 | Biopro, Inc. | Bone fixation apparatus and method of manufacture |
US20100023024A1 (en) * | 2008-07-25 | 2010-01-28 | Zeiner Mark S | Reloadable laparoscopic fastener deploying device with disposable cartridge for use in a gastric volume reduction procedure |
US20100023022A1 (en) * | 2008-07-25 | 2010-01-28 | Zeiner Mark S | Reloadable laparoscopic fastener deploying device with disposable cartridge use in a gastric volume reduction procedure |
US20110082471A1 (en) * | 2009-10-06 | 2011-04-07 | Holcomb Matthew D | Reloadable Laparoscopic Fastener Deploying Device |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
WO2010051494A1 (en) | 2008-10-31 | 2010-05-06 | C.R. Bard, Inc. | Systems and methods for identifying an acess port |
US11890443B2 (en) | 2008-11-13 | 2024-02-06 | C. R. Bard, Inc. | Implantable medical devices including septum-based indicators |
US8932271B2 (en) | 2008-11-13 | 2015-01-13 | C. R. Bard, Inc. | Implantable medical devices including septum-based indicators |
US8157834B2 (en) | 2008-11-25 | 2012-04-17 | Ethicon Endo-Surgery, Inc. | Rotational coupling device for surgical instrument with flexible actuators |
US20100179567A1 (en) * | 2009-01-09 | 2010-07-15 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US8361066B2 (en) | 2009-01-12 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
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 |
US20100191255A1 (en) * | 2009-01-26 | 2010-07-29 | Lawrence Crainich | Method for Applying A Surgical Staple |
US8801732B2 (en) * | 2009-01-26 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical 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 |
US9713471B2 (en) | 2009-01-26 | 2017-07-25 | Ethicon Endo-Surgery, Inc. | Surgical device with tandem fasteners |
US8439244B2 (en) | 2010-01-20 | 2013-05-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler fastening device with movable anvil |
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 |
US8602286B2 (en) * | 2009-01-26 | 2013-12-10 | Ethicon Endo-Surgery, Inc. | Apparatus for feeding staples in a low profile surgical stapler |
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 |
US20100187283A1 (en) * | 2009-01-26 | 2010-07-29 | Lawrence Crainich | Method For Feeding Staples In a Low Profile Surgical Stapler |
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 |
US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
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 |
EP2451512A1 (en) | 2009-07-07 | 2012-05-16 | C.R. Bard Inc. | Extensible internal bolster for a medical device |
US8236011B2 (en) * | 2009-10-06 | 2012-08-07 | Ethicon Endo-Surgery, Inc. | Method for deploying fasteners for use in a gastric volume reduction procedure |
US9295463B2 (en) | 2009-10-08 | 2016-03-29 | Covidien Lp | Shape memory fasteners and method of use |
US10194904B2 (en) * | 2009-10-08 | 2019-02-05 | Covidien Lp | Surgical staple and method of use |
US20110098704A1 (en) | 2009-10-28 | 2011-04-28 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices |
JP2013510652A (en) | 2009-11-17 | 2013-03-28 | シー・アール・バード・インコーポレーテッド | Overmolded access port including locking feature and identification feature |
US20110144662A1 (en) * | 2009-12-15 | 2011-06-16 | Mclawhorn Tyler E | Clip devices and systems and methods for deployment |
US9480511B2 (en) | 2009-12-17 | 2016-11-01 | Engage Medical Holdings, Llc | Blade fixation for ankle fusion and arthroplasty |
US9028483B2 (en) | 2009-12-18 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising an electrode |
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 |
US8496671B1 (en) * | 2010-06-16 | 2013-07-30 | Cardica, Inc. | Mitral valve treatment |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US20120078244A1 (en) | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
US8733613B2 (en) | 2010-09-29 | 2014-05-27 | Ethicon Endo-Surgery, Inc. | Staple cartridge |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US9700317B2 (en) | 2010-09-30 | 2017-07-11 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a releasable tissue thickness compensator |
US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9220500B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US9044228B2 (en) | 2010-09-30 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a plurality of fastener cartridges |
US9113865B2 (en) | 2010-09-30 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a layer |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
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 |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US9351730B2 (en) | 2011-04-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising channels |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
WO2012083205A1 (en) | 2010-12-16 | 2012-06-21 | Medicinelodge, Inc. Dba Imds Co-Innovation | Arthroplasty systems and methods |
USD682416S1 (en) | 2010-12-30 | 2013-05-14 | C. R. Bard, Inc. | Implantable access port |
USD676955S1 (en) | 2010-12-30 | 2013-02-26 | C. R. Bard, Inc. | Implantable access port |
RU2756986C2 (en) | 2011-02-04 | 2021-10-08 | Юниверсити Оф Массачусетс | Wound closure device with the creation of negative pressure |
US9421132B2 (en) | 2011-02-04 | 2016-08-23 | University Of Massachusetts | Negative pressure wound closure device |
US9149265B2 (en) | 2011-02-26 | 2015-10-06 | Abbott Cardiovascular Systems, Inc. | Hinged tissue support device |
US9233241B2 (en) | 2011-02-28 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9254169B2 (en) | 2011-02-28 | 2016-02-09 | Ethicon Endo-Surgery, Inc. | Electrical ablation devices and methods |
US9049987B2 (en) | 2011-03-17 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Hand held surgical device for manipulating an internal magnet assembly within a patient |
AU2012250197B2 (en) | 2011-04-29 | 2017-08-10 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
US9414822B2 (en) | 2011-05-19 | 2016-08-16 | Abbott Cardiovascular Systems, Inc. | Tissue eversion apparatus and tissue closure device and methods for use thereof |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US9254130B2 (en) | 2011-11-01 | 2016-02-09 | Hyun Bae | Blade anchor systems for bone fusion |
FR2982142B1 (en) * | 2011-11-07 | 2013-11-29 | Synchro Medical | AGRAFE FOR OSTEOSYNTHESIS |
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 |
US8992547B2 (en) | 2012-03-21 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Methods and devices for creating tissue plications |
US10238382B2 (en) * | 2012-03-26 | 2019-03-26 | Engage Medical Holdings, Llc | Blade anchor for foot and ankle |
BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Tissue thickness compensator with multiple layers |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
RU2644272C2 (en) | 2012-03-28 | 2018-02-08 | Этикон Эндо-Серджери, Инк. | Limitation node with tissue thickness compensator |
US9427255B2 (en) | 2012-05-14 | 2016-08-30 | Ethicon Endo-Surgery, Inc. | Apparatus for introducing a steerable camera assembly into a patient |
CN107280857A (en) | 2012-05-22 | 2017-10-24 | 史密夫及内修公开有限公司 | Wound healing device |
MX2014014266A (en) | 2012-05-22 | 2015-06-23 | Smith & Nephew | Apparatuses and methods for wound therapy. |
CN104736110B (en) | 2012-05-24 | 2019-05-31 | 史密夫和内修有限公司 | Device and method for wound to be handled and closed using negative pressure |
US20130317481A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US20130317438A1 (en) | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US9241707B2 (en) | 2012-05-31 | 2016-01-26 | Abbott Cardiovascular Systems, Inc. | Systems, methods, and devices for closing holes in body lumens |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
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 |
US9408606B2 (en) | 2012-06-28 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Robotically powered surgical device with manually-actuatable reversing system |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
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 |
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 |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9078662B2 (en) | 2012-07-03 | 2015-07-14 | Ethicon Endo-Surgery, Inc. | Endoscopic cap electrode and method for using the same |
CN110448407B (en) | 2012-07-16 | 2022-08-09 | 史密夫和内修有限公司 | Negative pressure wound closure device |
US9545290B2 (en) | 2012-07-30 | 2017-01-17 | Ethicon Endo-Surgery, Inc. | Needle probe guide |
US9572623B2 (en) | 2012-08-02 | 2017-02-21 | Ethicon Endo-Surgery, Inc. | Reusable electrode and disposable sheath |
US10314649B2 (en) | 2012-08-02 | 2019-06-11 | Ethicon Endo-Surgery, Inc. | Flexible expandable electrode and method of intraluminal delivery of pulsed power |
US9277957B2 (en) | 2012-08-15 | 2016-03-08 | Ethicon Endo-Surgery, Inc. | Electrosurgical devices and methods |
US10070850B2 (en) | 2012-10-19 | 2018-09-11 | Cook Medical Technologies Llc | Vascular closure with multiple connections |
US9486132B2 (en) * | 2013-01-17 | 2016-11-08 | Abbott Cardiovascular Systems, Inc. | Access device for accessing tissue |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
US9730691B2 (en) * | 2013-02-12 | 2017-08-15 | The Cleveland Clinic Foundation | Endovascular staple clip and stapler |
US10098527B2 (en) | 2013-02-27 | 2018-10-16 | Ethidcon Endo-Surgery, Inc. | System for performing a minimally invasive surgical procedure |
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 |
RU2669463C2 (en) | 2013-03-01 | 2018-10-11 | Этикон Эндо-Серджери, Инк. | Surgical instrument with soft stop |
US20140249557A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Thumbwheel switch arrangements for surgical instruments |
US9788842B2 (en) * | 2013-03-06 | 2017-10-17 | St. Jude Medical, Cardiology Division, Inc. | PMVR clip configurations for mitral leaflet |
US9107646B2 (en) * | 2013-03-11 | 2015-08-18 | St. Jude Medical Puerto Rico Llc | Active securement detachable sealing tip for extra-vascular closure device and methods |
US9936951B2 (en) | 2013-03-12 | 2018-04-10 | Covidien Lp | Interchangeable tip reload |
EP2968016B1 (en) | 2013-03-13 | 2018-07-11 | Smith&Nephew, Inc. | Negative pressure wound closure device and systems and methods of use in treating wounds with negative pressure |
WO2014140692A1 (en) | 2013-03-13 | 2014-09-18 | Memometal Technologies | Adjustable forceps for osteosynthesis clip |
US9345481B2 (en) | 2013-03-13 | 2016-05-24 | Ethicon Endo-Surgery, Llc | Staple cartridge tissue thickness sensor system |
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 |
BR112015021123A2 (en) | 2013-03-14 | 2017-07-18 | Smith & Nephew | compressible wound fillers and systems and methods for use in treating negative pressure injuries |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
US10136887B2 (en) | 2013-04-16 | 2018-11-27 | Ethicon Llc | Drive system decoupling arrangement for a surgical instrument |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
RU2016104132A (en) | 2013-07-16 | 2017-08-21 | СМИТ ЭНД НЕФЬЮ ПиЭлСи | DEVICE FOR TREATMENT OF THE RAS |
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. |
WO2015039024A1 (en) * | 2013-09-16 | 2015-03-19 | Oregon Health & Science University | Bioabsorbable clips and applicator for tissue closure |
EP3060181B1 (en) | 2013-10-21 | 2021-11-03 | Smith & Nephew, Inc. | Negative pressure wound closure device |
US9539005B2 (en) * | 2013-11-08 | 2017-01-10 | C.R. Bard, Inc. | Surgical fastener deployment system |
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 |
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 |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
WO2015110410A1 (en) | 2014-01-21 | 2015-07-30 | Smith & Nephew Plc | Collapsible dressing for negative pressure wound treatment |
AU2015208298B2 (en) | 2014-01-21 | 2019-10-10 | Smith & Nephew Plc | Wound treatment apparatuses |
US9700312B2 (en) | 2014-01-28 | 2017-07-11 | Covidien Lp | Surgical apparatus |
US9936952B2 (en) | 2014-02-03 | 2018-04-10 | Covidien Lp | Introducer assembly for a surgical fastener applying apparatus |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
US20140166725A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple. |
CN106232029B (en) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | Fastening system including firing member locking piece |
US20150272580A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Verification of number of battery exchanges/procedure count |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
US9804618B2 (en) | 2014-03-26 | 2017-10-31 | Ethicon Llc | Systems and methods for controlling a segmented circuit |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US11185330B2 (en) | 2014-04-16 | 2021-11-30 | Cilag Gmbh International | Fastener cartridge assemblies and staple retainer cover arrangements |
US20150297222A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
CN106456176B (en) | 2014-04-16 | 2019-06-28 | 伊西康内外科有限责任公司 | Fastener cartridge including the extension with various configuration |
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 |
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 |
US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
US9844377B2 (en) | 2014-04-25 | 2017-12-19 | Incisive Surgical, Inc. | Method and apparatus for wound closure with sequential tissue positioning and retention |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
US9907551B2 (en) | 2014-08-04 | 2018-03-06 | Howmedica Osteonics Corp. | Surgical instrument for implanting fixation device |
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 |
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 |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
CN107106182B (en) | 2014-11-03 | 2019-11-22 | 俄勒冈健康与科学大学 | Fixture and applicator for tissue closure |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10077420B2 (en) | 2014-12-02 | 2018-09-18 | Histogenics Corporation | Cell and tissue culture container |
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 |
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 |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
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 |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
USD752219S1 (en) | 2015-01-02 | 2016-03-22 | Incisive Surgical, Inc. | Tissue fastening instrument |
US10321907B2 (en) | 2015-02-27 | 2019-06-18 | Ethicon Llc | System for monitoring whether a surgical instrument needs to be serviced |
US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
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 |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
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 |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US10390825B2 (en) | 2015-03-31 | 2019-08-27 | Ethicon Llc | Surgical instrument with progressive rotary drive systems |
AU2016254119A1 (en) | 2015-04-29 | 2017-10-05 | Smith & Nephew Inc. | Negative pressure wound closure device |
US10405863B2 (en) | 2015-06-18 | 2019-09-10 | Ethicon Llc | Movable firing beam support arrangements for articulatable surgical instruments |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
BR112018003693B1 (en) | 2015-08-26 | 2022-11-22 | Ethicon Llc | SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPPING INSTRUMENT |
US10098642B2 (en) | 2015-08-26 | 2018-10-16 | Ethicon Llc | Surgical staples comprising features for improved fastening of tissue |
CN105054983A (en) * | 2015-09-01 | 2015-11-18 | 天津天耀金属制品有限公司 | Prepuce stitching staple and circumcision anastomat adopting same |
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 |
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 |
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 |
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 |
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 |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US10561420B2 (en) | 2015-09-30 | 2020-02-18 | Ethicon Llc | Tubular absorbable constructs |
JP6823321B2 (en) * | 2015-10-09 | 2021-02-03 | 国立大学法人東海国立大学機構 | Bioabsorbable staple |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
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 |
BR112018016098B1 (en) | 2016-02-09 | 2023-02-23 | Ethicon Llc | SURGICAL INSTRUMENT |
US10433837B2 (en) | 2016-02-09 | 2019-10-08 | Ethicon Llc | Surgical instruments with multiple link articulation arrangements |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
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 |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control 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 |
USD822206S1 (en) | 2016-06-24 | 2018-07-03 | Ethicon Llc | Surgical fastener |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
US10675024B2 (en) | 2016-06-24 | 2020-06-09 | Ethicon Llc | Staple cartridge comprising overdriven staples |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
CN109310431B (en) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | Staple cartridge comprising wire staples and punch staples |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
JP7038701B2 (en) | 2016-08-30 | 2022-03-18 | スミス アンド ネフュー ピーエルシー | System for applying decompression therapy |
US10390955B2 (en) | 2016-09-22 | 2019-08-27 | Engage Medical Holdings, Llc | Bone implants |
WO2018060144A1 (en) | 2016-09-27 | 2018-04-05 | Smith & Nephew Plc | Wound closure devices with dissolvable portions |
CA3042673A1 (en) | 2016-11-02 | 2018-05-11 | Smith & Nephew Inc. | Wound closure devices |
US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
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 |
US10758229B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument comprising improved jaw control |
US10682138B2 (en) | 2016-12-21 | 2020-06-16 | Ethicon Llc | Bilaterally asymmetric staple forming pocket pairs |
US20180168648A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Durability features for end effectors and firing assemblies of surgical stapling instruments |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US10617414B2 (en) | 2016-12-21 | 2020-04-14 | Ethicon Llc | Closure member arrangements for surgical instruments |
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 |
US10675025B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Shaft assembly comprising separately actuatable and retractable systems |
US10588632B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical end effectors and firing members thereof |
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 |
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 |
US10588630B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical tool assemblies with closure stroke reduction features |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
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 |
US11540928B2 (en) | 2017-03-03 | 2023-01-03 | Engage Uni Llc | Unicompartmental knee arthroplasty |
US10456272B2 (en) | 2017-03-03 | 2019-10-29 | Engage Uni Llc | Unicompartmental knee arthroplasty |
AU2018285236B2 (en) | 2017-06-13 | 2024-02-29 | Smith & Nephew Plc | Wound closure device and method of use |
EP3638169A1 (en) | 2017-06-13 | 2020-04-22 | Smith & Nephew PLC | Collapsible structure and method of use |
US11395873B2 (en) | 2017-06-14 | 2022-07-26 | Smith & Nephew, Inc. | Control of wound closure and fluid removal management in wound therapy |
WO2018229012A1 (en) | 2017-06-14 | 2018-12-20 | Smith & Nephew Plc | Collapsible sheet for wound closure and method of use |
US11583623B2 (en) | 2017-06-14 | 2023-02-21 | Smith & Nephew Plc | Collapsible structure for wound closure and method of use |
JP2020523052A (en) | 2017-06-14 | 2020-08-06 | スミス アンド ネフュー インコーポレイテッド | Fluid removal management and control of wound closure in wound care |
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 |
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 |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
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 |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
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 |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling 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 |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
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 |
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 |
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 |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
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 |
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 |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US20180368844A1 (en) | 2017-06-27 | 2018-12-27 | Ethicon Llc | Staple forming pocket arrangements |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
US11020114B2 (en) | 2017-06-28 | 2021-06-01 | Cilag Gmbh International | Surgical instruments with articulatable end effector with axially shortened articulation joint configurations |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
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 |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
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 |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US11607344B2 (en) | 2017-07-27 | 2023-03-21 | Smith & Nephew Plc | Customizable wound closure device and method of use |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
WO2019030136A1 (en) | 2017-08-07 | 2019-02-14 | Smith & Nephew Plc | Wound closure device with protective layer and method of use |
WO2019042790A1 (en) | 2017-08-29 | 2019-03-07 | Smith & Nephew Plc | Systems and methods for monitoring wound closure |
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 |
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 |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
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 |
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 |
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 |
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 |
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 |
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 |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
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 |
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 |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
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 |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
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 |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
CN109288552B (en) * | 2018-09-20 | 2020-05-29 | 哈尔滨杰瑞斯医疗科技有限公司 | Achilles tendon skin multi-section separation combined type minimally invasive treatment external fixing support |
EP3893825A1 (en) | 2018-12-13 | 2021-10-20 | University of Massachusetts | Negative pressure wound closure devices and methods |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing 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 |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping 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 |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11229437B2 (en) | 2019-06-28 | 2022-01-25 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11523822B2 (en) | 2019-06-28 | 2022-12-13 | Cilag Gmbh International | Battery pack including a circuit interrupter |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
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 |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
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 |
US11523820B2 (en) * | 2020-01-29 | 2022-12-13 | DePuy Synthes Products, Inc. | Shape memory implants and a method and apparatus for the loading and implanting thereof |
US11812966B2 (en) | 2020-04-24 | 2023-11-14 | NeuraMedica Inc. | Clips, appliers, and cartridges |
CN111920469B (en) * | 2020-05-20 | 2021-07-02 | 沈平平 | Anastomat for achilles tendon |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
US20220031350A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with double pivot articulation joint arrangements |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
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 |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
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 |
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 |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
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 |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
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 |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
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 |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US20220378426A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a mounted shaft orientation sensor |
US11911039B2 (en) * | 2021-08-13 | 2024-02-27 | Cilag Gmbh International | Circular surgical stapler having staples with expandable crowns |
US11944310B2 (en) | 2021-08-13 | 2024-04-02 | Cilag Gmbh International | Non-circular end effector features for surgical stapler |
USD1003436S1 (en) | 2021-08-19 | 2023-10-31 | Medline Industries, Lp | Surgical staple |
USD1004088S1 (en) | 2021-08-19 | 2023-11-07 | Medline Industries, Lp | Surgical staple |
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 |
Citations (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5108421A (en) * | 1990-10-01 | 1992-04-28 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5112308A (en) * | 1990-10-03 | 1992-05-12 | Cook Incorporated | Medical device for and a method of endoscopic surgery |
US5192300A (en) * | 1990-10-01 | 1993-03-09 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5391182A (en) * | 1993-08-03 | 1995-02-21 | Origin Medsystems, Inc. | Apparatus and method for closing puncture wounds |
US5391183A (en) * | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
US5415657A (en) * | 1992-10-13 | 1995-05-16 | Taymor-Luria; Howard | Percutaneous vascular sealing method |
US5439006A (en) * | 1991-08-28 | 1995-08-08 | Medtronic, Inc. | Steerable stylet and manipulative handle assembly |
US5476469A (en) * | 1992-10-19 | 1995-12-19 | Indiana University Foundation | Apparatus and method for positive closure of an internal tissue membrane opening |
US5496332A (en) * | 1994-10-20 | 1996-03-05 | Cordis Corporation | Wound closure apparatus and method for its use |
US5507744A (en) * | 1992-04-23 | 1996-04-16 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US5509900A (en) * | 1992-03-02 | 1996-04-23 | Kirkman; Thomas R. | Apparatus and method for retaining a catheter in a blood vessel in a fixed position |
US5613974A (en) * | 1992-12-10 | 1997-03-25 | Perclose, Inc. | Apparatus and method for vascular closure |
US5810846A (en) * | 1995-08-03 | 1998-09-22 | United States Surgical Corporation | Vascular hole closure |
US5919207A (en) * | 1998-06-02 | 1999-07-06 | Taheri; Syde A. | Percutaneous arterial closure with staples |
US6004341A (en) * | 1996-12-05 | 1999-12-21 | Loma Linda University Medical Center | Vascular wound closure device |
US6197042B1 (en) * | 2000-01-05 | 2001-03-06 | Medical Technology Group, Inc. | Vascular sheath with puncture site closure apparatus and methods of use |
US20020026208A1 (en) * | 2000-01-05 | 2002-02-28 | Medical Technology Group, Inc. | Apparatus and methods for delivering a closure device |
US6368341B1 (en) * | 1996-08-06 | 2002-04-09 | St. Jude Medical Puerto Rico, B.V. | Insertion assembly and method of inserting a hemostatic closure device into an incision |
US6461364B1 (en) * | 2000-01-05 | 2002-10-08 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
Family Cites Families (40)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4317451A (en) | 1980-02-19 | 1982-03-02 | Ethicon, Inc. | Plastic surgical staple |
GB8516670D0 (en) * | 1985-07-02 | 1985-08-07 | Gatehouse Tech Ventures | Absorbent composition |
US4821939A (en) | 1987-09-02 | 1989-04-18 | United States Surgical Corporation | Staple cartridge and an anvilless surgical stapler |
US5158567A (en) | 1987-09-02 | 1992-10-27 | United States Surgical Corporation | One-piece surgical staple |
US4887601A (en) | 1987-11-06 | 1989-12-19 | Ophthalmic Ventures Limited Partnership | Adjustable surgical staple and method of using the same |
JPH02121645A (en) | 1988-10-31 | 1990-05-09 | Matsutani Seisakusho Co Ltd | Medical staple and preparation thereof |
US5007921A (en) | 1989-10-26 | 1991-04-16 | Brown Alan W | Surgical staple |
US5026390A (en) | 1989-10-26 | 1991-06-25 | Brown Alan W | Surgical staple |
US5074454A (en) | 1990-06-04 | 1991-12-24 | Peters Ronald L | Surgical stapler |
US5234447A (en) * | 1990-08-28 | 1993-08-10 | Robert L. Kaster | Side-to-end vascular anastomotic staple apparatus |
US5115958A (en) | 1990-11-08 | 1992-05-26 | Petty Paul M | Hemostatic surgical instrument comprising stapler and stapler combined with surgical scalpel |
US5129570A (en) | 1990-11-30 | 1992-07-14 | Ethicon, Inc. | Surgical stapler |
CA2060040A1 (en) | 1991-02-08 | 1992-08-10 | Miguel A. Velez | Surgical staple and endoscopic stapler |
EP0502733B1 (en) * | 1991-03-06 | 1997-09-10 | LOCTITE (IRELAND) Ltd. | Air-activatable polymerisable compositions |
US5297714A (en) | 1991-04-17 | 1994-03-29 | Ethicon, Inc. | Surgical staple with modified "B" shaped configuration |
US5251801A (en) | 1991-08-05 | 1993-10-12 | Edward Weck Incorporated | Surgical stapler |
US5170926A (en) | 1991-08-05 | 1992-12-15 | Edward Weck Incorporated | Surgical stapler |
WO1993006878A1 (en) | 1991-10-11 | 1993-04-15 | Boston Scientific Corporation | Catheter introducer sheath assembly |
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 |
DE4215449C1 (en) | 1992-05-11 | 1993-09-02 | Ethicon Gmbh & Co Kg, 2000 Norderstedt, De | |
CA2133687C (en) | 1992-10-09 | 2007-03-27 | David T. Green | Surgical clip applier |
US5540375A (en) | 1993-04-20 | 1996-07-30 | United States Surgical Corporation | Endoscopic stapler |
US5415334A (en) | 1993-05-05 | 1995-05-16 | Ethicon Endo-Surgery | Surgical stapler and staple cartridge |
DE4319105C1 (en) | 1993-06-04 | 1994-09-22 | Ethicon Endo Surgery Europe | Surgical clamping device for placing sutures, and device for applying the clamping device |
US5478354A (en) | 1993-07-14 | 1995-12-26 | United States Surgical Corporation | Wound closing apparatus and method |
US5725554A (en) * | 1993-10-08 | 1998-03-10 | Richard-Allan Medical Industries, Inc. | Surgical staple and stapler |
US5423857A (en) | 1993-11-02 | 1995-06-13 | Ethicon, Inc. | Three piece surgical staple |
US5465895A (en) | 1994-02-03 | 1995-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
US5695524A (en) | 1994-04-05 | 1997-12-09 | Tracor Aerospace, Inc. | Constant width, adjustable grip, staple apparatus and method |
US5544802A (en) | 1994-07-27 | 1996-08-13 | Crainich; Lawrence | Surgical staple and stapler device therefor |
US5584856A (en) | 1994-12-21 | 1996-12-17 | Jameel; Irfan M. | Removable surgical staple |
US5630540A (en) | 1995-05-24 | 1997-05-20 | United States Surgical Corporation | Surgical staple and staple drive member |
US5697542A (en) | 1995-10-19 | 1997-12-16 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical stapler with compact profile |
US6015417A (en) | 1996-01-25 | 2000-01-18 | Reynolds, Jr.; Walker | Surgical fastener |
US5947999A (en) * | 1996-12-03 | 1999-09-07 | Groiso; Jorge A. | Surgical clip and method |
US6149658A (en) | 1997-01-09 | 2000-11-21 | Coalescent Surgical, Inc. | Sutured staple surgical fasteners, instruments and methods for minimally invasive vascular and endoscopic surgery |
EP0955011A1 (en) | 1998-05-06 | 1999-11-10 | EOS Sarl | Orthopaedic staple |
US5941890A (en) * | 1998-06-26 | 1999-08-24 | Ethicon Endo-Surgery, Inc. | Implantable surgical marker |
US6391048B1 (en) | 2000-01-05 | 2002-05-21 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant and methods of use |
EP1435842B8 (en) | 2000-09-08 | 2011-03-02 | Abbott Vascular Inc. | Device for locating a puncture hole in a liquid-carrying vessel |
-
2002
- 2002-06-21 US US10/178,030 patent/US6767356B2/en not_active Expired - Fee Related
-
2003
- 2003-01-08 US US10/338,466 patent/US20030097140A1/en not_active Abandoned
- 2003-06-20 WO PCT/US2003/019534 patent/WO2004000133A1/en active Application Filing
- 2003-06-20 AU AU2003279226A patent/AU2003279226A1/en not_active Abandoned
- 2003-06-20 JP JP2004516043A patent/JP2005530559A/en not_active Withdrawn
- 2003-06-20 EP EP03742104A patent/EP1515648A1/en not_active Withdrawn
-
2004
- 2004-07-27 US US10/899,911 patent/US7597706B2/en not_active Expired - Lifetime
Patent Citations (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5391183A (en) * | 1990-09-21 | 1995-02-21 | Datascope Investment Corp | Device and method sealing puncture wounds |
US5192300A (en) * | 1990-10-01 | 1993-03-09 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5275616A (en) * | 1990-10-01 | 1994-01-04 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5601602A (en) * | 1990-10-01 | 1997-02-11 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5108421A (en) * | 1990-10-01 | 1992-04-28 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5591205A (en) * | 1990-10-01 | 1997-01-07 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5478352A (en) * | 1990-10-01 | 1995-12-26 | Quinton Instrument Company | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5275616B1 (en) * | 1990-10-01 | 1996-01-23 | Quinton Instr | Insertion assembly and method of inserting a vessel plug into the body of a patient |
US5112308A (en) * | 1990-10-03 | 1992-05-12 | Cook Incorporated | Medical device for and a method of endoscopic surgery |
US5439006A (en) * | 1991-08-28 | 1995-08-08 | Medtronic, Inc. | Steerable stylet and manipulative handle assembly |
US5509900A (en) * | 1992-03-02 | 1996-04-23 | Kirkman; Thomas R. | Apparatus and method for retaining a catheter in a blood vessel in a fixed position |
US5507744A (en) * | 1992-04-23 | 1996-04-16 | Scimed Life Systems, Inc. | Apparatus and method for sealing vascular punctures |
US5415657A (en) * | 1992-10-13 | 1995-05-16 | Taymor-Luria; Howard | Percutaneous vascular sealing method |
US5476469A (en) * | 1992-10-19 | 1995-12-19 | Indiana University Foundation | Apparatus and method for positive closure of an internal tissue membrane opening |
US5613974A (en) * | 1992-12-10 | 1997-03-25 | Perclose, Inc. | Apparatus and method for vascular closure |
US5391182A (en) * | 1993-08-03 | 1995-02-21 | Origin Medsystems, Inc. | Apparatus and method for closing puncture wounds |
US5496332A (en) * | 1994-10-20 | 1996-03-05 | Cordis Corporation | Wound closure apparatus and method for its use |
US5810846A (en) * | 1995-08-03 | 1998-09-22 | United States Surgical Corporation | Vascular hole closure |
US6368341B1 (en) * | 1996-08-06 | 2002-04-09 | St. Jude Medical Puerto Rico, B.V. | Insertion assembly and method of inserting a hemostatic closure device into an incision |
US6004341A (en) * | 1996-12-05 | 1999-12-21 | Loma Linda University Medical Center | Vascular wound closure device |
US5919207A (en) * | 1998-06-02 | 1999-07-06 | Taheri; Syde A. | Percutaneous arterial closure with staples |
US6197042B1 (en) * | 2000-01-05 | 2001-03-06 | Medical Technology Group, Inc. | Vascular sheath with puncture site closure apparatus and methods of use |
US20020026208A1 (en) * | 2000-01-05 | 2002-02-28 | Medical Technology Group, Inc. | Apparatus and methods for delivering a closure device |
US6461364B1 (en) * | 2000-01-05 | 2002-10-08 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
Cited By (142)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7931669B2 (en) | 2000-01-05 | 2011-04-26 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant and methods of use |
US9579091B2 (en) | 2000-01-05 | 2017-02-28 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US8956388B2 (en) | 2000-01-05 | 2015-02-17 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant |
US8758396B2 (en) | 2000-01-05 | 2014-06-24 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
US10111664B2 (en) | 2000-01-05 | 2018-10-30 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US8758400B2 (en) | 2000-01-05 | 2014-06-24 | Integrated Vascular Systems, Inc. | Closure system and methods of use |
US9050087B2 (en) | 2000-01-05 | 2015-06-09 | Integrated Vascular Systems, Inc. | Integrated vascular device with puncture site closure component and sealant and methods of use |
US20060190014A1 (en) * | 2000-01-05 | 2006-08-24 | Ginn Richard S | Integrated vascular device with puncture site closure component and sealant and methods of use |
US7819895B2 (en) | 2000-01-05 | 2010-10-26 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
US7828817B2 (en) | 2000-01-05 | 2010-11-09 | Integrated Vascular Systems, Inc. | Apparatus and methods for delivering a closure device |
US7901428B2 (en) | 2000-01-05 | 2011-03-08 | Integrated Vascular Systems, Inc. | Vascular sheath with bioabsorbable puncture site closure apparatus and methods of use |
US6926731B2 (en) | 2000-09-08 | 2005-08-09 | James Coleman | Surgical stapler |
US9402625B2 (en) | 2000-09-08 | 2016-08-02 | Abbott Vascular Inc. | Surgical stapler |
US20030199924A1 (en) * | 2000-09-08 | 2003-10-23 | James Coleman | Surgical stapler |
US9060769B2 (en) | 2000-09-08 | 2015-06-23 | Abbott Vascular Inc. | Surgical stapler |
US8784447B2 (en) | 2000-09-08 | 2014-07-22 | Abbott Vascular Inc. | Surgical stapler |
US9089674B2 (en) | 2000-10-06 | 2015-07-28 | Integrated Vascular Systems, Inc. | Apparatus and methods for positioning a vascular sheath |
US7887555B2 (en) | 2000-12-07 | 2011-02-15 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US7842068B2 (en) | 2000-12-07 | 2010-11-30 | Integrated Vascular Systems, Inc. | Apparatus and methods for providing tactile feedback while delivering a closure device |
US8236026B2 (en) | 2000-12-07 | 2012-08-07 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8182497B2 (en) | 2000-12-07 | 2012-05-22 | Integrated Vascular Systems, Inc. | Closure device |
US10245013B2 (en) | 2000-12-07 | 2019-04-02 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8128644B2 (en) | 2000-12-07 | 2012-03-06 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8257390B2 (en) | 2000-12-07 | 2012-09-04 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US9320522B2 (en) | 2000-12-07 | 2016-04-26 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8486092B2 (en) | 2000-12-07 | 2013-07-16 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US9585646B2 (en) | 2000-12-07 | 2017-03-07 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US7879071B2 (en) | 2000-12-07 | 2011-02-01 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8690910B2 (en) | 2000-12-07 | 2014-04-08 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8486108B2 (en) | 2000-12-07 | 2013-07-16 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US8597325B2 (en) | 2000-12-07 | 2013-12-03 | Integrated Vascular Systems, Inc. | Apparatus and methods for providing tactile feedback while delivering a closure device |
US9554786B2 (en) | 2000-12-07 | 2017-01-31 | Integrated Vascular Systems, Inc. | Closure device and methods for making and using them |
US7806904B2 (en) | 2000-12-07 | 2010-10-05 | Integrated Vascular Systems, Inc. | Closure device |
US8603136B2 (en) | 2000-12-07 | 2013-12-10 | Integrated Vascular Systems, Inc. | Apparatus and methods for providing tactile feedback while delivering a closure device |
US8728119B2 (en) | 2001-06-07 | 2014-05-20 | Abbott Vascular Inc. | Surgical staple |
US7887563B2 (en) | 2001-06-07 | 2011-02-15 | Abbott Vascular Inc. | Surgical staple |
US20040028502A1 (en) * | 2001-06-07 | 2004-02-12 | Christy Cummins | Surgical staple |
US7918873B2 (en) | 2001-06-07 | 2011-04-05 | Abbott Vascular Inc. | Surgical staple |
US7108709B2 (en) * | 2001-06-07 | 2006-09-19 | Christy Cummins | Surgical staple |
US20040249391A1 (en) * | 2001-08-09 | 2004-12-09 | Christy Cummins | Surgical stapling device and method |
US7008435B2 (en) | 2001-08-09 | 2006-03-07 | Christy Cummins | Surgical stapling device and method |
US20040236355A1 (en) * | 2001-08-09 | 2004-11-25 | Thomas Anthony | Surgical stapling device |
US7163551B2 (en) | 2001-08-09 | 2007-01-16 | Thomas Anthony | Surgical stapling device |
US8007512B2 (en) | 2002-02-21 | 2011-08-30 | Integrated Vascular Systems, Inc. | Plunger apparatus and methods for delivering a closure device |
US8579932B2 (en) | 2002-02-21 | 2013-11-12 | Integrated Vascular Systems, Inc. | Sheath apparatus and methods for delivering a closure device |
US10201340B2 (en) | 2002-02-21 | 2019-02-12 | Integrated Vascular Systems, Inc. | Sheath apparatus and methods for delivering a closure device |
US9498196B2 (en) | 2002-02-21 | 2016-11-22 | Integrated Vascular Systems, Inc. | Sheath apparatus and methods for delivering a closure device |
US9980728B2 (en) | 2002-06-04 | 2018-05-29 | Abbott Vascular Inc | Blood vessel closure clip and delivery device |
US8469995B2 (en) | 2002-06-04 | 2013-06-25 | Abbott Vascular Inc. | Blood vessel closure clip and delivery device |
US9295469B2 (en) | 2002-06-04 | 2016-03-29 | Abbott Vascular Inc. | Blood vessel closure clip and delivery device |
US7850709B2 (en) | 2002-06-04 | 2010-12-14 | Abbott Vascular Inc. | Blood vessel closure clip and delivery device |
US8192459B2 (en) | 2002-06-04 | 2012-06-05 | Abbott Vascular Inc. | Blood vessel closure clip and delivery device |
US20050256537A1 (en) * | 2002-07-03 | 2005-11-17 | Christy Cummins | Surgical stapling device |
US7111768B2 (en) | 2002-07-03 | 2006-09-26 | Christy Cummins | Surgical stapling device |
US7806910B2 (en) | 2002-11-26 | 2010-10-05 | Abbott Laboratories | Multi-element biased suture clip |
US8202283B2 (en) | 2002-12-31 | 2012-06-19 | Integrated Vascular Systems, Inc. | Methods for manufacturing a clip and clip |
US7854810B2 (en) | 2002-12-31 | 2010-12-21 | Integrated Vascular Systems, Inc. | Methods for manufacturing a clip and clip |
US7850797B2 (en) | 2002-12-31 | 2010-12-14 | Integrated Vascular Systems, Inc. | Methods for manufacturing a clip and clip |
US8585836B2 (en) | 2002-12-31 | 2013-11-19 | Integrated Vascular Systems, Inc. | Methods for manufacturing a clip and clip |
US8398656B2 (en) | 2003-01-30 | 2013-03-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US9398914B2 (en) | 2003-01-30 | 2016-07-26 | Integrated Vascular Systems, Inc. | Methods of use of a clip applier |
US8202293B2 (en) | 2003-01-30 | 2012-06-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US7905900B2 (en) | 2003-01-30 | 2011-03-15 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8202294B2 (en) | 2003-01-30 | 2012-06-19 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US20080312666A1 (en) * | 2003-01-30 | 2008-12-18 | Abbott Laboratories | Clip applier and methods of use |
US8926656B2 (en) | 2003-01-30 | 2015-01-06 | Integated Vascular Systems, Inc. | Clip applier and methods of use |
US7867249B2 (en) | 2003-01-30 | 2011-01-11 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US10398418B2 (en) | 2003-01-30 | 2019-09-03 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8529587B2 (en) | 2003-01-30 | 2013-09-10 | Integrated Vascular Systems, Inc. | Methods of use of a clip applier |
US11589856B2 (en) | 2003-01-30 | 2023-02-28 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US9271707B2 (en) | 2003-01-30 | 2016-03-01 | Integrated Vascular Systems, Inc. | Clip applier and methods of use |
US8590760B2 (en) | 2004-05-25 | 2013-11-26 | Abbott Vascular Inc. | Surgical stapler |
US7727245B2 (en) | 2005-03-28 | 2010-06-01 | Cardica, Inc. | Method for closing an opening in tissue with a splayable staple |
US7458978B1 (en) | 2005-03-28 | 2008-12-02 | Cardica, Inc. | Vascular closure system utilizing a staple |
US7320692B1 (en) | 2005-03-28 | 2008-01-22 | Cardica, Inc. | Tissue closure system |
US20080017691A1 (en) * | 2005-03-28 | 2008-01-24 | Cardica, Inc. | System for Closing a Tissue Structure from Inside |
US7344544B2 (en) | 2005-03-28 | 2008-03-18 | Cardica, Inc. | Vascular closure system |
US20060217744A1 (en) * | 2005-03-28 | 2006-09-28 | Cardica, Inc. | Vascular closure system |
US20080114397A1 (en) * | 2005-03-28 | 2008-05-15 | Cardica, Inc. | Method for Closing an Opening in Tissue With a Splayable Staple |
US7744610B2 (en) | 2005-03-28 | 2010-06-29 | Cardica, Inc. | System for closing a tissue structure from inside |
US7670348B2 (en) | 2005-03-28 | 2010-03-02 | Cardica, Inc. | Heart defect closure apparatus |
US8926633B2 (en) | 2005-06-24 | 2015-01-06 | Abbott Laboratories | Apparatus and method for delivering a closure element |
US8313497B2 (en) | 2005-07-01 | 2012-11-20 | Abbott Laboratories | Clip applier and methods of use |
US9050068B2 (en) | 2005-07-01 | 2015-06-09 | Abbott Laboratories | Clip applier and methods of use |
US10085753B2 (en) | 2005-07-01 | 2018-10-02 | Abbott Laboratories | Clip applier and methods of use |
US11344304B2 (en) | 2005-07-01 | 2022-05-31 | Abbott Laboratories | Clip applier and methods of use |
US8518057B2 (en) | 2005-07-01 | 2013-08-27 | Abbott Laboratories | Clip applier and methods of use |
US8920442B2 (en) | 2005-08-24 | 2014-12-30 | Abbott Vascular Inc. | Vascular opening edge eversion methods and apparatuses |
US9456811B2 (en) | 2005-08-24 | 2016-10-04 | Abbott Vascular Inc. | Vascular closure methods and apparatuses |
US8808310B2 (en) | 2006-04-20 | 2014-08-19 | Integrated Vascular Systems, Inc. | Resettable clip applier and reset tools |
US8556930B2 (en) | 2006-06-28 | 2013-10-15 | Abbott Laboratories | Vessel closure device |
USD611144S1 (en) | 2006-06-28 | 2010-03-02 | Abbott Laboratories | Apparatus for delivering a closure element |
US9962144B2 (en) | 2006-06-28 | 2018-05-08 | Abbott Laboratories | Vessel closure device |
US8758398B2 (en) | 2006-09-08 | 2014-06-24 | Integrated Vascular Systems, Inc. | Apparatus and method for delivering a closure element |
US7875053B2 (en) | 2006-09-15 | 2011-01-25 | Cardica, Inc. | Apparatus and method for closure of patent foramen ovale |
US20080071294A1 (en) * | 2006-09-15 | 2008-03-20 | Bender Theodore M | Apparatus and method for closure of patent foramen ovale |
US7533790B1 (en) | 2007-03-08 | 2009-05-19 | Cardica, Inc. | Surgical stapler |
US20090134198A1 (en) * | 2007-03-08 | 2009-05-28 | Cardica, Inc. | Surgical Method for Stapling Tissue |
US7753250B2 (en) | 2007-03-08 | 2010-07-13 | Cardica, Inc. | Surgical stapler with splaying mechanism |
US7473258B2 (en) | 2007-03-08 | 2009-01-06 | Cardica, Inc. | Surgical stapler |
US20090072006A1 (en) * | 2007-03-08 | 2009-03-19 | Cardica, Inc. | Surgical Stapler With Splaying Mechanism |
US20080217376A1 (en) * | 2007-03-08 | 2008-09-11 | Cardica, Inc. | Surgical Stapler |
US8066720B2 (en) | 2007-03-08 | 2011-11-29 | Cardica, Inc. | Surgical method for stapling tissue |
US8226681B2 (en) | 2007-06-25 | 2012-07-24 | Abbott Laboratories | Methods, devices, and apparatus for managing access through tissue |
US20090093826A1 (en) * | 2007-10-05 | 2009-04-09 | Cardica, Inc. | Patent Foramen Ovale Closure System |
US8893947B2 (en) | 2007-12-17 | 2014-11-25 | Abbott Laboratories | Clip applier and methods of use |
US8672953B2 (en) | 2007-12-17 | 2014-03-18 | Abbott Laboratories | Tissue closure system and methods of use |
US8820602B2 (en) | 2007-12-18 | 2014-09-02 | Abbott Laboratories | Modular clip applier |
US7841502B2 (en) | 2007-12-18 | 2010-11-30 | Abbott Laboratories | Modular clip applier |
US20090254121A1 (en) * | 2008-04-02 | 2009-10-08 | Cardica, Inc. | Vascular Closure with Multi-Pronged Clip |
US9282965B2 (en) | 2008-05-16 | 2016-03-15 | Abbott Laboratories | Apparatus and methods for engaging tissue |
US10413295B2 (en) | 2008-05-16 | 2019-09-17 | Abbott Laboratories | Engaging element for engaging tissue |
US9241696B2 (en) | 2008-10-30 | 2016-01-26 | Abbott Vascular Inc. | Closure device |
US8398676B2 (en) | 2008-10-30 | 2013-03-19 | Abbott Vascular Inc. | Closure device |
US8657852B2 (en) | 2008-10-30 | 2014-02-25 | Abbott Vascular Inc. | Closure device |
US8323312B2 (en) | 2008-12-22 | 2012-12-04 | Abbott Laboratories | Closure device |
US8858594B2 (en) | 2008-12-22 | 2014-10-14 | Abbott Laboratories | Curved closure device |
US9414820B2 (en) | 2009-01-09 | 2016-08-16 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US10537313B2 (en) | 2009-01-09 | 2020-01-21 | Abbott Vascular, Inc. | Closure devices and methods |
US11439378B2 (en) | 2009-01-09 | 2022-09-13 | Abbott Cardiovascular Systems, Inc. | Closure devices and methods |
US9486191B2 (en) | 2009-01-09 | 2016-11-08 | Abbott Vascular, Inc. | Closure devices |
US9089311B2 (en) | 2009-01-09 | 2015-07-28 | Abbott Vascular Inc. | Vessel closure devices and methods |
US9173644B2 (en) | 2009-01-09 | 2015-11-03 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US9314230B2 (en) | 2009-01-09 | 2016-04-19 | Abbott Vascular Inc. | Closure device with rapidly eroding anchor |
US9414824B2 (en) | 2009-01-16 | 2016-08-16 | Abbott Vascular Inc. | Closure devices, systems, and methods |
US8905937B2 (en) | 2009-02-26 | 2014-12-09 | Integrated Vascular Systems, Inc. | Methods and apparatus for locating a surface of a body lumen |
US9585647B2 (en) | 2009-08-26 | 2017-03-07 | Abbott Laboratories | Medical device for repairing a fistula |
US8303624B2 (en) | 2010-03-15 | 2012-11-06 | Abbott Cardiovascular Systems, Inc. | Bioabsorbable plug |
US8758399B2 (en) | 2010-08-02 | 2014-06-24 | Abbott Cardiovascular Systems, Inc. | Expandable bioabsorbable plug apparatus and method |
US8603116B2 (en) | 2010-08-04 | 2013-12-10 | Abbott Cardiovascular Systems, Inc. | Closure device with long tines |
US8821534B2 (en) | 2010-12-06 | 2014-09-02 | Integrated Vascular Systems, Inc. | Clip applier having improved hemostasis and methods of use |
US8617184B2 (en) | 2011-02-15 | 2013-12-31 | Abbott Cardiovascular Systems, Inc. | Vessel closure system |
US9149276B2 (en) | 2011-03-21 | 2015-10-06 | Abbott Cardiovascular Systems, Inc. | Clip and deployment apparatus for tissue closure |
US8556932B2 (en) | 2011-05-19 | 2013-10-15 | Abbott Cardiovascular Systems, Inc. | Collapsible plug for tissue closure |
US9332976B2 (en) | 2011-11-30 | 2016-05-10 | Abbott Cardiovascular Systems, Inc. | Tissue closure device |
US20150250461A1 (en) * | 2012-09-26 | 2015-09-10 | Eric Berreklouw | Constrictor for closing or narrowing a passage through tissue of a hollow organ |
US9364209B2 (en) | 2012-12-21 | 2016-06-14 | Abbott Cardiovascular Systems, Inc. | Articulating suturing device |
US10537312B2 (en) | 2012-12-21 | 2020-01-21 | Abbott Cardiovascular Systems, Inc. | Articulating suturing device |
US11672518B2 (en) | 2012-12-21 | 2023-06-13 | Abbott Cardiovascular Systems, Inc. | Articulating suturing device |
EP3563776A3 (en) * | 2013-11-13 | 2020-08-05 | Arthrex, Inc | Staples for generating and applying compression within a body |
CN105943169A (en) * | 2016-04-19 | 2016-09-21 | 上海市肺科医院 | 3D-printed in-vitro assistant positioning device for lung mass and preparation method for same |
US20170360441A1 (en) * | 2016-06-15 | 2017-12-21 | Covidien Lp | Tool assembly for leak resistant tissue dissection |
Also Published As
Publication number | Publication date |
---|---|
WO2004000133A1 (en) | 2003-12-31 |
US7597706B2 (en) | 2009-10-06 |
JP2005530559A (en) | 2005-10-13 |
US20040267312A1 (en) | 2004-12-30 |
US6767356B2 (en) | 2004-07-27 |
US20030032981A1 (en) | 2003-02-13 |
EP1515648A1 (en) | 2005-03-23 |
AU2003279226A1 (en) | 2004-01-06 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US6506210B1 (en) | Wound site management and wound closure device | |
US20030097140A1 (en) | Wound site management and wound closure device | |
US6755842B2 (en) | Advanced wound site management systems and methods | |
US7198631B2 (en) | Advanced wound site management systems and methods | |
US7074232B2 (en) | Advanced wound site management systems and methods | |
US8551134B2 (en) | Wound site management and wound closure device | |
US11051801B2 (en) | Closure devices and methods | |
US6149660A (en) | Method and apparatus for delivery of an appliance in a vessel | |
EP1032314B1 (en) | Suturing apparatus | |
US7087066B2 (en) | Surgical clips and methods for tissue approximation | |
JP5089609B2 (en) | Wound closer device | |
US20040093024A1 (en) | Advanced wound site management systems and methods | |
WO2008033558A2 (en) | Tissue closure, delivery device and method of use | |
JP2021514755A (en) | Medical device for closing tissue openings | |
EP3785643A1 (en) | Medical apparatus and method for closing an opening in a tissue |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: MEDTRONIC ANGIOLINK, INC., CALIFORNIA Free format text: MERGER;ASSIGNORS:ANGIOLINK CORPORATION;SWINGLINE ACQUISITION CORP.;REEL/FRAME:016016/0151 Effective date: 20041101 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |