An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Systems, instruments, methods, and compositions are described involving removing a portion of the epidermis within a donor site on a subject, and harvesting dermal plugs within the donor site. An injectable filler is formed by mincing the dermal plugs. The injectable filler is configured for injecting into a recipient site on the subject.

An ultrasound cardiac stimulation system includes: a system for measuring the heart electrical activity; a system for generating a beam of focussed ultrasound signals focussed on a targeted zone, the signals being calibrated to generate electrical stimulation in a zone of the heart, the beam generation being synchronised with a first selected time of the electrocardiogram, the generation of the beam corresponding to a pulse with a duration of less than 80 ms; a system for locating the targeted zone coupled with a system for positioning the system for generating the focussed beam to control the beam of focussed ultrasound signals in the targeted zone, the location system being synchronised with the system for generating the beam of focussed signals; a single monitoring system following in real time a temperature and tissue deformation in the targeted zone, the monitoring system taking measurements in synchronisation with the rhythm of the electrocardiogram.

A stylet control system for selectively advancing and retracting a stylet includes a stylet having a first end and a second end, the second end being threaded, a screwdriver defining a bore for receiving a portion of the stylet and having a screw-engaging end for engaging a screw, the stylet being rotationally fixed relative to the screwdriver. The system includes a control device having a passage for receiving the screwdriver and having an inner portion defining a lumen for receiving the portion of the stylet, the inner portion being threaded for engaging the threaded second end of the stylet, when the screwdriver is rotated in the first rotation direction and the control device is prevented from rotating, the screwdriver advances the screw in the first axial direction and the stylet retracts in a second axial direction, opposite the first axial direction.

Systems, methods, and instrumentalities are disclosed for switching a control scheme to control a set of system modules and/or modular devices of a surgical hub. A surgical hub may determine a first control scheme that is configured to control a set of system modules and/or modular devices. The surgical hub may receive an input from one of the set of modules or a device located in an OR. The surgical hub may make a determination that at least one of a safety status level or an overload status level of the surgical hub is higher than its threshold value. Based on at least the received input and the determination, the surgical hub may determine a second control scheme to be used to control the set of system modules. The surgical hub may send a control program indicating the second control scheme to one or more system modules and/or modular devices.

A method for characterizing a state of an end effector of an ultrasonic device is disclosed. The ultrasonic device including an electromechanical ultrasonic system defined by a predetermined resonant frequency. The electromechanical ultrasonic system further including an ultrasonic transducer coupled to an ultrasonic blade. The method including applying, by an energy source, a power level to the ultrasonic transducer; measuring, by a control circuit coupled to a memory, an impedance value of the ultrasonic transducer; comparing, by the control circuit, the impedance value to a reference impedance value stored in the memory; classifying, by the control circuit, the impedance value based on the comparison; characterizing, by the control circuit, the state of the electromechanical ultrasonic system based on the classification of the impedance value; and adjusting, by the control circuit, the power level applied to the ultrasonic transducer based on the characterization of the state of the end effector.

A surgical apparatus comprises a body, an ultrasonic transducer, a shaft, an acoustic waveguide, an articulation section, an end effector, and an articulation drive assembly. The ultrasonic transducer is operable to convert electrical power into ultrasonic vibrations. The shaft couples the end effector and the body together. The acoustic waveguide is coupled with the transducer. The articulation section includes a collar that is located distal to a nodal portion of the waveguide and is operable to deflect the end effector away from the longitudinal axis. The end effector comprises an ultrasonic blade in acoustic communication with the ultrasonic transducer. The articulation drive assembly is operable to drive articulation of the articulation section. The articulation drive assembly comprises at least one translating articulation driver coupled with the collar. The ultrasonic blade is operable to deliver ultrasonic vibrations to tissue even when the articulation section is in an articulated state.

A surgical apparatus includes a body assembly, a shaft, an acoustic waveguide, an articulation section, an end effector, and a rigidizing member. The shaft extends distally from the body assembly and defines a longitudinal axis. The acoustic waveguide includes a flexible portion. The articulation section is coupled with the shaft. A portion of the articulation section encompasses the flexible portion of the waveguide. The articulation section includes a first member and a second member. The second member is longitudinally translatable relative to the first member. The end effector includes an ultrasonic blade in acoustic communication with the waveguide. The rigidizing member is configured to selectively engage at least a portion of the articulation section to thereby selectively provide rigidity to the articulation section.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

Various surgical systems are disclosed. A surgical system can include a surgical robot and a surgical hub. The surgical robot can include a control unit in signal communication with a control console and a robotic tool. The surgical hub can include a display. The surgical hub can be in signal communication with the control unit. A facility can include a plurality of surgical hubs that communicate data from the surgical robots to a primary server. To alleviate bandwidth competition among the surgical hubs, the surgical hubs can include prioritization protocols for collecting, storing, and/or communicating data to the primary server.