A steerable instrument has an actuator at a proximal side and a bendable zone at a distal side. The actuator controls bending of the flexible zone by means of one or more longitudinal elements. The instrument has a first cylindrical element, a second cylindrical element and a third cylindrical element. The second cylindrical element has a zone with a longitudinal element portion with a first height in a radial direction of the instrument. Radial spacers are located at mutual sides of the longitudinal element portion, which have, at least locally, a second height in the radial direction larger than the first height.

A minimally invasive surgical device characterized by comprising: a manipulable handle (2) manipulated by a user inside a body cavity, a treatment part (3) that holds a specific swappable surgical instrument that is inserted into the body cavity and manipulated using the manipulable part, and a linking part (4), provided between the manipulable handle and the treatment part, for disposing the surgical instrument held by the treatment part in a desired orientation at a desired position within the body cavity. The linking part comprising: two or more connecting parts (7a, 7b, 8a, 8b) that are connected in series in the longitudinal direction of the linking part, and form a joint (7, 8) that enables rotation around the longitudinal axis or an axis orthogonal to the longitudinal axis; and a linking part control mechanism that moves the two or more connecting parts toward or away from each other to open or constrict the angle of the joint around the longitudinal axis and/or the angle thereof around an axis orthogonal to the longitudinal axis, thereby disposing the treatment part at the desired position and in the desired orientation within the body cavity.

A robotic system and methods are disclosed. A common axis is defined for an instrument and an energy applicator extending from the instrument. A manipulator has a plurality of links and actuators configured to move the links to position the instrument and energy applicator. A force/torque sensor coupled to the manipulator generates an output in response to forces/torques applied to the instrument. Controller(s) defines a centering point that intersects the common axis. Controller(s) model the instrument and the energy applicator as a virtual rigid body and determine forces/torques to apply to the virtual rigid body, which are determined, in part, based on the output of the force/torque sensor. Controller(s) control the manipulator to advance the energy applicator based on the determined forces/torques applied to the virtual rigid body and reorient the instrument such that the common axis pivots about the centering point during advancement of the energy applicator.

A surgical access device includes a cannula having a variable length. The cannula may include a shaft assembly including an outer shaft, an intermediate shaft disposed within and longitudinal slidable relative to the outer shaft, and an inner shaft disposed within and longitudinal slidable relative to the intermediate shaft. The shaft assembly is movable between an unextended position, a fully extended position, and a semi-extended position between the unextended and fully extended positions. The cannula may include a shaft having annular folds formed therein. The annular folds are axially movable relative to each other such that the shaft is longitudinally movable between an unextended position and a plurality of extended positions.

A surgical instrument includes a housing having an elongated shaft extending distally therefrom. An end effector for treating tissue is supported by the elongated shaft. One or more tensile members extend at least partially through the elongated shaft. A proximal end of a tensile member is operatively coupled to at least one actuator and a distal end is operatively coupled to the end effector such that manipulation of the actuator induces movement of the tensile member to move the end effector. A de-tensioning mechanism is operatively associated with the tensile member to move the tensile member between a first relaxed configuration and a second stressed configuration. The de-tensioning mechanism includes a spacer insertable into a cavity defined in the housing to move the tensile member to the first relaxed configuration and removable from the cavity to move the at least one tensile member to the second stressed configuration.

A surgical instrument with a rotatable and articulatable end effector. The end effector includes first and second jaws that are movable between an open position and a closed position by an axially movable drive member. The end effector is coupled to an elongate shaft such that the end effector is rotatable relative to the shaft about a shaft axis when the drive member is rotated. A releasable lock system is provided to selectively lock the end effector in a desired rotary position.

A fastener cartridge can comprise a support portion, a tissue thickness compensator positioned relative to the support portion, and a plurality of fasteners positioned within the support portion and/or the tissue thickness compensator which can be utilized to fasten tissue. In use, the fastener cartridge can be positioned in a first jaw of a surgical fastening device, wherein a second jaw, or anvil, can be positioned opposite the first jaw. To deploy the fasteners, a staple-deploying member is advanced through the fastener cartridge to move the fasteners toward the anvil. As the fasteners are deployed, the fasteners can capture at least a portion of the tissue thickness compensator therein along with at least a portion of the tissue being fastened.

A stapling assembly comprising a tissue thickness compensator is disclosed. The tissue thickness compensator comprises a body portion comprising a porous material and a plurality of cavities defined in the body portion, wherein the cavities are aligned with forming surfaces of an anvil such that fasteners of a fastener cartridge are configured to at least one of the cavities when the fasteners are ejected from the fastener cartridge or capture the cavities and compress the cavities within the tissue thickness compensator when the fasteners are ejected from the fastener cartridge and formed by forming surfaces of the anvil. The stapling assembly further comprises at least one medicament positioned within each cavity prior to firing the stapler, wherein the medicament is different than the porous material.

An apparatus comprises a body assembly and a shaft extending distally therefrom. The shaft defines a longitudinal axis. The apparatus further comprises an acoustic waveguide and an articulation section coupled with the shaft. A portion of the articulation section encompasses a flexible portion of the waveguide. The articulation section further comprises first member and a second member that is longitudinally translatable relative to the first member. The apparatus further comprises an end effector including an ultrasonic blade in acoustic communication with the waveguide. A distal portion the ultrasonic blade is disposed in a first direction away from the longitudinal axis at a bend angle. The end effector also includes a clamp arm that is coupled with the first member and the second member, and an articulation drive assembly operable to drive articulation of the articulation section to thereby deflect the end effector from the longitudinal axis in the first direction.

Forceps including a housing, a first body, a second body and a drive shaft. The first body has a passageway extending therethrough. The drive shaft extending through the passageway and connected to the first body such that the first body and the drive shaft are slidable with respect to the housing to drive jaws located at a distal portion of the drive shaft between an open position and a closed position. The second body having a second passageway. The drive shaft extending through the second passageway such that the second body is guided by the drive shaft and is slidable relative to the first body and the drive shaft to displace a blade shaft between a retracted position and an extended position.