Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS20050240178 A1
Publication typeApplication
Application numberUS 10/798,727
Publication dateOct 27, 2005
Filing dateMar 11, 2004
Priority dateDec 29, 2000
Also published asUS6840938, US7422592, US20070123855
Publication number10798727, 798727, US 2005/0240178 A1, US 2005/240178 A1, US 20050240178 A1, US 20050240178A1, US 2005240178 A1, US 2005240178A1, US-A1-20050240178, US-A1-2005240178, US2005/0240178A1, US2005/240178A1, US20050240178 A1, US20050240178A1, US2005240178 A1, US2005240178A1
InventorsTracey Morley, Daniel Wallace, Christopher Maurer
Original AssigneeIntuitive Surgical, Inc.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Bipolar cauterizing instrument
US 20050240178 A1
Abstract
A bipolar surgical instrument that includes opposing grips that can engage the tissue. A current is delivered from an electrosurgical power source to electrodes disposed on the grips to cauterize the tissue. The electrode configurations provide efficient cauterization of the tissue. In some embodiments, the positive and negative electrodes will be offset from each other to prevent shorting and to provide a thin line of coagulation heating to the gripped tissue. In some embodiments the electrodes are removably coupled to the grips through nonconductive sleeves. In some embodiments, the first electrode is disposed in a groove and the second electrode is disposed on a boss.
Images(20)
Previous page
Next page
Claims(18)
1-60. (canceled)
61. An electrosurgical instrument comprising:
a first body comprising;
a second body rotatably coupled to the first body;
a first effector and a second end effector rotatably coupled to the second body, wherein the first and second end effectors each comprise a proximal portion and a distal portion,
wherein the proximal portions of the first and second end effectors comprise a nonconductive body;
wherein the distal portions of the first and second end effectors comprise a substantially triangular shaped conductive grip body for gripping a target tissue;
a first lead coupled to the first end effector and a second conductive lead coupled to the second end effector,
wherein the first and second leads are attachable to a power source to deliver energy to the distal portions of the first and second end effectors.
62. The electrosurgical instrument of claim 61 wherein the first body comprises a robotic manipulator interface.
63. The electrosurgical instrument of claim 61 wherein the second body is rotatably coupled to the first body about a first axis, and the end effectors are rotatably coupled to the second body about a second axis,
wherein the first axis and second axis are substantially orthogonal to each other.
64. The electrosurgical instrument of claim 63 wherein a third axis extends longitudinally down the first body, wherein the first body, second body and end effectors are rotatable about the third axis.
65. The electrosurgical instrument of claim 61 wherein the triangular shaped conductive grip body on the first end effector and the second end effector each comprise an opening.
66. The electrosurgical instrument of claim 61 wherein the nonconductive body surrounds the proximal portion of the end effector to insulate the first end effector from the second end effector.
67. The electrosurgical instrument of claim 61 wherein the substantially triangular shaped conductive grip bodies comprise teeth.
68. The electrosurgical instrument of claim 61 wherein the second body comprises a pulley assembly,
wherein a plurality of drive cables interact with the pulley assembly and the non-conductive bodies to move the second body and the first and second end effectors.
69. The electrosurgical instrument of claim 61 wherein the first lead is coupled to the proximal portion of the first end effector and is received within the nonconductive body of the first end effector and the second lead is coupled to the proximal portion of the second end effector and is received within the nonconductive body of the second end effector.
70. An electrosurgical instrument comprising:
a first body;
a second body rotatably coupled to the first body;
a first effector and a second end effector rotatably coupled to the second body, wherein the first and second end effectors each comprise a proximal portion and a distal portion,
wherein the proximal portions of the first and second end effectors comprise a nonconductive body;
wherein the distal portions of the first and second end effectors comprise a conductive grip body that comprises an opening therethrough;
a first lead coupled to the first end effector and a second conductive lead coupled to the second end effector,
wherein the first and second leads are attachable to a power source to deliver energy to the distal portions of the first and second end effectors.
71. The electrosurgical instrument of claim 70 wherein the proximal end of the first body comprises a robotic manipulator interface.
72. The electrosurgical instrument of claim 70 wherein the second body is rotatably coupled to the first body about a first axis, and the end effectors are rotatably coupled to the second body about a second axis,
wherein the first axis and second axis are substantially orthogonal to each other.
73. The electrosurgical instrument of claim 70 wherein a third axis extends longitudinally down the first body, wherein the first body, second body and end effectors are rotatable about the third axis.
74. The electrosurgical instrument of claim 70 wherein the nonconductive body surrounds the proximal portion of the end effector.
75. The electrosurgical instrument of claim 70 wherein the conductive grip bodies comprise teeth.
76. The electrosurgical instrument of claim 70 wherein the second body comprises a pulley assembly, wherein a plurality of drive cables interact with the pulley assembly and non-conductive body to move the first and second end effectors and second body.
77. The electrosurgical instrument of claim 70 wherein the first lead is coupled to the proximal portion of the first end effector and is received within the nonconductive body of the first end effector and the second lead is coupled to the proximal portion of the second end effector and is received within the nonconductive body of the second end effector.
Description
    CROSS REFERENCES TO RELATED APPLICATIONS
  • [0001]
    The present application claims benefit, under 37 C.F.R. § 1.78, to U.S. Provisional Patent Application Ser. No. 60/258,750, filed Dec. 29, 2000, entitled “Bipolar Cauterizing Instrument,” the complete disclosure of which is incorporated herein by reference.
  • [0002]
    The present application is also related to U.S. patent application Ser. No. 09/418,726, filed Oct. 15, 1999 and U.S. patent application Ser. No. 09/415,568, filed Oct. 8, 1999, the complete disclosure of which are incorporated herein by reference for all purposes.
  • BACKGROUND OF THE INVENTION
  • [0003]
    The present invention relates generally to surgical tools and methods. More particularly, the present invention relates to a bipolar cauterizing and cutting tool for use with robotic surgical systems.
  • [0004]
    A significant number of different surgical instruments are used during each surgical procedure. In minimally invasive or robotic surgical procedures, the number of entry ports into a patient is generally limited because of space constraints, as well as the desire to avoid unnecessary incisions in the patient. Hence, a number of different surgical instruments will typically be introduced through the same trocar sleeve into the abdomen during, for example, laparoscopic procedures. As a result, the number of surgical instruments will often be attached and detached from a single instrument holder of a manipulator during an operation. Since each instrument change lengthens the surgical procedure and increases the patient's risk, it is beneficial to make a minimal amount of instrument changes during the surgical procedure.
  • [0005]
    Electrosurgery refers broadly to a class of medical procedures which rely on the application of high frequency electrical energy, usually radio frequency energy, to patient tissue to achieve a number of possible effects, such as cutting, coagulation, necrosis, and the like. Of particular interest to the present invention, bipolar electrosurgical procedures rely on contacting electrodes of different polarity in close proximity to each other against or into tissue. For example, in some minimally invasive and robotically controlled surgical procedures, tissue in the patient's body must be cauterized and severed. To perform such a procedure, bipolar or monopolar cauterizing grips can be introduced through the trocar to engage the target tissue. An electrical energy, such as radio frequency energy, is delivered to the grips to cauterize the engaged tissue. Unfortunately, conventional cauterizing grips are insufficient to cut the cauterized tissue because they generally use the entire two grips as the two electrodes. The grips are designed primarily to grasp tissue and have a large surface area. The large surface area translates into a small power density and mkes them more effective as widespread heating (i.e. the size of the grips and some peripheral thermal damage to the surrounding tissue). Unfortunately, the heating does not concentrate the energy enough to allow for cutting of the gripped tissue. Thus, to achieve cutting of the cauterized tissue, a separate cutting instrument can be introduced into the body cavity through the trocar. However, the time associated with disconnecting the cauterizing grips from the body and connecting the cutting instrument to the robotic arm unnecessarily lengthens the surgical procedure and increases the risk to the patient.
  • [0006]
    One possible method of improving cauterizing and cutting with a robotic surgical system is to integrate a cutting element with the cauterizing grips. Unfortunately, because of the small size of the trocar and surgical instruments, it is difficult to integrate a cutting element with the cauterizing grips. Moreover, the incorporation of the cutting element in the grips is difficult because of the space available, especially with offset electrodes when trying to maintain a slim profile for good visualization.
  • [0007]
    In light of the above, it would be desirable to provide improved robotic surgery tools, systems, and method. It would further be desirable to provide a bipolar tool that can cauterize and cut tissue. It would be especially desirable if these enhanced robotic tools and techniques resulted in further improvement in the safety and reliability of the robotic surgical systems.
  • SUMMARY OF THE INVENTION
  • [0008]
    The present invention provides robotic systems, instruments, and methods for cauterizing tissue. In particular, the surgical instruments of the present invention are adapted to be used with a robotic system. The surgical instruments generally include opposing end effectors having grips that can engage the tissue. A current is delivered from an electrosurgical power source to electrodes disposed on the end effectors to cauterize the tissue. The electrode configurations provide efficient cauterization of the tissue. In particular, the positive and negative electrodes will be offset from each other so as to prevent shorting when the grips are closed and to provide a thin line of coagulation heating to the gripped tissue. Consequently, a small amount of tensioning force from the end effectors can sever the cauterized tissue without having to use a separate cutting element.
  • [0009]
    The surgical instruments will generally include an actuation mechanism that controls the orientation and movement of the distal end effectors. The actuation mechanism will typically be controlled by a robotic manipulator assembly that is controlled remotely by a user. For example, in one configuration, the actuation mechanism will be manipulated by the robotic manipulator assembly to move the end effectors between an open position and a closed position. In the closed position, the end effectors will contact the electrodes against the tissue to cauterize and/or sever the engaged tissue.
  • [0010]
    Some embodiments of the surgical instrument will include a wrist or rotatable body coupled to the distal end of the shaft to provide additional axes of rotation for the end effectors. For robotic surgery procedures, a plurality of degrees of rotation of the distal end effectors is preferred. For example, in many embodiments, the distal end of the surgical instrument will have two degrees of rotation, three degrees of rotation, or more.
  • [0011]
    The electrodes disposed on the end effectors are contacted against the tissue so that current will flow from one electrode to the other electrode through the engaged tissue. In some configurations the electrodes will both be disposed on the same end effectors. In other configurations, however, the positive electrode will be disposed on one end effector, and the negative electrode will be disposed on the other end effector. In either configuration, it is preferred that when the end effectors are in the closed position, the electrodes will be offset and spaced from each other such that delivery of a high frequency electrical energy will flow through the tissue between the electrodes without shorting the electrodes. Even if no tissue is between the end effectors, there will typically be a gap between the electrodes. When the end effectors are in the closed position the spacing between the negative and positive electrode will generally be between approximately 0.01 and 0.10 inches, and preferably between approximately 0.010 inches and 0.025 inches. It should be appreciated however, that the spacing of the electrodes will vary depending on the area, volume, width, material of the electrodes, and the like.
  • [0012]
    The electrodes of the present invention can be disposed directly in the end effectors or on nonconductive sleeves that are attached to the end effectors. The electrodes will generally be metal inserts or a conductive material deposited or etched onto the sleeves or end effectors. The electrodes will be electrically coupled to a conductive lead or to the grip drive shaft(s) so as to deliver the high frequency electrical energy to the engaged tissue. The electrodes and/or conductive wires will typically be composed of aluminum, copper, silver, tin, gold, tungsten, platinum, or the like.
  • [0013]
    As noted, the electrodes will usually be coupled to the end effectors with nonconductive sleeves or directly on the end effectors and insulated with bushings. The nonconductive sleeves can be removably placed over the end effectors to insulate the current carrying electrodes from the end effectors. If the electrodes are disposed directly on or in the end effectors, the insulating bushing can be positioned between the “live” electrode and the grip.
  • [0014]
    In alternative designs, the end effectors themselves (and the surrounding elements on the surgical instrument) can be composed of a nonconductive material. The nonconductive sleeves, end effectors, and bushing can be composed of a ceramic, a thermoset, a plastic such as UltemŽ, a thermoplastic, or other high temperature nonconductive materials so that the only conductive portion of the distal portion of the surgical instrument are the electrodes.
  • [0015]
    In exemplary embodiments, one electrode will be disposed within a groove (either in the grip itself or on the nonconductive sleeve), while the other electrode can be disposed on a boss (either in the grip itself or on the nonconductive sleeve). When the end effectors are closed, the groove and boss interact in an interdigitating fashion. The interdigitating can apply tension to the tissue to help produce the cutting action. Applicants have found that by positioning the electrodes on a groove and boss that the tissue tends to wrap around the electrode so as to get better contact and better transfer of energy. Even in the boss and groove configuration, there will typically still be a gap between the positive and negative electrode.
  • [0016]
    The electrical energy can be delivered to the electrodes through the actuation drive shafts (e.g., cables) or through separate conductor wires. Accordingly, the drive shafts and conductor wires will usually be at least partially insulated so as to prevent current arcing to surrounding conductive elements in the instrument. If the drive shafts carry the electrical energy, they can be insulated in the main body of the device, but are typically not insulated through the wrist so that when the cables contact the end effectors, they transfer the energy to the end effectors. The end effectors can be separated by a non-conductive bushing to keep the two poles separate.
  • [0017]
    In one exemplary configuration, a sleeve or insulation layer can be disposed around at least a portion of the drive shaft(s) and the electrical energy can be delivered through the insulated drive shafts. In such a configuration, the distal portion of the surgical instrument (i.e., end effectors, pulleys, and wrist) can be at least partially composed of nonconductive material (such as a plastic or ceramic) so that the only “live” portion of the distal end of the instrument will be the end effectors, electrodes and cables.
  • [0018]
    In other arrangements, separate insulated conductor wires can be run through the shaft and wrist and attached directly to the electrodes disposed on the end effectors. In such an arrangement, the wrist, pulleys, and the like can be metal, since the conductor wires will only electrically contact the electrodes on the end effectors.
  • [0019]
    In one particular design, the conductor wires can be run outside of the wrist so as to allow for easy installation and replacement of the conductor wires. In such a design, the electrodes will typically be disposed on a removable and disposable sleeve.
  • [0020]
    In one particular aspect, the present invention provides a surgical instrument for use with a robotic arm. The surgical instrument includes a wrist rotatably coupled to a body. A pair of opposed end effectors are rotatably coupled to the wrist and are movable between an open position and a closed position. A first and second electrode are coupled to the end effectors. In the closed position, the first and second electrodes are spaced from each other so as to prevent shorting the electrodes.
  • [0021]
    In another exemplary embodiment, the present invention provides a bipolar tool for use with a robotic surgery system. The tool comprises first and second opposing end effectors rotatably coupled to a body. Nonconductive sleeves are disposed over the opposing end effectors and first and second electrodes are attached on the nonconductive sleeves. Conductors connect the first and second electrodes to an electrosurgical power source. An actuation mechanism moves the first and second end effectors between an open position and a closed position.
  • [0022]
    In another aspect, the present invention provides methods of cauterizing tissue. In an exemplary embodiment, the method includes providing a first grip and a second grip. A first electrode is in a groove on one of the end effectors and a second electrode is on a boss on the end effectors. The tissue is gripped between the first and second grip and a current is applied to the electrodes to cauterize the tissue.
  • [0023]
    Optionally, after the tissue has been cauterized, the tissue is tensioned between the end effectors to cut the tissue. Drive cables of the surgical instrument can be actuated with a robotic manipulator to close the end effectors about the tissue. In a particular embodiment, the electrical energy can be delivered to the electrodes through the drive cables.
  • [0024]
    In yet another method of cauterizing tissue, nonconductive sleeves are placed over a pair of end effectors. The tissue is gripped with the insulated end effectors and a current is delivered through electrodes disposed on the sleeves to cauterize the gripped tissue.
  • [0025]
    In another aspect, the present invention provides a robotic surgical system. The robotic surgical system will generally involve the use of a user interface and multiple robotic arms. One or more of the robotic arms will often support an articulated surgical tool, such as a bipolar cauterizer. The bipolar cauterizer can include a shaft and a pair of opposing end effectors. Electrodes will be coupled to the end effectors such that movement of the end effectors from an open position to a closed position will grip and cauterize tissue engaged by the electrodes. As the tissue is cauterized, the tension force created by the gripping of the tissue in conjunction with the electrode configuration can be sufficient to sever the gripped tissue.
  • [0026]
    In an exemplary configuration, a first electrode is disposed within a groove in the end effectors and a second electrode is disposed on a protruding boss on the end effectors. When the end effectors are moved to the closed position, the electrodes can interdigitate but will still be maintained in a spaced or offset configuration so as to prevent shorting. The spacing between the electrodes is typically between 0.010 inches and 0.10 inches. In one specific configuration, the electrodes will have a center to center distance of approximately 0.052 inches and a gap between the edges of approximately 0.022 inches. It should be appreciated however, that the spacing between the electrodes may change depending on the electrode configuration, current, the type of tissue being treated, or the like.
  • [0027]
    For a further understanding of the nature and advantages of the invention, reference should be made to the following description taken in conjunction with the accompanying drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0028]
    FIG. 1 illustrates a robotic surgical procedure in which a surgeon at a master station directs movement of robotic surgical tools effected by a slave manipulator, and shows an assistant preparing to change a tool mounted to a tool holder of the slave.
  • [0029]
    FIG. 2 is a perspective view of a robotic surgical arm cart system in which a series of passive set-up joints support robotically actuated manipulators (typically, the center arm would support a camera).
  • [0030]
    FIG. 2A is a perspective view of a robotic surgical manipulator for use in the cart system of FIG. 2.
  • [0031]
    FIGS. 2B and C are side and front views, respectively, of the linkage of the robotic manipulator of FIG. 2, showing how the manipulator maintains a remote center of rotation along a shaft of the surgical tool.
  • [0032]
    FIG. 3 is a perspective view of the cart structure and passive set-up joints which support the robotic manipulators in the system of FIG. 2.
  • [0033]
    FIG. 4A is a perspective view of an exemplary tool according to the principles of the present invention;
  • [0034]
    FIG. 4B illustrates a drive system of the present invention;
  • [0035]
    FIGS. 5A and 5B are close up views of a distal end of a surgical tool with the end effectors in a closed position;
  • [0036]
    FIG. 6A illustrates a first grip with a recessed electrode;
  • [0037]
    FIG. 6B illustrates an opposing second grip with a raised electrode;
  • [0038]
    FIGS. 7A and 7B are exploded view showing the electrode, sleeve, and jaw blade;
  • [0039]
    FIGS. 8A to 8C schematically illustrate various electrode configurations of the present invention;
  • [0040]
    FIG. 9 illustrates an embodiment of the bipolar cauterizer in which a current is delivered through drive cables;
  • [0041]
    FIG. 10A shows another embodiment of a bipolar cauterizing end effectors with the end effectors in a closed position;
  • [0042]
    FIG. 10B shows the embodiment of FIG. 10A with the cauterizing end effectors in an open position;
  • [0043]
    FIGS. 11A and 11B show left and right elevational views of the cauterizing end effectors of FIG. 10A;
  • [0044]
    FIGS. 12A and 12B are partially exploded views showing elements of the end effector;
  • [0045]
    FIG. 13 is an exploded view illustrating the interaction of an exemplary sleeve, electrode and jaw blade;
  • [0046]
    FIG. 14 illustrates a path of the conductive lead through the shaft and clevis;
  • [0047]
    FIG. 15 is a top view of a shaft body having a plurality of lumens;
  • [0048]
    FIG. 16A illustrates an embodiment of the bipolar cauterizing instrument having conductive end effectors in which the end effectors are in an open position;
  • [0049]
    FIG. 16B illustrates the embodiment of FIG. 16A in which the end effectors are in a closed position;
  • [0050]
    FIG. 17 is an exploded view of an end effector of FIGS. 16A and 16B;
  • [0051]
    FIG. 18 is an alternative triangular shaped grip.
  • DESCRIPTION OF THE SPECIFIC EMBODIMENTS
  • [0052]
    Robotic surgery will generally involve the use of multiple robotic arms. One or more of the robotic arms will often support a surgical tool which may be articulated (such as cauterizing grips, cauterizers, scissors, jaws, graspers, needle holders, microdissectors, staple appliers, tackers, suction/irrigation tools, clip appliers, or the like) or non-articulated (such as cutting blades, probes, irrigators, catheters, suction orifices, or the like). One or more of the robotic arms will often be used to support a surgical image capture device such as an endoscope (which may be any of the variety of structures such as a laparoscope, an arthroscope, a hysteroscope, or the like), or optionally, some other imaging modality (such as ultrasound, fluoroscopy, magnetic resonance imaging, or the like). Typically, the robotic arms will support at least two surgical tools corresponding to the two hands of a surgeon and one optical image capture device.
  • [0053]
    The robotic systems of the present invention will find application in a variety of surgical procedures. The most immediate applications will be to improve existing minimally invasive surgical procedures, such as coronary artery bypass grafting and mitral and aortic valve repair and/or replacement. The invention will also have applications for surgical procedures which are difficult to perform using existing minimally invasive techniques, such as Nissen Fundoplications. Additionally, it is anticipated that these surgical systems will find uses in entirely new surgeries that would be difficult and/or impossible to perform using traditionally open or known minimally invasive techniques. For example, by synchronizing the movements of the image capture device and/or surgical tools with a tissue undergoing physiological movement (such a beating heart), the moving tissue may be accurately manipulated and treated without halting the physiological movement. Additional potential applications include vascular surgery (such as for the repair of thoracic and abdominal aneurysms), general and digestive surgeries (such as cholecystectomy, inguinal hernia repair, colon resection, and the like), gynecology (for fertility procedures, hysterectomies, and the like), and a wide variety of alternative procedures.
  • [0054]
    While the remaining discussion generally relates to electrosurgical robotic surgery, it should be appreciated that the concepts of the present invention are also applicable to manually actuated electrosurgical surgical instruments or for other non-surgical robotically assisted methods and devices.
  • [0055]
    Referring now to FIG. 1, the robotic surgical system of the present invention 20 generally includes master controller 22 and a robotic arm slave cart 24. Master controller 22 generally includes master controllers (not shown) which are grasped by the surgeon and manipulated in space while the surgeon views the procedure view on a stereo display. The master controllers are manual input devices which preferably move with six degrees of freedom, and which often further have an actuatable handle for actuating tools (for example, for closing grasping jaws, applying an electrical potential to the electrode(s), or the like). In this embodiment, the master control station 22 includes a processor for processing the inputs from the surgeon.
  • [0056]
    Robotic arm cart 24 is positioned adjacent to patient body P and moves tools having shafts. The shafts extend into an internal surgical site within the patient body via openings O. As illustrated in FIG. 1, one or more assistant may be present during surgery to assist the surgeon, particularly during removal and replacement of tools. Robotic surgery systems and methods are further described in co-pending U.S. patent application Ser. No. 09/418,726, filed Oct. 15, 1999, and U.S. Pat. No. 6,132,368, the full disclosures of which are incorporated herein by reference.
  • [0057]
    Robotic arm cart 24 is shown in isolation in FIG. 2. Cart 22 includes a base 26 from which three surgical tools 28 are supported. More specifically, tools 28 are each supported by a series of passive set-up joints 30 and a robotic manipulator 32. It should be noted that these structures are here illustrated with protective covers extending over much of the robotic linkage. It should be understood that these protective covers are optional, and may be limited in size or entirely eliminated in some embodiments to minimize the inertia that is manipulated by the servo mechanism, and to limit the overall weight of cart 22.
  • [0058]
    Cart 24 will generally have dimensions suitable for transporting the cart between operating rooms. The cart will typically fit through standard operating room doors and onto standard hospital elevators. The cart should have a weight and wheel (or other transportation) system that allows the cart to be positioned adjacent an operating table by a single attendant. The cart should have sufficient stability in the transport configuration to avoid tipping at minor discontinuities of the floor, and to easily withstand overturning moments that will be imposed at the ends of the robotic arms during use.
  • [0059]
    Referring now to FIGS. 2A-C, robotic manipulators 32 preferably include a linkage 34 that constrains movement of tool 28. More specifically, linkage 34 includes rigid links coupled together by rotational joints in a parallelogram arrangement so that tool 28 rotates around a point in space 36, as more fully described in issued U.S. Pat. No. 5,817,084, the full disclosure of which is incorporated herein by reference. The parallelogram arrangement constrains rotation to pivoting about an axis 38, sometimes called the pitch axis. The links supporting the parallelogram linkage are pivotally mounted to set-up joints so that tool 28 further rotates about an axis 40, sometimes called the yaw axis. The pitch and yaw axes intersect at the remote center 36, which is aligned along a shaft 44 of tool 28.
  • [0060]
    Tool 28 has driven degrees of freedom as supported by manipulator 32, including sliding motion of the tool along insertion axis 36 (the axis of shaft 44), sometimes referred to as insertion. As tool 28 slides along axis 42 relative to manipulator 32, remote center 36 remains fixed relative to base 46 of manipulator 32. Hence, the entire manipulator is generally moved to re-position remote center 36.
  • [0061]
    Linkage 34 of manipulator 32 is driven by a series of motors 48 (FIG. 2B). These motors actively move linkage 34 in response to commands from a processor. Motors 48 are further coupled to the tool so as to rotate the tool about shaft 44, and often to articulate a wrist at the distal end of the tool about at least one, and often two, and sometimes three or more degrees of rotation. Additionally, motors 48 can be used to actuate an articulatable end effector of the tool for grasping tissues in the jaws of a forceps or the like. Motors 48 may be coupled to at least some of the joints of tool 28 using cables and pulleys, as more fully described in U.S. Pat. No. 5,792,135, the full disclosure of which is also incorporated herein by reference. As described in that reference, the manipulator will often include flexible members for transferring motion from the drive components to the surgical tool. For endoscopic procedures, manipulator 32 will often include a cannula 50. Cannula 50 supports tool 28, allowing the tool to rotate and move axially through the central bore of the cannula.
  • [0062]
    As described above, manipulator 32 is generally supported by passive set-up joints 30. Exemplary set-up joint structures are illustrated in FIG. 3. The exemplary set-up joint system includes three types of structures. First, a vertical column 52 supports vertically sliding joints 54 that are used to position manipulator 32 along the vertical or Z axis. Second, rotary joints 56 separated by rigid links 58 are used to horizontally position manipulators 32 in the X-Y plane. Third, another series of rotary joints 57 mounted adjacent a manipulator interface 60 rotationally orients the manipulators.
  • [0063]
    The structure of column 52, vertical sliding joints 54, and base 26 can be understood with reference to FIG. 3. Beginning with base 26, the base will generally distribute the weight of the robotic structures and the forces imposed on the robotic arms. Column 52 extends upward from base 26, and may optionally comprise a box steel structure. Sliding joints 54 are counterbalanced by weights mounted with column 52. Sensors (typically in the form of potentiometers) indicate vertical position of sliding joints 54, and also indicate the rotational position of each rotary joint 56. As the structure of the joint elements is known, the processor can accurately determine the position and orientation of the manipulator base. As the position of the tool and tool end effector will be known relative to the manipulator base, the processor can further accurately determine end effector position and orientation, as well as how to effect movement in a desired direction by articulating one or more the driven joints.
  • [0064]
    Each of rotational joints 56 and slider joints 54 can include a brake. The brake prevents articulation about the joint unless the brake is released, the brake being normally on. The brakes at all the joints are actuated in unison by a button on the set-up joints, thereby allowing the operating room personnel to position the manipulator in space when the brake is released. Additional rotational joints similarly allow the orientation of the manipulator to be set while the brake is released. The exemplary set-up joint structure is more fully described in co-pending patent application Ser. No. 09/368,309, filed Aug. 3, 1999, the full disclosure of which is incorporated herein by reference.
  • [0065]
    Exemplary tools 28 of the present invention are illustrated in FIGS. 4A to 11. As shown in FIG. 4A, tool 28 generally includes a rigid shaft 62 having a proximal end 64 and distal end 66. A surgical end effector is coupled to shaft 62 through a clevis or wrist body 74 that can provide at least 1 degree of freedom, and ideally providing at least 2 degrees of freedom to the end effectors. A proximal housing 68 includes an interface 70 which mechanically and electrically couples the shaft and end effectors to the robotic manipulator.
  • [0066]
    As illustrated schematically in FIG. 4B, a drive system 76 mechanically couples first and second end effector elements 78, 80 to driven elements of interface 70. The actuating drive system 76 will typically include a plurality of drive shafts and pulleys to facilitate actuation of the end effectors. The drive system is more fully described in U.S. Pat. No. 5,792,135, the full disclosure of which is incorporated herein by reference. Stated simply, the drive system translates mechanical inputs from driven elements into articulation of the wrist 74 about first and second axes A1, A2, as well as into actuation of the end effectors 78, 80 by relative movement of the end effector elements about axis A2 to move the end effectors between an open and closed position. In addition, as shown in FIG. 4A, the driven elements can effect rotation of the end effector about the axis of shaft 62 (A3) by rotating the shaft relative to proximal housing 68, and allowing the cables to twist (within a limited angular range) within the shaft.
  • [0067]
    A wide variety of alternative drive systems might be employed, including alternative cabling arrangements, drive chains or belts, hydraulic drive systems, gear trains, or the like. In some of these drive systems, motion of end effectors about the axes may be coupled to multiple driven elements. In other embodiments, there may be a one to one correspondence between driven elements and motion of an end effector element about an axis. Still other embodiments may require fewer (or more) driven elements to effect the desired degrees of freedom, for example, when a single element end effector is provided. Hence, manipulation of the end effector via interface 70 will generally involve some reconfiguration of the robotic system during the tool change.
  • [0068]
    One exemplary bipolar cauterizer 28 that can be removably attached with the robotic surgical systems of the present invention is shown in FIGS. 5A and 5B. The cauterizer 28 includes a proximal clevis or shaft 62. A distal clevis or wrist body 74 is rotatably coupled to shaft 62 about the first axis A1. End effectors 78, 80 are rotatably coupled to the wrist 74 about a second axis A2. Both the end effectors and clevis can be rotatable about the longitudinal axis A3 of the shaft 62. A negative and positive electrode 82 a, 82 b (shown most clearly in FIGS. 6A and 6B) can be coupled to the end effectors to deliver a high frequency electrical energy into tissue engaged by the jaws 78, 80.
  • [0069]
    The conductive electrodes 82 a, 82 b can be coupled to an electric power supply (not shown) through conductive leads 84 a, 84 b. In an exemplary embodiment, the conductive leads can be run from the proximal end of the instrument, through lumens in clevis 74 and up to the electrodes 82 a, 82 b disposed on the end effectors 78, 80. The distal portion of the conductive leads 84 a, 84 b can be run outside of the clevis 74 so as to allow for easy connection and disconnection of the conductive leads 84 a, 84 b from the electrodes.
  • [0070]
    Depending on the specific configuration of the cauterizer, the end effectors 78, 80 and drive system can be composed of a nonconductive material or a conductive material. In some embodiments, the electrodes can be insulated from the end effector with either a nonconductive bushing or sleeve that is composed of plastic, ceramic, TeflonŽ, UltemŽ, or other non-conductive materials. If the electrodes are attached directly to the end effectors, an insulating bushing can be disposed between the conductive end effectors and the electrodes so that the only “live” portion of the surgical instrument are the electrodes.
  • [0071]
    The electrodes of the present invention are preferably made of a conductive material such as aluminum, stainless steel, platinum, tungsten, gold, or the like. The electrodes can be in the form of strips, deposited material, inserts, or the like. In some embodiments, the jaws themselves can be the electrodes.
  • [0072]
    For the bipolar methods of the present invention, the two electrodes on the end effectors should be at two electrical potentials and should not come in contact with each other. Thus, in most embodiments the electrodes are configured to have a gap between the electrodes even when the end effectors are in the closed configuration. As is the case with conventional electrosurgical instruments, a range of supply settings may be used for cutting, coagulation and the like. Moreover, it should be appreciated, that the electrodes can be configured in a wide variety of patterns and designs, some of which are illustrated in FIGS. 6 to 8C.
  • [0073]
    An exemplary power supply can create a wattage up to approximately 120 Watts of power for cauterizing the target tissue. Some exemplary radio frequency power sources that can be used with the bipolar cauterizers of the present invention are manufactured by Valleylab, under the trade name Force FX. Alternatively commercially available units such as Valleylab Force EZ, Erbe Erboton ICC 350 and the like, may be used. The voltage used with bipolar cauterizer 28 is generally between 0 V and 1000 V peak-to peak, and preferably between 100 V and 500 V. As long as the jaws and electrodes are both in good contact with the tissue intended to be cauterized and cut, there is much less chance of voltage from the electrodes arcing to other conductive components on the instrument (e.g., the wrist, shaft, or pulleys). It should be appreciated, however, that the voltage setting of the electrosurgical power generator will vary depending on the specific dimensions of the electrodes, the tissue to be treated, and the like.
  • [0074]
    In exemplary embodiments, movement of end effectors 78, 80 are effected through mechanical actuation of a yaw cable 86 and pitch cable 88 via surgeon input devices. Actuation of the pitch cable 88 can rotate the end effectors 78, 80 about the wrist axis A1, while actuation of the yaw cable 86 moves the jaws about axis A2, an axis that is substantially perpendicular to axis A1, between an open and closed position. Typically, the cables 86, 88 are directed through lumens in the shaft and wrist body and through a conductive or nonconductive pulley assembly 90.
  • [0075]
    As shown in FIGS. 6A to 7B, in one configuration the end effectors 78, 80 include a jaw body 92 and a pivot body 94. Nonconductive sleeves 96 can be removably coupled to jaw body 92 to attach electrodes 82 a, 82 b to the end effector. As shown, the sleeves 96 include grip surfaces 98 that can contact and grip the target tissue. The electrodes 82 a, 82 b can be molded inserts or a conductive material etched or deposited onto the sleeves. The nonconductive sleeves can include a slot 100 for receiving the jaw body 92 so as to insulate the end effectors from the conductive electrodes. In some configurations, the electrodes and grip surfaces of the jaws can be “non-stick,” such as coated with a non-stick polymer, e.g., TeflonŽ. The conductive leads can be routed through openings 102 in the sleeves 96 and jaw body 92 to contact the electrodes 82 a, 82 b.
  • [0076]
    The sleeves 96 are preferably disposable so as to allow the physician to replace the sleeves between each surgical procedure, if desired. The conductive leads 84 a, 84 b can also be detachable from the electrodes 82 a, 82 b so as to decouple the electrodes from the power supply. During or after the surgical procedure, the sleeves 96 and the electrodes 82 a, 82 b can be removed from the jaw body 92 and replaced. Thus, different sized electrodes, a different tooth configuration on the end effectors, a different configuration of electrodes, or the like, can be easily attached to the jaw body 92. In such arrangements, to allow for easy detachment, the conductive leads 84 a, 84 b can be routed through a lumen in the wrist and to an unprotected path outside the wrist. In other embodiments, the jaws 78, 80, wrist 74, and pulleys 90 can be composed of a nonconductive material and the electrodes can be directly coupled to the end effectors. Consequently, non-conductive bushings can be positioned between the end effectors, and nonconductive sleeves that overly the jaw body 92 are not needed.
  • [0077]
    In exemplary arrangements, as shown most clearly in FIGS. 6A and 6B, the first electrode 82 a will be disposed in a groove 104 on the jaw or sleeve and the second electrode 82 b will be disposed on a boss 106. When the end effectors are moved to the closed position, the boss 106 and groove 104 will interdigitate while still maintaining a gap between the two electrodes. The boss and groove configuration has been found to create thin coagulation heating lines in the tissue when current is delivered between the electrodes. The thin heating lines in the tissue make it easy for the user to cut and separate the tissue by applying a small amount of tension. The time of heating will depend primarily on the size of the tissue being coagulated, the electrode configuration, the current, and the like.
  • [0078]
    It should be appreciated that the electrodes can be positioned on opposing end effector or on the same end effector. Moreover, the electrodes do not have to be disposed within a groove or on a boss. The electrodes can contact the engaged tissue disposed between the electrodes 82 a, 82 b and a current is applied between the spaced electrodes to deliver a current flow to cauterize the tissue. If desired, a tension force applied from the end effectors can cut the tissue along the cauterization heat lines to separate the tissue. As shown in phantom in FIGS. 8A to 8C, the jaws can optionally include a cutting blade 85 disposed on the jaws to facilitate cutting of the tissue. The blade 85 can be stationary or spring loaded and may be conductive or nonconductive.
  • [0079]
    In the exemplary electrode embodiments illustrated schematically in FIGS. 8A-8C, the electrodes will be placed in an offset and spaced configuration such that when the jaws are moved to the closed position there will be a gap between the electrodes so as to prevent shorting. As shown in FIG. 8A, in some embodiments a first electrode 82 a will be positioned on first jaw 78 and second electrode 82 b will be positioned on second jaw 80 (FIG. 8A). When the jaws are moved to the closed position, the electrodes will be positioned in a parallel arrangement with a gap between the electrodes.
  • [0080]
    In an alternative embodiment shown in FIG. 8B, both of the electrodes 82 a, 82 b can be disposed on the first jaw 78. Thus, when the first jaw 78 and second jaw 80 are moved to the closed position, the engaged tissue will be contacted with both the first and second electrode without shorting.
  • [0081]
    In yet another embodiment shown in FIG. 8C, the first jaw 78 can have a first electrode 82 a disposed substantially in the center. The second jaw 80 can have a second electrode 82 b and third electrode 82 c disposed adjacent the edge of the grip such that when the jaws are moved to the closed position, the second electrode 82 b and third electrode 82 c will be disposed on both sides of the first electrode 82 a.
  • [0082]
    While not shown, both of the electrodes 82 a, 82 b can be disposed in grooves on opposite jaws 78, 80 such that when the jaws are in the closed configuration, there is still space between the electrodes 82 a, 82 b.
  • [0083]
    FIG. 9 schematically shows an embodiment of the bipolar cautery instrument 28 that uses at least one of drive shafts 86, 88 to deliver the voltage to cauterize the tissue at the target site. In such embodiments, each of the jaws 78, 80 and drive cables 86, 88 should be electrically isolated from each other. Since the yaw cables 86 run through shaft 62 of the instrument and can contact the pitch cables 88 as well as other drive shafts, the drive shafts carrying the current need to be insulated. Consequently, hypotubes 108 or other insulating members which the cables can coupled around or attached to at least a proximal portion of the drive shafts. This can prevent the current from traveling from the end effectors to the other conductive portions of the instrument. The distal portion of the drive cables also need to be insulated from each other at the distal end of the instrument. For example, to insulate the distal wrist 74 from the end effectors a combination of the following could be done: (1) make the shaft and wrist of a nonconductive material (e.g., plastic or ceramic), (2) put a nonconductive material bushing over a distal pin that the end effectors rotate about, (3) modify the end effectors so metal of one grip does not contact the metal of the other grip, and (4) make distal and proximal pulleys of a nonconductive material.
  • [0084]
    FIGS. 10A to 14 illustrate an alternative embodiment of the cauterizing instrument 28′ of the present invention. As shown in FIGS. 10A, 10B, 11A, and 11B, similar to the above embodiments, the cauterizer 28′ includes a proximal clevis or shaft 62. A distal clevis or wrist body 74 is rotatably coupled to the shaft 62 about the first axis A1. End effectors 78, 80 are rotatably coupled to the wrist 74 about a second axis A2. Both the end effectors and clevis can be rotatable about the longitudinal axis A3 of the shaft 62. Yaw and pitch cables 86, 88 are attached to the end effectors and disposed through a pulley assembly 90 to actuate movement of the end effectors between an open and closed configuration about axis A1 and to rotate the end effectors about wrist axis A2. Movement of the end effectors is effected through actuation of a pitch and yaw cable, as described above. The end effectors 78′, 80′ of this embodiment include a first, solid conductive jaw 80′ that can be ground through the shaft of the cauterizer and a second jaw having an electrode 82.
  • [0085]
    Referring now to FIG. 12A, the first end effector 80′ will have a grip 110 attached to a pivot body 112. Yaw cable 86 will extend through the pulley assembly 90 and around pivot body 112 such that movement of yaw cable 86 causes rotation of the first end effector 80′ about the pivot axis A2. In the illustrated embodiment, the first end effector does not have a connection to a power supply and the treatment of the gripped tissue can be through a monopolar energy. The conductor 84 may be connected to a conventional electro-surgical power supply configured for monopolar energy to supply electrical energy to electrode 82. The circuit may be complete by grounding grip 110, to be functionally a second electrode, by a conductive path through the instrument clevis and shaft, or by an optional second conductive lead. Although monopolar energy is thus employed, the embodiment is “bipolar” in that current flow is confined to the gap between the grips. However, if bipolar energy delivery is desired, in other embodiments, the first end effector can have the same structure as the second end effector, as described below.
  • [0086]
    FIGS. 12B and 13 most clearly illustrate the second end effector 78′. The second end effector 78′ comprises a body comprising a jaw blade 114 and a pivot body 116. The pivot body 116 allows for rotation of the jaw body 114 about axis A2. As shown in FIG. 12B, the pivot body 116 typically includes a conductor loop 118 and an opening 120 that can receive the conductive lead 84.
  • [0087]
    Note that alternatively, each of the opposed pair of end effector may comprise a sleeve-electrode-jaw-pulley assembly of the kind shown in FIG. 13, the opposed electrodes 82 being adjacent one another when the end effector is in the closed position. A second conductive lead 84 may be provided to couple the second electrode 82 to a power supply. The sleeve-electrode assembly 96, 82 may be removably, replaceably mounted, and may be disposable. Optionally, each electrode may be coupled to a bipolar power supply.
  • [0088]
    Removable insulating sleeve 96 will be used to couple the electrode to the jaw body 114. In the embodiment shown, the insulating sleeve has grips 122 for contacting the target tissue, a slot 124 for receiving the electrode 82, and a slot 126 for receiving the jaw blade 114. Electrode 82 can be delivered into electrode slot 124 in the sleeve and locked into place with a retainer clip 128. The retainer clip 128 can have an aperture 130 such that conductive lead 84 can extend through opening 120 in the pivot body, through aperture 130 in the retainer clip and into contact with the electrode. If desired, electrode 82 can also include an opening to facilitate better contact with conductive lead 84. While not shown, a yaw cable can be positioned around pivot body 116 to actuate rotation of the second end effector about axis A2.
  • [0089]
    If desired, the jaws 132 may optionally be replaceably, removably mounted to the pulley assembly 136, 138 so as to electrically couple to conductive lead 84 when mounted to the pulley. The jaw mounting may include a snap-fit mounting, spring-clip mounting or secure frictional mounting, for example as described in the above mentioned U.S. patent application Ser. No. 09/415,568, filed Oct. 8, 1999, entitled “Minimally Invasive Surgical Hook Apparatus And Method For Using Same”, the full disclosure of which is incorporated by this reference.
  • [0090]
    As shown in FIGS. 14 and 15, conductive lead 84 can extend through a lumen 132 in shaft 62 and wrap around conductor loop 118 in the pivot body 116 of the second end effector 78′ and extend through the opening 120 to contact the electrode 82 that is disposed on jaw body 78′. As shown further in FIG. 15, shaft 62 typically includes a plurality of lumens that extend through at least a portion of the shaft for receiving the yaw cable 86, pitch cable 88, and one or more conductive leads 84.
  • [0091]
    FIGS. 16A and 16B illustrate yet another embodiment of the cauterizer of the present invention. In the illustrated embodiments, the bipolar cauterizer includes first and second conductive end effectors 78″, 80″ through which the radio frequency current can be delivered. Similar to the above embodiments, the jaws are movable between an open (FIG. 16A) and closed configuration (FIG. 16B).
  • [0092]
    As shown most clearly in FIG. 17, each of the end effectors include a distal jaw body 132 having grips 133 and an opening disposed in the middle of the jaw body 132. A proximal end 134 of the jaw can be electrically and mechanically connected to a conductive lead 84. Conductive leads 84 can be coupled (e.g., crimped, attached with a conductive adhesive, or the like) to a proximal portion of each of the end effectors. To prevent shorting between the end effectors 78″, 80″ first and second insulating pulleys 136, 138 can be disposed around each of the proximal ends 134 of the end effectors. Similar to above, while not shown, yaw cables can be coupled to the pulleys to actuate movement of the jaws.
  • [0093]
    It should be appreciated however, that the jaws of the present invention can take a variety of shapes. Specifically, as shown in FIG. 18, the end effector can include a triangular shaped distal end 132 that has a narrower point that may allow for more finesse in grasping the target tissue. Additionally, the triangular shape more closely replicates the shape of conventional forceps.
  • [0094]
    Some exemplary methods of the present invention will now be described. As noted above, the bipolar cauterizers of the present invention are for use with a surgical robotic system. The cauterizers can be attached to a robotic arm and inserted into the patient, as described above in relation to FIGS. 1-3. The cauterizer can be moved to a target tissue and grasp the tissue with the end effectors. A high frequency energy will be delivered to electrodes disposed on the end effectors to cauterize the tissue.
  • [0095]
    As noted above, the electrodes can be provided on the end effectors in a variety of ways. In one configuration, a first end effector can have a first electrode in a groove and the second end effector can have the second electrode can be on a boss, such that when the end effectors interdigitate, the electrodes will be maintained in a spaced configuration. In another configuration, the electrodes can be disposed on nonconductive sleeves that are placed over the end effectors. Note that while the embodiments shown in FIGS. 5-8 and 16-18 are preferably operated with bipolar RF energy, alternative embodiments having the aspects of these examples may by employed with monopolar energy, wherein one of the conductive leads is connected to a ground.
  • [0096]
    While all the above is a complete description of the preferred embodiments of the inventions, various alternatives, modifications, and equivalents may be used. For example, instead of using RF energy, it is possible to couple a resistive metal lead (in an exemplary embodiment delivering a current of 4 Amps and having a voltage of approximately 6 Volts) to the wrist and end effectors to coagulate and cut the engaged tissue. In other alternative embodiments, a cutter may be incorporated on the device between the electrodes. The cutter can be stationary or spring loaded.
  • [0097]
    While not shown, the nonconductive sleeves and electrodes can have a universal interface that can snap fit or otherwise connect to the end effector of the instrument. The universal interface can be used to connect and disconnect various electrodes on the nonconductive sleeve to the conductive lead on the cauterizer so as to allow a quick disconnect of the sleeve and a quick connect of another sleeve. Thus, if the electrode configuration of the cauterizer that is inserted into the body needs to be changed, the surgeon can merely remove the cauterizer from the body, remove the sleeve and place on another nonconductive sleeve that automatically couples the electrode having a more appropriate electrode configuration, to the conductive lead on the instrument. Although the foregoing invention has been described in detail for purposes of clarity of understanding, it will be obvious that certain modifications may be practiced within the scope of the appended claims.
Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US4281447 *Mar 1, 1979Aug 4, 1981Mcdonnell Douglas CorporationDetachable tool interface system for a robot
US4332066 *Jan 7, 1980Jun 1, 1982General Dynamics CorporationCompliance mechanism
US4486928 *Jul 9, 1981Dec 11, 1984Magnavox Government And Industrial Electronics CompanyApparatus for tool storage and selection
US4500065 *Mar 1, 1982Feb 19, 1985Cincinnati Milacron Inc.Releasable tool mount for manipulator
US4512709 *Jul 25, 1983Apr 23, 1985Cincinnati Milacron Inc.Robot toolchanger system
US4706372 *May 23, 1986Nov 17, 1987D.E.A. Digital Electronic Automation S.P.A.Device for effecting automatic exchange of measuring tools in a measuring robot or machine
US4710093 *Jun 4, 1985Dec 1, 1987Kuka Schweissanlagen & Roboter GmbhDevice for the automatic gripping and releasing of a tool holder in a manipulator
US4793053 *Apr 16, 1987Dec 27, 1988General Motors CorporationQuick disconnect device
US4809747 *Jul 31, 1987Mar 7, 1989General Motors CorporationQuick disconnect device
US4830569 *Mar 28, 1988May 16, 1989Asea Brown Boveri AbIndustrial robot having a detachable electrical connection between housing on robot arm and tool holder
US4832198 *Jun 7, 1988May 23, 1989Raza AlikhanContainer for packaging and counting surgical sponges
US4943939 *Aug 29, 1988Jul 24, 1990Rocklin HooverSurgical instrument accounting apparatus and method
US4979949 *Apr 26, 1988Dec 25, 1990The Board Of Regents Of The University Of WashingtonRobot-aided system for surgery
US4996975 *Jun 1, 1990Mar 5, 1991Kabushiki Kaisha ToshibaElectronic endoscope apparatus capable of warning lifetime of electronic scope
US5018266 *Oct 23, 1989May 28, 1991Megamation IncorporatedNovel means for mounting a tool to a robot arm
US5078140 *Sep 23, 1986Jan 7, 1992Kwoh Yik SImaging device - aided robotic stereotaxis system
US5143453 *Nov 27, 1990Sep 1, 1992G.I.R.Temperature monitoring device containing at least one element of an alloy which memorizes its shape
US5154717 *Oct 31, 1990Oct 13, 1992The Board Of Regents Of The University Of WashingtonRobot-aided system for surgery
US5174300 *Feb 7, 1992Dec 29, 1992Symbiosis CorporationEndoscopic surgical instruments having rotatable end effectors
US5217003 *Mar 18, 1991Jun 8, 1993Wilk Peter JAutomated surgical system and apparatus
US5221283 *May 15, 1992Jun 22, 1993General Electric CompanyApparatus and method for stereotactic surgery
US5236432 *Aug 24, 1992Aug 17, 1993Board Of Regents Of The University Of WashingtonRobot-aided system for surgery
US5255429 *Apr 7, 1992Oct 26, 1993Matsushita Electric Industrial Co., Ltd.Component mounting apparatus
US5257998 *Jun 30, 1992Nov 2, 1993Mitaka Kohki Co., Ltd.Medical three-dimensional locating apparatus
US5271384 *Jan 23, 1992Dec 21, 1993Mcewen James APowered surgical retractor
US5294209 *Jul 22, 1992Mar 15, 1994Yamaha Hatsudoki Kabushiki KaishaTool attaching device
US5305203 *Oct 2, 1990Apr 19, 1994Faro Medical Technologies Inc.Computer-aided surgery apparatus
US5312212 *Sep 28, 1992May 17, 1994United Technologies CorporationAxially compliant tool holder
US5313935 *Aug 17, 1993May 24, 1994Symbiosis CorporationApparatus for counting the number of times a surgical instrument has been used
US5343385 *Aug 17, 1993Aug 30, 1994International Business Machines CorporationInterference-free insertion of a solid body into a cavity
US5354314 *Aug 28, 1992Oct 11, 1994Medical Instrumentation And Diagnostics CorporationThree-dimensional beam localization apparatus and microscope for stereotactic diagnoses or surgery mounted on robotic type arm
US5355743 *Dec 19, 1991Oct 18, 1994The University Of Texas At AustinRobot and robot actuator module therefor
US5359993 *Dec 31, 1992Nov 1, 1994Symbiosis CorporationApparatus for counting the number of times a medical instrument has been used
US5372147 *Jun 16, 1992Dec 13, 1994Origin Medsystems, Inc.Peritoneal distension robotic arm
US5397323 *Oct 30, 1992Mar 14, 1995International Business Machines CorporationRemote center-of-motion robot for surgery
US5399951 *May 11, 1993Mar 21, 1995Universite Joseph FourierRobot for guiding movements and control method thereof
US5400267 *Dec 8, 1992Mar 21, 1995Hemostatix CorporationLocal in-device memory feature for electrically powered medical equipment
US5402801 *Apr 28, 1994Apr 4, 1995International Business Machines CorporationSystem and method for augmentation of surgery
US5403319 *Jun 4, 1993Apr 4, 1995Board Of Regents Of The University Of WashingtonBone imobilization device
US5417210 *May 27, 1992May 23, 1995International Business Machines CorporationSystem and method for augmentation of endoscopic surgery
US5427097 *Dec 10, 1992Jun 27, 1995Accuray, Inc.Apparatus for and method of carrying out stereotaxic radiosurgery and radiotherapy
US5451368 *Apr 1, 1994Sep 19, 1995Jacob; AdirProcess and apparatus for dry sterilization of medical devices and materials
US5649956 *Jun 7, 1995Jul 22, 1997Sri InternationalSystem and method for releasably holding a surgical instrument
US5697939 *Apr 18, 1995Dec 16, 1997Olympus Optical Co., Ltd.Apparatus for holding a medical instrument in place
US5762458 *Feb 20, 1996Jun 9, 1998Computer Motion, Inc.Method and apparatus for performing minimally invasive cardiac procedures
US5792135 *May 16, 1997Aug 11, 1998Intuitive Surgical, Inc.Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US5800423 *Jul 20, 1995Sep 1, 1998Sri InternationalRemote center positioner with channel shaped linkage element
US5891142 *Jun 18, 1997Apr 6, 1999Eggers & Associates, Inc.Electrosurgical forceps
US5908420 *Oct 3, 1997Jun 1, 1999Everest Medical CorporationSurgical scissors with bipolar distal electrodes
US6083222 *Oct 18, 1996Jul 4, 2000Boston Scientific CorporationDeflectable catheter for ablating cardiac tissue
US6086586 *Sep 14, 1998Jul 11, 2000Enable Medical CorporationBipolar tissue grasping apparatus and tissue welding method
US6132368 *Nov 21, 1997Oct 17, 2000Intuitive Surgical, Inc.Multi-component telepresence system and method
US6152923 *Apr 28, 1999Nov 28, 2000Sherwood Services AgMulti-contact forceps and method of sealing, coagulating, cauterizing and/or cutting vessels and tissue
US6162200 *Apr 22, 1999Dec 19, 2000Maeda Sangyo Co., Ltd.Syringe and apparatus for manufacturing the same
US6206903 *Oct 8, 1999Mar 27, 2001Intuitive Surgical, Inc.Surgical tool with mechanical advantage
US6331181 *Oct 15, 1999Dec 18, 2001Intuitive Surgical, Inc.Surgical robotic tools, data architecture, and use
US6394998 *Sep 17, 1999May 28, 2002Intuitive Surgical, Inc.Surgical tools for use in minimally invasive telesurgical applications
US6458130 *Apr 3, 2001Oct 1, 2002Sherwood Services AgEndoscopic bipolar electrosurgical forceps
US6511480 *Oct 22, 1999Jan 28, 2003Sherwood Services AgOpen vessel sealing forceps with disposable electrodes
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US7666191Dec 20, 2005Feb 23, 2010Intuitive Surgical, Inc.Robotic surgical system with sterile surgical adaptor
US8021358Jul 9, 2007Sep 20, 2011Carefusion 2200, Inc.Surgical tool kit
US8105319Dec 17, 2008Jan 31, 2012Carefusion 2200, Inc.Hand-actuated articulating surgical tool
US8216250Dec 31, 2009Jul 10, 2012Intuitive Surgical Operations, Inc.Sterile surgical adaptor
US8353897Jul 14, 2010Jan 15, 2013Carefusion 2200, Inc.Surgical tool kit
US8398619Jun 29, 2009Mar 19, 2013Carefusion 2200, Inc.Flexible wrist-type element and methods of manufacture and use thereof
US8821480Jul 16, 2008Sep 2, 2014Intuitive Surgical Operations, Inc.Four-cable wrist with solid surface cable channels
US8915940Jan 26, 2011Dec 23, 2014Agile Endosurgery, Inc.Surgical tool
US8931682May 27, 2011Jan 13, 2015Ethicon Endo-Surgery, Inc.Robotically-controlled shaft based rotary drive systems for surgical instruments
US8973804Mar 18, 2014Mar 10, 2015Ethicon Endo-Surgery, Inc.Cartridge assembly having a buttressing member
US8978954Apr 29, 2011Mar 17, 2015Ethicon Endo-Surgery, Inc.Staple cartridge comprising an adjustable distal portion
US8991677May 21, 2014Mar 31, 2015Ethicon Endo-Surgery, Inc.Detachable motor powered surgical instrument
US8998058May 20, 2014Apr 7, 2015Ethicon Endo-Surgery, Inc.Detachable motor powered surgical instrument
US8998799Jun 15, 2012Apr 7, 2015Intuitive Surgical Operations, Inc.Sterile surgical adaptor
US8998930Jun 6, 2012Apr 7, 2015Intuitive Surgical Operations, Inc.Disposable sterile surgical adaptor
US9028478 *Jul 20, 2011May 12, 2015Covidien LpArticulating surgical apparatus
US9028494Jun 28, 2012May 12, 2015Ethicon Endo-Surgery, Inc.Interchangeable end effector coupling arrangement
US9044230Feb 13, 2012Jun 2, 2015Ethicon Endo-Surgery, Inc.Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9050084Sep 23, 2011Jun 9, 2015Ethicon Endo-Surgery, Inc.Staple cartridge including collapsible deck arrangement
US9055941Sep 23, 2011Jun 16, 2015Ethicon Endo-Surgery, Inc.Staple cartridge including collapsible deck
US9060770May 27, 2011Jun 23, 2015Ethicon Endo-Surgery, Inc.Robotically-driven surgical instrument with E-beam driver
US9072515Jun 25, 2014Jul 7, 2015Ethicon Endo-Surgery, Inc.Surgical stapling apparatus
US9072535May 27, 2011Jul 7, 2015Ethicon Endo-Surgery, Inc.Surgical stapling instruments with rotatable staple deployment arrangements
US9072536Jun 28, 2012Jul 7, 2015Ethicon Endo-Surgery, Inc.Differential locking arrangements for rotary powered surgical instruments
US9084601Mar 15, 2013Jul 21, 2015Ethicon Endo-Surgery, Inc.Detachable motor powered surgical instrument
US9095339May 19, 2014Aug 4, 2015Ethicon Endo-Surgery, Inc.Detachable motor powered surgical instrument
US9101358Jun 15, 2012Aug 11, 2015Ethicon Endo-Surgery, Inc.Articulatable surgical instrument comprising a firing drive
US9101385 *Jun 28, 2012Aug 11, 2015Ethicon Endo-Surgery, Inc.Electrode connections for rotary driven surgical tools
US9113874Jun 24, 2014Aug 25, 2015Ethicon Endo-Surgery, Inc.Surgical instrument system
US9119657Jun 28, 2012Sep 1, 2015Ethicon Endo-Surgery, Inc.Rotary actuatable closure arrangement for surgical end effector
US9125662Jun 28, 2012Sep 8, 2015Ethicon Endo-Surgery, Inc.Multi-axis articulating and rotating surgical tools
US9138225Feb 26, 2013Sep 22, 2015Ethicon Endo-Surgery, Inc.Surgical stapling instrument with an articulatable end effector
US9179911May 23, 2014Nov 10, 2015Ethicon Endo-Surgery, Inc.End effector for use with a surgical fastening instrument
US9186143Jun 25, 2014Nov 17, 2015Ethicon Endo-Surgery, Inc.Robotically-controlled shaft based rotary drive systems for surgical instruments
US9198662Jun 26, 2012Dec 1, 2015Ethicon Endo-Surgery, Inc.Tissue thickness compensator having improved visibility
US9204878Aug 14, 2014Dec 8, 2015Ethicon Endo-Surgery, Inc.Surgical stapling apparatus with interlockable firing system
US9204879Jun 28, 2012Dec 8, 2015Ethicon Endo-Surgery, Inc.Flexible drive member
US9204880Mar 28, 2012Dec 8, 2015Ethicon Endo-Surgery, Inc.Tissue thickness compensator comprising capsules defining a low pressure environment
US9211120Mar 28, 2012Dec 15, 2015Ethicon Endo-Surgery, Inc.Tissue thickness compensator comprising a plurality of medicaments
US9211121Jan 13, 2015Dec 15, 2015Ethicon Endo-Surgery, Inc.Surgical stapling apparatus
US9216019Sep 23, 2011Dec 22, 2015Ethicon Endo-Surgery, Inc.Surgical stapler with stationary staple drivers
US9220500Mar 28, 2012Dec 29, 2015Ethicon Endo-Surgery, Inc.Tissue thickness compensator comprising structure to produce a resilient load
US9220501Mar 28, 2012Dec 29, 2015Ethicon Endo-Surgery, Inc.Tissue thickness compensators
US9226751Jun 28, 2012Jan 5, 2016Ethicon Endo-Surgery, Inc.Surgical instrument system including replaceable end effectors
US9232941Mar 28, 2012Jan 12, 2016Ethicon Endo-Surgery, Inc.Tissue thickness compensator comprising a reservoir
US9241714Mar 28, 2012Jan 26, 2016Ethicon Endo-Surgery, Inc.Tissue thickness compensator and method for making the same
US9271799Jun 25, 2014Mar 1, 2016Ethicon Endo-Surgery, LlcRobotic surgical system with removable motor housing
US9272406Feb 8, 2013Mar 1, 2016Ethicon Endo-Surgery, LlcFastener cartridge comprising a cutting member for releasing a tissue thickness compensator
US9277919Mar 28, 2012Mar 8, 2016Ethicon Endo-Surgery, LlcTissue thickness compensator comprising fibers to produce a resilient load
US9282962Feb 8, 2013Mar 15, 2016Ethicon Endo-Surgery, LlcAdhesive film laminate
US9282966Feb 7, 2014Mar 15, 2016Ethicon Endo-Surgery, Inc.Surgical stapling instrument
US9283054Aug 23, 2013Mar 15, 2016Ethicon Endo-Surgery, LlcInteractive displays
US9289206Dec 15, 2014Mar 22, 2016Ethicon Endo-Surgery, LlcLateral securement members for surgical staple cartridges
US9289212Sep 17, 2010Mar 22, 2016Ethicon Endo-Surgery, Inc.Surgical instruments and batteries for surgical instruments
US9289256Jun 28, 2012Mar 22, 2016Ethicon Endo-Surgery, LlcSurgical end effectors having angled tissue-contacting surfaces
US9301752Mar 28, 2012Apr 5, 2016Ethicon Endo-Surgery, LlcTissue thickness compensator comprising a plurality of capsules
US9301753Mar 28, 2012Apr 5, 2016Ethicon Endo-Surgery, LlcExpandable tissue thickness compensator
US9301759Feb 9, 2012Apr 5, 2016Ethicon Endo-Surgery, LlcRobotically-controlled surgical instrument with selectively articulatable end effector
US9307965Jun 25, 2012Apr 12, 2016Ethicon Endo-Surgery, LlcTissue stapler having a thickness compensator incorporating an anti-microbial agent
US9307986Mar 1, 2013Apr 12, 2016Ethicon Endo-Surgery, LlcSurgical instrument soft stop
US9307988Oct 28, 2013Apr 12, 2016Ethicon Endo-Surgery, LlcStaple cartridges for forming staples having differing formed staple heights
US9307989Jun 26, 2012Apr 12, 2016Ethicon Endo-Surgery, LlcTissue stapler having a thickness compensator incorportating a hydrophobic agent
US9314246Jun 25, 2012Apr 19, 2016Ethicon Endo-Surgery, LlcTissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US9314247Jun 26, 2012Apr 19, 2016Ethicon Endo-Surgery, LlcTissue stapler having a thickness compensator incorporating a hydrophilic agent
US9320518Jun 25, 2012Apr 26, 2016Ethicon Endo-Surgery, LlcTissue stapler having a thickness compensator incorporating an oxygen generating agent
US9320520Aug 19, 2015Apr 26, 2016Ethicon Endo-Surgery, Inc.Surgical instrument system
US9320523Mar 28, 2012Apr 26, 2016Ethicon Endo-Surgery, LlcTissue thickness compensator comprising tissue ingrowth features
US9320568May 21, 2012Apr 26, 2016Intuitive Surgical Operations, Inc.Sterile surgical drape
US9326767Mar 1, 2013May 3, 2016Ethicon Endo-Surgery, LlcJoystick switch assemblies for surgical instruments
US9326768Mar 12, 2013May 3, 2016Ethicon Endo-Surgery, LlcStaple cartridges for forming staples having differing formed staple heights
US9326769Mar 6, 2013May 3, 2016Ethicon Endo-Surgery, LlcSurgical instrument
US9326770Mar 6, 2013May 3, 2016Ethicon Endo-Surgery, LlcSurgical instrument
US9332974Mar 28, 2012May 10, 2016Ethicon Endo-Surgery, LlcLayered tissue thickness compensator
US9332984Mar 27, 2013May 10, 2016Ethicon Endo-Surgery, LlcFastener cartridge assemblies
US9332987Mar 14, 2013May 10, 2016Ethicon Endo-Surgery, LlcControl arrangements for a drive member of a surgical instrument
US9345477Jun 25, 2012May 24, 2016Ethicon Endo-Surgery, LlcTissue stapler having a thickness compensator comprising incorporating a hemostatic agent
US9345481Mar 13, 2013May 24, 2016Ethicon Endo-Surgery, LlcStaple cartridge tissue thickness sensor system
US9351726Mar 14, 2013May 31, 2016Ethicon Endo-Surgery, LlcArticulation control system for articulatable surgical instruments
US9351727Mar 14, 2013May 31, 2016Ethicon Endo-Surgery, LlcDrive train control arrangements for modular surgical instruments
US9351730Mar 28, 2012May 31, 2016Ethicon Endo-Surgery, LlcTissue thickness compensator comprising channels
US9358003Mar 1, 2013Jun 7, 2016Ethicon Endo-Surgery, LlcElectromechanical surgical device with signal relay arrangement
US9358005Jun 22, 2015Jun 7, 2016Ethicon Endo-Surgery, LlcEnd effector layer including holding features
US9364230Jun 28, 2012Jun 14, 2016Ethicon Endo-Surgery, LlcSurgical stapling instruments with rotary joint assemblies
US9364233Mar 28, 2012Jun 14, 2016Ethicon Endo-Surgery, LlcTissue thickness compensators for circular surgical staplers
US9370358Oct 19, 2012Jun 21, 2016Ethicon Endo-Surgery, LlcMotor-driven surgical cutting and fastening instrument with tactile position feedback
US9370364Mar 5, 2013Jun 21, 2016Ethicon Endo-Surgery, LlcPowered surgical cutting and stapling apparatus with manually retractable firing system
US9386984Feb 8, 2013Jul 12, 2016Ethicon Endo-Surgery, LlcStaple cartridge comprising a releasable cover
US9386988Mar 28, 2012Jul 12, 2016Ethicon End-Surgery, LLCRetainer assembly including a tissue thickness compensator
US9393015May 10, 2013Jul 19, 2016Ethicon Endo-Surgery, LlcMotor driven surgical fastener device with cutting member reversing mechanism
US9398911Mar 1, 2013Jul 26, 2016Ethicon Endo-Surgery, LlcRotary powered surgical instruments with multiple degrees of freedom
US9402626Jul 18, 2012Aug 2, 2016Ethicon Endo-Surgery, LlcRotary actuatable surgical fastener and cutter
US9408604Feb 28, 2014Aug 9, 2016Ethicon Endo-Surgery, LlcSurgical instrument comprising a firing system including a compliant portion
US9408606Jun 28, 2012Aug 9, 2016Ethicon Endo-Surgery, LlcRobotically powered surgical device with manually-actuatable reversing system
US9414838Mar 28, 2012Aug 16, 2016Ethicon Endo-Surgery, LlcTissue thickness compensator comprised of a plurality of materials
US9433419Mar 28, 2012Sep 6, 2016Ethicon Endo-Surgery, Inc.Tissue thickness compensator comprising a plurality of layers
US9439649Dec 12, 2012Sep 13, 2016Ethicon Endo-Surgery, LlcSurgical instrument having force feedback capabilities
US9439732Aug 6, 2013Sep 13, 2016Intuitive Surgical Operations, Inc.Instrument interface of a robotic surgical system
US9445813Aug 23, 2013Sep 20, 2016Ethicon Endo-Surgery, LlcClosure indicator systems for surgical instruments
US9451958Aug 5, 2013Sep 27, 2016Ethicon Endo-Surgery, LlcSurgical instrument with firing actuator lockout
US9468438Mar 1, 2013Oct 18, 2016Eticon Endo-Surgery, LLCSensor straightened end effector during removal through trocar
US9480476Mar 28, 2012Nov 1, 2016Ethicon Endo-Surgery, LlcTissue thickness compensator comprising resilient members
US9486214May 20, 2013Nov 8, 2016Ethicon Endo-Surgery, LlcMotor driven surgical fastener device with switching system configured to prevent firing initiation until activated
US9492167Mar 14, 2013Nov 15, 2016Ethicon Endo-Surgery, LlcArticulatable surgical device with rotary driven cutting member
US9498219Jun 30, 2015Nov 22, 2016Ethicon Endo-Surgery, LlcDetachable motor powered surgical instrument
US9510828Aug 23, 2013Dec 6, 2016Ethicon Endo-Surgery, LlcConductor arrangements for electrically powered surgical instruments with rotatable end effectors
US9510830Oct 23, 2014Dec 6, 2016Ethicon Endo-Surgery, LlcStaple cartridge
US9517063Mar 28, 2012Dec 13, 2016Ethicon Endo-Surgery, LlcMovable member for use with a tissue thickness compensator
US9517068Aug 5, 2013Dec 13, 2016Ethicon Endo-Surgery, LlcSurgical instrument with automatically-returned firing member
US9522029Mar 12, 2013Dec 20, 2016Ethicon Endo-Surgery, LlcMotorized surgical cutting and fastening instrument having handle based power source
US9532849Apr 24, 2012Jan 3, 2017Intuitive Surgical Operations, Inc.Surgical accessory clamp and system
US9545245 *Apr 21, 2015Jan 17, 2017Covidien LpArticulating surgical apparatus
US9554794Mar 1, 2013Jan 31, 2017Ethicon Endo-Surgery, LlcMultiple processor motor control for modular surgical instruments
US9561032Aug 13, 2013Feb 7, 2017Ethicon Endo-Surgery, LlcStaple cartridge comprising a staple driver arrangement
US9561038Jun 28, 2012Feb 7, 2017Ethicon Endo-Surgery, LlcInterchangeable clip applier
US9566061Feb 8, 2013Feb 14, 2017Ethicon Endo-Surgery, LlcFastener cartridge comprising a releasably attached tissue thickness compensator
US9572574Jun 22, 2015Feb 21, 2017Ethicon Endo-Surgery, LlcTissue thickness compensators comprising therapeutic agents
US9572577Mar 27, 2013Feb 21, 2017Ethicon Endo-Surgery, LlcFastener cartridge comprising a tissue thickness compensator including openings therein
US9574644May 30, 2013Feb 21, 2017Ethicon Endo-Surgery, LlcPower module for use with a surgical instrument
US9585657Feb 8, 2013Mar 7, 2017Ethicon Endo-Surgery, LlcActuator for releasing a layer of material from a surgical end effector
US9585658Apr 7, 2016Mar 7, 2017Ethicon Endo-Surgery, LlcStapling systems
US9585663Mar 8, 2016Mar 7, 2017Ethicon Endo-Surgery, LlcSurgical stapling instrument configured to apply a compressive pressure to tissue
US9592050Feb 8, 2013Mar 14, 2017Ethicon Endo-Surgery, LlcEnd effector comprising a distal tissue abutment member
US9592052Mar 12, 2014Mar 14, 2017Ethicon Endo-Surgery, LlcStapling assembly for forming different formed staple heights
US9592053May 22, 2014Mar 14, 2017Ethicon Endo-Surgery, LlcStaple cartridge comprising multiple regions
US9592054Nov 4, 2015Mar 14, 2017Ethicon Endo-Surgery, LlcSurgical stapler with stationary staple drivers
US9603595Feb 28, 2014Mar 28, 2017Ethicon Endo-Surgery, LlcSurgical instrument comprising an adjustable system configured to accommodate different jaw heights
US9603598Aug 30, 2013Mar 28, 2017Ethicon Endo-Surgery, LlcSurgical stapling device with a curved end effector
US9615826Feb 8, 2013Apr 11, 2017Ethicon Endo-Surgery, LlcMultiple thickness implantable layers for surgical stapling devices
US9629623Mar 14, 2013Apr 25, 2017Ethicon Endo-Surgery, LlcDrive system lockout arrangements for modular surgical instruments
US9629629Mar 7, 2014Apr 25, 2017Ethicon Endo-Surgey, LLCControl systems for surgical instruments
US9629814Mar 20, 2014Apr 25, 2017Ethicon Endo-Surgery, LlcTissue thickness compensator configured to redistribute compressive forces
US9649110Apr 9, 2014May 16, 2017Ethicon LlcSurgical instrument comprising a closing drive and a firing drive operated from the same rotatable output
US9649111Jun 28, 2012May 16, 2017Ethicon Endo-Surgery, LlcReplaceable clip cartridge for a clip applier
US9655614Mar 11, 2013May 23, 2017Ethicon Endo-Surgery, LlcRobotically-controlled motorized surgical instrument with an end effector
US9655624Aug 30, 2013May 23, 2017Ethicon LlcSurgical stapling device with a curved end effector
US9662110Sep 15, 2015May 30, 2017Ethicon Endo-Surgery, LlcSurgical stapling instrument with an articulatable end effector
US9675355Aug 30, 2013Jun 13, 2017Ethicon LlcSurgical stapling device with a curved end effector
US9687230Mar 14, 2013Jun 27, 2017Ethicon LlcArticulatable surgical instrument comprising a firing drive
US9687237Jun 8, 2015Jun 27, 2017Ethicon Endo-Surgery, LlcStaple cartridge including collapsible deck arrangement
US9687312Mar 17, 2015Jun 27, 2017Intuitive Surgical Operations, Inc.Detection pins to determine presence of surgical instrument and adapter on manipulator
US9690362Mar 26, 2014Jun 27, 2017Ethicon LlcSurgical instrument control circuit having a safety processor
US9693777Feb 24, 2014Jul 4, 2017Ethicon LlcImplantable layers comprising a pressed region
US9700309Mar 1, 2013Jul 11, 2017Ethicon LlcArticulatable surgical instruments with conductive pathways for signal communication
US9700310Aug 23, 2013Jul 11, 2017Ethicon LlcFiring member retraction devices for powered surgical instruments
US9700317Feb 8, 2013Jul 11, 2017Ethicon Endo-Surgery, LlcFastener cartridge comprising a releasable tissue thickness compensator
US9700321May 28, 2014Jul 11, 2017Ethicon LlcSurgical stapling device having supports for a flexible drive mechanism
US9706991Feb 19, 2014Jul 18, 2017Ethicon Endo-Surgery, Inc.Staple cartridge comprising staples including a lateral base
US9724091Aug 29, 2013Aug 8, 2017Ethicon LlcSurgical stapling device
US9724094Sep 5, 2014Aug 8, 2017Ethicon LlcAdjunct with integrated sensors to quantify tissue compression
US9724098Nov 13, 2014Aug 8, 2017Ethicon Endo-Surgery, LlcStaple cartridge comprising an implantable layer
US9724163Mar 9, 2015Aug 8, 2017Intuitive Surgical Operations, Inc.Disposable sterile surgical adaptor
US9730692Mar 12, 2013Aug 15, 2017Ethicon LlcSurgical stapling device with a curved staple cartridge
US9730695Sep 17, 2015Aug 15, 2017Ethicon Endo-Surgery, LlcPower management through segmented circuit
US9730697Apr 23, 2015Aug 15, 2017Ethicon Endo-Surgery, LlcSurgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9733663Mar 26, 2014Aug 15, 2017Ethicon LlcPower management through segmented circuit and variable voltage protection
US9737301Sep 5, 2014Aug 22, 2017Ethicon LlcMonitoring device degradation based on component evaluation
US9737302Mar 8, 2016Aug 22, 2017Ethicon LlcSurgical stapling instrument having a restraining member
US9737303Sep 10, 2015Aug 22, 2017Ethicon LlcArticulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US9743928Mar 25, 2014Aug 29, 2017Ethicon Endo-Surgery, Inc.Surgical instrument having a feedback system
US9743929Mar 26, 2014Aug 29, 2017Ethicon LlcModular powered surgical instrument with detachable shaft assemblies
US9750498Sep 28, 2015Sep 5, 2017Ethicon Endo Surgery, LlcDrive systems for surgical instruments
US9750499Mar 26, 2014Sep 5, 2017Ethicon LlcSurgical stapling instrument system
US9750501May 24, 2016Sep 5, 2017Ethicon Endo-Surgery, LlcSurgical stapling devices having laterally movable anvils
US9757123Mar 7, 2013Sep 12, 2017Ethicon LlcPowered surgical instrument having a transmission system
US9757124Feb 24, 2014Sep 12, 2017Ethicon LlcImplantable layer assemblies
US9757128Sep 5, 2014Sep 12, 2017Ethicon LlcMultiple sensors with one sensor affecting a second sensor's output or interpretation
US9757130Mar 12, 2014Sep 12, 2017Ethicon LlcStapling assembly for forming different formed staple heights
US20060161138 *Dec 20, 2005Jul 20, 2006Intuitive Surgical Inc.Sterile surgical adaptor
US20070287994 *Jun 12, 2006Dec 13, 2007Pankaj Amrit PatelEndoscopically Introducible Expandable Bipolar Probe
US20070288001 *Jun 11, 2007Dec 13, 2007Pankaj PatelEndoscopically introducible expandable cautery device
US20080108443 *Oct 30, 2007May 8, 2008Terumo Kabushiki KaishaManipulator
US20090320637 *Jun 29, 2009Dec 31, 2009Allegiance CorporationFlexible wrist-type element and methods of manufacture and use thereof
US20100011901 *Jul 16, 2008Jan 21, 2010Intuitive Surgical, Inc.Four-cable wrist with solid surface cable channels
US20100174293 *Dec 31, 2009Jul 8, 2010Intuitive Surgical, Inc.Sterile surgical adaptor
US20120209263 *Feb 16, 2011Aug 16, 2012Tyco Healthcare Group LpSurgical Instrument with Dispensable Components
US20130023872 *Jul 20, 2011Jan 24, 2013Tyco Healthcare Group LpArticulating Surgical Apparatus
US20140005680 *Jun 28, 2012Jan 2, 2014Ethicon Endo-Surgery, Inc.Electrode connections for rotary driven surgical tools
US20150011996 *Sep 22, 2014Jan 8, 2015Intuitive Surgical Operations, Inc.Cut and seal instrument
US20150223790 *Apr 21, 2015Aug 13, 2015Covidien LpArticulating surgical apparatus
EP1917929A1Nov 5, 2007May 7, 2008Terumo Kabushiki KaishaManipulator
EP2744435B1 *Aug 14, 2012May 11, 2016Covidien LPSurgical forceps
EP3050532A1 *Aug 14, 2012Aug 3, 2016Covidien LPSurgical forceps
WO2007142698A2 *Dec 20, 2006Dec 13, 2007Intuitive Sugical, Inc.Sterile surgical adaptor
WO2007142698A3 *Dec 20, 2006Feb 21, 2008Intuitive Sugical IncSterile surgical adaptor
WO2010009221A2 *Jul 15, 2009Jan 21, 2010Intuitive Surgical, Inc.Four-cable wrist with solid surface cable channels
WO2010009221A3 *Jul 15, 2009Mar 11, 2010Intuitive Surgical, Inc.Four-cable wrist with solid surface cable channels
WO2015142789A1 *Mar 17, 2015Sep 24, 2015Intuitive Surgical Operations, Inc.Alignment and engagement for teleoperated actuated surgical instruments
WO2017075336A1 *Oct 28, 2016May 4, 2017Imricor Medical Systems, Inc.Sliding distal component assembly
Classifications
U.S. Classification606/51
International ClassificationA61B19/00, A61B18/14
Cooperative ClassificationA61B34/30, A61B2034/305, A61B2090/506, A61B34/71, A61B2017/00477, A61B2018/00208, A61B18/1445, A61B2018/1495, A61B2018/1861, A61B2017/003
European ClassificationA61B19/22B, A61B18/14F2