A simulated abdominal wall model that is ideal for practicing laparoscopic first entry surgical techniques is provided. The model includes a simulated abdominal wall portion captured between two frame elements of a support. The support is connectable to a surgical trainer. When connected to the trainer, the model provides a penetrable abdominal tissue portion for accessing an internal cavity of the trainer. The simulated abdominal wall includes a plurality of layers including a skin layer, a fabric posterior rectus sheath layer, a simulated fat layer of low-resilience polyurethane foam and at least two layers that provide distinctive haptic feedback upon penetration of the simulated transversalis fascia and muscle layers. The simulated abdominal wall includes a simulated umbilicus across several layers of simulated tissue.
G09B 23/28 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la médecine
B29C 39/02 - Moulage par coulée, c. à d. en introduisant la matière à mouler dans un moule ou entre des surfaces enveloppantes sans pression significative de moulage; Appareils à cet effet pour la fabrication d'objets de longueur définie, c. à d. d'objets séparés
G09B 5/02 - Matériel à but éducatif à commande électrique avec présentation visuelle du sujet à étudier, p.ex. en utilisant une bande filmée
2.
ELECTROSURGICAL INSTRUMENTS AND CONNECTIONS THERETO
An electrosurgical instrument includes jaws having an electrode configuration utilized to electrically modify tissue in contact with one or more electrodes. The instrument is removably connectable to an electrosurgical unit via an electrosurgical connector extending from the instrument and a receptacle on the electrosurgical unit. The electrosurgical instrument is rotatable without disrupting electrical connection to the electrodes of the jaws. One or more of the electrodes is retractable. The electrosurgical unit and instrument optimally seals and/or cuts tissue based on identifying the tissue and monitoring the modification of the tissue by the application of radio frequency energy.
A simulated abdominal wall for laparoscopic surgical training and methods of making the wall are provided. The simulated abdominal wall is dome-shaped having a visual appearance of an insufflated abdomen. Also, the wall is strong enough to withstand penetration with surgical trocars without unrealistic buckling or deformation. The wall is supported by a frame along the perimeter without any support structures traversing the wall that would interfere with port placement. The wall includes multiple layers connected together to form a unitary wall to fit a laparoscopic trainer. In one method, a projection of a dome is cut from a flat layer of foam material and assembled within a mold cavity. Consecutive layers with the same or different projection pattern are laid up inside the mold cavity. In another method, a vacuum mold together with heat is used to deform each foam layer. Adhesive is applied between layers to simultaneously join the adjacent layers upon deformation.
A surgical simulation system is provided. The system includes at least one simulated body organ placed upon the base of an organ tray and at least one covering layer placed over the simulated body organ. At least one of the simulated body organ and covering layer includes electro-conductive gel that is operably severable under application of electrical current to simulate electrosurgery in a training environment. The training environment comprises a top cover connected to and spaced apart from a base to define an internal cavity that is partially obstructed from direct observation by a practitioner. The tray, simulated body organs and covering layer are placed inside the internal cavity for the practice of laparoscopic surgical procedures.
Simulated tissue structures and methods of making them are disclosed. An elastic first material is placed in tension. An elastic second material is adhered to the first material while the first material is in tension. The adhered second material and the first material in tension forms a first shape of the simulated tissue structure. Tension on the first material is released. In releasing the tension of the first material, a force is exerted on the adhered second material bring the combination of the first material and the second material into a second shape. The first shape is maintained by a mold or mandrel and the second shape is the desired shape of the simulated tissue structure.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include a rotational mechanism arranged to discretely position the rotatable actuation shaft in one of the rotational orientations. The rotational mechanism can be arranged for single handed operation such as by including a slidable switch or selector to rotate the actuation shaft.
A TME surgical simulator is provided. The TME surgical simulator includes a simulated tissue layers and simulated vasculature and/or organ structures. The simulated tissue surgical simulator is adapted for but not limited to laparoscopic and/or transanal TME surgical procedures.
A powered handle for a surgical stapler can have a drive system including an electric motor. The powered handle can include a manual articulation mechanism to articulate a jaw assembly coupled to a reload shaft connected to the handle. The manual articulation mechanism can include a ball screw mechanism that translates an articulation member responsive to rotation of an articulation knob. The articulation mechanism includes a release function that allows the jaw assembly to return to a longitudinally centered orientation. The powered handle includes a battery pack serving as a power supply for the drive system. A control system can control actuation of the motor based on user inputs and operating parameters of the stapler. The powered handle can include a manual return mechanism.
A surgical stapler includes a jaw assembly at a distal end connected to a handle assembly that is configured to control the stapler and actuate the deployment of staples. The surgical stapler successfully eliminates intermediate caming portions commonly known as pushers that are located between the staples and a translating slider. The staples are located in pockets at an angle such that the base of the staple is parallel to an angled caming surface of the slider. The translating slider comes into direct contact with staples during deployment as the slider moves through each staple pocket where staples are partially supported by recesses along the slider pathway. The staples are deployed at an angle against the anvil surface. Because there are no pushers, a great deal of space is saved resulting in a much smaller diameter surgical stapler that is particularly suitable for laparoscopic stapling applications.
A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside the enclosure. The simulated tissue model is adapted for practicing a number of surgical procedures including but not limited to transanal excisions and transvaginal hysterectomies. The simulated tissue model includes one more components and is interchangeably connected to the frame with fasteners configured to pass through apertures in the frame to suspend the simulated tissue model within the frame. The enclosure of the frame is increasingly laterally constricted along the longitudinal axis to progressively increase the confinement of the components of the simulated tissue model.
A powered handle for a surgical stapler can have a drive system including an electric motor. The powered handle can include a manual return mechanism. The powered handle can also include a retention mechanism to prevent unintentional movement of drivetrain components upon actuation of the manual return mechanism. For example, the retention mechanism can apply a direction-dependent frictional force on an actuation shaft of the handle assembly to prevent unintentional movement of the actuation shaft towards a distal end of the handle assembly. The retention mechanism can include a featherboard-like configuration with a plurality of ribs oriented transversely to the actuation shaft to restrict movement of the actuation shaft in one direction while allowing movement of the shaft in the opposite direction.
Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.
A guard for providing a cut-resistant pathway through a body orifice or incision to circumferentially protect tissue at the margin is provided. The guard is made of flexible, cut-resistant mesh material having a plurality of interwoven thermosoftening filaments. The guard has a central lumen and at least one flared end. The flared end, which serves to anchor the guard in the body opening, is deformable into a reduced configuration to facilitate its insertion and removal. The layer of mesh stretches laterally to increase the diameter of the central lumen. The flexibility and expandability of the guard allows the guard to conform to body openings of different sizes. The guard may include a drawstring to cinch the flared distal end from the proximal end. The guard is thermoset with the flared distal end that is biased to spring back to its normal, undeformed configuration when released from a deformed configuration.
B29C 67/00 - Techniques de façonnage non couvertes par les groupes , ou
B29C 51/00 - Façonnage par thermoformage, p.ex. façonnage de feuilles dans des moules en deux parties ou par emboutissage profond; Appareils à cet effet
A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside an enclosure. The simulated tissue model is adapted for practicing hysterectomies and includes at least a simulated uterus and a simulated vagina. The simulated tissue model is suspending inside the enclosure with two planar sheets of silicone such that the tissue model is located between the two sheets each of which form a fold and are in turn connected to the frame. The frame may be shaped like a cylinder and located inside a cavity of a larger laparoscopic trainer having a penetrable simulated abdominal wall. The tissue model is interchangeable and accessible laterally through an aperture provided in a support leg of the trainer.
Surgical stapler systems can include lockout mechanisms to restrict further movement of a jaw assembly and provide different functionality when a jaw assembly is empty and when a partially or fully fired reload cartridge is present in the jaw assembly. When the jaw assembly is empty, the empty jaw assembly lockout mechanism can arrest an open-close stroke of the jaw assembly. When an at least partially fired reload is present in the jaw assembly, a fired reload lockout mechanism can allow operation of the jaw assembly through a substantial portion of an open-close stroke, but restrict actuation of the jaw assembly in a firing stroke. The separate lockout mechanisms can be embodied in a single lockout lever actuatable by lockout actuators to three distinct positions or by two independently-operable lockout levers.
A circumferential retractor system is provided that includes a circumferential retractor and a flexible retainer. The circumferential retractor and retainer retracts and protects a patient's body opening, providing access into a patient.
An electrosurgical generator arranged to supply radio frequency (RF) energy to fuse tissue is provided. The generator is arranged to supply RF energy through a removably coupled electrosurgical instrument to fuse tissue grasped by the instrument. The generator monitors a phase angle of the supplied RF energy and adjusts or terminates the supplied RF energy based on the monitored phase angle in comparison to predetermined thresholds and conditions to optimally fuse the tissue. The electrosurgical instrument conducts radio frequency energy to fuse tissue captured between the jaws and a blade to mechanically cut tissue between the jaws. A conductive post positioned on the jaw adjacent to the blade.
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p.ex. des courants à haute fréquence
A surgical stapling system can include a reload shaft. The shaft can include an elongate tubular member with have a jaw assembly at the distal end thereof and a coupling collar at the proximal end thereof. The shaft assembly also includes an articulation joint coupling the jaw assembly to the distal end. A drive member and an articulation member extend within the tubular body of the shaft from the proximal end to the distal end. A firing member is connected to the distal end of the drive member such that advancement of the drive beam advances the firing member to close the jaw assemblies and fire staples from a reload positioned in the jaw assembly. The shaft assembly can also include a lockout mechanism to prevent a firing operation on a previously-fired reload or no reload.
A powered handle for a surgical stapler has a drive system including an electric motor. The powered handle includes a shaft recognition mechanism such that when a reload shaft for use with the surgical stapler is installed, a control system can actuate the drive system with the recognized shaft. The powered handle further comprises a LED light ring driven by a light control scheme to display a handle status. The control system also includes a startup module to assess hardware and control system performance before use. The startup module assesses different criteria depending on whether the handle is new, previously used, or previously reset. The control system of the powered handle further includes a lockout module configured to identify when a lockout has been encountered. The lockout module applies different criteria depending on whether the motor is operating at a maximum speed state or less than a maximum speed state.
Surgical stapler systems can include a jaw assembly with one jaw defining a reload support capable of receiving and firing multiple disposable reload cartridges in a single surgical procedure. The reload cartridge can be protected by a reload cover engageable therewith. The reload cover can include snap features configured to prevent manual removal of the reload cover from the reload cartridge before proper positioning and installation in the reload support. The reload cover can desirably maintain a plurality of staples within staple pockets in the reload cartridge and can maintain a staple deployment mechanism in an unfired position.
The lighted surgical access system is provided that includes a circumferential retractor/protector and a light emitter system attached thereto. The circumferential retractor/protector retracts and protects a patient's body opening while the light emitter system illuminates the internal surgical site, body cavity or body opening.
A surgical simulation scope system is provided as effective as a surgical scope without the added expense and complexities. The surgical simulation scope comprises an optics housing, a lens and an image sensor placed in such a way to ensure the location of the sensor is within the depth of focus of the lens is maintained while not damaging the sensor and, in some cases, to provide angled and/or rotational viewing.
Pressure conditioning systems for supplying insufflation gas to an open-ended body conduit such as a rectal cavity during a transanal minimally invasive surgery (TAMIS) procedure can reduce billowing of walls of the body conduit. A pressure conditioning system can include a pressure storage component, an accumulator, and a flow restrictor. The pressure storage component can include a variable volume reservoir that is biased to a relatively low volume state. The flow restrictor can include insufflation tubing with a restrictor plate having a relatively low diameter orifice. The pressure storage component, accumulator, and flow restrictor can be fluidly connected in various orders in series or as side branches from a gas flow conduit. Despite a pulsed or otherwise discontinuous insufflation gas flow and leakage and absorption from the body conduit, the pressure conditioning system can maintain a constant pressure within the body conduit.
A tissue retrieval system including a tissue retrieval bag deployable from an introducer and suspended in an open configuration by support arms can include retention features to prevent inadvertent movement of the tissue retrieval bag relative to the support arms. The support arms can include protruding domes, folds, or curls to restrict sliding of the tissue retrieval bag relative to the support arms. Alternately, tension can be maintained in a cord loop coupled to an opening of the tissue retrieval bag to prevent the tissue retrieval bag from inadvertently sliding relative to the support arms.
An electrosurgical system is provided and includes a bipolar electrosurgical instrument and an electrosurgical generator. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the bipolar electrosurgical instrument. The electrosurgical generator is arranged to supply RF energy through the bipolar electrosurgical instrument, monitor the supplied RF energy, and adjust or terminate the supplied RF energy to optimally seal the tissue.
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p.ex. des courants à haute fréquence
A61B 34/00 - Chirurgie assistée par ordinateur; Manipulateurs ou robots spécialement adaptés à l’utilisation en chirurgie
A surgical stapler is provided. The stapler employs circumferential channels through which staples are deployed along an arc pathway against an anvil surface. The curved channels allow staples with relatively longer legs to be used in the stapler having a smaller diameter at the jaws. Also, by utilizing a curved path, a much larger staple can be placed in the same diameter device. Specialized curved staples for use with the stapler of the present invention are also provided. To further enable the benefits of the stapler with circumferential channels and method of staple deployment, novel jaw reinforcement structures are provided in the present invention. The jaw reinforcement structures are located towards the center or bladeline of the device instead of around the circumference as in conventional staplers, thereby clearing the outer area near the circumference of the device to provide room for longer staples and staple firing components.
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessures; Chargeurs de clamps pour blessures
The surgical robotic access system provides access for robotic instruments and/or actuators including the introduction, operation and withdrawal of such robotic manipulators into a body cavity without permitting the escape of pressurized fluid or gas. The surgical robotic access system also provides a multi-faceted range of movement without touching or effecting pressure on the opening in the patient's body cavity.
A61B 1/00 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments
The lighted surgical access system is provided that includes a circumferential retractor and a plastic optical fiber (POF) attached thereto. The circumferential retractor retracts and protects a patient’s body opening while the POF illuminates the internal surgical site, body cavity and/or body opening.
A61B 1/07 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments avec dispositifs d'éclairement utilisant des moyens conduisant la lumière, p.ex. des fibres optiques
A61B 1/313 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments pour l'introduction dans des incisions chirurgicales, p.ex. laparoscopes
29.
MULTISKILL EXERCISE FOR LAPAROSCOPIC INSTRUMENTATION
A surgical training model for teaching, practicing, and assessing motor and cognitive skills associated with laparoscopic surgery is provided. The surgical training model has at least a portion (e.g., limbs) that is manipulatable by a user in order to maneuver those portions in a desired manner in order to interact with other portions of the surgical training model. Force perception mechanisms can also be included to inform a user when an applied force on one or more portions of the surgical training model is over a pre-determined amount.
A simulated training model having a force perception mechanism to identify and notify to a user when an amount of force being applied to the model exceeds a pre-determined amount. The force perception mechanism has two states that are used to identify when an amount of force being applied to the model exceeds the pre-determined amount. In a first state, one or more portions of the simulated training model are removably connected to each other; for example the body to the base and/or the post to the body. The second state corresponds to when one or more of the portions of the simulated training model become detached from each other. When the transition occurs between the first state to the second state, the surgical training model informs the user that the force being applied to one or more of the portions of the simulated training model had exceeded the pre-determined amount.
Surgical tools that can be used in single port laparoscopic procedures can include a low-profile handle assembly to minimize tool interference adjacent the incision site. For example, a handle assembly for a surgical instrument can have a generally in-line configuration extending linearly along a central longitudinal axis of an elongate shaft of the instrument. A linkage mechanism including a trigger, an actuation link, and an actuation shaft can be positioned within the in-line handle. The linkage mechanism can be pivoted between an open position in which end effectors of the instrument are open and a toggle position in which the end effectors are locked closed. A locking mechanism such as a ratchet mechanism can also be used to lock the end effectors. A surgical dissector can include gripping jaws having a curved profile or an angled elongate shaft to minimize tool interference and maximize visibility within a procedure site.
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A surgical training model for teaching, practicing, and assessing motor and cognitive skills associated with laparoscopic surgery is provided. The surgical training model has at least a portion (e.g., limbs) that is manipulatable by a user in order to maneuver those portions in a desired manner in order to interact with other portions of the surgical training model. Force perception mechanisms can also be included to inform a user when an applied force on one or more portions of the surgical training model is over a pre-determined amount.
A simulated training model having a force perception mechanism to identify and notify to a user when an amount of force being applied to the model exceeds a pre-determined amount. The force perception mechanism has two states that are used to identify when an amount of force being applied to the model exceeds the pre-determined amount. In a first state, one or more portions of the simulated training model are removably connected to each other; for example the body to the base and/or the post to the body. The second state corresponds to when one or more of the portions of the simulated training model become detached from each other. When the transition occurs between the first state to the second state, the surgical training model informs the user that the force being applied to one or more of the portions of the simulated training model had exceeded the pre-determined amount.
An electrosurgical instrument is provided that captures, compresses, fuses and cuts tissue between upper and lower jaws connected to pivotably movable handles. The instrument includes a force and over compression regulation mechanism that is configured such that in a clamped configuration, the jaws delivers a gripping force between the first jaw and the second jaw between a predetermined minimum force and a predetermined maximum force.
A retractor/protector suitable for use in a surgical incision or a natural orifice comprises a longitudinal axis defining an instrument access channel extending from a proximal end to a distal end; a flexible outer ring; an inner ring; a flexible sheath extending between the outer ring and the inner ring; and at least one rigid segment adapted to attach to the flexible outer ring to thereby increase the rigidity of the outer ring. Embodiments of the retractor/protector are described that have interlocking and non-interlocking rigid segments. Embodiments are also described that have bases that insert into or under the flexible outer ring in addition to or in lieu of rigid segments to increase rigidity and/or provide support for a detachable cap.
A simulated tissue structure for surgical training is provided. The simulated tissue structure includes a first layer made of silicone and a second layer made of silicone interconnected by a third layer made of polyester fiber that is embedded in part in the first layer and in part in the second layer to create a mechanical linkage between the first layer and the second layer. Part of the third layer that is adjacent to the first layer and part of the third layer that is adjacent to the second layer includes fiber strands coated in silicone. An inclusion that mimics an anatomical structure is located between the first layer and the second layer. The third layer of polyester fibers provides a realistic dissection plane for the practice of the surgical excision of the inclusion.
Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag and the guard is configured to protect the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The guard is adjustable for easy insertion and removal and configured to securely anchor to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.
Embodiments of a surgical access port system that comprises a retractor that is adapted for being coupled to a cap and that is particularly useful in natural orifice surgery are described. The retractor comprises an outer ring, wherein the outer ring is configured to be disposed proximate the natural orifice of the patient and substantially surround the orifice; a tubular body; and various stabilizing mechanisms surrounding the tubular body, sized and configured to stabilize and retain the retractor within the orifice. The stabilizing embodiments described herein are useful in all natural orifices and are of particular use in the vaginal surgery.
A renal hilum surgical simulation system is provided. The renal hilum surgical simulation system includes simulated tissue layers and simulated renal organs and/or vasculatures. The renal hilum surgical simulation system is adapted for but not limited to laparoscopic donor nephrectomy surgical procedures.
G09B 23/28 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la médecine
G09B 23/32 - Modèles anatomiques avec des parties mobiles
A61B 1/313 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments pour l'introduction dans des incisions chirurgicales, p.ex. laparoscopes
40.
LAPAROSCOPIC GRASPER WITH FORCE-LIMITING GRASPING MECHANISM
A surgical instrument is provided having an actuator mechanism with an integrated extension element. The surgical instrument comprises a handle assembly, an elongate shaft, and an end effector. The end effector can comprise a jaw assembly having atraumatic pads positioned thereon to reduce force on grasped tissue. An actuator is movable within the elongate shaft to actuate jaws of the jaw assembly responsive to movement of a movable handle of the handle assembly. The actuator can have an integrated extension element that allows the actuator to translate within the elongate shaft upon application of a relatively low force and translate and extend upon application of a relatively higher force to the actuator to limit the force applied by the jaw assembly. The actuator is also able to utilize force stored with the integrated extension element to provide a dynamic amount of force used to grasp the tissue in scenarios where the tissue volume decreases while in the jaws.
A colpotomy model is provided for assisting in the training and practice of users performing a colpotomy procedure. The colpotomy model has a simulated vaginal opening which covers a proximal end of a simulated pelvic frame and a simulated vaginal canal which defines an internal space that encompasses a simulated cervix. The simulated cervix is suspended via at least one cord to provide a realistic response to user interaction with the simulated cervix. The user is directed to manipulate the simulated cervix and make one or more incisions where the simulated vaginal canal becomes reflected near the simulated cervix from the manipulations. The user is then directed to continue through the colpotomy model to access a simulated peritoneal cavity or other portions of the colpotomy model in accordance with a simulated procedure being performed.
A colpotomy model is provided for assisting in the training and practice of users performing a colpotomy procedure. The colpotomy model has a simulated vaginal opening which covers a proximal end of a simulated pelvic frame and a simulated vaginal canal which defines an internal space that encompasses a simulated cervix. The simulated cervix is suspended via at least one cord to provide a realistic response to user interaction with the simulated cervix. The user is directed to manipulate the simulated cervix and make one or more incisions where the simulated vaginal canal becomes reflected near the simulated cervix from the manipulations. The user is then directed to continue through the colpotomy model to access a simulated peritoneal cavity or other portions of the colpotomy model in accordance with a simulated procedure being performed.
A colpotomy model is provided for assisting in the training and practice of users performing a colpotomy procedure. The colpotomy model has a simulated vaginal opening which covers a proximal end of a simulated pelvic frame and a simulated vaginal canal which defines an internal space that encompasses a simulated cervix. The simulated cervix is suspended via at least one cord to provide a realistic response to user interaction with the simulated cervix. The user is directed to manipulate the simulated cervix and make one or more incisions where the simulated vaginal canal becomes reflected near the simulated cervix from the manipulations. The user is then directed to continue through the colpotomy model to access a simulated peritoneal cavity or other portions of the colpotomy model in accordance with a simulated procedure being performed.
A retractor introducer system is provided that includes a circumferential retractor and a retractor introducer. The circumferential retractor retracts and protects a patient’s body opening and the retractor introducer facilitates insertion and positioning of the circumferential retractor within the patient’s body.
A simulated tissue structure and a method for making the same is provided. The simulated tissue structure is made to have a longitudinal strength that is sufficient to withstand manipulations and movements when used with a simulated surgical training model while still being severable by conventional and electro- surgical tools. The simulated tissue structure has a first and second inner layer that is encompassed by an outer layer. Portions of the first inner layer are connectable with other simulated organs to simulate conditions for training laparoscopic procedures.
A tissue retrieval system including a tissue retrieval bag deployable by an actuator from an introducer and suspended in an open configuration by support arms can be serially redeployed between a partially or fully stowed configuration and a first deployed configuration to be used in procedures to collect multiple samples. The system can include defeasible proximal and distal stop mechanisms to limit movement of the actuator for serial redeployment. The tissue retrieval system can include a retention latch to couple a bead of the tissue retrieval bag to the actuator with the retrieval bag in the first deployed position and a user-selectable deployment release to allow deployment of the retrieval bag to a fully deployed position where it is released from the actuator. A bead stop is positioned to engage the introducer to prevent reintroduction of the bead and bag into the introducer once the bag has been fully deployed.
A simulated tissue structure and a method for making the same is provided. The simulated tissue structure is made to have a longitudinal strength that is sufficient to withstand manipulations and movements when used with a simulated surgical training model while still being severable by conventional and electro- surgical tools. The simulated tissue structure has a first and second inner layer that is encompassed by an outer layer. Portions of the first inner layer are connectable with other simulated organs to simulate conditions for training laparoscopic procedures.
A simulated tissue structure and a method for making the same is provided. The simulated tissue structure is made to have a longitudinal strength that is sufficient to withstand manipulations and movements when used with a simulated surgical training model while still being severable by conventional and electro-surgical tools. The simulated tissue structure has a first and second inner layer that is encompassed by an outer layer. Portions of the first inner layer are connectable with other simulated organs to simulate conditions for training laparoscopic procedures.
G09B 23/34 - Modèles anatomiques avec des parties amovibles
B29C 70/30 - Façonnage par empilage, c.à d. application de fibres, de bandes ou de feuilles larges sur un moule, un gabarit ou un noyau; Façonnage par pistolage, c.à d. pulvérisation de fibres sur un moule, un gabarit ou un noyau
09 - Appareils et instruments scientifiques et électriques
10 - Appareils et instruments médicaux
Produits et services
Surgical simulation trainer and accessories thereof, namely,
anatomy models, suturing models, and abdominal wall models. Medical instruments for laparoscopic surgery.
A surgical training model can have features for training surgical suturing techniques. The training model can be formed as a sheet of simulated tissue having at least one cut with markings arranged on either side of the cut. The markings can be formed of a first layer of resilient simulated tissue material having a color that contrasts with a color of the remainder of the sheet of simulated tissue material. The sheet of simulated tissue material can have several cuts having different configurations and orientations to facilitate suturing training for a variety of tissue orientations. The sheet of simulated tissue material can further include holes positioned to be mounted to a base of a surgical training system. The sheet of simulated tissue material can be manufactured by molding a marking layer and casting a tissue layer over the marking layer.
G09B 23/28 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la médecine
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
51.
SURGICAL STAPLER WITH SELF-ADJUSTING STAPLE HEIGHT
A surgical stapler is provided that includes a spring loaded lift that automatically adjusts a staple cartridge and/or staple formation between a range of sizes. The lift is automatically released as the staple firing mechanism begins its forward translation of the firing sequence. The automatic one-way adjustment also adjusts the staple cartridge while maintaining the cartridge parallel to the anvil to provide consistent staple formations.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include a rotational mechanism arranged to discretely position the rotatable actuation shaft in one of the rotational orientations. The rotational mechanism can be arranged for single handed operation such as by including a slidable switch or selector to rotate the actuation shaft.
A surgical access port or trocar is provided. The trocar has a trocar seal housing and a trocar cannula with an optical obturator insertable through the trocar seal housing and the trocar cannula. The trocar is configured to access a body cavity, to maintain positive pressure and to prevent loss of surgical insufflation gas used in laparoscopic procedures. The trocar seal housing can be releasably attached to the trocar cannula. The trocar seal housing may also have a shield and/or alignment channel that provide protection or assist in operation of instrument and zero seals housed in the trocar seal housing.
A surgical simulation network system is provided that facilitates user training in various surgical procedures and subsequent assessments of the user by allowing the users and assessors to be at different physical locations. The surgical simulation network system is part of a network having various surgical trainers that capture user performance data related to various surgical simulations. The user performance data is subsequently accessible by one or more assessors via the surgical simulation network system that allows the assessors to assess the user's competency. Thus, the users and the assessors can be located at different locations. Furthermore, the performance of the simulation and the assessments can be performed at different times.
A surgical simulation network system is provided that facilitates user training in various surgical procedures and subsequent assessments of the user by allowing the users and assessors to be at different physical locations. The surgical simulation network system is part of a network having various surgical trainers that capture user performance data related to various surgical simulations. The user performance data is subsequently accessible by one or more assessors via the surgical simulation network system that allows the assessors to assess the user's competency. Thus, the users and the assessors can be located at different locations. Furthermore, the performance of the simulation and the assessments can be performed at different times.
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
G09B 23/28 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la médecine
57.
GYN PATHOLOGY SURGICAL SIMULATION MODELS AND SYSTEMS FOR SURGICAL TRAINING
Embodiments of the present invention provide GYN pathology simulation models for surgical training. These models are energy-compatible models emulating the tissue-based diseases of the female reproductive system to allow the surgical trainees and surgeons to practice advanced OB/GYN surgical skills. One simulated GYN model includes an electrically conductive elongated tube encapsulating a mass of non-conductive material. The elongated tube having a sidewall with an inner surface and outer surface extending between a proximal end and distal end. The sidewall is configured to have a cavity with a specific volume to yield an external protuberance when filled with the mass of non-conductive material. Another simulated GYN model includes a fluid-filled cystic body encapsulated within an electrically conductive bulbous hollow structure. The fluid-filled cystic body is selectively adhered to the bulbous hollow structure in at least one or more regions, thereby creating a plane for a combination of blunt and sharp dissection.
Embodiments of the present invention provide GYN pathology simulation models for surgical training. These models are energy-compatible models emulating the tissue-based diseases of the female reproductive system to allow the surgical trainees and surgeons to practice advanced OB/GYN surgical skills. One simulated GYN model includes an electrically conductive elongated tube encapsulating a mass of non-conductive material. The elongated tube having a sidewall with an inner surface and outer surface extending between a proximal end and distal end. The sidewall is configured to have a cavity with a specific volume to yield an external protuberance when filled with the mass of non-conductive material. Another simulated GYN model includes a fluid-filled cystic body encapsulated within an electrically conductive bulbous hollow structure. The fluid-filled cystic body is selectively adhered to the bulbous hollow structure in at least one or more regions, thereby creating a plane for a combination of blunt and sharp dissection.
Embodiments of the present invention provide GYN pathology simulation models for surgical training. These models are energy-compatible models emulating the tissue-based diseases of the female reproductive system to allow the surgical trainees and surgeons to practice advanced OB/GYN surgical skills. One simulated GYN model includes an electrically conductive elongated tube encapsulating a mass of non-conductive material. The elongated tube having a sidewall with an inner surface and outer surface extending between a proximal end and distal end. The sidewall is configured to have a cavity with a specific volume to yield an external protuberance when filled with the mass of non-conductive material. Another simulated GYN model includes a fluid-filled cystic body encapsulated within an electrically conductive bulbous hollow structure. The fluid-filled cystic body is selectively adhered to the bulbous hollow structure in at least one or more regions, thereby creating a plane for a combination of blunt and sharp dissection.
A system for training surgical camera navigation skills is provided. A plurality of two-dimensional targets is printed on an upper surface of a flat sheet of material. The sheet is easily transportable and placed onto a base of a typical box trainer that defines a simulated abdominal cavity between the base and a top. A scope is inserted through a port in the top and the targets are viewed on a live video feed displayed to a trainee on a screen with the targets being otherwise obscured from view by the box trainer. The trainee can move the scope back and forth, roll and angulate the scope about the port in order to view the targets on the sheet at different angles and distances. The trainee is instructed to follow a sequence of targets marked on the sheet and manipulate the scope to align consecutively each target with the edges of the screen in the sequence provided.
G09B 23/28 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la médecine
A61B 1/00 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments
A61B 1/05 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments combinés avec des dispositifs photographiques ou de télévision caractérisés par le fait que le capteur d'images, p.ex. l'appareil photographique, est placé dans la partie de l'extrémité distale
A61B 1/313 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p.ex. endoscopes; Dispositions pour l'éclairage dans ces instruments pour l'introduction dans des incisions chirurgicales, p.ex. laparoscopes
The present invention provides a surgical training device for training laparoscopic first entry surgical techniques. The training device includes a simulated abdominal wall that is penetrable with an optical trocar. A receptacle containing a tissue simulation is located inside the receptacle. The tissue simulation is observable via scope placed inside the optical trocar. Upon penetration of the one or more of the simulated abdominal wall and receptacle, the tissue simulation appears to translate distally relative to the simulated abdominal wall. The distal translation is effected by a variety of ways including the release of negative pressure inside the receptacle upon penetration and the expansion of an elastic wall of the receptacle with the introduction of fluid under pressure into the receptacle.
The surgical robotic access system provides access for robotic instruments and/or actuators including the introduction, operation and withdrawal of such robotic manipulators into a body cavity without permitting the escape of pressurized fluid or gas. The surgical robotic access system also provides a multi-faceted range of movement without touching or effecting pressure on the opening in the patient's body cavity.
A tissue retractor comprising an outer ring, an inner ring, and a flexible, metal sheath extending therebetween is described. Embodiments of the inner ring comprise a flat or wedge-shaped conformation useful for insertion between muscle layers. Other embodiments of the inner ring include variable diameter inner rings, where the diameter can be adjusted as required and optionally locked into place, and reshapeable inner rings that permit a user to conform the inner ring to the anatomy of the patient when placing the inner ring.
A laparoscopic suturing device is provided. The suturing device can pass a suturing needle back and forth between jaws of a jaw assembly to suture tissue at a surgical site in a minimally invasive procedure. The jaw assembly can have a pivotable jaw member in each jaw to position the jaw assembly and needle in a low-profile stowed configuration for insertion through a low diameter surgical port. The jaw assembly can be actuated by a handle assembly that provides simultaneous needle passing from a driving jaw to a receiving jaw and latching the needle within the receiving jaw in a single trigger cycle.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
A61B 17/062 - Dispositifs pour manipuler les aiguilles
A61B 17/06 - Aiguilles; Supports ou empaquetages pour aiguilles ou matériaux de suture
67.
Surgical training model for laparoscopic procedures
A surgical training device is provided. The training device includes a model for practicing the passage of needle and suture. The model includes a base with a plurality of openings configured to receive a plurality of suture tabs. The suture tabs are made of elastomeric material. Some suture tabs includes pre-formed tab apertures for the passage of a suture. Other suture tabs include a penetrable area through which a suture needle may penetrate for passing a suture. The suture tabs are movable with respect to the base to orientate them at different angles with respect to the base. The base itself may include portions that are angled with respect to each other. The suture tabs are movable with respect to the base to pull, expose or open the tab apertures and surfaces. Some of the tab apertures are slits that open upon being pulled relative to the base requiring the user to practice holding the tab while passing the needle through the tab.
G09B 23/28 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la médecine
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets pour refermer les plaies ou les maintenir fermées, p.ex. agrafes chirurgicales; Accessoires utilisés en liaison avec ces opérations pour la suture des plaies; Supports ou emballages pour aiguilles ou matériaux de suture
G09B 23/32 - Modèles anatomiques avec des parties mobiles
G09B 23/36 - Modèles à usage scientifique, médical ou mathématique, p.ex. dispositif en vraie grandeur pour la démonstration pour la zoologie
G09B 23/34 - Modèles anatomiques avec des parties amovibles
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A cannula assembly having a retention member and a method of manufacture of the cannula assembly is provided. The cannula assembly includes a cannula and a sleeve disposed around the cannula from a proximal end to a distal end. The sleeve can include a balloon formed by a stretch blow molding process following local heating once advanced over the cannula. Once formed, the balloon can be conditioned to constrict against the cannula. A conditioning aid can be advanced over the balloon when it is still formable to constrict the balloon against the cannula.
Jaw assemblies for a surgical stapler are provided. The jaw assemblies comprise a first jaw having a first clamping surface and a plurality of staples disposed therein and second jaw assembly having a second clamping surface. The jaw assemblies can be actuated from a closed configuration in which the first clamping surface contacts or is adjacent to the second clamping surface to an open configuration in which the second jaw is pivoted away from the first jaw to a stapling position in which the second clamping surface is parallel to the first clamping surface and spaced apart from the first clamping surface. A pivoting link or sliding pivot joint can couple the second jaw to the first jaw to facilitate motion between the closed position, the open position, and the stapling position.
A circumferential retractor system is provided that includes a circumferential retractor and a flexible retainer. The circumferential retractor and retainer retracts and protects a patient's body opening, providing access into a patient.
A circumferential retractor system is provided that includes a circumferential retractor and a flexible retainer. The circumferential retractor and retainer retracts and protects a patient's body opening, providing access into a patient.
Medical and surgical devices, namely, electrosurgical
instruments in the nature of vessel and tissue fusing,
sealing, coagulating and cutting hand tools, generators for
powering electrosurgical instruments.
A TME surgical simulator is provided. The TME surgical simulator includes a simulated tissue layers and simulated vasculature and/or organ structures. The simulated tissue surgical simulator is adapted for but not limited to laparoscopic and/or transanal TME surgical procedures.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a second rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include an articulation mechanism including a ball screw to selectively articulate the jaw assembly relative to an elongate shaft. The handle assembly can include a mechanism to lock out selection of the staple firing mode and actuation of the articulation mechanism if a reload shaft is not securely coupled to the handle assembly.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a second rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include an articulation mechanism including a ball screw to selectively articulate the jaw assembly relative to an elongate shaft. The handle assembly can include a mechanism to lock out selection of the staple firing mode and actuation of the articulation mechanism if a reload shaft is not securely coupled to the handle assembly.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a second rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include an articulation mechanism including a ball screw to selectively articulate the jaw assembly relative to an elongate shaft. The handle assembly can include a mechanism to lock out selection of the staple firing mode and actuation of the articulation mechanism if a reload shaft is not securely coupled to the handle assembly.
09 - Appareils et instruments scientifiques et électriques
Produits et services
Medical teaching and training apparatus for simulating surgical procedures, sold together as a unit with accessories thereof, namely, anatomy models, suturing models, abdominal wall models, and functional replicas of laparoscopic tools
91.
Surgical stapling instrument having a two-position lockout mechanism
Surgical stapler systems can include lockout mechanisms to restrict further movement of a jaw assembly and provide different functionality when a jaw assembly is empty and when a partially or fully fired reload cartridge is present in the jaw assembly. When the jaw assembly is empty, the empty jaw assembly lockout mechanism can arrest an open-close stroke of the jaw assembly. When an at least partially fired reload is present in the jaw assembly, a fired reload lockout mechanism can allow operation of the jaw assembly through a substantial portion of an open-close stroke, but restrict actuation of the jaw assembly in a firing stroke. The separate lockout mechanisms can be embodied in a single lockout lever actuatable by lockout actuators to three distinct positions or by two independently-operable lockout levers.
Devices, methods, and systems provide a surgical access device comprising an internal retractor device integrated with or coupled to a body wall or wound retractor. The wound retractor retracts an opening in a body wall into a body cavity, while the internal retractor permits a user to control the positions of internal structures within the body cavity, thereby permitting a user to define a surgical field. Embodiments of the internal retractor are adjustable.
A surgical simulator for surgical training is provided. The simulator includes a frame defining an enclosure and a simulated tissue model located inside the frame. The simulated tissue model is adapted for practicing a number of surgical procedures including but not limited to transanal excisions and transvaginal hysterectomies. Portions of the frame comprises a material adhesively compatible with the material of portions of the simulated tissue model to secure and suspend the simulated tissue model within the frame. The simulated tissue model may also include simulated vasculature configured to loop through apertures in the frame to secure and suspend the simulated tissue model within the frame.
09 - Appareils et instruments scientifiques et électriques
10 - Appareils et instruments médicaux
Produits et services
Medical teaching and training apparatus for simulating surgical procedures Medical devices, namely, energy devices in the nature of vessel and tissue fusing and sealing and coagulating and cutting hand tools, electrosurgical tools being surgical apparatus and instruments, access systems comprised of urological and laparoscopic and vascular access ports for medical use, laparoscopic instruments, graspers for surgical use, trocars, suction irrigation devices for sugical use, surgical apparatus for extraction and retrieval, surgical retractors and wound protectors for use in surgery, stents and sheaths for surgical use, surgical guidewires, occlusion devices for surgical use, surgical clip appliers, surgical clips and clamps, catheters, insufflation needles for medical use, and scope-warmer apparatus for surgical use
09 - Appareils et instruments scientifiques et électriques
10 - Appareils et instruments médicaux
Produits et services
Medical teaching and training apparatus for simulating surgical procedures Medical devices, namely, energy devices in the nature of vessel and tissue fusing and sealing and coagulating and cutting hand tools, electrosurgical tools being surgical apparatus and instruments, access systems comprised of urological, laparoscopic, and vascular access ports for medical use, laparoscopic instruments, graspers for surgical use, trocars, suction irrigation devices for sugical use, surgical apparatus for extraction and retrieval, surgical retractors and wound protectors for use in surgery, stents and sheaths for surgical use, surgical guidewires, occlusion devices for surgical use, surgical clip appliers, surgical clips and clamps, catheters, insufflation needles for medical use, and scope-warmer apparatus for surgical use
A retractor introducer system is provided that includes a circumferential retractor and a retractor introducer. The circumferential retractor retracts and protects a patient's body opening while the retractor introducer facilitates insertion and positioning of the circumferential retractor within the patient's body.
A retractor introducer system is provided that includes a circumferential retractor and a retractor introducer. The circumferential retractor retracts and protects a patient's body opening while the retractor introducer facilitates insertion and positioning of the circumferential retractor within the patient's body.
A handle assembly for a surgical stapler can comprise a rotatable actuation shaft. The actuation shaft can have a first rotational orientation in which it can actuate a jaw assembly in a repeatable open and close mode, a second rotational orientation in which it can actuate a jaw assembly in a staple firing mode, and a third rotational orientation in which it can actuate a jaw assembly in a reversing mode. The handle assembly can include an articulation mechanism including a ball screw to selectively articulate the jaw assembly relative to an elongate shaft.
Simulated tissue structures and methods of making them are disclosed. An elastic first material is placed in tension. An elastic second material is adhered to the first material while the first material is in tension. The adhered second material and the first material in tension forms a first shape of the simulated tissue structure. Tension on the first material is released. In releasing the tension of the first material, a force is exerted on the adhered second material bring the combination of the first material and the second material into a second shape. The first shape is maintained by a mold or mandrel and the second shape is the desired shape of the simulated tissue structure.
B29C 41/22 - Fabrication d'objets multicouches ou polychromes
B29K 83/00 - Utilisation de polymères contenant dans la chaîne principale uniquement du silicium avec ou sans soufre, azote, oxygène ou carbone comme matière de moulage
A powered handle for a surgical stapler can have a drive system including an electric motor. The powered handle can include a manual articulation mechanism to articulate a jaw assembly coupled to a reload shaft connected to the handle. The manual articulation mechanism can include a ball screw mechanism that translates an articulation member responsive to rotation of an articulation knob. The articulation mechanism includes a release function that allows the jaw assembly to return to a longitudinally centered orientation. The powered handle includes a battery pack serving as a power supply for the drive system. A control system can control actuation of the motor based on user inputs and operating parameters of the stapler. The powered handle can include a manual return mechanism.
H02J 7/00 - Circuits pour la charge ou la dépolarisation des batteries ou pour alimenter des charges par des batteries
A61B 17/072 - Agrafeuses chirurgicales pour appliquer une rangée d'agrafes en une seule opération
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux, p.ex. tourniquets
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p.ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 90/98 - Moyens d’identification pour les patients ou les instruments, p.ex. étiquettes utilisant des moyens électromagnétiques, p.ex. transpondeurs
