A minimally invasive surgery device includes a guide tube with a highly-curved distal end housed within a channel. The highly-curved distal end is configured with a curvature optimized for improved triangulation in a tissue workspace. The highly-curved distal end of the guide tube extends from a curved channel inside an endoscopic device on a surgical robot. The combination of the curved channel and the highly-curved distal end of the guide tube provides improved maneuverability in the workspace. In some embodiments, the highly-curved distal end includes nitinol and shapeset to a desired curvature. The highly-curved distal ends may be curved to achieve a stable shape with repeatable performance. In some embodiments, each first and second guide tube includes a double-curvature configuration.

Apparatus for performing a minimally-invasive procedure, the apparatus comprising: a tool comprising: a shaft having a distal end and a proximal end; a handle attached to the proximal end of the shaft; and an end effector attached to the distal end of the shaft; wherein the shaft comprises a flexible portion extending distally from the proximal end of the shaft, and an articulating portion extending proximally from the distal end of the shaft, and wherein the articulating portion comprises a flexible spine; wherein a plurality of articulation cables extend through the shaft from the handle to the flexible spine, such that when tension is applied to at least one of the plurality of articulation cables, the flexible spine bends; wherein a rotatable element extends through the shaft from the handle to the end effector, such that when the rotatable element is rotated, the end effector rotates; and wherein an actuation element extends through the shaft from the handle to the end effector, such that when the actuation element is moved, the end effector is actuated.

An organ retraction device includes a surgical instrument and an expandable body operable for expansion by connection of the surgical instrument thereto. The expandable body includes a first expandable section configured to be expandable to a predetermined size and shape in a first stage to move an organ in an abdominal cavity, and a second expandable section configured to be expandable to a predetermined size and shape in a second stage to fix the organ.

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

A surgical instrument system is disclosed which comprises a control screen usable to control the surgical instrument system in real time.

A surgical instrument. The surgical instrument has a force delivery system which communicates a changing force to a user of the surgical instrument when a limit of a surgical function is reached. A sensor senses position of a moving element to communicate a signal to the force delivery system. In various embodiments, the system generates a vibratory force to signal the user.

Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes using an apparatus to apply pressure to a parietal pericardium, retracting the apparatus, and puncturing the parietal pericardium by delivering electrical energy using a puncture device. Another method includes moving a portion of parietal pericardium away from a surface of myocardium of the heart and puncturing the parietal pericardium by delivering electrical energy using a puncture device. The methods may include a step of confirming that the puncture device is at least partially within the parietal cavity by injecting or aspirating fluid through a lumen in the puncture device or measuring the pressure or electrical impedance at the distal end of the puncture device.

A scar subcision devices comprising a first elongated element comprising a pivotal connection to a second elongated element, the first elongated element having a blunt distal end, the second elongated element having a proximal-facing cutting edge at a distal end thereof, the device having a first state wherein the cutting edge is retracted to a location within an outer perimeter of the first elongated element, and a second state wherein the cutting edge is exposed outside of the outer perimeter of the first elongated element and the device transitioning between the first state and the second state by the first elongated element and the second elongated element rotating relative to each other about the pivotal connection are disclosed. Methods are also disclosed.

An end effector is disclosed. The end effector includes a first jaw and a second jaw configured to move from a first position to a second position. The second jaw includes a channel and a cartridge removably coupled to the channel. A first electrode is configured to apply electrosurgical energy to a tissue and a second electrode is configured to apply electrosurgical energy to the tissue. In the second position a distance between the first electrode and the first jaw is greater than a distance between the second electrode and the first jaw. The first electrode is configured to apply electrosurgical energy to the tissue when the first and second jaws are moving from the first position to the second position, and the second electrode is configured to apply electrosurgical energy to the tissue in the second position.

A method is disclosed. The method includes delivering staples from a surgical staple cartridge of a surgical instrument to a first tissue during a first procedure; removing the surgical staple cartridge from the surgical instrument; and delivering radio-frequency energy from a radio-frequency cartridge of the surgical instrument to a second tissue during a second procedure.