An instrument for therapeutically cytotoxically ablating parathyroidal tissue is disclosed. A substance is capable of transforming the parathyroid gland from overproduction of parathyroid hormone when the substance's quantity exceeds a set amount, and is capable of transforming the parathyroid gland from overproduction only when activated by application of sufficient units of an electromagnetic energy having a frequency ranging from 400 THz to 30 PHz when the substance's quantity is below the set amount. A delivery device is operable to introduce the substance into the parathyroidal tissue and to quantitatively limit the quantity to below the set amount. An energy device is operable to apply units of the electromagnetic energy after the substance has been introduced. A sensor is operable to monitor the activation of the substance as the electromagnetic energy is applied. The energy device is further operable to modulate applying the electromagnetic energy when the substance has been activated.

An energy surgical instrument includes a first grasping piece, a second grasping piece which is allowed to grasp a blood vessel, an energy application unit provided in at least one of the first grasping piece and the second grasping piece, which applies treatment energy to the blood vessel grasped, a setting unit which sets information regarding a wall thickness of the blood vessel, and a grasping force adjustment unit which adjusts a grasping force to a first grasping force when the wall thickness set by the setting unit is larger than a predetermined thickness and adjusting the grasping force to a second grasping force, which is smaller than the first grasping force, when the wall thickness set by the setting unit is equal to or smaller than the predetermined thickness.

Surgical devices are provided having power-assisted or fully powered jaw closure. The devices herein generally include a handle portion, an elongate shaft, and an effector having first and second jaws configured to engage tissue. A motor and one or more compression springs can be operatively coupled, and activation of the motor can compress the spring(s) to reduce the amount of user supplied force to compress tissue between the jaws. In some embodiments, the devices can be configured to regulate an amount of compression applied by the jaws prior to, during, and/or after cutting of the tissue to promote hemostasis. For example, the devices can include sensors, processors, and/or other components that analyze data indicative of tissue type and tissue load. Based on this feedback, the device can automatically adjust the amount of compression or energy applied to the tissue to seal the tissue.

Provided is an endoscopic vessel harvesting system comprising a direct current (DC) power control system connected to a therapeutic tool comprising a heating element. The DC power control system may include an input connection to receive power from a power supply. A first power control circuit may supply constant output power during a first time interval to heat the heating element to a target temperature. A second power control circuit may supply pulsed output power during a second time interval to maintain a temperature of the heating element within a target temperature range. An output connection may receive the output power and may supply controlled power to the heating element by supplying the constant output power during the first time interval, the pulsed output power during the second time interval, followed by a third time interval during which no power is supplied. Methods and systems are also disclosed.

Jaw members of end effector assemblies include sealing plates configured to direct the amount and flow of energy through the sealing plates. The sealing plates may have a height varying from a minimal height to a maximum height along a width or a length of the sealing plate and/or a sealing surface including at least two impedance zones having different impedance values.

A vessel harvesting system removes a target vessel from a patient for use as a bypass. An elongated harvesting instrument inserts into a body along a path of a target vessel which includes at least one side branch. The harvesting instrument includes a cutter for applying thermal energy to sever and cauterize the side branch. An endoscopic camera captures visible-light images from a distal tip of the instrument within a dissected tunnel around the target vessel. A thermal camera captures thermograms coinciding with the visible-light images to characterize a temperature present at respective surfaces in the tunnel. An image processor (e.g., an electronic controller) renders a video stream including the visible-light images and an overlay depicting the temperatures present on at least some of the respective surfaces when applying the thermal energy. A display presenting the video stream and overlay to a user can be an augmented-reality display.

A tissue clip for use in electrosurgical procedures includes an arm having a first electrode formed thereon. The tissue clip also includes a body pivotally coupled to the arm. The body includes a power source and a second electrode. The arm is moveable from a first position relative to the body for approximating tissue and a second position closer to the body for grasping tissue therebetween.

An endoscopic surgical instrument is provided. The instrument includes a housing, a handle, an elongated shaft extending distally from the housing and defining a longitudinal axis, an end effector assembly, a drive assembly, a clevis, a first link, and a second link. The end effector assembly is disposed adjacent a distal end of the elongated shaft and includes a first jaw member and a second jaw member. The first link is pivotably connected to the clevis about a first pivot axis, and is pivotably connected to the first jaw member about a first jaw member pivot. The second link is pivotably connected to the clevis about a second pivot axis, and is pivotably connected to the second jaw member about a second jaw member pivot. The first pivot axis and the second pivot axis are offset from the longitudinal axis.

A variable-frequency stimulator for electrosurgery includes an impedance analyzer to identify the electrical impedance of biological tissue being treated by an electrosurgical instrument, such as a laparoscope. Based on the identified tissue impedance, a controller adjusts the frequency of electrical current delivered to the electrosurgical instrument to reduce, minimize or normalize the impedance of the tissue, thereby preventing collateral damage to the tissue in and about the surgical site. Additionally, the laparoscope may be configured with multiple electrically conductive grasping arms that are used to deliver the electrical current to the surgical site. The conductive grasping arms provide multiple current paths for the electrical current to flow, thus concentrating the electrical current at the surgical site during an electrosurgical procedure. Thus, the unwanted spread of electrical current in the tissue is prevented, resulting in the reduction or prevention of collateral damage to tissue in and about the surgical site.

A vessel dissector for harvesting a target vessel from a donor has a generally cylindrical tip body with a sloping channel formed along a longitudinal side. A channel bottom provides a channel depth that decreases from a distal channel end to a proximal channel end. The tip body has a crescent-shaped forward lip extending distally from the channel. An arcuate collar is slidably disposed in an arcuate recess within the tip body to selectably bridge the channel at the distal end of the channel to form a ring profile with the forward lip. A first ferromagnetic heating element is disposed along a radially outward surface of the forward lip. A second ferromagnetic heating element is disposed on a distal edge of the arcuate collar. The first and second ferromagnetic heating elements are adapted to be energized simultaneously to make a vasiform cut including a pedicle around the target vessel.