An endoscopic medical system can include an endoscopic end effector including three or more jaws. Each of the three or more jaws can respectively include a corresponding electromagnetic energy signal conductor. The end effector can also include two or more jaw linkages, an individual jaw linkage corresponding to a respective one of the jaws, such that at least two of the jaws are configured to move, independent of one another.

A manipulator adapted to grasp and draw tissue comprises first and second arms having proximal ends and distal ends separated by a distance. First and second grasping surfaces each connected to and extending from respective distal ends of the first and second arms are biased toward each other by a respective spring force. When the first and second arms are actuated to reduce the distance, the manipulator is configured such that tissue arranged between the first and second grasping surfaces resist actuation of the first and second arms. The first and second arms are further actuatable to overcome the spring force of the first and second grasping surfaces so that the first and second grasping surfaces pivot at respective pivot points such that the distance between the distal ends of the first and second arms is reduced.

A forceps including a gripping assembly. The gripping assembly includes an upper jaw and a lower jaw. The upper jaw includes a proximal end and a distal end. The upper jaw includes an upper tooth having an upper proximally facing canted tooth surface and an upper distally facing canted tooth surface. The lower jaw includes a proximal end and a distal end. The lower jaw includes a socket having a lower distally facing canted socket surface and a lower proximally facing socket surface. The upper jaw, the lower jaw, or both are moveable so that the gripping assembly moves between an open position and a gripping position. In the gripping position, a gap is defined between the upper distally facing canted tooth surface and the lower proximally facing socket surface.

A surgical instrument end effector assembly includes a first jaw member defining an insulative tissue-contacting surface and first and second electrically-conductive tissue-contacting surfaces disposed on either side of the insulative tissue-contacting surface. A second jaw member includes an ultrasonic blade body positioned to oppose the insulative tissue-contacting surface of the first jaw member. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position to apply a first grasping force to tissue disposed therebetween. A slider is movable, independent of the first jaw member, between a retracted position, wherein the slider is disposed proximally of the first and second jaw members, and an extended position, wherein the slider extends about the first jaw member and urges the first jaw member from the approximated position further towards the second jaw member to apply a second, greater grasping force to tissue.

Techniques for grasp adjustment include a computer-assisted device comprising a repositionable structure configured to support an end effector and one or more processors. The one or more processors are configured to receive one or more images of the end effector; determine, based on the one or more images, at least one of a first length between a proximal end of jaws of the end effector and a proximal end of a grasping zone, a second length corresponding to a length of the grasping zone, a third length between a distal end of the grasping zone and the distal end of the at least one jaw; or an angle between the jaws of the end effector; and adjust a force or a torque magnitude limit used to limit actuation of the end effector based on at least one of the first length, the second length, the third length, or the angle.

A surgical end effector assembly is disclosed. The surgical end effector assembly comprises a shaft, an end effector comprising a first jaw and a second jaw movable relative to the first jaw, and an articulation joint attaching the end effector to the shaft, wherein the articulation joint defines an articulation axis about which said end effector is articulatable relative to the shaft. The articulation joint comprises a first rotary drive member rotatable about the articulation axis and a second rotary drive member rotatable about the articulation axis, wherein the first rotary drive member and the second rotary drive member are rotatable in the same direction to articulate the end effector about the articulation axis. The surgical end effector assembly further comprises a jaw drive output cooperatively driven by the first rotary drive member and the second rotary drive member configured to clamp and unclamp tissue with the second jaw.

A surgical stapling instrument includes an end effector, an adapter assembly, and a rotation lockout assembly. The end effector includes a staple cartridge assembly and an anvil assembly that are coupled to a proximal housing and movably positioned relative to one another. The staple cartridge assembly has a drive beam and a sled. The sled carries a knife that is rotatably supported on the sled. The drive beam is configured to move the knife relative to the drive beam. The adapter assembly has an elongated shaft that extends distally to an articulating assembly. The articulating assembly includes distal and proximal joint members coupled by a pin to articulate the end effector. The rotation lockout assembly prevents rotation of the end effector during a firing of the surgical stapling instrument.

A surgical instrument includes a shaft and a pair of jaw members disposed on the shaft and extending from an at least partially spherical element. The jaw members are moveable in pitch and yaw relative to the center of the sphere in response to actuation forces applied to a proximal drive mechanism of the instrument. The surgical instrument may include a manually operated handle for manual input of actuation forces by a user, or it may be removably mounted to a drive component of a robotic system such that its proximal drive mechanism is operatively engaged with actuators that generate mechanical output that is transferred to the proximal drive mechanism.

Medical systems, devices and methods are provided for engaging tissue, e.g. for clipping tissue, closing a perforation or performing hemostasis. Generally, the medical system including a housing, first and second jaws rotatable relative to the housing, a driver, and an elongate drive wire. The elongate drive wire may be disconnected from the driver, first and second jaws, and the housing, which are left in vivo engaged with the tissue.

Developed is a tissue joining device for endoscopic surgery, which can be used in NOTES, or the like. As a result of intensive studies carried out to solve the problem described above, the inventors of the present invention have conceived of two tissue joining device having quite novel structures and completed the present invention.