A surgical instrument assembly is provided. In some embodiments, an example surgical instrument assembly includes a surgical instrument configured to pass through a guide tube having a proximal end and a distal end. The surgical instrument can include one or more arms configured to extend from the intermediate position, each arm having one or more joints positioned along the arm and an end effector attached at the distal end of each arm. The surgical instrument assembly can include a control assembly positioned at the proximal end and configured to control the movement of the joints and the end effectors.

A robotic surgical instrument comprising a shaft and end effector element connected by an articulation. The articulation comprises a first joint driveable by a first pair of driving elements. The first joint permits the end effector element to rotate about a first axis transverse to a longitudinal axis of the shaft, the rotation of the end effector element about the first axis bounded by an extreme rotation angle relative to the longitudinal axis. A second joint is driveable by a second pair of driving elements. A pulley arrangement constrains the second pair of driving elements, and comprises a first set of pulleys rotatable about the first axis, and a second set of pulleys located relative to the first set of pulleys such that at the extreme rotation angle the second pair of driving elements is retained in contact with both the first and second sets of pulleys.

A surgical stapling apparatus. Various embodiments include a rotatable elongated body that extends from a rotatable shroud on handle assembly and has a distal end configured for attachment to a disposable loading unit. The apparatus further includes a lockable rotation system for selectively locking the rotatable shroud to prevent rotation thereof about a longitudinal axis.

In various embodiments, a tissue thickness compensator can comprise a compressible extracellular matrix and a bioabsorbable material dispersed within the extracellular matrix, wherein the bioapsorption of the bioabsorbable material is configured to leave behind channels in the extracellular matrix. The tissue thickness compensator can also comprise generation means for generating the ingrowth of tissue into the channels. In at least one embodiment, the tissue thickness compensator can comprise dissolvable wicking members which, when dissolved, can leave behind channels in the tissue thickness compensator. In certain embodiments, the tissue thickness compensator can comprise at least one rupturable capsule.

A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

A surgical tool for use with a robotic system that includes a tool drive assembly that is operatively coupled to a control unit of the robotic system that is operable by inputs from an operator and is configured to robotically-generate output motions. A drive system is configured to interface with a corresponding portion of the tool drive assembly for receiving the robotically-generated output motions and applying the output motions to a drive shaft assembly which is configured to apply control motions to a surgical end effector operably coupled thereto. A manually-actuatable control system operably interfaces with the drive shaft assembly to facilitate the selective application of manually-generated control motions to the drive shaft assembly.

A surgical system includes at least one input coupler, an end effector assembly having a pair of jaw members configured to grasp tissue, and an actuation assembly. The pair of jaw members are caused to transition from an open position to a closed position to apply a jaw force to tissue. The surgical system also includes an articulating section configured to transition the end effector assembly between an un-articulated position and at least one articulated position and a storage device storing setting information and adjustment information. The setting information enables determination of a first input to cause the pair of jaw members to apply the jaw force to the tissue. The adjustment information enables adjustment of the setting information based on the position of the end effector assembly, for determination of a second input to cause the pair of jaw members to apply the jaw force to the tissue.

A treatment device includes a shaft extending along a longitudinal axis and including a plurality of segments arranged along the longitudinal axis, a treatment portion at a distal-end side of the shaft, an operation portion at a proximal-end side of the shaft, and an imaging device. A first segment of the plurality of segments is at the distal-end side of a second segment of the plurality of segments and is rotatably attached to the second segment at a first pivot point. The imaging device is provided in the second segment. The first segment is rotatable about the first pivot point relative to the second segment such that a longitudinal axis of the first segment intersects a longitudinal axis of the second segment at a first angle and at least a part of the treatment portion enters a field of view of the imaging device.

A medical instrument includes an instrument shaft with exit holes near a distal end of the shaft, a tool coupled to the distal end of the shaft, and a backend. The backend may include a mechanism that manipulates a drive element that extends through the shaft and couples to the tool, a fluid inlet, and a fluid channel assembly providing fluid communication between the fluid inlet and the proximal end of the shaft. Cleaning fluid is directed into the fluid inlet, through the fluid channel assembly, and into the shaft. A chassis or other structural piece of the backend may form part of the fluid channel assembly.

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.