This relates to an apparatus and method for cutting and sealing blood vessels or tissue using a bipolar linear travel device that compresses the tissue or vessel and then RF power is applied to seal the tissue and cut the tissue.
In order to seal blood vessels during surgery, for the purpose of defunctionalizing the vessels or to halt or prevent bleeding, radiofrequency (RF) energy can be applied to the vessel structure instead of staples or clips. Traditionally, forceps are used to create a single seal per application with bipolar RF energy. Normally, forceps that have a hinge between the tines that press against either side of the vessel are clamped about tissue and power is applied. Problems are sometimes encountered with this technique because of the forceps bending or the lack of parallelism between the tines thus affecting how the tissue or vessel is compressed and sealed.
U.S. Pat. No. 5,585,896 has a percutaneous device for sealing openings in blood vessels. A balloon is inserted into the vessel and then inflated to force the vessel wall into a fixation collar.
U.S. Pat. No. 5,383,897 has a device for sealing punctures in blood vessels by conforming to the inner lumen of the vessel and placing barbs in the vessel for the purpose of sealing.
U.S. Pat. No. 5,391,183 has a device for sealing punctures in vessels by inserting hemostatic material into the puncture site and around the outside of the vessel, for the purpose of closing the puncture site.
U.S. Pat. No. 5,437,292 has a percutaneous device to seal arterial or venous puncture sites, whether accidental or intentional, which mixes fibrinogen and thrombin to form a gel around the puncture site to provide occlusion.
U.S. Pat. No. 5,411,520 has a device for percutaneously sealing blood vessels that slides down a holding catheter and enters the blood vessel with an anchor and collagen plug.
U.S. Pat. No. 5,415,657 has a device that approaches the puncture in the blood vessel, engages the outer surface and applies energy to provide hemostasis.
U.S. Pat. No. 5,429,616 has a device for sealing punctures in vessels by applying a fluid and then compressing the edges while it seals.
U.S. Pat. No. 5,441,517 has a system for sealing punctures in blood vessels by mechanically inserting a plug with an anchor to seal the puncture.
U.S. Pat. No. 5,425,739 discloses a stent placed inside the vessel to seal it or placed in such a way as to anastomose the vessel edges.
U.S. Pat. No. 5,354,271 discloses a sliding sheath for closing puncture sites that has two parts that expand radially outward and may use an accordion shape if a catheter.
U.S. Pat. No. 5,342,393 is a device that repairs punctures in vessels by clamping the tissue from both inside and outside of the vessel. Riveting is used to close the clamped sections and heat may be applied to separate the rivet from the delivery system. This device does apply heat energy but only to separate the rivet from the closure site.
U.S. Pat. No. 5,176,695 is a monopolar laparoscopic mechanical cutting device with a linear reciprocating blade that sharply cuts tissue residing in its slot. The present bipolar invention does not contain a sharp blade since it seals and cuts using RF energy.
U.S. Pat. No. 3,862,630 is a device wherein ultrasonic energy is used to close off blood vessels by mechanical vibration and frictional rubbing. Any heating of the tissue is a minimal and superficial byproduct of the mechanical vibration used to seal vessels.
U.S. Pat. No. 2,011,169 is a surgical electrode with end jaws that are U-shaped and nest one inside the other. They are not insulated from each other and thus are monopolar. In the present invention the jaws are insulated and bipolar. The jaws of '169 are mounted on an endoscope. They do not fit together as in the present invention and are designed more for the purpose of removing bites out of tissue and coagulating at the same time.
All of the above devices are different from the disclosure herein for several reasons. These devices are made for wound puncture closure. This implies that a viable flow channel will remain within the lumen of the blood vessel after each device is applied. The device now disclosed remains external to the blood vessel where no puncture site would normally exist either before or after the procedure. The present device and method seals the blood vessel, and thus does not provide a pathway for blood as do the prior devices discussed. In most cases, after the sealing with the instant device and method, the vessel will still be intact, although with a seal across it. In addition, the mere clamping by the disclosed device does not seal the blood vessel. It is the application of RF energy that forms an autologous clamp causing a fusion of the intima to provide the seal.
Therefore to solve the difficulties of the prior devices a patient contacting instrument for holding and applying electrosurgical energy is shown and described. During surgical dissection, blood vessels are frequently encountered that need to be sealed and thus defunctionalized. To do this in a safe, reliable manner so the vessel is properly sealed and will not leak, a tool that applies energy to create an autologous clip is valuable and required. The device and method are briefly described. A long tube connects to one side of a bipolar power supply. The tube moves longitudinally, that is along its long axis to meet against and compress the vessel with an endpiece. The two pieces that meet on either side of the vessel could be flat, curved, triangular, angled, notched, or other shapes, as long as one fits the other. If the endpieces are of some shape other than flat, this increases the surface area that traverses the vessel creating a longer seal in the vessel without increasing the diameter of the end pieces. An applied pulse of RF power cuts the tissue after sealing. The device and method when tested on fresh vessels produced a burst pressure adequate to prove a solid seal.
Advantages of the current device and method are the parallel axial closure of the end pieces to provide a compact bipolar sealer and prevent shorting. An in-line force transducer could provide feedback information on the applied force used during surgery. The device is bipolar to assure added safety by confinement of RF current flow through the tissue between the bipolar electrodes at the end of the device.
An axially elongate bipolar tissue sealer or cutter for application of electrosurgical energy by a surgeon to the tissue and bodily fluids of a patient preferably has a handle for holding and manipulation by the surgeon. A chassis carried on the handle may extend axially relative to the handle and away from the surgeon. The chassis may be moveable to and from the handle along the axis. The chassis may have a handle end and a distal end. A tube could be carried for axial movement relative to or along the chassis. The tube is elongate relative to the chassis and has a surgeon end and a patient end disposed along its axis in the preferred embodiment.
An effector on the patient end most preferably is in position to first contact tissue upon movement axially away from the handle by the surgeon. The effector is preferably of a material for conducting electrosurgical energy. A member may be supported by the distal end of the chassis in position opposite the patient end of the tube. A part on the member at the distal end thereof is most preferably transversely located relative to the tube axis. The part may be made of a material for conducting electrosurgical energy and to act as an opposed end effector.
A first bipolar electrosurgical electrode can be electrically connected to the effector of the patient end. A second bipolar electrosurgical electrode could be electrically connected to the part or opposed end effector. The second bipolar electrosurgical electrode is electrically isolated from the first bipolar electrosurgical electrode. An electrosurgical generator may be electrically coupled to the first and second electrosurgical electrodes. The electrosurgical generator can be arranged for selectively supplying bipolar electrosurgical energy across the first and second bipolar electrosurgical electrodes.
A mechanical activator is most preferably movably supported on the handle for use by the surgeon. The activator most preferably connects to the tube for axially moving the patient end and its end effector thereof toward or away from the part or opposed end effector. The tissue and bodily fluid between the end effectors may be sealed or cut by application of axial compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes.
The end effector and the part or opposed end effector preferably include partial mating complimentary sealing or cutting surfaces for partial mating engagement upon axial movement along the axis toward one another. The end effector and/or port can be removably attached to patient end and/or member. The complimentary surfaces may be partially mated and curvelinear for providing more tissue contacting area than flat surfaces would. Alternatively, the partial mating complimentary surfaces might be parallel but skewed to the axis to provide elongate contact with axial movement between the end effector and the port. The partial mating complimentary surfaces could be substantially flat. The partial mating complimentary surfaces may be circular. The partial mating complimentary surfaces might be elliptical. The partial mating complimentary surfaces could also be triangular. The partial mating complimentary surfaces may include at least one conjugating rib and slot. The partial mating complimentary surfaces could include one or more ribs and mating slots.
A method of using an elongate along an axis tissue sealer or cutter for application by a surgeon of bipolar electrosurgical energy to tissue and bodily fluids of a patient may seal or cut. The method may have the steps of holding and manipulating by a surgeon of a handle. Extending axially a chassis and/or a tube carried on the handle might be a step. The method can have the step of moving along the axis the chassis and/or the tube with the handle. Carrying the tube for axial movement relative to and along the chassis might be a step of the method. The method step may include positioning an effector on a patient end of the tube for first contact with tissue upon movement axially away from the handle by the surgeon. Using a supported member on a distal end of the chassis in position away from the patient end of the tube can be a step of the method. The method may have the step of having a part located transversely relative to the axis and on the member.
The method of using may be performed with a first bipolar electrosurgical electrode coupled to the end effector of the patient end and a second bipolar electrosurgical electrode coupled to the part. Electrically isolating the second bipolar electrosurgical electrode from the first bipolar electrosurgical electrode is another preferred step of the method of using. The method preferably has the step of selectively electrically coupling an electrosurgical generator to the first and second electrosurgical electrodes to supply bipolar electrosurgical RF energy from the electrosurgical generator to the first and second bipolar electrosurgical electrodes. The method most preferably has the step of a surgeon using a mechanical activator that is movably supported on the handle. Moving axially with the activator the patient end and/or the opposed end effector so that tissue and bodily fluid therebetween may be sealed or cut between the end effector and the part through the application of compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes is a preferred step.
The method may have the steps of applying the provided effector with the partially mating complimentary sealing or cutting surfaces, and partially mating engagement of the complimentary sealing or cutting surfaces upon axial movement toward one another along the axis. The method might use the step of removably attaching the part and/or end effector to the member and the chassis respectively. The method has the step of using partially mating the complimentary surfaces engagable along curvelinear paths for providing more tissue contacting area than between flat surfaces. The method has the step of using the partially mating the complimentary surfaces preferably parallel but along a plane skewed to the axis to provide elongate contact with axial movement between the end effector and the port.
The method may have the step of using the partially mating complimentary flat surfaces that are perhaps along the planes of the flat surfaces. The method could have the step of using partially mating complimentary circular surfaces that might be along the arcs of the circular surfaces. The method might have the step of using partially mating complimentary elliptical surfaces which are preferably along the curves of ellipses. The method can have the step of using partially mating complimentary triangular surfaces along edges of the triangles. The method could have the step of using partially mating complimentary surfaces by engaging at least one conjugating rib with a slot. The method may have the step of using partially mating complimentary surfaces that may include one or more ribs and companion slots.
End effector 21 on the distal end 20 is in position to contact tissue upon movement axially away from the handle 11 by the surgeon's manipulation of second handle grip 14.
A first bipolar electrosurgical electrode 26 for contact with the patient's tissue or bodily fluids is electrically coupled to the effector 22 beyond the patient end 18. A second bipolar electrosurgical electrode 27 is electrically coupled to the effectors 21 and 22 for contact with the patient's tissue or bodily fluids. The second bipolar electrosurgical electrode 27 is electrically isolated from the first bipolar electrosurgical electrode 26 but is in position to deliver bipolar electrosurgical energy across tissue held therebetween. An electrosurgical generator 28, in
A mechanical activator 32, in
The end effectors 21 and 22 include complimentary sealing or cutting surfaces 33 and 34 for partial mating engagement upon their axial movement toward one another along the axis “A.”
Any complimentary mating curvelinear jaws even “S” shaped or those shown in
The partial mating complimentary surfaces 33 and 34 might be parallel but skewed to axis “A” as in
A method of applying the elongate tubular bipolar tissue sealer or cutter 10 along an axis “A” includes use by a surgeon to deliver bipolar electrosurgical energy to the tissue and bodily fluids of a patient. The method has the steps of holding and manipulating the handle 11 by the surgeon. Extending axially inner tube 19 and/or the chassis 15 carried on the handle 11 away from the surgeon is a step. The method can have the step moving the inner tube 19 relative to the chassis 15 along the axis “A.” Carrying inner tube 19 for axial movement relative to and along the chassis 15 is a step of the preferred method. The method step includes positioning end effector 22 on the patient end 18 to first contact tissue upon movement axially of the inner tube 19 by the surgeon. Using a supported member 24 the chassis 15 is a step of the method. The method may have the step of using a part 25 located transversely relative to the axis “A” and on the member 24.
The method of using has a first bipolar electrosurgical electrode 26 coupled to the end effector 22 extending from the patient end 18 and a second bipolar electrosurgical electrode 27 coupled to the end effector 21. Electrically isolating the second bipolar electrosurgical electrode 27 from the first bipolar electrosurgical electrode 26 is another preferred method step for using. The method preferably has the step of selectively coupling electrically an electrosurgical generator 28 to the first and second electrosurgical electrodes to supply bipolar electrosurgical energy from the electrosurgical generator to the first and second bipolar electrosurgical electrodes 26 and 27. The method most preferably has the step of a surgeon using a mechanical activator 32 movably supported on the handle 11. Moving axially with the mechanical activator 32 the inner tube 19 and the end effector 21 thereof toward or away from the end effector 22 so that tissue and bodily fluid therebetween may be sealed or cut between the end effectors 21 and 22 the application of compression and bipolar electrosurgical energy between the first and second electrosurgical electrodes 26 and 27 is a preferred step.
The method may have the steps of applying the provided end effectors with partially complimentary sealing or cutting surfaces 33 and 34, and partially mating engagement of the complimentary sealing or cutting surfaces 33 and 34 upon axial movement toward one another along the axis “A.”
The method has the step of using the partially mating complimentary flat surface 33 and 34 that are perhaps along the planes of the flat surfaces. The method has the step of using the partially mating complimentary circular surfaces 33 and 34 that might be along the arcs of the circular surfaces. The method has the step of using the partially mating complimentary elliptical surfaces 33 and 34 which are preferably along the curves of the ellipses. The method has the step of using the partially mating complimentary triangular surfaces 33 and 34 that can be along edges of the triangles. The method has the step of using the partially mating complimentary surfaces 33 and 34 by engaging at least one conjugating rib and slot. The method has the step of using the partially mating complimentary surfaces 33 and 34 that include one or more ribs.
As a result of laboratory testing of a model of the bipolar tissue sealer or cutter results have shown excellent performance in sealing a range of vessels of various sizes. The bipolar tissue sealer or cutter with linear travel was tested on freshly excised porcine splenic arteries ranging from 1.8 to 3.3 mm. A single activation of power (14 W, 500 kHz) was used on each vessel firmly clamped between the end effector bipolar electrodes.
Data, shown in the graphs of
The vessels were closely examined after each sealing and found to have no charring. In 2 out of 13 trials, the vessel was adherent to one of the end effectors. Histological analysis showed that the vessel walls were completely welded with the integrity of the intima, adventitia, and media completely lost. The proteins were melted and a semi-translucent weld resulted. Adjacent to the weld site, the vessel wall was relatively normal.
The preferred elongate tubular bipolar tissue sealer or cutter 10 for application of electrosurgical energy to tissue by a surgeon as covered in the claims that follow has structure that slides along its axis “A” with an internal, concentric sliding portion. The inner or inside sliding tube 19 is attached to the proximal end effector 21 and the external fixed tube or chassis 15 connects to the distal end effector 22 in the preferred embodiment. The two end effectors 21 and 22 are matched so that the distal end effector 22 fits snugly against the proximal end effector 21. These end effectors 21 and 22 can be any of a number of conjugating shaped pairs including triangular, spherical, rectangular, with or without a notch. The notch is not just for alignment but also may define a sharp edge to sever the tissue or vessel by application of a pulse of high-power RF to the clamped site of tissue in between the end effectors 21 and 22. In the preferred embodiment, the handle 11 is squeezed so the inner tube 19 slides away the user and the chassis 15 is fix in relation to the inner tube 19 as the end effectors 21 and 22 act on the tissue therebetween. Of course it can be reversed so the chassis 15 moves and the inner tube 19 is fixed.
This application ia a Continuation in Part of prior application Ser. No. 09/591,328 filed on Jun. 9, 2000 now abandoned; which is a continuation of prior application Ser. No. 08/925,805 filed on Sep. 9, 1997 now U.S. Pat. No. 6,267,761.
Number | Name | Date | Kind |
---|---|---|---|
371664 | Brannan et al. | Oct 1887 | A |
702472 | Pignolet | Jun 1902 | A |
728883 | Downes | May 1903 | A |
1586645 | Bierman | Jun 1926 | A |
2002594 | Wappler et al. | May 1935 | A |
2011169 | Wappler | Aug 1935 | A |
2176479 | Willis | Oct 1939 | A |
2305156 | Grubel | Apr 1942 | A |
2632661 | Cristofv | Mar 1953 | A |
2668538 | Baker | Feb 1954 | A |
2796065 | Kapp | Jun 1957 | A |
3459187 | Pallotta | Aug 1969 | A |
3643663 | Sutter | Feb 1972 | A |
3651811 | Hildebrandt et al. | Mar 1972 | A |
3862630 | Balamuth | Jan 1975 | A |
3866610 | Kletschka | Feb 1975 | A |
3911766 | Fridolph et al. | Oct 1975 | A |
3920021 | Hiltebrandt | Nov 1975 | A |
3921641 | Hulka | Nov 1975 | A |
3938527 | Rioux et al. | Feb 1976 | A |
3952749 | Fridolph et al. | Apr 1976 | A |
4005714 | Hiltebrandt | Feb 1977 | A |
4074718 | Morrison, Jr. | Feb 1978 | A |
4088134 | Mazzariello | May 1978 | A |
4165746 | Burgin | Aug 1979 | A |
4300564 | Furihata | Nov 1981 | A |
4370980 | Lottick | Feb 1983 | A |
D276790 | Laske | Dec 1984 | S |
4492231 | Auth | Jan 1985 | A |
4552143 | Lottick | Nov 1985 | A |
4574804 | Kurwa | Mar 1986 | A |
4597379 | Kihn et al. | Jul 1986 | A |
4657016 | Garito et al. | Apr 1987 | A |
4662372 | Sharkany et al. | May 1987 | A |
4671274 | Sorochenko | Jun 1987 | A |
4685459 | Koch et al. | Aug 1987 | A |
D295893 | Sharkany et al. | May 1988 | S |
D295894 | Sharkany et al. | May 1988 | S |
4763669 | Jaeger | Aug 1988 | A |
4827929 | Hodge | May 1989 | A |
4887612 | Esser et al. | Dec 1989 | A |
4938761 | Ensslin | Jul 1990 | A |
5007908 | Rydell | Apr 1991 | A |
5026370 | Lottick | Jun 1991 | A |
5099840 | Goble et al. | Mar 1992 | A |
5116332 | Lottick | May 1992 | A |
5151102 | Kamiyama et al. | Sep 1992 | A |
5176695 | Dulebohn | Jan 1993 | A |
5197964 | Parins | Mar 1993 | A |
5215101 | Jacobs et al. | Jun 1993 | A |
5217457 | Delahuerga et al. | Jun 1993 | A |
5217458 | Parins | Jun 1993 | A |
5244462 | Delahuerga et al. | Sep 1993 | A |
5250047 | Rydell | Oct 1993 | A |
5258006 | Rydell et al. | Nov 1993 | A |
5261918 | Phillips et al. | Nov 1993 | A |
5275615 | Rose | Jan 1994 | A |
5277201 | Stern | Jan 1994 | A |
5282799 | Rydell | Feb 1994 | A |
5290286 | Parins | Mar 1994 | A |
5304203 | El-Mallawany et al. | Apr 1994 | A |
5308357 | Lichtman | May 1994 | A |
5318589 | Lichtman | Jun 1994 | A |
5324289 | Eggers | Jun 1994 | A |
5330471 | Eggers | Jul 1994 | A |
5334183 | Wuchinich | Aug 1994 | A |
5334215 | Chen | Aug 1994 | A |
5336221 | Anderson | Aug 1994 | A |
5342359 | Rydell | Aug 1994 | A |
5342381 | Tidemand | Aug 1994 | A |
5342393 | Stack | Aug 1994 | A |
5352222 | Rydell | Oct 1994 | A |
5354271 | Voda | Oct 1994 | A |
5356408 | Rydell | Oct 1994 | A |
5366477 | LeMarie, III et al. | Nov 1994 | A |
5383897 | Wholey | Jan 1995 | A |
5389098 | Tsuruta et al. | Feb 1995 | A |
5389104 | Hahnen et al. | Feb 1995 | A |
5391166 | Eggers | Feb 1995 | A |
5391183 | Janzen et al. | Feb 1995 | A |
5403312 | Yates et al. | Apr 1995 | A |
5411519 | Tovey et al. | May 1995 | A |
5411520 | Nash et al. | May 1995 | A |
5413571 | Katsaros et al. | May 1995 | A |
5415657 | Taymor-Luria | May 1995 | A |
5423810 | Goble et al. | Jun 1995 | A |
5425739 | Jessen | Jun 1995 | A |
5429616 | Schaffer | Jul 1995 | A |
5431674 | Basile et al. | Jul 1995 | A |
5437292 | Kipshidze et al. | Aug 1995 | A |
5438302 | Goble | Aug 1995 | A |
5441517 | Kensey et al. | Aug 1995 | A |
5443463 | Stern et al. | Aug 1995 | A |
5443464 | Russell et al. | Aug 1995 | A |
5443480 | Jacobs et al. | Aug 1995 | A |
5445638 | Rydell et al. | Aug 1995 | A |
5445658 | Durrfeld et al. | Aug 1995 | A |
5451224 | Goble et al. | Sep 1995 | A |
5456684 | Schmidt et al. | Oct 1995 | A |
5458598 | Feinberg et al. | Oct 1995 | A |
5460629 | Shlain et al. | Oct 1995 | A |
5462546 | Rydell | Oct 1995 | A |
5472443 | Cordis et al. | Dec 1995 | A |
5478351 | Meade et al. | Dec 1995 | A |
5484436 | Eggers et al. | Jan 1996 | A |
5496317 | Goble et al. | Mar 1996 | A |
5499997 | Sharpe et al. | Mar 1996 | A |
5509922 | Aranyi et al. | Apr 1996 | A |
5514134 | Rydell et al. | May 1996 | A |
5527313 | Scott et al. | Jun 1996 | A |
5531744 | Nardella et al. | Jul 1996 | A |
5540684 | Hassler, Jr. | Jul 1996 | A |
5540685 | Parins et al. | Jul 1996 | A |
5540715 | Katsaros et al. | Jul 1996 | A |
5558671 | Yates | Sep 1996 | A |
5558672 | Edwards et al. | Sep 1996 | A |
5569241 | Edwards | Oct 1996 | A |
5569243 | Kortenbach et al. | Oct 1996 | A |
5571100 | Goble et al. | Nov 1996 | A |
5573535 | Viklund | Nov 1996 | A |
5585896 | Yamazaki et al. | Dec 1996 | A |
5590570 | LeMaire, III et al. | Jan 1997 | A |
5603711 | Parins et al. | Feb 1997 | A |
5603723 | Aranyi et al. | Feb 1997 | A |
5626578 | Tihon | May 1997 | A |
5630833 | Katsaros et al. | May 1997 | A |
5637110 | Pennybacker et al. | Jun 1997 | A |
5643294 | Tovey et al. | Jul 1997 | A |
5647869 | Goble et al. | Jul 1997 | A |
5649959 | Hannam et al. | Jul 1997 | A |
5658281 | Heard | Aug 1997 | A |
5662680 | Desai | Sep 1997 | A |
5667526 | Levin | Sep 1997 | A |
5674220 | Fox et al. | Oct 1997 | A |
5693051 | Schulze et al. | Dec 1997 | A |
5695522 | LeMaire, III et al. | Dec 1997 | A |
5700261 | Brinkerhoff | Dec 1997 | A |
5702390 | Austin et al. | Dec 1997 | A |
5707369 | Vaitekunas et al. | Jan 1998 | A |
5709680 | Yates et al. | Jan 1998 | A |
5727428 | LeMaire, III et al. | Mar 1998 | A |
5743906 | Parins et al. | Apr 1998 | A |
5755717 | Yates et al. | May 1998 | A |
5766166 | Hooven | Jun 1998 | A |
5766170 | Eggers | Jun 1998 | A |
5769849 | Eggers | Jun 1998 | A |
5776128 | Eggers | Jul 1998 | A |
5776130 | Buysse et al. | Jul 1998 | A |
5779701 | McBrayer et al. | Jul 1998 | A |
5792137 | Carr et al. | Aug 1998 | A |
5792177 | Kaseda | Aug 1998 | A |
5797958 | Yoon | Aug 1998 | A |
5800449 | Wales | Sep 1998 | A |
5810808 | Eggers | Sep 1998 | A |
5810811 | Yates et al. | Sep 1998 | A |
5814043 | Shapeton | Sep 1998 | A |
5827271 | Buysse et al. | Oct 1998 | A |
5827279 | Hughett et al. | Oct 1998 | A |
5827281 | Levin | Oct 1998 | A |
5833690 | Yates et al. | Nov 1998 | A |
5843080 | Fleenor et al. | Dec 1998 | A |
5849022 | Sakashita et al. | Dec 1998 | A |
5853412 | Mayenberger | Dec 1998 | A |
5891141 | Rydell | Apr 1999 | A |
5891142 | Eggers et al. | Apr 1999 | A |
5893863 | Yoon | Apr 1999 | A |
5893875 | Oconnor et al. | Apr 1999 | A |
5902301 | Olig | May 1999 | A |
5908420 | Parins et al. | Jun 1999 | A |
5913874 | Berns et al. | Jun 1999 | A |
5921984 | Sutcu et al. | Jul 1999 | A |
5935126 | Riza | Aug 1999 | A |
5951549 | Richardson et al. | Sep 1999 | A |
5954720 | Wilson et al. | Sep 1999 | A |
5976129 | Desai | Nov 1999 | A |
5976132 | Morris | Nov 1999 | A |
5989277 | LeMaire, III et al. | Nov 1999 | A |
6004335 | Vaitekunas et al. | Dec 1999 | A |
6022347 | Lindenmeier et al. | Feb 2000 | A |
6024744 | Kese et al. | Feb 2000 | A |
6033399 | Gines | Mar 2000 | A |
6039733 | Buysse et al. | Mar 2000 | A |
6050996 | Schmaltz et al. | Apr 2000 | A |
6053914 | Eggers et al. | Apr 2000 | A |
6053933 | Balazs et al. | Apr 2000 | A |
D424694 | Tetzlaff et al. | May 2000 | S |
D425201 | Tetzlaff et al. | May 2000 | S |
RE36795 | Rydell | Jul 2000 | E |
6083223 | Baker | Jul 2000 | A |
6086586 | Hooven | Jul 2000 | A |
6090107 | Borgmeier et al. | Jul 2000 | A |
6099550 | Yoon | Aug 2000 | A |
6102909 | Chen et al. | Aug 2000 | A |
6110171 | Rydell | Aug 2000 | A |
6113596 | Hooven et al. | Sep 2000 | A |
6113598 | Baker | Sep 2000 | A |
H1904 | Yates et al. | Oct 2000 | H |
6126658 | Baker | Oct 2000 | A |
6152923 | Ryan | Nov 2000 | A |
6174309 | Wrublewski et al. | Jan 2001 | B1 |
6179834 | Buysse et al. | Jan 2001 | B1 |
6179837 | Hooven | Jan 2001 | B1 |
6183467 | Shapeton et al. | Feb 2001 | B1 |
6187003 | Buysse et al. | Feb 2001 | B1 |
6190386 | Rydell | Feb 2001 | B1 |
6193718 | Kortenbach et al. | Feb 2001 | B1 |
6206877 | Kese et al. | Mar 2001 | B1 |
6224593 | Ryan et al. | May 2001 | B1 |
6228080 | Gines | May 2001 | B1 |
6228083 | Lands et al. | May 2001 | B1 |
6267761 | Ryan | Jul 2001 | B1 |
6273887 | Yamauchi et al. | Aug 2001 | B1 |
6277117 | Tetzlaff et al. | Aug 2001 | B1 |
D449886 | Tetzlaff et al. | Oct 2001 | S |
6334861 | Chandler et al. | Jan 2002 | B1 |
6350264 | Hooven | Feb 2002 | B1 |
6352536 | Buysse et al. | Mar 2002 | B1 |
D457958 | Dycus et al. | May 2002 | S |
6409728 | Ehr et al. | Jun 2002 | B1 |
H2037 | Yates et al. | Jul 2002 | H |
6419675 | Gallo, Sr. | Jul 2002 | B1 |
6443970 | Schulze et al. | Sep 2002 | B1 |
6451018 | Lands et al. | Sep 2002 | B1 |
6458128 | Schulze | Oct 2002 | B1 |
6458130 | Frazier et al. | Oct 2002 | B1 |
6511480 | Tetzlaff et al. | Jan 2003 | B1 |
6575969 | Rittman et al. | Jun 2003 | B1 |
6585735 | Frazier et al. | Jul 2003 | B1 |
6613045 | Laufer et al. | Sep 2003 | B1 |
6620161 | Schulze et al. | Sep 2003 | B2 |
6682528 | Frazier et al. | Jan 2004 | B2 |
6743229 | Buysse et al. | Jun 2004 | B2 |
20010020126 | Swanson et al. | Sep 2001 | A1 |
20020111548 | Swanson et al. | Aug 2002 | A1 |
20020188294 | Couture et al. | Dec 2002 | A1 |
20030018331 | Dycus et al. | Jan 2003 | A1 |
Number | Date | Country |
---|---|---|
2104423 | Feb 1994 | CA |
19608716 | Apr 1997 | DE |
0364216 | Apr 1990 | EP |
518230 | Dec 1992 | EP |
0 541 930 | May 1993 | EP |
0572131 | Dec 1993 | EP |
0 584 787 | Mar 1994 | EP |
0623316 | Nov 1994 | EP |
0650701 | May 1995 | EP |
0694290 | Mar 1996 | EP |
0717966 | Jun 1996 | EP |
0754437 | Mar 1997 | EP |
0 853 922 | Jul 1998 | EP |
0887046 | Jan 1999 | EP |
0923907 | Jun 1999 | EP |
1034747 | Sep 2000 | EP |
1034748 | Sep 2000 | EP |
1025807 | Oct 2000 | EP |
1034746 | Oct 2000 | EP |
1050278 | Nov 2000 | EP |
1053719 | Nov 2000 | EP |
1053720 | Nov 2000 | EP |
1055399 | Nov 2000 | EP |
1055400 | Nov 2000 | EP |
1080694 | Mar 2001 | EP |
1082944 | Mar 2001 | EP |
2214430 | Jun 1989 | GB |
5-40112 | Feb 1993 | JP |
06343644 | Dec 1994 | JP |
07265328 | Oct 1995 | JP |
08056955 | Mar 1996 | JP |
08252263 | Oct 1996 | JP |
09010223 | Jan 1997 | JP |
11244298 | Sep 1999 | JP |
2000342599 | Dec 2000 | JP |
2000350732 | Dec 2000 | JP |
2001008944 | Jan 2001 | JP |
2001029356 | Feb 2001 | JP |
2001128990 | May 2001 | JP |
401367 | Oct 1973 | SU |
WO 9206642 | Apr 1992 | WO |
WO 9502369 | Jan 1995 | WO |
WO 9700646 | Jan 1997 | WO |
WO 9700647 | Jan 1997 | WO |
WO 9724073 | Jul 1997 | WO |
WO 9724993 | Jul 1997 | WO |
WO 9827880 | Jul 1998 | WO |
WO 9903407 | Jan 1999 | WO |
WO 9903408 | Jan 1999 | WO |
WO 9903409 | Jan 1999 | WO |
WO 9940857 | Aug 1999 | WO |
WO 9951158 | Oct 1999 | WO |
WO 0024330 | May 2000 | WO |
WO 0041638 | Jul 2000 | WO |
WO 0053112 | Sep 2000 | WO |
WO 0154604 | Aug 2001 | WO |
WO 02080796 | Oct 2002 | WO |
Number | Date | Country | |
---|---|---|---|
20050101965 A1 | May 2005 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 09591328 | Jun 2000 | US |
Child | 09992301 | US | |
Parent | 08925805 | Sep 1997 | US |
Child | 09591328 | US |