Gerrett alcon rep

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As the firing member is advanced distally, the first cam and the second cam can control the distance, or tissue gap, between the deck 24 of the staple cartridge 16 and the anvil The firing member also comprises a knife configured to incise the tissue captured intermediate the staple cartridge 16 and the anvil The shaft portion 11 encompasses and guides a firing motion from the housing 8 through a longitudinally-reciprocating laminated firing bar extending proximally from the firing member.

In particular, the shaft portion 11 includes a longitudinal firing bar slot that receives the firing bar. The housing 8 depicted in FIGS. The housing 8 may be configured for use in connection with interchangeable shaft assemblies that include end effectors that are adapted to support different sizes and types of staple cartridges, have different shaft lengths, sizes, and types, etc. Referring to FIGS. The end effector 12 is rotatable about a longitudinal articulation axis 19 , defined by the shaft portion 11 , between an unarticulated, or home, configuration and an articulated configuration.

An articulation driver 34 is configured to drive the articulation of the end effector 12 relative to the shaft portion In at least one form, the closure drive system 30 may include an actuator in the form of a closure trigger 32 that is pivotally supported by the handle assembly In various forms, the closure drive system 30 further includes a closure linkage assembly that is pivotally coupled to the closure trigger As can be seen in FIG.

Referring primarily to FIGS. The closure shuttle includes a pair of proximally-protruding hooks that are configured for attachment to the attachment pin 37 that is attached to the closure link A proximal end of a closure tube is coupled to the closure shuttle for relative rotation thereto.

For example, a U shaped connector is inserted into an annular slot in the proximal end of the closure tube and is retained within vertical slots in the closure shuttle Such an arrangement serves to attach the closure tube to the closure shuttle for axial travel therewith while enabling the closure tube to rotate relative to the closure shuttle about a longitudinal axis The anvil 18 is closed by distally translating the closure tube and thus a shaft closure sleeve assembly , causing it to strike a proximal surface on the anvil 18 in the manner described in the aforementioned reference U.

Patent Application Publication No. As was also described in detail in that reference, the anvil 18 is opened by proximally translating the closure tube and the shaft closure sleeve assembly , causing a tab and a horseshoe aperture to contact and push against the anvil tab to lift the anvil In the anvil-open position, the closure tube is moved to its proximal position. Various other components and operational features of the closure drive system 30 are disclosed in U.

Furthermore, the shaft portion 11 of the interchangeable shaft assembly 46 can further include a proximal housing or nozzle comprised of nozzle portions and The nozzle is coupled to the closure tube such that rotation of the nozzle about the longitudinal axis 19 causes a corresponding rotation in the shaft portion 11 and the end effector 12 about the longitudinal axis Rotation of end effector 12 about the longitudinal axis 19 allows a clinician a great deal of flexibility in orienting the end effector 12 with respect to tissue.

However, once the tissue is captured by the end effector 12 , an additional rotation of the end effector 12 may lead to undesirable tissue damage. The present disclosure presents several solutions that permit an axial rotation of the end effector 12 while the end effector 12 is in an open configuration, but prevent, or at least resist, the axial rotation of the end effector 12 while the end effector 12 is in a closed configuration. Referring generally to FIGS. On the other hand, the rotation locking mechanism 50 is configured to permit the axial rotation of the end effector 12 and the shaft portion 11 relative to the housing 8 and the closure shuttle while the end effector 12 is in the closed configuration.

The end effector 12 and the shaft portion 11 are axially rotatable together as a unit about the longitudinal axis The closure shuttle and the housing 8 are not rotated with the end effector 12 and the shaft portion 11 about the longitudinal axis Furthermore, the rotation locking mechanism 50 can be transitioned between unlocked configuration FIG.

In the unlocked configuration, the axial rotation of the shaft portion 11 and the end effector 12 relative to the housing 8 and the closure shuttle is permitted. In the locked configuration, the axial rotation of the shaft portion 11 and the end effector 12 relative to the housing 8 and the closure shuttle is prevented by the rotation locking mechanism The rotation locking mechanism 50 is synchronized to the closure drive system 30 such that the rotation locking mechanism 50 is in an unlocked configuration while the end effector 12 is in an open configuration, and the rotation locking mechanism 50 is in a locked configuration while the end effector 12 is in a closed configuration.

In some examples, as illustrated in FIGS. The nozzle is prevented from the axial rotation by the closure shuttle in the closed configuration. As described above, the closure shuttle is translated distally in a closure motion of the closure drive system 30 that transitions the end effector 12 to the closed configuration. In its distal position, as illustrated in FIG. To transition the end effector back to its open configuration, the closure shuttle is translated proximally in an opening motion of the closure drive system In its proximal position, as illustrated in FIG.

The closure shuttle comprises an engagement portion configured for locking engagement with an engagement portion of the nozzle while the closure shuttle is in its distal position and the end effector 12 in the closed configuration. The engagement portions , include a plurality of projections , which are configured for locking engagement in the locked configuration. In the example illustrated in FIGS. Attempting to axially rotate the nozzle while the end effector 12 is in the closed configuration would require the projections of the engagement portion of the closure shuttle to be rotated.

However, since the closure shuttle is unable to rotate axially relative to the housing 8 , the nozzle and, consequently, the shaft portion 11 and the end effector 12 are also unable to rotate axially relative to the housing 8 in the closed configuration.

As illustrated in FIG. Consequently, the projections are out of meshing engagement with the projections allowing the nozzle and, consequently, the shaft portion 11 and the end effector 12 to be freely rotated relative to the housing 8. To reestablish a meshing engagement between the projections and the projections , the projections need to be advanced distally.

This is achieved by advancing the closure shuttle distally, which causes the end effector 12 to be transitioned to the closed configuration. In various examples, the rotation locking mechanism 50 can be implemented in other suitable portions of the interchangeable shaft assembly The engagement portion of the closure shuttle can be implemented in other portions of the closure drive system 30 that, like the closure shuttle , are translatable axially to close the end effector 12 but are not rotated with the shaft portion 11 and the end effector 12 relative to the longitudinal axis Likewise, the engagement portion of the nozzle can be implemented in other portions of the interchangeable shaft assembly 46 that are axially rotated with the shaft portion 11 and the end effector Further to the above, in the example illustrated in FIG.

The projections protrude from the annular body toward the longitudinal axis In the example of FIG. Referring again to FIG. This arrangement permits the projections to meshingly engage the projections as the closure shuttle reaches its distal position. To prevent the closure shuttle from retreating from its distal position prematurely, a closure locking mechanism can be employed. Suitable closure locking mechanisms are described in U. In various instances, a clinician may desire to make subtle additional changes to an orientation of an end effector after the rotation is locked in the closed configuration.

The interchangeable shaft assembly is similar in many respects to the to the interchangeable shaft assembly For example, the interchangeable shaft assembly includes the end effector 12 , the shaft portion 11 , and the nozzle The interchangeable shaft assembly , however, includes a rotation locking mechanism that is slightly different than the rotation locking mechanism In one aspect, the engagement portion is spaced apart from the closure shuttle A biasing member extends between, and connects, the engagement portion and the closure shuttle , as illustrated in FIG.

The biasing member includes a first end attached to the closure shuttle and a second end attached to the engagement portion The biasing member sets a predetermined torque beyond which the nozzle will be rotated axially relative to the housing 8. A clinician can force an axial rotation of the nozzle , and consequently the shaft portion 11 and the end effector 12 , by applying a torque to the nozzle that is greater than or equal to the predetermined torque.

Such torque application, in the closed configuration, causes the projections to fall out of meshing engagement with the projections , thus moving the engagement portion toward the closure shuttle and, in the process, compressing the biasing member When the torque applied by the clinician falls below the predetermined torque, the projections are returned into a meshing engagement with the projections at a different section of the annular body An alternative embodiment that may permit a clinician to make subtle changes to an orientation of an end effector in the closed configuration is depicted in FIGS.

The interchangeable shaft assembly is similar in many respects to the interchangeable shaft assemblies 46 and The interchangeable shaft assembly further includes a closure shuttle , which is similar in many respects to the closure shuttle The interchangeable shaft assembly also includes one or more brake assemblies Engagement portions of the closure shuttle are configured to motivate the brake assemblies to apply a predetermined load against the nozzle in the closed configuration.

The predetermined load causes a frictional force to be applied to the nozzle In result, as illustrated in FIG. In addition, as illustrated in FIG. The increased torque in the closed configuration allows the clinician to fine tune the orientation of the end effector 12 by making subtle additional changes to the axial rotational position of the nozzle The brake assemblies each include a cam wedge , a plurality of biasing members , and a brake shoe arranged laterally in the nozzle The brake shoe is positioned closest to the inner surface of the nozzle and furthest from the longitudinal axis The cam wedge is positioned furthest from the inner surface and closest to the longitudinal axis The biasing members are nestled between the cam wedge and the brake shoe In the example of FIGS.

In alternative embodiments, more or less than two brake assemblies can be employed to apply a predetermined load to the inner surface in the closed configuration. The brake assemblies are spaced apart, and are spatially arranged circumferentially. In alternative embodiments, more or less than three biasing members can be utilized. The biasing members maintain a predetermined spacing between the cam wedge and the brake shoe in the open configuration, as illustrated in FIG.

In the closed configuration, however, the engagement portions press the cam wedges against the brake shoes compressing the biasing members and causing a predetermined frictional force to be applied by the brake shoes against the inner surface of the nozzle Furthermore, as illustrated in FIGS. Although various devices have been described herein in connection with certain embodiments, modifications and variations to those embodiments may be implemented.

Particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined in whole or in part, with the features, structures or characteristics of one ore more other embodiments without limitation. Also, where materials are disclosed for certain components, other materials may be used.

Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function or functions. The foregoing description and following claims are intended to cover all such modification and variations. The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times.

In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, the disassembly of the device, followed by cleaning or replacement of particular pieces of the device, and subsequent reassembly of the device.

Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application. The devices disclosed herein may be processed before surgery. First, a new or used instrument may be obtained and, when necessary, cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag.

The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure.

This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated materials do not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure.

As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

A surgical instrument that comprises a housing, a shaft assembly extending distally from the housing, and a rotation locking mechanism. The shaft assembly comprises a shaft portion defining a longitudinal axis and an end effector extending distally from the shaft portion. The end effector and the shaft portion are axially rotatable relative to the housing about the longitudinal axis.

The end effector comprises a first jaw and a second jaw movable relative to the first jaw to transition the end effector between an open configuration and a closed configuration. The surgical instrument of Example 1, wherein the rotation locking mechanism comprises a closure member movable from a first position to a second position to transition the end effector to the closed configuration and the rotation locking mechanism to a locked configuration.

The surgical instrument of Example 2, wherein the closure member is movable from the second position to the first position to transition the end effector to the open configuration and the rotation locking mechanism to an unlocked configuration.

The surgical instrument of Example 2 or 3, wherein the shaft portion comprises a first plurality of teeth, wherein the closure member comprises a second plurality of teeth configured to lockingly engage the first plurality of teeth in the locked configuration.

The surgical instrument of Example 4, wherein the second plurality of teeth are configured to disengage from the first plurality of teeth as the closure member is moved from the second position to the first position.

The surgical instrument of Example 2, 3, 4, or 5, wherein the second position is distal to the first position. The surgical instrument of Example 1, 2, 3, 4, 5, or 6, wherein the first jaw comprises a staple cartridge.

The surgical instrument of Example 7, wherein the second jaw comprises an anvil movable by the closure member to capture tissue between the staple cartridge and the anvil in the closed configuration.

The rotation locking mechanism is configured to resist an axial rotation of the end effector and the shaft portion relative to the housing in the closed configuration up to a predetermined torque. The surgical instrument of Example 9, wherein the rotation locking mechanism comprises a closure member movable from a first position to a second position to transition the end effector to the closed configuration and the rotation locking mechanism to a locked configuration.

The surgical instrument of Example 10, wherein the closure member is movable from the second position to the first position to transition the end effector to the open configuration and the rotation locking mechanism to an unlocked configuration.

The surgical instrument of Example 9 or 10, wherein the second position is distal to the first position. The surgical instrument of Example 10, 11, or 12, wherein the shaft portion comprises a first plurality of teeth. The rotation locking mechanism comprises an engagement member comprising a second plurality of teeth and a biasing member. The biasing member comprises a first end attached to the closure member and a second end attached to the engagement member.

The biasing member is configured to bias the second plurality of teeth into a meshing engagement with the first plurality of teeth. The surgical instrument of Example 13, wherein the second plurality of teeth are configured to disengage from the first plurality of teeth as the closure member is moved from the second position to the first position.

The surgical instrument of Example 9, 10, 11, 12, 13, or 14, wherein the first jaw comprises a staple cartridge. The surgical instrument of Example 15, wherein the second jaw comprises an anvil movable by the closure member to capture tissue between the staple cartridge and the anvil in the closed configuration. A surgical instrument that comprises a housing, a shaft assembly extending distally from the housing, and a rotation braking system.

The shaft portion and the end effector are axially rotatable relative to the housing about the longitudinal axis. The rotation braking system is configured to selectively apply a rotation braking force against the shaft portion. The surgical instrument of Example 17, wherein the rotation braking system is configured to apply the rotation braking force against the shaft portion in the closed configuration.

The surgical instrument of Example 17 or 18, wherein the rotation braking system comprises a brake shoe configured to selectively apply the rotation braking force against an inner surface of the shaft portion. The surgical instrument of Example 19, wherein the rotation braking system comprises a plurality of biasing members configured to bias the brake shoe into contact with the inner surface of the shaft portion.

What is claimed is: 1. A surgical instrument, comprising: a housing;. The surgical instrument of claim 1 , wherein the rotation locking mechanism comprises a closure member movable from a first position to a second position to transition the end effector to the closed configuration and the rotation locking mechanism to a locked configuration.

The surgical instrument of claim 2 , wherein the closure member is movable from the second position to the first position to transition the end effector to the open configuration and the rotation locking mechanism to an unlocked configuration. The surgical instrument of claim 3 , wherein the shaft portion comprises a first plurality of teeth, and wherein the closure member comprises a second plurality of teeth configured to lockingly engage the first plurality of teeth in the locked configuration.

The surgical instrument of claim 4 , wherein the second plurality of teeth are configured to disengage from the first plurality of teeth as the closure member is moved from the second position to the first position. The surgical instrument of claim 5 , wherein the second position is distal to the first position.

The surgical instrument of claim 6 , wherein the first jaw comprises a staple cartridge. The surgical instrument of claim 7 , wherein the second jaw comprises an anvil movable by the closure member to capture tissue between the staple cartridge and the anvil in the closed configuration.

The surgical instrument of claim 9 , wherein the rotation locking mechanism comprises a closure member movable from a first position to a second position to transition the end effector to the closed configuration and the rotation locking mechanism to a locked configuration. The surgical instrument of claim 10 , wherein the closure member is movable from the second position to the first position to transition the end effector to the open configuration and the rotation locking mechanism to an unlocked configuration.

The surgical instrument of claim 11 , wherein the second position is distal to the first position. The surgical instrument of claim 12 , wherein the shaft portion comprises a first plurality of teeth, and wherein the rotation locking mechanism comprises: an engagement member comprising a second plurality of teeth; and. The surgical instrument of claim 13 , wherein the second plurality of teeth are configured to disengage from the first plurality of teeth as the closure member is moved from the second position to the first position.

The surgical instrument of claim 14 , wherein the first jaw comprises a staple cartridge. The surgical instrument of claim 15 , wherein the second jaw comprises an anvil movable by the closure member to capture tissue between the staple cartridge and the anvil in the closed configuration. The surgical instrument of claim 17 , wherein the rotation braking system is configured to apply the rotation braking force against the shaft portion in the closed configuration.

The surgical instrument of claim 18 , wherein the rotation braking system comprises a brake shoe configured to selectively apply the rotation braking force against an inner surface of the shaft portion.

The surgical instrument of claim 19 , wherein the rotation braking system comprises a plurality of biasing members configured to bias the brake shoe into contact with the inner surface of the shaft portion. USB2 en. EPA1 en. JPA en. CNA en. BRA2 en. WOA1 en. USDS1 en. Jaw actuated lock arrangements for preventing advancement of a firing member in a surgical end effector unless an unfired cartridge is installed in the end effector.

Robotically-controlled surgical stapling devices that produce formed staples having different lengths. Overlaid multi sensor radio frequency RF electrode system to measure tissue compression.

Surgical instruments with jaw opening features for increasing a jaw opening distance. Surgical instruments with open and closable jaws and axially movable firing member that is initially parked in close proximity to the jaws prior to firing. Methods for closed loop control of motor velocity of a surgical stapling and cutting instrument.

Progressively releasable implantable adjunct for use with a surgical stapling instrument. System for detecting the mis-insertion of a staple cartridge into a surgical stapler. Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts. Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument. Systems and methods for controlling displacement member velocity for a surgical instrument.

Staple cartridge and staple cartridge channel comprising windows defined therein. Adaptive tissue compression techniques to adjust closure rates for multiple tissue types. Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments.

Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status. Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member. Surgical shaft assemblies with slip ring assemblies with increased contact pressure. Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member.

Motor-driven surgical cutting instrument with electric actuator directional control assembly. Systems and methods for providing alerts according to the operational state of a surgical instrument. Surgical instrument comprising an articulation system lockable by a closure system. Surgical stapler anvils with tissue stop features configured to avoid tissue pinch. Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments.

Systems and methods for controlling motor speed according to user input for a surgical instrument. Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions. Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto.

Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly. Fastener cartridge assembly comprising a fixed anvil and different staple heights. Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system.

Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument. Display screen or portion thereof with a graphical user interface for a surgical instrument.

Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument. Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument. Surgical shaft assemblies with slip ring assemblies forming capacitive channels. Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing.

Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors. Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments. Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations. Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument. Powered multi-axial articulable electrosurgical device with external dissection features.

End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments.

Surgical tools configured for interchangeable use with different controller interfaces. Surgical stapler having motor control based on an electrical parameter related to a motor current. Systems and methods of controlling a clamping member firing rate of a surgical instrument.

Surgical stapler anvils with staple directing protrusions and tissue stability features. To ensure that you're the person making the purchase, Affirm sends a text message to your cell phone with a unique authorization code. Enter the authorization code into the application form. Within a few seconds, Affirm notifies you of the loan amount you're approved for, the interest rate, and the number of months you have to pay off your loan. You have the option to pay off your loan over three, six, or twelve months.

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The Monroe News-Star. Retrieved April 22, Garret Graves, Gov. John Bel Edwards sniping about flood recovery, again". The Baton Rouge Advocate. Retrieved April 24, Representative Garret Graves. Retrieved 23 January Republican Study Committee.

Archived from the original on December 22, Retrieved December 21, Congressional Western Caucus. Retrieved 27 June House of Representatives International Conservation Caucus.

Archived from the original on 1 August Retrieved 1 August Official Congressional Directory th Congress, ISBN Wikiquote has quotations related to Garret Graves. Wikimedia Commons has media related to Garret Graves. Ruben Gallego. Glenn Grothman.

Chairs and ranking members of United States House committees. Louisiana's current delegation to the United States Congress. Members of the U. House of Representatives from Louisiana. Livingston White H. Livingston Vitter Jindal Scalise. Boggs Maloney H. Boggs L. Boggs Jefferson Cao Richmond Carter. Brent Overton Bullard Garland J. Landry Boustany Higgins. Bossier Morse J. Nash E. Robertson Lewis Irion E. Robertson S. Favrot Kemp Sanders Jr.

Griffith Sanders Jr. Morrison Rarick H. Moore Baker Cazayoux Cassidy Graves. Aswell Overton Dear Allen G. Long S. Long G. Long C. Long Holloway. Robertson Butler Johnston Sheridan. Clark Poydras. Louisiana 's delegation s to the th—present United States Congresses ordered by seniority.

Cassidy R. Graves R. Kennedy R. Johnson R. Carter D. Current members of the United States House of Representatives. Speaker : Kevin McCarthy. Republican Party conference. Carter J. Graves S. Johnson D. Johnson M. Johnson Jordan D. Joyce J. Joyce Kean Jr. Kelly T.