Abstract: Methods and devices are provided utilizing an end effector having three jaws movably coupled thereto for grasping and/or dissecting tissue. In one embodiment, each of the three jaws are movable between an open position in which the distal ends of the three jaws are spaced apart from one another, and a closed position in which the distal ends directly contact one another. The jaws can define an opening therebetween when the jaws are in the closed position.

Abstract: A patient-referenced surgical support frame and method of use are provided. In one embodiment, a surgical support frame can have at least three support members coupled by adjustable linkages. Each support member can have a lumen extending therethrough for receiving a cannula, and each support member can be configured such that the at least three support members (or the cannulas extending therethrough) are angularly adjustable relative to one another, and such that a distance between each of the at least three support members is adjustable. In use, the surgical support frame can be positioned on a skin surface of a patient and used to retain one or more instruments extending through the support members in a fixed orientation or position with respect to the patient, thereby allowing more than two instruments to be used simultaneously.

Abstract: Methods and devices are provided for controlling movement of a distal end of a surgical instrument. In general, the methods and devices can allow for controlling movement of surgical tools, and in particular for causing mimicked motion between an external control unit and a surgical tool positioned within a patient's body. In one embodiment, a surgical system is provided having a master assembly including an input tool and a slave assembly including a surgical instrument. The master assembly and the slave assembly can be configured to be electronically coupled together such that movement of the master assembly can be electronically communicated to the slave assembly to cause mimicked movement of the slave assembly.

Abstract: A surgical device comprising a clevis defining a longitudinal axis and a jaw comprising a first member and a second member. A slider is slidably engaged to the clevis, the slider comprising a pin. The pin is receiveably engaged in the first slot and the jaw is selectively moveable between a first position and a second position through longitudinal movement of the slider. In various embodiments, the first and second members are movable between an angular open position, a parallel open position, and a parallel closed position.

Abstract: Suture anchoring devices are disclosed, including a T-tag anchoring device that is suitably small enough to fit into the hollow tip of a needle and, furthermore, provide protection to the suture against being cut or otherwise damaged by the sharp edge of the needle tip. One disclosed device includes a slot for providing a pivot point between the suture and the body when deployed, which can be employed to form a T-tag.

Abstract: An electrical ablation apparatus comprises first and second electrodes. Each electrode comprises a first end configured to couple an energy source and a second end configured to couple to a tissue treatment region. An energy source is coupled to the first and second electrodes. The energy source is configured to deliver a first series of electrical pulses sufficient to induce cell necrosis by irreversible electroporation and a second series of electrical pulses sufficient to induce cell necrosis by thermal heating, through at least one of the first and second electrodes. The first series of electrical pulses is characterized by a first amplitude, a first pulse length, and a first frequency. The second series of electrical pulses is characterized by a second amplitude, a second pulse length, and a second frequency.

Abstract: An interface system for interfacing between at least one endoscopic surgical instrument and a cable-controlled guide tube system. Various embodiments may include a tool docking assembly that is supportable relative to the cable-controlled guide system. The tool docking assembly may comprise one or more tool docking stations for retainingly supporting at least one endoscopic surgical instrument for selective pivotal travel about transverse axes. The system may further include cable attachment arrangements for coupling steering cables from the guide tube assembly to the various tool docking stations.

Abstract: An electrical ablation apparatus comprises first and second electrodes. Each electrode comprises a first end configured to couple an energy source and a second end configured to couple to a tissue treatment region. An energy source is coupled to the first and second electrodes. The energy source is configured to deliver a first series of electrical pulses sufficient to induce cell necrosis by irreversible electroporation and a second series of electrical pulses sufficient to induce cell necrosis by thermal heating, through at least one of the first and second electrodes. The first series of electrical pulses is characterized by a first amplitude, a first pulse length, and a first frequency. The second series of electrical pulses is characterized by a second amplitude, a second pulse length, and a second frequency.

Abstract: An endoscopic overtube with articulating fingers extending from the distal end. The articulating fingers form an opening that may be expanded by a balloon. When positioned in a puncture site in a tissue wall, the articulating fingers dilate and enlarge the puncture site to allow for the body of the overtube to pass through the puncture site. In various embodiments, the fingers may further comprise cutting elements to assist in the dilation of the puncture site.

Abstract: Methods and devices are provided for delivering a preloaded loop of suture extending from a knotting element to tissue to be ligated within a body. The knotting element can be threaded with a loop of suture and loaded onto a deployment device using a loading device. A protective sheath can be placed around the knotting element and the loop of suture to facilitate safe insertion of the loop of suture through a working channel of a minimally invasive device.

Abstract: A bipolar forceps including a first electrode, a second electrode, and a conductor operably connected to an electrical source, wherein the conductor can be selectively placed in electrical communication with the first electrode when the first electrode is moved between open and closed positions. The conductor can include a contact end which is not in contact with the first electrode when the first electrode is in its open position. In such an open position, the first electrode may not be in electrical communication with the electrical source and, as a result, current may not flow through the first electrode. The first electrode can be moved into its closed position such that the first electrode is in contact with the contact end of the wire. In such a closed position, the first electrode may be in electrical communication with the electrical source allowing current to flow through the first electrode.

Abstract: An electrosurgical device comprises an end effector, a cutting member, and en electromechanical driver. The end effector comprises a pair of jaws that clamp tissue. The jaws include electrodes that deliver RF energy to clamped tissue. The cutting member cuts tissue clamped between the jaws. The electromechanical driver drives the cutting member. A control module commands the electromechanical driver, and regulates the delivery of RF energy to the electrodes, based on a combination of user input and feedback signals from the electrodes and from the electromechanical driver. The device may provide tactile feedback to the user through the user input feature, based on a load encountered by the cutting member. The device may alert the user when the exterior of end effector makes incidental contact with tissue, to avoid inadvertently burning the tissue. The device may include a removable battery pack to power the electromechanical driver and the electrodes.

Abstract: Methods and devices are provided for controlling movement of an end effector assembly, and in particular for causing mimicking motion between a handle and an end effector assembly. In an exemplary embodiment, a surgical device is provided having a handle or actuator, an elongate shaft, and an end effector assembly coupled to a distal end of the elongate shaft. The handle or actuator is configured such that movement of the handle is mimicked, not mirrored, by the end effector assembly. The mimicking motion can be achieved using various techniques, but in an exemplary embodiment the handle is located distal to an input joint, and motion is transferred to the end effector assembly through an output joint at a distal end of the elongate shaft. The motion is preferably transferred using a mechanical transmission coupled between the input and output joints.

Abstract: A surgical instrument for supplying energy to tissue can comprise a jaw member comprising an electrode, wherein the electrode is configured to supply energy from a power source to captured tissue. The surgical instrument comprises a tissue-cutting element to transect the captured tissue. The rate of distal translation of the tissue-cutting element during the operational stroke may be regulated by a linear actuator, for example.

Abstract: A first guidewire structure includes a medical guidewire extendable beyond a distal end of a medical instrument and having first and second segments, wherein the bending moment of inertia of the first segment is less than the bending moment of inertia of the second segment. A second guidewire structure includes a medical guidewire extendable beyond a distal end of a medical instrument having a mechanized guidewire drive assembly. The medical guidewire has an exterior surface including a repetitive series of spaced-apart surface elevation features. One example of surface elevation features is external threads. The spaced-apart surface elevation features are adapted for operable engagement with the mechanized guidewire drive assembly.

Abstract: An end-effector assembly is configured to be attached to a surgical instrument. The end-effector assembly comprises a first jaw comprising an electrode, a second jaw comprising a rivet cavity, and a rivet. At least one of the first jaw and the second jaw is movable relative to the other jaw. At least a portion of the rivet is removably positioned within the rivet cavity. The rivet comprises a tissue-engaging portion, an elongate portion extending from the tissue-engaging portion, and a meltable portion. The end-effector assembly comprises a driver configured to move the rivet between a first position in which the rivet is stored at least partially within the rivet cavity and a second position in which the rivet is at least partially deployed from the rivet cavity. The meltable portion of the rivet is positioned against or adjacent to the electrode when the rivet is in the second position.

Abstract: An electrosurgical instrument can comprise a handle, a shaft, and an end effector, wherein the end effector can be rotatably coupled to the shaft by an articulation joint. The instrument can further comprise a drive member and the articulation joint can comprise flexible support members which can be configured to support the drive member. The instrument can further comprise supply wires electrically coupled to electrodes in the end effector and a wire tensioning device configured to prevent the supply wires from accumulating slack within the articulation joint. The drive member can comprise a plurality of flexible layers wherein some of the layers can be comprised of an electrically insulative material and other layers can be comprised of an electrically conductive material which is in electrical communication with a cutting member in the end effector and/or electrodes positioned within the end effector.

Abstract: Various embodiments are directed to a surgical instrument comprising, a shaft, and an end effector. The shaft may be coupled to the handle and may extend distally along a longitudinal axis. The end effector may be positioned at a distal end of the shaft and may comprise first and second jaw members and a reciprocating member. The first and second jaw members may define first and second longitudinal slots. One or both of the jaw members may be pivotable relative to the other about a pivot point. The reciprocating member may be translatable distally and proximally parallel to the longitudinal axis and through the first and second longitudinal slots. A distal portion of the reciprocating member may define a blade. The instrument may comprise an overtube translatable distally to exert a force on a portions of the first and second jaw members tending to close the first and second jaw members.

Abstract: Various embodiments are directed to a surgical instrument comprising a handle, a shaft coupled to the handle and extending along a longitudinal axis, an end effector, and a cable. The end effector may comprise a first jaw member, a second jaw member and a reciprocating member. The cable may extend distally from the handle through the shaft to a first pulley of the first jaw member. From the first pulley, the cable may extend proximally to the reciprocating member, such that proximally directed motion of the cable exerts a distally directed force on the reciprocating member.

Abstract: A surgical instrument is provided that can comprise and end effector including two jaws and a cutting member configured to move between the jaws. In at least one embodiment, one or both of the jaws may be flexible, such that a jaw is configured to flex when gripping tissue. Further, at least one of the jaws may include a thin cross-sectional area such that the jaw flexes when gripping tissue. Additionally, in at least one embodiment, one or more compression elements may extend from the cutting member and may be configured to cause the jaws to close when the cutting member is advanced. The compression elements may comprise a roller and/or a low-friction material. Moreover, in at least one embodiment, one or both of the jaws may be precurved, away from the cutting member's longitudinal axis. Accordingly, in various embodiments, the overall force required to advance the cutting member and/or close the jaws may be reduced.