Abstract: Systems, devices, and methods for controlling cooperative surgical instruments are provided. Various aspects of the present disclosure provide for coordinated operation of surgical instruments accessing a common body cavity of a patient from different approaches to achieve a common surgical purpose. For example, various methods, devices, and systems disclosed herein can enable the coordinated treatment of surgical tissue by disparate minimally invasive surgical systems that approach the tissue from varying anatomical spaces and operate in concert with one another to effect a desired surgical treatment.

Abstract: An apparatus includes a shaft including a distal shaft end. At least a portion of the shaft defines a first axis. The apparatus also includes a sleeve slidably coupled to the shaft. The sleeve includes a distal sleeve end. The apparatus further includes a colpotomy cup fixedly secured to the distal sleeve end, and a movable member extending distally from the distal shaft end. The movable member is configured to move relative to the shaft between a first state in which the movable member extends substantially along the first axis and a second state in which the movable member extends at least partially along a second axis transverse to the first axis for manipulating an anatomical structure.

Abstract: An ultrasonic surgical instrument that can be used in a robotic surgical system includes an end effector having an ultrasonic blade and a clamp arm pivotally secured relative to the ultrasonic blade. A shaft assembly extends proximally from the end effector and includes a tube, an acoustic waveguide received within the tube, and a sheath positioned between the acoustic waveguide and the tube to damp acoustic vibrations from the acoustic waveguide toward the tube. At least one sensor is positioned on at least one of the end effector or the sheath to measure a force applied at the end effector or the sheath as a measured force, respectively, and thereby provide real-time feedback of a non-clamping force applied against one of the ultrasonic blade or the clamp arm.

Abstract: A fastener cartridge can include, one, a cartridge body comprising a deck and a plurality of fastener cavities and, two, a plurality of fasteners positioned in the fastener cavities. The cartridge body can further comprise extensions extending from the deck having different sizes and/or configurations. The extensions can control the flow of tissue relative to the deck and/or support the fasteners as they are ejected from the fastener cavities.

Abstract: A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

Abstract: An ultrasonic surgical instrument comprises a shaft assembly including a waveguide, and an end effector arranged at a distal end of the shaft assembly and including an ultrasonic blade and a clamp arm. The instrument also comprises a base translatably coupled to shaft assembly. The base includes a first mechanical input and a second mechanical input. The instrument further comprises a closure actuation mechanism operatively connected between the first mechanical input and the clamp arm and configured to actuate the clamp arm from an open position toward a closed position upon selective drive of the first mechanical input. The instrument also includes an insertion actuation mechanism operatively connected between the second mechanical input and the shaft assembly and configured to actuate the shaft assembly from a proximal position toward a distal position upon selective drive of the second mechanical input for insertion of the end effector.

Abstract: In various embodiments, a tissue thickness compensator can comprise one or more capsules and/or pockets comprising at least one medicament therein. In at least one embodiment, staples can be fired through the tissue thickness compensator to rupture the capsules. In certain embodiments, a firing member, or knife, can be advanced through the tissue thickness compensator to rupture the capsules.

Abstract: A surgical instrument includes a drive housing, a spline, a carriage, an elongate shaft assembly, an end effector, and an activating mechanism. The at least one spline includes a drive gear rotatable with the spline. The elongate shaft assembly extends from the carriage. The activating mechanism includes a barrel cam extending along a rotational axis and having a first cam profile radially extending about the rotational axis. The barrel cam is operatively coupled to the drive gear such that rotation of the drive gear is configured to actuate the activating mechanism to move at least a portion of the end effector. The first cam profile defines a plurality of slopes relative to the rotational axis such that the first cam profile is configured to drive movement of the end effector or the elongate shaft assembly at different rates according to the plurality of slopes.

Abstract: A surgical instrument comprising an end effector configured to perform a plurality of end effector functions is disclosed. The surgical instrument further comprises a drive shaft which is both rotatable and translatable to drive the end effector functions.

Abstract: A robotic surgical tool includes a drive housing having a lead screw extending from a first end of the drive housing, a carriage movably mounted to the lead screw at a carriage nut secured to the carriage, and an elongate shaft extending from the carriage and penetrating the first end, the shaft having an end effector arranged at a distal end thereof and comprising a proximal shaft portion releasably coupled to a distal shaft portion at a releasable interface. Proximal and distal portions of one or more mechanisms of the surgical tool extend from the carriage to the end effector within the proximal and distal shaft portions, respectively, and the one or more mechanisms are operable to operate or articulate the end effector.

Abstract: An ultrasonic surgical instrument including an end effector having an ultrasonic blade, a shaft assembly that defines a longitudinal axis proximally extending from the end effector and an ultrasonic transducer assembly proximally extending from an acoustic waveguide in communication with the ultrasonic blade. The ultrasonic surgical instrument also includes a housing proximally projecting from the shaft assembly such that the ultrasonic transducer assembly is positioned within the housing and a carrier moveably supports the ultrasonic transducer assembly along the longitudinal axis. The carrier collectively moves the ultrasonic transducer assembly, the acoustic waveguide, and the end effector relative to the housing from a proximal, retracted position to a distal, extended position, for inserting the ultrasonic blade into a patient.

Abstract: A surgical instrument. The surgical instrument includes an elongated channel configured to support a staple cartridge, an anvil pivotably connected to the elongated channel, a knife mechanically coupled to the staple cartridge, an electric motor and a control circuit electrically connected to the electric motor. The control circuit is configured to change a firing motion of the surgical instrument based on a combination of events.

Abstract: An apparatus includes a proximal structure configured to be positioned extracorporeally relative to a patient and defining a primary axis, and a distal structure extending distally from the proximal structure and configured to be passed through a body wall and into a body cavity of the patient. The distal structure cooperates with the proximal structure to define a working channel sized and configured to receive and guide a surgical instrument distally therethrough. The distal structure includes a proximal portion and an angled distal portion. The angled distal portion defines a secondary axis that is angled relative to the primary axis. At least the angled distal portion of the distal structure is rotatable relative to proximal structure about the primary axis.

Abstract: An apparatus includes a proximal structure configured to be positioned extracorporeally relative to a patient, and a distal structure extending distally from the proximal structure and configured to be passed through a body wall and into a body cavity of the patient. The distal structure cooperates with the primary structure to define a primary axis and a working channel sized and configured to receive and guide a surgical scope shaft distally therethrough along the primary axis. The proximal structure has a greater maximum dimension in a direction transverse to the primary axis than the distal structure. The apparatus further includes an articulation feature at a distal end of the distal structure that is configured to articulate relative to the proximal structure to direct the surgical scope shaft along a secondary axis that is angled relative to the primary axis.

Abstract: A robotic surgical tool includes a drive housing having opposing first and second ends, a carriage arranged within the drive housing, a shaft extending from the carriage, a firing rod extending within the shaft and defining external threads, an end effector arranged at an end of the shaft and including a knife coupled to the firing rod such that movement of the firing rod moves the knife, and an activating mechanism coupled to the carriage. The activating mechanism including a motor mounted to the carriage and operable to rotate a drive gear, and a driven gear engageable with the drive gear such that rotation of the drive gear rotates the driven gear and actuates the activating mechanism. The driven gear defines internal threads and is rotatably mounted to the firing rod at the external threads such that rotation of the driven gear longitudinally moves the firing rod and the knife.

Abstract: A system includes a controller, a robotic arm in communication with the controller and having a head, and a surgical scope coupled with the head and having a scope shaft sized and configured to be inserted through an opening in a body wall and into a body cavity of a patient. The controller is programmed to control the robotic arm to manipulate the surgical scope relative to the patient while inhibiting the head from entering a predefined zone of a robotic arm workspace that overlies the body wall.

Abstract: Various methods and devices are provided for allowing multiple surgical instruments to be inserted into sealing elements of a single surgical access device. The sealing elements can be movable along predefined pathways within the device to allow surgical instruments inserted through the sealing elements to be moved laterally, rotationally, angularly, and vertically relative to a central longitudinal axis of the device for ease of manipulation within a patient's body while maintaining insufflation.

Abstract: 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.

Abstract: A tissue thickness compensator may generally comprise a first layer comprising a first biocompatible material sealingly enclosed in a water impermeable material and a second layer comprising a second biocompatible material comprising at least one encapsulation, wherein the first biocompatible material expands when contacted with a fluid. The tissue thickness compensator may comprise a haemostatic agent, an anti-inflammatory agent, an antibiotic agent, anti-microbial agent, an anti-adhesion agent, an anti-coagulant agent, a medicament, and/or pharmaceutically active agent. The encapsulation may comprise a biodegradable material to degrade in vivo and/or in situ. The tissue thickness compensator may comprise a hydrogel. The reaction product may comprise a fluid-swellable composition. Articles of manufacture comprising the tissue thickness compensator and methods of making and using the tissue thickness compensator are also described.

Abstract: A fastener cartridge can include, one, a cartridge body comprising a deck and a plurality of fastener cavities and, two, a plurality of fasteners positioned in the fastener cavities. The cartridge body can further comprise extensions extending from the deck having different sizes and/or configurations. The extensions can control the flow of tissue relative to the deck and/or support the fasteners as they are ejected from the fastener cavities.