An electrosurgical system is provided and includes a bipolar electrosurgical instrument and an electrosurgical generator. The bipolar electrosurgical instrument is arranged to seal and cut tissue captured between jaws of the bipolar electrosurgical instrument. The electrosurgical generator is arranged to supply RF energy through the bipolar electrosurgical instrument, monitor the supplied RF energy, and adjust or terminate the supplied RF energy to optimally seal the tissue.

A surgical instrument that includes a surgical end effector that is articulatable relative to a proximal shaft segment of the surgical instrument. The surgical end effector is attached to the proximal shaft segment by an articulation joint that comprises a plurality of movably interconnected links that interface with a centrally disposed drive member to apply articulation motions thereto and which serve to provide improved lateral stability to the articulation joint.

An electrosurgical instrument is provided that captures, compresses, fuses and cuts tissue between upper and lower jaws connected to pivotably movable handles. The instrument includes a force and over compression regulation mechanism that is configured such that in a clamped configuration, the jaws delivers a gripping force between the first jaw and the second jaw between a predetermined minimum force and a predetermined maximum force.

A system for creating an arteriovenous (AV) fistula comprises a vessel access sheath having a hollow interior and an exit port, a side access needle catheter configured to fit within the hollow interior of the sheath, a needle configured to be inserted into a blood vessel through the side access needle catheter, a toggle delivery catheter configured to fit within the hollow interior of the sheath, and a toggle apparatus configured to be delivered into a vessel through the toggle delivery catheter. The toggle apparatus comprises a shaft and a toggle member pivotably attached to a distal end of the shaft. A source of RF energy or resistive heat energy may be provided for application to the toggle member and/or to a heater insert in the toggle delivery catheter, for the purpose of creating the fistula.

Various aspects of a generator, ultrasonic device, and method for estimating and controlling a state of an end effector of an ultrasonic device are disclosed. The ultrasonic device includes an electromechanical ultrasonic system defined by a predetermined resonant frequency, including an ultrasonic transducer coupled to an ultrasonic blade. A control circuit measures a complex impedance of an ultrasonic transducer, wherein the complex impedance as defined as

[00001]$Z_g\left(t\right)=\frac{V_g\left(t\right)}{I_g\left(t\right)};$

The control circuit receives a complex impedance measurement data point and compares the complex impedance measurement data point to a data point in a reference complex impedance characteristic pattern. The control circuit then classifies the complex impedance measurement data point based on a result of the comparison analysis and assigns a state or condition of the end effector based on the result of the comparison analysis. The control circuit estimates the state of the end effector of the ultrasonic device and controls the state of the end effector of the ultrasonic device based on the estimated state.

An electrosurgical instrument is provided that captures, compresses, fuses and cuts tissue between upper and lower jaws connected to pivotably movable handles. The instrument includes a force and over compression regulation mechanism that is configured such that in a clamped configuration, the jaws delivers a gripping force between the first jaw and the second jaw between a predetermined minimum force and a predetermined maximum force.

An end effector assembly for use with a forceps includes a pair of jaw members, a knife assembly, and one or more cam assemblies. One or more of the jaw members are moveable relative to the other about a pivot between open and closed positions. One or more of the jaw members include a knife channel. The pivot includes first and second sections defining a passage therebetween. The knife assembly includes a knife blade and an actuation shaft. The knife blade is disposed distally relative to the pivot. The actuation shaft is configured for slidable translation through the passage to allow selective advancement of the knife blade through the knife channel. The one or more cam assemblies are operably coupled to the one or more moveable jaw members and are actuatable to move the one or more jaw members between the open and closed positions for grasping tissue therebetween.

A medical device includes a shaft including a central lumen configured to direct a flow of fluid through the shaft, and an electrode positioned at a distal portion of the shaft. The electrode includes an electrode lumen in fluid communication with the central lumen, and the electrode lumen is configured to receive the flow of fluid from the central lumen. The electrode also includes one or more channels angled relative to the electrode lumen, and the one or more channels are in fluid communication with the electrode lumen to receive the flow of fluid from the electrode lumen. The one or more channels are configured to divert the flow of fluid from the electrode lumen toward one or more outlets laterally offset from the electrode lumen.

A powered surgical instrument comprising a housing, an elongate shaft, an articulation joint, a rotary drive member configured to rotate in response to rotary motion from an electric motor, a coupling portion, and a stapling attachment releasably attachable to the coupling portion is disclosed. The stapling attachment is secured to the coupling portion by rotating one of the stapling attachment and the coupling portion relative to the other of the stapling attachment and the coupling portion. The stapling attachment comprises an elongate channel configured to receive a staple cartridge. The stapling attachment further comprises an anvil, a drive screw, and a firing member operably engaged with the drive screw. The coupling portion operably couples the rotary drive member and the drive screw when the stapling attachment is attached to the elongate shaft. The firing member is advanced distally within the stapling attachment when the drive screw is rotated.

An apparatus for operating on tissue includes a body, a shaft assembly, and an end effector. The shaft assembly extends distally from the body and includes an acoustic waveguide. The waveguide is configured to acoustically couple with an ultrasonic transducer. The end effector includes an ultrasonic blade, a clamp arm, and a clamp pad. The blade is in acoustic communication with the waveguide. The clamp arm is configured to pivot about a first pivot point toward and away from the ultrasonic blade and includes a coupling feature. The clamp pad is selectively attachable to the blade to acoustically isolate the clamp arm from the ultrasonic blade. The coupling feature of the clamp arm is configured to provide a snap fit between the clamp pad and the clamp arm and thereby permit manipulation of the clamp pad for removal of the clamp pad from the clamp arm.