1. Technical Field
The present invention relates generally to an electrosurgical instrument and, more particularly to an electrosurgical pencil having drag sensing capabilities.
2. Background of Related Art
Electrosurgical instruments have become widely used by surgeons in recent years. Accordingly, a need has developed for equipment that is easy to handle and operate, reliable and safe. By and large, most electrosurgical instruments typically include a hand-held instrument, or pencil, which transfers radio-frequency (RF) electrical energy to a tissue site. The electrosurgical energy is returned to the electrosurgical source via a return electrode pad positioned under a patient (i.e., a monopolar system configuration) or a smaller return electrode positionable in bodily contact with or immediately adjacent to the surgical site (i.e., a bipolar system configuration). The waveforms produced by the RF source yield a predetermined electrosurgical effect known generally as electrosurgical fulguration.
In particular, electrosurgical fulguration comprises the application of electric spark to biological tissue, for example, human flesh or the tissue of internal organs, without significant cutting. The spark is produced by bursts of radio-frequency electrical energy generated from an appropriate electrosurgical generator. Generally, fulguration is used to dehydrate, shrink, necrose or char the tissue. As a result, the instrument is primarily used to stop bleeding and oozing. These operations are generically embraced by the term “Coagulation”. Meanwhile, electrosurgical cutting includes the use of the applied electric spark to tissue which produces a cutting effect. Electrosurgical searing includes utilizing both electrosurgical energy and pressure to melt the tissue collagen into a fused mass.
As used herein the term “electrosurgical pencil” is intended to include instruments which have a handpiece which is attached to an active electrode and are used to coagulate, cut and/or sear tissue. The pencil may be operated by a handswitch or a foot switch. The active electrode is an electrically conducting element which is usually elongated and may be in the form of a thin flat blade with a pointed or rounded distal end. Alternatively, the active electrode may include an elongated narrow cylindrical needle which is solid or hollow with a flat, rounded, pointed or slanted distal end. Typically electrodes of this sort are known in the art as “blade”, “loop” or “snare”, “needle” or “ball” electrodes.
As mentioned above, the handpiece of the pencil is connected to a suitable electrosurgical source (i.e., generator) which produces the radio-frequency electrical energy necessary for the operation of the electrosurgical pencil. In general, when an operation is performed on a patient with an electrosurgical pencil, electrical energy from the electrosurgical generator is conducted through the active electrode to the tissue at the site of the operation and then through the patient to a return electrode. The return electrode is typically placed at a convenient place on the patient's body and is attached to the generator by a conductive material.
When using electrosurgical instruments in an operation, the active electrode may be rendered less efficient if the tissue distorts or encounters inconsistencies in the tissue. These instances are sensed as a change in the tension required to pass the electrode through the tissue (i.e., “drag”).
Also, when using electrosurgical instruments in an operation, the tissue tends to to char during the surgical procedure and adhere to the active electrode. When the active electrode is an electrosurgical blade, the charred tissue can in some instances effect the overall performance of the electrosurgical blade. Performance degradation of the blade may reduce the effectiveness of the instrument during the operation. For example, a build up of charred tissue on the active electrode may effect cutting efficiency of the blade. As a result, the surgeon may find it necessary to increase the electrical current to the electrosurgical blade in order to compensate for the degradation of the cutting blade. This raises the possibility that the tissue will be more easily and rapidly charred when contacting the tissue.
Another concern resulting from the build up of charred tissue on the active electrode is that the charred tissue can fracture and contaminate the surgical site which may delay the overall healing process. The build up of charred tissue on the active electrode may also increase drag (i.e., the amount of resistance the body tissue exhibits during cutting). Drag may distort the tissue and consequently alter anatomical relationships which can effect proper suturing, possibly delay healing, and result in more visible scarring.
Accordingly, the need exists for an electrosurgical pencil which includes drag sensing capabilities to readily alert the operator when the drag force acting on the electrosurgical blade has surpassed a predetermined threshhold level and/or the electrosurgical blade has been displaced beyond a predetermined acceptable level.
An electrosurgical pencil being configured and adapted to provide an operator with the ability to monitor the degree of drag taking place at the cutting tip of the electrosurgical pencil, as the cutting tip is advanced through body tissue, is disclosed. The electrosurgical pencil includes an elongated housing having a blade receptacle provided at a distal end thereof, an electrocautery blade supported within the blade receptacle, wherein the blade has a distal end extending distally from the housing and a proximal end extending into the housing, an activation button electrically coupled to the blade and a strain gauge affixed to the electrocautery blade for measuring a displacement of the blade. Preferably, the strain gauge is either a wire, a foil, a semiconductor material or an optical strain transducer.
In a preferred embodiment, the strain gauge includes a temperature compensator resistor electrically coupled to the strain gauge or a temperature compensated transducer. The compensator resistor being configured and adapted to compensate for displacement variations due to changes in temperature.
In a further preferred embodiment, the activation button is supported on the housing. In another preferred embodiment, the strain gauge is mechanically coupled to a proximal end of the electrocautery blade.
It is contemplated that the strain gauge mounted in the electrosurgical pencil is connected to an appropriate signal conditioner that monitors a change in voltage, a change in electrical current and/or a change in optical wavelength.
It is contemplated that the electrosurgical pencil provide an indication of the mechanical resistance of the blade passing through tissue in terms of strain gauge signal amplitude. This strain signal output provides sensor feedback in a control system that controls the wave form output of the electrosurgical generator.
It is further contemplated that the electrosurgical pencil preferably include means for producing a signal when the strain gauge measures a displacement of the blade which satisfies a predetermined level and, more preferably a feedback system which produces an audible and/or a visible signal when the predetermined level is met.
In an alternative embodiment, electrosurgical instrument includes a control circuit electrically coupled between the electrocautery blade and the electrosurgical generator. The control circuit is configured and adapted to control power supplied to electrocautery blade based on the displacement measured by the strain gauge. Preferably, the control circuit is configured and adapted to increase the power supplied to the electrocautery blade when the displacement of the electrocautery blade, measured by the strain gauge, is greater than a preset value and decreases the power supplied to the electrocautery blade when the displacement of the electrocautery blade, measured by the strain gauge, is less than a preset value.
These and other objects will be more clearly illustrated below by the description of the drawings and the detailed description of the preferred embodiments.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with a general description of the invention given above, and the detailed description of the embodiments given below, serve to explain the principles of the invention.
Preferred embodiments of the presently disclosed electrosurgical pencil will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein, the term “distal” refers to that portion which is further from the user while the term “proximal” refers to that portion which is closer to the user.
As shown, electrosurgical pencil 10 is coupled to a conventional electrosurgical generator 18 via connecting wire 20. Connecting wire 20 includes a current wire 22 which electrically interconnects electrosurgical generator 18 and the proximal end of blade 16 and a coating 21 which electrically insulates and encapsulates current wire 22 to protect the operator from stray electrical currents. By way of example only, electrosurgical generator 18 may be any one the following, or equivalents thereof: the “FORCE FX”, “FORCE 2” or “FORCE 4” generators manufactured by Valleylab, Inc of Boulder, Co. Ideally, the electrosurgical generator can be preset to selectively provide an appropriate first predetermined RF signal (e.g., 1 to 300 watts) for tissue cutting and an appropriate second predetermined RF signal (e.g., 1 to 120 watts) for tissue coagulation.
Electrosurgical pencil 10 further includes an activation button 24 supported on an outer surface of housing 12. Activation button 24 is operable to control a depressible switch 26 which is used to control the RF electrical energy supplied to blade 16. It is contemplated that electrosurgical pencil 10 further includes an electrical control circuit (not shown) which is electrically coupled between current wire 22 and activation button 24. In one embodiment the control circuit includes conventional on/off connection capabilities as well as high/low power capabilities utilizing a conventional resistive matrix. It will be apparent to those skilled in the art that virtually any control circuit may be utilized which regulates/monitors the electrical energy passing through current wire 22 between depressible switch 26 and blade receptacle 14.
In accordance with the present invention, electrosurgical pencil 10 further includes a strain gauge 30 (i.e., a device used to measure mechanical displacement/deflection) mounted to the surface of the proximal end 15 of blade 16. Strain gauge 30 includes a pair of signal wires 32 electrically or a pair of optical fibers 33 (see
It is contemplated that strain gauge 30 be made of wire, foil or semiconductor material. Wire and foil strain gauges are typically constructed by cementing a high-resistance metal to a backing of paper or epoxy, which is then cemented to the structural element (i.e., the proximal end 15 of blade 16). It is contemplated that in order to obtain a higher resistance, the wire or foil making up the strain gauge is often folded in a zig-zag pattern on the backing. As is known in the art, many of the wires and foils which have desirable characteristics as strain gauge materials are also sensitive to changes in temperature. In other words, changes in temperature will alter the resistance of the wire. Thus, in the present instance, wherein changes in temperature in blade 16 are likely, it is contemplated that strain gauge 30 be provided with a compensator resistor 34, placed in close proximity to the strain gauge. Preferably, resistor 34 is configured to compensate for the changes in temperature experienced by blade 16 which are measured by strain gauge 30. It is further contemplated that a semiconductor strain gauge made up of piezoresistive material, usually silicone, be used. In operation, when pressure (i.e., resistance due to drag) is applied to the underlying substrate (i.e., blade 16), the resistance of the metal making up the strain gauge is altered and typically a change in the output voltage and/or electrical current can be monitored. Alternatively, strain gauge 30 could be an optical transducer.
As seen in particular in
As used in the present invention, as the drag acting against the distal end 17 of blade 16 increases, due to the pressure applied by the operator and/or the build up of charred tissue on blade 16, the deflection and/or displacement of the proximal end 15 of blade 16 will also increase. The displacement of the proximal end 15 of blade 16 is measured by strain gauge 30 which, in turn, converts this displacement into an electrical or optical signal which can be monitored on generator 18. Accordingly, as the operator uses pencil 10 to cut or coagulate, the operator continually monitors meter 36 for any significant changes which surpass a predetermined threshold level. These changes alert the operator that either: 1) the advancement of blade 16 through the tissue site is too fast which may result in the tissue becoming distorted; or 2) that the build up of charred tissue on blade 16 is approaching a level at which continued advancement of electrosurgical pencil 10 may cause the tissue to become distorted.
It is contemplated that electrosurgical pencil 10 may be provided with a feedback system, as will be described in greater detail below, connected to the electrosurgical generator. The feedback of the sensed drag would contribute an input to a control circuit in the generator that modulates the generator output waveform. For example, increased drag Would indicate the need for increasing the output current to the active electrode.
It is further contemplated that electrosurgical pencil 10 may be provided with an audible or visible (i.e., light) feedback system (not shown) which would indicate to the operator when the drag acting on the distal end of blade 16 is approaching, has equaled or has surpassed the predetermined threshold level. For example, feedback system can include a buzzer and/or light which are set to be activated when the level on meter 36 on meter 36 reaches a certain predetermined number or range level. In this manner, the operator does not have to actively monitor meter 36. Instead, the operator can focus on the target tissue site and be alerted either by the sound of a buzzer, by the flashing of a light, or by both when the resistance acting against the advancement of the distal end of blade 16 has become greater than the predetermined threshold level. Over time, it is envisioned that the operator of electrosurgical pencil 10 will condition himself or herself to tactily recognize when the resistance on the distal end of blade 16 is becoming too great.
Turning now to
As shown, electrosurgical pencil 100 is coupled to a conventional electrosurgical generator 118 via connecting wire 120. Connecting wire 120 includes a current wire 122 which electrically interconnects electrosurgical generator 118 and the proximal end of blade 116 and a coating 121 which electrically insulates and encapsulates current wire 122 to protect the operator from stray electrical current. Electrosurgical pencil 100 further includes an activation button 124 supported on an outer surface of housing 112. Activation button 124 is operable to control a depressible switch 126 which is used to control the RF electrical energy supplied to blade 116. It is contemplated that electrosurgical pencil 100 further includes an electrical control circuit 110 which is electrically coupled between current wire 122 and activation button 124. In one embodiment, control circuit 110 includes conventional on/off connection capabilities as well as high/low power capabilities utilizing a conventional resistive matrix.
As seen in
One mode of operation of electrical control circuit 110 is best illustrated with reference to
Operation of control circuit 110 will now be described in detail with reference to
If the measured drag signal is above the preset “drag value”, drag evaluation circuit 142 transmits a signal to feedback correction circuit 144 which in turn instructs electrosurgical generator 118 to increase the energy output to blade 116. In addition, feedback correction circuit 144 resets the “drag value” to the value of the higher measured drag signal. If the measured drag signal is not above the preset “drag value”, drag evaluation circuit 142 evaluates to see if the measured drag signal is below the preset “drag value.” If the measured drag signal is below the preset “drag value”, drag evaluation circuit 142 transmits a signal to feedback correction circuit 144 which in turn instructs electrosurgical generator 118 to decrease the energy output to blade 116. In addition, feedback correction circuit 144 resets the “drag value” to the value of the lower measured drag signal. If the measured drag signal is not below the preset “drag value” the evaluation process repeats from the beginning.
This evaluation process is continually ongoing so long as electrosurgical pencil 100 is activated. Preferably, the evaluation process occurs on the order of 100 times per second. In this manner, the power delivered to blade 116 is constantly monitored and adjusted in order to ensure that minimal trauma to the target site occurs. It is envisioned that the evaluation rate can be adjusted as needed. For example, a higher rate of evaluation may be desired for more delicate target surgical sites while a reduced rate of evaluation may be desired for hardier target sites.
It is envisioned that control circuit 110 can be provided with a cut-off control circuit (not shown). Cut-off control circuit would prevent the power being delivered to blade 116 from exceeding a threshold value in order to prevent electrosurgical pencil 100 from transmitting a damaging amount of energy to the target surgical site.
While the present invention has been particularly shown and described with reference to the preferred embodiments thereof, it will be understood by those skilled in the art that the foregoing and other changes in form and details may be made therein without departing from the spirit and scope of the invention. For example, as discussed above, while the present invention has been described as being used in connection with an electrosurgical pencil, it is envisioned that the present invention can be used in connection with any electrocautery device. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.
This application is a continuation application claiming the benefit of and priority to U.S. application Ser. No. 12/137,717 filed Jun. 12, 2008, now U.S. Pat. No. 7,621,909, which is a continuation of U.S. patent application Ser. No. 10/521,901 filed Oct. 5, 2005, now U.S. Pat. No. 7,393,354, which is a U.S. National Stage Application that claims the benefit under 35 U.S.C. §371(a) of International Patent Application Ser. No. PCT/US03/22900 filed on Jul. 23, 2003, which claims the benefit of priority to U.S. Provisional Patent Application Ser. No. 60/398,620 filed Jul. 25, 2002 and U.S. Provisional Patent Application Ser. No. 60/413,410 filed Sep. 25, 2002, the entire contents of each of which are incorporated herein by reference.
Number | Name | Date | Kind |
---|---|---|---|
2031682 | Charles et al. | Feb 1936 | A |
2102270 | Hyams | Dec 1937 | A |
2993178 | Burger | Jul 1961 | A |
3058470 | Seeliger et al. | Oct 1962 | A |
3219029 | Richards et al. | Nov 1965 | A |
3421509 | Fiore | Jan 1969 | A |
3460539 | Anhalt, Sr. | Aug 1969 | A |
3494363 | Jackson | Feb 1970 | A |
3565078 | Vailliancort et al. | Feb 1971 | A |
3648001 | Anderson et al. | Mar 1972 | A |
3675655 | Sittner | Jul 1972 | A |
3699967 | Anderson | Oct 1972 | A |
3720896 | Beierlein | Mar 1973 | A |
3801766 | Morrison, Jr. | Apr 1974 | A |
3801800 | Newton | Apr 1974 | A |
3825004 | Durden, III | Jul 1974 | A |
3828780 | Morrison, Jr. | Aug 1974 | A |
3853127 | Spademan | Dec 1974 | A |
3875945 | Friedman | Apr 1975 | A |
3902494 | Haberlen et al. | Sep 1975 | A |
3906955 | Roberts | Sep 1975 | A |
3907310 | Dufour | Sep 1975 | A |
3911241 | Jarrard | Oct 1975 | A |
3967084 | Pounds | Jun 1976 | A |
3974833 | Durden, III | Aug 1976 | A |
3994287 | Turp et al. | Nov 1976 | A |
4000739 | Stevens | Jan 1977 | A |
4014343 | Esty | Mar 1977 | A |
4032738 | Esty et al. | Jun 1977 | A |
4034761 | Prater et al. | Jul 1977 | A |
4038984 | Sittner | Aug 1977 | A |
4112932 | Chiulli | Sep 1978 | A |
4112950 | Pike | Sep 1978 | A |
D253247 | Gill | Oct 1979 | S |
4173350 | Sieghartner | Nov 1979 | A |
4177814 | Knepshield et al. | Dec 1979 | A |
4177997 | Cartwright | Dec 1979 | A |
4232676 | Herczog | Nov 1980 | A |
4240335 | Stucka et al. | Dec 1980 | A |
4240411 | Hosono | Dec 1980 | A |
4311315 | Kronenberg | Jan 1982 | A |
4314559 | Allen | Feb 1982 | A |
4334688 | Spargo et al. | Jun 1982 | A |
4338689 | Zieg | Jul 1982 | A |
4386756 | Muchow | Jun 1983 | A |
4387879 | Tauschinski | Jun 1983 | A |
4427006 | Nottke | Jan 1984 | A |
4430081 | Timmermans | Feb 1984 | A |
4443935 | Zamba et al. | Apr 1984 | A |
4447237 | Frisch et al. | May 1984 | A |
4459443 | Lewandowski | Jul 1984 | A |
4463234 | Bennewitz | Jul 1984 | A |
4463759 | Garito et al. | Aug 1984 | A |
4464178 | Dalton | Aug 1984 | A |
4492231 | Auth | Jan 1985 | A |
4492832 | Taylor | Jan 1985 | A |
4545375 | Cline | Oct 1985 | A |
4553760 | Reed et al. | Nov 1985 | A |
4562838 | Walker | Jan 1986 | A |
4588195 | Antonini et al. | May 1986 | A |
4589411 | Friedman | May 1986 | A |
4593691 | Lindstrom et al. | Jun 1986 | A |
4595809 | Pool | Jun 1986 | A |
4601710 | Moll | Jul 1986 | A |
4606342 | Zamba et al. | Aug 1986 | A |
4619258 | Pool | Oct 1986 | A |
4620548 | Hasselbrack | Nov 1986 | A |
4625723 | Altnether et al. | Dec 1986 | A |
4626245 | Weinstein | Dec 1986 | A |
4640279 | Beard | Feb 1987 | A |
4641842 | Kataoka | Feb 1987 | A |
4642128 | Solorzano | Feb 1987 | A |
4654030 | Moll et al. | Mar 1987 | A |
4655215 | Pike | Apr 1987 | A |
4655752 | Honkanen et al. | Apr 1987 | A |
4657016 | Garito et al. | Apr 1987 | A |
4673393 | Suzuki et al. | Jun 1987 | A |
4683884 | Hatfield et al. | Aug 1987 | A |
4688569 | Rabinowitz | Aug 1987 | A |
4701193 | Robertson et al. | Oct 1987 | A |
4705511 | Kocak | Nov 1987 | A |
4712544 | Ensslin | Dec 1987 | A |
4715360 | Akui et al. | Dec 1987 | A |
4723550 | Bales et al. | Feb 1988 | A |
4735603 | Goodson et al. | Apr 1988 | A |
4754754 | Garito et al. | Jul 1988 | A |
4758225 | Cox et al. | Jul 1988 | A |
4785807 | Blanch | Nov 1988 | A |
4788977 | Farin et al. | Dec 1988 | A |
4794215 | Sawada et al. | Dec 1988 | A |
4796623 | Krasner et al. | Jan 1989 | A |
4803323 | Bauer et al. | Feb 1989 | A |
4811733 | Borsanyi et al. | Mar 1989 | A |
4827911 | Broadwin et al. | May 1989 | A |
4827927 | Newton | May 1989 | A |
D301739 | Turner et al. | Jun 1989 | S |
4842591 | Luther | Jun 1989 | A |
4844483 | Iijima et al. | Jul 1989 | A |
4844484 | Antonini et al. | Jul 1989 | A |
4846790 | Hornlein et al. | Jul 1989 | A |
4850353 | Stasz et al. | Jul 1989 | A |
4857062 | Russell | Aug 1989 | A |
4860745 | Farin et al. | Aug 1989 | A |
4862889 | Feucht | Sep 1989 | A |
4862890 | Stasz et al. | Sep 1989 | A |
4869715 | Sherburne | Sep 1989 | A |
4869717 | Adair | Sep 1989 | A |
4872454 | DeOliveira et al. | Oct 1989 | A |
4874378 | Hillstead | Oct 1989 | A |
4876110 | Blanch | Oct 1989 | A |
4886060 | Wiksell | Dec 1989 | A |
4889349 | Muller | Dec 1989 | A |
4901719 | Trenconsky et al. | Feb 1990 | A |
4903696 | Stasz et al. | Feb 1990 | A |
4909249 | Akkas et al. | Mar 1990 | A |
4909798 | Fleischhacker et al. | Mar 1990 | A |
4911159 | Johnson et al. | Mar 1990 | A |
4916275 | Almond | Apr 1990 | A |
4917668 | Haindl | Apr 1990 | A |
4919129 | Weber, Jr. et al. | Apr 1990 | A |
4921476 | Wuchinich | May 1990 | A |
4922903 | Welch et al. | May 1990 | A |
4929235 | Merry et al. | May 1990 | A |
4931047 | Broadwin et al. | Jun 1990 | A |
4932633 | Johnson et al. | Jun 1990 | A |
4943280 | Lander | Jul 1990 | A |
4949734 | Bernstein | Aug 1990 | A |
4960412 | Fink | Oct 1990 | A |
4966588 | Rayman et al. | Oct 1990 | A |
4969885 | Farin | Nov 1990 | A |
4986839 | Wertz et al. | Jan 1991 | A |
4988334 | Hornlein et al. | Jan 1991 | A |
4998740 | Tellier | Mar 1991 | A |
5000745 | Guest et al. | Mar 1991 | A |
5000754 | DeOliveira et al. | Mar 1991 | A |
5002557 | Hasson | Mar 1991 | A |
5011483 | Sleister | Apr 1991 | A |
5013312 | Parins et al. | May 1991 | A |
5015000 | Perini | May 1991 | A |
5015227 | Broadwin et al. | May 1991 | A |
5026085 | Ducote | Jun 1991 | A |
5026368 | Adair | Jun 1991 | A |
5035695 | Weber, Jr. et al. | Jul 1991 | A |
5035696 | Rydell | Jul 1991 | A |
5038756 | Kepley | Aug 1991 | A |
5041095 | Littrell | Aug 1991 | A |
5046506 | Singer | Sep 1991 | A |
5053014 | Van Heugten | Oct 1991 | A |
5053016 | Lander | Oct 1991 | A |
5055100 | Olsen | Oct 1991 | A |
5071418 | Rosenbaum | Dec 1991 | A |
5073169 | Raiken | Dec 1991 | A |
5074863 | Dines | Dec 1991 | A |
5076276 | Sakurai et al. | Dec 1991 | A |
5085657 | Ben-Simhon | Feb 1992 | A |
5088997 | Delahuerga et al. | Feb 1992 | A |
5098430 | Fleenor | Mar 1992 | A |
5100402 | Fan | Mar 1992 | A |
5104383 | Schichman | Apr 1992 | A |
5108391 | Flachenecker et al. | Apr 1992 | A |
5127626 | Hilal et al. | Jul 1992 | A |
5133714 | Beane | Jul 1992 | A |
5137520 | Maxson et al. | Aug 1992 | A |
5147292 | Kullas et al. | Sep 1992 | A |
D330253 | Burek | Oct 1992 | S |
5154709 | Johnson | Oct 1992 | A |
5160334 | Billings et al. | Nov 1992 | A |
5162044 | Gahn et al. | Nov 1992 | A |
5167636 | Clement | Dec 1992 | A |
5167659 | Ohtomo et al. | Dec 1992 | A |
5178012 | Culp | Jan 1993 | A |
5178605 | Imonti | Jan 1993 | A |
5180373 | Green et al. | Jan 1993 | A |
5190517 | Zieve et al. | Mar 1993 | A |
5192267 | Shapira et al. | Mar 1993 | A |
5195959 | Smith | Mar 1993 | A |
5196007 | Ellman et al. | Mar 1993 | A |
5197955 | Stephens et al. | Mar 1993 | A |
5197962 | Sansom et al. | Mar 1993 | A |
5199944 | Cosmescu | Apr 1993 | A |
5201714 | Gentelia et al. | Apr 1993 | A |
5209736 | Stephens et al. | May 1993 | A |
5209737 | Ritchart et al. | May 1993 | A |
5217457 | Delahuerga et al. | Jun 1993 | A |
5221264 | Wilk et al. | Jun 1993 | A |
5224944 | Elliott | Jul 1993 | A |
5226891 | Bushatz et al. | Jul 1993 | A |
5226904 | Gentelia et al. | Jul 1993 | A |
5233515 | Cosman | Aug 1993 | A |
5234428 | Kaufman | Aug 1993 | A |
5234429 | Goldhaber | Aug 1993 | A |
5242412 | Blake, III | Sep 1993 | A |
5242442 | Hirschfeld | Sep 1993 | A |
5244462 | Delahuerga et al. | Sep 1993 | A |
5246440 | Van Noord | Sep 1993 | A |
5254082 | Takase | Oct 1993 | A |
5254117 | Rigby et al. | Oct 1993 | A |
5256138 | Burek et al. | Oct 1993 | A |
5261906 | Pennino et al. | Nov 1993 | A |
5261918 | Phillips et al. | Nov 1993 | A |
5269781 | Hewell, III | Dec 1993 | A |
5290304 | Storace | Mar 1994 | A |
5299813 | McKenna | Apr 1994 | A |
5300036 | Mueller et al. | Apr 1994 | A |
5300087 | Knoepfler | Apr 1994 | A |
5304763 | Ellman et al. | Apr 1994 | A |
5306238 | Fleenor | Apr 1994 | A |
5308336 | Hart et al. | May 1994 | A |
5312329 | Beaty et al. | May 1994 | A |
5312400 | Bales et al. | May 1994 | A |
5312401 | Newton et al. | May 1994 | A |
5313935 | Kortenbach et al. | May 1994 | A |
5318516 | Cosmescu | Jun 1994 | A |
5318565 | Kuriloff et al. | Jun 1994 | A |
5322503 | Desai | Jun 1994 | A |
5324270 | Kayan et al. | Jun 1994 | A |
5330470 | Hagen | Jul 1994 | A |
5334183 | Wuchinich | Aug 1994 | A |
5342315 | Rowe et al. | Aug 1994 | A |
5342356 | Ellman et al. | Aug 1994 | A |
5348555 | Zinnanti | Sep 1994 | A |
5366464 | Belknap | Nov 1994 | A |
5376077 | Gomringer | Dec 1994 | A |
5376089 | Smith | Dec 1994 | A |
5380320 | Morris | Jan 1995 | A |
5382247 | Cimino et al. | Jan 1995 | A |
5385553 | Hart et al. | Jan 1995 | A |
5395342 | Yoon | Mar 1995 | A |
5395363 | Billings et al. | Mar 1995 | A |
5399823 | McCusker | Mar 1995 | A |
5400267 | Denen et al. | Mar 1995 | A |
5401273 | Shippert | Mar 1995 | A |
5403882 | Huggins | Apr 1995 | A |
5406945 | Riazzi et al. | Apr 1995 | A |
5407433 | Loomas | Apr 1995 | A |
5409484 | Erlich et al. | Apr 1995 | A |
5411483 | Loomas et al. | May 1995 | A |
5413575 | Haenggi | May 1995 | A |
5421829 | Olichney et al. | Jun 1995 | A |
5423838 | Willard | Jun 1995 | A |
5431645 | Smith et al. | Jul 1995 | A |
5431650 | Cosmescu | Jul 1995 | A |
5431667 | Thompson et al. | Jul 1995 | A |
5451222 | De Maagd et al. | Sep 1995 | A |
5456284 | Ryan et al. | Oct 1995 | A |
5460602 | Shapira | Oct 1995 | A |
5462522 | Sakurai et al. | Oct 1995 | A |
5468240 | Gentelia et al. | Nov 1995 | A |
5472442 | Klicek | Dec 1995 | A |
5472443 | Cordis et al. | Dec 1995 | A |
5484398 | Stoddard | Jan 1996 | A |
5484434 | Cartmell et al. | Jan 1996 | A |
5486162 | Brumbach | Jan 1996 | A |
5496280 | Vandenbroek et al. | Mar 1996 | A |
5496314 | Eggers | Mar 1996 | A |
5498654 | Shimasaki et al. | Mar 1996 | A |
5514098 | Pfoslgraf et al. | May 1996 | A |
5519197 | Robinson et al. | May 1996 | A |
D370731 | Corace et al. | Jun 1996 | S |
5531722 | Van Hale | Jul 1996 | A |
5545142 | Stephens et al. | Aug 1996 | A |
5549604 | Sutcu et al. | Aug 1996 | A |
5561278 | Rutten | Oct 1996 | A |
5601224 | Bishop et al. | Feb 1997 | A |
5609573 | Sandock | Mar 1997 | A |
5626575 | Crenner | May 1997 | A |
5630417 | Petersen et al. | May 1997 | A |
5630426 | Eggers et al. | May 1997 | A |
5630812 | Ellman et al. | May 1997 | A |
5633578 | Eggers et al. | May 1997 | A |
5634908 | Loomas | Jun 1997 | A |
5634911 | Hermann et al. | Jun 1997 | A |
5634912 | Injev | Jun 1997 | A |
5634935 | Taheri | Jun 1997 | A |
5634937 | Mollenauer et al. | Jun 1997 | A |
5643256 | Urueta | Jul 1997 | A |
D384148 | Monson | Sep 1997 | S |
5662647 | Crow et al. | Sep 1997 | A |
5667489 | Kraff et al. | Sep 1997 | A |
5669907 | Platt, Jr. et al. | Sep 1997 | A |
5674219 | Monson et al. | Oct 1997 | A |
5685858 | Kawand | Nov 1997 | A |
5693044 | Cosmescu | Dec 1997 | A |
5693050 | Speiser | Dec 1997 | A |
5693052 | Weaver | Dec 1997 | A |
5697926 | Weaver | Dec 1997 | A |
5702360 | Dieras et al. | Dec 1997 | A |
5702387 | Arts et al. | Dec 1997 | A |
5712543 | Sjostrom | Jan 1998 | A |
5713895 | Lontine et al. | Feb 1998 | A |
5720745 | Farin et al. | Feb 1998 | A |
D393067 | Geary et al. | Mar 1998 | S |
5749869 | Lindenmeier et al. | May 1998 | A |
5749871 | Hood et al. | May 1998 | A |
5765418 | Rosenberg | Jun 1998 | A |
5776092 | Farin et al. | Jul 1998 | A |
5788688 | Bauer et al. | Aug 1998 | A |
5797907 | Clement | Aug 1998 | A |
5800431 | Brown | Sep 1998 | A |
5827228 | Rowe | Oct 1998 | A |
5836897 | Sakurai et al. | Nov 1998 | A |
5836909 | Cosmescu | Nov 1998 | A |
5836944 | Cosmescu | Nov 1998 | A |
D402030 | Roberts et al. | Dec 1998 | S |
D402031 | Roberts et al. | Dec 1998 | S |
5843109 | Mehta et al. | Dec 1998 | A |
5846236 | Lindenmeier et al. | Dec 1998 | A |
5859527 | Cook | Jan 1999 | A |
5868768 | Wicherski et al. | Feb 1999 | A |
5876400 | Songer | Mar 1999 | A |
5888200 | Walen | Mar 1999 | A |
5893848 | Negus et al. | Apr 1999 | A |
5893849 | Weaver | Apr 1999 | A |
5893862 | Pratt et al. | Apr 1999 | A |
5913864 | Garito et al. | Jun 1999 | A |
5919219 | Knowlton | Jul 1999 | A |
5928159 | Eggers et al. | Jul 1999 | A |
5938589 | Wako et al. | Aug 1999 | A |
5941887 | Steen et al. | Aug 1999 | A |
5944737 | Tsonton et al. | Aug 1999 | A |
5951548 | DeSisto et al. | Sep 1999 | A |
5951581 | Saadat et al. | Sep 1999 | A |
5954686 | Garito et al. | Sep 1999 | A |
5972007 | Sheffield et al. | Oct 1999 | A |
6004318 | Garito et al. | Dec 1999 | A |
6004333 | Sheffield et al. | Dec 1999 | A |
6004335 | Vaitekunas et al. | Dec 1999 | A |
6010499 | Cobb | Jan 2000 | A |
6022347 | Lindenmeier et al. | Feb 2000 | A |
6045564 | Walen | Apr 2000 | A |
6063050 | Manna et al. | May 2000 | A |
6068603 | Suzuki | May 2000 | A |
6068627 | Orszulak et al. | May 2000 | A |
6070444 | Lontine et al. | Jun 2000 | A |
6071281 | Burnside et al. | Jun 2000 | A |
6074386 | Goble et al. | Jun 2000 | A |
6074387 | Heim et al. | Jun 2000 | A |
6086544 | Hibner et al. | Jul 2000 | A |
6090123 | Culp et al. | Jul 2000 | A |
6099525 | Cosmescu | Aug 2000 | A |
6117134 | Cunningham et al. | Sep 2000 | A |
6139547 | Lontine et al. | Oct 2000 | A |
D433752 | Saravia | Nov 2000 | S |
6142995 | Cosmescu | Nov 2000 | A |
6146353 | Platt, Jr. | Nov 2000 | A |
6149648 | Cosmescu | Nov 2000 | A |
6156035 | Songer | Dec 2000 | A |
6197024 | Sullivan | Mar 2001 | B1 |
6200311 | Danek et al. | Mar 2001 | B1 |
D441077 | Garito et al. | Apr 2001 | S |
6213999 | Platt, Jr. et al. | Apr 2001 | B1 |
6214003 | Morgan et al. | Apr 2001 | B1 |
6238388 | Ellman et al. | May 2001 | B1 |
6241723 | Heim et al. | Jun 2001 | B1 |
6241753 | Knowlton | Jun 2001 | B1 |
6249706 | Sobota et al. | Jun 2001 | B1 |
6251110 | Wampler | Jun 2001 | B1 |
6257241 | Wampler | Jul 2001 | B1 |
6258088 | Tzonev et al. | Jul 2001 | B1 |
6273862 | Privitera et al. | Aug 2001 | B1 |
6277083 | Eggers et al. | Aug 2001 | B1 |
6286512 | Loeb et al. | Sep 2001 | B1 |
6287305 | Heim et al. | Sep 2001 | B1 |
6287344 | Wampler et al. | Sep 2001 | B1 |
6312441 | Deng | Nov 2001 | B1 |
6325799 | Goble | Dec 2001 | B1 |
D453222 | Garito et al. | Jan 2002 | S |
D453833 | Hess | Feb 2002 | S |
6350276 | Knowlton | Feb 2002 | B1 |
6352544 | Spitz | Mar 2002 | B1 |
6355034 | Cosmescu | Mar 2002 | B2 |
6358281 | Berrang et al. | Mar 2002 | B1 |
6361532 | Burek | Mar 2002 | B1 |
D457955 | Bilitz | May 2002 | S |
6386032 | Lemkin et al. | May 2002 | B1 |
6395001 | Ellman et al. | May 2002 | B1 |
6402741 | Keppel et al. | Jun 2002 | B1 |
6402742 | Blewett et al. | Jun 2002 | B1 |
6402743 | Orszulak et al. | Jun 2002 | B1 |
6402748 | Schoenman et al. | Jun 2002 | B1 |
6409725 | Khandkar et al. | Jun 2002 | B1 |
6413255 | Stern | Jul 2002 | B1 |
6416491 | Edwards et al. | Jul 2002 | B1 |
6416509 | Goble et al. | Jul 2002 | B1 |
6425912 | Knowlton | Jul 2002 | B1 |
6458122 | Pozzato | Oct 2002 | B1 |
6458125 | Cosmescu | Oct 2002 | B1 |
6461352 | Morgan et al. | Oct 2002 | B2 |
6464702 | Schulze et al. | Oct 2002 | B2 |
6471659 | Eggers et al. | Oct 2002 | B2 |
6494882 | Lebouitz et al. | Dec 2002 | B1 |
6500169 | Deng | Dec 2002 | B1 |
6511479 | Gentelia et al. | Jan 2003 | B2 |
6526320 | Mitchell | Feb 2003 | B2 |
6551313 | Levin | Apr 2003 | B1 |
6558383 | Cunningham et al. | May 2003 | B2 |
6585664 | Burdorff et al. | Jul 2003 | B2 |
6589239 | Khandkar et al. | Jul 2003 | B2 |
6610054 | Edwards et al. | Aug 2003 | B1 |
6610057 | Ellman et al. | Aug 2003 | B1 |
6616658 | Ineson | Sep 2003 | B2 |
6618626 | West, Jr. et al. | Sep 2003 | B2 |
6620161 | Schulze et al. | Sep 2003 | B2 |
6632193 | Davison et al. | Oct 2003 | B1 |
6652514 | Ellman et al. | Nov 2003 | B2 |
6662053 | Borkan | Dec 2003 | B2 |
6669691 | Taimisto | Dec 2003 | B1 |
6685701 | Orszulak et al. | Feb 2004 | B2 |
6685704 | Greep | Feb 2004 | B2 |
6702812 | Cosmescu | Mar 2004 | B2 |
6710546 | Crenshaw | Mar 2004 | B2 |
6712813 | Ellman et al. | Mar 2004 | B2 |
6719746 | Blanco | Apr 2004 | B2 |
6740079 | Eggers et al. | May 2004 | B1 |
6747218 | Huseman et al. | Jun 2004 | B2 |
6755825 | Shoenman et al. | Jun 2004 | B2 |
D493530 | Reschke | Jul 2004 | S |
D493888 | Reschke | Aug 2004 | S |
D494270 | Reschke | Aug 2004 | S |
D495051 | Reschke | Aug 2004 | S |
D495052 | Reschke | Aug 2004 | S |
6794929 | Pelly | Sep 2004 | B2 |
6830569 | Thompson et al. | Dec 2004 | B2 |
6840948 | Albrecht et al. | Jan 2005 | B2 |
6855140 | Albrecht et al. | Feb 2005 | B2 |
6902536 | Manna et al. | Jun 2005 | B2 |
6905496 | Ellman et al. | Jun 2005 | B1 |
6923804 | Eggers et al. | Aug 2005 | B2 |
6923809 | Eggers et al. | Aug 2005 | B2 |
6939347 | Thompson | Sep 2005 | B2 |
6955674 | Eick et al. | Oct 2005 | B2 |
D515412 | Waaler et al. | Feb 2006 | S |
7033353 | Stoddard et al. | Apr 2006 | B2 |
D521641 | Reschke et al. | May 2006 | S |
D535396 | Reschke et al. | Jan 2007 | S |
7156842 | Sartor et al. | Jan 2007 | B2 |
7156844 | Reschke et al. | Jan 2007 | B2 |
7235072 | Sartor et al. | Jun 2007 | B2 |
7241294 | Reschke | Jul 2007 | B2 |
7244257 | Podhajsky et al. | Jul 2007 | B2 |
7306592 | Morgan et al. | Dec 2007 | B2 |
7311706 | Schoenman et al. | Dec 2007 | B2 |
7393354 | Buchman, II et al. | Jul 2008 | B2 |
7503917 | Sartor et al. | Mar 2009 | B2 |
7621909 | Buchman, II et al. | Nov 2009 | B2 |
20010047183 | Privitera et al. | Nov 2001 | A1 |
20010049524 | Morgan et al. | Dec 2001 | A1 |
20020019596 | Eggers et al. | Feb 2002 | A1 |
20020019631 | Kidder et al. | Feb 2002 | A1 |
20020022838 | Cunningham et al. | Feb 2002 | A1 |
20020026145 | Bagaoisan et al. | Feb 2002 | A1 |
20020035364 | Schoenman et al. | Mar 2002 | A1 |
20020049427 | Wiener et al. | Apr 2002 | A1 |
20020058958 | Walen | May 2002 | A1 |
20020087079 | Kaufman et al. | Jul 2002 | A1 |
20020095199 | West, Jr. et al. | Jul 2002 | A1 |
20020103485 | Melnyk et al. | Aug 2002 | A1 |
20020111622 | Khandkar et al. | Aug 2002 | A1 |
20020133148 | Daniel et al. | Sep 2002 | A1 |
20020151886 | Wood | Oct 2002 | A1 |
20020151887 | Stern et al. | Oct 2002 | A1 |
20020156471 | Stern et al. | Oct 2002 | A1 |
20020173776 | Batchelor et al. | Nov 2002 | A1 |
20020198519 | Qin et al. | Dec 2002 | A1 |
20030004508 | Morgan et al. | Jan 2003 | A1 |
20030014043 | Henry et al. | Jan 2003 | A1 |
20030032950 | Altshuler et al. | Feb 2003 | A1 |
20030050633 | Ellman et al. | Mar 2003 | A1 |
20030055421 | West et al. | Mar 2003 | A1 |
20030061661 | Borders et al. | Apr 2003 | A1 |
20030065321 | Carmel et al. | Apr 2003 | A1 |
20030078572 | Pearson et al. | Apr 2003 | A1 |
20030083655 | Van Wyk | May 2003 | A1 |
20030088247 | Ineson | May 2003 | A1 |
20030109864 | Greep et al. | Jun 2003 | A1 |
20030109865 | Greep et al. | Jun 2003 | A1 |
20030130663 | Walen | Jun 2003 | A1 |
20030144680 | Kellogg et al. | Jul 2003 | A1 |
20030163125 | Greep | Aug 2003 | A1 |
20030199856 | Hill et al. | Oct 2003 | A1 |
20030199866 | Stern et al. | Oct 2003 | A1 |
20030199869 | Johnson et al. | Oct 2003 | A1 |
20030212393 | Knowlton et al. | Nov 2003 | A1 |
20030212397 | Avrahami et al. | Nov 2003 | A1 |
20030216728 | Stern et al. | Nov 2003 | A1 |
20030220635 | Knowlton et al. | Nov 2003 | A1 |
20030220638 | Metzger | Nov 2003 | A1 |
20030225401 | Eggers et al. | Dec 2003 | A1 |
20030229341 | Albrecht et al. | Dec 2003 | A1 |
20030229343 | Albrecht et al. | Dec 2003 | A1 |
20040000316 | Knowlton et al. | Jan 2004 | A1 |
20040002704 | Knowlton et al. | Jan 2004 | A1 |
20040002705 | Knowlton et al. | Jan 2004 | A1 |
20040010246 | Takahashi | Jan 2004 | A1 |
20040015160 | Lovewell | Jan 2004 | A1 |
20040015161 | Lovewell | Jan 2004 | A1 |
20040015162 | McGaffigan | Jan 2004 | A1 |
20040015216 | DeSisto | Jan 2004 | A1 |
20040024395 | Ellman et al. | Feb 2004 | A1 |
20040024396 | Eggers | Feb 2004 | A1 |
20040030328 | Eggers et al. | Feb 2004 | A1 |
20040030330 | Brassell et al. | Feb 2004 | A1 |
20040030332 | Knowlton et al. | Feb 2004 | A1 |
20040030367 | Yamaki et al. | Feb 2004 | A1 |
20040034346 | Stern et al. | Feb 2004 | A1 |
20040054370 | Given | Mar 2004 | A1 |
20040111087 | Stern et al. | Jun 2004 | A1 |
20040124964 | Wang et al. | Jul 2004 | A1 |
20040127889 | Zhang et al. | Jul 2004 | A1 |
20040143677 | Novak | Jul 2004 | A1 |
20040147909 | Johnston et al. | Jul 2004 | A1 |
20040162553 | Peng et al. | Aug 2004 | A1 |
20040167512 | Stoddard et al. | Aug 2004 | A1 |
20040172011 | Wang et al. | Sep 2004 | A1 |
20040172015 | Novak | Sep 2004 | A1 |
20040172016 | Bek et al. | Sep 2004 | A1 |
20040181140 | Falwell et al. | Sep 2004 | A1 |
20040243120 | Orszulak et al. | Dec 2004 | A1 |
20040267252 | Washington et al. | Dec 2004 | A1 |
20040267254 | Manzo et al. | Dec 2004 | A1 |
20040267297 | Malackowski | Dec 2004 | A1 |
20050033286 | Eggers et al. | Feb 2005 | A1 |
20050059858 | Frith et al. | Mar 2005 | A1 |
20050059967 | Breazeale, Jr. et al. | Mar 2005 | A1 |
20050065510 | Carmel et al. | Mar 2005 | A1 |
20050070891 | DeSisto | Mar 2005 | A1 |
20050085804 | McGaffigan | Apr 2005 | A1 |
20050096645 | Wellman et al. | May 2005 | A1 |
20050096646 | Wellman et al. | May 2005 | A1 |
20050096681 | Desinger et al. | May 2005 | A1 |
20050113817 | Isaacson et al. | May 2005 | A1 |
20050113818 | Sartor et al. | May 2005 | A1 |
20050113824 | Sartor et al. | May 2005 | A1 |
20050113825 | Cosmescu | May 2005 | A1 |
20050149001 | Uchikubo et al. | Jul 2005 | A1 |
20050154385 | Heim et al. | Jul 2005 | A1 |
20060058783 | Buchman | Mar 2006 | A1 |
20060178667 | Sartor et al. | Aug 2006 | A1 |
20070049914 | Eggleston | Mar 2007 | A1 |
20070049926 | Sartor | Mar 2007 | A1 |
20070093810 | Sartor | Apr 2007 | A1 |
20070142832 | Sartor | Jun 2007 | A1 |
20070260239 | Sartor | Nov 2007 | A1 |
20070260240 | Rusin | Nov 2007 | A1 |
20090143778 | Sartor et al. | Jun 2009 | A1 |
20090149851 | Craig | Jun 2009 | A1 |
20090248008 | Kerr | Oct 2009 | A1 |
20090248010 | Fry et al. | Oct 2009 | A1 |
20090248015 | Heard et al. | Oct 2009 | A1 |
20090248016 | Heard | Oct 2009 | A1 |
20090248017 | Heard | Oct 2009 | A1 |
20090248018 | Kerr | Oct 2009 | A1 |
20090322034 | Cunningham et al. | Dec 2009 | A1 |
Number | Date | Country |
---|---|---|
24 29 021 | Jan 1976 | DE |
24 60 481 | Jun 1976 | DE |
30 45 996 | Jul 1982 | DE |
0186369 | Jul 1986 | EP |
1050277 | Nov 2000 | EP |
1050279 | Nov 2000 | EP |
1082945 | Mar 2001 | EP |
1293171 | Mar 2003 | EP |
1645233 | Apr 2006 | EP |
1645234 | Apr 2006 | EP |
1656900 | May 2006 | EP |
1852078 | Nov 2007 | EP |
2235669 | Jan 1975 | FR |
2798579 | Mar 2001 | FR |
WO 9304717 | Mar 1993 | WO |
WO 9420032 | Sep 1994 | WO |
WO 9513023 | May 1995 | WO |
WO 9604936 | Feb 1996 | WO |
WO 9639086 | Dec 1996 | WO |
WO 9704761 | Feb 1997 | WO |
WO 9843264 | Oct 1998 | WO |
WO 9853865 | Dec 1998 | WO |
WO 0164122 | Sep 2001 | WO |
WO 0247568 | Jun 2002 | WO |
WO 2004010883 | Feb 2004 | WO |
WO 2004045436 | Jun 2004 | WO |
WO 2004073753 | Sep 2004 | WO |
WO 2005060849 | Jul 2005 | WO |
WO 2009124063 | Oct 2009 | WO |
Number | Date | Country | |
---|---|---|---|
20100114088 A1 | May 2010 | US |
Number | Date | Country | |
---|---|---|---|
60398620 | Jul 2002 | US | |
60413410 | Sep 2002 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 12137717 | Jun 2008 | US |
Child | 12582799 | US | |
Parent | 10521901 | Oct 2005 | US |
Child | 12137717 | US |