A surgical instrument includes an end effector and a feedback system. The end effector includes a first jaw and a second jaw, wherein at least one of the first jaw and the second jaw is movable relative to the other one of the first jaw and the second jaw to transition the end effector during a closure stroke between an open configuration, a first approximated configuration, and a second approximated configuration. The feedback system includes an indicator, the indicator transitionable between a first indicator position, a second indicator position, and a third indicator position, wherein the indicator is in the first indicator position when the end effect is in the open configuration, wherein the indicator is in the second indicator position when the end effector is in the first approximated configuration, and wherein the indicator is in the third indicator position when the end effector is in the second approximated configuration.

An end effector for a wristed surgical instrument includes a first jaw member, a second jaw member coupled to the first jaw member by a pivot pin, an actuation string, and a blade supported between the first and second jaw members. The first and second jaw members are positioned to pivot and articulate about a pivot axis defined by the pivot pin. The blade is secured to the actuation string and movable relative to the first and second jaw members to sever tissue clamped between the first and second jaw members in response to actuation of the actuation string.

A surgical instrument comprising a shiftable transmission is disclosed. The transmission comprises a mechanism for assuring that the transmission is in one of a plurality of predefined configurations.

A forceps having at least a first jaw with a longitudinal axis is disclosed. The first jaw can include a body portion, a first flange, a second flange and a cam pin. The first flange can define a first cam slot with a longitudinal extent along the longitudinal axis. The second flange can be spaced from the first flange a distance transverse to the longitudinal axis of the first jaw and can have a second cam slot. The cam pin, with a longitudinal axis, can be moveably secured within the first cam slot and the second cam slot. A diameter of the cam pin can be less than a width between a first longitudinal edge that defines a first side of each of the first cam slot and the second cam slot and a second longitudinal edge that defines a second opposing side of each of the first cam slot and the second cam slot so that the cam pin is moveably received by both the first cam slot and the second cam slot. With the first jaw pivoted to at least a first position, the cam pin and first flange can be configured such that the first longitudinal edge is contacted by the cam pin but the second longitudinal edge is spaced from the cam pin. The cam pin and second flange can be configured such that the first longitudinal edge is spaced from the cam pin but the second longitudinal edge is contacted by the cam pin.

An ultrasonic surgical instrument and method for identifying tissue state and energizing the surgical instrument includes an end effector having an ultrasonic blade and an RF electrode, a shaft assembly, a body, and a power controller. A first ultrasonic energy input is configured to be actuated from a first unactuated energy input state to a first actuated energy input state. A trigger input is configured to be actuated from an unactuated trigger input state to an actuated trigger input state. The power controller is operatively connected to the ultrasonic blade, the RF electrode, the first ultrasonic energy input, and the trigger input and configured to direct at least one of the ultrasonic blade or the RF electrode to be selectively driven according to a predetermined drive function based on the tissue impedance, the state of the first energy input, and the state of the trigger input.

An ultrasonic forceps comprises a housing, an acoustic assembly, and a tine. The housing joins the acoustic assembly and the tine to the forceps and permits the tine to pivot relative to the acoustic assembly. The acoustic assembly comprises a transducer, a waveguide, and ultrasonic blade, and a waveguide sheath. The transducer is configured to generate ultrasonic vibrations directing the ultrasonic vibrations to the waveguide. The waveguide communicates the ultrasonic vibrations distally to the ultrasonic blade. The ultrasonic blade is configured to vibrate in response to the ultrasonic vibrations generated by the transducer. When the tine is pivoted relative to the transducer, the tine is configured to move toward the ultrasonic blade. Tissue may be grasped between the tine and the ultrasonic blade. The tissue may be denatured when the ultrasonic vibrations generated by the transducer vibrate the ultrasonic blade, thus resulting in the tissue being cut and/or sealed.

A cutting device including a first contact member and at second contact member assembled so as to be openable and closable, a contact mechanism that rotates the first contact member toward the second contact member to bring the first contact member and the second contact member into contact with a target portion, and a cutting mechanism for cutting the target portion in a state where the first contact member and the second contact member are in contact with the target portion by the contact mechanism.

An ultrasonic surgical instrument and method of limiting an ultrasonic blade temperature includes adjusting at least one power parameter of the ultrasonic energy in response to reaching a predetermined frequency parameter change threshold in the ultrasonic blade limiting the temperature of the ultrasonic blade to an upper temperature limit. The ultrasonic surgical instrument further includes an end effector having an ultrasonic blade, a jaw, and a controller. The jaw is movably positioned relative to the ultrasonic blade and configured to move between an open position and a closed position. The controller operatively connects to the ultrasonic blade and is configured to measure an ultrasonic frequency of the ultrasonic blade. The controller has a memory including a plurality of predetermined data correlations that correlate changes in measured ultrasonic frequency of the ultrasonic blade to a blade temperature of the ultrasonic blade.

A medical manipulator includes: an elongated portion; an end effector provided to a distal end of the elongated portion and having a pair of jaws that open and close; and a manipulating portion provided to a proximal end of the elongated portion. One of the pair of jaws has a first member and a second member, the second member being rotatably attached to the first member. The other of the pair of jaws has a third member rotatably attached to the first member and the second member, a front portion of the third member being located to face the second member. The manipulating portion has a switching portion configured to switch between a first mode in which rotation of the second member with respect to the first member is restricted and a second mode in which rotation of the second member with respect to the first member is not restricted.

A surgical tool can include a handle, an outer tube, an end effector, an inner tube, and a guide tube. The outer tube can be connected to the handle and can extend along a longitudinal axis. The end effector can be connected to the outer tube. The inner shaft can be located within the outer tube and can extend along the longitudinal axis. The inner shaft can be connected to the end effector and the outer shaft. The handle can be operable to translate the inner shaft with respect to the outer tube to operate the end effector. The guide tube can be located within the outer tube between the handle and the end effector. The guide tube can include a conduit extending therethrough.