Abstract: Instruments for treating bone defects of the joint, particularly at the subchondral level, such as bone marrow lesions or bone marrow edema, are provided. In particular, these instruments may be delivery instruments that comprise features to control the location to which they deliver injectable materials or other tools to the bone to be treated. Also provided is an injection instrument that delivers a treatment material to the bone defect and stimulates a natural healing response in the bone.

Abstract: Described here are devices and methods for accessing the pericardial space. The access devices may include a piercing member such as a needle and a proximal shoulder having a contact surface for contacting the pericardium as the piercing member pierces the pericardium. In some instances, the distance between the piercing member and the proximal shoulder may be adjustable.

Abstract: An external fixation system for adjusting a load occurring at a joint connecting a first bone to a second bone. The external fixation system includes a first bone clamp to connect to the first bone, a second bone clamp to connect to the second bone, and a pivot assembly to operatively connect the first bone clamp and to the second bone clamp. The pivot assembly includes a first pivot body pivotably coupled to a second pivot body at a pivot axis, wherein one of the first pivot body and the second pivot body includes an adjustment mechanism configured to adjust the position of one of the first pivot body and the second pivot body with respect to the other of the first pivot body and the second pivot body at other than the pivot axis.

Abstract: A system for flexibly stabilizing a vertebral motion segment by connecting a first vertebra and a second vertebra is disclosed. The system includes an elongate connection element with end portions interconnected by a flexible coupling member. The system includes first and second attachment portions for connecting the connection element to the vertebrae. A first resilient member is positioned between the first end portion and the first attachment portion, and a second resilient member is positioned between the first attachment portion and the second attachment portion. The system is designed such that the second resilient member is compressed when the first and second attachment portions move towards each other, and the first resilient member is compressed when the first and second attachment portions extend away from each other.

Abstract: An apparatus for treating spinal vertebrae of patients that require therapeutic mechanical effects. Two interconnected articulated U-shape frame assemblies 20; 70 provide the necessary supporting at adjustable relative angular disposition with respect to each other to conform with the characteristics of the spinal segment being treated. Upper frame assembly 20 is mounted at a predetermined location of a patient's spine. Connector assemblies 40; 40? are mounted to upper assembly 20 and to telescopic tubular assembly 50 extension. Pivoting connectors 60; 60? are connected to a tubular assembly 50 and provide pivoting movement in two ortographic planes for tubular assembly 50 and lower frame assembly 70.

Abstract: A vertebral column correction system for correcting a spinal deformity without fusing the joint segments is disclosed. The vertebral column correction system may have first and second vertebral anchors secured to first and second vertebrae. The vertebral column correction system may further comprise one or more intermediate vertebral anchors secured to vertebrae between the first and second vertebrae. A connection member may be disposed within a head portion of the vertebral anchors. At least a portion of the connection member may be a flexible member, such as a flexible cord, configured for tensioning between at least two vertebral anchors for providing a desired amount of tension to apply a correctional force to the spinal column. A spring member, or other tensioning member, may maintain the tension of the connection member.

Abstract: A dynamic stabilizing device (1) for bones (3), in particular for vertebrae, includes two bone anchoring elements (2) spaced from one another, which are connectable via fastening elements (4) with at least one rod (5) that is at least partly elastic. The rod (5) has an adjustable device (7) for affecting its elasticity, which is adjustable before and/or after the implantation of the stabilizing device (1). The adjustable device (7) is formed, such that it changes the free length of an elastic section (11) of the rod (5). The adjustable device (7) includes a carriage that is displaceable over the rod (5), and the carriage (20) engages the rod (5) on a peripheral side at least partially.

Abstract: A system and method for ameliorating spinal column anomalies, such as scoliosis, includes bone screws which are to be implanted in the pedicle region(s) of individual to-be-derotated vertebrae and in vertebrae to which balancing forces must be applied as the spinal column is derotated en mass to achieve an over-all correction of the condition. A pedicle screw cluster derotation tool simultaneously engages multiple pedicle screws and transmits rotative forces to multiple vertebrae to effect a whole-spine correction. Precontoured spinal rods are engaged post-derotation to secure the correction.

Abstract: A polyaxial bone anchoring device is provided, comprising a bone anchoring element having a shank, a head, a receiving part for pivotably receiving the head, and a channel for receiving a rod; a pressure member configured to be arranged in the receiving part and to exert pressure onto and lock the head; a locking assembly insertable into the channel, the locking assembly comprising a first locking member having a bore; a second locking member to be provided in the bore, wherein, when the second locking member is rotated, in a first configuration, the first locking member and the second locking member are rotationally fixed relative to each other and the first locking element is advanced to contact the pressure member and in a second configuration, the second locking member is rotatable within the first locking member and the second locking member is advanced to contact the rod.

Abstract: A stabilizer device for the spinal column, comprising first engagement means and second engagement means, which are adapted to be connected to each other by a rod-like element, the first and second engagement means being adapted to be fitted on first and second pedicle screws, which are adapted to be in turn inserted in two adjacent vertebrae, the first and second engagement means being fixable on the pedicle screws; the first and second engagement means accommodate bearing means, which are adapted to rotate within the first and second engagement means and to be fitted on the pedicle screws, in order to allow the fitting of the first and second engagement means on the pedicle screws.

Abstract: A polyaxial bone anchoring device includes a bone anchoring element having a shank and a head, a receiving part having a first end and a second end, a central axis, a first bore, a second bore, and a first support surface between the first bore and the second bore that is substantially perpendicular to the central axis, and an insert piece having a seat for pivotably holding the head, a bounding edge, and a second support surface configured to engage the first support surface to support the insert piece when mounted to the receiving part, the second support surface formed by a projection at an end of the insert piece opposite the bounding edge, wherein the insert piece projects out of the second bore and is rotatable, and is configured to permit the bone anchoring element to pivot at a larger angle at a first location of the bounding edge.

Abstract: Implementations of the present disclosure provide a snap fit rod and fastener system including one or more fasteners for securing one or more rods to secure a spine or other anatomical structure. The fasteners include a fixation shaft, a clamp and a connector. The fixation shaft (for example a pedicle screw) is configured to frictionally engage a bone (vertebra) or other workpiece. The clamp has a pressure responsive portion that defines an opening configured to receive a rod. The connector is configured to connect the clamp to the fixation shaft and exert pressure on the clamp to modify the opening and secure the rod. A bias mechanism, such as a washer spring may be included to urge against the pressure responsive portion and which can be overcome by pressure on the rod for the “snap fit” effect. For additional adjustability, the clamp may be pivotally mounted on the fixation shaft.

Abstract: An axial spinal rod connector includes a central connector and first and second portions. The first and second portions are each integrally formed with the central connector to define a longitudinal axis. Each of the first and second portions includes an outer end portion and a set screw. The outer end portion defines a passage about the longitudinal axis and defines a blind hole orthogonal to the longitudinal axis. The blind hole extends into the passage. The passage is sized and configured to slidably receive a spinal rod. The set screw is sized and configured to engage the blind hole. The set screw at lease partially interfering with the passage when engaged with the blind hole to fix a spinal rod relative to the spinal rod connector.

Abstract: A bone fixation device adapted to be coupled to bone anchors that allows movement of rods to permit a screw-rod construct to lengthen in response to bone growth without necessitating post surgical installation adjustment of the device. The bone fixation device includes a locking mechanism that is operably associated with a housing to allow relative movement of a rod and a housing in a first direction and inhibiting relative movement of the rod and the housing in a second direction.

Abstract: Methods and devices are provided for manipulating a vertebra. In one embodiment, a surgical device can include a frame configured to couple two or more surgical instruments attached to one or more vertebrae. Coupling the two or more surgical instruments together, the frame and/or at least one of the surgical instruments can be manipulated to move at least one of the surgical instruments, thereby effecting movement at least one of the vertebra or vertebrae to which the surgical instruments coupled to the frame are attached. In this way, the surgical device can be used to facilitate rotation of a vertebra relative to another vertebra to correct the angular relationship of the vertebrae.

Abstract: The present invention describes a system suitable for guiding a cross-connector to a target area, such as spinal implants including spinal implant rods, within the body (in vivo) and method of using the same. The system includes a targeting member being constructed of, or having a steering material, which can be coupled to the cross-connector. The system further includes one or more devices which are used to maneuver the targeting member into position prior to attachment of the cross-connector. The cross-connector is traversed into position through the passageway created by the targeting member and secured to one or more spinal implant members.

Abstract: Devices and methods for facilitating insertion of a spinal rod into a rod-receiving channel formed in a bone fixation element are described herein. In some embodiments, a reduction sleeve can include a through-bore sized to receive the bone fixation element and a transverse channel sized to receive the spinal rod and substantially aligned with the rod-receiving channel formed in the bone fixation element. The reduction sleeve can also include at least one break-off point for breaking and removal of the reduction sleeve The reduction sleeve can also include a plurality of threads for engaging a reduction instrument, an alignment mechanism so that the bone fixation element can only be inserted into the reduction sleeve when the rod-receiving channels are aligned, and an inwardly projecting protrusion formed on the inner surface of the reduction sleeve so that, once inserted, the projection contacts a top surface formed on the bone fixation element.

Abstract: A rear-retaining structure for dynamic hip screw (DHS) includes a retaining block and a positioning element. The dynamic hip screw comprises a lag screw, a sideplate, a sleeve with a higher orifice and a lower orifice, and a compression screw. The retaining block of the rear-retaining structure is attached to the sideplate of the dynamic hip screw by the positioning element. A stopper portion of the retaining block is located opposite to the lower orifice of the sleeve. The height of the highest point of the stopper portion in the lower orifice is in inverse proportion to the distance that the lag screw and the compression screw are allowed to slip back in the sleeve from an implant position to the lower orifice; namely, the higher the height of the highest point of the stopper portion is in the lower orifice, the smaller the distance for the slip back.

Abstract: An intramedullary nail has a proximal part for engagement with a proximal bone fragment and a distal part for engagement with a distal bone fragment. A motion assembly interconnects the parts and allows limited axial relative motion of the proximal and distal parts. This limited axial motion provides micromotion and in some embodiments also dynamization. The nail may comprise a stem for fastening to one bone fragment and an insert within the stem for fastening to the other bone fragment, the insert being adapted to guide insertion of a bone screw through the stem and to prevent relative rotation of the distal and proximal bone fragments. The motion assembly may include spring bias and/or damping means between the parts, possibly including one or more Belleville washers.

Abstract: A hip fracture support plate, in combination with hip screw fixation of an intertrochanteric hip fracture, provides additional support of the femoral head and neck fragment, tending to reduce hip screw cut-out or fracture, with collapse and mal-union of the head and neck.

Abstract: Orthopedic plating assemblies and methods for bone fixation that include an orthopedic plate and orthopedic anchors that can accommodate subsidence in the vertebral bodies as well as prevent the anchors from “backing out” of their installed position. The orthopedic anchors may be capable of rotating and translating with respect to the plate, and the plate may be able to translate after being fastened to the vertebral bodies.

Abstract: A bone fastener for use in orthopedic surgery for fixing an implant to bone has a threaded or unthreaded shaft configured to engage bone and a head having a thread on an outer surface to engage the implant. The thread on the head of the fastener has a profile in cross section that includes peaks with a curved shape.

Abstract: A dynamic bone fixation element can include a sleeve elongate along a first direction and a fixation member. The sleeve can define a channel that extends from a proximal end through to a distal end along the first direction. The channel has a first cross-sectional dimension. The fixation member has a head, a shaft extending from the head and elongate along a second direction, and an abutment member extending from the shaft and integral with the shaft, wherein the shaft extends through the channel such that the sleeve is captured between the abutment member and the head. At least a portion of the shaft that is within the channel has a second cross-sectional dimension that is less than the first cross-sectional dimension such that the fixation member is moveable with respect to the sleeve along a direction that has a directional component transverse to the first direction.

Abstract: A mixing device, for a mixable material, has at least one cartridge and a closure piece. The cartridge contains a first component of the mixable material and has a cartridge head in which at least one air opening is arranged, and the closure piece is arranged on the cartridge head in such a way that the at least one air opening in the cartridge head can be closed and opened by the closure piece. The closure piece is mounted so as to be rotatable or slideable relative to the cartridge head, and a connection extends through the cartridge head or a cartridge wall into the interior of the cartridge and connects the interior of the cartridge to a container for a second component of the mixable material.

Abstract: A system for preparing a proximal femur can include a broach that includes a broach body having an anterior side, a posterior side, a lateral side and a medial side. The medial side can have a roughened cutting surface. The lateral side can have a smooth, non-cutting surface. The system can further comprise a cutting scribe assembly and a cutting guide assembly.

Abstract: A surgical reduction clamp has a first clamping arm and a second clamping arm movable relative to the first clamping arm. The first clamping arm comprises a base portion, a tip portion, a joint movably coupling the tip portion to the base portion, and a locking member adapted to lock the joint so as to fasten a position of the tip portion relative to the base portion. The joint is a revolute joint having a spherical portion which can be locked into position by a clamping force.

Abstract: A modular dynamic pedicle screw system including anchoring device having a threaded shank for anchoring within a vertebra, an intermediate element and a head portion configured to receive and secure a rigid or non-rigid stabilization rod. The threaded shank, the intermediate element and the head portion of the anchoring device are cannulated to permit percutaneous implantation of the device. The intermediate portion is designed to be removable from the threaded shank portion subsequent to implantation of the anchoring device to enable substitution of another intermediate element having different dynamic characteristics. The dynamic stabilization system includes an adjustable torque limiting device that is interchangeable between a tap device and a screw driver. The torque device provides information relative to the patient's bone quality inter-operatively in order to determine the appropriate modulus of elasticity for the dynamic pedicle screw.

Abstract: An angled instrument assembly includes an angled sleeve, a driver shaft, and a tool bit. The angled sleeve includes a straight passage segment that meets an angled passage segment at a junction. The junction includes an inner elbow and an outer elbow. Material is removed from the inner surface of the inner elbow in order to improve the ease with which the driver shaft can be moved in and out of the angled sleeve. The assembly can also include drafted female or male engagement bodies for facilitating the engagement and disengagement of the tool bit with a tool bit engagement assembly located at the distal end of the driver shaft.

Abstract: Cryotreatment devices and methods of ablating tissue within the body are disclosed. A cryotreatment device in accordance with an exemplary embodiment of the present invention includes an elongated member having one or more needle-like ablation tips configured to induce necrosis at a target site within the heart. A cooling fluid such as a cryogen may be injected through a lumen extending into the distal portion of the device. The ablation tips can be configured to pierce and ablate surrounding tissue, blocking electrical stimuli that can cause fibrillations or other arrhythmias of the heart. The device may also include means for controlling the transmural depth at which the ablation tips are inserted into the cardiac tissue. Methods of forming a contiguous line of conduction block in accordance with the present invention are also disclosed.

Abstract: An electrode structure and a mechanism for automated or user-selected operation or compensation of the electrodes, for example to determine tissue coverage and/or prevent arcing between bottom electrodes during electrocautery is disclosed.

Abstract: An RF surgical apparatus and method for operating such an apparatus. The RF surgical apparatus comprises at least two RF generators and at least one neutral electrode output for one neutral electrode. At least two outputs for connecting RF surgical instruments for applying treatment currents to the surgical instruments are provided. Furthermore, a switching device is provided. To enable a simultaneous operation of several RF surgical apparatuses, and not generate any neuromuscular stimulation, a separate generator is provided for each RF surgical instrument and a single neutral electrode is provided for all of the instruments and generators. The switching device is adapted to be arranged in a controlling connection with the RF generators such that the RF generators will never generate, and output to the instruments, any treatment currents at the same time (that is, they output only sequentially).

Abstract: A method and system for assessing lesion formation in tissue is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire values for first and second components of a complex impedance between the electrode and the tissue, and to calculate an index responsive to the first and second values. The ECU is further configured to process the ECI to assess lesion formation in the tissue.

Abstract: An RF ablation device comprises an electrode including a DLC coating deposited on at least a portion thereof. A method of forming an RF ablation device, comprises forming a DLC coating on a portion of a metallic electrode.

Abstract: Electrosurgical devices, methods, and systems for electrosurgical procedures as enabled by bipolar radiofrequency energy. An electrosurgical tissue dissecting device includes a shaft, two jaws extending from the shaft, a first electrode that is positioned on either one or both of the jaws, and a second electrode that is positioned at least partially between the two jaws.

Abstract: An energy delivery device for treating a patient includes a probe body and a plurality of elongate electrode elements that extend radially away from the probe body when deployed into tissue of the patient. The electrode elements are adapted to receive electrical treatment energy such as irreversible electroporation (IRE) pulses from an energy source. In one embodiment, each electrode element has a longitudinally varying electrical resistance at the electrode-tissue interface along the electrode so as to provide a uniform electric field along the length of the electrode. The uniform electric field allows a more uniform ablation of tissue within a treatment zone.

Abstract: A device and method for transvaginal or transrectal treatment of a bladder pathology. The device includes an elongate body that includes a longitudinal axis, a handle at one end of the body, a head at the other end of the body, and a shaft between the handle and the head. The head includes a substantially flat surface and one or more retractable needle electrodes extending through the flat surface. The method includes inserting a probe into a vagina or rectum of a patient, where the probe includes a head portion comprising one or more retractable needle electrodes; heating one or more pelvic nerves supplying the patient's bladder by emitting radiofrequency energy from the one or more needle electrodes; and as a result of the heating, damaging the one or more pelvic nerves.

Abstract: A wall of a uterus is ablated by expanding a structure in the uterus and applying energy across the wall of the structure into the uterine wall. An exterior surface of the structure conforms to an inner wall of the uterus, and the energy may cause vapor to collect between the wall and the structure. The vapor is released by providing a barrier to release which is inflated at a pressure above which the barrier at least partially collapses to allow the vapor to leave the uterus.

Abstract: Catheter systems and methods are disclosed. An exemplary catheter includes an outer tubing housing and an inner fluid delivery tubing, the inner fluid delivery tubing having at least one fluid delivery port. The catheter also includes a deployment member movable axially within the inner fluid delivery tubing. A plurality of splines are each connected at a proximal end to the outer tubing and at a distal end to deployment member. A seal is provided between the outer tubing and the inner fluid delivery tubing. A gasket is provided between the deployment member and the inner fluid delivery tubing. Both the seal and the gasket are configured to prevent blood or other fluid from ingressing into the outer tubing.

Abstract: Neuromodulation catheters with nerve monitoring features for transmitting digital neural signals and associated systems and methods are disclosed herein. A neuromodulation catheter configured in accordance with some embodiments of the present technology can include, for example, a handle and an elongated shaft attached to the handle. The shaft can have a proximal portion and a distal portion configured to be moved within a lumen of a blood vessel of a human patient. The neuromodulation catheter can further include an array of contacts at the distal portion of the shaft and a digitizer at the handle or the shaft. The contacts can be configured to detect analog neural signals from within the blood vessel. The digitizer can be configured to receive the analog neural signals from the contacts, digitize the analog neural signals into digital neural signals, and transmit the digital neural signals to a read/write module external to the patient.

Abstract: An apparatus, including an insertion tube having a proximal tube end and a distal tube end that includes an electrode, a first irrigation line including proximal and distal irrigation line ends and configured to supply fluid from the distal irrigation line end through apertures in the tube, and an electrical line including a proximal electrical line end and a distal electric line end coupled to the electrode. The apparatus includes a slip ring unit having a stator, a rotor connected to the proximal electrical line end, and a hollow channel extending through respective centers of the stator and the rotor along a longitudinal axis of the slip ring unit. The apparatus includes a rotary joint in fluid communication with the proximal irrigation line end, an angle sensor configured to detect torsion of the proximal irrigation line end, and a drive mechanism coupled to rotate the rotor responsively to the torsion.

Abstract: A surgical instrument includes an elongated shaft, with components arranged in the shaft. The elongated shaft is slightly curved. Arranged on a proximal end of the surgical instrument is an actuation device in the form of a lever mechanism and rotary knob. A force transmission element in the form of a plastic hollow section is arranged in the shaft. The force transmission element is a plastic section designed for transmitting compressive and tensile forces. The plastic section is provided with a plurality of longitudinally extending channels. Therefore, the plastic section does not only serve as a force transmission element, but electric lines and a pull-push shaft may additionally extend in the channels. The longitudinal channels may be used for supplying cooling media for the electrodes or the thermo-fusion device or for feeding agents promoting wound repair. The plastic section is electrically insulating, so that the risk of short-circuits is reduced.

Abstract: Ultra-short pulsed laser radiation is applied to a patient's eye to create a row of bubbles oriented perpendicular to the axis of vision. The row of bubbles leads to a region of the eye to be ablated. In a second step, a femtosecond laser beam guided through the row of bubbles converts it to a channel perpendicular to the axis of vision. In a third step, a femtosecond laser beam is guided through the channel to ablate a portion of the eye. Using a femtosecond laser with intensity in the range of 1011-1015 W/cm2 for the second and third steps facilitates multi-photon ablation that is practically devoid of eye tissue heating. Creating bubbles in the first step increases the speed of channel creation and channel diameter uniformity, thereby increasing the precision of the subsequent multi-photon ablation.

Abstract: In one embodiment, the disclosure is directed to an integrated apparatus for delivering energy to a tissue. The integrated apparatus included a housing having a distal end and a tubular structure located within the housing forming a first annulus between the tubular structure and the housing. The tubular structure is configured to accept an energy delivery component and is configured to form a second annulus between the tubular structure and the energy delivery component. The first annulus and the second annulus are configured to communicate with each other proximate to the distal end of the housing.

Abstract: A catheter tip is provided according to various embodiments of the disclosure. The catheter tip may comprise a distal end, a proximal end, and tubular walls. The distal end includes a distal aperture with a distal inside diameter, and the proximal end includes a proximal aperture with a proximal inside diameter. The proximal inside diameter may be greater than the distal inside diameter. The proximal end comprises attachment means configured to couple the proximal end with a distal end of a laser catheter. The tubular walls may include at least an inside taper from the proximal end to the distal end such that the inner tubular walls generally taper from the proximal inside diameter to the distal inside diameter. Moreover, the tubular walls may be configured to direct at least a liquid medium, for example, a biocompatible solution, toward the distal aperture.

Abstract: An adjustable stringer configured to string the ring handles of one or more surgical instruments, the stringer including two or more rod sections, wherein each rod section is configured to be inserted in one ring handle of the one or more surgical instruments, two or more angle sections, each angle section configured having one or more slidable connector sections, each slidable connector section configured to extend and retract along at least one of the two or more rod sections, and two or more releasable connectors, each releasable connector positioned between two of the two or more angle sections.

Abstract: A medical device and method for facilitating a surgery through a body opening is disclosed. The medical device includes a flexible member configured to be placed within the body opening so as to cover a portion of the body opening. The flexible member includes a distal end portion with a closed end, a proximal end portion with an open end and an elongate portion joining the proximal end portion and the distal end portion. The proximal end portion is configured to extend out of the patient's body opening to cover an area around and outside the patient's body opening.

Abstract: A medical instrument guiding device includes a body base component, and a guide body upper component assembled to the body base component. The guide body upper component has a substantially semi-spherical shape to house a medical instrument guide ball resting on a friction surface located within the body base component. The surface of the guide body upper component includes a cut out working area, and a surface of the medical instrument guide ball is exposed by the cut out working area. A medical instrument port is arranged on a truncated surface of the medical instrument guide ball, and a medical instrument may be passed through the medical instrument port. The medical instrument guide ball permits the medical instrument to be moved in three dimensions. The medical instrument port permits the medical instrument to be advanced into a patient.

Abstract: A surgical end effector includes a clevis and two jaws pivotally coupled to the clevis. A wire is coupled to each jaw and extended through a guide way in the other jaw and through an end of the clevis. The jaws may be opened and closed by pushing and pulling on the two cables. Pulling on each wire creates a closing force in both jaws. A rocking pin may be pivotally supported by the clevis and pivotally coupled to the jaws to constrain the jaws to have opposite motions. The clevis may be coupled to an elongate shaft and the wires extended through the shaft to provide an endoscopic instrument. A wire guide may support the wires in the shaft such that they are able to transmit a compressive force without buckling. The wires may carry electricity to the jaws for electrocautery.

Abstract: A mechanical interface for a robotic medical instrument permits engagement of the instrument and a drive system without causing movement of an actuated portion of the instrument. An instrument interface can include a symmetrical, tapered or cylindrical projection on one of a medical instrument or a drive system and a complementary bore in the other of the drive system or the medical instrument. Symmetry of the projection and the bore allows the projection to be compression fit to the bore regardless of the rotation angle of the drive system relative to the medical instrument.

Abstract: In one implementation, a method is disclosed in which a lock sensing mode is entered for a robotic surgical instrument. In the lock sensing mode, the degrees of freedom of movement in the robotic surgical instrument are switchably reduced. Further in the lock sensing mode, one or more end effectors of the robotic surgical instrument are switchably clamped together in the robotic surgical instrument. An increased level of torque may also be applied to the end effectors to increase a gripping force applied by the one or more end effectors in response to the reduced degrees of freedom of movement in the robotic surgical instrument.