An ultrasonic surgical system is disclosed including an end effector, an elongate shaft, an articulation joint, and an articulation system. The end effector is rotatable relative to the elongate shaft about the articulation joint. The articulation system includes a distal plate, a first cable, a second cable, and a gear. The distal plate is configured to articulate toward a first side of the gear based on the gear rotating in a first direction and articulate toward a second side of the gear based on the gear rotating in a second direction. The end effector is configured to articulate in a first articulation direction about the articulation joint based on the distal plate articulating toward the first side of the gear. The end effector is configured to articulate in a second articulation direction about the articulation joint based on the distal plate articulating toward the second side of the gear.

A surgical stapler, or fastening instrument, may generally comprise a layer, such as a tissue thickness compensator, for example, releasably attached to a fastener cartridge and/or anvil by a flowable attachment portion. The flowable attachment portion may be indefinitely flowable. The flowable attachment portion may be flowable from the time that layer is installed to the fastener cartridge to the time in which the layer is implanted to patient tissue. The flowable attachment portion may comprise a pressure sensitive adhesive. The flowable attachment portion may comprise an adhesive laminate comprising a base layer comprising the tissue thickness compensator and an adhesive layer on at least a portion of a surface of the base layer comprising the pressure sensitive adhesive. Articles of manufacture comprising flowable attachment portion and methods of making and using the flowable attachment portion are also described.

A surgical instrument comprising a jaw assembly is disclosed. The surgical instrument further comprises a motor-driven drive system configured to open the jaw assembly. The surgical instrument also comprises a control system configured to control the drive system and, also, control a power supply system configured to supply electrical power to electrodes defined in the outer surface, or outer surfaces, of the jaw assembly. In use, the surgical instrument can be used to apply mechanical energy and electrical energy to the tissue of a patient at the same time, or at different times. In certain embodiments, the user controls when the mechanical and electrical energies are applied. In some embodiments, the control system controls when the mechanical and electrical energies are applied.

A surgical tool for use with a robotic system that includes a tool drive assembly that is operatively coupled to a control unit of the robotic system that is operable by inputs from an operator and is configured to robotically-generate output motions. A drive system is configured to interface with a corresponding portion of the tool drive assembly for receiving the robotically-generated output motions and applying the output motions to a drive shaft assembly which is configured to apply control motions to a surgical end effector operably coupled thereto. A manually-actuatable control system operably interfaces with the drive shaft assembly to facilitate the selective application of manually-generated control motions to the drive shaft assembly.

A medical device includes a shaft including a distal end including a passive electrode that defines a central opening extending through the passive electrode, and an active electrode within the central opening. The active electrode is movable between at least an extended position in which the active electrode does not contact the passive electrode, and a retracted position in which the active electrode contacts the passive electrode.

A medical manipulator includes: an insertion portion, an end effector, a bend restraining unit, a position detector, an operation unit, a first drive unit, and a control unit. The control unit is configured to generate the first drive signal based on an output and the position of the bend restraining unit which is detected by the position detector. The output is output from the operation unit that operates the bending portion.

A catheter system may comprise an articulation joint including a first pair of links and a second pair of links. Each link may include a central channel enclosed at least in part by radially extending arcuate segments. The first pair of links may include a first link and a second link, and the second pair of links may include the second link and a third link. The system may also comprise a first pair of springs coupled between the first and second links. The system may also comprise a second pair of springs coupled between the second and third links. The system may also include control wires extending through the first pair of springs and a control wires extending through the second pair of springs. The spring walls may share a radial dimension with the link walls.

Certain aspects relate to systems and techniques for articulating medical instruments. In one aspect, the instrument includes a wrist having at least two degrees of freedom of movement, and an end effector coupled to the wrist. The end effector can include an upper jaw, a lower jaw, and a firing mechanism configured to form staples in tissue. Actuation of the firing mechanism can be decoupled from the movement of the wrist in the at least two degrees of freedom.

An end-effector for an endoscopic surgical instrument, the end-effector comprising: a tool configured to interact with tissue; a main body comprising a bearing stud, the tool being connected to the bearing stud; a base comprising a surface facing the bearing stud, the bearing stud and the surface forming a ball joint; and a plurality of tendons connected to the main body so as to control movement of the tool in two degrees of freedom.

A surgical instrument including a first jaw that is configured to support a staple cartridge therein. An axially movable firing member is configured to move between a beginning position and an ending position by a first flexible drive member and a second flexible drive member. A firing member lock is configured to prevent the firing member from distally moving from the beginning position to the ending position unless an axially movable camming member in the staple cartridge that is supported in the first jaw is in a starting position.