DOCSLIB.ORG

Surgical Stapler with Terminal Staple Orientation Crossing Center Line

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

(19) TZZ¥__T (11) EP 3 155 985 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.: 19.04.2017 Bulletin 2017/16 A61B 17/072 (2006.01) (21) Application number: 16193975.6 (22) Date of filing: 14.10.2016 (84) Designated Contracting States: (71) Applicant: Ethicon Endo-Surgery, LLC AL AT BE BG CH CY CZ DE DK EE ES FI FR GB 00969 Guaynabo (PR) GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR (72) Inventors: Designated Extension States: • SCHEIB, Charles J. BA ME Cincinnati, OH 45242 (US) Designated Validation States: • SHELTON, IV, Frederick E. MA MD Cincinnati, OH 45242 (US) (30) Priority: 15.10.2015 US 201514884096 (74) Representative: Carpmaels & Ransford LLP One Southampton Row London WC1B 5HA (GB) (54) SURGICAL STAPLER WITH TERMINAL STAPLE ORIENTATION CROSSING CENTER LINE (57) A surgical instrument includes a shaft assembly, tridge is received within the second jaw. The staple car- an end effector, and a staple cartridge. The end effector tridge includes a deck and a plurality of staples. The deck includes a first jaw and a second jaw. The first jaw in- has a plurality of staple openings. The staples are posi- cludes an anvil that is configured to form a plurality of tioned within respective staple openings. At least one of staples pressed against the anvil. The first and second the staple openings obliquely crosses a centerline of the jaws are configured to transition between an open con- end effector. figuration and a closed configuration. The staple car- EP 3 155 985 A1 Printed by Jouve, 75001 PARIS (FR) 1 EP 3 155 985 A1 2 Description Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission," issued May 6, 2008; U.S. BACKGROUND Pat.No. 7,380,695, entitled "Surgical Stapling Instrument Having a Single Lockout Mechanism for Prevention of [0001] In some settings, endoscopic surgical instru- 5 Firing," issued June 3, 2008; U.S. Pat. No. 7,380,696, ments may be preferred over traditional open surgical entitled "Articulating Surgical Stapling Instrument Incor- devices since a smaller incision may reduce the post- porating a Two-Piece E-Beam Firing Mechanism," is- operative recovery time and complications. Consequent- sued June 3, 2008; U.S. Pat. No. 7,404,508, entitled "Sur- ly, some endoscopic surgical instruments may be suita- gical Stapling and Cutting Device," issued July 29, 2008; ble for placement of a distal end effector at a desired10 U.S. Pat. No. 7,434,715, entitled "Surgical Stapling In- surgical site through the cannula of a trocar. These distal strument Having Multistroke Firing with Opening Lock- end effectors may engage tissue in a number of ways to out," issued October 14, 2008; U.S. Pat. No. 7,721,930, achieve a diagnostic or therapeutic effect (e.g., endoc- entitled "Disposable Cartridge with Adhesive for Use with utter, grasper, cutter, stapler, clip applier, access device, a Stapling Device," issued May 25, 2010; U.S. Pat. No. drug/gene therapy delivery device, and energy delivery 15 8,408,439, entitled "Surgical Stapling Instrument with An device using ultrasonic vibration, RF, laser, etc.). Endo- Articulatable End Effector," issued April 2, 2013; and U.S. scopic surgical instruments may include a shaft between Pat. No. 8,453,914, entitled "Motor-Driven Surgical Cut- the end effector and a handle portion, which is manipu- ting Instrument with Electric Actuator Directional Control lated by the clinician. Such a shaft may enable insertion Assembly," issued June 4, 2013. to a desired depth and rotation about the longitudinal axis 20 [0003] While the surgical staplers referred to above are of the shaft, thereby facilitating positioning of the end described as being used in endoscopic procedures, it effector within the patient. Positioning of an end effector should be understood that such surgical staplers may may be further facilitated through inclusion of one or more also be used in open procedures and/or other non-en- articulation joints or features, enabling the end effector doscopic procedures. By way of example only, a surgical to be selectively articulated or otherwise deflected rela- 25 stapler may be inserted through a thoracotomy, and tive to the longitudinal axis of the shaft. thereby between a patient’s ribs, to reach one or more [0002] Examples of endoscopic surgical instruments organs in a thoracic surgical procedure that does not use include surgical staplers. Some such staplers are oper- a trocar as a conduit for the stapler. Such procedures able to clamp down on layers of tissue, cut through the may include the use of the stapler to sever and close a clamped layers of tissue, and drive staples through the 30 vessel leading to a lung. For instance, the vessels leading layers of tissue to substantially seal the severed layers to an organ may be severed and closed by a stapler be- of tissue together near the severed ends of the tissue fore removal of the organ from the thoracic cavity. Of layers. Merely exemplary surgical staplers are disclosed course, surgical staplers may be used in various other in U.S. Pat. No. 4,805,823, entitled "Pocket Configuration settings and procedures. for Internal Organ Staplers," issued February 21, 1989; 35 [0004] Examples of surgical staplers that may be par- U.S. Pat. No. 5,415,334, entitled "Surgical Stapler and ticularly suited or use through a thoracotomy are dis- Staple Cartridge," issued May 16, 1995; U.S. Pat. No. closed in U.S. Patent App. No. 14/810,786, entitled "Sur- 5,465,895, entitled "Surgical Stapler Instrument," issued gical Staple Cartridge with Compression Feature at Knife November 14, 1995; U.S. Pat. No. 5,597,107, entitled Slot," filed July 29, 2015; U.S. Patent Pub. No. "Surgical Stapler Instrument," issued January 28, 1997; 40 2014/0243801, entitled "Surgical Instrument End Effec- U.S. Pat. No. 5,632,432, entitled "Surgical Instrument," tor Articulation Drive with Pinion and Opposing Racks," issued May 27, 1997; U.S. Pat. No. 5,673,840, entitled published August 28, 2014; U.S. Patent Pub. No. "Surgical Instrument," issued October 7, 1997; U.S. Pat. 2014/0239041, entitled "Lockout Feature for Movable No. 5,704,534, entitled "Articulation Assembly for Surgi- Cutting Member of Surgical Instrument," published Au- cal Instruments," issued January 6, 1998; U.S. Pat. No. 45 gust 28, 2014; U.S. Patent Pub. No. 2014/0239042, en- 5,814,055, entitled "Surgical Clamping Mechanism," is- titled "Integrated Tissue Positioning and Jaw Alignment sued September 29,1998; U.S. Pat. No. 6,978,921, en- Features for Surgical Stapler," published August 28, titled "Surgical Stapling Instrument Incorporating an E- 2014; U.S. Patent Pub. No. 2014/0239036, entitled "Jaw Beam Firing Mechanism," issued December 27, 2005; Closure Feature for End Effector of Surgical Instrument," U.S. Pat. No. 7,000,818, entitled "Surgical Stapling In- 50 published August 28, 2014; U.S. Patent Pub. No. strument Having Separate Distinct Closing and Firing 2014/0239040, entitled "Surgical Instrument with Articu- Systems," issued February 21,2006; U.S. Pat. No. lation Lock having a Detenting Binary Spring," published 7,143,923, entitled "Surgical Stapling Instrument Having August 28, 2014; U.S. Patent Pub. No. 2014/0239043, aFiring Lockout for an UnclosedAnvil," issued December entitled "Distal Tip Features for End Effector of Surgical 5, 2006; U.S. Pat. No. 7,303,108, entitled "Surgical Sta- 55 Instrument," published August 28, 2014; U.S. Patent pling Instrument Incorporating a Multi-Stroke Firing Pub. No. 2014/0239037, entitled "Staple Forming Fea- Mechanism with a Flexible Rack," issued December 4, tures for Surgical Stapling Instrument," published August 2007; U.S. Pat. No. 7,367,485, entitled "Surgical Stapling 28, 2014; U.S. Patent Pub. No. 2014/0239038, entitled 2 3 EP 3 155 985 A1 4 "Surgical Instrument with Multi-Diameter Shaft," pub- FIG. 11 depicts a top view of a lower jaw of the end lished August 28, 2014; and U.S. Patent Pub. No. effector of FIG. 10; 2014/0239044, entitled "Installation Features for Surgi- cal Instrument End Effector Cartridge," published August FIG. 12 depicts a bottom view of an upper jaw of the 28, 2014. 5 end effector of FIG. 10; [0005] While various kinds of surgical stapling instru- ments and associated components have been made and FIG. 13 depicts an exploded perspective view of the used, it is believed that no one prior to the inventor(s) lower jaw of FIG. 11; has made or used the invention described in the append- ed claims. 10 FIG. 14 depicts a perspective view of a cross driver assembly of the lower jaw of FIG. 11; BRIEF DESCRIPTION OF THE DRAWINGS FIG. 15 depicts a top view of the cross driver assem- [0006] The accompanying drawings, which are incor- bly of FIG. 14; porated in and constitute a part of this specification, il- 15 lustrate embodiments of the invention, and, together with FIG. 16A depicts a schematic representation of a the general description of the invention given above, and liver having a vessel extending through the liver tis- the detailed description of the embodiments given below, sue; serve to explain the principles of the present invention. 20 FIG. 16B depicts the schematic representation of the FIG. 1 depicts a perspective view of an exemplary end effector of FIG. 10 severing the liver tissue of articulating surgical stapling instrument; FIG. 16A; FIG. 2 depicts a side elevational view of the instru- FIG. 16C depicts the schematic representation of ment of FIG. 1; 25 the vessel of FIG. 16B exposed from the severed liver tissue of FIG.
Recommended publications
  • B.J.ZH.F.Panther Medical Equipment Co., Ltd. 北京派爾特醫療科技股份

    B.J.ZH.F.Panther Medical Equipment Co., Ltd. 北京派爾特醫療科技股份

    The Stock Exchange of Hong Kong Limited and the Securities and Futures Commission take no responsibility for the contents of this Application Proof, make no representation as to its accuracy or completeness and expressly disclaim any liability whatsoever for any loss howsoever arising from or in reliance upon the whole or any part of the contents of this Application Proof. Application Proof of B.J.ZH.F.Panther Medical Equipment Co., Ltd. 北京派爾特醫療科技股份有限公司 (the “Company”) (a joint stock company incorporated in the People’s Republic of China with limited liability) WARNING The publication of this Application Proof is required by The Stock Exchange of Hong Kong Limited (the “Stock Exchange”) and the Securities and Futures Commission (the “Commission”) solely for the purpose of providing information to the public in Hong Kong. This Application Proof is in draft form. The information contained in it is incomplete and is subject to change which can be material. By viewing this document, you acknowledge, accept and agree with the Company, its sole sponsor, advisors or members of the underwriting syndicate that: (a) this document is only for the purpose of providing information about the Company to the public in Hong Kong and not for any other purposes. No investment decision should be based on the information contained in this document; (b) the publication of this document or supplemental, revised or replacement pages on the Stock Exchange’s website does not give rise to any obligation of the Company, its sole sponsor, advisors or members of the underwriting syndicate to proceed with an offering in Hong Kong or any other jurisdiction.
  • Snakes, Worms and Catheters: Continuum and Serpentine Robots for Minimally Invasive Surgery

    Snakes, Worms and Catheters: Continuum and Serpentine Robots for Minimally Invasive Surgery

    IEEE ICRA 2010 Full Day Workshop Snakes, Worms and Catheters: Continuum and Serpentine Robots for Minimally Invasive Surgery Monday May 3, 2010 Anchorage, Alaska USA Organizers: Pierre E. Dupont Mohsen Mahvash Workshop Contents 1- Introduction 2- Abstract of Invited Talks • Neal Tanner, Hansen Medical (commercialization) 3 • David Camarillo, Hansen Medical (robotic catheters) 5 • Howie Choset, Carnegie Mellon University (snakes) 6 • Pierre Dupont, Children’s Hospital Boston, HMS (continuum robots) 8 • Koji Ikuta, Nagoya University (robotic catheters) 9 • Joseph Madsen, MD, Children’s Hospital, Harvard Med (clinical perspective) 11 • Mohsen Mahvash, Children’s Hospital Boston, HMS (continuum robots) 12 • Rajni Patel, University of Western Ontario (robotic catheters) 14 • Cameron Riviere, Carnegie Mellon University (worm robots) 16 • Nabil Simaan, Columbia University (NOTES) 17 • Russell Taylor, Johns Hopkins University (snake robots) 19 • Robert Webster, Vanderbilt University (continuum robots) 20 • Guang-Zhong Yang, Imperial College (snake robots) 23 3- Short Papers • A Highly Articulated Robotic System (CardioARM) is Safer than a Rigid System for Intrapericardial Intervention in a Porcine Model 24 • Towards a Minimally Invasive Neurosurgical Intracranial Robot 27 • Uncertainty Analysis in Continuum Robot Kinematics 30 • Ultrasound Image-Controlled Robotic Cardiac Catheter System 33 • Steerable Continuum Robot Design for Cochlear Implant Surgery 36 • Modular Needle Steering Driver for MRI-guided Transperineal Prostate Intervention 39
  • Advanced Energy Systems for Laparoscopic Gynecology Procedures

    Advanced Energy Systems for Laparoscopic Gynecology Procedures

    Available at www.obgmanagement.com S U pp L ement to This supplement is supported by a grant from Ethicon Endo-Surgery, Inc., and has been peer reviewed by the editors of OBG Management. November 2009 Advanced energy systems for laparoscopic gynecology procedures Multifunctional technology yields reliable outcomes, enhances patient safety, and increases procedure efficiency Chair Dr Brill: Probably no surgical instrument defines the gynecolo- gist more than the Kleppinger forceps, the first bipolar device Andrew I. Brill, MD Director of Minimally Invasive used for tubal ligation. It remains an important part of our ar- Gynecology mamentarium despite thermal spread, smoke, char, tissue stick- California Pacific Medical Center ing, and inconsistent hemostasis,1-5 shortcomings that have led San Francisco, California to the development of newer bipolar electrosurgical devices— the LigaSure™ Vessel Sealing System, PlasmaKinetic (PK) plat- Faculty form, and ENSEAL®. These energy-based surgical devices offer John D. Bertrand, MD Director added functionality—coagulation and cutting in a single instru- Minimally Invasive Surgery ment—as well as increased efficiency. These instruments offer Texas Health Dallas specific features that appeal to gynecologic surgeons who have Walnut Hill OB/GYN Associates Dallas, Texas different needs and preferences. Ultrasonic energy technology has also advanced significantly, with instruments such as the Steven D. McCarus, MD Harmonic ACE®, which both cuts and coagulates at the point Chief, Division of Gynecologic Surgery of impact for use in soft-tissue incisions and transections. Director, The Center for Despite our collective surgical experience, the comparative Pelvic Health Florida Hospital Cenebration strengths and weaknesses of these devices have yet to be clearly Orlando, Florida established in an unbiased and reproducible fashion.
  • Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices

    Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices

    September 12, 2006 NOTICE Our file number: 06-120629-368 Re: Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices Health Canada is pleased to announce the release of the revised Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices. This guidance document supersedes the January 14, 2000 version of the same document. The Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices is intended to assist manufacturers in confirming the classification of medical device products after application of the Classification Rules for Medical Devices set out in Schedule 1 of the Medical Devices Regulations. This guidance document has been revised to reflect changes to the risk- based classification of particular medical device groups. Specifically, the following major changes have been made to the document: • the reclassification of specific medical device groups; • the removal of redundant information; • the addition of medical device groups; and • the omission of product groups that do not fit the meaning of a medical device as defined in the Food and Drugs Act. To search for a medical device group within the Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices PDF file, go to Edit/Find and enter a keyword, preferred name code or description in the “Find” field. For instance, to verify the risk-based classification of dental burs, enter “bur” or “drill” in the “Find” field. Please note that this guidance document is provided only as a guide and that in the event of any discrepancy between this document and the Classification Rules for Medical Devices described in the Medical Devices Regulations, the latter shall prevail.
  • Fine Surgical Instruments for Research™

    Fine Surgical Instruments for Research™

    FINE SCIENCE TOOLS CATALOG 2021 FINE SCIENCE TOOLS CATALOG FINE SURGICAL INSTRUMENTS FOR RESEARCH™ TABLE OF CONTENTS | CATALOG 2021 Scissors 3 – 35 Spring 3 – 14 Fine 15 – 28 Letter from the Managing Partner Surgical 29 – 35 Bone Instruments 36 – 49 Rongeurs 36 – 38 Dear Customers, Cutters 39 – 47 Other Bone Instruments 47 – 48 After my uncle and founder of Fine Science Tools, Hans, handed Curettes & Chisels 49 over the management of the company to my cousin Rob and I Scalpels & Knives 50 – 61 last year, a lot has happened. Coming to FST as an “outsider”, my primary goal was to learn everything about the products, customers and the entire company. From my very first day, Forceps 63 – 91 I learned just how much my uncle Hans and the excellent Dumont 63 – 73 managerial team, Rob, Michael and Christina were able to Fine 72 – 80 grow the company over the last 45 years from a single office in Moria 74 S&T 75, 77 Vancouver into a global enterprise, a tremendous achievement Standard 81 – 91 that they should be proud of. Through excellent customer Hemostats 92 – 97 service, impeccable product quality and a passionate team, FST has become a household name in surgical and microsurgical instruments and accessories. During the COVID19 pandemic and the following worldwide lockdown, whether at their home office or on-site, our teams Probes & Hooks 99 – 103 around the world were able to provide our customers with the Spatulae 102 – 105 instruments and accessories they needed. Under challenging Hippocampal Tools & Spoons 106 – 107 circumstances, we kept our warehouses open in order to ship Pins & Holders 108 – 109 products to research laboratories, biotech’s and academic Wound Closure 110 – 121 institutions around the world while our support staff actively Needle Holders & Suture 110 – 118 Staplers, Clips & Applicators 119 – 121 continued to provide assistance to all customer questions and Retractors 122 – 129 inquiries.
  • Product Catalogue Surgical Metal Instruments

    Product Catalogue Surgical Metal Instruments

    Single-use Surgical Instruments PRODUCT CATALOGUE Table of Content AcXess Single Use Instruments and Application Sets Surgical Scissors 2 Dissecting Scissors 3 More Scissors 4 Forceps 6 Artery Forceps 7 Anatomic Artery Forceps 7 Surgical Tissue Forceps 9 Forceps 11 Anatomic Dissecting Forceps 11 Surgical Tissue Forceps 12 Needle holder 14 Retractors 15 Curettes 16 AcXess OR Sets 17 ProKit Application Sets 18 ProKit Suture Removal Sets 18 ProKit Care Sets for Wound Treatment 19 AcXess Stitch Alternatives 20 Surgical Stapler 20 Surgical Staple Remover 20 Product Overview AcXess SUORG Disposable Instruments for high demands o Complex, precise finishing o Special steel alloy o Funktionality and safety suitable for long interventions without loss of quality Instruments in SUORG quality are marked in light blue 1 AcXess Surgical Scissors Single-use surgical instruments Item no.: Characteristic Length SU* MI.22.111.130 sharp/sharp, straight 130 mm 20 pcs. MI.22.111.140 sharp/sharp, straight 140 mm 20 pcs. *: individual sterile packaging Item no.: Characteristic Length SU* MI.23.111.130 sharp/blunt, straight 130 mm 20 pcs. MI.23.111.140 sharp/blunt, straight 140 mm 20 pcs. *: individual sterile packaging Item no.: Characteristic Length SU* MI.24.111.130 blunt/blunt, straight 130 mm 20 pcs. MI.24.111.140 blunt/blunt, straight 140 mm 20 pcs. *: individual sterile packaging Item no.: Characteristic Length SU* MI.22.112.115 sharp/sharp, curved 115 mm 20 pcs. MI.22.112.130 sharp/sharp, curved 130 mm 20 pcs. MI.22.112.140 sharp/sharp, curved 140 mm 20 pcs.
  • Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices

    Keyword Index to Assist Manufacturers in Verifying the Class of Medical Devices

    Therapeutic Products Programme Programme des produits thérapeutiques OUR MISSION: To ensure that the drugs, medical devices, NOTRE MISSION: Faire en sorte que les médicaments, lesmatériels and other therapeutic products available in Canada are safe, médicaux et les autres produits thérapeutiques disponibles au Canada effective and of high quality. soient sûrs, efficaces et de haute qualité. Therapeutic Products Programme Keyword Index To Assist Manufacturers In Verifying The Class of Medical Devices For more information please contact: Don Boyer Licensing Services Division Medical Devices Bureau 1605 Statistics Canada Main Building, Postal Locator: 0301H1 Tunney’s Pasture, Ottawa, Ontario K1A 0L2 phone: (613) 957-7090 fax: (613) 954-7666 e-mail: [email protected] Therapeutic Products Programme Medical Device Keyword Index DRAFT Introduction The Medical Device Keyword Index was prepared to assist manufacturers in verifying the device class for products after application of the Classification Rules for Medical Devices of the Medical Devices Regulations. The Index should also be used in conjunction with the guidance document “Guidance For The Risk Based Classification System, GD006/RevDR-MDB.” Please note that this document is provided as a guide and that in the event of any discrepancy between this guide and the Classification Rules for Medical Devices of the Medical Devices Regulations, the latter shall prevail. What is a Keyword Index? The Medical Device Keyword Index is an alphabetical listing of all the words which appear in all the short descriptors for all the device groups that have been identified by the Medical Devices Bureau. It contains synonyms and industry words that are commonly used to describe the products in these device groups.
  • Biodegradable Surgical Staple Composed of Magnesium Alloy

    Biodegradable Surgical Staple Composed of Magnesium Alloy

    www.nature.com/scientificreports OPEN Biodegradable Surgical Staple Composed of Magnesium Alloy Hizuru Amano 1, Kotaro Hanada2, Akinari Hinoki3, Takahisa Tainaka3, Chiyoe Shirota3, Wataru Sumida3, Kazuki Yokota3, Naruhiko Murase3, Kazuo Oshima3, Kosuke Chiba3, 3 3 Received: 11 February 2019 Yujiro Tanaka & Hiroo Uchida Accepted: 25 September 2019 Currently, surgical staples are composed of non–biodegradable titanium (Ti) that can cause allergic Published: xx xx xxxx reactions and interfere with imaging. This paper proposes a novel biodegradable magnesium (Mg) alloy staple and discusses analyses conducted to evaluate its safety and feasibility. Specifcally, fnite element analysis revealed that the proposed staple has a suitable stress distribution while stapling and maintaining closure. Further, an immersion test using artifcial intestinal juice produced satisfactory biodegradable behavior, mechanical durability, and biocompatibility in vitro. Hydrogen resulting from rapid corrosion of Mg was observed in small quantities only in the frst week of immersion, and most staples maintained their shapes until at least the fourth week. Further, the tensile force was maintained for more than a week and was reduced to approximately one-half by the fourth week. In addition, the Mg concentration of the intestinal artifcial juice was at a low cytotoxic level. In porcine intestinal anastomoses, the Mg alloy staples caused neither technical failure nor such complications as anastomotic leakage, hematoma, or adhesion. No necrosis or serious infammation reaction was histopathologically recognized. Thus, the proposed Mg alloy staple ofers a promising alternative to Ti alloy staples. Intestinal anastomosis using staples is widely practiced in surgery nowadays1–4. Staples used for this procedure are primarily composed of non–biodegradable titanium (Ti) alloy.
  • Nurse/Surgical Assistant Quickguide for Baha® FAST Surgery

    Nurse/Surgical Assistant Quickguide for Baha® FAST Surgery

    Nurse/Surgical Assistant Quickguide for Baha® FAST Surgery sound sense for a better life Products in this manual are protected by the following patents: US 5 735 790, US 5 935 170, EP 0715839, EP 0715838 and corresponding patents in other countries and pending patent applications. All products can be subject to change without notice. No part of this publication may be replaced, stored in a retrieval system, or transmitted, in any form by means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher. Caution: Federal law (USA) restricts this device to sale by or on the order of a medical practitioner. ©Entific Medical Systems AB, 2005. All rights reserved. Nurse/Surgical Assistant Quickguide 3 Contents C o n t e n t s • Instruments for set-up 4 • Procedure step by step 6 • Preparation for surgery 8 • Sterilization guidelines 9 • Implantmed sterilization guidelines 11 • Check list 13 Nurse/Surgical Assistant Quickguide 3 Instruments for set-up Instruments for set-up Surgical instruments Pick’n Place instrument set for Baha® The instrument set for Baha® includes instruments for fixture/abutment connection. A complete list of the instruments included is described in detail below. 1. 1. Surgical organizer, titanium 2. Dissector 2. 3. Forceps, titanium 4. Cylinder wrench 3. 5. Screwdriver Unigrip 95 mm 6. Counter torque wrench 4. 7. Drill indicator 8. Connection to handpiece 5. 9. Fixture mount Unigrip (should be placed into titanium organizer) 10. Indicator for Baha 6. 11. Machine screwdriver Unigrip 25 mm 12. Hexagon screwdriver 20 mm 7. 13. Raspatorium 14.
  • Medical and Surgical Management, and Implications for the Practicing Gastroenterologist

    Medical and Surgical Management, and Implications for the Practicing Gastroenterologist

    UCSF UC San Francisco Previously Published Works Title Morbid obesity-the new pandemic: medical and surgical management, and implications for the practicing gastroenterologist. Permalink https://escholarship.org/uc/item/8pw8k8v6 Journal Clinical and translational gastroenterology, 4(6) ISSN 2155-384X Authors Cello, John P Rogers, Stanley J Publication Date 2013-06-06 DOI 10.1038/ctg.2013.6 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Citation: Clinical and Translational Gastroenterology (2013) 4, e35; doi:10.1038/ctg.2013.6 & 2013 the American College of Gastroenterology All rights reserved 2155-384X/13 www.nature.com/ctg CLINICAL/NARRATIVE REVIEW Morbid Obesity—The New Pandemic: Medical and Surgical Management, and Implications for the Practicing Gastroenterologist John P. Cello, MD1 and Stanley J. Rogers, MD1 The gastroenterologist, whether in academic or clinical practice, must face the reality that an increasingly large percentage of adult patients are morbidly obese. Morbid obesity is associated with significant morbidity and mortality including enhanced morbidity from cardiovascular, cerebrovascular, hepatobiliary and colonic diseases. Most of these associated diseases are actually preventable. Based on the 1991 NIH consensus conference criteria, for most patients with a body mass index (BMI ¼ weight in kilograms divided by the height in meters squared) of 40 or more, or for patients with a BMI of 35 or more and significant health complications, surgery may be the only reliable option. Currently in the United States, over 250,000 bariatric surgical procedures are being performed annually. The practicing gastroenterologist in every community, large and small, must be familiar with the various surgical procedures together with their associated anatomic changes.
  • (12) STANDARD PATENT No. AU 2010200618 B2 (19

    (12) STANDARD PATENT No. AU 2010200618 B2 (19

    (12) STANDARD PATENT (11) Application No. AU 2010200618 B2 (19) AAUSTRALIAN PATENT OFFICE (54) Title Circular Stapler Buttress Combination (51) International Patent Classification(s) A61B 17/00 (2006.01) A61B 17/072 (2006.01) A61B 17/115 (2006.01) A61B 17/11 (2006.01) (21) Application No: 2010200618 (22) Date of Filing: 2010.02.19 (43) Publication Date: 2010.03.11 (43) Publication Journal Date: 2010.03.11 (44) Accepted Journal Date: 2012.06.21 (62) Divisional of: 2003220427 (71) Applicant(s) Synovis Life Technologies, Inc. (72) Inventor(s) Mooradian, Daniel L.;Oray, Nicholas B.;Kluester, William F. (74) Agent / Attorney Wrays, Ground Floor 56 Ord Street, West Perth, WA, 6005 (56) Related Art US 6099551 US 5503638 39 2010 ABSTRACT A combination medical device comprising a circular stapler instrument and Feb one or more portions of preformed buttress material adapted to be stably positioned 19 upon the staple cartridge and/or anvil components of the stapler prior or at the time of 5 use. Positioned buttress material(s) are delivered to a tissue site where the circular stapler is actuated to connect previously severed tissue portions. An embodiment of the invention allows tissue portions to be joined without the use of sutures. The buttress material is made up of two regions, one of which serves primarily to secure the buttress material to the stapler prior to actuation, and one of which serves 2010200618 10 primarily to form the improved seal. The former region is severed and discarded upon activation of the circular stapler to form anastomoses, while the remaining material secures and seals the newly connected tissue.
  • (Title of the Thesis)*

    (Title of the Thesis)*

    DEVELOPMENT OF ELECTRONIC INSTRUMENTATION FOR COMPUTER-ASSISTED SURGERY by Kaci Carter A thesis submitted to the Department of Electrical and Computer Engineering In conformity with the requirements for the degree of Master of Applied Science Queen’s University Kingston, Ontario, Canada (August, 2015) Copyright ©Kaci Carter, 2015 Abstract In the operating room, feedback, such as instrument positioning guidance provided by surgical navigation systems is typically displayed on an external computer monitor. The surgeon’s attention is usually focused on the surgical tool and the surgical site, so the display is typically out of the direct line of sight. A simple visual feedback mechanism was developed to be mounted on the surgical tool. This feedback is within the surgeon’s direct line of sight and alerts the surgeon when it is necessary to look at the monitor for detailed navigation information. The combination of visual feedback with the surgical navigation system is designed to aid the surgeon in cutting around a tumor, maintaining negative margins, while reducing the amount of healthy tissue contained within the cut. The tool- mounted visual feedback device was designed to be light-weight, compatible with electromagnetic (EM) tracking, and pose no risk of galvanic connection to the patient. The device was tested through the resection of multiple tumor contour models using computer navigation screen only, and computer navigation screen with visual feedback mounted on the surgical tool. Use of the device was shown to decrease the amount of healthy tissue contained within the surgical cut, and to increase the subjects’ confidence in their ability to follow acceptable margins.