Newness and distinctiveness is claimed in the features of ornamentation as shown inside the broken line circle in the accompanying representation.

Display screen or portion thereof with graphical user interface

A surgical instrument can comprise a channel configured to support a staple cartridge and, in addition, an anvil pivotable between open and closed positions relative to the channel. The surgical instrument can further comprise a cutting member configured to incise tissue positioned captured between the staple cartridge and the anvil and, in addition, means for stopping the cutting member prior to a distal end datum, wherein the distal end datum can be defined by the distal-most staple cavity in the staple cartridge. In such embodiments, the incision within the tissue may not extend beyond the portion of the tissue that has been stapled.

Surgical stapling instrument with an articulatable end effector

A surgical severing and stapling instrument, suitable for laparoscopic and endoscopic clinical procedures, clamps tissue within an end effector of an elongate channel pivotally opposed by an anvil. An E-beam firing bar moves distally through the clamped end effector to sever tissue and to drive staples on each side of the cut. The E-beam firing bar affirmatively spaces the anvil from the elongate channel to assure properly formed closed staples, especially when an amount of tissue is clamped that is inadequate to space the end effector. In particular, an upper pin of the firing bar longitudinally moves through an anvil slot and a channel slot is captured between a lower cap and a middle pin of the firing bar to assure a minimum spacing. Forming the E-beam from a thickened distal portion and a thinned proximal strip enhances manufacturability and facilitates use in such articulating surgical instruments.

Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism

A surgical instrument including a handle assembly, a first endoscopic portion, a motor, and a first end effector is disclosed. The first endoscopic portion is selectively connectable to a distal portion of the handle assembly and defines a longitudinal axis. The first endoscopic portion includes a housing adjacent its proximal portion and includes an actuation member. The motor is disposed in mechanical cooperation with the housing of the first endoscopic portion and is operatively connected to the actuation member for moving the actuation member substantially along the longitudinal axis. The first end effector is selectively connectable to a distal portion of the first endoscopic portion and is configured to perform a first stapling function.

Powered surgical instrument

A surgical cutting and fastening instrument is disclosed. According to various embodiments, the instrument includes an end effector comprising an elongate channel, a clamping member pivotably connected to the channel, and a moveable cutting instrument for traversing the channel to cut an object clamped in the end effector by the clamping member when the clamping member is in a clamped position. The instrument may also comprise a main drive shaft assembly for actuating the cutting instrument in the end effector, a gear drive train connected to the main drive shaft assembly, and a motor for actuating the gear drive train. The instrument may also includes a closure trigger and a firing trigger, separate from the closure trigger, for actuating the motor when the firing trigger is retracted. Also, the instrument may comprise a mechanical closure system connected to the closure trigger and to the clamping member for causing the clamping member to pivot to the clamped position when the closure trigger is retracted.

Motor-driven surgical cutting and fastening instrument with tactile position feedback

An active-constraint robot (4), particularly for surgical use, is controlled by means of a series of motorised joints to provide a surgeon with real-time tactile feedback of an operation in progress. The robot system holds, in memory, a series of constraint surfaces beyond which it would be dangerous for the surgeon to go, and a resistive force is applied to the cutting tool (14) as the surgeon approaches any such surface. To improve the overall quality of feedback experienced by the surgeon, the resistive force applied to the cutting tool (14) depends upon the point of intersection (1) between the force factor applied by the surgeon and the surface. Further improvements are achieved by adjusting the tangential resistive force, when the tool is adjacent to the surface, in dependence upon the surrounding shape of the surface.

Active-constraint robots

We performed a prospective, randomised controlled trial of unicompartmental knee arthroplasty comparing the performance of the Acrobot system with conventional surgery A total of 27 patients (28 knees) awaiting unicompartmental knee arthroplasty were randomly allocated to have the operation performed conventionally or with the assistance of the Acrobot The primary outcome measurement was the angle of tibiofemoral alignment in the coronal plane, measured by CT Other secondary parameters were evaluated and are reported All of the Acrobot group had tibiofemoral alignment in the coronal plane within 2 degrees of the planned position, while only 40% of the conventional group achieved this level of accuracy While the operations took longer, no adverse effects were noted, and there was a trend towards improvement in performance with increasing accuracy based on the Western Ontario and McMaster Universities Osteoarthritis Index and American Knee Society scores at six weeks and three months The Acrobot device allows the surgeon to reproduce a pre-operative plan more reliably than is possible using conventional techniques which may have clinical advantages

Hands-on robotic unicompartmental knee replacement: A PROSPECTIVE, RANDOMISED CONTROLLED STUDY OF THE ACROBOT SYSTEM

The performance of a novel "hands-on" robotic system for total knee replacement (TKR) surgery is evaluated. An integrated robotic system for accurately machining the bone surfaces in TKR surgery is described. Details of the system, comprising an "active constraint" robot, called Acrobot, a "gross positioning" robot, and patient clamps, are provided. The intraoperative protocol and the preoperative, CT-based, planning system are also described. A number of anatomical registration and cutting trials, using plastic bones, are described, followed by results from two preliminary clinical trials, which demonstrate the accuracy achieved in the anatomical registration. Finally, the first clinical trial is described, in which the results of the anatomical registration and bone cutting are seen to be of high quality. The Acrobot system has been successfully used to accurately register and cut the knee bones in TKR surgery. This demonstrates the great potential of a "hands-on" robot for improving accuracy and increasing safety in surgery.

https://www.tandfonline.com/doi/pdf/10.3109/10929080109146302

The First Clinical Application of a "Hands-on" Robotic Knee Surgery System

As men age, their prostates can enlarge, causing urinary difficulty. Surgery to correct this [transurethral resection of the prostate (TURP)] is a skilled and time-consuming operation requiring many repetitive motions of a cutter. A robot has been developed to perform these motions, relieving the surgeon of much of the burden of surgery. This robot has been tried both in the laboratory and later on human subjects and has proved itself capable of performing prostate resection. The Probot system consists of on-line imaging and three-dimensional prostate model construction, an appropriate surgeon-computer interface, a counterbalanced mounting frame and a computer controlled robot.

The Probot--an active robot for prostate resection.

Surgeons need to be able to measure angles and distances in three dimensions in the planning and assessment of knee replacement. Computed tomography (CT) offers the accuracy needed but involves greater radiation exposure to patients than traditional long-leg standing radiographs, which give very little information outside the plane of the image. There is considerable variation in CT radiation doses between research centres, scanning protocols and individual scanners, and ethics committees are rightly demanding more consistency in this area. By refining the CT scanning protocol we have reduced the effective radiation dose received by the patient down to the equivalent of one long-leg standing radiograph. Because of this, it will be more acceptable to obtain the three-dimensional data set produced by CT scanning. Surgeons will be able to document the impact of implant position on outcome with greater precision.

Simon Harris

Papers

Active-constraint robots

Hands-on robotic unicompartmental knee replacement: A PROSPECTIVE, RANDOMISED CONTROLLED STUDY OF THE ACROBOT SYSTEM

The First Clinical Application of a "Hands-on" Robotic Knee Surgery System

The Probot--an active robot for prostate resection.

Very low-dose computed tomography for planning and outcome measurement in knee replacement: THE IMPERIAL KNEE PROTOCOL