Methods for performing certain medical procedures wherein a steerable endoluminal punch is used to not only gain access but to create a channel or punch through tissue, thus facilitating follow-up therapeutic procedures. The distal end of the steerable endoluminal punch is controllably articulated by the operator using a control device at the proximal end.

A surgical instrument system is disclosed which comprises a distal end and a staple cartridge assembly comprising staples removably stored therein. The instrument system further comprises a firing drive including an electric motor and a firing member operably couplable with the electric motor. The electric motor is operable to advance the firing member toward the distal end during a staple firing stroke to eject the staples from the staple cartridge. The electric motor is operable to retract the firing member away from the distal end during a retraction stroke. The surgical instrument system further comprises a manually-operated bailout mechanism operable to perform the retraction stroke in lieu of the electric motor, a controller, and a display in communication with the controller. The controller is configured to display the progress of the retraction stroke when the firing member is being manually retracted by the bailout mechanism.

A surgical instrument comprising a sensing system is disclosed.

Illustrative systems and methods for inserting an elongate flexible instrument into a target environment are described. An illustrative system includes a guide device positioned near an opening to the target environment and having a rotary mechanism and a motor configured to drive the rotary mechanism. The system further includes a sensor system associated with insertion of the elongate flexible instrument along an insertion axis and a processor communicatively coupled to the motor and the sensor system. The processor is configured to receive sensor data from the sensor system, evaluate the sensor data, and control, based on the evaluation, the motor to actuate the elongate flexible instrument along the insertion axis. In some examples, the processor controls the motor to vary a rate of rotation of the rotary mechanism based on a determined system status.

An instrument support apparatus for use in a robotic surgery system is disclosed. The apparatus includes a housing, and a mounting interface disposed on the housing, the mounting interface being operably configured to receive and support a proximal end of an elongate shaft of a surgical instrument, the instrument including a tool disposed at a distal end of the elongate shaft. The apparatus also includes an automated drive coupled to the proximal end of the instrument and controlled by the robotic surgery system to cause movement of the proximal end for extending or retracting the instrument to position the tool within a surgical operating site. The apparatus further includes a manual actuator disposed on an accessible location on the housing and configured to be rotated by an operator to cause a manual retraction of the instrument in the event of a failure of the automated drive.

A surgical instrument including a shaft including a distal portion and an articulatable portion is disclosed. The articulatable portion, positioned proximal to the distal portion, includes a plurality of joint members. A first articulation cable extends through each first channel of each of the plurality of joint members and a second articulation cable extends through each second channel of each of the plurality of joint members to the distal portion. The first and second articulation cables are transitionable between: (i) an unlocked state, where the first and second articulation cables are free to translate distally and proximally and the plurality of joint members are slidable relative to one another to pivot the distal portion away from a longitudinal axis, and (ii) a locked state, where translation of the first and second articulation cables is locked, causing a position of the distal portion relative to the longitudinal axis to be locked.

A device and method for delivering a synthetic mesh or graft for anatomical repair at a defect site. A plurality of flexible arms is connected to the synthetic mesh or graft. Grasping jaws are individually controlled at or near a proximal end of the device for connection of the graft and release of the graft at the surgical site. The flexible arms, with graft attached are positioned through a surgical incision to the defect site. An actuator positions the flexible arms to assume a radial array at the surgical site, unfolding and spreading the graft for attachment. The length of each flexible arm is individually adjustable to adapt to the size and shape of the graft selected for installation at the defect site to repair the defect.

Prosthetic heart valves described herein can be deployed using a transcatheter delivery system and technique to interface and anchor in cooperation with the anatomical structures of a native heart valve. Some embodiments of prosthetic mitral valves described herein include an anchor portion that couples the prosthetic mitral valve to the anatomy near the native mitral valve, and a valve portion that is mateable with the anchor portion. Some embodiments of the transcatheter delivery system can include systems and techniques for retrieval of the anchor portions and the valve portion.

Deflectable guide catheters and methods, including methods for using deflectable guide catheters to perform transnasal procedures within the ear, nose, throat, paranasal sinuses or cranium. Some deflectable guide catheters of the present invention comprise a substantially rigid tube, a helical spring attached to and extending from the distal end of the substantially rigid tube, a tubular plastic inner jacket, an outer plastic jacket substantially covering at least the helical spring member. The spring member is deflectable to cause the distal portion of the guide catheter to deflect to a curved configuration. In embodiments for transnasal use the deflectable guide catheter may have a length of less than 25 cm.

Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may comprise a simple helical coil or interlocking helical channels, and the array can be used to locally deflect or elongate an axis of the coil under control of a processor. Liquid inflation fluid may be directed so as to pressurize the balloons from an inflation fluid canister, and may vaporize within a plenum or the channels or balloons of the articulation system, with the inflation system preferably including valves controlled by the processor. The articulation structures can be employed in minimally invasive medical catheter systems, and also for industrial robotics, for supporting imaging systems, for entertainment and consumer products, and the like.