Abstract: A computer-assisted medical device is configured and used to endoluminally navigate to a location in the gastrointestinal system and there treat certain body lumen wall areas while avoiding other body lumen wall areas. Embodiments ablate the inner mucosal layer and sub-mucosal nerve plexus of the stomach, duodenum and jejunum to effect treatment of insulin resistance and metabolic disorders, such as Type II diabetes (T2D), polycystic ovarian syndrome (PCOS), non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), congestive heart failure (CHF) and obstructive sleep apnea (OSA). Various sensors are used to assist a clinical operator to navigate from the mouth through the pyloric sphincter and into and through the duodenum and/or jejunum. Various sensors are used to map and identify portions of the duodenum and/or jejunum. Various lumen wall ablation devices and methods are described. Various post-treatment assessments are described.

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 computer-assisted medical device is configured and used to endoluminally navigate to a location in the gastrointestinal system and there treat certain body lumen wall areas while avoiding other body lumen wall areas. Embodiments ablate the inner mucosal layer and sub-mucosal nerve plexus of the stomach, duodenum and jejunum to effect treatment of insulin resistance and metabolic disorders, such as Type II diabetes (T2D), polycystic ovarian syndrome (PCOS), non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), congestive heart failure (CHF) and obstructive sleep apnea (OSA). Various sensors are used to assist a clinical operator to navigate from the mouth through the pyloric sphincter and into and through the duodenum and/or jejunum. Various sensors are used to map and identify portions of the duodenum and/or jejunum. Various lumen wall ablation devices and methods are described. Various post-treatment assessments are described.

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: Surgical instruments and assemblies for sealing and cutting tissue monitor jaw angle and/or jaw clamping force to provide feedback to an operator of the surgical instrument indicative of whether the tissue is suitable clamped for sealing and/or cutting. A surgical instrument or assembly includes a jaw operable to clamp tissue, a sealing mechanism, a cutting mechanism, an actuation monitoring assembly, and a feedback assembly. The actuation monitoring assembly monitors jaw angle and/or clamping force. The feedback assembly outputs feedback to the operator, based on the jaw angle and/or clamping force, as to whether the current clamping angle and/or jaw angle is suitable for sealing and/or clamping tissue.

Abstract: Systems and methods of controlled grasping and energy delivery include a computer-assisted device. The computer-assisted device includes an end effector and one or more processors. The end effector includes a first jaw, a second jaw, and a plurality of electrodes for delivering energy. The one or more processors are configured to grasp a material using the first jaw and the second jaw, determine characteristics of the grasp, determine characteristics of the material, and control one or more of the grasp or energy delivery by the plurality of electrodes based on the determined characteristics of the grasp and the determined characteristics of the material. According to some embodiments, the characteristics of the material include one or more of thermal, dielectric, or stiffness of the material. In some embodiments, the characteristics of the grasp include one or more of applied pressure, jaw angle, jaw separation, force, torque, or wrist articulation.

Abstract: Surgical instruments and assemblies for sealing and cutting tissue monitor jaw angle and/or jaw clamping force to provide feedback to an operator of the surgical instrument indicative of whether the tissue is suitable clamped for sealing and/or cutting. A surgical instrument or assembly includes a jaw operable to clamp tissue, a sealing mechanism, a cutting mechanism, an actuation monitoring assembly, and a feedback assembly. The actuation monitoring assembly monitors jaw angle and/or clamping force. The feedback assembly outputs feedback to the operator, based on the jaw angle and/or clamping force, as to whether the current clamping angle and/or jaw angle is suitable for sealing and/or clamping tissue.

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: Surgical instruments and assemblies for sealing and cutting tissue monitor jaw angle and/or jaw clamping force to provide feedback to an operator of the surgical instrument indicative of whether the tissue is suitable clamped for sealing and/or cutting. A surgical instrument or assembly includes a jaw operable to clamp tissue, a sealing mechanism, a cutting mechanism, an actuation monitoring assembly, and a feedback assembly. The actuation monitoring assembly monitors jaw angle and/or clamping force. The feedback assembly outputs feedback to the operator, based on the jaw angle and/or clamping force, as to whether the current clamping angle and/or jaw angle is suitable for sealing and/or clamping tissue.