Abstract: An automated evoked potential analysis apparatus for improved monitoring, detecting and identifying changes to a patient's physiological system is described. The apparatus includes an input device for obtaining electrical potential data from the patient's physiological system after application of stimulation to a patient's nerve and a computing system for receiving and analyzing the electrical potential data. The computing system includes a processing circuit configured to: generate a plurality of evoked potential waveforms (EPs) based on the electrical potential data, measure changes or trends in the generated EPs utilizing a sliding window of analysis, display incremental changes in waveforms between full subsets of EPs, and determine an alert vote for each subset, representative of changes to the physiological system generating the EPs.

Abstract: Devices, systems, and methods for resecting tissue are disclosed. In some embodiments, a tissue resecting device may comprise an elongated structure having a longitudinal axis, the elongated structure comprising an outer sleeve with a distal window configured to receive uterine polyp tissue and an inner sleeve configured to move between a proximal position and a distal position relative to the window. In some further embodiments, the device may also comprise an electrode element coupled to the inner sleeve. In some even further embodiments, the device may include an insulative layer covering at least a portion of the inner sleeve, wherein the tissue resecting device is configured to fail when used to resect tissue more fibrous than uterine polyp tissue.

Abstract: For a scalable filtering infrastructure, a library of filters each usable at different control rates is provided by defining filters in a continuous time mode despite eventual use for digital filtering. For implementation, a filter is selected and discretized for the desired control rate. The discretized filter is then deployed as a discrete time realization for convolution. In a distributed system with multiple control rates, the library may be used to more rapidly and conveniently generate the desired filters.

Abstract: Tissue is resected and extracted from an interior location in a patient's body using a probe or tool which both effects resection and causes vaporization of a liquid or other fluid to propel the resected tissue through an extraction lumen of the resecting device. Resection is achieved using an electrosurgical electrode assembly including a first electrode on a resecting member and a second electrode within a resection probe or tool. Over a first resecting portion, radio frequency current helps resect the tissue and over a second or over transition region, the RF current initiates vaporization of the fluid or other liquid to propel the tissue from the resection device. In one embodiment, an extending element extends from a housing and into a channel in a resecting member as the resecting member moves toward a distal position.

Abstract: Apparatus and related methods for sequentially positioning and retaining opposing sides of a tissue wound. The apparatus includes a device body having a head portion for positioning between first and second sides of the wound, with the head portion defining first and second retention zones on opposed side of the head portion. The device body further includes first and second approximation arms. The device body further includes a trigger assembly defining three stages of operation. A first stage of operation positions the first approximation arm proximate the first retention zone. A second stage of operation positions the second approximation arm proximate the second retention zone with the first approximation arm remaining in approximation to the first retention zone. A third stage of operation advances a fastener into the first and second retention zones. In this manner, the apparatus sequentially positions the first and second sides with respect to the head portion.

Abstract: A system for treating uterine tissue comprises an elongated shaft having a proximal end, a distal end, and a longitudinal axis extending between said proximal and distal ends. An energy applicator at the distal end of the elongated shaft is actuatable between a non-expanded shape to be inserted through a patient's cervical canal and an expanded shape to conform to the walls of the patient's uterus. A handle is coupled to a proximal end of the elongated shaft. The handle may include first and second moveable grips coupled to actuate the energy applicator with an upper spring and a lower spring disposed to urge the first and second moveable grips to move apart. An inflatable seal may be located at a distal end of the elongated shaft with a thermally insulating sleeve disposed over the elongated shaft proximal to the inflatable seal.

Abstract: A surgical robot includes a surgical tool including a bendable joint portion, and a bending tendon connected to the joint portion and configured to bend the joint portion, a tube connected to the surgical tool and configured to accommodate the bending tendon therein, a base housing configured to rotatably support the tube and accommodate the bending tendon that passes through the tube, a bending driver configured to grasp the bending tendon, and translate in a longitudinal direction parallel to a rotation axis of the tube with respect to the base housing, and a rotation driver configured to rotatably support the tube with respect to the base housing, wherein when the tube rotates, the rotation driver is connected to one portion of the bending driver that grasps the bending tendon, and rotates the tube and the bending tendon together.

Abstract: Systems, methods and devices are disclosed for use in electronic guidance systems for surgical navigation. A sensor is provided with an optical sensor and an inclinometer (e.g. accelerometer or other inclination measuring sensor) and communicates measurements of patient inclination to an inter-operative computing unit. A registration device is useful to construct a registration coordinate frame. The direction of gravity may be used to construct the registration coordinate frame such as determined from inclination measurements.

Abstract: A surgical robotic tool used with a surgical robotic system can include cables that effect movement in the surgical robotic tool. A brake in any of these cables can be detected by checking a plurality of conditions. A process can compare a) a tension error against a first threshold, b) a rate of change of the sensed tension of the cable against a second threshold, and c) a rate of change of a cable extension error against a third threshold. If all thresholds are exceeded, the process can disable the respective actuator.

Abstract: A tissue cutting device has an outer sleeve with a distal window and an inner cutting sleeve which moves past the window to cut tissue. The inner cutting sleeve has a lumen which may have a larger proximal diameter than distal diameter. A perimeter of the window may comprise a dielectric material. A distal edge of the inner sleeve may be displaced inwardly.

Abstract: Various user input device (UID) disengagement-detection techniques based on real-time time-series data processing and deep learning. More specifically, various UID disengagement-detection techniques include training a long short-term memory (LSTM) network-based classifier based on the acquired time-series data of UID motions including both surgical motions and docking motions. The trained deep-learning classifier can then be used during teleoperation sessions to monitor the movements of UIDs, and continuously classify the real-time UID motions as either teleoperation motions or docking motions. The disengagement-detection techniques can immediately disengage the UIDs from the surgical tools as soon as the monitored UID motions are classified as docking motions by the trained classifier, thereby preventing unintended surgical tool motions.

Abstract: Systems and methods are described herein to generate a 3D surface scan of a surface profile of a patient's anatomy. The 3D surface scan may be generated by reflections of structured light off the surface profile of the anatomy. The 3D surface scan may be used during intra-operative surgical navigation by a localization system. Optionally, a pre-operative medical image may also be registered to the localization system or used to enhance the 3D surface scan.

Abstract: In various embodiments, surgical devices and methods are provided. One such surgical device includes a ferromagnetic heater assembly. The ferromagnetic heater assembly includes an electrical conductor, a ferromagnetic heater, and an encapsulant. The electrical conductor has a first leg, a second leg, and a bend between the first and second legs. The bend is located at a distal tip of the electrical conductor, and the first and second legs are spaced apart from one another between the distal end and a proximal end of the electrical conductor. The ferromagnetic heater is disposed on the first leg of the electrical conductor. The encapsulant at least partially surrounds the ferromagnetic heater and a portion of the second leg opposite the ferromagnetic heater, and a surface of the ferromagnetic heater is at least partially exposed by the encapsulant.

Abstract: For control about a remote center of motion (RCM) of a surgical robotic system, possible configurations of a robotic manipulator are searched to find the configuration providing a greatest overlap of the workspace of the surgical instrument with the target anatomy. The force at the RCM may be measured, such as with one or more sensors on the cannula or in an adaptor connecting the robotic manipulator to the cannula. The measured force is used to determine a change in the RCM to minimize the force exerted on the patient at the RCM. Given this change, the configuration of the robotic manipulator may be dynamically updated. Various aspects of this RCM control may be used alone or in combination, such as to optimize the alignment of workspace to the target anatomy, to minimize force at the RCM, and/or to dynamically control the robotic manipulator configuration based on workspace alignment and force measurement.

Abstract: Proposed are a surgical tool device having a wire hysteresis compensation function and a method for controlling the surgical tool device compensating for hysteresis of a wire. The surgical tool device includes a flexible tube part having a surgical tool disposed in a channel positioned inside the tube part, the flexible tube part being configured such that a position and an orientation of the flexible tube part are changed according to a traction wire, a manipulation unit to which a manipulation command is input so as to control the position and the orientation of the flexible tube part or the surgical tool, and a hysteresis compensation drive control unit provided with a plurality of modes so as to change the position and the orientation of the flexible tube part and the surgical tool and so as to control hysteresis compensation by calibrating hysteresis of the wire.

Abstract: Provided herein are devices, systems, and methods for characterizing a biological sample in vivo or ex vivo in real-time using time-resolved spectroscopy. A light source generates a light pulse or continuous light wave and excites the biological sample, inducing a responsive fluorescent signal. A demultiplexer splits the signal into spectral bands and a time delay is applied to the spectral bands so as to capture data with a detector from multiple spectral bands from a single excitation pulse. The biological sample is characterized by analyzing the fluorescence intensity magnitude and/or decay of the spectral bands. The sample may comprise one or more exogenous or endogenous fluorophore. The device may be a two-piece probe with a detachable, disposable distal end. The systems may combine fluorescence spectroscopy with other optical spectroscopy or imaging modalities. The light pulse may be focused at a single focal point or scanned or patterned across an area.

Abstract: Volumetrically oscillating plasma flows, the volume of which controllably expands and contracts with time, are disclosed. Volumetrically oscillating plasma flows are generated by providing an energy with a power density that changes with time to the plasma-generating gas to form a plasma flow. The changes in the energy power density result in plasma flow volumetric oscillations. Volumetric oscillations with a frequency of above 20,000 Hz results in ultrasonic acoustic waves, which are known to be beneficial for various medical applications. System for providing volumetrically oscillating plasma flows and a variety of surgical non-surgical applications of such flows are also disclosed.

Abstract: The disclosed embodiments relate to systems and methods for a surgical tool or a surgical robotic system. One example system for detecting disengagement of a surgical tool, includes an end effector connected to and driven by cables of a tool driver, sensors configured to detect forces associated with the cables, and one or more processors. The one or more processors identify cable tensions derived from forces detected by the sensors, compare the tension to a threshold tension value, calculate a velocity norm value based on a vector including the velocity value for each of the cables, compare the velocity norm value to a statistic velocity threshold, and identify a disengagement of at least one of the plurality of cables based on the first comparison and the second comparison.

Abstract: For teleoperation of a surgical robotic system, the user command for the pose of the end effector is projected into a subspace reachable by the end effector. For example, a user command with six DOF is projected to a five DOF subspace. The six DOF user interface device may be used to more intuitively control, based on the projection, the end effector with the limited DOF relative to the user interface device.

Abstract: Hysteroscopic system includes a hysteroscope having a main body coupled to an extension portion. The extension portion may be a shaft configured to extend transcervically to a patient's uterine cavity. First, second, and third channels extend from the main body to a distal end of the extension portion. A fluid source is coupleable to a proximal end of the first channel, and a pressure sensor is coupleable to a proximal end of the second channel. A tissue resecting probe is configured for introduction through the third channel. At least one resistance feature is included which is configured to provide a selected level of resistance to axial sliding of the probe through the third channel while permitting rotation of the probe within the third channel.