A surgical instrument system comprising a first motor, a second motor, and a third motor is disclosed. The surgical instrument system comprises a first handle comprising a first number of controls, a second handle comprising a second number of controls, and a shaft assembly. The shaft assembly is attachable to the first handle in a first orientation in order to engage one of the motors. The shaft assembly is attachable to the second handle in a second orientation to engage a different motor. The surgical instrument system is configured to perform a different function of an end effector in the first orientation and the second orientation.

Systems, devices and methods of determining orientation of a distal end of a medical instrument (e.g., electrode-tissue orientation of an RF ablation catheter) are described herein. One or more processors may be configured to receive temperature measurements from each of a plurality of temperature-measurement devices distributed along a length of the distal end of the medical instrument and determine the orientation from a group of two or more possible orientation options based on whether temperature measurement values or characteristics of temperature response determined from the temperature measurement values satisfy one or more orientation criteria.

A surgical instrument includes an ultrasonic transducer, a shaft defining a longitudinal axis, and an end effector at a distal end of the shaft. The end effector includes an ultrasonic blade driven by the ultrasonic transducer to treat tissue with ultrasonic energy. A tissue treatment portion of the ultrasonic blade includes a linear blade region extending parallel to the longitudinal axis, a curved blade region extending distally from the linear blade region along a curved path that deflects laterally from the longitudinal axis, an upper treatment side, a lower treatment side, a first lateral side having a first sweeping side surface, and a second lateral side having a second sweeping side surface. The sweeping side surfaces define respective first and second side edges of a transverse cross-section of the tissue treatment portion, and are configured such that the first and second side edges are parallel to one another.

In an example, an electrosurgical device includes a housing defining an interior bore. The electrosurgical device also includes a shaft telescopically moveable in the interior bore of the housing, an electrosurgical blade coupled to the shaft, and a helical conductor coiled around the shaft and configured to supply electrosurgical energy from an electrosurgical generator to the electrosurgical blade.

An end-effector is disclosed. The end-effector includes a clamp arm and an ultrasonic blade configured to acoustically couple to an ultrasonic transducer and electrically couple to a pole of an electrical generator. The clamp arm includes a clamp jaw, a clamp arm pad, and a cantilever electrode that is free to deflect. The cantilever electrode is configured to electrically couple to an opposite pole of the electrical generator. Also disclosed are configurations where the clamp arm includes a peripheral cantilever electrode and a clamp arm pad extending beyond the electrode, a floating cantilever electrode and a resilient clamp arm pad, an interlocked cantilever electrode plate and a clamp arm pad configured to receive the plate, a laterally deflectable cantilever electrode and a clamp arm pad extending beyond the electrode, and a flexible cantilever electrode and a clamp arm pad extending beyond the electrode.

An electrosurgical instrument has a movable tissue cutting mechanism, a shaft housing at least a portion of the movable tissue cutting mechanism, and a pair of opposing jaws rotatable relative to the shaft. Each jaw has an electrically conductive core member, a slot for receiving the cutting mechanism, and a sealing surface. A pin is coupled to the shaft and the jaws. The pin passes through the jaws and the cutting mechanism. A first link is rotatably coupled to the first jaw and a rod. The rod is interior of and translatable relative to the shaft. Each jaw has a coating made of a substantially non-conductive material covering a portion of the conductive core member but exposing the seal surface, whereby the coating limits an energy path from the respective conductive medium to the respective seal surface.

One described aspect is an optical fiber comprising: a fiber core that extends along a fiber axis, is configured to transmit a laser energy along the fiber axis, and terminates at a distal end; a first cladding that extends along the fiber axis, is adjacent to the fiber core, and terminates at a distal end; a coating that extends along the fiber axis and terminates at a distal end, wherein the coating is a gold coating; a second cladding that surrounds a portion of the gold coating along the fiber axis, and terminates at a distal end; an outer jacket that extends along the fiber axis and terminates at a distal end; and a fiber tip. Associated laser systems are also disclosed.

Methods are disclosed which involve a catheter having a distal end that includes electrically and thermally conducting inner and outer layers, a polymer layer between the inner and outer layers, thermal bridges selectively positioned between the inner and outer layers through the polymer layer to transfer heath between the two layers through the polymer layer. An ablation method includes inserting the distal end into a body of a subject, contacting tissue with the outer layer, passing ablation current via the outer layer into tissue such that heat is transferred to the inner layer via the thermal bridges, and passing irrigation fluid through irrigation channels through the inner layer, outer layer, and polymer layer to evacuate heath from the inner layer into blood.

Medical apparatus includes an insertion tube configured for insertion into a body cavity of a patient and an expandable assembly connected distally to the insertion tube and comprising electrodes, which are configured to apply electrical energy to tissue within the body cavity. A flexible porous sheath is fitted over the expandable assembly and configured to contact the tissue within the body cavity so that the electrical energy is applied from the electrodes through the sheath to the tissue.

Various embodiments disclosed relate to a device and methods for electrosurgery, where the device end effector includes an anti-smoke layer. The present disclosure includes a device having first and second electrodes that include the anti-smoke layer, which can be a hydrophobic layer to aid in reduction of smoke production during operation.