 surgical instrument
专利摘要:
CLIPPING AND LINEAR AIR CUTTING DEVICE WITH SELECTIVELY DISENGATABLE CUTTING ELEMENT The present invention relates to a surgical stapling instrument that includes a selective actuating cutting element. The stapling instrument can be like a surgical stapler, without cutting the tissue or, if desired, the surgeon can selectively activate the cutting element to cut tissue while the staples are being implanted and formed. A stapling instrument can include an actuator button, which has at least one drive bar attached to it. Advance of the actuator button in a distal direction causes the propellant bars to apply a discharge movement to the staples contained within a staple cartridge supported within the stapling instrument. A cutter bar can be selectively attachable to the actuator button in the distal direction advances the cutter bar which has a portion of the cutter blade to advance between the rows of staples on the staple cartridge to an unacted position where the movement of the actuator button advance the propellant bars without advancing the cutter bar. 公开号:BR112013002208B1 申请号:R112013002208-6 申请日:2011-07-27 公开日:2020-12-01 发明作者:Chester O. Baxter Iii；Mark Tsonton 申请人:Ethicon Endo-Surgery, Inc； IPC主号:
专利说明:
[0001] [0001] The present invention relates to stapling instruments and, in various modalities, to a stapling and surgical cutting instrument to produce one or more rows of staples. Background of the Related Art [0002] [0002] In recent years, there has been a growing tendency for surgeons to use stapling instruments to suture body tissues, such as, for example, lungs, esophagus, stomach, duodenum and / or other organs in the intestinal tract. The use of an appropriate stapling instrument can, in many cases, do a better job in less time and simplify previously difficult surgical procedures, such as gastrointestinal anastomoses. The two- and four-row linear cutting staplers comprised instruments without a cartridge into which the staples were manually loaded. Other prior devices included a pre-sterilized disposable staple loading unit and a cutting element that could be used to divide the fabric and form rows of staples simultaneously. An example of such a surgical stapler is presented in US patent No. 3,499,591, entitled INSTRUMENT FOR PLACING LATERAL GASTROINTESTINAL ANASTOMOSES, which was granted on March 10, 1970, the description of which is incorporated herein by way of reference. [0003] [0003] A stapling instrument may include a pair of elongated cooperating claw elements, each claw element being adapted to be inserted into an internal tubular body organ to be joined by anastomosis. In various embodiments, one claw element can support a staple cartridge with at least two rows of staples spaced laterally, and the other claw element can support a fixed claw with staple-forming pockets aligned with the staple rows in the Bobby pins. In general, the stapling instrument may further include a drive bar and a cutting blade assembly which are slidable with respect to the claw elements to sequentially eject staples from the staple cartridge through cam surfaces on the drive bar. In at least one embodiment, the cam surfaces can be configured to activate a plurality of cartridge-loaded clamp drivers and associated with the individual clamps to push the clamps against the fixed claw and form spaced laterally rows of clamps deformed in the fabric trapped between the clamps. claw elements. In typical stapling instruments, however, the fixed claw is not movable in relation to the clamp cartridge since the clamping elements have been joined and the formed height of the clamps cannot be adjusted. In at least one embodiment, the cutting blade can follow the drive bar and cut the fabric along a line between the rows of staples. However, the cutting blade and the propeller bar generally comprise an assembly so that both the propeller bar (s) and the cutting blade are simultaneously actuated. Examples of such stapling instruments are provided in US Patent No. 4,429,695, entitled SURGICAL INSTRUMENTS, which was issued on February 7, 1984, the full description of which is incorporated herein by way of reference. Other examples of linear staples and staple cartridges are presented in US patent application serial number 12 / 725,993, filed on March 17, 2010, entitled STAPLE CARTRIDGE, the description of which is incorporated herein by reference, in its wholeness. [0004] [0004] During some surgical procedures, it is not necessary to cut tissue during the stapling process. In many existing linear stapling devices, staples are triggered while the cutting element is directed through the fabric. Consequently, there is a need for a linear cutting and stapling device that has a selectively disengaging cutting element so that a surgeon can use the device to install staples without cutting the tissue, but with the ability to cut the tissue if necessary. [0005] [0005] The aforementioned discussion is only intended to illustrate some of the disadvantages present in the field of the invention at the moment, and should not be taken as a denial of the scope of the claims. summary [0006] [0006] In at least one form of the present invention, a surgical instrument is provided. In various embodiments, the surgical instrument includes a first claw element that is configured to operationally support a staple cartridge that has a plurality of staples supported therein. A second claw element is removably attachable to the first claw element to allow the fabric to be trapped between them. At least one set of propellers is operationally supported in relation to the first claw element and being configured to selectively apply a discharge movement to the clamps held in the clamp cartridge while the at least one set of propellers is distally advanced through of the staple cartridge A cutting bar, configured to cut the tissue stuck between the first and second claw elements, is operationally supported in relation to the first claw element and the at least one set of propellant bars. A selector switch creating interfaces in operational mode with the cutter bar and being movable between an activated position, in which an application of an activation movement to at least one set of propellant bars causes the cutter bar and at least one set of propellers move simultaneously in a distal direction within the first claw element and a disabled position in which the application of the activation movement to at least one set of propellers causes the at least one set of propellers to move in the distal direction, without moving the cut bar in the distal direction. [0007] [0007] In accordance with other general aspects of the present invention, a surgical staple cartridge is provided for use with a surgical stapling instrument that has an end effector with first and second claw elements for securing tissue between them. The surgical stapling instrument also has a set of cutting bars to generate a cutting movement and a propelling bar arrangement to generate a movement of unloading staples that is independent of said cutting movement. Various embodiments of the staple cartridge comprise a cartridge body, which is configured to be removably supported on the end effector. The cartridge body operationally supports a plurality of clamps, which are oriented in longitudinally extending strips and are configured to be ejected from it by applying the clamping motion to them. The cutting blade is operationally supported on the cartridge body and is selectively movable from an unacted position, at a first end of the cartridge body to a position actuated at a second end of the cartridge body by applying the cutting motion at the same. The cutting blade is configured to selectively remain in the non-actuated position during the application of the firing movement to all the clamps and move from the non-actuated position to the acted position by applying the cutting movement to it. BRIEF DESCRIPTION OF THE DRAWINGS [0008] [0008] The characteristics mentioned above and other characteristics and advantages of this invention, and the way of obtaining them, will become more apparent and the invention itself will be better understood by reference to the following description of modalities of the invention, taken in conjunction with the attached drawings, being that: Figure 1 is a perspective view of an embodiment of a stapling instrument of the present invention; Figure 2 is a side elevation view showing the stapling instrument of Figure 1 partially disassembled with the claw element carrying the upper fixed jaw separated from the claw element carrying the lower clamp cartridge; Figure 3 is a side elevation view showing the stapling instrument of Figure 1 in an assembled configuration; Figure 4 is a cross-sectional view of the stapling instrument of Figure 1 taken along line 4-4 in Figure 1 showing a cam mechanism for separating the rear portions of the upper and lower grip elements; Figure 5 is a bottom view of the claw element carrying the fixed claw of the stapling instrument of Figure 1; Figure 6 is a top view of the claw element carrying the staple cartridge of the stapling instrument of Figure 1; Figure 7 is a bottom view of the stapling instrument of Figure 1; Figure 8 is a view of the front end of the stapling instrument of Figure 1; Figure 9 is a view of the rear end of the stapling instrument of Figure 1; Figure 10 is a perspective view of a drive bar and cutting blade assembly of the stapling instrument of Figure 1; Figure 11 is a perspective view of a drive block and actuator that are components of the drive bar and cutting blade assembly of the stapling instrument of Figure 10; Figure 12 is a partial cross-sectional view of a portion of a drive block with the blade selector switch in a disabled position; Figure 13 is another partial cross-sectional view of the drive block portion of Figure 12 with the blade selector switch in an activated position; Figure 14 is a cross-sectional view of a portion of the propeller block and blade bar of an embodiment of the present invention; Figure 15 is a partial cross-sectional view of the rear portion of the stapling instrument of Figure 1 illustrating the cam mechanism in its non-operational position; Figure 16 is a partial cross-sectional view of the rear portion of the stapling instrument of Figure 1 illustrating the cam mechanism in its operational position; Figure 17 is a side view of the staple cartridge of the stapling instrument of Figure 1; Figure 18 is a top view of a staple cartridge embodiment of the present invention; Figure 19 is a bottom view of the staple cartridge of Figure 18; Figure 20 is a partial cross-sectional view of the claw elements carrying a staple cartridge and a fixed claw of Figures 5 and 6 illustrating the operation of the drive bar and cutting blade assembly of Figure 10; Figure 21 is a side elevation view of another embodiment of the staple cartridge of the present invention; Figure 22 is a top view of the staple cartridge embodiment of Figure 21; Figure 23 is a side elevation view of another embodiment of the staple cartridge of the present invention; Figure 24 is a partial perspective view of a cutting blade and blade bar arrangement of an embodiment of the present invention; and Figure 25 is a partial perspective view of a cutting blade and blade bar arrangement of another embodiment of the present invention. [0009] [0009] The corresponding reference characters indicate the corresponding parts through the various views. The exemplifications described herein illustrate preferred embodiments of the invention, in one form, and such exemplifications should not be considered to limit the scope of the invention in any way. DETAILED DESCRIPTION [0010] [00010] Certain exemplary modalities will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the devices and methods described here. One or more examples of three modalities are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are exemplary non-limiting modalities, and that the scope of the various modalities of the present invention is defined only by the claims. The aspects illustrated or described in connection with an exemplary modality can be combined with the aspects of other modalities. These modifications and variations are intended to be included in the scope of the present invention. [0011] [00011] The reference from beginning to end of the specification of "various modalities", "some modalities", "a modality", or "the modality", or similar, means that an attribute, structure, or characteristics described together with the modality is included in at least one modality. Therefore, the appearance of the phrases "in various modalities", "in some modalities," "in one modality," or "in the modality", or similar, in places from beginning to end of the specification are not necessarily all referring to the same modality. In addition, the particular attributes, structures, or characteristics can be combined in any suitable way in one or more modalities. Therefore, the particular attributes, structures, or features illustrated or described in conjunction with a modality can be combined, in whole or in part, with the structures of the attributes, or features of one or more other modalities without limitation. These modifications and variations are intended to be included in the scope of the present invention. [0012] [00012] The terms "proximal" and "distal" are used in the present invention with reference to a clinician manipulating the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion located farthest from the clinician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and absolute. [0013] [00013] With reference to figures 1 and 2, in conjunction with various embodiments of the present invention, the linear stapling instrument, generally 20, comprises a claw element carrying an elongated upper fixed claw 22 and a claw element carrying a cartridge of lower elongated staples 24. Exemplary stapling instruments of this type are presented in US Patent Application Publication No. US 2009/0200355 A1, entitled SURGICAL STAPLING INSTRUMENT WITH IMPROVED FIRING TRIGGER ARRANGEMENT, which is incorporated herein by way of reference, in its wholeness. In the illustrated embodiment, the claw element carrying a fixed claw 22 is supported by a cable 26 with a front portion of the claw element 22 extending forward from it. The gripper element carrying a lower staple cartridge 24 is supported by a handle 28 with a front portion of the gripper element 24 extending forward from it. As shown in figure 3, the upper handle 26 and the lower handle 28 are properly shaped to form a handle facilitating the handling and operation of the stapling instrument by a surgeon. An enlarged front protrusion 27 and a small rear protrusion 29 are provided on each cable for this purpose. In various embodiments, cables 26 and 28 can, for example, be made of plastic or other lightweight materials, while claw elements 22 and 24 can, for example, be made of stainless steel or other similar materials. [0014] [00014] As shown in figure 5, in various embodiments, the upper or "second" claw element 22 comprises a one-piece structure in the form of an elongated channel including a pair of opposite and elongated side walls 30 connected by a wall of top 31. Top handle 26 includes a pair of dependent ears 32, located inside the top handle adjacent to its front end. Upper claw element 22 includes a slot 34 (figure 4) formed in an intermediate position along its top wall 31 through which the dependent ears 32 can project downward. A locking pin 36 extends through holes formed in the side walls 30 of the upper claw element 22 and through the holes formed in the dependent ears 32 to pivotally connect the upper claw element to the upper handle 26. [0015] [00015] Referring to figure 5, in various embodiments, the front portion of the upper jaw element 22 has a pair of elongated inwardly extending flanges 38, which define a fixed jaw 40 of the stapling instrument. The flanges 38 are separated by a central longitudinal slot 42 that extends along the entire length of the fixed jaw 40. At the proximal end of the central slot 42, the flanges 38 are provided with the guide surfaces 41 angled inward. In various embodiments, each flange 38 has two longitudinal rows of evenly spaced clamps 44 that form pockets. With reference to figures 4 and 5, the tip of the tapered fixed claw 46 is mounted on the front of the claw element carrying a fixed claw 22 to facilitate insertion of the claw element into hollow body organs, for example, tubular organ. The fixed claw tip 46 includes an elongated body 48 (figure 4) that can be inserted through the longitudinal passage above the fixed claw 40 defined by the side walls 30 and flanges 38 of the upper claw element. This elongated body 48 can extend between the dependent ears 32, above the lock pin 36 and can include an enlarged rear portion 50 located behind the ears 32 to hold the claw tip 46 in place on the upper claw element 22. [0016] [00016] With reference to figures 2 and 6, in various embodiments, the "first" or lower claw element carrying a staple cartridge 24 comprises an elongated channel-shaped one piece structure including a pair of opposite side walls, elongated 52 connected by a bottom wall 53. Together with the rear portion of the lower jaw element 24, a pair of spaced lateral, vertical and elongated flanges 54 (figure 2) can extend upwards from their opposite side walls 52 As shown in figures 5 and 6, in at least one embodiment, the width of the lower jaw element 24 between its side flanges 54 is greater than the width of the upper jaw element 22, between its side walls 30 to allow that the rear part of the upper clamping element to be received between side flanges 54 of the clamping element when the stapling instrument is assembled for operation. As shown in figure 2, each side flange 54 of the lower jaw element 24 includes a vertical notch 56 located in alignment with the locking pin 36 on the upper jaw element 22. When the upper jaw element 22 and a lower jaw element 24 are mounted, the opposite ends of the lock pin 36 can be received in notches 56. [0017] [00017] As shown in figures 2 and 6, the lower jaw element 24 is configured to hold a staple cartridge 60, which is adapted to receive a plurality of surgical staples 61 (figure 20) arranged in at least two longitudinal rows laterally spaced. The staple cartridge 60 can be mounted on the front portion of the lower jaw element 24 between its side walls 52. The staple cartridge 60 is divided longitudinally by means of an elongated central groove 62 (figure 6) extending from a proximal or first end 67 of the cartridge to its distal or second end 69. In various embodiments, a plurality of staple openings 64 formed in the staple cartridge 60 can be arranged in two pairs of rows spaced laterally, with each pair of rows arranged on opposite sides of the central longitudinal groove 62. A plurality of surgical clips 61 (figure 20) is mounted in the openings 64 of the cartridge 60. As shown in figure 6, the openings for staples 64 in the adjacent rows are misaligned to obtain a more staple tissue, when the instrument is put into operation. Referring to Figures 18 and 19, the staple cartridge 60 may include a pair of longitudinal grooves 66 located on opposite sides of the elongated central slot 62 and disposed between the alternating rows of openings 64 on each side of the central groove. Each longitudinal groove 66 can extend from the proximal end 67 of the cartridge 60 towards its distal end 69. [0018] [00018] As shown in figure 20, in various embodiments, a plurality of clamp actuators 65 are slidably mounted in openings 64 of clamps to drive clamps 61, which are loaded into the clamp cartridge 60. Referring to figure 6 , each staple driver 65 can be designed to simultaneously actuate two staples 61 located in the adjacent rows provided in the staple cartridge 60. Therefore, in various embodiments, a first set of staple actuators 65 is used to drive the staples 61 in the misaligned rows located on one side of the central longitudinal slot 62, and a second set of clip drivers 65 can be used to drive the clips 61 in the pair of adjacent rows located on the other side of the central longitudinal slot 62. [0019] [00019] With reference to figure 2, various modalities of a stapling instrument 20 include a locking mechanism, generally 90, for locking the upper jaw element 22 and the lower jaw element 24 together in an intermediate position along the elements claw. In various embodiments, the gripper elements 22 and 24 can be locked together in a position adjacent to the proximal ends of the fixed gripper 40 and staple cartridge 60. In at least one embodiment, the locking mechanism 90 comprises a locking arm 92 ( figure 2) which is hingedly connected to lower the claw element 24 through a pivot pin 80 (figure 4). The locking arm 92 can be in the form of a channel in configuration and can include a pair of opposing and elongated side walls 94 (figure 6) that are spaced apart enough to encompass the side walls 52 of the lower claw element 24. Each side wall 94 of the lock arm 92 includes a hook element 96 extending upwards and forwards provided with a forward-facing groove 98 to receive the lock pin 36. A housing 100 is mounted on the lower surface of the arm locking device 92. When the fixing arm 92 is closed, as shown in figure 3, the housing 100 can be aligned with the bottom of the lower cable 28 to facilitate the handling and operation of the stapling instrument 20 by the surgeon. In various embodiments, housing 100 may be made of plastic or other lightweight materials, for example, while locking arm 92 may be made of stainless steel, for example. As shown in figure 7, housing 100 may include elongated flanges 102 and 104 extending outwardly from their opposite sides, which can serve as grip points to allow locking arm 92 to be rotated downwardly from from your locked position to your unlocked position. When the lock arm 92 is moved to its closed or locked position, the groove surfaces 98 of the hook elements 96 cooperate with the lock pin 36, which can act as a lock above the center to hold the lock arm 92 in its locked position. [0020] [00020] With reference to figures 6 and 10, various types of stapling instrument 20 include an improved propeller bar and a selectively engaged blade bar assembly, generally 110, which can be slidably mounted for longitudinal movement relative to the elements of upper and lower jaws 22 and 24, respectively, for driving or "firing" staples 61 from the staple cartridge 60 in the fabric trapped between the clamping elements. While the clamps are fired, they are moved through the tissue trapped between the claw elements and the fixed claw 40. If desired, the surgeon can also cut the tissue along a line between the clamp lines formed in the tissue. In various embodiments, a drive bar and cutting blade assembly 110 include a drive block 112 (figure 6) that can be slidably received inside the lower jaw element 24 in the form of a channel between its vertical side flanges 54. As shown in figures 10 and 11, the propeller block 112 has an actuator button 114 that includes a flange portion 116, which is connected to the propeller block 112 through, for example, welding, adhesive, fitting characteristics, flanges, etc. The flange 116 of the actuator button 114 can extend through and travel along an elongated groove 122 (figure 2) formed on a side flange 54 of the lower jaw element 24. [0021] [00021] Also in various embodiments, the propeller bar and cutting blade assembly 110 include a pair of clamp propeller bars 124 (figure 10) that protrude forward from the propeller block 112 and received slidingly into the grooves staple cartridge 66 (Fig. 19) 60. In certain embodiments, the drive block 112 has a pair of vertical grooves 126 (Fig. 11) in which the drive bars 124 are protected. In the illustrated embodiments, for example, two propellant bars 124 are employed. This arrangement serves to facilitate the performance of multiple lines of clamps, as will be discussed in detail below. However, other modalities are contemplated that employ at least one propellant bar and more than two propellant bars. As shown in figure 10, the front end of each clamp propeller bar 124 has a wedge-shaped tip 128 that defines an inclined cam surface. 130 to engage clamp actuators 65 while drive bars 124 are advanced into the clamp cartridge 60. As shown in figure 20, each clamp actuator 65 is provided with an inclined surface 132 oriented at the same angle as the meat surface 130 of each bar staple thruster 124 to provide flat, sliding contact between surfaces. While the drive bars 124 are moved distally through the staple cartridge, they make contact with the staple actuators 65 to apply a "firing motion" that causes the actuators to move the staples to make contact with the fixed jaw 40. [0022] [00022] As can be seen in figures 10 to 14, various modalities of the selectively engaged cutting blade assembly 110 include a slide blade selector switch 300. In certain embodiments, the drive block 112 has a longitudinal groove 302 that is sized for slide blade bar 136. The blade selector switch 300 includes a selector bar 304 which is laterally slidable in a transverse groove 310 in drive block 112, and is configured to retain a proximal end portion engaged and disengaged 320 of the blade support bar 136. See figures 10 and 11. In various embodiments, the selector bar 304 has a groove 330 that can slide the proximal end portion 320 of the blade support bar 136 that has a sliding formation hook-shaped 322 on it. See figures 12 and 13. Thus, when the selector bar 304 is slid transversely to the off position shown in figure 12, the groove 330 in the selector bar 304 is aligned to allow the propeller block 112 to slide in relation to the blade bar136. As such, when the selector bar 304 is in the deactivated position, the surgeon can slide the propeller block 112 in a distal "DD" direction to advance the propeller bars 124 distally without advancing the slide bar 136. When the surgeon wants to cut tissue, the selector bar 304 is transversely slid to the activated position shown in figure 13. When in this position, the hook-shaped formation 322 engages the selector bar 304 so that the movement of the propeller bar 112 in the distal direction "DD" causes the slide bar 136 is advanced in the distal direction with the propeller bars 124. Similarly, when the surgeon moves the propeller bar 112 in the proximal direction "PD", the slide bar 136 also moves in the proximal direction to be retracted from the staple cartridge 60. [0023] [00023] In certain embodiments, as can be seen in figures 4, 10 and 20, an inclined cutting blade 138 having a bevel cutting edge 140 is formed or otherwise connected to the distal end 137 of the blade bar 136 The bevel cutting edge 140 of the cutting blade 138 can be oriented at an angle to the elongated claw elements 22 and 24 and can be slidably received in the central longitudinal groove 62 of the staple cartridge 60. In other embodiments , a separate cutting blade 438 can be provided in the staple cartridge 60 '. See figures 21 and 22. In such embodiments, for example, the staple cartridge 60 'can be substantially identical to the staple cartridge 60 described above, except that the staple cartridge 60' includes a longitudinally movable cutting blade 438 therein. In such embodiments, the staple cartridge 60 'may have a shell 440 formed thereon or attached thereto, as shown in figure 23 to protect the cutting edge of the cutting blade 438, before being used. The cutting blade 438 is slidable and oriented with the elongated central slot 62 (figure 22) and is adapted to be driven in the distal direction DD when contacted by a distal end of the blade bar 136 '. See figure 24. Using such modalities, once the cutting blade 438 has been advanced distally to the distal end of the elongated central groove 62, the cutting blade 438 will remain in this position when the surgeon retracts the propeller block 122 and the blade bar 136 ', as well as the propellant bars 124. In this way, the surgeon can discard the spent cartridge 60' and use a new cartridge that has a new cutting blade 438 ', which may or may not be used. In alternative embodiments, the cutting blade 438 can be provided with a hook characteristic 450 that is adapted to engage a hook characteristic 462 at the distal end 460 of the blade bar 136 ". See figure 25. [0024] [00024] According to various embodiments of the invention, the stapling instrument 20 can be provided with clamping means for clamping to apply clamping forces to the clamping elements joining the clamp cartridge 60 and the fixed claw 40 during the formation of the clamps. clamps 61. The clamping means for clamping may include means for urging the clamping elements apart in the remote position of the locking mechanism to resist the forces exerted on the clamp cartridge 60 and the clamshell 40 when clamps 61 are formed. In at least one embodiment, a cam means can be mounted on one of the claw elements and can be engaged with the other claw element to move said separate claw elements in the remote position to urge the clamp cartridge 60 and the claw fixed 40 together. In various embodiments, a cam element can be pivotally mounted to one of the claw elements in the remote position of the locking mechanism. The cam element can be pivoted from a first non-operating position to a second operating position to move the remote ends of the separate claw elements. The cam element may be operable by the drive block 112 of the drive bar and cutting blade assembly 110 to move to its operational position when the drive block is advanced and to return to its non-operating position when the drive block is retracted. [0025] [00025] In various embodiments, a cam mechanism, generally 150, can be placed adjacent to the rear end of the lower jaw element 24, as shown in figure 4. The cam mechanism 150 can include a hinge member 152 hingedly mounted on a transverse pivot axis 154 extending between the vertical side flanges 54 of the lower jaw element 24. The cam element 152 may include a first lower cam surface 156 for engaging the top wall 31 of the upper jaw element 22 with the cam 152 in its first non-operating position (figure 15) and a second upper cam surface 158 for engaging the upper wall 31 of the upper jaw element 22 with the cam 152 disposed in its second operating position (figure 16). The first cam surface 156 can be arranged to keep the upper and lower jaw elements substantially parallel with the cam 152 in its non-operational position. The second cam surface 158 can be arranged to lift the rear end of the upper jaw element 22 by approximately 3.2 mm (0.125 inches), for example, when the cam 152 rotates from its non-operational position to its position operational. In addition, an upper jaw element 22 may be flexible enough to allow the rear portion of the upper jaw element 22 to fold upward, away from the lower jaw element 24 when the cam element 152 is moved from its non-operating position. to your operational position. [0026] [00026] As shown in figure 4, the cam element 152 may include a notch 160 that extends radially, and which divides the cam into a large front finger 162 and a small rear finger 164. The front cam finger 162 may include a flat rear-facing surface 165, and a rear cam finger 164 may include a forward-facing inclined surface 166. With cam 152 in its non-operating position, the front cam finger 162 and the rear cam finger 164 can extend downwards through an elongated groove 168 formed in the bottom wall 53 of the lower jaw element 24. [0027] [00027] In various embodiments, the cam element 152 may be operable per drive block 112 to move from its non-operating position to its operating position when the drive block is advanced. As shown in figure 11, the drive block 112 has a cam actuator 174 of the pin protruding from it. With reference to figures 4 and 11, with cam elements 152 arranged in their non-operational position, cam actuator pin 174 is received in the notch 160 between front finger 162 and rear finger 164 of the cam element. [0028] [00028] As shown in figure 15, with cam element 152 arranged in its first non-operating position, the top wall 31 of the upper jaw element 22 can rest on the first cam surface 156 of the cam element. With cam element 152 in its non-operational position, the top wall 31 of the upper claw element 22 can be substantially parallel to the bottom wall 53 of the lower claw element 24. In addition, the drive block 112 can be located in its starting position. When drive block 112 is advanced, as indicated by arrow 182 (figure 13), cam actuator pin 174 can engage the rear surface 165 of front cam finger 162 to rotate cam element 152 counterclockwise, as indicated by arrow 184, to rotate the cam element to its second operating position and to move its second cam surface 158 in engagement with the top wall 31 of the upper gripper element 22. With the cam element 152 turned to the In its operational position, the upper wall 31 of the upper claw element 22 can be folded upwards, as indicated by the arrow 186, away from the bottom wall 53 of the lower claw element 24. The cam element can apply forces to the upper jaw 22 and a lower jaw element 24 that fold the rear portions of the separate jaw elements. As a result of bending the rear portions of the upper jaw element 22 and a separate lower jaw element 24, additional clamping forces can be applied to the front portions of the upper jaw element 22 and a lower jaw element 24 to secure the jaw fixes 40 and the staple cartridge 60 against the fabric trapped between the gripping elements. Thus, the fixed jaw 40 and the staple cartridge 60 can be held together to withstand the forces exerted on the fixed jaw and the staple cartridge, when the drive bar and cutting blade 110 is advanced to form staples 61 and cut the fabric. [0029] [00029] With reference to figure 16, when the drive block 112 is removed after the clamps 61 are formed, the cam actuator pin 174 can engage the inclined surface 166 of the rear cam finger 164 to pivot the cam element 152 in the opposite direction schedule. While the cam actuator pin 174 moves along the inclined surface 166 to the notch 160, the cam element 152 can rotate clockwise and return to its first non-operating position (figure 15) with its first cam surface 156 in engages with the upper wall 31 of the upper claw element 22. As a result, the forces exerted on the rear portions of the upper claw element 22 and a lower claw element 24 by the cam 152 can be released and the top wall 31 of the element upper jaw 22 can return to a substantially parallel relationship with the bottom wall 53 of the lower jaw element 24. Similarly, the clamping forces applied to the front portions of the jaw elements 22 and 24 can be released to loosen the jaw fixes 40 and the staple cartridge 60. [0030] [00030] In various embodiments, the stapling instrument 20 may include spacing means mounted on one of the claw elements for maintaining a predetermined distance between the clamps on the cartridge 60 and the fixed claw 40 of the stapling instrument. With reference to figures 4 and 6, this spacing means can be incorporated as a spacer pin 190 mounted adjacent the distal end of the staple cartridge 60. The spacer pin 190 can extend vertically upwards from the bottom wall 53 of the element lower jaw 24 through the staple cartridge 60 and project upwards from the top of the staple cartridge, with a predetermined distance. As shown in figure 5, a flange 38 of the fixed jaw 40 can include a flange section 192, adjacent to its distal end to engage the spacer pin 190 With the stapling instrument mounted for operation (figure 4), the spacer pin 190 can engage the flange section 192 to maintain a predetermined space between the fixed jaw 40 and the staple cartridge 60. [0031] [00031] In the operation of the stapling instrument 20, the so-called "target tissue" is initially placed between the clamping elements 22 and 24 and secured by the clamping elements. Thus, the cables 26 and 28 can be unlocked by the articulation movement of the lock arm 92 downwards to their unlocked position (figure 2). As a result, the opposite ends of the lock pin 36 can be disengaged from the notches 98 formed in the hook elements 96 of the lock arm 92. Then, the upper and lower claw elements 22 and 24 can be separated by disengaging the lock pin. lock 36 from grooves 56 formed on the side flanges 54 of the lower jaw element. [0032] [00032] Next, the target tissue is placed on the clamping elements 22 and 24. For example, as shown in figure 20, a piece of tubular intestinal tissue can be slid to the front of each clamping element. After the fabric is placed on the staple element, the stapling instrument 20 can be reassembled. Reassembly can be carried out by aligning the locking pin 36 with vertical grooves 56 formed on vertical side flanges 54 of the lower jaw element 24. Thereafter, the side flanges 54 of the lower jaw element 24 can be positioned inside the upper cable 26 , covering the side walls 30 of the upper clamping element 22, while the opposite ends of the locking pin 36 can be inserted into the vertical slots 56. Finally, the locking arm 92 can be rotated upwards to its locked position (figure 3) with its cover 100 flush with the bottom of the lower cable 28. As a result, the hook elements 92 can be rotated on the lock pin 36 and the grooves 98 can receive the opposite ends of the lock pin. In this way, an upper jaw element 22 and a lower jaw element 24 can be locked together in an intermediate position along them adjacent to the fixed jaw 40 and the staple cartridge 60. In addition, the spacer pin 190 can engage the flange section 192 of the fixed jaw 40, through the body fabric, to maintain a predetermined gap between the fixed jaw 40 and the staple cartridge 60. [0033] [00033] After the tissue is trapped between the clamping elements, the surgeon can then determine whether he or she wants to cut and staple the tissue, or whether it is desirable to staple the tissue without cutting through it. If the surgeon wants to cut the tissue, the selector bar 304 is moved transversely to the activated position (figure 13). The stapling instrument 20 can then be triggered by advancing the actuator button 114 to actuate the propeller bar and cutter blade 110. Referring to figure 20, during the initial advancement of the propeller block 112, propeller bars 124 slide distally and the wedge-shaped tips 128 of the drive bars begin to advance through the grooves 66 of the staple cartridge 60. As the drive block 112 advances in the distal "DD" direction, its cam actuator pin 174 engages the rear surface 165 of the front cam 162 to rotate cam 152 counterclockwise, as indicated by the arrow 184 of figure 16, to move the second cam surface 158 of the cam element in engagement with the top wall 31 of the upper gripper element 22. The cam element 152 applies forces to the upper clamshell element 22 and a lower clamshell element 24 that bend the rear portions of the apart clamshell elements. As a result, the rear end of the top wall 31 of the upper claw element 22 can be folded upward by approximately 3.2 mm (0.125 inches), for example, relative to the rear end of the bottom wall 53 of the claw element bottom 24. Folding the rear ends of the separate gripper elements 22 and 24 can result in additional clamping forces on the front portions of the gripper elements to secure the fixed gripper 40 and the staple cartridge 60 against the fabric trapped between the gripping elements. claw. These additional clamping forces tend to resist the forces exerted on the fixed jaw 40 and the staple cartridge 60, while the fabric is cut and the clamps 61 are formed against the fixed jaw 40, to maintain the desired spacing between the fixed jaw 40 and the staple cartridge 60 to produce the formed staples 61 that are substantially uniform in height. [0034] [00034] While the powertrain 112 is advanced, the staple propeller bars 124 can be moved longitudinally along the grooves 66 provided in the staple cartridge 60 The two wedge shaped flesh surfaces 130 of staple propeller bars 124 can move through slots 66 to engage with the inclined surfaces of the clamp actuators 65, to sequentially drive the clamps 61 from the cartridge 60 and form clamps 61 in a B-shaped configuration against the flanges of the fixed claw 38. The clamping surfaces cam 130 can be located at an equal distance from the drive block 112 to simultaneously actuate the clip drivers 65 located on opposite sides of the central longitudinal groove 62. At the same time, the cutting blade 138 is advanced through the central longitudinal groove 42 of the jaw fixes 40 and through the central longitudinal groove 62 of the staple cartridge 60 to cut the fabric trapped between the clamping elements. The additional clamping forces applied to the front portions of the upper jaw element 22 and a lower jaw element 24 by means of the cam mechanism 150 may tend to resist the forces exerted on the fixed jaw 40 and the staple cartridge 60 when the staples 61 are formed. [0035] [00035] After drive block 112 is fully advanced to form all clamps on cartridge 60, drive block 112 can be retracted to its starting position by retracting actuator button 114. As a result, clamp drive bars 124 and 138 of the cutting blade are simultaneously removed from the staple cartridge 60 and fixed jaw 40. [0036] [00036] While the drive block 112 returns from its initial position, the cam actuator pin 174 can engage the inclined surface 166 of the rear cam finger 164 to rotate the cam element 152 clockwise in the direction of its non-position. operational. The cam actuator pin 174 can move along the inclined surface 166 in the groove 160 between the cam fingers 162 and 164 to return the cam elements 152 to their non-operating position. As a result, a second cam surface 158 of the cam element 152 can be disengaged from the upper wall of the upper gripper element 22 and the rear end of the upper wall 31 of the upper gripper element 22 and move downwards to engage with the first cam surface 156. At the same time, the front cam finger 162 can rotate downwards Then, with the cam element 152 in its non-operational position, the locking arm 92 can be rotated downwards, as shown in figure 2 , to allow the upper gripper element 22 and the lower gripper element 24 to be disassembled. At this point, the cut and stapled fabric can be removed from the clamping elements. [0037] [00037] For procedures that do not require tissue cutting, the surgeon moves the selector bar 304 to the deactivated position (figure 12). When in this position, the drive block 122 is free to be longitudinally advanced in the distal direction of the cutting bar 136, without causing the blade bar 136 to be distally advanced. In this way, the movement of the propeller block 122 activates the staple propeller bars 124, in the manner described above, but without the tissue being cut by blade 138. Consequently, these modalities provide the surgeon with the additional flexibility of being able to staple tissue without cutting it In addition, various embodiments of the present invention include a staple cartridge that has several rows of staples operationally supported within it and a new cutting blade that may or may not be used. If the surgeon wants to cut the tissue while firing the clips, the selector bar is moved to the activated position and the propellant bar is advanced. Once the fabric has been cut and staples have been released, the cartridge can be discarded. This arrangement allows the surgical instrument to be reused with a new cartridge that contains a new cutting blade. Still other embodiments employ a reusable cutting blade arrangement. [0038] [00038] The devices described here can be designed to be discarded after a single use, or they can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, in any number of particular parts or parts of the device can be selectively replaced or removed, in any combination. When cleaning and / or replacing particular parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately before a surgical procedure. Those skilled in the art will appreciate that the reconditioning of a device can use a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present patent application. [0039] [00039] Preferably, the present invention described here will be processed before surgery. First, a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the instrument are then placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays or high-energy electrons. The radiation kills bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened at the medical facility. [0040] [00040] Any patent, publication or other description material, in whole or in part, which is said to be incorporated into the present invention for reference purposes, is incorporated into the present invention only to the extent that the incorporated materials do not come into effect. conflict with existing definitions, statements or other description material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein replaces any conflicting material incorporated herein by way of reference. Any material, or portion thereof, that is deemed to be incorporated by reference into the present invention, but which conflicts with definitions, statements, or other description materials existing herein will be incorporated here only to the extent that no conflict will appear between the embedded material and the existing description material. [0041] [00041] Although this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of the description. It is intended, therefore, that this application covers any variations, uses or adaptations of the invention with the use of its general principles. In addition, this application is intended to cover such changes to the present description, in accordance with known or customary practice in the technique to which this invention belongs.
权利要求:
Claims (9) [0001] Surgical instrument (20), comprising: a first claw element (24) configured to operationally support a staple cartridge (60, 60 ') that has a plurality of staples (61) therein; a second claw element (22) removably attachable to the first claw element (24) to allow the fabric to be trapped between them; at least one set of propellant bars (112, 124) operationally supported in relation to the first claw element (24) and being configured to selectively apply a discharge movement to the clamps (61) held in the clamp cartridge (60, 60 ') as at least one set of propellant bars (112, 124) is distally advanced through the staple cartridge (60, 60'); a cutting bar (136, 136 ', 136'') operationally supported in relation to the first claw element (24) and at least one set of propellant bars (112, 124), the cutting bar (136, 136', 136 '') being configured to cut the fabric stuck between the first and second claw elements (22, 24); characterized by the fact that it also comprises: a selector switch (300) creating an operational mode interface with the cutter bar (136, 136 ', 136'') and being movable between an activated position, in which an application of an activation movement to at least one set of propellers (112, 124) causes the cutter bar (136, 136 ', 136'') and at least one set of propellers (112, 124) to move simultaneously in a distal direction within the first claw element (24) and a disabled position in which the application of the activation movement to at least one set of propellant bars (112, 124) causes at least one set of propellant bars (112, 124) to move in the distal direction, without move the cutter bar (136, 136 ', 136'') in the distal direction. [0002] Surgical instrument (20) according to claim 1, characterized by the fact that the cutter bar (136, 136 ', 136' ') and at least one propeller bar assembly are operationally supported by a propeller block ( 112) which is removably supported in a portion of the first claw element (24), the drive block (112) creating an operational mode interface with the selector switch (300). [0003] Surgical instrument (20) according to claim 2, characterized by the fact that the selector switch (300) comprises a selector bar (304) movably supported within the propulsion block (112) and being selectively movable between the activated position where the drive block (112) is coupled to the cutter bar (136, 136 ', 136' ') and a disabled position where the drive block (112) is selectively movable in relation to the cutter bar (136, 136' , 136 ''). [0004] Surgical instrument (20) according to claim 3, characterized by the fact that at least one propellant bar (124) is connected to the propellant block (112) and in which the cutter bar (136, 136 ', 136' ' ) is received slidingly within a longitudinal groove (302) in the drive block (112) and in which the selector bar (304) is selectively movable along an axis that is substantially transversal to the longitudinal groove (302) between the positions on and off. [0005] Surgical instrument (20) according to claim 1, characterized in that the cutter bar (136, 136 ’, 136’ ’) has a blade (138) at a distal end thereof. [0006] Surgical instrument (20) according to claim 5, characterized in that the blade (138) is separable from the distal end of the cutting bar (136, 136 ’, 136’ ’). [0007] Surgical instrument (20) according to claim 1, characterized by the fact that it comprises a blade (138) operationally supported on the staple cartridge (60, 60 ') and configured to receive a cutting movement from the cutter bar (136, 136 ', 136' '). [0008] Surgical instrument (20), according to claim 7, characterized by the fact that the distal end of the cutting bar (136, 136 ', 136' ') is configured to be in the border position of the blade (138) in the cartridge staples (60, 60 ') and advance the blade (138) distally inside the staple cartridge (60, 60') over the application of the activation movement to the cutter bar (136, 136 ', 136' '). [0009] Surgical instrument according to claim 1, characterized by the fact that at least one of the first claw element (24) and the staple cartridge (60, 60 ') is configured to slide a staple driver ( 65) configured to deploy the staples (61) of the staple cartridge (60, 60 '); the second claw element (22) has a fixed claw portion (40) configured to deform the clamps (61) when the clamps (61) are implanted from the clamp cartridge (60, 60 '); an actuator button (114) extending from at least one drive bar (124) and being movable towards the distal ends of the first and second claw elements (22, 24); wherein the cutter bar (136, 136 ', 136'') is operationally supported in relation to the actuator button (114); and selection means interacting with the actuator button (114) and the cutter bar (136, 136 ', 136'') to selectively engage the cutter bar (136, 136', 136 '') with the actuator button (114) so that when the actuator button (114) is moved towards the distal ends of the first and second claw elements (22, 24), the cutter bar (136, 136 ', 136'') and at least one drive bar (124) are advanced towards the distal ends of the first and second claw elements (22, 24), the selection means additionally configured to selectively disengage the cutter bar (136, 136 ', 136'') from the actuator button ( 114) such that when the actuator button (114) is moved towards the distal ends of the first and second claw elements (22, 24), at least one drive bar (124) is advanced towards the first and second ends distal, without the cutting bar (136, 136 ', 136'') being advanced with it.
类似技术:
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同族专利:
公开号 | 公开日 AU2011282705A1|2013-02-14| WO2012015935A1|2012-02-02| BR112013002208A2|2016-05-24| CN103037782A|2013-04-10| US20120024936A1|2012-02-02| US8789740B2|2014-07-29| JP5795373B2|2015-10-14| CA2806437C|2019-06-04| AU2011282705B2|2014-01-23| CN103037782B|2015-12-09| CA2806437A1|2012-02-02| JP2013533056A|2013-08-22| EP2598051A1|2013-06-05| EP2598051B1|2019-10-16|
引用文献:
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soft stop| RU2672520C2|2013-03-01|2018-11-15|Этикон Эндо-Серджери, Инк.|Hingedly turnable surgical instruments with conducting ways for signal transfer| US20140263552A1|2013-03-13|2014-09-18|Ethicon Endo-Surgery, Inc.|Staple cartridge tissue thickness sensor system| US9629629B2|2013-03-14|2017-04-25|Ethicon Endo-Surgey, LLC|Control systems for surgical instruments| US9687230B2|2013-03-14|2017-06-27|Ethicon Llc|Articulatable surgical instrument comprising a firing drive| US9572577B2|2013-03-27|2017-02-21|Ethicon Endo-Surgery, Llc|Fastener cartridge comprising a tissue thickness compensator including openings therein| US9332984B2|2013-03-27|2016-05-10|Ethicon Endo-Surgery, Llc|Fastener cartridge assemblies| US9795384B2|2013-03-27|2017-10-24|Ethicon Llc|Fastener cartridge comprising a tissue thickness compensator and a gap setting element| US10136887B2|2013-04-16|2018-11-27|Ethicon Llc|Drive system decoupling arrangement for a surgical instrument| US9574644B2|2013-05-30|2017-02-21|Ethicon Endo-Surgery, Llc|Power module for use with a surgical instrument| MX369362B|2013-08-23|2019-11-06|Ethicon Endo Surgery Llc|Firing member retraction devices for powered surgical instruments.| US20150053746A1|2013-08-23|2015-02-26|Ethicon Endo-Surgery, Inc.|Torque optimization for surgical instruments| WO2015090157A1|2013-12-17|2015-06-25|苏州天臣国际医疗科技有限公司|Linear cutting stapler| US20150173756A1|2013-12-23|2015-06-25|Ethicon Endo-Surgery, Inc.|Surgical cutting and stapling methods| US9839428B2|2013-12-23|2017-12-12|Ethicon Llc|Surgical cutting and stapling instruments with independent jaw control features| US9642620B2|2013-12-23|2017-05-09|Ethicon Endo-Surgery, Llc|Surgical cutting and stapling instruments with articulatable end effectors| US9681870B2|2013-12-23|2017-06-20|Ethicon Llc|Articulatable surgical instruments with separate and distinct closing and firing systems| US9724092B2|2013-12-23|2017-08-08|Ethicon Llc|Modular surgical instruments| US9687232B2|2013-12-23|2017-06-27|Ethicon Llc|Surgical staples| US9962161B2|2014-02-12|2018-05-08|Ethicon Llc|Deliverable surgical instrument| CN106232029B|2014-02-24|2019-04-12|伊西康内外科有限责任公司|Fastening system including firing member locking piece| US9775608B2|2014-02-24|2017-10-03|Ethicon Llc|Fastening system comprising a firing member lockout| US9913642B2|2014-03-26|2018-03-13|Ethicon Llc|Surgical instrument comprising a sensor system| US10013049B2|2014-03-26|2018-07-03|Ethicon Llc|Power management through sleep options of segmented circuit and wake up control| US10004497B2|2014-03-26|2018-06-26|Ethicon Llc|Interface systems for use with surgical instruments| US20150272580A1|2014-03-26|2015-10-01|Ethicon Endo-Surgery, Inc.|Verification of number of battery exchanges/procedure count| US11259799B2|2014-03-26|2022-03-01|Cilag Gmbh International|Interface systems for use with surgical instruments| JP6612256B2|2014-04-16|2019-11-27|エシコンエルエルシー|Fastener cartridge with non-uniform fastener| US10561422B2|2014-04-16|2020-02-18|Ethicon Llc|Fastener cartridge comprising deployable tissue engaging members| US10045781B2|2014-06-13|2018-08-14|Ethicon Llc|Closure lockout systems for surgical instruments| US9757128B2|2014-09-05|2017-09-12|Ethicon Llc|Multiple sensors with one sensor affecting a second sensor's output or interpretation| BR112017004361A2|2014-09-05|2017-12-05|Ethicon Llc|medical overcurrent modular power supply| US9801627B2|2014-09-26|2017-10-31|Ethicon Llc|Fastener cartridge for creating a flexible staple line| BR112017005981A2|2014-09-26|2017-12-19|Ethicon Llc|surgical staplers and ancillary materials| US10076325B2|2014-10-13|2018-09-18|Ethicon Llc|Surgical stapling apparatus comprising a tissue stop| US9924944B2|2014-10-16|2018-03-27|Ethicon Llc|Staple cartridge comprising an adjunct material| US10517594B2|2014-10-29|2019-12-31|Ethicon Llc|Cartridge assemblies for surgical staplers| US11141153B2|2014-10-29|2021-10-12|Cilag Gmbh International|Staple cartridges comprising driver arrangements| 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articulation link arrangements| US10448948B2|2016-02-12|2019-10-22|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments| US10258331B2|2016-02-12|2019-04-16|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments| US11224426B2|2016-02-12|2022-01-18|Cilag Gmbh International|Mechanisms for compensating for drivetrain failure in powered surgical instruments| US10376263B2|2016-04-01|2019-08-13|Ethicon Llc|Anvil modification members for surgical staplers| US10307159B2|2016-04-01|2019-06-04|Ethicon Llc|Surgical instrument handle assembly with reconfigurable grip portion| US10271851B2|2016-04-01|2019-04-30|Ethicon Llc|Modular surgical stapling system comprising a display| US10617413B2|2016-04-01|2020-04-14|Ethicon Llc|Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts| US10828028B2|2016-04-15|2020-11-10|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion| US10492783B2|2016-04-15|2019-12-03|Ethicon, Llc|Surgical instrument with improved stop/start control during a firing motion| US10405859B2|2016-04-15|2019-09-10|Ethicon Llc|Surgical instrument with adjustable stop/start control during a firing motion| US10357247B2|2016-04-15|2019-07-23|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion| US10335145B2|2016-04-15|2019-07-02|Ethicon Llc|Modular surgical instrument with configurable operating mode| US10426467B2|2016-04-15|2019-10-01|Ethicon Llc|Surgical instrument with detection sensors| US11179150B2|2016-04-15|2021-11-23|Cilag Gmbh International|Systems and methods for controlling a surgical stapling and cutting instrument| US10456137B2|2016-04-15|2019-10-29|Ethicon Llc|Staple formation detection mechanisms| US10368867B2|2016-04-18|2019-08-06|Ethicon Llc|Surgical instrument comprising a lockout| US10987156B2|2016-04-29|2021-04-27|Ethicon Llc|Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members| US10856934B2|2016-04-29|2020-12-08|Ethicon Llc|Electrosurgical instrument with electrically conductive gap setting and tissue engaging members| USD850617S1|2016-06-24|2019-06-04|Ethicon Llc|Surgical fastener cartridge| USD826405S1|2016-06-24|2018-08-21|Ethicon Llc|Surgical fastener| USD847989S1|2016-06-24|2019-05-07|Ethicon Llc|Surgical fastener cartridge| US10542979B2|2016-06-24|2020-01-28|Ethicon Llc|Stamped staples and staple cartridges using the same| USD822206S1|2016-06-24|2018-07-03|Ethicon Llc|Surgical fastener| US10751117B2|2016-09-23|2020-08-25|Ethicon Llc|Electrosurgical instrument with fluid diverter| US10675026B2|2016-12-21|2020-06-09|Ethicon Llc|Methods of stapling tissue| US20180168608A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical instrument system comprising an end effector lockout and a firing assembly lockout| 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tissue retention and gap setting features| US11033325B2|2017-02-16|2021-06-15|Cilag Gmbh International|Electrosurgical instrument with telescoping suction port and debris cleaner| US10799284B2|2017-03-15|2020-10-13|Ethicon Llc|Electrosurgical instrument with textured jaws| US10881396B2|2017-06-20|2021-01-05|Ethicon Llc|Surgical instrument with variable duration trigger arrangement| US10980537B2|2017-06-20|2021-04-20|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations| US10368864B2|2017-06-20|2019-08-06|Ethicon Llc|Systems and methods for controlling displaying motor velocity for a surgical instrument| US10307170B2|2017-06-20|2019-06-04|Ethicon Llc|Method for closed loop control of motor velocity of a surgical stapling and cutting instrument| US10390841B2|2017-06-20|2019-08-27|Ethicon Llc|Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation| USD890784S1|2017-06-20|2020-07-21|Ethicon Llc|Display panel with changeable graphical user interface| US11090046B2|2017-06-20|2021-08-17|Cilag Gmbh International|Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument| US10327767B2|2017-06-20|2019-06-25|Ethicon Llc|Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation| US10881399B2|2017-06-20|2021-01-05|Ethicon Llc|Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument| US10646220B2|2017-06-20|2020-05-12|Ethicon Llc|Systems and methods for controlling displacement member velocity for a surgical instrument| US10624633B2|2017-06-20|2020-04-21|Ethicon Llc|Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument| USD879808S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with graphical user interface| 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Llc|Surgical anvil arrangements| US11266405B2|2017-06-27|2022-03-08|Cilag Gmbh International|Surgical anvil manufacturing methods| US10993716B2|2017-06-27|2021-05-04|Ethicon Llc|Surgical anvil arrangements| US10903685B2|2017-06-28|2021-01-26|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies forming capacitive channels| USD906355S1|2017-06-28|2020-12-29|Ethicon Llc|Display screen or portion thereof with a graphical user interface for a surgical instrument| US11246592B2|2017-06-28|2022-02-15|Cilag Gmbh International|Surgical instrument comprising an articulation system lockable to a frame| USD869655S1|2017-06-28|2019-12-10|Ethicon Llc|Surgical fastener cartridge| US11259805B2|2017-06-28|2022-03-01|Cilag Gmbh International|Surgical instrument comprising firing member supports| US10211586B2|2017-06-28|2019-02-19|Ethicon Llc|Surgical shaft assemblies with watertight housings| USD854151S1|2017-06-28|2019-07-16|Ethicon Llc|Surgical instrument shaft| 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advancement of closure member during firing| US10258418B2|2017-06-29|2019-04-16|Ethicon Llc|System for controlling articulation forces| US10932772B2|2017-06-29|2021-03-02|Ethicon Llc|Methods for closed loop velocity control for robotic surgical instrument| US10743872B2|2017-09-29|2020-08-18|Ethicon Llc|System and methods for controlling a display of a surgical instrument| US10729501B2|2017-09-29|2020-08-04|Ethicon Llc|Systems and methods for language selection of a surgical instrument| USD907647S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface| USD917500S1|2017-09-29|2021-04-27|Ethicon Llc|Display screen or portion thereof with graphical user interface| US10765429B2|2017-09-29|2020-09-08|Ethicon Llc|Systems and methods for providing alerts according to the operational state of a surgical instrument| US10796471B2|2017-09-29|2020-10-06|Ethicon Llc|Systems and methods of displaying a knife position for a surgical instrument| 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法律状态:
2018-12-26| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]| 2019-09-10| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]| 2020-04-22| B06A| Patent application procedure suspended [chapter 6.1 patent gazette]| 2020-08-04| B09A| Decision: intention to grant [chapter 9.1 patent gazette]| 2020-12-01| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 27/07/2011, OBSERVADAS AS CONDICOES LEGAIS. |
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申请号 | 申请日 | 专利标题 US12/846,986|US8789740B2|2010-07-30|2010-07-30|Linear cutting and stapling device with selectively disengageable cutting member| US12/846,986|2010-07-30| PCT/US2011/045555|WO2012015935A1|2010-07-30|2011-07-27|Linear cutting and stapling device with selectively disengageable cutting member| 相关专利
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