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 numberUS3763860 A
Publication typeGrant
Publication dateOct 9, 1973
Filing dateAug 26, 1971
Priority dateAug 26, 1971
Publication numberUS 3763860 A, US 3763860A, US-A-3763860, US3763860 A, US3763860A
InventorsH Clarke
Original AssigneeH Clarke
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Laparoscopy instruments and method for suturing and ligation
US 3763860 A
Abstract
An improved combined laparoscopic needle and forceps comprising an elongated parallelogram type of linkage suitable for insertion through a trocar and having first and second ends, a needle, means for mounting said needle on said first end for movement from a position in substantial alignment with said linkage, which permits it to pass through a trocar, to a position transverse to said linkage, handle means on said second end of said linkage for actuating said linkage to effect movement of said needle, and a forceps construction including jaw means mounted proximate said first end of said needle linkage and being formed from a portion of said linkage and a portion of the holder of the needle. An improved combined laparoscopic forceps, suture guide and cutter comprising an elongated parallelogram type of linkage which is sufficiently slender for passage through a trocar and having first and second ends, jaw means on said first end, and handle means on said second end for actuating said linkage to move said jaws, groove means associated with said jaws for receiving a suture to thus act as a suture guide, and cutter means mounted on said jaws for cutting a suture. An improved laparoscopic ligator comprising an elongated stem having first and second ends, a handle at said first end and suture guiding means at said second end, said suture guiding means being of substantially the same cross sectional dimension as said elongated stem for guiding a suture through a trocar. An improved method of performing a surgical operation by laparoscopy comprising the steps of inserting at least first and second trocars through the body of a patient at spaced locations, inserting a first instrument comprising the above described combined laparoscopic needle and forceps through said first trocar, inserting a second instrument comprising the above described laparoscopic forceps, suture guide and cutter through said second trocar, manipulating said first and second instruments in cooperating relationship with each other in a predetermined area to bring the central portion of a suture in position, withdrawing one of said instruments to bring the end of the suture outside of the patient's body, tying a knot in the suture outside of the body, and bringing the knot into the desired position by means of said laparoscopic ligator.
Images(3)
Previous page
Next page
Claims  available in
Description  (OCR text may contain errors)

United States Patent 1 Clarke 7 1 Oct. 9, 1973 LAPAROSCOPY INSTRUMENTS AND METHOD FOR SUTURING AND LIGATION [76] Inventor: Henry C. N. Clarke, 100 High St., Buffalo, N.Y. 14203 [22] Filed: Aug. 26, I971 [21] Appl. No.: 175,163

OTHER PUBLICATIONS Muller Instrument Catalogue 1956, Pages 82, 106, 124.

Primary Examiner-Aldrich F. Medbery Attorneyl(enneth R. Sommer et al.

[57] ABSTRACT An improved combined laparoscopic needle and forceps comprising an elongated parallelogram type of linkage suitable for insertion through a trocar and having first and second ends, a needle, means for mounting said needle on said first end for movement from a position in substantial alignment with said linkage, which permits it to pass through a trocar, to a position transverse to said linkage, handle means on said second end of said linkage for actuating said linkage to effect movement of said needle, and a forceps construction including jaw means mounted proximate said first end of said needle linkage and being formed from a portion of said linkage and a portion of the holder of the needle. An improved combined laparoscopic forceps, suture guide and cutter comprising an elongated parallelogram type of linkage which is sufficiently slender for passage through a trocar and having first and second ends, jaw means on said first end, and handle means on said second end for actuating said linkage to move said jaws, groove means associated with said jaws for receiving a suture to thus act as a suture guide, and cutter means mounted on said jaws for cutting a suture. An improved laparoscopic ligator comprising an elongated stem having first and second ends, a handle at said first end and suture guiding means at said second end, said suture guiding means being of substantially the same cross sectional dimension as said elongated stem for guiding a suture through a trocar. An improved method of performing a surgical operation by laparoscopy comprising the steps of inserting at least first and second trocars through the body of a patient at spaced locations, inserting a first instrument comprising the above described combined laparoscopic needle and forceps through said first trocar, inserting a second instrument comprising the above described laparoscopic forceps, suture guide and cutter through said second trocar, manipulating said first and second instruments in cooperating relationship with each other in a predetermined area to bring the central portion of a suture in position, withdrawing one of said instruments to bring the end of the suture outside of the patients body, tying a knot in the suture outside of the body, and bringing the knot into the desired position by means of said laparoscopic ligator.

4 Claims, 25 Drawing Figures sum 1 0r 3 PATENTEB OCT 91973 I'l |IIII|II Illllllllu INVENTOR,

HENRY C. N. CLARKE AZW I rwhaze.

ATTORNEYS PATENTEDBBT 91915 SHEET 2 U 3 INVENTOR HENRY C. N. CLARKE ATTORNEYS PATENTED 9m 9 SHU 3L"- 3 INVENTOR HENRY C. N. CLARKE ATTORNEYS LAPAROSCOPY INSTRUMENTS AND METHOD FOR SUTURING AND LIGATION The present invention relates to improved laparoscopy instruments for suturing and ligationand to an improved method of laparoscopy.

By way of background, recently there has been an increasing use of laparoscopy in pelvic surgery. The most common uses of laparoscopy are for diagnosis of pelvic disease and tubal electrocoagulation and cutting. Among the operations performed with a great degree of safety and less morbidity for the patient than be laparotomy are: biopsy and electrocoagulation; lysis of adhesions with electrocoagulation; fertility studies by intrauterine dye injection; ovarian follicle aspiration; biopsy of the ovary; extended post coital aspiration tests; tuboplasty by opening the fimbriated ends of closed tubes; cul-de-sac aspiration; ovarian cyst aspiration; electrocoagulation of bleeding points such as bleeding corpus luteum or bleeding secondary to instrumentation; electrocoagulation of endometriosis; electrocoagulation of tumor implants; biopsies in general; and excision of small tumors with electrocoagulation.

In certain of the foregoing procedures difficulty has been encountered when blood vessels are cut and hemostatis cannot be maintained by electrocoagulation. This bleeding has been an especially troublesome'problem in tubal electrocoagulation and cutting. When bleeding difficulties have been encountered, laparotomy has become necessary because of the past inability to suture and ligate with laparoscopic procedures.

It is accordingly one important object of the present invention to provide an improved series of instruments which increase the ability to suture and ligate in laparoscopy. A related object of the present invention is to provide a combined laparoscopic needle and foreceps. Another related object of the present invention is to provide a combined laparoscopic tissue forceps, suture guide and cutter. A further related object of the present invention is to provide an improved laparoscopic ligator.

Another object of the present invention is to provide a new and improved surgical method of laparoscopy. Other objects and attendant advantages of the present invention will readily be perceived hereafter.

The improved combined laparoscopic needle and forceps of the present invention comprises an elongated linkage portion having first and second ends, a needle, means for mounting said needle on said first end for movement from a position in substantial alignment with said linkage, which permits it to pass through a trocar, to a position transverse to said linkage, means on said second end of said linkage for actuating said linkage to effect said movement of said needle, and a forceps construction including jaw means mounted proximate said first end of said linkage.

The improved combined laparoscopic forceps, suture guide and cutter comprises an elongated linkage having first and second ends, jaw means mounted on said first end and handle means on said second end for actuating said linkage to move said jaws, groove means associated with said jaws for receiving a suture to thus act as a suture guide, and cutter means mounted on said jaws for cutting a suture.

The improved laparoscopic ligator of the present invention comprises an elongated stem having first and second ends, a handle at said first end, and suture guiding means at said second end, said suture guiding means being of substantially the same cross sectional dimension as said elongated stem for guiding a suture through a trocar.

The improved method of performing a surgical operation by laparoscopy, in its broadest aspect, comprises the steps of inserting at least first and second trocars through the body at spaced locations, inserting a first instrument through said first trocar, inserting a second instrument through said second trocar and manipulating said first and second instruments in cooperating relationship with each other in a predetermined area to perform said operation.

The various aspects of the present invention will be I more fully understood when the following portions of the specification are read in conjunction with the accompanying drawings wherein:

FIG. 1 is a side elevational view of a trocar of the type suitable for use in a laparoscopy;

FIG. 2 is a fragmentary cross sectional view thereof taken substantially along line 2-2 of FIG. 1;

FIG. 3 is a side elevational view of a combined laparoscopic tissue forceps, suture guide, and suture cutter;

FIG. 4 is an enlarged fragmentary top plan view thereof taken substantially in the direction of arrows 4-4 of FIG. 3;

FIG. 5 is a fragmentary longitudinal sectional view thereof taken substantially along line 5-5 of FIG. 4 and showing the suture guide and cutter associated with the jaws; I

FIG. 6 is an enlarged fragmentary longitudinal sectional view of the rear portion thereof taken substantially along line 6-6 of FIG. 9 and showing the linkage associated with the handles;

FIG. 7 is a cross sectional view thereof taken substantially along line 7-7 of FIG. 5 and showing the suture cutter structure;

FIG. 8 is a cross sectional view thereof taken substantially along line 8-8 of FIG. 5 and showing the jaw mounting linkage;

FIG. 8A is an enlarged cross sectional view thereof taken substantially along line 8A-8A of FIG. 3 and showing details of the spring structure for biasing the links together;

FIG. 9 is a fragmentary cross sectional view thereof taken substantially along line 9-9 of FIG. 6 and showing the linkage associated with the handles;

FIG. 10 is a side elevational view of a combined laparoscopic needle and forceps;

FIG. 11 is an enlarged fragmentary top plan view thereof taken substantially in the direction of arrows 11-11 of FIG. 10;

FIG. 12 .is a fragmentary longitudinal sectional view thereof taken substantially along line 12-12 of FIG. 11 and showing the linkage for moving the needle and the jaws;

FIG. 13 is a fragmentary view similar to FIG. 12 but showing the forcep jaws open;

FIG. 14 is a cross sectional view thereof taken substantially along line 14-14 of FIG. 12;

FIG. 15 is an enlarged fragmentary longitudinal sectional view thereof taken substantially along line 15-15 of FIG. 16 and showing the linkage associated with the handles;

FIG. 16 is a fragmentary cross sectional view thereof taken substantially along line 16-16 of FIG. 15;

FIG. 17 is a side elevational view of a laparoscopic ligator with an open ended circular tip;

FIG. 18 is a fragmentary enlarged view of the ligator of FIG. 17 with the handle portion of the ligator illustrated in section;

FIG. 19 is a fragmentary cross sectional view thereof taken substantially along line 19-19 of FIG. 18 and showing the tip of the ligator in greater detail;

FIG. 20 is a fragmentary perspective view showing the first step of s surgical operation wherein a tissue tube is clamped by the forceps and the needle is brought into the clamped area;

FIG. 21 is a view showing the needle deflected around the tube with the forceps released from the tube and grasping the end of the suture;

FIG. 22 is a fragmentary perspective view showing the suture being held in the suture guide portion of the forceps with the forceps associated with the needle pulling the suture;

FIG. 23 is a fragmentary perspective view showing the ligator pushing the suture knot toward the tube; and

FIG. 24 is a fragmentary perspective view showing the cutter portion of the forceps severing the suture after tying has been completed.

By way of introduction, the laparoscopy which is performed with the instruments of the present'invention consists of the steps of inserting first and second sheathed trocars approximately 4 centimeters above the lower third of the inguinal ligament on each side of the patient. A third trocar is inserted through the naval for receiving an endoscope. A tissue forceps is inserted through the first trocar to hold the tissue which is to be sutured-ligated. Through the second trocar, the laparoscopic needle threaded with suture is introduced and brought into the area of the tissue forceps. Thereafter the instruments are manipulated as will be described hereafter after their structure has been described.

The trocars which are used are shown in FIGS. 1 and 2. In assembled condition the trocar includes a stem 1 1 having a pointed end 12 at one end and a head 13 at the other end. A sheath 14 is located on stem 11 and mounts an enlarged portion 15 which includes a diaphragm member 16 mounted thereon. As is well understood by those skilled in the art, the assembled stem and sheath are inserted through the skin and thereafter stem 11 is withdrawn leaving sheath 14 in place. The laparoscopic instruments are inserted through tube 14 and a seal is maintained with them by means of diaphragm 16, to prevent the escape of gas which has been pumped into the abdominal cavity to separate the abdominal wall from body organs. This sealing is effected in the manner shown in FIG. 2 by having the circular diaphragm 16 engage the instrument.

The combined laparoscopic tissue forceps, suture guide and cutter 17 is shown in FIGS. 3-9. Basically, it includes a pair of elongated slender links 18 and 19 which lie in side-by-side relationship and are attached at one end to each other by means of cross link 20 which is pivotally mounted on pin 21 secured to the bifurcated end 22 of link 18, and is also pivotally mounted on pin 23 on bifurcated end 24 of link 19. The opposite ends of links 18 and 19 are secured to each other by cross link 25 which has the end thereof pivotally mounted on pin 26 attached to opposite side portions 26' of link 19 and an adjacent portion pivotally mounted on pin 27 mounted on bifurcated end 18' of link 18, as can be seen from FIGS. 6 and 9. Link 25 is essentially an extension of handle 28 having finger receiving opening 29 therein. Located proximate handle 28 is handle 30 which is an extension of link 18 and has finger receiving opening 31 therein.

Links 18, 19, 20 and 25 essentially define a parallelogram type of linkage so that when handle portions 28 and 30 are spread apart from the position shown in FIG. 3 link 19 will move essentially in the direction of arrow 32 relative to link 18 which moves essentially in the direction of arrow 33 relative to link 19. The foregoing action will cause link 20 to pivot in a clockwise direction as viewed in FIG. 5 about pin 21 which in turn will cause jaw 34 which is formed integrally with link 20 to pivot in a clockwise direction about pin 21 to thereby move away from jaw 35 which is an extension of link 18 and formed integrally therewith. It will be appreciated that jaws 34 and 35, when closed, can be inserted through trocar sheath 14 and links 18 and 19, in all positions thereof, can be moved relative to sheath 14, as is required during surgery. A spring structure 19 (FIGS. 3 and 8A) biases links 18 and 19 together to maintain jaws 34 and 35 biased to a closed position. Spring 19 includes a longitudinally extending strip 20' from which U shaped portions 21, 22' and 23 extend, with portions 21' and 23 embracing link 19 and portion 22 embracing link 18. A plastic sheath, not shown, can be used to cover spring 19' so that it will not snag in the trocar.

The combined laparoscopic tissue forceps, suture guide and cutter l7 performs a plurality of functions. First of all, jaws 34 and 35 have serrations 34 and 35' on their opposing surfaces to provide a good grip on either the tissue or the suture which is to be held. In addition jaws 34 and 35 have opposing grooves 36 and 37, respectively, in their opposing surfaces intermediate the ends of the serrated portions 34' and 35'. When the jaws are closed grooves 36 and 37 provide an opening or hole 38 having a continuous periphery. As will become more apparent hereafter, a suture can be received in opening 38 and guided therethrough during a suturing operation. In addition, jaws 34 and 35 have shear blades-39 and 40, respectively, secured thereon to provide a suture cutting action as will also become more apparent hereafter. Because of the fact that the combinated laparoscopic forceps, suture guide and cutter performs a plurality of functions, it is not necessary to insert a plurality of individual instruments through a particular trocar sheath because the same instruments can be maintained in position therein to perform a plurality of functions, as desired, thereby lessening the number of times that entry need be made through the trocar.

The combined laparoscopic needle and forceps 41 of the present invention, shown in FIGS. 10-16, includes a pair of elongated slender links 42 and 43 which are maintained in side-by-side relationship by cross links which provide a parallelogram type of linkage. More specifically, cross link 44 is pivotally connected to link 42 by pin 45, to link 43 by pin 46. Pin 45 is secured to the bifurcated end portion of link 42, and pin 46 is secured to opposite sides 47 of link 43. The lower end of link 44 lies within depression 47 in link 43. Needle holder portion 48, which supports needle 49 at its outer end, is fonned integrally as an extension of link 44. The ends of links 42 and 43 which are remote from needle 49 are fastened together by link 50 which is pivotally mounted on pin 51 carried by opposite side portions 51' of link 42 and on pin 52 mounted on bifurcated end 52' of link 43. Link 50 is an extension of and integral with handle 53 having finger-receiving opening 54 at the end thereof. Handle 55 having finger-receiving opening 56 at the end thereof is integral with and an extension of link 43.

By suitable manipulation of handles 53 and 55 link 42 can be caused to move in the direction of arrow 57 (FlG. 13) relative to link 43 which moves in the directionof arrow 58 relative to link 42. This will cause link 44 and needle holder 48 to pivot from the position shown in FIG. 12 to the position shown in FIG. 13. A detent tab 59 is rigidly attached at portion 60 to handle 53, and handle 55 slides across tab 59 in frictional engagement therewith. Thus when handles 53 and 55 are released, the needle holder 48 will remain in the position in which it was last placed until the handles are again manipulated. Because needle 49 can move from a position shown in FIG. 12 to the position shown in FIG. 13, it can be moved essentially through a right angle after it is placed in position within the body, as will become more apparent hereafter. It will be appreciated that because of the slender nature of links 42 and 43, and further because needle 49 is in substantially longitudinal alignment therewith, the needle can be inserted through the trocar and thereafter be movedto any desired position therein, as required.

It is also to be noted that a pair of opposing jaws 61 and 62 are provided. Jaw 61 is located on'one side of needle holder 48 and jaw 62 is located at the end of link 43 (FIG. 13). It can thus be seen that the combined laparoscopic needle and forceps can be used to provide both a sewing action and a clamping action as required to obviate the necessity of using two separate instruments, thereby lessening the number of times that entry and withdrawal of instruments need be made through the trocar.

The laparoscopic ligator 63 of the present invention, shown in FlGS. 17-19, includes an elongated stem 64 having an enlarged end 65 which is embedded in handle 66. The opposite end of ligator 63 is formed into a pair of curved integral arms 67 separated by slot 68. The end of stem 64 between the arms is formed into grooved portions 69. The suture is received in opening 70 for ligating, as will be described in greater detail hereafter.

The laparoscopy is performed by the above described instruments in the following manner. Firstly, as noted above, two sheathed trocars 14 are inserted'approximately 4 centimeters above the lower third of the inguinal ligaments on each side of the patient, in the event the operation is for the purpose of tying ofi' the Fallopian tubes. A third trocar is inserted through the naval for the purpose of receiving an endoscope. Through one lateral trocar sheath, the tissue forceps 17 is inserted and the tissue to be suture ligated, namely, the tube 71, is clamped and held between jaws 34 and 35. Through the other lateral trocar sheath the laparoscopic needle 41 is introduced. This needle prior to insertion is threaded with suture 72 which is held on needle 49 by being wedged into a crotch formed between the needle proper and protuberance 73 thereon. After the needle is brought to the proper position, such as shown in H0. 21, and while the tube is still clamped as shown in FIG. 20, handles 53 and 55 are manipulated to move needle 49 from its in-line position to a lateral position where it extends transversely to links 42 and 43, this lateral position being illustrated in FIG. 21. After the needle has been so flexed, the tissue 74 is pierced to bring the suture 72 through the tissue. Thereafter handles 28 and 30 of the tissue forceps are manipulated so as to cause jaws 34 and 35 to release tube 71 and to grasp the end 75 of suture 72, as shown in FIG. 21, and disengage it from needle 49 which is then withdrawn from tissue 74.-Next, the suture 72 is carried around tube 71 by forceps 17 and end 75 of suture 72 is clamped between the jaws 61 and 62 of laparoscopic forceps 41. The opening 38 formed between the jaws of forceps 17 may be closed around suture 72, as shown in FIG. 22, to provide a guide for suture 72 to prevent suture-pull on delicate tissue as needle 49 is being withdrawn through trocar 14 to bring the free end 75 of suture 72 outside of the body. The diaphragm 16 at the end of trocar 14 prevents the escape of gas from the inflated abdominal cavity and externally of this diaphragm free end 75 of the suture is tied with end 76 thereof to provide a first tie. This tie is then introduced by ligator 63 through sheath 14 (FlG. 23), with the tie being held in groove of the ligator. This tie is carried down to the central portion 77 of the suture to close off tube 71. Thereafter second and third ties may be formed at ends and 76 and brought down into position with ligator 63 in the same manner as just described. A surgical knot has been found to be most convenient to provide the type of tie at 78 which is desired. Thereafter the shear blades 39 and 40 which are located on forceps 17 are used to cut the free ends of suture 72 to complete the tying operation.

It will be appreciated that because each of the instruments 17 and 41 performs a plurality of functions, there is no necessity to keep reinserting different instruments through the trocars to effect the various functions which are required. Furthermore, because the links which form the main central body portions of the instruments are extremely slender and do not spread apart appreciably when the instruments are manipulated, they can be conveniently inserted and removed through the trocars and manipulated while therein as required.

lclaim:

1. A laparoscopic forcepneedle comprising elongated linkage having first and second ends, a needle, means for mounting said needle on said first end of said linkage for movement between a first position in substantial alignment with said linkage and a second position transverse to said linkage, said linkage with said needle in said first position being sized as to be insertable into a trocar, and manually operated means on said second end of said linkage for actuating said linkage to effect said movement of said needle.

2. A laparoscopic forcepneedle as set forth in claim 1 wherein said linkage includes first and second elongated links located in side-by-side relationship, and said needle mounting means includes first and second pivots on said first and second links, respectively, on said first end of said linkage, a cross link coupled to said first and second pivots and means supporting said needle on said cross link.

3. A laparoscopic forcepneedle as set forth in claim 2 wherein said manually operated means includes third and fourth pivots on said first and second elongated links, respectively, at said second end, a second crosslink coupled to said third'and fourth pivots and a pair 7 8 of handles one of which is connected to said second 4. A laparoscopic forcep needle as set forth in claim cross-link and the other of which is connected to one 1 wherein Said needle includes a crotch portion for of said elongated links to cause said first and second elongated links to move longitudinally relative to each other.

wedgingly receiving a suture.

* IR IF

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US3006344 *Feb 24, 1959Oct 31, 1961Isaac J VogelfangerSurgical ligator and cutter
US3090386 *Jul 20, 1961May 21, 1963Curtis Scott CompanySurgical suturing instrument
US3139089 *Nov 16, 1961Jun 30, 1964George S SchwerinNeedle manipulating device
Non-Patent Citations
Reference
1 *Muller Instrument Catalogue 1956, Pages 82, 106, 124.
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3856016 *Nov 3, 1972Dec 24, 1974H DavisMethod for mechanically applying an occlusion clip to an anatomical tubular structure
US3882854 *Aug 23, 1973May 13, 1975Research CorpSurgical clip and applicator
US3989049 *Oct 29, 1974Nov 2, 1976In Bae YoonMethod of applying an elastic ring to an anatomical tubular structure
US3994287 *Jul 1, 1974Nov 30, 1976Centre De Recherche Industrielle Du QuebecTrocar
US4085756 *Sep 30, 1976Apr 25, 1978Kenneth WeaverMethod and apparatus for performing an electrosurgical procedure
US4493323 *Dec 13, 1982Jan 15, 1985University Of Iowa Research FoundationSuturing device and method for using same
US4949717 *Mar 17, 1988Aug 21, 1990Shaw Edward LSurgical instrument with suture cutter
US5112344 *Oct 4, 1989May 12, 1992Petros Peter ESurgical instrument and method of utilization of such
US5289963 *Oct 18, 1991Mar 1, 1994United States Surgical CorporationApparatus and method for applying surgical staples to attach an object to body tissue
US5318578 *Mar 17, 1992Jun 7, 1994Harrith M. HassonApparatus for delivering a suture into a body cavity and method of using the apparatus
US5334198 *Oct 9, 1992Aug 2, 1994Innovasive Devices, Inc.Surgical instrument
US5356064 *Sep 23, 1992Oct 18, 1994United States Surgical CorporationApparatus and method for applying surgical staples to attach an object to body tissue
US5364002 *Mar 31, 1992Nov 15, 1994United States Surgical CorporationApparatus and method for applying surgical staples to attach an object to body tissue
US5382258 *Aug 30, 1993Jan 17, 1995LinvatecArthroscopic knot tying device
US5383877 *Oct 8, 1992Jan 24, 1995Clarke; Henry C.Instruments and method for suturing and ligation
US5392978 *Oct 15, 1993Feb 28, 1995United States Surgical CorporationSurgical staple and endoscopic stapler
US5405354 *Aug 6, 1993Apr 11, 1995Vance Products Inc.Suture driver
US5454791 *Sep 7, 1993Oct 3, 1995United States Surgical CorporationTrocar with tissue penetration pressure indicator
US5470316 *Mar 4, 1994Nov 28, 1995United States Surgical CorporationBody tissue penetrating device having a vacuum indicator
US5497933 *Oct 8, 1993Mar 12, 1996United States Surgical CorporationApparatus and method for applying surgical staples to attach an object to body tissue
US5564615 *Oct 31, 1995Oct 15, 1996Ethicon, Inc.Surgical instrument
US5577654 *May 23, 1996Nov 26, 1996Ethicon Endo-Surgery, Inc.Surgical instrument
US5588580 *May 23, 1996Dec 31, 1996Ethicon Endo-Surgery, Inc.Surgical instrument
US5588581 *May 23, 1996Dec 31, 1996Ethicon Endo-Surgery, Inc.Surgical instrument
US5601224 *Jun 10, 1994Feb 11, 1997Ethicon, Inc.Surgical instrument
US5618304 *Jan 18, 1994Apr 8, 1997Innovasive Devices, Inc.Surgical instrument
US5626587 *May 18, 1995May 6, 1997Ethicon Endo-Surgery, Inc.Method for operating a surgical instrument
US5634584 *May 23, 1996Jun 3, 1997Ethicon Endo-Surgery, Inc.Surgical instrument
US5662662 *Sep 16, 1996Sep 2, 1997Ethicon Endo-Surgery, Inc.Surgical instrument and method
US5741281 *May 7, 1996Apr 21, 1998Smith & Nephew, Inc.Suture securing apparatus
US5759189 *Feb 25, 1997Jun 2, 1998Smith & Nephew Inc.Knot pusher
US5817109 *Sep 17, 1996Oct 6, 1998United States Surgical CorporationApparatus and method for applying surgical staples to attach an object to body tissue
US6491703Oct 8, 1996Dec 10, 2002Ethicon, Inc.Surgical instrument for treating female urinary incontinence
US6612977Jul 27, 2001Sep 2, 2003American Medical Systems Inc.Sling delivery system and method of use
US6641525Nov 21, 2001Nov 4, 2003Ams Research CorporationSling assembly with secure and convenient attachment
US6652450Jul 27, 2001Nov 25, 2003American Medical Systems, Inc.Implantable article and method for treating urinary incontinence using means for repositioning the implantable article
US6802807Jul 27, 2001Oct 12, 2004American Medical Systems, Inc.Surgical instrument and method
US6911003Mar 3, 2003Jun 28, 2005Ams Research CorporationTransobturator surgical articles and methods
US6932759Oct 31, 2002Aug 23, 2005Gene W. KammererSurgical instrument and method for treating female urinary incontinence
US6971986Oct 25, 2002Dec 6, 2005American Medical Systems, Inc.Sling delivery system and method of use
US6976992Jul 16, 2002Dec 20, 2005Suturecut, LlcDual-function medical instrument
US6984237May 22, 2002Jan 10, 2006Orthopaedic Biosystems Ltd., Inc.Suture passing surgical instrument
US7048682Oct 25, 2002May 23, 2006American Medical Systems, Inc.Surgical articles and methods
US7070556Nov 27, 2002Jul 4, 2006Ams Research CorporationTransobturator surgical articles and methods
US7083568Jul 11, 2003Aug 1, 2006American Medical SystemsImplantable article for treatment of urinary incontinence
US7083637Jun 7, 2000Aug 1, 2006Tannhauser Robert JMethod and apparatus for adjusting flexible areal polymer implants
US7087065Oct 3, 2002Aug 8, 2006Ethicon, Inc.Mesh for pelvic floor repair
US7094199Jul 23, 2003Aug 22, 2006Sherwood Services AgIvs obturator instrument and procedure
US7104949Aug 30, 2002Sep 12, 2006Ams Research CorporationSurgical articles for placing an implant about a tubular tissue structure and methods
US7112171Jul 11, 2003Sep 26, 2006Ams Research CorporationSling assembly with secure and convenient attachment
US7121997Jun 4, 2001Oct 17, 2006Ethicon, Inc.Surgical instrument and method for treating female urinary incontinence
US7131943Feb 6, 2003Nov 7, 2006Ethicon, Inc.Surgical instrument and method for treating organ prolapse conditions
US7156858Feb 21, 2001Jan 2, 2007Ethicon G.M.B.H.Implant
US7226407Jul 9, 2002Jun 5, 2007Ethicon, Inc.Surgical instrument and method for treating female urinary incontinence
US7229453Dec 31, 2002Jun 12, 2007Ams Research CorporationPelvic floor implant system and method of assembly
US7267645Jul 11, 2003Sep 11, 2007American Medical Systems Inc.Surgical instrument and method
US7285086Jul 27, 2005Oct 23, 2007Ethicon, Inc.Minimally invasive medical implant and insertion device and method for using the same
US7288063Jul 14, 2006Oct 30, 2007Sherwood Services AgIVS obturator instrument and procedure
US7291104Sep 30, 2003Nov 6, 2007American Medical Systems Inc.Surgical articles and methods
US7297102Jul 27, 2005Nov 20, 2007Ethicon, Inc.Minimally invasive medical implant and insertion device and method for using the same
US7347812Mar 19, 2004Mar 25, 2008Ams Research CorporationProlapse repair
US7351197May 7, 2004Apr 1, 2008Ams Research CorporationMethod and apparatus for cystocele repair
US7357773Dec 18, 2003Apr 15, 2008Ams Research CorporationHandle and surgical article
US7364541Aug 14, 2003Apr 29, 2008Boston Scientific Scimed, Inc.Systems, methods and devices relating to delivery of medical implants
US7407480Apr 25, 2003Aug 5, 2008Ams Research CorporationMethod and apparatus for correction of urinary and gynecological pathologies, including treatment of incontinence cystocele
US7413540Feb 9, 2004Aug 19, 2008Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US7481314Feb 2, 2005Jan 27, 2009Ethicon, Inc.Packaging assembly for surgical mesh implants
US7494495Mar 26, 2004Feb 24, 2009Coloplast A/SMethod and implant for curing cystocele
US7500945Apr 30, 2004Mar 10, 2009Ams Research CorporationMethod and apparatus for treating pelvic organ prolapse
US7527588Sep 15, 2004May 5, 2009Ethicon, Inc.System and method for surgical implant placement
US7527633Jun 5, 2001May 5, 2009Boston Scientific Scimed Inc.Methods and devices for the treatment of urinary incontinence
US7547316Nov 8, 2005Jun 16, 2009Ethicon, Inc.Method and apparatus for adjusting flexible areal polymer implants
US7588598Mar 29, 2004Sep 15, 2009Coloplast A/SImplant for treating rectocele and a device for putting said implant into place
US7614999Jul 28, 2006Nov 10, 2009Boston Scientific Scimed, Inc.Systems, devices, and methods for minimally invasive pelvic surgery
US7615059May 24, 2002Nov 10, 2009Ams Research CorporationSurgical suture passers and methods
US7621864Jan 21, 2005Nov 24, 2009Coloplast A/SMethod for treating urinary incontinence in women and implantable device intended to correct urinary incontinence
US7621865Jul 26, 2006Nov 24, 2009Boston Scientific Scimed, Inc.Systems, devices, and methods for minimally invasive pelvic surgery
US7624903Jan 8, 2004Dec 1, 2009Green David TApparatus for applying surgical fastners to body tissue
US7658743Jun 25, 2002Feb 9, 2010Ethicon, Inc.Surgical instrument and method for treating female urinary incontinence
US7681772Oct 30, 2007Mar 23, 2010Green David TApparatus for applying surgical fasteners to body tissue
US7691050Feb 9, 2004Apr 6, 2010Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US7691052Sep 10, 2004Apr 6, 2010Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US7762942Jun 27, 2005Jul 27, 2010Ams Research CorporationImplantable article for the treatment of incontinence
US7828187Aug 26, 2009Nov 9, 2010Tyco Healthcare Group LpApparatus for applying surgical fasteners to body tissue
US7866526Aug 26, 2009Jan 11, 2011Tyco Healthcare Group LpApparatus for applying surgical fasteners to body tissue
US7867161Aug 15, 2005Jan 11, 2011Ams Research CorporationSling delivery system and method of use
US7871367Aug 1, 2006Jan 18, 2011Ams Research CorporationSurgical articles for placing an implant about a tubular tissue structure and methods
US7927342Mar 24, 2009Apr 19, 2011Boston Scientific Scimed, Inc.Methods and devices for the treatment of urinary incontinence
US7972262Sep 25, 2006Jul 5, 2011Ams Research CorporationSling assembly with secure and convenient attachment
US7975698May 23, 2005Jul 12, 2011Coloplast A/SImplant for treatment of vaginal and/or uterine prolapse
US7985173Mar 17, 2006Jul 26, 2011Ethicon, Inc.Method and apparatus for treating pelvic organ prolapses in female patients
US7988615Oct 5, 2005Aug 2, 2011Ams Research CorporationTransobturator surgical articles and methods
US7993261Mar 31, 2008Aug 9, 2011Ams Research CorporationMethod and apparatus for cystocele repair
US8007430Jul 16, 2010Aug 30, 2011Coloplast A/SApparatus and method for treating female urinary incontinence
US8029433Jun 23, 2006Oct 4, 2011Sheila SalterIlluminated IVS tunneling device
US8038594Jan 28, 2008Oct 18, 2011Ams Research CorporationProlapse repair
US8043204Jan 27, 2010Oct 25, 2011Ams Research CorporationTransobturator surgical articles and methods
US8047982May 7, 2004Nov 1, 2011Ethicon, Inc.Mesh tape with wing-like extensions for treating female urinary incontinence
US8047983Apr 4, 2011Nov 1, 2011Coloplast A/SSurgical system for supporting pelvic anatomy
US8088131Sep 24, 2009Jan 3, 2012Ams Research CorporationSurgical suture passers and methods
US8118727Jun 14, 2011Feb 21, 2012Coloplast A/SMethod for supporting pelvic anatomy
US8118728Jun 21, 2011Feb 21, 2012Coloplast A/SMethod for implanting an adjustable surgical implant for treating urinary incontinence
US8123673Jun 21, 2011Feb 28, 2012Coloplast A/SAdjustable surgical implant for treating urinary incontinence
US8128554Jun 14, 2011Mar 6, 2012Coloplast A/SSystem for introducing a pelvic implant
US8162818Jun 1, 2011Apr 24, 2012Coloplast A/SAdjustable surgical implant for pelvic anatomy
US8167785Feb 28, 2008May 1, 2012Coloplast A/SUrethral support system
US8172744Apr 6, 2010May 8, 2012Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US8182412Jun 17, 2011May 22, 2012Coloplast A/SPelvic implant with fibrous anchor
US8182413Jun 17, 2011May 22, 2012Coloplast A/SMethod for fibrous anchoring of a pelvic support
US8206281Aug 13, 2010Jun 26, 2012Ams Research CorporationMethod and apparatus for treating pelvic organ prolapse
US8211005Jan 22, 2009Jul 3, 2012Ams Research CorporationMethod and apparatus for treating pelvic organ prolapse
US8215310Apr 28, 2011Jul 10, 2012Coloplast A/SImplant for treatment of vaginal and/or uterine prolapse
US8273011Jun 1, 2011Sep 25, 2012Coloplast A/SAdjustable surgical implant and method for treating urinary incontinence
US8308629Jan 12, 2011Nov 13, 2012Ams Research CorporationSurgical articles for placing an implant about a tubular tissue structure and methods
US8316651Jul 19, 2006Nov 27, 2012Bruker Biospin GmbhSuperconducting magnet system with radiation shield disposed between the cryogenic fluid tank and a refrigerator
US8388514Oct 26, 2007Mar 5, 2013Ams Research CorporationSurgical articles and methods for treating pelvic conditions
US8449450Jun 1, 2011May 28, 2013Coloplast A/SPass through introducer and sling
US8449573Aug 28, 2009May 28, 2013Boston Scientific Scimed, Inc.Insertion device and method for delivery of a mesh carrier
US8454492Jun 1, 2011Jun 4, 2013Coloplast A/SAbsorbable anchor and method for mounting mesh to tissue
US8460169Jun 22, 2007Jun 11, 2013Ams Research CorporationAdjustable tension incontinence sling assemblies
US8460170Jun 14, 2011Jun 11, 2013Ethicon, Inc.Method and apparatus for treating pelvic organ prolapses in female patients
US8469875Aug 26, 2009Jun 25, 2013Coloplast A/SMethod and device for treating urinary incontinence
US8469877Jan 27, 2012Jun 25, 2013Coloplast A/SSystem for introducing a pelvic implant
US8475357Jan 4, 2011Jul 2, 2013Ams Research CorporationSling delivery system and method of use
US8480556Jun 14, 2011Jul 9, 2013Ethicon, Inc.Method and apparatus for treating pelvic organ prolapses in female patients
US8480559Sep 12, 2007Jul 9, 2013C. R. Bard, Inc.Urethral support system
US8512223Jun 1, 2011Aug 20, 2013Coloplast A/SPelvic implant with selective locking anchor
US8535217Jul 25, 2006Sep 17, 2013Ams Research CorporationMethods and systems for treatment of prolapse
US8574148Jun 1, 2011Nov 5, 2013Coloplast A/SSystem for introducing soft tissue anchors
US8574149Jun 15, 2012Nov 5, 2013C. R. Bard, Inc.Adjustable tissue support member
US8602965Feb 1, 2008Dec 10, 2013Boston Scientific Scimed, Inc.System, methods and devices relating to delivery of medical implants
US8623034Oct 19, 2007Jan 7, 2014Ethicon, GmbhSoft tissue repair implant
US8636641Oct 31, 2007Jan 28, 2014Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US8668635Feb 23, 2012Mar 11, 2014Coloplast A/SPelvic implant with suspending system
US8690898Jun 24, 2005Apr 8, 2014Smith & Nephew, Inc.Suture passing surgical instrument
US8702585Oct 31, 2007Apr 22, 2014Ams Research CorporationPelvic health implants and methods
US8709471Oct 6, 2008Apr 29, 2014Coloplast A/SMedicament delivery device and a method of medicament delivery
US8727962Aug 20, 2007May 20, 2014Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US8727963Jul 31, 2009May 20, 2014Ams Research CorporationMethods and implants for treating urinary incontinence
US8753260Sep 19, 2011Jun 17, 2014Ams Research CorporationProlapse repair
US8777836Nov 7, 2007Jul 15, 2014Ams Research CorporationPelvic health implants and methods
US8777837Feb 4, 2013Jul 15, 2014Ams Research CorporationSurgical articles and methods for treating pelvic
US8784295May 25, 2011Jul 22, 2014Ams Research CorporationSling assembly with secure and convenient attachment
US8790238Jul 14, 2011Jul 29, 2014Boston Scientific Scimed, Inc.Systems, devices, and methods for minimally invasive pelvic surgery
US8801596Jun 14, 2011Aug 12, 2014Coloplast A/SSling with support and suspending members formed from same polymer
US8808162Mar 28, 2012Aug 19, 2014Ams Research CorporationImplants, tools, and methods for treatment of pelvic conditions
US8814777Oct 31, 2007Aug 26, 2014Boston Scientific Scimed, Inc.Devices for minimally invasive pelvic surgery
US8821369Jun 1, 2011Sep 2, 2014Colorplast A/SMethod for soft tissue anchoring with introducer
US8821370Aug 14, 2013Sep 2, 2014Coloplast A/SDevice, system and methods for introducing soft tissue anchors
US8834350Jun 15, 2007Sep 16, 2014Ams Research CorporationSurgical implants, tools, and methods for treating pelvic conditions
US20120123201 *Nov 30, 2011May 17, 2012Olympus Medical Systems Corp.Treatment tool for endoscope
DE102011107178A1 *Jul 13, 2011Jan 17, 2013Karl Storz Gmbh & Co. KgMedizinisches Schneidinstrument zum Schneiden von Muskeln und Sehnen
EP2226017A2May 24, 2002Sep 8, 2010AMS Research CorporationSurgical suture passer
EP2545857A2 *Jul 7, 2012Jan 16, 2013Karl Storz GmbH & Co. KGMedical cutting instrument for cutting muscles and tendons
WO1990003766A1 *Oct 4, 1989Apr 19, 1990Peter Emanuel PetrosSurgical instrument prosthesis and method of utilisation of such
WO2005039420A1 *Oct 26, 2004May 6, 2005Takashi HoraguchiSuture thread shifting device
Classifications
U.S. Classification128/830
International ClassificationA61B17/04, A61B17/28
Cooperative ClassificationA61B17/29, A61B17/0469, A61B2017/0474
European ClassificationA61B17/04E, A61B17/29