Abstract: Surgical devices, systems, and related methods provide automated assessment of the status of a surgical instrument. A surgical device is configured to staple tissue via a replaceable stapler cartridge. The surgical device includes a pusher member configured to articulate the stapler cartridge to deploy staples. The surgical device includes an actuation mechanism that articulates the pusher member and a control unit configured to control operation of the actuation mechanism to attempt move the pusher member from a first position to a second position subject to an output limit for the actuation mechanism and determine an attribute of the stapler cartridge based on an amount of movement of the pusher member achieved. The determined attribute can indicate a type of the stapler cartridge selected from different stapler cartridges, whether the stapler cartridge has already been fired, or that no stapler cartridge is mounted to the surgical device.

Abstract: Sealing assemblies and methods are disclosed for sealing a surgical instrument having an internal drive shaft subject to lateral displacement. A sealing assembly includes a rigid portion shaped to interface with an instrument shaft of the surgical instrument. A laterally oriented slot is open at a radially perimeter location and configured to receive an o-ring seal via the perimeter location. Apertures are disposed on opposing sides of the slot and open to the slot. The apertures are configured to receive the drive shaft there through and are larger than the drive shaft to accommodate lateral displacement of the drive shaft. The slot includes opposing internal sides spaced to interface with opposed axial surfaces of the o-ring seal. The seal inhibits axial transmission of an insufflated gas and/or bodily fluids while accommodating lateral displacement of the drive shaft.

Abstract: Surgical tools having a two degree-of-freedom wrist, wrist articulation by linked tension members, mechanisms for transmitting torque through an angle, and minimally invasive surgical tools incorporating these features are disclosed. An elongate intermediate wrist member is pivotally coupled with a distal end of an instrument shaft so as to rotate about a first axis transverse to the shaft, and an end effector body is pivotally coupled with the intermediate member so as to rotate about a second axis that is transverse to the first axis. Linked tension members interact with attachment features to articulate the wrist. A torque-transmitting mechanism includes a coupling member, coupling pins, a drive shaft, and a driven shaft. The drive shaft is coupled with the driven shaft so as to control the relative orientations of the drive shaft, the coupling member, and the driven shaft.

Abstract: Methods, systems, and devices for analyzing communication messages (e.g., emails) and selecting corresponding actions are described. In some database systems, a user may receive multiple messages at a user device. To efficiently determine responses to these messages, the user device may send the messages to a backend server for analysis. The server may perform natural language processing (NLP) to classify the message with one or more binary classifications and may extract metadata from each message. Based on the classifications and the metadata, the server may determine one or more actions the user device may perform to respond to each message. The server may send instructions to the user device indicating the suggested actions, and the user device may display these actions as options to a user. Additionally, the user device may use the classifications and metadata to automatically generate one or more communication templates in response to the message.

Abstract: Methods, systems, and devices for analyzing communication messages (e.g., emails or activities) to determine relationship strength using a distributed graph are described. In some systems, a user may be associated with a specific tenant. A database server of the system may receive communication messages associated with the user and a target user. The server may perform a natural language processing (NLP) analysis on the communication messages to extract metadata, and may generate or update a distributed graph indicating connections between users based on the extracted metadata. Using the connections of the graph, the server may calculate a closeness score between the user and the target user. Additionally, the server may calculate closeness scores between the target and other users associated with the tenant, and may determine the users with the greatest closeness scores. The server may send a suggestion for the determined users to initiate communication with the target.

Abstract: An electrically energized medical instrument uses one or more drive cables to both actuate mechanical components of a wrist mechanism or an effector and to electrically energize the effector. Electrical isolation can be achieved using an insulating main tube through which drive cables extend from a backend mechanism to the effector, an insulating end cover that leaves only the desired portions of the effector exposed, and one or more seals to prevent electrically conductive liquid from entering the main tube. Component count and cost may be further reduced using a pair of pulleys that are shared by four drive cables.

Abstract: Sealing assemblies and methods are disclosed for sealing a surgical instrument having an internal drive shaft subject to lateral displacement. A sealing assembly includes a rigid portion shaped to interface with an instrument shaft of the surgical instrument. A laterally oriented slot is open at a radially perimeter location and configured to receive an o-ring seal via the perimeter location. Apertures are disposed on opposing sides of the slot and open to the slot. The apertures are configured to receive the drive shaft there through and are larger than the drive shaft to accommodate lateral displacement of the drive shaft. The slot includes opposing internal sides spaced to interface with opposed axial surfaces of the o-ring seal. The seal inhibits axial transmission of an insufflated gas and/or bodily fluids while accommodating lateral displacement of the drive shaft.

Abstract: A system and method of variable velocity control of a surgical instrument in a computer-assisted medical device including an end effector located at a distal end of the instrument, an actuator, and drive mechanisms for coupling force or torque from the actuator to the end effector. To perform an operation with the instrument, the computer-assisted medical device sets a velocity set point of the actuator to an initial velocity, monitors force or torque applied by the actuator, reduces the velocity set point when the applied force or torque is above a first threshold, increases the velocity set point when the applied force or torque is below a second threshold, decreases the velocity set point to zero when the applied force or torque is above a maximum threshold, and drives the actuator based on the velocity set point. The first and second thresholds are lower than the maximum threshold.

Abstract: Surgical tools having a two degree-of-freedom wrist, wrist articulation by linked tension members, mechanisms for transmitting torque through an angle, and minimally invasive surgical tools incorporating these features are disclosed. An elongate intermediate wrist member is pivotally coupled with a distal end of an instrument shaft so as to rotate about a first axis transverse to the shaft, and an end effector body is pivotally coupled with the intermediate member so as to rotate about a second axis that is transverse to the first axis. Linked tension members interact with attachment features to articulate the wrist. A torque-transmitting mechanism includes a coupling member, coupling pins, a drive shaft, and a driven shaft. The drive shaft is coupled with the driven shaft so as to control the relative orientations of the drive shaft, the coupling member, and the driven shaft.

Abstract: A system and method of variable velocity control of a surgical instrument in a computer-assisted medical device includes a surgical instrument having an end effector located at a distal end of the instrument, an actuator, and one or more drive mechanisms for coupling force or torque from the actuator to the end effector. To perform an operation with the instrument, the computer-assisted medical device is configured to set a velocity set point of the actuator to an initial velocity and monitor force or torque applied by the actuator. When the applied force or torque is above a first force or torque limit it is determined whether a continue condition for the operation is satisfied. When the continue condition is satisfied the operation is paused and when the continue condition is not satisfied it is determined whether forced firing of the actuator should take place.

Abstract: End effectors with redundant closing mechanisms, and related tools and methods are disclosed. The disclosed end effectors may be particularly beneficial when used for minimally invasive surgery. An example surgical tool comprises an elongate shaft having a proximal end and a distal end, a tool body disposed at the distal end of the shaft, a jaw movable relative to the tool body between a clamped configuration and an open configuration, a first actuation mechanism coupled with the jaw and operable to vary the position of the jaw relative to the tool body between the clamped configuration and the open configuration, and a second actuation mechanism coupled with the jaw. The second actuation mechanism has a first configuration where the jaw is held in the clamped configuration and a second configuration where the position of the jaw relative to the tool body is unconstrained by the second actuation mechanism.

Abstract: Surgical tools having a two degree-of-freedom wrist, wrist articulation by linked tension members, mechanisms for transmitting torque through an angle, and minimally invasive surgical tools incorporating these features are disclosed. An elongate intermediate wrist member is pivotally coupled with a distal end of an instrument shaft so as to rotate about a first axis transverse to the shaft, and an end effector body is pivotally coupled with the intermediate member so as to rotate about a second axis that is transverse to the first axis. Linked tension members interact with attachment features to articulate the wrist. A torque-transmitting mechanism includes a coupling member, coupling pins, a drive shaft, and a driven shaft. The drive shaft is coupled with the driven shaft so as to control the relative orientations of the drive shaft, the coupling member, and the driven shaft.

Abstract: End effectors with redundant closing mechanisms, and related tools and methods are disclosed. The disclosed end effectors may be particularly beneficial when used for minimally invasive surgery. An example surgical tool comprises an elongate shaft having a proximal end and a distal end, a tool body disposed at the distal end of the shaft, a jaw movable relative to the tool body between a clamped configuration and an open configuration, a first actuation mechanism coupled with the jaw and operable to vary the position of the jaw relative to the tool body between the clamped configuration and the open configuration, and a second actuation mechanism coupled with the jaw. The second actuation mechanism has a first configuration where the jaw is held in the clamped configuration and a second configuration where the position of the jaw relative to the tool body is unconstrained by the second actuation mechanism.

Abstract: Surgical tools having a two degree-of-freedom wrist, wrist articulation by linked tension members, mechanisms for transmitting torque through an angle, and minimally invasive surgical tools incorporating these features are disclosed. An elongate intermediate wrist member is pivotally coupled with a distal end of an instrument shaft so as to rotate about a first axis transverse to the shaft, and an end effector body is pivotally coupled with the intermediate member so as to rotate about a second axis that is transverse to the first axis. Linked tension members interact with attachment features to articulate the wrist. A torque-transmitting mechanism includes a coupling member, coupling pins, a drive shaft, and a driven shaft. The drive shaft is coupled with the driven shaft so as to control the relative orientations of the drive shaft, the coupling member, and the driven shaft.

Abstract: A cartridge of a surgical instrument includes a housing, a lead screw mounted for rotation in the housing, a drive member operatively coupled with the lead screw, and a knife member. The knife member is driven distally by the drive member and is configured to cut when moved distally. During an initial distal movement of the drive member, the knife member is coupled with the housing to restrain the knife member from moving distally. Subsequent to the initial distal movement of the drive member, the drive member drives the knife member toward the distal end.

Abstract: A cannula fixation device for insertion at a surgical incision includes a sleeve having a passage configured to receive a cannula, and a clamp configured to rotatably couple the cannula to the sleeve and to maintain an axial position of the cannula relative to the sleeve.

Abstract: An electrically energized medical instrument uses one or more drive cables to both actuate mechanical components of a wrist mechanism or an effector and to electrically energize the effector. Electrical isolation can be achieved using an insulating main tube through which drive cables extend from a backend mechanism to the effector, an insulating end cover that leaves only the desired portions of the effector exposed, and one or more seals to prevent electrically conductive liquid from entering the main tube. Component count and cost may be further reduced using a pair of pulleys that are shared by four drive cables.

Abstract: A device to regulate tension of an actuation element for actuating movement of a surgical instrument includes an elastically deformable body configured to be coupled to the actuation element. The deformable body is configured to elastically deform in response to a state of slack occurring in the actuation element. As slack occurs in the actuation element, the deformable body is configured to divert a path of the actuation element to accommodate the slack so the path of the actuation element differs from an axis the actuation element follows prior to the actuation element developing slack. A force transmission mechanism for a teleoperated surgical instrument includes a chassis, an actuation input mechanism, an actuation element, and a tension regulator coupled to the actuation element to compensate for slack of the actuation element.

Abstract: A cartridge of a surgical instrument includes a housing, a lead screw mounted for rotation in the housing, a drive member operatively coupled with the lead screw, and a knife member. The knife member is driven distally by the drive member and is configured to cut when moved distally. During an initial distal movement of the drive member, the knife member is coupled with the housing to restrain the knife member from moving distally. Subsequent to the initial distal movement of the drive member, the drive member drives the knife member toward the distal end.

Abstract: Mechanisms, assemblies, systems, tools, and methods include an offset drive shaft within an independently rotating member. An example method of transmitting torque through an offset drive shaft routed within a rotatable main shaft includes supporting a main shaft to rotate relative to a base so that the main shaft rotates about a main shaft rotational axis. A drive shaft is supported to rotate relative to the main shaft so that the drive shaft rotates about a drive shaft rotational axis that is offset from the main shaft rotational axis. The drive shaft is engaged with a drive feature having a drive feature rotational axis that is fixed relative to the base as the main shaft rotates. The main shaft is rotated relative to the base. The drive feature is rotated relative to the main shaft so as to rotate the drive shaft relative to the main shaft.