Patent Grant
9005198
i. Field of the Invention
The present invention generally relates to surgical devices and methods.
ii. Description of the Related Art
Traditional, or open, surgical techniques may require a surgeon to make large incisions in a patient's body in order to access a tissue treatment region, or surgical site. In some instances, these large incisions may prolong the recovery time of and/or increase the scarring to the patient. As a result, minimally invasive surgical techniques are becoming more preferred among surgeons and patients owing to the reduced size of the incisions required for various procedures. In some circumstances, minimally invasive surgical techniques may reduce the possibility that the patient will suffer undesirable post-surgical conditions, such as scarring and/or infections, for example. Further, such minimally invasive techniques can allow the patient to recover more rapidly as compared to traditional surgical procedures.
Endoscopy is one minimally invasive surgical technique which allows a surgeon to view and evaluate a surgical site by inserting at least one cannula, or trocar, into the patient's body through a natural opening in the body and/or through a relatively small incision. In use, an endoscope can be inserted into, or through, the trocar so that the surgeon can observe the surgical site. In various embodiments, the endoscope may include a flexible or rigid shaft, a camera and/or other suitable optical device, and a handle portion. In at least one embodiment, the optical device can be located on a first, or distal, end of the shaft and the handle portion can be located on a second, or proximal, end of the shaft. In various embodiments, the endoscope may also be configured to assist a surgeon in taking biopsies, retrieving foreign objects, and introducing surgical instruments into the surgical site.
Laparoscopic surgery is another minimally invasive surgical technique where procedures in the abdominal or pelvic cavities can be performed through small incisions in the patient's body. A key element of laparoscopic surgery is the use of a laparoscope which typically includes a telescopic lens system that can be connected to a video camera. In various embodiments, a laparoscope can further include a fiber optic system connected to a halogen or xenon light source, for example, in order to illuminate the surgical site. In various laparoscopic, and/or endoscopic, surgical procedures, a body cavity of a patient, such as the abdominal cavity, for example, can be insufflated with carbon dioxide gas, for example, in order to create a temporary working space for the surgeon. In such procedures, a cavity wall can be elevated above the organs within the cavity by the carbon dioxide gas. Carbon dioxide gas is usually used for insufflation because it can be easily absorbed and removed by the body.
In at least one minimally invasive surgical procedure, an endoscope and/or laparoscope can be inserted through a natural opening of a patient to allow a surgeon to access a surgical site. Such procedures are generally referred to as Nature Orifice Transluminal Endoscopic Surgery or (NOTES)™ and can be utilized to treat tissue while reducing the number of incisions, and external scars, to a patient's body. In various NOTES procedures, for example, an endoscope can include at least one working channel defined therein which can be used to allow the surgeon to insert a surgical instrument therethrough in order to access the surgical site.
The foregoing discussion is intended only to illustrate various aspects of the related art in the field of the invention at the time, and should not be taken as a disavowal of claim scope.
Various features of the embodiments described herein are set forth with particularity in the appended claims. The various embodiments, however, both as to organization and methods of operation, together with advantages thereof, may be understood in accordance with the following description taken in conjunction with the accompanying drawings as follows.
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.
Various embodiments are directed to apparatuses, systems, and methods for the electrical ablation treatment of undesirable tissue such as diseased tissue, cancer, malignant and benign tumors, masses, lesions, and other abnormal tissue growths. 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. It will be understood by those skilled in the art, however, that the embodiments may be practiced without such specific details. In other instances, well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. Those of ordinary skill in the art 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 do not necessarily limit the scope of the embodiments, the scope of which is defined solely by the appended claims.
Reference throughout the specification to “various embodiments,” “some embodiments,” “one embodiment,” or “an embodiment”, or the like, means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in various embodiments,” “in some embodiments,” “in one embodiment,” or “in an embodiment”, or the like, in places throughout the specification are not necessarily all referring to the same embodiment. Furthermore, the 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 or more other embodiments without limitation.
It will be appreciated that the terms “proximal” and “distal” may be used throughout the specification with reference to a clinician manipulating one end of an instrument used to treat a patient. The term “proximal” refers to the portion of the instrument closest to the clinician and the term “distal” refers to the portion located furthest from the clinician. It will be further appreciated that for conciseness and clarity, spatial terms such as “vertical,” “horizontal,” “up,” and “down” may be used herein with respect to the illustrated embodiments. However, surgical instruments may be used in many orientations and positions, and these terms are not intended to be limiting and absolute.
Electrical ablation devices in accordance with the described embodiments may comprise one or more electrodes configured to be positioned into or proximal to undesirable tissue in a tissue treatment region (e.g., target site, worksite) where there is evidence of abnormal tissue growth, for example. In general, the electrodes comprise an electrically conductive portion (e.g., medical grade stainless steel) and are configured to electrically couple to an energy source. Once the electrodes are positioned into or proximal to the undesirable tissue, an energizing potential is applied to the electrodes to create an electric field to which the undesirable tissue is exposed. The energizing potential (and the resulting electric field) may be characterized by multiple parameters such as frequency, amplitude, pulse width (duration of a pulse or pulse length), and/or polarity. Depending on the diagnostic or therapeutic treatment to be rendered, a particular electrode may be configured either as an anode (+) or a cathode (−) or may comprise a plurality of electrodes with at least one configured as an anode and at least one other configured as a cathode. Regardless of the initial polar configuration, the polarity of the electrodes may be reversed by reversing the polarity of the output of the energy source.
In various embodiments, a suitable energy source may comprise an electrical waveform generator, which may be configured to create an electric field that is suitable to create irreversible electroporation in undesirable tissue at various electric filed amplitudes and durations. The energy source may be configured to deliver irreversible electroporation pulses in the form of direct-current (DC) and/or alternating-current (AC) voltage potentials (e.g., time-varying voltage potentials) to the electrodes. The irreversible electroporation pulses may be characterized by various parameters such as frequency, amplitude, pulse length, and/or polarity. The undesirable tissue may be ablated by exposure to the electric potential difference across the electrodes.
In one embodiment, the energy source may comprise a wireless transmitter to deliver energy to the electrodes using wireless energy transfer techniques via one or more remotely positioned antennas. Those skilled in the art will appreciate that wireless energy transfer or wireless power transmission is the process of transmitting electrical energy from an energy source to an electrical load without interconnecting wires. An electrical transformer is the simplest instance of wireless energy transfer. The primary and secondary circuits of a transformer are not directly connected and the transfer of energy takes place by electromagnetic coupling through a process known as mutual induction. Power also may be transferred wirelessly using RF energy. Wireless power transfer technology using RF energy is produced by Powercast, Inc. and can achieve an output of 6 volts for a little over one meter. Other low-power wireless power technology has been proposed such as described in U.S. Pat. No. 6,967,462, the entire disclosure of which is incorporated by reference herein.
The apparatuses, systems, and methods in accordance with certain described embodiments may be configured for minimally invasive ablation treatment of undesirable tissue through the use of irreversible electroporation to be able to ablate undesirable tissue in a controlled and focused manner without inducing thermally damaging effects to the surrounding healthy tissue. The apparatuses, systems, and methods in accordance with the described embodiments may be configured to ablate undesirable tissue through the use of electroporation or electropermeabilization. More specifically, in various embodiments, the apparatuses, systems, and methods in accordance with the described embodiments may be configured to ablate undesirable tissue through the use of irreversible electroporation. Electroporation increases the permeabilization of a cell membrane by exposing the cell to electric pulses. The external electric field (electric potential/per unit length) to which the cell membrane is exposed to significantly increases the electrical conductivity and permeability of the plasma in the cell membrane. The primary parameter affecting the transmembrane potential is the potential difference across the cell membrane. Irreversible electroporation is the application of an electric field of a specific magnitude and duration to a cell membrane such that the permeabilization of the cell membrane cannot be reversed, leading to cell death without inducing a significant amount of heat in the cell membrane. The destabilizing potential forms pores in the cell membrane when the potential across the cell membrane exceeds its dielectric strength causing the cell to die under a process known as apoptosis and/or necrosis. The application of irreversible electroporation pulses to cells is an effective way for ablating large volumes of undesirable tissue without deleterious thermal effects to the surrounding healthy tissue associated with thermal-inducing ablation treatments. This is because irreversible electroporation destroys cells without heat and thus does not destroy the cellular support structure or regional vasculature. A destabilizing irreversible electroporation pulse, suitable to cause cell death without inducing a significant amount of thermal damage to the surrounding healthy tissue, may have amplitude in the range of about several hundred to about several thousand volts and is generally applied across biological membranes over a distance of about several millimeters, for example, for a relatively long duration. Thus, the undesirable tissue may be ablated in-vivo through the delivery of destabilizing electric fields by quickly creating cell necrosis.
The apparatuses, systems, and methods for electrical ablation therapy in accordance with the described embodiments may be adapted for use in minimally invasive surgical procedures to access the tissue treatment region in various anatomic locations such as the brain, lungs, breast, liver, gall bladder, pancreas, prostate gland, and various internal body lumen defined by the esophagus, stomach, intestine, colon, arteries, veins, anus, vagina, cervix, fallopian tubes, and the peritoneal cavity, for example, without limitation. Minimally invasive electrical ablation devices may be introduced to the tissue treatment region using a trocar inserted though a small opening formed in the patient's body or through a natural body orifice such as the mouth, anus, or vagina using translumenal access techniques known as Natural Orifice Translumenal Endoscopic Surgery (NOTES)™. Once the electrical ablation devices (e.g., electrodes) are located into or proximal to the undesirable tissue in the treatment region, electric field potentials can be applied to the undesirable tissue by the energy source. The electrical ablation devices can comprise portions that may be inserted into the tissue treatment region percutaneously (e.g., where access to inner organs or other tissue is done via needle-puncture of the skin). Other portions of the electrical ablation devices may be introduced into the tissue treatment region endoscopically (e.g., laparoscopically and/or thoracoscopically) through trocars or working channels of the endoscope, through small incisions, or transcutaneously (e.g., where electric pulses are delivered to the tissue treatment region through the skin).
In one embodiment, the electrical ablation system 10 may be employed in conjunction with a flexible endoscope 12, as well as a rigid endoscope, laparoscope, or thoracoscope, such as the GIF-100 model available from Olympus Corporation. In one embodiment, the endoscope 12 may be introduced to the tissue treatment region trans-anally through the colon, trans-orally through the esophagus and stomach, trans-vaginally through the cervix, transcutaneously, or via an external incision or keyhole formed in the abdomen in conjunction with a trocar. The electrical ablation system 10 may be inserted and guided into or proximate the tissue treatment region using the endoscope 12.
In the embodiment illustrated in
In one embodiment, the electrical ablation system 10 may comprise an electrical ablation device 20, a plurality of electrical conductors 18, a handpiece 16 comprising an activation switch 62, and an energy source 14, such as an electrical waveform generator, electrically coupled to the activation switch 62 and the electrical ablation device 20. The electrical ablation device 20 comprises a relatively flexible member or shaft 22 that may be introduced to the tissue treatment region using a variety of known techniques such as an open incision and a trocar, through one of more of the working channels of the endoscope 12, percutaneously, or transcutaneously, for example.
In one embodiment, one or more electrodes (e.g., needle electrodes, balloon electrodes), such as first and second electrodes 24a,b, extend out from the distal end of the electrical ablation device 20. In one embodiment, the first electrode 24a may be configured as the positive electrode and the second electrode 24b may be configured as the negative electrode. The first electrode 24a is electrically connected to a first electrical conductor 18a, or similar electrically conductive lead or wire, which is coupled to the positive terminal of the energy source 14 through the activation switch 62. The second electrode 24b is electrically connected to a second electrical conductor 18b, or similar electrically conductive lead or wire, which is coupled to the negative terminal of the energy source 14 through the activation switch 62. The electrical conductors 18a,b are electrically insulated from each other and surrounding structures, except for the electrical connections to the respective electrodes 24a,b. In various embodiments, the electrical ablation device 20 may be configured to be introduced into or proximate the tissue treatment region using the endoscope 12 (laparoscope or thoracoscope), open surgical procedures, or external and non-invasive medical procedures. The electrodes 24a,b may be referred to herein as endoscopic or laparoscopic electrodes, although variations thereof may be inserted transcutaneously or percutaneously. As previously discussed, either one or both electrodes 24a,b may be adapted and configured to slideably move in and out of a cannula, lumen, or channel defined within the flexible shaft 22.
Once the electrodes 24a,b are positioned at the desired location into or proximate the tissue treatment region, the electrodes 24a,b may be connected to or disconnected from the energy source 14 by actuating or de-actuating the switch 62 on the handpiece 16. The switch 62 may be operated manually or may be mounted on a foot switch (not shown), for example. The electrodes 24a,b deliver electric field pulses to the undesirable tissue. The electric field pulses may be characterized based on various parameters such as pulse shape, amplitude, frequency, and duration. The electric field pulses may be sufficient to induce irreversible electroporation in the undesirable tissue. The induced potential depends on a variety of conditions such as tissue type, cell size, and electrical pulse parameters. The primary electrical pulse parameter affecting the transmembrane potential for a specific tissue type is the amplitude of the electric field and pulse length that the tissue is exposed to.
In one embodiment, a protective sleeve or sheath 26 may be slideably disposed over the flexible shaft 22 and within a handle 28. In another embodiment, the sheath 26 may be slideably disposed within the flexible shaft 22 and the handle 28, without limitation. The sheath 26 is slideable and may be located over the electrodes 24a,b to protect the trocar and prevent accidental piercing when the electrical ablation device 20 is advanced therethrough. Either one or both of the electrodes 24a,b of the electrical ablation device 20 may be adapted and configured to slideably move in and out of a cannula, lumen, or channel formed within the flexible shaft 22. The second electrode 24b may be fixed in place. The second electrode 24b may provide a pivot about which the first electrode 24a can be moved in an arc to other points in the tissue treatment region to treat larger portions of the diseased tissue that cannot be treated by fixing the electrodes 24a,b in one location. In one embodiment, either one or both of the electrodes 24a,b may be adapted and configured to slideably move in and out of a working channel formed within a flexible shaft 32 of the flexible endoscope 12 or may be located independently of the flexible endoscope 12. Various features of the first and second electrodes 24a,b are described in more detail in
In one embodiment, the first and second electrical conductors 18a,b may be provided through the handle 28. In the illustrated embodiment, the first electrode 24a can be slideably moved in and out of the distal end of the flexible shaft 22 using a slide member 30 to retract and/or advance the first electrode 24a. In various embodiments either or both electrodes 24a,b may be coupled to the slide member 30, or additional slide members, to advance and retract the electrodes 24a,b, e.g., position the electrodes 24a,b. In the illustrated embodiment, the first electrical conductor 18a coupled to the first electrode 24a is coupled to the slide member 30. In this manner, the first electrode 24a, which is slideably movable within the cannula, lumen, or channel defined by the flexible shaft 22, can advanced and retracted with the slide member 30.
In various other embodiments, transducers or sensors 29 may be located in the handle 28 of the electrical ablation device 20 to sense the force with which the electrodes 24a,b penetrate the tissue in the tissue treatment zone. This feedback information may be useful to determine whether either one or both of the electrodes 24a,b have been properly inserted in the tissue treatment region. As is particularly well known, cancerous tumor tissue tends to be denser than healthy tissue and thus greater force is required to insert the electrodes 24a,b therein. The transducers or sensors 29 can provide feedback to the operator, surgeon, or clinician to physically sense when the electrodes 24a,b are placed within the cancerous tumor. The feedback information provided by the transducers or sensors 29 may be processed and displayed by circuits located either internally or externally to the energy source 14. The sensor 29 readings may be employed to determine whether the electrodes 24a,b have been properly located within the cancerous tumor thereby assuring that a suitable margin of error has been achieved in locating the electrodes 24a,b.
In one embodiment, the input to the energy source 14 may be connected to a commercial power supply by way of a plug (not shown). The output of the energy source 14 is coupled to the electrodes 24a,b, which may be energized using the activation switch 62 on the handpiece 16, or in one embodiment, an activation switch mounted on a foot activated pedal (not shown). The energy source 14 may be configured to produce electrical energy suitable for electrical ablation, as described in more detail below.
In one embodiment, the electrodes 24a,b are adapted and configured to electrically couple to the energy source 14 (e.g., generator, waveform generator). Once electrical energy is coupled to the electrodes 24a,b, an electric field is formed at a distal end of the electrodes 24a,b. The energy source 14 may be configured to generate electric pulses at a predetermined frequency, amplitude, pulse length, and/or polarity that are suitable to induce irreversible electroporation to ablate substantial volumes of undesirable tissue in the treatment region. For example, the energy source 14 may be configured to deliver DC electric pulses having a predetermined frequency, amplitude, pulse length, and/or polarity suitable to induce irreversible electroporation to ablate substantial volumes of undesirable tissue in the treatment region. The DC pulses may be positive or negative relative to a particular reference polarity. The polarity of the DC pulses may be reversed or inverted from positive-to-negative or negative-to-positive a predetermined number of times to induce irreversible electroporation to ablate substantial volumes of undesirable tissue in the treatment region.
In one embodiment, a timing circuit may be coupled to the output of the energy source 14 to generate electric pulses. The timing circuit may comprise one or more suitable switching elements to produce the electric pulses. For example, the energy source 14 may produce a series of n electric pulses (where n is any positive integer) of sufficient amplitude and duration to induce irreversible electroporation suitable for tissue ablation when the n electric pulses are applied to the electrodes 24a,b. In one embodiment, the electric pulses may have a fixed or variable pulse length, amplitude, and/or frequency.
The electrical ablation device 20 may be operated either in bipolar or monopolar mode. In bipolar mode, the first electrode 24a is electrically connected to a first polarity and the second electrode 24b is electrically connected to the opposite polarity. For example, in monopolar mode, the first electrode 24a is coupled to a prescribed voltage and the second electrode 24b is set to ground. In the illustrated embodiment, the energy source 14 may be configured to operate in either the bipolar or monopolar modes with the electrical ablation system 10. In bipolar mode, the first electrode 24a is electrically connected to a prescribed voltage of one polarity and the second electrode 24b is electrically connected to a prescribed voltage of the opposite polarity. When more than two electrodes are used, the polarity of the electrodes may be alternated so that any two adjacent electrodes may have either the same or opposite polarities, for example.
In monopolar mode, it is not necessary that the patient be grounded with a grounding pad. Since a monopolar energy source 14 is typically constructed to operate upon sensing a ground pad connection to the patient, the negative electrode of the energy source 14 may be coupled to an impedance simulation circuit. In this manner, the impedance circuit simulates a connection to the ground pad and thus is able to activate the energy source 14. It will be appreciated that in monopolar mode, the impedance circuit can be electrically connected in series with either one of the electrodes 24a,b that would otherwise be attached to a grounding pad.
In one embodiment, the energy source 14 may be configured to produce RF waveforms at predetermined frequencies, amplitudes, pulse widths or durations, and/or polarities suitable for electrical ablation of cells in the tissue treatment region. One example of a suitable RF energy source is a commercially available conventional, bipolar/monopolar electrosurgical RF generator such as Model Number ICC 350, available from Erbe, GmbH.
In one embodiment, the energy source 14 may be configured to produce destabilizing electrical potentials (e.g., fields) suitable to induce irreversible electroporation. The destabilizing electrical potentials may be in the form of bipolar/monopolar DC electric pulses suitable for inducing irreversible electroporation to ablate tissue undesirable tissue with the electrical ablation device 20. A commercially available energy source suitable for generating irreversible electroporation electric filed pulses in bipolar or monopolar mode is a pulsed DC generator such as Model Number ECM 830, available from BTX Molecular Delivery Systems Boston, Mass. In bipolar mode, the first electrode 24a may be electrically coupled to a first polarity and the second electrode 24b may be electrically coupled to a second (e.g., opposite) polarity of the energy source 14. Bipolar/monopolar DC electric pulses may be produced at a variety of frequencies, amplitudes, pulse lengths, and/or polarities. Unlike RF ablation systems, however, which require high power and energy levels delivered into the tissue to heat and thermally destroy the tissue, irreversible electroporation requires very little energy input into the tissue to kill the undesirable tissue without the detrimental thermal effects because with irreversible electroporation the cells are destroyed by electric field potentials rather than heat.
In one embodiment, the energy source 14 may be coupled to the first and second electrodes 24a,b by either a wired or a wireless connection. In a wired connection, the energy source 14 is coupled to the electrodes 24a,b by way of the electrical conductors 18a,b, as shown. In a wireless connection, the electrical conductors 18a,b may be replaced with a first antenna (not shown) coupled the energy source 14 and a second antenna (not shown) coupled to the electrodes 24a,b, wherein the second antenna is remotely located from the first antenna. In one embodiment, the energy source may comprise a wireless transmitter to deliver energy to the electrodes using wireless energy transfer techniques via one or more remotely positioned antennas. As previously discussed, wireless energy transfer or wireless power transmission is the process of transmitting electrical energy from the energy source 14 to an electrical load, e.g., the abnormal cells in the tissue treatment region, without using the interconnecting electrical conductors 18a,b. An electrical transformer is the simplest instance of wireless energy transfer. The primary and secondary circuits of a transformer are not directly connected. The transfer of energy takes place by electromagnetic coupling through a process known as mutual induction. Wireless power transfer technology using RF energy is produced by Powercast, Inc. The Powercast system can achieve a maximum output of 6 volts for a little over one meter. Other low-power wireless power technology has been proposed such as described in U.S. Pat. No. 6,967,462.
In one embodiment, the energy source 14 may be configured to produce DC electric pulses at frequencies in the range of about 1 Hz to about 10000 Hz, amplitudes in the range of about ±100 to about ±3000 VDC, and pulse lengths (e.g., pulse width, pulse duration) in the range of about 1 μs to about 100 ms. The polarity of the electric potentials coupled to the electrodes 24a,b may be reversed during the electrical ablation therapy. For example, initially, the DC electric pulses may have a positive polarity and an amplitude in the range of about +100 to about +3000 VDC. Subsequently, the polarity of the DC electric pulses may be reversed such that the amplitude is in the range of about −100 to about −3000 VDC. In one embodiment, the undesirable cells in the tissue treatment region may be electrically ablated with DC pulses suitable to induce irreversible electroporation at frequencies of about 10 Hz to about 100 Hz, amplitudes in the range of about +700 to about +1500 VDC, and pulse lengths of about 10 μs to about 50 μs. In another embodiment, the abnormal cells in the tissue treatment region may be electrically ablated with an electrical waveform having an amplitude of about +500 VDC and pulse duration of about 20 ms delivered at a pulse period T or repetition rate, frequency f=1/T, of about 10 Hz. It has been determined that an electric field strength of 1,000V/cm is suitable for destroying living tissue by inducing irreversible electroporation.
Various electrical ablation devices are disclosed in commonly-owned U.S. patent application Ser. No. 11/897,676 titled “ELECTRICAL ABLATION SURGICAL INSTRUMENTS,” filed Aug. 31, 2007, the entire disclosure of which is incorporated herein by reference in its entirety. Various other devices are disclosed in commonly-owned U.S. patent application Ser. No. 12/352,375, titled “ELECTRICAL ABLATION DEVICES”, filed on Jan. 12, 2009, the entire disclosure of which is incorporated herein by reference in its entirety.
In various embodiments, referring now to
In various embodiments, referring again to
In various embodiments, further to the above, the first electrode 124a can comprise a solid-core rod, or needle, having a diameter of about 1.0 mm, for example. The second electrode 124b can be cylindrical or tubular and, in at least one embodiment, the second electrode 124b can have an inner diameter of about 4.5 mm, for example, and a wall thickness of about 1.0 mm, for example. In at least one such embodiment, an annular or circumferential gap 142a can extend between the exterior perimeter of first electrode 124a and the inner perimeter of second electrode 124b, wherein the gap 142a can have a width of about 1.75 mm, for example. Similar to the above, the third electrode 124c can be cylindrical or tubular and, in at least one embodiment, the third electrode 124c can have an inner diameter of about 8.5 mm, for example, and a wall thickness of about 1.0 mm, for example. In at least one such embodiment, an annular or circumferential gap 142b can extend between the exterior perimeter of the second electrode 124b and the inner perimeter of the third electrode 124c, wherein the gap 142b can have a width of about 1.50 mm, for example. In various embodiments, the gap 142a and/or the gap 142b can have a constant, or an at least substantially constant, width along its circumference. In certain embodiments, the gaps 142a and 142b can have the same, or at least substantially the same, width.
In various embodiments, referring to
In various embodiments, referring now to
In various embodiments, referring now to
In at least one embodiment, the surgical instrument 100 can be utilized to treat mucus tissue within a patient's esophagus, for example, wherein the distal ends of the electrodes can be positioned against the mucus tissue. In various circumstances, owing to the water or plasma content of the mucus tissue, a relatively smaller voltage potential between the electrodes may be utilized to treat the mucus tissue as compared to the voltage potential used to treat the epidermis and/or dermis of a patient's skin, for example. In certain embodiments, the second electrode 124b can be set to about 500 VDC, for example, and the first electrode 124a and the third electrode 124c can be set to ground, for example. In certain embodiments, the distal ends of the electrodes 124a, 124b, and/or 124c can comprise one or more sharp edges and/or points which can be configured to incise the tissue being treated. In at least one such embodiment, the sharp edges and/or points can allow the electrodes to be burrowed into the tissue such that larger quantities of the tissue can be treated or more effectively treated. In certain embodiments, the distal ends of the electrodes 124a, 124b, and/or 124c can have roughened surfaces which can be configured to abrade the tissue.
As outlined above, a first conductor can be electrically coupled with the second electrode 124b and a second conductor can be electrically coupled with both the first electrode 124a and the third electrode 124c, wherein, as a result, the first electrode 124a and the third electrode 124c can have the same, or at least substantially the same, voltage potential, i.e., a first voltage potential. Furthermore, such a first voltage potential can be different than the voltage potential of the second electrode 124b, i.e., a second voltage potential. In at least one such embodiment, the first and second voltage potentials of the electrodes can be adjusted to provide the desired electric field and/or current within the tissue. In certain embodiments, the surgical instrument 100 can further comprise a third conductor electrically coupled with a third terminal of the power source, wherein, in at least one embodiment, the electrodes 124a, 124b, and 124c can each be electrically coupled with one of the first, second, and third electrodes. For example, the first electrode 124a can be electrically coupled with the first conductor, the second electrode 124b can be electrically coupled with the second conductor, and the third electrode can be electrically coupled with the third conductor. In at least one such embodiment, a first voltage potential can be applied to the first electrode 124a, a second voltage potential can be applied to the second electrode 124b, and a third voltage potential can be applied to the third electrode 124c, wherein the first, second, and third voltage potentials can have different magnitudes, polarities, phases, and/or any other suitable differences.
As discussed above, second electrode 124b and third electrode 124c can have circular, or at least substantially circular, configurations which can be concentric with one another. In other various embodiments, the circular second electrode 124b and the circular third electrode 124c may not be concentric with one another. In certain embodiments, the electrodes 124a, 124b, and/or 124c can have any other suitable configuration such as square configurations and/or triangular configurations, for example. Furthermore, although surgical instrument 100 has been illustrated and described as having three electrodes, other embodiments are envisioned which can comprise four or more electrodes, for example. In at least one such embodiment, the surgical instrument can comprise four concentric circular electrodes, for example. Certain embodiments may have two electrodes.
In various embodiments, referring now to
Further to the above, the electric field and/or current generated within the tissue can treat and/or destroy the tissue surrounding the electrodes 224a and 224b and/or positioned between the electrodes 224a and 224b. In various embodiments, the shaft 222 can compromise a first groove or recess 244a configured to receive the first electrode 224a. In at least one embodiment, the first groove 244a and/or the first electrode 224a can be annular, or at least substantially annular, and can extend around the entire perimeter of shaft 222. In various other embodiments, the first groove 244a and/or the first electrode 224a can have any suitable shape and can extend around less than the entire perimeter of shaft 222. In certain embodiments, the first electrode 224a can be seated within the first groove 244a such that there is no relative movement between the first electrode 224a and the shaft 222. Various other embodiments are envisioned in which first electrode 224a can move relative to shaft 222. In any event, the first electrode 224a can be press-fit or snap-fit within the first groove 244a and, in at least one embodiment, an adhesive can be used to secure the first electrode 224a within first groove 244a. In certain embodiments, one or more fasteners can be used to secure first electrode 224a within first groove 244a. The first electrode 224a can be comprised of metal, such as stainless steel, for example, and/or comprised of a flexible adhesive strip configured to adhere to shaft 222. In certain embodiments, the first electrode 224a can be plated, such as by an electroplating process, for example, onto the shaft 200, for example. Similarly, the first conductor electrically coupled with the first electrode 224a can be plated onto the shaft 200, for example.
In various embodiments, further to the above, the shaft 222 can compromise a second groove or recess 244b configured to receive the second electrode 224b. In at least one embodiment, the second groove 244b and/or the second electrode 224b can be annular, or at least substantially annular, and can extend around the entire perimeter of shaft 222. In various other embodiments, the second groove 244b and/or second electrode 224b can have any suitable shape and can extend around less than the entire perimeter of shaft 222. In certain embodiments, the second electrode 224b can be seated within the second groove 244b such that there is no relative movement between the second electrode 224b and the shaft 222. Various other embodiments are envisioned in which second electrode 224b can move relative to shaft 222. In any event, the second electrode 224b can be press-fit or snap-fit within the second groove 244b and, in at least one embodiment, an adhesive can be used to secure the second electrode 224b within second groove 244b. In certain embodiments, one or more fasteners can be used to secure second electrode 224b within second groove 244b. The second electrode 224b can be comprised of metal, such as stainless steel, for example, and/or comprised of a flexible adhesive strip configured to adhere to shaft 222. In certain embodiments, the second electrode 224b can be plated, such as by an electroplating process, for example, onto the shaft 200, for example. Similarly, the second conductor electrically coupled with the second electrode 224b can be plated onto the shaft 200, for example.
In various embodiments, further to the above, the first electrode 224a can be positioned within the first groove 244a such that the outer surface 225a of the first electrode 224a is flush with the outer surface of shaft 222. In at least one such embodiment, the first groove 244a can have a depth and the first electrode 224a can have a thickness, or height, which is the same, or at least substantially the same, as the depth of the first groove 244a. Similarly, the second electrode 224b can be positioned within the second groove 244b such that the outer surface 225b of second electrode 224b is flush with the outer surface of shaft 222. In at least one such embodiment, the second groove 244b can have a depth and the second electrode 224b can have a thickness, or height, which is the same, or at least substantially the same, as the depth of the second groove 244b. Such embodiments can allow the distal end 240 of the biopsy punch 200 to be inserted into a surgical site without electrodes 224a and 224b catching on the inside surface of a trocar, for example, and yet allow the outside surfaces 225a and 225b of electrodes 224a and 224b, respectively, to make intimate contact with the tissue within the surgical site. In certain other embodiments, however, at least a portion of one or more of the outside surfaces 225a and 225b can be raised, or project outwardly, from the outside surface of the shaft 222. In at least one such embodiment, the electrodes 224a and 224b can be mounted to shaft 222 without being positioned within a recess or groove, for example. In various other embodiments, at least a portion of one or more of the outside surfaces 225a and 225b can be recessed with respect to the outside surface of the shaft 222. In at least one such embodiment, the first groove 244a can be deeper than the thickness of the first electrode 224a, for example.
In various embodiments, further to the above, each of the first electrode 224a and/or the second electrode 224b can comprise a continuous ring of conductive material which extends around the entire perimeter of shaft 222. The first electrode 224a and the second electrode 224b can be positioned along an axis, such as longitudinal axis 299, for example, wherein the electrodes 224a and 224b can be centered, or at least substantially centered, with respect to axis 299. In at least one embodiment, the first electrode 224a and the second electrode 224b can be separated by a gap and/or an insulative material positioned therebetween. In at least one such embodiment, the shaft 200 can comprise one or more insulative materials which extend between and/or around the electrodes. In various embodiments, although not illustrated, a biopsy punch can comprise more than two electrodes positioned along an axis, for example. In at least one such embodiment, a biopsy punch can comprise three electrodes positioned along an axis, wherein a first electrode electrically coupled with a cathode of a power source can be positioned intermediate electrodes on opposite sides thereof which are electrically coupled with an anode of the power source. In certain embodiments, although not illustrated, each electrode 224a and 224b can comprise an array of electrode members positioned around the circumference of shaft 222. In at least one such embodiment, each electrode array member can be separated from adjacent electrode array members by a gap and/or an insulative material, for example. In certain embodiments, the shaft 222 may be curved and/or the electrodes may be positioned along a curved path.
In use, as described above, biopsy punch 200 can be inserted into tissue, such as skin, for example, wherein the distal end 240 of biopsy punch 200 can be sufficiently sharp and/or otherwise sufficiently configured to incise and/or penetrate the tissue. Although biopsy punch 200 can be inserted into skin, biopsy punch 200 can be inserted into any other suitable type of tissue. In any event, owing to a circular, or at least substantially circular, shape of distal end 240, for example, the distal end 240 can create a circular, or at least substantially circular, incision in the skin, although other configurations of distal end 240 are possible. The distal end 240 of the biopsy punch 200 can further comprise an aperture, or cavity, 242 which can be configured to receive a portion of the tissue as the tissue is incised. More particularly, in at least some circumstances, the sharp edge of distal end 240 can create a plug of tissue “P” which can be captured within the cavity 242 as the biopsy punch 240 is inserted into the tissue. Once the tissue plug P has been created, the tissue positioned around the distal end 240 can be incised such that the tissue plug P can be removed from the surgical site with the biopsy punch 200. In various circumstances, the tissue plug P is then examined and/or tested.
In various circumstances, further to the above, the biopsy punch 200 may be utilized to sample or remove potentially cancerous tissue. In certain circumstances, the distal end 240 may not be sufficiently sized to capture all of the potentially cancerous tissue and, as a result, it may also be desirable to treat or ablate the tissue which previously surrounded the tissue plug P. In various embodiments, further to the above, the first and second electrodes 224a, 224b, can be utilized to treat and/or destroy the tissue surrounding the outside perimeter of distal end 240. More particularly, as outlined above, one or more of the electrodes 224a and 224b can be polarized such that an electric field is created within the tissue surrounding the outside perimeter of shaft 222 and/or such that current can flow between the electrodes within the tissue surrounding the outside perimeter of shaft 200. In various embodiments, the electrodes 224a and 224b can be configured and arranged such that very little, if any, electric field or current is generated within tissue plug P. More particularly, in at least one embodiment, the electrodes 224a, 224b may not extend into the cavity 242 or along the inside surface of the shaft 222; rather they extend around the outside surface of shaft 222, for example. As a result of the above, the tissue plug P may be relatively unaffected by the electric field and/or current and may be better preserved for evaluation.
In various embodiments, further to the above, the second electrode 224b can be positioned distally with respect to the first electrode 224a such that the second electrode 224b is positioned deeper within the tissue when the biopsy punch 200 is inserted into the tissue. In various other embodiments, the first electrode 224a can be positioned distally with respect to the second electrode 224b. In certain embodiments, the first electrode 224a can be positioned on shaft 222 such that, when the second electrode 224b is positioned within the dermis and/or subcutis of a patient's skin, the first electrode 224a can be positioned within the epidermis of the skin, for example. In any event, once biopsy punch 200 has been suitably positioned within the tissue, electrode 224a and/or 224b can be polarized. In at least one embodiment, for example, the first electrode 224a can be polarized at 1500 VDC and the second electrode 224b can be set to ground.
In various embodiments, referring now to
Referring again to
In various embodiments, further to the above, the surgical instrument 300, for example, can comprise a first conductor 331 which can be electrically coupled to a cathode of a power source, for example, and the electrodes 324b. The first conductor 331 can comprise a wire extending along handle 322 to a slip ring connector 332 mounted on first spindle support 325a, for example. In at least one embodiment, the slip ring connector can comprise a first portion 333 mounted to spindle support 325a and a second portion 334 mounted to rotatable cylinder 324a. In at least one such embodiment, the second portion 334 can move relative to the first portion 333. More particularly, when the cylinder 324a is rotated relative to the first spindle support 325a, the second portion 334 of the slip ring connector 332 can rotate relative to the first portion 333 mounted to the first spindle 325a and yet still maintain electrical contact therebetween. In at least one such embodiment, the first portion 333 of the slip ring connector can comprise a circular conductive ring, for example, which is fixed to, or stationary with respect to, first spindle 325a and, in addition, the second portion 334 of the slip ring connector can comprise a brush, for example, positioned against the conductive ring. More particularly, the brush can comprise flexible metal bristles, for example, which are positioned against the conductive ring such that, as the brush is moved relative to the conductive ring, the bristles can slide over the conductive ring and maintain a conductive path therebetween.
In various embodiments, referring now to
The electrodes 324b can be polarized in order to generate electric fields which can treat and/or destroy the tissue surrounding the electrodes 324b. In various circumstances, electric current can flow from the electrodes 324b and into the tissue. In at least one embodiment, a grounding pad or return electrode can be positioned underneath the patient and/or relative to the tissue being treated such that the current flowing though the tissue can flow into the grounding pad or return electrode. In various embodiments, the surgical instrument 300 can comprise a ground or return electrode. More particularly, in at least one embodiment, cylinder 324a can comprise an electrode which can be configured to allow current to flow from electrodes 324b, through the tissue, and into cylinder 324a. In various embodiments, the exterior surface of cylinder 324a can comprise a conductive material, such as stainless steel, for example. In at least one embodiment, the surgical instrument 300 can further comprise a second conductor which is electrically coupled with the cylinder 324a and an anode of the power source.
In various circumstances, as described above, the instrument 300 can be positioned such that the electrodes 324b come into contact with the targeted tissue wherein the electrodes 324b can extend from the outside surface of cylinder 324a and penetrate the tissue. In various other embodiments, the electrodes may not extend from the outside surface of the cylinder 324a. In at least one embodiment, the electrodes can comprise a surface which sits flush, or at least substantially flush, with the outside surface of cylinder 324a. In certain embodiments, the electrodes can comprise curved surfaces defined by a radius of curvature which is the same as, or at least substantially the same as, the radius of curvature which defines the outside surface of cylinder 324a, for example. In at least one embodiment, the electrodes can comprise flat, or at least substantially flat, surfaces which are aligned, or at least substantially aligned, with the outside surface of cylinder 324a. Furthermore, although the exemplary embodiment is illustrated as having eight rows of electrodes, each row comprising four electrodes, other embodiments are envisioned in which the surgical instrument comprises any suitable number or rows of electrodes, such as four, twelve, and/or sixteen rows, for example, having any suitable number of electrodes, such as three, five, six, seven, and/or eight electrodes, for example.
In various embodiments, referring now to
In certain embodiments, the second electrode 424b can be configured to rotate freely relative to the first electrode 424a such that, owing to the rotation of first electrode 424a in direction A and the positioning of tissue T against the second electrode 424b, the second electrode 424b can be rotated in the direction indicated by arrow “B”. In at least one embodiment, the surgical instrument 400 can further comprise a motor 435 mounted to frame 420 which, similar to the above, can be configured to rotate the second electrode 424b. More particularly, the surgical instrument 400 can further comprise at least one drive belt and/or chain, such as belt 437, for example, which can be configured to transmit the rotation of drive gear 436 of motor 435 to sprocket 438, wherein, also similar to the above, sprocket 438 can be mounted to second electrode 424. In certain circumstances, the first electrode 424a and the second electrode 424b can be rotated simultaneously by motors 430 and 435, respectively, in order to pull the tissue T intermediate first electrode 424a and second electrode 424b. In some circumstances, the first electrode 424a and the second electrode 424 can be rotated sequentially. In various embodiments, the frame 420 can be rigid, or at least substantially rigid, such that there is little, if any, relative outward displacement between first electrode 424a and second electrode 424b. In some embodiments, however, leg 421 and/or leg 422 of frame 420 can be configured to move or flex outwardly, or away from one another. In at least one such embodiment, the outward movement of leg 421 and/or 422 can allow gap 440 to increase in size in order to accommodate thicker tissue therebetween. In certain embodiments, although not illustrated, at least one of the legs 421 and 422 can be pivotably attached to frame 420 wherein the instrument 400 can further comprise at least one spring configured to bias the first and second electrodes 424a and 424b toward one another.
In various embodiments, further to the above, the surgical instrument 400 can comprise means for polarizing one or more of the electrodes 424a and 424b. In certain embodiments, the surgical instrument 400 can further comprise a first conductor 425a extending through handle 422 and frame 420 wherein the first conductor 425a can be electrically coupled with a cathode of a power source and the first electrode 424a such that current can flow through the first conductor 425a and into the first electrode 424a. In various circumstances, the current can flow through the tissue T and into the second electrode 424b. The surgical instrument can further comprise a second conductor 425b extending through handle 422 and frame 420 wherein the second conductor 425b can be electrically coupled with the second electrode 424b and an anode of the power source and/or any suitable ground such that the current can flow from the second electrode 424b and out of the surgical instrument 400 via second conductor 425b, for example.
In various circumstances, the current flowing between the first electrode 424a and the second electrode 424b and through the tissue T can create a seal within the tissue. In certain circumstances, the current can heat the tissue and denature the collagen within the tissue such that, when the tissue cools, the collagen can form a seal therein. Such a seal can cause a portion of the tissue, i.e., a portion of the tissue sealed off from the blood supply, for example, to become necrotic. In various circumstances, the quality of the seal can depend on the force applied to the tissue by the first and second electrodes, 424a and 424b, for example. In certain circumstances, a larger force applied by the electrodes can create a better, or more consistent and effective, seal. As outlined above, the gap 440 between the first and second electrodes 424a and 424b can be sized and dimensioned such that the tissue T is compressed intermediate the electrodes and such that a sufficient force is applied to the tissue. In various embodiments, as also outlined above, the force applied to the tissue by the first and second electrodes 424a and 424b can be variable and/or adjustable by the application of a spring force, for example. In various embodiments, as illustrated in
In various surgical techniques, the first and second electrodes 424a and 424b can be positioned against tissue and at least one of the electrodes 424a and 424b can be rotated to pull the tissue in-between the electrodes. In some embodiments, a switch on surgical instrument 400, for example, can be operated to supply electrical current the electrical circuit comprising first conductor 425a, first electrode 424a, second electrode 424b, and second conductor 425b. In some techniques, the switch can be actuated before the electrodes 424a and 424b are positioned against the tissue while, in other techniques, the switch can be actuated after the tissue T has been positioned intermediate the electrodes 424a and 424b. Although the exemplary embodiment in
As discussed above, the electrodes of a surgical instrument disclosed herein can be positioned against the tissue of a patient, wherein an electric field can be created between the electrodes such that current can flow between the electrodes through the tissue. In various circumstances, a surgeon can apply a force to the surgical instrument in order to press the electrodes against, and/or into, the tissue. In at least one such embodiment, the force can be applied along a longitudinal axis, such as axis 199, for example, of the surgical instrument. In certain embodiments, one or more of the surgical instruments disclosed herein, for example, can comprise one or more vacuum lumens, or suction lines, which can be configured to hold tissue against the electrodes of the surgical instrument. More particularly, in at least one embodiment, surgical instrument 100, for example, can comprise a vacuum lumen having a suction inlet which is in close proximity to the distal ends of one or more of electrodes 124a, 124b, and/or 124c, for example. In use, the vacuum lumen can be operably coupled with a pump which can create a negative pressure differential at the suction inlet of the vacuum lumen in order to apply a sufficient holding force to the tissue and hold the tissue against the distal ends of one or more of the electrodes 124a, 124b, and/or 124c. In at least one such embodiment, a vacuum lumen can extend from a proximal handle of the surgical instrument to its distal end and, in various embodiments, the vacuum lumen can comprise a plurality of suction inlets to hold the tissue.
In various embodiments, a surgical instrument assembly, such as surgical instrument 700, for example, can comprise a handle, an elongate shaft, or catheter, 732 extending from the handle, and an end effector comprising a plurality of electrodes, such as electrodes 724a, 724b, and 724c, for example, wherein the electrodes can be positioned against the tissue to be treated. In certain embodiments, the surgical instrument 700 can further comprise a spreader mechanism, or biasing mechanism, 790 configured to position the electrodes 724a, 724b, and/or 724c relative to one another. In at least one embodiment, the handle, for example, of surgical instrument 700 can comprise an actuator which can be configured to move spreader mechanism 790 and electrodes 724a, 724b, and 724c between a first, or retracted, position in which the spreader mechanism 790 and at least a portion of electrodes 724a, 724b, and 724c are positioned within an aperture 733 in shaft 732 and a second, or extended, position (
When electrodes 724a, 724b, and 724c are in their extended position, further to the above, spreader mechanism 790 can be configured to position the electrodes 724a, 724b, and/or 724c relative to one another. More particularly, in at least one embodiment, the spreader mechanism 790 can be configured to position electrodes 724a, 724b, and 724c in a linear, or at least substantially linear, array, for example, wherein spreader mechanism 790 can position first electrode 724a relative to second electrode 724b and, in addition, third electrode 724c relative to second electrode 724b. As illustrated in
In various embodiments, spreader mechanism 790 can comprise a plurality of fingers, such as fingers 791a, 791b, and 791c, for example, configured to connect electrodes 724a, 724b, and 724c, respectively, to spreader mechanism 790. Further to the above, finger 791a can be configured to flex inwardly toward finger 791b when spreader mechanism 790 is pulled into shaft 732. When finger 791a is flexed inwardly, first electrode 724a can move toward second electrode 724b in order to decrease distance D1. Similarly, finger 791c can be configured to flex inwardly toward finger 791b when spreader mechanism 790 is pulled into shaft 732 and, when finger 791c is flexed inwardly, third electrode 724c can move toward second electrode 724b in order to decrease distance D1. In various embodiments, finger 791a can comprise a cam surface 792a which can be configured to contact the distal end 731 of shaft 732 such that finger 791a can be moved toward finger 791b. Similarly, finger 791c can comprise a cam surface 792c which can be configured to contact the distal end 731 of shaft 732 such that finger 791c can be moved toward finger 791b. In various embodiments, the surgical instrument 700 can further comprise one or more connectors which can be configured to limit the distance in which spreader mechanism 790 can separate the electrodes 724, 724b, and/or 724c. More particularly, in at least one embodiment, the surgical instrument 700 can further comprise a distal connector 793 connected to electrodes 724a, 724b, and/or 724c which can limit the distance in which the distal ends of electrodes 724a, 724b, and 724c can be spread, i.e., distance D1. In certain embodiments, distal connector 793 can comprise a string, chain, and/or flexible member. Similarly, the surgical instrument 700 can further comprise a proximal connector 794 connected to electrodes 724a, 724b, and/or 724c which can be configured to limit the relative movement of the proximal ends of electrodes 724a, 724b, and 724c.
In various embodiments, referring now to
The embodiments of the devices described herein may be introduced inside a patient using minimally invasive or open surgical techniques. In some instances it may be advantageous to introduce the devices inside the patient using a combination of minimally invasive and open surgical techniques. Minimally invasive techniques may provide more accurate and effective access to the treatment region for diagnostic and treatment procedures. To reach internal treatment regions within the patient, the devices described herein may be inserted through natural openings of the body such as the mouth, anus, and/or vagina, for example. Minimally invasive procedures performed by the introduction of various medical devices into the patient through a natural opening of the patient are known in the art as NOTES™ procedures. Some portions of the devices may be introduced to the tissue treatment region percutaneously or through small—keyhole—incisions.
Endoscopic minimally invasive surgical and diagnostic medical procedures are used to evaluate and treat internal organs by inserting a small tube into the body. The endoscope may have a rigid or a flexible tube. A flexible endoscope may be introduced either through a natural body opening (e.g., mouth, anus, and/or vagina) or via a trocar through a relatively small—keyhole—incision incisions (usually 0.5-1.5 cm). The endoscope can be used to observe surface conditions of internal organs, including abnormal or diseased tissue such as lesions and other surface conditions and capture images for visual inspection and photography. The endoscope may be adapted and configured with working channels for introducing medical instruments to the treatment region for taking biopsies, retrieving foreign objects, and/or performing surgical procedures.
Preferably, the various embodiments of the devices described herein will be processed before surgery. First, a new or used instrument is obtained and if necessary cleaned. The instrument can 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 are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility. Other sterilization techniques can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, and/or steam.
In various embodiments, the devices disclosed herein, and/or the electrodes thereof, can be cleaned utilizing one or more enzymatic cleaners, detergents, and/or acids, and/or one or more steam cleaning and/or mechanical polishing processes, for example. In various embodiments, one or more of the electrodes of the devices disclosed herein can be removed from the device and replaced. In certain embodiments, one or more of the electrodes can be removed from the device, cleaned, and reattached via solder, welding, epoxy, and/or an adhesive, for example. In various embodiments, the devices disclosed herein, and/or the electrodes thereof, can be sterilized utilizing steam, gamma radiation, ethylene oxide, peroxide solution, and/or electron-beam processes, for example.
Although the various embodiments of the devices have been described herein in connection with certain disclosed embodiments, many modifications and variations to those embodiments may be implemented. For example, different types of end effectors may be employed. Also, where materials are disclosed for certain components, other materials may be used. The foregoing description and following claims are intended to cover all such modification and variations.
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 does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
| Number | Name | Date | Kind |
|---|---|---|---|
| 645576 | Telsa | Mar 1900 | A |
| 649621 | Tesla | May 1900 | A |
| 787412 | Tesla | Apr 1905 | A |
| 1039354 | Bonadio | Sep 1912 | A |
| 1127948 | Wappler | Feb 1915 | A |
| 1482653 | Lilly | Feb 1924 | A |
| 1625602 | Gould et al. | Apr 1927 | A |
| 1916722 | Ende | Jul 1933 | A |
| 2028635 | Wappler | Jan 1936 | A |
| 2031682 | Wappler et al. | Feb 1936 | A |
| 2113246 | Wappler | Apr 1938 | A |
| 2155365 | Rankin | Apr 1939 | A |
| 2191858 | Moore | Feb 1940 | A |
| 2196620 | Attarian | Apr 1940 | A |
| 2388137 | Graumlich | Oct 1945 | A |
| 2493108 | Casey, Jr. | Jan 1950 | A |
| 2504152 | Riker et al. | Apr 1950 | A |
| 2938382 | De Graaf | May 1960 | A |
| 2952206 | Becksted | Sep 1960 | A |
| 3069195 | Buck | Dec 1962 | A |
| 3070088 | Brahos | Dec 1962 | A |
| 3170471 | Schnitzer | Feb 1965 | A |
| 3435824 | Gamponia | Apr 1969 | A |
| 3470876 | Barchilon | Oct 1969 | A |
| 3595239 | Petersen | Jul 1971 | A |
| 3669487 | Roberts et al. | Jun 1972 | A |
| 3746881 | Fitch et al. | Jul 1973 | A |
| 3799672 | Vurek | Mar 1974 | A |
| 3854473 | Matsuo | Dec 1974 | A |
| 3946740 | Bassett | Mar 1976 | A |
| 3948251 | Hosono | Apr 1976 | A |
| 3961632 | Moossun | Jun 1976 | A |
| 3965890 | Gauthier | Jun 1976 | A |
| 3994301 | Agris | Nov 1976 | A |
| 4011872 | Komiya | Mar 1977 | A |
| 4012812 | Black | Mar 1977 | A |
| 4085743 | Yoon | Apr 1978 | A |
| 4164225 | Johnson et al. | Aug 1979 | A |
| 4174715 | Hasson | Nov 1979 | A |
| 4178920 | Cawood, Jr. et al. | Dec 1979 | A |
| 4207873 | Kruy | Jun 1980 | A |
| 4235238 | Ogiu et al. | Nov 1980 | A |
| 4258716 | Sutherland | Mar 1981 | A |
| 4269174 | Adair | May 1981 | A |
| 4278077 | Mizumoto | Jul 1981 | A |
| 4285344 | Marshall | Aug 1981 | A |
| 4311143 | Komiya | Jan 1982 | A |
| 4329980 | Terada | May 1982 | A |
| 4396021 | Baumgartner | Aug 1983 | A |
| 4406656 | Hattler et al. | Sep 1983 | A |
| 4452246 | Bader et al. | Jun 1984 | A |
| 4461281 | Carson | Jul 1984 | A |
| 4491132 | Aikins | Jan 1985 | A |
| 4527331 | Lasner et al. | Jul 1985 | A |
| 4527564 | Eguchi et al. | Jul 1985 | A |
| 4538594 | Boebel et al. | Sep 1985 | A |
| D281104 | Davison | Oct 1985 | S |
| 4569347 | Frisbie | Feb 1986 | A |
| 4580551 | Siegmund et al. | Apr 1986 | A |
| 4646722 | Silverstein et al. | Mar 1987 | A |
| 4653476 | Bonnet | Mar 1987 | A |
| 4655219 | Petruzzi | Apr 1987 | A |
| 4669470 | Brandfield | Jun 1987 | A |
| 4671477 | Cullen | Jun 1987 | A |
| 4677982 | Llinas et al. | Jul 1987 | A |
| 4685447 | Iversen et al. | Aug 1987 | A |
| 4711240 | Goldwasser et al. | Dec 1987 | A |
| 4712545 | Honkanen | Dec 1987 | A |
| 4721116 | Schintgen et al. | Jan 1988 | A |
| 4727600 | Avakian | Feb 1988 | A |
| 4733662 | DeSatnick et al. | Mar 1988 | A |
| D295894 | Sharkany et al. | May 1988 | S |
| 4763669 | Jaeger | Aug 1988 | A |
| 4770188 | Chikama | Sep 1988 | A |
| 4815450 | Patel | Mar 1989 | A |
| 4823794 | Pierce | Apr 1989 | A |
| 4829999 | Auth | May 1989 | A |
| 4867140 | Hovis et al. | Sep 1989 | A |
| 4869238 | Opie et al. | Sep 1989 | A |
| 4869459 | Bourne | Sep 1989 | A |
| 4873979 | Hanna | Oct 1989 | A |
| 4880015 | Nierman | Nov 1989 | A |
| 4911148 | Sosnowski et al. | Mar 1990 | A |
| 4926860 | Stice et al. | May 1990 | A |
| 4938214 | Specht et al. | Jul 1990 | A |
| 4950273 | Briggs | Aug 1990 | A |
| 4950285 | Wilk | Aug 1990 | A |
| 4953539 | Nakamura et al. | Sep 1990 | A |
| 4960133 | Hewson | Oct 1990 | A |
| 4977887 | Gouda | Dec 1990 | A |
| 4979950 | Transue et al. | Dec 1990 | A |
| 4984581 | Stice | Jan 1991 | A |
| 4994079 | Genese et al. | Feb 1991 | A |
| 5007917 | Evans | Apr 1991 | A |
| 5010876 | Henley et al. | Apr 1991 | A |
| 5020514 | Heckele | Jun 1991 | A |
| 5020535 | Parker et al. | Jun 1991 | A |
| 5025778 | Silverstein et al. | Jun 1991 | A |
| 5033169 | Bindon | Jul 1991 | A |
| 5037433 | Wilk et al. | Aug 1991 | A |
| 5041129 | Hayhurst et al. | Aug 1991 | A |
| 5046513 | Gatturna et al. | Sep 1991 | A |
| 5050585 | Takahashi | Sep 1991 | A |
| 5052372 | Shapiro | Oct 1991 | A |
| 5065516 | Dulebohn | Nov 1991 | A |
| 5066295 | Kozak et al. | Nov 1991 | A |
| 5108421 | Fowler | Apr 1992 | A |
| 5123913 | Wilk et al. | Jun 1992 | A |
| 5123914 | Cope | Jun 1992 | A |
| 5133727 | Bales et al. | Jul 1992 | A |
| 5147374 | Fernandez | Sep 1992 | A |
| 5174300 | Bales et al. | Dec 1992 | A |
| 5176126 | Chikama | Jan 1993 | A |
| 5190050 | Nitzsche | Mar 1993 | A |
| 5190555 | Wetter et al. | Mar 1993 | A |
| 5192284 | Pleatman | Mar 1993 | A |
| 5192300 | Fowler | Mar 1993 | A |
| 5197963 | Parins | Mar 1993 | A |
| 5201752 | Brown et al. | Apr 1993 | A |
| 5201908 | Jones | Apr 1993 | A |
| 5203785 | Slater | Apr 1993 | A |
| 5203787 | Noblitt et al. | Apr 1993 | A |
| 5209747 | Knoepfler | May 1993 | A |
| 5217003 | Wilk | Jun 1993 | A |
| 5217453 | Wilk | Jun 1993 | A |
| 5219357 | Honkanen et al. | Jun 1993 | A |
| 5219358 | Bendel et al. | Jun 1993 | A |
| 5222362 | Maus et al. | Jun 1993 | A |
| 5222965 | Haughton | Jun 1993 | A |
| 5234437 | Sepetka | Aug 1993 | A |
| 5234453 | Smith et al. | Aug 1993 | A |
| 5235964 | Abenaim | Aug 1993 | A |
| 5242456 | Nash et al. | Sep 1993 | A |
| 5245460 | Allen et al. | Sep 1993 | A |
| 5246424 | Wilk | Sep 1993 | A |
| 5257999 | Slanetz, Jr. | Nov 1993 | A |
| 5259366 | Reydel et al. | Nov 1993 | A |
| 5263958 | deGuillebon et al. | Nov 1993 | A |
| 5273524 | Fox et al. | Dec 1993 | A |
| 5275607 | Lo et al. | Jan 1994 | A |
| 5275614 | Haber et al. | Jan 1994 | A |
| 5275616 | Fowler | Jan 1994 | A |
| 5284128 | Hart | Feb 1994 | A |
| 5284162 | Wilk | Feb 1994 | A |
| 5287845 | Faul et al. | Feb 1994 | A |
| 5287852 | Arkinstall | Feb 1994 | A |
| 5290299 | Fain et al. | Mar 1994 | A |
| 5290302 | Pericic | Mar 1994 | A |
| 5295977 | Cohen et al. | Mar 1994 | A |
| 5297536 | Wilk | Mar 1994 | A |
| 5297687 | Freed | Mar 1994 | A |
| 5301061 | Nakada et al. | Apr 1994 | A |
| 5312023 | Green et al. | May 1994 | A |
| 5312333 | Churinetz et al. | May 1994 | A |
| 5312351 | Gerrone | May 1994 | A |
| 5312416 | Spaeth et al. | May 1994 | A |
| 5312423 | Rosenbluth et al. | May 1994 | A |
| 5318589 | Lichtman | Jun 1994 | A |
| 5320636 | Slater | Jun 1994 | A |
| 5324261 | Amundson et al. | Jun 1994 | A |
| 5325845 | Adair | Jul 1994 | A |
| 5330471 | Eggers | Jul 1994 | A |
| 5330486 | Wilk | Jul 1994 | A |
| 5330488 | Goldrath | Jul 1994 | A |
| 5330496 | Alferness | Jul 1994 | A |
| 5330502 | Hassler et al. | Jul 1994 | A |
| 5331971 | Bales et al. | Jul 1994 | A |
| 5334168 | Hemmer | Aug 1994 | A |
| 5334198 | Hart et al. | Aug 1994 | A |
| 5341815 | Cofone et al. | Aug 1994 | A |
| 5342396 | Cook | Aug 1994 | A |
| 5344428 | Griffiths | Sep 1994 | A |
| 5345927 | Bonutti | Sep 1994 | A |
| 5350391 | Iacovelli | Sep 1994 | A |
| 5352184 | Goldberg et al. | Oct 1994 | A |
| 5352222 | Rydell | Oct 1994 | A |
| 5354302 | Ko | Oct 1994 | A |
| 5354311 | Kambin et al. | Oct 1994 | A |
| 5356381 | Ensminger et al. | Oct 1994 | A |
| 5356408 | Rydell | Oct 1994 | A |
| 5360428 | Hutchinson, Jr. | Nov 1994 | A |
| 5364408 | Gordon | Nov 1994 | A |
| 5364410 | Failla et al. | Nov 1994 | A |
| 5366466 | Christian et al. | Nov 1994 | A |
| 5366467 | Lynch et al. | Nov 1994 | A |
| 5368605 | Miller, Jr. | Nov 1994 | A |
| 5370647 | Graber et al. | Dec 1994 | A |
| 5370679 | Atlee, III | Dec 1994 | A |
| 5374273 | Nakao et al. | Dec 1994 | A |
| 5374275 | Bradley et al. | Dec 1994 | A |
| 5374277 | Hassler | Dec 1994 | A |
| 5377695 | An Haack | Jan 1995 | A |
| 5383877 | Clarke | Jan 1995 | A |
| 5383888 | Zvenyatsky et al. | Jan 1995 | A |
| 5386817 | Jones | Feb 1995 | A |
| 5387259 | Davidson | Feb 1995 | A |
| 5391174 | Weston | Feb 1995 | A |
| 5392789 | Slater et al. | Feb 1995 | A |
| 5395386 | Slater | Mar 1995 | A |
| 5401248 | Bencini | Mar 1995 | A |
| 5403311 | Abele et al. | Apr 1995 | A |
| 5403328 | Shallman | Apr 1995 | A |
| 5403342 | Tovey et al. | Apr 1995 | A |
| 5403348 | Bonutti | Apr 1995 | A |
| 5405073 | Porter | Apr 1995 | A |
| 5405359 | Pierce | Apr 1995 | A |
| 5409478 | Gerry et al. | Apr 1995 | A |
| 5417699 | Klein et al. | May 1995 | A |
| 5423821 | Pasque | Jun 1995 | A |
| 5433721 | Hooven et al. | Jul 1995 | A |
| 5439471 | Kerr | Aug 1995 | A |
| 5439478 | Palmer | Aug 1995 | A |
| 5441059 | Dannan | Aug 1995 | A |
| 5441494 | Ortiz | Aug 1995 | A |
| 5441499 | Fritzsch | Aug 1995 | A |
| 5443463 | Stern et al. | Aug 1995 | A |
| 5445638 | Rydell et al. | Aug 1995 | A |
| 5445648 | Cook | Aug 1995 | A |
| 5449021 | Chikama | Sep 1995 | A |
| 5454827 | Aust et al. | Oct 1995 | A |
| 5456667 | Ham et al. | Oct 1995 | A |
| 5456684 | Schmidt et al. | Oct 1995 | A |
| 5458131 | Wilk | Oct 1995 | A |
| 5458583 | McNeely et al. | Oct 1995 | A |
| 5460168 | Masubuchi et al. | Oct 1995 | A |
| 5460629 | Shlain et al. | Oct 1995 | A |
| 5462561 | Voda | Oct 1995 | A |
| 5465731 | Bell et al. | Nov 1995 | A |
| 5467763 | McMahon et al. | Nov 1995 | A |
| 5468250 | Paraschac et al. | Nov 1995 | A |
| 5470308 | Edwards et al. | Nov 1995 | A |
| 5470320 | Tiefenbrun et al. | Nov 1995 | A |
| 5478347 | Aranyi | Dec 1995 | A |
| 5478352 | Fowler | Dec 1995 | A |
| 5480404 | Kammerer et al. | Jan 1996 | A |
| 5482054 | Slater et al. | Jan 1996 | A |
| 5484451 | Akopov et al. | Jan 1996 | A |
| 5489256 | Adair | Feb 1996 | A |
| 5496347 | Hashiguchi et al. | Mar 1996 | A |
| 5499990 | Schülken et al. | Mar 1996 | A |
| 5499992 | Meade et al. | Mar 1996 | A |
| 5501692 | Riza | Mar 1996 | A |
| 5503616 | Jones | Apr 1996 | A |
| 5505686 | Willis et al. | Apr 1996 | A |
| 5507755 | Gresl et al. | Apr 1996 | A |
| 5511564 | Wilk | Apr 1996 | A |
| 5514157 | Nicholas et al. | May 1996 | A |
| 5518501 | Oneda et al. | May 1996 | A |
| 5522829 | Michalos | Jun 1996 | A |
| 5522830 | Aranyi | Jun 1996 | A |
| 5527321 | Hinchliffe | Jun 1996 | A |
| 5533418 | Wu et al. | Jul 1996 | A |
| 5536248 | Weaver et al. | Jul 1996 | A |
| 5538509 | Dunlap et al. | Jul 1996 | A |
| 5540648 | Yoon | Jul 1996 | A |
| 5549637 | Crainich | Aug 1996 | A |
| 5554151 | Hinchliffe | Sep 1996 | A |
| 5555883 | Avitall | Sep 1996 | A |
| 5558133 | Bortoli et al. | Sep 1996 | A |
| 5562693 | Devlin et al. | Oct 1996 | A |
| 5569243 | Kortenbach et al. | Oct 1996 | A |
| 5569298 | Schnell | Oct 1996 | A |
| 5571090 | Sherts | Nov 1996 | A |
| 5573540 | Yoon | Nov 1996 | A |
| 5578030 | Levin | Nov 1996 | A |
| 5582611 | Tsuruta et al. | Dec 1996 | A |
| 5582617 | Klieman et al. | Dec 1996 | A |
| 5584845 | Hart | Dec 1996 | A |
| 5591179 | Edelstein | Jan 1997 | A |
| 5591205 | Fowler | Jan 1997 | A |
| 5593420 | Eubanks, Jr. et al. | Jan 1997 | A |
| 5595562 | Grier | Jan 1997 | A |
| 5597378 | Jervis | Jan 1997 | A |
| 5601573 | Fogelberg et al. | Feb 1997 | A |
| 5601588 | Tonomura et al. | Feb 1997 | A |
| 5601602 | Fowler | Feb 1997 | A |
| 5604531 | Iddan et al. | Feb 1997 | A |
| 5607389 | Edwards et al. | Mar 1997 | A |
| 5607406 | Hernandez et al. | Mar 1997 | A |
| 5607450 | Zvenyatsky et al. | Mar 1997 | A |
| 5609601 | Kolesa et al. | Mar 1997 | A |
| 5613975 | Christy | Mar 1997 | A |
| 5616117 | Dinkler et al. | Apr 1997 | A |
| 5618303 | Marlow et al. | Apr 1997 | A |
| 5620415 | Lucey et al. | Apr 1997 | A |
| 5624399 | Ackerman | Apr 1997 | A |
| 5624431 | Gerry et al. | Apr 1997 | A |
| 5626578 | Tihon | May 1997 | A |
| 5628732 | Antoon, Jr. et al. | May 1997 | A |
| 5630782 | Adair | May 1997 | A |
| 5643283 | Younker | Jul 1997 | A |
| 5643292 | Hart | Jul 1997 | A |
| 5643294 | Tovey et al. | Jul 1997 | A |
| 5644798 | Shah | Jul 1997 | A |
| 5645083 | Essig et al. | Jul 1997 | A |
| 5645565 | Rudd et al. | Jul 1997 | A |
| 5649372 | Souza | Jul 1997 | A |
| 5653677 | Okada et al. | Aug 1997 | A |
| 5653690 | Booth et al. | Aug 1997 | A |
| 5653722 | Kieturakis | Aug 1997 | A |
| 5657755 | Desai | Aug 1997 | A |
| 5662621 | Lafontaine | Sep 1997 | A |
| 5662663 | Shallman | Sep 1997 | A |
| 5667527 | Cook | Sep 1997 | A |
| 5669875 | van Eerdenburg | Sep 1997 | A |
| 5681324 | Kammerer et al. | Oct 1997 | A |
| 5681330 | Hughett et al. | Oct 1997 | A |
| 5685820 | Riek et al. | Nov 1997 | A |
| 5690606 | Slotman | Nov 1997 | A |
| 5690656 | Cope et al. | Nov 1997 | A |
| 5690660 | Kauker et al. | Nov 1997 | A |
| 5695448 | Kimura et al. | Dec 1997 | A |
| 5695505 | Yoon | Dec 1997 | A |
| 5695511 | Cano et al. | Dec 1997 | A |
| 5700275 | Bell et al. | Dec 1997 | A |
| 5702438 | Avitall | Dec 1997 | A |
| 5704892 | Adair | Jan 1998 | A |
| 5709708 | Thal | Jan 1998 | A |
| 5711921 | Langford | Jan 1998 | A |
| 5716326 | Dannan | Feb 1998 | A |
| 5716375 | Fowler | Feb 1998 | A |
| 5728094 | Edwards | Mar 1998 | A |
| 5730740 | Wales et al. | Mar 1998 | A |
| 5735849 | Baden et al. | Apr 1998 | A |
| 5741234 | Aboul-Hosn | Apr 1998 | A |
| 5741278 | Stevens | Apr 1998 | A |
| 5741285 | McBrayer et al. | Apr 1998 | A |
| 5741429 | Donadio, III et al. | Apr 1998 | A |
| 5743456 | Jones et al. | Apr 1998 | A |
| 5746759 | Meade et al. | May 1998 | A |
| 5749826 | Faulkner | May 1998 | A |
| 5749881 | Sackier et al. | May 1998 | A |
| 5749889 | Bacich et al. | May 1998 | A |
| 5752951 | Yanik | May 1998 | A |
| 5755731 | Grinberg | May 1998 | A |
| 5762604 | Kieturakis | Jun 1998 | A |
| 5766167 | Eggers et al. | Jun 1998 | A |
| 5766170 | Eggers | Jun 1998 | A |
| 5766205 | Zvenyatsky et al. | Jun 1998 | A |
| 5769849 | Eggers | Jun 1998 | A |
| 5779701 | McBrayer et al. | Jul 1998 | A |
| 5779716 | Cano et al. | Jul 1998 | A |
| 5779727 | Orejola | Jul 1998 | A |
| 5782859 | Nicholas et al. | Jul 1998 | A |
| 5782861 | Cragg et al. | Jul 1998 | A |
| 5782866 | Wenstrom, Jr. | Jul 1998 | A |
| 5791022 | Bohman | Aug 1998 | A |
| 5792113 | Kramer et al. | Aug 1998 | A |
| 5792153 | Swain et al. | Aug 1998 | A |
| 5792165 | Klieman et al. | Aug 1998 | A |
| 5797835 | Green | Aug 1998 | A |
| 5797928 | Kogasaka | Aug 1998 | A |
| 5797939 | Yoon | Aug 1998 | A |
| 5797941 | Schulze et al. | Aug 1998 | A |
| 5797959 | Castro et al. | Aug 1998 | A |
| 5803903 | Athas et al. | Sep 1998 | A |
| 5808665 | Green | Sep 1998 | A |
| 5810806 | Ritchart et al. | Sep 1998 | A |
| 5810849 | Kontos | Sep 1998 | A |
| 5810865 | Koscher et al. | Sep 1998 | A |
| 5810876 | Kelleher | Sep 1998 | A |
| 5810877 | Roth et al. | Sep 1998 | A |
| 5813976 | Filipi et al. | Sep 1998 | A |
| 5814058 | Carlson et al. | Sep 1998 | A |
| 5817061 | Goodwin et al. | Oct 1998 | A |
| 5817107 | Schaller | Oct 1998 | A |
| 5817119 | Klieman et al. | Oct 1998 | A |
| 5819736 | Avny et al. | Oct 1998 | A |
| 5823947 | Yoon et al. | Oct 1998 | A |
| 5824071 | Nelson et al. | Oct 1998 | A |
| 5827276 | LeVeen et al. | Oct 1998 | A |
| 5827281 | Levin | Oct 1998 | A |
| 5827299 | Thomason et al. | Oct 1998 | A |
| 5827323 | Klieman et al. | Oct 1998 | A |
| 5830231 | Geiges, Jr. | Nov 1998 | A |
| 5833603 | Kovacs et al. | Nov 1998 | A |
| 5833700 | Fogelberg et al. | Nov 1998 | A |
| 5833703 | Manushakian | Nov 1998 | A |
| 5836960 | Kolesa et al. | Nov 1998 | A |
| 5843017 | Yoon | Dec 1998 | A |
| 5843121 | Yoon | Dec 1998 | A |
| 5849022 | Sakashita et al. | Dec 1998 | A |
| 5853374 | Hart et al. | Dec 1998 | A |
| 5855585 | Kontos | Jan 1999 | A |
| 5860913 | Yamaya et al. | Jan 1999 | A |
| 5860995 | Berkelaar | Jan 1999 | A |
| 5868762 | Cragg et al. | Feb 1999 | A |
| 5876411 | Kontos | Mar 1999 | A |
| 5882331 | Sasaki | Mar 1999 | A |
| 5882344 | Stouder, Jr. | Mar 1999 | A |
| 5893846 | Bales et al. | Apr 1999 | A |
| 5893874 | Bourque et al. | Apr 1999 | A |
| 5893875 | O'Connor et al. | Apr 1999 | A |
| 5897487 | Ouchi | Apr 1999 | A |
| 5899919 | Eubanks, Jr. et al. | May 1999 | A |
| 5902254 | Magram | May 1999 | A |
| 5904702 | Ek et al. | May 1999 | A |
| 5908420 | Parins et al. | Jun 1999 | A |
| 5908429 | Yoon | Jun 1999 | A |
| 5911737 | Lee et al. | Jun 1999 | A |
| 5916146 | Allotta et al. | Jun 1999 | A |
| 5916147 | Boury | Jun 1999 | A |
| 5921993 | Yoon | Jul 1999 | A |
| 5921997 | Fogelberg et al. | Jul 1999 | A |
| 5922008 | Gimpelson | Jul 1999 | A |
| 5925052 | Simmons | Jul 1999 | A |
| 5928255 | Meade et al. | Jul 1999 | A |
| 5928266 | Kontos | Jul 1999 | A |
| 5936536 | Morris | Aug 1999 | A |
| 5944718 | Austin et al. | Aug 1999 | A |
| 5951547 | Gough et al. | Sep 1999 | A |
| 5951549 | Richardson et al. | Sep 1999 | A |
| 5954720 | Wilson et al. | Sep 1999 | A |
| 5954731 | Yoon | Sep 1999 | A |
| 5957936 | Yoon et al. | Sep 1999 | A |
| 5957943 | Vaitekunas | Sep 1999 | A |
| 5957953 | DiPoto et al. | Sep 1999 | A |
| 5964782 | Lafontaine et al. | Oct 1999 | A |
| 5971995 | Rousseau | Oct 1999 | A |
| 5972002 | Bark et al. | Oct 1999 | A |
| 5976074 | Moriyama | Nov 1999 | A |
| 5976075 | Beane et al. | Nov 1999 | A |
| 5976130 | McBrayer et al. | Nov 1999 | A |
| 5976131 | Guglielmi et al. | Nov 1999 | A |
| 5980539 | Kontos | Nov 1999 | A |
| 5980556 | Giordano et al. | Nov 1999 | A |
| 5984938 | Yoon | Nov 1999 | A |
| 5984939 | Yoon | Nov 1999 | A |
| 5984950 | Cragg et al. | Nov 1999 | A |
| 5989182 | Hori et al. | Nov 1999 | A |
| 5993447 | Blewett et al. | Nov 1999 | A |
| 5993474 | Ouchi | Nov 1999 | A |
| 5995875 | Blewett et al. | Nov 1999 | A |
| 5997555 | Kontos | Dec 1999 | A |
| 6001120 | Levin | Dec 1999 | A |
| 6004269 | Crowley et al. | Dec 1999 | A |
| 6004330 | Middleman et al. | Dec 1999 | A |
| 6007566 | Wenstrom, Jr. | Dec 1999 | A |
| 6010515 | Swain et al. | Jan 2000 | A |
| 6012494 | Balazs | Jan 2000 | A |
| 6016452 | Kasevich | Jan 2000 | A |
| 6017356 | Frederick et al. | Jan 2000 | A |
| 6019770 | Christoudias | Feb 2000 | A |
| 6024708 | Bales et al. | Feb 2000 | A |
| 6024747 | Kontos | Feb 2000 | A |
| 6027522 | Palmer | Feb 2000 | A |
| 6030365 | Laufer | Feb 2000 | A |
| 6030384 | Nezhat | Feb 2000 | A |
| 6030634 | Wu et al. | Feb 2000 | A |
| 6033399 | Gines | Mar 2000 | A |
| 6036685 | Mueller | Mar 2000 | A |
| 6053927 | Hamas | Apr 2000 | A |
| 6053937 | Edwards et al. | Apr 2000 | A |
| 6066160 | Colvin et al. | May 2000 | A |
| 6068603 | Suzuki | May 2000 | A |
| 6068629 | Haissaguerre et al. | May 2000 | A |
| 6071233 | Ishikawa et al. | Jun 2000 | A |
| 6074408 | Freeman | Jun 2000 | A |
| 6086530 | Mack | Jul 2000 | A |
| 6090105 | Zepeda et al. | Jul 2000 | A |
| 6090108 | McBrayer et al. | Jul 2000 | A |
| 6090129 | Ouchi | Jul 2000 | A |
| 6096046 | Weiss | Aug 2000 | A |
| 6102909 | Chen et al. | Aug 2000 | A |
| 6102926 | Tartaglia et al. | Aug 2000 | A |
| 6106473 | Violante et al. | Aug 2000 | A |
| 6106521 | Blewett et al. | Aug 2000 | A |
| 6109852 | Shahinpoor et al. | Aug 2000 | A |
| 6110183 | Cope | Aug 2000 | A |
| 6113593 | Tu et al. | Sep 2000 | A |
| 6117144 | Nobles et al. | Sep 2000 | A |
| 6117158 | Measamer et al. | Sep 2000 | A |
| 6139555 | Hart et al. | Oct 2000 | A |
| 6141037 | Upton et al. | Oct 2000 | A |
| 6146391 | Cigaina | Nov 2000 | A |
| 6148222 | Ramsey, III | Nov 2000 | A |
| 6149653 | Deslauriers | Nov 2000 | A |
| 6149662 | Pugliesi et al. | Nov 2000 | A |
| 6152920 | Thompson et al. | Nov 2000 | A |
| 6156006 | Brosens et al. | Dec 2000 | A |
| 6159200 | Verdura et al. | Dec 2000 | A |
| 6165175 | Wampler et al. | Dec 2000 | A |
| 6165184 | Verdura et al. | Dec 2000 | A |
| 6168570 | Ferrera | Jan 2001 | B1 |
| 6168605 | Measamer et al. | Jan 2001 | B1 |
| 6169269 | Maynard | Jan 2001 | B1 |
| 6170130 | Hamilton et al. | Jan 2001 | B1 |
| 6179776 | Adams et al. | Jan 2001 | B1 |
| 6179832 | Jones et al. | Jan 2001 | B1 |
| 6179837 | Hooven | Jan 2001 | B1 |
| 6183420 | Douk et al. | Feb 2001 | B1 |
| 6190353 | Makower et al. | Feb 2001 | B1 |
| 6190383 | Schmaltz et al. | Feb 2001 | B1 |
| 6190384 | Ouchi | Feb 2001 | B1 |
| 6190399 | Palmer et al. | Feb 2001 | B1 |
| 6203533 | Ouchi | Mar 2001 | B1 |
| 6206872 | Lafond et al. | Mar 2001 | B1 |
| 6206877 | Kese et al. | Mar 2001 | B1 |
| 6206904 | Ouchi | Mar 2001 | B1 |
| 6210409 | Ellman et al. | Apr 2001 | B1 |
| 6214007 | Anderson | Apr 2001 | B1 |
| 6214028 | Yoon et al. | Apr 2001 | B1 |
| 6216043 | Swanson et al. | Apr 2001 | B1 |
| 6228096 | Marchand | May 2001 | B1 |
| 6231506 | Hu et al. | May 2001 | B1 |
| 6234958 | Snoke et al. | May 2001 | B1 |
| 6245079 | Nobles et al. | Jun 2001 | B1 |
| 6246914 | de la Rama et al. | Jun 2001 | B1 |
| 6258064 | Smith et al. | Jul 2001 | B1 |
| 6261242 | Roberts et al. | Jul 2001 | B1 |
| 6264664 | Avellanet | Jul 2001 | B1 |
| 6270497 | Sekino et al. | Aug 2001 | B1 |
| 6270505 | Yoshida et al. | Aug 2001 | B1 |
| 6277136 | Bonutti | Aug 2001 | B1 |
| 6283963 | Regula | Sep 2001 | B1 |
| 6293909 | Chu et al. | Sep 2001 | B1 |
| 6293952 | Brosens et al. | Sep 2001 | B1 |
| 6296630 | Altman et al. | Oct 2001 | B1 |
| 6314963 | Vaska et al. | Nov 2001 | B1 |
| 6322578 | Houle et al. | Nov 2001 | B1 |
| 6325534 | Hawley et al. | Dec 2001 | B1 |
| 6326177 | Schoenbach et al. | Dec 2001 | B1 |
| 6328730 | Harkrider, Jr. | Dec 2001 | B1 |
| 6350267 | Stefanchik | Feb 2002 | B1 |
| 6350278 | Lenker et al. | Feb 2002 | B1 |
| 6352503 | Matsui et al. | Mar 2002 | B1 |
| 6352543 | Cole | Mar 2002 | B1 |
| 6355013 | van Muiden | Mar 2002 | B1 |
| 6355035 | Manushakian | Mar 2002 | B1 |
| 6361534 | Chen et al. | Mar 2002 | B1 |
| 6364879 | Chen et al. | Apr 2002 | B1 |
| 6368340 | Malecki et al. | Apr 2002 | B2 |
| 6371956 | Wilson et al. | Apr 2002 | B1 |
| 6379366 | Fleischman et al. | Apr 2002 | B1 |
| 6383195 | Richard | May 2002 | B1 |
| 6383197 | Conlon et al. | May 2002 | B1 |
| 6387671 | Rubinsky et al. | May 2002 | B1 |
| 6391029 | Hooven et al. | May 2002 | B1 |
| 6398708 | Hastings et al. | Jun 2002 | B1 |
| 6402735 | Langevin | Jun 2002 | B1 |
| 6402746 | Whayne et al. | Jun 2002 | B1 |
| 6406440 | Stefanchik | Jun 2002 | B1 |
| 6409727 | Bales et al. | Jun 2002 | B1 |
| 6409733 | Conlon et al. | Jun 2002 | B1 |
| 6419639 | Walther et al. | Jul 2002 | B2 |
| 6419641 | Mark et al. | Jul 2002 | B1 |
| 6427089 | Knowlton | Jul 2002 | B1 |
| 6431500 | Jacobs et al. | Aug 2002 | B1 |
| 6436107 | Wang et al. | Aug 2002 | B1 |
| 6443970 | Schulze et al. | Sep 2002 | B1 |
| 6443988 | Felt et al. | Sep 2002 | B2 |
| 6447511 | Slater | Sep 2002 | B1 |
| 6447523 | Middleman et al. | Sep 2002 | B1 |
| 6454783 | Piskun | Sep 2002 | B1 |
| 6454785 | De Hoyos Garza | Sep 2002 | B2 |
| 6458076 | Pruitt | Oct 2002 | B1 |
| 6464701 | Hooven et al. | Oct 2002 | B1 |
| 6464702 | Schulze et al. | Oct 2002 | B2 |
| 6470218 | Behl | Oct 2002 | B1 |
| 6475104 | Lutz et al. | Nov 2002 | B1 |
| 6485411 | Konstorum et al. | Nov 2002 | B1 |
| 6489745 | Koreis | Dec 2002 | B1 |
| 6491626 | Stone et al. | Dec 2002 | B1 |
| 6491627 | Komi | Dec 2002 | B1 |
| 6491691 | Morley et al. | Dec 2002 | B1 |
| 6493590 | Wessman et al. | Dec 2002 | B1 |
| 6494893 | Dubrul et al. | Dec 2002 | B2 |
| 6500176 | Truckai et al. | Dec 2002 | B1 |
| 6503192 | Ouchi | Jan 2003 | B1 |
| 6506190 | Walshe | Jan 2003 | B1 |
| 6508827 | Manhes | Jan 2003 | B1 |
| 6514239 | Shimmura et al. | Feb 2003 | B2 |
| 6520954 | Ouchi | Feb 2003 | B2 |
| 6526320 | Mitchell | Feb 2003 | B2 |
| 6527782 | Hogg et al. | Mar 2003 | B2 |
| 6530922 | Cosman et al. | Mar 2003 | B2 |
| 6535764 | Imran et al. | Mar 2003 | B2 |
| 6537200 | Leysieffer et al. | Mar 2003 | B2 |
| 6543456 | Freeman | Apr 2003 | B1 |
| 6551270 | Bimbo et al. | Apr 2003 | B1 |
| 6554766 | Maeda et al. | Apr 2003 | B2 |
| 6554823 | Palmer et al. | Apr 2003 | B2 |
| 6554829 | Schulze et al. | Apr 2003 | B2 |
| 6558384 | Mayenberger | May 2003 | B2 |
| 6562034 | Edwards et al. | May 2003 | B2 |
| 6562035 | Levin | May 2003 | B1 |
| 6562052 | Nobles et al. | May 2003 | B2 |
| 6569159 | Edwards et al. | May 2003 | B1 |
| 6572629 | Kalloo et al. | Jun 2003 | B2 |
| 6572635 | Bonutti | Jun 2003 | B1 |
| 6575988 | Rousseau | Jun 2003 | B2 |
| 6579311 | Makower | Jun 2003 | B1 |
| 6581889 | Carpenter et al. | Jun 2003 | B2 |
| 6585642 | Christopher | Jul 2003 | B2 |
| 6585717 | Wittenberger et al. | Jul 2003 | B1 |
| 6587750 | Gerbi et al. | Jul 2003 | B2 |
| 6592559 | Pakter et al. | Jul 2003 | B1 |
| 6592603 | Lasner | Jul 2003 | B2 |
| 6602262 | Griego et al. | Aug 2003 | B2 |
| 6605105 | Cuschieri et al. | Aug 2003 | B1 |
| 6610072 | Christy et al. | Aug 2003 | B1 |
| 6610074 | Santilli | Aug 2003 | B2 |
| 6613038 | Bonutti et al. | Sep 2003 | B2 |
| 6613068 | Ouchi | Sep 2003 | B2 |
| 6616632 | Sharp et al. | Sep 2003 | B2 |
| 6620193 | Lau et al. | Sep 2003 | B1 |
| 6623448 | Slater | Sep 2003 | B2 |
| 6626919 | Swanstrom | Sep 2003 | B1 |
| 6632229 | Yamanouchi | Oct 2003 | B1 |
| 6632234 | Kieturakis et al. | Oct 2003 | B2 |
| 6638275 | McGaffigan et al. | Oct 2003 | B1 |
| 6638286 | Burbank et al. | Oct 2003 | B1 |
| 6645225 | Atkinson | Nov 2003 | B1 |
| 6652518 | Wellman et al. | Nov 2003 | B2 |
| 6652521 | Schulze | Nov 2003 | B2 |
| 6652551 | Heiss | Nov 2003 | B1 |
| 6656194 | Gannoe et al. | Dec 2003 | B1 |
| 6663641 | Kovac et al. | Dec 2003 | B1 |
| 6663655 | Ginn et al. | Dec 2003 | B2 |
| 6666854 | Lange | Dec 2003 | B1 |
| 6672338 | Esashi et al. | Jan 2004 | B1 |
| 6673058 | Snow | Jan 2004 | B2 |
| 6673087 | Chang et al. | Jan 2004 | B1 |
| 6673092 | Bacher | Jan 2004 | B1 |
| 6679882 | Kornerup | Jan 2004 | B1 |
| 6685628 | Vu | Feb 2004 | B2 |
| 6685724 | Haluck | Feb 2004 | B1 |
| 6692445 | Roberts et al. | Feb 2004 | B2 |
| 6692462 | MacKenzie et al. | Feb 2004 | B2 |
| 6692493 | McGovern et al. | Feb 2004 | B2 |
| 6699180 | Kobayashi | Mar 2004 | B2 |
| 6699256 | Logan et al. | Mar 2004 | B1 |
| 6699263 | Cope | Mar 2004 | B2 |
| 6706018 | Westlund et al. | Mar 2004 | B2 |
| 6708066 | Herbst et al. | Mar 2004 | B2 |
| 6709188 | Ushimaru | Mar 2004 | B2 |
| 6709445 | Boebel et al. | Mar 2004 | B2 |
| 6716226 | Sixto, Jr. et al. | Apr 2004 | B2 |
| 6731875 | Kartalopoulos | May 2004 | B1 |
| 6736822 | McClellan et al. | May 2004 | B2 |
| 6740030 | Martone et al. | May 2004 | B2 |
| 6743166 | Berci et al. | Jun 2004 | B2 |
| 6743226 | Cosman et al. | Jun 2004 | B2 |
| 6743239 | Kuehn et al. | Jun 2004 | B1 |
| 6743240 | Smith et al. | Jun 2004 | B2 |
| 6749560 | Konstorum et al. | Jun 2004 | B1 |
| 6749609 | Lunsford et al. | Jun 2004 | B1 |
| 6752768 | Burdorff et al. | Jun 2004 | B2 |
| 6752811 | Chu et al. | Jun 2004 | B2 |
| 6752822 | Jespersen | Jun 2004 | B2 |
| 6758857 | Cioanta et al. | Jul 2004 | B2 |
| 6761685 | Adams et al. | Jul 2004 | B2 |
| 6761718 | Madsen | Jul 2004 | B2 |
| 6761722 | Cole et al. | Jul 2004 | B2 |
| 6773434 | Ciarrocca | Aug 2004 | B2 |
| 6776787 | Phung et al. | Aug 2004 | B2 |
| 6780151 | Grabover et al. | Aug 2004 | B2 |
| 6780352 | Jacobson | Aug 2004 | B2 |
| 6783491 | Saadat et al. | Aug 2004 | B2 |
| 6786382 | Hoffman | Sep 2004 | B1 |
| 6786864 | Matsuura et al. | Sep 2004 | B2 |
| 6786905 | Swanson et al. | Sep 2004 | B2 |
| 6788977 | Fenn et al. | Sep 2004 | B2 |
| 6790173 | Saadat et al. | Sep 2004 | B2 |
| 6790217 | Schulze et al. | Sep 2004 | B2 |
| 6795728 | Chornenky et al. | Sep 2004 | B2 |
| 6800056 | Tartaglia et al. | Oct 2004 | B2 |
| 6808491 | Kortenbach et al. | Oct 2004 | B2 |
| 6817974 | Cooper et al. | Nov 2004 | B2 |
| 6818007 | Dampney et al. | Nov 2004 | B1 |
| 6824548 | Smith et al. | Nov 2004 | B2 |
| 6830545 | Bendall | Dec 2004 | B2 |
| 6836688 | Ingle et al. | Dec 2004 | B2 |
| 6837847 | Ewers et al. | Jan 2005 | B2 |
| 6840246 | Downing | Jan 2005 | B2 |
| 6840938 | Morley et al. | Jan 2005 | B1 |
| 6843794 | Sixto, Jr. et al. | Jan 2005 | B2 |
| 6861250 | Cole et al. | Mar 2005 | B1 |
| 6866627 | Nozue | Mar 2005 | B2 |
| 6866628 | Goodman et al. | Mar 2005 | B2 |
| 6869394 | Ishibiki | Mar 2005 | B2 |
| 6878106 | Herrmann | Apr 2005 | B1 |
| 6878110 | Yang et al. | Apr 2005 | B2 |
| 6881213 | Ryan et al. | Apr 2005 | B2 |
| 6881216 | Di Caprio et al. | Apr 2005 | B2 |
| 6884213 | Raz et al. | Apr 2005 | B2 |
| 6887255 | Shimm | May 2005 | B2 |
| 6889089 | Behl et al. | May 2005 | B2 |
| 6896683 | Gadberry et al. | May 2005 | B1 |
| 6896692 | Ginn et al. | May 2005 | B2 |
| 6899710 | Hooven | May 2005 | B2 |
| 6908427 | Fleener et al. | Jun 2005 | B2 |
| 6908476 | Jud et al. | Jun 2005 | B2 |
| 6913613 | Schwarz et al. | Jul 2005 | B2 |
| 6916284 | Moriyama | Jul 2005 | B2 |
| 6918871 | Schulze | Jul 2005 | B2 |
| 6918908 | Bonner et al. | Jul 2005 | B2 |
| 6926725 | Cooke et al. | Aug 2005 | B2 |
| 6932810 | Ryan | Aug 2005 | B2 |
| 6932824 | Roop et al. | Aug 2005 | B1 |
| 6932827 | Cole | Aug 2005 | B2 |
| 6932834 | Lizardi et al. | Aug 2005 | B2 |
| 6936003 | Iddan | Aug 2005 | B2 |
| 6939327 | Hall et al. | Sep 2005 | B2 |
| 6942613 | Ewers et al. | Sep 2005 | B2 |
| 6944490 | Chow | Sep 2005 | B1 |
| 6945472 | Wuttke et al. | Sep 2005 | B2 |
| 6945979 | Kortenbach et al. | Sep 2005 | B2 |
| 6955683 | Bonutti | Oct 2005 | B2 |
| 6958035 | Friedman et al. | Oct 2005 | B2 |
| 6960162 | Saadat et al. | Nov 2005 | B2 |
| 6960163 | Ewers et al. | Nov 2005 | B2 |
| 6962587 | Johnson et al. | Nov 2005 | B2 |
| 6964662 | Kidooka | Nov 2005 | B2 |
| 6966909 | Marshall et al. | Nov 2005 | B2 |
| 6966919 | Sixto, Jr. et al. | Nov 2005 | B2 |
| 6967462 | Landis | Nov 2005 | B1 |
| 6971988 | Orban, III | Dec 2005 | B2 |
| 6972017 | Smith et al. | Dec 2005 | B2 |
| 6974411 | Belson | Dec 2005 | B2 |
| 6976992 | Sachatello et al. | Dec 2005 | B2 |
| 6984203 | Tartaglia et al. | Jan 2006 | B2 |
| 6984205 | Gazdzinski | Jan 2006 | B2 |
| 6986774 | Middleman et al. | Jan 2006 | B2 |
| 6988987 | Ishikawa et al. | Jan 2006 | B2 |
| 6989028 | Lashinski et al. | Jan 2006 | B2 |
| 6991627 | Madhani et al. | Jan 2006 | B2 |
| 6991631 | Woloszko et al. | Jan 2006 | B2 |
| 6994708 | Manzo | Feb 2006 | B2 |
| 6997931 | Sauer et al. | Feb 2006 | B2 |
| 7000818 | Shelton, IV et al. | Feb 2006 | B2 |
| 7001341 | Gellman et al. | Feb 2006 | B2 |
| 7008375 | Weisel | Mar 2006 | B2 |
| 7008419 | Shadduck | Mar 2006 | B2 |
| 7009634 | Iddan et al. | Mar 2006 | B2 |
| 7010340 | Scarantino et al. | Mar 2006 | B2 |
| 7020531 | Colliou et al. | Mar 2006 | B1 |
| 7025580 | Heagy et al. | Apr 2006 | B2 |
| 7029435 | Nakao | Apr 2006 | B2 |
| 7029438 | Morin et al. | Apr 2006 | B2 |
| 7029450 | Gellman | Apr 2006 | B2 |
| 7032600 | Fukuda et al. | Apr 2006 | B2 |
| 7035680 | Partridge et al. | Apr 2006 | B2 |
| 7037290 | Gardeski et al. | May 2006 | B2 |
| 7041052 | Saadat et al. | May 2006 | B2 |
| 7052489 | Griego et al. | May 2006 | B2 |
| 7060024 | Long et al. | Jun 2006 | B2 |
| 7060025 | Long et al. | Jun 2006 | B2 |
| 7063697 | Slater | Jun 2006 | B2 |
| 7063715 | Onuki et al. | Jun 2006 | B2 |
| 7066879 | Fowler et al. | Jun 2006 | B2 |
| 7066936 | Ryan | Jun 2006 | B2 |
| 7070602 | Smith et al. | Jul 2006 | B2 |
| 7076305 | Imran et al. | Jul 2006 | B2 |
| 7083618 | Couture et al. | Aug 2006 | B2 |
| 7083620 | Jahns et al. | Aug 2006 | B2 |
| 7083629 | Weller et al. | Aug 2006 | B2 |
| 7083635 | Ginn | Aug 2006 | B2 |
| 7087071 | Nicholas et al. | Aug 2006 | B2 |
| 7088923 | Haruyama | Aug 2006 | B2 |
| 7090673 | Dycus et al. | Aug 2006 | B2 |
| 7090683 | Brock et al. | Aug 2006 | B2 |
| 7090685 | Kortenbach et al. | Aug 2006 | B2 |
| 7093518 | Gmeilbauer | Aug 2006 | B2 |
| 7101371 | Dycus et al. | Sep 2006 | B2 |
| 7101372 | Dycus et al. | Sep 2006 | B2 |
| 7101373 | Dycus et al. | Sep 2006 | B2 |
| 7105000 | McBrayer | Sep 2006 | B2 |
| 7105005 | Blake | Sep 2006 | B2 |
| 7108696 | Daniel et al. | Sep 2006 | B2 |
| 7108703 | Danitz et al. | Sep 2006 | B2 |
| 7112208 | Morris et al. | Sep 2006 | B2 |
| 7115092 | Park et al. | Oct 2006 | B2 |
| 7115124 | Xiao | Oct 2006 | B1 |
| 7117703 | Kato et al. | Oct 2006 | B2 |
| 7118531 | Krill | Oct 2006 | B2 |
| 7118578 | West, Jr. et al. | Oct 2006 | B2 |
| 7118587 | Dycus et al. | Oct 2006 | B2 |
| 7128708 | Saadat et al. | Oct 2006 | B2 |
| 7130697 | Chornenky et al. | Oct 2006 | B2 |
| RE39415 | Bales et al. | Nov 2006 | E |
| 7131978 | Sancoff et al. | Nov 2006 | B2 |
| 7131979 | DiCarlo et al. | Nov 2006 | B2 |
| 7131980 | Field et al. | Nov 2006 | B1 |
| 7137980 | Buysse et al. | Nov 2006 | B2 |
| 7137981 | Long | Nov 2006 | B2 |
| 7146984 | Stack et al. | Dec 2006 | B2 |
| 7147650 | Lee | Dec 2006 | B2 |
| 7150097 | Sremcich et al. | Dec 2006 | B2 |
| 7150655 | Mastrototaro et al. | Dec 2006 | B2 |
| 7150750 | Damarati | Dec 2006 | B2 |
| 7152488 | Hedrich et al. | Dec 2006 | B2 |
| 7153321 | Andrews | Dec 2006 | B2 |
| 7160296 | Pearson et al. | Jan 2007 | B2 |
| 7163525 | Franer | Jan 2007 | B2 |
| 7172714 | Jacobson | Feb 2007 | B2 |
| 7179254 | Pendekanti et al. | Feb 2007 | B2 |
| 7188627 | Nelson et al. | Mar 2007 | B2 |
| 7195612 | Van Sloten et al. | Mar 2007 | B2 |
| 7195631 | Dumbauld | Mar 2007 | B2 |
| 7204820 | Akahoshi | Apr 2007 | B2 |
| 7208005 | Frecker et al. | Apr 2007 | B2 |
| 7211092 | Hughett | May 2007 | B2 |
| 7220227 | Sasaki et al. | May 2007 | B2 |
| 7223272 | Francere et al. | May 2007 | B2 |
| 7229438 | Young | Jun 2007 | B2 |
| 7232414 | Gonzalez | Jun 2007 | B2 |
| 7232445 | Kortenbach et al. | Jun 2007 | B2 |
| 7235089 | McGuckin, Jr. | Jun 2007 | B1 |
| 7241290 | Doyle et al. | Jul 2007 | B2 |
| 7244228 | Lubowski | Jul 2007 | B2 |
| 7250027 | Barry | Jul 2007 | B2 |
| 7252660 | Kunz | Aug 2007 | B2 |
| 7255675 | Gertner et al. | Aug 2007 | B2 |
| 7261725 | Binmoeller | Aug 2007 | B2 |
| 7270663 | Nakao | Sep 2007 | B2 |
| 7291127 | Eidenschink | Nov 2007 | B2 |
| 7294139 | Gengler | Nov 2007 | B1 |
| 7301250 | Cassel | Nov 2007 | B2 |
| 7306597 | Manzo | Dec 2007 | B2 |
| 7308828 | Hashimoto | Dec 2007 | B2 |
| 7318802 | Suzuki et al. | Jan 2008 | B2 |
| 7320695 | Carroll | Jan 2008 | B2 |
| 7322934 | Miyake et al. | Jan 2008 | B2 |
| 7323006 | Andreas et al. | Jan 2008 | B2 |
| 7329256 | Johnson et al. | Feb 2008 | B2 |
| 7329257 | Kanehira et al. | Feb 2008 | B2 |
| 7329383 | Stinson | Feb 2008 | B2 |
| 7335220 | Khosravi et al. | Feb 2008 | B2 |
| 7344536 | Lunsford et al. | Mar 2008 | B1 |
| 7352387 | Yamamoto | Apr 2008 | B2 |
| 7364582 | Lee | Apr 2008 | B2 |
| 7371215 | Colliou et al. | May 2008 | B2 |
| 7381216 | Buzzard et al. | Jun 2008 | B2 |
| 7390324 | Whalen et al. | Jun 2008 | B2 |
| 7393222 | Wenchell | Jul 2008 | B2 |
| 7402162 | Ouchi | Jul 2008 | B2 |
| 7404791 | Linares et al. | Jul 2008 | B2 |
| 7410483 | Danitz et al. | Aug 2008 | B2 |
| 7413563 | Corcoran et al. | Aug 2008 | B2 |
| 7416554 | Lam et al. | Aug 2008 | B2 |
| 7422590 | Kupferschmid et al. | Sep 2008 | B2 |
| 7435229 | Wolf | Oct 2008 | B2 |
| 7435257 | Lashinski et al. | Oct 2008 | B2 |
| 7452327 | Durgin et al. | Nov 2008 | B2 |
| 7455208 | Wales et al. | Nov 2008 | B2 |
| 7468066 | Vargas et al. | Dec 2008 | B2 |
| 7476237 | Taniguchi et al. | Jan 2009 | B2 |
| 7485093 | Glukhovsky | Feb 2009 | B2 |
| 7488295 | Burbank et al. | Feb 2009 | B2 |
| 7494499 | Nagase et al. | Feb 2009 | B2 |
| 7497867 | Lasner et al. | Mar 2009 | B2 |
| 7498950 | Ertas et al. | Mar 2009 | B1 |
| 7507200 | Okada | Mar 2009 | B2 |
| 7510107 | Timm et al. | Mar 2009 | B2 |
| 7511733 | Takizawa et al. | Mar 2009 | B2 |
| 7515953 | Madar et al. | Apr 2009 | B2 |
| 7520876 | Ressemann et al. | Apr 2009 | B2 |
| 7524281 | Chu et al. | Apr 2009 | B2 |
| 7524302 | Tower | Apr 2009 | B2 |
| 7534228 | Williams | May 2009 | B2 |
| 7540872 | Schechter et al. | Jun 2009 | B2 |
| 7542807 | Bertolero et al. | Jun 2009 | B2 |
| 7544203 | Chin et al. | Jun 2009 | B2 |
| 7548040 | Lee et al. | Jun 2009 | B2 |
| 7549564 | Boudreaux | Jun 2009 | B2 |
| 7549998 | Braun | Jun 2009 | B2 |
| 7553278 | Kucklick | Jun 2009 | B2 |
| 7553298 | Hunt et al. | Jun 2009 | B2 |
| 7559452 | Wales et al. | Jul 2009 | B2 |
| 7559887 | Dannan | Jul 2009 | B2 |
| 7559916 | Smith et al. | Jul 2009 | B2 |
| 7560006 | Rakos et al. | Jul 2009 | B2 |
| 7561907 | Fuimaono et al. | Jul 2009 | B2 |
| 7561916 | Hunt et al. | Jul 2009 | B2 |
| 7566334 | Christian et al. | Jul 2009 | B2 |
| 7575144 | Ortiz et al. | Aug 2009 | B2 |
| 7575548 | Takemoto et al. | Aug 2009 | B2 |
| 7579550 | Dayton et al. | Aug 2009 | B2 |
| 7582096 | Gellman et al. | Sep 2009 | B2 |
| 7588177 | Racenet | Sep 2009 | B2 |
| 7588557 | Nakao | Sep 2009 | B2 |
| 7597229 | Boudreaux et al. | Oct 2009 | B2 |
| 7604150 | Boudreaux | Oct 2009 | B2 |
| 7608083 | Lee et al. | Oct 2009 | B2 |
| 7611479 | Cragg et al. | Nov 2009 | B2 |
| 7618398 | Holman et al. | Nov 2009 | B2 |
| 7621936 | Cragg et al. | Nov 2009 | B2 |
| 7632250 | Smith et al. | Dec 2009 | B2 |
| 7635373 | Ortiz | Dec 2009 | B2 |
| 7637903 | Lentz et al. | Dec 2009 | B2 |
| 7648519 | Lee et al. | Jan 2010 | B2 |
| 7650742 | Ushijima | Jan 2010 | B2 |
| 7651483 | Byrum et al. | Jan 2010 | B2 |
| 7651509 | Bojarski et al. | Jan 2010 | B2 |
| 7654431 | Hueil et al. | Feb 2010 | B2 |
| 7655004 | Long | Feb 2010 | B2 |
| 7662089 | Okada et al. | Feb 2010 | B2 |
| 7666180 | Holsten et al. | Feb 2010 | B2 |
| 7666203 | Chanduszko et al. | Feb 2010 | B2 |
| 7674259 | Shadduck | Mar 2010 | B2 |
| 7678043 | Gilad | Mar 2010 | B2 |
| 7680543 | Azure | Mar 2010 | B2 |
| 7684599 | Horn et al. | Mar 2010 | B2 |
| 7686826 | Lee et al. | Mar 2010 | B2 |
| 7697970 | Uchiyama et al. | Apr 2010 | B2 |
| 7699835 | Lee et al. | Apr 2010 | B2 |
| 7699864 | Kick et al. | Apr 2010 | B2 |
| 7713189 | Hanke | May 2010 | B2 |
| 7713270 | Suzuki | May 2010 | B2 |
| 7736374 | Vaughan et al. | Jun 2010 | B2 |
| 7744615 | Couture | Jun 2010 | B2 |
| 7749161 | Beckman et al. | Jul 2010 | B2 |
| 7753933 | Ginn et al. | Jul 2010 | B2 |
| 7758577 | Nobis et al. | Jul 2010 | B2 |
| 7762949 | Nakao | Jul 2010 | B2 |
| 7762998 | Birk et al. | Jul 2010 | B2 |
| 7763012 | Petrick et al. | Jul 2010 | B2 |
| 7765010 | Chornenky et al. | Jul 2010 | B2 |
| 7771416 | Spivey et al. | Aug 2010 | B2 |
| 7771437 | Hogg et al. | Aug 2010 | B2 |
| 7780683 | Roue et al. | Aug 2010 | B2 |
| 7780691 | Stefanchik | Aug 2010 | B2 |
| 7784663 | Shelton, IV | Aug 2010 | B2 |
| 7794409 | Damarati | Sep 2010 | B2 |
| 7794475 | Hess et al. | Sep 2010 | B2 |
| 7798386 | Schall et al. | Sep 2010 | B2 |
| 7815662 | Spivey et al. | Oct 2010 | B2 |
| 7828186 | Wales | Nov 2010 | B2 |
| 7833156 | Williams et al. | Nov 2010 | B2 |
| 7837615 | Le et al. | Nov 2010 | B2 |
| 7842028 | Lee | Nov 2010 | B2 |
| 7842068 | Ginn | Nov 2010 | B2 |
| 7846171 | Kullas et al. | Dec 2010 | B2 |
| 7850660 | Uth et al. | Dec 2010 | B2 |
| 7857183 | Shelton, IV | Dec 2010 | B2 |
| 7862546 | Conlon et al. | Jan 2011 | B2 |
| 7867216 | Wahr et al. | Jan 2011 | B2 |
| 7879004 | Seibel et al. | Feb 2011 | B2 |
| 7892220 | Faller et al. | Feb 2011 | B2 |
| 7896804 | Uchimura et al. | Mar 2011 | B2 |
| 7896887 | Rimbaugh et al. | Mar 2011 | B2 |
| 7905828 | Brock et al. | Mar 2011 | B2 |
| 7909809 | Scopton et al. | Mar 2011 | B2 |
| 7914513 | Voorhees, Jr. | Mar 2011 | B2 |
| 7918869 | Saadat et al. | Apr 2011 | B2 |
| 7927271 | Dimitriou et al. | Apr 2011 | B2 |
| 7931624 | Smith et al. | Apr 2011 | B2 |
| 7945332 | Schechter | May 2011 | B2 |
| 7947000 | Vargas et al. | May 2011 | B2 |
| 7953326 | Farr et al. | May 2011 | B2 |
| 7955298 | Carroll et al. | Jun 2011 | B2 |
| 7963975 | Criscuolo | Jun 2011 | B2 |
| 7965180 | Koyama | Jun 2011 | B2 |
| 7967808 | Fitzgerald et al. | Jun 2011 | B2 |
| 7969473 | Kotoda | Jun 2011 | B2 |
| 7972330 | Alejandro et al. | Jul 2011 | B2 |
| 7976552 | Suzuki | Jul 2011 | B2 |
| 7985239 | Suzuki | Jul 2011 | B2 |
| 7988685 | Ziaie et al. | Aug 2011 | B2 |
| 8034046 | Eidenschink | Oct 2011 | B2 |
| 8048067 | Davalos et al. | Nov 2011 | B2 |
| 8057510 | Ginn et al. | Nov 2011 | B2 |
| 8062311 | Litscher et al. | Nov 2011 | B2 |
| 8066632 | Dario et al. | Nov 2011 | B2 |
| 8075587 | Ginn | Dec 2011 | B2 |
| 8088062 | Zwolinski | Jan 2012 | B2 |
| 8096459 | Ortiz et al. | Jan 2012 | B2 |
| 8118821 | Mouw | Feb 2012 | B2 |
| 8147424 | Kassab et al. | Apr 2012 | B2 |
| 8157813 | Ko et al. | Apr 2012 | B2 |
| 8182414 | Handa et al. | May 2012 | B2 |
| 8221310 | Saadat et al. | Jul 2012 | B2 |
| 8303581 | Arts et al. | Nov 2012 | B2 |
| 8430811 | Hess et al. | Apr 2013 | B2 |
| 20010023333 | Wise et al. | Sep 2001 | A1 |
| 20010049497 | Kalloo et al. | Dec 2001 | A1 |
| 20020022771 | Diokno et al. | Feb 2002 | A1 |
| 20020022857 | Goldsteen et al. | Feb 2002 | A1 |
| 20020023353 | Ting-Kung | Feb 2002 | A1 |
| 20020029055 | Bonutti | Mar 2002 | A1 |
| 20020042562 | Meron et al. | Apr 2002 | A1 |
| 20020049439 | Mulier et al. | Apr 2002 | A1 |
| 20020068945 | Sixto, Jr. et al. | Jun 2002 | A1 |
| 20020078967 | Sixto, Jr. et al. | Jun 2002 | A1 |
| 20020082516 | Stefanchik | Jun 2002 | A1 |
| 20020095164 | Andreas et al. | Jul 2002 | A1 |
| 20020107530 | Sauer et al. | Aug 2002 | A1 |
| 20020133115 | Gordon et al. | Sep 2002 | A1 |
| 20020138086 | Sixto, Jr. et al. | Sep 2002 | A1 |
| 20020147456 | Diduch et al. | Oct 2002 | A1 |
| 20020165592 | Glukhovsky et al. | Nov 2002 | A1 |
| 20020173805 | Matsuno et al. | Nov 2002 | A1 |
| 20020183591 | Matsuura et al. | Dec 2002 | A1 |
| 20030014090 | Abrahamson | Jan 2003 | A1 |
| 20030023255 | Miles et al. | Jan 2003 | A1 |
| 20030036679 | Kortenbach et al. | Feb 2003 | A1 |
| 20030069602 | Jacobs et al. | Apr 2003 | A1 |
| 20030083681 | Moutafis et al. | May 2003 | A1 |
| 20030114731 | Cadeddu et al. | Jun 2003 | A1 |
| 20030114732 | Webler et al. | Jun 2003 | A1 |
| 20030120257 | Houston et al. | Jun 2003 | A1 |
| 20030124009 | Ravi et al. | Jul 2003 | A1 |
| 20030130564 | Martone et al. | Jul 2003 | A1 |
| 20030130656 | Levin | Jul 2003 | A1 |
| 20030158521 | Ameri | Aug 2003 | A1 |
| 20030167062 | Gambale et al. | Sep 2003 | A1 |
| 20030171651 | Page et al. | Sep 2003 | A1 |
| 20030176880 | Long et al. | Sep 2003 | A1 |
| 20030216611 | Vu | Nov 2003 | A1 |
| 20030216615 | Ouchi | Nov 2003 | A1 |
| 20030220545 | Ouchi | Nov 2003 | A1 |
| 20030225312 | Suzuki et al. | Dec 2003 | A1 |
| 20030225332 | Okada et al. | Dec 2003 | A1 |
| 20030229269 | Humphrey | Dec 2003 | A1 |
| 20030229371 | Whitworth | Dec 2003 | A1 |
| 20030236549 | Bonadio et al. | Dec 2003 | A1 |
| 20040002683 | Nicholson et al. | Jan 2004 | A1 |
| 20040024414 | Downing | Feb 2004 | A1 |
| 20040034369 | Sauer et al. | Feb 2004 | A1 |
| 20040054322 | Vargas | Mar 2004 | A1 |
| 20040098007 | Heiss | May 2004 | A1 |
| 20040101456 | Kuroshima et al. | May 2004 | A1 |
| 20040104999 | Okada | Jun 2004 | A1 |
| 20040116948 | Sixto, Jr. et al. | Jun 2004 | A1 |
| 20040127940 | Ginn et al. | Jul 2004 | A1 |
| 20040133077 | Obenchain et al. | Jul 2004 | A1 |
| 20040133089 | Kilcoyne et al. | Jul 2004 | A1 |
| 20040136779 | Bhaskar | Jul 2004 | A1 |
| 20040138525 | Saadat et al. | Jul 2004 | A1 |
| 20040138529 | Wiltshire et al. | Jul 2004 | A1 |
| 20040138587 | Lyons, IV | Jul 2004 | A1 |
| 20040161451 | Pierce et al. | Aug 2004 | A1 |
| 20040167545 | Sadler et al. | Aug 2004 | A1 |
| 20040176699 | Walker et al. | Sep 2004 | A1 |
| 20040186350 | Brenneman et al. | Sep 2004 | A1 |
| 20040193009 | Jaffe et al. | Sep 2004 | A1 |
| 20040193146 | Lee et al. | Sep 2004 | A1 |
| 20040193186 | Kortenbach et al. | Sep 2004 | A1 |
| 20040193188 | Francese | Sep 2004 | A1 |
| 20040193189 | Kortenbach et al. | Sep 2004 | A1 |
| 20040193200 | Dworschak et al. | Sep 2004 | A1 |
| 20040199052 | Banik et al. | Oct 2004 | A1 |
| 20040199159 | Lee et al. | Oct 2004 | A1 |
| 20040206859 | Chong et al. | Oct 2004 | A1 |
| 20040210245 | Erickson et al. | Oct 2004 | A1 |
| 20040215058 | Zirps et al. | Oct 2004 | A1 |
| 20040225183 | Michlitsch et al. | Nov 2004 | A1 |
| 20040225186 | Horne, Jr. et al. | Nov 2004 | A1 |
| 20040225323 | Nagase et al. | Nov 2004 | A1 |
| 20040230095 | Stefanchik et al. | Nov 2004 | A1 |
| 20040230096 | Stefanchik et al. | Nov 2004 | A1 |
| 20040230097 | Stefanchik et al. | Nov 2004 | A1 |
| 20040230161 | Zeiner | Nov 2004 | A1 |
| 20040243108 | Suzuki | Dec 2004 | A1 |
| 20040249246 | Campos | Dec 2004 | A1 |
| 20040249367 | Saadat et al. | Dec 2004 | A1 |
| 20040249394 | Morris et al. | Dec 2004 | A1 |
| 20040249443 | Shanley et al. | Dec 2004 | A1 |
| 20040254572 | McIntyre et al. | Dec 2004 | A1 |
| 20040260198 | Rothberg et al. | Dec 2004 | A1 |
| 20040260337 | Freed | Dec 2004 | A1 |
| 20050004515 | Hart et al. | Jan 2005 | A1 |
| 20050033265 | Engel et al. | Feb 2005 | A1 |
| 20050033277 | Clague et al. | Feb 2005 | A1 |
| 20050033319 | Gambale et al. | Feb 2005 | A1 |
| 20050033333 | Smith et al. | Feb 2005 | A1 |
| 20050043690 | Todd | Feb 2005 | A1 |
| 20050049616 | Rivera et al. | Mar 2005 | A1 |
| 20050059963 | Phan et al. | Mar 2005 | A1 |
| 20050059964 | Fitz | Mar 2005 | A1 |
| 20050065397 | Saadat et al. | Mar 2005 | A1 |
| 20050065509 | Coldwell et al. | Mar 2005 | A1 |
| 20050065517 | Chin | Mar 2005 | A1 |
| 20050070754 | Nobis et al. | Mar 2005 | A1 |
| 20050070763 | Nobis et al. | Mar 2005 | A1 |
| 20050070764 | Nobis et al. | Mar 2005 | A1 |
| 20050080413 | Canady | Apr 2005 | A1 |
| 20050085693 | Belson et al. | Apr 2005 | A1 |
| 20050085832 | Sancoff et al. | Apr 2005 | A1 |
| 20050090837 | Sixto, Jr. et al. | Apr 2005 | A1 |
| 20050090838 | Sixto, Jr. et al. | Apr 2005 | A1 |
| 20050096502 | Khalili | May 2005 | A1 |
| 20050101837 | Kalloo et al. | May 2005 | A1 |
| 20050101838 | Camillocci et al. | May 2005 | A1 |
| 20050101984 | Chanduszko et al. | May 2005 | A1 |
| 20050107663 | Saadat et al. | May 2005 | A1 |
| 20050107664 | Kalloo et al. | May 2005 | A1 |
| 20050110881 | Glukhovsky et al. | May 2005 | A1 |
| 20050113847 | Gadberry et al. | May 2005 | A1 |
| 20050119613 | Moenning et al. | Jun 2005 | A1 |
| 20050124855 | Jaffe et al. | Jun 2005 | A1 |
| 20050125010 | Smith et al. | Jun 2005 | A1 |
| 20050131279 | Boulais et al. | Jun 2005 | A1 |
| 20050131457 | Douglas et al. | Jun 2005 | A1 |
| 20050137454 | Saadat et al. | Jun 2005 | A1 |
| 20050143647 | Minai et al. | Jun 2005 | A1 |
| 20050143690 | High | Jun 2005 | A1 |
| 20050143774 | Polo | Jun 2005 | A1 |
| 20050143803 | Watson et al. | Jun 2005 | A1 |
| 20050149087 | Ahlberg et al. | Jul 2005 | A1 |
| 20050149096 | Hilal et al. | Jul 2005 | A1 |
| 20050159648 | Freed | Jul 2005 | A1 |
| 20050165272 | Okada et al. | Jul 2005 | A1 |
| 20050165378 | Heinrich et al. | Jul 2005 | A1 |
| 20050165411 | Orban, III | Jul 2005 | A1 |
| 20050165429 | Douglas et al. | Jul 2005 | A1 |
| 20050182429 | Yamanouchi | Aug 2005 | A1 |
| 20050192478 | Williams et al. | Sep 2005 | A1 |
| 20050192598 | Johnson et al. | Sep 2005 | A1 |
| 20050192602 | Manzo | Sep 2005 | A1 |
| 20050192654 | Chanduszko et al. | Sep 2005 | A1 |
| 20050209624 | Vijay | Sep 2005 | A1 |
| 20050215858 | Vail, III | Sep 2005 | A1 |
| 20050216050 | Sepetka et al. | Sep 2005 | A1 |
| 20050228224 | Okada et al. | Oct 2005 | A1 |
| 20050228406 | Bose | Oct 2005 | A1 |
| 20050234297 | Devierre et al. | Oct 2005 | A1 |
| 20050250983 | Tremaglio et al. | Nov 2005 | A1 |
| 20050250990 | Le et al. | Nov 2005 | A1 |
| 20050250993 | Jaeger | Nov 2005 | A1 |
| 20050251166 | Vaughan et al. | Nov 2005 | A1 |
| 20050251176 | Swanstrom et al. | Nov 2005 | A1 |
| 20050261674 | Nobis et al. | Nov 2005 | A1 |
| 20050267492 | Poncet et al. | Dec 2005 | A1 |
| 20050272975 | McWeeney et al. | Dec 2005 | A1 |
| 20050272977 | Saadat et al. | Dec 2005 | A1 |
| 20050273084 | Hinman et al. | Dec 2005 | A1 |
| 20050274935 | Nelson | Dec 2005 | A1 |
| 20050277945 | Saadat et al. | Dec 2005 | A1 |
| 20050277951 | Smith et al. | Dec 2005 | A1 |
| 20050277952 | Arp et al. | Dec 2005 | A1 |
| 20050277954 | Smith et al. | Dec 2005 | A1 |
| 20050277955 | Palmer et al. | Dec 2005 | A1 |
| 20050277956 | Francese et al. | Dec 2005 | A1 |
| 20050277957 | Kuhns et al. | Dec 2005 | A1 |
| 20050283118 | Uth et al. | Dec 2005 | A1 |
| 20050283119 | Uth et al. | Dec 2005 | A1 |
| 20050288555 | Binmoeller | Dec 2005 | A1 |
| 20060004406 | Wehrstein et al. | Jan 2006 | A1 |
| 20060004409 | Nobis et al. | Jan 2006 | A1 |
| 20060004410 | Nobis et al. | Jan 2006 | A1 |
| 20060015009 | Jaffe et al. | Jan 2006 | A1 |
| 20060015131 | Kierce et al. | Jan 2006 | A1 |
| 20060020167 | Sitzmann | Jan 2006 | A1 |
| 20060020247 | Kagan et al. | Jan 2006 | A1 |
| 20060025654 | Suzuki et al. | Feb 2006 | A1 |
| 20060025781 | Young et al. | Feb 2006 | A1 |
| 20060025812 | Shelton, IV | Feb 2006 | A1 |
| 20060025819 | Nobis et al. | Feb 2006 | A1 |
| 20060036267 | Saadat et al. | Feb 2006 | A1 |
| 20060041188 | Dirusso et al. | Feb 2006 | A1 |
| 20060058582 | Maahs et al. | Mar 2006 | A1 |
| 20060058776 | Bilsbury | Mar 2006 | A1 |
| 20060064083 | Khalaj et al. | Mar 2006 | A1 |
| 20060069396 | Meade et al. | Mar 2006 | A1 |
| 20060069424 | Acosta et al. | Mar 2006 | A1 |
| 20060069425 | Hillis et al. | Mar 2006 | A1 |
| 20060069429 | Spence et al. | Mar 2006 | A1 |
| 20060074413 | Behzadian | Apr 2006 | A1 |
| 20060079890 | Guerra | Apr 2006 | A1 |
| 20060089528 | Tartaglia et al. | Apr 2006 | A1 |
| 20060095031 | Ormsby | May 2006 | A1 |
| 20060095060 | Mayenberger et al. | May 2006 | A1 |
| 20060100687 | Fahey et al. | May 2006 | A1 |
| 20060106423 | Weisel et al. | May 2006 | A1 |
| 20060111209 | Hinman et al. | May 2006 | A1 |
| 20060111210 | Hinman et al. | May 2006 | A1 |
| 20060111704 | Brenneman et al. | May 2006 | A1 |
| 20060129166 | Lavelle | Jun 2006 | A1 |
| 20060135962 | Kick et al. | Jun 2006 | A1 |
| 20060135971 | Swanstrom et al. | Jun 2006 | A1 |
| 20060135984 | Kramer et al. | Jun 2006 | A1 |
| 20060142644 | Mulac et al. | Jun 2006 | A1 |
| 20060142652 | Keenan | Jun 2006 | A1 |
| 20060142790 | Gertner | Jun 2006 | A1 |
| 20060142798 | Holman et al. | Jun 2006 | A1 |
| 20060149131 | Or | Jul 2006 | A1 |
| 20060149132 | Iddan | Jul 2006 | A1 |
| 20060149135 | Paz | Jul 2006 | A1 |
| 20060161190 | Gadberry et al. | Jul 2006 | A1 |
| 20060167416 | Mathis et al. | Jul 2006 | A1 |
| 20060167482 | Swain et al. | Jul 2006 | A1 |
| 20060178560 | Saadat et al. | Aug 2006 | A1 |
| 20060183975 | Saadat et al. | Aug 2006 | A1 |
| 20060184161 | Maahs et al. | Aug 2006 | A1 |
| 20060189844 | Tien | Aug 2006 | A1 |
| 20060189845 | Maahs et al. | Aug 2006 | A1 |
| 20060190027 | Downey | Aug 2006 | A1 |
| 20060195084 | Slater | Aug 2006 | A1 |
| 20060200005 | Bjork et al. | Sep 2006 | A1 |
| 20060200121 | Mowery | Sep 2006 | A1 |
| 20060200169 | Sniffin | Sep 2006 | A1 |
| 20060200170 | Aranyi | Sep 2006 | A1 |
| 20060200199 | Bonutti et al. | Sep 2006 | A1 |
| 20060217665 | Prosek | Sep 2006 | A1 |
| 20060217697 | Lau et al. | Sep 2006 | A1 |
| 20060217701 | Young et al. | Sep 2006 | A1 |
| 20060217742 | Messerly et al. | Sep 2006 | A1 |
| 20060217743 | Messerly et al. | Sep 2006 | A1 |
| 20060229639 | Whitfield | Oct 2006 | A1 |
| 20060229640 | Whitfield | Oct 2006 | A1 |
| 20060237022 | Chen et al. | Oct 2006 | A1 |
| 20060237023 | Cox et al. | Oct 2006 | A1 |
| 20060241570 | Wilk | Oct 2006 | A1 |
| 20060247500 | Voegele et al. | Nov 2006 | A1 |
| 20060247576 | Poncet | Nov 2006 | A1 |
| 20060247663 | Schwartz et al. | Nov 2006 | A1 |
| 20060247673 | Voegele et al. | Nov 2006 | A1 |
| 20060253004 | Frisch et al. | Nov 2006 | A1 |
| 20060253039 | McKenna et al. | Nov 2006 | A1 |
| 20060258907 | Stefanchik et al. | Nov 2006 | A1 |
| 20060258908 | Stefanchik et al. | Nov 2006 | A1 |
| 20060258910 | Stefanchik et al. | Nov 2006 | A1 |
| 20060258954 | Timberlake et al. | Nov 2006 | A1 |
| 20060258955 | Hoffman et al. | Nov 2006 | A1 |
| 20060259010 | Stefanchik et al. | Nov 2006 | A1 |
| 20060259073 | Miyamoto et al. | Nov 2006 | A1 |
| 20060264752 | Rubinsky et al. | Nov 2006 | A1 |
| 20060264904 | Kerby et al. | Nov 2006 | A1 |
| 20060264930 | Nishimura | Nov 2006 | A1 |
| 20060270902 | Igarashi et al. | Nov 2006 | A1 |
| 20060271042 | Latterell et al. | Nov 2006 | A1 |
| 20060271102 | Bosshard et al. | Nov 2006 | A1 |
| 20060276835 | Uchida | Dec 2006 | A1 |
| 20060281970 | Stokes et al. | Dec 2006 | A1 |
| 20060282106 | Cole et al. | Dec 2006 | A1 |
| 20060285732 | Horn et al. | Dec 2006 | A1 |
| 20060287644 | Inganas et al. | Dec 2006 | A1 |
| 20060287666 | Saadat et al. | Dec 2006 | A1 |
| 20060293626 | Byrum et al. | Dec 2006 | A1 |
| 20070002135 | Glukhovsky | Jan 2007 | A1 |
| 20070005019 | Okishige | Jan 2007 | A1 |
| 20070010801 | Chen et al. | Jan 2007 | A1 |
| 20070015965 | Cox et al. | Jan 2007 | A1 |
| 20070016225 | Nakao | Jan 2007 | A1 |
| 20070032700 | Fowler et al. | Feb 2007 | A1 |
| 20070032701 | Fowler et al. | Feb 2007 | A1 |
| 20070043261 | Watanabe et al. | Feb 2007 | A1 |
| 20070043345 | Davalos et al. | Feb 2007 | A1 |
| 20070049800 | Boulais | Mar 2007 | A1 |
| 20070049902 | Griffin et al. | Mar 2007 | A1 |
| 20070051375 | Milliman | Mar 2007 | A1 |
| 20070060880 | Gregorich et al. | Mar 2007 | A1 |
| 20070066869 | Hoffman | Mar 2007 | A1 |
| 20070067017 | Trapp | Mar 2007 | A1 |
| 20070073102 | Matsuno et al. | Mar 2007 | A1 |
| 20070073269 | Becker | Mar 2007 | A1 |
| 20070079924 | Saadat et al. | Apr 2007 | A1 |
| 20070083195 | Werneth et al. | Apr 2007 | A1 |
| 20070088370 | Kahle et al. | Apr 2007 | A1 |
| 20070100375 | Mikkaichi et al. | May 2007 | A1 |
| 20070100376 | Mikkaichi et al. | May 2007 | A1 |
| 20070106118 | Moriyama | May 2007 | A1 |
| 20070106317 | Shelton, IV et al. | May 2007 | A1 |
| 20070112251 | Nakhuda | May 2007 | A1 |
| 20070112331 | Weber et al. | May 2007 | A1 |
| 20070112342 | Pearson et al. | May 2007 | A1 |
| 20070112383 | Conlon et al. | May 2007 | A1 |
| 20070112384 | Conlon et al. | May 2007 | A1 |
| 20070112385 | Conlon | May 2007 | A1 |
| 20070112417 | Shanley et al. | May 2007 | A1 |
| 20070112425 | Schaller et al. | May 2007 | A1 |
| 20070118115 | Artale et al. | May 2007 | A1 |
| 20070122425 | Schaller et al. | May 2007 | A1 |
| 20070123840 | Cox | May 2007 | A1 |
| 20070129605 | Schaaf | Jun 2007 | A1 |
| 20070129719 | Kendale et al. | Jun 2007 | A1 |
| 20070129760 | Demarais et al. | Jun 2007 | A1 |
| 20070135709 | Rioux et al. | Jun 2007 | A1 |
| 20070135803 | Belson | Jun 2007 | A1 |
| 20070142706 | Matsui et al. | Jun 2007 | A1 |
| 20070142710 | Yokoi et al. | Jun 2007 | A1 |
| 20070142780 | Van Lue | Jun 2007 | A1 |
| 20070154460 | Kraft et al. | Jul 2007 | A1 |
| 20070156028 | Van Lue et al. | Jul 2007 | A1 |
| 20070156127 | Rioux et al. | Jul 2007 | A1 |
| 20070161855 | Mikkaichi et al. | Jul 2007 | A1 |
| 20070162101 | Burgermeister et al. | Jul 2007 | A1 |
| 20070167901 | Herrig et al. | Jul 2007 | A1 |
| 20070173691 | Yokoi et al. | Jul 2007 | A1 |
| 20070173869 | Gannoe et al. | Jul 2007 | A1 |
| 20070173870 | Zacharias | Jul 2007 | A2 |
| 20070173872 | Neuenfeldt | Jul 2007 | A1 |
| 20070179525 | Frecker et al. | Aug 2007 | A1 |
| 20070179530 | Tieu et al. | Aug 2007 | A1 |
| 20070197865 | Miyake et al. | Aug 2007 | A1 |
| 20070198057 | Gelbart et al. | Aug 2007 | A1 |
| 20070203398 | Bonadio et al. | Aug 2007 | A1 |
| 20070203487 | Sugita | Aug 2007 | A1 |
| 20070208336 | Kim et al. | Sep 2007 | A1 |
| 20070208364 | Smith et al. | Sep 2007 | A1 |
| 20070213754 | Mikkaichi et al. | Sep 2007 | A1 |
| 20070225554 | Maseda et al. | Sep 2007 | A1 |
| 20070233040 | Macnamara et al. | Oct 2007 | A1 |
| 20070244358 | Lee | Oct 2007 | A1 |
| 20070250038 | Boulais | Oct 2007 | A1 |
| 20070250057 | Nobis et al. | Oct 2007 | A1 |
| 20070255096 | Stefanchik et al. | Nov 2007 | A1 |
| 20070255100 | Barlow et al. | Nov 2007 | A1 |
| 20070255273 | Fernandez et al. | Nov 2007 | A1 |
| 20070255303 | Bakos et al. | Nov 2007 | A1 |
| 20070255306 | Conlon et al. | Nov 2007 | A1 |
| 20070260112 | Rahmani | Nov 2007 | A1 |
| 20070260117 | Zwolinski et al. | Nov 2007 | A1 |
| 20070260121 | Bakos et al. | Nov 2007 | A1 |
| 20070260242 | Dycus et al. | Nov 2007 | A1 |
| 20070260273 | Cropper et al. | Nov 2007 | A1 |
| 20070260302 | Igaki | Nov 2007 | A1 |
| 20070270629 | Charles | Nov 2007 | A1 |
| 20070270889 | Conlon et al. | Nov 2007 | A1 |
| 20070270895 | Nobis et al. | Nov 2007 | A1 |
| 20070270907 | Stokes et al. | Nov 2007 | A1 |
| 20070282165 | Hopkins et al. | Dec 2007 | A1 |
| 20070282371 | Lee et al. | Dec 2007 | A1 |
| 20070293727 | Goldfarb et al. | Dec 2007 | A1 |
| 20070299387 | Williams et al. | Dec 2007 | A1 |
| 20080004650 | George | Jan 2008 | A1 |
| 20080015409 | Barlow et al. | Jan 2008 | A1 |
| 20080015413 | Barlow et al. | Jan 2008 | A1 |
| 20080015552 | Doyle et al. | Jan 2008 | A1 |
| 20080021416 | Arai et al. | Jan 2008 | A1 |
| 20080022927 | Zhang et al. | Jan 2008 | A1 |
| 20080027387 | Grabinsky | Jan 2008 | A1 |
| 20080033451 | Rieber et al. | Feb 2008 | A1 |
| 20080051629 | Sugiyama et al. | Feb 2008 | A1 |
| 20080051735 | Measamer et al. | Feb 2008 | A1 |
| 20080058586 | Karpiel | Mar 2008 | A1 |
| 20080058854 | Kieturakis et al. | Mar 2008 | A1 |
| 20080065169 | Colliou et al. | Mar 2008 | A1 |
| 20080071264 | Azure | Mar 2008 | A1 |
| 20080086172 | Martin et al. | Apr 2008 | A1 |
| 20080097159 | Ishiguro | Apr 2008 | A1 |
| 20080097472 | Agmon et al. | Apr 2008 | A1 |
| 20080097483 | Ortiz et al. | Apr 2008 | A1 |
| 20080103527 | Martin et al. | May 2008 | A1 |
| 20080114384 | Chang et al. | May 2008 | A1 |
| 20080119870 | Williams | May 2008 | A1 |
| 20080119891 | Miles et al. | May 2008 | A1 |
| 20080125796 | Graham | May 2008 | A1 |
| 20080132892 | Lunsford et al. | Jun 2008 | A1 |
| 20080139882 | Fujimori | Jun 2008 | A1 |
| 20080140069 | Filloux et al. | Jun 2008 | A1 |
| 20080140071 | Vegesna | Jun 2008 | A1 |
| 20080147113 | Nobis et al. | Jun 2008 | A1 |
| 20080171907 | Long et al. | Jul 2008 | A1 |
| 20080177135 | Muyari et al. | Jul 2008 | A1 |
| 20080188710 | Segawa et al. | Aug 2008 | A1 |
| 20080188868 | Weitzner et al. | Aug 2008 | A1 |
| 20080200755 | Bakos | Aug 2008 | A1 |
| 20080200762 | Stokes et al. | Aug 2008 | A1 |
| 20080200911 | Long | Aug 2008 | A1 |
| 20080200933 | Bakos et al. | Aug 2008 | A1 |
| 20080200934 | Fox | Aug 2008 | A1 |
| 20080208213 | Benjamin et al. | Aug 2008 | A1 |
| 20080221587 | Schwartz | Sep 2008 | A1 |
| 20080228213 | Blakeney et al. | Sep 2008 | A1 |
| 20080230972 | Ganley | Sep 2008 | A1 |
| 20080234696 | Taylor et al. | Sep 2008 | A1 |
| 20080243106 | Coe et al. | Oct 2008 | A1 |
| 20080243148 | Mikkaichi et al. | Oct 2008 | A1 |
| 20080243176 | Weitzner et al. | Oct 2008 | A1 |
| 20080249567 | Kaplan | Oct 2008 | A1 |
| 20080262513 | Stahler et al. | Oct 2008 | A1 |
| 20080262524 | Bangera et al. | Oct 2008 | A1 |
| 20080262540 | Bangera et al. | Oct 2008 | A1 |
| 20080269782 | Stefanchik et al. | Oct 2008 | A1 |
| 20080269783 | Griffith | Oct 2008 | A1 |
| 20080275474 | Martin et al. | Nov 2008 | A1 |
| 20080275475 | Schwemberger et al. | Nov 2008 | A1 |
| 20080287737 | Dejima | Nov 2008 | A1 |
| 20080287983 | Smith et al. | Nov 2008 | A1 |
| 20080300461 | Shaw et al. | Dec 2008 | A1 |
| 20080300547 | Bakos | Dec 2008 | A1 |
| 20080309758 | Karasawa et al. | Dec 2008 | A1 |
| 20080312496 | Zwolinski | Dec 2008 | A1 |
| 20080312499 | Handa et al. | Dec 2008 | A1 |
| 20080312500 | Asada et al. | Dec 2008 | A1 |
| 20080312506 | Spivey et al. | Dec 2008 | A1 |
| 20080319436 | Daniel et al. | Dec 2008 | A1 |
| 20080319439 | Ootsubu | Dec 2008 | A1 |
| 20090005636 | Pang et al. | Jan 2009 | A1 |
| 20090054728 | Trusty | Feb 2009 | A1 |
| 20090062788 | Long et al. | Mar 2009 | A1 |
| 20090062792 | Vakharia et al. | Mar 2009 | A1 |
| 20090062795 | Vakharia et al. | Mar 2009 | A1 |
| 20090069634 | Larkin | Mar 2009 | A1 |
| 20090076499 | Azure | Mar 2009 | A1 |
| 20090078736 | Van Lue | Mar 2009 | A1 |
| 20090082776 | Cresina | Mar 2009 | A1 |
| 20090082779 | Nakao | Mar 2009 | A1 |
| 20090112059 | Nobis | Apr 2009 | A1 |
| 20090112062 | Bakos | Apr 2009 | A1 |
| 20090112063 | Bakos et al. | Apr 2009 | A1 |
| 20090125042 | Mouw | May 2009 | A1 |
| 20090131751 | Spivey et al. | May 2009 | A1 |
| 20090131932 | Vakharia et al. | May 2009 | A1 |
| 20090131933 | Ghabrial et al. | May 2009 | A1 |
| 20090143639 | Stark | Jun 2009 | A1 |
| 20090143649 | Rossi | Jun 2009 | A1 |
| 20090143794 | Conlon et al. | Jun 2009 | A1 |
| 20090143818 | Faller et al. | Jun 2009 | A1 |
| 20090149710 | Stefanchik et al. | Jun 2009 | A1 |
| 20090177031 | Surti et al. | Jul 2009 | A1 |
| 20090177219 | Conlon | Jul 2009 | A1 |
| 20090182332 | Long et al. | Jul 2009 | A1 |
| 20090192344 | Bakos et al. | Jul 2009 | A1 |
| 20090192534 | Ortiz et al. | Jul 2009 | A1 |
| 20090198231 | Esser et al. | Aug 2009 | A1 |
| 20090198253 | Omori | Aug 2009 | A1 |
| 20090210000 | Sullivan et al. | Aug 2009 | A1 |
| 20090216248 | Uenohara et al. | Aug 2009 | A1 |
| 20090221873 | McGrath | Sep 2009 | A1 |
| 20090227828 | Swain et al. | Sep 2009 | A1 |
| 20090228001 | Pacey | Sep 2009 | A1 |
| 20090248055 | Spivey et al. | Oct 2009 | A1 |
| 20090259105 | Miyano et al. | Oct 2009 | A1 |
| 20090269317 | Davalos | Oct 2009 | A1 |
| 20090281559 | Swain et al. | Nov 2009 | A1 |
| 20090287206 | Jun | Nov 2009 | A1 |
| 20090287236 | Bakos et al. | Nov 2009 | A1 |
| 20090292164 | Yamatani | Nov 2009 | A1 |
| 20090299135 | Spivey | Dec 2009 | A1 |
| 20090299143 | Conlon et al. | Dec 2009 | A1 |
| 20090299362 | Long et al. | Dec 2009 | A1 |
| 20090299385 | Stefanchik et al. | Dec 2009 | A1 |
| 20090299406 | Swain et al. | Dec 2009 | A1 |
| 20090299409 | Coe et al. | Dec 2009 | A1 |
| 20090306658 | Nobis et al. | Dec 2009 | A1 |
| 20090306683 | Zwolinski et al. | Dec 2009 | A1 |
| 20090322864 | Karasawa et al. | Dec 2009 | A1 |
| 20090326332 | Carter | Dec 2009 | A1 |
| 20090326561 | Carroll, II et al. | Dec 2009 | A1 |
| 20100010294 | Conlon et al. | Jan 2010 | A1 |
| 20100010298 | Bakos et al. | Jan 2010 | A1 |
| 20100010299 | Bakos et al. | Jan 2010 | A1 |
| 20100010303 | Bakos | Jan 2010 | A1 |
| 20100010510 | Stefanchik | Jan 2010 | A1 |
| 20100010511 | Harris et al. | Jan 2010 | A1 |
| 20100023032 | Granja Filho | Jan 2010 | A1 |
| 20100030211 | Davalos et al. | Feb 2010 | A1 |
| 20100036198 | Tacchino et al. | Feb 2010 | A1 |
| 20100042045 | Spivey | Feb 2010 | A1 |
| 20100048990 | Bakos | Feb 2010 | A1 |
| 20100049190 | Long et al. | Feb 2010 | A1 |
| 20100049223 | Granja Filho | Feb 2010 | A1 |
| 20100056861 | Spivey | Mar 2010 | A1 |
| 20100056862 | Bakos | Mar 2010 | A1 |
| 20100056864 | Lee | Mar 2010 | A1 |
| 20100057085 | Holcomb et al. | Mar 2010 | A1 |
| 20100057108 | Spivey et al. | Mar 2010 | A1 |
| 20100063538 | Spivey et al. | Mar 2010 | A1 |
| 20100076451 | Zwolinski et al. | Mar 2010 | A1 |
| 20100076460 | Taylor et al. | Mar 2010 | A1 |
| 20100081877 | Vakharia | Apr 2010 | A1 |
| 20100087813 | Long | Apr 2010 | A1 |
| 20100091128 | Ogasawara et al. | Apr 2010 | A1 |
| 20100113872 | Asada et al. | May 2010 | A1 |
| 20100121362 | Clague et al. | May 2010 | A1 |
| 20100130817 | Conlon | May 2010 | A1 |
| 20100130975 | Long | May 2010 | A1 |
| 20100131005 | Conlon | May 2010 | A1 |
| 20100152539 | Ghabrial et al. | Jun 2010 | A1 |
| 20100152609 | Zwolinski et al. | Jun 2010 | A1 |
| 20100152746 | Ceniccola et al. | Jun 2010 | A1 |
| 20100179510 | Fox et al. | Jul 2010 | A1 |
| 20100179530 | Long et al. | Jul 2010 | A1 |
| 20100191050 | Zwolinski | Jul 2010 | A1 |
| 20100191267 | Fox | Jul 2010 | A1 |
| 20100198005 | Fox | Aug 2010 | A1 |
| 20100198149 | Fox | Aug 2010 | A1 |
| 20100198244 | Spivey et al. | Aug 2010 | A1 |
| 20100198248 | Vakharia | Aug 2010 | A1 |
| 20100217367 | Belson | Aug 2010 | A1 |
| 20100249700 | Spivey | Sep 2010 | A1 |
| 20100261994 | Davalos et al. | Oct 2010 | A1 |
| 20100286791 | Goldsmith | Nov 2010 | A1 |
| 20100298642 | Trusty et al. | Nov 2010 | A1 |
| 20100312056 | Galperin et al. | Dec 2010 | A1 |
| 20100331622 | Conlon | Dec 2010 | A2 |
| 20100331758 | Davalos et al. | Dec 2010 | A1 |
| 20100331774 | Spivey | Dec 2010 | A2 |
| 20110077476 | Rofougaran | Mar 2011 | A1 |
| 20110093009 | Fox | Apr 2011 | A1 |
| 20110098694 | Long | Apr 2011 | A1 |
| 20110098704 | Long et al. | Apr 2011 | A1 |
| 20110105850 | Voegele et al. | May 2011 | A1 |
| 20110106221 | Neal, II et al. | May 2011 | A1 |
| 20110112434 | Ghabrial et al. | May 2011 | A1 |
| 20110115891 | Trusty | May 2011 | A1 |
| 20110124964 | Nobis | May 2011 | A1 |
| 20110152609 | Trusty et al. | Jun 2011 | A1 |
| 20110152610 | Trusty et al. | Jun 2011 | A1 |
| 20110152612 | Trusty et al. | Jun 2011 | A1 |
| 20110152858 | Long et al. | Jun 2011 | A1 |
| 20110152859 | Long et al. | Jun 2011 | A1 |
| 20110152878 | Trusty et al. | Jun 2011 | A1 |
| 20110152923 | Fox | Jun 2011 | A1 |
| 20110160514 | Long et al. | Jun 2011 | A1 |
| 20110190764 | Long et al. | Aug 2011 | A1 |
| 20110193948 | Amling et al. | Aug 2011 | A1 |
| 20110245619 | Holcomb | Oct 2011 | A1 |
| 20110285488 | Scott et al. | Nov 2011 | A1 |
| 20110306971 | Long | Dec 2011 | A1 |
| 20120004502 | Weitzner et al. | Jan 2012 | A1 |
| 20120029335 | Sudam et al. | Feb 2012 | A1 |
| 20120088965 | Stokes et al. | Apr 2012 | A1 |
| 20120089089 | Swain et al. | Apr 2012 | A1 |
| 20120089093 | Trusty | Apr 2012 | A1 |
| 20120116155 | Trusty | May 2012 | A1 |
| 20120179148 | Conlon | Jul 2012 | A1 |
| 20120191075 | Trusty | Jul 2012 | A1 |
| 20120191076 | Voegele et al. | Jul 2012 | A1 |
| 20120220998 | Long et al. | Aug 2012 | A1 |
| 20120220999 | Long | Aug 2012 | A1 |
| 20120221002 | Long et al. | Aug 2012 | A1 |
| 20120238796 | Conlon | Sep 2012 | A1 |
| 20120330306 | Long et al. | Dec 2012 | A1 |
| 20130090666 | Hess et al. | Apr 2013 | A1 |
| Number | Date | Country |
|---|---|---|
| 666310 | Feb 1996 | AU |
| 3008120 | Sep 1980 | DE |
| 4323585 | Jan 1995 | DE |
| 19713797 | Oct 1997 | DE |
| 19757056 | Aug 2008 | DE |
| 102006027873 | Oct 2009 | DE |
| 0086338 | Aug 1983 | EP |
| 0286415 | Oct 1988 | EP |
| 0589454 | Mar 1994 | EP |
| 0464479 | Mar 1995 | EP |
| 0529675 | Feb 1996 | EP |
| 0621009 | Jul 1997 | EP |
| 0724863 | Jul 1999 | EP |
| 0760629 | Nov 1999 | EP |
| 0818974 | Jul 2001 | EP |
| 1281356 | Feb 2003 | EP |
| 0947166 | May 2003 | EP |
| 0836832 | Dec 2003 | EP |
| 1402837 | Mar 2004 | EP |
| 0744918 | Apr 2004 | EP |
| 0931515 | Aug 2004 | EP |
| 0941128 | Oct 2004 | EP |
| 1411843 | Oct 2004 | EP |
| 1150614 | Nov 2004 | EP |
| 1477104 | Nov 2004 | EP |
| 1481642 | Dec 2004 | EP |
| 1493391 | Jan 2005 | EP |
| 0848598 | Feb 2005 | EP |
| 1281360 | Mar 2005 | EP |
| 1568330 | Aug 2005 | EP |
| 1452143 | Sep 2005 | EP |
| 1616527 | Jan 2006 | EP |
| 1006888 | Mar 2006 | EP |
| 1629764 | Mar 2006 | EP |
| 1013229 | Jun 2006 | EP |
| 1721561 | Nov 2006 | EP |
| 1153578 | Mar 2007 | EP |
| 1334696 | Mar 2007 | EP |
| 1769766 | Apr 2007 | EP |
| 1836971 | Sep 2007 | EP |
| 1836980 | Sep 2007 | EP |
| 1854421 | Nov 2007 | EP |
| 1857061 | Nov 2007 | EP |
| 1875876 | Jan 2008 | EP |
| 1891881 | Feb 2008 | EP |
| 1902663 | Mar 2008 | EP |
| 1477106 | Jun 2008 | EP |
| 1949844 | Jul 2008 | EP |
| 1518499 | Aug 2008 | EP |
| 1582138 | Sep 2008 | EP |
| 1709918 | Oct 2008 | EP |
| 1985226 | Oct 2008 | EP |
| 1994904 | Nov 2008 | EP |
| 1707130 | Dec 2008 | EP |
| 0723462 | Mar 2009 | EP |
| 1769749 | Nov 2009 | EP |
| 2135545 | Dec 2009 | EP |
| 1493397 | Sep 2011 | EP |
| 2731610 | Sep 1996 | FR |
| 330629 | Jun 1930 | GB |
| 2335860 | Oct 1999 | GB |
| 2403909 | Jan 2005 | GB |
| 2421190 | Jun 2006 | GB |
| 2443261 | Apr 2008 | GB |
| 56-46674 | Apr 1981 | JP |
| 63309252 | Dec 1988 | JP |
| 4038960 | Feb 1992 | JP |
| 8-29699 | Feb 1996 | JP |
| 2000245683 | Sep 2000 | JP |
| 2002-369791 | Dec 2002 | JP |
| 2003-088494 | Mar 2003 | JP |
| 2003-235852 | Aug 2003 | JP |
| 2004-33525 | Feb 2004 | JP |
| 2004-065745 | Mar 2004 | JP |
| 2005-121947 | May 2005 | JP |
| 2005-261514 | Sep 2005 | JP |
| 2006297005 | Nov 2006 | JP |
| 2006-343510 | Dec 2006 | JP |
| 1021295 | Feb 2004 | NL |
| 194230 | May 1967 | SU |
| 980703 | Dec 1982 | SU |
| WO 8401707 | May 1984 | WO |
| WO 9213494 | Aug 1992 | WO |
| WO 9310850 | Jun 1993 | WO |
| WO 9320760 | Oct 1993 | WO |
| WO 9320765 | Oct 1993 | WO |
| WO 9509666 | Apr 1995 | WO |
| WO 9622056 | Jul 1996 | WO |
| WO 9627331 | Sep 1996 | WO |
| WO 9639946 | Dec 1996 | WO |
| WO 9712557 | Apr 1997 | WO |
| WO 9801080 | Jan 1998 | WO |
| WO 9900060 | Jan 1999 | WO |
| WO 9909919 | Mar 1999 | WO |
| WO 9917661 | Apr 1999 | WO |
| WO 9930622 | Jun 1999 | WO |
| WO 0035358 | Jun 2000 | WO |
| WO 0068665 | Nov 2000 | WO |
| WO 0110319 | Feb 2001 | WO |
| WO 0126708 | Apr 2001 | WO |
| WO 0141627 | Jun 2001 | WO |
| WO 0158360 | Aug 2001 | WO |
| WO 0211621 | Feb 2002 | WO |
| WO 0234122 | May 2002 | WO |
| WO 02094082 | Nov 2002 | WO |
| WO 03045260 | Jun 2003 | WO |
| WO 03047684 | Jun 2003 | WO |
| WO 03059412 | Jul 2003 | WO |
| WO 03078721 | Sep 2003 | WO |
| WO 03081761 | Oct 2003 | WO |
| WO 03082129 | Oct 2003 | WO |
| WO 2004006789 | Jan 2004 | WO |
| WO 2004028613 | Apr 2004 | WO |
| WO 2004037123 | May 2004 | WO |
| WO 2004037149 | May 2004 | WO |
| WO 2004052221 | Jun 2004 | WO |
| WO 2004086984 | Oct 2004 | WO |
| WO 2005009211 | Feb 2005 | WO |
| WO 2005018467 | Mar 2005 | WO |
| WO 2005037088 | Apr 2005 | WO |
| WO 2005048827 | Jun 2005 | WO |
| WO 2005065284 | Jul 2005 | WO |
| WO 2005097019 | Oct 2005 | WO |
| WO 2005097234 | Oct 2005 | WO |
| WO 2005112810 | Dec 2005 | WO |
| WO 2005120363 | Dec 2005 | WO |
| WO 2005122866 | Dec 2005 | WO |
| WO 2006007399 | Jan 2006 | WO |
| WO 2006012630 | Feb 2006 | WO |
| WO 2006040109 | Apr 2006 | WO |
| WO 2006041881 | Apr 2006 | WO |
| WO 2006060405 | Jun 2006 | WO |
| WO 2006110733 | Oct 2006 | WO |
| WO 2006113216 | Oct 2006 | WO |
| WO 2007013059 | Feb 2007 | WO |
| WO 2007014063 | Feb 2007 | WO |
| WO 2007048085 | Apr 2007 | WO |
| WO 2007063550 | Jun 2007 | WO |
| WO 2007100067 | Sep 2007 | WO |
| WO 2007109171 | Sep 2007 | WO |
| WO 2007143200 | Dec 2007 | WO |
| WO 2007144004 | Dec 2007 | WO |
| WO 2008005433 | Jan 2008 | WO |
| WO 2008033356 | Mar 2008 | WO |
| WO 2008041225 | Apr 2008 | WO |
| WO 2008076337 | Jun 2008 | WO |
| WO 2008076800 | Jun 2008 | WO |
| WO 2008079440 | Jul 2008 | WO |
| WO 2008101075 | Aug 2008 | WO |
| WO 2008102154 | Aug 2008 | WO |
| WO 2008108863 | Sep 2008 | WO |
| WO 2008151237 | Dec 2008 | WO |
| WO 2009021030 | Feb 2009 | WO |
| WO 2009027065 | Mar 2009 | WO |
| WO 2009029065 | Mar 2009 | WO |
| WO 2009032623 | Mar 2009 | WO |
| WO 2009036457 | Mar 2009 | WO |
| WO 2009121017 | Oct 2009 | WO |
| WO 2010027688 | Mar 2010 | WO |
| WO 2010056716 | May 2010 | WO |
| WO 2010080974 | Jul 2010 | WO |
| WO 2010088481 | Aug 2010 | WO |
| Entry |
|---|
| International Search Report for PCT/US2011/021815, Aug. 30, 2011 (7 pages). |
| Zadno et al., “Linear Superelasticity in Cold-Warked NI-TI,” Engineering Aspects of Shape Memory Alloys, pp. 414-419 (1990). |
| How Stuff Works “How Smart Structures Will Work,” http://science.howstuffworks.com/engineering/structural/smart-structure1.htm; accessed online Nov. 1, 2011 (3 pages). |
| Instant Armor: Science Videos—Science News—ScienCentral; http://www.sciencentral.com/articles./view.php3?article—id=218392121; accessed online Nov. 1, 2011 (2 pages). |
| Stanway, Smart Fluids: Current and Future Developments. Material Science and Technology. 20. pp. 931-939, 2004; accessed online Nov. 1, 2011 at http://www.dynamics.group.shef.ac.uk/smart/smart.html (7 pages). |
| Jolly et al., Properties and Applications of Commercial Magnetorheological Fluids. SPIE 5th Annual Int. Symposium on Smart Structures and Materials, 1998 (18 pages). |
| U.S. Appl. No. 13/013,131, filed Jan. 25, 2011. |
| U.S. Appl. No. 13/013,147, filed Jan. 25, 2011. |
| U.S. Appl. No. 12/900,132, filed Oct. 7, 2010. |
| U.S. Appl. No. 12/939,441, filed Nov. 4, 2010. |
| U.S. Appl. No. 12/902,531, filed Oct. 12, 2010. |
| U.S. Appl. No. 12/902,550, filed Oct. 12, 2010. |
| U.S. Appl. No. 13/036,895, filed Feb. 28, 2011. |
| U.S. Appl. No. 13/036,908, filed Feb. 28, 2011. |
| U.S. Appl. No. 13/218,221, filed Aug. 25, 2011. |
| U.S. Appl. No. 13/267,251, filed Oct. 6, 2011. |
| Michael S. Kavic, M.D., “Natural Orifice Translumenal Endoscopic Surgery: “NOTES””, JSLS, vol. 10, pp. 133-134 (2006). |
| Ethicon, Inc., “Wound Closure Manual: Chapter 3 (The Surgical Needle),” 15 pages, (1994). |
| Guido M. Sclabas, M.D., et al., “Endoluminal Methods for Gastrotomy Closure in Natural Orifice TransEnteric Surgery (NOTES),” Surgical Innovation, vol. 13, No. 1, pp. 23-30, Mar. 2006. |
| Fritscher-Ravens, et al., “Transgastric Gastropexy and Hiatal Hernia Repair for GERD Under EUS Control: a Porcine Model,” Gastrointestinal Endoscopy, vol. 59, No. 1, pp. 89-95, 2004. |
| Ogando, “Prototype Tools That Go With The Flow,” Design News, 2 pages, Jul. 17, 2006. |
| Edd, et al., “In Vivo Results of a New Focal Tissue Ablation Technique: Irreversible Electroporation,” IEEE Trans Biomed Eng, vol. 53, pp. 1409-1415, 2006. |
| Kennedy, et al., “High-Burst-Strength, Feedback-Controlled Bipolar Vessel Sealing,” Surgical Endoscopy, vol. 12, pp. 876-878 (1998). |
| Collins et al., “Local Gene Therapy of Solid Tumors with GM-CSF and B7-1 Eradicates Both Treated and Distal Tumors,” Cancer Gene Therapy, vol. 13, pp. 1061-1071 (2006). |
| K. Sumiyama et al., “Transesophageal Mediastinoscopy by Submucosal Endoscopy With Mucosal Flap Safety Value Technique,” Gastrointest Endosc., Apr. 2007, vol. 65(4), pp. 679-683 (Abstract). |
| K. Sumiyama et al., “Submucosal Endoscopy with Mucosal Flap Safety Valve,” Gastrointest Endosc. Apr. 2007, vol. 65(4) pp. 694-695 (Abstract). |
| K. Sumiyama et al., “Transgastric Cholecystectomy: Transgastric Accessibility to the Gallbladder Improved with the SEMF Method and a Novel Multibending Therapeutic Endoscope,” Gastrointest Endosc., Jun. 2007, vol. 65(7), pp. 1028-1034 (Abstract). |
| K. Sumiyama et al., “Endoscopic Caps,” Tech. Gastrointest. Endosc., vol. 8, pp. 28-32, 2006. |
| “Z-Offset Technique Used in the Introduction of Trocar During Laparoscopic Surgery,” M.S. Hershey NOTES Presentation to EES NOTES Development Team, Sep. 27, 2007. |
| F.N. Denans, Nouveau Procede Pour La Guerison Des Plaies Des Intestines. Extrait Des Seances De La Societe Royale De Medecine De Marseille, Pendant Le Mois De Dec. 1825, et le Premier Tremestre De 1826, Séance Du 24 Fevrier 1826. Recueil De La Societe Royale De Medecin De Marseille. Marseille: Impr. D'Achard, 1826; 1:127-31. (with English translation). |
| I. Fraser, “An Historical Perspective on Mechanical Aids in Intestinal Anastamosis,” Surg. Gynecol. Obstet. (Oct. 1982), vol. 155, pp. 566-574. |
| M.E. Ryan et al., “Endoscopic Intervention for Biliary Leaks After Laparoscopic Cholecystectomy: A Multicenter Review,” Gastrointest. Endosc., vol. 47(3), 1998, pp. 261-266. |
| C. Cope, “Creation of Compression Gastroenterostomy by Means of the Oral, Percutaneous, or Surgical Introduction of Magnets: Feasibility Study in Swine,” J. Vasc Interv Radiol, (1995), vol. 6(4), pp. 539-545. |
| J.W. Hazey et al., “Natural Orifice Transgastric Endoscopic Peritoneoscopy in Humans: Initial Clinical Trial,” Surg Endosc, (Jan. 2008), vol. 22(1), pp. 16-20. |
| N. Chopita et al., “Endoscopic Gastroenteric Anastamosis Using Magnets,” Endoscopy, (2005), vol. 37(4), pp. 313-317. |
| C. Cope et al., “Long Term Patency of Experimental Magnetic Compression Gastroenteric Anastomoses Achieved with Covered Stents,” Gastrointest Endosc, (2001), vol. 53, pp. 780-784. |
| H. Okajima et al., “Magnet Compression Anastamosis for Bile Duct Stenosis After Duct to Duct Biliary Reconstruction in Living Donor Liver Transplantation,” Liver Transplantation (2005), pp. 473-475. |
| A. Fritscher-Ravens et al., “Transluminal Endosurgery: Single Lumen Access Anastamotic Device for Flexible Endoscopy,” Gastrointestinal Endosc, (2003), vol. 58(4), pp. 585-591. |
| G.A. Hallenbeck, M.D. et al., “An Instrument for Colorectal Anastomosis Without Sutrues,” Dis Col Rectum, (1963), vol. 5, pp. 98-101. |
| T. Hardy, Jr., M.D. et al., “A Biofragmentable Ring for Sutureless Bowel Anastomosis. An Experimental Study,” Dis Col Rectum, (1985), vol. 28, pp. 484-490. |
| P. O'Neill, M.D. et al., “Nonsuture Intestinal Anastomosis,” Am J. Surg, (1962), vol. 104, pp. 761-767. |
| C.P. Swain, M.D. et al., “Anastomosis at Flexible Endoscopy: An Experimental Study of Compression Button Gastrojejunostomy,” Gastrointest Endosc, (1991), vol. 37, pp. 628-632. |
| J.B. Murphy, M.D., “Cholecysto-Intestinal, Gastro-Intestinal, Entero-Intestinal Anastomosis, and Approximation Without Sutures (original research),” Med Rec, (Dec. 10, 1892), vol. 42(24), pp. 665-676. |
| USGI® EndoSurgical Operating System—g-Prox® Tissue Grasper/Approximation Device; [online] URL: http://www.usgimedical.com/eos/components-gprox.htm—accessed May 30, 2008 (2 pages). |
| Printout of web page—http://www.vacumed.com/zcom/product/Product.do?compid=27&prodid=852, #51XX Low-Cost Permanent Tubes 2MM ID, Smooth Interior Walls, VacuMed, Ventura, California, Accessed Jul. 24, 2007. |
| Endoscopic Retrograde Cholangiopancreatogram (ERCP); [online] URL: http://www.webmd.com/digestive-disorders/endoscopic-retrograde-cholangiopancreatogram-ercp.htm; last updated: Apr. 30, 2007; accessed: Feb. 21, 2008 (6 pages). |
| ERCP; Jackson Siegelbaum Gastroenterology; [online] URL: http://www.gicare.com/pated/epdgs20.htm; accessed Feb. 21, 2008 (3 pages). |
| D.G. Fong et al., “Transcolonic Ventral Wall Hernia Mesh Fixation in a Porcine Model,” Endoscopy 2007; 39: 865-869. |
| B. Rubinsky, Ph.D., “Irreversible Electroporation in Medicine,” Technology in Cancer Research and Treatment, vol. 6, No. 4, Aug. (2007), pp. 255-259. |
| D.B. Nelson, MD et al., “Endoscopic Hemostatic Devices,” Gastrointestinal Endoscopy, vol. 54, No. 6, 2001, pp. 833-840. |
| CRE™ Pulmonary Balloon Dilator; [online] URL: http://www.bostonscientific.com/Device.bsci?page=HCP—Overview&navRe1Id=1000.1003&method=D . . . , accessed Jul. 18, 2008 (4 pages). |
| J.D. Paulson, M.D., et al., “Development of Flexible Culdoscopy,” The Journal of the American Association of Gynecologic Laparoscopists, Nov. 1999, vol. 6, No. 4, pp. 487-490. |
| H. Seifert, et al., “Retroperitoneal Endoscopic Debridement for Infected Peripancreatic Necrosis,” The Lancet, Research Letters, vol. 356, Aug. 19, 2000, pp. 653-655. |
| K.E. Mönkemüller, M.D., et al., “Transmural Drainage of Pancreatic Fluid Collections Without Electrocautery Using the Seldinger Technique,” Gastrointestinal Endoscopy, vol. 48, No. 2, 1998, pp. 195-200, (Received Oct. 3, 1997; Accepted Mar. 31, 1998). |
| D. Wilhelm et al., “An Innovative, Safe and Sterile Sigmoid Access (ISSA) for NOTES,” Endoscopy 2007, vol. 39, pp. 401-406. |
| Nakazawa et al., “Radiofrequency Ablation of Hepatocellular Carcinoma: Correlation Between Local Tumor Progression After Ablation and Ablative Margin,” AJR, 188, pp. 480-488 (Feb. 2007). |
| Miklav{hacek over (c)}i{hacek over (c)}et al., “A validated model of in vivo electric field distribution in tissues for electrochemotherapy and for DNA electrotransfer for gene therapy,” Biochimica et Biophysica Acta, 1523, pp. 73-83 (2000). |
| Evans, “Ablative and cathether-delivered therapies for colorectal liver metastases (CRLM),” EJSO, 33, pp. S64-S75 (2007). |
| Wong et al., “Combined Percutaneous Radiofrequency Ablation and Ethanol Injection for Hepatocellular Carcinoma in High-Risk Locations,” AJR, 190, pp. W187-W195 (2008). |
| Heller et al., “Electrically mediated plasmid DNA delivery to hepatocellular carcinomas in vivo,” Gene Therapy, 7, pp. 826-829 (2000). |
| Widera et al., “Increased DNA Vaccine Delivery and Immunogenicity by Electroporation In Vivo,” The Journal of Immunology, 164, pp. 4635-4640 (2000). |
| Weaver et al., “Theory of electroporation: A review,” Bioelectrochemistry and Bioenergetics, 41, pp. 135-160 (1996). |
| Mulier et al., “Radiofrequency Ablation Versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?” Annals of Surgical Oncology, 15(1), pp. 144-157 (2008). |
| Link et al., “Regional Chemotherapy of Nonresectable Colorectal Liver Metastases with Mitoxanthrone, 5-Fluorouracil, Folinic Acid, and Mitomycin C May Prolong Survival,” Cancer, 92, pp. 2746-2753 (2001). |
| Guyton et al., “Membrane Potentials and Action Potentials,” W.B. Sanders, ed. Textbook of Medical Physiology, p. 56 (2000). |
| Guyton et al., “Contraction of Skeletal Muscle,” Textbook of Medical Physiology, pp. 82-84 (2000). |
| “Ethicon Endo-Surgery Novel Investigational Notes and SSL Devices Featured in 15 Presentations at Sages,” Apr. 22, 2009 Press Release; URL http://www.jnj.com/connect/news/all/20090422—152000; accessed Aug. 28, 2009 (3 pages). |
| “Ethicon Endo-Surgery Studies Presented At DDW Demonstrate Potential of Pure NOTES Surgery With Company's Toolbox,” Jun. 3, 2009 Press Release; URL http://www.jnj.com/connect/news/product/20090603—20000; accessed Aug. 28, 2009 (3 pages). |
| Castellvi et al., “Hybrid Transvaginal NOTES Sleeve Gastrectomy in a Porcine Model Using a Magnetically Anchored Camera and Novel Instrumentation,” Abstract submitted along with Poster at SAGES Annual Meeting in Phoenix, AZ, Apr. 22, 2009 (1 page). |
| Castellvi et al., “Hybrid Transvaginal NOTES Sleeve Gastrectomy in a Porcine Model Using a Magnetically Anchored Camera and Novel Instrumentation,” Poster submitted along with Abstract at SAGES Annual Meeting in Phoenix, AZ, Apr. 22, 2009 (1 page). |
| OCTO Port Modular Laparoscopy System for Single Incision Access, Jan. 4, 2010; URL http://www.medgadget.com/archives/2010/01/octo—port—modular—laparo . . . ; accessed Jan. 5, 2010 (4 pages). |
| Hakko Retractors, obtained Aug. 25, 2009 (5 pages). |
| U.S. Appl. No. 12/607,252, filed Oct. 28, 2009. |
| U.S. Appl. No. 12/580,400, filed Oct. 16, 2009. |
| U.S. Appl. No. 12/607,388, filed Oct. 28, 2009. |
| U.S. Appl. No. 12/612,911, filed Nov. 5, 2009. |
| U.S. Appl. No. 12/614,143, filed Nov. 6, 2009. |
| U.S. Appl. No. 12/617,998, filed Nov. 13, 2009. |
| U.S. Appl. No. 12/640,440, filed Dec. 17, 2009. |
| U.S. Appl. No. 12/640,469, filed Dec. 17, 2009. |
| U.S. Appl. No. 12/640,476, filed Dec. 17, 2009. |
| U.S. Appl. No. 12/640,492, filed Dec. 17, 2009. |
| U.S. Appl. No. 12/641,823, filed Dec. 18, 2009. |
| U.S. Appl. No. 12/641,853, filed Dec. 18, 2009. |
| U.S. Appl. No. 12/641,837, filed Dec. 18, 2009. |
| U.S. Appl. No. 12/651,181, filed Dec. 31, 2009. |
| U.S. Appl. No. 12/696,598, filed Jan. 29, 2010. |
| U.S. Appl. No. 12/752,701, filed Apr. 1, 2010. |
| U.S. Appl. No. 13/325,791, filed Dec. 14, 2011. |
| U.S. Appl. No. 13/352,495, filed Jan. 18, 2012. |
| U.S. Appl. No. 13/399,358, filed Feb. 17, 2012. |
| U.S. Appl. No. 13/420,805, filed Mar. 15, 2012. |
| U.S. Appl. No. 13/420,818, filed Mar. 15, 2012. |
| Rutala et al. “Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008” (available at http://www.cdc.gov/hicpac/Disinfection—Sterilization/13—11sterilizingPractices.html). |
| Bewlay et al., “Spinning” in ASM Handbook, vol. 14B, Metalworking: Sheet Forming (2006). |
| Number | Date | Country | |
|---|---|---|---|
| 20110190659 A1 | Aug 2011 | US |
