Surgical dissectors configured to apply mechanical and electrical energy

Information

  • Patent Grant
  • 11696778
  • Patent Number
    11,696,778
  • Date Filed
    Friday, August 24, 2018
    5 years ago
  • Date Issued
    Tuesday, July 11, 2023
    9 months ago
Abstract
A surgical instrument comprising an end effector is disclosed. The end effector comprises a surgical dissector. The surgical dissector can apply mechanical and/or electrosurgical energy to treated tissue.
Description
BACKGROUND

The present invention relates to surgical systems and, in various arrangements, to grasping instruments that are designed to grasp the tissue of a patient, dissecting instruments configured to manipulate the tissue of a patient, clip appliers configured to clip the tissue of a patient, and suturing instruments configured to suture the tissue of a patient, among others.





BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together with advantages thereof, may be understood in accordance with the following description taken in conjunction with the accompanying drawings as follows:



FIG. 1 illustrates a surgical system comprising a handle and several shaft assemblies—each of which are selectively attachable to the handle in accordance with at least one embodiment;



FIG. 2 is an elevational view of the handle and one of the shaft assemblies of the surgical system of FIG. 1;



FIG. 3 is a partial cross-sectional perspective view of the shaft assembly of FIG. 2;



FIG. 4 is another partial cross-sectional perspective view of the shaft assembly of FIG. 2;



FIG. 5 is a partial exploded view of the shaft assembly of FIG. 2;



FIG. 6 is a partial cross-sectional elevational view of the shaft assembly of FIG. 2;



FIG. 7 is an elevational view of a drive module of the handle of FIG. 1;



FIG. 8 is a cross-sectional perspective view of the drive module of FIG. 7;



FIG. 9 is an end view of the drive module of FIG. 7;



FIG. 10 is a partial cross-sectional view of the interconnection between the handle and shaft assembly of FIG. 2 in a locked configuration;



FIG. 11 is a partial cross-sectional view of the interconnection between the handle and shaft assembly of FIG. 2 in an unlocked configuration;



FIG. 12 is a cross-sectional perspective view of a motor and a speed reduction gear assembly of the drive module of FIG. 7;



FIG. 13 is an end view of the speed reduction gear assembly of FIG. 12;



FIG. 14 is a partial perspective view of an end effector of the shaft assembly of FIG. 2 in an open configuration;



FIG. 15 is a partial perspective view of the end effector of FIG. 14 in a closed configuration;



FIG. 16 is a partial perspective view of the end effector of FIG. 14 articulated in a first direction;



FIG. 17 is a partial perspective view of the end effector of FIG. 14 articulated in a second direction;



FIG. 18 is a partial perspective view of the end effector of FIG. 14 rotated in a first direction;



FIG. 19 is a partial perspective view of the end effector of FIG. 14 rotated in a second direction;



FIG. 20 is a partial cross-sectional perspective view of the end effector of FIG. 14 detached from the shaft assembly of FIG. 2;



FIG. 21 is an exploded view of the end effector of FIG. 14 illustrated with some components removed;



FIG. 22 is an exploded view of a distal attachment portion of the shaft assembly of FIG. 2;



FIG. 22A is an exploded view of the distal portion of the shaft assembly of FIG. 2 illustrated with some components removed;



FIG. 23 is another partial cross-sectional perspective view of the end effector of FIG. 14 detached from the shaft assembly of FIG. 2;



FIG. 24 is a partial cross-sectional perspective view of the end effector of FIG. 14 attached to the shaft assembly of FIG. 2;



FIG. 25 is a partial cross-sectional perspective view of the end effector of FIG. 14 attached to the shaft assembly of FIG. 2;



FIG. 26 is another partial cross-sectional perspective view of the end effector of FIG. 14 attached to the shaft assembly of FIG. 2;



FIG. 27 is a partial cross-sectional view of the end effector of FIG. 14 attached to the shaft assembly of FIG. 2 depicting a first, second, and third clutch of the end effector;



FIG. 28 depicts the first clutch of FIG. 27 in an unactuated condition;



FIG. 29 depicts the first clutch of FIG. 27 in an actuated condition;



FIG. 30 depicts the second clutch of FIG. 27 in an unactuated condition;



FIG. 31 depicts the second clutch of FIG. 27 in an actuated condition;



FIG. 32 depicts the third clutch of FIG. 27 in an unactuated condition;



FIG. 33 depicts the third clutch of FIG. 27 in an actuated condition;



FIG. 34 depicts the second and third clutches of FIG. 27 in their unactuated conditions and the end effector of FIG. 14 locked to the shaft assembly of FIG. 2;



FIG. 35 depicts the second clutch of FIG. 27 in its unactuated condition and the third clutch of FIG. 27 in its actuated condition;



FIG. 36 depicts the second and third clutches of FIG. 27 in their actuated conditions and the end effector of FIG. 14 unlocked from the shaft assembly of FIG. 2;



FIG. 37 is a partial cross-sectional view of a shaft assembly in accordance with at least one alternative embodiment comprising sensors configured to detect the conditions of the first, second, and third clutches of FIG. 27;



FIG. 38 is a partial cross-sectional view of a shaft assembly in accordance with at least one alternative embodiment comprising sensors configured to detect the conditions of the first, second, and third clutches of FIG. 27;



FIG. 39 depicts the first and second clutches of FIG. 38 in their unactuated conditions and a sensor in accordance with at least one alternative embodiment;



FIG. 40 depicts the second and third clutches of FIG. 38 in their unactuated conditions and a sensor in accordance with at least one alternative embodiment;



FIG. 41 is a partial cross-sectional view of a shaft assembly in accordance with at least one embodiment;



FIG. 42 is a partial cross-sectional view of the shaft assembly of FIG. 41 comprising a clutch illustrated in an unactuated condition;



FIG. 43 is a partial cross-sectional view of the shaft assembly of FIG. 41 illustrating the clutch in an actuated condition;



FIG. 44 is a partial cross-sectional view of a shaft assembly in accordance with at least one embodiment comprising first and second clutches illustrated in an unactuated condition;



FIG. 45 is a perspective view of the handle drive module of FIG. 7 and one of the shaft assemblies of the surgical system of FIG. 1;



FIG. 46 is another perspective view of the handle drive module of FIG. 7 and the shaft assembly of FIG. 45;



FIG. 47 is a partial cross-sectional view of the shaft assembly of FIG. 45 attached to the handle of FIG. 1;



FIG. 48 is another partial cross-sectional view of the shaft assembly of FIG. 45 attached to the handle of FIG. 1;



FIG. 49 is a partial cross-sectional perspective view of the shaft assembly of FIG. 45;



FIG. 50 is a schematic of the control system of the surgical system of FIG. 1.



FIG. 51 is an elevational view of a handle in accordance with at least one embodiment and one of the shaft assemblies of the surgical system of FIG. 1;



FIG. 52A is a partial top view of a drive module of the handle of FIG. 51 illustrated in a first rotation configuration;



FIG. 52B is a partial top view of the drive module of FIG. 52A illustrated in a second rotation configuration;



FIG. 53A is a partial top view of the drive module of FIG. 52A illustrated in a first articulation configuration;



FIG. 53B is a partial top view of the drive module of FIG. 52A illustrated in a second articulation configuration;



FIG. 54 is a partial cross-sectional perspective view of a drive module in accordance with at least one embodiment;



FIG. 55 is a partial perspective view of the drive module of FIG. 54 illustrated with some components removed;



FIG. 56 is a partial cross-sectional view of the drive module of FIG. 54 illustrating an eccentric drive in a disengaged condition;



FIG. 57 is a partial cross-sectional view of the drive module of FIG. 54 illustrating the eccentric drive of FIG. 56 in an engaged condition;



FIG. 58 is a partial top plan view of an embodiment of a surgical instrument;



FIG. 59 is a partial side elevation view of an embodiment of a surgical instrument;



FIG. 60 is a partial top plan view of various possible configurations of an embodiment of a surgical instrument;



FIG. 61 is a partial side elevation view of various possible configurations of an embodiment of a surgical instrument;



FIG. 62 is a partial top plan view of an embodiment of a surgical instrument;



FIG. 63 is a partial side elevation view of an embodiment of the surgical instrument depicted in FIG. 62;



FIG. 64 is a partial top plan view of an embodiment of a surgical instrument;



FIG. 65 is a partial top plan view of an embodiment of a surgical instrument;



FIG. 66 is a partial top plan view of an embodiment of a surgical instrument;



FIG. 67 is a partial top plan view of an embodiment of a surgical instrument;



FIG. 68 is a partial top plan view of an embodiment of a surgical instrument which depicts a manufacturing envelope from which an end effector of the surgical instrument is created;



FIG. 69 is a partial side elevation view of an embodiment of the surgical instrument depicted in FIG. 68;



FIG. 70 is a partial top plan view of an embodiment of a surgical instrument which depicts a manufacturing envelope from which an end effector of the surgical instrument is created;



FIG. 71 is a partial side elevation view of an embodiment of the surgical instrument depicted in FIG. 70 which depicts a manufacturing envelope from which an end effector of the surgical instrument is created;



FIG. 72 is a top perspective view of a jaw of a surgical instrument;



FIG. 73 is a partial perspective view of the jaw depicted in FIG. 72;



FIG. 74 is a top plan view of the jaw depicted in FIG. 72;



FIG. 75 is a bottom perspective view of the jaw depicted in FIG. 72;



FIG. 76 is a top perspective view of a jaw of a surgical instrument;



FIG. 77 is a top plan view of the jaw depicted in FIG. 76;



FIG. 78 is a partial perspective view of the jaw depicted in FIG. 76;



FIG. 79 is a partial perspective view of a jaw of a surgical instrument;



FIG. 80 is a partial cross-sectional view of a surgical instrument including a jaw assembly capable of grasping and dissection in accordance with at least one embodiment;



FIG. 81 is a graph depicting the force, speed, and orientation of the jaw assembly of FIG. 80 in accordance with at least one embodiment;



FIG. 82 is a partial perspective view of bipolar forceps being used to cut tissue;



FIG. 83 is a perspective view of the bipolar forceps of FIG. 82;



FIG. 84 is a graph depicting the force and speed of the jaws of the bipolar forceps of FIG. 82 in accordance with at least one embodiment; and



FIG. 85 is another graph depicting the operation of the bipolar forceps of FIG. 82 in accordance with at least one embodiment.





Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate various embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.


DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. Patent Applications that were filed on Aug. 24, 2018 and which are each herein incorporated by reference in their respective entireties:

    • U.S. patent application Ser. No. 16/112,129, entitled SURGICAL SUTURING INSTRUMENT CONFIGURED TO MANIPULATE TISSUE USING MECHANICAL AND ELECTRICAL POWER, now U.S. Patent Application Publication No. 2019/0125431;
    • U.S. patent application Ser. No. 16/112,155, entitled SURGICAL SUTURING INSTRUMENT COMPRISING A CAPTURE WIDTH WHICH IS LARGER THAN TROCAR DIAMETER, now U.S. Patent Application Publication No. 2019/0125335;
    • U.S. patent application Ser. No. 16/112,168, entitled SURGICAL SUTURING INSTRUMENT COMPRISING A NON-CIRCULAR NEEDLE, now U.S. Patent Application Publication No. 2019/0125336;
    • U.S. patent application Ser. No. 16/112,180 entitled ELECTRICAL POWER OUTPUT CONTROL BASED ON MECHANICAL FORCES, now U.S. Patent Application Publication No. 2019/0125432;
    • U.S. patent application Ser. No. 16/112,193, entitled REACTIVE ALGORITHM FOR SURGICAL SYSTEM, now U.S. Pat. No. 10,932,806;
    • U.S. patent application Ser. No. 16/112,099, entitled SURGICAL INSTRUMENT COMPRISING AN ADAPTIVE ELECTRICAL SYSTEM, now U.S. Patent Application Publication No. 2019/0125378;
    • U.S. patent application Ser. No. 16/112,112 entitled CONTROL SYSTEM ARRANGEMENTS FOR A MODULAR SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2019/0125320;
    • U.S. patent application Ser. No. 16/112,119, entitled ADAPTIVE CONTROL PROGRAMS FOR A SURGICAL SYSTEM COMPRISING MORE THAN ONE TYPE OF CARTRIDGE, now U.S. Patent Application Publication No. 2019/0125338;
    • U.S. patent application Ser. No. 16/112,097, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING BATTERY ARRANGEMENTS, now U.S. Patent Application Publication No. 2019/0125377;
    • U.S. patent application Ser. No. 16/112,109, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING HANDLE ARRANGEMENTS, now U.S. Patent Application Publication No. 2019/0125388;
    • U.S. patent application Ser. No. 16/112,114, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING FEEDBACK MECHANISMS, now U.S. Pat. No. 10,980,560;
    • U.S. patent application Ser. No. 16/112,117, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING LOCKOUT MECHANISMS, now U.S. Patent Application Publication No. 2019/0125476;
    • U.S. patent application Ser. No. 16/112,095, entitled SURGICAL INSTRUMENTS COMPRISING A LOCKABLE END EFFECTOR SOCKET, now U.S. Pat. No. 11,291,465;
    • U.S. patent application Ser. No. 16/112,121, entitled SURGICAL INSTRUMENTS COMPRISING A SHIFTING MECHANISM, now U.S. Pat. No. 11,026,712;
    • U.S. patent application Ser. No. 16/112,151, entitled SURGICAL INSTRUMENTS COMPRISING A SYSTEM FOR ARTICULATION AND ROTATION COMPENSATION, now U.S. Pat. No. 10,772,651;
    • U.S. patent application Ser. No. 16/112,154 entitled SURGICAL INSTRUMENTS COMPRISING A BIASED SHIFTING MECHANISM, now U.S. Pat. No. 11,207,090;
    • U.S. patent application Ser. No. 16/112,226, entitled SURGICAL INSTRUMENTS COMPRISING AN ARTICULATION DRIVE THAT PROVIDES FOR HIGH ARTICULATION ANGLES, now U.S. Pat. No. 11,129,636;
    • U.S. patent application Ser. No. 16/112,062, entitled SURGICAL DISSECTORS AND MANUFACTURING TECHNIQUES, now U.S. Pat. No. 10,959,744;
    • U.S. patent application Ser. No. 16/112,237, entitled SURGICAL CLIP APPLIER CONFIGURED TO STORE CLIPS IN A STORED STATE, now U.S. Pat. No. 11,026,713;
    • U.S. patent application Ser. No. 16/112,245, entitled SURGICAL CLIP APPLIER COMPRISING AN EMPTY CLIP CARTRIDGE LOCKOUT, now U.S. Pat. No. 11,051,836;
    • U.S. patent application Ser. No. 16/112,249, entitled SURGICAL CLIP APPLIER COMPRISING AN AUTOMATIC CLIP FEEDING SYSTEM, now U.S. Pat. No. 11,109,878;
    • U.S. patent application Ser. No. 16/112,253, entitled SURGICAL CLIP APPLIER COMPRISING ADAPTIVE FIRING CONTROL, now U.S. Pat. No. 11,103,268; and
    • U.S. patent application Ser. No. 16/112,257, entitled SURGICAL CLIP APPLIER COMPRISING ADAPTIVE CONTROL IN RESPONSE TO A STRAIN GAUGE CIRCUIT, now U.S. Pat. No. 11,071,560.


Applicant of the present application owns the following U.S. Patent Applications that were filed on May 1, 2018 and which are each herein incorporated by reference in their respective entireties:

    • U.S. Provisional Patent Application Ser. No. 62/665,129, entitled SURGICAL SUTURING SYSTEMS;
    • U.S. Provisional Patent Application Ser. No. 62/665,139, entitled SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS;
    • U.S. Provisional Patent Application Ser. No. 62/665,177, entitled SURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS;
    • U.S. Provisional Patent Application Ser. No. 62/665,128, entitled MODULAR SURGICAL INSTRUMENTS;
    • U.S. Provisional Patent Application Ser. No. 62/665,192, entitled SURGICAL DISSECTORS; and
    • U.S. Provisional Patent Application Ser. No. 62/665,134, entitled SURGICAL CLIP APPLIER.


Applicant of the present application owns the following U.S. Patent Applications that were filed on Feb. 28, 2018 and which are each herein incorporated by reference in their respective entireties:

    • U.S. patent application Ser. No. 15/908,021, entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE;
    • U.S. patent application Ser. No. 15/908,012, entitled SURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTOR MOVEMENT;
    • U.S. patent application Ser. No. 15/908,040, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;
    • U.S. patent application Ser. No. 15/908,057, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;
    • U.S. patent application Ser. No. 15/908,058, entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES; and
    • U.S. patent application Ser. No. 15/908,143, entitled SURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.


Applicant of the present application owns the following U.S. Patent Applications that were filed on Oct. 30, 2017 and which are each herein incorporated by reference in their respective entireties:

    • U.S. Provisional Patent Application Ser. No. 62/578,793, entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE;
    • U.S. Provisional Patent Application Ser. No. 62/578,804, entitled SURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTOR MOVEMENT;
    • U.S. Provisional Patent Application Ser. No. 62/578,817, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;
    • U.S. Provisional Patent Application Ser. No. 62/578,835, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS;
    • U.S. Provisional Patent Application Ser. No. 62/578,844, entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES; and
    • U.S. Provisional Patent Application Ser. No. 62/578,855, entitled SURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.


Applicant of the present application owns the following U.S. Provisional Patent Applications, filed on Dec. 28, 2017, the disclosure of each of which is herein incorporated by reference in its entirety:

    • U.S. Provisional Patent Application Ser. No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM;
    • U.S. Provisional Patent Application Ser. No. 62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS; and
    • U.S. Provisional Patent Application Ser. No. 62/611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM.


Applicant of the present application owns the following U.S. Provisional Patent Applications, filed on Mar. 28, 2018, each of which is herein incorporated by reference in its entirety:

    • U.S. Provisional Patent Application Ser. No. 62/649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;
    • U.S. Provisional Patent Application Ser. No. 62/649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;
    • U.S. Provisional Patent Application Ser. No. 62/649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS;
    • U.S. Provisional Patent Application Ser. No. 62/649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;
    • U.S. Provisional Patent Application Ser. No. 62/649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;
    • U.S. Provisional Patent Application Ser. No. 62/649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;
    • U.S. Provisional Patent Application Ser. No. 62/649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;
    • U.S. Provisional Patent Application Ser. No. 62/649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;
    • U.S. Provisional Patent Application Ser. No. 62/649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;
    • U.S. Provisional Patent Application Ser. No. 62/649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;
    • U.S. Provisional Patent Application Ser. No. 62/649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;
    • U.S. Provisional Patent Application Ser. No. 62/649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. Provisional Patent Application Ser. No. 62/649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and
    • U.S. Provisional Patent Application Ser. No. 62/649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.


Applicant of the present application owns the following U.S. Patent Applications, filed on Mar. 29, 2018, each of which is herein incorporated by reference in its entirety:

    • U.S. patent application Ser. No. 15/940,641, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;
    • U.S. patent application Ser. No. 15/940,648, entitled INTERACTIVE SURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATA CAPABILITIES;
    • U.S. patent application Ser. No. 15/940,656, entitled SURGICAL HUB COORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES;
    • U.S. patent application Ser. No. 15/940,666, entitled SPATIAL AWARENESS OF SURGICAL HUBS IN OPERATING ROOMS;
    • U.S. patent application Ser. No. 15/940,670, entitled COOPERATIVE UTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENT SURGICAL HUBS;
    • U.S. patent application Ser. No. 15/940,677, entitled SURGICAL HUB CONTROL ARRANGEMENTS;
    • U.S. patent application Ser. No. 15/940,632, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;
    • U.S. patent application Ser. No. 15/940,640, entitled COMMUNICATION HUB AND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICAL DEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS;
    • U.S. patent application Ser. No. 15/940,645, entitled SELF DESCRIBING DATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;
    • U.S. patent application Ser. No. 15/940,649, entitled DATA PAIRING TO INTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME;
    • U.S. patent application Ser. No. 15/940,654, entitled SURGICAL HUB SITUATIONAL AWARENESS;
    • U.S. patent application Ser. No. 15/940,663, entitled SURGICAL SYSTEM DISTRIBUTED PROCESSING;
    • U.S. patent application Ser. No. 15/940,668, entitled AGGREGATION AND REPORTING OF SURGICAL HUB DATA;
    • U.S. patent application Ser. No. 15/940,671, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;
    • U.S. patent application Ser. No. 15/940,686, entitled DISPLAY OF ALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;
    • U.S. patent application Ser. No. 15/940,700, entitled STERILE FIELD INTERACTIVE CONTROL DISPLAYS;
    • U.S. patent application Ser. No. 15/940,629, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;
    • U.S. patent application Ser. No. 15/940,704, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;
    • U.S. patent application Ser. No. 15/940,722, entitled CHARACTERIZATION OF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHT REFRACTIVITY; and
    • U.S. patent application Ser. No. 15/940,742, entitled DUAL CMOS ARRAY IMAGING.


Applicant of the present application owns the following U.S. Patent Applications, filed on Mar. 29, 2018, each of which is herein incorporated by reference in its entirety:

    • U.S. patent application Ser. No. 15/940,636, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;
    • U.S. patent application Ser. No. 15/940,653, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL HUBS;
    • U.S. patent application Ser. No. 15/940,660, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;
    • U.S. patent application Ser. No. 15/940,679, entitled CLOUD-BASED MEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCE ACQUISITION BEHAVIORS OF LARGER DATA SET;
    • U.S. patent application Ser. No. 15/940,694, entitled CLOUD-BASED MEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OF INSTRUMENT FUNCTION;
    • U.S. patent application Ser. No. 15/940,634, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;
    • U.S. patent application Ser. No. 15/940,706, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and
    • U.S. patent application Ser. No. 15/940,675, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES.


Applicant of the present application owns the following U.S. Patent Applications, filed on Mar. 29, 2018, each of which is herein incorporated by reference in its entirety:

    • U.S. patent application Ser. No. 15/940,627, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. patent application Ser. No. 15/940,637, entitled COMMUNICATION ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. patent application Ser. No. 15/940,642, entitled CONTROLS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. patent application Ser. No. 15/940,676, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. patent application Ser. No. 15/940,680, entitled CONTROLLERS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. patent application Ser. No. 15/940,683, entitled COOPERATIVE SURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. patent application Ser. No. 15/940,690, entitled DISPLAY ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and
    • U.S. patent application Ser. No. 15/940,711, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.


Applicant of the present application owns the following U.S. Provisional Patent Applications, filed on Mar. 30, 2018, each of which is herein incorporated by reference in its entirety:

    • U.S. Provisional Patent Application Ser. No. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES;
    • U.S. Provisional Patent Application Ser. No. 62/650,877, entitled SURGICAL SMOKE EVACUATION SENSING AND CONTROLS;
    • U.S. Provisional Patent Application Ser. No. 62/650,882, entitled SMOKE EVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and
    • U.S. Provisional Patent Application Ser. No. 62/650,898, entitled CAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS.


Applicant of the present application owns the following U.S. Provisional Patent Application, filed on Apr. 19, 2018, which is herein incorporated by reference in its entirety:

    • U.S. Provisional Patent Application Ser. No. 62/659,900, entitled METHOD OF HUB COMMUNICATION.


Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and illustrative. Variations and changes thereto may be made without departing from the scope of the claims.


The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”), and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a surgical system, device, or apparatus that “comprises,” “has,” “includes”, or “contains” one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that “comprises,” “has,” “includes”, or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features.


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


Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongate shaft of a surgical instrument can be advanced.


A surgical instrument, such as a grasper, for example, can comprise a handle, a shaft extending from the handle, and an end effector extending from the shaft. In various instances, the end effector comprises a first jaw and a second jaw, wherein one or both of the jaws are movable relative to the other to grasp the tissue of a patient. That said, an end effector of a surgical instrument can comprise any suitable arrangement and can perform any suitable function. For instance, an end effector can comprise first and second jaws configured to dissect or separate the tissue of a patient. Also, for instance, an end effector can be configured to suture and/or clip the tissue of a patient. In various instances, the end effector and/or shaft of the surgical instrument are configured to be inserted into a patient through a trocar, or cannula, and can have any suitable diameter, such as approximately 5 mm, 8 mm, and/or 12 mm, for example. U.S. patent application Ser. No. 11/013,924, entitled TROCAR SEAL ASSEMBLY, now U.S. Pat. No. 7,371,227, is incorporated by reference in its entirety. The shaft can define a longitudinal axis and at least a portion of the end effector can be rotatable about the longitudinal axis. Moreover, the surgical instrument can further comprise an articulation joint which can permit at least a portion of the end effector to be articulated relative to the shaft. In use, a clinician can rotate and/or articulate the end effector in order to maneuver the end effector within the patient.


A surgical instrument system is depicted in FIG. 1. The surgical instrument system comprises a handle assembly 1000 which is selectively usable with a shaft assembly 2000, a shaft assembly 3000, a shaft assembly 4000, a shaft assembly 5000, and/or any other suitable shaft assembly. The shaft assembly 2000 is attached to the handle assembly 1000 in FIG. 2 and the shaft assembly 4000 is attached to the handle assembly 1000 in FIG. 45. The shaft assembly 2000 comprises a proximal portion 2100, an elongate shaft 2200 extending from the proximal portion 2100, a distal attachment portion 2400, and an articulation joint 2300 rotatably connecting the distal attachment portion 2400 to the elongate shaft 2200. The shaft assembly 2000 further comprises a replaceable end effector assembly 7000 attached to the distal attachment portion 2400. The replaceable end effector assembly 7000 comprises a jaw assembly 7100 configured to be opened and closed to clamp and/or manipulate the tissue of a patient. In use, the end effector assembly 7000 can be articulated about the articulation joint 2300 and/or rotated relative to the distal attachment portion 2400 about a longitudinal axis to better position the jaw assembly 7100 within the patient, as described in greater detail further below.


Referring again to FIG. 1, the handle assembly 1000 comprises, among other things, a drive module 1100. As described in greater detail below, the drive module 1100 comprises a distal mounting interface which permits a clinician to selectively attach one of the shaft assemblies 2000, 3000, 4000, and 5000, for example, to the drive module 1100. Thus, each of the shaft assemblies 2000, 3000, 4000, and 5000 comprises an identical, or an at least similar, proximal mounting interface which is configured to engage the distal mounting interface of the drive module 1100. As also described in greater detail below, the mounting interface of the drive module 1100 mechanically secures and electrically couples the selected shaft assembly to the drive module 1100. The drive module 1100 further comprises at least one electric motor, one or more controls and/or displays, and a controller configured to operate the electric motor—the rotational output of which is transmitted to a drive system of the shaft assembly attached to the drive module 1100. Moreover, the drive module 1100 is usable with one ore more power modules, such as power modules 1200 and 1300, for example, which are operably attachable to the drive module 1100 to supply power thereto.


Further to the above, referring again to FIGS. 1 and 2, the handle drive module 1100 comprises a housing 1110, a first module connector 1120, and a second module connector 1120′. The power module 1200 comprises a housing 1210, a connector 1220, one or more release latches 1250, and one or more batteries 1230. The connector 1220 is configured to be engaged with the first module connector 1120 of the drive module 1100 in order to attach the power module 1200 to the drive module 1100. The connector 1220 comprises one or more latches 1240 which mechanically couple and fixedly secure the housing 1210 of the power module 1200 to the housing 1110 of the drive module 1100. The latches 1240 are movable into disengaged positions when the release latches 1250 are depressed so that the power module 1200 can be detached from the drive module 1100. The connector 1220 also comprises one or more electrical contacts which place the batteries 1230, and/or an electrical circuit including the batteries 1230, in electrical communication with an electrical circuit in the drive module 1100.


Further to the above, referring again to FIGS. 1 and 2, the power module 1300 comprises a housing 1310, a connector 1320, one or more release latches 1350, and one or more batteries 1330 (FIG. 47). The connector 1320 is configured to be engaged with the second module connector 1120′ of the drive module 1100 to attach the power module 1300 to the drive module 1100. The connector 1320 comprises one or more latches 1340 which mechanically couple and fixedly secure the housing 1310 of the power module 1300 to the housing 1110 of the drive module 1100. The latches 1340 are movable into disengaged positions when the release latches 1350 are depressed so that the power module 1300 can be detached from the drive module 1100. The connector 1320 also comprises one or more electrical contacts which place the batteries 1330 of the power module 1300, and/or an electrical power circuit including the batteries 1330, in electrical communication with an electrical power circuit in the drive module 1100.


Further to the above, the power module 1200, when attached to the drive module 1100, comprises a pistol grip which can allow a clinician to hold the handle 1000 in a manner which places the drive module 1100 on top of the clinician's hand. The power module 1300, when attached to the drive module 1100, comprises an end grip which allows a clinician to hold the handle 1000 like a wand. The power module 1200 is longer than the power module 1300, although the power modules 1200 and 1300 can comprise any suitable length. The power module 1200 has more battery cells than the power module 1300 and can suitably accommodate these additional battery cells owing to its length. In various instances, the power module 1200 can provide more power to the drive module 1100 than the power module 1300 while, in some instances, the power module 1200 can provide power for a longer period of time. In some instances, the housing 1110 of the drive module 1100 comprises keys, and/or any other suitable features, which prevent the power module 1200 from being connected to the second module connector 1120′ and, similarly, prevent the power module 1300 from being connected to the first module connector 1120. Such an arrangement can assure that the longer power module 1200 is used in the pistol grip arrangement and that the shorter power module 1300 is used in the wand grip arrangement. In alternative embodiments, the power module 1200 and the power module 1300 can be selectively coupled to the drive module 1100 at either the first module connector 1120 or the second module connector 1120′. Such embodiments provide a clinician with more options to customize the handle 1000 in a manner suitable to them.


In various instances, further to the above, only one of the power modules 1200 and 1300 is coupled to the drive module 1100 at a time. In certain instances, the power module 1200 can be in the way when the shaft assembly 4000, for example, is attached to the drive module 1100. Alternatively, both of the power modules 1200 and 1300 can be operably coupled to the drive module 1100 at the same time. In such instances, the drive module 1100 can have access to power provided by both of the power modules 1200 and 1300. Moreover, a clinician can switch between a pistol grip and a wand grip when both of the power modules 1200 and 1300 are attached to the drive module 1100. Moreover, such an arrangement allows the power module 1300 to act as a counterbalance to a shaft assembly, such as shaft assemblies 2000, 3000, 4000, or 5000, for example, attached to the drive module 1100.


Referring to FIGS. 7 and 8, the handle drive module 1100 further comprises a frame 1500, a motor assembly 1600, a drive system 1700 operably engaged with the motor assembly 1600, and a control system 1800. The frame 1500 comprises an elongate shaft that extends through the motor assembly 1600. The elongate shaft comprises a distal end 1510 and electrical contacts, or sockets, 1520 defined in the distal end 1510. The electrical contacts 1520 are in electrical communication with the control system 1800 of the drive module 1100 via one or more electrical circuits and are configured to convey signals and/or power between the control system 1800 and the shaft assembly, such as the shaft assembly 2000, 3000, 4000, or 5000, for example, attached to the drive module 1100. The control system 1800 comprises a printed circuit board (PCB) 1810, at least one microprocessor 1820, and at least one memory device 1830. The board 1810 can be rigid and/or flexible and can comprise any suitable number of layers. The microprocessor 1820 and the memory device 1830 are part of a control circuit defined on the board 1810 which controls the operation of the motor assembly 1600, as described in greater detail below.


Referring to FIGS. 12 and 13, the motor assembly 1600 comprises an electric motor 1610 including a housing 1620, a drive shaft 1630, and a gear reduction system. The electric motor 1610 further comprises a stator including windings 1640 and a rotor including magnetic elements 1650. The stator windings 1640 are supported in the housing 1620 and the rotor magnetic elements 1650 are mounted to the drive shaft 1630. When the stator windings 1640 are energized with an electric current controlled by the control system 1800, the drive shaft 1630 is rotated about a longitudinal axis. The drive shaft 1630 is operably engaged with a first planetary gear system 1660 which includes a central sun gear and several planetary gears operably intermeshed with the sun gear. The sun gear of the first planetary gear system 1660 is fixedly mounted to the drive shaft 1630 such that it rotates with the drive shaft 1630. The planetary gears of the first planetary gear system 1660 are rotatably mounted to the sun gear of a second planetary gear system 1670 and, also, intermeshed with a geared or splined inner surface 1625 of the motor housing 1620. As a result of the above, the rotation of the first sun gear rotates the first planetary gears which rotate the second sun gear. Similar to the above, the second planetary gear system 1670 further comprises planetary gears 1665 (FIG. 13) which drive a third planetary gear system and, ultimately, the drive shaft 1710. The planetary gear systems 1660, 1670, and 1680 co-operate to gear down the speed applied to the drive shaft 1710 by the motor shaft 1620. Various alternative embodiments are envisioned without a speed reduction system. Such embodiments are suitable when it is desirable to drive the end effector functions quickly. Notably, the drive shaft 1630 comprises an aperture, or hollow core, extending therethrough through which wires and/or electrical circuits can extend.


The control system 1800 is in communication with the motor assembly 1600 and the electrical power circuit of the drive module 1100. The control system 1800 is configured to control the power delivered to the motor assembly 1600 from the electrical power circuit. The electrical power circuit is configured to supply a constant, or at least nearly constant, direct current (DC) voltage. In at least one instance, the electrical power circuit supplies 3 VDC to the control system 1800. The control system 1800 comprises a pulse width modulation (PWM) circuit which is configured to deliver voltage pulses to the motor assembly 1600. The duration or width of the voltage pulses, and/or the duration or width between the voltage pulses, supplied by the PWM circuit can be controlled in order to control the power applied to the motor assembly 1600. By controlling the power applied to the motor assembly 1600, the PWM circuit can control the speed of the output shaft of the motor assembly 1600. In addition to or in lieu of a PWM circuit, the control system 1800 can include a frequency modulation (FM) circuit. As discussed in greater detail below, the control system 1800 is operable in more than one operating mode and, depending on the operating mode being used, the control system 1800 can operate the motor assembly 1600 at a speed, or a range of speeds, which is determined to be appropriate for that operating mode.


Further to the above, referring again to FIGS. 7 and 8, the drive system 1700 comprises a rotatable shaft 1710 comprising a splined distal end 1720 and a longitudinal aperture 1730 defined therein. The rotatable shaft 1710 is operably mounted to the output shaft of the motor assembly 1600 such that the rotatable shaft 1710 rotates with the motor output shaft. The handle frame 1510 extends through the longitudinal aperture 1730 and rotatably supports the rotatable shaft 1710. As a result, the handle frame 1510 serves as a bearing for the rotatable shaft 1710. The handle frame 1510 and the rotatable shaft 1710 extend distally from a mounting interface 1130 of the drive module 1110 and are coupled with corresponding components on the shaft assembly 2000 when the shaft assembly 2000 is assembled to the drive module 1100. Referring primarily to FIGS. 3-6, the shaft assembly 2000 further comprises a frame 2500 and a drive system 2700. The frame 2500 comprises a longitudinal shaft 2510 extending through the shaft assembly 2000 and a plurality of electrical contacts, or pins, 2520 extending proximally from the shaft 2510. When the shaft assembly 2000 is attached to the drive module 1100, the electrical contacts 2520 on the shaft frame 2510 engage the electrical contacts 1520 on the handle frame 1510 and create electrical pathways therebetween.


Similar to the above, the drive system 2700 comprises a rotatable drive shaft 2710 which is operably coupled to the rotatable drive shaft 1710 of the handle 1000 when the shaft assembly 2000 is assembled to the drive module 1100 such that the drive shaft 2710 rotates with the drive shaft 1710. To this end, the drive shaft 2710 comprises a splined proximal end 2720 which mates with the splined distal end 1720 of the drive shaft 1710 such that the drive shafts 1710 and 2710 rotate together when the drive shaft 1710 is rotated by the motor assembly 1600. Given the nature of the splined interconnection between the drive shafts 1710 and 2710 and the electrical interconnection between the frames 1510 and 2510, the shaft assembly 2000 is assembled to the handle 1000 along a longitudinal axis; however, the operable interconnection between the drive shafts 1710 and 2710 and the electrical interconnection between the frames 1510 and 2510 can comprise any suitable configuration which can allow a shaft assembly to be assembled to the handle 1000 in any suitable manner.


As discussed above, referring to FIGS. 3-8, the mounting interface 1130 of the drive module 1110 is configured to be coupled to a corresponding mounting interface on the shaft assemblies 2000, 3000, 4000, and 5000, for example. For instance, the shaft assembly 2000 comprises a mounting interface 2130 configured to be coupled to the mounting interface 1130 of the drive module 1100. More specifically, the proximal portion 2100 of the shaft assembly 2000 comprises a housing 2110 which defines the mounting interface 2130. Referring primarily to FIG. 8, the drive module 1100 comprises latches 1140 which are configured to releasably hold the mounting interface 2130 of the shaft assembly 2000 against the mounting interface 1130 of the drive module 1100. When the drive module 1100 and the shaft assembly 2000 are brought together along a longitudinal axis, as described above, the latches 1140 contact the mounting interface 2130 and rotate outwardly into an unlocked position. Referring primarily to FIGS. 8, 10, and 11, each latch 1140 comprises a lock end 1142 and a pivot portion 1144. The pivot portion 1144 of each latch 1140 is rotatably coupled to the housing 1110 of the drive module 1100 and, when the latches 1140 are rotated outwardly, as mentioned above, the latches 1140 rotate about the pivot portions 1144. Notably, each latch 1140 further comprises a biasing spring 1146 configured to bias the latches 1140 inwardly into a locked position. Each biasing spring 1146 is compressed between a latch 1140 and the housing 1110 of the drive module 1100 such that the biasing springs 1146 apply biasing forces to the latches 1140; however, such biasing forces are overcome when the latches 1140 are rotated outwardly into their unlocked positions by the shaft assembly 2000. That said, when the latches 1140 rotate outwardly after contacting the mounting interface 2130, the lock ends 1142 of the latches 1140 can enter into latch windows 2140 defined in the mounting interface 2130. Once the lock ends 1142 pass through the latch windows 2140, the springs 1146 can bias the latches 1140 back into their locked positions. Each lock end 1142 comprises a lock shoulder, or surface, which securely holds the shaft assembly 2000 to the drive module 1100.


Further to the above, the biasing springs 1146 hold the latches 1140 in their locked positions. The distal ends 1142 are sized and configured to prevent, or at least inhibit, relative longitudinal movement, i.e., translation along a longitudinal axis, between the shaft assembly 2000 and the drive module 1100 when the latches 1140 are in their locked positions. Moreover, the latches 1140 and the latch windows 1240 are sized and configured to prevent relative lateral movement, i.e., translation transverse to the longitudinal axis, between the shaft assembly 2000 and the drive module 1100. In addition, the latches 1140 and the latch windows 2140 are sized and configured to prevent the shaft assembly 2000 from rotating relative to the drive module 1100. The drive module 1100 further comprises release actuators 1150 which, when depressed by a clinician, move the latches 1140 from their locked positions into their unlocked positions. The drive module 1100 comprises a first release actuator 1150 slideably mounted in an opening defined in the first side of the handle housing 1110 and a second release actuator 1150 slideably mounted in an opening defined in a second, or opposite, side of the handle housing 1110. Although the release actuators 1150 are actuatable separately, both release actuators 1150 typically need to be depressed to completely unlock the shaft assembly 2000 from the drive module 1100 and allow the shaft assembly 2000 to be detached from the drive module 1100. That said, it is possible that the shaft assembly 2000 could be detached from the drive module 1100 by depressing only one release actuator 1150.


Once the shaft assembly 2000 has been secured to the handle 1000 and the end effector 7000, for example, has been assembled to the shaft 2000, the clinician can maneuver the handle 1000 to insert the end effector 7000 into a patient. In at least one instance, the end effector 7000 is inserted into the patient through a trocar and then manipulated in order to position the jaw assembly 7100 of the end effector assembly 7000 relative to the patient's tissue. Oftentimes, the jaw assembly 7100 must be in its closed, or clamped, configuration in order to fit through the trocar. Once through the trocar, the jaw assembly 7100 can be opened so that the patient tissue fit between the jaws of the jaw assembly 7100. At such point, the jaw assembly 7100 can be returned to its closed configuration to clamp the patient tissue between the jaws. The clamping force applied to the patient tissue by the jaw assembly 7100 is sufficient to move or otherwise manipulate the tissue during a surgical procedure. Thereafter, the jaw assembly 7100 can be re-opened to release the patient tissue from the end effector 7000. This process can be repeated until it is desirable to remove the end effector 7000 from the patient. At such point, the jaw assembly 7100 can be returned to its closed configuration and retracted through the trocar. Other surgical techniques are envisioned in which the end effector 7000 is inserted into a patient through an open incision, or without the use of the trocar. In any event, it is envisioned that the jaw assembly 7100 may have to be opened and closed several times throughout a surgical technique.


Referring again to FIGS. 3-6, the shaft assembly 2000 further comprises a clamping trigger system 2600 and a control system 2800. The clamping trigger system 2600 comprises a clamping trigger 2610 rotatably connected to the proximal housing 2110 of the shaft assembly 2000. As discussed below, the clamping trigger 2610 actuates the motor 1610 to operate the jaw drive of the end effector 7000 when the clamping trigger 2610 is actuated. The clamping trigger 2610 comprises an elongate portion which is graspable by the clinician while holding the handle 1000. The clamping trigger 2610 further comprises a mounting portion 2620 which is pivotably connected to a mounting portion 2120 of the proximal housing 2110 such that the clamping trigger 2610 is rotatable about a fixed, or an at least substantially fixed, axis. The closure trigger 2610 is rotatable between a distal position and a proximal position, wherein the proximal position of the closure trigger 2610 is closer to the pistol grip of the handle 1000 than the distal position. The closure trigger 2610 further comprises a tab 2615 extending therefrom which rotates within the proximal housing 2110. When the closure trigger 2610 is in its distal position, the tab 2615 is positioned above, but not in contact with, a switch 2115 mounted on the proximal housing 2110. The switch 2115 is part of an electrical circuit configured to detect the actuation of the closure trigger 2610 which is in an open condition the closure trigger 2610 is in its open position. When the closure trigger 2610 is moved into its proximal position, the tab 2615 comes into contact with the switch 2115 and closes the electrical circuit. In various instances, the switch 2115 can comprise a toggle switch, for example, which is mechanically switched between open and closed states when contacted by the tab 2615 of the closure trigger 2610. In certain instances, the switch 2115 can comprise a proximity sensor, for example, and/or any suitable type of sensor. In at least one instance, the switch 2115 comprises a Hall Effect sensor which can detect the amount in which the closure trigger 2610 has been rotated and, based on the amount of rotation, control the speed in which the motor 1610 is operated. In such instances, larger rotations of the closure trigger 2610 result in faster speeds of the motor 1610 while smaller rotations result in slower speeds, for example. In any event, the electrical circuit is in communication with the control system 2800 of the shaft assembly 2000, which is discussed in greater detail below.


Further to the above, the control system 2800 of the shaft assembly 2000 comprises a printed circuit board (PCB) 2810, at least one microprocessor 2820, and at least one memory device 2830. The board 2810 can be rigid and/or flexible and can comprise any suitable number of layers. The microprocessor 2820 and the memory device 2830 are part of a control circuit defined on the board 2810 which communicates with the control system 1800 of the handle 1000. The shaft assembly 2000 further comprises a signal communication system 2900 and the handle 1000 further comprises a signal communication system 1900 which are configured to convey data between the shaft control system 2800 and the handle control system 1800. The signal communication system 2900 is configured to transmit data to the signal communication system 1900 utilizing any suitable analog and/or digital components. In various instances, the communication systems 2900 and 1900 can communicate using a plurality of discrete channels which allows the input gates of the microprocessor 1820 to be directly controlled, at least in part, by the output gates of the microprocessor 2820. In some instances, the communication systems 2900 and 1900 can utilize multiplexing. In at least one such instance, the control system 2900 includes a multiplexing device that sends multiple signals on a carrier channel at the same time in the form of a single, complex signal to a multiplexing device of the control system 1900 that recovers the separate signals from the complex signal.


The communication system 2900 comprises an electrical connector 2910 mounted to the circuit board 2810. The electrical connector 2910 comprises a connector body and a plurality of electrically-conductive contacts mounted to the connector body. The electrically-conductive contacts comprise male pins, for example, which are soldered to electrical traces defined in the circuit board 2810. In other instances, the male pins can be in communication with circuit board traces through zero-insertion-force (ZIF) sockets, for example. The communication system 1900 comprises an electrical connector 1910 mounted to the circuit board 1810. The electrical connector 1910 comprises a connector body and a plurality of electrically-conductive contacts mounted to the connector body. The electrically-conductive contacts comprise female pins, for example, which are soldered to electrical traces defined in the circuit board 1810. In other instances, the female pins can be in communication with circuit board traces through zero-insertion-force (ZIF) sockets, for example. When the shaft assembly 2000 is assembled to the drive module 1100, the electrical connector 2910 is operably coupled to the electrical connector 1910 such that the electrical contacts form electrical pathways therebetween. The above being said, the connectors 1910 and 2910 can comprise any suitable electrical contacts. Moreover, the communication systems 1900 and 2900 can communicate with one another in any suitable manner. In various instances, the communication systems 1900 and 2900 communicate wirelessly. In at least one such instance, the communication system 2900 comprises a wireless signal transmitter and the communication system 1900 comprises a wireless signal receiver such that the shaft assembly 2000 can wirelessly communicate data to the handle 1000. Likewise, the communication system 1900 can comprise a wireless signal transmitter and the communication system 2900 can comprise a wireless signal receiver such that the handle 1000 can wirelessly communicate data to the shaft assembly 2000.


As discussed above, the control system 1800 of the handle 1000 is in communication with, and is configured to control, the electrical power circuit of the handle 1000. The handle control system 1800 is also powered by the electrical power circuit of the handle 1000. The handle communication system 1900 is in signal communication with the handle control system 1800 and is also powered by the electrical power circuit of the handle 1000. The handle communication system 1900 is powered by the handle electrical power circuit via the handle control system 1800, but could be directly powered by the electrical power circuit. As also discussed above, the handle communication system 1900 is in signal communication with the shaft communication system 2900. That said, the shaft communication system 2900 is also powered by the handle electrical power circuit via the handle communication system 1900. To this end, the electrical connectors 1910 and 2010 connect both one or more signal circuits and one or more power circuits between the handle 1000 and the shaft assembly 2000. Moreover, the shaft communication system 2900 is in signal communication with the shaft control system 2800, as discussed above, and is also configured to supply power to the shaft control system 2800. Thus, the control systems 1800 and 2800 and the communication systems 1900 and 2900 are all powered by the electrical power circuit of the handle 1000; however, alternative embodiments are envisioned in which the shaft assembly 2000 comprises its own power source, such as one or more batteries, for example, an and electrical power circuit configured to supply power from the batteries to the handle systems 2800 and 2900. In at least one such embodiment, the handle control system 1800 and the handle communication system 1900 are powered by the handle electrical power system and the shaft control system 2800 and the handle communication system 2900 are powered by the shaft electrical power system.


Further to the above, the actuation of the clamping trigger 2610 is detected by the shaft control system 2800 and communicated to the handle control system 1800 via the communication systems 2900 and 1900. Upon receiving a signal that the clamping trigger 2610 has been actuated, the handle control system 1800 supplies power to the electric motor 1610 of the motor assembly 1600 to rotate the drive shaft 1710 of the handle drive system 1700, and the drive shaft 2710 of the shaft drive system 2700, in a direction which closes the jaw assembly 7100 of the end effector 7000. The mechanism for converting the rotation of the drive shaft 2710 to a closure motion of the jaw assembly 7100 is discussed in greater detail below. So long as the clamping trigger 2610 is held in its actuated position, the electric motor 1610 will rotate the drive shaft 1710 until the jaw assembly 7100 reaches its fully-clamped position. When the jaw assembly 7100 reaches its fully-clamped position, the handle control system 1800 cuts the electrical power to the electric motor 1610. The handle control system 1800 can determine when the jaw assembly 7100 has reached its fully-clamped position in any suitable manner. For instance, the handle control system 1800 can comprise an encoder system which monitors the rotation of, and counts the rotations of, the output shaft of the electric motor 1610 and, once the number of rotations reaches a predetermined threshold, the handle control system 1800 can discontinue supplying power to the electric motor 1610. In at least one instance, the end effector assembly 7000 can comprise one or more sensors configured to detect when the jaw assembly 7100 has reached its fully-clamped position. In at least one such instance, the sensors in the end effector 7000 are in signal communication with the handle control system 1800 via electrical circuits extending through the shaft assembly 2000 which can include the electrical contacts 1520 and 2520, for example.


When the clamping trigger 2610 is rotated distally out of its proximal position, the switch 2115 is opened which is detected by the shaft control system 2800 and communicated to the handle control system 1800 via the communication systems 2900 and 1900. Upon receiving a signal that the clamping trigger 2610 has been moved out of its actuated position, the handle control system 1800 reverses the polarity of the voltage differential being applied to the electric motor 1610 of the motor assembly 1600 to rotate the drive shaft 1710 of the handle drive system 1700, and the drive shaft 2710 of the shaft drive system 2700, in an opposite direction which, as a result, opens the jaw assembly 7100 of the end effector 7000. When the jaw assembly 7100 reaches its fully-open position, the handle control system 1800 cuts the electrical power to the electric motor 1610. The handle control system 1800 can determine when the jaw assembly 7100 has reached its fully-open position in any suitable manner. For instance, the handle control system 1800 can utilize the encoder system and/or the one or more sensors described above to determine the configuration of the jaw assembly 7100. In view of the above, the clinician needs to be mindful about holding the clamping trigger 2610 in its actuated position in order to maintain the jaw assembly 7100 in its clamped configuration as, otherwise, the control system 1800 will open jaw assembly 7100. With this in mind, the shaft assembly 2000 further comprises an actuator latch 2630 configured to releasably hold the clamping trigger 2610 in its actuated position to prevent the accidental opening of the jaw assembly 7100. The actuator latch 2630 can be manually released, or otherwise defeated, by the clinician to allow the clamping trigger 2610 to be rotated distally and open the jaw assembly 7100.


The clamping trigger system 2600 further comprises a resilient biasing member, such as a torsion spring, for example, configured to resist the closure of the clamping trigger system 2600. The torsion spring can also assist in reducing and/or mitigating sudden movements and/or jitter of the clamping trigger 2610. Such a torsion spring can also automatically return the clamping trigger 2610 to its unactuated position when the clamping trigger 2610 is released. The actuator latch 2630 discussed above can suitably hold the clamping trigger 2610 in its actuated position against the biasing force of the torsion spring.


As discussed above, the control system 1800 operates the electric motor 1610 to open and close the jaw assembly 7100. The control system 1800 is configured to open and close the jaw assembly 7100 at the same speed. In such instances, the control system 1800 applies the same voltage pulses to the electric motor 1610, albeit with different voltage polarities, when opening and closing the jaw assembly 7100. That said, the control system 1800 can be configured to open and close the jaw assembly 7100 at different speeds. For instance, the jaw assembly 7100 can be closed at a first speed and opened at a second speed which is faster than the first speed. In such instances, the slower closing speed affords the clinician an opportunity to better position the jaw assembly 7100 while clamping the tissue. Alternatively, the control system 1800 can open the jaw assembly 7100 at a slower speed. In such instances, the slower opening speed reduces the possibility of the opening jaws colliding with adjacent tissue. In either event, the control system 1800 can decrease the duration of the voltage pulses and/or increase the duration between the voltage pulses to slow down and/or speed up the movement of the jaw assembly 7100.


As discussed above, the control system 1800 is configured to interpret the position of the clamping trigger 2610 as a command to position the jaw assembly 7100 in a specific configuration. For instance, the control system 1800 is configured to interpret the proximal-most position of the clamping trigger 2610 as a command to close the jaw assembly 7100 and any other position of the clamping trigger as a command to open the jaw assembly 7100. That said, the control system 1800 can be configured to interpret the position of the clamping trigger 2610 in a proximal range of positions, instead of a single position, as a command to close the jaw assembly 7100. Such an arrangement can allow the jaw assembly 7000 to be better responsive to the clinician's input. In such instances, the range of motion of the clamping trigger 2610 is divided into ranges—a proximal range which is interpreted as a command to close the jaw assembly 7100 and a distal range which is interpreted as a command to open the jaw assembly 7100. In at least one instance, the range of motion of the clamping trigger 2610 can have an intermediate range between the proximal range and the distal range. When the clamping trigger 2610 is in the intermediate range, the control system 1800 can interpret the position of the clamping trigger 2610 as a command to neither open nor close the jaw assembly 7100. Such an intermediate range can prevent, or reduce the possibility of, jitter between the opening and closing ranges. In the instances described above, the control system 1800 can be configured to ignore cumulative commands to open or close the jaw assembly 7100. For instance, if the closure trigger 2610 has already been fully retracted into its proximal-most position, the control assembly 1800 can ignore the motion of the clamping trigger 2610 in the proximal, or clamping, range until the clamping trigger 2610 enters into the distal, or opening, range wherein, at such point, the control system 1800 can then actuate the electric motor 1610 to open the jaw assembly 7100.


In certain instances, further to the above, the position of the clamping trigger 2610 within the clamping trigger range, or at least a portion of the clamping trigger range, can allow the clinician to control the speed of the electric motor 1610 and, thus, the speed in which the jaw assembly 7100 is being opened or closed by the control assembly 1800. In at least one instance, the sensor 2115 comprises a Hall Effect sensor, and/or any other suitable sensor, configured to detect the position of the clamping trigger 2610 between its distal, unactuated position and its proximal, fully-actuated position. The Hall Effect sensor is configured to transmit a signal to the handle control system 1800 via the shaft control system 2800 such that the handle control system 1800 can control the speed of the electric motor 1610 in response to the position of the clamping trigger 2610. In at least one instance, the handle control system 1800 controls the speed of the electric motor 1610 proportionately, or in a linear manner, to the position of the clamping trigger 2610. For example, if the clamping trigger 2610 is moved half way through its range, then the handle control system 1800 will operate the electric motor 1610 at half of the speed in which the electric motor 1610 is operated when the clamping trigger 2610 is fully-retracted. Similarly, if the clamping trigger 2610 is moved a quarter way through its range, then the handle control system 1800 will operate the electric motor 1610 at a quarter of the speed in which the electric motor 1610 is operated when the clamping trigger 2610 is fully-retracted. Other embodiments are envisioned in which the handle control system 1800 controls the speed of the electric motor 1610 in a non-linear manner to the position of the clamping trigger 2610. In at least one instance, the control system 1800 operates the electric motor 1610 slowly in the distal portion of the clamping trigger range while quickly accelerating the speed of the electric motor 1610 in the proximal portion of the clamping trigger range.


As described above, the clamping trigger 2610 is movable to operate the electric motor 1610 to open or close the jaw assembly 7100 of the end effector 7000. The electric motor 1610 is also operable to rotate the end effector 7000 about a longitudinal axis and articulate the end effector 7000 relative to the elongate shaft 2200 about the articulation joint 2300 of the shaft assembly 2000. Referring primarily to FIGS. 7 and 8, the drive module 1100 comprises an input system 1400 including a rotation actuator 1420 and an articulation actuator 1430. The input system 1400 further comprises a printed circuit board (PCB) 1410 which is in signal communication with the printed circuit board (PCB) 1810 of the control system 1800. The drive module 1100 comprises an electrical circuit, such as a flexible wiring harness or ribbon, for example, which permits the input system 1400 to communicate with the control system 1800. The rotation actuator 1420 is rotatably supported on the housing 1110 and is in signal communication with the input board 1410 and/or control board 1810, as described in greater detail below. The articulation actuator 1430 is supported by and in signal communication with the input board 1410 and/or control board 1810, as also described in greater detail below.


Referring primarily to FIGS. 8, 10, and 11, further to the above, the handle housing 1110 comprises an annular groove or slot defined therein adjacent the distal mounting interface 1130. The rotation actuator 1420 comprises an annular ring 1422 rotatably supported within the annular groove and, owing to the configuration of the sidewalls of the annular groove, the annular ring 1422 is constrained from translating longitudinally and/or laterally with respect to the handle housing 1110. The annular ring 1422 is rotatable in a first, or clockwise, direction and a second, or counter-clockwise direction, about a longitudinal axis extending through the frame 1500 of the drive module 1100. The rotation actuator 1420 comprises one or more sensors configured to detect the rotation of the annular ring 1422. In at least one instance, the rotation actuator 1420 comprises a first sensor positioned on a first side of the drive module 1100 and a second sensor positioned on a second, or opposite, side of the drive module 1100 and the annular ring 1422 comprises a detectable element which is detectable by the first and second sensors. The first sensor is configured to detect when the annular ring 1422 is rotated in the first direction and the second sensor is configured to detect when the annular ring 1422 is rotated in the second direction. When the first sensor detects that the annular ring 1422 is rotated in the first direction, the handle control system 1800 rotates the handle drive shaft 1710, the drive shaft 2710, and the end effector 7000 in the first direction, as described in greater detail below. Similarly, the handle control system 1800 rotates the handle drive shaft 1710, the drive shaft 2710, and the end effector 7000 in the second direction when the second sensor detects that the annular ring 1422 is rotated in the second direction. In view of the above, the reader should appreciate that the clamping trigger 2610 and the rotation actuator 1420 are both operable to rotate the drive shaft 2710.


In various embodiments, further to the above, the first and second sensors comprise switches which are mechanically closable by the detectable element of the annular ring 1422. When the annular ring 1422 is rotated in the first direction from a center position, the detectable element closes the switch of the first sensor. When the switch of the first sensor is closed, the control system 1800 operates the electric motor 1610 to rotate the end effector 7000 in the first direction. When the annular ring 1422 is rotated in the second direction toward the center position, the detectable element is disengaged from the first switch and the first switch is re-opened. Once the first switch is re-opened, the control system 1800 cuts the power to the electric motor 1610 to stop the rotation of the end effector 7000. Similarly, the detectable element closes the switch of the second sensor when the annular ring 1422 is rotated in the second direction from the center position. When the switch of the second sensor is closed, the control system 1800 operates the electric motor 1610 to rotate the end effector 7000 in the second direction. When the annular ring 1422 is rotated in the first direction toward the center position, the detectable element is disengaged from the second switch and the second switch is re-opened. Once the second switch is re-opened, the control system 1800 cuts the power to the electric motor 1610 to stop the rotation of the end effector 7000.


In various embodiments, further to the above, the first and second sensors of the rotation actuator 1420 comprise proximity sensors, for example. In certain embodiments, the first and second sensors of the rotation actuator 1420 comprise Hall Effect sensors, and/or any suitable sensors, configured to detect the distance between the detectable element of the annular ring 1422 and the first and second sensors. If the first Hall Effect sensor detects that the annular ring 1422 has been rotated in the first direction, then, as discussed above, the control system 1800 will rotate the end effector 7000 in the first direction. In addition, the control system 1800 can rotate the end effector 7000 at a faster speed when the detectable element is closer to the first Hall Effect sensor than when the detectable element is further away from the first Hall Effect sensor. If the second Hall Effect sensor detects that the annular ring 1422 has been rotated in the second direction, then, as discussed above, the control system 1800 will rotate the end effector 7000 in the second direction. In addition, the control system 1800 can rotate the end effector 7000 at a faster speed when the detectable element is closer to the second Hall Effect sensor than when the detectable element is further away from the second Hall Effect sensor. As a result, the speed in which the end effector 7000 is rotated is a function of the amount, or degree, in which the annular ring 1422 is rotated. The control system 1800 is further configured to evaluate the inputs from both the first and second Hall Effect sensors when determining the direction and speed in which to rotate the end effector 7000. In various instances, the control system 1800 can use the closest Hall Effect sensor to the detectable element of the annular ring 1422 as a primary source of data and the Hall Effect sensor furthest away from the detectable element as a confirmational source of data to double-check the data provided by the primary source of data. The control system 1800 can further comprise a data integrity protocol to resolve situations in which the control system 1800 is provided with conflicting data. In any event, the handle control system 1800 can enter into a neutral state in which the handle control system 1800 does not rotate the end effector 7000 when the Hall Effect sensors detect that the detectable element is in its center position, or in a position which is equidistant between the first Hall Effect sensor and the second Hall Effect sensor. In at least one such instance, the control system 1800 can enter into its neutral state when the detectable element is in a central range of positions. Such an arrangement would prevent, or at least reduce the possibility of, rotational jitter when the clinician is not intending to rotate the end effector 7000.


Further to the above, the rotation actuator 1420 can comprise one or more springs configured to center, or at least substantially center, the rotation actuator 1420 when it is released by the clinician. In such instances, the springs can act to shut off the electric motor 1610 and stop the rotation of the end effector 7000. In at least one instance, the rotation actuator 1420 comprises a first torsion spring configured to rotate the rotation actuator 1420 in the first direction and a second torsion spring configured to rotate the rotation actuator 1420 in the second direction. The first and second torsion springs can have the same, or at least substantially the same, spring constant such that the forces and/or torques applied by the first and second torsion springs balance, or at least substantially balance, the rotation actuator 1420 in its center position.


In view of the above, the reader should appreciate that the clamping trigger 2610 and the rotation actuator 1420 are both operable to rotate the drive shaft 2710 and either, respectively, operate the jaw assembly 7100 or rotate the end effector 7000. The system that uses the rotation of the drive shaft 2710 to selectively perform these functions is described in greater detail below.


Referring to FIGS. 7 and 8, the articulation actuator 1430 comprises a first push button 1432 and a second push button 1434. The first push button 1432 is part of a first articulation control circuit and the second push button 1434 is part of a second articulation circuit of the input system 1400. The first push button 1432 comprises a first switch that is closed when the first push button 1432 is depressed. The handle control system 1800 is configured to sense the closure of the first switch and, moreover, the closure of the first articulation control circuit. When the handle control system 1800 detects that the first articulation control circuit has been closed, the handle control system 1800 operates the electric motor 1610 to articulate the end effector 7000 in a first articulation direction about the articulation joint 2300. When the first push button 1432 is released by the clinician, the first articulation control circuit is opened which, once detected by the control system 1800, causes the control system 1800 to cut the power to the electric motor 1610 to stop the articulation of the end effector 7000.


In various instances, further to the above, the articulation range of the end effector 7000 is limited and the control system 1800 can utilize the encoder system discussed above for monitoring the rotational output of the electric motor 1610, for example, to monitor the amount, or degree, in which the end effector 7000 is rotated in the first direction. In addition to or in lieu of the encoder system, the shaft assembly 2000 can comprise a first sensor configured to detect when the end effector 7000 has reached the limit of its articulation in the first direction. In any event, when the control system 1800 determines that the end effector 7000 has reached the limit of articulation in the first direction, the control system 1800 can cut the power to the electric motor 1610 to stop the articulation of the end effector 7000.


Similar to the above, the second push button 1434 comprises a second switch that is closed when the second push button 1434 is depressed. The handle control system 1800 is configured to sense the closure of the second switch and, moreover, the closure of the second articulation control circuit. When the handle control system 1800 detects that the second articulation control circuit has been closed, the handle control system 1800 operates the electric motor 1610 to articulate the end effector 7000 in a second direction about the articulation joint 2300. When the second push button 1434 is released by the clinician, the second articulation control circuit is opened which, once detected by the control system 1800, causes the control system 1800 to cut the power to the electric motor 1610 to stop the articulation of the end effector 7000.


In various instances, the articulation range of the end effector 7000 is limited and the control system 1800 can utilize the encoder system discussed above for monitoring the rotational output of the electric motor 1610, for example, to monitor the amount, or degree, in which the end effector 7000 is rotated in the second direction. In addition to or in lieu of the encoder system, the shaft assembly 2000 can comprise a second sensor configured to detect when the end effector 7000 has reached the limit of its articulation in the second direction. In any event, when the control system 1800 determines that the end effector 7000 has reached the limit of articulation in the second direction, the control system 1800 can cut the power to the electric motor 1610 to stop the articulation of the end effector 7000.


As described above, the end effector 7000 is articulatable in a first direction (FIG. 16) and/or a second direction (FIG. 17) from a center, or unarticulated, position (FIG. 15). Once the end effector 7000 has been articulated, the clinician can attempt to re-center the end effector 7000 by using the first and second articulation push buttons 1432 and 1434. As the reader can appreciate, the clinician may struggle to re-center the end effector 7000 as, for instance, the end effector 7000 may not be entirely visible once it is positioned in the patient. In some instances, the end effector 7000 may not fit back through a trocar if the end effector 7000 is not re-centered, or at least substantially re-centered. With that in mind, the control system 1800 is configured to provide feedback to the clinician when the end effector 7000 is moved into its unarticulated, or centered, position. In at least one instance, the feedback comprises audio feedback and the handle control system 1800 can comprise a speaker which emits a sound, such as a beep, for example, when the end effector 7000 is centered. In certain instances, the feedback comprises visual feedback and the handle control system 1800 can comprise a light emitting diode (LED), for example, positioned on the handle housing 1110 which flashes when the end effector 7000 is centered. In various instances, the feedback comprises haptic feedback and the handle control system 1800 can comprise an electric motor comprising an eccentric element which vibrates the handle 1000 when the end effector 7000 is centered. Manually re-centering the end effector 7000 in this way can be facilitated by the control system 1800 slowing the motor 1610 when the end effector 7000 is approaching its centered position. In at least one instance, the control system 1800 slows the articulation of the end effector 7000 when the end effector 7000 is within approximately 5 degrees of center in either direction, for example.


In addition to or in lieu of the above, the handle control system 1800 can be configured to re-center the end effector 7000. In at least one such instance, the handle control system 1800 can re-center the end effector 7000 when both of the articulation buttons 1432 and 1434 of the articulation actuator 1430 are depressed at the same time. When the handle control system 1800 comprises an encoder system configured to monitor the rotational output of the electric motor 1610, for example, the handle control system 1800 can determine the amount and direction of articulation needed to re-center, or at least substantially re-center, the end effector 7000. In various instances, the input system 1400 can comprise a home button, for example, which, when depressed, automatically centers the end effector 7000.


Referring primarily to FIGS. 5 and 6, the elongate shaft 2200 of the shaft assembly 2000 comprises an outer housing, or tube, 2210 mounted to the proximal housing 2110 of the proximal portion 2100. The outer housing 2210 comprises a longitudinal aperture 2230 extending therethrough and a proximal flange 2220 which secures the outer housing 2210 to the proximal housing 2110. The frame 2500 of the shaft assembly 2000 extends through the longitudinal aperture 2230 of the elongate shaft 2200. More specifically, the shaft 2510 of the shaft frame 2500 necks down into a smaller shaft 2530 which extends through the longitudinal aperture 2230. That said, the shaft frame 2500 can comprise any suitable arrangement. The drive system 2700 of the shaft assembly 2000 also extends through the longitudinal aperture 2230 of the elongate shaft 2200. More specifically, the drive shaft 2710 of the shaft drive system 2700 necks down into a smaller drive shaft 2730 which extends through the longitudinal aperture 2230. That said, the shaft drive system 2700 can comprise any suitable arrangement.


Referring primarily to FIGS. 20, 23, and 24, the outer housing 2210 of the elongate shaft 2200 extends to the articulation joint 2300. The articulation joint 2300 comprises a proximal frame 2310 mounted to the outer housing 2210 such that there is little, if any, relative translation and/or rotation between the proximal frame 2310 and the outer housing 2210. Referring primarily to FIG. 22, the proximal frame 2310 comprises an annular portion 2312 mounted to the sidewall of the outer housing 2210 and tabs 2314 extending distally from the annular portion 2312. The articulation joint 2300 further comprises links 2320 and 2340 which are rotatably mounted to the frame 2310 and mounted to an outer housing 2410 of the distal attachment portion 2400. The link 2320 comprises a distal end 2322 mounted to the outer housing 2410. More specifically, the distal end 2322 of the link 2320 is received and fixedly secured within a mounting slot 2412 defined in the outer housing 2410. Similarly, the link 2340 comprises a distal end 2342 mounted to the outer housing 2410. More specifically, the distal end 2342 of the link 2340 is received and fixedly secured within a mounting slot defined in the outer housing 2410. The link 2320 comprises a proximal end 2324 rotatably coupled to a tab 2314 of the proximal articulation frame 2310. Although not illustrated in FIG. 22, a pin extends through apertures defined in the proximal end 2324 and the tab 2314 to define a pivot axis therebetween. Similarly, the link 2340 comprises a proximal end 2344 rotatably coupled to a tab 2314 of the proximal articulation frame 2310. Although not illustrated in FIG. 22, a pin extends through apertures defined in the proximal end 2344 and the tab 2314 to define a pivot axis therebetween. These pivot axes are collinear, or at least substantially collinear, and define an articulation axis A of the articulation joint 2300.


Referring primarily to FIGS. 20, 23, and 24, the outer housing 2410 of the distal attachment portion 2400 comprises a longitudinal aperture 2430 extending therethrough. The longitudinal aperture 2430 is configured to receive a proximal attachment portion 7400 of the end effector 7000. The end effector 7000 comprises an outer housing 6230 which is closely received within the longitudinal aperture 2430 of the distal attachment portion 2400 such that there is little, if any, relative radial movement between the proximal attachment portion 7400 of the end effector 7000 and the distal attachment portion 2400 of the shaft assembly 2000. The proximal attachment portion 7400 further comprises an annular array of lock notches 7410 defined on the outer housing 6230 which is releasably engaged by an end effector lock 6400 in the distal attachment portion 2400 of the shaft assembly 2000. When the end effector lock 6400 is engaged with the array of lock notches 7410, the end effector lock 6400 prevents, or at least inhibits, relative longitudinal movement between the proximal attachment portion 7400 of the end effector 7000 and the distal attachment portion 2400 of the shaft assembly 2000. As a result of the above, only relative rotation between the proximal attachment portion 7400 of the end effector 7000 and the distal attachment portion 2400 of the shaft assembly 2000 is permitted. To this end, the outer housing 6230 of the end effector 7000 is closely received within the longitudinal aperture 2430 defined in the distal attachment portion 2400 of the shaft assembly 2000.


Further to the above, referring to FIG. 21, the outer housing 6230 further comprises an annular slot, or recess, 6270 defined therein which is configured to receive an O-ring 6275 therein. The O-ring 6275 is compressed between the outer housing 6230 and the sidewall of the longitudinal aperture 2430 when the end effector 7000 is inserted into the distal attachment portion 2400. The O-ring 6275 is configured to resist, but permit, relative rotation between the end effector 7000 and the distal attachment portion 2400 such that the O-ring 6275 can prevent, or reduce the possibility of, unintentional relative rotation between the end effector 7000 and the distal attachment portion 2400. In various instances, the O-ring 6275 can provide a seal between the end effector 7000 and the distal attachment portion 2400 to prevent, or at least reduce the possibility of, fluid ingress into the shaft assembly 2000, for example.


Referring to FIGS. 14-21, the jaw assembly 7100 of the end effector 7000 comprises a first jaw 7110 and a second jaw 7120. Each jaw 7110, 7120 comprises a distal end which is configured to assist a clinician in dissecting tissue with the end effector 7000. Each jaw 7110, 7120 further comprises a plurality of teeth which are configured to assist a clinician in grasping and holding onto tissue with the end effector 7000. Moreover, referring primarily to FIG. 21, each jaw 7110, 7120 comprises a proximal end, i.e., proximal ends 7115, 7125, respectively, which rotatably connect the jaws 7110, 7120 together. Each proximal end 7115, 7125 comprises an aperture extending therethrough which is configured to closely receive a pin 7130 therein. The pin 7130 comprises a central body 7135 closely received within the apertures defined in the proximal ends 7115, 7125 of the jaws 7110, 7120 such that there is little, if any, relative translation between the jaws 7110, 7120 and the pin 7130. The pin 7130 defines a jaw axis J about which the jaws 7110, 7120 can be rotated and, also, rotatably mounts the jaws 7110, 7120 to the outer housing 6230 of the end effector 7000. More specifically, the outer housing 6230 comprises distally-extending tabs 6235 having apertures defined therein which are also configured to closely receive the pin 7130 such that the jaw assembly 7100 does not translate relative to a shaft portion 7200 of the end effector 7000. The pin 7130 further comprises enlarged ends which prevent the jaws 7110, 7120 from becoming detached from the pin 7130 and also prevents the jaw assembly 7100 from becoming detached from the shaft portion 7200. This arrangement defines a rotation joint 7300.


Referring primarily to FIGS. 21 and 23, the jaws 7110 and 7120 are rotatable between their open and closed positions by a jaw assembly drive including drive links 7140, a drive nut 7150, and a drive screw 6130. As described in greater detail below, the drive screw 6130 is selectively rotatable by the drive shaft 2730 of the shaft drive system 2700. The drive screw 6130 comprises an annular flange 6132 which is closely received within a slot, or groove, 6232 (FIG. 25) defined in the outer housing 6230 of the end effector 7000. The sidewalls of the slot 6232 are configured to prevent, or at least inhibit, longitudinal and/or radial translation between the drive screw 6130 and the outer housing 6230, but yet permit relative rotational motion between the drive screw 6130 and the outer housing 6230. The drive screw 6130 further comprises a threaded end 6160 which is threadably engaged with a threaded aperture 7160 defined in the drive nut 7150. The drive nut 7150 is constrained from rotating with the drive screw 6130 and, as a result, the drive nut 7150 is translated when the drive screw 6130 is rotated. In use, the drive screw 6130 is rotated in a first direction to displace the drive nut 7150 proximally and in a second, or opposite, direction to displace the drive nut 7150 distally. The drive nut 7150 further comprises a distal end 7155 comprising an aperture defined therein which is configured to closely receive pins 7145 extending from the drive links 7140. Referring primarily to FIG. 21, a first drive link 7140 is attached to one side of the distal end 7155 and a second drive link 7140 is attached to the opposite side of the distal end 7155. The first drive link 7140 comprises another pin 7145 extending therefrom which is closely received in an aperture defined in the proximal end 7115 of the first jaw 7110 and, similarly, the second drive link 7140 comprises another pin extending therefrom which is closely received in an aperture defined in the proximal end 7125 of the second jaw 7120. As a result of the above, the drive links 7140 operably connect the jaws 7110 and 7120 to the drive nut 7150. When the drive nut 7150 is driven proximally by the drive screw 6130, as described above, the jaws 7110, 7120 are rotated into the closed, or clamped, configuration. Correspondingly, the jaws 7110, 7120 are rotated into their open configuration when the drive nut 7150 is driven distally by the drive screw 6130.


As discussed above, the control system 1800 is configured to actuate the electric motor 1610 to perform three different end effector functions—clamping/opening the jaw assembly 7100 (FIGS. 14 and 15), rotating the end effector 7000 about a longitudinal axis (FIGS. 18 and 19), and articulating the end effector 7000 about an articulation axis (FIGS. 16 and 17). Referring primarily to FIGS. 26 and 27, the control system 1800 is configured to operate a transmission 6000 to selectively perform these three end effector functions. The transmission 6000 comprises a first clutch system 6100 configured to selectively transmit the rotation of the drive shaft 2730 to the drive screw 6130 of the end effector 7000 to open or close the jaw assembly 7100, depending on the direction in which the drive shaft 2730 is rotated. The transmission 6000 further comprises a second clutch system 6200 configured to selectively transmit the rotation of the drive shaft 2730 to the outer housing 6230 of the end effector 7000 to rotate the end effector 7000 about the longitudinal axis L. The transmission 6000 also comprises a third clutch system 6300 configured to selectively transmit the rotation of the drive shaft 2730 to the articulation joint 2300 to articulate the distal attachment portion 2400 and the end effector 7000 about the articulation axis A. The clutch systems 6100, 6200, and 6300 are in electrical communication with the control system 1800 via electrical circuits extending through the shaft 2510, the connector pins 2520, the connector pins 1520, and the shaft 1510, for example. In at least one instance, each of these clutch control circuits comprises two connector pins 2520 and two connector pins 1520, for example.


In various instances, further to the above, the shaft 2510 and/or the shaft 1510 comprise a flexible circuit including electrical traces which form part of the clutch control circuits. The flexible circuit can comprise a ribbon, or substrate, with conductive pathways defined therein and/or thereon. The flexible circuit can also comprise sensors and/or any solid state component, such as signal smoothing capacitors, for example, mounted thereto. In at least one instance, each of the conductive pathways can comprise one or more signal smoothing capacitors which can, among other things, even out fluctuations in signals transmitted through the conductive pathways. In various instances, the flexible circuit can be coated with at least one material, such as an elastomer, for example, which can seal the flexible circuit against fluid ingress.


Referring primarily to FIG. 28, the first clutch system 6100 comprises a first clutch 6110, an expandable first drive ring 6120, and a first electromagnetic actuator 6140. The first clutch 6110 comprises an annular ring and is slideably disposed on the drive shaft 2730. The first clutch 6110 is comprised of a magnetic material and is movable between a disengaged, or unactuated, position (FIG. 28) and an engaged, or actuated, position (FIG. 29) by electromagnetic fields EF generated by the first electromagnetic actuator 6140. In various instances, the first clutch 6110 is at least partially comprised of iron and/or nickel, for example. In at least one instance, the first clutch 6110 comprises a permanent magnet. As illustrated in FIG. 22A, the drive shaft 2730 comprises one or more longitudinal key slots 6115 defined therein which are configured to constrain the longitudinal movement of the clutch 6110 relative to the drive shaft 2730. More specifically, the clutch 6110 comprises one or more keys extending into the key slots 6115 such that the distal ends of the key slots 6115 stop the distal movement of the clutch 6110 and the proximal ends of the key slots 6115 stop the proximal movement of the clutch 6110.


When the first clutch 6110 is in its disengaged position (FIG. 28), the first clutch 6110 rotates with the drive shaft 2130 but does not transmit rotational motion to the first drive ring 6120. As can be seen in FIG. 28, the first clutch 6110 is separated from, or not in contact with, the first drive ring 6120. As a result, the rotation of the drive shaft 2730 and the first clutch 6110 is not transmitted to the drive screw 6130 when the first clutch assembly 6100 is in its disengaged state. When the first clutch 6110 is in its engaged position (FIG. 29), the first clutch 6110 is engaged with the first drive ring 6120 such that the first drive ring 6120 is expanded, or stretched, radially outwardly into contact with the drive screw 6130. In at least one instance, the first drive ring 6120 comprises an elastomeric band, for example. As can be seen in FIG. 29, the first drive ring 6120 is compressed against an annular inner sidewall 6135 of the drive screw 6130. As a result, the rotation of the drive shaft 2730 and the first clutch 6110 is transmitted to the drive screw 6130 when the first clutch assembly 6100 is in its engaged state. Depending on the direction in which the drive shaft 2730 is rotated, the first clutch assembly 6100 can move the jaw assembly 7100 into its open and closed configurations when the first clutch assembly 6100 is in its engaged state.


As described above, the first electromagnetic actuator 6140 is configured to generate magnetic fields to move the first clutch 6110 between its disengaged (FIG. 28) and engaged (FIG. 29) positions. For instance, referring to FIG. 28, the first electromagnetic actuator 6140 is configured to emit a magnetic field EFL which repulses, or drives, the first clutch 6110 away from the first drive ring 6120 when the first clutch assembly 6100 is in its disengaged state. The first electromagnetic actuator 6140 comprises one or more wound coils in a cavity defined in the shaft frame 2530 which generate the magnetic field EFL when current flows in a first direction through a first electrical clutch circuit including the wound coils. The control system 1800 is configured to apply a first voltage polarity to the first electrical clutch circuit to create the current flowing in the first direction. The control system 1800 can continuously apply the first voltage polarity to the first electric shaft circuit to continuously hold the first clutch 6110 in its disengaged position. While such an arrangement can prevent the first clutch 6110 from unintentionally engaging the first drive ring 6120, such an arrangement can also consume a lot of power. Alternatively, the control system 1800 can apply the first voltage polarity to the first electrical clutch circuit for a sufficient period of time to position the first clutch 6110 in its disengaged position and then discontinue applying the first voltage polarity to the first electric clutch circuit, thereby resulting in a lower consumption of power. That being said, the first clutch assembly 6100 further comprises a first clutch lock 6150 mounted in the drive screw 6130 which is configured to releasably hold the first clutch 6110 in its disengaged position. The first clutch lock 6150 is configured to prevent, or at least reduce the possibility of, the first clutch 6110 from becoming unintentionally engaged with the first drive ring 6120. When the first clutch 6110 is in its disengaged position, as illustrated in FIG. 28, the first clutch lock 6150 interferes with the free movement of the first clutch 6110 and holds the first clutch 6110 in position via a friction force and/or an interference force therebetween. In at least one instance, the first clutch lock 6150 comprises an elastomeric plug, seat, or detent, comprised of rubber, for example. In certain instances, the first clutch lock 6150 comprises a permanent magnet which holds the first clutch 6110 in its disengaged position by an electromagnetic force. In any event, the first electromagnetic actuator 6140 can apply an electromagnetic pulling force to the first clutch 6110 that overcomes these forces, as described in greater detail below.


Further to the above, referring to FIG. 29, the first electromagnetic actuator 6140 is configured to emit a magnetic field EFD which pulls, or drives, the first clutch 6110 toward the first drive ring 6120 when the first clutch assembly 6100 is in its engaged state. The coils of the first electromagnetic actuator 6140 generate the magnetic field EFD when current flows in a second, or opposite, direction through the first electrical clutch circuit. The control system 1800 is configured to apply an opposite voltage polarity to the first electrical clutch circuit to create the current flowing in the opposite direction. The control system 1800 can continuously apply the opposite voltage polarity to the first electrical clutch circuit to continuously hold the first clutch 6110 in its engaged position and maintain the operable engagement between the first drive ring 6120 and the drive screw 6130. Alternatively, the first clutch 6110 can be configured to become wedged within the first drive ring 6120 when the first clutch 6110 is in its engaged position and, in such instances, the control system 1800 may not need to continuously apply a voltage polarity to the first electrical clutch circuit to hold the first clutch assembly 6100 in its engaged state. In such instances, the control system 1800 can discontinue applying the voltage polarity once the first clutch 6110 has been sufficiently wedged in the first drive ring 6120.


Notably, further to the above, the first clutch lock 6150 is also configured to lockout the jaw assembly drive when the first clutch 6110 is in its disengaged position. More specifically, referring again to FIG. 28, the first clutch 6110 pushes the first clutch lock 6150 in the drive screw 6130 into engagement with the outer housing 6230 of the end effector 7000 when the first clutch 6110 is in its disengaged position such that the drive screw 6130 does not rotate, or at least substantially rotate, relative to the outer housing 6230. The outer housing 6230 comprises a slot 6235 defined therein which is configured to receive the first clutch lock 6150. When the first clutch 6110 is moved into its engaged position, referring to FIG. 29, the first clutch 6110 is no longer engaged with the first clutch lock 6150 and, as a result, the first clutch lock 6150 is no longer biased into engagement with the outer housing 6230 and the drive screw 6130 can rotate freely with respect to the outer housing 6230. As a result of the above, the first clutch 6110 can do at least two things—operate the jaw drive when the first clutch 6110 is in its engaged position and lock out the jaw drive when the first clutch 6110 is in its disengaged position.


Moreover, further to the above, the threads of the threaded portions 6160 and 7160 can be configured to prevent, or at least resist, backdriving of the jaw drive. In at least one instance, the thread pitch and/or angle of the threaded portions 6160 and 7160, for example, can be selected to prevent the backdriving, or unintentional opening, of the jaw assembly 7100. As a result of the above, the possibility of the jaw assembly 7100 unintentionally opening or closing is prevented, or at least reduced.


Referring primarily to FIG. 30, the second clutch system 6200 comprises a second clutch 6210, an expandable second drive ring 6220, and a second electromagnetic actuator 6240. The second clutch 6210 comprises an annular ring and is slideably disposed on the drive shaft 2730. The second clutch 6210 is comprised of a magnetic material and is movable between a disengaged, or unactuated, position (FIG. 30) and an engaged, or actuated, position (FIG. 31) by electromagnetic fields EF generated by the second electromagnetic actuator 6240. In various instances, the second clutch 6210 is at least partially comprised of iron and/or nickel, for example. In at least one instance, the second clutch 6210 comprises a permanent magnet. As illustrated in FIG. 22A, the drive shaft 2730 comprises one or more longitudinal key slots 6215 defined therein which are configured to constrain the longitudinal movement of the second clutch 6210 relative to the drive shaft 2730. More specifically, the second clutch 6210 comprises one or more keys extending into the key slots 6215 such that the distal ends of the key slots 6215 stop the distal movement of the second clutch 6210 and the proximal ends of the key slots 6215 stop the proximal movement of the second clutch 6210.


When the second clutch 6210 is in its disengaged position, referring to FIG. 30, the second clutch 6210 rotates with the drive shaft 2730 but does not transmit rotational motion to the second drive ring 6220. As can be seen in FIG. 30, the second clutch 6210 is separated from, or not in contact with, the second drive ring 6220. As a result, the rotation of the drive shaft 2730 and the second clutch 6210 is not transmitted to the outer housing 6230 of the end effector 7000 when the second clutch assembly 6200 is in its disengaged state. When the second clutch 6210 is in its engaged position (FIG. 31), the second clutch 6210 is engaged with the second drive ring 6220 such that the second drive ring 6220 is expanded, or stretched, radially outwardly into contact with the outer housing 6230. In at least one instance, the second drive ring 6220 comprises an elastomeric band, for example. As can be seen in FIG. 31, the second drive ring 6220 is compressed against an annular inner sidewall 7415 of the outer housing 6230. As a result, the rotation of the drive shaft 2730 and the second clutch 6210 is transmitted to the outer housing 6230 when the second clutch assembly 6200 is in its engaged state. Depending on the direction in which the drive shaft 2730 is rotated, the second clutch assembly 6200 can rotate the end effector 7000 in a first direction or a second direction about the longitudinal axis L when the second clutch assembly 6200 is in its engaged state.


As described above, the second electromagnetic actuator 6240 is configured to generate magnetic fields to move the second clutch 6210 between its disengaged (FIG. 30) and engaged (FIG. 31) positions. For instance, the second electromagnetic actuator 6240 is configured to emit a magnetic field EFL which repulses, or drives, the second clutch 6210 away from the second drive ring 6220 when the second clutch assembly 6200 is in its disengaged state. The second electromagnetic actuator 6240 comprises one or more wound coils in a cavity defined in the shaft frame 2530 which generate the magnetic field EFL when current flows in a first direction through a second electrical clutch circuit including the wound coils. The control system 1800 is configured to apply a first voltage polarity to the second electrical clutch circuit to create the current flowing in the first direction. The control system 1800 can continuously apply the first voltage polarity to the second electric clutch circuit to continuously hold the second clutch 6120 in its disengaged position. While such an arrangement can prevent the second clutch 6210 from unintentionally engaging the second drive ring 6220, such an arrangement can also consume a lot of power. Alternatively, the control system 1800 can apply the first voltage polarity to the second electrical clutch circuit for a sufficient period of time to position the second clutch 6210 in its disengaged position and then discontinue applying the first voltage polarity to the second electric clutch circuit, thereby resulting in a lower consumption of power. That being said, the second clutch assembly 6200 further comprises a second clutch lock 6250 mounted in the outer housing 6230 which is configured to releasably hold the second clutch 6210 in its disengaged position. Similar to the above, the second clutch lock 6250 can prevent, or at least reduce the possibility of, the second clutch 6210 from becoming unintentionally engaged with the second drive ring 6220. When the second clutch 6210 is in its disengaged position, as illustrated in FIG. 30, the second clutch lock 6250 interferes with the free movement of the second clutch 6210 and holds the second clutch 6210 in position via a friction and/or interference force therebetween. In at least one instance, the second clutch lock 6250 comprises an elastomeric plug, seat, or detent, comprised of rubber, for example. In certain instances, the second clutch lock 6250 comprises a permanent magnet which holds the second clutch 6210 in its disengaged position by an electromagnetic force. That said, the second electromagnetic actuator 6240 can apply an electromagnetic pulling force to the second clutch 6210 that overcomes these forces, as described in greater detail below.


Further to the above, referring to FIG. 31, the second electromagnetic actuator 6240 is configured to emit a magnetic field EFD which pulls, or drives, the second clutch 6210 toward the second drive ring 6220 when the second clutch assembly 6200 is in its engaged state. The coils of the second electromagnetic actuator 6240 generate the magnetic field EFD when current flows in a second, or opposite, direction through the second electrical shaft circuit. The control system 1800 is configured to apply an opposite voltage polarity to the second electrical shaft circuit to create the current flowing in the opposite direction. The control system 1800 can continuously apply the opposite voltage polarity to the second electric shaft circuit to continuously hold the second clutch 6210 in its engaged position and maintain the operable engagement between the second drive ring 6220 and the outer housing 6230. Alternatively, the second clutch 6210 can be configured to become wedged within the second drive ring 6220 when the second clutch 6210 is in its engaged position and, in such instances, the control system 1800 may not need to continuously apply a voltage polarity to the second shaft electrical circuit to hold the second clutch assembly 6200 in its engaged state. In such instances, the control system 1800 can discontinue applying the voltage polarity once the second clutch 6210 has been sufficiently wedged in the second drive ring 6220.


Notably, further to the above, the second clutch lock 6250 is also configured to lockout the rotation of the end effector 7000 when the second clutch 6210 is in its disengaged position. More specifically, referring again to FIG. 30, the second clutch 6210 pushes the second clutch lock 6250 in the outer shaft 6230 into engagement with the articulation link 2340 when the second clutch 6210 is in its disengaged position such that the end effector 7000 does not rotate, or at least substantially rotate, relative to the distal attachment portion 2400 of the shaft assembly 2000. As illustrated in FIG. 27, the second clutch lock 6250 is positioned or wedged within a slot, or channel, 2345 defined in the articulation link 2340 when the second clutch 6210 is in its disengaged position. As a result of the above, the possibility of the end effector 7000 unintentionally rotating is prevented, or at least reduced. Moreover, as a result of the above, the second clutch 6210 can do at least two things—operate the end effector rotation drive when the second clutch 6210 is in its engaged position and lock out the end effector rotation drive when the second clutch 6210 is in its disengaged position.


Referring primarily to FIGS. 22, 24, and 25, the shaft assembly 2000 further comprises an articulation drive system configured to articulate the distal attachment portion 2400 and the end effector 7000 about the articulation joint 2300. The articulation drive system comprises an articulation drive 6330 rotatably supported within the distal attachment portion 2400. That said, the articulation drive 6330 is closely received within the distal attachment portion 2400 such that the articulation drive 6330 does not translate, or at least substantially translate, relative to the distal attachment portion 2400. The articulation drive system of the shaft assembly 2000 further comprises a stationary gear 2330 fixedly mounted to the articulation frame 2310. More specifically, the stationary gear 2330 is fixedly mounted to a pin connecting a tab 2314 of the articulation frame 2310 and the articulation link 2340 such that the stationary gear 2330 does not rotate relative to the articulation frame 2310. The stationary gear 2330 comprises a central body 2335 and an annular array of stationary teeth 2332 extending around the perimeter of the central body 2335. The articulation drive 6330 comprises an annular array of drive teeth 6332 which is meshingly engaged with the stationary teeth 2332. When the articulation drive 6330 is rotated, the articulation drive 6330 pushes against the stationary gear 2330 and articulates the distal attachment portion 2400 of the shaft assembly 2000 and the end effector 7000 about the articulation joint 2300.


Referring primarily to FIG. 32, the third clutch system 6300 comprises a third clutch 6310, an expandable third drive ring 6320, and a third electromagnetic actuator 6340. The third clutch 6310 comprises an annular ring and is slideably disposed on the drive shaft 2730. The third clutch 6310 is comprised of a magnetic material and is movable between a disengaged, or unactuated, position (FIG. 32) and an engaged, or actuated, position (FIG. 33) by electromagnetic fields EF generated by the third electromagnetic actuator 6340. In various instances, the third clutch 6310 is at least partially comprised of iron and/or nickel, for example. In at least one instance, the third clutch 6310 comprises a permanent magnet. As illustrated in FIG. 22A, the drive shaft 2730 comprises one or more longitudinal key slots 6315 defined therein which are configured to constrain the longitudinal movement of the third clutch 6310 relative to the drive shaft 2730. More specifically, the third clutch 6310 comprises one or more keys extending into the key slots 6315 such that the distal ends of the key slots 6315 stop the distal movement of the third clutch 6310 and the proximal ends of the key slots 6315 stop the proximal movement of the third clutch 6310.


When the third clutch 6310 is in its disengaged position, referring to FIG. 32, the third clutch 6310 rotates with the drive shaft 2730 but does not transmit rotational motion to the third drive ring 6320. As can be seen in FIG. 32, the third clutch 6310 is separated from, or not in contact with, the third drive ring 6320. As a result, the rotation of the drive shaft 2730 and the third clutch 6310 is not transmitted to the articulation drive 6330 when the third clutch assembly 6300 is in its disengaged state. When the third clutch 6310 is in its engaged position, referring to FIG. 33, the third clutch 6310 is engaged with the third drive ring 6320 such that the third drive ring 6320 is expanded, or stretched, radially outwardly into contact with the articulation drive 6330. In at least one instance, the third drive ring 6320 comprises an elastomeric band, for example. As can be seen in FIG. 33, the third drive ring 6320 is compressed against an annular inner sidewall 6335 of the articulation drive 6330. As a result, the rotation of the drive shaft 2730 and the third clutch 6310 is transmitted to the articulation drive 6330 when the third clutch assembly 6300 is in its engaged state. Depending on the direction in which the drive shaft 2730 is rotated, the third clutch assembly 6300 can articulate the distal attachment portion 2400 of the shaft assembly 2000 and the end effector 7000 in a first or second direction about the articulation joint 2300.


As described above, the third electromagnetic actuator 6340 is configured to generate magnetic fields to move the third clutch 6310 between its disengaged (FIG. 32) and engaged (FIG. 33) positions. For instance, referring to FIG. 32, the third electromagnetic actuator 6340 is configured to emit a magnetic field EFL which repulses, or drives, the third clutch 6310 away from the third drive ring 6320 when the third clutch assembly 6300 is in its disengaged state. The third electromagnetic actuator 6340 comprises one or more wound coils in a cavity defined in the shaft frame 2530 which generate the magnetic field EFL when current flows in a first direction through a third electrical clutch circuit including the wound coils. The control system 1800 is configured to apply a first voltage polarity to the third electrical clutch circuit to create the current flowing in the first direction. The control system 1800 can continuously apply the first voltage polarity to the third electric clutch circuit to continuously hold the third clutch 6310 in its disengaged position. While such an arrangement can prevent the third clutch 6310 from unintentionally engaging the third drive ring 6320, such an arrangement can also consume a lot of power. Alternatively, the control system 1800 can apply the first voltage polarity to the third electrical clutch circuit for a sufficient period of time to position the third clutch 6310 in its disengaged position and then discontinue applying the first voltage polarity to the third electric clutch circuit, thereby resulting in a lower consumption of power.


Further to the above, the third electromagnetic actuator 6340 is configured to emit a magnetic field EFD which pulls, or drives, the third clutch 6310 toward the third drive ring 6320 when the third clutch assembly 6300 is in its engaged state. The coils of the third electromagnetic actuator 6340 generate the magnetic field EFD when current flows in a second, or opposite, direction through the third electrical clutch circuit. The control system 1800 is configured to apply an opposite voltage polarity to the third electrical shaft circuit to create the current flowing in the opposite direction. The control system 1800 can continuously apply the opposite voltage polarity to the third electric shaft circuit to continuously hold the third clutch 6310 in its engaged position and maintain the operable engagement between the third drive ring 6320 and the articulation drive 6330. Alternatively, the third clutch 6210 can be configured to become wedged within the third drive ring 6320 when the third clutch 6310 is in its engaged position and, in such instances, the control system 1800 may not need to continuously apply a voltage polarity to the third shaft electrical circuit to hold the third clutch assembly 6300 in its engaged state. In such instances, the control system 1800 can discontinue applying the voltage polarity once the third clutch 6310 has been sufficiently wedged in the third drive ring 6320. In any event, the end effector 7000 is articulatable in a first direction or a second direction, depending on the direction in which the drive shaft 2730 is rotated, when the third clutch assembly 6300 is in its engaged state.


Further to the above, referring to FIGS. 22, 32, and 33, the articulation drive system further comprises a lockout 6350 which prevents, or at least inhibits, the articulation of the distal attachment portion 2400 of the shaft assembly 2000 and the end effector 7000 about the articulation joint 2300 when the third clutch 6310 is in its disengaged position (FIG. 32). Referring primarily to FIG. 22, the articulation link 2340 comprises a slot, or groove, 2350 defined therein wherein the lockout 6350 is slideably positioned in the slot 2350 and extends at least partially under the stationary articulation gear 2330. The lockout 6350 comprises at attachment hook 6352 engaged with the third clutch 6310. More specifically, the third clutch 6310 comprises an annular slot, or groove, 6312 defined therein and the attachment hook 6352 is positioned in the annular slot 6312 such that the lockout 6350 translates with the third clutch 6310. Notably, however, the lockout 6350 does not rotate, or at least substantially rotate, with the third clutch 6310. Instead, the annular groove 6312 in the third clutch 6310 permits the third clutch 6310 to rotate relative to the lockout 6350. The lockout 6350 further comprises a lockout hook 6354 slideably positioned in a radially-extending lockout slot 2334 defined in the bottom of the stationary gear 2330. When the third clutch 6310 is in its disengaged position, as illustrated in FIG. 32, the lockout 6350 is in a locked position in which the lockout hook 6354 prevents the end effector 7000 from rotating about the articulation joint 2300. When the third clutch 6310 is in its engaged position, as illustrated in FIG. 33, the lockout 6350 is in an unlocked position in which the lockout hook 6354 is no longer positioned in the lockout slot 2334. Instead, the lockout hook 6354 is positioned in a clearance slot defined in the middle or body 2335 of the stationary gear 2330. In such instances, the lockout hook 6354 can rotate within the clearance slot when the end effector 7000 rotates about the articulation joint 2300.


Further to the above, the radially-extending lockout slot 2334 depicted in FIGS. 32 and 33 extends longitudinally, i.e., along an axis which is parallel to the longitudinal axis of the elongate shaft 2200. Once the end effector 7000 has been articulated, however, the lockout hook 6354 is no longer aligned with the longitudinal lockout slot 2334. With this in mind, the stationary gear 2330 comprises a plurality, or an array, of radially-extending lockout slots 2334 defined in the bottom of the stationary gear 2330 such that, when the third clutch 6310 is deactuated and the lockout 6350 is pulled distally after the end effector 7000 has been articulated, the lockout hook 6354 can enter one of the lockout slots 2334 and lock the end effector 7000 in its articulated position. Thus, as a result, the end effector 7000 can be locked in an unarticulated and an articulated position. In various instances, the lockout slots 2334 can define discrete articulated positions for the end effector 7000. For instance, the lockout slots 2334 can be defined at 10 degree intervals, for example, which can define discrete articulation orientations for the end effector 7000 at 10 degree intervals. In other instances, these orientations can be at 5 degree intervals, for example. In alternative embodiments, the lockout 6350 comprises a brake that engages a circumferential shoulder defined in the stationary gear 2330 when the third clutch 6310 is disengaged from the third drive ring 6320. In such an embodiment, the end effector 7000 can be locked in any suitable orientation. In any event, the lockout 6350 prevents, or at least reduces the possibility of, the end effector 7000 unintentionally articulating. As a result of the above, the third clutch 6310 can do things—operate the articulation drive when it is in its engaged position and lock out the articulation drive when it is in its disengaged position.


Referring primarily to FIGS. 24 and 25, the shaft frame 2530 and the drive shaft 2730 extend through the articulation joint 2300 into the distal attachment portion 2400. When the end effector 7000 is articulated, as illustrated in FIGS. 16 and 17, the shaft frame 2530 and the drive shaft 2730 bend to accommodate the articulation of the end effector 7000. Thus, the shaft frame 2530 and the drive shaft 2730 are comprised of any suitable material which accommodates the articulation of the end effector 7000. Moreover, as discussed above, the shaft frame 2530 houses the first, second, and third electromagnetic actuators 6140, 6240, and 6340. In various instances, the first, second, and third electromagnetic actuators 6140, 6240, and 6340 each comprise wound wire coils, such as copper wire coils, for example, and the shaft frame 2530 is comprised of an insulative material to prevent, or at least reduce the possibility of, short circuits between the first, second, and third electromagnetic actuators 6140, 6240, and 6340. In various instances, the first, second, and third electrical clutch circuits extending through the shaft frame 2530 are comprised of insulated electrical wires, for example. Further to the above, the first, second, and third electrical clutch circuits place the electromagnetic actuators 6140, 6240, and 6340 in communication with the control system 1800 in the drive module 1100.


As described above, the clutches 6110, 6210, and/or 6310 can be held in their disengaged positions so that they do not unintentionally move into their engaged positions. In various arrangements, the clutch system 6000 comprises a first biasing member, such as a spring, for example, configured to bias the first clutch 6110 into its disengaged position, a second biasing member, such as a spring, for example, configured to bias the second clutch 6210 into its disengaged position, and/or a third biasing member, such as a spring, for example, configured to bias the third clutch 6110 into its disengaged position. In such arrangements, the biasing forces of the springs can be selectively overcome by the electromagnetic forces generated by the electromagnetic actuators when energized by an electrical current. Further to the above, the clutches 6110, 6210, and/or 6310 can be retained in their engaged positions by the drive rings 6120, 6220, and/or 6320, respectively. More specifically, in at least one instance, the drive rings 6120, 6220, and/or 6320 are comprised of an elastic material which grips or frictionally holds the clutches 6110, 6210, and/or 6310, respectively, in their engaged positions. In various alternative embodiments, the clutch system 6000 comprises a first biasing member, such as a spring, for example, configured to bias the first clutch 6110 into its engaged position, a second biasing member, such as a spring, for example, configured to bias the second clutch 6210 into its engaged position, and/or a third biasing member, such as a spring, for example, configured to bias the third clutch 6110 into its engaged position. In such arrangements, the biasing forces of the springs can be overcome by the electromagnetic forces applied by the electromagnetic actuators 6140, 6240, and/or 6340, respectively, as needed to selectively hold the clutches 6110, 6210, and 6310 in their disengaged positions. In any one operational mode of the surgical system, the control assembly 1800 can energize one of the electromagnetic actuators to engage one of the clutches while energizing the other two electromagnetic actuators to disengage the other two clutches.


Although the clutch system 6000 comprises three clutches to control three drive systems of the surgical system, a clutch system can comprise any suitable number of clutches to control any suitable number of systems. Moreover, although the clutches of the clutch system 6000 slide proximally and distally between their engaged and disengaged positions, the clutches of a clutch system can move in any suitable manner. In addition, although the clutches of the clutch system 6000 are engaged one at a time to control one drive motion at a time, various instances are envisioned in which more than one clutch can be engaged to control more than one drive motion at a time.


In view of the above, the reader should appreciate that the control system 1800 is configured to, one, operate the motor system 1600 to rotate the drive shaft system 2700 in an appropriate direction and, two, operate the clutch system 6000 to transfer the rotation of the drive shaft system 2700 to the appropriate function of the end effector 7000. Moreover, as discussed above, the control system 1800 is responsive to inputs from the clamping trigger system 2600 of the shaft assembly 2000 and the input system 1400 of the handle 1000. When the clamping trigger system 2600 is actuated, as discussed above, the control system 1800 activates the first clutch assembly 6100 and deactivates the second clutch assembly 6200 and the third clutch assembly 6300. In such instances, the control system 1800 also supplies power to the motor system 1600 to rotate the drive shaft system 2700 in a first direction to clamp the jaw assembly 7100 of the end effector 7000. When the control system 1800 detects that the jaw assembly 7100 is in its clamped configuration, the control system 1800 stops the motor assembly 1600 and deactivates the first clutch assembly 6100. When the control system 1800 detects that the clamping trigger system 2600 has been moved to, or is being moved to, its unactuated position, the control system 1800 activates, or maintains the activation of, the first clutch assembly 6100 and deactivates, or maintains the deactivation of, the second clutch assembly 6200 and the third clutch assembly 6300. In such instances, the control system 1800 also supplies power to the motor system 1600 to rotate the drive shaft system 2700 in a second direction to open the jaw assembly 7100 of the end effector 7000.


When the rotation actuator 1420 is actuated in a first direction, further to the above, the control system 1800 activates the second clutch assembly 6200 and deactivates the first clutch assembly 6100 and the third clutch assembly 6300. In such instances, the control system 1800 also supplies power to the motor system 1600 to rotate the drive shaft system 2700 in a first direction to rotate the end effector 7000 in a first direction. When the control system 1800 detects that the rotation actuator 1420 has been actuated in a second direction, the control system 1800 activates, or maintains the activation of, the second clutch assembly 6200 and deactivates, or maintains the deactivation of, the first clutch assembly 6100 and the third clutch assembly 6300. In such instances, the control system 1800 also supplies power to the motor system 1600 to rotate the drive shaft system 2700 in a second direction to rotate the drive shaft system 2700 in a second direction to rotate the end effector 7000 in a second direction. When the control system 1800 detects that the rotation actuator 1420 is not actuated, the control system 1800 deactivates the second clutch assembly 6200.


When the first articulation actuator 1432 is depressed, further to the above, the control system 1800 activates the third clutch assembly 6300 and deactivates the first clutch assembly 6100 and the second clutch assembly 6200. In such instances, the control system 1800 also supplies power to the motor system 1600 to rotate the drive shaft system 2700 in a first direction to articulate the end effector 7000 in a first direction. When the control system 1800 detects that the second articulation actuator 1434 is depressed, the control system 1800 activates, or maintains the activation of, the third clutch assembly 6200 and deactivates, or maintains the deactivation of, the first clutch assembly 6100 and the second clutch assembly 6200. In such instances, the control system 1800 also supplies power to the motor system 1600 to rotate the drive shaft system 2700 in a second direction to articulate the end effector 7000 in a second direction. When the control system 1800 detects that neither the first articulation actuator 1432 nor the second articulation actuator 1434 are actuated, the control system 1800 deactivates the third clutch assembly 6200.


Further to the above, the control system 1800 is configured to change the operating mode of the stapling system based on the inputs it receives from the clamping trigger system 2600 of the shaft assembly 2000 and the input system 1400 of the handle 1000. The control system 1800 is configured to shift the clutch system 6000 before rotating the shaft drive system 2700 to perform the corresponding end effector function. Moreover, the control system 1800 is configured to stop the rotation of the shaft drive system 2700 before shifting the clutch system 6000. Such an arrangement can prevent the sudden movements in the end effector 7000. Alternatively, the control system 1800 can shift the clutch system 600 while the shaft drive system 2700 is rotating. Such an arrangement can allow the control system 1800 to shift quickly between operating modes.


As discussed above, referring to FIG. 34, the distal attachment portion 2400 of the shaft assembly 2000 comprises an end effector lock 6400 configured to prevent the end effector 7000 from being unintentionally decoupled from the shaft assembly 2000. The end effector lock 6400 comprises a lock end 6410 selectively engageable with the annular array of lock notches 7410 defined on the proximal attachment portion 7400 of the end effector 7000, a proximal end 6420, and a pivot 6430 rotatably connecting the end effector lock 6400 to the articulation link 2320. When the third clutch 6310 of the third clutch assembly 6300 is in its disengaged position, as illustrated in FIG. 34, the third clutch 6310 is contact with the proximal end 6420 of the end effector lock 6400 such that the lock end 6410 of the end effector lock 6400 is engaged with the array of lock notches 7410. In such instances, the end effector 7000 can rotate relative to the end effector lock 6400 but cannot translate relative to the distal attachment portion 2400. When the third clutch 6310 is moved into its engaged position, as illustrated in FIG. 35, the third clutch 6310 is no longer engaged with the proximal end 6420 of the end effector lock 6400. In such instances, the end effector lock 6400 is free to pivot upwardly and permit the end effector 7000 to be detached from the shaft assembly 2000.


The above being said, referring again to FIG. 34, it is possible that the second clutch 6210 of the second clutch assembly 6200 is in its disengaged position when the clinician detaches, or attempts to detach, the end effector 7000 from the shaft assembly 2000. As discussed above, the second clutch 6210 is engaged with the second clutch lock 6250 when the second clutch 6210 is in its disengaged position and, in such instances, the second clutch lock 6250 is pushed into engagement with the articulation link 2340. More specifically, the second clutch lock 6250 is positioned in the channel 2345 defined in the articulation 2340 when the second clutch 6210 is engaged with the second clutch lock 6250 which may prevent, or at least impede, the end effector 7000 from being detached from the shaft assembly 2000. To facilitate the release of the end effector 7000 from the shaft assembly 2000, the control system 1800 can move the second clutch 6210 into its engaged position in addition to moving the third clutch 6310 into its engaged position. In such instances, the end effector 7000 can clear both the end effector lock 6400 and the second clutch lock 6250 when the end effector 7000 is removed.


In at least one instance, further to the above, the drive module 1100 comprises an input switch and/or sensor in communication with the control system 1800 via the input system 1400, and/or the control system 1800 directly, which, when actuated, causes the control system 1800 to unlock the end effector 7000. In various instances, the drive module 1100 comprises an input screen 1440 in communication with the board 1410 of the input system 1400 which is configured to receive an unlock input from the clinician. In response to the unlock input, the control system 1800 can stop the motor system 1600, if it is running, and unlock the end effector 7000 as described above. The input screen 1440 is also configured to receive a lock input from the clinician in which the input system 1800 moves the second clutch assembly 6200 and/or the third clutch assembly 6300 into their unactuated states to lock the end effector 7000 to the shaft assembly 2000.



FIG. 37 depicts a shaft assembly 2000′ in accordance with at least one alternative embodiment. The shaft assembly 2000′ is similar to the shaft assembly 2000 in many respects, most of which will not be repeated herein for the sake of brevity. Similar to the shaft assembly 2000, the shaft assembly 2000′ comprises a shaft frame, i.e., shaft frame 2530′. The shaft frame 2530′ comprises a longitudinal passage 2535′ and, in addition, a plurality of clutch position sensors, i.e., a first sensor 6180′, a second sensor 6280′, and a third sensor 6380′ positioned in the shaft frame 2530′. The first sensor 6180′ is in signal communication with the control system 1800 as part of a first sensing circuit. The first sensing circuit comprises signal wires extending through the longitudinal passage 2535′; however, the first sensing circuit can comprise a wireless signal transmitter and receiver to place the first sensor 6180′ in signal communication with the control system 1800. The first sensor 6180′ is positioned and arranged to detect the position of the first clutch 6110 of the first clutch assembly 6100. Based on data received from the first sensor 6180′, the control system 1800 can determine whether the first clutch 6110 is in its engaged position, its disengaged position, or somewhere in-between. With this information, the control system 1800 can assess whether or not the first clutch 6110 is in the correct position given the operating state of the surgical instrument. For instance, if the surgical instrument is in its jaw clamping/opening operating state, the control system 1800 can verify whether the first clutch 6110 is properly positioned in its engaged position. In such instances, further to the below, the control system 1800 can also verify that the second clutch 6210 is in its disengaged position via the second sensor 6280′ and that the third clutch 6310 is in its disengaged position via the third sensor 6380′. Correspondingly, the control system 1800 can verify whether the first clutch 6110 is properly positioned in its disengaged position if the surgical instrument is not in its jaw clamping/opening state. To the extent that the first clutch 6110 is not in its proper position, the control system 1800 can actuate the first electromagnetic actuator 6140 in an attempt to properly position the first clutch 6110. Likewise, the control system 1800 can actuate the electromagnetic actuators 6240 and/or 6340 to properly position the clutches 6210 and/or 6310, if necessary.


The second sensor 6280′ is in signal communication with the control system 1800 as part of a second sensing circuit. The second sensing circuit comprises signal wires extending through the longitudinal passage 2535′; however, the second sensing circuit can comprise a wireless signal transmitter and receiver to place the second sensor 6280′ in signal communication with the control system 1800. The second sensor 6280′ is positioned and arranged to detect the position of the second clutch 6210 of the first clutch assembly 6200. Based on data received from the second sensor 6280′, the control system 1800 can determine whether the second clutch 6210 is in its engaged position, its disengaged position, or somewhere in-between. With this information, the control system 1800 can assess whether or not the second clutch 6210 is in the correct position given the operating state of the surgical instrument. For instance, if the surgical instrument is in its end effector rotation operating state, the control system 1800 can verify whether the second clutch 6210 is properly positioned in its engaged position. In such instances, the control system 1800 can also verify that the first clutch 6110 is in its disengaged position via the first sensor 6180′ and, further to the below, the control system 1800 can also verify that the third clutch 6310 is in its disengaged position via the third sensor 6380′. Correspondingly, the control system 1800 can verify whether the second clutch 6110 is properly positioned in its disengaged position if the surgical instrument is not in its end effector rotation state. To the extent that the second clutch 6210 is not in its proper position, the control system 1800 can actuate the second electromagnetic actuator 6240 in an attempt to properly position the second clutch 6210. Likewise, the control system 1800 can actuate the electromagnetic actuators 6140 and/or 6340 to properly position the clutches 6110 and/or 6310, if necessary.


The third sensor 6380′ is in signal communication with the control system 1800 as part of a third sensing circuit. The third sensing circuit comprises signal wires extending through the longitudinal passage 2535′; however, the third sensing circuit can comprise a wireless signal transmitter and receiver to place the third sensor 6380′ in signal communication with the control system 1800. The third sensor 6380′ is positioned and arranged to detect the position of the third clutch 6310 of the third clutch assembly 6300. Based on data received from the third sensor 6380′, the control system 1800 can determine whether the third clutch 6310 is in its engaged position, its disengaged position, or somewhere in-between. With this information, the control system 1800 can assess whether or not the third clutch 6310 is in the correct position given the operating state of the surgical instrument. For instance, if the surgical instrument is in its end effector articulation operating state, the control system 1800 can verify whether the third clutch 6310 is properly positioned in its engaged position. In such instances, the control system 1800 can also verify that the first clutch 6110 is in its disengaged position via the first sensor 6180′ and that the second clutch 6210 is in its disengaged position via the second sensor 6280′. Correspondingly, the control system 1800 can verify whether the third clutch 6310 is properly positioned in its disengaged position if the surgical instrument is not in its end effector articulation state. To the extent that the third clutch 6310 is not in its proper position, the control system 1800 can actuate the third electromagnetic actuator 6340 in an attempt to properly position the third clutch 6310. Likewise, the control system 1800 can actuate the electromagnetic actuators 6140 and/or 6240 to properly position the clutches 6110 and/or 6210, if necessary.


Further to the above, the clutch position sensors, i.e., the first sensor 6180′, the second sensor 6280′, and the third sensor 6380′ can comprise any suitable type of sensor. In various instances, the first sensor 6180′, the second sensor 6280′, and the third sensor 6380′ each comprise a proximity sensor. In such an arrangement, the sensors 6180′, 6280′, and 6380′ are configured to detect whether or not the clutches 6110, 6210, and 6310, respectively, are in their engaged positions. In various instances, the first sensor 6180′, the second sensor 6280′, and the third sensor 6380′ each comprise a Hall Effect sensor, for example. In such an arrangement, the sensors 6180′, 6280′, and 6380′ can not only detect whether or not the clutches 6110, 6210, and 6310, respectively, are in their engaged positions but the sensors 6180′, 6280′, and 6380′ can also detect how close the clutches 6110, 6210, and 6310 are with respect to their engaged or disengaged positions.



FIG. 38 depicts the shaft assembly 2000′ and an end effector 7000″ in accordance with at least one alternative embodiment. The end effector 7000″ is similar to the end effector 7000 in many respects, most of which will not be repeated herein for the sake of brevity. Similar to the end effector 7000, the shaft assembly 7000″ comprises a jaw assembly 7100 and a jaw assembly drive configured to move the jaw assembly 7100 between its open and closed configurations. The jaw assembly drive comprises drive links 7140, a drive nut 7150″, and a drive screw 6130″. The drive nut 7150″ comprises a sensor 7190″ positioned therein which is configured to detect the position of a magnetic element 6190″ positioned in the drive screw 6130″. The magnetic element 6190″ is positioned in an elongate aperture 6134″ defined in the drive screw 6130″ and can comprise a permanent magnet and/or can be comprised of iron, nickel, and/or any suitable metal, for example. In various instances, the sensor 7190″ comprises a proximity sensor, for example, which is in signal communication with the control system 1800. In certain instances, the sensor 7190″ comprises a Hall Effect sensor, for example, in signal communication with the control system 1800. In certain instances, the sensor 7190″ comprises an optical sensor, for example, and the detectable element 6190″ comprises an optically detectable element, such as a reflective element, for example. In either event, the sensor 7190″ is configured to communicate wirelessly with the control system 1800 via a wireless signal transmitter and receiver and/or via a wired connection extending through the shaft frame passage 2532′, for example.


The sensor 7190″, further to the above, is configured to detect when the magnetic element 6190″ is adjacent to the sensor 7190″ such that the control system 1800 can use this data to determine that the jaw assembly 7100 has reached the end of its clamping stroke. At such point, the control system 1800 can stop the motor assembly 1600. The sensor 7190″ and the control system 1800 are also configured to determine the distance between where the drive screw 6130″ is currently positioned and where the drive screw 6130″ should be positioned at the end of its closure stroke in order to calculate the amount of closure stroke of the drive screw 6130″ that is still needed to close the jaw assembly 7100. Moreover, such information can be used by the control system 1800 to assess the current configuration of the jaw assembly 7100, i.e., whether the jaw assembly 7100 is in its open configuration, its closed configuration, or a partially closed configuration. The sensor system could be used to determine when the jaw assembly 7100 has reached its fully open position and stop the motor assembly 1600 at that point. In various instances, the control system 1800 could use this sensor system to confirm that the first clutch assembly 6100 is in its actuated state by confirming that the jaw assembly 7100 is moving while the motor assembly 1600 is turning. Similarly, the control system 1800 could use this sensor system to confirm that the first clutch assembly 6100 is in its unactuated state by confirming that the jaw assembly 7100 is not moving while the motor assembly 1600 is turning.



FIG. 39 depicts a shaft assembly 2000′″ and an end effector 7000′″ in accordance with at least one alternative embodiment. The shaft assembly 2000′″ is similar to the shaft assemblies 2000 and 2000′ in many respects, most of which will not be repeated herein for the sake of brevity. The end effector 7000′″ is similar to the end effectors 7000 and 7000″ in many respects, most of which will not be repeated herein for the sake of brevity. Similar to the end effector 7000, the end effector 7000′″ comprises a jaw assembly 7100 and a jaw assembly drive configured to move the jaw assembly 7100 between its open and closed configurations and, in addition, an end effector rotation drive that rotates the end effector 7000′″ relative to the distal attachment portion 2400 of the shaft assembly 2000′. The end effector rotation drive comprises an outer housing 6230′″ that is rotated relative to a shaft frame 2530′″ of the end effector 7000′″ by the second clutch assembly 6200. The shaft frame 2530′″ comprises a sensor 6290′″ positioned therein which is configured to detect the position of a magnetic element 6190′″ positioned in and/or on the outer housing 6230′″. The magnetic element 6190′″ can comprise a permanent magnet and/or can be comprised of iron, nickel, and/or any suitable metal, for example. In various instances, the sensor 6290′″ comprises a proximity sensor, for example, in signal communication with the control system 1800. In certain instances, the sensor 6290′″ comprises a Hall Effect sensor, for example, in signal communication with the control system 1800. In either event, the sensor 6290′″ is configured to communicate wirelessly with the control system 1800 via a wireless signal transmitter and receiver and/or via a wired connection extending through the shaft frame passage 2532′, for example. In various instances, the control system 1800 can use the sensor 6290′″ to confirm whether the magnetic element 6190′″ is rotating and, thus, confirm that the second clutch assembly 6200 is in its actuated state. Similarly, the control system 1800 can use the sensor 6290′″ to confirm whether the magnetic element 6190′″ is not rotating and, thus, confirm that the second clutch assembly 6200 is in its unactuated state. The control system 1800 can also use the sensor 6290′″ to confirm that the second clutch assembly 6200 is in its unactuated state by confirming that the second clutch 6210 is positioned adjacent the sensor 6290′″.



FIG. 40 depicts a shaft assembly 2000″″ in accordance with at least one alternative embodiment. The shaft assembly 2000″″ is similar to the shaft assemblies 2000, 2000′, and 2000′″ in many respects, most of which will not be repeated herein for the sake of brevity. Similar to the shaft assembly 2000, the shaft assembly 2000″″ comprises, among other things, an elongate shaft 2200, an articulation joint 2300, and a distal attachment portion 2400 configured to receive an end effector, such as end effector 7000′, for example. Similar to the shaft assembly 2000, the shaft assembly 2000″″ comprises an articulation drive, i.e., articulation drive 6330″″ configured to rotate the distal attachment portion 2400 and the end effector 7000′ about the articulation joint 2300. Similar to the above, a shaft frame 2530″″ comprises a sensor positioned therein configured to detect the position, and/or rotation, of a magnetic element 6390″″ positioned in and/or on the articulation drive 6330″″. The magnetic element 6390″″ can comprise a permanent magnet and/or can be comprised of iron, nickel, and/or any suitable metal, for example. In various instances, the sensor comprises a proximity sensor, for example, in signal communication with the control system 1800. In certain instances, the sensor comprises a Hall Effect sensor, for example, in signal communication with the control system 1800. In either event, the sensor is configured to communicate wirelessly with the control system 1800 via a wireless signal transmitter and receiver and/or via a wired connection extending through the shaft frame passage 2532′, for example. In various instances, the control system 1800 can use the sensor to confirm whether the magnetic element 6390″″ is rotating and, thus, confirm that the third clutch assembly 6300 is in its actuated state. Similarly, the control system 1800 can use the sensor to confirm whether the magnetic element 6390″″ is not rotating and, thus, confirm that the third clutch assembly 6300 is in its unactuated state. In certain instances, the control system 1800 can use the sensor to confirm that the third clutch assembly 6300 is in its unactuated state by confirming that the third clutch 6310 is positioned adjacent the sensor.


Referring to FIG. 40 once again, the shaft assembly 2000″″ comprises an end effector lock 6400′ configured to releasably lock the end effector 7000′, for example, to the shaft assembly 2000″″. The end effector lock 6400′ is similar to the end effector lock 6400 in many respects, most of which will not be discussed herein for the sake of brevity. Notably, though, a proximal end 6420′ of the lock 6400′ comprises a tooth 6422′ configured to engage the annular slot 6312 of the third clutch 6310 and releasably hold the third clutch 6310 in its disengaged position. That said, the actuation of the third electromagnetic assembly 6340 can disengage the third clutch 6310 from the end effector lock 6400′. Moreover, in such instances, the proximal movement of the third clutch 6310 into its engaged position rotates the end effector lock 6400′ into a locked position and into engagement with the lock notches 7410 to lock the end effector 7000′ to the shaft assembly 2000″″. Correspondingly, the distal movement of the third clutch 6310 into its disengaged position unlocks the end effector 7000′ and allows the end effector 7000′ to be disassembled from the shaft assembly 2000″″.


Further to the above, an instrument system including a handle and a shaft assembly attached thereto can be configured to perform a diagnostic check to assess the state of the clutch assemblies 6100, 6200, and 6300. In at least one instance, the control system 1800 sequentially actuates the electromagnetic actuators 6140, 6240, and/or 6340—in any suitable order—to verify the positions of the clutches 6110, 6210, and/or 6310, respectively, and/or verify that the clutches are responsive to the electromagnetic actuators and, thus, not stuck. The control system 1800 can use sensors, including any of the sensors disclosed herein, to verify the movement of the clutches 6110, 6120, and 6130 in response to the electromagnetic fields created by the electromagnetic actuators 6140, 6240, and/or 6340. In addition, the diagnostic check can also include verifying the motions of the drive systems. In at least one instance, the control system 1800 sequentially actuates the electromagnetic actuators 6140, 6240, and/or 6340—in any suitable order—to verify that the jaw drive opens and/or closes the jaw assembly 7100, the rotation drive rotates the end effector 7000, and/or the articulation drive articulates the end effector 7000, for example. The control system 1800 can use sensors to verify the motions of the jaw assembly 7100 and end effector 7000.


The control system 1800 can perform the diagnostic test at any suitable time, such as when a shaft assembly is attached to the handle and/or when the handle is powered on, for example. If the control system 1800 determines that the instrument system passed the diagnostic test, the control system 1800 can permit the ordinary operation of the instrument system. In at least one instance, the handle can comprise an indicator, such as a green LED, for example, which indicates that the diagnostic check has been passed. If the control system 1800 determines that the instrument system failed the diagnostic test, the control system 1800 can prevent and/or modify the operation of the instrument system. In at least one instance, the control system 1800 can limit the functionality of the instrument system to only the functions necessary to remove the instrument system from the patient, such as straightening the end effector 7000 and/or opening and closing the jaw assembly 7100, for example. In at least one respect, the control system 1800 enters into a limp mode. The limp mode of the control system 1800 can reduce a current rotational speed of the motor 1610 by any percentage selected from a range of about 75% to about 25%, for example. In one example, the limp mode reduces a current rotational speed of the motor 1610 by 50%. In one example, the limp mode reduces the current rotational speed of the motor 1610 by 75%. The limp mode may cause a current torque of the motor 1610 to be reduced by any percentage selected from a range of about 75% to about 25%, for example. In one example, the limp mode reduces a current torque of the motor 1610 by 50%. The handle can comprise an indicator, such as a red LED, for example, which indicates that the instrument system failed the diagnostic check and/or that the instrument system has entered into a limp mode. The above being said, any suitable feedback can be used to warn the clinician that the instrument system is not operating properly such as, for example, an audible warning and/or a tactile or vibratory warning, for example.



FIGS. 41-43 depict a clutch system 6000′ in accordance with at least one alternative embodiment. The clutch system 6000′ is similar to the clutch system 6000 in many respects, most of which will not be repeated herein for the sake of brevity. Similar to the clutch system 6000, the clutch system 6000′ comprises a clutch assembly 6100′ which is actuatable to selectively couple a rotatable drive input 6030′ with a rotatable drive output 6130′. The clutch assembly 6100′ comprises clutch plates 6110′ and drive rings 6120′. The clutch plates 6110′ are comprised of a magnetic material, such as iron and/or nickel, for example, and can comprise a permanent magnet. As described in greater detail below, the clutch plates 6110′ are movable between unactuated positions (FIG. 42) and actuated positions (FIG. 43) within the drive output 6130′. The clutch plates 6110′ are slideably positioned in apertures defined in the drive output 6130′ such that the clutch plates 6110′ rotate with the drive output 6130′ regardless of whether the clutch plates 6110′ are in their unactuated or actuated positions.


When the clutch plates 6110′ are in their unactuated positions, as illustrated in FIG. 42, the rotation of the drive input 6030′ is not transferred to the drive output 6130′. More specifically, when the drive input 6030′ is rotated, in such instances, the drive input 6030′ slides past and rotates relative to the drive rings 6120′ and, as a result, the drive rings 6120′ do not drive the clutch plates 6110′ and the drive output 6130′. When the clutch plates 6110′ are in their actuated positions, as illustrated in FIG. 43, the clutch plates 6110′ resiliently compress the drive rings 6120′ against the drive input 6030′. The drive rings 6120′ are comprised of any suitable compressible material, such as rubber, for example. In any event, in such instances, the rotation of the drive input 6030′ is transferred to the drive output 6130′ via the drive rings 6120′ and the clutch plates 6110′. The clutch system 6000′ comprises a clutch actuator 6140′ configured to move the clutch plates 6110′ into their actuated positions. The clutch actuator 6140′ is comprised of a magnetic material such as iron and/or nickel, for example, and can comprise a permanent magnet. The clutch actuator 6140′ is slideably positioned in a longitudinal shaft frame 6050′ extending through the drive input 6030′ and can be moved between an unactuated position (FIG. 42) and an actuated position (FIG. 43) by a clutch shaft 6060′. In at least one instance, the clutch shaft 6060′ comprises a polymer cable, for example. When the clutch actuator 6140′ is in its actuated position, as illustrated in FIG. 43, the clutch actuator 6140′ pulls the clutch plates 6110′ inwardly to compress the drive rings 6120′, as discussed above. When the clutch actuator 6140′ is moved into its unactuated position, as illustrated in FIG. 42, the drive rings 6120′ resiliently expand and push the clutch plates 6110′ away from the drive input 6030′. In various alternative embodiments, the clutch actuator 6140′ can comprise an electromagnet. In such an arrangement, the clutch actuator 6140′ can be actuated by an electrical circuit extending through a longitudinal aperture defined in the clutch shaft 6060′, for example. In various instances, the clutch system 6000′ further comprises electrical wires 6040′, for example, extending through the longitudinal aperture.



FIG. 44 depicts an end effector 7000a including a jaw assembly 7100a, a jaw assembly drive, and a clutch system 6000a in accordance with at least one alternative embodiment. The jaw assembly 7100a comprises a first jaw 7110a and a second jaw 7120a which are selectively rotatable about a pivot 7130a. The jaw assembly drive comprises a translatable actuator rod 7160a and drive links 7140a which are pivotably coupled to the actuator rod 7160a about a pivot 7150a. The drive links 7140a are also pivotably coupled to the jaws 7110a and 7120a such that the jaws 7110a and 7120a are rotated closed when the actuator rod 7160a is pulled proximally and rotated open when the actuator rod 7160a is pushed distally. The clutch system 6000a is similar to the clutch systems 6000 and 6000′ in many respects, most of which will not be repeated herein for the sake of brevity. The clutch system 6000a comprises a first clutch assembly 6100a and a second clutch assembly 6200a which are configured to selectively transmit the rotation of a drive input 6030a to rotate the jaw assembly 7100a about a longitudinal axis and articulate the jaw assembly 7100a about an articulation joint 7300a, respectively, as described in greater detail below.


The first clutch assembly 6100a comprises clutch plates 6110a and drive rings 6120a and work in a manner similar to the clutch plates 6110′ and drive rings 6120′ discussed above. When the clutch pates 6110a are actuated by an electromagnetic actuator 6140a, the rotation of the drive input 6030a is transferred to an outer shaft housing 7200a. More specifically, the outer shaft housing 7200a comprises a proximal outer housing 7210a and a distal outer housing 7220a which is rotatably supported by the proximal outer housing 7210a and is rotated relative to the proximal outer housing 7210a by the drive input 6030a when the clutch plates 6110a are in their actuated position. The rotation of the distal outer housing 7220a rotates the jaw assembly 7100a about the longitudinal axis owing to fact that the pivot 7130a of the jaw assembly 7100a is mounted to the distal outer housing 7220a. As a result, the outer shaft housing 7200a rotates the jaw assembly 7100a in a first direction when the outer shaft housing 7200a is rotated in a first direction by the drive input 6030a. Similarly, the outer shaft housing 7200a rotates the jaw assembly 7100a in a second direction when the outer shaft housing 7200a is rotated in a second direction by the drive input 6030a. When the electromagnetic actuator 6140a is de-energized, the drive rings 6120a expand and the clutch plates 6110a are moved into their unactuated positions, thereby decoupling the end effector rotation drive from the drive input 6030a.


The second clutch assembly 6200a comprises clutch plates 6210a and drive rings 6220a and work in a manner similar to the clutch plates 6110′ and drive rings 6120′ discussed above. When the clutch pates 6210a are actuated by an electromagnetic actuator 6240a, the rotation of the drive input 6030a is transferred to an articulation drive 6230a. The articulation drive 6230a is rotatably supported within an outer shaft housing 7410a of an end effector attachment portion 7400a and is rotatably supported by a shaft frame 6050a extending through the outer shaft housing 7410a. The articulation drive 6230a comprises a gear face defined thereon which is operably intermeshed with a stationary gear face 7230a defined on the proximal outer housing 7210a of the outer shaft housing 7200a. As a result, the articulation drive 6230a articulates the outer shaft housing 7200a and the jaw assembly 7100a in a first direction when the articulation drive 6230a is rotated in a first direction by the drive input 6030a. Similarly, the articulation drive 6230a articulates the outer shaft housing 7200a and the jaw assembly 7100a in a second direction when the articulation drive 6230a is rotated in a second direction by the drive input 6030a. When the electromagnetic actuator 6240a is de-energized, the drive rings 6220a expand and the clutch plates 6210a are moved into their unactuated positions, thereby decoupling the end effector articulation drive from the drive input 6030a.


Further to the above, the shaft assembly 4000 is illustrated in FIGS. 45-49. The shaft assembly 4000 is similar to the shaft assemblies 2000, 2000′, 2000′″, and 2000″″ in many respects, most of which will not be repeated herein for the sake of brevity. The shaft assembly 4000 comprises a proximal portion 4100, an elongate shaft 4200, a distal attachment portion 2400, and an articulate joint 2300 which rotatably connects the distal attachment portion 2040 to the elongate shaft 4200. The proximal portion 4100, similar to the proximal portion 2100, is operably attachable to the drive module 1100 of the handle 1000. The proximal portion 4100 comprises a housing 4110 including an attachment interface 4130 configured to mount the shaft assembly 4000 to the attachment interface 1130 of the handle 1000. The shaft assembly 4000 further comprises a frame 4500 including a shaft 4510 configured to be coupled to the shaft 1510 of the handle frame 1500 when the shaft assembly 4000 is attached to the handle 1000. The shaft assembly 4000 also comprises a drive system 4700 including a rotatable drive shaft 4710 configured to be operably coupled to the drive shaft 1710 of the handle drive system 1700 when the shaft assembly 4000 is attached to the handle 1000. The distal attachment portion 2400 is configured to receive an end effector, such as end effector 8000, for example. The end effector 8000 is similar to the end effector 7000 in many respects, most of which will not be repeated herein for the sake of brevity. That said, the end effector 8000 comprises a jaw assembly 8100 configured to, among other things, grasp tissue.


As discussed above, referring primarily to FIGS. 47-49, the frame 4500 of the shaft assembly 4000 comprises a frame shaft 4510. The frame shaft 4510 comprises a notch, or cut-out, 4530 defined therein. As discussed in greater detail below, the cut-out 4530 is configured to provide clearance for a jaw closure actuation system 4600. The frame 4500 further comprises a distal portion 4550 and a bridge 4540 connecting the distal portion 4550 to the frame shaft 4510. The frame 4500 further comprises a longitudinal portion 4560 extending through the elongate shaft 4200 to the distal attachment portion 2400. Similar to the above, the frame shaft 4510 comprises one or more electrical traces defined thereon and/or therein. The electrical traces extend through the longitudinal portion 4560, the distal portion 4550, the bridge 4540, and/or any suitable portion of the frame shaft 4510 to the electrical contacts 2520. Referring primarily to FIG. 48, the distal portion 4550 and longitudinal portion 4560 comprise a longitudinal aperture defined therein which is configured to receive a rod 4660 of the jaw closure actuation system 4600, as described in greater detail below.


As also discussed above, referring primarily to FIGS. 48 and 49, the drive system 4700 of the shaft assembly 4000 comprises a drive shaft 4710. The drive shaft 4710 is rotatably supported within the proximal shaft housing 4110 by the frame shaft 4510 and is rotatable about a longitudinal axis extending through the frame shaft 4510. The drive system 4700 further comprises a transfer shaft 4750 and an output shaft 4780. The transfer shaft 4750 is also rotatably supported within the proximal shaft housing 4110 and is rotatable about a longitudinal axis extending parallel to, or at least substantially parallel to, the frame shaft 4510 and the longitudinal axis defined therethrough. The transfer shaft 4750 comprises a proximal spur gear 4740 fixedly mounted thereto such that the proximal spur gear 4740 rotates with the transfer shaft 4750. The proximal spur gear 4740 is operably intermeshed with an annular gear face 4730 defined around the outer circumference of the drive shaft 4710 such that the rotation of the drive shaft 4710 is transferred to the transfer shaft 4750. The transfer shaft 4750 further comprises a distal spur gear 4760 fixedly mounted thereto such that the distal spur gear 4760 rotates with the transfer shaft 4750. The distal spur gear 4760 is operably intermeshed with an annular gear 4770 defined around the outer circumference of the output shaft 4780 such that the rotation of the transfer shaft 4750 is transferred to the output shaft 4780. Similar to the above, the output shaft 4780 is rotatably supported within the proximal shaft housing 4110 by the distal portion 4550 of the shaft frame 4500 such that the output shaft 4780 rotates about the longitudinal shaft axis. Notably, the output shaft 4780 is not directly coupled to the input shaft 4710; rather, the output shaft 4780 is operably coupled to the input shaft 4710 by the transfer shaft 4750. Such an arrangement provides room for the manually-actuated jaw closure actuation system 4600 discussed below.


Further to the above, referring primarily to FIGS. 47 and 48, the jaw closure actuation system 4600 comprises an actuation, or scissors, trigger 4610 rotatably coupled to the proximal shaft housing 4110 about a pivot 4620. The actuation trigger 4610 comprises an elongate portion 4612, a proximal end 4614, and a grip ring aperture 4616 defined in the proximal end 4614 which is configured to be gripped by the clinician. The shaft assembly 4000 further comprises a stationary grip 4160 extending from the proximal housing 4110. The stationary grip 4160 comprises an elongate portion 4162, a proximal end 4164, and a grip ring aperture 4166 defined in the proximal end 4164 which is configured to be gripped by the clinician. In use, as described in greater detail below, the actuation trigger 4610 is rotatable between an unactuated position and an actuated position (FIG. 48), i.e., toward the stationary grip 4160, to close the jaw assembly 8100 of the end effector 8000.


Referring primarily to FIG. 48, the jaw closure actuation system 4600 further comprises a drive link 4640 rotatably coupled to the proximal shaft housing 4110 about a pivot 4650 and, in addition, an actuation rod 4660 operably coupled to the drive link 4640. The actuation rod 4660 extends through an aperture defined in the longitudinal frame portion 4560 and is translatable along the longitudinal axis of the shaft frame 4500. The actuation rod 4660 comprises a distal end operably coupled to the jaw assembly 8100 and a proximal end 4665 positioned in a drive slot 4645 defined in the drive link 4640 such that the actuation rod 4660 is translated longitudinally when the drive link 4640 is rotated about the pivot 4650. Notably, the proximal end 4665 is rotatably supported within the drive slot 4645 such that the actuation rod 4660 can rotate with the end effector 8000.


Further to the above, the actuation trigger 4610 further comprises a drive arm 4615 configured to engage and rotate the drive link 4640 proximally, and translate the actuation rod 4660 proximally, when the actuation trigger 4610 is actuated, i.e., moved closer to the proximal shaft housing 4110. In such instances, the proximal rotation of the drive link 4640 resiliently compresses a biasing member, such as a coil spring 4670, for example, positioned intermediate the drive link 4640 and the frame shaft 4510. When the actuation trigger 4610 is released, the compressed coil spring 4670 re-expands and pushes the drive link 4640 and the actuation rod 4660 distally to open the jaw assembly 8100 of the end effector 8000. Moreover, the distal rotation of the drive link 4640 drives, and automatically rotates, the actuation trigger 4610 back into its unactuated position. That being said, the clinician could manually return the actuation trigger 4610 back into its unactuated position. In such instances, the actuation trigger 4610 could be opened slowly. In either event, the shaft assembly 4000 further comprises a lock configured to releasably hold the actuation trigger 4610 in its actuated position such that the clinician can use their hand to perform another task without the jaw assembly 8100 opening unintentionally.


In various alternative embodiments, further to the above, the actuation rod 4660 can be pushed distally to close the jaw assembly 8100. In at least one such instance, the actuation rod 4660 is mounted directly to the actuation trigger 4610 such that, when the actuation trigger 4610 is actuated, the actuation trigger 4610 drives the actuation rod 4660 distally. Similar to the above, the actuation trigger 4610 can compress a spring when the actuation trigger 4610 is closed such that, when the actuation trigger 4610 is released, the actuation rod 4660 is pushed proximally.


Further to the above, the shaft assembly 4000 has three functions—opening/closing the jaw assembly of an end effector, rotating the end effector about a longitudinal axis, and articulating the end effector about an articulation axis. The end effector rotation and articulation functions of the shaft assembly 4000 are driven by the motor assembly 1600 and the control system 1800 of the drive module 1100 while the jaw actuation function is manually-driven by the jaw closure actuation system 4600. The jaw closure actuation system 4600 could be a motor-driven system but, instead, the jaw closure actuation system 4600 has been kept a manually-driven system such that the clinician can have a better feel for the tissue being clamped within the end effector. While motorizing the end effector rotation and actuation systems provides certain advantages for controlling the position of the end effector, motorizing the jaw closure actuation system 4600 may cause the clinician to lose a tactile sense of the force being applied to the tissue and may not be able to assess whether the force is insufficient or excessive. Thus, the jaw closure actuation system 4600 is manually-driven even though the end effector rotation and articulation systems are motor-driven.



FIG. 50 is a logic diagram of the control system 1800 of the surgical system depicted in FIG. 1 in accordance with at least one embodiment. The control system 1800 comprises a control circuit. The control circuit includes a microcontroller 1840 comprising a processor 1820 and a memory 1830. One or more sensors, such as sensors 1880, 1890, 6180′, 6280′, 6380′, 7190″, and/or 6290′″, for example, provide real time feedback to the processor 1820. The control system 1800 further comprises a motor driver 1850 configured to control the electric motor 1610 and a tracking system 1860 configured to determine the position of one or more longitudinally movable components in the surgical instrument, such as the clutches 6110, 6120, and 6130 and/or the longitudinally-movable drive nut 7150 of the jaw assembly drive, for example. The tracking system 1860 is also configured to determine the position of one or more rotational components in the surgical instrument, such as the drive shaft 2530, the outer shaft 6230, and/or the articulation drive 6330, for example. The tracking system 1860 provides position information to the processor 1820, which can be programmed or configured to, among other things, determine the position of the clutches 6110, 6120, and 6130 and the drive nut 7150 as well as the orientation of the jaws 7110 and 7120. The motor driver 1850 may be an A3941 available from Allegro Microsystems, Inc., for example; however, other motor drivers may be readily substituted for use in the tracking system 1860. A detailed description of an absolute positioning system is described in U.S. Patent Application Publication No. 2017/0296213, entitled SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, the entire disclosure of which is hereby incorporated herein by reference.


The microcontroller 1840 may be any single core or multicore processor such as those known under the trade name ARM Cortex by Texas Instruments, for example. In at least one instance, the microcontroller 1840 is a LM4F230H5QR ARM Cortex-M4F Processor Core, available from Texas Instruments, for example, comprising on-chip memory of 256 KB single-cycle flash memory, or other non-volatile memory, up to 40 MHz, a prefetch buffer to improve performance above 40 MHz, a 32 KB single-cycle serial random access memory (SRAM), internal read-only memory (ROM) loaded with StellarisWare® software, 2 KB electrically erasable programmable read-only memory (EEPROM), one or more pulse width modulation (PWM) modules and/or frequency modulation (FM) modules, one or more quadrature encoder inputs (QEI) analog, one or more 12-bit Analog-to-Digital Converters (ADC) with 12 analog input channels, for example, details of which are available from the product datasheet.


In various instances, the microcontroller 1840 comprises a safety controller comprising two controller-based families such as TMS570 and RM4x known under the trade name Hercules ARM Cortex R4, also by Texas Instruments. The safety controller may be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while delivering scalable performance, connectivity, and memory options.


The microcontroller 1840 is programmed to perform various functions such as precisely controlling the speed and/or position of the drive nut 7150 of the jaw closure assembly, for example. The microcontroller 1840 is also programmed to precisely control the rotational speed and position of the end effector 7000 and the articulation speed and position of the end effector 7000. In various instances, the microcontroller 1840 computes a response in the software of the microcontroller 1840. The computed response is compared to a measured response of the actual system to obtain an “observed” response, which is used for actual feedback decisions. The observed response is a favorable, tuned, value that balances the smooth, continuous nature of the simulated response with the measured response, which can detect outside influences on the system.


The motor 1610 is controlled by the motor driver 1850. In various forms, the motor 1610 is a DC brushed driving motor having a maximum rotational speed of approximately 25,000 RPM, for example. In other arrangements, the motor 1610 includes a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor driver 1850 may comprise an H-bridge driver comprising field-effect transistors (FETs), for example. The motor driver 1850 may be an A3941 available from Allegro Microsystems, Inc., for example. The A3941 driver 1850 is a full-bridge controller for use with external N-channel power metal oxide semiconductor field effect transistors (MOSFETs) specifically designed for inductive loads, such as brush DC motors. In various instances, the driver 1850 comprises a unique charge pump regulator provides full (>10 V) gate drive for battery voltages down to 7 V and allows the A3941 to operate with a reduced gate drive, down to 5.5 V. A bootstrap capacitor may be employed to provide the above-battery supply voltage required for N-channel MOSFETs. An internal charge pump for the high-side drive allows DC (100% duty cycle) operation. The full bridge can be driven in fast or slow decay modes using diode or synchronous rectification. In the slow decay mode, current recirculation can be through the high-side or the lowside FETs. The power FETs are protected from shoot-through by resistor adjustable dead time. Integrated diagnostics provide indication of undervoltage, overtemperature, and power bridge faults, and can be configured to protect the power MOSFETs under most short circuit conditions. Other motor drivers may be readily substituted.


The tracking system 1860 comprises a controlled motor drive circuit arrangement comprising one or more position sensors, such as sensors 1880, 1890, 6180′, 6280′, 6380′, 7190″, and/or 6290′″, for example. The position sensors for an absolute positioning system provide a unique position signal corresponding to the location of a displacement member. As used herein, the term displacement member is used generically to refer to any movable member of the surgical system. In various instances, the displacement member may be coupled to any position sensor suitable for measuring linear displacement. Linear displacement sensors may include contact or non-contact displacement sensors. Linear displacement sensors may comprise linear variable differential transformers (LVDT), differential variable reluctance transducers (DVRT), a slide potentiometer, a magnetic sensing system comprising a movable magnet and a series of linearly arranged Hall Effect sensors, a magnetic sensing system comprising a fixed magnet and a series of movable linearly arranged Hall Effect sensors, an optical sensing system comprising a movable light source and a series of linearly arranged photo diodes or photo detectors, or an optical sensing system comprising a fixed light source and a series of movable linearly arranged photo diodes or photo detectors, or any combination thereof.


The position sensors 1880, 1890, 6180′, 6280′, 6380′, 7190″, and/or 6290′″, for example, may comprise any number of magnetic sensing elements, such as, for example, magnetic sensors classified according to whether they measure the total magnetic field or the vector components of the magnetic field. The techniques used to produce both types of magnetic sensors encompass many aspects of physics and electronics. The technologies used for magnetic field sensing include search coil, fluxgate, optically pumped, nuclear precession, SQUID, Hall-Effect, anisotropic magnetoresistance, giant magnetoresistance, magnetic tunnel junctions, giant magnetoimpedance, magnetostrictive/piezoelectric composites, magnetodiode, magnetotransistor, fiber optic, magnetooptic, and microelectromechanical systems-based magnetic sensors, among others.


In various instances, one or more of the position sensors of the tracking system 1860 comprise a magnetic rotary absolute positioning system. Such position sensors may be implemented as an AS5055EQFT single-chip magnetic rotary position sensor available from Austria Microsystems, AG and can be interfaced with the controller 1840 to provide an absolute positioning system. In certain instances, a position sensor comprises a low-voltage and low-power component and includes four Hall-Effect elements in an area of the position sensor that is located adjacent a magnet. A high resolution ADC and a smart power management controller are also provided on the chip. A CORDIC processor (for Coordinate Rotation Digital Computer), also known as the digit-by-digit method and Volder's algorithm, is provided to implement a simple and efficient algorithm to calculate hyperbolic and trigonometric functions that require only addition, subtraction, bitshift, and table lookup operations. The angle position, alarm bits, and magnetic field information are transmitted over a standard serial communication interface such as an SPI interface to the controller 1840. The position sensors can provide 12 or 14 bits of resolution, for example. The position sensors can be an AS5055 chip provided in a small QFN 16-pin 4×4×0.85 mm package, for example.


The tracking system 1860 may comprise and/or be programmed to implement a feedback controller, such as a PID, state feedback, and adaptive controller. A power source converts the signal from the feedback controller into a physical input to the system, in this case voltage. Other examples include pulse width modulation (PWM) and/or frequency modulation (FM) of the voltage, current, and force. Other sensor(s) may be provided to measure physical parameters of the physical system in addition to position. In various instances, the other sensor(s) can include sensor arrangements such as those described in U.S. Pat. No. 9,345,481, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is hereby incorporated herein by reference in its entirety; U.S. Patent Application Publication No. 2014/0263552, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is hereby incorporated herein by reference in its entirety; and U.S. patent application Ser. No. 15/628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTOR VELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, which is hereby incorporated herein by reference in its entirety. In a digital signal processing system, absolute positioning system is coupled to a digital data acquisition system where the output of the absolute positioning system will have finite resolution and sampling frequency. The absolute positioning system may comprise a compare and combine circuit to combine a computed response with a measured response using algorithms such as weighted average and theoretical control loop that drives the computed response towards the measured response. The computed response of the physical system takes into account properties like mass, inertial, viscous friction, inductance resistance, etc., to predict what the states and outputs of the physical system will be by knowing the input.


The absolute positioning system provides an absolute position of the displacement member upon power up of the instrument without retracting or advancing the displacement member to a reset (zero or home) position as may be required with conventional rotary encoders that merely count the number of steps forwards or backwards that the motor 1610 has taken to infer the position of a device actuator, drive bar, knife, and the like.


A sensor 1880 comprising a strain gauge or a micro-strain gauge, for example, is configured to measure one or more parameters of the end effector, such as, for example, the strain experienced by the jaws 7110 and 7120 during a clamping operation. The measured strain is converted to a digital signal and provided to the processor 1820. In addition to or in lieu of the sensor 1880, a sensor 1890 comprising a load sensor, for example, can measure the closure force applied by the closure drive system to the jaws 7110 and 7120. In various instances, a current sensor 1870 can be employed to measure the current drawn by the motor 1610. The force required to clamp the jaw assembly 7100 can correspond to the current drawn by the motor 1610, for example. The measured force is converted to a digital signal and provided to the processor 1820. A magnetic field sensor can be employed to measure the thickness of the captured tissue. The measurement of the magnetic field sensor can also be converted to a digital signal and provided to the processor 1820.


The measurements of the tissue compression, the tissue thickness, and/or the force required to close the end effector on the tissue as measured by the sensors can be used by the controller 1840 to characterize the position and/or speed of the movable member being tracked. In at least one instance, a memory 1830 may store a technique, an equation, and/or a look-up table which can be employed by the controller 1840 in the assessment. In various instances, the controller 1840 can provide the user of the surgical instrument with a choice as to the manner in which the surgical instrument should be operated. To this end, the display 1440 can display a variety of operating conditions of the instrument and can include touch screen functionality for data input. Moreover, information displayed on the display 1440 may be overlaid with images acquired via the imaging modules of one or more endoscopes and/or one or more additional surgical instruments used during the surgical procedure.


As discussed above, the drive module 1100 of the handle 1000 and/or the shaft assemblies 2000, 3000, 4000, and/or 5000, for example, attachable thereto comprise control systems. Each of the control systems can comprise a circuit board having one or more processors and/or memory devices. Among other things, the control systems are configured to store sensor data, for example. They are also configured to store data which identifies the shaft assembly to the handle 1000. Moreover, they are also configured to store data including whether or not the shaft assembly has been previously used and/or how many times the shaft assembly has been used. This information can be obtained by the handle 1000 to assess whether or not the shaft assembly is suitable for use and/or has been used less than a predetermined number of times, for example.


A drive module 1100′ in accordance with at least one alternative embodiment is illustrated in FIGS. 51-53. The drive module 1100′ is similar to the drive module 1100 in many respects, most of which will not be discussed herein for the sake of brevity. The drive module 1100′ comprises an actuator 1420′ configured to control the rotation and articulation of the end effector 7000. Similar to the actuator 1420, discussed above, the actuator 1420′ is rotatable about a longitudinal axis LA that extends through a shaft assembly attached to the drive module 1100. For instance, the longitudinal axis LA extends through the center, or substantially the center, of the elongate shaft 2200 of the shaft assembly 3000 (FIG. 1) when the shaft assembly 3000 is assembled to the drive module 1100′. The longitudinal axis LA also extends through the center, or substantially the center, of the end effector 7000 when the end effector 7000 is attached to the shaft assembly 3000, for example.


The actuator 1420′ is rotatable within a channel 1190′ defined in the housing 1110 in a first direction to rotate the end effector 7000 in the first direction and, similarly, in a second, or opposite, direction to rotate the end effector 7000 in the second direction. Similar to the drive module 1100, the drive module 1100′ comprises a sensor system in communication with the control system 1800 configured to detect the rotation of the actuator 1420′ about the longitudinal axis LA. In at least one instance, the sensor system comprises a first sensor 1422′ configured to detect the rotation of the actuator 1420′ about the longitudinal axis LA in the first direction (FIG. 52A) and a second sensor 1424′ configured to detect the rotation of the actuator 1420′ about the longitudinal axis LA in the second direction (FIG. 52B). The first and second sensors 1422′ and 1424′ comprise Hall Effect sensors, for example, but could comprise any suitable type of sensor. In at least one such instance, further to the above, the actuator 1420′ comprises a center magnetic element 1426′ positioned in the top of the actuator 1420′ which is detectable by the first and second sensors 1422′ and 1424′ to determine the rotation of the actuator 1420′. The center magnetic element 1426′ can comprise a permanent magnet and/or can be comprised of iron and/or nickel, for example.


Further to the above, the control system 1800 is configured to control the motor assembly 1600 and the clutch system 6000 to rotate the end effector 7000 about the longitudinal axis LA in the first direction when the actuator 1420′ is rotated about the longitudinal axis LA in the first direction. Similarly, the control system 1800 is configured to control the motor assembly 1600 and the clutch system 6000 to rotate the end effector 7000 about the longitudinal axis LA in the second direction when the actuator 1420′ is rotated about the longitudinal axis LA in the second direction. By associating the rotation of the end effector 7000 about the longitudinal axis LA with the rotation of the actuator 1420′ about the longitudinal axis LA, the clinician is provided with a system that is very intuitive to use.


As discussed above, the end effector 7000 is configured to rotate about a longitudinal axis within a socket defined in the distal attachment portion 2400 of the shaft assembly 2000. Depending on the amount of rotation desired, the end effector 7000 can be rotated less than 360 degrees or more than 360 degrees in either direction. In various instances, the end effector 7000 can be rotated through several rotations in either direction. In alternative embodiments, the rotation of the end effector 7000 about the longitudinal axis can be limited. In at least one embodiment, the shaft assembly 2000 comprises one or more stops which limit the rotation of the end effector 7000 to less than one rotation. In certain embodiments, the control system 1800 monitors the rotation of the drive shaft 1710, such as by an encoder and/or an absolute positioning sensor system, for example, and limits the rotation of the end effector 7000 by stopping or pausing the motor 1610 when the end effector 7000 has reached the end of its permitted range. In at least one instance, the control system 1800 can disengage the second clutch 6210 from the drive shaft 2730 to stop or pause the rotation of the end effector 7000 when the end effector 7000 has reached the end of its permitted range.


Further to the above, the drive module 1100′ and/or a shaft module attached to the drive module 1100′ can provide feedback to the clinician that the end effector 7000 has reached the end of its rotation. The drive module 1100′ and/or the shaft module attached thereto can comprise an indicator light 1427′, such as a red LED, for example, on a first side of the module housing 1110′ which is illuminated by the control system 1800 when the end effector 7000 has reached the end of its permitted rotation in the first direction, as illustrated in FIG. 52A. In at least one instance, the drive module 1100′ and/or the shaft module attached thereto can comprise an indicator light 1429′, such as a red LED, for example, on a second side of the module housing 1110′ which is illuminated by the control system 1800 when the end effector 7000 has reached the end of its permitted rotation in the second direction, as illustrated in FIG. 52B. In various instances, further to the above, the illumination of either the first light 1427′ or the second light 1429′ can indicate to the clinician that the motor 1610 has been paused and that the end effector 7000 is no longer rotating. In at least one instance, the first light 1427′ and/or the second light 1429′ can blink when the motor 1610 is paused.


In addition to or in lieu of the above, the drive module 1100′ and/or the shaft assembly attached thereto can comprise an annular series, or array, of indicator lights 1428′ extending around the perimeter thereof which is in communication with the control system 1800 and can indicate the rotational orientation of the end effector 7000. In at least one instance, the control system 1800 is configured to illuminate the particular indicator light which corresponds, or at least substantially corresponds, with the position in which the top of the end effector 7000 is oriented. In at least one instance, the center of the first jaw 7110 can be deemed the top of the end effector 7000, for example. In such instances, the illuminated light indicates the top-dead-center position of the end effector 7000. In other instances, the control system 1800 can illuminate the particular indicator light which corresponds, or at least substantially corresponds, with the position in which the bottom, or bottom-dead-center, of the end effector 7000 is oriented. In at least one instance, the center of the second jaw 7210 can be deemed the bottom of the end effector 7000, for example. As a result of the above, the illuminated indicator light can follow the rotation of the end effector 7000 around the array of indicator lights 1428′.


Further to the above, the actuator 1420′ is also rotatable, or tiltable, about a transverse axis TA within the housing channel 1190′. The sensor system of the drive module 1100′ is further configured to detect the rotation of the actuator 1420′ about the transverse axis TA in a first tilt direction and a second tilt direction. In at least one instance, the sensor system comprises a first tilt sensor 1423′ configured to detect the rotation of the actuator 1420′ about the longitudinal axis TA in the first tilt direction (FIG. 53A) and a second tilt sensor 1425′ configured to detect the rotation of the actuator 1420′ in the second tilt direction (FIG. 53B). The first and second tilt sensors 1423′ and 1425′ comprise Hall Effect sensors, for example, but could comprise any suitable type of sensor. The actuator 1420′ further comprises a first lateral magnetic element adjacent the first tilt sensor 1423′, the motion of which is detectable by the first tilt sensor 1423′. The actuator 1420′ also comprises a second lateral magnetic element adjacent the second tilt sensor 1425′, the motion of which is detectable by the second tilt sensor 1425′. The first and second lateral magnetic elements can comprise a permanent magnet and/or can be comprised of iron and/or nickel, for example. As illustrated in FIGS. 53A and 53B, the lateral sides of the actuator 1420′ are movable proximally and distally about the transverse axis TA and, as a result, the first and second lateral magnetic elements are also movable proximally and distally relative to the first and second tilt sensors. The reader should appreciate that, while the first and second lateral magnetic elements actually travel along arcuate paths about the transverse axis TA, the distances in which the first and second lateral magnetic elements move is small and, as a result, the arcuate motion of the first and second lateral magnetic elements approximates translation in the proximal and distal directions.


In various embodiments, further to the above, the entire actuator 1420′ comprises a magnetic ring of material which is detectable by the tilt sensors 1423′ and 1425′ of the drive module 1100′. In such embodiments, the rotation of the actuator 1420′ about the longitudinal axis LA would not create a compound motion relative to the tilt sensors when the actuator 1420′ is tilted. The magnetic ring of material can comprise a permanent magnet and/or can be comprised of iron and/or nickel, for example.


In any event, when the sensor system detects that the actuator 1420′ has been tilted in the first direction, as illustrated in FIG. 53A, the control system 1800 operates the motor assembly 1600 and the clutch system 6000 to articulate the end effector 7000 about the articulation joint 2300 in the first direction. Similarly, the control system 1800 operates the motor assembly 1600 and the clutch system 6000 to articulate the end effector 7000 about the articulation joint 2300 in the second direction when the sensor system detects that the actuator 1420′ has been tilted in the second direction, as illustrated in FIG. 53B. By associating the rotation of the end effector 7000 about the articulation joint 2300 with the rotation of the actuator 1420′ about the transverse axis TA, the clinician is provided with a system that is very intuitive to use.


Further to the above, the actuator 1420′ comprises a biasing system configured to center the actuator 1420′ in its unrotated and untilted position. In various instances, the biasing system comprises first and second rotation springs configured to center the actuator 1420′ in its unrotated position and first and second tilt springs configured to center the actuator 1420′ in its untilted position. These springs can comprise torsion springs and/or linear displacement springs, for example.


As discussed above, the end effector 7000 rotates relative to the distal attachment portion 2400 of the shaft assembly 3000. Such an arrangement allows the end effector 7000 to be rotated without having to rotate the shaft assembly 3000, although embodiments are possible in which an end effector and shaft assembly rotate together. That said, by rotating the end effector 7000 relative to the shaft assembly 3000, all of the rotation of the surgical system occurs distally relative to the articulation joint 2300. Such an arrangement prevents a large sweep of the end effector 7000 when the end effector 7000 is articulated and then rotated. Moreover, the articulation joint 2300 does not rotate with the end effector 7000 and, as a result, the articulation axis of the articulation joint 2300 is unaffected by the rotation of the end effector 7000. In order to mimic this arrangement, the transverse axis TA does not rotate with the actuator 1420′; rather, the transverse axis TA remains stationary with respect to the drive module 1100′. That said, in alternative embodiments, the transverse axis TA can rotate, or track the end effector 7000, when the articulation joint rotates with the end effector. Such an arrangement can maintain an intuitive relationship between the motion of the actuator 1420′ and the motion of the end effector 7000.


Further to the above, the transverse axis TA is orthogonal, or at least substantially orthogonal, to the longitudinal axis LA. Similarly, the articulation axis of the articulation joint 2300 is orthogonal, or at least substantially orthogonal, to the longitudinal axis LA. As a result, the transverse axis TA is parallel to, or at least substantially parallel to, the articulation axis.


In various alternative embodiments, the tiltable actuator 1420′ is only used to control the articulation of the end effector 7000 and is not rotatable about the longitudinal axis LA. Rather, in such embodiments, the actuator 1420′ is only rotatable about the transverse axis TA. In at least one instance, the housing of the drive module 1100′ comprises two posts 1421′ (FIG. 51) about which the actuator 1120′ is rotatably mounted which defines the transverse axis TA. The posts 1421′ are aligned along a common axis. The above being said, the posts 1421′, or any suitable structure, can be used in embodiments in which the actuator 1420′ is both rotatable and tiltable to control the rotation and articulation of the end effector 7000. In at least one such instance, the actuator 1420′ comprises an annular groove defined therein in which the posts 1421′ are positioned.


In various instances, the drive module 1100 and/or the shaft assembly attached thereto can comprise a series, or array, of indicator lights 1438′ which is in communication with the control system 1800 and can indicate the articulation orientation of the end effector 7000. In at least one instance, the control system 1800 is configured to illuminate the particular indicator light which corresponds, or at least substantially corresponds, with the position in which the end effector 7000 is articulated. As a result of the above, the illuminated indicator light can follow the articulation of the end effector 7000. Such an array of indicator lights can assist a clinician in straightening the end effector 7000 before attempting to remove the end effector 7000 from a patient through a trocar. In various instances, an unstraightened end effector may not pass through a trocar and prevent the removable of the end effector from the patient.


A drive module 1100″ in accordance with at least one alternative embodiment is illustrated in FIGS. 54-57. The drive module 1100″ is similar to the drive modules 1100 and 1100′ in many respects, most of which will not be discussed herein for the sake of brevity. The drive module 1100″ comprises a feedback system configured to inform the clinician using the surgical instrument system that the drive shaft and/or any other rotatable component of the surgical instrument system is rotating. The feedback system can use visual feedback, audio feedback, and/or tactile feedback, for example. Referring primarily to FIG. 55, the drive module 1100″ comprises a tactile feedback system which is operably engageable with the drive shaft 1710″ of the drive module 1100″. The tactile feedback system comprises a slideable clutch 1730″, a rotatable drive ring 1750″, and an eccentric, or offset, mass 1770″ mounted to the drive ring 1750″. The clutch 1730″ is slideable between an unactuated position (FIG. 56) and an actuated position (FIG. 57) along the drive shaft 1710″. The drive shaft 1710″ comprises one or more slots 1740″ defined therein which are configured to constrain the movement of the slideable clutch 1730″ relative to the drive shaft 1710″ such that the clutch 1730″ translates longitudinally relative to the drive shaft 1710″ but also rotates with the drive shaft 1710″. The frame shaft 1510″ of the handle frame 1500″ comprises an electromagnet 1530″ embedded therein which is configured to emit a first electromagnetic field to slide the clutch 1730″ toward its actuated position, as illustrated in FIG. 57, and a second, or opposite, electromagnetic field to slide the clutch 1730″ toward its unactuated position, as illustrated in FIG. 56. The clutch 1730″ is comprised of a permanent magnet and/or a magnetic material such as iron and/or nickel, for example. The electromagnet 1530″ is controlled by the control system 1800 to apply a first voltage polarity to a circuit including the electromagnet 1530″ to create the first electromagnetic field and a second, or opposite, voltage polarity to the circuit to create the second electromagnetic field.


When the clutch 1730″ is in its unactuated position, as illustrated in FIG. 56, the clutch 1730″ is not operably engaged with the drive ring 1750″. In such instances, the clutch 1730″ rotates with the drive shaft 1710″, but rotates relative to the drive ring 1750″. Stated another way, the drive ring 1750″ is stationary when the clutch 1730″ is in its unactuated position. When the clutch 1730″ is in its actuated position, as illustrated in FIG. 57, the clutch 1730″ is operably engaged with an angled face 1760″ of the drive ring 1750″ such that the rotation of the drive shaft 1710″ is transmitted to the drive ring 1750″ via the clutch 1730″ when the drive shaft 1710″ is rotated. The eccentric, or offset, mass 1770″ is mounted to the drive ring 1750″ such that the eccentric mass 1770″ rotates with the drive ring 1750″. In at least one instance, the eccentric mass 1770″ is integrally-formed with the drive ring 1750″. When the drive ring 1750″ and eccentric mass 1770″ rotate with the drive shaft 1710″, the eccentric mass 1770″ creates a vibration that can be felt by the clinician through the drive module 1100″ and/or the power modules assembled thereto. This vibration confirms to the clinician that the drive shaft 1710″ is rotating. In at least one instance, the control system 1800 energizes the electromagnet 1530″ when one of the clutches of the clutch system 6000 is energized. In such instances, the vibration can confirm to the clinician that the drive shaft 1710″ is rotating and that one of the clutches in the clutch system 6000 is engaged with the drive shaft 1710″. In at least one instance, the clutch 1730″ can be actuated when the jaw assembly 7100, for example, has reached or is reaching its closed position such that the clinician knows that the tissue has been clamped within the jaw assembly 7100 and that the surgical instrument can be used to manipulate the tissue. The above being said, the tactile feedback system, and/or any other feedback system, of the drive module 1100″ can be used to provide tactile feedback when appropriate.


As surgical techniques continue to advance and develop, there is a need for specialized surgical instruments. With the advent of 3-D printing and additive manufacturing, new methods and techniques have been developed to produce specialized surgical instruments. Customized surgical instruments can allow a technician or surgeon to produce and use surgical instruments that are customized to a patient's physiological conditions or for a specific surgical procedure.


Out of an abundance of caution, many surgical instruments have become one-use devices to prevent the spread of contamination or diseases between patients. As surgical devices are becoming single patient and single-use devices, customizing the devices for the specific patient can allow for better results and faster recovery time for patients. As recovery time for patients is a substantial cost to the healthcare system, having customized surgical devices that allow surgeons to specifically target and resolve a patient's ailment can greatly reduce the overall healthcare spend.


Surgical instruments, such as surgical dissectors have been in widespread use in various surgical procedures. These instruments allow a surgeon to manipulate, separate, and remove specific areas of tissue of a patient. Having the ability to develop custom dissectors for specific surgical procedures and for a patient's physiological conditions can be of great value.


As different surgical procedures and patient conditions require different surgical instruments, the present disclosure relates to customized surgical devices, methods of producing customized devices, and means for producing customized surgical devices using various techniques, such as additive manufacturing and/or 3-D printing, for example.


In developing customized surgical devices, a surgeon can determine the specifics of the required device based upon the specific procedure, the general size of the patient, i.e., a child vs. an adult, or through scans and/or x-rays of the patient to determine the specific profile required for the surgical instrument.


When a surgeon is customizing a surgical instrument for a specific procedure, they may consult a directory of predefined surgical instrument shapes and configurations to determine which device may best suit the procedure at hand. Such procedures for the production of ultrasonic blades are discussed in U.S. Patent Application Publication No. 2018/0014844 A1 to Conlon, titled ULTRASONIC SURGICAL INSTRUMENT WITH AS HOC FORMED BLADE, the disclosure of which is incorporated by reference in its entirety.


Once the surgeon determines the desired device characteristics, the surgeon may take a base device, such as a end effector connector having a core or stub and use an additive manufacturing process to produce the selected end effector configuration. In addition, or in the alternative, a surgeon may use the size of a patient to determine the required size of the surgical instrument. The surgeon may use various physiological standards, such as the size of the patients hand, tibia, abdomen, or other physiological marker that can provide an adequate representation of the desired size of the surgical instrument. In addition, or in the alternative, the surgeon may conduct scans or x-rays of the patient to determine the specific size, shape, and characteristic of the surgical device needed to perform a desired procedure.



FIG. 58 illustrates a surgical end effector 100000 having a standard connection portion 100050 and a customizable end effector portion 100060. The standard connection portion 100050 includes a first jaw portion 100006 and a second jaw portion 100008. The first jaw portion 100006 and the second jaw portion 100008 are rotatable about a joint 100004. The standard connection portion 100050 of the surgical end effector 100000 can be connected to a shaft of a surgical instrument. The shaft of the surgical instrument can have a diameter D. The customizable end effector portion 100060 can be customized within the customization region 100002, such that the diameter of the customization region 100002 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100060 being confined to the bounds of the customization region 100002, the surgical end effector 100000 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The first jaw portion 100006 of the end effector portion 100060 includes a core/stub portion 100010 that is adaptable through additive manufacturing techniques. The core/stub portion 100010 provides a base for building and customizing the geometry and characteristics of a customizable jaw 100012. Depending on various needs for the surgical procedure, the customizable jaw 100012 can be modified and adapted to meet the needs of the surgeon.


In certain embodiments, the surgical end effector 100000 can comprise a solid customizable region 100002. The solid customizable region 100002 can be made of various materials such as various metals and/or plastics, for example. When the surgeon determines the configuration required for the surgical procedure, the surgeon can use a manufacturing technique to remove the excess material to leave the desired shape of the customizable jaw 100012. In the alternative, the surgeon may start with a surgical end effector 100000 that does not have a core/stub portion 100100 and, instead, only has a standard connector portion 100050. With just the standard connector portion 100050, the surgeon can use a manufacturing process to create the desired shape and features of the customized jaw 100012 within the bounds of the customization region 100002.


In another embodiment, a surgical instrument may have a surgical end effector 100100, as illustrated in FIG. 59. The surgical end effector 100100 has a standard connection portion 100150 and a customizable end effector portion 100160. The standard connection portion 100150 includes a first jaw portion 100106 and a second jaw portion 100108. The first jaw portion 100106 and the second jaw portion 100108 are rotatable about a joint 100104. The standard connection portion 100150 of the surgical end effector 100100 can be connected to a shaft of a surgical instrument. The shaft of the surgical instrument can have a diameter D. The customizable end effector portion 100160 can be customized within the customization region 100102 such that the diameter of the customization region 100102 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100160 being confined to the bounds of the customization region 100102, the surgical end effector 100100 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The first jaw portion 100106 of the end effector portion 100160 includes a core/stub portion 100110 that is adaptable through additive manufacturing techniques. The core/stub portion 100110 provides a base for building and customizing the geometry and characteristics of a first customizable jaw 100112 and a second customizable jaw 100114. Depending on various needs for the surgical procedure, the first customizable jaw 100112 and the second customizable jaw 100114 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100112 and the second customizable jaw 100114 have a plurality of proximal features 100118 and a plurality of distal features 100116. As illustrated in FIG. 59, the plurality of proximal features 100118 comprises a plurality of proximal teeth. The plurality of distal features 100116 comprises a plurality of distal teeth. The proximal teeth are smaller and have a smaller height than the distal teeth. The progression of larger distal teeth to smaller proximal teeth can allow for a more aggressive hold and manipulation of tissue when using the distal portion of the first and second customizable jaws 100112, 100114. In various embodiments, however, the plurality of proximal and distal teeth may take various configurations based upon the needs of the surgical procedure, such as for example, a plurality of symmetrical teeth, a plurality of asymmetrical teeth, and/or a progression from large to small or small to large teeth.


In certain embodiments, the surgical end effector 100100 comprises a solid customized region 100102. The solid customizable region 100002 can be made of various materials such as various metals and/or plastics, for example. When the surgeon determines the configuration of the end effector 100100 required for the surgical procedure, the surgeon can use a manufacturing technique, such as grinding, wire EDMing, and/or polishing, for example, to remove the excess material to leave the desired shape of the customizable jaw 101012. In the alternative, the surgeon may start with a surgical end effector 100100 that only has a standard connector portion 100150. With just the standard connector portion 100150, the surgeon can use a manufacturing process to create the desired shape and features of the customized jaw 100112 within the bounds of the customization region 100102.



FIG. 60 illustrates a surgical end effector 100200 that is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100200 includes a standard connection portion 100250 and a customizable end effector portion 100260. The standard connection portion 100250 includes a first jaw portion 100206 and a second jaw portion 100208.


The customizable end effector portion 100260 can be customized within the customization region 100202, such that the diameter of the customization region 100202 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100260 being confined to the bounds of the customization region 100202, the surgical end effector 100200 can be inserted through a trocar into a patient's body cavity during minimally invasive surgical procedures.


The surgical end effector 100200 is illustrated as having various different customized jaw configurations 100212a-e. The various customized jaw configurations 100212a-e can be selected by a surgeon or clinician depending upon the type of procedure and a patient's physiological condition. The various customized jaw configurations 100212a-e can include different shape profiles, different diameters, different geometries, and can be comprised of various materials. In one embodiment, the various customized jaw configurations 100212a-e can be comprised of various plastics having different durometers and deformation characteristics. In another embodiment, the various customized jaw configurations 100212a-e can comprise metallic materials and materials having a greater rigidity. In addition, or in the alternative, the various customized jaw configurations 100212a-e can also comprise a combination of metallic and plastic materials to provide a desired characteristic to the surgical end effector 100200.


In certain embodiments, the various customized jaw configurations 100212a-e can have a metallic core with plastic and/or metal overlaid upon the core. The various materials used in the various customized jaw configurations 100212a-e can create end effectors meeting the needs of the surgeon, procedure, and/or patient.



FIG. 61 illustrates a surgical end effector 100300 that is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100300 includes a standard connection portion 100350 and a customizable end effector portion 100360. The standard connection portion 100350 includes a first jaw portion 100306 and a second jaw portion 100308. The first jaw portion 100306 and the second jaw portion 100308 are rotatable about a joint 100304.


The customizable end effector portion 100360 can be customized within the customization region 100302, such that, the diameter of the customization region 100302 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100360 being confined to the bounds of the customization region 100302, the surgical end effector 100300 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The first jaw portion 100306 of the end effector portion 100360 includes a core/stub portion 100310 that is adaptable through additive manufacturing techniques. The core/stub portion 100310 provides a base for building and customizing the geometry and characteristics of a first customizable jaw 100312 and a second customizable jaw 100314. Depending on various needs for the surgical procedure, the first customizable jaw 100312 and the second customizable jaw 100314 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100312 and the second customizable jaw 100314 have a plurality of proximal features 100318 and a plurality of distal features 100316. As illustrated in FIG. 61, the plurality of proximal features 100318 comprises a plurality of proximal teeth. The plurality of distal features 100316 comprises a plurality of distal teeth. The plurality of proximal teeth is approximately the same height as the plurality of distal teeth. However, in various embodiments the plurality of proximal and distal teeth may take various configurations based upon the needs of the surgical procedure, for example a plurality of symmetrical teeth, a plurality of asymmetrical teeth, and/or a progression from large to small or small to large teeth. In the alternative, the surgical end effector 100300 can include a plurality of miniature, or fine, teeth 100320. The various features 100316, 100318 and miniature teeth 100320 can extend along the first customizable jaw 100312 and the second customizable jaw 100314 in various lengths, can have smooth profiles, and/or can have sharper profiles depending on the desired configuration of the surgical end effector 100300.



FIG. 61 illustrates various different customized jaw configurations 100322a-c. In a first embodiment, the customized jaw configuration 100322a can comprise a curved end effector region. In a second alternative embodiment, the customized jaw configuration 100322b can comprise a protruding outer profile that can allow the surgical end effector 100300 to function as a dissector and divide tissue when the first jaw portion 100306 and the second jaw portion 100308 are rotated about a joint 100304 between an open configuration and a closed configuration. In a third alternative embodiment, the customized jaw configuration 100322c can comprise a longitudinal linear body. Other embodiments and configurations of the surgical end effector 100300 are also possible. One constraint on the configuration of the customizable end effector portion 100360 is that it should be confined to the bounds of the customization region 100302 so that the surgical end effector 100300 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures. In embodiments where the surgical end effector 100300 is being used in open surgical procedures, the customizable end effector portion 100360 can exceed the bounds of the customization region 100302. Also, embodiments are envisioned where a portion of the end effector is collapsible to permit laparoscopic end effectors to fit through a trocar. In such embodiments, the bounds of the customizable region can be larger than the diameter D of the shaft.



FIGS. 62 and 63 illustrate a surgical end effector 100400. The surgical end effector 100400 is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100400 includes a standard connection portion 100450 and a customizable end effector portion 100460. The standard connection portion 100450 includes a first jaw portion 100406 and a second jaw portion 100408. The first jaw portion 100406 and the second jaw portion 100408 are rotatable about a joint 100404.


The customizable end effector portion 100460 can be customized within the customization region 100402, such that the diameter of the customization region 100402 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100460 being confined to the bounds of the customization region 100402, the surgical end effector 100400 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The first jaw portion 100406 of the end effector portion 100460 includes a core/stub portion 100410 that is adaptable through additive manufacturing techniques. The core/stub portion 100410 provides a base for building and customizing the geometry and characteristics of a first customizable jaw 100412 and a second customizable jaw 100414. Depending on various needs for the surgical procedure, the first customizable jaw 100412 and the second customizable jaw 100414 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100412 and the second customizable jaw 100414 have a plurality of proximal features 100418 and a plurality of distal features 100416. As illustrated in FIG. 63, the plurality of proximal features 100418 comprises a plurality of proximal teeth. The plurality of distal features 100416 comprises a plurality of distal teeth. The plurality of proximal teeth is approximately the same height as the plurality of distal teeth. However, in various embodiments, the plurality of proximal and distal teeth may take various configurations based upon the needs of the surgical procedure such as, for example, a plurality of symmetrical teeth, a plurality of asymmetrical teeth, and/or a progression from large to small or small to large teeth.


In addition, the first customizable jaw 100412 and the second customizable jaw 100414 have a plurality of features 100430 and 100432, respectively, that are positioned on the outer portion of the first and second customizable jaws 100412, 100414. As illustrated in FIG. 63, the features 100430, 100432 can include ridges, or teeth, that allow the surgical end effector 100400 to engage, grasp, and/or manipulate tissue.


When selecting the configuration and various features for the surgical end effector 100400, the external features 100430, 100432, the proximal features 100418, the distal features 100416, the overall geometric shape of the first and second customizable jaws 100412, 100414, and the materials used in producing the customizable end effector portion 100460 are independent variables that are considered during the customization process. For example, when the surgical end effector 100400 is being customized for a minimally invasive surgical procedure, the various independent variables must result in an overall profile that falls within the customization region 100402 so that the surgical end effector 100400 can be inserted through a trocar and into a patient's body cavity.



FIGS. 64-67 illustrate surgical end effectors having various features and profiles. FIG. 64 illustrates a surgical end effector 100500 that is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100500 includes a standard connection portion 100550 and a customizable end effector portion 100560. The standard connection portion 100550 can include a first jaw portion 100506 and a second jaw portion 100508. The first jaw portion 100506 and the second jaw portion 100508 are rotatable about a joint 100504.


The customizable end effector portion 100560 can be customized within a customization region 100502, such that the diameter of the customization region 100502 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100560 being confined to the bounds of the customization region 100502, the surgical end effector 100500 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The customizable end effector portion 100560 can be produced through various additive manufacturing techniques to produce custom geometry and characteristics of a first customizable jaw 100512 and a second customizable jaw 100514. Depending on various needs for the surgical procedure, the first customizable jaw 100512 and the second customizable jaw 100514 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100512 and the second customizable jaw 100514 have a plurality of proximal features 100518 and a plurality of distal features 100516. As illustrated in FIG. 64, the plurality of proximal features 100518 comprises a plurality of small symmetrical proximal teeth. The plurality of distal features 100516 comprises a plurality of small symmetrical distal teeth. The plurality of proximal teeth is approximately the same height as the plurality of distal teeth and are continuous along the inner surfaces of the first customizable jaw 100512 and the second customizable jaw 100514. In addition, the first customizable jaw 100512 and the second customizable jaw 100514 comprise external surface features 100530, 100532, respectively. As illustrated in FIG. 64, the external surface features 100530, 100532 comprise substantially smooth surfaces. However, in alternative embodiments, the external surface features 100530, 100532 may comprise teeth, nubs and/or other protrusions to assist with the tissue interaction of the surgical end effector 100500.



FIG. 65 illustrates surgical end effector 100600 that is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100600 includes a standard connection portion 100650 and a customizable end effector portion 100660. The standard connection portion 100650 can include a first jaw portion 100606 and a second jaw portion 100608. The first jaw portion 100606 and the second jaw portion 100608 are rotatable about a joint 100604.


The customizable end effector portion 100660 can be customized within a customization region 100602, such that the diameter of the customization region 100602 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100660 being confined to the bounds of the customization region 100602, the surgical end effector 100600 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The customizable end effector portion 100660 can be produced through various additive manufacturing techniques to produce custom geometry and characteristics of a first customizable jaw 100612 and a second customizable jaw 100614. Depending on various needs for the surgical procedure, the first customizable jaw 100612 and the second customizable jaw 100614 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100612 and the second customizable jaw 100614 have a plurality of proximal features 100618 and a plurality of distal features 100616. As illustrated in FIG. 65, the plurality of proximal features 100618 comprises a substantially smooth surface. The plurality of distal features 100616 comprises a plurality of large distal teeth. The plurality of large distal teeth is only formed on a portion of the inner surfaces of the first customizable jaw 100612 and the second customizable jaw 100614. In addition, the first customizable jaw 100612 and the second customizable jaw 100614 comprise external surface features 100630, 100632, respectively. As illustrated in FIG. 65, the external surface features 100630, 100632 comprise substantially smooth surfaces. However, in alternative embodiments, the external surface features 100630, 100632 may comprise teeth, nubs, and/or other protrusions to assist with the tissue interaction of the surgical end effector 100600.



FIG. 66 illustrates a surgical end effector 100700 that is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100700 includes a standard connection portion 100750 and a customizable end effector portion 100760. The standard connection portion 100750 includes a first jaw portion 100706 and a second jaw portion 100708. The first jaw portion 100706 and the second jaw portion 100708 are rotatable about a joint 100704.


The customizable end effector portion 100760 can be customized within a customization region 100702. The diameter of the customization region 100702 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100760 being confined to the bounds of the customization region 100702, the surgical end effector 100700 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The customizable end effector portion 100760 can be produced through various additive manufacturing techniques to produce custom geometry and characteristics of a first customizable jaw 100712 and a second customizable jaw 100714. Depending on various requirements for the surgical procedure, the first customizable jaw 100712 and the second customizable jaw 100714 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100712 and the second customizable jaw 100714 have a plurality of proximal features 100718 and a plurality of distal features 100716. As illustrated in FIG. 66, the plurality of proximal features 100718 comprises a substantially smooth surface. The plurality of distal features 100716 comprises a plurality of smooth distal teeth. The plurality of smooth distal teeth is only formed on a portion of the inner surfaces of the first customizable jaw 100712 and the second customizable jaw 100714. In addition, the first customizable jaw 100712 and the second customizable jaw 100714 comprise external surface features 100730, 100732, respectively. As illustrated in FIG. 66, the external surface features 100730, 100732 comprise substantially smooth surfaces. However, in alternative embodiments, the external surface features 100730, 100732 may comprise teeth, nubs, and/or other protrusions to assist with the tissue interaction of the surgical end effector 100700.



FIG. 67 illustrates a surgical end effector 100800 that is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100800 includes a standard connection portion 100850 and a customizable end effector portion 100860. The standard connection portion 100850 can include a first jaw portion 100806 and a second jaw portion 100808. The first jaw portion 100806 and the second jaw portion 100808 are rotatable about a joint 100804.


The customizable end effector portion 100860 can be customized within a customization region 100802, such that the diameter of the customization region 100802 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100860 being confined to the bounds of the customization region 100802, the surgical end effector 100800 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The customizable end effector portion 100860 can be produced through various additive manufacturing techniques to produce custom geometry and characteristics of a first customizable jaw 100812 and a second customizable jaw 100814. Depending on various requirements for the surgical procedure, the first customizable jaw 100812 and the second customizable jaw 100814 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100812 and the second customizable jaw 100814 have a plurality of proximal features 100818 and a plurality of distal features 100816. As illustrated in FIG. 67, the plurality of proximal features 100818 comprises a substantially smooth surface. The plurality of distal features 100816 comprises a substantially smooth surface of low durometer material. The low durometer material allows the inner surfaces of the first customizable jaw 100812 and the second customizable jaw 100814 to grasp and manipulate an object, such as a patient's tissue.


The substantially smooth surface of low durometer material is only formed on a portion of the inner surfaces of the first customizable jaw 100812 and the second customizable jaw 100814. The substantially smooth surface can refer to a surface, for example, that is substantially free from projections or unevenness, generally flat or unruffled, and/or substantially of uniform consistency. In addition, the first customizable jaw 100812 and the second customizable jaw 100814 comprise external surface features 100830, 100832, respectively. As illustrated in FIG. 67, the external surface features 100830, 100832 comprise substantially smooth surfaces. However, in alternative embodiments, the external surface features 100830, 100832 may comprise teeth, nubs, and/or other protrusions to assist with the tissue interaction of the surgical end effector 100800.



FIGS. 68 and 69 illustrate another embodiment of a surgical end effector 100900. The surgical end effector 100900 is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 100900 includes a standard connection portion 100950 and a customizable end effector portion 100960. The standard connection portion 100950 can include a first jaw portion 100906 and a second jaw portion 100908. The first jaw portion 100906 and the second jaw portion 100908 are rotatable about a joint 100904.


The customizable end effector portion 100960 can be customized within the customization region 100902. The diameter of the customization region 100902 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 100960 being confined to the bounds of the customization region 100902, the surgical end effector 100900 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The surgical end effector 100900 includes a core/stub portion 100910 that is adaptable through additive manufacturing techniques. The core/stub portion 100910 provides a base for building and customizing the geometry and characteristics of a first customizable jaw 100912 and a second customizable jaw 100914. Depending on various needs for the surgical procedure, the first customizable jaw 100912 and the second customizable jaw 100914 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 100912 and the second customizable jaw 100914 have a plurality of proximal features 100918 and a plurality of distal features 100916. As illustrated in FIG. 69, the plurality of proximal features 100918 comprises a plurality of proximal teeth. The plurality of distal features 100916 comprises a plurality of distal teeth. The plurality of proximal teeth is approximately the same height as the plurality of distal teeth. However, in various embodiments the plurality of proximal and distal teeth may take various configurations based upon the needs of the surgical procedure, for example a plurality of symmetrical teeth, a plurality of asymmetrical teeth, and/or a progression from large to small or small to large teeth.


In addition, the first customizable jaw 100912 and the second customizable jaw 100914 have a plurality of features 100930 and 100932, respectively that are positioned on the outer portion of the first and second customizable jaws 100912, 100914. As illustrated in FIG. 69, the features 100930, 100932 can include ridges, and/or substantially smooth surfaces that allow the surgical end effector 100900 to engage, grasp, and/or manipulate an object, for example a patient's tissue.



FIG. 68 depicts a top plan view of the surgical end effector 100900. FIG. 69 depicts a side elevation view of the surgical end effector 100900. The overall geometric shape of the surgical end effector 100900 is a curved configuration. From the depictions of the surgical end effector 100900 in FIGS. 68 and 69, it will be apparent to a person of ordinary skill in the art that the overall profile of the surgical end effector 100900 has a three dimensional curved geometry.


When selecting the configuration and various features for the surgical end effector 100900, the external features 100930, 100932, the proximal features 100918, the distal features 100916, the overall geometric shape of the first and second customizable jaws 100912, 100914, and the materials used in producing the customizable end effector portion 100960 are independent variables that are considered during the customization process. For example, when the surgical end effector 100900 is being customized for a minimally invasive surgical procedure, the various independent variables must produce an overall profile of the surgical instrument that falls within the customization region 100902 so that the surgical end effector 100900 can be inserted through a trocar and into a patient's body cavity.



FIGS. 70 and 71 illustrate another embodiment of a surgical end effector 101000. The surgical end effector 101000 is configured to be modified and adjusted using various manufacturing techniques at the discretion of a surgeon. The surgical end effector 101000 includes a standard connection portion 101050 and a customizable end effector portion 101060. The standard connection portion 101050 can include a first jaw portion 101006 and a second jaw portion 101008. The first jaw portion 101006 and the second jaw portion 101008 are rotatable about a joint 101004.


The customizable end effector portion 101060 can be customized within the customization region 101002. The diameter of the customization region 101002 is equal to or less than the diameter D of the shaft of the surgical instrument. With the customizable end effector portion 101060 being confined to the bounds of the customization region 101002, the surgical end effector 101000 can be inserted through a trocar into a patient's body cavity through minimally invasive surgical procedures.


The surgical end effector 101000 includes a core/stub portion 101010 that is adaptable through additive manufacturing techniques. The core/stub portion 101010 provides a base for building and customizing the geometry and characteristics of a first customizable jaw 101012 and a second customizable jaw 101014. Depending on various needs for the surgical procedure, the first customizable jaw 101012 and the second customizable jaw 101014 can be modified and adapted to meet the needs of the surgeon. The first customizable jaw 101012 and the second customizable jaw 101014 have a plurality of proximal features 101018 and a plurality of distal features 101016. As illustrated in FIG. 71, the plurality of proximal features 101018 comprises a plurality of proximal teeth. The plurality of distal features 101016 comprises a plurality of distal teeth. The plurality of proximal teeth is approximately the same height as the plurality of distal teeth. However, in various embodiments the plurality of proximal and distal teeth may take various configurations based upon the needs of the surgical procedure such as, for example, a plurality of symmetrical teeth, a plurality of asymmetrical teeth, and/or a progression from large to small or small to large teeth.


In addition, the first customizable jaw 101012 and the second customizable jaw 101014 have a plurality of features 101030a-d and 101032a-d, respectively that are positioned on the outer portion of the first and second customizable jaws 101012, 101014. As illustrated in FIG. 71, the features 101030a and 101032a comprise distal concave features. The features 101030a and 101032a can have a low durometer surface that is sticky to the touch and can be used to manipulate an object, such as tissue. In at least one instance, the low-durometer features 101030a and 101032a have a durometer between about 15 and about 70 Shore 00, for example. In certain instances, the low-durometer features 101030a and 101032a have a durometer between about 15 and about 70 Shore A, for example. The features 101030b and 101032b comprise convex protruding features. The features 101030b and 101032b can have a low durometer surface that is sticky to the touch and can be used to manipulate an object, such as tissue. In at least one instance, the low-durometer features 101030b and 101032b have a durometer between about 15 and about 70 Shore 00, for example. In certain instances, the low-durometer features 101030b and 101032b have a durometer between about 15 and about 70 Shore A, for example. The features 101030c and 101032c comprise concave features. The features 101030c and 101032c can have a low durometer surface that is sticky to the touch and can be used to manipulate an object, such as tissue. The features 101030d and 101032d comprise a substantially smooth surface. The features 101030d and 101032d can have a low durometer surface that is sticky to the touch and can be used to manipulate an object, such as tissue.


In addition, or in the alternative, various additional configurations for the features 101030a-d and 101032a-d are possible. The feature 101030a-d and 101032a-d can include ridges, and/or substantially smooth surfaces that allow the surgical end effector 101000 to engage, grasp, and/or manipulate an object, for example a patient's tissue.



FIG. 70 depicts a top plan view of the surgical end effector 101000. FIG. 71 depicts a side elevation view of the surgical end effector 101000. The overall geometric shape of the surgical end effector 101000 is a substantially linear configuration.


When selecting the configuration and various features for the surgical end effector 101000, the external features 101030a-d, 101032a-d, the proximal features 101018, the distal features 101016, the overall geometric shape of the first and second customizable jaws 101012, 101014, and the materials used in producing the customizable end effector portion 101060 are independent variables that are considered during the customization process. For example, when the surgical end effector 101000 is being customized for a minimally invasive surgical procedure, the various independent variables must produce an overall profile that falls within the customization region 101002 so that the surgical end effector 101000 can be inserted through a trocar and into a patient's body cavity.


The various end effectors described above with respect to FIGS. 58-71 can be produced through a multi-step process where a first portion of the end effector, such as, a standard connection portion, for example, is produced in a manufacturing facility and shipped to hospitals or distributed to manufacturing hubs. Once the standard connection portion is at its end location, such as a hospital, or at a manufacturing facility, the standard connection portion can be customized to produce an end effector meeting the needs of the user. Such customization can allow surgical end effectors to be produced for specific procedures and/or specific patients.


The customized end effectors described above with respect to FIGS. 58-71 can be produced through various techniques. A clinician can access, for example, a dedicated human-machine interface to select and design the desired attributes of an end effector. The human-machine interface can comprise, for example, a graphical user interface of a computer. The computer can be connected to a manufacturing device. The computer-manufacturing device interface can be wired, wireless, and/or remote, for example, via the internet. When the clinician accesses the human-machine interface, they can select the various attributes desired of the end effector.


When selecting the various attributes of the end effector, the clinician can use information gained from the patient or information about the particular procedure to guide their design of the end effector. When the clinician is using information regarding a particular patient, for example, the patient's information can come from various patient tests, such as MRIs, X-rays, CT Scans, and/or other medical tests. These testing results can be entered into the computer and used to control the design parameters of the end effector. When the clinician uses the results of an MRI, for example, to detect a patient's tumor, the size and shape of the patient's tumor can be used as design parameters when producing the customized end effector.


In addition, or in the alternative, the clinician can use parameters from the particular surgical procedure to design the customized end effector. When the end effector is being designed for various bariatric procedures, for example, the requirements of the specific procedure, such as the size of a gastric bypass reduction, can be used as the design parameters when producing the customized end effector.


In selecting the various features for the end effector, the clinician can use various software programs to design the desired features of the end effector. The clinician, for example, can input the patient's scans and/or medical test information into the computer and a software program can determine the design features of the end effector to match the patient's condition. Once the software program approximates the necessary features of the end effector, the clinician can review and/or modify the parameters of the end effector using the human-machine interface.


In addition, or in the alternative, the clinician can access a software program using the human-machine interface to design the features of the end effector. The clinician, for example, can access the software program and select various predetermined shapes, features, and/or designs to combine to produce an end effector having the desired features. The clinician may also use a free-form command in the software to freely design the desired features of the end effector.


Once the features of the customized end effector are determined, the clinician and/or manufacturing staff can insert a core/stub portion into a manufacturing device. The manufacturing device is in communication with the human-machine interface of the computer via a wired, wireless, and/or remote internet connection. The clinician, using the software program, can send the design parameters to the manufacturing device to produce the end effector.


The manufacturing device can be designed to use various manufacturing processes or techniques. The manufacturing device, for example, can be a metal injection molding device, a plastic injection molding device, a CNC machine, an EDM device, a 3-D printing device, and/or various other manufacturing devices, such as additive manufacturing devices.


After the design parameters are transferred from the computer to the manufacturing device, the software controlling the manufacturing device causes the manufacturing device to perform a manufacturing procedure to produce the customized end effector. The manufacture procedure can add material to the core/stub portion of the end effector. In the alternative, the manufacturing procedure can remove material from the core/stub portion of the end effector. The manufacturing device can use one or more of the techniques described above in the production of the customized end effector. Once the manufacturing device has completed the overall design and structure of the customized end effector, the customized end effector can be finished or polished using a finishing machine and/or process. The finishing machine may be part of the manufacturing device, or it can be a separate machine/device.


Once the structure of the customized end effector is completed, the customized end effector can be tested, cleaned, and/or sterilized. The testing process can ensure that the customized end effector is designed to the necessary standards for the particular medical device. The cleaning process can remove any excess residual material leftover from the manufacturing process. The sterilization process can sterilize the end effector so that it can be used in a surgical procedure. After the customized end effector is sterilized, it can be packaged for storing until it is needed in a surgical procedure or can be used directly by a clinician in a surgical procedure.


A method for producing a customized end effector comprises preparing an end effector connection portion for customization. The end effector connection portion comprises a proximal connector configured to attach to a distal end of a surgical instrument. The proximal connector comprises an actuator. Once a standard connection portion is prepared, the user determines through interaction with a patient a first desired characteristic of the surgical end effector and a second desired characteristic of the end effector. Once the characteristics of the end effector are determined, a first jaw member is created on the standard connection portion having the first desired characteristic. Next, a second jaw member is created on the standard connection portion having the second desired characteristic. The first and second jaw members can be created through an additive manufacturing process, such as 3-D printing.


Surgical instruments can comprise devices that use mechanical energy to perform surgical procedures. Certain end effectors, such as grasping forceps can be used to grasp a target, such as the tissue of a patient, for example. Other end effectors, such as dissectors, for example, can be used to separate and/or tear the tissue using mechanical forces. Other types of end effectors, such as electrosurgical end effectors, for example, can use electrosurgical energy to deliver energy to the tissue of a patient and destroy and/or remove targeted tissue. These types of surgical instruments have been used independently of one another.


Surgical dissectors, such as the dissectors disclosed in U.S. Patent Application Publication No. 2010/0198248, entitled SURGICAL DISSECTOR, the disclosure of which is incorporated by reference in its entirety, for example, use mechanical forces and mechanical features on the jaws of the dissector, such as teeth, for example, to manipulate a patient's tissue. The teeth can be used to stretch and/or tear a patient's tissue. Depending on the type and/or amount of tissue that a mechanical dissector encounters, the mechanical dissector can apply various amounts of mechanical force to the tissue.


Surgical dissectors comprise a pair of jaws that are rotatable between open and closed positions. Each jaw can comprise a plurality of features, such as teeth or ridges that can engage a patient's tissue on inner and/or outer surfaces of the jaw, for example. The features, such as teeth, on the inner surfaces of a pair of surgical dissector jaws can be used to gasp and/or manipulate tissue when the jaws are closed upon a portion of the patient's tissue. In addition, or in the alternative, when a pair of surgical dissector jaws comprise teeth and/or ridges on outer surfaces thereof, such teeth can increase the traction and interaction between the jaws and the patient's tissue when the jaws are moved into an open position, for example. As the pair of surgical dissector jaws are opened, the teeth on the outer surfaces of the jaws can grip, stretch, and/or tear the tissue.


Electrosurgical devices for applying electrical energy to tissue in order to treat and/or destroy the tissue are finding increasingly widespread applications in surgical procedures. An electrosurgical device typically includes a handpiece and an instrument having a distally-mounted end effector (e.g., one or more electrodes). The end effector can be positioned against the tissue such that electrical current is introduced into the tissue. Electrosurgical devices can be configured for bipolar and/or monopolar operation. During bipolar operation, current is introduced into and returned from the tissue by active and return electrodes, respectively, of the end effector. During monopolar operation, current is introduced into the tissue by an active electrode of the end effector and returned through a return electrode (e.g., a grounding pad) separately located on a patient's body. Heat generated by the current flowing through the tissue may form hemostatic seals within the tissue and/or between tissues and thus may be particularly useful for sealing blood vessels, for example. In some instances, the voltage and current used ablates the tissue. The end effector of an electrosurgical device also may include a cutting member that is movable relative to the tissue and the electrodes to transect the tissue.


Electrical energy applied by an electrosurgical device can be transmitted to the instrument by a generator in communication with the handpiece. The electrical energy may be in the form of radio frequency (RF) energy that may be in a frequency range described in EN 60601-2-2:2009+A11:2011, Definition 201.3.218—HIGH FREQUENCY, the entire disclosure of which is incorporated by reference. In certain instances, the frequencies in monopolar RF applications are typically restricted to less than 5 MHz, for example. However, in bipolar RF applications, the frequency can be any suitable frequency. Frequencies above 200 kHz can be typically used for monopolar applications in order to avoid the unwanted stimulation of nerves and muscles which would result from the use of low frequency current, for instance. Lower frequencies may be used for bipolar techniques if the risk analysis shows the possibility of neuromuscular stimulation has been mitigated to an acceptable level. Normally, frequencies above 5 MHz are not used in order to minimize the problems associated with high frequency leakage currents. However, higher frequencies may be used in the case of bipolar techniques. In many instances, a minimum of 10 mA is needed to create thermal effects within the tissue.


In application, an electrosurgical device can transmit low frequency RF energy through tissue, which causes ionic agitation, or friction—in effect resistive heating—thereby increasing the temperature of the affected tissue. Because a sharp boundary is created between the affected tissue and the surrounding tissue, a surgeon can operate with a high level of precision and control without sacrificing un-targeted adjacent tissue. The low operating temperatures of RF energy is useful for removing, shrinking, and/or sculpting soft tissue while simultaneously sealing blood vessels. RF energy works particularly well on connective tissue, which is primarily comprised of collagen and shrinks when contacted by heat.


Other electrical surgical instruments include, without limitation, irreversible and/or reversible electroporation, and/or microwave technologies, among others. The techniques disclosed herein are applicable to ultrasonic, bipolar or monopolar RF (electrosurgical), irreversible and/or reversible electroporation, and/or microwave-based surgical instruments, among others. U.S. Patent Application Publication No. 2017/0086914 A1, to Wiener, et al., titled TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS provides examples of electrosurgical instruments and electrosurgical generators that can be used with the instruments described herein, the disclosure of which is incorporated by reference in its entirety.



FIGS. 72-79 illustrate surgical instruments that comprise the mechanical features of surgical dissectors and the electrosurgical features of electrosurgical devices. The combination of surgical dissector and electrosurgical instrument can allow the surgical instruments illustrated in FIGS. 72-79 to perform various surgical procedures. In addition, the combination of the mechanical and electrosurgical features may allow a surgeon to perform a surgical procedure without having to switch between different surgical instruments. As discussed in greater detail below with respect to FIG. 80, the combination of a mechanical dissector and an electrosurgical instrument can provide synergistic effects and improve the overall efficiencies and abilities of surgical end effectors.


The embodiments disclosed in FIGS. 72-79 illustrate various end effector jaws comprising mechanical dissector features and electrosurgical device features. These end effector jaws can be used with surgical instruments to deliver mechanical as well as electrical energy to a patient's tissue. The surgical instruments can comprise proximal and distal end effector portions. The proximal portion may include a user interface, such as a handle portion and/or a connector that can connect the surgical instrument to a robotic system, for example. The distal portion of the surgical instruments can comprise a surgical end effector. The surgical end effector can comprise a pair of jaws that are rotatable between open and closed positions. The embodiments disclosed in FIGS. 72-79 illustrate an end effector jaw that can be used in a pair of jaws of a surgical end effector.



FIGS. 72-75 illustrate a surgical end effector jaw 101100 comprising a frame 101102, a metallic core 101130, and a covering 101126. The end effector jaw 101100 comprises an inner surface 101118 and an outer surface 101108. When the end effector jaw 101100 is used in a pair of jaws of a surgical instrument, the inner surfaces 101118 of the end effector jaws 101100 are positioned adjacent one another. The outer surfaces, 101108 of the end effector jaw 101100 are positioned on opposite sides of the end effector jaw 101100.


The frame 101102 of the surgical end effector jaw 101100 comprises a socket 101104. When the end effector jaw 101100 is used in a pair of jaws of a surgical instrument, the sockets 101104 of the two end effector jaws 101100 are aligned and a pin can be inserted through the sockets 101104. The pair of end effector jaws 101100 can be rotated about the pin between open and closed positions. The surgical instrument can also comprise an actuator that can move the end effector jaws 101100 between open and closed positions.


The surgical end effector jaw 101100 comprises a proximal portion 101106 and a distal portion 101110. The overall geometry of the end effector jaw 101100 is curved between the proximal portion 101106 and the distal portion 101110. In addition, the end effector jaw 101100 is tapered from the wider proximal portion 101106 to the narrower distal portion 101110. The tapered profile of the end effector jaw 101100 can permit a surgeon to target a specific location within a patient.


In addition, or in the alternative, the surgical end effector jaw 101100 can comprise other geometries, such as a symmetrical geometry and/or and a tapered geometry with a larger distal portion 101110 and a narrower proximal portion 101106, for example. When the surgical end effector jaw 101100 comprises a symmetrical profile, the surgical end effector jaw 101100 can grasp a patient's tissue evenly over the entire end effector jaw 101100. When the surgical end effector jaw 101100 comprises a tapered geometry with a larger distal portion 101110 and a narrower proximal portion 101106, the larger distal portion 101110 can allow the surgical end effector 101100 to grasp a larger portion of the patient's tissue.


The proximal portion 101106 of the outer surface 101108 comprises a substantially smooth surface. The substantially smooth surface can refer to a surface, for example, that is substantially free from projections or unevenness, generally flat or unruffled, and/or substantially of uniform consistency. The distal portion 101110 of the outer surface 101108 comprises a plurality of features. The plurality of features comprises central features 101120, peripheral features 101122, and lateral features 101132, and/or any other suitable features.


The central features 101120, peripheral features 101122, and lateral features 101132 comprise ridges, or teeth, but could comprise any suitable configuration. The central features 101120, peripheral features 101122, and lateral features 101132 can be comprised of various materials. The central, peripheral, and/or lateral features 101120, 101122, 101132 can be comprised of a first material and the outer surface 101108 of the end effector jaw 101100 can be comprised of a second material. The first material can have a greater elasticity than the second material. The second material can have a greater rigidity than the first material. With a less rigid and more elastic material, the central, peripheral, and/or lateral features 101120, 101122, 101132 can deform against a target, such as a patient's tissue, and increase the traction and interaction between the surgical end effector jaw 101100 and the target object.


The plurality of central features 101120 can be substantially perpendicular to the chord of the arc of the jaw 101108. The plurality of central features 101120 are raised above the outer surface of the jaw 101108. In addition, the central features 101120 can be overlaid or overmolded with the lateral features 101132 that can be positioned along the jaw 101108. The lateral features 101132 can be comprised of a different material having a different rigidity and elasticity. For instance, the lateral features 101132 can be more elastic and/or have greater compliance than the central features 101120 which can allow the lateral features 101132 to have a greater ability to interact with a target, such as a patient's tissue. The plurality of central features 101120 can have a slight concavity with respect to the proximal portion 101106 of the end effector jaw 101100, for example. The plurality of peripheral features 101122 can include a convex shape with respect to the proximal portion 101106 of the end effector jaw 101100, for example. The convex-concave-convex pattern of the peripheral-central-peripheral feature combination can allow for greater interaction with a target, such as a patient's tissue.


Where the central features 101120 are aligned substantially perpendicular to the chord of the arc on the surgical end effector jaw 101100, the central features 101120 can facilitate a desired interaction with a patient's tissue. This configuration may allow the surgical end effector jaw 101100 to be drawn through the tissue plane and create a parting action of the tissue. Furthermore, where the patterns of the central features 101120 at the tip of the surgical instrument are aligned with the chord of the arc of the surgical end effector jaw 101100, this pattern facilitates the lateral movement of the surgical end effector jaw 101100 to create a tissue parting action.


The central, peripheral, and lateral features 101120, 101122, 101132 of the end effector jaw 101100 can include symmetrical or asymmetrical patterns that extend along the end effector jaw 101100. The patterns of the central, peripheral, and/or lateral features 101120, 101122, 101132 can be continuous or interlocking and become more interrupted and staggered as they extend towards the proximal portion 101106 and/or distal portion 101110 of the end effector jaw 101100. The various configurations of the central, peripheral, and lateral features 101120, 101122, 101132 can result in posts or standing pillars that can enhance the interaction of these features with the target object, such as a patient's tissue.


The central, peripheral, and lateral features 101120, 101122, 101132 can comprise overmolded plastic and/or polymers. The central, peripheral, and lateral features 101120, 101122, 101132 can comprise various polymers or plastics having different densities and/or properties. A first layer of plastic may be overmolded onto portions of the metallic core 101130 of the end effector jaw 101100. The first layer of plastic can have a first density, rigidity, and elasticity. A second layer of plastic may be overmolded onto portions of the first layer of overmolded plastic and/or onto portions of the metallic core 101130. The second layer of plastic can have a second density, rigidity, and elasticity. The first density, rigidity, and/or elasticity can be the same or different than the second density, rigidity and/or elasticity.


Various sections of the covering 101126 can comprise overmolded plastic and/or polymers. The various sections of the covering 101126 can comprise various polymers or plastics having different densities and/or properties. A first layer of plastics may be overmolded onto portions of the metallic core 101130 of the end effector jaw 101100. The first layer of plastic can have a first density, rigidity, and elasticity. A second layer of plastic may be overmolded onto portions of the first layer of overmolded plastic and/or onto portions of the metallic core 101130. The second layer of plastic can have a second density, rigidity, and elasticity. The first density, rigidity, and/or elasticity can be the same or different than the second density, rigidity and/or elasticity.


In one embodiment, the first layer can comprise a rigid layer that can provide a structural support or backbone to the end effector jaw 101100 along with the metallic core 101130. The second layer can comprise a more elastic and/or less rigid layer. The second layer can be more deformable to create a tissue interaction outer surface that allows for grasping and securing the tissue. The first layer that is more rigid can have a sharper profile and edges that can maintain its shape and actively shear tissue while the outer softer layer acts more like a bumper to prevent cutting tissue before the surgical end effector jaw 101100 is engaged with the desired location or section of tissue.


The inner surface 101118 of the end effector jaw 101100 comprises a plurality of teeth 101116 that extend between the proximal portion 101106 and the distal portion 101110 of the end effector jaw 101100. The plurality of teeth 101116 extend across the width of the inner surface 101118 and follow the tapered profile of the end effector jaw 101100. The central portion of the plurality of teeth 101116 comprises an exposed section of the metallic core 101130. The exposed section of the metallic core 101130 extends substantially uniformly down the central portion of the plurality of teeth 10116 between the proximal portion 101106 and the distal portion 101110. In the alternative, the metallic core 101130 can extend to the inner surface 101118 of the end effector jaw 101100, for example, in an asymmetrical pattern. The different exposed patterns of the metallic core 101130 can allow the end effector jaw 101100 to transmit electrosurgical energy to a patient's tissue in different ways, as described in greater detail below.


When a patient's tissue comes in contact with the metallic core 101130, a surgeon can apply electrosurgical energy to the targeted tissue through the metallic core 101130. The electrosurgical energy can cause ablation and/or cauterization of the targeted tissue.


The distal most portion of the inner surface 101118 comprises a distal bumper portion 101124 and a distal tip 101128. The distal bumper portion 101124 comprises an elastic and/or deformable material that can allow the end effector jaw 101100 to interact with a target object with less irritation to the object. The distal tip 101128 comprises the metallic core 101130 and is configured to deliver electrosurgical energy to a target object, such as a patient's tissue. The distal bumper portion 101124 being constructed of a more elastic and less rigid material can allow the user of the surgical end effector jaw 101100 to be more aggressive without increasing the irritation of the target object, such as a patient's tissue.


In addition, or in the alternative, the various polymers and/or plastics that comprise the surgical end effector jaw 101100 may comprise hydrophobic plastic or materials. The hydrophobic materials can repel liquid, such as body fluids and/or water to keep the dissection features free to dissect. In addition, by repelling fluids, the hydrophobic material may allow a user greater visibility of the interaction portions of the device when using the device in a minimally invasive procedure. The hydrophobic materials may also allow for a consistent dissection surface during the use of the surgical instrument by repelling and keeping away the fluids from the interaction site.



FIGS. 76-78 illustrate a surgical end effector jaw 101200 comprising a frame 101202, a metallic core 101230, and a covering 101226. The end effector jaw 101200 comprises an inner surface 101218 and an outer surface 101208. When the end effector jaw 101200 is used in a pair of jaws of a surgical instrument, the inner surfaces 101218 of the end effector jaws 101200 are positioned adjacent one another. The outer surfaces 101208 of the end effector jaw 101200 are positioned on opposite sides of the end effector jaw 101200.


The frame 101202 of the surgical end effector jaw 101200 comprises a socket 101204. When the end effector jaw 101200 is used in a pair of jaws of a surgical instrument, the sockets 101204 of the two end effector jaws 101200 are aligned and a pin can be inserted through the sockets 101204. The pair of end effector jaws 101200 can be rotated about the pin between open and closed positions. The surgical instrument can also comprise an actuator that can move the end effector jaws 101200 between open and closed positions.


The surgical end effector jaw 101200 comprises a proximal portion 101206 and a distal portion 101210. The overall geometry of the end effector jaw 101200 is curved between the proximal portion 101206 and the distal portion 101210. In addition, the end effector jaw 101200 is tapered from the wider proximal portion 101206 to the narrower distal portion 101210. The tapered profile of the end effector jaw 101200 can permit a surgeon to target a specific location within a patient.


In addition, or in the alternative, the surgical end effector jaw 101200 can comprise other geometries, such as a symmetrical geometry and/or and a tapered geometry with a larger distal portion 101210 and a narrower proximal portion 101206, for example. When the surgical end effector jaw 101200 comprises a symmetrical profile, the surgical end effector jaw 101200 can grasp a patient's tissue evenly over the entire end effector jaw 101200. When the surgical end effector jaw 101200 comprises a tapered geometry with a larger distal portion 101210 and a narrower proximal portion 101206, the larger distal portion 101210 can allow the surgical end effector 101200 to grasp a larger portion of the patient's tissue.


The proximal portion 101206 of the outer surface 101208 comprises a substantially smooth surface. The substantially smooth surface can refer to a surface, for example, that is substantially free from projections or unevenness, generally flat or unruffled, and/or substantially of uniform consistency. The distal portion 101210 of the outer surface 101208 comprises a plurality of features. The plurality of features comprises central features 101220, peripheral features 101222, and lateral features 101232, and/or any other suitable features.


The central features 101220, peripheral features 101222, and lateral features 101232 comprise recesses or through holes, but could comprise any suitable configuration. The recesses or through holes expose the metallic core 101230 to the outer surface 101208 and patient tissue. The central features 101220, peripheral features 101122, and lateral features 101232 can comprise different diameters and/or depths, or the same diameters and/or depths. The central features 101220, peripheral features 101122, and lateral features 101232 can also comprise different patterns and/or orientations along the outer surface 101208 of the surgical end effector jaw 101200.


The central features 101220, peripheral features 101222, and lateral features 101232 allow a patient's tissue to come in contact with the metallic core 101230 of the surgical end effector jaw 101200. When a pair of end effector jaws 101200 is used to stretch out tissue, the mechanical forces used to stretch out the tissue can cause the tissue to flow into the central features 101220, peripheral features 101222, and/or lateral features 101232. Once the tissue is in contact with the metallic core 101230 within the central features 101220, peripheral features 101222, and/or lateral features 101232, a clinician can apply electrosurgical energy to the tissue. The combination of mechanical force and electrosurgical energy can allow for ablation of the tissue without tearing the tissue. In addition, or in the alternative, the electrosurgical energy can allow the end effector jaws 101200 to cauterize the tissue as the tissue is spread and/or torn. The combination of electrosurgical energy and mechanical forces can allow a surgeon to perform a surgical procedure with using less mechanical force as the effects of the electrosurgical energy and mechanical force are cumulative.


In various instances, less mechanical force, for example, is required to dissect tissue when more electrosurgical energy is applied. Correspondingly, more mechanical force is required to dissect tissue when less electrosurgical energy is applied. That said, the ratio of mechanical force to electrosurgical energy can be held constant throughout the opening stroke of the dissector jaws. In other instances, the ratio of mechanical force to electrosurgical energy can change throughout the opening stroke of the dissector jaws. In at lease one instance, the electrosurgical energy can increase as the dissector jaws are opened. Such an arrangement can apply the electrosurgical energy when tissue tearing and/or bleeding is most likely to occur. In other instances, the electrosurgical energy can decrease as the dissector jaws are opened. Such an arrangement can create or start an initial otomy that then is stretched open by the mechanical force.


The inner surface 101218 of the end effector jaw 101200 comprises a plurality of teeth 101216 that extend between the proximal portion 101206 and the distal portion 101210 of the end effector jaw 101200. The plurality of teeth 101216 extend across the width of the inner surface 101218 and follow the tapered profile of the end effector jaw 101200. The central portion of the plurality of teeth 101216 comprises an exposed section of the metallic core 101230. The exposed section of the metallic core 101230 extends substantially uniformly down the central portion of the plurality of teeth 10126 between the proximal portion 101206 and the distal portion 101210. In the alternative, the metallic core 101230 can extend to the inner surface 101218 of the end effector jaw 101200, for example, in an asymmetrical pattern. The different exposed patterns of the metallic core 101230 can allow the end effector jaw 101200 to transmit electrosurgical energy to a patient's tissue in different ways, as described in greater detail below.


When a patient's tissue comes in contact with the metallic core 101230, a surgeon can apply electrosurgical energy to the targeted tissue through the metallic core 101230. The electrosurgical energy can cause ablation and/or cauterization of the targeted tissue.


The distal most portion of the inner surface 101218 comprises a distal bumper portion 101224 and a distal tip 101228. The distal bumper portion 101224 comprises an elastic and/or deformable material that can allow the end effector jaw 101200 to interact with a target object with less irritation to the object. The distal tip 101228 comprises the metallic core 101230 and is configured to deliver electrosurgical energy to a target object, such as a patient's tissue. The distal bumper portion 101224 being constructed of a more elastic and less rigid material can allow the user of the surgical end effector jaw 101200 to be more aggressive without increasing the irritation of the target object, such as a patient's tissue.


Various sections of the covering 101226 can comprise overmolded plastic and/or polymers. The various sections of the covering 101226 can comprise various polymers or plastics having different densities and/or properties. A first layer of plastics may be overmolded onto portions of the metallic core 101230 of the end effector jaw 101200. The first layer of plastic can have a first density, rigidity, and elasticity. A second layer of plastic may be overmolded onto portions of the first layer of overmolded plastic and/or onto portions of the metallic core 101230. The second layer of plastic can have a second density, rigidity, and elasticity. The first density, rigidity, and/or elasticity can be the same or different than the second density, rigidity and/or elasticity.


In addition, or in the alternative, the various polymers and/or plastics that comprise the surgical end effector jaw 101200 may comprise hydrophobic plastic or materials. The hydrophobic materials can repel liquid, such as body fluids and/or water to keep the dissection features free to dissect. In addition, by repelling fluids, the hydrophobic material may allow a user greater visibility of the interaction portions of the device when using the device in a minimally invasive procedure. The hydrophobic materials may also allow for a consistent dissection surface during the use of the surgical instrument by repelling and keeping away the fluids from the interaction site.



FIG. 79 illustrates an embodiment similar to the end effector 101300, discussed above. The end effector 101300 includes a central distal feature 101336 and lateral distal features 101334 that are positioned on the distal nose of the end effector jaw 101300. The central distal feature 101336 and lateral distal features 101334 comprise recesses or through holes. The recesses or through holes expose the metallic core 101330 to the outer surface 101308. The central distal feature 101336 and lateral distal features 101334 can comprise different diameters and/or depths, or the same diameters and/or depths. The central distal feature 101336 and lateral distal features 101334 can also comprise different patterns and/or orientations along the outer surface 101308 of the surgical end effector jaw 101300.


The central distal feature 101336 and lateral distal features 101334 allow a patient's tissue to come in contact with the metallic core 101330 of the surgical end effector jaw 101300. When a surgeon pushes tissue with the nose of the surgical end effector jaw 101300, the mechanical forces used to push the jaw 101300 into the tissue to stretch out the tissue can cause the tissue to flow into the central distal feature 101336 and lateral distal features 101334. Once the tissue is in contact with the metallic core 101330 within the central distal feature 101336 and/or lateral distal features 101334, electrosurgical energy can be transmitted to the tissue. The combination of mechanical force and electrosurgical energy can allow for ablation of the tissue without tearing the tissue. In addition, or in the alternative, the electrosurgical energy can allow the end effector jaws 101300 to cauterize the tissue as the tissue is spread and/or torn. The combination of electrosurgical energy and mechanical forces can allow a surgeon to perform a surgical procedure with using less mechanical force as the effects of the electrosurgical energy and mechanical force are cumulative.


In various instances, less mechanical force, for example, is required to dissect tissue when more electrosurgical energy is applied. Correspondingly, more mechanical force is required to dissect tissue when less electrosurgical energy is applied. That said, the ratio of mechanical force to electrosurgical energy can be held constant throughout the opening stroke of the dissector jaws. In other instances, the ratio of mechanical force to electrosurgical energy can change throughout the opening stroke of the dissector jaws. In at lease one instance, the electrosurgical energy can increase as the dissector jaws are opened. Such an arrangement can apply the electrosurgical energy when tissue tearing and/or bleeding is most likely to occur. In other instances, the electrosurgical energy can decrease as the dissector jaws are opened. Such an arrangement can create or start an initial otomy that then is stretched open by the mechanical force.


The surgical end effector jaws may also have overmolded plastic bodies having fractal exterior geometries. The fractal exterior geometries can enable the distal tip of the end effector jaws to be more aggressive without creating undesired interaction with the tissue. In another embodiment, the metallic core of the end effector jaws can be positioned near the outer surface and at the distal tip as well as along the spine of the surgical end effector, as seen in FIGS. 76-79. The metallic core may be exposed to the tissue through the various features and recesses along the end effector jaw's outer surface. The metallic core may be recessed within 0.0001-0.001 mm of the outer surface and in electrical contact with the shaft of the surgical instrument to permit the transmission of electrosurgical energy along the end effector jaw. With the metallic core exposed to the tissue, the metallic core can deliver electrosurgical energy to the patient's tissue. In this configuration, the surgical instrument may operate as a hybrid between a mechanical surgical dissector and an electrosurgical instrument.


The various features and characteristics described with regard to the surgical instruments and end effectors illustrated in FIGS. 58-79 can be comprised of various materials. The end effectors illustrated in FIGS. 72-79 can comprise a metallic core that can deliver electrosurgical energy from an electrosurgical instrument to a patient's tissue. The various features described above can comprise overmolded plastic or polymers. The features can comprise polymers or plastics having various densities and properties. A first layer of plastics may be overmolded onto portions of the metallic core of the end effector. The first layer of plastic can have a first density, rigidity, and elasticity. A second layer of plastics may be overmolded onto portions of the first layer of overmolded plastic and/or onto portions of the metallic core. The second layer of plastic can have a second density, rigidity, and elasticity. The first density, rigidity and/or elasticity can be the same or different than the second density, rigidity and/or elasticity.


In one embodiment, the first layer can comprise a rigid layer that can provide a structural support or backbone to the end effector. The second layer can comprise a more elastic and less rigid layer. The second layer can be more deformable to create a tissue interaction outer surface that allows for grasping and securing the tissue. The first layer that is more rigid can have a sharper profile and edges that can maintain its shape and actively shear tissue while the outer softer layer acts more like a bumper to prevent cutting tissue before the surgical end effector is engaged with the desired portion or section of tissue.


The surgical instruments illustrated in FIGS. 72-79 can be produced through traditional manufacturing processes. In addition, or in the alternative, the surgical instruments illustrated in FIGS. 72-79 can be produced through the additive manufacturing procedures discussed above with respect to FIGS. 58-71. The surgical instruments of FIGS. 72-79 can comprise a metallic core and the outer shape and features of the end effectors can be produced through an additive manufacturing process to produce customized surgical end effectors having desired features and/or shapes.


As discussed above, with regard to FIGS. 72-79, surgical end effector jaws can be used to employ a combination of electrosurgical and mechanical forces to effected tissue. FIG. 80 illustrates a graphical representation 101400 of the relationship between various parameters for a surgical instrument having mechanical and electrosurgical features. The various parameters include the current delivered to the tissue 101402, the voltage to current ratio 101404, the impedance of the tissue being treated 101406, and the mechanical force being applied to the tissue 101408. The various parameters are illustrated with a reference to various aspects of a surgical procedure, such as a dissection procedure 101410, for example. The dissection procedure 101410 includes an initial force loading condition 101412, a tissue spreading condition 101414, and a force unloading condition 101416.


During the initial force loading condition 101412, the current delivered to the tissue 101402, the voltage to current ratio 101404, and the impedance of the tissue being treated 101406 initially increase. Over the initial force loading condition 101412, the current delivered to the tissue 101402 and the voltage to current ratio 101404 continue to increase while the impedance of the tissue being treated 101406 decreases and then levels out. The mechanical force being applied to the tissue 101408 also increases over the initial force loading condition 101412. As the mechanical force being applied to the tissue 101408 increase, the surgical end effector jaws begin to push layers of the tissue away.


Once the initial force loading condition 101412 is completed, the tissue spreading condition 101414 occurs. Over a first stage of the tissue spreading condition 101414, the current delivered to the tissue 101402 and the impedance of the tissue being treated 101406 remain relatively steady while the voltage to current ratio 101404 fluctuates. In addition, over the first stage of the tissue spreading condition 101414, the mechanical force being applied to the tissue 101408 increases and begins to exceed a higher reinforcement threshold. When the higher reinforcement threshold is exceeded, the current delivered to the tissue 101402 and the voltage to current ratio 101404 are increased to reinforce the tissue spreading, which in turn reduces the impedance of the tissue being treated 101406. The mechanical force being applied to the tissue 101408 by the end effector jaws drop due to the assistance of the electrosurgical energy, as such, the levels for the current delivered to the tissue 101402 and the voltage to current ratio 101404 are reduced. When the mechanical force being applied to the tissue 101408 falls below a lower reinforcement threshold, the current delivered to the tissue 101402 and the voltage to current ratio 101404 are reduced as the need for reinforcement assistance from the electrosurgical aspects of the surgical instrument are reduced. Once the mechanical force being applied to the tissue 101408 climbs above the lower reinforcement threshold, the current delivered to the tissue 101402 and the voltage to current ratio 101404 return to their previous levels.


After the tissue spreading condition 101414 occurs, the mechanical forces and electrosurgical energy being applied are reduced as represented by the unloading condition 101416. During the force unloading condition 101416, the current delivered to the tissue 101402, the voltage to current ratio 101404, the impedance of the tissue being treated 101406, and the mechanical force being applied to the tissue 101408 are all reduced to the initial unloaded condition. The combination of the mechanical force being applied to the tissue 101408 and electrosurgical energy allows the surgical instrument to perform the surgical procedure using less mechanical energy which can result in less tearing of the tissue. The application of the electrosurgical energy can also seal the tissue as it is being separated by the opening of the end effector jaws.


To detect the various threshold levels, discussed above, a surgical instrument may have sensors to monitor the pressures, currents, voltages, impedance of the tissue, and forces applied during a surgical procedure and modify the parameters to prevent any of the threshold from being exceeded. In addition, or in the alternative, a surgeon may be provided with tactical feedback regarding the parameters and manually control the various parameters.


A surgical system 128000 is illustrated in FIG. 80. The surgical system 128000 comprises a handle, a shaft 128020 extending from the handle, and an end effector 128030 extending from the shaft 128020. In alternative embodiments, the surgical system 128000 comprises a housing configured to be mounted to a robotic surgical system. In at least one such embodiment, the shaft 128020 extends from the robotic housing mount instead of the handle. In either event, the end effector 128030 comprises jaws 128040 and 128050 which are closeable to grasp a target, such as the tissue T of a patient and/or a suture needle, for example, as discussed in greater detail below. The jaws 128040 and 128050 are also openable to dissect the tissue of a patient, for example. In at least one instance, the jaws 128040 and 128050 are insertable into the patient tissue to create an otomy therein and then spread to open the otomy, as discussed in greater detail below.


Referring again to FIG. 80, the jaws 128040 and 128050 are pivotably coupled to the shaft 128020 about a pivot joint 128060. The pivot joint 128060 defines a fixed axis of rotation, although any suitable arrangement could be used. The jaw 128040 comprises a distal end, or tip, 128041 and an elongate profile which narrows from its proximal end to its distal end 128041. Similarly, the jaw 128050 comprises a distal end, or tip, 128051 and an elongate profile which narrows from its proximal end to its distal end 128051. The distance between the tips 128041 and 128051 define the mouth width, or opening, 128032 of the end effector 128030. When the tips 128041 and 128051 are close to one another, or in contact with one another, the mouth 128032 is small, or closed, and the mouth angle θ is small, or zero. When the tips 128041 and 128051 are far apart, the mouth 128032 is large and the mouth angle θ is large.


Further to the above, the jaws of the end effector 128030 are driven by a jaw drive system including an electric motor. In use, a voltage potential is applied to the electric motor to rotate the drive shaft of the electric motor and drive the jaw drive system. The surgical system 128000 comprises a motor control system configured to apply the voltage potential to the electric motor. In at least one instance, the motor control system is configured to apply a constant DC voltage potential to the electric motor. In such instances, the electric motor will run at a constant speed, or an at least substantially constant speed. In various instances, the motor control system comprises a pulse width modulation (PWM) circuit and/or a frequency modulation (FM) circuit which can apply voltage pulses to the electric motor. The PWM and/or FM circuits can control the speed of the electric motor by controlling the frequency of the voltage pulses supplied to the electric motor, the duration of the voltage pulses supplied to the electric motor, and/or the duration between the voltage pulses supplied to the electric motor.


The motor control system is also configured to monitor the current drawn by the electric motor as a means for monitoring the force being applied by the jaws of the end effector 128030. When the current being drawn by the electric motor is low, the loading force on the jaws is low. Correspondingly, the loading force on the jaws is high when the current being drawn by the electric motor is high. In various instances, the voltage being applied to the electric motor is fixed, or held constant, and the motor current is permitted to fluctuate as a function of the force loading at the jaws. In certain instances, the motor control system is configured to limit the current drawn by the electric motor to limit the force that can be applied by the jaws. In at least one embodiment, the motor control system can include a current regulation circuit that holds constant, or at least substantially constant, the current drawn by the electric motor to maintain a constant loading force at the jaws.


The force generated between the jaws of the end effector 128030, and/or on the jaws of the end effector 128030, may be different depending on the task that the jaws are being used to perform. For instance, the force needed to hold a suture needle may be high as suture needles are typically small and it is possible that a suture needle may slip during use. As such, the jaws of the end effector 128030 are often used to generate large forces when the jaws are close together. On the other hand, the jaws of the end effector 128030 are often used to apply smaller forces when the jaws are positioned further apart to perform larger, or gross, tissue manipulation, for example.


Referring to the upper portion 128110 of the graph 128100 illustrated in FIG. 81, the loading force, f, experienced by the jaws of the end effector 128030 can be limited by a force profile stored in the motor control system. The force limit profile 128110o for opening the jaws 128040 and 128050 is different than the force limit profile 128110c for closing the jaws 128040 and 128050. This is because the procedures performed when forcing the jaws 128040 and 128050 open are typically different than the procedures performed when forcing the jaws 128040 and 128050 closed. That said, the opening and closing force limit profiles could be the same. While it is likely that the jaws 128040 and 128050 will experience some force loading regardless of whether the jaws 128050 are being opened or closed, the force limit profiles typically come into play when the jaws 128040 and 128050 are being used to perform a particular procedure within the patient. For instance, the jaws 128040 and 128050 are forced open to create and expand an otomy in the tissue of a patient, as represented by graph sections 128115 and 128116, respectively, of graph 128100, while the jaws 128040 and 128050 are forced closed to grasp a needle and/or the patient tissue, as represented by graph sections 128111 and 128112, respectively, of graph 128100.


Referring again to FIG. 81, the opening and closing jaw force limit profiles 128110o and 128110c, respectively, are depicted on the opposite sides of a zero force line depicted in the graph 128100. As can be seen in the upper section 128110 of graph 128100, the jaw force limit threshold is higher—for both force limit profiles 128110o and 128110c—when the jaws 128040 and 128050 are just being opened from their fully-closed position. As can also be seen in the upper section 128110 of graph 128100, the jaw force limit threshold is lower—for both force limit profiles 128110o and 128110c—when the jaws 128040 and 128050 are reaching their fully-opened position. Such an arrangement can reduce the possibility of the jaws 128040 and 128050 damaging adjacent tissue when the being fully opened, for example. In any event, the force that the jaws 128040 and 128050 are allowed to apply is a function of the mouth opening size between the jaws and/or the direction in which the jaws are being moved. For instance, when the jaws 128040 and 128050 are opened widely, or at their maximum, to grasp large objects, referring to graph section 128114 of upper graph section 128110, the jaw force f limit is very low as compared to when the jaws 128040 and 128050 are more closed to perform gross tissue manipulation, referring to graph section 128113 of upper graph section 128110. Moreover, different jaw force limit profiles can be used for different jaw configurations. For instance, Maryland dissectors, which have narrow and pointy jaws, may have a different jaw force limit profile than a grasper having blunt jaws, for example.


In addition to or in lieu of the above, the speed of the jaws 128040 and 128050 can be controlled and/or limited by the motor control system as a function of the mouth opening size between the jaws 128040 and 128050 and/or the direction the jaws are being moved. Referring to the middle portion 128120 and lower portion 128130 of the graph 128100 in FIG. 81, the rate limit profile for moving the jaws 128040 and 128050 permits the jaws to be moved slowly when the jaws are near their closed position and moved quickly when the jaws are near their open position. In such instances, the jaws 128040 and 128050 are accelerated as the jaws are opened. Such an arrangement can provide fine control over the jaws 128040 and 128050 when they are close together to facilitate the fine dissection of tissue, for example. Notably, the rate limit profile for opening and closing the jaws 128040 and 128050 is the same, but they could be different in other embodiments. In alternative embodiments, the rate limit profile for moving the jaws 128040 and 128050 permits the jaws to be moved quickly when the jaws are near their closed position and slowly when the jaws are near their open position. In such instances, the jaws 128040 and 128050 are decelerated as the jaws are opened. Such an arrangement can provide fine control over the jaws 128040 and 128050 when the jaws are being used to stretch an otomy, for example. The above being said, the speed of the jaws 128040 and 128050 can be adjusted once the jaws experience loading resistance from the patient tissue, for example. In at least one such instance, the jaw opening rate and/or the jaw closing rate can be reduced once the jaws 128040 and 128050 begin to experience force resistance above a threshold, for example.


In various instances, further to the above, the handle of the surgical system 128000 comprises an actuator, the motion of which tracks, or is supposed to track, the motion of the jaws 128040 and 128050 of the end effector 128030. For instance, the actuator can comprise a scissors-grip configuration which is openable and closable to mimic the opening and closing of the end effector jaws 128040 and 128050. The control system of the surgical system 128000 can comprise one or more sensor systems configured to monitor the state of the end effector jaws 128040 and 128050 and the state of the handle actuator and, if there is a discrepancy between the two states, the control system can take a corrective action once the discrepancy exceeds a threshold and/or threshold range. In at least one instance, the control system can provide feedback, such as audio, tactile, and/or haptic feedback, for example, to the clinician that the discrepancy exists and/or provide the degree of discrepancy to the clinician. In such instances, the clinician can make mental compensations for this discrepancy. In addition to or in lieu of the above, the control system can adapt its control program of the jaws 128040 and 128050 to match the motion of the actuator. In at least one instance, the control system can monitor the loading force being applied to the jaws and align the closed position of the actuator with the position of the jaws when the jaws experience the peak force loading condition when grasping tissue. Similarly, the control system can align the open position of the actuator with the position of the jaws when the jaws experience the minimum force loading condition when grasping tissue. In various instances, the control system is configured to provide the clinician with a control to override these adjustments and allow the clinician to use their own discretion in using the surgical system 128000 in an appropriate manner.


A surgical system 128700 is illustrated in FIGS. 82 and 83. The surgical system 128700 comprises a handle, a shaft assembly 128720 extending from the handle, and an end effector 128730 extending from the shaft assembly 128720. In alternative embodiments, the surgical system 128700 comprises a housing configured to be mounted to a robotic surgical system. In at least one such embodiment, the shaft 128720 extends from the robotic housing mount instead of the handle. In either event, the end effector 128730 comprises shears configured to transect the tissue of a patient. The shears comprise two jaws 128740 and 128750 configured to transect the patient tissue positioned between the jaws 128740 and 128750 as the jaws 128740 and 128750 are being closed. Each of the jaws 128740 and 128750 comprises a sharp edge configured to cut the tissue and are pivotably mounted to the shaft 128720 about a pivot joint 128760. Such an arrangement can comprise bypassing scissors shears. Other embodiments are envisioned in which one of the jaws 128740 and 128750 comprises a knife edge and the other comprises a mandrel against the tissue is supported and transected. Such an arrangement can comprise a knife wedge in which the knife wedge is moved toward the mandrel. In at least one embodiment, the jaw comprising the knife edge is movable and the jaw comprising the mandrel is stationary. The above being said, embodiments are envisioned in which the tissue-engaging edges of one or both of the jaws 128740 and 128750 are not necessarily sharp.


As discussed above, the end effector 128730 comprises two scissor jaws 128740 and 128750 movable between an open position and a closed position to cut the tissue of a patient. The jaw 128740 comprises a sharp distal end 128741 and the jaw 128750 comprises a sharp distal end 128751 which are configured to snip the tissue of the patient at the mouth 128731 of the end effector 128730, for example. That said, other embodiments are envisioned in which the distal ends 128741 and 128751 are blunt and can be used to dissect tissue, for example. In any event, the jaws are driven by a jaw drive system including an electric drive motor, the speed of which is adjustable to adjust the closure rate and/or opening rate of the jaws. Referring to the graph 128400 of FIG. 84, the control system of the surgical system is configured to monitor the loading, or shear, force on the jaws 128740 and 128750 as the jaws 128740 and 128750 are being closed and adaptively slow down the drive motor when large forces, or forces above a threshold Fc, are experienced by the jaws 128740 and 128750. Such large forces often occur when the tissue T being cut by the jaws 128740 and 128750 is thick, for example. Similar to the above, the control system can monitor the current drawn by the drive motor as a proxy for the loading force being experienced by the jaws 128740 and 128750. In addition to or in lieu of this approach, the control system can be configured to measure the jaw loading force directly by one or more load cells and/or strain gauges, for example. Once the loading force experienced by the jaws 128740 and 128750 drops below the force threshold Fc, the control system can adaptively speed up the jaw closure rate. Alternatively, the control system can maintain the lower closure rate of the jaws 128740 and 128750 even though the force threshold is no longer being exceeded.


The above-provided discussion with respect to the surgical system 128700 can provide mechanical energy or a mechanical cutting force to the tissue of a patient. That said, the surgical system 128700 is also configured to provide electrosurgical energy or an electrosurgical cutting force to the tissue of a patient. In various instances, the electrosurgical energy comprises RF energy, for example; however, electrosurgical energy could be supplied to the patient tissue at any suitable frequency. In addition to or in lieu of AC power, the surgical system 128700 can be configured to supply DC power to the patient tissue. The surgical system 128700 comprises a generator in electrical communication with one or more electrical pathways defined in the instrument shaft 128720 which can supply electrical power to the jaws 128740 and 128750 and also provide a return path for the current. In at least one instance, the jaw 128740 comprises an electrode 128742 in electrical communication with a first electrical pathway in the shaft 128720 and the jaw 128750 comprises an electrode 128752 in electrical communication with a second electrical pathway in the shaft 128720. The first and second electrical pathways are electrically insulated, or at least substantially insulated, from one another and the surrounding shaft structure such that the first and second electrical pathways, the electrodes 128742 and 128752, and the tissue positioned between the electrodes 128742 and 128752 forms a circuit. Such an arrangement provides a bipolar arrangement between the electrodes 128742 and 128752. That said, embodiments are envisioned in which a monopolar arrangement could be used. In such an arrangement, the return path for the current goes through the patient and into a return electrode positioned on or under the patient, for example.


As discussed above, the tissue of a patient can be cut by using a mechanical force and/or an electrical force. Such mechanical and electrical forces can be applied simultaneously and/or sequentially. For instance, both forces can be applied at the beginning of a tissue cutting actuation and then the mechanical force can be discontinued in favor of the electrosurgical force finishing the tissue cutting actuation. Such an approach can apply an energy-created hemostatic seal to the tissue after the mechanical cutting has been completed. In such arrangements, the electrosurgical force is applied throughout the duration of the tissue cutting actuation. In other instances, the mechanical cutting force, without the electrosurgical cutting force, can be used to start a tissue cutting actuation which is then followed by the electrosurgical cutting force after the mechanical cutting force has been stopped. In such arrangements, the mechanical and electrosurgical forces are not overlapping or co-extensive. In various instances, both the mechanical and electrosurgical forces are overlapping and co-extensive throughout the entire tissue cutting actuation. In at least one instance, both forces are overlapping and co-extensive throughout the entire tissue cutting actuation but in magnitudes or intensities that change during the tissue cutting actuation. The above being said, any suitable combination, pattern, and/or sequence of mechanical and electrosurgical cutting forces and energies could be used.


Further to the above, the surgical system 128700 comprises a control system configured to co-ordinate the application of the mechanical force and electrosurgical energy to the patient tissue. In various instances, the control system is in communication with the motor controller which drives the jaws 128740 and 128750 and, also, the electrical generator and comprises one or more sensing systems for monitoring the mechanical force and electrosurgical energy being applied to the tissue. Systems for monitoring the forces within a mechanical drive system are disclosed elsewhere herein. Systems for monitoring the electrosurgical energy being applied to the patient tissue include monitoring the impedance, or changes in the impedance, of the patient tissue via the electrical pathways of the electrosurgical circuit. In at least one instance, referring to the graph 128800 in FIG. 85, the RF current/voltage ratio of the electrosurgical power being applied to the patient tissue by the generator is evaluated by monitoring the current and voltage of the power being supplied by the generator. The impedance of the tissue and the RF current/voltage ratio of the electrosurgical power are a function of many variables such as the temperature of the tissue, the density of the tissue, the thickness of the tissue, the type of tissue between the jaws 128740 and 128750, the duration in which the power is applied to the tissue, among others, which change throughout the application of the electrosurgical energy.


Further to the above, the control system and/or generator of the surgical system 128700 comprises one or more ammeter circuits and/or voltmeter circuits configured to monitor the electrosurgical current and/or voltage, respectively, being applied to the patient tissue. Referring again to FIG. 85, a minimum amplitude limit and/or a maximum amplitude limit on the current being applied to the patient tissue can be preset in the control system and/or can be controllable by the user of the surgical instrument system through one or more input controls. The minimum and maximum amplitude limits can define a current envelope within which the electrosurgical portion of the surgical system 128700 is operated.


In various instances, the control system of the surgical system 128700 is configured to adaptively increase the electrosurgical energy applied to the patient tissue when the drive motor slows. The motor slowing can be a reaction to an increase in the tissue cutting load and/or an adaptation of the control system. Similarly, the control system of the surgical system 128700 is configured to adaptively increase the electrosurgical energy applied to the patient tissue when the drive motor stops. Again, the motor stopping can be a reaction to an increase in the tissue cutting load and/or an adaptation of the control system. Increasing the electrosurgical energy when the electric motor slows and/or stops can compensate for a reduction in mechanical cutting energy. In alternative embodiments, the electrosurgical energy can be reduced and/or stopped when the electric motor slows and/or stops. Such embodiments can afford the clinician to evaluate the situation in a low-energy environment.


In various instances, the control system of the surgical system 128700 is configured to adaptively decrease the electrosurgical energy applied to the patient tissue when the drive motor speeds up. The motor speeding up can be a reaction to a decrease in the cutting load and/or an adaptation of the control system. Decreasing the electrosurgical energy when the electric motor slows and/or stops can compensate for, or balance out, an increase in mechanical cutting energy. In alternative embodiments, the electrosurgical energy can be increased when the electric motor speeds up. Such embodiments can accelerate the closure of the jaws and provide a clean, quick cutting motion.


In various instances, the control system of the surgical system 128700 is configured to adaptively increase the speed of the drive motor when the electrosurgical energy applied to the patient tissue decreases. The electrosurgical energy decreasing can be a reaction to a change in tissue properties and/or an adaptation of the control system. Similarly, the control system of the surgical system 128700 is configured to adaptively increase the speed of the drive motor when electrosurgical energy applied to the patient tissue stops in response to an adaptation of the control system. Increasing the speed of the drive motor when the electrosurgical energy decreases or is stopped can compensate for a reduction in electrosurgical cutting energy. In alternative embodiments, the speed of the drive motor can be reduced and/or stopped when the electrosurgical energy decreases and/or is stopped. Such embodiments can afford the clinician to evaluate the situation in a low-energy and/or static environment.


In various instances, the control system of the surgical system 128700 is configured to adaptively decrease the speed of the electric motor when the electrosurgical energy applied to the patient tissue increases. The electrosurgical energy increasing can be a reaction to a change in tissue properties and/or an adaptation of the control system. Decreasing the drive motor speed when the electrosurgical energy increases can compensate for, or balance out, an increase in electrosurgical cutting energy. In alternative embodiments, the drive motor speed can be increased when the electrosurgical energy increases. Such embodiments can accelerate the closure of the jaws and provide a clean, quick cutting motion.


In various instances, the surgical system 128700 comprises controls, such as on the handle of the surgical system 128700, for example, that a clinician can use to control when the mechanical and/or electrosurgical forces are applied. In addition to or in lieu of manual controls, the control system of the surgical system 128700 is configured to monitor the mechanical force and electrical energy being applied to the tissue and adjust one or the other, if needed, to cut the tissue in a desirable manner according to one or more predetermined force-energy curves and/or matrices. In at least one instance, the control system can increase the electrical energy being delivered to the tissue once the mechanical force being applied reaches a threshold limit. Moreover, the control system is configured to consider other parameters, such as the impedance of the tissue being cut, when making adjustments to the mechanical force and/or electrical energy being applied to the tissue.


The surgical instrument systems described herein are motivated by an electric motor; however, the surgical instrument systems described herein can be motivated in any suitable manner. In certain instances, the motors disclosed herein may comprise a portion or portions of a robotically controlled system. U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, discloses several examples of a robotic surgical instrument system in greater detail, the entire disclosure of which is incorporated by reference herein.


The surgical instrument systems described herein can be used in connection with the deployment and deformation of staples. Various embodiments are envisioned which deploy fasteners other than staples, such as clamps or tacks, for example. Moreover, various embodiments are envisioned which utilize any suitable means for sealing tissue. For instance, an end effector in accordance with various embodiments can comprise electrodes configured to heat and seal the tissue. Also, for instance, an end effector in accordance with certain embodiments can apply vibrational energy to seal the tissue. In addition, various embodiments are envisioned which utilize a suitable cutting means to cut the tissue.


EXAMPLES

Example 1—A surgical end effector for use with a surgical instrument. The surgical end effector comprises a proximal connector configured to attach to a distal end of the surgical instrument. The proximal connector comprises an actuator. The surgical end effector further comprises a first jaw member. The first jaw member comprises a first portion comprising a first feature, and a second portion comprising a second feature. The surgical end effector further comprises a second jaw member. At least one of the first jaw member and the second jaw member is movable relative to the other one of the first jaw member and the second jaw member between an open configuration and a closed configuration. The second jaw member comprises a first portion comprising a first feature, and a second portion comprising a second feature. At least one of the first feature of the first jaw member and the first feature of the second jaw member is selected by a user in an additive manufacturing process.


Example 2—The surgical end effector of Example 1, wherein the additive manufacturing process comprises 3-D printing.


Example 3—The surgical end effector of Examples 1 or 2, wherein the first jaw member comprises an inner surface and an outer surface, wherein the second jaw member comprises an inner surface and an outer surface, and wherein the inner surface of the first jaw member and the inner surface of the second jaw member comprise a mating relationship when the surgical end effector is in the closed configuration.


Example 4—The surgical end effector of Examples 1, 2, or 3, wherein the first feature of the first jaw member comprises a tooth, wherein the first feature of the second jaw member comprises a void, and wherein, when the surgical end effector is in the closed configuration, the tooth is received in the void.


Example 5—The surgical end effector of Examples 1, 2, 3, or 4, wherein the first feature of the first jaw member comprises a first material, wherein the second feature of the first jaw member comprises a second material, and wherein the first material is different than the second material.


Example 6—The surgical end effector of Examples 1, 2, 3, or 4, wherein the first feature of the first jaw member comprises a first material, wherein the first feature of the second jaw member comprises a second material, and wherein the first material is different than the second material.


Example 7—The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein the first feature of the first jaw member comprises a first symmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second symmetrical pattern of protrusions, and wherein the first symmetrical pattern of protrusions and the second symmetrical pattern of protrusions are complementary.


Example 8—The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein the first feature of the first jaw member comprises a first symmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second symmetrical pattern of protrusions, and wherein the first symmetrical pattern of protrusions is different than the second symmetrical pattern of protrusions.


Example 9—The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein the first feature of the first jaw member comprises a first asymmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second asymmetrical pattern of protrusions, and wherein the first asymmetrical pattern of protrusions and the second asymmetrical pattern of protrusions are complementary.


Example 10—The surgical end effector of Examples 1, 2, 3, 4, 5, or 6, wherein the first feature of the first jaw member comprises a first asymmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second asymmetrical pattern of protrusions, and wherein the first asymmetrical pattern of protrusions is different than the second asymmetrical pattern of protrusions.


Example 11—The surgical end effector of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, wherein the first portion of the first jaw member is proximal to the second portion of the first jaw member.


Example 12—The surgical end effector of Examples 1, 2, 3, 4, 5, 6, or 11, wherein the first feature of the first jaw member comprises a plurality of protrusions.


Example 13—The surgical end effector of Examples 1, 2, 3, 4, 5, 6, 11, or 12, wherein the second feature of the first jaw member comprises a plurality of protrusions.


Example 14—The surgical end effector of Examples 1, 2, 3, 4, 5, 6, 11, 12, or 13, wherein the first feature of the first jaw member comprises a plurality of protrusions, and wherein the second feature of the first jaw member comprises a substantially smooth surface.


Example 15—The surgical end effector of Examples 1 or 2, wherein the first jaw member comprises an inside surface and an outside surface, and wherein the first portion of the first jaw member is positioned along the inside surface of the first jaw member, and wherein the second portion of the first jaw member is positioned along the outside surface of the first jaw member.


Example 16—The surgical end effector of Examples 1, 2, or 15, wherein the first feature of the first jaw member comprises a plurality of protrusions, and wherein the second feature of the first jaw member comprises a substantially smooth surface.


Example 17—The surgical end effector of Examples 1, 2, or 15, wherein the first feature of the first jaw member comprises a substantially smooth surface, and wherein the second feature of the first jaw member comprises a plurality of protrusions.


Example 18—The surgical end effector of Examples 1, 2, or 15, wherein the first feature of the first jaw member comprises a plurality of first protrusions, and wherein the second feature of the first jaw member comprises a plurality of second protrusions.


Example 19—The surgical end effector of Example 18, wherein the plurality of first protrusions is different than the plurality of second protrusions.


Example 20—The surgical end effector of Examples 1, 2, or 15, wherein the first feature of the first jaw member comprises an asymmetrical profile, and wherein the second feature of the first jaw member comprises a symmetrical profile.


Example 21—The surgical end effector of Examples 1, 2, 15, or 20, wherein the first feature of the first jaw member comprises a low durometer surface.


Example 22—The surgical end effector of Examples 1, 2, 15, 20, or 21 wherein the second feature of the first jaw member comprises a low durometer surface.


Example 23—The surgical end effector of Examples 1, 2, or 15, wherein the first feature of the first jaw member comprises a curved profile.


Example 24—The surgical end effector of Examples 1, 2, or 15, wherein the second feature of the first jaw member comprises a curved profile.


Example 25—The surgical end effector of Examples 1, 2, 15, 16, 17, 18, 19, 20, 21, 22, 23, or 24, wherein the first feature of the first jaw member comprises a metallic material.


Example 26—The surgical end effector of Examples 1, 2, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, or 25, wherein the second feature of the first jaw member comprises a metallic material.


Example 27—A surgical end effector for use with a surgical instrument. The surgical end effector comprises a proximal connector configured to attach to a distal end of the surgical instrument. The proximal connector comprises an actuator. The surgical end effector further comprises a first jaw member. The first jaw member comprises a first portion comprising a first feature, and a second portion comprising a second feature. The surgical end effector further comprises a second jaw member. At least one of the first jaw member and the second jaw member is movable relative to the other one of the first jaw member and the second jaw member between an open configuration and a closed configuration. The second jaw member comprises a first portion comprising a first feature, and a second portion comprising a second feature. The surgical end effector further comprises means for selecting at least one of the first feature of the first jaw member and the first feature of the second jaw member by a user.


Example 28—The surgical end effector of Example 27, wherein the means comprises an additive manufacturing process.


Example 29—The surgical end effector of Examples 27 or 28, wherein the first jaw member comprises an inner surface and an outer surface, wherein the second jaw member comprises an inner surface and an outer surface, and wherein the inner surface of the first jaw member and the inner surface of the second jaw member comprise a mating relationship when the surgical end effector is in the closed configuration.


Example 30—The surgical end effector of Examples 27, 28, or 29, wherein the first feature of the first jaw member comprises a tooth, wherein the first feature of the second jaw member comprises a void, and wherein, when the surgical end effector is in the closed configuration, the tooth is received in the void.


Example 31—The surgical end effector of Examples 27, 28, 29, or 30, wherein the first feature of the first jaw member comprises a first material, wherein the second feature of the first jaw member comprises a second material, and wherein the first material is different than the second material.


Example 32—The surgical end effector of Examples 27, 28, 29, or 30, wherein the first feature of the first jaw member comprises a first material, wherein the first feature of the second jaw member comprises a second material, and wherein the first material is different than the second material.


Example 33—The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, wherein the first feature of the first jaw member comprises a first symmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second symmetrical pattern of protrusions, and wherein the first symmetrical pattern of protrusions and the second symmetrical pattern of protrusions are complementary.


Example 34—The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, wherein the first feature of the first jaw member comprises a first symmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second symmetrical pattern of protrusions, and wherein the first symmetrical pattern of protrusions is different than the second symmetrical pattern of protrusions.


Example 35—The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, wherein the first feature of the first jaw member comprises a first asymmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second asymmetrical pattern of protrusions, and wherein the first asymmetrical pattern of protrusions and the second asymmetrical pattern of protrusions are complementary.


Example 36—The surgical end effector of Examples 27, 28, 29, 30, 31, or 32, wherein the first feature of the first jaw member comprises a first asymmetrical pattern of protrusions, wherein the first feature of the second jaw member comprises a second asymmetrical pattern of protrusions, and wherein the first asymmetrical pattern of protrusions is different than the second asymmetrical pattern of protrusions.


Example 37—The surgical end effector of Examples 27, 28, 29, 30, 31, 32, 33, 34, 35, or 36, wherein the first portion of the first jaw member is proximal to the second portion of the first jaw member.


Example 38—The surgical end effector of Examples 27, 28, 29, 30, 31, 32, or 37, wherein the first feature of the first jaw member comprises a plurality of protrusion.


Example 39—The surgical end effector of Examples 27, 28, 29, 30, 31, 32, 37, or 38, wherein the second feature of the first jaw member comprises a plurality of protrusions.


Example 40—The surgical end effector of Examples 27, 28, 29, 30, 31, 32, 37, 38, or 39, wherein the first feature of the first jaw member comprises a plurality of protrusions, and wherein the second feature of the first jaw member comprises a substantially smooth surface.


Example 41—The surgical end effector of Examples 27 or 28, wherein the first jaw member comprises an inside surface and an outside surface, and where the first portion of the first jaw member is positioned along the inside surface of the first jaw member, and wherein the second portion of the first jaw member is positioned along the outside surface of the first jaw member.


Example 42—The surgical end effector of Examples 27, 28, or 41, wherein the first feature of the first jaw member comprises a plurality of protrusions, and wherein the second feature of the first jaw member comprises a substantially smooth surface.


Example 43—The surgical end effector of Examples 27, 28, or 41, wherein the first feature of the first jaw member comprises a substantially smooth surface, and wherein the second feature of the first jaw member comprises a plurality of protrusions.


Example 44—The surgical end effector of Examples 27, 28, or 43, wherein the first feature of the first jaw member comprises a plurality of first protrusions, and wherein the second feature of the first jaw member comprises a plurality of second protrusions.


Example 45—The surgical end effector of Example 44, wherein the plurality of first protrusions is different than the plurality of second protrusions.


Example 46—The surgical end effector of Examples 27, 28, or 41, wherein the first feature of the first jaw member comprises an asymmetrical profile, and wherein the second feature of the first jaw member comprises a symmetrical profile.


Example 47—The surgical end effector of Examples 27, 28, 41, or 46, wherein the first feature of the first jaw member comprises a low durometer surface.


Example 48—The surgical end effector of Examples 27, 28, 41, 46, or 47, wherein the second feature of the first jaw member comprises a low durometer surface.


Example 49—The surgical end effector of Examples 27, 28, or 41, wherein the first feature of the first jaw member comprises a curved profile.


Example 50—The surgical end effector of Examples 27, 28, or 41, wherein the second feature of the first jaw member comprises a curved profile.


Example 51—The surgical end effector of Examples 27, 28, 41, 42, 43, 44, 45, 46, 47, 48, 49, or 50, wherein the first feature of the first jaw member comprises a metallic material.


Example 52—The surgical end effector of Examples 27, 28, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, or 51 wherein the second feature of the first jaw member comprises a metallic material.


Example 53—A method for producing a customized end effector. The method comprises preparing an end effector connector for customization. The end effector connector comprises a proximal connector configured to attach to a distal end of a surgical instrument. The proximal connector comprises an actuator. The method further comprises determining through interaction with a patient a first desired characteristic of the end effector, determining through interaction with a patient a second desired characteristic of the end effector, and creating a first jaw member having the first desired characteristic. The first jaw member is attached to a distal portion of the end effector. The method further comprises creating a second jaw member having the second desired characteristic. The second jaw member is attached to a distal portion of the end effector.


Example 54—The method of Example 53, further comprising producing the first jaw member and the second jaw member using an additive manufacturing process.


Example 55—The method of Example 54, wherein the additive manufacturing process comprises 3-D printing.


Example 56—The method of Examples 53, 54, or 55, wherein the first characteristic of the first jaw member comprises a tooth, wherein the second characteristic of the second jaw member comprises a void.


Example 57—The method of Examples 53, 54, 55, or 56, wherein the first characteristic comprises a first material, wherein the second characteristic comprises a second material, and wherein the first material is different than the second material.


Example 58—The method of Examples 53, 54, 55, 56, or 57, wherein the first characteristic comprises a first symmetrical pattern of protrusions, wherein the second characteristic comprises a second symmetrical pattern of protrusions, and wherein the first symmetrical pattern of protrusions and the second symmetrical pattern of protrusions are complementary.


Example 59—The method of Examples 53, 54, 55, 56, or 57, wherein the first characteristic comprises a first symmetrical pattern of protrusions, wherein the second characteristic comprises a second symmetrical pattern of protrusions, and wherein the first symmetrical pattern of protrusions is different than the second symmetrical pattern of protrusions.


Example 60—The method of Examples 53, 54, 55, 56, or 57, wherein the first characteristic comprises a first asymmetrical pattern of protrusions, wherein the second characteristic comprises a second asymmetrical pattern of protrusions, and wherein the first asymmetrical pattern of protrusions and the second asymmetrical pattern of protrusions are complementary.


Example 61—The method of Examples 53, 54, 55, 56, or 57, wherein the first characteristic comprises a first asymmetrical pattern of protrusions, wherein the second characteristic comprises a second asymmetrical pattern of protrusions, and wherein the first asymmetrical pattern of protrusions is different than the second asymmetrical pattern of protrusions.


Example 62—The method of Example 53, further comprising creating a third desired characteristic on the first jaw member, and creating a fourth desired characteristic on the second jaw member.


Example 63—The method of Example 62, wherein the first characteristic comprises a plurality of protrusions.


Example 64—The method of Examples 62 or 63, wherein the third characteristic comprises a plurality of protrusions.


Example 65—The method of Examples 62 or 64, wherein the first characteristic comprises a plurality of protrusions, and wherein the third characteristic comprises a substantially smooth surface.


Example 66—The method of Examples 62, 63, 64, or 65, wherein the first jaw member comprises an inside surface and an outside surface, and where the first characteristic is positioned along the inside surface of the first jaw member, and wherein the third characteristic is positioned along the outside surface of the first jaw member.


Example 67—The method of Examples 62, 63, 64, 65, or 66, wherein the first characteristic comprises a plurality of protrusions, and wherein the third characteristic comprises a substantially smooth surface.


Example 68—The method of Examples 62, 63, 64, 65, or 66, wherein the first characteristic comprises a substantially smooth surface, and wherein the third characteristic comprises a plurality of protrusions.


Example 69—The method of Examples 62, 63, 64, 65, or 66, wherein the first characteristic comprises a plurality of first protrusions, and wherein the third characteristic comprises a plurality of second protrusions.


Example 70—The method of Example 69, wherein the plurality of first protrusions is different than the plurality of second protrusions.


Example 71—The method of Examples 62, 63, 64, 65, or 66, wherein the first characteristic comprises an asymmetrical profile, and wherein the third characteristic comprises a symmetrical profile.


Example 72—The method of Examples 62, 63, 64, 65, or 66, wherein the first characteristic comprises a low durometer surface.


Example 73—The method of Examples 62, 63, 64, 65, or 66, wherein the third characteristic comprises a low durometer surface.


Example 74—The method of Examples 62, 63, 64, 65, or 66, wherein the first characteristic comprises a curved profile.


Example 75—The method of Examples 62, 63, 64, 65, or 66, wherein the third characteristic comprises a curved profile.


Example 76—The method of Examples 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, or 75, wherein the first characteristic comprises a metallic material.


Example 77—The method of Examples 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, or 76, wherein the third characteristic comprises a metallic material.


Example 78—A surgical instrument comprising a composite dissector jaw. The composite dissector jaw comprises a first jaw. The first jaw comprises a proximal portion, a distal portion, a tissue contacting surface, a metallic core, and at least one layer of molded plastic on the metallic core. The at least one layer of molded plastic defines a pattern. The pattern defines at least a portion of the tissue contacting surface. The tissue contacting surface further comprises at least a portion of the metallic core. The composite dissector jaw further comprises a second jaw. At least one of the first jaw and the second jaw is rotatable with respect to the other one of the first jaw and the second jaw.


Example 79—The surgical instrument of Example 78, wherein the pattern comprises a first pattern on the proximal portion and a second pattern on the distal portion.


Example 80—The surgical instrument of Example 79, wherein the first pattern is different than the second pattern.


Example 81—The surgical instrument of Examples 79 or 80, wherein the first pattern comprises a first thickness of the at least one layer of molded plastic, wherein the second pattern comprises a second thickness of the at least one layer of molded plastic, and wherein the first thickness is different than the second thickness.


Example 82—The surgical instrument of Example 81, wherein the first thickness is greater than the second thickness.


Example 83—The surgical instrument of Example 81, wherein the first thickness is less than the second thickness.


Example 84—The surgical instrument of Examples 78, 79, 80, 81, 82, or 83, wherein the at least one layer of molded plastic comprises a first layer and a second layer.


Example 85—The surgical instrument of Example 84, wherein the first layer is different than the second layer.


Example 86—The surgical instrument of Examples 84 or 85, wherein the first layer comprises a first material, wherein the second layer comprises a second material, and wherein the first material is different than the second material.


Example 87—The surgical instrument of Examples 84, 85, or 86, wherein the first layer is in contact with the metallic core, and wherein the second layer is in contact with the first layer.


Example 88—The surgical instrument of Examples 84, 85, or 86, wherein the first layer is positioned on the proximal portion, and wherein the second layer is positioned on the distal portion.


Example 89—The surgical instrument of Examples 84, 85, 86, 87, or 88, wherein the first layer comprises a first rigidity, wherein the second layer comprises a second rigidity, wherein the first rigidity is different than the second rigidity.


Example 90—The surgical instrument of Example 89, wherein the first rigidity is greater than the second rigidity.


Example 91—The surgical instrument of Example 89, wherein the first rigidity is less than the second rigidity.


Example 92—The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, or 91, wherein the first pattern comprises a plurality of recesses.


Example 93—The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, or 92, wherein the first pattern comprises a plurality of ridges.


Example 94—The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, or 93, wherein the first pattern is symmetrical.


Example 95—The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, or 93, wherein the first pattern is asymmetrical.


Example 96—The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, or 95, wherein the at least one layer of molded plastic on the metallic core comprises openings, and wherein the metallic core is exposed to tissue via the openings.


Example 97—The surgical instrument of Examples 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, or 96, wherein the first jaw and the second jaw are mechanically driven open to create an ostomy.


Example 98—A surgical dissector comprising a first jaw member. The first jaw member comprises a proximal end, a distal end, a first tissue contacting surface, a second tissue contacting surface, a metallic core, and a nonmetallic layer. The metallic core of the first jaw member is configured to transmit electrosurgical energy. The nonmetallic layer is disposed over at least a portion of the metallic core of the first jaw member. The surgical dissector further comprises a second jaw member. The second jaw member comprises a proximal end, a distal end, a first tissue contacting surface, a second tissue contacting surface, a metallic core, and a nonmetallic layer. The metallic core of the second jaw member is configured to transmit electrosurgical energy. The nonmetallic layer is disposed over at least a portion of the metallic core of the second jaw member. The surgical dissector further comprises a joint. The first jaw member and the second jaw member are rotatable about the joint between closed and open positions.


Example 99—The surgical dissector of Example 98, wherein the first tissue contacting surface of the first jaw member is positioned adjacent the first tissue contacting surface of the second jaw member when the first and the second jaw members are in the closed position.


Example 100—The surgical dissector of Examples 98 or 99, wherein the first tissue contacting surface of the first jaw member comprises a first pattern, and wherein the first tissue contacting surface of the second jaw member comprises a second pattern, and wherein the first pattern is different than the second pattern.


Example 101—The surgical dissector of Examples 98 or 99, wherein the first tissue contacting surface of the first jaw member comprises a first pattern, and wherein the first tissue contacting surface of the second jaw member comprises a second pattern, and wherein the first pattern is complementary to the second pattern.


Example 102—The surgical dissector of Examples 98 or 99, wherein the first tissue contacting surface of the first jaw member comprises a first pattern, and wherein the first tissue contacting surface of the second jaw member comprises a second pattern, wherein the first pattern comprises a plurality of first teeth, and wherein the second pattern comprises a plurality of second teeth.


Example 103—The surgical dissector of Examples 98 or 99, wherein the first tissue contacting surface of the first jaw member comprises a first pattern, and wherein the first tissue contacting surface of the second jaw member comprises a second pattern, wherein the first pattern comprises a plurality of first recesses, and wherein the second pattern comprises a plurality of second recesses.


Example 104—The surgical dissector of Examples 98, 99, 100, 101, 102, or 103, wherein the nonmetallic layer of the first jaw member comprises a first nonmetallic layer and a second nonmetallic layer.


Example 105—The surgical dissector of Example 104, wherein the first nonmetallic layer is different than the second nonmetallic layer.


Example 106—The surgical dissector of Examples 104 or 105, wherein the first nonmetallic layer comprises a first rigidity, wherein the second nonmetallic layer comprises a second rigidity, and wherein the first rigidity is different than the second rigidity.


Example 107—The surgical dissector of Example 98, wherein the first tissue contacting surface of the first jaw member comprises a first pattern, wherein the second tissue contacting surface of the first jaw member comprises a second pattern, and wherein the first pattern is different than the second pattern.


Example 108—The surgical dissector of Example 107, wherein the first pattern comprises a symmetrical pattern, and wherein the second pattern comprises an asymmetrical pattern.


Example 109—The surgical dissector of Examples 107 or 108, wherein the first pattern comprises a plurality of teeth, and wherein the second pattern comprises a plurality of cavities.


Example 110—The surgical dissector of Examples 107 or 108, wherein the first pattern comprises a plurality of first cavities, wherein the second pattern comprises a plurality of second cavities.


Example 111—The surgical dissector of Example 110, wherein the plurality of first cavities comprises a first depth, wherein the plurality of second cavities comprises a second depth, and wherein the first depth is different than the second depth.


Example 112—A surgical instrument comprising a jaw. The jaw comprises a metallic core and an outer skin. The outer skin comprises a plurality of first through holes exposing the metallic core to an outer surface of the jaw. The plurality of first through holes comprise a first through hole size. The outer skin further comprises a plurality of second through holes exposing the metallic core to the outer surface of the jaw. The plurality of second through holes comprise a second through hole size. The first through hole size is different than the second through hole size.


Example 113—The surgical instrument of Example 112, wherein the jaw further comprises a first region. The plurality of first through holes are positioned within the first region. The jaw further comprises a second region. The plurality of second through holes are positioned within the second region. The first region is different than the second region.


Example 114—The surgical instrument of Examples 112 or 113, wherein the jaw comprises a tip region, wherein the first through hole size is smaller than the second through hole size, and wherein the plurality of first through holes are positioned within the tip region.


Example 115—The surgical instrument of Examples 112 or 113, wherein the jaw comprises a tip region, wherein the first through hole size is larger than the second through hole size, and wherein the plurality of first through holes are positioned within the tip region.


Example 116—The surgical instrument of Examples 112, 113, 114, or 115, wherein the plurality of first through holes and the plurality of second through holes are intermixed along the outer skin.


Example 117—The surgical instrument of Examples 112, 113, 114, 115, or 116, wherein the plurality of first through holes are round, and wherein the plurality of second through holes are round.


Example 118—The surgical instrument of Examples 112, 113, 114, 115, or 116, wherein the plurality of first through holes are round, and wherein the plurality of second through holes are non-round.


Example 119—The surgical instrument of Examples 112, 113, 114, 115, or 116, wherein the plurality of first through holes are non-round, and wherein the plurality of second through holes are non-round.


Example 120—The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118, or 119, wherein the outer skin comprises an insulative plastic.


Example 121—The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118, or 119, wherein the outer skin comprises a semi-conductive plastic.


Example 122—The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118, or 119, wherein the outer skin is semi-conductive.


Example 123—The surgical instrument of Examples 112, 113, 114, 115, 116, 117, 118, or 119, wherein the outer skin comprises intrinsically conducting polymers.


Example 124—A surgical dissector comprising a first jaw member. The first jaw member comprises a first tissue contacting surface. The first tissue contacting surface comprises a first electrically conductive portion and a first electrically insulative portion. The surgical dissector further comprises a second jaw member. The second jaw member comprises a second tissue contacting surface. The second tissue contacting surface comprises a second electrically conductive portion and a second electrically insulative portion. The surgical dissector further comprises a pivot. The first jaw member and the second jaw member are rotatable about the pivot. The surgical dissector further comprises means for separating tissue. The means for separating tissue comprises means for applying a mechanical force to tissue of a patient through rotation of at least one of the first jaw member and the second jaw member, and means for applying electrosurgical force to the tissue through at least one of the first electrically conductive portion and the second electrically conductive portion.


Example 125—The surgical dissector of Example 124, wherein the means for separating tissue comprises applying the mechanical force in an amount less than the separation pressure needed to separate the tissue and applying electrosurgical force which supplements the mechanical force to separate the tissue.


The devices, systems, and methods disclosed in the Subject Application can be used with the devices, systems, and methods disclosed in U.S. Provisional Patent Application No. 62/659,900, entitled METHOD OF HUB COMMUNICATION, filed on Apr. 19, 2018, U.S. Provisional Patent Application No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM, filed on Dec. 28, 2017, U.S. Provisional Patent Application No. 62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed on Dec. 28, 2017, and U.S. Provisional Patent Application No. 62/611,339, entitled ROBOT ASSISTED SURGICAL PLATFORM, filed on Dec. 28, 2017, which are incorporated in their entireties herein. The devices, systems, and methods disclosed in the Subject Application can also be used with the devices, systems, and methods disclosed in U.S. patent application Ser. No. 15/908,021, entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE, filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,012, entitled SURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTOR MOVEMENT, filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,040, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,057, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed on Feb. 28, 2018, U.S. patent application Ser. No. 15/908,058, entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES, filed on Feb. 28, 2018, and U.S. patent application Ser. No. 15/908,143, entitled SURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed on Feb. 28, 2018, which are incorporated in their entireties herein. The devices, systems, and methods disclosed in the Subject Application can also be used with the devices, systems, and methods disclosed in U.S. patent application Ser. No. 14/226,133, now U.S. Patent Application Publication No. 2015/0272557, entitled MODULAR SURGICAL INSTRUMENT SYSTEM, filed on Mar. 26, 2014, which is incorporated in its entirety herein.


The entire disclosures of:

    • U.S. patent application Ser. No. 11/013,924, entitled TROCAR SEAL ASSEMBLY, now U.S. Pat. No. 7,371,227;
    • U.S. patent application Ser. No. 11/162,991, entitled ELECTROACTIVE POLYMER-BASED ARTICULATION MECHANISM FOR GRASPER, now U.S. Pat. No. 7,862,579;
    • U.S. patent application Ser. No. 12/364,256, entitled SURGICAL DISSECTOR, now U.S. Patent Application Publication No. 2010/0198248;
    • U.S. patent application Ser. No. 13/536,386, entitled EMPTY CLIP CARTRIDGE LOCKOUT, now U.S. Pat. No. 9,282,974;
    • U.S. patent application Ser. No. 13/832,786, entitled CIRCULAR NEEDLE APPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS, now U.S. Pat. No. 9,398,905;
    • U.S. patent application Ser. No. 12/592,174, entitled APPARATUS AND METHOD FOR MINIMALLY INVASIVE SUTURING, now U.S. Pat. No. 8,123,764;
    • U.S. patent application Ser. No. 12/482,049, entitled ENDOSCOPIC STITCHING DEVICES, now U.S. Pat. No. 8,628,545;
    • U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535;
    • U.S. patent application Ser. No. 11/343,803, entitled SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No. 7,845,537;
    • U.S. patent application Ser. No. 14/200,111, entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629;
    • U.S. patent application Ser. No. 14/248,590, entitled MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now U.S. Pat. No. 9,826,976;
    • U.S. patent application Ser. No. 14/813,242, entitled SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR ASSURING THE PROPER SEQUENTIAL OPERATION OF THE SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2017/0027571;
    • U.S. patent application Ser. No. 14/248,587, entitled POWERED SURGICAL STAPLER, now U.S. Pat. No. 9,867,612;
    • U.S. patent application Ser. No. 12/945,748, entitled SURGICAL TOOL WITH A TWO DEGREE OF FREEDOM WRIST, now U.S. Pat. No. 8,852,174;
    • U.S. patent application Ser. No. 13/297,158, entitled METHOD FOR PASSIVELY DECOUPLING TORQUE APPLIED BY A REMOTE ACTUATOR INTO AN INDEPENDENTLY ROTATING MEMBER, now U.S. Pat. No. 9,095,362;
    • International Application No. PCT/US2015/023636, entitled SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION, now International Patent Publication No. WO 2015/153642 A1;
    • International Application No. PCT/US2015/051837, entitled HANDHELD ELECTROMECHANICAL SURGICAL SYSTEM, now International Patent Publication No. WO 2016/057225 A1;
    • U.S. patent application Ser. No. 14/657,876, entitled SURGICAL GENERATOR FOR ULTRASONIC AND ELECTROSURGICAL DEVICES, U.S. Patent Application Publication No. 2015/0182277;
    • U.S. patent application Ser. No. 15/382,515, entitled MODULAR BATTERY POWERED HANDHELD SURGICAL INSTRUMENT AND METHODS THEREFOR, U.S. Patent Application Publication No. 2017/0202605;
    • U.S. patent application Ser. No. 14/683,358, entitled SURGICAL GENERATOR SYSTEMS AND RELATED METHODS, U.S. Patent Application Publication No. 2016/0296271;
    • U.S. patent application Ser. No. 14/149,294, entitled HARVESTING ENERGY FROM A SURGICAL GENERATOR, U.S. Pat. No. 9,795,436;
    • U.S. patent application Ser. No. 15/265,293, entitled TECHNIQUES FOR CIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, U.S. Patent Application Publication No. 2017/0086910; and
    • U.S. patent application Ser. No. 15/265,279, entitled TECHNIQUES FOR OPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMS AND SURGICAL INSTRUMENTS, U.S. Patent Application Publication No. 2017/0086914, are hereby incorporated by reference herein.


Although various devices have been described herein in connection with certain embodiments, modifications and variations to those embodiments may be implemented. Particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined in whole or in part, with the features, structures or characteristics of one ore more other embodiments without limitation. Also, where materials are disclosed for certain components, other materials may be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function or functions. The foregoing description and following claims are intended to cover all such modification and variations.


The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, the disassembly of the device, followed by cleaning or replacement of particular pieces of the device, and subsequent reassembly of the device. In particular, a reconditioning facility and/or surgical team can disassemble a device and, after cleaning and/or replacing particular parts of the device, the device can be reassembled for subsequent use. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.


The devices disclosed herein may be processed before surgery. First, a new or used instrument may be obtained and, when necessary, cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, and/or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. A device may also be sterilized using any other technique known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma peroxide, and/or steam.


While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles.


Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials do 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.

Claims
  • 1. A surgical dissector, comprising: a first jaw member, comprising: a proximal end;a distal end;a first tissue contacting surface;a second tissue contacting surface;a metallic core, wherein said metallic core of said first jaw member is configured to transmit electrosurgical energy; anda nonmetallic layer disposed over at least a portion of said metallic core of said first jaw member, wherein said metallic core of said first jaw member is recessed relative to said nonmetallic layer of said first jaw member, and wherein said metallic core of said first jaw member is configured to contact tissue through a tissue-receiving recess defined in said nonmetallic layer of said first jaw member;a second jaw member, comprising: a proximal end;a distal end;a first tissue contacting surface;a second tissue contacting surface;a metallic core, wherein said metallic core of said second jaw member is configured to transmit electrosurgical energy; anda nonmetallic layer disposed over at least a portion of said metallic core of said second jaw member, wherein said metallic core of said second jaw member is recessed relative to said nonmetallic layer of said second jaw member, and wherein said metallic core of said second jaw member is configured to contact tissue through a tissue-receiving recess defined in said nonmetallic layer of said second jaw member; anda joint, wherein said first jaw member and said second jaw member are rotatable about said joint between closed and open positions, wherein said first jaw member and said second jaw member are configured to separate tissue by applying: a mechanical force to the tissue upon opening said first jaw member and said second jaw member from a said closed position to a said open position; andan electrosurgical force to the tissue.
  • 2. The surgical dissector of claim 1, wherein said first tissue contacting surface of said first jaw member is positioned adjacent said first tissue contacting surface of said second jaw member when said first and said second jaw members are in said closed position.
  • 3. The surgical dissector of claim 2, wherein said first tissue contacting surface of said first jaw member comprises a first pattern, wherein said first tissue contacting surface of said second jaw member comprises a second pattern, and wherein said first pattern is different than said second pattern.
  • 4. The surgical dissector of claim 2, wherein said first tissue contacting surface of said first jaw member comprises a first pattern, wherein said first tissue contacting surface of said second jaw member comprises a second pattern, and wherein said first pattern is complementary to said second pattern.
  • 5. The surgical dissector of claim 2, wherein said first tissue contacting surface of said first jaw member comprises a first pattern, wherein said first tissue contacting surface of said second jaw member comprises a second pattern, wherein said first pattern comprises a plurality of first teeth, and wherein said second pattern comprises a plurality of second teeth.
  • 6. The surgical dissector of claim 2, wherein said first tissue contacting surface of said first jaw member comprises a first pattern, wherein said first tissue contacting surface of said second jaw member comprises a second pattern, wherein said first pattern comprises a plurality of first recesses, and wherein said second pattern comprises a plurality of second recesses.
  • 7. The surgical dissector of claim 2, wherein said nonmetallic layer of said first jaw member comprises a first nonmetallic layer and a second nonmetallic layer.
  • 8. The surgical dissector of claim 7, wherein said first nonmetallic layer is different than said second nonmetallic layer.
  • 9. The surgical dissector of claim 7, wherein said first nonmetallic layer comprises a first rigidity, wherein said second nonmetallic layer comprises a second rigidity, and wherein said first rigidity is different than said second rigidity.
  • 10. The surgical dissector of claim 1, wherein said first tissue contacting surface of said first jaw member comprises a first pattern, wherein said second tissue contacting surface of said first jaw member comprises a second pattern, and wherein said first pattern is different than said second pattern.
  • 11. The surgical dissector of claim 10, wherein said first pattern comprises a symmetrical pattern, and wherein said second pattern comprises an asymmetrical pattern.
  • 12. The surgical dissector of claim 10, wherein said first pattern comprises a plurality of teeth, and wherein said second pattern comprises a plurality of cavities.
  • 13. The surgical dissector of claim 10, wherein said first pattern comprises a plurality of first cavities, wherein said second pattern comprises a plurality of second cavities.
  • 14. The surgical dissector of claim 13, wherein said plurality of first cavities comprises a first depth, wherein said plurality of second cavities comprises a second depth, and wherein said first depth is different than said second depth.
  • 15. A surgical instrument, comprising: a jaw, comprising: a metallic core; andan outer skin, wherein said outer skin comprises: an outer skin surface;a plurality of first through holes exposing said metallic core to an outer skin surface, wherein said plurality of first through holes comprise a first through hole size, and wherein said first through holes define a first recessed depth between said outer skin surface and a first tissue-contacting surface of said metallic core; anda plurality of second through holes exposing said metallic core to said outer skin surface, wherein said plurality of second through holes comprise a second through hole size, wherein said first through hole size is different than said second through hole size, and wherein said second through holes define a second recessed depth between said outer skin surface and a second tissue-contacting surface of said metallic core.
  • 16. The surgical instrument of claim 15, wherein said jaw further comprises: a first region, wherein said plurality of first through holes are positioned within said first region; anda second region, wherein said plurality of second through holes are positioned within said second region, and wherein said first region is different than said second region.
  • 17. The surgical instrument of claim 15, wherein said jaw comprises a tip region, wherein said first through hole size is smaller than said second through hole size, and wherein said plurality of first through holes are positioned within said tip region.
  • 18. The surgical instrument of claim 15, wherein said jaw comprises a tip region, wherein said first through hole size is larger than said second through hole size, and wherein said plurality of first through holes are positioned within said tip region.
  • 19. The surgical instrument of claim 15, wherein said plurality of first through holes and said plurality of second through holes are intermixed along said outer skin.
  • 20. The surgical instrument of claim 15, wherein said plurality of first through holes are round, and wherein said plurality of second through holes are round.
  • 21. The surgical instrument of claim 15, wherein said plurality of first through holes are round, and wherein said plurality of second through holes are non-round.
  • 22. The surgical instrument of claim 15, wherein said plurality of first through holes are non-round, and wherein said plurality of second through holes are non-round.
  • 23. The surgical instrument of claim 15, wherein said outer skin comprises an insulative plastic.
  • 24. The surgical instrument of claim 15, wherein said outer skin comprises a semi-conductive plastic.
  • 25. The surgical instrument of claim 15, wherein said outer skin is semi-conductive.
  • 26. The surgical instrument of claim 15, wherein said outer skin comprises intrinsically conducting polymers.
  • 27. A surgical dissector, comprising: a first jaw member, comprising: a first tissue contacting surface, comprising: a first electrically conductive portion; anda first electrically insulative portion;a second jaw member, comprising: a second tissue contacting surface, comprising: a second electrically conductive portion; anda second electrically insulative portion;a pivot, wherein said first jaw member and said second jaw member are rotatable about said pivot; andmeans for separating tissue, comprising: means for applying a mechanical force to tissue of a patient through rotation of at least one of said first jaw member and said second jaw member into an open configuration from a closed configuration; andmeans for applying electrosurgical force to the tissue through at least one of said first electrically conductive portion and said second electrically conductive portion.
  • 28. The surgical dissector of claim 27, wherein said means for applying said mechanical force to the tissue comprises means for applying said mechanical force in an amount less than a separation pressure needed to separate the tissue, and wherein said means for applying electrosurgical force to the tissue comprises means for applying electrosurgical force which supplements said mechanical force to separate the tissue.
  • 29. The surgical dissector of claim 27, wherein said first electrically conductive portion is recessed within a tissue-receiving recess defined in said first electrically insulative portion and is configured to contact tissue through said tissue-receiving recess to apply electrosurgical force to tissue.
CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 62/578,793, entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE, filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No. 62/578,804, entitled SURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTOR MOVEMENT, filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No. 62/578,817, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No. 62/578,835, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No. 62/578,844, entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES, filed Oct. 30, 2017, and of U.S. Provisional Patent Application Ser. No. 62/578,855, entitled SURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed Oct. 30, 2017, the disclosures of which are incorporated by reference herein in their entirety. This non-provisional application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 62/665,129, entitled SURGICAL SUTURING SYSTEMS, filed May 1, 2018, of U.S. Provisional Patent Application Ser. No. 62/665,139, entitled SURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS, filed May 1, 2018, of U.S. Provisional Patent Application Ser. No. 62/665,177, entitled SURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS, filed May 1, 2018, of U.S. Provisional patent application Ser. No. 62/665,128, entitled MODULAR SURGICAL INSTRUMENTS, filed May 1, 2018, of U.S. Provisional Patent Application Ser. No. 62/665,192, entitled SURGICAL DISSECTORS, filed May 1, 2018, and of U.S. Provisional Patent Application Ser. No. 62/665,134, entitled SURGICAL CLIP APPLIER, filed May 1, 2018, the disclosures of which are incorporated by reference herein in their entirety.

US Referenced Citations (2619)
Number Name Date Kind
1853416 Hall Apr 1932 A
2222125 Stehlik Nov 1940 A
3082426 Miles Mar 1963 A
3503396 Pierie et al. Mar 1970 A
3584628 Green Jun 1971 A
3626457 Duerr et al. Dec 1971 A
3633584 Farrell Jan 1972 A
3759017 Young Sep 1973 A
3863118 Lander et al. Jan 1975 A
3898545 Coppa et al. Aug 1975 A
3912121 Steffen Oct 1975 A
3915271 Harper Oct 1975 A
3932812 Milligan Jan 1976 A
4041362 Ichiyanagi Aug 1977 A
4052649 Greenwell et al. Oct 1977 A
4087730 Goles May 1978 A
4157859 Terry Jun 1979 A
4171700 Farin Oct 1979 A
4202722 Paquin May 1980 A
4412539 Jarvik Nov 1983 A
4448193 Ivanov May 1984 A
4523695 Braun et al. Jun 1985 A
4608160 Zoch Aug 1986 A
4614366 North et al. Sep 1986 A
4633874 Chow et al. Jan 1987 A
4701193 Robertson et al. Oct 1987 A
4735603 Goodson et al. Apr 1988 A
4788977 Farin et al. Dec 1988 A
4849752 Bryant Jul 1989 A
D303787 Messenger et al. Oct 1989 S
4892244 Fox et al. Jan 1990 A
4976173 Yang Dec 1990 A
5010341 Huntley et al. Apr 1991 A
5026387 Thomas Jun 1991 A
5035692 Lyon et al. Jul 1991 A
5042460 Sakurai et al. Aug 1991 A
5047043 Kubota et al. Sep 1991 A
5084057 Green et al. Jan 1992 A
5100402 Fan Mar 1992 A
D327061 Soren et al. Jun 1992 S
5129570 Schulze et al. Jul 1992 A
5151102 Kamiyama Sep 1992 A
5156315 Green et al. Oct 1992 A
5158585 Saho et al. Oct 1992 A
5171247 Hughett et al. Dec 1992 A
5189277 Boisvert et al. Feb 1993 A
5197962 Sansom et al. Mar 1993 A
5204669 Dorfe et al. Apr 1993 A
5217003 Wilk Jun 1993 A
5242474 Herbst et al. Sep 1993 A
5253793 Green et al. Oct 1993 A
5271543 Grant et al. Dec 1993 A
RE34519 Fox et al. Jan 1994 E
5275323 Schulze et al. Jan 1994 A
5318516 Cosmescu Jun 1994 A
5318563 Malis et al. Jun 1994 A
5322055 Davison et al. Jun 1994 A
5342349 Kaufman Aug 1994 A
5364003 Williamson, IV Nov 1994 A
5383880 Hooven Jan 1995 A
5385544 Edwards et al. Jan 1995 A
5396900 Slater Mar 1995 A
5397046 Savage et al. Mar 1995 A
5403312 Yates et al. Apr 1995 A
5403327 Thornton et al. Apr 1995 A
5413267 Solyntjes et al. May 1995 A
5415335 Knodell, Jr. May 1995 A
5417699 Klein et al. May 1995 A
5439468 Schulze et al. Aug 1995 A
5445304 Plyley et al. Aug 1995 A
5462545 Wang et al. Oct 1995 A
5465895 Knodel et al. Nov 1995 A
5467911 Tsuruta et al. Nov 1995 A
5474566 Alesi et al. Dec 1995 A
5485947 Olson et al. Jan 1996 A
5496315 Weaver et al. Mar 1996 A
5496317 Goble et al. Mar 1996 A
5503320 Webster et al. Apr 1996 A
5529235 Boiarski et al. Jun 1996 A
5531743 Nettekoven et al. Jul 1996 A
5545148 Wurster Aug 1996 A
5552685 Young et al. Sep 1996 A
5560372 Cory Oct 1996 A
5584425 Savage et al. Dec 1996 A
5610379 Muz et al. Mar 1997 A
5610811 Honda Mar 1997 A
5613966 Makower et al. Mar 1997 A
5624452 Yates Apr 1997 A
D379346 Mieki May 1997 S
5626587 Bishop et al. May 1997 A
5643291 Pier et al. Jul 1997 A
5654750 Weil et al. Aug 1997 A
5673841 Schulze et al. Oct 1997 A
5673842 Bittner et al. Oct 1997 A
5675227 Roos et al. Oct 1997 A
5693042 Boiarski et al. Dec 1997 A
5693052 Weaver Dec 1997 A
5695502 Pier et al. Dec 1997 A
5697926 Weaver Dec 1997 A
5706998 Plyley et al. Jan 1998 A
5718359 Palmer et al. Feb 1998 A
5724468 Leone et al. Mar 1998 A
5725536 Oberlin et al. Mar 1998 A
5725542 Yoon Mar 1998 A
5735445 Vidal et al. Apr 1998 A
5735848 Yates et al. Apr 1998 A
5746209 Yost et al. May 1998 A
5749362 Funda et al. May 1998 A
5749893 Vidal et al. May 1998 A
5752644 Bolanos et al. May 1998 A
5762255 Chrisman et al. Jun 1998 A
5762458 Wang et al. Jun 1998 A
5766186 Faraz et al. Jun 1998 A
5769791 Benaron et al. Jun 1998 A
5775331 Raymond et al. Jul 1998 A
5797537 Oberlin et al. Aug 1998 A
5800350 Coppleson et al. Sep 1998 A
D399561 Ellingson Oct 1998 S
5817093 Wlliamson, IV et al. Oct 1998 A
5820009 Melling et al. Oct 1998 A
5833690 Yates et al. Nov 1998 A
5836849 Mathiak et al. Nov 1998 A
5836869 Kudo et al. Nov 1998 A
5836909 Cosmescu Nov 1998 A
5843080 Fleenor et al. Dec 1998 A
5846237 Nettekoven Dec 1998 A
5849022 Sakashita et al. Dec 1998 A
5873873 Smith et al. Feb 1999 A
5878938 Bittner et al. Mar 1999 A
5893849 Weaver Apr 1999 A
5906625 Bito et al. May 1999 A
5942333 Arnett et al. Aug 1999 A
5947996 Logeman Sep 1999 A
5968032 Sleister Oct 1999 A
5980510 Tsonton et al. Nov 1999 A
5987346 Benaron et al. Nov 1999 A
5997528 Bisch et al. Dec 1999 A
6004269 Crowley et al. Dec 1999 A
6010054 Johnson et al. Jan 2000 A
6030437 Gourrier et al. Feb 2000 A
6036637 Kudo Mar 2000 A
6039734 Goble Mar 2000 A
6039735 Greep Mar 2000 A
6059799 Aranyi et al. May 2000 A
6066137 Greep May 2000 A
6079606 Milliman et al. Jun 2000 A
6090107 Borgmeier et al. Jul 2000 A
6099537 Sugai et al. Aug 2000 A
6102907 Smethers et al. Aug 2000 A
6109500 Alli et al. Aug 2000 A
6113598 Baker Sep 2000 A
6126592 Proch et al. Oct 2000 A
6126658 Baker Oct 2000 A
6131789 Schulze et al. Oct 2000 A
6155473 Tompkins et al. Dec 2000 A
6214000 Fleenor et al. Apr 2001 B1
6258105 Hart et al. Jul 2001 B1
6269411 Reasoner Jul 2001 B1
6273887 Yamauchi et al. Aug 2001 B1
6283960 Ashley Sep 2001 B1
6301495 Gueziec et al. Oct 2001 B1
6302881 Farin Oct 2001 B1
6308089 von der Ruhr et al. Oct 2001 B1
6325808 Bernard et al. Dec 2001 B1
6325811 Messerly Dec 2001 B1
6331181 Tierney et al. Dec 2001 B1
6341164 Dilkie et al. Jan 2002 B1
6391102 Sodden et al. May 2002 B1
6423057 He et al. Jul 2002 B1
6434416 Mizoguchi et al. Aug 2002 B1
6443973 Whitman Sep 2002 B1
6451015 Rittman, III et al. Sep 2002 B1
6454781 Witt et al. Sep 2002 B1
6457625 Tormala et al. Oct 2002 B1
6461352 Morgan et al. Oct 2002 B2
6466817 Kaula et al. Oct 2002 B1
6480796 Wiener Nov 2002 B2
6482217 Pintor et al. Nov 2002 B1
6524307 Palmerton et al. Feb 2003 B1
6530933 Yeung et al. Mar 2003 B1
6551243 Bocionek et al. Apr 2003 B2
6569109 Sakurai et al. May 2003 B2
6582424 Fleenor et al. Jun 2003 B2
6584358 Carter et al. Jun 2003 B2
6585791 Garito et al. Jul 2003 B1
6611793 Burnside et al. Aug 2003 B1
6618626 West, Jr. et al. Sep 2003 B2
6633234 Wiener et al. Oct 2003 B2
6648223 Boukhny et al. Nov 2003 B2
6678552 Pearlman Jan 2004 B2
6679899 Wiener et al. Jan 2004 B2
6685704 Greep Feb 2004 B2
6699187 Webb et al. Mar 2004 B2
6731514 Evans May 2004 B2
6742895 Robin Jun 2004 B2
6752816 Culp et al. Jun 2004 B2
6760616 Hoey et al. Jul 2004 B2
6770072 Truckai et al. Aug 2004 B1
6773444 Messerly Aug 2004 B2
6775575 Bommannan et al. Aug 2004 B2
6778846 Martinez et al. Aug 2004 B1
6781683 Kacyra et al. Aug 2004 B2
6783524 Anderson et al. Aug 2004 B2
6783525 Greep et al. Aug 2004 B2
6793652 Whitman et al. Sep 2004 B1
6793663 Kneifel et al. Sep 2004 B2
6824539 Novak Nov 2004 B2
6846308 Whitman et al. Jan 2005 B2
6849074 Chen et al. Feb 2005 B2
6852219 Hammond Feb 2005 B2
6863650 Irion Mar 2005 B1
6869430 Balbierz et al. Mar 2005 B2
6869435 Blake, III Mar 2005 B2
6911033 de Guillebon et al. Jun 2005 B2
6913471 Smith Jul 2005 B2
6937892 Leyde et al. Aug 2005 B2
6945981 Donofrio et al. Sep 2005 B2
6951559 Greep Oct 2005 B1
6962587 Johnson et al. Nov 2005 B2
6978921 Shelton, IV et al. Dec 2005 B2
6988649 Shelton, IV et al. Jan 2006 B2
7000818 Shelton, IV et al. Feb 2006 B2
7009511 Mazar et al. Mar 2006 B2
7030146 Baynes et al. Apr 2006 B2
7032798 Whitman et al. Apr 2006 B2
7041941 Faries, Jr. et al. May 2006 B2
7044352 Shelton, IV et al. May 2006 B2
7044911 Drinan et al. May 2006 B2
7044949 Orszulak et al. May 2006 B2
7048775 Jornitz et al. May 2006 B2
7053752 Wang et al. May 2006 B2
7055730 Ehrenfels et al. Jun 2006 B2
7073765 Newkirk Jul 2006 B2
7077853 Kramer et al. Jul 2006 B2
7077856 Whitman Jul 2006 B2
7081096 Brister et al. Jul 2006 B2
7097640 Wang et al. Aug 2006 B2
7103688 Strong Sep 2006 B2
7104949 Anderson et al. Sep 2006 B2
7118564 Ritchie et al. Oct 2006 B2
7121460 Parsons et al. Oct 2006 B1
7137980 Buysse et al. Nov 2006 B2
7140528 Shelton, IV Nov 2006 B2
7143923 Shelton, IV et al. Dec 2006 B2
7143925 Shelton, IV et al. Dec 2006 B2
7147139 Schwemberger et al. Dec 2006 B2
7155316 Sutherland et al. Dec 2006 B2
7164940 Hareyama et al. Jan 2007 B2
7169145 Isaacson et al. Jan 2007 B2
7177533 McFarlin et al. Feb 2007 B2
7182775 de Guillebon et al. Feb 2007 B2
7207472 Wukusick et al. Apr 2007 B2
7208005 Frecker et al. Apr 2007 B2
7217269 El-Galley et al. May 2007 B2
7230529 Ketcherside, Jr. et al. Jun 2007 B2
7232447 Gellman et al. Jun 2007 B2
7236817 Papas et al. Jun 2007 B2
7246734 Shelton, IV Jul 2007 B2
7252664 Nasab et al. Aug 2007 B2
7278563 Green Oct 2007 B1
7294106 Birkenbach et al. Nov 2007 B2
7294116 Ellman et al. Nov 2007 B1
7296724 Green et al. Nov 2007 B2
7317955 McGreevy Jan 2008 B2
7328828 Ortiz et al. Feb 2008 B2
7334717 Rethy et al. Feb 2008 B2
7343565 Ying et al. Mar 2008 B2
7344532 Goble et al. Mar 2008 B2
7353068 Tanaka et al. Apr 2008 B2
7362228 Nycz et al. Apr 2008 B2
7371227 Zeiner May 2008 B2
7380695 Doll et al. Jun 2008 B2
7383088 Spinelli et al. Jun 2008 B2
7391173 Schena Jun 2008 B2
7407074 Ortiz et al. Aug 2008 B2
7408439 Wang et al. Aug 2008 B2
7413541 Konishi Aug 2008 B2
7422136 Marczyk Sep 2008 B1
7422139 Shelton, IV et al. Sep 2008 B2
7423972 Shaham et al. Sep 2008 B2
D579876 Novotney et al. Nov 2008 S
7457804 Uber, III et al. Nov 2008 B2
D583328 Chiang Dec 2008 S
7464847 Viola et al. Dec 2008 B2
7464849 Shelton, IV et al. Dec 2008 B2
7496418 Kim et al. Feb 2009 B2
D589447 Sasada et al. Mar 2009 S
7515961 Germanson et al. Apr 2009 B2
7518502 Austin et al. Apr 2009 B2
7554343 Bromfield Jun 2009 B2
7563259 Takahashi Jul 2009 B2
7568604 Ehrenfels et al. Aug 2009 B2
7575144 Ortiz et al. Aug 2009 B2
7597731 Palmerton et al. Oct 2009 B2
7617137 Kreiner et al. Nov 2009 B2
7621192 Conti et al. Nov 2009 B2
7621898 Lalomia et al. Nov 2009 B2
7631793 Rethy et al. Dec 2009 B2
7637410 Marczyk Dec 2009 B2
7637907 Blaha Dec 2009 B2
7641092 Kruszynski et al. Jan 2010 B2
7644848 Swayze et al. Jan 2010 B2
7667592 Ohyama et al. Feb 2010 B2
7667839 Bates Feb 2010 B2
7670334 Hueil et al. Mar 2010 B2
7694865 Scirica Apr 2010 B2
7699860 Huitema et al. Apr 2010 B2
7720306 Gardiner et al. May 2010 B2
7721934 Shelton, IV et al. May 2010 B2
7721936 Shalton, IV et al. May 2010 B2
7722603 McPherson May 2010 B2
7736357 Lee, Jr. et al. Jun 2010 B2
7742176 Braunecker et al. Jun 2010 B2
7743960 Whitman et al. Jun 2010 B2
7753245 Boudreaux et al. Jul 2010 B2
7757028 Druke et al. Jul 2010 B2
7766207 Mather et al. Aug 2010 B2
7766905 Paterson et al. Aug 2010 B2
7770773 Whitman et al. Aug 2010 B2
7771429 Ballard et al. Aug 2010 B2
7776037 Odom Aug 2010 B2
7782789 Stultz et al. Aug 2010 B2
7784663 Shelton, IV Aug 2010 B2
7803151 Whitman Sep 2010 B2
7810692 Hall et al. Oct 2010 B2
7818041 Kim et al. Oct 2010 B2
7819298 Hall et al. Oct 2010 B2
7832612 Baxter, III et al. Nov 2010 B2
7833219 Tashiro et al. Nov 2010 B2
7836085 Petakov et al. Nov 2010 B2
7837079 Holsten et al. Nov 2010 B2
7837680 Isaacson et al. Nov 2010 B2
7841980 Minosawa et al. Nov 2010 B2
7845537 Shelton, IV et al. Dec 2010 B2
7857185 Swayze et al. Dec 2010 B2
D631252 Leslie Jan 2011 S
7862560 Marlon Jan 2011 B2
7862579 Ortiz et al. Jan 2011 B2
7865236 Cory et al. Jan 2011 B2
7884735 Newkirk Feb 2011 B2
7887530 Zemlok et al. Feb 2011 B2
7892337 Palmerton et al. Feb 2011 B2
7907166 Lamprecht et al. Mar 2011 B2
7913891 Doll et al. Mar 2011 B2
7918230 Whitman et al. Apr 2011 B2
7918377 Measamer et al. Apr 2011 B2
7920706 Asokan et al. Apr 2011 B2
7927014 Dehler Apr 2011 B2
7932826 Fritchie et al. Apr 2011 B2
7942300 Rethy et al. May 2011 B2
7945065 Menzl et al. May 2011 B2
7945342 Tsai et al. May 2011 B2
7951148 McClurken May 2011 B2
7954682 Giordano et al. Jun 2011 B2
7954687 Zemlok et al. Jun 2011 B2
7955322 Devengenzo et al. Jun 2011 B2
7956620 Gilbert Jun 2011 B2
7963433 Whitman et al. Jun 2011 B2
7966269 Bauer et al. Jun 2011 B2
7967180 Scirica Jun 2011 B2
7976553 Shelton, IV et al. Jul 2011 B2
7979157 Anvari Jul 2011 B2
7980443 Scheib et al. Jul 2011 B2
7982776 Dunki-Jacobs et al. Jul 2011 B2
7988028 Farascioni et al. Aug 2011 B2
7993140 Sakezles Aug 2011 B2
7993354 Brecher et al. Aug 2011 B1
7995045 Dunki-Jacobs Aug 2011 B2
8005947 Morris et al. Aug 2011 B2
8007494 Taylor et al. Aug 2011 B1
8007513 Nalagatla et al. Aug 2011 B2
8010180 Quaid et al. Aug 2011 B2
8012170 Whitman et al. Sep 2011 B2
8015976 Shah Sep 2011 B2
8016855 Whitman et al. Sep 2011 B2
8019094 Hsieh et al. Sep 2011 B2
8025199 Whitman et al. Sep 2011 B2
8027710 Dannan Sep 2011 B1
8035685 Jensen Oct 2011 B2
8038686 Huitema et al. Oct 2011 B2
8038693 Allen Oct 2011 B2
8043560 Okumoto et al. Oct 2011 B2
8054184 Cline et al. Nov 2011 B2
8054752 Druke et al. Nov 2011 B2
8062306 Nobis et al. Nov 2011 B2
8062330 Prommersberger et al. Nov 2011 B2
8066721 Kortenbach et al. Nov 2011 B2
8074861 Ehrenfels et al. Dec 2011 B2
8075571 Vitali et al. Dec 2011 B2
8096459 Ortiz et al. Jan 2012 B2
8118206 Zand et al. Feb 2012 B2
8120301 Goldberg et al. Feb 2012 B2
8123764 Meade et al. Feb 2012 B2
D655678 Kobayashi et al. Mar 2012 S
8128625 Odom Mar 2012 B2
8131565 Dicks et al. Mar 2012 B2
8136712 Zingman Mar 2012 B2
8146149 Steinkogler et al. Mar 2012 B2
D657368 Magee et al. Apr 2012 S
8147486 Honour et al. Apr 2012 B2
8155479 Hoffman et al. Apr 2012 B2
8157145 Shelton, IV et al. Apr 2012 B2
8157150 Viola et al. Apr 2012 B2
8157151 Ingmanson et al. Apr 2012 B2
8160098 Yan et al. Apr 2012 B1
8160690 Wilfley et al. Apr 2012 B2
8161977 Shelton, IV et al. Apr 2012 B2
8170396 Kuspa et al. May 2012 B2
8172836 Ward May 2012 B2
8181839 Beetel May 2012 B2
8185409 Putnam et al. May 2012 B2
8206345 Abboud et al. Jun 2012 B2
8208707 Mendonca et al. Jun 2012 B2
8210411 Yates et al. Jul 2012 B2
8214007 Baker et al. Jul 2012 B2
8216849 Petty Jul 2012 B2
8220688 Laurent et al. Jul 2012 B2
8225643 Abboud et al. Jul 2012 B2
8225979 Farascioni et al. Jul 2012 B2
8229549 Whitman et al. Jul 2012 B2
8231042 Hessler et al. Jul 2012 B2
8239066 Jennings et al. Aug 2012 B2
8241322 Whitman et al. Aug 2012 B2
8255045 Gharib et al. Aug 2012 B2
D667838 Magee et al. Sep 2012 S
8257387 Cunningham Sep 2012 B2
8260016 Maeda et al. Sep 2012 B2
8262560 Whitman Sep 2012 B2
8292639 Achammer et al. Oct 2012 B2
8292888 Whitman Oct 2012 B2
8295902 Salahieh et al. Oct 2012 B2
8308040 Huang et al. Nov 2012 B2
8321581 Katis et al. Nov 2012 B2
8322590 Patel et al. Dec 2012 B2
8328065 Shah Dec 2012 B2
8335590 Costa et al. Dec 2012 B2
D675164 Kobayashi et al. Jan 2013 S
8343065 Bartol et al. Jan 2013 B2
8346392 Walser et al. Jan 2013 B2
8360299 Zemlok et al. Jan 2013 B2
8364222 Cook et al. Jan 2013 B2
D676392 Gassauer Feb 2013 S
8365975 Manoux et al. Feb 2013 B1
D678196 Miyauchi et al. Mar 2013 S
D678304 Yakoub et al. Mar 2013 S
8388652 Viola Mar 2013 B2
8393514 Shelton, IV et al. Mar 2013 B2
8397972 Kostrzewski Mar 2013 B2
8398541 DiMaio et al. Mar 2013 B2
8403944 Pain et al. Mar 2013 B2
8403945 Whitfield et al. Mar 2013 B2
8403946 Whitfield et al. Mar 2013 B2
8406859 Zuzak et al. Mar 2013 B2
8411034 Boillot et al. Apr 2013 B2
8413871 Racenet et al. Apr 2013 B2
8422035 Hinderling et al. Apr 2013 B2
8423182 Robinson et al. Apr 2013 B2
8428722 Verhoef et al. Apr 2013 B2
8429153 Birdwell et al. Apr 2013 B2
8439910 Greep et al. May 2013 B2
8444663 Houser et al. May 2013 B2
8452615 Abri May 2013 B2
8454506 Rothman et al. Jun 2013 B2
8461744 Wiener et al. Jun 2013 B2
8468030 Stroup et al. Jun 2013 B2
8469973 Meade et al. Jun 2013 B2
8472630 Konrad et al. Jun 2013 B2
8473066 Aghassian et al. Jun 2013 B2
D687146 Juzkiw et al. Jul 2013 S
8476227 Kaplan et al. Jul 2013 B2
8478418 Fahey Jul 2013 B2
8489235 Moll et al. Jul 2013 B2
8499992 Whitman et al. Aug 2013 B2
8500728 Newton et al. Aug 2013 B2
8500756 Papa et al. Aug 2013 B2
8503759 Greer et al. Aug 2013 B2
8505801 Ehrenfels et al. Aug 2013 B2
8506478 Mizuyoshi Aug 2013 B2
8512325 Mathonnet Aug 2013 B2
8512365 Wiener et al. Aug 2013 B2
8515520 Brunnett et al. Aug 2013 B2
8517239 Scheib et al. Aug 2013 B2
8521331 Itkowitz Aug 2013 B2
8523043 Ullrich et al. Sep 2013 B2
8533475 Frikart et al. Sep 2013 B2
8540709 Allen Sep 2013 B2
8546996 Messerly et al. Oct 2013 B2
8554697 Claus et al. Oct 2013 B2
8560047 Haider et al. Oct 2013 B2
8561870 Baxter, III et al. Oct 2013 B2
8562598 Falkenstein et al. Oct 2013 B2
8566115 Moore Oct 2013 B2
8567393 Hickle et al. Oct 2013 B2
8568411 Falkenstein et al. Oct 2013 B2
8571598 Valavi Oct 2013 B2
8573459 Smith et al. Nov 2013 B2
8573465 Shelton, IV Nov 2013 B2
8574229 Eder et al. Nov 2013 B2
8585631 Dacquay Nov 2013 B2
8585694 Amoah et al. Nov 2013 B2
8590762 Hess et al. Nov 2013 B2
8591536 Robertson Nov 2013 B2
8595607 Nekoomaram et al. Nov 2013 B2
8596513 Olson et al. Dec 2013 B2
8596515 Okoniewski Dec 2013 B2
8604709 Jalbout et al. Dec 2013 B2
8608044 Hueil et al. Dec 2013 B2
8608045 Smith et al. Dec 2013 B2
8616431 Timm et al. Dec 2013 B2
8617155 Johnson et al. Dec 2013 B2
8620055 Barratt et al. Dec 2013 B2
8620473 Diolaiti et al. Dec 2013 B2
8622275 Baxter, III et al. Jan 2014 B2
8623027 Price et al. Jan 2014 B2
8627483 Rachlin et al. Jan 2014 B2
8627993 Smith et al. Jan 2014 B2
8627995 Smith et al. Jan 2014 B2
8628518 Blumenkranz et al. Jan 2014 B2
8628545 Cabrera et al. Jan 2014 B2
8631987 Shelton, IV et al. Jan 2014 B2
8632525 Kerr et al. Jan 2014 B2
8636190 Zemlok et al. Jan 2014 B2
8636736 Yates et al. Jan 2014 B2
8641621 Razzaque et al. Feb 2014 B2
8652086 Gerg et al. Feb 2014 B2
8652121 Quick et al. Feb 2014 B2
8652128 Ward Feb 2014 B2
8657176 Shelton, IV et al. Feb 2014 B2
8657177 Scirica et al. Feb 2014 B2
8663220 Wiener et al. Mar 2014 B2
8663222 Anderson et al. Mar 2014 B2
8666544 Moll et al. Mar 2014 B2
8679114 Chapman Mar 2014 B2
8682049 Zhao et al. Mar 2014 B2
8682489 Itkowitz et al. Mar 2014 B2
8685056 Evans et al. Apr 2014 B2
8688188 Heller et al. Apr 2014 B2
8690864 Hoarau Apr 2014 B2
8701962 Kostrzewski Apr 2014 B2
D704839 Juzkiw et al. May 2014 S
8719061 Birchall May 2014 B2
8720766 Hess et al. May 2014 B2
8733613 Huitema et al. May 2014 B2
8740840 Foley et al. Jun 2014 B2
8740866 Reasoner et al. Jun 2014 B2
8747238 Shelton, IV et al. Jun 2014 B2
8752749 Moore et al. Jun 2014 B2
8757465 Woodard, Jr. et al. Jun 2014 B2
8761717 Buchheit Jun 2014 B1
8763879 Shelton, IV et al. Jul 2014 B2
8768251 Claus et al. Jul 2014 B2
8771270 Burbank Jul 2014 B2
8775196 Simpson et al. Jul 2014 B2
8779648 Giordano et al. Jul 2014 B2
8790253 Sunagawa et al. Jul 2014 B2
8794497 Zingman Aug 2014 B2
8795001 Lam et al. Aug 2014 B1
8799008 Johnson et al. Aug 2014 B2
8799009 Mellin et al. Aug 2014 B2
8800838 Shelton, IV Aug 2014 B2
8801703 Gregg et al. Aug 2014 B2
8814996 Giurgiutiu et al. Aug 2014 B2
8818556 Sanchez et al. Aug 2014 B2
8819581 Nakamura et al. Aug 2014 B2
8820603 Shelton, IV et al. Sep 2014 B2
8820608 Miyamoto Sep 2014 B2
8827134 Viola et al. Sep 2014 B2
8827136 Hessler Sep 2014 B2
8840003 Morgan et al. Sep 2014 B2
D716333 Chotin et al. Oct 2014 S
8851354 Swensgard et al. Oct 2014 B2
8852174 Burbank Oct 2014 B2
8875973 Whitman Nov 2014 B2
8876857 Burbank Nov 2014 B2
8882662 Charles Nov 2014 B2
8885032 Igarashi et al. Nov 2014 B2
8886790 Harrang et al. Nov 2014 B2
8893949 Shelton, IV et al. Nov 2014 B2
8899479 Cappuzzo et al. Dec 2014 B2
8905977 Shelton et al. Dec 2014 B2
8912746 Reid et al. Dec 2014 B2
8914098 Brennan et al. Dec 2014 B2
8917513 Hazzard Dec 2014 B1
8918207 Prisco Dec 2014 B2
8920186 Shishikura Dec 2014 B2
8920414 Stone et al. Dec 2014 B2
8920433 Barrier et al. Dec 2014 B2
8930203 Kiaie et al. Jan 2015 B2
8930214 Woolford Jan 2015 B2
8931679 Kostrzewski Jan 2015 B2
8934684 Mohamed Jan 2015 B2
8936614 Allen, IV Jan 2015 B2
8945095 Blumenkranz et al. Feb 2015 B2
8945163 Voegele et al. Feb 2015 B2
8955732 Zemlok et al. Feb 2015 B2
8956581 Rosenbaum et al. Feb 2015 B2
8960519 Whitman et al. Feb 2015 B2
8960520 McCuen Feb 2015 B2
8962062 Podhajsky et al. Feb 2015 B2
8967443 McCuen Mar 2015 B2
8967455 Zhou Mar 2015 B2
8968276 Zemlok et al. Mar 2015 B2
8968296 McPherson Mar 2015 B2
8968309 Roy et al. Mar 2015 B2
8968312 Marczyk et al. Mar 2015 B2
8968337 Whitfield et al. Mar 2015 B2
8968358 Reschke Mar 2015 B2
8974429 Gordon et al. Mar 2015 B2
8979890 Boudreaux Mar 2015 B2
8986288 Konishi Mar 2015 B2
8986302 Aldridge et al. Mar 2015 B2
8989903 Weir et al. Mar 2015 B2
8991678 Wellman et al. Mar 2015 B2
8992565 Brisson et al. Mar 2015 B2
8998797 Omori Apr 2015 B2
9002518 Manzo et al. Apr 2015 B2
9010608 Casasanta, Jr. et al. Apr 2015 B2
9010611 Ross et al. Apr 2015 B2
9011366 Dean et al. Apr 2015 B2
9011427 Price et al. Apr 2015 B2
9016539 Kostrzewski et al. Apr 2015 B2
9017326 DiNardo et al. Apr 2015 B2
9020240 Pettersson et al. Apr 2015 B2
D729267 Yoo et al. May 2015 S
9023032 Robinson May 2015 B2
9023071 Miller et al. May 2015 B2
9027431 Tang et al. May 2015 B2
9028494 Shelton, IV et al. May 2015 B2
9035568 Ganton et al. May 2015 B2
9038882 Racenet et al. May 2015 B2
9043027 Durant et al. May 2015 B2
9044227 Shelton, IV et al. Jun 2015 B2
9044244 Ludwin et al. Jun 2015 B2
9044261 Houser Jun 2015 B2
9050063 Roe et al. Jun 2015 B2
9050083 Yates et al. Jun 2015 B2
9050120 Swarup et al. Jun 2015 B2
9052809 Vesto Jun 2015 B2
9055035 Porsch et al. Jun 2015 B2
9055870 Meador et al. Jun 2015 B2
9060770 Shelton, IV et al. Jun 2015 B2
9060775 Wiener et al. Jun 2015 B2
9066650 Sekiguchi Jun 2015 B2
9072523 Houser et al. Jul 2015 B2
9072535 Shelton, IV et al. Jul 2015 B2
9072536 Shelton, IV et al. Jul 2015 B2
9078653 Leimbach et al. Jul 2015 B2
9078727 Miller Jul 2015 B2
9084606 Greep Jul 2015 B2
9089360 Messerly et al. Jul 2015 B2
9095362 Dachs, II et al. Aug 2015 B2
9095367 Olson et al. Aug 2015 B2
9099863 Smith et al. Aug 2015 B2
9101358 Kerr et al. Aug 2015 B2
9101359 Smith et al. Aug 2015 B2
9101374 Hoch et al. Aug 2015 B1
9106270 Puterbaugh et al. Aug 2015 B2
9107573 Birnkrant Aug 2015 B2
9107662 Kostrzewski Aug 2015 B2
9107684 Ma Aug 2015 B2
9107688 Kimball et al. Aug 2015 B2
9107689 Robertson et al. Aug 2015 B2
9107694 Hendriks et al. Aug 2015 B2
9111548 Nandy et al. Aug 2015 B2
9113880 Zemlok et al. Aug 2015 B2
9114494 Mah Aug 2015 B1
9116597 Gulasky Aug 2015 B1
9119617 Souls et al. Sep 2015 B2
9119655 Bowling et al. Sep 2015 B2
9119657 Shelton, IV et al. Sep 2015 B2
9123155 Cunningham et al. Sep 2015 B2
9125644 Lane et al. Sep 2015 B2
9129054 Nawana et al. Sep 2015 B2
9137254 Bilbrey et al. Sep 2015 B2
9138129 Diolaiti Sep 2015 B2
9138225 Huang et al. Sep 2015 B2
9149322 Knowlton Oct 2015 B2
9155503 Cadwell Oct 2015 B2
9160853 Daddi et al. Oct 2015 B1
9161803 Yates et al. Oct 2015 B2
9168054 Turner et al. Oct 2015 B2
9168091 Janssen et al. Oct 2015 B2
9168104 Dein Oct 2015 B2
9179912 Yates et al. Nov 2015 B2
9183723 Sherman et al. Nov 2015 B2
9186143 Timm et al. Nov 2015 B2
9192375 Skinlo et al. Nov 2015 B2
9192447 Choi et al. Nov 2015 B2
9192707 Gerber et al. Nov 2015 B2
9198711 Joseph Dec 2015 B2
9202078 Abuelsaad et al. Dec 2015 B2
9204830 Zand et al. Dec 2015 B2
9204879 Shelton, IV Dec 2015 B2
9204995 Scheller et al. Dec 2015 B2
9211120 Scheib et al. Dec 2015 B2
9216062 Duque et al. Dec 2015 B2
9218053 Komuro et al. Dec 2015 B2
9220502 Zemlok et al. Dec 2015 B2
9226689 Jacobsen et al. Jan 2016 B2
9226751 Shelton, IV et al. Jan 2016 B2
9226766 Aldridge et al. Jan 2016 B2
9226767 Stulen et al. Jan 2016 B2
9226791 McCarthy et al. Jan 2016 B2
9232883 Ozawa et al. Jan 2016 B2
9237891 Shelton, IV Jan 2016 B2
9237921 Messerly et al. Jan 2016 B2
9241728 Price et al. Jan 2016 B2
9241730 Babaev Jan 2016 B2
9241731 Boudreaux et al. Jan 2016 B2
9247996 Merana et al. Feb 2016 B1
9250172 Harris et al. Feb 2016 B2
9255907 Heanue et al. Feb 2016 B2
9259282 Azizian et al. Feb 2016 B2
9265429 St. Pierre et al. Feb 2016 B2
9265585 Wingardner et al. Feb 2016 B2
9265959 Drew et al. Feb 2016 B2
9272406 Aronhalt et al. Mar 2016 B2
9277956 Zhang Mar 2016 B2
9277961 Panescu et al. Mar 2016 B2
9277969 Brannan et al. Mar 2016 B2
9280884 Schultz et al. Mar 2016 B1
9282962 Schmid et al. Mar 2016 B2
9282974 Shelton, IV Mar 2016 B2
9283045 Rhee et al. Mar 2016 B2
9283054 Morgan et al. Mar 2016 B2
9289211 Williams et al. Mar 2016 B2
9289212 Shelton, IV et al. Mar 2016 B2
9295514 Shelton, IV et al. Mar 2016 B2
9301691 Hufnagel et al. Apr 2016 B2
9301753 Aldridge et al. Apr 2016 B2
9301755 Shelton, IV et al. Apr 2016 B2
9301759 Spivey et al. Apr 2016 B2
9301810 Amiri et al. Apr 2016 B2
9302213 Manahan et al. Apr 2016 B2
9307894 von Grunberg et al. Apr 2016 B2
9307914 Fahey Apr 2016 B2
9307986 Hall et al. Apr 2016 B2
9314246 Shelton, IV et al. Apr 2016 B2
9314308 Parihar et al. Apr 2016 B2
9320563 Brustad et al. Apr 2016 B2
9325732 Stickle et al. Apr 2016 B1
9326767 Koch et al. May 2016 B2
9326770 Shelton, IV et al. May 2016 B2
9331422 Nazzaro et al. May 2016 B2
9332987 Leimbach et al. May 2016 B2
9333042 Diolaiti et al. May 2016 B2
9336385 Spencer et al. May 2016 B1
9341704 Picard et al. May 2016 B2
9345481 Hall et al. May 2016 B2
9345490 Ippisch May 2016 B2
9345544 Hourtash et al. May 2016 B2
9345546 Toth et al. May 2016 B2
9345900 Wu et al. May 2016 B2
9351726 Leimbach et al. May 2016 B2
9351727 Leimbach et al. May 2016 B2
9358003 Hall et al. Jun 2016 B2
9358685 Meier et al. Jun 2016 B2
9360449 Durie Jun 2016 B2
9364230 Shelton, IV et al. Jun 2016 B2
9364231 Wenchell Jun 2016 B2
9364249 Kimball et al. Jun 2016 B2
9364294 Razzaque et al. Jun 2016 B2
9370400 Parihar Jun 2016 B2
9375282 Nau, Jr. et al. Jun 2016 B2
9375539 Stearns et al. Jun 2016 B2
9381003 Todor et al. Jul 2016 B2
9381058 Houser et al. Jul 2016 B2
9386984 Aronhalt et al. Jul 2016 B2
9386988 Baxter, III et al. Jul 2016 B2
9387295 Mastri et al. Jul 2016 B1
9393017 Flanagan et al. Jul 2016 B2
9393037 Olson et al. Jul 2016 B2
9398905 Martin Jul 2016 B2
9398911 Auld Jul 2016 B2
9402629 Ehrenfels et al. Aug 2016 B2
9414776 Sillay et al. Aug 2016 B2
9414940 Stein et al. Aug 2016 B2
9419018 Sasagawa et al. Aug 2016 B2
9421014 Ingmanson et al. Aug 2016 B2
9433470 Choi Sep 2016 B2
9439622 Case et al. Sep 2016 B2
9439668 Timm et al. Sep 2016 B2
9439736 Olson Sep 2016 B2
9445764 Gross et al. Sep 2016 B2
9445813 Shelton, IV et al. Sep 2016 B2
9450701 Do et al. Sep 2016 B2
9451949 Gorek et al. Sep 2016 B2
9451958 Shelton, IV et al. Sep 2016 B2
9463022 Swayze et al. Oct 2016 B2
9463646 Payne et al. Oct 2016 B2
9468438 Baber et al. Oct 2016 B2
9474565 Shikhman et al. Oct 2016 B2
D772252 Myers et al. Nov 2016 S
9480492 Aranyi et al. Nov 2016 B2
9485475 Speier et al. Nov 2016 B2
9486271 Dunning Nov 2016 B2
9492146 Kostrzewski et al. Nov 2016 B2
9492237 Kang et al. Nov 2016 B2
9493807 Little et al. Nov 2016 B2
9498182 Case et al. Nov 2016 B2
9498215 Duque et al. Nov 2016 B2
9498231 Halder et al. Nov 2016 B2
9509566 Chu et al. Nov 2016 B2
9516239 Blanquart et al. Dec 2016 B2
9519753 Gerdeman et al. Dec 2016 B1
9522003 Weir et al. Dec 2016 B2
9526407 Hoeg et al. Dec 2016 B2
9526499 Kostrzewski et al. Dec 2016 B2
9526587 Zhao et al. Dec 2016 B2
9532827 Morgan et al. Jan 2017 B2
9532845 Dossett et al. Jan 2017 B1
9539007 Dhakad et al. Jan 2017 B2
9539020 Conlon et al. Jan 2017 B2
9542481 Halter et al. Jan 2017 B2
9546662 Shener-Irmakoglu et al. Jan 2017 B2
9549781 He et al. Jan 2017 B2
9554692 Levy Jan 2017 B2
9554794 Baber et al. Jan 2017 B2
9554854 Yates et al. Jan 2017 B2
9561038 Shelton, IV et al. Feb 2017 B2
9561045 Hinman et al. Feb 2017 B2
9561082 Yen et al. Feb 2017 B2
9561982 Enicks et al. Feb 2017 B2
9566708 Kurnianto Feb 2017 B2
9572592 Price et al. Feb 2017 B2
9579099 Penna et al. Feb 2017 B2
9579503 McKinney et al. Feb 2017 B2
9585657 Shelton, IV et al. Mar 2017 B2
9592095 Panescu et al. Mar 2017 B2
9597081 Swayze et al. Mar 2017 B2
9600031 Kaneko et al. Mar 2017 B2
9600138 Thomas et al. Mar 2017 B2
9603024 Wang et al. Mar 2017 B2
9603277 Morgan et al. Mar 2017 B2
9603609 Kawashima et al. Mar 2017 B2
D783675 Yagisawa et al. Apr 2017 S
D784270 Bhattacharya Apr 2017 S
9610114 Baxter, III et al. Apr 2017 B2
9610412 Zemlok et al. Apr 2017 B2
9615877 Tyrrell Apr 2017 B2
9622684 Wybo Apr 2017 B2
9622808 Beller et al. Apr 2017 B2
9628501 Datta Ray et al. Apr 2017 B2
9629560 Joseph Apr 2017 B2
9629623 Lytle, IV et al. Apr 2017 B2
9629628 Aranyi Apr 2017 B2
9629629 Leimbach et al. Apr 2017 B2
9630318 Ibarz Gabardos et al. Apr 2017 B2
9636096 Heaton, II et al. May 2017 B1
9636112 Penna et al. May 2017 B2
9636188 Gattani et al. May 2017 B2
9636239 Durand et al. May 2017 B2
9636825 Penn et al. May 2017 B2
9641596 Unagami et al. May 2017 B2
9641815 Richardson et al. May 2017 B2
9642620 Baxter, III et al. May 2017 B2
9643022 Mashiach et al. May 2017 B2
9649110 Parihar et al. May 2017 B2
9649111 Shelton, IV et al. May 2017 B2
9649126 Robertson et al. May 2017 B2
9649169 Cinquin et al. May 2017 B2
9652655 Satish et al. May 2017 B2
9655616 Aranyi May 2017 B2
9656092 Golden May 2017 B2
9662116 Smith et al. May 2017 B2
9662177 Weir et al. May 2017 B2
9668729 Williams et al. Jun 2017 B2
9668732 Patel et al. Jun 2017 B2
9668765 Grace et al. Jun 2017 B2
9671860 Ogawa et al. Jun 2017 B2
9675264 Acquista et al. Jun 2017 B2
9675354 Weir et al. Jun 2017 B2
9681870 Baxter, III et al. Jun 2017 B2
9686306 Chizeck et al. Jun 2017 B2
9687230 Leimbach et al. Jun 2017 B2
9690362 Leimbach et al. Jun 2017 B2
9700292 Nawana et al. Jul 2017 B2
9700309 Jaworek et al. Jul 2017 B2
9700312 Kostrzewski et al. Jul 2017 B2
9700320 Dinardo et al. Jul 2017 B2
9706993 Hessler et al. Jul 2017 B2
9710214 Lin et al. Jul 2017 B2
9710644 Reybok et al. Jul 2017 B2
9713424 Spaide Jul 2017 B2
9713503 Goldschmidt Jul 2017 B2
9717141 Tegg Jul 2017 B1
9717498 Aranyi et al. Aug 2017 B2
9717525 Ahluwalia et al. Aug 2017 B2
9717548 Couture Aug 2017 B2
9724094 Baber et al. Aug 2017 B2
9724100 Scheib et al. Aug 2017 B2
9724118 Schulte et al. Aug 2017 B2
9733663 Leimbach et al. Aug 2017 B2
9737301 Baber et al. Aug 2017 B2
9737310 Whitfield et al. Aug 2017 B2
9737335 Butler et al. Aug 2017 B2
9737355 Yates et al. Aug 2017 B2
9737371 Romo et al. Aug 2017 B2
9740826 Raghavan et al. Aug 2017 B2
9743016 Nestares et al. Aug 2017 B2
9743929 Leimbach et al. Aug 2017 B2
9743946 Faller et al. Aug 2017 B2
9743947 Price et al. Aug 2017 B2
9750499 Leimbach et al. Sep 2017 B2
9750500 Malkowski Sep 2017 B2
9750522 Scheib et al. Sep 2017 B2
9750523 Tsubuku Sep 2017 B2
9750560 Ballakur et al. Sep 2017 B2
9750563 Shikhman et al. Sep 2017 B2
9753135 Bosch Sep 2017 B2
9753568 McMillen Sep 2017 B2
9757126 Cappola Sep 2017 B2
9757128 Baber et al. Sep 2017 B2
9757142 Shimizu Sep 2017 B2
9757152 Ogilvie et al. Sep 2017 B2
9763741 Alvarez et al. Sep 2017 B2
9764164 Wiener et al. Sep 2017 B2
9770541 Carr et al. Sep 2017 B2
9775611 Kostrzewski Oct 2017 B2
9777913 Talbert et al. Oct 2017 B2
9782164 Mumaw et al. Oct 2017 B2
9782169 Kimsey et al. Oct 2017 B2
9782212 Wham et al. Oct 2017 B2
9782214 Houser et al. Oct 2017 B2
9788835 Morgan et al. Oct 2017 B2
9788836 Overmyer et al. Oct 2017 B2
9788851 Dannaher et al. Oct 2017 B2
9788902 Inoue et al. Oct 2017 B2
9788907 Alvi et al. Oct 2017 B1
9795436 Yates et al. Oct 2017 B2
9797486 Zergiebel et al. Oct 2017 B2
9801531 Morita et al. Oct 2017 B2
9801626 Parihar et al. Oct 2017 B2
9801627 Harris et al. Oct 2017 B2
9801679 Trees et al. Oct 2017 B2
9802033 Hibner et al. Oct 2017 B2
9804618 Leimbach et al. Oct 2017 B2
9805472 Chou et al. Oct 2017 B2
9808244 Leimbach et al. Nov 2017 B2
9808245 Richard et al. Nov 2017 B2
9808246 Shelton, IV et al. Nov 2017 B2
9808248 Hoffman Nov 2017 B2
9808249 Shelton, IV Nov 2017 B2
9814457 Martin et al. Nov 2017 B2
9814460 Kimsey et al. Nov 2017 B2
9814462 Woodard, Jr. et al. Nov 2017 B2
9814463 Williams et al. Nov 2017 B2
9820699 Bingley et al. Nov 2017 B2
9820738 Lytle, IV et al. Nov 2017 B2
9820741 Kostrzewski Nov 2017 B2
9820768 Gee et al. Nov 2017 B2
9826976 Parihar et al. Nov 2017 B2
9826977 Leimbach et al. Nov 2017 B2
9827054 Richmond et al. Nov 2017 B2
9827059 Robinson et al. Nov 2017 B2
9830424 Dixon et al. Nov 2017 B2
9833241 Huitema et al. Dec 2017 B2
9833254 Barral et al. Dec 2017 B1
9839419 Deck et al. Dec 2017 B2
9839424 Zergiebel et al. Dec 2017 B2
9839428 Baxter, III et al. Dec 2017 B2
9839467 Harper et al. Dec 2017 B2
9839470 Gilbert et al. Dec 2017 B2
9839487 Dachs, II Dec 2017 B2
9844321 Ekvall et al. Dec 2017 B1
9844368 Boudreaux et al. Dec 2017 B2
9844369 Huitema et al. Dec 2017 B2
9844374 Lytle, IV et al. Dec 2017 B2
9844375 Overmyer et al. Dec 2017 B2
9844376 Baxter, III et al. Dec 2017 B2
9844379 Shelton, IV et al. Dec 2017 B2
9848058 Johnson et al. Dec 2017 B2
9848877 Shelton, IV et al. Dec 2017 B2
9861354 Saliman et al. Jan 2018 B2
9861363 Chen et al. Jan 2018 B2
9861428 Trees et al. Jan 2018 B2
9864839 Baym et al. Jan 2018 B2
9867612 Parihar et al. Jan 2018 B2
9867651 Wham Jan 2018 B2
9867670 Brannan et al. Jan 2018 B2
9867914 Bonano et al. Jan 2018 B2
9872609 Levy Jan 2018 B2
9872683 Hopkins et al. Jan 2018 B2
9877718 Weir et al. Jan 2018 B2
9877721 Schellin et al. Jan 2018 B2
9883860 Leimbach Feb 2018 B2
9888864 Rondon et al. Feb 2018 B2
9888914 Martin et al. Feb 2018 B2
9888919 Leimbach et al. Feb 2018 B2
9888921 Williams et al. Feb 2018 B2
9888975 Auld Feb 2018 B2
9895148 Shelton, IV et al. Feb 2018 B2
9900787 Ou Feb 2018 B2
9901342 Shelton, IV et al. Feb 2018 B2
9901406 State et al. Feb 2018 B2
9905000 Chou et al. Feb 2018 B2
9907196 Susini et al. Feb 2018 B2
9907550 Sniffin et al. Mar 2018 B2
9913642 Leimbach et al. Mar 2018 B2
9913645 Zerkle et al. Mar 2018 B2
9918326 Gilson et al. Mar 2018 B2
9918730 Trees et al. Mar 2018 B2
9918778 Walberg et al. Mar 2018 B2
9918788 Paul et al. Mar 2018 B2
9922304 DeBusk et al. Mar 2018 B2
9924941 Burbank Mar 2018 B2
9924944 Shelton, IV et al. Mar 2018 B2
9924961 Shelton, IV et al. Mar 2018 B2
9931040 Homyk et al. Apr 2018 B2
9931118 Shelton, IV et al. Apr 2018 B2
9931124 Gokharu Apr 2018 B2
9936863 Tesar Apr 2018 B2
9936942 Chin et al. Apr 2018 B2
9936955 Miller et al. Apr 2018 B2
9936961 Chien et al. Apr 2018 B2
9937012 Hares et al. Apr 2018 B2
9937014 Bowling et al. Apr 2018 B2
9937626 Rockrohr Apr 2018 B2
9938972 Walley Apr 2018 B2
9943230 Kaku et al. Apr 2018 B2
9943309 Shelton, IV et al. Apr 2018 B2
9943312 Posada et al. Apr 2018 B2
9943377 Yates et al. Apr 2018 B2
9943379 Gregg, II et al. Apr 2018 B2
9943918 Grogan et al. Apr 2018 B2
9943964 Hares Apr 2018 B2
9949785 Price et al. Apr 2018 B2
9962157 Sapre May 2018 B2
9968355 Shelton, IV et al. May 2018 B2
9974595 Anderson et al. May 2018 B2
9980140 Spencer et al. May 2018 B1
9980769 Trees et al. May 2018 B2
9980778 Ohline et al. May 2018 B2
9987000 Shelton, IV et al. Jun 2018 B2
9987068 Anderson et al. Jun 2018 B2
9987072 McPherson Jun 2018 B2
9990856 Kuchenbecker et al. Jun 2018 B2
9993248 Shelton, IV et al. Jun 2018 B2
9993258 Shelton, IV et al. Jun 2018 B2
9993305 Andersson Jun 2018 B2
10004491 Martin et al. Jun 2018 B2
10004497 Overmyer et al. Jun 2018 B2
10004500 Shelton, IV et al. Jun 2018 B2
10004501 Shelton, IV et al. Jun 2018 B2
10004527 Gee et al. Jun 2018 B2
10004557 Gross Jun 2018 B2
D822206 Shelton, IV et al. Jul 2018 S
10010322 Shelton, IV et al. Jul 2018 B2
10010324 Huitema et al. Jul 2018 B2
10013049 Leimbach et al. Jul 2018 B2
10016199 Baber et al. Jul 2018 B2
10021318 Hugosson et al. Jul 2018 B2
10022090 Whitman Jul 2018 B2
10022120 Martin et al. Jul 2018 B2
10022391 Ruderman Chen et al. Jul 2018 B2
10022568 Messerly et al. Jul 2018 B2
10028402 Walker Jul 2018 B1
10028744 Shelton, IV et al. Jul 2018 B2
10028761 Leimbach et al. Jul 2018 B2
10028788 Kang Jul 2018 B2
10034704 Asher et al. Jul 2018 B2
10037641 Hyde et al. Jul 2018 B2
10037715 Toly et al. Jul 2018 B2
D826405 Shelton, IV et al. Aug 2018 S
10039546 Williams et al. Aug 2018 B2
10039564 Hibner et al. Aug 2018 B2
10039565 Vezzu Aug 2018 B2
10039589 Virshek et al. Aug 2018 B2
10041822 Zemlok Aug 2018 B2
10044791 Kamen et al. Aug 2018 B2
10045704 Fagin et al. Aug 2018 B2
10045776 Shelton, IV et al. Aug 2018 B2
10045779 Savage et al. Aug 2018 B2
10045781 Cropper et al. Aug 2018 B2
10045782 Murthy Aravalli Aug 2018 B2
10045813 Mueller Aug 2018 B2
10048379 Markendorf et al. Aug 2018 B2
10052044 Shelton, IV et al. Aug 2018 B2
10052102 Baxter, III et al. Aug 2018 B2
10052104 Shelton, IV et al. Aug 2018 B2
10054441 Schorr et al. Aug 2018 B2
10058393 Bonutti et al. Aug 2018 B2
10069633 Gulati et al. Sep 2018 B2
10076326 Yates et al. Sep 2018 B2
10080618 Marshall et al. Sep 2018 B2
10084833 McDonnell et al. Sep 2018 B2
D831209 Huitema et al. Oct 2018 S
10085748 Morgan et al. Oct 2018 B2
10085749 Cappola et al. Oct 2018 B2
10092355 Hannaford et al. Oct 2018 B1
10095942 Mentese et al. Oct 2018 B2
10097578 Baldonado et al. Oct 2018 B2
10098527 Weisenburgh, II et al. Oct 2018 B2
10098635 Burbank Oct 2018 B2
10098642 Baxter, III et al. Oct 2018 B2
10098705 Brisson et al. Oct 2018 B2
10102926 Leonardi Oct 2018 B1
10105140 Malinouskas et al. Oct 2018 B2
10105142 Baxter, III et al. Oct 2018 B2
10105470 Reasoner et al. Oct 2018 B2
10111658 Chowaniec et al. Oct 2018 B2
10111665 Aranyi et al. Oct 2018 B2
10111679 Baber et al. Oct 2018 B2
10111703 Cosman, Jr. et al. Oct 2018 B2
D834541 You et al. Nov 2018 S
10117649 Baxter et al. Nov 2018 B2
10117651 Whitman et al. Nov 2018 B2
10117702 Danziger et al. Nov 2018 B2
10118119 Sappok et al. Nov 2018 B2
10130359 Hess et al. Nov 2018 B2
10130360 Olson et al. Nov 2018 B2
10130361 Yates et al. Nov 2018 B2
10130367 Cappola et al. Nov 2018 B2
10130432 Auld et al. Nov 2018 B2
10133248 Fitzsimmons et al. Nov 2018 B2
10135242 Baber et al. Nov 2018 B2
10136246 Yamada Nov 2018 B2
10136887 Shelton, IV et al. Nov 2018 B2
10136891 Shelton, IV et al. Nov 2018 B2
10136949 Felder et al. Nov 2018 B2
10136954 Johnson et al. Nov 2018 B2
10137245 Melker et al. Nov 2018 B2
10143526 Walker et al. Dec 2018 B2
10143948 Bonifas et al. Dec 2018 B2
10147148 Wu et al. Dec 2018 B2
10149680 Parihar et al. Dec 2018 B2
10152789 Carnes et al. Dec 2018 B2
10154841 Weaner et al. Dec 2018 B2
10159044 Hrabak Dec 2018 B2
10159481 Whitman et al. Dec 2018 B2
10159483 Beckman et al. Dec 2018 B2
10164466 Calderoni Dec 2018 B2
10166025 Leimbach et al. Jan 2019 B2
10166061 Berry et al. Jan 2019 B2
10169862 Andre et al. Jan 2019 B2
10172618 Shelton, IV et al. Jan 2019 B2
10172687 Garbus et al. Jan 2019 B2
10175096 Dickerson Jan 2019 B2
10175127 Collins et al. Jan 2019 B2
10178992 Wise et al. Jan 2019 B2
10179413 Rockrohr Jan 2019 B2
10180463 Beckman et al. Jan 2019 B2
10182814 Okonlewski Jan 2019 B2
10182816 Shelton, IV et al. Jan 2019 B2
10182818 Hensel et al. Jan 2019 B2
10188385 Kerr et al. Jan 2019 B2
10189157 Schlegel et al. Jan 2019 B2
10190888 Hryb et al. Jan 2019 B2
10194891 Jeong et al. Feb 2019 B2
10194907 Marczyk et al. Feb 2019 B2
10194913 Nalagatla et al. Feb 2019 B2
10194972 Yates et al. Feb 2019 B2
10197803 Badiali et al. Feb 2019 B2
10198965 Hart Feb 2019 B2
10201311 Chou et al. Feb 2019 B2
10201349 Leimbach et al. Feb 2019 B2
10201364 Leimbach et al. Feb 2019 B2
10201365 Boudreaux et al. Feb 2019 B2
10205708 Fletcher et al. Feb 2019 B1
10206605 Shelton, IV et al. Feb 2019 B2
10206752 Hares et al. Feb 2019 B2
10213201 Shelton, IV et al. Feb 2019 B2
10213203 Swayze et al. Feb 2019 B2
10213266 Zemlok et al. Feb 2019 B2
10213268 Dachs, II Feb 2019 B2
10219491 Stiles, Jr. et al. Mar 2019 B2
10220522 Rockrohr Mar 2019 B2
10222750 Bang et al. Mar 2019 B2
10226249 Jaworek et al. Mar 2019 B2
10226250 Beckman et al. Mar 2019 B2
10226254 Cabrera et al. Mar 2019 B2
10226302 Lacal et al. Mar 2019 B2
10231634 Zand et al. Mar 2019 B2
10231733 Ehrenfels et al. Mar 2019 B2
10231775 Shelton, IV et al. Mar 2019 B2
10238413 Hibner et al. Mar 2019 B2
10245027 Shelton, IV et al. Apr 2019 B2
10245028 Shelton, IV et al. Apr 2019 B2
10245029 Hunter et al. Apr 2019 B2
10245030 Hunter et al. Apr 2019 B2
10245033 Overmyer et al. Apr 2019 B2
10245037 Conklin et al. Apr 2019 B2
10245038 Hopkins et al. Apr 2019 B2
10245040 Milliman Apr 2019 B2
10251661 Collings et al. Apr 2019 B2
10251725 Valentine et al. Apr 2019 B2
10258331 Shelton, IV et al. Apr 2019 B2
10258359 Kapadia Apr 2019 B2
10258362 Conlon Apr 2019 B2
10258363 Worrell et al. Apr 2019 B2
10258415 Harrah et al. Apr 2019 B2
10258418 Shelton, IV et al. Apr 2019 B2
10258425 Mustufa et al. Apr 2019 B2
10263171 Wiener et al. Apr 2019 B2
10265004 Yamaguchi et al. Apr 2019 B2
10265035 Fehre et al. Apr 2019 B2
10265066 Measamer et al. Apr 2019 B2
10265068 Harris et al. Apr 2019 B2
10265072 Shelton, IV et al. Apr 2019 B2
10265090 Ingmanson et al. Apr 2019 B2
10265130 Hess et al. Apr 2019 B2
10271840 Sapre Apr 2019 B2
10271844 Valentine et al. Apr 2019 B2
10271850 Wiliams Apr 2019 B2
10271851 Shelton, IV et al. Apr 2019 B2
D847989 Shelton, IV et al. May 2019 S
10278698 Racenet May 2019 B2
10278778 State et al. May 2019 B2
10283220 Azizian et al. May 2019 B2
10285694 Viola et al. May 2019 B2
10285698 Cappola et al. May 2019 B2
10285700 Scheib May 2019 B2
10285705 Shelton, IV et al. May 2019 B2
10292610 Srivastava May 2019 B2
10292704 Harris et al. May 2019 B2
10292707 Shelton, IV et al. May 2019 B2
10292758 Boudreaux et al. May 2019 B2
10292769 Yu May 2019 B1
10292771 Wood et al. May 2019 B2
10293129 Fox et al. May 2019 B2
10299792 Huitema et al. May 2019 B2
10299870 Connolly et al. May 2019 B2
10305926 Mihan et al. May 2019 B2
D850617 Shelton, IV et al. Jun 2019 S
10307159 Harris et al. Jun 2019 B2
10307170 Parfett et al. Jun 2019 B2
10307199 Farritor et al. Jun 2019 B2
10311036 Hussam et al. Jun 2019 B1
10313137 Aarnio et al. Jun 2019 B2
10314577 Laurent et al. Jun 2019 B2
10314582 Shelton, IV et al. Jun 2019 B2
10321907 Shelton, IV et al. Jun 2019 B2
10321964 Grover et al. Jun 2019 B2
10327764 Harris et al. Jun 2019 B2
10327779 Richard et al. Jun 2019 B2
10335147 Rector et al. Jul 2019 B2
10335149 Baxter, III et al. Jul 2019 B2
10335180 Johnson et al. Jul 2019 B2
10335227 Heard Jul 2019 B2
10339496 Matson et al. Jul 2019 B2
10342543 Shelton, IV et al. Jul 2019 B2
10342602 Strobl et al. Jul 2019 B2
10342623 Huelman et al. Jul 2019 B2
10343102 Reasoner et al. Jul 2019 B2
10349824 Claude et al. Jul 2019 B2
10349939 Shelton, IV et al. Jul 2019 B2
10349941 Marczyk et al. Jul 2019 B2
10350016 Burbank et al. Jul 2019 B2
10357184 Crawford et al. Jul 2019 B2
10357246 Shelton, IV et al. Jul 2019 B2
10357247 Shelton, IV et al. Jul 2019 B2
10362179 Harris Jul 2019 B2
10363032 Scheib et al. Jul 2019 B2
10363037 Aronhalt et al. Jul 2019 B2
10368861 Baxter, III et al. Aug 2019 B2
10368865 Harris et al. Aug 2019 B2
10368867 Harris et al. Aug 2019 B2
10368876 Bhatnagar et al. Aug 2019 B2
10368894 Madan et al. Aug 2019 B2
10368903 Morales et al. Aug 2019 B2
10376263 Morgan et al. Aug 2019 B2
10376305 Yates et al. Aug 2019 B2
10376337 Kilroy et al. Aug 2019 B2
10376338 Taylor et al. Aug 2019 B2
10378893 Mankovskii Aug 2019 B2
10383518 Abu-Tarif et al. Aug 2019 B2
10383699 Kilroy et al. Aug 2019 B2
10384021 Koeth et al. Aug 2019 B2
10386990 Shikhman et al. Aug 2019 B2
10390718 Chen et al. Aug 2019 B2
10390794 Kuroiwa et al. Aug 2019 B2
10390825 Shelton, IV et al. Aug 2019 B2
10390831 Holsten et al. Aug 2019 B2
10390895 Henderson et al. Aug 2019 B2
10398348 Osadchy et al. Sep 2019 B2
10398434 Shelton, IV et al. Sep 2019 B2
10398517 Eckert et al. Sep 2019 B2
10398521 Itkowitz et al. Sep 2019 B2
10404521 McChord et al. Sep 2019 B2
10404801 Martch Sep 2019 B2
10405857 Shelton, IV et al. Sep 2019 B2
10405859 Harris et al. Sep 2019 B2
10405863 Wise et al. Sep 2019 B2
10413291 Worthington et al. Sep 2019 B2
10413293 Shelton, IV et al. Sep 2019 B2
10413297 Harris et al. Sep 2019 B2
10417446 Takeyama Sep 2019 B2
10420552 Shelton, IV et al. Sep 2019 B2
10420558 Nalagatla et al. Sep 2019 B2
10420559 Marczyk et al. Sep 2019 B2
10420620 Rockrohr Sep 2019 B2
10420865 Reasoner et al. Sep 2019 B2
10422727 Pliskin Sep 2019 B2
10426466 Contini et al. Oct 2019 B2
10426467 Miller et al. Oct 2019 B2
10426468 Contini et al. Oct 2019 B2
10426471 Shelton, IV et al. Oct 2019 B2
10426481 Aronhalt et al. Oct 2019 B2
10433837 Worthington et al. Oct 2019 B2
10433844 Shelton, IV et al. Oct 2019 B2
10433849 Shelton, IV et al. Oct 2019 B2
10433918 Shelton, IV et al. Oct 2019 B2
10441279 Shelton, IV et al. Oct 2019 B2
10441345 Aldridge et al. Oct 2019 B2
10448948 Shelton, IV et al. Oct 2019 B2
10448950 Shelton, IV et al. Oct 2019 B2
10456137 Vendely et al. Oct 2019 B2
10456140 Shelton, IV et al. Oct 2019 B2
10456193 Yates et al. Oct 2019 B2
10463365 Williams Nov 2019 B2
10463367 Kostrzewski et al. Nov 2019 B2
10463371 Kostrzewski Nov 2019 B2
10463436 Jackson et al. Nov 2019 B2
10470762 Leimbach et al. Nov 2019 B2
10470764 Baxter, III et al. Nov 2019 B2
10470768 Harris et al. Nov 2019 B2
10470791 Houser Nov 2019 B2
10471254 Sano et al. Nov 2019 B2
10478181 Shelton, IV et al. Nov 2019 B2
10478182 Taylor Nov 2019 B2
10478185 Nicholas Nov 2019 B2
10478189 Bear et al. Nov 2019 B2
10478190 Miller et al. Nov 2019 B2
10478544 Friederichs et al. Nov 2019 B2
10485450 Gupta et al. Nov 2019 B2
10485542 Shelton, IV et al. Nov 2019 B2
10485543 Shelton, IV et al. Nov 2019 B2
10492783 Shelton, IV et al. Dec 2019 B2
10492784 Beardsley et al. Dec 2019 B2
10492785 Overmyer et al. Dec 2019 B2
10496788 Amarasingham et al. Dec 2019 B2
10498269 Zemlok et al. Dec 2019 B2
10499847 Latimer et al. Dec 2019 B2
10499891 Chaplin et al. Dec 2019 B2
10499914 Huang et al. Dec 2019 B2
10499915 Aranyi Dec 2019 B2
10499994 Luks et al. Dec 2019 B2
10507068 Kopp et al. Dec 2019 B2
10510267 Jarc et al. Dec 2019 B2
10512413 Schepis et al. Dec 2019 B2
10512461 Gupta et al. Dec 2019 B2
10512499 McHenry et al. Dec 2019 B2
10512509 Bowling et al. Dec 2019 B2
10512514 Nowlin et al. Dec 2019 B2
10517588 Gupta et al. Dec 2019 B2
10517595 Hunter et al. Dec 2019 B2
10517596 Hunter et al. Dec 2019 B2
10517686 Vokrot et al. Dec 2019 B2
10524789 Swayze et al. Jan 2020 B2
10531579 Hsiao et al. Jan 2020 B2
10531874 Morgan et al. Jan 2020 B2
10531929 Widenhouse et al. Jan 2020 B2
10532330 Diallo et al. Jan 2020 B2
10536617 Liang et al. Jan 2020 B2
10537324 Shelton, IV et al. Jan 2020 B2
10537325 Bakos et al. Jan 2020 B2
10537351 Shelton, IV et al. Jan 2020 B2
10542978 Chowaniec et al. Jan 2020 B2
10542979 Shelton, IV et al. Jan 2020 B2
10542982 Beckman et al. Jan 2020 B2
10542991 Shelton, IV et al. Jan 2020 B2
D876466 Kobayashi et al. Feb 2020 S
10548504 Shelton, IV et al. Feb 2020 B2
10548612 Martinez et al. Feb 2020 B2
10548673 Harris et al. Feb 2020 B2
10552574 Sweeney Feb 2020 B2
10555675 Satish et al. Feb 2020 B2
10555748 Yates et al. Feb 2020 B2
10555750 Conlon et al. Feb 2020 B2
10555769 Worrell et al. Feb 2020 B2
10561349 Wedekind et al. Feb 2020 B2
10561422 Schellin et al. Feb 2020 B2
10561470 Hourtash et al. Feb 2020 B2
10561471 Nichogi Feb 2020 B2
10561560 Boutoussov et al. Feb 2020 B2
10561753 Thompson et al. Feb 2020 B2
10568625 Harris et al. Feb 2020 B2
10568626 Shelton, IV et al. Feb 2020 B2
10568632 Miller et al. Feb 2020 B2
10568704 Savaii et al. Feb 2020 B2
10575868 Hall et al. Mar 2020 B2
10582928 Hunter et al. Mar 2020 B2
10582931 Mujawar Mar 2020 B2
10582964 Weinberg et al. Mar 2020 B2
10586074 Rose et al. Mar 2020 B2
10588623 Schmid et al. Mar 2020 B2
10588625 Weaner et al. Mar 2020 B2
10588629 Malinouskas et al. Mar 2020 B2
10588630 Shelton, IV et al. Mar 2020 B2
10588631 Shelton, IV et al. Mar 2020 B2
10588632 Shelton, IV et al. Mar 2020 B2
10588711 DiCarlo et al. Mar 2020 B2
10592067 Merdan et al. Mar 2020 B2
10595844 Nawana et al. Mar 2020 B2
10595882 Parfett et al. Mar 2020 B2
10595887 Shelton, IV et al. Mar 2020 B2
10595930 Scheib et al. Mar 2020 B2
10595952 Forrest et al. Mar 2020 B2
10602007 Takano Mar 2020 B2
10602848 Magana Mar 2020 B2
10603036 Hunter et al. Mar 2020 B2
10603128 Zergiebel et al. Mar 2020 B2
10610223 Wellman et al. Apr 2020 B2
10610224 Shelton, IV et al. Apr 2020 B2
10610286 Wiener et al. Apr 2020 B2
10610313 Bailey et al. Apr 2020 B2
10617412 Shelton, IV et al. Apr 2020 B2
10617414 Shelton, IV et al. Apr 2020 B2
10617482 Houser et al. Apr 2020 B2
10617484 Kilroy et al. Apr 2020 B2
10624635 Harris et al. Apr 2020 B2
10624667 Faller et al. Apr 2020 B2
10624691 Wiener et al. Apr 2020 B2
10631423 Collins et al. Apr 2020 B2
10631858 Burbank Apr 2020 B2
10631912 McFarlin et al. Apr 2020 B2
10631916 Horner et al. Apr 2020 B2
10631917 Ineson Apr 2020 B2
10631939 Dachs, II et al. Apr 2020 B2
10639027 Shelton, IV et al. May 2020 B2
10639034 Harris et al. May 2020 B2
10639035 Shelton, IV et al. May 2020 B2
10639036 Yates et al. May 2020 B2
10639037 Shelton, IV et al. May 2020 B2
10639039 Vendely et al. May 2020 B2
10639098 Cosman et al. May 2020 B2
10639111 Kopp May 2020 B2
10639185 Agrawal et al. May 2020 B2
10653413 Worthington et al. May 2020 B2
10653476 Ross May 2020 B2
10653489 Kopp May 2020 B2
10656720 Holz May 2020 B1
10660705 Piron et al. May 2020 B2
10667809 Bakos et al. Jun 2020 B2
10667810 Shelton, IV et al. Jun 2020 B2
10667811 Harris et al. Jun 2020 B2
10667877 Kapadia Jun 2020 B2
10674897 Levy Jun 2020 B2
10675021 Harris et al. Jun 2020 B2
10675023 Cappola Jun 2020 B2
10675024 Shelton, IV et al. Jun 2020 B2
10675025 Swayze et al. Jun 2020 B2
10675026 Harris et al. Jun 2020 B2
10675035 Zingman Jun 2020 B2
10675100 Frushour Jun 2020 B2
10675104 Kapadia Jun 2020 B2
10677764 Ross et al. Jun 2020 B2
10679758 Fox et al. Jun 2020 B2
10682136 Harris et al. Jun 2020 B2
10682138 Shelton, IV et al. Jun 2020 B2
10686805 Reybok, Jr. et al. Jun 2020 B2
10687806 Shelton, IV et al. Jun 2020 B2
10687809 Shelton, IV et al. Jun 2020 B2
10687810 Shelton, IV et al. Jun 2020 B2
10687884 Wiener et al. Jun 2020 B2
10687905 Kostrzewski Jun 2020 B2
10695055 Shelton, IV et al. Jun 2020 B2
10695081 Shelton, IV et al. Jun 2020 B2
10695134 Barral et al. Jun 2020 B2
10702270 Shelton, IV et al. Jul 2020 B2
10702271 Aranyi et al. Jul 2020 B2
10709446 Harris et al. Jul 2020 B2
10716489 Kalvoy et al. Jul 2020 B2
10716615 Shelton, IV et al. Jul 2020 B2
10716639 Kapadia et al. Jul 2020 B2
10717194 Griffiths et al. Jul 2020 B2
10722222 Aranyi Jul 2020 B2
10722233 Wellman Jul 2020 B2
10722292 Arya et al. Jul 2020 B2
D893717 Messerly et al. Aug 2020 S
10729458 Stoddard et al. Aug 2020 B2
10729509 Shelton, IV et al. Aug 2020 B2
10733267 Pedersen Aug 2020 B2
10736219 Seow et al. Aug 2020 B2
10736616 Scheib et al. Aug 2020 B2
10736628 Yates et al. Aug 2020 B2
10736629 Shelton, IV et al. Aug 2020 B2
10736636 Baxter, III et al. Aug 2020 B2
10736705 Scheib et al. Aug 2020 B2
10743872 Leimbach et al. Aug 2020 B2
10748115 Laster et al. Aug 2020 B2
10751052 Stokes et al. Aug 2020 B2
10751136 Farritor et al. Aug 2020 B2
10751768 Hersey et al. Aug 2020 B2
10755813 Shelton, IV et al. Aug 2020 B2
D896379 Shelton, IV et al. Sep 2020 S
10758229 Shelton, IV et al. Sep 2020 B2
10758230 Shelton, IV et al. Sep 2020 B2
10758294 Jones Sep 2020 B2
10758310 Shelton, IV et al. Sep 2020 B2
10765376 Brown, III et al. Sep 2020 B2
10765424 Baxter, III et al. Sep 2020 B2
10765427 Shelton, IV et al. Sep 2020 B2
10765470 Yates et al. Sep 2020 B2
10772630 Wixey Sep 2020 B2
10772651 Shelton, IV et al. Sep 2020 B2
10772673 Allen, IV et al. Sep 2020 B2
10772688 Peine et al. Sep 2020 B2
10779818 Zemlok et al. Sep 2020 B2
10779821 Harris et al. Sep 2020 B2
10779823 Shelton, IV et al. Sep 2020 B2
10779897 Rockrohr Sep 2020 B2
10779900 Pedros et al. Sep 2020 B2
10783634 Nye et al. Sep 2020 B2
10786298 Johnson Sep 2020 B2
10786317 Zhou et al. Sep 2020 B2
10786327 Anderson et al. Sep 2020 B2
10792038 Becerra et al. Oct 2020 B2
10792118 Prpa et al. Oct 2020 B2
10792422 Douglas et al. Oct 2020 B2
10799304 Kapadia et al. Oct 2020 B2
10803977 Sanmugalingham Oct 2020 B2
10806445 Penna et al. Oct 2020 B2
10806453 Chen et al. Oct 2020 B2
10806454 Kopp Oct 2020 B2
10806499 Castaneda et al. Oct 2020 B2
10806506 Gaspredes et al. Oct 2020 B2
10806532 Grubbs et al. Oct 2020 B2
10813638 Shelton, IV et al. Oct 2020 B2
10813703 Swayze et al. Oct 2020 B2
10818383 Sedeh et al. Oct 2020 B2
10828028 Harris et al. Nov 2020 B2
10828030 Weir et al. Nov 2020 B2
10835206 Bell et al. Nov 2020 B2
10835245 Swayze et al. Nov 2020 B2
10835246 Shelton, IV et al. Nov 2020 B2
10835247 Shelton, IV et al. Nov 2020 B2
10842473 Scheib et al. Nov 2020 B2
10842490 DiNardo et al. Nov 2020 B2
10842492 Shelton, IV et al. Nov 2020 B2
10842522 Messerly et al. Nov 2020 B2
10842523 Shelton, IV et al. Nov 2020 B2
10842575 Panescu et al. Nov 2020 B2
10842897 Schwartz et al. Nov 2020 B2
D904612 Wynn et al. Dec 2020 S
10849697 Yates et al. Dec 2020 B2
10849700 Kopp et al. Dec 2020 B2
10856768 Osadchy et al. Dec 2020 B2
10856867 Shelton, IV et al. Dec 2020 B2
10856868 Shelton, IV et al. Dec 2020 B2
10856870 Harris et al. Dec 2020 B2
10863984 Shelton, IV et al. Dec 2020 B2
10864037 Mun et al. Dec 2020 B2
10864050 Tabandeh et al. Dec 2020 B2
10872684 McNutt et al. Dec 2020 B2
10881399 Shelton, IV et al. Jan 2021 B2
10881401 Baber et al. Jan 2021 B2
10881446 Strobl Jan 2021 B2
10881464 Odermatt et al. Jan 2021 B2
10888321 Shelton, IV et al. Jan 2021 B2
10888322 Morgan et al. Jan 2021 B2
10892899 Shelton, IV et al. Jan 2021 B2
10892995 Shelton, IV et al. Jan 2021 B2
10893863 Shelton, IV et al. Jan 2021 B2
10893864 Harris et al. Jan 2021 B2
10893884 Stoddard et al. Jan 2021 B2
10898183 Shelton, IV et al. Jan 2021 B2
10898186 Bakos et al. Jan 2021 B2
10898189 McDonald, II Jan 2021 B2
10898256 Yates et al. Jan 2021 B2
10898280 Kopp Jan 2021 B2
10898622 Shelton, IV et al. Jan 2021 B2
10902944 Casey et al. Jan 2021 B1
10903685 Yates et al. Jan 2021 B2
10905415 DiNardo et al. Feb 2021 B2
10905418 Shelton, IV et al. Feb 2021 B2
10905420 Jasemian et al. Feb 2021 B2
10912559 Harris et al. Feb 2021 B2
10912567 Shelton, IV et al. Feb 2021 B2
10912580 Green et al. Feb 2021 B2
10912619 Jarc et al. Feb 2021 B2
10916415 Karancsi et al. Feb 2021 B2
D914878 Shelton, IV et al. Mar 2021 S
10932784 Mozdzierz et al. Mar 2021 B2
10950982 Regnier et al. Mar 2021 B2
10952732 Binmoeller et al. Mar 2021 B2
10966590 Takahashi et al. Apr 2021 B2
10980595 Wham Apr 2021 B2
11000276 Shelton, IV et al. May 2021 B2
11051817 Shelton, IV et al. Jul 2021 B2
11051902 Kruecker et al. Jul 2021 B2
11058501 Tokarchuk et al. Jul 2021 B2
11071595 Johnson et al. Jul 2021 B2
11141213 Yates et al. Oct 2021 B2
11185325 Shelton, IV et al. Nov 2021 B2
11273290 Kowshik Mar 2022 B2
D950728 Bakos et al. May 2022 S
D952144 Boudreaux May 2022 S
11382715 Arai et al. Jul 2022 B2
D964564 Boudreaux Sep 2022 S
20010056237 Cane et al. Dec 2001 A1
20020049551 Friedman et al. Apr 2002 A1
20020052616 Wiener et al. May 2002 A1
20020072746 Lingenfelder Jun 2002 A1
20020138642 Miyazawa et al. Sep 2002 A1
20020169584 Fu et al. Nov 2002 A1
20030009111 Cory et al. Jan 2003 A1
20030009154 Whitman Jan 2003 A1
20030018329 Hooven Jan 2003 A1
20030046109 Uchikubo Mar 2003 A1
20030069573 Kadhiresan et al. Apr 2003 A1
20030093503 Yamaki et al. May 2003 A1
20030114851 Truckai et al. Jun 2003 A1
20030130711 Pearson et al. Jul 2003 A1
20030210812 Khamene et al. Nov 2003 A1
20030223877 Anstine et al. Dec 2003 A1
20040015053 Bieger et al. Jan 2004 A1
20040078236 Stoodley et al. Apr 2004 A1
20040108825 Lee et al. Jun 2004 A1
20040199180 Knodel et al. Oct 2004 A1
20040199659 Ishikawa et al. Oct 2004 A1
20040206365 Knowlton Oct 2004 A1
20040229496 Robinson et al. Nov 2004 A1
20040243147 Lipow Dec 2004 A1
20040243148 Wasielewski Dec 2004 A1
20040243435 Williams Dec 2004 A1
20050020909 Moctezuma de la Barrera et al. Jan 2005 A1
20050020918 Wilk et al. Jan 2005 A1
20050021027 Shields et al. Jan 2005 A1
20050023324 Doll et al. Feb 2005 A1
20050063575 Ma et al. Mar 2005 A1
20050065438 Miller Mar 2005 A1
20050070800 Takahashi Mar 2005 A1
20050100867 Hilscher et al. May 2005 A1
20050131390 Heinrich et al. Jun 2005 A1
20050139629 Schwemberger et al. Jun 2005 A1
20050143759 Kelly Jun 2005 A1
20050148854 Ito et al. Jul 2005 A1
20050149001 Uchikubo et al. Jul 2005 A1
20050149356 Cyr et al. Jul 2005 A1
20050165390 Mauti et al. Jul 2005 A1
20050182655 Merzlak et al. Aug 2005 A1
20050192633 Montpetit Sep 2005 A1
20050203380 Sauer et al. Sep 2005 A1
20050203384 Sati et al. Sep 2005 A1
20050203504 Wham et al. Sep 2005 A1
20050213832 Schofield et al. Sep 2005 A1
20050222631 Dalal et al. Oct 2005 A1
20050228246 Lee et al. Oct 2005 A1
20050228425 Boukhny et al. Oct 2005 A1
20050236474 Onuma et al. Oct 2005 A1
20050251233 Kanzius Nov 2005 A1
20050277913 McCary Dec 2005 A1
20060020272 Gildenberg Jan 2006 A1
20060025816 Shelton Feb 2006 A1
20060059018 Shiobara et al. Mar 2006 A1
20060069388 Truckai Mar 2006 A1
20060079872 Eggleston Apr 2006 A1
20060079874 Faller et al. Apr 2006 A1
20060116908 Dew et al. Jun 2006 A1
20060136622 Rouvelin et al. Jun 2006 A1
20060142739 DiSilestro et al. Jun 2006 A1
20060184160 Ozaki et al. Aug 2006 A1
20060241399 Fabian Oct 2006 A1
20060282009 Oberg et al. Dec 2006 A1
20060287645 Tashiro et al. Dec 2006 A1
20070010838 Shelton et al. Jan 2007 A1
20070016235 Tanaka et al. Jan 2007 A1
20070016979 Damaj et al. Jan 2007 A1
20070027459 Horvath et al. Feb 2007 A1
20070038080 Salisbury et al. Feb 2007 A1
20070049947 Menn et al. Mar 2007 A1
20070066970 Ineson Mar 2007 A1
20070078678 DiSilvestro et al. Apr 2007 A1
20070084896 Doll et al. Apr 2007 A1
20070085528 Govari et al. Apr 2007 A1
20070156019 Larkin et al. Jul 2007 A1
20070167702 Hasser et al. Jul 2007 A1
20070168461 Moore Jul 2007 A1
20070173803 Wham et al. Jul 2007 A1
20070175955 Shelton et al. Aug 2007 A1
20070179482 Anderson Aug 2007 A1
20070179508 Arndt Aug 2007 A1
20070191713 Eichmann et al. Aug 2007 A1
20070192139 Cookson et al. Aug 2007 A1
20070203744 Scholl Aug 2007 A1
20070225556 Ortiz et al. Sep 2007 A1
20070225690 Sekiguchi et al. Sep 2007 A1
20070239028 Houser et al. Oct 2007 A1
20070244478 Bahney Oct 2007 A1
20070249990 Cosmescu Oct 2007 A1
20070270660 Caylor et al. Nov 2007 A1
20070282195 Masini et al. Dec 2007 A1
20070282321 Shah et al. Dec 2007 A1
20070282333 Fortson et al. Dec 2007 A1
20070293218 Meylan et al. Dec 2007 A1
20080013460 Allen et al. Jan 2008 A1
20080015664 Podhajsky Jan 2008 A1
20080015912 Rosenthal et al. Jan 2008 A1
20080019393 Yamaki Jan 2008 A1
20080033404 Romoda et al. Feb 2008 A1
20080039742 Hashimshony et al. Feb 2008 A1
20080040151 Moore Feb 2008 A1
20080058593 Gu et al. Mar 2008 A1
20080059658 Williams Mar 2008 A1
20080077158 Haider et al. Mar 2008 A1
20080083414 Messerges Apr 2008 A1
20080091071 Kumar et al. Apr 2008 A1
20080114212 Messerges May 2008 A1
20080114350 Park et al. May 2008 A1
20080129465 Rao Jun 2008 A1
20080140090 Aranyi et al. Jun 2008 A1
20080167644 Shelton et al. Jul 2008 A1
20080177258 Govari et al. Jul 2008 A1
20080177362 Phillips et al. Jul 2008 A1
20080200940 Eichmann et al. Aug 2008 A1
20080223904 Marczyk Sep 2008 A1
20080234708 Houser et al. Sep 2008 A1
20080235052 Node-Langlois et al. Sep 2008 A1
20080255413 Zemlok et al. Oct 2008 A1
20080262654 Omori et al. Oct 2008 A1
20080272172 Zemlok et al. Nov 2008 A1
20080281301 DeBoer et al. Nov 2008 A1
20080281678 Keuls et al. Nov 2008 A1
20080296346 Shelton, IV et al. Dec 2008 A1
20080306759 Ilkin et al. Dec 2008 A1
20080312953 Claus Dec 2008 A1
20090017910 Rofougaran et al. Jan 2009 A1
20090030437 Houser et al. Jan 2009 A1
20090036750 Weinstein et al. Feb 2009 A1
20090036794 Stubhaug et al. Feb 2009 A1
20090043253 Podaima Feb 2009 A1
20090046146 Hoyt Feb 2009 A1
20090048589 Takashino et al. Feb 2009 A1
20090048611 Funda et al. Feb 2009 A1
20090076409 Wu et al. Mar 2009 A1
20090090763 Zemlok et al. Apr 2009 A1
20090099866 Newman Apr 2009 A1
20090114699 Viola May 2009 A1
20090128084 Johnson et al. May 2009 A1
20090182577 Squilla et al. Jul 2009 A1
20090206131 Weisenburgh, II et al. Aug 2009 A1
20090217932 Voegele Sep 2009 A1
20090234352 Behnke et al. Sep 2009 A1
20090259149 Tahara et al. Oct 2009 A1
20090259221 Tahara et al. Oct 2009 A1
20090259489 Kimura et al. Oct 2009 A1
20090270678 Scott et al. Oct 2009 A1
20090299214 Wu et al. Dec 2009 A1
20090306581 Claus Dec 2009 A1
20090307681 Armado et al. Dec 2009 A1
20090326321 Jacobsen et al. Dec 2009 A1
20090326336 Lemke et al. Dec 2009 A1
20100036374 Ward Feb 2010 A1
20100036405 Giordano et al. Feb 2010 A1
20100038403 D'Arcangelo Feb 2010 A1
20100057106 Sorrentino et al. Mar 2010 A1
20100065604 Weng Mar 2010 A1
20100069939 Konishi Mar 2010 A1
20100069942 Shelton, IV Mar 2010 A1
20100070417 Flynn et al. Mar 2010 A1
20100120266 Rimborg May 2010 A1
20100132334 Duclos et al. Jun 2010 A1
20100137845 Ramstein et al. Jun 2010 A1
20100137886 Zergiebel et al. Jun 2010 A1
20100168561 Anderson Jul 2010 A1
20100179831 Brown et al. Jul 2010 A1
20100191100 Anderson et al. Jul 2010 A1
20100198200 Horvath Aug 2010 A1
20100198248 Vakharia Aug 2010 A1
20100204717 Knodel Aug 2010 A1
20100217991 Choi Aug 2010 A1
20100234996 Schreiber et al. Sep 2010 A1
20100235689 Tian et al. Sep 2010 A1
20100250571 Pierce et al. Sep 2010 A1
20100258327 Esenwein et al. Oct 2010 A1
20100292535 Paskar Nov 2010 A1
20100292684 Cybulski et al. Nov 2010 A1
20100301095 Shelton, IV et al. Dec 2010 A1
20110022032 Zemlok et al. Jan 2011 A1
20110036890 Ma Feb 2011 A1
20110043612 Keller et al. Feb 2011 A1
20110046618 Minar et al. Feb 2011 A1
20110071530 Carson Mar 2011 A1
20110077512 Boswell Mar 2011 A1
20110087238 Wang et al. Apr 2011 A1
20110087502 Yelton et al. Apr 2011 A1
20110105277 Shauli May 2011 A1
20110105895 Kornblau et al. May 2011 A1
20110112569 Friedman May 2011 A1
20110118708 Burbank et al. May 2011 A1
20110119075 Dhoble May 2011 A1
20110125149 El-Galley et al. May 2011 A1
20110152712 Cao et al. Jun 2011 A1
20110163147 Laurent et al. Jul 2011 A1
20110166883 Palmer et al. Jul 2011 A1
20110196398 Robertson et al. Aug 2011 A1
20110237883 Chun Sep 2011 A1
20110251612 Faller et al. Oct 2011 A1
20110264000 Paul et al. Oct 2011 A1
20110264078 Lipow et al. Oct 2011 A1
20110265311 Kondo et al. Nov 2011 A1
20110273465 Konishi et al. Nov 2011 A1
20110278343 Knodel et al. Nov 2011 A1
20110290024 Lefler Dec 2011 A1
20110295270 Giordano et al. Dec 2011 A1
20110306840 Allen et al. Dec 2011 A1
20120012638 Huang et al. Jan 2012 A1
20120021684 Schultz et al. Jan 2012 A1
20120022519 Huang et al. Jan 2012 A1
20120029354 Mark et al. Feb 2012 A1
20120046662 Gilbert Feb 2012 A1
20120059684 Hampapur et al. Mar 2012 A1
20120078247 Worrell Mar 2012 A1
20120080336 Shelton, IV et al. Apr 2012 A1
20120083786 Artale et al. Apr 2012 A1
20120100517 Bowditch et al. Apr 2012 A1
20120101488 Aldridge et al. Apr 2012 A1
20120116265 Houser et al. May 2012 A1
20120116381 Houser et al. May 2012 A1
20120116394 Timm et al. May 2012 A1
20120130217 Kauphusman et al. May 2012 A1
20120145714 Farascioni et al. Jun 2012 A1
20120172696 Kallback et al. Jul 2012 A1
20120190981 Harris et al. Jul 2012 A1
20120191091 Allen Jul 2012 A1
20120191162 Villa Jul 2012 A1
20120197619 Namer Yelin et al. Aug 2012 A1
20120203067 Higgins et al. Aug 2012 A1
20120203785 Awada Aug 2012 A1
20120211542 Racenet Aug 2012 A1
20120226150 Balicki et al. Sep 2012 A1
20120245958 Lawrence et al. Sep 2012 A1
20120253329 Zemlok et al. Oct 2012 A1
20120253847 Dell'Anno et al. Oct 2012 A1
20120265555 Cappuzzo et al. Oct 2012 A1
20120292367 Morgan et al. Nov 2012 A1
20120319859 Taub et al. Dec 2012 A1
20130001121 Metzger Jan 2013 A1
20130006241 Takashino Jan 2013 A1
20130008677 Huifu Jan 2013 A1
20130024213 Poon Jan 2013 A1
20130046182 Hegg et al. Feb 2013 A1
20130046279 Niklewski et al. Feb 2013 A1
20130046295 Kerr et al. Feb 2013 A1
20130066647 Andrie et al. Mar 2013 A1
20130090526 Suzuki et al. Apr 2013 A1
20130090755 Kiryu et al. Apr 2013 A1
20130093829 Rosenblatt et al. Apr 2013 A1
20130096597 Anand et al. Apr 2013 A1
20130116218 Kaplan et al. May 2013 A1
20130131845 Guilleminot May 2013 A1
20130144284 Behnke, II et al. Jun 2013 A1
20130153635 Hodgkinson Jun 2013 A1
20130165776 Blomqvist Jun 2013 A1
20130178853 Hyink et al. Jul 2013 A1
20130191647 Ferrara, Jr. et al. Jul 2013 A1
20130193188 Shelton, IV et al. Aug 2013 A1
20130197531 Boukhny et al. Aug 2013 A1
20130201356 Kennedy et al. Aug 2013 A1
20130206813 Nalagatla Aug 2013 A1
20130214025 Zemlok et al. Aug 2013 A1
20130253480 Kimball et al. Sep 2013 A1
20130256373 Schmid et al. Oct 2013 A1
20130267874 Marcotte et al. Oct 2013 A1
20130268283 Vann et al. Oct 2013 A1
20130277410 Fernandez et al. Oct 2013 A1
20130317837 Ballantyne et al. Nov 2013 A1
20130321425 Greene et al. Dec 2013 A1
20130325809 Kim et al. Dec 2013 A1
20130331873 Ross et al. Dec 2013 A1
20130331875 Ross et al. Dec 2013 A1
20140001231 Shelton, IV et al. Jan 2014 A1
20140001234 Shelton, IV et al. Jan 2014 A1
20140005640 Shelton, IV et al. Jan 2014 A1
20140006132 Barker Jan 2014 A1
20140006943 Robbins et al. Jan 2014 A1
20140009894 Yu Jan 2014 A1
20140013565 MacDonald et al. Jan 2014 A1
20140018788 Engelman et al. Jan 2014 A1
20140029411 Nayak et al. Jan 2014 A1
20140033926 Fassel et al. Feb 2014 A1
20140035762 Shelton, IV et al. Feb 2014 A1
20140066700 Wilson et al. Mar 2014 A1
20140073893 Bencini Mar 2014 A1
20140074076 Gertner Mar 2014 A1
20140081255 Johnson et al. Mar 2014 A1
20140081659 Nawana et al. Mar 2014 A1
20140084949 Smith et al. Mar 2014 A1
20140087999 Kaplan et al. Mar 2014 A1
20140092089 Kasuya et al. Apr 2014 A1
20140107697 Patani et al. Apr 2014 A1
20140108035 Akbay et al. Apr 2014 A1
20140108983 William R. et al. Apr 2014 A1
20140117256 Mueller et al. May 2014 A1
20140121669 Claus May 2014 A1
20140148729 Schmitz et al. May 2014 A1
20140148803 Taylor May 2014 A1
20140163359 Sholev et al. Jun 2014 A1
20140166724 Schellin et al. Jun 2014 A1
20140171778 Tsusaka et al. Jun 2014 A1
20140176576 Spencer Jun 2014 A1
20140187856 Holoien et al. Jul 2014 A1
20140188440 Donhowe et al. Jul 2014 A1
20140194864 Martin et al. Jul 2014 A1
20140195052 Tsusaka et al. Jul 2014 A1
20140204190 Rosenblatt, III et al. Jul 2014 A1
20140226572 Thota et al. Aug 2014 A1
20140243799 Parihar Aug 2014 A1
20140243809 Gelfand et al. Aug 2014 A1
20140243811 Reschke et al. Aug 2014 A1
20140246475 Hall et al. Sep 2014 A1
20140249557 Koch et al. Sep 2014 A1
20140252064 Mozdzierz et al. Sep 2014 A1
20140263541 Leimbach et al. Sep 2014 A1
20140263552 Hall et al. Sep 2014 A1
20140275760 Lee et al. Sep 2014 A1
20140276749 Johnson Sep 2014 A1
20140287393 Kumar et al. Sep 2014 A1
20140296694 Jaworski Oct 2014 A1
20140303660 Boyden et al. Oct 2014 A1
20140303990 Schoenefeld et al. Oct 2014 A1
20140336943 Pellini et al. Nov 2014 A1
20140337052 Pellini et al. Nov 2014 A1
20140364691 Krivopisk et al. Dec 2014 A1
20150006201 Pait et al. Jan 2015 A1
20150025549 Kilroy et al. Jan 2015 A1
20150032150 Ishida et al. Jan 2015 A1
20150051452 Ciaccio Feb 2015 A1
20150051598 Orszulak et al. Feb 2015 A1
20150051617 Takemura et al. Feb 2015 A1
20150053737 Leimbach et al. Feb 2015 A1
20150053743 Yates et al. Feb 2015 A1
20150057675 Akeel et al. Feb 2015 A1
20150062316 Haraguchi et al. Mar 2015 A1
20150066000 An et al. Mar 2015 A1
20150070187 Wiesner et al. Mar 2015 A1
20150073400 Sverdlik et al. Mar 2015 A1
20150077528 Awdeh Mar 2015 A1
20150083774 Measamer et al. Mar 2015 A1
20150108198 Estrella Apr 2015 A1
20150133945 Dushyant et al. May 2015 A1
20150136833 Shelton, IV et al. May 2015 A1
20150140982 Postrel May 2015 A1
20150145682 Harris May 2015 A1
20150148830 Stulen et al. May 2015 A1
20150157354 Bales, Jr. et al. Jun 2015 A1
20150173673 Toth et al. Jun 2015 A1
20150173756 Baxter, III et al. Jun 2015 A1
20150182220 Yates et al. Jul 2015 A1
20150196295 Shelton, IV et al. Jul 2015 A1
20150199109 Lee Jul 2015 A1
20150201918 Kumar et al. Jul 2015 A1
20150202014 Kim et al. Jul 2015 A1
20150208934 Sztrubel et al. Jul 2015 A1
20150223725 Engel et al. Aug 2015 A1
20150223868 Brandt et al. Aug 2015 A1
20150237502 Schmidt et al. Aug 2015 A1
20150238355 Vezzu et al. Aug 2015 A1
20150272557 Overmyer et al. Oct 2015 A1
20150272571 Leimbach et al. Oct 2015 A1
20150272580 Leimbach et al. Oct 2015 A1
20150272582 Leimbach et al. Oct 2015 A1
20150272694 Charles Oct 2015 A1
20150282821 Look et al. Oct 2015 A1
20150296042 Aoyama Oct 2015 A1
20150297200 Fitzsimmons et al. Oct 2015 A1
20150297222 Huitema et al. Oct 2015 A1
20150297228 Huitema et al. Oct 2015 A1
20150297233 Huitema et al. Oct 2015 A1
20150297311 Tesar Oct 2015 A1
20150302157 Collar et al. Oct 2015 A1
20150310174 Coudert et al. Oct 2015 A1
20150313538 Bechtel et al. Nov 2015 A1
20150317899 Dumbauld et al. Nov 2015 A1
20150320423 Aranyi Nov 2015 A1
20150324114 Hurley et al. Nov 2015 A1
20150328474 Flyash et al. Nov 2015 A1
20150332003 Stamm et al. Nov 2015 A1
20150332196 Stiller et al. Nov 2015 A1
20150335344 Aljuri et al. Nov 2015 A1
20150374259 Garbey et al. Dec 2015 A1
20160000437 Giordano et al. Jan 2016 A1
20160001411 Alberti Jan 2016 A1
20160015471 Piron et al. Jan 2016 A1
20160022374 Haider et al. Jan 2016 A1
20160034648 Mohlenbrock et al. Feb 2016 A1
20160038224 Couture et al. Feb 2016 A1
20160038253 Piron et al. Feb 2016 A1
20160048780 Sethumadhavan et al. Feb 2016 A1
20160058439 Shelton, IV et al. Mar 2016 A1
20160066913 Swayze et al. Mar 2016 A1
20160078190 Greene et al. Mar 2016 A1
20160100837 Huang et al. Apr 2016 A1
20160106516 Mesallum Apr 2016 A1
20160106934 Hiraga et al. Apr 2016 A1
20160121143 Mumaw et al. May 2016 A1
20160157717 Gaster Jun 2016 A1
20160158468 Tang et al. Jun 2016 A1
20160166336 Razzaque et al. Jun 2016 A1
20160174998 Lal et al. Jun 2016 A1
20160175025 Strobl Jun 2016 A1
20160180045 Syed Jun 2016 A1
20160182637 Adriaens et al. Jun 2016 A1
20160184054 Lowe Jun 2016 A1
20160192960 Bueno et al. Jul 2016 A1
20160203599 Gillies et al. Jul 2016 A1
20160206202 Frangioni Jul 2016 A1
20160206362 Mehta et al. Jul 2016 A1
20160224760 Petak et al. Aug 2016 A1
20160225551 Shedletsky Aug 2016 A1
20160228061 Kallback et al. Aug 2016 A1
20160228204 Quaid et al. Aug 2016 A1
20160235303 Fleming et al. Aug 2016 A1
20160242836 Eggers et al. Aug 2016 A1
20160249910 Shelton, IV et al. Sep 2016 A1
20160249920 Gupta et al. Sep 2016 A1
20160270861 Guru et al. Sep 2016 A1
20160275259 Nolan et al. Sep 2016 A1
20160278841 Panescu et al. Sep 2016 A1
20160287312 Tegg et al. Oct 2016 A1
20160287316 Worrell et al. Oct 2016 A1
20160287912 Warnking Oct 2016 A1
20160292456 Dubey et al. Oct 2016 A1
20160296246 Schaller Oct 2016 A1
20160302210 Thornton et al. Oct 2016 A1
20160310055 Zand et al. Oct 2016 A1
20160310204 Mchenry et al. Oct 2016 A1
20160314716 Grubbs Oct 2016 A1
20160314717 Grubbs Oct 2016 A1
20160321400 Durrant et al. Nov 2016 A1
20160323283 Kang et al. Nov 2016 A1
20160331460 Cheatham, III et al. Nov 2016 A1
20160342753 Feazell Nov 2016 A1
20160342916 Arceneaux et al. Nov 2016 A1
20160345857 Jensrud et al. Dec 2016 A1
20160345976 Gonzalez et al. Dec 2016 A1
20160350490 Martinez et al. Dec 2016 A1
20160354160 Crowley et al. Dec 2016 A1
20160354162 Yen et al. Dec 2016 A1
20160361070 Ardel et al. Dec 2016 A1
20160367305 Hareland Dec 2016 A1
20160367401 Claus Dec 2016 A1
20160374710 Sinelnikov et al. Dec 2016 A1
20160374723 Frankhouser et al. Dec 2016 A1
20160374762 Case et al. Dec 2016 A1
20160379504 Bailey et al. Dec 2016 A1
20170000516 Stulen et al. Jan 2017 A1
20170000553 Wiener et al. Jan 2017 A1
20170005911 Kasargod et al. Jan 2017 A1
20170007247 Shelton, IV et al. Jan 2017 A1
20170027603 Pandey Feb 2017 A1
20170042604 McFarland et al. Feb 2017 A1
20170068792 Reiner Mar 2017 A1
20170079530 DiMaio et al. Mar 2017 A1
20170079730 Azizian et al. Mar 2017 A1
20170086829 Vendely et al. Mar 2017 A1
20170086930 Thompson et al. Mar 2017 A1
20170105754 Boudreaux et al. Apr 2017 A1
20170105787 Witt et al. Apr 2017 A1
20170116873 Lendvay et al. Apr 2017 A1
20170127499 Unoson et al. May 2017 A1
20170132374 Lee et al. May 2017 A1
20170132385 Hunter et al. May 2017 A1
20170132785 Wshah et al. May 2017 A1
20170143284 Sehnert et al. May 2017 A1
20170143442 Tesar et al. May 2017 A1
20170156076 Eom et al. Jun 2017 A1
20170164997 Johnson et al. Jun 2017 A1
20170165008 Finley Jun 2017 A1
20170165012 Chaplin et al. Jun 2017 A1
20170172550 Mukherjee et al. Jun 2017 A1
20170172565 Heneveld Jun 2017 A1
20170172614 Scheib et al. Jun 2017 A1
20170172674 Hanuschik et al. Jun 2017 A1
20170172676 Itkowitz et al. Jun 2017 A1
20170173262 Veltz Jun 2017 A1
20170177807 Fabian Jun 2017 A1
20170178069 Paterra et al. Jun 2017 A1
20170185732 Niklewski et al. Jun 2017 A1
20170196583 Sugiyama Jul 2017 A1
20170196637 Shelton, IV et al. Jul 2017 A1
20170202591 Shelton, IV et al. Jul 2017 A1
20170202595 Shelton, IV Jul 2017 A1
20170202607 Shelton, IV et al. Jul 2017 A1
20170202608 Shelton, IV et al. Jul 2017 A1
20170209145 Swayze et al. Jul 2017 A1
20170215944 Keffeler Aug 2017 A1
20170224332 Hunter et al. Aug 2017 A1
20170224334 Worthington et al. Aug 2017 A1
20170224428 Kopp Aug 2017 A1
20170231553 Igarashi et al. Aug 2017 A1
20170231627 Shelton, IV et al. Aug 2017 A1
20170231628 Shelton, IV et al. Aug 2017 A1
20170245809 Ma et al. Aug 2017 A1
20170249431 Shelton, IV et al. Aug 2017 A1
20170249432 Grantcharov Aug 2017 A1
20170262604 Francois Sep 2017 A1
20170265864 Hessler et al. Sep 2017 A1
20170265943 Sela et al. Sep 2017 A1
20170273715 Piron et al. Sep 2017 A1
20170281171 Shelton, IV et al. Oct 2017 A1
20170281173 Shelton, IV et al. Oct 2017 A1
20170281186 Shelton, IV et al. Oct 2017 A1
20170281189 Nalagatla et al. Oct 2017 A1
20170290585 Shelton, IV et al. Oct 2017 A1
20170296169 Yates et al. Oct 2017 A1
20170296173 Shelton, IV et al. Oct 2017 A1
20170296185 Swensgard et al. Oct 2017 A1
20170296213 Swensgard et al. Oct 2017 A1
20170303984 Malackowskl Oct 2017 A1
20170304007 Piron et al. Oct 2017 A1
20170304020 Ng et al. Oct 2017 A1
20170311777 Hirayama et al. Nov 2017 A1
20170312456 Phillips Nov 2017 A1
20170325876 Nakadate et al. Nov 2017 A1
20170325878 Messerly et al. Nov 2017 A1
20170333152 Wade Nov 2017 A1
20170337043 Brincat et al. Nov 2017 A1
20170360358 Amiot et al. Dec 2017 A1
20170360499 Greep et al. Dec 2017 A1
20170367583 Black et al. Dec 2017 A1
20170367695 Shelton, IV et al. Dec 2017 A1
20170367754 Narisawa Dec 2017 A1
20170367771 Tako et al. Dec 2017 A1
20170367772 Gunn et al. Dec 2017 A1
20170370710 Chen et al. Dec 2017 A1
20180008359 Randle Jan 2018 A1
20180011983 Zuhars et al. Jan 2018 A1
20180021058 Meglan Jan 2018 A1
20180042659 Rupp et al. Feb 2018 A1
20180050196 Pawsey et al. Feb 2018 A1
20180052971 Hanina et al. Feb 2018 A1
20180055529 Messerly et al. Mar 2018 A1
20180065248 Barral et al. Mar 2018 A1
20180078170 Panescu et al. Mar 2018 A1
20180098049 Sugano et al. Apr 2018 A1
20180098816 Govari et al. Apr 2018 A1
20180108438 Ryan et al. Apr 2018 A1
20180110523 Shelton, IV Apr 2018 A1
20180116662 Shelton, IV et al. May 2018 A1
20180116735 Tierney et al. May 2018 A1
20180122506 Grantcharov et al. May 2018 A1
20180125590 Giordano et al. May 2018 A1
20180132895 Silver May 2018 A1
20180144243 Hsieh et al. May 2018 A1
20180153436 Olson Jun 2018 A1
20180153574 Faller et al. Jun 2018 A1
20180153628 Grover et al. Jun 2018 A1
20180153632 Tokarchuk et al. Jun 2018 A1
20180154297 Maletich et al. Jun 2018 A1
20180161062 Kaga et al. Jun 2018 A1
20180161716 Li et al. Jun 2018 A1
20180165780 Romeo Jun 2018 A1
20180168574 Robinson et al. Jun 2018 A1
20180168575 Simms et al. Jun 2018 A1
20180168577 Aronhalt et al. Jun 2018 A1
20180168578 Aronhalt et al. Jun 2018 A1
20180168579 Aronhalt et al. Jun 2018 A1
20180168584 Harris et al. Jun 2018 A1
20180168586 Shelton, IV et al. Jun 2018 A1
20180168590 Overmyer et al. Jun 2018 A1
20180168592 Overmyer et al. Jun 2018 A1
20180168593 Overmyer et al. Jun 2018 A1
20180168597 Fanelli et al. Jun 2018 A1
20180168598 Shelton, IV et al. Jun 2018 A1
20180168608 Shelton, IV et al. Jun 2018 A1
20180168609 Fanelli et al. Jun 2018 A1
20180168610 Shelton, IV et al. Jun 2018 A1
20180168614 Shelton, IV et al. Jun 2018 A1
20180168615 Shelton, IV et al. Jun 2018 A1
20180168617 Shelton, IV et al. Jun 2018 A1
20180168618 Scott et al. Jun 2018 A1
20180168619 Scott et al. Jun 2018 A1
20180168623 Simms et al. Jun 2018 A1
20180168625 Posada et al. Jun 2018 A1
20180168627 Weaner et al. Jun 2018 A1
20180168628 Hunter et al. Jun 2018 A1
20180168633 Shelton, IV et al. Jun 2018 A1
20180168647 Shelton, IV et al. Jun 2018 A1
20180168648 Shelton, IV et al. Jun 2018 A1
20180168649 Shelton, IV et al. Jun 2018 A1
20180168650 Shelton, IV et al. Jun 2018 A1
20180168651 Shelton, IV et al. Jun 2018 A1
20180172420 Hein et al. Jun 2018 A1
20180177383 Noonan et al. Jun 2018 A1
20180182475 Cossler et al. Jun 2018 A1
20180183684 Jacobson et al. Jun 2018 A1
20180193579 Hanrahan et al. Jul 2018 A1
20180206884 Beaupre Jul 2018 A1
20180206905 Batchelor et al. Jul 2018 A1
20180211726 Courtemanche et al. Jul 2018 A1
20180214025 Homyk et al. Aug 2018 A1
20180221005 Hamel et al. Aug 2018 A1
20180221598 Silver Aug 2018 A1
20180228557 Darisse et al. Aug 2018 A1
20180233222 Daley et al. Aug 2018 A1
20180235719 Jarc Aug 2018 A1
20180235722 Baghdadi et al. Aug 2018 A1
20180242967 Meade Aug 2018 A1
20180247128 Alvi et al. Aug 2018 A1
20180247711 Terry Aug 2018 A1
20180250086 Grubbs Sep 2018 A1
20180250825 Hashimoto et al. Sep 2018 A1
20180263699 Murphy et al. Sep 2018 A1
20180263710 Sakaguchi et al. Sep 2018 A1
20180268320 Shekhar Sep 2018 A1
20180271520 Shelton, IV et al. Sep 2018 A1
20180271603 Nir et al. Sep 2018 A1
20180289427 Griffiths et al. Oct 2018 A1
20180294060 Kassab Oct 2018 A1
20180296286 Peine et al. Oct 2018 A1
20180296289 Rodriguez-Navarro et al. Oct 2018 A1
20180303552 Ryan et al. Oct 2018 A1
20180304471 Tokuchi Oct 2018 A1
20180310935 Wixey Nov 2018 A1
20180310986 Batchelor et al. Nov 2018 A1
20180315492 Bishop et al. Nov 2018 A1
20180317826 Muhsin et al. Nov 2018 A1
20180317916 Wixey Nov 2018 A1
20180333188 Nott et al. Nov 2018 A1
20180333207 Moctezuma De La Barrera Nov 2018 A1
20180333209 Frushour et al. Nov 2018 A1
20180351987 Patel et al. Dec 2018 A1
20180353186 Mozdzierz et al. Dec 2018 A1
20180357383 Allen et al. Dec 2018 A1
20180360454 Shelton, IV et al. Dec 2018 A1
20180360456 Shelton, IV et al. Dec 2018 A1
20180366213 Fidone et al. Dec 2018 A1
20180368930 Esterberg et al. Dec 2018 A1
20180369511 Zerglebel et al. Dec 2018 A1
20190000446 Shelton, IV et al. Jan 2019 A1
20190000478 Messerly et al. Jan 2019 A1
20190000565 Shelton, IV et al. Jan 2019 A1
20190000569 Crawford et al. Jan 2019 A1
20190001079 Zergiebel et al. Jan 2019 A1
20190005641 Yamamoto Jan 2019 A1
20190006047 Gorek et al. Jan 2019 A1
20190025040 Andreason et al. Jan 2019 A1
20190036688 Wasily et al. Jan 2019 A1
20190038335 Mohr et al. Feb 2019 A1
20190038364 Enoki Feb 2019 A1
20190045515 Kwasnick et al. Feb 2019 A1
20190046198 Stokes et al. Feb 2019 A1
20190053801 Wixey et al. Feb 2019 A1
20190053866 Seow et al. Feb 2019 A1
20190059986 Shelton, IV et al. Feb 2019 A1
20190069949 Vrba et al. Mar 2019 A1
20190069964 Hagn Mar 2019 A1
20190069966 Petersen et al. Mar 2019 A1
20190070550 Lalomia et al. Mar 2019 A1
20190070731 Bowling et al. Mar 2019 A1
20190083190 Graves et al. Mar 2019 A1
20190087544 Peterson Mar 2019 A1
20190099221 Schmidt et al. Apr 2019 A1
20190104919 Shelton, IV et al. Apr 2019 A1
20190110828 Despatie Apr 2019 A1
20190110855 Barral et al. Apr 2019 A1
20190115108 Hegedus et al. Apr 2019 A1
20190122330 Saget et al. Apr 2019 A1
20190125320 Shelton, IV et al. May 2019 A1
20190125321 Shelton, IV et al. May 2019 A1
20190125324 Scheib et al. May 2019 A1
20190125335 Shelton, IV et al. May 2019 A1
20190125336 Deck et al. May 2019 A1
20190125337 Shelton, IV et al. May 2019 A1
20190125338 Shelton, IV et al. May 2019 A1
20190125339 Shelton, IV et al. May 2019 A1
20190125347 Stokes et al. May 2019 A1
20190125348 Shelton, IV et al. May 2019 A1
20190125352 Shelton, IV et al. May 2019 A1
20190125353 Shelton, IV et al. May 2019 A1
20190125354 Deck et al. May 2019 A1
20190125355 Shelton, IV et al. May 2019 A1
20190125356 Shelton, IV et al. May 2019 A1
20190125357 Shelton, IV et al. May 2019 A1
20190125358 Shelton, IV et al. May 2019 A1
20190125359 Shelton, IV et al. May 2019 A1
20190125360 Shelton, IV et al. May 2019 A1
20190125361 Shelton, IV et al. May 2019 A1
20190125377 Shelton, IV May 2019 A1
20190125378 Shelton, IV et al. May 2019 A1
20190125379 Shelton, IV et al. May 2019 A1
20190125380 Hunter et al. May 2019 A1
20190125383 Scheib et al. May 2019 A1
20190125384 Scheib et al. May 2019 A1
20190125385 Scheib et al. May 2019 A1
20190125386 Shelton, IV et al. May 2019 A1
20190125387 Parihar et al. May 2019 A1
20190125388 Shelton, IV et al. May 2019 A1
20190125389 Shelton, IV et al. May 2019 A1
20190125431 Shelton, IV et al. May 2019 A1
20190125432 Shelton, IV et al. May 2019 A1
20190125454 Stokes et al. May 2019 A1
20190125455 Shelton, IV et al. May 2019 A1
20190125456 Shelton, IV et al. May 2019 A1
20190125457 Parihar et al. May 2019 A1
20190125458 Shelton, IV et al. May 2019 A1
20190125459 Shelton, IV et al. May 2019 A1
20190125476 Shelton, IV et al. May 2019 A1
20190133703 Seow et al. May 2019 A1
20190142449 Shelton, IV et al. May 2019 A1
20190142535 Seow et al. May 2019 A1
20190145942 Dutriez et al. May 2019 A1
20190150975 Kawasaki et al. May 2019 A1
20190159777 Ehrenfels et al. May 2019 A1
20190159778 Shelton, IV et al. May 2019 A1
20190162179 O'Shea et al. May 2019 A1
20190163875 Allen et al. May 2019 A1
20190167296 Tsubuku et al. Jun 2019 A1
20190192044 Ravi et al. Jun 2019 A1
20190192157 Scott et al. Jun 2019 A1
20190192236 Shelton, IV et al. Jun 2019 A1
20190200844 Shelton, IV et al. Jul 2019 A1
20190200863 Shelton, IV et al. Jul 2019 A1
20190200905 Shelton, IV et al. Jul 2019 A1
20190200906 Shelton, IV et al. Jul 2019 A1
20190200977 Shelton, IV et al. Jul 2019 A1
20190200980 Shelton, IV et al. Jul 2019 A1
20190200981 Harris et al. Jul 2019 A1
20190200984 Shelton, IV et al. Jul 2019 A1
20190200985 Shelton, IV et al. Jul 2019 A1
20190200986 Shelton, IV et al. Jul 2019 A1
20190200987 Shelton, IV et al. Jul 2019 A1
20190200988 Shelton, IV Jul 2019 A1
20190200996 Shelton, IV et al. Jul 2019 A1
20190200997 Shelton, IV et al. Jul 2019 A1
20190200998 Shelton, IV et al. Jul 2019 A1
20190201020 Shelton, IV et al. Jul 2019 A1
20190201021 Shelton, IV et al. Jul 2019 A1
20190201023 Shelton, IV et al. Jul 2019 A1
20190201024 Shelton, IV et al. Jul 2019 A1
20190201025 Shelton, IV et al. Jul 2019 A1
20190201026 Shelton, IV et al. Jul 2019 A1
20190201027 Shelton, IV et al. Jul 2019 A1
20190201028 Shelton, IV et al. Jul 2019 A1
20190201029 Shelton, IV et al. Jul 2019 A1
20190201030 Shelton, IV et al. Jul 2019 A1
20190201033 Yates et al. Jul 2019 A1
20190201034 Shelton, IV et al. Jul 2019 A1
20190201036 Nott et al. Jul 2019 A1
20190201037 Houser et al. Jul 2019 A1
20190201038 Yates et al. Jul 2019 A1
20190201039 Widenhouse et al. Jul 2019 A1
20190201040 Messerly et al. Jul 2019 A1
20190201041 Kimball et al. Jul 2019 A1
20190201042 Nott et al. Jul 2019 A1
20190201043 Shelton, IV et al. Jul 2019 A1
20190201044 Shelton, IV et al. Jul 2019 A1
20190201045 Yates et al. Jul 2019 A1
20190201046 Shelton, IV et al. Jul 2019 A1
20190201047 Yates et al. Jul 2019 A1
20190201073 Nott et al. Jul 2019 A1
20190201074 Yates et al. Jul 2019 A1
20190201075 Shelton, IV et al. Jul 2019 A1
20190201076 Honda et al. Jul 2019 A1
20190201077 Yates et al. Jul 2019 A1
20190201079 Shelton, IV et al. Jul 2019 A1
20190201080 Messerly et al. Jul 2019 A1
20190201081 Shelton, IV et al. Jul 2019 A1
20190201082 Shelton, IV et al. Jul 2019 A1
20190201083 Shelton, IV et al. Jul 2019 A1
20190201084 Shelton, IV et al. Jul 2019 A1
20190201085 Shelton, IV et al. Jul 2019 A1
20190201086 Shelton, IV et al. Jul 2019 A1
20190201087 Shelton, IV et al. Jul 2019 A1
20190201090 Shelton, IV et al. Jul 2019 A1
20190201091 Yates et al. Jul 2019 A1
20190201092 Yates et al. Jul 2019 A1
20190201102 Shelton, IV et al. Jul 2019 A1
20190201104 Shelton, IV et al. Jul 2019 A1
20190201105 Shelton, IV et al. Jul 2019 A1
20190201111 Shelton, IV et al. Jul 2019 A1
20190201112 Wiener et al. Jul 2019 A1
20190201113 Shelton, IV et al. Jul 2019 A1
20190201114 Shelton, IV et al. Jul 2019 A1
20190201115 Shelton, IV et al. Jul 2019 A1
20190201116 Shelton, IV et al. Jul 2019 A1
20190201118 Shelton, IV et al. Jul 2019 A1
20190201119 Harris et al. Jul 2019 A1
20190201120 Shelton, IV et al. Jul 2019 A1
20190201123 Shelton, IV et al. Jul 2019 A1
20190201124 Shelton, IV et al. Jul 2019 A1
20190201125 Shelton, IV et al. Jul 2019 A1
20190201126 Shelton, IV et al. Jul 2019 A1
20190201127 Shelton, IV et al. Jul 2019 A1
20190201128 Yates et al. Jul 2019 A1
20190201129 Shelton, IV et al. Jul 2019 A1
20190201130 Shelton, IV et al. Jul 2019 A1
20190201135 Shelton, IV et al. Jul 2019 A1
20190201136 Shelton, IV et al. Jul 2019 A1
20190201137 Shelton, IV et al. Jul 2019 A1
20190201138 Yates et al. Jul 2019 A1
20190201139 Shelton, IV et al. Jul 2019 A1
20190201140 Yates et al. Jul 2019 A1
20190201141 Shelton, IV et al. Jul 2019 A1
20190201142 Shelton, IV et al. Jul 2019 A1
20190201143 Shelton, IV et al. Jul 2019 A1
20190201144 Shelton, IV et al. Jul 2019 A1
20190201145 Shelton, IV et al. Jul 2019 A1
20190201146 Shelton, IV et al. Jul 2019 A1
20190201158 Shelton, IV et al. Jul 2019 A1
20190201159 Shelton, IV et al. Jul 2019 A1
20190201594 Shelton, IV et al. Jul 2019 A1
20190201597 Shelton, IV et al. Jul 2019 A1
20190204201 Shelton, IV et al. Jul 2019 A1
20190205001 Messerly et al. Jul 2019 A1
20190205441 Shelton, IV et al. Jul 2019 A1
20190205566 Shelton, IV et al. Jul 2019 A1
20190205567 Shelton, IV et al. Jul 2019 A1
20190206003 Harris et al. Jul 2019 A1
20190206004 Shelton, IV et al. Jul 2019 A1
20190206050 Yates et al. Jul 2019 A1
20190206216 Shelton, IV et al. Jul 2019 A1
20190206542 Shelton, IV et al. Jul 2019 A1
20190206551 Yates et al. Jul 2019 A1
20190206555 Morgan et al. Jul 2019 A1
20190206556 Shelton, IV et al. Jul 2019 A1
20190206561 Shelton, IV et al. Jul 2019 A1
20190206562 Shelton, IV et al. Jul 2019 A1
20190206563 Shelton, IV et al. Jul 2019 A1
20190206564 Shelton, IV et al. Jul 2019 A1
20190206565 Shelton, IV Jul 2019 A1
20190206569 Shelton, IV et al. Jul 2019 A1
20190206576 Shelton, IV et al. Jul 2019 A1
20190207911 Wiener et al. Jul 2019 A1
20190208641 Yates et al. Jul 2019 A1
20190224434 Silver et al. Jul 2019 A1
20190254759 Azizian Aug 2019 A1
20190261984 Nelson et al. Aug 2019 A1
20190269476 Bowling et al. Sep 2019 A1
20190272917 Couture et al. Sep 2019 A1
20190274662 Rockman et al. Sep 2019 A1
20190274705 Sawhney et al. Sep 2019 A1
20190274706 Nott et al. Sep 2019 A1
20190274707 Sawhney et al. Sep 2019 A1
20190274708 Boudreaux Sep 2019 A1
20190274709 Scoggins Sep 2019 A1
20190274710 Black Sep 2019 A1
20190274711 Scoggins et al. Sep 2019 A1
20190274712 Faller et al. Sep 2019 A1
20190274713 Scoggins et al. Sep 2019 A1
20190274714 Cut et al. Sep 2019 A1
20190274716 Nott et al. Sep 2019 A1
20190274717 Nott et al. Sep 2019 A1
20190274718 Denzinger et al. Sep 2019 A1
20190274719 Stulen Sep 2019 A1
20190274720 Gee et al. Sep 2019 A1
20190274749 Brady et al. Sep 2019 A1
20190274750 Jayme et al. Sep 2019 A1
20190274752 Denzinger et al. Sep 2019 A1
20190278262 Taylor et al. Sep 2019 A1
20190282311 Nowlin et al. Sep 2019 A1
20190290389 Kopp Sep 2019 A1
20190298340 Shelton, IV et al. Oct 2019 A1
20190298341 Shelton, IV et al. Oct 2019 A1
20190298342 Shelton, IV et al. Oct 2019 A1
20190298343 Shelton, IV et al. Oct 2019 A1
20190298346 Shelton, IV et al. Oct 2019 A1
20190298347 Shelton, IV et al. Oct 2019 A1
20190298350 Shelton, IV et al. Oct 2019 A1
20190298351 Shelton, IV et al. Oct 2019 A1
20190298352 Shelton, IV et al. Oct 2019 A1
20190298353 Shelton, IV et al. Oct 2019 A1
20190298354 Shelton, IV et al. Oct 2019 A1
20190298355 Shelton, IV et al. Oct 2019 A1
20190298356 Shelton, IV et al. Oct 2019 A1
20190298357 Shelton, IV et al. Oct 2019 A1
20190298464 Abbott Oct 2019 A1
20190298481 Rosenberg et al. Oct 2019 A1
20190307520 Peine et al. Oct 2019 A1
20190311802 Kokubo et al. Oct 2019 A1
20190314015 Shelton, IV et al. Oct 2019 A1
20190314016 Huitema et al. Oct 2019 A1
20190314081 Brogna Oct 2019 A1
20190320929 Spencer et al. Oct 2019 A1
20190321117 Itkowitz et al. Oct 2019 A1
20190333626 Mansi et al. Oct 2019 A1
20190343594 Garcia Kilroy et al. Nov 2019 A1
20190374140 Tucker et al. Dec 2019 A1
20190374292 Barral et al. Dec 2019 A1
20190378610 Barral et al. Dec 2019 A1
20200000470 Du et al. Jan 2020 A1
20200000509 Hayashida et al. Jan 2020 A1
20200038120 Ziraknejad et al. Feb 2020 A1
20200046353 Deck et al. Feb 2020 A1
20200054317 Pisarnwongs et al. Feb 2020 A1
20200054320 Harris et al. Feb 2020 A1
20200054321 Harris et al. Feb 2020 A1
20200054322 Harris et al. Feb 2020 A1
20200054323 Harris et al. Feb 2020 A1
20200054326 Harris et al. Feb 2020 A1
20200054328 Harris et al. Feb 2020 A1
20200054330 Harris et al. Feb 2020 A1
20200078070 Henderson et al. Mar 2020 A1
20200078071 Asher Mar 2020 A1
20200078076 Henderson et al. Mar 2020 A1
20200078077 Henderson et al. Mar 2020 A1
20200078078 Henderson et al. Mar 2020 A1
20200078079 Morgan et al. Mar 2020 A1
20200078080 Henderson et al. Mar 2020 A1
20200078081 Jayme et al. Mar 2020 A1
20200078082 Henderson et al. Mar 2020 A1
20200078089 Henderson et al. Mar 2020 A1
20200078096 Barbagli et al. Mar 2020 A1
20200078106 Henderson et al. Mar 2020 A1
20200078110 Henderson et al. Mar 2020 A1
20200078111 Oberkircher et al. Mar 2020 A1
20200078112 Henderson et al. Mar 2020 A1
20200078113 Sawhney et al. Mar 2020 A1
20200078114 Asher et al. Mar 2020 A1
20200078115 Asher et al. Mar 2020 A1
20200078116 Oberkircher et al. Mar 2020 A1
20200078117 Henderson et al. Mar 2020 A1
20200078118 Henderson et al. Mar 2020 A1
20200078119 Henderson et al. Mar 2020 A1
20200078120 Aldridge et al. Mar 2020 A1
20200081585 Petre et al. Mar 2020 A1
20200090808 Carroll et al. Mar 2020 A1
20200100825 Henderson et al. Apr 2020 A1
20200100830 Henderson et al. Apr 2020 A1
20200106220 Henderson et al. Apr 2020 A1
20200162896 Su et al. May 2020 A1
20200168323 Bullington et al. May 2020 A1
20200178760 Kashima et al. Jun 2020 A1
20200178971 Harris et al. Jun 2020 A1
20200193600 Shameli et al. Jun 2020 A1
20200197027 Hershberger et al. Jun 2020 A1
20200203004 Shanbhag et al. Jun 2020 A1
20200214699 Shelton, IV et al. Jul 2020 A1
20200226751 Jin et al. Jul 2020 A1
20200230803 Yamashita et al. Jul 2020 A1
20200237372 Park Jul 2020 A1
20200261075 Boudreaux et al. Aug 2020 A1
20200261076 Boudreaux et al. Aug 2020 A1
20200261077 Shelton, IV et al. Aug 2020 A1
20200261078 Bakos et al. Aug 2020 A1
20200261080 Bakos et al. Aug 2020 A1
20200261081 Boudreaux et al. Aug 2020 A1
20200261082 Boudreaux et al. Aug 2020 A1
20200261083 Bakos et al. Aug 2020 A1
20200261084 Bakos et al. Aug 2020 A1
20200261085 Boudreaux et al. Aug 2020 A1
20200261086 Zeiner et al. Aug 2020 A1
20200261087 Timm et al. Aug 2020 A1
20200261088 Harris et al. Aug 2020 A1
20200261089 Shelton, IV et al. Aug 2020 A1
20200275928 Shelton, IV et al. Sep 2020 A1
20200275930 Harris et al. Sep 2020 A1
20200281665 Kopp Sep 2020 A1
20200305924 Carroll Oct 2020 A1
20200305945 Morgan et al. Oct 2020 A1
20200314569 Morgan et al. Oct 2020 A1
20200348662 Cella et al. Nov 2020 A1
20200405304 Mozdzierz et al. Dec 2020 A1
20200405375 Shelton, IV et al. Dec 2020 A1
20210000555 Shelton, IV et al. Jan 2021 A1
20210007760 Reisin Jan 2021 A1
20210015568 Liao et al. Jan 2021 A1
20210022731 Eisinger Jan 2021 A1
20210022738 Weir et al. Jan 2021 A1
20210022809 Crawford et al. Jan 2021 A1
20210059674 Shelton, IV et al. Mar 2021 A1
20210068834 Shelton, IV et al. Mar 2021 A1
20210076966 Grantcharov et al. Mar 2021 A1
20210128149 Whitfield et al. May 2021 A1
20210153889 Nott et al. May 2021 A1
20210169516 Houser et al. Jun 2021 A1
20210176179 Shelton, IV Jun 2021 A1
20210177452 Nott et al. Jun 2021 A1
20210177489 Yates et al. Jun 2021 A1
20210186454 Behzadi et al. Jun 2021 A1
20210192914 Shelton, IV et al. Jun 2021 A1
20210201646 Shelton, IV et al. Jul 2021 A1
20210205020 Shelton, IV et al. Jul 2021 A1
20210205021 Shelton, IV et al. Jul 2021 A1
20210205028 Shelton, IV et al. Jul 2021 A1
20210205029 Wiener et al. Jul 2021 A1
20210205030 Shelton, IV et al. Jul 2021 A1
20210205031 Shelton, IV et al. Jul 2021 A1
20210212602 Shelton, IV et al. Jul 2021 A1
20210212694 Shelton, IV et al. Jul 2021 A1
20210212717 Yates et al. Jul 2021 A1
20210212719 Houser et al. Jul 2021 A1
20210212770 Messerly et al. Jul 2021 A1
20210212771 Shelton, IV et al. Jul 2021 A1
20210212774 Shelton, IV et al. Jul 2021 A1
20210212775 Shelton, IV et al. Jul 2021 A1
20210212782 Shelton, IV et al. Jul 2021 A1
20210219976 DiNardo et al. Jul 2021 A1
20210220058 Messerly et al. Jul 2021 A1
20210240852 Shelton, IV et al. Aug 2021 A1
20210241898 Shelton, IV et al. Aug 2021 A1
20210249125 Morgan et al. Aug 2021 A1
20210251487 Shelton, IV et al. Aug 2021 A1
20210259687 Gonzalez et al. Aug 2021 A1
20210259697 Shelton, IV et al. Aug 2021 A1
20210259698 Shelton, IV et al. Aug 2021 A1
20210282780 Shelton, IV et al. Sep 2021 A1
20210282781 Shelton, IV et al. Sep 2021 A1
20210306176 Park et al. Sep 2021 A1
20210315579 Shelton, IV et al. Oct 2021 A1
20210315580 Shelton, IV et al. Oct 2021 A1
20210315581 Shelton, IV et al. Oct 2021 A1
20210315582 Shelton, IV et al. Oct 2021 A1
20210322014 Shelton, IV et al. Oct 2021 A1
20210322015 Shelton, IV et al. Oct 2021 A1
20210322017 Shelton, IV et al. Oct 2021 A1
20210322018 Shelton, IV et al. Oct 2021 A1
20210322019 Shelton, IV et al. Oct 2021 A1
20210322020 Shelton, IV et al. Oct 2021 A1
20210336939 Wiener et al. Oct 2021 A1
20210353287 Shelton, IV et al. Nov 2021 A1
20210353288 Shelton, IV et al. Nov 2021 A1
20210358599 Alvi et al. Nov 2021 A1
20210361284 Shelton, IV et al. Nov 2021 A1
20220000484 Shelton, IV et al. Jan 2022 A1
20220054158 Shelton, IV et al. Feb 2022 A1
20220079591 Bakos et al. Mar 2022 A1
20220160438 Shelton, IV et al. May 2022 A1
20220175374 Shelton, IV et al. Jun 2022 A1
20220230738 Shelton, IV et al. Jul 2022 A1
20220241027 Shelton, IV et al. Aug 2022 A1
20220249097 Shelton, IV et al. Aug 2022 A1
20220323092 Shelton, IV et al. Oct 2022 A1
20220323095 Nott et al. Oct 2022 A1
20220323150 Yates et al. Oct 2022 A1
20220331011 Shelton, IV et al. Oct 2022 A1
20220331018 Parihar et al. Oct 2022 A1
Foreign Referenced Citations (93)
Number Date Country
2015201140 Mar 2015 AU
2795323 May 2014 CA
101617950 Jan 2010 CN
104490448 Mar 2017 CN
206097107 Apr 2017 CN
107811710 Mar 2018 CN
108652695 Oct 2018 CN
2037167 Jul 1980 DE
3016131 Oct 1981 DE
3824913 Feb 1990 DE
4002843 Apr 1991 DE
102005051367 Apr 2007 DE
102016207666 Nov 2017 DE
0000756 Oct 1981 EP
0408160 Jan 1991 EP
0473987 Mar 1992 EP
0929263 Jul 1999 EP
1214913 Jun 2002 EP
2730209 May 2014 EP
2732772 May 2014 EP
2942023 Nov 2015 EP
3047806 Jul 2016 EP
3056923 Aug 2016 EP
3095399 Nov 2016 EP
3120781 Jan 2017 EP
3135225 Mar 2017 EP
3141181 Mar 2017 EP
2838234 Oct 2003 FR
2509523 Jul 2014 GB
S5191993 Jul 1976 JP
S5373315 Jun 1978 JP
S57185848 Nov 1982 JP
S58207752 Dec 1983 JP
H07132122 May 1995 JP
H08332169 Dec 1996 JP
2001029353 Feb 2001 JP
2001195686 Jul 2001 JP
2001340350 Dec 2001 JP
2002272758 Sep 2002 JP
2006117143 May 2006 JP
2006288431 Oct 2006 JP
2007123394 May 2007 JP
2007300312 Nov 2007 JP
2009039515 Feb 2009 JP
2010057642 Mar 2010 JP
2010131265 Jun 2010 JP
2012065698 Apr 2012 JP
2012239669 Dec 2012 JP
2013144057 Jul 2013 JP
2014155207 Aug 2014 JP
2016174836 Oct 2016 JP
2017047022 Mar 2017 JP
2017513561 Jun 2017 JP
2017526510 Sep 2017 JP
2017532168 Nov 2017 JP
20140104587 Aug 2014 KR
101587721 Jan 2016 KR
WO-9734533 Sep 1997 WO
WO-0024322 May 2000 WO
WO-0108578 Feb 2001 WO
WO-0112089 Feb 2001 WO
WO-0120892 Mar 2001 WO
WO-03079909 Oct 2003 WO
WO-2006001264 Jan 2006 WO
WO-2007137304 Nov 2007 WO
WO-2008053485 May 2008 WO
WO-2008056618 May 2008 WO
WO-2008069816 Jun 2008 WO
WO-2008147555 Dec 2008 WO
WO-2011112931 Sep 2011 WO
WO-2013143573 Oct 2013 WO
WO-2014031800 Feb 2014 WO
WO-2014071184 May 2014 WO
WO-2014134196 Sep 2014 WO
WO-2015054665 Apr 2015 WO
WO-2015129395 Sep 2015 WO
WO-2016093049 Jun 2016 WO
WO-2016100719 Jun 2016 WO
WO-2016118752 Jul 2016 WO
WO-2016206015 Dec 2016 WO
WO-2017011382 Jan 2017 WO
WO-2017011646 Jan 2017 WO
WO-2017058617 Apr 2017 WO
WO-2017058695 Apr 2017 WO
WO-2017151996 Sep 2017 WO
WO-2017183353 Oct 2017 WO
WO-2017189317 Nov 2017 WO
WO-2017205308 Nov 2017 WO
WO-2017210499 Dec 2017 WO
WO-2017210501 Dec 2017 WO
WO-2018116247 Jun 2018 WO
WO-2018152141 Aug 2018 WO
WO-2018176414 Oct 2018 WO
Non-Patent Literature Citations (60)
Entry
US 10,504,709 B2, 12/2019, Karancsi et al. (withdrawn)
Flores et al., “Large-scale Offloading in the Internet of Things,” 2017 IEEE International Conference on Pervasive Computing and Communications Workshops (PERCOM Workshops), IEEE, pp. 479-484, Mar. 13, 2017.
Kalantarian et al., “Computation Offloading for Real-Time Health-Monitoring Devices,” 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EBMC), IEEE, pp. 4971-4974, Aug. 16, 2016.
Yuyi Mao et al., “A Survey on Mobile Edge Computing: The Communication Perspective,” IEEE Communications Surveys & Tutorials, pp. 2322-2358, Jun. 13, 2017.
Khazaei et al., “Health Informatics for Neonatal Intensive Care Units: An Analytical Modeling Perspective,” IEEE Journal of Translational Engineering in Health and Medicine, vol. 3, pp. 1-9, Oct. 21, 2015.
Benkmann et al., “Concept of iterative optimization of minimally invasive surgery,” 2017 22nd International Conference on Methods and Models in Automation and Robotics (MMAR), IEEE pp. 443-446, Aug. 28, 2017.
Trautman, Peter, “Breaking the Human-Robot Deadlock: Surpassing Shared Control Performance Limits with Sparse Human-Robot Interaction,” Robotics: Science and Systems XIIII, pp. 1-10, Jul. 12, 2017.
Yang et al., “A dynamic stategy for packet scheduling and bandwidth allocation based on channel quality in IEEE 802.16e OFDMA system,” Journal of Network and Computer Applications, vol. 39, pp. 52-60, May 2, 2013.
Takahashi et al., “Automatic smoke evacuation in laparoscopic surgery: a simplified method for objective evaluation,” Surgical Endoscopy, vol. 27, No. 8, pp. 2980-2987, Feb. 23, 2013.
Miksch et al., “Utilizing temporal data abstraction for data validation and therapy planning for artificially ventilated newborn infants,” Artificial Intelligence in Medicine, vol. 8, No. 6, pp. 543-576 (1996).
Horn et al., “Effective data validation of high-frequency data: Time-point-time-interval-, and trend-based methods,” Computers in Biology and Medic, New York, NY, vol. 27, No. 5, pp. 389-409 (1997).
Stacey et al., “Temporal abstraction in intelligent clinical data analysis: A survey,” Artificial Intelligence in Medicine, vol. 39, No. 1, pp. 1-24 (2006).
Zoccali, Bruno, “A Method for Approximating Component Temperatures at Altitude Conditions Based on CFD Analysis at Sea Level Conditions,” (white paper), www.tdmginc.com, Dec. 6, 2018 (9 pages).
Slocinski et al., “Distance measure for impedance spectra for quantified evaluations,” Lecture Notes on Impedance Spectroscopy, vol. 3, Taylor and Francis Group (Jul. 2012)—Book Not Attached.
Engel et al. “A safe robot system for craniofacial surgery”, 2013 IEEE International Conference on Robotics and Automation (ICRA); May 6-10, 2013; Karlsruhe, Germany, vol. 2, Jan. 1, 2001, pp. 2020-2024.
Bonaci et al., “To Make a Robot Secure: An Experimental Analysis of Cyber Security Threats Against Teleoperated Surgical Robots,” May 13, 2015. Retrieved from the Internet: URL:https://arxiv.org/pdf/1504.04339v2.pdf [retrieved on Aug. 24, 2019].
Homa Alemzadeh et al., “Targeted Attacks on Teleoperated Surgical Robots: Dynamic Model-Based Detection and Mitigation,” 2016 46th Annual IEEE/IFIP International Conference on Dependable Systems and Networks (DSN), IEEE, Jun. 28, 2016, pp. 395-406.
Phumzile Malindi, “5. QoS in Telemedicine,” “Telemedicine,” Jun. 20, 2011, IntechOpen, pp. 119-138.
Staub et al., “Contour-based Surgical Instrument Tracking Supported by Kinematic Prediction,” Proceedings of the 2010 3rd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics, Sep. 1, 2010, pp. 746-752.
Allan et al., “3-D Pose Estimation of Articulated Instruments in Robotic Minimally Invasive Surgery,” IEEE Transactions on Medical Imaging, vol. 37, No. 5, May 1, 2018, pp. 1204-1213.
Kassahun et al., “Surgical Robotics Beyond Enhanced Dexterity Instrumentation: A Survey of the Machine Learning Techniques and their Role in Intelligent and Autonomous Surgical Actions.” International Journal of Computer Assisted Radiology and Surgery, vol. 11, No. 4, Oct. 8, 2015, pp. 553-568.
Weede et al. “An Intelligent and Autonomous Endoscopic Guidance System for Minimally Invasive Surgery,” 2013 IEEE International Conference on Robotics ad Automation (ICRA), May 6-10, 2013. Karlsruhe, Germany, May 1, 2011, pp. 5762-5768.
Altenberg et al., “Genes of Glycolysis are Ubiquitously Overexpressed in 24 Cancer Classes,” Genomics, vol. 84, pp. 1014-1020 (2004).
Harold I. Brandon and V. Leroy Young, Mar. 1997, Surgical Services Management vol. 3 No. 3. retrieved from the internet <https://www.surgimedics.com/Research%20Articles/Electrosurgical%20Plume/Characterization%20And%20Removal%20Of%20Electrosurgical%20Smoke.pdf> (Year: 1997).
Marshall Brain, How Microcontrollers Work, 2006, retrieved from the internet <https://web.archive.org/web/20060221235221/http://electronics.howstuffworks.com/microcontroller.htm/printable> (Year: 2006).
CRC Press, “The Measurement, Instrumentation and Sensors Handbook,” 1999, Section VII, Chapter 41, Peter O'Shea, “Phase Measurement,” pp. 1303-1321, ISBN 0-8493-2145-X.
Jiang, “‘Sound of Silence’: a secure indoor wireless ultrasonic communication system,” Article, 2014, pp. 46-50, Snapshots of Doctoral Research at University College Cork, School of Engineering—Electrical & Electronic Engineering, UCC, Cork, Ireland.
Li, et al., “Short-range ultrasonic communications in air using quadrature modulation,” Journal, Oct. 30, 2009, pp. 2060-2072, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, vol. 56, No. 10, IEEE.
Salamon, “AI Detects Polyps Better Than Colonoscopists” Online Article, Jun. 3, 2018, Medscape Medical News, Digestive Disease Week (DDW) 2018: Presentation 133.
Misawa, et al. “Artificial Intelligence-Assisted Polyp Detection for Colonoscopy: Initial Experience,” Article, Jun. 2018, pp. 2027-2029, vol. 154, Issue 8, American Gastroenterolgy Association.
Dottorato, “Analysis and Design of the Rectangular Microstrip Patch Antennas forTM0n0 operating mode,”Article, Oct. 8, 2010, pp. 1-9, Microwave Journal.
Miller, et al., “Impact of Powered and Tissue-Specific Endoscopic Stapling Technology on Clinical and Economic Outcomes of Video-Assisted Thoracic Surgery Lobectomy Procedures: A Retrospective, Observational Study,” Article, Apr. 2018, pp. 707-723, vol. 35 (Issue 5), Advances in Therapy.
Hsiao-Wei Tang, “ARCM”, Video, Sep. 2012. YouTube, 5 screenshots. Retrieved from internet: <https://www.youtube.com/watch?v=UldQaxb3fRw&feature=youtu.be>.
Giannios, et al., “Visible to near-infrared refractive properties of freshly-excised human-liver tissues: marking hepatic malignancies,” Article, Jun. 14, 2016, pp. 1-10, Scientific Reports 6, Article No. 27910, Nature.
Vander Heiden, et al., “Understanding the Warburg effect: the metabolic requirements of cell proliferation,” Article, May 22, 2009, pp. 1-12, vol. 324, Issue 5930, Science.
Hirayama et al., “Quantitative Metabolome Profiling of Colon and Stomach Cancer Microenvironment by Capillary Electrophoresis Time-of-Flight Mass Spectrometry,” Article, Jun. 2009, pp. 4918-4925, vol. 69, Issue 11, Cancer Research.
Cengiz, et al., “A Tale of Two Compartments: Interstitial Versus Blood Glucose Monitoring,” Article, Jun. 2009, pp. S11-S16, vol. 11, Supplement 1, Diabetes Technology & Therapeutics.
Shen, et al., “An iridium nanoparticles dispersed carbon based thick film electrochemical biosensor and its application for a single use, disposable glucose biosensor,” Article, Feb. 3, 2007, pp. 106-113, vol. 125, Issue 1, Sensors and Actuators B: Chemical, Science Direct.
“ATM-MPLS Network Interworking Version 2.0, af-aic-0178.001” ATM Standard, The ATM Forum Technical Committee, published Aug. 2003.
IEEE Std 802.3-2012 (Revision of IEEE Std 802.3-2008, published Dec. 28, 2012.
IEEE Std No. 177, “Standard Definitions and Methods of Measurement for Piezoelectric Vibrators,” published May 1966, The Institute of Electrical and Electronics Engineers, Inc., New York, N.Y.
Shi et al., An Intuitive control console for robotic syrgery system, 2014, IEEE, p. 404-407 (Year: 2014).
Choi et al., A haptic augmented reality surgeon console for a laparoscopic surgery robot system, 2013, IEEE, p. 355-357 (Year: 2013).
Xie et al., Development of stereo vision and master-slave controller for a compact surgical robot system, 2015, IEEE, p. 403-407 (Year: 2015).
Sun et al., Innovative effector design for simulation training in robotic surgery, 2010, IEEE, p. 1735-1759 (Year: 2010).
Anonymous, “Internet of Things Powers Connected Surgical Device Infrastructure Case Study”, Dec. 31, 2016 (Dec. 31, 2016), Retrieved from the Internet: URL:https://www.cognizant.com/services-resources/150110_IoT_connected_surgicai_devices.pdf.
Draijer, Matthijs et al., “Review of laser pseckle contrast techniques for visualizing tissue perfusion,” Lasers in Medical Science, Springer-Verlag, LO, vol. 2 4, No. 4, Dec. 3, 2008, pp. 639-651.
Roy D Cullum, “Handbook of Engineering Design”, ISBN: 9780408005586, Jan. 1, 1988 (Jan. 1, 1988), XP055578597, ISBN: 9780408005586, 10-20, ChapterG, p. 138, right-hand column, paragraph 3.
“Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization”; Mhlaba et al.; Sep. 23, 2015 (Year: 2015).
Nabil Simaan et al., “Intelligent Surgical Robots with Situational Awareness: From Good to Great Surgeons”, DOI: 10.1115/1.2015-Sep-6 external link, Sep. 2015 (Sep. 2015), p. 3-6, Retrieved from the Internet: URL:http://memagazineselect.asmedigitalcollection.asme.org/data/journals/meena/936888/me-2015-sep6.pdf XP055530863.
Anonymous: “Titanium Key Chain Tool 1.1, Ultralight Multipurpose Key Chain Tool, Forward Cutting Can Opener—Vargo Titanium,” vargooutdoors.com, Jul. 5, 2014 (Jul. 5, 2014), retrieved from the internet: https://vargooutdoors.com/titanium-key-chain-tool-1-1.html.
Anonymous: “Screwdriver—Wikipedia”, en.wikipedia.org, Jun. 23, 2019, XP055725151, Retrieved from the Internet: URL:https://en.wikipedia.org/w/index.php?title=Screwdriver&oldid=903111203 [retrieved on Mar. 20, 2021].
Nordlinger, Christopher, “The Internet of Things and the Operating Room of the Future,” May 4, 2015, https://medium.com/@chrisnordlinger/the-internet-of-things-and-the-operating-room-of-the-future-8999a143d7b1, retrieved from the internet on Apr. 27, 2021, 9 pages.
Screen captures from YouTube video clip entitled “Four ways to use the Lego Brick Separator Tool,” 2 pages, uploaded on May 29, 2014 by user “Sarah Lewis”. Retrieved from internet: https://www.youtube.com/watch?v=ucKiRD6U1LU (Year: 2014).
Sorrells, P., “Application Note AN680. Passive RFID Basics,” retrieved from http://ww1.microchip.com/downloads/en/AppNotes/00680b.pdf on Feb. 26, 2020, Dec. 31, 1998, pp. 1-7.
“ATM-MPLS Network Interworking Version 2.0, af-aic-0178.001” ATM Standard, The ATM Forum Technical Committe, published Aug. 2003.
Lalys, et al., “Automatic knowledge-based recognition of low-level tasks in ophthalmological procedures”, Int J CARS, vol. 8, No. 1, pp. 1-49, Apr. 19, 2012.
Hu, Jinwen, Stimulations of adaptive temperature control with self-focused hyperthermia system for tumor treatment, Jan. 9, 2012, Ultrasonics 53, pp. 171-177, (Year: 2012).
Hussain et al., “A survey on resource allocation in high performance distributed computing systems”, Parallel Computing, vol. 39, No. 11, pp. 709-736 (2013).
Extended European Search Report for Application No. 18203447.0, dated Jun. 28, 2019.
Related Publications (1)
Number Date Country
20190125430 A1 May 2019 US
Provisional Applications (12)
Number Date Country
62665177 May 2018 US
62665128 May 2018 US
62665129 May 2018 US
62665139 May 2018 US
62665134 May 2018 US
62665192 May 2018 US
62578804 Oct 2017 US
62578844 Oct 2017 US
62578855 Oct 2017 US
62578835 Oct 2017 US
62578817 Oct 2017 US
62578793 Oct 2017 US