ИЗОГНУТЫЙ КОНЦЕВОЙ РАБОЧИЙ ОРГАН ДЛЯ СШИВАЮЩЕГО ИНСТРУМЕНТА

Группа изобретений включает кассету со скобками и концевой рабочий орган хирургического сшивающего инструмента, относится к области медицинской техники и предназначена для использования в области хирургии. Кассета со скобками включает корпус, содержащий пластину, множество первых и вторых полостей для скобок, множество приводных устройств, искривленный продольный проход и сжимаемый компенсатор толщины тканей. Множество первых полостей для скобок расположены вдоль первой кривой, причем указанная первая кривая определяется первым радиусом кривизны, и при этом каждая указанная первая полость для скобок содержит отверстие в указанной пластине. Множество вторых полостей для скобок расположены вдоль второй кривой, причем указанная вторая кривая определяется вторым радиусом кривизны, при этом указанный первый радиус кривизны отличается от второго радиуса кривизны, при этом каждая указанная вторая полость для скобок включает отверстие в указанной пластине. Множество приводных устройств для скобок ...

ПОВОРОТНЫЕ ПРИВОДНЫЕ КОНСТРУКЦИИ ДЛЯ ХИРУРГИЧЕСКИХ ИНСТРУМЕНТОВ

Изобретения относятся к медицинской технике, а именно к хирургическим инструментам, в том числе применяемым с роботизированной системой, и, в частности, к поворотной приводной конструкции для хирургического инструмента. Хирургический инструмент для применения с роботизированной системой, которая включает в себя узел привода инструмента, функционально соединенный с блоком управления роботизированной системы, управление которым осуществляется по входным командам оператора и который выполнен с возможностью генерировать выходные движения, содержит монтажную часть для инструмента, поворотную приводную систему, узел удлиненного стержня, хирургический концевой эффектор и поворотную трансмиссию. Монтажная часть для инструмента выполнена с возможностью функционального взаимодействия с частью роботизированной системы. Поворотная приводная система функционально поддерживается монтажной частью для инструмента и взаимодействует с узлом привода инструмента роботизированной системы, принимая от него выходные ...

СОЕДИНИТЕЛЬНАЯ КОНФИГУРАЦИЯ ВЗАИМОЗАМЕНЯЕМОГО КОНЦЕВОГО ЭФФЕКТОРА

Изобретение относится к медицинской технике. Хирургический инструмент содержит взаимозаменяемый концевой эффектор, узел рукоятки и узел стержня. Взаимозаменяемый концевой эффектор содержит первый элемент бранши с первым электродом и второй элемент бранши со вторым электродом. Первый элемент бранши выполнен с возможностью перемещения относительно второго элемента бранши между первым положением и вторым положением. Узел рукоятки расположен проксимально к хирургическому концевому эффектору. Узел стержня проходит между узлом рукоятки и взаимозаменяемым концевым эффектором. Поворотный приводной стержень выполнен с возможностью передачи поворотных движений. Поворотный приводной стержень выполнен с возможностью избирательного перемещения по оси относительно узла стержня между отдельными положениями. Соединительная конфигурация предназначается для разъемного прикрепления взаимозаменяемого концевого эффектора к узлу стержня. 10 з.п. ф-лы, 168 ил.

СИСТЕМА ХИРУРГИЧЕСКОГО ИНСТРУМЕНТА, ВКЛЮЧАЮЩАЯ СМЕННЫЕ КОНЦЕВЫЕ ЭФФЕКТОРЫ

Группа изобретений относится к медицинской технике, а именно к системе хирургического инструмента, включающей сменные концевые эффекторы. Система хирургического инструмента содержит корпус, первый концевой эффектор и второй концевой эффектор. Корпус включает в себя приводной стержень с приводом от двигателя, причем приводной стержень с приводом от двигателя выполнен с возможностью совершения заданного числа оборотов в течение пусковой активации. Первый концевой эффектор и второй концевой эффектор выполнены с возможностью соединения с корпусом и отсоединения от него. Первый концевой эффектор образует первую пусковую траекторию, имеющую первую пусковую длину. Второй концевой эффектор образует вторую пусковую траекторию, имеющую вторую пусковую длину, причем вторая пусковая длина отличается от первой пусковой длины. Первый концевой эффектор содержит первый пусковой элемент и первый приводной винт. Второй концевой эффектор содержит второй пусковой элемент и второй приводной винт. Первый пусковой ...

ХИРУРГИЧЕСКОЕ СШИВАЮЩЕЕ УСТРОЙСТВО С СИСТЕМОЙ БЛОКИРОВКИ ДЛЯ ПРЕДОТВРАЩЕНИЯ АКТИВАЦИИ В ОТСУТСТВИЕ УСТАНОВЛЕННОЙ КАССЕТЫ СО СКОБАМИ

... 1. Хирургический сшивающий инструмент, содержащий:концевой эффектор, содержащий:удлиненный канал, выполненный с возможностью функционально поддерживать в себе хирургическую кассету со скобами; иупор, поддерживаемый на удлиненном канале с возможностью перемещения между открытым и закрытым положением в ответ на приложение к нему открывающих и закрывающих движений; иэлемент блокировки упора, взаимодействующий с упором для удержания упора в открытом положении, когда кассета со скобами не установлена в удлиненный канал, и предотвращающий перемещение упора в закрытое положение до тех пор, пока в удлиненный канал не будет установлена кассета со скобами.2. Хирургический сшивающий инструмент по п. 1, в котором упор содержит монтажную часть упора, поддерживаемую с возможностью поворота на удлиненном канале, и причем элемент блокировки упора смещен в контакт с монтажной частью упора.3. Хирургический сшивающий инструмент по п. 2, в котором монтажная часть упора дополнительно содержит пару противоположных ...

СОЕДИНИТЕЛЬНЫЕ КОНСТРУКЦИИ ДЛЯ ПРИКРЕПЛЕНИЯ ХИРУРГИЧЕСКИХ КОНЦЕВЫХ ЭФФЕКТОРОВ К ПРИВОДНЫМ СИСТЕМАМ ДЛЯ НИХ

... 1. Хирургический инструмент, содержащий:концевой эффектор;проксимальный поворотный передаточный узел, функционально соединенный с источником поворотных и осевых управляющих движений, причем проксимальный поворотный передаточный узел дополнительно выполнен с возможностью продольного смещения в результате сообщения ему осевых управляющих движений;дистальный поворотный передаточный узел, функционально соединенный с концевым эффектором для сообщения ему поворотных управляющих движений;проксимальный осевой передаточный узел, функционально соединенный с источником других осевых управляющих движений;дистальный осевой передаточный узел, функционально соединенный с концевым эффектором для сообщения ему осевых управляющих движений; исоединительную конструкцию для одновременного прикрепления проксимального поворотного передаточного узла к дистальному поворотному передаточному узлу и проксимального осевого передаточного узла к дистальному осевому передаточному узлу и их одновременного отсоединения.2 ...

ПОДДЕРЖИВАЮЩИЕ КОНСТРУКЦИИ ПУСКОВОЙ ШТАНГИ, ВЫПОЛНЕННОЙ С ВОЗМОЖНОСТЬЮ ПЕРЕМЕЩЕНИЯ, ДЛЯ ХИРУРГИЧЕСКИХ ИНСТРУМЕНТОВ С ВОЗМОЖНОСТЬЮ ШАРНИРНОГО ПОВОРОТА

ХИРУРГИЧЕСКИЙ СШИВАЮЩИЙ ИНСТРУМЕНТ С ЗАМЕНЯЕМЫМИ КАССЕТАМИ СО СКОБКАМИ

... 1. Хирургический инструмент, включающий:узел рукоятки;удлиненный узел штока, смонтированный на указанном узле рукоятки и выступающий из нее, причем указанный удлиненный узел штока включает:удлиненный центральный элемент, который имеет дистальный конец, предназначенный для съемного присоединения концевого эффектора, а такжепусковую трубку, способную аксиально перемещаться вдоль указанного удлиненного центрального элемента, и взаимодействовать с пусковой системой, которая поддерживается указанным узлом рукоятки, чтобы заставлять указанную пусковую трубку избирательно двигаться на указанном центральном элементе таким образом, что указанная пусковая трубка может выборочно перемещаться в аксиальном направлении из неактивного положения, в котором дистальный конец центрального элемента съемным образом соединяется с частью концевого эффектора, в положение зацепления, в котором дистальная часть указанной пусковой трубки удерживает указанную часть указанного концевого эффектора в зацеплении с указанным ...

ХИРУРГИЧЕСКИЙ ИНСТРУМЕНТ, СОДЕРЖАЩИЙ ГИБКУЮ СИСТЕМУ ШАРНИРНОГО СОЧЛЕНЕНИЯ

КОМПЕНСАТОР ТОЛЩИНЫ ТКАНИ ДЛЯ ХИРУРГИЧЕСКОГО СШИВАЮЩЕГО ИНСТРУМЕНТА, СОДЕРЖАЩИЙ РЕГУЛИРУЕМЫЙ УПОР

... 1. Хирургический сшивающий инструмент, содержащийкассету со скобками, содержащую:корпус кассеты, содержащий множество гнезд для скобок; имножество скобок, расположенных внутри указанных гнезд для скобок;узел упора, содержащий:раму упора;упор, содержащий позиционирующую поверхность и по меньшей мере одну поверхность для формирования скобок, причем указанный упор удерживается с возможностью перемещения по указанной раме упора; ирегулирующий элемент, выполненный с возможностью перемещения и установки между указанной рамой упора и указанным упором, причем указанный регулирующий элемент содержит первую ступень, имеющую первую высоту, и вторую ступень, имеющую вторую высоту, причем указанная вторая высота отличается от указанной первой высоты, и причем указанный регулирующий элемент выполнен с возможностью перемещения между первым положением и вторым положением избирательно для расположения одной из указанной первой ступени и указанной второй ступени между указанной рамой упора и указанной позиционирующей ...

КОМПЕНСАТОР ТОЛЩИНЫ ТКАНИ, СОДЕРЖАЩИЙ КАПСУЛУ ДЛЯ СРЕДЫ С НИЗКИМ ДАВЛЕНИЕМ

... 1. Картридж со скобками, содержащий:корпус картриджа, содержащий полости для скобок;скобки, размещенные с возможностью извлечения в полостях для скобок, при этом скобки могут выталкиваться из полостей для скобок; икомпенсатор, содержащий емкость, причем емкость образует герметичную внутреннюю полость, причем герметичная внутренняя полость содержит внутреннюю атмосферу, при этом внутренняя атмосфера имеет давление ниже атмосферного давления, если емкость находится в неповрежденном состоянии, причем скобки выполнены с возможностью разрыва емкости, когда скобки выталкиваются из полостей для скобок.2. Картридж со скобками по п. 1, причем компенсатор выполнен с возможностью расширяться между смятым состоянием и расширенным состоянием, когда емкость разрывается скобками.3. Картридж со скобками по п. 2, в котором емкость ограничена стенкой емкости, причем стенка емкости изогнута, например является круглой, когда компенсатор находится в расширенном состоянии, и при этом стенка емкости сплющена, ...

ШАРНИРНО ПОВОРАЧИВАЕМЫЙ ХИРУРГИЧЕСКИЙ ИНСТРУМЕНТ, СОДЕРЖАЩИЙ ПУСКОВОЙ ПРИВОД

... 1. Хирургический инструмент для обработки ткани, содержащий:рукоятку, содержащую спусковой механизм;стержень, направленный от указанной рукоятки;концевой эффектор;шарнирное сочленение, причем указанный концевой эффектор поворотно соединен с указанным стержнем указанным шарнирным сочленением;пусковой элемент, функционально соединенный с указанным спусковым механизмом, причем работа указанного спускового механизма предусматривает возможность продвигать указанный пусковой элемент к указанному концевому эффектору; ишарнирный элемент, функционально соединенный с указанным концевым эффектором, причем указанный шарнирный элемент может избирательно зацепляться с указанным пусковым элементом так, что указанный шарнирный элемент функционально зацеплен с указанным пусковым элементом в зацепленном состоянии, и так, что указанный шарнирный элемент функционально расцеплен с указанным пусковым элементом в расцепленном состоянии, и причем указанный пусковой элемент выполнен с возможностью перемещать указанный ...

ХИРУРГИЧЕСКИЕ КОНЦЕВЫЕ ЭФФЕКТОРЫ С НАКЛОНЕННЫМИ КОНТАКТИРУЮЩИМИ С ТКАНЬЮ ПОВЕРХНОСТЯМИ

... 1. Концевой эффектор, содержащий:первый элемент бранши, содержащий первую наклоненную под положительным углом контактирующую с тканью поверхность; ивторой элемент бранши, содержащий вторую наклоненную под положительным углом контактирующую с тканью поверхность;причем первый элемент бранши выполнен с возможностью перемещения относительно второго элемента бранши между открытым положением и закрытым положением;причем по меньшей мере один из первого элемента бранши и второго элемента бранши содержит по меньшей мере один активный электрод, расположенный на элементе бранши смежно с наклоненной под положительным углом контактирующей с тканью поверхностью ипричем по меньшей мере один активный электрод выполнен с возможностью подачи РЧ-энергии к ткани, размещенной между первым элементом бранши и вторым элементом бранши в закрытом положении.2. Концевой эффектор по п. 1, в котором по меньшей мере один активный электрод расположен на втором элементе бранши, а также дополнительно содержащий по меньшей ...

ПОВОРОТНЫЕ ПРИВОДНЫЕ КОНСТРУКЦИИ ДЛЯ ХИРУРГИЧЕСКИХ ИНСТРУМЕНТОВ

... 1. Хирургический инструмент для применения с роботизированной системой, которая включает в себя узел привода инструмента, функционально соединенный с блоком управления роботизированной системы, управление которым осуществляется по входным командам оператора и который выполнен с возможностью генерировать выходные движения, причем указанный хирургический инструмент содержит:монтажную часть для инструмента, выполненную с возможностью функционального взаимодействия с частью роботизированной системы;поворотную приводную систему, которая функционально поддерживается монтажной частью для инструмента и взаимодействует с узлом привода инструмента роботизированной системы, принимая от него выходные движения;узел удлиненного стержня, функционально проходящий от монтажной части для инструмента и включающий в себя узел приводного стержня, который функционально взаимодействует с поворотной приводной системой, причем узел приводного стержня выполнен с возможностью избирательного перемещения по оси между ...

ПОВОРОТНЫЕ ОПОРНО-СОЕДИНИТЕЛЬНЫЕ УЗЛЫ ДЛЯ СОЕДИНЕНИЯ ПЕРВОЙ ЧАСТИ ХИРУРГИЧЕСКОГО ИНСТРУМЕНТА СО ВТОРОЙ ЧАСТЬЮ ХИРУРГИЧЕСКОГО ИНСТРУМЕНТА

... 1. Хирургическое сшивающее устройство, содержащее:узел удлиненного стержня, имеющий дистальный конец и образующий продольную ось инструмента;концевой эффектор, содержащий:узел удлиненного канала, включающий часть, выполненную с возможностью функциональной поддержки в ней хирургической кассеты со скобами; иупор, поддерживаемый с возможностью перемещения относительно узла удлиненного канала, и причем хирургическое сшивающее устройство дополнительно содержит поворотное соединение, соединяющее узел удлиненного канала с дистальным концом узла удлиненного стержня для обеспечения избирательного поворота узла удлиненного канала вокруг продольной оси инструмента относительно дистального конца узла удлиненного стержня.2. Хирургическое сшивающее устройство по п. 1, в котором поворотное соединение содержит:первую кольцеобразную канавку в одном из узла удлиненного стержня или узла удлиненного канала;вторую кольцеобразную канавку в другом из узла удлиненного канала или узла удлиненного стержня, предназначенную ...

Surgical instrument articulation

Powering a bipolar electrocautery surgical instrument

Pulley arrangement for articulating a surgical instrument

GUIDABLE SURGICAL INSTRUMENT

Apparatus for endoscopic procedures

APPARATUS FOR ENDOSCOPIC PROCEDURES The present disclosure relates to electromechanical surgical systems (10) configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue. A force transmitting assembly of surgical instrument (100) transmits a rotation of a rotatable drive member (118, 120, 122) of the surgical instrument (100) to the rotation receiving member (218, 220, 222) of the end effector (400). A distal neck assembly (236) of the surgical instrument (100) includes at least one gear system (240, 250) configured to convert a rotational input of the rotatable drive member (118, 120, 122) into at least two output forces to the end effector (400); and an articulating neck assembly (230) interconnecting the tubular body (210) and the distal neck housing (236). The articulating neck assembly (230) is configured to enable off-axis articulation of the distal neck assembly (236). The rotatable drive member (118, 120 ...

Applicator instruments having surgical fastener insertion tools for dispensing surgical fasteners

An applicator instrument for dispensing surgical fasteners includes a housing, an elongated shaft, and an elongated conduit extending through the elongated shaft. A firing system is disposed within the housing. The firing system has an insertion tool having a top surface that extends proximal and distal ends thereof and a stripper ramp that projects above the top surface. An actuator activates the firing system to commence a firing cycle. During the firing cycle, the firing system drives the insertion tool toward the distal end of the elongated shaft. The elongated conduit has a top wall with a top notch formed therein. The stripper ramp slides through the top notch for guiding movement of the insertion tool as the firing system drives the insertion tool toward the distal end of the elongated shaft.

Surgical fastening device

In accordance with one aspect of the disclosure, a surgical fastener is disclosed. The surgical fastener includes a base at a proximal end of the surgical fastener. A first arm and a second arm extend helically from the base about a longitudinal axis towards a distal end of the surgical fastener. A first needle capture zone is disposed on a distal portion of the first arm, and a second needle capture zone is disposed on a distal portion of the second arm. The first needle capture zone and the second needle capture zone are configured to engage with a respective first needle and a second needle when the first and the second needle are extending from a fastener deployment device and disengage with the respective first and second needle when the first and the second needle are retracting into the fastener deployment device.

Surgical instrument

Surgical instruments with reconfigurable shaft segments

A surgical instrument having a handle assembly and an elongated shaft assembly protruding therefrom. Various embodiments of the elongated shaft assemblies include reconfigurable shaft segments that have portions that may be selectively arranged in coaxial alignment with each other and in other configurations wherein at least some portions thereof are not in coaxial alignment with each other. Various locking arrangements are disclosed for releasably locking the reconfigurable shaft segments in desired orientations. A movable closure tube is supported on the elongated shaft segment and is oriented to provide actuation motions to an end effector coupled to the distal end of the elongated shaft.

Fastener system comprising a plurality of fastener cartridges

A surgical fastening instrument can comprise a handle and an end effector, wherein the end effector can comprise a first jaw comprising a first cartridge attachment portion and a second jaw comprising a second cartridge attachment portion, and wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw and the second jaw. The surgical fastening instrument can further comprise a first cartridge that is insertable into the first jaw and attachable to the first cartridge attachment portion and, in addition, a second cartridge that is insertable into the second jaw and attachable to the second cartridge attachment portion. In various embodiments, the first cartridge can comprise first fastener portions which are engageable with second fastener portions in the second cartridge.

Fastener system comprising a plurality of connected retention matrix elements

A surgical fastener system can comprise a plurality of fasteners which can be connected to each other by a flexible retention matrix which is assembled to the fasteners in order to capture tissue therebetween. The flexible retention matrix can comprise, one, a plurality of retention matrix elements configured to engage the fasteners and, two, a lattice of connectors which connect one or more retention matrix elements.

Articulating surgical tools and tool sheaths, and methods of deploying the same

A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Articulating surgical instruments and methods of deploying the same

A robotic introducer system comprises a first assembly comprising a cable control assembly configured for use in a plurality of medical procedures, a second assembly comprising a distal link extension assembly configured for fewer uses than the first assembly, and a third assembly comprising an articulating probe assembly, coupled between the first and second assemblies and configured for fewer uses than the second assembly.

Rotary powered surgical instruments with multiple degrees of freedom

A surgical instrument may comprise a drive system that is configured to electrically generate a plurality of discrete rotary control motions. In at least one form, the surgical instrument may include an elongate shaft assembly that is operably couplable to the drive system for receiving a first rotary control motion therefrom for rotating the elongate shaft assembly about a shaft axis. The elongate shaft assembly may be further configured to receive and transmit a second rotary control motion from the drive system to a surgical end effector that is operably coupled to the elongate shaft assembly to cause the surgical end effector to rotate about the shaft axis relative to the elongate shaft assembly. The elongate shaft assembly may be further configured to receive and transmit a third rotary control motion from the drive system to an articulation joint that communicates with the elongate shaft assembly and the surgical end effector to articulate the surgical end effector about an articulation ...

Medical device with articulating shaft

A medical device (10) includes an articulating shaft (20, 20a, 20b, 20c, 20d, 20e, or 20f) with a pair of slat assemblies (31, 33). By moving an articulator (37), the slat assemblies (31, 33) are configured to concurrently push while the other pulls in order to bend the articulating shaft (20). The articulating shaft (20) includes a series of pivot members (26, 26a, 26b, 26c, 26d, 126e and 226e, or 126f and 226f). The pivot members (26) may include inner links (126e, 126f) and outer links (226e, 226f). A method for articulating a shaft of a medical device is also provided.

Articulation assembly for surgical instruments

SURGICAL APPARATUS

The disclosure provides a surgical apparatus comprising: a steerable member that is bendable and comprises a plurality of bending segments with channels therein; and a plurality of bending actuation wires that are arranged to pass through the steerable member and cause the steerable member to bend, the steerable member comprising at least one outwardly opening lumen through which the bending actuation wires pass.

ROBOTIC SURGICAL DEVICES, SYSTEMS AND RELATED METHODS

The various inventions relate to robotic surgical devices, consoles for operating such surgical devices, operating theaters in which the various devices can be used, insertion systems for inserting and using the surgical devices, and related methods.

SURGICAL FASTENING DEVICE

In accordance with one aspect of the disclosure, a surgical fastener is disclosed. The surgical fastener includes a base at a proximal end of the surgical fastener. A first arm and a second arm extend helically from the base about a longitudinal axis towards a distal end of the surgical fastener. A first needle capture zone is disposed on a distal portion of the first arm, and a second needle capture zone is disposed on a distal portion of the second arm. The first needle capture zone and the second needle capture zone are configured to engage with a respective first needle and a second needle when the first and the second needle are extending from a fastener deployment device and disengage with the respective first and second needle when the first and the second needle are retracting into the fastener deployment device.

SYSTEMS AND METHODS FOR STEERING GUIDEWIRES

Embodiments of the present disclosure can include a system for steering a guidewire comprising: a guidewire tip integrably connected to a guidewire, the guidewire tip comprising a hollow body having first joint and second joints comprising a plurality of asymmetric recesses in the hollow body; a plurality of tendons operably connected to the first and second joints; and a control unit operably connected to the tendons and configured to actuate the tendons to provide multiple degrees of freedom of movement to the guidewire tip.

SURGICAL INSTRUMENT SOFT STOP

A surgical instrument includes a drive member movable by a drive motor between a home position and an end of stroke. A mechanical stop is disposed at or near the end of stroke and is structured to increase resistance to movement of the drive member from a first position to a second position. A control system detects a current spike associated with the increased resistance and interrupts power to the drive motor.

ARTICULATING SURGICAL INSTRUMENTS AND METHOD OF DEPLOYING THE SAME

A surgical instrument comprises a steering mechanism. The steering mechanism comprises a handle at a proximal end of the surgical instrument. The handle includes a plurality of controls for controlling a movement of the surgical instrument. The steering mechanism also comprises a hub that rotatably mates with the handle and a housing positioned about the hub. The handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom. An articulation region is at a distal end of the surgical instrument. A movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion.

FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS

A surgical fastener system can comprise a plurality of fasteners which can be connected to each other by a flexible retention matrix which is assembled to the fasteners in order to capture tissue therebetween. The flexible retention matrix can comprise, one, a plurality of retention matrix elements configured to engage the fasteners and, two, a lattice of connectors which connect one or more retention matrix elements.

FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX

A surgical stapling instrument can comprise, one, a handle comprising an actuator and, two, an end effector comprising a proximal end, a distal end, and a longitudinal axis extending between the proximal end and the distal end. The end effector can further comprise a first jaw configured to support staples comprising staple legs and, in addition, a second jaw supporting a matrix element opposite the staples, wherein one of the jaws is movable toward the other in order to engage the matrix element with the staple legs. The stapling instrument can further comprise a cam operably coupled with the actuator, wherein the cam is movable along the longitudinal axis to deform the staple legs.

APPARATUS FOR ENDOSCOPIC PROCEDURES

An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable.

APPARATUS FOR ENDOSCOPIC PROCEDURES

An electromechanical surgical system is provided including a hand-held surgical instrument; an end effector; and a shaft assembly for selectively interconnecting the end effector and the surgical device. The shaft assembly includes a transmission housing; an outer tubular body; a distal neck housing for interconnecting a rotatable drive member of the surgical instrument and a rotation receiving member supported in the end effector, wherein the distal neck housing includes at least one gear system configured to convert a rotational input of the rotatable drive member into at least two output forces to the end effector; and an articulating neck assembly interconnecting the tubular body and the distal neck housing. The articulating neck assembly enables off-axis articulation of the distal neck assembly, and wherein the rotatable drive member extends through the articulating neck assembly.

SURGICAL INSTRUMENT

A surgical apparatus for use in endoscopic surgery having a user interface operatively coupled to an articulating tool assembly via an elongate tubular member. Movement at the articulating tool mirrors movement at the user interface thereby providing intuitive operation of the surgical apparatus. The apparatus is configured such that the range of motion of the articulating tool assembly emulates the range of motion of the human wrist.

ARTICULATING SURGICAL TOOLS AND TOOL SHEATHS, AND METHODS OF DEPLOYING THE SAME

A system for performing a medical procedure includes an articulating probe including inner and outer sleeves, and a surgical tool including a functional element positioned at a distal end of a tool shaft, the tool shaft having an articulation region. The articulating probe and the surgical tool are independently controllable.

Collapsible fastener cartridge

A fastener cartridge can comprise a crushable cartridge body and fasteners embedded within the crushable cartridge body which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein the first jaw can be positioned opposite a second jaw, or anvil. The anvil can be engaged with the fastener cartridge to crush the cartridge body and deform, or otherwise deploy, the fasteners contained therein. As the fasteners are deformed or deployed, the fasteners can capture at least a portion of the cartridge body therein along with at least a portion of the tissue being fastened. A fastener cartridge can comprise a compressible cartridge body having a thickness which can be reduced by the compressive pressure applied by the anvil. In certain embodiments, a fastener cartridge can comprise a cartridge body which can collapse from the compressive pressure.

Manipulator and its use as a surgical instrument.

DRIVING DEVICE USABLE WITH ROBOT ARM AND ROBOT ARM

링크 유닛, 암 모듈 및 이들을 가지는 수술용 장치

... 충분한 강성을 가지는 고정 모드와, 자유로운 움직임이 가능한 조향모드를 가진 수술용 장치를 개시한다. 수술용 장치는 적어도 1 이상의 자유도를 가지도록 구성된 적어도 하나의 암 모듈을 포함하고, 적어도 하나의 암 모듈은 암 모듈을 움직이게 하는 적어도 하나의 스티어링 케이블과, 적층되어 적어도 하나의 암 모듈을 형성하도록 구성된 복수의 링크 유닛을 포함하고, 링크 유닛은 링크 유닛의 상측에 반구형으로 형성되는 머리부와, 다른 링크 유닛의 머리부가 안착될 수 있도록 링크 유닛의 하측에 형성되는 안착부와, 머리부와 안착부가 서로 슬라이딩될 수 있도록 안착부에 마련되는 슬라이딩 볼을 포함하여 구성될 수 있다.

관절식 수술용 도구들 및 이를 배치하는 방법

... 로봇형 도입기 시스템은 케이블 제어 조립체를 포함하는 제1 조립체로서, 복수의 의료 절차들에서 사용되도록 구성되며 배열되는 제1 조립체, 말단 링크 연장 조립체를 포함하는 제2 조립체로서, 상기 제1 조립체에 비하여 더 적은 횟수로 사용되도록 구성되며 배열되는 제2 조립체, 및 관절식 프로브 조립체를 포함하는 제3 조립체로서, 제1 조립체 및 제2 조립체 사이에 결합되고 상기 제2 조립체에 비하여 더 적은 사용 횟수로 사용되도록 구성되며 배열되는 제3 조립체를 포함한다.

DEVICES, SYSTEMS, AND METHODS FOR LEAD DELIVERY

Devices, systems, and methods for lead delivery. In at least one exemplary embodiment of a catheter for delivering a lead within a mammalian body of the present disclosure, the catheter comprises an elongated tube comprising a wall extending from a proximal end to a distal end, a lead delivery channel within the elongated tube, the lead delivery channel defining an outlet for delivering a lead, a balloon chamber positioned at or near the distal end of the elongated tube, and at least one balloon positioned within the balloon chamber, the at least one balloon capable of inflation to reversibly anchor the elongated tube within a mammalian body when at least a portion of the elongated tube is positioned therein.

METHODS AND APPARATUS TO SHAPE FLEXIBLE ENTRY GUIDES FOR MINIMALLY INVASIVE SURGERY

In one embodiment of the invention, an apparatus for performing surgical procedures is disclosed including a flexible entry guide tube, and a first steering device. The flexible entry guide tube has one or more lumens extending along its length from a proximal end to substantially at or near a distal end. At least one of the one or more lumens is an instrument lumen with open ends to receive a flexible shaft of a surgical tool to perform surgery near the distal end of the flexible entry guide tube. The first steering device is insertable into the instrument lumen to shape the flexible entry guide tube as it is inserted through an opening in a body and along a path towards a surgical site. The apparatus may further include a flexible locking device to couple to the flexible entry guide tube and selectively rigidize the flexible entry guide tube to hold its shape. The flexible entry guide tube may be steered by remote control with one or more actuators.

INSTRUMENT WRIST WITH CYCLOIDAL SURFACES

An instrument wrist uses members having epicycloidal and hypocycloidal surfaces to bear loads and preserve a separation of reference points in the same manner as circles rolling on each other. The cycloidal surfaces can be uniform, stepped, or blended and can be arranged to ensure geared motion of members without addition of additional gearing structures. A hypocycloidal surface provides a concave contact that improves resistance to deformations under load. The wrist mechanism is tendon stayed, which keeps members in contact, and optionally gear structures can be integrated into the members to ensure geared motion and support roll toques.

DEVICES FOR TRANSCATHETER CERCLAGE ANNULOPLASTY

Devices, apparatus, and methods for catheter-based repair of cardiac valves, including transcatheter -mitral -valve - cerclage annuloplasty and transcatheter-mitral -valve reapposition. In particular, a target and capture device is provided for guiding a cerclage traversal catheter system through a cerclage trajectory, particularly through a reentry site of the cerclage trajectory. The target and capture device (200,300,500) provides the user with a target (208,306) through which the cerclage traversal catheter system must be guided, particularly under imaging guidance, so as to properly traverse the cerclage trajectory at any desired location, particularly at a reentry site. The target and capture device (200,300,500) can, further, ensnare and externalize the cerclage traversal catheter system.

TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple- deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

ROBOTIC ARM AND ROBOTIC SURGICAL SYSTEM

A robotic arm according to various implementations includes: a tool driver configured to hold a surgical tool; a first section comprising a first end coupled to a base, a second end distal from first end; a first link that includes a motor configured to rotate at least a portion of the first section around a pitch axis; a second link coupled to the first link, the second link including a motor configured to rotate at least a portion of the first section around a roll axis; and a second section comprising: a first end coupled to the second end of the first section, a second end distal from the first end, a first link that includes a motor configured to rotate at least a portion of the second section around a roll axis, a second link coupled to the first link.

Surgical cutting and stapling instruments

Surgical methods for cutting and fastening tissue are disclosed. The methods may include employing a surgical end effector that includes a pair of jaws wherein an upper jaw is movable relative to a lower jaw that supports a surgical fastener cartridge. The methods may include manipulating the end effector to a compact configuration to facilitate its insertion through a trocar port and then manipulating and actuating the end effector to treat target tissue.

Robotic arm and robotic surgical system

A robotic arm according to various implementations includes: a tool driver configured to hold a surgical tool; a first section comprising a first end coupled to a base, a second end distal from first end; a first link that includes a motor configured to rotate at least a portion of the first section around a pitch axis; a second link coupled to the first link, the second link including a motor configured to rotate at least a portion of the first section around a roll axis; and a second section comprising: a first end coupled to the second end of the first section, a second end distal from the first end, a first link that includes a motor configured to rotate at least a portion of the second section around a roll axis, a second link coupled to the first link.

FIXATION OF VESSELS FOR PERCUTANEOUS FISTULA CREATION

A method of percutaneously creating a fistula includes inserting percutaneously a medical instrument to a target location having a first blood vessel and a second blood vessel. A fastener is then deployed via the medical instrument to the target location. The fastener is in a first configuration before the deploying and a second configuration after the deploying. The fastener limits relative movement between the first blood vessel and the second blood vessel when in the second configuration. An anastomosis between the first blood vessel and the second blood vessel is percutaneously produced.

Anvil layer attached to a proximal end of an end effector

An anvil-attachable layer for use with a surgical stapler, or fastening instrument, wherein a proximal end portion of the layer is attached to a staple cartridge assembly, for example. The layer may be attached to the staple cartridge assembly by an adhesive, weld, or a staple-cartridge-based clamp, wherein the attachment is weak enough to allow the layer to pull away from the staple cartridge assembly with stapled tissue. Alternatively, the layer can include two or more lateral slits that define a connector region that can be cut by a knife of a surgical stapler to release the layer.

ROTARY DRIVE ARRANGEMENTS FOR SURGICAL INSTRUMENTS

A rotary drive arrangement for a surgical instrument that includes a surgical end effector. In one form, the rotary drive arrangement includes a drive shaft assembly that is selectively axially movable between a first position and a second position. A rotary transmission operably interfaces with the drive shaft assembly such that when the drive shaft assembly is in the first axial position, application of one of the rotary drive motions to the drive shaft assembly causes the rotary transmission to apply a first rotary control motion to the surgical end effector and when the drive shaft assembly is in the second axial position, application of the rotary drive motion to the drive shaft assembly causes the rotary transmission to apply a second rotary control motion to the surgical end effector.

ROBOTIC CATHETER SYSTEM

A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES

A surgical instrument comprising an elongate shaft assembly that defines a shaft axis. An end effector mounting assembly may be movably coupled to the elongate shaft assembly for selective articulation about an articulation axis that is transverse to the shaft axis. First and second jaws may be movably coupled to the end effector mounting assembly such that the first and second jaws are each movable relative to each other and the shaft axis about a common pivot axis between an open position and closed positions. The first and second jaws may close at different closure rates upon the simultaneous application of closure motions thereto.

SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING POCKETS

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR

An anvil-attachable layer for use with a surgical stapler, or fastening instrument, wherein a proximal end portion of the layer is attached to a staple cartridge assembly, for example. The layer may be attached to the staple cartridge assembly by an adhesive, weld, or a staple-cartridge-based clamp, wherein the attachment is weak enough to allow the layer to pull away from the staple cartridge assembly with stapled tissue. Alternatively, the layer can include two or more lateral slits that define a connector region that can be cut by a knife of a surgical stapler to release the layer.

Handle assembly for endoscopic suturing device

A handle assembly for operating an articulatable surgical instrument is provided and includes a housing; an actuation shaft translatably and rotatably supported in the housing; a first trigger supported on the housing and connected to the actuation shaft, the first trigger being configured to translate the actuation shaft to operate a first function of the surgical instrument; a second trigger supported on the housing and connected to the actuation shaft, the second trigger being configured to rotate the actuation shaft to operate a second function of the surgical instrument; and a second-trigger release supported in the housing, the second-trigger release having a first position blocking actuation of the second trigger and a second position permitting actuation of the second trigger, where the second-trigger release is actuated from the first position to the second position upon and complete actuation of the first trigger.

Medical Manipulator

This manipulator is provided with: a shaft; a tip operation section having a gripper; and a handle that causes the operation of the gripper. The tip operation section is provided with: a bowing section that is provided between the gripper and the shaft and that causes the tip operation section to bow in a direction differing from the axial direction of the shaft by means of a bending-direction operating force transmitted from the handle; and a hollow tube that is provided to a position overlapping the bowing section, can bow following the bowing section, and transmits to the gripper operating force transmitted from the handle in the rotational direction rotating centered on the axis of the gripper, thus being able to unlimitedly rotate the gripper.

Staple cartridge assembly comprising an implantable layer

An end effector for stapling tissue is disclosed. The end effector comprises a cartridge body comprising a deck, staples removably stored in the cartridge body, and an anvil configured to deform the staples. The end effector further comprises an implantable layer positioned intermediate the deck and the anvil. The layer comprises a tissue-facing surface, raised portions, and grooves defined intermediate the raised portions, wherein the raised portions apply localized compression to the tissue, and wherein the layer is releasably attached to the cartridge body.

Pulley arrangement for articulating a surgical instrument

A robotic surgical instrument comprising a shaft and end effector element connected by an articulation. The articulation comprises a first joint driveable by a first pair of driving elements. The first joint permits the end effector element to rotate about a first axis transverse to a longitudinal axis of the shaft, the rotation of the end effector element about the first axis bounded by an extreme rotation angle relative to the longitudinal axis. A second joint is driveable by a second pair of driving elements. A pulley arrangement constrains the second pair of driving elements, and comprises a first set of pulleys rotatable about the first axis, and a second set of pulleys located relative to the first set of pulleys such that at the extreme rotation angle the second pair of driving elements is retained in contact with both the first and second sets of pulleys.

MEDICAL DEVICE WITH ARTICULATING SHAFT

SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS

MULTIDIRECTIONAL APPARATUS

LOCKOUT ARRANGEMENTS FOR SURGICAL INSTRUMENTS

ХИРУРГИЧЕСКИЙ ИНСТРУМЕНТ С МЯГКИМ УПОРОМ

Изобретение относится к медицине, а именно к хирургическим инструментам. Хирургический инструмент содержит электромеханический стопор, приводной двигатель; приводной элемент, выполненный с возможностью перемещения приводным двигателем по приводному ходу между исходным положением и концом хода. При этом конец хода проходит между первым положением и вторым положением. Механический стопор, расположенный на дистальном конце хода или вблизи от него, и выполненный с возможностью увеличения сопротивления перемещению приводного элемента по приводному ходу от первого положения до второго положения. И система управления, выполненная с возможностью обнаружения скачка тока, связанного с увеличившимся сопротивлением, причем подача питания на приводной двигатель прерывается при обнаружении системой управления скачка тока. При этом механический стопор дополнительно содержит: упор, выполненный с возможностью перемещения из первого положения во второе положение и с возможностью контакта с приводным элементом ...

СШИВАЮЩИЙ ТКАНЬ ИНСТРУМЕНТ, ИМЕЮЩИЙ КОМПЕНСАТОР ТОЛЩИНЫ, В КОТОРЫЙ ВВЕДЕН ГИДРОФИЛЬНЫЙ АГЕНТ

Изобретение относится к медицинской технике и может быть использовано с хирургическим сшивающим инструментом. Узел включает корпус кассеты, который имеет опорную часть с множеством гнезд для скоб с отверстиями. По меньшей мере часть каждой скобы съемно хранится внутри гнезда для скобы. Каждая скоба выполнена с возможностью перемещения между неактивированным положением и активированным положением и деформации между неактивированной конфигурацией и активированной конфигурацией. Сжимаемый компенсатор толщины ткани выполнен с возможностью захвата внутри скоб. Сжимаемый компенсатор толщины ткани по меньшей мере частично покрывает отверстия гнезд для скоб. Сжимаемый компенсатор толщины ткани выполнен с возможностью принимать разные значения высоты в сжатом состоянии внутри разных скоб и содержит лиофилизированный пеноматериал, имеющий внедренный в него гидрофильный агент. 3 н. и 8 з.п. ф-лы, 540 ил.

КОНСТРУКЦИИ СИСТЕМЫ ДВУХШАРНИРНОГО ПРИВОДА ДЛЯ ХИРУРГИЧЕСКИХ ИНСТРУМЕНТОВ С ВОЗМОЖНОСТЬЮ ШАРНИРНОГО ПОВОРОТА

Группа изобретений относится к медицинской технике, а именно к хирургическим сшивающим и режущим инструментам и предназначенным для применения с ними кассетам со скобами. Хирургический сшивающий инструмент содержит узел удлиненного ствола, хирургический концевой эффектор и систему шарнирного сочленения. Система шарнирного сочленения содержит первый дистальный приводной элемент шарнирного сочленения, второй дистальный приводной элемент шарнирного сочленения, по меньшей мере одно зубчатое колесо в зубчатом зацеплении с первым дистальным приводным элементом шарнирного сочленения и вторым дистальным приводным элементом шарнирного сочленения, средство для избирательной блокировки хирургического концевого эффектора в шарнирно повернутых положениях относительно узла удлиненного ствола и проксимальный приводной элемент шарнирного сочленения. Во втором варианте выполнения хирургический сшивающий инструмент содержит узел удлиненного ствола, хирургический концевой эффектор и систему шарнирного сочленения ...

УЗЕЛ ХИРУРГИЧЕСКОГО ИНСТРУМЕНТА, СОДЕРЖАЩИЙ СИСТЕМУ ШАРНИРНОГО СОЧЛЕНЕНИЯ С ВОЗМОЖНОСТЬЮ БЛОКИРОВКИ

Группа изобретений относится к медицинской технике, а именно к хирургическим сшивающим и режущим инструментам и предназначенным для применения с ними кассетам со скобами. Узел ствола для применения с хирургическим инструментом содержит концевой эффектор, шарнирное сочленение, вводной исполнительный механизм, закрывающую систему, пусковую систему, систему шарнирного сочленения и систему переключения. Концевой эффектор содержит проксимальный конец, дистальный конец и браншу, выполненную с возможностью закрытия. Концевой эффектор выполнен с возможностью вращения вокруг шарнирного сочленения. Вводной исполнительный механизм выполнен с возможностью перемещения в проксимальном направлении и дистальном направлении. Закрывающая система содержит закрывающий элемент, выполненный с возможностью перемещения между открытой конфигурацией и закрытой конфигурацией для закрытия бранши. Пусковая система содержит пусковой элемент, выполненный с возможностью приведения в действие концевого эффектора. Система ...

СШИВАЮЩИЙ ТКАНЬ ИНСТРУМЕНТ, ИМЕЮЩИЙ КОМПЕНСАТОР ТОЛЩИНЫ, В КОТОРЫЙ ВВЕДЕН ГИДРОФОБНЫЙ АГЕНТ

Изобретение относится к медицине и может быть использовано с хирургическим сшивающим инструментом. Узел кассеты со скобами содержит сжимаемый компенсатор толщины ткани и корпус кассеты, имеющий опорную часть с множеством гнезд для скоб с отверстиями. По меньшей мере, часть каждой скобы хранится внутри гнезда для скобы. Каждая скоба выполнена с возможностью перемещения между неактивированным положением и активированным положением и с возможностью деформации между неактивированной конфигурацией и активированной конфигурацией. Сжимаемый компенсатор толщины ткани выполнен с возможностью захвата внутри скоб и, по меньшей мере, частично покрывает отверстия гнезд для скоб. Сжимаемый компенсатор имеет возможность принимать разные значения высоты в сжатом состоянии внутри разных скоб и содержит лиофилизированный пеноматериал с гидрофобным агентом. 3 н. и 13 з.п. ф-лы, 540 ил.

ПОВОРОТНЫЕ ОПОРНО-СОЕДИНИТЕЛЬНЫЕ УЗЛЫ ДЛЯ СОЕДИНЕНИЯ ПЕРВОЙ ЧАСТИ ХИРУРГИЧЕСКОГО ИНСТРУМЕНТА СО ВТОРОЙ ЧАСТЬЮ ХИРУРГИЧЕСКОГО ИНСТРУМЕНТА

Группа изобретений относится к медицинской технике, а именно к хирургическим инструментам, и в частности, к поворотному опорно-соединительному узлу для соединения хирургического концевого эффектора с узлом удлиненного стержня хирургического инструмента и способу соединения первой части хирургического инструмента со второй. Хирургическое сшивающее устройство содержит узел удлиненного стержня и концевой эффектор. Узел удлиненного стержня имеет дистальный конец и образует продольную ось инструмента. Концевой эффектор содержит узел удлиненного канала и упор. Узел удлиненного канала включает часть, выполненную с возможностью функциональной поддержки в ней хирургической кассеты со скобами. Упор поддерживается с возможностью перемещения относительно узла удлиненного канала. Хирургическое сшивающее устройство дополнительно содержит поворотное соединение, соединяющее узел удлиненного канала с дистальным концом узла удлиненного стержня для обеспечения избирательного поворота узла удлиненного канала ...

ХИРУРГИЧЕСКИЙ СШИВАЮЩИЙ АППАРАТ С ШАРНИРНО ЗАКРЕПЛЕННЫМ УПОРОМ

Группа изобретений относится к медицинской технике, а именно к хирургическим инструментам, в частности к хирургическим рассекающим и сшивающим аппаратам и используемым в них скобочным блокам, предназначенным для рассечения ткани и сшивания ее скобками. Хирургический сшивающий аппарат выполнен с возможностью приема скобочного блока, содержащего скобки, причем хирургический сшивающий аппарат содержит рукоять, ствол, опорную браншу и браншу упора. Рукоять содержит спусковой механизм и пусковой узел. При этом спусковой механизм выполнен с возможностью приведения в действие пускового узла. Ствол продолжается из рукояти, при этом ствол содержит ножедержатель, функционально соединенный с пусковым узлом. Ножедержатель содержит кулачок, режущую кромку и концевой зажим. Концевой зажим включает проксимальный конец и дистальный конец. Опорная бранша содержит опорную поверхность, смещающую направляющую. Опорная поверхность выполнена с возможностью поддержки скобочного блока, при этом опорная поверхность ...

ХИРУРГИЧЕСКОЕ СШИВАЮЩЕЕ И РЕЖУЩЕЕ УСТРОЙСТВО

Изобретение относится к медицине. Хирургический сшивающий и режущий инструмент содержит удлиненный ствол с проксимальным и дистальным концами. Дистальный конец ствола имеет гибкую шейку, отходящую от него. Концевое исполнительное устройство размещено на проксимальном конце гибкой шейки и содержит противолежащие первую и вторую бранши. Бранши выполнены с возможностью размещения ткани между ними. К первой бранше прикреплен картридж, который содержит множество шовных скобок для введения в ткани. Вторая бранша содержит упорный элемент для деформирования шовных скобок. Устройство также содержит пользовательский интерфейс дистанционного управления, прикрепленный к проксимальному концу удлиняющей трубки. Интерфейс функционально связан с гибкой шейкой так, что движение пользовательского интерфейса дистанционного управления имитируется гибкой шейкой. 2 з.п. ф-лы, 16 ил.

ХИРУРГИЧЕСКИЙ СШИВАЮЩИЙ АППАРАТ С ШАРНИРНО ЗАКРЕПЛЕННЫМ УПОРОМ

... 1. Хирургический сшивающий аппарат, выполненный с возможностью приема скобочного блока, содержащего скобки, причем упомянутый хирургический сшивающий аппарат содержит:рукоять, содержащую спусковой механизм ии пусковой узел, при этом упомянутый спусковой механизм выполнен с возможностью приведения в действие упомянутого пускового узла;ствол, продолжающийся из упомянутой рукояти, при этом упомянутый ствол содержит ножедержатель, оперативно соединенный с упомянутым пусковым узлом, при этом упомянутый ножедержатель содержит:кулачок;режущую кромку иконцевой зажим, содержащийпроксимальный конец,дистальный конец;опорную браншу, содержащую:опорную поверхность, выполненную с возможностью поддержки скобочного блока, при этом упомянутая опорная поверхность образует опорную плоскость; исмещающую направляющую, образованную вдоль оси поперечной по отношению к упомянутой опорной плоскости; ибраншу упора, содержащую:ведомый механизм, принимаемый с возможностью скольжения в упомянутой смещающей направляющей ...

МОТОРИЗОВАННЫЙ РЕЖУЩИЙ И КРЕПЕЖНЫЙ ХИРУРГИЧЕСКИЙ ИНСТРУМЕНТ, ИМЕЮЩИЙ ИСТОЧНИК ПИТАНИЯ НА ОСНОВЕ РУКОЯТКИ

... 1. Хирургический инструмент для резания и скрепления, содержащий: ! рабочий орган; ! вал, соединенный с рабочим органом, причем вал содержит цепь привода для приведения в действие рабочего органа; и ! рукоятку, соединенную с валом, причем рукоятка содержит: ! электрический двигатель постоянного тока, соединенный с цепью привода для приведения в действие цепи привода; ! блок питания, который содержит, по меньшей мере, одно зарядо-аккумулирующее устройство, соединенное с двигателем постоянного тока, для приведения в действие двигателя постоянного тока. ! 2. Хирургический инструмент для резания и скрепления по п.1, в котором, по меньшей мере, одно зарядо-аккумулирующее устройство содержит множество последовательно соединенных зарядо-аккумулирующих устройств. ! 3. Хирургический инструмент для резания и скрепления по п.2, в котором множество последовательно соединенных зарядо-аккумулирующих устройств содержит множество последовательно соединенных суперконденсаторов. ! 4. Хирургический инструмент ...

СШИВАЮЩИЙ ТКАНЬ ИНСТРУМЕНТ, ИМЕЮЩИЙ КОМПЕНСАТОР ТОЛЩИНЫ, В КОТОРЫЙ ВВЕДЕН ГИДРОФИЛЬНЫЙ АГЕНТ

Изобретение относится к медицинской технике и может быть использовано с хирургическим сшивающим инструментом. Узел включает корпус кассеты, который имеет опорную часть с множеством гнезд для скоб с отверстиями. По меньшей мере часть каждой скобы съемно хранится внутри гнезда для скобы. Каждая скоба выполнена с возможностью перемещения между неактивированным положением и активированным положением и деформации между неактивированной конфигурацией и активированной конфигурацией. Сжимаемый компенсатор толщины ткани выполнен с возможностью захвата внутри скоб. Сжимаемый компенсатор толщины ткани по меньшей мере частично покрывает отверстия гнезд для скоб. Сжимаемый компенсатор толщины ткани выполнен с возможностью принимать разные значения высоты в сжатом состоянии внутри разных скоб и содержит лиофилизированный пеноматериал, имеющий внедренный в него гидрофильный агент. 3 н. и 8 з.п. ф-лы, 540 ил.

УСТРОЙСТВО ОРИЕНТАЦИИ ДЛЯ ИСПОЛЬЗОВАНИЯ ПРИ ВОССТАНОВЛЕНИИ МИТРАЛЬНОГО КЛАПАНА

СПОСОБЫ ХИРУРГИЧЕСКОЙ ОБРАБОТКИ ПУТЕМ РЕЗАНИЯ И СШИВАНИЯ СКОБКАМИ

СОЕДИНИТЕЛЬНАЯ КОНФИГУРАЦИЯ ВЗАИМОЗАМЕНЯЕМОГО КОНЦЕВОГО ЭФФЕКТОРА

... 1. Хирургический инструмент, содержащий:взаимозаменяемый концевой эффектор, содержащий:первый элемент бранши, включающий первый электрод; ивторой элемент бранши, включающий второй электрод, причем первый элемент бранши выполнен с возможностью перемещения относительно второго элемента бранши между первым положением и вторым положением;узел рукоятки, проксимальный к указанному хирургическому концевому эффектору;узел стержня, проходящий между указанным узлом рукоятки и указанным взаимозаменяемым концевым эффектором, причем узел стержня содержит:поворотный приводной стержень, выполненный с возможностью передачи поворотных движений, причем поворотный приводной стержень выполнен с возможностью избирательного перемещения по оси относительно узла стержня между множеством отдельных положений; исоединительную конфигурацию для разъемного прикрепления взаимозаменяемого концевого эффектора к узлу стержня.2. Хирургический инструмент по п. 1, в котором соединительная конфигурация включает электрическое ...

СКОБОЧНЫЙ БЛОК, СОДЕРЖАЩИЙ КОМПЕНСАТОР ТОЛЩИНЫ ТКАНИ

... 1. Узел скобочного блока для применения с хирургическим сшивающим аппаратом, в котором упомянутый узел скобочного блока приспособлен для использования с тканью, имеющей толщину, где упомянутый узел скобочного блока содержит:корпус блока, содержащий опорную часть, при этом упомянутая опорная часть содержит множество полостей скобок, причем каждая упомянутая полость скобки содержит отверстие;множество скобок при этом по меньшей мере часть каждой упомянутой скобки хранится с возможностью извлечения в упомянутой полости скобки, причем каждая упомянутая скобка способна перемещаться между нерабочим положением и приведенным в действие положением, при этом каждая упомянутая скобка выполнена с возможностью деформации между нерабочей конфигурацией и приведенной в действие конфигурацией, когда каждая упомянутая скобка перемещается между упомянутым нерабочим положением и упомянутым приведенным в действие положением; исжимаемый компенсатор толщины ткани, выполненный с возможностью захвата в упомянутые ...

Symmetrically arranged surgical instrument articulation

Manipulator

Steerable introducer for catheter device

EQUIPMENT FOR THE PREPARATION OF A KOLOREKTALER SURGERY

Articulation assembly for surgical instruments

Surgical instrument

Surgical instrument

Handle assembly for endoscopic suturing device

Surgical instrument

The invention relates to a surgical instrument comprising a proximal and a distal end respectively comprising an articulation region, and a rigid central section resistant to bending arranged between said ends. The proximal end section can be connected to an actuating device, and a cutting, abrasive or milling tool that can be driven by means of a drive element is connected to the distal end section. The aim of the invention is to improve such a surgical instrument such that it can be used in a flexible manner and has a larger working surface. To this end, the instrument is provided with an outer hollow cylindrical shaft, an inner hollow cylindrical shaft, and a control element arranged between said shafts, with at least two longitudinal elements transmitting tractive and/or pressure forces and extending at least essentially from the proximal articulation region to the distal articulation region. The longitudinal elements are arranged in the peripheral direction of the instrument at essentially ...

Steerable surgical instrument

Implantable fastener cartridge having a non-uniform arrangement

A fastener cartridge comprises a compressible, collapsible, and/or crushable cartridge body and fasteners embedded within the cartridge body which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in first jaw of a surgical fastening device, wherein the first jaw can be positioned opposite a second jaw, or anvil. The anvil can be engaged with the fastener cartridge to compress, collapse, and/or crush the cartridge body and deform, or otherwise deploy, the fasteners contained therein. As the fasteners are deformed or deployed, the fasteners can capture at least a portion of the cartridge body therein along with at least a portion of the tissue being fastened. The cartridge body can comprise a thickness which is not uniform thereacross. In at least one embodiment, the fasteners can comprise different unformed heights and/or different formed heights.

Fastening instrument for deploying a fastener system comprising a retention matrix

A surgical stapling instrument can comprise, one, a handle comprising an actuator and, two, an end effector comprising a proximal end, a distal end, and a longitudinal axis extending between the proximal end and the distal end. The end effector can further comprise a first jaw configured to support staples comprising staple legs and, in addition, a second jaw supporting a matrix element opposite the staples, wherein one of the jaws is movable toward the other in order to engage the matrix element with the staple legs. The stapling instrument can further comprise a cam operably coupled with the actuator, wherein the cam is movable along the longitudinal axis to deform the staple legs.

Fastener system comprising a retention matrix

A surgical fastener system can comprise a plurality of fasteners which can be connected to one another by a retention matrix which is assembled to the fasteners in order to capture tissue therebetween. In various embodiments, each fastener can comprise a base and the distance in which the retention matrix is seated relative to the fastener bases can be selectively determined by a surgeon in order to apply a desired pressure to the tissue. In certain embodiments, each fastener can further comprise a fastener leg and the retention matrix can comprise a first layer configured to engage the fastener legs. The retention matrix can further comprise a second layer mounted to the first layer which can comprise one or more encapsulations containing a medicine therein. The encapsulations can be aligned with retention apertures in the retention matrix such that they can be punctured by the fastener legs.

Compressible fastener cartridge

A fastener cartridge can comprise a compressible, collapsible, and/or crushable cartridge body and fasteners embedded within the cartridge body which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein the first jaw can be positioned opposite a second jaw, or anvil. The anvil can be engaged with the fastener cartridge to compress, collapse, and/or crush the cartridge body and deform, or otherwise deploy, the fasteners contained therein. As the fasteners are deformed or deployed, the fasteners can capture at least a portion of the cartridge body therein along with at least a portion of the tissue being fastened. In various embodiments, the cartridge body can comprise a plurality of layers wherein at least one of the layers can be detached from the other layers and removed from the surgical site.

Tissue thickness compensator comprising portions having different properties

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

Compressible staple cartridge assembly

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

Implantable fastener cartridge having a non-uniform arrangement

A fastener cartridge can comprise a compressible, collapsible, and/or crushable cartridge body and fasteners embedded within the cartridge body which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein the first jaw can be positioned opposite a second jaw, or anvil. The anvil can be engaged with the fastener cartridge to compress, collapse, and/or crush the cartridge body and deform, or otherwise deploy, the fasteners contained therein. As the fasteners are deformed or deployed, the fasteners can capture at least a portion of the cartridge body therein along with at least a portion of the tissue being fastened. In various embodiments, the cartridge body can comprise a thickness which is not uniform thereacross. In at least one embodiment, the fasteners can comprise different unformed heights and/or different formed heights.

Surgical stapler with floating anvil

A surgical instrument can include an anvil and, in addition, a staple cartridge support configured to support a staple cartridge. In various embodiments, the jaw can be moved toward the staple cartridge to deform staples contained within the staple cartridge. The anvil can be configured to be translated and/or rotated as the anvil is moved toward the staple cartridge. In certain embodiments, the anvil can be configured to float and adjust such that the anvil is moved downwardly in a level manner.

Staple cartridge comprising a releasable portion

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

Remote-controlled actuator

A remote control actuator includes a spindle guide section ( 3 ), a distal end member ( 2 ) fitted to the tip of the spindle guide section for alteration in attitude, a tool ( 1 ) provided rotatably in the distal end member, a tool rotation drive source ( 41 ) for rotating the tool, and an attitude altering drive source ( 42 ) for altering the attitude of the distal end member. The spindle guide section has therein a rotary shaft ( 22 ) for transmitting a rotation of the tool rotation drive source to the tool, and an attitude altering member ( 31 ) capable of being selectively advanced or retracted by the attitude altering drive source for altering the attitude of the distal end member. A position detector ( 47 ) is provided for detecting the advanced or retracted position of the attitude altering member at a site distant from the attitude altering drive source.

Endoscopic imaging system

An endoscopic imaging system includes a reusable control cabinet having a number of actuators that control the orientation of a lightweight endoscope that is connectable thereto. The endoscope is used with a single patient and is then disposed. The endoscope includes an illumination mechanism, an image sensor and an elongate shaft having one or more lumens located therein. A polymeric articulation joint at the distal end of the endoscope allows the distal end to be oriented by the control cabinet. The endoscope is coated with a hydrophilic coating that reduces its coefficient of friction and because it is lightweight, requires less force to advance it to a desired location within a patient.

Surgical device and accessories

The present invention relates to a device developed for surgical interventions comprising (i) an inner end ( 1 ) guidable/steerable to the operation field, (ii) an outer end ( 3 ) operated by the user and (iii) a middle part ( 2 ) which connects both ends ( 1, 3 ) together. According to the main concept of the present invention, it further comprises force transmission units extending between the outer ( 3 ) and the inner ( 1 ) ends, and said force transmission units, the outer and the inner ends and the middle part ( 2 ) are designed to transfer the movements of the outer end ( 3 ) to the inner end ( 1 ) in an identical measure, as if the inner end ( 1 ) were the straight continuation of the outer end ( 3 ).

Tissue thickness compensator comprising structure to produce a resilient load

A fastener cartridge assembly for an end effector of a surgical instrument can comprise a cartridge body, a deformable tube, and a fastener moveable between an initial position and a fired position. The deformable tube can be longitudinally positioned along a length of the cartridge body. When the fastener is moved to the fired position, the fastener can compress a portion of the deformable tube. The deformable tube can comprise a resilient material such that deformation of the deformable tube generates a restoring force. The deformable tube can comprise a lattice of strands woven together to form a tube wall. Further, the deformable tube can be bioabsorbable and can hold a therapeutic agent. The fastener cartridge assembly can comprise multiple, substantially parallel deformable tubes positioned side-by-side and/or within each other.

Surgical instrument

A surgical apparatus for use in endoscopic surgery having a user interface operatively coupled to an articulating tool assembly via an elongate tubular member. Movement at the articulating tool mirrors movement at the user interface thereby providing intuitive operation of the surgical apparatus. The apparatus is configured such that the range of motion of the articulating tool assembly emulates the range of motion of the human wrist.

Swinging Bars with Axial Wheels to Drive Articulating Cables

Disclosed is an articulation mechanism for a surgical instrument including a housing defining a longitudinal axis. The housing has a first slot extending at least partially through the housing and a second slot extending at least partially through the housing offset from the first slot. The articulation mechanism further includes a first bar member which is adapted for insertion into the first slot. The articulation mechanism further includes a second bar member which is adapted for insertion into the second slot. Each bar member is rotatable within its respective slot to articulate a cable. Each end portion of each bar member includes a pulley inserted into a channel of the end portion which is adapted for the engagement with a cable.

Endoscope Combined Deflection Control and Lock

An endoscope including a shaft having a deflectable distal end; a handle at a proximal end of the shaft; and a deflection control connected to the distal end. The deflection control includes a combined lock and deflection control member at the handle. The control member is adapted to be moved to a selected location by a single finger of a user and thereby deflect the distal end. The control member is adapted to be locked at the user selected location by movement of the control member to a locked position by the single finger of the user.

Actuator for releasing a tissue thickness compensator from a fastener cartridge

A fastener cartridge assembly for use with a surgical end effector. The fastener cartridge assembly can comprise a cartridge body having fastener cavities, fasteners removably positioned in the fastener cavities, a layer of material releasably secured relative to the cartridge body, a connector configured to secure the layer of material to the cartridge body at a location distal to at least one fastener cavity, and an actuator. The layer of material can be a tissue thickness compensator. When actuated, the actuator can overcome the connector, and can overcome the connector prior to the removal of the fasteners from the fastener cavities. The actuator can be actuated at a location proximal to at least one fastener cavity, and can extend distally past at least one fastener cavity toward the connector.

Robotic catheter system

A robotic catheter system includes a controller with a master input device. An instrument driver is in communication with the controller and has a guide instrument interface including a plurality of guide instrument drive elements responsive to control signals generated, at least in part, by the master input device. An elongate guide instrument has a base, distal end, and a working lumen, wherein the guide instrument base is operatively coupled to the guide instrument interface. The guide instrument includes a plurality of guide instrument control elements operatively coupled to respective guide drive elements and secured to the distal end of the guide instrument. The guide instrument control elements are axially moveable relative to the guide instrument such that movement of the guide instrument distal end may be controlled by the master input device.

Segmented instrument shaft with antirotation features

Deflectable instrument shafts are formed of a plurality of vertebral segments. One embodiment utilizes alternating segments, each of which has a first end or face contacting an adjacent segment along a first plane, and a second end or face contacting an adjacent segment along a second plane that is transverse to the first plane. In some embodiments, the alternating segments are first and second segments having differently shaped contacting ends/faces. In other embodiment the alternating segments are identical to one another but are positioned such that segments having their first contacting end/face facing distally are alternated with segments having their second contacting ends/faces facing distally. In other embodiments, embodiments having semi-spherical articulating surfaces are used.

Surgical instrument

A surgical instrument for minimally invasive surgery. The surgical instrument includes a manipulator, a proximal universal joint mounted to the manipulator, a tube mounted to the proximal joint, a distal universal joint mounted to the tube, and an end effector including at least one movable jaw mounted to the distal joint. Cables operatively couple the manipulator, proximal joint, and distal joints and concurrently operatively couple the manipulator and the end effector. Four cables may control two degrees of freedom of the distal joint and one degree of freedom of the jaw. Pivoting of the manipulator and a proximal yoke of the proximal joint results in a corresponding motion in a distal yoke of the distal joint. Actuation of an anchor in the manipulator results in operation of any moveable jaws in the end effector. The distal universal joint and the end effector may be integrated into one end segment part.

Endovascular Closure Device

An aneurysm closure device that includes a retention assembly, adapted to retain the closure device in place on an aneurysm neck. Also, a seal has a wire frame, defining a set of eyeholes and thread, threaded through the set of eyeholes, to form a lattice. Finally, an expanse of silicone, is cured onto the thread, to form a barrier.

CONTROL SYSTEM FOR MEDICAL DEVICES AND RELATED METHODS OF USE

A system for controlling a medical device includes a shaft rotatable about a longitudinal axis and a plurality of arms extending radially outwards from the shaft. Each arm includes an inward end positioned near the shaft and an outward end. The system also includes a collapsible pulley formed from a plurality of pulley pieces. At least one of the pulley pieces is slidably mounted on at least one of the plurality of arms and has a surface configured to receive at least one control element. The system further includes at least one biasing member located between the shaft and the at least one slidably-mounted pulley piece. 120.-. (canceled)21. A method for steering a distal end of a medical device , comprising: the control element extends from the control system to the distal end of the medical device, and', 'the control system includes a collapsible pulley having a variable diameter; and, 'rotating a shaft of a control system about a longitudinal axis to cause movement of a control element and deflection of the distal end of the medical device, whereindecreasing the diameter of the pulley.22. The method of claim 21 , wherein the control system includes a plurality of arms claim 21 , the collapsible pulley includes a plurality of pulley pieces claim 21 , and each of the plurality of pulley pieces is movably mounted to a corresponding one of the plurality of arms.23. The method of claim 22 , wherein decreasing the diameter of the pulley includes moving at least one of the plurality of pulley pieces towards the shaft along the corresponding one of the plurality of arms.24. The method of claim 22 , wherein the plurality of arms extend radially outward from the shaft.25. The method of claim 21 , wherein rotating the shaft causes decreasing the diameter of the pulley.26. The method of claim 21 , wherein the control system further includes at least one biasing member located between the shaft and the collapsible pulley.27. The method of claim 21 , wherein the collapsible ...

METHODS AND APPARATUS TO SHAPE FLEXIBLE ENTRY GUIDES FOR MINIMALLY INVASIVE SURGERY

In one embodiment of the invention, an apparatus for performing surgical procedures is disclosed including a flexible entry guide tube, and a first steering device. The flexible entry guide tube has one or more lumens extending along its length from a proximal end to substantially at or near a distal end. At least one of the one or more lumens is an instrument lumen with open ends to receive a flexible shaft of a surgical tool to perform surgery near the distal end of the flexible entry guide tube. The first steering device is insertable into the instrument lumen to shape the flexible entry guide tube as it is inserted through an opening in a body and along a path towards a surgical site. The apparatus may further include a flexible locking device to couple to the flexible entry guide tube and selectively rigidize the flexible entry guide tube to hold its shape. The flexible entry guide tube may be steered by remote control with one or more actuators. 1. An apparatus for surgical procedures , the apparatus comprising:a flexible entry guide tube having one or more lumens extending along its length from a proximal end to substantially at or near a distal end, wherein at least one of the one or more lumens is a first instrument lumen with open ends to receive a surgical tool with a flexible shaft to perform surgery near the distal end of the flexible entry guide tube; anda first steering device insertable into the first instrument lumen, the first steering device to shape the flexible entry guide tube as the flexible entry guide tube is inserted through an opening in a body and guided towards a surgical site.2. The apparatus of claim 1 , whereinthe flexible entry guide tube includesa flexible locking device to couple to the flexible entry guide, the flexible locking device to selectively rigidize the flexible entry guide tube to hold its shape.3. The apparatus of claim 1 , whereinthe first steering device is a first surgical tool with control cables to move a steerable ...

DEVICES AND METHODS FOR FACILITATING EJECTION OF SURGICAL FASTENERS FROM CARTRIDGES

Devices and methods are provided for stabilizing fasteners post-deployment. Devices and methods are also provided for facilitating ejection of surgical fasteners from a cartridge. Devices and methods are also provided for guiding surgical fasteners. Devices and methods are also provided for facilitating closing and clamping of an end effector of a surgical device. Devices and methods are also provided for securing fasteners and adjunct materials to tissue. Devices and methods are also provided for removably coupling a cartridge to an end effector of a surgical device. Devices and methods are also provided for locking a surgical device based on loading of a fastener cartridge in the surgical device. Devices and methods are provided for adjusting a tissue gap of an end effector of a surgical device. Devices and methods are also provided for manually retracting a drive shaft, drive beam, and associated components. 1. A method for fastening tissue , comprising:engaging tissue between opposed jaws of an end effector; andadvancing a sled through the end effector to rotate a plurality of fasteners into the tissue, each fastener including an anti-rotation mechanism that substantially prevents counter-rotation of the fastener within the tissue.2. The method of claim 1 , wherein the fasteners plastically deform during rotation claim 1 , and are frangibly detached from a carrier disposed within the end effector.3. A method for fastening tissue claim 1 , comprising:engaging tissue between opposed jaws of an end effector; and wherein the sled causes a plurality of fasteners frangibly coupled to a carrier to rotate about a pivot point and into the tissue between the jaws, the fasteners at least partially shearing at the pivot point, and', 'wherein the shearing element subsequently shears the fasteners at the pivot point to separate the fasteners from the carrier., 'advancing a sled and a shearing element through one of the jaws,'}4. The method of claim 3 , wherein the shearing ...

Surgical Device, in Particular for Minimally Invasive Surgery

A surgical device with a shaft having a distal end to which a surgical instrument is mountable and a proximal end equipped for handling the instrument, wherein the shaft is hollow and the surgical instrument is mountable on inserts that are longitudinally movable in the shaft parallel to the longitudinal axis and that are diametrically opposed to each other. The shaft comprises outer and inner tubes rotatable in opposite directions with respect to the longitudinal axis, and the inserts are coupled to the outer and inner tubes to convert rotational movement of the tubes into longitudinal movement of the inserts.

MEDICAL INSTRUMENTS FOR TISSUE CAUTERIZATION

Certain aspects relate to systems and techniques for an articulating monopolar medical instrument. In one aspect, the medical instrument includes a wrist comprising a proximal clevis and a distal clevis; an end effector coupled to the distal clevis via a distal axle; at least one proximal pulley in the proximal clevis; at least one distal pulley in the distal clevis and coupled to the distal axle; a first cable configured to engage with the at least one proximal pulley and the at least one distal pulley; and a second cable configured to engage with the at least one proximal pulley without engaging the at least one distal pulley. 1. A medical instrument , comprising:a wrist comprising a proximal clevis and a distal clevis;an end effector coupled to the distal clevis via a distal axle;at least one proximal pulley in the proximal clevis;at least one distal pulley in the distal clevis and coupled to the distal axle; andat least one first cable segment configured to engage the at least one proximal pulley and the at least one distal pulley, wherein the at least one first cable segment extends along a substantially linear path between the at least one proximal pulley and the at least one distal pulley.2. The instrument of claim 1 , wherein the at least one first cable segment is configured to engage the at least one proximal pulley and the at least one distal pulley without engaging with stationary redirect surfaces between the at least one proximal pulley and the at least one distal pulley.3. The instrument of claim 1 , wherein:the at least one cable segment is formed of metal, andthe at least the distal clevis is formed of plastic.4. The instrument of claim 1 , wherein the at least one cable segment has a fleet angle of about zero as the at least one cable segment extends between the at least one proximal pulley and the at least one distal pulley.5. The instrument of claim 1 , wherein the at least one cable segment has a fleet angle greater than about zero as the at ...

APPARATUS FOR ENDOSCOPIC PROCEDURES

An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable. 115-. (canceled)16. A surgical instrument , comprising:a first jaw member comprising a proximal end, a distal end, and a channel extending from the proximal end to the distal end, the channel being configured to receive a staple cartridge assembly;a second jaw member including an anvil plate having a plurality of staple forming pockets, the first and second jaw members supported in relation to each other for movement between approximated and spaced positions; anda drive beam movable between the proximal end and the distal end of the first jaw member and having a substantially I-shaped cross-sectional profile, the drive beam having a first strut, a second strut, and a support beam extending between and connecting the first strut and the second strut along a first axis, wherein the first strut protrudes from the support beam along a second axis that is substantially perpendicular to the first axis, wherein the second strut protrudes from the support beam along a third axis that is substantially perpendicular to the first axis, and wherein the first strut is configured to engage with the first jaw member and the second strut is configured to engage with the second jaw member to progressively move the first and second jaw members to the approximated position as the drive beam moves from the proximal end of the first jaw toward the distal end of the first jaw;wherein the staple cartridge assembly comprises a knife, a sled, and a plurality of staples, wherein the knife has a knife blade, and wherein the sled has a plurality of wedge members and is configured to engage a plurality of staple pushers;wherein the knife ...

METHOD FOR MANUFACTURING A STEERABLE INSTRUMENT AND SUCH STEERABLE INSTRUMENT

Disclosed is a method for manufacturing a steerable instrument for endoscopic and/or invasive type applications, the instrument including an elongated tubular body having a proximal end part, a distal end part and an intermediate part between proximal and distal end parts, the proximal end part having at least one actuation proximal zone. The distal end part has at least one flexible distal zone, and the elongated tubular body is configured such that a movement of an actuation proximal zone is transferred to a corresponding flexible distal zone for a corresponding movement thereof. The elongated tubular body includes an inner, outer, and intermediate cylindrical elements having longitudinal elements between the inner and outer cylindrical elements. Inner, outer and intermediate cylindrical elements are coupled so movement of an actuation proximal zone is transferred by the longitudinal elements of one of the intermediate cylindrical elements to a corresponding flexible distal zone. 127-. (canceled)28. A method for manufacturing a steerable instrument for endoscopic and/or invasive type applications , such as in surgery , the instrument comprisingan elongated tubular body having a proximal end part, a distal end part and an intermediate part between proximal and distal end parts, the proximal end part having at least one actuation proximal zone, the distal end part having at least one flexible distal zone, and the elongated tubular body being configured such that a movement of an actuation proximal zone is transferred to a corresponding flexible distal zone for a corresponding movement thereof,the elongated tubular body comprising an inner cylindrical element, an outer cylindrical element and at least one intermediate cylindrical element having longitudinal elements and provided between the inner and outer cylindrical elements, the inner, outer and intermediate cylindrical elements being coupled such that movement of an actuation proximal zone is transferred by the ...

SURGICAL DEVICE WITH ARTICULATION AND WRIST ROTATION

A surgical instrument comprising a handle assembly, an elongated shaft, an end effector, a rotation mechanism, and an articulation mechanism is disclosed. The rotation mechanism is disposed in mechanical cooperation with the handle assembly and effects rotation of the end effector about the second longitudinal axis. The articulation mechanism is disposed in mechanical cooperation with the handle assembly and effects movement of the end effector from a first position where the first longitudinal axis is substantially aligned with the second longitudinal axis to a second position where the second longitudinal axis is displaced from the first longitudinal axis. The articulation mechanism comprises a first articulation control disposed in mechanical cooperation with the handle assembly, a first cable and a second cable. Actuation of the first articulation control in a first direction causes the first cable to move distally and causes the second cable to move proximally. 1. (canceled)2. A surgical instrument comprising;a handle assembly;an elongated shaft extending distally from the handle assembly and defining a first longitudinal axis;an end effector disposed in mechanical cooperation with a distal portion of the elongated shaft, the end effector defining a second longitudinal axis and including a pair of jaw members;a rotation mechanism disposed in mechanical cooperation with the handle assembly and configured to rotate the pair of jaw members of the end effector about the second longitudinal axis by a rotation of at least a portion of the rotation mechanism about the first longitudinal axis relative to the handle assembly; and a first articulation control disposed in mechanical cooperation with the handle assembly;', 'a second articulation control disposed in mechanical cooperation with the handle assembly, the first articulation control and the second articulation control being independently actuatable with respect to each other;', 'a first cable, a distal portion ...

REMOTELY POWERED ARTICULATED MEDICAL APPARATUS

One or more apparatus and systems for articulated movement, particularly for an articulated medical device such as an endoscope or medical robot. The apparatus comprises an articulated movement portion with tendon control, a transition portion comprising actuation rods, springs, and distal stoppers, a conduit portion comprising lumen filled with air or hydraulic fluid; a translation portion comprising a proximal stopper; and a power unit. 1. A medical apparatus comprising: a central lumen extending the length of the articulated movement portion,', 'a wall formed about the central lumen, and', 'two or more tendons slideably situated in the wall;, 'an articulated movement portion comprising two or more actuation rods, each being mechanically coupled to one of the two or more tendons,', 'two or more springs, and', 'two or more distal stoppers,', 'wherein the transition portion is configured such that movement of each distal stopper causes movement of each tendon;, 'a transition portion comprisinga conduit portion comprising two or more lumen filled with air or hydraulic fluid and each being sealed at the distal end by one of the two or more distal stoppers;a translation portion comprising two or more proximal stoppers; anda power unit proximal to the translation portion that is configured to cause hydraulic fluid or air to move through the two or more lumens extending through the conduit such that the tendons move.2. The medical apparatus of claim 1 , wherein the spring is configured such that when the power unit releases the pressure on the hydraulic fluid/air claim 1 , then return spring move the distal stopper(s) to a neutral position or beyond claim 1 , thereby bending a tendon to a neutral position.3. The medical apparatus of claim 1 , wherein at least a portion of wall formed about the central lumen comprises an inner sheath and a plurality of cylindrical rings where the two or more tendons are anchored to a distal cylindrical ring and slideably situated in the ...

COMPUTER-ASSISTED TELEOPERATED SURGERY SYSTEMS AND METHODS

Systems and methods for minimally invasive computer-assisted telesurgery are described. For example, this disclosure describes computer-assisted teleoperated surgery instruments with cable-actuated joint mechanisms Some such joint mechanisms include linkages that maintain the joints in operable configurations without relying on cable tension to do so. 1. A joint mechanism , comprising:a first end joint member;a middle joint member;a second end joint member;a first linkage member comprising a first annular band, the first linkage member pivotably coupled with the first end joint member and pivotably coupled with the middle joint member; anda second linkage member comprising a second annular band, the second linkage member pivotably coupled with the middle joint member and pivotably coupled with the second end joint member.2. The joint mechanism of claim 1 , wherein the first and second end joint members are constrained by the first and second linkage members to pivot in relation to middle joint member along respective paths that are orthogonal to each other.3. The joint mechanism of claim 1 , wherein the first and second linkage members are each unitary components.4. The joint mechanism of claim 1 , wherein the first linkage member further comprises:a first pair of bosses that protrude from the first annular band; anda second pair of bosses that protrude from the first annular band, and wherein the second linkage member further comprises:a third pair of bosses that protrude from the second annular band; anda fourth pair of bosses that protrude from the second annular band.5. The joint mechanism of claim 4 , wherein each boss of the first pair of bosses claim 4 , second pair of bosses claim 4 , third pair of bosses claim 4 , and fourth pair of bosses includes a feature to pivotably couple with a respective joint member of the first end joint member claim 4 , middle joint member claim 4 , and second end joint member.6. The joint mechanism of claim 5 , wherein the ...

Flexible harmonic waveguides/blades for surgical instruments

In one embodiment, a surgical instrument comprises an articulable harmonic waveguide. The articulable harmonic waveguide comprises a first drive section comprising a proximal end and a distal end. The proximal end of the first drive section may be configured to connect to an ultrasonic transducer. The articulable harmonic waveguide further comprises a first flexible waveguide coupled to the distal end of the first drive section. An end effector extends distally from the first flexible waveguide. The surgical instrument further comprises an articulation actuator to flex the first flexible waveguide.

CARDIAC LEAD EXTRACTION DEVICE

The invention relates to a cardiac lead extraction system, comprising: a handle; an elongated body in communication with said handle; a bendable flexible portion in communication with said elongated body, said bendable flexible portion comprising a first lumen sized and shaped to fit over a cardiac lead; said bendable flexible portion being more flexible than said elongated body; an operational distal end in communication with said bendable flexible portion; where said bendable portion is configured to bend to a bending radius of less than 4 cm while keeping said first lumen open; and where said operational distal end comprises at least one lead extraction assistive tool, said operational distal end comprising a second lumen sized and shaped to fit over a cardiac lead, said second lumen being in communication with said first lumen, and said first lumen comprises an inner diameter of from about 1 mm to about 5 mm. 1. A cardiac lead extraction system , comprising:a. a handle;b. an elongated body in communication with said handle;c. a bendable flexible portion in communication with said elongated body, said bendable flexible portion comprising a first lumen sized and shaped to fit over a cardiac lead; said bendable flexible portion being more flexible than said elongated body;d. an operational distal end in communication with said bendable flexible portion;wherein said bendable portion is configured to bend to a bending radius of less than 4 cm while keeping said first lumen open; andwherein said operational distal end comprises at least one lead extraction assistive tool, said operational distal end comprising a second lumen sized and shaped to fit over a cardiac lead, said second lumen being in communication with said first lumen, and said first lumen comprises an inner diameter of from about 1 mm to about 8 mm.2. The system of claim 1 , wherein said system further comprises a controllable steering mechanism configured to orient said operational distal end.3. The ...

SURGICAL INSTRUMENT APPARATUS, ACTUATOR, AND DRIVE

A surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient is disclosed and includes an elongate manipulator having a distal end for receiving an end effector and including a plurality of control links extending through the manipulator operable to cause movement of the distal end in response to movement of the control links in a longitudinal direction. An actuator chassis is disposed at a proximal end of the manipulator and includes a plurality of actuators slidingly mounted within the actuator chassis for linear movement in the longitudinal direction. Each actuator is coupled to a control link and adjacently disposed about a curved periphery of the actuator chassis. An outwardly oriented portion couples a drive force to the actuator to cause movement of the control link. 120-. (canceled)21. A surgical instrument apparatus for performing a surgical procedure within a body cavity of a patient , the apparatus comprising:an elongate manipulator having a distal end configured to support an end effector and including a plurality of control links extending through the manipulator and operatively engaged with the end effector, the manipulator defining a longitudinal axis; andan actuator chassis disposed at a proximal end of the manipulator, wherein the actuator chassis defines a substantially cylindrical profile, the actuator chassis including a plurality of actuators slidingly mounted within the actuator chassis and configured to move linearly in a direction aligned with the longitudinal axis, each actuator being coupled to a respective one of the control links, the actuators being adjacently radially disposed about the periphery of the actuator chassis, each actuator including an outwardly oriented portion configured to couple a drive force to the actuator to cause movement of the control link.22. The apparatus of claim 21 , wherein the plurality of actuators are mounted within slots extending longitudinally along the periphery ...

FLEXIBLE MANIPULATOR

A medical manipulator includes: an elongated flexible portion configured to be inserted into a body; an end effector disposed on a distal end of the elongated flexible portion; a proximal portion coupled to a proximal end of the elongated flexible portion, the proximal portion being configured to generate power for actuating the end effector; at least two wires configured to transmit the power to the end effector; at least two sheaths configured to form a path of each of the wires within the elongated flexible portion; and a rotating mechanism configured such that either a distal end or a proximal end of each of the sheaths rotates relative to the elongated flexible portion about a longitudinal axis of the elongated flexible portion. 1. A medical manipulator comprising:an elongated flexible portion configured to be inserted into a body;an end effector disposed on a distal end of the elongated flexible portion;a proximal portion coupled to a proximal end of the elongated flexible portion, the proximal portion being configured to generate power for actuating the end effector;at least two wires configured to transmit the power to the end effector;at least two sheaths configured to form a path of each of the wires within the elongated flexible portion; anda rotating mechanism configured such that either a distal end or a proximal end of each of the sheaths rotates relative to the elongated flexible portion about a longitudinal axis of the elongated flexible portion.2. The medical manipulator according to claim 1 , wherein the rotating mechanism comprises:a distal end portion coupled to the distal end of each of the sheaths, the distal end portion being configured to be fixed to the elongated flexible portion;a rotating portion coupled to the proximal end of each of the sheaths and the proximal portion, the rotating portion being configured to rotate relative to the elongated flexible portion about the longitudinal axis of the elongated flexible portion.3. The medical ...

Surgical stapler with floating anvil

A surgical instrument can include an anvil and, in addition, a staple cartridge support configured to support a staple cartridge. In various embodiments, the jaw can be moved toward the staple cartridge to deform staples contained within the staple cartridge. The anvil can be configured to be translated and/or rotated as the anvil is moved toward the staple cartridge. In certain embodiments, the anvil can be configured to float and adjust such that the anvil is moved downwardly in a level manner.

APPARATUS FOR ENDOSCOPIC PROCEDURES

An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable. 111-. (canceled)12. An electromechanical surgical system , comprising:an instrument housing defining a connecting portion for selectively connecting with a shaft assembly, the surgical instrument having at least one rotatable drive member;an end effector configured to perform at least one function and having a rotation hub; andthe shaft assembly being arranged for selectively interconnecting the end effector and the instrument housing, the shaft assembly including at least one drive member, the at least one drive member of the shaft assembly being connectable to the rotation hub when the shaft assembly is connected to the end effector; the shaft assembly having a clutch mechanism attached to at least one of the at least one drive member of the shaft assembly.13. The electromechanical surgical system according to claim 12 , wherein the clutch mechanism has a plunger member with camming surfaces and a coupling member with camming surfaces.14. The electromechanical surgical system according to claim 13 , wherein the clutch mechanism includes a biasing member engaged with the plunger member to press the plunger member against the coupling member so that the camming surfaces of the plunger member are in engagement with the camming surfaces of the coupling member.15. The electromechanical surgical system according to claim 13 , wherein the clutch mechanism includes a coupler defining an angled inner-annular surface for mating with an angled outer annular profile of the plunger member.16. A shaft assembly for interconnecting a surgical instrument and an end effector claim 13 , comprising:a proximal neck housing;a ...

Surgical clip applier comprising an automatic clip feeding system

A surgical clip applier is disclosed which is configured to automatically feed a clip from a clip cartridge once the surgical clip applier is positioned in the patient.

Fixation devices, systems and methods for engaging tissue

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each includes a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.

TREATMENT-TOOL ADAPTOR, ENDOSCOPE AND ENDOSCOPE SYSTEM

A treatment-tool adaptor including: an adaptor body that is secured to the tip of an insertion portion of an endoscope; a movable member that is disposed along the longitudinal direction of the insertion portion and that supports the tip portion of a treatment-tool channel member through which a treatment tool is passed; and a moving mechanism that causes the movable member to translationally move relative to the adaptor body in a direction intersecting the longitudinal axis of the treatment-tool channel member supported by the movable member. 1. A treatment-tool adaptor comprising:an adaptor body that is secured to an insertion portion of an endoscope;a movable member that is disposed along the longitudinal direction of the insertion portion and that supports a treatment-tool channel member through which a treatment tool is passed; anda moving mechanism that causes the movable member to translationally move relative to the adaptor body in a direction intersecting the longitudinal axis of the treatment-tool channel member supported by the movable member.2. A treatment-tool adaptor according to claim 1 , wherein the moving mechanism is provided with an elongated hole that accommodates the movable member in a manner allowing movement in the longitudinal direction claim 1 , elongated members that are secured to the movable member and that flank the movable member and extend to both sides thereof claim 1 , and elongated-member support portions that support the elongated members in the vicinity of both ends of the elongated hole in such a manner as to allow movement in respective longitudinal directions thereof.3. A treatment-tool adaptor according to claim 2 , wherein the adaptor body is provided with an insertion-portion securing portion that secures the insertion portion claim 2 , and the elongated hole is formed in an arc shape radially outward of the insertion portion secured in the insertion-portion securing portion.4. A treatment-tool adaptor according to claim 2 ...

Ultrasonic surgical instruments with control mechanisms

A surgical instrument including a shaft including a distal portion and an articulatable portion is disclosed. The articulatable portion, positioned proximal to the distal portion, includes a plurality of joint members. A first articulation cable extends through each first channel of each of the plurality of joint members and a second articulation cable extends through each second channel of each of the plurality of joint members to the distal portion. The first and second articulation cables are transitionable between: (i) an unlocked state, where the first and second articulation cables are free to translate distally and proximally and the plurality of joint members are slidable relative to one another to pivot the distal portion away from a longitudinal axis, and (ii) a locked state, where translation of the first and second articulation cables is locked, causing a position of the distal portion relative to the longitudinal axis to be locked.

SURGICAL INSTRUMENT

In one embodiment, a surgical instrument comprises an articulable waveguide. The articulable waveguide may be configured to transmit ultrasonic energy therealong. The articulable waveguide comprises a proximal drive section, an end effector and a first flexible. The proximal drive section is configured to couple to an ultrasonic transducer. The end effector is located at a distal portion of the articulable waveguide. The first flexible section comprises a flex bias and be positioned between the proximal drive section and the end effector. The surgical instrument further comprises a first tine extending longitudinally relative to the articulable waveguide. 120-. (canceled)21. A system , comprising:a robotic surgical system; a tool mounting portion configured to removably couple to the robotic surgical system;', a drive section operably coupled to an ultrasonic transducer, wherein the drive section comprises a first cross-sectional shape, and wherein the drive section defines a longitudinal drive axis; and', a first portion comprising a first thickness defined relative to the longitudinal drive axis; and', 'a second section comprising a second thickness defined relative to the longitudinal drive axis, wherein the first thickness is different than the second thickness; and, 'a flexible section extending the drive section, wherein the flexible section comprises a second cross-sectional shape that is different than the first cross-sectional shape, wherein the second cross-sectional shape comprises a substantially rectangular cross-sectional shape, and wherein the flexible section comprises], 'an articulatable waveguide, comprising, 'an articulation actuator, wherein pivotable movement of the articulation actuator is configured to articulate a distal end of the flexible section away from the longitudinal drive axis., 'a surgical instrument, comprising22. The system of claim 21 , wherein the surgical instrument further comprises an outer sheath claim 21 , wherein the ...

Surgical end effectors with positive jaw opening arrangements

A surgical instrument comprising a surgical end effector that comprises a first jaw and a second jaw that is movably supported relative to the first jaw for selective movement between an open position and closed positions. The surgical instrument further comprises a closure member that is axially movable in response to closing and opening motions. The closure member comprises at least one opening cam that protrudes therefrom to movably engage a corresponding cam surface on the second jaw such that upon application of the opening motion, the at least one opening cam movably engages the corresponding cam surface to move the second jaw to an open position, even when the jaws are under a load.

Ultrasonic blade and clamp arm alignment features

A surgical instrument includes an end effector, a shaft assembly, and an axial location feature. The end effector includes an ultrasonic blade and a clamp arm that can move between an open and closed position. The shaft assembly includes a proximal shaft portion, an acoustic waveguide extending proximally from the ultrasonic blade, a distal shaft portion extending along a distal axis, and an articulation section interposed between the proximal shaft portion and the distal shaft portion. The articulation section can deflect the distal shaft portion and the end effector relative to the longitudinal axis between a non-deflected position and a deflected position. The axial location feature can inhibit the ultrasonic blade from shifting relative to the clamp arm along the distal axis as the end effector is driven between the non-deflected position and the deflected position.

Instruments, systems, and methods for medical procedures

Systems and instruments for medical procedures and methods relating thereto, such as, for example, those that can be used in minimally invasive medical procedures, among other procedures.

MEDICAL INSTRUMENTS FOR TISSUE CAUTERIZATION

Certain aspects relate to systems and techniques for an articulating monopolar medical instrument. In one aspect, the medical instrument includes a wrist comprising a proximal clevis and a distal clevis; an end effector coupled to the distal clevis via a distal axle; at least one proximal pulley in the proximal clevis; at least one distal pulley in the distal clevis and coupled to the distal axle; a first cable configured to engage with the at least one proximal pulley and the at least one distal pulley; and a second cable configured to engage with the at least one proximal pulley without engaging the at least one distal pulley. 1. A medical instrument , comprising:a wrist comprising a proximal clevis and a distal clevis;an end effector coupled to the distal clevis via a distal axle;at least one proximal pulley in the proximal clevis;at least one distal pulley in the distal clevis and coupled to the distal axle;a first cable configured to engage with the at least one proximal pulley and the at least one distal pulley; anda second cable configured to engage with the at least one proximal pulley without engaging the at least one distal pulley, the second cable configured to engage with the distal clevis at a single side of the distal clevis offset from a central axis of the wrist.2. The instrument of claim 1 , wherein the distal clevis comprises a surface area free of stationary redirect surfaces.3. The instrument of claim 2 , wherein the distal clevis is completely devoid of any stationary redirect surfaces.4. The instrument of claim 1 , wherein the proximal clevis and the distal clevis are formed of one or more insulating materials.5. The instrument of claim 4 , wherein inner surfaces of the proximal clevis and the distal clevis are completely formed of the one or more insulating materials.6. The instrument of claim 1 , wherein:the at least one proximal pulley is configured to rotate with respect to a pitch axis providing a first degree of freedom for articulation ...

Surgical instrument system including replaceable end effectors

A surgical instrument system that includes a housing and a rotatable drive shaft, a motor operably coupled to the drive shaft, and a plurality of replaceable end effectors that can be connected to the housing. Each replaceable end effector includes a drive screw that is turned a fixed number of revolutions by the motor-driven rotatable drive shaft when the end effector is connected to the housing. Each end effector further comprises a firing member operably coupled with the drive screw of the end effector. The drive screw is configured to displace the firing member over a firing length as a result of the fixed number of revolutions. In certain embodiments, each replaceable end effector can include a drive screw with a thread pitch set to the firing length divided by the fixed number of revolutions.

Autonomous system and method for planning, tracking, and controlling the operation of steerable surgical devices

An autonomous system and method for controlling the operation of a steerable surgical device includes multiple surgical device actuation elements, an imaging apparatus (e.g., ultrasound) arranged external to a mammalian body, and at least one processor. The processor(s) is/are configured to generate a transit path between an insertion point and a target point, control the surgical device actuation elements to advance the steerable surgical device along one or more segments of the transit path, identify deviation of position relative to the transit path utilizing signals from the imaging apparatus and generate an updated transit path, and control the surgical device actuation elements to advance the steerable surgical device along at least one segment of the updated transit path. Transit of the steerable surgical device between the insertion point and the target point may be controlled without human intervention.

ARTICULATING SURGICAL INSTRUMENTS AND METHOD OF DEPLOYING THE SAME

A surgical instrument comprises a steering mechanism. The steering mechanism comprises a handle at a proximal end of the surgical instrument. The handle includes a plurality of controls for controlling a movement of the surgical instrument. The steering mechanism also comprises a hub that rotatably mates with the handle and a housing positioned about the hub. The handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom. An articulation region is at a distal end of the surgical instrument. A movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion. 1. (canceled)2198-. (canceled)199. A surgical instrument comprising: a handle at a proximal end of the surgical instrument, the handle including', 'a plurality of controls for controlling a movement of the surgical instrument; and', 'a hub that rotatably mates with the handle; and, 'a steering mechanism, comprisinga housing positioned about the hub, wherein the handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom, the surgical instrument further comprising an articulation region at a distal end of the surgical instrument, wherein a movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion,wherein the steering mechanism further comprises a locking mechanism controlled by at least one locking control of the plurality of controls of the handle, the locking mechanism constructed and arranged to disable one of the first and second degrees of freedom to limit a movement of the articulation region in the single plane ...

Apparatus for endoscopic procedures

An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable.

Medical articulation devices and methods of using the same

A medical device that includes a handle, a shaft extending distally from the handle, an end effector extending distally from the shaft, a first actuator movably coupled to the handle, and a second actuator movably coupled to the handle. The first actuator is configured to (1) articulate the shaft in response to translating the first actuator in a first direction relative to the handle and the second actuator, and (2) actuate the end effector in response to translating the first actuator in a second direction relative to the handle and the second actuator. The second actuator is configured to (1) articulate the shaft in response to translating the second actuator in the first direction relative to the handle and the first actuator, and (2) actuate the end effector in response to translating the second actuator in the second direction relative to the handle and the first actuator.

Multi-direction steerable handles for steering catheters

Disclosed herein are steerable catheter assemblies and methods of steering catheters that utilize gimbal plate and ring mechanisms to accomplish independent control of catheter flex magnitude and catheter flex direction. Some embodiments include a catheter with two or more pull wires that flex the catheter, a housing connected to the catheter, a gimbal ring pivotally connected to the housing, a gimbal plate pivotally connected to the gimbal ring to form a gimbal assembly, and an adjustment member coupled to the gimbal assembly, such that the adjustment member is movable axially and rotationally relative to the gimbal assembly. The two or more pull wires are connected to the gimbal plate, the adjustment member engages the gimbal plate such that movement of the adjustment member adjusts the position of the gimbal assembly to thereby flex the catheter with the pull wires.

Surgical Instruments Formed from Articulating or Dilating Tubes

A shaft for a surgical instrument includes a tubular shaft and an end effector comprising a pair of jaw members. The end effector is formed by laser cutting a distal end of the tubular shaft to form the jaws and to form a pivot. The pivot enables movement of the a jaw about the pivot relative to a more proximal portion of the shaft. 1. A shaft for a surgical instrument comprising:a tubular shaft and an end effector comprising a pair of jaw members, the end effector formed by laser cutting a distal end of the tubular shaft to form the jaws and to form a pivot, the pivot enabling movement of the a jaw about the pivot relative to a more proximal portion of the shaft.2. The shaft of claim 1 , further including a joint laser cut into the shaft claim 1 , proximal to the pivot claim 1 , the joint enabling articulation of the end effector relative to the shaft.3. The shaft of claim 1 , wherein the shaft further includes an inner tubular member having an outer surface claim 1 , wherein the tubular member is an outer tubular member coaxially disposed over the inner tubular member claim 1 , defining tendon pathways between the outer surface of the inner tubular member and the inner surface of the outer tubular member claim 1 , and wherein the shaft further includes actuation elements disposed within the channels claim 1 , each actuation element having a distal end anchored to the shaft and a proximal end.4. A method of making a surgical instrument shaft claim 1 , comprising the steps of:providing an elongate tube;laser cutting a pair of jaws into the elongate tube to create a distal end effector on a proximal portion of the tube;laser cutting a pivot between each jaw member and the proximal portion of the tube.5. The method of claim 5 , further comprising the step of laser cutting an articulation joint in the proximal portion of the tube. In laparoscopic and robotic surgery, wristed and articulating instruments provide additional dexterity for the surgeon—enabling access to ...

Articulable Endoscopic Instruments

In one embodiment, an articulable endoscopic instrument including an articulable retractor configured to pass through a working channel of an endoscope, the articulable retractor including an end effector mounted to a distal end of the articulable retractor, and a handle to which the articulable retractor is mounted, the handle comprising controls that enable a user of the instrument to both articulate the retractor and actuate the end effector, wherein the retractor can be articulated using the controls to form two independent bends lying within one plane, the bends together forming a complex curve. 1. An articulable endoscopic instrument comprising:an articulable retractor configured to pass through a working channel of an endoscope, the articulable retractor comprising an end effector mounted to a distal end of the articulable retractor; anda handle to which the articulable retractor is mounted, the handle comprising controls that enable a user of the instrument to both articulate the retractor and actuate the end effector, wherein the retractor can be articulated using the controls to form two independent bends lying within one plane, the bends together forming a complex curve.2. The instrument of claim 1 , wherein the articulable retractor comprises multiple articulable links that are connected together.3. The instrument of claim 2 , further comprising first and second retractor control wires that extend from the handle and through the articulable links claim 2 , wherein linear movement of the retractor control wires causes the retractor to bend.4. The instrument of claim 3 , wherein the first retractor control wire is connected to a distal articulable link of the retractor and the second retractor control wire is connected to a proximal articulable link of the retractor and wherein linear movement of the first retractor control wire causes the retractor to form a distal bend of the complex curve and wherein linear movement of the second retractor control wire ...

Endoscopic instrument having a deflectable distal tool

Embodiments of the disclosure may include a medical device comprising a flexible elongate member including a longitudinal axis and a tool connected to the elongate member at a pivot axis, wherein the tool may be configured to conduct electricity and deliver a fluid, and wherein the tool may be configured to pivot towards either side of the longitudinal axis relative to the elongate member at the pivot axis.

Miniature Shredding Tools for Use in Medical Applications, Methods for Making, and Procedures for Using

The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described. 1. A method of removing tissue from a target location in a subject , comprising:positioning a distal housing of a medical device to a target tissue site, wherein the distal housing comprises a first rotatable member and a second rotatable member;rotating the first and second rotatable members in opposite directions;directing tissue at the tissue site into the distal housing between the oppositely rotating first and second rotatable members.2. The method of further comprising advancing the first rotatable member and the second rotatable member into tissue to cause the first and second rotating members to direct tissue at the tissue site into the distal housing via a movement selected from the group consisting of: (1) distally oriented movement of the housing claim 1 , and (2) laterally oriented movement of the housing.3. The method of wherein the rotating of the first and second rotatable members comprises a function selected from the group consisting of (1) rotating the first rotatable member in a direction opposite that of the second rotatable member; (2) rotating each of the plurality of rotatable members around an axis which is fixed in position relative to the distal housing; and (3) the first and second rotatable member rotate about spaced apart parallel axes of rotation that are substantially orthogonal to a longitudinal axis of the distal housing.4. The method of ...

Steerable catheters and methods for making them

Deflectable apparatus and methods for performing a procedure within a patient's body using such apparatus are provided. Generally, the apparatus includes an elongate tubular member including a proximal end, a distal end, a longitudinal axis extending between the proximal and distal ends, a deflectable distal portion including first and second lumens spaced apart from one another on generally opposite sides of the longitudinal axis, and a handle coupled to the proximal end of the tubular member, and. A pull wire includes a loop disposed within the handle and first and second segments extending from the loop and slidably received in the first and second lumens, respectively, and coupled to the distal end. An actuator is provided on the handle for applying tension to either the first or the second segment to cause a distal portion of the tubular member to deflect, e.g., in opposite directions.

DEVICES, SYSTEM, AND METHODS FOR GUIDING AN OPERATIVE TOOL INTO AN INTERIOR BODY REGION

A guide device establishes a guide passage through a guide tube, through which an operative tool can be deployed into an interior body region for use. A steering assembly, in use, deflects or bends the distal end region of the guide tube, so that the operative tool can be placed in a desired orientation with respect to tissue. The steering assembly is desirable configured for single handed operation by the clinician. The steering assembly is also desirably configured to provide a mechanical advantage sufficient to translate relatively small increments of clinician control an to relatively larger increments of guide tube deflection. In one arrangement, the steering assembly includes a rack and pinion linkage system. In another arrangement, the steering assembly includes a pivoting lever system. 110-. (canceled)11. A handheld tack applier system for securing a prosthesis to underlying soft tissue , the tack applier system , comprising , a handle;', 'a guide tube extending from the handle, the guide tube including a deflectable distal end, the guide tube defining a longitudinal axis;', 'a drive mechanism supported by the handle;', 'a fastener driver rotatably coupled to the drive mechanism and extending through the guide tube, the fastener driver rotatable within the guide tube by the drive mechanism, the fastener including a coupling feature configured and adapted to rotate a fastener supported at a distal end thereof;, 'a handle assembly including a continuous stainless steel helical coil with a sharpened leading tip at a distal end thereof; and', 'a rotation receiving feature configured to receive rotational forces from the fastener driver;, 'a fastener disposed at the distal end of the fastener driver, the fastener includingwherein the fastener driver rotates the fastener when the drive mechanism is actuated.12. The handheld tack applier system according to claim 11 , wherein the handle assembly includes a steering assembly for deflecting the distal end of the ...

Surgical rotary cutting tool including articulable head

An articulating rotary cutting tool configured to articulate a distal cutting tip upon a trigger being operated. The trigger can be locked into various articulating positions. The velocity of rotation of a cutting bit is substantially constant in both articulating and non-articulating positions. An articulation joint is one of a hex ball joint or a flexible spring joint. A button is included to release a locking pressure holding the trigger in a locked position. The trigger may employ articulating sliding surfaces that provide constraint to a flexed head in both directions of articulation.

ELECTROMECHANICAL SURGICAL SYSTEM

A surgical system includes a drive unit on a support. The drive unit includes motors or other actuators and a plurality of output elements arranged such that operation of each drive unit linearly translates a corresponding one of the output elements. A surgical device has actuation elements extending through an elongate shaft to a distal articulation section, and an input subsystem carried at the proximal end of the shaft. Linear translatable input elements or pistons of the input subsystem are each associated with a corresponding one of the actuation elements. The input and output elements are positioned such that operation of an actuator linearly translates an output element, causing linear translation of a corresponding input element and engagement of an actuation element. A sterile drape is positionable between the input elements and the output elements. 1. A surgical system comprising:a drive unit on a support, the drive unit comprising a plurality of actuators and a plurality of output elements, each drive unit operable to linearly translate a corresponding one of the output elements; an elongate shaft having a distal articulation section, and a plurality of actuation elements extending through the shaft,', 'an input subsystem carried at the proximal end of the shaft, the input subsystem including a plurality of input elements each operatively associated with a corresponding one of the actuation elements, each input element linearly translatable relative to the elongate shaft;, 'a surgical device comprising'}wherein the surgical device is removably mounted relative to support to position each output element in a drive relationship with a corresponding input element; andwherein operation of an actuator linearly translates an output element, causing linear translation of a corresponding input element and engagement of an actuation member.2. The surgical system of claim 1 , wherein each output element and its corresponding input element is linearly translatable ...

BODY CAVITY DRAINAGE DEVICES INCLUDING DRAINAGE TUBES HAVING INLINE PORTIONS AND RELATED METHODS

A body cavity drainage device includes a drainage tube with a distal end configured for insertion into the body cavity of a patient, a fluid outlet at a proximal end of the drainage tube; and an activation apparatus coupled to the drainage tube between the proximal end of the drainage tube and the distal end of the drainage tube. The activation apparatus may be configured to alter a position of the distal end of the drainage tube in response to an input at a control device of the activation apparatus, and a first portion of the drainage tube extending from the activation apparatus toward the distal end may be at least substantially coaxial with a second portion of the drainage tube extending from the activation apparatus toward the proximal end. Methods relate to forming a body cavity drainage devices. 1. A drainage device , comprising: a distal end configured for insertion into a body cavity of a patient;', 'a drainage lumen defined by a wall of the drainage tube;', 'a plurality of lateral openings in the wall of the drainage tube proximate to the distal end of the drainage tube, each of the plurality of lateral openings in fluid communication with the drainage lumen; and', 'a fluid outlet proximate a proximal end of the drainage tube, the fluid outlet in fluid communication with the drainage lumen of the drainage tube; and, 'a drainage tube comprisingan activation apparatus detachably coupled to the drainage tube, the activation apparatus comprising a control device.2. The drainage device of claim 1 , further comprising at least two flexible members extending longitudinally though the wall of the drainage tube.3. The drainage device of claim 2 , wherein the at least two flexible members are operatively coupled to the control device.4. The drainage device of claim 3 , further comprising at least two linking elements claim 3 , each linking element configured to operatively couple one of the at least two flexible members to the control device.5. The drainage device ...

FLEXIBLE ARTICULATED DEVICE

The present innovation pertains to a device and method for enabling movement of a flexible medical device. 141.-. (canceled)42. A surgical device comprising a three-bar-linkage retraction mechanism , said mechanism comprises a distal element , link and a flexible elongated (endless) shaft provided proximally to said three link bar , wherein said link is interconnected to said shaft , by mean of a rigid clevis , said rigid clevis configured to enable simultaneously three degrees of freedom namely rotation , actuation and articulation.43. The device of claim 42 , wherein said rigid clevis is provided with a guide configured for guiding said actuator wire.44. The device of claim 43 , wherein said guide configured by having at least a section of a concaved-parabolic nozzle-like shape.45. The device of claim 44 , wherein said nozzle-like shape is configured for guidance of the wire and fixture at the nozzles throat.46. The device of claim 42 , wherein said rigid clevis is provided with a guide configured for separating said actuator wire from link.47. The device of wherein said guide is configured for guiding said actuator wire.48. The device of wherein said guide is configured for separating said actuator wire.49. The device of claim 42 , wherein said rigid clevis is coupled to the distal end of said elongate flexible shaft and to the proximal end of said end effector.50. The device of claim 42 , further comprising said actuation wire extending along said elongate shaft claim 42 , configured to be linearly reciprocated in parallel with the main longitudinal axis of said shaft.51. The device of further comprising said actuation wire extending through the elongate shaft claim 42 , configured to translate claim 42 , along a longitudinal axis of the elongate shaft claim 42 , actuation of said effector.52. The device of claim 42 , wherein at least a portion of said clevis is characterized by a concaved-parabolic nozzle-like shape.53. The device of claim 42 , wherein at least ...

Methods for delivery of heart valve devices using intravascular ultrasound imaging

Methods related to delivery of various heart valve implants are described. The implant may be delivered using an ultrasound imaging delivery system. The ultrasound imaging delivery system may be used to deliver a variety of different devices, including mitral valve reshaping devices, mitral valve replacement valves, and others. A deployment catheter carrying an implant having a tissue anchor is advanced to a deployment site in a heart. An imaging element is positioned adjacent the implant and a relationship between the tissue anchor and an anatomical landmark in the heart is visualized. The implant is then attached by driving the tissue anchor into tissue in the heart.

Surgical cutting and stapling methods

Surgical methods for cutting and fastening tissue are disclosed. The methods may include employing a surgical end effector that includes a pair of jaws wherein an upper jaw is movable relative to a lower jaw that supports a surgical fastener cartridge. The methods may include manipulating the end effector to a compact configuration to facilitate its insertion through a trocar port and then manipulating and actuating the end effector to treat target tissue.

ULTRASONIC SURGICAL INSTRUMENT WITH ARTICULATION JOINT HAVING PLURALITY OF LOCKING POSITIONS

An apparatus comprises a body assembly, a shaft, an acoustic waveguide, an articulation section, an end effector, an articulation drive assembly, and a locking feature. The shaft extends distally from the body assembly. The waveguide comprises a flexible portion. The articulation drive assembly is operable to drive articulation of the articulation section to thereby deflect the end effector from the longitudinal axis of the shaft. The articulation drive assembly comprises an actuator. The actuator is movable relative to the body assembly to drive articulation of the articulation section. The locking feature is in communication with the actuator. The locking feature is movable between an unlocked state and a locked state. The locking feature is configured to permit movement of the actuator relative to the body assembly in the unlocked state. The locking feature is configured to prevent movement of the actuator relative to the body assembly in the locked state.

ELECTROMECHANICAL SURGICAL SYSTEM

A surgical system includes a drive unit on a support. The drive unit includes motors or other actuators and a plurality of output elements arranged such that operation of each drive unit linearly translates a corresponding one of the output elements. A surgical device has actuation elements extending through an elongate shaft to a distal articulation section, and an input subsystem carried at the proximal end of the shaft. Linear translatable input elements or pistons of the input subsystem are each associated with a corresponding one of the actuation elements. The input and output elements are positioned such that operation of an actuator linearly translates an output element, causing linear translation of a corresponding input element and engagement of an actuation element. A sterile drape is positionable between the input elements and the output elements. 1. A method or operating a drive assembly of a surgical system , comprising:providing a drive unit comprising a plurality of output elements, each output element linearly moveable in first and second directions, the second direction opposite to the first direction,providing a surgical device including a plurality of linearly moveable input elements, each input element linearly moveable in the first and second directions;positioning the drive unit, and surgical device, and a sterile barrier such that a plurality of the output elements are longitudinally aligned with corresponding ones of a plurality of the input elements, and the sterile barrier extends between the output and input elements;operating a plurality of actuators to cause select ones of actuators to linearly translate in the first or second direction, thereby causing corresponding linear translation of the corresponding input elements in the first or second direction, each drive element translating along a common axis with its corresponding input element.2. The method according to claim 1 , wherein:the surgical device comprises an elongate shaft ...

SURGICAL INSTRUMENTS FOR GRASPING TISSUE AND SENSING TISSUE PROPERTIES

An endoscopic surgical instrument includes an elongated shaft and a pair of elongated arms extending through the shaft. The arms have a distal end portion configured to grasp tissue therebetween. The distal end portion of at least one of the arms is equipped with a sensor for sensing a property of the tissue. 1. A surgical instrument , comprising:an elongated shaft defining a passageway therethrough; anda pair of first and second elongated arms extending through the shaft, each of the first and second arms having a generally arcuate, distal end portion configured to extend distally out of the shaft and to surround tissue, the distal end portion of the first arm having a sensor configured to sense a property of the tissue, wherein each of the first and second arms has a distal tip fabricated from a magnetic material such that the distal tips are magnetically attracted to one another.2. The surgical instrument according to claim 1 , wherein the distal end portion of the second arm has an emitter configured to emit a signal sensed by the sensor.3. The surgical instrument according to claim 2 , wherein the sensor is a photodetector claim 2 , and the emitter is an infrared or LED emitter.4. The surgical instrument according to claim 2 , further comprising a processor in communication with the sensor and the emitter claim 2 , wherein the processor is configured to determine the property of the tissue based on information received from the sensor.5. The surgical instrument according to claim 4 , wherein the processor is configured to cause the emitter to emit the signal upon the distal tips engaging one another.6. The surgical instrument according to claim 1 , wherein the distal tip of the first arm and the distal tip of the second arm are oriented toward one another.7. The surgical instrument according to claim 1 , wherein the first and second arms are configured to translate relative to the shaft between a retracted position claim 1 , in which the distal end portion of ...

SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM

A surgical instrument can include a shaft, an end effector, and an articulation joint configured to permit the end effector to rotate relative to the shaft about the articulation joint. The surgical instrument can further comprise a first articulation actuator for rotating the end effector in a first direction and a second articulation actuator for rotating the end effector in a second direction. The articulation actuators can be configured to push the end effector. The articulation actuators can assume different configurations depending on whether they are experiencing a compressive load or a tensile load. The articulation joint can comprise an articulation frame which forms a proximal joint with the shaft and a distal joint with the end effector. The joints can comprise fixed axis joints and/or ball-and-socket joints, for example. The articulation joint can comprise links having different sizes to facilitate the articulation of the articulation joint. 1. A surgical instrument , comprising:a shaft comprising a shaft frame; an end effector frame; and', 'a jaw movable relative to said end effector frame;, 'an end effector, comprising [ a proximal articulation end; and', 'a distal articulation end;, 'an articulation frame, comprising, 'a first articulation joint connecting said proximal articulation end to said shaft frame; and', 'a second articulation joint connecting said distal articulation end to said end effector frame;, 'an articulation joint, comprisinga firing system movable relative to said shaft frame, said articulation frame, and said end effector frame, wherein said firing system comprises a cutting member movable relative to said end effector frame.2. The surgical instrument of claim 1 , further comprising an outer tube movable relative to said articulation joint claim 1 , wherein said outer tube is configured to move said jaw between an open position and a closed position.3. The surgical instrument of claim 1 , further comprising:a first articulation ...

PULLEY ARRANGEMENT FOR ARTICULATING A SURGICAL INSTRUMENT

A robotic surgical instrument comprising a shaft and end effector element connected by an articulation. The articulation comprises a first joint driveable by a first pair of driving elements. The first joint permits the end effector element to rotate about a first axis transverse to a longitudinal axis of the shaft, the rotation of the end effector element about the first axis bounded by an extreme rotation angle relative to the longitudinal axis. A second joint is driveable by a second pair of driving elements. A pulley arrangement constrains the second pair of driving elements, and comprises a first set of pulleys rotatable about the first axis, and a second set of pulleys located relative to the first set of pulleys such that at the extreme rotation angle the second pair of driving elements is retained in contact with both the first and second sets of pulleys. 1. A robotic surgical instrument comprising:a shaft extending between an instrument interface at one end and an articulation at the other end; a first joint driveable by a first pair of driving elements, the first joint permitting the end effector element to rotate about a first axis transverse to a longitudinal axis of the shaft, and', 'a second joint driveable by a second pair of driving elements; and, 'the articulation connecting an end effector element to the shaft, the articulation comprising a first set of pulleys rotatable about the first axis, and', 'a second set of pulleys, wherein each pulley of the second set of pulleys is rotatable about an offset axis offset from the first axis in a direction transverse to the longitudinal direction of the shaft, and the second set of pulleys is located between the first set of pulleys and the instrument interface end of the shaft., 'a pulley arrangement around which the second pair of driving elements is constrained to move, the pulley arrangement comprising2. A robotic surgical instrument as claimed in claim 1 , wherein the second set of pulleys is located ...

SURGICAL INSTRUMENT

In one embodiment, a surgical instrument comprises an articulable waveguide. The articulable waveguide may be configured to transmit ultrasonic energy therealong. The articulable waveguide comprises a proximal drive section, an end effector and a first flexible. The proximal drive section is configured to couple to an ultrasonic transducer. The end effector is located at a distal portion of the articulable waveguide. The first flexible section comprises a flex bias and be positioned between the proximal drive section and the end effector. The surgical instrument further comprises a first tine extending longitudinally relative to the articulable waveguide. 120-. (canceled)21. A surgical instrument , comprising:an outer sheath extending along a longitudinal axis; a drive section disposed within the outer sheath, wherein the drive section comprises a proximal end and a distal end, and wherein the proximal end of the drive section is configured to couple to an ultrasonic transducer; and', 'a flexible waveguide coupled to the distal end of the drive section;, 'an articulable waveguide configured to transmit ultrasonic energy, wherein the articulable waveguide comprisesan articulation actuator positioned proximal to the flexible waveguide;a first translatable member coupled to and extending distally from the articulation actuator to a distal portion of the outer sheath;a second translatable member coupled to and extending distally from the articulation actuator to the distal portion of the outer sheath;wherein the articulation actuator is configured to translate the first translatable member and the second translatable member along the longitudinal axis simultaneously, in opposite directions, to articulate the outer sheath away from the longitudinal axis, and wherein the flexible waveguide is configured to flex with the outer sheath away from the longitudinal axis.22. The surgical instrument of claim 21 , wherein the articulation actuator is configured to pivot about a ...

SURGICAL INSTRUMENTS WITH ARTICULATING SHAFTS

Various example embodiments described herein are directed to articulating surgical instruments for treating tissue comprising an end effector and a shaft extending proximally from the end effector along a longitudinal axis. In certain embodiments, the shaft comprises a plurality of transverse spacer members as well as first and second rotatable members extending through at least a portion of the plurality of transverse spacer members. The first and second rotatable members may both be biased away from the longitudinal axis such that their respective directions of bias vary with rotation of the first rotatable member. When the respective directions of bias of the first and second rotatable members oppose one another, the shaft may be substantially straight. When the respective directions of bias of the first and second rotatable members are aligned with one another, the shaft may articulate away from the longitudinal axis in the direction of the alignment. 120-. (canceled)21. An articulatable surgical instrument comprising: a first gear and a second gear both configured to rotate on a common first plane;', 'a first connecting gear mechanically coupled to the first gear;', 'a second connecting gear mechanically coupled to the second gear;', 'a first shaft extending along a longitudinal axis and mechanically coupled to the first connecting gear and configured to rotate on a second plane perpendicular to both the first plane and the longitudinal axis; and', 'a second shaft extending parallel to the longitudinal axis and mechanically coupled to the second connecting gear and configured to rotate on the second plane perpendicular to both the first plane and the longitudinal axis;, 'a robotic instrument mounting portion comprisinga plurality of transverse spacer members coupled to the first shaft and the second shaft; andan end effector coupled to distal ends of the first shaft and the second shaft;wherein the first shaft comprises a first pivotable portion extending ...

Surgical instrument system including replaceable end effectors

A surgical instrument system that includes a housing and a rotatable drive shaft, a motor operably coupled to the drive shaft, and a plurality of replaceable end effectors that can be connected to the housing. Each replaceable end effector includes a drive screw that is turned a fixed number of revolutions by the motor-driven rotatable drive shaft when the end effector is connected to the housing. Each end effector further comprises a firing member operably coupled with the drive screw of the end effector. The drive screw is configured to displace the firing member over a firing length as a result of the fixed number of revolutions. In certain embodiments, each replaceable end effector can include a drive screw with a thread pitch set to the firing length divided by the fixed number of revolutions.

Stapling assembly for forming different formed staple heights

A surgical stapling assembly can include a staple cartridge, an anvil, and a firing system configured to eject staples from the staple cartridge. The firing system can include a firing member configured to relatively position the anvil and the staple cartridge. The staple cartridge can include a first deck portion, a second deco portion, and a wall defined between the first deck portion and the second deck portion.

Detachable surgical tool configured as a finite state machine

Many embodiments of a surgical tool are set forth herein that can be employed for use in minimally invasive surgical procedures and in remote access surgical procedures. The surgical tool has multiple bodies with one or more detachable structural interfaces that can be established between one or more pairs of the bodies. Certain locks, interlocks, and/or joints can be present in the surgical tool and among the bodies in various embodiments in order to provide certain functionalities during use.

Surgical cutting and stapling methods

Surgical methods for cutting and fastening tissue are disclosed. The methods may include employing a surgical end effector that includes a pair of jaws wherein an upper jaw is movable relative to a lower jaw that supports a surgical fastener cartridge. The methods may include manipulating the end effector to a compact configuration to facilitate its insertion through a trocar port and then manipulating and actuating the end effector to treat target tissue.

TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT

A tissue thickness compensator can comprise a compensator body and at least one vessel contained in the compensator body. The vessel can define an inner cavity which can comprise an inner atmosphere having a pressure which is lower than the atmospheric pressure of the atmosphere surrounding the tissue thickness compensator. In at least one embodiment, the vessel and the compensator body can be maintained in a collapsed state until staples are fired through the vessel. At such point, the vessel can re-expand and apply a biasing force to tissue captured within the staples. 119-. (canceled)20. A staple cartridge , comprising:a cartridge body, wherein a plurality of staple cavities are defined in said cartridge body;a plurality of staples removably positioned in said staple cavities; and a first zone comprising a tissue-supporting surface;', 'a second zone comprising a cartridge body contacting surface; and', 'an intermediate zone positioned intermediate said first zone and said second zone,, 'an absorbable tissue thickness compensator releasably secured to said cartridge body, wherein said absorbable tissue thickness compensator compriseswherein said first zone comprises a first spring rate, wherein said second zone comprises a second spring rate greater than said first spring rate, and wherein said intermediate zone comprises a third spring rate less than said first spring rate.21. A staple cartridge , comprising:a cartridge body, wherein a plurality of staple cavities are defined in said cartridge body;a plurality of staples removably positioned in said staple cavities; and a first zone comprising a tissue-supporting surface, wherein said first zone comprises a first compressibility;', 'a second zone comprising a cartridge body contacting surface, wherein said second zone comprises a second compressibility that is less than said first compressibility; and', 'an intermediate zone positioned between said first zone and said second zone, wherein said intermediate zone ...

Staple cartridge comprising a releasable portion

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE

A fastener cartridge assembly for use with a surgical end effector. The fastener cartridge assembly can comprise a cartridge body having fastener cavities, fasteners removably positioned in the fastener cavities, a layer of material releasably secured relative to the cartridge body, a connector configured to secure the layer of material to the cartridge body at a location distal to at least one fastener cavity, and an actuator. The layer of material can be a tissue thickness compensator. When actuated, the actuator can overcome the connector, and can overcome the connector prior to the removal of the fasteners from the fastener cavities. The actuator can be actuated at a location proximal to at least one fastener cavity, and can extend distally past at least one fastener cavity toward the connector. 1. A fastener cartridge assembly , comprising:a cartridge body comprising a plurality of fastener cavities;a plurality of fasteners, wherein each said fastener is removably positioned in a said fastener cavity;a tissue thickness compensator releasably secured relative to said cartridge body;a connector, wherein said connector secures said tissue thickness compensator to said cartridge body at a location, and wherein the location is distal to at least one said fastener cavity; andan actuator configured to overcome said connector when actuated, wherein said actuator overcomes said connector prior to the removal of said fasteners from said fastener cavities.2. The fastener cartridge assembly of claim 1 , wherein said tissue thickness compensator is released from said cartridge body when said actuator overcomes said connector.3. The fastener cartridge assembly of claim 1 , wherein said actuator shifts distally to cut said connector when actuated.4. The fastener cartridge assembly of claim 1 , wherein said actuator comprises a slot extending from a proximal end of said actuator claim 1 , and wherein said slot comprises a release stop.5. The fastener cartridge assembly of ...

Articulating surgical instruments and method of deploying the same

A surgical instrument comprises a steering mechanism. The steering mechanism comprises a handle at a proximal end of the surgical instrument. The handle includes a plurality of controls for controlling a movement of the surgical instrument. The steering mechanism also comprises a hub that rotatably mates with the handle and a housing positioned about the hub. The handle, the housing, and the hub communicate with each other to provide at least a first degree of freedom and a second degree of freedom. An articulation region is at a distal end of the surgical instrument. A movement of the steering mechanism handle in one and only one of the first or second degrees of freedom relative to at least one of the housing or the hub translates to a movement of the articulation region in a single plane of motion.

Multi-Spectrum Ring Illuminated Surgical Camera

Multi-spectrum ring illuminated surgical cameras and scopes having a ring lens and a plurality of LEDs. The LEDs set behind an electronic imaging sensor (camera) and positioned radially about the longitudinal axis of the lens and/or scope.

Medical device for modification of left atrial appendage and related systems and methods

Devices, methods and systems are provided for occluding an opening within the tissue of a body, such as a left atrial appendage. In one embodiment, a device includes a framework extending between a primary hub and a secondary hub. The secondary hub is moveable relative to the primary hub upon deploying the framework from a constricted position to a deployed position such that the secondary hub remains proximal a distal end of the framework. The framework, in the deployed position, includes engaging members proximal the distal end of the framework, and the framework includes multiple frame segments each extending with an arcuate configuration at a distal side of the framework such that the frame segments, at the distal side thereof, each extend radially and distally toward the distal end, then turn and extend radially and proximally inward toward the secondary hub.

Manipulator Device and Therapeutic and Diagnostic Methods

Dexterous manipulation devices are provided having an end effector enabling large curvature with a diameter of 1 mm or less that can articulate about an axis in a working space of about or less than 4 mm by 4 mm. Preferred devices are robotically actuated and controlled and can be used for a variety of therapeutic and diagnostic applications.

Surgical suturing instrument comprising a non-circular needle

A surgical suturing system is disclosed. The surgical suturing system comprises a shaft comprising a shaft diameter, a firing drive, and an end effector extending distally from the shaft. The end effector comprises a needle track and a needle comprising suturing material attached thereto, wherein the needle is configured to be guided by the needle track and actuated by the firing drive through a firing stroke, and wherein the needle is movable along a needle path comprising a maximum capture width which is greater than the shaft diameter.

Clip applier comprising clip advancing systems

A surgical device for clipping tissue is disclosed. The surgical device comprises a housing, a shaft defining a shaft axis, and an end effector. The end effector comprises a first jaw, a second jaw, and a receiver. The first jaw and the second jaw are movable relative to each other between an open position and a closed position. The receiver is at least partially defined between said first jaw and said second jaw. The surgical device further comprises a rotatable clip magazine configured to rotate about the shaft axis, a first advancing system, and a second advancing system. The clip magazine is configured to store at least two clips. The second advancing system is configured to operate sequentially with the first advancing system. The first advancing system and the second advancing system are configured to sequentially advance the clips into the receiver of the end effector.

Surgical clip applier comprising adaptive firing control

A surgical clip applier comprising an electric motor system is disclosed. The electric motor system is configured to drive one or more drive systems of the surgical clip applier. The surgical clip applier comprises a control system configured to control the electric motor system. The control system is configured to monitor a parameter of the electric motor system to assess the operation of the one or more drive systems. In at least one instance, the control system monitors the electric current drawn by an electric motor and adapts the operation of the electric motor based on the electric current being drawn by the motor. The control system slows the electric motor down when the electric current drawn by the electric motor exceeds a threshold. The control system modulates the width, or duration, of voltage pulses applied to the electric motor to control the speed of the electric motor.

Clip applier comprising a movable clip magazine

A surgical device for clipping tissue is disclosed. The surgical device comprises a housing, a shaft extending from the housing, an end effector extending from the shaft, a motor, a rotary input configured to rotate in response to the motor, and a clip magazine comprising a plurality of clips. The shaft defines a shaft axis. The clip magazine is operably connected to the rotary input. The clip magazine is movable in a first direction through a clip feed stroke in response to the rotation of the rotary input. The clip magazine is movable in a second direction in response to the rotation of the rotary input. The second direction is transverse to the first direction.

Surgical dissectors configured to apply mechanical and electrical energy

A surgical instrument comprising an end effector is disclosed. The end effector comprises a surgical dissector. The surgical dissector can apply mechanical and/or electrosurgical energy to treated tissue.

Manual release assembly for robotic surgical tool

A surgical tool includes a drive housing that houses a plurality of drive cable capstans, an elongate shaft that extends from the drive housing, and an end effector operatively coupled to a distal end of the elongate shaft. A plurality of drive cables extend between the drive housing and the end effector, wherein each drive cable is associated with a corresponding drive cable capstan and rotation of the drive cable capstans correspondingly moves the drive cables to articulate the end effector. A manual release assembly is coupled to the drive housing and includes a release switch that is manually movable between a disengaged position and an engaged position. When the release switch is manually moved to the engaged position, the drive cable capstans are rotated to move the drive cables and thereby manually articulate the end effector.

ROBOTICALLY-CONTROLLED SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR

Devices and systems are provided for controlling movement of a working end of a surgical device by means of a robotic system. In one embodiment, systems and devices are provided for moving an end effector on a distal end of a surgical fastening device. Movement can include rotational movement of the end effector about an axis of the shaft, articulation of the end effector relative to the shaft, and actuation of an end effector, e.g., closing, firing, and/or cutting. 1. A surgical tool for use with a robotic system that has a tool drive assembly that is operatively coupled to a control unit of the robotic system that is operable by inputs from an operator and is configured to provide at least one rotary output motion to at least one rotatable body portion supported on the tool drive assembly , said surgical tool comprising:a surgical end effector configured to perform a surgical procedure in response to control motions applied thereto from the robotic system;an elongated shaft assembly operably coupled to said surgical end effector and defining a longitudinal tool axis, said elongated shaft having an articulation joint operably supported therein configured to enable said surgical end effector to be selectively articulated about a first tool articulation axis relative to the longitudinal tool axis and about a second tool articulation axis relative to said longitudinal tool axis; anda tool mounting portion operably coupled to said elongated shaft and configured to operably interface with the tool drive assembly of the robotic system, said tool mounting portion operably supporting a transmission arrangement comprising an articulation transmission configured to apply articulation control motions to said articulation joint in response to said at least one rotary output motion applied thereto from the tool drive assembly.2. The surgical tool of wherein:said first tool articulation axis is substantially transverse to said longitudinal tool axis; andsaid second tool ...

ARTICULATING ULTRASONIC SURGICAL INSTRUMENTS AND SYSTEMS

An articulating ultrasonic surgical end effector includes a clevis, a transducer housing pivotably coupled to the clevis, an ultrasonic transducer disposed within the transducer housing, a waveguide extending distally from the ultrasonic transducer, an ultrasonic blade disposed at the distal end of the waveguide, a shaft extending distally from the transducer housing about at least a portion of the ultrasonic blade, and a clamp arm pivotably coupled to the shaft and movable relative to the ultrasonic blade between an open position and a clamping position. Ultrasonic energy produced by the ultrasonic transducer is transmitted along the waveguide to the ultrasonic blade for treating tissue therewith. 1. An articulating ultrasonic surgical end effector , comprising:a clevis;a transducer housing pivotably coupled to the clevis;an ultrasonic transducer disposed within the transducer housing;a waveguide extending distally from the ultrasonic transducer;an ultrasonic blade disposed at the distal end of the waveguide, wherein ultrasonic energy produced by the ultrasonic transducer is transmitted along the waveguide to the ultrasonic blade for treating tissue therewith;a shaft extending distally from the transducer housing about at least a portion of the ultrasonic blade; anda clamp arm pivotably coupled to the shaft and movable relative to the ultrasonic blade between an open position and a clamping position.2. The articulating ultrasonic surgical end effector according to claim 1 , wherein at least one pulley and cable operably couples the transducer housing with the clevis to permit pivoting of the transducer housing relative to the clevis.3. The articulating ultrasonic surgical end effector according to claim 1 , wherein at least one pulley and cable extends between the clamp arm and the clevis to permit pivoting of the clamp arm relative to the ultrasonic blade regardless of the orientation of the transducer housing relative to the clevis.4. The articulating ultrasonic ...

ARTICULATION MECHANISM FOR SURGICAL STAPLING DEVICE

A surgical device includes an adapter assembly and a tool assembly that is coupled to the adapter assembly by a pivot member to facilitate articulation of the tool assembly in relation to the adapter assembly. The adapter assembly supports a drive assembly for actuating or firing the tool assembly. The adapter assembly includes an articulation mechanism that adjusts the position of the tool assembly in relation to the drive assembly to compensate for changes in stroke length of the drive assembly that result from articulation of the tool assembly. 1. (canceled)2. A surgical stapling device comprising:a tool assembly defining a first longitudinal axis and having an anvil and a cartridge assembly, the anvil coupled to the cartridge assembly to facilitate movement of the tool assembly between an open position and a clamped position; andan adapter assembly defining a second longitudinal axis and including:an outer tube having a proximal portion and a distal portion, the distal portion of the outer tube supporting the tool assembly such that the tool assembly is movable between a non-articulated position in which the first longitudinal axis of the tool assembly is aligned with the second longitudinal axis of the adapter assembly, and an articulated position in which the first longitudinal axis of the tool assembly is misaligned with the second longitudinal axis of the adapter assembly;a drive assembly movable in relation to the tool assembly between a retracted position and an advanced position to move the tool assembly from the open position to the clamped position and to eject staples from the cartridge assembly; andan articulation mechanism including an adapter cam and a first articulation link, the adapter cam defining a first cam channel, and a second cam channel, the first articulation link having a distal portion coupled to the tool assembly and a proximal portion that supports a first cam member that is received within the first cam channel of the adapter cam, ...

Steerable instrument comprising a radial spacers between coaxial cylindrical elements

A steerable instrument () has an actuator () at a proximal side and a bendable zone () at a distal side. The actuator () controls bending of the flexible zone () by means of one or more longitudinal elements. The instrument has a first cylindrical element (), a second cylindrical element () and a third cylindrical element (). The second cylindrical element () has a zone () with a longitudinal element portion () with a first height in a radial direction of the instrument. Radial spacers () are located at mutual sides of the longitudinal element portion (), which have, at least locally, a second height in the radial direction larger than the first height. 1. A steerable instrument for endoscopic and/or invasive type of applications , such as in surgery , the instrument comprising an elongated tubular body extending in a longitudinal direction and having at least one actuation means at a proximal side of the steerable instrument and at least one bendable zone at a distal side of the steerable instrument , said at least one actuation means being arranged to control bending of said at least one flexible zone by means of at least one longitudinal element ,the instrument comprising a first cylindrical element, a second cylindrical element and a third cylindrical element, the first cylindrical element surrounding the second cylindrical element and the second cylindrical element surrounding the third cylindrical element,the second cylindrical element comprising at least a zone with a longitudinal element portion of said at least one longitudinal element, said longitudinal element portion having a first height in a radial direction of said instrument,wherein the instrument is provided with at least two radial spacers at mutual sides of said longitudinal element portion, each one of said radial spacers having, at least locally, a second height in the radial direction larger than the first height.2. The steerable instrument according to claim 1 , wherein said second height is ...

CLOT RETRIEVAL DEVICE FOR REMOVING OCCLUSIVE CLOT FROM A BLOOD VESSEL

A clot retrieval device for removal of occlusive clot from a blood vessel comprises a clot engaging element having a constrained delivery configuration and an expanded deployed configuration. In the expanded configuration peripheral portions are laterally spaced-apart and the clot engaging section extends between the peripheral portions. The device may have two superimposed wave patterns provided by a large amplitude curve and shorter pitch sinusoidal patterns . A wave shape varies the contact pressure between a clot and the device along the length of the device, reducing the compression of the clot by the device at some locations. The device can elongate when placed under tension which aids elongation of the clot during dislodgement. 1. A clot retrieval device for removing occlusive clot from a blood vessel comprising a clot engaging element having a constrained delivery configuration and an expanded deployed configuration , the clot engaging element having a first peripheral portion , a second peripheral portion and a clot engaging section extending between the first and second peripheral portions wherein , in the expanded configuration , the peripheral portions are laterally spaced-apart , the clot engaging section extends between the peripheral portions , and wherein at least a portion of the device has a longitudinally extending undulating edge.2. A clot retrieval device as claimed in wherein the undulating edge has a wave-like form.3. A clot retrieval device as claimed in wherein the undulating edge has a sinusoidal wave form.4. A clot retrieval device as claimed in wherein the device has at least two wave patterns.5. A clot retrieval device as claimed in wherein the wave patterns are superimposed on one another.6. A clot retrieval device as claimed in wherein a first pattern has a wavelength and an amplitude and the second pattern has a wavelength and an amplitude which are larger than those of the first pattern.7. A clot retrieval device as claimed in ...

SURGICAL END EFFECTORS HAVING ANGLED TISSUE-CONTACTING SURFACES

Surgical end effectors are disclosed having angled tissue-contacting surfaces. The end effectors may have a first jaw member that is movable relative to a second jaw member between an open position and a closed position. The first jaw member may have a first positively-angled tissue-contacting surface. The second jaw member may have a second positively-angled tissue-contacting surface. At least one of the jaw members may have at least one active electrode configured to deliver RF energy to tissue located between the first jaw member and the second jaw member when in the closed position. 1. An end effector comprising:a first jaw member comprising a first positively-angled tissue-contacting surface; anda second jaw member comprising a second positively-angled tissue-contacting surface;wherein the first jaw member is movable relative to the second jaw member between an open position and a closed position;wherein at least one of the first jaw member and the second jaw member comprises at least one active electrode disposed on the jaw member adjacent to the positively-angled tissue-contacting surface; andwherein the at least one active electrode is configured to deliver RF energy to tissue located between the first jaw member and the second jaw member when in the closed position.2. The end effector of claim 1 , wherein the at least one active electrode is disposed on the second jaw member claim 1 , and further comprising at least one return electrode disposed on the first jaw member claim 1 , wherein the at least one active electrode and the at least one return electrode are in a bipolar configuration.3. The end effector of claim 1 , wherein:the first jaw member comprises the first positively-angled tissue-contacting surface and a first negatively-angled tissue-contacting surface; andthe second jaw member comprises the second positively-angled tissue-contacting surface and a second-negatively angled tissue-contacting surface;wherein the first positively-angled tissue- ...

SURGICAL DEVICE WITH ARTICULATION AND WRIST ROTATION

A surgical instrument comprising a handle assembly, an elongated shaft, an end effector, a rotation mechanism, and an articulation mechanism is disclosed. The rotation mechanism is disposed in mechanical cooperation with the handle assembly and effects rotation of the end effector about the second longitudinal axis. The articulation mechanism is disposed in mechanical cooperation with the handle assembly and effects movement of the end effector from a first position where the first longitudinal axis is substantially aligned with the second longitudinal axis to a second position where the second longitudinal axis is displaced from the first longitudinal axis. The articulation mechanism comprises a first articulation control disposed in mechanical cooperation with the handle assembly, a first cable and a second cable. Actuation of the first articulation control in a first direction causes the first cable to move distally and causes the second cable to move proximally. 1. (canceled)2. A surgical instrument , comprising;a handle assembly;an elongated shaft extending distally from the handle assembly and defining a first longitudinal axis;an end effector disposed in mechanical cooperation with a distal portion of the elongated shaft, the end effector defining a second longitudinal axis and including a pair of jaw members;a rotation mechanism disposed in mechanical cooperation with the handle assembly for effecting rotation of the pair of jaw members of the end effector about the second longitudinal axis and relative to the handle assembly; and a first articulation control disposed in mechanical cooperation with the handle assembly;', 'a second articulation control disposed in mechanical cooperation with the handle assembly, the first articulation control and the second articulation control being independently actuatable with respect to each other;', 'a first cable, a distal portion of the first cable being in mechanical cooperation with the end effector;', 'a second ...

Flexible and steerable elongate instruments with shape control and support elements

An instrument having a flexible and elongated body includes at least a lumen and a flex member disposed within the lumen. The flex member may be capable of providing steering control to a first portion of the elongate body while providing load bearing support to a second portion of the elongate body. A pull wire may be disposed within the flex member, and at least a distal portion of the pull wire may be coupled to the elongate body and a proximal portion of the pull wire may be operatively coupled to a control unit. The control unit may be coupled to a proximal portion of the elongate body. In addition, a control member may be operatively coupled to the control unit such that a distal portion of the control member may be positioned near a proximal portion of the flex member. The control member may be configured to support the flex member and control the movement or displacement of the flex member. Furthermore, the flex member may be configured to selectively decouple articulation or steering forces of a first portion of the elongate body away from a second portion of the elongate body; thereby, preventing compression of the second portion of the elongate body while maintaining elasticity or flexibility of the second portion of the elongate body.

SURGICAL INSTRUMENT WITH FLEXIBLE SHAFT AND ACTUATION ELEMENT GUIDE

A surgical instrument includes a shaft, a force transmission mechanism disposed at a first end of the shaft, an end effector disposed at a second end of the shaft, an actuation element that extends along the shaft from the force transmission mechanism to the end effector, and an actuation element guide extending along the shaft. The actuation element guide defines a lumen in which the actuation element guide is received. The actuation element guide is compressed into a pre-compressed state along at least a portion of an axial length of the shaft. The actuation element guide can be compressed between first and second blocks of the instrument. The instrument can include a flush tube configured to receive a cleaning fluid, with the actuation element guide being in flow communication with the flush tube to receive the cleaning fluid in the lumen of the actuation element guide. 1. A surgical instrument , comprising:a shaft extending along a longitudinal axis, the shaft comprising a bendable portion;a force transmission mechanism coupled to the shaft;an end effector coupled to the shaft;an actuation element extending along the shaft and operably coupling the force transmission mechanism to the end effector, the actuation element being configured to transmit an actuation force from the force transmission mechanism to the end effector; andan actuation element guide extending along at least the bendable portion of the shaft, wherein the actuation element guide defines a lumen in which the actuation element is received;a first block at a first end of the actuation element guide; anda second block at a second end of the actuation element guide opposite the first end;wherein one of the first or second blocks is adjustably positionable, a position being set by any of set screws, a wedge, complementary threaded engagement features, a ratchet structure, a clamping mechanism, or a flange on the first or second block engageable with a mount, andwherein, in the absence of both a ...

SURGICAL CLIP APPLIER

A surgical instrument, such as an endoscopic surgical clip applier, has a simplified handle assembly and a simplified drive assembly. The handle assembly and the drive assembly are configured to advance and form a surgical clip, for instance. 1. An actuation mechanism for use with a surgical instrument having a housing , a pivotable handle , and a driver , the actuation mechanism comprising:a compliant member including a first arm, a second arm, and a third arm, the first arm including a first pivot point configured to pivotably engage the housing of the surgical instrument, the second arm including a second pivot point configured to pivotably engage the pivotable handle of the surgical instrument, and the third arm including a third pivot point configured to pivotably engage the driver of the surgical instrument,wherein the compliant member is a unitary structure, and is movable between a first position and a second position in response to the pivotable handle moving from a first, unactuated position to a second, actuated position.2. The actuation mechanism according to claim 1 , wherein the first arm and the second arm of the compliant member define a first angle therebetween claim 1 , the second arm and the third arm of the compliant member define a second angle therebetween claim 1 , the first arm and the third arm of the compliant member define a third angle therebetween claim 1 , and the third angle is less than 180° when the compliant member is in its second position.3. The actuation mechanism according to claim 2 , wherein the third angle is less than 180° when the compliant member is in its first position.4. The actuation mechanism according to claim 3 , wherein the first angle and the second angle are obtuse when the compliant member is in the first position.5. The actuation mechanism according to claim 4 , wherein the first angle and the second angle are obtuse when the compliant member is in the second position.6. The actuation mechanism according to ...

ARTICULATION SECTION FOR SHAFT ASSEMBLY OF SURGICAL INSTRUMENT

An apparatus includes a body, a shaft assembly, an end effector, and an articulation section. The articulation section is longitudinally interposed between a distal end of the shaft assembly and a proximal end of the end effector. The articulation section is configured to flex to thereby provide deflection of the end effector away from the longitudinal axis of the shaft assembly. The articulation section includes a first frame member, a second frame member, and a sleeve. The proximal end of the second frame member is proximal to the proximal end of the first frame member. The sleeve is disposed about the first and second frame members. 120.-. (canceled)21. An apparatus , comprising:(a) a shaft assembly defining a longitudinal axis;(b) an end effector located distally relative to the shaft assembly;(c) an articulation drive assembly configured to actuate relative to the shaft assembly; and (i) a first frame member comprising a first alignment feature,', '(ii) a second frame member comprises a second alignment feature, and', '(iii) a sleeve disposed about the first frame member and the second frame member, wherein the sleeve comprises a complementary alignment feature configured to directly engage both the first alignment feature and the second alignment feature to rotationally align the sleeve with the first frame member and the second frame member with the sleeve., '(d) an articulation section interposed between the shaft assembly and the end effector, wherein the articulation section is configured to flex in response to actuation of the articulation drive assembly relative to the shaft assembly, wherein the articulation section comprises22. The apparatus of claim 21 , wherein the first frame member comprises a first proximal end claim 21 , wherein the second frame member comprises a second proximal end claim 21 , wherein the first proximal end is distal relative to the second frame member.23. The apparatus of claim 22 , wherein the first frame member comprises a ...

MEDICAL DEVICE INCLUDING A VARIABLE TORQUE ASSEMBLY FOR DEVICE DEFLECTION

The present disclosure provides a medical device comprising a deflecting assembly configured to assist in deflecting a distal portion of a catheter shaft. The deflecting assembly may include a first rotatable member having a first diameter and a first pull wire coupled thereto and a second rotatable member having a second diameter smaller than the first diameter and a second pull wire coupled thereto, wherein the second rotatable member is coupled to the first rotatable member such that a center point of the second rotatable member is offset from a center point of the first rotatable member. The first and second rotatable members are configured such that rotation of the first rotatable member via the first pull wire causes rotation of the second rotatable member and second pull wire, thus resulting in deflection of a distal portion of the medical device. 17.-. (canceled)8. A medical device comprising:a catheter shaft having a proximal end and a deflectable distal region;a handle coupled to the proximal end of the catheter shaft, wherein the handle includes an plunger movable relative to the handle along a longitudinal axis; and a first rotatable member coupled to the plunger via a first pull wire and having a first diameter; and', 'a second rotatable member coupled to the deflectable distal region via a second pull wire and having a second diameter smaller than the first diameter;', 'wherein the second rotatable member is coupled to the first rotatable member such that a center point of the second rotatable member is offset from a center point of the first rotatable member;, 'a deflecting assembly comprisingwherein the deflecting assembly is configured such that distal movement of the plunger effects rotational movement in a first direction of the first rotatable member and the second rotatable member resulting in deflection of the deflectable distal region of the catheter shaft.9. The medical device of wherein the first pull wire is configured to wrap around an ...

Catheter handle

A steerable catheter. A catheter tube is connected to a catheter handle. A steering wire has a center point affixed to the distal tip of the catheter tube, and each leg of the steering wire is affixed to respective racks inside the catheter handle. The racks are toothed and slidable and are mounted in opposition to each other within the catheter handle. A gear is disposed between the toothed racks and a knob is attached to the gear. Operating the knob rotates the gear and causes the racks to slide in opposite directions thereby pulling one of the steering wire legs to deflect the distal end of the catheter tube.