WO2020131685A1 - Surgical instruments with switches for deactivating and/or identifying stapler cartridges - Google Patents
Surgical instruments with switches for deactivating and/or identifying stapler cartridges Download PDFInfo
- Publication number
- WO2020131685A1 WO2020131685A1 PCT/US2019/066513 US2019066513W WO2020131685A1 WO 2020131685 A1 WO2020131685 A1 WO 2020131685A1 US 2019066513 W US2019066513 W US 2019066513W WO 2020131685 A1 WO2020131685 A1 WO 2020131685A1
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- WIPO (PCT)
- Prior art keywords
- drive member
- switch
- surgical stapling
- stapling instrument
- surgical
- Prior art date
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- Ceased
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/08—Accessories or related features not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/90—Identification means for patients or instruments, e.g. tags
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/90—Identification means for patients or instruments, e.g. tags
- A61B90/98—Identification means for patients or instruments, e.g. tags using electromagnetic means, e.g. transponders
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00314—Separate linked members
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
- A61B2090/066—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring torque
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0814—Preventing re-use
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/371—Surgical systems with images on a monitor during operation with simultaneous use of two cameras
Definitions
- the field of the present disclosure relates to medical instruments, and more particularly to tissue sealing instruments for use in surgeries. Even more particularly, the present disclosure relates to a surgical stapling instrument having a novel switch-activated lockout mechanism to prevent firing of a surgical stapling instrument while a spent stapler cartridge remains in place on the jaw. The present disclosure further relates to a surgical stapling instrument configured for use with a surgical system having a control unit configured to identify the type and size of a reload installed in the surgical stapling instrument.
- Minimally invasive medical techniques are intended to reduce the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery' time, discomfort, and deleterious side effects.
- One effect of minimally invasive surgery for example, is reduced post-operative hospital recovery times.
- the average hospital stay for a standard open surgery is typically significantly longer than the average stay for an analogous minimally invasive surgery (MIS).
- MIS minimally invasive surgery
- increased use of MIS could save millions of dollars in hospital costs each year. While many of the surgeries performed each year in the United States could potentially be performed in a minimally invasive manner, only a portion of the current surgeries uses these advantageous techniques due to limitations in minimally invasive surgical instruments and the additional surgical training involved in mastering them.
- MIS tissue access, navigation, dissection and sealing instruments
- endoscopy a common form of minimally invasive surgery
- laparoscopy a common form of endoscopy
- a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately one- half inch or less) incisions to provide entry ports for laparoscopic instruments.
- Laparoscopic surgical instruments generally include an endoscope (e.g., laparoscope) for viewing the surgical field and tools for working at the surgical site.
- the working tools are typically similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube (also known as, e.g., an instrument shaft or a main shaft).
- the end effector can include, for example, a clamp, grasper, scissor, stapler, cautery tool, linear cutter, or needle holder.
- the surgeon passes working tools through cannula sleeves to an internal surgical site and manipulates them from outside the abdomen.
- the surgeon views the procedure from a monitor that displays an image of the surgical site taken from the endoscope.
- Similar endoscopic techniques are employed in, for example, arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cistemoscopy, sinoscopy, hysteroscopy, urethroscopy, and the like.
- Minimally invasive telesurgical robotic systems are being developed to increase a surgeon's dexterity when working on an internal surgical site, as well as to allow a surgeon to operate on a patient from a remote location (outside the sterile field).
- the surgeon is often provided with an image of the surgical site at a control console. While viewing a three dimensional image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the control console, which in turn control motion of the servo-mechanically operated slave instruments.
- the servomechanism used for telesurgery will often accept input from two master controllers (one for each of the surgeon's hands) and may include two or more robotic arms.
- a surgical instrument is mounted on each of the robotic arms.
- Operative communication between master controllers and associated robotic arm and instrument assemblies is typically achieved through a control system.
- the control system typically includes at least one processor that relays input commands from the master controllers to the associated robotic arm and instrument assemblies and back in the case of, for example, force feedback or the like.
- One example of a robotic surgical system is the DA VINCITM system commercialized by Intuitive Surgical, Inc. of Sunnyvale, California.
- the driven linkage or "slave” is often called a robotic surgical manipulator, and exemplary linkage arrangements for use as a robotic surgical manipulator during minimally invasive robotic surgery are described in U.S. Pat. Nos. 7,594,912, 6,758,843, 6,246,200, and 5,800,423, the full disclosures of which are incorporated herein by reference in their entirety for all purposes.
- These linkages often manipulate an instrument holder to which an instrument having a shaft is mounted.
- Such a manipulator structure can include a parallelogram linkage portion that generates motion of the instrument holder that is limited to rotation about a pitch axis that intersects a remote center of manipulation located along the length of the instrument shaft.
- Such a manipulator structure can also include a yaw joint that generates motion of the instrument holder that is limited to rotation about a yaw axis that is perpendicular to the pitch axis and that also intersects the remote center of manipulation.
- an end effector of the surgical instrument can be positioned safely by moving the proximal end of the shaft using the manipulator linkage without imposing potentially hazardous forces against the abdominal wall.
- Alternative manipulator structures are described, for example, in U.S. Pat. Nos. 6,702,805, 6,676,669, 5,855,583, 5,808,665, 5,445,166, and 5,184,601, the full disclosures of which are incorporated herein by reference in their entirety for all purposes.
- the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors that perform various functions for the surgeon, for example, holding or driving a needle, grasping a blood vessel, dissecting tissue, or the like, in response to manipulation of the master input devices.
- Manipulation and control of these end effectors is a particularly beneficial aspect of robotic surgical systems.
- Such mechanisms should be appropriately sized for use in a minimally invasive procedure and relatively simple in design to reduce possible points of failure.
- such mechanisms should provide an adequate range of motion to allow the end effector to be manipulated in a wide variety of positions.
- Surgical instruments are often deployed into restrictive body cavities (e.g., through a cannula to inside the pelvis). Accordingly, it is desirable for the surgical instrument to be both compact and maneuverable for best access to and visibility of the surgical site.
- Known surgical instruments may fail to be both compact and maneuverable. For example, known surgical instruments may lack maneuverability with respect to multiple degrees of freedom (e.g., roll, pitch, and yaw) and associated desired ranges of motion.
- Surgical clamping and cuting instruments e.g., non-robotic linear clamping, stapling, and cuting devices, also known as surgical staplers; and electrosurgical vessel sealing devices
- a surgical stapler can be used to resect a cancerous or anomalous tissue from a gastro-intestinal tract.
- Many known surgical clamping and cuting devices, including known surgical staplers, have opposing jaws that clamp tissue and an articulated knife to cut the clamped tissue.
- Many surgical clamping and cuting instruments include an instrument shaft supporting an end effector to which a replaceable stapler cartridge is mounted.
- An actuation mechanism articulates the stapler cartridge to deploy staples from the stapler cartridge to staple tissue clamped between the stapler cartridge and an articulable jaw of the end effector.
- Different types of stapler cartridges can be used that have different staple lengths suitable for different tissues to be stapled.
- replaceable stapler cartridges does, however, give rise to some additional issues. For example, prior to use, a suitable stapler cartridge having the correct staple length should be mounted to the end effector. If a stapler cartridge having an unsuitable staple length is mistakenly mounted to the end effector, the tissue may be stapled with the unsuitable length staples if the error is not detected and corrected prior to stapling of the tissue. As another example, if a previously used stapler cartridge is not replaced with a new stapler cartridge, the tissue clamped between the previously used stapler cartridge and the articulable jaw cannot be stapled due to the lack of staples to deploy. A similar problem can arise if no stapler cartridge is mounted to the end effector.
- a reload detection mechanism that can detect: whether a stapler cartridge is mounted to the surgical instrument; whether the mounted stapler cartridge is unfired (i.e., fresh) or has already been fired; and the type of the mounted stapler cartridge mounted to the end effector to ensure that the mounted stapler cartridge has a suitable staple length for the tissue to be stapled.
- the present disclosure relates to surgical stapling instruments that have devices or mechanisms for identifying and/or deactivating disposable stapler cartridges for use with the stapling instruments.
- the stapling instrument includes a drive member for actuating a staple cartridge and a locking member movable from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke.
- the staple cartridge may include a switch for maintaining the locking member in the disabled position.
- the switch may be further configured to operate as a reload detection mechanism for determining the type of reload present in the surgical stapling instrument.
- a surgical stapling instrument includes an end effector defining a longitudinal axis including a first jaw and a second jaw.
- the first jaw includes an anvil and, the second jaw is configured to receive a stapler cartridge having one or more staples.
- the surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector.
- the surgical stapling instrument further includes a locking member movable from a disabled position permitting distal translation of the drive member to at least an axial position wherein the drive member engages at least one of the staples, to a locking position inhibiting distal translation of the drive member to said axial position.
- the locking member functions to deactivate the stapler cartridge by preventing firing of a surgical stapling instrument while a spent stapler cartridge remains in place on the jaw. This ensures that a surgeon will not attempt to clamp or seal tissue with a staple cartridge that has already been deployed and thus is unable to drive staples into the tissue.
- the locking member is maintained in the disabled position by a portion of the stapler cartridge.
- the portion of the stapler cartridge that maintains the locking member in the disabled position is a switch movably coupled to the stapler cartridge.
- the locking member moves in a first direction, and the switch is movable in a second direction different from the first direction. This is advantageous because it allows for maintenance of reduced instrument diameter, as the switch and the locking member will not be contained in the same space within the surgical instrument once actuation has occurred.
- the locking member includes a distal portion configured to contact the switch, and a distal drive member-engaging portion.
- the drive member includes one or more inclined distal surfaces or ramps.
- the inclined distal surface(s) of the drive member engage the switch and moves the switch from a first portion to a second position. In the first position, the switch maintains the locking member in the disabled position, permitting the drive member to translate distally through the end effector.
- the inclined distal surfaces of the drive member contact the switch, they move the switch into the second position, wherein the switch no longer engages the locking member.
- the locking member which is preferably biased towards the locking position, will then automatically move into the locking position.
- the switch is preferably retained in the second position once it has been moved into this position.
- the stapler cartridge can only be used once.
- the locking member moves into the locking position and remains in this position so that the drive member can no longer translate distally to actuate the stapler cartridge.
- the switch includes a cutout of a predetermined height configured to be engaged by the inclined distal surface of the drive member.
- engagement of the inclined distal surface of the drive member with the cutout creates a detectable resistance readable by a control unit of a surgical system to detect a given reload size or type.
- the switch includes a stationary portion and a movable portion, the stationary portion configured to be separated from the movable portion by shearing along an axis upon contact by the drive member.
- the engagement between an inclined distal surface of the drive member with the switch creates a detectable resistance, the detectable resistance readable by a control unit of a surgical system to detect a given reload size or type.
- the locking member pivots between the disabled position and the locking position. In embodiments, the locking member pivots about a pivot point that is laterally offset from the longitudinal axis of the end effector. In embodiments, the locking member pivots in a direction substantially perpendicular to the longitudinal axis defined by the end effector.
- the drive member includes a first portion that translates through a channel in the first jaw.
- the actuation mechanism includes a coil that applies a distal force to the first portion of the drive member.
- the surgical stapling instrument further includes an elongated shaft, the end effector mounted on a distal end portion of the elongated shaft.
- the surgical stapling instrument further includes an articulation mechanism configured to articulate the end effector relative to the elongate shaft.
- the surgical stapling instrument further includes an actuator operatively connected to the actuation mechanism.
- the actuator includes a movable handle of a handle assembly provided at a proximal end portion of the surgical instrument.
- the actuator includes a control device of a robotic surgical system.
- the drive member includes a knife configured to cut tissue grasped between the first and second jaw.
- the present disclosure relates to a surgical stapling instrument including an end effector defining a longitudinal axis including a first jaw and a second jaw, the first jaw including an anvil.
- the surgical stapling instrument further includes a stapler cartridge having one or more staples and a switch.
- the second jaw is configured to receive the stapler cartridge.
- the surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector.
- the drive member is configured to contact the switch of the stapler cartridge at an axial position of the drive member relative to the end effector.
- the switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position.
- This detectable resistance is advantageous because it may provide information for a reload detection mechanism that can detect: whether a stapler cartridge is mounted to the surgical instrument; whether the mounted stapler cartridge is unfired (or fresh) or has already been fired; and the type of the mounted stapler cartridge mounted to the end effector to ensure that the mounted stapler cartridge has a suitable staple length for the tissue to be stapled.
- the surgical stapling instrument further includes a lockout assembly including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke the surgical stapling instrument further includes a switch movable in a second direction different from the first direction, from a first position and second position, wherein when the switch is in the first position the switch maintains the locking member in the disabled position, and wherein when the switch is in the second position the switch disengages from the locking member.
- the drive member includes one or more inclined distal ramps and the switch has a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector.
- the contact portion of the switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
- the surgical instrument includes two or more staple cartridges.
- Each of the staple cartridges includes a switch having a contact portion configured to contact the one or more distal ramps of the drive member.
- Each of the contact portions of the switches is located at a different height relative to the end effector (and the drive member). Since the distal ramp(s) of the drive member are inclined, the drive member will contact each of the switches of the different staple cartridges at different axial positions of the drive member relative to the staple cartridge. This contact is detectable by a control unit or other suitable mechanism such that each of the staple cartridges may be identified by the control unit.
- the surgical instrument is operatively coupled to a control unit, the control unit configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
- the switch is configured to provide the detectable resistance to the control until upon engagement of the drive member with the contact portion of the switch.
- the switch includes a detachable portion configured to detach from the remainder of the switch upon contact with the drive member.
- the control until detects resistance upon detachment of the detachable portion, thereby identifying the stapler cartridge.
- the switch include a stationary portion and a movable portion, the stationary portion being configured to be separated from the movable portion by shearing along an axis upon contact by the drive member.
- the present disclosure relates to a surgical stapling instrument including an end effector defining a longitudinal axis including a first jaw and a second jaw.
- the first jaw includes an anvil and, the second jaw is configured to receive a stapler cartridge having one or more staples.
- the surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector.
- the surgical stapling instrument further includes a lockout assembly including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke.
- the drive member is configured to contact a switch at an axial position of the drive member relative to the end effector, and wherein the switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position.
- the locking member is maintained in the disabled position by a portion of the stapler cartridge.
- the portion of the stapler cartridge that maintains the locking member in the disabled position comprises the switch.
- the locking member moves in a first direction, and the switch is movable in a second direction different from the first direction.
- the drive member includes one or more inclined distal ramps and the switch has a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector.
- the contact portion of the switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
- the surgical instrument is operatively coupled to a surgical system including a control unit, the control unit configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
- the switch includes a stationary portion and a movable portion.
- the stationary portion is configured to be separated from the movable portion by shearing along an axis upon contact by the drive member.
- the surgical instrument is operatively coupled to a surgical system including a control unit.
- the control unit is configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
- the present disclosure relates to a surgical stapling instrument including an end effector defining a longitudinal axis including a first jaw and a second jaw.
- the first jaw includes an anvil and, the second jaw is configured to receive a stapler cartridge having one or more staples.
- the surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector.
- the surgical stapling instrument further includes a lockout assembly including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke.
- the drive member is configured to contact a first switch at an axial position of the drive member relative to the end effector, and a second switch, and wherein the first switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position. This is advantageous because the detectable resistance provided upon engagement of the drive member with the first switch for reload detection may occur at a more proximal position within the surgical instrument, such as a proximal tail portion of the cartridge.
- the locking member is maintained in the disabled position by a portion of the stapler cartridge.
- the portion of the stapler cartridge that maintains the locking member in the disabled position comprises the second switch.
- the locking member moves in a first direction, and the first switch and second switch are both movable in a second direction different from the first direction.
- the drive member includes one or more inclined distal ramps and the first switch and second switch have contact portions configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector.
- the contact portion of the first switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
- the first switch is formed on a proximal tail portion of the stapler cartridge.
- the surgical instrument is operatively coupled to a surgical system including a control unit.
- the control unit is configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
- FIG. 1 is a perspective view of an illustrative surgical instrument having an end effector mounted to an elongated shaft, and an actuation mechanism;
- FIG. 2 is a perspective view of the distal end portion of an illustrative surgical instrument in accordance with the present disclosure with the jaws in the open position;
- Fig. 3 is an exploded view of the end effector of Fig. 2;
- Fig. 4 is an exploded view of the cartridge, surgical fasteners, staple drivers, and switches which form part of the cartridge assembly of Fig. 3;
- FIG. 5 depicts a partial cross-sectional side view of the end effector of a surgical stapling instrument including a lockout assembly in accordance with an embodiment of the present disclosure having an unfired stapler cartridge installed;
- Fig. 6 depicts a top view of a locking member in accordance with the embodiment of Fig. 5 in the unlocked position
- Fig. 6A depicts a top view of a locking member in accordance with the embodiment of Fig. 5 in the locked position
- Fig. 7 depicts a perspective view of the proximal end of a stapler cartridge in accordance with the embodiment of Fig. 5 having a lockout assembly including a switch for enabling and disabling the locking member;
- FIG. 7A depicts a perspective view of a switch in accordance with the embodiment of Fig. 5;
- FIG. 8 is a partial perspective view of the end effector including a lockout assembly in accordance with the embodiment of Fig. 5 showing a wedge of the drive member contacting a switch;
- FIG. 9 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a drive member moving distally towards a switch;
- FIG. 10 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a drive member contacting a switch upon translating distally;
- FIG. 11 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a wedge of the drive member engaging and pushing a switch upwards during actuation;
- Fig. 12 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a switch pushed completely upwards into a raised position, and the drive member translating distally underneath the switch;
- Fig. 13 is a top view of an end effector in accordance with the embodiment of Fig. 5 showing a drive member translated distally, a switch in the raised position, and a locking member that is enabled;
- FIGs. 13A-13D are perspective views of the proximal ends of a series of stapler cartridges, each stapler cartridge containing a unique switch for reload detection;
- Fig. 14 is a cross-sectional side of a two-part clevis of the surgical instrument of Fig. 1;
- FIG. 15 is a perspective view of the end portion of an illustrative surgical instrument with parts removed;
- FIG. 16 is a perspective view of a drive member in accordance with the illustrative surgical instrument of Fig. 1;
- FIG. 17A is a cross-sectional perspective view of the actuation mechanism for a drive member in accordance with the surgical instrument of Fig. 1;
- Fig. 17B is a cross-sectional side view of the actuation mechanism for a drive member in accordance with the surgical instrument of Fig. 1;
- Fig. 18A shows a movable lower jaw of an illustrative surgical instrument in an open configuration
- Fig. 18B shows a movable lower jaw of an illustrative surgical instrument pivoting towards a closed position
- Fig. 18C shows a movable lower jaw of an illustrative surgical instrument in a closed position
- Fig. 19 is a perspective view of a switch usable with an alternative embodiment of the present disclosure.
- Fig. 20 is a perspective view of a stapler cartridge including the switch of
- Fig. 21 is a perspective view of a stapler cartridge including the switch of Fig. 19 after actuation;
- Fig. 22 is a partial side view of the proximal portion of the stapler cartridge of Fig. 21;
- Fig. 23 is a cross-sectional top view of an illustrative end effector with a switch and stapler cartridge in accordance with Fig. 20 installed before actuation;
- Fig. 24 is a partial side view of a portion of the illustrative end effector of
- FIG. 23 showing a shuttle contacting the switch upon actuation of the surgical instrument
- Fig. 25 is a partial side view with parts removed of a portion of the illustrative end effector of Fig. 23 showing the switch after it has been engaged by a shuttle upon actuation;
- Fig. 26 shows an alternative embodiment having an illustrative stapler cartridge containing a first switch for reload detection, and a second switch for engaging locking member;
- FIG. 27 illustrates a top view of an operating room employing a robotic surgical system utilizing aspects of the present disclosure
- Fig. 28 illustrates a simplified side view of a robotic arm assembly that is usable with various aspects of the present disclosure.
- the surgical clamping and cutting instrument may be a minimally invasive (e.g., laparoscopic) instrument or an instrument used for open surgery.
- surgical stapling instruments may be readily adapted for use in surgical instruments that are activated using any technique within the purview of those skilled in the art, such as, for example, manually activated surgical instruments, powered surgical instruments (e.g., electro-mechanically powered instruments), robotic surgical instruments, and the like.
- FIG. 1 is a perspective view of an illustrative surgical instrument 100 in accordance with embodiments of the present disclosure having a handle assembly 102, and an end effector 110 mounted on an elongated shaft 106.
- End effector 110 includes a stationary jaw 111 and a moveable jaw 112.
- Handle assembly 102 includes a stationary handle 102a and a moveable handle 102b which serves as an actuator for surgical instrument 100.
- handle assembly 102 may include input couplers
- the input couplers provide a mechanical coupling between the drive tendons or cables of the instrument and motorized axes of the mechanical interface of a drive system.
- the input couplers may interface with, and be driven by, corresponding output couplers (not shown) of a telesurgical surgery system, such as the system disclosed in U.S Pub. No. 2014/0183244A1, the entire disclosure of which is incorporated by reference herein.
- the input couplers are drivingly coupled with one or more input members (not shown) that are disposed within the instrument shaft 106.
- the input members are drivingly coupled with the end effector 110.
- Suitable input couplers can be adapted to mate with various types of motor packs (not shown), such as the stapler-specific motor packs disclosed in U.S. Pat. No. 8,912,746, or the universal motor packs disclosed in U.S. Pat. No. 8,529,582, the disclosures of both of which are incorporated by reference herein in their entirety. Further details of known input couplers and surgical systems are described, for example, in U.S. Pat. No. 8,597,280, U.S. Pat. No. 7,048,745, and U.S. Pat No. 10,016,244. Each of these patents is hereby incorporated by reference in its entirety.
- Actuation mechanisms of surgical instrument 100 may employ drive cables that are used in conjunction with a system of motors and pulleys.
- Powered surgical systems including robotic surgical systems that utilize drive cables connected to a system of motors and pulleys for various functions including opening and closing of jaws, as well as for movement and actuation of end effectors are well known. Further details of known drive cable surgical systems are described, for example, in U.S. Pat. No. 7,666,191 and U.S. Pat No. 9,050,119 both of which are hereby incorporated by reference in their entireties. While described herein with respect to an instrument configured for use with a robotic surgical system, it should be understood that the wrist assemblies described herein may be incorporated into manually actuated instruments, electro-mechanical powered instruments, or instruments actuated in any other way.
- Fig. 2 shows the distal end portion of surgical instrument 100, including an end effector 110 defining a longitudinal axis X-X and having a first jaw 111, a second jaw 112, a clevis 140 for mounting jaws 111, 112 to the instrument. ).
- second jaw 112 is a movable jaw configured to move from an open position to a closed position relative to first jaw 111.
- first jaw 111 is a movable jaw configured to move between open and closed positions relative to second jaw 112.
- both jaws 111, 112 are movable relative to each other.
- First jaw 111 includes an anvil 115 having staple-forming pockets 116.
- Second jaw 112 is configured to move from an open position to a closed position relative to stationary jaw 111.
- a fresh stapler cartridge 122 such as the exemplary one shown in Fig. 3 (sometimes referred to as a reload) can be loaded into movable jaw 112 and tissue may be positioned between the jaws 111, 112.
- jaws 111, 112 In the closed position, jaws 111, 112 cooperate to clamp tissue such that cartridge 122 and the anvil 115 are in close cooperative alignment.
- stapler cartridge 122 may include a plurality of staples 124 supported on corresponding staple drivers 126 provided within respective staple retention openings 127 formed in stapler cartridge 122.
- a shuttle 123 (see Fig. 3) having an inclined distal portion 125 sequentially acts on staple drivers 126 upon distal movement of the drive member 150, camming staple drivers 126 upwardly, thereby moving staples 124 into deforming contact with anvil 115.
- shuttle 123 may be included within stapler cartridge 122.
- inclined distal portions 125 may be integrated with drive member 150 as seen in Fig. 3.
- stapler cartridge 122 further includes one or more switches 191 positioned on the proximal side of the proximal-most pusher 126p within stapler cartridge 122. The functionality of switches 191 will be described in more detail below.
- end effector 110 may also include a lockout assembly including locking member 170, switch 191, and spring 178.
- Locking member 170 includes a distal, switch-contacting portion 172 and a proximal engagement portion 174 (See Fig. 5).
- End effector 110 may also include a drive member 150 configured to translate distally and retract proximally through the end effector and includes an integrated shuttle 123 having an inclined distal portion 125 formed thereon.
- upper shoe 152 of drive member 150 is substantially aligned with and translates through a channel 118 in fixed jaw 111, while lower shoe 154 (see Fig. 16) of drive member 150 is substantially aligned with and translates through a channel 119 and below jaw 112. The details of the drive member and actuation will be described below.
- Fig. 5 shows a portion of an illustrative surgical instrument with an unfired reload installed, including stapler cartridge 122, spring 178, locking member 170, and switch 191
- switch 191 When an unfired stapler cartridge is installed, as shown in Fig. 5, switch 191 is in a first unraised position. In a fresh, unfired stapler cartridge, switch 191 is in contact with distal portion 172 of locking member 170, keeping distal portion 172 held within channel 119 and proximal engagement portion 174 outside of channel 119.
- locking member 170 is in this disabled position, distal translation of drive member 150 is permitted, as locking member 170 will not obstruct movement of drive member 150 because engagement portion 174 is held out of alignment with channel 119.
- Figs. 6 and 6A show a top view of locking member 170 in the unlocked or disabled position and the locked position, respectively.
- Locking member 170 pivots about a pivot point 179, that is laterally offset from channel 119, and is configured to move in a lateral direction, preferably substantially perpendicular to, the longitudinal axis of the end effector.
- Spring 178 biases engagement portion 174 of locking member 170 into channel 119 to lock the instrument.
- switch 191 engages distal portion 172 of locking member 170, overcoming the bias of spring 178 and holding engagement portion 174 out of channel 119, permitting distal movement of drive member 150.
- switch 191 When switch 191 is no longer in contact with distal portion 172 of locking member 170, spring 178 forces engagement portion 174 of locking member into channel 119, where it obstructs distal movement of drive member 150, as best seen in Fig. 6A.
- Figs. 7 and 7A show an unfired stapler cartridge with switch 191 in the initial, pre-firing position.
- Switch 191 may be contained in stapler cartridge 122, and may be substantially aligned with staple drivers 126 on a desired side of the stapler cartridge where it may engage distal portion 172 of locking member 170 (see Fig. 8).
- Switch 191 includes a cutout 196 (see Fig. 13 A) configured to be engaged by inclined distal portion 125 of shuttle 123 upon distal advancement of drive member 150 when the surgical instrument 100 is actuated.
- switch 191 In an unfired stapler cartridge, as shown in Fig. 7, switch 191 is in an initial pre-firing position, where it rests on the bottom of a switch channel 129 within stapler cartridge 122.
- Switch channel 129 extends upwardly towards anvil 115.
- switch 191 further includes detent 193.
- Detent 193 is configured to provide mechanical resistance that must be overcome by drive member 150 in order to slide switch 191 from the initial position toward anvil 115. This ensures that the lockout will not unintentionally activate as may happen if switch 191 freely slides in channel 129 (e.g., in the absence of detent 193).
- Fig. 8 depicts inclined distal portions 125 of drive member 150 interfacing with switch 191 to disable locking member 170. Distal portion 172 of locking member 170 is shown protruding into channel 119, as switch 191 is blocking it from being laterally displaced.
- Figs. 9-12 depict sequential cross-sectional views (with locking member
- Inclined distal portions 125 of drive member 150 are shown interfacing with switch 191 to move it from the unraised position, to the raised position in which locking member 170 becomes enabled.
- drive member 150 begins to translate distally along the longitudinal axis of the end effector and has not yet contacted switch 191.
- inclined distal portion 125 of drive member 150 contacts switch 191.
- inclined distal portion 125 of drive member 150 then begins to force switch 191 upwards within switch channel 129 of stapler cartridge 122 as drive member 150 continues to translate distally.
- Switch 191 travels in a direction substantially perpendicular to the longitudinal axis of the end effector. In embodiments, switch 191 travels vertically, while locking member 170 travels laterally, allowing for maintenance of a reduced instrument diameter, as they will not compete for the same space within the instrument after actuation has occurred.
- drive member 150 continues to travel distally and forces switch 191 into a fully raised position within channel 129, allowing the entirety of drive member 150 to pass by switch 191 such that it may complete the firing stroke.
- Switch 191 is fitted into channel 129 such that it may not return to the unraised position once the drive member has traveled distally. As drive member 150 displaces switch 191, distal portion 172 of locking member 170 is prevented from lateral movement by contact with drive member 150.
- Fig. 13 depicts a top view of an illustrative surgical instrument during actuation.
- drive member 150 has translated past switch 191 and moved it into the fully raised position, enabling locking member 170.
- drive member 150 may continue to travel distally to drive staples into the tissue grasped between jaws 111, 112 and cut the stapled tissue.
- a proximal surface on the proximal end of drive member 150 engages a proximal ramped surface 176 on locking member 170, allowing drive member 150 to return to a position proximal of locking member 170.
- drive member 150 will be obstructed by engagement portion 174 of locking member 150, preventing actuation of an unloaded instrument.
- the particular type of stapler cartridge (or reload) installed in the end effector may be detected based on the configuration of the switches 191.
- different stapler cartridges 122 may have switches 191 including a cutout 196 of a given height depending on the type of reload present within stapler cartridge 122.
- Figs. 13A-13D depict four different stapler cartridges 122 having switches 191 each including a cutout 196 of a given height depicted by arrows A-D respectively . As the length of cutout 196 increases, the distance that shuttle 123 must travel, as described above, before engaging switch 191increases.
- a control unit of a robotic surgical system may be configured to detect the axial position along a firing stroke at which the shuttle 123 engages a given switch 191 via detection of a detectable resistance, such as a torque spike, allowing the system to determine the type of reload presently installed.
- Varying the length of the cutout formed on a given switch will adjust the axial position at which the drive member engages the switch to create the detectable resistance.
- a control unit operatively coupled with the actuation mechanism, determines the correct amount of forces to apply to the drive member depending upon the features of the detected stapler cartridge, including but not limited to, the number of staples contained therein, the size of the staples contained therein, and the geometry of the staples contained therein.
- An exemplary surgical stapler including a control unit of a surgical system that is operatively coupled to the actuation mechanism is described for example in International Application No. PCT/US2017050747, the disclosure of which is hereby incorporated by reference in its entirety.
- Jaws 111, 112 are attached to surgical instrument 100 via clevis 140. See, Fig. 14.
- Clevis 140 includes a proximal surface 140a and a distal surface 140b.
- Clevis 140 further includes upper clevis portion 142 and lower clevis portion 141 that cooperate when assembled to form protrusion 145 (best seen in Fig. 18A) configured to engage tabs 113 (best seen in in Fig. 18A of jaw 111 to securely mount jaw 111 in a fixed position on instrument 100.
- lower clevis portion 141 includes a pair of distally extending arms 147 for supporting movable jaw 112.
- Arms 147 include opening 149 for receiving a pivot pin 130 defining a pivot axis around which jaw 112 pivots as described in more detail below.
- Lower clevis portion 141 also includes ramped groove 144 configured to guide a portion of an actuation coil 120 emerging from wrist 160.
- Upper clevis portion 142 includes a complementary shaped ramped groove 146 that cooperates with ramped groove 144 of lower clevis portion 141 to form an enclosed channel 180 that guides coil 120 as it jogs upwards from wrist 160 towards distal surface 157 of upper shoe 152 of drive member 150.
- channel 180 may include a first end 181 at a central portion of proximal surface 140a and a second end 182 at a peripheral portion of distal surface 140b.
- enclosed channel 180 may be substantially“S” shaped.
- the clevis may be a unitary structure formed, for example, by molding, machining, 3-D printing, or the like.
- End effector 110 may be articulated in multiple directions by an articulation mechanism.
- the articulation mechanism may be a wrist 160 as shown, although other articulation mechanisms are contemplated.
- wrist 160 includes a plurality of articulation joints 162, 164, 166, etc. that define a bore 167 through which an actuation mechanism (in embodiments, coil 120 and drive cable 171, see Fig. 17A) may pass.
- actuation mechanism in embodiments, coil 120 and drive cable 171, see Fig. 17A
- coil 120 Upon exiting articulation wrist 160, coil 120 enters and passes through channel 180 of clevis 140 (see Fig. 14), ultimately engaging proximal surface 153 of upper shoe 152 of drive member 150.
- Other articulation mechanisms within the purview of those skilled in the art may substitute for wrist 160.
- One suitable articulation mechanism is described for example in U.S. Publication No. 2015/0250530, the disclosure of which is hereby incorporated by reference in its entirety.
- drive member 150 Upon actuation of the surgical instrument, drive member 150 is advanced distally through end effector 110 to move jaws 111, 112 from the open position to the closed position, after which shuttle 123 and knife 128 are advanced distally through cartridge 122 to staple and cut tissue grasped between jaws 111, 112.
- Drive member 150 may be any structure capable of pushing at least one of a shuttle or a knife of a surgical stapling instrument with the necessary force to effectively sever or staple human tissue.
- Drive member 150 may be an I-beam, an E-beam, or any other type of drive member capable of performing similar functions.
- Drive member 150 is movably supported on the surgical stapling instrument 100 such that it may pass distally through cartridge 122 and upper fixed jaw 111 and lower jaw 112 when the surgical stapling instrument is fired (e.g., actuated).
- drive member 150 may include a body 151, upper shoe 152, lower shoe 154, and central portion 156.
- Upper shoe 152 of drive member 150 is substantially aligned with and translates through a channel 118 in fixed jaw 111, while lower shoe 154 of drive member 150 is substantially aligned with and translates through a channel 119 and below jaw 112.
- Bore 158 is formed through upper shoe 152 to receive drive cable 171 as will be described in more detail below.
- Proximal surface 153 of upper shoe 152 is configured to be engaged by a coil 120 of actuation assembly 190 such that coil 120 may apply force to upper shoe 152 to advance drive member 150 distally, i.e., in the direction of arrow“A” in Fig. 17B.
- a knife 128 may be formed on drive member 150 along the distal edge between upper shoe 152 and central portion 156.
- inclined distal portions 125 may be formed on either side of drive member 150.
- Actuation assembly 190 includes a drive cable 171, a coil 120, a sheath 121 surrounding coil 120, and a drive rod 175.
- Drive cable 171 includes an enlarged distal end 173.
- upper shoe 152 of drive member 150 includes a bore 158 into which drive cable 171 is routed.
- coil 120 and a protective sheath 121 are slipped over the free end of drive cable 171.
- the free end of drive cable 171 is attached to a drive rod 175 securing coil 120 and the protective sheath 121 between drive member 150 and drive rod 175 as seen in Fig. 17B.
- Sheath 121 may function to promote stability, smooth movement, and prevent buckling upon actuation of surgical instrument 100.
- Sheath 121 may be made from polyimide, or any other suitable material having the requisite strength requirements such as various reinforced plastics, a nickel titanium alloy such as NITINOLTM, poly para- phenyleneterphtalamide materials such as KEVLARTM commercially available from DuPont. Other suitable materials may be envisioned by those of skill in the art.
- Enlarged distal end 173 of drive cable 171 resides within an enlarged distal portion 159 of bore 158 in upper shoe 152 of body 150, such that the proximal face 157 of enlarged distal end 173 may apply a retraction force on upper shoe 152 when the drive cable 171 is pulled proximally, i.e., in the direction of arrow“B” in Fig. 17B.
- Drive rod 175 is operationally connected to an actuator (e.g., movable handle 102b), which allows distal translation and proximal retraction of actuation assembly 190.
- the surgical instrument may be designed such that the drive member 150 is not retracted in the proximal direction after the staples have been fired.
- the actuator in a manually actuated instrument, the actuator may be a movable handle, such as moveable handle 102b shown in Fig. 1; in a powered instrument the actuator may be a button (not shown) that causes a motor to act on the drive rod; and in a robotic system, the actuator may be a control device such as the control devices described below in connection with Fig. 28.
- Any suitable backend actuation mechanism for driving the components of the surgical stapling instrument may be used.
- exemplary actuation mechanisms using push/pull drive cables see, e.g., commonly owned International Application WO 2018/049217, the disclosure of which is hereby incorporated by reference in its entirety.
- drive rod 175 applies force to coil 120, thereby causing coil 120 to apply force to upper shoe 152 of drive member 150, translating it distally (i.e., in the direction of arrow“A” in Fig. 17B) initially closing jaws 111,112 and then ejecting staples 124 from stapler cartridge 122 to staple tissue. After stapling is complete, drive rod 175 applies a force in the proximal direction to effect retraction of drive member.
- enlarged distal end 173 of drive cable 171 is obstructed by wall 157 of enlarged portion 159 of bore 158, causing drive cable 171 to apply force to upper shoe 152 of drive member 150, thereby translating drive member 150 in the proximal direction.
- drive member 150, drive cable 171, and drive rod 175 all move in unison and remain in the same relative position to each other.
- drive cable 171 advances drive member 150 through fixed jaw 111 (instead of through the staple cartridge jaw as in conventional surgical stapling instruments). Eliminating the internal channel for the actuation mechanism from the staple cartridge provides more space in the cartridge for the staples and for the reinforcing wall discussed above.
- coil 120 of actuation assembly 190 may be coupled with lower shoe 154 instead of upper shoe 152. In these embodiments, coil 120 applies force to lower shoe 153 to advance drive member 150 distally through a channel (not shown) in the lower jaw 112. In these embodiments, coil 120 will advance at least through a portion of lower jaw 112 and staple cartridge 122.
- FIGs. 18A-C depict fixed jaw 111 and movable jaw 112 of illustrative surgical instrument 100 sequentially moving from an open configuration to a closed configuration.
- drive member 150 is positioned proximally of cam surface 114 formed on movable jaw 112.
- cam surface 114 formed on movable jaw 112.
- drive member 150 has come into contact with cam surface 114 of movable jaw 112. As lower portion 154 of drive member 150 rides underneath cam surface 114, drive member 150 pushes movable jaw 112, causing it to pivot towards the closed position.
- Fig. 18C illustrates jaws 111, 112 in the closed position.
- Drive member 150 has translated distally past cam surface 114. In this position, tissue is clamped, and further advancement of the drive member will sever and staple tissue.
- switch 191 is replaced with a switch 292 having a detachable portion configured for detachment from the remainder of switch 191 as drive member engages the switch 292.
- switch 292 is configured to be sheared into two separate pieces along a shear plane X’-X ⁇
- the surgical system may detect the force applied by a shuttle in shearing switch 292 to determine the type of reload within a given stapler cartridge.
- Switch 292 may be any desired shape, and may be sheared at various angles or along any line substantially parallel to the path of the drive member as it translates through a firing stroke.
- the axial position at which switch 292 is contacted by a drive member may be adjusted by including a cutout of a predetermined height in a similar manner as above in connection with previously described embodiments to create a detectable resistance at a unique axial position.
- the detectable resistance may similarly be used for reload detection in a similar manner as described above.
- switch 292 is shearable, it is envisioned that the design of switch 292 may be adjusted to shear under a specific amount of force from the drive member that also provides for a suitable amount of detectable resistance depending on the sensitivity of the control unit of the surgical system being used.
- Fig. 20 depicts the proximal portion of an illustrative stapler cartridge having two switches 292 in an unraised position. In this configuration, actuation has not yet occurred and switch 292 has not been engaged by an inclined distal portion of a shuttle or drive member having a shuttle integrated thereon.
- Figs. 21 and 22 show switch 292 after it has been engaged by a shuttle upon actuation of the surgical instrument.
- stationary portion 294 of switch 292 may include a protrusion 295 configured to fit within a cutout 227 formed within a sidewall of stapler cartridge 222, helping stationary portion 294 to remain substantially unmoved throughout actuation.
- FIGs. 23-25 sequentially depict actuation of an illustrative surgical instrument having an end effector with a stapler cartridge in accordance with Fig. 20 installed.
- a fresh stapler cartridge 222 having switches 292 has been installed into end effector 210 of an illustrative surgical instrument.
- a locking member 270 is biased by a spring 278 towards a channel 219 through which drive member 250 is configured to pass.
- switch 292 in the unraised position maintains locking member 270 out of engagement with channel 219, thereby allowing drive member 250 to translate distally upon actuation to cut tissue and drive staples and cut tissue.
- FIG. 24 an inclined distal portion 225 of a shuttle 223 is shown driving distally to engage switch 292.
- Shuttle 223 may be coupled to a drive member 250 as in the embodiments previously described.
- the forces applied to switch 292 by shuttle 223 have caused switch 292 to be sheared into two separate pieces.
- Movable portion 293 of switch 292 is forced into the raised position where it is no longer aligned with locking member 270. This allows for spring 278 to force locking member 270 to swing into channel 219. In this position, drive member 250 is obstructed by locking member 270 should a user attempt to again actuate the surgical instrument.
- Stationary portion 294 of switch 292 remains in a substantially similar position.
- stapler cartridge 222 may include an additional switch 298 positioned on a proximal tail portion 224 of stapler cartridge 222 as best seen in Fig. 26.
- the engagement of shuttle 223 with switch 298 upon distal translation of drive member 250 may serve as the reload detection point. In some instances, this configuration is desirable as the reload detection point is at a more proximal position than if reload detection was accomplished using switch 292.
- switch 298 operates independently of locking member 270, and switch 292 independently activates or disables locking member 270.
- FIG. 27 illustrates, as an example, a top view of an operating room employing a robotic surgical system.
- the robotic surgical system in this case is a robotic surgical system 300 including a Console (“C”) utilized by a Surgeon (“S”) while performing a minimally invasive diagnostic or surgical procedure, usually with assistance from one or more Assistants (“A”), on a Patient (“P”) who is lying down on an Operating table (“O”).
- C Console
- S Surgeon
- A Assistants
- P Patient
- O Operating table
- the Console includes a monitor 304 for displaying an image of a surgical site to the Surgeon, left and right manipulatable control devices 308 and 309, a foot pedal 305, and a processor 302.
- the control devices 308 and 309 may include any one or more of a variety of input devices such as joysticks, gloves, trigger-guns, hand-operated controllers, or the like.
- the processor 302 may be a dedicated computer that may be integrated into the Console or positioned next to it.
- the Surgeon performs a minimally invasive surgical procedure by manipulating the control devices 308 and 309 (also referred to herein as “master manipulators”) so that the processor 302 causes their respectively associated robotic arm assemblies, 328 and 329, (also referred to herein as“slave manipulators”) to manipulate their respective removably coupled surgical instruments 338 and 339 (also referred to herein as“tools”) accordingly, while the Surgeon views the surgical site in 3-D on the Console monitor 304 as it is captured by a stereoscopic endoscope 340.
- master manipulators also referred to herein as “master manipulators”
- the processor 302 causes their respectively associated robotic arm assemblies, 328 and 329, (also referred to herein as“slave manipulators”) to manipulate their respective removably coupled surgical instruments 338 and 339 (also referred to herein as“tools”) accordingly, while the Surgeon views the surgical site in 3-D on the Console monitor 304 as it is captured by a stereoscopic endoscope 340.
- Each of the tools 338 and 339, as well as the endoscope 340, may be inserted through a cannula or other tool guide (not shown) into the Patient so as to extend down to the surgical site through a corresponding minimally invasive incision such as incision 366.
- Each of the robotic arms is conventionally formed of links, such as link 362, which are coupled together and manipulated through motor controlled or active joints, such as joint 363.
- the number of surgical tools used at one time and consequently, the number of robotic arms being used in the system 300 will generally depend on the diagnostic or surgical procedure and the space constraints within the operating room, among other factors. If it is necessary to change one or more of the tools being used during a procedure, the Assistant may remove the tool no longer being used from its robotic arm, and replace it with another tool 331 from a Tray (“T”) in the operating room.
- T Tray
- the monitor 304 may be positioned near the Surgeon's hands so that it will display a projected image that is oriented so that the Surgeon feels that he or she is actually looking directly down onto the operating site. To that end, images of the tools 338 and 339 may appear to be located substantially where the Surgeon's hands are located.
- the processor 302 performs various functions in the system 300.
- One function that it performs is to translate and transfer the mechanical motion of control devices 308 and 309 to their respective robotic arms 328 and 329 through control signals over bus 310 so that the Surgeon can effectively manipulate their respective tools 338 and 339.
- Another important function is to implement various control system processes as described herein.
- 302 may be implemented in practice by any combination of hardware, software and firmware. Also, its functions as described herein may be performed by one unit, or divided up among different components, each of which may be implemented in turn by any combination of hardware, software and firmware.
- FIG. 28 illustrates, as an example, a side view of a simplified (not necessarily in proportion or complete) illustrative robotic arm assembly 400 (which is representative of robotic arm assemblies 328 and 329) holding a surgical instrument 450 (which is representative of tools 338 and 339) for performing a surgical procedure.
- the surgical instrument 450 is removably held in tool holder 440.
- the arm assembly 400 is mechanically supported by a base 401, which may be part of a patient-side movable cart or affixed to the operating table or ceiling. It includes links 402 and 403 which are coupled together and to the base 401 through setup joints 404 and 405.
- setup joints 404 and 405 in this example are passive joints that allow manual positioning of the arm 400 when their brakes are released.
- setup joint 404 allows link 402 to be manually rotated about axis 406
- setup joint 405 allows link 403 to be manually rotated about axis 407.
- setup joints 404 and 405 are useful for horizontal positioning of the arm 400, additional setup joints may be included and useful for limited vertical and angular positioning of the arm 400.
- the arm 400 may also be slidably moved along the vertical axis of the base 401 and locked in position.
- the robotic arm assembly 400 also includes three active joints driven by motors.
- a yaw joint 410 allows arm section 430 to rotate around an axis 461, and a pitch joint 420 allows arm section 430 to rotate about an axis perpendicular to that of axis 46 land orthogonal to the plane of the drawing.
- the arm section 430 is configured so that sections 431 and 432 are always parallel to each other as the pitch joint 420 is rotated by its motor.
- the instrument 450 may be controllably moved by driving the yaw and pitch motors so as to pivot about the pivot point 462, which is generally located through manual positioning of the setup joints 404 and 405 so as to be at the point of incision into the patient.
- an insertion gear 445 may be coupled to a linear drive mechanism (not shown) to extend or retract the instrument 450 along its axis 463.
- each of the yaw, pitch and insertion joints or gears, 410, 420 and 445 is controlled by an individual joint or gear controller
- the three controllers are controlled by a common master/slave control system so that the robotic arm assembly 400 (also referred to herein as a“slave manipulator”) may be controlled through user (e.g., surgeon) manipulation of its associated master manipulator.
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Abstract
Surgical stapling instruments include mechanisms for identifying and/or deactivating stapler cartridge for use with the instruments. The stapling instrument includes a drive member for actuating a staple cartridge and a locking member movable from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke. The staple cartridge may include a switch for maintaining the locking member in the disabled position. The switch may be further configured to operate as a reload detection mechanism for determining the type of reload present in the surgical stapling instrument.
Description
SURGICAL INSTRUMENTS WITH SWITCHES FOR DEACTIVATING
AND/OR IDENTIFYING STAPLER CARTRIDGES
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional Application No.
62/783,429, filed December 21, 2018, the entire disclosure of which is incorporated herein by reference for all purposes.
BACKGROUND
[0002] The field of the present disclosure relates to medical instruments, and more particularly to tissue sealing instruments for use in surgeries. Even more particularly, the present disclosure relates to a surgical stapling instrument having a novel switch-activated lockout mechanism to prevent firing of a surgical stapling instrument while a spent stapler cartridge remains in place on the jaw. The present disclosure further relates to a surgical stapling instrument configured for use with a surgical system having a control unit configured to identify the type and size of a reload installed in the surgical stapling instrument.
[0003] Minimally invasive medical techniques are intended to reduce the amount of extraneous tissue that is damaged during diagnostic or surgical procedures, thereby reducing patient recovery' time, discomfort, and deleterious side effects. One effect of minimally invasive surgery, for example, is reduced post-operative hospital recovery times. The average hospital stay for a standard open surgery is typically significantly longer than the average stay for an analogous minimally invasive surgery (MIS). Thus, increased use of MIS could save millions of dollars in hospital costs each year. While many of the surgeries performed each year in the United States could potentially be performed in a
minimally invasive manner, only a portion of the current surgeries uses these advantageous techniques due to limitations in minimally invasive surgical instruments and the additional surgical training involved in mastering them.
[0004] Improved surgical instruments such as tissue access, navigation, dissection and sealing instruments have enabled MIS to redefine the field of surgery. These instruments allow surgeries and diagnostic procedures to be performed with reduced trauma to the patient. A common form of minimally invasive surgery is endoscopy, and a common form of endoscopy is laparoscopy, which is minimally invasive inspection and surgery inside the abdominal cavity. In standard laparoscopic surgery, a patient's abdomen is insufflated with gas, and cannula sleeves are passed through small (approximately one- half inch or less) incisions to provide entry ports for laparoscopic instruments.
[0005] Laparoscopic surgical instruments generally include an endoscope (e.g., laparoscope) for viewing the surgical field and tools for working at the surgical site. The working tools are typically similar to those used in conventional (open) surgery, except that the working end or end effector of each tool is separated from its handle by an extension tube (also known as, e.g., an instrument shaft or a main shaft). The end effector can include, for example, a clamp, grasper, scissor, stapler, cautery tool, linear cutter, or needle holder.
[0006] To perform surgical procedures, the surgeon passes working tools through cannula sleeves to an internal surgical site and manipulates them from outside the abdomen. The surgeon views the procedure from a monitor that displays an image of the surgical site taken from the endoscope. Similar endoscopic techniques are employed in, for example, arthroscopy, retroperitoneoscopy, pelviscopy, nephroscopy, cystoscopy, cistemoscopy, sinoscopy, hysteroscopy, urethroscopy, and the like.
[0007] Minimally invasive telesurgical robotic systems are being developed to increase a surgeon's dexterity when working on an internal surgical site, as well as to allow
a surgeon to operate on a patient from a remote location (outside the sterile field). In a telesurgery system, the surgeon is often provided with an image of the surgical site at a control console. While viewing a three dimensional image of the surgical site on a suitable viewer or display, the surgeon performs the surgical procedures on the patient by manipulating master input or control devices of the control console, which in turn control motion of the servo-mechanically operated slave instruments.
[0008] The servomechanism used for telesurgery will often accept input from two master controllers (one for each of the surgeon's hands) and may include two or more robotic arms. A surgical instrument is mounted on each of the robotic arms. Operative communication between master controllers and associated robotic arm and instrument assemblies is typically achieved through a control system. The control system typically includes at least one processor that relays input commands from the master controllers to the associated robotic arm and instrument assemblies and back in the case of, for example, force feedback or the like. One example of a robotic surgical system is the DA VINCI™ system commercialized by Intuitive Surgical, Inc. of Sunnyvale, California.
[0009] A variety of structural arrangements have been used to support the surgical instrument at the surgical site during robotic surgery. The driven linkage or "slave" is often called a robotic surgical manipulator, and exemplary linkage arrangements for use as a robotic surgical manipulator during minimally invasive robotic surgery are described in U.S. Pat. Nos. 7,594,912, 6,758,843, 6,246,200, and 5,800,423, the full disclosures of which are incorporated herein by reference in their entirety for all purposes. These linkages often manipulate an instrument holder to which an instrument having a shaft is mounted. Such a manipulator structure can include a parallelogram linkage portion that generates motion of the instrument holder that is limited to rotation about a pitch axis that intersects a remote center of manipulation located along the length of the instrument shaft. Such a
manipulator structure can also include a yaw joint that generates motion of the instrument holder that is limited to rotation about a yaw axis that is perpendicular to the pitch axis and that also intersects the remote center of manipulation. By aligning the remote center of manipulation with the incision point to the internal surgical site (for example, with a trocar or cannula at an abdominal wall during laparoscopic surgery), an end effector of the surgical instrument can be positioned safely by moving the proximal end of the shaft using the manipulator linkage without imposing potentially hazardous forces against the abdominal wall. Alternative manipulator structures are described, for example, in U.S. Pat. Nos. 6,702,805, 6,676,669, 5,855,583, 5,808,665, 5,445,166, and 5,184,601, the full disclosures of which are incorporated herein by reference in their entirety for all purposes.
[0010] During the surgical procedure, the telesurgical system can provide mechanical actuation and control of a variety of surgical instruments or tools having end effectors that perform various functions for the surgeon, for example, holding or driving a needle, grasping a blood vessel, dissecting tissue, or the like, in response to manipulation of the master input devices. Manipulation and control of these end effectors is a particularly beneficial aspect of robotic surgical systems. For this reason, it is desirable to provide surgical tools that include mechanisms that provide two or three degrees of rotational movement of an end effector to mimic the natural action of a surgeon's wrist. Such mechanisms should be appropriately sized for use in a minimally invasive procedure and relatively simple in design to reduce possible points of failure. In addition, such mechanisms should provide an adequate range of motion to allow the end effector to be manipulated in a wide variety of positions.
[0011] Surgical instruments are often deployed into restrictive body cavities (e.g., through a cannula to inside the pelvis). Accordingly, it is desirable for the surgical instrument to be both compact and maneuverable for best access to and visibility of the
surgical site. Known surgical instruments, however, may fail to be both compact and maneuverable. For example, known surgical instruments may lack maneuverability with respect to multiple degrees of freedom (e.g., roll, pitch, and yaw) and associated desired ranges of motion.
[0012] Surgical clamping and cuting instruments (e.g., non-robotic linear clamping, stapling, and cuting devices, also known as surgical staplers; and electrosurgical vessel sealing devices) have been employed in many different surgical procedures. For example, a surgical stapler can be used to resect a cancerous or anomalous tissue from a gastro-intestinal tract. Many known surgical clamping and cuting devices, including known surgical staplers, have opposing jaws that clamp tissue and an articulated knife to cut the clamped tissue.
[0013] Many surgical clamping and cuting instruments include an instrument shaft supporting an end effector to which a replaceable stapler cartridge is mounted. An actuation mechanism articulates the stapler cartridge to deploy staples from the stapler cartridge to staple tissue clamped between the stapler cartridge and an articulable jaw of the end effector. Different types of stapler cartridges can be used that have different staple lengths suitable for different tissues to be stapled.
[0014] The use of replaceable stapler cartridges does, however, give rise to some additional issues. For example, prior to use, a suitable stapler cartridge having the correct staple length should be mounted to the end effector. If a stapler cartridge having an unsuitable staple length is mistakenly mounted to the end effector, the tissue may be stapled with the unsuitable length staples if the error is not detected and corrected prior to stapling of the tissue. As another example, if a previously used stapler cartridge is not replaced with a new stapler cartridge, the tissue clamped between the previously used stapler cartridge and the articulable jaw cannot be stapled due to the lack of staples to deploy. A similar
problem can arise if no stapler cartridge is mounted to the end effector. The danger of firing a surgical stapling instrument while a spent stapler cartridge remains in place on the jaw has given rise to the development of various lockout mechanisms. However, incorporating lockout features typically increases the diameter of the end effector, increasing overall instrument size and making a given instrument less ideal for minimally invasive surgery.
[0015] Accordingly, while the new telesurgical systems and devices have proven highly effective and advantageous, still further improvements would be desirable. In general, it would be desirable to have a relatively compact mechanism in place to prevent firing of a surgical stapling instrument while a spent stapler cartridge remains in place on the jaw. Additionally, it would be desirable to have a mechanism allowing a robotic surgical system to detect the type of stapler cartridge or reload that has been installed. Thus, a need exists for a reload detection mechanism that can detect: whether a stapler cartridge is mounted to the surgical instrument; whether the mounted stapler cartridge is unfired (i.e., fresh) or has already been fired; and the type of the mounted stapler cartridge mounted to the end effector to ensure that the mounted stapler cartridge has a suitable staple length for the tissue to be stapled.
SUMMARY
[0016] The following presents a simplified summary of the claimed subject matter in order to provide a basic understanding of some aspects of the claimed subject matter. This summary is not an extensive overview of the claimed subject matter. It is intended to neither identify key or critical elements of the claimed subject matter nor delineate the scope of the claimed subject matter. Its sole purpose is to present some concepts of the claimed subject matter in a simplified form as a prelude to the more detailed description that is presented later.
[0017] The present disclosure relates to surgical stapling instruments that have devices or mechanisms for identifying and/or deactivating disposable stapler cartridges for use with the stapling instruments. The stapling instrument includes a drive member for actuating a staple cartridge and a locking member movable from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke. The staple cartridge may include a switch for maintaining the locking member in the disabled position. The switch may be further configured to operate as a reload detection mechanism for determining the type of reload present in the surgical stapling instrument.
[0018] In one embodiment, a surgical stapling instrument includes an end effector defining a longitudinal axis including a first jaw and a second jaw. The first jaw includes an anvil and, the second jaw is configured to receive a stapler cartridge having one or more staples. The surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector. The surgical stapling instrument further includes a locking member movable from a disabled position permitting distal translation of the drive member to at least an axial position wherein the drive member engages at least one of the staples, to a locking position inhibiting distal translation of the drive member to said axial position. In the locking position, the locking member functions to deactivate the stapler cartridge by preventing firing of a surgical stapling instrument while a spent stapler cartridge remains in place on the jaw. This ensures that a surgeon will not attempt to clamp or seal tissue with a staple cartridge that has already been deployed and thus is unable to drive staples into the tissue.
[0019] In embodiments, the locking member is maintained in the disabled position by a portion of the stapler cartridge. In embodiments, the portion of the stapler cartridge
that maintains the locking member in the disabled position is a switch movably coupled to the stapler cartridge. In embodiments, the locking member moves in a first direction, and the switch is movable in a second direction different from the first direction. This is advantageous because it allows for maintenance of reduced instrument diameter, as the switch and the locking member will not be contained in the same space within the surgical instrument once actuation has occurred.
[0020] In embodiments, the locking member includes a distal portion configured to contact the switch, and a distal drive member-engaging portion.
[0021] In embodiments, the drive member includes one or more inclined distal surfaces or ramps. In embodiments, upon distal advancement of the drive member, the inclined distal surface(s) of the drive member engage the switch and moves the switch from a first portion to a second position. In the first position, the switch maintains the locking member in the disabled position, permitting the drive member to translate distally through the end effector. As the inclined distal surfaces of the drive member contact the switch, they move the switch into the second position, wherein the switch no longer engages the locking member. The locking member, which is preferably biased towards the locking position, will then automatically move into the locking position.
[0022] The switch is preferably retained in the second position once it has been moved into this position. Thus, the stapler cartridge can only be used once. As soon as the drive member actuates the staples and moves the switch into the second position, the locking member moves into the locking position and remains in this position so that the drive member can no longer translate distally to actuate the stapler cartridge.
[0023] In embodiments, the switch includes a cutout of a predetermined height configured to be engaged by the inclined distal surface of the drive member. In embodiments, engagement of the inclined distal surface of the drive member with the
cutout creates a detectable resistance readable by a control unit of a surgical system to detect a given reload size or type.
[0024] In embodiments, the switch includes a stationary portion and a movable portion, the stationary portion configured to be separated from the movable portion by shearing along an axis upon contact by the drive member. In embodiments, the engagement between an inclined distal surface of the drive member with the switch creates a detectable resistance, the detectable resistance readable by a control unit of a surgical system to detect a given reload size or type.
[0025] In embodiments, the locking member pivots between the disabled position and the locking position. In embodiments, the locking member pivots about a pivot point that is laterally offset from the longitudinal axis of the end effector. In embodiments, the locking member pivots in a direction substantially perpendicular to the longitudinal axis defined by the end effector.
[0026] In embodiments, the drive member includes a first portion that translates through a channel in the first jaw. In embodiments, the actuation mechanism includes a coil that applies a distal force to the first portion of the drive member.
[0027] In embodiments, the surgical stapling instrument further includes an elongated shaft, the end effector mounted on a distal end portion of the elongated shaft.
[0028] In embodiments, the surgical stapling instrument further includes an articulation mechanism configured to articulate the end effector relative to the elongate shaft. In embodiments, the surgical stapling instrument further includes an actuator operatively connected to the actuation mechanism. In embodiments, the actuator includes a movable handle of a handle assembly provided at a proximal end portion of the surgical instrument. In embodiments, the actuator includes a control device of a robotic surgical system. In embodiments, the drive member includes a knife configured to cut tissue grasped
between the first and second jaw.
[0029] In another aspect, the present disclosure relates to a surgical stapling instrument including an end effector defining a longitudinal axis including a first jaw and a second jaw, the first jaw including an anvil. The surgical stapling instrument further includes a stapler cartridge having one or more staples and a switch. The second jaw is configured to receive the stapler cartridge. The surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector. The drive member is configured to contact the switch of the stapler cartridge at an axial position of the drive member relative to the end effector. The switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position. This detectable resistance is advantageous because it may provide information for a reload detection mechanism that can detect: whether a stapler cartridge is mounted to the surgical instrument; whether the mounted stapler cartridge is unfired (or fresh) or has already been fired; and the type of the mounted stapler cartridge mounted to the end effector to ensure that the mounted stapler cartridge has a suitable staple length for the tissue to be stapled.
[0030] In embodiments, the surgical stapling instrument further includes a lockout assembly including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke the surgical stapling instrument further includes a switch movable in a second direction different from the first direction, from a first position and second position, wherein when the switch is in the first position the switch maintains the locking member in the disabled position, and wherein when the switch is in the second position the switch disengages from the locking member.
[0031] In embodiments, the drive member includes one or more inclined distal ramps and the switch has a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector. In embodiments, the contact portion of the switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
[0032] In certain embodiments, the surgical instrument includes two or more staple cartridges. Each of the staple cartridges includes a switch having a contact portion configured to contact the one or more distal ramps of the drive member. Each of the contact portions of the switches is located at a different height relative to the end effector (and the drive member). Since the distal ramp(s) of the drive member are inclined, the drive member will contact each of the switches of the different staple cartridges at different axial positions of the drive member relative to the staple cartridge. This contact is detectable by a control unit or other suitable mechanism such that each of the staple cartridges may be identified by the control unit.
[0033] In embodiments, the surgical instrument is operatively coupled to a control unit, the control unit configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
[0034] In certain embodiments, the switch is configured to provide the detectable resistance to the control until upon engagement of the drive member with the contact portion of the switch. I
[0035] In other embodiments, the switch includes a detachable portion configured to detach from the remainder of the switch upon contact with the drive member. In these embodiments, the control until detects resistance upon detachment of the detachable portion, thereby identifying the stapler cartridge. In an exemplary embodiment, the switch
include a stationary portion and a movable portion, the stationary portion being configured to be separated from the movable portion by shearing along an axis upon contact by the drive member.
[0036] In another aspect, the present disclosure relates to a surgical stapling instrument including an end effector defining a longitudinal axis including a first jaw and a second jaw. The first jaw includes an anvil and, the second jaw is configured to receive a stapler cartridge having one or more staples. The surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector. The surgical stapling instrument further includes a lockout assembly including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke. The drive member is configured to contact a switch at an axial position of the drive member relative to the end effector, and wherein the switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position.
[0037] In embodiments, the locking member is maintained in the disabled position by a portion of the stapler cartridge. In embodiments, the portion of the stapler cartridge that maintains the locking member in the disabled position comprises the switch. In embodiments, the locking member moves in a first direction, and the switch is movable in a second direction different from the first direction.
[0038] In embodiments, the drive member includes one or more inclined distal ramps and the switch has a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector. In embodiments, the contact portion of the switch is disposed at a predetermined height such
that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
[0039] In embodiments, the surgical instrument is operatively coupled to a surgical system including a control unit, the control unit configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
[0040] In embodiments, the switch includes a stationary portion and a movable portion. The stationary portion is configured to be separated from the movable portion by shearing along an axis upon contact by the drive member.
[0041] In embodiments, the surgical instrument is operatively coupled to a surgical system including a control unit. The control unit is configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
[0042] In yet another aspect, the present disclosure relates to a surgical stapling instrument including an end effector defining a longitudinal axis including a first jaw and a second jaw. The first jaw includes an anvil and, the second jaw is configured to receive a stapler cartridge having one or more staples. The surgical stapling instrument further includes a drive member configured to translate distally and an actuation mechanism configured to translate the drive member distally through the end effector. The surgical stapling instrument further includes a lockout assembly including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke. The drive member is configured to contact a first switch at an axial position of the drive member relative to the end effector, and a second switch, and wherein the first switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position. This is advantageous because the detectable resistance provided upon engagement of the drive
member with the first switch for reload detection may occur at a more proximal position within the surgical instrument, such as a proximal tail portion of the cartridge.
[0043] In embodiments, the locking member is maintained in the disabled position by a portion of the stapler cartridge. In embodiments, the portion of the stapler cartridge that maintains the locking member in the disabled position comprises the second switch. In embodiments, the locking member moves in a first direction, and the first switch and second switch are both movable in a second direction different from the first direction.
[0044] In embodiments, the drive member includes one or more inclined distal ramps and the first switch and second switch have contact portions configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector. In embodiments, the contact portion of the first switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
[0045] In embodiments, the first switch is formed on a proximal tail portion of the stapler cartridge.
[0046] In embodiments, the surgical instrument is operatively coupled to a surgical system including a control unit. The control unit is configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument. BRIEF DESCRIPTION OF THE DRAWINGS
[0047] The above and other aspects, features, and advantages of the present surgical instruments having a locking mechanism will become more apparent in light of the following detailed description when taken in conjunction with the accompanying drawings in which:
[0048] Fig. 1 is a perspective view of an illustrative surgical instrument having an
end effector mounted to an elongated shaft, and an actuation mechanism;
[0049] Fig. 2 is a perspective view of the distal end portion of an illustrative surgical instrument in accordance with the present disclosure with the jaws in the open position;
[0050] Fig. 3 is an exploded view of the end effector of Fig. 2;
[0051] Fig. 4 is an exploded view of the cartridge, surgical fasteners, staple drivers, and switches which form part of the cartridge assembly of Fig. 3;
[0052] Fig. 5 depicts a partial cross-sectional side view of the end effector of a surgical stapling instrument including a lockout assembly in accordance with an embodiment of the present disclosure having an unfired stapler cartridge installed;
[0053] Fig. 6 depicts a top view of a locking member in accordance with the embodiment of Fig. 5 in the unlocked position;
[0054] Fig. 6A depicts a top view of a locking member in accordance with the embodiment of Fig. 5 in the locked position;
[0055] Fig. 7 depicts a perspective view of the proximal end of a stapler cartridge in accordance with the embodiment of Fig. 5 having a lockout assembly including a switch for enabling and disabling the locking member;
[0056] Fig. 7A depicts a perspective view of a switch in accordance with the embodiment of Fig. 5;
[0057] Fig. 8 is a partial perspective view of the end effector including a lockout assembly in accordance with the embodiment of Fig. 5 showing a wedge of the drive member contacting a switch;
[0058] Fig. 9 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a drive member moving distally towards a switch;
[0059] Fig. 10 is a partial perspective view of an end effector in accordance with
the embodiment of Fig. 5 showing a drive member contacting a switch upon translating distally;
[0060] Fig. 11 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a wedge of the drive member engaging and pushing a switch upwards during actuation;
[0061] Fig. 12 is a partial perspective view of an end effector in accordance with the embodiment of Fig. 5 showing a switch pushed completely upwards into a raised position, and the drive member translating distally underneath the switch;
[0062] Fig. 13 is a top view of an end effector in accordance with the embodiment of Fig. 5 showing a drive member translated distally, a switch in the raised position, and a locking member that is enabled;
[0063] Figs. 13A-13D are perspective views of the proximal ends of a series of stapler cartridges, each stapler cartridge containing a unique switch for reload detection;
[0064] Fig. 14 is a cross-sectional side of a two-part clevis of the surgical instrument of Fig. 1;
[0065] Fig. 15 is a perspective view of the end portion of an illustrative surgical instrument with parts removed;
[0066] Fig. 16 is a perspective view of a drive member in accordance with the illustrative surgical instrument of Fig. 1;
[0067] Fig. 17A is a cross-sectional perspective view of the actuation mechanism for a drive member in accordance with the surgical instrument of Fig. 1;
[0068] Fig. 17B is a cross-sectional side view of the actuation mechanism for a drive member in accordance with the surgical instrument of Fig. 1;
[0069] Fig. 18A shows a movable lower jaw of an illustrative surgical instrument in an open configuration;
[0070] Fig. 18B shows a movable lower jaw of an illustrative surgical instrument pivoting towards a closed position;
[0071] Fig. 18C shows a movable lower jaw of an illustrative surgical instrument in a closed position;
[0072] Fig. 19 is a perspective view of a switch usable with an alternative embodiment of the present disclosure;
[0073] Fig. 20 is a perspective view of a stapler cartridge including the switch of
Fig. 19 in a first position before actuation;
[0074] Fig. 21 is a perspective view of a stapler cartridge including the switch of Fig. 19 after actuation;
[0075] Fig. 22 is a partial side view of the proximal portion of the stapler cartridge of Fig. 21;
[0076] Fig. 23 is a cross-sectional top view of an illustrative end effector with a switch and stapler cartridge in accordance with Fig. 20 installed before actuation;
[0077] Fig. 24 is a partial side view of a portion of the illustrative end effector of
Fig. 23 showing a shuttle contacting the switch upon actuation of the surgical instrument;
[0078] Fig. 25 is a partial side view with parts removed of a portion of the illustrative end effector of Fig. 23 showing the switch after it has been engaged by a shuttle upon actuation;
[0079] Fig. 26 shows an alternative embodiment having an illustrative stapler cartridge containing a first switch for reload detection, and a second switch for engaging locking member;
[0080] Fig. 27 illustrates a top view of an operating room employing a robotic surgical system utilizing aspects of the present disclosure; and
[0081] Fig. 28 illustrates a simplified side view of a robotic arm assembly that is
usable with various aspects of the present disclosure.
DFTATT FD DESCRIPTION
[0082] Particular embodiments of the present surgical instruments are described hereinbelow with reference to the accompanying drawings; however, it is to be understood that the disclosed embodiments are merely exemplary of the disclosure and may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure. Well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in any unnecessary detail.
[0083] While the following disclosure is presented with respect to a linear surgical stapler where staples are sequentially fired, it should be understood that the features of the presently described surgical instruments may be readily adapted for use in any type of surgical clamping, cutting, or sealing instruments. The surgical clamping and cutting instrument may be a minimally invasive (e.g., laparoscopic) instrument or an instrument used for open surgery.
[0084] Additionally, the features of the presently described surgical stapling instruments may be readily adapted for use in surgical instruments that are activated using any technique within the purview of those skilled in the art, such as, for example, manually activated surgical instruments, powered surgical instruments (e.g., electro-mechanically powered instruments), robotic surgical instruments, and the like.
[0085] Fig. 1 is a perspective view of an illustrative surgical instrument 100 in accordance with embodiments of the present disclosure having a handle assembly 102, and
an end effector 110 mounted on an elongated shaft 106. End effector 110 includes a stationary jaw 111 and a moveable jaw 112. Handle assembly 102 includes a stationary handle 102a and a moveable handle 102b which serves as an actuator for surgical instrument 100.
[0086] In certain embodiments, handle assembly 102 may include input couplers
(not shown) instead of, or in addition to, the stationary and movable handles. The input couplers provide a mechanical coupling between the drive tendons or cables of the instrument and motorized axes of the mechanical interface of a drive system. The input couplers may interface with, and be driven by, corresponding output couplers (not shown) of a telesurgical surgery system, such as the system disclosed in U.S Pub. No. 2014/0183244A1, the entire disclosure of which is incorporated by reference herein. The input couplers are drivingly coupled with one or more input members (not shown) that are disposed within the instrument shaft 106. The input members are drivingly coupled with the end effector 110. Suitable input couplers can be adapted to mate with various types of motor packs (not shown), such as the stapler-specific motor packs disclosed in U.S. Pat. No. 8,912,746, or the universal motor packs disclosed in U.S. Pat. No. 8,529,582, the disclosures of both of which are incorporated by reference herein in their entirety. Further details of known input couplers and surgical systems are described, for example, in U.S. Pat. No. 8,597,280, U.S. Pat. No. 7,048,745, and U.S. Pat No. 10,016,244. Each of these patents is hereby incorporated by reference in its entirety.
[0087] Actuation mechanisms of surgical instrument 100 may employ drive cables that are used in conjunction with a system of motors and pulleys. Powered surgical systems, including robotic surgical systems that utilize drive cables connected to a system of motors and pulleys for various functions including opening and closing of jaws, as well as for movement and actuation of end effectors are well known. Further details of known drive
cable surgical systems are described, for example, in U.S. Pat. No. 7,666,191 and U.S. Pat No. 9,050,119 both of which are hereby incorporated by reference in their entireties. While described herein with respect to an instrument configured for use with a robotic surgical system, it should be understood that the wrist assemblies described herein may be incorporated into manually actuated instruments, electro-mechanical powered instruments, or instruments actuated in any other way.
[0088] Fig. 2 shows the distal end portion of surgical instrument 100, including an end effector 110 defining a longitudinal axis X-X and having a first jaw 111, a second jaw 112, a clevis 140 for mounting jaws 111, 112 to the instrument. ). In certain embodiments, second jaw 112 is a movable jaw configured to move from an open position to a closed position relative to first jaw 111. In other embodiments, first jaw 111 is a movable jaw configured to move between open and closed positions relative to second jaw 112. In still other embodiments, both jaws 111, 112 are movable relative to each other.
[0089] First jaw 111 includes an anvil 115 having staple-forming pockets 116.
Second jaw 112 is configured to move from an open position to a closed position relative to stationary jaw 111. In the open position, a fresh stapler cartridge 122 such as the exemplary one shown in Fig. 3 (sometimes referred to as a reload) can be loaded into movable jaw 112 and tissue may be positioned between the jaws 111, 112. In the closed position, jaws 111, 112 cooperate to clamp tissue such that cartridge 122 and the anvil 115 are in close cooperative alignment.
[0090] As shown in Fig. 4, stapler cartridge 122 may include a plurality of staples 124 supported on corresponding staple drivers 126 provided within respective staple retention openings 127 formed in stapler cartridge 122. In embodiments, a shuttle 123 (see Fig. 3) having an inclined distal portion 125 sequentially acts on staple drivers 126 upon distal movement of the drive member 150, camming staple drivers 126 upwardly,
thereby moving staples 124 into deforming contact with anvil 115. In embodiments, shuttle 123 may be included within stapler cartridge 122. In embodiments, inclined distal portions 125 may be integrated with drive member 150 as seen in Fig. 3. In embodiments, stapler cartridge 122 further includes one or more switches 191 positioned on the proximal side of the proximal-most pusher 126p within stapler cartridge 122. The functionality of switches 191 will be described in more detail below.
[0091] As shown in Figs. 3 and 4, end effector 110 may also include a lockout assembly including locking member 170, switch 191, and spring 178. Locking member 170 includes a distal, switch-contacting portion 172 and a proximal engagement portion 174 (See Fig. 5). End effector 110 may also include a drive member 150 configured to translate distally and retract proximally through the end effector and includes an integrated shuttle 123 having an inclined distal portion 125 formed thereon. As seen in Fig. 2, upper shoe 152 of drive member 150 is substantially aligned with and translates through a channel 118 in fixed jaw 111, while lower shoe 154 (see Fig. 16) of drive member 150 is substantially aligned with and translates through a channel 119 and below jaw 112. The details of the drive member and actuation will be described below.
[0092] Fig. 5 shows a portion of an illustrative surgical instrument with an unfired reload installed, including stapler cartridge 122, spring 178, locking member 170, and switch 191 When an unfired stapler cartridge is installed, as shown in Fig. 5, switch 191 is in a first unraised position. In a fresh, unfired stapler cartridge, switch 191 is in contact with distal portion 172 of locking member 170, keeping distal portion 172 held within channel 119 and proximal engagement portion 174 outside of channel 119. When locking member 170 is in this disabled position, distal translation of drive member 150 is permitted, as locking member 170 will not obstruct movement of drive member 150 because engagement portion 174 is held out of alignment with channel 119.
[0093] Figs. 6 and 6A show a top view of locking member 170 in the unlocked or disabled position and the locked position, respectively.
[0094] Locking member 170 pivots about a pivot point 179, that is laterally offset from channel 119, and is configured to move in a lateral direction, preferably substantially perpendicular to, the longitudinal axis of the end effector. Spring 178 biases engagement portion 174 of locking member 170 into channel 119 to lock the instrument. In the unlocked position of Figs. 5 and 6, switch 191 engages distal portion 172 of locking member 170, overcoming the bias of spring 178 and holding engagement portion 174 out of channel 119, permitting distal movement of drive member 150. When switch 191 is no longer in contact with distal portion 172 of locking member 170, spring 178 forces engagement portion 174 of locking member into channel 119, where it obstructs distal movement of drive member 150, as best seen in Fig. 6A.
[0095] Figs. 7 and 7A show an unfired stapler cartridge with switch 191 in the initial, pre-firing position. Switch 191 may be contained in stapler cartridge 122, and may be substantially aligned with staple drivers 126 on a desired side of the stapler cartridge where it may engage distal portion 172 of locking member 170 (see Fig. 8). Switch 191 includes a cutout 196 (see Fig. 13 A) configured to be engaged by inclined distal portion 125 of shuttle 123 upon distal advancement of drive member 150 when the surgical instrument 100 is actuated. In an unfired stapler cartridge, as shown in Fig. 7, switch 191 is in an initial pre-firing position, where it rests on the bottom of a switch channel 129 within stapler cartridge 122. Switch channel 129 extends upwardly towards anvil 115. As shown in Fig. 7A, switch 191 further includes detent 193. Detent 193 is configured to provide mechanical resistance that must be overcome by drive member 150 in order to slide switch 191 from the initial position toward anvil 115. This ensures that the lockout will not unintentionally activate as may happen if switch 191 freely slides in channel 129 (e.g., in
the absence of detent 193).
[0096] Fig. 8 depicts inclined distal portions 125 of drive member 150 interfacing with switch 191 to disable locking member 170. Distal portion 172 of locking member 170 is shown protruding into channel 119, as switch 191 is blocking it from being laterally displaced.
[0097] Figs. 9-12 depict sequential cross-sectional views (with locking member
170 not shown) of a portion of an illustrative surgical instrument throughout distal translation of drive member 150 during actuation. Inclined distal portions 125 of drive member 150 are shown interfacing with switch 191 to move it from the unraised position, to the raised position in which locking member 170 becomes enabled.
[0098] In Fig. 9, drive member 150 begins to translate distally along the longitudinal axis of the end effector and has not yet contacted switch 191. In Fig. 10, inclined distal portion 125 of drive member 150 contacts switch 191. As seen in Fig. 11, inclined distal portion 125 of drive member 150 then begins to force switch 191 upwards within switch channel 129 of stapler cartridge 122 as drive member 150 continues to translate distally. Switch 191 travels in a direction substantially perpendicular to the longitudinal axis of the end effector. In embodiments, switch 191 travels vertically, while locking member 170 travels laterally, allowing for maintenance of a reduced instrument diameter, as they will not compete for the same space within the instrument after actuation has occurred.
[0099] As seen in Fig. 12, drive member 150 continues to travel distally and forces switch 191 into a fully raised position within channel 129, allowing the entirety of drive member 150 to pass by switch 191 such that it may complete the firing stroke. Switch 191 is fitted into channel 129 such that it may not return to the unraised position once the drive member has traveled distally. As drive member 150 displaces switch 191, distal portion
172 of locking member 170 is prevented from lateral movement by contact with drive member 150.
[00100] Fig. 13 depicts a top view of an illustrative surgical instrument during actuation. In Fig. 13, drive member 150 has translated past switch 191 and moved it into the fully raised position, enabling locking member 170. In this configuration, drive member 150 may continue to travel distally to drive staples into the tissue grasped between jaws 111, 112 and cut the stapled tissue. Upon retraction, a proximal surface on the proximal end of drive member 150 engages a proximal ramped surface 176 on locking member 170, allowing drive member 150 to return to a position proximal of locking member 170. However, once drive member 150 is positioned proximally of locking member 170, if another attempt is made to actuate the instrument, drive member 150 will be obstructed by engagement portion 174 of locking member 150, preventing actuation of an unloaded instrument.
[00101] In another aspect of the present disclosure, the particular type of stapler cartridge (or reload) installed in the end effector may be detected based on the configuration of the switches 191. Specifically, different stapler cartridges 122 may have switches 191 including a cutout 196 of a given height depending on the type of reload present within stapler cartridge 122. Figs. 13A-13D depict four different stapler cartridges 122 having switches 191 each including a cutout 196 of a given height depicted by arrows A-D respectively . As the length of cutout 196 increases, the distance that shuttle 123 must travel, as described above, before engaging switch 191increases. Thus, as the length of cutout 196 increases, the contact point between inclined distal portion 125 and switch 191 moves upwards and towards the proximal end of inclined distal portion 125. When the drive member 150 engages switch 191, it creates a detectable resistance and urges switch 191 upwards towards a raised position as drive member 150 travels distally.
[00102] In embodiments, a control unit of a robotic surgical system may be configured to detect the axial position along a firing stroke at which the shuttle 123 engages a given switch 191 via detection of a detectable resistance, such as a torque spike, allowing the system to determine the type of reload presently installed. Varying the length of the cutout formed on a given switch will adjust the axial position at which the drive member engages the switch to create the detectable resistance. Based on the detected resistance, a control unit, operatively coupled with the actuation mechanism, determines the correct amount of forces to apply to the drive member depending upon the features of the detected stapler cartridge, including but not limited to, the number of staples contained therein, the size of the staples contained therein, and the geometry of the staples contained therein. An exemplary surgical stapler including a control unit of a surgical system that is operatively coupled to the actuation mechanism is described for example in International Application No. PCT/US2017050747, the disclosure of which is hereby incorporated by reference in its entirety.
[00103] Jaws 111, 112 are attached to surgical instrument 100 via clevis 140. See, Fig. 14. Clevis 140 includes a proximal surface 140a and a distal surface 140b. Clevis 140 further includes upper clevis portion 142 and lower clevis portion 141 that cooperate when assembled to form protrusion 145 (best seen in Fig. 18A) configured to engage tabs 113 (best seen in in Fig. 18A of jaw 111 to securely mount jaw 111 in a fixed position on instrument 100. As seen in Fig. 14, lower clevis portion 141 includes a pair of distally extending arms 147 for supporting movable jaw 112. Arms 147 include opening 149 for receiving a pivot pin 130 defining a pivot axis around which jaw 112 pivots as described in more detail below. Lower clevis portion 141 also includes ramped groove 144 configured to guide a portion of an actuation coil 120 emerging from wrist 160. Upper clevis portion 142 includes a complementary shaped ramped groove 146 that cooperates
with ramped groove 144 of lower clevis portion 141 to form an enclosed channel 180 that guides coil 120 as it jogs upwards from wrist 160 towards distal surface 157 of upper shoe 152 of drive member 150. In embodiments, channel 180 may include a first end 181 at a central portion of proximal surface 140a and a second end 182 at a peripheral portion of distal surface 140b. In embodiments, enclosed channel 180 may be substantially“S” shaped. Although shown as a two-part clevis, it should be understood that the clevis may be a unitary structure formed, for example, by molding, machining, 3-D printing, or the like.
[00104] End effector 110 may be articulated in multiple directions by an articulation mechanism. In embodiments, the articulation mechanism may be a wrist 160 as shown, although other articulation mechanisms are contemplated. As seen in Fig. 15, wrist 160 includes a plurality of articulation joints 162, 164, 166, etc. that define a bore 167 through which an actuation mechanism (in embodiments, coil 120 and drive cable 171, see Fig. 17A) may pass. Upon exiting articulation wrist 160, coil 120 enters and passes through channel 180 of clevis 140 (see Fig. 14), ultimately engaging proximal surface 153 of upper shoe 152 of drive member 150. Other articulation mechanisms within the purview of those skilled in the art may substitute for wrist 160. One suitable articulation mechanism is described for example in U.S. Publication No. 2015/0250530, the disclosure of which is hereby incorporated by reference in its entirety.
[00105] Upon actuation of the surgical instrument, drive member 150 is advanced distally through end effector 110 to move jaws 111, 112 from the open position to the closed position, after which shuttle 123 and knife 128 are advanced distally through cartridge 122 to staple and cut tissue grasped between jaws 111, 112. Drive member 150 may be any structure capable of pushing at least one of a shuttle or a knife of a surgical stapling instrument with the necessary force to effectively sever or staple human tissue.
Drive member 150 may be an I-beam, an E-beam, or any other type of drive member capable of performing similar functions. Drive member 150 is movably supported on the surgical stapling instrument 100 such that it may pass distally through cartridge 122 and upper fixed jaw 111 and lower jaw 112 when the surgical stapling instrument is fired (e.g., actuated).
[00106] As seen in Fig. 16, drive member 150 may include a body 151, upper shoe 152, lower shoe 154, and central portion 156. Upper shoe 152 of drive member 150 is substantially aligned with and translates through a channel 118 in fixed jaw 111, while lower shoe 154 of drive member 150 is substantially aligned with and translates through a channel 119 and below jaw 112. Bore 158 is formed through upper shoe 152 to receive drive cable 171 as will be described in more detail below. Proximal surface 153 of upper shoe 152 is configured to be engaged by a coil 120 of actuation assembly 190 such that coil 120 may apply force to upper shoe 152 to advance drive member 150 distally, i.e., in the direction of arrow“A” in Fig. 17B. A knife 128 may be formed on drive member 150 along the distal edge between upper shoe 152 and central portion 156. In embodiments, inclined distal portions 125 may be formed on either side of drive member 150.
[00107] Actuation assembly 190 includes a drive cable 171, a coil 120, a sheath 121 surrounding coil 120, and a drive rod 175. Drive cable 171 includes an enlarged distal end 173.
[00108] As seen in Figs. 17A and 17B, upper shoe 152 of drive member 150 includes a bore 158 into which drive cable 171 is routed. When assembling illustrative surgical instrument 100, coil 120 and a protective sheath 121 are slipped over the free end of drive cable 171. The free end of drive cable 171 is attached to a drive rod 175 securing coil 120 and the protective sheath 121 between drive member 150 and drive rod 175 as seen in Fig. 17B. Sheath 121 may function to promote stability, smooth movement, and prevent
buckling upon actuation of surgical instrument 100. Sheath 121 may be made from polyimide, or any other suitable material having the requisite strength requirements such as various reinforced plastics, a nickel titanium alloy such as NITINOL™, poly para- phenyleneterphtalamide materials such as KEVLAR™ commercially available from DuPont. Other suitable materials may be envisioned by those of skill in the art. Enlarged distal end 173 of drive cable 171 resides within an enlarged distal portion 159 of bore 158 in upper shoe 152 of body 150, such that the proximal face 157 of enlarged distal end 173 may apply a retraction force on upper shoe 152 when the drive cable 171 is pulled proximally, i.e., in the direction of arrow“B” in Fig. 17B. Drive rod 175 is operationally connected to an actuator (e.g., movable handle 102b), which allows distal translation and proximal retraction of actuation assembly 190.
[00109] In certain embodiments, the surgical instrument may be designed such that the drive member 150 is not retracted in the proximal direction after the staples have been fired. Those skilled in the art will recognize that in a manually actuated instrument, the actuator may be a movable handle, such as moveable handle 102b shown in Fig. 1; in a powered instrument the actuator may be a button (not shown) that causes a motor to act on the drive rod; and in a robotic system, the actuator may be a control device such as the control devices described below in connection with Fig. 28. Any suitable backend actuation mechanism for driving the components of the surgical stapling instrument may be used. For additional details relating to exemplary actuation mechanisms using push/pull drive cables see, e.g., commonly owned International Application WO 2018/049217, the disclosure of which is hereby incorporated by reference in its entirety.
[00110] During actuation of illustrative surgical instrument 100, drive rod 175 applies force to coil 120, thereby causing coil 120 to apply force to upper shoe 152 of drive member 150, translating it distally (i.e., in the direction of arrow“A” in Fig. 17B) initially
closing jaws 111,112 and then ejecting staples 124 from stapler cartridge 122 to staple tissue. After stapling is complete, drive rod 175 applies a force in the proximal direction to effect retraction of drive member. During retraction, enlarged distal end 173 of drive cable 171 is obstructed by wall 157 of enlarged portion 159 of bore 158, causing drive cable 171 to apply force to upper shoe 152 of drive member 150, thereby translating drive member 150 in the proximal direction. One of ordinary skill in the art will appreciate that drive member 150, drive cable 171, and drive rod 175 all move in unison and remain in the same relative position to each other.
[00111] In the preferred embodiment, drive cable 171 advances drive member 150 through fixed jaw 111 (instead of through the staple cartridge jaw as in conventional surgical stapling instruments). Eliminating the internal channel for the actuation mechanism from the staple cartridge provides more space in the cartridge for the staples and for the reinforcing wall discussed above. In alternative embodiments, coil 120 of actuation assembly 190 may be coupled with lower shoe 154 instead of upper shoe 152. In these embodiments, coil 120 applies force to lower shoe 153 to advance drive member 150 distally through a channel (not shown) in the lower jaw 112. In these embodiments, coil 120 will advance at least through a portion of lower jaw 112 and staple cartridge 122.
[00112] Figs. 18A-C depict fixed jaw 111 and movable jaw 112 of illustrative surgical instrument 100 sequentially moving from an open configuration to a closed configuration. As shown in Fig. 18A, in the open configuration, drive member 150 is positioned proximally of cam surface 114 formed on movable jaw 112. As drive member 150 translates in the distal direction“A” movable jaw 112 will rotate towards the closed position around pivot 117.
[00113] In Fig. 18B, drive member 150 has come into contact with cam surface 114 of movable jaw 112. As lower portion 154 of drive member 150 rides underneath cam
surface 114, drive member 150 pushes movable jaw 112, causing it to pivot towards the closed position.
[00114] Fig. 18C illustrates jaws 111, 112 in the closed position. Drive member 150 has translated distally past cam surface 114. In this position, tissue is clamped, and further advancement of the drive member will sever and staple tissue.
[00115] In an alternative embodiment shown in Fig. 19, switch 191 is replaced with a switch 292 having a detachable portion configured for detachment from the remainder of switch 191 as drive member engages the switch 292. In an exemplary embodiment, switch 292 is configured to be sheared into two separate pieces along a shear plane X’-X\ In such embodiments, the surgical system may detect the force applied by a shuttle in shearing switch 292 to determine the type of reload within a given stapler cartridge. Switch 292 may be any desired shape, and may be sheared at various angles or along any line substantially parallel to the path of the drive member as it translates through a firing stroke.
[00116] In embodiments, the axial position at which switch 292 is contacted by a drive member may be adjusted by including a cutout of a predetermined height in a similar manner as above in connection with previously described embodiments to create a detectable resistance at a unique axial position. The detectable resistance may similarly be used for reload detection in a similar manner as described above. In embodiments in which switch 292 is shearable, it is envisioned that the design of switch 292 may be adjusted to shear under a specific amount of force from the drive member that also provides for a suitable amount of detectable resistance depending on the sensitivity of the control unit of the surgical system being used. Thus, the act of shearing switch 292 alone provides for a suitable detectable resistance that may be used by a control system to determine the type of stapler cartridge present by determining the axial position at which the drive member experiences the resistance associated with shearing switch 292.
[00117] Fig. 20 depicts the proximal portion of an illustrative stapler cartridge having two switches 292 in an unraised position. In this configuration, actuation has not yet occurred and switch 292 has not been engaged by an inclined distal portion of a shuttle or drive member having a shuttle integrated thereon. Figs. 21 and 22 show switch 292 after it has been engaged by a shuttle upon actuation of the surgical instrument. In this position, switch 292 has been sheared, and a movable portion 293 of switch has been forced into a raised position by a shuttle, while a stationary portion 294 remains in a substantially the same position as when switch 292 was in the unraised position. As shown in Fig. 22, stationary portion 294 of switch 292 may include a protrusion 295 configured to fit within a cutout 227 formed within a sidewall of stapler cartridge 222, helping stationary portion 294 to remain substantially unmoved throughout actuation.
[00118] Figs. 23-25 sequentially depict actuation of an illustrative surgical instrument having an end effector with a stapler cartridge in accordance with Fig. 20 installed.
[00119] In Fig. 23, a fresh stapler cartridge 222 having switches 292 has been installed into end effector 210 of an illustrative surgical instrument. A locking member 270 is biased by a spring 278 towards a channel 219 through which drive member 250 is configured to pass. As in the embodiments previously described, switch 292 in the unraised position maintains locking member 270 out of engagement with channel 219, thereby allowing drive member 250 to translate distally upon actuation to cut tissue and drive staples and cut tissue.
[00120] In Fig. 24, an inclined distal portion 225 of a shuttle 223 is shown driving distally to engage switch 292. Shuttle 223 may be coupled to a drive member 250 as in the embodiments previously described. In Fig. 25, the forces applied to switch 292 by shuttle 223 have caused switch 292 to be sheared into two separate pieces. Movable portion 293
of switch 292 is forced into the raised position where it is no longer aligned with locking member 270. This allows for spring 278 to force locking member 270 to swing into channel 219. In this position, drive member 250 is obstructed by locking member 270 should a user attempt to again actuate the surgical instrument. Stationary portion 294 of switch 292 remains in a substantially similar position.
[00121] In embodiments, stapler cartridge 222 may include an additional switch 298 positioned on a proximal tail portion 224 of stapler cartridge 222 as best seen in Fig. 26. In embodiments, the engagement of shuttle 223 with switch 298 upon distal translation of drive member 250 may serve as the reload detection point. In some instances, this configuration is desirable as the reload detection point is at a more proximal position than if reload detection was accomplished using switch 292. In embodiments, switch 298 operates independently of locking member 270, and switch 292 independently activates or disables locking member 270.
[00122] FIG. 27 illustrates, as an example, a top view of an operating room employing a robotic surgical system. The robotic surgical system in this case is a robotic surgical system 300 including a Console (“C”) utilized by a Surgeon (“S”) while performing a minimally invasive diagnostic or surgical procedure, usually with assistance from one or more Assistants (“A”), on a Patient (“P”) who is lying down on an Operating table (“O”).
[00123] The Console includes a monitor 304 for displaying an image of a surgical site to the Surgeon, left and right manipulatable control devices 308 and 309, a foot pedal 305, and a processor 302. The control devices 308 and 309 may include any one or more of a variety of input devices such as joysticks, gloves, trigger-guns, hand-operated controllers, or the like. The processor 302 may be a dedicated computer that may be integrated into the Console or positioned next to it.
[00124] The Surgeon performs a minimally invasive surgical procedure by manipulating the control devices 308 and 309 (also referred to herein as “master manipulators”) so that the processor 302 causes their respectively associated robotic arm assemblies, 328 and 329, (also referred to herein as“slave manipulators”) to manipulate their respective removably coupled surgical instruments 338 and 339 (also referred to herein as“tools”) accordingly, while the Surgeon views the surgical site in 3-D on the Console monitor 304 as it is captured by a stereoscopic endoscope 340.
[00125] Each of the tools 338 and 339, as well as the endoscope 340, may be inserted through a cannula or other tool guide (not shown) into the Patient so as to extend down to the surgical site through a corresponding minimally invasive incision such as incision 366. Each of the robotic arms is conventionally formed of links, such as link 362, which are coupled together and manipulated through motor controlled or active joints, such as joint 363.
[00126] The number of surgical tools used at one time and consequently, the number of robotic arms being used in the system 300 will generally depend on the diagnostic or surgical procedure and the space constraints within the operating room, among other factors. If it is necessary to change one or more of the tools being used during a procedure, the Assistant may remove the tool no longer being used from its robotic arm, and replace it with another tool 331 from a Tray (“T”) in the operating room.
[00127] The monitor 304 may be positioned near the Surgeon's hands so that it will display a projected image that is oriented so that the Surgeon feels that he or she is actually looking directly down onto the operating site. To that end, images of the tools 338 and 339 may appear to be located substantially where the Surgeon's hands are located.
[00128] The processor 302 performs various functions in the system 300. One function that it performs is to translate and transfer the mechanical motion of control
devices 308 and 309 to their respective robotic arms 328 and 329 through control signals over bus 310 so that the Surgeon can effectively manipulate their respective tools 338 and 339. Another important function is to implement various control system processes as described herein.
[00129] Although described as a processor, it is to be appreciated that the processor
302 may be implemented in practice by any combination of hardware, software and firmware. Also, its functions as described herein may be performed by one unit, or divided up among different components, each of which may be implemented in turn by any combination of hardware, software and firmware.
[00130] For additional details on robotic surgical systems, see, e.g., commonly owned U.S. Pat. No. 6,493,608, U.S. Pat. No. 6,671, and International Application WO 2017/132611. Each of these disclosures is herein incorporated in their entireties by this reference.
[00131] FIG. 28 illustrates, as an example, a side view of a simplified (not necessarily in proportion or complete) illustrative robotic arm assembly 400 (which is representative of robotic arm assemblies 328 and 329) holding a surgical instrument 450 (which is representative of tools 338 and 339) for performing a surgical procedure. The surgical instrument 450 is removably held in tool holder 440. The arm assembly 400 is mechanically supported by a base 401, which may be part of a patient-side movable cart or affixed to the operating table or ceiling. It includes links 402 and 403 which are coupled together and to the base 401 through setup joints 404 and 405.
[00132] The setup joints 404 and 405 in this example are passive joints that allow manual positioning of the arm 400 when their brakes are released. For example, setup joint 404 allows link 402 to be manually rotated about axis 406, and setup joint 405 allows
link 403 to be manually rotated about axis 407.
[00133] Although only two links and two setup joints are shown in this example, more or less of each may be used as appropriate in this and other robotic arm assemblies in conjunction with the present invention. For example, although setup joints 404 and 405 are useful for horizontal positioning of the arm 400, additional setup joints may be included and useful for limited vertical and angular positioning of the arm 400. For major vertical positioning of the arm 400, however, the arm 400 may also be slidably moved along the vertical axis of the base 401 and locked in position.
[00134] The robotic arm assembly 400 also includes three active joints driven by motors. A yaw joint 410 allows arm section 430 to rotate around an axis 461, and a pitch joint 420 allows arm section 430 to rotate about an axis perpendicular to that of axis 46 land orthogonal to the plane of the drawing. The arm section 430 is configured so that sections 431 and 432 are always parallel to each other as the pitch joint 420 is rotated by its motor. As a consequence, the instrument 450 may be controllably moved by driving the yaw and pitch motors so as to pivot about the pivot point 462, which is generally located through manual positioning of the setup joints 404 and 405 so as to be at the point of incision into the patient. In addition, an insertion gear 445 may be coupled to a linear drive mechanism (not shown) to extend or retract the instrument 450 along its axis 463.
[00135] Although each of the yaw, pitch and insertion joints or gears, 410, 420 and 445, is controlled by an individual joint or gear controller, the three controllers are controlled by a common master/slave control system so that the robotic arm assembly 400 (also referred to herein as a“slave manipulator”) may be controlled through user (e.g., surgeon) manipulation of its associated master manipulator.
[00136] While several embodiments have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as
broad in scope as the art will allow and that the specification be read likewise. Therefore, the above description should not be construed as limiting, but merely as exemplifications of presently disclosed embodiments. For example, the invention is not limited to the mechanisms described herein for identifying and/or deactivating stapler cartridges. Other suitable devices or mechanisms are described in co-pending and co-owned International
Patent Application No. _ , filed December 16, 2019 and entitled
“SURGICAL INSTRUMENTS HAVING MECHANISMS FOR IDENTIFYING AND/OR DEACTIVATING STAPLER CARTRIDGES”, the entire disclosure of which is incorporated herein by reference in its entirety.
[00137] Thus, the scope of the embodiments should be determined by the appended claims and their legal equivalents, rather than by the examples given.
[00138] Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Various alternatives and modifications can be devised by those skilled in the art without departing from the disclosure. Accordingly, the present disclosure is intended to embrace all such alternatives, modifications and variances. As well, one skilled in the art will appreciate further features and advantages of the present disclosure based on the above-described embodiments. Accordingly, the present disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims.
Claims
1. A surgical stapling instrument comprising:
an end effector defining a longitudinal axis including a first jaw and a second jaw, the first jaw including an anvil and, the second jaw configured to receive a stapler cartridge having one or more staples;
a drive member configured to translate distally; and
a locking member movable from a disabled position permitting distal translation of the drive member to at least an axial position wherein the drive member engages at least one of the staples, to a locking position inhibiting distal translation of the drive member to said axial position.
2. The surgical stapling instrument of claim 1, wherein the locking member is maintained in the disabled position by a portion of the stapler cartridge.
3. The surgical stapling instrument of claim 2, wherein the portion of the stapler cartridge that maintains the locking member in the disabled position is a switch.
4. The surgical stapling instrument of claim 3, wherein the locking member moves in a first direction, and the switch is movable in a second direction different from the first direction.
5. The surgical stapling instrument of claim 4, wherein the locking member includes a distal portion configured to contact the switch, and a distal drive member- engaging portion.
6. The surgical stapling instrument of claim 5, wherein the drive member includes an inclined distal surface.
7. The surgical stapling instrument of claim 6, wherein, upon distal advancement of the drive member, the inclined distal surface of the drive member engages the switch while the switch is in the first position.
8. The surgical stapling instrument of claim 7, wherein the switch includes a cutout of a predetermined height configured to be engaged by the inclined distal surface of the drive member.
9. The surgical stapling instrument of claim 8, wherein the engagement of the inclined distal surface of the drive member with the cutout creates a detectable resistance readable by a control unit to identify a stapler cartridge.
10. The surgical stapling instrument of claim 1, wherein the switch includes a stationary portion and a movable portion, the stationary portion configured to be separated from the movable portion upon contact by the drive member.
11. The surgical instrument of claim 10, wherein the separation of the stationary portion from the movable portion by the drive member creates a detectable resistance, the detectable resistance readable by a control unit of a surgical system to detect a given reload size or type.
12. The surgical stapling instrument of claim 11, wherein the locking member pivots between the disabled position and the locking position.
13. The surgical stapling instrument of claim 12, wherein the locking member pivots about a pivot point that is laterally offset from the longitudinal axis of the end effector.
14. The surgical stapling instrument of claim 13, wherein the locking member pivots in a direction substantially perpendicular to the longitudinal axis defined by the end effector.
15. The surgical stapling instrument according to claim 14, wherein the drive member includes a first portion that translates through a channel in the first jaw.
16. The surgical stapling instrument according to claim 14 further comprising an actuation mechanism configured to translate the drive member distally through the end effector; wherein the actuation mechanism includes a coil that applies a distal force to the first portion of the drive member.
17. The surgical stapling instrument according to claim 16 further comprising an elongated shaft, the end effector mounted on a distal end portion of the elongated shaft.
18. The surgical stapling instrument according to claim 17 further comprising an articulation mechanism configured to articulate the end effector relative to the elongate shaft.
19. The surgical stapling instrument according to claim 16 further comprising an actuator operatively connected to the actuation mechanism.
20. The surgical stapling instrument according to claim 19 wherein the actuator includes a movable handle of a handle assembly provided at a proximal end portion of the surgical instrument.
21. The surgical stapling instrument according to claim 19 wherein the actuator includes a control device of a robotic surgical system.
22. The surgical stapling instrument according to claim 1 wherein the drive member includes a knife configured to cut tissue grasped between the first and second jaw.
23. A surgical stapling instrument comprising:
an end effector defining a longitudinal axis including a first jaw and a second jaw, the first jaw including an anvil;
a stapler cartridge having one or more staples and a switch, the second jaw configured to receive the stapler cartridge; and
a drive member configured to translate distally;
wherein the drive member is configured to contact the switch of the stapler cartridge at an axial position of the drive member relative to the end effector, and wherein the switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position.
24. The surgical stapling instrument according to claim 23, further including a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke; and
a switch movable in a second direction different from the first direction, from a first position and second position, wherein when the switch is in the first position the switch maintains the locking member in the disabled position, and wherein when the switch is in the second position the switch disengages from the locking member.
25. The surgical stapling instrument according to claim 23, wherein the drive member comprises one or more inclined distal ramps and the switch has a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector.
26. The surgical stapling instrument of claim 25, wherein the contact portion of the switch is disposed at a height relative to the drive member such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
27. The surgical stapling instrument of claim 26, wherein the axial position of the drive member identifies the stapler cartridge.
28. The surgical stapling instrument of claim 27, wherein the surgical instrument is operatively coupled to a control unit, the control unit configured to process
the detectable resistance to identify a type of stapler cartridge present in the surgical stapling instrument.
29. The surgical stapling instrument of claim 23, wherein the switch includes a stationary portion and a movable portion, the stationary portion configured to be separated from the movable portion upon contact by the drive member.
30. The surgical instrument of claim 29, wherein the separation of the stationary portion from the movable portion by the drive member creates the detectable resistance.
31. The surgical instrument of claim 23, further comprising a control unit coupled to the surgical stapling instrument, the control unit being configured to read the detectable resistance.
32. The surgical instrument of claim 23, wherein the staple cartridge is a first stapler cartridge, the instrument further comprising a second stapler cartridge having a second switch having a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector, wherein the contact portion of the second switch is disposed at a second height relative to the drive member that is different than the height of the contact portion of the switch on the first stapler cartridge.
33. The surgical instrument of claim 32, wherein the inclined distal ramp of the drive member contacts the contact portion of the second switch at a different axial position than the axial position of the first stapler cartridge.
34. A surgical stapling instrument comprising:
an end effector defining a longitudinal axis including a first jaw and a second jaw, the first jaw including an anvil and, the second jaw configured to receive a stapler cartridge having one or more staples;
a drive member configured to translate distally;
a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke; and
wherein the drive member is configured to contact a switch at an axial position of the drive member relative to the end effector, and wherein the switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position.
35. The surgical stapling instrument of claim 34, wherein the locking member is maintained in the disabled position by a portion of the stapler cartridge.
36. The surgical stapling instrument of claim 35, wherein the portion of the stapler cartridge that maintains the locking member in the disabled position comprises the switch.
37. The surgical stapling instrument of claim 36, wherein the locking member moves in a first direction, and the switch is movable in a second direction different from the first direction.
38. The surgical stapling instrument according to claim 37, wherein the drive member comprises one or more inclined distal ramps and the switch has a contact portion
configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector.
39. The surgical stapling instrument of claim 38, wherein the contact portion of the switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
40. The surgical stapling instrument of claim 39, wherein the surgical instrument is operatively coupled to a surgical system including a control unit, the control unit configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
41. The surgical stapling instrument of claim 39, wherein the switch includes a stationary portion and a movable portion, the stationary portion configured to be separated from the movable portion upon contact by the drive member.
42. The surgical stapling instrument of claim 41, further comprising a control unit, the control unit configured to process the detectable resistance to identify a type of reload present in the surgical stapling instrument.
43. The surgical instrument of claim 42, wherein the separation of the stationary portion from the movable portion by the drive member creates the detectable resistance.
44. The surgical instrument of claim 34, wherein the staple cartridge is a first stapler cartridge, the instrument further comprising a second stapler cartridge having a
second switch having a contact portion configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector, wherein the contact portion of the second switch is disposed at a second height relative to the drive member that is different than the height of the contact portion of the switch on the first stapler cartridge.
45. The surgical instrument of claim 44, wherein the inclined distal ramp of the drive member contacts the contact portion of the second switch at a different axial position than the axial position of the first stapler cartridge.
46. A surgical stapling instrument comprising:
an end effector defining a longitudinal axis including a first jaw and a second jaw, the first jaw including an anvil and, the second jaw configured to receive a stapler cartridge having one or more staples;
a drive member configured to translate distally; and
a locking member movable in a first direction from a disabled position permitting distal translation of the drive member through a staple firing stroke, to a locking position inhibiting distal translation of the drive member through the staple firing stroke;
wherein the drive member is configured to contact a first switch at an axial position of the drive member relative to the end effector, and a second switch, and wherein the first switch is configured to provide a detectable resistance upon engagement of the drive member at said axial position.
47. The surgical stapling instrument of claim 46, wherein the locking member is maintained in the disabled position by a portion of the stapler cartridge.
48. The surgical stapling instrument of claim 47, wherein the portion of the stapler cartridge that maintains the locking member in the disabled position comprises the second switch.
49. The surgical stapling instrument of claim 48, wherein the locking member moves in a first direction, and the first switch and second switch are both movable in a second direction different from the first direction.
50. The surgical stapling instrument according to claim 49, wherein the drive member comprises one or more inclined distal ramps and the first switch and second switch have contact portions configured to contact the one or more distal ramps upon distal translation of the drive member through the end effector.
51. The surgical stapling instrument of claim 50, wherein the contact portion of the first switch is disposed at a predetermined height such that the inclined distal ramp of the drive member is located at the axial position upon contact with the contact portion.
52. The surgical stapling instrument of claim 51, wherein the first switch is formed on a proximal tail portion of the stapler cartridge.
53. The surgical stapling instrument of claim 52, wherein the surgical instrument is operatively coupled to a control unit, the control unit configured to process the detectable resistance to identify a type of staple cartridge present in the surgical stapling instrument.
Priority Applications (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US17/414,805 US11723661B2 (en) | 2018-12-21 | 2019-12-16 | Surgical instruments with switches for deactivating and/or identifying stapler cartridges |
| US18/212,746 US12383268B2 (en) | 2018-12-21 | 2023-06-22 | Surgical instruments with switches for deactivating and/or identifying stapler cartridges |
| US19/265,011 US20250331857A1 (en) | 2018-12-21 | 2025-07-10 | Surgical instruments with switches for deactivating and/or identifying stapler cartridges |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201862783429P | 2018-12-21 | 2018-12-21 | |
| US62/783,429 | 2018-12-21 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| US17/414,805 A-371-Of-International US11723661B2 (en) | 2018-12-21 | 2019-12-16 | Surgical instruments with switches for deactivating and/or identifying stapler cartridges |
| US18/212,746 Continuation US12383268B2 (en) | 2018-12-21 | 2023-06-22 | Surgical instruments with switches for deactivating and/or identifying stapler cartridges |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2020131685A1 true WO2020131685A1 (en) | 2020-06-25 |
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Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/US2019/066513 Ceased WO2020131685A1 (en) | 2018-12-21 | 2019-12-16 | Surgical instruments with switches for deactivating and/or identifying stapler cartridges |
| PCT/US2019/066530 Ceased WO2020131692A1 (en) | 2018-12-21 | 2019-12-16 | Surgical instruments having mechanisms for identifying and/or deactivating stapler cartridges |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/US2019/066530 Ceased WO2020131692A1 (en) | 2018-12-21 | 2019-12-16 | Surgical instruments having mechanisms for identifying and/or deactivating stapler cartridges |
Country Status (4)
| Country | Link |
|---|---|
| US (6) | US11723661B2 (en) |
| EP (1) | EP3897402A4 (en) |
| CN (1) | CN113271870A (en) |
| WO (2) | WO2020131685A1 (en) |
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|---|---|---|---|---|
| CN111904515A (en) * | 2020-09-15 | 2020-11-10 | 赛诺微医疗科技(浙江)有限公司 | Surgical instrument and position identification and control device and method of actuator of surgical instrument |
| WO2022159369A1 (en) | 2021-01-19 | 2022-07-28 | Intuitive Surgical Operations, Inc. | Stapler reload assemblies and related devices, systems, and methods |
| US12064110B2 (en) | 2019-02-27 | 2024-08-20 | Intuitive Surgical Operations, Inc. | Stapler cartridge assemblies and related devices, systems, and methods |
| EP4378397A4 (en) * | 2021-07-29 | 2024-11-13 | Reach Surgical, Inc. | SURGICAL INSTRUMENT |
| US12349905B2 (en) | 2019-05-31 | 2025-07-08 | Intuitive Surgical Operations, Inc. | Staple cartridge for a surgical instrument |
| US12359696B2 (en) | 2015-11-13 | 2025-07-15 | Intuitive Surgical Operations, Inc. | Stapler with composite cardan and screw drive |
| US12402883B2 (en) | 2021-01-08 | 2025-09-02 | Intuitive Surgical Operations, Inc. | Surgical instrument with linear and purse string suture staples |
| US12508024B2 (en) | 2021-12-29 | 2025-12-30 | Intuitive Surgical Operations, Inc. | Surgical stapling instruments |
Families Citing this family (20)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10863988B2 (en) | 2017-11-29 | 2020-12-15 | Intuitive Surgical Operations, Inc. | Surgical instrument with lockout mechanism |
| WO2019157500A2 (en) | 2018-02-12 | 2019-08-15 | Intuitive Surgical, Inc. | Surgical instrument with lockout mechanism |
| WO2019165403A1 (en) | 2018-02-26 | 2019-08-29 | Intuitive Surgical, Inc. | Surgical instrument with lockout mechanism |
| US12029473B2 (en) | 2018-05-31 | 2024-07-09 | Intuitive Surgical Operations, Inc. | Surgical instruments having a jaw locking mechanism |
| WO2020081960A1 (en) | 2018-10-19 | 2020-04-23 | Intuitive Surgical Operations, Inc. | Endoscopic purse string suture surgical device |
| US11944301B2 (en) | 2018-12-21 | 2024-04-02 | Intuitive Surgical Operations, Inc. | Surgical instruments having a reinforced staple cartridge |
| CN113271870A (en) | 2018-12-21 | 2021-08-17 | 直观外科手术操作公司 | Surgical instrument with mechanism for identifying and/or deactivating a stapler cartridge |
| US11857188B2 (en) | 2018-12-21 | 2024-01-02 | Intuitive Surgical Operations, Inc. | Articulation assemblies for surgical instruments |
| EP3897405A4 (en) | 2018-12-21 | 2022-09-14 | Intuitive Surgical Operations, Inc. | ACTUATING MECHANISMS FOR SURGICAL INSTRUMENTS |
| WO2020214258A1 (en) | 2019-04-15 | 2020-10-22 | Intuitive Surgical Operations, Inc. | Staple cartridge for a surgical instrument |
| WO2020214397A1 (en) | 2019-04-17 | 2020-10-22 | Intuitive Surgical Operations, Inc. | Surgical stapling instrument |
| US11786325B2 (en) | 2019-07-02 | 2023-10-17 | Intuitive Surgical Operations, Inc. | Remotely controlling a system using video |
| EP4044936A4 (en) | 2019-10-18 | 2024-02-28 | Intuitive Surgical Operations, Inc. | Surgical instrument with adjustable jaws |
| US12324589B2 (en) | 2020-01-07 | 2025-06-10 | Intuitive Surgical Operations, Inc. | Surgical instruments for applying multiple clips |
| US11642129B2 (en) | 2020-01-15 | 2023-05-09 | Intuitive Surgical Operations, Inc. | Staple cartridge and drive member for surgical instrument |
| WO2022150215A1 (en) * | 2021-01-08 | 2022-07-14 | Intuitive Surgical Operations, Inc. | Surgical stapling instruments |
| WO2022233019A1 (en) * | 2021-05-07 | 2022-11-10 | Covidien Lp | Surgical stapling device with stopper for pusher/knife retention |
| CN113693646B (en) * | 2021-10-28 | 2021-12-28 | 极限人工智能(北京)有限公司 | Control handle, instrument and minimally invasive surgery robot |
| WO2024201198A1 (en) * | 2023-03-31 | 2024-10-03 | Covidien Lp | Surgical stapling apparatus with lockout assemblies |
| US12383265B1 (en) * | 2024-06-21 | 2025-08-12 | Bolanle Asiyanbola | Endostapler, particularly for use in operations on the pancreas |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2017527396A (en) * | 2014-09-15 | 2017-09-21 | アプライド メディカル リソーシーズ コーポレイション | Self-adjusting staple height surgical stapler |
| US20180168641A1 (en) * | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instruments with lockout arrangements for preventing firing system actuation unless an unspent staple cartridge is present |
| US20180168581A1 (en) * | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Articulation lock arrangements for locking an end effector in an articulated position in response to actuation of a jaw closure system |
| US20180168649A1 (en) * | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Articulatable surgical stapling instruments |
| JP6411461B2 (en) * | 2013-04-16 | 2018-10-24 | 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 shaft having a switch for controlling operation of the surgical instrument |
Family Cites Families (471)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6671A (en) | 1849-08-28 | Improvement in sugar-pans | ||
| US75364A (en) | 1868-03-10 | Improvement in angular shaft-coupling | ||
| DE694747C (en) | 1936-08-11 | 1940-08-07 | Framo Werke G M B H | Drive joint for the steering wheels of motor vehicles |
| SU405234A1 (en) | 1970-09-02 | 1975-09-05 | Всесоюзный Научно-Исследовательский Институт Хирургической Аппаратуры И Инструментов | Matrix for suturing surgical apparatus |
| SU886900A1 (en) | 1979-03-26 | 1981-12-07 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Surgical apparatus for applying line sutures |
| US4429695A (en) | 1980-02-05 | 1984-02-07 | United States Surgical Corporation | Surgical instruments |
| US4319576A (en) | 1980-02-26 | 1982-03-16 | Senco Products, Inc. | Intralumenal anastomosis surgical stapling instrument |
| CA1170536A (en) | 1980-08-25 | 1984-07-10 | United States Surgical Corporation | Surgical staples |
| US4403892A (en) | 1980-11-03 | 1983-09-13 | Kane Patrick J | Apparatus for driving fasteners and other insertable objects into remote structures |
| JPS5794132A (en) | 1980-12-03 | 1982-06-11 | Hitachi Ltd | Angle transmitting device |
| US4352276A (en) | 1980-12-15 | 1982-10-05 | Borg-Warner Corporation | Constant velocity universal joint with improved centering device and boot seal |
| US4509932A (en) | 1981-04-15 | 1985-04-09 | The Zeller Corporation | Double cardan universal joint with improved centering means |
| US4809695A (en) | 1981-10-21 | 1989-03-07 | Owen M. Gwathmey | Suturing assembly and method |
| US4509518A (en) | 1982-02-17 | 1985-04-09 | United States Surgical Corporation | Apparatus for applying surgical clips |
| US4610383A (en) | 1983-10-14 | 1986-09-09 | Senmed, Inc. | Disposable linear surgical stapler |
| US4767044A (en) | 1984-10-19 | 1988-08-30 | United States Surgical Corporation | Surgical fastener applying apparatus |
| US4605001A (en) | 1984-10-19 | 1986-08-12 | Senmed, Inc. | Surgical stapling instrument with dual staple height mechanism |
| US4633874A (en) | 1984-10-19 | 1987-01-06 | Senmed, Inc. | Surgical stapling instrument with jaw latching mechanism and disposable staple cartridge |
| US4608981A (en) | 1984-10-19 | 1986-09-02 | Senmed, Inc. | Surgical stapling instrument with staple height adjusting mechanism |
| US4750488A (en) | 1986-05-19 | 1988-06-14 | Sonomed Technology, Inc. | Vibration apparatus preferably for endoscopic ultrasonic aspirator |
| SU1333319A2 (en) | 1985-12-10 | 1987-08-30 | Петрозаводский государственный университет им.О.В.Куусинена | Suture appliance for hollow organs |
| DE3764460D1 (en) | 1986-05-21 | 1990-09-27 | Novo Industri As | PRODUCTION OF AN ENZYME-CONTAINING GRANULATE AND ITS USE IN CLEANING AGENTS. |
| SU1459659A1 (en) | 1986-09-29 | 1989-02-23 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Surgical suturing apparatus for applying line sutures |
| SU1442191A1 (en) | 1987-01-19 | 1988-12-07 | Петрозаводский государственный университет им.О.В.Куусинена | Surgical suturing apparatus |
| ZA88681B (en) | 1987-02-02 | 1988-08-01 | Cassella Aktiengesellschaft | Mixtures of monoazo dyestuffs |
| US4930503A (en) | 1987-06-11 | 1990-06-05 | Pruitt J Crayton | Stapling process and device for use on the mesenteries of the abdomen |
| US4848637A (en) | 1987-06-11 | 1989-07-18 | Pruitt J Crayton | Staple device for use on the mesenteries of the abdomen |
| US5027834A (en) | 1987-06-11 | 1991-07-02 | United States Surgical Corporation | Stapling process for use on the mesenteries of the abdomen |
| DE3724525C1 (en) | 1987-07-24 | 1988-05-19 | Daimler Benz Ag | Adjusting device |
| US4892244A (en) | 1988-11-07 | 1990-01-09 | Ethicon, Inc. | Surgical stapler cartridge lockout device |
| AU4633589A (en) | 1988-11-18 | 1990-06-12 | Immuno Sweden Ab | Instrument for anastomosis |
| US4978049A (en) | 1989-05-26 | 1990-12-18 | United States Surgical Corporation | Three staple drive member |
| US5040715B1 (en) | 1989-05-26 | 1994-04-05 | United States Surgical Corp | Apparatus and method for placing staples in laparoscopic or endoscopic procedures |
| US5133735A (en) | 1990-05-10 | 1992-07-28 | Symbiosis Corporation | Thumb-activated actuating member for imparting reciprocal motion to push rod of a disposable laparoscopic surgical instrument |
| US5133736A (en) | 1990-05-10 | 1992-07-28 | Symbiosis Corporation | Investment cast end effectors for disposable laparoscopic surgical instrument |
| US5342395A (en) | 1990-07-06 | 1994-08-30 | American Cyanamid Co. | Absorbable surgical repair devices |
| GB9016481D0 (en) | 1990-07-27 | 1990-09-12 | Gkn Cardantec | Double hookes universal joints |
| US5129570A (en) | 1990-11-30 | 1992-07-14 | Ethicon, Inc. | Surgical stapler |
| US5571285A (en) | 1991-02-19 | 1996-11-05 | Ethicon, Inc. | Surgical staple for insertion into tissue |
| US5147357A (en) | 1991-03-18 | 1992-09-15 | Rose Anthony T | Medical instrument |
| US5279309A (en) | 1991-06-13 | 1994-01-18 | International Business Machines Corporation | Signaling device and method for monitoring positions in a surgical operation |
| US5688269A (en) | 1991-07-10 | 1997-11-18 | Electroscope, Inc. | Electrosurgical apparatus for laparoscopic and like procedures |
| US5184601A (en) | 1991-08-05 | 1993-02-09 | Putman John M | Endoscope stabilizer |
| US5312023A (en) | 1991-10-18 | 1994-05-17 | United States Surgical Corporation | Self contained gas powered surgical apparatus |
| US5307976A (en) | 1991-10-18 | 1994-05-03 | Ethicon, Inc. | Linear stapling mechanism with cutting means |
| US6250532B1 (en) | 1991-10-18 | 2001-06-26 | United States Surgical Corporation | Surgical stapling apparatus |
| US5289963A (en) | 1991-10-18 | 1994-03-01 | United States Surgical Corporation | Apparatus and method for applying surgical staples to attach an object to body tissue |
| US5443198A (en) | 1991-10-18 | 1995-08-22 | United States Surgical Corporation | Surgical fastener applying apparatus |
| CA2075227C (en) | 1991-10-18 | 2004-02-10 | Robert J. Geiste | Surgical fastening apparatus with shipping interlock |
| ATE238140T1 (en) | 1992-01-21 | 2003-05-15 | Stanford Res Inst Int | SURGICAL SYSTEM |
| US5180092A (en) | 1992-02-05 | 1993-01-19 | Lawrence Crainich | Linear surgical stapling instrument |
| US5484095A (en) | 1992-03-31 | 1996-01-16 | United States Surgical Corporation | Apparatus for endoscopically applying staples individually to body tissue |
| US5484451A (en) | 1992-05-08 | 1996-01-16 | Ethicon, Inc. | Endoscopic surgical instrument and staples for applying purse string sutures |
| US5762458A (en) | 1996-02-20 | 1998-06-09 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive cardiac procedures |
| JPH0675830B2 (en) | 1992-08-24 | 1994-09-28 | 丸善株式会社 | Stepper |
| US5601224A (en) | 1992-10-09 | 1997-02-11 | Ethicon, Inc. | Surgical instrument |
| US5342396A (en) | 1993-03-02 | 1994-08-30 | Cook Melvin S | Staples |
| US5540375A (en) | 1993-04-20 | 1996-07-30 | United States Surgical Corporation | Endoscopic stapler |
| US6716232B1 (en) | 1993-04-30 | 2004-04-06 | United States Surgical Corporation | Surgical instrument having an articulated jaw structure and a detachable knife |
| US5415334A (en) | 1993-05-05 | 1995-05-16 | Ethicon Endo-Surgery | Surgical stapler and staple cartridge |
| CA2121194A1 (en) | 1993-05-06 | 1994-11-07 | Corbett Stone | Bipolar electrosurgical instruments |
| US6406472B1 (en) | 1993-05-14 | 2002-06-18 | Sri International, Inc. | Remote center positioner |
| DE69417229T2 (en) | 1993-05-14 | 1999-07-08 | Sri International, Menlo Park, Calif. | SURGERY DEVICE |
| US5709680A (en) | 1993-07-22 | 1998-01-20 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device |
| CA2132503C (en) | 1993-10-07 | 2005-05-10 | Donald F. Wilson | Curved knife for linear staplers |
| US5439155A (en) | 1993-10-07 | 1995-08-08 | United States Surgical Corporation | Cartridge for surgical fastener applying apparatus |
| US5452837A (en) | 1994-01-21 | 1995-09-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with tissue gripping ridge |
| US5487500A (en) | 1994-02-03 | 1996-01-30 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
| US5465895A (en) | 1994-02-03 | 1995-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
| US5452836A (en) | 1994-02-07 | 1995-09-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with improved jaw closure and staple firing actuator mechanism |
| CA2144818C (en) | 1994-04-07 | 2006-07-11 | Henry Bolanos | Graduated anvil for surgical stapling instruments |
| US5529235A (en) | 1994-04-28 | 1996-06-25 | Ethicon Endo-Surgery, Inc. | Identification device for surgical instrument |
| US5628446A (en) | 1994-05-05 | 1997-05-13 | United States Surgical Corporation | Self-contained powered surgical apparatus |
| US5833695A (en) | 1994-07-13 | 1998-11-10 | Yoon; Inbae | Surgical stapling system and method of applying staples from multiple staple cartridges |
| US5533521A (en) | 1994-07-15 | 1996-07-09 | United States Surgical Corporation | Interchangeable tissue measuring device |
| EP0699418A1 (en) | 1994-08-05 | 1996-03-06 | United States Surgical Corporation | Self-contained powered surgical apparatus |
| US5779130A (en) | 1994-08-05 | 1998-07-14 | United States Surgical Corporation | Self-contained powered surgical apparatus |
| US5480089A (en) | 1994-08-19 | 1996-01-02 | United States Surgical Corporation | Surgical stapler apparatus with improved staple pockets |
| US5571116A (en) | 1994-10-02 | 1996-11-05 | United States Surgical Corporation | Non-invasive treatment of gastroesophageal reflux disease |
| US5752973A (en) | 1994-10-18 | 1998-05-19 | Archimedes Surgical, Inc. | Endoscopic surgical gripping instrument with universal joint jaw coupler |
| US5632432A (en) | 1994-12-19 | 1997-05-27 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
| US5652849A (en) | 1995-03-16 | 1997-07-29 | Regents Of The University Of Michigan | Apparatus and method for remote control using a visual information stream |
| US5624452A (en) | 1995-04-07 | 1997-04-29 | Ethicon Endo-Surgery, Inc. | Hemostatic surgical cutting or stapling instrument |
| US5630540A (en) | 1995-05-24 | 1997-05-20 | United States Surgical Corporation | Surgical staple and staple drive member |
| DE19521257C2 (en) | 1995-06-10 | 1999-01-28 | Winter & Ibe Olympus | Surgical forceps |
| US5752644A (en) | 1995-07-11 | 1998-05-19 | United States Surgical Corporation | Disposable loading unit for surgical stapler |
| US5762256A (en) | 1995-08-28 | 1998-06-09 | United States Surgical Corporation | Surgical stapler |
| US6032849A (en) | 1995-08-28 | 2000-03-07 | United States Surgical | Surgical stapler |
| US5782396A (en) | 1995-08-28 | 1998-07-21 | United States Surgical Corporation | Surgical stapler |
| US5697542A (en) | 1995-10-19 | 1997-12-16 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical stapler with compact profile |
| US5700270A (en) | 1995-10-20 | 1997-12-23 | United States Surgical Corporation | Surgical clip applier |
| US5941442A (en) | 1995-10-27 | 1999-08-24 | United States Surgical | Surgical stapler |
| US5651491A (en) | 1995-10-27 | 1997-07-29 | United States Surgical Corporation | Surgical stapler having interchangeable loading units |
| US5667626A (en) | 1996-01-29 | 1997-09-16 | Minnesota Mining And Manufacturing Company | Masking device hub providing two position tape support |
| US5762255A (en) | 1996-02-20 | 1998-06-09 | Richard-Allan Medical Industries, Inc. | Surgical instrument with improvement safety lockout mechanisms |
| US5855583A (en) | 1996-02-20 | 1999-01-05 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive cardiac procedures |
| US5820009A (en) | 1996-02-20 | 1998-10-13 | Richard-Allan Medical Industries, Inc. | Articulated surgical instrument with improved jaw closure mechanism |
| US5673842A (en) * | 1996-03-05 | 1997-10-07 | Ethicon Endo-Surgery | Surgical stapler with locking mechanism |
| IL117607A0 (en) | 1996-03-21 | 1996-07-23 | Dev Of Advanced Medical Produc | Surgical stapler and method of surgical fastening |
| US5792135A (en) | 1996-05-20 | 1998-08-11 | Intuitive Surgical, Inc. | Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity |
| US8529582B2 (en) | 1996-12-12 | 2013-09-10 | Intuitive Surgical Operations, Inc. | Instrument interface of a robotic surgical system |
| US7666191B2 (en) | 1996-12-12 | 2010-02-23 | Intuitive Surgical, Inc. | Robotic surgical system with sterile surgical adaptor |
| US6331181B1 (en) | 1998-12-08 | 2001-12-18 | Intuitive Surgical, Inc. | Surgical robotic tools, data architecture, and use |
| US6126666A (en) | 1997-04-14 | 2000-10-03 | Forschungszcutrum Karlsruhe Gmbh | Device for inserting a surgical suture needle into an endoscopic suture apparatus |
| US5919198A (en) | 1997-04-17 | 1999-07-06 | Ethicon Endo-Surgery, Inc. | Disposable cartridge with drivers |
| US6312426B1 (en) | 1997-05-30 | 2001-11-06 | Sherwood Services Ag | Method and system for performing plate type radiofrequency ablation |
| US5959892A (en) | 1997-08-26 | 1999-09-28 | Macronix International Co., Ltd. | Apparatus and method for programming virtual ground EPROM array cell without disturbing adjacent cells |
| US5865361A (en) | 1997-09-23 | 1999-02-02 | United States Surgical Corporation | Surgical stapling apparatus |
| US6050996A (en) | 1997-11-12 | 2000-04-18 | Sherwood Services Ag | Bipolar electrosurgical instrument with replaceable electrodes |
| WO1999040861A1 (en) | 1998-02-17 | 1999-08-19 | Baker James A | Radiofrequency medical instrument for vessel welding |
| DE69940850D1 (en) | 1998-08-04 | 2009-06-18 | Intuitive Surgical Inc | Articular device for positioning a manipulator for robotic surgery |
| US6585735B1 (en) | 1998-10-23 | 2003-07-01 | Sherwood Services Ag | Endoscopic bipolar electrosurgical forceps |
| US7118570B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealing forceps with disposable electrodes |
| US6493608B1 (en) | 1999-04-07 | 2002-12-10 | Intuitive Surgical, Inc. | Aspects of a control system of a minimally invasive surgical apparatus |
| US6330956B1 (en) | 1998-12-09 | 2001-12-18 | J.W. Pet Company | Molded plastic pet bowl |
| US20030171747A1 (en) | 1999-01-25 | 2003-09-11 | Olympus Optical Co., Ltd. | Medical treatment instrument |
| US6174309B1 (en) | 1999-02-11 | 2001-01-16 | Medical Scientific, Inc. | Seal & cut electrosurgical instrument |
| US8025199B2 (en) | 2004-02-23 | 2011-09-27 | Tyco Healthcare Group Lp | Surgical cutting and stapling device |
| US6264087B1 (en) | 1999-07-12 | 2001-07-24 | Powermed, Inc. | Expanding parallel jaw device for use with an electromechanical driver device |
| US6488196B1 (en) | 1999-06-30 | 2002-12-03 | Axya Medical, Inc. | Surgical stapler and method of applying plastic staples to body tissue |
| US7594912B2 (en) | 2004-09-30 | 2009-09-29 | Intuitive Surgical, Inc. | Offset remote center manipulator for robotic surgery |
| CA2322061A1 (en) | 1999-10-05 | 2001-04-05 | Anil K. Nalagatla | Stapling instrument having two staple forming surfaces |
| US6702805B1 (en) | 1999-11-12 | 2004-03-09 | Microdexterity Systems, Inc. | Manipulator |
| JP2001170069A (en) | 1999-12-17 | 2001-06-26 | Olympus Optical Co Ltd | Medical treatment instrument |
| US7334717B2 (en) | 2001-10-05 | 2008-02-26 | Tyco Healthcare Group Lp | Surgical fastener applying apparatus |
| JP4549018B2 (en) | 2000-10-13 | 2010-09-22 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Surgical fastener applicator |
| US20040267310A1 (en) | 2000-10-20 | 2004-12-30 | Racenet David C | Directionally biased staple and anvil assembly for forming the staple |
| US6503259B2 (en) | 2000-12-27 | 2003-01-07 | Ethicon, Inc. | Expandable anastomotic device |
| 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 |
| 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 |
| US6656193B2 (en) | 2001-05-07 | 2003-12-02 | Ethicon Endo-Surgery, Inc. | Device for attachment of buttress material to a surgical fastening device |
| US20060199999A1 (en) | 2001-06-29 | 2006-09-07 | Intuitive Surgical Inc. | Cardiac tissue ablation instrument with flexible wrist |
| US6817974B2 (en) | 2001-06-29 | 2004-11-16 | Intuitive Surgical, Inc. | Surgical tool having positively positionable tendon-actuated multi-disk wrist joint |
| US6895219B2 (en) | 2001-08-27 | 2005-05-17 | Symbol Technologies Inc. | Dual use of FFT circuity in imagers and transceivers |
| US10285694B2 (en) | 2001-10-20 | 2019-05-14 | Covidien Lp | Surgical stapler with timer and feedback display |
| US6770072B1 (en) | 2001-10-22 | 2004-08-03 | Surgrx, Inc. | Electrosurgical jaw structure for controlled energy delivery |
| US6926716B2 (en) | 2001-11-09 | 2005-08-09 | Surgrx Inc. | Electrosurgical instrument |
| DE10158246C1 (en) | 2001-11-28 | 2003-08-21 | Ethicon Endo Surgery Europe | Surgical stapling instrument |
| US8233501B2 (en) | 2002-02-13 | 2012-07-31 | Interdigital Technology Corporation | Transport block set segmentation |
| WO2003086206A1 (en) | 2002-04-11 | 2003-10-23 | Tyco Healthcare Group, Lp | Surgical stapling apparatus including an anvil and cartridge each having cooperating mating surfaces |
| EP1503671B1 (en) | 2002-05-10 | 2006-10-11 | Tyco Healthcare Group Lp | Wound closure material applicator and stapler |
| EP1503675B1 (en) | 2002-05-10 | 2010-12-15 | Tyco Healthcare Group LP | Surgical stapling apparatus having a wound closure material applicator assembly |
| WO2003094747A1 (en) | 2002-05-13 | 2003-11-20 | Tyco Healthcare Group, Lp | Surgical stapler and disposable loading unit having different size staples |
| US7033356B2 (en) | 2002-07-02 | 2006-04-25 | Gyrus Medical, Inc. | Bipolar electrosurgical instrument for cutting desiccating and sealing tissue |
| US20040006340A1 (en) | 2002-07-02 | 2004-01-08 | Gyrus Medical, Inc. | Bipolar electrosurgical instrument for cutting, desiccating and sealing tissue |
| WO2004020859A1 (en) | 2002-08-28 | 2004-03-11 | Kwok-Wah Pun | Constant velocity universal joint with less axles and can bend a greater angle |
| US7931649B2 (en) | 2002-10-04 | 2011-04-26 | Tyco Healthcare Group Lp | Vessel sealing instrument with electrical cutting mechanism |
| AU2003279854B2 (en) | 2002-10-04 | 2008-12-18 | Covidien Lp | Tool assembly for a surgical stapling device |
| US7276068B2 (en) | 2002-10-04 | 2007-10-02 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
| US7799026B2 (en) | 2002-11-14 | 2010-09-21 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
| JP4006385B2 (en) | 2002-11-20 | 2007-11-14 | 株式会社日立ハイテクノロジーズ | Sugar chain synthesizer |
| US8128624B2 (en) | 2003-05-01 | 2012-03-06 | Covidien Ag | Electrosurgical instrument that directs energy delivery and protects adjacent tissue |
| EP1628586B1 (en) | 2003-05-15 | 2011-07-06 | Covidien AG | Tissue sealer with non-conductive variable stop members |
| US7044352B2 (en) | 2003-05-20 | 2006-05-16 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a single lockout mechanism for prevention of firing |
| US7140528B2 (en) | 2003-05-20 | 2006-11-28 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated single lockout mechanism for prevention of firing |
| US7380695B2 (en) | 2003-05-20 | 2008-06-03 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a single lockout mechanism for prevention of firing |
| US7380696B2 (en) | 2003-05-20 | 2008-06-03 | Ethicon Endo-Surgery, Inc. | Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
| US6988649B2 (en) | 2003-05-20 | 2006-01-24 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a spent cartridge lockout |
| US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
| US6978921B2 (en) | 2003-05-20 | 2005-12-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an E-beam firing mechanism |
| US20070010838A1 (en) | 2003-05-20 | 2007-01-11 | Shelton Frederick E Iv | Surgical stapling instrument having a firing lockout for an unclosed anvil |
| US7143923B2 (en) | 2003-05-20 | 2006-12-05 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a firing lockout for an unclosed anvil |
| US8100824B2 (en) | 2003-05-23 | 2012-01-24 | Intuitive Surgical Operations, Inc. | Tool with articulation lock |
| US7494039B2 (en) | 2003-06-17 | 2009-02-24 | Tyco Healthcare Group Lp | Surgical stapling device |
| JP4664909B2 (en) | 2003-06-17 | 2011-04-06 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Surgical stapling device |
| US6964363B2 (en) | 2003-07-09 | 2005-11-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having articulation joint support plates for supporting a firing bar |
| US6786382B1 (en) | 2003-07-09 | 2004-09-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an articulation joint for a firing bar track |
| US7111769B2 (en) | 2003-07-09 | 2006-09-26 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis |
| US6981628B2 (en) | 2003-07-09 | 2006-01-03 | Ethicon Endo-Surgery, Inc. | Surgical instrument with a lateral-moving articulation control |
| US7055731B2 (en) | 2003-07-09 | 2006-06-06 | Ethicon Endo-Surgery Inc. | Surgical stapling instrument incorporating a tapered firing bar for increased flexibility around the articulation joint |
| US7083075B2 (en) | 2003-09-29 | 2006-08-01 | Ethicon Endo-Surgery, Inc. | Multi-stroke mechanism with automatic end of stroke retraction |
| US7303108B2 (en) | 2003-09-29 | 2007-12-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multi-stroke firing mechanism with a flexible rack |
| US7434715B2 (en) | 2003-09-29 | 2008-10-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having multistroke firing with opening lockout |
| US6959852B2 (en) | 2003-09-29 | 2005-11-01 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with multistroke firing incorporating an anti-backup mechanism |
| US6905057B2 (en) | 2003-09-29 | 2005-06-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a firing mechanism having a linked rack transmission |
| US7364061B2 (en) | 2003-09-29 | 2008-04-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multistroke firing position indicator and retraction mechanism |
| US7000819B2 (en) | 2003-09-29 | 2006-02-21 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having multistroke firing incorporating a traction-biased ratcheting mechanism |
| JP4642770B2 (en) | 2003-10-17 | 2011-03-02 | タイコ ヘルスケア グループ リミテッド パートナーシップ | Surgical stapling device with independent tip rotation |
| US7296722B2 (en) | 2003-10-17 | 2007-11-20 | Tyco Healthcare Group Lp | Surgical fastener applying apparatus with controlled beam deflection |
| EP2889011B1 (en) | 2003-11-12 | 2017-01-04 | Applied Medical Resources Corporation | Overmolded grasper jaw |
| US9848938B2 (en) | 2003-11-13 | 2017-12-26 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
| ITPI20030107A1 (en) | 2003-11-14 | 2005-05-15 | Massimo Bergamasco | DEVICE FOR PERFORMING OPERATIONS |
| US7367976B2 (en) | 2003-11-17 | 2008-05-06 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
| US7204835B2 (en) | 2004-02-02 | 2007-04-17 | Gyrus Medical, Inc. | Surgical instrument |
| 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 |
| US7678117B2 (en) | 2004-06-07 | 2010-03-16 | Novare Surgical Systems, Inc. | Articulating mechanism with flex-hinged links |
| US7059508B2 (en) | 2004-06-30 | 2006-06-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an uneven multistroke firing mechanism having a rotary transmission |
| US7367485B2 (en) | 2004-06-30 | 2008-05-06 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary transmission |
| US7487899B2 (en) | 2004-07-28 | 2009-02-10 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating EAP complete firing system lockout mechanism |
| US8905977B2 (en) | 2004-07-28 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser |
| US7147138B2 (en) | 2004-07-28 | 2006-12-12 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having an electroactive polymer actuated buttress deployment mechanism |
| US7143925B2 (en) | 2004-07-28 | 2006-12-05 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating EAP blocking lockout mechanism |
| US7506790B2 (en) | 2004-07-28 | 2009-03-24 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation mechanism |
| US7857183B2 (en) | 2004-07-28 | 2010-12-28 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation mechanism |
| US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
| US8057508B2 (en) | 2004-07-28 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated articulation locking mechanism |
| US20060025812A1 (en) | 2004-07-28 | 2006-02-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating an electrically actuated pivoting articulation mechanism |
| US7128254B2 (en) | 2004-09-07 | 2006-10-31 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary slip-clutch transmission |
| 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 |
| US7121446B2 (en) | 2004-12-13 | 2006-10-17 | Niti Medical Technologies Ltd. | Palm-size surgical stapler for single hand operation |
| AU2006206651A1 (en) | 2005-01-19 | 2006-07-27 | Applied Medical Resources Corporation | Disposable laparoscopic instrument |
| US7559450B2 (en) | 2005-02-18 | 2009-07-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument incorporating a fluid transfer controlled articulation mechanism |
| US7654431B2 (en) | 2005-02-18 | 2010-02-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument with guided laterally moving articulation member |
| WO2006089533A2 (en) | 2005-02-22 | 2006-08-31 | Dieter Faude | Universal joint |
| US8197472B2 (en) | 2005-03-25 | 2012-06-12 | Maquet Cardiovascular, Llc | Tissue welding and cutting apparatus and method |
| US7491202B2 (en) | 2005-03-31 | 2009-02-17 | Covidien Ag | Electrosurgical forceps with slow closure sealing plates and method of sealing tissue |
| US20060271042A1 (en) | 2005-05-26 | 2006-11-30 | Gyrus Medical, Inc. | Cutting and coagulating electrosurgical forceps having cam controlled jaw closure |
| CA2549224A1 (en) | 2005-06-02 | 2006-12-02 | Tyco Healthcare Group Lp | Expandable backspan staple |
| US8579178B2 (en) | 2005-08-15 | 2013-11-12 | Covidien Lp | Surgical stapling instruments including a cartridge having multiple staples sizes |
| US7398908B2 (en) | 2005-08-15 | 2008-07-15 | Tyco Healthcare Group Lp | Surgical stapling instruments including a cartridge having multiple staple sizes |
| US7401721B2 (en) | 2005-08-15 | 2008-07-22 | Tyco Healthcare Group Lp | Surgical stapling instruments including a cartridge having multiple staple sizes |
| US7407075B2 (en) | 2005-08-15 | 2008-08-05 | Tyco Healthcare Group Lp | Staple cartridge having multiple staple sizes for a surgical stapling instrument |
| US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
| US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
| US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
| US7500979B2 (en) | 2005-08-31 | 2009-03-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling device with multiple stacked actuator wedge cams for driving staple drivers |
| US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
| US7635074B2 (en) | 2005-10-04 | 2009-12-22 | Tyco Healthcare Group Lp | Staple drive assembly |
| US7641091B2 (en) | 2005-10-04 | 2010-01-05 | Tyco Healthcare Group Lp | Staple drive assembly |
| US20080086034A1 (en) | 2006-08-29 | 2008-04-10 | Baxano, Inc. | Tissue Access Guidewire System and Method |
| US7673783B2 (en) | 2005-11-04 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments structured for delivery of medical agents |
| US7328828B2 (en) | 2005-11-04 | 2008-02-12 | Ethicon Endo-Surgery, Inc, | Lockout mechanisms and surgical instruments including same |
| US7955322B2 (en) | 2005-12-20 | 2011-06-07 | Intuitive Surgical Operations, Inc. | Wireless communication in a robotic surgical system |
| US8597280B2 (en) | 2006-06-13 | 2013-12-03 | Intuitive Surgical Operations, Inc. | Surgical instrument actuator |
| EP1875870B1 (en) | 2006-07-07 | 2009-12-02 | Ethicon Endo-Surgery, Inc. | A surgical stapling instrument. |
| US7441684B2 (en) * | 2006-08-02 | 2008-10-28 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with audible and visual feedback features |
| US8360297B2 (en) | 2006-09-29 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling instrument with self adjusting anvil |
| US7721930B2 (en) | 2006-11-10 | 2010-05-25 | Thicon Endo-Surgery, Inc. | Disposable cartridge with adhesive for use with a stapling device |
| 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 |
| US20080169332A1 (en) | 2007-01-11 | 2008-07-17 | Shelton Frederick E | Surgical stapling device with a curved cutting member |
| EP2131749B1 (en) | 2007-03-06 | 2016-11-02 | Covidien LP | Surgical stapling apparatus |
| US20090001130A1 (en) | 2007-03-15 | 2009-01-01 | Hess Christopher J | Surgical procedure using a cutting and stapling instrument having releasable staple-forming pockets |
| WO2008118728A1 (en) | 2007-03-22 | 2008-10-02 | Tyco Healthcare Group Lp | Apparatus for forming variable height surgical fasteners |
| US7832611B2 (en) | 2007-05-16 | 2010-11-16 | The Invention Science Fund I, Llc | Steerable surgical stapler |
| US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
| US7950561B2 (en) | 2007-06-18 | 2011-05-31 | Tyco Healthcare Group Lp | Structure for attachment of buttress material to anvils and cartridges of surgical staplers |
| US7731072B2 (en) | 2007-06-18 | 2010-06-08 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting instrument with improved anvil opening features |
| US9050098B2 (en) | 2007-11-28 | 2015-06-09 | Covidien Ag | Cordless medical cauterization and cutting device |
| US8490851B2 (en) | 2008-01-15 | 2013-07-23 | Covidien Lp | Surgical stapling apparatus |
| US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
| US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
| GB0804688D0 (en) | 2008-03-13 | 2008-04-16 | Gyrus Group Plc | Surgical instrument |
| US9869339B2 (en) | 2008-04-11 | 2018-01-16 | Flexdex, Inc. | End-effector jaw closure transmission systems for remote access tools |
| US8091756B2 (en) | 2008-05-09 | 2012-01-10 | Tyco Healthcare Group Lp | Varying tissue compression using take-up component |
| US7942303B2 (en) | 2008-06-06 | 2011-05-17 | Tyco Healthcare Group Lp | Knife lockout mechanisms for surgical instrument |
| US20100057081A1 (en) | 2008-08-28 | 2010-03-04 | Tyco Healthcare Group Lp | Tissue Fusion Jaw Angle Improvement |
| US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
| US8197479B2 (en) | 2008-12-10 | 2012-06-12 | Tyco Healthcare Group Lp | Vessel sealer and divider |
| US8632539B2 (en) | 2009-01-14 | 2014-01-21 | Covidien Lp | Vessel sealer and divider |
| US20100198248A1 (en) | 2009-02-02 | 2010-08-05 | Ethicon Endo-Surgery, Inc. | Surgical dissector |
| US8393516B2 (en) | 2009-02-26 | 2013-03-12 | Covidien Lp | Surgical stapling apparatus with curved cartridge and anvil assemblies |
| US8858547B2 (en) | 2009-03-05 | 2014-10-14 | Intuitive Surgical Operations, Inc. | Cut and seal instrument |
| US8365972B2 (en) | 2009-03-31 | 2013-02-05 | Covidien Lp | Surgical stapling apparatus |
| US8701960B1 (en) | 2009-06-22 | 2014-04-22 | Cardica, Inc. | Surgical stapler with reduced clamp gap for insertion |
| US8784404B2 (en) | 2009-06-29 | 2014-07-22 | Carefusion 2200, Inc. | Flexible wrist-type element and methods of manufacture and use thereof |
| US20110022078A1 (en) | 2009-07-23 | 2011-01-27 | Cameron Dale Hinman | Articulating mechanism |
| US20110036891A1 (en) | 2009-08-11 | 2011-02-17 | Tyco Healthcare Group Lp | Surgical stapler with visual positional indicator |
| US8955732B2 (en) * | 2009-08-11 | 2015-02-17 | Covidien Lp | Surgical stapling apparatus |
| US8852174B2 (en) | 2009-11-13 | 2014-10-07 | Intuitive Surgical Operations, Inc. | Surgical tool with a two degree of freedom wrist |
| US8996173B2 (en) | 2010-09-21 | 2015-03-31 | Intuitive Surgical Operations, Inc. | Method and apparatus for hand gesture control in a minimally invasive surgical system |
| US20110118708A1 (en) | 2009-11-13 | 2011-05-19 | Intuitive Surgical Operations, Inc. | Double universal joint |
| EP2467065B1 (en) | 2009-11-13 | 2020-01-08 | Intuitive Surgical Operations, Inc. | End effector with redundant closing mechanisms |
| US8235272B2 (en) | 2009-11-20 | 2012-08-07 | Tyco Healthcare Group Lp | Surgical stapling device with captive anvil |
| US8887595B2 (en) | 2009-12-22 | 2014-11-18 | Intuitive Surgical Operations, Inc. | Instrument wrist with cycloidal surfaces |
| US8328061B2 (en) | 2010-02-02 | 2012-12-11 | Covidien Lp | Surgical instrument for joining tissue |
| US8348127B2 (en) | 2010-04-07 | 2013-01-08 | Covidien Lp | Surgical fastener applying apparatus |
| US8834518B2 (en) | 2010-04-12 | 2014-09-16 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with cam-actuated jaws |
| US8496682B2 (en) | 2010-04-12 | 2013-07-30 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with cam-actuated jaws |
| US8685020B2 (en) | 2010-05-17 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instruments and end effectors therefor |
| US8672939B2 (en) | 2010-06-01 | 2014-03-18 | Covidien Lp | Surgical device for performing an electrosurgical procedure |
| US8491624B2 (en) | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
| US8647343B2 (en) | 2010-06-23 | 2014-02-11 | Covidien Lp | Surgical forceps for sealing and dividing tissue |
| US8439246B1 (en) | 2010-07-20 | 2013-05-14 | Cardica, Inc. | Surgical stapler with cartridge-adjustable clamp gap |
| US8663270B2 (en) | 2010-07-23 | 2014-03-04 | Conmed Corporation | Jaw movement mechanism and method for a surgical tool |
| US8740038B2 (en) | 2010-09-30 | 2014-06-03 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a releasable portion |
| US9351730B2 (en) | 2011-04-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising channels |
| US9216019B2 (en) | 2011-09-23 | 2015-12-22 | Ethicon Endo-Surgery, Inc. | Surgical stapler with stationary staple drivers |
| CN102440813B (en) | 2010-09-30 | 2013-05-08 | 上海创亿医疗器械技术有限公司 | Endoscopic surgical cutting anastomat with chain joints |
| CN101991452B (en) * | 2010-12-10 | 2012-07-04 | 苏州天臣国际医疗科技有限公司 | Linear type surgical stapling apparatus |
| KR102081754B1 (en) | 2011-02-15 | 2020-02-26 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | Systems for detecting clamping or firing failure |
| US9393017B2 (en) * | 2011-02-15 | 2016-07-19 | Intuitive Surgical Operations, Inc. | Methods and systems for detecting staple cartridge misfire or failure |
| KR102184421B1 (en) | 2011-02-18 | 2020-12-01 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | Fusing and cutting surgical instrument and related methods |
| US8800841B2 (en) | 2011-03-15 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridges |
| US9370362B2 (en) | 2011-04-07 | 2016-06-21 | Wake Forest University Health Sciences | Surgical staplers with tissue protection and related methods |
| CN102743201B (en) | 2011-04-20 | 2014-03-12 | 苏州天臣国际医疗科技有限公司 | Linear cutting suturing device |
| EP2522280B1 (en) | 2011-05-11 | 2016-03-02 | University Of Dundee | Medical instrument for grasping an object, in particular a needle holder |
| US9161807B2 (en) | 2011-05-23 | 2015-10-20 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
| US8763876B2 (en) | 2011-06-30 | 2014-07-01 | Covidien Lp | Surgical instrument and cartridge for use therewith |
| US8960521B2 (en) | 2011-07-15 | 2015-02-24 | Covidien Lp | Loose staples removal system |
| US8968307B2 (en) | 2011-08-18 | 2015-03-03 | Covidien Lp | Surgical forceps |
| KR101322030B1 (en) | 2011-09-05 | 2013-10-28 | 주식회사 모바수 | Instrument for Minimally Invasive Surgery Having Articulation Unit Including Spherical Parts |
| US8833632B2 (en) | 2011-09-06 | 2014-09-16 | Ethicon Endo-Surgery, Inc. | Firing member displacement system for a stapling instrument |
| US9254180B2 (en) | 2011-09-15 | 2016-02-09 | Ethicon Endo-Surgery, Inc. | Surgical instrument with staple reinforcement clip |
| US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
| US9089326B2 (en) | 2011-10-07 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Dual staple cartridge for surgical stapler |
| US9016539B2 (en) * | 2011-10-25 | 2015-04-28 | Covidien Lp | Multi-use loading unit |
| US8672206B2 (en) | 2011-10-25 | 2014-03-18 | Covidien Lp | Apparatus for endoscopic procedures |
| WO2013063522A2 (en) | 2011-10-26 | 2013-05-02 | Reid Robert Cyrus | Surgical instrument motor pack latch |
| US8864010B2 (en) | 2012-01-20 | 2014-10-21 | Covidien Lp | Curved guide member for articulating instruments |
| US8825811B2 (en) | 2012-03-15 | 2014-09-02 | International Business Machines Corporation | Connection management and optimization for services delivered over networks |
| FR2988501B1 (en) | 2012-03-20 | 2015-01-02 | Commissariat Energie Atomique | DEVICE AND METHOD FOR IDENTIFYING CYCLIC MOVEMENT, CORRESPONDING COMPUTER PROGRAM |
| 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 |
| WO2013158436A1 (en) * | 2012-04-18 | 2013-10-24 | Cardica, Inc. | Safety lockout for surgical stapler |
| DE102012103503A1 (en) | 2012-04-20 | 2013-10-24 | Aesculap Ag | Medical TFT instrument with pivotable electrode bearing |
| US9668807B2 (en) | 2012-05-01 | 2017-06-06 | Covidien Lp | Simplified spring load mechanism for delivering shaft force of a surgical instrument |
| US9820765B2 (en) | 2012-05-01 | 2017-11-21 | Covidien Lp | Surgical instrument with stamped double-flange jaws |
| US9226751B2 (en) | 2012-06-28 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Surgical instrument system including replaceable end effectors |
| US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
| US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
| US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
| US9554796B2 (en) | 2012-07-18 | 2017-01-31 | Covidien Lp | Multi-fire surgical stapling apparatus including safety lockout and visual indicator |
| US9301757B2 (en) | 2012-07-27 | 2016-04-05 | Covidien Lp | Surgical fastener applying apparatus including fluid-activated firing mechanism |
| US9549749B2 (en) | 2012-10-08 | 2017-01-24 | Covidien Lp | Surgical forceps |
| US9386985B2 (en) | 2012-10-15 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Surgical cutting instrument |
| US9421014B2 (en) | 2012-10-18 | 2016-08-23 | Covidien Lp | Loading unit velocity and position feedback |
| US9439665B2 (en) | 2012-12-20 | 2016-09-13 | Covidien Lp | Pediatric combination surgical device |
| CN104902826B (en) | 2012-12-31 | 2017-10-27 | 直观外科手术操作公司 | Surgical staple cartridge with increased knife clearance |
| US9675354B2 (en) | 2013-01-14 | 2017-06-13 | Intuitive Surgical Operations, Inc. | Torque compensation |
| US9522003B2 (en) | 2013-01-14 | 2016-12-20 | Intuitive Surgical Operations, Inc. | Clamping instrument |
| US10277097B2 (en) | 2013-01-14 | 2019-04-30 | Intuitive Surgical Operations, Inc. | Motor assembly |
| MX360430B (en) | 2013-02-08 | 2018-10-31 | Ethicon Endo Surgery Inc | Staple cartridge comprising a releasable cover. |
| FR3002012B1 (en) | 2013-02-11 | 2015-01-30 | Zf Systemes De Direction Nacam Sas | CARDAN JAW, DOUBLE CARDAN ROD ASSEMBLY AND MACHINING METHOD |
| US9839421B2 (en) | 2013-02-28 | 2017-12-12 | Ethicon Llc | Jaw closure feature for end effector of surgical instrument |
| US9717497B2 (en) | 2013-02-28 | 2017-08-01 | Ethicon Llc | Lockout feature for movable cutting member of surgical instrument |
| US9808248B2 (en) | 2013-02-28 | 2017-11-07 | Ethicon Llc | Installation features for surgical instrument end effector cartridge |
| US9782169B2 (en) * | 2013-03-01 | 2017-10-10 | Ethicon Llc | Rotary powered articulation joints for surgical instruments |
| MX364729B (en) | 2013-03-01 | 2019-05-06 | Ethicon Endo Surgery Inc | Surgical instrument with a soft stop. |
| KR102046373B1 (en) | 2013-03-11 | 2019-11-20 | 삼성전자주식회사 | Laparoscopic surgery device having wire reducer |
| US9814463B2 (en) | 2013-03-13 | 2017-11-14 | Covidien Lp | Surgical stapling apparatus |
| US9345481B2 (en) | 2013-03-13 | 2016-05-24 | Ethicon Endo-Surgery, Llc | Staple cartridge tissue thickness sensor system |
| US9668729B2 (en) * | 2013-03-13 | 2017-06-06 | Covidien Lp | Surgical stapling apparatus |
| US9717498B2 (en) | 2013-03-13 | 2017-08-01 | Covidien Lp | Surgical stapling apparatus |
| EP3135225B1 (en) | 2013-03-13 | 2019-08-14 | Covidien LP | Surgical stapling apparatus |
| US9629628B2 (en) | 2013-03-13 | 2017-04-25 | Covidien Lp | Surgical stapling apparatus |
| US9107685B2 (en) | 2013-03-13 | 2015-08-18 | Ethicon Endo-Surgery, Inc. | Electrosurgical device with disposable shaft having clamshell coupling |
| US9877782B2 (en) | 2013-03-14 | 2018-01-30 | Ethicon Llc | Electrosurgical instrument end effector with compliant electrode |
| EP2967548B1 (en) | 2013-03-15 | 2017-11-29 | Ceterix Orthopaedics, Inc. | Suture passer devices |
| EP3488807B1 (en) | 2013-03-18 | 2020-09-09 | Intuitive Surgical Operations Inc. | Surgical instrument drive element, related devices and systems |
| US9510827B2 (en) | 2013-03-25 | 2016-12-06 | Covidien Lp | Micro surgical instrument and loading unit for use therewith |
| US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
| US9775610B2 (en) | 2013-04-09 | 2017-10-03 | Covidien Lp | Apparatus for endoscopic procedures |
| BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
| US9387045B2 (en) | 2013-05-14 | 2016-07-12 | Intuitive Surgical Operations, Inc. | Grip force normalization for surgical instrument |
| US9351788B2 (en) | 2013-06-06 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Surgical instrument having knife band with curved distal edge |
| WO2015023853A1 (en) | 2013-08-15 | 2015-02-19 | Intuitive Surgical Operations, Inc. | Robotic instrument driven element |
| US9936949B2 (en) | 2013-09-23 | 2018-04-10 | Ethicon Llc | Surgical stapling instrument with drive assembly having toggle features |
| DE102013110847B3 (en) | 2013-10-01 | 2015-01-22 | gomtec GmbH | Control device and method for controlling a robot system by means of gesture control |
| US9949785B2 (en) | 2013-11-21 | 2018-04-24 | Ethicon Llc | Ultrasonic surgical instrument with electrosurgical feature |
| US10159525B2 (en) | 2013-12-18 | 2018-12-25 | Covidien Lp | Electrosurgical end effectors |
| US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
| US20150173789A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulatable shaft arrangements |
| US9585662B2 (en) | 2013-12-23 | 2017-03-07 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising an extendable firing member |
| US9700312B2 (en) | 2014-01-28 | 2017-07-11 | Covidien Lp | Surgical apparatus |
| US9629627B2 (en) | 2014-01-28 | 2017-04-25 | Coviden Lp | Surgical apparatus |
| US9197697B2 (en) | 2014-03-10 | 2015-11-24 | Gazoo, Inc. | Cloud computing system and method |
| CN106413580B (en) | 2014-03-26 | 2019-10-15 | 伊西康内外科有限责任公司 | Modular Surgical Instrument System |
| US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
| US9526518B2 (en) | 2014-03-28 | 2016-12-27 | Ethicon Endo-Surgery, Llc | Surgical cutting devices and methods that include a self-adjusting cutting blade |
| US9757126B2 (en) | 2014-03-31 | 2017-09-12 | Covidien Lp | Surgical stapling apparatus with firing lockout mechanism |
| US10542988B2 (en) | 2014-04-16 | 2020-01-28 | Ethicon Llc | End effector comprising an anvil including projections extending therefrom |
| US10426476B2 (en) | 2014-09-26 | 2019-10-01 | Ethicon Llc | Circular fastener cartridges for applying radially expandable fastener lines |
| US10175127B2 (en) * | 2014-05-05 | 2019-01-08 | Covidien Lp | End-effector force measurement drive circuit |
| JP2017518803A (en) | 2014-05-15 | 2017-07-13 | コヴィディエン リミテッド パートナーシップ | Surgical fastener application device |
| US9668734B2 (en) | 2014-05-16 | 2017-06-06 | Covidien Lp | In-situ loaded stapler |
| ES2984959T3 (en) | 2014-05-30 | 2024-10-31 | Applied Med Resources | Electrosurgical sealing and dissection systems |
| US10335147B2 (en) | 2014-06-25 | 2019-07-02 | Ethicon Llc | Method of using lockout features for surgical stapler cartridge |
| US9700333B2 (en) | 2014-06-30 | 2017-07-11 | Ethicon Llc | Surgical instrument with variable tissue compression |
| JP6701172B2 (en) | 2014-08-13 | 2020-05-27 | コヴィディエン リミテッド パートナーシップ | Robot control for grasping mechanical profit |
| US9848877B2 (en) | 2014-09-02 | 2017-12-26 | Ethicon Llc | Methods and devices for adjusting a tissue gap of an end effector of a surgical device |
| US9943312B2 (en) | 2014-09-02 | 2018-04-17 | Ethicon Llc | Methods and devices for locking a surgical device based on loading of a fastener cartridge in the surgical device |
| US10016199B2 (en) | 2014-09-05 | 2018-07-10 | Ethicon Llc | Polarity of hall magnet to identify cartridge type |
| EP2992849B1 (en) | 2014-09-08 | 2020-06-17 | Erbe Elektromedizin GmbH | System for simultaneous tissue coagulation and tissue dissection |
| JP6648119B2 (en) | 2014-09-26 | 2020-02-14 | エシコン エルエルシーEthicon LLC | Surgical stapling buttress and accessory materials |
| US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
| US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
| 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 |
| EP4541299A3 (en) | 2014-12-23 | 2025-06-18 | Applied Medical Resources Corporation | Bipolar electrosurgical sealer and divider |
| GB2535006B (en) | 2015-01-14 | 2018-12-12 | Gyrus Medical Ltd | End effector for electrosurgical instrument |
| GB2535222B (en) | 2015-02-13 | 2020-08-12 | Gyrus Medical Ltd | End effector for electrosurgical instrument |
| US10085749B2 (en) | 2015-02-26 | 2018-10-02 | Covidien Lp | Surgical apparatus with conductor strain relief |
| US10285698B2 (en) | 2015-02-26 | 2019-05-14 | Covidien Lp | Surgical apparatus |
| US10813684B2 (en) | 2015-03-30 | 2020-10-27 | Ethicon Llc | Control of cutting and sealing based on tissue mapped by segmented electrode |
| 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 |
| US10463368B2 (en) | 2015-04-10 | 2019-11-05 | Covidien Lp | Endoscopic stapler |
| EP3294185B1 (en) | 2015-05-15 | 2020-04-01 | Intuitive Surgical Operations Inc. | System for reducing blade exposures |
| US9918781B2 (en) | 2015-05-22 | 2018-03-20 | Covidien Lp | Surgical instruments and methods for performing tonsillectomy, adenoidectomy, and other surgical procedures |
| US10803662B2 (en) | 2015-05-22 | 2020-10-13 | The University Of North Carolina At Chapel Hill | Methods, systems, and computer readable media for transoral lung access |
| JP2017021186A (en) | 2015-07-10 | 2017-01-26 | キヤノン株式会社 | Frame fastening method, frame, sheet conveying apparatus, and image forming apparatus |
| US10548599B2 (en) | 2015-07-20 | 2020-02-04 | Covidien Lp | Endoscopic stapler and staple |
| EP3332717A4 (en) | 2015-08-07 | 2019-08-28 | Olympus Corporation | Treatment device |
| US10098642B2 (en) | 2015-08-26 | 2018-10-16 | Ethicon Llc | Surgical staples comprising features for improved fastening of tissue |
| EP3138522B1 (en) | 2015-09-03 | 2020-11-04 | Erbe Elektromedizin GmbH | Instrument for mounting, separating and/or coagulation of biological tissue |
| US11020200B2 (en) | 2015-10-19 | 2021-06-01 | Ethicon Llc | Surgical instrument with dual mode end effector and compound lever with detents |
| WO2017083130A1 (en) | 2015-11-13 | 2017-05-18 | Intuitive Surgical Operations, Inc. | Push-pull stapler with two degree of freedom wrist |
| US20190076143A1 (en) | 2015-11-13 | 2019-03-14 | Intuitive Surgical Operations, Inc. | Stapler anvil with compliant tip |
| WO2017083125A1 (en) | 2015-11-13 | 2017-05-18 | Intuitive Surgical Operations, Inc. | Stapler with composite cardan and screw drive |
| AT518032B1 (en) | 2015-11-20 | 2017-11-15 | Johann Klaffenböck Mag | MEDICAL INSTRUMENT |
| US10285693B2 (en) | 2015-12-31 | 2019-05-14 | Ethicon Llc | Surgical stapler with locking translatable pin |
| HRP20231179T1 (en) | 2016-01-25 | 2024-01-05 | K-Nine Writing Systems Pvt. Ltd. | Tissue/vessel sealer and/or cutter with variable shapes of jaw assembly with partial dlc coating |
| JP6914942B2 (en) | 2016-01-29 | 2021-08-04 | インテュイティブ サージカル オペレーションズ, インコーポレイテッド | Systems and methods for variable speed surgical instruments |
| US10420559B2 (en) | 2016-02-11 | 2019-09-24 | Covidien Lp | Surgical stapler with small diameter endoscopic portion |
| US11304770B2 (en) | 2016-03-09 | 2022-04-19 | Intuitive Surgical Operations, Inc. | Force transmission mechanism for surgical instrument, and related devices, systems, and methods |
| KR102535333B1 (en) * | 2016-04-12 | 2023-05-30 | 어플라이드 메디컬 리소시스 코포레이션 | Reload shaft assembly for surgical stapler |
| US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
| US10368867B2 (en) | 2016-04-18 | 2019-08-06 | Ethicon Llc | Surgical instrument comprising a lockout |
| WO2017199411A1 (en) | 2016-05-20 | 2017-11-23 | オリンパス株式会社 | Medical stapler |
| EP3463162A4 (en) | 2016-06-03 | 2020-06-24 | Covidien LP | Systems, methods, and computer-readable program products for controlling a robotically delivered manipulator |
| CN114767266A (en) | 2016-06-09 | 2022-07-22 | 直观外科手术操作公司 | Computer-assisted teleoperation surgical system and method |
| KR102438357B1 (en) | 2016-07-01 | 2022-09-01 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | Computer-assisted medical systems and methods |
| CN109688959B (en) | 2016-09-09 | 2021-10-01 | 直观外科手术操作公司 | Push-pull surgical instrument end effector actuation using flexible tensioning members |
| EP4122408A1 (en) | 2016-09-09 | 2023-01-25 | Intuitive Surgical Operations, Inc. | Wrist architecture |
| WO2018071497A1 (en) | 2016-10-11 | 2018-04-19 | Intuitive Surgical Operations, Inc. | Stapler cartridge with an integral knife |
| WO2018144090A2 (en) | 2016-11-08 | 2018-08-09 | Innoblative Designs, Inc. | Electrosurgical tissue and vessel sealing device |
| US11272947B2 (en) | 2016-11-17 | 2022-03-15 | Covidien Lp | Surgical instruments for performing tonsillectomy, adenoidectomy, and other surgical procedures |
| CN110099619B (en) * | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | Latching device for surgical end effector and replaceable tool assembly |
| US11090048B2 (en) | 2016-12-21 | 2021-08-17 | Cilag Gmbh International | Method for resetting a fuse of a surgical instrument shaft |
| US20180168647A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments having end effectors with positive opening features |
| JP7010957B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | Shaft assembly with lockout |
| US10499914B2 (en) | 2016-12-21 | 2019-12-10 | Ethicon Llc | Staple forming pocket arrangements |
| US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
| US10918385B2 (en) | 2016-12-21 | 2021-02-16 | Ethicon Llc | Surgical system comprising a firing member rotatable into an articulation state to articulate an end effector of the surgical system |
| US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
| US11229480B2 (en) | 2017-02-02 | 2022-01-25 | Covidien Lp | Latching mechanism for in-line activated electrosurgical device |
| US10765442B2 (en) | 2017-04-14 | 2020-09-08 | Ethicon Llc | Surgical devices and methods for biasing an end effector to a closed configuration |
| US11129666B2 (en) | 2017-06-28 | 2021-09-28 | Cilag Gmbh International | Shaft module circuitry arrangements |
| US12446909B2 (en) | 2017-07-11 | 2025-10-21 | Conmed Corporation | Jaw assembly for a vessel sealer |
| US10932806B2 (en) | 2017-10-30 | 2021-03-02 | Ethicon Llc | Reactive algorithm for surgical system |
| EP4595914A3 (en) * | 2017-11-02 | 2025-08-20 | Intuitive Surgical Operations, Inc. | Systems and methods for end effector position set point correction |
| US10905411B2 (en) | 2017-11-03 | 2021-02-02 | Covidien Lp | Surgical suturing and grasping device |
| JP7233427B2 (en) | 2017-11-13 | 2023-03-06 | ヴィカリアス サージカル インク. | Wrist assembly using virtual reality |
| US12114853B2 (en) | 2017-11-14 | 2024-10-15 | Intuitive Surgical Operations, Inc. | Electrically weldable suture material, and apparatus and method for forming welded suture loops and other welded structures |
| US10863988B2 (en) | 2017-11-29 | 2020-12-15 | Intuitive Surgical Operations, Inc. | Surgical instrument with lockout mechanism |
| US11369368B2 (en) | 2017-12-21 | 2022-06-28 | Cilag Gmbh International | Surgical instrument comprising synchronized drive systems |
| US10595887B2 (en) | 2017-12-28 | 2020-03-24 | Ethicon Llc | Systems for adjusting end effector parameters based on perioperative information |
| US10743871B2 (en) | 2018-02-01 | 2020-08-18 | Ethicon, Llc | Surgical clip applier with distal clip feeder |
| US10631866B2 (en) | 2018-02-06 | 2020-04-28 | Ethicon Llc | Release mechanism for linear surgical stapler |
| WO2019157500A2 (en) | 2018-02-12 | 2019-08-15 | Intuitive Surgical, Inc. | Surgical instrument with lockout mechanism |
| WO2019165403A1 (en) | 2018-02-26 | 2019-08-29 | Intuitive Surgical, Inc. | Surgical instrument with lockout mechanism |
| US11406382B2 (en) | 2018-03-28 | 2022-08-09 | Cilag Gmbh International | Staple cartridge comprising a lockout key configured to lift a firing member |
| US11207067B2 (en) | 2018-03-28 | 2021-12-28 | Cilag Gmbh International | Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing |
| US11589865B2 (en) | 2018-03-28 | 2023-02-28 | Cilag Gmbh International | Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems |
| US20190314107A1 (en) | 2018-04-17 | 2019-10-17 | Ethicon Llc | Protection Measures for Robotic Electrosurgical Instruments |
| US12029473B2 (en) | 2018-05-31 | 2024-07-09 | Intuitive Surgical Operations, Inc. | Surgical instruments having a jaw locking mechanism |
| WO2020081960A1 (en) | 2018-10-19 | 2020-04-23 | Intuitive Surgical Operations, Inc. | Endoscopic purse string suture surgical device |
| CN113271870A (en) | 2018-12-21 | 2021-08-17 | 直观外科手术操作公司 | Surgical instrument with mechanism for identifying and/or deactivating a stapler cartridge |
| US11857188B2 (en) | 2018-12-21 | 2024-01-02 | Intuitive Surgical Operations, Inc. | Articulation assemblies for surgical instruments |
| US11944301B2 (en) | 2018-12-21 | 2024-04-02 | Intuitive Surgical Operations, Inc. | Surgical instruments having a reinforced staple cartridge |
| EP3897405A4 (en) | 2018-12-21 | 2022-09-14 | Intuitive Surgical Operations, Inc. | ACTUATING MECHANISMS FOR SURGICAL INSTRUMENTS |
| US11701109B2 (en) | 2018-12-28 | 2023-07-18 | Cilag Gmbh International | Surgical stapler with sloped staple deck for varying tissue compression |
| US11259808B2 (en) | 2019-03-13 | 2022-03-01 | Covidien Lp | Tool assemblies with a gap locking member |
| WO2020214258A1 (en) | 2019-04-15 | 2020-10-22 | Intuitive Surgical Operations, Inc. | Staple cartridge for a surgical instrument |
| WO2020214397A1 (en) | 2019-04-17 | 2020-10-22 | Intuitive Surgical Operations, Inc. | Surgical stapling instrument |
| CN113905675B (en) | 2019-05-31 | 2025-01-14 | 直观外科手术操作公司 | Staple cartridge for surgical instruments |
| US11786325B2 (en) | 2019-07-02 | 2023-10-17 | Intuitive Surgical Operations, Inc. | Remotely controlling a system using video |
| EP4044936A4 (en) | 2019-10-18 | 2024-02-28 | Intuitive Surgical Operations, Inc. | Surgical instrument with adjustable jaws |
| CN119548247A (en) | 2019-10-25 | 2025-03-04 | 直观外科手术操作公司 | Joint structure and related device and method |
| US20210177500A1 (en) | 2019-12-12 | 2021-06-17 | Intuitive Surgical Operations, Inc. | Surgical instruments having non-linear cam slots |
| US20210196357A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with asynchronous energizing electrodes |
| US12324589B2 (en) | 2020-01-07 | 2025-06-10 | Intuitive Surgical Operations, Inc. | Surgical instruments for applying multiple clips |
| US11642129B2 (en) | 2020-01-15 | 2023-05-09 | Intuitive Surgical Operations, Inc. | Staple cartridge and drive member for surgical instrument |
| US11278282B2 (en) | 2020-01-31 | 2022-03-22 | Covidien Lp | Stapling device with selective cutting |
| US11452524B2 (en) | 2020-01-31 | 2022-09-27 | Covidien Lp | Surgical stapling device with lockout |
| US11857247B2 (en) | 2020-07-17 | 2024-01-02 | Cilag Gmbh International | Jaw for surgical instrument end effector |
| US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
| US11869169B2 (en) | 2021-08-10 | 2024-01-09 | Samsung Electronics Co., Ltd. | Adaptive sub-pixel spatial temporal interpolation for color filter array |
| US11653922B2 (en) | 2021-09-29 | 2023-05-23 | Covidien Lp | Surgical stapling device with firing lockout mechanism |
-
2019
- 2019-12-16 CN CN201980084202.XA patent/CN113271870A/en active Pending
- 2019-12-16 WO PCT/US2019/066513 patent/WO2020131685A1/en not_active Ceased
- 2019-12-16 US US17/414,805 patent/US11723661B2/en active Active
- 2019-12-16 EP EP19898247.2A patent/EP3897402A4/en active Pending
- 2019-12-16 US US17/414,819 patent/US11806015B2/en active Active
- 2019-12-16 WO PCT/US2019/066530 patent/WO2020131692A1/en not_active Ceased
-
2023
- 2023-06-22 US US18/212,746 patent/US12383268B2/en active Active
- 2023-10-04 US US18/376,562 patent/US12251107B2/en active Active
-
2025
- 2025-03-04 US US19/070,366 patent/US20250302472A1/en active Pending
- 2025-07-10 US US19/265,011 patent/US20250331857A1/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP6411461B2 (en) * | 2013-04-16 | 2018-10-24 | 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 shaft having a switch for controlling operation of the surgical instrument |
| JP2017527396A (en) * | 2014-09-15 | 2017-09-21 | アプライド メディカル リソーシーズ コーポレイション | Self-adjusting staple height surgical stapler |
| US20180168641A1 (en) * | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instruments with lockout arrangements for preventing firing system actuation unless an unspent staple cartridge is present |
| US20180168581A1 (en) * | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Articulation lock arrangements for locking an end effector in an articulated position in response to actuation of a jaw closure system |
| US20180168649A1 (en) * | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Articulatable surgical stapling instruments |
Cited By (12)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US12359696B2 (en) | 2015-11-13 | 2025-07-15 | Intuitive Surgical Operations, Inc. | Stapler with composite cardan and screw drive |
| US12064110B2 (en) | 2019-02-27 | 2024-08-20 | Intuitive Surgical Operations, Inc. | Stapler cartridge assemblies and related devices, systems, and methods |
| US12349905B2 (en) | 2019-05-31 | 2025-07-08 | Intuitive Surgical Operations, Inc. | Staple cartridge for a surgical instrument |
| CN111904515A (en) * | 2020-09-15 | 2020-11-10 | 赛诺微医疗科技(浙江)有限公司 | Surgical instrument and position identification and control device and method of actuator of surgical instrument |
| CN111904515B (en) * | 2020-09-15 | 2023-03-28 | 赛诺微医疗科技(浙江)有限公司 | Surgical instrument and position identification and control device and method of actuator of surgical instrument |
| US12402883B2 (en) | 2021-01-08 | 2025-09-02 | Intuitive Surgical Operations, Inc. | Surgical instrument with linear and purse string suture staples |
| WO2022159369A1 (en) | 2021-01-19 | 2022-07-28 | Intuitive Surgical Operations, Inc. | Stapler reload assemblies and related devices, systems, and methods |
| EP4534037A2 (en) | 2021-01-19 | 2025-04-09 | Intuitive Surgical Operations, Inc. | Stapler reload assemblies and related devices, systems, and methods |
| US12478373B2 (en) | 2021-01-19 | 2025-11-25 | Intuitive Surgical Operations, Inc. | Stapler reload assemblies and related devices, systems, and methods |
| EP4378397A4 (en) * | 2021-07-29 | 2024-11-13 | Reach Surgical, Inc. | SURGICAL INSTRUMENT |
| US12490987B2 (en) | 2021-07-29 | 2025-12-09 | Reach Surgical, Inc. | Surgical instrument |
| US12508024B2 (en) | 2021-12-29 | 2025-12-30 | Intuitive Surgical Operations, Inc. | Surgical stapling instruments |
Also Published As
| Publication number | Publication date |
|---|---|
| US11806015B2 (en) | 2023-11-07 |
| EP3897402A4 (en) | 2023-02-08 |
| US20220015763A1 (en) | 2022-01-20 |
| US20250331857A1 (en) | 2025-10-30 |
| US20250302472A1 (en) | 2025-10-02 |
| US20220015762A1 (en) | 2022-01-20 |
| US12251107B2 (en) | 2025-03-18 |
| US20230329711A1 (en) | 2023-10-19 |
| US20240023961A1 (en) | 2024-01-25 |
| US11723661B2 (en) | 2023-08-15 |
| US12383268B2 (en) | 2025-08-12 |
| EP3897402A1 (en) | 2021-10-27 |
| WO2020131692A1 (en) | 2020-06-25 |
| CN113271870A (en) | 2021-08-17 |
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