Source: http://www.google.ca/patents/US6607479
Timestamp: 2013-12-13 03:06:41
Document Index: 43431385

Matched Legal Cases: ['art.\n26', 'art. 34', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70', 'art 70']

Patent US6607479 - Methods and apparatus for stabilizing tissue - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inAdvanced Patent SearchPatentsA tissue stabilizer includes a pneumatic rigidifying bladder which is flexible when at ambient pressure and rigid when at negative pressure or evacuated. Structure such as straps with hook-and-eye fasteners attaches the rigidifying bladder to tissue to be stabilized, such as a broken arm. When positioned...http://www.google.ca/patents/US6607479?utm_source=gb-gplus-sharePatent US6607479 - Methods and apparatus for stabilizing tissueAdvanced Patent SearchPublication numberUS6607479 B1Publication typeGrantApplication numberUS 09/268,556Publication date19 Aug 2003Filing date15 Mar 1999Priority date17 Mar 1998Fee statusPaidAlso published asDE69941425D1, US6251065Publication number09268556, 268556, US 6607479 B1, US 6607479B1, US-B1-6607479, US6607479 B1, US6607479B1InventorsGary S. Kochamba, Suzanne E. KochambaOriginal AssigneeGary S. Kochamba, Suzanne E. KochambaExport CitationBiBTeX, EndNote, RefManPatent Citations (6), Referenced by (6), Classifications (18), Legal Events (4) External Links: USPTO, USPTO Assignment, EspacenetMethods and apparatus for stabilizing tissueUS 6607479 B1Abstract A tissue stabilizer includes a pneumatic rigidifying bladder which is flexible when at ambient pressure and rigid when at negative pressure or evacuated. Structure such as straps with hook-and-eye fasteners attaches the rigidifying bladder to tissue to be stabilized, such as a broken arm. When positioned on the tissue, the bladder is evacuated, thereby rigidifying the bladder and supporting the tissue. The tissue stabilizer may be configured for use in surgical procedures, such as performing coronary artery bypass grafting (CABG) on a warm, beating heart. In a cardiac embodiment, the tissue stabilizer includes an attaching bladder with a plurality of openings. When suction is applied at a port of the attaching bladder, suction is applied at the openings, which is utilized to attach the stabilizer to the epicardium of the heart. Once in position on the heart, suction may be applied at a port of the rigidifying bladder. When rigid, the heart may be moved as desired to perform CABG procedures.
What is claimed is: 1. A tissue stabilizer configured to facilitate a surgical procedure comprising:
a flexible rigidifying bladder having a plurality of windows formed through said rigidifying bladder and including: a chamber defined within said bladder; a port through which said chamber is evacuatable; rigidifying structure disposed within, said chamber and configured to be substantially rigid when said chamber is evacuated; and a suction apparatus attached to the flexible rigidifying bladder, the suction apparatus configured to be disposed between the flexible rigidifying bladder and tissue to which the tissue stabilizer is attached for stabilization, the suction apparatus facilitating creation of a subatmospheric pressure between the tissue and the suction apparatus enabling attachment of said rigidifying bladder to tissue. 2. A tissue stabilizer configured to facilitate a surgical procedure comprising:
a flexible rigidifying bladder having a plurality of windows formed through said rigidifying bladder wherein said windows are configured to facilitate delivery of a medical therapy and including: a chamber defined within said bladder; a port through which said chamber is evacuatable; rigidifying structure disposed within said chamber and configured to be substantially rigid when said chamber is evacuated; and a suction apparatus attached to the flexible rigidifying bladder, the suction apparatus configured to be disposed between the flexible rigidifying bladder and tissue to which the tissue stabilizer is attached for stabilization, the suction apparatus facilitating creation of a subatmospheric pressure between the tissue and the suction apparatus enabling attachment of said rigidifying bladder to tissue. 3. A tissue stabilizer as claimed in claim 2 wherein the medical therapy is Transmyocardial Revascularization.
4. A tissue stabilizer as claimed in claim 2 wherein the medical therapy is intramyocardial injection of angiogenic or myocardial cell growth substance.
5. A method for stabilizing tissue during a surgical procedure comprising the steps of:
providing a tissue stabilizer having a window in the tissue stabilizer for providing access to a surgical site comprising: a rigidifying bladder comprising a rigidifying bladder configured to be attachable to a heart including: a port; a chamber defined within said bladder and in communication with said port; and rigidifying structure disposed within said chamber such that said rigidifying structure is substantially flexible when no suction is applied at said port and substantially rigid when suction is applied at said port; attaching means for securing said rigidifying bladder to tissue; positioning said tissue stabilizer on tissue to be stabilized, wherein said step of positioning comprises the step of positioning said tissue stabilizer on the epicardium of the heart; attaching said tissue stabilizer to the epicardium of the heart with said attaching means; and rigidifying said tissue stabilizer by applying suction at said port. 6. A method for stabilizing tissue during a surgical procedure comprising the steps of providing:
a tissue stabilizer having a plurality of windows in the tissue stabilizer to facilitate the delivery of a medical therapy, comprising: a rigidifying bladder configured to be attachable to a heart, including: a port; a chamber defined within said bladder and in communication with said port; and rigidifying structure disposed within said chamber such that said rigidifying structure is substantially flexible when no suction is applied at said port and substantially rigid when suction is applied at said port; and attaching means for securing said rigidifying bladder to tissue; positioning said tissue stabilizer on an epicardium of the heart to be stabilized; attaching said tissue stabilizer to the epicardium of the heart with said attaching means; and rigidifying said tissue stabilizer by applying suction at said port. 7. A method for stabilizing tissue as claimed in claim 6 further comprising the step of applying the medical therapy of Transmyocardial Revascularization.
8. A method for stabilizing tissue as claimed in claim 6 further comprising the step of applying the medical therapy of intramyocardial injection of angigenic or myocardial cell growth substance.
9. A tissue stabilizer comprising:
a flexible rigidifying bladder including: a chamber defined within said bladder; a port through which pressure in said chamber may be reduced to below atmospheric pressure; a valve in communication with said port adapted to be closed to maintain below atmospheric pressure within said chamber; rigidifying structure disposed within said chamber and configured to be substantially rigid when said chamber is evacuated; and means for attaching said rigidifying bladder to tissue. 10. A tissue stabilizer as claimed in claim 9 wherein said rigidifying bladder further comprises a valve for sealing said chamber.
11. A tissue stabilizer as claimed in claim 10 wherein said valve is adapted to seal the chamber at a pressure below atmospheric pressure.
12. A tissue stabilizer as claimed in claim 9 wherein said rigidifying structure includes a plurality of beads.
13. A tissue stabilizer as claimed in claim 12 wherein said plurality of beads includes beads which are movable.
14. A tissue stabilizer as claimed in claim 9 wherein said rigidifying structure includes mesh.
15. A tissue stabilizer as claimed in claim 14 wherein said mesh is attached to said bladder.
16. A tissue stabilizer as claimed in claim 9 wherein said rigidifying bladder includes a plurality of walls which divide said chamber into a plurality of cells connected by a plurality of air passages.
17. A tissue stabilizer as claimed in claim 9 wherein said rigidifying bladder includes at least one inner wall which separates said chamber into layers.
18. A tissue stabilizer as claimed in claim 17 wherein said at least one inner wall includes at least one air passage so that each of said layer is in pneumatic communication with each other.
19. A tissue stabilizer as claimed in claim 9 wherein said means for attaching comprises an attaching bladder including:
an attaching chamber defined within said attaching bladder; a port through which the pressure in said chamber may be reduced to below atmosphere pressure; a valve in communication with said port adapted to be closed to maintain the below atmospheric pressure within said chamber; and at least one opening formed through said attaching bladder and in communication with said attaching chamber such that said at least one opening applies suction when said attaching bladder is being evacuated. 20. A tissue stabilizer as claimed in claim 9 wherein said means for attaching comprises at least one strap with hook-and-eye fasteners.
21. A tissue stabilizer as claimed in claim 9 wherein said means for attaching comprises at least one strap with adhesive.
22. A tissue stabilizer as claimed in claim 9 wherein said means for attaching comprises adhesive.
23. A tissue stabilizer as claimed in claim 9 further comprising a window formed through said rigidifying bladder.
24. A tissue stabilizer as claimed in claim 9 wherein said window is configured to provide access to a surgical site.
25. A tissue stabilizer as claimed in claim 9 wherein said rigidifying bladder is configured to be attachable to a heart.
26. A tissue stabilizer comprising:
a first bladder including: a first port; a first chamber defined within said first bladder and in communication with said first port wherein pressure in said first chamber may be reduced to below atmospheric pressure; a valve in communication with said first port adapted to be closed to maintain below atmospheric pressure; an opening formed through said first bladder and in communication with said first chamber such that said opening applies suction in response to suction applied at said first port; and a second bladder attached to said first bladder and including: a second port; a second chamber defined within said second bladder and in communication with said second port; and rigidifying structure disposed within said second chamber such that said rigidifying structure is substantially: flexible when no suction is applied at said second port; and rigid when suction is applied at said second port. 27. A tissue stabilizer as claimed in claim 26 wherein said first bladder includes a plurality of said openings.
28. A tissue stabilizer as claimed in claim 26 wherein said bladders are substantially coextensive.
29. A tissue stabilizer as claimed in claim 28 wherein said bladders are substantially U shaped.
30. A tissue stabilizer as claimed in claim 26 wherein further comprising:
retaining structure attached to at least one of said bladders for engaging with external support. 31. A tissue stabilizer as claimed in claim 30 wherein said retaining structure includes:
a rigid plate; ball for releasably engaging with complementary external support structure. 32. A tissue stabilizer configured to facilitate a surgical procedure comprising:
a flexible rigidifying bladder including: a chamber defined within said bladder; a port through which said chamber is evacuatable; and rigidifying structure disposed within said chamber and configured to be substantially rigid when said chamber is evacuated; and a suction apparatus attached to the flexible rigidifying bladder, the suction apparatus configured to be disposed between the flexible rigidifying bladder and tissue to which the tissue stabilizer is attached for stabilization, the suction apparatus facilitating creation of a sub-atmospheric pressure between the tissue and the suction apparatus enabling attachment of said rigidifying bladder to tissue, said tissue stabilizer configured into a compact form via folding and/or rolling so as to be loaded into a sheath for deployment through a port access. 33. A method of stabilizing tissue during a surgical procedure comprising the steps of:
providing a tissue stabilizer comprising: a rigidifying bladder configured to be attachable to a heart including: a first port; a chamber defined within said bladder and in communication with said port; and rigidifying structure disposed within said chamber such that said rigidifying structure is substantially flexible when no suction is applied at said port and substantially rigid when suction is applied at said port; and attaching means for securing said rigidifying bladder to tissue; positioning said tissue stabilizer on heart epicardium to be stabilized; attaching said tissue stabilizer to heart epicardium with said attaching means; rigidifying said tissue stabilizer by applying suction at said port; rolling the tissue stabilizer; loading the tissue stabilizer into a sheath; inserting the loaded sheath into a body through a port; deploying the tissue stabilizer; and attaching the tissue stabilizer to the heart. 34. A tissue stabilizer configured to facilitate a surgical procedure comprising:
a flexible rigidifying bladder including: a chamber defined within said bladder; a port through which said chamber is evacuatable; and rigidifying structure disposed within said chamber and configured to be substantially rigid when said chamber is evacuated; and means for attaching said tissue stabilizer to tissue wherein said attachment means comprises at least one strap with adhesive. 35. A tissue stabilizer configured to facilitate a surgical procedure comprising:
a flexible rigidifying bladder including: a chamber defined within said bladder; a port through which said chamber is evacuatable; and rigidifying structure disposed within said chamber and configured to be substantially rigid when said chamber is evacuated; and means for attaching said tissue stabilizer wherein said means for attaching comprises adhesive. Description
This application is a continuation-in-part of U.S. patent application Ser. No. 09/042,853 filed Mar. 17, 1998 now U.S. Pat. No. 6,251,065.
In addition to these examples of external tissue stabilization, internal organs may also need to be stabilized for specific medical procedures. For example, the heart may need to be stabilized during cardiac procedures. One such procedures is coronary artery bypass graft surgery (CABG), which is the most commonly performed cardiac operation, accounting for over 80% of all cardiovascular surgery. Indeed, more than 400,000 CABG operations were performed in 1997 alone. The clinical spectrum of presenting problems resulting in consideration for CABG includes angina, unstable angina, congestive heart failure due to ischemia, myocardial infarction, survival of sudden cardiac death, and asymptomatic ischemia. In recent years, the profile of a typical CABG patient has expanded to include higher-risk patients, such as older patients and patients with more advanced stages of coronary artery disease, as well as patients for �re-do� operations who have already had at least one CABG operation. The effect of these changes is reflected in the higher morbidity and mortality associated with these higher-risk patients.
In recent years, advances have been made so that the heart does not need to be stopped in order to perform CABG procedures, allowing CABG to be performed on a warm, beating heart. To do so, a relatively stabile operating platform needs to be maintained. Conventional apparatus developed to provide a stabile operating platform include devices which apply pressure against the heart and devices with a finger-shaped configuration which adhere to the heart through suction. To apply these devices to the heart, it takes both of the surgeons hands to position the devices on the heart. In addition, the devices do not establish secure contact with the epicardium of the heart and often need to be repositioned during the CABG procedure, which is time consuming and a nuisance.
SUMMARY OF THE INVENTION These and other objects are achieved by the tissue stabilizers of the present invention and the method for their use which stabilize tissue through the use of pneumatics. In accordance with broad, functional aspects of the present invention, the tissue stabilizer of the invention includes a bladder which is substantially flexible when at ambient assure. However, when subject to negative pressure, such as through suction or vacuum, the bladder becomes substantially rigid. Because of these features, in use the tissue stabilizer may be positioned on tissue to be stabilized by, for example, wrapping the stabilizer around the tissue in the case of an arm, or contouring the stabilizer to the surface topography of the tissue in the case of a heart. When in a desired position, the rigidifying bladder may be subject to negative pressure, thereby rigidifying the tissue stabilizer. When rigid, the tissue stabilizer maintains the tissue in a stable position. The tissue stabilizer is particularly useful when configured for performing coronary artery bypass procedures (CABG) on a warm, beating heart.
The rigidifying bladder may also include a plurality of inner walls which separate the chamber into layers. The inner walls may includes air passages so that each of the layers is in pneumatic communication with each other. The rigidity of the rigidifying bladder is generally proportional to the number of layers. For example, in embodiments of the stabilizer configured to stabilize broken bones, the chamber may be divided into four or five layers, each of which includes a pair of opposing layers of mesh and a plurality of movable beads.
FIG. 5B is an example of one embodiment of the invention;
FIG. 24 is a schematic view of a tissue stabilizer of the present invention-in use with a trocar sheath.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Referring more particularly to the drawings, an exemplary tissue stabilizer 10 configured in accordance with the teachings of the present invention is illustrated in FIGS. 1 and 2. For descriptive purposes and without limiting the scope of the present invention, exemplary stabilizer 10 is illustrated as a cardiac stabilizer for stabilizing a heart during surgical procedures, particularly surgical procedures which are performed on a heart which is not immobilized but rather which is warm and beating. Tissue stabilizers configured for alternative functions are contemplated as being within the scope of the invention as will be understood by those skilled in the art. Those skilled in the art will also appreciated that exemplary tissue stabilizer 10 utilized during cardiac procedures must be biocompatible and possess substantially atraumatic features. However, these additional properties may not be essential to all tissue stabilizers produced in accordance with the teachings of the invention.
With additional reference to FIG. 3A, exemplary stabilizer 10 includes structure for attaching the stabilizer to tissue, such as an attaching bladder 12, and structure for becoming substantially rigid upon actuation, such as a rigidifying bladder 14. Attaching bladder 12 has a port 16 leading into an inner chamber 18 in which a plurality of openings 20 are formed. Exemplary bladder 12 is substantially flexible and configured so that openings 26 apply suction when suction is applied at port 16. Rigidifying bladder 14 has a port 22 leading into an inner chamber 24 in which rigidifying structure 26 is disposed. A portion of rigidifying structure 26 may be attached to bladder 14, and a portion of the rigidifying structure may be unattached or free floating. In FIG. 3A, free-floating rigidifying structure is exemplified in the figures by substantially spherical beads or balls, although any structured configured in accordance with the principles of the present invention may be utilized. In addition, rigidifying structure 26 may be configured as a mesh-like sheet or as a corrugated sheet of material made from for example, nylon implanted or impregnated with silicone. At least a portion of the mesh-like or corrugated sheet may be attached to rigidifying bladder 14. (The dimensions for the components of stabilizer 10 in the drawings, for example, the thickness of the walls of bladders 12 and 14 are exaggerated for illustrative purposes.)
The applied suction may attach stabilizer 10 to the heart 70 with a level of force which allows the stabilizer to be moved or slid across the tissue under hand pressure. This feature facilitates the positioning of stabilizer 10 to a desired location. It also enables flexible stabilizer 10 to be contoured to the anatomical topography of the heart 70, providing optimal contact or incidence of the openings 20 on the surface of the epicardium. As shown in FIG. 10, stabilizer 10 conforms to the left ventricle much like a patch, substantially �wrapping� around a portion thereof. The U-shape configuration of stabilizer 10 allows the surgeon to place a hand on the stabilizer with his or her fingers straddling window 56, which ergonomically facilitates the positioning and contouring thereof. Only one hand is need to position the cardiac stabilizer on the heart.
External support structure 96 may include an articulated arm 98 with a socket 100, preferably a quick-release socket as shown, which is releasably engageable with ball 58 of stabilizer 10. Although a ball-and-socket arrangement is used for the purposes of this description, any complementary releasable fastening means may be implemented. External support structure 96 may include a sternal retractor 102 or a bed post 104 to which support arm 98 is attachable. Articulated support arm 98 may bendable under sufficient hand force. Alternatively, arm 98 may be substantially flexible for positioning and then made rigid through the use of a tensioning cable mechanism, as known in the art. Although only one support arm 98 is shown, external support structure 96 may include a second support arm attached to the second ball-and-post arrangement (58 and 60) of stabilizer 10. Once stabilizer 10 is retained by the external support structure 96, the heart 70 is in a stable position and the coronary anastomosis may be performed.
During the coronary anastomosis, the heart 70 may be repositioned as desired by bending or repositioning articulated arm 98. Alternatively, the heart 70 may be repositioned by releasing stabilizer 10 from support arm 98, repositioning the stabilizer and heart as desired, and then reattaching the. stabilizer to the arm. After the coronary anastomosis is completed, stabilizer 10 may be detached from the external support structure 96, allowing the heart 70 to be returned to the normal cardiac anatomical position. The suction may then be disconnected from ports 16 and 22 by actuating valves 92 and 94. Accordingly, stabilizer 10 becomes flexible and unattached to the heart 70 and may be removed. As many patients require more than one bypass.to be performed, the surgeon may then reapply stabilizer 10 to another portion of the heart 70 to performed another CABG procedure, such as on the right coronary artery 74, in the manner described above. This reapplying of the stabilizer 10 may continued a plurality of times to perform as many CABG are necessary for the patient.
In a commercial medical embodiment of tissue stabilizer 10, bladders 12 and 14 may be made from substantially pneumatically impervious and biocompatible material such as silicone or rubber. Rigidifying structure 26 may be made from silicone or epoxy material or from metal and may include free-floating metal or epoxy beads. Rigidifying structure 26 may also me made from nylon-reinforced silicone mounted to bladder 14. Retaining structure 54 may be made for stainless steel or other suitably rigid material such as nylon.
Referencing FIGS. 12A, 12B, and 16, exemplary rigidifying structure 120 may include mesh 130 attached to bladder 114 and a plurality of movable beads 132. Chamber 116 is preferably configured with opposing layers of mesh, referenced as 130 a and 130 b, between which a plurality of beads 132 are disposed. When chamber 116 is at ambient pressure (i.e., not evacuated or under vacuum), rigidifying bladder 114 and, accordingly, tissue stabilizer 110 are flexible, as shown in FIG. 12A. However, when chamber 116 is evacuated through port 118, rigidifying bladder 114 collapses under the negative pressure, drawing opposing layers of mesh. 130 a and 130 b together. Beads or balls 132 lodge within recesses 134 in mesh 130 and are urged therein under the applied negative pressure, thereby rigidifying the bladder, as shown in FIG. 12B. Rigidifying bladder 114 may include a valve 136 disposed over port 118 which may be closed to retain the vacuum of chamber 116, thereby retaining the rigidity of bladder 114.
Rigidifying bladder 114 may include a plurality of walls 138 which separate inner chamber 116 into a plurality of layers. Each layer may be in pneumatic communication via air passages 140 formed through walls 138. Generally speaking, the more layers that rigidifying bladder 114 has, the more rigid the bladder becomes under vacuum. Each of the layers may include a pair of opposing layers of mesh 130a and 130b, as well as a plurality of movable beads 132, as shown in FIGS. 12A and 12B. The increased rigidity results from the increased number of beads 132 which may be provided to lodge and engage with multiple sheets of mesh 130. The applied negative pressure increases the frictional forces between the plurality of beads 132 and the mesh 130, as well as between each other, which resists flexing and movement.
As mentioned above, the tissue stabilizer of the present invention may be configured to satisfy a wide range of applications. As already mentioned in reference to FIG. 15, tissue stabilizer 110 may be configured to stabilize an injured leg, for example, a broken leg. Referencing FIG. 20, exemplary tissue stabilizer 110 is configured to provide support and stabilize the neck of an injured person. In this embodiment, tissue stabilizer 110 may be carried by emergency rescue teams to remote locations for use in stabilizing potential victims of neck and spinal injuries. At remote locations, a portable pump 152 may be engaged with valve 136 and actuated to evacuate chamber 116 to rigidify bladder 114. Portable pump 152 may be of the type analogous to those used for inflating blood-pressure cuffs. Whereas conventional neck braces are manufactured in standard sizes which might not fits all patients, tissue stabilizer 110 of the present invention may be contours to fit the neck of each individual patient, thereby providing much better support and stability.
As previously mentions, the rigidifying bladder may be made from silicone impregnated with nylon (with the nylon comprising at least a portion of the rigidifying'structure). The rigidifying bladder may be include natural fibers such as cotton (e.g., canvas) or metallic fibers such as stainless-steel mesh to provide durability. Alternatively, tissue stabilizer may be made from substantially resilient material, such as certain silicones, so as to stretch under sufficient force. In addition, rather than pneumatic evacuation of rigidifying bladder of the invention, fluids other than air, such as hydraulics may be used. As an alternative means for attaching the rigidifying bladder to tissue, rather than including straps 112, tissue stabilizer 110 may include a layer of adhesive coated onto one side of the rigidifying bladder 114 with a peel-away backing. The layer of adhesive may be adhered directed to the skin of the patient or to a layer of pre-wrap (as known in the art).
Patent CitationsCited PatentFiling datePublication dateApplicantTitleUS37459986 Jan 197117 Jul 1973Bio Medical Syst IncVacuum formed support structures and immobilizer devicesUS572756920 Feb 199617 Mar 1998Cardiothoracic Systems, Inc.Surgical devices for imposing a negative pressure to fix the position of cardiac tissue during surgeryUS578274615 Feb 199621 Jul 1998Wright; John T. M.Local cardiac immobilization surgical deviceUS580724320 Feb 199615 Sep 1998Heartport, Inc.Method for isolating a surgical siteUS583631120 Sep 199517 Nov 1998Medtronic, Inc.Method and apparatus for temporarily immobilizing a local area of tissueUS592728421 Aug 199727 Jul 1999Medtronic, IncMethod and apparatus for temporarily immobilizing a local area of tissueReferenced byCiting PatentFiling datePublication dateApplicantTitleUS672662220 Dec 200127 Apr 2004Origin Medsystems, Inc.Device to permit offpump beating heart coronary bypass surgeryUS673002022 Dec 20004 May 2004Origin Medsystems Inc.Locking arm having ball joints for use in an organ manipulator apparatusUS6890292 *12 Mar 200310 May 2005Kochamba Family TrustTissue stabilization systemUS6902523 *12 Mar 20037 Jun 2005Gary S. KochambaTissue stabilizationUS8449449 *8 Dec 200828 May 2013Medtronic, Inc.Methods and apparatus providing suction-assisted tissue engagement through a minimally invasive incisionUS20090082620 *8 Dec 200826 Mar 2009Medtronic, Inc.Methods and Apparatus Providing Suction-Assisted Tissue Engagement Through a Minimally Invasive Incision* Cited by examinerClassifications U.S. Classification600/37, 128/898International ClassificationA61F5/055, A61F5/058, A61B17/30, A61B17/00, A61B17/02Cooperative ClassificationA61B2017/0243, A61F5/055, A61B17/02, A61F5/05833, A61B2017/306, A61B2018/00392, A61B2017/00243, A61B2017/00247European ClassificationA61F5/058G, A61B17/02, A61F5/055Legal EventsDateCodeEventDescription17 Feb 2011FPAYFee paymentYear of fee payment: 821 Aug 2007SULPSurcharge for late payment20 Aug 2007FPAYFee paymentYear of fee payment: 47 Mar 2007REMIMaintenance fee reminder mailedRotateOriginal ImageGoogle Home - Sitemap - USPTO Bulk Downloads - Privacy Policy - Terms of Service - About Google Patents - Send FeedbackData provided by IFI CLAIMS Patent Services©2012 Google