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WO1993004635A1 - Bistouri cauterisant pour fascias - Google Patents

Bistouri cauterisant pour fascias Download PDF

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Publication number
WO1993004635A1
WO1993004635A1 PCT/US1992/007512 US9207512W WO9304635A1 WO 1993004635 A1 WO1993004635 A1 WO 1993004635A1 US 9207512 W US9207512 W US 9207512W WO 9304635 A1 WO9304635 A1 WO 9304635A1
Authority
WO
WIPO (PCT)
Prior art keywords
blade
shaft
slot
fascia
distal
Prior art date
Application number
PCT/US1992/007512
Other languages
English (en)
Inventor
Craig B. Mizes
Wayne A. Noda
Original Assignee
Laparomed Corporation
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 Laparomed Corporation filed Critical Laparomed Corporation
Priority to EP92919699A priority Critical patent/EP0603289A4/fr
Publication of WO1993004635A1 publication Critical patent/WO1993004635A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • 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
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00184—Moving parts
    • A61B2018/00196—Moving parts reciprocating lengthwise

Definitions

  • the present invention relates generally to the structure and use of surgical instruments, and more particularly, to a device and method for enlarging abdominal penetrations by the controlled cutting of the fascia transversalis.
  • Least invasive surgical (LIS) techniques such as laparoscopic, endoscopic, and arthroscopic surgery, are generally performed through small incisions using specialized instruments to perform desired surgical procedures. Usually the instruments are introduced through a tube, such as a cannula, while the physician observes manipulation of the instruments through specialized imaging equipment, such as a laparoscopes, endoscopes, and arthroscopes.
  • LIS techniques offer significant advantages over conventional "open" surgical procedures. In particular, the LIS techniques are usually less traumatic, require a shorter recovery time, and are less costly than the corresponding conventional surgical techniques.
  • laparoscopic cholecystectomy procedures where the gallbladder is surgically severed and withdrawn through a small cannula, typically having a diameter of about 10 mm. While such procedures have been very successful and have become increasingly common, complications sometimes arise when the gallbladder is enlarged or contains gallstones which are too large to be withdrawn through the cannula. In such cases, it is frequently necessary to remove the cannula and to enlarge the abdominal penetration, typically by making one or more incisions at the penetration using a scalpel or other conventional cutting blade. The ability to surgically enlarge the penetration, however is problematic.
  • the surgeon must hold onto the gallbladder, and great care must be taken to avoid losing the gallbladder, cutting the gallbladder with the scalpel, or otherwise causing the gallbladder to spill its contents within the abdomen. Loss of the contents of the gallbladder into the abdomen is problematic, often causing bile septicemia.
  • fascia transversalis which is a sheet of tough, fibrous material that envelops the body beneath the skin. It is the fascia transversalis which provides the primary barrier or resistance when making any abdominal incision or penetration. While the resistance is not a particular problem when an initial penetration is made using a needle, trocar, or other instrument, enlargement of an initial hole is problematic.
  • the fascia transversalis lies beneath the skin, a superficial fascial layer, and the rectus muscle, thus making access quite limited.
  • U. S. Patent No. 3,815,604 describes a device for intraocular surgery comprising an outer tube having an aperture and an inner tubular blade which can be advanced to sever material penetrating the aperture.
  • U. S. Patent Nos. 1,978,495; 1,881,250; 1,798,902; and 1,683,708, describe electrosurgical instruments comprising a blade which reciprocates in an enclosed ring. The instruments are intended for removing tonsils, where the tonsils are captured by the ring, and the blade advanced within the ring to sever the tonsils.
  • U. S. Patent No. 749,689 describes a surgical instrument with an actuable blade.
  • 1,731,069 describe surgical instruments having actuable components at their distal ends.
  • the present invention comprises a novel device and method for cutting and enlarging fascial penetrations during surgical procedures, such as laparoscopic cholecystectomy.
  • the device and method permit the surgeon to locate the fascial layer "by feel" as the device is introduced through a previously formed narrow diameter abdominal penetration. Once the fascial layer has been located, the device can be readily positioned to make a first cut. The first cut can be lengthened by making successive cuts in the same direction. Alternatively, a series of radially spaced-apart incisions can be formed about the periphery of the hole through the fascial layer. In this way, the fascial penetration, which is the primary barrier to intra- abdominal access, can be enlarged with minimum risk of injury to surrounding tissues and structures.
  • the device of the present invention comprises an elongate shaft having a U-shaped transversely oriented slot at its distal end.
  • a blade having a generally transverse cutting edge is mounted to axially reciprocate within the slot, and a means for manually reciprocating the blade is provided at the proximal end of the shaft.
  • An electrical connector is optionally provided to permit connection of the cutting blade to conventional electrosurgical power supply, allowing the surgeon to optionally perform cauterization following (or simultaneously with) each incision.
  • reciprocating means is not critical, but the reciprocating means will usually comprise a conventional three-ring actuator, lever grip, or the like.
  • the dimensions of the device are preferably selected to permit controlled cutting of the fascial penetration, where the initial abdominal penetration was made to receive a 5 mm or 10 mm cannula.
  • the width of the shaft (along the distal end which will be inserted into the abdominal penetration) will be 10 mm or less, preferably being 7 mm or less, and more preferably being about 5 mm or less, at least over the distal 5 cm of its length.
  • the length of the slot in the axial direction will be sufficient to receive the thickness of the fascial layer, typically being in the range from about 3 mm to 5 mm.
  • the depth of the transverse slot will be selected to provide a. desired depth of cut, typically being in the range from 2 mm to 6 mm.
  • the shaft is inserted into a previously formed abdominal penetration until the surgeon can feel the distal tip of the shaft reach the fascial layer.
  • the shaft is then manipulated so that the fascial layer is received within the slot, and the surgeon can then make a first incision by actuating the blade using the manual actuating means.
  • the incision is cauterized by applying current through the electrosurgical power supply.
  • the surgeon will make a series of incremental cuts in a single direction from the preexisting hole, resulting in an enlarged penetration.
  • the enlarged penetration will be used to remove an enlarged gallbladder or a gallbladder containing oversized gallstones as part of a laparoscopic cholecystectomy procedure.
  • FIG. 1 is a perspective view of a fascial cutter device constructed in accordance with the principles of the present invention.
  • Fig. 2 is a side elevational view of the fascial cutter of Fig. 1, shown in section.
  • FIG. 3 illustrates an alternate blade configuration which could be employed with the fascial cutter of Fig. 1.
  • Figs. 4 and 5 illustrate alternate blade actuating means comprising a lever grip handle.
  • Figs. 6A-6C illustrate the method of the present invention for enlarging a penetration through the fascia transversalis in the abdomen. DESCRIPTION OF THE SPECIFIC EMBODIMENTS
  • the fascia cutter of the present invention comprises an elongate shaft having proximal and distal ends and a U-shaped slot near its distal end.
  • the blade having a generally transverse cutting edge, is reciprocatably mounted within the shaft so that it can be axially translated through the slot.
  • the blade will be axially advanced in the distal direction, but there is no reason why the design of the device could not be modified to permit the blade to be advanced in the proximal direction.
  • a means for manually reciprocating the blade is provided at the proximal end of the shaft, and the device will be used by introducing the distal.end of the shaft through a previously formed abdominal penetration and engaging the slot about an edge of a fascial layer, usually the fascia transversalis.
  • the blade can then be reciprocated to make one or more successive radial incisions in a single direction in the periphery of the previously formed hole through the fascial layer.
  • the shaft of the fascia cutter will typically be tubular, but could have other cross-sectional geometries, such as rectangular, polygonal, irregular, or the like.
  • the distal portion of the shaft must have a maximal dimension (in any direction) which permits easy introduction of the shaft into the previously formed abdominal penetrations.
  • the maximal dimension i»e. , diameter in the case of tubular shafts
  • the narrow width of the shaft will usually be maintained along its entire length, but there is no reason why a proximal portion of the shaft cannot be enlarged.
  • the narrow dimension of the shaft be maintained over a distal length sufficient to permit introduction of the shaft to a desired depth, usually being at least 5 cm, preferably being at least 3 cm.
  • the dimensions of the transverse slot are more critical.
  • the slot should have a sufficient axial length to permit receiving of the fascial layer, typically being from 3 mm to 5 mm in axial length, although in some embodiments being 10 mm or longer in the axial direction.
  • the depth of the slot will be selected to provide the desired depth of the cut when the blade is actuated, usually being from 1 mm to 6 mm, preferably being from 2 mm to 5 mm.
  • the slot will be located at or near the distal tip of the shaft, preferably being within 5 mm of the distal tip, more preferably being within 2 mm of the distal tip. In some embodiments, however, the device may employ a more tapered blade which necessitates that the axial slot be moved proximally from the distal tip of the shaft (See Fig. 3 and the accompanying description hereinbelow) .
  • the shaft will be substantially rigid, usually being formed from a metal or rigid plastic. Conveniently, the shaft may be formed from surgical stainless steel. The entire device will usually be disposable, but it will be possible to construct reuseable (sterilizable) devices having a replaceable 5 cutting blade.
  • the blade will be similar to conventional surgical scalpel blades. It is possible, although not necessary, to construct the device to receive and utilize conventional scalpel blades. Preferably, the device will
  • the cutting edge of the cutting blade will be oriented transversely to the axis of the elongate shaft. By transverse, it is meant that the cutting edge of the
  • the blade will be able to cut through the fascial layer as the blade is axially advanced.
  • the blade is oriented at an angle in the range from about 75° to 90° relative to the axis of the shaft. Such a blade orientation is utilized when the
  • shaft will have a blunt (non-tapered) end as illustrated in Figs. 1 and 2.
  • the cutting edge of the blade can be tapered, as illustrated in Fig. 3, in which case the distal tip of the shaft will usually be tapered to accommodate the blade.
  • Such tapered blades will be
  • Fascia cutter 10 comprises an elongate shaft 12 having a distal end 14 and a proximal end 16.
  • transversely oriented slot 18 is formed near the distal end 14 of the shaft 12.
  • a cutting blade 20 slidably mounted within an axial lumen 22 of the shaft and connected to a rod assembly 24.
  • the rod assembly 24 includes a reduced diameter region 26 which passes through a flange 30 formed in the lumen of the shaft 12.
  • a spring 28 is received on the reduced diameter region 26 and abuts the flange 30 so that it is compressed as the rod assembly 24 is advanced distally, as described in more detail below. In this way, the blade 20 can be axially advanced by pressing on the end of the rod assembly 24 against the force provided by spring 28.
  • a three-ring actuator is provided on the elongate shaft 12.
  • Radially opposed side rings 40 and 42 are mounted on the shaft 12 itself, while the third ring 34 is secured to the proximal end of the rod assembly 34. In this way, the surgeon can hold the device in one hand with a pair of fingers inserted through rings 40 and 42 and a thumb inserted through ring 44. The surgeon can then manually actuate the blade 20 simply by manually depressing the third ring 44. As illustrated in Figs. 1 and 2, the distal end 14 of the shaft 12 is blunt (non-tapered) and the slot 18 is located very close to the distal tip. Such a blade and tip design is desirable since it permits the surgeon to locate the fascial layer with the tip, and only minor manipulation is necessary to engage the slot 18 through the previously formed hole in the fascial layer.
  • Blade 20• has a tapered cutting edge 50.
  • Distal end 14' of the shaft must similarly be tapered in order to accommodate full advancement of the blade 20'. While the embodiment of Fig. 3 may be slightly more difficult to position than the embodiment of Figs. 1 and 2, the tapered nature of the blade 20' may enhance the cutting ability.
  • An electrical connector 60 is attached to the proximal end of the rod assembly 24.
  • the rod assembly 24 will be electrically conductive, or include a separate wire connector, so that a conductive path is provided between the connector 60 and the blade 20.
  • Connector 60 extends outward through an elongate slot 62 in the shaft 12. In this way, the connector 60 can reciprocate back and forth within the slot 62 as the blade 20 is being advanced and retracted.
  • the connector 60 is suitable for coupling the device 10 to a conventional electrosurgical power supply.
  • Such power supplies are available from commercial suppliers, such as Valleylab, Inc. (a Pfizer Co.), Boulder, Colorado; Aspen Labs, Inc. (a Conmed Co.), Englewood, Colorado; and Birtcher Corp. , Irvine,
  • the cutting blade 22 can thus be used for monopolar cauterization in a conventional manner.
  • FIG. 4 and 5 illustrates a conventional type of lever grip actuator assembly.
  • a fascia cutter 70 comprises a shaft 72 having an integral handle structure 74.
  • a transverse slot 76 is formed near the distal end 78 of the shaft 72, and a blade 80 is mounted to reciprocate past the slot.
  • Blade 80 is connected to a rod 84 which extends into a hollow cavity 86 formed in the handle 74.
  • a lever 86 is pivotally mounted on pin 88 connected to a proximal end of rod 84 by pin 90.
  • a spring 92 is mounted within the handle, so that the spring is compressed when the lever 86 is pulled into the handle 74 (i.e., when the blade 80 is advanced) . In this way, the blade 80 can be axially advanced in the distal direction and will return to its retracted position under the force of spring 92.
  • Fig. 5 is similar in most respects to that of Fig. 4, with identical components being given the same reference numbers.
  • the primary difference in the embodiment of Fig. 5 is that a spring 94 is connected between the proximal end of rod 84 and a fixed pin 96 within the handle 74.
  • spring 94 will be extended.
  • the spring 94 will thus be able to retract the blade 80 in a manner similar to spring 92 of the embodiment of Fig. 4.
  • a cannula 100 will have been previously placed through an abdominal penetration.
  • the cannula extends through the skin S (dermis) , superficial fascia SF, rectus muscle RM, fascia transversalis FT, and the peritoneum P.
  • the method of the present invention is intended to enlarge the penetration which has already been formed in the fascia transversalis FT.
  • the cannula 100 will have a diameter of about 10 mm, and it will be desired to enlarge the abdominal penetration (particularly the hole through the fascia transversalis) to a size in the range from about 12 mm to 20 mm.
  • the shaft 12 of the device 10 of the present invention is inserted through the skin S, superficial fascia SF, and rectus muscle RM, until the distal tip of the shaft engages the fascia transversalis FT.
  • the fascia transversalis is much more resistant to penetration than the other layers, and the surgeon will be able to feel when the tip of the shaft initially encounters the fascia transversalis. At that point, shaft 12 will be in the position illustrated in Fig. 6B.
  • the surgeon next manipulates the distal end of shaft 12 until the edge of the fascia transversalis FT is received into the transverse slot 18 of the shaft 12.
  • the surgeon will be able to confirm that the fascia has been engaged by feeling resistance in both directions as the shaft is urged up and down within the penetration.
  • the blade 20 can be manually reciprocated by the surgeon so that an initial radial incision is formed in the periphery of the hole.
  • the incision can then be lengthened by making a series of successive (incremental) cuts in generally the same direction as the initial cut.
  • the shaft 12 may then be withdrawn and the enlarged penetration is available for a variety of procedures.
  • the enlarged penetration may facilitate removal of relatively large body parts or organs, such as removal of the gallbladder.
  • the shaft 12 of the device 10 may be introduced after the gallbladder has been partially withdrawn through an abdominal penetration, typically using forceps after the cannula has been removed.
  • the shaft 12 may be introduced down alongside the gallbladder which has been partially withdrawn, frequently after removal of the gallbladder has proven difficult. In this way, the penetration through the fascial layer can be enlarged during the course of a laparoscopic cholecystectomy.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

Un bistouri (10) pour fascias comprend un tube (12) présentant une fente transversale (18) à son extrémité distale (14). La lame (20) est montée de manière à effectuer un va-et-vient à l'intérieur du tube (12), de manière qu'elle peut être avancée axialement dans la fente (18). Une tige (24) faisant aller et venir manuellement la lame (20) est ménagée sur l'extrémité proximale (16) du tube. Le bistouri (10) pour fascias est utile pour agrandir des ouvertures abdominales formées préalablement, dans lesquelles on insère ledit tube (12), la fente (18) venant se positionner autour du bord du fascia, une incision radiale étant effectuée dans ce dernier.
PCT/US1992/007512 1991-09-10 1992-09-02 Bistouri cauterisant pour fascias WO1993004635A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP92919699A EP0603289A4 (fr) 1991-09-10 1992-09-02 Bistouri cauterisant pour fascias.

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US75717091A 1991-09-10 1991-09-10
US757,170 1991-09-10

Publications (1)

Publication Number Publication Date
WO1993004635A1 true WO1993004635A1 (fr) 1993-03-18

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ID=25046675

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1992/007512 WO1993004635A1 (fr) 1991-09-10 1992-09-02 Bistouri cauterisant pour fascias

Country Status (2)

Country Link
EP (1) EP0603289A4 (fr)
WO (1) WO1993004635A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5681337A (en) * 1995-06-07 1997-10-28 Bray Jr.; Robert S. Bone shaver
WO2000025691A1 (fr) * 1998-10-30 2000-05-11 Karl Storz Gmbh & Co. Kg Instrument medical pour preparer des tissus
WO2011160101A1 (fr) * 2010-06-18 2011-12-22 Linvatec Corporation Coupe-fils jetable

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US769829A (en) * 1904-05-04 1904-09-13 Irvine K Mott Surgical instrument.
US1881250A (en) * 1929-06-20 1932-10-04 Tomlinson George Milton Electrosurgical instrument
US1978495A (en) * 1927-10-08 1934-10-30 Firm Elek Citatsgesellschaft S Medical instrument
US3606878A (en) * 1968-10-04 1971-09-21 Howard B Kellogg Jr Needle instrument for extracting biopsy sections
US4622966A (en) * 1981-06-30 1986-11-18 Abbott Laboratories Surgical cutting device
US4669469A (en) * 1986-02-28 1987-06-02 Devices For Vascular Intervention Single lumen atherectomy catheter device
US4784137A (en) * 1987-11-16 1988-11-15 Kulik Yaroslav P Surgical suturing instrument
US5009661A (en) * 1989-04-24 1991-04-23 Michelson Gary K Protective mechanism for surgical rongeurs
US5089000A (en) * 1987-09-18 1992-02-18 John M. Agee Surgical method and instrument therefor
US5092873A (en) * 1990-02-28 1992-03-03 Devices For Vascular Intervention, Inc. Balloon configuration for atherectomy catheter
US5106364A (en) * 1989-07-07 1992-04-21 Kabushiki Kaisha Topcon Surgical cutter

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3802074A (en) * 1971-05-21 1974-04-09 C Hoppe Surgical suture extractor
DE2737014A1 (de) * 1977-08-17 1979-03-01 Wolf Gmbh Richard Endoskop zum aufschlitzen von harnroehren-strikturen
DE3231127A1 (de) * 1982-08-21 1984-02-23 Olympus Winter & Ibe GmbH, 2000 Hamburg Strikturskalpell mit leitkatheter
DE3403962A1 (de) * 1984-02-04 1985-08-08 Olympus Winter & Ibe GmbH, 2000 Hamburg Stichkanalvorbereitungsgeraet fuer die perkutane nephroskopie
DE3917328A1 (de) * 1989-05-27 1990-11-29 Wolf Gmbh Richard Bipolares koagulationsinstrument
US5029573A (en) * 1990-03-30 1991-07-09 Chow James C System for endoscopic surgery

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US769829A (en) * 1904-05-04 1904-09-13 Irvine K Mott Surgical instrument.
US1978495A (en) * 1927-10-08 1934-10-30 Firm Elek Citatsgesellschaft S Medical instrument
US1881250A (en) * 1929-06-20 1932-10-04 Tomlinson George Milton Electrosurgical instrument
US3606878A (en) * 1968-10-04 1971-09-21 Howard B Kellogg Jr Needle instrument for extracting biopsy sections
US4622966A (en) * 1981-06-30 1986-11-18 Abbott Laboratories Surgical cutting device
US4669469A (en) * 1986-02-28 1987-06-02 Devices For Vascular Intervention Single lumen atherectomy catheter device
US5089000A (en) * 1987-09-18 1992-02-18 John M. Agee Surgical method and instrument therefor
US4784137A (en) * 1987-11-16 1988-11-15 Kulik Yaroslav P Surgical suturing instrument
US5009661A (en) * 1989-04-24 1991-04-23 Michelson Gary K Protective mechanism for surgical rongeurs
US5106364A (en) * 1989-07-07 1992-04-21 Kabushiki Kaisha Topcon Surgical cutter
US5092873A (en) * 1990-02-28 1992-03-03 Devices For Vascular Intervention, Inc. Balloon configuration for atherectomy catheter

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP0603289A4 *

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5681337A (en) * 1995-06-07 1997-10-28 Bray Jr.; Robert S. Bone shaver
WO2000025691A1 (fr) * 1998-10-30 2000-05-11 Karl Storz Gmbh & Co. Kg Instrument medical pour preparer des tissus
US6387094B1 (en) 1998-10-30 2002-05-14 Karl Storz Gmbh & Co. Kg Medical instrument for dissecting tissue
WO2011160101A1 (fr) * 2010-06-18 2011-12-22 Linvatec Corporation Coupe-fils jetable
US8597307B2 (en) 2010-06-18 2013-12-03 Linvatec Corporation Disposable suture cutter

Also Published As

Publication number Publication date
EP0603289A4 (fr) 1995-02-22
EP0603289A1 (fr) 1994-06-29

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