A medical system includes a sheath and an acoustic reflective element that is capable of amplifying acoustic energy. Methods of using a medical system are also provided herein.

A surgical instrument includes a shaft, an ultrasonic transducer, a waveguide acoustically coupled with the ultrasonic transducer and extending distally through the shaft, and an end effector arranged at a distal end of the shaft. The end effector includes an ultrasonic blade acoustically coupled with the waveguide, a clamp arm movable relative to the ultrasonic blade for clamping tissue, and an RF electrode operable to seal tissue with RF energy. The ultrasonic transducer is operable to drive the waveguide and the ultrasonic blade with ultrasonic energy. The surgical instrument further includes an ultrasonic electrical circuit operable to energize the ultrasonic transducer, and an RF electrical circuit operable to deliver RF energy to the RF electrode. A return path of the ultrasonic electrical circuit and a return path of the RF electrical circuit pass through a shared electrically conductive element.

Aspects of the disclosure relate to an adjustable implant configured to be implanted into a patient that includes an adjustable portion moveable relative to a housing. The adjustable implant may include various smart components for enhancing operation of the implant. Smart components may include a controller for managing operations and a transducer for communicating ultrasound data with an external interface device. Additional smart components may include a load cell within the housing for measuring an imparted load; a sensor for measuring angular position of the adjustable portion; a dual sensor arrangement for measuring imparted forces; a reed switch; a half piezo transducer; and an energy harvester.

A resecting probe includes a shaft assembly having an outer sleeve and an inner sleeve. The outer sleeve has an axial bore and an outer window in a distal side thereof, and the inner sleeve has an axial extraction channel and inner window in a distal side thereof. The inner sleeve is rotationally disposed in the axial bore of the outer sleeve to allow the inner sleeve window to be rotated in and out of alignment with the outer sleeve window, and the shaft assembly forms a flow aperture in a distal portion when the inner cutting window and the outer cutting window are out of alignment. An electrode is carried on the inner sleeve, and a motor drive is coupled to rotate the inner sleeve relative to the outer sleeve. A controller is coupled to the motor drive and controls rotation of the inner sleeve.

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

A surgical device drive system comprising a gear coupled to a drive train is disclosed. The gear is configured to transmit a proximal retraction motion to a drive member. The surgical device drive system further comprises a control system coupled to the gear, and a manual input device comprising an input component and a ratchet mechanism. The input component is selectively coupled to the gear by the ratchet mechanism. The drive train is operable in a distal advancement direction and in a proximal retraction direction. In a first state, the control system is configured to drive the gear and the drive train in the distal advancement direction and the proximal retraction direction. In a second state, the manual input device is configured to drive the gear and the drive train in the proximal retraction direction, but not the distal advancement direction, using the ratchet mechanism.

A clip applier system includes: a clip applier that operates a pair of jaws by supplying an operating fluid from a driving device to an opening/closing mechanism, which opens and closes the pair of jaws with a degree of opening corresponding to the amount of the operating fluid, and discharging the operating fluid from the opening/closing mechanism to the driving device; an operation device that outputs an operation signal corresponding to the amount of operation performed on an operation tool; a detection device that outputs a signal corresponding to the degree of opening of the pair of the jaws; and a control device that performs an opening degree control. In the opening degree control, the control device controls the motion of the driving device according to a difference between a command based on the operation signal and an actual value based on the signal from the detection device.

A surgical instrument system comprising an adaptive control system is disclosed.

A surgical instrument is disclosed herein. The surgical instrument includes a handheld device and an adapter assembly. The handheld device includes a first drive assembly and a power source. The adapter assembly includes an outer housing that defines an internal cavity configured to accommodate a handheld device. The adapter assembly is configured to establish a sterile barrier around the handheld device. The surgical instrument includes an energy management system configured to extract energy dissipated by the handheld device from the internal cavity without disrupting the sterile barrier. In some aspects, the surgical instrument further includes a plurality of interchangeable end effectors and the adapter assembly includes a drive interface assembly. The plurality of interchangeable end effectors can include different drive interfaces and operating modes, and the drive interface assembly can connect the first drive assembly of the handheld device to each end effector of the plurality of interchangeable end effectors.

The present disclosure is directed to an electromechanical surgical system having an end effector and an adapter assembly for selectively interconnecting the end effector and a hand-held surgical instrument. A one-wire bidirectional serial communications interface or bus extends through the end effector, the adapter assembly, and the hand-held surgical instrument. The hand-held surgical instrument includes a master circuit coupled to the bus and configured to identify or control the adapter assembly or the end effector. A power source is couplable to the bus and configured to provide power to the adapter assembly or the end effector. A first switch connects the master circuit to the bus and a second switch connects the power source to the bus. A processor controls operation of the hand-held surgical instrument. The controller has a wake-up pin connected to the bus and is configured to receive a presence pulse from the adapter or end effector.