Abstract: The embodiments disclosed herein are breakaway suture constructs containing releasable locking connections and/or methods of assembly that allow a plurality of sutures, and/or suture ends to be attached or connected together along a portion of their length to form a spliced region that unifies the sutures or suture ends and prevent movement of a suture end relative to other suture end. The releasable connections allow the surgeon to easily manipulate the spliced suture ends with little or no force to result in the unified ends of the sutures to be separated without requiring cutting or severing of the individual sutures or the releasable locking connections.

Abstract: A tissue fixation system including a delivery tube and an elongated fastener with a loop at a proximal end and a distal end, A proximal end of an elongated curved needle is attached to the delivery tube. A distal end of the needle is configured to penetrate tissue. The needle includes an open channel sized to receive the elongated fastener with the loop located near the proximal end of the elongated curved needle and the distal end of the elongated fastener located near the distal end of the elongated curved needle. A capture needle is slidably positioned in the delivery tube to slide through the loop in the proximal end of the elongated fastener. The capture needle is configured to grasp the distal end of the elongated fastener and pull the distal end of the elongated fastener through the loop to cinch the elongated fastener.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods that include a cord that is flexible and elongated defining a length. The cord may include a core having a porous surface and a porosity-reducing element on at least a portion of the core.

Abstract: An arthroscopic staple used by a surgeon to arthroscopically fixate the tendon of the long head of the biceps brachii in-situ to the humerus within the bicipital groove when performing an arthroscopic high supra-pectoral biceps tenodesis is provided. The arthroscopic staple includes a cylindrical body, and the top of the cylindrical body includes a center aperture formed by a central vertical cavity located at the center of the cylindrical body. The cylindrical body includes a first aperture and a second aperture formed by a first vertical cavity and a second vertical cavity radially displaced from the center of the cylindrical body and a pair of protrusions located on the underside of the cylindrical body. Each of the protrusions includes a sharp point and at least one barb.

Abstract: An orthopedic implant system can be used to fixate two bones (e.g., to portions of a single bone) relative to each other during a surgical procedure. In some configurations, the implant system includes a staple having at least two legs separated by a bridge. The staple can include at least two couplings on either side of the bridge accessible through a top surface of the staple connectable to two corresponding coupling shafts. The coupling shafts can attach through the top surface of the staple without extending below an underside of the staple. The coupling shafts can be used to bias the at least two legs of the staple away from each other for insertion into holes formed into two bones. By attaching the coupling shafts through the top of the staple, the staple can be inserted flush with the two bones before releasing the shafts.

Abstract: An orthopedic implant system can be used to fixate two bones (e.g., to portions of a single bone) relative to each other during a surgical procedure. In some configurations, the implant system includes a staple having at least two legs separated by a bridge. The staple can include at least two couplings on either side of the bridge accessible through a top surface of the staple connectable to two corresponding coupling shafts. The coupling shafts can attach through the top surface of the staple without extending below an underside of the staple. The coupling shafts can be used to bias the at least two legs of the staple away from each other for insertion into holes formed into two bones. By attaching the coupling shafts through the top of the staple, the staple can be inserted flush with the two bones before releasing the shafts.

Abstract: A method of operating a surgical instrument is disclosed. The surgical instrument includes an electronic system comprising an electric motor coupled to the end effector; a motor controller coupled to the motor; a parameter threshold detection module configured to monitor multiple parameter thresholds; a sensing module configured to sense tissue compression; a processor coupled to the parameter threshold detection module and the motor controller; and a memory coupled to the processor. The memory stores executable instructions that when executed by the processor cause the processor to monitor multiple levels of action thresholds and monitor speed of the motor and increment a drive unit of the motor, sense tissue compression, and provide rate and control feedback to the user of the surgical instrument.

Abstract: Implantable materials for use with end effectors like surgical stapling devices, and methods for using the same, are generally provided. In some embodiments, adjunct materials for use with surgical staplers are provided. For example, a kit for stapling tissue is provided that can include a surgical stapler having an end effector. The end effector can have first and second jaws. The kit can include an adjunct material having hydrophobic surface regions and hydrophilic surface regions and the adjunct material can be configured to mate to at least one of the jaws of the end effector. Other implants, devices, and methods for surgical stapling are also provided.

Abstract: A surgical instrument has a staple cartridge housing a plurality of staples and an anvil configured to capture tissue therebetween. The surgical instrument also has a firing assembly configured to deploy the plurality of staples into the captured tissue during a firing sequence, and a handle that includes an electric motor operably coupled to the firing assembly, wherein the electric motor is configured to motivate the firing assembly to deploy the plurality of staples into the captured tissue during the firing sequence, and a power pack. The power pack includes rechargeable battery cells configured to power the electric motor, at least one battery-cell health indicator, and an electronic control circuit configured to assess whether a subset of rechargeable battery cells is damaged during the firing sequence based on at least one measurement performed by the at least one battery-cell health indicator.

Abstract: A surgical stapling device includes a tool assembly having a U-shaped frame, an anvil assembly, and a cartridge assembly. The cartridge assembly includes a knife that is movable between retracted and advanced positions. The anvil assembly is supported on the distal frame portion and includes a cutting plate and an anvil plate. The cutting plate is positioned between the distal frame portion and the anvil plate and is engaged by the knife as the knife moves from the retracted position towards the advanced position. The cutting plate is formed of a material that deforms locally and structurally upon engagement with the knife.

Abstract: A surgical stapler includes a first half having a first elongate member and a surface with staple forming pockets. The stapler also includes a second half for releasably coupling with the first half and including a second elongate member having a distal portion for deploying staples. The elongate members are pivotable relative to each other about a pivot axis when the halves are releasably coupled. The stapler further includes a latching member for selectively clamping the halves in a clamped state. The stapler also includes a detent member extending laterally from one of the halves toward the other. The stapler further includes a shoulder member positioned on the other of the halves and configured to selectively engage the detent member in response to rotation of the first elongate member away from the second elongate member to an open state in which the elongate members assume a maximum angular orientation.

Abstract: A surgical instrument is disclosed comprising an end effector including a first jaw and a second jaw, wherein the first jaw is rotatable relative to the second jaw, and a closure system configured to close the first jaw during a closure stroke. The surgical instrument further comprises an articulation joint rotatably connecting the end effector to the shaft, an articulation system configured to articulate the end effector relative to the shaft, and a firing system operably engaged with the electric motor, wherein the firing member is configured to move through the end effector during a firing stroke. The surgical instrument further comprises a first rotatable member configured to selectively synchronize the motion of the firing system with the motion of the articulation system and a second rotatable member operably engageable with the articulation system, wherein the closure system is configured to stop the rotation of the second rotatable member.

Abstract: The present disclosure provides a surgical instrument, such as a tissue sealing instrument, with an elongate shaft and an end effector movably coupled to the shaft with a joint or wrist assembly. The wrist assembly includes a first outer link, a second outer link, and an inner link. The first outer link is connected to the elongated shaft and movably coupled to the second outer link by the inner link. The inner link includes a pair of posts, and the first and second outer links each include a recess configured to receive a respective one of the pair of posts. The posts and recesses defining a rocking hinge, which permits the wrist assembly to accommodate a reduction in the size of the rolling radius to reduce the likelihood of grabbing and pinching tissue during articulation of the end effector without sacrificing the internal bend radius of the hinge joint.

Abstract: An assembly includes an applicator, which includes a housing defining a gap configured to receive an end effector jaw of a surgical stapler. The applicator also includes a platform positioned within the gap. The assembly also includes a buttress assembly having a first length and positioned on the platform. The assembly further includes a trimming feature presented by the applicator or the buttress assembly, and configured to facilitate trimming of the buttress assembly from the first length to a predetermined second length.

Abstract: A device for laparoscopically approximating edges of a tissue opening toward each other for surgical attachment, the device including a first tissue engaging component, and a second tissue engaging component, a spreader component for moving the first tissue engaging component away from the second tissue engaging component, and a control for moving the first tissue engaging component away from the second tissue engaging component. Related apparatus and methods are also described.

Abstract: An anastomosis background device for surgical work-holding during the suturing of a vessel, the device comprising: a base for placement on a surgical site; at least one attachment point provided on the base for attaching at least one clamp for clamping a vessel to be sutured; and a guide structure provided on the base and positioned relative to the at least one attachment point for guiding a suture thread used in the suturing of the vessel to be sutured.

Abstract: An easily detachable connection of a hollow cylindrical component, such as a graft, at a recess in tissue, such as a heart or a blood vessel, an annular element, a guide element and a spring element are provided, which are secured by way of a suture ring at the body part and at the hollow cylindrical component, and which permit an easily disengagable mutual locking by way of the spring element. To this end, the annular element comprises a groove extending around the periphery thereof, into which the spring element plunges for locking.

Abstract: A system for delivering an implant device to a vascular site in a patient a delivery pusher apparatus, an implant device detachably connected to the delivery pusher apparatus by a tether having a distal end connected to a proximal end of the implant device, wherein the tether is substantially non-tensioned when connecting the implant device to the delivery pusher, and an electrical heating element configured coaxially around at least a portion of the tether, wherein heat generated by the heating element severs the tether at a point near the proximal end of the implant device.

Abstract: A medical implant for occluding a left atrial appendage may include an expandable framework configured to shift between a collapsed configuration and an expanded configuration. The expandable framework may include a plurality of interconnected struts and a plurality of anchor members extending radially outward from the plurality of interconnected struts in the expanded configuration. Each anchor member of the plurality of anchor members may include a base portion fixedly attached to the plurality of interconnected struts and an anchor tip portion. The anchor tip portion may include a central penetrating element and at least one tissue support element extending outward from the central penetrating element. The at least one tissue support element may be configured to be non-penetrating.

Abstract: A system includes a clip having a pair of clip arms, proximal ends of the clip arms received within a channel of a capsule to be moved between an open configuration and a closed configuration. A proximal end of the capsule including a plurality of connecting elements extending proximally therefrom. Each of the connecting elements including a hook along a proximal portion thereof. An applicator includes an elongated flexible member and a control member extending therethrough, the control member configured to be connected to the clip arms to move the clip assembly between the open and closed configurations, the elongated flexible member including a bushing including a first ramped portion and a necked portion extending proximally from the first ramped portion, a proximal end of the first ramped portion including a lip configured to engage the hook when the connecting elements are crimped thereover.

Abstract: A hemostatic device is disclosed, which includes a tube fixing portion that is provided to a fixing member which fixes an inflatable member. The tube fixing portion includes a first member, a second member that is located closer to the inflatable member than is the first member, a slit portion, and a tube holding portion. A part of the first member is further away from the inflatable member than is the second member in a direction perpendicular to a virtual plane defined by the slit portion. A first distal-end surface includes a first region not facing a second distal-end surface, and a second region facing the second distal-end surface. A first curved portion has a first curved surface curved toward the second member and facing the second distal-end surface.

Abstract: A method of operating a surgical system includes controlling a robotic arm in a first control mode in which the robotic arm constrains movement of a surgical tool coupled to the robotic arm to a virtual geometry correlated with an anatomical feature, switching, responsive to the surgical tool crossing an exit boundary, from the first control mode to a second control mode, and controlling the robotic arm in the second control mode in which movement of the surgical tool is unconstrained by the virtual geometry.

Abstract: A reversible compressor-distractor device may be used during a surgical procedure, such as a surgical procedure to correct a bunion deformity. In some examples, the reversible compressor-distractor is configured to be interchangeably used on right and left feet by reversing the orientation of the compressor-distractor. For example, the compressor-distractor may include a first engagement arm having at least two oppositely orientated pin-receiving holes on different sides of the engagement arm. The compressor-distractor may also include a second engagement arm having at least one pin-receiving hole. In use, the clinician can select an orientation of the compressor-distractor and engage pin-receiving holes associated with the selected orientation.

Abstract: Devices and methods for performing total knee arthroplasty procedures with kinematic alignment are described herein. A method of performing a total knee arthroplasty can comprise positioning a femoral cut guide adjacent a distal end of a femur, positioning a tibial cut guide proximate a proximal end of a tibia adjacent an anterior surface of the tibia, adjusting a position of the femoral cut guide and the tibial cut guide relative to each other using a tibial positioning device, fixing the position of the femoral cut guide relative to the tibial cut guide using the tibial positioning device, and resecting the femur and tibia with parallel resections using the femoral and tibial cut guides.

Abstract: A surgical system including a machining tool aimed at being manually displaced by an operator, a lockable unit including at least two linked and manually displaceable elements aimed at being manually arranged according to a least one calculated locked configuration, a sensor unit including at least one sensor aimed at following, in real time, a real time configuration of the lockable unit within an anatomical reference system, where the at least two elements of the lockable unit cooperate with lockable element, the lockable element being configured to be activated by a control unit when the real time configuration of the lockable unit corresponds to the at least one locked configuration recorded inside the control unit.

Abstract: Provided are a bone cutting tool assembly for artificial joint surgery. The assembly comprises a guide unit including a body having at least one guide slit and an anchor configured to extend from a side of the body, having a plurality of pin insertion holes; and a length measuring unit including a reference module having a slit insertion part inserted into the guide slit and a moving guide part extending in a direction perpendicular to a surface of the slit insertion part, and a position variable module slidingly coupled to the reference module through the moving guide part.

Abstract: A powered surgical handpiece system including a cutting accessory having a shaft extending along an axis and having a distal tissue working member and a proximal section. The proximal section includes retention features and a flat. The system includes a drive shaft having a bore for receiving the proximal section of the cutting accessory. A collet attached to the drive shaft includes a base, a leg, and a foot. The collet rotates with the drive shaft and the foot seats against the shaft of the cutting accessory. A lock assembly selectively moves the foot of the collet from a run state and a load state. An alignment collar has a non-circular opening such that when the flat of the shaft of the cutting accessory presses against a planar surface of the alignment collar, retention features are aligned with the foot of the collet.

Abstract: A method of adjusting velocity in a motorized surgical instrument is provided. The surgical instrument comprises a displacement member configured to translate within the surgical instrument over a plurality of predefined zones, a motor coupled to the displacement member to translate the displacement member, a control circuit coupled to the motor, a position sensor coupled to the control circuit, the position sensor configured to measure the position of the displacement member and a timer circuit coupled to the control circuit, the timer circuit configured to measure elapsed time. The method includes setting a directed velocity of the displacement member; determining an actual velocity of the displacement member; determining an error between the directed velocity of the displacement member and the actual velocity of the displacement member; and controlling the actual velocity of the displacement member based on the magnitude of the error.

Abstract: Orthopedic instalments for removing bone including along an intramedullary canal and methods of their fabrication are disclosed. In one example, the orthopedic instrument can include a body having an exterior surface and can define an interior cavity. The body can have a plurality of channels communicating with the interior cavity from the exterior surface.

Abstract: Disclosed herein are patient-specific cutting guides for guiding a surgical instrument for resecting a portion of a glenoid of a patient. The cutting guides include a base portion having a contact surface shaped to substantially match at least a portion of a cavity of the glenoid. The base portion has a guide hole extending therethrough in which the guide hole has an axis coaxial with an axis of rotation. The cutting guides include one or more stabilization members extending outwardly from the base portion and having a contact surface shaped to substantially match an outer surface of a portion of a scapula of the patient. The stabilization members are oriented to take into account the patient's anatomy in orienting and stabilizing the guide with respect to the glenoid. The guide hole of the base portion is for guiding the surgical instrument to create a guide hole in the glenoid.

Abstract: Provided are a bone cutting guide tool assembly for artificial joint surgery. The assembly comprises a base unit having a through hole, a guide rod inserted into the through hole and being inserted into a bone through a hole drilled at an end of the bone, a positioning unit having a plurality of holes for driving a pin into the bone in contact with the bone, a connection unit mechanically connecting the base unit and the positioning unit so that the base unit and the positioning unit is enabled to slide vertically with each other, and a guide unit having a pin insertion hole to be inserted into the pin and seated on the bone.

Abstract: Systems, techniques, and devices are described that may be used in a minimally invasive bone realignment procedure. In some examples, a method of performing a minimally invasive metatarsal correction procedure involves using a bone preparation guide having a guide surface with a length less than a diameter of a bone to be cut using the guide surface. The clinician can guide a bone preparation instrument along the guide surface and angle the bone preparation instrument beyond one or both ends of the guide surface to cut the end of the underlying bone beyond one or both of the ends.

Abstract: Systems and methods include positioning of a catheter lumen in a first position with respect to a thrombus, the catheter lumen defined by a catheter, initiating of evacuation of a tubing lumen, where the tubing lumen is not in fluid communication with the catheter lumen, determination that a pressure within the tubing lumen is equal to or less than a target aspiration pressure, and, in response to the determination that the pressure within the tubing lumen is equal to or less than a target aspiration pressure, automatic establishment of fluid communication between the tubing lumen and the catheter lumen.

Abstract: A suction pump system for aspirating fluids and other materials from a human body comprises a power source, an aspiration pump, and an electrical motor coupled to the power source and the aspiration pump, wherein the aspiration pump is pulsed at a frequency below 100 Hz.

Abstract: The present teachings provide devices and methods of engaging, capturing, and retrieving emboli. Specifically, one aspect of the present teachings provides a device comprising a generally cylindrical body, with its proximal ends joining to a delivery system and a plurality of cells forming its luminal surface. The cylindrical body is configured to axially rotate as it radially expands. Another aspect of the present teachings provides a device comprising two elongated bodies one disposed within the other. As the device expands radially, both elongated bodies are configured to axially rotate independently.

Abstract: A photoacoustic catheter adapted for placement within a blood vessel having a vessel wall includes an elongate shaft, a balloon and a photoacoustic transducer. The elongate shaft can extend from a proximal region to a distal region. The elongate shaft can include a light guide that is configured to be placed in optical communication with a light source. The balloon is coupled to the elongate shaft, and can be configured to expand from a collapsed configuration suitable for advancing the photoacoustic catheter through a patient's vasculature to a first expanded configuration suitable for anchoring the photoacoustic catheter in position relative to a treatment site. The photoacoustic transducer can be disposed on a surface of the balloon and in optical communication with the light guide. The photoacoustic transducer can include a light-absorbing material and a thermal expansion material.

Abstract: A forceps having a first jaw and a second jaw, where at least one of the first and second jaws is capable of moving between an open position and a closed position. The forceps including an inner shaft located within an outer shaft and extending along the longitudinal axis, and a drive bar coupled to and extending distally from the inner shaft. The drive bar including a pair of drive bar struts extending from a distal portion of the inner shaft and positioned laterally inward of at least one of first and second set of flanges of the first and second jaws. A drive pin is securable to the pair of drive bar struts and the drive bar is translatable within the outer shaft to translate the drive pin to move the first jaw and/or the second jaw between open and closed positions.

Abstract: Provided herein is a mechanism to controllably move a wire within a flexible tubular member, the wire including opposed wire ends extending outwardly of a proximal end of the flexible tubular member, comprising a drive mechanism and a coupling located between the drive mechanism and the wire end, wherein movement of the coupling in the direction of the wire end results in opposed motion of the wire end.

Abstract: Disclosed is an endoscope apparatus. The endoscope apparatus of the present invention includes: an endoscope including a flexible insertion section to be inserted into a human body; a flexible channel attached to the insertion section so that a part forms a passage in a longitudinal direction of the insertion section; and an assistant arm movably inserted into the passage and manipulated by a control device, and the assistant arm includes forceps capable of gripping a human body tissue, and a bending section bent by the control device to pull the human body tissue griped by the forceps.

Abstract: A rotary shaver arrangement for a surgical instrument includes an outer tubular member with a first cutting window at the distal end thereof, an inner tubular member providing a central suction lumen and rotatably mounted in a central passageway of the outer tubular member, and the inner tubular member having a second cutting window at the distal end of the inner tubular member. The first and second cutting windows are arranged such that: (i) when the inner tubular member is rotated to a first range of angular positions, the first and second cutting windows overlap to form an opening of the central suction lumen; and (ii) when the inner tubular member is rotated to a second range of angular positions, the first and second cutting windows do not overlap. The first and/or second cutting window includes a spline-shaped region to permit the second range of angular positions to be greater than if the spline-shaped region was notch-shaped having angular discontinuities.

Abstract: A method of performing a carpal tunnel release procedure on a hand may involve advancing a shaft of a soft tissue cutting device into the hand, positioning a distal end of the shaft at or near a carpal tunnel, sensing a first pressure in the hand, using a pressure sensor of the soft tissue cutting device, moving a blade along the shaft to cut a transverse carpal ligament, and sensing a second pressure in the hand, using the pressure sensor.

Abstract: An in-situ fenestration device. The device includes a sheath, a sonic catheter extending with the sheath and having a cutting tool at a distal section thereof, and a balloon catheter extending within the sonic catheter. The cutting tool of the sonic catheter is configured to cut a fenestration in a graft material at a fenestration site of a stent graft upon being energized with ultrasonic energy at a cutting frequency.

Abstract: Provided is an estimation method executed by a processor of an estimation device. The estimation method includes: acquiring monitor information regarding an electrical characteristic value in an energy treatment tool when non-treatment energy for monitoring is applied to a living tissue from the energy treatment tool; acquiring image information regarding an endoscopic image obtained by imaging the living tissue; and performing estimation regarding thermal invasion in the living tissue based on at least one of the monitor information and the image information and on an output setting value of treatment energy for treating the living tissue with the energy treatment tool.

Abstract: Provided is a system and medical device that includes self diagnosing control switches. The control switch may be slidable within a slot in order to control activation of some function of the medical device. Due to natural wear and tear of movement of a control switch, the distances along the sliding slot that correspond to how much energy is used for the function may need to be adjusted over time in order to reflect the changing physical attributes of the actuator mechanism. The self diagnosing control switches of the present disclosures may be configured to automatically adjust for these thresholds using, for example, Hall effect sensors and magnets. In addition, in some cases, the self diagnosing control switches may be capable of indicating external influences on the controls, as well as predict a time until replacement is needed.

Abstract: An apparatus is provided for scoring a treatment location in a vessel. A catheter includes an expandable element or inflatable balloon for achieving dilatation. A scoring element includes an elongated scoring wire having at least one ring for selective positioning over the inflatable balloon, which may then be inflated to provide scoring function in both a longitudinal and transverse direction. A plurality of the rings may be provided, and may be adapted for use with a variety of different sizes or lengths of balloons. Related methods are also disclosed.

Abstract: Provided herein is a recanalization system including (i) a handle located at a proximal end of the system, (ii) a first elongate member, (iii) a second elongate member, the first and second elongate members being movable relative to each other elongate member, and (iv) a recanalization device located at a distal end of the system. The recanalization device includes (i) a first end portion coupled to the first elongate member, (ii) a second end portion coupled to the second elongate member, and (iii) at least one strut extending between the first and second end portions. The recanalization device is configured to be (i) selectively radially expanded and compressed and (ii) axially moved relative to the first and second elongate members.

Abstract: This application provides a thrombectomy device, including a cutter net and a cutter head. The cutter net is fixed to a front end surface of a catheter. The cutter head is located inside the catheter. A hollowed-out portion is arranged on the cutter net in an axially-penetrating manner. The cutter head is drivable to rotate in the catheter. A front end of the cutter head cooperates with the cutter net to form a cutting structure to excise a thrombus sucked from the hollowed-out portion. The cutting structure includes a first cutter edge and a second cutter edge. When the thrombectomy device is operated, the first cutter edge rotates, the second cutter edge is fixed, and the first cutter edge and the second cutter edge cooperate to excise the thrombus. The thrombectomy device provided by this application has the advantages of good thrombectomy effect and the like.

Abstract: Surgical hub systems are disclosed. A surgical hub system comprises a surgical hub configured to communicably couple to a modular device comprising a sensor configured to detect data associated with the modular device and a device processor. The surgical hub comprises a hub processor, a hub memory coupled to the hub processor. The surgical hub system also comprises a distributed control system executable at least in part by each of the device processor and the hub processor. The distributed control system is configured to: receive the data detected by the sensor; determine control adjustments for the modular device according to the data; and control the modular device according to the control adjustments. When in a first mode, the distributed control system is executed by both the hub processor and the device processor. In a second mode, the distributed control system is executed solely by the device processor.

Abstract: Embodiments of the present disclosure provide a puncture device and a puncture system. The puncture device includes a puncture needle mechanism, a mobile mechanism, and a clamping mechanism. The clamping mechanism is provided on the mobile mechanism and is capable of clamping or releasing the puncture needle mechanism. The puncture device enables a puncture operation to be performed remotely, ensures that image assistance is available in real-time during the puncture operation, and improves the precision, safety, and smoothness of the puncture operation.

Abstract: Provided is an obturator that includes a shaft that is inserted into a cannula and of which a distal end is sharp-pointed in a needle-like shape to be stuck into a body wall, a grip to which a proximal end of the shaft is attached and that is gripped by an operator, and at least two recessed portions that are formed at the grip and on which fingers of the operator are hooked.