An ultrasound treatment tool includes a handle 6, a vibration transmitting member 13 that is formed in an elongated shape, the vibration transmitting member being configured to transmit an ultrasound vibration generated by a vibration generation source, a holder 112 configured to hold the vibration transmitting portion 13, and a rotary knob 9 configured to rotate about a longitudinal axis Ax1 of the vibration transmitting portion 13 in accordance with a user operation. The holder 112 and the rotary knob 9 are integrally coupled with each other, and are positioned respectively in a radial direction about the longitudinal axis Ax1 with respect to the handle 6. One of the holder 112 and the rotary knob 9 is positioned in a direction along the longitudinal axis Ax1 with respect to the handle 6.

A surgical instrument includes a housing, a shaft extending from the housing, an end effector assembly extending from the shaft and configured to rotate and/or articulate relative to the housing, a motor disposed within the housing and operably coupled to the end effector assembly to rotate and/or articulate of the end effector assembly relative to the housing, and a sensing assembly configured to sense movement of the housing relative to a reference position and to drive the motor to rotate and/or articulate of the end effector assembly relative to the housing based upon the sensed movement. The sensing assembly is configured to operate in each of a standard mode, wherein movement of the housing effects rotation and/or articulation of the end effector assembly in a similar direction, and a reversed mode, wherein movement of the housing effects rotation and/or articulation of the end effector assembly in an opposite direction.

A surgical instrument includes an end effector, a shaft assembly, and a torque wrench integrally connected with the shaft assembly. The shaft assembly has an acoustic waveguide extending therethrough and the end effector projects distally from the shaft assembly. The acoustic waveguide has a proximal end portion configured to rotatably couple with an ultrasonic transducer assembly. The torque wrench is configured to transmit torque applied to the acoustic waveguide up to a predetermined torque. A portion of the torque wrench is configured to deflect upon receipt of torque greater than the predetermined torque. Accordingly, the portion of the torque wrench slips relative to the acoustic waveguide for limiting coupling of the acoustic waveguide to the ultrasonic transducer assembly to the predetermined torque.

Cutting instruments and related methods are disclosed herein in which the diameter of the retrograde cutting blade can be adjusted to any of a plurality of diameter settings, allowing the same instrument to be used to form holes of different diameters. The limit diameter can be preset such that, during the cutting operation, the user need not be concerned with selecting the appropriate diameter, but rather can simply deploy the cutting blade until the preset limit is reached. Cutting instruments are also disclosed in which the retrograde cutting blade is distinct from the forward drilling tip and protected within a cavity formed in the body of the instrument when not in use, as are instruments in which the user is given visual and/or tactile feedback to confirm desired positioning of the cutting blade.

A catheter with a distal end that rotates through the conversion of linear motion to rotational motion, thus the distal end may be rotated without longitudinally advancing or retracting the distal end. The catheter includes a tube with a single helix or a dual chirality helix cut into the tube, a distal end segment, means for linear displacement of the helix, and means for coupling the junction point of the helix to the distal segment.

The disclosure describes systems and methods for altering bone sections in a patient. In one embodiment, a system may include an intramedullary implant including: a housing configured to be secured to a first section of bone, where the housing may include one or more shaft engaging grooves axially extending along an inner surface thereof; a distraction shaft configured to be secured to a second section of bone, where the distraction shaft may include one or more grooves axially extending along an inner surface thereof. The system may further include an actuator disposed within the housing and operably coupled to the distraction shaft, and in response to rotation of the actuator, the one or more grooves of the distraction shaft may engage with the one or more shaft engaging grooves of the housing, causing axial displacement of the distraction shaft relative to the housing.

A surgical instrument is disclosed. The surgical instrument can include an end effector, comprising an anvil and a staple cartridge. The surgical instrument can further include a shaft defining a longitudinal axis. The surgical instrument can also include an articulation joint, wherein the end effector is rotatably connected to the shaft about the articulation joint between an unarticulated position and at least one articulated position. The surgical instrument can include means for adjusting the length of a firing stroke as a function of the degree in which the end effector is articulated relative to the longitudinal axis. The surgical instrument can include a sensor configured to defect shifting of lateral portions of a flexible firing bar that extends through the articulation joint. Additionally or alternatively, the surgical instrument can include a relief feature configured to accommodate shifting of lateral portions of a flexible firing bar.

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, the catheter can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to a leaflet suture. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae.

Robotic systems and methods include a robotic manipulator and a skin incision tool to be coupled to the robotic manipulator and being configured to create an incision in skin of a patient. A skin tracker is attached to the skin of the patient to track the skin of the patient. A robotic controller controls the robotic manipulator to move the skin incision tool relative to a determined location on the skin of the patient. The robotic controller controls the robotic manipulator to constrain movement of the skin incision tool with a haptic object defined relative to the determined location to guide the skin incision tool to the determined location for making the incision in the skin.

Medical systems and methods for making and using medical systems are disclosed. Example medical systems may include an atherectomy system configured to engage and remove plaque from walls in vessels of a vascular system. The atherectomy system may include a drive shaft, a rotational member coupled to an end of the drive shaft, a motor coupled to the drive shaft to rotate the rotational tip, and a control unit configured to control a motor state of the motor. The motor may be an electric motor. The control unit may adjust the motor state to decelerate the motor in response to detecting a jam or a stall condition. The jam or stall condition may be detected when a speed of the motor or other motor state reaches or goes beyond a threshold value as prescribed by a reference schedule.