The present disclosure includes a calculi fracture device having an acoustic transducer for transferring acoustic energy via a primary fragmentation probe to fracture a calculi mass into calculi fragments, an evacuation tube connecting the probe to a pressure source, and a secondary fragmentation device located in an evacuation pathway extending along the fragmentation probe and the evacuation tube to further break up the calculi fragments to inhibit clogging at a more proximal location in the evacuation pathway. A method of inhibiting clogging of a calculi fracture device can include receiving, from a primary fragmentation device, fragments of a calculi mass along a passage of a evacuation pathway of the calculi fracture device and further breaking up the calculi fragments along the passage of the evacuation pathway at a location that is more proximal to a primary fragmentation location.

A surgical instrument includes a housing, a shaft coupled to and extending distally from the housing, an end effector assembly disposed at a distal end of the shaft, a movable handle coupled to the housing, a drive assembly coupled to the end effector assembly, and an extension mechanism disposed within the housing. The extension mechanism is configured to couple to the shaft and between the movable handle and the drive assembly for moving the shaft and drive assembly between a retracted position and an extended position relative to the housing. The extension mechanism is coupled between the movable handle and the drive assembly in each of the retracted and extended positions such that the movable handle is operable to effect manipulation of the end effector assembly in each of the retracted and extended positions.

An electrosurgical snare device is provided which uses a flow of inert gas to assist in the cutting and sealing process of tissue, while substantially reducing the formation of eschar and collateral tissue damage. The electrosurgical device includes a housing having a longitudinal axis; a support shaft attached to a distal end of the housing, and an end effector coupled to a distal end of the support shaft. The end effector includes a tube including a plurality of apertures and an electrically conducting spring disposed around the tube, where a spacing of the coils of the spring coincides with a spacing of the plurality of apertures, wherein a gas assisted electrosurgical effect is formed at each of the plurality of apertures when an inert gas flows through the tube and the spring is energized. The tube may be configured as a loop or snare.

A surgical instrument has an end-effector located on the end of a rotatable shaft, the shaft projecting from a handle. A thumbwheel is provided at the proximal end of the handle, which controls the rotation of the shaft, and hence the rotational orientation of the end-effector. The end-effector is capable of grasping, cutting, and sealing and/or coagulating tissue, and one of the operations is controlled by a switch located on the upper surface of the proximal end of the handle. The switch is oriented on the handle to be generally above the thumbwheel, in a relative position to the thumbwheel so that both the thumbwheel and the switch may be activated by the user's thumb, without the user having to alter his grip on the handle. In one embodiment of the invention the switch is therefore vertically oriented above the thumbwheel.

An end effector of a surgical instrument may generally comprise a blade, and a clamp arm assembly comprising a clamp arm movable between an open position and a closed position relative to the blade, and at least one camming member rotationally attached to the clamp arm, wherein the at least one camming member is configured to rotate relative to the blade as the clamp arm moves from the open position to the closed position.

In general, surgical devices switchable between monopolar functionality and bipolar functionality are provided. In an exemplary embodiment, a surgical device is configured to selectively apply each of bipolar energy and monopolar energy.

An electrosurgical instrument includes an end effector comprising two movable jaws for grasping tissue therebetween. The jaws connect to an electrosurgical energy source to deliver energy through tissue between the jaws to effect a seal. The jaws include a knife channel to reciprocate a knife therealong for severing tissue held between the jaws. A two-stage articulation joint is coupled to the end effector and to articulation bands configured to articulate the end effector. The two-stage articulation joint includes an outer cut metal tube comprising a plurality of sections and a solid but flexible inner core positioned within the outer cut metal tube. The electrosurgical instrument also may include a rotatable closure ring and a closure link operatively coupled to the rotatable closure ring, a rotatable coupling joint coupled to the articulation section, and/or a hollow flexible tube coupled to the knife and an active rod extending longitudinally therethrough.

A suction and irrigation apparatus includes: a handle having a mounting space therein; an insertion unit extending from the handle and inserted into a patient's abdominal cavity; and a suction and supply unit disposed in the mounting space and supplying an irrigation fluid to the insertion unit or suctioning blood or other contaminated fluids from the patient's abdominal cavity through the insertion unit.

Systems and devices are described which include a tissue cutting device including a central rotatable shaft having a first end and a second end; a motor operably coupled to the first end of the central rotatable shaft, the motor including circuitry configured to rotate the central rotatable shaft; a moveable component configured to move along at least a portion of the length of the central rotatable shaft; and an elongated flexible cutting component having a first end and a second end, the first end of the elongated flexible cutting component secured to the moveable component and the second end of the elongated flexible cutting component secured to the central rotatable shaft in proximity to the second end of the central rotatable shaft; wherein movement of the moveable component along the at least a portion of the length of the central rotatable shaft changes a shape formed by the elongated flexible cutting component.

Forceps can include a drive pin, an outer tube, a first jaw, a second jaw, and an inner shaft. The outer tube can extend along a longitudinal axis. The first jaw can be pivotably connected to the outer tube. The first jaw can include a first flange that can be located at a proximal portion of the first jaw. The first flange can include a first chamfered edge configured to limit extension of the first flange laterally beyond an outer surface of the outer tube when the first jaw is in a closed position. The inner shaft can be located within the outer tube and can extend along the longitudinal axis.