CN101083941A - 半自动缝合设备 - Google Patents

半自动缝合设备 Download PDF

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CN101083941A
CN101083941A CNA2005800258578A CN200580025857A CN101083941A CN 101083941 A CN101083941 A CN 101083941A CN A2005800258578 A CNA2005800258578 A CN A2005800258578A CN 200580025857 A CN200580025857 A CN 200580025857A CN 101083941 A CN101083941 A CN 101083941A
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菲利普·L·吉尔登伯格
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GILDENBERG PHILLIP L
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0491—Sewing machines for surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06019—Means for attaching suture to needle by means of a suture-receiving lateral eyelet machined in the needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2947—Pivots
    • 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

Abstract

本发明涉及一种缝合身体组织的半自动缝合设备以及该设备的使用方法，其中所述设备包括：壳体；至少两个远端臂，所述远端臂连接至所述壳体并从所述壳体向远端伸出，其中，所述至少两个远端臂可独立伸出和缩回；缝合针钩，所述缝合针钩连接至所述至少两个远端臂中的每个臂的远端，其中，所述缝合针钩可垂直于其所连接的远端臂的纵轴线沿径向转动；以及至少一个控制器，所述控制器可操作以控制所述至少两个远端臂的伸出或缩回、所述缝合钩的转动以及所述缝合针钩的打开和闭合的至少一部分。

Description

半自动缝合设备
相关申请的交叉引用
本发明要求U.S.临时申请60/582,752(申请日为2004年6月24日)的优先权。
技术领域
本发明涉及一种用于缝合组织的手术设备，特别是在缝合组织中使用的半自动缝合设备。在此公开的本发明特别有利于在限定的空间内或用微小缝合针进行的组织缝合。所公开的本发明还提供一种用于在缝合针刺穿且穿过要缝合的组织时优化缝合针的轨迹的机构以最小化对组织的损伤。
背景技术
在许多医疗过程中，组织的缝合可以是最耗时、冗长的组成部分之一。缝合一般需要医生各手均持握工具。组织镊子交替夹住组织和针，所以在整个缝合过程中再没有空闲的工具以固定组织。例如，习惯用右手的外科医生进行的组织缝合通常包括医生右手持握的持针器和左手持握的镊子。缝合针由右手中的持针器夹住，而组织最初由左手中的镊子夹住。接着，使针刺穿组织并且被推过组织直到持针器靠近组织。接下来，左手中的镊子释放组织并用镊子夹住针的远端。接着针从右手中的持针器中释放并通过镊子被拉出组织。然后，针的基端再次由医生右手中的持针器夹住，针从左手中的镊子中释放。接下来，缝合通过拉出组织的剩余路程而进行直到具有适当的张力使组织结合在一起。然后使用镊子再次夹住组织准备缝合针的下次插入。
通常，组织的缝合必须在通过体壁上的手术开口或者通过内窥镜或内窥镜工作通道的有限或限定的空间中进行，诸如在体腔内。在这些情况下，由于灵活性有限及潜在的视野有限，缝合过程更难进行。而且，在缝合针从持针器向镊子传送及反方向传送的缝合的部分过程中，灵活性和视野的限制增加了脱落或不当放置缝合针的可能性。为了缓解或减少一些所述困难，开发了一种如美国专利No.5,938,668中描述的缝合辅助器。在此公开的工具通过在两个延长管状件的远端上设置钳夹使医生在定位、释放以及收回缝合针方面增大了可靠性。所述钳夹可以通过使一套钳夹夹住缝合针，另一套钳夹向柄部(壳体)缩回的方式控制。接着缝合针刺穿要缝合的组织，并且穿过该组织直到其远端离开组织。接下来，缩回的构件伸出并且钳夹接合缝合针的远端。另一个构件的钳夹释放缝合针并且向柄部附近缩回。因此，该机构在限定的区域内使缝合针在两套钳夹之间穿过，而始终对针本身及组织提供具有可靠的机械的控制的安全性。
但是由这些设备提供的优点并不限于只在限定空间中进行的缝合。许多类型的手术过程，诸如吻合血管都需要使用极其微小的缝合针。由于微小缝合针的尺寸小，其从一个钳夹向另一个钳夹的自动传送减小了缝合针脱落或夹不住的可能性。而且，这种自动传送将使医生视野的焦点保持在结扎的组织上，而不用将其焦点在各手中的工具和组织之间来回转移。最终，这些设备使医生主要使用一只手就可进行缝合，因此，使医生能够使用另一只手持续地固定住组织而使缝合更精准地进行。缝合组织的稳定性的增加和缝合更精准地进行对于如缝合多层组织、缝合薄壁的血管或缝合在牵引力或张力作用下受缝合针移动产生变形而易于损坏的组织等的组织缝合是更有利的。
如上所述，在典型的缝合过程中，组织被缝合针刺穿，接着该针穿过组织并从另一侧被夹住，针在该侧被拉过剩余路线并被拉出组织。缝合针穿过组织由通过持针器或缝合设备的转动施加在缝合针上的力控制。然而，因为各缝合针因其自身的物理性质而具有给定的长度和弧形，当针穿过组织时，医生必须试图对于针的长度模仿针的弧形以在进行缝合时减小对组织的扭曲。而多种长度和弧形的缝合针增加了复杂性。
因为通常使用的持针器并不在正常手腕的转动中心持握缝合针，而是通过从医生手腕的转动中心偏离几厘米的弧形来摆动针，因此出现了另一种机械性的缺点，外科医生必须手动提供补偿性运动使针平滑地通过其弧形移动，其中针的弧形是针的尺寸和曲线的函数。而且，即使如上述设备的缝合辅助器也不使用调整至缝合针角度/弧形的钳夹或缝合钩。而缺少调整则增大了由于增大缝合针的转动中心和设备的转动中心之间的偏差而维持针通道正常弧形的难度。
因此，有利的是具有一种能够持续对缝合针进行机械性控制，而且同时提供一种驱动缝合针沿其自身限定的弧形穿过组织的机构。另外，这种设备还可以特别用于使用任何数量的多种缝合针的情况。或者，有利的是可以具有几种不同尺寸的半自动/自动缝合设备以便于适应用于从微血管或内窥镜过程中至用于缝合较大血管或心脏瓣膜的所有尺寸的缝合针。
发明内容
一种用于缝合身体组织的半自动设备，包括：壳体；至少两个远端臂，所述远端臂连接至所述壳体并从所述壳体向远端伸出，其中，所述至少两个远端臂可独立伸出和缩回；缝合针钩，所述缝合针钩连接至所述至少两个远端臂中的每个臂的远端，其中，所述缝合针钩可垂直于其所连接的远端臂的纵轴线径向转动；以及至少一个控制器，所述控制器可操作以控制所述至少两个远端臂的伸出或缩回、所述缝合钩的转动以及所述缝合针钩的打开和闭合的至少一部分。
在某些实施例中，所述半自动装置进一步包括径向驱动器，所述径向驱动器使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。所述径向驱动器可以被所述至少一个控制器启动和停止。在这些实施例的一些实施例中，所述径向驱动器是以预定的持续速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动，而在其它实施例中是以可变速率转动。
在某些其它实施例中，所述的半自动设备还包括：横向驱动器，所述横向驱动器从所述壳体向近端和远端伸出和缩回所述至少两个远端臂；以及纵向驱动器，所述纵向驱动器从所述壳体的纵向中心向近端和远端移动所述至少两个远端臂，并送于所述至少两个远端臂的纵向中心转动所述至少两个远端臂。而在其它实施例中，所述设备进一步包括：程序界面，其中，所述程序界面能够用于存储所述半自动设备中的设置，所述设置指导通过横向驱动器确定的所述至少两个远端臂的横向定位，以及通过纵向驱动器确定的缝合针钩的径向角度，以与预定缝合针的弧形相匹配。
在其它实施例中，所述半自动装置还包括：横向驱动器，所述横向驱动器自所述壳体向近端和远端伸出和缩回所述至少两个远端臂；纵向驱动器，所述纵向驱动器自所述壳体的纵向中心向近端和远端移动所述至少两个远端臂，并关于所述至少两个远端臂的纵向中心转动所述至少两个远端臂；以及径向驱动器，所述径向驱动器使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。在这些实施例的一些实施例中，所述设备还包括：程序界面，其中，所述程序界面可以用于存储所述半自动设备中的设置，所述设置指导通过横向驱动器确定的所述至少两个远端臂的横向定位，以及通过纵向驱动器确定的缝合针钩的径向角度，以与预定缝合针的弧形相匹配。而在这些实施例的其它实施例中，所述径向驱动器使所述至少两个远端臂围绕所述壳体的纵轴线以预定的持续速率或可变速率沿径向转动。
本发明的某些实施例还具有缝合针，所述缝合针的弧形不是圆形。
某些其它的实施例还包括万向架，所述至少两个远端臂被安装在所述万向架上，所述万向架允许所述至少两个远端臂以可变角度偏离所述壳体的纵轴线。
所述半自动装置的某些其它实施例还包括自动臂所用的附件。
本发明的其它实施例提供一种半自动缝合设备，包括：壳体；至少两个缝合钩臂，所述缝合钩臂从所述壳体向远端伸出，其中，所述至少两个缝合钩臂包括缝合钩机构；用于控制所述钩机构相对于所述缝合钩臂的径向角度的装置；用于控制独立从可缩回主钩臂或可缩回次钩臂的柄部独立向远端伸出或向所述柄部近端缩回的装置；用于通过所述可缩回主钩臂的钩机构或所述可缩回次钩臂的钩机构独立地控制扣住缝合针的装置。
本发明还提供一种采用半自动缝合设备缝合组织的方法，包括以下步骤：提供本发明的半自动设备，其中半自动设备具有两个远端臂；使用所述至少一个控制器来指导：通过连接至一个所述远端臂的所述可转动缝合针钩扣住缝合针；另一所述远端臂向所述壳体缩回，接着在所述缝合针的远端穿过待缝合组织之后另一所述远端臂伸出；通过连接至目前伸出的所述另一远端臂的可转动的缝合针钩扣住缝合针；使所述缝合针从所述第一远端臂的可转动缝合针钩上释放以接合所述针，接着所述第一远端臂向所述壳体近端缩回。
附图说明
通过结合附图参考以下说明，本发明能够被更好地理解，图中，相似的附图标记表示相似的元件，且图中：
图1示出了半自动缝合设备的一个实施例；
图2示出了半自动缝合设备缝合组织的纵向示意图；
图3示出了远端臂的座标定位以及各种缝合针的长度和弧形之间的关系。
图4显示了缝合针钩的角度定位和所用的缝合针的弧形之间的关系；
图5显示了半自动缝合装置与不同弧形的缝合针相适应的能力；
图6示出了自动缝合设备的远端臂自纵向观察点的径向位置，其中，在接近针尖的一短距离处持握针远端；
图7示出了设于远端臂端部的缝合持握钩的各种实施例。
具体实施方式
本发明提供了一种可用于缝合任何类型组织的半自动缝合设备。所述设备的特定实施例尤其适用于在例如内窥镜过程中或通过小的手术开口的限定区域中进行的组织缝合。所述设备还特别适用于使用微小的缝合针进行的缝合，例如用于吻合血管，其中该针的弧形直径仅仅为3-4mm，尽管即使使用较大的针，使用速度和方便性以及对组织的损伤的减小也是有利地。
参考图1，根据本发明的一个实施例的半自动缝合设备包括：壳体1，其在该设备的手持型中起柄部的作用或在该设备的非手持型中起连接部分的作用；一套至少一个控制器2-4；程序界面5；以及至少两个远端臂9、10，其直接或间接地耦合至壳体1。在一些实施例中，可以调整远端臂以与所述设备的纵向中心8成一限定的角度和距离从壳体1伸出。所述远端臂9、10在其最远端包括缝合针钩9a、10a。可以启动位于该自动缝合设备的壳体1上的控制器2-4使远端臂9、10缩回或伸出、各缝合针钩9a或10a的打开及闭合或远端臂9、10沿预定弧形的转动(如下文所述)。
在一些实施例中，壳体1可以完全或部分地包围侧向驱动器、纵向驱动器和/或径向驱动器。所述侧向驱动器可以独立地控制各远端臂9、10相对该设备纵向中心8的侧向位置，如图5所示。所述纵向驱动器可以独立地控制各远端臂9、10向壳体1的远端伸出或向壳体1的近端缩回，如图2所示。所述径向驱动器可以控制远端臂9、10的相互径向位置(将所述臂分开的角度，该角度的起点是自动缝合设备纵向中心8或任何其它预定的转动中心)，如图5所示。该径向驱动器还可以以预定的弧形17围绕该半自动缝合设备的纵向中心8或任何其它预定的转动中心转动远端臂9、10，如图3所示。本发明可替换的半自动实施例可以使径向驱动器不具备转动远端臂9、10以通过预定的弧形17移动缝合针11的能力，而依靠医生手动操作该设备移动缝合针。
表1与图2对应的各缝合步骤
  步骤         远端臂      缝合针钩             行为
  图2   9     10 9 10
  A   伸出     伸出/缩回 闭合 打开 接合针的近端
  B   伸出     缩回 闭合 打开 使针穿过组织
  B-C   伸出     伸出 闭合 打开 置于接合针的位置
  B-C   伸出     伸出 闭合 闭合 两个缝合针钩接合针
  C   伸出     伸出 打开 闭合 接合针的远端，松开针的近端
  D   缩回     伸出 打开 闭合 缝合针钩9开始越过组织
  D   缩回     伸出 打开 闭合 将针拉过组织的剩余路线
  D-E   伸出     伸出 打开 闭合 置于接合针的位置
  D-E   伸出     伸出 闭合 闭合 两个缝合针钩接合针
  F   伸出     伸出 闭合 打开 接合针的近端，松开针的远端
  A   伸出     缩回 闭合 打开 缝合针钩10开始越过组织
在此的公开包括使用所述半自动缝合设备的方法。在一个实施例中，本发明的半自动缝合设备可以通过缝合循环的各独立阶段进行操作，如图2所示。缝合针可以在臂9和10伸出时装载，两个缝合针钩最初均打开，接着交替地，一个缝合针钩10松开并且其远端臂10缩回，该针可以在设备如图2B所示定位时装载。本领域的技术人员易于认识到，远端臂9、10的纵向位置(即，伸出或缩回)对于针的装载并不是决定性的，几种可能的位置均可以进行缝合针初始的装载。例如，缝合循环以两个远端臂伸出并且缝合针11装载入所述远端臂9、10的缝合针钩9a、10a中开始，称作主远端臂9(另一个远端臂称作次远端臂10)的缝合针钩9a靠近缝合针11的近端接合/夹住与缝合线相连的缝合针。接着，远端臂9、10插入缝合区域，从而缝合针11的远尖端靠近要缝合的组织12。在一些实施例中，半自动缝合设备可以位于手术腔内，接合缝合设备的两个夹子以保护针不接触组织或防止与组织意外接触在夹子中的错位。接下来，次远端臂10缩回，如图2B所示(尽管次远端臂10可在装载缝合针11或将设备插入缝合区域之前缩回)，并且启动径向驱动器以使两个远端臂9、10沿所使用的缝合针11的长度及形状限定的弧形17转动(如下文所述)，从而使缝合针11的远端刺穿并移动穿过组织12。所述径向驱动器可以将缝合针11移动至任何位置，其中针的远端离开缝合的组织。如上所述对于缺少径向驱动器的实施例或径向驱动器未启动的情况，医生可以手动(physically)转动设备以模仿径向驱动器的行为。接着，次远端臂10伸出，如图2C所示，同时缝合针钩10a打开以接合针。由此，缝合针11通过两个缝合针钩9a/10a与夹子之间的刺穿的组织接合。接下来，主远端臂9的缝合针钩9a打开以释放针。接着，主远端臂9缩回，如图2D所示，并且接合径向驱动器使(或由医生操作使)远端臂9、10再次沿与缝合针11的曲线对应的弧形17转动，直到针离开组织。这种转动使针的近端并且带着缝合线从缝合的组织中拉过。接下来，主远端臂9纵向伸出，同时缝合针钩9a打开，如图2E所示，并且缝合针钩9a在其近端接合缝合针。然后，次远端臂10的缝合针钩10a打开以松开针，并且所述设备的近端从缝合区域拉离以在缝合部11b获得适当的张力。或者，紧接在针穿过组织之后且在针从次缝合针钩10a向主缝合针钩9a传送之前，就可以产生张力，或可以通过摄子或其它工具拉过缝合线以保证产生适当的组织的接近和张力。
所述设备还可以设计为可以引入由外科医生的左手或习惯用左手的外科医生进行的缝合，其中如上所述的臂9和10的作用将相反。
因为要缝合的组织不总是与所述缝合设备可以被引入切口的方向相切，所以所述半自动缝合设备的远端可以安装在铰链或万向架上，因此所述设备可以由外科医生操作变换角度以将缝合定向成与进行缝合要刺穿的组织相切。而且，在一些实施例中，当使缝合针刺穿组织时，可以对所述径向驱动器设定程序产生增强的初始刺穿力，而增强缝合针对于组织的机械性优点。
在这种过程中使用所述半自动缝合设备对于典型的缝合过程具有以下几个优点。例如，因为该设备使医生用一只手就可完成缝合处理，而另一只手使用传统的镊子以固定被缝合的组织，所以提高了进行缝合的精度，并在缝合针11插入过程中减小了对组织的扭曲。而且，所述半自动缝合设备不会失去对缝合针的物理控制。在包括径向驱动器的实施例中，所述设备增加了移动缝合针11通过与缝合针的弧形17相匹配的弧形的精度，从而减小了由被插入并穿过的缝合针11的力产生在组织12上的扭曲力。而且，在利用径向驱动器以移动缝合针11的实施例中，转动速率可以改变。换言之，当缝合针刺穿组织时，可以通过程序界面5对所述设备设定程序从而以设定的恒定速推动缝合针11或提供增大的初始刺穿力，从而增大缝合针11进入组织12的能力，并同时最小化因其插入而产生的组织扭曲。可以对缝合针通过其弧形行进的距离准确地设定程序以确保针穿过组织最长的行进距离，从而保护组织不受由前进得太远的缝合针钩9a产生的来自缝合针钩9a的压力引起的应力的影响。
在本发明的一些实施例中，径向驱动器使远端臂9、10沿由所述缝合针的弧形限定的弧形17行进，如图3所示。该弧形围绕所述设备的纵向中心居中，而本发明的另一些实施例将该弧形17的中心设置在所述设备纵向中心以外的特定位置。换言之，该弧形的中心可以偏离所述设备的中心。但该弧形17的中心和所述缝合针的尺寸仍然可以对所述远端臂9、10要行进的径向路径进行限定或设定参数。
要行进的弧形17由所述缝合针11的曲线限定，因为各缝合针具有穿过缝合组织的最佳路径或轨迹，其与所述针的弧形或形状直接相关。图4示出了本发明的设备的远端臂的纵向视图。最佳的，所述缝合针11的轨迹将沿与所述缝合针的弧形一致的弧形行进(至少对于具有一定弧形的缝合针，所述弧形表示圆的一部分并且针的弧形中的转动中心由圆的半径长度限定)。如果缝合针11沿所述弧形17移动，所述组织和所述针之间的交叉区域应当靠近弧形17和切向量之间的切点31，其中切向量与缝合针钩9a、10a的内表面相匹配，从而减小或最小化当缝合针刺穿或穿过所述组织时由缝合针产生的拉力或扭曲力。
所述设备和具有两个臂的现有技术之间的一个显著的区别在于所述设备的针夹住部分的构造。所述设备夹住所述针的曲线，所述设备在其特定的弧形牢固地保持针。现有技术的设备从一侧到另一侧而夹住针，该设备使针在最小的组织压力作用下从其弧形偏移。即使所述针沿其弧形被精确地驱动，组织的阻力将易于使针与持针器的钳夹相关联地移动，这将使针沿不同于所述针的弧形的其它路径前进，这样，这对于现有技术的设备是相当可能的(所述设备优于现有设备仅有一个优点)。
大多数缝合针由反映圆的弧形的曲线限定，并且缝合针的长度通常为3/8或1/2的圆周。但是，因为可以使用多种形状和尺寸的缝合针，本发明的半自动缝合设备可以调节构造以适合多种不同的针。可以使用横向驱动器和径向驱动器将远端臂9、10置于笛卡儿坐标系中的任何必要的位置，如图5和图6所示。换言之，可以使用横向驱动器将远端臂9、10置于由所使用的缝合针确定的沿所述弧形预定的位置上，同时径向驱动器同样可以将远端臂9、10置于沿所述弧形的任意点上。例如，在图6中，如果所述缝合针11的弧形是圆或大于180度，远端臂9、10可以被置于所述弧形上相互成180度角并与转动中心8等距离的位置上。或者，如果缝合针11自身的弧形小于180度，所述径向驱动器可以将远端臂9、10置于沿所述弧形小于180度间隔的位置上以使所述远端臂9、10与所述针配合。或者有利地，可以使用弧形略大于180度的缝合针，其中远端臂可以置于沿大于180度间隔的弧形的位置上。
本发明的半自动缝合设备还可以与具有与圆形不同的椭圆或非圆形状的缝合针一起使用。在这些情况时，远端臂9、10将通过径向驱动器和横向驱动器置于沿由缝合针11限定的椭圆弧形上。这时，在转动过程中所述径向驱动器和横向驱动器共同作用以连续调节两个远端臂9、10的笛卡儿坐标，从而使远端臂保持在椭圆弧形上。当缝合针11缝合组织时，因为缝合针11最小化对组织的横向或远端拉力及扭曲，因此期望将缝合针11经过模仿所述针(圆或椭圆)的弧形17穿过组织12。
在一些实施例中，缝合针钩转动以与针的弧形相匹配。换言之，当使用弧形大于或小于180度的针时，不仅移动远端臂配合针的弧形，而且还转动缝合针钩以配合所述针的弧形，如图6所示。例如，在本发明的一些实施例中，可不必考虑所述远端臂的径向位置，而对远端臂9、10远端的缝合针钩9a、10a径向地定位，这样可以独立地调节远端臂的x-y位置、远端臂的长度以及远端臂的转动。这种特性使缝合针钩9a、10a置于抓紧缝合针11的优化的位置，而不必考虑所使用的缝合针。图4显示了由各钳夹26的内表面限定的缝合针钩9a、10a的平分向量形成与由所述缝合针自身限定的弧形大致相切的线。在有些实施例中，切向量32和由所使用的缝合针11限定的弧形之间接触的切点31在缝合针钩9a、10a的中心。因此，缝合针钩9a、10a相对远端臂9、10的径向位置为使各钩以使由钩的内表面限定的切向量32与由缝合针限定的弧形在切点31交叉的方式定位。当缝合针11仅通过一个远端臂9、10抓紧时，切点31在缝合针钩9a、10a中心的定位增强了使缝合针11保持适当定位的能力。
然而，本发明的另一些实施例可以使切点31置于非缝合针钩9a、10a的中心的缝合针钩9a、10a中的位置。本领域的技术人员将认识到缝合针钩9a、10a(或在这方面的远端臂9、10)偏离上述位置的细微变化仍然会使所述设备良好地发挥作用，尤其是在考虑到许多组织具有足够的弹性适应缝合针的不当定位。换言之，缝合针11位置或轨迹的微小至中等的偏离不足以损害本发明的功能或实用性，并由此应该在本发明的范围内。
本发明的一些实施例提供的半自动缝合设备可以自动调节远端臂9、10和缝合针钩9a、10a以及基于要使用的特定缝合针而转动的弧形的位置。所述设备可以具有对应各种单个缝合针的多程序设定。例如，在一些实施例中，医生可以通过程序界面5对要使用的缝合针简单地输入产品号，或其它独特的标识，并且所述设备将基于存储的有关缝合针的信息自动采用恰当的构造，从而使所述设备沿恰当的弧形推进缝合针，刺穿组织并全部穿过其长度。这种程序设计可以包含在所述设备中并且可以具有直接输入识别缝合针数据的装置。另一些实施例设置有所述设备的外部程序，诸如通过程序界面5将设备连接至电脑或其它程序装置，从而将需要的构造传送至所述设备。在具有椭圆弧形的缝合针的情况时，可以使用程序界面5输入运行轨迹或座标设置以及缝合针钩的位置，这些对于使所述设备沿指定的弧形移动缝合针是需要的。
位于远端臂9、10的远端上的缝合针钩9a、10a可以是适于抓紧缝合针11的任何设计。本领域普通技术人员应当理解多种机构可以用于固定缝合针。因此，术语缝合针钩表示包括所有的这些机构。例如，如图7所示，缝合针钩9a、10a可以包括一对钳夹26，其与镊子或普通的持针器相似。所述钳夹可以附连至钩控制致动器21，其能够相对远端臂9、10的滑动部分20a进行纵向地操作。钩控制致动器21相对远端臂9、10的滑动部分20a向近端的移动可以使连接两个钳夹26的绞链28通过由远端臂9、10的滑动部分20a的内表面沿所述钳夹26的长度纵向施加在钳夹外表面上的机械力而闭合。在一些实施例中，为获得更多机械性优点所述设备可以包含单作用绞链或双作用绞链机构，或其它设计成能够确保抓紧缝合针的机构。在另一些实施例中，例如如图7所示，缝合针钩包括连接至钩控制致动器22的固定钳夹29和连接至钩控制致动器23的活动钳夹30。所述实施例使固定钳夹致动器22保持在一位置上，而具有角部分的活动钳夹30从所述设备的壳体1向远端移动，从而所述角通过在活动钳夹30和固定钳夹29之间扣住缝合针而抓住缝合针。而且，在有些实施例中，钳夹可以具有限定保持缝合针的位置的凹槽，以在钳夹和针之间提供优化的定向。这种凹槽可以形成符合要抓紧的缝合针的截面构造的形状，以进一步确保缝合针恰当的定向。
本发明的半自动缝合设备的一些实施例进一步能够使医生控制缝合过程的每个步骤。位于壳体上的一套控制器2-4(一个或多个控制器)可以被赋予多个相关的或独立的功能。例如，在一实施例中，在缝合的整个步骤中(其中单个步骤指任何特定的运动，如远端臂9、10的转动，远端臂9、10的伸出或缩回，或者缝合针钩9a、10a的接合或松开)，控制器2可以向前移动所述设备，而另一控制器4在缝合的整个步骤中可以向后移动所述设备，第三控制器3可以提供紧急制动。在其它的实施例中，可以使两个或多个步骤相关联以在启动单一控制器时按顺序出现。例如，一次输入可以使远端臂9、10伸出，之后进行其缝合针钩9a、10a的接合。在另一些实施例中，所述设备可以具有控制器2-4，其作为可以在任意方向上被触发的紧急松开装置以选择性松开任一个钳夹，或按下该紧急松开装置以同时松开两个钳夹。所述设备的其它实施例提供用于控制给定远端臂的伸出和缩回、特定的缝合针钩的打开和闭合以及远端臂向前和向后的转动的单独的控制器2-4。本发明的其它实施例还可以提供比上述多或少的控制器，并且本领域的技术人员将易于认识到这些控制器的多种构造通过缝合过程的必要步骤就足以操作所述设备。
所述设备的电源可以是内部的，其包含在设备内并由电池或可充电的电源供电；或者电源可以是外部的，其连接至外部电源。
最后，在此公开的半自动缝合设备可以由医生的手持握而手动地使用，或所述设备可以安装在用于内窥镜手术的自动控制的长臂端部(其长臂由医生持握)，或者由机器人控制长臂的位置而自动地使用。如果被自动地控制，缝合针的行进速度也可以由机器人控制而使组织的扭曲最小。

Claims (22)

1.一种用于缝合身体组织的半自动设备，包括：
壳体；
至少两个远端臂，所述远端臂连接至所述壳体并从所述壳体向远端伸出，其中，所述至少两个远端臂可独立伸出和缩回；
缝合针钩，所述缝合针钩连接至所述至少两个远端臂中的每个臂的远端，其中，所述缝合针钩可垂直于其所连接的远端臂的纵轴线沿径向转动；以及
至少一个控制器，所述控制器可操作以控制所述至少两个远端臂的伸出或缩回、所述缝合钩的转动以及所述缝合针钩的打开和闭合的至少一部分。
2.如权利要求1所述的半自动设备，进一步包括径向驱动器，所述径向驱动器使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
3.如权利要求2所述的半自动设备，其中，所述径向驱动器可以被所述至少一个控制器启动和停止。
4.如权利要求2所述的半自动设备，其中，所述径向驱动器是以预定的持续速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
5.如权利要求2所述的半自动设备，其中，所述径向驱动器是以可变速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
6.如权利要求1所述的半自动设备，进一步包括：
横向驱动器，所述横向驱动器从所述壳体向近端和远端伸出和缩回所述至少两个远端臂；以及
纵向驱动器，所述纵向驱动器从所述壳体的纵向中心向近端和远端移动所述至少两个远端臂，并关于所述至少两个远端臂的纵向中心转动所述至少两个远端臂。
7.如权利要求6所述的半自动设备，进一步包括：程序界面，其中，所述程序界面可以用于存储所述半自动设备中的设置，所述设置指导通过横向驱动器确定的所述至少两个远端臂的横向定位，以及通过纵向驱动器确定的缝合针钩的径向角度，以与预定缝合针的弧形相匹配。
8.如权利要求1所述的半自动设备，进一步包括：
横向驱动器，所述横向驱动器从所述壳体向近端和远端伸出和缩回所述至少两个远端臂；
纵向驱动器，所述纵向驱动器从所述壳体的纵向中心向近端和远端移动所述至少两个远端臂，并关于所述至少两个远端臂的纵向中心转动所述至少两个远端臂；以及
径向驱动器，所述径向驱动器使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
9.如权利要求8所述的半自动设备，进一步包括：程序界面，其中，所述程序界面可以用于存储所述半自动设备中的设置，所述设置指导通过横向驱动器确定的所述至少两个远端臂的横向定位，以及通过纵向驱动器确定的缝合针钩的径向角度，以与预定缝合针的弧形相匹配。
10.如权利要求9所述的半自动设备，其中，所述缝合针的弧形不是圆形的。
11.如权利要求9所述的半自动设备，其中，所述径向驱动器能够通过所述至少一个控制器被启动和停止。
12.如权利要求9所述的半自动设备，其中，所述径向驱动器是以预定的持续速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
13.如权利要求9所述的半自动设备，其中，所述径向驱动器是以可变速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
14.如权利要求9所述的半自动设备，其中，所述至少两个远端臂被安装在万向架上，所述万向架允许所述至少两个远端臂以可变角度偏离所述壳体的纵轴线。
15.如权利要求1所述的半自动设备，进一步包括：自动臂所用的附件。
16.一种采用半自动缝合设备缝合组织的方法，包括：
提供权利要求1的半自动设备，其中，所述权利要求1的半自动缝合设备具有两个远端臂，以及
使用所述至少一个控制器来指导：
通过连接至一个所述远端臂的所述可转动缝合针钩扣住缝合针；
另一所述远端臂向所述壳体缩回，接着在所述缝合针的远端穿过要被缝合组织之后另一所述远端臂伸出；
通过连接至目前伸出的所述另一远端臂的可转动的缝合针钩扣住缝合针；
使所述缝合针从所述第一远端臂的可转动缝合针钩上释放，以接合所述针，接着所述第一远端臂向所述壳体近端缩回。
17.如权利要求16所述的方法，其中，所述权利要求1的半自动设备进一步包括：
横向驱动器，所述横向驱动器从所述壳体向近端和远端伸出和缩回所述至少两个远端臂；
纵向驱动器，所述纵向驱动器从所述壳体的纵向中心向近端或远端移动所述至少两个远端臂，并关于所述至少两个远端臂的纵向中心转动所述至少两个远端臂；以及
径向驱动器，所述径向驱动器使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
18.如权利要求17所述的半自动设备，进一步包括：程序界面，其中，所述程序界面可以用于存储在所述半自动设备中的或者存储于程序设计设备中的设置，所述设置指导通过所述横向驱动器确定的所述至少两个远端臂的横向定位，以及通过纵向驱动器确定的缝合针钩的径向角度，以与预定的缝合针的弧形相匹配。
19.如权利要求18所述的半自动设备，其中，所述径向驱动器能够通过所述至少一个控制器被启动和停止。
20.如权利要求19所述的半自动设备，其中，所述径向驱动器是以预定的持续速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
21.如权利要求19所述的半自动设备，其中，所述径向驱动器是以可变速率使所述至少两个远端臂围绕所述壳体的纵轴线沿径向转动。
22.一种半自动缝合设备，包括：
壳体；
至少两个缝合钩臂，所述缝合钩臂从所述壳体向远端伸出，其中，所述至少两个缝合钩臂包括缝合钩机构；
用于控制所述钩机构相对于所述缝合钩臂的径向角度的装置；
用于控制从可缩回的主钩臂或可缩回的次钩臂的柄部独立向远端伸出或向所述柄部近端独立缩回的装置；
用于通过所述可缩回的主钩臂的钩机构或所述可缩回的次钩臂的钩机构独立地控制扣住缝合针的装置。
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Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102293672A (zh) * 2005-09-14 2011-12-28 雷菲斯医药公司 缝合装置、系统及方法
CN107582119A (zh) * 2017-10-19 2018-01-16 中国人民解放军第三军医大学第二附属医院 一种带导引装置的医用电动缝合器及导引方法
US9986995B2 (en) 2005-09-14 2018-06-05 Boss Instruments, Ltd., Inc. Replaceable tip suturing devices, system, and methods for use with differing needles
CN108852509A (zh) * 2018-05-18 2018-11-23 陈光鑫 一种新型手足显微外科医疗器械夹具
CN113768565A (zh) * 2021-10-08 2021-12-10 巢湖市宾雄医疗器械有限公司 一种医用缝合针便携存放拿取装置及其存放方法
US11337690B2 (en) 2011-06-08 2022-05-24 Boss Instruments, Ltd., Inc. Offset jaw suturing device, system, and methods

Families Citing this family (353)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6241747B1 (en) 1993-05-03 2001-06-05 Quill Medical, Inc. Barbed Bodily tissue connector
US8795332B2 (en) 2002-09-30 2014-08-05 Ethicon, Inc. Barbed sutures
US5931855A (en) 1997-05-21 1999-08-03 Frank Hoffman Surgical methods using one-way suture
US7056331B2 (en) 2001-06-29 2006-06-06 Quill Medical, Inc. Suture method
US6848152B2 (en) * 2001-08-31 2005-02-01 Quill Medical, Inc. Method of forming barbs on a suture and apparatus for performing same
US6773450B2 (en) 2002-08-09 2004-08-10 Quill Medical, Inc. Suture anchor and method
US20040088003A1 (en) 2002-09-30 2004-05-06 Leung Jeffrey C. Barbed suture in combination with surgical needle
US8100940B2 (en) 2002-09-30 2012-01-24 Quill Medical, Inc. Barb configurations for barbed sutures
US7624487B2 (en) 2003-05-13 2009-12-01 Quill Medical, Inc. Apparatus and method for forming barbs on a suture
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US7960935B2 (en) 2003-07-08 2011-06-14 The Board Of Regents Of The University Of Nebraska Robotic devices with agent delivery components and related methods
SG164370A1 (en) 2004-05-14 2010-09-29 Quill Medical Inc Suture methods and devices
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
US7850683B2 (en) 2005-05-20 2010-12-14 Myoscience, Inc. Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat)
US7713266B2 (en) 2005-05-20 2010-05-11 Myoscience, Inc. Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat)
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US9579088B2 (en) 2007-02-20 2017-02-28 Board Of Regents Of The University Of Nebraska Methods, systems, and devices for surgical visualization and device manipulation
US8679096B2 (en) 2007-06-21 2014-03-25 Board Of Regents Of The University Of Nebraska Multifunctional operational component for robotic devices
CA2655964C (en) 2006-06-22 2014-10-28 Board Of Regents Of The University Of Nebraska Magnetically coupleable robotic devices and related methods
US8974440B2 (en) 2007-08-15 2015-03-10 Board Of Regents Of The University Of Nebraska Modular and cooperative medical devices and related systems and methods
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
EP2083727B1 (en) * 2006-10-05 2013-12-11 Covidien LP Flexible endoscopic stitching devices
US9254162B2 (en) 2006-12-21 2016-02-09 Myoscience, Inc. Dermal and transdermal cryogenic microprobe systems
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
US8540128B2 (en) 2007-01-11 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling device with a curved end effector
US8409185B2 (en) 2007-02-16 2013-04-02 Myoscience, Inc. Replaceable and/or easily removable needle systems for dermal and transdermal cryogenic remodeling
US20080255612A1 (en) * 2007-04-13 2008-10-16 Angiotech Pharmaceuticals, Inc. Self-retaining systems for surgical procedures
US11857181B2 (en) 2007-06-04 2024-01-02 Cilag Gmbh International Robotically-controlled shaft based rotary drive systems for surgical instruments
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US9211119B2 (en) 2007-07-03 2015-12-15 Ceterix Orthopaedics, Inc. Suture passers and methods of passing suture
US9861354B2 (en) 2011-05-06 2018-01-09 Ceterix Orthopaedics, Inc. Meniscus repair
US10441273B2 (en) 2007-07-03 2019-10-15 Ceterix Orthopaedics, Inc. Pre-tied surgical knots for use with suture passers
US9314234B2 (en) 2007-07-03 2016-04-19 Ceterix Orthopaedics, Inc. Pre-tied surgical knots for use with suture passers
US8911456B2 (en) 2007-07-03 2014-12-16 Ceterix Orthopaedics, Inc. Methods and devices for preventing tissue bridging while suturing
US20100130990A1 (en) * 2007-07-03 2010-05-27 Saliman Justin D Methods of suturing and repairing tissue using a continuous suture passer device
US8702731B2 (en) 2007-07-03 2014-04-22 Ceterix Orthopaedics, Inc. Suturing and repairing tissue using in vivo suture loading
US8465505B2 (en) 2011-05-06 2013-06-18 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US8663253B2 (en) * 2007-07-03 2014-03-04 Ceterix Orthopaedics, Inc. Methods of meniscus repair
US8500809B2 (en) 2011-01-10 2013-08-06 Ceterix Orthopaedics, Inc. Implant and method for repair of the anterior cruciate ligament
EP3673855B1 (en) 2007-07-12 2021-09-08 Board of Regents of the University of Nebraska Systems of actuation in robotic devices
BRPI0701767A2 (pt) * 2007-07-20 2009-03-10 Marcial Trilha Jr sistema de sutura remotamente operado
JP2010536435A (ja) 2007-08-15 2010-12-02 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ 医療用膨張、取り付けおよび送達装置、ならびに関連する方法
WO2009042841A2 (en) 2007-09-27 2009-04-02 Angiotech Pharmaceuticals, Inc. Self-retaining sutures including tissue retainers having improved strength
WO2009061504A1 (en) * 2007-11-05 2009-05-14 Revolutionary Surgical Device, Llc Suture passing instrument and method
US8298216B2 (en) 2007-11-14 2012-10-30 Myoscience, Inc. Pain management using cryogenic remodeling
EP2222233B1 (en) 2007-12-19 2020-03-25 Ethicon, LLC Self-retaining sutures with heat-contact mediated retainers
US8916077B1 (en) 2007-12-19 2014-12-23 Ethicon, Inc. Self-retaining sutures with retainers formed from molten material
US8118834B1 (en) 2007-12-20 2012-02-21 Angiotech Pharmaceuticals, Inc. Composite self-retaining sutures and method
ES2602570T3 (es) * 2008-01-30 2017-02-21 Ethicon Llc Aparato y método para formar suturas de auto-retención
US8615856B1 (en) 2008-01-30 2013-12-31 Ethicon, Inc. Apparatus and method for forming self-retaining sutures
BRPI0901282A2 (pt) 2008-02-14 2009-11-17 Ethicon Endo Surgery Inc instrumento cirúrgico de corte e fixação dotado de eletrodos de rf
EP2249712B8 (en) * 2008-02-21 2018-12-26 Ethicon LLC Method and apparatus for elevating retainers on self-retaining sutures
US8216273B1 (en) 2008-02-25 2012-07-10 Ethicon, Inc. Self-retainers with supporting structures on a suture
US8641732B1 (en) 2008-02-26 2014-02-04 Ethicon, Inc. Self-retaining suture with variable dimension filament and method
US20090228021A1 (en) * 2008-03-06 2009-09-10 Leung Jeffrey C Matrix material
CN102056552B (zh) 2008-04-15 2013-07-03 伊西康有限责任公司 具有双向保持器或单向保持器的自保持缝合线
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
MX339174B (es) 2008-11-03 2016-05-12 Ethicon Llc Longitud de sutura autorretenible y metodo y dispositivo para su uso.
EP2373239B1 (en) 2008-12-22 2013-08-14 Myoscience, Inc. Integrated cryosurgical system with refrigerant and electrical power source
WO2010083110A1 (en) * 2009-01-16 2010-07-22 Rhaphis Medical, Inc. Surgical suturing latch
US8696690B2 (en) * 2009-09-01 2014-04-15 Luis Jose Almodovar Continuous driver with changeable parameters
JP5719374B2 (ja) 2009-11-09 2015-05-20 セテリックス オーソピーディクス インコーポレイテッド 半月板を修復するためのデバイス、システム、及び方法
US11744575B2 (en) 2009-11-09 2023-09-05 Ceterix Orthopaedics, Inc. Suture passer devices and methods
US9011454B2 (en) 2009-11-09 2015-04-21 Ceterix Orthopaedics, Inc. Suture passer with radiused upper jaw
US9848868B2 (en) 2011-01-10 2017-12-26 Ceterix Orthopaedics, Inc. Suture methods for forming locking loops stitches
US8894633B2 (en) 2009-12-17 2014-11-25 Board Of Regents Of The University Of Nebraska Modular and cooperative medical devices and related systems and methods
WO2011090628A2 (en) 2009-12-29 2011-07-28 Angiotech Pharmaceuticals, Inc. Bidirectional self-retaining sutures with laser-marked and/or non-laser marked indicia and methods
CA2798373C (en) 2010-05-04 2018-10-23 Ethicon, Llc Self-retaining systems having laser-cut retainers
EP3155978B1 (en) 2010-06-11 2022-04-13 Cilag GmbH International Suture delivery tools for endoscopic and robot-assisted surgery
JP2014529414A (ja) 2010-08-06 2014-11-13 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ 自然開口部手術用材料の取扱または送達のための方法およびシステム
US9282962B2 (en) 2010-09-30 2016-03-15 Ethicon Endo-Surgery, Llc Adhesive film laminate
US11849952B2 (en) 2010-09-30 2023-12-26 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
WO2012061658A2 (en) 2010-11-03 2012-05-10 Angiotech Pharmaceuticals, Inc. Drug-eluting self-retaining sutures and methods relating thereto
US9675341B2 (en) 2010-11-09 2017-06-13 Ethicon Inc. Emergency self-retaining sutures and packaging
US9913638B2 (en) 2011-01-10 2018-03-13 Ceterix Orthopaedics, Inc. Transosteal anchoring methods for tissue repair
JP6125488B2 (ja) 2011-03-23 2017-05-10 エシコン・エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 自己保持可変ループ縫合材
CA2834649C (en) 2011-04-29 2021-02-16 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples positioned within a compressible portion thereof
US20130172931A1 (en) 2011-06-06 2013-07-04 Jeffrey M. Gross Methods and devices for soft palate tissue elevation procedures
CA2838637C (en) 2011-06-10 2020-11-17 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to surgical end effectors
CA3082073C (en) 2011-07-11 2023-07-25 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems, and related methods
US10524778B2 (en) 2011-09-28 2020-01-07 Ceterix Orthopaedics Suture passers adapted for use in constrained regions
CA2860754C (en) 2012-01-10 2020-12-29 Shane Farritor Methods, systems, and devices for surgical access and insertion
US9314290B2 (en) 2012-01-13 2016-04-19 Myoscience, Inc. Cryogenic needle with freeze zone regulation
US9241753B2 (en) 2012-01-13 2016-01-26 Myoscience, Inc. Skin protection for subdermal cryogenic remodeling for cosmetic and other treatments
EP2802278B1 (en) 2012-01-13 2016-12-07 Myoscience, Inc. Cryogenic probe filtration system
US9017318B2 (en) 2012-01-20 2015-04-28 Myoscience, Inc. Cryogenic probe system and method
BR112014024098B1 (pt) 2012-03-28 2021-05-25 Ethicon Endo-Surgery, Inc. cartucho de grampos
BR112014024102B1 (pt) 2012-03-28 2022-03-03 Ethicon Endo-Surgery, Inc Conjunto de cartucho de prendedores para um instrumento cirúrgico, e conjunto de atuador de extremidade para um instrumento cirúrgico
US9498292B2 (en) 2012-05-01 2016-11-22 Board Of Regents Of The University Of Nebraska Single site robotic device and related systems and methods
US11871901B2 (en) 2012-05-20 2024-01-16 Cilag Gmbh International Method for situational awareness for surgical network or surgical network connected device capable of adjusting function based on a sensed situation or usage
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
EP3424651B1 (en) 2012-06-22 2020-02-12 Board of Regents of the University of Nebraska Local control robotic surgical devices
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9770305B2 (en) 2012-08-08 2017-09-26 Board Of Regents Of The University Of Nebraska Robotic surgical devices, systems, and related methods
JP2015526171A (ja) 2012-08-08 2015-09-10 ボード オブ リージェンツ オブ ザ ユニバーシティ オブ ネブラスカ ロボット手術用デバイス、システム及び関連の方法
CN104736074B (zh) * 2012-11-14 2018-05-25 直观外科手术操作公司 用于双控制手术器械的系统和方法
CA2905948C (en) 2013-03-14 2022-01-11 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to robotic surgical devices, end effectors, and controllers
US9888966B2 (en) 2013-03-14 2018-02-13 Board Of Regents Of The University Of Nebraska Methods, systems, and devices relating to force control surgical systems
US10667883B2 (en) 2013-03-15 2020-06-02 Virtual Incision Corporation Robotic surgical devices, systems, and related methods
CN105208954B (zh) 2013-03-15 2019-06-04 肌肉科技股份有限公司 低温钝性解剖方法和设备
US10016229B2 (en) 2013-03-15 2018-07-10 Myoscience, Inc. Methods and systems for treatment of occipital neuralgia
US9295512B2 (en) 2013-03-15 2016-03-29 Myoscience, Inc. Methods and devices for pain management
US9610112B2 (en) 2013-03-15 2017-04-04 Myoscience, Inc. Cryogenic enhancement of joint function, alleviation of joint stiffness and/or alleviation of pain associated with osteoarthritis
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
EP3021779A4 (en) 2013-07-17 2017-08-23 Board of Regents of the University of Nebraska Robotic surgical devices, systems and related methods
US20150053746A1 (en) * 2013-08-23 2015-02-26 Ethicon Endo-Surgery, Inc. Torque optimization for surgical instruments
US9247935B2 (en) 2013-09-23 2016-02-02 Ceterix Orthopaedics, Inc. Arthroscopic knot pusher and suture cutter
EP3065658B1 (en) 2013-11-05 2021-03-31 Pacira CryoTech, Inc. Secure cryosurgical treatment system
WO2015095133A1 (en) 2013-12-16 2015-06-25 Ceterix Orthopaedics, Inc. Automatically reloading suture passer devices having pre-tied knots and methods
EP3082635B1 (en) 2013-12-18 2022-05-04 Covidien LP Electrosurgical end effectors
EP2929841B1 (en) 2014-04-08 2017-11-15 Ceterix Orthopaedics, Inc. Suture passers adapted for use in constrained regions
JP6636452B2 (ja) 2014-04-16 2020-01-29 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 異なる構成を有する延在部を含む締結具カートリッジ
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
JP6532889B2 (ja) 2014-04-16 2019-06-19 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 締結具カートリッジ組立体及びステープル保持具カバー配置構成
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US10111679B2 (en) 2014-09-05 2018-10-30 Ethicon Llc Circuitry and sensors for powered medical device
US10342561B2 (en) 2014-09-12 2019-07-09 Board Of Regents Of The University Of Nebraska Quick-release end effectors and related systems and methods
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11504192B2 (en) 2014-10-30 2022-11-22 Cilag Gmbh International Method of hub communication with surgical instrument systems
CA2967593C (en) 2014-11-11 2024-02-27 Board Of Regents Of The University Of Nebraska Robotic device with compact joint design and related systems and methods
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
MX2017008108A (es) 2014-12-18 2018-03-06 Ethicon Llc Instrumento quirurgico con un yunque que puede moverse de manera selectiva sobre un eje discreto no movil con relacion a un cartucho de grapas.
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
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
US10226245B2 (en) 2015-07-21 2019-03-12 Ceterix Orthopaedics, Inc. Automatically reloading suture passer devices that prevent entanglement
WO2017024081A1 (en) 2015-08-03 2017-02-09 Board Of Regents Of The University Of Nebraska Robotic surgical devices systems and related methods
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10285699B2 (en) 2015-09-30 2019-05-14 Ethicon Llc Compressible adjunct
US10405853B2 (en) 2015-10-02 2019-09-10 Ceterix Orthpaedics, Inc. Knot tying accessory
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US11311327B2 (en) 2016-05-13 2022-04-26 Pacira Cryotech, Inc. Methods and systems for locating and treating nerves with cold therapy
EP4353182A2 (en) 2016-05-18 2024-04-17 Virtual Incision Corporation Robotic surgical devices and systems
US11173617B2 (en) 2016-08-25 2021-11-16 Board Of Regents Of The University Of Nebraska Quick-release end effector tool interface
EP3507065A4 (en) 2016-08-30 2020-04-29 Board of Regents of the University of Nebraska ROBOTIC DEVICE HAVING COMPACT ARTICULATION DESIGN AND ADDITIONAL DEGREE OF FREEDOM, AND RELATED SYSTEMS AND METHODS
US11357595B2 (en) 2016-11-22 2022-06-14 Board Of Regents Of The University Of Nebraska Gross positioning device and related systems and methods
EP3548773A4 (en) 2016-11-29 2020-08-05 Virtual Incision Corporation USER CONTROL DEVICE WITH USER PRESENCE DETECTION AND ASSOCIATED SYSTEMS AND PROCEDURES
US10722319B2 (en) 2016-12-14 2020-07-28 Virtual Incision Corporation Releasable attachment device for coupling to medical devices and related systems and methods
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
JP7010956B2 (ja) 2016-12-21 2022-01-26 エシコン エルエルシー 組織をステープル留めする方法
US11090048B2 (en) 2016-12-21 2021-08-17 Cilag Gmbh International Method for resetting a fuse of a surgical instrument shaft
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US11484310B2 (en) 2017-06-28 2022-11-01 Cilag Gmbh International Surgical instrument comprising a shaft including a closure tube profile
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
CA3076625A1 (en) 2017-09-27 2019-04-04 Virtual Incision Corporation Robotic surgical devices with tracking camera technology and related systems and methods
US10932804B2 (en) 2017-10-30 2021-03-02 Ethicon Llc Surgical instrument with sensor and/or control systems
US11291510B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11801098B2 (en) 2017-10-30 2023-10-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11026687B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Clip applier comprising clip advancing systems
US11116485B2 (en) 2017-10-30 2021-09-14 Cilag Gmbh International Surgical instrument with modular power sources
US11229436B2 (en) 2017-10-30 2022-01-25 Cilag Gmbh International Surgical system comprising a surgical tool and a surgical hub
US11311342B2 (en) 2017-10-30 2022-04-26 Cilag Gmbh International Method for communicating with surgical instrument systems
US11564756B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11510741B2 (en) 2017-10-30 2022-11-29 Cilag Gmbh International Method for producing a surgical instrument comprising a smart electrical system
US11129636B2 (en) 2017-10-30 2021-09-28 Cilag Gmbh International Surgical instruments comprising an articulation drive that provides for high articulation angles
US11317919B2 (en) 2017-10-30 2022-05-03 Cilag Gmbh International Clip applier comprising a clip crimping system
WO2019089305A1 (en) * 2017-10-30 2019-05-09 Ethicon Llc Surgical suturing instrument configured to manipulate tissue using mechanical and electrical power
US11911045B2 (en) 2017-10-30 2024-02-27 Cllag GmbH International Method for operating a powered articulating multi-clip applier
EP3476305B1 (en) * 2017-10-30 2022-09-21 Ethicon LLC Adaptive control programs for a surgical system comprising more than one type of cartridge
US11129634B2 (en) 2017-10-30 2021-09-28 Cilag Gmbh International Surgical instrument with rotary drive selectively actuating multiple end effector functions
US11134998B2 (en) 2017-11-15 2021-10-05 Pacira Cryotech, Inc. Integrated cold therapy and electrical stimulation systems for locating and treating nerves and associated methods
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US11179152B2 (en) 2017-12-21 2021-11-23 Cilag Gmbh International Surgical instrument comprising a tissue grasping system
US11234756B2 (en) 2017-12-28 2022-02-01 Cilag Gmbh International Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter
US11147607B2 (en) 2017-12-28 2021-10-19 Cilag Gmbh International Bipolar combination device that automatically adjusts pressure based on energy modality
US20190201118A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Display arrangements for robot-assisted surgical platforms
US11069012B2 (en) 2017-12-28 2021-07-20 Cilag Gmbh International Interactive surgical systems with condition handling of devices and data capabilities
US10695081B2 (en) 2017-12-28 2020-06-30 Ethicon Llc Controlling a surgical instrument according to sensed closure parameters
US10987178B2 (en) 2017-12-28 2021-04-27 Ethicon Llc Surgical hub control arrangements
US11266468B2 (en) 2017-12-28 2022-03-08 Cilag Gmbh International Cooperative utilization of data derived from secondary sources by intelligent surgical hubs
US11096693B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing
US11744604B2 (en) 2017-12-28 2023-09-05 Cilag Gmbh International Surgical instrument with a hardware-only control circuit
US11576677B2 (en) 2017-12-28 2023-02-14 Cilag Gmbh International Method of hub communication, processing, display, and cloud analytics
US11051876B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Surgical evacuation flow paths
US11857152B2 (en) 2017-12-28 2024-01-02 Cilag Gmbh International Surgical hub spatial awareness to determine devices in operating theater
US11464559B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Estimating state of ultrasonic end effector and control system therefor
US11612444B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Adjustment of a surgical device function based on situational awareness
US11678881B2 (en) 2017-12-28 2023-06-20 Cilag Gmbh International Spatial awareness of surgical hubs in operating rooms
US11937769B2 (en) 2017-12-28 2024-03-26 Cilag Gmbh International Method of hub communication, processing, storage and display
US11179208B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Cloud-based medical analytics for security and authentication trends and reactive measures
US10943454B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Detection and escalation of security responses of surgical instruments to increasing severity threats
US11273001B2 (en) 2017-12-28 2022-03-15 Cilag Gmbh International Surgical hub and modular device response adjustment based on situational awareness
US11304763B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Image capturing of the areas outside the abdomen to improve placement and control of a surgical device in use
US11311306B2 (en) 2017-12-28 2022-04-26 Cilag Gmbh International Surgical systems for detecting end effector tissue distribution irregularities
US11253315B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Increasing radio frequency to create pad-less monopolar loop
US10758310B2 (en) 2017-12-28 2020-09-01 Ethicon Llc Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US20190200981A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Method of compressing tissue within a stapling device and simultaneously displaying the location of the tissue within the jaws
US11291495B2 (en) 2017-12-28 2022-04-05 Cilag Gmbh International Interruption of energy due to inadvertent capacitive coupling
US11571234B2 (en) 2017-12-28 2023-02-07 Cilag Gmbh International Temperature control of ultrasonic end effector and control system therefor
US11419667B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Ultrasonic energy device which varies pressure applied by clamp arm to provide threshold control pressure at a cut progression location
US11818052B2 (en) 2017-12-28 2023-11-14 Cilag Gmbh International Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11376002B2 (en) 2017-12-28 2022-07-05 Cilag Gmbh International Surgical instrument cartridge sensor assemblies
US11179175B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Controlling an ultrasonic surgical instrument according to tissue location
US11257589B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes
US11304720B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Activation of energy devices
US11559308B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure
US11602393B2 (en) 2017-12-28 2023-03-14 Cilag Gmbh International Surgical evacuation sensing and generator control
US11317937B2 (en) 2018-03-08 2022-05-03 Cilag Gmbh International Determining the state of an ultrasonic end effector
US11903601B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Surgical instrument comprising a plurality of drive systems
US11464535B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Detection of end effector emersion in liquid
US11423007B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Adjustment of device control programs based on stratified contextual data in addition to the data
US11633237B2 (en) 2017-12-28 2023-04-25 Cilag Gmbh International Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures
US11786251B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11666331B2 (en) 2017-12-28 2023-06-06 Cilag Gmbh International Systems for detecting proximity of surgical end effector to cancerous tissue
US10892995B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11132462B2 (en) 2017-12-28 2021-09-28 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11284936B2 (en) 2017-12-28 2022-03-29 Cilag Gmbh International Surgical instrument having a flexible electrode
US11166772B2 (en) 2017-12-28 2021-11-09 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
US20190201039A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Situational awareness of electrosurgical systems
US10849697B2 (en) 2017-12-28 2020-12-01 Ethicon Llc Cloud interface for coupled surgical devices
US11540855B2 (en) 2017-12-28 2023-01-03 Cilag Gmbh International Controlling activation of an ultrasonic surgical instrument according to the presence of tissue
US11056244B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks
US10944728B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Interactive surgical systems with encrypted communication capabilities
US11109866B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Method for circular stapler control algorithm adjustment based on situational awareness
US11202570B2 (en) 2017-12-28 2021-12-21 Cilag Gmbh International Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems
US20190201146A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Safety systems for smart powered surgical stapling
US11446052B2 (en) 2017-12-28 2022-09-20 Cilag Gmbh International Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue
US11786245B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Surgical systems with prioritized data transmission capabilities
US11589888B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Method for controlling smart energy devices
US10966791B2 (en) 2017-12-28 2021-04-06 Ethicon Llc Cloud-based medical analytics for medical facility segmented individualization of instrument function
US11364075B2 (en) 2017-12-28 2022-06-21 Cilag Gmbh International Radio frequency energy device for delivering combined electrical signals
US11308075B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical network, instrument, and cloud responses based on validation of received dataset and authentication of its source and integrity
US11304745B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical evacuation sensing and display
US11045591B2 (en) 2017-12-28 2021-06-29 Cilag Gmbh International Dual in-series large and small droplet filters
US11424027B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Method for operating surgical instrument systems
US11304699B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US20190201139A1 (en) 2017-12-28 2019-07-04 Ethicon Llc Communication arrangements for robot-assisted surgical platforms
US11896322B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub
US11076921B2 (en) 2017-12-28 2021-08-03 Cilag Gmbh International Adaptive control program updates for surgical hubs
US11559307B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method of robotic hub communication, detection, and control
US11896443B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Control of a surgical system through a surgical barrier
US11864728B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Characterization of tissue irregularities through the use of mono-chromatic light refractivity
US11410259B2 (en) 2017-12-28 2022-08-09 Cilag Gmbh International Adaptive control program updates for surgical devices
US11832840B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical instrument having a flexible circuit
US11832899B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical systems with autonomously adjustable control programs
US11026751B2 (en) 2017-12-28 2021-06-08 Cilag Gmbh International Display of alignment of staple cartridge to prior linear staple line
US11432885B2 (en) 2017-12-28 2022-09-06 Cilag Gmbh International Sensing arrangements for robot-assisted surgical platforms
US11324557B2 (en) 2017-12-28 2022-05-10 Cilag Gmbh International Surgical instrument with a sensing array
US10892899B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Self describing data packets generated at an issuing instrument
US11659023B2 (en) 2017-12-28 2023-05-23 Cilag Gmbh International Method of hub communication
US11419630B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Surgical system distributed processing
US10755813B2 (en) 2017-12-28 2020-08-25 Ethicon Llc Communication of smoke evacuation system parameters to hub or cloud in smoke evacuation module for interactive surgical platform
US10932872B2 (en) 2017-12-28 2021-03-02 Ethicon Llc Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set
US11529187B2 (en) 2017-12-28 2022-12-20 Cilag Gmbh International Surgical evacuation sensor arrangements
US11389164B2 (en) 2017-12-28 2022-07-19 Cilag Gmbh International Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices
US11160605B2 (en) 2017-12-28 2021-11-02 Cilag Gmbh International Surgical evacuation sensing and motor control
US11278281B2 (en) 2017-12-28 2022-03-22 Cilag Gmbh International Interactive surgical system
US11100631B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Use of laser light and red-green-blue coloration to determine properties of back scattered light
CN117140580A (zh) 2018-01-05 2023-12-01 内布拉斯加大学董事会 具有紧凑型关节设计的单臂机器人装置及相关系统和方法
US11259830B2 (en) 2018-03-08 2022-03-01 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
US11589915B2 (en) 2018-03-08 2023-02-28 Cilag Gmbh International In-the-jaw classifier based on a model
US11389188B2 (en) 2018-03-08 2022-07-19 Cilag Gmbh International Start temperature of blade
US11259806B2 (en) 2018-03-28 2022-03-01 Cilag Gmbh International Surgical stapling devices with features for blocking advancement of a camming assembly of an incompatible cartridge installed therein
US10973520B2 (en) 2018-03-28 2021-04-13 Ethicon Llc Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature
US11219453B2 (en) 2018-03-28 2022-01-11 Cilag Gmbh International Surgical stapling devices with cartridge compatible closure and firing lockout arrangements
US11096688B2 (en) 2018-03-28 2021-08-24 Cilag Gmbh International Rotary driven firing members with different anvil and channel engagement features
US11278280B2 (en) 2018-03-28 2022-03-22 Cilag Gmbh International Surgical instrument comprising a jaw closure lockout
US11213294B2 (en) 2018-03-28 2022-01-04 Cilag Gmbh International Surgical instrument comprising co-operating lockout features
US11471156B2 (en) 2018-03-28 2022-10-18 Cilag Gmbh International Surgical stapling devices with improved rotary driven closure systems
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
US11090047B2 (en) 2018-03-28 2021-08-17 Cilag Gmbh International Surgical instrument comprising an adaptive control system
AU2019288581A1 (en) 2018-06-20 2021-02-04 Dynamic Suture, Inc. Needle drivers for suturing instruments and methods of manufacture
WO2020081651A1 (en) * 2018-10-16 2020-04-23 Activ Surgical, Inc. Autonomous methods and systems for tying surgical knots
KR102253299B1 (ko) * 2018-12-07 2021-05-20 조선대학교산학협력단 의료용 자동 봉합장치
CA3125742A1 (en) 2019-01-07 2020-07-16 Virtual Incision Corporation Robotically assisted surgical system and related devices and methods
US11317915B2 (en) 2019-02-19 2022-05-03 Cilag Gmbh International Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers
US11291444B2 (en) 2019-02-19 2022-04-05 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a closure lockout
US11357503B2 (en) 2019-02-19 2022-06-14 Cilag Gmbh International Staple cartridge retainers with frangible retention features and methods of using same
US11464511B2 (en) 2019-02-19 2022-10-11 Cilag Gmbh International Surgical staple cartridges with movable authentication key arrangements
US11369377B2 (en) 2019-02-19 2022-06-28 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
USD964564S1 (en) 2019-06-25 2022-09-20 Cilag Gmbh International Surgical staple cartridge retainer with a closure system authentication key
USD950728S1 (en) 2019-06-25 2022-05-03 Cilag Gmbh International Surgical staple cartridge
USD952144S1 (en) 2019-06-25 2022-05-17 Cilag Gmbh International Surgical staple cartridge retainer with firing system authentication key
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11350938B2 (en) 2019-06-28 2022-06-07 Cilag Gmbh International Surgical instrument comprising an aligned rfid sensor
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US20220031320A1 (en) 2020-07-28 2022-02-03 Cilag Gmbh International Surgical instruments with flexible firing member actuator constraint arrangements
US20220047259A1 (en) * 2020-08-13 2022-02-17 Covidien Lp Endoluminal robotic systems and methods for suturing
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments

Family Cites Families (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4635638A (en) * 1984-02-07 1987-01-13 Galil Advanced Technologies Ltd. Power-driven gripping tool particularly useful as a suturing device
JP3419869B2 (ja) * 1993-12-28 2003-06-23 オリンパス光学工業株式会社 医療器具
US5437681A (en) * 1994-01-13 1995-08-01 Suturtek Inc. Suturing instrument with thread management
US5938668A (en) * 1994-10-07 1999-08-17 United States Surgical Surgical suturing apparatus
US5540705A (en) * 1995-05-19 1996-07-30 Suturtek, Inc. Suturing instrument with thread management
US5993466A (en) * 1997-06-17 1999-11-30 Yoon; Inbae Suturing instrument with multiple rotatably mounted spreadable needle holders
US5984932A (en) * 1996-11-27 1999-11-16 Yoon; Inbae Suturing instrument with one or more spreadable needle holders mounted for arcuate movement
US6126665A (en) * 1997-05-01 2000-10-03 Yoon; Inbae Surgical instrument with arcuately movable offset end effectors and method of using the same
US6071283A (en) * 1997-06-06 2000-06-06 Medical Scientific, Inc. Selectively coated electrosurgical instrument
DE69813129T2 (de) * 1997-10-08 2004-02-26 Ethicon Endo-Surgery, Inc., Cincinnati Chirurgischer Nadelhalter als Hilfsvorrichtung beim Nähen
US6206894B1 (en) * 1997-10-09 2001-03-27 Ethicon Endo-Surgery, Inc. Electrically powered needle holder to assist in suturing
CA2260164A1 (en) * 1998-01-23 1999-07-23 Ethicon, Endo-Surgery, Inc. A needle holder to assist in suturing
US6071289A (en) * 1999-03-15 2000-06-06 Ethicon Endo-Surgery, Inc. Surgical device for suturing tissue
JP4014792B2 (ja) * 2000-09-29 2007-11-28 株式会社東芝 マニピュレータ
EP2308391B1 (en) * 2001-06-14 2016-08-31 Endoevolution, Llc Apparatus for surgical suturing with thread management

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102293672A (zh) * 2005-09-14 2011-12-28 雷菲斯医药公司 缝合装置、系统及方法
US8603113B2 (en) 2005-09-14 2013-12-10 Suturenetics, Inc. Suturing device, system, and method
CN102293672B (zh) * 2005-09-14 2016-08-03 雷菲斯医药公司 缝合装置、系统及方法
US9986995B2 (en) 2005-09-14 2018-06-05 Boss Instruments, Ltd., Inc. Replaceable tip suturing devices, system, and methods for use with differing needles
US9993244B2 (en) 2005-09-14 2018-06-12 Boss Instruments, Ltd., Inc. Suturing device, system and method
US11337690B2 (en) 2011-06-08 2022-05-24 Boss Instruments, Ltd., Inc. Offset jaw suturing device, system, and methods
US11439387B2 (en) 2011-06-08 2022-09-13 Boss Instruments, Ltd., Inc. Offset jaw suturing device, system, and methods
CN107582119A (zh) * 2017-10-19 2018-01-16 中国人民解放军第三军医大学第二附属医院 一种带导引装置的医用电动缝合器及导引方法
CN107582119B (zh) * 2017-10-19 2023-08-18 中国人民解放军第三军医大学第二附属医院 一种带导引装置的医用电动缝合器及导引方法
CN108852509A (zh) * 2018-05-18 2018-11-23 陈光鑫 一种新型手足显微外科医疗器械夹具
CN113768565A (zh) * 2021-10-08 2021-12-10 巢湖市宾雄医疗器械有限公司 一种医用缝合针便携存放拿取装置及其存放方法
CN113768565B (zh) * 2021-10-08 2023-04-25 巢湖市宾雄医疗器械有限公司 一种医用缝合针便携存放拿取装置及其存放方法

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