WO2001008572A1 - Systeme de canule permettant l'introduction d'instruments endoscopiques dans un corps humain ou animal - Google Patents

Systeme de canule permettant l'introduction d'instruments endoscopiques dans un corps humain ou animal Download PDF

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Publication number
WO2001008572A1
WO2001008572A1 PCT/EP2000/007242 EP0007242W WO0108572A1 WO 2001008572 A1 WO2001008572 A1 WO 2001008572A1 EP 0007242 W EP0007242 W EP 0007242W WO 0108572 A1 WO0108572 A1 WO 0108572A1
Authority
WO
WIPO (PCT)
Prior art keywords
cannula
stylet
hollow
arrangement according
hollow cannula
Prior art date
Application number
PCT/EP2000/007242
Other languages
German (de)
English (en)
Inventor
Norbert Heske
Thomas Heske
Original Assignee
Norbert Heske
Thomas Heske
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
Priority claimed from DE1999135976 external-priority patent/DE19935976A1/de
Application filed by Norbert Heske, Thomas Heske filed Critical Norbert Heske
Priority to AU64388/00A priority Critical patent/AU6438800A/en
Publication of WO2001008572A1 publication Critical patent/WO2001008572A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3476—Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3474—Insufflating needles, e.g. Veress needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A61B2017/3458—Details of tips threaded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
    • A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
    • A61B2017/349—Trocar with thread on outside
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0043—Catheters; Hollow probes characterised by structural features
    • A61M2025/006—Catheters; Hollow probes characterised by structural features having a special surface topography or special surface properties, e.g. roughened or knurled surface

Definitions

  • Cannula assembly for introducing endoscopic instruments into a human or animal body
  • the invention relates to a cannula arrangement for introducing endoscopic instruments into a human or animal body with a hollow cannula which forms a through-channel into intracorpular areas after penetration of skin layers, and with a stylet which can be inserted into the hollow cannula.
  • endoscopic and endosurgical instruments In the field of minimally invasive surgery, a variety of surgical procedures are performed using endoscopic and endosurgical instruments. In order to reach the area to be operated on inside the body with the endoscopic instruments, hollow cannulas are inserted through the skin layers, which serve as working channels for the introduction of endoscopic surgical instruments and the like into the inside of the body.
  • Previously known hollow cannulas have a cutting tip at their distal end with which they literally cut through the tissue to be penetrated.
  • this is locally cut with a scalpel knife to create an insertion opening.
  • the distal, pointed end is now pushed axially into the inside of the body, causing the Cutting tip cuts through vessels, nerves, muscle fibers during insertion. This primarily causes bleeding, which complicates the surgical procedure.
  • stronger scarring forms which lead to increased sensitivity to the weather or other side effects associated with pain.
  • the abdominal wall is also subjected to considerable stretching loads, which can be associated with traumatic tissue irritation.
  • the indentations caused by the insertion process of the hollow cannula in the abdominal wall can lead to strong compressions on the internal organs, for example on the intestinal loops, as a result of which internal organs can be severely affected. Bleeding within the inner abdomen can also not be ruled out when using known hollow cannulas with the described surgical techniques into the interior of the body.
  • the known hollow cannulas usually designed with a smooth outer wall, cannot be fixed independently after being introduced into the interior of the body relative to the permeated skin layer.
  • endoscope instruments are used that are passed through the hollow cannula. There are constant relative movements between the hollow cannula and the permeated skin layer, which means that it is also subjected to strong mechanical loads during the operation.
  • the invention is based on the object of designing a cannula arrangement for introducing endoscopic instruments into a human or animal body with a hollow channel-like cannula which, after penetrating skin layers, forms a through channel into intracorporeal areas in such a way that during the introduction process into the interior of the body and also while performing endoscopic operations on the skin layer to be pierced or mechanical stresses affecting the body cover, which are associated with traumatic tissue irritation, should be decisively reduced.
  • the disadvantages occurring in the prior art are to be avoided.
  • a cannula arrangement for introducing endoscopic instruments into a human or animal body is designed with a hollow cannula that forms a through-channel into intracorpular areas after penetration of skin layers, and with a stylet that can be inserted into the hollow cannula in such a way that the hollow cannula has an outer wall with a helical circumferential helical contour coaxial to the cannula longitudinal axis, and that for penetrating the hollow cannula through the skin layers, the stylet is designed as a straight cylindrical stylet that has an outer contour that is adapted to the inner contour of the hollow cannula in such a way that the stylet can be pushed into the hollow cannula with a precise fit and has a distal end region with a tip, which is inscribed by a cone and from the tip of which a helical thread extends from the proximal side.
  • a hollow cannula which has a screw contour that lifts off its surface on the outer wall
  • a stylet which provides a conically tapering tip with screw thread at its distal end
  • the straight cylindrical stylet with its screw thread which in the manner of a corkscrew, essentially dilates the skin layers to the side without them injured by cuts.
  • the stylet works largely automatically distally into the tissue.
  • the length of the stylet is such that when the stylet is fully inserted into the hollow cannula, the conically tapering tip of the stylet protrudes completely at the distal end of the cannula.
  • the transition between the hollow cannula and the stylet is preferably without an intermediate gap, so that, with a corresponding penetration process through a skin layer, no tissue parts can get caught between the stylet and the hollow cannula.
  • the outer diameter of the stylet is matched to the inner diameter of the hollow cannula, on the other hand, the outer contour of the cannula in the distal region conforms continuously to the outer circumference of the stylet.
  • a corresponding recess is provided, into which a pin-like extension engages on the outer wall of the stylet and, with a corresponding rotation in one or the other direction, abuts an abutting edge provided in the recess.
  • the hollow cannula is also rotated when the stylet is rotated.
  • the pin-like extension on the proximal area of the stylet and the recess on the proximal end of the cannula are designed in such a way that in a direction of rotation in which the screw thread of the stylet and the hollow cannula can be screwed distally into a body cover, the screw thread at the distal transition from the cannula to Mandrin blends seamlessly.
  • an electric motor drive is preferably provided, which is designed as a hand-held device and has a rotary shaft, on which the stylet with its proximal end is connected via a plug-and-clamp connection is releasably fixed.
  • the electric motor drive can drive the stylet and the hollow cannula placed on it clockwise or anticlockwise via a corresponding toggle switch.
  • the abdominal wall is preferably locally scratched with a scalpel.
  • the screw contour on the distal tip of the stylet is able to insert the entire cannula arrangement through the abdominal wall in a self-propelling manner.
  • a particular advantage of the helically designed screw thread during the insertion process is the fact that tissue facing the tip of the mandrel is only displaced laterally while the tip moves forward on the distal side. This causes no or significantly less cuts in the tissue, which would prolong a subsequent healing process.
  • the advancement of the stylet and the hollow cannula sitting on the stylet does not take place, as previously, by axial pressure on the cannula arrangement, but only by the rotary movement by means of the electromotive hand-held device, whose rotational speed, which is preferably in the range between 0.1 and 10 revolutions per second, ensures self-propulsion of the cannula arrangement within the tissue. Also, due to the self-propulsion of the cannula arrangement, no adjacent organs are caused by deformation of the abdominal wall compresses or deforms, which is beneficial for performing a gentle operation.
  • Fig. 4 Alternative, hollow-channel-shaped cannula with an external thread and stylet with a tapered tip with an external thread
  • a hollow cannula 1 which has a basic shape in the form of a rectilinear hollow cylinder.
  • a screw thread 2 is provided on the outer wall of the hollow cannula 1 and rises from the outer wall 3 of the hollow cannula 1.
  • Tests on skin samples showed that the hollow cannula was formed Teflon enables the hollow cannula to glide smoothly through the skin layer.
  • the distal region of the hollow cannula 1 is cut off in a straight line and ends in a circular cannula edge 4, the distal wall thickness of which is thinned to a minimum.
  • the screw thread 2 ends at the cannula edge 4 immediately in unchanged form.
  • the cannula edge 4 can also have a transition area 4 'in the intermediate area between two screw threads.
  • a recess 5 is provided which is delimited by two stop edges 6, 7.
  • a sloping section S is provided between the stop edges 5, 6 in order to increase the distance between the stop edges 6, 7 and thus to provide an improved possibility of completely sinking the stylet into the hollow cannula - as will be described below.
  • a recess V can also be worked into the hollow cannula in the contour of the recess in the immediate vicinity of a stop edge in order to enable a locking, in which pin-like extension snaps into the recess.
  • Typical dimensions for the inner diameter d of the hollow cannula are between 4 and 25 mm.
  • the path difference h of the screw contour 2 is approximately between 3 and 8 mm.
  • the height a of the screw contour has typical values between 0.5 and 2 mm.
  • a recess 9 engages in the recess 5 and is provided at the proximal end of a stylet 8, which is shown in FIG. 1b.
  • the stylet 8 has a geometry attached to the inner contour of the hollow channel 1 and moreover provides at its distal end a tapered tip 10, on the outer contour of which a screw thread 11 is provided.
  • the cross section of the screw thread preferably has a sawtooth-like geometry 12, which is shown in the detailed illustration according to FIG. 1b.
  • the sawtooth-like structure has a sharp edge 13 with which the skin layer can be cut automatically. In this way it is ensured that the area of skin to be pierced is only cut or dilated to the extent that is so that the hollow cannula can be screwed into the inside of the body with its outer circumference.
  • the stylet 8 is preferably made of Teflon in order to improve the sliding properties.
  • a type of implant made of a harder material, for example made of metal, is preferably incorporated at the tip of the stylet 8 for reasons of improved penetration.
  • the proximal end of the stylet 8 has a bore 16 for plugging onto a rotary shaft 14, a rotating unit 15 (according to FIG. 2), which ensures that the stylet is detachably and firmly plugged onto the rotating unit 15.
  • the rotating unit 15 according to FIG. 2 is provided with a toggle switch 17 which, depending on the tilted position, ensures that the rotary shaft 14 rotates to the right or left.
  • a battery compartment which can be closed with a cover 18 is provided, as a result of which the rotary unit 15 can be used as a completely portable tool.
  • the stylet 8 placed on the rotary shaft 14 is secured with the aid of a snap ring (not shown in the figure) and ensures that the stylet 8 is pulled off the shaft 14 by means of a certain amount of force.
  • the hollow channel 1 is subsequently inserted over the stylet 8 until the pin-like extension 9 rests in the recess 5 on a stop edge 6, 7.
  • the hollow cannula 1 is also set in rotation, which bores into the interior of the body through appropriate skin layers.
  • the inner stylet 8 can be removed from the hollow channel.
  • the surgeon switches on the opposite direction of rotation on the handheld device, whereby the inner stylet is turned back without doing so
  • the reason for this is the size of the recess 5, ie in particular the spacing of the stop edges 6, 7.
  • the extension 9 runs from one stop edge 7 to the other stop edge 6, without causing the cannula 1 to rotate.
  • the stylet 8 After the stylet 8 has been completely retracted into the sleeve 1, it can be completely removed by pulling it longitudinally out of the cannula 1, wherein the cannula 1 can serve as a working channel for further endoscopic surgical measures.
  • Preferred materials for the stylet and sleeve are stainless steel or body-compatible plastics.
  • FIG. 1 A longitudinal section through a stylet 8 is shown in FIG.
  • the stylet 8 is penetrated lengthways by a hollow channel 19.
  • the hollow channel 19 opens into an opening 20 which is directed distally.
  • the hollow channel 19 opens laterally into an opening 21 which is not covered by the hollow cannula which is pushed over the stylet 8. This can also be seen from the fact that the opening 21 is arranged proximal to the pin-like extension 9. In principle, it is also possible to position the opening on the proximal end of the stylet 8.
  • a rotary coupling 23 in the manner of a rubber sleeve is provided in a gas-tight and rotatable manner around the outer wall of the stylet 8 at the level of the opening 21 in order to ensure a possibility of a gas supply through the hollow channel 19.
  • a supply line is provided on the rubber sleeve 23, which is connected to a gas supply 22, not shown in detail.
  • the hollow channel 19 is used for insufflation of the inside of the body, and on the other hand, the gas supply is used in particular for monitoring or checking whether the cannula arrangement, for example, during the penetration process into the tissue Has penetrated the abdominal wall and is located in an intracorporeal cavity.
  • a pressure sensor 25 for example in the form of a manometer, is provided in the gas supply line 24, on which the current pressure prevailing in the hollow channel 19 can be read.
  • the gas in the cavity cannot escape through the distal opening 20.
  • the gas escapes, as a result of which the gas pressure drops suddenly. The surgeon can observe this pressure drop on the manometer 25 and knows that, for example, he has completely penetrated the abdominal wall.
  • FIGS. 4 a and b show an alternative embodiment to the cannula with stylet shown in FIGS. 1 a, b.
  • the proximal end of the hollow cannula 1 has an internal thread 26, into the thread contour of which the pin extension 9 of the stylet 8 protrudes as soon as the stylet 8 is pushed sufficiently far into the hollow cannula 1 on the proximal side.
  • the thread contour serves the same purpose as the sloping section S and the stop edges 6, 7 in the embodiment according to FIG. 1.
  • the stylet 8 has a cutting thread 27 tapering to a distal tip, which, in contrast to the screw thread 11 according to FIG. Fig. 1 b provides a rectilinear, with an incline thread contour 28 which ends in a tip 29 which is not itself arranged centrally to the longitudinal axis of the stylet, but is oriented towards the longitudinal axis of the stylet.
  • This tip formation which faces the longitudinal axis of the stylet, ensures that the penetration process of the tip of the stylet 8, for example through a skin layer, is easier, i.e. takes place in a self-cutting manner and without exerting a large contact pressure on the skin layer to be penetrated.
  • the tip 29 can be made from the same material as the stylet 8 itself, for example from Teflon. However, better cutting effects can be achieved if the tip is made of cutting steel or a similar hard material as diamond.

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

Abstract

La présente invention concerne un système de canule permettant l'introduction d'instruments endoscopiques dans un corps humain ou animal. Ce système comprend une canule creuse (1) qui, après avoir traversé les couches de la peau, forme un canal de passage à l'intérieur du corps, ainsi qu'un mandrin (8) qui peut être introduit dans ladite canule creuse (1). Cette invention se caractérise en ce que la canule creuse (1) présente une paroi extérieure (3) dont le contour de vis coaxial entoure de façon hélicoïdale l'axe longitudinal de canule et en ce que le mandrin (8) est conçu sous forme de cylindre droit, afin de faire passer la canule creuse (1) à travers les couches de la peau. Le mandrin présente un contour extérieur qui est adapté au contour intérieur de la canule creuse (1), de façon que le mandrin (8) peut être inséré avec précision dans la canule creuse (1) et dispose d'une pointe distale conique (10) à partir de laquelle un filetage de vis (11) devient de plus en plus grand de manière hélicoïdale, la forme, le volume et la taille dudit filetage de vis correspondant, à la transition entre la pointe conique (10) et le mandrin sous forme de cylindre droit (8), au filetage hélicoïdal (2) de la paroi extérieure (3) de la canule creuse (1).
PCT/EP2000/007242 1999-07-30 2000-07-27 Systeme de canule permettant l'introduction d'instruments endoscopiques dans un corps humain ou animal WO2001008572A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU64388/00A AU6438800A (en) 1999-07-30 2000-07-27 Cannula system for introducing endoscopic tools in a human or animal body

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE1999135976 DE19935976A1 (de) 1999-11-16 1999-07-30 Kanülenanordnung zum Einbringen endoskopischer Instrumente in einen menschlichen oder tierischen Körper
DE19935976.8 1999-07-30

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WO2001008572A1 true WO2001008572A1 (fr) 2001-02-08

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WO (1) WO2001008572A1 (fr)

Cited By (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002076312A2 (fr) * 2001-03-14 2002-10-03 Power Medical Interventions, Inc. Trocart
WO2006093976A1 (fr) 2005-02-28 2006-09-08 Spirus Medical Inc. Systeme de sondage de type a avancement-rotation
US7780650B2 (en) 2005-05-04 2010-08-24 Spirus Medical, Inc. Rotate-to-advance catheterization system
US7874981B2 (en) 2002-07-31 2011-01-25 Tyco Healthcare Group Lp Orifice introducer device
US7905897B2 (en) 2001-03-14 2011-03-15 Tyco Healthcare Group Lp Trocar device
US8740932B2 (en) 2001-11-30 2014-06-03 Covidien Lp Surgical device
US8858589B2 (en) 2002-01-08 2014-10-14 Covidien Lp Surgical device
US8870755B2 (en) 2007-05-18 2014-10-28 Olympus Endo Technology America Inc. Rotate-to-advance catheterization system
US9017371B2 (en) 2007-09-21 2015-04-28 Covidien Lp Surgical device having multiple drivers
US9033868B2 (en) 1999-06-02 2015-05-19 Covidien Lp Couplings for interconnecting components of an electro-mechanical surgical device
US9113878B2 (en) 2002-01-08 2015-08-25 Covidien Lp Pinion clip for right angle linear cutter
US9113847B2 (en) 1999-06-02 2015-08-25 Covidien Lp Electro-mechanical surgical device
US9204877B2 (en) 2007-09-21 2015-12-08 Covidien Lp Surgical device having a rotatable jaw portion
US9861362B2 (en) 2002-06-14 2018-01-09 Covidien Lp Surgical device
US9867523B2 (en) 2002-01-30 2018-01-16 Covidien Lp Surgical imaging device
US10973821B2 (en) 2016-05-25 2021-04-13 F2G Limited Pharmaceutical formulation
US11065228B2 (en) 2014-11-21 2021-07-20 F2G Limited Antifungal agents
US11819503B2 (en) 2019-04-23 2023-11-21 F2G Ltd Method of treating coccidioides infection

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5147376A (en) * 1990-05-04 1992-09-15 Francesco Pianetti Trocar needle laparoscopy with a threaded truncated cone bit
US5258003A (en) * 1992-06-01 1993-11-02 Conmed Corporation Method and apparatus for induction of pneumoperitoneum
WO1995020358A1 (fr) * 1994-01-26 1995-08-03 Kieturakis Maciej J Instrument pour incisions anatomiques et procede correspondant
DE29611170U1 (de) * 1995-08-23 1996-09-05 Golser, Karl, Dr., Innsbruck Arbeitskanüle für die Arthroskopie
US5662673A (en) * 1995-04-05 1997-09-02 Kieturakis; Maciej J. Surgical trocar and method for placing a trocar sleeve in a body wall

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5147376A (en) * 1990-05-04 1992-09-15 Francesco Pianetti Trocar needle laparoscopy with a threaded truncated cone bit
US5258003A (en) * 1992-06-01 1993-11-02 Conmed Corporation Method and apparatus for induction of pneumoperitoneum
WO1995020358A1 (fr) * 1994-01-26 1995-08-03 Kieturakis Maciej J Instrument pour incisions anatomiques et procede correspondant
US5662673A (en) * 1995-04-05 1997-09-02 Kieturakis; Maciej J. Surgical trocar and method for placing a trocar sleeve in a body wall
DE29611170U1 (de) * 1995-08-23 1996-09-05 Golser, Karl, Dr., Innsbruck Arbeitskanüle für die Arthroskopie

Cited By (31)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9033868B2 (en) 1999-06-02 2015-05-19 Covidien Lp Couplings for interconnecting components of an electro-mechanical surgical device
US10314659B2 (en) 1999-06-02 2019-06-11 Covidien Lp Electro-mechanical surgical device
US9364200B2 (en) 1999-06-02 2016-06-14 Covidien Lp Electro-mechanical surgical device
US9113847B2 (en) 1999-06-02 2015-08-25 Covidien Lp Electro-mechanical surgical device
US9078654B2 (en) 1999-06-02 2015-07-14 Covidien Lp Surgical device
US7905897B2 (en) 2001-03-14 2011-03-15 Tyco Healthcare Group Lp Trocar device
WO2002076312A3 (fr) * 2001-03-14 2002-11-14 Power Med Interventions Inc Trocart
WO2002076312A2 (fr) * 2001-03-14 2002-10-03 Power Medical Interventions, Inc. Trocart
US9055971B2 (en) 2001-03-14 2015-06-16 Covidien Lp Trocar device
US8740932B2 (en) 2001-11-30 2014-06-03 Covidien Lp Surgical device
US9113878B2 (en) 2002-01-08 2015-08-25 Covidien Lp Pinion clip for right angle linear cutter
US8858589B2 (en) 2002-01-08 2014-10-14 Covidien Lp Surgical device
US9867523B2 (en) 2002-01-30 2018-01-16 Covidien Lp Surgical imaging device
US9861362B2 (en) 2002-06-14 2018-01-09 Covidien Lp Surgical device
US7874981B2 (en) 2002-07-31 2011-01-25 Tyco Healthcare Group Lp Orifice introducer device
US9554824B2 (en) 2002-07-31 2017-01-31 Covidien Lp Orifice introducer device
EP1861133A4 (fr) * 2005-02-28 2009-04-29 Spirus Medical Inc Systeme de sondage de type a avancement-rotation
WO2006093976A1 (fr) 2005-02-28 2006-09-08 Spirus Medical Inc. Systeme de sondage de type a avancement-rotation
EP1861133A1 (fr) * 2005-02-28 2007-12-05 Spirus Medical Inc. Systeme de sondage de type a avancement-rotation
US7780650B2 (en) 2005-05-04 2010-08-24 Spirus Medical, Inc. Rotate-to-advance catheterization system
US8870755B2 (en) 2007-05-18 2014-10-28 Olympus Endo Technology America Inc. Rotate-to-advance catheterization system
US9282961B2 (en) 2007-09-21 2016-03-15 Covidien Lp Surgical device having multiple drivers
US9204877B2 (en) 2007-09-21 2015-12-08 Covidien Lp Surgical device having a rotatable jaw portion
US9017371B2 (en) 2007-09-21 2015-04-28 Covidien Lp Surgical device having multiple drivers
US10117651B2 (en) 2007-09-21 2018-11-06 Covidien Lp Surgical device having a rotatable jaw portion
US10420548B2 (en) 2007-09-21 2019-09-24 Covidien Lp Surgical device having multiple drivers
US10881397B2 (en) 2007-09-21 2021-01-05 Covidien Lp Surgical device having a rotatable jaw portion
US11317909B2 (en) 2007-09-21 2022-05-03 Covidien Lp Surgical device having multiple drivers
US11065228B2 (en) 2014-11-21 2021-07-20 F2G Limited Antifungal agents
US10973821B2 (en) 2016-05-25 2021-04-13 F2G Limited Pharmaceutical formulation
US11819503B2 (en) 2019-04-23 2023-11-21 F2G Ltd Method of treating coccidioides infection

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