A surgical stapling instrument comprising a housing, a shaft, an end effector, a first articulation joint configured to permit the end effector to be articulated in a first plane, a second articulation joint configured to permit the end effector to be articulated in a second plane, and a staple firing drive is disclosed. The end effector comprises a distal end, a proximal end, a first jaw, a second jaw rotatable relative to the first iaw, and a staple cartridge. The staple firing drive comprises a firing member and a flexible drive tube extending through the first articulation joint and the second articulation joint. The firing member comprises a first cam, a second cam, and a round attachment aperture. The flexible drive tube comprises a longitudinal length, an outer circumference, a distal end seated in the round attachment aperture, and interlocking cuts in the outer circumference extending longitudinally and circumferentially.

Systems, devices, and methods for controlling cooperative surgical instruments with variable surgical site access trajectories are provided. Various aspects of the present disclosure provide for coordinated operation of surgical instruments accessing a common surgical site from different approach and/or separate body cavities to achieve a common surgical purpose. For example, various methods, devices, and systems disclosed herein can enable the coordinated treatment of tissue by disparate minimally invasive surgical systems that approach the tissue from varying anatomical spaces and must operate differently, but in concert with one another, to effect a desired surgical treatment.

A medical device having an elongate body with a proximal portion, a distal portion, and defining a lumen therethrough. The medical device has an expandable element coupled to the distal portion of the elongate body, the expandable element defining a proximal portion, a distal portion opposite the proximal portion and an intermediate portion disposed between the proximal portion and the distal portion. The expandable element also has an inner surface and an outer surface opposite the inner surface. The medical device has a plurality of cutting members, each cutting member being coupled with the outer surface of the expandable element, each cutting member having a proximal end and a distal end opposite the proximal end, the proximal end being proximate the proximal portion of the expandable element and the distal end being proximate to the intermediate portion of the expandable element.

A staple cartridge comprising a cartridge body, staples, a first staple driver, a second staple driver, and a third staple driver is disclosed. The cartridge body comprises a knife slot and staple cavities defined in the cartridge body and arranged in an inner longitudinal row of staple cavities, a middle longitudinal row of staple cavities, and an outer longitudinal row of staple cavities on one side of the knife slot. The staples are removably stored within the staple cavities. The first staple driver is configured to eject a first quantity of staples from the staple cavities. The second staple driver is configured to eject a second quantity of staples from the staple cavities which is different than the first quantity of staples. The third staple driver is configured to eject a third quantity of staples that is the same as the first quantity of staples.

Arthroscopic cutters are used for resecting tissues, such as meniscal tissues, in meniscectomies or other arthroscopic procedures. The arthroscopic cutters have a shaft assembly with openable-closeable jaws at a working end of the shaft. A handpiece having a motor drive may be detachably coupled to a hub on a hub end of the handpiece. When the shaft is coupled to the handpiece, the motor drive will couple to the jaw structure to open and close the jaw structure to cut meniscal and other tissues.

A method for navigational support of a person performing a resection on a patient following extraction of a resectate includes recording a first surface data set of the resectate using an ex vivo scan appliance, and determining a second surface data set of the extraction region using a recording instrument. The second surface data set covers at least one part of the remaining tissue surface of the extraction region of the resectate in the patient. The method also includes registering the first surface data set of the resectate with the second surface data set of the extraction region based on corresponding surface features of the resectate and the remaining tissue surface in the extraction region, and performing at least one support measure that supports the navigation in the extraction region relative to the resectate, using the registration.

Methods and tools for implanting prosthetic heart valves and modifying leaflets of an existing valvular structure in a subject are disclosed herein. Prior to or during implantation of the prosthetic heart valve within the existing valvular structure, each tool can be provided in the ascending aorta (or equivalent thereof) of a subject and can be used to pierce, lacerate, slice, tear, cut or otherwise modify a leaflet or commissure of the existing valvular structure. The existing valvular structure can be a native aortic valve or other native heart valve, or a previously-implanted prosthetic heart valve. The modification can avoid, or at least reduce the likelihood of, issues that leaflets of the existing valvular structure might otherwise cause once the prosthetic heart valve has been fully installed, for example, obstruction of blood flow to the coronary arteries and/or improper valve mounting due to a non-circular cross-section.

Systems and methods for noncontact ablation of tissues or materials in/on the body using an ablation catheter that has a directional ablation unit. The ablation unit has a set of individual transducer (e.g., ultrasound) elements that are movably positioned. A position adjustment element (a deformer) is movable with respect to the ultrasonic transducer to alter the positions of the individual transducer elements and thereby alter the directions in which the transducer elements emit ultrasonic energy. In one embodiment, the ablation catheter is a lumen catheter through which a positioning/measurement catheter can be inserted. The luminal ablation catheter is inserted through the skin and into the body via conventional methods. The ablation and positioning catheters can be used to make electrical measurements with respect to the surrounding tissue, and the ablation catheter can be used to emit energy in a desired direction and/or pattern to ablate target tissue.

Embodiments of the present disclosure includes method and devices for minimally invasive spinal fusion surgery. A method for minimally invasive spinal fusion surgery can include accessing a spinal column through a working channel device, wherein the working channel has a proximal end and a distal end, advancing the working channel so that the distal end pierces an outer layer of a vertebral disc, inserting a disc extractor through the working channel device and into the vertebral disc to cut the vertebral disc into pieces, inserting a disc blade through the working channel device and into the vertebral disc to cut the vertebral disc into pieces, using a disc rake to remove the pieces of the vertebral disc, inserting a disc shaver to clean a number of surfaces of vertebra adjacent to the vertebral disc, and inserting and implanting a disc implant in a space from where the vertebral disc was removed.

A surgical access assembly and method of use is disclosed. The surgical access assembly comprises an outer sheath and an obturator. The outer sheath and obturator are configured to be delivered to an area of interest within the brain. Either the outer sheath or the obturator may be configured to operate with a navigational system to track the location of either within the brain. Once positioned at a desired location, the obturator is removed, leaving a distal end of the outer sheath adjacent an area of interest, and creating a working corridor. Interrogation of the area of interest may be performed to evaluate a disorder and/or abnormality, as well as evaluate treatment regimes. Interventional devices may also be introduced to the area of interest, as well as a variety of treatments.