Abstract: A method of fusing a first bone and a second bone. An abrading and harvesting device is provided that includes a needle portion having a sharpened tip. The needle portion has a central bore extending therethrough. The needle portion has a proximal end and a distal end. The sharpened tip is attached to the distal end of the needle portion. A probe is provided having an unsharpened tip portion. The probe is extended between the first bone and the second bone. The needle portion is extended over the probe by passing the proximal end of the probe through the central bore. The first bone and the second bone are abraded with the sharpened tip to cause bleeding bone to be exposed on the first bone and the second bone. A device is placed along a path formed by the needle portion between the first bone and the second bone.

Abstract: Devices and methods to stabilize an eye and suture with wound visibility are shown. In selected examples, a forceps is shown that includes one or more transparent projections. In use, the one or more transparent projections can be concurrently pressed against the wound while holding an eye stable with gripping surfaces of the forceps. The one or more transparent projections and the gipping of the forceps work together to aid in a suture placement.

Abstract: A tool having a detectable wireless marker or tag is provided. The tool has a working portion with a projection or tang by which the working portion of the tool is held, a wireless tag located on, but insulated from the tang, and a handle disposed over and encompassing the projection or tang and the wireless tag. In an exemplary embodiment, the wireless tag is insulated from the tang using a housing assembly made up of an inner holder, an outer holder, and the detectable wireless tag positioned between the inner and outer holders. The invention allows for the use of fragile markers or tags, which are protected by the housing assembly from temperatures and pressures used during, for example, tool handle manufacturing processes. Also provided is a method for providing a tool with a detectable wireless tag, and a method for tracking and tracing tools used within a packaging facility.

Abstract: A deployment mechanism for selectively deploying and retracting an energizable member and/an insulative member relative to an end effector assembly of a surgical instrument includes one or more actuators, a clutch assembly, and a drive assembly. The clutch assembly is configured to couple to the actuator(s) to provide rotational motion in the first direction in response to such rotation of the actuator(s) and to decouple from the actuator(s) in response to rotation thereof in the second direction. The drive assembly is operably coupled to the clutch assembly and is configured to convert the rotational motion provided by the clutch assembly into longitudinal motion to translate the energizable member and/or insulative member from a storage position to a deployed position and to translate the energizable member and/or the insulative member from the deployed position back to the storage position.

Abstract: An apparatus for operating on tissue includes a body assembly, a shaft, an acoustic waveguide, and an end effector. The end effector includes an ultrasonic blade, a clamp arm, and a blade guard. The ultrasonic blade is in acoustic communication with the waveguide. The clamp arm is configured to pivot toward and away from the ultrasonic blade. The clamp arm has a first tine. The blade guard extends from the shaft. The blade guard has a longitudinally extending arm defining a concave pathway and a second tine located distal to the longitudinally extending arm. The ultrasonic blade is partially housed within the concave pathway. The first tine and the second tine are configured to grasp tissue when the clamp arm pivots toward the ultrasonic blade.

Abstract: A medical instrument with excellent operability is provided. The medical instrument includes stick-shaped extra-narrow metal members. The extra-narrow member has a hardened layer formed on the surface thereof without losing flexibility.

Abstract: An insertable robot for minimally invasive surgery includes a tube array having a guide tube housed within a straightening tube. The guide tube includes a curved working end. The guide tube may be axially translated and rotated relative to the straightening tube such that the curved working end is constrained inside the straightening tube, causing the curved working end to achieve a smaller dimension. The tube array is inserted into a working channel on an endoscope, resectoscope or trocar. Once the tube array is inserted, the curved working end of the guide tube is translated forward beyond the distal end of the working channel, allowing the curved working end to return to its pre-formed shape. A surgical tool is inserted through the guide tube for an operation. The straightening tube allows the guide tube curved working end to be temporarily straightened during insertion and removal of the tube array.

Abstract: An obturator includes a unitary body having an elongate portion, a handle portion formed on a proximal portion of the elongate portion, and a piercing tip formed on a distal portion of the elongate portion. The obturator further includes a section of heat shrink tubing received about the handle portion of the unitary body. A method of assembling an obturator includes selecting an obturator body having a unitary structure and having a handle portion, placing a section of heat shrink tubing about the handle portion of the obturator body, heating the section of heat shrink tubing to shrink the tubing about the handle portion, and trimming the section of heat shrink tubing.

Abstract: Disclosed embodiments provide a biopsy tool and methodologies for obtain biopsies and/or a tool and methodology that may be used to add material to a subject's tissue.

Abstract: Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

Abstract: The present invention relates to a sensor applicator assembly for a continuous glucose monitoring system and provides a sensor applicator assembly for a continuous glucose monitoring system, which is manufactured with a sensor module assembled inside an applicator, thereby minimizing additional work by a user for attaching the sensor module to the body and allowing the sensor module to be attached to the body simply by operating the applicator, and thus can be used more conveniently. A battery is built in the sensor module and a separate transmitter is connected to the sensor module so as to receive power supply from the sensor module and be continuously used semi-permanently, thereby making the assembly economical. The sensor module and the applicator are used as disposables, thereby allowing accurate and safe use and convenient maintenance.

Abstract: The present disclosure relates generally to the field of medical devices and establishing access to the renal capsule. In particular, the present disclosure relates to devices and methods for performing a percutaneous nephrolithotomy (PCNL) procedure accurately and efficiently while minimizing exposure of the medical professional to harmful radiation.

Abstract: A female urethral catheterization assist device and method of use. The female urethral catheterization assist device includes a pair of lateral arms pivotally connected at a middle point that enables a user to selectively open and close the lateral arms. A handle is positioned at one end of each lateral arm and a paddle is disposed at an opposing end. The paddles extend in the same direction and form an interior lateral side. Each paddle is adapted to engage with a labia minora and majora, to allow for the insertion of a female urethral catheter.

Abstract: In some embodiments, a microsurgical instrument includes a trocar having a rigid, hollow shaft formed with a lumen extending from a proximal end to a distal end of the shaft. The distal end of the shaft may be shaped for tissue penetration. The instrument may further include a composite microcannula slidably engaged with the trocar in the lumen. The microcannula includes a light guide and a flexible hollow tube having an outer diameter less than an inner diameter of the lumen in the trocar. Other embodiments include placing the microcannula in the lumen of the trocar, illuminating the end of the trocar by illuminating the end of the microcannula, advancing the trocar from a selected entry point on an eye into a selected structure in the eye, and extending the illuminated end of the microcannula from the trocar into the selected structure.

Abstract: An optical obturator apparatus includes an obturator sleeve defining a longitudinal axis and having a longitudinal bore for receiving surgical instrumentation and a transparent window mounted to the obturator sleeve and being dimensioned and configured to pass through tissue. The transparent window is mounted for movement between a first position in general alignment with the longitudinal axis of the obturator sleeve and a second position radially displaced from the longitudinal axis to thereby expose the longitudinal bore of the obturator sleeve to permit passage of the surgical instrumentation. The transparent window may include a cutting blade, or alternatively two cutting blades, adapted to penetrate tissue.

Abstract: Methods and systems are disclosed for accessing and treating the interior of the facet joint for vertebral distraction and immobilization. The systems include a number of tools that facilitate access to the facet joint, distraction of the articulating decortication of the articulating surfaces, and delivery of implants and agents into the facet joint for fusion.

Abstract: A core needle biopsy device includes a body, a needle assembly and a drive assembly. The needle assembly extends distally from the body and includes a hollow piercer and a hollow cutter. The piercer is disposed within the cutter. The cutter includes a distal tip and a swaged portion proximate the distal tip. The drive assembly is configured to selectively cock and fire the piercer and the cutter.

Abstract: A connection member for connecting a surgical tool to a plurality of different kinds of corresponding connector. A surgical tool including the connection member. A surgical kit including the surgical tool. The connection member includes an elongate shaft having a longitudinal axis, a proximal end and a distal end. The connection member also includes a plurality of connection features located at the proximal end of the shaft. The plurality of connection features includes at least one connection feature for mating with a first kind of corresponding connector. The plurality of connection features also includes at least one connection feature for mating with a second, different kind of corresponding connector. The connection member may be a male connection member and the corresponding connectors may be female. A method including providing the surgical tool and connecting the connection member to a corresponding connector.

Abstract: A system for fracturing a frame of a deployed prosthesis with ultrasonic vibration includes a shaft, a tip assembly, an ultrasonic electric generator, and an ultrasonic transducer. The shaft includes a proximal portion and a distal portion. The tip assembly is coupled to the distal portion of the shaft. The tip assembly includes a cutting edge. The ultrasonic transducer is electrically coupled to the ultrasonic generator. Ultrasonic vibration generated by the ultrasonic transducer is translated to the tip assembly. The cutting edge of the tip assembly is configured to focus the vibration of the tip assembly onto a frame of a deployed prosthesis to fracture the frame of the prosthesis. The ultrasonic transducer may be coupled to the proximal portion or the distal portion of the shaft.

Abstract: Described herein is an anti-skid surgical instrument for use in preparing holes in bone tissue. The disclosed surgical instrument provides the ability to prepare a precise hole in bone tissue during surgery (e.g., spinal surgeries and pedicle screw placement, intramedullary screw placement). The disclosed surgical instrument accomplishes precise hole placement regardless of whether the angle between the drill axis and surface of the bone tissue is perpendicular. The disclosed technology includes a flat drilling surface which is perpendicular to the surface of the body of the surgical instrument. This reduces the likelihood of the surgical instrument skidding on the surface of the bone tissue and thereby increases the precision of the hole.

Abstract: A method and device for perforating an aortic valve to remove excessive calcium deposits on aortic valve leaflets improves the implantation of TAVI replacement valves in patients. By removing excessive calcium deposits, the radial pressure exerted by implanted TAVI replacement valves is reduced, such that there is less blood leakage around the valve and less stress on the cardiac conductive system. A device with a collapsible punch is inserted into the aortic valve. The punch is separable such that the aortic valve leaflets are positioned between at least two elements of the punch. The two elements then compress together with the leaflets between them, causing the aortic valve to be perforated. A circumferential ring of the remaining aortic valve and calcium deposits are left to provide stability for the TAVI replacement valve.

Abstract: Disclosed are devices and methods for creating a bore in bone. The devices and methods described involve driving a rotating bit in an axial direction such that both rotation and linear movement are controlled and measurable. The instrument is useful for a surgeon to control and simultaneously measure the travel of the tool into the bone and prevent injury to surrounding structures.

Abstract: An apparatus for releasably holding a surgical tool having a body, the body having a longitudinal axis, a monolithic construction, and a shape apportioned to be grasped by a human hand, with body further having a tool engaging portion, a hand receiving portion, and a button pressing portion. A longitudinal bore is disposed along the longitudinal axis of the body, and on one end. A transverse bore is disposed through the body into the longitudinal bore, with the transverse bore disposed such that the longitudinal axis of the transverse bore intersects the longitudinal axis of the longitudinal bore. A button disposed on and pivotably attached at a resilient member to the button pressing portion of the exterior of the body, with the button being proximal to the tool engaging portion. The button has a button bore and a boss extending from the button bore into the transverse bore which is alignable with the longitudinal bore.

Abstract: A surgical device may include a tube and a cutting blade movable between a first position in which the cutting blade is concealed inside the tube and a second position in which the cutting blade is exposed through a sidewall of the tube.

Abstract: A system for closing a blood vessel includes a housing having a proximal end and a distal end and configured to be held in the hand of a user, an elongate body extending from the distal end of the housing, a distal housing having a proximal end coupled to a distal end of the elongate body and having a cavity including an opening on a side of the distal housing, a lumen passing through the elongate body and terminating at the cavity of the distal housing and configured to couple to a vacuum source, a sensor carried by the distal housing adjacent the cavity and configured for identifying a blood vessel, wherein the lumen is configured to maintain a vacuum within the cavity when a probe having a vessel closure module is inserted within the lumen and the vessel closure module is within the cavity.

Abstract: A bone cutting surgical instrument includes features to mitigate heat generation during use. Excessive heat can be detrimental to bone health as well as to the instrument itself. In one example a liquid dispensing feature provides a flow of cooling liquid to an ultrasonic blade via a lumen in a waveguide of the instrument. In another example, the blade has a serrated edge with a plurality of teeth arranged in a pattern to provide dimension and space during cutting actions. In another example, the blade has an oversize distal portion that creates an oversize slot when cutting to avoid excessive contact between the cut bone and proximal portions of the blade. In another example the blade includes an irrigation slot and also a micro slot in a distal end of the blade that connects with the irrigation slot.

Abstract: A surgical tool-piece and a coupling mechanism for a surgical tool-piece are provided. The surgical tool-piece is configured to be driving by a driving mechanism. The surgical tool-piece comprises a shaft having a longitudinal axis running from a distal end of the shaft to a coupling portion at a proximal end of the shaft. The coupling portion comprises a driving section comprising at least three indentations located around the circumference of the coupling portion, each indentation being configured to receive a corresponding driving element of the driving mechanism to secure the tool-piece both longitudinally and rotationally.

Abstract: A fluid diversion device configured in accordance with embodiments of the present technology can include, for example, a housing including channels configured to receive respective tubes, and a bore that extends laterally across the plurality of channels. The device can include an occlusion member disposed in the bore, where rotation of the occlusion member selectively occludes either a first subset of tubes or a second subset of tubes. The device can include an actuator that enables rotation of the occlusion member to a first position and a second position such that the first subset of tubes and the second subset of tubes are alternatively occluded in the first position or the second position for fluid communication in different directions relative to chambers of a delivery device operable to deploy and recapture the medical device.

Abstract: A system for cleaning bone that includes a base unit with a motor, a cleaning head with a cleaning element and a mill head with a mill element. Both the cleaning head and the mill head are designed to be coupled to the base unit. Both the cleaning element and mill element have features that facilitate their coupling to the motor. When the cleaning head is attached to the base unit, a motor in the base unit rotates the cleaning element to remove soft tissue from the bone so as to clean the bone. The mill element is placed on the base unit and the cleaned bone placed in the mill head. The actuation of the base unit motor results in the actuations of the mill element. The actuation of the mill element converts the cleaned bone into bone chips.

Abstract: A surgical device includes a cannula for use in combination with one or more surgical implements. The cannula includes a base member at a proximal end, a sidewall connected to the base member; and a bore defined by the base member and the sidewall. The sidewall further has an opening into the bore between axially-extending edges of the sidewall. The base member includes a combination track including a first section and a second section. The first section is an opening through the base member into the bore and the second section is an opening into an action area outside of the bore and radially between the edges of the sidewall. The combination track is configured to slidably receive a first surgical implement through the first section and into the bore and slidable receive a second surgical implement through the second section and into the action area.

Abstract: A medical system includes an insertion device and an insertion device handle. The insertion device handle has a proximal portion and a distal portion, with a delivery shaft extending from the distal portion. The medical system also includes a medical device, including a spool and a medical device handle. The medical device handle has a central opening, and the spool and the medical device handle are rotatably movable to one another and form a channel. The medical system includes an adapter couplable to a portion of the insertion device handle, and the adaptor includes a post element to be received within the central opening of the medical device handle.

Abstract: A medical device includes an elongated sleeve having a longitudinal axis, a proximal end and a distal end. A cutting member extends distally from the distal end of the elongated sleeve and has sharp cutting edges. The cutting head is formed from a wear-resistant ceramic material, and a motor coupled to the proximal end of elongated sleeve rotate the cutting member. The cutter is engaged against bone and rotated to cut bone tissue without leaving any foreign particles in the site.

Abstract: Embodiments of the invention include drive units and other effective types of movement inducing devices that include load sensing mechanisms capable of giving feedback to a user when a force is being applied to the devices during use. The applied force for which monitoring is provided may be one or more of a lateral force transverse to a longitudinal rotating axis of a surgical blade, burr, or other mechanism, a force applied along the longitudinal rotating axis, and other forces.

Abstract: Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to a medical device. The device can include an elongate core member having a distal portion configured to be intravascularly positioned at a treatment site within a blood vessel lumen, and an interventional element connected to the distal portion of the elongate core member. The interventional element includes a body that is expandable from a first configuration to a second configuration and an electrically conductive radiopaque marker coupled to the body. An electrically conductive lead has a distal portion electrically coupled to the radiopaque marker and a proximal portion configured to be electrically coupled to a current source.

Abstract: An atherectomy system may include an atherectomy apparatus including a drive housing, a catheter shaft extending distally from the drive housing, and a rotatable drive shaft extending within the catheter shaft and operably coupled to the drive housing, the rotatable drive shaft having a guidewire lumen configured to receive a guidewire; and a guidewire management device including: a frame including at least one frame rail extending longitudinally; a movable tray slidably coupled to the at least one frame rail; and a guidewire locking element fixed to the frame. The drive housing may be releasably secured to the movable tray.

Abstract: An endoscopic surgical blade is disclosed. The blade is of a low-profile design, having a downward angled cutting surface that is radiused at its upper end. The blade is part of an endoscopic knife assembly which also contains a knife tube. The endoscopic knife assembly is for use in endoscopic surgery by insertion of the assembly through a slotted cannula. The knife tube is hollow and allows the insertion of an endoscope for viewing of the surgical procedure. A method for a performing an operative procedure on a target tissue in a subject using an endoscopic knife assembly having a low-profile, downward angled blade is also described.

Abstract: An embodiment includes an apparatus for carpel tunnel syndrome surgery. The apparatus comprises: a shaft including a shaft proximal end, a shaft distal end, and a shaft long axis, wherein the shaft distal end comprises a raised edge; a linkage included within the shaft; a blade coupled to a distal end of the linkage; wherein (a)(i) an axis parallel to the shaft long axis intersects the raised edge but does not intersect the shaft, (a)(ii) the raised edge is curvilinear, (a)(iii) the raised edge includes a first lateral edge portion, a second lateral edge portion, and a middle edge portion between the first and second lateral edge portions; and (a)(iv) the first and second lateral edge portions are both proximal to the middle edge portion. Other embodiments are described herein.

Abstract: A mitral valve prosthesis to be implanted in a heart, comprises an asymmetrical ring, the asymmetrical ring is dimensioned to mimic a native mitral annulus of a patient; an anterior flexible leaflet and a posterior flexible leaflet, said leaflets suspended from the asymmetrical ring and configured to substantially coapt with each other; and at least four sets of cords, each set of cords attached to the anterior or posterior leaflet on a first end and attached into a cap on a second end, the cap is configured to be attached onto papillary muscles of the heart on another end of the cap.

Abstract: A medical knife has a flat projection shape of a cutting part formed in an approximate rhomboid shape including a front end part, a widest part with the largest width, and a side surface part formed between the front end part and the widest part. A front side bevel constituting an edge on the front side and a back side bevel constituting an edge on the back side are individually formed, having as a boundary a virtual surface including an edge formed along the periphery of the cutting part. A ratio of the angle ? between the virtual surface and the back side bevel to the angle ? between the virtual surface and the front side bevel at the front end part is greater than the ratio of the angle ? between the virtual surface and the back side bevel to the angle ? at the side surface part.

Abstract: A flushable catheter device has an outer tube with a first distal end opening to be introduced into a blood vessel and defining a first lumen. An inner tube is disposed in the first lumen with a second distal end opening proximally spaced from the first distal end opening and defining a second lumen. A space axially disposed between the end openings defines an outflow/inflow inhibiting portion which inhibits a flow of fluid out from the first lumen into the into the vessel as a result of a perfusion of a flushing fluid being supplied through the first lumen and into the second lumen.

Abstract: A manual tool includes a support (1) with stops (20) on which the carving elements (2) are arranged and includes a first central tubular sector (7) having a hollow interior; second lateral sectors (10); wings (11) facing each other that start from each of the second sectors (10); a recess (12) between both wings (11), for housing the carving element (2); and a rotating part (16) mounted between the wings (11), that includes two couplings (15) and two housings (17) and (18), in which the rotating part (16) is rotatory between a first position in which the carving element (2) linked to the first housing (17) while the carving element (2) linked to the second housing (18) is oriented inwards the recess (12) and a second position in which the carving element (2) of the first housing (17) is oriented inward toward the recess (12).

Abstract: A personal appliance. The personal appliance includes a handle having an implement connecting structure. An implement is connected to the implement connecting structure. An implement displacement sensor is associated with the handle. The implement displacement sensor measures a displacement of the implement relative to a fixed position of the handle. A power source, an acceleration sensor and an angular velocity sensor are associated with the handle.

Abstract: A surgical instrument includes a handle assembly; a shaft assembly and an end effector. The shaft assembly includes an exterior shaft, a first clutch positioned within the exterior shaft to drive a first function of the surgical instrument when engaged. A second clutch within the exterior shaft to drive a second function when engaged. A rotary driver is positioned within the exterior shaft and configured to rotate within the exterior shaft. The rotary driver includes a first clutch engagement mechanism to engage the first clutch and a second clutch engagement mechanism configured to engage the second clutch independent of the first clutch engagement mechanism engaging the first clutch, such that, at different times both the first clutch and the second clutch are engaged simultaneously only the first clutch is engaged only the second clutch is engaged and neither the first clutch nor the second clutch is engaged simultaneously.

Abstract: Aspects of the disclosure are directed to methods and/or apparatuses involving the deployment and coupling of catheters. As may be implemented in accordance with one or more embodiments, each of first and second catheters extend from a proximal end to a distal end and has a magnet. The catheters may be deployed, and the distal ends of the respective catheters can be aligned and connected via magnetic coupling of the magnets to one another. A shaft structure is configured and arranged to extend within the first catheter and into the second catheter, through the connected distal ends of the respective catheters.

Abstract: A robotic surgical tool includes a tool driver, a drive housing mountable to the tool driver and including one or more component parts made of or including a magnetically responsive material, a first inductor coil included on the tool driver and configured to generate a magnetic field, and a second inductor coil included on the drive housing and configured to measure an intensity of the magnetic field and a field distortion caused by the one or more component parts. A change in the field distortion provides an indication of movement of the one or more component parts.

Abstract: A forceps includes jaws, a first shaft having a first slot, a second shaft extending along the first shaft and having a second slot, and a rod that extends along the second shaft. The rod has a third slot including a locking portion and a guide track portion. A pin extends through the first slot, the second slot, and the third slot to prevent deployment of the rod when the pin is in the locking portion and to permit deployment of the rod when the pin is in the guide track portion. A first actuator produces relative movement of the first and second shafts to move the jaws relative to each other and move the pin from the locking portion to the guide track portion of the third slot. A second actuator produces movement of the rod to deploy the rod when the pin is in the guide track portion.

Abstract: An electronic forceps system includes a handle including a pair of pivotable arms distally extending from a proximal end of the handle, at least one arm of the pair of arms having an electrically-conductive arm element connectable to a power source, wherein each arm of the pair of arms comprises a respective pair of arm interfaces, and the electrically-conductive arm element extends to at least one interface of the pair of interfaces. Also provided is a pair of tips, at least one tip of the pair of tips having an electrically-conductive tip element, wherein each tip has a tip interface configured to removably connect to a respective arm interface, each tip has a distal working surface, the electrically-conductive tip element is configured to removably and electrically connect to the electrically-conductive arm element, the electrically-conductive tip element is connected to a heater.

Abstract: A surgical knife safety device having a handle, a blade connected to the handle, and a guard carried by the handle for sliding movement between a retracted position in which the blade is exposed for use, and an extended position for covering the sharp cutting edge of the blade. In the retracted position, an enlarged guard radius is provided at the distal end of the handle to allow improved handle control and blade orientation. The enlarged guard radius is positioned to allow the user to firmly grip a large distal handle portion which is preferably molded as a single piece with the blade holder, preventing unwanted blade or handle movement due to guard mechanism tolerances.

Abstract: Provided is a spiral soft tissue biopsy needle, comprising a puncture needle rod (1), a sampling needle rod (2), and a hand shank (3) for fixing the puncture needle rod (1) and the sampling needle rod (2), wherein the sampling needle rod (2) comprises a spiral needle rod (21) for fixing the sampling site and a cutting needle rod (22) for separating the sample from the sampling site, the spiral needle rod (21) has a hollow structure, the front end of the spiral needle rod (21) is provided with a spring spiral tube (211), and the front end of the cutting needle rod (22) is provided with a cutting edge (221). The spiral soft tissue biopsy needle of the present invention can improve the success rate of one-time sampling and achieve a multi-point sampling in different positions.

Abstract: Surgical instruments having a rotary drive that can selectively actuate multiple end effector functions are described herein. In at least one embodiment, a surgical instrument includes a shaft, an end effector coupled to the shaft, a rotatable drive shaft coaxially disposed within an inner lumen of the shaft, and a plurality of selectively engageable clutches configured to transfer torque from the rotatable drive shaft to the end effector. Each of the clutches is configured to convert the rotation of the drive shaft into one of a plurality of movements of the end effector relative to the outer shaft.