The present disclosure relates to surgical instruments. More particularly, the present disclosure relates to surgical forceps for sealing and/or cutting tissue.
Electrosurgical forceps utilize both mechanical clamping action and electrical energy to effect hemostasis by heating tissue and blood vessels to coagulate, cauterize and/or seal tissue. As an alternative to open forceps for use with open surgical procedures, many modern surgeons use endoscopic or laparoscopic instruments for remotely accessing organs through smaller, puncture-like incisions or natural orifices. As a direct result thereof, patients tend to benefit from less scarring and reduced healing time.
Endoscopic instruments, for example, are inserted into the patient through a cannula, or port, which has been made with a trocar. Typical sizes for cannulas range from three millimeters to twelve millimeters. Smaller cannulas are usually preferred, which, as can be appreciated, ultimately presents a design challenge to instrument manufacturers who must find ways to make endoscopic instruments that fit through the smaller cannulas.
Many endoscopic surgical procedures require cutting or ligating blood vessels or vascular tissue. Due to the inherent spatial considerations of the surgical cavity, surgeons often have difficulty suturing vessels or performing other traditional methods of controlling bleeding, e.g., clamping and/or tying-off transected blood vessels. By utilizing an endoscopic electrosurgical forceps, a surgeon can either cauterize, coagulate/desiccate and/or simply reduce or slow bleeding simply by controlling the intensity, frequency and duration of the electrosurgical energy applied through the jaw members to the tissue. Most small blood vessels, i.e., in the range below two millimeters in diameter, can often be closed using standard electrosurgical instruments and techniques. However, if a larger vessel is ligated, it may be necessary for the surgeon to convert the endoscopic procedure into an open-surgical procedure and thereby abandon the benefits of endoscopic surgery. Alternatively, the surgeon can seal the larger vessel or tissue. Typically, after a vessel or tissue is sealed, the surgeon advances a knife to sever the sealed tissue disposed between the opposing jaw members.
The present disclosure relates to a forceps including a housing having a shaft attached thereto and an end effector assembly disposed at a distal end of the shaft. The end effector assembly includes a pair of jaw members disposed in opposing relation relative to one another. One (or both) of the jaw members is moveable relative to the other between a spaced apart position and an approximated position for grasping tissue therebetween. One or more shape memory cutting members are coupled to one of the jaw members. The shape memory cutting member(s) is transitionable between a retracted state and an extended state. More specifically, the shape memory cutting member(s) is extended between the jaw members to cut tissue disposed therebetween when transitioned to the extended state.
In one embodiment, the shape memory cutting member is temperature dependent. More specifically, when the shape memory cutting member is heated from an at-rest temperature, the shape memory cutting member is transitioned from the retracted state to the extended state. On the other hand, when the shape memory cutting member is cooled back to the at-rest temperature, the shape memory cutting member is transitioned from the extended state back to the retracted state.
In another embodiment, the shape memory cutting member is adapted to connect to a source of energy for selectively heating the shape memory cutting member to transition the shape memory cutting member from the retracted state to the extended state.
In another embodiment, the shape memory cutting member is formed partially, or entirely, from a Nitinol shape memory alloy. The shape memory cutting member may also be formed from a bimetallic strip of two different materials.
In yet another embodiment, the shape memory cutting member is coiled within a proximal end of one of the jaw members in the retracted state and is uncoiled and extends distally between the jaw members to cut tissue disposed therebetween in the extended state.
In still another embodiment, the end effector assembly includes a plurality of shape memory cutting members coupled to one (or both) of the jaw members. When in the retracted state, each shape memory cutting member is disposed within a recess defined within the jaw member(s). When transitioned to the extended state, each shape memory cutting member extends from the recess and between the jaw members to cut tissue disposed therebetween.
In still yet another embodiment, each end of the shape memory cutting member is engaged to a protrusion extending from one of the jaw members. The shape memory cutting member extends longitudinally along one of the jaw members and is curved inwardly to a position adjacent the jaw member when disposed in the retracted state. In the expanded state, the cutting member is curved outwardly to extend toward the opposed jaw member to cut tissue disposed between the jaw members.
In another embodiment, each jaw member includes an opposed electrically conductive tissue sealing surface adapted to connect to an electrosurgical energy source to communicate energy to tissue disposed between the jaw members to seal tissue disposed therebetween when the jaw members are in the approximated position. In such an embodiment, the shape memory cutting member(s) may be insulated from the tissue sealing surfaces.
The present disclosure also relates to an end effector assembly for use with a surgical forceps. The end effector assembly includes a pair of jaw members disposed in opposing relation relative to one another. One (or both) of the jaw members is moveable relative to the other between a spaced apart position and an approximated position for grasping tissue therebetween. The end effector assembly also includes a shape memory cutting member configured to transition between a coiled state and an expanded state. In the coiled state, the shape memory cutting member is coiled and nested within a proximal end of one of the jaw members. In the expanded state, the shape memory cutting member is uncoiled and extends distally between the jaw members to cut tissue disposed between the jaw members. The shape memory cutting member may be a temperature dependent bimetallic strip formed from two different materials.
The present disclosure further relates to another embodiment of an end effector assembly for use with a forceps. The end effector assembly includes a pair of jaw members disposed in opposing relation relative to one another. One (or both) of the jaw members is moveable relative to the other between a spaced apart position and an approximated position for grasping tissue therebetween. The end effector assembly also includes a plurality of shape memory cutting members. Each shape memory cutting member is coupled to one of the jaw members. The shape memory cutting members are transitionable between a retracted state and an extended state. In the retracted state, each shape memory cutting member is disposed within a recess defined within the jaw member. When transitioned to the extended state, the shape memory cutting members extend from the recesses between the jaw members to cut tissue disposed between the jaw members. The shape memory cutting members may be temperature dependent shape memory alloys (SMAs).
Various embodiments of the presently disclosed forceps are described herein with reference to the drawings, wherein:
Embodiments of the presently disclosed surgical instrument are described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein, the term “distal” refers to the portion that is being described which is further from a user, while the term “proximal” refers to the portion that is being described which is closer to a user.
Turning now to
Forceps 10 also includes electrosurgical cable 310 that connects forceps 10 to a generator (not shown). Cable 310 has sufficient length to extend through shaft 12 in order to provide electrical energy to at least one of jaw members 110 and 120 of end effector assembly 100.
With continued reference to
Various embodiments of end effectors similar to end effector 100 and configured for use with forceps 10 are described in detail with reference to FIGS. 2-10B. Each end effector assembly described hereinbelow includes one or more shape memory cutting members. The respective shape memory cutting members 230, 330, 430 of end effector assemblies 200, 300, 400 (see
More specifically, with respect to shape memory alloys (SMAs), the SMA cutting members, e.g., cutting members 230, 330, 430, may be configured for two-way shape memory effect. In other words, the SMA cutting member may be configured to remember two different shapes, a “cold” shape corresponding to a retracted state and a “hot” shape corresponding to an extended state. For purposes herein, Mf is the temperature at which the transition to a martensite phase or stage is finished during cooling, and As and Af are the temperatures at which the transition from the martensite phase to the austenite phase starts and finishes, respectively, during heating. As may be determined by the SMA material and composition and, typically, ranges from about 150° C. to about 200° C. Af may also be determined by the SMA material and composition and/or the loading conditions and, typically, ranges from about 2° C. to about 20° C. or hotter. SMAs suitable for forming cutting members 230, 330, 430 include, but are not limited to, copper-zinc-aluminum-nickel, copper-aluminum-nickel, and nickel-titanium, commonly referred to as Nitinol alloys.
The SMA cutting members, e.g., cutting members 230, 330, 430, may initially be disposed in a retracted state, as shown in
If the SMA is allowed to cool (or is cooled), the SMA, as its temperature decreases, will transition from the austenite stage back to the martensite stage such that the SMA cutting members 230, 330, 430 return to the retracted state, shown in
Alternatively, as mentioned above, shape memory cutting members 230, 330, 430 of end effector assemblies 200, 300, 400, respectively (see
Accordingly, the bimetallic shape memory cutting members, e.g., cutting members 230, 330, 430, may be configured to expand, curve, or uncoil upon application of heat thereto. More specifically, the bimetallic cutting members may be transitionable between a retracted state, wherein the temperature of the bimetallic cutting member is below a first threshold T1, and an extended state, wherein the temperature of the bimetallic cutting member is above a second threshold T2. At temperatures between the first and second thresholds T1 and T2, respectively, the bimetallic cutting member transitions, e.g., is heated or cooled, between the retracted state and the extended state. The specific shape of the bimetallic cutting members in each of the retracted and extended states as well as the temperature thresholds T1, T2 are determined by the material and composition of the bimetallic strip, the relative thermal expansion rates of the materials and/or by the loading conditions.
One embodiment of an end effector assembly configured for use with forceps 10 is shown in
Referring now to
With continued reference to
As shown in
An electrically insulated wire 240 extends from housing 20, through shaft 12, and into protrusions 218a and/or 218b of jaw member 210 to electrically couple shape memory cutting wire 230 to an electrosurgical energy source, e.g., a generator, and supplies energy, e.g., electrosurgical energy, to shape memory cutting wire 230. Specifically, the electrosurgical energy supplied to shape memory cutting wire 230 may be supplied using variable voltages, frequencies and/or currents and may, for example, heat shape memory cutting wire 230 via resistive heating or RF energy heating. With protrusions 218 of jaw member 210 and internal surface 229 of recess 228 being insulated from sealing surfaces 212, 222 of jaw members 210, 220, respectively, shape memory cutting wire 230 may be independently heated by supplying electrosurgical energy thereto, without effecting sealing surfaces 212, 222. Similarly, supplying electrosurgical energy to sealing surfaces 212, 222, e.g., during tissue sealing, does not directly heat shape member cutting wire 230.
The operation of end effector assembly 200 of forceps 10 is described with reference to
Once end effector assembly 200 is positioned with tissue to be sealed and/or cut disposed between jaw members 210, 220, jaw members 210, 220 may be moved to the approximated position, as shown in
With continued reference to
From the position shown in
After sealing is complete, sealing surfaces 212, 222 may be deactivated, i.e., the application of electrosurgical energy thereto may be stopped. Electrosurgical or resistive energy may then be applied to shape memory cutting wire 230, e.g., via insulated wires 240, to heat shape memory cutting wire 230. As shape memory cutting wire 230 is heated, shape memory cutting wire 230 is transitioned from the retracted state (
More specifically, in embodiments where cutting wire 230 is a SMA cutting wire, as cutting wire 230 is heated above As, cutting wire 230 begins to transition, i.e., extend, from the retracted state to the extended state. Similarly, in embodiments where cutting wire 230 is a bimetallic cutting wire, as cutting wire 230 is heated above T1, the metallic strips begin to expand (at different rates), thereby expanding the cutting wire 230 from the retracted state to the extended state.
As cutting wire 230 is expanded to the extended state, central portion 236 of cutting wire 230 is bowed, or curved outwardly from jaw member 210 toward jaw member 220 (the “hot” shape). Accordingly, as central portion 236 of cutting wire 230 is curved, or extended toward jaw member 220, cutting wire 230 is advanced through tissue, e.g., vessel “V,” thereby cutting vessel “V” along the previously formed tissue seal, as best shown in
Once cutting wire 230 has been heated to (or above) the “hot” temperature, Af (for SMA) or T2 (for bimetallic), cutting wire 230 is fully transitioned to the extended state. As mentioned above, in the extended state, central portion 236 of cutting wire 230 is bowed outwardly from a suspended position between protrusions 218a, 218b to a position adjacent bottom surface 229 of recess 228, as best shown in
Once tissue has been cut, shape memory cutting member 230 may be allowed to return, i.e., cooled, from the extended state shown in
Another end effector assembly configured for use with forceps 10 is shown in
Jaw member 310 includes a plurality of recessed portions 318 defined within sealing surface 312 and positioned longitudinally therealong. Recessed portions 318 may be equally spaced along sealing surface 312 of jaw member 310, or alternatively, may be positioned in any other suitable configuration. Additionally, recessed portions 318 may be longitudinally aligned in one or more columns, or may be staggered with respect to a longitudinal axis of end effector assembly 300. Further, although five (5) recessed portions 318 are shown in
As best shown in
Initially, shape memory cutting members 330 are disposed in a retracted state (
With continued reference to
As shown in
In operation, once end effector assembly 300 is positioned with tissue to be sealed and/or cut disposed between jaw members 310, 320, jaw members 310, 320 may be moved to the approximated position to grasp and seal tissue, e.g., vessel “V,” between sealing surfaces 312, 322 of jaw members 310, 320, respectively, as discussed above in relation to end effector assembly 200. Next, electrosurgical energy may be applied, via wires 340, to cutting members 330 to heat, or transition cutting members 330 from the retracted state (FIGS. 5 and 6A-6B) to the extended state (
In embodiments where cutting members 330 are SMA cutting members, cutting members 330 begin to reshape, or extend from the retracted state once cutting members 330 are heated above the at-rest temperature As. Similarly, in embodiments where cutting members 330 are bimetallic cutting members, cutting members 330 are reshaped, or extended from the retracted state once cutting members 330 are heated above the first threshold temperature T1.
As cutting members 330 are further heated toward the extended state, free ends 334 of cutting members 330 are extended from respective recesses 318 of jaw member 310. More specifically, cutting members 330 are extended between jaw members 310, 320, and eventually into channel(s) 328 defined within jaw member 320, as shown in
Cutting members 330 may be positioned along jaw member 310 such that tissue is perforated when cutting members 330 are transitioned to the extended state, thereby allowing for relatively easy tissue division along the perforations. Alternatively, cutting members 330 may be positioned along jaw member 310 such that the plurality of cutting members 330 divide tissue disposed between jaw members 310, 320 when transitioned to the extended state. For example, if perforating tissue is desired, end effector assembly 300 may be provided with fewer cutting members 330 and/or cutting members 330 may be spaced further apart from one another. On the other hand, if dividing tissue is desired, end effector assembly 300 may be configured with more cutting members 330 and/or cutting members 330 may be more concentrated within a given area.
Once tissue has been cut or preforated, shape memory cutting members 330 may be allowed to return, i.e., cool, from the extended state shown in
Yet another end effector assembly configured for use with forceps 10 is shown in
As shown in
Sealing surfaces 412 and/or 422 of jaw members 410, 420, respectively, may include channels (not shown) defined therein to accommodate extension of cutting member 430 therethrough. Alternatively, cutting member 430 may be configured to extend between jaw members 410, 420, obviating the need for the channel(s) (not shown).
In operation, jaw members 410, 420 may be moved to the approximated position (
When it is desired to cut tissue disposed between jaw members 410, 420, electrosurgical energy may be applied, e.g., via wires 440, to cutting member 430 to transition cutting member 430 from the “cold” shape (
In embodiments where cutting members 430 are SMA cutting members, cutting member 430 is uncoiled from the “cold” shape upon heating of cutting member 430 above the at-rest temperature A. Similarly, in embodiments where cutting member 430 is a bimetallic strip, cutting member 430 is uncoiled, or extended from the “cold” shape upon heating of cutting member 430 above the first threshold temperature T1.
As cutting member 430 is uncoiled and advanced distally, free end 434 of cutting member 430 is extended distally from cutting member housing 428 between jaw members 410, 420, as shown in
From the foregoing and with reference to the various figure drawings, those skilled in the art will appreciate that certain modifications can also be made to the present disclosure without departing from the scope of the same. While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended hereto.
Number | Name | Date | Kind |
---|---|---|---|
D249549 | Pike | Sep 1978 | S |
D263020 | Rau, III | Feb 1982 | S |
D295893 | Sharkany et al. | May 1988 | S |
D295894 | Sharkany et al. | May 1988 | S |
D298353 | Manno | Nov 1988 | S |
D299413 | DeCarolis | Jan 1989 | S |
D343453 | Noda | Jan 1994 | S |
D348930 | Olson | Jul 1994 | S |
D349341 | Lichtman et al. | Aug 1994 | S |
D354564 | Medema | Jan 1995 | S |
D358887 | Feinberg | May 1995 | S |
D384413 | Zlock et al. | Sep 1997 | S |
D402028 | Grimm et al. | Dec 1998 | S |
D416089 | Barton et al. | Nov 1999 | S |
D424694 | Tetzlaff et al. | May 2000 | S |
D425201 | Tetzlaff et al. | May 2000 | S |
6273887 | Yamauchi et al. | Aug 2001 | B1 |
D449886 | Tetzlaff et al. | Oct 2001 | S |
D454951 | Bon | Mar 2002 | S |
D457958 | Dycus et al. | May 2002 | S |
D457959 | Tetzlaff et al. | May 2002 | S |
D465281 | Lang | Nov 2002 | S |
D466209 | Bon | Nov 2002 | S |
6656175 | Francischelli et al. | Dec 2003 | B2 |
D493888 | Reschke | Aug 2004 | S |
D496997 | Dycus et al. | Oct 2004 | S |
D499181 | Dycus et al. | Nov 2004 | S |
D502994 | Blake, III | Mar 2005 | S |
D509297 | Wells | Sep 2005 | S |
D525361 | Hushka | Jul 2006 | S |
7070597 | Truckai et al. | Jul 2006 | B2 |
D531311 | Guerra et al. | Oct 2006 | S |
D533274 | Visconti et al. | Dec 2006 | S |
D533942 | Kerr et al. | Dec 2006 | S |
D535027 | James et al. | Jan 2007 | S |
D538932 | Malik | Mar 2007 | S |
D541418 | Schechter et al. | Apr 2007 | S |
D541611 | Aglassinger | May 2007 | S |
D541938 | Kerr et al. | May 2007 | S |
D545432 | Watanabe | Jun 2007 | S |
D547154 | Lee | Jul 2007 | S |
7270664 | Johnson et al. | Sep 2007 | B2 |
D564662 | Moses et al. | Mar 2008 | S |
D567943 | Moses et al. | Apr 2008 | S |
D575395 | Hushka | Aug 2008 | S |
D575401 | Hixson et al. | Aug 2008 | S |
D582038 | Swoyer et al. | Dec 2008 | S |
7491202 | Odom et al. | Feb 2009 | B2 |
D617900 | Kingsley et al. | Jun 2010 | S |
D617901 | Unger et al. | Jun 2010 | S |
D617902 | Twomey et al. | Jun 2010 | S |
D617903 | Unger et al. | Jun 2010 | S |
D618798 | Olson et al. | Jun 2010 | S |
D621503 | Otten et al. | Aug 2010 | S |
20030018332 | Schmaltz et al. | Jan 2003 | A1 |
20040073238 | Makower | Apr 2004 | A1 |
20040073256 | Marchitto et al. | Apr 2004 | A1 |
20040210282 | Flock et al. | Oct 2004 | A1 |
20040243125 | Dycus et al. | Dec 2004 | A1 |
20080045947 | Johnson et al. | Feb 2008 | A1 |
20100042140 | Cunningham | Feb 2010 | A1 |
20100204697 | Dumbauld et al. | Aug 2010 | A1 |
20100204698 | Chapman et al. | Aug 2010 | A1 |
20100217258 | Floume et al. | Aug 2010 | A1 |
20100249769 | Nau, Jr. et al. | Sep 2010 | A1 |
20100249776 | Kerr | Sep 2010 | A1 |
Number | Date | Country |
---|---|---|
2415263 | Oct 1975 | DE |
2514501 | Oct 1976 | DE |
2627679 | Jan 1977 | DE |
3423356 | Jun 1986 | DE |
3612646 | Apr 1987 | DE |
8712328 | Mar 1988 | DE |
4303882 | Aug 1994 | DE |
4403252 | Aug 1995 | DE |
19515914 | Jul 1996 | DE |
19506363 | Aug 1996 | DE |
29616210 | Jan 1997 | DE |
19608716 | Apr 1997 | DE |
19751106 | May 1998 | DE |
19751108 | May 1999 | DE |
10045375 | Oct 2002 | DE |
10 2004 02617 | Dec 2005 | DE |
20 2007 00931 | Oct 2007 | DE |
19738457 | Jan 2009 | DE |
1159926 | Dec 2001 | EP |
61-501068 | Sep 1984 | JP |
65-502328 | Mar 1992 | JP |
5-5106 | Jan 1993 | JP |
5-40112 | Feb 1993 | JP |
06343644 | Dec 1994 | JP |
07265328 | Oct 1995 | JP |
08056955 | Mar 1996 | JP |
08252263 | Oct 1996 | JP |
09010223 | Jan 1997 | JP |
10-24051 | Jan 1998 | JP |
11-070124 | May 1998 | JP |
2000-102545 | Sep 1998 | JP |
11-169381 | Jun 1999 | JP |
11244298 | Sep 1999 | JP |
2000-342599 | Dec 2000 | JP |
2000-350732 | Dec 2000 | JP |
2001-008944 | Jan 2001 | JP |
2001-029356 | Feb 2001 | JP |
2001-128990 | May 2001 | JP |
401367 | Nov 1974 | SU |
WO 0036986 | Jun 2000 | WO |
WO 0154604 | Aug 2001 | WO |
WO 2005110264 | Nov 2005 | WO |
Entry |
---|
U.S. Appl. No. 09/387,883, filed Sep. 1, 1999. |
U.S. Appl. No. 09/591,328, filed Jun. 9, 2000. |
U.S. Appl. No. 12/336,970, filed Dec. 17, 2008. |
U.S. Appl. No. 12/429,533, filed Apr. 24, 2009. |
U.S. Appl. No. 12/434,382, filed May 1, 2009. |
U.S. Appl. No. 12/437,254, filed May 7, 2009. |
U.S. Appl. No. 12/503,256, filed Jul. 15, 2009. |
U.S. Appl. No. 12/535,869, filed Aug. 5, 2009. |
U.S. Appl. No. 12/543,831, filed Aug. 19, 2009. |
U.S. Appl. No. 12/548,031, filed Aug. 26, 2009. |
U.S. Appl. No. 12/548,534, filed Aug. 27, 2009. |
U.S. Appl. No. 12/548,566, filed Aug. 27, 2009. |
U.S. Appl. No. 12/551,944, filed Sep. 1, 2009. |
U.S. Appl. No. 12/553,509, filed Sep. 3, 2009. |
U.S. Appl. No. 12/556,025, filed Sep. 9, 2009. |
U.S. Appl. No. 12/556,407, filed Sep. 9, 2009. |
U.S. Appl. No. 12/556,427, filed Sep. 9, 2009. |
U.S. Appl. No. 12/556,796, filed Sep. 10, 2009. |
U.S. Appl. No. 12/562,281, filed Sep. 18, 2009. |
U.S. Appl. No. 12/565,281, filed Sep. 23, 2009. |
U.S. Appl. No. 12/568,199, filed Sep. 28, 2009. |
U.S. Appl. No. 12/568,282, filed Sep. 28, 2009. |
U.S. Appl. No. 12/568,838, filed Sep. 29, 2009. |
U.S. Appl. No. 12/569,395, filed Sep. 29, 2009. |
U.S. Appl. No. 12/569,710, filed Sep. 29, 2009. |
U.S. Appl. No. 12/574,001, filed Oct. 6, 2009. |
U.S. Appl. No. 12/574,292, filed Oct. 6, 2009. |
U.S. Appl. No. 12/576,380, filed Oct. 9, 2009. |
U.S. Appl. No. 12/597,213, filed Oct. 23, 2009. |
U.S. Appl. No. 12/607,191, filed Oct. 28, 2009. |
U.S. Appl. No. 12/619,100, filed Nov. 16, 2009. |
U.S. Appl. No. 12/692,414, filed Jan. 22, 2010. |
U.S. Appl. No. 12/696,592, filed Jan. 29, 2010. |
U.S. Appl. No. 12/696,857, filed Jan. 29, 2010. |
U.S. Appl. No. 12/700,856, filed Feb. 5, 2010. |
U.S. Appl. No. 12/719,407, filed Mar. 8, 2010. |
U.S. Appl. No. 12/728,994, filed Mar. 22, 2010. |
U.S. Appl. No. 12/748,028, filed Mar. 26, 2010. |
U.S. Appl. No. 12/757,340, filed Apr. 9, 2010. |
U.S. Appl. No. 12/758,524, filed Apr. 12, 2010. |
U.S. Appl. No. 12/759,551, filed Apr. 13, 2010. |
U.S. Appl. No. 12/769,444, filed Apr. 28, 2010. |
U.S. Appl. No. 12/770,369, filed Apr. 29, 2010. |
U.S. Appl. No. 12/770,380, filed Apr. 29, 2010. |
U.S. Appl. No. 12/770,387, filed Apr. 29, 2010. |
U.S. Appl. No. 12/773,526, filed May 4, 2010. |
U.S. Appl. No. 12/773,644, filed May 4, 2010. |
U.S. Appl. No. 12/775,553, filed May 7, 2010. |
U.S. Appl. No. 12/786,589, filed May 25, 2010. |
U.S. Appl. No. 12/791,112, filed Jun. 1, 2010. |
U.S. Appl. No. 12/792,001, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,008, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,019, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,038, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,051, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,068, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,097, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,262, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,299, filed Jun. 2, 2010. |
U.S. Appl. No. 12/792,330, filed Jun. 2, 2010. |
U.S. Appl. No. 12/822,024, filed Jun. 23, 2010. |
U.S. Appl. No. 12/821,253, filed Jun. 23, 2010. |
U.S. Appl. No. 12/832,772, filed Jul. 8, 2010. |
U.S. Appl. No. 12/833,270, filed Jul. 9, 2010. |
U.S. Appl. No. 12/843,384, filed Jul. 26, 2010. |
U.S. Appl. No. 12/845,203, filed Jul. 28, 2010. |
U.S. Appl. No. 12/846,602, filed Jul. 29, 2010. |
U.S. Appl. No. 12/853,896, filed Aug. 10, 2010. |
U.S. Appl. No. 12/859,896, filed Aug. 20, 2010. |
U.S. Appl. No. 12/859,985, filed Aug. 20, 2010. |
U.S. Appl. No. 12/861,198, filed Aug. 23, 2010. |
U.S. Appl. No. 12/861,209, filed Aug. 23, 2010. |
U.S. Appl. No. 12/876,662, filed Sep. 7, 2010. |
U.S. Appl. No. 12/876,668, filed Sep. 7, 2010. |
U.S. Appl. No. 12/876,680, filed Sep. 7, 2010. |
U.S. Appl. No. 12/876,705, filed Sep. 7, 2010. |
U.S. Appl. No. 12/876,731, filed Sep. 7, 2010. |
U.S. Appl. No. 12/877,199, filed Sep. 8, 2010. |
U.S. Appl. No. 12/877,482, filed Sep. 8, 2010. |
U.S. Appl. No. 12/879,505, filed Sep. 10, 2010. |
U.S. Appl. No. 12/882,304, filed Sep. 15, 2010. |
U.S. Appl. No. 12/895,020, filed Sep. 30, 2010. |
U.S. Appl. No. 12/896,100, filed Oct. 1, 2010. |
U.S. Appl. No. 12/897,346, filed Oct. 4, 2010. |
Michael Choti, “Abdominoperineal Resection with the LigaSure Vessel Sealing System and LigaSure Atlas 20 cm Open Instrument”; Innovations That Work, Jun. 2003. |
Chung et al., “Clinical Experience of Sutureless Closed Hemorrhoidectomy with LigaSure” Diseases of the Colon & Rectum vol. 46, No. 1 Jan. 2003. |
Tinkcler L.F., “Combined Diathermy and Suction Forceps”, Feb. 6, 1967 (Feb. 6, 1965), British Medical Journal Feb. 6, 1976, vol. 1, nr. 5431 p. 361, ISSN: 0007-1447. |
Carbonell et al., “Comparison of theGyrus PlasmaKinetic Sealer and the Valleylab LigaSure Device in the Hemostasis of Small, Medium, and Large-Sized Arteries” Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC; Date: Aug. 2003. |
Peterson et al. “Comparison of Healing Process Following Ligation with Sutures and Bipolar Vessel Sealing” Surgical Technology International (2001). |
“Electrosurgery: A Historical Overview” Innovations in Electrosurgery; Sales/Product Literature; Dec. 31, 2000. |
Johnson et al. “Evaluation of a Bipolar Electrothermal Vessel Sealing Device in Hemorrhoidectomy” Sales/Product Literature; Jan. 2004. |
E. David Crawford “Evaluation of a New Vessel Sealing Device in Urologic Cancer Surgery” Sales/Product Literature 2000. |
Johnson et al. “Evaluation of the LigaSure Vessel Sealing System in Hemorrhoidectormy” American College of Surgeons (ACS) Clinicla Congress Poster (2000). |
Muller et al., “Extended Left Hemicolectomy Using the LigaSure Vessel Sealing System” Innovations That Work, Sep. 1999. |
Kennedy et al. “High-burst-strength, feedback-controlled bipolar vessel sealing” Surgical Endoscopy (1998) 12: 876-878. |
Burdette et al. “In Vivo Probe Measurement Technique for Determining Dielectric Properties at VHF Through Microwave Frequencies”, IEEE Transactions on Microwave Theory and Techniques, vol. MTT-28, No. 4, Apr. 1980 pp. 414-427. |
Carus et al., “Initial Experience With the LigaSure Vessel Sealing System in Abdominal Surgery” Innovations That Work, Jun. 2002. |
Heniford et al. “Initial Research and Clinical Results with an Electrothermal Bipolar Vessel Sealer” Oct. 1999. |
Heniford et al. “Initial Results with an Electrothermal Bipolar Vessel Sealer” Surgical Endoscopy (2000) 15:799-801. |
Herman et al., “Laparoscopic Intestinal Resection With the LigaSure Vessel Sealing System: A Case Report”; Innovations That Work, Feb. 2002. |
Koyle et al., “Laparoscopic Palomo Varicocele Ligation in Children and Adolescents” Pediatric Endosurgery & Innovative Techniques, vol. 6, No. 1, 2002. |
W. Scott Helton, “LigaSure Vessel Sealing System: Revolutionary Hemostasis Product for General Surgery”; Sales/Product Literature 1999. |
LigaSure Vessel Sealing System, the Seal of Confidence in General, Gynecologic, Urologic, and Laparaoscopic Surgery; Sales/Product Literature; Apr. 2002. |
Joseph Ortenberg “LigaSure System Used in Laparoscopic 1st and 2nd Stage Orchiopexy” Innovations That Work, Nov. 2002. |
Sigel et al. “The Mechanism of Blood Vessel Closure by High Frequency Electrocoagulation” Surgery Gynecology & Obstetrics, Oct. 1965 pp. 823-831. |
Sampayan et al, “Multilayer Ultra-High Gradient Insulator Technology” Discharges and Electrical Insulation in Vacuum, 1998. Netherlands Aug. 17-21, 1998; vol. 2, pp. 740-743. |
Paul G. Horgan, “A Novel Technique for Parenchymal Division During Hepatectomy” The American Journal of Surgery, vol. 181, No. 3, Apr. 2001 pp. 236-237. |
Benaron et al., “Optical Time-of-Flight and Absorbance Imaging of Biologic Media”, Science, American Association for the Advancement of Science, Washington, DC, vol. 259, Mar. 5, 1993, pp. 1463-1466. |
Olsson et al. “Radical Cystectomy in Females” Current Surgical Techniques in Urology, vol. 14, Issue 3, 2001. |
Palazzo et al. “Randomized clinical trial of Ligasure versus open haemorrhoidectomy” British Journal of Surgery 2002, 89, 154-157. |
Levy et al. “Randomized Trial of Suture Versus Electrosurgical Bipolar Vessel Sealing in Vaginal Hysterectomy” Obstetrics & Gynecology, vol. 102, No. 1, Jul. 2003. |
“Reducing NeedleStick Injuries in the Operating Room” Sales/Product Literature 2001. |
Bergdahl et al. “Studies on Coagulation and the Development of an Automatic Computerized Bipolar Coagulator” J.Neurosurg, vol. 75, July 1991, pp. 148-151. |
Strasberg et al. “A Phase I Study of the LigaSure Vessel Sealing System in Hepatic Surgery” Section of HPB Surger, Washington University School of Medicine, St. Louis MO, Presented at AHPBA, Feb. 2001. |
Sayfan et al. “Sutureless Closed Hemorrhoidectomy: A New Technique” Annals of Surgery vol. 234 No. 1 Jul. 2001; pp. 21-24. |
Levy et al., “Update on Hysterectomy—New Technologies and Techniques” OBG Management, Feb. 2003. |
Dulemba et al. “Use of a Bipolar Electrothermal Vessel Sealer in Laparoscopically Assisted Vaginal Hysterectomy” Sales/Product Literature; Jan. 2004. |
Strasberg et al., “Use of a Bipolar Vessel-Sealing Device for Parenchymal Transection During Liver Surgery” Journal of Gastrointestinal Surgery, vol. 6, No. 4, Jul./Aug. 2002 pp. 569-574. |
Sengupta et al., “Use of a Computer-Controlled Bipolar Diathermy System in Radical Prostatectomies and Other Open Urological Surgery” ANZ Journal of Surgery (2001) 71.9 pp. 538-540. |
Rothenberg et al. “Use of the LigaSure Vessel Sealing System in Minimally Invasive Surgery in Children” Int'L Pediatric Endosurgery Group (IPEG) 2000. |
Crawford et al. “Use of the LigaSure Vessel Sealing System in Urologic Cancer Surgery” Grand Rounds in Urology 1999 vol. 1 Issue 4 pp. 10-17. |
Craig Johnson, “Use of the LigaSure Vessel Sealing System in Bloodless Hemorrhoidectomy” Innovations That Work, Mar. 2000. |
Levy et al. “Use of a New Energy-based Vessel Ligation Device During Vaginal Hysterectomy” Int'l Federation of Gynecology and Obstetrics (FIGO) World Congress 1999. |
Barbara Levy, “Use of a New Vessel Ligation Device During Vaginal Hysterectomy” FIGO 2000, Washington, D.C. |
E. David Crawford “Use of a Novel Vessel Sealing Technology in Management of the Dorsal Veinous Complex” Sales/Product Literature 2000. |
Jarrett et al., “Use of the LigaSure Vessel Sealing System for Peri-Hilar Vessels in Laparoscopic Nephrectomy” Sales/Product Literature 2000. |
Crouch et al. “A Velocity-Dependent Model for Needle Insertion in Soft Tissue” MICCAI 2005; LNCS 3750 pp. 624-632, Dated: 2005. |
McLellan et al. “Vessel Sealing for Hemostasis During Pelvic Surgery” Int'l Federation of Gynecology and Obstetrics FIGO World Congress 2000, Washington, D.C. |
McLellan et al. “Vessel Sealing for Hemostasis During Gynecologic Surgery” Sales/Product Literature 1999. |
Int'l Search Report EP 98944778.4 dated Oct. 31, 2000. |
Int'l Search Report EP 98957771 dated Aug. 9, 2001. |
Int'l Search Report EP 98957773 dated Aug. 1, 2001. |
Int'l Search Report EP 98958575.7 dated Sep. 20, 2002. |
Int'l Search Report EP 04013772.1 dated Apr. 1, 2005. |
Int'l Search Report EP 04027314.6 dated Mar. 10, 2005. |
Int'l Search Report EP 04027479.7 dated Mar. 8, 2005. |
Int'l Search Report EP 04027705.5 dated Feb. 3, 2005. |
Int'l Search Report EP 04752343.6 dated Jul. 20, 2007. |
Int'l Search Report EP 05002671.5 dated Dec. 22, 2008. |
Int'l Search Report EP 05002674.9 dated Jan. 16, 2009. |
Int'l Search Report EP 05013463.4 dated Oct. 7, 2005. |
Int'l Search Report EP 05013894 dated Feb. 3, 2006. |
Int'l Search Report EP 05013895.7 dated Oct. 21, 2005. |
Int'l Search Report EP 05016399.7 dated Jan. 13, 2006. |
Int'l Search Report EP 05017281.6 dated Nov. 24, 2005. |
Int'l Search Report EP 05019130.3 dated Oct. 27, 2005. |
Int'l Search Report EP 05019429.9 dated May 6, 2008. |
Int'l Search Report EP 05020532 dated Jan. 10, 2006. |
Int'l Search Report EP 05020665.5 dated Feb. 27, 2006. |
Int'l Search Report EP 05020666.3 dated Feb. 27, 2006. |
Int'l Search Report EP 05021197.8 dated Feb. 20, 2006. |
Int'l Search Report EP 05021779.3 dated Feb. 2, 2006. |
Int'l Search Report EP 05021780.1 dated Feb. 23, 2006. |
Int'l Search Report EP 05021937.7 dated Jan. 23, 2006. |
Int'l Search Report—extended—EP 05021937.7 dated Mar. 15, 2006. |
Int'l Search Report EP 05023017.6 dated Feb. 24, 2006. |
Int'l Search Report EP 06002279.5 dated Mar. 30, 2006. |
Int'l Search Report EP 06005185.1 dated May 10, 2006. |
Int'l Search Report EP 06006716.2 dated Aug. 4, 2006. |
Int'l Search Report EP 06008515.6 dated Jan. 8, 2009. |
Int'l Search Report EP 06008779.8 dated Jul. 13, 2006. |
Int'l Search Report EP 06014461.5 dated Oct. 31, 2006. |
Int'l Search Report EP 06020574.7 dated Oct. 2, 2007. |
Int'l Search Report EP 06020583.8 dated Feb. 7, 2007. |
Int'l Search Report EP 06020584.6 dated Feb. 1, 2007. |
Int'l Search Report EP 06020756.0 dated Feb. 16, 2007. |
Int'l Search Report EP 06 024122.1 dated Apr. 16, 2007. |
Int'l Search Report EP 06024123.9 dated Mar. 6, 2007. |
Int'l Search Report EP 07 001480.8 dated Apr. 19, 2007. |
Int'l Search Report EP 07 001488.1 dated Jun. 5, 2007. |
Int'l Search Report EP 07 009026.1 dated Oct. 8, 2007. |
Int'l Search Report Extended- EP 07 009029.5 dated Jul. 20, 2007. |
Int'l Search Report EP 07 009321.6 dated Aug. 28, 2007. |
Int'l Search Report EP 07 010672.9 dated Oct. 16, 2007. |
Int'l Search Report EP 07 013779.9 dated Oct. 26, 2007. |
Int'l Search Report EP 07 014016 dated Jan. 28, 2008. |
Int'l Search Report EP 07 015191.5 dated Jan. 23, 2008. |
Int'l Search Report EP 07 015601.3 dated Jan. 4, 2008. |
Int'l Search Report EP 07 016911 dated May 28, 2010. |
Int'l Search Report EP 07 020283.3 dated Feb. 5, 2008. |
Int'l Search Report EP 07 021646.0 dated Mar. 20, 2008. |
Int'l Search Report EP 07 021646.0 dated Jul. 9, 2008. |
Int'l Search Report EP 07 021647.8 dated May 2, 2008. |
Int'l Search Report EP 08 002692.5 dated Dec. 12, 2008. |
Int'l Search Report EP 08 004655.0 dated Jun. 24, 2008. |
Int'l Search Report EP 08 006732.5 dated Jul. 29, 2008. |
Int'l Search Report EP 08 006917.2 dated Jul. 3, 2008. |
Int'l Search Report EP 08 016539.2 dated Jan. 8, 2009. |
Int'l Search Report EP 08 020807.7 dated Apr. 24, 2009. |
Int'l Search Report EP 09 003677.3 dated May 4, 2009. |
Int'l Search Report EP 09 003813.4 dated Aug. 3, 2009. |
Int'l Search Report EP 09 004491.8 dated Sep. 9, 2009. |
Int'l Search Report EP 09 005051.9 dated Jul. 6, 2009. |
Int'l Search Report EP 09 005575.7 dated Sep. 9, 2009. |
Int'l Search Report EP 09 010521.4 dated Dec. 16, 2009. |
Int'l Search Report EP 09 011745.8 dated Jan. 5, 2010. |
Int'l Search Report EP 09 012629.3 dated Dec. 8, 2009. |
Int'l Search Report EP 09 012687.1 dated Dec. 23, 2009. |
Int'l Search Report EP 09 012688.9 dated Dec. 28, 2009. |
Int'l Search Report EP 09 152267.2 dated Jun. 15, 2009. |
Int'l Search Report EP 09 152898.4 dated Jun. 10, 2009. |
Int'l Search Report EP 09 154850.3 dated Jul. 20, 2009. |
Int'l Search Report EP 09 160476.9 dated Aug. 4, 2009. |
Int'l Search Report EP 09 164903.8 dated Aug. 21, 2009. |
Int'l Search Report EP 09 165753.6 dated Nov. 11, 2009. |
Int'l Search Report EP 09 168153.6 dated Jan. 14, 2010. |
Int'l Search Report EP 09 168810.1 dated Feb. 2, 2010. |
Int'l Search Report EP 09 172749.5 dated Dec. 4, 2009. |
Int'l Search Report EP 10 000259.1 dated Jun. 30, 2010. |
Int'l Search Report EP 10 157500.9 dated Jul. 30, 2010. |
Int'l Search Report EP 10 159205.3 dated Jul. 7, 2010. |
Int'l Search Report EP 10 160870,1 dated Aug. 9, 2010. |
Int'l Search Report EP 10 161596.1 dated Jul. 28, 2010. |
Int'l Search Report PCT/US98/18640 dated Jan. 29, 1999. |
Int'l Search Report PCT/US98/23950 dated Jan. 14, 1999. |
Int'l Search Report PCT/US98/24281 dated Feb. 22, 1999. |
Int'l Search Report PCT/US99/24869 dated Feb. 3, 2000. |
Int'l Search Report PCT/US01/11218 dated Aug. 14, 2001. |
Int'l Search Report PCT/US01/11224 dated Nov. 13, 2001. |
Int'l Search Report PCT/US01/11340 dated Aug. 16, 2001. |
Int'l Search Report PCT/US01/11420 dated Oct. 16, 2001. |
Int'l Search Report PCT/US02/01890 dated Jul. 25, 2002. |
Int'l Search Report PCT/US02/11100 dated Jul. 16, 2002. |
Int'l Search Report PCT/US03/08146 dated Aug. 8, 2003. |
Int'l Search Report PCT/US03/18676 dated Sep. 19, 2003. |
Int'l Search Report PCT/US03/28534 dated Dec. 19, 2003. |
Int'l Search Report PCT/US04/03436 dated Mar. 3, 2005. |
Int'l Search Report PCT/US04/13273 dated Dec. 15, 2004. |
Int'l Search Report PCT/US04/15311 dated Jan. 12, 2005. |
Int'l Search Report PCT/US07/021438 dated Apr. 1, 2008. |
Int'l Search Report PCT/US07/021440 dated Apr. 8, 2008. |
Int'l Search Report PCT/US08/52460 dated Apr. 24, 2008. |
Int'l Search Report PCT/US08/61498 dated Sep. 22, 2008. |
Int'l Search Report PCT/US09/032690 dated Jun. 16, 2009. |
Number | Date | Country | |
---|---|---|---|
20120041438 A1 | Feb 2012 | US |