Moses, Michael C. (Boulder, CO, US)
Romero, Paul R. (Loveland, CO, US)
Johnson, Kristin D. (Louisville, CO, US)
Kerr, Duane E. (Berthoud, CO, US)
Dycus, Sean T. (Denver, CO, US)

Plaque It! Sponsored by: Flash of Genius

10/873860

08/07/2007

06/22/2004

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Sherwood Services AG (Schaffenhausen, CH)

606/51

606/1

A61B18/18

606/1, 606/50-52, 606/40-42

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0702472		June, 1902	Pignolet
0728883		May, 1903	Downes
1588645	High-pressure valve	June, 1926	Bierman
2002594	Instrument for electro-surgical treatment of tissue	May, 1935	Wappler et al.
2011169	Forcipated surgical electrode	August, 1935	Wappler
2031682	Method and means for electrosurgical severance of adhesions	February, 1936	Wappler et al.
2068721	Method for electrosurgical severance of adhesions	January, 1937	Wappler et al.
2176479	Apparatus for finding and removing metal particles from human and animal bodies	October, 1939	Willis
2305156	Box lock pivot and method of assembling same	December, 1942	Grubel
2315328	High silica glass article	March, 1943	Gmeiner
2632661	Joint for surgical instruments	March, 1953	Cristofv
2668538	Surgical clamping means	February, 1954	Baker
2676406	Paring knife	April, 1954	Hoke
2679249	Instrument for surgical operations	May, 1954	Weihmann
2796065	Surgical clamping means	June, 1957	Kapp
2853074	Stapling instrument for surgical purposes	September, 1958	Olson
3175556	Dissector-obstructor apparatus	March, 1965	Wood et al.
3443313	HEMOSTAT FOR CUTTING AND REMOVING SUTURES	May, 1969	Profy
3459187	SURGICAL INSTRUMENT AND METHOD OF MANUFACTURE	August, 1969	Pallotta
3643663	COAGULATING INSTRUMENT	February, 1972	Sutter
3651811	SURGICAL CUTTING INSTRUMENT	March, 1972	Hildebrandt et al.
3862630	ULTRASONIC SURGICAL METHODS	January, 1975	Balamuth
3866610	CARDIOVASCULAR CLAMPS	February, 1975	Kletschka
3911766	Box lock surgical instrument and method of its manufacture	October, 1975	Fridolph et al.
3920021	Coagulating devices	November, 1975	Hiltebrandt
3921641	Controlling forceps	November, 1975	Hulka
3938527	Instrument for laparoscopic tubal cauterization	February, 1976	Rioux et al.
3952749	Box lock surgical instrument	April, 1976	Fridolph et al.
4005714	Bipolar coagulation forceps	February, 1977	Hiltebrandt
4041952	Electrosurgical forceps	August, 1977	Morrison, Jr. et al.
4074718	Electrosurgical instrument	February, 1978	Morrison, Jr.
4088134	Forceps	May, 1978	Mazzariello
4128099	Single-pole coagulation forceps	December, 1978	Bauer
4165746	Plastic forceps	August, 1979	Burgin
4271838	Suture cutter	June, 1981	Lasner et al.
4300564	Forceps for extracting stones in the pelvis of a kidney	November, 1981	Furihata
4370980	Electrocautery hemostat	February, 1983	Lottick
4416276	Adaptive, return electrode monitoring system	November, 1983	Newton et al.
4452246	Surgical instrument	June, 1984	Bader et al.
4492231	Non-sticking electrocautery system and forceps	January, 1985	Auth
4552143	Removable switch electrocautery instruments	November, 1985	Lottick
4574804	Optic nerve clamp	March, 1986	Kurwa
4597379	Method of coagulating muscle tissue	July, 1986	Kihn et al.
4600007	Parametrium cutting forceps	July, 1986	Lahodny et al.
4655216	Combination instrument for laparoscopical tube sterilization	April, 1987	Tischer
4657016	Electrosurgical handpiece for blades, needles and forceps	April, 1987	Garito et al.
4662372	Disposable surgical instrument and method of forming	May, 1987	Sharkany et al.
4671274	Bipolar electrosurgical instrument	June, 1987	Sorochenko
4685459	Device for bipolar high-frequency coagulation of biological tissue	August, 1987	Xoch et al.
D295893	Disposable surgical clamp	May, 1988	Sharkany et al.
D295894	Disposable surgical scissors	May, 1988	Sharkany et al.
4763669	Surgical instrument with adjustable angle of operation	August, 1988	Jaeger
4827929	Angulated surgical instrument	May, 1989	Hodge
4887612	Endoscopic biopsy forceps	December, 1989	Esser et al.
4938214	Hand held surgical tool	July, 1990	Specht et al.
4938761	Bipolar electrosurgical forceps	July, 1990	Ensslin
4985030	Bipolar coagulation instrument	January, 1991	Melzer et al.
5007908	Electrosurgical instrument having needle cutting electrode and spot-coag electrode	April, 1991	Rydell
5026370	Electrocautery instrument	June, 1991	Lottick
5084057	Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures	January, 1992	Green et al.
5099840	Diathermy unit	March, 1992	Goble et al.
5116332	Electrocautery hemostat	May, 1992	Lottick
5147356	Surgical instrument	September, 1992	Bhatta
5147357	Medical instrument	September, 1992	Rose et al.
5151102	Blood vessel coagulation/stanching device	September, 1992	Xamiyama et al.
5176695	Surgical cutting means	January, 1993	Dulebohn
5176696	Handles for microsurgical instruments	January, 1993	Saunders
5190541	Surgical instrument and method	March, 1993	Abele et al.
5196009	Non-sticking electrosurgical device having nickel tips	March, 1993	Kirwan, Jr.
5196023	Surgical needle holder and cutter for an endo-suture, endo-ligature or the like	March, 1993	Martin
5197964	Bipolar instrument utilizing one stationary electrode and one movable electrode	March, 1993	Parins
5215101	Sharply angled kelly (Jacobs's) clamp	June, 1993	Jacobs et al.
5217457	Enhanced electrosurgical apparatus	June, 1993	Delahuerga et al.
5217458	Bipolar biopsy device utilizing a rotatable, single-hinged moving element	June, 1993	Parins
5217460	Multiple purpose forceps	June, 1993	Knoepfler
5219354	Dissecting-cum haemostapling scissors	June, 1993	Choudhury et al.
5244462	Electrosurgical apparatus	September, 1993	Delahuerga et al.
5250047	Bipolar laparoscopic instrument with replaceable electrode tip assembly	October, 1993	Rydell
5258006	Bipolar electrosurgical forceps	November, 1993	Rydell et al.
5261918	Sheathed surgical instrument and applicator kit	November, 1993	Phillips et al.
5275615	Medical instrument having gripping jaws	January, 1994	Rose
5277201	Endometrial ablation apparatus and method	January, 1994	Stern
5282799	Bipolar electrosurgical scalpel with paired loop electrodes	February, 1994	Rydell
5282817	Actuating handle for multipurpose surgical instrument	February, 1994	Hoogeboom et al.
5290286	Bipolar instrument utilizing one stationary electrode and one movable electrode	March, 1994	Parins
5290287	Endoscopic coagulation forceps	March, 1994	Boebel et al.
5304203	Tissue extracting forceps for laparoscopic surgery	April, 1994	El-Mallawany et al.
5308357	Handle mechanism for manual instruments	May, 1994	Lichtman
5318589	Surgical instrument for endoscopic surgery	June, 1994	Lichtman
5324289	Hemostatic bi-polar electrosurgical cutting apparatus and methods of use	June, 1994	Eggers
5330471	Bi-polar electrosurgical endoscopic instruments and methods of use	July, 1994	Eggers
5331971	Endoscopic surgical instruments	July, 1994	Bales et al.
5334183	Endoscopic electrosurgical apparatus	August, 1994	Wuchinich
5334215	Pincers having disposable end members	August, 1994	Chen
5336221	Method and apparatus for applying thermal energy to tissue using a clamp	August, 1994	Anderson
5342359	Bipolar coagulation device	August, 1994	Rydell
5342381	Combination bipolar scissors and forceps instrument	August, 1994	Tidemand
5342393	Method and device for vascular repair	August, 1994	Stack
5352222	Surgical scissors with bipolar coagulation feature	October, 1994	Rydell
5354271	Vascular sheath	October, 1994	Voda
5356408	Bipolar electrosurgical scissors having nonlinear blades	October, 1994	Rydell
5366477	Actuating forces transmission link and assembly for use in surgical instruments	November, 1994	LeMarie, III et al.
5368600	Steerable bulldog clamp applier	November, 1994	Failla et al.
5383897	Method and apparatus for closing blood vessel punctures	January, 1995	Wholey
5389098	Surgical device for stapling and/or fastening body tissues	February, 1995	Tsuruta et al.
5389104	Arthroscopic surgical instruments	February, 1995	Hahnen et al.
5391166	Bi-polar electrosurgical endoscopic instruments having a detachable working end	February, 1995	Eggers
5391183	Device and method sealing puncture wounds	February, 1995	Janzen et al.
5396900	Endoscopic end effectors constructed from a combination of conductive and non-conductive materials and useful for selective endoscopic cautery	March, 1995	Slater et al.
5403312	Electrosurgical hemostatic device	April, 1995	Yates et al.
5411519	Surgical apparatus having hinged jaw structure	May, 1995	Tovey et al.
5411520	Hemostatic vessel puncture closure system utilizing a plug located within the puncture tract spaced from the vessel, and method of use	May, 1995	Nash et al.
5413571	Device for sealing hemostatic incisions	May, 1995	Katsaros et al.
5415657	Percutaneous vascular sealing method	May, 1995	Taymor-Luria
5422567	High frequency power measurement	June, 1995	Matsunaga
5423810	Cauterising apparatus	June, 1995	Goble et al.
5423841	Intraocular knife	June, 1995	Kornefeld
5425739	Anastomosis stent and stent selection system	June, 1995	Jessen
5429616	Occludable catheter	July, 1995	Schaffer
5431674	Compound motion cutting device	July, 1995	Basile et al.
5437292	Method for sealing blood vessel puncture sites	August, 1995	Kipshidze et al.
5438302	Electrosurgical radiofrequency generator having regulated voltage across switching device	August, 1995	Goble
5441517	Hemostatic puncture closure system and method of use	August, 1995	Kensey et al.
5443463	Coagulating forceps	August, 1995	Stern et al.
5443464	External fixator apparatus	August, 1995	Russell et al.
5443480	Sharply angled kelly (Jacobs) clamp	August, 1995	Jacobs et al.
5445638	Bipolar coagulation and cutting forceps	August, 1995	Rydell et al.
5445658	Gasification apparatus for a finely divided combustible material	August, 1995	Durrfeld et al.
5451224	Apparatus for radio frequency bipolar electrosurgery	September, 1995	Goble et al.
5456684	Multifunctional minimally invasive surgical instrument	October, 1995	Schmidt et al.
5458598	Cutting and coagulating forceps	October, 1995	Feinberg et al.
5460629	Electrosurgical device and method	October, 1995	Shlain et al.
5462546	Bipolar electrosurgical forceps	October, 1995	Rydell
5472443	Electrosurgical apparatus employing constant voltage and methods of use	December, 1995	Cordis et al.
5478351	Endoscopic surgical tool with handle and detachable tool assembly	December, 1995	Meade et al.
5480409	Laparoscopic surgical instrument	January, 1996	Riza
5484436	Bi-polar electrosurgical instruments and methods of making	January, 1996	Eggers et al.
5496317	Laparoscopic surgical instrument	March, 1996	Goble et al.
5496347	Surgical instrument	March, 1996	Hashiguchi et al.
5499997	Endoscopic tenaculum surgical instrument	March, 1996	Sharpe et al.
5509922	Endoscopic surgical instrument	April, 1996	Aranyi et al.
5514134	Bipolar electrosurgical scissors	May, 1996	Rydell et al.
5527313	Bipolar surgical instruments	June, 1996	Scott et al.
5531744	Alternative current pathways for bipolar surgical cutting tool	July, 1996	Nardella et al.
5536251	Thoracoscopic devices and methods for arresting the heart	July, 1996	Evard et al.
5540684	Method and apparatus for electrosurgically treating tissue	July, 1996	Hassler, Jr.
5540685	Bipolar electrical scissors with metal cutting edges and shearing surfaces	July, 1996	Parins et al.
5540715	Device for sealing hemostatic incisions	July, 1996	Katsaros et al.
5542945	Electro-surgical radio-frequency instrument	August, 1996	Fritzsch
5554164	Curved knife for linear staplers	September, 1996	Wilson et al.
5558672	Thin layer ablation apparatus	September, 1996	Edwards et al.
5562694	Morcellator	October, 1996	Sauer et al.
5562699	Forceps	October, 1996	Heimberger et al.
5569241	Thin layer ablation apparatus	October, 1996	Edwardds
5569243	Double acting endoscopic scissors with bipolar cautery capability	October, 1996	Kortenbach et al.
5571100	Electrosurgical apparatus	November, 1996	Goble et al.
5573424	Apparatus for interfacing a bipolar electrosurgical instrument to a monopolar generator	November, 1996	Poppe
5573534	Bipolar electrosurgical instruments	November, 1996	Stone
5573535	Bipolar surgical instrument for coagulation and cutting	November, 1996	Viklund
5582611	Surgical device for stapling and/or fastening body tissues	December, 1996	Tsukagoshi et al.
5585896	Image forming apparatus with a contact member contacting an image carrier	December, 1996	Yamazaki et al.
5590570	Actuating forces transmission link and assembly for use in surgical instruments	January, 1997	LeMaire, III et al.
5601601	Hand held surgical device	February, 1997	Tal et al.
5603711	Endoscopic bipolar biopsy forceps	February, 1997	Parins et al.
5603723	Surgical instrument configured to be disassembled for cleaning	February, 1997	Aranyi et al.
5611798	Resistively heated cutting and coagulating surgical instrument	March, 1997	Eggers
5626578	RF valvulotome	May, 1997	Tihon
5626609	Endoscopic surgical instrument	May, 1997	Zvenyatsky et al.
5630833	Device for sealing hemostatic incisions	May, 1997	Katsaros et al.
5637110	Electrocautery surgical tool with relatively pivoted tissue engaging jaws	June, 1997	Pennybacker et al.
5643294	Surgical apparatus having an increased range of operability	July, 1997	Tovey et al.
5647869	Electrosurgical apparatus	July, 1997	Goble et al.
5647871	Electrosurgery with cooled electrodes	July, 1997	Levine et al.
5649959	Assembly for sealing a puncture in a vessel	July, 1997	Hannam et al.
5658281	Bipolar electrosurgical scissors and method of manufacture	August, 1997	Heard
5662667	Surgical clamping mechanism	September, 1997	Knodel
5665100	Multifunctional instrument with interchangeable operating units for performing endoscopic procedures	September, 1997	Yoon
5667526	Tissue retaining clamp	September, 1997	Levin
5674220	Bipolar electrosurgical clamping device	October, 1997	Fox et al.
5681282	Methods and apparatus for ablation of luminal tissues	October, 1997	Eggers et al.
5693051	Electrosurgical hemostatic device with adaptive electrodes	December, 1997	Schulze et al.
5695511	Surgical instruments for minimally invasive procedures	December, 1997	Cano et al.
5695522	Actuating forces transmission link and assembly for use in surgical instruments	December, 1997	LeMaire, III et al.
5700261	Bipolar Scissors	December, 1997	Brinkerhoff
5702390	Bioplar cutting and coagulation instrument	December, 1997	Austin et al.
5707369	Temperature feedback monitor for hemostatic surgical instrument	January, 1998	Vaitekunas et al.
5709680	Electrosurgical hemostatic device	January, 1998	Yates et al.
5716366	Hemostatic surgical cutting or stapling instrument	February, 1998	Yates
5720744	Control system for neurosurgery	February, 1998	Eggleston et al.
5727428	Actuating forces transmission link and assembly for use in surgical instruments	March, 1998	LeMaire, III et al.
5730750	Intraoral tissue trimming device	March, 1998	Haradon
5735848	Electrosurgical stapling device	April, 1998	Yates et al.
5743906	Endoscopic bipolar biopsy forceps	April, 1998	Parins et al.
5749893	Surgical instrument having an articulated jaw structure and a detachable knife	May, 1998	Vidal et al.
5755717	Electrosurgical clamping device with improved coagulation feedback	May, 1998	Yates et al.
5766130	Vascular testing method	June, 1998	Selmonosky
5766166	Bipolar Electrosurgical scissors	June, 1998	Hooven
5766170	Electrosurgical endoscopic instruments and methods of use	June, 1998	Eggers
5769849	Bi-polar electrosurgical endoscopic instruments	June, 1998	Eggers
5772655	Medical instrument with a tilting distal end	June, 1998	Bauer et al.
5772670	Forceps for the surgical introduction of catheters and the like	June, 1998	Brosa
5776128	Hemostatic bi-polar electrosurgical cutting apparatus	July, 1998	Eggers
5776130	Vascular tissue sealing pressure control	July, 1998	Buysse et al.
5779701	Bipolar endoscopic surgical scissor blades and instrument incorporating the same	July, 1998	McBrayer et al.
5792137	Coagulating microsystem	August, 1998	Carr et al.
5792177	Forceps	August, 1998	Kaseda
5797936	Microsurgical instrument	August, 1998	Kleihues
5797938	Self protecting knife for curved jaw surgical instruments	August, 1998	Paraschac et al.
5797958	Endoscopic grasping instrument with scissors	August, 1998	Yoon
5800449	Knife shield for surgical instruments	September, 1998	Wales
5807393	Surgical tissue treating device with locking mechanism	September, 1998	Williamson, IV et al.
5810808	Hemostatic bi-polar electrosurgical cutting apparatus and methods of use	September, 1998	Eggers
5810811	Electrosurgical hemostatic device	September, 1998	Yates et al.
5810877	Endoscopic microsurgical instruments and methods	September, 1998	Roth et al.
5814043	Bipolar electrosurgical device	September, 1998	Shapeton
5817093	Impedance feedback monitor with query electrode for electrosurgical instrument	October, 1998	Williamson, IV et al.
5820630	Medical forceps jaw assembly	October, 1998	Lind
5827271	Energy delivery system for vessel sealing	October, 1998	Buysse et al.
5827279	Knife coupler mechanism for an endoscopic instrument	October, 1998	Hughett et al.
5827281	Insulated surgical scissors	October, 1998	Levin
5833690	Electrosurgical device and method	November, 1998	Yates et al.
5843080	Bipolar instrument with multi-coated electrodes	December, 1998	Fleenor et al.
5849022	Medical instrument for use in combination with endoscopes	December, 1998	Sakashita et al.
5853412	Bipolar surgical grasping instrument	December, 1998	Mayenberger
5860976	Electrosurgical cutting device	January, 1999	Billings et al.
5876401	Electrosurgical hemostatic device with adaptive electrodes	March, 1999	Schulze et al.
5891141	Bipolar electrosurgical instrument for cutting and sealing tubular tissue structures	April, 1999	Rydell
5891142	Electrosurgical forceps	April, 1999	Eggers et al.
5893863	Surgical instrument with jaws and movable internal hook member for use thereof	April, 1999	Yoon
5893875	Surgical instrument with replaceable jaw assembly	April, 1999	O'Connor et al.
5893877	Surgical instrument with offset handle	April, 1999	Gampp, Jr. et al.
5902301	Cutting/coagulating forceps with interleaved electrodes	May, 1999	Olig
5906630	Eccentric surgical forceps	May, 1999	Anderhub et al.
5908420	Surgical scissors with bipolar distal electrodes	June, 1999	Parins et al.
5911719	Resistively heating cutting and coagulating surgical instrument	June, 1999	Eggers
5913874	Cartridge for a surgical instrument	June, 1999	Berns et al.
5921984	Bipolar electrosurgical instrument with coagulation feature	July, 1999	Sutcu et al.
5925043	Electrosurgical electrode with a conductive, non-stick coating	July, 1999	Kumar et al.
5935126	Surgical instrument with jaws having electrical contacts	August, 1999	Riza
5944718	Electrosurgical instrument end effector	August, 1999	Dafforn et al.
5951549	Bipolar electrosurgical scissors	September, 1999	Richardson et al.
5954720	Bipolar electrosurgical end effectors	September, 1999	Wilson et al.
5957923	Loop electrodes for electrocautery probes for use with a resectoscope	September, 1999	Hahnen et al.
5961514	Cordless electrosurgical instrument	October, 1999	Long et al.
5976132	Bipolar surgical shears	November, 1999	Morris
5984939	Multifunctional grasping instrument with cutting member and operating channel for use in endoscopic and non-endoscopic procedures	November, 1999	Yoon
5989277	Surgical instrument with offset jaw actuator	November, 1999	LeMaire, III et al.
6004335	Ultrasonic hemostatic and cutting instrument	December, 1999	Vaitekunas et al.
6010516	Bipolar coaptation clamps	January, 2000	Hulka
6024741	Surgical tissue treating device with locking mechanism	February, 2000	Williamson et al.	606/40
6024744	Combined bipolar scissor and grasper	February, 2000	Kese et al.
6033399	Electrosurgical generator with adaptive power control	March, 2000	Gines
6039733	Method of vascular tissue sealing pressure control	March, 2000	Buysse et al.
6041679	Endoscopic end effectors constructed from a combination of conductive and non-conductive materials and useful for selective endoscopic cautery	March, 2000	Slater et al.
6050996	Bipolar electrosurgical instrument with replaceable electrodes	April, 2000	Schmaltz et al.
6053914	Pivot screw for bipolar surgical instruments	April, 2000	Eggers et al.
6053933	Gripping unit for application in minimally invasive surgery	April, 2000	Balazs et al.
D424694	Forceps	May, 2000	Tetzlaff et al.
D425201	Disposable electrode assembly	May, 2000	Tetzlaff et al.
6059782	Bipolar high-frequency surgical instrument	May, 2000	Novak et al.
RE36795	Surgical scissors with bipolar coagulation feature	July, 2000	Rydell
6083223	Methods and apparatus for welding blood vessels	July, 2000	Baker
6086586	Bipolar tissue grasping apparatus and tissue welding method	July, 2000	Hooven
6090107	Resposable electrosurgical instrument	July, 2000	Borgmeier et al.
6096031	High repetition rate erbium:YAG laser for tissue ablation	August, 2000	Mitchell et al.
6096037	Tissue sealing electrosurgery device and methods of sealing tissue	August, 2000	Mulier et al.
6099550	Surgical instrument having jaws and an operating channel and method for use thereof	August, 2000	Yoon
6102909	Scissorlike electrosurgical cutting instrument	August, 2000	Chen et al.
6110171	Electrosurgical cutting and coagulating instrument for open surgery	August, 2000	Rydell
6113596	Combination monopolar-bipolar electrosurgical instrument system, instrument and cable	September, 2000	Hooven et al.
6113598	Radiofrequency medical instrument and methods for vessel welding	September, 2000	Baker
6117158	Ratchet release mechanism for hand held instruments	September, 2000	Measamer et al.
6123701	Methods and systems for organ resection	September, 2000	Nezhat
H001904	Electrosurgical hemostatic method and device	October, 2000	Yates et al.
6126658	Radiofrequency medical instrument and methods for vessel welding	October, 2000	Baker
6146399	Tissue cutting clamp apparatus	November, 2000	Lee
6152923	Multi-contact forceps and method of sealing, coagulating, cauterizing and/or cutting vessels and tissue	November, 2000	Ryan
6174309	Seal & cut electrosurgical instrument	January, 2001	Wrublewski et al.
6179834	Vascular tissue sealing pressure control and method	January, 2001	Buysse et al.
6179837	Bipolar electrosurgical scissors	January, 2001	Hooven
6183467	Package for removable device tips	February, 2001	Shapeton et al.
6187003	Bipolar electrosurgical instrument for sealing vessels	February, 2001	Buysse et al.
6190386	Electrosurgical forceps with needle electrodes	February, 2001	Rydell
6193718	Endoscopic electrocautery instrument	February, 2001	Kortenbach et al.
6206876	Electrosurgery with cooled electrodes	March, 2001	Levine et al.
6206877	Combined bipolar scissor and grasper and method of forming thereof	March, 2001	Kese et al.
6217602	Method of performing illuminated subcutaneous surgery	April, 2001	Redmon
6224593	Tissue sealing using microwaves	May, 2001	Ryan et al.
6228080	Electrosurgical generator with adaptive power control	May, 2001	Gines
6228083	Laparoscopic bipolar electrosurgical instrument	May, 2001	Lands et al.
6267761	Apparatus and method for sealing and cutting tissue	July, 2001	Ryan
6270497	High-frequency treatment apparatus having control mechanism for incising tissue after completion of coagulation by high-frequency treatment tool	August, 2001	Sekino et al.
6270508	End effector and instrument for endoscopic and general surgery needle control	August, 2001	Klieman et al.
6273887	High-frequency treatment tool	August, 2001	Yamauchi et al.
6277117	Open vessel sealing forceps with disposable electrodes	August, 2001	Tetzlaff et al.
6280458	Surgical grasping and holding forceps	August, 2001	Boche et al.
6283961	Apparatus for electrosurgical spine surgery	September, 2001	Underwood et al.
D449886	Forceps with disposable electrode	October, 2001	Tetzlaff et al.
6322561	Pivot screw for bipolar surgical instruments	November, 2001	Eggers et al.
6334860	Bipolar medical instrument	January, 2002	Dorn
6334861	Biopolar instrument for vessel sealing	January, 2002	Chandler et al.
6350264	Bipolar electrosurgical scissors	February, 2002	Hooven
6352536	Bipolar electrosurgical instrument for sealing vessels	March, 2002	Buysse et al.
6358268	Surgical instrument	March, 2002	Hunt et al.
D457958	Vessel sealer and divider	May, 2002	Dycus et al.
D457959	Vessel sealer	May, 2002	Tetzlaff et al.
6387094	Medical instrument for dissecting tissue	May, 2002	Eitenmuller
6398779	Vessel sealing system	June, 2002	Buysse et al.
6402747	Handswitch cord and circuit	June, 2002	Lindemann et al.
6409728	Rotatable bipolar forceps	June, 2002	Ehr et al.
H002037	Electrosurgical hemostatic device including an anvil	July, 2002	Yates et al.
6419675	Electrosurgical coagulating and cutting instrument	July, 2002	Gallo, Sr.
6425896	Endoscopically useable instrument for coagulation by means of high frequency and for the serving of coagulated tissue areas	July, 2002	Baltschun et al.
6443952	Tissue sealing electrosurgery device and methods of sealing tissue	September, 2002	Mulier et al.
6443970	Surgical instrument with a dissecting tip	September, 2002	Schulze et al.
6451018	Laparoscopic bipolar electrosurgical instrument	September, 2002	Lands et al.
6458128	Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element	October, 2002	Schulze
6458130	Endoscopic bipolar electrosurgical forceps	October, 2002	Frazier et al.
6464701	Bipolar electrosurgical scissors	October, 2002	Hooven et al.
6464704	Bipolar electrosurgical instrument with replaceable electrodes	October, 2002	Schmaltz et al.
6478794	Bipolar coagulation and cutting device for endoscopic surgery	November, 2002	Trapp et al.
6503248	Cooled, non-sticking electrosurgical devices	January, 2003	Levine
6506189	Cool-tip electrode thermosurgery system	January, 2003	Rittman, III et al.
6508815	Radio-frequency generator for powering an ablation device	January, 2003	Strul et al.
6511480	Open vessel sealing forceps with disposable electrodes	January, 2003	Tetzlaff et al.
6514251	Cooled-wet electrode	February, 2003	Ni et al.
6544264	Electrosurgery with cooled electrodes	April, 2003	Levine et al.
6569162	Passively self-cooled electrode design for ablation catheters	May, 2003	He
6585735	Endoscopic bipolar electrosurgical forceps	July, 2003	Frazier et al.
6620161	Electrosurgical instrument with an operational sequencing element	September, 2003	Schulze et al.
6652521	Surgical instrument with a bi-directional cutting element	November, 2003	Schulze
6656177	Electrosurgical systems and techniques for sealing tissue	December, 2003	Truckai et al.
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Peffley, Michael

Vrettakos, Pete

CROSS REFERENCE TO RELATED APPLICATION

The present application is a continuation-in-part of Ser. No. 10/991,157 filed on Nov. 17, 2004 and claims the benefit of priority to U.S. Provisional Application Ser. No. 60/523,387 (now U.S. Pat. No. 7,131,970) filed on Nov. 19, 2003 by Moses et al., the entire contents of which being incorporated by reference herein.

What is claimed is:

1. An open electrosurgical forceps for sealing tissue, comprising: a pair of first and second shaft members each having a jaw member disposed at a distal end thereof, the jaw members being movable from a first position in spaced relation relative to one another to at least one subsequent position wherein the jaw members cooperate to grasp tissue therebetween; each of the jaw members including an electrically conductive sealing plate for communicating electrosurgical energy through tissue held therebetween; at least one of the jaw members including a knife channel defined along a length thereof, the knife channel being dimensioned to reciprocate a cutting mechanism therealong; an actuator for selectively advancing the cutting mechanism from a first position wherein the cutting mechanism is disposed proximal to tissue held between the jaw members to at least one subsequent position wherein the cutting mechanism is disposed distal to tissue held between the jaw members, the actuator including a trigger which cooperates with a rack and pinion system to advance the cutting mechanism between its first and second positions; and wherein the rack and pinion system includes a first gear-like rack in mechanical cooperation with the trigger, a second gear-like rack in mechanical cooperation with the cutting mechanism, and a pinion rotatable about an axis disposed between the first and second gear-like racks.

2. An open electrosurgical forceps for sealing tissue according to claim 1 wherein the rack and pinion system is disposed within one of the first and second shaft members.

3. An open electrosurgical forceps for sealing tissue according to claim 1 wherein the trigger of the actuator is pulled proximally to actuate the rack and pinion system to distally advance the cutting mechanism through the cutting slot.

4. An open electrosurgical forceps for sealing tissue according to claim 1 wherein the trigger of the actuator is pulled proximally to proximally move the first rack and to distally advance the second rack.

5. An open electrosurgical forceps for sealing tissue according to claim 1 further comprising a safety lockout to prevent reciprocation of the cutting mechanism when the jaw members are disposed in the first position.

6. An open electrosurgical forceps for sealing tissue according to claim 5 wherein the safety lockout forms part of at least one of the jaw members.

7. An open electrosurgical forceps for sealing tissue according to claim 5 wherein the safety lockout forms part of the cutting mechanism.

8. An open electrosurgical forceps for sealing tissue according to claim 1 further comprising at least one spring for automatically biasing the cutting mechanism in the first position.

9. An open electrosurgical forceps for sealing tissue according to claim 8 wherein the at least one spring for automatically returning the cutting mechanism back to the first position is mechanically associated with the cutting mechanism.

10. An open electrosurgical forceps for sealing tissue according to claim 1 wherein the first rack is integrally associated with the trigger.

11. An open electrosurgical forceps for sealing tissue according to claim 1 wherein the second rack is integrally associated with the cutting mechanism.

12. An open electrosurgical forceps for sealing tissue according to claim 1, wherein the trigger is proximally and distally translatable along one of the first and second shaft members.

BACKGROUND

The present disclosure relates to forceps used for open surgical procedures. More particularly, the present disclosure relates to an open forceps which applies a combination of mechanical clamping pressure and electrosurgical energy to seal tissue and a knife which is selectively advanceable to sever tissue along the tissue seal.

TECHNICAL FIELD

A forceps is a plier-like instrument which relies on mechanical action between its jaws to grasp, clamp and constrict vessels or tissue. So-called “open forceps” are commonly used in open surgical procedures whereas “endoscopic forceps” or “laparoscopic forceps” are, as the name implies, used for less invasive endoscopic surgical procedures. Electrosurgical forceps (open or endoscopic) utilize both mechanical clamping action and electrical energy to effect hemostasis by heating tissue and blood vessels to coagulate and/or cauterize tissue.

Certain surgical procedures require more than simply cauterizing tissue and rely on the unique combination of clamping pressure, precise electrosurgical energy control and gap distance (i.e., distance between opposing jaw members when closed about tissue) to “seal” tissue, vessels and certain vascular bundles.

Vessel sealing or tissue sealing is a recently-developed technology which utilizes a unique combination of radiofrequency energy, pressure and gap control to effectively seal or fuse tissue between two opposing jaw members or sealing plates. Vessel or tissue sealing is more than “cauterization” which involves the use of heat to destroy tissue (also called “diathermy” or “electrodiathermy”). Vessel sealing is also more than “coagulation” which is the process of desiccating tissue wherein the tissue cells are ruptured and dried. “Vessel sealing” is defined as the process of liquefying the collagen, elastin and ground substances in the tissue so that the tissue reforms into a fused mass with significantly-reduced demarcation between the opposing tissue structures.

In order to effectively “seal” tissue or vessels, two predominant mechanical parameters must be accurately controlled: 1) the pressure or closure force applied to the vessel or tissue; and 2) the gap distance between the conductive tissue contacting surfaces (electrodes). As can be appreciated, both of these parameters are affected by the thickness of the tissue being sealed. Accurate application of pressure is important for several reasons: to reduce the tissue impedance to a low enough value that allows enough electrosurgical energy through the tissue; to overcome the forces of expansion during tissue heating; and to contribute to the end tissue thickness which is an indication of a good seal. It has been determined that a good seal for certain tissues is optimum between about 0.001 inches and about 0.006 inches.

With respect to smaller vessels or tissue, the pressure applied becomes less relevant and the gap distance between the electrically conductive surfaces becomes more significant for effective sealing. In other words, the chances of the two electrically conductive surfaces touching during activation increases as the tissue thickness and the vessels become smaller.

Commonly owned, U.S. Pat. No. 6,511,480, PCT Patent Application Nos. PCT/US01/11420 and PCT/US01/11218, U.S. patent applications Ser. Nos. 10/116,824, 10/284,562 and 10/299,650 all describe various open surgical forceps which seal tissue and vessels. All of these references are hereby incorporated by reference herein. In addition, several journal articles have disclosed methods for sealing small blood vessels using electrosurgery. An article entitled Studies on Coagulation and the Development of an Automatic Computerized Bipolar Coagulator , J. Neurosurg., Volume 75, July 1991, describes a bipolar coagulator which is used to seal small blood vessels. The article states that it is not possible to safely coagulate arteries with a diameter larger than 2 to 2.5 mm. A second article is entitled Automatically Controlled Bipolar Electrocoagulation—“COA - COMP ”, Neurosurg. Rev. (1984), pp. 187-190, describes a method for terminating electrosurgical power to the vessel so that charring of the vessel walls can be avoided.

Typically and particularly with respect to open electrosurgical procedures, once a vessel is sealed, the surgeon has to remove the sealing instrument from the operative site, substitute a new instrument and accurately sever the vessel along the newly formed tissue seal. As can be appreciated, this additional step may be both time consuming (particularly when sealing a significant number of vessels) and may contribute to imprecise separation of the tissue along the sealing line due to the misalignment or misplacement of the severing instrument along the center of the tissue sealing line.

Many endoscopic vessel sealing instruments have been designed which incorporate a knife or blade member which effectively severs the tissue after forming a tissue seal. For example, commonly-owned U.S. Application Ser. No. 10/116,944 (now U.S. Pat. No. 7,083,618) and Ser. No. 10/179,863 (now U.S. Pat. No. 7,101,371) describe one such endoscopic instrument which effectively seals and cuts tissue along the tissue seal. Other instruments include blade members or shearing members which simply cut tissue in a mechanical and/or electromechanical manner and are relatively ineffective for vessel sealing purposes.

There exists a need to develop an open electrosurgical forceps which is simple, reliable and inexpensive to manufacture and which effectively seals tissue and vessels and which allows a surgeon to utilize the same instrument to effectively sever the tissue along the newly formed tissue seal.

SUMMARY

The present disclosure relates to an open electrosurgical forceps for sealing tissue and includes a pair of first and second shaft members each having a jaw member disposed at a distal end thereof. The jaw members are movable from a first position in spaced relation relative to one another to at least one subsequent position wherein the jaw members cooperate to grasp tissue therebetween. Each of the jaw members includes an electrically conductive sealing plate or sealing surface on an inner facing surface which communicates electrosurgical energy through tissue held therebetween. Preferably, one of the jaw members includes a knife slot or knife channel defined along a longitudinal length thereof which is dimensioned to reciprocate a cutting mechanism therealong to sever tissue held between the jaw members. An actuator is included for selectively advancing the cutting mechanism from a first position wherein the cutting mechanism is disposed proximal to tissue held between the jaw members to at least one subsequent position wherein the cutting mechanism is disposed distal to tissue held between the jaw members.

Preferably, the actuator includes a trigger which cooperates with a rack and pinion system to advance the cutting mechanism from the first to second positions through tissue held therebetween. The rack and pinion system includes a first gear-like rack associated with the trigger; a second gear-like rack associated with the cutting mechanism; and a pinion disposed between the first and second racks. Preferably, the trigger of the actuator may be moved proximally, distally or laterally to distally advance the cutting mechanism through the knife channel. Advantageously, the rack and pinion system is disposed within one of the first and second shaft members.

In one embodiment, the forceps includes a safety mechanism or safety lockout to prevent reciprocation of the cutting mechanism when the jaw members are disposed in the first position. The safety lockout may form part of one or both of the jaw members and/or may be integrally associated with the cutting mechanism.

In another embodiment, the forceps includes one or more springs which automatically bias the cutting mechanism in the first position such that after the cutting mechanism severs the tissue held between the jaw members, the cutting mechanism automatically returns to the first position. Preferably, the cutting mechanism includes at least one spring for automatically returning the cutting mechanism back to the first position.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the subject instrument are described herein with reference to the drawings wherein:

FIG. 1 is a left, perspective view of an open forceps with a cutting mechanism according to the present disclosure;

FIG. 2 is a left, side view of the forceps of FIG. 1;

FIG. 3 is an internal, perspective view of the forceps of FIG. 1 showing a rack and pinion actuating mechanism for advancing the cutting mechanism and a series of internally disposed electrical connections for energizing the forceps;

FIG. 4 is an internal, side view of the forceps showing the rack and pinion actuating mechanism and the internally disposed electrical connections;

FIG. 5 is an enlarged, perspective view showing the area of detail in FIG. 3;

FIG. 6 is an enlarged, perspective view showing the area of detail in FIG. 3;

FIG. 7 is a perspective view of the forceps of FIG. 1 with parts separated;

FIG. 8 is a perspective view of one shaft of the forceps of FIG. 1;

FIG. 9 is an enlarged, perspective view showing the area of detail in FIG. 8;

FIG. 10 is an enlarged, perspective view of the cutting mechanism;

FIG. 11 is a side cross section along lines 11 - 11 of FIG. 10;

FIG. 12 is an enlarged, perspective view of the area of detail in FIG. 10;

FIG. 13 is a greatly-enlarged perspective view of a distal electrical connector of the forceps of FIG. 1;

FIG. 14 is an enlarged, left perspective view of the one of the jaw members of the forceps of FIG. 1;

FIG. 15 is an enlarged, right perspective view of the jaw member of FIG. 14;

FIG. 16 is side cross sectional view showing the forceps in open configuration for grasping tissue;

FIG. 17 is a side cross sectional view showing the area of detail in FIG. 16;

FIG. 18 is a rear, perspective view of the forceps of FIG. 1 shown grasping tissue with a ratchet mechanism shown prior to engagement;

FIG. 19 is a rear view of the forceps of FIG. 1 showing the ratchet mechanism engaged;

FIG. 20 is a greatly-enlarged, side cross sectional view showing the forceps in a closed position and defining a gap distance “G” between opposing jaw members;

FIG. 21 is a greatly-enlarged, perspective view of a tissue seal;

FIG. 22 is a side cross sectional view taken along line 22 - 22 of FIG. 21;

FIG. 23 is a side cross sectional view showing the forceps in a closed position and showing the activation and advancement of the cutting mechanism;

FIG. 24 is an enlarged view of the area of detail in FIG. 24; and

FIG. 25 is a greatly-enlarged, cross sectional view showing tissue separated along the tissue seal after advancement of the cutting mechanism.

DETAILED DESCRIPTION

Referring now to FIGS. 1-7, a forceps 10 for use with open surgical procedures includes elongated shaft portions 12 a and 12 b each having a proximal end 14 a , 14 b and a distal end 16 a and 16 b , respectively. In the drawings and in the descriptions which follow, the term “proximal”, as is traditional, will refer to the end of the forceps 10 which is closer to the user, while the term “distal” will refer to the end which is further from the user.

The forceps 10 includes an end effector assembly 100 which attaches to the distal ends 16 a and 16 b of shafts 12 a and 12 b , respectively. As explained in more detail below, the end effector assembly 100 includes pair of opposing jaw members 110 and 120 which are pivotably connected about a pivot pin 65 and which are movable relative to one another to grasp tissue.

Preferably, each shaft 12 a and 12 b includes a handle 15 and 17 , respectively, disposed at the proximal end 14 a and 14 b thereof which each define a finger hole 15 a and 17 a , respectively, therethrough for receiving a finger of the user. As can be appreciated, finger holes 15 a and 17 a facilitate movement of the shafts 12 a and 12 b relative to one another which, in turn, pivot the jaw members 110 and 120 from an open position wherein the jaw members 110 and 120 are disposed in spaced relation relative to one another to a clamping or closed position wherein the jaw members 110 and 120 cooperate to grasp tissue therebetween.

As best seen in FIG. 7, shaft 12 b is constructed from two components, namely, 12 b 1 and 12 b 2 , which matingly engage one another about the distal end 16 a of shaft 12 a to form shaft 12 b . It is envisioned that the two component halves 12 b 1 and 12 b 2 may be ultrasonically-welded together at a plurality of different weld points or the component halves 12 b 1 and 12 b 2 may be mechanically engaged in any other known fashion, snap-fit, glued, screwed, etc. After component halves 12 b 1 and 12 b 2 are welded together to form shaft 12 b , shaft 12 a is secured about pivot 65 and positioned within a cut-out or relief 21 defined within shaft portion 12 b 2 such that shaft 12 a is movable relative to shaft 12 b . More particularly, when the user moves the shaft 12 a relative to shaft 12 b to close or open the jaw members 110 and 120 , the distal portion of shaft 12 a moves within cutout 21 formed within portion 12 b 2 . It is envisioned that configuring the two shafts 12 a and 12 b in the fashion facilitates gripping and reduces the overall size of the forceps 10 which is especially advantageous during surgeries in small cavities.

As best illustrated in FIG. 1, one of the shafts, e.g., 12 b , includes a proximal shaft connector 77 which is designed to connect the forceps 10 to a source of electrosurgical energy such as an electrosurgical generator (not shown). The proximal shaft connector 77 electromechanically engages an electrosurgical cable 70 such that the user may selectively apply electrosurgical energy as needed. Alternatively, the cable 70 may be feed directly into shaft 12 b.

As explained in more detail below, the distal end of the cable 70 connects to a handswitch 50 to permit the user to selectively apply electrosurgical energy as needed to seal tissue grasped between jaw members 110 and 120 . More particularly, the interior of cable 70 houses leads 71 a , 71 b and 71 c which upon activation of the handswitch 50 conduct the different electrical potentials from the electrosurgical generator to the jaw members 110 and 120 (See FIGS. 3 and 4). As can be appreciated, positioning the switch 50 on the forceps 10 gives the user more visual and tactile control over the application of electrosurgical energy. These aspects are explained below with respect to the discussion of the handswitch 50 and the electrical connections associated therewith.

The two opposing jaw members 110 and 120 of the end effector assembly 100 are pivotable about pin 65 from the open position to the closed position for grasping tissue therebetween. Preferably, pivot pin 65 consists of two component halves 65 a and 65 b which matingly engage and pivotably secure the shafts 12 a and 12 b during assembly such that the jaw members 110 and 120 are freely pivotable between the open and closed positions. For example, the pivot pin 65 may be configured to be spring loaded such that the pivot snap fits together at assembly to secure the two shafts 12 a and 12 b for rotation about the pivot pin 65 .

The tissue grasping portions of the jaw members 110 and 120 are generally symmetrical and include similar component features which cooperate to permit facile rotation about pivot pin 65 to effect the grasping and sealing of tissue. As a result and unless otherwise noted, jaw member 110 and the operative features associated therewith are initially described herein in detail and the similar component features with respect to jaw member 120 will be briefly summarized thereafter.

Moreover, many of the features of the jaw members 110 and 120 are described in detail in commonly-owned U.S. Patent Application Ser. Nos. 10/284,562, 10/116,824, 09/425,696 (now U.S. Pat. No. 6,511,480), 09/178,027 (now U.S. Pat. No. 6,277,117) and PCT Application Ser. No. PCT/US01/11420 the contents of which are all hereby incorporated by reference in their entirety herein.

As best shown in FIGS. 14 and 15, jaw member 110 includes an insulated outer housing 116 which is dimensioned to mechanically engage an electrically conductive sealing surface 112 . The outer insulative housing 116 extends along the entire length of jaw member 110 to reduce alternate or stray current paths during sealing and/or incidental burning of tissue. The electrically conductive surface 112 conducts electrosurgical energy of a first potential to the tissue upon activation of the handswitch 50 . Insulated outer housing 116 is dimensioned to securely engage the electrically conductive sealing surface 112 . It is envisioned that this may be accomplished by stamping, by overmolding, by overmolding a stamped electrically conductive sealing plate and/or by overmolding a metal injection molded seal plate. Other methods of affixing the seal surface 112 to the outer housing 116 are described in detail in one or more of the above-identified references. Preferably, the jaw members 110 and 120 are made form a conductive material and powder coated with an insulative coating to reduce stray current concentrations during sealing.

It is also contemplated that the electrically conductive sealing surface 112 may include an outer peripheral edge which has a radius and the insulated outer housing 116 meets the electrically conductive sealing surface 112 along an adjoining edge which is generally tangential to the radius and/or meets along the radius. Preferably, at the interface, the electrically conductive surface 112 is raised relative to the insulated outer housing 116 . Alternatively, the jaw member 110 including the sealing plate 112 and the outer insulative housing 116 may be formed as part of a molding process to facilitate manufacturing and assembly. These and other envisioned embodiments are discussed in commonly-owned, co-pending PCT application Ser. No. PCT/US01/11412 and commonly owned, co-pending PCT application Ser. No. PCT/US01/11411, the contents of both of these applications being incorporated by reference herein in their entirety.

Preferably, the insulated outer housing 116 and the electrically conductive sealing surface 112 are dimensioned to limit and/or reduce many of the known undesirable effects related to tissue sealing, e.g., flashover, thermal spread and stray current dissipation. All of the aforementioned and cross referenced manufacturing techniques produce an electrode having an electrically conductive surface 112 which is substantially surrounded by an insulated outer housing 116 .

Likewise, jaw member 120 includes similar elements which include: an outer housing 126 which engages an electrically conductive sealing