An articulating ultrasonic surgical end effector for use with a hand-held surgical instrument or a robotic surgical system includes an articulation assembly, a clevis operably coupled to the articulation assembly, and a transducer assembly pivotably coupled to the clevis. The transducer assembly includes a transducer housing and an ultrasonic transducer and a waveguide disposed within the transducer housing. The waveguide is coupled to the ultrasonic transducer and extends distally from the ultrasonic transducer. The transducer assembly also includes an ultrasonic blade disposed at the distal end of the waveguide and extending from the transducer housing and a clamp arm pivotably coupled to the transducer housing and movable relative to the ultrasonic blade between an open position and a clamping position. Ultrasonic energy produced by the ultrasonic transducer is transmitted along the waveguide to the ultrasonic blade for treating tissue.

An ultrasonic surgical instrument including a blade that treats tissue and a fluid control system to cool the blade by pumping cooling fluid through the blade. The blade defines a blade lumen in fluid contact with an inflow and return conduit of the fluid control system. The inflow conduit defines an open distal end positioned within the blade lumen adjacent the distal end of the blade lumen and the return conduit defines an open distal end positioned within the blade lumen adjacent the proximal end of the blade lumen. The fluid control system may further include a fluid reservoir holding the cooling fluid and an inflow pump. The inflow pump is configured to deliver the fluid from the fluid reservoir, through the inflow conduit and the blade lumen, and into return conduit.

A treatment device includes: a probe including a treatment portion that performs treatment to a treatment target portion by transmission of ultrasonic vibration; a first sheath having a first edge and enclosing a periphery of the probe; a second sheath having a second edge and enclosing a periphery of the first sheath; a suction path including a suction opening between the first edge and the second edge and provided between the first sheath and the second sheath; and a connection part communicating with the suction path and connected to a suction source.

A surgical instrument end effector assembly includes a first jaw member defining an insulative tissue-contacting surface and first and second electrically-conductive tissue-contacting surfaces disposed on either side of the insulative tissue-contacting surface. A second jaw member includes an ultrasonic blade body positioned to oppose the insulative tissue-contacting surface of the first jaw member. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position to apply a first grasping force to tissue disposed therebetween. A slider is movable, independent of the first jaw member, between a retracted position, wherein the slider is disposed proximally of the first and second jaw members, and an extended position, wherein the slider extends about the first jaw member and urges the first jaw member from the approximated position further towards the second jaw member to apply a second, greater grasping force to tissue.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

An access device for accessing an intervertebral disc having an outer shield comprising an access shield with a larger diameter (˜16-30 mm) that reaches from the skin down to the facet line, with an inner shield having a second smaller diameter (˜5-12 mm) extending past the access shield and reaches down to the disc level. This combines the benefits of the direct visual microsurgical/mini open approaches and the percutaneous, “ultra-MIS” techniques.

An apparatus includes a body, a shaft assembly, and an end effector. The shaft assembly includes an outer tube, an inner tube, and an acoustic waveguide. The end effector includes an ultrasonic blade and a clamp arm. The ultrasonic blade is acoustically coupled with the acoustic waveguide. A first portion of the clamp arm is pivotably coupled with a distal end of the outer tube. A second portion of the clamp arm is pivotably coupled with a distal end of the inner tube. The outer tube and the inner tube are configured to removably couple with the body such that the outer tube, the inner tube, and the clamp arm are configured to removably couple with the body and the remainder of the shaft assembly and end effector as a unit.

A system for controlling a robotic end-effector is disclosed. The system includes a robotic arm, a surgical tool including an end-effector with articulatable arm and a clamp jaw. A tool driver is coupled to the surgical tool and a motor is coupled to the tool driver and is configured to drive the surgical tool. A sensor is configured to sense external forces applied to the end-effector. A central control circuit is configured to control the tool driver. The central control circuit is configured to receive a sensed parameter from the sensor, receive a sensed motor current (I) from the motor, and control the tool driver based on the sensed parameter and the motor current (I).

A system for fracturing a frame of a deployed prosthesis with ultrasonic vibration includes a shaft, a tip assembly, an ultrasonic electric generator, and an ultrasonic transducer. The shaft includes a proximal portion and a distal portion. The tip assembly is coupled to the distal portion of the shaft. The tip assembly includes a cutting edge. The ultrasonic transducer is electrically coupled to the ultrasonic generator. Ultrasonic vibration generated by the ultrasonic transducer is translated to the tip assembly. The cutting edge of the tip assembly is configured to focus the vibration of the tip assembly onto a frame of a deployed prosthesis to fracture the frame of the prosthesis. The ultrasonic transducer may be coupled to the proximal portion or the distal portion of the shaft.

A surgical instrument end effector assembly includes a first jaw member and a second jaw member. The second jaw member includes an ultrasonic blade body and first and second electrodes disposed on either side of the ultrasonic blade body and extending longitudinally along a majority of a length of the ultrasonic blade body. The ultrasonic blade body is adapted to receive ultrasonic energy from an ultrasonic waveguide. The first and second electrodes taper in width proximally to distally and are adapted to connect to a source of electrosurgical energy. The first jaw member is movable relative to the second jaw member between a spaced-apart position and an approximated position for grasping tissue therebetween.