Abstract: Apparatus comprises: (a) a longitudinal member (32), having a distal portion (34); (b) a plurality of electrodes (38) disposed on the distal portion of the longitudinal member, such that a first electrode (38a) of the plurality of electrodes is disposed distally along the longitudinal member from a second electrode (38b) of the plurality of electrodes; and (c) a controller (40). The controller comprises an actuator, and circuitry (42) electrically connected to the electrodes via the longitudinal member. The actuator is configured to move the longitudinal member in discrete incremental movements such that for each incremental movement, (i) before the incremental movement the first electrode is disposed in a starting position, (ii) during each incremental movement the actuator moves second electrode toward the starting position, and (iii) at the end of each incremental movement the second electrode is stationary at the starting position.

Abstract: Provided are devices, systems, and methods for treating or preventing heart failure or a symptom of heart failure through coordinated nerve activity interruption for one or more target nerves. Devices disclosed herein may comprise a vascular catheter comprising a telescopic needle assembly configured to puncture vascular tissue in contact with the catheter, wherein the needle assembly comprises one or more electrodes configured to deliver electrical energy to a tissue in contact with the one or more electrodes. Methods may include treating or preventing heart failure or a symptom of heart failure by inserting a catheter into a vascular tissue of the subject; guiding the catheter towards the greater splanchnic nerve; piercing the vascular tissue of the subject with a telescopic needle assembly extending outwards from the catheter towards the target nerve; and ablating the target nerve by delivering a stimulation energy to the target nerve with one or more electrodes.

Abstract: Disclosed embodiments include apparatuses, systems, and methods for positioning electrodes within a body. In an illustrative embodiment, a control handle is selectively engageable with primary and secondary actuators respectively coupled with primary and secondary electrodes. At a first position, the primary and secondary actuators are movably engaged to move in concert to a second position where distal ends of the electrodes extend into a target region. At the second position, the control handle is engaged with the secondary actuator and movable independently of the primary actuator in a first direction to a third position where the distal end of the secondary electrode extends beyond the distal end of the primary electrode. At the third position, the control handle is movably engaged with the primary actuator and movable independently of the secondary actuator in a second direction to a fourth position to partially retract the distal end of the primary electrode.

Abstract: Methods and devices for controlling motorized surgical devices are provided. In general, the methods and devices can allow a surgical device to grasp and cut tissue. In some embodiments, the device can include at least one sensor and a motor, and an output of the motor can be configured to be adjusted based at least in part on an output from the at least one sensor. The output of the motor can be configured to provide power for translation of a cutting element along an end effector of the device. Adjusting the motor's output can cause the cutting element to translate through the end effector at different speeds, thereby allowing the cutting element to cut through tissue being grasped by the end effector at different speeds.

Abstract: An apparatus includes a catheter and an end effector. At least a portion of the catheter is sized and configured to fit within a lumen of a human cardiovascular system. The end effector is positioned at a distal end of the catheter. The end effector includes an expandable assembly and at least one flex circuit. The expandable assembly is configured to transition between a non-expanded state and an expanded state. The expandable assembly includes at least one deformable strut or cage. Each flex circuit includes a flexible substrate secured, without an adhesive, to the expandable assembly and an electrode secured to the flexible substrate. The expandable assembly in the expanded state is configured to urge the electrode into contact with tissue. The electrode has a fishbone-like configuration that defines a longitudinally elongated portion and a plurality of fingers extending transversely from the longitudinally elongated portion.

Abstract: Systems and methods for performing and assessing neuromodulation therapy are disclosed herein. One method for assessing the efficacy of neuromodulation therapy includes positioning a neuromodulation catheter at a target site within a renal blood vessel of a human patient and delivering neuromodulation energy at the target site with the neuromodulation catheter. The method can further include obtaining a measurement related to a blood flow rate through the renal blood vessel via the neuromodulation catheter. The measurement can be compared to a baseline measurement related to the blood flow rate through the renal blood vessel to assess the efficacy of the neuromodulation therapy. In some embodiments, the baseline and post-neuromodulation measurements are obtained by injecting an indicator fluid into the renal blood vessel upstream of the target site and detecting a transient change in vessel impedance caused by the indicator fluid.

Abstract: A method for controlling an operation of an ultrasonic blade of an ultrasonic electromechanical system is disclosed. The method includes providing an ultrasonic electromechanical system comprising an ultrasonic transducer coupled to an ultrasonic blade via an ultrasonic waveguide; applying, by an energy source, a power level to the ultrasonic transducer; determining, by a control circuit coupled to a memory, a mechanical property of the ultrasonic electromechanical system; comparing, by the control circuit, the mechanical property with a reference mechanical property stored in the memory; and adjusting, by the control circuit, the power level applied to the ultrasonic transducer based on the comparison of the mechanical property with the reference mechanical property.

Abstract: An electrosurgical instrument for use in a robotic surgical system includes an electrosurgical end effector, a housing configured to be operably coupled to an instrument drive unit, a shaft extending distally from the housing, and a wrist assembly coupled to a distal end portion of the shaft. The wrist assembly includes a first pivot member and a second pivot member having a proximal end portion movably coupled to the first pivot member, and a distal end portion configured to be coupled to the end effector. The first pivot member has a pair of first and second distally-extending arms each defining a first groove configured to receive and guide a cable.

Abstract: A surgical apparatus system for minimally invasive surgery (MIS) which includes a wrist assembly. The wrist assembly includes a first jaw, a first actuation hub, and a cable redirecting hub operably coupled to the first actuation hub, a second jaw, a second actuation hub, a housing for the first and second jaws, a first cable, a second cable, a third cable, rotational position sensors, and a control system. The first and second jaws of the wrist assembly are movably opposed, and the cables are configured such that applying tensions upon them cables produces rotation about a jaw axis. The wrist assembly may further include a hinge-rotary assembly to configured to provide rotation about a pitch axis and/or a roll axis. The wrist assembly may further include a fourth cable configured such that applying tensions upon the fourth cable and the opposing cable produces rotation about a pitch axis.

Abstract: According to one aspect, a medical system may include an instrument including an end effector for acting as a monopolar electrode. The end effector may be configured to be positioned in a body of a subject and emit radiofrequency energy towards a target area in the body. The medical system may further include a return electrode. The return electrode may be deliverable within the body proximate the target area and separately from the instrument and the monopolar electrode. The return electrode may be configured to contact tissue in the body proximate the target area and receive radiofrequency energy emitted from the end effector.

Abstract: Methods for treating hypertension and associated systems and methods are disclosed herein. One aspect of the present technology, for example, is directed to methods for therapeutic renal neuromodulation that partially inhibit sympathetic neural activity in renal nerves proximate a renal blood vessel of a human patient having a 24-hour heart rate at or above a median heart rate for a population of hypertensive patients. This reduction in sympathetic neural activity is expected to therapeutically treat one or more conditions associated with hypertension of the patient. Renal sympathetic nerve activity can be modulated, for example, using an intravascularly positioned catheter carrying a neuromodulation assembly, e.g., a neuromodulation assembly configured to use electrically-induced, thermally-induced, and/or chemically-induced approaches to modulate the renal nerves.

Abstract: A surgical end effector may comprise first and second jaw members. The second jaw member may comprise an offset proximal supply electrode that is positioned to contact an opposing member of the first jaw member when the first and second jaw members are in the closed position. The second jaw member may also comprise a distal supply electrode that is positioned distal of the offset proximal electrode and is aligned with a conductive surface of the first jaw member when the first and second jaw members are in the closed position. When the first and second jaw members are in the closed position, the proximal supply electrode may be in contact with the opposing member and the distal supply electrode is not in contact with the conductive surface of the first jaw member.

Abstract: An instrument including working arms and a moveable member. The working arms include a first arm, a second arm, a first electrode located on the first arm, and a second electrode located on the second arm. The moveable member includes a passive circuit element, a first terminal, and a second terminal. The moveable member is moveable to a first position and a second position. In the first position, the first terminal is in electrical communication with the first electrode and the second terminal is in electrical communication with the second electrode so that in the first position an electrical circuit is completed. An impedance is measured of the passive circuit element in the completed electrical circuit. The instrument is adapted to provide a modality based on the measured impedance or a determined position of the moveable member.

Abstract: An electrosurgical end effector for a surgical tool to perform teleoperated surgical operations. The electrosurgical end effector comprises a first end effector jaw; a second end effector jaw coupled to the first end effector jaw; and a coupling pin configured to rotatingly couple the first end effector jaw to the second end effector jaw so as to cooperatively rotate open and close about an axis of rotation. The electrosurgical end effector further comprises an actuation mechanism coupled to an end of the first end effector jaw to rotate the first end effector jaw about the coupling pin; an otomy feature coupled to the second end effector jaw; and a first electrical conductor to electrically couple the otomy feature to a generator. In one embodiment, the otomy feature is electrically activated by contact with a cam portion of the first end effector jaw, when opened beyond a predetermined jaw angle.

Abstract: A surgical instrument assembly comprising a shaft, an actuator positioned within the shaft, an articulation joint, an attachment interface positioned distal to the articulation joint and an end effector removably attachable to and detachable from said articulation joint by the attachment interface is disclosed. The end effector is configured to be articulated relative to the shaft. The end effector comprises a first jaw, a second jaw movable relative to the first jaw, and a firing member configured to move the second jaw relative to the first jaw when the end effector is attached to the attachment interface and control motions are applied to the firing member by the actuator. When the end effector is attached to the articulation joint, the actuator is movable between an engaged position in which the actuator and the firing member are operably engaged and a disengaged position.

Abstract: An electrosurgical forceps includes a pair of first and second shaft members pivotably coupled to one another, an end effector assembly coupled to the pair of first and second shaft members, a knife, and a knife deployment mechanism. The knife deployment mechanism has one or more safety features that resist an inadvertent deployment of the knife.

Abstract: An electrosurgical lysing device and related methods. In some embodiments, the device may comprise a lysing tip comprising one or more beads. The bead(s) may comprise an at least substantially electrically non-conductive surface and may define, at least in part, both a distally-facing and a proximally-facing recess. At least one electrically conductive lysing member configured to deliver electrosurgical energy may be positioned adjacent to the at least one bead, the at least one lysing member defining at least one lysing segment extending within a recess at least partially defined by the at least one bead.

Abstract: A medical device for cutting bone and soft tissue includes a shaft having a rotating component with a distal working end. A cutting member is carried on the working end of the rotating component and a motor rotates the rotating component. The cutting member has a ceramic body with cutting edges, and the ceramic body is formed of a ceramic composite including alumina and zirconia, wherein the alumina has a grain size ranging between 0.5-1.5 microns and the zirconia has a grain size ranging between 0.1-1.0 micron. The alumina grain shape and zirconia grain shape are non-elongated.

Abstract: A surgical instrument component for coupling an end effector to a shaft of a surgical instrument may comprise a distal portion made of an electrically conductive first material, a proximal portion made of an electrically conductive second material, and an intermediate portion made of an electrically insulating third material. The intermediate portion is disposed between and integrally connected to the proximal portion and to the distal portion.

Abstract: An electrosurgical instrument includes an elongated first shaft fabricated from thermally-conductive plastic material, an elongated second shaft, and opposing first and second jaw members each having a proximal end portion coupled to a distal end portion of the respective first and second shafts. One or both of the jaw members has a jaw frame and an electrically-conductive tissue sealing structure disposed over the jaw frame. The first shaft has a heat sink disposed therein configured to dissipate heat from the tissue sealing structure toward the thermally-conductive plastic material.