An electrosurgical system can include an electrosurgical generator, a feedback circuit or controller, and an electrosurgical tool. The feedback circuit can provide an electrosurgery endpoint by determining the phase end point of a tissue to be treated. The electrosurgical system can include more than one electrosurgical tool for different electrosurgical operations and can include a variety of user interface features and audio/visual performance indicators. The electrosurgical system can also power conventional bipolar electrosurgical tools and direct current surgical appliances.

A hand tool has a pivot connection pivotally attaching a first arm to a second arm, with the pivot connection fixed relative to the first arm and movable to first and second positions relative to the second arm. A spring urges the pivot connection into the first position. When jaws on the front ends of the arms clamp tissue with force greater than a pre-set threshold, the spring force is overcome and the jaws may move linearly apart, allowing for more uniform clamping of the tissue. The first arm may have an arm spring extending between a front segment pivotally attached to a rear segment of the first arm.

Developed is a tissue joining device for endoscopic surgery, which can be used in NOTES, or the like. As a result of intensive studies carried out to solve the problem described above, the inventors of the present invention have conceived of two tissue joining device having quite novel structures and completed the present invention.

Provided herein are expandable devices, rail systems, and motorized devices, in one embodiment, an expandable device comprises an expandable sac having a tool housed therein. The expandable device is optionally configured for operation while inside a body cavity. The expandable device optionally comprises at least one rail in the sac, and at least one railed device coupled to the rail for movement there on. Movement of the railed device on the rail is provided by, for example, a motor such as an electromagnetic motor or an inch-worm type motor. Expandable devices can be used, for example, to perform minimally invasive medical procedures requiring access to a body cavity. Expandable devices can also be used, for example, to provide safe and stable transport of instruments to the body cavity.

Various surgical systems are disclosed. A surgical system comprises a robotic tool, a robot control system, a surgical instrument, and a surgical hub. The robot control system comprises a control console and a control unit in signal communication with the control console and the robotic tool. The surgical hub comprises a display. The surgical hub is in signal communication with the robot control system. The surgical hub is configured to detect the surgical instrument and represent the surgical instrument on the display.

Presented herein are methods, systems, devices, and computer-readable media for image guided surgery. The systems herein allow a physician to use multiple instruments for a surgery and simultaneously provide image-guidance data for those instruments. Various embodiments disclosed herein provide information to physicians about procedures they are performing, the devices (such as ablation needles, ultrasound wands or probes, scalpels, cauterizers, etc.) they are using during the procedure, the relative emplacements or poses of these devices, prediction information for those devices, and other information. Some embodiments provide useful information about 3D data sets. Additionally, some embodiments provide for quickly calibratable surgical instruments or attachments for surgical instruments.

A blood vessel puncturing means within the internal cavity of the sealing jaws of an electrosurgical instrument. A forceps type electrosurgical device provided with jaws having electrically conductive sealing plates on the inner surfaces that is used to seal a blood vessel during will usually have an inner cavity of the jaws between the jaws within which a blood vessel is received and may expand during electrosurgical sealing. To prevent a blood vessel expanding during electrosurgical sealing to a dangerous size, the inner cavity is provided with a means to puncture the blood vessel in a controlled fashion, and thereby relieve the pressure within the blood vessel. The puncturing means may comprise one or more relief vents. The relief vents may provide channels to allow pressure to be vented to the external of the jaws, thus relieving the internal pressure on the jaws during coagulation.

Presented herein are methods, systems, devices, and computer-readable media for image management in image-guided medical procedures. Some embodiments herein allow a physician to use multiple instruments for a surgery and simultaneously provide image-guidance data for those instruments. Various embodiments disclosed herein provide information to physicians about procedures they are performing, the devices (such as ablation needles, ultrasound transducers or probes, scalpels, cauterizers, etc.) they are using during the procedure, the relative emplacements or poses of these devices, prediction information for those devices, and other information. Some embodiments provide useful information about 3D data sets and allow the operator to control the presentation of regions of interest. Additionally, some embodiments provide for quick calibration of surgical instruments or attachments for surgical instruments.

A surgical instrument is disclosed. The surgical instrument comprises an end effector comprising an ultrasonic blade and a clamp arm. The clamp arm is movable relative to the ultrasonic blade to transition the end effector between an open configuration and a closed configuration to clamp tissue between the ultrasonic blade and the clamp arm. The surgical instrument further comprises an ultrasonic transducer configured to generate an ultrasonic energy output and a waveguide configured to transmit the ultrasonic energy output to the ultrasonic blade. The surgical instrument further comprises a control circuit, configured to detect an immersion of the end effector in a liquid and compensate for heat flux lost due to the immersion of the end effector in the liquid.

Systems, tools and methods are disclosed for the selective and rapid application of DC voltage to drive irreversible electroporation, with the system controller capable of being configured to apply voltages to independently selected subsets of electrodes and capable of generating at least one control signal to maintain the temperature near an electrode head within a desired range of values. Electrode clamp devices are also disclosed for generating electric fields to drive irreversible electroporation while modulating temperature to elevate the irreversible electroporation threshold utilizing a variety of means such as cooling fluid or solid state thermoelectric heat pumps.