US20030153902A1 - Hand-actuated articulating surgical tool - Google Patents

Hand-actuated articulating surgical tool Download PDF

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Publication number
US20030153902A1
US20030153902A1 US10/388,795 US38879503A US2003153902A1 US 20030153902 A1 US20030153902 A1 US 20030153902A1 US 38879503 A US38879503 A US 38879503A US 2003153902 A1 US2003153902 A1 US 2003153902A1
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US
United States
Prior art keywords
slave
control
hydraulic
cavity
controller
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10/388,795
Inventor
Mark Doyle
Jimmy Caputo
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Allegiance Corp
Original Assignee
Doyle Mark C.
Caputo Jimmy C.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Doyle Mark C., Caputo Jimmy C. filed Critical Doyle Mark C.
Priority to US10/388,795 priority Critical patent/US20030153902A1/en
Publication of US20030153902A1 publication Critical patent/US20030153902A1/en
Priority to US10/996,872 priority patent/US20050090811A1/en
Assigned to KINETIC SURGICAL, LLC reassignment KINETIC SURGICAL, LLC ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: TIVA MEDICAL, INC.
Priority to US11/352,899 priority patent/US7470268B2/en
Assigned to ALLEGIANCE CORPORATION reassignment ALLEGIANCE CORPORATION ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CARDINAL HEALTH 200, INC.
Assigned to CARDINAL HEALTH 200, INC. reassignment CARDINAL HEALTH 200, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: KINETIC SURGICAL, LLC
Priority to US12/336,950 priority patent/US8105319B2/en
Priority to US12/792,630 priority patent/US20100241137A1/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70Manipulators specially adapted for use in surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/35Surgical robots for telesurgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30Surgical robots
    • A61B34/37Master-slave robots
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00539Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/2812Surgical forceps with a single pivotal connection
    • A61B17/282Jaws
    • A61B2017/2829Jaws with a removable cover
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2901Details of shaft
    • A61B2017/2908Multiple segments connected by articulations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2927Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2931Details of heads or jaws with releasable head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2932Transmission of forces to jaw members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2932Transmission of forces to jaw members
    • A61B2017/2944Translation of jaw members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2948Sealing means, e.g. for sealing the interior from fluid entry
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/036Abutting means, stops, e.g. abutting on tissue or skin abutting on tissue or skin

Definitions

  • the invention relates generally to surgical instruments. More particularly, the invention relates to a hand-actuated articulating surgical tool for use in minimally invasive surgical procedures.
  • the present invention provides an apparatus for performing minimally invasive surgery while allowing articulation of the tool within the patient's body. Further, the present invention provides a surgical tool that is simple and inexpensive to sterilize and reuse. Another embodiment of the invention allows a surgeon to operate on a portion of an organ, for example, the heart, without the need for arresting the entire organ.
  • One embodiment of the present invention is a surgical device, comprising at least one controller located at the proximal end of the device adapted to transmit hydraulic control signals. At least one manipulator, configured to be controlled by a human finger actuates the controller. At least one slave, located at the distal end of the device, is in fluid communication with the controller and is configured to respond to the hydraulic control signals transmitted by the controller. A control line provides hydraulic communication between the controller and the slave.
  • the controller comprises a control cavity and a piston within the control cavity.
  • the piston divides the control cavity into a first control cavity portion and a second control cavity portion and prevents communication between the two portions.
  • the slave comprises a slave cavity and a piston within the slave cavity that divides the slave cavity into first and second portions and prevents communication between the two portions.
  • the control line provides hydraulic communication between the first control cavity portion and the first slave cavity portion.
  • a second control line provides hydraulic communication between the second control cavity portion and the second slave cavity portion.
  • the surgical device comprises a control portion located at the proximal end having a plurality of controllers, each controller being adapted to transmit hydraulic control signals.
  • a plurality of manipulators configured to be controlled by a human finger, actuate a corresponding controller.
  • a slave portion located at the distal end of the device comprises a plurality of slaves. Each slave is in communication with a corresponding controller, and responds to the hydraulic control signals transmitted by the controller.
  • a surgical tip is manipulated by the slaves in response to the hydraulic control signals.
  • Control lines provide communication between the controllers and the slaves. In a preferred embodiment, an outer sleeve envelops the control lines.
  • the device can also include an articulating portion.
  • the articulating portion comprises a spring bar on one side and a plurality of pockets on an opposing side.
  • the pockets are configured to receive a hydraulic fluid and expand, causing the device to bend as desired.
  • the device includes a stabilizer having a rigid shaft and a stabilizing plate.
  • the stabilizing plate has an access cutout, and is configured to pivot about the end of the shaft.
  • the shaft can include an articulating portion, if desired.
  • FIG. 1 is an overview of one embodiment of the invention.
  • FIG. 2 is a detailed drawing of one embodiment of the control portion of the invention.
  • FIG. 2A is top view
  • FIG. 2B is side view
  • FIG. 2C is front view.
  • FIG. 2D shows a top view of a grasp cam.
  • FIG. 2E shows a top view of a bend cam.
  • FIG. 3 is a detailed drawing of an embodiment of a control cylinder.
  • FIG. 3A shows the cylinder's retracted position
  • FIG. 3B shows the cylinder's extended position
  • FIG. 3D shows the components of the control cylinder individually.
  • FIG. 4 is a detailed drawing of an embodiment of a hydraulic extend module.
  • FIG. 4A shows the module's retracted position, while FIG. 4B shows the module's extended position.
  • FIG. 4C shows the front view of the module.
  • FIGS. 4 D-E show two embodiments of an electrical extend module.
  • FIG. 5A is a detailed drawing of an embodiment of a hydraulic rotate module.
  • FIG. 5B is a detailed drawing of an embodiment of an electrical rotate module.
  • FIG. 6A is a detailed drawing of an embodiment of a hydraulic bend module.
  • FIG. 6B is a drawing of a gear component in the module.
  • FIG. 6C is a drawing of a rack component in the module.
  • FIG. 6D is a detailed drawing of an embodiment of an electrical bend module.
  • FIG. 7A-B is a detailed drawing of an embodiment of a hydraulic grasp module.
  • FIG. 7A is top view and FIG. 7B is side view.
  • FIG. 7C is a detailed drawing of an embodiment of an electrical grasp module.
  • FIG. 8 depicts a tool adapted to fit over the tynes of a grasp module.
  • FIG. 9 depicts various arrangements of the modules.
  • FIG. 9A shows the modules in bend-extend-rotate-grasp configuration, with the bend module in the straight conformation.
  • FIG. 9B shows the same arrangement with the bend module in the bent conformation.
  • FIG. 9C shows the modules in extend-rotate-bend-grasp configuration, with the bend module in the straight conformation.
  • FIG. 9D shows the same arrangement with the bend module in the bent conformation.
  • FIG. 10 shows an embodiment of the tubing management.
  • FIG. 10A shows the guide tubes as they are attached to the cannula using an elastic strap.
  • FIG. 10B shows the position of the guide tubes with respect to the bend module, while
  • FIG. 10C shows the position of the guide tubes with respect to the extend module.
  • FIGS. 11 A-B show an embodiment of the patient restraint.
  • FIG. 12 shows an embodiment of the tissue restraint module.
  • FIG. 12A is top view while FIG. 12B is side view.
  • FIGS. 12 C-E show various embodiments of the separable tynes of the tissue restraint modules.
  • FIG. 13 shows the different cylinder diameters for changing the ratio of movement between the control cylinder and slave cylinder.
  • FIG. 14 shows an embodiment of the multiple stroke cylinder.
  • FIGS. 15 A-B are side views showing the articulation mechanism of the present invention.
  • FIGS. 16 A-C are side views showing the articulation mechanism of FIGS. 15 A-B in greater detail.
  • FIG. 1 shows a surgical tool according to the present invention.
  • the tool has a control portion 110 , 112 at the proximal end of the device and a slave portion 120 at the distal end of the device.
  • proximal refers to the part of the device that remains outside the patient's body, closest to the user.
  • distal refers to the end inserted into the patient, farthest away from the user.
  • proximal refers to the part of the component closest to the proximal end of the device, whereas “distal” refers to the part of the component closest to the distal end of the device.
  • An intermediate portion 190 lies between the control portion 110 and the slave portion 120 .
  • the “slave portion,” or the “distal end of the device,” 120 is the portion of the device comprising the slave modules, i.e., the extend module, the bend module, the rotate module, and the grasp module, as each is described in greater detail below. Each portion will now be described in greater detail.
  • the term “cannula” is used to refer to the portion of the device comprising both the intermediate portion 190 and the slave portion 120 .
  • the control portion 110 , 112 may be any device that can translate the movements of the user's hand and fingers into hydraulic, mechanical, or electrical signals to actuate the corresponding parts of the slave portion 120 of the device. For example, two such devices are shown in FIG. 1.
  • the control portion 110 , 112 uses hydraulic fluid to transfer pressure from a control cylinder to a slave cylinder.
  • the fluid is preferably sterilized distilled water, however a saline solution, a perfluorinated hydrocarbon liquid, or any other physiologically compatible fluid could also be used.
  • a “physiologically compatible fluid” is a fluid that once exposed to tissues and organs, does not create any intolerable reaction, such as a rash or immune response, in the patient, and does not adversely interfere with the normal physiological function of the tissues or organs to which it is exposed.
  • a physiologically compatible fluid can remain in a patient's body or in contact with a tissue or an organ without the need to remove the fluid.
  • control portion 112 clamps onto the arm of the user by way of a clamp 115 .
  • the control portion 112 features finger loops 117 , into which the user inserts the user's fingers. By squeezing each finger loop 117 , the user creates hydraulic pressure or an electrical signal that results in a corresponding motion at the distal end 120 of the device. The user may then “open” the squeezed finger to create the opposite motion.
  • Each finger loop 117 is connected with a control cylinder 310 (shown in FIG. 3).
  • the finger loop 117 should be large enough to allow comfortable insertion of a human finger.
  • the finger loop 117 is connected to a longitudinal shaft.
  • the shaft may be made of, for example, metal, ground glass, or ceramic.
  • the shaft may be of any cross-sectional shape, but a circular cross-section is preferred.
  • the cross-sectional size of the shaft, along with the material, are designed to provide sufficient stiffness for predictable control when the finger loop 117 is moved.
  • the shaft slides through an opening in the end of the cylinder body.
  • the interface between the shaft and the opening in the end of the cylinder body is formed to allow for smooth forward and backward movement of the shaft and preferably, at the same time, to provide a waterproof seal.
  • Another embodiment of the invention includes a control portion 110 that is clamped to the side of a surgical bed using clamps 130 .
  • the user grasps the control portion 110 much in the same way that a motorcycle driver grasps the handles of a motorcycle.
  • the user may turn the handles, push them in, pull them out, pivot them about their axes, or, with the aid of a thumb loop, squeeze them.
  • each of these motions creates a corresponding motion at the distal end 120 of the device.
  • control portion 110 is clamped to an object other than the surgical bed, such as a table or a cart.
  • the control portion 110 is clamped to the user's arms or hand.
  • the control portion 110 is held by the user, without it being clamped to anything.
  • FIG. 2A shows the top view of the control portion 110 .
  • a handle 210 is provided for the user's fingers to pass through, while the user's thumb is inserted through a thumb loop 212 .
  • the handle 210 may exhibit ridges on the inside of the open loop in order to more comfortably accommodate a user's fingers.
  • the movements of the control portion 110 are translated into hydraulic motion through the use of control cylinders 214 , 216 , 218 , 220 .
  • a bend cam 222 is turned about a vertical axis.
  • the bend cam 222 is shown in FIG. 2D.
  • a roller 224 is pushed towards the back of the handle.
  • the roller 224 is connected to an outer cylinder 312 of a control cylinder 214 via a shaft 318 .
  • the backward movement of the shaft 318 extends a piston 320 backwards, thereby creating the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device.
  • the function of a control cylinder and its connection to a slave cylinder are discussed in greater detail below.
  • the squeezing of the thumb loop actuates a grasp function at the distal end 120 .
  • the control portion 110 may be attached to the side of a surgical bed using a clamp 130 . However, the control portion is free to rotate about a vertical axis 226 , shown in FIG. 2B. The rotation of the control portion 110 about the axis 226 causes a roller 230 to move within a bend cam 228 . The bend cam 228 is shown in FIG. 2E.
  • the roller 230 is connected to an outer cylinder 312 of a control cylinder 220 via a shaft 318 . The forward movement of the shaft 318 extends the piston 320 forward, thereby creating the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device.
  • the turning of the handle results in a rotation of the distal end 120 of the device through a rotate module, described in detail below.
  • a user may also push the handle 210 forward, in which case, the top portion of the control portion 110 moves forward over a slide 232 .
  • the slide 232 is connected to an outer cylinder 312 of a control cylinder 218 via an attachment point 330 .
  • the outer cylinder 312 is in turn attached to the piston 320 via a shaft 318 .
  • the forward movement of the shaft 318 extends the piston 320 forward, thereby creating the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device.
  • the forward movement of the handle results in an extension of the distal end 120 of the device through an extension module, described in detail below.
  • the handle part of the control portion 110 may also rotate along a longitudinal axis coinciding with the shaft 234 , as shown in FIG. 2B.
  • the turning of the handle part causes a screw 236 to rotate within a nut 238 .
  • the screw 236 is stationary and the nut 238 is mobile, whereas in other embodiments of the invention, the screw 236 is mobile and the nut 238 is stationary.
  • the movement of the screw 236 within the nut 238 causes the mobile unit to move linearly with respect to the stationary unit.
  • the mobile unit, whether the screw or the nut is connected to an outer cylinder 312 of a control cylinder 216 via an attachment point 330 .
  • the outer cylinder 312 is in turn attached to the piston 320 via a shaft 318 .
  • the forward movement of the shaft 318 extends the piston 320 forward, while the backward movement of the shaft 318 pulls the piston 320 backward.
  • the forward and backward motion of the piston 320 creates the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device.
  • rotation of the handle part results in the rotation of the distal end 120 of the device through a rotation module, described in detail below.
  • the movements of the different parts of the control portion 110 creates electrical signals that are sent through wires in the intermediate portion 190 to the slave cylinders in the distal end 120 of the device, The electrical signal is sufficient to actuate a motor in the corresponding slave cylinder, which in turn results in the slave module being actuated.
  • a forward movement of the handle 210 creates an electrical signal that actuates a motor in an extend module, which results in the extension of that module.
  • the rotation of the handle 210 , the bending of the handle 210 , and the squeezing of the thumb loop 212 result in the rotate module, the bend module, and the grasp module, respectively, being actuated.
  • the slave modules having a motor are described in greater detail below.
  • Cylinders 214 , 216 , 218 , and 220 are control cylinders.
  • a typical control cylinder 310 is shown in its retracted position in FIG. 3A and in its extended position in FIG. 3B.
  • the control cylinder 310 comprises an outer cylinder 312 and an inner cylinder 314 .
  • the inner cylinder 314 has a diameter that allows it to move within the outer cylinder 312 .
  • the outer cylinder 312 is connected to a shaft 318 , which in turn is connected to the control portion 110 through the attachment point 330 .
  • the movements of the control portion 110 described above, causes the outer cylinder 312 to move longitudinally with respect to the stationary inner cylinder 314 .
  • a piston 320 attached to a shaft 318 , moves within the inner cylinder 314 , within a distance defined by the two inlet points 322 , 324 for the hydraulic fluid.
  • the distal end of the shaft 318 is configured to be capable of attachment to the piston 320
  • the proximal end of the shaft 318 is configured to be capable of attachment to the outer cylinder at a site close to the attachment point 330 .
  • the outer cylinder or the handle assembly may be provided with ratchet teeth.
  • the ratchet teeth are adapted to engage with a locking mechanism to secure the piston 320 at a desired position relative to the cylinder body.
  • a locking mechanism may employ a friction lock to secure the piston 320 at a desired position.
  • the piston 320 has a solid front face and is movable along the longitudinal axis of the inner cylinder 314 .
  • the front face of the piston 320 is identical in shape to the cross section of the cylindrical cavity.
  • the outer surface of the piston 320 forms an airtight seal with the inner surface of the inner cylinder 314 .
  • the portion of the cavity on one side of the piston 320 does not communicate with the portion of the cavity on the other side of the piston 320 .
  • the piston 320 must be allowed to move smoothly back and forth along the longitudinal axis of the inner cylinder 314 .
  • the proximal end of the inner cylinder 314 is sealed with a seal 316 , comprising an opening therethrough, through which the shaft 318 can slide.
  • the distalend of the inner cylinder 314 is sealed with another seal 328 , optionally comprising an 0 -ring 326 .
  • piston 320 may move from any point along the two extremes to any other point along the two extremes, and thereby cause a corresponding movement in a slave cylinder.
  • the cannula 190 comprises hydraulic tubings, connecting the control cylinders of the control portion 110 with the slave cylinders at the distal end 120 , and housings for the hydraulic tubings.
  • the distal end 120 comprises modular components.
  • the components can be selected from, for example, an extend module, a rotate module, a bend module, and a grasp module. Other functions can be included as well and activated in the manner described in detail below.
  • Each module is individually describe in greater detail below.
  • the invention is adapted such that the user can pick the combination of modules and the quantity of each individual module that is best suitable for the user's needs and assemble them conveniently.
  • the extend module 410 is depicted in both its retracted position, FIG. 4A, and extended position, FIG. 4B.
  • the extend module 410 is identical in its construction to the control module 310 ; however, the function of the two are reversed.
  • hydraulic fluid enters the inner cylinder 414 pushing the piston 420 towards the distal end of the module and the distal seal 416 .
  • the shaft 418 moves through the distal seal 416 , but it is attached to the outer cylinder 412 at the distal end of the outer cylinder 430 .
  • the movement of the piston 420 moves the outer cylinder 412 towards the distal end of the module, thereby extending the cannula.
  • the hydraulic fluid present inside the inner cylinder 414 exits the inner cylinder 414 through the distal outlet 422 .
  • the proximal seal 428 prevents the leakage of hydraulic fluid from proximal end of the inner cylinder 414 .
  • Additional modules can be attached to the extend module either at its distal end, through the distal attachment point 430 , or at its proximal end, through the proximal attachment point 431 .
  • the extend module may be extended using electrical power instead of hydraulic power.
  • the user by pushing forward on the handle 210 of the control portion 110 , the user causes an electrical connection to be formed, whereby electrical signal is sent from the control portion 110 through wires in the intermediate portion 190 to the extend module 432 , FIGS. 4D, 4E.
  • the electrical signal causes an electrical motor 434 to turn.
  • FIG. 4D a screw 436 is mounted within the motor 434 .
  • the turning of the motor 434 causes the screw to move outward, thereby causing the outer cylinder 440 to move away from the inner cylinder 442 .
  • the motor is stationary, i.e., it is attached to the inner cylinder 442
  • the screw is mobile, i.e., it moves with respect to the motor and the inner cylinder 442
  • the screw 436 is attached at its distal end to the outer cylinder 440 .
  • the motor 434 causes the screw 436 to turn within a nut 438 .
  • the nut 438 is attached to the outer cylinder 440 .
  • the turning of the screw 436 causes the nut 438 to move with respect to the screw 436 , thereby moving the outer cylinder 440 longitudinally with respect to the inner cylinder 442 , causing the module to extend.
  • the motor 434 and the screw 436 are stationary with respect to the inner cylinder 442 , whereas the nut 438 and the outer cylinder 440 are mobile.
  • the rotate module 510 comprises similar hydraulic components as those of the extend module 410 .
  • hydraulic pressure applied by rotating the control portion 110 along a longitudinal axis, causes piston 520 to move toward the distal end of the module, causing the shaft 518 to move in that direction as well.
  • the shaft 518 is attached to a lead screw 522 at an attachment point 524 .
  • Extension of the shaft 518 causes the lead screw 522 to move towards the distal end of the module.
  • the lead screw is incapable of rotating, since a stabilizer 526 prevents its rotation.
  • the lead screw 522 instead is extended through a nut assembly 528 which is immovably attached to an outer cylinder 530 . The movement of the lead screw 522 through the nut assembly 528 causes the nut assembly 528 to rotate, thereby rotating the outer cylinder 530 .
  • Additional modules can be attached to the rotate module either at its distal end, through the distal attachment point 532 , or at its proximal end, through the proximal attachment point 534 .
  • the rotate module may be rotated using electrical power instead of hydraulic power.
  • the user by turning the handle 210 of the control portion 110 , the user causes an electrical connection to be formed, whereby an electrical signal is sent from the control portion 110 through wires in the intermediate portion 190 to the rotate module 540 , FIGS. 5B.
  • the electrical signal causes an electrical motor 542 to turn.
  • the electrical motor 542 is attached to a shaft 544 which in turn is attached to the outer cylinder 546 .
  • the turning of the shaft rotates the outer cylinder.
  • a gear reducer assembly 548 may also be present to reduce the rotation speed.
  • the connection between the outer cylinder 546 and the cylinder housing the motor assembly 542 may feature a bearing assembly 550 .
  • the bend module 610 is depicted in FIG. 6A. This module also features the same hydraulic assembly present in the extend and the rotate modules, above. Applying hydraulic pressure by rotating the control portion 110 along the vertical axis 226 in a clockwise direction causes the piston 620 and the shaft 618 to move towards the distal end of the module.
  • the shaft 618 is attached to a rack 624 either directly or through an attachment assembly 622 . The movement of the shaft 618 moves the rack 624 .
  • the rack 624 has teeth that correspond to the teeth on a gear 626 . The movement of the rack 624 causes the gear 626 to rotate clockwise.
  • the gear 626 is connected to the distal end 628 of the module.
  • the rotation of the gear 626 causes the distal end 628 of the module to bend clockwise.
  • the piston 620 is moved towards the proximal end of the module, causing the rack 624 to move backwards as well, which in turn causes the gear 626 to turn counter-clockwise, which in turn causes the distal end 628 of the module to bend counter-clockwise.
  • the bending of the distal end 628 of the module is through an angle of at least 110°, i.e., when the piston 620 moves from the proximal end of the hydraulic portion completely to the distal end of the hydraulic portion, the distal end 628 of the module bends at least 110°.
  • the rotation is an angle of at least 110°, at least 150°, at least 200°; at least 250°, at least 300°, or an angle of at least 350°.
  • Additional modules can be attached to the bend module either at its distal end, through the distal attachment point 630 , or at its proximal end, through the proximal attachment point 632 .
  • the bend module may be bent using electrical power instead of hydraulic power.
  • the user by turning the handle 210 of the control portion 110 , the user causes an electrical connection to be formed, whereby electrical signal is sent from the control portion 110 through wires in the intermediate portion 190 to the bend module.
  • the electrical signal causes an electrical motor to turn.
  • the electrical motor is attached to a shaft which in turn is attached to the rack 624 .
  • the movement of the shaft 618 moves the rack 624 , which in turn causes the gear 626 to rotate, which in turn causes the distal end 628 of the module to bend.
  • the turning of the motor 640 causes a lead screw 642 to rotate within a nut 644 .
  • the lead screw 642 is stationary with respect to the motor 640 and the outer body of the module, whereas the nut 644 is mobile.
  • the nut 644 is connected to a link 646 at the proximal end of the link 646 .
  • the distal end of the link 646 is connected to the distal end of the module.
  • the nut 644 When the nut 644 is moved backwards, it causes the link 646 to move backwards, thereby causing the distal end of the module to rotate. Reversing the electrical current, by rotating the control portion 110 in the opposite direction, will cause the motor to turn in the opposite direction, thereby causing the nut to move forward and the distal end of the module to bend in a clockwise direction.
  • FIG. 7A depicts the top view of the grasp module 710
  • FIG. 7B depicts its side view.
  • the grasp module 710 also features a hydraulic portion similar to those of other modules.
  • the thumb loop 212 is squeezed towards the handle 210
  • hydraulic pressure is applied and the shaft 718 moves towards the distal end of the module.
  • This movement causes the pin 720 to move towards the distal end of the module as well, thereby causing the two pins 722 to move away from the center.
  • the angle defined by pin 722 -pin 720 -pin 722 tends away from 90° and towards 180°.
  • the movement of the pins 722 causes the two tynes 724 to move towards each other and, eventually, touch. Moving the thumb loop 212 away from the handle 210 will have the opposite effect of causing the tynes 724 to move away from each other and open up.
  • the squeezing of the thumb loop 212 causes an electrical current to turn a motor 740 , FIG. 7C, in the grasp module 730 .
  • the motor 740 turns a stationary lead screw 742 , which in turn causes a nut 744 to move longitudinally.
  • the movement of the nut 744 causes the tynes to move closer to each other and, eventually, touch. Moving the thumb loop 212 away from the handle 210 will have the opposite effect of causing the tynes 724 to move away from each other and open up.
  • the tynes 724 of the grasp module 710 are configured to accommodate a number of different tools.
  • a grasp tool 810 is shown that can fit over the tynes 724 .
  • the end portion of the grasp tool 810 also move toward each other and, eventually, touch. If an object or tissue is located between the end portions of the grasp tool 810 , the object is then grasped by the tool.
  • tools There may be a number of tools that can be attached over the tynes 724 .
  • these include a scissors, a knife for cutting the tissue, drill bits for drilling into bones, heating elements for cauterizing tissue, or any other tool necessary during a surgical procedure.
  • All the above tools and other tools can fit individually and interchangeably on the grasp module 710 . Therefore, during a surgical procedure, the user may attach one tool to the grasp module 710 , use it, remove it, and then attach another tool to the same grasp module 710 . This process can be repeated any number of times with any number of tools.
  • FIG. 9 depicts four of the modules attached in the order of (from proximal end to distal end) bend, extend, rotate, and grasp.
  • FIG. 9A shows the bend module in its retracted position, where the cannula is straight.
  • FIG. 9B shows the bend module in its extended position where the module is bent.
  • the four modules could be arranged in the extend-rotate-bend-grasp configuration, as shown in FIGS. 9C, 9D. Other combinations are also possible.
  • the user may attach more than a single module of a particular type, for example, two or three or more extend modules or two or three or more bend modules, could be put together, along with other modules to form the distal end 120 of the device.
  • the grasp module 710 is always the most distally located module.
  • FIG. 4C the front view of the extend module, the hydraulic tubing connecting the various modules to the control cylinders are located at one side of the slave cylinders.
  • the hydraulic tubing runs alongside the cannula and connects to the inlet openings of the hydraulic portion of each module.
  • a series of low friction guide tubes 1010 are attached to the cannula by an elastic strap 1012 (FIG. 10A).
  • Each hydraulic tubing 1014 fits through one guide tubing and is free to move longitudinally, i.e., in the direction of the arrow 1016 , within the guide tubing 1010 .
  • the hydraulic tubing can move along the cannula and maintain the connection 1018 with the hydraulic inlets of each of the modules.
  • the present invention features a restraint 1110 that can be attached to the cannula 190 using a thumb screw 1112 (FIG. 11).
  • the restraint 1110 sits adjacent to the patient's skin on the outside of the patient's body at the point of entry of the cannula 190 .
  • the restraint 1110 keeps the depth of the cannula 190 with respect to the body of the patient's body. If the patient makes any moves during the surgery, for example if the anesthesia begins to wear off and the patient jolts, the cannula moves with the patient. More importantly, the depth of the cannula inside the patient's body remains unchanged. Therefore, if the patient moves, the patient will not be damaged by the cannula.
  • tissue restraint module 1210 (FIG. 12) that can be inserted into the patient's body at or near the site where any other cannula has been inserted.
  • the tissue restraint module 1210 features a bend module, as described above.
  • the separable tynes 1214 can be brought close to the tissue that is to be restrained.
  • the bend module allows the tyne assembly to be bent with respect to the cannula, so that the tynes 1214 may be placed over the tissue.
  • the tynes 1214 are separable so that they can provide a relatively stable tissue area for the performance of the surgery.
  • the tissue restraint module comprises two tynes 1214 .
  • the tynes 1214 are adapted to be separable. When inserting the module into the patient's body, the tynes 1214 are held together to reduce the width of the device. Inside the patient's body, the tynes 1214 can be separated. In the embodiment shown in FIG. 12C, one tyne 1214 is stationary, while the second tyne 1214 slides away from the first tyne 1214 . In the embodiment shown in FIG. 12D, both tynes 1214 move away from the center.
  • the tissue restraint module may comprise only one tyne.
  • the single-tyne module may have a shape such as “ ⁇ ”, “ ⁇ ”, or “ ”.
  • the tissue restraint module is held against a tissue or an organ during the surgical procedure.
  • a surface area of the tissue or organ becomes restrained, i.e., the local motion of the tissue or the organ is considerably reduced as compared with an unrestrained region of the tissue or the organ.
  • the restraining of the tissue or the organ provides a relatively stable area on which the user can perform the surgical procedure.
  • the immediate portion 190 of the cannula can be adapted to hold a number of different tools to be used during the operation.
  • the cannula may be the cannula leading to the tissue restraint module or the cannula leading to the grasp module 710 at the distal end 120 of the device.
  • the cannula is the one leading the tissue restraint module.
  • the user can retrieve a first tool from the cannula while within the patient's body and attach it to the grasp module 710 . After using the first tool, the user can then return the first tool to the cannula, retrieve a second tool and attach it to the grasp module 710 . Other tools may subsequently be used in a similar fashion.
  • the cannula 190 is held in place using a positioning arm 140 (see FIG. 1).
  • the positioning arm 140 comprises at least one joint capable of being tightened or loosened using a release mechanism.
  • the user can release the joint, move the positioning arm 140 to a desired location, and thereby re-position the cannula 190 .
  • the invention provides for a one-hand-release mechanism.
  • the user can grasp the positioning arm 140 with one hand, and while holding the positioning arm 140 , loosen the joint using the same hand, move the positioning arm 140 to a new location using the same hand, and then tighten the joint, again using the same hand.
  • the one-hand-release mechanism allows the user to reposition the cannula using one hand, while manipulating the distal end 120 of the device using the control portion 110 with the other hand.
  • FIGS. 15 A-B and 16 A-C illustrate one embodiment of an articulation mechanism implemented in the articulation portion of the intermediate portion 190 .
  • a spring bar 1510 is embedded within the body of the outer sleeve.
  • the spring bar may be made of any material, such as plastic or metal, that allows it to resiliently bend while exerting a reacting force against the bending.
  • the spring bar 1510 acts to prevent the articulation portion from bending unless a force is exerted to cause it to bend.
  • An opposite wall of the sleeve is lined with small pouches 1520 .
  • FIG. 16C illustrates the arrangement of the pouches 1520 and the spring bar 1510 in a cross-sectional view of the articulation portion.
  • the pouches 1520 are densely placed along the length of the articulation portion.
  • the pouches 1520 are connected to a reservoir of hydraulic liquid (not shown) by a series of orifices or valves in each pouch.
  • the pouches 1520 are filled with the hydraulic liquid.
  • the filled pouches 1520 press against one another and force an expansion of the side of the articulation portion with the pouches 1520 . This expansion causes the spring bar 1510 to bend, causing the articulation portion to bend, as shown in FIG. 16B.
  • FIG. 13 Another aspect of the present invention includes a double acting/double cylinder system.
  • This system is depicted in FIG. 13.
  • the system comprises a control cylinder 1320 and a slave cylinder 1310 .
  • the control cylinder comprises a piston 1318 and a shaft 1320 attached thereto.
  • the piston 1318 is capable of moving within the control cylinder 1320 .
  • the piston divides the control cylinder into two cavities: a distal cavity, a wall of which is A 1 , and a proximal cavity, a wall of which is A 2 .
  • the shaft 1322 passes through the proximal cavity.
  • the piston 1318 prevents liquid communication between the distal cavity and the proximal cavity.
  • the slave cylinder comprises a piston 1314 and a shaft 1316 attached thereto.
  • the piston 1314 is capable of moving within the slave cylinder 1310 .
  • the piston divides the slave cylinder into two cavities: a distal cavity, a wall of which is A 3 , and a proximal cavity, a wall of which is A 4 .
  • the shaft 1316 passes through the proximal cavity.
  • the piston 1314 prevents liquid communication between the distal cavity and the proximal cavity.
  • a control line provides hydraulic communication between the proximal cavity of the control cylinder and the proximal cavity of the slave cylinder.
  • Another control line provides hydraulic communication between the distal cavity of the control cylinder and the proximal cavity of the slave cylinder.
  • the two distal cavities are in hydraulic communication with each other
  • the two proximal cavities are in hydraulic communication with each other, but no proximal cavity is in hydraulic communication with any distal cavity.
  • control cylinder piston 1318 moves towards the distal end of the control cylinder 1320 , hydraulic fluid is moved from the distal cavity of the control cylinder, through a control line, and into the distal cavity of the slave cylinder, thereby pushing the slave cylinder piston 1314 towards the proximal end of the slave cylinder 1310 .
  • the reverse may also happen. If the control cylinder piston 1318 moves towards the proximal end of the control cylinder 1320 , hydraulic fluid is moved from the proximal cavity of the control cylinder, through a control line, and into the proximal cavity of the slave cylinder, thereby pushing the slave cylinder piston 1314 towards the distal end of the slave cylinder 1310 . Further, while the control cylinder piston 1318 remains stationary, the salve cylinder piston 1314 also remains stationary.
  • the double acting/double cylinder system of the invention comprises an overpressure reservoir. If the hydraulic pressure within the cylinders or the control lines exceeds a certain amount, some hydraulic fluid is transferred to the overpressure reservoir.
  • the opening to the overpressure reservoir may comprise a pressure gauge device, which can become activated when the hydraulic pressure within a system surpasses a certain preset value. When the pressure gauge device is activated, the opening to the overpressure reservoir opens and hydraulic fluid can then enter the reservoir.
  • the overpressure reservoir comprises an opening, which is in constant fluid communication with the hydraulic fluid within the system.
  • the reservoir further comprises a spring mechanism at the side opposite to the opening.
  • hydraulic pressure within the system surpasses the pressure applied by the spring mechanism, hydraulic fluid enters the reservoir from the system.
  • the reservoir may also function as a fluid replacement reservoir.
  • the flow of the hydraulic fluid inside the system will move very easily so that not enough resistance is afforded. In these situations, it is difficult for a user to control the movement of the cylinders with fine precision. Therefore, certain embodiments of the invention feature a narrowing at a point in the hydraulic tubing, the purpose of which is to create resistance. In some embodiments, the user can change the amount of narrowing, and therefore, the amount of resistance in the hydraulic tubing.
  • FIG. 13 depicts the relationship between the control cylinder 1310 and the slave cylinder 1312 .
  • the control cylinder 1310 has a piston 1314 and a shaft 1316 .
  • the front of the piston 1314 i.e., the opposite face from where the shaft 1316 attaches to the piston 1314 , has an area of A 3 and the back of the piston 1314 , i.e., the face where the shaft 1316 attaches, has an area is A 4 .
  • a 3 is equal to A 4 plus the area of the shaft 1316 .
  • the slave cylinder 1312 also has a piston 1318 and a shaft 1320 .
  • the volumes of displaced hydraulic fluid in front of and behind the piston 1318 must be equal to the volume of displaced hydraulic fluid in front of and behind the piston 1314 .
  • the present invention features a multiple stroke cylinder system (FIG. 14).
  • a stroke of the control cylinder 1410 causes check valve 1414 to close and check valve 1412 to open. Hydraulic fluid is then transferred from the control cylinder 1410 to the slave cylinder 1418 .
  • Another stroke of the control cylinder 1410 will then cause additional movement in the slave cylinder 1418 .
  • the system is also equipped with a “dump” valve 1416 .
  • the dump valve 1416 may be activated by the user at anytime. When the dump valve 1416 is activated, hydraulic fluid is transferred from the slave cylinder 1418 back to the reservoir 1422 .
  • a spring mechanism 1420 is placed behind the piston of the slave cylinder.
  • Those of skill in the art know of other mechanisms that can be used to return the piston of the slave cylinder to its original position.
  • the system is so configured that the user can reverse the flow of the hydraulic fluid. Therefore by additional strokes of the control cylinder the user can remove hydraulic fluid from the slave cylinder 1418 and transfer it back to the reservoir 1422 .

Abstract

A double cylinder system is disclosed, comprising at least one controller being adapted to transmit hydraulic control signals; at least one slave being in fluid communication with the controller and being configured to respond to the hydraulic control signals transmitted by the controller; and at least one control line providing hydraulic communication between the controller and the slave. Also disclosed is a surgical device, comprising at least one controller located at a proximal end of the device, the controller being adapted to transmit hydraulic control signals; at least one manipulator, the manipulator being configured to be controlled by a human hand and to actuate the controller; at least one slave located at a distal end of the device, the slave being in fluid communication with the controller and being configured to respond to the hydraulic control signals transmitted by the controller; and at least one control line providing hydraulic communication between the controller and the slave.

Description

    RELATED APPLICATIONS
  • This application claims priority to the U.S. Provisional Application Serial No. 60/219,593, filed Jul. 20, 2000, by Doyle et al., and entitled “HAND-ACTUATED ARTICULATING SURGICAL TOOL,” which is incorporated by reference herein in its entirety, including any drawings.[0001]
  • FIELD OF THE INVENTION
  • The invention relates generally to surgical instruments. More particularly, the invention relates to a hand-actuated articulating surgical tool for use in minimally invasive surgical procedures. [0002]
  • BACKGROUND OF THE INVENTION
  • Current laparoscopic surgical tools are limited in accessibility of certain regions of the human body. Existing tools can perform invasive surgery without making a substantial incision, but these tools are incapable of bending within the body to reach, for example, the backside of the human heart. [0003]
  • Additionally, existing tools rely on use of cables to manipulate the surgical tip of the tool. These tools have the disadvantage of requiring extensive sterilization of the internal components. The cleaning of internal metal cables can be a lengthy and expensive process. This process must be repeated prior to each procedure. Alternatively, disposable components may be used with a substantial increase in recurring costs. [0004]
  • In order for a surgeon to perform a surgical procedure on an active organ, such as the heart, current tools require the organ to be arrested. For example, in order to operate on a small portion of the heart, the patient must be placed on an artificial support system while the heart is temporarily stopped for the surgery. This requires additional equipment such as the artificial support system, substantially increasing the cost of the procedure. Also, the recovery period for the patient is substantially increased. [0005]
  • SUMMARY OF THE INVENTION
  • The present invention provides an apparatus for performing minimally invasive surgery while allowing articulation of the tool within the patient's body. Further, the present invention provides a surgical tool that is simple and inexpensive to sterilize and reuse. Another embodiment of the invention allows a surgeon to operate on a portion of an organ, for example, the heart, without the need for arresting the entire organ. [0006]
  • One embodiment of the present invention is a surgical device, comprising at least one controller located at the proximal end of the device adapted to transmit hydraulic control signals. At least one manipulator, configured to be controlled by a human finger actuates the controller. At least one slave, located at the distal end of the device, is in fluid communication with the controller and is configured to respond to the hydraulic control signals transmitted by the controller. A control line provides hydraulic communication between the controller and the slave. [0007]
  • In a preferred embodiment, the controller comprises a control cavity and a piston within the control cavity. The piston divides the control cavity into a first control cavity portion and a second control cavity portion and prevents communication between the two portions. The slave comprises a slave cavity and a piston within the slave cavity that divides the slave cavity into first and second portions and prevents communication between the two portions. The control line provides hydraulic communication between the first control cavity portion and the first slave cavity portion. A second control line provides hydraulic communication between the second control cavity portion and the second slave cavity portion. [0008]
  • In another embodiment, the surgical device comprises a control portion located at the proximal end having a plurality of controllers, each controller being adapted to transmit hydraulic control signals. A plurality of manipulators, configured to be controlled by a human finger, actuate a corresponding controller. A slave portion located at the distal end of the device comprises a plurality of slaves. Each slave is in communication with a corresponding controller, and responds to the hydraulic control signals transmitted by the controller. A surgical tip is manipulated by the slaves in response to the hydraulic control signals. Control lines provide communication between the controllers and the slaves. In a preferred embodiment, an outer sleeve envelops the control lines. [0009]
  • The device can also include an articulating portion. The articulating portion comprises a spring bar on one side and a plurality of pockets on an opposing side. The pockets are configured to receive a hydraulic fluid and expand, causing the device to bend as desired. In a preferred embodiment, the device includes a stabilizer having a rigid shaft and a stabilizing plate. The stabilizing plate has an access cutout, and is configured to pivot about the end of the shaft. The shaft can include an articulating portion, if desired. [0010]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The features, objects and advantages of the present invention will become more apparent from the detailed description set forth below when taken in conjunction with the drawings in which like references identify correspondingly throughout, and wherein: [0011]
  • FIG. 1 is an overview of one embodiment of the invention. [0012]
  • FIG. 2 is a detailed drawing of one embodiment of the control portion of the invention. FIG. 2A is top view, FIG. 2B is side view, and FIG. 2C is front view. FIG. 2D shows a top view of a grasp cam. FIG. 2E shows a top view of a bend cam. [0013]
  • FIG. 3 is a detailed drawing of an embodiment of a control cylinder. FIG. 3A shows the cylinder's retracted position, while FIG. 3B shows the cylinder's extended position. FIG. 3D shows the components of the control cylinder individually. [0014]
  • FIG. 4 is a detailed drawing of an embodiment of a hydraulic extend module. FIG. 4A shows the module's retracted position, while FIG. 4B shows the module's extended position. FIG. 4C shows the front view of the module. FIGS. [0015] 4D-E show two embodiments of an electrical extend module.
  • FIG. 5A is a detailed drawing of an embodiment of a hydraulic rotate module. FIG. 5B is a detailed drawing of an embodiment of an electrical rotate module. [0016]
  • FIG. 6A is a detailed drawing of an embodiment of a hydraulic bend module. FIG. 6B is a drawing of a gear component in the module. FIG. 6C is a drawing of a rack component in the module. FIG. 6D is a detailed drawing of an embodiment of an electrical bend module. [0017]
  • FIG. 7A-B is a detailed drawing of an embodiment of a hydraulic grasp module. FIG. 7A is top view and FIG. 7B is side view. FIG. 7C is a detailed drawing of an embodiment of an electrical grasp module. [0018]
  • FIG. 8 depicts a tool adapted to fit over the tynes of a grasp module. [0019]
  • FIG. 9 depicts various arrangements of the modules. FIG. 9A shows the modules in bend-extend-rotate-grasp configuration, with the bend module in the straight conformation. FIG. 9B shows the same arrangement with the bend module in the bent conformation. FIG. 9C shows the modules in extend-rotate-bend-grasp configuration, with the bend module in the straight conformation. FIG. 9D shows the same arrangement with the bend module in the bent conformation. [0020]
  • FIG. 10 shows an embodiment of the tubing management. FIG. 10A shows the guide tubes as they are attached to the cannula using an elastic strap. FIG. 10B shows the position of the guide tubes with respect to the bend module, while FIG. 10C shows the position of the guide tubes with respect to the extend module. [0021]
  • FIGS. [0022] 11A-B show an embodiment of the patient restraint.
  • FIG. 12 shows an embodiment of the tissue restraint module. FIG. 12A is top view while FIG. 12B is side view. FIGS. [0023] 12C-E show various embodiments of the separable tynes of the tissue restraint modules.
  • FIG. 13 shows the different cylinder diameters for changing the ratio of movement between the control cylinder and slave cylinder. [0024]
  • FIG. 14 shows an embodiment of the multiple stroke cylinder. [0025]
  • FIGS. [0026] 15A-B are side views showing the articulation mechanism of the present invention.
  • FIGS. [0027] 16A-C are side views showing the articulation mechanism of FIGS. 15A-B in greater detail.
  • DETAILED DESCRIPTION OF THE INVENTION
  • Certain embodiments of the invention will now be described in detail with reference to the figures. [0028]
  • FIG. 1 shows a surgical tool according to the present invention. The tool has a [0029] control portion 110, 112 at the proximal end of the device and a slave portion 120 at the distal end of the device. As used herein, “proximal” refers to the part of the device that remains outside the patient's body, closest to the user. “Distal” refers to the end inserted into the patient, farthest away from the user. As with a specific component of the device, “proximal” refers to the part of the component closest to the proximal end of the device, whereas “distal” refers to the part of the component closest to the distal end of the device. An intermediate portion 190 lies between the control portion 110 and the slave portion 120. The “slave portion,” or the “distal end of the device,” 120 is the portion of the device comprising the slave modules, i.e., the extend module, the bend module, the rotate module, and the grasp module, as each is described in greater detail below. Each portion will now be described in greater detail. The term “cannula” is used to refer to the portion of the device comprising both the intermediate portion 190 and the slave portion 120.
  • The [0030] control portion 110, 112 may be any device that can translate the movements of the user's hand and fingers into hydraulic, mechanical, or electrical signals to actuate the corresponding parts of the slave portion 120 of the device. For example, two such devices are shown in FIG. 1.
  • In certain embodiments, the [0031] control portion 110, 112 uses hydraulic fluid to transfer pressure from a control cylinder to a slave cylinder. The fluid is preferably sterilized distilled water, however a saline solution, a perfluorinated hydrocarbon liquid, or any other physiologically compatible fluid could also be used. A “physiologically compatible fluid” is a fluid that once exposed to tissues and organs, does not create any intolerable reaction, such as a rash or immune response, in the patient, and does not adversely interfere with the normal physiological function of the tissues or organs to which it is exposed. In addition, a physiologically compatible fluid can remain in a patient's body or in contact with a tissue or an organ without the need to remove the fluid.
  • In one embodiment, the [0032] control portion 112 clamps onto the arm of the user by way of a clamp 115. The control portion 112 features finger loops 117, into which the user inserts the user's fingers. By squeezing each finger loop 117, the user creates hydraulic pressure or an electrical signal that results in a corresponding motion at the distal end 120 of the device. The user may then “open” the squeezed finger to create the opposite motion.
  • Each [0033] finger loop 117 is connected with a control cylinder 310 (shown in FIG. 3). The finger loop 117 should be large enough to allow comfortable insertion of a human finger. The finger loop 117 is connected to a longitudinal shaft. The shaft may be made of, for example, metal, ground glass, or ceramic. The shaft may be of any cross-sectional shape, but a circular cross-section is preferred. The cross-sectional size of the shaft, along with the material, are designed to provide sufficient stiffness for predictable control when the finger loop 117 is moved. The shaft slides through an opening in the end of the cylinder body. The interface between the shaft and the opening in the end of the cylinder body is formed to allow for smooth forward and backward movement of the shaft and preferably, at the same time, to provide a waterproof seal.
  • Another embodiment of the invention includes a [0034] control portion 110 that is clamped to the side of a surgical bed using clamps 130. In this embodiment, the user grasps the control portion 110 much in the same way that a motorcycle driver grasps the handles of a motorcycle. The user may turn the handles, push them in, pull them out, pivot them about their axes, or, with the aid of a thumb loop, squeeze them. As detailed below, each of these motions creates a corresponding motion at the distal end 120 of the device.
  • In another embodiment, the [0035] control portion 110 is clamped to an object other than the surgical bed, such as a table or a cart. In yet another embodiment, the control portion 110 is clamped to the user's arms or hand. In still another embodiment, the control portion 110 is held by the user, without it being clamped to anything.
  • FIG. 2A shows the top view of the [0036] control portion 110. A handle 210 is provided for the user's fingers to pass through, while the user's thumb is inserted through a thumb loop 212. The handle 210 may exhibit ridges on the inside of the open loop in order to more comfortably accommodate a user's fingers.
  • The movements of the [0037] control portion 110 are translated into hydraulic motion through the use of control cylinders 214, 216, 218, 220. When the user squeezes the thumb loop 212 towards the handle 210, a bend cam 222 is turned about a vertical axis. The bend cam 222 is shown in FIG. 2D. As the bend cam 222 turns, a roller 224 is pushed towards the back of the handle. The roller 224 is connected to an outer cylinder 312 of a control cylinder 214 via a shaft 318. The backward movement of the shaft 318 extends a piston 320 backwards, thereby creating the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device. The function of a control cylinder and its connection to a slave cylinder are discussed in greater detail below. In one embodiment of the invention, the squeezing of the thumb loop actuates a grasp function at the distal end 120.
  • The [0038] control portion 110 may be attached to the side of a surgical bed using a clamp 130. However, the control portion is free to rotate about a vertical axis 226, shown in FIG. 2B. The rotation of the control portion 110 about the axis 226 causes a roller 230 to move within a bend cam 228. The bend cam 228 is shown in FIG. 2E. The roller 230 is connected to an outer cylinder 312 of a control cylinder 220 via a shaft 318. The forward movement of the shaft 318 extends the piston 320 forward, thereby creating the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device. In one embodiment of the invention, the turning of the handle results in a rotation of the distal end 120 of the device through a rotate module, described in detail below.
  • A user may also push the [0039] handle 210 forward, in which case, the top portion of the control portion 110 moves forward over a slide 232. The slide 232 is connected to an outer cylinder 312 of a control cylinder 218 via an attachment point 330. The outer cylinder 312 is in turn attached to the piston 320 via a shaft 318. The forward movement of the shaft 318 extends the piston 320 forward, thereby creating the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device. In one embodiment of the invention, the forward movement of the handle results in an extension of the distal end 120 of the device through an extension module, described in detail below.
  • The handle part of the [0040] control portion 110 may also rotate along a longitudinal axis coinciding with the shaft 234, as shown in FIG. 2B. In certain embodiments of the invention, the turning of the handle part causes a screw 236 to rotate within a nut 238. In some embodiments of the invention, the screw 236 is stationary and the nut 238 is mobile, whereas in other embodiments of the invention, the screw 236 is mobile and the nut 238 is stationary. The movement of the screw 236 within the nut 238 causes the mobile unit to move linearly with respect to the stationary unit. The mobile unit, whether the screw or the nut, is connected to an outer cylinder 312 of a control cylinder 216 via an attachment point 330. The outer cylinder 312 is in turn attached to the piston 320 via a shaft 318. The forward movement of the shaft 318 extends the piston 320 forward, while the backward movement of the shaft 318 pulls the piston 320 backward. The forward and backward motion of the piston 320 creates the hydraulic pressure needed to actuate a slave cylinder in the distal end 120 of the device. In some embodiments of the invention, rotation of the handle part results in the rotation of the distal end 120 of the device through a rotation module, described in detail below.
  • In certain embodiments of the invention, the movements of the different parts of the [0041] control portion 110 creates electrical signals that are sent through wires in the intermediate portion 190 to the slave cylinders in the distal end 120 of the device, The electrical signal is sufficient to actuate a motor in the corresponding slave cylinder, which in turn results in the slave module being actuated. Thus, for example, a forward movement of the handle 210 creates an electrical signal that actuates a motor in an extend module, which results in the extension of that module. Similarly, the rotation of the handle 210, the bending of the handle 210, and the squeezing of the thumb loop 212, result in the rotate module, the bend module, and the grasp module, respectively, being actuated. The slave modules having a motor are described in greater detail below.
  • [0042] Cylinders 214, 216, 218, and 220 are control cylinders. A typical control cylinder 310 is shown in its retracted position in FIG. 3A and in its extended position in FIG. 3B. The control cylinder 310 comprises an outer cylinder 312 and an inner cylinder 314. The inner cylinder 314 has a diameter that allows it to move within the outer cylinder 312. The outer cylinder 312 is connected to a shaft 318, which in turn is connected to the control portion 110 through the attachment point 330. The movements of the control portion 110, described above, causes the outer cylinder 312 to move longitudinally with respect to the stationary inner cylinder 314.
  • A [0043] piston 320, attached to a shaft 318, moves within the inner cylinder 314, within a distance defined by the two inlet points 322, 324 for the hydraulic fluid. The distal end of the shaft 318 is configured to be capable of attachment to the piston 320, while the proximal end of the shaft 318 is configured to be capable of attachment to the outer cylinder at a site close to the attachment point 330. The outer cylinder or the handle assembly may be provided with ratchet teeth. The ratchet teeth are adapted to engage with a locking mechanism to secure the piston 320 at a desired position relative to the cylinder body. Alternatively, a locking mechanism may employ a friction lock to secure the piston 320 at a desired position.
  • The [0044] piston 320 has a solid front face and is movable along the longitudinal axis of the inner cylinder 314. The front face of the piston 320 is identical in shape to the cross section of the cylindrical cavity. The outer surface of the piston 320 forms an airtight seal with the inner surface of the inner cylinder 314. Thus, the portion of the cavity on one side of the piston 320 does not communicate with the portion of the cavity on the other side of the piston 320. At the same time, the piston 320 must be allowed to move smoothly back and forth along the longitudinal axis of the inner cylinder 314.
  • The proximal end of the [0045] inner cylinder 314 is sealed with a seal 316, comprising an opening therethrough, through which the shaft 318 can slide. The distalend of the inner cylinder 314 is sealed with another seal 328, optionally comprising an 0-ring 326.
  • Thus, in the extended position of the [0046] control cylinder 310, FIG. 3B, the piston 320 is at rest against the proximal seal 316. The hydraulic fluid is located in the inner cylinder 314 in front of the piston 320. When the control portion 110 is moved in a way described above, i.e., when the handle 210 is moved forward, the outer cylinder 312 moves forward, thereby moving the shaft 318 and the piston 320. Hydraulic fluid exits the inner cylinder 314 through an inlet 324, creating a hydraulic pressure at a point in the distal end 120 of the device. Additional hydraulic fluid, displaced from a slave cylinder, enters to the back of the piston 320 through another inlet 322, thereby keeping the volume of the hydraulic fluid in the system constant. When the control portion 110 is moved completely, the control cylinder 310 is in its retracted position, FIG. 3A. In this position, the piston 320 is at the distal end of the inner cylinder 314, resting against the distal seal 328. The hydraulic fluid is in the back of the piston 320. Those of skill in the art understand that although in the above discussion the piston 320 is described to move from the fully retracted position to the fully extended position, the piston 320 may move from any point along the two extremes to any other point along the two extremes, and thereby cause a corresponding movement in a slave cylinder.
  • The [0047] cannula 190 comprises hydraulic tubings, connecting the control cylinders of the control portion 110 with the slave cylinders at the distal end 120, and housings for the hydraulic tubings.
  • The [0048] distal end 120 comprises modular components. The components can be selected from, for example, an extend module, a rotate module, a bend module, and a grasp module. Other functions can be included as well and activated in the manner described in detail below. Each module is individually describe in greater detail below. The invention is adapted such that the user can pick the combination of modules and the quantity of each individual module that is best suitable for the user's needs and assemble them conveniently.
  • The extend [0049] module 410 is depicted in both its retracted position, FIG. 4A, and extended position, FIG. 4B. The extend module 410 is identical in its construction to the control module 310; however, the function of the two are reversed. By applying hydraulic pressure using the control portion 110, hydraulic fluid enters the inner cylinder 414 pushing the piston 420 towards the distal end of the module and the distal seal 416. The shaft 418 moves through the distal seal 416, but it is attached to the outer cylinder 412 at the distal end of the outer cylinder 430. The movement of the piston 420 moves the outer cylinder 412 towards the distal end of the module, thereby extending the cannula. The hydraulic fluid present inside the inner cylinder 414 exits the inner cylinder 414 through the distal outlet 422. The proximal seal 428 prevents the leakage of hydraulic fluid from proximal end of the inner cylinder 414.
  • Additional modules can be attached to the extend module either at its distal end, through the distal attachment point [0050] 430, or at its proximal end, through the proximal attachment point 431.
  • In another embodiment, the extend module may be extended using electrical power instead of hydraulic power. In this embodiment, by pushing forward on the [0051] handle 210 of the control portion 110, the user causes an electrical connection to be formed, whereby electrical signal is sent from the control portion 110 through wires in the intermediate portion 190 to the extend module 432, FIGS. 4D, 4E. The electrical signal causes an electrical motor 434 to turn. In one embodiment, FIG. 4D, a screw 436 is mounted within the motor 434. The turning of the motor 434 causes the screw to move outward, thereby causing the outer cylinder 440 to move away from the inner cylinder 442. In this embodiment, the motor is stationary, i.e., it is attached to the inner cylinder 442, whereas the screw is mobile, i.e., it moves with respect to the motor and the inner cylinder 442. The screw 436 is attached at its distal end to the outer cylinder 440.
  • In another embodiment, FIG. 4E, the [0052] motor 434 causes the screw 436 to turn within a nut 438. The nut 438 is attached to the outer cylinder 440. The turning of the screw 436 causes the nut 438 to move with respect to the screw 436, thereby moving the outer cylinder 440 longitudinally with respect to the inner cylinder 442, causing the module to extend. In this embodiment, the motor 434 and the screw 436 are stationary with respect to the inner cylinder 442, whereas the nut 438 and the outer cylinder 440 are mobile.
  • The rotate [0053] module 510, FIG. 5A, comprises similar hydraulic components as those of the extend module 410. As in the extend module 410, hydraulic pressure, applied by rotating the control portion 110 along a longitudinal axis, causes piston 520 to move toward the distal end of the module, causing the shaft 518 to move in that direction as well. The shaft 518 is attached to a lead screw 522 at an attachment point 524. Extension of the shaft 518 causes the lead screw 522 to move towards the distal end of the module. The lead screw is incapable of rotating, since a stabilizer 526 prevents its rotation. The lead screw 522 instead is extended through a nut assembly 528 which is immovably attached to an outer cylinder 530. The movement of the lead screw 522 through the nut assembly 528 causes the nut assembly 528 to rotate, thereby rotating the outer cylinder 530.
  • Additional modules can be attached to the rotate module either at its distal end, through the [0054] distal attachment point 532, or at its proximal end, through the proximal attachment point 534.
  • In another embodiment, the rotate module may be rotated using electrical power instead of hydraulic power. In this embodiment, by turning the [0055] handle 210 of the control portion 110, the user causes an electrical connection to be formed, whereby an electrical signal is sent from the control portion 110 through wires in the intermediate portion 190 to the rotate module 540, FIGS. 5B. The electrical signal causes an electrical motor 542 to turn. The electrical motor 542 is attached to a shaft 544 which in turn is attached to the outer cylinder 546. The turning of the shaft rotates the outer cylinder. In some embodiments, a gear reducer assembly 548 may also be present to reduce the rotation speed. In certain embodiments, the connection between the outer cylinder 546 and the cylinder housing the motor assembly 542 may feature a bearing assembly 550.
  • The [0056] bend module 610 is depicted in FIG. 6A. This module also features the same hydraulic assembly present in the extend and the rotate modules, above. Applying hydraulic pressure by rotating the control portion 110 along the vertical axis 226 in a clockwise direction causes the piston 620 and the shaft 618 to move towards the distal end of the module. The shaft 618 is attached to a rack 624 either directly or through an attachment assembly 622. The movement of the shaft 618 moves the rack 624. The rack 624 has teeth that correspond to the teeth on a gear 626. The movement of the rack 624 causes the gear 626 to rotate clockwise. The gear 626 is connected to the distal end 628 of the module. The rotation of the gear 626 causes the distal end 628 of the module to bend clockwise. By rotating the control portion 110 in a counter-clockwise direction, the piston 620 is moved towards the proximal end of the module, causing the rack 624 to move backwards as well, which in turn causes the gear 626 to turn counter-clockwise, which in turn causes the distal end 628 of the module to bend counter-clockwise.
  • In some embodiments, the bending of the [0057] distal end 628 of the module is through an angle of at least 110°, i.e., when the piston 620 moves from the proximal end of the hydraulic portion completely to the distal end of the hydraulic portion, the distal end 628 of the module bends at least 110°. In other embodiments, the rotation is an angle of at least 110°, at least 150°, at least 200°; at least 250°, at least 300°, or an angle of at least 350°.
  • Additional modules can be attached to the bend module either at its distal end, through the [0058] distal attachment point 630, or at its proximal end, through the proximal attachment point 632.
  • In another embodiment, the bend module may be bent using electrical power instead of hydraulic power. In this embodiment, by turning the [0059] handle 210 of the control portion 110, the user causes an electrical connection to be formed, whereby electrical signal is sent from the control portion 110 through wires in the intermediate portion 190 to the bend module. The electrical signal causes an electrical motor to turn. The electrical motor is attached to a shaft which in turn is attached to the rack 624. The movement of the shaft 618 moves the rack 624, which in turn causes the gear 626 to rotate, which in turn causes the distal end 628 of the module to bend.
  • In another embodiment, FIG. 6D, the turning of the [0060] motor 640 causes a lead screw 642 to rotate within a nut 644. The lead screw 642 is stationary with respect to the motor 640 and the outer body of the module, whereas the nut 644 is mobile. The nut 644 is connected to a link 646 at the proximal end of the link 646. The distal end of the link 646 is connected to the distal end of the module. When the nut 644 is moved backwards, it causes the link 646 to move backwards, thereby causing the distal end of the module to rotate. Reversing the electrical current, by rotating the control portion 110 in the opposite direction, will cause the motor to turn in the opposite direction, thereby causing the nut to move forward and the distal end of the module to bend in a clockwise direction.
  • FIG. 7A depicts the top view of the [0061] grasp module 710, whereas FIG. 7B depicts its side view. The grasp module 710 also features a hydraulic portion similar to those of other modules. When the thumb loop 212 is squeezed towards the handle 210, hydraulic pressure is applied and the shaft 718 moves towards the distal end of the module. This movement causes the pin 720 to move towards the distal end of the module as well, thereby causing the two pins 722 to move away from the center. As the two pins 722 move away from the center, the angle defined by pin 722-pin 720-pin 722 tends away from 90° and towards 180°. The movement of the pins 722 causes the two tynes 724 to move towards each other and, eventually, touch. Moving the thumb loop 212 away from the handle 210 will have the opposite effect of causing the tynes 724 to move away from each other and open up.
  • In another embodiment, the squeezing of the [0062] thumb loop 212 causes an electrical current to turn a motor 740, FIG. 7C, in the grasp module 730. The motor 740 turns a stationary lead screw 742, which in turn causes a nut 744 to move longitudinally. The movement of the nut 744 causes the tynes to move closer to each other and, eventually, touch. Moving the thumb loop 212 away from the handle 210 will have the opposite effect of causing the tynes 724 to move away from each other and open up.
  • The [0063] tynes 724 of the grasp module 710 are configured to accommodate a number of different tools. For example, in FIG. 8, a grasp tool 810 is shown that can fit over the tynes 724. When the tynes 724 move towards each other, the end portion of the grasp tool 810 also move toward each other and, eventually, touch. If an object or tissue is located between the end portions of the grasp tool 810, the object is then grasped by the tool. There may be a number of tools that can be attached over the tynes 724. In addition to the grasp tool, these include a scissors, a knife for cutting the tissue, drill bits for drilling into bones, heating elements for cauterizing tissue, or any other tool necessary during a surgical procedure.
  • All the above tools and other tools can fit individually and interchangeably on the [0064] grasp module 710. Therefore, during a surgical procedure, the user may attach one tool to the grasp module 710, use it, remove it, and then attach another tool to the same grasp module 710. This process can be repeated any number of times with any number of tools.
  • As mentioned above, the modules of the present invention are designed to be placed in order that the user deems most useful. For example, FIG. 9 depicts four of the modules attached in the order of (from proximal end to distal end) bend, extend, rotate, and grasp. FIG. 9A shows the bend module in its retracted position, where the cannula is straight. FIG. 9B shows the bend module in its extended position where the module is bent. Alternatively, the four modules could be arranged in the extend-rotate-bend-grasp configuration, as shown in FIGS. 9C, 9D. Other combinations are also possible. In addition, the user may attach more than a single module of a particular type, for example, two or three or more extend modules or two or three or more bend modules, could be put together, along with other modules to form the [0065] distal end 120 of the device. Preferably, the grasp module 710 is always the most distally located module.
  • As shown in FIG. 4C, the front view of the extend module, the hydraulic tubing connecting the various modules to the control cylinders are located at one side of the slave cylinders. The hydraulic tubing runs alongside the cannula and connects to the inlet openings of the hydraulic portion of each module. In some embodiments of the invention, to keep the hydraulic tubing in place, a series of low [0066] friction guide tubes 1010 are attached to the cannula by an elastic strap 1012 (FIG. 10A). Each hydraulic tubing 1014 fits through one guide tubing and is free to move longitudinally, i.e., in the direction of the arrow 1016, within the guide tubing 1010. Thus, when the bend module bends, FIG. 10B, or when the extend module extends, FIG. 10C, the hydraulic tubing can move along the cannula and maintain the connection 1018 with the hydraulic inlets of each of the modules.
  • In certain embodiments, the present invention features a [0067] restraint 1110 that can be attached to the cannula 190 using a thumb screw 1112 (FIG. 11). The restraint 1110 sits adjacent to the patient's skin on the outside of the patient's body at the point of entry of the cannula 190. The restraint 1110 keeps the depth of the cannula 190 with respect to the body of the patient's body. If the patient makes any moves during the surgery, for example if the anesthesia begins to wear off and the patient jolts, the cannula moves with the patient. More importantly, the depth of the cannula inside the patient's body remains unchanged. Therefore, if the patient moves, the patient will not be damaged by the cannula.
  • As part of their normal physiological function, certain organs in the body have continuous motion. For example, the heart beats, the lungs expand and contract as the patient breathes, and the gastrointestinal tract also undergoes contractile motion. When performing surgery, it is often necessary stabilize the part of the organ undergoing surgery so that additional injury to the organ does not occur and the organ can be worked on. Aspects of the invention also feature a tissue restraint module [0068] 1210 (FIG. 12) that can be inserted into the patient's body at or near the site where any other cannula has been inserted. The tissue restraint module 1210 features a bend module, as described above. Once inserted into the patient's body, the separable tynes 1214 can be brought close to the tissue that is to be restrained. The bend module allows the tyne assembly to be bent with respect to the cannula, so that the tynes 1214 may be placed over the tissue. The tynes 1214 are separable so that they can provide a relatively stable tissue area for the performance of the surgery.
  • A number of different mechanisms for separating the [0069] tynes 1214 are shown in FIGS. 12C-E. In the embodiments shown, the tissue restraint module comprises two tynes 1214. The tynes 1214 are adapted to be separable. When inserting the module into the patient's body, the tynes 1214 are held together to reduce the width of the device. Inside the patient's body, the tynes 1214 can be separated. In the embodiment shown in FIG. 12C, one tyne 1214 is stationary, while the second tyne 1214 slides away from the first tyne 1214. In the embodiment shown in FIG. 12D, both tynes 1214 move away from the center. Since the two tynes 1214 are bent inward, in their fully extended position the distal end of the two tynes 1214 would be parallel to each other. The embodiment shown in FIG. 12E functions similarly, except that the two tynes are not bent. In the fully extended position the two tynes 1214 form a “V” shaped opening. Other embodiments are also contemplated. For example, the tissue restraint module may comprise only one tyne. In certain embodiments, the single-tyne module may have a shape such as “∩”, “┌”, or “
    Figure US20030153902A1-20030814-P00900
    ”.
  • In certain embodiments, the tissue restraint module is held against a tissue or an organ during the surgical procedure. By doing so, in the space between the two [0070] tynes 1214, or a particular space created within a single tyne, a surface area of the tissue or organ becomes restrained, i.e., the local motion of the tissue or the organ is considerably reduced as compared with an unrestrained region of the tissue or the organ. The restraining of the tissue or the organ provides a relatively stable area on which the user can perform the surgical procedure.
  • In certain embodiments, the [0071] immediate portion 190 of the cannula can be adapted to hold a number of different tools to be used during the operation. The cannula may be the cannula leading to the tissue restraint module or the cannula leading to the grasp module 710 at the distal end 120 of the device. Preferably, the cannula is the one leading the tissue restraint module. During the operation, the user can retrieve a first tool from the cannula while within the patient's body and attach it to the grasp module 710. After using the first tool, the user can then return the first tool to the cannula, retrieve a second tool and attach it to the grasp module 710. Other tools may subsequently be used in a similar fashion.
  • The [0072] cannula 190 is held in place using a positioning arm 140 (see FIG. 1). The positioning arm 140 comprises at least one joint capable of being tightened or loosened using a release mechanism. The user can release the joint, move the positioning arm 140 to a desired location, and thereby re-position the cannula 190. In one embodiment, the invention provides for a one-hand-release mechanism. In this embodiment, the user can grasp the positioning arm 140 with one hand, and while holding the positioning arm 140, loosen the joint using the same hand, move the positioning arm 140 to a new location using the same hand, and then tighten the joint, again using the same hand. The one-hand-release mechanism allows the user to reposition the cannula using one hand, while manipulating the distal end 120 of the device using the control portion 110 with the other hand.
  • In using the devices of the present invention, it is often the case that the tools at the distal portion of the device are to move a short distance. This distance is small enough that it would become difficult for the user to move his hands or fingers for that short a distance. Therefore, a system is needed to convert a longer movement of the user's hands and fingers at the proximal end of the device to a short movement of the tools at the distal end of the device. This is accomplished by having the control cylinder and the slave cylinder be of different diameters. Of importance, is the relationship between the piston area and the shaft area when using cylinders of different diameters, as generally described below. [0073]
  • At least a portion of the [0074] intermediate portion 190 of the laparoscopic tool is preferably an articulation portion. FIGS. 15A-B and 16A-C illustrate one embodiment of an articulation mechanism implemented in the articulation portion of the intermediate portion 190. A spring bar 1510 is embedded within the body of the outer sleeve. The spring bar may be made of any material, such as plastic or metal, that allows it to resiliently bend while exerting a reacting force against the bending. The spring bar 1510 acts to prevent the articulation portion from bending unless a force is exerted to cause it to bend. An opposite wall of the sleeve is lined with small pouches 1520. FIG. 16C illustrates the arrangement of the pouches 1520 and the spring bar 1510 in a cross-sectional view of the articulation portion. The pouches 1520 are densely placed along the length of the articulation portion. The pouches 1520 are connected to a reservoir of hydraulic liquid (not shown) by a series of orifices or valves in each pouch. When hydraulic fluid is supplied to the pouches 1520 through the orifices or valves, the pouches 1520 are filled with the hydraulic liquid. The filled pouches 1520 press against one another and force an expansion of the side of the articulation portion with the pouches 1520. This expansion causes the spring bar 1510 to bend, causing the articulation portion to bend, as shown in FIG. 16B.
  • Double Acting/Double Cylinder System [0075]
  • Another aspect of the present invention includes a double acting/double cylinder system. This system is depicted in FIG. 13. The system comprises a [0076] control cylinder 1320 and a slave cylinder 1310. The control cylinder comprises a piston 1318 and a shaft 1320 attached thereto. The piston 1318 is capable of moving within the control cylinder 1320. The piston divides the control cylinder into two cavities: a distal cavity, a wall of which is A1, and a proximal cavity, a wall of which is A2. The shaft 1322 passes through the proximal cavity. The piston 1318 prevents liquid communication between the distal cavity and the proximal cavity.
  • The slave cylinder comprises a [0077] piston 1314 and a shaft 1316 attached thereto. The piston 1314 is capable of moving within the slave cylinder 1310. The piston divides the slave cylinder into two cavities: a distal cavity, a wall of which is A3, and a proximal cavity, a wall of which is A4. The shaft 1316 passes through the proximal cavity. The piston 1314 prevents liquid communication between the distal cavity and the proximal cavity.
  • A control line provides hydraulic communication between the proximal cavity of the control cylinder and the proximal cavity of the slave cylinder. Another control line provides hydraulic communication between the distal cavity of the control cylinder and the proximal cavity of the slave cylinder. Thus, in the system, the two distal cavities are in hydraulic communication with each other, the two proximal cavities are in hydraulic communication with each other, but no proximal cavity is in hydraulic communication with any distal cavity. [0078]
  • If the [0079] control cylinder piston 1318 moves towards the distal end of the control cylinder 1320, hydraulic fluid is moved from the distal cavity of the control cylinder, through a control line, and into the distal cavity of the slave cylinder, thereby pushing the slave cylinder piston 1314 towards the proximal end of the slave cylinder 1310. The reverse may also happen. If the control cylinder piston 1318 moves towards the proximal end of the control cylinder 1320, hydraulic fluid is moved from the proximal cavity of the control cylinder, through a control line, and into the proximal cavity of the slave cylinder, thereby pushing the slave cylinder piston 1314 towards the distal end of the slave cylinder 1310. Further, while the control cylinder piston 1318 remains stationary, the salve cylinder piston 1314 also remains stationary.
  • In an embodiment, the double acting/double cylinder system of the invention comprises an overpressure reservoir. If the hydraulic pressure within the cylinders or the control lines exceeds a certain amount, some hydraulic fluid is transferred to the overpressure reservoir. The opening to the overpressure reservoir may comprise a pressure gauge device, which can become activated when the hydraulic pressure within a system surpasses a certain preset value. When the pressure gauge device is activated, the opening to the overpressure reservoir opens and hydraulic fluid can then enter the reservoir. [0080]
  • In another embodiment, the overpressure reservoir comprises an opening, which is in constant fluid communication with the hydraulic fluid within the system. The reservoir further comprises a spring mechanism at the side opposite to the opening. When the hydraulic pressure within the system surpasses the pressure applied by the spring mechanism, hydraulic fluid enters the reservoir from the system. Conversely, when the pressure within the system falls below the pressure applied by the spring mechanism, for example due to a leak in the system, hydraulic fluid enters the system from the reservoir. Thus, the reservoir may also function as a fluid replacement reservoir. [0081]
  • In certain embodiments, the flow of the hydraulic fluid inside the system will move very easily so that not enough resistance is afforded. In these situations, it is difficult for a user to control the movement of the cylinders with fine precision. Therefore, certain embodiments of the invention feature a narrowing at a point in the hydraulic tubing, the purpose of which is to create resistance. In some embodiments, the user can change the amount of narrowing, and therefore, the amount of resistance in the hydraulic tubing. [0082]
  • FIG. 13 depicts the relationship between the [0083] control cylinder 1310 and the slave cylinder 1312. The control cylinder 1310 has a piston 1314 and a shaft 1316. The front of the piston 1314, i.e., the opposite face from where the shaft 1316 attaches to the piston 1314, has an area of A3 and the back of the piston 1314, i.e., the face where the shaft 1316 attaches, has an area is A4. Thus, A3 is equal to A4 plus the area of the shaft 1316. When the piston 1314 moves backwards a distance of l2, the amount of hydraulic fluid displaced in front of the piston 1314 will have a volume of A3l2. However, the volume of the hydraulic fluid displaced behind the piston 1314 will be A4l2.
  • The slave cylinder [0084] 1312 also has a piston 1318 and a shaft 1320. The volumes of displaced hydraulic fluid in front of and behind the piston 1318 must be equal to the volume of displaced hydraulic fluid in front of and behind the piston 1314. In other words,
  • A 1 l 1 =A 3 l 2
  • and[0085]
  • A 2 l 1 =A 4 l 2
  • where l[0086] 1 is the distance traveled by the slave cylinder. Rearranging the equations results in 1 2 = A 1 1 2 A 3 = A 2 1 1 A 4
    Figure US20030153902A1-20030814-M00001
  • which result in the basic relationship between the various surface areas as [0087] A 1 A 3 = A 2 A 4
    Figure US20030153902A1-20030814-M00002
  • It is readily understood by those of skill in the art that the above relationship will also hold true if the control cylinder and the slave cylinder are configured such that small movements by the user's hands and fingers results in longer movements at the distal end of the device, In other words, in FIG. 13, in one embodiment [0088] 1312 represents the slave cylinder and 1310 represents the control cylinder, whereas in another embodiment, 1312 represents the control cylinder and 1310 represents the slave cylinder.
  • In certain embodiments, when it is desirable to have a long range of movement or very fine movement at the distal end of the device, it is preferable to affect a full range of movement at a slave cylinder at the distal end of the device using multiple strokes of a control cylinder. In these embodiments, the present invention features a multiple stroke cylinder system (FIG. 14). A stroke of the control cylinder [0089] 1410 causes check valve 1414 to close and check valve 1412 to open. Hydraulic fluid is then transferred from the control cylinder 1410 to the slave cylinder 1418. Returning the piston of the control cylinder 1410 to the original position, i.e., at the proximal end of the control cylinder, causes the check valve 1412 to close and the check valve 1414 to open. Additional hydraulic fluid is then transferred from the reservoir 1422 to the control cylinder 1410. Another stroke of the control cylinder 1410 will then cause additional movement in the slave cylinder 1418.
  • The system is also equipped with a “dump” [0090] valve 1416. The dump valve 1416 may be activated by the user at anytime. When the dump valve 1416 is activated, hydraulic fluid is transferred from the slave cylinder 1418 back to the reservoir 1422.
  • In some embodiments, to aid the removal of the hydraulic fluid from the slave cylinder [0091] 1418 a spring mechanism 1420 is placed behind the piston of the slave cylinder. Those of skill in the art know of other mechanisms that can be used to return the piston of the slave cylinder to its original position.
  • In other embodiments, the system is so configured that the user can reverse the flow of the hydraulic fluid. Therefore by additional strokes of the control cylinder the user can remove hydraulic fluid from the [0092] slave cylinder 1418 and transfer it back to the reservoir 1422.
  • Conclusion
  • Thus, those of skill in the art will appreciate that the devices described herein provide a relatively easy and economical instrument to perform minimally invasive surgery. [0093]
  • One skilled in the art will appreciate that these devices are and may be adapted to carry out the objects and obtain the ends and advantages mentioned, as well as those inherent therein. The methods, procedures, and devices described herein are presently representative of preferred embodiments and are exemplary and are not intended as limitations on the scope of the invention. Changes therein and other uses will occur to those skilled in the art which are encompassed within the spirit of the invention and are defined by the scope of the disclosure. [0094]
  • It will be apparent to one skilled in the art that varying substitutions and modifications may be made to the invention disclosed herein without departing from the scope and spirit of the invention. [0095]
  • Those skilled in the art recognize that the aspects and embodiments of the invention set forth herein may be practiced separate from each other or in conjunction with each other. Therefore, combinations of separate embodiments are within the scope of the invention as disclosed herein. [0096]
  • All patents and publications mentioned in the specification are indicative of the levels of those skilled in the art to which the invention pertains. All patents and publications are herein incorporated by reference to the same extent as if each individual publication was specifically and individually indicated to be incorporated by reference. [0097]
  • The invention illustratively described herein suitably may be practiced in the absence of any element or elements, limitation or limitations which is not specifically disclosed herein. Thus, for example, in each instance herein any of the terms “comprising”, “consisting essentially of” and “consisting of” may be replaced with either of the other two terms. The terms and expressions which have been employed are used as terms of description and not of limitation, and there is no intention that in the use of such terms and expressions indicates the exclusion of equivalents of the features shown and described or portions thereof. It is recognized that various modifications are possible within the scope of the invention disclosed. Thus, it should be understood that although the present invention has been specifically disclosed by preferred embodiments and optional features, modification and variation of the concepts herein disclosed may be resorted to by those skilled in the art, and that such modifications and variations are considered to be within the scope of this invention as defined by the disclosure. [0098]

Claims (18)

What is claimed is:
1. A double cylinder system, comprising:
at least one controller being adapted to transmit hydraulic control signals, said controller further comprises:
a control cavity; and
a first piston within said control cavity, said first piston dividing said control cavity into a first control cavity portion and a second control cavity portion and preventing communication between said first control cavity portion and said second control cavity portion;
at least one slave being in fluid communication with said controller and being configured to respond to said hydraulic control signals transmitted by said controller, said slave comprising
a slave cavity; and
a second piston within said slave cavity, said second piston dividing said slave cavity into a first slave cavity portion and a second slave cavity portion and preventing communication between said first slave cavity portion and said second slave cavity portion; and
at least one control line providing hydraulic communication between said first control cavity portion and said first slave cavity portion; and
at least one control line providing hydraulic communication between said second control cavity portion and said second slave cavity portion.
2. The system of claim 1, further comprising an overpressure reservoir.
3. The system of claim 1, further comprising a manipulator, wherein said manipulator is adapted to change the position of said first piston within said control cavity.
4. A surgical device, comprising:
at least one controller located at a proximal end of the device, said controller being adapted to transmit hydraulic control signals;
at least one manipulator, said manipulator being configured to be controlled by a human hand and to actuate said controller;
at least one slave located at a distal end of the device, said slave being in fluid communication with said controller and being configured to respond to said hydraulic control signals transmitted by said controller; and
at least one control line providing hydraulic communication between said controller and said slave.
5. The surgical device according to claim 4, wherein said controller further comprises:
a control cavity; and
a piston within said control cavity, said piston dividing said control cavity into a first control cavity portion and a second control cavity portion and preventing communication between said first control cavity portion and said second control cavity portion;
wherein said slave further comprises:
a slave cavity; and
a piston within said slave cavity, said piston dividing said slave cavity into a first slave cavity portion and a second slave cavity portion and preventing communication between said first slave cavity portion and said second slave cavity portion; and
wherein said control line provides hydraulic communication between said first control cavity portion and said first slave cavity portion.
6. The surgical device according to claim 5, further comprising a second control line providing hydraulic communication between said second control cavity portion and said second slave cavity portion.
7. A surgical device, comprising:
a control portion located at a proximal end of the device, comprising:
a plurality of controllers, each of said plurality of controllers being adapted to transmit hydraulic control signals; and
a plurality of manipulators, each of said plurality of manipulators being configured to actuate a corresponding one of said plurality of controllers;
a slave portion located at a distal end of the device, comprising:
a plurality of slaves, each of said plurality of slaves being in communication with a corresponding one of said plurality of controllers and being configured to respond to said hydraulic control signals transmitted by said corresponding one of said plurality of controllers; and
an intermediate portion, comprising a plurality of control lines, each of said plurality of control lines providing communication with one of said plurality of controllers and a corresponding one of said plurality of slaves.
8. The surgical device according to claim 7, wherein said intermediate portion further comprises an outer sleeve enveloping said plurality of control lines.
9. The surgical device according to claim 7, wherein said intermediate portion further comprises an articulating portion, said articulating portion further comprising:
a spring bar on a first side of said articulating portion; and
a plurality of pockets on a second side of said articulating portion, said second side opposing said first side,
wherein said pockets are configured to receive a hydraulic fluid, and
wherein, said pockets are configured to expand when said hydraulic fluid is received.
10. The surgical device of claim 7, further comprising a tip adapted to be manipulated by at least one of said plurality of slaves in response to said hydraulic control signals.
11. The surgical device of claim 7, wherein said hydraulic communication is through a hydraulic fluid.
12. The surgical device of claim 11, wherein said hydraulic fluid is physiologically acceptable.
13. The surgical device of claim 7, wherein each of said plurality of slaves has a predefined function.
14. The surgical device of claim 13, wherein said predefined function is selected from extension, rotation, bending, and grasping.
15. The surgical device of claim 13, wherein said predefined function of at least one of said plurality of slaves is different than said predefined function of at least another one of said plurality of slaves.
16. The surgical device of claim 7, further comprising a patient restraint.
17. A tissue restraint module comprising at least one remotely manipulatable tyne capable of restraining a tissue.
18. The tissue restraint module of claim 17, wherein said at least one remotely manipulatable tyne is configured to pivot about the distal end of said module.
US10/388,795 2000-07-20 2003-03-13 Hand-actuated articulating surgical tool Abandoned US20030153902A1 (en)

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US10/996,872 US20050090811A1 (en) 2000-07-20 2004-11-23 Hand-actuated articulating surgical tool
US11/352,899 US7470268B2 (en) 2000-07-20 2006-02-13 Hand-actuated articulating surgical tool
US12/336,950 US8105319B2 (en) 2000-07-20 2008-12-17 Hand-actuated articulating surgical tool
US12/792,630 US20100241137A1 (en) 2000-07-20 2010-06-02 Hand-actuated articulating surgical tool

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US10/996,872 Abandoned US20050090811A1 (en) 2000-07-20 2004-11-23 Hand-actuated articulating surgical tool
US11/352,899 Expired - Lifetime US7470268B2 (en) 2000-07-20 2006-02-13 Hand-actuated articulating surgical tool
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Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050107667A1 (en) * 2003-05-23 2005-05-19 Novare Surgical Systems, Inc. Hand-actuated device for remote manipulation of a grasping tool
US20050251112A1 (en) * 2003-05-23 2005-11-10 Danitz David J Articulating mechanism for remote manipulation of a surgical or diagnostic tool
US20050273084A1 (en) * 2004-06-07 2005-12-08 Novare Surgical Systems, Inc. Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools
US20050273085A1 (en) * 2004-06-07 2005-12-08 Novare Surgical Systems, Inc. Articulating mechanism with flex-hinged links
US20060111210A1 (en) * 2004-11-23 2006-05-25 Novare Surgical Systems, Inc. Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools
US20060111616A1 (en) * 2004-11-24 2006-05-25 Novare Surgical Systems, Inc. Articulating mechanism components and system for easy assembly and disassembly
US20070250113A1 (en) * 2003-05-23 2007-10-25 Hegeman David E Tool with articulation lock
US20070287993A1 (en) * 2006-06-13 2007-12-13 Hinman Cameron D Tool with rotation lock
US20080255588A1 (en) * 2007-04-16 2008-10-16 Hinman Cameron D Tool with multi-state ratcheted end effector
US20080255608A1 (en) * 2007-04-16 2008-10-16 Hinman Cameron D Tool with end effector force limiter
US20080255421A1 (en) * 2007-04-16 2008-10-16 David Elias Hegeman Articulating tool with improved tension member system
US20100041945A1 (en) * 2008-08-18 2010-02-18 Isbell Jr Lewis Instrument with articulation lock
US7785252B2 (en) 2004-11-23 2010-08-31 Novare Surgical Systems, Inc. Articulating sheath for flexible instruments
US20100241136A1 (en) * 2006-12-05 2010-09-23 Mark Doyle Instrument positioning/holding devices
US20100331879A1 (en) * 2009-06-25 2010-12-30 The Curators Of The University Of Missouri Articulating Surgical Hand Tool
WO2011153082A2 (en) * 2010-06-02 2011-12-08 Carefusion 2200, Inc. Hand-actuated articulating surgical tool
US9161771B2 (en) 2011-05-13 2015-10-20 Intuitive Surgical Operations Inc. Medical instrument with snake wrist structure
US9221179B2 (en) 2009-07-23 2015-12-29 Intuitive Surgical Operations, Inc. Articulating mechanism
US11896255B2 (en) 2015-10-05 2024-02-13 Flexdex, Inc. End-effector jaw closure transmission systems for remote access tools

Families Citing this family (585)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE60134236D1 (en) * 2000-07-20 2008-07-10 Kinetic Surgical Llc MANUALLY CONTROLLED SURGICAL TOOL WITH JOINT
WO2002017799A1 (en) 2000-08-30 2002-03-07 Cerebral Vascular Applications Inc. Medical instrument
US6755338B2 (en) * 2001-08-29 2004-06-29 Cerebral Vascular Applications, Inc. Medical instrument
US6723087B2 (en) 2001-12-14 2004-04-20 Medtronic, Inc. Apparatus and method for performing surgery on a patient
CA2497897C (en) * 2002-09-30 2008-11-25 Sightline Technologies Ltd. Piston-actuated endoscopic tool
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US20050131394A1 (en) * 2003-12-10 2005-06-16 Minnesota Scientific, Inc. Clamping device
DE102004009135B3 (en) * 2004-02-25 2005-12-22 Siemens Ag Device for manually remotely controllable navigation of a probe insertable into a human body
US7241290B2 (en) * 2004-06-16 2007-07-10 Kinetic Surgical, Llc Surgical tool kit
US8353897B2 (en) * 2004-06-16 2013-01-15 Carefusion 2200, Inc. Surgical tool kit
US7717875B2 (en) 2004-07-20 2010-05-18 St. Jude Medical, Atrial Fibrillation Division, Inc. Steerable catheter with hydraulic or pneumatic actuator
US8905977B2 (en) 2004-07-28 2014-12-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
DE102005021234A1 (en) * 2005-05-09 2006-11-16 Karl Storz Gmbh & Co. Kg Medical instrument
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US7673781B2 (en) 2005-08-31 2010-03-09 Ethicon Endo-Surgery, Inc. Surgical stapling device with staple driver that supports multiple wire diameter staples
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US7673780B2 (en) 2005-11-09 2010-03-09 Ethicon Endo-Surgery, Inc. Articulation joint with improved moment arm extension for articulating an end effector of a surgical instrument
US7799039B2 (en) 2005-11-09 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument having a hydraulically actuated end effector
EP1983904A1 (en) * 2006-01-27 2008-10-29 Medtronic, Inc. Device and system for surgical dissection and or guidance of other medical devices into body
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US7770775B2 (en) 2006-01-31 2010-08-10 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with adaptive user feedback
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US7766210B2 (en) 2006-01-31 2010-08-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with user feedback system
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US7568603B2 (en) 2006-01-31 2009-08-04 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with articulatable end effector
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US8236010B2 (en) 2006-03-23 2012-08-07 Ethicon Endo-Surgery, Inc. Surgical fastener and cutter with mimicking end effector
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US7740159B2 (en) 2006-08-02 2010-06-22 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist
US7506791B2 (en) 2006-09-29 2009-03-24 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical mechanism for limiting maximum tissue compression
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
JP5153776B2 (en) * 2006-10-03 2013-02-27 バーチャル ポーツ リミテッド Clip instrument for assisting surgery
BRPI0719934A2 (en) * 2006-12-05 2014-03-11 Allegiance Corp DEVICE FOR USE IN POSITIONING AN INSTRUMENT FOR USE IN A SURGICAL PROCEDURE AND METHOD FOR POSITIONING WITH AN PATIENT AN INSTRUMENT FOR USE IN A SURGICAL PROCEDURE
US7721931B2 (en) 2007-01-10 2010-05-25 Ethicon Endo-Surgery, Inc. Prevention of cartridge reuse in a surgical instrument
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US7954682B2 (en) 2007-01-10 2011-06-07 Ethicon Endo-Surgery, Inc. Surgical instrument with elements to communicate between control unit and end effector
US7738971B2 (en) 2007-01-10 2010-06-15 Ethicon Endo-Surgery, Inc. Post-sterilization programming of surgical instruments
US7721936B2 (en) 2007-01-10 2010-05-25 Ethicon Endo-Surgery, Inc. Interlock and surgical instrument including same
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US7900805B2 (en) 2007-01-10 2011-03-08 Ethicon Endo-Surgery, Inc. Surgical instrument with enhanced battery performance
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US20080169332A1 (en) 2007-01-11 2008-07-17 Shelton Frederick E Surgical stapling device with a curved cutting member
US20090001130A1 (en) 2007-03-15 2009-01-01 Hess Christopher J Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US8056787B2 (en) 2007-03-28 2011-11-15 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting instrument with travel-indicating retraction member
US7798386B2 (en) 2007-05-30 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument articulation joint cover
US7810693B2 (en) 2007-05-30 2010-10-12 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting instrument with articulatable end effector
US8157145B2 (en) 2007-05-31 2012-04-17 Ethicon Endo-Surgery, Inc. Pneumatically powered surgical cutting and fastening instrument with electrical feedback
US7905380B2 (en) 2007-06-04 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8534528B2 (en) 2007-06-04 2013-09-17 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US11857181B2 (en) 2007-06-04 2024-01-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US7819299B2 (en) 2007-06-04 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical instrument having a common trigger for actuating an end effector closing system and a staple firing system
US7832408B2 (en) 2007-06-04 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US7510107B2 (en) 2007-06-18 2009-03-31 Ethicon Endo-Surgery, Inc. Cable driven surgical stapling and cutting instrument with apparatus for preventing inadvertent cable disengagement
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
DE102007030854A1 (en) * 2007-06-26 2009-01-02 Aesculap Ag Surgical instrument
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US7703653B2 (en) 2007-09-28 2010-04-27 Tyco Healthcare Group Lp Articulation mechanism for surgical instrument
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US8453908B2 (en) 2008-02-13 2013-06-04 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US7766209B2 (en) 2008-02-13 2010-08-03 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with improved firing trigger arrangement
US7905381B2 (en) 2008-09-19 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with cutting member arrangement
US8540133B2 (en) 2008-09-19 2013-09-24 Ethicon Endo-Surgery, Inc. Staple cartridge
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US7857185B2 (en) 2008-02-14 2010-12-28 Ethicon Endo-Surgery, Inc. Disposable loading unit for surgical stapling apparatus
US7793812B2 (en) 2008-02-14 2010-09-14 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
US8459525B2 (en) 2008-02-14 2013-06-11 Ethicon Endo-Sugery, Inc. Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US7810692B2 (en) 2008-02-14 2010-10-12 Ethicon Endo-Surgery, Inc. Disposable loading unit with firing indicator
US7913891B2 (en) 2008-02-14 2011-03-29 Ethicon Endo-Surgery, Inc. Disposable loading unit with user feedback features and surgical instrument for use therewith
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US7819297B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with reprocessible handle assembly
JP5410110B2 (en) 2008-02-14 2014-02-05 エシコン・エンド−サージェリィ・インコーポレイテッド Surgical cutting / fixing instrument with RF electrode
US7861906B2 (en) 2008-02-14 2011-01-04 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with articulatable components
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
US7819296B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with retractable firing systems
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US20090206139A1 (en) 2008-02-15 2009-08-20 Ethicon Endo-Surgery, Inc. Buttress material for a surgical instrument
US8608044B2 (en) 2008-02-15 2013-12-17 Ethicon Endo-Surgery, Inc. Feedback and lockout mechanism for surgical instrument
US7980443B2 (en) 2008-02-15 2011-07-19 Ethicon Endo-Surgery, Inc. End effectors for a surgical cutting and stapling instrument
US20090206131A1 (en) 2008-02-15 2009-08-20 Ethicon Endo-Surgery, Inc. End effector coupling arrangements for a surgical cutting and stapling instrument
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9770245B2 (en) 2008-02-15 2017-09-26 Ethicon Llc Layer arrangements for surgical staple cartridges
US7959051B2 (en) 2008-02-15 2011-06-14 Ethicon Endo-Surgery, Inc. Closure systems for a surgical cutting and stapling instrument
US7922061B2 (en) 2008-05-21 2011-04-12 Ethicon Endo-Surgery, Inc. Surgical instrument with automatically reconfigurable articulating end effector
WO2009147669A1 (en) * 2008-06-03 2009-12-10 Virtual Ports Ltd. A multi-components device, system and method for assisting minimally invasive procedures
US8083120B2 (en) 2008-09-18 2011-12-27 Ethicon Endo-Surgery, Inc. End effector for use with a surgical cutting and stapling instrument
US7837080B2 (en) 2008-09-18 2010-11-23 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with device for indicating when the instrument has cut through tissue
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9050083B2 (en) 2008-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8020743B2 (en) 2008-10-15 2011-09-20 Ethicon Endo-Surgery, Inc. Powered articulatable surgical cutting and fastening instrument with flexible drive member
US7918377B2 (en) 2008-10-16 2011-04-05 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with apparatus for providing anvil position feedback
US8485413B2 (en) 2009-02-05 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising an articulation joint
US8414577B2 (en) 2009-02-05 2013-04-09 Ethicon Endo-Surgery, Inc. Surgical instruments and components for use in sterile environments
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
US8453907B2 (en) 2009-02-06 2013-06-04 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with cutting member reversing mechanism
CN102341048A (en) 2009-02-06 2012-02-01 伊西康内外科公司 Driven surgical stapler improvements
US8066167B2 (en) 2009-03-23 2011-11-29 Ethicon Endo-Surgery, Inc. Circular surgical stapling instrument with anvil locking system
JP5489187B2 (en) 2009-04-03 2014-05-14 ザ ボード オブ トラスティーズ オブ ザ リーランド スタンフォード ジュニア ユニバーシティー Surgical apparatus and method
US10507071B2 (en) * 2009-05-11 2019-12-17 Carefusion 2200, Inc. Hand actuated, articulating device having an electric force enhancement system
AT507563B1 (en) * 2009-05-15 2010-06-15 Klaffenboeck Johann Mag DEVICE FOR ACTUATING AN END EFFECTOR
US8784404B2 (en) * 2009-06-29 2014-07-22 Carefusion 2200, Inc. Flexible wrist-type element and methods of manufacture and use thereof
WO2011025886A1 (en) 2009-08-26 2011-03-03 Carefusion 2200, Inc. Mechanisms for positioning and/or holding surgical instruments and performing other functions, and methods of manufacture and use thereof
EP2470104A4 (en) * 2009-08-26 2017-01-04 Care Fusion 2200, Inc. Articulated surgical tool
US8141762B2 (en) 2009-10-09 2012-03-27 Ethicon Endo-Surgery, Inc. Surgical stapler comprising a staple pocket
US8353439B2 (en) 2009-11-19 2013-01-15 Ethicon Endo-Surgery, Inc. Circular stapler introducer with radially-openable distal end portion
US8136712B2 (en) 2009-12-10 2012-03-20 Ethicon Endo-Surgery, Inc. Surgical stapler with discrete staple height adjustment and tactile feedback
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8267300B2 (en) 2009-12-30 2012-09-18 Ethicon Endo-Surgery, Inc. Dampening device for endoscopic surgical stapler
US8608046B2 (en) 2010-01-07 2013-12-17 Ethicon Endo-Surgery, Inc. Test device for a surgical tool
JP2013518222A (en) * 2010-01-22 2013-05-20 ケアフュージョン2200、インコーポレイテッド Hydraulic system with spool valve and method of using the same
AU2011209722A1 (en) * 2010-01-26 2012-07-26 Carefusion 2200, Inc. Powered signal controlled hand actuated articulating device and method of use
EP2528531A4 (en) * 2010-01-27 2017-04-12 Carefusion 2200, Inc. Overforce mechanism
EP2582316A4 (en) * 2010-06-17 2017-04-26 Carefusion 2200, Inc. Systems, apparatuses and methods of tool exchange
CA2806278C (en) * 2010-07-28 2020-08-04 Medrobotics Corporation Surgical positioning and support system
US8801734B2 (en) 2010-07-30 2014-08-12 Ethicon Endo-Surgery, Inc. Circular stapling instruments with secondary cutting arrangements and methods of using same
US8789740B2 (en) 2010-07-30 2014-07-29 Ethicon Endo-Surgery, Inc. Linear cutting and stapling device with selectively disengageable cutting member
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US20120031400A1 (en) * 2010-08-03 2012-02-09 Peter Shimm Cricoid manipulating apparatus for anesthesia assistance and tracheal intubation
US9498107B2 (en) 2010-08-06 2016-11-22 Carefusion 2200, Inc. Clamping system
US8776800B2 (en) * 2010-09-30 2014-07-15 Carefusion 2200, Inc. Sterile drape having multiple drape interface mechanisms
WO2012027509A2 (en) * 2010-08-26 2012-03-01 Carefusion 2200, Inc. Control portion of and device for remotely controlling an articulating surgical instrument
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US20120065645A1 (en) * 2010-09-10 2012-03-15 Mark Doyle Protective sheath
US8632525B2 (en) 2010-09-17 2014-01-21 Ethicon Endo-Surgery, Inc. Power control arrangements for surgical instruments and batteries
US9289212B2 (en) 2010-09-17 2016-03-22 Ethicon Endo-Surgery, Inc. Surgical instruments and batteries for surgical instruments
US9877720B2 (en) 2010-09-24 2018-01-30 Ethicon Llc Control features for articulating surgical device
US8733613B2 (en) 2010-09-29 2014-05-27 Ethicon Endo-Surgery, Inc. Staple cartridge
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
AU2011308701B2 (en) 2010-09-30 2013-11-14 Ethicon Endo-Surgery, Inc. Fastener system comprising a retention matrix and an alignment matrix
US9220500B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising structure to produce a resilient load
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US8777004B2 (en) 2010-09-30 2014-07-15 Ethicon Endo-Surgery, Inc. Compressible staple cartridge comprising alignment members
US9301752B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising a plurality of capsules
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US8740883B2 (en) 2010-09-30 2014-06-03 Carefusion 2200, Inc. Detachable handle mechanism for use in instrument positioning
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9788834B2 (en) 2010-09-30 2017-10-17 Ethicon Llc Layer comprising deployable attachment members
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9044228B2 (en) 2010-09-30 2015-06-02 Ethicon Endo-Surgery, Inc. Fastener system comprising a plurality of fastener cartridges
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9055941B2 (en) 2011-09-23 2015-06-16 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck
US8640706B2 (en) 2010-09-30 2014-02-04 Carefusion 2200, Inc. Interface mechanism between a drape and a handle
US20120083825A1 (en) * 2010-09-30 2012-04-05 Carefusion 2200, Inc. Detachable shaft
WO2012044590A2 (en) * 2010-09-30 2012-04-05 Carefusion 2200, Inc. Interface mechanism and detachable shaft
US9241714B2 (en) 2011-04-29 2016-01-26 Ethicon Endo-Surgery, Inc. Tissue thickness compensator and method for making the same
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
USD650074S1 (en) 2010-10-01 2011-12-06 Ethicon Endo-Surgery, Inc. Surgical instrument
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8992421B2 (en) 2010-10-22 2015-03-31 Medrobotics Corporation Highly articulated robotic probes and methods of production and use of such probes
AU2011338931B2 (en) 2010-11-11 2017-02-09 Medrobotics Corporation Introduction devices for highly articulated robotic probes and methods of production and use of such probes
EP2675374B1 (en) 2011-02-14 2015-09-09 The Board of Trustees of The Leland Stanford Junior University Apparatus and systems for performing laparoscopic surgery
US8858590B2 (en) 2011-03-14 2014-10-14 Ethicon Endo-Surgery, Inc. Tissue manipulation devices
US8540131B2 (en) 2011-03-15 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical staple cartridges with tissue tethers for manipulating divided tissue and methods of using same
US8800841B2 (en) 2011-03-15 2014-08-12 Ethicon Endo-Surgery, Inc. Surgical staple cartridges
US8926598B2 (en) 2011-03-15 2015-01-06 Ethicon Endo-Surgery, Inc. Surgical instruments with articulatable and rotatable end effector
US9044229B2 (en) 2011-03-15 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical fastener instruments
US8857693B2 (en) 2011-03-15 2014-10-14 Ethicon Endo-Surgery, Inc. Surgical instruments with lockable articulating end effector
BR112013027794B1 (en) 2011-04-29 2020-12-15 Ethicon Endo-Surgery, Inc CLAMP CARTRIDGE SET
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
EP2561821A1 (en) * 2011-08-25 2013-02-27 Perfint Healthcare Private Limited Tool positioning system
US9198661B2 (en) 2011-09-06 2015-12-01 Ethicon Endo-Surgery, Inc. Stapling instrument comprising a plurality of staple cartridges stored therein
JP6395605B2 (en) 2011-09-13 2018-09-26 メドロボティクス コーポレイション Highly articulated probe having anti-twist link arrangement, formation method thereof, and medical procedure execution method
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
CN108262741A (en) 2011-12-21 2018-07-10 美的洛博迪克斯公司 The application method of the securing device of probe, the forming method of the device and the device is hinged for the height with chain regulating device
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9078653B2 (en) 2012-03-26 2015-07-14 Ethicon Endo-Surgery, Inc. Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge
MX353040B (en) 2012-03-28 2017-12-18 Ethicon Endo Surgery Inc Retainer assembly including a tissue thickness compensator.
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
CN104334098B (en) 2012-03-28 2017-03-22 伊西康内外科公司 Tissue thickness compensator comprising capsules defining a low pressure environment
RU2014143258A (en) 2012-03-28 2016-05-20 Этикон Эндо-Серджери, Инк. FABRIC THICKNESS COMPENSATOR CONTAINING MANY LAYERS
EP2881069B1 (en) * 2012-04-27 2020-03-11 KUKA Deutschland GmbH Surgical robot system and surgical instrument
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US20140005718A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Multi-functional powered surgical device with external dissection features
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9282974B2 (en) 2012-06-28 2016-03-15 Ethicon Endo-Surgery, Llc Empty clip cartridge lockout
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US8747238B2 (en) 2012-06-28 2014-06-10 Ethicon Endo-Surgery, Inc. Rotary drive shaft assemblies for surgical instruments with articulatable end effectors
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
BR112014032776B1 (en) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
JP6290201B2 (en) 2012-06-28 2018-03-07 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Lockout for empty clip cartridge
US9700310B2 (en) 2013-08-23 2017-07-11 Ethicon Llc Firing member retraction devices for powered surgical instruments
WO2014033717A1 (en) * 2012-08-30 2014-03-06 Human Extensions Ltd. Interface between user and laparoscopic tools
US9386985B2 (en) 2012-10-15 2016-07-12 Ethicon Endo-Surgery, Llc Surgical cutting instrument
CN104755124B (en) * 2012-11-01 2019-04-12 玛芬股份有限公司 For determining the tool of sheath pipe transfer
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
JP6382235B2 (en) 2013-03-01 2018-08-29 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Articulatable surgical instrument with a conductive path for signal communication
US9326767B2 (en) 2013-03-01 2016-05-03 Ethicon Endo-Surgery, Llc Joystick switch assemblies for surgical instruments
JP6345707B2 (en) 2013-03-01 2018-06-20 エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. Surgical instrument with soft stop
US9345481B2 (en) 2013-03-13 2016-05-24 Ethicon Endo-Surgery, Llc Staple cartridge tissue thickness sensor system
US20140276968A1 (en) * 2013-03-14 2014-09-18 Ethicon, Inc. Applicator systems for surgical fasteners
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9687230B2 (en) 2013-03-14 2017-06-27 Ethicon Llc Articulatable surgical instrument comprising a firing drive
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9649110B2 (en) 2013-04-16 2017-05-16 Ethicon Llc Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
BR112015026109B1 (en) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc surgical instrument
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
MX369362B (en) 2013-08-23 2019-11-06 Ethicon Endo Surgery Llc Firing member retraction devices for powered surgical instruments.
DK3038542T3 (en) 2013-09-01 2019-04-15 Human Extensions Ltd CONTROL UNIT FOR A MEDICAL DEVICE
US20140171986A1 (en) 2013-09-13 2014-06-19 Ethicon Endo-Surgery, Inc. Surgical Clip Having Comliant Portion
US9642620B2 (en) 2013-12-23 2017-05-09 Ethicon Endo-Surgery, Llc Surgical cutting and stapling instruments with articulatable end effectors
US9681870B2 (en) 2013-12-23 2017-06-20 Ethicon Llc Articulatable surgical instruments with separate and distinct closing and firing systems
US20150173756A1 (en) 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling methods
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9968354B2 (en) 2013-12-23 2018-05-15 Ethicon Llc Surgical staples and methods for making the same
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US20140166725A1 (en) 2014-02-24 2014-06-19 Ethicon Endo-Surgery, Inc. Staple cartridge including a barbed staple.
JP6462004B2 (en) 2014-02-24 2019-01-30 エシコン エルエルシー Fastening system with launcher lockout
US20150272571A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Surgical instrument utilizing sensor adaptation
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US20150272557A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Modular surgical instrument system
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
BR112016021943B1 (en) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE
US10299792B2 (en) 2014-04-16 2019-05-28 Ethicon Llc Fastener cartridge comprising non-uniform fasteners
US10327764B2 (en) 2014-09-26 2019-06-25 Ethicon Llc Method for creating a flexible staple line
BR112016023807B1 (en) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc CARTRIDGE SET OF FASTENERS FOR USE WITH A SURGICAL INSTRUMENT
CN106456158B (en) 2014-04-16 2019-02-05 伊西康内外科有限责任公司 Fastener cartridge including non-uniform fastener
JP6636452B2 (en) 2014-04-16 2020-01-29 エシコン エルエルシーEthicon LLC Fastener cartridge including extension having different configurations
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
BR112017004361B1 (en) 2014-09-05 2023-04-11 Ethicon Llc ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
MX2017003960A (en) 2014-09-26 2017-12-04 Ethicon Llc Surgical stapling buttresses and adjunct materials.
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US10117649B2 (en) 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9943309B2 (en) 2014-12-18 2018-04-17 Ethicon Llc Surgical instruments with articulatable end effectors and movable firing beam support arrangements
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
BR112017012996B1 (en) 2014-12-18 2022-11-08 Ethicon Llc SURGICAL INSTRUMENT WITH AN ANvil WHICH IS SELECTIVELY MOVABLE ABOUT AN IMMOVABLE GEOMETRIC AXIS DIFFERENT FROM A STAPLE CARTRIDGE
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
KR102602379B1 (en) 2015-02-20 2023-11-16 스트리커 코포레이션 Sterile barrier assembly, mounting system, and method for coupling surgical components
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US20160249910A1 (en) 2015-02-27 2016-09-01 Ethicon Endo-Surgery, Llc Surgical charging system that charges and/or conditions one or more batteries
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10226250B2 (en) 2015-02-27 2019-03-12 Ethicon Llc Modular stapling assembly
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
JP2020121162A (en) 2015-03-06 2020-08-13 エシコン エルエルシーEthicon LLC Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
US10335149B2 (en) 2015-06-18 2019-07-02 Ethicon Llc Articulatable surgical instruments with composite firing beam structures with center firing support member for articulation support
WO2017006377A1 (en) 2015-07-09 2017-01-12 川崎重工業株式会社 Surgical robot
US10835249B2 (en) 2015-08-17 2020-11-17 Ethicon Llc Implantable layers for a surgical instrument
CN108348233B (en) 2015-08-26 2021-05-07 伊西康有限责任公司 Surgical staple strip for allowing changing staple characteristics and achieving easy cartridge loading
US10213203B2 (en) 2015-08-26 2019-02-26 Ethicon Llc Staple cartridge assembly without a bottom cover
MX2022006191A (en) 2015-09-02 2022-06-16 Ethicon Llc Surgical staple configurations with camming surfaces located between portions supporting surgical staples.
US10238390B2 (en) 2015-09-02 2019-03-26 Ethicon Llc Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US10478188B2 (en) 2015-09-30 2019-11-19 Ethicon Llc Implantable layer comprising a constricted configuration
JP6817607B2 (en) * 2015-11-05 2021-01-20 国立大学法人九州大学 Fine work support system and manipulator for fine work
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10588625B2 (en) 2016-02-09 2020-03-17 Ethicon Llc Articulatable surgical instruments with off-axis firing beam arrangements
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
JP6911054B2 (en) 2016-02-09 2021-07-28 エシコン エルエルシーEthicon LLC Surgical instruments with asymmetric joint composition
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11284890B2 (en) 2016-04-01 2022-03-29 Cilag Gmbh International Circular stapling system comprising an incisable tissue support
US11064997B2 (en) 2016-04-01 2021-07-20 Cilag Gmbh International Surgical stapling instrument
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10531874B2 (en) 2016-04-01 2020-01-14 Ethicon Llc Surgical cutting and stapling end effector with anvil concentric drive member
US11045191B2 (en) 2016-04-01 2021-06-29 Cilag Gmbh International Method for operating a surgical stapling system
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
USD826405S1 (en) 2016-06-24 2018-08-21 Ethicon Llc Surgical fastener
JP6957532B2 (en) 2016-06-24 2021-11-02 エシコン エルエルシーEthicon LLC Staple cartridges including wire staples and punched staples
US10675024B2 (en) 2016-06-24 2020-06-09 Ethicon Llc Staple cartridge comprising overdriven staples
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
JP2020501779A (en) 2016-12-21 2020-01-23 エシコン エルエルシーEthicon LLC Surgical stapling system
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US10888322B2 (en) 2016-12-21 2021-01-12 Ethicon Llc Surgical instrument comprising a cutting member
JP7010956B2 (en) 2016-12-21 2022-01-26 エシコン エルエルシー How to staple tissue
US10485543B2 (en) 2016-12-21 2019-11-26 Ethicon Llc Anvil having a knife slot width
US20180168647A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments having end effectors with positive opening features
US10588632B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical end effectors and firing members thereof
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
JP6983893B2 (en) 2016-12-21 2021-12-17 エシコン エルエルシーEthicon LLC Lockout configuration for surgical end effectors and replaceable tool assemblies
US10980536B2 (en) 2016-12-21 2021-04-20 Ethicon Llc No-cartridge and spent cartridge lockout arrangements for surgical staplers
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
US10835246B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Staple cartridges and arrangements of staples and staple cavities therein
US10588631B2 (en) 2016-12-21 2020-03-17 Ethicon Llc Surgical instruments with positive jaw opening features
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10675026B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Methods of stapling tissue
US20180168598A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Staple forming pocket arrangements comprising zoned forming surface grooves
US10675025B2 (en) 2016-12-21 2020-06-09 Ethicon Llc Shaft assembly comprising separately actuatable and retractable systems
US20180168608A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical instrument system comprising an end effector lockout and a firing assembly lockout
US10524789B2 (en) 2016-12-21 2020-01-07 Ethicon Llc Laterally actuatable articulation lock arrangements for locking an end effector of a surgical instrument in an articulated configuration
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US11141154B2 (en) 2017-06-27 2021-10-12 Cilag Gmbh International Surgical end effectors and anvils
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
EP4070740A1 (en) 2017-06-28 2022-10-12 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US20190000461A1 (en) 2017-06-28 2019-01-03 Ethicon Llc Surgical cutting and fastening devices with pivotable anvil with a tissue locating arrangement in close proximity to an anvil pivot axis
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11058424B2 (en) 2017-06-28 2021-07-13 Cilag Gmbh International Surgical instrument comprising an offset articulation joint
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US11096754B2 (en) 2017-10-04 2021-08-24 Mako Surgical Corp. Sterile drape assembly for surgical robot
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US10682134B2 (en) 2017-12-21 2020-06-16 Ethicon Llc Continuous use self-propelled stapling instrument
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
EP3890643A2 (en) 2018-12-04 2021-10-13 Mako Surgical Corporation Mounting system with sterile barrier assembly for use in coupling surgical components
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
US20220031351A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with differential articulation joint arrangements for accommodating flexible actuators
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
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US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
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US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US20220378424A1 (en) 2021-05-28 2022-12-01 Cilag Gmbh International Stapling instrument comprising a firing lockout
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters

Citations (45)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2426695A (en) * 1945-03-06 1947-09-02 Adel Prec Products Corp Multiple station control
US3642159A (en) * 1970-08-19 1972-02-15 Massey Ferguson Inc Earthworking vehicle
US3702535A (en) * 1971-01-15 1972-11-14 John I House Rearview mirror
US4122678A (en) * 1977-05-23 1978-10-31 Wilson Mahlon T Hydraulic control with feedback for powered machinery
US4167792A (en) * 1976-11-18 1979-09-18 Normalair-Garret (Holdings) Limited Mechanical hands
US4485817A (en) * 1982-05-28 1984-12-04 United States Surgical Corporation Surgical stapler apparatus with flexible shaft
US4488523A (en) * 1982-09-24 1984-12-18 United States Surgical Corporation Flexible, hydraulically actuated device for applying surgical fasteners
US4721099A (en) * 1985-10-30 1988-01-26 Kabushiki Kaisha Machida Seisakusho Operating mechanism for bendable section of endoscope
US4832473A (en) * 1987-02-06 1989-05-23 Olympus Optical Co., Ltd. Endoscope with elastic actuator comprising a synthetic rubber tube with only radial expansion controlled by a mesh-like tube
US4890602A (en) * 1987-11-25 1990-01-02 Hake Lawrence W Endoscope construction with means for controlling rigidity and curvature of flexible endoscope tube
US4946329A (en) * 1988-04-01 1990-08-07 Albert Einstein College Of Medicine Of Yeshiva University Micromanipulator using hydraulic bellows
US5112184A (en) * 1990-06-11 1992-05-12 Reach All Multi-function hydraulic control handle
US5179934A (en) * 1990-02-20 1993-01-19 Olympus Optical Co., Ltd. Endoscope
US5201743A (en) * 1992-05-05 1993-04-13 Habley Medical Technology Corp. Axially extendable endoscopic surgical instrument
US5217003A (en) * 1991-03-18 1993-06-08 Wilk Peter J Automated surgical system and apparatus
US5275614A (en) * 1992-02-21 1994-01-04 Habley Medical Technology Corporation Axially extendable endoscopic surgical instrument
US5282806A (en) * 1992-08-21 1994-02-01 Habley Medical Technology Corporation Endoscopic surgical instrument having a removable, rotatable, end effector assembly
US5290249A (en) * 1990-10-09 1994-03-01 Vance Products Incorporated Surgical access sheath
US5312391A (en) * 1992-07-29 1994-05-17 Wilk Peter J Laparoscopic instrument assembly
US5361583A (en) * 1993-09-30 1994-11-08 Ethicon, Inc. Pressurized fluid actuation system with variable force and stroke output for use in a surgical instrument
US5368015A (en) * 1991-03-18 1994-11-29 Wilk; Peter J. Automated surgical system and apparatus
US5626595A (en) * 1992-02-14 1997-05-06 Automated Medical Instruments, Inc. Automated surgical instrument
US5681262A (en) * 1994-10-05 1997-10-28 Very Inventive Physicians Inc. Endoscope and tool therefore
US5762458A (en) * 1996-02-20 1998-06-09 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5779727A (en) * 1997-02-18 1998-07-14 Orejola; Wilmo C. Hydraulically operated surgical scissors
US5792135A (en) * 1996-05-20 1998-08-11 Intuitive Surgical, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5797900A (en) * 1996-05-20 1998-08-25 Intuitive Surgical, Inc. Wrist mechanism for surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5807376A (en) * 1994-06-24 1998-09-15 United States Surgical Corporation Apparatus and method for performing surgical tasks during laparoscopic procedures
US5807377A (en) * 1996-05-20 1998-09-15 Intuitive Surgical, Inc. Force-reflecting surgical instrument and positioning mechanism for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5807378A (en) * 1995-06-07 1998-09-15 Sri International Surgical manipulator for a telerobotic system
US5833656A (en) * 1996-02-08 1998-11-10 Symbiosis Corporation Endoscopic robotic surgical tools and methods
US5855583A (en) * 1996-02-20 1999-01-05 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5971976A (en) * 1996-02-20 1999-10-26 Computer Motion, Inc. Motion minimization and compensation system for use in surgical procedures
US6017358A (en) * 1997-05-01 2000-01-25 Inbae Yoon Surgical instrument with multiple rotatably mounted offset end effectors
US6063095A (en) * 1996-02-20 2000-05-16 Computer Motion, Inc. Method and apparatus for performing minimally invasive surgical procedures
US6131480A (en) * 1997-09-03 2000-10-17 Narishige Co., Ltd. Hydraulically-operated micromanipulator apparatus
US6132368A (en) * 1996-12-12 2000-10-17 Intuitive Surgical, Inc. Multi-component telepresence system and method
US6132441A (en) * 1996-11-22 2000-10-17 Computer Motion, Inc. Rigidly-linked articulating wrist with decoupled motion transmission
US6168634B1 (en) * 1999-03-25 2001-01-02 Geoffrey W. Schmitz Hydraulically energized magnetorheological replicant muscle tissue and a system and a method for using and controlling same
US6201984B1 (en) * 1991-06-13 2001-03-13 International Business Machines Corporation System and method for augmentation of endoscopic surgery
US6206903B1 (en) * 1999-10-08 2001-03-27 Intuitive Surgical, Inc. Surgical tool with mechanical advantage
US6246200B1 (en) * 1998-08-04 2001-06-12 Intuitive Surgical, Inc. Manipulator positioning linkage for robotic surgery
US6309397B1 (en) * 1999-12-02 2001-10-30 Sri International Accessories for minimally invasive robotic surgery and methods
US6312435B1 (en) * 1999-10-08 2001-11-06 Intuitive Surgical, Inc. Surgical instrument with extended reach for use in minimally invasive surgery
US6331181B1 (en) * 1998-12-08 2001-12-18 Intuitive Surgical, Inc. Surgical robotic tools, data architecture, and use

Family Cites Families (90)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3266494A (en) * 1963-08-26 1966-08-16 Possis Machine Corp Powered forceps
US4848338A (en) * 1987-01-20 1989-07-18 Minnesota Mining And Manufacturing Company Hydraulically operated surgical instrument
JPH0646935B2 (en) * 1990-04-09 1994-06-22 工業技術院長 Master Slave Micro Mechanism
US5279309A (en) * 1991-06-13 1994-01-18 International Business Machines Corporation Signaling device and method for monitoring positions in a surgical operation
US6731988B1 (en) * 1992-01-21 2004-05-04 Sri International System and method for remote endoscopic surgery
ATE238140T1 (en) * 1992-01-21 2003-05-15 Stanford Res Inst Int SURGICAL SYSTEM
US5631973A (en) * 1994-05-05 1997-05-20 Sri International Method for telemanipulation with telepresence
US6963792B1 (en) 1992-01-21 2005-11-08 Sri International Surgical method
US6788999B2 (en) 1992-01-21 2004-09-07 Sri International, Inc. Surgical system
US5620459A (en) * 1992-04-15 1997-04-15 Microsurge, Inc. Surgical instrument
US5478351A (en) * 1992-06-24 1995-12-26 Microsurge, Inc. Endoscopic surgical tool with handle and detachable tool assembly
CA2106039A1 (en) * 1992-09-23 1994-03-24 David A. Nicholas Surgical biopsy forceps apparatus
GB9309142D0 (en) * 1993-05-04 1993-06-16 Gyrus Medical Ltd Laparoscopic instrument
US6406472B1 (en) 1993-05-14 2002-06-18 Sri International, Inc. Remote center positioner
WO1994026167A1 (en) * 1993-05-14 1994-11-24 Sri International Remote center positioner
US5791231A (en) * 1993-05-17 1998-08-11 Endorobotics Corporation Surgical robotic system and hydraulic actuator therefor
US5456684A (en) 1994-09-08 1995-10-10 Hutchinson Technology Incorporated Multifunctional minimally invasive surgical instrument
US6447511B1 (en) * 1994-12-13 2002-09-10 Symbiosis Corporation Bipolar endoscopic surgical scissor blades and instrument incorporating the same
CA2168404C (en) * 1995-02-01 2007-07-10 Dale Schulze Surgical instrument with expandable cutting element
US6391029B1 (en) * 1995-03-07 2002-05-21 Enable Medical Corporation Bipolar electrosurgical scissors
US6179837B1 (en) * 1995-03-07 2001-01-30 Enable Medical Corporation Bipolar electrosurgical scissors
US5575799A (en) 1995-03-30 1996-11-19 United States Surgical Corporation Articulating surgical apparatus
US5599350A (en) * 1995-04-03 1997-02-04 Ethicon Endo-Surgery, Inc. Electrosurgical clamping device with coagulation feedback
US5618307A (en) * 1995-04-03 1997-04-08 Heartport, Inc. Clamp assembly and method of use
SE510202C2 (en) * 1995-05-19 1999-04-26 Stroemsholmen Ab Device for a hydraulic system
US5649956A (en) * 1995-06-07 1997-07-22 Sri International System and method for releasably holding a surgical instrument
WO1997000649A1 (en) 1995-06-20 1997-01-09 Wan Sing Ng Articulated arm for medical procedures
US5752972A (en) * 1995-11-09 1998-05-19 Hoogeboom; Thomas J. Modular endoscopic surgical instrument
US5700261A (en) 1996-03-29 1997-12-23 Ethicon Endo-Surgery, Inc. Bipolar Scissors
JPH09271478A (en) * 1996-04-03 1997-10-21 Satoshi Nishimoto Water pressure type callus elongater
US6786896B1 (en) 1997-09-19 2004-09-07 Massachusetts Institute Of Technology Robotic apparatus
US5876410A (en) * 1996-07-22 1999-03-02 Phillip J. Petillo Hydraulic powered surgical device
GB9624486D0 (en) * 1996-11-26 1997-01-15 Univ Bristol Control means
US7083613B2 (en) 1997-03-05 2006-08-01 The Trustees Of Columbia University In The City Of New York Ringed forceps
US6083618A (en) * 1997-06-25 2000-07-04 The Gillette Company Correction fluids comprising composite polymeric particles
JPH10325401A (en) * 1997-05-27 1998-12-08 Yukio Saito Bilateral position and force transmission device and rehabilitation robot
US6102909A (en) * 1997-08-26 2000-08-15 Ethicon, Inc. Scissorlike electrosurgical cutting instrument
US7758569B2 (en) 1998-02-24 2010-07-20 Hansen Medical, Inc. Interchangeable surgical instrument
US6860878B2 (en) * 1998-02-24 2005-03-01 Endovia Medical Inc. Interchangeable instrument
US6197017B1 (en) * 1998-02-24 2001-03-06 Brock Rogers Surgical, Inc. Articulated apparatus for telemanipulator system
US6554844B2 (en) * 1998-02-24 2003-04-29 Endovia Medical, Inc. Surgical instrument
US7297142B2 (en) 1998-02-24 2007-11-20 Hansen Medical, Inc. Interchangeable surgical instrument
US6692485B1 (en) * 1998-02-24 2004-02-17 Endovia Medical, Inc. Articulated apparatus for telemanipulator system
US20020128662A1 (en) * 1998-02-24 2002-09-12 Brock David L. Surgical instrument
US7789875B2 (en) * 1998-02-24 2010-09-07 Hansen Medical, Inc. Surgical instruments
US7901399B2 (en) * 1998-02-24 2011-03-08 Hansen Medical, Inc. Interchangeable surgical instrument
US7371210B2 (en) * 1998-02-24 2008-05-13 Hansen Medical, Inc. Flexible instrument
US7090683B2 (en) 1998-02-24 2006-08-15 Hansen Medical, Inc. Flexible instrument
US6665554B1 (en) 1998-11-18 2003-12-16 Steve T. Charles Medical manipulator for use with an imaging device
US6468265B1 (en) 1998-11-20 2002-10-22 Intuitive Surgical, Inc. Performing cardiac surgery without cardioplegia
US6659939B2 (en) 1998-11-20 2003-12-09 Intuitive Surgical, Inc. Cooperative minimally invasive telesurgical system
US6398726B1 (en) * 1998-11-20 2002-06-04 Intuitive Surgical, Inc. Stabilizer for robotic beating-heart surgery
WO2000030557A1 (en) * 1998-11-23 2000-06-02 Microdexterity Systems, Inc. Surgical manipulator
US7125403B2 (en) * 1998-12-08 2006-10-24 Intuitive Surgical In vivo accessories for minimally invasive robotic surgery
US6770081B1 (en) 2000-01-07 2004-08-03 Intuitive Surgical, Inc. In vivo accessories for minimally invasive robotic surgery and methods
US6193732B1 (en) 1999-01-08 2001-02-27 Cardiothoracic System Surgical clips and apparatus and method for clip placement
US6394998B1 (en) 1999-01-22 2002-05-28 Intuitive Surgical, Inc. Surgical tools for use in minimally invasive telesurgical applications
US6424885B1 (en) * 1999-04-07 2002-07-23 Intuitive Surgical, Inc. Camera referenced control in a minimally invasive surgical apparatus
US6594552B1 (en) * 1999-04-07 2003-07-15 Intuitive Surgical, Inc. Grip strength with tactile feedback for robotic surgery
EP1176921B1 (en) 1999-05-10 2011-02-23 Hansen Medical, Inc. Surgical instrument
CA2272040A1 (en) 1999-05-13 2000-11-13 Ecole Polytechnique Robotic observation camera for use in an operating room
US6788018B1 (en) 1999-08-03 2004-09-07 Intuitive Surgical, Inc. Ceiling and floor mounted surgical robot set-up arms
US6491691B1 (en) 1999-10-08 2002-12-10 Intuitive Surgical, Inc. Minimally invasive surgical hook apparatus and method for using same
US6702805B1 (en) * 1999-11-12 2004-03-09 Microdexterity Systems, Inc. Manipulator
US6488265B2 (en) 2000-03-01 2002-12-03 Hale Products, Inc. Ball valve assembly
US6622980B2 (en) 2000-03-28 2003-09-23 Hill-Rom Services, Inc. Socket and rail clamp apparatus
DE60134236D1 (en) * 2000-07-20 2008-07-10 Kinetic Surgical Llc MANUALLY CONTROLLED SURGICAL TOOL WITH JOINT
WO2002007611A2 (en) 2000-07-21 2002-01-31 Atropos Limited A surgical instrument
US6902560B1 (en) * 2000-07-27 2005-06-07 Intuitive Surgical, Inc. Roll-pitch-roll surgical tool
US6746443B1 (en) * 2000-07-27 2004-06-08 Intuitive Surgical Inc. Roll-pitch-roll surgical tool
WO2002017799A1 (en) 2000-08-30 2002-03-07 Cerebral Vascular Applications Inc. Medical instrument
EP2932884B1 (en) * 2000-11-28 2020-09-09 Intuitive Surgical Operations, Inc. Endoscopic beating-heart stabilizer and vessel occlusion fastener
US6840938B1 (en) * 2000-12-29 2005-01-11 Intuitive Surgical, Inc. Bipolar cauterizing instrument
WO2002062199A2 (en) * 2001-01-16 2002-08-15 Microdexterity Systems, Inc. Surgical manipulator
US7699835B2 (en) 2001-02-15 2010-04-20 Hansen Medical, Inc. Robotically controlled surgical instruments
US20030135204A1 (en) * 2001-02-15 2003-07-17 Endo Via Medical, Inc. Robotically controlled medical instrument with a flexible section
US7101371B2 (en) 2001-04-06 2006-09-05 Dycus Sean T Vessel sealer and divider
US7083618B2 (en) 2001-04-06 2006-08-01 Sherwood Services Ag Vessel sealer and divider
US6994708B2 (en) * 2001-04-19 2006-02-07 Intuitive Surgical Robotic tool with monopolar electro-surgical scissors
US6783524B2 (en) 2001-04-19 2004-08-31 Intuitive Surgical, Inc. Robotic surgical tool with ultrasound cauterizing and cutting instrument
US6827725B2 (en) 2001-05-10 2004-12-07 Gyrus Medical Limited Surgical instrument
US6817974B2 (en) 2001-06-29 2004-11-16 Intuitive Surgical, Inc. Surgical tool having positively positionable tendon-actuated multi-disk wrist joint
US6755338B2 (en) * 2001-08-29 2004-06-29 Cerebral Vascular Applications, Inc. Medical instrument
US6676684B1 (en) * 2001-09-04 2004-01-13 Intuitive Surgical, Inc. Roll-pitch-roll-yaw surgical tool
DE10147145C2 (en) 2001-09-25 2003-12-18 Kunz Reiner Multi-function instrument for micro-invasive surgery
US6723087B2 (en) * 2001-12-14 2004-04-20 Medtronic, Inc. Apparatus and method for performing surgery on a patient
EP2070487B1 (en) 2002-08-13 2014-03-05 NeuroArm Surgical, Ltd. Microsurgical robot system
CN100389730C (en) * 2002-12-06 2008-05-28 直观外科手术公司 Flexible wrist for surgical tool
US7083615B2 (en) 2003-02-24 2006-08-01 Intuitive Surgical Inc Surgical tool having electrocautery energy supply conductor with inhibited current leakage
US7246734B2 (en) * 2005-12-05 2007-07-24 Ethicon Endo-Surgery, Inc. Rotary hydraulic pump actuated multi-stroke surgical instrument

Patent Citations (51)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2426695A (en) * 1945-03-06 1947-09-02 Adel Prec Products Corp Multiple station control
US3642159A (en) * 1970-08-19 1972-02-15 Massey Ferguson Inc Earthworking vehicle
US3702535A (en) * 1971-01-15 1972-11-14 John I House Rearview mirror
US4167792A (en) * 1976-11-18 1979-09-18 Normalair-Garret (Holdings) Limited Mechanical hands
US4122678A (en) * 1977-05-23 1978-10-31 Wilson Mahlon T Hydraulic control with feedback for powered machinery
US4485817A (en) * 1982-05-28 1984-12-04 United States Surgical Corporation Surgical stapler apparatus with flexible shaft
US4488523A (en) * 1982-09-24 1984-12-18 United States Surgical Corporation Flexible, hydraulically actuated device for applying surgical fasteners
US4721099A (en) * 1985-10-30 1988-01-26 Kabushiki Kaisha Machida Seisakusho Operating mechanism for bendable section of endoscope
US4832473A (en) * 1987-02-06 1989-05-23 Olympus Optical Co., Ltd. Endoscope with elastic actuator comprising a synthetic rubber tube with only radial expansion controlled by a mesh-like tube
US4890602A (en) * 1987-11-25 1990-01-02 Hake Lawrence W Endoscope construction with means for controlling rigidity and curvature of flexible endoscope tube
US4946329A (en) * 1988-04-01 1990-08-07 Albert Einstein College Of Medicine Of Yeshiva University Micromanipulator using hydraulic bellows
US5179934A (en) * 1990-02-20 1993-01-19 Olympus Optical Co., Ltd. Endoscope
US5112184A (en) * 1990-06-11 1992-05-12 Reach All Multi-function hydraulic control handle
US5290249A (en) * 1990-10-09 1994-03-01 Vance Products Incorporated Surgical access sheath
US5217003A (en) * 1991-03-18 1993-06-08 Wilk Peter J Automated surgical system and apparatus
US5368015A (en) * 1991-03-18 1994-11-29 Wilk; Peter J. Automated surgical system and apparatus
US6201984B1 (en) * 1991-06-13 2001-03-13 International Business Machines Corporation System and method for augmentation of endoscopic surgery
US5626595A (en) * 1992-02-14 1997-05-06 Automated Medical Instruments, Inc. Automated surgical instrument
US5275614A (en) * 1992-02-21 1994-01-04 Habley Medical Technology Corporation Axially extendable endoscopic surgical instrument
US5201743A (en) * 1992-05-05 1993-04-13 Habley Medical Technology Corp. Axially extendable endoscopic surgical instrument
US5312391A (en) * 1992-07-29 1994-05-17 Wilk Peter J Laparoscopic instrument assembly
US5282806A (en) * 1992-08-21 1994-02-01 Habley Medical Technology Corporation Endoscopic surgical instrument having a removable, rotatable, end effector assembly
US5361583A (en) * 1993-09-30 1994-11-08 Ethicon, Inc. Pressurized fluid actuation system with variable force and stroke output for use in a surgical instrument
US5807376A (en) * 1994-06-24 1998-09-15 United States Surgical Corporation Apparatus and method for performing surgical tasks during laparoscopic procedures
US5681262A (en) * 1994-10-05 1997-10-28 Very Inventive Physicians Inc. Endoscope and tool therefore
US5807378A (en) * 1995-06-07 1998-09-15 Sri International Surgical manipulator for a telerobotic system
US5814038A (en) * 1995-06-07 1998-09-29 Sri International Surgical manipulator for a telerobotic system
US5833656A (en) * 1996-02-08 1998-11-10 Symbiosis Corporation Endoscopic robotic surgical tools and methods
US6007550A (en) * 1996-02-20 1999-12-28 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5762458A (en) * 1996-02-20 1998-06-09 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US6244809B1 (en) * 1996-02-20 2001-06-12 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US6102850A (en) * 1996-02-20 2000-08-15 Computer Motion, Inc. Medical robotic system
US5855583A (en) * 1996-02-20 1999-01-05 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5971976A (en) * 1996-02-20 1999-10-26 Computer Motion, Inc. Motion minimization and compensation system for use in surgical procedures
US6063095A (en) * 1996-02-20 2000-05-16 Computer Motion, Inc. Method and apparatus for performing minimally invasive surgical procedures
US6001108A (en) * 1996-02-20 1999-12-14 Computer Motion, Inc. Method and apparatus for performing minimally invasive cardiac procedures
US5807377A (en) * 1996-05-20 1998-09-15 Intuitive Surgical, Inc. Force-reflecting surgical instrument and positioning mechanism for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5797900A (en) * 1996-05-20 1998-08-25 Intuitive Surgical, Inc. Wrist mechanism for surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5976122A (en) * 1996-05-20 1999-11-02 Integrated Surgical Systems, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5792135A (en) * 1996-05-20 1998-08-11 Intuitive Surgical, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US6132441A (en) * 1996-11-22 2000-10-17 Computer Motion, Inc. Rigidly-linked articulating wrist with decoupled motion transmission
US6132368A (en) * 1996-12-12 2000-10-17 Intuitive Surgical, Inc. Multi-component telepresence system and method
US5779727A (en) * 1997-02-18 1998-07-14 Orejola; Wilmo C. Hydraulically operated surgical scissors
US6017358A (en) * 1997-05-01 2000-01-25 Inbae Yoon Surgical instrument with multiple rotatably mounted offset end effectors
US6131480A (en) * 1997-09-03 2000-10-17 Narishige Co., Ltd. Hydraulically-operated micromanipulator apparatus
US6246200B1 (en) * 1998-08-04 2001-06-12 Intuitive Surgical, Inc. Manipulator positioning linkage for robotic surgery
US6331181B1 (en) * 1998-12-08 2001-12-18 Intuitive Surgical, Inc. Surgical robotic tools, data architecture, and use
US6168634B1 (en) * 1999-03-25 2001-01-02 Geoffrey W. Schmitz Hydraulically energized magnetorheological replicant muscle tissue and a system and a method for using and controlling same
US6206903B1 (en) * 1999-10-08 2001-03-27 Intuitive Surgical, Inc. Surgical tool with mechanical advantage
US6312435B1 (en) * 1999-10-08 2001-11-06 Intuitive Surgical, Inc. Surgical instrument with extended reach for use in minimally invasive surgery
US6309397B1 (en) * 1999-12-02 2001-10-30 Sri International Accessories for minimally invasive robotic surgery and methods

Cited By (72)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100261971A1 (en) * 2003-05-23 2010-10-14 Danitz David J Articulating retractors
US20050251112A1 (en) * 2003-05-23 2005-11-10 Danitz David J Articulating mechanism for remote manipulation of a surgical or diagnostic tool
US11547287B2 (en) 2003-05-23 2023-01-10 Intuitive Surgical Operations, Inc. Surgical instrument
US10722314B2 (en) 2003-05-23 2020-07-28 Intuitive Surgical Operations, Inc. Articulating retractors
US20060094931A1 (en) * 2003-05-23 2006-05-04 Novare Surgical Systems, Inc. Articulating mechanism for remote manipulation of a surgical or diagnostic tool
US10342626B2 (en) 2003-05-23 2019-07-09 Intuitive Surgical Operations, Inc. Surgical instrument
US9737365B2 (en) 2003-05-23 2017-08-22 Intuitive Surgical Operations, Inc. Tool with articulation lock
US9550300B2 (en) 2003-05-23 2017-01-24 Intuitive Surgical Operations, Inc. Articulating retractors
US20070250113A1 (en) * 2003-05-23 2007-10-25 Hegeman David E Tool with articulation lock
US20050107667A1 (en) * 2003-05-23 2005-05-19 Novare Surgical Systems, Inc. Hand-actuated device for remote manipulation of a grasping tool
US7410483B2 (en) * 2003-05-23 2008-08-12 Novare Surgical Systems, Inc. Hand-actuated device for remote manipulation of a grasping tool
US9498888B2 (en) 2003-05-23 2016-11-22 Intuitive Surgical Operations, Inc. Articulating instrument
US9440364B2 (en) 2003-05-23 2016-09-13 Intuitive Surgical Operations, Inc. Articulating instrument
US9434077B2 (en) 2003-05-23 2016-09-06 Intuitive Surgical Operations, Inc Articulating catheters
US9370868B2 (en) 2003-05-23 2016-06-21 Intuitive Surgical Operations, Inc. Articulating endoscopes
US9085085B2 (en) 2003-05-23 2015-07-21 Intuitive Surgical Operations, Inc. Articulating mechanisms with actuatable elements
US7682307B2 (en) 2003-05-23 2010-03-23 Novare Surgical Systems, Inc. Articulating mechanism for remote manipulation of a surgical or diagnostic tool
US9072427B2 (en) 2003-05-23 2015-07-07 Intuitive Surgical Operations, Inc. Tool with articulation lock
US8535347B2 (en) 2003-05-23 2013-09-17 Intuitive Surgical Operations, Inc. Articulating mechanisms with bifurcating control
US8100824B2 (en) 2003-05-23 2012-01-24 Intuitive Surgical Operations, Inc. Tool with articulation lock
US20100262180A1 (en) * 2003-05-23 2010-10-14 Danitz David J Articulating mechanisms with bifurcating control
US20100262075A1 (en) * 2003-05-23 2010-10-14 Danitz David J Articulating catheters
US20100262161A1 (en) * 2003-05-23 2010-10-14 Danitz David J Articulating instruments with joystick control
US9517326B2 (en) 2004-06-07 2016-12-13 Intuitive Surgical Operations, Inc. Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools
US9861786B2 (en) 2004-06-07 2018-01-09 Intuitive Surgical Operations, Inc. Articulating mechanism with flex hinged links
US7828808B2 (en) 2004-06-07 2010-11-09 Novare Surgical Systems, Inc. Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools
US9095253B2 (en) 2004-06-07 2015-08-04 Intuitive Surgical Operations, Inc. Articulating mechanism with flex hinged links
US20050273084A1 (en) * 2004-06-07 2005-12-08 Novare Surgical Systems, Inc. Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools
US7678117B2 (en) 2004-06-07 2010-03-16 Novare Surgical Systems, Inc. Articulating mechanism with flex-hinged links
US11491310B2 (en) 2004-06-07 2022-11-08 Intuitive Surgical Operations, Inc. Articulating mechanism with flex-hinged links
US8920429B2 (en) 2004-06-07 2014-12-30 Intuitive Surgical Operations, Inc. Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools
US10729885B2 (en) 2004-06-07 2020-08-04 Intuitive Surgical Operations, Inc. Articulating mechanism with flex-hinged links
US20050273085A1 (en) * 2004-06-07 2005-12-08 Novare Surgical Systems, Inc. Articulating mechanism with flex-hinged links
US20100234831A1 (en) * 2004-06-07 2010-09-16 Hinman Cameron D Articulating mechanism with flex-hinged links
US8419747B2 (en) 2004-06-07 2013-04-16 Intuitive Surgical Operations, Inc. Link systems and articulation mechanisms for remote manipulation of surgical or diagnostic tools
US8323297B2 (en) 2004-06-07 2012-12-04 Intuitive Surgical Operations, Inc. Articulating mechanism with flex-hinged links
US20100249759A1 (en) * 2004-06-07 2010-09-30 Cameron Dale Hinman Link systems and articulation mechanisms for remote manipulation of surgical of diagnostic tools
US7785252B2 (en) 2004-11-23 2010-08-31 Novare Surgical Systems, Inc. Articulating sheath for flexible instruments
US11638590B2 (en) 2004-11-23 2023-05-02 Intuitive Surgical Operations, Inc. Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools
US9700334B2 (en) 2004-11-23 2017-07-11 Intuitive Surgical Operations, Inc. Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools
US10321927B2 (en) 2004-11-23 2019-06-18 Intuitive Surgical Operations, Inc. Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools
US20110087071A1 (en) * 2004-11-23 2011-04-14 Intuitive Surgical Operations, Inc. Articulation sheath for flexible instruments
US9155449B2 (en) 2004-11-23 2015-10-13 Intuitive Surgical Operations Inc. Instrument systems and methods of use
US20060111210A1 (en) * 2004-11-23 2006-05-25 Novare Surgical Systems, Inc. Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools
US8277375B2 (en) 2004-11-23 2012-10-02 Intuitive Surgical Operations, Inc. Flexible segment system
US20060111209A1 (en) * 2004-11-23 2006-05-25 Novare Surgical Systems, Inc. Articulating mechanisms and link systems with torque transmission in remote manipulation of instruments and tools
US8182417B2 (en) 2004-11-24 2012-05-22 Intuitive Surgical Operations, Inc. Articulating mechanism components and system for easy assembly and disassembly
US20060111616A1 (en) * 2004-11-24 2006-05-25 Novare Surgical Systems, Inc. Articulating mechanism components and system for easy assembly and disassembly
US20070287993A1 (en) * 2006-06-13 2007-12-13 Hinman Cameron D Tool with rotation lock
US9561045B2 (en) 2006-06-13 2017-02-07 Intuitive Surgical Operations, Inc. Tool with rotation lock
US20100241136A1 (en) * 2006-12-05 2010-09-23 Mark Doyle Instrument positioning/holding devices
US8409244B2 (en) 2007-04-16 2013-04-02 Intuitive Surgical Operations, Inc. Tool with end effector force limiter
US20080255608A1 (en) * 2007-04-16 2008-10-16 Hinman Cameron D Tool with end effector force limiter
US20080255421A1 (en) * 2007-04-16 2008-10-16 David Elias Hegeman Articulating tool with improved tension member system
US7862554B2 (en) 2007-04-16 2011-01-04 Intuitive Surgical Operations, Inc. Articulating tool with improved tension member system
US8562640B2 (en) 2007-04-16 2013-10-22 Intuitive Surgical Operations, Inc. Tool with multi-state ratcheted end effector
US20080255588A1 (en) * 2007-04-16 2008-10-16 Hinman Cameron D Tool with multi-state ratcheted end effector
US11234694B2 (en) 2008-08-18 2022-02-01 Intuitive Surgical Operations, Inc. Instrument with multiple articulation locks
US20100041945A1 (en) * 2008-08-18 2010-02-18 Isbell Jr Lewis Instrument with articulation lock
US9737298B2 (en) 2008-08-18 2017-08-22 Intuitive Surgical Operations, Inc. Instrument with articulation lock
US9033960B2 (en) 2008-08-18 2015-05-19 Intuitive Surgical Operations, Inc. Instrument with multiple articulation locks
US8465475B2 (en) 2008-08-18 2013-06-18 Intuitive Surgical Operations, Inc. Instrument with multiple articulation locks
US20100331879A1 (en) * 2009-06-25 2010-12-30 The Curators Of The University Of Missouri Articulating Surgical Hand Tool
US9221179B2 (en) 2009-07-23 2015-12-29 Intuitive Surgical Operations, Inc. Articulating mechanism
EP2588003A4 (en) * 2010-06-02 2017-05-10 Carefusion 2200, Inc. Hand-actuated articulating surgical tool
WO2011153083A3 (en) * 2010-06-02 2012-04-05 Carefusion 2200, Inc. Instrument positioning/holding devices
WO2011153082A3 (en) * 2010-06-02 2012-04-05 Carefusion 2200, Inc. Hand-actuated articulating surgical tool
WO2011153082A2 (en) * 2010-06-02 2011-12-08 Carefusion 2200, Inc. Hand-actuated articulating surgical tool
US10335177B2 (en) 2011-05-13 2019-07-02 Intuitive Surgical Operations, Inc. Medical instrument with snake wrist structure
US11357526B2 (en) 2011-05-13 2022-06-14 Intuitive Surgical Operations, Inc. Medical instrument with snake wrist structure
US9161771B2 (en) 2011-05-13 2015-10-20 Intuitive Surgical Operations Inc. Medical instrument with snake wrist structure
US11896255B2 (en) 2015-10-05 2024-02-13 Flexdex, Inc. End-effector jaw closure transmission systems for remote access tools

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EP1309277A2 (en) 2003-05-14
ATE551965T1 (en) 2012-04-15
ES2383004T3 (en) 2012-06-15
US20090105727A1 (en) 2009-04-23
KR20030040365A (en) 2003-05-22
AU2001280635B2 (en) 2006-09-21
ATE396650T1 (en) 2008-06-15
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EP1309277B1 (en) 2008-05-28
US20050090811A1 (en) 2005-04-28
AU8063501A (en) 2002-02-05
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US20060195071A1 (en) 2006-08-31
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EP2005914A3 (en) 2008-12-31
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CA2415250C (en) 2010-07-06
DE60134236D1 (en) 2008-07-10
US6607475B2 (en) 2003-08-19
US20020111604A1 (en) 2002-08-15
US8105319B2 (en) 2012-01-31

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