An offset guide that places a surgical tool through a bone of a surgical joint. The offset guide may hold the surgical joint in a reduced configuration at a first location along the bone; the first location preferred for engaging the bone. The offset guide may engage the bone with a hook that engages two opposing sides of the bone to center the surgical tool through the bone. The offset guide may guide placement of a surgical tool through the bone center at a second location along the bone, the second location offset from the first location. The second location may be a preferable location for receiving the surgical tool therethrough. The surgical tool may include both a drill and an implant insertion tool. The implant insertion tool may place an implant at the second location, while the offset guide holds the surgical joint.

Systems and methods are described for correcting sagittal imbalance in a spine including instruments for performing the controlled release of the anterior longitudinal ligament through a lateral access corridor and hyper-lordotic lateral implants.

An endoluminal punch and introducer sheath are described wherein the endoluminal punch comprises a guidewire lumen through which a user is capable of placing a guidewire. The endoluminal punch system further comprises a mechanism affixed to the hub which is capable of controlling the axial positioning of the guidewire relative to the endoluminal punch distal end. The control mechanism can be released so that the endoluminal punch can be removed from a patient while retaining the guidewire in place within the patient. The endoluminal punch introducer, including a sheath and dilator, can comprise energy emitting electrodes or transducers for cutting larger size holes in stubborn (friable, scarred, or fibrotic) tissue. In other embodiments, the endoluminal punch can comprise a guidewire or stylet, wherein the guidewire or stylet is capable of emitting energy to cut through tissue.

An example cutting apparatus includes a scalpel and a housing defining a scalpel guide. A handle is coupled to a proximal end of the scalpel. A blade holder at a distal end of the scalpel. The scalpel has a length longer than a length of the housing. The scalpel guide constrains the movement path of the scalpel.

A surgical stapling instrument includes an anvil and a stapling head assembly. The anvil defines staple forming pockets. The stapling head assembly includes a body, a coupling member, a firing assembly, and a staple deck. The coupling member is configured to actuate relative to the body to thereby acuate the anvil relative to the body. The firing assembly is configured to drive staples against the staple forming pockets of the anvil. The staple deck is defined by an outer arched perimeter and an inner arched perimeter fixed to the body. The staple deck defines staple openings. At least one non-tangential staple opening in the of staple openings extends along a longitudinal axis in a non-tangential relationship with a closest tangent line of the inner arched perimeter or the outer arched perimeter.

A surgical tool configured for operation in connection with a robotic system. The surgical tool includes a shaft and an end effector extending distally from the shaft. The end effector comprises a first jaw member and a second jaw member movable relative to the first jaw member from a closed position to an open position in response to at least one axial motion. In addition, the surgical tool includes a motor configured to generate at least one rotational motion and a motion conversion assembly operably coupled to the motor and the second jaw member, wherein the motion conversion assembly is configured to convert the at least one rotational motion to the at least one axial motion.

A surgical fastener applier having a housing containing a compartment therein, an elongated member extending distally from the housing and first and second jaws. A firing mechanism is positioned within the housing movable to a second position to effect firing of fasteners. A power pack is removably loadable into the compartment, the power pack having one or both of a) a first motor and a first engagement member removably engageable with the firing mechanism when the power pack is loaded into the compartment to effect movement of the firing mechanism; and b) a second motor and a second engagement member removably engageable with an articulating mechanism in the housing of the surgical fastener applier to effect movement of an articulation mechanism to effect articulation. One or both of a firing position and an articulation position are tracked during the surgical procedure. Sensors are provided to detect select parameters and instrument functions.

A number of improvements are provided relating to computer aided surgery. The improvement relates to both the methods used during computer aided surgery and the devices used during such procedures. Some of the improvement relate to controlling the selection of which data to display during a procedure and/or how the data is displayed to aid the surgeon. Other improvements relate to the structure of the tools used during a procedure and how the tools can be controlled automatically to improve the efficiency of the procedure. Still other improvements relate to methods of providing feedback during a procedure to improve either the efficiency or quality, or both, for a procedure.

A scalpel guide configured to be coupled with a scalpel blade. The scalpel guide engages a guidewire during use to constrain lateral displacement of the scalpel blade with respect to the guidewire. The scalpel guide includes laterally extending walls between which the guidewire is placed during use. The guide may be attached to the scalpel blade or formed integral to the scalpel blade.

A surgical device comprising a first jaw member, a second jaw member, a clamping member and a clamp apparatus is disclosed. The clamping member is slidably positioned to translate at least partially through the first jaw member. The clamping member engages the first jaw member and the second jaw member, and has a knife blade for cutting tissue. A flange of the clamping member is configured to engage a cam surface to pivot the second jaw member with respect to the first jaw member from an open position toward an approximated position. The clamp apparatus is movable from a retracted position to an advanced position for preventing a gap between proximal portions of the first jaw member and the second jaw member from exceeding a predetermined distance. The clamping member and the clamp apparatus are separately movable.