The present application relates to surgical instruments and, in various embodiments, to surgical stapling and/or cutting instruments and staple cartridges for use therewith.
The features and advantages of this invention, and the manner of attaining them, will become more apparent and the invention itself will be better understood by reference to the following description of embodiments of the invention taken in conjunction with the accompanying drawings, wherein:
The Applicant of the present application also owns the U.S. Patent Applications identified below which are each herein incorporated by reference in their respective entirety:
U.S. patent application Ser. No. 12/894,311, entitled SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS; now U.S. Patent Publication No. 2012/0080496;
U.S. patent application Ser. No. 12/894,340, entitled SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS; now U.S. Patent Publication No. 2012/0080482;
U.S. patent application Ser. No. 12/894,327, entitled JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS; now U.S. Patent Publication No. 2012/0080499;
U.S. patent application Ser. No. 12/894,351, entitled SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS; now U.S. Patent Publication No. 2012/0080502;
U.S. patent application Ser. No. 12/894,338, entitled IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT; now U.S. Patent Publication No. 2012/0080481;
U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER; now U.S. Patent Publication No. 2012/0080344;
U.S. patent application Ser. No. 12/894,312, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS; now U.S. Patent Publication No. 2012/0080479;
U.S. patent application Ser. No. 12/894,377, entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE; now U.S. Pat. No. 8,393,514;
U.S. patent application Ser. No. 12/894,339, entitled SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT; now U.S. Patent Publication No. 2012/0080500;
U.S. patent application Ser. No. 12/894,360, entitled SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM; now U.S. Patent Publication No. 2012/0080484;
U.S. patent application Ser. No. 12/894,322, entitled SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS; now U.S. Patent Publication No. 2012/0080501;
U.S. patent application Ser. No. 12/894,350, entitled SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES; now U.S. Patent Publication No. 2012/0080478;
U.S. patent application Ser. No. 12/894,383, entitled IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLE LAYERS; now U.S. Patent Publication No. 2012/0080345;
U.S. patent application Ser. No. 12/894,389, entitled COMPRESSIBLE FASTENER CARTRIDGE; now U.S. Patent Publication No. 2012/0080335;
U.S. patent application Ser. No. 12/894,345, entitled FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT; now U.S. Patent Publication No. 2012/0080483;
U.S. patent application Ser. No. 12/894,306, entitled COLLAPSIBLE FASTENER CARTRIDGE; now U.S. Patent Publication No. 2012/0080332;
U.S. patent application Ser. No. 12/894,318, entitled FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS; now U.S. Patent Publication No. 2012/0080480;
U.S. patent application Ser. No. 12/894,330, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX; now U.S. Patent Publication No. 2012/0080503;
U.S. patent application Ser. No. 12/894,361, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX; now U.S. Pat. No. 8,529,600;
U.S. patent application Ser. No. 12/894,367, entitled FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX; now U.S. Patent Publication No. 2012/0080485;
U.S. patent application Ser. No. 12/894,388, entitled FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER; now U.S. Pat. No. 8,474,677;
U.S. patent application Ser. No. 12/894,376, entitled FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES; now U.S. Patent Publication No. 2012/0080486;
U.S. patent application Ser. No. 13/097,865, entitled SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS; now U.S. Patent Publication No. 2012/0080488;
U.S. patent application Ser. No. 13/097,936, entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER; now U.S. Patent Publication No. 2012/0080339;
U.S. patent application Ser. No. 13/097,954, entitled STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLE PORTION; now U.S. Patent Publication No. 2012/0080340;
U.S. patent application Ser. No. 13/097,856, entitled STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF; now U.S. Patent Publication No. 2012/0080336;
U.S. patent application Ser. No. 13/097,928, entitled TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS; now U.S. Patent Publication No. 2012/0080490;
U.S. patent application Ser. No. 13/097,891, entitled TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL; now U.S. Patent Publication No. 2012/0080489;
U.S. patent application Ser. No. 13/097,948, entitled STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION; now U.S. Patent Publication No. 2012/0083836;
U.S. patent application Ser. No. 13/097,907, entitled COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY; now U.S. Patent Publication No. 2012/0080338;
U.S. patent application Ser. No. 13/097,861, entitled TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES; now U.S. Patent Publication No. 2012/0080337;
U.S. patent application Ser. No. 13/097,869, entitled STAPLE CARTRIDGE LOADING ASSEMBLY; now U.S. Patent Publication No. 2012/0160721;
U.S. patent application Ser. No. 13/097,917, entitled COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS; now U.S. Patent Publication No. 2012/0083834;
U.S. patent application Ser. No. 13/097,873, entitled STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION; now U.S. Patent Publication No. 2012/0083833;
U.S. patent application Ser. No. 13/097,938, entitled STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANT COMPONENTS; now U.S. Patent Publication No. 2012/0080491;
U.S. patent application Ser. No. 13/097,924, entitled STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2012/0083835;
U.S. patent application Ser. No. 13/242,029, entitled SURGICAL STAPLER WITH FLOATING ANVIL; now U.S. Patent Publication No. 2012/0080493;
U.S. patent application Ser. No. 13/242,066, entitled CURVED END EFFECTOR FOR A STAPLING INSTRUMENT; now U.S. Patent Publication No. 2012/0080498;
U.S. patent application Ser. No. 13/242,086, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK; now U.S. Patent Publication No. 2013/0075450;
U.S. patent application Ser. No. 13/241,912, entitled STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT; now U.S. Patent Publication No. 2013/0075448;
U.S. patent application Ser. No. 13/241,922, entitled SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS; now U.S. Patent Publication No. 2013/0075449;
U.S. patent application Ser. No. 13/241,637, entitled SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATION MOTIONS; now U.S. Patent Publication No. 2012/0074201;
U.S. patent application Ser. No. 13/241,629, entitled SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR; now U.S. Patent Publication No. 2012/0074200;
U.S. application Ser. No. 13/433,096, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF CAPSULES; now U.S. Patent Publication No. 2012/0241496;
U.S. application Ser. No. 13/433,103, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS; now U.S. Patent Publication No. 2012/0241498;
U.S. application Ser. No. 13/433,098, entitled EXPANDABLE TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2012/0241491;
U.S. application Ser. No. 13/433,102, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR; now U.S. Patent Publication No. 2012/0241497;
U.S. application Ser. No. 13/433,114, entitled RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2012/0241499;
U.S. application Ser. No. 13/433,136, entitled TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT; now U.S. Patent Publication No. 2012/0241492;
U.S. application Ser. No. 13/433,141, entitled TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE AND EXPANSION; now U.S. Patent Publication No. 2012/0241493;
U.S. application Ser. No. 13/433,144, entitled TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD; now U.S. Patent Publication No. 2012/0241500;
U.S. application Ser. No. 13/433,148, entitled TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD; now U.S. Patent Publication No. 2012/0241501;
U.S. application Ser. No. 13/433,155, entitled TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS; now U.S. Patent Publication No. 2012/0241502;
U.S. application Ser. No. 13/433,163, entitled METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS; now U.S. Patent Publication No. 2012/0248169;
U.S. application Ser. No. 13/433,167, entitled TISSUE THICKNESS COMPENSATORS; now U.S. Patent Publication No. 2012/0241503;
U.S. application Ser. No. 13/433,175, entitled LAYERED TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2012/0253298;
U.S. application Ser. No. 13/433,179, entitled TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS; now U.S. Patent Publication No. 2012/0241505;
U.S. application Ser. No. 13/763,028, entitled ADHESIVE FILM LAMINATE; now U.S. Patent Publication No. 2013/0146643;
U.S. application Ser. No. 13/433,115, entitled TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT; now U.S. Patent Publication No. 2013/0256372;
U.S. application Ser. No. 13/433,118, entitled TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OF MATERIALS; now U.S. Patent Publication No. 2013/0256365;
U.S. application Ser. No. 13/433,135, entitled MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2013/0256382;
U.S. application Ser. No. 13/433,140, entitled TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME; now U.S. Patent Publication No. 2013/0256368;
U.S. application Ser. No. 13/433,129, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF MEDICAMENTS; now U.S. Patent Publication No. 2013/0256367;
U.S. application Ser. No. 11/216,562, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S. Pat. No. 7,669,746;
U.S. application Ser. No. 11/714,049, entitled SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS, now U.S. Patent Publication No. 2007/0194082;
U.S. application Ser. No. 11/711,979, entitled SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 8,317,070;
U.S. application Ser. No. 11/711,975, entitled SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT, now U.S. Patent Publication No. 2007/0194079;
U.S. application Ser. No. 11/711,977, entitled SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES, now U.S. Pat. No. 7,673,781;
U.S. application Ser. No. 11/712,315, entitled SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS, now U.S. Pat. No. 7,500,979;
U.S. application Ser. No. 12/038,939, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S. Pat. No. 7,934,630;
U.S. application Ser. No. 13/020,263, entitled SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Patent Publication No. 2011/0147434;
U.S. application Ser. No. 13/118,278, entitled ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S. Patent Publication No. 2011/0290851;
U.S. application Ser. No. 13/369,629, entitled ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS, now U.S. Patent Publication No. 2012/0138660;
U.S. application Ser. No. 12/695,359, entitled SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS, now U.S. Pat. No. 8,464,923;
U.S. application Ser. No. 13/072,923, entitled STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S. Pat. No. 8,567,656;
U.S. application Ser. No. 13/766,325, entitled LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR; now U.S. Patent Publication No. 2013/0256380;
U.S. application Ser. No. 13/763,078, entitled ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR; now U.S. Patent Publication No. 2013/0256383;
U.S. application Ser. No. 13/763,094, entitled LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS; now U.S. Patent Publication No. 2013/0256377;
U.S. application Ser. No. 13/763,106, entitled END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER; now U.S. Patent Publication No. 2013/0256378;
U.S. application Ser. No. 13/433,147, entitled TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS; now U.S. Patent Publication No. 2013/0256369;
U.S. application Ser. No. 13/763,112, entitled SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES; now U.S. Patent Publication No. 2013/0256379;
U.S. application Ser. No. 13/763,035, entitled ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE; now U.S. Patent Publication No. 2013/0214030;
U.S. application Ser. No. 13/763,042, entitled RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME; now U.S. Patent Publication No. 2013/0221063;
U.S. application Ser. No. 13/763,048, entitled FASTENER CARTRIDGE COMPRISING A RELEASABLE TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2013/0221064;
U.S. application Ser. No. 13/763,054, entitled FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR;
U.S. application Ser. No. 13/763,065, entitled FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS COMPENSATOR; now U.S. Patent Publication No. 2013/0221065;
U.S. application Ser. No. 13/763,021, entitled STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER;
U.S. application Ser. No. 13/763,078, entitled ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR; now U.S. Patent Publication No. 2013/0256383;
U.S. application Ser. No. 13/763,095, entitled LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES; now U.S. Patent Publication No. 2013/0161374;
U.S. application Ser. No. 13/463,147, entitled IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES; now U.S. Patent Publication No. 2013/0292398;
U.S. application Ser. No. 13/763,192, entitled MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES; now U.S. Patent Publication No. 2013/0146642;
U.S. application Ser. No. 13/763,161, entitled RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME; now U.S. Patent Publication No. 2013/0153641;
U.S. application Ser. No. 13/763,177, entitled ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR; now U.S. Patent Publication No. 2013/0146641;
U.S. application Ser. No. 13/763,037, entitled STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORTION;
U.S. application Ser. No. 13/433,126, entitled TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTH FEATURES; now U.S. Patent Publication No. 2013/0256366;
U.S. application Ser. No. 13/433,132, entitled DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS; now U.S. Patent Publication No. 2013/0256373.
U.S. application Ser. No. 13/851,703, entitled FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR INCLUDING OPENINGS THEREIN;
U.S. application Ser. No. 13/851,676, entitled TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH;
U.S. application Ser. No. 13/851,693, entitled FASTENER CARTRIDGE ASSEMBLIES; and
U.S. application Ser. No. 13/851,684, entitled FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR AND A GAP SETTING ELEMENT.
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various embodiments of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” or “an embodiment”, or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment”, or “in an embodiment”, or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined, in whole or in part, with the features structures, or characteristics of one or more other embodiments without limitation. Such modifications and variations are intended to be included within the scope of the present invention.
The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the surgical instrument. The term “proximal” referring to the portion closest to the clinician and the term “distal” referring 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.
Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the person of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, those of ordinary skill in the art will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongated shaft of a surgical instrument can be advanced.
Turning to the drawings wherein like numerals denote like components throughout the several views,
In various embodiments, the shaftless end effector 6 comprises a first jaw member 8a and a second jaw member 8b. The first jaw member 8a comprises an anvil 10 having a staple-forming surface. The staple-forming surface can comprise a plurality of staple forming pockets therein. The first jaw member 8a is moveably coupled to a second jaw member 8b. The second jaw member 8b comprises a longitudinal channel 42 configured to receive a staple cartridge 12. The staple cartridge 12 comprises a plurality of staples 14 disposed therein. A pin 15 extending from first jaw member 8a is received within a slot 16 formed on the second jaw member 8b. The pin 15 and the slot 16 are configured to allow pivoting (rotation) and/or vertical movement (translation) of the first jaw member 8a with respect to the second jaw member 8b. In various embodiments, the second jaw member 8b may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc., and may be formed with spaced side walls. The first jaw member 8a may be fabricated from, for example, 300 & 400 Series, 17-4 & 17-7 stainless steel, titanium, etc., and have a staple forming undersurface comprising a plurality of staple forming pockets formed therein.
Various forms of staple cartridges may be employed with the various embodiments of the end effector 6 disclosed herein. In some embodiments, an implantable staple cartridge 12 may be used. In at least one embodiment, the staple cartridge 12 comprises a body portion 18 that comprises a compressible material such as, for example, a hemostatic material, oxidized regenerated cellulose (“ORC”) and/or a bioabsorbable foam in which lines of unformed metal staples 14, for example, are supported. In at least some embodiments, in order to prevent the alignment of the staples 14 within the cartridge body 18 from being affected and/or the hemostatic material from being activated during the introduction and positioning of the end effector 6 within a surgical site, the entire staple cartridge 12 may be coated or wrapped in a biodegradable film, such as, for example, a polydioxanone film sold under the trademark PDS®, a Polyglycerol sebecate (PGS) film, a biodegradable film formed from PGA (Polyglycolic acid, marketed under the trademark Vicryl), PCL (Polycaprolactone), PLA or PLLA (Polylactic acid), PHA (polyhydroxyalkanoate), PGCL (poliglecaprone 25, sold under the trademark Monocryl), and/or a composite of PGA, PCL, PLA, and/or PDS that would be impermeable until ruptured. The body portion 18 of the staple cartridge 12 is sized to be supported within the longitudinal channel 42 of the lower jaw member 8b such that each staple 14 is aligned with a corresponding staple forming pocket in the anvil 10 when the anvil 10 is driven into forming contact with the staple cartridge 12. In various instances, the staple cartridge 12 can be removable from the end effector 6 and, in other instances, the staple cartridge 12 may not be removable from the end effector 6.
In use, the end effector 6 is positioned adjacent to target tissue. The end effector 6 is manipulated to capture or clamp the target tissue between the anvil 10 and the staple cartridge 12. Referring to
Further to the above, the end effector 6 can comprise a closure system configured to close the anvil 10.
Further to the above, the end slides 22a, 22b can each define a cavity 24 for receiving the first jaw member 8a and the second jaw member 8b therein. The inner surface of the cavity 24 defined in each of the end slides 22a, 22b can comprise a cam surface, such as cam surface 30, for example. In various instances, each cam surface 30 can comprise an angled surface, for example. In certain instances, the angled surfaces can be configured to engage angled surfaces on the first jaw 8a. For example, the proximal end of the first jaw 8a can comprise a follower surface 32 which can be engaged by the cam surface 30 defined on the proximal end slide 22a as the proximal end slide 22a is moved distally toward the distal end slide 22b. Similarly, the distal end of the first jaw 8a can comprise a follower surface 32 which can be engaged by the cam surface 30 defined on the distal end slide 22b as the distal end slide 22b is moved proximally toward the distal end slide 22a. In various instances, the angle of the cam surface 30 can match an angle of the follower surface 32 while, in other instances, the angle of the cam surface 30 can be different than an angle of the follower surface 32. In certain instances, one set of surfaces 30, 32, such as the proximal set of surfaces, may be defined by a first matching angle and the other set of surfaces 30, 32, such as the distal set of surfaces, may be defined by a second matching angle which is different than the first matching angle. In various embodiments, the configurations of the cam surfaces 30 and the follower surfaces 32 can be selected to allow the anvil 10 to maintain an at least substantially parallel orientation with respect to the staple cartridge 12 in order to form of all staple 14 simultaneously.
In some embodiments, the end effector 6 can comprise at least one gauge configured to indicate the formed height of the staples. In various instances, the proximal end of the end effector 6 can include a formed height gauge 31 and/or the distal end of the end effector 6 can include a formed height gauge 31, for example. In certain instances, the proximal end slide 22a and/or the distal end slide 22b comprise a gauge element configured to indicate the formed height of the staples 14. In various instances, a gauge can include a series or an array of demarcations defined on the distal end of the second jaw 8a and, in addition, a gauge element extending from the distal end slide 22b. In at least one such embodiment, the gauge element can comprise an arm 34 including a head 36 and the array of demarcations can comprise a plurality of teeth 38 wherein the position of the head 36 relative to the teeth 38 can indicate the distance in which the anvil 10 has been pushed downwardly. Similarly, a gauge can include a series or an array of demarcations defined on the proximal end of the second jaw 8a and a gauge element extending from the proximal end slide 22a. Also similar to the above, the gauge element can comprise an arm 34 including a head 36 and the array of demarcations can comprise a plurality of teeth 38 wherein the position of the head 36 relative to the teeth 38 can indicate the distance in which the anvil 10 has been pushed downwardly. Referring again to
Various embodiments disclosed herein employ a compressible staple cartridge 12 that supports staples in a substantially stationary position for forming contact by the anvil 10. In various embodiments, the anvil 10 is driven into the unformed staples 14 wherein, in at least one such embodiment, the degree of staple formation attained is dependent upon how far the anvil 10 is driven into the staples. Such an arrangement provides the surgeon with the ability to adjust the amount of forming or firing pressure applied to the staples and thereby alters the final formed height of the staples.
Further to the above, the gauge elements extending from the end slides 22a and 22b can comprise retention members which can be configured to hold and/or lock the end slides 22a and 22b in position. In various instances, the heads 36 of the gauge elements and/or the teeth 38 can include lock shoulders configured to, one, permit the end slides 22a and 22b to be moved inwardly and, two, resist the outward movement of the end slides 22a and 22b. In various embodiments, the gauges can comprise ratchet systems permitting movement in one direction but prohibiting movement in the opposite direction. In order to overcome the locking effects of the gauge elements, the heads 36 of the gauge elements can be raised and/or deflected away from the arrays of teeth 38. Once the gauge elements have been disengaged from the first jaw 8a, the end slides 22a, 22b can be moved outwardly to permit the first jaw 8a to open. As discussed above, the first jaw 8a can be moved into its open position by a spring and/or can be pulled open by a grasper, such as grasper 154 (
Previous end effectors extended from a shaft of a surgical instrument wherein one or more drive members extending through the shaft were utilized to operate the end effector. As the reader will appreciate, the end effector 6 is not attached to the shaft of a surgical instrument and, thus, is shaftless. In various instances, as discussed above, a grasper, for example, can be utilized to push the end slides 22a, 22b of the end effector 6 inwardly. The grasper can be configured to move the end slides 22a, 22b one at a time or simultaneously. In various instances, a closure mechanism, such as, for example, a grasper (not shown) is coupled to the shaftless closure system 20. In certain instances, the grasper is opened and the shaftless end effector 6 is positioned between two arms of the grasper. The grasper is transitioned from an open position to a closed position to cause the proximal slide 22a and the distal slide 22b to slide towards a middle point of the shaftless end effector 6. The cam surfaces 30 of the proximal slide 22a and the distal slide 22b interface with the follower surfaces 32 defined on the anvil 10, causing the anvil 10 to compress towards the staple cartridge 12. As discussed above, the anvil 10 can compress the target tissue “T” and deploy the staples 14 into the target tissue “T.” Once the staples 14 have been formed and fastened to the target tissue “T”, further to the above, the surgeon can open the grasper and remove it from the surgical site. The anvil 10 can then be opened to release the stapled tissue “T” and the end effector 6 can be removed from the surgical site. As the reader will appreciate, the staple body 18 crushed and captured by the staples 14 can remain behind, or implanted. The remaining “crushed” staple body 18 can act as a hemostatic material, a staple line reinforcement, and/or a compensator for variations in tissue thickness. As used herein the term “implantable” means that, in addition to the staples 14, at least a portion of the staple cartridge body 18 captured by the staples 14 will also remain in the patient. The implanted cartridge body 18 may or may not eventually be absorbed by the patient's body. Although the various embodiments are described herein with reference to implantable staple cartridges, one skilled in the art will recognize that non-implantable cartridges, i.e., cartridges in which the staple cartridge remains positioned within the shaftless end effector after it is fired, may also be used. In various instances, such surgical stapling arrangements can employ staple driving elements which can lift the staples towards the anvil.
Although the shaftless end effector 6 is illustrated comprising a proximal slide 22a and a distal slide 22b, the reader will recognize that either the proximal slide 22a and/or the distal slide 22b may be omitted. In some embodiments, after the staples have been formed or fired into the target tissue, the shaftless end effector 6 may be released, for example, by actuating a release mechanism. The release mechanism can release the proximal slide 22a and/or the distal slide 22b causing the anvil 10 to assume an open position.
In certain embodiments, the shaftless end effector 6 may be solely used as a tissue stapling device. However, in various embodiments, the shaftless end effector 6 comprises a cutting member 40. The cutting member 40 is configured to cut the target tissue “T” along a longitudinal axis of the end effector 6. In some embodiments, the cutting member 40 comprises a fixed blade. In at least one embodiment, the lower jaw member 8b comprises a sharpened cutting member 40 configured to interface with a mating member formed on the anvil 10. When the anvil 10 is compressed towards the staple cartridge 12, the anvil 10 pushes the tissue T against the cutting member 40 which then cuts the target tissue T. In other embodiments, the cutting member can comprise a slideable cutting member deployable from an un-actuated position adjacent to the proximal end of the shaftless end effector 6 to an actuated position adjacent the distal end, for example. In at least one such instance, the cutting member can be configured to slideably extend through a slot in the anvil 10 and a centrally disposed slot in the staple cartridge 12. A slideable cutting member may be deployed, for example, by a rotatable shaft, which is described in greater detail further below. In some embodiments, the slideable cutting member comprises a sled for deploying the staples 14.
A rotatable shaft 464 extends longitudinally through the second jaw member 408b. The rotatable shaft 464 is operably engaged with a proximal slide 422a and a distal slide 422b of the drive system 420. The proximal slide 422a and the distal slide 422b can each comprise a cam 430. One and/or both of the cams 430 are configured to engage the anvil 410, rotate the anvil 410 into a closed position, and translate the anvil 410 downwardly toward the cartridge 412. The shaft 464 comprises a proximal drive end 466 extending from the proximal slide 422a. In various instances, a rotatable input, such as rotation mechanism 468, for example, can be coupled to the proximal drive end 466 to rotate the rotatable shaft 464. The shaft 464 can further comprise a first threaded portion 465a, a second threaded portion 465b, and a third threaded portion 465c. The first threaded portion 465a can be threadably engaged with a threaded longitudinal aperture defined in the proximal slide 422a. When the shaft 464 is rotated in a first direction, the first threaded portion 465a can displace the proximal slide 422a toward the distal slide 422b. The second threaded portion 465b can be threadably engaged with a threaded longitudinal aperture defined in the distal slide 422b. When the shaft 464 is rotated in the first direction, the second threaded portion 465b can displace the distal slide 422b toward the proximal slide 422a. In order to achieve such relative motion, in various embodiments, the first threaded portion 465a can comprise right-hand threads while the second threaded portion 465b can comprise left-hand threads, for example. When the proximal slide 422a and the distal slide 422b are moved toward each other, one and/or both of the slides 422a and 422b can rotate the anvil 410 into a closed position and push the anvil 410 downwardly to crush the staples 14.
Referring again to
As outlined above, the first threaded portion 465a can advance the proximal slide 422a from its unactuated position (
After the knife 440 has been sufficiently advanced by the shaft 464 to incise the tissue T and/or incise the cartridge 412, the knife 440 can be retracted by rotating the shaft 464 in a second, or opposite, direction. In such instances, the knife 440 can travel back along the third threaded portion 465c until it returns to its pre-staged position in which it is no longer threadably engaged with the third threaded portion 465c. Similarly, the rotation of the shaft 464 in the second direction can return the proximal slide 422a and the distal slide 422b to their unactuated positions and allow the anvil 410 to be reopened. In certain instances, the cutting member 440 can contact the proximal slide 422a as the cutting member 440 is being retracted in order to nudge the proximal slide 422a back onto the first threaded portion 465a. In various instances, the end effector 406 can further include a threaded member configured to ride on the shaft 464 and nudge the distal slide 422b back onto the second threaded portion 465b. In any event, the threaded portions of the shaft 464 can have the same thread pitch. In such instances, the portions of the end effector 406 displaced by the shaft 464 can move at the same speed. In other instances, one or more of the threaded portions of the shaft 464 can have a different thread pitch wherein, as a result, one or more of the components of the end effector 406 can move at different speeds for a given rotational speed of the shaft 464.
As the reader will appreciate, the end effector 406 includes a single rotational drive input which can close the anvil 410 in a first stage, deform the staples 14 in a second stage, and advance the knife 440 in a third stage. In certain instances, one or more of these stages may occur consecutively. In at least one instance, one or more of these stages may not overlap with each other. In various instances, one or more of these stages may occur simultaneously. In at least one instance, one or more of these stages may at least partially overlap with one or more other stages. In some instances, it may be desired for the staple forming stage to at least partially occur before the cutting stage. In other instances, it may be desired for the staple forming stage to be completed before the cutting stage begins. Such an embodiment may be desired in order to prevent the tissue T from being cut prior to being stapled. As described in greater detail below, certain embodiments can include two or more drive systems to perform the various operating stages of an end effector.
A rotatable shaft 564 extends longitudinally through the lower jaw member 508b. The rotatable shaft 564 is coupled to a proximal slide 522a and a distal slide 522b of the closure mechanism 520. The proximal slide 522a and the distal slide 522b can each comprise a cam 530. Each cam 530 can comprise an angle configured to interface with one or more beveled surfaces formed on the first jaw 8a. The rotatable shaft 564 comprises a drive end 566 which can be attached to a rotatable drive input, such as rotatable drive input 568, for example. Similar to the above, the rotatable drive input 568 can rotate the shaft 564 which can, in turn, move the proximal slide 522a and the distal slide 522b longitudinally towards a center point of the end effector 506. The movement of the proximal slide 522a and the distal slide 522b longitudinally towards the center point of the shaftless end effector 506 brings the cams 530 into contact with the first jaw 8a in order to drive the anvil 510 into contact with the staple cartridge 512. The anvil 510 can compress the staple cartridge 512 and deploy the staples 14 through the target tissue “T”, as illustrated in
Further to the above, the end effector 506 can include a second drive system configured to incise the tissue T and/or the staple cartridge 512. Referring primarily to
As the reader can appreciate, the first drive system of the end effector 506 can be configured to close the anvil 510 and fire the staples 14 while the second drive system of the end effector 506 can be configured to incise the tissue T captured within the end effector 506. The first drive system and the second drive system can be operated independently of one another. For instance, the first drive system can be operated by a clinician wherein the clinician can decide whether to operate and/or when to operate the second drive system.
Referring primarily to
As discussed above, the collar 690 can comprise a connection portion. In various instances, the collar 690 can comprise one or more drive slots 691 defined therein which can be configured to receive at least a portion of the rotatable outer drive 686 of the firing mechanism 680. In certain instances, the rotatable outer drive 686 can include one or more drive tabs 687 which can be positioned within the drive slots 691. In at least one instance, the collar 690 can include a first drive slot 691 located on a first side of the collar 690 and a second drive slot 691 located on a second, or opposite, side of the collar 690 and, correspondingly, the rotatable outer drive 686 can include a first drive tab 687 positionable within the first drive slot 691 a second drive tab 687 positionable within the second drive slot 691. In use, the drive tabs 687 can transmit rotational motion from the rotatable outer drive 686 to the rotatable collar 690. In various instances, the drive tabs 687 can be closely received within the drive slots 691 such that the drive tabs 687 can engage the sidewalls of the drive slots 691 that they are positioned within. In use, the outer drive 686 can be rotated in a first direction in order to rotate the collar 690 in a first direction and close the end effector 606. As outlined above, the outer drive 686 can be utilized to close the end effector 606, compress the cartridge 612, and deform the staples 14. At any suitable point during the use of the end effector 606, the outer drive 686 can be rotated in a second, or opposite, direction in order to rotate the collar in a second, or opposite, direction and open the end effector 606.
As discussed above, the cutting member 640 can include a connection member 643. In various instances, the connection member 643 can include a connection slot 644 defined therein which can be configured to receive at least a portion of the translatable inner drive 688 of the firing mechanism 680. In certain embodiments, the inner drive 688 can include a drive end 684 which can be releasably retained in the connection slot 644. As illustrated in
In use, the rotatable collar 690 may or may not be able to pivot the jaws 608a and 608b into their completely closed positions. Such instances can typically arise when the tissue captured between the jaws 608a and 608b is thick. In various embodiments, the cutting member 640 can include one or more gap-setting flanges, such as flanges 641a and 641b, for example, which can facilitate the closure of the jaws 608a and 608b. More particularly, the cutting member 640 can include a first gap-setting flange 641a which can be configured to engage the first jaw 608a as the cutting member 640 is advanced distally. In various instances, the first flange 641a, the second flange 641b, and the cutting portion 672 can comprise an I-shaped or I-beam configuration, for example. Referring primarily to
The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device can be disassembled, and any number of the particular pieces or parts of the device can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the device can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
Preferably, the invention described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.
Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. 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.
While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this invention pertains.
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0276104 | Jul 1988 | EP |
0379721 | Aug 1990 | EP |
0178940 | Jan 1991 | EP |
0178941 | Jan 1991 | EP |
0169044 | Jun 1991 | EP |
0248844 | Jan 1993 | EP |
0539762 | May 1993 | EP |
0545029 | Jun 1993 | EP |
0548998 | Jun 1993 | EP |
0277959 | Oct 1993 | EP |
0591946 | Oct 1993 | EP |
0233940 | Nov 1993 | EP |
0261230 | Nov 1993 | EP |
0639349 | Feb 1994 | EP |
0324636 | Mar 1994 | EP |
0593920 | Apr 1994 | EP |
0594148 | Apr 1994 | EP |
0427949 | Jun 1994 | EP |
0523174 | Jun 1994 | EP |
0600182 | Jun 1994 | EP |
0310431 | Nov 1994 | EP |
0375302 | Nov 1994 | EP |
0376562 | Nov 1994 | EP |
0623311 | Nov 1994 | EP |
0630612 | Dec 1994 | EP |
0630614 | Dec 1994 | EP |
0634144 | Jan 1995 | EP |
0646356 | Apr 1995 | EP |
0646357 | Apr 1995 | EP |
0505036 | May 1995 | EP |
0653189 | May 1995 | EP |
0669104 | Aug 1995 | EP |
0387980 | Oct 1995 | EP |
0511470 | Oct 1995 | EP |
0674876 | Oct 1995 | EP |
0679367 | Nov 1995 | EP |
0392547 | Dec 1995 | EP |
0685204 | Dec 1995 | EP |
0364216 | Jan 1996 | EP |
0699418 | Mar 1996 | EP |
0702937 | Mar 1996 | EP |
0488768 | Apr 1996 | EP |
0705571 | Apr 1996 | EP |
0528478 | May 1996 | EP |
0711611 | May 1996 | EP |
0484677 | Jun 1996 | EP |
0541987 | Jul 1996 | EP |
0667119 | Jul 1996 | EP |
0737446 | Oct 1996 | EP |
0748614 | Dec 1996 | EP |
0708618 | Mar 1997 | EP |
0770355 | May 1997 | EP |
0503662 | Jun 1997 | EP |
0447121 | Jul 1997 | EP |
0621009 | Jul 1997 | EP |
0625077 | Jul 1997 | EP |
0633749 | Aug 1997 | EP |
0710090 | Aug 1997 | EP |
0578425 | Sep 1997 | EP |
0623312 | Sep 1997 | EP |
0621006 | Oct 1997 | EP |
0625335 | Nov 1997 | EP |
0552423 | Jan 1998 | EP |
0592244 | Jan 1998 | EP |
0648476 | Jan 1998 | EP |
0649290 | Mar 1998 | EP |
0598618 | Sep 1998 | EP |
0676173 | Sep 1998 | EP |
0678007 | Sep 1998 | EP |
0869104 | Oct 1998 | EP |
0603472 | Nov 1998 | EP |
0605351 | Nov 1998 | EP |
0878169 | Nov 1998 | EP |
0879742 | Nov 1998 | EP |
0695144 | Dec 1998 | EP |
0722296 | Dec 1998 | EP |
0760230 | Feb 1999 | EP |
0623316 | Mar 1999 | EP |
0650701 | Mar 1999 | EP |
0537572 | Jun 1999 | EP |
0923907 | Jun 1999 | EP |
0640317 | Sep 1999 | EP |
0843906 | Mar 2000 | EP |
0552050 | May 2000 | EP |
0833592 | May 2000 | EP |
0832605 | Jun 2000 | EP |
0830094 | Sep 2000 | EP |
1034747 | Sep 2000 | EP |
1034748 | Sep 2000 | EP |
0694290 | Nov 2000 | EP |
1050278 | Nov 2000 | EP |
1053719 | Nov 2000 | EP |
1053720 | Nov 2000 | EP |
1055399 | Nov 2000 | EP |
1055400 | Nov 2000 | EP |
1058177 | Dec 2000 | EP |
1080694 | Mar 2001 | EP |
1090592 | Apr 2001 | EP |
1095627 | May 2001 | EP |
0806914 | Sep 2001 | EP |
0768840 | Dec 2001 | EP |
0908152 | Jan 2002 | EP |
0717959 | Feb 2002 | EP |
0872213 | May 2002 | EP |
0862386 | Jun 2002 | EP |
0949886 | Sep 2002 | EP |
1238634 | Sep 2002 | EP |
0858295 | Dec 2002 | EP |
0656188 | Jan 2003 | EP |
0717960 | Feb 2003 | EP |
1284120 | Feb 2003 | EP |
1287788 | Mar 2003 | EP |
0717966 | Apr 2003 | EP |
2003-148903 | May 2003 | EP |
0869742 | May 2003 | EP |
2003-164066 | Jun 2003 | EP |
0829235 | Jun 2003 | EP |
0887046 | Jul 2003 | EP |
1323384 | Jul 2003 | EP |
0852480 | Aug 2003 | EP |
0891154 | Sep 2003 | EP |
0813843 | Oct 2003 | EP |
0873089 | Oct 2003 | EP |
0856326 | Nov 2003 | EP |
1374788 | Jan 2004 | EP |
0741996 | Feb 2004 | EP |
0814712 | Feb 2004 | EP |
1402837 | Mar 2004 | EP |
0705570 | Apr 2004 | EP |
0959784 | Apr 2004 | EP |
1407719 | Apr 2004 | EP |
1411626 | Apr 2004 | EP |
1086713 | May 2004 | EP |
0996378 | Jun 2004 | EP |
1426012 | Jun 2004 | EP |
0833593 | Jul 2004 | EP |
1442694 | Aug 2004 | EP |
0888749 | Sep 2004 | EP |
0959786 | Sep 2004 | EP |
1453432 | Sep 2004 | EP |
1459695 | Sep 2004 | EP |
1254636 | Oct 2004 | EP |
1473819 | Nov 2004 | EP |
1477119 | Nov 2004 | EP |
1479345 | Nov 2004 | EP |
1479347 | Nov 2004 | EP |
1479348 | Nov 2004 | EP |
0754437 | Dec 2004 | EP |
1025807 | Dec 2004 | EP |
1001710 | Jan 2005 | EP |
1496805 | Jan 2005 | EP |
1256318 | Feb 2005 | EP |
1520521 | Apr 2005 | EP |
1520522 | Apr 2005 | EP |
1520523 | Apr 2005 | EP |
1520525 | Apr 2005 | EP |
1522264 | Apr 2005 | EP |
1523942 | Apr 2005 | EP |
1550408 | Jul 2005 | EP |
1557129 | Jul 2005 | EP |
1064883 | Aug 2005 | EP |
1067876 | Aug 2005 | EP |
0870473 | Sep 2005 | EP |
1157666 | Sep 2005 | EP |
0880338 | Oct 2005 | EP |
1158917 | Nov 2005 | EP |
1344498 | Nov 2005 | EP |
0906764 | Dec 2005 | EP |
1330989 | Dec 2005 | EP |
0771176 | Jan 2006 | EP |
1621138 | Feb 2006 | EP |
1621139 | Feb 2006 | EP |
1621141 | Feb 2006 | EP |
1621143 | Feb 2006 | EP |
1621145 | Feb 2006 | EP |
1621151 | Feb 2006 | EP |
1034746 | Mar 2006 | EP |
1201196 | Mar 2006 | EP |
1632191 | Mar 2006 | EP |
1647231 | Apr 2006 | EP |
1065981 | May 2006 | EP |
1082944 | May 2006 | EP |
1230899 | May 2006 | EP |
1652481 | May 2006 | EP |
1382303 | Jun 2006 | EP |
1253866 | Jul 2006 | EP |
1676539 | Jul 2006 | EP |
1032318 | Aug 2006 | EP |
1045672 | Aug 2006 | EP |
1617768 | Aug 2006 | EP |
1693015 | Aug 2006 | EP |
1400214 | Sep 2006 | EP |
1702567 | Sep 2006 | EP |
1129665 | Nov 2006 | EP |
1400206 | Nov 2006 | EP |
1721568 | Nov 2006 | EP |
1256317 | Dec 2006 | EP |
1285633 | Dec 2006 | EP |
1728473 | Dec 2006 | EP |
1728475 | Dec 2006 | EP |
1736105 | Dec 2006 | EP |
1011494 | Jan 2007 | EP |
1479346 | Jan 2007 | EP |
1484024 | Jan 2007 | EP |
1749485 | Feb 2007 | EP |
1754445 | Feb 2007 | EP |
1759812 | Mar 2007 | EP |
1767157 | Mar 2007 | EP |
1767163 | Mar 2007 | EP |
1563792 | Apr 2007 | EP |
1769756 | Apr 2007 | EP |
1769758 | Apr 2007 | EP |
1581128 | May 2007 | EP |
1780825 | May 2007 | EP |
1785097 | May 2007 | EP |
1790293 | May 2007 | EP |
1790294 | May 2007 | EP |
1563793 | Jun 2007 | EP |
1791473 | Jun 2007 | EP |
1800610 | Jun 2007 | EP |
1300117 | Aug 2007 | EP |
1813199 | Aug 2007 | EP |
1813200 | Aug 2007 | EP |
1813201 | Aug 2007 | EP |
1813202 | Aug 2007 | EP |
1813203 | Aug 2007 | EP |
1813207 | Aug 2007 | EP |
1813209 | Aug 2007 | EP |
1815950 | Aug 2007 | EP |
1330991 | Sep 2007 | EP |
1806103 | Sep 2007 | EP |
1837041 | Sep 2007 | EP |
0922435 | Oct 2007 | EP |
1487359 | Oct 2007 | EP |
1599146 | Oct 2007 | EP |
1839596 | Oct 2007 | EP |
2110083 | Oct 2007 | EP |
1679096 | Nov 2007 | EP |
1857057 | Nov 2007 | EP |
1402821 | Dec 2007 | EP |
1872727 | Jan 2008 | EP |
1550410 | Feb 2008 | EP |
1671593 | Feb 2008 | EP |
1897502 | Mar 2008 | EP |
1611856 | Apr 2008 | EP |
1908417 | Apr 2008 | EP |
1917929 | May 2008 | EP |
1330201 | Jun 2008 | EP |
1702568 | Jul 2008 | EP |
1943955 | Jul 2008 | EP |
1943957 | Jul 2008 | EP |
1943959 | Jul 2008 | EP |
1943962 | Jul 2008 | EP |
1943964 | Jul 2008 | EP |
1943976 | Jul 2008 | EP |
1593337 | Aug 2008 | EP |
1970014 | Sep 2008 | EP |
1974678 | Oct 2008 | EP |
1980213 | Oct 2008 | EP |
1980214 | Oct 2008 | EP |
1759645 | Nov 2008 | EP |
1987780 | Nov 2008 | EP |
1990014 | Nov 2008 | EP |
1992296 | Nov 2008 | EP |
1552795 | Dec 2008 | EP |
1693008 | Dec 2008 | EP |
1759640 | Dec 2008 | EP |
1997439 | Dec 2008 | EP |
2000101 | Dec 2008 | EP |
2000102 | Dec 2008 | EP |
2005894 | Dec 2008 | EP |
2005897 | Dec 2008 | EP |
2005901 | Dec 2008 | EP |
2008595 | Dec 2008 | EP |
2025293 | Feb 2009 | EP |
1736104 | Mar 2009 | EP |
1749486 | Mar 2009 | EP |
1782743 | Mar 2009 | EP |
2039302 | Mar 2009 | EP |
2039308 | Mar 2009 | EP |
2039316 | Mar 2009 | EP |
1721576 | Apr 2009 | EP |
1733686 | Apr 2009 | EP |
2044890 | Apr 2009 | EP |
2055243 | May 2009 | EP |
1550409 | Jun 2009 | EP |
1550413 | Jun 2009 | EP |
1719461 | Jun 2009 | EP |
1834594 | Jun 2009 | EP |
1709911 | Jul 2009 | EP |
2077093 | Jul 2009 | EP |
1745748 | Aug 2009 | EP |
2090231 | Aug 2009 | EP |
2090237 | Aug 2009 | EP |
2090241 | Aug 2009 | EP |
2090244 | Aug 2009 | EP |
2090245 | Aug 2009 | EP |
2090254 | Aug 2009 | EP |
2090256 | Aug 2009 | EP |
2095777 | Sep 2009 | EP |
2098170 | Sep 2009 | EP |
2110082 | Oct 2009 | EP |
2110084 | Oct 2009 | EP |
2111803 | Oct 2009 | EP |
1762190 | Nov 2009 | EP |
1813208 | Nov 2009 | EP |
1908426 | Nov 2009 | EP |
2116195 | Nov 2009 | EP |
2116197 | Nov 2009 | EP |
1607050 | Dec 2009 | EP |
1815804 | Dec 2009 | EP |
1875870 | Dec 2009 | EP |
1878395 | Jan 2010 | EP |
2151204 | Feb 2010 | EP |
1813211 | Mar 2010 | EP |
2165656 | Mar 2010 | EP |
2165660 | Mar 2010 | EP |
2165664 | Mar 2010 | EP |
1566150 | Apr 2010 | EP |
1813206 | Apr 2010 | EP |
2184014 | May 2010 | EP |
1769754 | Jun 2010 | EP |
1854416 | Jun 2010 | EP |
1911408 | Jun 2010 | EP |
2198787 | Jun 2010 | EP |
2214610 | Aug 2010 | EP |
2218409 | Aug 2010 | EP |
1647286 | Sep 2010 | EP |
1825821 | Sep 2010 | EP |
1535565 | Oct 2010 | EP |
1702570 | Oct 2010 | EP |
1785098 | Oct 2010 | EP |
2005896 | Oct 2010 | EP |
2030578 | Nov 2010 | EP |
2036505 | Nov 2010 | EP |
2245993 | Nov 2010 | EP |
2245994 | Nov 2010 | EP |
2253280 | Nov 2010 | EP |
1627605 | Dec 2010 | EP |
2027811 | Dec 2010 | EP |
2130498 | Dec 2010 | EP |
2258282 | Dec 2010 | EP |
2263568 | Dec 2010 | EP |
1994890 | Jan 2011 | EP |
2005900 | Jan 2011 | EP |
2277667 | Jan 2011 | EP |
2283780 | Feb 2011 | EP |
2286738 | Feb 2011 | EP |
1494595 | Mar 2011 | EP |
1690502 | Mar 2011 | EP |
1884201 | Mar 2011 | EP |
2292153 | Mar 2011 | EP |
1769755 | Apr 2011 | EP |
2090240 | Apr 2011 | EP |
2303388 | Apr 2011 | EP |
2305135 | Apr 2011 | EP |
2314254 | Apr 2011 | EP |
2316345 | May 2011 | EP |
2316366 | May 2011 | EP |
2319443 | May 2011 | EP |
2324776 | May 2011 | EP |
1813205 | Jun 2011 | EP |
2042107 | Jun 2011 | EP |
2090243 | Jun 2011 | EP |
2329773 | Jun 2011 | EP |
2090239 | Jul 2011 | EP |
2340771 | Jul 2011 | EP |
2353545 | Aug 2011 | EP |
2361562 | Aug 2011 | EP |
2377472 | Oct 2011 | EP |
1836986 | Nov 2011 | EP |
1908414 | Nov 2011 | EP |
2153781 | Nov 2011 | EP |
2389928 | Nov 2011 | EP |
1847225 | Dec 2011 | EP |
2397079 | Dec 2011 | EP |
2399538 | Dec 2011 | EP |
1785102 | Jan 2012 | EP |
1316290 | Feb 2012 | EP |
2415416 | Feb 2012 | EP |
2090253 | Mar 2012 | EP |
2430986 | Mar 2012 | EP |
1347638 | May 2012 | EP |
1943956 | May 2012 | EP |
2446834 | May 2012 | EP |
2455007 | May 2012 | EP |
2457519 | May 2012 | EP |
2462878 | Jun 2012 | EP |
2462880 | Jun 2012 | EP |
1813204 | Jul 2012 | EP |
2189121 | Jul 2012 | EP |
2248475 | Jul 2012 | EP |
2005895 | Aug 2012 | EP |
2090248 | Aug 2012 | EP |
2481359 | Aug 2012 | EP |
2486860 | Aug 2012 | EP |
2486862 | Aug 2012 | EP |
1908412 | Sep 2012 | EP |
1935351 | Sep 2012 | EP |
2497431 | Sep 2012 | EP |
1550412 | Oct 2012 | EP |
1616549 | Oct 2012 | EP |
2030579 | Oct 2012 | EP |
2090252 | Oct 2012 | EP |
2517637 | Oct 2012 | EP |
2517638 | Oct 2012 | EP |
2517642 | Oct 2012 | EP |
2517645 | Oct 2012 | EP |
2517649 | Oct 2012 | EP |
2517651 | Oct 2012 | EP |
2526877 | Nov 2012 | EP |
2526883 | Nov 2012 | EP |
1884206 | Mar 2013 | EP |
2090238 | Apr 2013 | EP |
2586380 | May 2013 | EP |
2586383 | May 2013 | EP |
2606812 | Jun 2013 | EP |
2606834 | Jun 2013 | EP |
1982657 | Jul 2013 | EP |
2614782 | Jul 2013 | EP |
2090234 | Sep 2013 | EP |
2633830 | Sep 2013 | EP |
2644124 | Oct 2013 | EP |
2644209 | Oct 2013 | EP |
2649948 | Oct 2013 | EP |
2649949 | Oct 2013 | EP |
1997438 | Nov 2013 | EP |
2684529 | Jan 2014 | EP |
2700367 | Feb 2014 | EP |
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1772105 | May 2014 | EP |
2759267 | Jul 2014 | EP |
2764826 | Aug 2014 | EP |
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2777520 | Sep 2014 | EP |
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2786714 | Oct 2014 | EP |
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2446835 | Jan 2015 | EP |
2845545 | Mar 2015 | EP |
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2090255 | Apr 2015 | EP |
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1774914 | Dec 2015 | EP |
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2823773 | Apr 2016 | EP |
2131750 | May 2016 | EP |
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