1. Technical Field
The present disclosure relates generally to electrosurgical instruments and, more particularly, to an electrosurgical pencil having an integral manual aspirator/irrigator. The present disclosure is also directed to methods of using the electrosurgical pencils disclosed herein.
2. Background of Related Art
Electrosurgical instruments have become widely used by surgeons in recent years. Accordingly, a need has developed for equipment and instruments which are easy to handle, are reliable and are safe in an operating environment. By and large, most electrosurgical instruments are hand-held instruments, e.g., an electrosurgical pencil, which transfer 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 includes 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 coagulate, cut or blend body tissue. Coagulation is defined as a process of desiccating tissue wherein the tissue cells are ruptured and dehydrated/dried. Electrosurgical cutting, on the other hand, includes applying an electrical spark to tissue in order to produce a cutting or dividing effect. Blending includes the function of cutting combined with the production of a hemostasis effect.
As used herein the term “electrosurgical pencil” is intended to include instruments which have a handpiece which is attached to an active electrode and which is used to cauterize, coagulate, blend and/or cut tissue. Typically, the electrosurgical 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 electrosurgical pencil is connected to a suitable electrosurgical energy source (e.g., 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.
During surgery, these electrosurgical instruments generally produce a plume (typically of smoke) when organic material (e.g., the tissue of the patient) is being vaporized. The plume created by the vaporization of the organic material is offensive in the operating room and especially if inhaled.
In the typical technique, the plume is aspirated by a conventional suction tube being held near the site of the electrosurgical procedure by an assistant. Unfortunately, this method inefficiently requires the full time attention of the assistant and the placement of the often bulky suction tube in the operative field of the surgeon thus obstructing the surgeon's view. Additionally, these suction tubes typically operate on a continuous basis and create substantial noise levels during surgery thus potentially interfering with normal operating room dialogue.
Accordingly, electrosurgical instruments including integrated systems for aspirating the plume produced by the electrosurgical instruments during the electrosurgical procedures as well as for aspirating excess blood of bodily fluids prior to coagulating the remaining vessels have been developed. For example, electrosurgical instruments have been developed which include an aspirating system including a suction tube having at least one suction opening disposed in close proximity to the electrocautery tip (e.g., a blade, loop, etc.) a proximal end which is in fluid communication with a remote source of vacuum. In order to reduce the potential of the suction tube from becoming tangled or interfering with the movement of the operating staff around the operating room, the source of vacuum is place close to the operative site thus keeping the suction tube shorter. As a result, the noise from the source of vacuum is also closer to the operative site and thus continues to potentially interfere with the normal operating room dialogue.
It is an object of the present disclosure to provide an electrosurgical pencil including a manual aspirator/irrigator.
It is another object of the present disclosure to provide an electrosurgical instrument including a self-contained manual aspirator/irrigator.
It is a further object of the present disclosure to provide an electrosurgical instrument having a manual aspirator/irrigator which effectively removes a plume created during surgical procedures and which effectively delivers a fluid during the surgical procedures.
It is still a further object of the present disclosure to provide an electrosurgical instrument having a manual aspirator/irrigator which can deliver a quantity of irrigating solution and/or medicament during the surgical procedure.
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 present disclosure is directed to an electrosurgical pencil having an aspirating/irrigating system. According to one aspect of the present disclosure, the electrosurgical pencil includes an elongate housing, an electrocautery blade supported within the housing and extending distally from the housing, the electrocautery blade being connected to a source of electrosurgical energy, and an activation button supported on the housing, the activation button being configured and adapted to complete a control loop extending from the source of electrosurgical energy upon actuation thereof. The electrosurgical pencil further includes an aspirating/irrigating system operatively connected to the housing, wherein the aspirating/irrigating system is configured and adapted to manually perform at least one of delivering a quantity of fluid to a target surgical site and withdrawing a quantity of fluid from the target surgical site.
It is envisioned that the aspirating/irrigating system includes a resilient or compliant handle which defines at least one chamber therein. The aspirating/irrigating system can further include a fluid passage extending between at least one chamber of the resilient handle and at least one aperture formed in a distal end of the housing. A quantity of fluid is contained within the at least one chamber of the resilient or compliant handle.
The handle has an expanded condition and is compressible to a non-expanded condition, wherein compression of the resilient handle causes the quantity of fluid contained in the at least one chamber of the resilient handle to be urged through the fluid passage and out of at least one aperture formed in the distal end of the housing. Accordingly, when the resilient handle is allowed to return to its expanded condition from the non-expanded condition, fluid is drawn into the at least one chamber of the resilient handle through the fluid passage and in through at least one aperture formed in the distal end of the housing.
The aspirating/irrigating system preferably further includes a valve disposed between at least one fluid passage and at least one fluid chamber. The valve is configured and adapted to allow fluid to pass from the chamber to the fluid passage when the resilient handle is compressed to a non-expanded condition. The aspirating/irrigating system preferably further includes a second valve disposed in fluid communication with a second chamber. The second valve is configured and adapted to allow fluid to pass into the second chamber when the resilient handle is allowed to return to its expanded condition. The second valve is disposed between a second chamber in the handle and a second passage which communicates with at least one aperture at the distal end of the housing. Preferably, the resilient handle is fabricated rubber.
It is envisioned that the electrosurgical pencil further includes a mode selector supported on the housing, the mode selector being electrically connected to the source of electrosurgical energy and is configured and adapted to vary a waveform duty cycle which is delivered from the source of electrosurgical energy to the electrocautery blade. The mode selector is configured and adapted to vary the waveform duty cycle to produce at least one of a cutting, blending and coagulating effect.
In another embodiment, the aspirating/irrigating system includes a resilient handle and defines first and second chambers separated by a dividing member, and first and second fluid passages extending respectively between the first and second chambers of the resilient handle and the at least one aperture formed in a distal end of the housing. The handle has an expanded condition and is compressible to a non-expanded condition.
The aspirating/irrigating system includes a first valve disposed between the first fluid passage and the first chamber, a second valve disposed between the second fluid passage and the second chamber, and a relief valve for equalizing the environmental conditions between the first and second chambers.
The first chamber preferably includes a quantity of fluid contained therein. The first valve is configured and adapted to allow the quantity of fluid contained in the first chamber to pass from the first chamber to the first fluid passage when the resilient handle is compressed to a non-expanded condition. The second valve is configured and adapted to allow fluid to be drawn into the second chamber when the resilient handle is allowed to return to the expanded condition from the non-expanded condition.
According to another aspect of the present disclosure, an electrosurgical pencil for selectively providing electrosurgical energy to tissue, the electrosurgical pencil having an electrosurgical blade electrically connected to the source of electrosurgical energy is provided. The electrosurgical pencil includes an elongate housing configured and adapted to receive the electrosurgical blade in a distal end thereof, and a self-contained, manual aspirating/irrigating system operatively connected to the housing. The aspirating/irrigating system includes a body portion defining at least one chamber therein, and a fluid passage extending between an aperture formed in a distal end of the housing and the at least one chamber, wherein the body portion has an expanded condition in which at least one chamber has a first volume and a non-expanded condition in which at least one chamber has a second volume which is less than the first volume.
The aspirating/irrigating system includes a first valve disposed between at least one chamber and the fluid passage, and a second valve disposed in the body portion and in fluid communication with at least one chamber. The first valve is configured and adapted to allow fluid to pass out of at least one chamber and the second valve is configured and adapted to allow fluid to enter at least one chamber.
At least one chamber of the body portion contains a quantity of fluid. Accordingly, when the body portion is compressed from the first volume to the second volume the quantity of fluid is urged out of one of the chambers through the first valve and when the body portion is allowed to return to the first volume from the second volume fluid enters a different one of the chambers from the second valve.
According to yet another aspect of the present disclosure, a method of aspirating/irrigating a target surgical site during an electrosurgical procedure is provided. The method includes the step of providing an electrosurgical pencil including an elongate housing, an electrocautery blade supported within the housing and extending distally from the housing, the electrocautery blade being connected to a source of electrosurgical energy, an activation button supported on the housing, the activation button being configured and adapted to complete a control loop extending from the source of electrosurgical energy upon actuation thereof, and an aspirating/irrigating system operatively connected to the housing, wherein the aspirating/irrigating system includes a resilient handle which is configured and adapted to at least one of deliver a quantity of fluid contained in the handle to a target surgical site when the handle is compressed and withdraw a quantity of fluid from the target surgical site when the handle is allowed to expand.
The method further includes the steps of performing an electrocautery function at a target surgical site, and at least one of compressing the handle to deliver the quantity of fluid contained therein to the target surgical site and allowing the handle to expand to withdraw a quantity of fluid from the target surgical site.
It is envisioned that the aspirating/irrigating system includes a fluid passage extending between an aperture formed in a distal end of the housing and the at least one chamber.
With the handle at least partially compressed, the method further includes the step of placing the aperture in a quantity of fluid and allowing the handle to expand to withdraw fluid into the at least one chamber.
These and other features and advantages of the present disclosure will be readily apparent from the following drawings and detailed description of 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 seen in
As shown in
Reference is made to commonly assigned U.S. Provisional Patent No. 60/413,410 filed Sep. 25, 2002; U.S. Provisional Patent No. 60/424,352 filed Nov. 5, 2002; and U.S. Provisional Patent No. 60/448,520 filed Feb. 20, 2003, the entire contents of each of which are incorporated herein by reference, for a more detailed explanation and for alternative configurations of control loop 107.
By way of example only, electrosurgical generator “G” may be any one of the following, or equivalents thereof: the “FORCE FX”, “FORCE 2” or “FORCE 4” generators manufactured by Valleylab, Inc., a division of Tyco Healthcare, LP, located in Boulder, Colo. Preferably, electrosurgical generator “G” can be variable in order to provide appropriate first RF signals (e.g., 1 to 120 watts) for tissue cutting and appropriate second RF signals (e.g., 1 to 300 watts) for tissue coagulation. Generator “G” may also include a “blend” mode.
Preferably, an exemplary electrosurgical generator “G” is disclosed in commonly assigned U.S. Pat. No. 6,068,627 to Orszulak, et al., the entire contents of which is hereby incorporated by reference. The electrosurgical generator disclosed in the '627 patent includes, inter alia, an identifying circuit and a switch therein. In general, the identifying circuit is responsive to information received from a generator and transmits a verification signal back to the generator. Meanwhile, the switch is connected to the identifying circuit and is responsive to signaling received from the identifying circuit.
Turning back to
Electrosurgical pencil 100 further includes at least one mode selector 128 operatively supported on housing 102. Mode selector 128 is configured and adapted to enable the surgeon to set electrosurgical pencil 100 to one of a number of discreet modes of operation, such as, for example, cutting, blending and/or coagulating. As seen in
It is contemplated that mode selector 128 may be provided with a series of cooperating discreet positions defining a series of positions, preferably three, to allow easy selection of the mode of operation of electrosurgical pencil 100 between, for example, cutting, blending and coagulating. The series of cooperating discreet or detented positions also provide the surgeon with a degree of tactile feedback.
Electrosurgical pencil 100 further includes a manual aspirating/irrigating system 140 operatively connected to a proximal end of housing 102. Aspirating/irrigating system 140 includes a handle or body portion 142 preferably fabricated from a resilient or substantially compliant material, such as, for example, rubber, and defines a hollow chamber 144 therein (see
Handle 142 has a fully expanded condition and a plurality of non-expanded conditions when handle 142 is squeezed and/or compressed an amount by the surgeon. In the fully expanded condition, chamber 144 of handle 142 defines a first volume, while in one of its plurality of non-fully expanded conditions, chamber 144 of handle 142 defines a plurality of second volumes, each of which are less than the first volume. In this manner, when handle 142 is in one of the plurality of second volumes and then released, handle 142 creates a suction force at aperture(s) 148, through fluid passage 146.
When handle 142 is urged from its fully expanded condition to its non-fully expanded condition (i.e., to at least partially evacuate chamber 144), a fluid “F”, contained within chamber 144 of handle 142, is urged and/or squeezed through fluid passage 146 and out through aperture(s) 148. When handle 142 is allowed to return to its fully expanded condition, from its non-fully expanded condition, (i.e., as by allowing resilient handle 142 to overcome the squeezing and/or compressing forces and to return to its fully expanded condition), as described above, a suction is created at apertures 148, through fluid passage 146, to withdraw fluid “F” into chamber 144. As used herein, and in no way is it to be considered limiting, the term fluid is understood to include air, water, saline, medicament, body fluid, blood, lymph fluid, smoke, etc.
In operation and depending on the particular electrosurgical function desired (e.g. cutting, blending or coagulating), the surgeon manipulates, e.g., rotates, mode selector 128 in direction “X” until the desired electrosurgical function is selected. The surgeon then depresses activation button 124, in the direction indicated by arrow “Y” (see
Preferably, as seen throughout the figures, activation button 124 and mode selector 128 are supported in a recess or depression 109 formed in outer wall 107 of housing 102. Desirably, activation button 124 is positioned at a location where the fingers of the surgeon would normally rest when electrosurgical pencil 100 is held in the hand of the surgeon while mode selector 128 is placed at a location which would not be confused with activation button 124.
Moreover, depending on the particular electrosurgical procedure being performed, the stage of the procedure and the resulting effects created by electrocautery blade 106 on the body tissue, the surgeon may desire or be required to manipulate aspirating/irrigating system 140. For example, fluid produced by the body and located at the surgical site (e.g., blood, lymph fluid, etc.) during the surgical procedure can be aspirated from the surgical site using electrosurgical pencil 100. Aspiration of fluid from the surgical site can be achieved, for example with chamber 144 of handle 142 empty, by the surgeon initially squeezing and/or compressing handle 142 to at least partially evacuate chamber 144, placing aperture(s) 148 in or near a quantity of fluid “F”, and allowing handle 142 to expand causing the vacuum of chamber 144 to withdraw fluid from the surgical site into chamber 144 through fluid passage 146.
The aspiration step can be repeated, without first evacuating chamber 144 of fluid “F” contained therein, by first orienting and/or tilting electrosurgical pencil 100 to a position where fluid “F” contained in chamber 144 does not cover, as seen in
In addition, during the surgical procedure, it may be desired or necessary to irrigate the surgical site with a fluid “F”. Irrigation of the surgical site with fluid “F”, can be achieved by orienting and/or tilting electrosurgical pencil 100 to a position where fluid “F”, contained in chamber 144, covers (see
It is contemplated that aspirating/irrigating system 140 can include a control switch 152 incorporated into handle 142 and connected to chamber 144 and a valve 154 disposed at interface 150, between fluid passage 146 and chamber 144. Preferably, valve 154 is a one-way check-type valve which cooperates with control switch 152 to permit a unidirectional flow of fluid either into (or out of) chamber 144 through fluid passage 146 depending upon a particular purpose.
As best seen if
A relief valve may be utilized to restore environmental equilibrium between the two chambers 144a′ and 144b′ after each irrigation/aspiration cycle. Alternatively, control switch 152 may be utilized with a single check valve which allows selective flow into the chamber or out of the chamber upon activation. As can be appreciated, more than one check valve may be utilized for this purpose, i.e., a first check valve 144a′ for storing liquid and contaminants from the surgical site and a second check valve 144b′ for storing irrigation fluid (see
In one method of use, as seen in
In another method of use, valve 154 can be configured to allow electrosurgical pencil 100 to simply aspirate the surgical site. In this manner, when handle 142 is squeezed/compressed to its non-expanded condition, air is expelled from chamber 144 through a relief valve 157 (see
It is contemplated that using valve 154 (or multiple valves) enables electrosurgical pencil 100 to be oriented in any direction when performing an aspirating function. However, when performing the irrigating function, in order for fluid “F” to be expelled from chamber 144 upon squeezing/compressing of handle 146, electrosurgical pencil 100 needs to be oriented such that valve 154 is at least partially covered by fluid “F” contained within chamber 144.
It is further envisioned that aspirating/irrigating system 140 can be provided with an additional valve (not shown) which can be used to empty chamber 144 if filled with fluid from the surgical site and/or refill chamber 144 with fluid “F” if emptied. In this manner, if a different type of fluid “F” is desired to be contained in chamber 144 for use during the surgical procedure, chamber 144 can be filled accordingly.
It is further envisioned that aspirating/irrigating system 140 can be removed from housing 102 and replaced with a new aspirating/irrigating system 140. In this manner, when chamber 144 has been filled with fluid from the surgical site or emptied of fluid “F” originally contained therein, used aspirating/irrigating system 140 can be replaced with a new aspirating/irrigating system 140. Moreover, new aspirating/irrigating system 140 can be provided with a different fluid “F” contained therein which different fluid “F” is selected by the surgeon according to the properties desired.
Turning now to
As seen in
In one method of use, first valve 160 is set such that fluid “F” can only flow out of chamber 144a′ (as indicated by arrow “B”) when handle 142′ is squeezed/compressed to its non-expanded condition, while second valve 162 is set such that fluid from the surgical site can only flow into chamber 144b′ (as indicated by arrow “A”) when handle 142′ is allowed to return to its expanded condition. Meanwhile, third valve 164 is set such that fluid (e.g., air) can only flow from chamber 144b′ to chamber 144a′ (as indicated by arrow “C”). In this manner, when handle 142′ is squeezed/compressed to a non-expanded condition, first valve 160 allows fluid “F” to be expelled from electrosurgical instrument 100 through fluid passage 146a, second valve 162 prevents fluid from the surgical site from being expelled from electrosurgical instrument 100 through fluid passage 144b′, and relief valve 164 allows passage of air from chamber 144b′ to chamber 144a′. Accordingly, the vacuum created within chamber 144a′ by the squeezing/compressing of handle 142′ is at least partially distributed, preferably equally distributed, between chambers 144a′ and 144b′ via relief valve 164 (i.e., chambers 144a′ and 144b′ are in equilibrium or equilibrated). As such, when handle 142′ is allowed to return to its expanded condition, relief valve 164 disposed between chambers 144a′ and 144b′ returns the equilibrium between chambers 144b′ and 144a′.
The process is repeated as many times as needed until either chamber 144a′ has been emptied of fluid “F” contained therein or until chamber 144b′ has been filled with fluid from the surgical site. It is contemplated that each of chambers 144a′ and 144b′ can be provided with an additional valve (not shown). Preferably, the additional valve for chamber 144a′ can be used to refill chamber 144a′ with fluid “F” after chamber 144a′ has been at least partially emptied during the surgical procedure. The additional valve for chamber 144b′ can be used to empty chamber 144b′ of fluid from the surgical site after chamber 144b′ has been at least partially filled during the surgical procedure.
In an alternative embodiment, it is envisioned that aspirating/irrigating system 140′ can be removed from housing 102 and replaced by another or a replacement aspirating/irrigating system 140′. In this manner, when chamber 144a′ has been emptied of fluid “F” and/or chamber 144b′ has been filled with fluid from the surgical site a new aspirating/irrigating system 140′ can be attached to housing 102 as or when needed. Moreover, if a different fluid “F”, to be expelled from electrosurgical pencil 100, is desired to be used by the surgeon, a new aspirating/irrigating system 140′ containing a different fluid “F” is attached to housing 102 of electrosurgical pencil 100.
Although the presently-illustrated embodiments of the preset disclosure show electrosurgical pencils for use with the manual aspirator/irrigator as described herein, it is also contemplated that the manual aspirator/irrigator may be configured for use with other surgical devices, e.g., laparoscopes, coagulators, vessel sealers, ultrasonic devices etc.
It is also envisioned that the presently disclosed aspirator/irrigator may include a hard handle with a compliant pump or bladder disposed therein. A user would successively pump the bladder or pump to dispense or suction fluid to or from the operating site.
While embodiments of electrosurgical pencils according to the present disclosure have been described herein, it is not intended that the disclosure be limited there and that the above description should be construed as merely exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the present disclosure.
Number | Name | Date | Kind |
---|---|---|---|
2102270 | Hyams | Dec 1937 | A |
2993178 | Burger | Jul 1961 | A |
3058470 | Seeliger et al. | Oct 1962 | A |
3219029 | Richards et al. | Nov 1965 | A |
3460539 | Anhalt, Sr. | Aug 1969 | A |
3494363 | Jackson | Feb 1970 | 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 |
3875945 | Friedman | Apr 1975 | A |
3902494 | Haberlen et al. | Sep 1975 | A |
3906955 | Roberts | Sep 1975 | A |
3967084 | Pounds | Jun 1976 | A |
3974833 | Durden, III | Aug 1976 | 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 |
4112950 | Pike | Sep 1978 | A |
D253247 | Gill | Oct 1979 | S |
4232676 | Herczog | Nov 1980 | A |
4314559 | Allen | Feb 1982 | A |
4427006 | Nottke | Jan 1984 | A |
4443935 | Zamba et al. | Apr 1984 | A |
4459443 | Lewandowski | Jul 1984 | A |
4463234 | Bennewitz | Jul 1984 | A |
4463759 | Garito et al. | Aug 1984 | A |
4492231 | Auth | Jan 1985 | A |
4545375 | Cline | Oct 1985 | A |
4562838 | Walker | Jan 1986 | A |
4589411 | Friedman | May 1986 | A |
4593691 | Lindstrom et al. | Jun 1986 | A |
4595809 | Pool | Jun 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 |
4640279 | Beard | Feb 1987 | A |
4642128 | Solorzano | Feb 1987 | A |
4655215 | Pike | Apr 1987 | A |
4657016 | Garito et al. | Apr 1987 | A |
4683884 | Hatfield et al. | Aug 1987 | A |
4688569 | Rabinowitz | Aug 1987 | A |
4701193 | Robertson et al. | Oct 1987 | A |
4712544 | Ensslin | Dec 1987 | A |
4735603 | Goodson et al. | Apr 1988 | A |
4754754 | Garito 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 |
4846790 | Hornlein et al. | Jul 1989 | A |
4850353 | Stasz et al. | Jul 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 |
4872454 | DeOliveira et al. | Oct 1989 | A |
4876110 | Blanch | Oct 1989 | A |
4886060 | Wiksell | Dec 1989 | A |
4901719 | Trenconsky et al. | Feb 1990 | A |
4903696 | Stasz et al. | Feb 1990 | A |
4909249 | Akkas et al. | Mar 1990 | A |
4911159 | Johnson et al. | Mar 1990 | A |
4916275 | Almond | Apr 1990 | A |
4919129 | Weber, Jr. et al. | Apr 1990 | A |
4921476 | Wuchinich | May 1990 | A |
4922903 | Welch et al. | May 1990 | A |
4931047 | Broadwin et al. | Jun 1990 | A |
4949734 | Bernstein | Aug 1990 | A |
4969885 | Farin | Nov 1990 | A |
4986839 | Wertz et al. | Jan 1991 | A |
4988334 | Hornlein et al. | Jan 1991 | A |
5000754 | DeOliveira et al. | Mar 1991 | A |
5011483 | Sleister | Apr 1991 | A |
5013312 | Parins et al. | May 1991 | A |
5015227 | Broadwin et al. | May 1991 | A |
5026368 | Adair | Jun 1991 | A |
5035695 | Weber, Jr. et al. | Jul 1991 | A |
5046506 | Singer | Sep 1991 | A |
5055100 | Olsen | Oct 1991 | A |
5071418 | Rosenbaum | Dec 1991 | A |
5074863 | Dines | Dec 1991 | A |
5076276 | Sakurai et al. | Dec 1991 | A |
5088997 | Delahuerga et al. | Feb 1992 | A |
5098430 | Fleenor | Mar 1992 | A |
5100402 | Fan | Mar 1992 | A |
5108391 | Flachenecker et al. | Apr 1992 | A |
5133714 | Beane | Jul 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 |
5167659 | Ohtomo et al. | Dec 1992 | A |
5178605 | Imonti | Jan 1993 | A |
5190517 | Zieve et al. | Mar 1993 | A |
5190541 | Abele et al. | Mar 1993 | A |
5192267 | Shapira et al. | Mar 1993 | A |
5195959 | Smith | Mar 1993 | A |
5196007 | Ellman et al. | Mar 1993 | A |
5197962 | Sansom et al. | Mar 1993 | A |
5199944 | Cosmescu | Apr 1993 | A |
5217457 | Delahuerga et al. | Jun 1993 | A |
5224944 | Elliott | 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 |
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 |
5269781 | Hewell, III | Dec 1993 | A |
5300087 | Knoepfler | Apr 1994 | A |
5304763 | Ellman et al. | Apr 1994 | A |
5306238 | Fleenor | Apr 1994 | A |
5312329 | Beaty et al. | May 1994 | A |
5312400 | Bales et al. | May 1994 | A |
5312401 | Newton et al. | May 1994 | A |
5318516 | Cosmescu | Jun 1994 | A |
5318565 | Kuriloff et al. | Jun 1994 | A |
5322503 | Desai | Jun 1994 | A |
5330470 | Hagen | Jul 1994 | A |
5334183 | Wuchinich | Aug 1994 | A |
5342356 | Ellman et al. | Aug 1994 | A |
5348555 | Zinnanti | Sep 1994 | A |
5376089 | Smith | Dec 1994 | A |
5380320 | Morris | Jan 1995 | A |
5382247 | Cimino et al. | Jan 1995 | A |
5395363 | Billings et al. | Mar 1995 | A |
5399823 | McCusker | Mar 1995 | A |
5401273 | Shippert | Mar 1995 | A |
5403882 | Huggins | Apr 1995 | A |
5406945 | Riazzi et al. | Apr 1995 | A |
5409484 | Erlich et al. | Apr 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 |
5451222 | De Maagd et al. | Sep 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 |
5496314 | Eggers | Mar 1996 | A |
5498654 | Shimasaki et al. | Mar 1996 | A |
D370731 | Corace et al. | Jun 1996 | S |
5531722 | Van Hale | Jul 1996 | A |
5549604 | Sutcu et al. | Aug 1996 | A |
5561278 | Rutten | Oct 1996 | A |
5599346 | Edwards et al. | Feb 1997 | A |
5601224 | Bishop et al. | Feb 1997 | A |
5609573 | Sandock | Mar 1997 | A |
5626575 | Crenner | May 1997 | A |
5630426 | Eggers et al. | May 1997 | A |
5630812 | Ellman et al. | May 1997 | A |
5633578 | Eggers et al. | May 1997 | A |
5634912 | Injev | Jun 1997 | A |
5634935 | Taheri | Jun 1997 | A |
5643256 | Urueta | Jul 1997 | A |
D384148 | Monson | Sep 1997 | S |
5669907 | Platt, Jr. et al. | Sep 1997 | A |
5674219 | Monson et al. | Oct 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 |
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 |
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 |
5879347 | Saadat | 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 |
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 |
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 |
6712813 | Ellman et al. | Mar 2004 | B2 |
6740079 | Eggers et al. | May 2004 | B1 |
6747218 | Huseman 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 |
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 | Culp 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 | Mar 2003 | A1 |
20030055421 | West et al. | Mar 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 | Jul 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 |
20040034346 | Stern et al. | Feb 2004 | A1 |
20040054370 | Given | Mar 2004 | A1 |
20040092927 | Podhajsky et al. | May 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 |
20040230262 | Sartor et al. | Nov 2004 | A1 |
20040236323 | Schoenman et al. | Nov 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 |
20050107782 | Reschke | May 2005 | A1 |
20050113817 | Isaacson et al. | May 2005 | A1 |
20050113818 | Sartor et al. | May 2005 | A1 |
20050113823 | Reschke 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 |
20060041257 | Sartor et al. | Feb 2006 | A1 |
20060058783 | Buchman | Mar 2006 | A1 |
Number | Date | Country |
---|---|---|
24 29 021 | Jan 1976 | DE |
30 45 996 | Jul 1982 | DE |
0 186 369 | Jul 1986 | EP |
1050277 | Nov 2000 | EP |
1050279 | Nov 2000 | EP |
1082945 | Mar 2001 | EP |
1293171 | Mar 2003 | EP |
2235669 | Jan 1975 | FR |
WO9420032 | Sep 1994 | WO |
WO 9639086 | Dec 1996 | WO |
WO 9843264 | Oct 1998 | WO |
WO0164122 | Sep 2001 | WO |
WO 0247568 | Jun 2002 | WO |
WO 2004010883 | Feb 2004 | WO |
WO 2004073753 | Sep 2004 | WO |
WO 2005060849 | Jul 2005 | WO |
Number | Date | Country | |
---|---|---|---|
20050107782 A1 | May 2005 | US |