Control program adaptation based on device status and user input

Abstract
A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to run a control program to operate the surgical system is disclosed. The surgical instrument comprises the end effector which includes a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved with respect to one another between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical system, detect at least one user input, and modify the control program in response to the detected first parameter and the at least one user input.
Description
BACKGROUND

The present invention relates to surgical instruments designed to treat tissue, including but not limited to surgical instruments that are configured to cut and fasten tissue. The surgical instruments may include electrosurgical instruments powered by generators to effect tissue dissecting, cutting, and/or coagulation during surgical procedures. The surgical instruments may include instruments that are configured to cut and staple tissue using surgical staples and/or fasteners. The surgical instruments may be configured for use in open surgical procedures, but have applications in other types of surgery, such as laparoscopic, endoscopic, and robotic-assisted procedures and may include end effectors that are articulatable relative to a shaft portion of the instrument to facilitate precise positioning within a patient.


SUMMARY

In various embodiments, a surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to run a control program to operate the surgical system is disclosed. The surgical instrument comprises the end effector which includes a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved with respect to one another between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical system, detect at least one user input, and modify the control program in response to the detected first parameter and the at least one user input.


In various embodiments, a surgical system comprising a surgical instrument, a generator configured to supply power to the surgical instrument, and a processor configured to run a control program to operate the surgical system is disclosed. The processor is configured to detect a status of the surgical instrument, detect at least one user input, and adapt the control program in response to the detected status of the surgical instrument and the at least one user input.


In various embodiments, a surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to run a control program to operate the surgical system is disclosed. The surgical instrument comprises the end effector which includes a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved with respect to one another between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical instrument, detect a second parameter of the generator, detect at least one user input, and modify the control program in response to the detected first parameter, the detected second parameter, and the at least one user input.





FIGURE DESCRIPTIONS

The novel features of the various aspects are set forth with particularity in the appended claims. The described aspects, however, both as to organization and methods of operation, may be best understood by reference to the following description, taken in conjunction with the accompanying drawings in which:



FIG. 1 illustrates an example of a generator for use with a surgical system, in accordance with at least one aspect of the present disclosure;



FIG. 2 illustrates one form of a surgical system comprising a generator and an electrosurgical instrument usable therewith, in accordance with at least one aspect of the present disclosure;



FIG. 3 illustrates a schematic diagram of a surgical instrument or tool, in accordance with at least one aspect of the present disclosure;



FIG. 4 is a perspective view of a surgical system comprising a surgical instrument and a display monitor, wherein the surgical instrument comprises a display screen in accordance with at least one embodiment;



FIG. 5 is a schematic representation of the corresponding views of the display screen of the surgical instrument and the display monitor of FIG. 4 in accordance with at least one embodiment;



FIG. 6 is a schematic representation of the corresponding views of the display screen of the surgical instrument and the display monitor of FIG. 4 in accordance with at least one embodiment;



FIG. 7 is a schematic representation of the corresponding views of the display screen of the surgical instrument and the display monitor of FIG. 4 in accordance with at least one embodiment;



FIG. 8 is a schematic representation of the corresponding views of the display screen of the surgical instrument and the display monitor of FIG. 4 in accordance with at least one embodiment;



FIG. 9 is a schematic representation of the corresponding views of the display screen of the surgical instrument and the display monitor of FIG. 4 in accordance with at least one embodiment;



FIG. 10 is a graphical depiction of the relationship between the total effective energy delivered by one or more generators of a surgical system and a duty cycle of a motor from a smoke evacuator in accordance with at least one embodiment;



FIG. 11 is a schematic representation of a surgical system comprising a surgical hub, a combination electrosurgical instrument powered by a plurality of generators, a smoke evacuation system, and a display in accordance with at least one embodiment;



FIG. 12 is a graphical depiction of the relationship between the power supplied by one or more generators of a surgical system over time and the impedance of treated tissue over time in accordance with at least one embodiment;



FIG. 13 is a schematic representation of the communication pathways with a surgical system, wherein the surgical system comprises a surgical hub, a smoke evacuation device, a surgical instrument, a first generator configured to power a first operation of the surgical instrument, and a second generator configured to power a second operation of the surgical instrument in accordance with at least one embodiment;



FIG. 14 is a schematic representation of a surgical system comprising a surgical hub and a plurality of robotic arms configured to receive tools thereon, wherein the surgical system comprises an authentication module configured to approve the tools for attachment to and/or use with the surgical system in accordance with at least one embodiment;



FIG. 15 is a schematic representation of a surgical system positioned within a treatment room in accordance with at least one embodiment;



FIG. 16 is a chart depicting various operational parameters and/or specifications of a surgical instrument at various stages of a surgical procedure in accordance with at least one embodiment;



FIG. 17 is an elevational view of the surgical instrument of FIG. 16 shown at a first time delivering bipolar energy to patient tissue;



FIG. 18 is an elevational view of the surgical instrument of FIG. 16 shown at a second time delivering bipolar and monopolar energies to patient tissue;



FIG. 19 is an elevational view of the surgical instrument of FIG. 16 shown at a fourth time delivering monopolar energy to patient tissue;



FIG. 20 is a graphical representation of various operational parameters and/or specifications of the surgical instrument of FIG. 16 at various stages of the surgical procedure;



FIG. 21 is a graphical representation of measured tissue impedance over a duration of a surgical procedure in accordance with at least one embodiment;



FIG. 22 is a schematic representing a strain calculation, wherein the applied strain is calculated using a gap defined between jaws of an end effector when the end effector is in an open configuration in accordance with at least one embodiment;



FIG. 23 is a schematic representing the strain calculation of FIG. 22, wherein the calculated applied strain overestimates an actual applied strain as the patient tissue is not in contact with positioned between the jaws of the end effector;



FIG. 24 is a schematic representing a tissue impedance calculation, wherein the tissue impedance is calculated using a gap defined between the jaws of the end effector when the jaws of the end effector contact the patient tissue positioned therebetween in accordance with at least one embodiment;



FIG. 25 is a graphical representation of a relationship between motor current and jaw gap over time in accordance with at least one embodiment;



FIG. 26 is a schematic representation of a network formed by surgical instruments and a cloud-based storage medium in accordance with at least one embodiment;



FIG. 27 is a graphical representation of a relationship between a change in jaw gap and jaw motor clamp current determined from the network of FIG. 26;



FIG. 28 is a graphical representation of a relationship between generator power over time determined from the network of FIG. 26;



FIG. 29 is a graphical representation of a relationship between activation cycles of a surgical instrument and a measured impedance when an end effector of the surgical instrument is in a closed configuration without patient tissue positioned therebetween in accordance with at least one embodiment;



FIG. 30 is a graphical representation of the relationships between tissue conductance, jaw aperture dimension, and jaw motor force during a jaw clamp stroke in accordance with at least one embodiment; and



FIG. 31 is a graphical representation of a jaw closure speed based on a user input and the jaw closure speed based on the user input and a monitored parameter in accordance with at least one embodiment.





DESCRIPTION

Applicant of the present application owns the following U.S. Patent Applications that were filed on May 28, 2020 and which are each herein incorporated by reference in their respective entireties:


U.S. patent application Ser. No. 16/885,813, entitled METHOD FOR AN ELECTROSURGICAL PROCEDURE, now U.S. Patent Application Publication No. 2021/0196354;


U.S. patent application Ser. No. 16/885,820, entitled ARTICULATABLE SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2021/0196301;


U.S. patent application Ser. No. 16/885,823, entitled SURGICAL INSTRUMENT WITH JAW ALIGNMENT FEATURES, now U.S. Patent Application Publication No. 2021/0196355;


U.S. patent application Ser. No. 16/885,826, entitled SURGICAL INSTRUMENT WITH ROTATABLE AND ARTICULATABLE SURGICAL END EFFECTOR, now U.S. Pat. No. 11,684,412;


U.S. patent application Ser. No. 16/885,838, entitled ELECTROSURGICAL INSTRUMENT WITH ASYNCHRONOUS ENERGIZING ELECTRODES, now U.S. Patent Application Publication No. 2021/0196357;


U.S. patent application Ser. No. 16/885,851, entitled ELECTROSURGICAL INSTRUMENT WITH ELECTRODES BIASING SUPPORT, now U.S. Patent Application Publication No. 2021/0196358;


U.S. patent application Ser. No. 16/885,860, entitled ELECTROSURGICAL INSTRUMENT WITH FLEXIBLE WIRING ASSEMBLIES, now U.S. Patent Application Publication No. 2021/0196349;


U.S. patent application Ser. No. 16/885,866, entitled ELECTROSURGICAL INSTRUMENT WITH VARIABLE CONTROL MECHANISMS, now U.S. Patent Application Publication No. 2021/0196350;


U.S. patent application Ser. No. 16/885,870, entitled ELECTROSURGICAL SYSTEMS WITH INTEGRATED AND EXTERNAL POWER SOURCES, now U.S. Patent Application Publication No. 2021/0196343;


U.S. patent application Ser. No. 16/885,873, entitled ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING ENERGY FOCUSING FEATURES, now U.S. Patent Application Publication No. 2021/0196359;


U.S. patent application Ser. No. 16/885,879, entitled ELECTROSURGICAL INSTRUMENTS WITH ELECTRODES HAVING VARIABLE ENERGY DENSITIES, now U.S. Pat. No. 11,589,916;


U.S. patent application Ser. No. 16/885,881, entitled ELECTROSURGICAL INSTRUMENT WITH MONOPOLAR AND BIPOLAR ENERGY CAPABILITIES, now U.S. Patent Application Publication No. 2021/0196361;


U.S. patent application Ser. No. 16/885,888, entitled ELECTROSURGICAL END EFFECTORS WITH THERMALLY INSULATIVE AND THERMALLY CONDUCTIVE PORTIONS, now U.S. Patent Application Publication No. 2021/0196362;


U.S. patent application Ser. No. 16/885,893, entitled ELECTROSURGICAL INSTRUMENT WITH ELECTRODES OPERABLE IN BIPOLAR AND MONOPOLAR MODES, now U.S. Patent Application Publication No. 2021/0196363;


U.S. patent application Ser. No. 16/885,900, entitled ELECTROSURGICAL INSTRUMENT FOR DELIVERING BLENDED ENERGY MODALITIES TO TISSUE, now U.S. Patent Application Publication No. 2021/0196364;


U.S. patent application Ser. No. 16/885,923, entitled CONTROL PROGRAM FOR MODULAR COMBINATION ENERGY DEVICE, now U.S. Patent Application Publication No. 2021/0196366; and


U.S. patent application Ser. No. 16/885,931, entitled SURGICAL SYSTEM COMMUNICATION PATHWAYS, now U.S. Patent Application Publication No. 2021/0196344.


Applicant of the present application owns the following U.S. Provisional Patent Applications that were filed on Dec. 30, 2019, the disclosure of each of which is herein incorporated by reference in its entirety:


U.S. Provisional Patent Application Ser. No. 62/955,294, entitled USER INTERFACE FOR SURGICAL INSTRUMENT WITH COMBINATION ENERGY MODALITY END-EFFECTOR;


U.S. Provisional Patent Application Ser. No. 62/955,292, entitled COMBINATION ENERGY MODALITY END-EFFECTOR; and


U.S. Provisional Patent Application Ser. No. 62/955,306, entitled SURGICAL INSTRUMENT SYSTEMS.


Applicant of the present application owns the following U.S. Patent Applications, the disclosure of each of which is herein incorporated by reference in its entirety:


U.S. patent application Ser. No. 16/209,395, titled METHOD OF HUB COMMUNICATION, now U.S. Patent Application Publication No. 2019/0201136;


U.S. patent application Ser. No. 16/209,403, titled METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB, now U.S. Patent Application Publication No. 2019/0206569;


U.S. patent application Ser. No. 16/209,407, titled METHOD OF ROBOTIC HUB COMMUNICATION, DETECTION, AND CONTROL, now U.S. Patent Application Publication No. 2019/0201137;


U.S. patent application Ser. No. 16/209,416, titled METHOD OF HUB COMMUNICATION, PROCESSING, DISPLAY, AND CLOUD ANALYTICS, now U.S. Patent Application Publication No. 2019/0206562;


U.S. patent application Ser. No. 16/209,423, titled METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS, now U.S. Patent Application Publication No. 2019/0200981;


U.S. patent application Ser. No. 16/209,427, titled METHOD OF USING REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLE SENSORS TO OPTIMIZE PERFORMANCE OF RADIO FREQUENCY DEVICES, now U.S. Patent Application Publication No. 2019/0208641;


U.S. patent application Ser. No. 16/209,433, titled METHOD OF SENSING PARTICULATE FROM SMOKE EVACUATED FROM A PATIENT, ADJUSTING THE PUMP SPEED BASED ON THE SENSED INFORMATION, AND COMMUNICATING THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE HUB, now U.S. Patent Application Publication No. 2019/0201594;


U.S. patent application Ser. No. 16/209,447, titled METHOD FOR SMOKE EVACUATION FOR SURGICAL HUB, now U.S. Patent Application Publication No. 2019/0201045;


U.S. patent application Ser. No. 16/209,453, titled METHOD FOR CONTROLLING SMART ENERGY DEVICES, now U.S. Patent Application Publication No. 2019/0201046;


U.S. patent application Ser. No. 16/209,458, titled METHOD FOR SMART ENERGY DEVICE INFRASTRUCTURE, now U.S. Patent Application Publication No. 2019/0201047;


U.S. patent application Ser. No. 16/209,465, titled METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORK CONTROL AND INTERACTION, now U.S. Patent Application Publication No. 2019/0206563;


U.S. patent application Ser. No. 16/209,478, titled METHOD FOR SITUATIONAL AWARENESS FOR SURGICAL NETWORK OR SURGICAL NETWORK CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON A SENSED SITUATION OR USAGE, now U.S. Patent Application Publication No. 2019/0104919;


U.S. patent application Ser. No. 16/209,490, titled METHOD FOR FACILITY DATA COLLECTION AND INTERPRETATION, now U.S. Patent Application Publication No. 2019/0206564;


U.S. patent application Ser. No. 16/209,491, titled METHOD FOR CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENT BASED ON SITUATIONAL AWARENESS, now U.S. Patent Application Publication No. 2019/0200998;


U.S. patent application Ser. No. 16/562,123, titled METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES;


U.S. patent application Ser. No. 16/562,135, titled METHOD FOR CONTROLLING AN ENERGY MODULE OUTPUT;


U.S. patent application Ser. No. 16/562,144, titled METHOD FOR CONTROLLING A MODULAR ENERGY SYSTEM USER INTERFACE; and


U.S. patent application Ser. No. 16/562,125, titled METHOD FOR COMMUNICATING BETWEEN MODULES AND DEVICES IN A MODULAR SURGICAL SYSTEM.


Before explaining various aspects of an electrosurgical system in detail, it should be noted that the illustrative examples are not limited in application or use to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. The illustrative examples may be implemented or incorporated in other aspects, variations, and modifications, and may be practiced or carried out in various ways. Further, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative examples for the convenience of the reader and are not for the purpose of limitation thereof. Also, it will be appreciated that one or more of the following-described aspects, expressions of aspects, and/or examples, can be combined with any one or more of the other following-described aspects, expressions of aspects, and/or examples.


Various aspects are directed to electrosurgical systems that include electrosurgical instruments powered by generators to effect tissue dissecting, cutting, and/or coagulation during surgical procedures. The electrosurgical instruments may be configured for use in open surgical procedures, but has applications in other types of surgery, such as laparoscopic, endoscopic, and robotic-assisted procedures.


As described below in greater detail, an electrosurgical instrument generally includes a shaft having a distally-mounted end effector (e.g., one or more electrodes). The end effector can be positioned against the tissue such that electrical current is introduced into the tissue. Electrosurgical instruments can be configured for bipolar or monopolar operation. During bipolar operation, current is introduced into and returned from the tissue by active and return electrodes, respectively, of the end effector. During monopolar operation, current is introduced into the tissue by an active electrode of the end effector and returned through a return electrode (e.g., a grounding pad) separately located on a patient's body. Heat generated by the current flowing through the tissue may form hemostatic seals within the tissue and/or between tissues and thus may be particularly useful for sealing blood vessels, for example.



FIG. 1 illustrates an example of a generator 900 configured to deliver multiple energy modalities to a surgical instrument. The generator 900 provides RF and/or ultrasonic signals for delivering energy to a surgical instrument. The generator 900 comprises at least one generator output that can deliver multiple energy modalities (e.g., ultrasonic, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others) through a single port, and these signals can be delivered separately or simultaneously to an end effector to treat tissue. The generator 900 comprises a processor 902 coupled to a waveform generator 904. The processor 902 and waveform generator 904 are configured to generate a variety of signal waveforms based on information stored in a memory coupled to the processor 902, not shown for clarity of disclosure. The digital information associated with a waveform is provided to the waveform generator 904 which includes one or more DAC circuits to convert the digital input into an analog output. The analog output is fed to an amplifier 906 for signal conditioning and amplification. The conditioned and amplified output of the amplifier 906 is coupled to a power transformer 908. The signals are coupled across the power transformer 908 to the secondary side, which is in the patient isolation side. A first signal of a first energy modality is provided to the surgical instrument between the terminals labeled ENERGY1 and RETURN. A second signal of a second energy modality is coupled across a capacitor 910 and is provided to the surgical instrument between the terminals labeled ENERGY2 and RETURN. It will be appreciated that more than two energy modalities may be output and thus the subscript “n” may be used to designate that up to n ENERGYn terminals may be provided, where n is a positive integer greater than 1. It also will be appreciated that up to “n” return paths RETURNn may be provided without departing from the scope of the present disclosure.


A first voltage sensing circuit 912 is coupled across the terminals labeled ENERGY1 and the RETURN path to measure the output voltage therebetween. A second voltage sensing circuit 924 is coupled across the terminals labeled ENERGY2 and the RETURN path to measure the output voltage therebetween. A current sensing circuit 914 is disposed in series with the RETURN leg of the secondary side of the power transformer 908 as shown to measure the output current for either energy modality. If different return paths are provided for each energy modality, then a separate current sensing circuit should be provided in each return leg. The outputs of the first and second voltage sensing circuits 912, 924 are provided to respective isolation transformers 928, 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 916. The outputs of the isolation transformers 916, 928, 922 on the primary side of the power transformer 908 (non-patient isolated side) are provided to a one or more ADC circuit 926. The digitized output of the ADC circuit 926 is provided to the processor 902 for further processing and computation. The output voltages and output current feedback information can be employed to adjust the output voltage and current provided to the surgical instrument and to compute output impedance, among other parameters. Input/output communications between the processor 902 and patient isolated circuits is provided through an interface circuit 920. Sensors also may be in electrical communication with the processor 902 by way of the interface circuit 920.


In one aspect, the impedance may be determined by the processor 902 by dividing the output of either the first voltage sensing circuit 912 coupled across the terminals labeled ENERGY1/RETURN or the second voltage sensing circuit 924 coupled across the terminals labeled ENERGY2/RETURN by the output of the current sensing circuit 914 disposed in series with the RETURN leg of the secondary side of the power transformer 908. The outputs of the first and second voltage sensing circuits 912, 924 are provided to separate isolations transformers 928, 922 and the output of the current sensing circuit 914 is provided to another isolation transformer 916. The digitized voltage and current sensing measurements from the ADC circuit 926 are provided the processor 902 for computing impedance. As an example, the first energy modality ENERGY1 may be RF monopolar energy and the second energy modality ENERGY2 may be RF bipolar energy. Nevertheless, in addition to bipolar and monopolar RF energy modalities, other energy modalities include ultrasonic energy, irreversible and/or reversible electroporation and/or microwave energy, among others. Also, although the example illustrated in FIG. 1 shows a single return path RETURN may be provided for two or more energy modalities, in other aspects, multiple return paths RETURNn may be provided for each energy modality ENERGYn.


As shown in FIG. 1, the generator 900 comprising at least one output port can include a power transformer 908 with a single output and with multiple taps to provide power in the form of one or more energy modalities, such as ultrasonic, bipolar or monopolar RF, irreversible and/or reversible electroporation, and/or microwave energy, among others, for example, to the end effector depending on the type of treatment of tissue being performed. For example, the generator 900 can deliver energy with higher voltage and lower current to drive an ultrasonic transducer, with lower voltage and higher current to drive RF electrodes for sealing tissue, or with a coagulation waveform for spot coagulation using either monopolar or bipolar RF electrosurgical electrodes. The output waveform from the generator 900 can be steered, switched, or filtered to provide the frequency to the end effector of the surgical instrument. In one example, a connection of RF bipolar electrodes to the generator 900 output would be preferably located between the output labeled ENERGY2 and RETURN. In the case of monopolar output, the preferred connections would be active electrode (e.g., pencil or other probe) to the ENERGY2 output and a suitable return pad connected to the RETURN output.


Additional details are disclosed in U.S. Patent Application Publication No. 2017/0086914, titled TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, which published on Mar. 30, 2017, which is herein incorporated by reference in its entirety.



FIG. 2 illustrates one form of a surgical system 1000 comprising a generator 1100 and various surgical instruments 1104, 1106, 1108 usable therewith, where the surgical instrument 1104 is an ultrasonic surgical instrument, the surgical instrument 1106 is an RF electrosurgical instrument, and the multifunction surgical instrument 1108 is a combination ultrasonic/RF electrosurgical instrument. The generator 1100 is configurable for use with a variety of surgical instruments. According to various forms, the generator 1100 may be configurable for use with different surgical instruments of different types including, for example, ultrasonic surgical instruments 1104, RF electrosurgical instruments 1106, and multifunction surgical instruments 1108 that integrate RF and ultrasonic energies delivered simultaneously from the generator 1100. Although in the form of FIG. 2 the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108 in one form, the generator 1100 may be formed integrally with any of the surgical instruments 1104, 1106, 1108 to form a unitary surgical system. The generator 1100 comprises an input device 1110 located on a front panel of the generator 1100 console. The input device 1110 may comprise any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 may be configured for wired or wireless communication.


The generator 1100 is configured to drive multiple surgical instruments 1104, 1106, 1108. The first surgical instrument is an ultrasonic surgical instrument 1104 and comprises a handpiece 1105 (HP), an ultrasonic transducer 1120, a shaft 1126, and an end effector 1122. The end effector 1122 comprises an ultrasonic blade 1128 acoustically coupled to the ultrasonic transducer 1120 and a clamp arm 1140. The handpiece 1105 comprises a trigger 1143 to operate the clamp arm 1140 and a combination of the toggle buttons 1137, 1134b, 1134c to energize and drive the ultrasonic blade 1128 or other function. The toggle buttons 1137, 1134b, 1134c can be configured to energize the ultrasonic transducer 1120 with the generator 1100.


The generator 1100 also is configured to drive a second surgical instrument 1106. The second surgical instrument 1106 is an RF electrosurgical instrument and comprises a handpiece 1107 (HP), a shaft 1127, and an end effector 1124. The end effector 1124 comprises electrodes in clamp arms 1145, 1142b and return through an electrical conductor portion of the shaft 1127. The electrodes are coupled to and energized by a bipolar energy source within the generator 1100. The handpiece 1107 comprises a trigger 1145 to operate the clamp arms 1145, 1142b and an energy button 1135 to actuate an energy switch to energize the electrodes in the end effector 1124. The second surgical instrument 1106 can also be used with a return pad to deliver monopolar energy to tissue.


The generator 1100 also is configured to drive a multifunction surgical instrument 1108. The multifunction surgical instrument 1108 comprises a handpiece 1109 (HP), a shaft 1129, and an end effector 1125. The end effector 1125 comprises an ultrasonic blade 1149 and a clamp arm 1146. The ultrasonic blade 1149 is acoustically coupled to the ultrasonic transducer 1120. The handpiece 1109 comprises a trigger 1147 to operate the clamp arm 1146 and a combination of the toggle buttons 11310, 1137b, 1137c to energize and drive the ultrasonic blade 1149 or other function. The toggle buttons 11310, 1137b, 1137c can be configured to energize the ultrasonic transducer 1120 with the generator 1100 and energize the ultrasonic blade 1149 with a bipolar energy source also contained within the generator 1100. Monopolar energy can be delivered to the tissue in combination with, or separately from, the bipolar energy.


The generator 1100 is configurable for use with a variety of surgical instruments. According to various forms, the generator 1100 may be configurable for use with different surgical instruments of different types including, for example, the ultrasonic surgical instrument 1104, the RF electrosurgical instrument 1106, and the multifunction surgical instrument 1108 that integrates RF and ultrasonic energies delivered simultaneously from the generator 1100. Although in the form of FIG. 2, the generator 1100 is shown separate from the surgical instruments 1104, 1106, 1108, in another form the generator 1100 may be formed integrally with any one of the surgical instruments 1104, 1106, 1108 to form a unitary surgical system. As discussed above, the generator 1100 comprises an input device 1110 located on a front panel of the generator 1100 console. The input device 1110 may comprise any suitable device that generates signals suitable for programming the operation of the generator 1100. The generator 1100 also may comprise one or more output devices 1112. Further aspects of generators for digitally generating electrical signal waveforms and surgical instruments are described in US patent application publication US-2017-0086914-A1, which is herein incorporated by reference in its entirety.



FIG. 3 illustrates a schematic diagram of a surgical instrument or tool 600 comprising a plurality of motor assemblies that can be activated to perform various functions. In the illustrated example, a closure motor assembly 610 is operable to transition an end effector between an open configuration and a closed configuration, and an articulation motor assembly 620 is operable to articulate the end effector relative to a shaft assembly. In certain instances, the plurality of motors assemblies can be individually activated to cause firing, closure, and/or articulation motions in the end effector. The firing, closure, and/or articulation motions can be transmitted to the end effector through a shaft assembly, for example.


In certain instances, the closure motor assembly 610 includes a closure motor. The closure 603 may be operably coupled to a closure motor drive assembly 612 which can be configured to transmit closure motions, generated by the motor to the end effector, in particular to displace a closure member to close to transition the end effector to the closed configuration. The closure motions may cause the end effector to transition from an open configuration to a closed configuration to capture tissue, for example. The end effector may be transitioned to an open position by reversing the direction of the motor.


In certain instances, the articulation motor assembly 620 includes an articulation motor that be operably coupled to an articulation drive assembly 622 which can be configured to transmit articulation motions, generated by the motor to the end effector. In certain instances, the articulation motions may cause the end effector to articulate relative to the shaft, for example.


One or more of the motors of the surgical instrument 600 may comprise a torque sensor to measure the output torque on the shaft of the motor. The force on an end effector may be sensed in any conventional manner, such as by force sensors on the outer sides of the jaws or by a torque sensor for the motor actuating the jaws.


In various instances, the motor assemblies 610, 620 include one or more motor drivers that may comprise one or more H-Bridge FETs. The motor drivers may modulate the power transmitted from a power source 630 to a motor based on input from a microcontroller 640 (the “controller”), for example, of a control circuit 601. In certain instances, the microcontroller 640 can be employed to determine the current drawn by the motor, for example.


In certain instances, the microcontroller 640 may include a microprocessor 642 (the “processor”) and one or more non-transitory computer-readable mediums or memory units 644 (the “memory”). In certain instances, the memory 644 may store various program instructions, which when executed may cause the processor 642 to perform a plurality of functions and/or calculations described herein. In certain instances, one or more of the memory units 644 may be coupled to the processor 642, for example. In various aspects, the microcontroller 640 may communicate over a wired or wireless channel, or combinations thereof.


In certain instances, the power source 630 can be employed to supply power to the microcontroller 640, for example. In certain instances, the power source 630 may comprise a battery (or “battery pack” or “power pack”), such as a lithium-ion battery, for example. In certain instances, the battery pack may be configured to be releasably mounted to a handle for supplying power to the surgical instrument 600. A number of battery cells connected in series may be used as the power source 630. In certain instances, the power source 630 may be replaceable and/or rechargeable, for example.


In various instances, the processor 642 may control a motor driver to control the position, direction of rotation, and/or velocity of a motor of the assemblies 610, 620. In certain instances, the processor 642 can signal the motor driver to stop and/or disable the motor. It should be understood that the term “processor” as used herein includes any suitable microprocessor, microcontroller, or other basic computing device that incorporates the functions of a computer's central processing unit (CPU) on an integrated circuit or, at most, a few integrated circuits. The processor 642 is a multipurpose, programmable device that accepts digital data as input, processes it according to instructions stored in its memory, and provides results as output. It is an example of sequential digital logic, as it has internal memory. Processors operate on numbers and symbols represented in the binary numeral system.


In one instance, the processor 642 may be any single-core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments. In certain instances, the microcontroller 620 may be an LM 4F230H5QR, available from Texas Instruments, for example. In at least one example, the Texas Instruments LM4F230H5QR is an ARM Cortex-M4F Processor Core comprising an on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle SRAM, an internal ROM loaded with StellarisWare® software, a 2 KB EEPROM, one or more PWM modules, one or more QEI analogs, one or more 12-bit ADCs with 12 analog input channels, among other features that are readily available for the product datasheet. Other microcontrollers may be readily substituted for use with the surgical instrument 600. Accordingly, the present disclosure should not be limited in this context.


In certain instances, the memory 644 may include program instructions for controlling each of the motors of the surgical instrument 600. For example, the memory 644 may include program instructions for controlling the closure motor and the articulation motor. Such program instructions may cause the processor 642 to control the closure and articulation functions in accordance with inputs from algorithms or control programs of the surgical instrument 600.


In certain instances, one or more mechanisms and/or sensors such as, for example, sensors 645 can be employed to alert the processor 642 to the program instructions that should be used in a particular setting. For example, the sensors 645 may alert the processor 642 to use the program instructions associated with closing and articulating the end effector. In certain instances, the sensors 645 may comprise position sensors which can be employed to sense the position of a closure actuator, for example. Accordingly, the processor 642 may use the program instructions associated with closing the end effector to activate the motor of the closure drive assembly 620 if the processor 642 receives a signal from the sensors 630 indicative of actuation of the closure actuator.


In some examples, the motors may be brushless DC electric motors, and the respective motor drive signals may comprise a PWM signal provided to one or more stator windings of the motors. Also, in some examples, the motor drivers may be omitted and the control circuit 601 may generate the motor drive signals directly.


It is common practice during various laparoscopic surgical procedures to insert a surgical end effector portion of a surgical instrument through a trocar that has been installed in the abdominal wall of a patient to access a surgical site located inside the patient's abdomen. In its simplest form, a trocar is a pen-shaped instrument with a sharp triangular point at one end that is typically used inside a hollow tube, known as a cannula or sleeve, to create an opening into the body through which surgical end effectors may be introduced. Such arrangement forms an access port into the body cavity through which surgical end effectors may be inserted. The inner diameter of the trocar's cannula necessarily limits the size of the end effector and drive-supporting shaft of the surgical instrument that may be inserted through the trocar.


Regardless of the specific type of surgical procedure being performed, once the surgical end effector has been inserted into the patient through the trocar cannula, it is often necessary to move the surgical end effector relative to the shaft assembly that is positioned within the trocar cannula in order to properly position the surgical end effector relative to the tissue or organ to be treated. This movement or positioning of the surgical end effector relative to the portion of the shaft that remains within the trocar cannula is often referred to as “articulation” of the surgical end effector. A variety of articulation joints have been developed to attach a surgical end effector to an associated shaft in order to facilitate such articulation of the surgical end effector. As one might expect, in many surgical procedures, it is desirable to employ a surgical end effector that has as large a range of articulation as possible.


Due to the size constraints imposed by the size of the trocar cannula, the articulation joint components must be sized so as to be freely insertable through the trocar cannula. These size constraints also limit the size and composition of various drive members and components that operably interface with the motors and/or other control systems that are supported in a housing that may be handheld or comprise a portion of a larger automated system. In many instances, these drive members must operably pass through the articulation joint to be operably coupled to or operably interface with the surgical end effector. For example, one such drive member is commonly employed to apply articulation control motions to the surgical end effector. During use, the articulation drive member may be unactuated to position the surgical end effector in an unarticulated position to facilitate insertion of the surgical end effector through the trocar and then be actuated to articulate the surgical end effector to a desired position once the surgical end effector has entered the patient.


Thus, the aforementioned size constraints form many challenges to developing an articulation system that can effectuate a desired range of articulation, yet accommodate a variety of different drive systems that are necessary to operate various features of the surgical end effector. Further, once the surgical end effector has been positioned in a desired articulated position, the articulation system and articulation joint must be able to retain the surgical end effector in that position during the actuation of the end effector and completion of the surgical procedure. Such articulation joint arrangements must also be able to withstand external forces that are experienced by the end effector during use.


Various modes of one or more surgical devices are often used throughout a particular surgical procedure. Communication pathways extending between the surgical devices and a centralized surgical hub can promote efficiency and increase success of the surgical procedure, for example. In various instances, each surgical device within a surgical system comprises a display, wherein the display communicates a presence and/or an operating status of other surgical devices within the surgical system. The surgical hub can use the information received through the communication pathways to assess compatibility of the surgical devices for use with one another, assess compatibility of the surgical devices for use during a particular surgical procedure, and/or optimize operating parameters of the surgical devices. As described in greater detail herein, the operating parameters of the one or more surgical devices can be optimized based on patient demographics, a particular surgical procedure, and/or detected environmental conditions such as tissue thickness, for example.


A divided display system is shown in FIGS. 4-9. The divided display communicates various generator and/or surgical device parameters between a display 27010 of a handheld surgical instrument 27000 and a primary monitor display 27100. FIG. 4 depicts an example of the display 27010 of the handheld surgical instrument 27000. In various instances, the display 27010 includes a touch-sensitive graphical user interface capable of receiving user inputs. The display 27010 comprises various settings and/or modes that allow a user to customize the information and/or images shown on the display 27010 at any given time.


The surgical instrument 27000 is in communication with the main display monitor 27100. The main display monitor 27100 comprises a larger screen than the display 27010 of the surgical instrument 27000. In various instances, the main display monitor 27100 displays the same information and/or images as the display 27010 of the surgical instrument 27000. In other instances, the main display monitor 27100 displays different information and/or images than the display 27010 of the surgical instrument 27000. In various instances, the main display monitor 27100 includes a touch-sensitive graphical user interface capable of receiving user inputs. Similar to the display 27010 of the surgical instrument 27000, the main display monitor 27100 comprises various settings and/or modes that allow a user to customize the information and/or images shown on the main display monitor 27100 at any given time. As described in greater detail herein, a selected mode on the main display monitor 27100 can change the mode of the display 27010 on the surgical instrument 27000 and vice versa. Stated another way, the main display monitor 27100 and the surgical instrument display 27010 co-operate together to communicate the selected operational parameters most effectively to a user.


The depicted handheld surgical instrument 27000 comprises a combination electrosurgical functionality, wherein the surgical instrument 27000 includes an end effector comprising a first jaw and a second jaw. The first jaw and the second jaw comprise electrodes disposed thereon. The electrosurgical instrument 27000 comprises one or more power generators configured to supply power to the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first jaw and the second jaw is achieved by energizing the electrodes which are configured to deliver energy in a monopolar mode, bipolar mode, and/or a combination mode. The combination mode is configured to deliver alternating or blended bipolar and monopolar energies. In at least one embodiment, the at least one power generator comprises a battery, a rechargeable battery, a disposable battery, and/or combinations thereof. Various details regarding the operation of the first and second generators is described in greater detail in U.S. patent application Ser. No. 16/562,123, titled METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES, and filed on Sep. 5, 2019, which is hereby incorporated by reference in its entirety.


The display 27010 of the surgical instrument 27000 and the main display monitor 27100 comprise divided displays to communicate numerous operational parameters to a user. The divided displays are configured to be selectively segmentable. Stated another way, a user is able to select which operational parameters to display and/or where to display the selected operational parameters. Such customization minimizes distraction by eliminating unwanted and/or unnecessary information while allowing the user to efficiently observe the information needed and/or desired to control the surgical instrument 27000 and/or to perform the surgical procedure. The display 27010 of the surgical instrument 27000 comprises a first portion 27012, wherein the power level of a particular mode is displayed. The display 27010 of the surgical instrument 27000 further comprises a second portion 27014, wherein the mode that the surgical instrument 27000 is in and/or the type of energy being delivered by the surgical instrument 27000 is identified, or otherwise communicated.


Similarly, the main display monitor 27100 comprises a segmented display; however, in various instances, the images displayed on the display monitor 27100 can be overlaid onto one another. A central portion 27110 of the main display monitor 27100 streams a live feed and/or still images of a surgical site to the procedure room. The live feed and/or images of the surgical site are captured through an appropriately positioned camera, such as an endoscope. A menu selection portion 27130 of the main display monitor 27100 prompts and/or otherwise allows a user to select which mode the main display monitor 27100 is in and/or what information a user wishes to see on the main display monitor 27100. A device status portion 27120 of the main display monitor 27100 communicates information similar to the first portion 27012 of the surgical instrument display 27010. In various instances, the device status portion 27120 is further divided into multiple sections. For example, a first portion 27122 is configured to communicate an operating parameter reflective of a bipolar mode. Such an operating parameter can be specific and/or generic. A specific operating parameter can reflect the power level of the bipolar mode, for example. A general operating parameter can indicate whether the bipolar mode is active or inactive, for example. A second portion 27124 is configured to communicate an operating parameter reflective of a monopolar mode. Such an operating parameter can be specific and/or generic. A specific operating parameter can reflect the power level of the monopolar mode, for example. A general operating parameter can indicate whether the monopolar mode is active or inactive, for example. A third portion 27126 is configured to communicate an operating parameter reflective of a smoke evacuation system. Such an operating parameter can be specific and/or generic. A specific operating parameter can reflect the power level of the smoke evacuation system, for example. A general operating parameter can indicate whether the smoke evacuation system is active or inactive, for example.


Referring now to FIGS. 5-9, the display 27010 of the surgical instrument 27000 is shown alongside a corresponding display on the main display monitor 27100. As described in greater detail herein, as a user changes a power level on the handheld surgical instrument 27000, such a power level change is reflected on the main display monitor 27100. For example, as shown in FIG. 5, a generator operating the bipolar mode is currently operating at a power level of 80 watts as indicated in the device status portion 27120 of the main display monitor 27100 and the first and second portions 27012, 27014 of the surgical instrument display 27010. More specifically, the first portion 27012 of the surgical instrument display 27010 represents the output of a generator while the second portion 27014 of the surgical instrument display 27010 represents the mode and/or type of energy. Similarly, the device status portion 27120 of the main display monitor 27100 indicates that a generator is operating the bipolar energy mode at a power level of 80 watts and a generator is operating the monopolar energy mode at a power level of zero watts. Upon receiving a command to increase the power output of the generator operating the bipolar mode to 100 watts, the surgical instrument display 27010 and the main display monitor 27100 change accordingly as shown in FIG. 6. More specifically, the first portion 27012 of the surgical instrument display 27010 now represents the power level of 100 watts, and the device status portion 27120 of the main display monitor 27100 now indicates that the generator is operating the bipolar mode at a power level of 100 watts. The main display monitor 27100 continues to indicate that the monopolar energy mode is operating at a power level of zero watts; however, the main display monitor 27100 also indicates that the smoke detection system has been activated to 20% 27126 due to the detection of smoke within the surgical site and/or the increased power level of the surgical instrument.



FIGS. 7-9 depict the display 27010 of the surgical instrument 27000 and the corresponding main display monitor 27100 when a combination of both bipolar and monopolar energies are being delivered to patient tissue. FIG. 7 shows the first portion 27012′ of the surgical instrument display 27010 in a total power mode. As shown on the main display monitor 27100, the bipolar energy mode 27122 is operating at a power level of 60 watts and the monopolar energy model 27124 is operating at a power level of 60 watts. However, a combined and/or total power level of 120 watts is represented on the first portion 27012′ of the surgical instrument display 27010. The main display monitor 27100 also indicates that the smoke detection system has been activated to 50% 27126 due to the detection of smoke within the surgical site and/or the increased power level of the surgical instrument. As shown in FIG. 8, the user may wish to see the individual power levels of the bipolar mode and the monopolar mode on the first portion 27012″ of the surgical instrument display 27010 and the total power level on the device status portion 27122′ of the main display monitor 27100. Stated another way, the information shown on the displays in FIG. 8 are reversed from the displays shown in FIG. 7. The main display monitor 27100 further indicates that the smoke detection system has been activated to 73% 27126 due to the detection of smoke within the surgical site and/or the change of power levels of the bipolar and/or monopolar modes. The pair of displays shown in FIG. 9 are similar in many respects to the pair of displays shown in FIG. 8; however, the user has selected to remove the indication of the operating level of the smoke detection system from the main display monitor 27100.


As discussed in greater detail herein, the surgical instrument display 27010 and/or the main display monitor 27100 can comprise touch-sensitive graphical user interfaces. In various instances, the surgical instrument display 27010 is used to control what is being displayed on the surgical instrument display 27010 versus what is being displayed on the main display monitor 27100. In other instances, the main display monitor 27100 is used to control what is being displayed on the surgical instrument display 27010 versus what is being displayed on the main display monitor 27100. In various instances, each display is configured to control what is displayed on its own display. In various instances, each display within a surgical system is configured to cooperatively control what is displayed on other displays within the surgical system.


In various instances, a surgical system comprises an electrosurgical device and a smoke evacuation system. As discussed in greater detail herein, the electrosurgical device is configured to deliver energy to patient tissue supported between the jaws of an end effector by energizing electrodes. The electrodes are configured to deliver energy in a monopolar mode, bipolar mode, and/or a combination mode with alternating or blended bipolar and monopolar energies. In various instances, a first generator is configured to control the bipolar energy modality and a second generator is configured to control the monopolar energy modality. A third generator is configured to control the smoke evacuation system. Various details regarding the operation of the first and second generators is described in greater detail in U.S. patent application Ser. No. 16/562,123, titled METHOD FOR CONSTRUCTING AND USING A MODULAR SURGICAL ENERGY SYSTEM WITH MULTIPLE DEVICES, and filed on Sep. 5, 2019, which is hereby incorporated by reference in its entirety.



FIG. 10 is a graphical representation 27200 depicting the proportional relationship between a duty cycle of the smoke evacuation system and the total effective energy delivered to patient tissue. Time 27210 is represented along the x-axis while power (W) 27220a and duty cycle of the smoke evacuation system (%) 27220b are represented along the y-axis. The total effective energy is represented in three facets: (1) bipolar therapy 27230; (2) monopolar therapy 27240; and (3) combined energy 27250. The percentage of the smoke evacuator duty cycle is represented in two facets: (1) in response to the combined energy 27260; and (2) in response to only the bipolar therapy 27270. For example, at time t0, power is not being delivered to the patient tissue and the smoke evacuation system is inactive. At time t1, bipolar therapy 27230 is delivered at a first power level P1. At time t1, bipolar therapy 27230 is the only energy delivered to the patient tissue. As the power increased to P1 during the time period of t0 to t1, the smoke evacuation system activated. At time t1, a first percentage S1 of the smoke evacuation duty cycle is utilized.


At time t2, the power level of the bipolar therapy 27230 increased and monopolar therapy 27240 has begun to be delivered. At time t3, the bipolar therapy 27230 decreased while the monopolar therapy 27240 increased. Overall, the combined energy 27250 has remained substantially the same from t2 to t3. At time t3, the combined energy 27250 is delivered at a third power level P3, which is higher than the first power level P1 delivered at time t1. As the power increased to P3 during the time period of t1 to t3, the percentage of the smoke evacuation system duty cycle also increased. At time t3, a third percentage S3 of the smoke evacuation duty cycle is utilized. The third percentage S3 is greater than the first percentage S1. At time t4, delivery of the bipolar therapy 27230 has ceased and the only energy delivered to the patient tissue is through monopolar therapy 27240. Notably, at time t4, the monopolar therapy 27240 delivers energy to the patient tissue at the highest level P4 of monopolar therapy delivered during the entire surgical procedure. Thus, as the delivered energy P4 at time t4 is greater than the delivered energy P3 at time t3, the percentage of the smoke evacuation duty cycle also increased. At time t4, a fourth percentage S4 of the smoke evacuation duty cycle is utilized. The fourth percentage S4 is greater than the third percentage S3 and the first percentage S1.


The graphical representation of FIG. 10 shows bipolar energy 27230 being delivered at varying levels throughout different time points of a surgical procedure. Such time points can correspond to a tissue sealing cycle in which the surgical hub commands the smoke evacuation system to increase or decrease its operating level in response to the current bipolar power level. After the tissue sealing cycle is complete, monopolar energy can be applied for a defined period of time in order to cut the patient tissue. As patient tissue is being cut, the surgical hub can command the smoke evacuation system to increase its operating level based on the increase in energy being applied to cut the tissue as such an increase in applied energy typically corresponds to an increase in smoke from burning tissue, for example. During the particular surgical procedure, the surgical hub is aware of pre-defined time points at which the energy delivery and power levels change. The pre-defined time points can vary based on the type of particular surgical procedure to be performed, for example. The pre-defined time points can vary based on patient demographics identified to the surgical hub, for example. Any detected change in the type of energy being applied and/or the level of energy being applied can trigger responses of different components of the surgical system.


Similar to the surgical system described with respect to FIG. 10, a surgical system 27700 depicted in FIG. 11 comprises an electrosurgical instrument 27710 in communication with a surgical hub. The electrosurgical instrument 27710 is configured to deliver energy to patient tissue supported between the jaws of an end effector by electrodes which are configured to deliver energy in a monopolar mode, bipolar mode, and/or a combination mode. The electrosurgical instrument 27710 is configured to apply alternating or blended bipolar and monopolar energies to the patient tissue when in the combination mode. The surgical system 27700 further comprises a first generator 27720 configured to control the monopolar energy modality and a second generator 27730 configured to control the bipolar energy modality. A display screen 27750 is positioned in a location within a procedure room that is within a field of vision of a user. In various instances, the electrosurgical instrument 27710 comprises a display positioned thereon. As the second generator 27730 causes bipolar energy to be delivered to patient tissue, the instrument display and/or the display screen 27750 within the procedure room indicates the level of power being applied. In various instances, a level of smoke evacuation by the smoke evacuation system is indicated on the display(s), wherein the level of smoke evacuation is based on the level of power and/or type of energy being applied. As discussed in greater detail herein, when the first generator 27720 causes monopolar energy to be delivered to patient tissue and/or the second generator 27730 causes a reduced amount of bipolar energy to be delivered to patient tissue, the display(s) are configured to update the displayed, or otherwise communicated, operational parameters. As the levels of power change during the surgical procedure, such changes are communicated to the surgical hub. In response, the surgical hub is configured to automatically, or without an external prompt, alter the level of smoke evacuation to compensate for the changes in the level of energy and/or type of energy being applied to patient tissue.


At least one of the instrument display and the display screen 27750 comprise a touch-sensitive graphical user interface which is configured to receive a user input. The user is able to select what information is displayed, where the selected information is displayed on a particular display, and/or which display within the surgical system displays the desired information. In various instances, the surgical system 27700 further comprises one or more cameras positioned within the procedure room. The one or more cameras are configured to monitor movements of the user and/or the devices of the surgical system. The one or more cameras can communicate any detected movement to the surgical hub, wherein the surgical hub recognizes that the detected movement corresponds to a pre-determined command. For example, a camera can detect when a user waves an arm. A memory within the surgical hub correlates arm waving with the user's desire to clear the display of all operational parameters, so that all that remains on the display is a live feed and/or images of the surgical site. Exemplary commands that can be associated with a specific user and/or instrument movement include adjusting a position of the display(s), adjusting the view of the display(s), adjusting the information presented on the display(s), adjusting the location of the displayed information on a particular display, adjusting the size of the displayed information, controlling power levels of the generator(s), and/or controlling operational parameters of various surgical instruments of the surgical system.


As discussed with respect to the surgical system 27700, the electrosurgical instrument 27710 comprises a combination electrical modality. A monopolar modality of the electrosurgical instrument is operated by the first generator 27720, while a bipolar modality is operated by a second generator 27730. Monopolar energy is delivered to patient tissue to make an incision, or otherwise cut the treated tissue. Prior to cutting the patient tissue, bipolar energy is delivered to the tissue in order to seal and/or cauterize the target tissue. A graphical representation 27300 of the power level (wattage) of the first generator and the second generators 27320a with respect to time (t) 27310 is shown in FIG. 12. The power level is represented in two facets: (1) of the first generator 27340; and (2) of the second generator 27330. The graphical representation 27300 further depicts the relationship of tissue impedance (Ω) 27320b with respect to time (t) 27310. The tissue impedance is represented in two facets (1) in response to the monopolar energy delivered 27345; and (2) in response to the bipolar energy delivered 27335.


As the power level of the second generator 27330 increases from zero, bipolar energy is delivered to patient tissue. The impedance of the patient tissue increases in response to the application of bipolar energy 27335. Notably, the impedance of the patient tissue continues to increase for an amount of time even after the power level of the second generator 27330 begins to decrease. Stated another way, the impedance of the tissue sealed by the bipolar energy 27335 eventually decreases after the power level of the second generator 27330 is reduced absent the delivery of monopolar energy to cut the patient tissue; however, the impedance of the tissue in such instances does not necessarily immediately decrease. At time t1, the power level of the first generator 27340 increases, thereby cutting the tissue through delivery of monopolar energy to the patient tissue. The impedance of the patient tissue also increases in response to the application of monopolar energy 27345. Notably, the impedance of the patient tissue exponentially grows as the tissue is cut and the power level of the first generator 27340 decreases.



FIG. 13 depicts an algorithm 27400 for controlling various components of a surgical system. The surgical system comprises a surgical instrument configured to perform an intended surgical function. In various instances, the surgical instrument is handheld and comprises a handle. A user is configured to operate various modes of the surgical instrument through an input element on the handle. As described in greater detail herein, the surgical instrument comprises a first generator configured to power a monopolar modality and a second generator configured to power a bipolar modality. The surgical system further comprises a smoke evacuation system configured to remove smoke and/or other unwanted particulates from a surgical site. The surgical instrument and/or the smoke evacuation system are in signal communication with a surgical hub, wherein the surgical hub is configured to orchestrate the appropriate response(s) of the components of the surgical system in response to a user input on the surgical instrument, the smoke evacuation system, and/or another component within the surgical system.


As shown in FIG. 13, a control algorithm 27400 begins when a user changes a mode 27410 of the surgical instrument. For example, the user may wish to increase the power level of the first generator to cut patient tissue. In another example, the user may wish for the surgical instrument to seal and/or cut patient tissue. In any event, the surgical instrument then communicates 27412, 27414 the user input to the first generator and the second generator, respectively. The surgical instrument further communicates 27415 the user input to the surgical hub. After the surgical hub is informed 27420 of the desired increase in monopolar energy, the surgical hub is configured to command the second generator 27425 to supply and/or administer an appropriate power level. Upon receiving the communication 27412 from the surgical instrument, the first generator increases a waveform 27440 in preparation for cutting patient tissue. Upon receiving the communication 27414 from the surgical instrument and the command 27425 from the surgical hub, the second generator increases the power level associated with the bipolar modality 27450 in preparation for sealing the patient tissue after the cut is performed. The second generator can then communicate 27455 its readiness to the first generator. The first generator is then able to start cutting the patient tissue 27442. Stated another way, the surgical hub prevents a monopolar electrode from being energized until the bipolar electrode has been energized to prevent cutting of tissue that has not been cauterized and/or sealed. The surgical hub is further configured to command 27426 the smoke evacuation system to increase a motor rate in response to an increase in power levels of the first and second generators. After the smoke evacuation system increases its motor rate 27430, the smoke evacuation system is configured to maintain a line of communication with the surgical hub, the surgical instrument, and/or the first and second generators throughout the duration of the surgical procedure. For example, the smoke evacuation system is configured to continuously communicate a current motor rate 27435 to the surgical hub. In such instances, the smoke evacuation system sends its current motor rate to the surgical hub every minute, or every two minutes; however, the smoke evacuation system is able to communicate its current motor rate at any suitable frequency. Upon the surgical instrument completing the desired tissue cut, the user can once again provide an input on the instrument handle to reduce the power level of the first generator and/or end the control algorithm 27400. In various instances, the control algorithm 27400 is configured to automatically reduce the power level of the first generator after a pre-determined period of time that corresponds to a completion a tissue cut. Utilizing the control algorithm 27400, the surgical hub is able to orchestrate the operating parameters of the components of the surgical system to facilitate an efficient and/or effective surgical procedure, for example.


Numerous surgical devices, tools, and/or replaceable components are often used during a particular surgical procedure. Various systems are disclosed herein that serve to, among other things, streamline the devices and/or components that are stocked within a procedure room for use during a particular procedure, minimize operator error, and/or minimize delays during surgical procedures. The systems described herein increase the efficiency of surgical procedures using, among other things, artificial intelligence and machine learning developed over the course of one or more surgical procedures.


Various components of an exemplary surgical system 27500 are shown in FIG. 14. During a particular surgical procedure, a patient rests on an operating table, or any suitable procedure surface 27510. In various instances, the particular procedure is performed at least in part using a surgical robot. The surgical robot comprises one or more robot arms 27520. Each robot arm 27520 is configured to receive a tool component 27590. The tool components 27590 are configured to cooperate with one another to perform and/or assist the clinician in performing the particular surgical procedure. The tool components may comprise, for example, a surgical stapling and/or tissue cutting tool component, a tissue grasping tool component, and/or an electrosurgical tool component. The tool components may comprise other distinguishing characteristics such as, for example, size, manufacturer, date of manufacture, number of previous uses, and/or expiration date.


The surgical system 27500 further comprises a surgical hub 27530. Various surgical hubs are described in described in U.S. patent application Ser. No. 16/209,395, titled METHOD OF HUB COMMUNICATION, and filed on Dec. 4, 2018, which is hereby incorporated by reference in its entirety. The surgical hub 27530 comprises a memory 27535 that stores various suitable, or otherwise appropriate, combinations of tool components 27590 to be used during the particular procedure. Stated another way, the memory 27535 of the surgical hub 27530 comprises a stored information bank which can be used to indicate which tool components 27590 are appropriate for utilization during a selected procedure.


Prior to performing a desired surgical procedure, a clinician can notify, or otherwise communicate, details relating to the desired surgical procedure and/or the patient to the surgical hub 27530. Such details can include, for example, an identity of the surgical procedure, an identity of the clinician performing the surgical procedure, and/or a biometric profile of the patient, for example. The surgical hub 27530 is then configured to utilize one or more of the communicated details to evaluate and/or determine which tool components 27950 are necessary and/or appropriate to perform the desired surgical procedure. In various instances, the surgical hub 27530 is configured to assess which modes of each tool components 27950 are appropriate for performing the desired surgical procedure on the particular patient.


As shown in FIG. 14, four robot arms 27250 surround, or are otherwise attached to, the operating table 27510. Three tool components 27590 are connected to three corresponding robot arms 27250, leaving one robot arm free to receive an additional tool component. A plurality of unique tool components 27560, 27570, 27580 are shown stored on a moving stand 27550 within the procedure room. As discussed above, the type and/or functionality of the tool components 27560, 27570, 27580 can be different. In such instances, the surgical hub 27530 evaluates the available tool components 27560, 27570, 27580 and identifies an appropriate tool component for attachment to the surgical robot. An appropriate tool component is identified based on one or more factors such as, which tool-type and/or function is still needed by the surgical robot and/or which tool component completes a pre-determined pairing of tool components that is associated with the desired surgical procedure, for example. In various instances, the surgical robot comprises a memory storing pre-determined tool component pairings based on a particular surgical procedure and/or a particular patient demographic, for example. In such instances, the surgical robot is able to identify an appropriate tool component for attachment to the surgical robot based on the identity of the tool components already attached.


In other instances, the tool components 27560, 27570, 27580 comprise the same type and/or functionality; however, the tool components 27560, 27570, 27580 comprise at least one other distinguishing characteristic such as, for example, a difference in size, manufacturer, expiration date, and/or number of previous uses. The surgical hub 27530 evaluates a profile of each available tool component 27560, 27570, 27580 and identifies an appropriate tool component based on which characteristics are compatible with the profiles of the other selected and/or attached tool components 27590.


As shown in FIG. 14, each tool component 27560, 27570, 27580 comprises a QR code 27565, 27575, 27585 positioned at any suitable location thereon, wherein each QR code contains a profile of information representative of the tool component to which the QR code is coupled. A user scans and/or reads the QR codes 27565, 27575, 27585 using any appropriate scanning tool 27540. The scanning tool 27540 then communicates the QR code and/or the information contained within the QR code to the surgical hub 27530. In instances where the QR code itself is communicated by the scanning tool 27540 to the surgical hub 27530, a processor of the surgical hub 27530 is configured to decrypt the profile of information contained by the received QR code. While the depicted embodiment comprises QR codes, the tool components can comprise any suitable memory device such as a barcode, an RFID tag, and/or a memory chip, for example.


The surgical hub 27530 is configured to alert a user when a tool component is not acceptable and/or desirable for use during the surgical procedure. Such an alert can be communicated through various forms of feedback, including, for example, haptic, acoustic, and/or visual feedback. In at least one instance, the feedback comprises audio feedback, and the surgical system 27500 can comprise a speaker which emits a sound, such as a beep, for example, when an error is detected. In certain instances, the feedback comprises visual feedback and the tool components can each comprise a light emitting diode (LED), for example, which flashes when an error is detected. In certain instances, the visual feedback can be communicated to a user through an alert presented on a display monitor within a field of vision of the clinician. In various instances, the feedback comprises haptic feedback and a component of the surgical system 27500 can comprise an electric motor comprising an eccentric element which vibrates when an error is detected. The alert can be specific or generic. For example, the alert can specifically state that the QR code on the tool component is unable to be detected, or the alert can specifically state that the QR code comprises information representative of an incompatible and/or defective tool component.


For example, a user attempts to attach a first tool component 27560 to the available robot arm 27590 of the surgical robot. Prior to attaching the first tool component 27560 to the robot arm 27590, the scanning tool 27540 scans the QR code 27565 displayed on the first tool component 27560. The scanning tool 27540 communicates the QR code 27565 and/or the information contained within the QR code 27565 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27565 to a stored list of acceptable tool components associated with the particular surgical procedure and/or a stored list of acceptable tool components compatible with the tool components that are currently attached to the surgical robot. In this instance, the surgical hub 27530 fails to recognize and/or locate the first tool component 27560 within its memory 27535. Thus, the first tool component 27560 is not recommended and/or appropriate for use with the surgical robot. As discussed above, the surgical hub 27530 is configured to alert the clinician of the incompatibility of the first tool component 27560 with the surgical robot and/or the particular surgical procedure. In various instances, the surgical system 27500 can prevent the first tool component 27560 from being attached thereto through a mechanical and/or electrical lockout, for example. Such an attachment lockout prevents a clinician from missing and/or simply ignoring the alert issued by the surgical system 27500. Stated another way, the attachment lockout requires the clinician to take affirmative steps in overriding the error communicated by the surgical system 27500. In such instances, an override can be activated to allow the clinician to override any system lockout and utilize operational functions of the first tool component 27560. In various instances, an override is unavailable in order to prevent a clinician from utilizing the functionality of the first tool component 27560 while the first tool component 27560 is recognized as incompatible for use with the surgical robot.


Similarly, a user attempts to attach a second tool component 27570 to the available robot arm 27590 of the surgical robot. Prior to attaching the second tool component 27570 to the robot arm 27590, the scanning tool 27540 scans the QR code 27575 displayed on the second tool component 27570. The scanning tool 27540 communicates the QR code 27575 and/or the information contained within the QR code 27575 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27575 to a stored list of acceptable tool components associated with the particular surgical procedure and/or a stored list of acceptable tool components compatible with the tool components that are currently attached to the surgical robot. In this instance, the surgical hub 27530 fails to recognize and/or locate the second tool component 27570 within its memory 27535. Thus, the second tool component 27570 is not recommended and/or appropriate for use with the surgical robot. As discussed above, the surgical hub 27530 is configured to alert the clinician of the incompatibility of the second tool component 27570 with the surgical robot and/or the particular surgical procedure. In various instances, the surgical system 27500 can prevent the second tool component 27570 from being attached thereto. Such an attachment lockout prevents a clinician from missing and/or simply ignoring the alert issued by the surgical system 27500. Stated another way, the attachment lockout requires the clinician to take affirmative steps in overriding the error communicated by the surgical system 27500. In such instances, an override can be activated to allow the clinician to override any system lockout and utilize operational functions of the second tool component 27570. In various instances, an override is unavailable in order to prevent a clinician from utilizing the functionality of the second tool component 27570 while the second tool component 27570 is recognized as incompatible for use with the surgical robot.


A user attempts to attach a third tool component 27580 to the available robot arm 27590 of the surgical robot. Prior to attaching the third tool component 27580 to the robot arm 27590, the scanning tool 27540 scans the QR code 27585 displayed on the third tool component 27580. The scanning tool 27540 communicates the QR code 27585 and/or the information contained within the QR code 27585 to the surgical hub 27530. The surgical hub 27530 compares the information contained within the QR code 27585 to a stored list of acceptable tool components associated with the particular surgical procedure and/or a stored list of acceptable tool components compatible with the tool components that are currently attached to the surgical robot. In this instance, the surgical hub 27530 successfully recognizes and/or locates the third tool component 27580 within its memory 27535. The third tool component 27580 is then determined to be appropriate for use with the surgical robot during the particular surgical procedure and/or with the other attached tool components. In various instances, the surgical hub 27530 is configured to alert the clinician of the compatibility of the third tool component 27580 with the surgical robot. In other instances, the surgical system 27500 simply does not prevent the attachment of the third tool component 27580 to the available robot arm 27590.


In various instances, the memory 27535 of the surgical hub 27530 is configured to store the QR codes associated with each tool component used during a particular surgical procedure. The surgical hub 27530 can then analyze the collected information to form observations and/or conclusions regarding factors such as, for example, the efficiency and/or the effectiveness of a particular tool component and/or a plurality of tool components during a surgical procedure. The observations and/or conclusions can then be used by the surgical hub 27530 in selecting and/or recommending which tool components to utilize during future surgical procedures.



FIG. 15 depicts a surgical system 27600 comprising one or more cameras configured to assist a clinician in performing an efficient and/or successful surgical procedure. Similar to the surgical system 27500, the surgical system 27600 comprises an operating table 27610, or any suitable procedure surface. The surgical system 27600 further comprises a surgical hub 27650, and a device tower 27660. Various surgical hubs are described in described in U.S. patent application Ser. No. 16/209,395, titled METHOD OF HUB COMMUNICATION, and filed on Dec. 4, 2018, which is hereby incorporated by reference in its entirety.


The surgical system 27600 further comprises a camera system including one or more cameras 27640 positioned at various locations throughout the procedure room. In the depicted embodiment, two cameras 27640 are positioned in opposing corners of the procedure room; however, the cameras 27640 can be positioned and/or oriented in any suitable location that allows the cameras 27640 to cooperatively capture the procedure room in an unimpeded manner. An artificial intelligence protocol detects and/or identifies various devices, equipment and/or personnel and their corresponding locations and/or orientations within the procedure room.


The cameras 27640 of the camera system are in communication with the surgical hub 27650. Stated another way, the live feeds of the cameras 27640 can be transmitted to the surgical hub 27650 for processing and analysis. Through analysis of the footage collected by the cameras 27640, the surgical hub 27650 is able to maintain a real-time inventory of the devices, equipment, and/or personnel within the procedure room and/or monitor and/or control the interactions between the detected devices, equipment and/or personnel. Using the images and/or data collected by the camera system, the surgical hub 27650 is configured to be informed regarding the identities of the detected devices, alert a clinician regarding compatibility concerns about the detected devices, and/or control various components of the surgical system 27600 based on the presence and/or operation of the detected devices. The surgical hub 27650 is configured to compare any detected devices to determine compatibility between the devices and/or during the particular surgical procedure, facilitate the cooperation of two devices that are intended to work together, and/or facilitate the cooperation of two devices that build off of one another's sensed and/or controlled operations.


As shown in FIG. 15, an anesthesia cart 27670 and a preparation table 27620 are positioned within a procedure room. The preparation table 27620 is configured to support various surgical tools and/or devices in a manner that makes them easily accessible for use during a surgical procedure. Such surgical tools and/or devices can include replaceable staple cartridges of varying sizes or shaft assemblies comprising end effectors of varying sizes and/or functionalities, for example. In the depicted embodiment, the preparation table 27620 supports a first device 27630a, a second device 27630b, and a third device 27630c.


The cameras 27640 are configured to detect identifying information regarding the devices, equipment, and/or personnel located within the procedure room. For example, the cameras 27640 can capture a serial number printed on a visible portion of each device 27630a, 27630b, 27630c, such as on a packaging of the devices, for example. In various instances, the packaging comprises a QR code printed thereon which contains information regarding a device contained therein. The QR code is captured by the cameras 27640 and communicated to the surgical hub 27650 for analysis and identification of the staple cartridge.


Such an identification system can be useful, for example, during a surgical procedure in which a surgical stapling instrument comprising an end effector, wherein a 60 mm staple cartridge is configured to be seated within the end effector. The cameras 27640 within the procedure room are configured to capture the presence of a surgical stapling instrument in the form of a live video feed and/or a still image, for example. The cameras 27640 then communicate the captured image(s) to the surgical hub 27650. The surgical hub 27650 is configured to identify the surgical stapling instrument based on the image(s) received from the cameras 27640. In instances where the surgical hub 27650 is aware of the surgical procedure to be performed, the surgical hub 27650 can alert the clinician as to whether or not the identified surgical stapling instrument is appropriate. For example, knowing that a 45 mm staple cartridge is associated with a particular surgical procedure, the surgical hub 27650 can alert the clinician that the detected surgical stapling instrument is inappropriate, as the end effector of the detected surgical stapling instrument is configured to receive a 60 mm staple cartridge.


The surgical hub 27650 comprises a memory 27655 that stores the technical requirements and/or specifications associated with various devices therein. For example, the memory 27655 of the surgical hub 27650 recognizes that the surgical stapling instrument described above is configured to receive a 60 mm staple cartridge. In various instances, the memory 27655 can also recognize a particular brand of 60 mm staple cartridges compatible with the surgical stapling instrument. In various instances, the cameras 27640 can capture the presence of replaceable staple cartridges in the form of a live video feed and/or a still image, for example. The cameras 27640 then communicate the captured image(s) to the surgical hub 27650. The surgical hub 27650 is configured to identify a characteristic of the replaceable staple cartridge based on the image(s) received from the cameras 27640. Such characteristics include, for example, a size, a brand, and/or a manufacturing lot. As discussed in greater detail herein, the alert can be specific or generic. In instances where the cameras 27640 capture the presence of packaging containing a replaceable 45 mm staple cartridge, the surgical hub 27650 is configured to alert the clinician that an incompatible staple cartridge has been mistakenly stocked within the room. Such an alert can prevent surgical instrument malfunction, injury to the patient, and/or valuable time loss during the surgical procedure, for example.


As discussed above, the camera system is configured to facilitate the surgical hub 27650 in coordinating the devices detected within the procedure room. In various instances, a combination energy device and a smoke evacuation system are detected by the camera system. The combination energy device is configured to apply bipolar energy and monopolar energy to patient tissue. As the camera system and/or the surgical hub 27650 detects an activation of the combination energy device, the presence of the combination energy device at a position near the patient, and/or the presence of smoke in the procedure room, the surgical hub 27650 is configured to direct a generator to enable the smoke evacuation system, for example.


A surgical instrument can utilize a measurable, or otherwise detectable, characteristic of an end effector to confirm a particular stage of the surgical procedure and/or to control various operational parameters of the surgical instrument. Such a characteristic can include, for example, a distance between the jaws of the end effector. A memory of the surgical instrument and/or the surgical hub comprises stored information that associates a particular jaw gap distance with a particular stage of a surgical procedure. For example, when the distance between the jaws is measured between 0.030 inches and 0.500 inches, the surgical instrument and/or the surgical hub confirms that the end effector is delivering bipolar energy to patient tissue. In other instances, when the distance between the jaws is measured between 0.030 inches and 0.500 inches, the surgical instrument and/or the surgical hub activates a generator, thereby initiating the delivery of bipolar energy to the patient tissue. Stated another way, a detection of a characteristic of the surgical instrument and/or contacted patient tissue can be used by the surgical instrument and/or the surgical hub in order to confirm and/or adapt the operation of the surgical instrument.



FIG. 16 comprises a chart depicting various operational parameters and/or specifications of a surgical instrument that correspond to various stages of a surgical procedure. Similar to the surgical instruments described in greater detail herein, the surgical instrument 27000 depicted in FIGS. 17-19 comprises a combination electrosurgical functionality, wherein the surgical instrument includes an end effector comprising a first jaw 27810 and a second jaw 27820. At least one of the first jaw 27810 and the second jaw 27820 are movable with respect to one another, and the end effector is configurable between an open configuration and a closed configuration. The first jaw 27810 comprises a first tissue-supporting and/or tissue-contacting surface 27815, and the second jaw 27820 comprises a second tissue-supporting and/or tissue-contacting surface 27825. The first jaw 27810 and the second jaw 27810 comprise electrodes disposed thereon. The electrosurgical instrument 27000 comprises one or more power generators configured to supply power to the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first jaw and the second jaw is achieved by the electrodes which are configured to deliver energy in a monopolar mode, bipolar mode, and/or a combination mode. Alternating or blended bipolar and monopolar energies are configured to be delivered in the combination mode. In at least one embodiment, the at least one power generator comprises a battery, a rechargeable battery, a disposable battery, and/or combinations thereof.


The end effector 27800 is used to perform various end effector functions during the surgical procedure. At an original time t0, the end effector 27800 is not in contact with the patient tissue T10. Thus, the electrodes of the end effector 27800 are not delivering any energy. At the original time t0, the patient tissue T10 is in a relaxed, uncompressed state. The end effector 27800 is shown in the open configuration. In the open configuration, a distance do spans anywhere from 0.500 inches to 0.700 inches between the first tissue-supporting surface 27815 and the second tissue-supporting surface 27825. Stated another way, the tissue-supporting surfaces 27815, 27825 are separated a maximum distance do of 0.500 inches to 0.700 inches from one another when the end effector 27800 is in the open configuration.


At a first time t1, the jaws 27810, 27820 of the end effector 27800 are brought into contact with the patient tissue Tt1. At least a portion of the patient tissue Tt1 is positioned in between the jaws 27810, 27820 of the end effector 27800 as the end effector 27800 moves from the open configuration toward the closed configuration. As the jaws 27810, 27820 are moved toward the closed configuration, the tissue Tt1 is compressed therebetween. At time t1, the end effector 27800 is configured to deliver bipolar energy to the patient tissue Tt1. The application of bipolar energy allows the end effector 27800 to feather through parenchymal cells, for example. The end effector 27800 is in a partially closed configuration at time T1. A first distance d1 spans anywhere from 0.030 inches to 0.500 inches between the first tissue-supporting surface 27815 and the second tissue-supporting surface 27825 at time t1. Stated another way, the tissue-supporting surfaces 27815, 27825 are separated a maximum first distance d1 of 0.030 inches to 0.500 inches when the end effector is delivering bipolar energy to the patient tissue Tt1 at time t1. A detailed depiction of the jaws 27810, 27820 of the end effector 27800 delivering bipolar energy to the patient tissue Tt1 at a first time t1 is shown in FIG. 17.


At a second time t2, the jaws 27810, 27820 of the end effector 27800 maintain contact with the patient tissue Tt2. At least a portion of the patient tissue Tt2 is positioned in between the jaws 27810, 27820 of the end effector 27800. At time t2, the end effector 27800 is configured to deliver a combination of bipolar and monopolar energies to the patient tissue Tt2. The application of bipolar energy and monopolar energy allows the end effector 27800 to warm the patient tissue Tt2. The end effector 27800 is in a partially closed configuration at time t2; however, the end effector 27800 is closer to a fully-closed configuration at time t2 than the end effector 27800 at time t1. More specifically, a second distance d2 spans anywhere from 0.010 inches to 0.030 inches between the first tissue-supporting surface 27815 and the second tissue-supporting surface 27825 at time t2. Stated another way, the tissue-supporting surfaces 27815, 27825 are separated a maximum second distance d2 of 0.010 inches to 0.030 inches when the end effector is delivering bipolar and monopolar energies to the patient tissue Tt2 at time t2. A detailed depiction of the jaws 27810, 27820 of the end effector 27800 delivering bipolar and monopolar energies to the patient tissue Tt2 at a second time t2 is shown in FIG. 18.


At a third time t3, the jaws 27810, 27820 of the end effector 27800 maintain contact with the patient tissue Tt3. At least a portion of the patient tissue Tt3 is positioned in between the jaws 27810, 27820 of the end effector 27800. At time t3, the end effector 27800 is configured to continue delivering a combination of bipolar and monopolar energies to the patient tissue Tt3. The continued application of bipolar energy and monopolar energy allows the end effector 27800 to seal the patient tissue Tt3. The end effector 27800 is in a partially closed and/or fully-closed configuration at time t3. Stated another way, the end effector 27800 is in the fully-closed configuration and/or closer to the fully-closed configuration at time t3 than the end effector 27800 at time t2. More specifically, a third distance d3 spans anywhere from 0.003 inches to 0.010 inches between the first tissue-supporting surface 27815 and the second tissue-supporting surface 27825 at time t3. Stated another way, the tissue-supporting surfaces 27815, 27825 are separated a maximum third distance d3 of 0.003 inches to 0.100 inches when the end effector is delivering bipolar and monopolar energies to the patient tissue Tt3 at time t3. A detailed depiction of the jaws 27810, 27820 of the end effector 27800 delivering bipolar and monopolar energies to the patient tissue at a third time t3 is also shown in FIG. 18.


At a fourth time t4, the jaws 27810, 27820 of the end effector 27800 maintain contact with the patient tissue Tt4. At least a portion of the patient tissue Tt4 is positioned in between the jaws 27810, 27820 of the end effector 27800 as the end effector 27800. At time t4, the end effector 27800 is configured to deliver monopolar energy to the patient tissue Tt4. The application of monopolar energy allows the end effector 27800 to cut through the patient tissue Tt4. The end effector 27800 is in a partially closed and/or fully-closed configuration at time t4. Stated another way, the end effector 27800 is in the fully-closed configuration and/or closer to the fully-closed configuration at time t4 than the end effector 27800 at time t2. More specifically, a fourth distance d4 spans anywhere from 0.003 inches to 0.010 inches between the first tissue-supporting surface 27815 and the second tissue-supporting surface 27825 at time t4. Stated another way, the tissue-supporting surfaces 27815, 27825 are separated a maximum fourth distance d4 of 0.003 inches to 0.010 inches when the end effector is delivering monopolar energy to the patient tissue Tt4 at time t4. A detailed depiction of the jaws 27810, 27820 of the end effector 27800 delivering monopolar energy to the patient tissue Tt4 at a fourth time t4 is shown in FIG. 19.


The graph 27900 shown in FIG. 20 illustrates the relationships between various operational parameters and/or specifications of the surgical instrument of FIGS. 16-19 with respect to time. The surgical instrument and/or the surgical hub can utilize the depicted relationships to confirm proper functionality of the surgical instrument during the surgical procedure and/or to operate and/or adjust various functionalities of the surgical instrument in response to one or more measured parameters. The graph illustrates (1) the change 27930 in the power (W 27920a of a generator controlling a bipolar modality of the surgical instrument time 27910; (2) the change 27935 in the power (W 27920a of a generator controlling a monopolar modality of the surgical instrument over time 27910; (3) the change 27940 in the distance between the jaws of the end effector 27920b over time 27910; (4) the change 27950 in the force of the jaw motor (F) 27920c over time 27910; and (5) the change 27960 in the velocity of the jaw motor (V) 27920d over time 27910.


At time t0, the electrodes of the end effector are not delivering energy to patient tissue, and the end effector is not yet in contact with patient tissue. The distance 27920b between the jaws of the end effector is at a maximum at time to due to the end effector being in the open configuration. The force to clamp 27950 the jaws is minimal from time t0 to time t1 as the end effector experiences little to no resistance from patient tissue when moving from the open configuration toward the closed configuration. The jaws of the end effector continue to close around patient tissue from time t1 to time t2, over which time period the end effector begins to deliver bipolar energy 27930. The distance between the jaws of the end effector is less at time t1 than at time t0. From time t1 to time t2, the jaw motor velocity 27960 begins to slow down as the force to clamp 27950 the jaws of the end effector begins to increase.


As described with respect to FIGS. 16-29, a combination of monopolar energy 27935 and bipolar energy 27930 is delivered to patient tissue from time t2 to time t3. The jaws of the end effector continue to close around patient tissue during this time period. The distance between the jaws of the end effector is less at time t2 than at time t1. The particular distance between the jaws of the end effector at time t2 indicates to the surgical instrument and/or the surgical hub that a tissue-warming phase of the surgical procedure has been reached and that a combination of monopolar and bipolar energies should be and/or is being delivered to the patient tissue. From time t2 to time t3, the jaw motor velocity continues to decrease and is less than the jaw motor velocity at t1. The force required to clamp the jaws suddenly increases between time t2 and time t3, thereby confirming to the surgical instrument and/or the surgical hub that a combination of monopolar and bipolar energies is being delivered to the patient tissue.


Monopolar and bipolar energies continue to be delivered to the patient tissue, and the patient tissue is sealed from time t3 to time t4. As the end effector reaches its fully-closed configuration at time t3, the force to clamp the jaws also reaches a maximum; however, the force to clamp the jaws remains stable between time t3 and time t4. The power level of the generator delivering monopolar energy increases between time t3 and time t4, while the power level of the generator delivering bipolar energy decreases between time t3 and time t4. Ultimately between time t4 and to, monopolar energy is the only energy being delivered in order to cut the patient tissue. While the patient tissue is being cut, the force to clamp the jaws of the end effector may vary. In instances where the force to clamp the jaws decreases 27952 from its steady-state level maintained between time t3 and t4, an efficient and/or effective tissue cut is recognized by the surgical instrument and/or the surgical hub. In instances where the force to clamp the jaws increases 27954 from its steady-state level maintained between time t3 and t4, an inefficient and/or ineffective tissue cut is recognized by the surgical instrument and/or the surgical hub. In such instances, an error can be communicated to the user.


In various instances, the clamping operation of the jaws of the end effector can be adjusted based on a detected characteristic of contacted patient tissue. In various instances, the detected characteristic comprises tissue thickness and/or tissue type. For example, operations such as a range of gap distances between the jaws during a jaw closure stroke, a load threshold value, a rate of jaw closure, current limits applied during the jaw closure stroke, and/or a wait time between the jaw closure stroke and delivery of energy can be adjusted based on the detected thickness of patient tissue. In various instances, the detected characteristic of the contacted patient tissue can be used to adjust tissue weld parameters. More specifically, the detected characteristic can be used to adjust a multi-frequency sweep of impedance sensing, a balance and/or sequence of energy modality, an energy delivery level, an impedance shutoff level, and/or a wait time between energy level adjustments, for example.


As discussed in greater detail above, a surgical instrument and/or a surgical hub can utilize measured tissue characteristics to control and/or adjust an operational parameter of the surgical instrument. For example, tissue impedance can be detected as patient tissue is positioned between the jaws of an end effector. The detection of tissue impedance alerts the surgical instrument and/or the surgical hub that the jaws of the end effector are in contact with and/or near patient tissue. Referring now to FIG. 21, a graph 28000 illustrates the tissue impedance 28020 calculated overtime 28010. When the jaws of the end effector are not in contact with patient tissue, the tissue impedance 28030a is infinite. As the jaws of the end effector are clamped around the patient tissue positioned therebetween, the patient tissue comes into contact with both jaws. In such instances, the tissue impedance 28030b is measureable. The ability to measure tissue impedance indicates to the surgical instrument and/or the surgical hub that patient tissue is appropriately positioned between the jaws of the end effector. The surgical instrument and/or the surgical hub can then initiate an operation, such as applying bipolar and/or monopolar energies to the patient tissue, for example.


In various instances, the surgical instrument and/or the surgical hub can utilize the magnitude of the detected tissue impedance to determine a phase of the surgical procedure. For example, as shown in FIG. 21, the tissue impedance 28030b is measured at a first level upon initial contact between the jaws of the end effector and the patient tissue. The surgical instrument can then begin to deliver bipolar energy to the patient tissue. Upon the detected tissue impedance 28030b increasing to and/or above a first pre-determined level, the surgical instrument begins to deliver a combination of bipolar and monopolar energies to the patient tissue to warm the patient tissue and/or to form a seal. As the detected tissue impedance 28030b continues to increase, the tissue impedance 28030b reaches and/or exceeds a second pre-determined level, at which point the surgical instrument ceases delivery of the bipolar energy while continuing to deliver monopolar energy to cut the patient tissue. Ultimately, the tissue impedance reaches an infinite level as the patient tissue is no longer positioned between the jaws of the end effector upon completion of the cut. In such instances, the surgical instrument and/or the surgical hub can cease delivery of the monopolar energy.


In various instances, strain can be a metric used to adjust operational parameters of the surgical instrument such as the clamping mechanism, for example. However, contact between the jaws of an end effector and patient tissue is desirable for an accurate estimation of compressive strain. As discussed in greater detail in reference to FIG. 21, a surgical instrument and/or a surgical hub can determine that contact exists between the jaws of the end effector and patient tissue by detected tissue impedance. FIG. 22 illustrates an end effector 28100 comprising a first jaw 28110 and a second jaw 28120, wherein the end effector is in an open configuration. A gap D0A is defined between the first jaw 28110 and the second jaw 28120 in the open configuration. The jaws 28110, 28120 of the end effector 28100 are configured to receive patient tissue therebetween. At an initial time t0, patient tissue TA,0 is positioned in between the first jaw 28110 and the second jaw 28120. Notably, the patient tissue TA,0 is in contact with both the first jaw 28110 and the second jaw 28120. Stated another way, a thickness of the patient tissue TA,0 is greater than or equal to the gap D0A. As at least one of the first jaw 28110 and the second jaw 28120 move toward one another, the patient tissue compresses and the gap D1A defined between the first jaw 28110 and the second jaw 28120 is reduced. The patient tissue TA,1 is shown compressed between the first jaw 28110 and the second jaw 28120 at time t1. The compressive strain can be calculated using the equation shown in FIG. 22. Because the patient tissue TA,0 was in contact with the jaws 28110, 28120 of the end effector 28100 at time t0, the applied strain is calculated accurately.



FIG. 23 illustrates the end effector 28100 of FIG. 22 in the open configuration. A gap D0B is defined between the first jaw 28110 and the second jaw 28120 in the open configuration. The jaws 28110, 28120 of the end effector 28100 are configured to receive patient tissue therebetween. At an initial time t0, patient tissue TB, 0 is positioned in between the first jaw 28110 and the second jaw 28120. However, unlike the patient tissue TA,0, the patient tissue TB, 0 is not in contact with both the first jaw 28110 and the second jaw 28120. Stated another way, a thickness of the patient tissue TB,0 is less than or equal to the gap D0B. As at least one of the first jaw 28110 and the second jaw 28120 move toward one another, the gap D1B defined between the first jaw 28110 and the second jaw 28120 is reduced. The patient tissue TB,1 is shown compressed between and/or in contact with the first jaw 28110 and the second jaw 28120 at time t1. The compressive strain can be calculated using the equation shown in FIG. 23; however, the calculated compressive strain will be overestimated as the patient tissue TB, 0 was not in contact with the jaws 28110, 28120 of the end effector 28100 at time t0.


As described above, calculating compressive strain by utilizing the gap defined between the first jaw and the second jaw of the end effector when the end effector is in the open configuration only leads to an accurate calculation when the patient tissue is in contact with both jaws of the end effector at an initial time t0. Therefore, using the standard gap defined between the first jaw and the second jaw of the end effector when the end effector is in the open configuration is not desirable. Instead, the gap defined between the first jaw and the second jaw of the end effector when patient tissue initially contacts both jaws should be used when calculating compressive strain. An end effector is shown in the open configuration 28150 in FIG. 24. Notably, the patient tissue is not in contact with both end effector jaws 28110, 28120. Thus, no dimensions and/or specifications of the end effector in this configuration 28150 should be used in calculating compressive strain. As at least one of the first jaw 28110 and the second jaw 28120 continue to move toward one another, a gap D0C is defined between the first jaw 28110 and the second jaw 28120. At an initial time t0, patient tissue TC,0 is positioned in between the first jaw 28110 and the second jaw 28120. Notably, the patient tissue TC,0 is now in contact with both the first jaw 28110 and the second jaw 28120. Stated another way, a thickness of the patient tissue TC,0 is greater than or equal to the gap D0C. As at least one of the first jaw 28110 and the second jaw 28120 continue to move toward one another, the patient tissue compresses and the gap D1C defined between the first jaw 28110 and the second jaw 28120 is reduced. The patient tissue TC,1 is shown compressed between the first jaw 28110 and the second jaw 28120 at time t1. The compressive strain can be calculated using the equation shown in FIG. 24. As the patient tissue TC,0 was in contact with the jaws 28110, 28120 of the end effector 28100 at time t0 and the gap D0C defined between the first jaw 28110 and the second jaw 28120 at the point of initial tissue contact was realized, the applied strain is calculated accurately.


A motor control program of a combination electrosurgical instrument can utilize detected tissue stability as an input. The surgical instrument can detect compression rate and/or can measure the creep of the patient tissue compressed between end effector jaws to determine tissue stability. The control program can be modified to adjust wait times between end effector functions, define when to make an additional tissue stability determination, and/or adjust the rate of jaw clamping based on the determined tissue stability.


As shown in FIG. 25, an end effector 28250 comprises a first jaw 28254 and a second jaw 28256, wherein at least one of the first jaw 28254 and the second jaw 28256 is configured to move toward one another, wherein patient tissue T is configured to be positioned therebetween. FIG. 25 provides a schematic representation of the various positions of the first jaw 28254 and the second jaw 28256 with respect to patient tissue T during a jaw clamping stroke. The gap 28220a defined between the jaws of the end effector and the motor current 28220b required to clamp the jaws of the end effector vary over time 28210 due, at least in part, to tissue stability measurement. An initial slope S0 corresponds to the jaw gap 28230 change between when the jaws are fully open to the point at which an initial contact is made between the jaws and the patient tissue T. The resulting motor current 28240 remains low while no tissue contact is present up until the end effector jaws contact the patient tissue T. The surgical system is configured to monitor the current 28220b over time 28210 to identify when the current slop flattens—i.e., when the tissue stabilizes. When the current slope flattens, the surgical system is configured to take the difference between the peak current at the time at which the end effector made initial contact with the tissue and the point at which the current flattens out. Stated another way, the jaws are able to continue clamping the tissue positioned therebetween when a wait time expires, wherein the wait time is defined by the time it takes for the tissue compression to stabilize. The creep of the motor current drives the next stage of motor current and velocity to the desired jaw gap, or level of tissue compression. The measurement of creep is repeated to drive next stages of motor current and velocity until the final jaw cap, or level of tissue compression, is achieved.


In addition to sensing parameters associated with the jaw clamping stroke, the surgical system can monitor additional functions to adjust and/or refine operational parameters of the surgical instrument. For example, the surgical system can monitor an orientation of the surgical instrument with respect to the user and/or the patient, the impedance of tissue positioned between the jaws of the end effector to determine tissue position and/or tissue composition, the level of grounding to the patient, and/or leakage current. Leakage current can be monitored to determine secondary leakage from other devices and/or to create parasitic generated energy outputs through capacitive coupling.


In various instances, a surgical instrument is configured to modify instrument and/or generator settings and/or control programs using local unsupervised machine learning. In such instances, the surgical instrument may update and/or adjust local functional behaviors based on a summarization and/or aggregation of data from various surgical procedures performed with the same surgical instrument. Such functional behaviors can be adjusted based on previous uses and/or preferences of a particular user and/or hospital. In such instances, a control program of the surgical instrument recognizes the same user and automatically modifies a default program with the preferences of the identified user. The surgical instrument is able to be updated by receiving regional and/or global updates and/or improvements of digitally enabled control programs and/or displayed information through interaction with a non-local server.


In various instances, a surgical instrument is configured to modify instrument and/or generator settings and/or control programs using global aggregation of instrument operational parameters and/or surgical procedure outcomes. A global surgical system is configured to collect data regarding related and/or contributing instrument parameters such as, for example, outcomes, complications, co-morbities, cost of surgical instrument, instrument utilization, procedure duration, procedure data, and/or patient data. The global surgical system is further configured to collect data regarding generator operation data such as, for example, impedance curves, power levels, energy modalities, event annotation, and/or adverse incidents. The global surgical system is further configured to collect data regarding intelligent device operation parameters such as, for example, clamp time, tissue pressure, wait times, number of uses, time of the patient on the operating table, battery levels, motor current, and/or actuation strokes. The global surgical system is configured to adapt default control programs and/or update existing control programs based on the detected operational parameters. In this way, each surgical instrument within the global surgical system is able to perform the most effective and/or efficient surgical procedures as possible.



FIG. 26 illustrates a network 28300 of surgical instruments 28310 that communicate with a cloud-based storage medium 28320. The cloud-based storage medium 28320 is configured to receive data relating to operational parameters from the surgical instrument 28310 that was collected over numerous surgical procedures. The data is used by the cloud-based storage medium 28320 to optimize control programs to achieve efficient and/or desirable results. The cloud-based storage medium 28320 is further configured to analyze all of the collected data in random batches 28340. The results of the analysis from the random batches 28340 can further be used in re-defining a control program. For example, the data collected within Batch A might be representative of significantly different wear profiles. A conclusion might then be able to be made from this data that suggests that instruments that adjust power rather than clamp current degrade faster, for example. The cloud-based storage medium 28320 is configured to communicate this finding and/or conclusion with the surgical instrument. The surgical instrument could then maximize the life of the instrument by adjusting clamp current instead of power and/or the surgical system could alert a clinician of this finding.



FIG. 26 illustrates a network 28300 of surgical instruments 28310 that communicate with a cloud-based storage medium 28320. The cloud-based storage medium 28320 is configured to receive data relating to operational parameters from the surgical instrument 28310 that was collected over numerous surgical procedures. The data is used by the cloud-based storage medium 28320 to optimize control programs to achieve efficient and/or desirable results. The cloud-based storage medium 28320 is further configured to analyze all of the collected data in random batches 28340. The results of the analysis from the random batches 28340 can further be used in re-defining a control program. For example, the data collected within Batch A might be representative of significantly different wear profiles. A conclusion might then be able to be made from this data that suggests that instruments that adjust power rather than clamp current degrade faster, for example. The cloud-based storage medium 28320 is configured to communicate this finding and/or conclusion with the surgical instrument. The surgical instrument could then maximize the life of the instrument by adjusting clamp current instead of power and/or the surgical system could alert a clinician of this finding.


The information gathered from the network 28300 of surgical instruments 28310 by the cloud-based storage medium 28320 is presented in graphical form in FIGS. 27 and 28. More specifically, a relationship between the gap 28430 defined between the jaws of the end effector from the point of initial tissue contact changes over time during a surgical procedure as a function of jaw motor clamp current 28440 is shown in FIG. 27. The number of times that a particular end effector has reached a fully-clamped state during the jaw clamping stroke impacts the amount of force needed to clamp the same thickness tissue. For example, the jaws of the end effector are able to clamp to a greater degree with less current for instruments fully-clamped 1-10 times 28430a than instruments fully-clamped 10-15 times 28430b. Furthermore, the jaws of the end effector are able to clamp to a greater degree with less current for instruments fully-clamped 10-15 times 28430b than instruments fully-clamped 16-20 times 28430c. Ultimately, more force, and therefore current, is needed to clamp the same thickness tissue to the same fully-clamped gap as the surgical instrument continues to be used. A control program can be modified using the collected information from the surgical instruments 28310 and the cloud-based storage medium 28320 to perform a more efficient and/or time-effective jaw clamping stroke.


The current required to clamp the same thickness tissue by achieving the same fully-clamped gap between the jaws of the end effector is used to set a motor current threshold for a generator. As shown in FIG. 28, the motor current threshold is lower for an end effector that has reached a fully-clamped state less than ten times, as less current is required to achieve the fully-clamped state. Thus, a control program sets a lower threshold generator power of newer end effectors than the threshold generator power of older end effectors. If the same generator power was used in an older end effector than what is used in a newer end effector, the tissue may not be sufficiently clamped and/or compressed between the jaws of the end effector. If the same generator power was used in a newer end effector that what is used in an older end effector, the tissue and/or the instrument may be damaged as the tissue may be over-compressed by the jaws of the end effector.


In various instances, a surgical system comprises modular components. For example, the surgical system comprises a surgical robot comprising robot arms, wherein the robot arms are configured to receive tools of different capabilities thereon. A control program of the surgical system is modified based on the modular attachments, such as the type of tools connected to the surgical robot arms, for example. In other instances, the surgical system comprises a handheld surgical instrument configured to receive different and/or replaceable end effectors thereon. Prior to performing an intended surgical function, the handheld surgical instrument is configured to identify the attached end effector and modify a control program based on the determined identity of the end effector.


The surgical system is configured to identify the attached modular component using adaptive and/or intelligent interrogation techniques. In various instances, the surgical system uses a combination of electrical interrogations in combination with a mechanical actuation interrogation to determine the capacities and/or the capabilities of an attached component. Responses to interrogations can be recorded and/or compared to information stored within a memory of the surgical system to establish baseline operational parameters associated with the identified modular attachment. In various instances, the established baseline parameters are stored within the memory of the surgical system to be used when the same or a similar modular attachment is identified in the future.


In various instances, an electrical interrogation signal is sent from a handle of a surgical instrument to an attached modular component, wherein the electrical interrogation signal is sent in an effort to determine an identity, an operational parameter, and/or a status of the attached modular component. The attached modular component is configured to send a response signal with the identifying information. In various instances, no response is received to the interrogation signal and/or the response signal comprises unidentifiable information. In such instances, a surgical instrument can perform a default function in order to assess the capabilities of the attached modular component. The default function is defined by conservative operational parameters. Stated another way, the default operational parameters used during a performance of the default function are defined to a particular level so as to avoid damage to the surgical instrument and/or the attached modular component, injury to the patient, and/or injury to the user. The surgical instrument is configured to utilize results of the default function in order to set an operating program specific to the attached modular component.


For example, a surgical instrument can perform a tissue cutting stroke, wherein a cutting member traverses through an attached end effector from a proximal position toward a distal position. In instances where the surgical instrument is unable to identify the attached end effector, the surgical instrument is configured to perform the tissue cutting stroke using the default operational parameters. Utilizing a position of the cutting member within the end effector at the end of the tissue cutting stroke, the surgical instrument can determine a length of the tissue cutting stroke associated and/or appropriate for completion with the attached end effector. The surgical instrument is configured to record the distal-most position of the cutting member in order to set additional operational parameters associated with the attached end effector. Such additional operational parameters include, for example, a speed of the cutting element during the tissue cutting stroke and/or the length of the end effector.


The default function can also be used to determine a current state and/or status of the attached modular component. For example, the default function can be performed to determine if the attached end effector is articulated and/or to what degree the attached end effector is articulated. The surgical instrument is then configured to adjust a control program accordingly. A length of the cutting stroke changes as the end effector is articulated across a range of articulation angles. Stated another way, the length of the cutting stroke is different when the end effector is in articulated state as compared to when the end effector is in an unarticulated state. The surgical instrument is configured to update a control program to perform cutting strokes spanning the length associated with the last detected full stroke. The surgical instrument is further configured to use the length of the last completed cutting stroke to determine if the full length of the cutting stroke is accomplished and/or completed with the current control program when the end effector is unarticulated compared to when the end effector is articulated.


In various instances, the surgical system can perform an intelligent assessment of a characteristic of the attached component. Such a characteristic includes, for example, tissue pad wear, degree of attachment usage, and/or operating condition of the attachment. Stated another way, the surgical system is configured to assess the functionality and/or condition of the attached component. Upon detecting the characteristic of the attached modular component, a control program used to operate the surgical system is adjusted accordingly.


A surgical instrument comprises one or more tissue pads positioned on the jaws of an end effector. It is generally well known that tissue pads tend to degrade and wear over time due to frictional engagement with a blade when no tissue is present therebetween, for example. The surgical instrument is configured to determine a degree of tissue pad wear by analyzing the remaining tissue pad thickness and/or stiffness, for example. Utilizing the determined status of the tissue pad(s), the surgical instrument adjusts a control program accordingly. For example, the control program can alter an applied pressure and/or a power level of the surgical instrument based on the determined status of the tissue pad(s). In various instances, the power level of the surgical instrument can be automatically reduced by a processor of the surgical instrument in response to a detected thickness of the tissue pad(s) that is less than a threshold thickness.


A surgical instrument comprises a combination electrosurgical functionality, wherein the surgical instrument includes an end effector comprising a first jaw and a second jaw. At least one of the first jaw and the second jaw is configured to move toward one another to transition the end effector between an open configuration and a closed configuration. The first jaw and the second jaw comprise electrodes disposed thereon. The electrosurgical instrument comprises one or more power generators configured to supply power to the electrodes to energize the electrodes. The surgical instrument can assess a degree of charring and/or tissue contamination on one or more of the end effector jaws by measuring an impedance when the end effector is in the closed configuration without any patient tissue positioned therebetween. A pre-determined impedance can be stored within a memory of the surgical instrument, wherein if the impedance exceeds the pre-determined threshold, the jaws comprise an undesirable level of char and/or tissue contamination thereon. As discussed in greater detail herein, an alert can be issued to a user upon detection of an undesirable level of char. In various instances, an operational parameter can automatically be adjusted by a processor of the surgical instrument and/or a surgical hub in response to the detected closed jaw impedance. Such operational parameters include power level, applied pressure level, and/or advanced tissue cutting parameters, for example.


As shown in FIG. 29, a graphical representation 28500 illustrates a relationship 28530 between the measured impedance 28250 and a number of activation cycles 28510. A baseline impedance is measured and recorded within the memory prior to any energy activation (n=0 activations). As discussed above, the impedance is measured when the end effector of the surgical instrument is in the closed configuration and no patient tissue is positioned therebetween. The surgical instrument and/or a surgical hub prompts a user to transition the end effector into the closed configuration for the closed jaw impedance to be measured. Such prompts can be delivered at pre-defined activation intervals, such as n=5, 10, 15, etc., for example. As char and/or tissue contamination accumulate on the jaws of the end effector, impedance increases. At and/or above a first pre-determined level 28540, the surgical instrument and/or the surgical hub is configured to alert the user of such char accumulation and advise the user to clean the end effector. At and/or above a second pre-determined level 28550, the surgical instrument and/or the surgical hub can prevent the user from using various operational functions of the surgical instrument until the end effector is cleaned. The operational lockout can be removed upon cleaning of the end effector, assuming that the measured impedance has reduced to an acceptable level.


As discussed above, the surgical hub and/or the surgical instrument is configured to alert a user when a pre-determined impedance is met and/or exceeded. Such an alert can be communicated through various forms of feedback, including, for example, haptic, acoustic, and/or visual feedback. In at least one instance, the feedback comprises audio feedback, and the surgical instrument can comprise a speaker which emits a sound, such as a beep, for example, when an error is detected. In certain instances, the feedback comprises visual feedback and the surgical instrument can comprise a light emitting diode (LED), for example, which flashes when an error is detected. In certain instances, the visual feedback can be communicated to a user through an alert presented on a display monitor within a field of vision of the user. In various instances, the feedback comprises haptic feedback, and the surgical instrument can comprise an electric motor comprising an eccentric element which vibrates when an error is detected. The alert can be specific or generic. For example, the alert can specifically state that the closed jaw impedance exceeded a pre-determined level, or the alert can specifically state the measured impedance.


In various instances, the surgical instrument and/or the surgical hub is configured to detect parameters such as integral shaft stretch, damage, and/or tolerance stack up to compensate for functional parameter operations of motorized actuators. The surgical instrument is configured to alert a user when a detected parameter of the attached end effector and/or shaft is close to being and/or is outside of desirable operating ranges specific to the attached component. In addition to alerting the user, in various instances, operation of the surgical instrument is prevented when it has been detected that the surgical instrument is incapable of operating within a pre-defined envelope of adjustment. The surgical instrument and/or the surgical hub comprises an override, wherein the user is allowed to override the lockout in certain pre-defined conditions. Such pre-defined conditions include an emergency, the surgical instrument is currently in use during a surgical procedure where the inability to use the surgical instrument would result in harm to the patient, and a single use override to allow for one additional use of the surgical instrument at the discretion of the user. In various instances, an override is also available to allow a user to perform a secondary end effector function that is unrelated to a primary end effector function. For example, if a surgical instrument prevents the jaws of the end effector from being articulated, the user may activate the override to allow the surgical instrument to articulate the end effector.


A surgical system can adapt a control program configured to operate a surgical instrument in response to a detected instrument actuation parameter, an energy generator parameter, and/or a user input. A determined status of the surgical instrument is used in combination with the user input to adapt the control program. The determined status of the surgical instrument can include whether an end effector is in its open configuration, whether an end effector is in its closed configuration and/or whether a tissue impedance is detectable, for example. The determined status of the surgical instrument can include more than one detected characteristic. For example, the determined status of the surgical instrument can be assessed using a combination of two or more measures, a series of ordered operations, and/or interpretations of a familiar user input based on its situational usage. The control program is configured to adjust various functions of the surgical instrument such as the power level, an incremental step up or step down of power, and/or various motor control parameters, for example.


A surgical system comprises a surgical instrument including a combination electrosurgical functionality, wherein the surgical instrument includes an end effector comprising a first jaw and a second jaw with electrodes disposed thereon. The electrosurgical instrument comprises one or more power generators configured to supply power to the electrodes to energize the electrodes. More specifically, energy delivery to patient tissue supported between the first jaw and the second jaw is achieved by the electrodes which are configured to deliver energy in a monopolar mode, bipolar mode, and/or a combination mode with alternating or blended bipolar and monopolar energies. As described in greater detail herein, the surgical system can adapt a level of energy power activation of the one or more generators based on various monitored parameters of the surgical instrument.


The surgical system is configured to adapt energy power activation based on instrument monitored parameters. In various instances, the surgical system can monitor the sequence in which various surgical instrument functions are activated. The surgical system can then automatically adjust various operating parameters based on the activation of surgical instrument functions. For example, the surgical system can monitor the activation of rotation and/or articulation controls and prevent the ability for the surgical instrument to deliver energy to patient tissue while such secondary non-clamp controls are in use.


In various instances, the surgical system can adapt instrument power levels to compensate for detected operating parameters such as inadequate battery and/or motor drive power levels, for example. The detection of inadequate battery and/or motor drive power levels can indicate to the surgical system that clamp strength of the end effector is impacted and/or impaired, thereby resulting in undesirable control over the patient tissue positioned therebetween, for example.


The surgical system can record operating parameters of the surgical instrument during periods of use that are associated with a particular intended function. The surgical system can then use the recorded operating parameters to adapt energy power levels and/or surgical instrument modes, for example, when the surgical system identifies that the particular intended function is being performed. Stated another way, the surgical system can automatically adjust energy power levels and/or surgical instrument modes with stored preferred operating parameters when a desired function of the surgical instrument is identified and/or the surgical instrument can adjust energy power levels and/or surgical instrument modes in an effort to support and compliment the desired function. For example, a surgical system can supplement a detected lateral loading on the shaft with application of monopolar power, as detected lateral loading on the shaft often results from abrasive dissection with the end effector in its closed configuration. The surgical system decided to apply monopolar power, as the surgical system is aware, through previous procedures and/or through information stored in the memory, that monopolar power results in improved dissection. In various instances, the surgical system is configured to apply the monopolar power proportionate to increases in the detected lateral load.


The surgical system can adapt a control program configured to operate a surgical instrument in response to a detected end effector parameter. As shown in FIG. 30, a surgical instrument can utilize measured tissue conductance to automatically modify a gap clamp control program. Tissue conductance is measured at two frequencies such as 50 kHz and 5 MHz, for example. Low frequency conductance (GE) is driven by extracellular fluid, whereas high frequency conductance (GI) is driven by intracellular fluid. The intracellular fluid levels change through as cells become damaged, for example. The end effector is configurable in an open configuration and a closed configuration. Thus, as the end effector is motivated from its open configuration toward its closed configuration, the jaws of the end effector compress the tissue positioned therebetween. During the tissue compression, changes in the conductance between the two frequencies can be detected and/or recorded. The surgical system is configured to adapt the control program to control end effector clamp compression based on the ratio of low frequency conductance (GE) to high frequency conductance (GI). The surgical system adapts the control program until a discrete pre-determined point and/or until an inflection point is approached, whereby the pre-determined point and/or the inflection point indicate that cellular damage could be near.


More specifically, FIG. 30 is a graphical representation 29000 of relationships between measured tissue conductance 29100, a ratio of low frequency conductance to high frequency conductance 29200, dimension of jaw aperture 29300, and jaw motor force 29400 over the duration 29010 of a jaw clamp stroke. At the beginning of the jaw clamp stroke, measured tissue conductance is at its lowest as the jaws of the end effector initially come into contact with patient tissue, and the jaw aperture 29300 is at its largest value when the end effector is in its open configuration. Due, at least in part, to the small amount of resistance provided against the jaws from the tissue positioned therebetween, the jaw motor force is low at the beginning of the jaw clamp stroke. Prior to compression, but after contact between the patient tissue and the jaws of the end effector, the low frequency conductance 29110 increases indicating the presence of extracellular fluid within the captured tissue. Similarly, prior to compression, but after contact between the patient tissue and the jaws of the end effector, the high energy conductance 29120 increases indicating the presence of intracellular fluid.


As the end effector begins to move toward its closed configuration, the jaws of the end effector begin to clamp the tissue positioned therebetween, and thus, the jaw aperture 29300 continues to decrease. The tissue begins to be compressed by the jaws; however until fluid begins to expel from the compressed tissue, the patient tissue is not desirable to be sealed by the surgical instrument. The jaw motor force continues to increase during the jaw clamp stroke, as increased resistance is expelled against the end effector jaws by the captured tissue.


After the initial expulsion of extracellular fluid causes a decrease in the low frequency conductance (GE) 29110, the low frequency conductance (GE) 29110 remains relatively constant during the jaw clamp stroke. The high frequency conductance (GI) 29120 remains relatively constant during the jaw clamp stroke until after the patient tissue is sealed. As the tissue continues to be compressed after the seal is completed, intracellular tissue damage occurs and the intracellular fluid is expelled. At such point, the high frequency conductance 29120 decreases, causing a spike in the ratio 29210 of low frequency conductance to high frequency conductance. A tissue damage threshold 29220 is predetermined to alert a user and/or automatically prompt the surgical system to modify operational parameters when the spike in the ratio 29210 of low frequency conductance to high frequency conductance reaches and/or exceeds the tissue damage threshold 29220. At such point, the surgical system is configured to modify the control program to stop motivating the jaws of the end effector toward the closed configuration of the end effector and/or begin motivating the jaws of the end effector back toward the open configuration of the end effector. In various instances, the surgical system is configured to modify the control program to reduce the jaw clamp force. Such adaptation of the control program prevents additional tissue damage.


A surgical system is configured to modify a control program based on cooperative dual inputs. More specifically, a surgical system can vary a motor actuation rate based on a user input and pre-defined settings. For example, the more force that a user applies to a handle control, the faster the motor is actuated to trigger the system. In various instances, a handle control can be used to communicate different commands to the surgical system depending on its situational usage. More specifically, the surgical system can monitor and/or record a particular user input. The particular user input can be analyzed for its length, duration, and/or any suitable characteristic that can be used to distinguish the input. For example, a handle of a surgical instrument can include a trigger, wherein the trigger is configured to control shaft rotation. In various instances, faster actuation of the trigger corresponds to an increase in the rate at which the shaft is rotated; however, the maximum force (current) threshold of the motor remains constant. In other instances, faster actuation of the triggers corresponds to an increase in force being applied while a rotation speed threshold remains the same. Such control can be further differentiated by the shaft rotation speed being increased based on the duration that a user actuates the trigger while the force is based on the rate at which the trigger is actuated.


In various instances, motor actuation control is based on a combination of a pre-defined setting and a detection of an instrument operating parameter and/or a user control parameter. FIG. 31 is a graphical representation 29500 of the relationship between actual jaw closure speed 29520 and a trigger speed indicated by a user input 29510. The jaw closure speed 29520 resulting solely from a corresponding user input 29510 is represented by a first line 29530. As the user input trigger speed 29510 increases, the jaw closure speed 29520 also increases. Such a relationship 29530 is determined without the consideration of any additional parameters. The jaw closure speed 29520 resulting from a corresponding user input 29510 and a determination of thick tissue positioned between the jaws of the end effector is represented by a second line 29540. As the user input trigger speed 29510 increases, the jaw closure speed 29520 also increases; however, the jaw closure speed 29520 is less than if the user input trigger speed was being considered alone. The additional consideration of tissue thickness slows the jaw closure speed down in order to prevent damage to the patient tissue and/or the surgical instrument, for example.


A surgical system comprises numerous components. For example, the surgical system comprises numerous handheld surgical instruments, a surgical hub, and a surgical robot. In various instances, each component of the surgical system is in communication with the other components and can issue commands and/or alter a control program based on at least one monitored parameter and/or a user input. The surgical system comprises means to determine which system is in charge and which system makes portions of operational decisions. This designation can be changed based on situational awareness, the occurrence of pre-determined events, and/or the exceedance of thresholds. In various instances, a command protocol can be established within the surgical system to indicate a type of command each component is able to issue and/or to which components within the surgical system the issuing component can direct a command.


The command protocol can use pre-defined thresholds to determine when a control hand-off is warranted. For example, the surgical system comprises a generator and a handheld surgical instrument including various controls therein. At the beginning of a surgical procedure, the generator is initially in control and adjusts the power based on detected impedance. The generator uses the detected impedance and/or the current power level to command a pressure control within a handle of the surgical instrument to follow specific pressure needs. At a point during the surgical procedure, a lower impedance threshold is exceeded indicative that the generator algorithm has detected an electrical short. The generator passes control to the pressure control within the handle by instructing the pressure control to determine if tissue is still positioned between the jaws of the end effector. The pressure control is then able to determine an appropriate tissue compression and can communicate what power level and/or energy modality is most appropriate for the detected tissue.


The control protocol can be determined based on a consensus reached by a plurality of the components within the surgical system. For example, three components within the surgical system detect a first value relating to a monitored parameter while two components within the surgical system detect a second value relating to the same monitored parameter, wherein the first value and the second value are different. The group of three components comprise more components than the group of two components, and thus, the first value of the monitored parameter controls. Each component within the surgical system can be assigned a positioned within a hierarchy. The hierarchy can be established based on reliability of the particular component and/or the capabilities of the particular component. A first component detects a first value relating to a monitored parameter, and a second component detects a second value relating to the same monitored parameter, wherein the first value is different than the second value. The second component “outranks” the first component within the hierarchy of the surgical system, and thus, the second value of the monitored parameter detected by the second component controls.


Various aspects of the subject matter described herein are set out in the following examples.


Example Set 1

Example 1—A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to run a control program to operate the surgical system. The surgical instrument comprises the end effector that includes a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved with respect to one another between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical system, detect at least one user input, and modify the control program in response to the detected first parameter and the at least one user input.


Example 2—The surgical system of Example 1, wherein the control program is configured to control a power level of the generator.


Example 3—The surgical system of Examples 1 or 2, wherein the control program is configured to control a motor, wherein the motor is configured to cause the end effector to move between the open configuration and the closed configuration.


Example 4—The surgical system of Example 3, wherein the control program is configured to control the motor through motor control parameters, and wherein the control program is configured to adjust the motor control parameters in response to the detected first parameter and the detected user input.


Example 5—The surgical system of Examples 1, 2, 3, or 4, wherein the first parameter comprises an instrument actuation parameter.


Example 6—The surgical system of Examples 1, 2, 3, 4, or 5, wherein the first parameter comprises a generator operating parameter.


Example 7—The surgical system of Examples 1, 2, 3, 4, 5, or 6, wherein the first parameter comprises a status of the end effector.


Example 8—The surgical system of Examples 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the end effector is in the open configuration or the closed configuration.


Example 9—The surgical system of Examples 1, 2, 3, 4, 5, 6, or 7, wherein the first parameter indicates whether the tissue is positioned between the first jaw and the second jaw.


Example 10—The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the surgical instrument is in operational control, and wherein the generator is a slave control system by default.


Example 11—The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the control program is configured to cause the generator to be in operational control and the surgical instrument to be the slave control system in response to the detected first parameter and the detected user input.


Example 12—The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, wherein the first parameter comprises a combination of two measures.


Example 13—The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12, wherein the surgical system further comprises a trigger configured to receive the user input, wherein the processor is configured to interpret multiple user inputs received by the trigger, wherein each user input comprises a different meaning based on situational usage.


Example 14—A surgical system comprising a surgical instrument, a generator configured to supply power to the surgical instrument, and a processor configured to run a control program to operate the surgical system. The processor is configured to detect a status of the surgical instrument, detect at least one user input, and adapt the control program in response to the detected status of the surgical instrument and the at least one user input.


Example 15—The surgical system of Example 14, wherein the surgical instrument comprises an end effector, wherein the end effector is configurable in an open configuration and a closed configuration, and wherein the status of the surgical instrument corresponds to whether the end effector is in the open configuration or the closed configuration.


Example 16—The surgical system of Examples 14 or 15, wherein the surgical instrument comprises an end effector, wherein the end effector is configurable in an open configuration and a closed configuration, and wherein the status of the surgical instrument corresponds to whether patient tissue is positioned between the first jaw and the second jaw.


Example 17—The surgical system of Examples 14, 15, or 16, wherein the surgical system further comprises an input member configured to receive the user input, wherein the processor is configured to interpret multiple user inputs received by the input member, wherein each received user input comprises a different meaning based on situational usage of the surgical system.


Example 18—A surgical system comprising a surgical instrument, a generator configured to supply power to an end effector, and a processor configured to run a control program to operate the surgical system. The surgical instrument comprises the end effector which includes a first jaw and a second jaw. At least one of the first jaw and the second jaw is moved with respect to one another between an open position and a closed position. Tissue is configured to be positioned between the first jaw and the second jaw. The processor is configured to detect a first parameter of the surgical instrument, detect a second parameter of the generator, detect at least one user input, and modify the control program in response to the detected first parameter, the detected second parameter, and the at least one user input.


Example 19—The surgical system of Example 18, wherein the first parameter of the surgical instrument corresponds to whether the end effector is in the open configuration or the closed configuration and whether patient tissue is positioned between the first jaw and the second jaw.


Example 20—The surgical system of Examples 18 or 19, wherein the surgical instrument further comprises an input member configured to receive the user input, wherein the processor is configured to interpret multiple user inputs received by the input member, wherein each received user input comprises a different meaning based on situational usage of the surgical instrument within the surgical system.


Example Set 2

Example 1—A surgical instrument comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The shaft assembly comprises an end effector. The memory is configured to store program instructions which, when executed from the memory cause the processor to send an electrical interrogation signal to the attached shaft assembly, receive a response signal from the attached shaft assembly, cause a default function to be performed when a response signal is not received by the attached shaft assembly, determine an identifying characteristic of the attached shaft assembly as a result of the performance of the default function, and modify a control program based on the identifying characteristic of the attached shaft assembly.


Example 2—The surgical instrument of Example 1, wherein the identifying characteristic comprises remaining capacity of the attached shaft assembly.


Example 3—The surgical instrument of Examples 1 or 2, wherein the identifying characteristic comprises a performance level of the attached shaft assembly.


Example 4—The surgical instrument of Examples 1, 2, or 3, wherein the identifying characteristic is different for attached shaft assemblies of different capabilities.


Example 5—The surgical instrument of Example 1, 2, 3, or 4, wherein the memory comprises a lookup table comprising operating parameters corresponding to particular shaft assemblies, wherein the processor utilizes the received response signal to identify the attached shaft assembly within the lookup table, and wherein the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.


Example 6—The surgical instrument of Examples 1, 2, 3, 4, or 5, wherein the memory further comprises program instructions which, when executed, cause the processor to store the modified control program in the memory.


Example 7—A surgical instrument comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is replaceably connected to the housing. The shaft assembly comprises an end effector. The memory is configured to store program instructions which, when executed from the memory cause the processor to send a variable interrogative communication to the attached shaft assembly, determine a capability of the attached shaft assembly based on a response to the variable interrogative communication, and modify a control program based on the determined capability of the attached shaft assembly.


Example 8—The surgical instrument of Example 7, wherein the variable interrogative communication comprises an electrical interrogation signal and a physical actuation of the surgical instrument.


Example 9—The surgical instrument of Examples 7 or 8, wherein the physical actuation of the surgical instrument is monitored to determine a functional capability of the attached shaft assembly.


Example 10—The surgical instrument of Examples 7, 8, or 9, wherein the determined capability relates to a remaining capacity of the shaft assembly.


Example 11—The surgical instrument of Examples 7, 8, 9, or 10, wherein the determined capability relates to a performance level of the shaft assembly.


Example 12—The surgical instrument of Examples 7, 8, 9, 10, or 11, wherein the capability to be determined differs based on the connected shaft assembly.


Example 13—The surgical instrument of Examples 7, 8, 9, 10, 11, or 12, wherein the memory further comprises further comprises program instructions which, when executed, cause the processor to store the modified control program and the determined shaft assembly capability in the memory.


Example 14—A surgical instrument comprising a housing, a shaft assembly, a processor, and a memory. The shaft assembly is interchangeably coupled to the housing. The shaft assembly comprises an end effector. The memory is configured to store program instructions which, when executed from the memory, cause the processor to send an interrogation signal to the shaft assembly coupled to the housing, receive a response signal from the shaft assembly coupled to the housing, cause a default end effector function to be performed when a response signal is not recognized, determine an identifying characteristic of the shaft assembly coupled to the housing as a result of the performance of the default end effector function, and modify a control program based on the identifying characteristic of the shaft assembly coupled to the housing.


Example 15—The surgical instrument of Example 14, wherein the response signal is not recognized by the processor because the response signal is not received by the processor.


Example 16—The surgical instrument of Examples 14 or 15, wherein the identifying characteristic comprises remaining capacity of the shaft assembly coupled to the housing.


Example 17—The surgical instrument of Examples 14, 15, or 16, wherein the identifying characteristic comprises a performance level of the shaft assembly coupled to the housing.


Example 18—The surgical instrument of Examples 14, 15, 16, or 17, wherein the determined characteristic can differ based on the shaft assembly interchangeably coupled to the housing.


Example 19—The surgical instrument of Examples 14, 15, 16, 17, or 18, wherein the memory comprises a lookup table comprising operating parameters corresponding to particular shaft assemblies, wherein the processor utilizes the received response signal to identify the shaft assembly coupled to the housing within the lookup table, and wherein the control program is modified using the stored operating parameters corresponding to the identified shaft assembly.


Example 20—The surgical instrument of Examples 14, 15, 16, 17, 18, or 19, wherein the memory further comprises program instructions which, when executed, cause the processor to store the modified control program in the memory.


Example Set 3

Example 1—A surgical system comprising a surgical hub, a surgical instrument, a generator configured to energize an end effector; and a smoke evacuation system configured to remove smoke from a surgical site. The surgical instrument comprises the end effector. A control command is passed directly from the surgical hub to the surgical instrument. The surgical instrument is configured to pass the control command received from the surgical hub to the generator and the smoke evacuation system in a daisy-chain manner.


Example 2—The surgical system of Example 1, wherein the surgical instrument is configured to modify the control command with a parameter detected by the surgical instrument.


Example 3—The surgical system of Example 2, wherein the surgical instrument is configured to pass the modified control command to the generator.


Example 4—The surgical system of Examples 2 or 3, wherein an operating parameter of the generator is controlled by the modified control command.


Example 5—The surgical system of Examples 2, 3, or 4, wherein the generator is configured to alter the modified control command with a second parameter detected by the generator.


Example 6—The surgical system of Examples 2, 3, 4, or 5, wherein the surgical instrument is configured to pass the modified control command to the surgical hub, and wherein the surgical hub is configured to pass the modified control command to the generator.


Example 7—The surgical system of Example 1, wherein the surgical instrument detects a first parameter of the surgical instrument, wherein the surgical instrument is configured to communicate the detected first parameter to the generator, and wherein generator is configured to modify the control command with the first parameter.


Example 8—The surgical system of Example 1, wherein the surgical instrument detects a first parameter of the surgical instrument, wherein the surgical instrument is configured to communicate the detected first parameter to the generator, wherein the generator detects a second parameter, and wherein the generator is configured to modify the control command with the first parameter and the second parameter.


Example 9—The surgical system of Examples 1, 2, 3, 4, 5, 6, 7, or 8, further comprising a display screen configured to display a live feed of a surgical site and a first operating parameter of the surgical instrument.


Example 10—The surgical system of Example 9, wherein the surgical instrument further comprises an instrument display configured to display a second operating parameter of the surgical instrument, and wherein the first operating parameter is the same as the second operating parameter.


Example 11—The surgical system of Example 9, wherein the surgical instrument further comprises an instrument display configured to display a second operating parameter of the surgical instrument, and wherein the first operating parameter is different than the second operating parameter.


Example 12—The surgical system of Examples 9, 10, or 11, wherein the display screen is further configured to display an operating parameter of the generator.


Example 13—A surgical system comprising a surgical hub, a surgical instrument, a generator configured to energize an end effector, and a smoke evacuation system configured to remove smoke from a surgical site. The surgical instrument comprises the end effector. A control command is passed directly from the surgical hub to the surgical instrument. The surgical instrument is configured to pass the control command received from the surgical hub to the generator and the smoke evacuation system.


Example 14—The surgical system of Example 13, wherein the surgical instrument is configured to pass the control command received from the surgical hub to the generator and the smoke evacuation system in a daisy-chain manner.


Example 15—A surgical system comprising a surgical hub, a first surgical instrument, a first generator configured to energize a first end effector, and a second surgical instrument. The first surgical instrument comprises the first end effector. A control command is passed directly from the surgical hub to the first surgical instrument. The first surgical instrument is configured to pass the control command received from the surgical hub to the first generator and the second surgical instrument in a daisy-chain manner.


Example 16—The surgical system of Example 15, wherein the first surgical instrument is configured to modify the control command with a first parameter detected by the first surgical instrument.


Example 17—The surgical system of Example 16, wherein the first surgical instrument is configured to pass the modified control command to the second surgical instrument.


Example 18—The surgical system of Example 17, wherein the second surgical instrument is configured to alter the modified control command with a second parameter detected by the second surgical instrument, and wherein the second surgical instrument is configured to pass the altered control command to the first surgical instrument.


Example 19—The surgical system of Example 15, wherein the first surgical instrument is configured to detect a first parameter, wherein the second surgical instrument is configured to detect a second parameter, wherein the second surgical instrument is configured to communicate the detected second parameter to the first surgical instrument, and wherein the first surgical instrument is configured to modify the control command with the first parameter detected by the first surgical instrument and the second parameter detected by the second surgical instrument.


Example 20—The surgical system of Examples 15, 16, 17, 18, or 19, wherein the second surgical instrument comprises a smoke evacuation system configured to remove smoke from a surgical site.


While several forms have been illustrated and described, it is not the intention of Applicant to restrict or limit the scope of the appended claims to such detail. Numerous modifications, variations, changes, substitutions, combinations, and equivalents to those forms may be implemented and will occur to those skilled in the art without departing from the scope of the present disclosure. Moreover, the structure of each element associated with the described forms can be alternatively described as a means for providing the function performed by the element. Also, where materials are disclosed for certain components, other materials may be used. It is therefore to be understood that the foregoing description and the appended claims are intended to cover all such modifications, combinations, and variations as falling within the scope of the disclosed forms. The appended claims are intended to cover all such modifications, variations, changes, substitutions, modifications, and equivalents.


The foregoing detailed description has set forth various forms of the devices and/or processes via the use of block diagrams, flowcharts, and/or examples. Insofar as such block diagrams, flowcharts, and/or examples contain one or more functions and/or operations, it will be understood by those within the art that each function and/or operation within such block diagrams, flowcharts, and/or examples can be implemented, individually and/or collectively, by a wide range of hardware, software, firmware, or virtually any combination thereof. Those skilled in the art will recognize that some aspects of the forms disclosed herein, in whole or in part, can be equivalently implemented in integrated circuits, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or as virtually any combination thereof, and that designing the circuitry and/or writing the code for the software and or firmware would be well within the skill of one of skill in the art in light of this disclosure. In addition, those skilled in the art will appreciate that the mechanisms of the subject matter described herein are capable of being distributed as one or more program products in a variety of forms, and that an illustrative form of the subject matter described herein applies regardless of the particular type of signal bearing medium used to actually carry out the distribution.


Instructions used to program logic to perform various disclosed aspects can be stored within a memory in the system, such as dynamic random access memory (DRAM), cache, flash memory, or other storage. Furthermore, the instructions can be distributed via a network or by way of other computer readable media. Thus a machine-readable medium may include any mechanism for storing or transmitting information in a form readable by a machine (e.g., a computer), but is not limited to, floppy diskettes, optical disks, compact disc, read-only memory (CD-ROMs), and magneto-optical disks, read-only memory (ROMs), random access memory (RAM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), magnetic or optical cards, flash memory, or a tangible, machine-readable storage used in the transmission of information over the Internet via electrical, optical, acoustical or other forms of propagated signals (e.g., carrier waves, infrared signals, digital signals, etc.). Accordingly, the non-transitory computer-readable medium includes any type of tangible machine-readable medium suitable for storing or transmitting electronic instructions or information in a form readable by a machine (e.g., a computer).


As used in any aspect herein, the term “control circuit” may refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more individual instruction processing cores, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuit may, collectively or individually, be embodied as circuitry that forms part of a larger system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system on-chip (SoC), desktop computers, laptop computers, tablet computers, servers, smart phones, etc. Accordingly, as used herein “control circuit” includes, but is not limited to, electrical circuitry having at least one discrete electrical circuit, electrical circuitry having at least one integrated circuit, electrical circuitry having at least one application specific integrated circuit, electrical circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program which at least partially carries out processes and/or devices described herein, or a microprocessor configured by a computer program which at least partially carries out processes and/or devices described herein), electrical circuitry forming a memory device (e.g., forms of random access memory), and/or electrical circuitry forming a communications device (e.g., a modem, communications switch, or optical-electrical equipment). Those having skill in the art will recognize that the subject matter described herein may be implemented in an analog or digital fashion or some combination thereof.


As used in any aspect herein, the term “logic” may refer to an app, software, firmware and/or circuitry configured to perform any of the aforementioned operations. Software may be embodied as a software package, code, instructions, instruction sets and/or data recorded on non-transitory computer readable storage medium. Firmware may be embodied as code, instructions or instruction sets and/or data that are hard-coded (e.g., nonvolatile) in memory devices.


As used in any aspect herein, the terms “component,” “system,” “module” and the like can refer to a computer-related entity, either hardware, a combination of hardware and software, software, or software in execution.


As used in any aspect herein, an “algorithm” refers to a self-consistent sequence of steps leading to a desired result, where a “step” refers to a manipulation of physical quantities and/or logic states which may, though need not necessarily, take the form of electrical or magnetic signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It is common usage to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. These and similar terms may be associated with the appropriate physical quantities and are merely convenient labels applied to these quantities and/or states.


A network may include a packet switched network. The communication devices may be capable of communicating with each other using a selected packet switched network communications protocol. One example communications protocol may include an Ethernet communications protocol which may be capable permitting communication using a Transmission Control Protocol/Internet Protocol (TCP/IP). The Ethernet protocol may comply or be compatible with the Ethernet standard published by the Institute of Electrical and Electronics Engineers (IEEE) titled “IEEE 802.3 Standard”, published in December, 2008 and/or later versions of this standard. Alternatively or additionally, the communication devices may be capable of communicating with each other using an X.25 communications protocol. The X.25 communications protocol may comply or be compatible with a standard promulgated by the International Telecommunication Union-Telecommunication Standardization Sector (ITU-T). Alternatively or additionally, the communication devices may be capable of communicating with each other using a frame relay communications protocol. The frame relay communications protocol may comply or be compatible with a standard promulgated by Consultative Committee for International Telegraph and Telephone (CCITT) and/or the American National Standards Institute (ANSI). Alternatively or additionally, the transceivers may be capable of communicating with each other using an Asynchronous Transfer Mode (ATM) communications protocol. The ATM communications protocol may comply or be compatible with an ATM standard published by the ATM Forum titled “ATM-MPLS Network Interworking 2.0” published August 2001, and/or later versions of this standard. Of course, different and/or after-developed connection-oriented network communication protocols are equally contemplated herein.


Unless specifically stated otherwise as apparent from the foregoing disclosure, it is appreciated that, throughout the foregoing disclosure, discussions using terms such as “processing,” “computing,” “calculating,” “determining,” “displaying,” or the like, refer to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented as physical (electronic) quantities within the computer system's registers and memories into other data similarly represented as physical quantities within the computer system memories or registers or other such information storage, transmission or display devices.


One or more components may be referred to herein as “configured to,” “configurable to,” “operable/operative to,” “adapted/adaptable,” “able to,” “conformable/conformed to,” etc. Those skilled in the art will recognize that “configured to” can generally encompass active-state components and/or inactive-state components and/or standby-state components, unless context requires otherwise.


The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” refers to the portion closest to the clinician and the term “distal” refers to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.


Those skilled in the art will recognize that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations.


In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention analogous to “at least one of A, B, and C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, and C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). In those instances where a convention analogous to “at least one of A, B, or C, etc.” is used, in general such a construction is intended in the sense one having skill in the art would understand the convention (e.g., “a system having at least one of A, B, or C” would include but not be limited to systems that have A alone, B alone, C alone, A and B together, A and C together, B and C together, and/or A, B, and C together, etc.). It will be further understood by those within the art that typically a disjunctive word and/or phrase presenting two or more alternative terms, whether in the description, claims, or drawings, should be understood to contemplate the possibilities of including one of the terms, either of the terms, or both terms unless context dictates otherwise. For example, the phrase “A or B” will be typically understood to include the possibilities of “A” or “B” or “A and B.”


With respect to the appended claims, those skilled in the art will appreciate that recited operations therein may generally be performed in any order. Also, although various operational flow diagrams are presented in a sequence(s), it should be understood that the various operations may be performed in other orders than those which are illustrated, or may be performed concurrently. Examples of such alternate orderings may include overlapping, interleaved, interrupted, reordered, incremental, preparatory, supplemental, simultaneous, reverse, or other variant orderings, unless context dictates otherwise. Furthermore, terms like “responsive to,” “related to,” or other past-tense adjectives are generally not intended to exclude such variants, unless context dictates otherwise.


It is worthy to note that any reference to “one aspect,” “an aspect,” “an exemplification,” “one exemplification,” and the like means that a particular feature, structure, or characteristic described in connection with the aspect is included in at least one aspect. Thus, appearances of the phrases “in one aspect,” “in an aspect,” “in an exemplification,” and “in one exemplification” in various places throughout the specification are not necessarily all referring to the same aspect. Furthermore, the particular features, structures or characteristics may be combined in any suitable manner in one or more aspects.


In this specification, unless otherwise indicated, terms “about” or “approximately” as used in the present disclosure, unless otherwise specified, means an acceptable error for a particular value as determined by one of ordinary skill in the art, which depends in part on how the value is measured or determined. In certain embodiments, the term “about” or “approximately” means within 1, 2, 3, or 4 standard deviations. In certain embodiments, the term “about” or “approximately” means within 50%, 20%, 15%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, or 0.05% of a given value or range.


In this specification, unless otherwise indicated, all numerical parameters are to be understood as being prefaced and modified in all instances by the term “about,” in which the numerical parameters possess the inherent variability characteristic of the underlying measurement techniques used to determine the numerical value of the parameter. At the very least, and not as an attempt to limit the application of the doctrine of equivalents to the scope of the claims, each numerical parameter described herein should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques.


Any numerical range recited herein includes all sub-ranges subsumed within the recited range. For example, a range of “1 to 10” includes all sub-ranges between (and including) the recited minimum value of 1 and the recited maximum value of 10, that is, having a minimum value equal to or greater than 1 and a maximum value equal to or less than 10. Also, all ranges recited herein are inclusive of the end points of the recited ranges. For example, a range of “1 to 10” includes the end points 1 and 10. Any maximum numerical limitation recited in this specification is intended to include all lower numerical limitations subsumed therein, and any minimum numerical limitation recited in this specification is intended to include all higher numerical limitations subsumed therein. Accordingly, Applicant reserves the right to amend this specification, including the claims, to expressly recite any sub-range subsumed within the ranges expressly recited. All such ranges are inherently described in this specification.


Any patent application, patent, non-patent publication, or other disclosure material referred to in this specification and/or listed in any Application Data Sheet is incorporated by reference herein, to the extent that the incorporated materials is not inconsistent herewith. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.


In summary, numerous benefits have been described which result from employing the concepts described herein. The foregoing description of the one or more forms has been presented for purposes of illustration and description. It is not intended to be exhaustive or limiting to the precise form disclosed. Modifications or variations are possible in light of the above teachings. The one or more forms were chosen and described in order to illustrate principles and practical application to thereby enable one of ordinary skill in the art to utilize the various forms and with various modifications as are suited to the particular use contemplated. It is intended that the claims submitted herewith define the overall scope.

Claims
  • 1. A surgical system, comprising: a surgical instrument, comprising: an end effector, comprising: a first jaw; anda second jaw, wherein at least one of the first jaw and the second jaw is moved with respect to one another between an open position and a closed position, wherein tissue is configured to be positioned between the first jaw and the second jaw;an actuator configured to receive at least one user input, wherein the actuator is configured to move at a speed in response to the at least one user input;a generator configured to supply power to the end effector; anda processor configured to run a control program to operate the surgical system, wherein the processor is configured to: detect a first parameter of the surgical system;detect the speed of the actuator in response to the at least one user input; andmodify the control program to control a jaw closure speed in response to the first parameter and the speed of the actuator responsive to the at least one user input.
  • 2. The surgical system of claim 1, wherein the control program is configured to control a power level of the generator.
  • 3. The surgical system of claim 1, wherein the control program is configured to control a motor, wherein the motor is configured to cause the end effector to move between the open position and the closed position.
  • 4. The surgical system of claim 3, wherein the control program is configured to control the motor through motor control parameters, and wherein the control program is configured to adjust the motor control parameters in response to the first parameter and the at least one user input.
  • 5. The surgical system of claim 1, wherein the first parameter comprises an instrument actuation parameter.
  • 6. The surgical system of claim 1, wherein the first parameter comprises a generator operating parameter.
  • 7. The surgical system of claim 1, wherein the first parameter comprises a status of the end effector.
  • 8. The surgical system of claim 7, wherein the first parameter indicates whether the end effector is in the open position or the closed position.
  • 9. The surgical system of claim 7, wherein the first parameter indicates whether the tissue is positioned between the first jaw and the second jaw.
  • 10. The surgical system of claim 1, wherein the surgical instrument is in operational control, and wherein the generator is a slave control system by default.
  • 11. The surgical system of claim 10, wherein the control program is configured to cause the generator to be in operational control and the surgical instrument to be the slave control system in response to the first parameter and the at least one user input.
  • 12. The surgical system of claim 1, wherein the first parameter comprises a combination of two measures.
  • 13. The surgical system of claim 1, wherein the actuator comprises a trigger configured to receive the user input, wherein the processor is configured to interpret multiple user inputs received by the trigger, wherein each user input comprises a different meaning based on situational usage.
  • 14. The surgical system of claim 1, wherein the surgical instrument comprises a combination electrosurgical functionality.
  • 15. The surgical system of claim 1, wherein the first parameter comprises a thickness of the tissue positioned between the first jaw and the second jaw.
CROSS REFERENCE TO RELATED APPLICATION

This non-provisional application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 62/955,299, entitled DEVICES AND SYSTEMS FOR ELECTROSURGERY, filed Dec. 30, 2019, the disclosure of which is incorporated by reference herein in its entirety.

US Referenced Citations (3217)
Number Name Date Kind
969528 Disbrow Sep 1910 A
1570025 Young Jan 1926 A
1813902 Bovie Jul 1931 A
2188497 Calva Jan 1940 A
2366274 Luth et al. Jan 1945 A
2425245 Johnson Aug 1947 A
2442966 Wallace Jun 1948 A
2458152 Eakins Jan 1949 A
2510693 Green Jun 1950 A
2597564 Bugg May 1952 A
2704333 Calosi et al. Mar 1955 A
2736960 Armstrong Mar 1956 A
2748967 Roach Jun 1956 A
2845072 Shafer Jul 1958 A
2849788 Creek Sep 1958 A
2867039 Zach Jan 1959 A
2874470 Richards Feb 1959 A
2990616 Balamuth et al. Jul 1961 A
RE25033 Balamuth et al. Aug 1961 E
3015961 Roney Jan 1962 A
3033407 Alfons May 1962 A
3053124 Balamuth et al. Sep 1962 A
3082805 Royce Mar 1963 A
3166971 Stoecker Jan 1965 A
3322403 Murphy May 1967 A
3432691 Shoh Mar 1969 A
3433226 Boyd Mar 1969 A
3489930 Shoh Jan 1970 A
3513848 Winston et al. May 1970 A
3514856 Camp et al. Jun 1970 A
3525912 Wallin Aug 1970 A
3526219 Balamuth Sep 1970 A
3554198 Tatoian et al. Jan 1971 A
3580841 Cadotte et al. May 1971 A
3606682 Camp et al. Sep 1971 A
3614484 Shoh Oct 1971 A
3616375 Inoue Oct 1971 A
3629726 Popescu Dec 1971 A
3636943 Balamuth Jan 1972 A
3668486 Silver Jun 1972 A
3702948 Balamuth Nov 1972 A
3703651 Blowers Nov 1972 A
3776238 Peyman et al. Dec 1973 A
3777760 Essner Dec 1973 A
3805787 Banko Apr 1974 A
3809977 Balamuth et al. May 1974 A
3830098 Antonevich Aug 1974 A
3854737 Gilliam, Sr. Dec 1974 A
3862630 Balamuth Jan 1975 A
3875945 Friedman Apr 1975 A
3885438 Harris, Sr. et al. May 1975 A
3900823 Sokal et al. Aug 1975 A
3918442 Nikolaev et al. Nov 1975 A
3924335 Balamuth et al. Dec 1975 A
3946738 Newton et al. Mar 1976 A
3955859 Stella et al. May 1976 A
3956826 Perdreaux, Jr. May 1976 A
3989952 Hohmann Nov 1976 A
4005714 Hiltebrandt Feb 1977 A
4012647 Balamuth et al. Mar 1977 A
4034762 Cosens et al. Jul 1977 A
4058126 Leveen Nov 1977 A
4074719 Semm Feb 1978 A
4156187 Murry et al. May 1979 A
4167944 Banko Sep 1979 A
4188927 Harris Feb 1980 A
4200106 Douvas et al. Apr 1980 A
4203430 Takahashi May 1980 A
4203444 Bonnell et al. May 1980 A
4220154 Semm Sep 1980 A
4237441 van Konynenburg et al. Dec 1980 A
4244371 Farin Jan 1981 A
4281785 Brooks Aug 1981 A
4300083 Heiges Nov 1981 A
4302728 Nakamura Nov 1981 A
4304987 van Konynenburg Dec 1981 A
4306570 Matthews Dec 1981 A
4314559 Allen Feb 1982 A
4353371 Cosman Oct 1982 A
4409981 Lundberg Oct 1983 A
4445063 Smith Apr 1984 A
4461304 Kuperstein Jul 1984 A
4463759 Garito et al. Aug 1984 A
4491132 Aikins Jan 1985 A
4492231 Auth Jan 1985 A
4494759 Kieffer Jan 1985 A
4504264 Kelman Mar 1985 A
4512344 Barber Apr 1985 A
4526571 Wuchinich Jul 1985 A
4535773 Yoon Aug 1985 A
4541638 Ogawa et al. Sep 1985 A
4545374 Jacobson Oct 1985 A
4545926 Fouts, Jr. et al. Oct 1985 A
4549147 Kondo Oct 1985 A
4550870 Krumme et al. Nov 1985 A
4553544 Nomoto et al. Nov 1985 A
4562838 Walker Jan 1986 A
4574615 Bower et al. Mar 1986 A
4582236 Hirose Apr 1986 A
4593691 Lindstrom et al. Jun 1986 A
4608981 Rothfuss et al. Sep 1986 A
4617927 Manes Oct 1986 A
4633119 Thompson Dec 1986 A
4633874 Chow et al. Jan 1987 A
4634420 Spinosa et al. Jan 1987 A
4640279 Beard Feb 1987 A
4641053 Takeda Feb 1987 A
4646738 Trott Mar 1987 A
4646756 Watmough et al. Mar 1987 A
4649919 Thimsen et al. Mar 1987 A
4662068 Polonsky May 1987 A
4674502 Imonti Jun 1987 A
4694835 Strand Sep 1987 A
4708127 Abdelghani Nov 1987 A
4712722 Hood et al. Dec 1987 A
4735603 Goodson et al. Apr 1988 A
4761871 O'Connor et al. Aug 1988 A
4808154 Freeman Feb 1989 A
4819635 Shapiro Apr 1989 A
4827911 Broadwin et al. May 1989 A
4830462 Karny et al. May 1989 A
4832683 Idemoto et al. May 1989 A
4836186 Scholz Jun 1989 A
4838853 Parisi Jun 1989 A
4844064 Thimsen et al. Jul 1989 A
4849133 Yoshida et al. Jul 1989 A
4850354 McGurk-Burleson et al. Jul 1989 A
4852578 Companion et al. Aug 1989 A
4860745 Farin et al. Aug 1989 A
4862890 Stasz et al. Sep 1989 A
4865159 Jamison Sep 1989 A
4867157 McGurk-Burleson et al. Sep 1989 A
4878493 Pasternak et al. Nov 1989 A
4880015 Nierman Nov 1989 A
4881550 Kothe Nov 1989 A
4896009 Pawlowski Jan 1990 A
4903696 Stasz et al. Feb 1990 A
4910389 Sherman et al. Mar 1990 A
4915643 Samejima et al. Apr 1990 A
4920978 Colvin May 1990 A
4922902 Wuchinich et al. May 1990 A
4926860 Stice et al. May 1990 A
4936842 D'Amelio et al. Jun 1990 A
4954960 Lo et al. Sep 1990 A
4965532 Sakurai Oct 1990 A
4979952 Kubota et al. Dec 1990 A
4981756 Rhandhawa Jan 1991 A
5001649 Lo et al. Mar 1991 A
5009661 Michelson Apr 1991 A
5013956 Kurozumi et al. May 1991 A
5015227 Broadwin et al. May 1991 A
5020514 Heckele Jun 1991 A
5026370 Lottick Jun 1991 A
5026387 Thomas Jun 1991 A
5035695 Weber, Jr. et al. Jul 1991 A
5042461 Inoue et al. Aug 1991 A
5042707 Taheri Aug 1991 A
5052145 Wang Oct 1991 A
5061269 Muller Oct 1991 A
5075839 Fisher et al. Dec 1991 A
5084052 Jacobs Jan 1992 A
5099840 Goble et al. Mar 1992 A
5104025 Main et al. Apr 1992 A
5105117 Yamaguchi Apr 1992 A
5106538 Barma et al. Apr 1992 A
5108383 White Apr 1992 A
5109819 Custer et al. May 1992 A
5112300 Ureche May 1992 A
5113139 Furukawa May 1992 A
5123903 Quaid et al. Jun 1992 A
5126618 Takahashi et al. Jun 1992 A
D327872 McMills et al. Jul 1992 S
5152762 McElhenney Oct 1992 A
5156633 Smith Oct 1992 A
5160334 Billings et al. Nov 1992 A
5162044 Gahn et al. Nov 1992 A
5163421 Bernstein et al. Nov 1992 A
5163537 Radev Nov 1992 A
5163945 Ortiz et al. Nov 1992 A
5167619 Wuchinich Dec 1992 A
5167725 Clark et al. Dec 1992 A
5172344 Ehrlich Dec 1992 A
5174276 Crockard Dec 1992 A
D332660 Rawson et al. Jan 1993 S
5176677 Wuchinich Jan 1993 A
5176695 Dulebohn Jan 1993 A
5184605 Grzeszykowski Feb 1993 A
5188102 Idemoto et al. Feb 1993 A
D334173 Liu et al. Mar 1993 S
5190517 Zieve et al. Mar 1993 A
5190518 Takasu Mar 1993 A
5190541 Abele et al. Mar 1993 A
5196007 Ellman et al. Mar 1993 A
5203380 Chikama Apr 1993 A
5205459 Brinkerhoff et al. Apr 1993 A
5205817 Idemoto et al. Apr 1993 A
5209719 Baruch et al. May 1993 A
5213569 Davis May 1993 A
5214339 Naito May 1993 A
5217460 Knoepfler Jun 1993 A
5218529 Meyer et al. Jun 1993 A
5221282 Wuchinich Jun 1993 A
5222937 Kagawa Jun 1993 A
5226909 Evans et al. Jul 1993 A
5226910 Kajiyama et al. Jul 1993 A
5231989 Middleman et al. Aug 1993 A
5234428 Kaufman Aug 1993 A
5241236 Sasaki et al. Aug 1993 A
5241968 Slater Sep 1993 A
5242339 Thornton Sep 1993 A
5242460 Klein et al. Sep 1993 A
5246003 DeLonzor Sep 1993 A
5254129 Alexander Oct 1993 A
5257988 L'Esperance, Jr. Nov 1993 A
5258004 Bales et al. Nov 1993 A
5258006 Rydell et al. Nov 1993 A
5261922 Hood Nov 1993 A
5263957 Davison Nov 1993 A
5264925 Shipp et al. Nov 1993 A
5269297 Weng et al. Dec 1993 A
5275166 Vaitekunas et al. Jan 1994 A
5275607 Lo et al. Jan 1994 A
5275609 Pingleton et al. Jan 1994 A
5282800 Foshee et al. Feb 1994 A
5282817 Hoogeboom et al. Feb 1994 A
5285795 Ryan et al. Feb 1994 A
5285945 Brinkerhoff et al. Feb 1994 A
5290286 Parins Mar 1994 A
5293863 Zhu et al. Mar 1994 A
5300068 Rosar et al. Apr 1994 A
5304115 Pflueger et al. Apr 1994 A
D347474 Olson May 1994 S
5307976 Olson et al. May 1994 A
5309927 Welch May 1994 A
5312023 Green et al. May 1994 A
5312425 Evans et al. May 1994 A
5318525 West et al. Jun 1994 A
5318563 Malis et al. Jun 1994 A
5318564 Eggers Jun 1994 A
5318570 Hood et al. Jun 1994 A
5318589 Lichtman Jun 1994 A
5322055 Davison et al. Jun 1994 A
5324299 Davison et al. Jun 1994 A
5326013 Green et al. Jul 1994 A
5326342 Pflueger et al. Jul 1994 A
5330471 Eggers Jul 1994 A
5330502 Hassler et al. Jul 1994 A
5334183 Wuchinich Aug 1994 A
5339723 Huitema Aug 1994 A
5342356 Ellman et al. Aug 1994 A
5342359 Rydell Aug 1994 A
5344420 Hilal et al. Sep 1994 A
5345937 Middleman et al. Sep 1994 A
5346502 Estabrook et al. Sep 1994 A
5353474 Good et al. Oct 1994 A
5357164 Imabayashi et al. Oct 1994 A
5357423 Weaver et al. Oct 1994 A
5359994 Krauter et al. Nov 1994 A
5361583 Huitema Nov 1994 A
5366466 Christian et al. Nov 1994 A
5368557 Nita et al. Nov 1994 A
5370645 Klicek et al. Dec 1994 A
5371429 Manna Dec 1994 A
5374813 Shipp Dec 1994 A
D354564 Medema Jan 1995 S
5381067 Greenstein et al. Jan 1995 A
5383874 Jackson et al. Jan 1995 A
5383917 Desai et al. Jan 1995 A
5387207 Dyer et al. Feb 1995 A
5387215 Fisher Feb 1995 A
5389098 Tsuruta et al. Feb 1995 A
5394187 Shipp Feb 1995 A
5395033 Byrne et al. Mar 1995 A
5395312 Desai Mar 1995 A
5395363 Billings et al. Mar 1995 A
5395364 Anderhub et al. Mar 1995 A
5396266 Brimhall Mar 1995 A
5396900 Slater et al. Mar 1995 A
5400267 Denen et al. Mar 1995 A
5403312 Yates et al. Apr 1995 A
5403334 Evans et al. Apr 1995 A
5406503 Williams, Jr. et al. Apr 1995 A
5408268 Shipp Apr 1995 A
D358887 Feinberg May 1995 S
5411481 Allen et al. May 1995 A
5417709 Slater May 1995 A
5419761 Narayanan et al. May 1995 A
5421829 Olichney et al. Jun 1995 A
5423844 Miller Jun 1995 A
5428504 Bhatla Jun 1995 A
5429131 Scheinman et al. Jul 1995 A
5438997 Sieben et al. Aug 1995 A
5441499 Fritzsch Aug 1995 A
5443463 Stern et al. Aug 1995 A
5445638 Rydell et al. Aug 1995 A
5445639 Kuslich et al. Aug 1995 A
5447509 Mills et al. Sep 1995 A
5449370 Vaitekunas Sep 1995 A
5451053 Garrido Sep 1995 A
5451161 Sharp Sep 1995 A
5451220 Ciervo Sep 1995 A
5451227 Michaelson Sep 1995 A
5456684 Schmidt et al. Oct 1995 A
5458598 Feinberg et al. Oct 1995 A
5462604 Shibano et al. Oct 1995 A
5465895 Knodel et al. Nov 1995 A
5471988 Fujio et al. Dec 1995 A
5472443 Cordis et al. Dec 1995 A
5476479 Green et al. Dec 1995 A
5478003 Green et al. Dec 1995 A
5480409 Riza Jan 1996 A
5483501 Park et al. Jan 1996 A
5484436 Eggers et al. Jan 1996 A
5486162 Brumbach Jan 1996 A
5486189 Mudry et al. Jan 1996 A
5490860 Middle et al. Feb 1996 A
5496317 Goble et al. Mar 1996 A
5499992 Meade et al. Mar 1996 A
5500216 Julian et al. Mar 1996 A
5501654 Failla et al. Mar 1996 A
5504650 Katsui et al. Apr 1996 A
5505693 Mackool Apr 1996 A
5507297 Slater et al. Apr 1996 A
5507738 Ciervo Apr 1996 A
5509922 Aranyi et al. Apr 1996 A
5511556 DeSantis Apr 1996 A
5520704 Castro et al. May 1996 A
5522832 Kugo et al. Jun 1996 A
5522839 Pilling Jun 1996 A
5527331 Kresch et al. Jun 1996 A
5531744 Nardella et al. Jul 1996 A
5536267 Edwards et al. Jul 1996 A
5540681 Strul et al. Jul 1996 A
5540693 Fisher Jul 1996 A
5542916 Hirsch et al. Aug 1996 A
5548286 Craven Aug 1996 A
5549637 Crainich Aug 1996 A
5553675 Pitzen et al. Sep 1996 A
5558671 Yates Sep 1996 A
5562609 Brumbach Oct 1996 A
5562610 Brumbach Oct 1996 A
5562659 Morris Oct 1996 A
5562703 Desai Oct 1996 A
5563179 Stone et al. Oct 1996 A
5569164 Lurz Oct 1996 A
5571121 Heifetz Nov 1996 A
5573424 Poppe Nov 1996 A
5573533 Strul Nov 1996 A
5573534 Stone Nov 1996 A
5577654 Bishop Nov 1996 A
5584830 Ladd et al. Dec 1996 A
5591187 Dekel Jan 1997 A
5593414 Shipp et al. Jan 1997 A
5599350 Schulze et al. Feb 1997 A
5600526 Russell et al. Feb 1997 A
5601601 Tal et al. Feb 1997 A
5603773 Campbell Feb 1997 A
5607436 Pratt et al. Mar 1997 A
5607450 Zvenyatsky et al. Mar 1997 A
5609573 Sandock Mar 1997 A
5611813 Lichtman Mar 1997 A
5618304 Hart et al. Apr 1997 A
5618307 Donlon et al. Apr 1997 A
5618492 Auten et al. Apr 1997 A
5620447 Smith et al. Apr 1997 A
5624452 Yates Apr 1997 A
5626587 Bishop et al. May 1997 A
5626595 Sklar et al. May 1997 A
5626608 Cuny et al. May 1997 A
5628760 Knoepfler May 1997 A
5630420 Vaitekunas May 1997 A
5632432 Schulze et al. May 1997 A
5632717 Yoon May 1997 A
5638827 Palmer et al. Jun 1997 A
5640741 Yano Jun 1997 A
D381077 Hunt Jul 1997 S
5647871 Levine et al. Jul 1997 A
5649937 Bito et al. Jul 1997 A
5649955 Hashimoto et al. Jul 1997 A
5651780 Jackson et al. Jul 1997 A
5653713 Michelson Aug 1997 A
5655100 Ebrahim et al. Aug 1997 A
5658281 Heard Aug 1997 A
5662662 Bishop et al. Sep 1997 A
5662667 Knodel Sep 1997 A
5665085 Nardella Sep 1997 A
5665100 Yoon Sep 1997 A
5669922 Hood Sep 1997 A
5674219 Monson et al. Oct 1997 A
5674220 Fox et al. Oct 1997 A
5674235 Parisi Oct 1997 A
5678568 Uchikubo et al. Oct 1997 A
5688270 Yates et al. Nov 1997 A
5690269 Bolanos et al. Nov 1997 A
5693042 Boiarski et al. Dec 1997 A
5693051 Schulze et al. Dec 1997 A
5694936 Fujimoto et al. Dec 1997 A
5695510 Hood Dec 1997 A
5700261 Brinkerhoff Dec 1997 A
5704534 Huitema et al. Jan 1998 A
5704791 Gillio Jan 1998 A
5707369 Vaitekunas et al. Jan 1998 A
5709680 Yates et al. Jan 1998 A
5711472 Bryan Jan 1998 A
5713896 Nardella Feb 1998 A
5715817 Stevens-Wright et al. Feb 1998 A
5716366 Yates Feb 1998 A
5717306 Shipp Feb 1998 A
5720742 Zacharias Feb 1998 A
5720744 Eggleston et al. Feb 1998 A
5722980 Schulz et al. Mar 1998 A
5723970 Bell Mar 1998 A
5728130 Ishikawa et al. Mar 1998 A
5730752 Alden et al. Mar 1998 A
5733074 Stock et al. Mar 1998 A
5735848 Yates et al. Apr 1998 A
5741226 Strukel et al. Apr 1998 A
5743906 Parins et al. Apr 1998 A
5752973 Kieturakis May 1998 A
5755717 Yates et al. May 1998 A
5762255 Chrisman et al. Jun 1998 A
5766164 Mueller et al. Jun 1998 A
5772659 Becker et al. Jun 1998 A
5776130 Buysse et al. Jul 1998 A
5776155 Beaupre et al. Jul 1998 A
5779130 Alesi et al. Jul 1998 A
5779701 McBrayer et al. Jul 1998 A
5782834 Lucey et al. Jul 1998 A
5792135 Madhani et al. Aug 1998 A
5792138 Shipp Aug 1998 A
5792165 Klieman et al. Aug 1998 A
5796188 Bays Aug 1998 A
5797941 Schulze et al. Aug 1998 A
5797958 Yoon Aug 1998 A
5797959 Castro et al. Aug 1998 A
5800432 Swanson Sep 1998 A
5800448 Banko Sep 1998 A
5800449 Wales Sep 1998 A
5805140 Rosenberg et al. Sep 1998 A
5807393 Williamson, IV et al. Sep 1998 A
5808396 Boukhny Sep 1998 A
5810811 Yates et al. Sep 1998 A
5810828 Lightman et al. Sep 1998 A
5810859 DiMatteo et al. Sep 1998 A
5817033 DeSantis et al. Oct 1998 A
5817084 Jensen Oct 1998 A
5817093 Williamson, IV et al. Oct 1998 A
5817119 Klieman et al. Oct 1998 A
5823197 Edwards Oct 1998 A
5827271 Buysse et al. Oct 1998 A
5827323 Klieman et al. Oct 1998 A
5828160 Sugishita Oct 1998 A
5833696 Whitfield et al. Nov 1998 A
5836897 Sakurai et al. Nov 1998 A
5836909 Cosmescu Nov 1998 A
5836943 Miller, III Nov 1998 A
5836957 Schulz et al. Nov 1998 A
5836990 Li Nov 1998 A
5843109 Mehta et al. Dec 1998 A
5851212 Zirps et al. Dec 1998 A
5853412 Mayenberger Dec 1998 A
5854590 Dalstein Dec 1998 A
5858018 Shipp et al. Jan 1999 A
5865361 Milliman et al. Feb 1999 A
5873873 Smith et al. Feb 1999 A
5873882 Straub et al. Feb 1999 A
5876401 Schulze et al. Mar 1999 A
5878193 Wang et al. Mar 1999 A
5879364 Bromfield et al. Mar 1999 A
5880668 Hall Mar 1999 A
5883615 Fago et al. Mar 1999 A
5891142 Eggers et al. Apr 1999 A
5893835 Witt et al. Apr 1999 A
5897523 Wright et al. Apr 1999 A
5897569 Kellogg et al. Apr 1999 A
5903607 Tailliet May 1999 A
5904681 West, Jr. May 1999 A
5906625 Bito et al. May 1999 A
5906627 Spaulding May 1999 A
5906628 Miyawaki et al. May 1999 A
5910129 Koblish et al. Jun 1999 A
5911699 Anis et al. Jun 1999 A
5913823 Hedberg et al. Jun 1999 A
5916229 Evans Jun 1999 A
5921956 Grinberg et al. Jul 1999 A
5929846 Rosenberg et al. Jul 1999 A
5935143 Hood Aug 1999 A
5935144 Estabrook Aug 1999 A
5938633 Beaupre Aug 1999 A
5944718 Austin et al. Aug 1999 A
5944737 Tsonton et al. Aug 1999 A
5947984 Whipple Sep 1999 A
5954717 Behl et al. Sep 1999 A
5954736 Bishop et al. Sep 1999 A
5954746 Holthaus et al. Sep 1999 A
5957882 Nita et al. Sep 1999 A
5957943 Vaitekunas Sep 1999 A
5968007 Simon et al. Oct 1999 A
5968060 Kellogg Oct 1999 A
5974342 Petrofsky Oct 1999 A
D416089 Barton et al. Nov 1999 S
5980510 Tsonton et al. Nov 1999 A
5980546 Hood Nov 1999 A
5984938 Yoon Nov 1999 A
5987344 West Nov 1999 A
5989274 Davison et al. Nov 1999 A
5989275 Estabrook et al. Nov 1999 A
5993465 Shipp et al. Nov 1999 A
5993972 Reich et al. Nov 1999 A
5994855 Lundell et al. Nov 1999 A
6003517 Sheffield et al. Dec 1999 A
6004335 Vaitekunas et al. Dec 1999 A
6013052 Durman et al. Jan 2000 A
6024741 Williamson, IV et al. Feb 2000 A
6024744 Kese et al. Feb 2000 A
6024750 Mastri et al. Feb 2000 A
6027515 Cimino Feb 2000 A
6031526 Shipp Feb 2000 A
6033375 Brumbach Mar 2000 A
6033399 Gines Mar 2000 A
6036667 Manna et al. Mar 2000 A
6036707 Spaulding Mar 2000 A
6039734 Goble Mar 2000 A
6048224 Kay Apr 2000 A
6050943 Slayton et al. Apr 2000 A
6050996 Schmaltz et al. Apr 2000 A
6051010 DiMatteo et al. Apr 2000 A
6056735 Okada et al. May 2000 A
6063098 Houser et al. May 2000 A
6066132 Chen et al. May 2000 A
6066151 Miyawaki et al. May 2000 A
6068627 Orszulak et al. May 2000 A
6068629 Haissaguerre et al. May 2000 A
6068647 Witt et al. May 2000 A
6074389 Levine et al. Jun 2000 A
6077285 Boukhny Jun 2000 A
6080149 Huang et al. Jun 2000 A
6083191 Rose Jul 2000 A
6086584 Miller Jul 2000 A
6090120 Wright et al. Jul 2000 A
6091995 Ingle et al. Jul 2000 A
6096033 Tu et al. Aug 2000 A
6099483 Palmer et al. Aug 2000 A
6099542 Cohn et al. Aug 2000 A
6099550 Yoon Aug 2000 A
6109500 Alli et al. Aug 2000 A
6110127 Suzuki Aug 2000 A
6113594 Savage Sep 2000 A
6113598 Baker Sep 2000 A
6117152 Huitema Sep 2000 A
H1904 Yates et al. Oct 2000 H
6126629 Perkins Oct 2000 A
6126658 Baker Oct 2000 A
6129735 Okada et al. Oct 2000 A
6129740 Michelson Oct 2000 A
6132368 Cooper Oct 2000 A
6132427 Jones et al. Oct 2000 A
6132429 Baker Oct 2000 A
6132448 Perez et al. Oct 2000 A
6139320 Hahn Oct 2000 A
6139561 Shibata et al. Oct 2000 A
6142615 Qiu et al. Nov 2000 A
6142994 Swanson et al. Nov 2000 A
6144402 Norsworthy et al. Nov 2000 A
6147560 Erhage et al. Nov 2000 A
6152902 Christian et al. Nov 2000 A
6152923 Ryan Nov 2000 A
6154198 Rosenberg Nov 2000 A
6156029 Mueller Dec 2000 A
6159160 Hsei et al. Dec 2000 A
6159175 Strukel et al. Dec 2000 A
6162194 Shipp Dec 2000 A
6162208 Hipps Dec 2000 A
6165150 Banko Dec 2000 A
6174309 Wrublewski et al. Jan 2001 B1
6174310 Kirwan, Jr. Jan 2001 B1
6176857 Ashley Jan 2001 B1
6179853 Sachse et al. Jan 2001 B1
6183426 Akisada et al. Feb 2001 B1
6187003 Buysse et al. Feb 2001 B1
6190386 Rydell Feb 2001 B1
6193709 Miyawaki et al. Feb 2001 B1
6204592 Hur Mar 2001 B1
6205383 Hermann Mar 2001 B1
6205855 Pfeiffer Mar 2001 B1
6206844 Reichel et al. Mar 2001 B1
6206876 Levine et al. Mar 2001 B1
6210337 Dunham et al. Apr 2001 B1
6210402 Olsen et al. Apr 2001 B1
6210403 Klicek Apr 2001 B1
6214023 Whipple et al. Apr 2001 B1
6228080 Gines May 2001 B1
6231565 Tovey et al. May 2001 B1
6232899 Craven May 2001 B1
6233476 Strommer et al. May 2001 B1
6238366 Savage et al. May 2001 B1
6238384 Peer May 2001 B1
6241724 Fleischman et al. Jun 2001 B1
6245065 Panescu et al. Jun 2001 B1
6251110 Wampler Jun 2001 B1
6252110 Uemura et al. Jun 2001 B1
D444365 Bass et al. Jul 2001 S
D445092 Lee Jul 2001 S
D445764 Lee Jul 2001 S
6254623 Haibel, Jr. et al. Jul 2001 B1
6257241 Wampler Jul 2001 B1
6258034 Hanafy Jul 2001 B1
6259230 Chou Jul 2001 B1
6267761 Ryan Jul 2001 B1
6270831 Kumar et al. Aug 2001 B2
6273852 Lehe et al. Aug 2001 B1
6274963 Estabrook et al. Aug 2001 B1
6277115 Saadat Aug 2001 B1
6277117 Tetzlaff et al. Aug 2001 B1
6278218 Madan et al. Aug 2001 B1
6280407 Manna et al. Aug 2001 B1
6283981 Beaupre Sep 2001 B1
6287344 Wampler et al. Sep 2001 B1
6290575 Shipp Sep 2001 B1
6292700 Morrison et al. Sep 2001 B1
6299591 Banko Oct 2001 B1
6306131 Hareyama et al. Oct 2001 B1
6306157 Shchervinsky Oct 2001 B1
6309400 Beaupre Oct 2001 B2
6311783 Harpell Nov 2001 B1
6319221 Savage et al. Nov 2001 B1
6325795 Lindemann et al. Dec 2001 B1
6325799 Goble Dec 2001 B1
6325811 Messerly Dec 2001 B1
6328751 Beaupre Dec 2001 B1
6332891 Himes Dec 2001 B1
6338657 Harper et al. Jan 2002 B1
6340352 Okada et al. Jan 2002 B1
6340878 Oglesbee Jan 2002 B1
6350269 Shipp et al. Feb 2002 B1
6352532 Kramer et al. Mar 2002 B1
6356224 Wohlfarth Mar 2002 B1
6358246 Behl et al. Mar 2002 B1
6358264 Banko Mar 2002 B2
6364888 Niemeyer et al. Apr 2002 B1
6379320 Lafon et al. Apr 2002 B1
D457958 Dycus et al. May 2002 S
6383194 Pothula May 2002 B1
6384690 Wilhelmsson et al. May 2002 B1
6387094 Eitenmuller May 2002 B1
6387109 Davison et al. May 2002 B1
6388657 Natoli May 2002 B1
6390973 Ouchi May 2002 B1
6391026 Hung et al. May 2002 B1
6391042 Cimino May 2002 B1
6398779 Buysse et al. Jun 2002 B1
6402743 Orszulak et al. Jun 2002 B1
6402748 Schoenman et al. Jun 2002 B1
6405184 Bohme et al. Jun 2002 B1
6405733 Fogarty et al. Jun 2002 B1
6409722 Hoey et al. Jun 2002 B1
H2037 Yates et al. Jul 2002 H
6416469 Phung et al. Jul 2002 B1
6416486 Wampler Jul 2002 B1
6419675 Gallo, Sr. Jul 2002 B1
6423073 Bowman Jul 2002 B2
6423082 Houser et al. Jul 2002 B1
6425906 Young et al. Jul 2002 B1
6428538 Blewett et al. Aug 2002 B1
6428539 Baxter et al. Aug 2002 B1
6430446 Knowlton Aug 2002 B1
6432118 Messerly Aug 2002 B1
6436114 Novak et al. Aug 2002 B1
6436115 Beaupre Aug 2002 B1
6440062 Ouchi Aug 2002 B1
6443968 Holthaus et al. Sep 2002 B1
6443969 Novak et al. Sep 2002 B1
6449006 Shipp Sep 2002 B1
6454781 Witt et al. Sep 2002 B1
6454782 Schwemberger Sep 2002 B1
6458128 Schulze Oct 2002 B1
6458130 Frazier et al. Oct 2002 B1
6458142 Faller et al. Oct 2002 B1
6459363 Walker et al. Oct 2002 B1
6461363 Gadberry et al. Oct 2002 B1
6464689 Qin et al. Oct 2002 B1
6464702 Schulze et al. Oct 2002 B2
6468270 Hovda et al. Oct 2002 B1
6475211 Chess et al. Nov 2002 B2
6475215 Tanrisever Nov 2002 B1
6480796 Wiener Nov 2002 B2
6485490 Wampler et al. Nov 2002 B2
6491690 Goble et al. Dec 2002 B1
6491701 Tierney et al. Dec 2002 B2
6491708 Madan et al. Dec 2002 B2
6497715 Satou Dec 2002 B2
6500112 Khouri Dec 2002 B1
6500176 Truckai et al. Dec 2002 B1
6500188 Harper et al. Dec 2002 B2
6500312 Wedekamp Dec 2002 B2
6503248 Levine Jan 2003 B1
6506208 Hunt et al. Jan 2003 B2
6511478 Burnside et al. Jan 2003 B1
6511480 Tetzlaff et al. Jan 2003 B1
6511493 Moutafis et al. Jan 2003 B1
6514252 Nezhat et al. Feb 2003 B2
6514267 Jewett Feb 2003 B2
6517565 Whitman et al. Feb 2003 B1
6524251 Rabiner et al. Feb 2003 B2
6524316 Nicholson et al. Feb 2003 B1
6527736 Attinger et al. Mar 2003 B1
6531846 Smith Mar 2003 B1
6533784 Truckai et al. Mar 2003 B2
6537272 Christopherson et al. Mar 2003 B2
6537291 Friedman et al. Mar 2003 B2
6543452 Lavigne Apr 2003 B1
6543456 Freeman Apr 2003 B1
6544260 Markel et al. Apr 2003 B1
6551309 LePivert Apr 2003 B1
6554829 Schulze et al. Apr 2003 B2
6558376 Bishop May 2003 B2
6558380 Lingenfelder et al. May 2003 B2
6561983 Cronin et al. May 2003 B2
6562035 Levin May 2003 B1
6562037 Paton et al. May 2003 B2
6565558 Lindenmeier et al. May 2003 B1
6572563 Ouchi Jun 2003 B2
6572632 Zisterer et al. Jun 2003 B2
6572639 Ingle et al. Jun 2003 B1
6575969 Rittman, III et al. Jun 2003 B1
6582427 Goble et al. Jun 2003 B1
6582451 Marucci et al. Jun 2003 B1
6584360 Francischelli et al. Jun 2003 B2
D477408 Bromley Jul 2003 S
6585735 Frazier et al. Jul 2003 B1
6588277 Giordano et al. Jul 2003 B2
6589200 Schwemberger et al. Jul 2003 B1
6589239 Khandkar et al. Jul 2003 B2
6590733 Wilson et al. Jul 2003 B1
6599288 Maguire et al. Jul 2003 B2
6602252 Mollenauer Aug 2003 B2
6602262 Griego et al. Aug 2003 B2
6607540 Shipp Aug 2003 B1
6610059 West, Jr. Aug 2003 B1
6610060 Mulier et al. Aug 2003 B2
6611793 Burnside et al. Aug 2003 B1
6616450 Mossle et al. Sep 2003 B2
6619529 Green et al. Sep 2003 B2
6620161 Schulze et al. Sep 2003 B2
6622731 Daniel et al. Sep 2003 B2
6623482 Pendekanti et al. Sep 2003 B2
6623500 Cook et al. Sep 2003 B1
6623501 Heller et al. Sep 2003 B2
6626848 Neuenfeldt Sep 2003 B2
6626926 Friedman et al. Sep 2003 B2
6629974 Penny et al. Oct 2003 B2
6632221 Edwards et al. Oct 2003 B1
6633234 Wiener et al. Oct 2003 B2
6635057 Harano et al. Oct 2003 B2
6644532 Green et al. Nov 2003 B2
6651669 Burnside Nov 2003 B1
6652513 Panescu et al. Nov 2003 B2
6652539 Shipp et al. Nov 2003 B2
6652545 Shipp et al. Nov 2003 B2
6656132 Ouchi Dec 2003 B1
6656177 Truckai et al. Dec 2003 B2
6656198 Tsonton et al. Dec 2003 B2
6660017 Beaupre Dec 2003 B2
6662127 Wiener et al. Dec 2003 B2
6663941 Brown et al. Dec 2003 B2
6666860 Takahashi Dec 2003 B1
6666875 Sakurai et al. Dec 2003 B1
6669690 Okada et al. Dec 2003 B1
6669710 Moutafis et al. Dec 2003 B2
6673248 Chowdhury Jan 2004 B2
6676660 Wampler et al. Jan 2004 B2
6678621 Wiener et al. Jan 2004 B2
6679875 Honda et al. Jan 2004 B2
6679882 Kornerup Jan 2004 B1
6679899 Wiener et al. Jan 2004 B2
6682501 Nelson et al. Jan 2004 B1
6682544 Mastri et al. Jan 2004 B2
6685700 Behl et al. Feb 2004 B2
6685701 Orszulak et al. Feb 2004 B2
6685703 Pearson et al. Feb 2004 B2
6689145 Lee et al. Feb 2004 B2
6689146 Himes Feb 2004 B1
6690960 Chen et al. Feb 2004 B2
6695840 Schulze Feb 2004 B2
6702821 Bonutti Mar 2004 B2
6716215 David et al. Apr 2004 B1
6719692 Kleffner et al. Apr 2004 B2
6719765 Bonutti Apr 2004 B2
6719776 Baxter et al. Apr 2004 B2
6722552 Fenton, Jr. Apr 2004 B2
6723091 Goble et al. Apr 2004 B2
D490059 Conway et al. May 2004 S
6730080 Harano et al. May 2004 B2
6731047 Kauf et al. May 2004 B2
6733498 Paton et al. May 2004 B2
6733506 McDevitt et al. May 2004 B1
6736813 Yamauchi et al. May 2004 B2
6739872 Turri May 2004 B1
6740079 Eggers et al. May 2004 B1
D491666 Kimmell et al. Jun 2004 S
6743245 Lobdell Jun 2004 B2
6746284 Spink, Jr. Jun 2004 B1
6746443 Morley et al. Jun 2004 B1
6752815 Beaupre Jun 2004 B2
6755825 Shoenman et al. Jun 2004 B2
6761698 Shibata et al. Jul 2004 B2
6762535 Take et al. Jul 2004 B2
6766202 Underwood et al. Jul 2004 B2
6770072 Truckai et al. Aug 2004 B1
6773409 Truckai et al. Aug 2004 B2
6773434 Ciarrocca Aug 2004 B2
6773435 Schulze et al. Aug 2004 B2
6773443 Truwit et al. Aug 2004 B2
6773444 Messerly Aug 2004 B2
6775575 Bommannan et al. Aug 2004 B2
6778023 Christensen Aug 2004 B2
6783524 Anderson et al. Aug 2004 B2
6786382 Hoffman Sep 2004 B1
6786383 Stegelmann Sep 2004 B2
6789939 Schrodinger et al. Sep 2004 B2
6790173 Saadat et al. Sep 2004 B2
6790216 Ishikawa Sep 2004 B1
6794027 Araki et al. Sep 2004 B1
6796981 Wham et al. Sep 2004 B2
D496997 Dycus et al. Oct 2004 S
6800085 Selmon et al. Oct 2004 B2
6802843 Truckai et al. Oct 2004 B2
6808525 Latterell et al. Oct 2004 B2
6809508 Donofrio Oct 2004 B2
6810281 Brock et al. Oct 2004 B2
6811842 Ehrnsperger et al. Nov 2004 B1
6814731 Swanson Nov 2004 B2
6819027 Saraf Nov 2004 B2
6821273 Mollenauer Nov 2004 B2
6827712 Tovey et al. Dec 2004 B2
6828712 Battaglin et al. Dec 2004 B2
6835082 Gonnering Dec 2004 B2
6835199 McGuckin, Jr. et al. Dec 2004 B2
6840938 Morley et al. Jan 2005 B1
6843789 Goble Jan 2005 B2
6849073 Hoey et al. Feb 2005 B2
6860878 Brock Mar 2005 B2
6860880 Treat et al. Mar 2005 B2
6863676 Lee et al. Mar 2005 B2
6866671 Tierney et al. Mar 2005 B2
6869439 White et al. Mar 2005 B2
6875220 Du et al. Apr 2005 B2
6877647 Green et al. Apr 2005 B2
6882439 Ishijima Apr 2005 B2
6887209 Kadziauskas et al. May 2005 B2
6887252 Okada et al. May 2005 B1
6893435 Goble May 2005 B2
6898536 Wiener et al. May 2005 B2
6899685 Kermode et al. May 2005 B2
6905497 Truckai et al. Jun 2005 B2
6908463 Treat et al. Jun 2005 B2
6908472 Wiener et al. Jun 2005 B2
6913579 Truckai et al. Jul 2005 B2
6915623 Dey et al. Jul 2005 B2
6923804 Eggers et al. Aug 2005 B2
6923806 Hooven et al. Aug 2005 B2
6926712 Phan Aug 2005 B2
6926716 Baker et al. Aug 2005 B2
6926717 Garito et al. Aug 2005 B1
6929602 Hirakui et al. Aug 2005 B2
6929622 Chian Aug 2005 B2
6929632 Nita et al. Aug 2005 B2
6929644 Truckai et al. Aug 2005 B2
6933656 Matsushita et al. Aug 2005 B2
D509589 Wells Sep 2005 S
6942660 Pantera et al. Sep 2005 B2
6942677 Nita et al. Sep 2005 B2
6945981 Donofrio et al. Sep 2005 B2
6946779 Birgel Sep 2005 B2
6948503 Refior et al. Sep 2005 B2
6953461 McClurken et al. Oct 2005 B2
6958070 Witt et al. Oct 2005 B2
D511145 Donofrio et al. Nov 2005 S
6974450 Weber et al. Dec 2005 B2
6976844 Hickok et al. Dec 2005 B2
6976969 Messerly Dec 2005 B2
6977495 Donofrio Dec 2005 B2
6979332 Adams Dec 2005 B2
6981628 Wales Jan 2006 B2
6984220 Wuchinich Jan 2006 B2
6984231 Goble et al. Jan 2006 B2
6988295 Tillim Jan 2006 B2
6994708 Manzo Feb 2006 B2
6994709 Iida Feb 2006 B2
7000818 Shelton, IV et al. Feb 2006 B2
7001335 Adachi et al. Feb 2006 B2
7001379 Behl et al. Feb 2006 B2
7001382 Gallo, Sr. Feb 2006 B2
7004951 Gibbens, III Feb 2006 B2
7011657 Truckai et al. Mar 2006 B2
7014638 Michelson Mar 2006 B2
7018389 Camerlengo Mar 2006 B2
7025732 Thompson et al. Apr 2006 B2
7033356 Latterell et al. Apr 2006 B2
7033357 Baxter et al. Apr 2006 B2
7037306 Podany et al. May 2006 B2
7041083 Chu et al. May 2006 B2
7041088 Nawrocki et al. May 2006 B2
7041102 Truckai et al. May 2006 B2
7044949 Orszulak et al. May 2006 B2
7052494 Goble et al. May 2006 B2
7052496 Yamauchi May 2006 B2
7055731 Shelton, IV et al. Jun 2006 B2
7063699 Hess et al. Jun 2006 B2
7066893 Hibner et al. Jun 2006 B2
7066895 Podany Jun 2006 B2
7066936 Ryan Jun 2006 B2
7070597 Truckai et al. Jul 2006 B2
7074218 Washington et al. Jul 2006 B2
7074219 Levine et al. Jul 2006 B2
7077039 Gass et al. Jul 2006 B2
7077845 Hacker et al. Jul 2006 B2
7077853 Kramer et al. Jul 2006 B2
7083075 Swayze et al. Aug 2006 B2
7083613 Treat Aug 2006 B2
7083618 Couture et al. Aug 2006 B2
7083619 Truckai et al. Aug 2006 B2
7087054 Truckai et al. Aug 2006 B2
7090637 Danitz et al. Aug 2006 B2
7090672 Underwood et al. Aug 2006 B2
7094235 Francischelli Aug 2006 B2
7101371 Dycus et al. Sep 2006 B2
7101372 Dycus et al. Sep 2006 B2
7101373 Dycus et al. Sep 2006 B2
7101378 Salameh et al. Sep 2006 B2
7104834 Robinson et al. Sep 2006 B2
7108695 Witt et al. Sep 2006 B2
7111769 Wales et al. Sep 2006 B2
7112201 Truckai et al. Sep 2006 B2
7113831 Hooven Sep 2006 B2
D531311 Guerra et al. Oct 2006 S
7117034 Kronberg Oct 2006 B2
7118564 Ritchie et al. Oct 2006 B2
7118570 Tetzlaff et al. Oct 2006 B2
7118587 Dycus et al. Oct 2006 B2
7119516 Denning Oct 2006 B2
7124932 Isaacson et al. Oct 2006 B2
7125409 Truckai et al. Oct 2006 B2
7128720 Podany Oct 2006 B2
7131860 Sartor et al. Nov 2006 B2
7131970 Moses et al. Nov 2006 B2
7135018 Ryan et al. Nov 2006 B2
7135030 Schwemberger et al. Nov 2006 B2
7137980 Buysse et al. Nov 2006 B2
7143925 Shelton, IV et al. Dec 2006 B2
7144403 Booth Dec 2006 B2
7147138 Shelton, IV Dec 2006 B2
7153315 Miller Dec 2006 B2
D536093 Nakajima et al. Jan 2007 S
7156189 Bar-Cohen et al. Jan 2007 B1
7156846 Dycus et al. Jan 2007 B2
7156853 Muratsu Jan 2007 B2
7157058 Marhasin et al. Jan 2007 B2
7159750 Racenet et al. Jan 2007 B2
7160259 Tardy et al. Jan 2007 B2
7160296 Pearson et al. Jan 2007 B2
7160298 Lawes et al. Jan 2007 B2
7160299 Baily Jan 2007 B2
7163548 Stulen et al. Jan 2007 B2
7166103 Carmel et al. Jan 2007 B2
7169144 Hoey et al. Jan 2007 B2
7169146 Truckai et al. Jan 2007 B2
7169156 Hart Jan 2007 B2
7179254 Pendekanti et al. Feb 2007 B2
7179271 Friedman et al. Feb 2007 B2
7186253 Truckai et al. Mar 2007 B2
7189233 Truckai et al. Mar 2007 B2
7195631 Dumbauld Mar 2007 B2
D541418 Schechter et al. Apr 2007 S
7198635 Danek et al. Apr 2007 B2
7204820 Akahoshi Apr 2007 B2
7207471 Heinrich et al. Apr 2007 B2
7207997 Shipp et al. Apr 2007 B2
7208005 Frecker et al. Apr 2007 B2
7210881 Greenberg May 2007 B2
7211079 Treat May 2007 B2
7217128 Atkin et al. May 2007 B2
7217269 El-Galley et al. May 2007 B2
7220951 Truckai et al. May 2007 B2
7223229 Inman et al. May 2007 B2
7225964 Mastri et al. Jun 2007 B2
7226447 Uchida et al. Jun 2007 B2
7226448 Bertolero et al. Jun 2007 B2
7229455 Sakurai et al. Jun 2007 B2
7232440 Dumbauld et al. Jun 2007 B2
7235071 Gonnering Jun 2007 B2
7235073 Levine et al. Jun 2007 B2
7241294 Reschke Jul 2007 B2
7244262 Wiener et al. Jul 2007 B2
7251531 Mosher et al. Jul 2007 B2
7252641 Thompson et al. Aug 2007 B2
7252667 Moses et al. Aug 2007 B2
7258688 Shah et al. Aug 2007 B1
7264618 Murakami et al. Sep 2007 B2
7267677 Johnson et al. Sep 2007 B2
7267685 Butaric et al. Sep 2007 B2
7269873 Brewer et al. Sep 2007 B2
7273483 Wiener et al. Sep 2007 B2
D552241 Bromley et al. Oct 2007 S
7282048 Goble et al. Oct 2007 B2
7285895 Beaupre Oct 2007 B2
7287682 Ezzat et al. Oct 2007 B1
7297149 Vitali et al. Nov 2007 B2
7300431 Dubrovsky Nov 2007 B2
7300435 Wham et al. Nov 2007 B2
7300446 Beaupre Nov 2007 B2
7300450 Vleugels et al. Nov 2007 B2
7303531 Lee et al. Dec 2007 B2
7303557 Wham et al. Dec 2007 B2
7306597 Manzo Dec 2007 B2
7307313 Ohyanagi et al. Dec 2007 B2
7309849 Truckai et al. Dec 2007 B2
7311706 Schoenman et al. Dec 2007 B2
7311709 Truckai et al. Dec 2007 B2
7317955 McGreevy Jan 2008 B2
7318831 Alvarez et al. Jan 2008 B2
7318832 Young et al. Jan 2008 B2
7326236 Andreas et al. Feb 2008 B2
7329257 Kanehira et al. Feb 2008 B2
7331410 Yong et al. Feb 2008 B2
7335165 Truwit et al. Feb 2008 B2
7335997 Wiener Feb 2008 B2
7337010 Howard et al. Feb 2008 B2
7353068 Tanaka et al. Apr 2008 B2
7354440 Truckal et al. Apr 2008 B2
7357287 Shelton, IV et al. Apr 2008 B2
7357802 Palanker et al. Apr 2008 B2
7361172 Cimino Apr 2008 B2
7364577 Wham et al. Apr 2008 B2
7367976 Lawes et al. May 2008 B2
7371227 Zeiner May 2008 B2
RE40388 Gines Jun 2008 E
7380695 Doll et al. Jun 2008 B2
7380696 Shelton, IV et al. Jun 2008 B2
7381209 Truckai et al. Jun 2008 B2
7384420 Dycus et al. Jun 2008 B2
7390317 Taylor et al. Jun 2008 B2
7396356 Mollenauer Jul 2008 B2
7403224 Fuller et al. Jul 2008 B2
7404508 Smith et al. Jul 2008 B2
7407077 Ortiz et al. Aug 2008 B2
7408288 Hara Aug 2008 B2
7412008 Lliev Aug 2008 B2
7416101 Shelton, IV et al. Aug 2008 B2
7416437 Sartor et al. Aug 2008 B2
D576725 Shumer et al. Sep 2008 S
7419490 Falkenstein et al. Sep 2008 B2
7422139 Shelton, IV et al. Sep 2008 B2
7422463 Kuo Sep 2008 B2
7422582 Malackowski et al. Sep 2008 B2
D578643 Shumer et al. Oct 2008 S
D578644 Shumer et al. Oct 2008 S
D578645 Shumer et al. Oct 2008 S
7431694 Stefanchik et al. Oct 2008 B2
7431704 Babaev Oct 2008 B2
7431720 Pendekanti et al. Oct 2008 B2
7435582 Zimmermann et al. Oct 2008 B2
7441684 Shelton, IV et al. Oct 2008 B2
7442193 Shields et al. Oct 2008 B2
7445621 Dumbauld et al. Nov 2008 B2
7449004 Yamada et al. Nov 2008 B2
7451904 Shelton, IV Nov 2008 B2
7455208 Wales et al. Nov 2008 B2
7455641 Yamada et al. Nov 2008 B2
7462181 Kraft et al. Dec 2008 B2
7464846 Shelton, IV et al. Dec 2008 B2
7464849 Shelton, IV et al. Dec 2008 B2
7472815 Shelton, IV et al. Jan 2009 B2
7473145 Ehr et al. Jan 2009 B2
7473253 Dycus et al. Jan 2009 B2
7473263 Johnston et al. Jan 2009 B2
7479148 Beaupre Jan 2009 B2
7479160 Branch et al. Jan 2009 B2
7481775 Weikel, Jr. et al. Jan 2009 B2
7488285 Honda et al. Feb 2009 B2
7488319 Yates Feb 2009 B2
7491201 Shields et al. Feb 2009 B2
7491202 Odom et al. Feb 2009 B2
7494468 Rabiner et al. Feb 2009 B2
7494501 Ahlberg et al. Feb 2009 B2
7498080 Tung et al. Mar 2009 B2
7502234 Goliszek et al. Mar 2009 B2
7503893 Kucklick Mar 2009 B2
7503895 Rabiner et al. Mar 2009 B2
7506790 Shelton, IV Mar 2009 B2
7506791 Omaits et al. Mar 2009 B2
7507239 Shadduck Mar 2009 B2
7510107 Timm et al. Mar 2009 B2
7510556 Nguyen et al. Mar 2009 B2
7513025 Fischer Apr 2009 B2
7517349 Truckai et al. Apr 2009 B2
7520865 Radley Young et al. Apr 2009 B2
7524320 Tierney et al. Apr 2009 B2
7525309 Sherman et al. Apr 2009 B2
7530986 Beaupre et al. May 2009 B2
7534243 Chin et al. May 2009 B1
7535233 Kojovic et al. May 2009 B2
D594983 Price et al. Jun 2009 S
7540871 Gonnering Jun 2009 B2
7540872 Schechter et al. Jun 2009 B2
7543730 Marczyk Jun 2009 B1
7544200 Houser Jun 2009 B2
7549564 Boudreaux Jun 2009 B2
7550216 Ofer et al. Jun 2009 B2
7553309 Buysse et al. Jun 2009 B2
7554343 Bromfield Jun 2009 B2
7559450 Wales et al. Jul 2009 B2
7559452 Wales et al. Jul 2009 B2
7563259 Takahashi Jul 2009 B2
7566318 Haefner Jul 2009 B2
7567012 Namikawa Jul 2009 B2
7568603 Shelton, IV et al. Aug 2009 B2
7569057 Liu et al. Aug 2009 B2
7572266 Young et al. Aug 2009 B2
7572268 Babaev Aug 2009 B2
7578820 Moore et al. Aug 2009 B2
7582084 Swanson et al. Sep 2009 B2
7582086 Privitera et al. Sep 2009 B2
7582087 Tetzlaff et al. Sep 2009 B2
7582095 Shipp et al. Sep 2009 B2
7585181 Olsen Sep 2009 B2
7586289 Andruk et al. Sep 2009 B2
7587536 McLeod Sep 2009 B2
7588176 Timm et al. Sep 2009 B2
7588177 Racenet Sep 2009 B2
7594925 Danek et al. Sep 2009 B2
7597693 Garrison Oct 2009 B2
7601119 Shahinian Oct 2009 B2
7601136 Akahoshi Oct 2009 B2
7604150 Boudreaux Oct 2009 B2
7607557 Shelton, IV et al. Oct 2009 B2
7617961 Viola Nov 2009 B2
7621930 Houser Nov 2009 B2
7625370 Hart et al. Dec 2009 B2
7628791 Garrison et al. Dec 2009 B2
7628792 Guerra Dec 2009 B2
7632267 Dahla Dec 2009 B2
7632269 Truckai et al. Dec 2009 B2
7637410 Marczyk Dec 2009 B2
7641653 Dalla Betta et al. Jan 2010 B2
7641671 Crainich Jan 2010 B2
7644848 Swayze et al. Jan 2010 B2
7645240 Thompson et al. Jan 2010 B2
7645277 McClurken et al. Jan 2010 B2
7645278 Ichihashi et al. Jan 2010 B2
7648499 Orszulak et al. Jan 2010 B2
7649410 Andersen et al. Jan 2010 B2
7654431 Hueil et al. Feb 2010 B2
7655003 Lorang et al. Feb 2010 B2
7658311 Boudreaux Feb 2010 B2
7659833 Warner et al. Feb 2010 B2
7662151 Crompton, Jr. et al. Feb 2010 B2
7665647 Shelton, IV et al. Feb 2010 B2
7666206 Taniguchi et al. Feb 2010 B2
7667592 Ohyama et al. Feb 2010 B2
7670334 Hueil et al. Mar 2010 B2
7670338 Albrecht et al. Mar 2010 B2
7674263 Ryan Mar 2010 B2
7678069 Baker et al. Mar 2010 B1
7678105 McGreevy et al. Mar 2010 B2
7678125 Shipp Mar 2010 B2
7682366 Sakurai et al. Mar 2010 B2
7686770 Cohen Mar 2010 B2
7686826 Lee et al. Mar 2010 B2
7688028 Phillips et al. Mar 2010 B2
7691095 Bednarek et al. Apr 2010 B2
7691098 Wallace et al. Apr 2010 B2
7696441 Kataoka Apr 2010 B2
7699846 Ryan Apr 2010 B2
7703459 Saadat et al. Apr 2010 B2
7703653 Shah et al. Apr 2010 B2
7708735 Chapman et al. May 2010 B2
7708751 Hughes et al. May 2010 B2
7708758 Lee et al. May 2010 B2
7708768 Danek et al. May 2010 B2
7713202 Boukhny et al. May 2010 B2
7713267 Pozzato May 2010 B2
7714481 Sakai May 2010 B2
7717312 Beetel May 2010 B2
7717914 Kimura May 2010 B2
7717915 Miyazawa May 2010 B2
7721935 Racenet et al. May 2010 B2
7722527 Bouchier et al. May 2010 B2
7722607 Dumbauld et al. May 2010 B2
D618797 Price et al. Jun 2010 S
7726537 Olson et al. Jun 2010 B2
7727177 Bayat Jun 2010 B2
7731717 Odom et al. Jun 2010 B2
7738969 Bleich Jun 2010 B2
7740594 Hibner Jun 2010 B2
7744615 Couture Jun 2010 B2
7749240 Takahashi et al. Jul 2010 B2
7751115 Song Jul 2010 B2
7753245 Boudreaux et al. Jul 2010 B2
7753904 Shelton, IV et al. Jul 2010 B2
7753908 Swanson Jul 2010 B2
7762445 Heinrich et al. Jul 2010 B2
D621503 Otten et al. Aug 2010 S
7766210 Shelton, IV et al. Aug 2010 B2
7766693 Sartor et al. Aug 2010 B2
7766910 Hixson et al. Aug 2010 B2
7768510 Tsai et al. Aug 2010 B2
7770774 Mastri et al. Aug 2010 B2
7770775 Shelton, IV et al. Aug 2010 B2
7771425 Dycus et al. Aug 2010 B2
7771444 Patel et al. Aug 2010 B2
7775972 Brock et al. Aug 2010 B2
7776036 Schechter et al. Aug 2010 B2
7776037 Odom Aug 2010 B2
7778733 Nowlin et al. Aug 2010 B2
7780054 Wales Aug 2010 B2
7780593 Ueno et al. Aug 2010 B2
7780651 Madhani et al. Aug 2010 B2
7780659 Okada et al. Aug 2010 B2
7780663 Yates et al. Aug 2010 B2
7784662 Wales et al. Aug 2010 B2
7784663 Shelton, IV Aug 2010 B2
7789883 Takashino et al. Sep 2010 B2
7793814 Racenet et al. Sep 2010 B2
7794475 Hess et al. Sep 2010 B2
7796969 Kelly et al. Sep 2010 B2
7798386 Schall et al. Sep 2010 B2
7799020 Shores et al. Sep 2010 B2
7799027 Hafner Sep 2010 B2
7799045 Masuda Sep 2010 B2
7803151 Whitman Sep 2010 B2
7803152 Honda et al. Sep 2010 B2
7803156 Eder et al. Sep 2010 B2
7803168 Gifford et al. Sep 2010 B2
7806891 Nowlin et al. Oct 2010 B2
7810693 Broehl et al. Oct 2010 B2
7811283 Moses et al. Oct 2010 B2
7815238 Cao Oct 2010 B2
7815641 Dodde et al. Oct 2010 B2
7819298 Hall et al. Oct 2010 B2
7819299 Shelton, IV et al. Oct 2010 B2
7819819 Quick et al. Oct 2010 B2
7819872 Johnson et al. Oct 2010 B2
7821143 Wiener Oct 2010 B2
D627066 Romero Nov 2010 S
7824401 Manzo et al. Nov 2010 B2
7832408 Shelton, IV et al. Nov 2010 B2
7832611 Boyden et al. Nov 2010 B2
7832612 Baxter, III et al. Nov 2010 B2
7834484 Sartor Nov 2010 B2
7837699 Yamada et al. Nov 2010 B2
7845537 Shelton, IV et al. Dec 2010 B2
7846155 Houser et al. Dec 2010 B2
7846159 Morrison et al. Dec 2010 B2
7846160 Payne et al. Dec 2010 B2
7846161 Dumbauld et al. Dec 2010 B2
7854735 Houser et al. Dec 2010 B2
D631155 Peine et al. Jan 2011 S
7861906 Doll et al. Jan 2011 B2
7862560 Marion Jan 2011 B2
7862561 Swanson et al. Jan 2011 B2
7867228 Nobis et al. Jan 2011 B2
7871392 Sartor Jan 2011 B2
7871423 Livneh Jan 2011 B2
7876030 Taki et al. Jan 2011 B2
D631965 Price et al. Feb 2011 S
7877852 Unger et al. Feb 2011 B2
7878991 Babaev Feb 2011 B2
7879029 Jimenez Feb 2011 B2
7879033 Sartor et al. Feb 2011 B2
7879035 Garrison et al. Feb 2011 B2
7879070 Ortiz et al. Feb 2011 B2
7883475 Dupont et al. Feb 2011 B2
7892606 Thies et al. Feb 2011 B2
7896875 Heim et al. Mar 2011 B2
7897792 Iikura et al. Mar 2011 B2
7901400 Wham et al. Mar 2011 B2
7901423 Stulen et al. Mar 2011 B2
7905881 Masuda et al. Mar 2011 B2
7909220 Viola Mar 2011 B2
7909820 Lipson et al. Mar 2011 B2
7909824 Masuda et al. Mar 2011 B2
7918848 Lau et al. Apr 2011 B2
7919184 Mohapatra et al. Apr 2011 B2
7922061 Shelton, IV et al. Apr 2011 B2
7922651 Yamada et al. Apr 2011 B2
7931611 Novak et al. Apr 2011 B2
7931649 Couture et al. Apr 2011 B2
D637288 Houghton May 2011 S
D638540 Ijiri et al. May 2011 S
7935114 Takashino et al. May 2011 B2
7936203 Zimlich May 2011 B2
7951095 Makin et al. May 2011 B2
7951165 Golden et al. May 2011 B2
7955331 Truckai et al. Jun 2011 B2
7956620 Gilbert Jun 2011 B2
7959050 Smith et al. Jun 2011 B2
7959626 Hong et al. Jun 2011 B2
7963963 Francischelli et al. Jun 2011 B2
7967602 Lindquist Jun 2011 B2
7972328 Wham et al. Jul 2011 B2
7972329 Refior et al. Jul 2011 B2
7975895 Milliman Jul 2011 B2
7976544 McClurken et al. Jul 2011 B2
7980443 Scheib et al. Jul 2011 B2
7981050 Ritchart et al. Jul 2011 B2
7981113 Truckai et al. Jul 2011 B2
7997278 Utley et al. Aug 2011 B2
7998157 Culp et al. Aug 2011 B2
8002732 Visconti Aug 2011 B2
8002770 Swanson et al. Aug 2011 B2
8020743 Shelton, IV Sep 2011 B2
8025672 Novak et al. Sep 2011 B2
8028885 Smith et al. Oct 2011 B2
8033173 Ehlert et al. Oct 2011 B2
8034049 Odom et al. Oct 2011 B2
8038693 Allen Oct 2011 B2
8048070 O'Brien et al. Nov 2011 B2
8052672 Laufer et al. Nov 2011 B2
8055208 Lilia et al. Nov 2011 B2
8056720 Hawkes Nov 2011 B2
8056787 Boudreaux et al. Nov 2011 B2
8057468 Konesky Nov 2011 B2
8057498 Robertson Nov 2011 B2
8058771 Giordano et al. Nov 2011 B2
8061014 Smith et al. Nov 2011 B2
8066167 Measamer et al. Nov 2011 B2
8070036 Knodel Dec 2011 B1
8070711 Bassinger et al. Dec 2011 B2
8070762 Escudero et al. Dec 2011 B2
8075555 Truckai et al. Dec 2011 B2
8075558 Truckai et al. Dec 2011 B2
8089197 Rinner et al. Jan 2012 B2
8092475 Cotter et al. Jan 2012 B2
8096459 Ortiz et al. Jan 2012 B2
8097012 Kagarise Jan 2012 B2
8100894 Mucko et al. Jan 2012 B2
8105230 Honda et al. Jan 2012 B2
8105323 Buysse et al. Jan 2012 B2
8105324 Palanker et al. Jan 2012 B2
8114104 Young et al. Feb 2012 B2
8118276 Sanders et al. Feb 2012 B2
8128624 Couture et al. Mar 2012 B2
8133218 Daw et al. Mar 2012 B2
8136712 Zingman Mar 2012 B2
8141762 Bedi et al. Mar 2012 B2
8142421 Cooper et al. Mar 2012 B2
8142461 Houser et al. Mar 2012 B2
8147485 Wham et al. Apr 2012 B2
8147488 Masuda Apr 2012 B2
8147508 Madan et al. Apr 2012 B2
8152801 Goldberg et al. Apr 2012 B2
8152825 Madan et al. Apr 2012 B2
8157145 Shelton, IV et al. Apr 2012 B2
8161977 Shelton, IV et al. Apr 2012 B2
8162966 Connor et al. Apr 2012 B2
8170717 Sutherland et al. May 2012 B2
8172846 Brunnett et al. May 2012 B2
8172870 Shipp May 2012 B2
8177800 Spitz et al. May 2012 B2
8182502 Stulen et al. May 2012 B2
8186560 Hess et al. May 2012 B2
8186877 Klimovitch et al. May 2012 B2
8187267 Pappone et al. May 2012 B2
D661801 Price et al. Jun 2012 S
D661802 Price et al. Jun 2012 S
D661803 Price et al. Jun 2012 S
D661804 Price et al. Jun 2012 S
8197472 Lau et al. Jun 2012 B2
8197479 Olson et al. Jun 2012 B2
8197502 Smith et al. Jun 2012 B2
8207651 Gilbert Jun 2012 B2
8210411 Yates et al. Jul 2012 B2
8211100 Podhajsky et al. Jul 2012 B2
8220688 Laurent et al. Jul 2012 B2
8221306 Okada et al. Jul 2012 B2
8221415 Francischelli Jul 2012 B2
8221418 Prakash et al. Jul 2012 B2
8226580 Govari et al. Jul 2012 B2
8226665 Cohen Jul 2012 B2
8226675 Houser et al. Jul 2012 B2
8231607 Takuma Jul 2012 B2
8235917 Joseph et al. Aug 2012 B2
8236018 Yoshimine et al. Aug 2012 B2
8236019 Houser Aug 2012 B2
8236020 Smith et al. Aug 2012 B2
8241235 Kahler et al. Aug 2012 B2
8241271 Millman et al. Aug 2012 B2
8241282 Unger et al. Aug 2012 B2
8241283 Guerra et al. Aug 2012 B2
8241284 Dycus et al. Aug 2012 B2
8241312 Messerly Aug 2012 B2
8246575 Viola Aug 2012 B2
8246615 Behnke Aug 2012 B2
8246616 Amoah et al. Aug 2012 B2
8246618 Bucciaglia et al. Aug 2012 B2
8246642 Houser et al. Aug 2012 B2
8251994 McKenna et al. Aug 2012 B2
8252012 Stulen Aug 2012 B2
8253303 Giordano et al. Aug 2012 B2
8257377 Wiener et al. Sep 2012 B2
8257387 Cunningham Sep 2012 B2
8262563 Bakos et al. Sep 2012 B2
8267300 Boudreaux Sep 2012 B2
8267935 Couture et al. Sep 2012 B2
8273087 Kimura et al. Sep 2012 B2
D669992 Schafer et al. Oct 2012 S
D669993 Merchant et al. Oct 2012 S
8277446 Heard Oct 2012 B2
8277447 Garrison et al. Oct 2012 B2
8277471 Wiener et al. Oct 2012 B2
8282581 Zhao et al. Oct 2012 B2
8282669 Gerber et al. Oct 2012 B2
8286846 Smith et al. Oct 2012 B2
8287485 Kimura et al. Oct 2012 B2
8287528 Wham et al. Oct 2012 B2
8287532 Carroll et al. Oct 2012 B2
8292886 Kerr et al. Oct 2012 B2
8292888 Whitman Oct 2012 B2
8292905 Taylor et al. Oct 2012 B2
8295902 Salahieh et al. Oct 2012 B2
8298223 Wham et al. Oct 2012 B2
8298225 Gilbert Oct 2012 B2
8298232 Unger Oct 2012 B2
8298233 Mueller Oct 2012 B2
8303576 Brock Nov 2012 B2
8303579 Shibata Nov 2012 B2
8303580 Wham et al. Nov 2012 B2
8303583 Hosier et al. Nov 2012 B2
8303613 Crandall et al. Nov 2012 B2
8306629 Mioduski et al. Nov 2012 B2
8308040 Huang et al. Nov 2012 B2
8319400 Houser et al. Nov 2012 B2
8323302 Robertson et al. Dec 2012 B2
8323310 Kingsley Dec 2012 B2
8328061 Kasvikis Dec 2012 B2
8328761 Widenhouse et al. Dec 2012 B2
8328802 Deville et al. Dec 2012 B2
8328833 Cuny Dec 2012 B2
8328834 Isaacs et al. Dec 2012 B2
8333764 Francischelli et al. Dec 2012 B2
8333778 Smith et al. Dec 2012 B2
8333779 Smith et al. Dec 2012 B2
8334468 Palmer et al. Dec 2012 B2
8334635 Voegele et al. Dec 2012 B2
8337407 Quistgaard et al. Dec 2012 B2
8338726 Palmer et al. Dec 2012 B2
8343146 Godara et al. Jan 2013 B2
8344596 Nield et al. Jan 2013 B2
8348880 Messerly et al. Jan 2013 B2
8348947 Takashino et al. Jan 2013 B2
8348967 Stulen Jan 2013 B2
8353297 Dacquay et al. Jan 2013 B2
8357103 Mark et al. Jan 2013 B2
8357144 Whitman et al. Jan 2013 B2
8357149 Govari et al. Jan 2013 B2
8357158 McKenna et al. Jan 2013 B2
8360299 Zemlok et al. Jan 2013 B2
8361066 Long et al. Jan 2013 B2
8361072 Dumbauld et al. Jan 2013 B2
8361569 Saito et al. Jan 2013 B2
8366727 Witt et al. Feb 2013 B2
8372064 Douglass et al. Feb 2013 B2
8372099 Deville et al. Feb 2013 B2
8372101 Smith et al. Feb 2013 B2
8372102 Stulen et al. Feb 2013 B2
8374670 Selkee Feb 2013 B2
8377044 Coe et al. Feb 2013 B2
8377059 Deville et al. Feb 2013 B2
8377085 Smith et al. Feb 2013 B2
8382748 Geisel Feb 2013 B2
8382775 Bender et al. Feb 2013 B1
8382782 Robertson et al. Feb 2013 B2
8382792 Chojin Feb 2013 B2
8388646 Chojin Mar 2013 B2
8388647 Nau, Jr. et al. Mar 2013 B2
8393514 Shelton, IV et al. Mar 2013 B2
8394115 Houser et al. Mar 2013 B2
8397971 Yates et al. Mar 2013 B2
8398394 Sauter et al. Mar 2013 B2
8398674 Prestel Mar 2013 B2
8403926 Nobis et al. Mar 2013 B2
8403945 Whitfield et al. Mar 2013 B2
8403948 Deville et al. Mar 2013 B2
8403949 Palmer et al. Mar 2013 B2
8403950 Palmer et al. Mar 2013 B2
8409234 Stabler et al. Apr 2013 B2
8414577 Boudreaux et al. Apr 2013 B2
8418073 Mohr et al. Apr 2013 B2
8418349 Smith et al. Apr 2013 B2
8419757 Smith et al. Apr 2013 B2
8419758 Smith et al. Apr 2013 B2
8419759 Dietz Apr 2013 B2
8423182 Robinson et al. Apr 2013 B2
8425410 Murray et al. Apr 2013 B2
8425545 Smith et al. Apr 2013 B2
8430811 Hess et al. Apr 2013 B2
8430874 Newton et al. Apr 2013 B2
8430876 Kappus et al. Apr 2013 B2
8430897 Novak et al. Apr 2013 B2
8430898 Wiener et al. Apr 2013 B2
8435257 Smith et al. May 2013 B2
8437832 Govari et al. May 2013 B2
8439912 Cunningham et al. May 2013 B2
8439939 Deville et al. May 2013 B2
8444036 Shelton, IV May 2013 B2
8444637 Podmore et al. May 2013 B2
8444662 Palmer et al. May 2013 B2
8444663 Houser et al. May 2013 B2
8444664 Balanev et al. May 2013 B2
8453906 Huang et al. Jun 2013 B2
8454599 Inagaki et al. Jun 2013 B2
8454639 Du et al. Jun 2013 B2
8459525 Yates et al. Jun 2013 B2
8460284 Aronow et al. Jun 2013 B2
8460288 Tamai et al. Jun 2013 B2
8460292 Truckai et al. Jun 2013 B2
8461744 Wiener et al. Jun 2013 B2
8469981 Robertson et al. Jun 2013 B2
8471685 Shingai Jun 2013 B2
8479969 Shelton, IV Jul 2013 B2
8480703 Nicholas et al. Jul 2013 B2
8484833 Cunningham et al. Jul 2013 B2
8485413 Scheib et al. Jul 2013 B2
8485970 Widenhouse et al. Jul 2013 B2
8486057 Behnke, II Jul 2013 B2
8486096 Robertson et al. Jul 2013 B2
8491578 Manwaring et al. Jul 2013 B2
8491625 Horner Jul 2013 B2
8496682 Guerra et al. Jul 2013 B2
D687549 Johnson et al. Aug 2013 S
8506555 Ruiz Morales Aug 2013 B2
8509318 Tailliet Aug 2013 B2
8512336 Couture Aug 2013 B2
8512337 Francischelli et al. Aug 2013 B2
8512359 Whitman et al. Aug 2013 B2
8512364 Kowalski et al. Aug 2013 B2
8512365 Wiener et al. Aug 2013 B2
8518067 Masuda et al. Aug 2013 B2
8521331 Itkowitz Aug 2013 B2
8523043 Ullrich et al. Sep 2013 B2
8523882 Huitema et al. Sep 2013 B2
8523889 Stulen et al. Sep 2013 B2
8528563 Gruber Sep 2013 B2
8529437 Taylor et al. Sep 2013 B2
8529565 Masuda et al. Sep 2013 B2
8531064 Robertson et al. Sep 2013 B2
8535308 Govari et al. Sep 2013 B2
8535311 Schall Sep 2013 B2
8535340 Allen Sep 2013 B2
8535341 Allen Sep 2013 B2
8540128 Shelton, IV et al. Sep 2013 B2
8546996 Messerly et al. Oct 2013 B2
8546999 Houser et al. Oct 2013 B2
8551077 Main et al. Oct 2013 B2
8551086 Kimura et al. Oct 2013 B2
8556929 Harper et al. Oct 2013 B2
8561870 Baxter, III et al. Oct 2013 B2
8562592 Conlon et al. Oct 2013 B2
8562598 Falkenstein et al. Oct 2013 B2
8562600 Kirkpatrick et al. Oct 2013 B2
8562604 Nishimura Oct 2013 B2
8568390 Mueller Oct 2013 B2
8568397 Horner et al. Oct 2013 B2
8568400 Gilbert Oct 2013 B2
8568412 Brandt et al. Oct 2013 B2
8569997 Lee Oct 2013 B2
8573461 Shelton, IV et al. Nov 2013 B2
8573465 Shelton, IV Nov 2013 B2
8574231 Boudreaux et al. Nov 2013 B2
8574253 Gruber et al. Nov 2013 B2
8579176 Smith et al. Nov 2013 B2
8579897 Vakharia et al. Nov 2013 B2
8579928 Robertson et al. Nov 2013 B2
8579937 Gresham Nov 2013 B2
8585727 Polo Nov 2013 B2
8588371 Ogawa et al. Nov 2013 B2
8591459 Clymer et al. Nov 2013 B2
8591506 Wham et al. Nov 2013 B2
8591536 Robertson Nov 2013 B2
D695407 Price et al. Dec 2013 S
D696631 Price et al. Dec 2013 S
8596513 Olson et al. Dec 2013 B2
8597193 Grunwald et al. Dec 2013 B2
8597287 Benamou et al. Dec 2013 B2
8602031 Reis et al. Dec 2013 B2
8602288 Shelton, IV et al. Dec 2013 B2
8603085 Jimenez Dec 2013 B2
8603089 Viola Dec 2013 B2
8608044 Hueil et al. Dec 2013 B2
8608045 Smith et al. Dec 2013 B2
8608745 Guzman et al. Dec 2013 B2
8613383 Beckman et al. Dec 2013 B2
8616431 Timm et al. Dec 2013 B2
8617152 Werneth et al. Dec 2013 B2
8617194 Beaupre Dec 2013 B2
8622274 Yates et al. Jan 2014 B2
8623011 Spivey Jan 2014 B2
8623016 Fischer Jan 2014 B2
8623027 Price et al. Jan 2014 B2
8623040 Artsyukhovich et al. Jan 2014 B2
8623044 Timm et al. Jan 2014 B2
8628529 Aldridge et al. Jan 2014 B2
8628534 Jones et al. Jan 2014 B2
8632461 Glossop Jan 2014 B2
8636736 Yates et al. Jan 2014 B2
8638428 Brown Jan 2014 B2
8640788 Dachs, II et al. Feb 2014 B2
8641663 Kirschenman et al. Feb 2014 B2
8647350 Mohan et al. Feb 2014 B2
8650728 Wan et al. Feb 2014 B2
8652120 Giordano et al. Feb 2014 B2
8652132 Tsuchiya et al. Feb 2014 B2
8652155 Houser et al. Feb 2014 B2
8657489 Ladurner et al. Feb 2014 B2
8659208 Rose et al. Feb 2014 B1
8663214 Weinberg et al. Mar 2014 B2
8663220 Wiener et al. Mar 2014 B2
8663222 Anderson et al. Mar 2014 B2
8663223 Masuda et al. Mar 2014 B2
8663262 Smith et al. Mar 2014 B2
8668691 Heard Mar 2014 B2
8668710 Slipszenko et al. Mar 2014 B2
8684253 Giordano et al. Apr 2014 B2
8685016 Wham et al. Apr 2014 B2
8685020 Weizman et al. Apr 2014 B2
8690582 Rohrbach et al. Apr 2014 B2
8695866 Leimbach et al. Apr 2014 B2
8696366 Chen et al. Apr 2014 B2
8696665 Hunt et al. Apr 2014 B2
8696666 Sanai et al. Apr 2014 B2
8696917 Petisce et al. Apr 2014 B2
8702609 Hadjicostis Apr 2014 B2
8702704 Shelton, IV et al. Apr 2014 B2
8704425 Giordano et al. Apr 2014 B2
8708213 Shelton, IV et al. Apr 2014 B2
8709008 Willis et al. Apr 2014 B2
8709031 Stulen Apr 2014 B2
8709035 Johnson et al. Apr 2014 B2
8715270 Weitzner et al. May 2014 B2
8715277 Weizman May 2014 B2
8721640 Taylor et al. May 2014 B2
8721657 Kondoh et al. May 2014 B2
8733613 Huitema et al. May 2014 B2
8733614 Ross et al. May 2014 B2
8734443 Hixson et al. May 2014 B2
8738110 Tabada et al. May 2014 B2
8747238 Shelton, IV et al. Jun 2014 B2
8747351 Schultz Jun 2014 B2
8747404 Boudreaux et al. Jun 2014 B2
8749116 Messerly et al. Jun 2014 B2
8752264 Ackley et al. Jun 2014 B2
8752749 Moore et al. Jun 2014 B2
8753338 Widenhouse et al. Jun 2014 B2
8754570 Voegele et al. Jun 2014 B2
8758342 Bales et al. Jun 2014 B2
8758352 Cooper et al. Jun 2014 B2
8758391 Swayze et al. Jun 2014 B2
8764735 Coe et al. Jul 2014 B2
8764747 Cummings et al. Jul 2014 B2
8767970 Eppolito Jul 2014 B2
8770459 Racenet et al. Jul 2014 B2
8771269 Sherman et al. Jul 2014 B2
8771270 Burbank Jul 2014 B2
8771293 Surti et al. Jul 2014 B2
8773001 Wiener et al. Jul 2014 B2
8777944 Frankhouser et al. Jul 2014 B2
8777945 Floume et al. Jul 2014 B2
8779648 Giordano et al. Jul 2014 B2
8783541 Shelton, IV et al. Jul 2014 B2
8784415 Malackowski et al. Jul 2014 B2
8784418 Romero Jul 2014 B2
8790342 Stulen et al. Jul 2014 B2
8795274 Hanna Aug 2014 B2
8795275 Hafner Aug 2014 B2
8795276 Dietz et al. Aug 2014 B2
8795327 Dietz et al. Aug 2014 B2
8800838 Shelton, IV Aug 2014 B2
8801710 Ullrich et al. Aug 2014 B2
8801752 Fortier et al. Aug 2014 B2
8807414 Ross et al. Aug 2014 B2
8808204 Irisawa et al. Aug 2014 B2
8808319 Houser et al. Aug 2014 B2
8814856 Elmouelhi et al. Aug 2014 B2
8814870 Paraschiv et al. Aug 2014 B2
8820605 Shelton, IV Sep 2014 B2
8821388 Naito et al. Sep 2014 B2
8827992 Koss et al. Sep 2014 B2
8827995 Schaller et al. Sep 2014 B2
8834466 Cummings et al. Sep 2014 B2
8834518 Faller et al. Sep 2014 B2
8844789 Shelton, IV et al. Sep 2014 B2
8845537 Tanaka et al. Sep 2014 B2
8845630 Mehta et al. Sep 2014 B2
8848808 Dress Sep 2014 B2
8851354 Swensgard et al. Oct 2014 B2
8852184 Kucklick Oct 2014 B2
8858547 Brogna Oct 2014 B2
8862955 Cesari Oct 2014 B2
8864749 Okada Oct 2014 B2
8864757 Klimovitch et al. Oct 2014 B2
8864761 Johnson et al. Oct 2014 B2
8870865 Frankhouser et al. Oct 2014 B2
8874220 Draghici et al. Oct 2014 B2
8876726 Amit et al. Nov 2014 B2
8876858 Braun Nov 2014 B2
8882766 Couture et al. Nov 2014 B2
8882791 Stulen Nov 2014 B2
8888776 Dietz et al. Nov 2014 B2
8888783 Young Nov 2014 B2
8888809 Davison et al. Nov 2014 B2
8899462 Kostrzewski et al. Dec 2014 B2
8900259 Houser et al. Dec 2014 B2
8906016 Boudreaux et al. Dec 2014 B2
8906017 Rioux et al. Dec 2014 B2
8911438 Swoyer et al. Dec 2014 B2
8911460 Neurohr et al. Dec 2014 B2
8920412 Fritz et al. Dec 2014 B2
8920414 Stone et al. Dec 2014 B2
8920421 Rupp Dec 2014 B2
8926607 Norvell et al. Jan 2015 B2
8926608 Bacher et al. Jan 2015 B2
8926620 Chasmawala et al. Jan 2015 B2
8931682 Timm et al. Jan 2015 B2
8932282 Gilbert Jan 2015 B2
8932299 Bono et al. Jan 2015 B2
8936614 Allen, IV Jan 2015 B2
8939974 Boudreaux et al. Jan 2015 B2
8945126 Garrison et al. Feb 2015 B2
8951248 Messerly et al. Feb 2015 B2
8951272 Robertson et al. Feb 2015 B2
8956349 Aldridge et al. Feb 2015 B2
8960520 McCuen Feb 2015 B2
8961515 Twomey et al. Feb 2015 B2
8961547 Dietz et al. Feb 2015 B2
8967443 McCuen Mar 2015 B2
8968283 Kharin Mar 2015 B2
8968294 Maass et al. Mar 2015 B2
8968296 McPherson Mar 2015 B2
8968355 Malkowski et al. Mar 2015 B2
8974447 Kimball et al. Mar 2015 B2
8974477 Yamada Mar 2015 B2
8974479 Ross et al. Mar 2015 B2
8974932 McGahan et al. Mar 2015 B2
8979843 Timm et al. Mar 2015 B2
8979844 White et al. Mar 2015 B2
8979890 Boudreaux Mar 2015 B2
8986287 Park et al. Mar 2015 B2
8986297 Daniel et al. Mar 2015 B2
8986302 Aldridge et al. Mar 2015 B2
8989855 Murphy et al. Mar 2015 B2
8989903 Weir et al. Mar 2015 B2
8991678 Wellman et al. Mar 2015 B2
8992422 Spivey et al. Mar 2015 B2
8992526 Brodbeck et al. Mar 2015 B2
8998891 Garito et al. Apr 2015 B2
9005199 Beckman et al. Apr 2015 B2
9011437 Woodruff et al. Apr 2015 B2
9011471 Timm et al. Apr 2015 B2
9017326 DiNardo et al. Apr 2015 B2
9017355 Smith et al. Apr 2015 B2
9017370 Reschke et al. Apr 2015 B2
9017372 Artale et al. Apr 2015 B2
9023035 Allen, IV et al. May 2015 B2
9023070 Levine et al. May 2015 B2
9023071 Miller et al. May 2015 B2
9028397 Naito May 2015 B2
9028476 Bonn May 2015 B2
9028478 Mueller May 2015 B2
9028481 Behnke, II May 2015 B2
9028494 Shelton, IV et al. May 2015 B2
9028519 Yates et al. May 2015 B2
9031667 Williams May 2015 B2
9033973 Krapohl et al. May 2015 B2
9035741 Hamel et al. May 2015 B2
9037259 Mathur May 2015 B2
9039690 Kersten et al. May 2015 B2
9039691 Moua et al. May 2015 B2
9039695 Giordano et al. May 2015 B2
9039696 Assmus et al. May 2015 B2
9039705 Takashino May 2015 B2
9039731 Joseph May 2015 B2
9043018 Mohr May 2015 B2
9044227 Shelton, IV et al. Jun 2015 B2
9044230 Morgan et al. Jun 2015 B2
9044238 Orszulak Jun 2015 B2
9044243 Johnson et al. Jun 2015 B2
9044245 Condie et al. Jun 2015 B2
9044256 Cadeddu et al. Jun 2015 B2
9044261 Houser Jun 2015 B2
9050083 Yates et al. Jun 2015 B2
9050093 Aldridge et al. Jun 2015 B2
9050098 Deville et al. Jun 2015 B2
9050123 Krause et al. Jun 2015 B2
9050124 Houser Jun 2015 B2
9055961 Manzo et al. Jun 2015 B2
9059547 McLawhorn Jun 2015 B2
9060770 Shelton, IV et al. Jun 2015 B2
9060775 Wiener et al. Jun 2015 B2
9060776 Yates et al. Jun 2015 B2
9060778 Condie et al. Jun 2015 B2
9066720 Ballakur et al. Jun 2015 B2
9066723 Beller et al. Jun 2015 B2
9066747 Robertson Jun 2015 B2
9072523 Houser et al. Jul 2015 B2
9072535 Shelton, IV et al. Jul 2015 B2
9072536 Shelton, IV et al. Jul 2015 B2
9072538 Suzuki et al. Jul 2015 B2
9072539 Messerly et al. Jul 2015 B2
9084624 Larkin et al. Jul 2015 B2
9089327 Worrell et al. Jul 2015 B2
9089360 Messerly et al. Jul 2015 B2
9095362 Dachs, II et al. Aug 2015 B2
9095367 Olson et al. Aug 2015 B2
9099863 Smith et al. Aug 2015 B2
9101358 Kerr et al. Aug 2015 B2
9101385 Shelton, IV et al. Aug 2015 B2
9107684 Ma Aug 2015 B2
9107689 Robertson et al. Aug 2015 B2
9107690 Bales, Jr. et al. Aug 2015 B2
9113900 Buysse et al. Aug 2015 B2
9113907 Allen, IV et al. Aug 2015 B2
9113940 Twomey Aug 2015 B2
9119657 Shelton, IV et al. Sep 2015 B2
9119957 Gantz et al. Sep 2015 B2
9125662 Shelton, IV Sep 2015 B2
9125667 Stone et al. Sep 2015 B2
9144453 Rencher et al. Sep 2015 B2
9147965 Lee Sep 2015 B2
9149324 Huang et al. Oct 2015 B2
9149325 Worrell et al. Oct 2015 B2
9161803 Yates et al. Oct 2015 B2
9165114 Jain et al. Oct 2015 B2
9168054 Turner et al. Oct 2015 B2
9168085 Juzkiw et al. Oct 2015 B2
9168089 Buysse et al. Oct 2015 B2
9173656 Schurr et al. Nov 2015 B2
9179912 Yates et al. Nov 2015 B2
9186199 Strauss et al. Nov 2015 B2
9186204 Nishimura et al. Nov 2015 B2
9186796 Ogawa Nov 2015 B2
9192380 (Tarinelli) Racenet et al. Nov 2015 B2
9192421 Garrison Nov 2015 B2
9192428 Houser et al. Nov 2015 B2
9192431 Woodruff et al. Nov 2015 B2
9198714 Worrell et al. Dec 2015 B2
9198715 Livneh Dec 2015 B2
9198718 Marczyk et al. Dec 2015 B2
9198776 Young Dec 2015 B2
9204879 Shelton, IV Dec 2015 B2
9204891 Weitzman Dec 2015 B2
9204918 Germain et al. Dec 2015 B2
9204923 Manzo et al. Dec 2015 B2
9216050 Condie et al. Dec 2015 B2
9216051 Fischer et al. Dec 2015 B2
9216062 Duque et al. Dec 2015 B2
9220483 Frankhouser et al. Dec 2015 B2
9220527 Houser et al. Dec 2015 B2
9220559 Worrell et al. Dec 2015 B2
9226750 Weir et al. Jan 2016 B2
9226751 Shelton, IV et al. Jan 2016 B2
9226766 Aldridge et al. Jan 2016 B2
9226767 Stulen et al. Jan 2016 B2
9232979 Parihar et al. Jan 2016 B2
9237891 Shelton, IV Jan 2016 B2
9237921 Messerly et al. Jan 2016 B2
9241060 Fujisaki Jan 2016 B1
9241692 Gunday et al. Jan 2016 B2
9241728 Price et al. Jan 2016 B2
9241730 Babaev Jan 2016 B2
9241731 Boudreaux et al. Jan 2016 B2
9241768 Sandhu et al. Jan 2016 B2
9247953 Palmer et al. Feb 2016 B2
9254165 Aronow et al. Feb 2016 B2
9259234 Robertson et al. Feb 2016 B2
9259265 Harris et al. Feb 2016 B2
9265567 Orban, III et al. Feb 2016 B2
9265926 Strobl et al. Feb 2016 B2
9265973 Akagane Feb 2016 B2
9266310 Krogdahl et al. Feb 2016 B2
9277962 Koss et al. Mar 2016 B2
9282974 Shelton, IV Mar 2016 B2
9283027 Monson et al. Mar 2016 B2
9283045 Rhee et al. Mar 2016 B2
9283054 Morgan et al. Mar 2016 B2
9289256 Shelton, IV et al. Mar 2016 B2
9295514 Shelton, IV et al. Mar 2016 B2
9301759 Spivey et al. Apr 2016 B2
9305497 Seo et al. Apr 2016 B2
9307388 Liang et al. Apr 2016 B2
9307986 Hall et al. Apr 2016 B2
9308009 Madan et al. Apr 2016 B2
9308014 Fischer Apr 2016 B2
9314261 Bales, Jr. et al. Apr 2016 B2
9314292 Trees et al. Apr 2016 B2
9314301 Ben-Haim et al. Apr 2016 B2
9326754 Polster May 2016 B2
9326767 Koch, Jr. et al. May 2016 B2
9326787 Sanai et al. May 2016 B2
9326788 Batross et al. May 2016 B2
9332987 Leimbach et al. May 2016 B2
9333025 Monson et al. May 2016 B2
9333034 Hancock May 2016 B2
9339289 Robertson May 2016 B2
9339323 Eder et al. May 2016 B2
9339326 McCullagh et al. May 2016 B2
9345481 Hall et al. May 2016 B2
9345534 Artale et al. May 2016 B2
9345900 Wu et al. May 2016 B2
9351642 Nadkarni et al. May 2016 B2
9351726 Leimbach et al. May 2016 B2
9351727 Leimbach et al. May 2016 B2
9351754 Vakharia et al. May 2016 B2
9352173 Yamada et al. May 2016 B2
9358003 Hall et al. Jun 2016 B2
9358065 Ladtkow et al. Jun 2016 B2
9364171 Harris et al. Jun 2016 B2
9364230 Shelton, IV et al. Jun 2016 B2
9364279 Houser et al. Jun 2016 B2
9370364 Smith et al. Jun 2016 B2
9370400 Parihar Jun 2016 B2
9370611 Ross et al. Jun 2016 B2
9375230 Ross et al. Jun 2016 B2
9375232 Hunt et al. Jun 2016 B2
9375256 Cunningham et al. Jun 2016 B2
9375264 Horner et al. Jun 2016 B2
9375267 Kerr et al. Jun 2016 B2
9385831 Marr et al. Jul 2016 B2
9386983 Swensgard et al. Jul 2016 B2
9393037 Olson et al. Jul 2016 B2
9393070 Gelfand et al. Jul 2016 B2
9398911 Auld Jul 2016 B2
9402680 Ginnebaugh et al. Aug 2016 B2
9402682 Worrell et al. Aug 2016 B2
9408606 Shelton, IV Aug 2016 B2
9408622 Stulen et al. Aug 2016 B2
9408660 Strobl et al. Aug 2016 B2
9414853 Stulen et al. Aug 2016 B2
9414880 Monson et al. Aug 2016 B2
9421014 Ingmanson et al. Aug 2016 B2
9421060 Monson et al. Aug 2016 B2
9427249 Robertson et al. Aug 2016 B2
9427279 Muniz-Medina et al. Aug 2016 B2
9439668 Timm et al. Sep 2016 B2
9439669 Wiener et al. Sep 2016 B2
9439671 Akagane Sep 2016 B2
9442288 Tanimura Sep 2016 B2
9445784 O'Keeffe Sep 2016 B2
9445832 Wiener et al. Sep 2016 B2
9451967 Jordan et al. Sep 2016 B2
9456863 Moua Oct 2016 B2
9456864 Witt et al. Oct 2016 B2
9468438 Baber et al. Oct 2016 B2
9468498 Sigmon, Jr. Oct 2016 B2
9474542 Slipszenko et al. Oct 2016 B2
9474568 Akagane Oct 2016 B2
9486236 Price et al. Nov 2016 B2
9492146 Kostrzewski et al. Nov 2016 B2
9492224 Boudreaux et al. Nov 2016 B2
9498245 Voegele et al. Nov 2016 B2
9498275 Wham et al. Nov 2016 B2
9504483 Houser et al. Nov 2016 B2
9504520 Worrell et al. Nov 2016 B2
9504524 Behnke, II Nov 2016 B2
9504855 Messerly et al. Nov 2016 B2
9510850 Robertson et al. Dec 2016 B2
9510906 Boudreaux et al. Dec 2016 B2
9522029 Yates et al. Dec 2016 B2
9522032 Behnke Dec 2016 B2
9526564 Rusin Dec 2016 B2
9526565 Strobl Dec 2016 B2
9545253 Worrell et al. Jan 2017 B2
9545497 Wenderow et al. Jan 2017 B2
9554465 Liu et al. Jan 2017 B1
9554794 Baber et al. Jan 2017 B2
9554846 Boudreaux Jan 2017 B2
9554854 Yates et al. Jan 2017 B2
9560995 Addison et al. Feb 2017 B2
9561038 Shelton, IV et al. Feb 2017 B2
9572592 Price et al. Feb 2017 B2
9574644 Parihar Feb 2017 B2
9585714 Livneh Mar 2017 B2
9592056 Mozdzierz et al. Mar 2017 B2
9592072 Akagane Mar 2017 B2
9597143 Madan et al. Mar 2017 B2
9603669 Govari et al. Mar 2017 B2
9610091 Johnson et al. Apr 2017 B2
9610114 Baxter, III et al. Apr 2017 B2
9615877 Tyrrell et al. Apr 2017 B2
9623237 Turner et al. Apr 2017 B2
9629623 Lytle, IV et al. Apr 2017 B2
9629629 Leimbach et al. Apr 2017 B2
9632573 Ogawa et al. Apr 2017 B2
9636135 Stulen May 2017 B2
9636165 Larson et al. May 2017 B2
9636167 Gregg May 2017 B2
9638770 Dietz et al. May 2017 B2
9642644 Houser et al. May 2017 B2
9642669 Takashino et al. May 2017 B2
9643052 Tchao et al. May 2017 B2
9649110 Parihar et al. May 2017 B2
9649111 Shelton, IV et al. May 2017 B2
9649126 Robertson et al. May 2017 B2
9649173 Choi et al. May 2017 B2
9655670 Larson et al. May 2017 B2
9662131 Omori et al. May 2017 B2
9668806 Unger et al. Jun 2017 B2
9671860 Ogawa et al. Jun 2017 B2
9674949 Liu et al. Jun 2017 B1
9675374 Stulen et al. Jun 2017 B2
9675375 Houser et al. Jun 2017 B2
9681884 Clem et al. Jun 2017 B2
9687230 Leimbach et al. Jun 2017 B2
9687290 Keller Jun 2017 B2
9690362 Leimbach et al. Jun 2017 B2
9693817 Mehta et al. Jul 2017 B2
9700309 Jaworek et al. Jul 2017 B2
9700339 Nield Jul 2017 B2
9700343 Messerly et al. Jul 2017 B2
9705456 Gilbert Jul 2017 B2
9707004 Houser et al. Jul 2017 B2
9707027 Ruddenklau et al. Jul 2017 B2
9707030 Davison et al. Jul 2017 B2
9713507 Stulen et al. Jul 2017 B2
9717548 Couture Aug 2017 B2
9717552 Cosman et al. Aug 2017 B2
9724094 Baber et al. Aug 2017 B2
9724118 Schulte et al. Aug 2017 B2
9724120 Faller et al. Aug 2017 B2
9724152 Horlle et al. Aug 2017 B2
9730695 Leimbach et al. Aug 2017 B2
9733663 Leimbach et al. Aug 2017 B2
9737301 Baber et al. Aug 2017 B2
9737326 Worrell et al. Aug 2017 B2
9737355 Yates et al. Aug 2017 B2
9737358 Beckman et al. Aug 2017 B2
9743929 Leimbach et al. Aug 2017 B2
9743946 Faller et al. Aug 2017 B2
9743947 Price et al. Aug 2017 B2
9750499 Leimbach et al. Sep 2017 B2
9757128 Baber et al. Sep 2017 B2
9757142 Shimizu Sep 2017 B2
9757150 Alexander et al. Sep 2017 B2
9757186 Boudreaux et al. Sep 2017 B2
9764164 Wiener et al. Sep 2017 B2
9770285 Zoran et al. Sep 2017 B2
9782169 Kimsey et al. Oct 2017 B2
9782214 Houser et al. Oct 2017 B2
9788836 Overmyer et al. Oct 2017 B2
9788851 Dannaher et al. Oct 2017 B2
9795405 Price et al. Oct 2017 B2
9795436 Yates et al. Oct 2017 B2
9795808 Messerly et al. Oct 2017 B2
9801626 Parihar et al. Oct 2017 B2
9801648 Houser et al. Oct 2017 B2
9802033 Hibner et al. Oct 2017 B2
9804618 Leimbach et al. Oct 2017 B2
9808244 Leimbach et al. Nov 2017 B2
9808246 Shelton, IV et al. Nov 2017 B2
9808308 Faller et al. Nov 2017 B2
9814460 Kimsey et al. Nov 2017 B2
9814514 Shelton, IV et al. Nov 2017 B2
9815211 Cao et al. Nov 2017 B2
9820738 Lytle, IV et al. Nov 2017 B2
9820768 Gee et al. Nov 2017 B2
9820771 Norton et al. Nov 2017 B2
9820806 Lee et al. Nov 2017 B2
9826976 Parihar et al. Nov 2017 B2
9826977 Leimbach et al. Nov 2017 B2
9839443 Brockman et al. Dec 2017 B2
9844368 Boudreaux et al. Dec 2017 B2
9844374 Lytle, IV et al. Dec 2017 B2
9844375 Overmyer et al. Dec 2017 B2
9848901 Robertson et al. Dec 2017 B2
9848902 Price et al. Dec 2017 B2
9848937 Trees et al. Dec 2017 B2
9861381 Johnson Jan 2018 B2
9861428 Trees et al. Jan 2018 B2
9867612 Parihar et al. Jan 2018 B2
9867651 Wham Jan 2018 B2
9867670 Brannan et al. Jan 2018 B2
9872722 Lech Jan 2018 B2
9872725 Worrell et al. Jan 2018 B2
9872726 Morisaki Jan 2018 B2
9877720 Worrell et al. Jan 2018 B2
9877776 Boudreaux Jan 2018 B2
9878184 Beaupre Jan 2018 B2
9883860 Leimbach et al. Feb 2018 B2
9883884 Neurohr et al. Feb 2018 B2
9888919 Leimbach et al. Feb 2018 B2
9888958 Evans et al. Feb 2018 B2
9895148 Shelton, IV et al. Feb 2018 B2
9901321 Harks et al. Feb 2018 B2
9901342 Shelton, IV et al. Feb 2018 B2
9901383 Hassler, Jr. Feb 2018 B2
9901754 Yamada Feb 2018 B2
9907563 Germain et al. Mar 2018 B2
9913642 Leimbach et al. Mar 2018 B2
9913656 Stulen Mar 2018 B2
9913680 Voegele et al. Mar 2018 B2
9918730 Trees et al. Mar 2018 B2
9924961 Shelton, IV et al. Mar 2018 B2
9925003 Parihar et al. Mar 2018 B2
9931118 Shelton, IV et al. Apr 2018 B2
9937001 Nakamura Apr 2018 B2
9943309 Shelton, IV et al. Apr 2018 B2
9949785 Price et al. Apr 2018 B2
9949788 Boudreaux Apr 2018 B2
9962182 Dietz et al. May 2018 B2
9968355 Shelton, IV et al. May 2018 B2
9974539 Yates et al. May 2018 B2
9987000 Shelton, IV et al. Jun 2018 B2
9987033 Neurohr et al. Jun 2018 B2
9993248 Shelton, IV et al. Jun 2018 B2
9993258 Shelton, IV et al. Jun 2018 B2
10004497 Overmyer et al. Jun 2018 B2
10004501 Shelton, IV et al. Jun 2018 B2
10004526 Dycus et al. Jun 2018 B2
10004527 Gee et al. Jun 2018 B2
D822206 Shelton, IV et al. Jul 2018 S
10010339 Witt et al. Jul 2018 B2
10010341 Houser et al. Jul 2018 B2
10013049 Leimbach et al. Jul 2018 B2
10016199 Baber et al. Jul 2018 B2
10016207 Suzuki et al. Jul 2018 B2
10022142 Aranyi et al. Jul 2018 B2
10022567 Messerly et al. Jul 2018 B2
10022568 Messerly et al. Jul 2018 B2
10028761 Leimbach et al. Jul 2018 B2
10028786 Mucilli et al. Jul 2018 B2
10034684 Weisenburgh, II et al. Jul 2018 B2
10034704 Asher et al. Jul 2018 B2
D826405 Shelton, IV et al. Aug 2018 S
10039588 Harper et al. Aug 2018 B2
10041822 Zemlok Aug 2018 B2
10045776 Shelton, IV et al. Aug 2018 B2
10045779 Savage et al. Aug 2018 B2
10045794 Witt et al. Aug 2018 B2
10045810 Schall et al. Aug 2018 B2
10045819 Jensen et al. Aug 2018 B2
10052044 Shelton, IV et al. Aug 2018 B2
10052102 Baxter, III et al. Aug 2018 B2
10070916 Artale Sep 2018 B2
10080609 Hancock et al. Sep 2018 B2
10085748 Morgan et al. Oct 2018 B2
10085762 Timm et al. Oct 2018 B2
10085792 Johnson et al. Oct 2018 B2
10092310 Boudreaux et al. Oct 2018 B2
10092344 Mohr et al. Oct 2018 B2
10092348 Boudreaux Oct 2018 B2
10092350 Rothweiler et al. Oct 2018 B2
10105140 Malinouskas et al. Oct 2018 B2
10111679 Baber et al. Oct 2018 B2
10111699 Boudreaux Oct 2018 B2
10111703 Cosman, Jr. et al. Oct 2018 B2
10117649 Baxter, III et al. Nov 2018 B2
10117667 Robertson et al. Nov 2018 B2
10117702 Danziger et al. Nov 2018 B2
10123835 Keller et al. Nov 2018 B2
10130367 Cappola et al. Nov 2018 B2
10130410 Strobl et al. Nov 2018 B2
10130412 Wham Nov 2018 B2
10135242 Baber et al. Nov 2018 B2
10136887 Shelton, IV et al. Nov 2018 B2
10149680 Parihar et al. Dec 2018 B2
10154848 Chernov et al. Dec 2018 B2
10154852 Conlon et al. Dec 2018 B2
10159483 Beckman et al. Dec 2018 B2
10159524 Yates et al. Dec 2018 B2
10166060 Johnson et al. Jan 2019 B2
10172665 Heckel et al. Jan 2019 B2
10172669 Felder et al. Jan 2019 B2
10178992 Wise et al. Jan 2019 B2
10179022 Yates et al. Jan 2019 B2
10180463 Beckman et al. Jan 2019 B2
10182816 Shelton, IV et al. Jan 2019 B2
10182818 Hensel et al. Jan 2019 B2
10188385 Kerr et al. Jan 2019 B2
10188455 Hancock et al. Jan 2019 B2
10194907 Marczyk et al. Feb 2019 B2
10194972 Yates et al. Feb 2019 B2
10194973 Wiener et al. Feb 2019 B2
10194976 Boudreaux Feb 2019 B2
10194977 Yang Feb 2019 B2
10194999 Bacher et al. Feb 2019 B2
10201364 Leimbach et al. Feb 2019 B2
10201365 Boudreaux et al. Feb 2019 B2
10201382 Wiener et al. Feb 2019 B2
10226250 Beckman et al. Mar 2019 B2
10226273 Messerly et al. Mar 2019 B2
10231747 Stulen et al. Mar 2019 B2
10238385 Yates et al. Mar 2019 B2
10238391 Leimbach et al. Mar 2019 B2
10245027 Shelton, IV et al. Apr 2019 B2
10245028 Shelton, IV et al. Apr 2019 B2
10245029 Hunter et al. Apr 2019 B2
10245030 Hunter et al. Apr 2019 B2
10245033 Overmyer et al. Apr 2019 B2
10245095 Boudreaux Apr 2019 B2
10245104 McKenna et al. Apr 2019 B2
10251664 Shelton, IV et al. Apr 2019 B2
10258331 Shelton, IV et al. Apr 2019 B2
10258505 Ovchinnikov Apr 2019 B2
10263171 Wiener et al. Apr 2019 B2
10265068 Harris et al. Apr 2019 B2
10265117 Wiener et al. Apr 2019 B2
10265118 Gerhardt Apr 2019 B2
10271840 Sapre Apr 2019 B2
10271851 Shelton, IV et al. Apr 2019 B2
D847989 Shelton, IV et al. May 2019 S
10278721 Dietz et al. May 2019 B2
10285705 Shelton, IV et al. May 2019 B2
10285724 Faller et al. May 2019 B2
10285750 Coulson et al. May 2019 B2
10292704 Harris et al. May 2019 B2
10299810 Robertson et al. May 2019 B2
10299821 Shelton, IV et al. May 2019 B2
D850617 Shelton, IV et al. Jun 2019 S
D851762 Shelton, IV et al. Jun 2019 S
10307159 Harris et al. Jun 2019 B2
10314579 Chowaniec et al. Jun 2019 B2
10314582 Shelton, IV et al. Jun 2019 B2
10314638 Gee et al. Jun 2019 B2
10321907 Shelton, IV et al. Jun 2019 B2
10321950 Yates et al. Jun 2019 B2
D854151 Shelton, IV et al. Jul 2019 S
10335149 Baxter, III et al. Jul 2019 B2
10335182 Stulen et al. Jul 2019 B2
10335183 Worrell et al. Jul 2019 B2
10335614 Messerly et al. Jul 2019 B2
10342543 Shelton, IV et al. Jul 2019 B2
10342602 Strobl et al. Jul 2019 B2
10342606 Cosman et al. Jul 2019 B2
10342623 Huelman et al. Jul 2019 B2
10348941 Elliot, Jr. et al. Jul 2019 B2
10349999 Yates et al. Jul 2019 B2
10350016 Burbank et al. Jul 2019 B2
10350025 Loyd et al. Jul 2019 B1
10357246 Shelton, IV et al. Jul 2019 B2
10357247 Shelton, IV et al. Jul 2019 B2
10357303 Conlon et al. Jul 2019 B2
10363084 Friedrichs Jul 2019 B2
10368861 Baxter, III et al. Aug 2019 B2
10368865 Harris et al. Aug 2019 B2
10376263 Morgan et al. Aug 2019 B2
10376305 Yates et al. Aug 2019 B2
10390841 Shelton, IV et al. Aug 2019 B2
10398439 Cabrera et al. Sep 2019 B2
10398466 Stulen et al. Sep 2019 B2
10398497 Batross et al. Sep 2019 B2
10405857 Shelton, IV et al. Sep 2019 B2
10405863 Wise et al. Sep 2019 B2
10413291 Worthington et al. Sep 2019 B2
10413293 Shelton, IV et al. Sep 2019 B2
10413297 Harris et al. Sep 2019 B2
10413352 Thomas et al. Sep 2019 B2
10413353 Kerr et al. Sep 2019 B2
10420552 Shelton, IV et al. Sep 2019 B2
10420579 Wiener et al. Sep 2019 B2
10420607 Woloszko et al. Sep 2019 B2
D865175 Widenhouse et al. Oct 2019 S
10426471 Shelton, IV et al. Oct 2019 B2
10426507 Wiener et al. Oct 2019 B2
10426546 Graham et al. Oct 2019 B2
10426978 Akagane Oct 2019 B2
10433837 Worthington et al. Oct 2019 B2
10433849 Shelton, IV et al. Oct 2019 B2
10433865 Witt et al. Oct 2019 B2
10433866 Witt et al. Oct 2019 B2
10433900 Harris et al. Oct 2019 B2
10441279 Shelton, IV et al. Oct 2019 B2
10441308 Robertson Oct 2019 B2
10441310 Olson et al. Oct 2019 B2
10441345 Aldridge et al. Oct 2019 B2
10448948 Shelton, IV et al. Oct 2019 B2
10448950 Shelton, IV et al. Oct 2019 B2
10448986 Zikorus et al. Oct 2019 B2
10456140 Shelton, IV et al. Oct 2019 B2
10456193 Yates et al. Oct 2019 B2
10463421 Boudreaux et al. Nov 2019 B2
10463887 Witt et al. Nov 2019 B2
10470762 Leimbach et al. Nov 2019 B2
10470764 Baxter, III et al. Nov 2019 B2
10478182 Taylor Nov 2019 B2
10478190 Miller et al. Nov 2019 B2
10485542 Shelton, IV et al. Nov 2019 B2
10485543 Shelton, IV et al. Nov 2019 B2
10485607 Strobl et al. Nov 2019 B2
D869655 Shelton, IV et al. Dec 2019 S
10492785 Overmyer et al. Dec 2019 B2
10492849 Juergens et al. Dec 2019 B2
10499914 Huang et al. Dec 2019 B2
10507033 Dickerson et al. Dec 2019 B2
10512795 Voegele et al. Dec 2019 B2
10517595 Hunter et al. Dec 2019 B2
10517596 Hunter et al. Dec 2019 B2
10517627 Timm et al. Dec 2019 B2
10524787 Shelton, IV et al. Jan 2020 B2
10524789 Swayze et al. Jan 2020 B2
10524854 Woodruff et al. Jan 2020 B2
10524872 Stewart et al. Jan 2020 B2
10531874 Morgan et al. Jan 2020 B2
10537324 Shelton, IV et al. Jan 2020 B2
10537325 Bakos et al. Jan 2020 B2
10537351 Shelton, IV et al. Jan 2020 B2
10542979 Shelton, IV et al. Jan 2020 B2
10542982 Beckman et al. Jan 2020 B2
10542991 Shelton, IV et al. Jan 2020 B2
10543008 Vakharia et al. Jan 2020 B2
10548504 Shelton, IV et al. Feb 2020 B2
10548655 Scheib et al. Feb 2020 B2
10555769 Worrell et al. Feb 2020 B2
10561560 Boutoussov et al. Feb 2020 B2
10568624 Shelton, IV et al. Feb 2020 B2
10568625 Harris et al. Feb 2020 B2
10568626 Shelton, IV et al. Feb 2020 B2
10568632 Miller et al. Feb 2020 B2
10575892 Danziger et al. Mar 2020 B2
10582928 Hunter et al. Mar 2020 B2
10588625 Weaner et al. Mar 2020 B2
10588630 Shelton, IV et al. Mar 2020 B2
10588631 Shelton, IV et al. Mar 2020 B2
10588632 Shelton, IV et al. Mar 2020 B2
10588633 Shelton, IV et al. Mar 2020 B2
10595929 Boudreaux et al. Mar 2020 B2
10595930 Scheib et al. Mar 2020 B2
10603036 Hunter et al. Mar 2020 B2
10610224 Shelton, IV et al. Apr 2020 B2
10610286 Wiener et al. Apr 2020 B2
10610313 Bailey et al. Apr 2020 B2
10617412 Shelton, IV et al. Apr 2020 B2
10617420 Shelton, IV et al. Apr 2020 B2
10617464 Duppuis Apr 2020 B2
10624635 Harris et al. Apr 2020 B2
10624691 Wiener et al. Apr 2020 B2
10631858 Burbank Apr 2020 B2
10631859 Shelton, IV et al. Apr 2020 B2
10632630 Cao et al. Apr 2020 B2
RE47996 Turner et al. May 2020 E
10639034 Harris et al. May 2020 B2
10639035 Shelton, IV et al. May 2020 B2
10639037 Shelton, IV et al. May 2020 B2
10639092 Corbett et al. May 2020 B2
10639098 Cosman et al. May 2020 B2
10646269 Worrell et al. May 2020 B2
10646292 Solomon et al. May 2020 B2
10653413 Worthington et al. May 2020 B2
10667809 Bakos et al. Jun 2020 B2
10667810 Shelton, IV et al. Jun 2020 B2
10667811 Harris et al. Jun 2020 B2
10675021 Harris et al. Jun 2020 B2
10675024 Shelton, IV et al. Jun 2020 B2
10675025 Swayze et al. Jun 2020 B2
10675026 Harris et al. Jun 2020 B2
10677764 Ross et al. Jun 2020 B2
10682136 Harris et al. Jun 2020 B2
10682138 Shelton, IV et al. Jun 2020 B2
10687806 Shelton, IV et al. Jun 2020 B2
10687809 Shelton, IV et al. Jun 2020 B2
10687810 Shelton, IV et al. Jun 2020 B2
10687884 Wiener et al. Jun 2020 B2
10688321 Wiener et al. Jun 2020 B2
10695055 Shelton, IV et al. Jun 2020 B2
10695057 Shelton, IV et al. Jun 2020 B2
10695058 Lytle, IV et al. Jun 2020 B2
10695119 Smith Jun 2020 B2
10702270 Shelton, IV et al. Jul 2020 B2
10702329 Strobl et al. Jul 2020 B2
10709446 Harris et al. Jul 2020 B2
10709469 Shelton, IV et al. Jul 2020 B2
10709906 Nield Jul 2020 B2
10716615 Shelton, IV et al. Jul 2020 B2
10722233 Wellman Jul 2020 B2
D893717 Messerly et al. Aug 2020 S
10729458 Stoddard et al. Aug 2020 B2
10729494 Parihar et al. Aug 2020 B2
10736629 Shelton, IV et al. Aug 2020 B2
10736685 Wiener et al. Aug 2020 B2
10751108 Yates et al. Aug 2020 B2
10758229 Shelton, IV et al. Sep 2020 B2
10758230 Shelton, IV et al. Sep 2020 B2
10758232 Shelton, IV et al. Sep 2020 B2
10758294 Jones Sep 2020 B2
10765427 Shelton, IV et al. Sep 2020 B2
10765470 Yates et al. Sep 2020 B2
10772629 Shelton, IV et al. Sep 2020 B2
10772630 Wixey Sep 2020 B2
10779821 Harris et al. Sep 2020 B2
10779823 Shelton, IV et al. Sep 2020 B2
10779824 Shelton, IV et al. Sep 2020 B2
10779825 Shelton, IV et al. Sep 2020 B2
10779845 Timm et al. Sep 2020 B2
10779849 Shelton, IV et al. Sep 2020 B2
10779879 Yates et al. Sep 2020 B2
10786253 Shelton, IV et al. Sep 2020 B2
10786276 Hirai et al. Sep 2020 B2
10806454 Kopp Oct 2020 B2
10813638 Shelton, IV et al. Oct 2020 B2
10820938 Fischer et al. Nov 2020 B2
10828058 Shelton, IV et al. Nov 2020 B2
10835245 Swayze et al. Nov 2020 B2
10835246 Shelton, IV et al. Nov 2020 B2
10835247 Shelton, IV et al. Nov 2020 B2
10835307 Shelton, IV et al. Nov 2020 B2
10842492 Shelton, IV et al. Nov 2020 B2
10842523 Shelton, IV et al. Nov 2020 B2
10842563 Gilbert et al. Nov 2020 B2
D906355 Messerly et al. Dec 2020 S
10856867 Shelton, IV et al. Dec 2020 B2
10856868 Shelton, IV et al. Dec 2020 B2
10856869 Shelton, IV et al. Dec 2020 B2
10856870 Harris et al. Dec 2020 B2
10856896 Eichmann et al. Dec 2020 B2
10856929 Yates et al. Dec 2020 B2
10856934 Trees et al. Dec 2020 B2
10874465 Weir et al. Dec 2020 B2
D908216 Messerly et al. Jan 2021 S
10881399 Shelton, IV et al. Jan 2021 B2
10881401 Baber et al. Jan 2021 B2
10881409 Cabrera Jan 2021 B2
10881449 Boudreaux et al. Jan 2021 B2
10888322 Morgan et al. Jan 2021 B2
10888347 Witt et al. Jan 2021 B2
10893863 Shelton, IV et al. Jan 2021 B2
10893864 Harris et al. Jan 2021 B2
10893883 Dannaher Jan 2021 B2
10898186 Bakos et al. Jan 2021 B2
10898256 Yates et al. Jan 2021 B2
10912559 Harris et al. Feb 2021 B2
10912580 Green et al. Feb 2021 B2
10912603 Boudreaux et al. Feb 2021 B2
10918385 Overmyer et al. Feb 2021 B2
10925659 Shelton, IV et al. Feb 2021 B2
D914878 Shelton, IV et al. Mar 2021 S
10932766 Tesar et al. Mar 2021 B2
10932847 Yates et al. Mar 2021 B2
10945727 Shelton, IV et al. Mar 2021 B2
10952788 Asher et al. Mar 2021 B2
10959727 Hunter et al. Mar 2021 B2
10966741 Illizaliturri-Sanchez et al. Apr 2021 B2
10966747 Worrell et al. Apr 2021 B2
10973516 Shelton, IV et al. Apr 2021 B2
10973517 Wixey Apr 2021 B2
10973520 Shelton, IV et al. Apr 2021 B2
10980536 Weaner et al. Apr 2021 B2
10987123 Weir et al. Apr 2021 B2
10987156 Trees et al. Apr 2021 B2
10993715 Shelton, IV et al. May 2021 B2
10993716 Shelton, IV et al. May 2021 B2
10993763 Batross et al. May 2021 B2
11000278 Shelton, IV et al. May 2021 B2
11000279 Shelton, IV et al. May 2021 B2
11020114 Shelton, IV et al. Jun 2021 B2
11020140 Gee et al. Jun 2021 B2
11033322 Wiener et al. Jun 2021 B2
11039834 Harris et al. Jun 2021 B2
11045191 Shelton, IV et al. Jun 2021 B2
11045192 Harris et al. Jun 2021 B2
11051840 Shelton, IV et al. Jul 2021 B2
11051873 Wiener et al. Jul 2021 B2
11058424 Shelton, IV et al. Jul 2021 B2
11058447 Houser Jul 2021 B2
11058448 Shelton, IV et al. Jul 2021 B2
11058475 Wiener et al. Jul 2021 B2
11064997 Shelton, IV et al. Jul 2021 B2
11065048 Messerly et al. Jul 2021 B2
11083455 Shelton, IV et al. Aug 2021 B2
11083458 Harris et al. Aug 2021 B2
11090048 Fanelli et al. Aug 2021 B2
11090049 Bakos et al. Aug 2021 B2
11090104 Wiener et al. Aug 2021 B2
11096688 Shelton, IV et al. Aug 2021 B2
11096752 Stulen et al. Aug 2021 B2
11109866 Shelton, IV et al. Sep 2021 B2
11129611 Shelton, IV et al. Sep 2021 B2
11129666 Messerly et al. Sep 2021 B2
11129669 Stulen et al. Sep 2021 B2
11129670 Shelton, IV et al. Sep 2021 B2
11134942 Harris et al. Oct 2021 B2
11134978 Shelton, IV et al. Oct 2021 B2
11141154 Shelton, IV et al. Oct 2021 B2
11141213 Yates et al. Oct 2021 B2
11147551 Shelton, IV Oct 2021 B2
11147553 Shelton, IV Oct 2021 B2
11160551 Shelton, IV et al. Nov 2021 B2
11166716 Shelton, IV et al. Nov 2021 B2
11172929 Shelton, IV Nov 2021 B2
11179155 Shelton, IV et al. Nov 2021 B2
11179173 Price et al. Nov 2021 B2
11191539 Overmyer et al. Dec 2021 B2
11191540 Aronhalt et al. Dec 2021 B2
11197668 Shelton, IV et al. Dec 2021 B2
11202670 Worrell et al. Dec 2021 B2
11207065 Harris et al. Dec 2021 B2
11207067 Shelton, IV et al. Dec 2021 B2
11213293 Worthington et al. Jan 2022 B2
11213294 Shelton, IV et al. Jan 2022 B2
11219453 Shelton, IV et al. Jan 2022 B2
11224426 Shelton, IV et al. Jan 2022 B2
11224497 Shelton, IV et al. Jan 2022 B2
11229437 Shelton, IV et al. Jan 2022 B2
11229450 Shelton, IV et al. Jan 2022 B2
11229471 Shelton, IV et al. Jan 2022 B2
11229472 Shelton, IV et al. Jan 2022 B2
11234698 Shelton, IV et al. Feb 2022 B2
11241235 Shelton, IV et al. Feb 2022 B2
11246592 Shelton, IV et al. Feb 2022 B2
11246625 Kane et al. Feb 2022 B2
11246678 Shelton, IV et al. Feb 2022 B2
11253256 Harris et al. Feb 2022 B2
11259803 Shelton, IV et al. Mar 2022 B2
11259805 Shelton, IV et al. Mar 2022 B2
11259806 Shelton, IV et al. Mar 2022 B2
11259807 Shelton, IV et al. Mar 2022 B2
11266405 Shelton, IV et al. Mar 2022 B2
11266430 Clauda et al. Mar 2022 B2
11272931 Boudreaux et al. Mar 2022 B2
11278280 Shelton, IV et al. Mar 2022 B2
11284890 Nalagatla et al. Mar 2022 B2
11291440 Harris et al. Apr 2022 B2
11291444 Boudreaux et al. Apr 2022 B2
11291445 Shelton, IV et al. Apr 2022 B2
11291447 Shelton, IV et al. Apr 2022 B2
11291451 Shelton, IV Apr 2022 B2
11298127 Shelton, IV Apr 2022 B2
11298129 Bakos et al. Apr 2022 B2
11298130 Bakos et al. Apr 2022 B2
11304695 Shelton, IV et al. Apr 2022 B2
11304696 Shelton, IV et al. Apr 2022 B2
11304699 Shelton, IV et al. Apr 2022 B2
11311306 Shelton, IV et al. Apr 2022 B2
11311326 Boudreaux Apr 2022 B2
11311342 Parihar et al. Apr 2022 B2
D950728 Bakos et al. May 2022 S
D952144 Boudreaux May 2022 S
11317915 Boudreaux et al. May 2022 B2
11324503 Shelton, IV et al. May 2022 B2
11324527 Aldridge et al. May 2022 B2
11324557 Shelton, IV et al. May 2022 B2
11331100 Boudreaux et al. May 2022 B2
11331101 Harris et al. May 2022 B2
11337747 Voegele et al. May 2022 B2
11344362 Yates et al. May 2022 B2
11350938 Shelton, IV et al. Jun 2022 B2
11357503 Bakos et al. Jun 2022 B2
11361176 Shelton, IV et al. Jun 2022 B2
11369377 Boudreaux et al. Jun 2022 B2
11376098 Shelton, IV et al. Jul 2022 B2
11382642 Robertson et al. Jul 2022 B2
11389161 Shelton, IV et al. Jul 2022 B2
11389164 Yates et al. Jul 2022 B2
11399837 Shelton, IV et al. Aug 2022 B2
11399855 Boudreaux et al. Aug 2022 B2
11406382 Shelton, IV et al. Aug 2022 B2
11413060 Faller et al. Aug 2022 B2
11419606 Overmyer et al. Aug 2022 B2
11419626 Timm et al. Aug 2022 B2
11424027 Shelton, IV Aug 2022 B2
11426167 Shelton, IV et al. Aug 2022 B2
11426191 Vakharia et al. Aug 2022 B2
11446029 Shelton, IV et al. Sep 2022 B2
11452525 Shelton, IV et al. Sep 2022 B2
11464511 Timm et al. Oct 2022 B2
11464512 Shelton, IV et al. Oct 2022 B2
11464601 Shelton, IV et al. Oct 2022 B2
11471155 Shelton, IV et al. Oct 2022 B2
11471156 Shelton, IV et al. Oct 2022 B2
11471206 Henderson et al. Oct 2022 B2
11471209 Yates et al. Oct 2022 B2
11478242 Shelton, IV et al. Oct 2022 B2
11484310 Shelton, IV et al. Nov 2022 B2
11504122 Shelton, IV et al. Nov 2022 B2
11517309 Bakos et al. Dec 2022 B2
11529137 Shelton, IV et al. Dec 2022 B2
11529139 Shelton, IV et al. Dec 2022 B2
20010025173 Ritchie et al. Sep 2001 A1
20010025183 Shahidi Sep 2001 A1
20010025184 Messerly Sep 2001 A1
20010031950 Ryan Oct 2001 A1
20010039419 Francischelli et al. Nov 2001 A1
20020002377 Cimino Jan 2002 A1
20020002380 Bishop Jan 2002 A1
20020019649 Sikora et al. Feb 2002 A1
20020022836 Goble et al. Feb 2002 A1
20020029036 Goble et al. Mar 2002 A1
20020029055 Bonutti Mar 2002 A1
20020032452 Tierney et al. Mar 2002 A1
20020049551 Friedman et al. Apr 2002 A1
20020052617 Anis et al. May 2002 A1
20020077550 Rabiner et al. Jun 2002 A1
20020107517 Witt et al. Aug 2002 A1
20020156466 Sakurai et al. Oct 2002 A1
20020156493 Houser et al. Oct 2002 A1
20020165577 Witt et al. Nov 2002 A1
20020177862 Aranyi et al. Nov 2002 A1
20030009164 Woloszko et al. Jan 2003 A1
20030014053 Nguyen et al. Jan 2003 A1
20030014087 Fang et al. Jan 2003 A1
20030036705 Hare et al. Feb 2003 A1
20030040758 Wang et al. Feb 2003 A1
20030050572 Brautigam et al. Mar 2003 A1
20030055443 Spotnitz Mar 2003 A1
20030073981 Whitman et al. Apr 2003 A1
20030109778 Rashidi Jun 2003 A1
20030109875 Tetzlaff et al. Jun 2003 A1
20030114851 Truckai et al. Jun 2003 A1
20030130693 Levin et al. Jul 2003 A1
20030139741 Goble et al. Jul 2003 A1
20030144680 Kellogg et al. Jul 2003 A1
20030158548 Phan et al. Aug 2003 A1
20030171747 Kanehira et al. Sep 2003 A1
20030176778 Messing Sep 2003 A1
20030181898 Bowers Sep 2003 A1
20030199794 Sakurai et al. Oct 2003 A1
20030204199 Novak et al. Oct 2003 A1
20030208186 Moreyra Nov 2003 A1
20030212332 Fenton et al. Nov 2003 A1
20030212363 Shipp Nov 2003 A1
20030212392 Fenton et al. Nov 2003 A1
20030212422 Fenton et al. Nov 2003 A1
20030225332 Okada et al. Dec 2003 A1
20030229344 Dycus et al. Dec 2003 A1
20040030254 Babaev Feb 2004 A1
20040030330 Brassell et al. Feb 2004 A1
20040047485 Sherrit et al. Mar 2004 A1
20040054364 Aranyi et al. Mar 2004 A1
20040064151 Mollenauer Apr 2004 A1
20040087943 Dycus et al. May 2004 A1
20040092921 Kadziauskas et al. May 2004 A1
20040092992 Adams et al. May 2004 A1
20040094597 Whitman et al. May 2004 A1
20040097911 Murakami et al. May 2004 A1
20040097912 Gonnering May 2004 A1
20040097919 Wellman et al. May 2004 A1
20040097996 Rabiner et al. May 2004 A1
20040116952 Sakurai et al. Jun 2004 A1
20040122423 Dycus et al. Jun 2004 A1
20040132383 Langford et al. Jul 2004 A1
20040138621 Jahns et al. Jul 2004 A1
20040142667 Lochhead et al. Jul 2004 A1
20040147934 Kiester Jul 2004 A1
20040147945 Fritzsch Jul 2004 A1
20040158237 Abboud et al. Aug 2004 A1
20040167508 Wham et al. Aug 2004 A1
20040176686 Hare et al. Sep 2004 A1
20040176751 Weitzner et al. Sep 2004 A1
20040181242 Stack et al. Sep 2004 A1
20040193150 Sharkey et al. Sep 2004 A1
20040193153 Sartor et al. Sep 2004 A1
20040193212 Taniguchi et al. Sep 2004 A1
20040199193 Hayashi et al. Oct 2004 A1
20040215132 Yoon Oct 2004 A1
20040243147 Lipow Dec 2004 A1
20040249374 Tetzlaff et al. Dec 2004 A1
20040260273 Wan Dec 2004 A1
20040260300 Gorensek et al. Dec 2004 A1
20040267311 Viola et al. Dec 2004 A1
20050015125 Mioduski et al. Jan 2005 A1
20050020967 Ono Jan 2005 A1
20050021018 Anderson et al. Jan 2005 A1
20050021065 Yamada et al. Jan 2005 A1
20050021078 Vleugels et al. Jan 2005 A1
20050033278 McClurken et al. Feb 2005 A1
20050033337 Muir et al. Feb 2005 A1
20050070800 Takahashi Mar 2005 A1
20050080427 Govari et al. Apr 2005 A1
20050088285 Jei Apr 2005 A1
20050090817 Phan Apr 2005 A1
20050096683 Ellins et al. May 2005 A1
20050099824 Dowling et al. May 2005 A1
20050107777 West et al. May 2005 A1
20050131390 Heinrich et al. Jun 2005 A1
20050143769 White et al. Jun 2005 A1
20050149108 Cox Jul 2005 A1
20050165429 Douglas et al. Jul 2005 A1
20050171522 Christopherson Aug 2005 A1
20050177184 Easley Aug 2005 A1
20050182339 Lee et al. Aug 2005 A1
20050187576 Whitman et al. Aug 2005 A1
20050188743 Land Sep 2005 A1
20050192610 Houser et al. Sep 2005 A1
20050192611 Houser Sep 2005 A1
20050206583 Lemelson et al. Sep 2005 A1
20050222598 Ho et al. Oct 2005 A1
20050234484 Houser et al. Oct 2005 A1
20050249667 Tuszynski et al. Nov 2005 A1
20050256405 Makin et al. Nov 2005 A1
20050261588 Makin et al. Nov 2005 A1
20050262175 Iino et al. Nov 2005 A1
20050267464 Truckai et al. Dec 2005 A1
20050271807 Iijima et al. Dec 2005 A1
20050273090 Nieman et al. Dec 2005 A1
20050288659 Kimura et al. Dec 2005 A1
20060025757 Heim Feb 2006 A1
20060030797 Zhou et al. Feb 2006 A1
20060030848 Craig et al. Feb 2006 A1
20060058825 Ogura et al. Mar 2006 A1
20060063130 Hayman et al. Mar 2006 A1
20060064086 Odom Mar 2006 A1
20060066181 Bromfield et al. Mar 2006 A1
20060074442 Noriega et al. Apr 2006 A1
20060079874 Faller et al. Apr 2006 A1
20060079879 Faller et al. Apr 2006 A1
20060095046 Trieu et al. May 2006 A1
20060109061 Dobson et al. May 2006 A1
20060159731 Shoshan Jul 2006 A1
20060190034 Nishizawa et al. Aug 2006 A1
20060206100 Eskridge et al. Sep 2006 A1
20060206115 Schomer et al. Sep 2006 A1
20060211943 Beaupre Sep 2006 A1
20060217729 Eskridge et al. Sep 2006 A1
20060224160 Trieu et al. Oct 2006 A1
20060247558 Yamada Nov 2006 A1
20060253050 Yoshimine et al. Nov 2006 A1
20060259026 Godara et al. Nov 2006 A1
20060264809 Hansmann et al. Nov 2006 A1
20060264995 Fanton et al. Nov 2006 A1
20060265035 Yachi et al. Nov 2006 A1
20060270916 Skwarek et al. Nov 2006 A1
20060271030 Francis et al. Nov 2006 A1
20060293656 Shadduck et al. Dec 2006 A1
20070016235 Tanaka et al. Jan 2007 A1
20070016236 Beaupre Jan 2007 A1
20070021738 Hasser et al. Jan 2007 A1
20070027468 Wales et al. Feb 2007 A1
20070032704 Gandini et al. Feb 2007 A1
20070055228 Berg et al. Mar 2007 A1
20070056596 Fanney et al. Mar 2007 A1
20070060935 Schwardt et al. Mar 2007 A1
20070063618 Bromfield Mar 2007 A1
20070066971 Podhajsky Mar 2007 A1
20070067123 Jungerman Mar 2007 A1
20070073185 Nakao Mar 2007 A1
20070073341 Smith et al. Mar 2007 A1
20070074584 Talarico et al. Apr 2007 A1
20070106317 Shelton et al. May 2007 A1
20070118115 Artale et al. May 2007 A1
20070130771 Ehlert et al. Jun 2007 A1
20070135803 Belson Jun 2007 A1
20070149881 Rabin Jun 2007 A1
20070156163 Davison et al. Jul 2007 A1
20070166663 Telles et al. Jul 2007 A1
20070173803 Wham et al. Jul 2007 A1
20070173813 Odom Jul 2007 A1
20070173872 Neuenfeldt Jul 2007 A1
20070175955 Shelton et al. Aug 2007 A1
20070185474 Nahen Aug 2007 A1
20070191712 Messerly et al. Aug 2007 A1
20070191713 Eichmann et al. Aug 2007 A1
20070203483 Kim et al. Aug 2007 A1
20070208336 Kim et al. Sep 2007 A1
20070208340 Ganz et al. Sep 2007 A1
20070219481 Babaev Sep 2007 A1
20070232926 Stulen et al. Oct 2007 A1
20070232928 Wiener et al. Oct 2007 A1
20070236213 Paden et al. Oct 2007 A1
20070239101 Kellogg Oct 2007 A1
20070249941 Salehi et al. Oct 2007 A1
20070260242 Dycus et al. Nov 2007 A1
20070265560 Soltani et al. Nov 2007 A1
20070265613 Edelstein et al. Nov 2007 A1
20070265616 Couture et al. Nov 2007 A1
20070265620 Kraas et al. Nov 2007 A1
20070275348 Lemon Nov 2007 A1
20070287933 Phan et al. Dec 2007 A1
20070288055 Lee Dec 2007 A1
20070299895 Johnson et al. Dec 2007 A1
20080005213 Holtzman Jan 2008 A1
20080009860 Odom Jan 2008 A1
20080013809 Zhu et al. Jan 2008 A1
20080015575 Odom et al. Jan 2008 A1
20080033465 Schmitz et al. Feb 2008 A1
20080039746 Hissong et al. Feb 2008 A1
20080046122 Manzo et al. Feb 2008 A1
20080051812 Schmitz et al. Feb 2008 A1
20080058775 Darian et al. Mar 2008 A1
20080058845 Shimizu et al. Mar 2008 A1
20080071269 Hilario et al. Mar 2008 A1
20080077145 Boyden et al. Mar 2008 A1
20080082039 Babaev Apr 2008 A1
20080082098 Tanaka et al. Apr 2008 A1
20080097501 Blier Apr 2008 A1
20080114355 Whayne et al. May 2008 A1
20080114364 Goldin et al. May 2008 A1
20080122496 Wagner May 2008 A1
20080125768 Tahara et al. May 2008 A1
20080147058 Horrell et al. Jun 2008 A1
20080147062 Truckai et al. Jun 2008 A1
20080147092 Rogge et al. Jun 2008 A1
20080171938 Masuda et al. Jul 2008 A1
20080177268 Daum et al. Jul 2008 A1
20080188755 Hart Aug 2008 A1
20080200940 Eichmann et al. Aug 2008 A1
20080208108 Kimura Aug 2008 A1
20080208231 Ota et al. Aug 2008 A1
20080214967 Aranyi et al. Sep 2008 A1
20080234709 Houser Sep 2008 A1
20080243162 Shibata et al. Oct 2008 A1
20080255413 Zemlok et al. Oct 2008 A1
20080275440 Kratoska et al. Nov 2008 A1
20080281200 Voic et al. Nov 2008 A1
20080281315 Gines Nov 2008 A1
20080287944 Pearson et al. Nov 2008 A1
20080287948 Newton et al. Nov 2008 A1
20080296346 Shelton, IV et al. Dec 2008 A1
20080300588 Groth et al. Dec 2008 A1
20090012516 Curtis et al. Jan 2009 A1
20090023985 Ewers Jan 2009 A1
20090036913 Wiener et al. Feb 2009 A1
20090043293 Pankratov et al. Feb 2009 A1
20090048537 Lydon et al. Feb 2009 A1
20090048589 Takashino et al. Feb 2009 A1
20090054886 Yachi et al. Feb 2009 A1
20090054889 Newton et al. Feb 2009 A1
20090054894 Yachi Feb 2009 A1
20090065565 Cao Mar 2009 A1
20090076506 Baker Mar 2009 A1
20090082716 Akahoshi Mar 2009 A1
20090082766 Unger et al. Mar 2009 A1
20090088785 Masuda Apr 2009 A1
20090090763 Zemlok et al. Apr 2009 A1
20090101692 Whitman et al. Apr 2009 A1
20090105750 Price et al. Apr 2009 A1
20090112206 Dumbauld et al. Apr 2009 A1
20090118751 Wiener et al. May 2009 A1
20090131885 Akahoshi May 2009 A1
20090131934 Odom et al. May 2009 A1
20090143678 Keast et al. Jun 2009 A1
20090143799 Smith et al. Jun 2009 A1
20090143800 Deville et al. Jun 2009 A1
20090157064 Hodel Jun 2009 A1
20090163807 Sliwa Jun 2009 A1
20090177119 Heidner et al. Jul 2009 A1
20090179923 Amundson et al. Jul 2009 A1
20090182322 D'Amelio et al. Jul 2009 A1
20090182331 D'Amelio et al. Jul 2009 A1
20090182332 Long et al. Jul 2009 A1
20090182333 Eder et al. Jul 2009 A1
20090192441 Gelbart et al. Jul 2009 A1
20090198272 Kerver et al. Aug 2009 A1
20090204114 Odom Aug 2009 A1
20090216157 Yamada Aug 2009 A1
20090223033 Houser Sep 2009 A1
20090240244 Malis et al. Sep 2009 A1
20090248021 McKenna Oct 2009 A1
20090248022 Falkenstein et al. Oct 2009 A1
20090254077 Craig Oct 2009 A1
20090254080 Honda Oct 2009 A1
20090259149 Tahara et al. Oct 2009 A1
20090264909 Beaupre Oct 2009 A1
20090270771 Takahashi Oct 2009 A1
20090270812 Litscher et al. Oct 2009 A1
20090270853 Yachi et al. Oct 2009 A1
20090270891 Beaupre Oct 2009 A1
20090270899 Carusillo et al. Oct 2009 A1
20090287205 Ingle Nov 2009 A1
20090292283 Odom Nov 2009 A1
20090299141 Downey et al. Dec 2009 A1
20090306639 Nevo et al. Dec 2009 A1
20090327715 Smith et al. Dec 2009 A1
20100004508 Naito et al. Jan 2010 A1
20100022825 Yoshie Jan 2010 A1
20100030233 Whitman et al. Feb 2010 A1
20100034605 Huckins et al. Feb 2010 A1
20100036370 Mirel et al. Feb 2010 A1
20100042093 Wham et al. Feb 2010 A9
20100049180 Wells et al. Feb 2010 A1
20100057081 Hanna Mar 2010 A1
20100057118 Dietz et al. Mar 2010 A1
20100063437 Nelson et al. Mar 2010 A1
20100063525 Beaupre et al. Mar 2010 A1
20100063528 Beaupre Mar 2010 A1
20100081863 Hess et al. Apr 2010 A1
20100081864 Hess et al. Apr 2010 A1
20100081883 Murray et al. Apr 2010 A1
20100094323 Isaacs et al. Apr 2010 A1
20100106173 Yoshimine Apr 2010 A1
20100109480 Forslund et al. May 2010 A1
20100158307 Kubota et al. Jun 2010 A1
20100168741 Sanai et al. Jul 2010 A1
20100181966 Sakakibara Jul 2010 A1
20100187283 Crainich et al. Jul 2010 A1
20100204721 Young et al. Aug 2010 A1
20100222714 Muir et al. Sep 2010 A1
20100222752 Collins, Jr. et al. Sep 2010 A1
20100228249 Mohr Sep 2010 A1
20100228250 Brogna Sep 2010 A1
20100234906 Koh Sep 2010 A1
20100274160 Yachi et al. Oct 2010 A1
20100274278 Fleenor et al. Oct 2010 A1
20100280368 Can et al. Nov 2010 A1
20100298743 Nield et al. Nov 2010 A1
20100331742 Masuda Dec 2010 A1
20100331871 Nield et al. Dec 2010 A1
20110004233 Muir et al. Jan 2011 A1
20110015650 Choi et al. Jan 2011 A1
20110022032 Zemlok et al. Jan 2011 A1
20110028964 Edwards Feb 2011 A1
20110071523 Dickhans Mar 2011 A1
20110082494 Kerr et al. Apr 2011 A1
20110106141 Nakamura May 2011 A1
20110112400 Emery et al. May 2011 A1
20110125149 El-Galley et al. May 2011 A1
20110125151 Strauss et al. May 2011 A1
20110144640 Heinrich et al. Jun 2011 A1
20110160725 Kabaya et al. Jun 2011 A1
20110238010 Kirschenman et al. Sep 2011 A1
20110238079 Hannaford et al. Sep 2011 A1
20110273465 Konishi et al. Nov 2011 A1
20110278343 Knodel et al. Nov 2011 A1
20110279268 Konishi et al. Nov 2011 A1
20110284014 Cadeddu et al. Nov 2011 A1
20110290856 Shelton, IV et al. Dec 2011 A1
20110295295 Shelton, IV et al. Dec 2011 A1
20110306967 Payne et al. Dec 2011 A1
20110313415 Fernandez et al. Dec 2011 A1
20120004655 Kim et al. Jan 2012 A1
20120016413 Timm et al. Jan 2012 A1
20120022519 Huang et al. Jan 2012 A1
20120022526 Aldridge et al. Jan 2012 A1
20120022583 Sugalski et al. Jan 2012 A1
20120041358 Mann et al. Feb 2012 A1
20120053597 Anvari et al. Mar 2012 A1
20120059286 Hastings et al. Mar 2012 A1
20120059289 Nield et al. Mar 2012 A1
20120071863 Lee et al. Mar 2012 A1
20120078244 Worrell et al. Mar 2012 A1
20120080344 Shelton, IV Apr 2012 A1
20120101495 Young et al. Apr 2012 A1
20120109186 Parrott et al. May 2012 A1
20120116222 Sawada et al. May 2012 A1
20120116265 Houser et al. May 2012 A1
20120116266 Houser et al. May 2012 A1
20120116379 Yates May 2012 A1
20120116381 Houser et al. May 2012 A1
20120136279 Tanaka et al. May 2012 A1
20120136347 Brustad et al. May 2012 A1
20120136386 Kishida et al. May 2012 A1
20120143211 Kishi Jun 2012 A1
20120150049 Zielinski et al. Jun 2012 A1
20120150169 Zielinksi et al. Jun 2012 A1
20120172904 Muir et al. Jul 2012 A1
20120191091 Allen Jul 2012 A1
20120193396 Zemlok et al. Aug 2012 A1
20120211542 Racenet Aug 2012 A1
20120226266 Ghosal et al. Sep 2012 A1
20120234893 Schuckmann et al. Sep 2012 A1
20120253328 Cunningham et al. Oct 2012 A1
20120265241 Hart et al. Oct 2012 A1
20120296325 Takashino Nov 2012 A1
20120296371 Kappus et al. Nov 2012 A1
20130023925 Mueller Jan 2013 A1
20130085510 Stefanchik et al. Apr 2013 A1
20130103031 Garrison Apr 2013 A1
20130123776 Monson et al. May 2013 A1
20130158659 Bergs et al. Jun 2013 A1
20130158660 Bergs et al. Jun 2013 A1
20130165929 Muir et al. Jun 2013 A1
20130190760 Allen, IV et al. Jul 2013 A1
20130214025 Zemlok et al. Aug 2013 A1
20130253256 Griffith et al. Sep 2013 A1
20130253480 Kimball et al. Sep 2013 A1
20130267874 Marcotte et al. Oct 2013 A1
20130277410 Fernandez et al. Oct 2013 A1
20130296843 Boudreaux et al. Nov 2013 A1
20130321425 Greene et al. Dec 2013 A1
20130334989 Kataoka Dec 2013 A1
20130345701 Allen, IV et al. Dec 2013 A1
20140001231 Shelton, IV et al. Jan 2014 A1
20140001234 Shelton, IV et al. Jan 2014 A1
20140005640 Shelton, IV et al. Jan 2014 A1
20140005663 Heard et al. Jan 2014 A1
20140005678 Shelton, IV et al. Jan 2014 A1
20140005702 Timm et al. Jan 2014 A1
20140005705 Weir et al. Jan 2014 A1
20140005718 Shelton, IV et al. Jan 2014 A1
20140014544 Bugnard et al. Jan 2014 A1
20140077426 Park Mar 2014 A1
20140121569 Schafer et al. May 2014 A1
20140135804 Weisenburgh, II et al. May 2014 A1
20140163541 Shelton, IV et al. Jun 2014 A1
20140163549 Yates et al. Jun 2014 A1
20140180274 Kabaya et al. Jun 2014 A1
20140194868 Sanai et al. Jul 2014 A1
20140194874 Dietz et al. Jul 2014 A1
20140194875 Reschke et al. Jul 2014 A1
20140207124 Aldridge et al. Jul 2014 A1
20140207135 Winter Jul 2014 A1
20140221994 Reschke Aug 2014 A1
20140246475 Hall et al. Sep 2014 A1
20140249557 Koch, Jr. et al. Sep 2014 A1
20140263541 Leimbach et al. Sep 2014 A1
20140263552 Hall et al. Sep 2014 A1
20140276794 Batchelor et al. Sep 2014 A1
20140276797 Batchelor et al. Sep 2014 A1
20140276798 Batchelor et al. Sep 2014 A1
20140303612 Williams Oct 2014 A1
20140373003 Grez et al. Dec 2014 A1
20150014392 Williams et al. Jan 2015 A1
20150032150 Ishida et al. Jan 2015 A1
20150048140 Penna et al. Feb 2015 A1
20150066027 Garrison et al. Mar 2015 A1
20150080876 Worrell et al. Mar 2015 A1
20150080887 Sobajima et al. Mar 2015 A1
20150088122 Jensen Mar 2015 A1
20150100056 Nakamura Apr 2015 A1
20150112335 Boudreaux et al. Apr 2015 A1
20150157356 Gee Jun 2015 A1
20150164533 Felder et al. Jun 2015 A1
20150164534 Felder et al. Jun 2015 A1
20150164535 Felder et al. Jun 2015 A1
20150164536 Czarnecki et al. Jun 2015 A1
20150164537 Cagle et al. Jun 2015 A1
20150238260 Nau, Jr. Aug 2015 A1
20150272557 Overmyer et al. Oct 2015 A1
20150272571 Leimbach et al. Oct 2015 A1
20150272580 Leimbach et al. Oct 2015 A1
20150272582 Leimbach et al. Oct 2015 A1
20150272659 Boudreaux et al. Oct 2015 A1
20150282879 Ruelas Oct 2015 A1
20150289364 Ilkko et al. Oct 2015 A1
20150313667 Allen, IV Nov 2015 A1
20150317899 Dumbauld et al. Nov 2015 A1
20150351765 Valentine et al. Dec 2015 A1
20150351857 Vander Poorten et al. Dec 2015 A1
20150374430 Weiler et al. Dec 2015 A1
20160000437 Giordano et al. Jan 2016 A1
20160038228 Daniel et al. Feb 2016 A1
20160044841 Chamberlain Feb 2016 A1
20160045248 Unger et al. Feb 2016 A1
20160051316 Boudreaux Feb 2016 A1
20160066913 Swayze et al. Mar 2016 A1
20160120601 Boudreaux May 2016 A1
20160175025 Strobl Jun 2016 A1
20160175029 Witt et al. Jun 2016 A1
20160206342 Robertson et al. Jul 2016 A1
20160249910 Shelton, IV et al. Sep 2016 A1
20160262786 Madan et al. Sep 2016 A1
20160270842 Strobl et al. Sep 2016 A1
20160296251 Olson et al. Oct 2016 A1
20160296252 Olson et al. Oct 2016 A1
20160296270 Strobl et al. Oct 2016 A1
20160358849 Jur et al. Dec 2016 A1
20170065331 Mayer et al. Mar 2017 A1
20170086909 Yates et al. Mar 2017 A1
20170119426 Akagane May 2017 A1
20170135751 Rothweiler et al. May 2017 A1
20170164972 Johnson et al. Jun 2017 A1
20170164997 Johnson et al. Jun 2017 A1
20170189095 Danziger et al. Jul 2017 A1
20170202591 Shelton, IV Jul 2017 A1
20170202595 Shelton, IV Jul 2017 A1
20170224332 Hunter et al. Aug 2017 A1
20170231628 Shelton, IV et al. Aug 2017 A1
20170281186 Shelton, IV et al. Oct 2017 A1
20170296169 Yates et al. Oct 2017 A1
20170296177 Harris et al. Oct 2017 A1
20170296180 Harris et al. Oct 2017 A1
20170303954 Ishii Oct 2017 A1
20170312018 Trees et al. Nov 2017 A1
20170325874 Noack et al. Nov 2017 A1
20170333073 Faller et al. Nov 2017 A1
20170348043 Wang et al. Dec 2017 A1
20170348044 Wang et al. Dec 2017 A1
20180014872 Dickerson Jan 2018 A1
20180132850 Leimbach et al. May 2018 A1
20180168575 Simms et al. Jun 2018 A1
20180168577 Aronhalt et al. Jun 2018 A1
20180168579 Aronhalt et al. Jun 2018 A1
20180168598 Shelton, IV et al. Jun 2018 A1
20180168608 Shelton, IV et al. Jun 2018 A1
20180168609 Fanelli et al. Jun 2018 A1
20180168610 Shelton, IV et al. Jun 2018 A1
20180168615 Shelton, IV et al. Jun 2018 A1
20180168618 Scott et al. Jun 2018 A1
20180168619 Scott et al. Jun 2018 A1
20180168623 Simms et al. Jun 2018 A1
20180168625 Posada et al. Jun 2018 A1
20180168633 Shelton, IV et al. Jun 2018 A1
20180168647 Shelton, IV et al. Jun 2018 A1
20180168648 Shelton, IV et al. Jun 2018 A1
20180168650 Shelton, IV et al. Jun 2018 A1
20180188125 Park et al. Jul 2018 A1
20180206904 Felder et al. Jul 2018 A1
20180221045 Zimmerman et al. Aug 2018 A1
20180289432 Kostrzewski et al. Oct 2018 A1
20180303493 Chapolini Oct 2018 A1
20180325517 Wingardner et al. Nov 2018 A1
20180353245 Mccloud et al. Dec 2018 A1
20180368844 Bakos et al. Dec 2018 A1
20190000459 Shelton, IV et al. Jan 2019 A1
20190000461 Shelton, IV et al. Jan 2019 A1
20190000475 Shelton, IV et al. Jan 2019 A1
20190000477 Shelton, IV et al. Jan 2019 A1
20190029746 Dudhedia et al. Jan 2019 A1
20190038283 Shelton, IV et al. Feb 2019 A1
20190104919 Shelton, IV et al. Apr 2019 A1
20190125384 Scheib et al. May 2019 A1
20190125390 Shelton, IV et al. May 2019 A1
20190183504 Shelton, IV et al. Jun 2019 A1
20190200844 Shelton, IV et al. Jul 2019 A1
20190200977 Shelton, IV et al. Jul 2019 A1
20190200981 Harris et al. Jul 2019 A1
20190200987 Shelton, IV et al. Jul 2019 A1
20190201030 Shelton, IV et al. Jul 2019 A1
20190201045 Yates et al. Jul 2019 A1
20190201046 Shelton, IV et al. Jul 2019 A1
20190201047 Yates et al. Jul 2019 A1
20190201048 Stulen et al. Jul 2019 A1
20190201104 Shelton, IV et al. Jul 2019 A1
20190201136 Shelton, IV et al. Jul 2019 A1
20190201137 Shelton, IV et al. Jul 2019 A1
20190201594 Shelton, IV et al. Jul 2019 A1
20190206562 Shelton, IV et al. Jul 2019 A1
20190206564 Shelton, IV et al. Jul 2019 A1
20190206569 Shelton, IV et al. Jul 2019 A1
20190209201 Boudreaux et al. Jul 2019 A1
20190223941 Kitamura et al. Jul 2019 A1
20190269455 Mensch et al. Sep 2019 A1
20190290265 Shelton, IV et al. Sep 2019 A1
20190298350 Shelton, IV et al. Oct 2019 A1
20190298353 Shelton, IV et al. Oct 2019 A1
20190366562 Zhang et al. Dec 2019 A1
20190388091 Eschbach et al. Dec 2019 A1
20200054321 Harris et al. Feb 2020 A1
20200078076 Henderson et al. Mar 2020 A1
20200078085 Yates et al. Mar 2020 A1
20200078609 Messerly et al. Mar 2020 A1
20200100825 Henderson et al. Apr 2020 A1
20200100830 Henderson et al. Apr 2020 A1
20200129261 Eschbach Apr 2020 A1
20200138473 Shelton, IV et al. May 2020 A1
20200188047 Itkowitz et al. Jun 2020 A1
20200222111 Yates et al. Jul 2020 A1
20200222112 Hancock et al. Jul 2020 A1
20200229834 Olson et al. Jul 2020 A1
20200237434 Scheib et al. Jul 2020 A1
20200261086 Zeiner et al. Aug 2020 A1
20200261141 Wiener et al. Aug 2020 A1
20200268433 Wiener et al. Aug 2020 A1
20200305870 Shelton, IV Oct 2020 A1
20200315623 Eisinger et al. Oct 2020 A1
20200315712 Jasperson et al. Oct 2020 A1
20200338370 Wiener et al. Oct 2020 A1
20200405296 Shelton, IV et al. Dec 2020 A1
20200405302 Shelton, IV et al. Dec 2020 A1
20200405316 Shelton, IV et al. Dec 2020 A1
20200405409 Shelton, IV et al. Dec 2020 A1
20200405410 Shelton, IV Dec 2020 A1
20200405439 Shelton, IV et al. Dec 2020 A1
20200410177 Shelton, IV Dec 2020 A1
20210052313 Shelton, IV et al. Feb 2021 A1
20210100578 Weir et al. Apr 2021 A1
20210100579 Shelton, IV et al. Apr 2021 A1
20210177481 Shelton, IV et al. Jun 2021 A1
20210177494 Houser et al. Jun 2021 A1
20210177496 Shelton, IV et al. Jun 2021 A1
20210186492 Shelton, IV et al. Jun 2021 A1
20210186493 Shelton, IV et al. Jun 2021 A1
20210186495 Shelton, IV et al. Jun 2021 A1
20210186497 Shelton, IV et al. Jun 2021 A1
20210186498 Boudreaux et al. Jun 2021 A1
20210186499 Shelton, IV et al. Jun 2021 A1
20210186501 Shelton, IV et al. Jun 2021 A1
20210186502 Shelton, IV et al. Jun 2021 A1
20210186553 Green et al. Jun 2021 A1
20210186554 Green et al. Jun 2021 A1
20210196263 Shelton, IV et al. Jul 2021 A1
20210196266 Shelton, IV et al. Jul 2021 A1
20210196267 Shelton, IV et al. Jul 2021 A1
20210196268 Shelton, IV et al. Jul 2021 A1
20210196269 Shelton, IV et al. Jul 2021 A1
20210196270 Shelton, IV et al. Jul 2021 A1
20210196271 Shelton, IV et al. Jul 2021 A1
20210196301 Shelton, IV et al. Jul 2021 A1
20210196302 Shelton, IV et al. Jul 2021 A1
20210196305 Strobl Jul 2021 A1
20210196306 Estera et al. Jul 2021 A1
20210196307 Shelton, IV Jul 2021 A1
20210196334 Sarley et al. Jul 2021 A1
20210196335 Messerly et al. Jul 2021 A1
20210196336 Faller et al. Jul 2021 A1
20210196343 Shelton, IV et al. Jul 2021 A1
20210196344 Shelton, IV et al. Jul 2021 A1
20210196345 Messerly et al. Jul 2021 A1
20210196346 Leuck et al. Jul 2021 A1
20210196349 Fiebig et al. Jul 2021 A1
20210196350 Fiebig et al. Jul 2021 A1
20210196351 Sarley et al. Jul 2021 A1
20210196352 Messerly et al. Jul 2021 A1
20210196353 Gee et al. Jul 2021 A1
20210196354 Shelton, IV et al. Jul 2021 A1
20210196355 Shelton, IV et al. Jul 2021 A1
20210196356 Shelton, IV et al. Jul 2021 A1
20210196357 Shelton, IV et al. Jul 2021 A1
20210196358 Shelton, IV et al. Jul 2021 A1
20210196359 Shelton, IV et al. Jul 2021 A1
20210196360 Shelton, IV et al. Jul 2021 A1
20210196361 Shelton, IV et al. Jul 2021 A1
20210196362 Shelton, IV et al. Jul 2021 A1
20210196363 Shelton, IV et al. Jul 2021 A1
20210196364 Shelton, IV et al. Jul 2021 A1
20210196366 Shelton, IV et al. Jul 2021 A1
20210196367 Salguero et al. Jul 2021 A1
20210212744 Shelton, IV et al. Jul 2021 A1
20210220036 Shelton, IV et al. Jul 2021 A1
20210236195 Asher et al. Aug 2021 A1
20210282804 Worrell et al. Sep 2021 A1
20210393288 Shelton, IV et al. Dec 2021 A1
20210393314 Wiener et al. Dec 2021 A1
20210393319 Shelton, IV et al. Dec 2021 A1
20220039891 Stulen et al. Feb 2022 A1
20220071655 Price et al. Mar 2022 A1
20220168005 Aldridge et al. Jun 2022 A1
20220168039 Worrell et al. Jun 2022 A1
20220226014 Clauda, IV et al. Jul 2022 A1
20220304736 Boudreaux Sep 2022 A1
Foreign Referenced Citations (170)
Number Date Country
2535467 Apr 1993 CA
2460047 Nov 2001 CN
1634601 Jul 2005 CN
1775323 May 2006 CN
1922563 Feb 2007 CN
2868227 Feb 2007 CN
201029899 Mar 2008 CN
101474081 Jul 2009 CN
101516285 Aug 2009 CN
101522112 Sep 2009 CN
102100582 Jun 2011 CN
102149312 Aug 2011 CN
202027624 Nov 2011 CN
102792181 Nov 2012 CN
103281982 Sep 2013 CN
103379853 Oct 2013 CN
203468630 Mar 2014 CN
104001276 Aug 2014 CN
104013444 Sep 2014 CN
104434298 Mar 2015 CN
107374752 Nov 2017 CN
3904558 Aug 1990 DE
9210327 Nov 1992 DE
4300307 Jul 1994 DE
29623113 Oct 1997 DE
20004812 Sep 2000 DE
20021619 Mar 2001 DE
10042606 Aug 2001 DE
10201569 Jul 2003 DE
102012109037 Apr 2014 DE
0171967 Feb 1986 EP
0336742 Oct 1989 EP
0136855 Nov 1989 EP
0705571 Apr 1996 EP
1698289 Sep 2006 EP
1862133 Dec 2007 EP
1972264 Sep 2008 EP
2060238 May 2009 EP
1747761 Oct 2009 EP
2131760 Dec 2009 EP
1214913 Jul 2010 EP
1946708 Jun 2011 EP
1767164 Jan 2013 EP
2578172 Apr 2013 EP
2668922 Dec 2013 EP
2076195 Dec 2015 EP
2510891 Jun 2016 EP
3476302 May 2019 EP
3476331 May 2019 EP
3694298 Aug 2020 EP
2032221 Apr 1980 GB
2317566 Apr 1998 GB
S50100891 Aug 1975 JP
S5968513 May 1984 JP
S59141938 Aug 1984 JP
S62221343 Sep 1987 JP
S62227343 Oct 1987 JP
S62292153 Dec 1987 JP
S62292154 Dec 1987 JP
S63109386 May 1988 JP
S63315049 Dec 1988 JP
H01151452 Jun 1989 JP
H01198540 Aug 1989 JP
H0271510 May 1990 JP
H02286149 Nov 1990 JP
H02292193 Dec 1990 JP
H0337061 Feb 1991 JP
H0425707 Feb 1992 JP
H0464351 Feb 1992 JP
H0430508 Mar 1992 JP
H04152942 May 1992 JP
H 0541716 Feb 1993 JP
H0595955 Apr 1993 JP
H05115490 May 1993 JP
H0670938 Mar 1994 JP
H06104503 Apr 1994 JP
H0824266 Jan 1996 JP
H08229050 Sep 1996 JP
H08275951 Oct 1996 JP
H08299351 Nov 1996 JP
H08336545 Dec 1996 JP
H09130655 May 1997 JP
H09135553 May 1997 JP
H09140722 Jun 1997 JP
H105237 Jan 1998 JP
10127654 May 1998 JP
H10295700 Nov 1998 JP
H11128238 May 1999 JP
H11169381 Jun 1999 JP
2000210299 Aug 2000 JP
2000271142 Oct 2000 JP
2000271145 Oct 2000 JP
2000287987 Oct 2000 JP
2001029353 Feb 2001 JP
2002059380 Feb 2002 JP
2002186901 Jul 2002 JP
2002263579 Sep 2002 JP
2002330977 Nov 2002 JP
2003000612 Jan 2003 JP
2003010201 Jan 2003 JP
2003116870 Apr 2003 JP
2003126104 May 2003 JP
2003126110 May 2003 JP
2003153919 May 2003 JP
2003339730 Dec 2003 JP
2004129871 Apr 2004 JP
2004147701 May 2004 JP
2005003496 Jan 2005 JP
2005027026 Jan 2005 JP
2005074088 Mar 2005 JP
2005337119 Dec 2005 JP
2006068396 Mar 2006 JP
2006081664 Mar 2006 JP
2006114072 Apr 2006 JP
2006217716 Aug 2006 JP
2006288431 Oct 2006 JP
2007037568 Feb 2007 JP
200801876 Jan 2008 JP
200833644 Feb 2008 JP
2008188160 Aug 2008 JP
D1339835 Aug 2008 JP
2010009686 Jan 2010 JP
2010121865 Jun 2010 JP
2012071186 Apr 2012 JP
2012235658 Nov 2012 JP
100789356 Dec 2007 KR
2154437 Aug 2000 RU
22035 Mar 2002 RU
2201169 Mar 2003 RU
2405603 Dec 2010 RU
2013119977 Nov 2014 RU
850068 Jul 1981 SU
WO-8103272 Nov 1981 WO
WO-9308757 May 1993 WO
WO-9314708 Aug 1993 WO
WO-9421183 Sep 1994 WO
WO-9424949 Nov 1994 WO
WO-9639086 Dec 1996 WO
WO-9712557 Apr 1997 WO
WO-9800069 Jan 1998 WO
WO-9840015 Sep 1998 WO
WO-9920213 Apr 1999 WO
WO-9923960 May 1999 WO
WO-0024330 May 2000 WO
WO-0064358 Nov 2000 WO
WO-0128444 Apr 2001 WO
WO-0167970 Sep 2001 WO
WO-0172251 Oct 2001 WO
WO-0195810 Dec 2001 WO
WO-03095028 Nov 2003 WO
WO-2004037095 May 2004 WO
WO-2004078051 Sep 2004 WO
WO-2004098426 Nov 2004 WO
WO-2006091494 Aug 2006 WO
WO-2007008710 Jan 2007 WO
WO-2008118709 Oct 2008 WO
WO-2008130793 Oct 2008 WO
WO-2010027109 Mar 2010 WO
WO-2010104755 Sep 2010 WO
WO-2011008672 Jan 2011 WO
WO-2011044343 Apr 2011 WO
WO-2011052939 May 2011 WO
WO-2011060031 May 2011 WO
WO-2012044606 Apr 2012 WO
WO-2012061722 May 2012 WO
WO-2012088535 Jun 2012 WO
WO-2012150567 Nov 2012 WO
WO-2016130844 Aug 2016 WO
WO-2019130090 Jul 2019 WO
WO-2019130113 Jul 2019 WO
Non-Patent Literature Citations (56)
Entry
Covidien Brochure, [Value Analysis Brief], LigaSure Advance™ Pistol Grip, dated Rev. Apr. 2010 (7 pages).
Wright, et al., “Time-Temperature Equivalence of Heat-Induced Changes in Cells and Proteins,” Feb. 1998. ASME Journal of Biomechanical Engineering, vol. 120, pp. 22-26.
Covidien Brochure, LigaSure Impact™ Instrument LF4318, dated Feb. 2013 (3 pages).
Covidien Brochure, LigaSure Atlas™ Hand Switching Instruments, dated Dec. 2008 (2 pages).
Covidien Brochure, The LigaSure™ 5 mm Blunt Tip Sealer/Divider Family, dated Apr. 2013 (2 pages).
Jang, J. et al. “Neuro-fuzzy and Soft Computing.” Prentice Hall, 1997, pp. 13-89, 199-293, 335-393, 453-496, 535-549.
Sullivan, “Optimal Choice for Number of Strands in a Litz-Wire Transformer Winding,” IEEE Transactions on Power Electronics, vol. 14, No. 2, Mar. 1999, pp. 283-291.
Weir, C.E., “Rate of shrinkage of tendon collagen—heat, entropy and free energy of activation of the shrinkage of untreated tendon. Effect of acid salt, pickle, and tannage on the activation of tendon collagen.” Journal of the American Leather Chemists Association, 44, pp. 108-140 (1949).
Wall et al., “Thermal modification of collagen,” J Shoulder Elbow Surg, No. 8, pp. 339-344 (Jul./Aug. 1999).
Chen et al., “Heat-Induced Changes in the Mechanics of a Collagenous Tissue: Isothermal Free Shrinkage,” Transactions of the ASME, vol. 119, pp. 372-378 (Nov. 1997).
Chen et al., “Phenomenological Evolution Equations for Heat-Induced Shrinkage of a Collagenous Tissue,” IEEE Transactions on Biomedical Engineering, vol. 45, No. 10, pp. 1234-1240 (Oct. 1998).
Harris et al., “Kinetics of Thermal Damage to a Collagenous Membrane Under Biaxial Isotonic Loading,” IEEE Transactions on Biomedical Engineering, vol. 51, No. 2, pp. 371-379 (Feb. 2004).
Harris et al., “Altered Mechanical Behavior of Epicardium Due to Isothermal Heating Under Biaxial Isotonic Loads,” Journal of Biomechanical Engineering, vol. 125, pp. 381-388 (Jun. 2003).
Lee et al., “A multi-sample denaturation temperature tester for collagenous biomaterials,” Med. Eng. Phy., vol. 17, No. 2, pp. 115-121 (Mar. 1995).
Moran et al., “Thermally Induced Shrinkage of Joint Capsule,” Clinical Orthopaedics and Related Research, No. 281, pp. 248-255 (Dec. 2000).
Wells et al., “Altered Mechanical Behavior of Epicardium Under Isothermal Biaxial Loading,” Transactions of the ASME, Journal of Biomedical Engineering, vol. 126, pp. 492-497 (Aug. 2004).
Gibson, “Magnetic Refrigerator Successfully Tested,” U.S. Department of Energy Research News, accessed online on Aug. 6, 2010 at http://www.eurekalert.org/features/doe/2001-11/dl-mrs062802.php (Nov. 1, 2001).
Humphrey, J.D., “Continuum Thermomechanics and the Clinical Treatment of Disease and Injury,” Appl. Mech. Rev., vol. 56, No. 2 pp. 231-260 (Mar. 2003).
National Semiconductors Temperature Sensor Handbook—http://www.national.com/appinfo/tempsensors/files/temphb.pdf; accessed online: Apr. 1, 2011.
Hayashi et al., “The Effect of Thermal Heating on the Length and Histologic Properties of the Glenohumeral Joint Capsule,” American Journal of Sports Medicine, vol. 25, Issue 1, 11 pages (Jan. 1997), URL: http://www.mdconsult.com/das/article/body/156183648-2/jorg=journal&source=Ml&sp=1 . . . , accessed Aug. 25, 2009.
Douglas, S.C. “Introduction to Adaptive Filter”. Digital Signal Processing Handbook. Ed. Vijay K. Madisetti and Douglas B. Williams. Boca Raton: CRC Press LLC, 1999.
Chen et al., “Heat-induced changes in the mechanics of a collagenous tissue: pseudoelastic behavior at 37° C.,” Journal of Biomechanics, 31, pp. 211-216 (1998).
Technology Overview, printed from www.harmonicscalpel.com, Internet site, website accessed on Jun. 13, 2007, (3 pages).
Sherrit et al., “Novel Horn Designs for Ultrasonic/Sonic Cleaning Welding, Soldering, Cutting and Drilling,” Proc. SPIE Smart Structures Conference, vol. 4701, Paper No. 34, San Diego, CA, pp. 353-360, Mar. 2002.
AST Products, Inc., “Principles of Video Contact Angle Analysis,” 20 pages, (2006).
Lim et al., “A Review of Mechanism Used in Laparoscopic Surgical Instruments,” Mechanism and Machine Theory, vol. 38, pp. 1133-1147, (2003).
Huston et al., “Magnetic and Magnetostrictive Properties of Cube Textured Nickel for Magnetostrictive Transducer Applications,” IEEE Transactions on Magnetics, vol. 9(4), pp. 636-640 (Dec. 1973).
Incropera et al., Fundamentals of Heat and Mass Transfer, Wiley, New York (1990). (Book—not attached).
F. A. Duck, “Optical Properties of Tissue Including Ultraviolet and Infrared Radiation,” pp. 43-71 in Physical Properties of Tissue (1990).
Graff, K.F., “Elastic Wave Propagation in a Curved Sonic Transmission Line,” IEEE Transactions on Sonics and Ultrasonics, SU-17(1), 1-6 (1970).
Makarov, S. N., Ochmann, M., Desinger, K., “The longitudinal vibration response of a curved fiber used for laser ultrasound surgical therapy,” Journal of the Acoustical Society of America 102, 1191-1199 (1997).
Walsh, S. J., White, R. G., “Vibrational Power Transmission in Curved Beams,” Journal of Sound and Vibration, 233(3), 455-488 (2000).
Covidien 501 (k) Summary Sonicision, dated Feb. 24, 2011 (7 pages).
Morley, L. S. D., “Elastic Waves in a Naturally Curved Rod,” Quarterly Journal of Mechanics and Applied Mathematics, 14: 155-172 (1961).
Gooch et al., “Recommended Infection-Control Practices for Dentistry, 1993,” Published: May 28, 1993; [retrieved on Aug. 23, 2008]. Retrieved from the internet: URL: http//wonder.cdc.gov/wonder/prevguid/p0000191/p0000191.asp (15 pages).
Sullivan, “Cost-Constrained Selection of Strand Diameter and Number in a Litz-Wire Transformer Winding,” IEEE Transactions on Power Electronics, vol. 16, No. 2, Mar. 2001, pp. 281-288.
Orr et al., “Overview of Bioheat Transfer,” pp. 367-384 in Optical-Thermal Response of Laser-Irradiated Tissue, A. J. Welch and M. J. C. van Gemert, eds., Plenum, New York (1995).
Fowler, K.R., “A Programmable, Arbitrary Waveform Electrosurgical Device,” IEEE Engineering in Medicine and Biology Society 10th Annual International Conference, pp. 1324, 1325 (1988).
LaCourse, J.R.; Vogt, M.C.; Miller, W.T., III; Selikowitz, S.M., “Spectral Analysis Interpretation of Electrosurgical Generator Nerve and Muscle Stimulation,” IEEE Transactions on Biomedical Engineering, vol. 35, No. 7, pp. 505-509, Jul. 1988.
Campbell et al, “Thermal Imaging in Surgery,” p. 19-3, in Medical Infrared Imaging, N. A. Diakides and J. D. Bronzino, Eds. (2008).
Gerhard, Glen C., “Surgical Electrotechnology: Quo Vadis?,” IEEE Transactions on Biomedical Engineering, vol. BME-31, No. 12, pp. 787-792, Dec. 1984.
Henriques. F.C., “Studies in thermal injury V. The predictability and the significance of thermally induced rate processes leading to irreversible epidermal injury.” Archives of Pathology, 434, pp. 489-502 (1947).
Arnoczky et al., “Thermal Modification of Conective Tissues: Basic Science Considerations and Clinical Implications,” J. Am Acad Orthop Surg, vol. 8, No. 5, pp. 305-313 (Sep./Oct. 2000).
Chen et al., “Heat-Induced Changes in the Mechanics of a Collagenous Tissue: Isothermal, Isotonic Shrinkage,” Transactions of the ASME, vol. 120, pp. 382-388 (Jun. 1998).
Kurt Gieck & Reiner Gieck, Engineering Formulas § Z.7 (7th ed. 1997).
https://www.kjmagnetics.com/fieldcalculator.asp, retrieved Jul. 11, 2016, backdated to Nov. 11, 2011 via https://web.archive.org/web/20111116164447/http://www.kjmagnetics.com/fieldcalculator.asp.
Leonard I. Malis, M.D., “The Value of Irrigation During Bipolar Coagulation,” 1989.
Covidien Brochure, The LigaSure Precise™ Instrument, dated Mar. 2011 (2 pages).
Glaser and Subak-Sharpe,Integrated Circuit Engineering, Addison-Wesley Publishing, Reading, MA (1979). (book—not attached).
Erbe Electrosurgery VIO® 200 S, (2012), p. 7, 12 pages, accessed Mar. 31, 2014 at http://www.erbe-med. com/erbe/media/Marketing materialien/85140170 ERBE EN VIO 200 S D027541.
Hörmann et al., “Reversible and irreversible denaturation of collagen fibers.” Biochemistry, 10, pp. 932-937 (1971).
Dean, D.A., “Electrical Impedance Spectroscopy Study of Biological Tissues,” J. Electrostat, 66(3-4), Mar. 2008, pp. 165-177. Accessed Apr. 10, 2018: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597841/.
Moraleda et al., A Temperature Sensor Based on a Polymer Optical Fiber Macro-Bend, Sensors 2013, 13, 13076-13089, doi: 10.3390/S131013076, ISSN 1424-8220.
IEEE Std 802.3-2012 (Revision of IEEE Std 802.3-2008, published Dec. 28, 2012.
“ATM-MPLS Network Interworking Version 2.0, af-aic-0178.001” ATM Standard, The ATM Forum Technical Committee, published Aug. 2003.
Missinne, et al. “Stretchable Optical Waveguides,” vol. 22, No. 4, Feb. 18, 2014, pp. 4168-4179 (12 pages).
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Provisional Applications (1)
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