US 9,010,609 B2Grant

Circular stapler including buttress

Issue Date:2015-04-21

•12 Claims

•16 Drawing Sheets

Abstract

A surgical stapling device for joining tissue portions includes a handle assembly, and a tubular body portion having a staple cartridge assembly containing a plurality of surgical staples in an annular array. The surgical stapling device includes an anvil assembly having a shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and the tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. The surgical stapling device includes a buttress material supported by the tubular body portion and disposed between the anvil assembly and the staple cartridge assembly. The surgical stapling device includes a suture material that is adapted for engagement with the tubular body portion and the buttress material to secure the buttress material to the tubular body portion.

Metadata

Assignee

Covidien LP

Inventors

Sally Carter
Richard P. Stevenson

Application Information

Application Number:US 13/358,539

Filing Date:2012-01-26

Priority Date:2012-01-26

Art Unit:3721

Classifications

IPC:

A61B17/068A61B17/072

Field of Search:

A61B 17/068A61B 17/0686A61B 17/072A61B 17/07207A61B 17/07292

Patent Drawings (16 sheets)

Description

Background

[0001] 1. Technical Field

[0002] The present disclosure relates to surgical stapling devices and buttress materials for use with said surgical stapling device and, more particularly, to structures and methods for attaching a buttress material to a surgical stapling device for use in anastomosis procedures.

[0003] 2. Background of Related Art

[0004] Staples have traditionally been used to replace suturing when joining or anastomosing various body structures such as, for example, the bowel or bronchus. The surgical stapling devices employed to apply these staples are generally designed to simultaneously cut and seal an extended segment of tissue in a patient, thus vastly reducing the time and risks of such procedures.

[0005] Linear or annular surgical stapling devices are employed by surgeons to sequentially or simultaneously apply one or more linear rows of surgical fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together and/or for the creation of anastomoses. Linear surgical stapling devices generally include a pair of jaws or finger-like structures between which body tissue to be joined is placed. When the surgical stapling device is actuated and/or “fired”, firing bars move longitudinally and contact staple drive members in one of the jaws, and surgical staples are pushed through the body tissue and into/against an anvil in the opposite jaw thereby crimping the staples closed. A knife blade may be provided to cut between the rows/lines of staples. Examples of such surgical stapling devices are described in U.S. Pat. Nos. 4,354,628, 5,014,899 and 5,040,715, the entirety of each of which is incorporated herein by reference.

[0006] Annular surgical stapling devices generally include an annular staple cartridge assembly including a plurality of annular rows of staples, typically two, an anvil assembly operatively associated with the annular cartridge assembly, and an annular blade disposed internal of the rows of staples. Examples of such annular surgical stapling devices are described in U.S. Pat. Nos. 5,799,857 and 5,915,616 to Robertson et al., the entirety of each of which is incorporated herein by reference.

[0007] In general, an end-to-end anastomosis stapler typically places an array of staples into the approximated sections of a patient's bowels or other tubular organs. The resulting anastomosis contains an inverted section of bowel which contains numerous “B” shaped staples to maintain a secure connection between the approximated sections of bowel.

[0008] For most procedures, the use of bare staples, with the staples in direct contact with the patient's tissue, is generally acceptable. The integrity of the tissue will normally serve to prevent the staples from tearing out of the tissue and compromising the sealing before healing has occurred. However, in some surgical operations, surgical supports, e.g., meshes or buttress materials, are employed by surgeons in combination with linear stapling devices to bridge, repair and/or reinforce tissue defects within a patient, especially those occurring in the abdominal wall, chest wall, diaphragm, and other musculo-aponeurotic areas of the body. Examples of suitable surgical supports are disclosed in U.S. Pat. Nos. 3,054,406, 3,124,136, 4,347,847, 4,655,221, 4,838,884, 5,002,551, and 7,942,890, the entirety of each of which is incorporated herein by reference.

[0009] When the staples are applied in surgical procedures utilizing surgical supports (i.e., reinforcing material), the legs of the staple typically pass from the cartridge jaw through a layer of the surgical support, and through the patient's tissue before encountering the anvil jaw.

[0010] The need exists for annular support structures for use in conjunction with annular or circular surgical stapling devices, for example, an end-to-end anastomosis stapler such as a Model “EEA™” instrument available from United States Surgical, a Division of Tyco Health-Care Group, LP, Norwalk, Conn. and disclosed in U.S. Pat. No. 5,392,979 to Green et al.

[0011] One possible side effect of any end-to-end bowel anastomosis is its tendency to undergo stenosis over time, which can decrease the diameter of the lumen over time. Accordingly, the need exists for an annular surgical structure which operates in conjunction with any end-to-end, annular, or circular anastomosis or stapling device and assists in keeping open the lumen of the anastomosed bowel or other tubular organ over time.

[0012] A need also exists for an annular support structure which operates in conjunction with any end-to-end, annular or circular stapling device to reduce the trauma suffered by the patient, reduce the instances of leakage, reduce the instances of bleeding, and create a relatively strong bond between adjacent body tissues.

Summary

[0013] In one aspect of the present disclosure, a surgical stapling device for joining tissue portions includes a handle assembly and a tubular body portion supported on a distal end of the handle assembly. The tubular body portion has a staple cartridge assembly containing a plurality of surgical staples in an annular array. The tubular body portion has a distal portion including at least one hole. The surgical stapling device further includes an anvil assembly at a distal end of the surgical stapling device having a shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and the tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. The surgical stapling device further includes a buttress material supported by the tubular body portion and disposed between the anvil assembly and the staple cartridge assembly. The surgical stapling device further includes an attachment member that is adapted for engagement with the tubular body portion and the buttress material to secure the buttress material to the tubular body portion. The attachment member defines a first end and a second end. The attachment member is adapted to engage the tubular body portion by insertion of at least one of the first end and second end through the at least one hole.

[0014] In another aspect of the present disclosure, the at least one hole forms an attachment portion on the tubular body portion.

[0015] In another aspect of the present disclosure, the first end of the attachment member is inserted through a first hole of the tubular body portion and the second end of the attachment member is inserted through a second hole of the tubular body portion.

[0016] In another aspect of the present disclosure, withdrawal of the attachment member from the first and second holes of the tubular body portion is limited by knotting the first and second ends together.

[0017] In another aspect of the present disclosure, withdrawal of the attachment member from the first and second holes of the tubular body portion is limited by sealing the first and second ends together.

[0018] In another aspect of the present disclosure, withdrawal of at least one of the first and second ends of the attachment member from the at least one hole of the tubular body portion is limited by knotting, heat mushrooming, a stop member or a barb.

[0019] In another aspect of the present disclosure, a distal portion of the tubular body portion includes at least one attachment portion disposed on at least one of the inner and outer surfaces where the attachment member is adapted to engage the tubular body portion by engaging the attachment portion.

[0020] In another aspect of the present disclosure, the at least one hole of the tubular body portion is filled with a gel.

[0021] In another aspect of the present disclosure, at least one of the first and second ends of the attachment member includes a stop member adapted to limit removal of the at least one of the first and second ends from the at least one hole of the tubular member when inserted therethrough.

[0022] In another aspect of the present disclosure, the other of the first and second ends includes a barb.

[0023] In another aspect of the present disclosure, the tubular body portion supports a knife blade that is actuatable upon actuation of the handle assembly, the attachment member being severable by the knife blade to release the buttress material during firing of the surgical stapling device.

[0024] In another aspect of the present disclosure, a surgical stapling device for joining tissue portions includes a handle assembly and a tubular body portion supported on a distal end of the handle assembly. The tubular body portion has a staple cartridge assembly containing a plurality of surgical staples in an annular array. The surgical stapling device further includes an anvil assembly at a distal end of the surgical stapling device having shaft for removably connecting the anvil assembly to the tubular body portion. The anvil assembly and the tubular body portion are juxtaposed with respect to one another along the shaft and are arranged so as to be approximated with respect to one another. The surgical stapling device further includes a buttress material supported by the anvil assembly and disposed between the anvil assembly and the staple cartridge assembly. The surgical stapling device further includes an attachment member extending through the buttress material to engage the anvil assembly and adapted to secure the buttress material to the anvil assembly.

[0025] In another aspect of the present disclosure, the buttress material includes a flange on an inner portion thereof. The attachment member is a suture material threaded through the flange and through a lumen extending through the shaft of the anvil assembly to secure the buttress material to the anvil assembly.

[0026] In another aspect of the present disclosure, the suture material is annularly stitched through the buttress material about the shaft of the anvil assembly and is transitionable between a first configuration and a second configuration, the second configuration defining a smaller diameter than the first configuration for securing the buttress material to the shaft of the anvil assembly.

[0027] In another aspect of the present disclosure, a method of using a buttress material with a surgical stapling device includes the steps of positioning the buttress material at least partially between an anvil assembly and a cartridge assembly of the surgical stapling device, securing the buttress material to the surgical stapling device by engaging a suture material with the buttress material and engaging the suture material with the surgical stapling device, receiving body tissue between the anvil assembly and the cartridge assembly, grasping the body tissue between the anvil assembly and the cartridge assembly, firing the surgical stapling device to drive a plurality of staples from the cartridge assembly through the buttress material and the body tissue, and releasing the suture material from the surgical stapling device to release the buttress material from the surgical stapling device.

[0028] In another aspect of the present disclosure, the step of securing the buttress material to the surgical stapling device includes the step of inserting at least one end of the suture material through at least one hole of one of the anvil assembly and the tubular body portion.

[0029] In another aspect of the present disclosure, the step of securing the buttress material to the surgical stapling device includes the step of attaching first and second ends of the suture material together after the first and second ends of the suture material have been inserted through the at least one hole.

[0030] In another aspect of the present disclosure, the step of releasing the suture material includes the step of severing the suture material with a knife blade disposed in the tubular body portion and movable relative to the tubular body portion.

[0031] In another aspect of the present disclosure, the step of securing the buttress material to the surgical stapling device includes the step of removably attaching the suture material to an attachment member of the surgical stapling device.

[0032] In another aspect of the present disclosure, the step of releasing the suture material includes the step of releasing the suture material from the attachment member of the surgical stapling device.

[0033] Any of the above aspects of the present disclosure described may be combined with any other aspect of the present disclosure without departing from the scope of the present disclosure.

Brief Description of Drawings

[0034] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above and the detailed description of the embodiments given below, serve to explain the principles of the disclosure, wherein:

[0035] FIG. 1 is a perspective view of an exemplary annular surgical stapling device according to the present disclosure;

[0036] FIG. 2 is a perspective view of a buttress material in accordance with an embodiment of the present disclosure, for use with the annular surgical stapling device of FIG. 1;

[0037] FIG. 3 is an enlarged perspective view of an anvil assembly and a tubular body portion of the annular surgical stapling device of FIG. 1;

[0038] FIG. 4A is an enlarged perspective view of a tubular body portion of the annular surgical stapling device of FIG. 1, illustrating attachment portions according to an embodiment of the present disclosure;

[0039] FIG. 4B is a detail view of a portion of the tubular body portion of FIG. 4A, illustrating one of the attachment portions;

[0040] FIG. 4C is a side, elevational view of the tubular body portion of FIG. 4A;

[0041] FIG. 5A is an enlarged perspective view of a tubular body portion of the annular surgical stapling device of FIG. 1, illustrating attachment portions according to another embodiment of the present disclosure;

[0042] FIG. 5B is a detail view of a portion of the tubular body portion of FIG. 5A, illustrating the attachment portions;

[0043] FIG. 5C is a perspective view, with parts separated, of the tubular body portion of FIG. 5A;

[0044] FIG. 5D is a perspective, longitudinal, cross-sectional view of the tubular body portion of FIG. 5A, as taken through 5D-5D of FIG. 5A, illustrating the suture extending through the openings;

[0045] FIG. 6A is an enlarged perspective view of a tubular body portion of the annular surgical stapling device of FIG. 1, illustrating attachment portions according to another embodiment of the present disclosure;

[0046] FIG. 6B is a detail view of a portion of the tubular body portion of FIG. 6A, illustrating the attachment portions;

[0047] FIG. 6C is a perspective view, with parts separated, of the tubular body portion of FIG. 6A;

[0048] FIG. 7A is an enlarged perspective view of a tubular body portion of the annular surgical stapling device of FIG. 1, illustrating attachment portions according to another embodiment of the present disclosure;

[0049] FIG. 7B is a detail view of a portion of the tubular body portion of FIG. 7A, illustrating the attachment portions;

[0050] FIG. 7C is a perspective view, with parts separated, of the tubular body portion of FIG. 7A;

[0051] FIG. 8 is a schematic, longitudinal, cross-sectional view of the annular surgical stapling device of FIG. 4A, illustrating the buttress material of FIG. 2 secured to the staple cartridge assembly of the tubular body portion with tissue disposed between the buttress material and the anvil assembly of the annular surgical stapling device;

[0052] FIG. 9 is a perspective view of the intestinal area of a patient, illustrating a method of positioning the annular surgical stapling device of FIG. 1 to connect the anvil assembly to the tubular body portion;

[0053] FIG. 10 is a schematic, longitudinal cross-sectional view of the anvil of the annular surgical stapling device of FIG. 1, illustrating the buttress material secured to the anvil by a suture extending through a lumen of the anvil; and

[0054] FIG. 11 is a perspective view of the anvil of the annular surgical stapling device of FIG. 1, illustrating the buttress material secured to the anvil by a suture inserted annularly through the buttress material circumferentially about the anvil.

Detailed Description of Embodiments

[0055] Embodiments of the presently disclosed annular surgical stapling device will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. As used herein and as is traditional, the term “distal” refers to that portion which is furthest from the user while the term “proximal” refers to that portion which is closest to the user.

[0056] Referring initially to FIGS. 1 and 3, an annular surgical stapling device for use with a buttress material is disclosed herein and is generally designated as 10. Surgical stapling device 10 includes a handle assembly 12 having at least one pivotable actuating handle member 14, and an advancing member 16. Extending from handle member 12, there is provided a tubular body portion 100 which may be constructed so as to have a curved shape along its length. Body portion 100 terminates in a staple cartridge assembly 102 defining an inner surface 108 and an outer surface 110. Staple cartridge assembly 102 includes at least one annular array of staple receiving slots 104 disposed at a distal end and a staple 116 disposed in each of staple receiving slots 104. For example, staple cartridge assembly 102 may include one, two, or more than two annular arrays of staple receiving slots 104. Staple receiving slots 104 extend through a tissue contacting surface 106 of the distal end of the staple cartridge assembly 102.

[0057] Staple cartridge assembly 102 may be fixedly connected to the distal end of tubular body portion 100 or may be configured to concentrically fit within the distal end of tubular body portion 100. Typically, staple cartridge assembly 102 includes a staple pusher (not shown) defining concentric rings of peripherally spaced fingers (not shown) to correspond with the staple receiving slots. Each one of the fingers is received within one of the respective staple receiving slots 104.

[0058] Typically, a knife 118 (see FIG. 8), substantially in the form of an open cup with the rim thereof defining a knife edge, is disposed within staple cartridge assembly 102 and mounted to a distal surface of a staple pusher (not shown). The knife edge is disposed radially inward of the pair of annular arrays of staples. Accordingly, in use, as the staple pusher is advanced, the knife 118 is also advanced axially outward.

[0059] Positioned distally of staple cartridge assembly 102 there is provided an anvil assembly 200 including an anvil member 202 and a shaft 204 operatively associated therewith for removably connecting anvil assembly 200 to a distal end portion of stapling device 10 Inner wall 108 forms an opening 112 in the distal end of staple cartridge assembly 102 and tubular body portion 100 includes a central shaft 114 extending through opening 112 for engagement with shaft 204 of anvil assembly 200.

[0060] Reference may be made to U.S. Pat. No. 5,915,616 to Viola et al., the entire contents of which are incorporated herein by reference, for a detailed discussion of the construction and operation of annular stapling device 10.

[0061] Referring now to FIG. 2, a buttress material 300 is generally annular in shape and includes an inner portion 302, a middle portion 304, and an outer portion 306. A substantially centrally located aperture 308, defined by the inner circumference of inner portion 302 is formed through buttress material 300. Buttress material 300 may be any shape sufficient to provide support for anastomosis of tissue after surgical stapling device 10 has been fired including, for example, a square, a circle, an oval, a triangle or any other polygonal or other shape.

[0062] As illustrated in FIGS. 4A-4C, buttress material 300 is sized such that when buttress material 300 is positioned over tissue contacting surface 106, inner portion 302 and outer portion 306 of buttress material 300 are substantially axially aligned with inner surface 108 and outer surface 110 of staple cartridge assembly 102, respectively. Aperture 308 of buttress material 300 is sized to at least receive shaft 204 of anvil assembly 200 and central shaft 114 of tubular body portion 100 therethrough and, in certain embodiments, may be substantially the same size as opening 112. It is also contemplated that buttress material 300 may extend radially beyond inner and outer surfaces 108, 110, respectively.

[0063] Each portion 302, 304, and 306 of buttress material 300 may be fabricated from surgical grade, biocompatible, non-absorbable material (i.e. permanent) or absorbable material (i.e. non-permanent) mesh or material desirably impregnated with an adhesive, sealant and/or other medicament. It is also contemplated that each portion may be a composite of both a non-absorbable and an absorbable material. Suitable materials for the fabrication of buttress material 300 and suitable adhesives, sealants, and/or medicaments for impregnation in or application to buttress material 300 may be found, for example, in U.S. Pat. No. 7,942,890, referenced above.

[0064] Buttress material 300 may be secured to staple cartridge assembly 102 through the use of one or more attachment members or sutures 500, as illustrated in FIGS. 4A-4C, 5A-5D, 6A-6C and 7A-7C. Generally, each suture 500 includes a second end 502, a first end 504 and an intermediate portion 506 extending between the second and first ends 502, 504, as will be described in the embodiments to follow.

[0065] Similar to buttress material 300, attachment members or sutures 500 may be fabricated from surgical grade, biocompatible, non-absorbable material (i.e. permanent), or absorbable material (i.e. non-permanent), or material desirably impregnated with an adhesive, sealant and/or other medicament. It is also contemplated that sutures 500 may be a composite of both a non-absorbable and an absorbable material. Suitable materials are described above with reference to buttress material 300. For any of the embodiments disclosed herein, the attachment members can be a suture, strap, cable, cord, rope or other member. The attachment member can be rigid or flexible, in any of the embodiments disclosed herein.

[0066] In one embodiment, with reference to FIGS. 4A-4C, cartridge assembly 102 includes one or more attachment portions 400 disposed on or about inner and outer surfaces 108, 110 for attaching or securing a length of the attachment member or suture 500 thereto. Although attachment portions 400 are illustrated as cleats 402 in FIGS. 4A-4C, attachment portions 400 may also be in the form of buttons, hooks, knobs, holes or other similar mechanisms for receiving and securing suture 500 thereto. Additionally or alternatively, the attachment portions can be tacky or adhesive.

[0067] Each cleat 402 includes an opening or depression 404 extending into the inner or outer surface 108, 110 of the staple cartridge assembly 102 defining a substantially arcuate or U-shape profile having a substantially linear distal edge 408. Each cleat 402 includes a tab 406 extending from the distal edge 408 into opening 404 and includes a base portion 410 and a tip portion 412. Tip portion 412 is dimensioned to allow body portion 506 of suture 500 to be inserted between tip portion 412 and opening 404 of cleat 402. Base portion 410 forms wedge points 414 with opening 404 for securing body portion 506 of suture 500 to cleat 402. It is contemplated that opening 404 may define other shapes such as, for example squares, rectangles, triangles, or other shapes suitable for receiving and securing a portion of suture 500 therein. Although illustrated as being substantially triangular in shape, tab 406 may alternatively include a rounded tip portion 412, a squared off tip portion 412, or another suitably shaped tip portion 412 so long as the portion of suture 500 is insertable between tip portion 412 and opening 404 and securable by wedge points 414.

[0068] As illustrated in FIGS. 4A-4C, cleats 402 are disposed on both inner and outer surfaces 108, 110 of staple cartridge assembly 102 such that one or more lengths of suture 500 can be alternately secured to cleats 402 on the inner surface 108 and the outer surface 110 of staple cartridge assembly 102 to secure buttress material 300 to the tissue contacting surface 106 of staple cartridge assembly 102. For example, a single suture 500 may be wound through a first cleat 402 on the outer surface 110 of staple cartridge assembly 102 and then drawn over buttress material 300 to engage buttress material 300 before being wound through a second cleat 402 on the inner surface 108 of staple cartridge assembly 102, thereby securing buttress material 300 to tissue contacting surface 106 of staple cartridge assembly 102. Each pair of inner and outer cleats 402 may receive a separate attachment member or suture 500 or a single attachment member 500 may be wound continuously through each of cleats 402. Alternatively an attachment member or single suture 500 may be secured to any number of cleats 402 where, for example, one, two or more sutures 500 may be included. The cleats can be formed on the body of the stapler, the staple cartridge assembly and/or other locations to retain the one or more sutures.

[0069] The first cleat 402 on the inner surface 108 of staple cartridge assembly 102 and the second cleat 402 on the outer surface 110 of staple cartridge assembly 102 may be substantially radially aligned with respect to one another or may be radially offset with respect to one another (See FIGS. 4A-4C), for example, to facilitate weaving suture 500 between more than one pair of cleats 402.

[0070] It is contemplated that attachment portions 400 may alternatively be holes (not shown) where, for example, one or more sutures 500 are inserted through one or more holes on outer surface 110, are being wound over buttress material 300 in a similar manner as described above for cleats 402, and are further inserted through holes (not shown) on inner surface 120. Suture 500 may be wound back and forth over buttress material 300 between the holes (not shown) in outer and inner surfaces 110, 120 to secure buttress material 300 to staple cartridge assembly 102.

[0071] The attachment members or sutures 500 are configured to break free from staple cartridge assembly 102, or to be severed, upon firing of the annular surgical stapling device 10 to allow buttress material 300 to separate from tissue contacting surface 106 of staple cartridge assembly 102 after anastomosis has occured. For, example, suture 500 may be configured to break free upon release of anastomized tissue from between the staple cartridge assembly 102 and the anvil assembly 200 or after the firing procedure is complete as the surgical stapling device 10 is withdrawn from the surgical site.

[0072] Attachment member or suture 500 may also include weakened portions or sections along intermediate portion 506 or at second and first ends 502, 504 at which suture 500 may break or sever upon application of force along its length.

[0073] Attachment member or suture 500 may also or alternatively, as mentioned above, be configured to be cut or severed by knife 118 as the knife 118 is actuated during the firing process where, for example, the portion of suture 500 disposed radially inward of inner surface 108 may be severed by knife 118 during firing of surgical stapling device 10. The surgeon may also manipulate suture 500 to release suture 500 from staple cartridge assembly 102.

[0074] In another embodiment, as illustrated in FIGS. 5A-5D and 6A-6C attachment portions 1400 of annular surgical stapling device 10 include openings 1404 extending through outer surface 110 of staple cartridge assembly 102. In this embodiment, sutures 500 are inserted through mesh 300 and through the tissue contacting surface 106 of staple cartridge assembly 102. For example, second and first ends 502, 504 of attachment members or sutures 500 are inserted through staple receiving slots 104. Sutures 500 are inserted through staple cartridge assembly 102 and through openings 1404 in outer surface 110 of staple cartridge assembly 102. Each of second and first ends 502, 504 of suture 500 may extend through a different opening 1404 (See FIGS. 5B and 6B) or both of second and first ends 502, 504 may extend through the same opening 1404. As illustrated in FIG. 5D, sutures 500 are drawn through openings 1404 until intermediate portion 506 engages buttress material 300 to secure buttress material 300 to tissue contacting surface 106 of staple cartridge assembly 102.

[0075] As illustrated in FIGS. 5A-5C, each of second and first ends 502, 504 of sutures 500 are secured in place through the use of knotting, heat mushrooming, buttons, stop members or other similar methods which will limit or prevent second and first ends 502, 504 of sutures 500 from being withdrawn through openings 1404.

[0076] Alternatively, as illustrated in FIGS. 6A-6C, second and first ends 502, 504 of attachment members or sutures 500 may be joined together through knotting, fusing, or other similar methods of combining or attaching second and first ends 502, 504 of sutures 500 together to limit or prevent second and first ends 502, 504 of sutures 500 from being withdrawn through openings 1404. It is contemplated that openings 1404 may alternatively or additionally extend through inner surface 108 of staple cartridge assembly 102.

[0077] Attachment members 500 are configured to break free or be severed from staple cartridge assembly 102 upon firing of the annular surgical stapling device 10 to allow buttress material 300 to separate from tissue contacting surface 106 of staple cartridge assembly 102 after anastomosis has occured. For example, as a staple 116 is driven through one of the staple receiving slots 104 through which a suture 500 extends, the staple 116 may pierce, puncture or otherwise tear the suture 500 to release buttress material 300 from staple cartridge assembly 102. The suture 500 may also or alternatively be configured to break upon release of anastomized tissue from between the staple cartridge assembly 102 and the anvil assembly 200 or after the firing procedure is complete as the surgical stapling device 10 is withdrawn from the surgical site. For example, the suture 500 may include weakened portions or sections along body portion 506 or at second and first ends 502, 504 of suture 500 at which suture 500 may break or sever upon application of force along its length. The surgeon may also manipulate the suture 500 to release suture 500 from staple cartridge assembly 102. The knife 118 may also be used to sever a portion of suture 500 extending through the openings 1404 in inner surface 108 of staple cartridge assembly 102 during firing of surgical stapling device 10.

[0078] In another embodiment, as illustrated in FIGS. 7A-7C, attachment portions 2400 are openings 2404 extending through inner surface 108 of staple cartridge assembly 102 of surgical stapling device 10. In this embodiment, second end 502 of the attachment member or suture 500 includes a barbed tip 508 such as, for example a unidirectional barb, single barb, composite barb or other suitable barb, and first end 504 of attachment member 500 includes a stop member 510. Barbed tip 508 may also extend along at least a portion of intermediate portion 506. Stop member 510 may include a button, knob, or other similar element which is suitable for preventing or limiting advancement of first end 504 through openings 2404. Stop member 510 may also or alternatively be formed by heat mushrooming at first end 504 and may have a transverse dimension that is greater than a transverse dimension of openings 2404. Initially second end 502 is inserted through a first of openings 2404 through the tissue contacting surface 106 of staple cartridge assembly 102 and through a first portion of the buttress material 300 until stop member 510 engages the first of openings 2404 to limit further advancement of attachment member or suture 500 through the first opening 2404. Second end 502 is then inserted through a second portion of the buttress material 300, through tissue contacting surface 106, and through a second of openings 2404 until body portion 506 engages buttress material 300 to secure buttress material 300 to tissue contacting surface 106 of staple cartridge assembly 102. Suture 500 may also extend through one or more of staple receiving slots 104.

[0079] In an embodiment, it is contemplated that openings 2404 may include a silicon or gel like material for engaging barbed tip 508 to limit withdrawal of suture 500 from openings 2404. Such material can include any surgically acceptable adhesive. Openings 2404 may also or alternatively extend through outer surface 110 of staple cartridge assembly 102.

[0080] As described above, the attachment members 500 are configured to break free or be severed from staple cartridge assembly 102 upon firing of the annular surgical stapling device 10. The attachment member or suture 500 may also be configured to be cut or severed by the knife 118 as the knife 118 is actuated to sever tissue “T” where, for example, one or both of barbed tip 508 and stop member 510 may be severed by the knife 118 during firing of surgical stapling device 10. The surgeon may also manipulate the suture 500 to release suture 500 from staple cartridge assembly 102 during or after firing of annular surgical stapling device 10.

[0081] Turning now to FIGS. 8 and 9, there is illustrated the use of annular surgical stapling device 10 and detachable anvil assembly 200 in an anastomosis procedure to effect joining of intestinal sections 20 and 22. The anastomosis procedure is typically performed using minimally invasive surgical techniques including laparoscopic means and instrumentation. At the point in the procedure shown in FIG. 9, a diseased intestinal section has been previously removed, anvil assembly 200 has been applied to the operative site either through a surgical incision or transanally and positioned within intestinal section 22, and tubular body portion 100 of annular surgical stapling device 10 has been inserted transanally into intestinal section 20. Intestinal sections 20 and 22 are also shown temporarily secured about their respective components (e.g., shaft 204 of anvil assembly 200, and the central shaft 114 of tubular body portion 100 by a purse-string suture or the like).

[0082] According to one method, with reference to FIGS. 4A-4C, 5A-5D, 6A-6C, 7A-7C, and as seen in FIGS. 8 and 9, buttress material 300 may be positioned and secured to the tissue contacting surface 106 of tubular body portion 100 by sutures 500 prior to the coupling of anvil assembly 200 to the central shaft 114 of tubular body portion 100. Tubular body portion 100 may come with buttress material 300 pre-positioned and secured to tissue contacting surface 106 by sutures 500. Alternatively the surgeon may secure buttress material 300 to tissue contacting surface 106 prior to use. With buttress material 300 secured in place, the surgeon maneuvers anvil assembly 200 until the proximal end of shaft 204 is inserted into the central shaft 114 of tubular body portion 100. Central shaft 114 is now engaged to shaft 204 with intestinal sections 20 and 22 disposed between anvil assembly 200 and staple cartridge assembly 102. As seen in FIG. 9, for example, buttress material 300 is disposed between cartridge assembly 102 and intestinal sections 20 and 22.

[0083] Anvil assembly 200 and tubular body portion 100 are then approximated to approximate intestinal sections 20, 22 and capture buttress material 300 between intestinal section 20 and tissue contacting surface 106 of staple cartridge assembly 102. Surgical stapling device 10 is then fired to staple buttress material 300 and intestinal sections 20, 22 together and the knife 118 is actuated to cut the portion of tissue and any portion of buttress material 300 and any portion of suture 500 disposed radially inward of knife 118 or extending across knife 118, to complete the anastomosis. The staples 116 which are driven or fired through staple receiving slots 104 may sever or break any portion of suture 500 disposed or extending through staple receiving slots 104 during the firing process. Once anastomosis is complete anvil assembly 200 and tubular body portion 100 are unapproximated to release intestinal sections 20, 22 and buttress material 300. Sutures 500 may break or sever upon release of intestinal sections 20, 22 or as described above, may be released by the surgeon or severed by the knife 118.

[0084] In another embodiment, referring now to FIGS. 10 and 11, buttress material 300 may be secured to the anvil assembly 200 instead of staple cartridge assembly 102 of surgical stapling device 10. The stapling device may be as described in connection with annular surgical stapling device 10 according to FIGS. 1 and 3. In this embodiment, aperture 308 of buttress material 300 is dimensioned to receive shaft 204 of anvil assembly 200 such that inner portion 302 of buttress material 300 abuts or is proximate to shaft 204. Buttress material 300 further includes flanges or tabs 310 extending from inner portion 302 of buttress material 300 with flanges 310 extending axially from inner portion 302 of buttress material 300 along shaft 204.

[0085] As illustrated in FIG. 10, shaft 204 includes a lumen 206 extending therethrough between opposite flanges 310 of buttress material 300. Second end 502 of an attachment member or suture 500 is inserted through a first flange 310, through lumen 206, and through a second flange 310 on an opposite side of shaft 204. Similar to the above embodiments, second and first ends 502, 504 of attachment member suture 500 may include buttons, knobs, stop members, barbs or other similar mechanisms for limiting advancement or withdrawal of suture 500 through flanges 310 and lumen 206. Second and first ends 502, 504 may also be heat mushroomed or sealed after insertion. Additional flanges 310 and/or lumens 206 may be included about the circumference of inner portion 302 of buttress material 300 and of shaft 204 respectively to further secure buttress material 300 to anvil assembly 200. Although illustrated as substantially linearly extending through shaft 204, lumens 206 may also or alternatively define arcuate or angled paths through shaft 204 where, for example, adjacent flanges 310 may be aligned with a single lumen 206 instead of opposite flanges 310. For example, lumens 206 may define a ninety degree angle through shaft 204 or may define a larger or smaller angle through shaft 204. Lumen 206 may also or alternatively define a curved or arcuate path through shaft 204. Second end 502 of suture 500 may be inserted through flanges 310 by piercing flanges 310 or flanges 310 may, for example, include one or more holes 312 for receiving sutures 500 therethrough.

[0086] In another embodiment, as illustrated in FIG. 11, attachment member 500 may instead be threaded through flanges 310 to encircle or surround shaft 204 and form a purse string. The surgical stapling device can be as described in connection with annular surgical stapling device 10. For example, attachment member or suture 500 may be annularly stitched through flanges 310 or buttress 300 about shaft 204 of anvil assembly 200. The annularly stitched suture 500 is transitionable between a first configuration defining a first diameter which is larger than the outer diameter of shaft 204 and a second configuration which is substantially the same as the outer diameter of shaft 204. As suture 500 is transitioned to the second configuration and tightened about shaft 204, flanges 310 press against shaft 204 to secure buttress material 300 in place against shaft 204. Buttress material 300 may be released from anvil assembly 200 in a manner similar to those described above in previous embodiments. Suture 500 may alternatively be annularly threaded or inserted through inner portion 302 of buttress material 300 instead of flanges 310.

[0087] In both of the above embodiments, buttress material 300 may be separated from anvil assembly as described above through breakage or slippage. For example, the surgeon may manipulate suture 500 to release buttress material 300 or attachment member or suture 500 may be adapted or configured to break or sever after firing of surgical stapling device 10. Alternatively, during firing, actuation of knife 118 may sever the portion of buttress material 300 disposed radially inward of the inner surface 108 of staple cartridge assembly 102, and may sever attachment member or suture 500, from the portion of buttress material 300 disposed on the staple cartridge assembly 102 such that only the anastomized portion of buttress material 300 remains attached to the intestinal sections 20, 22. In this way the remaining portion of buttress material 300 remains secured to the anvil assembly 200 for removal from the patient's body.

[0088] Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, the above description, disclosure, and figures should not be construed as limiting, but merely as exemplifications of particular embodiments. It is to be understood, therefore, that the disclosure is not limited to the precise embodiments described herein, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the present disclosure.

Claims

What is claimed is:

1. A surgical stapling device for joining tissue portions, comprising:

a handle assembly;

a tubular body portion supported on a distal end of the handle assembly, the tubular body portion having a staple cartridge assembly containing a plurality of surgical staples in an annular array, the tubular body portion including an inner surface and an outer surface, a distal portion of the tubular body portion including at least one attachment portion defining a first cleat;

an anvil assembly at a distal end of the surgical stapling device, the anvil assembly having a shaft for removably connecting the anvil assembly to the tubular body portion, the anvil assembly and tubular body portion being juxtaposed with respect to one another along the shaft and arranged so as to be approximated with respect to one another;

a buttress material supported by the tubular body portion, the buttress material being disposed between the anvil assembly and the staple cartridge assembly; and

an attachment member adapted for engagement with the tubular body portion and the buttress material to secure the buttress material to the tubular body portion, the attachment member defining a first end and a second end,

the attachment member being adapted to engage the tubular body portion by insertion of at least one of the first and second ends thereof into the first cleat of the at least one attachment portion.

2. A surgical stapling device according to claim 1, wherein the first cleat of the at least one attachment portion extends into an opening formed on the tubular body portion.

3. A surgical stapling device according to claim 2, wherein the first end of the attachment member is inserted into the first cleat and the second end of the attachment member is inserted into a second cleat.

4. A surgical stapling device according to claim 3, wherein the attachment member is configured to be wound through the first cleat disposed on the outer surface of the tubular body portion and wound through the second cleat disposed on the inner surface of the tubular body such that the attachment member lays over the buttress material thereby securing the buttress material to the staple cartridge assembly of the tubular body portion.

5. A surgical stapling device according to claim 3, wherein the first cleat disposed on the inner surface of the tubular body portion and the second cleat disposed on the outer surface of the tubular body portion are radially aligned with respect to one another.

6. A surgical stapling device according to claim 3, wherein the first cleat disposed on the inner surface of the tubular body portion and the second cleat disposed on the outer surface of the tubular body portion are radially offset with respect to one another.

7. A surgical stapling device according to claim 2, wherein the first cleat includes a tab extending proximally into the opening on the tubular body portion.

8. A surgical stapling device according to claim 2, wherein the first cleat includes a tip portion, the tip portion is configured to allow the attachment member to be inserted between the tip portion and the tubular body portion.

9. A surgical stapling device according to claim 2, wherein the first cleat includes a base portion, the base portion defining a wedge for securing the attachment member into the first cleat.

10. A surgical stapling device according to claim 9, wherein the wedge is substantially triangular in shape.

11. A surgical stapling device according to claim 1, wherein the at least one attachment portion is disposed on at least one of the inner and outer surfaces of the tubular body portion, the attachment member being adapted to engage the tubular body portion by engaging the at least one attachment portion.

12. A surgical stapling device according to claim 1, wherein the tubular body portion supports a knife blade that is actuatable upon actuation of the handle assembly, and wherein the attachment member is severable by the knife blade to release the buttress material during firing of the surgical stapling device.

Patent Citations (423)

Patent	Date	Inventor	Cited By
US3054406(A)	1962-09-01	Usher	Applicant
US3124136(A)	1964-03-01	Usher	Applicant
US4347847(A)	1982-09-01	Usher	Applicant
US4354628(A)	1982-10-01	Green	Applicant
US4452245(A)	1984-06-01	Usher	Applicant
US4605730(A)	1986-08-01	Shalaby et al.	Applicant
US4655221(A)	1987-04-01	Devereux	Applicant
US4834090(A)	1989-05-01	Moore	Applicant
US4838884(A)	1989-06-01	Dumican et al.	Applicant
US4927640(A)	1990-05-01	Dahlinder et al.	Applicant
US4930674(A)	1990-06-01	Barak	Applicant
US5002551(A)	1991-03-01	Linsky et al.	Applicant
US5014899(A)	1991-05-01	Presty et al.	Applicant
US5040715(A)	1991-08-01	Green et al.	Applicant
US5065929(A)	1991-11-01	Schulze et al.	Applicant
US5205459(A)	1993-04-01	Brinkerhoff et al.	Applicant
US5263629(A)	1993-11-01	Trumbull et al.	Applicant
US5314471(A)	1994-05-01	Brauker et al.	Applicant
US5344454(A)	1994-09-01	Clarke et al.	Applicant
US5392979(A)	1995-02-01	Green et al.	Applicant
US5397324(A)	1995-03-01	Carroll et al.	Applicant
US5425745(A)	1995-06-01	Green et al.	Applicant
US5441193(A)	1995-08-01	Gravener	Applicant
US5441507(A)	1995-08-01	Wilk et al.	Applicant
US5443198(A)	1995-08-01	Viola et al.	Applicant
US5468253(A)	1995-11-01	Bezwada et al.	Applicant
US5503638(A)	1996-04-01	Cooper et al.	Applicant
US5542594(A)	1996-08-01	McKean et al.	Applicant
US5549628(A)	1996-08-01	Cooper et al.	Applicant
US5575803(A)	1996-11-01	Cooper et al.	Applicant
US5653756(A)	1997-08-01	Clarke et al.	Applicant
US5683809(A)	1997-11-01	Freeman et al.	Applicant
US5690675(A)	1997-11-01	Sawyer et al.	Applicant
US5702409(A)	1997-12-01	Rayburn et al.	Applicant
US5752965(A)	1998-05-01	Francis et al.	Applicant
US5762256(A)	1998-06-01	Mastri et al.	Applicant
US5766188(A)	1998-06-01	Igaki	Applicant
US5769892(A)	1998-06-01	Kingwell	Applicant
US5782396(A)	1998-07-01	Mastri et al.	Applicant
US5799857(A)	1998-09-01	Robertson et al.	Applicant
US5810855(A)	1998-09-01	Rayburn et al.	Applicant
US5814057(A)	1998-09-01	Oi et al.	Applicant
US5833695(A)	1998-11-01	Yoon	Applicant
US5843096(A)	1998-12-01	Igaki et al.	Applicant
US5895412(A)	1999-04-01	Tucker	Applicant
US5895415(A)	1999-04-01	Chow et al.	Applicant
US5902312(A)	1999-05-01	Frater et al.	Applicant
US5908427(A)	1999-06-01	McKean et al.	Applicant
US5915616(A)	1999-06-01	Viola et al.	Applicant
US5931847(A)	1999-08-01	Bittner et al.	Applicant
US5964774(A)	1999-10-01	McKean et al.	Applicant
US5997895(A)	1999-12-01	Narotam et al.	Applicant
US6019791(A)	2000-02-01	Wood	Applicant
US6030392(A)	2000-02-01	Dakov et al.	Applicant
US6032849(A)	2000-03-01	Mastri et al.	Applicant
US6045560(A)	2000-04-01	McKean et al.	Applicant
US6063097(A)	2000-05-01	Oi et al.	Applicant
US6080169(A)	2000-06-01	Turtel	Applicant
US6099551(A)	2000-08-01	Gabbay	Applicant
US6149667(A)	2000-11-01	Hovland et al.	Applicant
US6155265(A)	2000-12-01	Hammerslag	Applicant
US6210439(B1)	2001-04-01	Firmin et al.	Applicant
US6214020(B1)	2001-04-01	Mulhauser et al.	Applicant
US6241139(B1)	2001-06-01	Milliman et al.	Applicant
US6258107(B1)	2001-07-01	Balazs et al.	Applicant
US6267772(B1)	2001-07-01	Mulhauser et al.	Applicant
US6273897(B1)	2001-08-01	Dalessandro et al.	Applicant
US6280453(B1)	2001-08-01	Kugel et al.	Applicant
US6299631(B1)	2001-10-01	Shalaby	Applicant
US6312457(B1)	2001-11-01	DiMatteo et al.	Applicant
US6312474(B1)	2001-11-01	Francis et al.	Applicant
US6325810(B1)	2001-12-01	Hamilton et al.	Applicant
US6436030(B2)	2002-08-01	Rehil	Applicant
US6454780(B1)	2002-09-01	Wallace	Applicant
US6461368(B2)	2002-10-01	Fogarty et al.	Applicant
US6503257(B2)	2003-01-01	Grant et al.	Applicant
US6514283(B2)	2003-02-01	DiMatteo et al.	Applicant
US6517566(B1)	2003-02-01	Hovland et al.	Applicant
US6551356(B2)	2003-04-01	Rousseau	Applicant
US6592597(B2)	2003-07-01	Grant et al.	Applicant
US6638285(B2)	2003-10-01	Gabbay	Applicant
US6652594(B2)	2003-11-01	Francis et al.	Applicant
US6656193(B2)	2003-12-01	Grant	Applicant
US6669735(B1)	2003-12-01	Pelissier	Applicant
US6677258(B2)	2004-01-01	Carroll et al.	Applicant
US6685714(B2)	2004-02-01	Rousseau	Applicant
US6702828(B2)	2004-03-01	Whayne	Applicant
US6704210(B1)	2004-03-01	Myers	Applicant
US6723114(B2)	2004-04-01	Shalaby	Applicant
US6726706(B2)	2004-04-01	Dominguez	Applicant
US6736823(B2)	2004-05-01	Darois et al.	Applicant
US6736854(B2)	2004-05-01	Vadurro et al.	Applicant
US6746458(B1)	2004-06-01	Cloud	Applicant
US6773458(B1)	2004-08-01	Brauker et al.	Applicant
US6896684(B2)	2005-05-01	Monassevitch et al.	Applicant
US6927315(B1)	2005-08-01	Heinecke et al.	Applicant
US6939358(B2)	2005-09-01	Palacios et al.	Applicant
US6946196(B2)	2005-09-01	Foss	Applicant
US6959851(B2)	2005-11-01	Heinrich	Applicant
US7060087(B2)	2006-06-01	DiMatteo et al.	Applicant
US7087065(B2)	2006-08-01	Ulmsten et al.	Applicant
US7108701(B2)	2006-09-01	Evens et al.	Applicant
US7128748(B2)	2006-10-01	Mooradian et al.	Applicant
US7141055(B2)	2006-11-01	Abrams et al.	Applicant
US7147138(B2)	2006-12-01	Shelton, IV	Applicant
US7160299(B2)	2007-01-01	Baily	Applicant
US7232449(B2)	2007-06-01	Sharkawy et al.	Applicant
US7241300(B2)	2007-07-01	Sharkawy et al.	Applicant
US7307031(B2)	2007-12-01	Carroll et al.	Applicant
US7311720(B2)	2007-12-01	Mueller et al.	Applicant
US7377928(B2)	2008-05-01	Zubik et al.	Applicant
US7434717(B2)	2008-10-01	Shelton, IV et al.	Applicant
US7438209(B1)	2008-10-01	Hess et al.	Applicant
US7547312(B2)	2009-06-01	Bauman et al.	Applicant
US7559937(B2)	2009-07-01	de la Torre et al.	Applicant
US7594921(B2)	2009-09-01	Browning	Applicant
US7604151(B2)	2009-10-01	Hess et al.	Applicant
US7665646(B2)	2010-02-01	Prommersberger	Applicant
US7666198(B2)	2010-02-01	Suyker et al.	Applicant
US7669747(B2)	2010-03-01	Weisenburgh, II et al.	Applicant
US7717313(B2)	2010-05-01	Bettuchi et al.	Applicant
US7722642(B2)	2010-05-01	Williamson, IV	Applicant
US7744627(B2)	2010-06-01	Orban, III et al.	Applicant
US7776060(B2)	2010-08-01	Mooradian	Applicant
US7793813(B2)	2010-09-01	Bettuchi	Applicant
US7799026(B2)	2010-09-01	Schechter et al.	Applicant
US7823592(B2)	2010-11-01	Bettuchi et al.	Applicant
US7824420(B2)	2010-11-01	Eldridge et al.	Applicant
US7845533(B2)	2010-12-01	Marczyk et al.	Applicant
US7845536(B2)	2010-12-01	Viola et al.	Applicant
US7846149(B2)	2010-12-01	Jankowski	Applicant
US7892247(B2)	2011-02-01	Conston et al.	Applicant
US7909224(B2)	2011-03-01	Prommersberger	Applicant
US7909837(B2)	2011-03-01	Crows et al.	Applicant
US7938307(B2)	2011-05-01	Bettuchi	Applicant
US7942890(B2)	2011-05-01	D'Agostino et al.	Applicant
US7950561(B2)	2011-05-01	Aranyi	Applicant
US7951166(B2)	2011-05-01	Orban	Applicant
US7967179(B2)	2011-06-01	Olson	Applicant
US7988027(B2)	2011-08-01	Olson	Applicant
US8011550(B2)	2011-09-01	Aranyi	Applicant
US8016177(B2)	2011-09-01	Bettuchi	Applicant
US8016178(B2)	2011-09-01	Olson	Applicant
US8028883(B2)	2011-10-01	Stopek	Applicant
US8062330(B2)	2011-11-01	Prommersberger	Applicant
US8083119(B2)	2011-12-01	Prommersberger	Applicant
US8123766(B2)	2012-02-01	Bauman	Applicant
US8123767(B2)	2012-02-01	Bauman	Applicant
US8146791(B2)	2012-04-01	Bettuchi	Applicant
US8157149(B2)	2012-04-01	Olson	Applicant
US8157151(B2)	2012-04-01	Ingmanson	Applicant
US8167895(B2)	2012-05-01	D'Agostino	Applicant
US8192460(B2)	2012-06-01	Orban	Applicant
US8210414(B2)	2012-07-01	Bettuchi	Applicant
US8225799(B2)	2012-07-01	Bettuchi	Applicant
US8225981(B2)	2012-07-01	Criscuolo et al.	Applicant
US8231043(B2)	2012-07-01	Tarinelli	Applicant
US8235273(B2)	2012-08-01	Olson	Applicant
US8245901(B2)	2012-08-01	Stopek	Applicant
US8256654(B2)	2012-09-01	Bettuchi	Applicant
US8257391(B2)	2012-09-01	Orban	Applicant
US8276800(B2)	2012-10-01	Bettuchi	Applicant
US8286849(B2)	2012-10-01	Bettuchi	Applicant
US8308042(B2)	2012-11-01	Aranyi	Applicant
US8308045(B2)	2012-11-01	Bettuchi	Applicant
US8308046(B2)	2012-11-01	Prommersberger	Applicant
US8312885(B2)	2012-11-01	Bettuchi	Applicant
US8313014(B2)	2012-11-01	Bettuchi	Applicant
US8348126(B2)	2013-01-01	Olson	Applicant
US8348130(B2)	2013-01-01	Shah	Applicant
US8365972(B2)	2013-02-01	Aranyi et al.	Applicant
US8371491(B2)	2013-02-01	Huitema	Applicant
US8371492(B2)	2013-02-01	Aranyi	Applicant
US8371493(B2)	2013-02-01	Aranyi	Applicant
US8393514(B2)	2013-03-01	Shelton, IV	Applicant
US8408440(B2)	2013-04-01	Olson	Applicant
US8413871(B2)	2013-04-01	Racenet	Applicant
US8424742(B2)	2013-04-01	Bettuchi	Applicant
US8453652(B2)	2013-06-01	Stopek	Applicant
US8453904(B2)	2013-06-01	Eskaros	Applicant
US8453909(B2)	2013-06-01	Olson	Applicant
US8453910(B2)	2013-06-01	Bettuchi	Applicant
US8464925(B2)	2013-06-01	Hull et al.	Applicant
US8474677(B2)	2013-07-01	Woodard, Jr.	Applicant
US8479968(B2)	2013-07-01	Hodgkinson	Applicant
US8485414(B2)	2013-07-01	Criscuolo et al.	Applicant
US8496683(B2)	2013-07-01	Prommersberger	Applicant
US8511533(B2)	2013-08-01	Viola	Applicant
US8512402(B2)	2013-08-01	Marczyk	Applicant
US8529600(B2)	2013-09-01	Woodard, Jr.	Applicant
US8540131(B2)	2013-09-01	Swayze	Applicant
US8551138(B2)	2013-10-01	Orban	Applicant
US8556918(B2)	2013-10-01	Bauman	Applicant
US8561873(B2)	2013-10-01	Ingmanson	Applicant
US8584920(B2)	2013-11-01	Hodgkinson	Applicant
US8590762(B2)	2013-11-01	Hess	Applicant
US8616430(B2)	2013-12-01	Prommersberger	Applicant
US8631989(B2)	2014-01-01	Aranyi	Applicant
US8657176(B2)	2014-02-01	Shelton et al.	Examiner
US8668129(B2)	2014-03-01	Olson	Applicant
US8684250(B2)	2014-04-01	Bettuchi	Applicant
US8727197(B2)	2014-05-01	Hess et al.	Examiner
US8746535(B2)	2014-06-01	Shelton et al.	Examiner
US8757466(B2)	2014-06-01	Olson	Applicant
US8777004(B2)	2014-07-01	Shelton et al.	Examiner
US8789737(B2)	2014-07-01	Hodgkinson et al.	Examiner
US8820606(B2)	2014-09-01	Hodgkinson	Applicant
US2002/0028243(A1)	2002-03-01	Masters	Applicant
US2002/0091397(A1)	2002-07-01	Chen	Applicant
US2003/0065345(A1)	2003-04-01	Weadock	Applicant
US2003/0083676(A1)	2003-05-01	Wallace	Applicant
US2003/0120284(A1)	2003-06-01	Palacios	Applicant
US2003/0181927(A1)	2003-09-01	Wallace	Applicant
US2003/0183671(A1)	2003-10-01	Mooradian et al.	Applicant
US2003/0208231(A1)	2003-11-01	Williamson, IV et al.	Applicant
US2004/0107006(A1)	2004-06-01	Francis et al.	Applicant
US2004/0254590(A1)	2004-12-01	Hoffman et al.	Applicant
US2004/0260315(A1)	2004-12-01	Dell et al.	Applicant
US2005/0002981(A1)	2005-01-01	Lahtinen et al.	Applicant
US2005/0021085(A1)	2005-01-01	Abrams et al.	Applicant
US2005/0059996(A1)	2005-03-01	Bauman et al.	Applicant
US2005/0059997(A1)	2005-03-01	Bauman et al.	Applicant
US2005/0070929(A1)	2005-03-01	Dalessandro et al.	Applicant
US2005/0118435(A1)	2005-06-01	DeLucia et al.	Applicant
US2005/0143756(A1)	2005-06-01	Jankowski	Applicant
US2005/0149073(A1)	2005-07-01	Arani et al.	Applicant
US2006/0004407(A1)	2006-01-01	Hiles et al.	Applicant
US2006/0135992(A1)	2006-06-01	Bettuchi	Applicant
US2006/0173470(A1)	2006-08-01	Oray et al.	Applicant
US2006/0178683(A1)	2006-08-01	Shimoji et al.	Applicant
US2006/0271104(A1)	2006-11-01	Viola et al.	Applicant
US2007/0026031(A1)	2007-02-01	Bauman et al.	Applicant
US2007/0034669(A1)	2007-02-01	de la Torre et al.	Applicant
US2007/0049953(A2)	2007-03-01	Shimoji et al.	Applicant
US2007/0123839(A1)	2007-05-01	Rousseau et al.	Applicant
US2007/0179528(A1)	2007-08-01	Soltz et al.	Applicant
US2007/0203509(A1)	2007-08-01	Bettuchi	Applicant
US2007/0203510(A1)	2007-08-01	Bettuchi	Applicant
US2007/0246505(A1)	2007-10-01	Pace-Floridia et al.	Applicant
US2008/0029570(A1)	2008-02-01	Shelton et al.	Applicant
US2008/0082126(A1)	2008-04-01	Murray et al.	Applicant
US2008/0110959(A1)	2008-05-01	Orban et al.	Applicant
US2008/0125812(A1)	2008-05-01	Zubik et al.	Applicant
US2008/0140115(A1)	2008-06-01	Stopek	Applicant
US2008/0161831(A1)	2008-07-01	Bauman et al.	Applicant
US2008/0161832(A1)	2008-07-01	Bauman et al.	Applicant
US2008/0169327(A1)	2008-07-01	Shelton et al.	Applicant
US2008/0169328(A1)	2008-07-01	Shelton	Applicant
US2008/0169329(A1)	2008-07-01	Shelton et al.	Applicant
US2008/0169330(A1)	2008-07-01	Shelton et al.	Applicant
US2008/0169331(A1)	2008-07-01	Shelton et al.	Applicant
US2008/0169332(A1)	2008-07-01	Shelton et al.	Applicant
US2008/0169333(A1)	2008-07-01	Shelton et al.	Applicant
US2008/0200949(A1)	2008-08-01	Hiles	Applicant
US2008/0290134(A1)	2008-11-01	Bettuchi et al.	Applicant
US2008/0308608(A1)	2008-12-01	Prommersberger	Applicant
US2008/0314960(A1)	2008-12-01	Marczyk et al.	Applicant
US2009/0001121(A1)	2009-01-01	Hess et al.	Applicant
US2009/0001122(A1)	2009-01-01	Prommersberger et al.	Applicant
US2009/0001123(A1)	2009-01-01	Morgan et al.	Applicant
US2009/0001124(A1)	2009-01-01	Hess et al.	Applicant
US2009/0001125(A1)	2009-01-01	Hess et al.	Applicant
US2009/0001126(A1)	2009-01-01	Hess et al.	Applicant
US2009/0001128(A1)	2009-01-01	Weisenburgh, II et al.	Applicant
US2009/0001130(A1)	2009-01-01	Hess et al.	Applicant
US2009/0005808(A1)	2009-01-01	Hess et al.	Applicant
US2009/0030452(A1)	2009-01-01	Bauman et al.	Applicant
US2009/0043334(A1)	2009-02-01	Bauman et al.	Applicant
US2009/0076510(A1)	2009-03-01	Bell et al.	Applicant
US2009/0076528(A1)	2009-03-01	Sgro	Applicant
US2009/0078739(A1)	2009-03-01	Viola	Applicant
US2009/0095791(A1)	2009-04-01	Eskaros et al.	Applicant
US2009/0095792(A1)	2009-04-01	Bettuchi	Applicant
US2009/0120994(A1)	2009-05-01	Murray et al.	Applicant
US2009/0134200(A1)	2009-05-01	Tarinelli et al.	Applicant
US2009/0206125(A1)	2009-08-01	Huitema et al.	Applicant
US2009/0206126(A1)	2009-08-01	Huitema et al.	Applicant
US2009/0206139(A1)	2009-08-01	Hall et al.	Applicant
US2009/0206141(A1)	2009-08-01	Huitema et al.	Applicant
US2009/0206142(A1)	2009-08-01	Huitema et al.	Applicant
US2009/0206143(A1)	2009-08-01	Huitema et al.	Applicant
US2009/0218384(A1)	2009-09-01	Aranyi	Applicant
US2009/0277947(A1)	2009-11-01	Viola	Applicant
US2009/0287230(A1)	2009-11-01	D'Agostino et al.	Applicant
US2010/0012704(A1)	2010-01-01	Tarinelli Racenet et al.	Applicant
US2010/0065606(A1)	2010-03-01	Stopek	Applicant
US2010/0065607(A1)	2010-03-01	Orban, III et al.	Applicant
US2010/0072254(A1)	2010-03-01	Aranyi et al.	Applicant
US2010/0147921(A1)	2010-06-01	Olson	Applicant
US2010/0147922(A1)	2010-06-01	Olson	Applicant
US2010/0147923(A1)	2010-06-01	D'Agostino et al.	Applicant
US2010/0236707(A1)	2010-09-01	Studer et al.	Applicant
US2010/0243708(A1)	2010-09-01	Aranyi et al.	Applicant
US2010/0243711(A1)	2010-09-01	Olson et al.	Applicant
US2010/0249805(A1)	2010-09-01	Olson et al.	Applicant
US2010/0264195(A1)	2010-10-01	Bettuchi	Applicant
US2010/0282815(A1)	2010-11-01	Bettuchi et al.	Applicant
US2011/0024476(A1)	2011-02-01	Bettuchi et al.	Applicant
US2011/0024481(A1)	2011-02-01	Bettuchi et al.	Applicant
US2011/0036894(A1)	2011-02-01	Bettuchi	Applicant
US2011/0042442(A1)	2011-02-01	Viola et al.	Applicant
US2011/0046650(A1)	2011-02-01	Bettuchi	Applicant
US2011/0057016(A1)	2011-03-01	Bettuchi	Applicant
US2011/0087279(A1)	2011-04-01	Shah et al.	Applicant
US2011/0215132(A1)	2011-09-01	Aranyi	Applicant
US2012/0074199(A1)	2012-03-01	Olson	Applicant
US2012/0080336(A1)	2012-04-01	Shelton	Applicant
US2012/0187179(A1)	2012-07-01	Gleiman	Applicant
US2012/0241499(A1)	2012-09-01	Baxter	Applicant
US2012/0273547(A1)	2012-11-01	Hodgkinson et al.	Applicant
US2013/0037596(A1)	2013-02-01	Bear et al.	Applicant
US2013/0105548(A1)	2013-05-01	Hodgkinson	Applicant
US2013/0105553(A1)	2013-05-01	Racenet	Applicant
US2013/0112732(A1)	2013-05-01	Aranyi	Applicant
US2013/0112733(A1)	2013-05-01	Aranyi	Applicant
US2013/0146641(A1)	2013-06-01	Shelton	Applicant
US2013/0153633(A1)	2013-06-01	Casasanta	Applicant
US2013/0153634(A1)	2013-06-01	Carter	Applicant
US2013/0153635(A1)	2013-06-01	Hodgkinson	Applicant
US2013/0153636(A1)	2013-06-01	Shelton	Applicant
US2013/0153638(A1)	2013-06-01	Carter	Applicant
US2013/0153639(A1)	2013-06-01	Hodgkinson	Applicant
US2013/0153640(A1)	2013-06-01	Hodgkinson	Applicant
US2013/0153641(A1)	2013-06-01	Shelton	Applicant
US2013/0161374(A1)	2013-06-01	Swayze	Applicant
US2013/0181031(A1)	2013-07-01	Olson	Applicant
US2013/0193186(A1)	2013-08-01	Racenet	Applicant
US2013/0193190(A1)	2013-08-01	Carter	Applicant
US2013/0193191(A1)	2013-08-01	Stevenson	Applicant
US2013/0193192(A1)	2013-08-01	Casasanta	Applicant
US2013/0209659(A1)	2013-08-01	Racenet	Applicant
US2013/0221062(A1)	2013-08-01	Hodgkinson	Applicant
US2013/0240600(A1)	2013-09-01	Bettuchi	Applicant
US2013/0240601(A1)	2013-09-01	Bettuchi	Applicant
US2013/0240602(A1)	2013-09-01	Stopek	Applicant
US2013/0277411(A1)	2013-10-01	Hodgkinson	Applicant
US2013/0306707(A1)	2013-11-01	Viola	Applicant
US2013/0310873(A1)	2013-11-01	Prommersberger	Applicant
US2013/0327807(A1)	2013-12-01	Olson	Applicant
US2014/0012317(A1)	2014-01-01	Orban	Applicant
US2014/0021242(A1)	2014-01-01	Hodgkinson	Applicant
US2014/0027490(A1)	2014-01-01	Marczyk	Applicant
US2014/0034704(A1)	2014-02-01	Ingmanson	Applicant
US2014/0048580(A1)	2014-02-01	Merchant	Applicant
US2014/0061280(A1)	2014-03-01	Ingmanson	Applicant
US2014/0061281(A1)	2014-03-01	Hodgkinson	Applicant
US2014/0084042(A1)	2014-03-01	Stopek	Applicant
US2014/0097224(A1)	2014-04-01	Prior	Applicant
US2014/0117066(A1)	2014-05-01	Aranyi	Applicant
US2014/0130330(A1)	2014-05-01	Olson	Applicant
US2014/0131418(A1)	2014-05-01	Kostrzewski	Applicant
US2014/0131419(A1)	2014-05-01	Bettuchi	Applicant
US2014/0138423(A1)	2014-05-01	Whitfield	Applicant
US2014/0151431(A1)	2014-06-01	Hodgkinson	Applicant
US2014/0155916(A1)	2014-06-01	Hodgkinson	Applicant
US2014/0158742(A1)	2014-06-01	Stopek	Applicant
US2014/0166721(A1)	2014-06-01	Stevenson	Applicant
US2014/0197224(A1)	2014-07-01	Penna	Applicant
US2014/0203061(A1)	2014-07-01	Hodgkinson	Applicant
US2014/0217147(A1)	2014-08-01	Milliman	Applicant
US2014/0217148(A1)	2014-08-01	Penna	Applicant
US2014/0239046(A1)	2014-08-01	Milliman	Applicant
US2014/0239047(A1)	2014-08-01	Hodgkinson	Applicant
CA2667434	2008-05-01		Applicant
DE19924311(A1)	2000-11-01		Applicant
DE19924311(A1)	2000-11-01		Applicant
EP594148(A1)	1994-04-01		Applicant
EP327022(B1)	1995-04-01		Applicant
EP667119(A1)	1995-08-01		Applicant
EP1064883(A1)	2001-01-01		Applicant
EP1256317(A2)	2002-11-01		Applicant
EP1256318	2002-11-01		Applicant
EP1520525(A1)	2005-04-01		Applicant
EP1621141(A2)	2006-02-01		Applicant
EP1702570(A1)	2006-09-01		Applicant
EP1759640(A2)	2007-03-01		Applicant
EP1815804(A2)	2007-08-01		Applicant
EP1825820	2007-08-01		Applicant
EP1929958	2008-06-01		Applicant
EP1994890(A1)	2008-11-01		Applicant
EP2005894(A2)	2008-12-01		Applicant
EP2005895(A2)	2008-12-01		Applicant
EP2008595(A2)	2008-12-01		Applicant
EP2090231	2009-08-01		Applicant
EP2090244	2009-08-01		Applicant
EP2090252	2009-08-01		Applicant
EP2198787(A1)	2010-06-01		Applicant
EP2236098(A2)	2010-10-01		Applicant
EP2236099	2010-10-01		Applicant
EP2311386	2011-04-01		Applicant
EP2436348	2012-04-01		Applicant
EP2462880	2012-06-01		Applicant
EP2517637	2012-10-01		Applicant
EP2586380	2013-05-01		Applicant
EP2604195	2013-06-01		Applicant
EP2604197	2013-06-01		Applicant
EP2620106	2013-07-01		Applicant
EP2630922	2013-08-01		Applicant
EP2644125	2013-10-01		Applicant
JP2000-166933	2000-06-01		Applicant
JP2002-202213	2002-07-01		Applicant
JP7-124166	2007-05-01		Applicant
WO90/05489(A1)	1990-05-01		Applicant
WO95/16221	1995-06-01		Applicant
WO96/22055(A1)	1996-07-01		Applicant
WO97/01989(A1)	1997-01-01		Applicant
WO97/13463(A1)	1997-04-01		Applicant
WO98/17180(A1)	1998-04-01		Applicant
WO99/45849(A1)	1999-09-01		Applicant
WO3/082126(A1)	2003-10-01		Applicant
WO3/088845	2003-10-01		Applicant
WO3/094743	2003-11-01		Applicant
WO3/105698(A2)	2003-12-01		Applicant
WO2005/079675	2005-09-01		Applicant
WO2006/023578(A2)	2006-03-01		Applicant
WO2006/044490(A2)	2006-04-01		Applicant
WO2006/083748(A1)	2006-08-01		Applicant
WO2007/121579(A1)	2007-11-01		Applicant
WO2008/057281(A2)	2008-05-01		Applicant
WO2008/109125AI	2008-09-01		Applicant
WO2010/075298(A2)	2010-07-01		Applicant
WO2011/143183(A2)	2011-11-01		Applicant
WO2012/044848(A1)	2012-04-01		Applicant

Non-Patent Literature (55)

International Search Report corresponding to European Application No. EP 12 15 2229.6, completed on Feb. 23, 2012 and mailed on Mar. 1, 2012; 4 pages.Applicant
International Search Report corresponding to European Application No. EP 12 15 0511.9, completed on Apr. 16, 2012 and mailed on Apr. 24, 2012; 7 pages.Applicant
International Search Report corresponding to European Application No. EP 12 15 2541.4, completed on Apr. 23, 2012 and mailed on May 3, 2012; 10 pages.Applicant
International Search Report corresponding to European Application No. EP 12 16 5609.4, completed on Jul. 5, 2012 and mailed on Jul. 13, 2012; 8 pages.Applicant
International Search Report corresponding to European Application No. EP 12 15 8861.0, completed on Jul. 17, 2012 and mailed on Jul. 24, 2012; 9 pages.Applicant
International Search Report corresponding to European Application No. EP 12 16 5878.5, completed on Jul. 24, 2012 and mailed on Aug. 6, 2012; 8 pages.Applicant
Extended European Search Report corresponding to EP 13 17 7437.4, completed Sep. 11, 2013 and mailed Sep. 19, 2013; (6 pp).Applicant
Extended European Search Report corresponding to EP 13 17 7441.6, completed Sep. 11, 2013 and mailed Sep. 19, 2013; (6 pp).Applicant
Extended European Search Report corresponding to EP 07 86 1534.1, completed Sep. 20, 2013 and mailed Sep. 30, 2013; (5 pp).Applicant
Extended European Search Report corresponding to EP 13 18 3876.5, completed Oct. 14, 2013 and mailed Oct. 24, 2013; (5 pp).Applicant
Extended European Search Report corresponding to EP 13 17 1856.1, completed Oct. 29, 2013 and mailed Nov. 7, 2013; (8 pp).Applicant
Extended European Search Report corresponding to EP 13 18 0373.6, completed Oct. 31, 2013 and mailed Nov. 13, 2013; (7 pp).Applicant
Extended European Search Report corresponding to EP 13 18 0881.8, completed Nov. 5, 2013 and mailed Nov. 14, 2013; (6 pp).Applicant
Extended European Search Report corresponding to EP 13 17 6895.4, completed Nov. 29, 2013 and mailed Dec. 12, 2013; (5 pp).Applicant
Extended European Search Report corresponding to EP 13 18 2911.1, completed Dec. 2, 2013 and mailed Dec. 16, 2013; (8 pp).Applicant
Extended European Search Report corresponding to EP 10 25 1795.0, completed Dec. 11, 2013 and mailed Dec. 20, 2013; (6 pp).Applicant
Extended European Search Report corresponding to EP 13 18 7911.6, completed Jan. 22, 2014 and mailed Jan. 31, 2014; (8 pp).Applicant
International Search Report corresponding to European Application No. EP 05 02 2585.3, completed on Jan. 25, 2006 and mailed on Feb. 3, 2006; 4 pages.Applicant
International Search Report corresponding to European Application No. EP 06 00 4598, completed on Jun. 22, 2006; 2 pages.Applicant
International Search Report corresponding to European Application No. EP 06 01 6962.0, completed on Jan. 3, 2007 and mailed on Jan. 11, 2007; 10 pages.Applicant
International Search Report corresponding to International Application No. PCT/US05/36740, completed on Feb. 20, 2007 and mailed on Mar. 23, 2007; 8 pages.Applicant
International Search Report corresponding to International Application No. PCT/US2007/022713, completed on Apr. 21, 2008 and mailed on May 15, 2008; 1 page.Applicant
International Search Report corresponding to International Application No. PCT/US2008/002981, completed on Jun. 9, 2008 and mailed on Jun. 26, 2008; 2 pages.Applicant
International Search Report corresponding to European Application No. EP 08 25 1779, completed on Jul. 14, 2008 and mailed on Jul. 23, 2008; 5 pages.Applicant
International Search Report corresponding to European Application No. EP 08 25 1989.3, completed on Mar. 11, 2010 and mailed on Mar. 24, 2010; 6 pages.Applicant
International Search Report corresponding to European Application No. EP 10 25 0639.1, completed on Jun. 17, 2010 and mailed on Jun. 28, 2010; 7 pages.Applicant
International Search Report corresponding to European Application No. EP 10 25 0715.9, completed on Jun. 30, 2010 and mailed on Jul. 20, 2010; 3 pages.Applicant
International Search Report corresponding to European Application No. EP 05 80 4382.9, completed on Oct. 5, 2010 and mailed on Oct. 12, 2010; 3 pages.Applicant
International Search Report corresponding to European Application No. EP 10 25 1437.9, completed on Nov. 22, 2010 and mailed on Dec. 16, 2010; 3 pages.Applicant
International Search Report corresponding to European Application No. EP 09 25 2897.5, completed on Feb. 7, 2011 and mailed on Feb. 15, 2011; 3 pages.Applicant
International Search Report corresponding to European Application No. EP 10 25 0642.5, completed on Mar. 25, 2011 and mailed on Apr. 4, 2011; 4 pages.Applicant
International Search Report corresponding to European Application No. EP 11 18 8309.6, completed on Dec. 15, 2011 and mailed on Jan. 12, 2012; 3 pages.Applicant
Extended European Search Report corresponding to EP No. 12 19 1035.0, completed Jan. 11, 2013 and mailed Jan. 18, 2013; 7 pages.Applicant
Extended European Search Report corresponding to EP No. 12 18 6175.1, completed Jan. 15, 2013 and mailed Jan. 23, 2013; 7 pages.Applicant
Extended European Search Report corresponding to EP No. 12 19 1114.3, completed Jan. 23, 2013 and mailed Jan. 31, 2013; 10 pages.Applicant
Extended European Search Report corresponding to EP No. 12 19 2224.9, completed Mar. 14, 2013 and mailed Mar. 26, 2013; 8 pages.Applicant
Extended European Search Report corresponding to EP No. 12 19 6911.7, completed Apr. 18, 2013 and mailed Apr. 24, 2013; 8 pages.Applicant
Extended European Search Report corresponding to EP 12 19 1035.0, completed Jan. 11, 2013 and mailed Jan. 18, 2013; 7 pages.Applicant
Extended European Search Report corresponding to EP 12 19 6904.2, completed Mar. 28, 2013 and mailed Jul. 26, 2013; 8 pages.Applicant
Extended European Search Report corresponding to EP 12 19 8749.9, completed May 21, 2013 and mailed May 31, 2013; 8 pages.Applicant
Extended European Search Report corresponding to EP 07 00 5842.5, completed May 13, 2013 and mailed May 29, 2013; 7 pages.Applicant
Extended European Search Report corresponding to EP 12 19 8776.2, completed May 16, 2013 and mailed May 27, 2013; 8 pages.Applicant
Extended European Search Report corresponding to EP 13 15 6297.7, completed Jun. 4, 2013 and mailed Jun. 13, 2013; 7 pages.Applicant
Extended European Search Report corresponding to EP 13 17 3985.6, completed Aug. 19, 2013 and mailed Aug. 28, 2013; 6 pages.Applicant
Extended European Search Report corresponding to EP 13 17 3986.4, completed Aug. 20, 2013 and mailed Aug. 29, 2013; 7 pages.Applicant
Extended European Search Report corresponding to EP 08 72 6500.5, completed Feb. 20, 2014 and mailed Mar. 3, 2014; (7 pp).Applicant
Extended European Search Report corresponding to EP 13 19 5919.9, completed Feb. 10, 2014 and mailed Mar. 3, 2014; (7 pp).Applicant
Extended European Search Report corresponding to EP 13 19 2123.1, completed Jan. 30, 2014 and mailed Feb. 10, 2014; (8 pp).Applicant
Extended European Search Report corresponding to EP 13 19 6816.6, completed Mar. 28, 2014 and mailed Apr. 9, 2014; (9 pp).Applicant
Extended European Search Report corresponding to EP 13 19 4995.0, completed Jun. 5, 2014 and mailed Jun. 16, 2014; (5 pp).Applicant
Extended European Search Report corresponding to EP 13 19 5019.8, completed Mar. 14, 2014 and mailed Mar. 24, 2014; (7 pp).Applicant
Extended European Search Report corresponding to EP 13 19 2111.6, completed Feb. 13, 2014 and mailed Feb. 27, 2014; (10 pp).Applicant
Extended European Search Report corresponding to EP 13 19 7958.5, completed Apr. 4, 2014 and mailed Apr. 15, 2014; (8 pp).Applicant
Extended European Search Report corresponding to EP 14 15 6342.9, completed Jul. 22, 2014 and mailed Jul. 29, 2014; (8 pp).Applicant
Extended European Search Report corresponding to EP 14 15 7195.0, completed Jun. 5, 2014 and mailed Jun. 18, 2014; (9 pp).Applicant

Abstract