Systems and techniques for nerve monitoring are described herein. The system can include a remote transmitter configured to send a stimulation signal to a nerve, and an electrosurgical device including an end effector configured to perform a surgical function in response to receiving a therapeutic signal from an electrosurgical generator. The system can also include a receiver configured to detect the stimulation signal, and in response to detecting the stimulation signal, determine a location of the nerve, and an in-vivo transmitter configured to emit a location signal in response to the determined location of the nerve.

An exemplary treatment system can be provided which can include a laser system configured to emit at least one laser beam, and an optical system configured to focus the laser beam(s) to a focal region at a selected distance from a surface of a tissue. The focal region can be configured to illuminate at least a portion of a target. The optical system can cause an irradiation energy transferred to the focal region of the laser beam(s) to (i) generate a plasma in a first region of the tissue adjacent to the target, and (ii) avoid a generation of a plasma in a second region of the tissue. The optical system has a numerical aperture that is in the range of about 0.5 to about 0.9. An exemplary method can also be provided to control such treatment system.

A surgical instrument is disclosed comprising a shaft, an end effector, and an articulation joint rotatably connecting the end effector to the shaft. The surgical instrument further comprises an articulation drive system configured to permit high degrees of articulation.

A dual port switching apparatus (12) comprising a connection part for mounting to a base unit (11), an input beam port to receive a main laser beam from a base unit (11) in an input optical path (22), a first output port (14) for connection to a flexible wave guide, a second output port (15) for connection to an articulated arm (16), and a switching element (56) moveable between a first position and a second position to direct an input beam to one of the first output port (14) and the second output port (15).

Methods and systems are adapted for ablation of target tissue in a living subject by predicting a lesion size that would result from placing an ablation electrode into contact with the target tissue at a particular contact force while applying energy at a given power level for a particular time interval. The prediction involves modeling the lesion size as a non-linear function of the contact force, the power level and the time interval. The prediction may be iterated by varying the contact force, the power level or the time interval until a saturation point is found, beyond which the lesion size does not increase. After it is established that one of the iterations predicts a desired lesion size, ablation of the target tissue may be conducted using the contact force, the power level and the time interval of the one iteration.

A surgical clip applier comprising an electric motor system is disclosed. The electric motor system is configured to drive a clip firing system of the surgical clip applier. The surgical clip applier further comprises a control system configured to control the electric motor system. The control system is configured to monitor a strain gauge circuit to assess the crimping force experienced by the clip firing system. In at least one instance, one or more strain gauges are mounted to a drive shaft and/or jaw of the clip firing system. The control system modifies the operation of the surgical clip applier when the voltage of the strain gauge circuit exceeds and/or falls below a threshold. In at least one instance, the control system modulates the width, or duration, of voltage pulses applied to the electric motor system to control the speed of the electric motor system.

A system includes a surgical instrument configured to perform a laparoscopic surgical operation, a location sensor configured to identify a spatial relationship between an anatomical structure and the surgical instrument, and a processor configured to receive a graphical representation of a patient, determine proximity of the distal end portion of the surgical instrument with the anatomical structure of the patient based on the spatial relationship, and generate a warning based on the determination of proximity.

A monitoring, managing and protecting system is provided that includes a monitoring probe working in conjunction with an ablating device. The probe is configured to be positioned in close proximity to a region of non-targeted tissue proximate an ablation site of targeted tissue and to be operatively connected to an electrical response assessment system or component. The probe includes an elongate shaft having proximal and distal ends, with a handle disposed at the proximal end thereof and a tissue monitoring and protecting apparatus disposed at the distal end thereof. The ablating device includes an elongate shaft having proximal and distal ends, with a handle mounted at the proximal end thereof and an ablation element mounted at the distal end thereof. The monitoring probe measures electrical characteristics of the non-targeted tissue and/or of the tissue between the monitoring electrode and the ablation electrode. The electrical response assessment system determines whether the tissue is being damaged based on the electrical measurements. The monitoring, managing and protecting system can notify a practitioner based on the determination, or modify or stop the ablation procedure.

An electrosurgical system with an electrosurgical instrument and an electrosurgical generator to which the electrosurgical instrument is connected. The electrosurgical generator has a processor and at least one generator data memory as well as optical and our acoustic signaling and/or display means. The electrosurgical instrument has at least one instrument data memory in which a data set with structured data is stored, wherein at least some of this data represent signaling instructions. The generator data memory contains an operating program for controlling the operation of the electrosurgical generator in conjunction with the electrosurgical instrument and, by means of the operating program, the processor is configured to control during the operation of the electrosurgical generator the signals or notifications to be output by the signaling and/or display means in dependence on the data representing signaling instructions, which is stored in the instrument data memory of the electrosurgical instrument.

A surgical system includes a surgical instrument configured for insertion into a surgical site, a sensor configured to sense at least one property of smoke at the surgical site, and a surgical generator including a controller and an energy output. The energy output is configured to supply energy to the surgical instrument for application to tissue at the surgical site to treat the tissue. The controller is configured to receive the at least one property, determine at least one parameter of smoke at the surgical site based upon the at least one property, and control the energy output based upon the at least one parameter and/or provide an output based upon the at least one parameter.