Surgical instruments

Information

  • Patent Grant
  • 9642644
  • Patent Number
    9,642,644
  • Date Filed
    Thursday, March 12, 2015
    9 years ago
  • Date Issued
    Tuesday, May 9, 2017
    7 years ago
Abstract
A surgical device. The surgical device may comprise a transducer configured to provide vibrations along a longitudinal axis and an end effector coupled to the transducer and extending from the transducer along the longitudinal axis. The surgical device also may comprise a lower jaw extending parallel to the end effector. The lower jaw may comprise a clamp face extending toward the longitudinal axis. Also, the lower jaw may be slidable relative to the end effector to bring the clamp face toward a distal end of the end effector.
Description
BACKGROUND

Ultrasonic instruments, including both hollow core and solid core instruments, are used for the safe and effective treatment of many medical conditions. Ultrasonic instruments, are advantageous because they may be used to cut and/or coagulate organic tissue using energy in the form of mechanical vibrations transmitted to a surgical end effector at ultrasonic frequencies. Ultrasonic vibrations, when transmitted to organic tissue at suitable energy levels and using a suitable end effector, may be used to cut, dissect, elevate or cauterize tissue or to separate muscle tissue off bone. Such instruments may be used for open procedures or minimally invasive procedures, such as endoscopic or laparoscopic procedures, wherein the end effector is passed through a trocar to reach the surgical site.


Activating or exciting the end effector (e.g., cutting blade) of such instruments at ultrasonic frequencies induces longitudinal vibratory movement that generates localized heat within adjacent tissue, facilitating both cutting and coagulation. Because of the nature of ultrasonic instruments, a particular ultrasonically actuated end effector may be designed to perform numerous functions, including, for example, cutting and coagulation.


Ultrasonic vibration is induced in the surgical end effector by electrically exciting a transducer, for example. The transducer may be constructed of one or more piezoelectric or magnetostrictive elements in the instrument hand piece. Vibrations generated by the transducer section are transmitted to the surgical end effector via an ultrasonic waveguide extending from the transducer section to the surgical end effector. The waveguides and end effectors are designed to resonate at the same frequency as the transducer. Therefore, when an end effector is attached to a transducer the overall system frequency is the same frequency as the transducer itself.


The zero to peak amplitude of the longitudinal ultrasonic vibration at the tip, d, of the end effector behaves as a simple sinusoid at the resonant frequency as given by:

d=A sin(ωt)

where:


ω=the radian frequency which equals 2π times the cyclic frequency, f; and


A=the zero-to-peak amplitude.


The longitudinal excursion is defined as the peak-to-peak (p-t-p) amplitude, which is just twice the amplitude of the sine wave or 2A.


Ultrasonic surgical instruments may be divided into two types, single element end effector devices and multiple-element end effector devices. Single element end effector devices include instruments such as scalpels and ball coagulators. Single-element end effector instruments have limited ability to apply blade-to-tissue pressure when the tissue is soft and loosely supported. Sometimes, substantial pressure may be necessary to effectively couple ultrasonic energy to the tissue. This inability to grasp the tissue results in a further inability to fully coapt tissue surfaces while applying ultrasonic energy, leading to less-than-desired hemostasis and tissue joining. In these cases, multiple-element end effectors may be used. Multiple-element end effector devices, such as clamping coagulators, include a mechanism to press tissue against an ultrasonic blade that can overcome these deficiencies.


Many surgical procedures utilizing harmonic and non-harmonic instruments create extraneous tissue fragments and other materials at the surgical site. If this material is not removed, it may obstruct the clinician's view and also may interfere with the blade or other end effector of the surgical device. To remove the material, the clinician must remove the instrument from the surgical area and introduce an aspiration tool. This can break the clinician's concentration and also contribute to physical and mental fatigue.


Also, in some surgical procedures, it is desirable to remove a core or other integral portion of tissue. In these procedures, the clinician uses a first instrument to grasp and sometimes cut an outline of the tissue to be removed. Then a second instrument is utilized to remove the tissue from surrounding material, often while the tissue is still grasped by the first instrument. This process may be particularly challenging for clinicians because it can require the use of multiple instruments, often simultaneously. Also, many coring procedures are performed at very delicate portions of the anatomy that require precise cuts.


In addition, existing harmonic instruments allow the clinician to turn them on or off, but provide limited control over the power delivered to tissue once the instrument is turned on. This limits the usefulness of harmonic instruments in delicate surgical procedures, where fine cutting control is required.


SUMMARY

In one general aspect, the various embodiments are directed to a surgical device. The surgical device may comprise a transducer configured to provide vibrations along a longitudinal axis and an end effector coupled to the transducer and extending from the transducer along the longitudinal axis. The surgical device also may comprise a lower jaw extending parallel to the end effector. The lower jaw may comprise a clamp face extending toward the longitudinal axis. Also, the lower jaw may be slidable relative to the end effector to bring the clamp face toward a distal end of the end effector.


In another general aspect, the various embodiments are directed to another surgical device comprising an end effector. The end effector may comprise a hollow portion defining a central lumen and at least one member extended across at least a portion of the central lumen at about a distal end of the end effector.


In yet another general aspect, the various embodiments are directed to a surgical device comprising a central instrument and an outer sheath surrounding the central instrument. The central instrument may be configured to engage tissue, and may be slidable relative to the outer sheath. The outer sheath may comprise a distal edge configured to clamp the tissue when the central instrument is slid to a position proximal from the distal edge of the outer sheath.


According to still another general aspect, the various embodiments are directed to a surgical device comprising a transducer configured to energize an end effector and a trigger actuable to cause the end effector to be energized. The end effector may be coupled to the transducer. The surgical device may further comprise a sensor positioned to sense a force exerted on the trigger, and control circuit in communication with the sensor. The control circuit may be configured to increase power delivered to the end effector by the transducer in response to an increase of the force exerted on the trigger.





FIGURES

The novel features of the various embodiments are set forth with particularity in the appended claims. The various embodiments, however, both as to organization and methods of operation, together with further objects and advantages thereof, may best be understood by reference to the following description, taken in conjunction with the accompanying drawings as follows.



FIG. 1 illustrates one embodiment of a surgical system including a surgical instrument and an ultrasonic generator;



FIG. 2 illustrates one embodiment of the surgical instrument shown in FIG. 1;



FIG. 3 illustrates an exploded view of one embodiment the surgical instrument shown in FIG. 1;



FIG. 4 illustrates one embodiment of a clamping mechanism that may be used with the surgical instrument shown in FIG. 1;



FIG. 5 illustrates a cut-away view of one embodiment of the surgical instrument shown in FIG. 1;



FIG. 6 illustrates various internal components of one embodiment of the surgical instrument shown in FIG. 1;



FIG. 7 illustrates one embodiment of a drive yoke of the surgical instrument shown in FIG. 1;



FIG. 8 illustrates one embodiment of a drive collar of the surgical instrument shown in FIG. 1;



FIG. 9 illustrates one embodiment of a surgical system including a surgical instrument having single element end effector;



FIG. 10 illustrates one embodiment of a surgical device;



FIGS. 11-12 illustrate exploded views of one embodiment of the surgical device shown in FIG. 10;



FIG. 13 illustrates a side view of one embodiment of the surgical device shown in FIG. 10 with the blade and clamp face separated from one another;



FIG. 14 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 with the blade and clamp face separated from one another;



FIG. 15 illustrates a side view of one embodiment of the surgical device shown in FIG. 10 with the blade and clamp face translated toward one another;



FIG. 16 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 with the blade and clamp face translated toward one another;



FIGS. 17-18 illustrate one embodiment of a lower jaw and outer sheath of the surgical device shown in FIG. 10;



FIGS. 19-20 illustrate a handle region of one embodiment of the surgical device shown in FIG. 10;



FIG. 20A illustrates one embodiment of the surgical device shown in FIG. 10;



FIG. 20B illustrates one embodiment of the surgical device shown in FIG. 20A where the end effector is configured to rotate as it moves forward toward the clamp face;



FIG. 21 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 including a blade defining a hollow lumen;



FIG. 22 illustrates one embodiment of the blade shown in FIG. 21;



FIG. 23 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 including a blade defining a hollow lumen and having members extending across the hollow lumen;



FIG. 24 illustrates one embodiment of the blade shown in FIG. 23;



FIG. 25 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 including a jaw member defining a lumen;



FIG. 26 illustrates one embodiment of a blade for use with the surgical device as shown in FIG. 25;



FIG. 26A illustrates an additional embodiment of the blade of FIG. 26 having cutting members positioned within a cavity of the blade.



FIG. 27 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10;



FIG. 28 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 including a plug feature received into a hollow lumen of the end effector;



FIG. 28A illustrates one embodiment of the surgical device of FIG. 10 including a rotating end effector;



FIG. 28B illustrates one embodiment of an electric motor for use with the surgical device of FIG. 28A.



FIG. 28C illustrates one embodiment of the surgical device of FIG. 28A having an angled blade;



FIG. 29 illustrates one embodiment of a hollow core end effector comprising members extending across a lumen;



FIG. 30 illustrates one embodiment of a hollow core end effector comprising members extending across a lumen;



FIG. 31 illustrates a cut away view of one embodiment of the hollow core end effector shown in FIG. 30;



FIG. 31A illustrates one embodiment of a hollow core end effector having angled members;



FIG. 32 illustrates one embodiment of an end effector having a non-integral blade;



FIG. 33 illustrates one embodiment of an end effector having a member extended across a lumen and edges extending beyond the member;



FIG. 34 illustrates one embodiment of an end effector having an inter-lumen member positioned non-parallel to a longitudinal axis of the end effector;



FIG. 35 illustrates one embodiment of an end effector having a multi-section inter-lumen member;



FIG. 36 illustrates one embodiment of an end effector having inter-lumen members extending distally;



FIG. 37 illustrates one embodiment of a surgical device comprising a central instrument and an outer sheath;



FIG. 38 illustrates one embodiment of the surgical device shown in FIG. 37 where the central instrument is grasping tissue;



FIG. 39 illustrates one embodiment of the surgical device shown in FIG. 37 where the outer sheath has clamped the tissue;



FIG. 40 illustrates one embodiment of the surgical device shown in FIG. 37 where the tissue has been severed;



FIGS. 41-42 illustrate one embodiment of the surgical device shown in FIG. 37 where the outer sheath comprises edge members;



FIGS. 43 and 45 illustrate one embodiment of the outer sheath of the device shown in FIG. 37 comprising a pair of jaw members in an open position;



FIGS. 44 and 46 illustrate one embodiment of the outer sheath of the device shown in FIG. 37 where the jaw members are in a closed position;



FIG. 47 illustrates one embodiment of another surgical device having a central instrument and an outer sheath;



FIG. 48 illustrates one embodiment of the surgical instrument of FIG. 47 where the central instrument is extended into tissue;



FIG. 49 illustrates one embodiment of the surgical instrument of FIG. 47 where the central instrument has been retracted from the tissue;



FIG. 50 illustrates one embodiment of the surgical instrument of FIG. 47 where the outer sheath has been extended into the tissue;



FIG. 51 illustrates one embodiment of the surgical instrument of FIG. 47 where the outer sheath has been retracted from the tissue;



FIG. 52 illustrates a block diagram of one embodiment of a surgical device;



FIG. 53 illustrates one embodiment of a surgical device;



FIG. 54 illustrates one embodiment of a surgical device;



FIG. 55 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 54;



FIG. 56 illustrates one embodiment of a surgical device comprising a hand-piece adapter; and



FIG. 57 illustrates a block diagram of one embodiment of a surgical device.





DESCRIPTION

Before explaining the various embodiments in detail, it should be noted that the embodiments are not limited in application or use to the details of construction and arrangement of parts illustrated in the accompanying drawings and description. The illustrative embodiments may be implemented or incorporated in other embodiments, variations and modifications, and may be practiced or carried out in various ways. For example, the surgical instruments and blade configurations disclosed below are illustrative only and not meant to limit the scope or application thereof. Also, the blade and end effector designs described hereinbelow may be used in conjunction with any suitable device. Furthermore, unless otherwise indicated, the terms and expressions employed herein have been chosen for the purpose of describing the illustrative embodiments for the convenience of the reader and are not to limit the scope thereof.


Examples of ultrasonic surgical instruments and blades are disclosed in U.S. Pat. Nos. 5,322,055 and 5,954,736, 6,309,400 B2, 6,278,218B1, 6,283,981 B1, and 6,325,811 B1, which are incorporated herein by reference in their entirety. These references disclose ultrasonic surgical instrument designs and blade designs where a longitudinal mode of the blade is excited. The result is a longitudinal standing wave within the instrument. Accordingly, the instrument has nodes, where the transverse motion is equal to zero, and anti-nodes, where the transverse motion is at its maximum. The instrument's tissue end effector is often positioned at an anti-node to maximize its longitudinal motion.


Various embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting embodiments and that the scope of the various embodiments is defined solely by the claims. The features illustrated or described in connection with one embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the claims.


It will be appreciated that the terms “proximal” and “distal” are used herein with reference to a clinician gripping a surgical device at its hand piece assembly, or other comparable piece. Thus, the end effector is distal with respect to the more proximal hand piece assembly. It will be further appreciated that, for convenience and clarity, spatial terms such as “top” and “bottom” also are used herein with respect to the clinician gripping the hand piece assembly, or comparable piece. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and absolute.



FIG. 1 illustrates one embodiment of a surgical system including a surgical instrument and an ultrasonic generator. FIG. 2 illustrates one embodiment of the apparatus shown in FIG. 1. In the embodiment illustrated in FIGS. 1-2, the surgical system 10 includes an ultrasonic clamp coagulator instrument 120 and an ultrasonic generator 30. The surgical instrument 120 includes an ultrasonic drive unit 50. As will be further described, an ultrasonic transducer of the drive unit 50, and an ultrasonic end effector 180 of the clamp instrument 120, together provide an acoustic assembly of the surgical system 10, with the acoustic assembly providing ultrasonic energy for surgical procedures when powered by generator 30. It will be noted that, in some applications, the ultrasonic drive unit 50 is referred to as a “hand piece assembly” because the surgical instrument 120 of the surgical system 10 is configured such that a clinician grasps and manipulates the ultrasonic drive unit 50 during various procedures and operations. The instrument 120 may include a scissors-like grip arrangement which facilitates positioning and manipulation of the instrument 120 apart from manipulation of the ultrasonic drive unit 50.


The generator 30 of the surgical system 10 sends an electrical signal through a cable 32 at a selected excursion, frequency, and phase determined by a control system of the generator 30. As will be further described, the signal causes one or more piezoelectric elements of the acoustic assembly of the surgical instrument 120 to expand and contract along a longitudinal axis, thereby converting the electrical energy into mechanical motion. The mechanical motion results in longitudinal waves of ultrasonic energy that propagate through the acoustic assembly in an acoustic standing wave to vibrate the acoustic assembly at a selected frequency and excursion. The end effector 180 is placed in contact with tissue of the patient to transfer the ultrasonic energy to the tissue. For example, a distal portion of blade 180′ of the end effector may be placed in contact with the tissue. As further described below, a surgical tool, such as, a jaw or clamping mechanism, may be utilized to press the tissue against the blade 180′.


As the end effector 180 couples with the tissue, thermal energy or heat is generated as a result of friction, acoustic absorption, and viscous losses within the tissue. The heat is sufficient to break protein hydrogen bonds, causing the highly structured protein (e.g., collagen and muscle protein) to denature (e.g., become less organized). As the proteins are denatured, a sticky coagulum forms to seal or coagulate small blood vessels. Deep coagulation of larger blood vessels results when the effect is prolonged.


The transfer of the ultrasonic energy to the tissue causes other effects including mechanical tearing, cutting, cavitation, cell disruption, and emulsification. The amount of cutting as well as the degree of coagulation obtained varies with the excursion of the end effector 180, the frequency of vibration, the amount of pressure applied by the user, the sharpness of the end effector 180, and the coupling between the end effector 180 and the tissue.


In the embodiment illustrated in FIG. 1, the generator 30 includes a control system integral with the generator 30, a power switch 34, and a triggering mechanism 36. The power switch 34 controls the electrical power to the generator 30, and when activated by the triggering mechanism 36, the generator 30 provides energy to drive the acoustic assembly of the surgical system 10 frequency and to drive the end effector 180 at a predetermined excursion level. The generator 30 drives or excites the acoustic assembly at any suitable resonant frequency of the acoustic assembly.


When the generator 30 is activated via the triggering mechanism 36, electrical energy is continuously applied by the generator 30 to a transducer stack or assembly 40 of the acoustic assembly. A phase-locked loop in the control system of the generator 30 monitors feedback from the acoustic assembly. The phase lock loop adjusts the frequency of the electrical energy sent by the generator 30 to match the resonant frequency of the selected longitudinal mode of vibration of the acoustic assembly. In addition, a second feedback loop in the control system maintains the electrical current supplied to the acoustic assembly at a pre-selected constant level in order to achieve substantially constant excursion at the end effector 180 of the acoustic assembly.


The electrical signal supplied to the acoustic assembly will cause the distal end of the end effector 180, e.g., the blade 180′, to vibrate longitudinally in the range of, for example, approximately 20 kHz to 250 kHz. According to various embodiments, the blade 180′ may vibrate in the range of about 54 kHz to 56 kHz, for example, at about 55.5 kHz. In other embodiments, the blade 180′ may vibrate at other frequencies including, for example, about 31 kHz or about 80 kHz. The excursion of the vibrations at the blade can be controlled by, for example, controlling the amplitude of the electrical signal applied to the transducer assembly 40 of the acoustic assembly by the generator 30.


As noted above, the triggering mechanism 36 of the generator 30 allows a user to activate the generator 30 so that electrical energy may be continuously supplied to the acoustic assembly. The triggering mechanism 36 may comprise a foot activating switch that is detachably coupled or attached to the generator 30 by a cable or cord. Alternatively, the triggering mechanism can be configured as a hand switch incorporated in the ultrasonic drive unit 50 to allow the generator 30 to be activated by a user.


The generator 30 also has a power line 38 for insertion in an electro-surgical unit or conventional electrical outlet. It is contemplated that the generator 30 can also be powered by a direct current (DC) source, such as a battery. The generator 30 can comprise any suitable generator, such as Model No. GEN04, available from Ethicon Endo-Surgery, Inc.


In the embodiment illustrated in FIGS. 1 and 3, the ultrasonic drive unit 50 of the surgical instrument includes a multi-piece housing 52 adapted to isolate the operator from the vibrations of the acoustic assembly. The drive unit housing 52 can be shaped to be held by a user in a conventional manner, but it is contemplated that the present clamp coagulator instrument 120 principally be grasped and manipulated by a scissors-like arrangement provided by a housing of the apparatus, as will be described. While the multi-piece housing 52 is illustrated, the housing 52 may comprise a single or unitary component.


The housing 52 of the ultrasonic drive unit 50 generally includes a proximal end, a distal end, and a cavity extending longitudinally therein. The distal end of the housing 52 includes an opening 60 configured to allow the acoustic assembly of the surgical system 10 to extend therethrough, and the proximal end of the housing 52 is coupled to the generator 30 by the cable 32. The cable 32 may include ducts or vents 62 to allow air or other fluids to be introduced into the housing 52 of the ultrasonic drive unit 50 to cool the transducer assembly 40 of the acoustic assembly.


The housing 52 of the ultrasonic drive unit 50 may be constructed from a durable plastic, such as ULTEM®. It is also contemplated that the housing 52 may alternatively be made from a variety of materials including other plastics (e.g. liquid crystal polymer (LCP), nylon, or polycarbonate) and/or metals (e.g., aluminum, steel, etc.). A suitable ultrasonic drive unit 50 is Model No. HP054, available from Ethicon Endo-Surgery, Inc.


The acoustic assembly of the surgical instrument generally includes a first acoustic portion and a second acoustic portion. The first acoustic portion may be carried by the ultrasonic drive unit 50, and the second acoustic portion (in the form of an end effector 180, as will be described) is carried by the ultrasonic clamp coagulator 120. The distal end of the first acoustic portion is operatively coupled to the proximal end of the second acoustic portion, preferably by a threaded connection.


In the embodiment illustrated in FIG. 2, the first acoustic portion includes the transducer stack or assembly 40 and a mounting device 84, and the second acoustic portion includes the end effector 180. The end effector 180 may in turn comprise a transmission component, or waveguide 181 (FIG. 3), as well as a distal portion, or blade 180′, for interfacing with tissue.


The components of the acoustic assembly may be acoustically tuned such that the length of each component is an integral number of one-half wavelengths (nλ/2), where the wavelength λ is the wavelength of a pre-selected or operating longitudinal vibration frequency f0 of the acoustic assembly, and n is any non-negative integer. It is also contemplated that the acoustic assembly may incorporate any suitable arrangement of acoustic elements.


The transducer assembly 40 of the acoustic assembly converts the electrical signal from the generator 30 into mechanical energy that results in longitudinal vibratory motion of the end effector 180 at ultrasonic frequencies. When the acoustic assembly is energized, a vibratory motion standing wave is generated through the acoustic assembly. The excursion of the vibratory motion at any point along the acoustic assembly depends on the location along the acoustic assembly at which the vibratory motion is measured. A minimum or zero crossing in the vibratory motion standing wave is generally referred to as a node (e.g., where motion is usually minimal), and a local absolute value maximum or peak in the standing wave is generally referred to as an anti-node. The distance between an anti-node and its nearest node is one-quarter wavelength (λ/4).


In the embodiment illustrated in FIG. 2, the transducer assembly 40 of the acoustic assembly, which is also known as a “Langevin stack”, generally includes a transduction portion 90, a first resonator 92, and a second resonator 94. The transducer assembly 40 may be an integral number of one-half system wavelengths (nλ/2) in length. It is to be understood that other embodiments of the transducer assembly 40 may comprise a magnetostrictive, electromagnetic or electrostatic transducer.


The distal end of the first resonator 92 is connected to the proximal end of transduction section 90, and the proximal end of the second resonator 94 is connected to the distal end of transduction portion 90. The first and second resonators 92 and 94 may be fabricated from titanium, aluminum, steel, or any other suitable material, and most preferably, the first resonator 92 is fabricated from 303 stainless steel and the second resonator 94 is fabricated from 7075-T651 Aluminum. The first and second resonators 92 and 94 have a length determined by a number of variables, including the length of the transduction section 90, the speed of sound of material used in the resonators 92 and 94, and the desired fundamental frequency f0 of the transducer assembly 40. The second resonator 94 can be tapered inwardly from its proximal end to its distal end to function as a velocity transformer and amplify the ultrasonic vibration excursion.


The transduction portion 90 of the transducer assembly 40 may comprise a piezoelectric section of alternating positive electrodes 96 and negative electrodes 98, with the piezoelectric elements 100 alternating between the electrodes 96 and 98. The piezoelectric elements 100 can be fabricated from any suitable material, such as, for example, lead zirconate-titanate, lead metaniobate, lead titanate, or other piezoelectric material. Each of the positive electrodes 96, negative electrodes 98, and piezoelectric elements 100 have a bore extending through the center. The positive and negative electrodes 96 and 98 are electrically coupled to wires 102 and 104, respectfully. The wires 102 and 104 transmit the electrical signal from the generator 30 to the electrodes 96 and 98.


The piezoelectric elements 100 may be held in compression between the first and second resonators 92 and 94 by a bolt 106. The bolt 106 may have a head, a shank, and a threaded distal end. The bolt 106 may be inserted from the proximal end of the first resonator 92 through the bores of the first resonator 92, the electrodes 96 and 98, and piezoelectric elements 100. The threaded distal end of the bolt 106 is screwed into a threaded bore in the proximal end of second resonator 94. The bolt 106 may be fabricated from steel, titanium, aluminum, or other suitable material. For example, the bolt 106 may be fabricated from Ti-6Al-4V Titanium or from 4037 low alloy steel.


The piezoelectric elements 100 may be energized in response to the electrical signal supplied from the generator 30 to produce an acoustic standing wave in the acoustic assembly. The electrical signal causes an electromagnetic field across the piezoelectric elements 100, causing the piezoelectric elements 100 to expand and contract in a continuous manner along the longitudinal axis of the voltage gradient, producing high frequency longitudinal waves of ultrasonic energy. The ultrasonic energy is transmitted through the acoustic assembly to the end effector 180.


The mounting device 84 of the acoustic assembly has a proximal end, a distal end, and may have a length substantially equal to an integral number of one-half system wavelengths (nλ/2). The proximal end of the mounting device 84 may be axially aligned and coupled to the distal end of the second resonator 94 by an internal threaded connection near an anti-node. It is also contemplated that the mounting device 84 may be attached to the second resonator 94 by any suitable means, and the second resonator 94 and mounting device 84 may be formed as a single or unitary component.


The mounting device 84 is coupled to the housing 52 of the ultrasonic drive unit 50 near a node. The mounting device 84 may include an integral mounting flange 108 disposed around its periphery. The mounting flange 108 may be disposed in an annular groove 110 formed in the housing 52 of the ultrasonic drive unit 50 to couple the mounting device 84 to the housing 52. A compliant member or material 112, such as a pair of silicone rubber O-rings attached by stand-offs, may be placed between the annular groove 110 of the housing 52 and the integral flange 108 of the mounting device 86 to reduce or prevent ultrasonic vibration from being transmitted from the mounting device 84 to the housing 52.


The mounting device 84 may be secured in a predetermined axial position by a plurality of pins 114, for example, four. The pins 114 are disposed in a longitudinal direction ninety (90) degrees apart from each other around the outer periphery of the mounting device 84. The pins 114 are coupled to the housing 52 of the ultrasonic drive unit 50 and are disposed through notches in the acoustic mounting flange 108 of the mounting device 84. The pins 114 may be fabricated from stainless steel. According to various embodiments, the pins 114 may be formed as integral components of the housing 52.


The mounting device 84 may be configured to amplify the ultrasonic vibration excursion that is transmitted through the acoustic assembly to the distal end of the end effector 180. In one embodiment, the mounting device 84 comprises a solid, tapered horn. As ultrasonic energy is transmitted through the mounting device 84, the velocity of the acoustic wave transmitted through the mounting device 84 is amplified. It is contemplated that the mounting device 84 be configured as any suitable shape, such as, for example, a stepped horn, a conical horn, an exponential horn, a unitary gain horn, or the like.


The mounting device 84 may be acoustically coupled to the second acoustic portion of the ultrasonic clamp coagulator instrument 120. The distal end of the mounting device 84 may be coupled to the proximal end of the second acoustic portion by an internal threaded connection near an anti-node, but alternative coupling arrangements can be employed.



FIG. 3 illustrates an exploded view of one embodiment the surgical instrument shown in FIG. 1. The proximal end of the ultrasonic clamp coagulator instrument 120 preferably receives and is fitted to the distal end of the ultrasonic drive unit 50 by insertion of the drive unit 50 into the housing 52, as shown in FIG. 2. The ultrasonic clamp coagulator instrument 120 may be attached to and removed from the ultrasonic drive unit 50 as a unit. The ultrasonic clamp coagulator 120 may be disposed of after a single use.


The ultrasonic clamp coagulator instrument 120 may include a handle assembly or a housing 130, which may comprise mating housing portions 131, 132, and an elongated or endoscopic portion 150. When the present apparatus is configured for endoscopic use, the construction can be dimensioned such that portion 150 has an outside diameter of about 5.5 mm. The elongated portion 150 of the ultrasonic clamp coagulator instrument 120 may extend substantially orthogonally from the apparatus housing 130. The elongated portion 150 can be selectively rotated with respect to the housing 130 as described below. The elongated portion 150 may include an outer tubular member or sheath 160, an inner tubular actuating member 170, and the second acoustic portion of the acoustic system in the form of an end effector 180 including a blade 180′. As will be described, the outer sheath 160, the actuating member 170, and the end effector 180 may be joined together for indexed rotation as a unit (together with ultrasonic drive unit 50) relative to housing 130.


The proximal end of the end effector 180 of the second acoustic portion may be detachably coupled to the mounting device 84 of the ultrasonic drive unit 50 near an anti-node as described above. The end effector 180 may have a length substantially equal to an integer number of one-half system wavelengths (nλ/2). The end effector 180 may be fabricated from a solid core shaft constructed out of material which propagates ultrasonic energy efficiently, such as a titanium alloy (e.g., Ti-6Al-4V) or an aluminum alloy. It is contemplated that the end effector 180 can alternatively be fabricated from any other suitable material.


As described, the end effector 180 may include a waveguide 181. The waveguide 181 may be substantially semi-flexible. It will be recognized that the waveguide 181 can alternatively be substantially rigid or may comprise a flexible wire. The waveguide 181 may be configured to amplify the mechanical vibrations transmitted through the waveguide to the blade as is well known in the art. The waveguide 181 may further have features to control the gain of the longitudinal vibration along the waveguide 181 and features to tune the waveguide to the resonant frequency of the system.


It will be recognized that the end effector 180 may have any suitable cross-sectional dimension. For example, the end effector 180 may have a substantially uniform cross-section or the end effector 180 may be tapered at various sections or may be tapered along its entire length.


Referring now to FIG. 3, the waveguide 181 portion of the end effector 180 is shown to comprise a first section 182, a second section 184, and a third section 186. The first section 182 of may extend distally from the proximal end of the end effector 180, and has a substantially continuous cross-section dimension. The first section 182 may include at least one radial hole or aperture 188 extending diametrically therethrough, substantially perpendicular to the axis of the end effector 180. The aperture 188 may be positioned at a node, but may be otherwise positioned. It will be recognized that the aperture 188 may have any suitable depth and may be any suitable shape. The aperture 188 is configured to receive a connector pin member which connects the wave guide 181, the tubular actuating member 170, and the tubular outer sheath 160 together for conjoint, indexed rotation relative to apparatus housing 130.


The second section 184 of the wave guide 181 extends distally from the first section 182. The second section 184 preferably also has a substantially continuous cross-section. The diameter of the second section 184 may be smaller than the diameter of the first section 182 and larger than the diameter of the third section 186. As ultrasonic energy passes from the first section 182 of the end effector 180 into the second section 184, narrowing of the second section 184 will result in an increased amplitude of the ultrasonic energy passing therethrough.


The third section 186 extends distally from the distal end of the second section 184. The third section 186 also has a substantially continuous cross-section. The third section 186 also may include small diameter changes along its length. According to various embodiments, the transition from the second section 184 to the third section 186 may be positioned at an anti-node so that the diameter change in the third section does not bring about an increase in the amplitude of vibration.


The third section 186 may have a plurality of grooves or notches (not shown) formed in its outer circumference. The grooves may be located at nodes of the end effector 180 to act as alignment indicators for the installation of a damping sheath (not shown) and stabilizing silicone rings or compliant supports during manufacturing. A seal may be provided at the distal-most node, nearest the blade 180′, to abate passage of tissue, blood, and other material in the region between the waveguide and actuating member 170.


The blade 180′ of the end effector 180 may be integral therewith and formed as a single unit. The blade 180′ may alternately be connected by a threaded connection, or by a welded joint. According to various embodiments, the blade 180′ may be mechanically sharp or mechanically blunt. The distal end of the blade 180′ is disposed near an anti-node in order to tune the acoustic assembly to a preferred resonant frequency f0 when the acoustic assembly is not loaded by tissue. When the transducer assembly is energized, the distal end of the blade 180′ is configured to move longitudinally in the range of, for example, approximately 10-500 microns peak-to-peak, and preferably in the range of about 10 to about 100 microns at a predetermined vibrational frequency f0.


In accordance with the illustrated embodiment, the blade 180′ may be cylindrical for cooperation with the associated clamping mechanism of the clamp coagulator 120. The end effector 180 may receive suitable surface treatment, as is known in the art.



FIG. 4 illustrates one embodiment of a clamping mechanism that may be used with the surgical instrument shown in FIG. 1. The clamping mechanism may be configured for cooperative action with the blade 180′ of the end effector 180. The clamping mechanism includes a pivotally movable clamp arm 190, which is pivotally connected at the distal end thereof to the distal end of outer tubular sheath 160. The clamp arm 190 includes a clamp arm tissue pad 192, preferably formed from TEFLON® or other suitable low-friction material, which is mounted for cooperation with the blade 180′, with pivotal movement of the clamp arm 190 positioning the clamp pad 192 in substantially parallel relationship to, and in contact with, the blade 180′. By this construction, tissue to be clamped is grasped between the tissue pad 192 and the blade 180′. The tissue pad 192 may be provided with a sawtooth-like configuration including a plurality of axially spaced, proximally extending gripping teeth 197 to enhance the gripping of tissue in cooperation with the blade 180′.


Pivotal movement of the clamp arm 190 with respect to the blade 180′ is effected by the provision of at least one, and preferably a pair of lever portions 193 of the clamp arm 190 at the proximal end thereof. The lever portions 193 are positioned on respective opposite sides of the end effector 180 and blade 180′, and are in operative engagement with a drive portion 194 of the reciprocal actuating member 170. Reciprocal movement of the actuating member 170, relative to the outer tubular sheath 160 and the end effector 180, thereby effects pivotal movement of the clamp arm 190 relative to the blade 180′. The lever portions 193 can be respectively positioned in a pair of openings defined by the drive portion 194, or otherwise suitably mechanically coupled therewith, whereby reciprocal movement of the actuating member 170 acts through the drive portion 194 and lever portions 193 to pivot the clamp arm 190.



FIG. 5 illustrates a cut-away view of one embodiment of the surgical instrument shown in FIG. 1, while FIG. 6 illustrates various internal components of one embodiment of the surgical instrument shown in FIG. 1. FIG. 7 illustrates one embodiment of a drive yoke, and FIG. 8 illustrates one embodiment of a drive collar of the surgical instrument shown in FIG. 1. In the embodiment illustrated in FIGS. 3 and 5-8, reciprocal movement of the actuating member 170 is effected by the provision of a drive collar 200 mounted on the proximal end of the actuating member 170 for conjoint rotation. The drive collar 200 may include a pair of diametrically opposed axially extending arms 202 each having a drive lug 204, with the drive lugs 204 being biased by the arms 202 into engagement with suitable openings 206 defined by the proximal portion of tubular actuating member 170. Rotation of the drive collar 200 together with the actuating member 170 is further effected by the provision of a pair of keys 208 diametrically engageable with suitable openings 210 defined by the proximal end of the actuating member 170. A circumferential groove 211 on the actuating member 170 receives an O-ring 211′ (FIG. 3) for engagement with the inside surface of outer sheath 160.


Rotation of the actuating member 170 together with the tubular outer sheath 160 and inner end effector 180 is provided by a connector pin 212 extending through these components of the instrument 120. The tubular actuating member 170 defines an elongated slot 214 through which the connector pin 212 extends to accommodate reciprocal movement of the actuating member relative to the outer tubular sheath and inner waveguide.


A rotation knob 216 mounted on the outer tubular sheath facilitates rotational positioning of the elongated portion 150 with respect to the housing 130 of the clamp coagulator instrument 120. Connector pin 212 preferably joins the knob 216 together with the sheath 160, member 170, and the end effector 180 for rotation as a unit relative to the housing 130. In the embodiment, hub portion 216′ of the rotation knob 216 acts to rotatably mount the outer sheath 160, the actuating member 170, and the end effector 180 (as a unit with the knob 216), on the housing 130.


The drive collar 200 provides a portion of the clamp drive mechanism of the instrument 120, which effects pivotal movement of the clamp arm 190 by reciprocation of the actuating member 170. The clamp drive mechanism further includes a drive yoke 220 which is operatively connected with an operating lever 222, with the operating lever thus interconnected with the reciprocal actuating member 170 via drive yoke 220 and drive collar 200. The operating lever 222 is pivotally connected to the housing 130 of the apparatus (by a pivot mount 223) for cooperation in a scissors-like fashion with a handgrip portion 224 of the housing. Movement of the lever 222 toward the handgrip portion 224 translates the actuating member 170 proximally, thereby pivoting the clamp arm 190 toward the blade 180′.


Operative connection of the drive yoke 220 with the operating lever 222 is provided by a spring 226, preferably comprising a compression coil spring 226. The spring 226 fits within a spring slot 228 defined by the drive yoke 220, which in turn is positioned between a pair of spring retainer flanges 230 of the operating lever 222. The drive yoke 220 is pivotally movable with respect to the spring flanges 230 (about pivot mount 223 of housing 130) in opposition to the compression coil spring, which bears against the surfaces of the spring slots defined by each of the spring flanges 230. In this manner, the force which can be applied to the actuating member 170, by pivotal movement of the operating lever 222 acting through the drive yoke 220 and the drive collar 200, is limited by the force with which the spring 226 bears against the spring flanges 230. Application of excessive force results in pivotal displacement of the drive yoke 220 relative to the spring flanges 230 of the operating lever 222 in opposition to spring 226. Stop portions of the housing 130 limit the travel of the operating lever 222 to prevent excessive compression of spring 226. In various embodiments, the force applied to the actuating member 170 may be limited by one or more springs (not shown) operatively positioned between the drive collar 200 and the member 170. For example, one or more cylindrical springs, such as a wave springs, may be used. An example embodiment utilizing a wave spring in this manner is described in U.S. Pat. No. 6,458,142, which is incorporated herein by reference.


Indexed rotational positioning of the elongated portion 150 of the present clamp coagulator instrument 120 may be provided by the provision of a detent mechanism incorporated into the clamp drive mechanism of the instrument 120. Specifically, the drive collar 200 may include a pair of axially spaced apart drive flanges 232. A detent-receiving surface may be provided between the drive flanges 232, and may define a plurality of circumferentially spaced teeth 234. The teeth 234 may define detent-receiving depressions generally about the periphery of the drive collar 200. In the embodiment illustrated in FIG. 7, twelve (12) of the teeth 234 are provided, thereby providing indexed positioning of the elongated portion 150 of the apparatus at 30° intervals relative to the housing 130 of the apparatus.


Indexed rotational movement may be further achieved by the provision of at least one, and preferably a pair, of diametrically opposed detents 236 respectively provided on cantilevered yoke arms 238 of the drive yoke 220. By this arrangement, the yoke arms 238 are positioned between the drive flanges 232 for engagement with the confronting surfaces thereof, and bias the detents 236 into engagement with the drive collar 200. Indexed relative rotation is thus achieved, with the detents 236 of the yoke arms 238 cooperating with the drive flanges 238 for effecting reciprocation of the actuating member 170. According to various embodiments, the drive yoke 220 may be formed from suitable polymeric material, with the biasing force created by the yoke arms 238 acting on the detents 236 thereof cooperating with the radial depressions defined by the drive collar to resist relative rotational torque less than about 5 to 20 inch-ounces. Accordingly, the elongated portion 150 of the clamp coagulator instrument 120 is maintained in any of its selected indexed rotational positions, relative to the housing 130, unless a torque is applied (such as by the rotation knob 216) exceeding this predetermined torque level. A snap-like indexing action is thus provided.


Rotation of the elongated proportion 150 of the present clamp coagulator instrument 120 may be effected together with relative rotational movement of ultrasonic drive unit 50 with respect to housing 130. In order to join the elongated portion 150 to the ultrasonic drive unit 50 in ultrasonic-transmitting relationship, the proximal portion of the outer tubular sheath 160 may be provided with a pair of wrench flats 240 (FIG. 3). The wrench flats allow torque to be applied by a suitable torque wrench or the like to thereby permit the end effector 180 to be joined to the ultrasonic drive unit 50. The ultrasonic drive unit 50, as well as the elongated portion 150, are thus rotatable, as a unit, by suitable manipulation of the rotation knob 216, relative to the housing 130 of the apparatus. The interior of housing 130 is dimensioned to accommodate such relative rotation of the drive unit 50.



FIG. 9 illustrates one embodiment of a surgical system 250 including a surgical instrument 251 having single element end effector 256. The system 250 may include a transducer assembly 252 coupled to the end effector 256 and a sheath 254 positioned around the proximal portions of the end effector 256 as shown. The transducer assembly 252 and end effector 256 may operate in a manner similar to that of the transducer assembly 50 and end effector 180 described above to produce ultrasonic energy that may be transmitted to tissue via blade 256



FIG. 10 illustrates one embodiment of a surgical device 300. FIGS. 11-12 illustrate exploded views of one embodiment of the surgical device 300 shown in FIG. 10. Generally, the surgical instrument 300 may comprise a transducer assembly 302, an end effector 304 and a lower jaw 306. The end effector 304 may be at least partially enclosed by a sheath 314. The lower jaw 306 may include a clamp face 308, and may be slidable relative to the end effector to bring the clamp face 308 toward a distal end of the end effector 304. According to various embodiments, the end effector 304 and/or the lower jaw 306 may define a lumen for aspirating a surgical site. Also, various blades 304′ may be included with the end effector 304, for example, to bring about different surgical results.



FIGS. 13-14 illustrate one embodiment of the surgical device 300 shown in FIG. 10 configured in an open position with the blade 304′ and clamp 308 separated from one another. In use, a clinician may introduce the device 300 to a surgical site the open position illustrated in FIGS. 13-14. When the device 300 is properly positioned, the clinician may transition the device 300 to a closed position, for example, by actuating a trigger 310. FIGS. 15-16 illustrate one embodiment of the surgical device 300 shown in FIG. 10 configured in a closed position with the blade 304′ and clamp 308 translated towards one another. In the embodiment shown in FIGS. 15-16, the trigger has been rotated towards a handle 312, causing the lower jaw 306 to translate relative to the end effector 304, and bringing the clamp face 308 towards the blade 304′. In this way tissue may be clamped between the blade 304′ and the clamp face 308. Energizing the end effector 304 may cause coagulation and/or cutting of the clamped tissue.


The various components of the surgical device 300 may be arranged in any suitable way. FIGS. 19-20 illustrate a handle region of one embodiment of the device 300 shown in FIG. 10. According to various embodiments, a frame member 316 may couple to the handle 312 and the trigger 310. The handle 312 may include a slot 334 for receiving the trigger 310. When the trigger 310 is positioned within the slot 334, and the frame member 316 is fitted over the handle 312 and trigger 310, the bore holes 328, 330 and 332 may align (FIGS. 11-12). Pin 320 may pass through bore holes 328, 330 and 332 to secure the frame member 316, the handle 312 and the trigger 310. The transducer assembly 302 and the end effector 304 may be received into a cavity 334 of the frame member 316. The sheath 314 may be received into a distal end of the cavity 334. A pin 318 may be placed through bore holes 340, 338 and 342 to secure the sheath 314, the end effector 304 and the frame member 316. In addition, the sheath 314 may include a tongue feature 324 that may be received into a corresponding groove feature 336 of the handle 312. (FIG. 11) FIGS. 17-18 illustrate one embodiment of a lower jaw 306 and outer sheath 314 of the surgical device 300 shown in FIG. 10, including a view of the tongue feature 324 of the sheath 314.


The lower jaw 306 may be coupled to the trigger 310 as well as the sheath 314, allowing the lower jaw 306 to translate relative to the sheath 314 and the end effector 304 when the trigger 310 is drawn toward the handle 312. For example, the lower jaw 306 may define a groove feature 326 configured to receive the tongue feature 324 of the sheath (FIGS. 17-18). A proximal end 348 of the lower jaw 306 may define one or more bore holes 346. The bore hole(s) 346 may be aligned with a slot 344 of the trigger 312, allowing pin 322 to be inserted. As illustrated in FIG. 19, the trigger 310 may pivot toward the handle 312 about pin 320. This may cause the pin 322 to slide within the slot 344, exerting a proximally directed force on the lower jaw 306 and causing the clamp face 308 to translate toward the blade 304′ of the end effector 304.


In the embodiments described above, the lower jaw 306 is slidable while the end effector 304 remains stationary. FIG. 20A illustrates one embodiment of a surgical device 300′ where the lower jaw is stationary and the end effector is slidable. A frame member 316′ may couple the transducer 302, sheath 314 and end effector 304. A trigger 310′ may couple to a consolidated handle/lower jaw member 306′ at pivot point 380, and to the frame member 316′ at pivot point 382. According to various embodiments, the pivot points 380 and 382 may comprise a pin and slot, as described above. In use, the clinician may pull the trigger 310′ toward the proximal portion of the handle/lower jaw member 306′. This may cause the trigger 310′ to rotate about the pivot point 380 and exert a distal force on the frame member 316′, transducer 302 and end effector 304, pushing the blade 304′ of the end effector distally toward the clamp face 308.



FIG. 20B illustrates one embodiment of the surgical device 300′ where the end effector 304 is configured to rotate as it moves forward toward the clamp face 308. The frame member 316′ may include slots 390. The end effector 304 may include a pin 392, which may be received by the slots 390. As the end effector 304 is moved distally, as described above, the orientation of the slots 392 may exert a torque on the pint 392, and consequently the end effector 304, causing it to rotate as shown. In various embodiments, the pin 392 may be replaced with multiple pins (not shown). For example, one pin may be placed on a first side of the end effector 304 and may be received by a first slot 390, while another pin may be placed on a second side of the end effector 304 and may be received by a second slot 390 opposite the first.


The end effector 304 and the blade 304′ may be constructed according to any suitable solid or hollow-core configuration. FIG. 21 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10 including a blade 304′ defining a hollow lumen 350. FIG. 22 illustrates one embodiment of the blade 304′ shown in FIG. 21. According to various embodiments, suction may be provided through the lumen 350 to aspirate tissue that is cut and coagulated by the end effector 304. FIG. 23 illustrates a distal portion of one embodiment of the surgical device 300 shown in FIG. 10 including a blade 304′ defining a hollow lumen 350 and having two members 352 extending across the hollow lumen 350. FIG. 24 illustrates one embodiment of the blade 304′ shown in FIG. 21. The members 352 may serve to cut tissue into portions smaller than the diameter of the lumen 350, thus lessening the risk of clogging the lumen 350. Various embodiments may include more or fewer members 352 than are shown. Also, the members 352 are shown to intersect one another at a right angle, although any other suitable configuration may be used.



FIG. 25 illustrates a distal portion of one embodiment of the surgical device 300 shown in FIG. 10 including a jaw member 306 defining a lumen, while FIG. 26 illustrates one embodiment of a blade 304′ for use with the surgical device as shown in FIG. 25. The blade 304′ of the end effector 304 may define a cavity 360. When the clamp face 308 is brought toward the blade 304′, the cavity 360 may cover a corresponding well 356 defined by the lower jaw 306. They well 356 may define an opening 354 to a lumen located within the lower jaw 306. Tissue cut and or coagulated by the end effector 304 may be aspirated via the lumen and its opening 354. FIG. 26A illustrates an additional embodiment of the blade 304′ having cutting members 361 positioned within the cavity 360. In use, the cutting members may morcellate tissue, reducing the size of tissue pieces received into the opening 354 and lessening the risk that the lumen will clog. FIG. 27 illustrates a distal portion of one embodiment of the surgical device shown in FIG. 10. In the embodiment shown in FIG. 27, the end effector 304 may include a blade 304′ defining a sharp edge 364. The blade 304′ may cover the well 356 and lumen opening 354 as described above.



FIG. 28 illustrates a distal portion of one embodiment of the surgical device 300 shown in FIG. 10 including a plug feature 362 received into a hollow lumen 350 of the end effector 304. When the clamp face 308 is brought toward the end effector 304, the plug feature 362 may be received into a lumen 350 defined by the end effector 304. In this way, the plug feature may help to remove any clogs or blockages present within the lumen 350. According to various embodiments, the plug feature 362 may have a cross sectional area smaller than that of the lumen 350. This may generally limit tissue portions removed by the device 300 to sizes smaller than the diameter of the lumen 350, reducing the likelihood of clogs.



FIG. 28A illustrates one embodiment of the surgical device 300 including a rotating end effector 370. The rotating end effector 370 may mount to an electric motor 372. FIG. 28B illustrates one embodiment of the electric motor 372 mounted to the end effector 370. A rotor 376 of the motor 372 may be mounted around the end effector 370. A coil 374 of the motor 372 may, when energized, cause the rotor 376 and end effector 370 to rotate clockwise or counter-clockwise. In use, the lower jaw 306 may be translated with respect to the end effector 370, causing the clamp face 308 to translate toward a blade 370′ of the rotating end effector 370. According to various embodiments, the embodiment shown in FIGS. 28A and 28B also may include a transducer (not shown in FIGS. 28A and 28B) for ultrasonically exciting the end effector 370. Accordingly, the end effector 370 may be rotated and ultrasonically excited simultaneously. Also, FIG. 28A illustrates a clamp pad 377 positioned between the clamp face 308 and the blade 370′. The clamp pad 377 may be made from any suitable material including, for example, a polymeric material.



FIG. 28C illustrates one embodiment of the surgical device 300″ having an angled blade 304″. The lower jaw 306 and clamp face 308″ may slide relative to the end effector 304 and blade 304″ according to any suitable method including, for example, the methods described above with respect to FIGS. 10, 20A, and 20B. The blade 304″ may have a distal surface 381 that is angled relative to the device 300″. For example, the distal surface 381 of the blade 304″ may be angled at an angle of 45°. According to various embodiments, the clamp face 308″ may also be angled, as shown, to match the angle of the blade 304″.



FIGS. 29-36 show various embodiments of hollow core end effectors that may be utilized to cut and/or coagulate tissue. The end effectors may define a central lumen and may comprise at least one member extended across at least a portion of the central lumen at a distal end of the end effector. The member or members may serve to break-up bone or other tissue before it passes through the lumen, making it less likely that the lumen will be clogged by tissue material. According to various embodiments, the end effectors may be utilized with any suitable manual or ultrasonic instrument. For example, the end effectors may be utilized with the surgical devices 10, 250 and 300 described above.



FIG. 29 illustrates one embodiment of a hollow core end effector 400 comprising members 404, 406 extending across a lumen 402 defined by the end effector 400. The members 404 and 406 may comprise wires that may be bonded to the end effector 400 at various points including points 408 and 410. The wires may be bonded to the end effector 400 according to any suitable method including, welding, adhesive, etc. Also, although the embodiment shown in FIG. 29 includes two members 404 and 406 intersecting at about the center of the lumen 402, it will be appreciated that any other suitable configuration or number of members may be utilized. FIG. 30 illustrates one embodiment of a hollow core end effector 412 comprising members 414, 416 extending across a lumen 402, while FIG. 31 illustrates a cut away view of one embodiment of the hollow core end effector 412 shown in FIG. 30. In the embodiment shown in FIGS. 30-31, the members 414 and 416 may be machined into the end effector 412 itself. Accordingly, portions of the members 414, 416 may extend proximally into the lumen 402. FIG. 31A illustrates one embodiment of a hollow core end effector 413 having angled members 417. The members 417 may not extend across the lumen 402. Instead, some or all of the angled members 417 may terminate in a central portion of the lumen 402.



FIG. 32 illustrates one embodiment of an end effector 418 having a non-integral blade 420. The blade 420 may include one or more members 422, for example, as described above with respect to end effectors 400 and 412. The blade 420 may be bonded to the remainder of the end effector 418 according to any suitable method. For example, the surfaces 424 and 426 may be threaded, allowing the blade 420 to be threaded onto the remainder of the end effector 418. Also, the blade 420 and end effector 418 may be coupled by press fitting, welding, brazing, adhesive bonding, etc. According to various embodiments, the non-integral blade 420 and the remainder of the end effector 418 may be made from different materials. For example, the end effector 418 may be made from a titanium alloy or other material with a low resistance to ultrasonic wave transmission. The blade 420 may be, in turn, made from material that is easily machined, and/or holds an edge such as, for example, a steel.



FIG. 33 illustrates one embodiment of an end effector 428 having a member 430 extended across a lumen 434 and edges 432 extending beyond the member 430. The member 430, as shown, is positioned proximally from the distal edge of the end effector 428. For example, the member 430 may be recessed within the lumen 434 by a distance of up to 15 mm. FIG. 34 illustrates one embodiment of an end effector 436 having an inter-lumen member 442 positioned non-parallel to a longitudinal axis 440 of the end effector 436. The member 442 may extend proximally into the lumen 438 at an angle that is not parallel to the axis 440. This may facilitate the cutting and removing of small portions of tissue, such as tissue portion 441. FIG. 35 illustrates one embodiment of an end effector 444 having a multi-section inter-lumen member 448. Each of the sections 450, 452 of the inter-lumen member 448 may be positioned at different angles relative to the longitudinal axis 446. FIG. 36 illustrates one embodiment of an end effector 454 having inter-lumen members 458, 460 extending distally from the lumen 434. The members 458, 460 may be angled relative to the longitudinal axis 459, as described above. The members 458 and 460 also may extend beyond the distal edge of the other portions of the end effector 454.



FIGS. 37-54 illustrate various embodiments of surgical devices that may be used as an ultrasonic or unpowered device to remove tissue portions. The embodiments illustrated in FIGS. 37-54 may be useful in surgical applications where it is desirable to remove a core or other integral portion of bone or other tissue. The devices may generally comprise a central instrument configured to engage tissue and an outer sheath surrounding the central instrument. The central instrument and sheath may be slidable relative to one another. Also, the outer sheath may comprise a distal edge configured to clamp the tissue when the central instrument is slid to a position proximal from the distal edge of the outer sheath.



FIGS. 37-40 illustrate a sequence of one embodiment of a surgical device 500 in use. The surgical device 500 may comprise a central instrument 502 and an outer sheath 504. The central instrument 502 comprises two jaw members 506 and 508. In use, the jaw member 506 may be pivotable toward the jaw member 508. According to various embodiments, the jaw member 508 may be ultrasonically energized, for example, as described above. FIG. 37 illustrates one embodiment of the surgical device 500 with a portion of tissue 510 positioned between the jaw members 506, 508. FIG. 38 illustrates one embodiment of the surgical device 500 shown in FIG. 37 where the central instrument 502 is grasping tissue. This may occur when the jaw members 506, 508 are pivoted toward one another to engage the tissue 510. In the embodiment shown in FIG. 38, the outer sheath 504 has been moved distally relative to the central instrument 502. FIG. 39 illustrates one embodiment of the surgical device 500 shown in FIG. 37 where the outer sheath 504 has clamped the tissue 510. This may occur when a distal portion of the outer sheath 504 clears the distal edge of the central instrument 502, allowing the outer sheath 504, and/or a component thereof, to clamp the tissue 510. According to various embodiments, a distal edge 512 of the outer sheath 504 may define a sharp edge to sever the tissue. Also, according to various embodiments, outer sheath 504 may be ultrasonically activated to promote cutting and/or coagulation. Once the outer sheath 504 has clamped the tissue 510, a clinician may manipulate the device 500, causing the clamped tissue 510 to tear or break. FIG. 40 illustrates one embodiment of the surgical device 500 shown in FIG. 37 where the tissue 510 has been severed.


The outer sheath 504 may exert a clamping force on the tissue 510 according to various different methods. For example, the outer sheath 504 may be constructed such that the distal edge portion 512 is biased in upon itself. Accordingly, the rest state of the edge portion 512 may be a closed or clamped position, as illustrated in FIG. 40. When the central instrument 502 is extended distally through the outer sheath 504, it may separate the edge portion 512, for example, as illustrated in FIGS. 37-38. According to various embodiments, the distal edge 512 may include multiple distal edge portions separated by one or more longitudinal slots (not shown). This may allow the distal edge 512 to separate. When the central instrument 502 is retracted through the outer sheath 504 the edge portion 512 may contract to its closed or clamped position, cutting or otherwise clamping the tissue 510. According to various embodiments, the edge portion 512 of the outer sheath 504 may be ultrasonically activated to promote cutting and/or coagulation of the tissue 510.



FIGS. 41-42 illustrate one embodiment of the surgical device 500 shown in FIG. 37 where the outer sheath comprises edge members 514. The edge members 514 may extend distally, as shown in FIG. 41, in response to the actuation of a trigger or other component of the device (not shown). When the edge members 514 reach the distal end of the outer sheath, they contract toward one another, as shown in FIG. 42, to sever or otherwise clamp the tissue 510. According to various embodiments, the members 514 may be ultrasonically activated.



FIGS. 43-46 illustrate one embodiment of the outer sheath 504 including jaw members 520. The jaw members 520 may pivot toward one another about pivot points 524 in response to distal movement of extenders 522. For example, when the central instrument 502 is initially engaging tissue 510, as shown in FIGS. 37-38, the extenders 522 may be retracted, leaving the jaw members 520 in an open position as shown in FIGS. 43 and 45. When the outer sheath 504 is extended distally relative to the central instrument, the extenders 522 may be translated distally. Distal translation of the extenders 522 may be caused by various mechanical or automated forces, for example, in response to a clinician activating a trigger or other component of the device (not shown). This distal translation may cause the jaw members 520 to pivot about pivot points 524 to a closed position, as shown in FIGS. 44 and 46.



FIGS. 47-51 illustrate another sequence of one embodiment of a surgical device 500 in use. The embodiment shown in FIGS. 47-51 may comprise a central instrument 530 that includes an ultrasonic end effector defining a coring cavity 532. When the central instrument 530 is extended into tissue 510, it may cut and/or coagulate around a portion of the tissue 535 corresponding to the cavity 532. FIG. 47 illustrates one embodiment of the surgical instrument 500 brought into the proximity of a mass of tissue 510. FIG. 48 illustrates one embodiment of the surgical instrument 500 of FIG. 47 where the central instrument 530 is extended into the tissue 510. Ultrasonic energy may be provided to the central instrument 530, allowing it to cut into the tissue 510. FIG. 49 illustrates one embodiment of the surgical instrument 500 of FIG. 47 where the central instrument 530 has been retracted from the tissue 510, leaving a core section 535 that has been partially severed from the tissue 510. FIG. 50 illustrates one embodiment of the surgical instrument 500 of FIG. 47 where the outer sheath 504 has been extended into the tissue 510. The outer sheath 504 may either sever the core section 535, or clamp it, allowing the clinician to tear or otherwise loosen the core section 535. FIG. 51 illustrates one embodiment of the surgical instrument 500 of FIG. 47 where the outer sheath 504 has been retracted from the tissue 510, removing the core section 535. According to various embodiments, the device 500 may omit the central instrument 502. For example, the outer sheath 504 may be ultrasonically energized to cut a portion of the tissue 510 in a manner similar to that of the central instrument 530. The outer sheath 504 may then clamp the tissue 510 for severing or tearing, for example, as described above.


The surgical device 500 may be operated by a clinician from a handle portion (not shown) that may include one or more triggers for actuating the central instrument 502 and the outer sheath 504. For example, the central instrument 502 may be actuated by any suitable manual or automatic means including, for example, a mechanical design similar to that described above with respect to the blade 180′ and clamp arm 190. The outer sheath 504 may similarly be extended and actuated by any suitable manual or automatic means. For example, the outer sheath 504 may be extended distally in response to the actuation of a trigger in a manner similar to the way that the reciprocal actuating member 170 is extended distally in response to actuation of the operating lever 222 described above. According to various embodiments, the central instrument 502 and the outer sheath 504 may be actuated by a single pull of a trigger. For example, a single trigger pull may both actuate the central instrument 502 and also subsequently extend and actuate the outer sheath 504.



FIGS. 52-55 illustrate force-feedback surgical devices, according to various embodiments, configured to apply ultrasonic energy to tissue at a variable power level and/or end effector amplitude. The level of power or end effector amplitude provided to the devices may be determined, for example, based on the force applied to a trigger, and/or the position or travel of the trigger. It will be appreciated that force feedback surgical devices, such as the embodiments shown in FIGS. 52-55, may give clinicians an increased level of control over the ultrasonic power delivered by the devices, facilitating precise operations.



FIG. 52 illustrates a block diagram of one embodiment of a force feedback surgical device 600. The device 600 may include an ultrasonic end effector 602, which may be activated when a clinician operates a trigger 610. When the trigger 610 is actuated, a force sensor 612 may generate a signal indicating the amount of force being applied to the trigger 610. In addition to, or instead of force sensor 612, the device 600 may include a position sensor 613, which may generate a signal indicating the position of the trigger 610 (e.g., how far the trigger has been depressed or otherwise actuated). A control circuit 608 may receive the signals from the sensors 612 and/or 613. The control circuit 608 may include any suitable analog or digital circuit components. The control circuit 608 also may communicate with the generator 606 and/or the transducer 604 to modulate the power delivered to the end effector 602 and/or the generator level or blade amplitude of the end effector 602 based on the force applied to the trigger 610 and/or the position of the trigger 610. For example, as more force is applied to the trigger 610, more power and/or a higher blade amplitude may be delivered to the end effector 602. According to various embodiments, the force sensor 612 may be replaced by a multi-position switch. FIG. 57 illustrates a block diagram of one embodiment of the surgical device 600 of FIG. 52 where the force sensor 612 is replaced by a multi-position switch 615. Each position of the switch may correspond to a different level of power to be delivered to the end effector 602.


According to various embodiments, the end effector 602 may include a clamping mechanism, for example, such as that described above with respect to FIG. 4. When the trigger 610 is initially actuated, clamping mechanism may close, clamping tissue between a clamp arm and the end effector 602. As the force applied to the trigger increases (e.g., as sensed by force sensor 612) the control circuit 608 may increase the power delivered to the end effector 602 by the transducer 604 and/or the generator level or blade amplitude brought about in the end effector 602. In one embodiment, trigger position, as sensed by position sensor 613, may be used by the control circuit 608 to set the power and/or amplitude of the end effector 602. For example, as the trigger is moved further towards a fully actuated position, the power and/or amplitude of the end effector 602 may be increased.


According to various embodiments, the surgical device 600 also may include one or more feedback devices for indicating the amount of power delivered to the end effector 602. For example, a speaker 614 may emit a signal indicative of the end effector power. According to various embodiments, the speaker 614 may emit a series of pulse sounds, where the frequency of the sounds indicates power. In addition to, or instead of the speaker 614, the device may include a visual display 616. The visual display 616 may indicate end effector power according to any suitable method. For example, the visual display 616 may include a series of light emitting diodes (LEDs), where end effector power is indicated by the number of illuminated LEDs. The speaker 614 and/or visual display 616 may be driven by the control circuit 608. According to various embodiments, the device 600 may include a ratcheting device (not shown) connected to the trigger 610. The ratcheting device may generate an audible sound as more force is applied to the trigger 610, providing an indirect indication of end effector power.


The device 600 may include other features that may enhance safety. For example, the control circuit 608 may be configured to prevent power from being delivered to the end effector 602 in excess of a predetermined threshold. Also, the control circuit 608 may implement a delay between the time when a change in end effector power is indicated (e.g., by speaker 614 or display 616), and the time when the change in end effector power is delivered. In this way, a clinician may have ample warning that the level of ultrasonic power that is to be delivered to the end effector 602 is about to change.


Force-feedback ultrasonic devices, such as the device 600, may be physically implemented in any suitable form. For example, FIG. 53 illustrates one embodiment of a force-feedback surgical device 620. The device 620 may comprise an ultrasonic end effector 622 excitable by a transducer 632. The transducer 632 may be in communication with a generator (not shown) via a wire 636. A clamp arm 624 may be pivotable towards the end effector 622 when a clinician pulls a trigger 628 towards a handle 626, similar to the clamp arm 190 and blade 180′ described above. A sensor 630 positioned on the trigger 628 may measure the force applied to the trigger 628 by the clinician and/or the position of the trigger 628. It will be appreciated that the sensor 630 may be alternatively placed at other locations within the device 620 including, for example, at trigger pivot point 634 or between the end effector 622 and clamp arm 624. A control circuit (not shown) may be positioned at any suitable location on or in the device 620 including, for example, within the handle 626 or trigger 628, the ultrasonic drive unit 50 or the generator 30.



FIG. 54-55 illustrate one embodiment of another force-feedback surgical device 640, which may be configured as an ultrasonic rongeur-type device. The device 640 may include a pair of handles 642, 644 that when squeezed towards one another about pivot point 646 may cause a pair of distally positioned jaw members 648, 650 to pivot towards one another to engage tissue by clamping or severing. One or both of the jaw members 648, 650 may include an ultrasonically active end effector. For example, FIG. 54 illustrates an ultrasonic end effector 652 positioned on jaw member 650 and driven by transducer 656. The transducer 656 may be in communication with a generator (not shown) via a wire 657. A clamp pad 654 may be positioned opposite the end effector 652. The transducer 656 may be positioned between the handles 642, 644, as shown, or at any other suitable position. For example, the transducer 656 may be positioned within one of the handles 642, 644. Force sensors 658, 660 may be positioned on the handles 642, 644 as shown, or may be positioned at various other locations within the device 640 including, for example, at the pivot point 646. Likewise, the control circuit (not shown) may be positioned at any suitable location on or in the device 640.



FIG. 56 illustrates one embodiment of another force feedback surgical device 700 comprising a hand-piece adapter 708. The device 700 may also comprise a transducer 704 configured to drive an end effector 702, for example, as described herein. The hand-piece adapter 708 may comprise one or more switches 706 for operating the transducer 704 and end effector 702. For example, actuating one or more of the switches 706 may cause the device 700 to activate. The switches 706 may correspond to the trigger 610 described with respect to FIG. 52. One or more sensors (not shown in FIG. 56) may be provided to sense the travel of the switches 706 and/or the amount of force applied to the switches 706 by the clinician. A control circuit (not shown in FIG. 56) may modulate the device power and/or end effector amplitude based on the output of the one or more sensors as described herein.


The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the device may be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular elements, and subsequent reassembly. In particular, the device may be disassembled, and any number of particular elements or components of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular components, the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.


Preferably, the various embodiments 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.


It is preferred that the device is sterilized prior to surgery. This can be done by any number of ways known to those skilled in the art including beta or gamma radiation, ethylene oxide, steam.


Although various embodiments have been described herein, 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.

Claims
  • 1. A surgical device comprising: an end effector comprising an ultrasonic blade;a trigger actuatable to cause the end effector to be energized;a circuit in communication with the trigger, wherein the circuit is configured to:when the trigger is in a first position, provide power to the end effector at a first power level; andwhen the trigger is in a second position, provide power to the end effector at a second power level greater than the first power level; anda transducer coupled to the end effector and configured to energize the end effector.
  • 2. The surgical device of claim 1, wherein the trigger is configured to be depressed further in the second position than in the first position.
  • 3. The surgical device of claim 2, wherein the trigger is configured to be depressed further towards a fully actuated position in the second position than in the first position.
  • 4. The surgical device of claim 1, further comprising a ratchet device positioned to generate a sound as the trigger is moved from the first position to the second position.
  • 5. The surgical device of claim 1, further comprising a sensor positioned to sense a position of the trigger, wherein a signal indicating a change in the position of the trigger is received from the sensor.
  • 6. A surgical device comprising: an end effector, the end effector comprising: an ultrasonic blade; anda clamp arm pivotable relative to the blade;a transducer coupled to the blade and configured to energize the blade;a multi-position switch actuatable to cause the blade to be energized; anda circuit in communication with the multi-position switch and with the transducer, wherein the circuit is configured to: when the multi-position switch is in a first position, configure the transducer to drive the end effector at a first level; andwhen the multi-position switch is in a second position, configure the transducer to drive the end effector at a second level.
  • 7. The surgical device of claim 6, wherein a power delivered to the end effector at the second level is higher than a power delivered to the end effector at the first level.
  • 8. The surgical device of claim 6, wherein the circuit is configured to implement a delay between indicating a change in the position of a trigger mechanism and a change from driving the end effector at the first level to driving the end effector at the second level.
  • 9. The surgical device of claim 6, further comprising a feedback device in communication with the circuit, wherein the feedback device is configured to indicate at least one of a power provided to the end effector or an amplitude of the end effector.
  • 10. The surgical device of claim 9, wherein the feedback device comprises at least one component selected from the group consisting of: a light source, wherein the light source indicates an amount of power delivered to the end effector by the transducer; anda speaker, wherein the circuit is further configured to cause the speaker to emit a plurality of sounds, wherein a frequency of the plurality of sounds indicates the power delivered to the end effector.
  • 11. The surgical device of claim 6, wherein the circuit is configured to prevent a power delivered to the end effector from exceeding a threshold power level.
  • 12. The surgical device of claim 6, wherein the first level and the second level correspond to a first end effector amplitude and a second end effector amplitude, and wherein the second end effector amplitude is greater than the first end effector amplitude.
  • 13. An ultrasonic surgical system for treating tissue, the system comprising: an ultrasonic transducer;an end effector comprising an ultrasonic blade coupled to the ultrasonic transducer;a switch having a first position and a second position; anda generator in communication with the switch and the ultrasonic transducer, wherein the generator is configured to:when the switch is in the first position, provide a first drive level to the ultrasonic transducer; andwhen the switch is in the second position, provide a second drive level to the ultrasonic transducer.
  • 14. The system of claim 13, further comprising a feedback device in communication with the generator, wherein the feedback device is configured to indicate the first drive level when the switch is in the first position.
  • 15. The system of claim 14, further comprising a plurality of light sources configured to illuminate to indicate the first drive level when the switch is in the first position.
  • 16. The system of claim 14, further comprising a speaker configured to emit a plurality of sounds, wherein a frequency of the plurality of sounds indicates at least one of a power provided to the end effector or an amplitude of the end effector.
  • 17. The system of claim 14, wherein the first drive level corresponds to a first power delivered to the end effector and the second drive level corresponds to a second power delivered to the end effector.
  • 18. The system of claim 17, wherein the generator is further configured to prevent a power provided to the end effector from exceeding a threshold power level.
  • 19. The system of claim 13, further comprising a handle, wherein the switch is positioned in the handle.
  • 20. The system of claim 13, wherein the first drive level corresponds to a first end effector amplitude and the second drive level corresponds to a second end effector amplitude.
PRIORITY CLAIM

The present application is a divisional of U.S. patent application Ser. No. 14/444,335, filed on Jul. 28, 2014, which is incorporated by reference herein in its entirety and is a divisional of U.S. application Ser. No. 11/881,602, now issued as U.S. Pat. No. 8,808,319, filed on Jul. 27, 2007, which is incorporated herein by reference in its entirety.

US Referenced Citations (1310)
Number Name Date Kind
969528 Disbrow Sep 1910 A
1570025 Young Jan 1926 A
1813902 Bovie Jul 1931 A
2188497 Calva Jan 1940 A
2442966 Wallace Jun 1948 A
2597564 Bugg May 1952 A
2704333 Calosi et al. Mar 1955 A
2736960 Armstrong Mar 1956 A
2845072 Shafer Jul 1958 A
2849788 Creek Sep 1958 A
2874470 Richards Feb 1959 A
2990616 Balamuth et al. Jul 1961 A
RE25033 Balamuth et al. Aug 1961 E
3015961 Roney Jan 1962 A
3033407 Alfons May 1962 A
3053124 Balamuth et al. Sep 1962 A
3082805 Royce Mar 1963 A
3432691 Shoh Mar 1969 A
3433226 Boyd Mar 1969 A
3489930 Shoh Jan 1970 A
3513848 Winston et al. May 1970 A
3514856 Camp et al. Jun 1970 A
3526219 Balamuth Sep 1970 A
3554198 Tatoian et al. Jan 1971 A
3606682 Camp et al. Sep 1971 A
3614484 Shoh Oct 1971 A
3616375 Inoue Oct 1971 A
3629726 Popescu Dec 1971 A
3636943 Balamuth Jan 1972 A
3668486 Silver Jun 1972 A
3702948 Balamuth Nov 1972 A
3776238 Peyman et al. Dec 1973 A
3805787 Banko Apr 1974 A
3809977 Balamuth et al. May 1974 A
3830098 Antonevich Aug 1974 A
3854737 Gilliam, Sr. Dec 1974 A
3862630 Balamuth Jan 1975 A
3875945 Friedman Apr 1975 A
3885438 Harris, Sr. et al. May 1975 A
3900823 Sokal et al. Aug 1975 A
3918442 Nikolaev et al. Nov 1975 A
3924335 Balamuth et al. Dec 1975 A
3946738 Newton et al. Mar 1976 A
3955859 Stella et al. May 1976 A
3956826 Perdreaux, Jr. May 1976 A
4012647 Balamuth et al. Mar 1977 A
4074719 Semm Feb 1978 A
4156187 Murry et al. May 1979 A
4167944 Banko Sep 1979 A
4188927 Harris Feb 1980 A
4200106 Douvas et al. Apr 1980 A
4203444 Bonnell et al. May 1980 A
4300083 Heiges Nov 1981 A
4302728 Nakamura Nov 1981 A
4306570 Matthews Dec 1981 A
4445063 Smith Apr 1984 A
4491132 Aikins Jan 1985 A
4494759 Kieffer Jan 1985 A
4504264 Kelman Mar 1985 A
4512344 Barber Apr 1985 A
4526571 Wuchinich Jul 1985 A
4545374 Jacobson Oct 1985 A
4574615 Bower et al. Mar 1986 A
4617927 Manes Oct 1986 A
4633119 Thompson Dec 1986 A
4634420 Spinosa et al. Jan 1987 A
4640279 Beard Feb 1987 A
4641053 Takeda Feb 1987 A
4646738 Trott Mar 1987 A
4646756 Watmough et al. Mar 1987 A
4649919 Thimsen et al. Mar 1987 A
4662068 Polonsky May 1987 A
4674502 Imonti Jun 1987 A
4708127 Abdelghani Nov 1987 A
4712722 Hood et al. Dec 1987 A
4808154 Freeman Feb 1989 A
4819635 Shapiro Apr 1989 A
4827911 Broadwin et al. May 1989 A
4832683 Idemoto et al. May 1989 A
4836186 Scholz Jun 1989 A
4838853 Parisi Jun 1989 A
4844064 Thimsen et al. Jul 1989 A
4850354 McGurk-Burleson et al. Jul 1989 A
4852578 Companion et al. Aug 1989 A
4865159 Jamison Sep 1989 A
4867157 McGurk-Burleson et al. Sep 1989 A
4878493 Pasternak et al. Nov 1989 A
4881550 Kothe Nov 1989 A
4896009 Pawlowski Jan 1990 A
4903696 Stasz et al. Feb 1990 A
4915643 Samejima et al. Apr 1990 A
4922902 Wuchinich et al. May 1990 A
4965532 Sakurai Oct 1990 A
4979952 Kubota et al. Dec 1990 A
4981756 Rhandhawa Jan 1991 A
5013956 Kurozumi et al. May 1991 A
5015227 Broadwin et al. May 1991 A
5026370 Lottick Jun 1991 A
5026387 Thomas Jun 1991 A
5042707 Taheri Aug 1991 A
5084052 Jacobs Jan 1992 A
5105117 Yamaguchi Apr 1992 A
5109819 Custer et al. May 1992 A
5112300 Ureche May 1992 A
5123903 Quaid et al. Jun 1992 A
5126618 Takahashi et al. Jun 1992 A
D327872 McMills et al. Jul 1992 S
5152762 McElhenney Oct 1992 A
5162044 Gahn et al. Nov 1992 A
5163421 Bernstein et al. Nov 1992 A
5163537 Radev Nov 1992 A
5167725 Clark et al. Dec 1992 A
5174276 Crockard Dec 1992 A
D332660 Rawson et al. Jan 1993 S
5176677 Wuchinich Jan 1993 A
5176695 Dulebohn Jan 1993 A
5184605 Grezeszykowski Feb 1993 A
5188102 Idemoto et al. Feb 1993 A
D334173 Liu et al. Mar 1993 S
5209719 Baruch et al. May 1993 A
5213569 Davis May 1993 A
5214339 Naito May 1993 A
5218529 Meyer et al. Jun 1993 A
5221282 Wuchinich Jun 1993 A
5222937 Kagawa Jun 1993 A
5226909 Evans et al. Jul 1993 A
5226910 Kajiyama et al. Jul 1993 A
5241236 Sasaki et al. Aug 1993 A
5241968 Slater Sep 1993 A
5242460 Klein et al. Sep 1993 A
5254129 Alexander Oct 1993 A
5257988 L'Esperance, Jr. Nov 1993 A
5261922 Hood Nov 1993 A
5263957 Davison Nov 1993 A
5264925 Shipp et al. Nov 1993 A
5275166 Vaitekunas et al. Jan 1994 A
5275607 Lo et al. Jan 1994 A
5275609 Pingleton et al. Jan 1994 A
5282800 Foshee et al. Feb 1994 A
5282817 Hoogeboom et al. Feb 1994 A
5285795 Ryan et al. Feb 1994 A
5300068 Rosar et al. Apr 1994 A
5304115 Pflueger et al. Apr 1994 A
D347474 Olson May 1994 S
5307976 Olson et al. May 1994 A
5312023 Green et al. May 1994 A
5312425 Evans et al. May 1994 A
5322055 Davison et al. Jun 1994 A
5324299 Davison et al. Jun 1994 A
5326013 Green et al. Jul 1994 A
5326342 Pflueger et al. Jul 1994 A
5344420 Hilal et al. Sep 1994 A
5345937 Middleman et al. Sep 1994 A
5346502 Estabrook et al. Sep 1994 A
5353474 Good et al. Oct 1994 A
5357164 Imabayashi et al. Oct 1994 A
5357423 Weaver et al. Oct 1994 A
5359994 Krauter et al. Nov 1994 A
5366466 Christian et al. Nov 1994 A
5368557 Nita et al. Nov 1994 A
5370645 Klicek et al. Dec 1994 A
5371429 Manna Dec 1994 A
5374813 Shipp Dec 1994 A
D354564 Medema Jan 1995 S
5381067 Greenstein et al. Jan 1995 A
5387215 Fisher Feb 1995 A
5389098 Tsuruta et al. Feb 1995 A
5394187 Shipp Feb 1995 A
5396266 Brimhall Mar 1995 A
5403312 Yates et al. Apr 1995 A
5403334 Evans et al. Apr 1995 A
5408268 Shipp Apr 1995 A
D358887 Feinberg May 1995 S
5411481 Allen et al. May 1995 A
5419761 Narayanan et al. May 1995 A
5421829 Olichney et al. Jun 1995 A
5423844 Miller Jun 1995 A
5438997 Sieben et al. Aug 1995 A
5445639 Kuslich et al. Aug 1995 A
5449370 Vaitekunas Sep 1995 A
5451220 Ciervo Sep 1995 A
5456684 Schmidt et al. Oct 1995 A
5471988 Fujio et al. Dec 1995 A
5472443 Cordis et al. Dec 1995 A
5478003 Green et al. Dec 1995 A
5483501 Park et al. Jan 1996 A
5486162 Brumbach Jan 1996 A
5490860 Middle et al. Feb 1996 A
5500216 Julian et al. Mar 1996 A
5501654 Failla et al. Mar 1996 A
5505693 Mackool Apr 1996 A
5507738 Ciervo Apr 1996 A
5527331 Kresch et al. Jun 1996 A
5540693 Fisher Jul 1996 A
5553675 Pitzen Sep 1996 A
5558671 Yates Sep 1996 A
5562609 Brumbach Oct 1996 A
5562610 Brumbach Oct 1996 A
5562659 Morris Oct 1996 A
5573424 Poppe Nov 1996 A
5577654 Bishop Nov 1996 A
5591187 Dekel Jan 1997 A
5593414 Shipp et al. Jan 1997 A
5601601 Tal et al. Feb 1997 A
5603773 Campbell Feb 1997 A
5607436 Pratt et al. Mar 1997 A
5618304 Hart et al. Apr 1997 A
5618492 Auten et al. Apr 1997 A
5620447 Smith et al. Apr 1997 A
5626587 Bishop et al. May 1997 A
5626595 Sklar et al. May 1997 A
5628760 Knoepfler May 1997 A
5630420 Vaitekunas May 1997 A
5632717 Yoon May 1997 A
5640741 Yano Jun 1997 A
D381077 Hunt Jul 1997 S
5651780 Jackson et al. Jul 1997 A
5653713 Michelson Aug 1997 A
5662662 Bishop et al. Sep 1997 A
5669922 Hood Sep 1997 A
5674235 Parisi Oct 1997 A
5678568 Uchikubo et al. Oct 1997 A
5690269 Bolanos et al. Nov 1997 A
5694936 Fujimoto et al. Dec 1997 A
5700261 Brinkerhoff Dec 1997 A
5704534 Huitema et al. Jan 1998 A
5709680 Yates et al. Jan 1998 A
5711472 Bryan Jan 1998 A
5713896 Nardella Feb 1998 A
5715817 Stevens-Wright et al. Feb 1998 A
5717306 Shipp Feb 1998 A
5728130 Ishikawa et al. Mar 1998 A
5730752 Alden et al. Mar 1998 A
5733074 Stöck et al. Mar 1998 A
5741226 Strukel et al. Apr 1998 A
5766164 Mueller et al. Jun 1998 A
5772659 Becker et al. Jun 1998 A
5792135 Madhani et al. Aug 1998 A
5792138 Shipp Aug 1998 A
5792165 Klieman et al. Aug 1998 A
5797959 Castro et al. Aug 1998 A
5805140 Rosenberg et al. Sep 1998 A
5808396 Boukhny Sep 1998 A
5810859 DiMatteo et al. Sep 1998 A
5817084 Jensen Oct 1998 A
5817119 Klieman et al. Oct 1998 A
5823197 Edwards Oct 1998 A
5827323 Klieman et al. Oct 1998 A
5828160 Sugishita Oct 1998 A
5833696 Whitfield et al. Nov 1998 A
5836897 Sakurai et al. Nov 1998 A
5836957 Schulz et al. Nov 1998 A
5843109 Mehta et al. Dec 1998 A
5851212 Zirps et al. Dec 1998 A
5858018 Shipp et al. Jan 1999 A
5873873 Smith et al. Feb 1999 A
5873882 Straub et al. Feb 1999 A
5878193 Wang et al. Mar 1999 A
5879364 Bromfield et al. Mar 1999 A
5883615 Fago et al. Mar 1999 A
5893835 Witt et al. Apr 1999 A
5897523 Wright et al. Apr 1999 A
5897569 Kellogg et al. Apr 1999 A
5903607 Tailliet May 1999 A
5904681 West, Jr. May 1999 A
5906627 Spaulding May 1999 A
5906628 Miyawaki et al. May 1999 A
5911699 Anis et al. Jun 1999 A
5916229 Evans Jun 1999 A
5929846 Rosenberg et al. Jul 1999 A
5935143 Hood Aug 1999 A
5935144 Estabrook Aug 1999 A
5938633 Beaupre Aug 1999 A
5944718 Austin et al. Aug 1999 A
5944737 Tsonton et al. Aug 1999 A
5947984 Whipple Sep 1999 A
5954736 Bishop et al. Sep 1999 A
5954746 Holthaus et al. Sep 1999 A
5957882 Nita et al. Sep 1999 A
5957943 Vaitekunas Sep 1999 A
5968007 Simon et al. Oct 1999 A
5968060 Kellogg Oct 1999 A
5974342 Petrofsky Oct 1999 A
D416089 Barton et al. Nov 1999 S
5980510 Tsonton et al. Nov 1999 A
5980546 Hood Nov 1999 A
5989274 Davison et al. Nov 1999 A
5989275 Estabrook et al. Nov 1999 A
5993465 Shipp et al. Nov 1999 A
5993972 Reich et al. Nov 1999 A
5994855 Lundell et al. Nov 1999 A
6024741 Williamson, IV et al. Feb 2000 A
6024750 Mastri et al. Feb 2000 A
6027515 Cimino Feb 2000 A
6031526 Shipp Feb 2000 A
6033375 Brumbach Mar 2000 A
6033399 Gines Mar 2000 A
6036667 Manna et al. Mar 2000 A
6036707 Spaulding Mar 2000 A
6048224 Kay Apr 2000 A
6050943 Slayton et al. Apr 2000 A
6051010 DiMatteo et al. Apr 2000 A
6056735 Okada et al. May 2000 A
6063098 Houser et al. May 2000 A
6066132 Chen et al. May 2000 A
6066151 Miyawaki et al. May 2000 A
6068627 Orszulak et al. May 2000 A
6068647 Witt et al. May 2000 A
6077285 Boukhny Jun 2000 A
6083191 Rose Jul 2000 A
6086584 Miller Jul 2000 A
6090120 Wright et al. Jul 2000 A
6096033 Tu et al. Aug 2000 A
6099542 Cohn et al. Aug 2000 A
6109500 Alli et al. Aug 2000 A
6110127 Suzuki Aug 2000 A
6113594 Savage Sep 2000 A
6117152 Huitema Sep 2000 A
6126629 Perkins Oct 2000 A
6129735 Okada et al. Oct 2000 A
6129740 Michelson Oct 2000 A
6132368 Cooper Oct 2000 A
6132427 Jones et al. Oct 2000 A
6132448 Perez et al. Oct 2000 A
6139320 Hahn Oct 2000 A
6139561 Shibata et al. Oct 2000 A
6142615 Qiu et al. Nov 2000 A
6142994 Swanson et al. Nov 2000 A
6147560 Erhage et al. Nov 2000 A
6152902 Christian et al. Nov 2000 A
6154198 Rosenberg Nov 2000 A
6159160 Hsei et al. Dec 2000 A
6159175 Strukel et al. Dec 2000 A
6162194 Shipp Dec 2000 A
6165150 Banko Dec 2000 A
6174310 Kirwan, Jr. Jan 2001 B1
6179853 Sachse et al. Jan 2001 B1
6183426 Akisada et al. Feb 2001 B1
6193709 Miyawaki et al. Feb 2001 B1
6204592 Hur Mar 2001 B1
6205855 Pfeiffer Mar 2001 B1
6206844 Reichel et al. Mar 2001 B1
6210337 Dunham et al. Apr 2001 B1
6210402 Olsen et al. Apr 2001 B1
6210403 Klicek Apr 2001 B1
6214023 Whipple et al. Apr 2001 B1
6228080 Gines May 2001 B1
6231565 Tovey et al. May 2001 B1
6233476 Strommer et al. May 2001 B1
6238366 Savage et al. May 2001 B1
6245065 Panescu et al. Jun 2001 B1
6252110 Uemura et al. Jun 2001 B1
D444365 Bass et al. Jul 2001 S
D445092 Lee Jul 2001 S
D445764 Lee Jul 2001 S
6254623 Haibel, Jr. et al. Jul 2001 B1
6257241 Wampler Jul 2001 B1
6258034 Hanafy Jul 2001 B1
6267761 Ryan Jul 2001 B1
6270831 Kumar et al. Aug 2001 B2
6273852 Lehe et al. Aug 2001 B1
6274963 Estabrook et al. Aug 2001 B1
6277115 Saadat Aug 2001 B1
6278218 Madan et al. Aug 2001 B1
6280407 Manna et al. Aug 2001 B1
6283981 Beaupre Sep 2001 B1
6287344 Wampler et al. Sep 2001 B1
6290575 Shipp Sep 2001 B1
6299591 Banko Oct 2001 B1
6306131 Hareyama Oct 2001 B1
6306157 Shchervinsky Oct 2001 B1
6309400 Beaupre Oct 2001 B2
6311783 Harpell Nov 2001 B1
6319221 Savage et al. Nov 2001 B1
6325795 Lindemann et al. Dec 2001 B1
6325799 Goble Dec 2001 B1
6325811 Messerly Dec 2001 B1
6328751 Beaupre Dec 2001 B1
6332891 Himes Dec 2001 B1
6338657 Harper et al. Jan 2002 B1
6340352 Okada et al. Jan 2002 B1
6350269 Shipp et al. Feb 2002 B1
6352532 Kramer et al. Mar 2002 B1
6358264 Banko Mar 2002 B2
6364888 Niemeyer et al. Apr 2002 B1
6379320 Lafon et al. Apr 2002 B1
D457958 Dycus et al. May 2002 S
6383194 Pothula May 2002 B1
6384690 Wilhelmsson et al. May 2002 B1
6387109 Davison et al. May 2002 B1
6388657 Natoli May 2002 B1
6391042 Cimino May 2002 B1
6398779 Buysse et al. Jun 2002 B1
6402743 Orszulak et al. Jun 2002 B1
6402748 Schoenman et al. Jun 2002 B1
6405733 Fogarty et al. Jun 2002 B1
6416486 Wampler Jul 2002 B1
6423073 Bowman Jul 2002 B2
6423082 Houser et al. Jul 2002 B1
6428538 Blewett et al. Aug 2002 B1
6428539 Baxter et al. Aug 2002 B1
6432118 Messerly Aug 2002 B1
6436114 Novak et al. Aug 2002 B1
6436115 Beaupre Aug 2002 B1
6440062 Ouchi Aug 2002 B1
6443968 Holthaus et al. Sep 2002 B1
6443969 Novak et al. Sep 2002 B1
6449006 Shipp Sep 2002 B1
6454781 Witt et al. Sep 2002 B1
6454782 Schwemberger Sep 2002 B1
6458142 Faller et al. Oct 2002 B1
6475215 Tanrisever Nov 2002 B1
6480796 Wiener Nov 2002 B2
6485490 Wampler et al. Nov 2002 B2
6491708 Madan et al. Dec 2002 B2
6497715 Satou Dec 2002 B2
6500176 Truckai et al. Dec 2002 B1
6500188 Harper et al. Dec 2002 B2
6500312 Wedekamp Dec 2002 B2
6506208 Hunt et al. Jan 2003 B2
6511478 Burnside et al. Jan 2003 B1
6511493 Moutafis et al. Jan 2003 B1
6514267 Jewett Feb 2003 B2
6524251 Rabiner et al. Feb 2003 B2
6524316 Nicholson et al. Feb 2003 B1
6527736 Attinger et al. Mar 2003 B1
6533784 Truckai et al. Mar 2003 B2
6537272 Christopherson et al. Mar 2003 B2
6537291 Friedman et al. Mar 2003 B2
6543452 Lavigne Apr 2003 B1
6543456 Freeman Apr 2003 B1
6544260 Markel et al. Apr 2003 B1
6558376 Bishop May 2003 B2
6561983 Cronin et al. May 2003 B2
6565558 Lindenmeier et al. May 2003 B1
6572563 Ouchi Jun 2003 B2
6572632 Zisterer et al. Jun 2003 B2
6575969 Rittman, III et al. Jun 2003 B1
6582427 Goble et al. Jun 2003 B1
6582451 Marucci et al. Jun 2003 B1
D477408 Bromley Jul 2003 S
6588277 Giordano et al. Jul 2003 B2
6589200 Schwemberger et al. Jul 2003 B1
6589239 Khandkar et al. Jul 2003 B2
6607540 Shipp Aug 2003 B1
6610059 West, Jr. Aug 2003 B1
6616450 Mossle et al. Sep 2003 B2
6619529 Green et al. Sep 2003 B2
6623500 Cook et al. Sep 2003 B1
6623501 Heller et al. Sep 2003 B2
6626848 Neuenfeldt Sep 2003 B2
6626926 Friedman et al. Sep 2003 B2
6629974 Penny et al. Oct 2003 B2
6633234 Wiener et al. Oct 2003 B2
6644532 Green et al. Nov 2003 B2
6652513 Panescu et al. Nov 2003 B2
6652539 Shipp et al. Nov 2003 B2
6652545 Shipp et al. Nov 2003 B2
6656132 Ouchi Dec 2003 B1
6656177 Truckai et al. Dec 2003 B2
6660017 Beaupre Dec 2003 B2
6662127 Wiener et al. Dec 2003 B2
6663941 Brown et al. Dec 2003 B2
6666860 Takahashi Dec 2003 B1
6666875 Sakurai et al. Dec 2003 B1
6669690 Okada et al. Dec 2003 B1
6669710 Moutafis et al. Dec 2003 B2
6676660 Wampler et al. Jan 2004 B2
6678621 Wiener et al. Jan 2004 B2
6679875 Honda et al. Jan 2004 B2
6679899 Wiener et al. Jan 2004 B2
6682544 Mastri et al. Jan 2004 B2
6685701 Orszulak et al. Feb 2004 B2
6685703 Pearson et al. Feb 2004 B2
6689145 Lee et al. Feb 2004 B2
6689146 Himes Feb 2004 B1
6716215 David et al. Apr 2004 B1
6719692 Kleffner et al. Apr 2004 B2
6719776 Baxter Apr 2004 B2
6723091 Goble et al. Apr 2004 B2
D490059 Conway et al. May 2004 S
6731047 Kauf et al. May 2004 B2
6733506 McDevitt et al. May 2004 B1
6739872 Turri May 2004 B1
6740079 Eggers et al. May 2004 B1
D491666 Kimmell et al. Jun 2004 S
6743245 Lobdell Jun 2004 B2
6746284 Spink, Jr. Jun 2004 B1
6746443 Morley et al. Jun 2004 B1
6752815 Beaupre Jun 2004 B2
6755825 Shoenman et al. Jun 2004 B2
6761698 Shibata et al. Jul 2004 B2
6762535 Take et al. Jul 2004 B2
6770072 Truckai et al. Aug 2004 B1
6773443 Truwit et al. Aug 2004 B2
6773444 Messerly Aug 2004 B2
6778023 Christensen Aug 2004 B2
6783524 Anderson et al. Aug 2004 B2
6786382 Hoffman Sep 2004 B1
6786383 Stegelmann Sep 2004 B2
6790173 Saadat et al. Sep 2004 B2
6790216 Ishikawa Sep 2004 B1
6796981 Wham et al. Sep 2004 B2
D496997 Dycus et al. Oct 2004 S
6802843 Truckai et al. Oct 2004 B2
6808525 Latterell et al. Oct 2004 B2
6809508 Donofrio Oct 2004 B2
6810281 Brock et al. Oct 2004 B2
6827712 Tovey et al. Dec 2004 B2
6828712 Battaglin et al. Dec 2004 B2
6835082 Gonnering Dec 2004 B2
6849073 Hoey et al. Feb 2005 B2
6860878 Brock Mar 2005 B2
6863676 Lee et al. Mar 2005 B2
6869439 White et al. Mar 2005 B2
6875220 Du et al. Apr 2005 B2
6877647 Green et al. Apr 2005 B2
6882439 Ishijima Apr 2005 B2
6887209 Kadziauskas et al. May 2005 B2
6887252 Okada et al. May 2005 B1
6899685 Kermode et al. May 2005 B2
6905497 Truckai et al. Jun 2005 B2
6908472 Wiener et al. Jun 2005 B2
6913579 Truckai et al. Jul 2005 B2
6915623 Dey et al. Jul 2005 B2
6923804 Eggers et al. Aug 2005 B2
6926712 Phan Aug 2005 B2
6926716 Baker et al. Aug 2005 B2
6929602 Hirakui et al. Aug 2005 B2
6929632 Nita et al. Aug 2005 B2
6929644 Truckai et al. Aug 2005 B2
6933656 Matsushita et al. Aug 2005 B2
D509589 Wells Sep 2005 S
6942660 Pantera et al. Sep 2005 B2
6942677 Nita et al. Sep 2005 B2
6945981 Donofrio et al. Sep 2005 B2
6946779 Birgel Sep 2005 B2
6948503 Refior et al. Sep 2005 B2
D511145 Donofrio et al. Nov 2005 S
6974450 Weber et al. Dec 2005 B2
6976844 Hickok et al. Dec 2005 B2
6977495 Donofrio Dec 2005 B2
6979332 Adams Dec 2005 B2
6981628 Wales Jan 2006 B2
6984220 Wuchinich Jan 2006 B2
6994708 Manzo Feb 2006 B2
7001335 Adachi et al. Feb 2006 B2
7011657 Truckai et al. Mar 2006 B2
7014638 Michelson Mar 2006 B2
7033357 Baxter et al. Apr 2006 B2
7037306 Podany May 2006 B2
7041083 Chu et al. May 2006 B2
7041088 Nawrocki et al. May 2006 B2
7041102 Truckai et al. May 2006 B2
7044949 Orszulak et al. May 2006 B2
7066893 Hibner et al. Jun 2006 B2
7066895 Podany Jun 2006 B2
7070597 Truckai et al. Jul 2006 B2
7074218 Washington et al. Jul 2006 B2
7074219 Levine et al. Jul 2006 B2
7077039 Gass et al. Jul 2006 B2
7077845 Hacker et al. Jul 2006 B2
7077853 Kramer et al. Jul 2006 B2
7083618 Couture Aug 2006 B2
7083619 Truckai et al. Aug 2006 B2
7087054 Truckai et al. Aug 2006 B2
7090672 Underwood et al. Aug 2006 B2
7101371 Dycus et al. Sep 2006 B2
7101378 Salameh et al. Sep 2006 B2
7104834 Robinson et al. Sep 2006 B2
7108695 Witt et al. Sep 2006 B2
7111769 Wales et al. Sep 2006 B2
7112201 Truckai et al. Sep 2006 B2
D531311 Guerra et al. Oct 2006 S
7117034 Kronberg Oct 2006 B2
7118564 Ritchie et al. Oct 2006 B2
7124932 Isaacson et al. Oct 2006 B2
7125409 Truckai et al. Oct 2006 B2
7128720 Podany Oct 2006 B2
7131860 Sartor et al. Nov 2006 B2
7135018 Ryan et al. Nov 2006 B2
7135030 Schwemberger et al. Nov 2006 B2
7137980 Buysse et al. Nov 2006 B2
7144403 Booth Dec 2006 B2
7153315 Miller Dec 2006 B2
D536093 Nakajima et al. Jan 2007 S
7156189 Bar-Cohen et al. Jan 2007 B1
7156853 Muratsu Jan 2007 B2
7157058 Marhasin et al. Jan 2007 B2
7159750 Racenet et al. Jan 2007 B2
7160296 Pearson et al. Jan 2007 B2
7160299 Baily Jan 2007 B2
7163548 Stulen et al. Jan 2007 B2
7169144 Hoey et al. Jan 2007 B2
7169146 Truckai et al. Jan 2007 B2
7179254 Pendekanti et al. Feb 2007 B2
7179271 Friedman et al. Feb 2007 B2
7186253 Truckai et al. Mar 2007 B2
7189233 Truckai et al. Mar 2007 B2
D541418 Schechter et al. Apr 2007 S
7204820 Akahoshi Apr 2007 B2
7207997 Shipp et al. Apr 2007 B2
7210881 Greenberg May 2007 B2
7211079 Treat May 2007 B2
7217128 Atkin et al. May 2007 B2
7217269 El-Galley et al. May 2007 B2
7220951 Truckai et al. May 2007 B2
7223229 Inman et al. May 2007 B2
7229455 Sakurai et al. Jun 2007 B2
7235071 Gonnering Jun 2007 B2
7244262 Wiener et al. Jul 2007 B2
7258688 Shah et al. Aug 2007 B1
7269873 Brewer et al. Sep 2007 B2
7273483 Wiener et al. Sep 2007 B2
D552241 Bromley et al. Oct 2007 S
7282048 Goble et al. Oct 2007 B2
7285895 Beaupré Oct 2007 B2
7300431 Dubrovsky Nov 2007 B2
7300435 Wham et al. Nov 2007 B2
7300446 Beaupre Nov 2007 B2
7303531 Lee et al. Dec 2007 B2
7303557 Wham et al. Dec 2007 B2
7306597 Manzo Dec 2007 B2
7309849 Truckai et al. Dec 2007 B2
7311706 Schoenman et al. Dec 2007 B2
7311709 Truckai et al. Dec 2007 B2
7317955 McGreevy Jan 2008 B2
7318831 Alvarez et al. Jan 2008 B2
7326236 Andreas et al. Feb 2008 B2
7331410 Yong et al. Feb 2008 B2
7335165 Truwit et al. Feb 2008 B2
7335997 Wiener Feb 2008 B2
7337010 Howard et al. Feb 2008 B2
7353068 Tanaka et al. Apr 2008 B2
7354440 Truckal et al. Apr 2008 B2
7364577 Wham et al. Apr 2008 B2
RE40388 Gines Jun 2008 E
7380695 Doll et al. Jun 2008 B2
7380696 Shelton, IV et al. Jun 2008 B2
7381209 Truckai et al. Jun 2008 B2
7390317 Taylor et al. Jun 2008 B2
7404508 Smith et al. Jul 2008 B2
7408288 Hara Aug 2008 B2
7416101 Shelton, IV et al. Aug 2008 B2
7416437 Sartor et al. Aug 2008 B2
D576725 Shumer et al. Sep 2008 S
7419490 Falkenstein et al. Sep 2008 B2
7422139 Shelton, IV et al. Sep 2008 B2
7422463 Kuo Sep 2008 B2
D578643 Shumer et al. Oct 2008 S
D578644 Shumer et al. Oct 2008 S
D578645 Shumer et al. Oct 2008 S
7431704 Babaev Oct 2008 B2
7441684 Shelton, IV et al. Oct 2008 B2
7455208 Wales et al. Nov 2008 B2
7462181 Kraft et al. Dec 2008 B2
7464846 Shelton, IV et al. Dec 2008 B2
7472815 Shelton, IV et al. Jan 2009 B2
7473263 Johnston et al. Jan 2009 B2
7479148 Beaupre Jan 2009 B2
7479160 Branch et al. Jan 2009 B2
7481775 Weikel, Jr. et al. Jan 2009 B2
7488285 Honda et al. Feb 2009 B2
7494468 Rabiner et al. Feb 2009 B2
7502234 Goliszek et al. Mar 2009 B2
7503893 Kucklick Mar 2009 B2
7503895 Rabiner et al. Mar 2009 B2
7506790 Shelton, IV Mar 2009 B2
7506791 Omaits et al. Mar 2009 B2
7524320 Tierney et al. Apr 2009 B2
7530986 Beaupre et al. May 2009 B2
7534243 Chin et al. May 2009 B1
D594983 Price et al. Jun 2009 S
7540871 Gonnering Jun 2009 B2
7544200 Houser Jun 2009 B2
7549564 Boudreaux Jun 2009 B2
7559450 Wales et al. Jul 2009 B2
7567012 Namikawa Jul 2009 B2
7569057 Liu et al. Aug 2009 B2
7572266 Young et al. Aug 2009 B2
7572268 Babaev Aug 2009 B2
7578820 Moore et al. Aug 2009 B2
7582084 Swanson et al. Sep 2009 B2
7582095 Shipp et al. Sep 2009 B2
7585181 Olsen Sep 2009 B2
7588176 Timm et al. Sep 2009 B2
7601119 Shahinian Oct 2009 B2
7607557 Shelton, IV et al. Oct 2009 B2
7621930 Houser Nov 2009 B2
7641653 Dalla Betta et al. Jan 2010 B2
7654431 Hueil et al. Feb 2010 B2
7659833 Warner et al. Feb 2010 B2
7665647 Shelton, IV et al. Feb 2010 B2
7670334 Hueil et al. Mar 2010 B2
7670338 Albrecht et al. Mar 2010 B2
7674263 Ryan Mar 2010 B2
7678069 Baker et al. Mar 2010 B1
7678125 Shipp Mar 2010 B2
7682366 Sakurai et al. Mar 2010 B2
7686770 Cohen Mar 2010 B2
7686826 Lee et al. Mar 2010 B2
7688028 Phillips et al. Mar 2010 B2
7691098 Wallace et al. Apr 2010 B2
7699846 Ryan Apr 2010 B2
7713202 Boukhny et al. May 2010 B2
7714481 Sakai May 2010 B2
7717312 Beetel May 2010 B2
7717915 Miyazawa May 2010 B2
7721935 Racenet et al. May 2010 B2
D618797 Price et al. Jun 2010 S
7726537 Olson et al. Jun 2010 B2
7727177 Bayat Jun 2010 B2
7738969 Bleich Jun 2010 B2
7740594 Hibner Jun 2010 B2
7751115 Song Jul 2010 B2
D621503 Otten et al. Aug 2010 S
7766210 Shelton, IV et al. Aug 2010 B2
7766693 Sartor et al. Aug 2010 B2
7770774 Mastri et al. Aug 2010 B2
7770775 Shelton, IV et al. Aug 2010 B2
7771425 Dycus et al. Aug 2010 B2
7771444 Patel et al. Aug 2010 B2
7775972 Brock et al. Aug 2010 B2
7778733 Nowlin et al. Aug 2010 B2
7780054 Wales Aug 2010 B2
7780593 Ueno et al. Aug 2010 B2
7780651 Madhani et al. Aug 2010 B2
7780659 Okada et al. Aug 2010 B2
7784662 Wales et al. Aug 2010 B2
7796969 Kelly et al. Sep 2010 B2
7798386 Schall et al. Sep 2010 B2
7799020 Shores et al. Sep 2010 B2
7799045 Masuda Sep 2010 B2
7803152 Honda et al. Sep 2010 B2
7806891 Nowlin et al. Oct 2010 B2
7810693 Broehl et al. Oct 2010 B2
7811283 Moses et al. Oct 2010 B2
7819819 Quick et al. Oct 2010 B2
7821143 Wiener Oct 2010 B2
D627066 Romero Nov 2010 S
7824401 Manzo et al. Nov 2010 B2
7832611 Boyden et al. Nov 2010 B2
7834484 Sartor Nov 2010 B2
7837699 Yamada et al. Nov 2010 B2
7845537 Shelton, IV et al. Dec 2010 B2
7846155 Houser et al. Dec 2010 B2
7846161 Dumbauld et al. Dec 2010 B2
7854735 Houser et al. Dec 2010 B2
D631155 Peine et al. Jan 2011 S
7861906 Doll et al. Jan 2011 B2
7862560 Marion Jan 2011 B2
7876030 Taki et al. Jan 2011 B2
D631965 Price et al. Feb 2011 S
7878991 Babaev Feb 2011 B2
7879033 Sartor et al. Feb 2011 B2
7892606 Thies et al. Feb 2011 B2
7901400 Wham et al. Mar 2011 B2
7901423 Stulen et al. Mar 2011 B2
7905881 Masuda et al. Mar 2011 B2
7909824 Masuda et al. Mar 2011 B2
7922061 Shelton, IV et al. Apr 2011 B2
7922651 Yamada et al. Apr 2011 B2
D637288 Houghton May 2011 S
D638540 Ijiri et al. May 2011 S
7936203 Zimlich May 2011 B2
7951095 Makin et al. May 2011 B2
7951165 Golden et al. May 2011 B2
7959050 Smith et al. Jun 2011 B2
7959626 Hong et al. Jun 2011 B2
7972329 Refior et al. Jul 2011 B2
7976544 McClurken et al. Jul 2011 B2
7981050 Ritchart et al. Jul 2011 B2
7998157 Culp et al. Aug 2011 B2
8038693 Allen Oct 2011 B2
8057498 Robertson Nov 2011 B2
8058771 Giordano et al. Nov 2011 B2
8061014 Smith et al. Nov 2011 B2
8070711 Bassinger et al. Dec 2011 B2
8070762 Escudero et al. Dec 2011 B2
8075558 Truckai et al. Dec 2011 B2
8089197 Rinner et al. Jan 2012 B2
8097012 Kagarise Jan 2012 B2
8105323 Buysse et al. Jan 2012 B2
8142461 Houser et al. Mar 2012 B2
8152801 Goldberg et al. Apr 2012 B2
8152825 Madan et al. Apr 2012 B2
8157145 Shelton, IV et al. Apr 2012 B2
8161977 Shelton, IV et al. Apr 2012 B2
8162966 Connor et al. Apr 2012 B2
8172846 Brunnett et al. May 2012 B2
8172870 Shipp May 2012 B2
8177800 Spitz et al. May 2012 B2
8182502 Stulen et al. May 2012 B2
8186877 Klimovitch et al. May 2012 B2
D661801 Price et al. Jun 2012 S
D661802 Price et al. Jun 2012 S
D661803 Price et al. Jun 2012 S
D661804 Price et al. Jun 2012 S
8197472 Lau et al. Jun 2012 B2
8197502 Smith et al. Jun 2012 B2
8207651 Gilbert Jun 2012 B2
8210411 Yates et al. Jul 2012 B2
8226675 Houser et al. Jul 2012 B2
8235917 Joseph et al. Aug 2012 B2
8236019 Houser Aug 2012 B2
8236020 Smith et al. Aug 2012 B2
8241271 Millman et al. Aug 2012 B2
8246575 Viola Aug 2012 B2
8246615 Behnke Aug 2012 B2
8252012 Stulen Aug 2012 B2
8253303 Giordano et al. Aug 2012 B2
8257377 Wiener et al. Sep 2012 B2
8257387 Cunningham Sep 2012 B2
8273087 Kimura et al. Sep 2012 B2
D669992 Schafer et al. Oct 2012 S
D669993 Merchant et al. Oct 2012 S
8286846 Smith et al. Oct 2012 B2
8287485 Kimura et al. Oct 2012 B2
8287528 Wham et al. Oct 2012 B2
8287532 Carroll et al. Oct 2012 B2
8292888 Whitman Oct 2012 B2
8298223 Wham et al. Oct 2012 B2
8298225 Gilbert Oct 2012 B2
8303576 Brock Nov 2012 B2
8303580 Wham et al. Nov 2012 B2
8303583 Hosier et al. Nov 2012 B2
8319400 Houser et al. Nov 2012 B2
8323302 Robertson et al. Dec 2012 B2
8333778 Smith et al. Dec 2012 B2
8333779 Smith et al. Dec 2012 B2
8334468 Palmer et al. Dec 2012 B2
8334635 Voegele et al. Dec 2012 B2
8337407 Quistgaard et al. Dec 2012 B2
8338726 Palmer et al. Dec 2012 B2
8344596 Nield et al. Jan 2013 B2
8348967 Stulen Jan 2013 B2
8357103 Mark et al. Jan 2013 B2
8366727 Witt et al. Feb 2013 B2
8372099 Deville et al. Feb 2013 B2
8372101 Smith et al. Feb 2013 B2
8372102 Stulen et al. Feb 2013 B2
8374670 Selkee Feb 2013 B2
8377059 Deville et al. Feb 2013 B2
8377085 Smith et al. Feb 2013 B2
8382748 Geisel Feb 2013 B2
8382775 Bender et al. Feb 2013 B1
8382782 Robertson et al. Feb 2013 B2
8403948 Deville et al. Mar 2013 B2
8403949 Palmer et al. Mar 2013 B2
8403950 Palmer et al. Mar 2013 B2
8418073 Mohr et al. Apr 2013 B2
8418349 Smith et al. Apr 2013 B2
8419757 Smith et al. Apr 2013 B2
8419758 Smith et al. Apr 2013 B2
8419759 Dietz Apr 2013 B2
8425545 Smith et al. Apr 2013 B2
8430898 Wiener et al. Apr 2013 B2
8435257 Smith et al. May 2013 B2
8439912 Cunningham et al. May 2013 B2
8439939 Deville et al. May 2013 B2
8444637 Podmore et al. May 2013 B2
8444662 Palmer et al. May 2013 B2
8444664 Balanev et al. May 2013 B2
8460288 Tamai et al. Jun 2013 B2
8461744 Wiener et al. Jun 2013 B2
8469981 Robertson et al. Jun 2013 B2
8479969 Shelton, IV Jul 2013 B2
8480703 Nicholas et al. Jul 2013 B2
8485413 Scheib et al. Jul 2013 B2
8486057 Behnke, II Jul 2013 B2
8486096 Robertson et al. Jul 2013 B2
8491578 Manwaring et al. Jul 2013 B2
D687549 Johnson et al. Aug 2013 S
8506555 Ruiz Morales Aug 2013 B2
8509318 Tailliet Aug 2013 B2
8512359 Whitman et al. Aug 2013 B2
8512365 Wiener et al. Aug 2013 B2
8523889 Stulen et al. Sep 2013 B2
8531064 Robertson et al. Sep 2013 B2
8535340 Allen Sep 2013 B2
8535341 Allen Sep 2013 B2
8546996 Messerly et al. Oct 2013 B2
8546999 Houser et al. Oct 2013 B2
8568400 Gilbert Oct 2013 B2
8573461 Shelton, IV et al. Nov 2013 B2
8573465 Shelton, IV Nov 2013 B2
8579928 Robertson et al. Nov 2013 B2
8591459 Clymer et al. Nov 2013 B2
8591506 Wham et al. Nov 2013 B2
8591536 Robertson Nov 2013 B2
D695407 Price et al. Dec 2013 S
D696631 Price et al. Dec 2013 S
8602031 Reis et al. Dec 2013 B2
8602288 Shelton, IV et al. Dec 2013 B2
8608745 Guzman et al. Dec 2013 B2
8616431 Timm et al. Dec 2013 B2
8623027 Price et al. Jan 2014 B2
8650728 Wan et al. Feb 2014 B2
8652155 Houser et al. Feb 2014 B2
8659208 Rose et al. Feb 2014 B1
8663220 Wiener et al. Mar 2014 B2
8690582 Rohrbach et al. Apr 2014 B2
8696366 Chen et al. Apr 2014 B2
8704425 Giordano et al. Apr 2014 B2
8709031 Stulen Apr 2014 B2
8747351 Schultz Jun 2014 B2
8749116 Messerly et al. Jun 2014 B2
8752749 Moore et al. Jun 2014 B2
8753338 Widenhouse et al. Jun 2014 B2
8754570 Voegele et al. Jun 2014 B2
8764735 Coe et al. Jul 2014 B2
8773001 Wiener et al. Jul 2014 B2
8779648 Giordano et al. Jul 2014 B2
8784418 Romero Jul 2014 B2
8808319 Houser et al. Aug 2014 B2
8827992 Koss et al. Sep 2014 B2
8845537 Tanaka et al. Sep 2014 B2
8882791 Stulen Nov 2014 B2
8888776 Dietz et al. Nov 2014 B2
8888809 Davison et al. Nov 2014 B2
8899462 Kostrzewski et al. Dec 2014 B2
8900259 Houser et al. Dec 2014 B2
8911460 Neurohr et al. Dec 2014 B2
8951248 Messerly et al. Feb 2015 B2
8951272 Robertson et al. Feb 2015 B2
8956349 Aldridge et al. Feb 2015 B2
8961547 Dietz et al. Feb 2015 B2
8968355 Malkowski et al. Mar 2015 B2
8974477 Yamada Mar 2015 B2
8979890 Boudreaux Mar 2015 B2
8986287 Park et al. Mar 2015 B2
8986302 Aldridge et al. Mar 2015 B2
8989903 Weir et al. Mar 2015 B2
9017326 DiNardo et al. Apr 2015 B2
9039695 Giordano et al. May 2015 B2
9044261 Houser Jun 2015 B2
9050093 Aldridge et al. Jun 2015 B2
9050124 Houser Jun 2015 B2
9060775 Wiener et al. Jun 2015 B2
9060776 Yates et al. Jun 2015 B2
9066747 Robertson Jun 2015 B2
9072539 Messerly et al. Jul 2015 B2
9089360 Messerly et al. Jul 2015 B2
9095367 Olson et al. Aug 2015 B2
9107689 Robertson et al. Aug 2015 B2
9113940 Twomey Aug 2015 B2
9168054 Turner et al. Oct 2015 B2
9198714 Worrell et al. Dec 2015 B2
9220527 Houser et al. Dec 2015 B2
9226766 Aldridge et al. Jan 2016 B2
9226767 Stulen et al. Jan 2016 B2
9232979 Parihar et al. Jan 2016 B2
9237921 Messerly et al. Jan 2016 B2
9241728 Price et al. Jan 2016 B2
9241731 Boudreaux et al. Jan 2016 B2
9259234 Robertson et al. Feb 2016 B2
9283045 Rhee et al. Mar 2016 B2
20010025173 Ritchie et al. Sep 2001 A1
20010025183 Shahidi et al. Sep 2001 A1
20010025184 Messerly Sep 2001 A1
20010031950 Ryan Oct 2001 A1
20010039419 Francischelli et al. Nov 2001 A1
20020002377 Cimino Jan 2002 A1
20020019649 Sikora et al. Feb 2002 A1
20020022836 Goble et al. Feb 2002 A1
20020029055 Bonutti Mar 2002 A1
20020049551 Friedman et al. Apr 2002 A1
20020052617 Anis et al. May 2002 A1
20020077550 Rabiner et al. Jun 2002 A1
20020156466 Sakurai et al. Oct 2002 A1
20020156493 Houser et al. Oct 2002 A1
20030014087 Fang et al. Jan 2003 A1
20030036705 Hare et al. Feb 2003 A1
20030050572 Brautigam et al. Mar 2003 A1
20030055417 Truckai Mar 2003 A1
20030055443 Spotnitz Mar 2003 A1
20030114851 Truckai et al. Jun 2003 A1
20030144680 Kellogg et al. Jul 2003 A1
20030199794 Sakurai et al. Oct 2003 A1
20030204199 Novak et al. Oct 2003 A1
20030212332 Fenton et al. Nov 2003 A1
20030212363 Shipp Nov 2003 A1
20030212392 Fenton et al. Nov 2003 A1
20030212422 Fenton et al. Nov 2003 A1
20030229344 Dycus et al. Dec 2003 A1
20040030254 Babaev Feb 2004 A1
20040030330 Brassell et al. Feb 2004 A1
20040047485 Sherrit et al. Mar 2004 A1
20040054364 Aranyi et al. Mar 2004 A1
20040064151 Mollenauer Apr 2004 A1
20040092921 Kadziauskas et al. May 2004 A1
20040092992 Adams et al. May 2004 A1
20040097912 Gonnering May 2004 A1
20040097919 Wellman et al. May 2004 A1
20040097996 Rabiner et al. May 2004 A1
20040116952 Sakurai et al. Jun 2004 A1
20040132383 Langford et al. Jul 2004 A1
20040147934 Kiester Jul 2004 A1
20040167508 Wham et al. Aug 2004 A1
20040176686 Hare et al. Sep 2004 A1
20040176751 Weitzner et al. Sep 2004 A1
20040199193 Hayashi et al. Oct 2004 A1
20040204728 Haefner Oct 2004 A1
20040243147 Lipow Dec 2004 A1
20040260300 Gorensek et al. Dec 2004 A1
20050020967 Ono Jan 2005 A1
20050021018 Anderson et al. Jan 2005 A1
20050021065 Yamada et al. Jan 2005 A1
20050033337 Muir et al. Feb 2005 A1
20050049546 Messerly et al. Mar 2005 A1
20050070800 Takahashi Mar 2005 A1
20050096683 Ellins et al. May 2005 A1
20050099824 Dowling et al. May 2005 A1
20050103819 Racenet et al. May 2005 A1
20050143769 White et al. Jun 2005 A1
20050149108 Cox Jul 2005 A1
20050165345 Laufer et al. Jul 2005 A1
20050177184 Easley Aug 2005 A1
20050182339 Lee et al. Aug 2005 A1
20050188743 Land Sep 2005 A1
20050192610 Houser et al. Sep 2005 A1
20050209620 Du et al. Sep 2005 A1
20050222598 Ho et al. Oct 2005 A1
20050234484 Houser et al. Oct 2005 A1
20050249667 Tuszynski et al. Nov 2005 A1
20050256405 Makin et al. Nov 2005 A1
20050261581 Hughes et al. Nov 2005 A1
20050261588 Makin et al. Nov 2005 A1
20050273090 Nieman et al. Dec 2005 A1
20050288659 Kimura et al. Dec 2005 A1
20060030797 Zhou et al. Feb 2006 A1
20060058825 Ogura et al. Mar 2006 A1
20060063130 Hayman et al. Mar 2006 A1
20060066181 Bromfield et al. Mar 2006 A1
20060074442 Noriega et al. Apr 2006 A1
20060079874 Faller et al. Apr 2006 A1
20060079879 Faller et al. Apr 2006 A1
20060084963 Messerly Apr 2006 A1
20060095046 Trieu et al. May 2006 A1
20060190034 Nishizawa et al. Aug 2006 A1
20060206100 Eskridge et al. Sep 2006 A1
20060206115 Schomer et al. Sep 2006 A1
20060211943 Beaupre Sep 2006 A1
20060217729 Eskridge et al. Sep 2006 A1
20060235306 Cotter et al. Oct 2006 A1
20060247558 Yamada Nov 2006 A1
20060253050 Yoshimine et al. Nov 2006 A1
20060264809 Hansmann et al. Nov 2006 A1
20060271030 Francis et al. Nov 2006 A1
20070016235 Tanaka et al. Jan 2007 A1
20070016236 Beaupre Jan 2007 A1
20070055228 Berg et al. Mar 2007 A1
20070056596 Fanney et al. Mar 2007 A1
20070060915 Kucklick Mar 2007 A1
20070060935 Schwardt et al. Mar 2007 A1
20070063618 Bromfield Mar 2007 A1
20070074584 Talarico et al. Apr 2007 A1
20070106317 Shelton, IV et al. May 2007 A1
20070129716 Daw et al. Jun 2007 A1
20070130771 Ehlert et al. Jun 2007 A1
20070131034 Ehlert et al. Jun 2007 A1
20070149881 Rabin Jun 2007 A1
20070162050 Sartor Jul 2007 A1
20070166663 Telles et al. Jul 2007 A1
20070173803 Wham et al. Jul 2007 A1
20070173813 Odom Jul 2007 A1
20070173872 Neuenfeldt Jul 2007 A1
20070175949 Shelton, IV et al. Aug 2007 A1
20070175959 Shelton, IV Aug 2007 A1
20070185380 Kucklick Aug 2007 A1
20070191712 Messerly et al. Aug 2007 A1
20070219481 Babaev Sep 2007 A1
20070239028 Houser et al. Oct 2007 A1
20070239101 Kellogg Oct 2007 A1
20070249941 Salehi et al. Oct 2007 A1
20070260234 McCullagh et al. Nov 2007 A1
20070265560 Soltani et al. Nov 2007 A1
20070275348 Lemon Nov 2007 A1
20070282335 Young et al. Dec 2007 A1
20070287933 Phan et al. Dec 2007 A1
20070288055 Lee Dec 2007 A1
20080009848 Paraschiv et al. Jan 2008 A1
20080013809 Zhu et al. Jan 2008 A1
20080051812 Schmitz et al. Feb 2008 A1
20080058585 Novak et al. Mar 2008 A1
20080058775 Darian et al. Mar 2008 A1
20080058845 Shimizu et al. Mar 2008 A1
20080077145 Boyden et al. Mar 2008 A1
20080082039 Babaev Apr 2008 A1
20080082098 Tanaka et al. Apr 2008 A1
20080097501 Blier Apr 2008 A1
20080114364 Goldin et al. May 2008 A1
20080125768 Tahara et al. May 2008 A1
20080140158 Hamel et al. Jun 2008 A1
20080147092 Rogge et al. Jun 2008 A1
20080171938 Masuda et al. Jul 2008 A1
20080172051 Masuda et al. Jul 2008 A1
20080177268 Daum et al. Jul 2008 A1
20080188878 Young Aug 2008 A1
20080200940 Eichmann et al. Aug 2008 A1
20080208108 Kimura Aug 2008 A1
20080208231 Ota et al. Aug 2008 A1
20080214967 Aranyi et al. Sep 2008 A1
20080234709 Houser Sep 2008 A1
20080243106 Coe et al. Oct 2008 A1
20080243162 Shibata et al. Oct 2008 A1
20080245371 Gruber Oct 2008 A1
20080249553 Gruber et al. Oct 2008 A1
20080255423 Kondo et al. Oct 2008 A1
20080262490 Williams Oct 2008 A1
20080281200 Voic et al. Nov 2008 A1
20080281315 Gines Nov 2008 A1
20080281322 Sherman et al. Nov 2008 A1
20080287948 Newton et al. Nov 2008 A1
20090023985 Ewers Jan 2009 A1
20090048537 Lydon et al. Feb 2009 A1
20090054886 Yachi et al. Feb 2009 A1
20090054894 Yachi Feb 2009 A1
20090076506 Baker Mar 2009 A1
20090082716 Akahoshi Mar 2009 A1
20090088785 Masuda Apr 2009 A1
20090112229 Omori et al. Apr 2009 A1
20090118751 Wiener et al. May 2009 A1
20090118802 Mioduski et al. May 2009 A1
20090138006 Bales et al. May 2009 A1
20090143799 Smith et al. Jun 2009 A1
20090143800 Deville et al. Jun 2009 A1
20090143806 Witt et al. Jun 2009 A1
20090149801 Crandall et al. Jun 2009 A1
20090163807 Sliwa Jun 2009 A1
20090207923 Dress Aug 2009 A1
20090216157 Yamada Aug 2009 A1
20090223033 Houser Sep 2009 A1
20090254077 Craig Oct 2009 A1
20090254080 Honda Oct 2009 A1
20090264909 Beaupre Oct 2009 A1
20090270771 Takahashi Oct 2009 A1
20090270812 Litscher et al. Oct 2009 A1
20090270853 Yachi et al. Oct 2009 A1
20090270899 Carusillo et al. Oct 2009 A1
20090275940 Malackowski et al. Nov 2009 A1
20090318945 Yoshimine et al. Dec 2009 A1
20090327715 Smith et al. Dec 2009 A1
20100004508 Naito et al. Jan 2010 A1
20100016785 Takuma Jan 2010 A1
20100016852 Manzo et al. Jan 2010 A1
20100022825 Yoshie Jan 2010 A1
20100030233 Whitman et al. Feb 2010 A1
20100030248 Palmer et al. Feb 2010 A1
20100036370 Mirel et al. Feb 2010 A1
20100042077 Okada Feb 2010 A1
20100049180 Wells et al. Feb 2010 A1
20100063525 Beaupre et al. Mar 2010 A1
20100063528 Beaupré Mar 2010 A1
20100069940 Miller et al. Mar 2010 A1
20100158307 Kubota et al. Jun 2010 A1
20100187283 Crainich et al. Jul 2010 A1
20100222714 Muir et al. Sep 2010 A1
20100228264 Robinson et al. Sep 2010 A1
20100234906 Koh Sep 2010 A1
20100262134 Jensen et al. Oct 2010 A1
20100274160 Yachi et al. Oct 2010 A1
20100280407 Polster Nov 2010 A1
20100292691 Brogna Nov 2010 A1
20100298743 Nield et al. Nov 2010 A1
20100298851 Nield Nov 2010 A1
20100331742 Masuda Dec 2010 A1
20110004233 Muir et al. Jan 2011 A1
20110009850 Main et al. Jan 2011 A1
20110077648 Lee et al. Mar 2011 A1
20110087218 Boudreaux et al. Apr 2011 A1
20110112526 Fritz et al. May 2011 A1
20110125151 Strauss et al. May 2011 A1
20110125174 Babaev May 2011 A1
20110144806 Sandhu et al. Jun 2011 A1
20110224689 Larkin et al. Sep 2011 A1
20110238065 Hunt et al. Sep 2011 A1
20110257650 Deville et al. Oct 2011 A1
20110270126 Gunday et al. Nov 2011 A1
20110290853 Shelton, IV et al. Dec 2011 A1
20110290856 Shelton, IV et al. Dec 2011 A1
20120004655 Kim et al. Jan 2012 A1
20120022525 Dietz et al. Jan 2012 A1
20120022530 Woodruff et al. Jan 2012 A1
20120022583 Sugalski et al. Jan 2012 A1
20120059289 Nield et al. Mar 2012 A1
20120065628 Naito Mar 2012 A1
20120071863 Lee et al. Mar 2012 A1
20120078139 Aldridge et al. Mar 2012 A1
20120078243 Worrell et al. Mar 2012 A1
20120078244 Worrell et al. Mar 2012 A1
20120078247 Worrell et al. Mar 2012 A1
20120078278 Bales, Jr. et al. Mar 2012 A1
20120080332 Shelton, IV et al. Apr 2012 A1
20120101495 Young et al. Apr 2012 A1
20120101501 Nishimura et al. Apr 2012 A1
20120109159 Jordan et al. May 2012 A1
20120116379 Yates et al. May 2012 A1
20120116391 Houser et al. May 2012 A1
20120116394 Timm et al. May 2012 A1
20120116395 Madan et al. May 2012 A1
20120130256 Buysse et al. May 2012 A1
20120130365 McLawhorn May 2012 A1
20120136354 Rupp May 2012 A1
20120138660 Shelton, IV Jun 2012 A1
20120143211 Kishi Jun 2012 A1
20120150170 Buysse et al. Jun 2012 A1
20120165816 Kersten et al. Jun 2012 A1
20120172873 Artale et al. Jul 2012 A1
20120172904 Muir et al. Jul 2012 A1
20120177005 Liang et al. Jul 2012 A1
20120184946 Price et al. Jul 2012 A1
20120199630 Shelton, IV Aug 2012 A1
20120199632 Spivey et al. Aug 2012 A1
20120203143 Sanai et al. Aug 2012 A1
20120203247 Shelton, IV et al. Aug 2012 A1
20120209289 Duque et al. Aug 2012 A1
20120209303 Frankhouser et al. Aug 2012 A1
20120210223 Eppolito Aug 2012 A1
20120215220 Manzo et al. Aug 2012 A1
20120245582 Kimball et al. Sep 2012 A1
20120253370 Ross et al. Oct 2012 A1
20120269676 Houser et al. Oct 2012 A1
20120330307 Ladtkow et al. Dec 2012 A1
20130012957 Shelton, IV et al. Jan 2013 A1
20130030433 Heard Jan 2013 A1
20130035680 Ben-Haim et al. Feb 2013 A1
20130053840 Krapohl et al. Feb 2013 A1
20130072856 Frankhouser et al. Mar 2013 A1
20130072857 Frankhouser et al. Mar 2013 A1
20130079762 Twomey et al. Mar 2013 A1
20130103023 Monson et al. Apr 2013 A1
20130103024 Monson et al. Apr 2013 A1
20130110145 Weitzman May 2013 A1
20130123776 Monson et al. May 2013 A1
20130123777 Monson et al. May 2013 A1
20130123782 Trees et al. May 2013 A1
20130123822 Wellman et al. May 2013 A1
20130131660 Monson et al. May 2013 A1
20130165929 Muir et al. Jun 2013 A1
20130217967 Mohr et al. Aug 2013 A1
20130226207 Stulen et al. Aug 2013 A1
20130226208 Wiener et al. Aug 2013 A1
20130245659 Robertson et al. Sep 2013 A1
20130253498 Germain et al. Sep 2013 A1
20130267975 Timm et al. Oct 2013 A1
20130274734 Maass et al. Oct 2013 A1
20130282038 Dannaher et al. Oct 2013 A1
20130282039 Wiener et al. Oct 2013 A1
20130296908 Schulte et al. Nov 2013 A1
20130338661 Behnke, II Dec 2013 A1
20130345689 Ruddenklau et al. Dec 2013 A1
20140005640 Shelton, IV et al. Jan 2014 A1
20140005653 Shelton, IV et al. Jan 2014 A1
20140005654 Batross et al. Jan 2014 A1
20140005656 Mucilli et al. Jan 2014 A1
20140005661 Shelton, IV et al. Jan 2014 A1
20140005662 Shelton, IV et al. Jan 2014 A1
20140005676 Shelton, IV et al. Jan 2014 A1
20140005680 Shelton, IV et al. Jan 2014 A1
20140005681 Gee et al. Jan 2014 A1
20140005701 Olson et al. Jan 2014 A1
20140005702 Timm et al. Jan 2014 A1
20140005703 Stulen et al. Jan 2014 A1
20140005704 Vakharia et al. Jan 2014 A1
20140005705 Weir et al. Jan 2014 A1
20140005708 Shelton, IV et al. Jan 2014 A1
20140005718 Shelton, IV et al. Jan 2014 A1
20140012299 Stoddard et al. Jan 2014 A1
20140066962 Robertson et al. Mar 2014 A1
20140087569 Lee Mar 2014 A1
20140107538 Wiener et al. Apr 2014 A1
20140114327 Boudreaux et al. Apr 2014 A1
20140135804 Weisenburgh, II et al. May 2014 A1
20140155921 Price et al. Jun 2014 A1
20140180280 Sigmon, Jr. Jun 2014 A1
20140243864 Voegele et al. Aug 2014 A1
20140276970 Messerly et al. Sep 2014 A1
20150045819 Houser et al. Feb 2015 A1
20150066067 Stulen Mar 2015 A1
20150073460 Stulen Mar 2015 A1
20150112335 Boudreaux et al. Apr 2015 A1
20150119914 Neurohr et al. Apr 2015 A1
20150119915 Neurohr et al. Apr 2015 A1
20150119916 Dietz et al. Apr 2015 A1
20150123348 Robertson et al. May 2015 A1
20150157355 Price et al. Jun 2015 A1
20150157356 Gee Jun 2015 A1
20150164533 Felder et al. Jun 2015 A1
20150164534 Felder et al. Jun 2015 A1
20150164535 Felder et al. Jun 2015 A1
20150164536 Czarnecki et al. Jun 2015 A1
20150164537 Cagle et al. Jun 2015 A1
20150164538 Aldridge et al. Jun 2015 A1
20150182251 Messerly et al. Jul 2015 A1
20150182276 Wiener et al. Jul 2015 A1
20150182277 Wiener et al. Jul 2015 A1
20150196318 Messerly et al. Jul 2015 A1
20150250495 Robertson et al. Sep 2015 A1
20150257780 Houser Sep 2015 A1
20150265308 Houser et al. Sep 2015 A1
20150282834 Robertson Oct 2015 A1
20150327883 Messerly et al. Nov 2015 A1
20150328484 Messerly et al. Nov 2015 A1
20150340586 Wiener et al. Nov 2015 A1
20150351789 Robertson et al. Dec 2015 A1
20160030076 Faller et al. Feb 2016 A1
20160089209 Parihar et al. Mar 2016 A1
20160089533 Turner et al. Mar 2016 A1
20160095617 Price et al. Apr 2016 A1
Foreign Referenced Citations (277)
Number Date Country
2003241752 Sep 2003 AU
2535467 Apr 1993 CA
1233944 Nov 1999 CN
1253485 May 2000 CN
1634601 Jul 2005 CN
1640365 Jul 2005 CN
1694649 Nov 2005 CN
1922563 Feb 2007 CN
1951333 Apr 2007 CN
101040799 Sep 2007 CN
101467917 Jan 2009 CN
3904558 Aug 1990 DE
9210327 Nov 1992 DE
4323585 Jan 1995 DE
19608716 Apr 1997 DE
20021619 Mar 2001 DE
10042606 Aug 2001 DE
0136855 Sep 1984 EP
0171967 Feb 1986 EP
1839599 Oct 1987 EP
0336742 Apr 1989 EP
0342448 Nov 1989 EP
0424685 May 1991 EP
0443256 Aug 1991 EP
0456470 Nov 1991 EP
0598976 Jan 1994 EP
0677275 Mar 1995 EP
0482195 Jan 1996 EP
0695535 Feb 1996 EP
0741996 Nov 1996 EP
0612570 Jun 1997 EP
1108394 Jun 2001 EP
1138264 Oct 2001 EP
0908148 Jan 2002 EP
1229515 Aug 2002 EP
1285634 Feb 2003 EP
0908155 Jun 2003 EP
0705570 Apr 2004 EP
0765637 Jul 2004 EP
0870473 Sep 2005 EP
0624346 Nov 2005 EP
1594209 Nov 2005 EP
1199044 Dec 2005 EP
1609428 Dec 2005 EP
1199043 Mar 2006 EP
1433425 Jun 2006 EP
1256323 Sep 2006 EP
1698289 Sep 2006 EP
1704824 Sep 2006 EP
1749479 Feb 2007 EP
1815950 Aug 2007 EP
1844720 Oct 2007 EP
1862133 Dec 2007 EP
1875875 Jan 2008 EP
1199045 Jun 2008 EP
1964530 Sep 2008 EP
1972264 Sep 2008 EP
1974771 Oct 2008 EP
1435852 Dec 2008 EP
1498082 Dec 2008 EP
1707131 Dec 2008 EP
1997438 Dec 2008 EP
1477104 Jan 2009 EP
2014218 Jan 2009 EP
2042112 Apr 2009 EP
1832259 Jun 2009 EP
2074959 Jul 2009 EP
2106758 Oct 2009 EP
2111813 Oct 2009 EP
2200145 Jun 2010 EP
1214913 Jul 2010 EP
2238938 Oct 2010 EP
2298154 Mar 2011 EP
1510178 Jun 2011 EP
2305144 Jun 2011 EP
2335630 Jun 2011 EP
1502551 Jul 2011 EP
2361562 Aug 2011 EP
2365608 Sep 2011 EP
2420197 Feb 2012 EP
2422721 Feb 2012 EP
1927321 Apr 2012 EP
2510891 Oct 2012 EP
2316359 Mar 2013 EP
1586275 May 2013 EP
1616529 Sep 2013 EP
2583633 Oct 2014 EP
1482943 Aug 1977 GB
2032221 Apr 1980 GB
2317566 Apr 1998 GB
2379878 Nov 2004 GB
2447767 Aug 2011 GB
S 50-100891 Dec 1973 JP
S 59-68513 Oct 1982 JP
S 59141938 Aug 1984 JP
62-221343 Sep 1987 JP
S 62-227343 Oct 1987 JP
62-292153 Dec 1987 JP
S 62-292154 Dec 1987 JP
63-109386 May 1988 JP
63-315049 Dec 1988 JP
H 01-151452 Jun 1989 JP
H 01-198540 Aug 1989 JP
02-71510 May 1990 JP
2-286149 Nov 1990 JP
H 02-292193 Dec 1990 JP
H 03-37061 Feb 1991 JP
04-25707 Feb 1992 JP
H 04-64351 Feb 1992 JP
4-30508 Mar 1992 JP
H 04-150847 May 1992 JP
H 04-152942 May 1992 JP
05-095955 Apr 1993 JP
H 05-115490 May 1993 JP
H 06-070938 Mar 1994 JP
6-104503 Apr 1994 JP
6-507081 Aug 1994 JP
H 06-217988 Aug 1994 JP
H 7-508910 Oct 1995 JP
7-308323 Nov 1995 JP
8-24266 Jan 1996 JP
8-275951 Oct 1996 JP
H 08-299351 Nov 1996 JP
H 08-336545 Dec 1996 JP
H 09-503146 Mar 1997 JP
H 09-135553 May 1997 JP
H 09-140722 Jun 1997 JP
H 10-005237 Jan 1998 JP
10-295700 Nov 1998 JP
H 11-501543 Feb 1999 JP
H 11-128238 May 1999 JP
H 11-192235 Jul 1999 JP
11-253451 Sep 1999 JP
H 11-318918 Nov 1999 JP
2000-041991 Feb 2000 JP
2000-070279 Mar 2000 JP
2000-210299 Aug 2000 JP
2000-287987 Oct 2000 JP
2001-029353 Feb 2001 JP
2001-502216 Feb 2001 JP
2003612 Jun 2001 JP
2001-309925 Nov 2001 JP
2002-186901 Jul 2002 JP
2002-204808 Jul 2002 JP
2002-263579 Sep 2002 JP
2002-301086 Oct 2002 JP
2002-330977 Nov 2002 JP
2002-542690 Dec 2002 JP
2003-000612 Jan 2003 JP
2003-010201 Jan 2003 JP
2003-510158 Mar 2003 JP
2003-116870 Apr 2003 JP
2003-126104 May 2003 JP
2003-126110 May 2003 JP
2003-310627 May 2003 JP
2003-530921 Oct 2003 JP
2003-339730 Dec 2003 JP
2004-147701 May 2004 JP
2005027026 Jan 2005 JP
2005-040222 Feb 2005 JP
2005-066316 Mar 2005 JP
2005-074088 Mar 2005 JP
2005-534451 Nov 2005 JP
2006-6410 Jan 2006 JP
2006-512149 Apr 2006 JP
2006-116194 May 2006 JP
2006-158525 Jun 2006 JP
2006-218296 Aug 2006 JP
2006217716 Aug 2006 JP
2006-288431 Oct 2006 JP
2007-050181 Mar 2007 JP
2007-229454 Sep 2007 JP
2007-527747 Oct 2007 JP
2008-508065 Mar 2008 JP
2008-119250 May 2008 JP
2008-521503 Jun 2008 JP
2008-212679 Sep 2008 JP
2008-536562 Sep 2008 JP
2008-284374 Nov 2008 JP
2009-511206 Mar 2009 JP
2009-517181 Apr 2009 JP
4262923 May 2009 JP
2009-523567 Jun 2009 JP
2009-236177 Oct 2009 JP
2009-254819 Nov 2009 JP
2010-000336 Jan 2010 JP
2010-514923 May 2010 JP
2010-534522 Nov 2010 JP
2010-540186 Dec 2010 JP
2011-505198 Feb 2011 JP
2012-235658 Nov 2012 JP
5208761 Jun 2013 JP
D1339835 Aug 2015 JP
2154437 Aug 2000 RU
22035 Mar 2002 RU
WO 9222259 Dec 1992 WO
WO 9308757 May 1993 WO
WO 9314708 Aug 1993 WO
WO 9316646 Sep 1993 WO
WO 9320877 Oct 1993 WO
WO 9421183 Sep 1994 WO
WO 9424949 Nov 1994 WO
WO 9509572 Apr 1995 WO
WO 9534259 Dec 1995 WO
WO 9630885 Oct 1996 WO
WO 9639086 Dec 1996 WO
WO 9816156 Apr 1998 WO
WO 9826739 Jun 1998 WO
WO 9835621 Aug 1998 WO
WO 9837815 Sep 1998 WO
WO 9847436 Oct 1998 WO
WO 9920213 Apr 1999 WO
WO 9952489 Oct 1999 WO
WO 0064358 Nov 2000 WO
WO 0074585 Dec 2000 WO
WO 0124713 Apr 2001 WO
WO 0154590 Aug 2001 WO
WO 0167970 Sep 2001 WO
WO 0195810 Dec 2001 WO
WO 0224080 Mar 2002 WO
WO 0238057 May 2002 WO
WO 02062241 Aug 2002 WO
WO 03082133 Oct 2003 WO
WO 2004012615 Feb 2004 WO
WO 2004026104 Apr 2004 WO
WO 2004032754 Apr 2004 WO
WO 2004032762 Apr 2004 WO
WO 2004032763 Apr 2004 WO
WO 2004037095 May 2004 WO
WO 2004098426 Nov 2004 WO
WO 2004112618 Dec 2004 WO
WO 2005117735 Dec 2005 WO
WO 2005122917 Dec 2005 WO
WO 2006012797 Feb 2006 WO
WO 2006042210 Apr 2006 WO
WO 2006058223 Jun 2006 WO
WO 2006063199 Jun 2006 WO
WO 2006083988 Aug 2006 WO
WO 2006101661 Sep 2006 WO
WO 2006119139 Nov 2006 WO
WO 2006119376 Nov 2006 WO
WO 2006129465 Dec 2006 WO
WO 2007008703 Jan 2007 WO
WO 2007008710 Jan 2007 WO
WO 2007038538 Apr 2007 WO
WO 2007040818 Apr 2007 WO
WO 2007047380 Apr 2007 WO
WO 2007047531 Apr 2007 WO
WO 2007056590 May 2007 WO
WO 2007087272 Aug 2007 WO
WO 2007143665 Dec 2007 WO
WO 2008016886 Feb 2008 WO
WO 2008042021 Apr 2008 WO
WO 2008049084 Apr 2008 WO
WO 2008051764 May 2008 WO
WO 2008089174 Jul 2008 WO
WO 2008118709 Oct 2008 WO
WO 2008130793 Oct 2008 WO
WO 2009010565 Jan 2009 WO
WO 2009018067 Feb 2009 WO
WO 2009018406 Feb 2009 WO
WO 2009027065 Mar 2009 WO
WO 2009046234 Apr 2009 WO
WO 2009073402 Jun 2009 WO
WO 2009120992 Oct 2009 WO
WO 2010017149 Feb 2010 WO
WO 2010068783 Jun 2010 WO
WO 2011008672 Jan 2011 WO
WO 2011052939 May 2011 WO
WO 2011100321 Aug 2011 WO
WO 2011144911 Nov 2011 WO
WO 2012061722 May 2012 WO
WO 2012128362 Sep 2012 WO
WO 2012135705 Oct 2012 WO
WO 2012135721 Oct 2012 WO
WO 2013018934 Feb 2013 WO
WO 2013062978 May 2013 WO
Non-Patent Literature Citations (32)
Entry
Partial Supplementary European Search Report for 08782286.2, dated Apr. 1, 2015 (7 pages).
Extended European Search Report for 08782286.2, dated Jul. 17, 2015 (10 pages).
International Preliminary Report on Patentability for PCT/US2008/070964, Feb. 2, 2010 (10 pages).
International Search Report for PCT/US2008/070964, Dec. 15, 2008 (6 pages).
Technology Overview, printed from www.harmonicscalpel.com, internet site, website accessed on Jun. 13, 2007, (3 pages).
Sherrit et al., “Novel Horn Designs for Ultrasonic/Sonic Cleaning Welding, Soldering, Cutting and Drilling,” Proc. SPIE Smart Structures Conference, vol. 4701, Paper No. 34, San Diego, CA, pp. 353-360, Mar. 2002.
AST Products, Inc., “Principles of Video Contact Angle Analysis,” 20 pages, (2006).
Lim et al., “A Review of Mechanism Used in Laparoscopic Surgical Instruments,” Mechanism and Machine Theory, vol. 38, pp. 1133-1147, (2003).
Gooch et al., “Recommended Infection-Control Practices for Dentistry, 1993,” Published: May 28, 1993; [retrieved on Aug. 23, 2008]. Retrieved from the internet: URL: http//wonder.cdc.gov/wonder/prevguid/p0000191/p0000191.asp (15 pages).
Huston et al., “Magnetic and Magnetostrictive Properties of Cube Textured Nickel for Magnetostrictive Transducer Applications,” IEEE Transactions on Magnetics, vol. 9(4), pp. 636-640 (Dec. 1973).
Incropera et al., “Fundamentals of Heat and Mass Transfer”, Wiley, New York (1990). (Book—not attached).
F. A. Duck, “Optical Properties of Tissue Including Ultraviolet and Infrared Radiation,” pp. 43-71 in Physical Properties of Tissue (1990).
Orr et al., “Overview of Bioheat Transfer,” pp. 367-384 in Optical-Thermal Response of Laser-Irradiated Tissue, A. J. Welch and M. J. C. van Gemert, eds., Plenum, New York (1995).
Campbell et al, “Thermal Imaging in Surgery,” p. 19-3, in Medical Infrared Imaging, N. A. Diakides and J. D. Bronzino, Eds. (2008).
Sullivan, “Cost-Constrained Selection of Strand Diameter and Number in a Litz-Wire Transformer Winding,” IEEE Transactions on Power Electronics, vol. 16, No. 2, Mar. 2001, pp. 281-288.
Sullivan, “Optimal Choice for Number of Strands in a Litz-Wire Transformer Winding,” IEEE Transactions on Power Electronics, vol. 14, No. 2, Mar. 1999, pp. 283-291.
Graff, K.F., “Elastic Wave Propagation in a Curved Sonic Transmission Line,” IEEE Transactions on Sonics and Ultrasonics, SU-17(1), 1-6 (1970).
Makarov, S. N., Ochmann, M., Desinger, K., “The longitudinal vibration response of a curved fiber used for laser ultrasound surgical therapy,” Journal of the Acoustical Society of America 102, 1191-1199 (1997).
Morley, L. S. D., “Elastic Waves in a Naturally Curved Rod,” Quarterly Journal of Mechanics and Applied Mathematics, 14: 155-172 (1961).
Walsh, S. J., White, R. G., “Vibrational Power Transmission in Curved Beams,” Journal of Sound and Vibration, 233(3), 455-488 (2000).
http://www.apicalinstr.com/generators.htm.
http://www.dotmed.com/listing/electrosurical-unit/ethicon/ultracision-g110-/1466724.
http:/www.ethicon.com/gb-en/healthcare-professionals/products/energy-devices/capital//ge . . . .
http://www.4-traders.com/JOHNSON-JOHNSON-4832/news/Johnson-Johnson-Ethicon-E . . . .
http://www.medicalexpo.com/medical-manufacturer/electrosurgical-generator-6951.html.
http://www—megadyne.com/es—generator.php.
http://www.valleylab.com/product/es/generators/index.html.
Covidien 501(k) Summary Sonicision, dated Feb. 24, 2011 (7 pages).
Gerhard, Glen C., “Surgical Electrotechnology: Quo Vadis?,” Biomedical Engineering, IEEE Transactions on , vol. BME-31, No. 12, pp. 787, 792, Dec. 1984.
Fowler, K.R., “A programmable, arbitrary waveform electrosurgical device,” Engineering in Medicine and Biology Society, 1988. Proceedings of the Annual International Conference of the IEEE, vol., No., pp. 1324, 1325 vol. 3, Nov. 4-7, 1988.
LaCourse, Jr.; Vogt, M.C.; Miller, W.T., III; Selikowitz, S.M., “Spectral analysis interpretation of electro-surgical generator nerve and muscle stimulation,” Biomedical Engineering, IEEE Transactions on , vol. 35, No. 7, pp. 505, 509, Jul. 1988.
U.S. Appl. No. 13/751,680, filed Jan. 28, 2013.
Related Publications (1)
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20150257781 A1 Sep 2015 US
Divisions (2)
Number Date Country
Parent 14444335 Jul 2014 US
Child 14645786 US
Parent 11881602 Jul 2007 US
Child 14444335 US