Abstract: A surgical device for use in combination with a percutaneous elongate shaft defining a longitudinal axis. The shaft comprises a distal end and a proximal end, the distal end comprising an attachment mechanism. A surgical end effector is selectively attachable in vivo and detachable in vivo to the attachment mechanism of the percutaneous elongate shaft. A percutaneous elongate loader comprises an articulating distal end. The distal end comprises a tube with an opening at the distal tip, the tube being dimensioned to receive the surgical end effector. The distal end further comprises an engagement feature capable of frictionally holding the surgical end effector in the tube during in vivo attachment to and in vivo detachment from the percutaneous elongate shaft.

Abstract: A surgical apparatus comprises a body, a user input feature, a shaft assembly, an end effector, and a blade cooling system. The end effector comprises a clamp arm and an ultrasonic blade that may be coupled with an ultrasonic transducer. The clamp arm is configured to pivot toward and away from the ultrasonic blade. The cooling system is operable to deliver liquid coolant to the ultrasonic blade to thereby cool the ultrasonic blade. The user input feature is operable to both actuate the clamp arm and actuate the cooling system.

Abstract: A surgical device for use in combination with a percutaneous elongate shaft defining a longitudinal axis. The shaft comprises a distal end and a proximal end, the distal end comprising an attachment mechanism. A surgical end effector is selectively attachable in vivo and detachable in vivo to the attachment mechanism of the percutaneous elongate shaft. A percutaneous elongate loader comprises an articulating distal end. The distal end comprises a tube with an opening at the distal tip, the tube being dimensioned to receive the surgical end effector. The distal end further comprises an engagement feature capable of frictionally holding the surgical end effector in the tube during in vivo attachment to and in vivo detachment from the percutaneous elongate shaft.

Abstract: A laparoscopic surgical method comprises obtaining a first instrument comprising an elongate shaft with a distal end and a proximal end connected to a first handle. The distal end of the first instrument is passed through a percutaneous incision. A surgical end effector is obtained having a distal end with operable jaws and a proximal end selectively attachable to and detachable from the distal end of the first instrument. A second instrument is obtained comprising a distal end and a proximal end connected to a second handle. The surgical end effector is loaded ex vivo on the distal end of the second instrument. The distal end of the second instrument with the loaded surgical end effector is passed through a second incision spaced from the percutaneous incision. The proximal end of the surgical end effector is attached in vivo to the distal end of the first instrument. Tissue is manipulated by actuating the handle of the first instrument to operate the jaws of the surgical end effector.

Abstract: An apparatus comprises a body assembly, a shaft, an acoustic waveguide, an articulation section, an end effector, and an articulation drive assembly. The shaft extends distally from the body assembly and defines a longitudinal axis. The acoustic waveguide comprises a flexible portion. The articulation section is coupled with the shaft. A portion of the articulation section encompasses the flexible portion of the waveguide. The articulation section comprises a plurality of body portions aligned along the longitudinal axis and a flexible locking member. The flexible locking member is operable to secure the body portions in relation to each other and in relation to the shaft. The end effector comprises an ultrasonic blade in acoustic communication with the waveguide. The articulation drive assembly is operable to drive articulation of the articulation section to thereby deflect the end effector from the longitudinal axis.

Abstract: Devices and methods for cutting tissue are provided, and more particularly the devices and methods provide for ways to prevent a cutting blade from becoming dislodged or otherwise disassociated from jaws of a surgical device. In one exemplary embodiment, a surgical device includes a jaw assembly having first and second jaws and a cutting blade. The cutting blade can include a spring mechanism configured to engage a portion of the second jaw to bias a cutting edge of the cutting blade towards the first jaw such that a top of the cutting blade distal portion contacts a portion of the first jaw. In another exemplary embodiment, a biasing block is included as part of a surgical instrument to help maintain distal ends of two cutting blades hooked against each other to form a single cutting surface. Other devices and methods for cutting tissue are also provided.

Abstract: A medical instrument handle includes a stem, a joystick assembly, and a medical-instrument-member first articulation cable. The stem has a proximal stem portion and a distal stem portion. The joystick assembly includes a platform, a proximal joystick portion and a distal joystick portion, wherein the distal joystick portion is articulatably connected to the proximal stem portion. The first articulation cable includes a proximal cable portion which is connected to the platform and which is substantially transversely constrained by the stem. Articulation of the joystick assembly with respect to the stem changes a distance between the platform and the stem as measured along the first articulation cable. A medical instrument includes a medical instrument handle and a medical end effector. Examples of medical end effectors include, without limitation, a medical grasper and a medical snare.

Abstract: Surgical devices and methods are described herein that provide improved motor control and feedback, thereby combining advantages of manually-operated and powered surgical devices. In one embodiment, a surgical device includes a proximal handle portion that includes a motor, a distal end effector coupled to the handle portion, and a cutting element configured to cut tissue engaged by the end effector, wherein the motor is configured to supply power that moves the cutting element. The device also includes a motor control mechanism configured to cause the amount of the power to dynamically change in response to a manual user input when the cutting element is moving.

Abstract: Various surgical devices are provided for shielding tissue from potentially harmful byproducts generated by surgical devices that use energy to treat tissue. In general, a shield member is provided that includes a connector element for removably connecting the shield member to a surgical device and a shield body configured to extend adjacent to an energy-emitting end effector of the device. When energy is delivered to treated tissue captured by the end effector, the shield body can be configured to serve as a physical barrier between the end effector and tissue adjacent to the treated tissue. In this way, the shield member can protect the adjacent tissue from potentially harmful byproducts of the end effector, e.g., heat and steam, and/or can deflect the byproducts back toward the treated tissue.

Abstract: An apparatus for cleaning a lens, or one or more lenses, of an endoscopic camera while the endoscope is deployed in a patient during a medical procedure, such as a minimally invasive procedure, or a therapeutic or diagnostic procedure, is disclosed. The cleaning apparatus generally includes a conduit having a fluid delivery port, an alignment system, and a flexible supply tube to fluidly connect the conduit to one or both of a source of a fluid and a suction device.

Abstract: A surgical stapler has a body, a shaft assembly extending distally from the body, and an end effector coupled with a distal end of the shaft assembly. The end effector has a stapling head assembly, an anvil, and a vacuum port. The vacuum port is operable to draw tissue between the stapling head assembly and the anvil. The anvil is operable to move toward and away from the stapling head assembly to thereby capture the tissue drawn between the stapling head assembly and the anvil. The stapling head assembly comprises a plurality of wheel assemblies and staple cartridges. At least one wheel assembly is operable to rotate to thereby move the anvil toward and away from the body. The remaining wheel assemblies are operable to rotate to thereby drive staples through the captured tissue. The body includes user input features operable to drive the wheel assemblies.

Abstract: A surgical instrument for forming a gastrotomy. In various embodiments, the surgical instrument may comprise a hollow tip for attachment to a distal end of a tubular member such as an endoscope. In other embodiments, the hollow tip is integrally formed on the distal end of the endoscope. The hollow tip is configured such that when it is brought into contact with the inner layer of tissue in the stomach, the tissue is caused to stretch. A hole-forming device may be passed through the hollow tip to pierce through the stretched inner layer and adjacent outer layers of tissue to form a passageway therethrough for permitting surgical procedures to be performed therethrough. After the surgical procedures are performed through the passageway, the hollow tip is removed from contact with the inner layer of tissue to permit the inner layer of tissue to relax and to cause the holes formed through the inner layer and outer layers of tissue to be offset from each other.

Abstract: A surgical apparatus comprises a body, an ultrasonic transducer, a shaft, an acoustic waveguide, an articulation section, and an end effector. The ultrasonic transducer is operable to convert electrical power into ultrasonic vibrations. The shaft couples the end effector and the body together. The acoustic waveguide is coupled with the transducer. The end effector comprises a clamp arm and an ultrasonic blade in acoustic communication with the ultrasonic transducer. The clamp arm is configured to pivot toward and away from the ultrasonic blade. The shaft assembly comprises an inner tube configured to longitudinally translate to thereby pivot the clamp arm toward and away from the ultrasonic blade. A distal portion of the inner tube is operable to flex to thereby accommodate pivoting of the clamp arm.

Abstract: Apparatus and methods for use in the performance of minimally invasive orthopaedic procedures, including apparatus and methods for use in the performance of such procedures under the visualization of an endoscope, are herein disclosed. Such procedures include a minimally invasive intramedullary nailing procedure, a minimally invasive bone graft harvesting procedure, a minimally invasive pelvic osteotomy procedure, an orthopaedic implant revision procedure, and a minimally invasive percutaneous bone plating procedure.

Abstract: Methods and devices are provided for controlling movement of a working end of a surgical device, and in particular for performing various surgical procedures using an instrument having an end effector that can be articulated relative to an elongate shaft of the device. A decoupling member can isolate the actuation of the end effector from the articulation of the end effector. In certain embodiments, the end effector can also optionally rotate relative to the elongate shaft of the device, and/or the shaft can rotate relative to a handle of the device.

Abstract: An apparatus for cleaning a lens, or one or more lenses, of an endoscopic camera while the endoscope is deployed in a patient during a medical procedure, such as a minimally invasive procedure, or a therapeutic or diagnostic procedure, is disclosed. The cleaning apparatus generally includes a conduit having a fluid delivery port, an alignment system, and a flexible supply tube to fluidly connect the conduit to one or both of a source of a fluid and a suction device.

Abstract: An introducer for an internal magnetic camera is provided. The introducer may be arranged to enable the camera to be placed inside of a body cavity through an otomy or incision and then oriented next to the tissue of the body cavity opposite an External Control Unit (“ECU”) outside of the body cavity. The camera may be retained in the introducer by a magnet or a magnetic material, by a selectively engageable retainer, or by covering the camera within a cavity. The camera may be retained in the introducer by a latch. The camera may include a keyed surface that only can align with a matching keyed surface on the retainer in a single orientation. The introducer may include a spring to eject the camera from the introducer when the retainer is disengaged.

Abstract: Methods and devices are provided for manipulating tissue in a body cavity, i.e., in vivo. In general, the methods and devices allow an end effector to engage tissue, be detached from a shaft used to control the end effector to engage the tissue, and then be moved to another location in the body cavity by a separate component, such as an external control unit. In some embodiments the end effector can include one or more deployable hooks that allow the end effector to remain at a surgical site independent of any shafts or external control units. Still further, in other embodiments the end effector can include a transverse bore to allow a second shaft to connect to the end effector to manipulate the tissue. Additional exemplary devices, kits, and methods related to manipulating tissue in vivo are also provided.

Abstract: The device includes an elongate shaft having a distal end coupled to a proximal end of an articulation joint, and an actuation wire extending through the elongate shaft and the articulation joint. The device includes an end effector having a distal tip coupled to a distal end of the articulation joint and receiving therethrough a distal end of the actuation wire. The end effector includes a hook knife disposed adjacent the distal tip and having a proximal end connected to the distal end of the actuation wire. The actuation wire is translatable along a longitudinal axis of the elongate shaft to extend and retract the distal end of the hook knife relative to the distal tip of the end effector, and the articulation joint is laterally articulatable relative to the longitudinal axis of the elongate shaft to allow the end effector to be angularly oriented relative to the elongate shaft.

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.