Surgical instruments

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 a 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.

According to still another general aspect, the various embodiments are directed to a surgical instrument including a transducer configured to provide vibrations along a longitudinal axis, an end effector operably coupled to the transducer, and a stationary lower jaw extending parallel to the end effector. The end effector extends along the longitudinal axis. The end effector comprises a blade. The stationary lower jaw comprises a clamp face positioned distal to the blade. The end effector is movable relative to the stationary lower jaw to drive the blade distally towards the clamp face. The end effector comprises a hollow lumen. The end effector further comprises at least one member extended across a portion of the hollow lumen.

According to still another general aspect, the various embodiments are directed to a surgical instrument including a transducer configured to provide vibrations along a longitudinal axis, an end effector operably coupled to the transducer, and a stationary lower jaw extending parallel to the end effector. The end effector extends along the longitudinal axis. The end effector comprises a cutting edge. The stationary lower jaw comprises a clamp face extending towards the longitudinal axis. The end effector is slidable relative to the stationary lower jaw to drive the cutting edge distally towards the clamp face. The end effector comprises a hollow lumen. The end effector further comprises at least one member extended across a portion of the hollow lumen.

According to still another general aspect, the various embodiments are directed to a surgical instrument including a transducer, an end effector operably coupled to the transducer, and an immobile lower jaw extending parallel to the end effector. The end effector is configured to vibrate in response to ultrasonic vibrations provided by the transducer. The end effector comprises a blade defining a hollow lumen. The immobile lower jaw comprises a clamp face positioned distal to the blade. The end effector is translatable relative to the immobile lower jaw to drive the blade distally towards the clamp face. The surgical instrument further includes at least one member extended across a portion of the hollow lumen.

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; and

FIG. 56 illustrates one embodiment of a surgical device 700 comprising a hand-piece adapter.

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, 6,278,218 B1, 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 f₀of 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 f₀of 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 f₀when 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 (not shown). 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 instrument comprising: a transducer configured to provide vibrations along a longitudinal axis;an end effector operably coupled to the transducer, wherein the end effector extends along the longitudinal axis, and wherein the end effector comprises a blade; anda stationary lower jaw extending parallel to the end effector, wherein the stationary lower jaw comprises a clamp face positioned distal to the blade, wherein the end effector is movable relative to the stationary lower jaw to drive the blade distally towards the clamp face;wherein the end effector comprises a hollow lumen; andwherein the end effector further comprises at least one member extended across a portion of the hollow lumen.
2. The surgical instrument of claim 1, further comprising a trigger, wherein rotation of the trigger is configured to drive the blade distally towards the clamp face.
3. The surgical instrument of claim 2, further comprising a frame member operably coupled to the trigger and the end effector, wherein the rotation of the trigger exerts a force on the frame member to drive the blade distally towards the clamp face.
4. The surgical instrument of claim 3, wherein the blade is non-rotatably driven distally towards the clamp face.
5. The surgical instrument of claim 3, wherein the blade is rotatably driven distally towards the clamp face.
6. The surgical instrument of claim 5, wherein the frame member comprises a slot, wherein the end effector comprises a pin, and wherein the slot is configured to exert a force on the pin to cause the blade to rotate as the blade is driven distally towards the clamp face.
7. The surgical instrument of claim 1, wherein the at least one member comprises two members, and wherein the two members intersect one another at a right angle.
8. A surgical instrument comprising: a transducer configured to provide vibrations along a longitudinal axis;an end effector operably coupled to the transducer, wherein the end effector extends along the longitudinal axis, and wherein the end effector comprises a cutting edge; anda stationary lower jaw extending parallel to the end effector, wherein the stationary lower jaw comprises a clamp face extending towards the longitudinal axis, wherein the end effector is slidable relative to the stationary lower jaw to drive the cutting edge distally towards the clamp face; andwherein the end effector comprises a hollow lumen; andwherein the end effector further comprises at least one member extended across a portion of the hollow lumen.
9. The surgical instrument of claim 8, further comprising a trigger, wherein rotation of the trigger is configured to drive the cutting edge distally towards the clamp face.
10. The surgical instrument of claim 9, further comprising a frame member operably coupled to the trigger and the end effector, wherein the rotation of the trigger exerts a force on the frame member to drive the cutting edge distally towards the clamp face.
11. The surgical instrument of claim 10, wherein the cutting edge is non-rotatably driven distally towards the clamp face.
12. The surgical instrument of claim 10, wherein the cutting edge is rotatably driven distally towards the clamp face.
13. The surgical instrument of claim 12, wherein the frame member comprises a slot, wherein the end effector comprises a pin, and wherein the slot is configured to exert a force on the pin to cause the cutting edge to rotate as the cutting edge is driven distally towards the clamp face.
14. The surgical instrument of claim 8, wherein the at least one member comprises two members, and wherein the two members intersect one another at a right angle.
15. A surgical instrument comprising: a transducer;an end effector operably coupled to the transducer, wherein the end effector is configured to vibrate in response to ultrasonic vibrations provided by the transducer, and wherein the end effector comprises a blade defining a hollow lumen;an immobile lower jaw extending parallel to the end effector, wherein the immobile lower jaw comprises a clamp face positioned distal to the blade, and wherein the end effector is translatable relative to the immobile lower jaw to drive the blade distally towards the clamp face; andat least one member extended across a portion of the hollow lumen.
16. The surgical instrument of claim 15, wherein the at least one member comprises two members, and wherein the two members intersect one another at an angle.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 15/653,366, entitled SURGICAL INSTRUMENTS, filed Jul. 18, 2017, now U.S. Patent Application Publication No. 2018/0092660, which is a continuation application claiming priority under 35 U.S.C. § 120 to U.S. patent application Ser. No. 14/645,796, entitled SURGICAL INSTRUMENTS, filed Mar. 12, 2015, which issued on Jul. 18, 2017 as U.S. Pat. No. 9,707,004, which is a divisional application claiming priority under 35 U.S.C. § 121 to U.S. patent application Ser. No. 14/444,335, entitled SURGICAL INSTRUMENTS, filed Jul. 28, 2014, which issued on Dec. 29, 2015 as U.S. Pat. No. 9,220,527, which is a divisional application claiming priority under 35 U.S.C. § 121 to U.S. patent application Ser. No. 11/881,602, entitled SURGICAL INSTRUMENTS, filed Jul. 27, 2007, which issued on Aug. 19, 2014 as U.S. Pat. No. 8,808,319, the entire disclosures of which are hereby incorporated by reference herein.

US Referenced Citations (2528)

Number	Name	Date	Kind
969528	Disbrow	Sep 1910	A
1570025	Young	Jan 1926	A
1813902	Bovie	Jul 1931	A
2188497	Calva	Jan 1940	A
2366274	Luth et al.	Jan 1945	A
2425245	Johnson	Aug 1947	A
2442966	Wallace	Jun 1948	A
2458152	Eakins	Jan 1949	A
2510693	Green	Jun 1950	A
2597564	Bugg	May 1952	A
2704333	Calosi et al.	Mar 1955	A
2736960	Armstrong	Mar 1956	A
2743726	Grieshaber	May 1956	A
2748967	Roach	Jun 1956	A
2845072	Shafer	Jul 1958	A
2849788	Creek	Sep 1958	A
2867039	Zach	Jan 1959	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
3166971	Stoecker	Jan 1965	A
3322403	Murphy	May 1967	A
3432691	Shoh	Mar 1969	A
3433226	Boyd	Mar 1969	A
3489930	Shoh	Jan 1970	A
3503396	Pierie et al.	Mar 1970	A
3503397	Fogarty et al.	Mar 1970	A
3503398	Fogarty et al.	Mar 1970	A
3513848	Winston et al.	May 1970	A
3514856	Camp et al.	Jun 1970	A
3525912	Wallin	Aug 1970	A
3526219	Balamuth	Sep 1970	A
3554198	Tatoian et al.	Jan 1971	A
3580841	Cadotte et al.	May 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
3703651	Blowers	Nov 1972	A
3776238	Peyman et al.	Dec 1973	A
3777760	Essner	Dec 1973	A
3792701	Kloz et al.	Feb 1974	A
3805787	Banko	Apr 1974	A
3809977	Balamuth et al.	May 1974	A
3830098	Antonevich	Aug 1974	A
3832776	Sawyer	Sep 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
3989952	Hohmann	Nov 1976	A
4005714	Hiltebrandt	Feb 1977	A
4012647	Balamuth et al.	Mar 1977	A
4034762	Cosens et al.	Jul 1977	A
4057660	Yoshida et al.	Nov 1977	A
4058126	Leveen	Nov 1977	A
4074719	Semm	Feb 1978	A
4085893	Durley, III	Apr 1978	A
4156187	Murry et al.	May 1979	A
4167944	Banko	Sep 1979	A
4169984	Parisi	Oct 1979	A
4173725	Asai et al.	Nov 1979	A
4188927	Harris	Feb 1980	A
4193009	Durley, III	Mar 1980	A
4200106	Douvas et al.	Apr 1980	A
4203430	Takahashi	May 1980	A
4203444	Bonnell et al.	May 1980	A
4220154	Semm	Sep 1980	A
4237441	van Konynenburg et al.	Dec 1980	A
4281785	Brooks	Aug 1981	A
4300083	Helges	Nov 1981	A
4302728	Nakamura	Nov 1981	A
4304987	van Konynenburg	Dec 1981	A
4306570	Matthews	Dec 1981	A
4314559	Allen	Feb 1982	A
4352459	Berger et al.	Oct 1982	A
4445063	Smith	Apr 1984	A
4452473	Ruschke	Jun 1984	A
4463759	Garito et al.	Aug 1984	A
4491132	Aikins	Jan 1985	A
4492231	Auth	Jan 1985	A
4494759	Kieffer	Jan 1985	A
4504264	Kelman	Mar 1985	A
4512344	Barber	Apr 1985	A
4526571	Wuchinich	Jul 1985	A
4535773	Yoon	Aug 1985	A
4541638	Ogawa et al.	Sep 1985	A
4545374	Jacobson	Oct 1985	A
4545926	Fouts, Jr. et al.	Oct 1985	A
4550870	Krumme et al.	Nov 1985	A
4553544	Nomoto et al.	Nov 1985	A
4562838	Walker	Jan 1986	A
4574615	Bower et al.	Mar 1986	A
4582236	Hirose	Apr 1986	A
4617927	Manes	Oct 1986	A
4633119	Thompson	Dec 1986	A
4633874	Chow et al.	Jan 1987	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
4663677	Griffith et al.	May 1987	A
4674502	Imonti	Jun 1987	A
4696667	Masch	Sep 1987	A
4708127	Abdelghani	Nov 1987	A
4712722	Hood et al.	Dec 1987	A
4735603	Goodson et al.	Apr 1988	A
4750488	Wuchinich et al.	Jun 1988	A
4761871	O'Connor et al.	Aug 1988	A
4783997	Lynnworth	Nov 1988	A
4808154	Freeman	Feb 1989	A
4819635	Shapiro	Apr 1989	A
4821719	Fogarty	Apr 1989	A
4827911	Broadwin et al.	May 1989	A
4830462	Karny 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
4849133	Yoshida et al.	Jul 1989	A
4850354	McGurk-Burleson et al.	Jul 1989	A
4852578	Companion et al.	Aug 1989	A
4860745	Farin et al.	Aug 1989	A
4862890	Stasz et al.	Sep 1989	A
4865159	Jamison	Sep 1989	A
4867157	McGurk-Burleson et al.	Sep 1989	A
4869715	Sherburne	Sep 1989	A
4878493	Pasternak et al.	Nov 1989	A
4880015	Nierman	Nov 1989	A
4881550	Kothe	Nov 1989	A
4896009	Pawlowski	Jan 1990	A
4903696	Stasz et al.	Feb 1990	A
4910389	Sherman et al.	Mar 1990	A
4915643	Samejima et al.	Apr 1990	A
4920978	Colvin	May 1990	A
4922902	Wuchinich et al.	May 1990	A
4936842	D'Amelio et al.	Jun 1990	A
4954960	Lo et al.	Sep 1990	A
4965532	Sakurai	Oct 1990	A
4978067	Berger et al.	Dec 1990	A
4979952	Kubota et al.	Dec 1990	A
4981756	Rhandhawa	Jan 1991	A
4983160	Steppe et al.	Jan 1991	A
5013956	Kurozumi et al.	May 1991	A
5015227	Broadwin et al.	May 1991	A
5020514	Heckele	Jun 1991	A
5026370	Lottick	Jun 1991	A
5026387	Thomas	Jun 1991	A
5035695	Weber, Jr. et al.	Jul 1991	A
5042461	Inoue et al.	Aug 1991	A
5042707	Taheri	Aug 1991	A
5047043	Kubota et al.	Sep 1991	A
5057119	Clark et al.	Oct 1991	A
5058570	Idemoto et al.	Oct 1991	A
5059210	Clark et al.	Oct 1991	A
5061269	Muller	Oct 1991	A
5084052	Jacobs	Jan 1992	A
5088687	Stender	Feb 1992	A
5096532	Neuwirth et al.	Mar 1992	A
5099840	Goble et al.	Mar 1992	A
5104025	Main et al.	Apr 1992	A
5105117	Yamaguchi	Apr 1992	A
5106538	Barma et al.	Apr 1992	A
5108383	White	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
D330253	Burek	Oct 1992	S
5152762	McElhenney	Oct 1992	A
5156613	Sawyer	Oct 1992	A
5156633	Smith	Oct 1992	A
5159226	Montgomery	Oct 1992	A
5160334	Billings et al.	Nov 1992	A
5162044	Gahn et al.	Nov 1992	A
5163421	Bernstein et al.	Nov 1992	A
5163537	Radev	Nov 1992	A
5167619	Wuchinich	Dec 1992	A
5167725	Clark et al.	Dec 1992	A
5172344	Ehrlich	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	Grzeszykowski	Feb 1993	A
5188102	Idemoto et al.	Feb 1993	A
D334173	Liu et al.	Mar 1993	S
5190518	Takasu	Mar 1993	A
5190541	Abele et al.	Mar 1993	A
5196007	Ellman et al.	Mar 1993	A
5205459	Brinkerhoff et al.	Apr 1993	A
5205817	Idemoto et al.	Apr 1993	A
5209719	Baruch et al.	May 1993	A
5209776	Bass et al.	May 1993	A
5213103	Martin et al.	May 1993	A
5213569	Davis	May 1993	A
5214339	Naito	May 1993	A
5217460	Knoepfler	Jun 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
5234428	Kaufman	Aug 1993	A
5234436	Eaton et al.	Aug 1993	A
5241236	Sasaki et al.	Aug 1993	A
5241968	Slater	Sep 1993	A
5242385	Strukel	Sep 1993	A
5242460	Klein et al.	Sep 1993	A
5254129	Alexander	Oct 1993	A
5257988	L'Esperance, Jr.	Nov 1993	A
5258004	Bales et al.	Nov 1993	A
5258006	Rydell et al.	Nov 1993	A
5261922	Hood	Nov 1993	A
5263957	Davison	Nov 1993	A
5264925	Shipp et al.	Nov 1993	A
5269297	Weng et al.	Dec 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
5285945	Brinkerhoff et al.	Feb 1994	A
5289436	Terhune	Feb 1994	A
5290286	Parins	Mar 1994	A
5293863	Zhu et al.	Mar 1994	A
5300068	Rosar et al.	Apr 1994	A
5304115	Pflueger et al.	Apr 1994	A
5306280	Bregen et al.	Apr 1994	A
D347474	Olson	May 1994	S
5307976	Olson et al.	May 1994	A
5309927	Welch	May 1994	A
5312023	Green et al.	May 1994	A
5312327	Bales et al.	May 1994	A
5312425	Evans et al.	May 1994	A
5318525	West et al.	Jun 1994	A
5318563	Malis et al.	Jun 1994	A
5318564	Eggers	Jun 1994	A
5318570	Hood et al.	Jun 1994	A
5318589	Lichtman	Jun 1994	A
5322055	Davison et al.	Jun 1994	A
5323055	Yamazaki	Jun 1994	A
5324297	Hood 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
5330471	Eggers	Jul 1994	A
5330502	Hassler et al.	Jul 1994	A
5338292	Clement et al.	Aug 1994	A
5339723	Huitema	Aug 1994	A
5342292	Nita et al.	Aug 1994	A
5342359	Rydell	Aug 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
5354265	Mackool	Oct 1994	A
5356064	Green et al.	Oct 1994	A
5357164	Imabayashi et al.	Oct 1994	A
5357423	Weaver et al.	Oct 1994	A
5358506	Green et al.	Oct 1994	A
5359994	Krauter et al.	Nov 1994	A
5361583	Huitema	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
5372585	Tiefenbrun et al.	Dec 1994	A
5374813	Shipp	Dec 1994	A
D354564	Medema	Jan 1995	S
5381067	Greenstein et al.	Jan 1995	A
5383874	Jackson et al.	Jan 1995	A
5383883	Wilk et al.	Jan 1995	A
5387207	Dyer et al.	Feb 1995	A
5387215	Fisher	Feb 1995	A
5389098	Tsuruta et al.	Feb 1995	A
5391144	Sakurai et al.	Feb 1995	A
5394187	Shipp	Feb 1995	A
5395033	Byrne et al.	Mar 1995	A
5395312	Desai	Mar 1995	A
5395363	Billings et al.	Mar 1995	A
5395364	Anderhub et al.	Mar 1995	A
5396266	Brimhall	Mar 1995	A
5396900	Slater et al.	Mar 1995	A
5397293	Alliger et al.	Mar 1995	A
5400267	Denen et al.	Mar 1995	A
5403312	Yates et al.	Apr 1995	A
5403334	Evans et al.	Apr 1995	A
5406503	Williams, Jr. et al.	Apr 1995	A
5408268	Shipp	Apr 1995	A
5409453	Lundquist et al.	Apr 1995	A
D358887	Feinberg	May 1995	S
5411481	Allen et al.	May 1995	A
5413107	Oakley et al.	May 1995	A
5417709	Slater	May 1995	A
5419761	Narayanan et al.	May 1995	A
5421829	Olichney et al.	Jun 1995	A
5423844	Miller	Jun 1995	A
5428504	Bhatia	Jun 1995	A
5429131	Scheinman et al.	Jul 1995	A
5438997	Sieben et al.	Aug 1995	A
5441499	Fritzsch	Aug 1995	A
5443463	Stern et al.	Aug 1995	A
5445638	Rydell et al.	Aug 1995	A
5445639	Kuslich et al.	Aug 1995	A
5447509	Mills et al.	Sep 1995	A
5449370	Vaitekunas	Sep 1995	A
5451220	Ciervo	Sep 1995	A
5451227	Michaelson	Sep 1995	A
5456684	Schmidt et al.	Oct 1995	A
5458598	Feinberg et al.	Oct 1995	A
5462604	Shibano et al.	Oct 1995	A
5465895	Knodel et al.	Nov 1995	A
5471988	Fujio et al.	Dec 1995	A
5472443	Cordis et al.	Dec 1995	A
5476479	Green et al.	Dec 1995	A
5478003	Green et al.	Dec 1995	A
5480409	Riza	Jan 1996	A
5483501	Park et al.	Jan 1996	A
5484436	Eggers et al.	Jan 1996	A
5486162	Brumbach	Jan 1996	A
5486189	Mudry et al.	Jan 1996	A
5490860	Middle et al.	Feb 1996	A
5496317	Goble et al.	Mar 1996	A
5496411	Candy	Mar 1996	A
5499992	Meade et al.	Mar 1996	A
5500216	Julian et al.	Mar 1996	A
5501654	Failla et al.	Mar 1996	A
5504650	Katsui et al.	Apr 1996	A
5505693	Mackool	Apr 1996	A
5507738	Ciervo	Apr 1996	A
5509922	Aranyi et al.	Apr 1996	A
5511556	DeSantis	Apr 1996	A
5520704	Castro et al.	May 1996	A
5522832	Kugo et al.	Jun 1996	A
5522839	Pilling	Jun 1996	A
5527273	Manna et al.	Jun 1996	A
5527331	Kresch et al.	Jun 1996	A
5531744	Nardella et al.	Jul 1996	A
5540681	Strul et al.	Jul 1996	A
5540693	Fisher	Jul 1996	A
5542916	Hirsch et al.	Aug 1996	A
5553675	Pitzen et al.	Sep 1996	A
5558671	Yates	Sep 1996	A
5562609	Brumbach	Oct 1996	A
5562610	Brumbach	Oct 1996	A
5562659	Morris	Oct 1996	A
5562703	Desai	Oct 1996	A
5563179	Stone et al.	Oct 1996	A
5569164	Lurz	Oct 1996	A
5571121	Heifetz	Nov 1996	A
5573424	Poppe	Nov 1996	A
5573534	Stone	Nov 1996	A
5575799	Bolanos et al.	Nov 1996	A
5577654	Bishop	Nov 1996	A
5582618	Chin et al.	Dec 1996	A
5584830	Ladd et al.	Dec 1996	A
5591187	Dekel	Jan 1997	A
5593414	Shipp et al.	Jan 1997	A
5599350	Schulze et al.	Feb 1997	A
5601601	Tal et al.	Feb 1997	A
5603773	Campbell	Feb 1997	A
5607436	Pratt et al.	Mar 1997	A
5607450	Zvenyatsky et al.	Mar 1997	A
5609573	Sandock	Mar 1997	A
5611813	Lichtman	Mar 1997	A
5618304	Hart et al.	Apr 1997	A
5618307	Donlon et al.	Apr 1997	A
5618492	Auten et al.	Apr 1997	A
5620447	Smith et al.	Apr 1997	A
5624452	Yates	Apr 1997	A
5626578	Tihon	May 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
5632432	Schulze et al.	May 1997	A
5632717	Yoon	May 1997	A
5640741	Yano	Jun 1997	A
D381077	Hunt	Jul 1997	S
5643301	Mollenauer	Jul 1997	A
5647851	Pokras	Jul 1997	A
5647871	Levine et al.	Jul 1997	A
5649937	Bito et al.	Jul 1997	A
5649955	Hashimoto et al.	Jul 1997	A
5651780	Jackson et al.	Jul 1997	A
5653713	Michelson	Aug 1997	A
5658281	Heard	Aug 1997	A
5662662	Bishop et al.	Sep 1997	A
5662667	Knodel	Sep 1997	A
5665085	Nardella	Sep 1997	A
5665100	Yoon	Sep 1997	A
5669922	Hood	Sep 1997	A
5674219	Monson et al.	Oct 1997	A
5674220	Fox et al.	Oct 1997	A
5674235	Parisi	Oct 1997	A
5678568	Uchikubo et al.	Oct 1997	A
5688270	Yates et al.	Nov 1997	A
5690269	Bolanos et al.	Nov 1997	A
5693051	Schulze et al.	Dec 1997	A
5694936	Fujimoto et al.	Dec 1997	A
5695510	Hood	Dec 1997	A
5700261	Brinkerhoff	Dec 1997	A
5704534	Huitema et al.	Jan 1998	A
5704791	Gillio	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
5716366	Yates	Feb 1998	A
5717306	Shipp	Feb 1998	A
5720742	Zacharias	Feb 1998	A
5720744	Eggleston et al.	Feb 1998	A
5722980	Schulz et al.	Mar 1998	A
5728130	Ishikawa et al.	Mar 1998	A
5730752	Alden et al.	Mar 1998	A
5733074	Stock et al.	Mar 1998	A
5735848	Yates et al.	Apr 1998	A
5735875	Bonutti et al.	Apr 1998	A
5741226	Strukel et al.	Apr 1998	A
5743906	Parins et al.	Apr 1998	A
5752973	Kieturakis	May 1998	A
5755717	Yates et al.	May 1998	A
5762255	Chrisman et al.	Jun 1998	A
5766164	Mueller et al.	Jun 1998	A
5772659	Becker et al.	Jun 1998	A
5776130	Buysse et al.	Jul 1998	A
5776155	Beaupre et al.	Jul 1998	A
5779130	Alesi et al.	Jul 1998	A
5779701	McBrayer et al.	Jul 1998	A
5782834	Lucey et al.	Jul 1998	A
5792135	Madhani et al.	Aug 1998	A
5792138	Shipp	Aug 1998	A
5792165	Klieman et al.	Aug 1998	A
5796188	Bays	Aug 1998	A
5797941	Schulze et al.	Aug 1998	A
5797959	Castro et al.	Aug 1998	A
5800432	Swanson	Sep 1998	A
5800448	Banko	Sep 1998	A
5800449	Wales	Sep 1998	A
5805140	Rosenberg et al.	Sep 1998	A
5807310	Hood	Sep 1998	A
5807393	Williamson, IV et al.	Sep 1998	A
5808396	Boukhny	Sep 1998	A
5810811	Yates et al.	Sep 1998	A
5810828	Lightman et al.	Sep 1998	A
5810859	DiMatteo et al.	Sep 1998	A
5810869	Kaplan et al.	Sep 1998	A
5817033	DeSantis et al.	Oct 1998	A
5817084	Jensen	Oct 1998	A
5817093	Williamson, IV et al.	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
5836909	Cosmescu	Nov 1998	A
5836943	Miller, III	Nov 1998	A
5836957	Schulz et al.	Nov 1998	A
5836990	Li	Nov 1998	A
5843109	Mehta et al.	Dec 1998	A
5851212	Zirps et al.	Dec 1998	A
5853290	Winston	Dec 1998	A
5853412	Mayenberger	Dec 1998	A
5858018	Shipp et al.	Jan 1999	A
5865361	Milliman et al.	Feb 1999	A
5873873	Smith et al.	Feb 1999	A
5873882	Straub et al.	Feb 1999	A
5876401	Schulze et al.	Mar 1999	A
5878193	Wang et al.	Mar 1999	A
5879363	Urich	Mar 1999	A
5879364	Bromfield et al.	Mar 1999	A
5880668	Hall	Mar 1999	A
5883615	Fago et al.	Mar 1999	A
5891142	Eggers et al.	Apr 1999	A
5893835	Witt et al.	Apr 1999	A
5893880	Egan et al.	Apr 1999	A
5895412	Tucker	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
5906625	Bito et al.	May 1999	A
5906627	Spaulding	May 1999	A
5906628	Miyawaki et al.	May 1999	A
5910129	Koblish et al.	Jun 1999	A
5910150	Saadat	Jun 1999	A
5911699	Anis et al.	Jun 1999	A
5916229	Evans	Jun 1999	A
5921956	Grinberg et al.	Jul 1999	A
5929846	Rosenberg et al.	Jul 1999	A
5935143	Hood	Aug 1999	A
5935144	Estabrook	Aug 1999	A
5938633	Beaupre	Aug 1999	A
5941887	Steen et al.	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
5971949	Levin et al.	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
5984938	Yoon	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
6001120	Levin	Dec 1999	A
6003517	Sheffield et al.	Dec 1999	A
6004335	Vaitekunas et al.	Dec 1999	A
6007552	Fogarty et al.	Dec 1999	A
6013052	Durman et al.	Jan 2000	A
6024741	Williamson, IV et al.	Feb 2000	A
6024744	Kese 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
6039734	Goble	Mar 2000	A
6048224	Kay	Apr 2000	A
6050943	Slayton et al.	Apr 2000	A
6050996	Schmaltz et al.	Apr 2000	A
6051010	DiMatteo et al.	Apr 2000	A
6053906	Honda et al.	Apr 2000	A
6056735	Okada et al.	May 2000	A
6063050	Manna 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
6068629	Haissaguerre et al.	May 2000	A
6068647	Witt et al.	May 2000	A
6074389	Levine et al.	Jun 2000	A
6077285	Boukhny	Jun 2000	A
6083191	Rose	Jul 2000	A
6086544	Hibner et al.	Jul 2000	A
6086584	Miller	Jul 2000	A
6090120	Wright et al.	Jul 2000	A
6091995	Ingle et al.	Jul 2000	A
6096033	Tu et al.	Aug 2000	A
6099483	Palmer et al.	Aug 2000	A
6099542	Cohn et al.	Aug 2000	A
6099550	Yoon	Aug 2000	A
6109500	Alli et al.	Aug 2000	A
6110127	Suzuki	Aug 2000	A
6113594	Savage	Sep 2000	A
6113598	Baker	Sep 2000	A
6117152	Huitema	Sep 2000	A
6120519	Weber et al.	Sep 2000	A
H1904	Yates et al.	Oct 2000	H
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
6144402	Norsworthy et al.	Nov 2000	A
6147560	Erhage et al.	Nov 2000	A
6152902	Christian et al.	Nov 2000	A
6152923	Ryan	Nov 2000	A
6154198	Rosenberg	Nov 2000	A
6156029	Mueller	Dec 2000	A
6159160	Hsei et al.	Dec 2000	A
6159175	Strukel et al.	Dec 2000	A
6162194	Shipp	Dec 2000	A
6162208	Hipps	Dec 2000	A
6165150	Banko	Dec 2000	A
6165186	Fogarty et al.	Dec 2000	A
6165191	Shibata et al.	Dec 2000	A
6174309	Wrublewski et al.	Jan 2001	B1
6174310	Kirwan, Jr.	Jan 2001	B1
6176857	Ashley	Jan 2001	B1
6179853	Sachse et al.	Jan 2001	B1
6183426	Akisada et al.	Feb 2001	B1
6187003	Buysse et al.	Feb 2001	B1
6190386	Rydell	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
6206876	Levine et al.	Mar 2001	B1
6206877	Kese 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
6217591	Egan et al.	Apr 2001	B1
6228080	Gines	May 2001	B1
6228104	Fogarty et al.	May 2001	B1
6231565	Tovey et al.	May 2001	B1
6233476	Strommer et al.	May 2001	B1
6238366	Savage et al.	May 2001	B1
6241724	Fleischman et al.	Jun 2001	B1
6245065	Panescu et al.	Jun 2001	B1
6251110	Wampler	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
6259230	Chou	Jul 2001	B1
6267761	Ryan	Jul 2001	B1
6270471	Hechel et al.	Aug 2001	B1
6270831	Kumar et al.	Aug 2001	B2
6273852	Lehe et al.	Aug 2001	B1
6273902	Fogarty et al.	Aug 2001	B1
6274963	Estabrook et al.	Aug 2001	B1
6277115	Saadat	Aug 2001	B1
6277117	Tetzlaff et al.	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
6292700	Morrison et al.	Sep 2001	B1
6293954	Fogarty et al.	Sep 2001	B1
6299591	Banko	Oct 2001	B1
6299621	Fogarty et al.	Oct 2001	B1
6306131	Hareyama et al.	Oct 2001	B1
6306157	Shchervinsky	Oct 2001	B1
6309400	Beaupre	Oct 2001	B2
6311783	Harpell	Nov 2001	B1
6312445	Fogarty et al.	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
6333488	Lawrence et al.	Dec 2001	B1
6338657	Harper et al.	Jan 2002	B1
6340352	Okada et al.	Jan 2002	B1
6340878	Oglesbee	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
6387094	Eitenmuller	May 2002	B1
6387109	Davison et al.	May 2002	B1
6387112	Fogarty et al.	May 2002	B1
6388657	Natoli	May 2002	B1
6391026	Hung et al.	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
6409722	Hoey et al.	Jun 2002	B1
6409743	Fenton, Jr.	Jun 2002	B1
H2037	Yates et al.	Jul 2002	H
6416469	Phung et al.	Jul 2002	B1
6416486	Wampler	Jul 2002	B1
6416525	Shibata	Jul 2002	B1
6419675	Gallo, Sr.	Jul 2002	B1
6423073	Bowman	Jul 2002	B2
6423082	Houser et al.	Jul 2002	B1
6425906	Young et al.	Jul 2002	B1
6425907	Shibata et al.	Jul 2002	B1
6428538	Blewett et al.	Aug 2002	B1
6428539	Baxter et al.	Aug 2002	B1
6430446	Knowlton	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
6458128	Schulze	Oct 2002	B1
6458130	Frazier et al.	Oct 2002	B1
6458142	Faller et al.	Oct 2002	B1
6461363	Gadberry et al.	Oct 2002	B1
6464689	Qin et al.	Oct 2002	B1
6464702	Schulze et al.	Oct 2002	B2
6468286	Mastri et al.	Oct 2002	B2
6475211	Chess et al.	Nov 2002	B2
6475215	Tanrisever	Nov 2002	B1
6480796	Wiener	Nov 2002	B2
6485490	Wampler et al.	Nov 2002	B2
6491690	Goble et al.	Dec 2002	B1
6491701	Tierney et al.	Dec 2002	B2
6491708	Madan et al.	Dec 2002	B2
6497715	Satou	Dec 2002	B2
6498421	Oh et al.	Dec 2002	B1
6500112	Khouri	Dec 2002	B1
6500176	Truckai et al.	Dec 2002	B1
6500188	Harper et al.	Dec 2002	B2
6500312	Wedekamp	Dec 2002	B2
6503248	Levine	Jan 2003	B1
6506208	Hunt et al.	Jan 2003	B2
6511478	Burnside et al.	Jan 2003	B1
6511480	Tetzlaff et al.	Jan 2003	B1
6511493	Moutafis et al.	Jan 2003	B1
6514252	Nezhat et al.	Feb 2003	B2
6514267	Jewett	Feb 2003	B2
6517565	Whitman et al.	Feb 2003	B1
6524251	Rabiner et al.	Feb 2003	B2
6524316	Nicholson et al.	Feb 2003	B1
6526976	Baran	Mar 2003	B1
6527736	Attinger et al.	Mar 2003	B1
6531846	Smith	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
6551309	LePivert	Apr 2003	B1
6554829	Schulze et al.	Apr 2003	B2
6558376	Bishop	May 2003	B2
6561983	Cronin et al.	May 2003	B2
6562035	Levin	May 2003	B1
6562037	Paton et al.	May 2003	B2
6562059	Edwards et al.	May 2003	B2
6565558	Lindenmeier et al.	May 2003	B1
6569109	Sakurai et al.	May 2003	B2
6569178	Miyawaki et al.	May 2003	B1
6572563	Ouchi	Jun 2003	B2
6572632	Zisterer et al.	Jun 2003	B2
6572639	Ingle et al.	Jun 2003	B1
6575929	Sussman 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
6584360	Francischelli et al.	Jun 2003	B2
D477408	Bromley	Jul 2003	S
6585735	Frazier et al.	Jul 2003	B1
6588277	Giordano et al.	Jul 2003	B2
6589200	Schwemberger et al.	Jul 2003	B1
6589239	Khandkar et al.	Jul 2003	B2
6599288	Maguire et al.	Jul 2003	B2
6602229	Coss	Aug 2003	B2
6602252	Mollenauer	Aug 2003	B2
6607540	Shipp	Aug 2003	B1
6610059	West, Jr.	Aug 2003	B1
6610060	Mulier et al.	Aug 2003	B2
6616450	Mossle et al.	Sep 2003	B2
6619529	Green et al.	Sep 2003	B2
6620161	Schulze et al.	Sep 2003	B2
6622731	Daniel et al.	Sep 2003	B2
6623444	Babaev	Sep 2003	B2
6623482	Pendekanti 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
6635057	Harano et al.	Oct 2003	B2
6644532	Green et al.	Nov 2003	B2
6648839	Manna et al.	Nov 2003	B2
6648883	Francischelli et al.	Nov 2003	B2
6651669	Burnside	Nov 2003	B1
6652513	Panescu et al.	Nov 2003	B2
6652539	Shipp et al.	Nov 2003	B2
6652545	Shipp et al.	Nov 2003	B2
6656124	Flesch et al.	Dec 2003	B2
6656132	Ouchi	Dec 2003	B1
6656177	Truckai et al.	Dec 2003	B2
6656198	Tsonton 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
6669696	Bacher et al.	Dec 2003	B2
6669710	Moutafis et al.	Dec 2003	B2
6673248	Chowdhury	Jan 2004	B2
6676660	Wampler et al.	Jan 2004	B2
6678621	Wiener et al.	Jan 2004	B2
6679875	Honda et al.	Jan 2004	B2
6679882	Kornerup	Jan 2004	B1
6679899	Wiener et al.	Jan 2004	B2
6682501	Nelson et al.	Jan 2004	B1
6682544	Mastri et al.	Jan 2004	B2
6685701	Orszulak et al.	Feb 2004	B2
6685703	Pearson et al.	Feb 2004	B2
6689086	Nita et al.	Feb 2004	B1
6689145	Lee et al.	Feb 2004	B2
6689146	Himes	Feb 2004	B1
6690960	Chen et al.	Feb 2004	B2
6695782	Ranucci et al.	Feb 2004	B2
6695840	Schulze	Feb 2004	B2
6699214	Gellman	Mar 2004	B2
6702761	Damadian et al.	Mar 2004	B1
6702821	Bonutti	Mar 2004	B2
6712805	Weimann	Mar 2004	B2
6716215	David et al.	Apr 2004	B1
6719692	Kleffner et al.	Apr 2004	B2
6719765	Bonutti	Apr 2004	B2
6719766	Buelna et al.	Apr 2004	B1
6719776	Baxter et al.	Apr 2004	B2
6722552	Fenton, Jr.	Apr 2004	B2
6723091	Goble et al.	Apr 2004	B2
D490059	Conway et al.	May 2004	S
6731047	Kauf et al.	May 2004	B2
6733498	Paton et al.	May 2004	B2
6733506	McDevitt et al.	May 2004	B1
6736813	Yamauchi et al.	May 2004	B2
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
6752154	Fogarty et al.	Jun 2004	B2
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
6766202	Underwood et al.	Jul 2004	B2
6770072	Truckai et al.	Aug 2004	B1
6773409	Truckai et al.	Aug 2004	B2
6773434	Ciarrocca	Aug 2004	B2
6773435	Schulze et al.	Aug 2004	B2
6773443	Truwit et al.	Aug 2004	B2
6773444	Messerly	Aug 2004	B2
6775575	Bommannan et al.	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
6789939	Schrodinger et al.	Sep 2004	B2
6790173	Saadat et al.	Sep 2004	B2
6790216	Ishikawa	Sep 2004	B1
6794027	Araki et al.	Sep 2004	B1
6796981	Wham et al.	Sep 2004	B2
D496997	Dycus et al.	Oct 2004	S
6800085	Selmon et al.	Oct 2004	B2
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
6811842	Ehrnsperger et al.	Nov 2004	B1
6814731	Swanson	Nov 2004	B2
6821273	Mollenauer	Nov 2004	B2
6827712	Tovey et al.	Dec 2004	B2
6828712	Battaglin et al.	Dec 2004	B2
6832988	Sproul	Dec 2004	B2
6835082	Gonnering	Dec 2004	B2
6835199	McGuckin, Jr. et al.	Dec 2004	B2
6840938	Morley et al.	Jan 2005	B1
6849073	Hoey et al.	Feb 2005	B2
6860878	Brock	Mar 2005	B2
6860880	Treat et al.	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
6887221	Baillargeon et al.	May 2005	B1
6887252	Okada et al.	May 2005	B1
6893435	Goble	May 2005	B2
6899685	Kermode et al.	May 2005	B2
6905497	Truckai et al.	Jun 2005	B2
6908463	Treat et al.	Jun 2005	B2
6908466	Bonutti et al.	Jun 2005	B1
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
6926717	Garito et al.	Aug 2005	B1
6929602	Hirakui et al.	Aug 2005	B2
6929622	Chian	Aug 2005	B2
6929632	Nita et al.	Aug 2005	B2
6929644	Truckai et al.	Aug 2005	B2
6932876	Statnikov	Aug 2005	B1
6933656	Matsushita et al.	Aug 2005	B2
D509589	Wells	Sep 2005	S
6942660	Pantera et al.	Sep 2005	B2
6942676	Buelna	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
6953461	McClurken et al.	Oct 2005	B2
6958070	Witt et al.	Oct 2005	B2
D511145	Donofrio et al.	Nov 2005	S
6974450	Weber et al.	Dec 2005	B2
6976844	Hickok et al.	Dec 2005	B2
6976969	Messerly	Dec 2005	B2
6977495	Donofrio	Dec 2005	B2
6979332	Adams	Dec 2005	B2
6981628	Wales	Jan 2006	B2
6984220	Wuchinich	Jan 2006	B2
6988295	Tillim	Jan 2006	B2
6989017	Howell et al.	Jan 2006	B2
6994708	Manzo	Feb 2006	B2
6994709	Iida	Feb 2006	B2
7000818	Shelton, IV et al.	Feb 2006	B2
7001335	Adachi et al.	Feb 2006	B2
7001382	Gallo, Sr.	Feb 2006	B2
7002283	Li et al.	Feb 2006	B2
7004951	Gibbens, III	Feb 2006	B2
7011657	Truckai et al.	Mar 2006	B2
7014638	Michelson	Mar 2006	B2
7018354	Tazi	Mar 2006	B2
7018389	Camerlengo	Mar 2006	B2
7033357	Baxter et al.	Apr 2006	B2
7037306	Podany et al.	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
7052494	Goble et al.	May 2006	B2
7052496	Yamauchi	May 2006	B2
7055731	Shelton, IV et al.	Jun 2006	B2
7063699	Hess et al.	Jun 2006	B2
7066893	Hibner et al.	Jun 2006	B2
7066895	Podany	Jun 2006	B2
7066936	Ryan	Jun 2006	B2
7070597	Truckai et al.	Jul 2006	B2
7074218	Washington et al.	Jul 2006	B2
7074219	Levine et al.	Jul 2006	B2
7077036	Adams	Jul 2006	B1
7077039	Gass et al.	Jul 2006	B2
7077845	Hacker et al.	Jul 2006	B2
7077853	Kramer et al.	Jul 2006	B2
7083075	Swayze et al.	Aug 2006	B2
7083618	Couture et al.	Aug 2006	B2
7083619	Truckai et al.	Aug 2006	B2
7087054	Truckai et al.	Aug 2006	B2
7090672	Underwood et al.	Aug 2006	B2
7094235	Francischelli	Aug 2006	B2
7101371	Dycus et al.	Sep 2006	B2
7101372	Dycus et al.	Sep 2006	B2
7101373	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
7118570	Tetzlaff et al.	Oct 2006	B2
7119516	Denning	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
7131970	Moses et al.	Nov 2006	B2
7131983	Murakami	Nov 2006	B2
7135018	Ryan et al.	Nov 2006	B2
7135029	Makin et al.	Nov 2006	B2
7135030	Schwemberger et al.	Nov 2006	B2
7137980	Buysse et al.	Nov 2006	B2
7143925	Shelton, IV et al.	Dec 2006	B2
7144403	Booth	Dec 2006	B2
7147138	Shelton, IV	Dec 2006	B2
7153315	Miller	Dec 2006	B2
D536093	Nakajima et al.	Jan 2007	S
7156189	Bar-Cohen et al.	Jan 2007	B1
7156201	Peshkovskiy et al.	Jan 2007	B2
7156846	Dycus et al.	Jan 2007	B2
7156853	Muratsu	Jan 2007	B2
7157058	Marhasin et al.	Jan 2007	B2
7159750	Racenet et al.	Jan 2007	B2
7160259	Tardy et al.	Jan 2007	B2
7160296	Pearson et al.	Jan 2007	B2
7160298	Lawes 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
7169156	Hart	Jan 2007	B2
7179254	Pendekanti et al.	Feb 2007	B2
7179271	Friedman et al.	Feb 2007	B2
7182762	Bortkiewicz	Feb 2007	B2
7186253	Truckai et al.	Mar 2007	B2
7189233	Truckai et al.	Mar 2007	B2
7195631	Dumbauld	Mar 2007	B2
D541418	Schechter et al.	Apr 2007	S
7198635	Danek et al.	Apr 2007	B2
7204820	Akahoshi	Apr 2007	B2
7207471	Heinrich et al.	Apr 2007	B2
7207997	Shipp et al.	Apr 2007	B2
7208005	Frecker 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
7225964	Mastri et al.	Jun 2007	B2
7226448	Bertolero et al.	Jun 2007	B2
7229455	Sakurai et al.	Jun 2007	B2
7232440	Dumbauld et al.	Jun 2007	B2
7235071	Gonnering	Jun 2007	B2
7235073	Levine et al.	Jun 2007	B2
7241294	Reschke	Jul 2007	B2
7244262	Wiener et al.	Jul 2007	B2
7251531	Mosher et al.	Jul 2007	B2
7252667	Moses et al.	Aug 2007	B2
7258688	Shah et al.	Aug 2007	B1
7264618	Murakami et al.	Sep 2007	B2
7267677	Johnson et al.	Sep 2007	B2
7267685	Butaric et al.	Sep 2007	B2
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
7282836	Kwon et al.	Oct 2007	B2
7285895	Beaupre	Oct 2007	B2
7287682	Ezzat et al.	Oct 2007	B1
7300431	Dubrovsky	Nov 2007	B2
7300435	Wham et al.	Nov 2007	B2
7300446	Beaupre	Nov 2007	B2
7300450	Vleugels et al.	Nov 2007	B2
7303531	Lee et al.	Dec 2007	B2
7303557	Wham et al.	Dec 2007	B2
7306597	Manzo	Dec 2007	B2
7307313	Ohyanagi et al.	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
7318832	Young et al.	Jan 2008	B2
7326236	Andreas et al.	Feb 2008	B2
7329257	Kanehira 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
7338463	Vigil	Mar 2008	B2
7353068	Tanaka et al.	Apr 2008	B2
7354440	Truckal et al.	Apr 2008	B2
7357287	Shelton, IV et al.	Apr 2008	B2
7361172	Cimino	Apr 2008	B2
7364577	Wham et al.	Apr 2008	B2
7367976	Lawes et al.	May 2008	B2
7371227	Zeiner	May 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
7384420	Dycus et al.	Jun 2008	B2
7390317	Taylor et al.	Jun 2008	B2
7396356	Mollenauer	Jul 2008	B2
7403224	Fuller et al.	Jul 2008	B2
7404508	Smith et al.	Jul 2008	B2
7407077	Ortiz et al.	Aug 2008	B2
7408288	Hara	Aug 2008	B2
7413123	Ortenzi	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
7431694	Stefanchik et al.	Oct 2008	B2
7431704	Babaev	Oct 2008	B2
7435582	Zimmermann et al.	Oct 2008	B2
7441684	Shelton, IV et al.	Oct 2008	B2
7442168	Novak et al.	Oct 2008	B2
7442193	Shields et al.	Oct 2008	B2
7445621	Dumbauld et al.	Nov 2008	B2
7449004	Yamada et al.	Nov 2008	B2
7451904	Shelton, IV	Nov 2008	B2
7455208	Wales et al.	Nov 2008	B2
7455641	Yamada 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
7473253	Dycus 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
7488319	Yates	Feb 2009	B2
7491201	Shields et al.	Feb 2009	B2
7491202	Odom et al.	Feb 2009	B2
7494468	Rabiner et al.	Feb 2009	B2
7494501	Ahlberg et al.	Feb 2009	B2
7498080	Tung et al.	Mar 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
7510107	Timm et al.	Mar 2009	B2
7510556	Nguyen et al.	Mar 2009	B2
7513025	Fischer	Apr 2009	B2
7517349	Truckai et al.	Apr 2009	B2
7520865	Radley Young et al.	Apr 2009	B2
7524320	Tierney et al.	Apr 2009	B2
7530986	Beaupre et al.	May 2009	B2
7533830	Rose	May 2009	B1
7534243	Chin et al.	May 2009	B1
D594983	Price et al.	Jun 2009	S
7540871	Gonnering	Jun 2009	B2
7540872	Schechter et al.	Jun 2009	B2
7543730	Marczyk	Jun 2009	B1
7544200	Houser	Jun 2009	B2
7549564	Boudreaux	Jun 2009	B2
7550216	Ofer et al.	Jun 2009	B2
7553309	Buysse et al.	Jun 2009	B2
7559450	Wales et al.	Jul 2009	B2
7559452	Wales et al.	Jul 2009	B2
7563259	Takahashi	Jul 2009	B2
7563269	Hashiguchi	Jul 2009	B2
7566318	Haefner	Jul 2009	B2
7567012	Namikawa	Jul 2009	B2
7568603	Shelton, IV et al.	Aug 2009	B2
7569057	Liu et al.	Aug 2009	B2
7572266	Young et al.	Aug 2009	B2
7572268	Babaev	Aug 2009	B2
7578166	Ethridge et al.	Aug 2009	B2
7578820	Moore et al.	Aug 2009	B2
7582084	Swanson et al.	Sep 2009	B2
7582086	Privitera et al.	Sep 2009	B2
7582095	Shipp et al.	Sep 2009	B2
7585181	Olsen	Sep 2009	B2
7586289	Andruk et al.	Sep 2009	B2
7587536	McLeod	Sep 2009	B2
7588176	Timm et al.	Sep 2009	B2
7588177	Racenet	Sep 2009	B2
7594925	Danek et al.	Sep 2009	B2
7597693	Garrison	Oct 2009	B2
7601119	Shahinian	Oct 2009	B2
7604150	Boudreaux	Oct 2009	B2
7607557	Shelton, IV et al.	Oct 2009	B2
7608054	Soring et al.	Oct 2009	B2
7617961	Viola	Nov 2009	B2
7621930	Houser	Nov 2009	B2
7625370	Hart et al.	Dec 2009	B2
7627936	Bromfield	Dec 2009	B2
7628791	Garrison et al.	Dec 2009	B2
7628792	Guerra	Dec 2009	B2
7632267	Dahla	Dec 2009	B2
7632269	Truckai et al.	Dec 2009	B2
7637410	Marczyk	Dec 2009	B2
7641653	Dalla Betta et al.	Jan 2010	B2
7641671	Crainich	Jan 2010	B2
7644848	Swayze et al.	Jan 2010	B2
7645245	Sekino et al.	Jan 2010	B2
7645277	McClurken et al.	Jan 2010	B2
7645278	Ichihashi et al.	Jan 2010	B2
7648499	Orszulak et al.	Jan 2010	B2
7654431	Hueil et al.	Feb 2010	B2
7658311	Boudreaux	Feb 2010	B2
7659833	Warner et al.	Feb 2010	B2
7662151	Crompton, Jr. et al.	Feb 2010	B2
7665647	Shelton, IV et al.	Feb 2010	B2
7666206	Taniguchi 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
7686763	Vaezy et al.	Mar 2010	B2
7686770	Cohen	Mar 2010	B2
7686826	Lee et al.	Mar 2010	B2
7688028	Phillips et al.	Mar 2010	B2
7691095	Bednarek et al.	Apr 2010	B2
7691098	Wallace et al.	Apr 2010	B2
7696670	Sakamoto	Apr 2010	B2
7699846	Ryan	Apr 2010	B2
7703459	Saadat et al.	Apr 2010	B2
7703653	Shah et al.	Apr 2010	B2
7708735	Chapman et al.	May 2010	B2
7708751	Hughes et al.	May 2010	B2
7708758	Lee et al.	May 2010	B2
7713202	Boukhny et al.	May 2010	B2
7713267	Pozzato	May 2010	B2
7714481	Sakai	May 2010	B2
7717312	Beetel	May 2010	B2
7717914	Kimura	May 2010	B2
7717915	Miyazawa	May 2010	B2
7721935	Racenet et al.	May 2010	B2
7722527	Bouchier et al.	May 2010	B2
7722607	Dumbauld et al.	May 2010	B2
D618797	Price et al.	Jun 2010	S
7726537	Olson et al.	Jun 2010	B2
7727177	Bayat	Jun 2010	B2
7734476	Wildman et al.	Jun 2010	B2
7738969	Bleich	Jun 2010	B2
7740594	Hibner	Jun 2010	B2
7749240	Takahashi et al.	Jul 2010	B2
7749273	Cauthen, III et al.	Jul 2010	B2
7751115	Song	Jul 2010	B2
7753904	Shelton, IV et al.	Jul 2010	B2
7753908	Swanson	Jul 2010	B2
7762445	Heinrich et al.	Jul 2010	B2
7762979	Wuchinich	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
7766910	Hixson 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
7776036	Schechter et al.	Aug 2010	B2
7776037	Odom	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
7780663	Yates et al.	Aug 2010	B2
7784662	Wales et al.	Aug 2010	B2
7784663	Shelton, IV	Aug 2010	B2
7789883	Takashino et al.	Sep 2010	B2
7793814	Racenet et al.	Sep 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
7803156	Eder et al.	Sep 2010	B2
7803168	Gifford 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
7815641	Dodde et al.	Oct 2010	B2
7815658	Murakami	Oct 2010	B2
7819298	Hall et al.	Oct 2010	B2
7819299	Shelton, IV et al.	Oct 2010	B2
7819819	Quick et al.	Oct 2010	B2
7819872	Johnson et al.	Oct 2010	B2
7821143	Wiener	Oct 2010	B2
D627066	Romero	Nov 2010	S
7824401	Manzo et al.	Nov 2010	B2
7828808	Hinman et al.	Nov 2010	B2
7832408	Shelton, IV et al.	Nov 2010	B2
7832611	Boyden et al.	Nov 2010	B2
7832612	Baxter, III et al.	Nov 2010	B2
7834484	Sartor	Nov 2010	B2
7834521	Habu et al.	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
7846159	Morrison et al.	Dec 2010	B2
7846160	Payne 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
7867228	Nobis et al.	Jan 2011	B2
7871392	Sartor	Jan 2011	B2
7871423	Livneh	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
7879035	Garrison et al.	Feb 2011	B2
7879070	Ortiz et al.	Feb 2011	B2
7883465	Donofrio et al.	Feb 2011	B2
7883475	Dupont et al.	Feb 2011	B2
7892606	Thies et al.	Feb 2011	B2
7896875	Heim et al.	Mar 2011	B2
7897792	Iikura et al.	Mar 2011	B2
7901400	Wham et al.	Mar 2011	B2
7901423	Stulen et al.	Mar 2011	B2
7905881	Masuda et al.	Mar 2011	B2
7909220	Viola	Mar 2011	B2
7909824	Masuda et al.	Mar 2011	B2
7918848	Lau et al.	Apr 2011	B2
7919184	Mohapatra et al.	Apr 2011	B2
7922061	Shelton, IV et al.	Apr 2011	B2
7922651	Yamada et al.	Apr 2011	B2
7922716	Malecki et al.	Apr 2011	B2
7931611	Novak et al.	Apr 2011	B2
7931649	Couture et al.	Apr 2011	B2
D637288	Houghton	May 2011	S
D638540	Ijiri et al.	May 2011	S
7935114	Takashino et al.	May 2011	B2
7936203	Zimlich	May 2011	B2
7951095	Makin et al.	May 2011	B2
7951165	Golden et al.	May 2011	B2
7955331	Truckai et al.	Jun 2011	B2
7959050	Smith et al.	Jun 2011	B2
7959626	Hong et al.	Jun 2011	B2
7963963	Francischelli et al.	Jun 2011	B2
7967602	Lindquist	Jun 2011	B2
7972329	Refior et al.	Jul 2011	B2
7976544	McClurken et al.	Jul 2011	B2
7980443	Scheib et al.	Jul 2011	B2
7981050	Ritchart et al.	Jul 2011	B2
7981113	Truckai et al.	Jul 2011	B2
7997278	Utley et al.	Aug 2011	B2
7998157	Culp et al.	Aug 2011	B2
8002732	Visconti	Aug 2011	B2
8006358	Cooke et al.	Aug 2011	B2
8016843	Escaf	Sep 2011	B2
8020743	Shelton, IV	Sep 2011	B2
8025630	Murakami et al.	Sep 2011	B2
8028885	Smith et al.	Oct 2011	B2
8033173	Ehlert et al.	Oct 2011	B2
8038693	Allen	Oct 2011	B2
8048011	Okabe	Nov 2011	B2
8048070	O'Brien et al.	Nov 2011	B2
8052672	Laufer et al.	Nov 2011	B2
8056720	Hawkes	Nov 2011	B2
8057467	Faller et al.	Nov 2011	B2
8057468	Konesky	Nov 2011	B2
8057498	Robertson	Nov 2011	B2
8058771	Giordano et al.	Nov 2011	B2
8061014	Smith et al.	Nov 2011	B2
8066167	Measamer et al.	Nov 2011	B2
8070036	Knodel	Dec 2011	B1
8070711	Bassinger et al.	Dec 2011	B2
8070762	Escudero et al.	Dec 2011	B2
8075555	Truckai et al.	Dec 2011	B2
8075558	Truckai et al.	Dec 2011	B2
8089197	Rinner et al.	Jan 2012	B2
8092475	Cotter et al.	Jan 2012	B2
8097012	Kagarise	Jan 2012	B2
8100894	Mucko et al.	Jan 2012	B2
8105230	Honda et al.	Jan 2012	B2
8105323	Buysse et al.	Jan 2012	B2
8105324	Palanker et al.	Jan 2012	B2
8114104	Young et al.	Feb 2012	B2
8128624	Couture et al.	Mar 2012	B2
8133218	Daw et al.	Mar 2012	B2
8136712	Zingman	Mar 2012	B2
8137263	Marescaux et al.	Mar 2012	B2
8141762	Bedi et al.	Mar 2012	B2
8142421	Cooper et al.	Mar 2012	B2
8142461	Houser et al.	Mar 2012	B2
8147488	Masuda	Apr 2012	B2
8147508	Madan et al.	Apr 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
8182501	Houser et al.	May 2012	B2
8182502	Stulen et al.	May 2012	B2
8186560	Hess et al.	May 2012	B2
8186877	Klimovitch et al.	May 2012	B2
8187267	Pappone 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
8197479	Olson et al.	Jun 2012	B2
8197502	Smith et al.	Jun 2012	B2
8207651	Gilbert	Jun 2012	B2
8210411	Yates et al.	Jul 2012	B2
8221306	Okada et al.	Jul 2012	B2
8221415	Francischelli	Jul 2012	B2
8226665	Cohen	Jul 2012	B2
8226675	Houser et al.	Jul 2012	B2
8231607	Takuma	Jul 2012	B2
8235917	Joseph et al.	Aug 2012	B2
8236018	Yoshimine et al.	Aug 2012	B2
8236019	Houser	Aug 2012	B2
8236020	Smith et al.	Aug 2012	B2
8241235	Kahler et al.	Aug 2012	B2
8241271	Millman et al.	Aug 2012	B2
8241282	Unger et al.	Aug 2012	B2
8241283	Guerra et al.	Aug 2012	B2
8241284	Dycus et al.	Aug 2012	B2
8241312	Messerly	Aug 2012	B2
8246575	Viola	Aug 2012	B2
8246615	Behnke	Aug 2012	B2
8246618	Bucciaglia et al.	Aug 2012	B2
8246642	Houser et al.	Aug 2012	B2
8251994	McKenna et al.	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
8262563	Bakos et al.	Sep 2012	B2
8267300	Boudreaux	Sep 2012	B2
8273087	Kimura et al.	Sep 2012	B2
D669992	Schafer et al.	Oct 2012	S
D669993	Merchant et al.	Oct 2012	S
8277446	Heard	Oct 2012	B2
8277447	Garrison et al.	Oct 2012	B2
8277471	Wiener et al.	Oct 2012	B2
8282581	Zhao et al.	Oct 2012	B2
8282669	Gerber et al.	Oct 2012	B2
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
8292886	Kerr et al.	Oct 2012	B2
8292888	Whitman	Oct 2012	B2
8298223	Wham et al.	Oct 2012	B2
8298225	Gilbert	Oct 2012	B2
8298232	Unger	Oct 2012	B2
8298233	Mueller	Oct 2012	B2
8303576	Brock	Nov 2012	B2
8303580	Wham et al.	Nov 2012	B2
8303583	Hosier et al.	Nov 2012	B2
8303613	Crandall et al.	Nov 2012	B2
8306629	Mioduski et al.	Nov 2012	B2
8308040	Huang et al.	Nov 2012	B2
8319400	Houser et al.	Nov 2012	B2
8323302	Robertson et al.	Dec 2012	B2
8323310	Kingsley	Dec 2012	B2
8328061	Kasvikis	Dec 2012	B2
8328761	Widenhouse et al.	Dec 2012	B2
8328802	Deville et al.	Dec 2012	B2
8328833	Cuny	Dec 2012	B2
8328834	Isaacs 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
8343146	Godara et al.	Jan 2013	B2
8344596	Nield et al.	Jan 2013	B2
8348880	Messerly et al.	Jan 2013	B2
8348967	Stulen	Jan 2013	B2
8353297	Dacquay et al.	Jan 2013	B2
8357103	Mark et al.	Jan 2013	B2
8357158	McKenna et al.	Jan 2013	B2
8366727	Witt et al.	Feb 2013	B2
8372064	Douglass 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
8377044	Coe et al.	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
8382792	Chojin	Feb 2013	B2
8388646	Chojin	Mar 2013	B2
8388647	Nau, Jr. et al.	Mar 2013	B2
8394096	Moses et al.	Mar 2013	B2
8394115	Houser et al.	Mar 2013	B2
8397971	Yates et al.	Mar 2013	B2
8403926	Nobis et al.	Mar 2013	B2
8403945	Whitfield et al.	Mar 2013	B2
8403948	Deville et al.	Mar 2013	B2
8403949	Palmer et al.	Mar 2013	B2
8403950	Palmer et al.	Mar 2013	B2
8409234	Stahler et al.	Apr 2013	B2
8414577	Boudreaux et al.	Apr 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
8423182	Robinson et al.	Apr 2013	B2
8425161	Nagaya et al.	Apr 2013	B2
8425410	Murray et al.	Apr 2013	B2
8425545	Smith et al.	Apr 2013	B2
8430811	Hess et al.	Apr 2013	B2
8430876	Kappus et al.	Apr 2013	B2
8430897	Novak et al.	Apr 2013	B2
8430898	Wiener et al.	Apr 2013	B2
8435257	Smith et al.	May 2013	B2
8435258	Young 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
8444663	Houser et al.	May 2013	B2
8444664	Balanev et al.	May 2013	B2
8453906	Huang et al.	Jun 2013	B2
8454599	Inagaki et al.	Jun 2013	B2
8454639	Du et al.	Jun 2013	B2
8460288	Tamai et al.	Jun 2013	B2
8460292	Truckai et al.	Jun 2013	B2
8460326	Houser 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
8484833	Cunningham et al.	Jul 2013	B2
8485413	Scheib et al.	Jul 2013	B2
8485970	Widenhouse 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
8491625	Horner	Jul 2013	B2
8496682	Guerra et al.	Jul 2013	B2
D687549	Johnson et al.	Aug 2013	S
8506555	Ruiz Morales	Aug 2013	B2
8509318	Tailliet	Aug 2013	B2
8512336	Couture	Aug 2013	B2
8512359	Whitman et al.	Aug 2013	B2
8512364	Kowalski et al.	Aug 2013	B2
8512365	Wiener et al.	Aug 2013	B2
8518067	Masuda et al.	Aug 2013	B2
8523889	Stulen et al.	Sep 2013	B2
8528563	Gruber	Sep 2013	B2
8529437	Taylor et al.	Sep 2013	B2
8529565	Masuda et al.	Sep 2013	B2
8531064	Robertson et al.	Sep 2013	B2
8535311	Schall	Sep 2013	B2
8535340	Allen	Sep 2013	B2
8535341	Allen	Sep 2013	B2
8540128	Shelton, IV et al.	Sep 2013	B2
8546996	Messerly et al.	Oct 2013	B2
8546999	Houser et al.	Oct 2013	B2
8551077	Main et al.	Oct 2013	B2
8551086	Kimura et al.	Oct 2013	B2
8562592	Conlon et al.	Oct 2013	B2
8562598	Falkenstein et al.	Oct 2013	B2
8562604	Nishimura	Oct 2013	B2
8568390	Mueller	Oct 2013	B2
8568400	Gilbert	Oct 2013	B2
8568412	Brandt et al.	Oct 2013	B2
8569997	Lee	Oct 2013	B2
8573461	Shelton, IV et al.	Nov 2013	B2
8573465	Shelton, IV	Nov 2013	B2
8574231	Boudreaux et al.	Nov 2013	B2
8574253	Gruber et al.	Nov 2013	B2
8579176	Smith et al.	Nov 2013	B2
8579897	Vakharia et al.	Nov 2013	B2
8579928	Robertson et al.	Nov 2013	B2
8579937	Gresham	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
8597193	Grunwald et al.	Dec 2013	B2
8602031	Reis et al.	Dec 2013	B2
8602288	Shelton, IV et al.	Dec 2013	B2
8608745	Guzman et al.	Dec 2013	B2
8610334	Bromfield	Dec 2013	B2
8613383	Beckman et al.	Dec 2013	B2
8616431	Timm et al.	Dec 2013	B2
8622274	Yates et al.	Jan 2014	B2
8623011	Spivey	Jan 2014	B2
8623016	Fischer	Jan 2014	B2
8623027	Price et al.	Jan 2014	B2
8623044	Timm et al.	Jan 2014	B2
8628529	Aldridge et al.	Jan 2014	B2
8628534	Jones et al.	Jan 2014	B2
8632461	Glossop	Jan 2014	B2
8636736	Yates et al.	Jan 2014	B2
8638428	Brown	Jan 2014	B2
8640788	Dachs, II et al.	Feb 2014	B2
8641663	Kirschenman et al.	Feb 2014	B2
8647350	Mohan et al.	Feb 2014	B2
8650728	Wan et al.	Feb 2014	B2
8651230	Peshkovsky et al.	Feb 2014	B2
8652120	Giordano et al.	Feb 2014	B2
8652132	Tsuchiya 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
8663222	Anderson et al.	Mar 2014	B2
8663262	Smith et al.	Mar 2014	B2
8668691	Heard	Mar 2014	B2
8668710	Slipszenko et al.	Mar 2014	B2
8684253	Giordano et al.	Apr 2014	B2
8685016	Wham et al.	Apr 2014	B2
8685020	Weizman et al.	Apr 2014	B2
8690582	Rohrbach et al.	Apr 2014	B2
8691268	Weimann	Apr 2014	B2
8695866	Leimbach et al.	Apr 2014	B2
8696366	Chen et al.	Apr 2014	B2
8696665	Hunt et al.	Apr 2014	B2
8702609	Hadjicostis	Apr 2014	B2
8702704	Shelton, IV et al.	Apr 2014	B2
8704425	Giordano et al.	Apr 2014	B2
8708213	Shelton, IV et al.	Apr 2014	B2
8709031	Stulen	Apr 2014	B2
8709035	Johnson et al.	Apr 2014	B2
8715270	Weitzner et al.	May 2014	B2
8715277	Weizman	May 2014	B2
8715306	Faller et al.	May 2014	B2
8721640	Taylor et al.	May 2014	B2
8721657	Kondoh et al.	May 2014	B2
8734443	Hixson et al.	May 2014	B2
8734476	Rhee et al.	May 2014	B2
8747238	Shelton, IV et al.	Jun 2014	B2
8747351	Schultz	Jun 2014	B2
8747404	Boudreaux et al.	Jun 2014	B2
8749116	Messerly et al.	Jun 2014	B2
8752264	Ackley 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
8758342	Bales et al.	Jun 2014	B2
8758352	Cooper et al.	Jun 2014	B2
8764735	Coe et al.	Jul 2014	B2
8764747	Cummings et al.	Jul 2014	B2
8767970	Eppolito	Jul 2014	B2
8770459	Racenet et al.	Jul 2014	B2
8771269	Sherman et al.	Jul 2014	B2
8771270	Burbank	Jul 2014	B2
8773001	Wiener et al.	Jul 2014	B2
8777944	Frankhouser et al.	Jul 2014	B2
8779648	Giordano et al.	Jul 2014	B2
8783541	Shelton, IV et al.	Jul 2014	B2
8784415	Malackowski et al.	Jul 2014	B2
8784418	Romero	Jul 2014	B2
8790342	Stulen et al.	Jul 2014	B2
8795276	Dietz et al.	Aug 2014	B2
8795327	Dietz et al.	Aug 2014	B2
8800838	Shelton, IV	Aug 2014	B2
8801710	Ullrich et al.	Aug 2014	B2
8801752	Fortier et al.	Aug 2014	B2
8808319	Houser et al.	Aug 2014	B2
8814856	Elmouelhi et al.	Aug 2014	B2
8814870	Paraschiv et al.	Aug 2014	B2
8820605	Shelton, IV	Sep 2014	B2
8821388	Naito et al.	Sep 2014	B2
8827992	Koss et al.	Sep 2014	B2
8827995	Schaller et al.	Sep 2014	B2
8834466	Cummings et al.	Sep 2014	B2
8834518	Faller et al.	Sep 2014	B2
8844789	Shelton, IV et al.	Sep 2014	B2
8845537	Tanaka et al.	Sep 2014	B2
8845630	Mehta et al.	Sep 2014	B2
8848808	Dress	Sep 2014	B2
8851354	Swensgard et al.	Oct 2014	B2
8852184	Kucklick	Oct 2014	B2
8858547	Brogna	Oct 2014	B2
8862955	Cesari	Oct 2014	B2
8864709	Akagane et al.	Oct 2014	B2
8864749	Okada	Oct 2014	B2
8864757	Klimovitch et al.	Oct 2014	B2
8864761	Johnson et al.	Oct 2014	B2
8870865	Frankhouser et al.	Oct 2014	B2
8870867	Walberg et al.	Oct 2014	B2
8882766	Couture et al.	Nov 2014	B2
8882791	Stulen	Nov 2014	B2
8882792	Dietz et al.	Nov 2014	B2
8888776	Dietz et al.	Nov 2014	B2
8888783	Young	Nov 2014	B2
8888809	Davison et al.	Nov 2014	B2
8899462	Kostrzewski et al.	Dec 2014	B2
8900259	Houser et al.	Dec 2014	B2
8906016	Boudreaux et al.	Dec 2014	B2
8906017	Rioux et al.	Dec 2014	B2
8911438	Swoyer et al.	Dec 2014	B2
8911460	Neurohr et al.	Dec 2014	B2
8920412	Fritz et al.	Dec 2014	B2
8920414	Stone et al.	Dec 2014	B2
8920421	Rupp	Dec 2014	B2
8926607	Norvell et al.	Jan 2015	B2
8926608	Bacher et al.	Jan 2015	B2
8931682	Timm et al.	Jan 2015	B2
8936614	Allen, IV	Jan 2015	B2
8939974	Boudreaux et al.	Jan 2015	B2
8951248	Messerly et al.	Feb 2015	B2
8951272	Robertson et al.	Feb 2015	B2
8956349	Aldridge et al.	Feb 2015	B2
8961515	Twomey et al.	Feb 2015	B2
8961547	Dietz et al.	Feb 2015	B2
8968283	Kharin	Mar 2015	B2
8968294	Maass et al.	Mar 2015	B2
8968355	Malkowski et al.	Mar 2015	B2
8974447	Kimball et al.	Mar 2015	B2
8974477	Yamada	Mar 2015	B2
8974479	Ross et al.	Mar 2015	B2
8979843	Timm et al.	Mar 2015	B2
8979844	White et al.	Mar 2015	B2
8979890	Boudreaux	Mar 2015	B2
8986287	Park et al.	Mar 2015	B2
8986302	Aldridge et al.	Mar 2015	B2
8989855	Murphy et al.	Mar 2015	B2
8989903	Weir et al.	Mar 2015	B2
8991678	Wellman et al.	Mar 2015	B2
8992422	Spivey et al.	Mar 2015	B2
8992526	Brodbeck et al.	Mar 2015	B2
9005199	Beckman et al.	Apr 2015	B2
9011437	Woodruff et al.	Apr 2015	B2
9011471	Timm et al.	Apr 2015	B2
9017326	DiNardo et al.	Apr 2015	B2
9017355	Smith et al.	Apr 2015	B2
9017372	Artale et al.	Apr 2015	B2
9023071	Miller et al.	May 2015	B2
9023072	Young et al.	May 2015	B2
9028397	Naito	May 2015	B2
9028476	Bonn	May 2015	B2
9028494	Shelton, IV et al.	May 2015	B2
9028519	Yates et al.	May 2015	B2
9031667	Williams	May 2015	B2
9033973	Krapohl et al.	May 2015	B2
9035741	Hamel et al.	May 2015	B2
9039690	Kersten et al.	May 2015	B2
9039695	Giordano et al.	May 2015	B2
9039705	Takashino	May 2015	B2
9043018	Mohr	May 2015	B2
9044227	Shelton, IV et al.	Jun 2015	B2
9044243	Johnson et al.	Jun 2015	B2
9044245	Condie et al.	Jun 2015	B2
9044256	Cadeddu et al.	Jun 2015	B2
9044261	Houser	Jun 2015	B2
9050093	Aldridge et al.	Jun 2015	B2
9050098	Deville et al.	Jun 2015	B2
9050124	Houser	Jun 2015	B2
9055961	Manzo et al.	Jun 2015	B2
9059547	McLawhorn	Jun 2015	B2
9060770	Shelton, IV et al.	Jun 2015	B2
9060775	Wiener et al.	Jun 2015	B2
9060776	Yates et al.	Jun 2015	B2
9063049	Beach et al.	Jun 2015	B2
9066723	Beller et al.	Jun 2015	B2
9066747	Robertson	Jun 2015	B2
9072535	Shelton, IV et al.	Jul 2015	B2
9072536	Shelton, IV et al.	Jul 2015	B2
9072539	Messerly et al.	Jul 2015	B2
9084624	Larkin et al.	Jul 2015	B2
9084878	Kawaguchi et al.	Jul 2015	B2
9089327	Worrell et al.	Jul 2015	B2
9089360	Messerly et al.	Jul 2015	B2
9095362	Dachs, II et al.	Aug 2015	B2
9095367	Olson et al.	Aug 2015	B2
9101385	Shelton, IV et al.	Aug 2015	B2
9107684	Ma	Aug 2015	B2
9107689	Robertson et al.	Aug 2015	B2
9107690	Bales, Jr. et al.	Aug 2015	B2
9113900	Buysse et al.	Aug 2015	B2
9113940	Twomey	Aug 2015	B2
9114245	Dietz et al.	Aug 2015	B2
9119657	Shelton, IV et al.	Sep 2015	B2
9119957	Gantz et al.	Sep 2015	B2
9125662	Shelton, IV	Sep 2015	B2
9125667	Stone et al.	Sep 2015	B2
9125722	Schwartz	Sep 2015	B2
9147965	Lee	Sep 2015	B2
9149324	Huang et al.	Oct 2015	B2
9149325	Worrell et al.	Oct 2015	B2
9161803	Yates et al.	Oct 2015	B2
9168054	Turner et al.	Oct 2015	B2
9168055	Houser et al.	Oct 2015	B2
9168085	Juzkiw et al.	Oct 2015	B2
9168089	Buysse et al.	Oct 2015	B2
9168090	Strobl et al.	Oct 2015	B2
9173656	Schurr et al.	Nov 2015	B2
9179912	Yates et al.	Nov 2015	B2
9186199	Strauss et al.	Nov 2015	B2
9186204	Nishimura et al.	Nov 2015	B2
9192380	(Tarinelli) Racenet et al.	Nov 2015	B2
9192431	Woodruff et al.	Nov 2015	B2
9198714	Worrell et al.	Dec 2015	B2
9198715	Livneh	Dec 2015	B2
9204879	Shelton, IV	Dec 2015	B2
9204891	Weitzman	Dec 2015	B2
9204918	Germain et al.	Dec 2015	B2
9204923	Manzo et al.	Dec 2015	B2
9216050	Condie et al.	Dec 2015	B2
9216062	Duque et al.	Dec 2015	B2
9220483	Frankhouser et al.	Dec 2015	B2
9220527	Houser et al.	Dec 2015	B2
9220559	Worrell et al.	Dec 2015	B2
9226750	Weir et al.	Jan 2016	B2
9226751	Shelton, IV et al.	Jan 2016	B2
9226766	Aldridge et al.	Jan 2016	B2
9226767	Stulen et al.	Jan 2016	B2
9232979	Parihar et al.	Jan 2016	B2
9237891	Shelton, IV	Jan 2016	B2
9237921	Messerly et al.	Jan 2016	B2
9237923	Worrell et al.	Jan 2016	B2
9241060	Fujisaki	Jan 2016	B1
9241692	Gunday et al.	Jan 2016	B2
9241728	Price et al.	Jan 2016	B2
9241730	Babaev	Jan 2016	B2
9241731	Boudreaux et al.	Jan 2016	B2
9241768	Sandhu et al.	Jan 2016	B2
9247953	Palmer et al.	Feb 2016	B2
9254165	Aronow et al.	Feb 2016	B2
9254171	Trees et al.	Feb 2016	B2
9259234	Robertson et al.	Feb 2016	B2
9259265	Harris et al.	Feb 2016	B2
9265567	Orban, III et al.	Feb 2016	B2
9265926	Strobl et al.	Feb 2016	B2
9265973	Akagane	Feb 2016	B2
9277962	Koss et al.	Mar 2016	B2
9282974	Shelton, IV	Mar 2016	B2
9283027	Monson et al.	Mar 2016	B2
9283045	Rhee et al.	Mar 2016	B2
9289256	Shelton, IV et al.	Mar 2016	B2
9295514	Shelton, IV et al.	Mar 2016	B2
9301759	Spivey et al.	Apr 2016	B2
9301772	Kimball et al.	Apr 2016	B2
9307388	Liang et al.	Apr 2016	B2
9307986	Hall et al.	Apr 2016	B2
9308009	Madan et al.	Apr 2016	B2
9308014	Fischer	Apr 2016	B2
9314292	Trees et al.	Apr 2016	B2
9314301	Ben-Haim et al.	Apr 2016	B2
9326754	Polster	May 2016	B2
9326787	Sanai et al.	May 2016	B2
9326788	Batross et al.	May 2016	B2
9333025	Monson et al.	May 2016	B2
9339289	Robertson	May 2016	B2
9339323	Eder et al.	May 2016	B2
9339326	McCullagh et al.	May 2016	B2
9345534	Artale et al.	May 2016	B2
9345900	Wu et al.	May 2016	B2
9351642	Nadkarni et al.	May 2016	B2
9351754	Vakharia et al.	May 2016	B2
9352173	Yamada et al.	May 2016	B2
9358065	Ladtkow et al.	Jun 2016	B2
9358407	Akagane	Jun 2016	B2
9364230	Shelton, IV et al.	Jun 2016	B2
9370400	Parihar	Jun 2016	B2
9370611	Ross et al.	Jun 2016	B2
9375230	Ross et al.	Jun 2016	B2
9375232	Hunt et al.	Jun 2016	B2
9375267	Kerr et al.	Jun 2016	B2
9381058	Houser et al.	Jul 2016	B2
9386983	Swensgard et al.	Jul 2016	B2
9393037	Olson et al.	Jul 2016	B2
D763442	Price et al.	Aug 2016	S
9402680	Ginnebaugh et al.	Aug 2016	B2
9402682	Worrell et al.	Aug 2016	B2
9408606	Shelton, IV	Aug 2016	B2
9408622	Stulen et al.	Aug 2016	B2
9408660	Strobl et al.	Aug 2016	B2
9414853	Stulen et al.	Aug 2016	B2
9414880	Monson et al.	Aug 2016	B2
9421060	Monson et al.	Aug 2016	B2
9427249	Robertson et al.	Aug 2016	B2
9439668	Timm et al.	Sep 2016	B2
9439669	Wiener et al.	Sep 2016	B2
9439671	Akagane	Sep 2016	B2
9445784	O'Keeffe	Sep 2016	B2
9445832	Wiener et al.	Sep 2016	B2
9445833	Akagane	Sep 2016	B2
9451967	Jordan et al.	Sep 2016	B2
9456863	Moua	Oct 2016	B2
9456864	Witt et al.	Oct 2016	B2
9468498	Sigmon, Jr.	Oct 2016	B2
9474542	Slipszenko et al.	Oct 2016	B2
9486235	Harrington et al.	Nov 2016	B2
9486236	Price et al.	Nov 2016	B2
9492187	Ravikumar et al.	Nov 2016	B2
9492224	Boudreaux et al.	Nov 2016	B2
9498245	Voegele et al.	Nov 2016	B2
9504483	Houser et al.	Nov 2016	B2
9504524	Behnke, II	Nov 2016	B2
9504855	Messerly et al.	Nov 2016	B2
9510850	Robertson et al.	Dec 2016	B2
9510906	Boudreaux et al.	Dec 2016	B2
9522029	Yates et al.	Dec 2016	B2
9526564	Rusin	Dec 2016	B2
9526565	Strobl	Dec 2016	B2
9545253	Worrell et al.	Jan 2017	B2
9545497	Wenderow et al.	Jan 2017	B2
9554846	Boudreaux	Jan 2017	B2
9554854	Yates et al.	Jan 2017	B2
9561038	Shelton, IV et al.	Feb 2017	B2
9574644	Parihar	Feb 2017	B2
9592072	Akagane	Mar 2017	B2
9597143	Madan et al.	Mar 2017	B2
9610091	Johnson et al.	Apr 2017	B2
9610114	Baxter, III et al.	Apr 2017	B2
9615877	Tyrrell et al.	Apr 2017	B2
9622729	Dewaele et al.	Apr 2017	B2
9623237	Turner et al.	Apr 2017	B2
9636135	Stulen	May 2017	B2
9638770	Dietz et al.	May 2017	B2
9642644	Houser et al.	May 2017	B2
9642669	Takashino et al.	May 2017	B2
9643052	Tchao et al.	May 2017	B2
9649111	Shelton, IV et al.	May 2017	B2
9649126	Robertson et al.	May 2017	B2
9662131	Omori et al.	May 2017	B2
9668806	Unger et al.	Jun 2017	B2
9671860	Ogawa et al.	Jun 2017	B2
9675374	Stulen et al.	Jun 2017	B2
9675375	Houser et al.	Jun 2017	B2
9687290	Keller	Jun 2017	B2
9700339	Nield	Jul 2017	B2
9700343	Messerly et al.	Jul 2017	B2
9707004	Houser et al.	Jul 2017	B2
9707027	Ruddenklau et al.	Jul 2017	B2
9707030	Davison et al.	Jul 2017	B2
9713507	Stulen et al.	Jul 2017	B2
9724118	Schulte et al.	Aug 2017	B2
9724152	Horlle et al.	Aug 2017	B2
9737326	Worrell et al.	Aug 2017	B2
9737355	Yates et al.	Aug 2017	B2
9737358	Beckman et al.	Aug 2017	B2
9737735	Dietz et al.	Aug 2017	B2
9743947	Price et al.	Aug 2017	B2
9757142	Shimizu	Sep 2017	B2
9757186	Boudreaux et al.	Sep 2017	B2
9764164	Wiener et al.	Sep 2017	B2
9782214	Houser et al.	Oct 2017	B2
9788851	Dannaher et al.	Oct 2017	B2
9795405	Price et al.	Oct 2017	B2
9795436	Yates et al.	Oct 2017	B2
9795808	Messerly et al.	Oct 2017	B2
9801648	Houser et al.	Oct 2017	B2
9801675	Sanai et al.	Oct 2017	B2
9808308	Faller et al.	Nov 2017	B2
9814514	Shelton, IV et al.	Nov 2017	B2
9820768	Gee et al.	Nov 2017	B2
9820771	Norton et al.	Nov 2017	B2
9820806	Lee et al.	Nov 2017	B2
9826976	Parihar et al.	Nov 2017	B2
9839443	Brockman et al.	Dec 2017	B2
9839796	Sawada	Dec 2017	B2
9848901	Robertson et al.	Dec 2017	B2
9848902	Price et al.	Dec 2017	B2
9848937	Trees et al.	Dec 2017	B2
9861428	Trees et al.	Jan 2018	B2
9872725	Worrell et al.	Jan 2018	B2
9877720	Worrell et al.	Jan 2018	B2
9877776	Boudreaux	Jan 2018	B2
9883884	Neurohr et al.	Feb 2018	B2
9888958	Evans et al.	Feb 2018	B2
9901339	Farascioni	Feb 2018	B2
9901359	Faller et al.	Feb 2018	B2
9907563	Germain et al.	Mar 2018	B2
9913655	Scheib et al.	Mar 2018	B2
9913656	Stulen	Mar 2018	B2
9913680	Voegele et al.	Mar 2018	B2
9918736	Van Tol et al.	Mar 2018	B2
9925003	Parihar et al.	Mar 2018	B2
9943325	Faller et al.	Apr 2018	B2
9949785	Price et al.	Apr 2018	B2
9949788	Boudreaux	Apr 2018	B2
9962182	Dietz et al.	May 2018	B2
9987033	Neurohr et al.	Jun 2018	B2
10010339	Witt et al.	Jul 2018	B2
10010341	Houser et al.	Jul 2018	B2
10016207	Suzuki et al.	Jul 2018	B2
10022142	Aranyi et al.	Jul 2018	B2
10022567	Messerly et al.	Jul 2018	B2
10022568	Messerly et al.	Jul 2018	B2
10028765	Hibner et al.	Jul 2018	B2
10028786	Mucilli et al.	Jul 2018	B2
10034684	Weisenburgh, II et al.	Jul 2018	B2
10034685	Boudreaux et al.	Jul 2018	B2
10034704	Asher et al.	Jul 2018	B2
10039588	Harper et al.	Aug 2018	B2
10045794	Witt et al.	Aug 2018	B2
10045819	Jensen et al.	Aug 2018	B2
10070916	Artale	Sep 2018	B2
10085762	Timm et al.	Oct 2018	B2
10092310	Boudreaux et al.	Oct 2018	B2
10092344	Mohr et al.	Oct 2018	B2
10092348	Boudreaux	Oct 2018	B2
10092350	Rothweiler et al.	Oct 2018	B2
10111699	Boudreaux	Oct 2018	B2
10117667	Robertson et al.	Nov 2018	B2
10117702	Danziger et al.	Nov 2018	B2
10130410	Strobl et al.	Nov 2018	B2
10154852	Conlon et al.	Dec 2018	B2
10159524	Yates et al.	Dec 2018	B2
10166060	Johnson et al.	Jan 2019	B2
10172669	Felder et al.	Jan 2019	B2
10179022	Yates et al.	Jan 2019	B2
10182837	Isola et al.	Jan 2019	B2
10188385	Kerr et al.	Jan 2019	B2
10194972	Yates et al.	Feb 2019	B2
10194973	Wiener et al.	Feb 2019	B2
10194976	Boudreaux	Feb 2019	B2
10194977	Yang	Feb 2019	B2
10201365	Boudreaux et al.	Feb 2019	B2
10201382	Wiener et al.	Feb 2019	B2
10226273	Messerly et al.	Mar 2019	B2
10231747	Stulen et al.	Mar 2019	B2
10245064	Rhee et al.	Apr 2019	B2
10245065	Witt et al.	Apr 2019	B2
10245095	Boudreaux	Apr 2019	B2
10251664	Shelton, IV et al.	Apr 2019	B2
10263171	Wiener et al.	Apr 2019	B2
10265094	Witt et al.	Apr 2019	B2
10265117	Wiener et al.	Apr 2019	B2
10265118	Gerhardt	Apr 2019	B2
D847990	Kimball	May 2019	S
10278721	Dietz et al.	May 2019	B2
10285723	Conlon et al.	May 2019	B2
10285724	Faller et al.	May 2019	B2
10299810	Robertson et al.	May 2019	B2
10299821	Shelton, IV et al.	May 2019	B2
10314638	Gee et al.	Jun 2019	B2
10321950	Yates et al.	Jun 2019	B2
10335182	Stulen et al.	Jul 2019	B2
10335614	Messerly et al.	Jul 2019	B2
10342602	Strobl et al.	Jul 2019	B2
10357303	Conlon et al.	Jul 2019	B2
10363058	Roberson et al.	Jul 2019	B2
10368892	Stulen et al.	Aug 2019	B2
10368894	Madan et al.	Aug 2019	B2
10368957	Denzinger et al.	Aug 2019	B2
10398466	Stulen et al.	Sep 2019	B2
10398497	Batross et al.	Sep 2019	B2
10413352	Thomas et al.	Sep 2019	B2
10420579	Wiener et al.	Sep 2019	B2
10420580	Messerly et al.	Sep 2019	B2
10420607	Woloszko et al.	Sep 2019	B2
10426507	Wiener et al.	Oct 2019	B2
10426978	Akagane	Oct 2019	B2
10433865	Witt et al.	Oct 2019	B2
10433866	Witt et al.	Oct 2019	B2
10433900	Harris et al.	Oct 2019	B2
10441308	Robertson	Oct 2019	B2
10441310	Olson et al.	Oct 2019	B2
10441345	Aldridge et al.	Oct 2019	B2
10463421	Boudreaux et al.	Nov 2019	B2
10463887	Witt et al.	Nov 2019	B2
10470788	Sinelnikov	Nov 2019	B2
10512795	Voegele et al.	Dec 2019	B2
10517627	Timm et al.	Dec 2019	B2
10524854	Woodruff et al.	Jan 2020	B2
10531910	Houser et al.	Jan 2020	B2
10537351	Shelton, IV et al.	Jan 2020	B2
10537352	Faller et al.	Jan 2020	B2
10537667	Anim	Jan 2020	B2
10543008	Vakharia et al.	Jan 2020	B2
10555750	Conlon et al.	Feb 2020	B2
10555769	Worrell et al.	Feb 2020	B2
10561436	Asher et al.	Feb 2020	B2
10575892	Danziger et al.	Mar 2020	B2
10595929	Boudreaux et al.	Mar 2020	B2
10595930	Scheib et al.	Mar 2020	B2
10603064	Zhang	Mar 2020	B2
10610286	Wiener et al.	Apr 2020	B2
10624665	Noui et al.	Apr 2020	B2
10624691	Wiener et al.	Apr 2020	B2
10639092	Corbett et al.	May 2020	B2
10677764	Ross et al.	Jun 2020	B2
10687884	Wiener et al.	Jun 2020	B2
10709469	Shelton, IV et al.	Jul 2020	B2
10709906	Nield	Jul 2020	B2
10716615	Shelton, IV et al.	Jul 2020	B2
10722261	Houser et al.	Jul 2020	B2
10729458	Stoddard et al.	Aug 2020	B2
10736649	Messerly et al.	Aug 2020	B2
10736685	Wiener et al.	Aug 2020	B2
10751108	Yates et al.	Aug 2020	B2
10758294	Jones	Sep 2020	B2
10779845	Timm et al.	Sep 2020	B2
10779847	Messerly et al.	Sep 2020	B2
10779848	Houser	Sep 2020	B2
10779849	Shelton, IV et al.	Sep 2020	B2
10779879	Yates et al.	Sep 2020	B2
10820920	Scoggins et al.	Nov 2020	B2
10820938	Fischer et al.	Nov 2020	B2
10828056	Messerly et al.	Nov 2020	B2
10828057	Neurohr et al.	Nov 2020	B2
10828058	Shelton, IV et al.	Nov 2020	B2
10828059	Price et al.	Nov 2020	B2
10835307	Shelton, IV et al.	Nov 2020	B2
10835768	Robertson et al.	Nov 2020	B2
10842522	Messerly et al.	Nov 2020	B2
10842523	Shelton, IV et al.	Nov 2020	B2
10842580	Gee et al.	Nov 2020	B2
10856896	Eichmann et al.	Dec 2020	B2
10874418	Houser et al.	Dec 2020	B2
10881449	Boudreaux et al.	Jan 2021	B2
10881451	Worrell et al.	Jan 2021	B2
10888347	Witt et al.	Jan 2021	B2
10893883	Dannaher	Jan 2021	B2
10912603	Boudreaux et al.	Feb 2021	B2
10952759	Messerly et al.	Mar 2021	B2
10959769	Mumaw et al.	Mar 2021	B2
10966744	Rhee et al.	Apr 2021	B2
10987123	Weir et al.	Apr 2021	B2
11000707	Voegele et al.	May 2021	B2
11006971	Faller et al.	May 2021	B2
11020140	Gee et al.	Jun 2021	B2
11033292	Green et al.	Jun 2021	B2
11033322	Wiener et al.	Jun 2021	B2
D924400	Kimball	Jul 2021	S
11051840	Shelton, IV et al.	Jul 2021	B2
11058447	Houser	Jul 2021	B2
11058448	Shelton, IV et al.	Jul 2021	B2
11058475	Wiener et al.	Jul 2021	B2
11129670	Shelton, IV et al.	Sep 2021	B2
11134978	Shelton, IV et al.	Oct 2021	B2
11141213	Yates et al.	Oct 2021	B2
20010011176	Boukhny	Aug 2001	A1
20010025173	Ritchie et al.	Sep 2001	A1
20010025183	Shahidi	Sep 2001	A1
20010025184	Messerly	Sep 2001	A1
20010031950	Ryan	Oct 2001	A1
20010032002	McClurken et al.	Oct 2001	A1
20010039419	Francischelli et al.	Nov 2001	A1
20020002377	Cimino	Jan 2002	A1
20020002378	Messerly	Jan 2002	A1
20020016603	Wells	Feb 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
20020052595	Witt et al.	May 2002	A1
20020052617	Anis et al.	May 2002	A1
20020077550	Rabiner et al.	Jun 2002	A1
20020099373	Schulze et al.	Jul 2002	A1
20020107446	Rabiner et al.	Aug 2002	A1
20020107517	Witt et al.	Aug 2002	A1
20020120266	Truckai et al.	Aug 2002	A1
20020156466	Sakurai et al.	Oct 2002	A1
20020156493	Houser et al.	Oct 2002	A1
20020165577	Witt et al.	Nov 2002	A1
20030014053	Nguyen et al.	Jan 2003	A1
20030014087	Fang et al.	Jan 2003	A1
20030036705	Hare et al.	Feb 2003	A1
20030040758	Wang et al.	Feb 2003	A1
20030050572	Brautigam et al.	Mar 2003	A1
20030055443	Spotnitz	Mar 2003	A1
20030093113	Fogarty et al.	May 2003	A1
20030109875	Tetzlaff et al.	Jun 2003	A1
20030114851	Truckai et al.	Jun 2003	A1
20030114874	Craig et al.	Jun 2003	A1
20030120306	Burbank et al.	Jun 2003	A1
20030130675	Kasahara et al.	Jul 2003	A1
20030130693	Levin et al.	Jul 2003	A1
20030139741	Goble et al.	Jul 2003	A1
20030144652	Baker et al.	Jul 2003	A1
20030144680	Kellogg et al.	Jul 2003	A1
20030158548	Phan et al.	Aug 2003	A1
20030160698	Andreasson et al.	Aug 2003	A1
20030171747	Kanehira et al.	Sep 2003	A1
20030195496	Maguire et al.	Oct 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
20030225332	Okada et al.	Dec 2003	A1
20030229344	Dycus et al.	Dec 2003	A1
20040030254	Babaev	Feb 2004	A1
20040030330	Brassell et al.	Feb 2004	A1
20040039242	Tolkoff et al.	Feb 2004	A1
20040047485	Sherrit et al.	Mar 2004	A1
20040054364	Aranyi et al.	Mar 2004	A1
20040064151	Mollenauer	Apr 2004	A1
20040087943	Dycus et al.	May 2004	A1
20040092921	Kadziauskas et al.	May 2004	A1
20040092992	Adams et al.	May 2004	A1
20040097911	Murakami 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
20040121159	Cloud et al.	Jun 2004	A1
20040122423	Dycus et al.	Jun 2004	A1
20040132383	Langford et al.	Jul 2004	A1
20040138621	Jahns et al.	Jul 2004	A1
20040147934	Kiester	Jul 2004	A1
20040147945	Fritzsch	Jul 2004	A1
20040147946	Mastri et al.	Jul 2004	A1
20040167508	Wham et al.	Aug 2004	A1
20040176686	Hare et al.	Sep 2004	A1
20040176751	Weitzner et al.	Sep 2004	A1
20040193150	Sharkey et al.	Sep 2004	A1
20040199193	Hayashi et al.	Oct 2004	A1
20040199194	Witt et al.	Oct 2004	A1
20040215132	Yoon	Oct 2004	A1
20040243147	Lipow	Dec 2004	A1
20040243157	Connor	Dec 2004	A1
20040249374	Tetzlaff et al.	Dec 2004	A1
20040260273	Wan	Dec 2004	A1
20040260300	Gorensek et al.	Dec 2004	A1
20040267298	Cimino	Dec 2004	A1
20050015125	Mioduski et al.	Jan 2005	A1
20050020967	Ono	Jan 2005	A1
20050021018	Anderson et al.	Jan 2005	A1
20050021065	Yamada et al.	Jan 2005	A1
20050021078	Vleugels et al.	Jan 2005	A1
20050033278	McClurken et al.	Feb 2005	A1
20050033337	Muir et al.	Feb 2005	A1
20050070800	Takahashi	Mar 2005	A1
20050085728	Fukuda	Apr 2005	A1
20050090817	Phan	Apr 2005	A1
20050096683	Ellins et al.	May 2005	A1
20050099824	Dowling et al.	May 2005	A1
20050131390	Heinrich et al.	Jun 2005	A1
20050143759	Kelly	Jun 2005	A1
20050143769	White et al.	Jun 2005	A1
20050149108	Cox	Jul 2005	A1
20050165429	Douglas et al.	Jul 2005	A1
20050171522	Christopherson	Aug 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
20050192611	Houser	Sep 2005	A1
20050222598	Ho et al.	Oct 2005	A1
20050228425	Boukhny 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
20050261588	Makin et al.	Nov 2005	A1
20050267464	Truckai et al.	Dec 2005	A1
20050273090	Nieman et al.	Dec 2005	A1
20050288659	Kimura et al.	Dec 2005	A1
20060030797	Zhou et al.	Feb 2006	A1
20060030848	Craig et al.	Feb 2006	A1
20060058825	Ogura et al.	Mar 2006	A1
20060063130	Hayman et al.	Mar 2006	A1
20060064086	Odom	Mar 2006	A1
20060066181	Bromfield et al.	Mar 2006	A1
20060074442	Noriega et al.	Apr 2006	A1
20060079874	Faller et al.	Apr 2006	A1
20060079877	Houser et al.	Apr 2006	A1
20060079879	Faller et al.	Apr 2006	A1
20060095046	Trieu et al.	May 2006	A1
20060159731	Shoshan	Jul 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
20060224160	Trieu et al.	Oct 2006	A1
20060241580	Mittelstein et al.	Oct 2006	A1
20060247558	Yamada	Nov 2006	A1
20060253050	Yoshimine et al.	Nov 2006	A1
20060257819	Johnson	Nov 2006	A1
20060264809	Hansmann et al.	Nov 2006	A1
20060270916	Skwarek et al.	Nov 2006	A1
20060271030	Francis et al.	Nov 2006	A1
20060293656	Shadduck et al.	Dec 2006	A1
20070016235	Tanaka et al.	Jan 2007	A1
20070016236	Beaupre	Jan 2007	A1
20070032704	Gandini et al.	Feb 2007	A1
20070055228	Berg et al.	Mar 2007	A1
20070056596	Fanney et al.	Mar 2007	A1
20070060935	Schwardt et al.	Mar 2007	A1
20070063618	Bromfield	Mar 2007	A1
20070073185	Nakao	Mar 2007	A1
20070073341	Smith et al.	Mar 2007	A1
20070074584	Talarico et al.	Apr 2007	A1
20070106317	Shelton et al.	May 2007	A1
20070118115	Artale et al.	May 2007	A1
20070130771	Ehlert et al.	Jun 2007	A1
20070149881	Rabin	Jun 2007	A1
20070156163	Davison et al.	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
20070185474	Nahen	Aug 2007	A1
20070191712	Messerly et al.	Aug 2007	A1
20070191713	Eichmann et al.	Aug 2007	A1
20070203483	Kim et al.	Aug 2007	A1
20070208340	Ganz et al.	Sep 2007	A1
20070219481	Babaev	Sep 2007	A1
20070232926	Stulen et al.	Oct 2007	A1
20070232928	Wiener et al.	Oct 2007	A1
20070236213	Paden et al.	Oct 2007	A1
20070239101	Kellogg	Oct 2007	A1
20070249941	Salehi et al.	Oct 2007	A1
20070260242	Dycus et al.	Nov 2007	A1
20070265560	Soltani et al.	Nov 2007	A1
20070265613	Edelstein et al.	Nov 2007	A1
20070265616	Couture et al.	Nov 2007	A1
20070275348	Lemon	Nov 2007	A1
20070276419	Rosenthal	Nov 2007	A1
20070282333	Fortson et al.	Dec 2007	A1
20070287933	Phan et al.	Dec 2007	A1
20070288055	Lee	Dec 2007	A1
20080013809	Zhu et al.	Jan 2008	A1
20080015575	Odom et al.	Jan 2008	A1
20080033465	Schmitz et al.	Feb 2008	A1
20080039746	Hissong et al.	Feb 2008	A1
20080051812	Schmitz et al.	Feb 2008	A1
20080058775	Darian et al.	Mar 2008	A1
20080058845	Shimizu et al.	Mar 2008	A1
20080071269	Hilario et al.	Mar 2008	A1
20080077145	Boyden et al.	Mar 2008	A1
20080082039	Babaev	Apr 2008	A1
20080082098	Tanaka et al.	Apr 2008	A1
20080097281	Zusman et al.	Apr 2008	A1
20080097501	Blier	Apr 2008	A1
20080114355	Whayne et al.	May 2008	A1
20080114364	Goldin et al.	May 2008	A1
20080125768	Tahara et al.	May 2008	A1
20080147058	Horrell et al.	Jun 2008	A1
20080147062	Truckai et al.	Jun 2008	A1
20080147092	Rogge et al.	Jun 2008	A1
20080171938	Masuda et al.	Jul 2008	A1
20080177268	Daum et al.	Jul 2008	A1
20080188755	Hart	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
20080243162	Shibata et al.	Oct 2008	A1
20080281200	Voic et al.	Nov 2008	A1
20080281315	Gines	Nov 2008	A1
20080287948	Newton et al.	Nov 2008	A1
20080294051	Koshigoe et al.	Nov 2008	A1
20080296346	Shelton, IV et al.	Dec 2008	A1
20080300588	Groth et al.	Dec 2008	A1
20090012516	Curtis et al.	Jan 2009	A1
20090023985	Ewers	Jan 2009	A1
20090043228	Northrop et al.	Feb 2009	A1
20090048537	Lydon et al.	Feb 2009	A1
20090048589	Takashino et al.	Feb 2009	A1
20090054886	Yachi et al.	Feb 2009	A1
20090054889	Newton et al.	Feb 2009	A1
20090054894	Yachi	Feb 2009	A1
20090069830	Mulvihill et al.	Mar 2009	A1
20090076506	Baker	Mar 2009	A1
20090082716	Akahoshi	Mar 2009	A1
20090082766	Unger et al.	Mar 2009	A1
20090088785	Masuda	Apr 2009	A1
20090118751	Wiener et al.	May 2009	A1
20090143678	Keast et al.	Jun 2009	A1
20090143799	Smith et al.	Jun 2009	A1
20090143800	Deville et al.	Jun 2009	A1
20090163807	Sliwa	Jun 2009	A1
20090182322	D'Amelio et al.	Jul 2009	A1
20090182331	D'Amelio et al.	Jul 2009	A1
20090182332	Long et al.	Jul 2009	A1
20090216157	Yamada	Aug 2009	A1
20090223033	Houser	Sep 2009	A1
20090248021	McKenna	Oct 2009	A1
20090254077	Craig	Oct 2009	A1
20090254080	Honda	Oct 2009	A1
20090259149	Tahara et al.	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
20090270891	Beaupre	Oct 2009	A1
20090270899	Carusillo et al.	Oct 2009	A1
20090287205	Ingle	Nov 2009	A1
20090299141	Downey et al.	Dec 2009	A1
20090327715	Smith et al.	Dec 2009	A1
20100004508	Naito et al.	Jan 2010	A1
20100022825	Yoshie	Jan 2010	A1
20100030233	Whitman et al.	Feb 2010	A1
20100034605	Huckins et al.	Feb 2010	A1
20100036370	Mirel et al.	Feb 2010	A1
20100042126	Houser et al.	Feb 2010	A1
20100049180	Wells et al.	Feb 2010	A1
20100057118	Dietz et al.	Mar 2010	A1
20100063525	Beaupre et al.	Mar 2010	A1
20100063528	Beaupre	Mar 2010	A1
20100081863	Hess et al.	Apr 2010	A1
20100081864	Hess et al.	Apr 2010	A1
20100081883	Murray et al.	Apr 2010	A1
20100094323	Isaacs et al.	Apr 2010	A1
20100106173	Yoshimine	Apr 2010	A1
20100109480	Forslund et al.	May 2010	A1
20100158307	Kubota et al.	Jun 2010	A1
20100168741	Sanai et al.	Jul 2010	A1
20100181966	Sakakibara	Jul 2010	A1
20100187283	Crainich et al.	Jul 2010	A1
20100204721	Young et al.	Aug 2010	A1
20100222714	Muir et al.	Sep 2010	A1
20100222752	Collins, Jr. et al.	Sep 2010	A1
20100228191	Alvarez et al.	Sep 2010	A1
20100234906	Koh	Sep 2010	A1
20100274160	Yachi et al.	Oct 2010	A1
20100274278	Fleenor et al.	Oct 2010	A1
20100280368	Can et al.	Nov 2010	A1
20100298743	Nield et al.	Nov 2010	A1
20100312186	Suchdev et al.	Dec 2010	A1
20100331742	Masuda	Dec 2010	A1
20100331873	Dannaher et al.	Dec 2010	A1
20110004233	Muir et al.	Jan 2011	A1
20110028964	Edwards	Feb 2011	A1
20110106141	Nakamura	May 2011	A1
20110125151	Strauss et al.	May 2011	A1
20110278343	Knodel et al.	Nov 2011	A1
20110284014	Cadeddu et al.	Nov 2011	A1
20110290856	Shelton, IV et al.	Dec 2011	A1
20110291526	Abramovich et al.	Dec 2011	A1
20110295295	Shelton, IV et al.	Dec 2011	A1
20110306967	Payne et al.	Dec 2011	A1
20110313415	Fernandez et al.	Dec 2011	A1
20120004655	Kim et al.	Jan 2012	A1
20120016413	Timm et al.	Jan 2012	A1
20120022519	Huang et al.	Jan 2012	A1
20120022526	Aldridge et al.	Jan 2012	A1
20120022583	Sugalski et al.	Jan 2012	A1
20120041358	Mann et al.	Feb 2012	A1
20120059289	Nield et al.	Mar 2012	A1
20120071863	Lee et al.	Mar 2012	A1
20120078244	Worrell et al.	Mar 2012	A1
20120078249	Eichmann et al.	Mar 2012	A1
20120101495	Young et al.	Apr 2012	A1
20120109186	Parrott et al.	May 2012	A1
20120116222	Sawada et al.	May 2012	A1
20120116265	Houser et al.	May 2012	A1
20120136279	Tanaka et al.	May 2012	A1
20120143211	Kishi	Jun 2012	A1
20120172904	Muir et al.	Jul 2012	A1
20120265241	Hart et al.	Oct 2012	A1
20120296371	Kappus et al.	Nov 2012	A1
20120330338	Messerly	Dec 2012	A1
20130023925	Mueller	Jan 2013	A1
20130090576	Stulen et al.	Apr 2013	A1
20130116717	Balek et al.	May 2013	A1
20130123776	Monson et al.	May 2013	A1
20130158659	Bergs et al.	Jun 2013	A1
20130158660	Bergs et al.	Jun 2013	A1
20130165929	Muir et al.	Jun 2013	A1
20130231691	Houser	Sep 2013	A1
20130253256	Griffith et al.	Sep 2013	A1
20130277410	Fernandez et al.	Oct 2013	A1
20130296843	Boudreaux et al.	Nov 2013	A1
20130331873	Ross et al.	Dec 2013	A1
20140001231	Shelton, IV et al.	Jan 2014	A1
20140001234	Shelton, IV et al.	Jan 2014	A1
20140005640	Shelton, IV et al.	Jan 2014	A1
20140005678	Shelton, IV et al.	Jan 2014	A1
20140005702	Timm et al.	Jan 2014	A1
20140005705	Weir et al.	Jan 2014	A1
20140005718	Shelton, IV et al.	Jan 2014	A1
20140014544	Bugnard et al.	Jan 2014	A1
20140081299	Dietz et al.	Mar 2014	A1
20140121569	Schafer et al.	May 2014	A1
20140135663	Funakubo et al.	May 2014	A1
20140135804	Weisenburgh, II et al.	May 2014	A1
20140194874	Dietz et al.	Jul 2014	A1
20140194875	Reschke et al.	Jul 2014	A1
20140207135	Winter	Jul 2014	A1
20140207163	Eichmann et al.	Jul 2014	A1
20140323926	Akagane	Oct 2014	A1
20140371735	Long	Dec 2014	A1
20150011889	Lee	Jan 2015	A1
20150080876	Worrell et al.	Mar 2015	A1
20150083774	Measamer et al.	Mar 2015	A1
20150112335	Boudreaux et al.	Apr 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
20150272659	Boudreaux et al.	Oct 2015	A1
20150289854	Cho et al.	Oct 2015	A1
20160045248	Unger et al.	Feb 2016	A1
20160051316	Boudreaux	Feb 2016	A1
20160114355	Sakai et al.	Apr 2016	A1
20160128769	Rontal et al.	May 2016	A1
20160175029	Witt et al.	Jun 2016	A1
20160206342	Robertson et al.	Jul 2016	A1
20160240768	Fujii et al.	Aug 2016	A1
20160262786	Madan et al.	Sep 2016	A1
20160270842	Strobl et al.	Sep 2016	A1
20160296251	Olson et al.	Oct 2016	A1
20160296252	Olson et al.	Oct 2016	A1
20160296270	Strobl et al.	Oct 2016	A1
20170027624	Wilson et al.	Feb 2017	A1
20170036044	Ito	Feb 2017	A1
20170086909	Yates et al.	Mar 2017	A1
20170119426	Akagane	May 2017	A1
20170135751	Rothweiler et al.	May 2017	A1
20170164972	Johnson et al.	Jun 2017	A1
20170189095	Danziger et al.	Jul 2017	A1
20170202572	Shelton, IV et al.	Jul 2017	A1
20170202591	Shelton, IV et al.	Jul 2017	A1
20170202595	Shelton, IV	Jul 2017	A1
20170202598	Shelton, IV et al.	Jul 2017	A1
20180055529	Messerly et al.	Mar 2018	A1
20180125523	Johnson	May 2018	A1
20190053822	Robertson et al.	Feb 2019	A1
20190239919	Witt et al.	Aug 2019	A1
20190262029	Messerly et al.	Aug 2019	A1
20190350615	Messerly et al.	Nov 2019	A1
20190380733	Stulen et al.	Dec 2019	A1
20190381340	Voegele et al.	Dec 2019	A1
20200008857	Conlon et al.	Jan 2020	A1
20200015798	Wiener et al.	Jan 2020	A1
20200015838	Robertson	Jan 2020	A1
20200046401	Witt et al.	Feb 2020	A1
20200054899	Wiener et al.	Feb 2020	A1
20200085462	Robertson	Mar 2020	A1
20200085466	Faller et al.	Mar 2020	A1
20200323551	Faller et al.	Oct 2020	A1
20210038248	Houser	Feb 2021	A1
20210121197	Houser et al.	Apr 2021	A1
20210128191	Messerly et al.	May 2021	A1
20210145531	Gee et al.	May 2021	A1
20210236157	Rhee et al.	Aug 2021	A1
20210315605	Gee et al.	Oct 2021	A1
20210378700	Houser	Dec 2021	A1

Foreign Referenced Citations (166)

Number	Date	Country
837241	Mar 1970	CA
2535467	Apr 1993	CA
2214413	Sep 1996	CA
2460047	Nov 2001	CN
1634601	Jul 2005	CN
1775323	May 2006	CN
1922563	Feb 2007	CN
2868227	Feb 2007	CN
202027624	Nov 2011	CN
102335778	Feb 2012	CN
103668171	Mar 2014	CN
103921215	Jul 2014	CN
106077718	Nov 2016	CN
2065681	Mar 1975	DE
3904558	Aug 1990	DE
9210327	Nov 1992	DE
4300307	Jul 1994	DE
4434938	Feb 1996	DE
29623113	Oct 1997	DE
20004812	Sep 2000	DE
20021619	Mar 2001	DE
10042606	Aug 2001	DE
10201569	Jul 2003	DE
0171967	Feb 1986	EP
0336742	Oct 1989	EP
0136855	Nov 1989	EP
0705571	Apr 1996	EP
1543854	Jun 2005	EP
1698289	Sep 2006	EP
1862133	Dec 2007	EP
1972264	Sep 2008	EP
2060238	May 2009	EP
1747761	Oct 2009	EP
2131760	Dec 2009	EP
1214913	Jul 2010	EP
1946708	Jun 2011	EP
1767164	Jan 2013	EP
2578172	Apr 2013	EP
2510891	Jun 2016	EP
2454351	Nov 1980	FR
2964554	Mar 2012	FR
2032221	Apr 1980	GB
2317566	Apr 1998	GB
2318298	Apr 1998	GB
2425480	Nov 2006	GB
S50100891	Aug 1975	JP
S5968513	May 1984	JP
S59141938	Aug 1984	JP
S62221343	Sep 1987	JP
S62227343	Oct 1987	JP
S62292153	Dec 1987	JP
S62292154	Dec 1987	JP
S63109386	May 1988	JP
S63315049	Dec 1988	JP
H01151452	Jun 1989	JP
H01198540	Aug 1989	JP
H0271510	May 1990	JP
H02286149	Nov 1990	JP
H02292193	Dec 1990	JP
H0337061	Feb 1991	JP
H0425707	Feb 1992	JP
H0464351	Feb 1992	JP
H0430508	Mar 1992	JP
H04152942	May 1992	JP
H04161078	Jun 1992	JP
H0595955	Apr 1993	JP
H05115490	May 1993	JP
H0647048	Feb 1994	JP
H0670938	Mar 1994	JP
H06104503	Apr 1994	JP
H07185457	Jul 1995	JP
H07299415	Nov 1995	JP
H0824266	Jan 1996	JP
H08229050	Sep 1996	JP
H08275950	Oct 1996	JP
H08275951	Oct 1996	JP
H08299351	Nov 1996	JP
H08336545	Dec 1996	JP
H09135553	May 1997	JP
H09140722	Jun 1997	JP
H105236	Jan 1998	JP
H105237	Jan 1998	JP
H10295700	Nov 1998	JP
H11128238	May 1999	JP
2000139943	May 2000	JP
2000210296	Aug 2000	JP
2000210299	Aug 2000	JP
2000271145	Oct 2000	JP
2000287987	Oct 2000	JP
2000312682	Nov 2000	JP
2001029353	Feb 2001	JP
2001057985	Mar 2001	JP
2001170066	Jun 2001	JP
2001198137	Jul 2001	JP
2002186901	Jul 2002	JP
2002233533	Aug 2002	JP
2002263579	Sep 2002	JP
2002330977	Nov 2002	JP
2003000612	Jan 2003	JP
2003010201	Jan 2003	JP
2003116870	Apr 2003	JP
2003126104	May 2003	JP
2003126110	May 2003	JP
2003153919	May 2003	JP
2003230567	Aug 2003	JP
2003339730	Dec 2003	JP
2004129871	Apr 2004	JP
2004147701	May 2004	JP
2004209043	Jul 2004	JP
2005027026	Jan 2005	JP
2005074088	Mar 2005	JP
2005094552	Apr 2005	JP
2005253674	Sep 2005	JP
2006217716	Aug 2006	JP
2006288431	Oct 2006	JP
3841627	Nov 2006	JP
D1339835	Aug 2008	JP
2009071439	Apr 2009	JP
2009297352	Dec 2009	JP
2010009686	Jan 2010	JP
2010121865	Jun 2010	JP
2011160586	Aug 2011	JP
2012235658	Nov 2012	JP
2015529140	Oct 2015	JP
2016022136	Feb 2016	JP
100789356	Dec 2007	KR
2154437	Aug 2000	RU
22035	Mar 2002	RU
2201169	Mar 2003	RU
2405603	Dec 2010	RU
850068	Jul 1981	SU
WO-8103272	Nov 1981	WO
WO-9308757	May 1993	WO
WO-9314708	Aug 1993	WO
WO-9421183	Sep 1994	WO
WO-9424949	Nov 1994	WO
WO-9639086	Dec 1996	WO
WO-9800069	Jan 1998	WO
WO-9805437	Feb 1998	WO
WO-9816157	Apr 1998	WO
WO-9920213	Apr 1999	WO
WO-9923960	May 1999	WO
WO-0024322	May 2000	WO
WO-0024330	May 2000	WO
WO-0064358	Nov 2000	WO
WO-0128444	Apr 2001	WO
WO-0132087	May 2001	WO
WO-0167970	Sep 2001	WO
WO-0195810	Dec 2001	WO
WO-02076685	Oct 2002	WO
WO-02080799	Oct 2002	WO
WO-2004037095	May 2004	WO
WO-2004078051	Sep 2004	WO
WO-2004098426	Nov 2004	WO
WO-2005084250	Sep 2005	WO
WO-2007008710	Jan 2007	WO
WO-2008118709	Oct 2008	WO
WO-2008130793	Oct 2008	WO
WO-2008154338	Dec 2008	WO
WO-2010104755	Sep 2010	WO
WO-2011008672	Jan 2011	WO
WO-2011052939	May 2011	WO
WO-2011060031	May 2011	WO
WO-2012044606	Apr 2012	WO
WO-2012066983	May 2012	WO
WO-2013048963	Apr 2013	WO

Non-Patent Literature Citations (62)

Entry
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.
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).
Covidien Brochure, The LigaSure Precise™ Instrument, dated Mar. 2011 (2 pages).
AST Products, Inc., “Principles of Video Contact Angle Analysis,” 20 pages, (2006).
Mitsui Chemicals Names DuPont™ Vespel® Business as Exclusive U.S., European Distributor of AUTUM® Thermoplastic Polyimide Resin, Feb. 24, 2003; http://www2.dupont.com/Vespel/en_US/news_events/article20030224.html.
Sadiq Muhammad et al: “High-performance planar ultrasonic tool based on d31-mode piezocrystal”, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, IEEE, US, vol. 62, No. 3, Mar. 30, 2015 (Mar. 30, 2015), pp. 428-438, XP011574640, ISSN: 0885-3010, DOI: 10.1109/TUFFC.2014.006437.
Leonard I. Malis, M.D., “The Value of Irrigation During Bipolar Coagulation,” 1989.
http:/www.ethicon.com/gb-en/healthcare-professionals/products/energy-devices/capital//ge . . . .
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).
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).
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).
Campbell et al, “Thermal Imaging in Surgery,” p. 19-3, in Medical Infrared Imaging, N. A. Diakides and J. D. Bronzino, Eds. (2008).
http://www.dotmed.com/listing/electrosurical-unit/ethicon/ultracision-g110-/1466724.
http://www.4-traders.com/JOHNSON-JOHNSON-4832/news/Johnson-Johnson-Ethicon-E . . . .
Gerhard, Glen C., “Surgical Electrotechnology: Quo Vadis?,” IEEE Transactions on Biomedical Engineering, vol. BME-31, No. 12, pp. 787-792, Dec. 1984.
Fowler, K.R., “A Programmable, Arbitrary Waveform Electrosurgical Device,” IEEE Engineering in Medicine and Biology Society 10th Annual International Conference, pp. 1324, 1325 (1988).
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.
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).
Covidien Brochure, [Value Analysis Brief], LigaSure Advance™ Pistol Grip, dated Rev. Apr. 2010 (7 pages).
Wright, et al., “Time-Temperature Equivalence of Heat-Induced Changes in Cells and Proteins,” Feb. 1998. ASME Journal of Biomechanical Engineering, vol. 120, pp. 22-26.
Covidien Brochure, LigaSure Impact™ Instrument LF4318, dated Feb. 2013 (3 pages).
Covidien Brochure, LigaSure Atlas™ Hand Switching Instruments, dated Dec. 2008 (2 pages).
Covidien Brochure, The LigaSure™ 5 mm Blunt Tip Sealer/Divider Family, dated Apr. 2013 (2 pages).
Erbe Electrosurgery VIO® 200 S, (2012), p. 7, 12 pages, accessed Mar. 31, 2014 at http://www.erbe-med. com/erbe/media/Marketing materialien/85140170 ERBE EN VIO 200 S D027541.
Jang, J. et al. “Neuro-fuzzy and Soft Computing.” Prentice Hall, 1997, pp. 13-89, 199-293, 335-393, 453-496, 535-549.
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.
Weir, C.E., “Rate of shrinkage of tendon collagen—heat, entropy and free energy of activation of the shrinkage of untreated tendon. Effect of acid salt, pickle, and tannage on the activation of tendon collagen.” Journal of the American Leather Chemists Association, 44, pp. 108-140 (1949).
Henriques. F.C., “Studies in thermal injury V. The predictability and the significance of thermally induced rate processes leading to irreversible epidermal injury.” Archives of Pathology, 434, pp. 489-502 (1947).
Wall et al., “Thermal modification of collagen,” J Shoulder Elbow Surg, No. 8, pp. 339-344 (Jul./Aug. 1999).
Arnoczky et al., “Thermal Modification of Conective Tissues: Basic Science Considerations and Clinical Implications,” J. Am Acad Orthop Surg, vol. 8, No. 5, pp. 305-313 (Sep./Oct. 2000).
Chen et al., “Heat-Induced Changes in the Mechanics of a Collagenous Tissue: Isothermal Free Shrinkage,” Transactions of the ASME, vol. 119, pp. 372-378 (Nov. 1997).
Chen et al., “Heat-Induced Changes in the Mechanics of a Collagenous Tissue: Isothermal, Isotonic Shrinkage,” Transactions of the ASME, vol. 120, pp. 382-388 (Jun. 1998).
Chen et al., “Phenomenological Evolution Equations for Heat-Induced Shrinkage of a Collagenous Tissue,” IEEE Transactions on Biomedical Engineering, vol. 45, No. 10, pp. 1234-1240 (Oct. 1998).
Harris et al., “Kinetics of Thermal Damage to a Collagenous Membrane Under Biaxial Isotonic Loading,” IEEE Transactions on Biomedical Engineering, vol. 51, No. 2, pp. 371-379 (Feb. 2004).
Harris et al., “Altered Mechanical Behavior of Epicardium Due to Isothermal Heating Under Biaxial Isotonic Loads,” Journal of Biomechanical Engineering, vol. 125, pp. 381-388 (Jun. 2003).
Lee et al., “A multi-sample denaturation temperature tester for collagenous biomaterials,” Med. Eng. Phy., vol. 17, No. 2, pp. 115-121 (Mar. 1995).
Moran et al., “Thermally Induced Shrinkage of Joint Capsule,” Clinical Orthopaedics and Related Research, No. 281, pp. 248-255 (Dec. 2000).
Wells et al., “Altered Mechanical Behavior of Epicardium Under Isothermal Biaxial Loading,” Transactions of the ASME, Journal of Biomedical Engineering, vol. 126, pp. 492-497 (Aug. 2004).
Gibson, “Magnetic Refrigerator Successfully Tested,” U.S. Department of Energy Research News, accessed online on Aug. 6, 2010 at http://www.eurekalert.org/features/doe/2001-11/dl-mrs062802.php (Nov. 1, 2001).
Humphrey, J.D., “Continuum Thermomechanics and the Clinical Treatment of Disease and Injury,” Appl. Mech. Rev., vol. 56, No. 2 pp. 231-260 (Mar. 2003).
National Semiconductors Temperature Sensor Handbook—http://www.national.com/appinfo/tempsensors/files/temphb.pdf; accessed online: Apr. 1, 2011.
Hayashi et al., “The Effect of Thermal Heating on the Length and Histologic Properties of the Glenohumeral Joint Capsule,” American Journal of Sports Medicine, vol. 25, Issue 1, 11 pages (Jan. 1997), URL: http://www.mdconsult.com/das/article/body/156183648-2/jorg=journal&source=MI&sp=1 . . . , accessed Aug. 25, 2009.
Douglas, S.C. “Introduction to Adaptive Filter”. Digital Signal Processing Handbook. Ed. Vijay K. Madisetti and Douglas B. Williams. Boca Raton: CRC Press LLC, 1999.
Chen et al., “Heat-induced changes in the mechanics of a collagenous tissue: pseudoelastic behavior at 37° C.,” Journal of Biomechanics, 31, pp. 211-216 (1998).
Kurt Gieck & Reiner Gieck, Engineering Formulas § Z.7 (7th ed. 1997).
Glaser and Subak-Sharpe,Integrated Circuit Engineering, Addison-Wesley Publishing, Reading, MA (1979). (book—not attached).
Covidien 501 (k) Summary Sonicision, dated Feb. 24, 2011 (7 pages).
http://www.megadyne.com/es_generator.php.
LaCourse, J.R.; Vogt, M.C.; Miller, W.T., III; Selikowitz, S.M., “Spectral Analysis Interpretation of Electrosurgical Generator Nerve and Muscle Stimulation,” IEEE Transactions on Biomedical Engineering, vol. 35, No. 7, pp. 505-509, Jul. 1988.
https://www.kjmagnetics.com/fieldcalculator.asp, retrieved Jul. 11, 2016, backdated to Nov. 11, 2011 via https://web.archive.org/web/20111116164447/http://www.kjmagnetics.com/fieldcalculator.asp.
http://www.apicalinstr.com/generators.htm.
http://www.medicalexpo.com/medical-manufacturer/electrosurgical-generator-6951.html.
http://www.valleylab.com/product/es/generators/index.html.
Emam, Tarek A. et al., “How Safe is High-Power Ultrasonic Dissection?,” Annals of Surgery, (2003), pp. 186-191, vol. 237, No. 2, Lippincott Williams & Wilkins, Inc., Philadelphia, PA.
Feil, Wolfgang, M.D., et al., “Ultrasonic Energy for Cutting, Coagulating, and Dissecting,” (2005), pp. IV, 17, 21, and 23; ISBN 3-13-127521-9 (New York, NY, Thieme, New York).
McCarus, Steven D. M.D., “Physiologic Mechanism of the Ultrasonically Activated Scalpel,” The Journal of the American Association of Gynecologic Laparoscopists; (Aug. 1996), vol. 3, No. 4., pp. 601-606 and 608.

Related Publications (1)

	Number	Date	Country
	20200054386 A1	Feb 2020	US

Divisions (2)

	Number	Date	Country
Parent	14444335	Jul 2014	US
Child	14645796		US
Parent	11881602	Jul 2007	US
Child	14444335		US

Continuations (2)

	Number	Date	Country
Parent	15653366	Jul 2017	US
Child	16535514		US
Parent	14645796	Mar 2015	US
Child	15653366		US

Surgical instruments

Information

Patent Number

Date Filed

Date Issued

Inventors

Original Assignees

Examiners

CPC

Field of Search

CPC

International Classifications

Term Extension

Abstract