A vessel harvesting system removes a target vessel from a patient for use as a bypass. An elongated harvesting instrument inserts into a body along a path of a target vessel which includes at least one side branch. The harvesting instrument includes a cutter for applying thermal energy to sever and cauterize the side branch. An endoscopic camera captures visible-light images from a distal tip of the instrument within a dissected tunnel around the target vessel. A thermal camera captures thermograms coinciding with the visible-light images to characterize a temperature present at respective surfaces in the tunnel. An image processor (e.g., an electronic controller) renders a video stream including the visible-light images and an overlay depicting the temperatures present on at least some of the respective surfaces when applying the thermal energy. A display presenting the video stream and overlay to a user can be an augmented-reality display.

Certain aspects relate to systems, devices and techniques for vessel sealing and cutting. In particular, an instrument is provided that is capable of performing multiple functions, including sealing and cutting. The instrument can be robotically controlled, and can include a shaft, a multi-DOF wrist, and an end effector. The end effector is capable of generating and delivering heat via different energy modalities to perform the various functions at different temperatures.

A surgical instrument includes a housing having a shaft with an end effector assembly disposed at a distal end thereof that includes first and second jaw members configured to treat tissue upon electrical activation thereof. A first handle is movable relative to the housing and is configured to move the jaw members relative to one other to grasp tissue therebetween. A switch is disposed on the housing and in the actuation path of the first handle, the switch configured for activation by the first handle when the first handle is fully actuated relative to the housing. An over-ride is disposed in the housing and is movable between a first position configured to block full actuation of the first handle relative to the housing to prevent activation of the switch and a second position allowing full actuation of the first handle and activation of the switch.

Medical methods and devices for treating aortic dissections. A catheter-based cutting device permits cutting a septum of acute or chronic aortic dissections, in a retrograde manner. The catheter includes a base section having a central lumen therethrough and two flexible arms extending from a distal end thereof. The flexible arms can each have a guide wire channel therethrough. With distal ends of the two flexible arms separated, the two arms form a Y-shape with the base section. In one embodiment, with distal ends of the two flexible arms together, the two arms have a longitudinal profile, about a periphery thereof, identical to a longitudinal profile of the base section. A cutting component resides between the two arms. The cutting component can face distally outward between the two arms with the distal ends of the two flexible arms separated.

An instrument may comprise a shaft and an end effector comprising a jaw mechanism coupled to the shaft. The jaw mechanism may comprise a first jaw member and a second jaw member movable relative to one another by pivoting about a pivot axis between an open configuration of the jaw mechanism and a closed configuration of the jaw mechanism. The second jaw member may be rotatable about a roll axis of the second jaw member between at least two orientations, the roll axis of the second jaw member being transverse to the pivot axis. In a first orientation of the at least two orientations, the jaw mechanism is configured to perform a first function. In a second orientation of the at least two orientations, the jaw mechanism is configured to perform a second function differing from the first function.

A blood vessel dissecting device is disclosed, which includes at least two dissecting devices, which are inserted into a living body along a blood vessel to dissect tissue in a direction of alignment thereof with the blood vessel. The at least two dissecting devices include a first dissecting device and a second dissecting device. The first dissecting device and the second dissecting device are disposed juxtaposedly in the living body, and a branch vessel branched from the blood vessel is located between the first dissecting device and the second dissecting device.

A blood vessel dissecting device is disclosed, which includes a dissecting device which, when being inserted into a living body along a blood vessel, dissects tissue in a direction of alignment thereof with the blood vessel, and a cutting device which, when being inserted into the living body along the blood vessel, cuts tissue surrounding the blood vessel in a direction of alignment thereof with the blood vessel. The cutting device includes a main body section which is inserted into the living body and holds the tissue between itself and the dissecting device, and a cutting section which cuts the tissue held between the main body section and the dissecting device.

A vein harvesting device is disclosed. The vein harvesting device includes a handle assembly, at least one elongated portion, first and second end effectors, and a tip. Each end effector is disposed adjacent a distal portion of the at least one elongated portion. Each end effector includes a first jaw member and a second jaw member, and at least one jaw member is movable toward the other jaw member. The tip is disposed in mechanical cooperation with the elongated portion. A distal end of the tip extends distally beyond a distal-most end of the first end effector. The first end effector is movable independently of the tip, and the second end effector is movable independently of the tip.

A vessel sealing instrument includes a housing having a shaft extending from a distal end thereof including an end effector assembly having opposing first and second jaw members operably coupled thereto. The jaw members movable between open and closed positions for clamping tissue with a closure pressure. The jaw members are adapted to connect to a generator for providing energy thereto. An anti-backdrive mechanism is operably associated with the end effector assembly, the anti-backdrive mechanism including first and second mesh-like electrodes disposed in opposing relation on respective first and second jaw members and including openings defined therein. The first and second mesh-like electrodes compressible between a first configuration for grasping tissue wherein the openings defined within each mesh-like electrode include a first diameter to a second configuration for sealing tissue wherein the openings defined within each mesh-like electrode expand to a second diameter configured to release steam upon activation.

An end effector assembly of a forceps includes a first jaw member and a second jaw member. The first jaw member and the second jaw member are selectively positionable relative to one another. At least one of the jaw members includes an electrically conductive tissue engaging surface configured to connect to an electrosurgical energy source, and at least one of the jaw members includes two blade channels defined therein and extending therealong and a feed in member selectively positioned between the two blade channels. The end effector further includes a cutting blade that is translatable such that selective positioning of the feed in member enables the cutting blade to selectively enter into at least one of the two blade channels.