A variety of surgical instruments include a tissue cutting element and one or more elements that transmit radio frequency (RF) energy to tissue (e.g., to coagulate or seal the tissue). An example of such an electrosurgical instrument is the ENSEAL® Tissue Sealing Device by Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio. Further examples of such devices and related concepts are disclosed in U.S. Pat. No. 6,500,176 entitled “Electrosurgical Systems and Techniques for Sealing Tissue,” issued Dec. 31, 2002, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,112,201 entitled “Electrosurgical Instrument and Method of Use,” issued Sep. 26, 2006, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,125,409, entitled “Electrosurgical Working End for Controlled Energy Delivery,” issued Oct. 24, 2006, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,169,146 entitled “Electrosurgical Probe and Method of Use,” issued Jan. 30, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,186,253, entitled “Electrosurgical Jaw Structure for Controlled Energy Delivery,” issued Mar. 6, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,189,233, entitled “Electrosurgical Instrument,” issued Mar. 13, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,220,951, entitled “Surgical Sealing Surfaces and Methods of Use,” issued May 22, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,309,849, entitled “Polymer Compositions Exhibiting a PTC Property and Methods of Fabrication,” issued Dec. 18, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,311,709, entitled “Electrosurgical Instrument and Method of Use,” issued Dec. 25, 2007, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,354,440, entitled “Electrosurgical Instrument and Method of Use,” issued Apr. 8, 2008, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 7,381,209, entitled “Electrosurgical Instrument,” issued Jun. 3, 2008, the disclosure of which is incorporated by reference herein.
Additional examples of electrosurgical cutting instruments and related concepts are disclosed in U.S. Pub. No. 2011/0087218, entitled “Surgical Instrument Comprising First and Second Drive Systems Actuatable by a Common Trigger Mechanism,” published Apr. 14, 2011, now U.S. Pat. No. 8,939,974, issued Jan. 27, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2012/0083783, entitled “Surgical Instrument with Jaw Member,” published Apr. 5, 2012, now U.S. Pat. No. 8,888,809, issued Nov. 18, 2014, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2012/0116379, entitled “Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback,” published May 10, 2012, now U.S. Pat. No. 9,161,803, issued Oct. 20, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2012/0078243, entitled “Control Features for Articulating Surgical Device,” published Mar. 29, 2012, now U.S. Pat. No. 9,877,720, issued Jan. 30, 2018, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2012/0078247, entitled “Articulation Joint Features for Articulating Surgical Device,” published Mar. 29, 2012, now U.S. Pat. No. 9,402,682, issued Aug. 2, 2016, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2013/0030428, entitled “Surgical Instrument with Multi-Phase Trigger Bias,” published Jan. 31, 2013, now U.S. Pat. No. 9,089,327, issued Jul. 28, 2015, the disclosure of which is incorporated by reference herein; and U.S. Pub. No. 2013/0023868, entitled “Surgical Instrument with Contained Dual Helix Actuator Assembly,” published Jan. 31, 2013, now U.S. Pat. No. 9,545,253, issued Jan. 17, 2017, the disclosure of which is incorporated by reference herein.
While a variety of surgical instruments have been made and used, it is believed that no one prior to the inventors has made or used the invention described in the appended claims.
While the specification concludes with claims which particularly point out and distinctly claim this technology, it is believed this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present technology, and together with the description serve to explain the principles of the technology; it being understood, however, that this technology is not limited to the precise arrangements shown.
The following description of certain examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the technology. As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
It is further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The following-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
For clarity of disclosure, the terms “proximal” and “distal” are defined herein relative to a surgeon or other operator grasping a surgical instrument having a distal surgical end effector. The term “proximal” refers the position of an element closer to the surgeon or other operator and the term “distal” refers to the position of an element closer to the surgical end effector of the surgical instrument and further away from the surgeon or other operator.
A. Exemplary Handpiece and Shaft
Electrosurgical instrument (10) of the present example includes a handpiece (20), a shaft (30) extending distally from handpiece (20), and an end effector (40) disposed at a distal end of shaft (30). Handpiece (20) of the present example includes a pistol grip (22), a pivoting trigger (24), an activation button (26), and an articulation control (28). Trigger (24) is pivotable toward and away from pistol grip (22) to selectively actuate end effector (40) as will be described in greater detail below. Activation button (26) is operable to selectively activate RF circuitry that is in communication with end effector (40), as will also be described in greater detail below. In some versions, activation button (26) also serves as a mechanical lockout against trigger (24), such that trigger (24) cannot be fully actuated unless button (26) is being pressed simultaneously. Examples of how such a lockout may be provided are disclosed in one or more of the references cited herein. In addition or in the alternative, trigger (24) may serve as an electrical and/or mechanical lockout against button (26), such that button (26) cannot be effectively activated unless trigger (24) is being squeezed simultaneously. It should be understood that pistol grip (22), trigger (24), and button (26) may be modified, substituted, supplemented, etc. in any suitable way, and that the descriptions of such components herein are merely illustrative.
Shaft (30) of the present example includes a rigid outer sheath (32) and an articulation section (36). Articulation section (36) is operable to selectively laterally deflect end effector (40) at various angles relative to the longitudinal axis defined by sheath (32). In some versions, articulation section (36) and/or some other portion of outer sheath (32) includes a flexible outer sheath (e.g., a heat shrink tube, etc.) disposed about its exterior. Articulation section (36) of shaft (30) may take a variety of forms. By way of example only, articulation section (36) may be configured in accordance with one or more teachings of U.S. Pub. No. 2012/0078247, now U.S. Pat. No. 9,402,682, the disclosure of which is incorporated by reference herein. As another merely illustrative example, articulation section (36) may be configured in accordance with one or more teachings of U.S. Pub. No. 2012/0078248, entitled “Articulation Joint Features for Articulating Surgical Device,” published Mar. 29, 2012, now U.S. Pat. No. 9,220,559, issued Dec. 29, 2015, the disclosure of which is incorporated by reference herein. Various other suitable forms that articulation section (36) may take will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that some versions of instrument (10) may simply lack articulation section (36).
In some versions, shaft (30) is also rotatable about the longitudinal axis defined by sheath (32), relative to handpiece (20), via a knob (34). Such rotation may provide rotation of end effector (40) and shaft (30) unitarily. In some other versions, knob (34) is operable to rotate end effector (40) without rotating articulation section (36) or any portion of shaft (30) that is proximal of articulation section (36). As another merely illustrative example, electrosurgical instrument (10) may include one rotation control that provides rotatability of shaft (30) and end effector (40) as a single unit; and another rotation control that provides rotatability of end effector (40) without rotating articulation section (36) or any portion of shaft (30) that is proximal of articulation section (36). Other suitable rotation schemes will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, rotatable features may simply be omitted if desired.
Articulation control (28) of the present example is operable to selectively control articulation section (36) of shaft (30), to thereby selectively laterally deflect end effector (40) at various angles relative to the longitudinal axis defined by shaft (30). While articulation control (28) is in the form of a rotary dial in the present example, it should be understood that articulation control (28) may take numerous other forms. By way of example only, some merely illustrative forms that articulation control (28) and other components of handpiece (20) may take are disclosed in U.S. Pub. No. 2012/0078243, now U.S. Pat. No. 9,877,720, issued Jan. 30, 2018, the disclosure of which is incorporated by reference herein; in U.S. Pub. No. 2012/0078244, entitled “Control Features for Articulating Surgical Device,” published Mar. 29, 2012, the disclosure of which is incorporated by reference herein; and in U.S. Pub. No. 2013/0023868, now U.S. Pat. No. 9,545,253, the disclosure of which is incorporated by reference herein. Still other suitable forms that articulation control (28) may take will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that some versions of instrument (10) may simply lack an articulation control (28).
B. Exemplary End Effector
End effector (40) of the present example comprises a first jaw (42) and a second jaw (44). In the present example, first jaw (42) is substantially fixed relative to shaft (30); while second jaw (44) pivots relative to shaft (30), toward and away from first jaw (42). Use of the term “pivot” should not be read as necessarily requiring pivotal movement about a fixed axis. In some versions, second jaw (44) pivots about an axis that is defined by a pin (or similar feature) that slides along an elongate slot or channel as second jaw (44) moves toward first jaw (42). In such versions, the pivot axis translates along the path defined by the slot or channel while second jaw (44) simultaneously pivots about that axis. It should be understood that such sliding/translating pivotal movement is encompassed within terms such as “pivot,” “pivots,” “pivotal,” “pivotable,” “pivoting,” and the like. Of course, some versions may provide pivotal movement of second jaw (44) about an axis that remains fixed and does not translate within a slot or channel, etc.
In some versions, actuators such as rods or cables, etc., may extend through sheath (32) and be joined with second jaw (44) at a pivotal coupling (43), such that longitudinal movement of the actuator rods/cables/etc. through shaft (30) provides pivoting of second jaw (44) relative to shaft (30) and relative to first jaw (42). Of course, jaws (42, 44) may instead have any other suitable kind of movement and may be actuated in any other suitable fashion. By way of example only, and as will be described in greater detail below, jaws (42, 44) may be actuated and thus closed by longitudinal translation of a firing beam (60), such that actuator rods/cables/etc. may simply be eliminated in some versions.
As best seen in
By way of example only, power source (80) and/or controller (82) may be configured in accordance with at least some of the teachings of U.S. Provisional Pat. App. No. 61/550,768, entitled “Medical Instrument,” filed Oct. 24, 2011, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0082486, entitled “Devices and Techniques for Cutting and Coagulating Tissue,” published Apr. 7, 2011, now U.S. Pat. No. 9,089,360, issued Jul. 28, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0087212, entitled “Surgical Generator for Ultrasonic and Electrosurgical Devices,” published Apr. 14, 2011 now U.S. Pat. No. 8,986,302, issued Mar. 24, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0087213, entitled “Surgical Generator for Ultrasonic and Electrosurgical Devices,” published Apr. 14, 2011, now U.S. Pat. No. 8,951,248, issued Feb. 10, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0087214, entitled “Surgical Generator for Ultrasonic and Electrosurgical Devices,” published Apr. 14, 2011, now U.S. Pat. No. 9,039,695, issued May 26, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0087215, entitled “Surgical Generator for Ultrasonic and Electrosurgical Devices,” published Apr. 14, 2011, now U.S. Pat. No. 9,050,093, issued Jun. 9, 2015, the disclosure of which is incorporated by reference herein; U.S. Pub. No. 2011/0087216, entitled “Surgical Generator for Ultrasonic and Electrosurgical Devices,” published Apr. 14, 2011, now U.S. Pat. No. 8,956,349, issued Feb. 17, 2015, the disclosure of which is incorporated by reference herein; and/or U.S. Pub. No. 2011/0087217, entitled “Surgical Generator for Ultrasonic and Electrosurgical Devices,” published Apr. 14, 2011, now U.S. Pat. No. 9,060,776, issued Jun. 23, 2015, the disclosure of which is incorporated by reference herein. Other suitable configurations for power source (80) and controller (82) will be apparent to those of ordinary skill in the art in view of the teachings herein.
As best seen in
With jaws (42, 44) in a closed position, shaft (30) and end effector (40) are sized and configured to fit through trocars having various inner diameters, such that electrosurgical instrument (10) is usable in minimally invasive surgery, though of course electrosurgical instrument (10) could also be used in open procedures if desired. By way of example only, with jaws (42, 44) in a closed position, shaft (30) and end effector (40) may present an outer diameter of approximately 5 mm. Alternatively, shaft (30) and end effector (40) may present any other suitable outer diameter (e.g., between approximately 2 mm and approximately 20 mm, etc.).
As another merely illustrative variation, either jaw (42, 44) or both of jaws (42, 44) may include at least one port, passageway, conduit, and/or other feature that is operable to draw steam, smoke, and/or other gases/vapors/etc. from the surgical site. Such a feature may be in communication with a source of suction, such as an external source or a source within handpiece (20), etc. In addition, end effector (40) may include one or more tissue cooling features (not shown) that reduce the degree or extent of thermal spread caused by end effector (40) on adjacent tissue when electrode surfaces (50, 52) are activated. Various suitable forms that such cooling features may take will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some versions, end effector (40) includes one or more sensors (not shown) that are configured to sense a variety of parameters at end effector (40), including but not limited to temperature of adjacent tissue, electrical resistance or impedance of adjacent tissue, voltage across adjacent tissue, forces exerted on jaws (42, 44) by adjacent tissue, etc. By way of example only, end effector (40) may include one or more positive temperature coefficient (PTC) thermistor bodies (54, 56) (e.g., PTC polymer, etc.), located adjacent to electrodes (50, 52) and/or elsewhere. Data from sensors may be communicated to controller (82). Controller (82) may process such data in a variety of ways. By way of example only, controller (82) may modulate or otherwise change the RF energy being delivered to electrode surfaces (50, 52), based at least in part on data acquired from one or more sensors at end effector (40). In addition or in the alternative, controller (82) may alert the user to one or more conditions via an audio and/or visual feedback device (e.g., speaker, lights, display screen, etc.), based at least in part on data acquired from one or more sensors at end effector (40). It should also be understood that some kinds of sensors need not necessarily be in communication with controller (82), and may simply provide a purely localized effect at end effector (40). For instance, a PTC thermistor bodies (54, 56) at end effector (40) may automatically reduce the energy delivery at electrode surfaces (50, 52) as the temperature of the tissue and/or end effector (40) increases, thereby reducing the likelihood of overheating. In some such versions, a PTC thermistor element is in series with power source (80) and electrode surface (50, 52); and the PTC thermistor provides an increased impedance (reducing flow of current) in response to temperatures exceeding a threshold. Furthermore, it should be understood that electrode surfaces (50, 52) may be used as sensors (e.g., to sense tissue impedance, etc.). Various kinds of sensors that may be incorporated into electrosurgical instrument (10) will be apparent to those of ordinary skill in the art in view of the teachings herein. Similarly various things that can be done with data from sensors, by controller (82) or otherwise, will be apparent to those of ordinary skill in the art in view of the teachings herein. Other suitable variations for end effector (40) will also be apparent to those of ordinary skill in the art in view of the teachings herein.
C. Exemplary Firing Beam
As also seen in
Distal blade (64) is substantially sharp, such that distal blade (64) will readily sever tissue that is captured between jaws (42, 44). Distal blade (64) is also electrically grounded in the present example, providing a return path for RF energy as described elsewhere herein. In some other versions, distal blade (64) serves as an active electrode. In addition or in the alternative, distal blade (64) may be selectively energized with ultrasonic energy (e.g., harmonic vibrations at approximately 55.5 kHz, etc.).
The “I-beam” type of configuration of firing beam (60) provides closure of jaws (42, 44) as firing beam (60) is advanced distally. In particular, flange (62) urges jaw (44) pivotally toward jaw (42) as firing beam (60) is advanced from a proximal position (
In the present example, flange (62) is configured to cam against a ramp feature at the proximal end of jaw (44) to open jaw (44) when firing beam (60) is retracted to a proximal position and to hold jaw (44) open when firing beam (60) remains at the proximal position. This camming capability may facilitate use of end effector (40) to separate layers of tissue, to perform blunt dissections, etc., by forcing jaws (42, 44) apart from a closed position. In some other versions, jaws (42, 44) are resiliently biased to an open position by a spring or other type of resilient feature. While jaws (42, 44) close or open as firing beam (60) is translated in the present example, it should be understood that other versions may provide independent movement of jaws (42, 44) and firing beam (60). By way of example only, one or more cables, rods, beams, or other features may extend through shaft (30) to selectively actuate jaws (42, 44) independently of firing beam (60). Such jaw (42, 44) actuation features may be separately controlled by a dedicated feature of handpiece (20). Alternatively, such jaw actuation features may be controlled by trigger (24) in addition to having trigger (24) control firing beam (60). It should also be understood that firing beam (60) may be resiliently biased to a proximal position, such that firing beam (60) retracts proximally when a user relaxes their grip on trigger (24).
D. Exemplary Operation
In an exemplary use, end effector (40) is inserted into a patient via a trocar. Articulation section (36) is substantially straight when end effector (40) and part of shaft (30) are inserted through the trocar. Articulation control (28) may then be manipulated to pivot or flex articulation section (36) of shaft (30) in order to position end effector (40) at a desired position and orientation relative to an anatomical structure within the patient. Two layers of tissue of the anatomical structure are then captured between jaws (42, 44) by squeezing trigger (24) toward pistol grip (22). Such layers of tissue may be part of the same natural lumen defining anatomical structure (e.g., blood vessel, portion of gastrointestinal tract, portion of reproductive system, etc.) in a patient. For instance, one tissue layer may comprise the top portion of a blood vessel while the other tissue layer may comprise the bottom portion of the blood vessel, along the same region of length of the blood vessel (e.g., such that the fluid path through the blood vessel before use of electrosurgical instrument (10) is perpendicular to the longitudinal axis defined by end effector (40), etc.). In other words, the lengths of jaws (42, 44) may be oriented perpendicular to (or at least generally transverse to) the length of the blood vessel. As noted above, flanges (62, 66) cammingly act to pivot jaw (42) toward jaw (44) when firing beam (60) is actuated distally by squeezing trigger (24) toward pistol grip (22). Jaws (42, 44) may be substantially clamping tissue before trigger (24) has swept through a full range of motion toward pistol grip (22), such that trigger (24) may continue pivoting toward pistol grip (22) through a subsequent range of motion after jaws (42, 44) have substantially clamped on the tissue.
With tissue layers captured between jaws (42, 44) firing beam (60) continues to advance distally by the user squeezing trigger (24) further toward pistol grip (22). As firing beam (60) continues to advance distally, distal blade (64) simultaneously severs the clamped tissue layers, resulting in separated upper layer portions being apposed with respective separated lower layer portions. In some versions, this results in a blood vessel being cut in a direction that is generally transverse to the length of the blood vessel. It should be understood that the presence of flanges (62, 66) immediately above and below jaws (42, 44), respectively, may help keep jaws (42, 44) in a closed and tightly clamping position. In particular, flanges (62, 66) may help maintain a significantly compressive force between jaws (42, 44). With severed tissue layer portions being compressed between jaws (42, 44), electrode surfaces (50, 52) are activated with bipolar RF energy by the user depressing activation button (26). In some versions, electrodes (50, 52) are selectively coupled with power source (80) (e.g., by the user depressing button (26), etc.) such that electrode surfaces (50, 52) of jaws (42, 44) are activated with a common first polarity while firing beam (60) is activated at a second polarity that is opposite to the first polarity. Thus, a bipolar RF current flows between firing beam (60) and electrode surfaces (50, 52) of jaws (42, 44), through the compressed regions of severed tissue layer portions. In some other versions, electrode surface (50) has one polarity while electrode surface (52) and firing beam (60) both have the other polarity. In either version (among at least some others), bipolar RF energy delivered by power source (80) ultimately thermally welds the tissue layer portions on one side of firing beam (60) together and the tissue layer portions on the other side of firing beam (60) together.
In certain circumstances, the heat generated by activated electrode surfaces (50, 52) can denature the collagen within the tissue layer portions and, in cooperation with clamping pressure provided by jaws (42, 44), the denatured collagen can form a seal within the tissue layer portions. Thus, the severed ends of the natural lumen defining anatomical structure are hemostatically sealed shut, such that the severed ends will not leak bodily fluids. In some versions, electrode surfaces (50, 52) may be activated with bipolar RF energy before firing beam (60) even begins to translate distally and thus before the tissue is even severed. For instance, such timing may be provided in versions where button (26) serves as a mechanical lockout relative to trigger (24) in addition to serving as a switch between power source (80) and electrode surfaces (50, 52). Other suitable ways in which instrument (10) may be operable and operated will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some instances, it may be desirable to provide one or more sensors that are operable to sense the gap between first jaw (42) and second jaw (44), and/or to sense the angle of second jaw (44) relative to first jaw (42). Such a sensor may be used to ensure that tissue captured between jaws (42, 44) is sealed to a desired degree when using electrosurgical instrument (10) in the procedure described above. In particular, such sensors may provide a signal to controller (82) that may cause controller (82) to modify certain sealing algorithm parameters. For instance, if the jaw gap or angle is over a certain value—indicating a larger tissue bundle—such sensors may communicate such a condition to controller (82). Controller (82) may then increase the RF power output to electrode surfaces (50, 52) to increase the sealing power of jaws (42, 44). Similarly, if the jaw gap or angle is under a certain value—indicating a relatively small tissue bundle such sensors may communicate such a condition to controller (82) so that controller (82) may decrease the sealing RF power of jaws (42, 44) or completely stop the delivery of RF power to the jaws (42, 44).
Additionally, such sensors may include certain adjustment features that may be used to calibrate or adjust the sensors. Such adjustment features may be used in the manufacturing environment to calibrate or adjust the sensors to compensate for tolerance variation of various parts of electrosurgical instrument (10). In addition or in alternative, such adjustment features may be used in the field to adjust or calibrate the sensors in response to various conditions encountered by an operator during a surgical procedure. Of course, sensors may include any other features or variations of features described herein, as will be apparent to those of ordinary skill in the art in view of the teachings herein. It should be understood that the examples discussed below may be used with any of the electrosurgical instruments discussed above or disclosed herein.
While instrument (110) of this example does not rely on distal advancement of a firing beam like firing beams (60, 70) in order to close jaw (144) toward jaw (142), instrument (110) may nevertheless still include a reciprocating firing beam like firing beam (60) that is operable to cut through tissue that is captured between jaws (142, 144). Such a firing beam may be configured similar to firing beam (60), similar to firing beam (70), or in any other suitable fashion. By way of example only, features in handpiece (120) may provide proximal retraction of actuation rod (150) to close jaws (142, 144) as trigger (124) is pivoted through a first range of motion toward pistol grip (122); followed by distal advancement of a firing beam as trigger (124) is pivoted through a second range of motion toward pistol grip (122). Various suitable components and configurations that may be used to provide such multi-stage operability of trigger (124) will be apparent to those of ordinary skill in the art in view of the teachings herein. It should also be understood that handpiece (120) may include separate actuation features (e.g., separate triggers, etc.) to provide separate actuation of actuation rod (150) and the firing beam.
Jaw sensor (146) includes a moveable protrusion (147) and an electrical wire (148). Moveable protrusion (147) protrudes from jaw sensor (146) toward the longitudinal axis of shaft (130) and may be pushed by second jaw (144) away from the longitudinal axis of shaft (130) as will be described in greater detail below. In the present example, movable protrusion (147) is resiliently biased toward the longitudinal axis of shaft (130) such that it may return to the position shown in
As can best be seen in
In the present example, jaw sensor (146) is a binary switch. In other words, jaw sensor (146) is configured to have two states—open or closed. For instance, in some versions, jaw sensor (146) may be in the opened state when second jaw (144) is in the open position and movable protrusion (147) is fully protruding from jaw sensor (146). Correspondingly, jaw sensor (146) will be in the closed state when second jaw (144) is in the closed position and movable protrusion (147) is fully engaged by second jaw (144). Of course, in other configurations jaw sensor (146) may be configured oppositely with the open state corresponding to the jaw being in the closed position and the closed state corresponding to the jaw being in the open position. Those of ordinary skill in the art will immediately recognize the various kinds of form that jaw sensor (146) may take, including but not limited to a contact switch, a reed switch, a hall effect sensor, capacitive sensor, etc.
In an exemplary mode of operation, second jaw (144) may be closed by actuation rod (150). As second jaw (144) is closed by actuation rod (144), the proximal end of second jaw (144) may engage movable protrusion (147) of jaw sensor (146). Further closure of second jaw (144) by actuation rod (144) will cause jaw sensor (144) to switch states (e.g., from open to closed, or closed to open). It should be understood that when such a switch in state occurs, second jaw (144) will be closed to a certain degree corresponding to a desired closure gap between first jaw (142) and second jaw (144).
Controller (82) may be configured to respond to changes in state of jaw sensor (146) communicated to controller (82) by wire (148). In particular, when controller (82) receives a signal from jaw sensor (146) corresponding to the closed position of second jaw (144), controller (82) may be converted into a ready state where subsequent activation of button (126) provides RF energy to jaws (142, 144). Conversely, if button (126) is activated before jaw sensor (146) indicates a sufficiently closed position of jaw (144), controller (82) may be prevented from providing RF energy to jaws (142, 144). In addition or in the alternative, controller (82) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that jaw (144) is insufficiently closed if the operator activates button (126) before jaw sensor (146) indicates a sufficiently closed position of jaw (144). In addition to or as an alternative to the foregoing, jaw sensor (146) may be configured to detect closure of jaws (142, 144) in the absence of tissue between jaws (142, 144). In other words, sensor (146) and controller (82) may be operable to determine that jaws (142, 144) have been closed without tissue being positioned between jaws (142, 144). In such instances, controller (82) may prevent the delivery of RF energy to jaws (142, 144). In addition or in the alternative, controller (82) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that end effector (140) needs to be repositioned in order to position tissue between jaws (142, 144) before jaws (142, 144) may deliver RF energy.
Although jaw sensor (146) is described herein as being binary in nature, it should be understood that in other examples jaw sensor (146) may be non-binary having a plurality of outputs to communicate different amount of closure of second jaw (144). In such examples, controller (82) may be responsive to varying degrees of input from jaw sensor (146) indicating differing amounts of closure of second jaw (144) such that RF power may be altered depending on different amounts of closure of second jaw (144). For instance, if jaw sensor (146) indicates a relatively wide separation of jaw (144) from jaw (142) when button (126) is activated (e.g., indicating a relatively thick bundle of tissue), controller (82) may provide a relatively high level of RF energy to jaws (142, 144). If jaw sensor (146) indicates a relatively small separation of jaw (144) from jaw (142) when button (126) is activated (e.g., indicating a relatively thin bundle of tissue), controller (82) may provide a relatively low level of RF energy to jaws (142, 144). It should also be understood that controller may (82) provide a control algorithm that factors in feedback from jaw sensor (146) and feedback indicating an electrical resistance of tissue in jaws (142, 144). Various suitable ways in which the electrical resistance of tissue may be sensed will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, controller (82) may be responsive to jaw sensor (146) and/or other sources of feedback in any other suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some instances it may be desirable to place a jaw sensor similar to jaw sensor (146) described above in a handpiece of an electrosurgical instrument, instead of in an end effector. In such examples, positioning of the jaw sensor in the handpiece may provide additional space for placement of various components which that be used with the jaw sensor. For instance, additional space may be required for adjustment mechanisms, electronic circuitry, and/or drive mechanisms that are configured to amplify the movement of the end effector and more precisely detect the position of a jaw in end effector. By way of example only, the mechanisms described below may be operable to amplify motion of approximately 0.01 inches to approximately 0.05 inches or greater. It should be understood that the electrosurgical instruments described below are merely exemplary and various features of each electrosurgical instrument may be combined with other electrosurgical instruments described herein.
A. Exemplary Electrosurgical Instrument with Jaw Sensor Activated by Upwardly Pivoting Arm
Shaft (230) of the present example includes a rigid outer sheath (232) without an articulation section, though it should be understood that some variations may include an articulation section. Shaft (230) is rotatable about the longitudinal axis defined by sheath (232), relative to handpiece (220), via a knob (234). Such rotation may provide rotation of end effector (240) and shaft (230) unitarily.
End effector (240) is similar to end effector (40) described above. Like end effector (40), end effector (240) comprises a first jaw (242) and a second jaw (244). First jaw (242) is fixed relative to shaft (230) such that first jaw (242) remains stationary as end effector (240) actuates. Second jaw (244) is pivotable relative to first jaw (244) such that second jaw (244) transitions between an open and closed position as end effector (240) is actuated. Second jaw (244) may be pivoted in any suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein. Instrument (210) further includes a firing beam (not shown) that is operable to translate through end effector (240) to thereby sever tissue captured between jaws (242, 244). By way of example only, such a firing beam may be configured similar to firing beam (60), similar to firing beam (70), or in any other suitable fashion.
As can best be seen in
To drive firing shaft (262), which ultimately drives the firing beam, second pinion (256) meshes with a second rack (260). Second rack (260) includes a longitudinally extending channel (264), which has an inner geometry that corresponds to coupling features (266) overmolded to firing shaft (262). Thus, second rack (260) is coupled to firing shaft (262) such that translation of second rack (260) correspondingly translates firing shaft (262). Second rack (260) is resiliently biased to the proximal position shown in
Jaw actuation assembly (270) comprises rigid link (272) and an actuation block (274). As best seen in
In an exemplary mode of operation, jaw actuation assembly (270) and firing beam actuation assembly (250) begin in the positions shown in
The firing sequence is initiated when an operator squeezes jaw trigger (225), which pivots jaw trigger (225) relative to handpiece (220) toward pistol grip (222). As can be seen in
With end effector (240) in the closed position, it may next be desirable to advance the firing beam distally. To advance the firing beam distally, the operator may squeeze blade trigger (224) to pivot blade trigger (224) proximally relative to handpiece (220). Pivoting of blade trigger (224) drives first rack (252) proximally. As can be seen in
At any suitable stage during the above described process, the operator may press activation button (226). In certain circumstances, this may provide delivery of RF energy to tissue grasped between jaws (242, 244). By way of example only, the operator may press activation button (226) after jaws (242, 244) are clamping on the tissue but before the firing beam is advanced through the tissue. Controller (82) and/or other features of instrument (210) may be configured such that pressing of activation button (226) does not provide delivery of RF energy unless jaws (242, 244) are already sufficiently clamped on the tissue. Similarly, controller (82) and/or other features of instrument (210) may be configured such that the firing beam may not be advanced distally until the tissue captured by jaws (242, 244) has been sufficiently sealed by application of RF energy.
Jaw sensor (308) is similar to jaw sensor (146) described above. In particular, jaw sensor (308) comprises a sensor body (310) and a movable protrusion (312). Movable protrusion (312) is resiliently biased to protrude outwardly from sensor body (310), as shown in
Sensor body (310) is secured to adjustment assembly (316). In particular and as will be described in greater detail below, adjustment assembly (316) may permit vertical adjustment of sensor body (310) to thereby adjust the vertical positioning of movable protrusion (312), which may in turn adjust the effective sensitivity of sensor (308). Adjustment assembly (316) comprises an adjustment mechanism (318) a lock plate (320), and a lock gear (322). In some examples, adjustment mechanism (318) comprises a threaded cylinder similar to a lead screw or worm gear such that adjustment mechanism (318) may engage corresponding threading inside a bore (not shown) extending vertically through sensor body (310). Thus, with adjustment mechanism (318) serving as a lead screw and sensor body (310) serving as a nut, rotation of adjustment mechanism (318) provides vertical movement of sensor body (310). Of course, adjustment mechanism (318) may comprise any other mechanism suitable to adjust the vertical height of sensor body (310) as will be apparent to those of ordinary skill in the art in view of the teachings herein.
Lock plate (320) comprises a thin plate that is formed like a leaf spring. A proximal end of lock plate (320) is secured to handpiece (220) such that the proximal end of lock plate (320) is fixed relative to handpiece (220). The distal end of lock plate (320) is free to move relative to handpiece (220). The distal end of lock plate (320) comprises a plurality of teeth (321), which are configured to engage lock gear (322) as will be described in greater detail below. Lock plate (320) is resiliently biased to assume a straight configuration (
Lock gear (322) is secured coaxially around adjustment mechanism (318). Lock gear (322) and adjustment mechanism (318) are secured together such that lock gear (322) and adjustment mechanism (318) rotate together unitarily about the longitudinal axis shared by lock gear (322) and adjustment mechanism (318). Although lock gear (322) and adjustment mechanism (318) are described separately, it should be understood that lock gear (322) and adjustment mechanism (318) may either be separate parts coupled together or a unitary part. Lock gear (322) comprises several protrusions (323) that extend outwardly from lock gear (322) like an angularly spaced array of teeth. As will be described in greater detail below, protrusions (323) may be engaged by teeth (321) of lock plate (320) to lock rotational motion of adjustment mechanism (318), thereby preventing adjustment of the vertical position of sensor body (310).
Once arm (294) engages moveable protrusion (312) of jaw sensor (308), jaw sensor (308) may switch an electronic circuit to an open or closed state, communicating such a change to sensor circuitry (314). It should be understood that such a change in state may correspond to a specific pivotal position of second jaw (244) relative to first jaw (242). In some examples, such a positioning of second jaw (244) may correspond to a 0.01 inch gap between second jaw (244) and first jaw (242). In other words, jaw sensor assembly (290) may be configured such that jaw sensor (308) is activated when second jaw (244) reaches a state of closure where jaws (242, 244) are separated by a gap of approximately 0.01 inches. Of course, any other gap value may be utilized as will be apparent to those of ordinary skill in the art in view of the teachings herein. In addition or in the alternative, jaw sensor assembly (290) may be configured such that jaw sensor (308) is activated when second jaw (244) reaches a state of closure where jaws (242, 244) define an angle of approximately 10 degrees or less. Of course, any other degree of separation may be utilized as will be apparent to those of ordinary skill in the art in view of the teachings herein. The controller (82) may adjust RF energy supplied to end effector (240) to facilitate proper sealing of tissue based on activation of jaw sensor (308) as described above with respect to electrosurgical instrument (110).
Controller (82) may be configured to respond to changes in state of jaw sensor (308) communicated to controller (82). In particular, when controller (82) receives a signal from jaw sensor (308) corresponding to the closed position of second jaw (244), controller (82) may be converted into a ready state where subsequent activation of button (226) provides RF energy to jaws (242, 244). Conversely, if button (226) is activated before jaw sensor (308) indicates a sufficiently closed position of jaw (244), controller (82) may be prevented from providing RF energy to jaws (242, 244). In addition or in the alternative, controller (82) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that jaw (244) is insufficiently closed if the operator activates button (226) before jaw sensor (308) indicates a sufficiently closed position of jaw (244). In addition to or as an alternative to the foregoing, jaw sensor (308) may be configured to detect closure of jaws (242, 244) in the absence of tissue between jaws (242, 244). In other words, sensor (308) and controller (82) may be operable to determine that jaws (242, 244) have been closed without tissue being positioned between jaws (242, 244). In such instances, controller (82) may prevent the delivery of RF energy to jaws (242, 244). In addition or in the alternative, controller (82) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that end effector (240) needs to be repositioned in order to position tissue between jaws (242, 244) before jaws (242, 244) may deliver RF energy.
It should be understood that the pivotal movement of lever arm (294) is proportional to the pivotal movement of jaw (244). Although jaw sensor (308) is described herein as being binary in nature, it should be understood that in other examples jaw sensor (308) may be non-binary having a plurality of outputs to communicate different amount of closure of second jaw (244). In such examples, controller (82) may be responsive to varying degrees of input from jaw sensor (308) indicating differing amounts of closure of second jaw (244) such that RF power may be altered depending on different amounts of closure of second jaw (244). For instance, if jaw sensor (308) indicates a relatively wide separation of jaw (244) from jaw (242) when button (226) is activated (e.g., indicating a relatively thick bundle of tissue), controller (82) may provide a relatively high level of RF energy to jaws (242, 244). If jaw sensor (308) indicates a relatively small separation of jaw (244) from jaw (242) when button (226) is activated (e.g., indicating a relatively thin bundle of tissue), controller (82) may provide a relatively low level of RF energy to jaws (242, 244). It should also be understood that controller may (82) provide a control algorithm that factors in feedback from jaw sensor (308) and feedback indicating an electrical resistance of tissue in jaws (242, 244). Various suitable ways in which the electrical resistance of tissue may be sensed will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, controller (82) may be responsive to jaw sensor (308) and/or other sources of feedback in any other suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
In some instances, it may be desirable to adjust the vertical positioning of jaw sensor (308). For instance, it is desirable for arm (294) of jaw sensor actuation mechanism (292) to engage movable protrusion (312) of jaw sensor (308) as second jaw (244) of end effector (240) reaches a predetermined pivotal point. However, due to variations in the manufacturing process, such a relationship may not initially exist. In addition or in alternative, it may also be desirable to adjust the vertical positioning of jaw sensor (308) in the field to modify the tissue sealing properties of electrosurgical instrument (210).
B. Exemplary Electrosurgical Instrument with Jaw Sensor Activated by Downwardly Pivoting Arm
Shaft (430) of the present example includes a rigid outer sheath (432) without an articulation section, though it should be understood that some variations may include an articulation section. Shaft (430) is rotatable about the longitudinal axis defined by sheath (432), relative to handpiece (420), via a knob (434). Such rotation may provide rotation of end effector (440) and shaft (430) unitarily.
End effector (440) is similar to end effector (40) described above Like end effector (40), end effector (440) comprises a first jaw (442) and a second jaw (444). First jaw (442) is fixed relative to shaft (430) such that first jaw (442) remains stationary as end effector (440) actuates. Second jaw (444) is pivotable relative to first jaw (442) such that second jaw (444) transitions between an open and closed position as end effector (440) is actuated. Second jaw (444) may be pivoted in any suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein. Instrument (410) further includes a firing beam (not shown) that is operable to translate through end effector (440) to thereby sever tissue captured between jaws (442, 444). By way of example only, such a firing beam may be configured similar to firing beam (60), similar to firing beam (70), or in any other suitable fashion.
Drive plate (472) is rotatable about drive plate pin (473), which is fixedly secured within handpiece (420). Drive plate (472) comprises a curved portion (474) and a notch (476). Drive plate (472) is connected to trigger (424) via second trigger pin (427). Thus, trigger (424) is operable to pivot drive plate (472) about drive plate pin (473) as trigger (424) is pivoted toward and away from pistol grip (422). As will be described in greater detail below, curved portion (474) and notch (476) work cooperatively to permit the two stage actuation of trigger (424) as drive plate (472) pivots about drive plate pin (473).
Guide plate (478) is substantially fixed within handpiece (420) by drive plate pin (473) and guide plate pin (477). Pins (473, 477) are fixedly secured within handpiece (420). Guide plate (478) comprises a guide plate channel (481), which receives a drive pin (488). As will be described in greater detail below, guide plate (476) and drive plate (472) work cooperatively to actuate drive pin (488) upwardly along guide plate channel (481) when trigger (424) is pivoted toward pistol grip (422).
First linkage (480) extends proximally from drive plate pin (473) and includes a notch (not shown) similar to notch (476). First linkage (480) is pivotable about drive plate pin (473). The proximal end of first linkage (480) is pivotally attached to second linkage (482) via a connector pin (483). As will be described in greater detail below, first linkage (480) works cooperatively with drive plate (472) and guide plate (476) to actuate drive block (484) proximally in response to pivotal movement of trigger (424) toward pistol grip (422).
Second linkage (482) extends between first linkage (480) and drive block (484). As described above, second linkage (482) is pivotally coupled with first linkage (480) via connector pin (483). Second linkage (482) is also pivotally coupled with drive block (484) via pin (486). Drive block (484) is secured to a fixed track within handpiece (420) such that drive block (484) is only free to translate distally and proximally. Accordingly, and as will be described in greater detail below, second linkage (482) is operable to translate drive block (484) proximally as first linkage (480) is driven upwardly by drive pin (488).
As best seen in
An exemplary mode of operation of jaw actuation assembly (470) can be seen by comparing
As trigger (424) completes pivotal movement toward pistol grip (422) through a first range of motion, drive block (484) reaches its proximal most position as shown in
Pinion (460) meshes with rack (462) such that rotational movement of pinion (460) is converted into translation of rack (462). In particular, clockwise motion of pinion (460) then correspondingly drives rack (462) in the distal direction. Rack (462) includes an attachment portion (464), which attaches to a firing shaft (not shown). A firing beam is secured to the firing shaft, such that translation of firing shaft provides translation of the firing beam. The firing beam and the firing shaft translate unitarily with rack (462). It should therefore be understood that pivotal motion of drive plate (452) provides longitudinal translation of the firing beam. The firing beam may thus be operable to cut through tissue that is captured between jaws (442, 444).
Drive channel (454) of drive plate (452) has a first leg (455) and a second leg (457), which together define an “L” shape. A first trigger pin (425) is slidably disposed in drive channel (454). Trigger pin (425) is fixedly secured to trigger (424) such that trigger pin (425) rotates unitarily with trigger (424) through the first and second ranges of motion described herein. It should be understood that trigger pin (425) is positioned laterally outboard of the components of jaw actuation assembly (470) such that trigger pin (425) does not contact any components of jaw actuation assembly (470) during the movement of trigger pin (425). The “L” shape of drive channel (454) is configured such that trigger pin (425) moves through first leg (455) of channel (454) as trigger (424) is pivoted toward pistol grip (422) through the first range of motion (i.e., the range of motion that provides actuation of jaw actuation assembly (470)); and such that trigger pin (425) moves through second leg (457) of channel (454) as trigger (424) is pivoted toward pistol grip (422) through a second range of motion.
An exemplary mode of operation of firing beam actuation assembly (450) can be seen by comparing
In some exemplary modes of operation, an operator may grasp tissue by pivoting trigger (424) toward pistol grip (422) through the first range of motion to grasp tissue between jaws (442, 444), actuate button (426) to activate RF energy to seal the tissue grasped between jaws (442, 444), and then pivot trigger (424) toward pistol grip (422) through a second range of motion to cut the tissue with the firing beam.
It should be understood that although not discussed herein, firing beam actuation assembly (450) and/or jaw actuation assembly (470) may include other features discussed above such as springs to resiliently bias said assemblies (450, 470). Of course, in other examples, the various components of firing beam actuation assembly (450) and/or jaw actuation assembly (470) may incorporate other elements of similar assemblies discussed above as will be apparent to those of ordinary skill in the art in view of the teachings herein.
Pivot feature (496) pivots elongate distal portion (494) up and down in response to movements of jaw shaft (487). In particular, pivot feature (496) includes an engagement tooth (498), which is configured to engage with an annular flange (499) of jaw shaft (487). As will be described in greater detail below, annular flange (499) is fixedly secured to jaw shaft (487) such that proximal translation of jaw shaft (487) correspondingly translates annular flange (499) toward engagement tooth (498). Pivot feature (496) pivots about a lever arm pin (500), which is rotatably secured to handpiece (420) such that pivot feature (496) is operable to pivot lever arm (492) relative to handpiece (420). Pivot feature (496) is also shown as being equipped with a spring (502) to resiliently bias elongate distal portion (494) upwardly relative to jaw sensor (506). Of course, in other examples, any other suitable structure may be used to resiliently bias elongate distal portion (494) upwardly as will be apparent to those of ordinary skill in the art in view of the teachings herein.
Sensor assembly (504) comprises a jaw sensor (506) and jaw sensor circuitry (510). Jaw sensor (506) is similar to jaw sensors (146, 308) described above insofar as jaw sensor (506) is a binary switch that includes a resiliently biased movable protrusion (508). Of course, in other examples jaw sensor (506) may comprise any other suitable kind of sensor such as a reed switch, hall effect sensor, capacitive sensor, rheostat, or any other suitable sensor as will be apparent to those of ordinary skill in the art in view of the teachings herein.
Jaw sensor circuitry (510) is operable to convert electronic changes in the state of jaw sensor (506) into signals that may be received by a controller (not shown) such as controller (82). By way of example only, jaw sensor circuitry (510) may comprise resistors, transistors, integrated circuits and/or other electronic circuitry. As will be described in greater detail below, jaw sensor circuitry (510) may communicate a signal to controller (82) that may allow controller (82) to identify whether end effector (440) is open or closed. Moreover, jaw sensor circuitry (510) may communicate a signal to controller (82) that may allow controller (82) to determine the degree to which end effector (440) is closed.
An exemplary mode of operation of jaw sensor assembly (490) can be seen by comparing
Controller (82) may be configured to respond to changes in state of jaw sensor (504) communicated to controller (82) by jaw sensor circuitry (510). In particular, when controller (82) receives a signal from jaw sensor (504) corresponding to the closed position of second jaw (444), controller (82) may be converted into a ready state where subsequent activation of button (426) provides RF energy to jaws (442, 444). Conversely, if button (426) is activated before jaw sensor (504) indicates a sufficiently closed position of jaw (444), controller (82) may be prevented from providing RF energy to jaws (442, 444). In addition or in the alternative, controller (82) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that jaw (444) is insufficiently closed if the operator activates button (426) before jaw sensor (504) indicates a sufficiently closed position of jaw (444). In addition to or as an alternative to the foregoing, jaw sensor (504) may be configured to detect closure of jaws (442, 444) in the absence of tissue between jaws (442, 444). In other words, sensor (446) and controller (82) may be operable to determine that jaws (442, 444) have been closed without tissue being positioned between jaws (442, 444). In such instances, controller (82) may prevent the delivery of RF energy to jaws (442, 444). In addition or in the alternative, controller (82) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that end effector (440) needs to be repositioned in order to position tissue between jaws (442, 444) before jaws (442, 444) may deliver RF energy.
It should be understood that the pivotal movement of lever arm (492) is proportional to the pivotal movement of jaw (444). Although jaw sensor (504) is described herein as being binary in nature, it should be understood that in other examples jaw sensor (504) may be non-binary having a plurality of outputs to communicate different amount of closure of second jaw (444). In such examples, controller (82) may be responsive to varying degrees of input from jaw sensor (504) indicating differing amounts of closure of second jaw (444) such that RF power may be altered depending on different amounts of closure of second jaw (444). For instance, if jaw sensor (504) indicates a relatively wide separation of jaw (444) from jaw (442) when button (426) is activated (e.g., indicating a relatively thick bundle of tissue), controller (82) may provide a relatively high level of RF energy to jaws (442, 444). If jaw sensor (504) indicates a relatively small separation of jaw (444) from jaw (442) when button (426) is activated (e.g., indicating a relatively thin bundle of tissue), controller (82) may provide a relatively low level of RF energy to jaws (442, 444). It should also be understood that controller may (82) provide a control algorithm that factors in feedback from jaw sensor (504) and feedback indicating an electrical resistance of tissue in jaws (442, 444). Various suitable ways in which the electrical resistance of tissue may be sensed will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, controller (82) may be responsive to jaw sensor (504) and/or other sources of feedback in any other suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
It should also be understood that jaw sensor (504) may be adjustable like jaw sensor (308) described above, such that the sensitivity of sensor (504) may be adjusted to select a desired predetermined gap (or angular separation) between jaws (442, 444).
C. Exemplary Electrosurgical Instrument with Jaw Sensor Activated by Rotary Member
Shaft (630) of the present example includes a rigid outer sheath (632) without an articulation section, though it should be understood that some variations may include an articulation section. Shaft (630) is rotatable about the longitudinal axis defined by sheath (632), relative to handpiece (620), via a knob (634). Such rotation may provide rotation of end effector (640) and shaft (630) unitarily.
End effector (640) is similar to end effector (440) described above. Like end effector (440), end effector (640) comprises a first jaw (642) and a second jaw (644). First jaw (642) is fixed relative to shaft (630) such that first jaw (642) remains stationary as end effector (640) actuates. Second jaw (644) is pivotable relative to first jaw (642) such that second jaw (644) transitions between an open and closed position as end effector (640) is actuated. Second jaw (644) may be pivoted in any suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein. Instrument (610) further includes a firing beam (not shown) that is operable to translate through end effector (640) to thereby sever tissue captured between jaws (642, 644). By way of example only, such a firing beam may be configured similar to firing beam (60), similar to firing beam (70), or in any other suitable fashion.
A sensor rack (687) is unitarily secured to jaw shaft (689) in this example, such that sensor rack (687) translates longitudinally as jaws (642, 644) transition between open and closed positions. Sensor rack (687) includes a set of integral rack teeth (686). Drive gear (696) meshes with rack teeth (686) of sensor rack (687). Thus, it should be understood that longitudinal motion of sensor rack (687) provides concomitant rotation of drive gear (696).
Jaw sensor circuitry (700) is configured to convert electrical energy from rotational rheostat (692) into a signal that may be received by a controller (710). The individual components of jaw sensor circuitry (700) are shown schematically in
An exemplary mode of operation of jaw sensor assembly (690) can be seen by comparing
Once end effector (640) is in the closed state, a certain gap (or angular separation) will be formed between first jaw (642) and second jaw (644). Because the resistance of rotational rheostat (692) is proportional to the position of second jaw (644), a certain resistance value of rotational rheostat (692) can be determined. This resistance value corresponds to the gap (or angular separation) formed between first jaw (642) and second jaw (644). This resistance value of rotational rheostat (692) may be programmed into IC chip (702) such that IC chip (702) may activate transistor (704) once the predetermined resistance value is reached. Activated transistor (704) may then communicate a signal to controller (710) to indicate that end effector (640) is closed. When controller (710) identifies that end effector (640) is in the closed state, controller (710) may modify the RF energy delivered to end effector (640) to ensure adequate sealing of tissue grasped by end effector (640).
Controller (710) may be configured to respond to changes in state of jaw sensor assembly (690) communicated to controller (710). In particular, when controller (710) receives a signal from jaw sensor assembly (690) corresponding to the closed position of second jaw (644), controller (710) may be converted into a ready state where subsequent activation of button (626) provides RF energy to jaws (642, 644). Conversely, if button (626) is activated before jaw sensor assembly (690) indicates a sufficiently closed position of jaw (644), controller (710) may be prevented from providing RF energy to jaws (642, 644). In addition or in the alternative, controller (710) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that jaw (644) is insufficiently closed if the operator activates button (626) before jaw sensor assembly (690) indicates a sufficiently closed position of jaw (644). In addition to or as an alternative to the foregoing, jaw sensor assembly (690) may be configured to detect closure of jaws (642, 644) in the absence of tissue between jaws (642, 644) (or closure where jaws (642, 644) are otherwise separated by a gap that is less than a threshold thickness). In other words, jaw sensor assembly (690) and controller (710) may be operable to determine that jaws (642, 644) have been closed without tissue being positioned between jaws (642, 644) (or closure where jaws (642, 644) are otherwise separated by a gap that is less than a threshold thickness). In such instances, controller (710) may prevent the delivery of RF energy to jaws (642, 644) to prevent a short circuit from occurring between electrodes of jaws (642, 644). In addition or in the alternative, controller (710) may activate a user feedback feature (e.g., audible tone, visible light, etc.) to alert the operator that end effector (640) needs to be repositioned in order to position tissue between jaws (642, 644) before jaws (642, 644) may deliver RF energy.
Since rheostat (692) is operable to provide variable resistance throughout a particular range, such resistance may vary in direct proportion to the degree of closure of second jaw (644). Thus, controller (710) may be responsive to varying degrees of input from jaw sensor assembly (690) indicating differing amounts of closure of second jaw (644) such that RF power may be altered depending on different amounts of closure of second jaw (644). For instance, if jaw sensor assembly (690) indicates a relatively wide separation of jaw (644) from jaw (642) when button (626) is activated (e.g., indicating a relatively thick bundle of tissue), controller (710) may provide a relatively high level of RF energy to jaws (642, 644). If jaw sensor assembly (690) indicates a relatively small separation of jaw (644) from jaw (642) when button (626) is activated (e.g., indicating a relatively thin bundle of tissue), controller (710) may provide a relatively low level of RF energy to jaws (642, 644). If jaw sensor assembly (690) indicates a jaw separation that is below a minimum threshold, controller (710) may terminate or prevent energy application to prevent a short circuit from occurring between electrodes of jaws (642, 644). It should also be understood that controller may (710) provide a control algorithm that factors in feedback from jaw sensor assembly (690) and feedback indicating an electrical resistance of tissue in jaws (642, 644). Various suitable ways in which the electrical resistance of tissue may be sensed will be apparent to those of ordinary skill in the art in view of the teachings herein. Of course, controller (710) may be responsive to jaw sensor assembly (690) and/or other sources of feedback in any other suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
Similarly, IC chip (702) may include additional functionality to identify different resistances of rotational rheostat (692). For instance, it may be desirable to different gaps between first jaw (642) and second jaw (644) such as for procedures where end effector (640) is used for sealing tissue of varying thicknesses. In such circumstances, an operator may select different modes (e.g., modes for thick or thin tissue) that may correspond to different jaw (642, 644) gap sizes, and IC chip (702) may accordingly identify different resistance levels that correspond to such different jaw (642, 644) gap sizes. In other examples, electrosurgical instrument (610) may change over time such that a resistance that once corresponded to a certain gap between jaws (642, 644), no longer corresponds to the certain gap. In such examples, IC chip (702) may be reprogrammed to essentially recalibrate electrosurgical instrument (610). In addition or in the alternative, IC chip (702) may be reprogrammed such that the specific resistance identified by IC chip (702) is altered to change sealing characteristics to suit user preferences. Still in other examples, IC chip (702) may be reprogrammed in any suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
It should be understood that any of the versions of electrosurgical instrument (10) described herein may include various other features in addition to or in lieu of those described above. By way of example only, any of the devices herein may also include one or more of the various features disclosed in any of the various references that are incorporated by reference herein.
It should also be understood that any of the devices described herein may be modified to include a motor or other electrically powered device to drive an otherwise manually moved component. Various examples of such modifications are described in U.S. Pub. No. 2012/0116379, entitled “Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback,” published May 10, 2012, now U.S. Pat. No. 9,161,803, issued Oct. 20, 2015, the disclosure of which is incorporated by reference herein. Various other suitable ways in which a motor or other electrically powered device may be incorporated into any of the devices herein will be apparent to those of ordinary skill in the art in view of the teachings herein.
It should also be understood that any of the devices described herein may be modified to contain most, if not all, of the required components within the medical device itself. More specifically, the devices described herein may be adapted to use an internal or attachable power source and/or controller instead of requiring the device to be plugged into an external power source and/or controller by a cable. Various examples of how medical devices may be adapted to include a portable power source and/or controller are disclosed in U.S. Provisional Application Ser. No. 61/410,603, filed Nov. 5, 2010, entitled “Energy-Based Surgical Instruments,” the disclosure of which is incorporated by reference herein. Various other suitable ways in which a power source may be incorporated into any of the devices herein will be apparent to those of ordinary skill in the art in view of the teachings herein.
While the examples herein are described mainly in the context of electrosurgical instruments, it should be understood that various teachings herein may be readily applied to a variety of other types of devices. By way of example only, the various teachings herein may be readily applied to other types of electrosurgical instruments, tissue graspers, tissue retrieval pouch deploying instruments, surgical staplers, surgical clip appliers, ultrasonic surgical instruments, etc. It should also be understood that the teachings herein may be readily applied to any of the instruments described in any of the references cited herein, such that the teachings herein may be readily combined with the teachings of any of the references cited herein in numerous ways. Other types of instruments into which the teachings herein may be incorporated will be apparent to those of ordinary skill in the art.
In versions where the teachings herein are applied to a surgical stapling instrument, it should be understood that the teachings herein may be combined with the teachings of one or more of the following, the disclosures of all of which are incorporated by reference herein: U.S. Pat. No. 4,805,823, entitled “Pocket Configuration for Internal Organ Staplers,” issued Feb. 21, 1989; U.S. Pat. No. 5,415,334, entitled “Surgical Stapler and Staple Cartridge,” issued May 16, 1995; U.S. Pat. No. 5,465,895, entitled “Surgical Stapler Instrument,” issued Nov. 14, 1995; U.S. Pat. No. 5,597,107, entitled “Surgical Stapler Instrument,” issued Jan. 28, 1997; U.S. Pat. No. 5,632,432, entitled “Surgical Instrument,” issued May 27, 1997; U.S. Pat. No. 5,673,840, entitled “Surgical Instrument,” issued Oct. 7, 1997; U.S. Pat. No. 5,704,534, entitled “Articulation Assembly for Surgical Instruments,” issued Jan. 6, 1998; U.S. Pat. No. 5,814,055, entitled “Surgical Clamping Mechanism,” issued Sep. 29, 1998; U.S. Pat. No. 6,978,921, entitled “Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism,” issued Dec. 27, 2005; U.S. Pat. No. 7,000,818, entitled “Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923, entitled “Surgical Stapling Instrument Having a Firing Lockout for an Unclosed Anvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled “Surgical Stapling Instrument Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack,” issued Dec. 4, 2007; U.S. Pat. No. 7,367,485, entitled “Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission,” issued May 6, 2008; U.S. Pat. No. 7,380,695, entitled “Surgical Stapling Instrument Having a Single Lockout Mechanism for Prevention of Firing,” issued Jun. 3, 2008; U.S. Pat. No. 7,380,696, entitled “Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism,” issued Jun. 3, 2008; U.S. Pat. No. 7,404,508, entitled “Surgical Stapling and Cutting Device,” issued Jul. 29, 2008; U.S. Pat. No. 7,434,715, entitled “Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout,” issued Oct. 14, 2008; U.S. Pat. No. 7,721,930, entitled “Disposable Cartridge with Adhesive for Use with a Stapling Device,” issued May 25, 2010; U.S. Pub. No. 2010/0264193, entitled “Surgical Stapling Instrument with An Articulatable End Effector,” published Oct. 21, 2010, now U.S. Pat. No. 8,408,439, issued Apr. 2, 2013; and U.S. Pub. No. 2012/0239012, entitled “Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly,” published Sep. 20, 2012, now U.S. Pat. No. 8,453,914, issued Jun. 4, 2013. Other suitable ways in which the teachings herein may be applied to a surgical stapling instrument will be apparent to those of ordinary skill in the art in view of the teachings herein.
In versions where the teachings herein are applied to an ultrasonic surgical instrument, it should be understood that some such instruments may lack a translating firing beam. The components described herein for translating a firing beam may instead simply translate a jaw closing member. Alternatively, such translating features may simply be omitted. In any case, it should be understood that the teachings herein may be combined with the teachings of one or more of the following: U.S. Pat. Pub. No. 2006/0079874, entitled “Tissue Pad for Use with an Ultrasonic Surgical Instrument,” published Apr. 13, 2006, now abandoned, the disclosure of which is incorporated by reference herein; U.S. Pat. Pub. No. 2007/0191713, entitled “Ultrasonic Device for Cutting and Coagulating,” published Aug. 16, 2007, now abandoned, the disclosure of which is incorporated by reference herein; U.S. Pat. Pub. No. 2007/0282333, entitled “Ultrasonic Waveguide and Blade,” published Dec. 6, 2007, now abandoned, the disclosure of which is incorporated by reference herein; U.S. Pat. Pub. No. 2008/0200940, entitled “Ultrasonic Device for Cutting and Coagulating,” published Aug. 21, 2008, now abandoned, the disclosure of which is incorporated by reference herein; U.S. Pat. Pub. No. 2011/0015660, entitled “Rotating Transducer Mount for Ultrasonic Surgical Instruments,” published Jan. 20, 2011, now U.S. Pat. No. 8,461,744, issued Jun. 11, 2013, the disclosure of which is incorporated by reference herein; U.S. Pat. No. 6,500,176, entitled “Electrosurgical Systems and Techniques for Sealing Tissue,” issued Dec. 31, 2002, the disclosure of which is incorporated by reference herein; U.S. Pat. Pub. No. 2011/0087218, entitled “Surgical Instrument Comprising First and Second Drive Systems Actuatable by a Common Trigger Mechanism,” published Apr. 14, 2011, now U.S. Pat. No. 8,939,974, issued Jan. 27, 2015, the disclosure of which is incorporated by reference herein; and/or U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” issued Aug. 31, 2004, the disclosure of which is incorporated by reference herein. Other suitable ways in which the teachings herein may be applied to an ultrasonic surgical instrument will be apparent to those of ordinary skill in the art in view of the teachings herein.
It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The above-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
It should be appreciated that 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 material 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.
Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures. By way of example only, various teachings herein may be readily incorporated into a robotic surgical system such as the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif. Similarly, those of ordinary skill in the art will recognize that various teachings herein may be readily combined with various teachings of U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument,” published Aug. 31, 2004, the disclosure of which is incorporated by reference herein.
Versions described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a user immediately prior to a procedure. Those skilled in the art will appreciate that reconditioning of a device may 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.
By way of example only, versions described herein may be sterilized before and/or after a procedure. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in the sterile container for later use. A device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.
Number | Name | Date | Kind |
---|---|---|---|
1754806 | Stevenson | Apr 1930 | A |
3297192 | Swett | Jan 1967 | A |
3419198 | Pettersen | Dec 1968 | A |
3619671 | Shoh | Nov 1971 | A |
4034762 | Cosens et al. | Jul 1977 | A |
4057220 | Kudlacek | Nov 1977 | A |
4535773 | Yoon | Aug 1985 | A |
4641076 | Linden et al. | Feb 1987 | A |
4662068 | Polonsky | May 1987 | A |
4666037 | Weissman | May 1987 | A |
4685459 | Koch et al. | Aug 1987 | A |
4717018 | Sacherer et al. | Jan 1988 | A |
4717050 | Wright | Jan 1988 | A |
4721097 | D'Amelio | Jan 1988 | A |
4768969 | Bauer et al. | Sep 1988 | A |
4800878 | Cartmell | Jan 1989 | A |
4805823 | Rothfuss | Feb 1989 | A |
4844259 | Glowczewskie, Jr. | Jul 1989 | A |
4878493 | Pasternak et al. | Nov 1989 | A |
5071417 | Sinofsky | Dec 1991 | A |
5107155 | Yamaguchi | Apr 1992 | A |
5144771 | Miwa | Sep 1992 | A |
5169733 | Savovic et al. | Dec 1992 | A |
5176677 | Wuchinich | Jan 1993 | A |
5246109 | Markle et al. | Sep 1993 | A |
5273177 | Campbell | Dec 1993 | A |
5277694 | Leysieffer et al. | Jan 1994 | A |
5308358 | Bond et al. | May 1994 | A |
5322055 | Davison | Jun 1994 | A |
5339799 | Kami et al. | Aug 1994 | A |
5358508 | Cobb et al. | Oct 1994 | A |
5361902 | Abidin et al. | Nov 1994 | A |
5415334 | Williamson, IV et al. | May 1995 | A |
5429229 | Chester et al. | Jul 1995 | A |
5449370 | Vaitekumas | Sep 1995 | A |
5454378 | Palmer et al. | Oct 1995 | A |
5465895 | Knodel et al. | Nov 1995 | A |
5501607 | Yoshioka et al. | Mar 1996 | A |
5507297 | Slater et al. | Apr 1996 | A |
5561881 | Klinger et al. | Oct 1996 | A |
5578052 | Koros et al. | Nov 1996 | A |
5580258 | Wakata | Dec 1996 | A |
5582617 | Klieman et al. | Dec 1996 | A |
5590778 | Dutchik | Jan 1997 | A |
5592065 | Oglesbee et al. | Jan 1997 | A |
5597107 | Knodel et al. | Jan 1997 | A |
5599350 | Schulze et al. | Feb 1997 | A |
5630420 | Vaitekunas | May 1997 | A |
5630456 | Hugo et al. | May 1997 | A |
5632432 | Schulze et al. | May 1997 | A |
5673840 | Schulze et al. | Oct 1997 | A |
5690222 | Peters | Nov 1997 | A |
5704534 | Huitema et al. | Jan 1998 | A |
5707369 | Vaitekunas et al. | Jan 1998 | A |
5741305 | Vincent et al. | Apr 1998 | A |
5776155 | Beaupre et al. | Jul 1998 | A |
5800336 | Ball et al. | Sep 1998 | A |
5814055 | Knodel et al. | Sep 1998 | A |
5817128 | Storz | Oct 1998 | A |
5868244 | Ivanov et al. | Feb 1999 | A |
5873873 | Smith et al. | Feb 1999 | A |
5882310 | Marian, Jr. | Mar 1999 | A |
5935144 | Estabrook | Aug 1999 | A |
5938633 | Beupre | Aug 1999 | A |
5944737 | Tsonton et al. | Aug 1999 | A |
5951575 | Bolduc et al. | Sep 1999 | A |
5980510 | Tsonton et al. | Nov 1999 | A |
5997531 | Loeb et al. | Dec 1999 | A |
6018227 | Kumar et al. | Jan 2000 | A |
6051010 | Dimatteo et al. | Apr 2000 | A |
6056735 | Okada et al. | May 2000 | A |
6063098 | Houser et al. | May 2000 | A |
6066151 | Miyawaki et al. | May 2000 | A |
6083191 | Rose | Jul 2000 | A |
6083223 | Baker | Jul 2000 | A |
6099537 | Sugai et al. | Aug 2000 | A |
6113593 | Tu et al. | Sep 2000 | A |
6123702 | Swanson et al. | Sep 2000 | A |
6147480 | Osadchy et al. | Nov 2000 | A |
6165191 | Shibata et al. | Dec 2000 | A |
6190386 | Rydell | Feb 2001 | B1 |
6204592 | Hur | Mar 2001 | B1 |
6214023 | Whipple et al. | Apr 2001 | B1 |
6246896 | Dumoulin et al. | Jun 2001 | B1 |
6248238 | Burtin et al. | Jun 2001 | B1 |
6287304 | Eggers et al. | Sep 2001 | B1 |
6325811 | Messerly | Dec 2001 | B1 |
6339368 | Leith | Jan 2002 | B1 |
6398755 | Belef et al. | Jun 2002 | B1 |
6409742 | Fulton, III et al. | Jun 2002 | B1 |
6500176 | Truckai et al. | Dec 2002 | B1 |
6500188 | Harper et al. | Dec 2002 | B2 |
6512667 | Shiue et al. | Jan 2003 | B2 |
6514267 | Jewett | Feb 2003 | B2 |
6520185 | Bommannan et al. | Feb 2003 | B1 |
6561983 | Cronin et al. | May 2003 | B2 |
6562032 | Ellman et al. | May 2003 | B1 |
6609414 | Mayer et al. | Aug 2003 | B2 |
6622731 | Daniel et al. | Sep 2003 | B2 |
6623500 | Cook et al. | Sep 2003 | B1 |
6626901 | Treat et al. | Sep 2003 | B1 |
6647281 | Morency | Nov 2003 | B2 |
6650091 | Shiue et al. | Nov 2003 | B1 |
6650975 | Ruffner | Nov 2003 | B2 |
6656177 | Truckai et al. | Dec 2003 | B2 |
6658301 | Loeb et al. | Dec 2003 | B2 |
6666875 | Sakurai et al. | Dec 2003 | B1 |
6669690 | Okada et al. | Dec 2003 | B1 |
6717193 | Olewine et al. | Apr 2004 | B2 |
6730042 | Fulton et al. | May 2004 | B2 |
6753673 | Shiue et al. | Jun 2004 | B2 |
6758855 | Fulton, III et al. | Jul 2004 | B2 |
6761698 | Shibata et al. | Jul 2004 | B2 |
6761701 | Cucin | Jul 2004 | B2 |
6783524 | Anderson et al. | Aug 2004 | B2 |
6815206 | Lin et al. | Nov 2004 | B2 |
6821671 | Hinton et al. | Nov 2004 | B2 |
6836097 | Turner et al. | Dec 2004 | B2 |
6838862 | Luu | Jan 2005 | B2 |
6847192 | Turner et al. | Jan 2005 | B2 |
6860880 | Treat et al. | Mar 2005 | B2 |
6869435 | Blake | Mar 2005 | B2 |
6923807 | Ryan et al. | Aug 2005 | B2 |
6978921 | Shelton, IV et al. | Dec 2005 | B2 |
6982696 | Shahoian | Jan 2006 | B1 |
6998822 | Turner et al. | Feb 2006 | B2 |
7000818 | Shelton, IV et al. | Feb 2006 | B2 |
7031155 | Sauciuc et al. | Apr 2006 | B2 |
7061749 | Liu et al. | Jun 2006 | B2 |
7077853 | Kramer et al. | Jul 2006 | B2 |
7083589 | Banko et al. | Aug 2006 | B2 |
7085123 | Shiue et al. | Aug 2006 | B2 |
7101371 | Dycus et al. | Sep 2006 | B2 |
7112201 | Truckai et al. | Sep 2006 | B2 |
7125409 | Truckai et al. | Oct 2006 | B2 |
7143923 | Shelton, IV et al. | Dec 2006 | B2 |
7150712 | Buehlmann et al. | Dec 2006 | B2 |
7169146 | Truckai et al. | Jan 2007 | B2 |
7186253 | Truckai et al. | Mar 2007 | B2 |
7186473 | Shiue et al. | Mar 2007 | B2 |
7189233 | Truckai et al. | Mar 2007 | B2 |
7220951 | Truckai et al. | May 2007 | B2 |
7221216 | Nguyen | May 2007 | B2 |
7232440 | Dumbauld et al. | Jun 2007 | B2 |
7244024 | Biscardi | Jul 2007 | B2 |
7292227 | Fukumoto et al. | Nov 2007 | B2 |
7296804 | Lechot et al. | Nov 2007 | B2 |
7303108 | Shelton, IV | Dec 2007 | B2 |
7303556 | Metzger | Dec 2007 | B2 |
7309849 | Truckai et al. | Dec 2007 | B2 |
7311709 | Truckai et al. | Dec 2007 | B2 |
7349741 | Maltan et al. | Mar 2008 | B2 |
7354440 | Truckai et al. | Apr 2008 | B2 |
7364061 | Swayze et al. | Apr 2008 | B2 |
7364554 | Bolze et al. | Apr 2008 | B2 |
7367485 | Shelton, IV et al. | May 2008 | B2 |
7380695 | Doll et al. | Jun 2008 | B2 |
7380696 | Shelton, IV et al. | Jun 2008 | B2 |
7381209 | Truckai et al. | Jun 2008 | B2 |
7404508 | Smith et al. | Jul 2008 | B2 |
7416101 | Shelton, IV et al. | Aug 2008 | B2 |
7422139 | Shelton, IV et al. | Sep 2008 | B2 |
7434715 | Shelton, IV et al. | Oct 2008 | B2 |
7464846 | Shelton, IV et al. | Dec 2008 | B2 |
7473145 | Ehr et al. | Jan 2009 | B2 |
7479152 | Fulton, III et al. | Jan 2009 | B2 |
7494492 | Da Silva et al. | Feb 2009 | B2 |
D594983 | Price et al. | Jun 2009 | S |
7560903 | Thrap | Jul 2009 | B2 |
7563142 | Wenger et al. | Jul 2009 | B1 |
7573151 | Acena et al. | Aug 2009 | B2 |
7583564 | Ketahara et al. | Sep 2009 | B2 |
7628791 | Garrison et al. | Dec 2009 | B2 |
7638958 | Philipp et al. | Dec 2009 | B2 |
7643378 | Genosar | Jan 2010 | B2 |
7658247 | Carter | Feb 2010 | B2 |
7692411 | Trainor et al. | Apr 2010 | B2 |
7717312 | Beetel | May 2010 | B2 |
7721930 | McKenna et al. | May 2010 | B2 |
7721936 | Shelton, IV et al. | May 2010 | B2 |
7738971 | Swayze et al. | Jun 2010 | B2 |
7761198 | Bhardwaj | Jul 2010 | B2 |
7766910 | Hixson et al. | Aug 2010 | B2 |
7766929 | Masuda | Aug 2010 | B2 |
7770722 | Donahoe et al. | Aug 2010 | B2 |
7770775 | Shelton et al. | Aug 2010 | B2 |
7776037 | Odom | Aug 2010 | B2 |
7780660 | Bourne et al. | Aug 2010 | B2 |
7802121 | Zansky et al. | Sep 2010 | B1 |
7815658 | Murakami | Oct 2010 | B2 |
7845537 | Shelton, IV et al. | Dec 2010 | B2 |
7846155 | Houser et al. | Dec 2010 | B2 |
7846159 | Morrison et al. | Dec 2010 | B2 |
7889489 | Richardson et al. | Feb 2011 | B2 |
7913891 | Doll et al. | Mar 2011 | B2 |
7922063 | Zemlok et al. | Apr 2011 | B2 |
7923151 | Lam et al. | Apr 2011 | B2 |
7948208 | Partovi et al. | May 2011 | B2 |
7952322 | Partovi et al. | May 2011 | B2 |
7952873 | Glahn et al. | May 2011 | B2 |
7959050 | Smith et al. | Jun 2011 | B2 |
7977921 | Bahai et al. | Jul 2011 | B2 |
7982439 | Trainor et al. | Jul 2011 | B2 |
8038025 | Stark et al. | Oct 2011 | B2 |
8040107 | Ishii | Oct 2011 | B2 |
8052605 | Muller et al. | Nov 2011 | B2 |
8058771 | Giordano et al. | Nov 2011 | B2 |
8075530 | Taylor et al. | Dec 2011 | B2 |
8083120 | Shelton et al. | Dec 2011 | B2 |
8097011 | Hideo et al. | Jan 2012 | B2 |
8142461 | Houser et al. | Mar 2012 | B2 |
8147488 | Masuda | Apr 2012 | B2 |
8177776 | Humayun et al. | May 2012 | B2 |
8195271 | Rahn | Jun 2012 | B2 |
8210411 | Yates et al. | Jul 2012 | B2 |
8216212 | Grant et al. | Jul 2012 | B2 |
8221418 | Prakash et al. | Jul 2012 | B2 |
8240498 | Ramsey et al. | Aug 2012 | B2 |
8246642 | Houser et al. | Aug 2012 | B2 |
8251994 | McKenna et al. | Aug 2012 | B2 |
8267094 | Danek et al. | Sep 2012 | B2 |
8277446 | Heard | Oct 2012 | B2 |
8292882 | Danek et al. | Oct 2012 | B2 |
8292888 | Whitman | Oct 2012 | B2 |
8298253 | Charles | Oct 2012 | B2 |
8301262 | Mi et al. | Oct 2012 | B2 |
8328802 | Deville et al. | Dec 2012 | B2 |
8333764 | Francischelli et al. | Dec 2012 | B2 |
8336725 | Ramsey et al. | Dec 2012 | B2 |
8337097 | Cao | Dec 2012 | B2 |
8344690 | Smith et al. | Jan 2013 | B2 |
8372099 | Deville et al. | Feb 2013 | B2 |
8377059 | Deville et al. | Feb 2013 | B2 |
8400108 | Powell 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 |
8408439 | Huang et al. | Apr 2013 | B2 |
8419757 | Smith et al. | Apr 2013 | B2 |
8419758 | Smith et al. | Apr 2013 | B2 |
8425545 | Smith et al. | Apr 2013 | B2 |
8444653 | Nycz et al. | May 2013 | B2 |
8444662 | Palmer et al. | May 2013 | B2 |
8449529 | Bek et al. | May 2013 | B2 |
8453914 | Laurent et al. | Jun 2013 | B2 |
8461744 | Weiner et al. | Jun 2013 | B2 |
8487487 | Dietz et al. | Jul 2013 | B2 |
8550106 | Hebach et al. | Oct 2013 | B2 |
8550981 | Woodruff et al. | Oct 2013 | B2 |
8551088 | Falkenstein et al. | Oct 2013 | B2 |
8564242 | Hansford et al. | Oct 2013 | B2 |
8573461 | Shelton et al. | Nov 2013 | B2 |
8602287 | Yates et al. | Dec 2013 | B2 |
8608045 | Smith et al. | Dec 2013 | B2 |
8617077 | van Groningen et al. | Dec 2013 | B2 |
8622274 | Yates et al. | Jan 2014 | B2 |
8623027 | Price et al. | Jan 2014 | B2 |
8632535 | Shelton, IV et al. | Jan 2014 | B2 |
8641629 | Kurokawa | Feb 2014 | B2 |
8657174 | Yates et al. | Feb 2014 | B2 |
8663112 | Slayton et al. | Mar 2014 | B2 |
8733614 | Ross et al. | May 2014 | B2 |
8758342 | Bales et al. | Jun 2014 | B2 |
8784415 | Malackowski et al. | Jul 2014 | B2 |
8808319 | Houser et al. | Aug 2014 | B2 |
8834465 | Ramstein et al. | Sep 2014 | B2 |
8864761 | Johnson et al. | Oct 2014 | B2 |
8906017 | Rioux et al. | Dec 2014 | B2 |
8926610 | Hafner et al. | Jan 2015 | B2 |
8961441 | Cioanta et al. | Feb 2015 | B2 |
8968648 | Kaneko et al. | Mar 2015 | B2 |
8998939 | Price et al. | Apr 2015 | B2 |
9000720 | Stulen et al. | Apr 2015 | B2 |
9011336 | Slayton et al. | Apr 2015 | B2 |
9011427 | Price et al. | Apr 2015 | B2 |
9011471 | Timm et al. | Apr 2015 | B2 |
9017849 | Stulen et al. | Apr 2015 | B2 |
9017851 | Felder et al. | Apr 2015 | B2 |
9023071 | Miller et al. | May 2015 | B2 |
9039720 | Madan | May 2015 | B2 |
9044261 | Houser | Jun 2015 | B2 |
9050125 | Boudreaux et al. | Jun 2015 | B2 |
9060750 | Lam | Jun 2015 | B2 |
9072523 | Houser et al. | Jul 2015 | B2 |
9078671 | Beale | Jul 2015 | B2 |
9089338 | Smith et al. | Jul 2015 | B2 |
9095346 | Houser et al. | Aug 2015 | B2 |
9113903 | Unger | Aug 2015 | B2 |
9179912 | Yates et al. | Nov 2015 | B2 |
9186046 | Ramamurthy et al. | Nov 2015 | B2 |
9186047 | Ramamurthy et al. | Nov 2015 | B2 |
9194428 | Houser et al. | Nov 2015 | B2 |
9247986 | Haberstich et al. | Feb 2016 | B2 |
9308009 | Madan et al. | Apr 2016 | B2 |
9318271 | Fletcher et al. | Apr 2016 | B2 |
9364279 | Houser et al. | Jun 2016 | B2 |
9364288 | Smith et al. | Jun 2016 | B2 |
9375255 | Houser et al. | Jun 2016 | B2 |
9375258 | Kendrick | Jun 2016 | B2 |
9381058 | Houser et al. | Jul 2016 | B2 |
9421062 | Houser et al. | Aug 2016 | B2 |
9441954 | Ramamurthy et al. | Sep 2016 | B2 |
9500472 | Ramamurthy et al. | Nov 2016 | B2 |
9500473 | Ramamurthy et al. | Nov 2016 | B2 |
9510895 | Houser et al. | Dec 2016 | B2 |
9526565 | Strobl | Dec 2016 | B2 |
9526921 | Kimball et al. | Dec 2016 | B2 |
9597143 | Madan et al. | Mar 2017 | B2 |
9622832 | Birkenbach et al. | Apr 2017 | B2 |
9629652 | Mumaw et al. | Apr 2017 | B2 |
9649150 | Houser et al. | May 2017 | B2 |
9675375 | Houser et al. | Jun 2017 | B2 |
20010032666 | Jenson et al. | Oct 2001 | A1 |
20020165577 | Witt et al. | Nov 2002 | A1 |
20030093103 | Malackowski et al. | May 2003 | A1 |
20030109802 | Laeseke et al. | Jun 2003 | A1 |
20030114851 | Truckai et al. | Jun 2003 | A1 |
20030144680 | Kellogg et al. | Jul 2003 | A1 |
20040097911 | Murakami et al. | May 2004 | A1 |
20040116952 | Sakurai et al. | Jun 2004 | A1 |
20040133189 | Sakurai | Jul 2004 | A1 |
20040173487 | Johnson et al. | Sep 2004 | A1 |
20050021065 | Yamada et al. | Jan 2005 | A1 |
20050033195 | Fulton et al. | Feb 2005 | A1 |
20050171522 | Christopherson | Aug 2005 | A1 |
20060030797 | Zhou et al. | Feb 2006 | A1 |
20060079829 | Fulton et al. | Apr 2006 | A1 |
20060079874 | Faller et al. | Apr 2006 | A1 |
20060079877 | Houser et al. | Apr 2006 | A1 |
20060079879 | Faller et al. | Apr 2006 | A1 |
20060253176 | Caruso et al. | Nov 2006 | A1 |
20070027447 | Theroux et al. | Feb 2007 | A1 |
20070078484 | Talarico et al. | Apr 2007 | A1 |
20070103437 | Rosenberg | May 2007 | A1 |
20070106297 | Dumbauld | May 2007 | A1 |
20070191713 | Eichmann et al. | Aug 2007 | A1 |
20070207354 | Curello et al. | Sep 2007 | A1 |
20070261978 | Sanderson | Nov 2007 | A1 |
20070265613 | Edelstein et al. | Nov 2007 | A1 |
20070265620 | Kraas et al. | Nov 2007 | A1 |
20070282333 | Fortson et al. | Dec 2007 | A1 |
20080003491 | Yahnker et al. | Jan 2008 | A1 |
20080004656 | Livneh | Jan 2008 | A1 |
20080057470 | Levy et al. | Mar 2008 | A1 |
20080147058 | Horrell et al. | Jun 2008 | A1 |
20080150754 | Quendt | Jun 2008 | A1 |
20080173651 | Ping | Jul 2008 | A1 |
20080188810 | Larsen et al. | Aug 2008 | A1 |
20080200940 | Eichmann et al. | Aug 2008 | A1 |
20080228104 | Uber, III et al. | Sep 2008 | A1 |
20080255413 | Zemlok et al. | Oct 2008 | A1 |
20080281301 | Deboer et al. | Nov 2008 | A1 |
20080315829 | Jones et al. | Dec 2008 | A1 |
20090076506 | Baker | Mar 2009 | A1 |
20090096430 | Van Der Linde et al. | Apr 2009 | A1 |
20090143799 | Smith et al. | Jun 2009 | A1 |
20090143800 | Deville et al. | Jun 2009 | A1 |
20090253030 | Kooij | Oct 2009 | A1 |
20090281430 | Wilder | Nov 2009 | A1 |
20100021022 | Pittel et al. | Jan 2010 | A1 |
20100030218 | Prevost | Feb 2010 | A1 |
20100060231 | Trainor et al. | Mar 2010 | A1 |
20100106144 | Matsumura et al. | Apr 2010 | A1 |
20100106146 | Boitor et al. | Apr 2010 | A1 |
20100125172 | Jayaraj | May 2010 | A1 |
20100152610 | Parihar et al. | Jun 2010 | A1 |
20100201311 | Alexander et al. | Aug 2010 | A1 |
20100249665 | Roche | Sep 2010 | A1 |
20100268221 | Beller et al. | Oct 2010 | A1 |
20100274160 | Yachi et al. | Oct 2010 | A1 |
20110009694 | Schultz et al. | Jan 2011 | A1 |
20110074336 | Miller | Mar 2011 | A1 |
20110077514 | Ulric et al. | Mar 2011 | A1 |
20110080134 | Miller | Apr 2011 | A1 |
20110082486 | Messerly et al. | Apr 2011 | A1 |
20110087212 | Aldridge et al. | Apr 2011 | A1 |
20110087213 | Messerly et al. | Apr 2011 | A1 |
20110087214 | Giordano et al. | Apr 2011 | A1 |
20110087215 | Aldridge et al. | Apr 2011 | A1 |
20110087216 | Aldridge et al. | Apr 2011 | A1 |
20110087217 | Yates et al. | Apr 2011 | A1 |
20110087218 | Boudreaux et al. | Apr 2011 | A1 |
20110221398 | Ferber | Sep 2011 | A1 |
20120078243 | Worrell et al. | Mar 2012 | A1 |
20120078244 | Worrell et al. | Mar 2012 | A1 |
20120078247 | Worrell et al. | Mar 2012 | A1 |
20120078248 | Worrell et al. | Mar 2012 | A1 |
20120083783 | Davison et al. | Apr 2012 | A1 |
20120111591 | Shelton, IV et al. | May 2012 | A1 |
20120116260 | Johnson et al. | May 2012 | A1 |
20120116261 | Mumaw et al. | May 2012 | A1 |
20120116262 | Houser et al. | May 2012 | A1 |
20120116263 | Houser et al. | May 2012 | A1 |
20120116265 | Houser et al. | May 2012 | A1 |
20120116266 | Houser et al. | May 2012 | A1 |
20120116379 | Yates et al. | May 2012 | A1 |
20120116381 | Houser et al. | May 2012 | A1 |
20120116391 | Houser et al. | May 2012 | A1 |
20120179036 | Patrick et al. | Jul 2012 | A1 |
20120292367 | Morgan et al. | Nov 2012 | A1 |
20120305427 | Felder et al. | Dec 2012 | A1 |
20130023868 | Worrell et al. | Jan 2013 | A1 |
20130030428 | Worrell et al. | Jan 2013 | A1 |
20130085330 | Ramamurthy et al. | Apr 2013 | A1 |
20130090528 | Ramamurthy et al. | Apr 2013 | A1 |
20130118733 | Kumar | May 2013 | A1 |
20140088379 | Bhamra et al. | Mar 2014 | A1 |
20140257284 | Artale | Sep 2014 | A1 |
20140263565 | Lytle, IV | Sep 2014 | A1 |
Number | Date | Country |
---|---|---|
101819334 | Sep 2010 | CN |
102008051866 | Oct 2010 | DE |
102009013034 | Oct 2010 | DE |
0897696 | Feb 1999 | EP |
0947167 | Oct 1999 | EP |
1330991 | Jul 2003 | EP |
1525853 | Apr 2005 | EP |
1535585 | Jun 2005 | EP |
1684396 | Jul 2006 | EP |
1721576 | Nov 2006 | EP |
1 728 475 | Dec 2006 | EP |
1743592 | Jan 2007 | EP |
1818021 | Aug 2007 | EP |
1839599 | Oct 2007 | EP |
1868275 | Dec 2007 | EP |
1886637 | Feb 2008 | EP |
1943976 | Jul 2008 | EP |
1970014 | Sep 2008 | EP |
1997439 | Dec 2008 | EP |
2027819 | Feb 2009 | EP |
2090256 | Aug 2009 | EP |
2105104 | Sep 2009 | EP |
2165660 | Mar 2010 | EP |
2218409 | Aug 2010 | EP |
2243439 | Oct 2010 | EP |
2345454 | Jul 2011 | EP |
2 772 210 | Sep 2014 | EP |
2425874 | Nov 2006 | GB |
2440566 | Feb 2008 | GB |
2000-210301 | Aug 2000 | JP |
3989121 | Oct 2000 | JP |
4145069 | Oct 2003 | JP |
WO 1997024072 | Jul 1997 | WO |
WO 2000065682 | Feb 2000 | WO |
WO 2003013374 | Feb 2003 | WO |
WO 2003020139 | Mar 2003 | WO |
WO 2004113991 | Dec 2004 | WO |
WO 2005079915 | Sep 2005 | WO |
WO 2006023266 | Mar 2006 | WO |
WO 2007004515 | Jan 2007 | WO |
WO 2007024983 | Mar 2007 | WO |
WO 2007090025 | Aug 2007 | WO |
WO 2007137115 | Nov 2007 | WO |
WO 2007137304 | Nov 2007 | WO |
WO 2008071898 | Jun 2008 | WO |
WO 2008102154 | Aug 2008 | WO |
WO 2008107902 | Sep 2008 | WO |
WO 2008131357 | Oct 2008 | WO |
WO 2009018409 | Feb 2009 | WO |
WO 2009046394 | Apr 2009 | WO |
WO 2009070780 | Jun 2009 | WO |
WO 2009073608 | Jun 2009 | WO |
WO 2010030850 | Mar 2010 | WO |
WO 2010096174 | Aug 2010 | WO |
WO 2011059785 | May 2011 | WO |
WO 2011089270 | Jul 2011 | WO |
WO 2012009431 | Jan 2012 | WO |
Entry |
---|
U.S. Appl. No. 61/410,603, filed Nov. 5, 2010. |
U.S. Appl. No. 61/550,768, filed Oct. 24, 2011. |
Dietz, T. et al., Partially Implantable Vibrating Ossicular Prosthesis, Transducers'97, vol. 1, International Conference on Solid State Sensors and Actuators, (Jun. 16-19, 1997) pp. 433-436 (Abstract). |
“System 6 Aseptic Battery System,” Stryker (2006) pp. 1-2. |
Australian First Examination Report dated May 18, 2015 for Application No. AU 2011323284. |
Australian First Examination Report dated Jun. 17, 2015 for Application No. AU 2011323279. |
Chinese First Office Action dated Jan. 29, 2015 for Application No. CN 2011800638159. |
Chinese First Office Action dated Mar. 4, 2015 for Application No. CN 201180063595X. |
Chinese First Office Action dated Mar. 27, 2015 for Application No. CN 2011800638214. |
Chinese First Office Action dated Jul. 1, 2015 for Application No. CN 201180063986.1. |
Chinese Second Office Action dated Aug. 4, 2015 for Application No. CN 2011800641486. |
EP Communication dated Feb. 19, 2014 for Application No. EP 11781972.2. |
International Search Report dated Jan. 12, 2012 for Application No. PCT/US2011/059226. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059226. |
International Search Report dated Jan. 26, 2012 for Application No. PCT/US2011/059220. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059220. |
International Search Report dated Feb. 1, 2012 for Application No. PCT/US2011/059223. |
International Preliminary Report on Patentability dated Feb. 1, 2012 for Application No. PCT/US2011/059223. |
International Search Report dated Feb. 2, 2012 for Application No. PCT/US2011/059354. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059354. |
International Search Report dated Feb. 7, 2012 for Application No. PCT/US2011/059351. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059351. |
International Search Report dated Feb. 13, 2012 for Application No. PCT/US2011/059217. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059217. |
International Search Report dated Feb. 23, 2012 for Application No. PCT/US2011/059371. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059371. |
International Search Report dated Mar. 15, 2012 for Application No. PCT/US2011/059338. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059338. |
International Search Report dated Mar. 22, 2012 for Application No. PCT/US2011/059362. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059362. |
International Search Report dated Apr. 4, 2012 for Application No. PCT/US2011/059215. |
International Preliminary Report on Patentability dated May 8, 2013 for Application No. PCT/US2011/059215. |
International Search Report dated Apr. 18, 2012 for Application No. PCT/US2011/059222. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059222. |
International Search Report dated May 24, 2012 for Application No. PCT/US2011/059378. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059378. |
International Search Report dated May 29, 2012 for Application No. PCT/US2011/059358. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059358. |
International Search Report dated Jun. 4, 2012 for Application No. PCT/US2011/059365. |
International Preliminary Report on Patentability dated May 8, 2013 for Application No. PCT/US2011/059365. |
International Search Report dated Jun. 12, 2012 for Application No. PCT/US2011/059218. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCY/US2011/059218. |
International Search Report dated Apr. 11, 2012 for Application No. PCT/US2011/059381. |
International Search Report, revised, dated Jul. 6, 2012 for Application No. PCT/US2011/059381. |
International Preliminary Report on Patentability dated May 8, 2013 for Application No. PCT/US2011/059381. |
International Search Report and Written Opinion dated Jan. 26, 2012 for Application No. PCT/US2011/059212. |
International Preliminary Report on Patentability dated May 7, 2013 for Application No. PCT/US2011/059212. |
Japanese Office Action, Notification of Reasons for Refusal, dated Sep. 8, 2015 for Application No. 2013/537829. |
Japanese Office Action, Notification of Reasons for Refusal, dated Jul. 5, 2016 for Application No. 2013/537829. |
Japanese Office Action, Notification of Reasons for Refusal, dated Sep. 29, 2015 for Application No. 2013/537877. |
U.S. Office Action, Non/Final dated Aug. 6, 2013 for U.S. Appl. No. 13/151,471. |
U.S. Office Action, Notice of Allowance, dated Dec. 6, 2013 for U.S. Appl. No. 13/151,471. |
U.S. Office Action, Non/Final, dated Mar. 28, 2014 for U.S. Appl. No. 13/151,471. |
U.S. Office Action, Notice of Allowance, dated Aug. 19, 2014 for U.S. Appl. No. 13/151,471. |
U.S. Office Action, Notice of Allowance, dated Nov. 21, 2014 for U.S. Appl. No. 13/151,471. |
U.S. Office Action, Restriction Requirement, dated Dec. 11, 2012 for U.S. Appl. No. 13/151,481. |
U.S. Office Action, Non/Final, dated Feb. 15, 2013 for U.S. Appl. No. 13/151,481. |
U.S. Office Action, Final, dated Jun. 7, 2013 for U.S. Appl. No. 13/151,481. |
U.S. Office Action, Non/Final, dated Aug. 14, 2014 for U.S. Appl. No. 13/151,481. |
U.S. Office Action, Final, dated Apr. 1, 2015 for U.S. Appl. No. 13/151,481. |
U.S. Office Action, Notice of Allowance, dated Jun. 10, 2015 for U.S. Appl. No. 13/151,481. |
U.S. Office Action, Restriction Requirement, dated Jul. 5, 2013 for U.S. Appl. No. 13/151,488. |
U.S. Office Action, Non/Final, dated Nov. 7, 2014 for U.S. Appl. No. 13/151,488. |
U.S. Office Action, Non/Final, dated Jun. 14, 2013 for U.S. Appl. No. 13/151,498. |
U.S. Office Action, Final, dated Nov. 21, 2013 for U.S. Appl. No. 13/151,498. |
U.S. Office Action, Non/Final, dated Mar. 18, 2014 for U.S. Appl. No. 13/151,498. |
U.S. Office Action, Notice of Allowance, dated Aug. 6, 2014 for U.S. Appl. No. 13/151,498. |
U.S. Office Action, Notice of Allowance, dated Nov. 21, 2014 for U.S. Appl. No. 13/151,498. |
U.S. Office Action, Non/Final, dated Jun. 18, 2014 for U.S. Appl. No. 13/151,503. |
U.S. Office Action, Non/Final, dated Nov. 6, 2014 for U.S. Appl. No. 13/151,503. |
U.S. Office Action, Restriction Requirement, dated Mar. 13, 2013 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Restriction Requirement, dated Jun. 24, 2013 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Non/Final, dated Sep. 26, 2013 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Final, dated Jan. 29, 2014 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Non/Final, dated Jul. 9, 2014 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Notice of Allowance, dated Oct. 28, 2014 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Notice of Allowance, dated Feb. 25, 2015 for U.S. Appl. No. 13/151,509. |
U.S. Office Action, Restriction Requirement, dated Jun. 11, 2014 for U.S. Appl. No. 13/151,512. |
U.S. Office Action, Notice of Allowance, dated Oct. 29, 2014 for U.S. Appl. No. 13/151,512. |
U.S. Office Action, Notice of Allowance, dated Feb. 17, 2015 for U.S. Appl. No. 13/151,512. |
U.S. Office Action, Restriction Requirement, dated Jul. 11, 2014 for U.S. Appl. No. 13/269,870. |
U.S. Office Action, Non/Final, dated Jan. 5, 2015 for U.S. Appl. No. 13/269,870. |
U.S. Office Action, Restriction Requirement, dated Feb. 28, 2013 for U.S. Appl. No. 13/270,667. |
U.S. Office Action, Non/Final, dated Apr. 26, 2013 for U.S. Appl. No. 13/270,667. |
U.S. Office Action, Final, dated Oct. 25, 2013 for U.S. Appl. No. 13/270,667. |
U.S. Office Action, Non/Final, dated Jul. 29, 2014 for U.S. Appl. No. 13/270,667. |
U.S. Office Action, Notice of Allowance, dated Dec. 17, 2014 for U.S. Appl. No. 13/270,667. |
U.S. Office Action, Restriction Requirement, dated Jul. 9, 2014 for U.S. Appl. No. 13/270,684. |
U.S. Office Action, Non/Final, dated Oct. 9, 2014 for U.S. Appl. No. 13/270,684. |
U.S. Office Action, Restriction Requirement, dated Sep. 11, 2014 for U.S. Appl. No. 13/270,701. |
U.S. Office Action, Non/Final, dated Dec. 16, 2014 for U.S. Appl. No. 13/270,701. |
U.S. Office Action, Non/Final, dated Nov. 21, 2013 for U.S. Appl. No. 13/271,352. |
U.S. Office Action, Restriction Requirement, dated Sep. 25, 2014 for U.S. Appl. No. 13/271,352. |
U.S. Office Action, Restriction Requirement, dated Feb. 25, 2015 for U.S. Appl. No. 13/271,364. |
U.S. Office Action, Restriction Requirement, dated Oct. 2, 2013 for U.S. Appl. No. 13/274,480. |
U.S. Office Action, Non/Final, dated Feb. 14, 2014 for U.S. Appl. No. 13/274,480. |
U.S. Office Action, Final, dated Jul. 17, 2014 for U.S. Appl. No. 13/274,480. |
U.S. Office Action, Non/Final, dated May 1, 2015 for U.S. Appl. No. 13/274,480. |
U.S. Office Action, Restriction Requirement, dated Dec. 9, 2013 for U.S. Appl. No. 13/274,496. |
U.S. Office Action, Non/Final, dated Feb. 6, 2014 for Appl. No. 13/274,496. |
U.S. Office Action, Final, dated May 15, 2014 for U.S. Appl. No. 13/274,496. |
U.S. Office Action, Final, dated Aug. 22, 2014 for U.S. Appl. No. 13/274,496. |
U.S. Office Action, Restriction Requirement, dated Mar. 28, 2014 for U.S. Appl. No. 13/274,507. |
U.S. Office Action, Non/Final, dated Jun. 19, 2014 for U.S. Appl. No. 13/274,507. |
U.S. Office Action, Non/Final, dated Dec. 21, 2012 for U.S. Appl. No. 13/274,516. |
U.S. Office Action, Final, dated Aug. 16, 2013 for U.S. Appl. No. 13/274,516. |
U.S. Office Action, Non/Final, dated Dec. 6, 2013 for U.S. Appl. No. 13/274,516. |
U.S. Office Action, Final, dated Jun. 12, 2014 for U.S. Appl. No. 13/274,516. |
U.S. Office Action, Non/Final, dated Oct. 8, 2014 for U.S. Appl. No. 13/274,516. |
U.S. Office Action, Restriction Requirement, dated Feb. 25, 2013 for U.S. Appl. No. 13/274,540. |
U.S. Office Action, Non/Final, dated Apr. 30, 2013 for U.S. Appl. No. 13/274,540. |
U.S. Office Action, Final, dated Oct. 25, 2013 for U.S. Appl. No. 13/274,540. |
U.S. Office Action, Non/Final, dated Aug. 26, 2014 for U.S. Appl. No. 13/274,540. |
U.S. Office Action, Notice of Allowance, dated Jan. 21, 2015 for U.S. Appl. No. 13/274,540. |
U.S. Office Action, Non/Final, dated Apr. 1, 2013 for U.S. Appl. No. 13/274,805. |
U.S. Office Action, Final, dated Sep. 12, 2013 for U.S. Appl. No. 13/274,805. |
U.S. Office Action, Non/Final, dated Aug. 14, 2014 for U.S. Appl. No. 13/274,805. |
U.S. Office Action, Notice of Allowance, dated Nov. 28, 2014 for U.S. Appl. No. 13/274,805. |
U.S. Office Action, Notice of Allowance, dated Jan. 21, 2015 for U.S. Appl. No. 13/274,805. |
U.S. Office Action, Restriction Requirement, dated Apr. 29, 2013 for U.S. Appl. No. 13/274,830. |
U.S. Office Action, Non/Final, dated Jun. 14, 2013 for U.S. Appl. No. 13/274,830. |
U.S. Office Action, Final, dated Nov. 26, 2013 for U.S. Appl. No. 13/274,830. |
U.S. Office Action, Non/Final, dated Oct. 22, 2014 for U.S. Appl. No. 13/274,830. |
U.S. Office Action, Restriction Requirement, dated Apr. 4, 2013 for U.S. Appl. No. 13/275,495. |
U.S. Office Action, Non/Final, dated May 31, 2013 for U.S. Appl. No. 13/275,495. |
U.S. Office Action, Final, dated Dec. 5, 2013 for U.S. Appl. No. 13/275,495. |
U.S. Office Action, Non/Final, dated Feb. 25, 2015 for U.S. Appl. No. 13/275,495. |
U.S. Office Action, Non/Final, dated Jan. 6, 2014 for U.S. Appl. No. 13/275,514. |
U.S. Office Action, Non/Final, dated Sep. 9, 2014 for U.S. Appl. No. 13/275,514. |
U.S. Office Action, Non/Final, dated May 17, 2013 for U.S. Appl. No. 13/275,547. |
U.S. Office Action, Final, dated Feb. 28, 2014 for U.S. Appl. No. 13/275,547. |
U.S. Office Action, Non/Final, dated Aug. 20, 2014 for U.S. Appl. No. 13/275,547. |
U.S. Office Action, Non/Final, dated Feb. 1, 2013 for U.S. Appl. No. 13/275,563. |
U.S. Office Action, Final, dated Aug. 29, 2013 for U.S. Appl. No. 13/275,563. |
U.S. Office Action, Non/Final, dated Oct. 23, 2014 for U.S. Appl. No. 13/275,563. |
U.S. Office Action, Restriction Requirement, dated Feb. 6, 2013 for U.S. Appl. No. 13/276,660. |
U.S. Office Action, Non/Final, dated Jun. 3, 2013 for U.S. Appl. No. 13/246,660. |
U.S. Office Action, Restriction Requirement, dated Jul. 9, 2014 for U.S. Appl. No. 13/276,660. |
U.S. Office Action, Notice of Allowance, dated Jun. 17, 2015 for U.S. Appl. No. 13/276,660. |
U.S. Office Action, Non/Final, dated Dec. 21, 2012 for U.S. Appl. No. 13/276,673. |
U.S. Office Action, Non/Final, dated Aug. 19, 2013 for U.S. Appl. No. 13/276,673. |
U.S. Office Action, Final, dated Mar. 21, 2014 for U.S. Appl. No. 13/276,673. |
U.S. Office Action, Non/Final, dated Aug. 14, 2014 for U.S. Appl. No. 13/276,673. |
U.S. Office Action, Final, dated Mar. 13, 2015 for U.S. Appl. No. 13/276,673. |
U.S. Office Action, Restriction Requirement, dated Feb. 6, 2013 for U.S. Appl. No. 13/276,687. |
U.S. Office Action, Non/Final, dated Jun. 12, 2013 for U.S. Appl. No. 13/276,687. |
U.S. Office Action, Notice of Allowance, dated Nov. 12, 2013 for U.S. Appl. No. 13/276,687. |
U.S. Office Action, Notice of Allowance, dated Jun. 2, 2014 for U.S. Appl. No. 13/276,687. |
U.S. Office Action, Notice of Allowance, dated Sep. 12, 2014 for U.S. Appl. No. 13/276,687. |
U.S. Office Action, Notice of Allowance, dated Dec. 23, 2014 for U.S. Appl. No. 13/276,687. |
U.S. Office Action, Restriction Requirement, dated Feb. 21, 2013 for U.S. Appl. No. 13/276,707. |
U.S. Office Action, Non/Final, dated May 6, 2013 for U.S. Appl. No. 13/276,707. |
U.S. Office Action, Final, dated Sep. 27, 2013 for U.S. Appl. No. 13/276,707. |
U.S. Office Action, Non/Final, dated Jan. 29, 2015 for U.S. Appl. No. 13/276,707. |
U.S. Office Action, Restriction Requirement, dated Feb. 6, 2013 for U.S. Appl. No. 13/276,725. |
U.S. Office Action, Non/Final, dated Aug. 20, 2014 for U.S. Appl. No. 13/276,725. |
U.S. Office Action, Restriction Requirement, dated Dec. 21, 2012 for U.S. Appl. No. 13/276,745. |
U.S. Office Action, Non/Final, dated Apr. 30, 2013 for U.S. Appl. No. 13/276,745. |
U.S. Office Action, Final, dated Nov. 8, 2013 for U.S. Appl. No. 13/276,745. |
U.S. Office Action, Non/Final, dated Feb. 28, 2014 for U.S. Appl. No. 13/276,745. |
U.S. Office Action, Notice of Allowance, dated Oct. 7, 2014 for U.S. Appl. No. 13/276,745. |
U.S. Office Action, Notice of Allowance, dated Dec. 19, 2014 for U.S. Appl. No. 13/276,745. |
U.S. Office Action, Restriction Requirement, dated Sep. 24, 2014 for U.S. Appl. No. 13/277,328. |
U.S. Office Action, Non/Final, dated Dec. 8, 2014 for U.S. Appl. No. 13/277,328. |
U.S. Office Action, Final, dated Mar. 24, 2015 for U.S. Appl. No. 13/277,328. |
U.S. Office Action, Notice of Allowance, dated Jun. 1, 2015 for U.S. Appl. No. 13/277,328. |
U.S. Office Action, Notice of Allowance, dated Jun. 17, 2016 for U.S. Appl. No. 13/277,328. |
International Search Report and Written Opinion dated Feb. 24, 2016 for Application No. PCT/US2015/053935, 16 pgs. |
Number | Date | Country | |
---|---|---|---|
20160120601 A1 | May 2016 | US |