A surgical instrument comprising an end effector, a shaft extending from the end effector, a firing driver movable relative to the end effector, a power-pack, a control system, and a handle connected to the shaft is disclosed. The handle comprises a motor configured to drive the firing driver. The handle is switchable between a plurality of operating states. The plurality of operating states comprises a control operating state in which the power-pack supplies the control system with a first amount of power and a firing operating state in which the power-pack supplies the motor with a second amount of power. The second amount of power is greater than the first amount of power.

A steerable instrument (10) has an actuator (14; 15) at a proximal side and a bendable zone (16; 17) at a distal side. The actuator (14; 15) controls bending of the flexible zone (16; 17) by means of one or more longitudinal elements. The instrument has a first cylindrical element (204), a second cylindrical element (206) and a third cylindrical element (208). The second cylindrical element (206) has a zone (14; 15; 16; 17) with a longitudinal element portion (274; 282) with a first height in a radial direction of the instrument. Radial spacers (275; 279) are located at mutual sides of the longitudinal element portion (274; 282), which have, at least locally, a second height in the radial direction larger than the first height.

A medical insertion device includes an elongated shaft extending from a proximal end to a distal end and having flexibility sufficient for insertion through a working channel of an endoscope along a tortuous path. The elongated shaft includes a coil extending from the proximal end to the distal end and having a channel extending longitudinally therethrough and a braided portion extending around a portion of the coil, the braided portion including a plurality of lines wound together such that first and second ones of the lines intersect to enclose a predetermined angle therebetween, the angle being between 25 and 55 degrees.

Apparatus for performing a minimally-invasive procedure, the apparatus comprising: a tool comprising: a shaft having a distal end and a proximal end; a handle attached to the proximal end of the shaft; and an end effector attached to the distal end of the shaft; wherein the shaft comprises a flexible portion extending distally from the proximal end of the shaft, and an articulating portion extending proximally from the distal end of the shaft, and wherein the articulating portion comprises a flexible spine; wherein a plurality of articulation cables extend through the shaft from the handle to the flexible spine, such that when tension is applied to at least one of the plurality of articulation cables, the flexible spine bends; wherein a rotatable element extends through the shaft from the handle to the end effector, such that when the rotatable element is rotated, the end effector rotates; and wherein an actuation element extends through the shaft from the handle to the end effector, such that when the actuation element is moved, the end effector is actuated.

Certain aspects relate to articulating medical instruments and corresponding systems and techniques. An articulating medical instrument can include an elongated shaft having two shaft sections and a bending section positioned therebetween. The instrument can include an articulation handle positioned at a proximal end of the shaft, and one or motors positioned within the articulation handle and configured to articulate the first bending section. The instrument can also include an insertion handle coupled to the shaft that enables translation of the shaft relative to the insertion handle.

A wall (39) of a catheter (38) (a) includes a braided portion (41) having an outer surface (45), an inner surface (47), and a braided interior (53) between the outer and inner surfaces (45, 47), and (b) is shaped to define first and second longitudinally-running channels (27a, 27b) therethrough. A distal portion of the catheter (38) is shaped to define first and second lateral openings (26a, 26b). An angle between (a) a first line (76) running between the first and second lateral openings (26a, 26b), and (b) a second line (78) that is parallel to a central longitudinal axis of the catheter (38) when the catheter (38) is straight, is between 30 and 150 degrees. A flexible longitudinal member (14) passes from a proximal portion of the catheter (38) to the distal portion via the first channel (27a), out of the first channel (27a) via the first lateral opening (26a), into the second channel (27b) via the second lateral opening (26b), and from the distal portion to the proximal portion via the second channel (27b).

A dilator tip may include an elongated tubular member defined by a circumferential wall and having a distal tip region and a proximal end, and a plurality of ribs extending longitudinally between the distal tip region and the proximal end. The plurality of ribs may extend radially outward from the elongated tubular member, and the plurality of ribs may be spaced apart circumferentially.

A bendable cutting apparatus for myocardium and a system with the same are provided. The cutting apparatus includes a cutting portion, a bendable portion, and a driving portion. The bendable portion is connected between the cutting portion and the bendable portion. the cutting portion is driven by the driving portion to cut down a target, and the bendable portion is configured to bend in response to being tensioned and loosen by the driving portion.

A medical manipulator includes: an end effector provided at a distal side of the medical manipulator; a proximal housing provided at a proximal side of the medical manipulator; and an elongated portion coupled to both the end effector and the proximal end. The elongated portion includes: a first elongated member coupled to both the end effector and the proximal housing; a second elongated member coupled to only either one of the end effector and the proximal housing, the second elongated member being configured to form by surrounding the first elongated member; and to be slidable in a longitudinal direction relative to the first elongated member; and a third elongated member coupled to both the end effector and the proximal housing, the third elongated member being configured to form an exterior of the elongated portion by surrounding the second elongated member.

Surgical devices and systems having rotating end effector assemblies for treating tissue are provided. Methods for using the same are also provided.