A gear arrangement including two drive units (210, 220, 310, 320, 410), and two translatory transmission elements (151, 152, 251, 252, 351, 352), to each of which a rotationally movable function unit (141, 142) of a distally arranged two-part end effector (140) can be coupled. The first drive unit (210, 310, 410) has at least one proximally arranged rotation element (311, 411) or a thrust element (210) for opening or closing the end effector (140) by rotation of at least one function unit (141, 142). The second drive unit (220, 320), with which the translatory transmission elements (151, 152, 251, 252, 351, 352) are movable in opposite directions, has at least one proximally arranged rotation element (224, 320, 421) for simultaneous and unidirectional pivoting of the function units (141, 142) of the end effector (140). A surgical instrument includes the gear arrangement (200, 300, 400) in the handle (180).

An end effector for a suturing and grasping device includes a stationary jaw member, a suturing jaw member, and a grasping jaw member. The suturing jaw member is selectively movable relative to the stationary jaw member to drive a suturing needle between the suturing jaw member and the stationary jaw member. The grasping jaw member is selectively movable relative to the stationary jaw member to grasp tissue between the stationary jaw member and the grasping jaw member.

End effectors with redundant closing mechanisms, and related tools and methods are disclosed. The disclosed end effectors may be particularly beneficial when used for minimally invasive surgery. An example surgical tool comprises an elongate shaft having a proximal end and a distal end, a tool body disposed at the distal end of the shaft, a jaw movable relative to the tool body between a clamped configuration and an open configuration, a first actuation mechanism coupled with the jaw and operable to vary the position of the jaw relative to the tool body between the clamped configuration and the open configuration, and a second actuation mechanism coupled with the jaw. The second actuation mechanism has a first configuration where the jaw is held in the clamped configuration and a second configuration where the position of the jaw relative to the tool body is unconstrained by the second actuation mechanism.

A surgical instrument includes a shaft and a pair of jaw members disposed on the shaft and extending from an at least partially spherical element. The jaw members are moveable in pitch and yaw relative to the center of the sphere in response to actuation forces applied to a proximal drive mechanism of the instrument. The surgical instrument may include a manually operated handle for manual input of actuation forces by a user, or it may be removably mounted to a drive component of a robotic system such that its proximal drive mechanism is operatively engaged with actuators that generate mechanical output that is transferred to the proximal drive mechanism.

A surgical system includes an attaching device having an end effector disposed at the distal end thereof. The end effector includes a support member, a wrist pivot pivotably coupling the end effector to the attaching device, and first and second jaw members pivotably coupled to one another and the support member. A first cable is operably coupled to the wrist pivot and configured to articulate the end effector relative to the attaching device. Second and third cables are operably coupled to the jaw members and configured to pivot the jaw members relative to the support member. A first actuation of the second and third cables collectively pivots the first and second jaw members relative to the support member. A second actuation of the second and third cables pivots the first and second jaw members relative to one another and the support member between a spaced-apart position and an approximated position.

Provided is a digestive-tract treatment method including: pulling, inside a digestive tract (A), an end portion of a first wall portion (A1) positioned at a rim of a treatment target site (B), and moving the first wall portion (A1) to a position on a second wall portion (A2) on an opposite side of the treatment target site (B) from the first wall portion (A1); and joining the first wall portion (A1) and the second wall portion (A2) in a state in which the first wall portion (A1) and the second wall portion (A2) are layered.

Various embodiments are direct to a surgical instrument comprising and end effector, an articulating shaft and an ultrasonic transducer assembly. The end effector may comprise an ultrasonic blade. The articulating shaft may extend proximally from the end effector along a longitudinal axis and may comprise a proximal shaft member and a distal shaft member pivotably coupled at an articulation joint. The ultrasonic transducer assembly may comprise an ultrasonic transducer acoustically coupled to the ultrasonic blade. The ultrasonic transducer assembly may be positioned distally from the articulation joint.

An adapter assembly for selectively interconnecting a surgical end effector including at least one axially translatable drive member and a powered actuator device including at least one rotatable drive shaft is provided. The adapter assembly includes an actuation shaft configured to convert rotation of a first drive shaft of the powered actuator device into an axial translation of a first drive member of the surgical end effector. The adapter assembly further includes an elongate tube configured to convert rotation of a second drive shaft of the powered actuator device into an axial translation of a second drive member of the surgical end effector. The actuation shaft is disposed within the elongate tube, and the actuation shaft and the elongate tube translate axially independent of each other.

Various exemplary surgical tool wrists are provided. In general, a surgical tool can include an elongate shaft and a wrist that couples an end effector to a distal end of the shaft. The surgical tool can include multiple elongate members configured to move, either individually or as a group of two or more of the elongate members, to cause movement of the end effector relative to the shaft. Each of the surgical tool's elongate members can be configured to extend along a helical path. Each of the elongate members can extend proximally from its associated helical path to a pulley at the wrist. The helical paths can be configured to guide the elongate members to approach and engage their respective pulleys at a substantially zero angle.

A surgical instrument for cutting and grasping tissue comprising a handle assembly, an elongated member and first and second jaws. A first movable member moves the second jaw in a first direction about a first pivot axis in a grasping action and a second movable member moves the second jaw in a second direction different than the first direction and about a second pivot axis in a cutting action. A switch is positioned at the proximal portion of the instrument and a selecting member is actuated by movement of the switch, the selecting member movable between a first position to enable movement of the second jaw in the first direction and prohibit movement in the second direction and a second position to enable movement of the second jaw in the second direction and prohibit movement in the first direction.