WO2001012089A1 - Nerve stimulation and tissue ablation apparatus and method - Google Patents

Nerve stimulation and tissue ablation apparatus and method Download PDF

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Publication number
WO2001012089A1
WO2001012089A1 PCT/US2000/040640 US0040640W WO0112089A1 WO 2001012089 A1 WO2001012089 A1 WO 2001012089A1 US 0040640 W US0040640 W US 0040640W WO 0112089 A1 WO0112089 A1 WO 0112089A1
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WO
WIPO (PCT)
Prior art keywords
needle electrode
low frequency
energy
nerve
high frequency
Prior art date
Application number
PCT/US2000/040640
Other languages
French (fr)
Inventor
Robin B. Bek
Original Assignee
Somnus Medical Technologies, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Somnus Medical Technologies, Inc. filed Critical Somnus Medical Technologies, Inc.
Priority to AU78806/00A priority Critical patent/AU7880600A/en
Publication of WO2001012089A1 publication Critical patent/WO2001012089A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/328—Applying electric currents by contact electrodes alternating or intermittent currents for improving the appearance of the skin, e.g. facial toning or wrinkle treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36031—Control systems using physiological parameters for adjustment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/36014—External stimulators, e.g. with patch electrodes
    • A61N1/3603—Control systems
    • A61N1/36034—Control systems specified by the stimulation parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00434—Neural system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature
    • A61B2018/00821—Temperature measured by a thermocouple
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A61B2018/1273—Generators therefor including multiple generators in one device

Definitions

  • This invention relates to an apparatus and method for nerve stimulation and tissue ablation whereby both diagnostic and treatment modalities are achievable.
  • Low frequency nerve stimulators previously have been employed to diagnose and evaluate alterations in and abnormalities of the neuromuscular system and/or to precisely locate nerves when operating in the proximity thereof.
  • nerve stimulation is used peri- operatively in order to evaluate and monitor the response to neuromuscular relaxant and other drugs administered during and after surgical procedures.
  • tissue ablation employs the application of higher frequency energy, often radio-frequency energy, in order to treat neurological and neuromuscular disorders and other anatomical abnormalities or variations by ablating dysfunctional neural or muscle tissue or other redundant or dysfunctional tissue.
  • the evaluation and successful treatment of certain disorders warrants the use of both diagnostic nerve stimulation and therapeutic tissue ablation at the same location, and during the same procedure, within the body.
  • a device capable of both nerve stimulation and tissue ablation in the human body for diagnosis and treatment of neurological, neuromuscular and other disorders.
  • Another object of the invention is to provide an apparatus and method of the above character which makes possible the sequential and/or simultaneous application of low frequency energy for nerve stimulation and high frequency energy to ablate tissue.
  • Another object of the invention is to provide an apparatus and method of the above character which are inexpensive, safe and reliable.
  • Figure 1 is a block diagram of a nerve stimulation and ablation device incorporating the present invention.
  • the nerve stimulation and tissue ablation apparatus in the body of a patient having nerves and tissue therein comprises a low frequency generator and a high frequency generator.
  • An energy conducting needle electrode is provided for contacting the body.
  • Means is provided for coupling the energy conducting electrode to the low frequency generator and high frequency generator sequentially or simultaneously to permit location and treatment with the same apparatus.
  • the apparatus 21 of the present invention consists of a first low high frequency generator 23 and a second or high frequency generator 24.
  • the first or low frequency generator 23 provides a low frequency controlled constant current of a frequency ranging 2-50 Hz and, preferably, between 8-12 Hz.
  • the controlled constant current is a very low current in the microamp to milliamp range as for example from 100 microamperes to 50 milliamperes with a voltage ranging from 100 to 200 volts.
  • the generator 23 is powered by a battery supply (not shown) and is capable of supplying a controlled constant current into body impedances ranging from 20 to 40,000 ohms.
  • the second or high frequency generator 24 provides high frequency energy having a frequency greater than 100 Hz and preferably approximately 460 Hz at a power up to 15 watts into an impedance ranging from 10 to 500 ohms.
  • the generator 24 is powered from a plug 26 adapted to be connected to a conventional source of operating power as for example 100- 240 volts AC at 50-60 Hz.
  • the apparatus 21 consists of a needle electrode 31 formed of a suitable conducting material such as stainless steel which is adapted to be placed in contact with tissue as for example the forehead 36 of a head 37 of a human being 38 as shown in Figure 1.
  • a needle electrode 31 formed of a suitable conducting material such as stainless steel which is adapted to be placed in contact with tissue as for example the forehead 36 of a head 37 of a human being 38 as shown in Figure 1.
  • the needle electrode 31 is mounted in a handle 41 formed of a suitable material such as plastic and is sized to be grasped by the fingers of a human hand as for example the thumb and forefinger.
  • the handle 31 is connected to a flexible cable 42 which carries conductors 43 and 44 with conductor 43 being connected to the needle electrode and conductor 44 being connected to a thermocouple 46 provided at the distal extremity of the needle electrode.
  • Conductor 44 as shown in the drawing is connected to the high frequency generator 24 and serves to ensure that temperature increase being created at the distal extremity of the needle electrode does not exceed a temperature greater than 80°C since the ablation only requires a temperature above 50°C.
  • the apparatus 21 also includes a return electrode 51 for bipolar operation which is adapted to placed on a suitable location on the body of the patient 39 as for example on the back side of the patient in a convenient location as for example near the neck which is as close as convenient to the site at which the treatment of the present invention is to be performed.
  • Means is provided for connecting the energy conducting needle electrode 31 to the low frequency generator 23 and the high frequency generator 24 to permit the delivery of a controlled constant current from the low frequency generator 23 and high frequency energy from the high frequency generator 24 sequentially or simultaneously to permit location and treatment with the same apparatus.
  • This means includes a return conductor 52 which is connected to the return electrode 51 and which is connected to the high frequency generator 24 as shown.
  • This return electrode 51 is also connected through a resistor 56 and an inductor 57 to the low frequency power supply 23. The inductor 57 prevents high frequency energy from entering the low frequency generator 23.
  • the low frequency output from the low frequency generator 23 is supplied by a conductor 61 to one end of a switch 62 and the other end of the switch is connected by a conductor 63 to the conductor 43 in the cable 42.
  • the switch 62 can be a switch provided on the case (not shown) containing the generators 23 and 24 and operated by the physician performing the procedure.
  • the switch could be provided in the handle 41 so that it can be opened and closed merely by pressing one of the fingers of the hand holding the handle 41.
  • the output from the high frequency generator 24 is supplied by a conductor 66 to one side of a switch 67 and the other side of the switch 67 is connected by a conductor 68 to one side of a coupling capacitor 71 which will pass the high frequency but not the low frequency from the low frequency power supply 23.
  • the other side of the coupling capacitor 71 is connected by a conductor 72 to the conductor 43.
  • the switch 67 also can be operated in various manners. For example it can be manually controlled by hand. However, this is not as desirable because the physician's hand may be holding the handle 41. For this reason, a foot-asperated pedal 76 has been provided which can be operated by the foot of the physician whose hand is holding the handle 41.
  • the forehead area 36 including the nasal and superciliary areas, are prepared.
  • the apparatus 21 can be turned on.
  • the physician grasps the handle 41 with the fingers of one hand and inserts the needle electrode 31 through the skin and into the vicinity of the nerve or nerves sought to be stimulated, as for example terminal branches of the temporal and zygomatic branches of the facial nerve.
  • the physician closes switch 62 to supply low frequency energy to the tip of the needle electrode 31.
  • the needle electrode 31 When the needle electrode 31 is positioned in close proximity to the specific branches of the temporal and zygomatic branches of the facial nerve, the surrounding orbicularis oculi, procerus and frontalis muscle tissue will begin to twitch and will continue twitching, aggressively furrowing the brow which is visible to the physician. This will indicate to the physician that he or she has located the desired nerve .
  • the physician thereafter actuates the foot pedal 76 to close switch 67 to supply high frequency energy to the needle electrode 31.
  • low frequency energy is concomitantly being supplied to the needle electrode 31, within a short period of time after ablation of the nerve being treated, muscle twitching should disappear and the furrowed brow should relax and forehead wrinkles will disappear.
  • opening switches 62 and 67 it may be assumed that the nerve in question has been successfully ablated and the application of the low frequency energy and the high frequency energy can be terminated by opening switches 62 and 67.
  • the physician can open the switch 62 and thereafter operate the foot pedal 76 to close the switch 67.
  • the physician can thereafter supply radio frequency energy to the needle electrode at a desired power for a desired amount of time which he believes applicable for the application being treated.
  • the physician can operate the foot pedal 76 to open the switch 67.
  • the physician can again close the switch 62 to see whether or not with the application of low frequency energy twitching reappears. If not, it can be assumed that the treatment has been successful. If it does, the physician can again terminate the application of low frequency energy by opening the switch 62 and thereafter close the switch 67 to again apply high frequency energy to cause further ablation for a desired period of time at a desired power level.
  • the physician can terminate the application of radio frequency energy to the needle electrode 31 by opening the switch 67.
  • the physician again tests the nerve to see whether or not it has been sufficiently ablated by determining whether or not twitching reoccurs. This procedure can be followed until the twitching and furrowing of the brow have ceased upon the application of low frequency energy.
  • the thermocouple senses the temperature during ablation and ensures that excessive temperatures will not be reached as for example greater than 80°C to thereby permit unwanted destruction of tissue during the ablation procedure. If such temperature is reached, the thermocouple will supply information to the radio frequency generator to shut down the radio frequency generator.

Abstract

Apparatus for nerve stimulation and tissue ablation in a patient. A low frequency generator (23) and a high frequency generator (24) are provided. A needle electrode (41) is provided which is adapted to engage the body of the patient. Circuitry couples the needle electrode to the low and high frequency generators sequentially or simultaneously whereby treatment of the patient can be accomplished with the same apparatus.

Description

NERVE STIMULATION AND TISSUE ABLATION APPARATUS AND METHOD
This invention relates to an apparatus and method for nerve stimulation and tissue ablation whereby both diagnostic and treatment modalities are achievable.
Low frequency nerve stimulators previously have been employed to diagnose and evaluate alterations in and abnormalities of the neuromuscular system and/or to precisely locate nerves when operating in the proximity thereof. In addition, nerve stimulation is used peri- operatively in order to evaluate and monitor the response to neuromuscular relaxant and other drugs administered during and after surgical procedures. On the other hand, tissue ablation employs the application of higher frequency energy, often radio-frequency energy, in order to treat neurological and neuromuscular disorders and other anatomical abnormalities or variations by ablating dysfunctional neural or muscle tissue or other redundant or dysfunctional tissue. The evaluation and successful treatment of certain disorders warrants the use of both diagnostic nerve stimulation and therapeutic tissue ablation at the same location, and during the same procedure, within the body. Various approaches for accomplishing this have heretofore been utilized, however, they all have had deficiencies, including the requirement of multiple devices and methods. There is therefore a need for a device capable of both nerve stimulation and tissue ablation in the human body and a method which overcome the deficiencies of prior art devices and methods. In general, it is an object of the present invention to provide a single apparatus and method capable of both nerve stimulation and tissue ablation in the human body for diagnosis and treatment of neurological, neuromuscular and other disorders. Another object of the invention is to provide an apparatus and method of the above character which makes possible the sequential and/or simultaneous application of low frequency energy for nerve stimulation and high frequency energy to ablate tissue. Another object of the invention is to provide an apparatus and method of the above character which are inexpensive, safe and reliable.
Additional objects and features of the invention will appear from the following description in which the preferred embodiment is described in conjunction with the accompanying drawings .
Figure 1 is a block diagram of a nerve stimulation and ablation device incorporating the present invention.
In general, the nerve stimulation and tissue ablation apparatus in the body of a patient having nerves and tissue therein comprises a low frequency generator and a high frequency generator. An energy conducting needle electrode is provided for contacting the body. Means is provided for coupling the energy conducting electrode to the low frequency generator and high frequency generator sequentially or simultaneously to permit location and treatment with the same apparatus.
More specifically, as shown in the drawing, the apparatus 21 of the present invention consists of a first low high frequency generator 23 and a second or high frequency generator 24. The first or low frequency generator 23 provides a low frequency controlled constant current of a frequency ranging 2-50 Hz and, preferably, between 8-12 Hz. The controlled constant current is a very low current in the microamp to milliamp range as for example from 100 microamperes to 50 milliamperes with a voltage ranging from 100 to 200 volts. The generator 23 is powered by a battery supply (not shown) and is capable of supplying a controlled constant current into body impedances ranging from 20 to 40,000 ohms. The second or high frequency generator 24 provides high frequency energy having a frequency greater than 100 Hz and preferably approximately 460 Hz at a power up to 15 watts into an impedance ranging from 10 to 500 ohms. The generator 24 is powered from a plug 26 adapted to be connected to a conventional source of operating power as for example 100- 240 volts AC at 50-60 Hz.
The apparatus 21 consists of a needle electrode 31 formed of a suitable conducting material such as stainless steel which is adapted to be placed in contact with tissue as for example the forehead 36 of a head 37 of a human being 38 as shown in Figure 1.
The needle electrode 31 is mounted in a handle 41 formed of a suitable material such as plastic and is sized to be grasped by the fingers of a human hand as for example the thumb and forefinger. The handle 31 is connected to a flexible cable 42 which carries conductors 43 and 44 with conductor 43 being connected to the needle electrode and conductor 44 being connected to a thermocouple 46 provided at the distal extremity of the needle electrode. Conductor 44 as shown in the drawing is connected to the high frequency generator 24 and serves to ensure that temperature increase being created at the distal extremity of the needle electrode does not exceed a temperature greater than 80°C since the ablation only requires a temperature above 50°C.
The apparatus 21 also includes a return electrode 51 for bipolar operation which is adapted to placed on a suitable location on the body of the patient 39 as for example on the back side of the patient in a convenient location as for example near the neck which is as close as convenient to the site at which the treatment of the present invention is to be performed.
Means is provided for connecting the energy conducting needle electrode 31 to the low frequency generator 23 and the high frequency generator 24 to permit the delivery of a controlled constant current from the low frequency generator 23 and high frequency energy from the high frequency generator 24 sequentially or simultaneously to permit location and treatment with the same apparatus. This means includes a return conductor 52 which is connected to the return electrode 51 and which is connected to the high frequency generator 24 as shown. This return electrode 51 is also connected through a resistor 56 and an inductor 57 to the low frequency power supply 23. The inductor 57 prevents high frequency energy from entering the low frequency generator 23. The low frequency output from the low frequency generator 23 is supplied by a conductor 61 to one end of a switch 62 and the other end of the switch is connected by a conductor 63 to the conductor 43 in the cable 42. The switch 62 can be a switch provided on the case (not shown) containing the generators 23 and 24 and operated by the physician performing the procedure. Alternatively, the switch could be provided in the handle 41 so that it can be opened and closed merely by pressing one of the fingers of the hand holding the handle 41. The output from the high frequency generator 24 is supplied by a conductor 66 to one side of a switch 67 and the other side of the switch 67 is connected by a conductor 68 to one side of a coupling capacitor 71 which will pass the high frequency but not the low frequency from the low frequency power supply 23. The other side of the coupling capacitor 71 is connected by a conductor 72 to the conductor 43. The switch 67 also can be operated in various manners. For example it can be manually controlled by hand. However, this is not as desirable because the physician's hand may be holding the handle 41. For this reason, a foot-asperated pedal 76 has been provided which can be operated by the foot of the physician whose hand is holding the handle 41. Operation and use of the apparatus 21 in performing the method of the present invention to effect nerve stimulation and tissue ablation may now be briefly described as follows. Let it be assumed that a patient has a condition or malady requiring diagnostic nerve stimulation and therapeutic ablation of the nerve sought to be stimulated and the tissue innervated by the nerve and that the procedure is to be performed percutaneously. For example, let it be assumed that the patient has developed a chronically furrowed brow with unsightly or otherwise problematic chronic forehead wrinkles. After appropriate placement of the grounding or return electrode 51 on the patient 39 as hereinbefore described and sedation and/or local or general anesthesia, the portion of the patient's body containing the nerve to be stimulated and the tissue to be ablated is sterilely cleansed and prepared using standard techniques. In treating a furrowed brow, the forehead area 36, including the nasal and superciliary areas, are prepared. After preparation of the patient 39 has been completed, the apparatus 21 can be turned on. The physician grasps the handle 41 with the fingers of one hand and inserts the needle electrode 31 through the skin and into the vicinity of the nerve or nerves sought to be stimulated, as for example terminal branches of the temporal and zygomatic branches of the facial nerve. When the needle electrode 41 has been appropriately placed, the physician closes switch 62 to supply low frequency energy to the tip of the needle electrode 31. When the needle electrode 31 is positioned in close proximity to the specific branches of the temporal and zygomatic branches of the facial nerve, the surrounding orbicularis oculi, procerus and frontalis muscle tissue will begin to twitch and will continue twitching, aggressively furrowing the brow which is visible to the physician. This will indicate to the physician that he or she has located the desired nerve .
Once the physician is confident that he or she has positioned the needle electrode 31 in an appropriate position on or very near the branches of the nerve sought to be ablated as confirmed by an optimal or maximal twitch response to low frequency stimulation, the physician thereafter actuates the foot pedal 76 to close switch 67 to supply high frequency energy to the needle electrode 31. If low frequency energy is concomitantly being supplied to the needle electrode 31, within a short period of time after ablation of the nerve being treated, muscle twitching should disappear and the furrowed brow should relax and forehead wrinkles will disappear. As soon as this occurs it may be assumed that the nerve in question has been successfully ablated and the application of the low frequency energy and the high frequency energy can be terminated by opening switches 62 and 67.
When the physician is confident he or she has ablated the pathological tissue as indicated, he or she simply removes the needle electrode from the patient and, if appropriate, applies a small dressing to the puncture site. It should be appreciated that the procedure may be repeated at the same site or at additional sites in the same manner as hereinbefore described.
If a sequential operation is desired by the physician, the physician can open the switch 62 and thereafter operate the foot pedal 76 to close the switch 67. The physician can thereafter supply radio frequency energy to the needle electrode at a desired power for a desired amount of time which he believes applicable for the application being treated. Thereafter, the physician can operate the foot pedal 76 to open the switch 67. Thereafter the physician can again close the switch 62 to see whether or not with the application of low frequency energy twitching reappears. If not, it can be assumed that the treatment has been successful. If it does, the physician can again terminate the application of low frequency energy by opening the switch 62 and thereafter close the switch 67 to again apply high frequency energy to cause further ablation for a desired period of time at a desired power level. Thereafter, the physician can terminate the application of radio frequency energy to the needle electrode 31 by opening the switch 67. By closing switch 62, the physician again tests the nerve to see whether or not it has been sufficiently ablated by determining whether or not twitching reoccurs. This procedure can be followed until the twitching and furrowing of the brow have ceased upon the application of low frequency energy. The thermocouple senses the temperature during ablation and ensures that excessive temperatures will not be reached as for example greater than 80°C to thereby permit unwanted destruction of tissue during the ablation procedure. If such temperature is reached, the thermocouple will supply information to the radio frequency generator to shut down the radio frequency generator.
It is apparent from the foregoing that there has been provided an apparatus and method for diagnostic nerve stimulation and tissue ablation which can be performed with a single apparatus. With the apparatus and method of the present invention it is possible to perform a procedure with a single needle electrode and applying a low frequency energy and a high frequency energy sequentially or simultaneously as desired by the physician without the necessity of moving the needle electrode until after the desired nerve and its ablation have been accomplished. The apparatus is easy to use. It is inexpensive, safe and reliable.

Claims

WHAT IS CLAIMED:
1. An apparatus for nerve stimulation and tissue ablation in the body of a patient having tissue and herves therein comprising a low frequency generator, a high frequency generator, a needle electrode for contacting the body and means coupling the needle electrode to the low frequency generator and to the high frequency generator sequentially or simultaneously to permit location and treatment with the same apparatus.
2. Apparatus as in Claim 1 wherein the low frequency generator provides energy having a frequency less than 50 Hz and the high frequency generator provides energy having a frequency greater than 100 KHz.
3. Apparatus as in Claim 1 further including temperature sensing means carried by the needle electrode for monitoring and controlling the ablation of tissue.
4. Apparatus as in Claim 3 wherein said temperature sensing means includes a thermocouple carried by said needle electrode.
5. Apparatus as in Claim 1 wherein the means coupling the needle electrode to the low frequency generator and to the high frequency generator sequentially or simultaneously includes a first switch for coupling low frequency energy from the low frequency generator to the needle electrode and a second switch for coupling high frequency energy from the high frequency generator to the needle electrode whereby the first and second switches can be operated sequentially or can be operated at the same time.
6. Apparatus as in Claim 1 wherein said low frequency generator provides a controlled constant current at a voltage ranging from 100 to 200 volts and a low current ranging from 100 microamperes to 50 milliamperes .
7. A method for nerve stimulation and tissue ablation in the body of a patient having tissue and nerves therein by the use of a needle electrode and low frequency energy and high frequency energy comprising the steps of locating the desired nerve by positioning the needle electrode in close proximity to the nerve and supplying low frequency energy to the needle electrode to cause twitching of the nerve visible to the physician, to thereby make it possible for the physician confirm whether or not the appropriate nerve has been located and supplying a radio frequency energy to the needle electrode after termination of the supplying of low frequency energy to the electrode or alternatively at the same time that low frequency energy is being supplied to the needle electrode to ablate the tissue and to thereby ablate the nerve and the tissue enervated by the nerve.
8. A method as in Claim 7 wherein the application of low frequency energy to the needle electrode is terminated prior to the application of high frequency energy to the needle electrode.
9. A method as in Claim 7 wherein the high frequency energy is supplied to the needle electrode during the time that the low frequency energy is being supplied to the needle electrode.
10. A method as in Claim 7 further including the step of monitoring the temperature of the ablation being carried out and terminating the ablation when the temperature of the tissue being ablated exceeds 80°C.
11. A method as in Claim 7 wherein the step of supplying low frequency energy to the needle electrode includes the step of supplying the low frequency energy at a controlled constant current to the needle electrode.
12. A method for treating a patient having chronic forehead wrinkles, the forehead having skin and underlying muscles, said forehead muscles being innervated by branches of the facial nerve, by the application of low frequency and high frequency energy to the branches of the facial nerve and forehead muscle tissue, the method comprising the steps of inserting an energy conducting member through the skin of the forehead, positioning the energy conducting member in close proximity to the branches of the facial nerve, conducting low frequency energy to the energy conducting member in order to confirm that the energy conducting member is positioned in close proximity to said branches of the facial nerve and conducting high frequency energy to the energy conducting member for a predetermined period of time in order to ablate the branches of the facial nerve and forehead muscle tissue innervated by said branches of the facial nerve until said forehead wrinkles are removed.
PCT/US2000/040640 1999-08-12 2000-08-14 Nerve stimulation and tissue ablation apparatus and method WO2001012089A1 (en)

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US09/373,098 1999-08-12

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Cited By (163)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002019932A1 (en) * 2000-09-05 2002-03-14 Gyrus Medical Limited Electrosurgery system
WO2006109334A1 (en) * 2005-04-14 2006-10-19 Francesco Peluso Portable electric stimulator for wrinkles with interchangeable microelectrodes applicator
EP1749492A1 (en) * 2005-08-02 2007-02-07 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
EP1862139A2 (en) * 2002-05-27 2007-12-05 Celon AG Medical Instruments Therapy equipment
WO2009124726A1 (en) * 2008-04-10 2009-10-15 Erbe Elektromedizin Gmbh Surgical apparatus comprising a nerve testing device
WO2010089037A1 (en) * 2009-02-06 2010-08-12 Erbe Elektromedizin Gmbh Hf surgery device
WO2011136962A1 (en) * 2010-04-30 2011-11-03 Medtronic Xomed, Inc. Interface module for use with nerve monitoring and electrosurgery
USRE44049E1 (en) * 2000-04-06 2013-03-05 Garrett D. Herzon Bipolar handheld nerve locator and evaluator
US8512715B2 (en) 2008-08-14 2013-08-20 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
US20140296738A1 (en) * 2010-03-10 2014-10-02 Covidien Lp System and method for determining proximity relative to a nerve
US9204925B2 (en) 2008-08-14 2015-12-08 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
AU2012318436B2 (en) * 2011-10-05 2016-09-08 Medtronic Xomed, Inc. Interface module allowing delivery of tissue stimulation and electrosurgery through a common surgical instrument
WO2019134008A3 (en) * 2017-12-28 2019-09-06 Ethicon Llc Radio frequency energy device for delivering combined electrical signals
US10512413B2 (en) 2014-08-26 2019-12-24 Avent, Inc. Method and system for identification of source of chronic pain and treatment
WO2020051448A1 (en) * 2018-09-07 2020-03-12 Ethicon Llc Energy module for driving multiple energy modalities through a port
US10595887B2 (en) 2017-12-28 2020-03-24 Ethicon Llc Systems for adjusting end effector parameters based on perioperative information
US10695081B2 (en) 2017-12-28 2020-06-30 Ethicon Llc Controlling a surgical instrument according to sensed closure parameters
US10755813B2 (en) 2017-12-28 2020-08-25 Ethicon Llc Communication of smoke evacuation system parameters to hub or cloud in smoke evacuation module for interactive surgical platform
US10758310B2 (en) 2017-12-28 2020-09-01 Ethicon Llc Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US10772651B2 (en) 2017-10-30 2020-09-15 Ethicon Llc Surgical instruments comprising a system for articulation and rotation compensation
US10849697B2 (en) 2017-12-28 2020-12-01 Ethicon Llc Cloud interface for coupled surgical devices
CN112055880A (en) * 2018-03-08 2020-12-08 爱惜康有限责任公司 Radio frequency energy device for delivering combined electrical signals
US10892899B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Self describing data packets generated at an issuing instrument
US10892995B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US10898622B2 (en) 2017-12-28 2021-01-26 Ethicon Llc Surgical evacuation system with a communication circuit for communication between a filter and a smoke evacuation device
US10932872B2 (en) 2017-12-28 2021-03-02 Ethicon Llc Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set
US10944728B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Interactive surgical systems with encrypted communication capabilities
US10943454B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Detection and escalation of security responses of surgical instruments to increasing severity threats
US10966791B2 (en) 2017-12-28 2021-04-06 Ethicon Llc Cloud-based medical analytics for medical facility segmented individualization of instrument function
US10973520B2 (en) 2018-03-28 2021-04-13 Ethicon Llc Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature
US10987178B2 (en) 2017-12-28 2021-04-27 Ethicon Llc Surgical hub control arrangements
US11013563B2 (en) 2017-12-28 2021-05-25 Ethicon Llc Drive arrangements for robot-assisted surgical platforms
US11026751B2 (en) 2017-12-28 2021-06-08 Cilag Gmbh International Display of alignment of staple cartridge to prior linear staple line
US11026687B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Clip applier comprising clip advancing systems
US11051876B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Surgical evacuation flow paths
USD924139S1 (en) 2019-09-05 2021-07-06 Ethicon Llc Energy module with a backplane connector
US11056244B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks
US11058498B2 (en) 2017-12-28 2021-07-13 Cilag Gmbh International Cooperative surgical actions for robot-assisted surgical platforms
US11069012B2 (en) 2017-12-28 2021-07-20 Cilag Gmbh International Interactive surgical systems with condition handling of devices and data capabilities
US11076921B2 (en) 2017-12-28 2021-08-03 Cilag Gmbh International Adaptive control program updates for surgical hubs
US11090047B2 (en) 2018-03-28 2021-08-17 Cilag Gmbh International Surgical instrument comprising an adaptive control system
USD928725S1 (en) 2019-09-05 2021-08-24 Cilag Gmbh International Energy module
US11096693B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing
US11096688B2 (en) 2018-03-28 2021-08-24 Cilag Gmbh International Rotary driven firing members with different anvil and channel engagement features
US11100631B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Use of laser light and red-green-blue coloration to determine properties of back scattered light
USD928726S1 (en) 2019-09-05 2021-08-24 Cilag Gmbh International Energy module monopolar port
US11114195B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Surgical instrument with a tissue marking assembly
US11109866B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Method for circular stapler control algorithm adjustment based on situational awareness
US11129611B2 (en) 2018-03-28 2021-09-28 Cilag Gmbh International Surgical staplers with arrangements for maintaining a firing member thereof in a locked configuration unless a compatible cartridge has been installed therein
US11132462B2 (en) 2017-12-28 2021-09-28 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11141219B1 (en) 2016-08-16 2021-10-12 BTL Healthcare Technologies, a.s. Self-operating belt
US11147607B2 (en) 2017-12-28 2021-10-19 Cilag Gmbh International Bipolar combination device that automatically adjusts pressure based on energy modality
US11160605B2 (en) 2017-12-28 2021-11-02 Cilag Gmbh International Surgical evacuation sensing and motor control
US11166772B2 (en) 2017-12-28 2021-11-09 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
US11179175B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Controlling an ultrasonic surgical instrument according to tissue location
US11179208B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Cloud-based medical analytics for security and authentication trends and reactive measures
US11185690B2 (en) 2016-05-23 2021-11-30 BTL Healthcare Technologies, a.s. Systems and methods for tissue treatment
US11202570B2 (en) 2017-12-28 2021-12-21 Cilag Gmbh International Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems
US11207067B2 (en) 2018-03-28 2021-12-28 Cilag Gmbh International Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing
USD939545S1 (en) 2019-09-05 2021-12-28 Cilag Gmbh International Display panel or portion thereof with graphical user interface for energy module
US11218822B2 (en) 2019-03-29 2022-01-04 Cilag Gmbh International Audio tone construction for an energy module of a modular energy system
US11219453B2 (en) 2018-03-28 2022-01-11 Cilag Gmbh International Surgical stapling devices with cartridge compatible closure and firing lockout arrangements
US11229436B2 (en) 2017-10-30 2022-01-25 Cilag Gmbh International Surgical system comprising a surgical tool and a surgical hub
US11234756B2 (en) 2017-12-28 2022-02-01 Cilag Gmbh International Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter
US11247039B2 (en) 2016-05-03 2022-02-15 Btl Healthcare Technologies A.S. Device including RF source of energy and vacuum system
US11247063B2 (en) 2019-04-11 2022-02-15 Btl Healthcare Technologies A.S. Methods and devices for aesthetic treatment of biological structures by radiofrequency and magnetic energy
US11253315B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Increasing radio frequency to create pad-less monopolar loop
US11253718B2 (en) 2015-07-01 2022-02-22 Btl Healthcare Technologies A.S. High power time varying magnetic field therapy
US11257589B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes
US11253717B2 (en) 2015-10-29 2022-02-22 Btl Healthcare Technologies A.S. Aesthetic method of biological structure treatment by magnetic field
US11259807B2 (en) 2019-02-19 2022-03-01 Cilag Gmbh International Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device
US11259806B2 (en) 2018-03-28 2022-03-01 Cilag Gmbh International Surgical stapling devices with features for blocking advancement of a camming assembly of an incompatible cartridge installed therein
US11259830B2 (en) 2018-03-08 2022-03-01 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
US11266852B2 (en) 2016-07-01 2022-03-08 Btl Healthcare Technologies A.S. Aesthetic method of biological structure treatment by magnetic field
US11266468B2 (en) 2017-12-28 2022-03-08 Cilag Gmbh International Cooperative utilization of data derived from secondary sources by intelligent surgical hubs
US11273001B2 (en) 2017-12-28 2022-03-15 Cilag Gmbh International Surgical hub and modular device response adjustment based on situational awareness
US11278281B2 (en) 2017-12-28 2022-03-22 Cilag Gmbh International Interactive surgical system
US11278280B2 (en) 2018-03-28 2022-03-22 Cilag Gmbh International Surgical instrument comprising a jaw closure lockout
US11284936B2 (en) 2017-12-28 2022-03-29 Cilag Gmbh International Surgical instrument having a flexible electrode
US11291510B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11291495B2 (en) 2017-12-28 2022-04-05 Cilag Gmbh International Interruption of energy due to inadvertent capacitive coupling
US11298148B2 (en) 2018-03-08 2022-04-12 Cilag Gmbh International Live time tissue classification using electrical parameters
US11304699B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11304720B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Activation of energy devices
US11304745B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical evacuation sensing and display
US11304763B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Image capturing of the areas outside the abdomen to improve placement and control of a surgical device in use
US11308075B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical network, instrument, and cloud responses based on validation of received dataset and authentication of its source and integrity
US11311342B2 (en) 2017-10-30 2022-04-26 Cilag Gmbh International Method for communicating with surgical instrument systems
US11311306B2 (en) 2017-12-28 2022-04-26 Cilag Gmbh International Surgical systems for detecting end effector tissue distribution irregularities
US11317937B2 (en) 2018-03-08 2022-05-03 Cilag Gmbh International Determining the state of an ultrasonic end effector
USD950728S1 (en) 2019-06-25 2022-05-03 Cilag Gmbh International Surgical staple cartridge
US11317915B2 (en) 2019-02-19 2022-05-03 Cilag Gmbh International Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers
US11317919B2 (en) 2017-10-30 2022-05-03 Cilag Gmbh International Clip applier comprising a clip crimping system
US11324557B2 (en) 2017-12-28 2022-05-10 Cilag Gmbh International Surgical instrument with a sensing array
USD952144S1 (en) 2019-06-25 2022-05-17 Cilag Gmbh International Surgical staple cartridge retainer with firing system authentication key
US11337746B2 (en) 2018-03-08 2022-05-24 Cilag Gmbh International Smart blade and power pulsing
US11357503B2 (en) 2019-02-19 2022-06-14 Cilag Gmbh International Staple cartridge retainers with frangible retention features and methods of using same
US11369377B2 (en) 2019-02-19 2022-06-28 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout
US11376002B2 (en) 2017-12-28 2022-07-05 Cilag Gmbh International Surgical instrument cartridge sensor assemblies
US11389164B2 (en) 2017-12-28 2022-07-19 Cilag Gmbh International Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices
US20220226644A1 (en) * 2009-08-04 2022-07-21 Pollogen Ltd. Cosmetic skin rejuvination
US11410259B2 (en) 2017-12-28 2022-08-09 Cilag Gmbh International Adaptive control program updates for surgical devices
US11424027B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Method for operating surgical instrument systems
US11419667B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Ultrasonic energy device which varies pressure applied by clamp arm to provide threshold control pressure at a cut progression location
US11419630B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Surgical system distributed processing
US11423007B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Adjustment of device control programs based on stratified contextual data in addition to the data
US11432885B2 (en) 2017-12-28 2022-09-06 Cilag Gmbh International Sensing arrangements for robot-assisted surgical platforms
USD964564S1 (en) 2019-06-25 2022-09-20 Cilag Gmbh International Surgical staple cartridge retainer with a closure system authentication key
US11446052B2 (en) 2017-12-28 2022-09-20 Cilag Gmbh International Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue
US11464511B2 (en) 2019-02-19 2022-10-11 Cilag Gmbh International Surgical staple cartridges with movable authentication key arrangements
US11464994B2 (en) 2016-05-10 2022-10-11 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11464559B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Estimating state of ultrasonic end effector and control system therefor
US11464535B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Detection of end effector emersion in liquid
US11464993B2 (en) 2016-05-03 2022-10-11 Btl Healthcare Technologies A.S. Device including RF source of energy and vacuum system
US11471156B2 (en) 2018-03-28 2022-10-18 Cilag Gmbh International Surgical stapling devices with improved rotary driven closure systems
US11484727B2 (en) 2016-07-01 2022-11-01 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11491342B2 (en) 2015-07-01 2022-11-08 Btl Medical Solutions A.S. Magnetic stimulation methods and devices for therapeutic treatments
US11491329B2 (en) 2020-05-04 2022-11-08 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11504192B2 (en) 2014-10-30 2022-11-22 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11510741B2 (en) 2017-10-30 2022-11-29 Cilag Gmbh International Method for producing a surgical instrument comprising a smart electrical system
US11529187B2 (en) 2017-12-28 2022-12-20 Cilag Gmbh International Surgical evacuation sensor arrangements
US11534619B2 (en) 2016-05-10 2022-12-27 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11534235B2 (en) 2019-04-04 2022-12-27 Acclarent, Inc. Needle instrument for posterior nasal neurectomy ablation
US11540855B2 (en) 2017-12-28 2023-01-03 Cilag Gmbh International Controlling activation of an ultrasonic surgical instrument according to the presence of tissue
US11559307B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method of robotic hub communication, detection, and control
US11559308B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure
US11564756B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11571234B2 (en) 2017-12-28 2023-02-07 Cilag Gmbh International Temperature control of ultrasonic end effector and control system therefor
US11576677B2 (en) 2017-12-28 2023-02-14 Cilag Gmbh International Method of hub communication, processing, display, and cloud analytics
US11590346B2 (en) 2009-11-16 2023-02-28 Pollogen Ltd. Apparatus and method for cosmetic treatment of human mucosal tissue
US11589888B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Method for controlling smart energy devices
US11589932B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures
US11596291B2 (en) 2017-12-28 2023-03-07 Cilag Gmbh International Method of compressing tissue within a stapling device and simultaneously displaying of the location of the tissue within the jaws
US11602393B2 (en) 2017-12-28 2023-03-14 Cilag Gmbh International Surgical evacuation sensing and generator control
US11612444B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Adjustment of a surgical device function based on situational awareness
US11612758B2 (en) 2012-07-05 2023-03-28 Btl Medical Solutions A.S. Device for repetitive nerve stimulation in order to break down fat tissue means of inductive magnetic fields
US11633596B2 (en) 2020-05-04 2023-04-25 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11659023B2 (en) 2017-12-28 2023-05-23 Cilag Gmbh International Method of hub communication
US11666331B2 (en) 2017-12-28 2023-06-06 Cilag Gmbh International Systems for detecting proximity of surgical end effector to cancerous tissue
US11696789B2 (en) 2018-09-07 2023-07-11 Cilag Gmbh International Consolidated user interface for modular energy system
US11744604B2 (en) 2017-12-28 2023-09-05 Cilag Gmbh International Surgical instrument with a hardware-only control circuit
US11771487B2 (en) 2017-12-28 2023-10-03 Cilag Gmbh International Mechanisms for controlling different electromechanical systems of an electrosurgical instrument
US11786245B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Surgical systems with prioritized data transmission capabilities
US11786251B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11786296B2 (en) 2019-02-15 2023-10-17 Accularent, Inc. Instrument for endoscopic posterior nasal nerve ablation
US11801098B2 (en) 2017-10-30 2023-10-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11804679B2 (en) 2018-09-07 2023-10-31 Cilag Gmbh International Flexible hand-switch circuit
US11818052B2 (en) 2017-12-28 2023-11-14 Cilag Gmbh International Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11832840B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical instrument having a flexible circuit
US11832899B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical systems with autonomously adjustable control programs
US11857252B2 (en) 2021-03-30 2024-01-02 Cilag Gmbh International Bezel with light blocking features for modular energy system
US11857152B2 (en) 2017-12-28 2024-01-02 Cilag Gmbh International Surgical hub spatial awareness to determine devices in operating theater
US11864728B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Characterization of tissue irregularities through the use of mono-chromatic light refractivity
US11871901B2 (en) 2012-05-20 2024-01-16 Cilag Gmbh International Method for situational awareness for surgical network or surgical network connected device capable of adjusting function based on a sensed situation or usage
US11896443B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Control of a surgical system through a surgical barrier
US11896322B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub
US11896816B2 (en) 2021-11-03 2024-02-13 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11903601B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Surgical instrument comprising a plurality of drive systems
US11911045B2 (en) 2017-10-30 2024-02-27 Cllag GmbH International Method for operating a powered articulating multi-clip applier
US11923084B2 (en) 2018-09-07 2024-03-05 Cilag Gmbh International First and second communication protocol arrangement for driving primary and secondary devices through a single port
US11918804B2 (en) 2009-11-16 2024-03-05 Pollogen Ltd. Method and device for skin treatment by heating and muscle stimulation
US11937769B2 (en) 2017-12-28 2024-03-26 Cilag Gmbh International Method of hub communication, processing, storage and display
US11950860B2 (en) 2021-03-30 2024-04-09 Cilag Gmbh International User interface mitigation techniques for modular energy systems

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5500012A (en) * 1992-07-15 1996-03-19 Angeion Corporation Ablation catheter system
US5782826A (en) * 1996-11-01 1998-07-21 Ep Technologies, Inc. System and methods for detecting ancillary tissue near tissue targeted for ablation
US6139545A (en) * 1998-09-09 2000-10-31 Vidaderm Systems and methods for ablating discrete motor nerve regions

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5500012A (en) * 1992-07-15 1996-03-19 Angeion Corporation Ablation catheter system
US5782826A (en) * 1996-11-01 1998-07-21 Ep Technologies, Inc. System and methods for detecting ancillary tissue near tissue targeted for ablation
US6139545A (en) * 1998-09-09 2000-10-31 Vidaderm Systems and methods for ablating discrete motor nerve regions

Cited By (311)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
USRE44049E1 (en) * 2000-04-06 2013-03-05 Garrett D. Herzon Bipolar handheld nerve locator and evaluator
WO2002019932A1 (en) * 2000-09-05 2002-03-14 Gyrus Medical Limited Electrosurgery system
EP1862139A3 (en) * 2002-05-27 2011-02-09 Celon AG Medical Instruments Therapy equipment
EP1862139A2 (en) * 2002-05-27 2007-12-05 Celon AG Medical Instruments Therapy equipment
WO2006109334A1 (en) * 2005-04-14 2006-10-19 Francesco Peluso Portable electric stimulator for wrinkles with interchangeable microelectrodes applicator
US7853326B2 (en) 2005-08-02 2010-12-14 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
EP1749492A1 (en) * 2005-08-02 2007-02-07 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
US8818503B2 (en) 2005-08-02 2014-08-26 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
US8560062B2 (en) 2005-08-02 2013-10-15 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
EP2289449A1 (en) * 2005-08-02 2011-03-02 Neurotherm, Inc. Apparatus for diagnosing and treating neural dysfunction
US8000785B2 (en) 2005-08-02 2011-08-16 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
US7574257B2 (en) 2005-08-02 2009-08-11 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
US8265747B2 (en) 2005-08-02 2012-09-11 Neurotherm, Inc. Method and apparatus for diagnosing and treating neural dysfunction
WO2009124726A1 (en) * 2008-04-10 2009-10-15 Erbe Elektromedizin Gmbh Surgical apparatus comprising a nerve testing device
US10441344B2 (en) 2008-04-10 2019-10-15 Erbe Elektromedizin Gmbh Surgical apparatus comprising a nerve testing device
US9204925B2 (en) 2008-08-14 2015-12-08 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
US8920816B2 (en) 2008-08-14 2014-12-30 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
US8512715B2 (en) 2008-08-14 2013-08-20 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
US9566112B2 (en) 2008-08-14 2017-02-14 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
US9265562B2 (en) 2008-08-14 2016-02-23 The Cleveland Clinic Foundation Apparatus and method for treating a neuromuscular defect
CN102368971B (en) * 2009-02-06 2013-12-18 厄比电子医学有限责任公司 HF surgery device
EP2393443B1 (en) * 2009-02-06 2018-08-08 Erbe Elektromedizin GmbH Hf surgery device
WO2010089037A1 (en) * 2009-02-06 2010-08-12 Erbe Elektromedizin Gmbh Hf surgery device
CN102368971A (en) * 2009-02-06 2012-03-07 厄比电子医学有限责任公司 Hf surgery device
US9339324B2 (en) 2009-02-06 2016-05-17 Erbe Elektromedizin Gmbh Radio frequency surgical apparatus
US11712560B2 (en) 2009-08-04 2023-08-01 Pollogen Ltd. Cosmetic skin rejuvenation
US20220226644A1 (en) * 2009-08-04 2022-07-21 Pollogen Ltd. Cosmetic skin rejuvination
US11918804B2 (en) 2009-11-16 2024-03-05 Pollogen Ltd. Method and device for skin treatment by heating and muscle stimulation
US11590346B2 (en) 2009-11-16 2023-02-28 Pollogen Ltd. Apparatus and method for cosmetic treatment of human mucosal tissue
US11865336B2 (en) 2009-11-16 2024-01-09 Pollogen Ltd. Apparatus and method for cosmetic treatment of human mucosal tissue
US20140296738A1 (en) * 2010-03-10 2014-10-02 Covidien Lp System and method for determining proximity relative to a nerve
US10980593B2 (en) 2010-04-30 2021-04-20 Medtronic Xomed, Inc. Interface module for use with nerve monitoring and electrosurgery
WO2011136962A1 (en) * 2010-04-30 2011-11-03 Medtronic Xomed, Inc. Interface module for use with nerve monitoring and electrosurgery
CN102985004A (en) * 2010-04-30 2013-03-20 美敦力施美德公司 Interface module for use with nerve monitoring and electrosurgery
JP2013525002A (en) * 2010-04-30 2013-06-20 メドトロニック ゾームド，インコーポレイテッド Interface module for neuromonitoring and electrosurgery
AU2011245597B2 (en) * 2010-04-30 2015-01-29 Medtronic Xomed, Inc. Interface module for use with nerve monitoring and electrosurgery
KR101505054B1 (en) 2010-04-30 2015-03-23 메드트로닉 좀드 인코퍼레이티드 Interface Module for Use with Nerve Monitoring and Electrosurgery
US10631912B2 (en) 2010-04-30 2020-04-28 Medtronic Xomed, Inc. Interface module for use with nerve monitoring and electrosurgery
AU2012318436B2 (en) * 2011-10-05 2016-09-08 Medtronic Xomed, Inc. Interface module allowing delivery of tissue stimulation and electrosurgery through a common surgical instrument
US9579503B2 (en) 2011-10-05 2017-02-28 Medtronic Xomed, Inc. Interface module allowing delivery of tissue stimulation and electrosurgery through a common surgical instrument
US11871901B2 (en) 2012-05-20 2024-01-16 Cilag Gmbh International Method for situational awareness for surgical network or surgical network connected device capable of adjusting function based on a sensed situation or usage
US11612758B2 (en) 2012-07-05 2023-03-28 Btl Medical Solutions A.S. Device for repetitive nerve stimulation in order to break down fat tissue means of inductive magnetic fields
US11826154B2 (en) 2014-08-26 2023-11-28 Avent, Inc. Method and system for identification of source of chronic pain and treatment
US10512413B2 (en) 2014-08-26 2019-12-24 Avent, Inc. Method and system for identification of source of chronic pain and treatment
US11504192B2 (en) 2014-10-30 2022-11-22 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11266850B2 (en) 2015-07-01 2022-03-08 Btl Healthcare Technologies A.S. High power time varying magnetic field therapy
US11491342B2 (en) 2015-07-01 2022-11-08 Btl Medical Solutions A.S. Magnetic stimulation methods and devices for therapeutic treatments
US11253718B2 (en) 2015-07-01 2022-02-22 Btl Healthcare Technologies A.S. High power time varying magnetic field therapy
US11253717B2 (en) 2015-10-29 2022-02-22 Btl Healthcare Technologies A.S. Aesthetic method of biological structure treatment by magnetic field
US11247039B2 (en) 2016-05-03 2022-02-15 Btl Healthcare Technologies A.S. Device including RF source of energy and vacuum system
US11883643B2 (en) 2016-05-03 2024-01-30 Btl Healthcare Technologies A.S. Systems and methods for treatment of a patient including RF and electrical energy
US11464993B2 (en) 2016-05-03 2022-10-11 Btl Healthcare Technologies A.S. Device including RF source of energy and vacuum system
US11602629B2 (en) 2016-05-03 2023-03-14 Btl Healthcare Technologies A.S. Systems and methods for treatment of a patient including rf and electrical energy
US11691024B2 (en) 2016-05-10 2023-07-04 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11464994B2 (en) 2016-05-10 2022-10-11 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11590356B2 (en) 2016-05-10 2023-02-28 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11534619B2 (en) 2016-05-10 2022-12-27 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11458307B2 (en) 2016-05-23 2022-10-04 Btl Healthcare Technologies A.S. Systems and methods for tissue treatment
US11878162B2 (en) 2016-05-23 2024-01-23 Btl Healthcare Technologies A.S. Systems and methods for tissue treatment
US11896821B2 (en) 2016-05-23 2024-02-13 Btl Healthcare Technologies A.S. Systems and methods for tissue treatment
US11185690B2 (en) 2016-05-23 2021-11-30 BTL Healthcare Technologies, a.s. Systems and methods for tissue treatment
US11623083B2 (en) 2016-05-23 2023-04-11 Btl Healthcare Technologies A.S. Systems and methods for tissue treatment
US11679270B2 (en) 2016-07-01 2023-06-20 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11497925B2 (en) 2016-07-01 2022-11-15 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11524171B2 (en) 2016-07-01 2022-12-13 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11628308B2 (en) 2016-07-01 2023-04-18 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11484727B2 (en) 2016-07-01 2022-11-01 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11794029B2 (en) 2016-07-01 2023-10-24 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11266852B2 (en) 2016-07-01 2022-03-08 Btl Healthcare Technologies A.S. Aesthetic method of biological structure treatment by magnetic field
US11607556B2 (en) 2016-07-01 2023-03-21 Btl Medical Solutions A.S. Aesthetic method of biological structure treatment by magnetic field
US11896299B2 (en) 2016-08-16 2024-02-13 Btl Healthcare Technologies A.S. Modular treatment device
US11141219B1 (en) 2016-08-16 2021-10-12 BTL Healthcare Technologies, a.s. Self-operating belt
US11925373B2 (en) 2017-10-30 2024-03-12 Cilag Gmbh International Surgical suturing instrument comprising a non-circular needle
US11045197B2 (en) 2017-10-30 2021-06-29 Cilag Gmbh International Clip applier comprising a movable clip magazine
US11911045B2 (en) 2017-10-30 2024-02-27 Cllag GmbH International Method for operating a powered articulating multi-clip applier
US11602366B2 (en) 2017-10-30 2023-03-14 Cilag Gmbh International Surgical suturing instrument configured to manipulate tissue using mechanical and electrical power
US11564756B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11564703B2 (en) 2017-10-30 2023-01-31 Cilag Gmbh International Surgical suturing instrument comprising a capture width which is larger than trocar diameter
US10772651B2 (en) 2017-10-30 2020-09-15 Ethicon Llc Surgical instruments comprising a system for articulation and rotation compensation
US11103268B2 (en) 2017-10-30 2021-08-31 Cilag Gmbh International Surgical clip applier comprising adaptive firing control
US11109878B2 (en) 2017-10-30 2021-09-07 Cilag Gmbh International Surgical clip applier comprising an automatic clip feeding system
US11648022B2 (en) 2017-10-30 2023-05-16 Cilag Gmbh International Surgical instrument systems comprising battery arrangements
US11510741B2 (en) 2017-10-30 2022-11-29 Cilag Gmbh International Method for producing a surgical instrument comprising a smart electrical system
US11123070B2 (en) 2017-10-30 2021-09-21 Cilag Gmbh International Clip applier comprising a rotatable clip magazine
US11071560B2 (en) 2017-10-30 2021-07-27 Cilag Gmbh International Surgical clip applier comprising adaptive control in response to a strain gauge circuit
US10932806B2 (en) 2017-10-30 2021-03-02 Ethicon Llc Reactive algorithm for surgical system
US11129636B2 (en) 2017-10-30 2021-09-28 Cilag Gmbh International Surgical instruments comprising an articulation drive that provides for high articulation angles
US11141160B2 (en) 2017-10-30 2021-10-12 Cilag Gmbh International Clip applier comprising a motor controller
US10959744B2 (en) 2017-10-30 2021-03-30 Ethicon Llc Surgical dissectors and manufacturing techniques
US11696778B2 (en) 2017-10-30 2023-07-11 Cilag Gmbh International Surgical dissectors configured to apply mechanical and electrical energy
US11413042B2 (en) 2017-10-30 2022-08-16 Cilag Gmbh International Clip applier comprising a reciprocating clip advancing member
US11406390B2 (en) 2017-10-30 2022-08-09 Cilag Gmbh International Clip applier comprising interchangeable clip reloads
US10980560B2 (en) 2017-10-30 2021-04-20 Ethicon Llc Surgical instrument systems comprising feedback mechanisms
US11759224B2 (en) 2017-10-30 2023-09-19 Cilag Gmbh International Surgical instrument systems comprising handle arrangements
US11317919B2 (en) 2017-10-30 2022-05-03 Cilag Gmbh International Clip applier comprising a clip crimping system
US11793537B2 (en) 2017-10-30 2023-10-24 Cilag Gmbh International Surgical instrument comprising an adaptive electrical system
US11311342B2 (en) 2017-10-30 2022-04-26 Cilag Gmbh International Method for communicating with surgical instrument systems
US11801098B2 (en) 2017-10-30 2023-10-31 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11819231B2 (en) 2017-10-30 2023-11-21 Cilag Gmbh International Adaptive control programs for a surgical system comprising more than one type of cartridge
US11207090B2 (en) 2017-10-30 2021-12-28 Cilag Gmbh International Surgical instruments comprising a biased shifting mechanism
US11291465B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Surgical instruments comprising a lockable end effector socket
US11291510B2 (en) 2017-10-30 2022-04-05 Cilag Gmbh International Method of hub communication with surgical instrument systems
US11026712B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Surgical instruments comprising a shifting mechanism
US11051836B2 (en) 2017-10-30 2021-07-06 Cilag Gmbh International Surgical clip applier comprising an empty clip cartridge lockout
US11026713B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Surgical clip applier configured to store clips in a stored state
US11026687B2 (en) 2017-10-30 2021-06-08 Cilag Gmbh International Clip applier comprising clip advancing systems
US11229436B2 (en) 2017-10-30 2022-01-25 Cilag Gmbh International Surgical system comprising a surgical tool and a surgical hub
US11786251B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11896322B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Sensing the patient position and contact utilizing the mono-polar return pad electrode to provide situational awareness to the hub
US11045591B2 (en) 2017-12-28 2021-06-29 Cilag Gmbh International Dual in-series large and small droplet filters
US11253315B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Increasing radio frequency to create pad-less monopolar loop
US11051876B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Surgical evacuation flow paths
US11257589B2 (en) 2017-12-28 2022-02-22 Cilag Gmbh International Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes
US11918302B2 (en) 2017-12-28 2024-03-05 Cilag Gmbh International Sterile field interactive control displays
US11864845B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Sterile field interactive control displays
US11864728B2 (en) 2017-12-28 2024-01-09 Cilag Gmbh International Characterization of tissue irregularities through the use of mono-chromatic light refractivity
US11857152B2 (en) 2017-12-28 2024-01-02 Cilag Gmbh International Surgical hub spatial awareness to determine devices in operating theater
US11213359B2 (en) 2017-12-28 2022-01-04 Cilag Gmbh International Controllers for robot-assisted surgical platforms
US11026751B2 (en) 2017-12-28 2021-06-08 Cilag Gmbh International Display of alignment of staple cartridge to prior linear staple line
US11266468B2 (en) 2017-12-28 2022-03-08 Cilag Gmbh International Cooperative utilization of data derived from secondary sources by intelligent surgical hubs
US11273001B2 (en) 2017-12-28 2022-03-15 Cilag Gmbh International Surgical hub and modular device response adjustment based on situational awareness
US11844579B2 (en) 2017-12-28 2023-12-19 Cilag Gmbh International Adjustments based on airborne particle properties
US11278281B2 (en) 2017-12-28 2022-03-22 Cilag Gmbh International Interactive surgical system
US11832899B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical systems with autonomously adjustable control programs
US11284936B2 (en) 2017-12-28 2022-03-29 Cilag Gmbh International Surgical instrument having a flexible electrode
US11832840B2 (en) 2017-12-28 2023-12-05 Cilag Gmbh International Surgical instrument having a flexible circuit
US11890065B2 (en) 2017-12-28 2024-02-06 Cilag Gmbh International Surgical system to limit displacement
US11291495B2 (en) 2017-12-28 2022-04-05 Cilag Gmbh International Interruption of energy due to inadvertent capacitive coupling
US11056244B2 (en) 2017-12-28 2021-07-06 Cilag Gmbh International Automated data scaling, alignment, and organizing based on predefined parameters within surgical networks
US11013563B2 (en) 2017-12-28 2021-05-25 Ethicon Llc Drive arrangements for robot-assisted surgical platforms
US11202570B2 (en) 2017-12-28 2021-12-21 Cilag Gmbh International Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems
US11818052B2 (en) 2017-12-28 2023-11-14 Cilag Gmbh International Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11896443B2 (en) 2017-12-28 2024-02-13 Cilag Gmbh International Control of a surgical system through a surgical barrier
US11304699B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Method for adaptive control schemes for surgical network control and interaction
US11304720B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Activation of energy devices
US11304745B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical evacuation sensing and display
US11304763B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Image capturing of the areas outside the abdomen to improve placement and control of a surgical device in use
US11308075B2 (en) 2017-12-28 2022-04-19 Cilag Gmbh International Surgical network, instrument, and cloud responses based on validation of received dataset and authentication of its source and integrity
US11058498B2 (en) 2017-12-28 2021-07-13 Cilag Gmbh International Cooperative surgical actions for robot-assisted surgical platforms
US11311306B2 (en) 2017-12-28 2022-04-26 Cilag Gmbh International Surgical systems for detecting end effector tissue distribution irregularities
US10987178B2 (en) 2017-12-28 2021-04-27 Ethicon Llc Surgical hub control arrangements
US11179208B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Cloud-based medical analytics for security and authentication trends and reactive measures
US11076921B2 (en) 2017-12-28 2021-08-03 Cilag Gmbh International Adaptive control program updates for surgical hubs
US11179204B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US11324557B2 (en) 2017-12-28 2022-05-10 Cilag Gmbh International Surgical instrument with a sensing array
US11786245B2 (en) 2017-12-28 2023-10-17 Cilag Gmbh International Surgical systems with prioritized data transmission capabilities
US11779337B2 (en) 2017-12-28 2023-10-10 Cilag Gmbh International Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices
US11771487B2 (en) 2017-12-28 2023-10-03 Cilag Gmbh International Mechanisms for controlling different electromechanical systems of an electrosurgical instrument
US11775682B2 (en) 2017-12-28 2023-10-03 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11179175B2 (en) 2017-12-28 2021-11-23 Cilag Gmbh International Controlling an ultrasonic surgical instrument according to tissue location
US11751958B2 (en) 2017-12-28 2023-09-12 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
US11744604B2 (en) 2017-12-28 2023-09-05 Cilag Gmbh International Surgical instrument with a hardware-only control circuit
US11364075B2 (en) 2017-12-28 2022-06-21 Cilag Gmbh International Radio frequency energy device for delivering combined electrical signals
US11737668B2 (en) 2017-12-28 2023-08-29 Cilag Gmbh International Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems
US11376002B2 (en) 2017-12-28 2022-07-05 Cilag Gmbh International Surgical instrument cartridge sensor assemblies
US11382697B2 (en) 2017-12-28 2022-07-12 Cilag Gmbh International Surgical instruments comprising button circuits
US11389164B2 (en) 2017-12-28 2022-07-19 Cilag Gmbh International Method of using reinforced flexible circuits with multiple sensors to optimize performance of radio frequency devices
US11712303B2 (en) 2017-12-28 2023-08-01 Cilag Gmbh International Surgical instrument comprising a control circuit
US11166772B2 (en) 2017-12-28 2021-11-09 Cilag Gmbh International Surgical hub coordination of control and communication of operating room devices
US10966791B2 (en) 2017-12-28 2021-04-06 Ethicon Llc Cloud-based medical analytics for medical facility segmented individualization of instrument function
US11234756B2 (en) 2017-12-28 2022-02-01 Cilag Gmbh International Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter
US11701185B2 (en) 2017-12-28 2023-07-18 Cilag Gmbh International Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US11410259B2 (en) 2017-12-28 2022-08-09 Cilag Gmbh International Adaptive control program updates for surgical devices
US11160605B2 (en) 2017-12-28 2021-11-02 Cilag Gmbh International Surgical evacuation sensing and motor control
US11424027B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Method for operating surgical instrument systems
US11419667B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Ultrasonic energy device which varies pressure applied by clamp arm to provide threshold control pressure at a cut progression location
US11419630B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Surgical system distributed processing
US11423007B2 (en) 2017-12-28 2022-08-23 Cilag Gmbh International Adjustment of device control programs based on stratified contextual data in addition to the data
US11432885B2 (en) 2017-12-28 2022-09-06 Cilag Gmbh International Sensing arrangements for robot-assisted surgical platforms
US11696760B2 (en) 2017-12-28 2023-07-11 Cilag Gmbh International Safety systems for smart powered surgical stapling
US11446052B2 (en) 2017-12-28 2022-09-20 Cilag Gmbh International Variation of radio frequency and ultrasonic power level in cooperation with varying clamp arm pressure to achieve predefined heat flux or power applied to tissue
US11147607B2 (en) 2017-12-28 2021-10-19 Cilag Gmbh International Bipolar combination device that automatically adjusts pressure based on energy modality
US11069012B2 (en) 2017-12-28 2021-07-20 Cilag Gmbh International Interactive surgical systems with condition handling of devices and data capabilities
US10943454B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Detection and escalation of security responses of surgical instruments to increasing severity threats
US10944728B2 (en) 2017-12-28 2021-03-09 Ethicon Llc Interactive surgical systems with encrypted communication capabilities
US10932872B2 (en) 2017-12-28 2021-03-02 Ethicon Llc Cloud-based medical analytics for linking of local usage trends with the resource acquisition behaviors of larger data set
US11464559B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Estimating state of ultrasonic end effector and control system therefor
US11464535B2 (en) 2017-12-28 2022-10-11 Cilag Gmbh International Detection of end effector emersion in liquid
US11132462B2 (en) 2017-12-28 2021-09-28 Cilag Gmbh International Data stripping method to interrogate patient records and create anonymized record
US11678881B2 (en) 2017-12-28 2023-06-20 Cilag Gmbh International Spatial awareness of surgical hubs in operating rooms
US10898622B2 (en) 2017-12-28 2021-01-26 Ethicon Llc Surgical evacuation system with a communication circuit for communication between a filter and a smoke evacuation device
US10892995B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11672605B2 (en) 2017-12-28 2023-06-13 Cilag Gmbh International Sterile field interactive control displays
US10892899B2 (en) 2017-12-28 2021-01-12 Ethicon Llc Self describing data packets generated at an issuing instrument
US11666331B2 (en) 2017-12-28 2023-06-06 Cilag Gmbh International Systems for detecting proximity of surgical end effector to cancerous tissue
US11931110B2 (en) 2017-12-28 2024-03-19 Cilag Gmbh International Surgical instrument comprising a control system that uses input from a strain gage circuit
US10849697B2 (en) 2017-12-28 2020-12-01 Ethicon Llc Cloud interface for coupled surgical devices
US11659023B2 (en) 2017-12-28 2023-05-23 Cilag Gmbh International Method of hub communication
US11109866B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Method for circular stapler control algorithm adjustment based on situational awareness
US11114195B2 (en) 2017-12-28 2021-09-07 Cilag Gmbh International Surgical instrument with a tissue marking assembly
US11903587B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Adjustment to the surgical stapling control based on situational awareness
US11529187B2 (en) 2017-12-28 2022-12-20 Cilag Gmbh International Surgical evacuation sensor arrangements
US11633237B2 (en) 2017-12-28 2023-04-25 Cilag Gmbh International Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures
US10758310B2 (en) 2017-12-28 2020-09-01 Ethicon Llc Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices
US10755813B2 (en) 2017-12-28 2020-08-25 Ethicon Llc Communication of smoke evacuation system parameters to hub or cloud in smoke evacuation module for interactive surgical platform
US11540855B2 (en) 2017-12-28 2023-01-03 Cilag Gmbh International Controlling activation of an ultrasonic surgical instrument according to the presence of tissue
US11559307B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method of robotic hub communication, detection, and control
US11559308B2 (en) 2017-12-28 2023-01-24 Cilag Gmbh International Method for smart energy device infrastructure
US11100631B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Use of laser light and red-green-blue coloration to determine properties of back scattered light
US11903601B2 (en) 2017-12-28 2024-02-20 Cilag Gmbh International Surgical instrument comprising a plurality of drive systems
US11571234B2 (en) 2017-12-28 2023-02-07 Cilag Gmbh International Temperature control of ultrasonic end effector and control system therefor
US11576677B2 (en) 2017-12-28 2023-02-14 Cilag Gmbh International Method of hub communication, processing, display, and cloud analytics
US10695081B2 (en) 2017-12-28 2020-06-30 Ethicon Llc Controlling a surgical instrument according to sensed closure parameters
US10595887B2 (en) 2017-12-28 2020-03-24 Ethicon Llc Systems for adjusting end effector parameters based on perioperative information
US11937769B2 (en) 2017-12-28 2024-03-26 Cilag Gmbh International Method of hub communication, processing, storage and display
US11612408B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Determining tissue composition via an ultrasonic system
US11589888B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Method for controlling smart energy devices
US11589932B2 (en) 2017-12-28 2023-02-28 Cilag Gmbh International Usage and technique analysis of surgeon / staff performance against a baseline to optimize device utilization and performance for both current and future procedures
US11596291B2 (en) 2017-12-28 2023-03-07 Cilag Gmbh International Method of compressing tissue within a stapling device and simultaneously displaying of the location of the tissue within the jaws
US11601371B2 (en) 2017-12-28 2023-03-07 Cilag Gmbh International Surgical network determination of prioritization of communication, interaction, or processing based on system or device needs
US11602393B2 (en) 2017-12-28 2023-03-14 Cilag Gmbh International Surgical evacuation sensing and generator control
US11096693B2 (en) 2017-12-28 2021-08-24 Cilag Gmbh International Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing
EP3509070A3 (en) * 2017-12-28 2019-11-06 Ethicon LLC Radio frequency energy device for delivering combined electrical signals
WO2019134008A3 (en) * 2017-12-28 2019-09-06 Ethicon Llc Radio frequency energy device for delivering combined electrical signals
US11612444B2 (en) 2017-12-28 2023-03-28 Cilag Gmbh International Adjustment of a surgical device function based on situational awareness
US11678927B2 (en) 2018-03-08 2023-06-20 Cilag Gmbh International Detection of large vessels during parenchymal dissection using a smart blade
US11464532B2 (en) 2018-03-08 2022-10-11 Cilag Gmbh International Methods for estimating and controlling state of ultrasonic end effector
US11617597B2 (en) 2018-03-08 2023-04-04 Cilag Gmbh International Application of smart ultrasonic blade technology
US11839396B2 (en) 2018-03-08 2023-12-12 Cilag Gmbh International Fine dissection mode for tissue classification
US11298148B2 (en) 2018-03-08 2022-04-12 Cilag Gmbh International Live time tissue classification using electrical parameters
US11844545B2 (en) 2018-03-08 2023-12-19 Cilag Gmbh International Calcified vessel identification
US11534196B2 (en) 2018-03-08 2022-12-27 Cilag Gmbh International Using spectroscopy to determine device use state in combo instrument
US11259830B2 (en) 2018-03-08 2022-03-01 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
US11317937B2 (en) 2018-03-08 2022-05-03 Cilag Gmbh International Determining the state of an ultrasonic end effector
CN112055880A (en) * 2018-03-08 2020-12-08 爱惜康有限责任公司 Radio frequency energy device for delivering combined electrical signals
US11589915B2 (en) 2018-03-08 2023-02-28 Cilag Gmbh International In-the-jaw classifier based on a model
US11337746B2 (en) 2018-03-08 2022-05-24 Cilag Gmbh International Smart blade and power pulsing
US11344326B2 (en) 2018-03-08 2022-05-31 Cilag Gmbh International Smart blade technology to control blade instability
US11389188B2 (en) 2018-03-08 2022-07-19 Cilag Gmbh International Start temperature of blade
US11399858B2 (en) 2018-03-08 2022-08-02 Cilag Gmbh International Application of smart blade technology
US11707293B2 (en) 2018-03-08 2023-07-25 Cilag Gmbh International Ultrasonic sealing algorithm with temperature control
US11701162B2 (en) 2018-03-08 2023-07-18 Cilag Gmbh International Smart blade application for reusable and disposable devices
US11701139B2 (en) 2018-03-08 2023-07-18 Cilag Gmbh International Methods for controlling temperature in ultrasonic device
US11678901B2 (en) 2018-03-08 2023-06-20 Cilag Gmbh International Vessel sensing for adaptive advanced hemostasis
US11457944B2 (en) 2018-03-08 2022-10-04 Cilag Gmbh International Adaptive advanced tissue treatment pad saver mode
US11471156B2 (en) 2018-03-28 2022-10-18 Cilag Gmbh International Surgical stapling devices with improved rotary driven closure systems
US11129611B2 (en) 2018-03-28 2021-09-28 Cilag Gmbh International Surgical staplers with arrangements for maintaining a firing member thereof in a locked configuration unless a compatible cartridge has been installed therein
US11589865B2 (en) 2018-03-28 2023-02-28 Cilag Gmbh International Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems
US11937817B2 (en) 2018-03-28 2024-03-26 Cilag Gmbh International Surgical instruments with asymmetric jaw arrangements and separate closure and firing systems
US11259806B2 (en) 2018-03-28 2022-03-01 Cilag Gmbh International Surgical stapling devices with features for blocking advancement of a camming assembly of an incompatible cartridge installed therein
US11219453B2 (en) 2018-03-28 2022-01-11 Cilag Gmbh International Surgical stapling devices with cartridge compatible closure and firing lockout arrangements
US11090047B2 (en) 2018-03-28 2021-08-17 Cilag Gmbh International Surgical instrument comprising an adaptive control system
US11213294B2 (en) 2018-03-28 2022-01-04 Cilag Gmbh International Surgical instrument comprising co-operating lockout features
US11207067B2 (en) 2018-03-28 2021-12-28 Cilag Gmbh International Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing
US10973520B2 (en) 2018-03-28 2021-04-13 Ethicon Llc Surgical staple cartridge with firing member driven camming assembly that has an onboard tissue cutting feature
US11406382B2 (en) 2018-03-28 2022-08-09 Cilag Gmbh International Staple cartridge comprising a lockout key configured to lift a firing member
US11197668B2 (en) 2018-03-28 2021-12-14 Cilag Gmbh International Surgical stapling assembly comprising a lockout and an exterior access orifice to permit artificial unlocking of the lockout
US11278280B2 (en) 2018-03-28 2022-03-22 Cilag Gmbh International Surgical instrument comprising a jaw closure lockout
US11166716B2 (en) 2018-03-28 2021-11-09 Cilag Gmbh International Stapling instrument comprising a deactivatable lockout
US11931027B2 (en) 2018-03-28 2024-03-19 Cilag Gmbh Interntional Surgical instrument comprising an adaptive control system
US11096688B2 (en) 2018-03-28 2021-08-24 Cilag Gmbh International Rotary driven firing members with different anvil and channel engagement features
US11510720B2 (en) 2018-09-07 2022-11-29 Cilag Gmbh International Managing simultaneous monopolar outputs using duty cycle and synchronization
US11696790B2 (en) 2018-09-07 2023-07-11 Cilag Gmbh International Adaptably connectable and reassignable system accessories for modular energy system
US11712280B2 (en) 2018-09-07 2023-08-01 Cilag Gmbh International Passive header module for a modular energy system
US11350978B2 (en) 2018-09-07 2022-06-07 Cilag Gmbh International Flexible neutral electrode
US11931089B2 (en) 2018-09-07 2024-03-19 Cilag Gmbh International Modular surgical energy system with module positional awareness sensing with voltage detection
US11666368B2 (en) 2018-09-07 2023-06-06 Cilag Gmbh International Method for constructing and using a modular surgical energy system with multiple devices
US11471206B2 (en) 2018-09-07 2022-10-18 Cilag Gmbh International Method for controlling a modular energy system user interface
US11923084B2 (en) 2018-09-07 2024-03-05 Cilag Gmbh International First and second communication protocol arrangement for driving primary and secondary devices through a single port
US11684400B2 (en) 2018-09-07 2023-06-27 Cilag Gmbh International Grounding arrangement of energy modules
US11684401B2 (en) 2018-09-07 2023-06-27 Cilag Gmbh International Backplane connector design to connect stacked energy modules
US11678925B2 (en) 2018-09-07 2023-06-20 Cilag Gmbh International Method for controlling an energy module output
US11918269B2 (en) 2018-09-07 2024-03-05 Cilag Gmbh International Smart return pad sensing through modulation of near field communication and contact quality monitoring signals
US11638602B2 (en) 2018-09-07 2023-05-02 Cilag Gmbh International Coordinated stackable multi-module surgical system
US11696791B2 (en) 2018-09-07 2023-07-11 Cilag Gmbh International Surgical instrument utilizing drive signal to power secondary function
US11804679B2 (en) 2018-09-07 2023-10-31 Cilag Gmbh International Flexible hand-switch circuit
US11806062B2 (en) 2018-09-07 2023-11-07 Cilag Gmbh International Surgical modular energy system with a segmented backplane
WO2020051448A1 (en) * 2018-09-07 2020-03-12 Ethicon Llc Energy module for driving multiple energy modalities through a port
US11696789B2 (en) 2018-09-07 2023-07-11 Cilag Gmbh International Consolidated user interface for modular energy system
US11628006B2 (en) 2018-09-07 2023-04-18 Cilag Gmbh International Method for energy distribution in a surgical modular energy system
US11896279B2 (en) 2018-09-07 2024-02-13 Cilag Gmbh International Surgical modular energy system with footer module
US11786296B2 (en) 2019-02-15 2023-10-17 Accularent, Inc. Instrument for endoscopic posterior nasal nerve ablation
US11331101B2 (en) 2019-02-19 2022-05-17 Cilag Gmbh International Deactivator element for defeating surgical stapling device lockouts
US11259807B2 (en) 2019-02-19 2022-03-01 Cilag Gmbh International Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device
US11291445B2 (en) 2019-02-19 2022-04-05 Cilag Gmbh International Surgical staple cartridges with integral authentication keys
US11298130B2 (en) 2019-02-19 2022-04-12 Cilag Gmbh International Staple cartridge retainer with frangible authentication key
US11331100B2 (en) 2019-02-19 2022-05-17 Cilag Gmbh International Staple cartridge retainer system with authentication keys
US11272931B2 (en) 2019-02-19 2022-03-15 Cilag Gmbh International Dual cam cartridge based feature for unlocking a surgical stapler lockout
US11751872B2 (en) 2019-02-19 2023-09-12 Cilag Gmbh International Insertable deactivator element for surgical stapler lockouts
US11925350B2 (en) 2019-02-19 2024-03-12 Cilag Gmbh International Method for providing an authentication lockout in a surgical stapler with a replaceable cartridge
US11298129B2 (en) 2019-02-19 2022-04-12 Cilag Gmbh International Method for providing an authentication lockout in a surgical stapler with a replaceable cartridge
US11517309B2 (en) 2019-02-19 2022-12-06 Cilag Gmbh International Staple cartridge retainer with retractable authentication key
US11291444B2 (en) 2019-02-19 2022-04-05 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a closure lockout
US11464511B2 (en) 2019-02-19 2022-10-11 Cilag Gmbh International Surgical staple cartridges with movable authentication key arrangements
US11369377B2 (en) 2019-02-19 2022-06-28 Cilag Gmbh International Surgical stapling assembly with cartridge based retainer configured to unlock a firing lockout
US11357503B2 (en) 2019-02-19 2022-06-14 Cilag Gmbh International Staple cartridge retainers with frangible retention features and methods of using same
US11317915B2 (en) 2019-02-19 2022-05-03 Cilag Gmbh International Universal cartridge based key feature that unlocks multiple lockout arrangements in different surgical staplers
US11743665B2 (en) 2019-03-29 2023-08-29 Cilag Gmbh International Modular surgical energy system with module positional awareness sensing with time counter
US11218822B2 (en) 2019-03-29 2022-01-04 Cilag Gmbh International Audio tone construction for an energy module of a modular energy system
US11534235B2 (en) 2019-04-04 2022-12-27 Acclarent, Inc. Needle instrument for posterior nasal neurectomy ablation
US11247063B2 (en) 2019-04-11 2022-02-15 Btl Healthcare Technologies A.S. Methods and devices for aesthetic treatment of biological structures by radiofrequency and magnetic energy
US11484725B2 (en) 2019-04-11 2022-11-01 Btl Medical Solutions A.S. Methods and devices for aesthetic treatment of biological structures by radiofrequency and magnetic energy
USD964564S1 (en) 2019-06-25 2022-09-20 Cilag Gmbh International Surgical staple cartridge retainer with a closure system authentication key
USD952144S1 (en) 2019-06-25 2022-05-17 Cilag Gmbh International Surgical staple cartridge retainer with firing system authentication key
USD950728S1 (en) 2019-06-25 2022-05-03 Cilag Gmbh International Surgical staple cartridge
USD928725S1 (en) 2019-09-05 2021-08-24 Cilag Gmbh International Energy module
USD924139S1 (en) 2019-09-05 2021-07-06 Ethicon Llc Energy module with a backplane connector
US11950823B2 (en) 2019-09-05 2024-04-09 Cilag Gmbh International Regional location tracking of components of a modular energy system
USD939545S1 (en) 2019-09-05 2021-12-28 Cilag Gmbh International Display panel or portion thereof with graphical user interface for energy module
USD928726S1 (en) 2019-09-05 2021-08-24 Cilag Gmbh International Energy module monopolar port
US11806528B2 (en) 2020-05-04 2023-11-07 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11679255B2 (en) 2020-05-04 2023-06-20 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11491329B2 (en) 2020-05-04 2022-11-08 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11633596B2 (en) 2020-05-04 2023-04-25 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11813451B2 (en) 2020-05-04 2023-11-14 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11826565B2 (en) 2020-05-04 2023-11-28 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11878167B2 (en) 2020-05-04 2024-01-23 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient
US11950832B2 (en) 2021-03-22 2024-04-09 Medtronic Xomed, Inc. Interface module for use with nerve monitoring and electrosurgery
US11857252B2 (en) 2021-03-30 2024-01-02 Cilag Gmbh International Bezel with light blocking features for modular energy system
US11950860B2 (en) 2021-03-30 2024-04-09 Cilag Gmbh International User interface mitigation techniques for modular energy systems
US11896816B2 (en) 2021-11-03 2024-02-13 Btl Healthcare Technologies A.S. Device and method for unattended treatment of a patient

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