A shaver arrangement for a surgical instrument includes an outer member and cutting blade at a distal end; the cutting blade being serrated to form teeth forming one or more tissue engaging cutting points being arranged to snag and/or cut tissue and being located inwardly from the outer member such that there are no tissue engaging cutting points capable in use of snagging and/or cutting tissue located on or outwards of an outer surface of the outer member. The shaver arrangement reduces the likelihood of collateral damage to surrounding non-target tissue. The shaver arrangement does not have tissue engagement cutting points on the outer profile of the cutting blade of the shaver arrangement, thereby reducing the likelihood of collateral damage when manoeuvring the surgical instrument as tissue is less likely to be inadvertently caught by the tissue cutting points.

A surgical system for applying an energy applicator to a target tissue and methods operating the same are disclosed. The energy applicator extends from a surgical instrument. The surgical system comprises a sensor to measure external forces and torques placed on the surgical instrument. A surgical manipulator is configured to move the energy applicator in a manual mode in response to the external forces and torques. At least one controller is configured to: model the surgical instrument and the energy applicator as a virtual rigid body having a virtual mass; calculate, using impulse modeling, constraining forces and torques to be applied to the virtual rigid body; determine total forces and torques based on the external forces and torques and the constraining forces and torques; and advance the energy applicator in the manual mode based on the total forces and torques.

Various embodiments are directed to an electrosurgical system including an end effector, a jaw closure trigger, and a control circuit. The end effector includes a first jaw and a second jaw. The control circuit is configured to receive an input indicating a repeat mode, apply a first tissue bite algorithm to a first electrode and a second electrode based on an occurrence of a first tissue bite, enter a hold state at a termination of the first tissue bite algorithm, and determine an occurrence of a second tissue bite. The first tissue bite is based on the second jaw moving toward a closed configuration via the jaw closure trigger. Entering the hold state includes maintaining a sub-therapeutic signal. Determining the occurrence of the second tissue bite includes sensing a reduction in impedance between the first electrode and the second electrode via the sub-therapeutic signal.

System and methods for channeling a path into bone include a trocar having a proximal end, distal end and a central channel disposed along a central axis of the trocar. The trocar includes a distal opening at the distal end of the trocar. The system includes a curved cannula sized to be received in the central channel, the curved cannula comprising a curved distal end configured to be extended outward from the distal opening to generate a curved path extending away from the trocar. The curved cannula has a central passageway having a diameter configured to allow a treatment device to be delivered through the central passageway to a location beyond the curved path.

A lesion control system includes a radio-frequency (RF) generator that produces RF energy having a predetermined frequency and power; a controller comprising a microprocessor; a multi-polar RF ablation probe having a plurality of electrical contacts; a plurality of RF input lines electrically coupled to an output terminal of the RF generator; a plurality of RF output lines, each RF output line electrically coupled to a respective one or more of the electrical contacts in the multi-polar RF ablation probe; an RF return line electrically coupled to a return terminal of the RF generator; and a plurality of switches, each switch having a respective terminal electrically coupled to a respective RF output line, each switch electrically coupled to the controller. The controller is configured to produce switch control signals that change a respective state of one or more of the switches to set a configuration of the multi-polar RF ablation probe.

Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device an energy delivery device).

A surgical instrument with a shaft is constructed as a hollow tube and has a longitudinal axis, proximal and distal ends and a metal wire having a first end section, a shaft section and a working section. The first end section is arranged in the area of the proximal end of the shaft or is guided out of the shaft on the proximal end. The shaft section is guided in the hollow tube and the wire is arranged such that it can move along the longitudinal axis of the shaft into a first position of the working section on the distal end projecting out of the shaft and into a second position of the working section within the shaft. The instrument is constructed as a bipolar instrument, wherein the metal wire is part of a first electrode and a second electrode is arranged in some sections on the shaft.

Described herein are various implementations of systems and methods for accessing and modulating tissue (for example, systems and methods for accessing and ablating nerves or other tissue within or surrounding a vertebral body to treat chronic lower back pain). Assessment of vertebral endplate degeneration or defects (e.g., pre-Modic changes) to facilitate identification of treatment sites and protocols are also provided in several embodiments. Several embodiments comprise the use of biomarkers to confirm or otherwise assess ablation, pain relief, efficacy of treatment, etc. Some embodiments include robotic elements for, as an example, facilitating robotically controlled access, navigation, imaging, and/or treatment.

A minimally invasive tissue incision system for creating joint capsulotomies and releasing/incising various tissues, tendons, and fibrous band structures is described. The system contains a penetrating needle which is retractable so as to expose a cutting element, and which may be used as a penetrating needle to pierce the skin and other soft tissue structures. The cutting element provided within the penetrating needle may be used to incise subsequent tissue structures after the initial penetration. The system facilitates such procedures by providing the cutting element with the confines of the needle which provides safe introduction of the cutting element directly to the site via the needle.

A steerable catheter, such as a dilator, includes an elongated shaft including a proximal end portion and a distal end portion, an end effector disposed at the distal end portion of the shaft, and a handle disposed at the proximal end portion of the shaft. The end effector includes a dilation portion disposed proximate the distal end portion of the shaft, a transition portion disposed distally on the dilation portion, and a distal tip portion disposed distally on the transition portion. The tip portion is movable relative to the dilation portion. The handle includes a tip portion steering actuator enabling a user to steer the tip portion. The tip portion has a tip portion diameter. The dilation portion has a dilation portion diameter which is greater than the tip portion diameter. The transition portion tapers from the tip portion diameter to the dilation portion diameter.