Abstract: A bipolar surgical instrument comprises a body, first and second opposed jaws located at the distal end of a shaft, the first jaw being movable with respect to the second jaw between an open position in which the first and second jaws are spaced apart from one another, and a closed position in which the first and second jaws are adjacent one another. The first and second elongate jaw members have respective first and second electrodes. A controller is operable to determine a starting voltage for application to the jaws.

Abstract: A surgical instrument end effector assembly includes a first jaw member defining an insulative tissue-contacting surface and first and second electrically-conductive tissue-contacting surfaces disposed on either side of the insulative surface. A second jaw member of the end effector assembly includes an ultrasonic blade body positioned to oppose the insulative surface of the first jaw member, and first and second electrically-conductive tissue-contacting surfaces disposed on either side of the ultrasonic blade body and positioned to oppose the first and second electrically-conductive surfaces, respectively, of the first jaw member. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position to grasp tissue therebetween.

Abstract: A force limiting apparatus for a surgical instrument to prevent too much force being applied to the jaws of the instrument. The instrument has a body with a drive shaft coupled to a pair of jaws, a bearing tube secured to the drive shaft, and a pair of tracks carrying a pivot pin that is biased into one end of the track. A lever is coupled to the pivot pin and abuts the bearing tube to move the bearing tube and close the jaws when squeezed by a user. If the lever is over actuated, the pivot pin will slide along the track against the bias of the spring assembly with the lever pivoting about the bearing tube rather than the pivot pin. As a result, the additional movement of lever does not result in any addition force being transmitted to the drive shaft via the bearing tube.

Abstract: Systems, devices, and methods for electroporation ablation therapy are disclosed, with the system including a pulse waveform signal generator for medical ablation therapy that may be coupled to an ablation device including at least one electrode for ablation pulse delivery to tissue. The signal generator may generate and deliver voltage pulses to the ablation device in the form of a pulse waveform in a predetermined sequence where the signal generator may independently configure a set of electrodes of an ablation device. The signal generator may further perform active monitoring of a set of electrode channels and discharge excess energy using the set of electrode channels.

Abstract: A boot for an electrosurgical instrument has a conductive boot shield substantially enclosed by one or more insulating layers. The boot shield has a flexible conductive medium. The flexible conductive medium has a plurality of conductive components suspended in at least one of a first liquid or a first gel, whereby the boot is configured to bend with a bend radius of about 10 millimeters or less without a loss in conductivity of the boot shield. A related method and system are also provided.

Abstract: Aspects of the present disclosure are presented for a medical instrument configured to adjust the power level for sealing procedures to account for changes in tissue impedance levels over time. In some aspects, a medical instrument may be configured to apply power according to a power algorithm to seal tissue by applying a gradually lower amount of power over to time as the tissue impedance level begins to rise out of the “bathtub region,” which is the time period during energy application where the tissue impedance is low enough for electrosurgical energy to be effective for sealing tissue. In some aspects, the power is then cut once the tissue impedance level exceeds the “bathtub region.” By gradually reducing the power, a balance is achieved between still applying an effective level of power for sealing and prolonging the time in which the tissue impedance remains in the “bathtub region.

Abstract: A treatment device includes: an end effector that includes a pair of grippers for gripping a target region; a channel for supplying a fluid to the end effector; and a fluid source for supplying the fluid to the channel. The treatment device is capable of controlling fluid flow to the end effector based on an open or closed state of the end effector.

Abstract: A hemostatic device is disclosed capable of effectively performing hemostasis on a puncture site of a subject without generating over-pressurization compression. The hemostatic device includes a first hemostatic member and a second hemostatic member which is movable relatively close to or away from the first hemostatic member, pinches a skin around the puncture site of the subject between the first hemostatic member and the second hemostatic member when the second hemostatic member moves toward the first hemostatic member, and performs hemostasis on the puncture site.

Abstract: Various systems and methods for controlling an ultrasonic surgical instrument according to the location of tissue grasped within an end effector are disclosed. A control circuit can be configured to apply varying power levels, via a generator, to an ultrasonic transducer driving an ultrasonic electromechanical system to oscillate an ultrasonic blade. Further, the control circuit can measure impedances of the ultrasonic transducer corresponding to the varying power levels and determine a location of tissue positioned within the end effector according to a difference between the impedances of the ultrasonic transducer relative to a threshold.

Abstract: An end-effector is disclosed. The end-effector includes a clamp arm and an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and electrically couple to a pole of an electrical generator. The clamp arm includes a clamp jaw and an electrode configured to electrically couple to an opposite pole of the electrical generator. In one configuration, the electrode is segmented. In another configuration, the ultrasonic blade includes electrically insulative material deposited on selected areas to prevent electrical shorting in the event of the ultrasonic blade contacts the electrode. In another configuration, the clamp arm, the ultrasonic blade, or both include selectively coated components.

Abstract: A computer-implemented method for controlling delivery of electrosurgical energy to a vessel to seal the vessel, includes collecting data from an electrosurgical system including an instrument and energy source while the instrument is delivering electrosurgical energy from the energy source to a vessel, predicting by using a machine learning algorithm a burst pressure probability of the vessel based on the data, and determining if the vessel is adequately sealed based on the prediction. The data includes an electrical parameter associated with the delivery of the electrosurgical energy.

Abstract: An instrument (10) that comprises a cartridge seat (24) for a knife cartridge (25). The knife cartridge (25) holds a knife (30), preferably in protected safe position in which the blade (32) of the knife (30) is reliably retained inside the housing (26) of the knife cartridge (25) during non-use, particularly if the knife cartridge (25) is not inserted in the sealing instrument (10). This concept leads to increased handling safety for the medical staff.

Abstract: A surgical instrument includes a first drive assembly, a second drive assembly, and a deployment mechanism. The first drive assembly is coupled to a first component and is configured to translate a first longitudinal distance X1 to deploy the first component. The second drive assembly is coupled to a second component and is configured to translate a second longitudinal distance X2 to deploy the second component. The deployment mechanism is operably coupled to both the first and second drive assemblies and is configured to move from a first position to a second position to translate the first and second drive assemblies the respective first and second longitudinal distances X1 and X2 to deploy the first and second components.

Abstract: An end effector assembly for use with an electrosurgical instrument is provided. The electrosurgical instrument includes a handle having a shaft that extends therefrom, an end effector disposed at a distal end of the shaft, at least one electrode operably coupled to the end effector and adapted to couple to a source of electrosurgical energy, a chromium nitride coating covering at least a portion of the electrode, and a hexamethyldisiloxane plasma coating covering at least a portion of the chromium nitride coating.

Abstract: An end-effector and a surgical instrument are disclosed. The end-effector includes a clamp arm and an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and to electrically couple to a pole of an electrical generator. The clamp arm includes a clamp jaw defining zones, a spring disposed in each of the zones, and a cantilever electrode configured to couple to an opposite pole of the electrical generator disposed along the zones and in contact with each of the springs to apply a variable spring bias along the length of the cantilever electrode. The cantilever electrode is fixed to the clamp jaw at a proximal end and free to deflect at a distal end. The spring bias force a spring in a zone is different from the spring bias force bias of another spring in another zone.

Abstract: A medical device includes opposing first and second end effectors coupled together to move from an open configuration to a closed configuration, a first link with a distal end pivotally connected to a proximal end of the first end effector, the first link including a first slot at a proximal end of the first link, a second link with a distal end pivotally connected to a proximal end of the second end effector, and a first actuator pin slidable within the first slot.

Abstract: An endoscopic system includes an integrated grasper device passing through a device lumen in the cannula. The grasper device has distal end forming two jaw portions that are biased to remain in an open position if unconstrained. The grasper has arch shaped portions that push against the inner surface of the device lumen when the grasper is retracted. To close the jaws of the grasper the grasper is retracted proximally until the arch shaped portions engage the opening of the device lumen. Further retraction causes the grasper jaws to close through engagement with the device lumen inner surface. The endoscopy system can include a single-use, removable cannula having a camera module on its distal tip. A re-usable portion can include the hand piece and display screen.

Abstract: An end-effector is disclosed including an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and electrically couple to a pole of an electrical generator and a clamp arm including a clamp jaw and a cantilever electrode fixed to the clamp jaw. The cantilever electrode is configured to electrically couple to an opposite pole of the electrical generator. The clamp arm may include an I-beam shaped clamp arm pad and the cantilever electrode is disposed between the I-beam. The clamp jaw, the cantilever electrode, and the clamp arm pad may define recesses along a length coinciding with the ultrasonic blade. The clamp arm pad may be fixed to the clamp jaw and disposed between the clamp jaw and the cantilever electrode and may extend beyond the surface of the cantilever electrode. The clamp arm may include a stationary gap setting pad and movable floating gap setting pads.

Abstract: An end-effector is disclosed. The end-effector includes a clamp arm and an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and to electrically couple to a pole of an electrical generator. The clamp arm includes a clamp jaw, a plurality of variable longitudinal support elements, and a cantilever electrode configured to electrically couple to an opposite pole of the electrical generator, the cantilever electrode fixed to the clamp jaw at a proximal end and free to deflect at a distal end. The cantilever electrode is supported by the variable longitudinal support elements. The variable longitudinal support elements apply a variable force on the cantilever electrode from the proximal end to the distal end.

Abstract: A surgical device that includes a first support member extending along a longitudinal axis; a bladder located on the first support member; a first sealing member located on the bladder; and a second sealing member located on the bladder. The sealing member is located on one side of the longitudinal axis; and the second sealing member is located on another side of the longitudinal axis. The bladder is inflatable, and inflating the bladder changes a position of the first sealing member, the second sealing member, or both relative to the first support member.

Abstract: An end effector is disclosed comprising an ultrasonic blade and a clamp arm pivotable relative to the ultrasonic blade to capture tissue therebetween. The clamp arm defines an arcuate surface configured to at least partially surround the ultrasonic blade. The clamp arm comprises a circuit positioned on the arcuate surface. The circuit comprises an electrode layer configured to transmit RF energy to the tissue positioned between the clamp arm and the ultrasonic blade, a compressible layer positioned between the electrode layer and the arcuate surface, first pressure sensor layer positioned beneath the compressible layer between the compressible layer and the arcuate surface, and a second pressure sensor layer positioned above the compressible layer. The compressible layer is compressible to allow the electrode layer to deflect away from the ultrasonic blade. The compressible layer is compressible to allow the second pressure sensor layer to deflect away from the ultrasonic blade.

Abstract: An electrosurgical instrument includes a housing and an elongated shaft extending from the housing. An end effector is disposed at a distal portion of the elongated shaft. The end effector is configured to deliver electrosurgical energy to tissue. The end effector includes a first jaw member having a first electrode plate and a second jaw member having a second electrode plate. A movable handle is operably coupled to the housing. The movable handle is configured to move at least one of the first or second jaw members between an open position and a closed position. A first plate is disposed on the first jaw member. A second plate is disposed on the first plate. The second plate includes an opening defined therein. A bead is disposed on the first plate and is configured to protrude through the opening defined in the second plate.

Abstract: An electrosurgical instrument includes jaws having an electrode configuration utilized to electrically modify tissue in contact with one or more electrodes. The instrument is removably connectable to an electrosurgical unit via an electrosurgical connector extending from the instrument and a receptacle on the electrosurgical unit. The electrosurgical instrument is rotatable without disrupting electrical connection to the electrodes of the jaws. One or more of the electrodes is retractable. The electrosurgical unit and instrument optimally seals and/or cuts tissue based on identifying the tissue and monitoring the modification of the tissue by the application of radio frequency energy.

Abstract: A surgical instrument operable to sever tissue includes a body assembly and a selectively coupleable end effector assembly. The end effector assembly may include a transmission assembly and an end effector. The body assembly includes a trigger and a casing configured to couple with the transmission assembly. An information transmission system transmits instrument information received from a sensor, for example, to a secure server via a secure gateway connected to the instrument. The instrument may be previously tested on a calibration kit to pre-determine and load surgeon-specific settings onto the instrument prior to use.

Abstract: A surgical apparatus includes an end effector configured to interact with a tissue during a plurality of zones of operation. The surgical apparatus further includes at least one drive mechanism operable to effect at least one motion in the end effector during each of the zones of operation. The surgical apparatus also includes one or more vibration sensors configured to record vibrations generated by the at least one drive mechanism during the zones of operation, wherein the one or more vibration sensors are configured to generate an output signal based on the sensed vibrations, and wherein the output signal is employed to determine a status of the surgical apparatus based on predetermined threshold values that are unique to each of the zones of operation.

Abstract: A medical apparatus includes a probe configured for insertion into a body of a patient and including three or more electrodes arrayed along a distal portion of the probe and configured to contact tissue within the body. An electrical signal generator is configured to apply between a selected pair of the electrodes signals having an amplitude sufficient to ablate the tissue contacted by the pair of the electrodes. A controller is configured to measure an electrical current flowing through at least one of the electrodes not included in the selected pair while applying the signals, and to issue a notification indicating that the tissue was inadequately ablated if the measured electrical current exceeds a preset threshold.

Abstract: A trigger assembly of a surgical instrument includes a trigger, a first linkage, a second linkage, and a slider block configured such that moving the manipulation portion in a first direction relative to a housing of the surgical instrument translates the slider block along a longitudinal axis relative to the housing. Another trigger assembly of a surgical instrument includes a trigger and a coupling sphere rotatably captured within a cavity of a retention portion of the trigger such that movement of a manipulation portion of the trigger relative to the housing translates the coupling sphere along the longitudinal axis relative to the housing.

Abstract: An end-effector is disclosed. The end-effector includes a clamp arm and an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and electrically couple to a pole of an electrical generator. The clamp arm includes a clamp jaw, a clamp arm pad, and a cantilever electrode that is free to deflect. The cantilever electrode is configured to electrically couple to an opposite pole of the electrical generator. Also disclosed are configurations where the clamp arm includes a peripheral cantilever electrode and a clamp arm pad extending beyond the electrode, a floating cantilever electrode and a resilient clamp arm pad, an interlocked cantilever electrode plate and a clamp arm pad configured to receive the plate, a laterally deflectable cantilever electrode and a clamp arm pad extending beyond the electrode, and a flexible cantilever electrode and a clamp arm pad extending beyond the electrode.

Abstract: Methods and surgical devices for performing an anastomosis of a living tissue. More particularly the methods and devices relate to anastomosis of tissue performed through tissue fusion performed by delivering energy to the tissue.

Abstract: In a treatment system, an energy treatment instrument includes a pair of grasping pieces. An energy output source outputs electric energy to the energy treatment instrument, thereby applying treatment energy to a blood vessel grasped between the grasping pieces. A measurement section measures a blood pressure at a site related to the grasped blood vessel. A processor controls output of the electric energy from the energy output source based on a measurement result obtained by the measurement section, and thereby switches an actuation state of the energy treatment instrument between a first mode for coagulating the blood vessel and a second mode for coagulating the blood vessel target that is different from the first mode.

Abstract: Methods and devices for controlling motorized surgical devices are provided. In general, the methods and devices can allow a surgical device to grasp and cut tissue. In some embodiments, the device can include at least one sensor and a motor, and an output of the motor can be configured to be adjusted based at least in part on an output from the at least one sensor. The output of the motor can be configured to provide power for translation of a cutting element along an end effector of the device. Adjusting the motor's output can cause the cutting element to translate through the end effector at different speeds, thereby allowing the cutting element to cut through tissue being grasped by the end effector at different speeds.

Abstract: An end effector assembly for use with a forceps includes a pair of jaw members, a knife assembly, and one or more cam assemblies. One or more of the jaw members are moveable relative to the other about a pivot between open and closed positions. One or more of the jaw members include a knife channel. The pivot includes first and second sections defining a passage therebetween. The knife assembly includes a knife blade and an actuation shaft. The knife blade is disposed distally relative to the pivot. The actuation shaft is configured for slidable translation through the passage to allow selective advancement of the knife blade through the knife channel. The one or more cam assemblies are operably coupled to the one or more moveable jaw members and are actuatable to move the one or more jaw members between the open and closed positions for grasping tissue therebetween.

Abstract: A medical device drive system may include a locking structure, a locking device sized and shaped to engage with the locking structure, the locking device coupled to a drive system component, and a lifter configured to actuate the locking device into and out of engagement with the locking structure, wherein the drive system component is selectively lockable by movement of the lifter.

Abstract: A manipulator adapted to grasp and draw tissue comprises first and second arms having proximal ends and distal ends separated by a distance. First and second grasping surfaces each connected to and extending from respective distal ends of the first and second arms are biased toward each other by a respective spring force. When the first and second arms are actuated to reduce the distance, the manipulator is configured such that tissue arranged between the first and second grasping surfaces resist actuation of the first and second arms. The first and second arms are further actuatable to overcome the spring force of the first and second grasping surfaces so that the first and second grasping surfaces pivot at respective pivot points such that the distance between the distal ends of the first and second arms is reduced.

Abstract: A force transmission mechanism includes a force adjuster that receives a driving force and that is configured to change a force transmission efficiency, and also includes a driving member that is configured to connect an end effector and the force adjuster via a joint section and transmit the driving force. The force adjuster converts the driving force into a linear force via a rotational force, and increases the conversion efficiency from the driving force to the linear force such that an amount of increase in the force transmission efficiency increases with increasing displacement amount of the driving member when the driving member is displaced in accordance with flexing or curving of the joint section.

Abstract: A bipolar forceps includes a mechanical forceps including first and second shafts each having a jaw member extending from a distal end thereof and a handle disposed at a proximal end thereof for effecting movement of the jaw members relative to one another about a pivot. A disposable is housing is configured to be releasably coupled to at least one of the shafts and an electrode assembly is configured to be releasably coupled to the disposable housing. The electrode assembly includes electrodes releasably coupled to the jaw members. At least one of the electrodes includes a knife channel configured to receive a knife blade therethrough to cut tissue grasped between the jaw members. A tissue stop has a knife slot that aligns with the knife channel to receive the knife blade. An actuation mechanism advances the knife blade through the knife channel to cut tissue.

Abstract: A forceps includes a handle, a shaft having a proximal end coupled to the handle, and an end effector assembly coupled to a distal end of the shaft. The forceps includes a first jaw member and a second jaw member for grasping tissue therebetween. One or both of the first and second jaw members may include one or more needles extending therefrom. The one or more needles are in fluid communication with a fluid conduit extending along one or both of the first and second jaw members. The fluid conduit couples to a source of contrast agent to enable selective delivery of the contrast agent through the one or more needles.

Abstract: A medical device is disclosed. The medical device comprises a bipolar forceps including a jaw assembly. The jaw assembly comprises a first jaw body; a second jaw body; and a sealing plate. A therapy current can be passed between the sealing plate and the first jaw body. The therapy current can be restricted from passing between the first jaw body and the second jaw body. The therapy current can be restricted from passing between the sealing plate and the second jaw body.

Abstract: An electrosurgical end effector for a surgical tool to perform teleoperated surgical operations. The electrosurgical end effector comprises a first end effector jaw; a second end effector jaw coupled to the first end effector jaw; and a coupling pin configured to rotatingly couple the first end effector jaw to the second end effector jaw so as to cooperatively rotate open and close about an axis of rotation. The electrosurgical end effector further comprises an actuation mechanism coupled to an end of the first end effector jaw to rotate the first end effector jaw about the coupling pin; an otomy feature coupled to the second end effector jaw; and a first electrical conductor to electrically couple the otomy feature to a generator. In one embodiment, the otomy feature is electrically activated by contact with a cam portion of the first end effector jaw, when opened beyond a predetermined jaw angle.

Abstract: A method of assembling a jaw member of an electrosurgical forceps includes aligning in vertical registration an electrically conductive seal plate, an insulative spacer and a jaw support. The method further includes stacking the seal plate atop the insulative spacer and the jaw support such that a flange depending from the seal plate seats within a corresponding cavity defined within a flange depending from the insulative spacer which, in turn, seats within a cavity defined within the jaw support. The method further includes mechanically securing the seal plate, insulative spacer and jaw support to one another and securing a jaw housing to surround the jaw support, the insulative spacer and the seal plate.

Abstract: An electrosurgical forceps includes a pair of first and second shaft members pivotably coupled to one another, an end effector assembly coupled to the pair of first and second shaft members, a knife, and a knife deployment mechanism. The knife deployment mechanism has one or more safety features that resist an inadvertent deployment of the knife.

Abstract: An electrosurgical system includes an RF current generator, a handle body, and an end effector. The end effector may include a first and a second energy delivery surface. At least a portion of either first or second energy delivery surfaces, or both, may include one or more patterned coatings of an electrically non-conducting non-stick material. The material may be deposited on a surface of, within a depression in, or on features extending from the energy surfaces, or through an overmolding process. The patterned coating may be formed from a coating of the material from which portions have been removed. An energy delivery surface has a first area, and the patterned coating has a second area. A ratio of the second area to the first area may be less than or equal to about 0.9, less than or equal to about 0.7, or less than or equal to about 0.5.

Abstract: An electrosurgical instrument includes an elongated first shaft fabricated from thermally-conductive plastic material, an elongated second shaft, and opposing first and second jaw members each having a proximal end portion coupled to a distal end portion of the respective first and second shafts. One or both of the jaw members has a jaw frame and an electrically-conductive tissue sealing structure disposed over the jaw frame. The first shaft has a heat sink disposed therein configured to dissipate heat from the tissue sealing structure toward the thermally-conductive plastic material.

Abstract: A surgical instrument end effector assembly includes a first jaw member defining an insulative tissue-contacting surface and first and second electrically-conductive tissue-contacting surfaces, and a second jaw member positioned including an ultrasonic blade body and defining at least one electrically-conductive tissue-contacting surface. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position to grasp tissue therebetween. The second jaw member is movable relative to the first jaw member between a first configuration, to facilitate transmission of ultrasonic energy to tissue grasped between the first and second jaw members, and a second configuration, to facilitate conduction of electrosurgical energy through tissue grasped between the first and second jaw members.

Abstract: The present invention generally relates to methods and devices for treatment of spinal deformity, and in particular to the utilization of at least one implant to either maintain the position of at least one vertebra of a patient to prevent increase in abnormal spinal curvature, to slow progression of abnormal curvature, or to impose at least one corrective displacement and/or rotation on at least one vertebra of a patient so as to incrementally correct abnormal spinal curvature.

Abstract: A surgical tool can include a shaft, a pin, an end effector, and a translating member. The shaft can define a longitudinal axis. The pin can be located at a distal portion of the shaft. The end effector can be connected to the shaft. The translating member can be positioned laterally inward of the shaft. The translating member can include a track and the pin can extend into the track to limit translation of the translating member along the longitudinal axis with respect to the end effector.

Abstract: An instrument including a first arm and a second arm. The first arm includes a first jaw including a first distal end. The second arm includes a second jaw including a second distal end. One of the first jaw and the second jaw includes a first protrusion. When the instrument is moved into a closed configuration, the first distal end and the second distal end make contact, which occurs after the first protrusion and the opposing jaw make contact.

Abstract: An electrosurgical forceps includes a pair of first and second shaft members pivotably coupled to one another, an end effector assembly coupled to the pair of first and second shaft members, a knife selectively translatable through the first shaft member and the end effector assembly, and a knife deployment mechanism. The second shaft member has a flange extending therefrom toward the first shaft member. The knife deployment mechanism includes a distal extension movably coupled to the first shaft member and configured to engage the flange of the second shaft member when the knife is an extended position and the end effector assembly is in a closed configuration. The engagement between the distal extension and the flange resists movement of the end effector assembly from the closed configuration.

Abstract: A surgical forceps includes a housing having one or more shafts attached thereto and an end effector assembly disposed at a distal end thereof. The end effector assembly includes first and second jaw members disposed in opposing relation relative to one another. At least one jaw member is moveable from an open position to a closed position for grasping tissue therebetween. The jaw members include at least one sensing component that determines an output of one or both of cross-sectional diameter and composition of tissue disposed between the jaw members. A processing component is configured to receive the output and determine a seal pressure for adequately sealing tissue disposed between the jaw members based upon the output. A regulating component regulates the movement of the jaw members between the first and second positions such that the determined seal pressure is applied to tissue disposed therebetween.

Abstract: A method implemented by a surgical instrument is disclosed. The surgical instrument includes first and second jaws and a flexible circuit including multiple sensors to optimize performance of a radio frequency (RF) device. The flexible circuit includes at least one therapeutic electrode couplable to a source of RF energy, at least two sensing electrodes, and at least one insulative layer. The insulative layer is positioned between the at least one therapeutic electrode and the at least two sensing electrodes. The method includes contacting tissue positioned between the first and second jaws of the surgical instrument with the at least one therapeutic electrode and at the least two sensing electrodes; sensing signals from the at least two sensing electrodes; and controlling RF energy delivered to the at least one therapeutic electrode based on the sensed signals.